BIOANALYTICAL STANDARDIZING FOR SEROLOGICAL DIAGNOSTIC MEDICAL DEVICES

OpenAIRE

A. Yu. Galkin; A. G. Komar; A. A. Grigorenko

2015-01-01

In article we analyzed national and international regulations concerning the quality and safety of medical devices for in vitro diagnostics. We discussed the possibility of a partial application of the recommendations of the State Pharmacopoeia of Ukraine to this type of product. The main guiding regulatory documents establishing requirements for quality and safety tools for the serological diagnosis products are The technical regulation on medical devices for the diagnosis in vitro, DSTU ISO...

Medical diagnostics with mobile devices: Comparison of intrinsic and extrinsic sensing.

Science.gov (United States)

Kwon, L; Long, K D; Wan, Y; Yu, H; Cunningham, B T

2016-01-01

We review the recent development of mobile detection instruments used for medical diagnostics, and consider the relative advantages of approaches that utilize the internal sensing capabilities of commercially available mobile communication devices (such as smartphones and tablet computers) compared to those that utilize a custom external sensor module. In this review, we focus specifically upon mobile medical diagnostic platforms that are being developed to serve the need in global health, personalized medicine, and point-of-care diagnostics. Copyright © 2016 Elsevier Inc. All rights reserved.

Medical big data: promise and challenges.

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Lee, Choong Ho; Yoon, Hyung-Jin

2017-03-01

The concept of big data, commonly characterized by volume, variety, velocity, and veracity, goes far beyond the data type and includes the aspects of data analysis, such as hypothesis-generating, rather than hypothesis-testing. Big data focuses on temporal stability of the association, rather than on causal relationship and underlying probability distribution assumptions are frequently not required. Medical big data as material to be analyzed has various features that are not only distinct from big data of other disciplines, but also distinct from traditional clinical epidemiology. Big data technology has many areas of application in healthcare, such as predictive modeling and clinical decision support, disease or safety surveillance, public health, and research. Big data analytics frequently exploits analytic methods developed in data mining, including classification, clustering, and regression. Medical big data analyses are complicated by many technical issues, such as missing values, curse of dimensionality, and bias control, and share the inherent limitations of observation study, namely the inability to test causality resulting from residual confounding and reverse causation. Recently, propensity score analysis and instrumental variable analysis have been introduced to overcome these limitations, and they have accomplished a great deal. Many challenges, such as the absence of evidence of practical benefits of big data, methodological issues including legal and ethical issues, and clinical integration and utility issues, must be overcome to realize the promise of medical big data as the fuel of a continuous learning healthcare system that will improve patient outcome and reduce waste in areas including nephrology.

Medical big data: promise and challenges

Directory of Open Access Journals (Sweden)

Choong Ho Lee

2017-03-01

Full Text Available The concept of big data, commonly characterized by volume, variety, velocity, and veracity, goes far beyond the data type and includes the aspects of data analysis, such as hypothesis-generating, rather than hypothesis-testing. Big data focuses on temporal stability of the association, rather than on causal relationship and underlying probability distribution assumptions are frequently not required. Medical big data as material to be analyzed has various features that are not only distinct from big data of other disciplines, but also distinct from traditional clinical epidemiology. Big data technology has many areas of application in healthcare, such as predictive modeling and clinical decision support, disease or safety surveillance, public health, and research. Big data analytics frequently exploits analytic methods developed in data mining, including classification, clustering, and regression. Medical big data analyses are complicated by many technical issues, such as missing values, curse of dimensionality, and bias control, and share the inherent limitations of observation study, namely the inability to test causality resulting from residual confounding and reverse causation. Recently, propensity score analysis and instrumental variable analysis have been introduced to overcome these limitations, and they have accomplished a great deal. Many challenges, such as the absence of evidence of practical benefits of big data, methodological issues including legal and ethical issues, and clinical integration and utility issues, must be overcome to realize the promise of medical big data as the fuel of a continuous learning healthcare system that will improve patient outcome and reduce waste in areas including nephrology.

Mapping the different methods adopted for diagnostic imaging instruction at medical schools in Brazil.

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Chojniak, Rubens; Carneiro, Dominique Piacenti; Moterani, Gustavo Simonetto Peres; Duarte, Ivone da Silva; Bitencourt, Almir Galvão Vieira; Muglia, Valdair Francisco; D'Ippolito, Giuseppe

2017-01-01

To map the different methods for diagnostic imaging instruction at medical schools in Brazil. In this cross-sectional study, a questionnaire was sent to each of the coordinators of 178 Brazilian medical schools. The following characteristics were assessed: teaching model; total course hours; infrastructure; numbers of students and professionals involved; themes addressed; diagnostic imaging modalities covered; and education policies related to diagnostic imaging. Of the 178 questionnaires sent, 45 (25.3%) were completed and returned. Of those 45 responses, 17 (37.8%) were from public medical schools, whereas 28 (62.2%) were from private medical schools. Among the 45 medical schools evaluated, the method of diagnostic imaging instruction was modular at 21 (46.7%), classic (independent discipline) at 13 (28.9%), hybrid (classical and modular) at 9 (20.0%), and none of the preceding at 3 (6.7%). Diagnostic imaging is part of the formal curriculum at 36 (80.0%) of the schools, an elective course at 3 (6.7%), and included within another modality at 6 (13.3%). Professors involved in diagnostic imaging teaching are radiologists at 43 (95.5%) of the institutions. The survey showed that medical courses in Brazil tend to offer diagnostic imaging instruction in courses that include other content and at different time points during the course. Radiologists are extensively involved in undergraduate medical education, regardless of the teaching methodology employed at the institution.

Ordering of diagnostic information in encoded medical images. Accuracy progression

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Przelaskowski, A.; Jóźwiak, R.; Krzyżewski, T.; Wróblewska, A.

2008-03-01

A concept of diagnostic accuracy progression for embedded coding of medical images was presented. Implementation of JPEG2000 encoder with a modified PCRD optimization algorithm was realized and initially verified as a tool for accurate medical image streaming. Mean square error as a distortion measure was replaced by other numerical measures to revise quality progression according to diagnostic importance of successively encoded image information. A faster increment of image diagnostic importance during reconstruction of initial packets of code stream was reached. Modified Jasper code was initially tested on a set of mammograms containing clusters of microcalcifications and malignant masses, and other radiograms. Teleradiologic applications were considered as the first area of interests.

The Application of Whole Cell-Based Biosensors for Use in Environmental Analysis and in Medical Diagnostics

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Gui, Qingyuan; Lawson, Tom; Shan, Suyan; Yan, Lu; Liu, Yong

2017-01-01

Various whole cell-based biosensors have been reported in the literature for the last 20 years and these reports have shown great potential for their use in the areas of pollution detection in environmental and in biomedical diagnostics. Unlike other reviews of this growing field, this mini-review argues that: (1) the selection of reporter genes and their regulatory proteins are directly linked to the performance of celllular biosensors; (2) broad enhancements in microelectronics and information technologies have also led to improvements in the performance of these sensors; (3) their future potential is most apparent in their use in the areas of medical diagnostics and in environmental monitoring; and (4) currently the most promising work is focused on the better integration of cellular sensors with nano and micro scaled integrated chips. With better integration it may become practical to see these cells used as (5) real-time portable devices for diagnostics at the bedside and for remote environmental toxin detection and this in situ application will make the technology commonplace and thus as unremarkable as other ubiquitous technologies. PMID:28703749

Medical diagnostic laboratories provisioning of services in India

Directory of Open Access Journals (Sweden)

Rahi Jain

2015-01-01

Full Text Available Context: Diagnostic services have a very important role to play in medical decision-making, which have an impact on the nation′s health status. The understanding of Indian diagnostic services provisioning has certain literature gaps. Aims: This study focused on understanding the functioning of provision of diagnostic services by Indian diagnostic laboratories. Materials and Methods: Exploratory field visits and literature review were used as tools to understand the Indian health system. Results: Indian diagnostic laboratory can be classified into various categories based on the type of services provided and governance. The difference in their financing, resources, quality assurance of services and patient access to services was found in these different laboratories. Conclusions: It was concluded from the study that patient′s access to laboratory services is affected by the functioning of laboratories in terms of governance, financing, resources, quality assurance of services and patient services.

Email for communicating results of diagnostic medical investigations to patients.

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Meyer, Barbara; Atherton, Helen; Sawmynaden, Prescilla; Car, Josip

2012-08-15

As medical care becomes more complex and the ability to test for conditions grows, pressure on healthcare providers to convey increasing volumes of test results to patients is driving investigation of alternative technological solutions for their delivery. This review addresses the use of email for communicating results of diagnostic medical investigations to patients. To assess the effects of using email for communicating results of diagnostic medical investigations to patients, compared to SMS/ text messaging, telephone communication or usual care, on outcomes, including harms, for health professionals, patients and caregivers, and health services. We searched: the Cochrane Consumers and Communication Review Group Specialised Register, Cochrane Central Register of Controlled Trials (CENTRAL, The Cochrane Library, Issue 1 2010), MEDLINE (OvidSP) (1950 to January 2010), EMBASE (OvidSP) (1980 to January 2010), PsycINFO (OvidSP) (1967 to January 2010), CINAHL (EbscoHOST) (1982 to February 2010), and ERIC (CSA) (1965 to January 2010). We searched grey literature: theses/dissertation repositories, trials registers and Google Scholar (searched July 2010). We used additional search methods: examining reference lists and contacting authors. Randomised controlled trials, quasi-randomised trials, controlled before and after studies and interrupted time series studies of interventions using email for communicating results of any diagnostic medical investigations to patients, and taking the form of 1) unsecured email 2) secure email or 3) web messaging. All healthcare professionals, patients and caregivers in all settings were considered. Two review authors independently assessed the titles and abstracts of retrieved citations. No studies were identified for inclusion. Consequently, no data collection or analysis was possible. No studies met the inclusion criteria, therefore there are no results to report on the use of email for communicating results of diagnostic medical

Diagnostic Biomarkers for Posttraumatic Stress Disorder (PTSD): Promising Horizons from Translational Neuroscience Research

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Michopoulos, Vasiliki; Norrholm, Seth Davin; Jovanovic, Tanja

2015-01-01

Posttraumatic stress disorder (PTSD) is a heterogeneous disorder that affects individuals exposed to trauma (e.g., combat, interpersonal violence, and natural disasters). Although its diagnostic features have been recently re-classified with the emergence of the Diagnostic and Statistical Manual for Mental Disorders, Fifth Edition (DSM-5), the disorder remains characterized by hyperarousal, intrusive reminders of the trauma, avoidance of trauma-related cues, and negative cognition and mood. This heterogeneity indicates the presence of multiple neurobiological mechanisms underlying the etiology and maintenance of PTSD. Translational research spanning the past few decades has revealed several potential avenues for the identification of diagnostic biomarkers for PTSD. These include, but are not limited to, monoaminergic transmitter systems, the hypothalamic-pituitary-adrenal (HPA) axis, metabolic hormonal pathways, inflammatory mechanisms, psychophysiological reactivity, and neural circuits. The current review provides an update to the literature with regard to the most promising putative PTSD biomarkers with specific emphasis on the interaction between neurobiological influences on disease risk and symptom progression. Such biomarkers will most likely be identified by multi-dimensional models derived from comprehensive descriptions of molecular, neurobiological, behavioral, and clinical phenotypes. PMID:25727177

System theory in medical diagnostic devices: an overview.

Science.gov (United States)

Baura, Gail D

2006-01-01

Medical diagnostics refers to testing conducted either in vitro or in vivo to provide critical health care information for risk assessment, early diagnosis, treatment, or disease management. Typical in vivo diagnostic tests include the computed tomography scan, magnetic resonance imaging, and blood pressure screening. Typical in vitro diagnostic tests include cholesterol, Papanicolaou smear, and conventional glucose monitoring tests. Historically, devices associated with both types of diagnostics have used heuristic curve fitting during signal analysis. However, since the early 1990s, a few enterprising engineers and physicians have used system theory to improve their core processing for feature detection and system identification. Current applications include automated Pap smear screening for detection of cervical cancer and diagnosis of Alzheimer's disease. Future applications, such as disease prediction before symptom onset and drug treatment customization, have been catalyzed by the Human Genome Project.

Methodology for quantitative evaluation of diagnostic medical imaging

International Nuclear Information System (INIS)

Metz, C.

1980-01-01

This report deals with the evaluation of the performance of diagnostic medical imaging procedures using the Receiver Operating Characteristic or ROC analysis. The development of new tests for the statistical significance of apparent differences between ROC curves is discussed

Developing diagnostic guidelines for the acute radiation syndrome

International Nuclear Information System (INIS)

Densow, D.; Fliedner, T.M.; Kindler, H.

1996-01-01

Diagnostic guidelines seem to be promising for improving medical care. One aspect of a diagnostic guideline for the acute radiation syndrome has been tested against an extensive case history database. Subsequently, the guideline has been optimized for a small set of case histories. The improved performance has been proven by a test against the rest of the case history database

Differential diagnostic value of procalcitonin in surgical and medical patients with septic shock.

Science.gov (United States)

Clec'h, Christophe; Fosse, Jean-Philippe; Karoubi, Philippe; Vincent, Francois; Chouahi, Imad; Hamza, Lilia; Cupa, Michel; Cohen, Yves

2006-01-01

To assess whether different diagnostic and prognostic cutoff values of procalcitonin should be considered in surgical and in medical patients with septic shock. Prospective observational study. Intensive care unit of the Avicenne teaching hospital, France. All patients with septic shock or noninfectious systemic inflammatory response syndrome within 48 hrs after admission. None. Patients were allocated to one of the following groups: group 1 (surgical patients with septic shock), group 2 (surgical patients with noninfectious systemic inflammatory response syndrome), group 3 (medical patients with septic shock), and group 4 (medical patients with noninfectious systemic inflammatory response syndrome). Procalcitonin at study entry was compared between group 1 and group 2 and between group 3 and group 4 to determine the diagnostic cutoff value in surgical and in medical patients, respectively. Procalcitonin was compared between survivors and nonsurvivors from group 1 and group 3 to determine its prognostic cutoff value. One hundred forty-three patients were included: 31 in group 1, 36 in group 2, 36 in group 3, and 40 in group 4. Median procalcitonin levels (ng/mL [interquartile range]) were higher in group 1 than in group 3 (34.00 [7.10-76.00] vs. 8.40 [3.63-24.70], p = .01). In surgical patients, the best diagnostic cutoff value was 9.70 ng/mL, with 91.7% sensitivity and 74.2% specificity. In medical patients, the best diagnostic cutoff value was 1.00 ng/mL, with 80% sensitivity and 94% specificity. Procalcitonin was a reliable early prognostic marker in medical but not in surgical patients with septic shock. A cutoff value of 6.00 ng/mL had 76% sensitivity and 72.7% specificity for separating survivors from nonsurvivors. The diagnostic cutoff value of procalcitonin was higher in surgical than in medical patients. Early procalcitonin was of prognostic interest in medical patients.

Analysis of errors during medical and computerized diagnostics of spherical lung neoplasms

International Nuclear Information System (INIS)

Pozmogov, A.I.; Petruk, D.A.

1985-01-01

Reasons for errors in medical and computerized diagnostics of spherical lung neoplasms are studied based on material of 212 case records and clinicoroentgenological data; it should promote improvement of their diagnostics

Course of radiological protection and safety in the medical diagnostic with X-rays

International Nuclear Information System (INIS)

Dominguez A, C.E.

1997-01-01

The obtention of images of human body to the medical diagnostic is one of the more old and generalized applications for X-ray. Therefore the design and performance of equipment and installations as well as the operation procedures must be oriented toward safety with the purpose to guarantee this radiological practice will bring a net positive benefit to the society. Given that in Mexico only exists the standardization related to source and equipment generators of ionizing radiation in the industrial area and medical therapy, but not so to the medical diagnostic area it is the purpose of this work to present those standards related with this application branch. Also it is presented the preparation of a manual for the course named Formation of teachers in radiological protection and safety in the X-ray medical diagnostic in 1997 which was imparted at ININ. (Author)

Sherlock Holmes' methods of deductive reasoning applied to medical diagnostics.

Science.gov (United States)

Miller, L

1985-03-01

Having patterned the character of Sherlock Holmes after one of his professors, Sir Arthur Conan Doyle, himself a physician, incorporated many of the didactic qualities of the 19th century medical diagnostician into the character of Holmes. In this paper I explore Holmes's techniques of deductive reasoning and their basis in 19th and 20th century medical diagnostics.

Unintentional exposure to radiation during pregnancy from nuclear medical diagnostic procedures

International Nuclear Information System (INIS)

Moka, D.

2005-01-01

The administration of radiopharmaceuticals during pregnancy is contraindicated due to a lack of vital indications. However, if prenatal exposure to radiation should occur in the framework of a nuclear medical diagnostic procedure then fortunately no longterm side-effects would normally be expected. Radiation damage in the preimplantation phase leads to early abortion. However, if the further course of pregnancy remains uncomplicated then no subsequent side-effects need be expected. On a conservative estimate, it would require doses exceeding 50 mGy to cause radiation damage within the uterus after the preimplantation phase. However, the standard radioactivities applied for diagnostic purposes in nuclear medicine, can be obtained with doses of less than 20 mGy. On the basis of current knowledge, therefore, there is no reason to terminate pregnancy on medical grounds after diagnostic exposure to radiopharmaceuticals. (orig.)

Synthetic biology devices for in vitro and in vivo diagnostics.

Science.gov (United States)

Slomovic, Shimyn; Pardee, Keith; Collins, James J

2015-11-24

There is a growing need to enhance our capabilities in medical and environmental diagnostics. Synthetic biologists have begun to focus their biomolecular engineering approaches toward this goal, offering promising results that could lead to the development of new classes of inexpensive, rapidly deployable diagnostics. Many conventional diagnostics rely on antibody-based platforms that, although exquisitely sensitive, are slow and costly to generate and cannot readily confront rapidly emerging pathogens or be applied to orphan diseases. Synthetic biology, with its rational and short design-to-production cycles, has the potential to overcome many of these limitations. Synthetic biology devices, such as engineered gene circuits, bring new capabilities to molecular diagnostics, expanding the molecular detection palette, creating dynamic sensors, and untethering reactions from laboratory equipment. The field is also beginning to move toward in vivo diagnostics, which could provide near real-time surveillance of multiple pathological conditions. Here, we describe current efforts in synthetic biology, focusing on the translation of promising technologies into pragmatic diagnostic tools and platforms.

An Interview with Medical Diagnostics Scientist Bernhard Weigl

Science.gov (United States)

Sullivan, Megan

2010-01-01

Medical diagnostics help us evaluate a range of disorders, such as cancer and infectious diseases. In the United States and other developed countries, doctors have access to advanced equipment and laboratories that provide reliable diagnoses. As a result, when we are sick, we feel confident that we will get the treatment we need. Unfortunately,…

Sherlock Holmes's Methods of Deductive Reasoning Applied to Medical Diagnostics

Science.gov (United States)

Miller, Larry

1985-01-01

Having patterned the character of Sherlock Holmes after one of his professors, Sir Arthur Conan Doyle, himself a physician, incorporated many of the didactic qualities of the 19th century medical diagnostician into the character of Holmes. In this paper I explore Holmes's techniques of deductive reasoning and their basis in 19th and 20th century medical diagnostics. PMID:3887762

Principles for new optical techniques in medical diagnostics for mHealth applications

Science.gov (United States)

Balsam, Joshua Michael

Medical diagnostics is a critical element of effective medical treatment. However, many modern and emerging diagnostic technologies are not affordable or compatible with the needs and conditions found in low-income and middle-income countries and regions. Resource-poor areas require low-cost, robust, easy-to-use, and portable diagnostics devices compatible with telemedicine (i.e. mHealth) that can be adapted to meet diverse medical needs. Many suitable devices will need to be based on optical technologies, which are used for many types of biological analyses. This dissertation describes the fabrication and detection principles for several low-cost optical technologies for mHealth applications including: (1) a webcam based multi-wavelength fluorescence plate reader, (2) a lens-free optical detector used for the detection of Botulinum A neurotoxin activity, (3) a low cost micro-array reader that allows the performance of typical fluorescence based assays demonstrated for the detection of the toxin staphylococcal enterotoxin (SEB), and (4) a wide-field flow cytometer for high throughput detection of fluorescently labeled rare cells. This dissertation discusses how these technologies can be harnessed using readily available consumer electronics components such as webcams, cell phones, CCD cameras, LEDs, and laser diodes. There are challenges in developing devices with sufficient sensitivity and specificity, and approaches are presented to overcoming these challenges to create optical detectors that can serve as low cost medical diagnostics in resource-poor settings for mHealth.

Non-Culture Diagnostics for Invasive Candidiasis: Promise and Unintended Consequences

Science.gov (United States)

Clancy, Cornelius J.; Nguyen, M. Hong

2018-01-01

Blood cultures are positive for Candida species in candidiasis, respectively. Non-culture tests such as mannan, anti-mannan antibody, Candida albicans germ tube antibody (CAGTA), 1,3-β-d-glucan (BDG), the T2Candida nanodiagnostic panel, and polymerase chain reaction (PCR) are available for clinical use, but their roles in patient care are uncertain. Sensitivity/specificity of combined mannan/anti-mannan, BDG, T2Candida and PCR for candidemia are ~80%/80%, ~80%/80%, ~90%/98%, and ~90%/90%, respectively. Limited data for intra-abdominal candidiasis suggest CAGTA, BDG sensitivity/specificity of ~65%/75% and PCR sensitivity of ~85–90%. PCR specificity has varied widely for intra-abdominal candidiasis (33–97%), and T2Candida data are lacking. Tests will be useful if restricted to cases in which positive and negative predictive values (PPVs, NPVs) differ in a clinically meaningful way from the pre-test likelihood of invasive candidiasis. In some patients, PPVs are sufficient to justify antifungal treatment, even if blood cultures are negative. In most patients, NPVs of each test are excellent, which may support decisions to withhold antifungal therapy. If test results are not interpreted judiciously, non-culture diagnostics may have unintended consequences for stewardship and infection prevention programs. In particular, discrepant non-culture test-positive/culture-negative results may promote inappropriate antifungal treatment of patients who are unlikely to have candidiasis, and lead to spurious reporting of hospital-acquired infections. In conclusion, non-culture Candida diagnostics have potential to advance patient care, but this promise will be realized only if users understand tests’ strengths and limitations, and plan proactively for how best to employ them at their hospitals. PMID:29463043

Medical image computing for computer-supported diagnostics and therapy. Advances and perspectives.

Science.gov (United States)

Handels, H; Ehrhardt, J

2009-01-01

Medical image computing has become one of the most challenging fields in medical informatics. In image-based diagnostics of the future software assistance will become more and more important, and image analysis systems integrating advanced image computing methods are needed to extract quantitative image parameters to characterize the state and changes of image structures of interest (e.g. tumors, organs, vessels, bones etc.) in a reproducible and objective way. Furthermore, in the field of software-assisted and navigated surgery medical image computing methods play a key role and have opened up new perspectives for patient treatment. However, further developments are needed to increase the grade of automation, accuracy, reproducibility and robustness. Moreover, the systems developed have to be integrated into the clinical workflow. For the development of advanced image computing systems methods of different scientific fields have to be adapted and used in combination. The principal methodologies in medical image computing are the following: image segmentation, image registration, image analysis for quantification and computer assisted image interpretation, modeling and simulation as well as visualization and virtual reality. Especially, model-based image computing techniques open up new perspectives for prediction of organ changes and risk analysis of patients and will gain importance in diagnostic and therapy of the future. From a methodical point of view the authors identify the following future trends and perspectives in medical image computing: development of optimized application-specific systems and integration into the clinical workflow, enhanced computational models for image analysis and virtual reality training systems, integration of different image computing methods, further integration of multimodal image data and biosignals and advanced methods for 4D medical image computing. The development of image analysis systems for diagnostic support or

National variation of ADHD diagnostic prevalence and medication use: health care providers and education policies.

Science.gov (United States)

Fulton, Brent D; Scheffler, Richard M; Hinshaw, Stephen P; Levine, Peter; Stone, Susan; Brown, Timothy T; Modrek, Sepideh

2009-08-01

Attention-deficit hyperactivity disorder (ADHD) diagnostic prevalence and medication use vary across U.S. census regions, but little is known about state-level variation. The purpose of this study was to estimate this variation across states and examine whether a state's health care provider characteristics and education policies are associated with this variation. Logistic regression models were estimated with 69,505 children aged four to 17 from the state-stratified and nationally representative 2003 National Survey of Children's Health, conducted by the Centers for Disease Control and Prevention. Diagnostic prevalence was higher in the South (odds ratio [OR]=1.42, p<.001) than in the West; among children with ADHD diagnoses, medication use was higher in the South (OR=1.60, p<.01) and the Midwest (OR=1.53, p<.01) versus the West. On these measures, several states differed from the U.S. averages, including some states that, on the basis of the regional patterns found above, would not be expected to differ: Michigan had a high diagnostic prevalence; Vermont, South Dakota, and Nebraska had low diagnostic prevalences; and Connecticut, New Jersey, and Kentucky had low medication rates. Both diagnosis and medication status were associated with the number, age, and type of physicians within a state, particularly pediatricians. However, state education policies were not significantly associated with either diagnostic prevalence or medication rates. To better understand the association between a state's health care provider characteristics and both diagnostic prevalence and medication use, it may be fruitful to examine the content of provider continuing education programs, including the recommendations of major health professional organization guidelines to treat ADHD.

Medical diagnostics for indoor mold exposure.

Science.gov (United States)

Hurraß, Julia; Heinzow, Birger; Aurbach, Ute; Bergmann, Karl-Christian; Bufe, Albrecht; Buzina, Walter; Cornely, Oliver A; Engelhart, Steffen; Fischer, Guido; Gabrio, Thomas; Heinz, Werner; Herr, Caroline E W; Kleine-Tebbe, Jörg; Klimek, Ludger; Köberle, Martin; Lichtnecker, Herbert; Lob-Corzilius, Thomas; Merget, Rolf; Mülleneisen, Norbert; Nowak, Dennis; Rabe, Uta; Raulf, Monika; Seidl, Hans Peter; Steiß, Jens-Oliver; Szewszyk, Regine; Thomas, Peter; Valtanen, Kerttu; Wiesmüller, Gerhard A

2017-04-01

In April 2016, the German Society of Hygiene, Environmental Medicine and Preventative Medicine (Gesellschaft für Hygiene, Umweltmedizin und Präventivmedizin (GHUP)) together with other scientific medical societies, German and Austrian medical societies, physician unions and experts has provided an AWMF (Association of the Scientific Medical Societies) guideline 'Medical diagnostics for indoor mold exposure'. This guideline shall help physicians to advise and treat patients exposed indoors to mold. Indoor mold growth is a potential health risk, even without a quantitative and/or causal association between the occurrence of individual mold species and health effects. Apart from the allergic bronchopulmonary aspergillosis (ABPA) and the mycoses caused by mold, there is only sufficient evidence for the following associations between moisture/mold damages and different health effects: Allergic respiratory diseases, asthma (manifestation, progression, exacerbation), allergic rhinitis, exogenous allergic alveolitis and respiratory tract infections/bronchitis. In comparison to other environmental allergens, the sensitizing potential of molds is estimated to be low. Recent studies show a prevalence of sensitization of 3-10% in the total population of Europe. The evidence for associations to mucous membrane irritation and atopic eczema (manifestation, progression, exacerbation) is classified as limited or suspected. Inadequate or insufficient evidence for an association is given for COPD, acute idiopathic pulmonary hemorrhage in children, rheumatism/arthritis, sarcoidosis, and cancer. The risk of infections from indoor molds is low for healthy individuals. Only molds that are capable to form toxins can cause intoxications. The environmental and growth conditions and especially the substrate determine whether toxin formation occurs, but indoor air concentrations are always very low. In the case of indoor moisture/mold damages, everyone can be affected by odor effects and

Biodosimetry for medical diagnostic X-ray workers using stable chromosome aberration

International Nuclear Information System (INIS)

Wang Zhiquan; Liu Xuping; Li Jin

1996-01-01

The stable chromosome aberrations of medical diagnostic X-ray workers were analyzed using G-banding and their accumulative doses were evaluated. The results showed that the frequencies of reciprocal translocation, stable aberration and total aberration among the 4417 metaphase spread from 44 cases of medical diagnostic X-ray workers were distinctly higher than control values (P<0.05∼0.005). The stable aberration predominated strikingly in total aberration and reciprocal translocation was 57% in the stable aberrations. The medical diagnostic X-ray workers were divided into 3 groups according to calendar year of entry. The data showed that the frequencies of total aberration, stable aberration and reciprocal translocation increased with working years, especially in two groups who started working before 1970, there are statistically significant differences between the calendar year of entry before 1960 and 1960∼1969 in X-ray workers and control group. According to the equation recommended by Straume, linear coefficient (α) in linear quadratic model recommended by Schmid and the transformation coefficient by Lucas, the accumulative doses calculated are 0.58, 0.37 and 0.07 Gy for calendar year of entry before 1960, 1960∼1969 and after 1970 in X-ray workers, respectively

Nordic working group for medical x-ray diagnostics: Diagnostic reference levels within xray diagnostics - experiences in the Nordic countries

International Nuclear Information System (INIS)

Leitz, W.; Groen, P.; Servomaa, A.; Einarsson, G.; Olerud, H.

2003-01-01

Medical x-ray diagnostics is one of the few applications of ionising radiation where people are irradiated on purpose. The strategy for radiation protection is also different compared to that in other areas that have the zero-alternative as its ultimate goal, meaning that no human beings at all are exposed in these practices. The focus in x-ray diagnostics concerning radiation protection is justification and optimisation. Optimisation implies that the examination is performed in such a way that the radiation dose is as small as possible without jeopardising the diagnostic security. X- ray diagnostics is a complex method where many technical parameters and methodology factors together are interacting in the determination of radiation dose and image quality. The optimisation process is not a simple and uncomplicated procedure, this difficulty is reflected in many international and national surveys showing a large spread of patient doses for one and the same type of examination. The concept diagnostic reference levels (DRL) has been introduced as a tool for reducing this wide distribution that is obviously indicating a lack of optimisation, and for cutting the highest radiation doses. In this presentation the concept for DRL and the experience gained in the Nordic countries with DRL are described. (orig.)

Non-Culture Diagnostics for Invasive Candidiasis: Promise and Unintended Consequences

Directory of Open Access Journals (Sweden)

Cornelius J. Clancy

2018-02-01

Full Text Available Blood cultures are positive for Candida species in < 50% and < 20% of hematogenously disseminated and intra-abdominal candidiasis, respectively. Non-culture tests such as mannan, anti-mannan antibody, Candida albicans germ tube antibody (CAGTA, 1,3-β-d-glucan (BDG, the T2Candida nanodiagnostic panel, and polymerase chain reaction (PCR are available for clinical use, but their roles in patient care are uncertain. Sensitivity/specificity of combined mannan/anti-mannan, BDG, T2Candida and PCR for candidemia are ~80%/80%, ~80%/80%, ~90%/98%, and ~90%/90%, respectively. Limited data for intra-abdominal candidiasis suggest CAGTA, BDG sensitivity/specificity of ~65%/75% and PCR sensitivity of ~85–90%. PCR specificity has varied widely for intra-abdominal candidiasis (33–97%, and T2Candida data are lacking. Tests will be useful if restricted to cases in which positive and negative predictive values (PPVs, NPVs differ in a clinically meaningful way from the pre-test likelihood of invasive candidiasis. In some patients, PPVs are sufficient to justify antifungal treatment, even if blood cultures are negative. In most patients, NPVs of each test are excellent, which may support decisions to withhold antifungal therapy. If test results are not interpreted judiciously, non-culture diagnostics may have unintended consequences for stewardship and infection prevention programs. In particular, discrepant non-culture test-positive/culture-negative results may promote inappropriate antifungal treatment of patients who are unlikely to have candidiasis, and lead to spurious reporting of hospital-acquired infections. In conclusion, non-culture Candida diagnostics have potential to advance patient care, but this promise will be realized only if users understand tests’ strengths and limitations, and plan proactively for how best to employ them at their hospitals.

[The diagnostic value of medical thoracoscopy for unexplained pleural effusion].

Science.gov (United States)

Jiang, Shu-juan; Mu, Xiao-yan; Zhang, Song; Su, Li-li; Ma, Wei-xia

2013-05-01

To explore the endoscopic features of patients with unexplained pleural effusion, and to evaluate the diagnostic value of medical thoracoscopy. A retrospective analysis of 2380 patients with unexplained pleural effusion (1320 males and 1060 females; age 15-94 years) in Shandong Provincial Hospital from 1992 to 2011 were performed .The diagnosis was confirmed by medical thoracoscopy. The endoscopic findings of malignant pleural effusion mostly showed nodules of varying sizes. The nodules could be grape-like, cauliflower-like, fused into masses, or diffused small nodules . The appearance of cancerous nodules was more diversified compared to tuberculous nodules. Tuberculous pleurisy was manifested as diffuse pleural congestion and miliary changes, multiple small gray-white nodules, fibrin deposition and adhesion in the pleural cavity, pleural thickening and loculation . The pathological diagnosis was as follows: pleural metastases in 899 (37.8%), primary pleural mesothelioma in 439 (18.4%), tuberculous pleurisy in 514 (21.6%), non-specific inflammation in 226 (9.5%), empyema in 190 (8.0%), hepatic pleural effusion in 36 (1.5%) and pleural effusion of unknown causes in 76 (3.2%) cases. The diagnostic positive rate of medical thoracoscopy was 96.8%. No serious complications were observed. Medical thoracoscopy is a relatively safe procedure and has an important application value in the diagnosis of unexplained pleural effusion.

Methodology for quantitative evaluation of diagnostic performance

International Nuclear Information System (INIS)

Metz, C.

1981-01-01

Of various approaches that might be taken to the diagnostic performance evaluation problem, Receiver Operating Characteristic (ROC) analysis holds great promise. Further development of the methodology for a unified, objective, and meaningful approach to evaluating the usefulness of medical imaging procedures is done by consideration of statistical significance testing, optimal sequencing of correlated studies, and analysis of observer performance

Safety of Medical Diagnostic Ultrasound

International Nuclear Information System (INIS)

Breyer, B.

1998-01-01

Large numbers of people (both sick and healthy) are routinely exposed to ultrasound waves. We shall discuss wave parameters and scanner properties that are relevant to the safety aspect. This includes central pulse frequency, pulse length, intensity (ISPTA and others), focusing, pulse repetition frequency, pulse pressure, etc. Since the transmitted ultrasound power has steadily been increasing during the last two decades, the problems are becoming more serious with time. Doppler methods have gained importance and 'popularity, which additionally increases ultrasound power requirements since the reflectivity of red blood cells is so small that the backscattered pressure is about 100 times less than that from soft tissue structures in the body. Main mechanisms that can potentially present hazard are heating and cavitation. The basic parameter used to assess thermal hazard is ISPTA and the optimal predictor of cavitation hazard is the peak rarefractional pressure. The hazard of heating-up can be summarized in saying that temperatures up to 38.5 o C are safe, while temperatures above 41 o C are definitely not. Care must be taken to stay within the safe zone. However, there does not exist a confirmed report of any type of hazardous effects on humans using intensities presently applied in diagnostic ultrasound scanners. Taking this into account, various international bodies have put limits to the application of ultrasound, which is best summarized in the FDA (USA) regulation that diagnostic apparatus may have an output of maximally 720 mW/cm 2 (derated) provided thermal and mechanical properties are indicated (onscreen) by properly defined Thermal Indices (TI) and Mechanical Index (MI). These aspects shall be discussed in some detail. We shall give the rules for the operator to apply ultrasound with minimal hazard. The general conclusion is that diagnostic ultrasound, as presently known, may be used whenever a qualified expert expects essential medical benefit for the

Diagnostic Reasoning across the Medical Education Continuum

Directory of Open Access Journals (Sweden)

C. Scott Smith

2014-07-01

Full Text Available We aimed to study linguistic and non-linguistic elements of diagnostic reasoning across the continuum of medical education. We performed semi-structured interviews of premedical students, first year medical students, third year medical students, second year internal medicine residents, and experienced faculty (ten each as they diagnosed three common causes of dyspnea. A second observer recorded emotional tone. All interviews were digitally recorded and blinded transcripts were created. Propositional analysis and concept mapping were performed. Grounded theory was used to identify salient categories and transcripts were scored with these categories. Transcripts were then unblinded. Systematic differences in propositional structure, number of concept connections, distribution of grounded theory categories, episodic and semantic memories, and emotional tone were identified. Summary concept maps were created and grounded theory concepts were explored for each learning level. We identified three major findings: (1 The “apprentice effect” in novices (high stress and low narrative competence; (2 logistic concept growth in intermediates; and (3 a cognitive state transition (between analytical and intuitive approaches in experts. These findings warrant further study and comparison.

MEDICAL DIAGNOSTICS BY MICROSTRUCTURAL ANALYSIS OF BIOLOGICAL LIQUID DRIED PATTERNS AS A PROBLEM OF BIOINFORMATICS

Directory of Open Access Journals (Sweden)

Petr Vladimirovich Lebedev-Stepanov, Dr.

2018-02-01

Full Text Available Motivation: It is important to develop the high-precision computerized methods for medical rapid diagnostic which is generalizing the unique clinical experience obtained in the past decade as specialized solutions for diagnostic problems of control of specific diseases and, potentially, for a wide health monitoring of virtually healthy population, identify the reserves of human health and take the actions to prevent of these reserves depletion. In this work we present one of the new directions in bioinformatics, i.e. medical diagnostics by automated expert system on basis of morphology analysis of digital image of biological liquid dried pattern. Results: Proposed method is combination of bioinformatics and biochemistry approaches for obtaining diagnostic information from a morphological analysis of standardized dried patterns of biological liquid sessile drop. We have carried out own research in collaboration with medical diagnostic centers and formed the electronic database for recognition the following types of diseases: candidiasis; neoplasms; diabetes mellitus; diseases of the circulatory system; cerebrovascular disease; diseases of the digestive system; diseases of the genitourinary system; infectious diseases; factors relevant to the work; factors associated with environmental pollution; factors related to lifestyle. The laboratory setup for diagnostics of the human body in pathology states is developed. The diagnostic results are considered. Availability: Access to testing the software can be obtained on request to the contact email below.

Radiation doses from medical diagnostic procedures in Canada

Energy Technology Data Exchange (ETDEWEB)

Aldrich, J E; Lentle, B C; Vo, C [British Columbia Univ., Vancouver, BC (Canada). Dept. of Radiology

1997-03-01

This document sets out to record and analyze the doses incurred in Canada from medical procedures involving the use of ionizing radiation in a typical year. Excluded are those doses incurred during therapeutic irradiation, since they differ in scale to such a large degree and because they are used almost exclusively in treating cancer. In this we are following a precedent set by the United Nations Scientific Committee on the Effects of Ionizing Radiation. Although the International Commission on Radiological Protection (ICRP) notes that dose limits should not be applied to medical exposures, it also observes that doses in different settings for the same procedure may vary by as much as two orders of magnitude, and that there are considerable opportunities for dose reductions in diagnostic radiology. Because these data do not stand in isolation the report also encompasses a review of the relevant literature and some background comment on the evolving technology of the radiological sciences. Because there is a somewhat incomplete perception of the changes taking place in diagnostic methods we have also provided some introductory explanations of the relevant technologies. In addition, there is an analysis of at least some of the limitations on the completeness of the data which are reported here. (author).

Radiation doses from medical diagnostic procedures in Canada

International Nuclear Information System (INIS)

Aldrich, J.E.; Lentle, B.C.; Vo, C.

1997-03-01

This document sets out to record and analyze the doses incurred in Canada from medical procedures involving the use of ionizing radiation in a typical year. Excluded are those doses incurred during therapeutic irradiation, since they differ in scale to such a large degree and because they are used almost exclusively in treating cancer. In this we are following a precedent set by the United Nations Scientific Committee on the Effects of Ionizing Radiation. Although the International Commission on Radiological Protection (ICRP) notes that dose limits should not be applied to medical exposures, it also observes that doses in different settings for the same procedure may vary by as much as two orders of magnitude, and that there are considerable opportunities for dose reductions in diagnostic radiology. Because these data do not stand in isolation the report also encompasses a review of the relevant literature and some background comment on the evolving technology of the radiological sciences. Because there is a somewhat incomplete perception of the changes taking place in diagnostic methods we have also provided some introductory explanations of the relevant technologies. In addition, there is an analysis of at least some of the limitations on the completeness of the data which are reported here. (author)

Clinical Training of Medical Physicists Specializing in Diagnostic Radiology

International Nuclear Information System (INIS)

2010-01-01

The application of radiation in human health, for both diagnosis and treatment of disease, is an important component of the work of the IAEA. The responsibility for the increasing technical aspects of this work is undertaken by the medical physicist. To ensure good practice in this vital area, structured clinical training programmes are required to complement academic learning. This publication is intended to be a guide to the practical implementation of such a programme for diagnostic radiology. There is a general and growing awareness that radiation medicine is increasingly dependent on well trained medical physicists based in the clinical setting. However, an analysis of the availability of medical physicists indicates a large shortfall of qualified and capable professionals. This is particularly evident in developing countries. While strategies to increase academic educational opportunities are critical to such countries, the need for guidance on structured clinical training was recognized by the members of the Regional Cooperative Agreement (RCA) for Research, Development and Training related to Nuclear Sciences for Asia and the Pacific. Consequently, a technical cooperation regional project (RAS6038) under the RCA programme was formulated to address this need in the Asia-Pacific region by developing suitable material and establishing its viability. Development of a clinical training guide for medical physicists specializing in diagnostic radiology started in 2007 with the appointment of a core drafting committee of regional and international experts. The publication drew on the experiences of clinical training programmes in Australia and New Zealand, the UK and the USA, and was moderated by physicists working in the Asian region. This publication follows the approach of the IAEA publication Training Course Series No. 37, Clinical Training of Medical Physicists specializing in Radiation Oncology. This approach to clinical training has been successfully tested

MO-F-204-00: Preparing for the ABR Diagnostic and Nuclear Medical Physics Exams

Energy Technology Data Exchange (ETDEWEB)

NONE

2016-06-15

Adequate, efficient preparation for the ABR Diagnostic and Nuclear Medical Physics exams is key to successfully obtain ABR certification. Each part of the ABR exam presents its own challenges: Part I: Determine the scope of basic medical physics study material, efficiently review this material, and solve related written questions/problems. Part II: Understand imaging principles, modalities, and systems, including image acquisition, processing, and display. Understand the relationship between imaging techniques, image quality, patient dose and safety, and solve related written questions/problems. Part III: Gain crucial, practical, clinical medical physics experience. Effectively communicate and explain the practice, performance, and significance of all aspects of clinical medical physics. All parts of the ABR exam require specific skill sets and preparation: mastery of basic physics and imaging principles; written problem solving often involving rapid calculation; responding clearly and succinctly to oral questions about the practice, methods, and significance of clinical medical physics. This symposium focuses on the preparation necessary for each part of the ABR exam. Although there is some overlap, the nuclear exam covers a different body of knowledge than the diagnostic exam. A separate speaker will address those unique aspects of the nuclear exam, and how preparing for a second specialty differs from the first. Medical physicists who recently completed each ABR exam portion will share their experiences, insights, and preparation methods to help attendees best prepare for the challenges of each part of the ABR exam. In accordance with ABR exam security policy, no recalls or exam questions will be discussed. Learning Objectives: How to prepare for Part 1 of the ABR exam by determining the scope of basic medical physics study material and related problem solving/calculations How to prepare for Part 2 of the ABR exam by understanding diagnostic and/or nuclear

MO-F-204-00: Preparing for the ABR Diagnostic and Nuclear Medical Physics Exams

International Nuclear Information System (INIS)

2016-01-01

Adequate, efficient preparation for the ABR Diagnostic and Nuclear Medical Physics exams is key to successfully obtain ABR certification. Each part of the ABR exam presents its own challenges: Part I: Determine the scope of basic medical physics study material, efficiently review this material, and solve related written questions/problems. Part II: Understand imaging principles, modalities, and systems, including image acquisition, processing, and display. Understand the relationship between imaging techniques, image quality, patient dose and safety, and solve related written questions/problems. Part III: Gain crucial, practical, clinical medical physics experience. Effectively communicate and explain the practice, performance, and significance of all aspects of clinical medical physics. All parts of the ABR exam require specific skill sets and preparation: mastery of basic physics and imaging principles; written problem solving often involving rapid calculation; responding clearly and succinctly to oral questions about the practice, methods, and significance of clinical medical physics. This symposium focuses on the preparation necessary for each part of the ABR exam. Although there is some overlap, the nuclear exam covers a different body of knowledge than the diagnostic exam. A separate speaker will address those unique aspects of the nuclear exam, and how preparing for a second specialty differs from the first. Medical physicists who recently completed each ABR exam portion will share their experiences, insights, and preparation methods to help attendees best prepare for the challenges of each part of the ABR exam. In accordance with ABR exam security policy, no recalls or exam questions will be discussed. Learning Objectives: How to prepare for Part 1 of the ABR exam by determining the scope of basic medical physics study material and related problem solving/calculations How to prepare for Part 2 of the ABR exam by understanding diagnostic and/or nuclear

Problem-solving versus cognitive restructuring of medically ill seniors with depression (PROMISE-D trial: study protocol and design

Directory of Open Access Journals (Sweden)

Sharpe Louise

2012-11-01

Full Text Available Abstract Background With an ageing population in most Western countries, people are living longer but often with one or more chronic physical health problems. Older people in physically poor health are at greater risk of developing clinical depression. Cognitive Behavioural Therapy (CBT and Problem Solving Therapy (PST have both been found to be efficacious in treating late-life depression, however patients with “multi-morbidity” (i.e. more than one chronic condition are often excluded from these trials. The aim of this study is to compare the efficacy of CBT and PST in treating older adults who have one or more chronic physical health conditions and a diagnosable depressive disorder. This study will be the first to explicitly target the treatment of depression in older people in primary care settings presenting with a range of health problems using behavioural interventions. Methods/design The PROMISE-D study is a randomised controlled trial of two evidence-based treatments for late-life major or minor depression for patients who also have at least one co-morbid chronic health problem. Participants will be randomised to two active interventions (PST or CBT or enhanced treatment-as-usual (E-TAU. Primary outcomes will be depression diagnostic status and severity of depression (according to the Hamilton Depression Rating Scale and the Geriatric Depression Scale. Secondary outcomes will be anxiety severity, quality of life and health care utilisation. Assessments will be conducted by a researcher who remains blind to the patient’s treatment allocation and will be conducted pre and post-treatment and at six and 12 months follow-up. Health care utilisation will be assessed throughout a two year period following entry to the trial. Executive function, rumination and emotion regulation will also be measured to determine the impact of these factors on treatment response in two treatment groups. Discussion Multi-morbidity, the experience of two or

An audit of diagnostic tests performed in medical microbiology, and ...

African Journals Online (AJOL)

Clinical audit is an important tool for reviewing and improving the quality of service in clinical laboratories. This is a three year audit of diagnostic test carried out in Medical Microbiology and Immunology laboratories of University of Maiduguri Teaching Hospital, Maiduguri, Nigeria. The objectives were to document and ...

The evaluation of diagnostic medical exposures in the Czech Republic

International Nuclear Information System (INIS)

Petrova, K.; Klener, V.; Heribanova, A.; Husak, V.; Masopust, J.

1998-01-01

Surveys were performed in the Czech Republic to evaluate diagnostic medical exposures. The results are presented in 4 tables: (i) burden from the use of radiopharmaceuticals (examination, radiopharmaceutical, no. of procedures, average administered activity, conversion factor, collective effective dose); (ii) use of radiopharmaceuticals at nuclear medicine departments (type of examination, type of radiopharmaceutical, no. of departments, average administered activity); (iii) reference levels of administered activity specified for some diagnostic procedures for the adult patient (examination, radionuclide, chemical form, administered activity); and (iv) X-ray examinations (examination, annual no. of procedures, effective dose, age distribution, sex distribution). (P.A.)

Children's exposure to diagnostic medical radiation and cancer risk: epidemiologic and dosimetric considerations

International Nuclear Information System (INIS)

Linet, Martha S.; Rajaraman, Preetha; Kim, Kwang pyo

2009-01-01

While the etiology of most childhood cancers is largely unknown, epidemiologic studies have consistently found an association between exposure to medical radiation during pregnancy and risk of childhood cancer in offspring. The relation between early life diagnostic radiation exposure and occurrence of pediatric cancer risks is less clear. This review summarizes current and historical estimated doses for common diagnostic radiologic procedures as well as the epidemiologic literature on the role of maternal prenatal, children's postnatal and parental preconception diagnostic radiologic procedures on subsequent risk of childhood malignancies. Risk estimates are presented according to factors such as the year of birth of the child, trimester and medical indication for the procedure, and the number of films taken. The paper also discusses limitations of the methods employed in epidemiologic studies to assess pediatric cancer risks, the effects on clinical practice of the results reported from the epidemiologic studies, and clinical and public health policy implications of the findings. Gaps in understanding and additional research needs are identified. Important research priorities include nationwide surveys to estimate fetal and childhood radiation doses from common diagnostic procedures, and epidemiologic studies to quantify pediatric and lifetime cancer risks from prenatal and early childhood exposures to diagnostic radiography, CT, and fluoroscopically guided procedures. (orig.)

Design of point-of-care (POC) microfluidic medical diagnostic devices

Science.gov (United States)

Leary, James F.

2018-02-01

Design of inexpensive and portable hand-held microfluidic flow/image cytometry devices for initial medical diagnostics at the point of initial patient contact by emergency medical personnel in the field requires careful design in terms of power/weight requirements to allow for realistic portability as a hand-held, point-of-care medical diagnostics device. True portability also requires small micro-pumps for high-throughput capability. Weight/power requirements dictate use of super-bright LEDs and very small silicon photodiodes or nanophotonic sensors that can be powered by batteries. Signal-to-noise characteristics can be greatly improved by appropriately pulsing the LED excitation sources and sampling and subtracting noise in between excitation pulses. The requirements for basic computing, imaging, GPS and basic telecommunications can be simultaneously met by use of smartphone technologies, which become part of the overall device. Software for a user-interface system, limited real-time computing, real-time imaging, and offline data analysis can be accomplished through multi-platform software development systems that are well-suited to a variety of currently available cellphone technologies which already contain all of these capabilities. Microfluidic cytometry requires judicious use of small sample volumes and appropriate statistical sampling by microfluidic cytometry or imaging for adequate statistical significance to permit real-time (typically medical decisions for patients at the physician's office or real-time decision making in the field. One or two drops of blood obtained by pin-prick should be able to provide statistically meaningful results for use in making real-time medical decisions without the need for blood fractionation, which is not realistic in the field.

Teaching Critical Thinking in Graduate Medical Education: Lessons Learned in Diagnostic Radiology.

Science.gov (United States)

Morrissey, Benjamin; Heilbrun, Marta E

2017-01-01

The 2014 Institute of Medicine report, Graduate Medical Education that Meets the Nation's Health Needs , challenged the current graduate medical training process and encouraged new opportunities to redefine the fundamental skills and abilities of the physician workforce. This workforce should be skilled in critically evaluating the current systems to improve care delivery and health. To meet these goals, current challenges, motivations, and educational models at the medical school and graduate medical education levels related to formal training in nonclinical aspects of medicine, especially critical thinking, are reviewed. Our diagnostic radiology training program is presented as a "case study" to frame the review.

Biomedical photonics handbook biomedical diagnostics

CERN Document Server

Vo-Dinh, Tuan

2014-01-01

Shaped by Quantum Theory, Technology, and the Genomics RevolutionThe integration of photonics, electronics, biomaterials, and nanotechnology holds great promise for the future of medicine. This topic has recently experienced an explosive growth due to the noninvasive or minimally invasive nature and the cost-effectiveness of photonic modalities in medical diagnostics and therapy. The second edition of the Biomedical Photonics Handbook presents fundamental developments as well as important applications of biomedical photonics of interest to scientists, engineers, manufacturers, teachers, studen

Exposure criteria for medical diagnostic ultrasound: 1, Criteria based on thermal mechanisms

International Nuclear Information System (INIS)

1992-01-01

A previous report (NCRP, 1983) contains a comprehensive review of biological effects and mechanisms of action of ultrasound and an analysis of their implications for medical ultrasound. This Report presents background material for a scientifically-based approach to safety assessment of ultrasound. It is intended to help the medical community take advantage of new developments, while maintaining the excellent safety record which now exists for diagnostic ultrasound

SU-E-P-01: An Informative Review On the Role of Diagnostic Medical Physicist in the Academic and Private Medical Centers

International Nuclear Information System (INIS)

Weir, V; Zhang, J

2014-01-01

Purpose: The role of physicist in the academic and private hospital environment continues to evolve and expand. This becomes more obvious with the newly revised requirements of the Joint Commission (JC) on imaging modalities and the continued updated requirements of ACR accreditation for medical physics (i.e., starting in June 2014, a physicists test will be needed before US accreditation). We provide an informative review on the role of diagnostic medical physicist and hope that our experience will expedite junior physicists in understanding their role in medical centers, and be ready to more opportunities. Methods: Based on our experience, diagnostic medical physicists in both academic and private medical centers perform several clinical functions. These include providing clinical service and physics support, ensuring that all ionizing radiation devices are tested and operated in compliance with the State and Federal laws, regulations and guidelines. We also discuss the training and education required to ensure that the radiation exposure to patients and staff is as low as reasonably achievable. We review the overlapping roles of medical and health physicist in some institutions. Results: A detailed scheme on the new requirements (effective 7/1/2014) of the JC is provided. In 2015, new standards for fluoroscopy, cone beam CT and the qualifications of staff will be phased in. A summary of new ACR requirements for different modalities is presented. Medical physicist have other duties such as sitting on CT and fluoroscopy committees for protocols design, training of non-radiologists to meet the new fluoroscopy rules, as well as helping with special therapies such as Yittrium 90 cases. Conclusion: Medical physicists in both academic and private hospitals are positioned to be more involved and prominent. Diagnostic physicists need to be more proactive to involve themselves in the day to day activities of the radiology department

SU-E-P-01: An Informative Review On the Role of Diagnostic Medical Physicist in the Academic and Private Medical Centers

Energy Technology Data Exchange (ETDEWEB)

Weir, V [Baylor Health Care System, Dallas, TX (United States); Zhang, J [University of Kentucky, Lexington, KY (United States)

2014-06-01

Purpose: The role of physicist in the academic and private hospital environment continues to evolve and expand. This becomes more obvious with the newly revised requirements of the Joint Commission (JC) on imaging modalities and the continued updated requirements of ACR accreditation for medical physics (i.e., starting in June 2014, a physicists test will be needed before US accreditation). We provide an informative review on the role of diagnostic medical physicist and hope that our experience will expedite junior physicists in understanding their role in medical centers, and be ready to more opportunities. Methods: Based on our experience, diagnostic medical physicists in both academic and private medical centers perform several clinical functions. These include providing clinical service and physics support, ensuring that all ionizing radiation devices are tested and operated in compliance with the State and Federal laws, regulations and guidelines. We also discuss the training and education required to ensure that the radiation exposure to patients and staff is as low as reasonably achievable. We review the overlapping roles of medical and health physicist in some institutions. Results: A detailed scheme on the new requirements (effective 7/1/2014) of the JC is provided. In 2015, new standards for fluoroscopy, cone beam CT and the qualifications of staff will be phased in. A summary of new ACR requirements for different modalities is presented. Medical physicist have other duties such as sitting on CT and fluoroscopy committees for protocols design, training of non-radiologists to meet the new fluoroscopy rules, as well as helping with special therapies such as Yittrium 90 cases. Conclusion: Medical physicists in both academic and private hospitals are positioned to be more involved and prominent. Diagnostic physicists need to be more proactive to involve themselves in the day to day activities of the radiology department.

Radiation protection in medical diagnostic radiology in the city of Sobral, Brazil

International Nuclear Information System (INIS)

Menezes, F.L.; Paschoal, C.M.M.; Ferreira, F.C.L.; Alcantara, M.C.

2015-01-01

The objective of this study was to evaluate the suitability to radiation protection of four diagnostic radiology medical services in the city of Sobral-CE, Northeast of Brazil, and to analyze results of the literature for the cities of Rio Branco-AC, North of Brazil, and Rio de Janeiro-RJ, South-east of Brazil. In Sobral-CE, it was performed interviews and direct observations with reference to Brazilian law, the National Ordinance No.453/1998 of the Ministry of Health that regulates the operation of medical and odontological diagnostic radiology services. The results show the occurrence of many items in disagreement with the standard. The technical and operational infractions have basically due to unfamiliarity with the legislation, the lack of investment in training and/or professional development courses. (authors)

Application of diagnostic reference levels in medical practice

Energy Technology Data Exchange (ETDEWEB)

Bourguignon, Michel [Faculty of Medicine of Paris, Deputy Director General, Nuclear Safety Authority (ASN), Paris (France)

2006-07-01

Diagnosis reference levels (D.R.L.) are defined in the Council Directive 97/43 EURATOM as 'Dose levels in medical radio diagnosis practices or in the case of radiopharmaceuticals, levels of activity, for typical examinations for groups of standards-sized patients or standards phantoms for broadly defined types of equipment. These levels are expected not to be exceeded for standard procedures when good and normal practice regarding diagnostic and technical performance is applied'. Thus D.R.L. apply only to diagnostic procedures and does not apply to radiotherapy. Radiation protection of patients is based on the application of 2 major radiation protection principles, justification and optimization. The justification principle must be respected first because the best way to protect the patient is not to carry a useless test. Radiation protection of the patient is a continuous process and local dose indicator values in the good range should not prevent the radiologist or nuclear medicine physician to continue to optimize their practice. (N.C.)

Application of diagnostic reference levels in medical practice

International Nuclear Information System (INIS)

Bourguignon, Michel

2006-01-01

Diagnosis reference levels (D.R.L.) are defined in the Council Directive 97/43 EURATOM as 'Dose levels in medical radio diagnosis practices or in the case of radiopharmaceuticals, levels of activity, for typical examinations for groups of standards-sized patients or standards phantoms for broadly defined types of equipment. These levels are expected not to be exceeded for standard procedures when good and normal practice regarding diagnostic and technical performance is applied'. Thus D.R.L. apply only to diagnostic procedures and does not apply to radiotherapy. Radiation protection of patients is based on the application of 2 major radiation protection principles, justification and optimization. The justification principle must be respected first because the best way to protect the patient is not to carry a useless test. Radiation protection of the patient is a continuous process and local dose indicator values in the good range should not prevent the radiologist or nuclear medicine physician to continue to optimize their practice. (N.C.)

Effects of job stress on hypertension among medical diagnostic X-ray workers in China

International Nuclear Information System (INIS)

Zhao Zhigang; Wang Jixian; Zhao Yongcheng; Zhang Wei

2004-01-01

Objective: To study the relation between job stress and hypertension among medical diagnostic x-ray workers in China. Methods: A total of 264 confirmed cases of hypertension were selected among medical diagnostic X-ray workers from 10 provinces and cities. A case-control study with 1:2 matched pair was conducted. Job stress was defined according to Siegrist effort-reward imbalance model. Results: High imbalance ,high overcommitment and severe work environment were associated with enhanced hypertension risk significantly. The OR was 1.848 (P=0.018), 2.058 (P=0.000) and 1.797 (P=0.008) for imbalance, overcommitment and severe work environment, respectively. After controlling other risk factors, the relation still remained significant. Conclusion: The main work-related risk factors causing hypertension among diagnostic X-ray workers are effort-reward imbalance, overcommitment and severe work environment. (authors)

Relativity Screens for Misvalued Medical Services: Impact on Noninvasive Diagnostic Radiology.

Science.gov (United States)

Rosenkrantz, Andrew B; Silva, Ezequiel; Hawkins, C Matthew

2017-11-01

In 2006, the AMA/Specialty Society Relative Value Scale Update Committee (RUC) introduced ongoing relativity screens to identify potentially misvalued medical services for payment adjustments. We assess the impact of these screens upon the valuation of noninvasive diagnostic radiology services. Data regarding relativity screens and relative value unit (RVU) changes were obtained from the 2016 AMA Relativity Assessment Status Report. All global codes in the 2016 Medicare Physician Fee Schedule with associated work RVUs were classified as noninvasive diagnostic radiology services versus remaining services. The frequency of having ever undergone a screen was compared between the two groups. Screened radiology codes were further evaluated regarding the RVU impact of subsequent revaluation. Of noninvasive diagnostic radiology codes, 46.0% (201 of 437) were screened versus 22.2% (1,460 of 6,575) of remaining codes (P < .001). Most common screens for which radiology codes were identified as potentially misvalued were (1) high expenditures (27.5%) and (2) high utilization (25.6%). The modality and body region most likely to be identified in a screen were CT (82.1%) and breast (90.9%), respectively. Among screened radiology codes, work RVUs, practice expense RVUs, and nonfacility total RVUs decreased in 20.3%, 65.9%, and 75.3%, respectively. All screened CT, MRI, brain, and spine codes exhibited decreased total RVUs. Policymakers' ongoing search for potentially misvalued medical services has disproportionately impacted noninvasive diagnostic radiology services, risking the introduction of unintended or artificial shifts in physician practice. Copyright © 2017 American College of Radiology. Published by Elsevier Inc. All rights reserved.

Mamma diagnostics for MTRA (medical-radiological personnel)/RT (radiologists); Mammadiagnostik fuer MTRA/RT

Energy Technology Data Exchange (ETDEWEB)

Fischer, Uwe; Baum, Friedemann

2014-07-01

The text book on mamma diagnostics for MTRA (medical-radiological personnel)/RT (radiologists) covers the following issues: Anatomy, development and physiology of mammary glands; tumor development an breast cancer risk; pathology, non-imaging diagnostics; mammography: physical-technical fundamentals; mammography: analogue technique; mammography: digital technique; mammography: quality assurance; mammography: legal questions and radiation protection; mammography: new developments; mammography: setting technique; mammography: use and appraisal; mamma-sonography: technique and methodology; mamma-sonography: assignment and appraisal, mamma-NMR: technique and methodology; mamma-NMR: assignment and appraisal lymph node diagnostics; mamma interventions; biopsy; mamma interventions: marking examination concepts; therapeutic concepts; hygienic concepts; communication and interaction.

X-ray medical diagnostics and thyroid cancer

International Nuclear Information System (INIS)

Tsenova, T.; Chobanova, N.; Pavlova, A; Bajrakova, A.

1998-01-01

An analytical epidemiological study for assessment of X-ray medical diagnosis as a risk factor for thyroid cancer (TC) has been carried out. The data from the investigation of 90 TC cases and 180 controls matched by sex and age are used. The risk assessment is based on the distribution of investigated persons according to thyroid gland irradiation (as an equivalent dose cumulated from the procedures) and the number of different procedures of organs and systems. There is a significantly increased risk for TC from diagnostic lung examinations; fluoroscopy (OR=3.49, 95% CI=1.66±7.39, p=0.0002) and radiography (OR=2.48, 95% CI=1.05±5.86, p=0.02) (author)

[Novelties in diagnostics and treatment of prostate cancer].

Science.gov (United States)

Riesz, Péter; Nyírádi, Péter

2016-03-13

Similarly to earlier years, a vast majority of novel findings were published on prostate cancer, which is the most common urological cancer. Clinical trials with long-term follow-up and promising observational studies were published. In this paper the author reviews the relevant novelties including the diagnostic use of magnetic resonance imaging and positron emission tomography/computed tomography as well as active surveillance, cytoreductive prostatectomy and medical treatment.

Health Technology Assessment for Molecular Diagnostics: Practices, Challenges, and Recommendations from the Medical Devices and Diagnostics Special Interest Group.

Science.gov (United States)

Garfield, Susan; Polisena, Julie; S Spinner, Daryl; Postulka, Anne; Y Lu, Christine; Tiwana, Simrandeep K; Faulkner, Eric; Poulios, Nick; Zah, Vladimir; Longacre, Michael

2016-01-01

Health technology assessments (HTAs) are increasingly used to inform coverage, access, and utilization of medical technologies including molecular diagnostics (MDx). Although MDx are used to screen patients and inform disease management and treatment decisions, there is no uniform approach to their evaluation by HTA organizations. The International Society for Pharmacoeconomics and Outcomes Research Devices and Diagnostics Special Interest Group reviewed diagnostic-specific HTA programs and identified elements representing common and best practices. MDx-specific HTA programs in Europe, Australia, and North America were characterized by methodology, evaluation framework, and impact. Published MDx HTAs were reviewed, and five representative case studies of test evaluations were developed: United Kingdom (National Institute for Health and Care Excellence's Diagnostics Assessment Programme, epidermal growth factor receptor tyrosine kinase mutation), United States (Palmetto's Molecular Diagnostic Services Program, OncotypeDx prostate cancer test), Germany (Institute for Quality and Efficiency in Healthcare, human papillomavirus testing), Australia (Medical Services Advisory Committee, anaplastic lymphoma kinase testing for non-small cell lung cancer), and Canada (Canadian Agency for Drugs and Technologies in Health, Rapid Response: Non-invasive Prenatal Testing). Overall, the few HTA programs that have MDx-specific methods do not provide clear parameters of acceptability related to clinical and analytic performance, clinical utility, and economic impact. The case studies highlight similarities and differences in evaluation approaches across HTAs in the performance metrics used (analytic and clinical validity, clinical utility), evidence requirements, and how value is measured. Not all HTAs are directly linked to reimbursement outcomes. To improve MDx HTAs, organizations should provide greater transparency, better communication and collaboration between industry and HTA

42 CFR 410.32 - Diagnostic x-ray tests, diagnostic laboratory tests, and other diagnostic tests: Conditions.

Science.gov (United States)

2010-10-01

... Procedural Terminology published by the American Medical Association. (3) Levels of supervision. Except where... & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM SUPPLEMENTARY MEDICAL INSURANCE (SMI) BENEFITS Medical and Other Health Services § 410.32 Diagnostic x-ray tests, diagnostic laboratory...

Advanced signal processing theory and implementation for sonar, radar, and non-invasive medical diagnostic systems

CERN Document Server

Stergiopoulos, Stergios

2009-01-01

Integrates topics of signal processing from sonar, radar, and medical system technologies by identifying their concept similarities. This book covers non-invasive medical diagnostic system applications, including intracranial ultrasound, a technology that attempts to address non-invasive detection on brain injuries and stroke.

[The Offer of Medical-Diagnostic Self-Tests on German Language Websites: Results of a Systematic Internet Search].

Science.gov (United States)

Kuecuekbalaban, P; Schmidt, S; Muehlan, H

2018-03-01

The aim of the current study was to provide an overview of medical-diagnostic self-tests which can be purchased without a medical prescription on German language websites. From September 2014 to March 2015, a systematic internet research was conducted with the following search terms: self-test, self-diagnosis, home test, home diagnosis, quick test, rapid test. 513 different self-tests for the diagnostics of 52 diverse diseases or health risks were identified, including chronic diseases (e. g. diabetes, chronic disease of the kidneys, liver, and lungs), sexually transmitted diseases (e. g. HIV, chlamydia, gonorrhea), infectious diseases (e. g. tuberculosis, malaria, Helicobacter pylori), allergies (e. g. house dust, cats, histamine) and cancer as well as tests for the diagnostics of 12 different psychotropic substances. These were sold by 90 companies in Germany and by other foreign companies. The number of medical-diagnostic self-tests which can be bought without a medical prescription on the Internet has increased enormously in the last 10 years. Further studies are needed for the identification of the determinants of the use of self-tests as well as the impact of the application on the experience and behavior of the user. © Georg Thieme Verlag KG Stuttgart · New York.

The analysis of distribution of the chromosome aberration breakpoints from medical diagnostic X-ray workers

International Nuclear Information System (INIS)

Wang Qin; Li Jin; Tang Weisheng; Wang Zhiquan

2003-01-01

Objective: To analyze the distribution of the chromosome aberration breakpoints from medical diagnostic x-ray workers. Methods: The breakpoints of lymphocyte chromosomes are analyzed using G-banding. Results: There are 146 breakpoints among 3545 metaphase in 37 cases of X-ray workers. There are statistically significant differences between observed values and expected values (χ 2 =42.82, df=23, P 0.05). Conclusion: The chromosome aberration breakpoints of medical diagnostic X-ray workers are non-random. The observed values of breakpoint numbers are higher than those of the expected values in 7 and 14 chromosomes (P<0.05)

A preface on advances in diagnostics for infectious and parasitic diseases: detecting parasites of medical and veterinary importance.

Science.gov (United States)

Stothard, J Russell; Adams, Emily

2014-12-01

There are many reasons why detection of parasites of medical and veterinary importance is vital and where novel diagnostic and surveillance tools are required. From a medical perspective alone, these originate from a desire for better clinical management and rational use of medications. Diagnosis can be at the individual-level, at close to patient settings in testing a clinical suspicion or at the community-level, perhaps in front of a computer screen, in classification of endemic areas and devising appropriate control interventions. Thus diagnostics for parasitic diseases has a broad remit as parasites are not only tied with their definitive hosts but also in some cases with their vectors/intermediate hosts. Application of current diagnostic tools and decision algorithms in sustaining control programmes, or in elimination settings, can be problematic and even ill-fitting. For example in resource-limited settings, are current diagnostic tools sufficiently robust for operational use at scale or are they confounded by on-the-ground realities; are the diagnostic algorithms underlying public health interventions always understood and well-received within communities which are targeted for control? Within this Special Issue (SI) covering a variety of diseases and diagnostic settings some answers are forthcoming. An important theme, however, throughout the SI is to acknowledge that cross-talk and continuous feedback between development and application of diagnostic tests is crucial if they are to be used effectively and appropriately.

Diagnostic Machine Learning Models for Acute Abdominal Pain: Towards an e-Learning Tool for Medical Students.

Science.gov (United States)

Khumrin, Piyapong; Ryan, Anna; Judd, Terry; Verspoor, Karin

2017-01-01

Computer-aided learning systems (e-learning systems) can help medical students gain more experience with diagnostic reasoning and decision making. Within this context, providing feedback that matches students' needs (i.e. personalised feedback) is both critical and challenging. In this paper, we describe the development of a machine learning model to support medical students' diagnostic decisions. Machine learning models were trained on 208 clinical cases presenting with abdominal pain, to predict five diagnoses. We assessed which of these models are likely to be most effective for use in an e-learning tool that allows students to interact with a virtual patient. The broader goal is to utilise these models to generate personalised feedback based on the specific patient information requested by students and their active diagnostic hypotheses.

Towards intelligent diagnostic system employing integration of mathematical and engineering model

International Nuclear Information System (INIS)

Isa, Nor Ashidi Mat

2015-01-01

The development of medical diagnostic system has been one of the main research fields during years. The goal of the medical diagnostic system is to place a nosological system that could ease the diagnostic evaluation normally performed by scientists and doctors. Efficient diagnostic evaluation is essentials and requires broad knowledge in order to improve conventional diagnostic system. Several approaches on developing the medical diagnostic system have been designed and tested since the earliest 60s. Attempts on improving their performance have been made which utilizes the fields of artificial intelligence, statistical analyses, mathematical model and engineering theories. With the availability of the microcomputer and software development as well as the promising aforementioned fields, medical diagnostic prototypes could be developed. In general, the medical diagnostic system consists of several stages, namely the 1) data acquisition, 2) feature extraction, 3) feature selection, and 4) classifications stages. Data acquisition stage plays an important role in converting the inputs measured from the real world physical conditions to the digital numeric values that can be manipulated by the computer system. One of the common medical inputs could be medical microscopic images, radiographic images, magnetic resonance image (MRI) as well as medical signals such as electrocardiogram (ECG) and electroencephalogram (EEG). Normally, the scientist or doctors have to deal with myriad of data and redundant to be processed. In order to reduce the complexity of the diagnosis process, only the significant features of the raw data such as peak value of the ECG signal or size of lesion in the mammogram images will be extracted and considered in the subsequent stages. Mathematical models and statistical analyses will be performed to select the most significant features to be classified. The statistical analyses such as principal component analysis and discriminant analysis as well

Towards intelligent diagnostic system employing integration of mathematical and engineering model

Science.gov (United States)

Isa, Nor Ashidi Mat

2015-05-01

The development of medical diagnostic system has been one of the main research fields during years. The goal of the medical diagnostic system is to place a nosological system that could ease the diagnostic evaluation normally performed by scientists and doctors. Efficient diagnostic evaluation is essentials and requires broad knowledge in order to improve conventional diagnostic system. Several approaches on developing the medical diagnostic system have been designed and tested since the earliest 60s. Attempts on improving their performance have been made which utilizes the fields of artificial intelligence, statistical analyses, mathematical model and engineering theories. With the availability of the microcomputer and software development as well as the promising aforementioned fields, medical diagnostic prototypes could be developed. In general, the medical diagnostic system consists of several stages, namely the 1) data acquisition, 2) feature extraction, 3) feature selection, and 4) classifications stages. Data acquisition stage plays an important role in converting the inputs measured from the real world physical conditions to the digital numeric values that can be manipulated by the computer system. One of the common medical inputs could be medical microscopic images, radiographic images, magnetic resonance image (MRI) as well as medical signals such as electrocardiogram (ECG) and electroencephalogram (EEG). Normally, the scientist or doctors have to deal with myriad of data and redundant to be processed. In order to reduce the complexity of the diagnosis process, only the significant features of the raw data such as peak value of the ECG signal or size of lesion in the mammogram images will be extracted and considered in the subsequent stages. Mathematical models and statistical analyses will be performed to select the most significant features to be classified. The statistical analyses such as principal component analysis and discriminant analysis as well

Towards intelligent diagnostic system employing integration of mathematical and engineering model

Energy Technology Data Exchange (ETDEWEB)

Isa, Nor Ashidi Mat [Imaging and Intelligent System Research Team (ISRT), School of Electrical and Electronic Engineering, Engineering Campus, Universiti Sains Malaysia, 14300 Nibong Tebal, Penang (Malaysia)

2015-05-15

The development of medical diagnostic system has been one of the main research fields during years. The goal of the medical diagnostic system is to place a nosological system that could ease the diagnostic evaluation normally performed by scientists and doctors. Efficient diagnostic evaluation is essentials and requires broad knowledge in order to improve conventional diagnostic system. Several approaches on developing the medical diagnostic system have been designed and tested since the earliest 60s. Attempts on improving their performance have been made which utilizes the fields of artificial intelligence, statistical analyses, mathematical model and engineering theories. With the availability of the microcomputer and software development as well as the promising aforementioned fields, medical diagnostic prototypes could be developed. In general, the medical diagnostic system consists of several stages, namely the 1) data acquisition, 2) feature extraction, 3) feature selection, and 4) classifications stages. Data acquisition stage plays an important role in converting the inputs measured from the real world physical conditions to the digital numeric values that can be manipulated by the computer system. One of the common medical inputs could be medical microscopic images, radiographic images, magnetic resonance image (MRI) as well as medical signals such as electrocardiogram (ECG) and electroencephalogram (EEG). Normally, the scientist or doctors have to deal with myriad of data and redundant to be processed. In order to reduce the complexity of the diagnosis process, only the significant features of the raw data such as peak value of the ECG signal or size of lesion in the mammogram images will be extracted and considered in the subsequent stages. Mathematical models and statistical analyses will be performed to select the most significant features to be classified. The statistical analyses such as principal component analysis and discriminant analysis as well

The future of novel diagnostics in medical mycology.

Science.gov (United States)

Teles, Fernando; Seixas, Jorge

2015-04-01

Several fungal diseases have become serious threats to human health and life, especially upon the advent of human immunodeficiency virus/AIDS epidemics and of other typical immunosuppressive conditions of modern life. Accordingly, the burden posed by these diseases and, concurrently, by intensive therapeutic regimens against these diseases has increased worldwide. Existing and available rapid tests for point-of-care diagnosis of important fungal diseases could enable the limitations of current laboratory methods for detection and identification of medically important fungi to be surpassed, both in low-income countries and for first-line diagnosis (screening) in richer countries. As with conventional diagnostic methods and devices, former immunodiagnostics have been challenged by molecular biology-based platforms, as a way to enhance the sensitivity and shorten the assay time, thus enabling early and more accurate diagnosis. Most of these tests have been developed in-house, without adequate validation and standardization. Another challenge has been the DNA extraction step, which is especially critical when dealing with fungi. In this paper, we have identified three major research trends in this field: (1) the application of newer biorecognition techniques, often applied in analytical chemistry; (2) the development of new materials with improved physico-chemical properties; and (3) novel bioanalytical platforms, allowing fully automated testing. Keeping up to date with the fast technological advances registered in this field, primarily at the proof-of-concept level, is essential for wise assessment of those that are likely to be more cost effective and, as already observed for bacterial and viral pathogens, may provide leverage to the current tepid developmental status of novel and improved diagnostics for medical mycology. © 2015 The Authors.

Retrospective Dose Reconstruction for Medical Diagnostic X Ray Workers in China using Stable Chromosome Aberrations

International Nuclear Information System (INIS)

Wang, Q.; Liu, P.; Li, J.; Wang, Q.; Tang, S.; Sun, M.; Wang, L.; Aoyama, T.; Sugahara, T.

1998-01-01

The chromosome rearrangements in medical diagnostic X ray workers were analysed using the G-banding technique and evaluated collectively in accumulated doses. A total of 9102 metaphase spreads from 84 medical diagnostic X ray workers and 17 controls were scored. The results showed that: (1) the frequencies of translocation, stable chromosome aberration and total aberration in X ray workers were significantly higher than those of controls (P < 0.05 γ 0.005), unstable chromosome aberrations (including dicentric and acentric aberration) tended upwards; (2) the main aberration in stable aberrations was reciprocal translocation; (3) the stable aberration predominated strikingly in total aberrations. The medical diagnostic X ray workers were divided into three groups according to calendar year of entry. The data showed that the frequencies of translocation, stable aberration and total aberration increased with earlier year of entry, especially in two groups who started working before 1970. According to the equation recommended by Straume et al, linear coefficient (α) in the linear quadratic model provided by Fernandez's experiment, their collective accumulation doses calculated were 0.53, 0.26 and 0.06 Gy for calendar year of entry before 1960, 1960-1969, and after 1970, in X ray workers, respectively. (author)

Children's exposure to diagnostic medical radiation and cancer risk: epidemiologic and dosimetric considerations

Energy Technology Data Exchange (ETDEWEB)

Linet, Martha S.; Rajaraman, Preetha [National Cancer Institute, Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, Bethesda, MD (United States); Kim, Kwang pyo [National Cancer Institute, Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, Bethesda, MD (United States); Kyung Hee University, Department of Nuclear Engineering, Yongin-si, Gyeonggi (Korea)

2009-02-15

While the etiology of most childhood cancers is largely unknown, epidemiologic studies have consistently found an association between exposure to medical radiation during pregnancy and risk of childhood cancer in offspring. The relation between early life diagnostic radiation exposure and occurrence of pediatric cancer risks is less clear. This review summarizes current and historical estimated doses for common diagnostic radiologic procedures as well as the epidemiologic literature on the role of maternal prenatal, children's postnatal and parental preconception diagnostic radiologic procedures on subsequent risk of childhood malignancies. Risk estimates are presented according to factors such as the year of birth of the child, trimester and medical indication for the procedure, and the number of films taken. The paper also discusses limitations of the methods employed in epidemiologic studies to assess pediatric cancer risks, the effects on clinical practice of the results reported from the epidemiologic studies, and clinical and public health policy implications of the findings. Gaps in understanding and additional research needs are identified. Important research priorities include nationwide surveys to estimate fetal and childhood radiation doses from common diagnostic procedures, and epidemiologic studies to quantify pediatric and lifetime cancer risks from prenatal and early childhood exposures to diagnostic radiography, CT, and fluoroscopically guided procedures. (orig.)

Principles and applications of polymerase chain reaction in medical diagnostic fields: a review.

Science.gov (United States)

Valones, Marcela Agne Alves; Guimarães, Rafael Lima; Brandão, Lucas André Cavalcanti; de Souza, Paulo Roberto Eleutério; de Albuquerque Tavares Carvalho, Alessandra; Crovela, Sergio

2009-01-01

Recent developments in molecular methods have revolutionized the detection and characterization of microorganisms in a broad range of medical diagnostic fields, including virology, mycology, parasitology, microbiology and dentistry. Among these methods, Polymerase Chain Reaction (PCR) has generated great benefits and allowed scientific advancements. PCR is an excellent technique for the rapid detection of pathogens, including those difficult to culture. Along with conventional PCR techniques, Real-Time PCR has emerged as a technological innovation and is playing an ever-increasing role in clinical diagnostics and research laboratories. Due to its capacity to generate both qualitative and quantitative results, Real-Time PCR is considered a fast and accurate platform. The aim of the present literature review is to explore the clinical usefulness and potential of both conventional PCR and Real-Time PCR assays in diverse medical fields, addressing its main uses and advances.

Structural shielding of medical X-ray rooms for diagnostic installations

International Nuclear Information System (INIS)

Rabitsch, H.

1979-06-01

In Part I (RIG 8), the various design procedures for shielding against X-rays are discussed and compared. In particular, this comparison is carried out between the shielding obtained conforming to the Austrian Regulations for Radiation Protection and that obtained from the DIN-standard DIN 6812; this latter includes the various operating conditions of diagnostic installations up to 150 kV. Several examples for particular structural shielding components in medical radiation rooms are given. (author)

Clinical Training of Medical Physicists Specializing in Diagnostic Radiology (French Edition)

International Nuclear Information System (INIS)

2012-01-01

The application of radiation in human health, for both diagnosis and treatment of disease, is an important component of the work of the IAEA. The responsibility for the increasing technical aspects of this work is undertaken by the medical physicist. To ensure good practice in this vital area, structured clinical training programmes are required to complement academic learning. This publication is intended to be a guide to the practical implementation of such a programme for diagnostic radiology. There is a general and growing awareness that radiation medicine is increasingly dependent on well trained medical physicists based in the clinical setting. However, an analysis of the availability of medical physicists indicates a large shortfall of qualified and capable professionals. This is particularly evident in developing countries. While strategies to increase academic educational opportunities are critical to such countries, the need for guidance on structured clinical training was recognized by the members of the Regional Cooperative Agreement (RCA) for Research, Development and Training related to Nuclear Sciences for Asia and the Pacific. Consequently, a technical cooperation regional project (RAS6038) under the RCA programme was formulated to address this need in the Asia-Pacific region by developing suitable material and establishing its viability. Development of a clinical training guide for medical physicists specializing in diagnostic radiology started in 2007 with the appointment of a core drafting committee of regional and international experts. The publication drew on the experiences of clinical training programmes in Australia and New Zealand, the UK and the USA, and was moderated by physicists working in the Asian region. This publication follows the approach of the IAEA publication Training Course Series No. 37, Clinical Training of Medical Physicists specializing in Radiation Oncology. This approach to clinical training has been successfully tested

Clinical Training of Medical Physicists Specializing in Diagnostic Radiology (Spanish Edition)

International Nuclear Information System (INIS)

2013-01-01

The application of radiation in human health, for both diagnosis and treatment of disease, is an important component of the work of the IAEA. The responsibility for the increasing technical aspects of this work is undertaken by the medical physicist. To ensure good practice in this vital area, structured clinical training programmes are required to complement academic learning. This publication is intended to be a guide to the practical implementation of such a programme for diagnostic radiology. There is a general and growing awareness that radiation medicine is increasingly dependent on well trained medical physicists based in the clinical setting. However, an analysis of the availability of medical physicists indicates a large shortfall of qualified and capable professionals. This is particularly evident in developing countries. While strategies to increase academic educational opportunities are critical to such countries, the need for guidance on structured clinical training was recognized by the members of the Regional Cooperative Agreement (RCA) for Research, Development and Training related to Nuclear Sciences for Asia and the Pacific. Consequently, a technical cooperation regional project (RAS6038) under the RCA programme was formulated to address this need in the Asia-Pacific region by developing suitable material and establishing its viability. Development of a clinical training guide for medical physicists specializing in diagnostic radiology started in 2007 with the appointment of a core drafting committee of regional and international experts. The publication drew on the experiences of clinical training programmes in Australia and New Zealand, the UK and the USA, and was moderated by physicists working in the Asian region. This publication follows the approach of the IAEA publication Training Course Series No. 37, Clinical Training of Medical Physicists specializing in Radiation Oncology. This approach to clinical training has been successfully tested

How 3D immersive visualization is changing medical diagnostics

Science.gov (United States)

Koning, Anton H. J.

2011-03-01

Originally the only way to look inside the human body without opening it up was by means of two dimensional (2D) images obtained using X-ray equipment. The fact that human anatomy is inherently three dimensional leads to ambiguities in interpretation and problems of occlusion. Three dimensional (3D) imaging modalities such as CT, MRI and 3D ultrasound remove these drawbacks and are now part of routine medical care. While most hospitals 'have gone digital', meaning that the images are no longer printed on film, they are still being viewed on 2D screens. However, this way valuable depth information is lost, and some interactions become unnecessarily complex or even unfeasible. Using a virtual reality (VR) system to present volumetric data means that depth information is presented to the viewer and 3D interaction is made possible. At the Erasmus MC we have developed V-Scope, an immersive volume visualization system for visualizing a variety of (bio-)medical volumetric datasets, ranging from 3D ultrasound, via CT and MRI, to confocal microscopy, OPT and 3D electron-microscopy data. In this talk we will address the advantages of such a system for both medical diagnostics as well as for (bio)medical research.

Value of multi-criteria decision analysis in early assessment of medical diagnostic devices

NARCIS (Netherlands)

IJzerman, Maarten Joost; Hummel, J. Marjan

2010-01-01

OBJECTIVES: Multicriteria decision analytic (MCDA) techniques are a powerful tool in evaluating health care interventions where multiple, often competing, factors need to be considered. The analytic hierarchy process (AHP) is one such technique. We have applied AHP to evaluate medical diagnostic

Cancer risk analysis among medical diagnostic X-ray workers in China

International Nuclear Information System (INIS)

Wang Jixian; Li Benxiao; Gao Zhiwei; Xu Jun; Zhang Jingyuan; Aoyama, Takashi; Sugahara, Tsutomu

1997-01-01

To provide the evidence and related rules of human malignant tumors produced by prolonged exposure to low level ionizing radiation. The cancer incidence (1950-1990) among 27011 medical diagnostic X-ray workers was compared with that among 25782 other medical specialists employed between 1950 and 1980 in China by means of O/E system. A significantly elevated risk of cancer was seen among diagnostic x-ray workers (RR = 1.1,95%Cl:1.0-1.2,P <0.05). Significantly elevated risks were seen for leukemia and cancers of skin, female breast, liver and esophagus, the RR being 2.3, 5.0, 1.6, 1.3 and 4.4 respectively. The RR for leukemia was higher for X-ray workers who began employment before 1970 and also for those who were young when employment began. The patterns of risk associated with length of service and with age and calendar year of initial employment suggest that the excesses of leukemia, skin cancer and female breast cancer were due to occupational exposure to X-rays. The ERR and EAR for leukemia and solid cancer were calculated roughly. (author)

[The challenges of standardization in clinical diagnostic laboratories of medical organizations].

Science.gov (United States)

Men'shikov, V V

2013-04-01

The generalized data concerning the conditions of application of regulations of national standards in clinical diagnostic laboratories of medical organizations is presented. The primary information was provided by 14 regions of 6 federal administrative okrugs of Russia. The causes of challenges of application of requirements of standards are presented. They are mostly related with insufficient financial support, lacking of manpower, difficulties with reagents supply, inadequate technical maintenance of devices and absence of support of administration of medical organizations. The recommendations are formulated concerning the necessity of publishing the document of Minzdrav of Russia to determine the need in application of standards in laboratory practice.

CSIR research, development and innovation initiatives for the medical device and diagnostic industry

CSIR Research Space (South Africa)

Vilakazi, Busisiwe

2017-10-01

Full Text Available This presentation is focused on development and innovation initiatives in the medical device and diagnostic industry. It is presented by Dr Busisiwe Vilakasi at The 6th CSIR Conference: Ideas that work for industrial development, 5-6 October 2017...

Diagnostic Imaging in the Medical Support of the Future Missions to the Moon

Science.gov (United States)

Sargsyan, Ashot E.; Jones, Jeffrey A.; Hamilton, Douglas R.; Dulchavsky, Scott A.; Duncan, J. Michael

2007-01-01

This viewgraph presentation is a course that reviews the diagnostic imaging techniques available for medical support on the future moon missions. The educational objectives of the course are to: 1) Update the audience on the curreultrasound imaging in space flight; 2) Discuss the unique aspects of conducting ultrasound imaging on ISS, interplanetary transit, ultrasound imaging on ISS, interplanetary transit, and lunar surface operations; and 3) Review preliminary data obtained in simulations of medical imaging in lunar surface operations.

Photoionization sensors for non-invasive medical diagnostics

Science.gov (United States)

Mustafaev, Aleksandr; Rastvorova, Iuliia; Khobnya, Kristina; Podenko, Sofia

2016-09-01

The analysis of biomarkers can help to identify the significant number of diseases: lung cancer, tuberculosis, diabetes, high levels of stress, psychosomatic disorders etc. To implement continuous monitoring of the state of human health, compact VUV photoionization detector with current-voltage measurement is designed by Saint-Petersburg Mining University Plasma Research Group. This sensor is based on the patented method of stabilization of electric parameters - CES (Collisional Electron Spectroscopy). During the operation at atmospheric pressure VUV photoionization sensor measures the energy of electrons, produced in the ionization with the resonance photons, whose wavelength situated in the vacuum ultraviolet (VUV). A special software was developed to obtain the second-order derivative of the I-U characteristics, taken by the VUV sensor, to construct the energy spectra of the characteristic electrons. VUV photoionization detector has an unique set of parameters: small size (10*10*1 mm), low cost, wide range of recognizable molecules, as well as accuracy, sufficient for using this instrument for the medical purposes. This device can be used for non-invasive medical diagnostics without compromising the quality of life, for control of environment and human life. Work supported by Foundation for Assistance to Small Innovative Enterprises in Science and Technology.

Medical thoracoscopy: a useful diagnostic tool for undiagnosed pleural effusion.

Science.gov (United States)

Agarwal, Abhishek; Prasad, Rajendra; Garg, Rajiv; Verma, S K; Singh, Abhijeet; Husain, N

2014-01-01

We aimed to assess the role of medical thoracoscopy in patients with undiagnosed pleural effusion. Patiens presenting with pleural effusion underwent three pleural aspirations. Patients in whom pleural fluid analysis was inconclusive underwent closed pleural biopsy for diagnostic confirmation. Patients in whom closed pleural biopsy was incolcusive underwent medical thoracoscopy using a rigid thoracoscope with a viewing angle of zero degrees was done under local anaesthesia and sedation with the patient lying in lateral decubitus position with the affected side up. Biopsy specimens from parietal pleura were obtained under direct vision and were sent for histopathological examination. Of the 128 patients with pleural effusion who were studied, pleural fluid examination established the diagnosis in 81 (malignancy 33, tuberculosis 33, pyogenic 14 and fungal 1); 47 patients underwent closed pleural biopsy and a diagnosis was made in 28 patients (malignancy 24, tuberculosis 4). The remaining 19 patients underwent medical thoracoscopy and pleural biopsy and the aetiological diagnosis could be confirmed in 13 of the 19 patients (69%) (adenocarcinoma 10, poorly differentiated carcinoma 2 and mesothelioma 1). Medical thoracoscopy is a useful tool for the diagnosis of pleural diseases. The procedure is safe with minimal complications.

Diagnostic radiology physics: A handbook for teachers and students. Endorsed by: American Association of Physicists in Medicine, Asia-Oceania Federation of Organizations for Medical Physics, European Federation of Organisations for Medical Physics

Energy Technology Data Exchange (ETDEWEB)

Dance, D. R. [Royal Surrey County Hospital, Guildford (United Kingdom); Christofides, S. [New Nicosia General Hospital (Cyprus); Maidment, A. D.A. [University of Pennsylvania (United States); McLean, I. D. [International Atomic Energy Agency, Vienna (Austria); Ng, K. H. [University of Malaya, Kuala Lumpur (Malaysia)

2014-09-15

This publication is written for students and teachers involved in programmes that train medical physicists for work in diagnostic radiology. It provides, in the form of a syllabus, a comprehensive overview of the basic medical physics knowledge required for the practice of modern diagnostic radiology. This makes it particularly useful for graduate students and residents in medical physics programmes. The material presented in the publication has been endorsed by the major international organizations and is the foundation for academic and clinical courses in both diagnostic radiology physics and in emerging areas such as imaging in radiotherapy.

Establishing diagnostic reference levels in digital radiology

International Nuclear Information System (INIS)

Bana, Remy Wilson

2016-04-01

Medical application of radiation has gained wider study since diagnostic radiology plays a very important role in modern medicine. The need of the service seems to increase since the invention of digital radiology as a new technology that promises greater accuracy while minimizing patient dose. However, it is not exempted in the harmonization of doses delivered to the patient undergoing same radiologic examination in different institutions either regional or nationwide. The objective of this project was to review the establishment of Diagnostic Reference Levels (DRLs) in digital radiology at National level with the aim to reduce patient dose while maintaining appropriate image quality. A general discussion on digital radiology has been presented focusing on the optimization of patient dose as well as dosimetric quantities used for the establishment of DRLs. Recommendations have been provided for Rwanda to initiate steps to establish National Diagnostic Reference Levels for common procedures in digital radiology. (au)

Update of diagnostic medical and dental x-ray exposures in Romania

Energy Technology Data Exchange (ETDEWEB)

Sorop, Ioana; Mossang, Daniela; Dadulescu, Elena [Radiation Hygiene Laboratory of Public Health Authority Dolj, 2, Constantin Lecca Street, Craiova (Romania); Iacob, Mihai Radu [University ' Alexandru Ioan Cuza' , 11, Carol I Street, 700506, Iasi (Romania); Iacob, Olga [Institute of Public Health, 14, Victor Babes Street, 700465 Iasi (Romania)], E-mail: danamossang@sanpubdj.ro

2008-12-15

This national study, the third in the last 15 years, updates the magnitude of medical radiation exposure from conventional x-ray examinations, in order to optimise the radiological protection to the population in a cost-effective manner. Effective doses from diagnostic radiology were estimated for adult and paediatric patients undergoing the 20 most important types of x-ray examination. Data were collected from 179 x-ray departments, selected by their annual workload, throughout the country. Estimates were made using two dosimetric quantities: entrance surface dose, derived from the absorbed dose in air measured by simulation of radiographic examinations, and dose-area product, measured during fluoroscopic examinations performed on adult and paediatric patients. Conversion coefficients to effective dose of the UK National Radiological Protection Board (NRPB) have been used in all calculations. The effective dose per patient from all medical x-ray examinations was 0.74 mSv and the resulting annual collective effective dose was 6930 man Sv, with annual effective dose per caput of 0.33 mSv. The current size of population exposure from diagnostic radiology is lower than the previous one by 40%, but could be about 30% higher by taking into account the estimated contribution from computed tomography (CT) procedures.

DXplain: a Web-based diagnostic decision support system for medical students.

Science.gov (United States)

London, S

1998-01-01

DXplain is a diagnostic decision support program, with a new World Wide Web interface, designed to help medical students and physicians formulate differential diagnoses based on clinical findings. It covers over 2000 diseases and 5000 clinical manifestations. DXplain suggests possible diagnoses, and provides brief descriptions of every disease in the database. Not all diseases are included, nor does DXplain take into account preexisting conditions or the chronological sequence of clinical manifestations. Despite these limitations, it is a useful educational tool, particularly for problem-based learning (PBL) cases and for students in clinical rotations, as it fills a niche not adequately covered by MEDLINE or medical texts. The system is relatively self-explanatory, requiring little or no end-user training. Medical libraries offering, or planning to offer, their users access to Web-based materials and resources may find this system a valuable addition to their electronic collections. Should it prove popular with the local users, provision of access may also establish or enhance the library's image as a partner in medical education.

Biomedical visual data analysis to build an intelligent diagnostic decision support system in medical genetics.

Science.gov (United States)

Kuru, Kaya; Niranjan, Mahesan; Tunca, Yusuf; Osvank, Erhan; Azim, Tayyaba

2014-10-01

In general, medical geneticists aim to pre-diagnose underlying syndromes based on facial features before performing cytological or molecular analyses where a genotype-phenotype interrelation is possible. However, determining correct genotype-phenotype interrelationships among many syndromes is tedious and labor-intensive, especially for extremely rare syndromes. Thus, a computer-aided system for pre-diagnosis can facilitate effective and efficient decision support, particularly when few similar cases are available, or in remote rural districts where diagnostic knowledge of syndromes is not readily available. The proposed methodology, visual diagnostic decision support system (visual diagnostic DSS), employs machine learning (ML) algorithms and digital image processing techniques in a hybrid approach for automated diagnosis in medical genetics. This approach uses facial features in reference images of disorders to identify visual genotype-phenotype interrelationships. Our statistical method describes facial image data as principal component features and diagnoses syndromes using these features. The proposed system was trained using a real dataset of previously published face images of subjects with syndromes, which provided accurate diagnostic information. The method was tested using a leave-one-out cross-validation scheme with 15 different syndromes, each of comprised 5-9 cases, i.e., 92 cases in total. An accuracy rate of 83% was achieved using this automated diagnosis technique, which was statistically significant (pbenefits of using hybrid image processing and ML-based computer-aided diagnostics for identifying facial phenotypes. Copyright © 2014. Published by Elsevier B.V.

Senior medical students' awareness of radiation risks from common diagnostic imaging examinations.

Science.gov (United States)

Scali, Elena; Mayo, John; Nicolaou, Savvas; Kozoriz, Michael; Chang, Silvia

2017-12-01

Senior medical students represent future physicians who commonly refer patients for diagnostic imaging studies that may involve ionizing radiation. The radiology curriculum at the University of British Columbia provides students with broad-based knowledge about common imaging examinations. The purpose of this study was to investigate students' awareness of radiation exposures and risks. An anonymous multiple-choice cross-sectional questionnaire was distributed to final year medical students to assess knowledge of radiation from common diagnostic examinations and radiation-related risks following completion of the longitudinal radiology curriculum, carried out over the four years of medical training. Sixty-three of 192 eligible students participated (33% response rate). The majority felt that knowledge of radiation doses of common imaging examinations is somewhat or very important; however, only 12% (N = 8) routinely discuss radiation-related risks with patients. While all respondents recognized children as most sensitive to the effects of radiation, only 24% (N = 15) correctly identified gonads as the most radiation-sensitive tissue. Almost all respondents recognized ultrasound and MRI as radiation free modalities. Respondents who correctly identified the relative dose of common imaging examinations in chest x-ray equivalents varied from 3-77% (N = 2 - 49); the remaining responses were largely underestimates. Finally, 44% (N = 28) correctly identified the excess risk of a fatal cancer from an abdominal CT in an adult, while the remainder underestimated this risk. Medical students acknowledge the importance of radiation-related issues to patient care. While almost all students are familiar with radiation-free modalities, many are not familiar with, and commonly underestimate, the relative doses and risks of common imaging studies. This may expose patients to increasing imaging investigations and exposure to radiation hazards.

Stochastic risk estimation from medical x-ray diagnostic examinations, 2

International Nuclear Information System (INIS)

Hashizume, Tadashi; Maruyama, Takashi; Noda, Yutaka; Iwai, Kazuo; Tateno, Y.; Nishizawa, Kanae.

1981-01-01

The risks of genetic, leukemia and malignant diseases from medical X-ray diagnostic examinations were estimated using the frequency of radiographic and fluoroscopic exposures per diagnostic examination, child expectancy, leukemia and malignancy significant factors, and using a weighting factor determined on the basis of data concerning the cancer mortality among atomic bomb survivors in Nagasaki and of a recommendation of International Commission of Radiological Protection. The organ or tissue doses with respect to the stochastic risks were determined with ionization chambers and thermoluminescent dosimeters placed at the positions of the organs or tissues in a RANDO woman phantom which was exposed to diagnostic X-rays according to technical factors of typical radiographic and fluoroscopic examinations obtained from a nationwide survey. The resultant risks by age-group and type of radiographic and fluoroscopic examination are tabulated in terms of risk level of 10 -6 . In general, the total risk defined as the sum of genetic, leukemia and malignant risks was a high value for the X-ray diagnosis of digestive organs involving barium meal and barium enema. For example, the total risk for young age-group was 100 to 200 x 10 -6 for the X-ray diagnosis of digestive organs. The total risk from the chest radiography was lower value as compared with the risk from the X-ray diagnosis of other organs or tissues. On the contrary, the risk from the chest tomography was comparable to the risk from the diagnosis of digestive organs. The total risk decreased with increasing of age for every X-ray diagnostic examination. (author)

Are diagnostic criteria for eating disorders markers of medical severity?

Science.gov (United States)

Peebles, Rebecka; Hardy, Kristina K; Wilson, Jenny L; Lock, James D

2010-05-01

The objective of this study was to compare the medical severity of adolescents who had eating disorders not otherwise specified (EDNOS) with those who had anorexia nervosa (AN) and bulimia nervosa (BN). Medical records of 1310 females aged 8 through 19 years and treated for AN, BN, or EDNOS were retrospectively reviewed. Patients with EDNOS were subcategorized into partial AN (pAN) and partial BN (pBN) when they met all Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition criteria but 1 for AN or BN, respectively. Primary outcome variables were heart rate, systolic blood pressure, temperature, and QTc interval on electrocardiogram. Additional physiologically significant medical complications were also reviewed. A total of 25.2% of females had AN, 12.4% had BN, and 62.4% had EDNOS. The medical severity of patients with EDNOS was intermediate to that of patients with AN and BN in all primary outcomes. Patients with pAN had significantly higher heart rates, systolic blood pressures, and temperatures than those with AN; patients with pBN did not differ significantly from those with BN in any primary outcome variable; however, patients with pAN and pBN differed significantly from each other in all outcome variables. Patients with pBN and BN had longer QTc intervals and higher rates of additional medical complications reported at presentation than other groups. EDNOS is a medically heterogeneous category with serious physiologic sequelae in children and adolescents. Broadening AN and BN criteria in pediatric patients to include pAN and pBN may prove to be clinically useful.

The Qualitative-Quantitative Analysis and the Study of Personnel's Awareness of the Management Strategies of the Wastes of Medical Diagnostic Laboratories of Rasht, in 2009

Directory of Open Access Journals (Sweden)

Nabizadeh R.

2012-01-01

Full Text Available Background and Objectives: Waste produced by health and treatment centers (hospitals including medical diagnostic laboratories is one of the sources of municipal waste production. Waste produced by medical diagnostic laboratories due to the existence of pathogens and infectious materials by high importance is one of the environmental issues. This survey has been done on the qualitative-quantitative analytical bases, and the investigation has focused on the management strategies of the waste material of medical diagnostic laboratories of Rasht, Iran in 2009. Methods: In this descriptive study, samples were collected from 19 medical diagnostic laboratories of Rasht in 3 consecutive days (Monday, Tuesday and Wednesday every week, after filling the questionnaire and interviewing with the managers. Then, the samples were separated manually, and divided into 46 different constituents and weighed. Next, the constituents were classified based on characteristics and potentiality of being hazardous.Results: The total amount of annual waste production by the medical diagnostic laboratories of Rasht is 25785.143kg. In this study, the share of manufacturing conventional waste (domestic type wastes, especially infectious, chemical, pharmaceutical, and radioactive wastes were 1.16%, 95.34%, 1.42% and 2.08%, respectively. The highest and lowest amount of waste production relates to plastic materials and wood which are 48.37 and 0.43%, respectively. In this study sharp cutting things were calculated to be 10.52%. Furthermore, 84 percent of the managers of the medical diagnostic laboratories had not had enough information of the circulars and instructions on the enforceable management strategies of the medical wastes.Conclusion: Concerning the management of the medical waste production in the medical diagnostic laboratories, it is suggested that the managers and the personnel be trained on the separation, collection, and disinfection techniques and final disposal

The Design of Diagnostic Medical Facilities where Ionising Radiation is used

International Nuclear Information System (INIS)

Malone, J.; O'Reilly, G.; O'Connor, U.; Gallagher, A.; Sheahan, N.; Fennell, S.

2009-06-01

The original Code of Practice on The Design of Diagnostic Medical Facilities Using Ionising Radiation was first published by the Nuclear Energy Board in 1988. In the intervening years the 'Blue Book' as it became known has served the medical community well as the sector has expanded and modernised and the late Dr Noel Nowlan, then Chief Executive of the Nuclear Energy Board, deserves much credit for initiating this pioneering contribution to radiation safety in Ireland. There have been significant developments since its publication in terms of the underlying radiation protection legislation, regulatory practice as well as developments in new technologies that have given rise to the need for a revision of the Code. This revised Code is based on a comprehensive draft document produced by the Haughton Institute under contract to the RPII and was finalised following extensive consultations with the relevant stakeholders. The revised Code includes a brief review of the current legislative framework and its specific impact on the management of building projects (Chapters 1 and 2), a presentation of the main types of radiological (Chapter 3) and nuclear medicine (Chapter 4) facilities, a treatment of the technical aspects of shielding calculations (Chapter 5) and a discussion of the practical aspects of implementing shielding solutions in a building context (Chapter 6). The primary purpose of the Code is to assist in the design of diagnostic facilities to the highest radiation protection standards in order to ensure the safety of workers and members of the public and the delivery of a safe service to patients. Diagnostic radiology is a dynamic environment and the Code is intended to be used in consultation with the current literature, an experienced Radiation Protection Advisor and a multidisciplinary project team

Medical Physics Staffing Needs in Diagnostic Imaging and Radionuclide Therapy: An Activity Based Approach [Endorsed by International Organization for Medical Physics

International Nuclear Information System (INIS)

2018-01-01

Over the last decades, the rapid technological development of diagnostic and interventional radiology and nuclear medicine has made them major tools of modern medicine. However, at the same time the involved risks, the growing number of procedures and the increasing complexity of the procedures require competent professional staff to ensure safe and effective patient diagnosis, treatment and management. Medical physicists (or clinically qualified medical physicists) have been recognized as vital health professionals with important and clear responsibilities related to quality and safety of applications of ionizing radiation in medicine. This publication describes an algorithm developed to determine the recommended staffing levels for clinical medical physics services in medical imaging and radionuclide therapy, based on current best practice, as described in international guidelines.

On-line integration of computer controlled diagnostic devices and medical information systems in undergraduate medical physics education for physicians.

Science.gov (United States)

Hanus, Josef; Nosek, Tomas; Zahora, Jiri; Bezrouk, Ales; Masin, Vladimir

2013-01-01

We designed and evaluated an innovative computer-aided-learning environment based on the on-line integration of computer controlled medical diagnostic devices and a medical information system for use in the preclinical medical physics education of medical students. Our learning system simulates the actual clinical environment in a hospital or primary care unit. It uses a commercial medical information system for on-line storage and processing of clinical type data acquired during physics laboratory classes. Every student adopts two roles, the role of 'patient' and the role of 'physician'. As a 'physician' the student operates the medical devices to clinically assess 'patient' colleagues and records all results in an electronic 'patient' record. We also introduced an innovative approach to the use of supportive education materials, based on the methods of adaptive e-learning. A survey of student feedback is included and statistically evaluated. The results from the student feedback confirm the positive response of the latter to this novel implementation of medical physics and informatics in preclinical education. This approach not only significantly improves learning of medical physics and informatics skills but has the added advantage that it facilitates students' transition from preclinical to clinical subjects. Copyright © 2011 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.

Medical History of Elderly Patients in the Emergency Setting: Not an Easy Point-of-Care Diagnostic Marker

Directory of Open Access Journals (Sweden)

Tobias Lindner

2015-01-01

Full Text Available Background. Medical histories are a crucially important diagnostic tool. Elderly patients represent a large and increasing group of emergency patients. Due to cognitive deficits, taking a reliable medical history in this patient group can be difficult. We sought to evaluate the medical history-taking in emergency patients above 75 years of age with respect to duration and completeness. Methods. Anonymous data of consecutive patients were recorded. Times for the defined basic medical history-taking were documented, as were the availability of other sources and times to assess these. Results. Data of 104 patients were included in the analysis. In a quarter of patients (25%, n=26 no complete basic medical history could be obtained. In the group of patients where complete data could be gathered, only 16 patients were able to provide all necessary information on their own. Including other sources like relatives or GPs prolonged the time until complete medical history from 7.3 minutes (patient only to 26.4 (+relatives and 56.3 (+GP minutes. Conclusions. Medical histories are important diagnostic tools in the emergency setting and are prolonged in the elderly, especially if additional documentation and third parties need to be involved. New technologies like emergency medical cards might help to improve the availability of important patient data but implementation of these technologies is costly and faces data protection issues.

X-ray diagnostics, X-ray therapy, diagnostics and therapy with radioactive materials in free medical practice

International Nuclear Information System (INIS)

Setzer, H.D.

1976-01-01

On the basis of the documents of the Kassenaerztliche Vereinigung Niederbayerns in Straubing, the work of the established general practicioners in the fields of X-ray and nuclear medicine was investigated for the 1st quarter of 1971, and the X-ray diagnostic services rendered were evaluated according to age and sex. 2/3 of all doctors participating in a health insurance plan in Lower Bavaria are general practitioners; all other fields are represented less often than in Munich. The values for the whole Federal Republic are in between. Internal specialists, radiologists, and urologists together carry out 85.7% of the ten examinations which contribute most to the total gonadal dose. An application of the data on the 1st quarter to the annual value is only possible by allowing for an error of 13.1%. All in all, 6% more X-ray services are administered to men than to women. For both sexes, the genetically most important group of 15-34 resp. 15-39 years of age is highly represented, although young men receive X-ray diagnostics more frequently. X-ray therapy makes up only about 0.5% of all services. Nuclear medical diagnostics is employed to the same extent by radiologists and internal specialists, while therapy with radioactive substances is almost exclusively provided by radiologists. Relative to the population density, radioactive substances are more often used in Lower Bavaria than in West Berlin. (orig.) [de

The role of radiology in diagnostic error: a medical malpractice claims review.

Science.gov (United States)

Siegal, Dana; Stratchko, Lindsay M; DeRoo, Courtney

2017-09-26

Just as radiologic studies allow us to see past the surface to the vulnerable and broken parts of the human body, medical malpractice claims help us see past the surface of medical errors to the deeper vulnerabilities and potentially broken aspects of our healthcare delivery system. And just as the insights we gain through radiologic studies provide focus for a treatment plan for healing, so too can the analysis of malpractice claims provide insights to improve the delivery of safe patient care. We review 1325 coded claims where Radiology was the primary service provider to better understand the problems leading to patient harm, and the opportunities most likely to improve diagnostic care in the future.

Molecular Diagnostics

OpenAIRE

Choe, Hyonmin; Deirmengian, Carl A.; Hickok, Noreen J.; Morrison, Tiffany N.; Tuan, Rocky S.

2015-01-01

Orthopaedic infections are complex conditions that require immediate diagnosis and accurate identification of the causative organisms to facilitate appropriate management. Conventional methodologies for diagnosis of these infections sometimes lack accuracy or sufficient rapidity. Current molecular diagnostics are an emerging area of bench-to-bedside research in orthopaedic infections. Examples of promising molecular diagnostics include measurement of a specific biomarker in the synovial fluid...

Risk factors of coronary heart disease among medical diagnostic X-ray workers

International Nuclear Information System (INIS)

Zhang Wei; Wang Jixian; Zhao Yongcheng; Li Benxiao; Fan Tiqiang; Zhao Zhigang; Lin Zhidong

2002-01-01

Objective: To investigate risk factors of coronary heart disease (CHD) in medical diagnostic X-ray workers in China, especially the relationship of CHD with occupational irradiation. Methods: A 1:2 matched case-control study was carried out. The study subjects consisted of 112 pair-matched cases and controls coming from different hospitals in China. Information about occupational and non-occupational risk factors obtained by interviewing every subjects personally. Individual doses were estimated by normalized work load method. SAS 6.12 software conditional Logistic regression method was applied to data analysis. Results: Variables such as family history of CHD (OR=17.298, P = 0.0001), history of hypertension (OR = 6.172, P = 0.0003), overweight (OR = 2.679, P = 0.0150), physical exercises (OR = 0.421, P0.0333), diabetes (OR = 7.823, P = 0.0200), radiation protection condition (OR = 3.992, P 0.0027), and accumulated radiation dose (OR = 1.612, P 0.0454) were included in the last model. Conclusions: For the medical diagnostic X-ray workers, family history of coronary heart disease, history of hypertension, diabetes, etc. are the main risk factors of CHD, and occupational exposure may be a potential risk factor. As for the mechanism, further studies are needed

Medical applications of model-based dynamic thermography

Science.gov (United States)

Nowakowski, Antoni; Kaczmarek, Mariusz; Ruminski, Jacek; Hryciuk, Marcin; Renkielska, Alicja; Grudzinski, Jacek; Siebert, Janusz; Jagielak, Dariusz; Rogowski, Jan; Roszak, Krzysztof; Stojek, Wojciech

2001-03-01

The proposal to use active thermography in medical diagnostics is promising in some applications concerning investigation of directly accessible parts of the human body. The combination of dynamic thermograms with thermal models of investigated structures gives attractive possibility to make internal structure reconstruction basing on different thermal properties of biological tissues. Measurements of temperature distribution synchronized with external light excitation allow registration of dynamic changes of local temperature dependent on heat exchange conditions. Preliminary results of active thermography applications in medicine are discussed. For skin and under- skin tissues an equivalent thermal model may be determined. For the assumed model its effective parameters may be reconstructed basing on the results of transient thermal processes. For known thermal diffusivity and conductivity of specific tissues the local thickness of a two or three layer structure may be calculated. Results of some medical cases as well as reference data of in vivo study on animals are presented. The method was also applied to evaluate the state of the human heart during the open chest cardio-surgical interventions. Reference studies of evoked heart infarct in pigs are referred, too. We see the proposed new in medical applications technique as a promising diagnostic tool. It is a fully non-invasive, clean, handy, fast and affordable method giving not only qualitative view of investigated surfaces but also an objective quantitative measurement result, accurate enough for many applications including fast screening of affected tissues.

Visualizing and measuring the temperature field produced by medical diagnostic ultrasound using thermography

International Nuclear Information System (INIS)

Vachutka, J; Grec, P; Mornstein, V; Caruana, C J

2008-01-01

The heating of tissues by diagnostic ultrasound can pose a significant hazard particularly in the imaging of the unborn child. The demonstration of the temperature field in tissue is therefore an important objective in the teaching of biomedical physics to healthcare professionals. The temperature field in a soft tissue model was made visible and measured using thermography. Temperature data from the images were used to investigate the dependence of temperature increase within the model on ultrasound exposure time and distance from the transducer. The experiment will be used within a multi-professional biomedical physics teaching laboratory for enhancing learning regarding the principles of thermography and the thermal effects of ultrasound to medical and healthcare students and also for demonstrating the quantitative use of thermographic imaging to students of biophysics, medical physics and medical technology

Radiation doses to patients in medical diagnostic x-ray examinations in New Zealand: a 1983-84 survey

International Nuclear Information System (INIS)

Williamson, B.D.P.; Poletti, J.L.; Cartwright, P.H.; Le Heron, J.C.

1993-06-01

A survey of doses to patients undergoing diagnostic x-ray examinations was performed in 1983-84. Developments since 1983-84 were reviewed and estimates made of the frequency of x-ray examinations, and doses to patients, as at 1992. The collective effective dose from general medical diagnostic radiology in 1983-84 was estimated to have been about 443 μSv per capita per annum. The figure excluded computed tomography which was estimated to have contributed about 5.6 μSv per capita per annum and mammography gave 0.3 μSv per annum. The total per capital effective dose from all medical diag over the whole period from 1983-84 to 1992. The highest dose examinations in 1983-84 were the fluoroscopic procedures barium enema and meal. Over the whole period 1983-84 to 1992 the genetically significant dose (GSD) to the population of New Zealand from medical diagnostic radiology was estimated to have been in the range 200-250 μSv per capita per annum. The two opposing tendencies noted for effective dose, viz, the fall in frequency of some examination types and the rise of Computed tomography, acted also upon this dose index. 43 refs., tabs., figs., ills

An epidemiologic investigation of cancers among medical diagnostic X-ray workers of 1950-1996 in Jiangsu province

International Nuclear Information System (INIS)

Yu Ningle; Wang Jin; Xu Cuizhen; Hu Lianzhi; Hou Bijun

2001-01-01

Objective: To research the phenomenon and characteristic of radiation oncogenesis among medical diagnostic X-ray workers. Methods: The cancer incidence data of the fixed cohort from the beginning of 1950 to the end of 1996 were collected. The estimates of relative risk (RR) were calculated by AMFIT in Epicure (Hirosoft International Corp, 1988-1992). Results: During the period of 1950-1996 there were 312 cancers among 215 355 person-years at risk in a cohort of 7701 subjects, including, medical diagnostic X-ray workers and workers of other departments in the same hospitals. The RR adjusted for sex and age for overall cancers was more than 1. The incidence of female breast cancer increased significantly (RR = 3.3, 95%, CI = 1.39 - 8.07), and the relative risks for solid cancer and leukemia were 1.2 and 2.6, respectively. The average age of occurrence of malignant tumors was moved up from 55.0 years in the controls to 51.3 years in the X-ray workers. Conclusions: There is a positive effect of radiation oncogenesis on medical diagnostic X-ray workers, although the sample size is not large enough to make a definite overall conclusion statistically. Further follow-up is needed

A flexible mobile-device biosensing instrumentation platform for point-of-care medical diagnostics applications

DEFF Research Database (Denmark)

Patou, François; Pfreundt, Andrea; Zulfiqar, Azeem

2014-01-01

helping to address this challenge. Specifically, Lab-on-Chip (LoC) devices have a key role to play in the advent of Point-of-Care (PoC) medical applications, driving a shift of the medical diagnostics paradigm and the transition from a centralized, technical, high-throughput biological sample analysis...... programmable electrical readout from LoCs potentially comprehending varied transducers addressing different targeted biological markers. A smart-phone/tablet docking-station embeds the hardware interface necessary for the implementation of a smart-phone digital lock-in amplifier. The platform is tested...

Advance of the National Program of Radiological Protection and Safety for medical diagnostic with X-rays

International Nuclear Information System (INIS)

Verdejo S, M.

1999-01-01

The National Program of Radiological Protection and Safety for medical diagnostic with X-ray (Programa Nacional de Proteccion y Seguridad Radiologica para diagnostico medico con rayos X) was initiated in the General Direction of Environmental Health (Direccion General de Salud Ambiental) in 1995. Task coordinated with different dependences of the Public Sector in collaboration between the Secretary of Health (Secretaria de Salud), the National Commission of Nuclear Safety and Safeguards (Comision Nacional de Seguridad Nuclear y Salvaguardias) and, the National Institute of Nuclear Research (Instituto Nacional de Investigaciones Nucleares). The surveillance to the fulfilment of the standardization in matter of Radiological Protection and Safety in the medical diagnostic with X-rays has been obtained for an important advance in the Public sector and it has been arousing interest in the Private sector. (Author)

Integrating Nursing Diagnostic Concepts into the Medical Entities Dictionary Using the ISO Reference Terminology Model for Nursing Diagnosis

OpenAIRE

Hwang, Jee-In; Cimino, James J.; Bakken, Suzanne

2003-01-01

Objective: The purposes of the study were (1) to evaluate the usefulness of the International Standards Organization (ISO) Reference Terminology Model for Nursing Diagnoses as a terminology model for defining nursing diagnostic concepts in the Medical Entities Dictionary (MED) and (2) to create the additional hierarchical structures required for integration of nursing diagnostic concepts into the MED.

Medical ADP Systems: Automated Medical Records Hold Promise to Improve Patient Care

Science.gov (United States)

1991-01-01

automated medical records. The report discusses the potential benefits that automation could make to the quality of patient care and the factors that impede...information systems, but no organization has fully automated one of the most critical types of information, patient medical records. The patient medical record...its review of automated medical records. GAO’s objectives in this study were to identify the (1) benefits of automating patient records and (2) factors

The introduction of compulsory compliance testing of medical diagnostic x-ray equipment in Western Australia

International Nuclear Information System (INIS)

Rafferty, M. W.; Jacob, C. S.

1995-01-01

Performance testing of medical diagnostic X-ray equipment can reveal equipment faults which, while not always clinically detectable, may contribute to reduced image quality and unnecessary radiation exposure of both patients and staff. Routine testing of such equipment is highly desirable to identify such faults and allows them to be rectified. The Radiological council of Western Australia is moving towards requiring compulsory compliance testing of all (new and existing) medical diagnostic X-ray equipment that all new mobile radiographic and new mammographic X-ray equipment be issued with a compliance test certificate as a prerequisite for registration. Workbooks which provide details of the tests required and recommended test methods have been prepared for medical radiographic (mobile and fixed), fluoroscopic and mammographic X-ray equipment. It is intended that future workbooks include details of the tests and methods for dental and computed tomography X-ray units. The workbooks are not limited to the compliance testing of items as specified in the Regulations, but include tests for other items such as film processing, darkrooms and image quality (for fluoroscopic equipment). Many of the workbook tests could be used within a regular quality assurance program for diagnostic X-ray equipment. Persons who conduct such compliance tests will need to be licensed and have all test certificates endorsed by a qualified expert. Suitable training and assessment of compliance testers will be required. Notification of such tests (including non-compliant items and corrective actions taken) will be required by the Radiological Council as a condition of equipment registration. 9 refs

Moving beyond quality control in diagnostic radiology and the role of the clinically qualified medical physicist.

Science.gov (United States)

Delis, H; Christaki, K; Healy, B; Loreti, G; Poli, G L; Toroi, P; Meghzifene, A

2017-09-01

Quality control (QC), according to ISO definitions, represents the most basic level of quality. It is considered to be the snapshot of the performance or the characteristics of a product or service, in order to verify that it complies with the requirements. Although it is usually believed that "the role of medical physicists in Diagnostic Radiology is QC", this, not only limits the contribution of medical physicists, but is also no longer adequate to meet the needs of Diagnostic Radiology in terms of Quality. In order to assure quality practices more organized activities and efforts are required in the modern era of diagnostic radiology. The complete system of QC is just one element of a comprehensive quality assurance (QA) program that aims at ensuring that the requirements of quality of a product or service will consistently be fulfilled. A comprehensive Quality system, starts even before the procurement of any equipment, as the need analysis and the development of specifications are important components under the QA framework. Further expanding this framework of QA, a comprehensive Quality Management System can provide additional benefits to a Diagnostic Radiology service. Harmonized policies and procedures and elements such as mission statement or job descriptions can provide clarity and consistency in the services provided, enhancing the outcome and representing a solid platform for quality improvement. The International Atomic Energy Agency (IAEA) promotes this comprehensive quality approach in diagnostic imaging and especially supports the field of comprehensive clinical audits as a tool for quality improvement. Copyright © 2017 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.

The study on cytogenetic analysis and dosimetry reconstruction for medical diagnostic X-ray workers using G-banding and fluorescence in situ hybridization

International Nuclear Information System (INIS)

Li Jin; Wang Qin; Tang Weisheng; Sun Yuanming; Wang Zhiquan

2003-01-01

Objective: To estimate the dose of medical diagnostic X-ray workers. Methods: The chromosome aberrations were analyzed by G-banding or FISH in medical diagnostic X-ray workers with different calendar years of entry. Results: The biological doses estimated by the two methods were in agreement with the doses evaluated by physical methods. Conclusion: G-banding and FISH are effective ways to analyse the chromosome translocations

Professional development of medical students: problems and promises.

Science.gov (United States)

Wear, D

1997-12-01

Observers and critics of the medical profession, both within and without, urge that more attention be paid to the moral sensibilities, the characters, of medical students. Passing on particular moral values and actions to physicians has always been an essential core of medical training, and this call for renewal is not new in modern medicine. Some of the structures and characteristics of modern medical education, however, often work directly against the professionalism that the education espouses. For example, medical students are socialized into a hierarchy that has broad implications for relations among health care professionals, other health care workers, and patients, and academic medicine has not promoted and taught critical reflection about the values and consequences of this hierarchy. Further, behind the formal curriculum lies the "hidden curriculum" of values that are unconsciously or half-consciously passed on from the faculty and older trainees. Two resources for thinking anew about professional development for medical students are feminist standpoint theory and critical multicultural theory, each of which raises important and fundamental questions about defining the role of medicine in society and the role of the physician in medicine. The author discusses these two theories and their implications for medical education, showing how they can be used to move discussions of professional development into analysis of the widespread social consequences of how a society organizes its health care and into critical reflection on the nature of medical knowledge.

In-phantom spectrometry of medical diagnostic x rays

International Nuclear Information System (INIS)

Stansbury, P.S.

1977-10-01

A program of measurements was made to determine the spectral fluence distributions at locations of significance in a heterogeneous, hominoid phantom exposed to x rays in a manner simulating medical diagnostic radiology. The measurements were made with a specially constructed NaI(Tl) scintillation detector. The detector had a spherically shaped active volume 0.6 cm in diameter. The resolution of this detector was five times worse than that of a more conventional NaI(Tl) spectrometer. Resolution broadening and other distortions were removed from the observed pulse height spectra with a computer-coded, iterative unfolding technique. The performance of the spectrometer and the unfolding scheme was assessed by comparing, in a few cases, the unfolded NaI(Tl) spectra with spectra determined with a high resolution Ge(Li) spectrometer. The measurements were made in a physical model of an idealized representation of an average adult patient

In-phantom spectrometry of medical diagnostic x rays

Energy Technology Data Exchange (ETDEWEB)

Stansbury, P. S.

1977-10-01

A program of measurements was made to determine the spectral fluence distributions at locations of significance in a heterogeneous, hominoid phantom exposed to x rays in a manner simulating medical diagnostic radiology. The measurements were made with a specially constructed NaI(Tl) scintillation detector. The detector had a spherically shaped active volume 0.6 cm in diameter. The resolution of this detector was five times worse than that of a more conventional NaI(Tl) spectrometer. Resolution broadening and other distortions were removed from the observed pulse height spectra with a computer-coded, iterative unfolding technique. The performance of the spectrometer and the unfolding scheme was assessed by comparing, in a few cases, the unfolded NaI(Tl) spectra with spectra determined with a high resolution Ge(Li) spectrometer. The measurements were made in a physical model of an idealized representation of an average adult patient.

Medical capsule robots: A renaissance for diagnostics, drug delivery and surgical treatment.

Science.gov (United States)

Mapara, Sanyat S; Patravale, Vandana B

2017-09-10

The advancements in electronics and the progress in nanotechnology have resulted in path breaking development that will transform the way diagnosis and treatment are carried out currently. This development is Medical Capsule Robots, which has emerged from the science fiction idea of robots travelling inside the body to diagnose and cure disorders. The first marketed capsule robot was a capsule endoscope developed to capture images of the gastrointestinal tract. Today, varieties of capsule endoscopes are available in the market. They are slightly larger than regular oral capsules, made up of a biocompatible case and have electronic circuitry and mechanisms to capture and transmit images. In addition, robots with diagnostic features such as in vivo body temperature detection and pH monitoring have also been launched in the market. However, a multi-functional unit that will diagnose and cure diseases inside the body has not yet been realized. A remote controlled capsule that will undertake drug delivery and surgical treatment has not been successfully launched in the market. High cost, inadequate power supply, lack of control over drug release, limited space for drug storage on the capsule, inadequate safety and no mechanisms for active locomotion and anchoring have prevented their entry in the market. The capsule robots can revolutionize the current way of diagnosis and treatment. This paper discusses in detail the applications of medical capsule robots in diagnostics, drug delivery and surgical treatment. In diagnostics, detailed analysis has been presented on wireless capsule endoscopes, issues associated with the marketed versions and their corresponding solutions in literature. Moreover, an assessment has been made of the existing state of remote controlled capsules for targeted drug delivery and surgical treatment and their future impact is predicted. Besides the need for multi-functional capsule robots and the areas for further research have also been

Diagnostic imaging over the last 50 years: research and development in medical imaging science and technology

International Nuclear Information System (INIS)

Doi, Kunio

2006-01-01

Over the last 50 years, diagnostic imaging has grown from a state of infancy to a high level of maturity. Many new imaging modalities have been developed. However, modern medical imaging includes not only image production but also image processing, computer-aided diagnosis (CAD), image recording and storage, and image transmission, most of which are included in a picture archiving and communication system (PACS). The content of this paper includes a short review of research and development in medical imaging science and technology, which covers (a) diagnostic imaging in the 1950s, (b) the importance of image quality and diagnostic performance, (c) MTF, Wiener spectrum, NEQ and DQE, (d) ROC analysis, (e) analogue imaging systems, (f) digital imaging systems, (g) image processing, (h) computer-aided diagnosis, (i) PACS, (j) 3D imaging and (k) future directions. Although some of the modalities are already very sophisticated, further improvements will be made in image quality for MRI, ultrasound and molecular imaging. The infrastructure of PACS is likely to be improved further in terms of its reliability, speed and capacity. However, CAD is currently still in its infancy, and is likely to be a subject of research for a long time. (review)

Upgrading the Medical Physics Calibration Laboratory Towards ISO/IEC 17025: Radiation Standards and Calibration in Diagnostic Radiology

International Nuclear Information System (INIS)

Asmaliza Hashim; Muhammad Jamal Md Isa; Abd Aziz Mhd Ramli; Wan Hazlinda Ismail; Norhayati Abdullah; Shahrul Azlan Azizan; Siti Sara Deraman; Nor Azlin Azraai; Md Khairusalih Md Zin

2010-01-01

Calibration of quality control (QC) test tools used in diagnostic radiology is legally required under the Ministry of Health (MOH) requirement. The Medical Physics Calibration Laboratory of the Malaysian Nuclear Agency is the national focal point for the calibration of quality control test tools used in diagnostic radiology. The Medical Physics Calibration Laboratory has measurement traceability to primary standard dosimetry laboratory (Physikalisch-Technische Bundesanstalt (PTB)), thus providing an interface between the primary standard dosimetry laboratory and Malaysian hospitals, clinics and license class H holder. The Medical Physics Calibration Laboratory facility is comprised of a constant potential x-ray system with a capability of 160 kV tube and a series of reference and working standard ion chambers. The stability of reference and working standard ion chambers was measured using strontium-90. Dosimetric instruments used in diagnostic radiology is calibrated in terms of air kerma to comply with an International Code of Practices of dosimetry for example IAEA's Technical Report Series number 457. The new series of standard radiation qualities was established based on ISO/IEC 61267. The measurement of beam homogeneity was measured using film and ion chamber to define the field size at certain distance and kV output was measured using the spectrometer and non-invasive kVp meter. The uncertainties measurement was determined with expended uncertainties to a level of confidence of approximately 95% (coverage factor k=2). This paper describes the available facility and the effort of the Medical Physics Calibration Laboratory to upgrade the laboratory towards ISO/IEC 17025. (author)

Unintentional exposure to radiation during pregnancy from nuclear medical diagnostic procedures; Unabsichtliche Strahlenexposition in der Schwangerschaft durch nuklearmedizinische Diagnostik

Energy Technology Data Exchange (ETDEWEB)

Moka, D. [Gemeinschaftspraxis fuer Radiologie und Nuklearmedizin, Essen (Germany)

2005-12-01

The administration of radiopharmaceuticals during pregnancy is contraindicated due to a lack of vital indications. However, if prenatal exposure to radiation should occur in the framework of a nuclear medical diagnostic procedure then fortunately no longterm side-effects would normally be expected. Radiation damage in the preimplantation phase leads to early abortion. However, if the further course of pregnancy remains uncomplicated then no subsequent side-effects need be expected. On a conservative estimate, it would require doses exceeding 50 mGy to cause radiation damage within the uterus after the preimplantation phase. However, the standard radioactivities applied for diagnostic purposes in nuclear medicine, can be obtained with doses of less than 20 mGy. On the basis of current knowledge, therefore, there is no reason to terminate pregnancy on medical grounds after diagnostic exposure to radiopharmaceuticals. (orig.)

The potential of high resolution melting analysis (hrma) to streamline, facilitate and enrich routine diagnostics in medical microbiology.

Science.gov (United States)

Ruskova, Lenka; Raclavsky, Vladislav

2011-09-01

Routine medical microbiology diagnostics relies on conventional cultivation followed by phenotypic techniques for identification of pathogenic bacteria and fungi. This is not only due to tradition and economy but also because it provides pure culture needed for antibiotic susceptibility testing. This review focuses on the potential of High Resolution Melting Analysis (HRMA) of double-stranded DNA for future routine medical microbiology. Search of MEDLINE database for publications showing the advantages of HRMA in routine medical microbiology for identification, strain typing and further characterization of pathogenic bacteria and fungi in particular. The results show increasing numbers of newly-developed and more tailor-made assays in this field. For microbiologists unfamiliar with technical aspects of HRMA, we also provide insight into the technique from the perspective of microbial characterization. We can anticipate that the routine availability of HRMA in medical microbiology laboratories will provide a strong stimulus to this field. This is already envisioned by the growing number of medical microbiology applications published recently. The speed, power, convenience and cost effectiveness of this technology virtually predestine that it will advance genetic characterization of microbes and streamline, facilitate and enrich diagnostics in routine medical microbiology without interfering with the proven advantages of conventional cultivation.

Study of results of prophylactic medical examination of personnel of radioisotope diagnostic laboratories

International Nuclear Information System (INIS)

Mokrousova, Eh.V.

1988-01-01

Preliminary results of the analysis of frequency of revealed diseases in radiological diagnostic personnel of leningrad medical establishments are given. A close connection between the frequency of revealed diseases and the age is more manifested than between the frequency of revealed diseases and personnel length of service. By the end of occupational activity the frequency of radiological personnel diseases doesn't exceed the similar frequency in population. 3 refs; 2 tabs

Noncancer death for medical diagnostic X-ray workers in China, 1950-1995

International Nuclear Information System (INIS)

Jia Weihua; Wang Jixian; Li Benxiao; Zhao Yongcheng; Zhang Jingyuan

2002-01-01

Objective: To investigate occupational radiation exposure effects on human non-cancer diseases. Methods: A cohort study for medical diagnostic X-ray workers and medical workers who never engaged in X-ray work was carried out. Results: The significantly enhanced noncancer deaths for X-ray workers were showed as follows: ischemic heart disease, RR was 1.39 ( P < 0.01 ); cerebrovascular disease, RR = 1.36 ( P < 0.01 ); aplastic anemia, RR = 10.35 (P < 0.01 ); disease of the nervous system, RR = 2.06 (P < 0.01); disease of the skin and subcutaneous tissues, RR = 3.23 (P < 0.05). Conclusions: Long-term occupational X-ray irradiation can enhance the overall risk of deaths, in which, risk for heart disease, cerebrovascular disease and aplastic anemia deaths may significantly related to the occupational exposure

Role of the medical physicist in quality control in diagnostic x-ray departments

International Nuclear Information System (INIS)

Cameron, J.R.

1973-01-01

Medical physicists can play a role in education of future radiologists and technologists by teaching quality control needs and techniques. He or she can also provide service to the diagnostic section by establishing a quality control program. Finally, the medical physicist can play an important role in the development of simple and inexpensive techniques for quality control by radiological technologists. The ongoing work at the University of Wisconsin in this area is to provide quality control in measurement of the effective kVcp, the measurement of the effective focal spot size, the performance of the processing equipment, the output in mR/mAs, and the measurement of the half-value-layer and the total filtration. (U.S.)

Diagnostic Imaging Workshop

International Nuclear Information System (INIS)

Sociedad Argentina de Fisica Medica

2012-01-01

The American Association of Physicist in Medicine (AAPM), the International Organization for Medical Physics (IOMP) and the Argentina Society of Medical Physics (SAFIM) was organized the Diagnostic Imaging Workshop 2012, in the city of Buenos Aires, Argentina. This workshop was an oriented training and scientific exchange between professionals and technicians who work in medical physics, especially in the areas of diagnostic imaging, nuclear medicine and radiotherapy, with special emphasis on the use of multimodal imaging for radiation treatment, planning as well of quality assurance associates.

Advances in medical diagnostic technology

CERN Document Server

Lai, Khin Wee; Mohamad Salim, Maheza Irna; Ong, Sang-Bing; Utama, Nugraha Priya; Myint, Yin Mon; Mohd Noor, Norliza; Supriyanto, Eko

2014-01-01

This book provides the most recent findings and knowledge in advanced diagnostics technology, covering a wide spectrum including brain activity analysis, breast and lung cancer detection, echocardiography, computer aided skeletal assessment to mitochondrial biology imaging at the cellular level. The authors explored magneto acoustic approaches and tissue elasticity imaging for the purpose of breast cancer detection. Perspectives in fetal echocardiography from an image processing angle are included. Diagnostic imaging in the field of mitochondrial diseases as well as the use of Computer-Aided System (CAD) are also discussed in the book. This book will be useful for students, lecturers or professional researchers in the field of biomedical sciences and image processing.

Design of portable ultraminiature flow cytometers for medical diagnostics

Science.gov (United States)

Leary, James F.

2018-02-01

Design of portable microfluidic flow/image cytometry devices for measurements in the field (e.g. initial medical diagnostics) requires careful design in terms of power requirements and weight to allow for realistic portability. True portability with high-throughput microfluidic systems also requires sampling systems without the need for sheath hydrodynamic focusing both to avoid the need for sheath fluid and to enable higher volumes of actual sample, rather than sheath/sample combinations. Weight/power requirements dictate use of super-bright LEDs with top-hat excitation beam architectures and very small silicon photodiodes or nanophotonic sensors that can both be powered by small batteries. Signal-to-noise characteristics can be greatly improved by appropriately pulsing the LED excitation sources and sampling and subtracting noise in between excitation pulses. Microfluidic cytometry also requires judicious use of small sample volumes and appropriate statistical sampling by microfluidic cytometry or imaging for adequate statistical significance to permit real-time (typically in less than 15 minutes) initial medical decisions for patients in the field. This is not something conventional cytometry traditionally worries about, but is very important for development of small, portable microfluidic devices with small-volume throughputs. It also provides a more reasonable alternative to conventional tubes of blood when sampling geriatric and newborn patients for whom a conventional peripheral blood draw can be problematical. Instead one or two drops of blood obtained by pin-prick should be able to provide statistically meaningful results for use in making real-time medical decisions without the need for blood fractionation, which is not realistic in the doctor's office or field.

Beyond Diagnostic Accuracy: The Clinical Utility of Diagnostic Tests

NARCIS (Netherlands)

Bossuyt, Patrick M. M.; Reitsma, Johannes B.; Linnet, Kristian; Moons, Karel G. M.

2012-01-01

Like any other medical technology or intervention, diagnostic tests should be thoroughly evaluated before their introduction into daily practice. Increasingly, decision makers, physicians, and other users of diagnostic tests request more than simple measures of a test's analytical or technical

Applying Machine Learning to Facilitate Autism Diagnostics: Pitfalls and Promises

Science.gov (United States)

Bone, Daniel; Goodwin, Matthew S.; Black, Matthew P.; Lee, Chi-Chun; Audhkhasi, Kartik; Narayanan, Shrikanth

2015-01-01

Machine learning has immense potential to enhance diagnostic and intervention research in the behavioral sciences, and may be especially useful in investigations involving the highly prevalent and heterogeneous syndrome of autism spectrum disorder. However, use of machine learning in the absence of clinical domain expertise can be tenuous and lead…

Lists I and II, nuclear medical diagnostics. As of January 18, 1983

International Nuclear Information System (INIS)

1983-01-01

The information booklet presents the guidelines of the Federal Association of Panel Doctors, concerning the minimum equipment required for nuclear medical diagnostics practices (nuclear medical equipment guidelines), in the amended version of May 18, 1981; it also contains the list I (modern commercially available equipment) and the list II (older types of equipment). The devices specified in these lists are products of firms that are members of the ZVEI, and are in compliance with the guidelines of the Panel Doctors' Association. Combinations of older computer equipment/cameras with up-to-date equipment, also come up to the standards given in the guidelines if specifically mentioned therein. The list of manufacturers gives addresses of the manufacturers of the equipment stated in list I and II. An appendix up-dates the information to the date of October 1, 1986. (orig./HP) [de

Ionizing radiation used in medical diagnostics as a source of radiation exposure of the patient with occupational diseases. Analysis and problems

International Nuclear Information System (INIS)

Apostolova, D.B.; Paskalev, Z.D.

2001-01-01

X-rays in medical diagnostic are the major source of Bulgarian population exposure to ionizing radiations. Diagnostic X-ray is the most diagnostic application and is used in a wide variety of examinations. The modern concept for radiation protection of patients in diagnostic radiology is based on two main principles: justification of the examinations and radiation protection optimization. It is pointed out that the collective effective dose of radiation may be considerably reduced by decreasing the number of clinically unwarranted X-ray examination of storage and delivery of diagnostic information and adopting a system for physical and technical quality control of the X-ray equipment. The aim of this investigation is assessment of the collective effective doses for the patients with occupational diseases exposed to ionizing radiation by radiological diagnostics. The study covers the period of 1990 through 1999. A total of 3293 patients, treated in the Department of Occupational Toxicology, Clinic of Occupational Diseases, Medical University - Sofia, were examined with X-ray and KT (cervical and lumbar spine, chest, skull, stomach, extremities, pelvis, brain). Most of the observed patients were with predominantlyheavy metals poisonings and a few with other chemical agents poisonings. Number of patients with radiological examinations was 1938, number of examination per capita was 0,59 and the total number of radiological examinations was 2536. The average number of radiological examination for one patient was 1,36, the most number of radiological examinations for one patient was 4. The collective effective dose for an examined patient was 1803 man.mSv. Our results shown the essential of the raising ensure that the medical exposure of patients be the minimum necessary to achieve the required diagnostic objective. (author)

Collective dose estimation in Portuguese population due to medical exams of diagnostic radiology and nuclear medicine

International Nuclear Information System (INIS)

Teles, Pedro; Vaz, Pedro; Paulo, Graciano; Santos, Joana; Pascoal, Ana; Lanca, Isabel; Matela, Nuno; Sousa, Patrick; Carvoeiras, Pedro; Parafita, Rui; Simaozinho, Paula

2013-01-01

In order to assess the exposure of the Portuguese population to ionizing radiation due to medical examinations of diagnostic radiology and nuclear medicine, a working group, consisting of 40 institutions, public and private, was created to evaluation the coletive dose in the Portuguese population in 2010. This work was conducted in collaboration with the Dose Datamed European consortium, which aims to assess the exposure of the European population to ionizing radiation due to 20 diagnostic radiology examinations most frequent in Europe (the 'TOP 20') and nuclear medicine examinations. We obtained an average value of collective dose of ≈ 1 mSv/caput, which puts Portugal in the category of countries medium to high exposure to Europe. We hope that this work can be a starting point to bridge the persistent lack of studies in the areas referred to in Portugal, and to enable the characterization periodic exposure of the Portuguese population to ionizing radiation in the context of medical applications

Diagnostic value and safety of medical thoracoscopy in tuberculous pleural effusion.

Science.gov (United States)

Wang, Zhen; Xu, Li-Li; Wu, Yan-Bing; Wang, Xiao-Juan; Yang, Yuan; Zhang, Jun; Tong, Zhao-Hui; Shi, Huan-Zhong

2015-09-01

Differentiating tuberculous pleural effusion from other lymphocytic pleural effusions is often challenging. This retrospective study aimed to assess the efficacy and safety of medical thoracoscopy in patients with suspected tuberculous pleural effusion. Between July 2005 and June 2014, patients with pleural effusions of unknown etiologies underwent medical thoracoscopy in our institute after less invasive means of diagnosis had failed. Demographic, radiographic, procedural, and histological data of patients with tuberculous pleural effusion were analyzed. During this 9-year study, 333 of 833 patients with pleural effusion were confirmed to have tuberculous pleurisy. Under thoracoscopy, we observed pleural nodules in 69.4%, pleural adhesion in 66.7%, hyperemia in 60.7%, plaque-like lesions in 6.0%, ulceration in 1.5% of patients with tuberculous pleurisy. Pleural biopsy revealed the presence of Mycobacterium tuberculosis in the pleural tissue or/and demonstration of caseating granulomas in 330 (99.1%) patients. No serious adverse events were recorded, and the most common minor complication was transient chest pain (43.2%) from the indwelling chest tube. Our data showed that medical thoracoscopy is a simple procedure with high diagnostic yield and excellent safety for the diagnosis of tuberculous pleural effusion. Copyright © 2015 Elsevier Ltd. All rights reserved.

Final Validation of the ProMisE Molecular Classifier for Endometrial Carcinoma in a Large Population-based Case Series.

Science.gov (United States)

Kommoss, S; McConechy, M K; Kommoss, F; Leung, S; Bunz, A; Magrill, J; Britton, H; Kommoss, F; Grevenkamp, F; Karnezis, A; Yang, W; Lum, A; Krämer, B; Taran, F; Staebler, A; Lax, S; Brucker, S Y; Huntsman, D G; Gilks, C B; McAlpine, J N; Talhouk, A

2018-02-07

Based on The Cancer Genome Atlas, we previously developed and confirmed a pragmatic molecular classifier for endometrial cancers; ProMisE (Proactive Molecular Risk Classifier for Endometrial Cancer). ProMisE identifies four prognostically distinct molecular subtypes, and can be applied to diagnostic specimens (biopsy/curettings), enabling earlier informed decision-making. We have strictly adhered to the Institute of Medicine (IOM) guidelines for the development of genomic biomarkers, and herein present the final validation step of a locked-down classifier prior to clinical application. We assessed a retrospective cohort of women from the Tübingen University Women's Hospital treated for endometrial carcinoma between 2003-13. Primary outcomes of overall, disease-specific and progression-free survival were evaluated for clinical, pathological, and molecular features. Complete clinical and molecular data were evaluable from 452 women. Patient age ranged from 29 - 93 (median 65) years, and 87.8% cases were endometrioid histotype. Grade distribution included 282 (62.4%) G1, 75 (16.6%) G2, and 95 (21.0%) G3 tumors. 276 (61.1%) patients had stage IA disease, with the remaining stage IB (89 (19.7%)), stage II (26 (5.8%)), and stage III/IV (61 (13.5%)). ProMisE molecular classification yielded 127 (28.1%) MMR-D, 42 (9.3%) POLE, 55 (12.2%) p53abn, and 228 (50.4%) p53wt. ProMisE was a prognostic marker for progression-free (P=0.001) and disease-specific (P=0.03) survival even after adjusting for known risk factors. Concordance between diagnostic and surgical specimens was highly favorable; accuracy 0.91, kappa 0.88. We have developed, confirmed and now validated a pragmatic molecular classification tool (ProMisE) that provides consistent categorization of tumors and identifies four distinct prognostic molecular subtypes. ProMisE can be applied to diagnostic samples and thus could be used to inform surgical procedure(s) and/or need for adjuvant therapy. Based on the IOM

Evidence of the preferential use of disease prototypes over case exemplars among early year one medical students prior to and following diagnostic training.

Science.gov (United States)

Papa, Frank J; Li, Feiming

2015-12-01

Two core dual processing theory (DPT) System I constructs (Exemplars and Prototypes) were used to: 1) formulate a training exercise designed to improve diagnostic performance in year one medical students, and 2) explore whether any observed performance improvements were associated with preferential use of exemplars or prototypes. With IRB approval, 117 year one medical students participated in an acute chest pain diagnostic training exercise. A pre- and post-training test containing the same 27 case vignettes was used to determine if the subjects' diagnostic performance improved via training in both exemplars and prototypes. Exemplar and Prototype theory was also used to generate a unique typicality estimate for each case vignette. Because these estimates produce different performance predictions, differences in the subjects' observed performance would make it possible to infer whether subjects were preferentially using Exemplars or Prototypes. Pre- vs. post-training comparison revealed a significant performance improvement; t=14.04, pmid typical vignettes: t=4.94, pleast typical: t=5.16, pmid typical: t=2.94, pleast typical: t=6.64, ptheory than Exemplar theory. DPT is useful in designing and evaluating the utility of new approaches to diagnostic training, and, investigating the cognitive factors driving diagnostic capabilities among early medical students.

Diagnostic reasoning strategies and diagnostic success.

Science.gov (United States)

Coderre, S; Mandin, H; Harasym, P H; Fick, G H

2003-08-01

Cognitive psychology research supports the notion that experts use mental frameworks or "schemes", both to organize knowledge in memory and to solve clinical problems. The central purpose of this study was to determine the relationship between problem-solving strategies and the likelihood of diagnostic success. Think-aloud protocols were collected to determine the diagnostic reasoning used by experts and non-experts when attempting to diagnose clinical presentations in gastroenterology. Using logistic regression analysis, the study found that there is a relationship between diagnostic reasoning strategy and the likelihood of diagnostic success. Compared to hypothetico-deductive reasoning, the odds of diagnostic success were significantly greater when subjects used the diagnostic strategies of pattern recognition and scheme-inductive reasoning. Two other factors emerged as independent determinants of diagnostic success: expertise and clinical presentation. Not surprisingly, experts outperformed novices, while the content area of the clinical cases in each of the four clinical presentations demonstrated varying degrees of difficulty and thus diagnostic success. These findings have significant implications for medical educators. It supports the introduction of "schemes" as a means of enhancing memory organization and improving diagnostic success.

Dual Processing Model for Medical Decision-Making: An Extension to Diagnostic Testing.

Science.gov (United States)

Tsalatsanis, Athanasios; Hozo, Iztok; Kumar, Ambuj; Djulbegovic, Benjamin

2015-01-01

Dual Processing Theories (DPT) assume that human cognition is governed by two distinct types of processes typically referred to as type 1 (intuitive) and type 2 (deliberative). Based on DPT we have derived a Dual Processing Model (DPM) to describe and explain therapeutic medical decision-making. The DPM model indicates that doctors decide to treat when treatment benefits outweigh its harms, which occurs when the probability of the disease is greater than the so called "threshold probability" at which treatment benefits are equal to treatment harms. Here we extend our work to include a wider class of decision problems that involve diagnostic testing. We illustrate applicability of the proposed model in a typical clinical scenario considering the management of a patient with prostate cancer. To that end, we calculate and compare two types of decision-thresholds: one that adheres to expected utility theory (EUT) and the second according to DPM. Our results showed that the decisions to administer a diagnostic test could be better explained using the DPM threshold. This is because such decisions depend on objective evidence of test/treatment benefits and harms as well as type 1 cognition of benefits and harms, which are not considered under EUT. Given that type 1 processes are unique to each decision-maker, this means that the DPM threshold will vary among different individuals. We also showed that when type 1 processes exclusively dominate decisions, ordering a diagnostic test does not affect a decision; the decision is based on the assessment of benefits and harms of treatment. These findings could explain variations in the treatment and diagnostic patterns documented in today's clinical practice.

Dual Processing Model for Medical Decision-Making: An Extension to Diagnostic Testing.

Directory of Open Access Journals (Sweden)

Athanasios Tsalatsanis

Full Text Available Dual Processing Theories (DPT assume that human cognition is governed by two distinct types of processes typically referred to as type 1 (intuitive and type 2 (deliberative. Based on DPT we have derived a Dual Processing Model (DPM to describe and explain therapeutic medical decision-making. The DPM model indicates that doctors decide to treat when treatment benefits outweigh its harms, which occurs when the probability of the disease is greater than the so called "threshold probability" at which treatment benefits are equal to treatment harms. Here we extend our work to include a wider class of decision problems that involve diagnostic testing. We illustrate applicability of the proposed model in a typical clinical scenario considering the management of a patient with prostate cancer. To that end, we calculate and compare two types of decision-thresholds: one that adheres to expected utility theory (EUT and the second according to DPM. Our results showed that the decisions to administer a diagnostic test could be better explained using the DPM threshold. This is because such decisions depend on objective evidence of test/treatment benefits and harms as well as type 1 cognition of benefits and harms, which are not considered under EUT. Given that type 1 processes are unique to each decision-maker, this means that the DPM threshold will vary among different individuals. We also showed that when type 1 processes exclusively dominate decisions, ordering a diagnostic test does not affect a decision; the decision is based on the assessment of benefits and harms of treatment. These findings could explain variations in the treatment and diagnostic patterns documented in today's clinical practice.

The Medical Exposure to Ionizing Radiation and Protection of the Patient in Medical Imaging Procedures for Diagnostic and Therapeutic Purposes (Excluding Radiotherapy) using X-Rays in Israel - Risk - Cost and Benefit

International Nuclear Information System (INIS)

Ben-Shlomo, A.

1998-10-01

Diagnostic and therapeutic radiology is playing a major role in modern medicine. The utilization of devices emitting ionizing radiation for medical diagnostic and therapeutic purposes is classified into three categories: a. Radiotherapy procedures for the treatment of malignant and benign tumors. b. Nuclear medicine procedures using radiopharmaceuticals that are introduced into the patient's body for diagnostic and therapeutic purposes. c. Diagnostic and therapeutic x-ray imaging procedures. This group includes conventional radiography, conventional fluoroscopy, cardiac catheterization, angiography, CT, mammography, dental, and fluoroscopy operation procedures. A survey was carried out on a sample of three major Israeli hospitals in order to: 1. Determine the status of radiation protection of patients in Israel with regard to the use of x-rays in medical imaging and interventional radiology. 2. Assess the extent of exposure of the population to medical x-rays, and assess the collective risk in Israel in this relation (based on Icr-60). 3. Carry out a cost-benefit optimization procedure related to the means that should be used to reduce the exposure of Israeli patients under x-ray procedures. 4. Establish a of practical recommendations to reduce the x-ray radiation exposure of patients and to increase the image quality. 5. Establish a number of basic rules to be utilized by health policy makers in Israel

The Medical Exposure to Ionizing Radiation and Protection of the Patient in Medical Imaging Procedures for Diagnostic and Therapeutic Purposes (Excluding Radiotherapy) using X-Rays in Israel - Risk - Cost and Benefit

Energy Technology Data Exchange (ETDEWEB)

Ben-Shlomo, A

1998-10-01

Diagnostic and therapeutic radiology is playing a major role in modern medicine. The utilization of devices emitting ionizing radiation for medical diagnostic and therapeutic purposes is classified into three categories: a. Radiotherapy procedures for the treatment of malignant and benign tumors. b. Nuclear medicine procedures using radiopharmaceuticals that are introduced into the patient's body for diagnostic and therapeutic purposes. c. Diagnostic and therapeutic x-ray imaging procedures. This group includes conventional radiography, conventional fluoroscopy, cardiac catheterization, angiography, CT, mammography, dental, and fluoroscopy operation procedures. A survey was carried out on a sample of three major Israeli hospitals in order to: 1. Determine the status of radiation protection of patients in Israel with regard to the use of x-rays in medical imaging and interventional radiology. 2. Assess the extent of exposure of the population to medical x-rays, and assess the collective risk in Israel in this relation (based on Icr-60). 3. Carry out a cost-benefit optimization procedure related to the means that should be used to reduce the exposure of Israeli patients under x-ray procedures. 4. Establish a of practical recommendations to reduce the x-ray radiation exposure of patients and to increase the image quality. 5. Establish a number of basic rules to be utilized by health policy makers in Israel.

Optical biosensor technologies for molecular diagnostics at the point-of-care

Science.gov (United States)

Schotter, Joerg; Schrittwieser, Stefan; Muellner, Paul; Melnik, Eva; Hainberger, Rainer; Koppitsch, Guenther; Schrank, Franz; Soulantika, Katerina; Lentijo-Mozo, Sergio; Pelaz, Beatriz; Parak, Wolfgang; Ludwig, Frank; Dieckhoff, Jan

2015-05-01

Label-free optical schemes for molecular biosensing hold a strong promise for point-of-care applications in medical research and diagnostics. Apart from diagnostic requirements in terms of sensitivity, specificity, and multiplexing capability, also other aspects such as ease of use and manufacturability have to be considered in order to pave the way to a practical implementation. We present integrated optical waveguide as well as magnetic nanoparticle based molecular biosensor concepts that address these aspects. The integrated optical waveguide devices are based on low-loss photonic wires made of silicon nitride deposited by a CMOS compatible plasma-enhanced chemical vapor deposition (PECVD) process that allows for backend integration of waveguides on optoelectronic CMOS chips. The molecular detection principle relies on evanescent wave sensing in the 0.85 μm wavelength regime by means of Mach-Zehnder interferometers, which enables on-chip integration of silicon photodiodes and, thus, the realization of system-on-chip solutions. Our nanoparticle-based approach is based on optical observation of the dynamic response of functionalized magneticcore/ noble-metal-shell nanorods (`nanoprobes') to an externally applied time-varying magnetic field. As target molecules specifically bind to the surface of the nanoprobes, the observed dynamics of the nanoprobes changes, and the concentration of target molecules in the sample solution can be quantified. This approach is suitable for dynamic real-time measurements and only requires minimal sample preparation, thus presenting a highly promising point-of-care diagnostic system. In this paper, we present a prototype of a diagnostic device suitable for highly automated sample analysis by our nanoparticle-based approach.

Course of radiological protection and safety in the medical diagnostic with X-rays; Curso de proteccion y seguridad radiologica en el diagnostico medico con rayos X

Energy Technology Data Exchange (ETDEWEB)

Dominguez A, C.E. [Instituto Nacional de Investigaciones Nucleares, A.P. 18-1027, 11801 Mexico D.F. (Mexico)

1997-07-01

The obtention of images of human body to the medical diagnostic is one of the more old and generalized applications for X-ray. Therefore the design and performance of equipment and installations as well as the operation procedures must be oriented toward safety with the purpose to guarantee this radiological practice will bring a net positive benefit to the society. Given that in Mexico only exists the standardization related to source and equipment generators of ionizing radiation in the industrial area and medical therapy, but not so to the medical diagnostic area it is the purpose of this work to present those standards related with this application branch. Also it is presented the preparation of a manual for the course named Formation of teachers in radiological protection and safety in the X-ray medical diagnostic in 1997 which was imparted at ININ. (Author)

Virtual reality aided visualization of fluid flow simulations with application in medical education and diagnostics.

Science.gov (United States)

Djukic, Tijana; Mandic, Vesna; Filipovic, Nenad

2013-12-01

Medical education, training and preoperative diagnostics can be drastically improved with advanced technologies, such as virtual reality. The method proposed in this paper enables medical doctors and students to visualize and manipulate three-dimensional models created from CT or MRI scans, and also to analyze the results of fluid flow simulations. Simulation of fluid flow using the finite element method is performed, in order to compute the shear stress on the artery walls. The simulation of motion through the artery is also enabled. The virtual reality system proposed here could shorten the length of training programs and make the education process more effective. © 2013 Published by Elsevier Ltd.

Magnetic resonance imaging and spectroscopy- emerging trends in medical diagnostics and therapy

International Nuclear Information System (INIS)

Deshmukh, Sudha

1997-01-01

A dramatic acceleration in the application of magnetic resonance techniques in the field of medical sciences has been witnessed over the past decade. Magnetic Resonance Imaging (MRI) has been called the most significant development since the discovery of x-rays. As a method of visualizing cross-sectional anatomy, MRI is without peer. MRI images can now provide in-vivo anatomical details that were earlier available only with invasive procedures. Yet, despite its extraordinary potential, MRI has had limited success, if any, in tissue characterization using the three image parameters T 1 , T 2 and proton density ρ. MR spectroscopy has however bridged this gap to a large extent and opened up the possibility of studying in vivo chemistry. In the present article an attempt has been made to give a brief account of the application of magnetic resonance imaging and spectroscopy in medical diagnostics and therapy. The basic principles pertaining to MRI and MRS are also discussed in brief. (author)

Diagnostic Biomarkers for Posttraumatic Stress Disorder (PTSD): Promising Horizons from Translational Neuroscience Research

OpenAIRE

Michopoulos, Vasiliki; Norrholm, Seth Davin; Jovanovic, Tanja

2015-01-01

Posttraumatic stress disorder (PTSD) is a heterogeneous disorder that affects individuals exposed to trauma (e.g., combat, interpersonal violence, and natural disasters). Although its diagnostic features have been recently re-classified with the emergence of the Diagnostic and Statistical Manual for Mental Disorders, Fifth Edition (DSM-5), the disorder remains characterized by hyperarousal, intrusive reminders of the trauma, avoidance of trauma-related cues, and negative cognition and mood. T...

Diagnostic x-ray in use in federal medical centre, case study Makurdi metropolis

International Nuclear Information System (INIS)

Onoja, R.A.; Fiase, J.O.

2009-01-01

Every year more than two thousand patients go for routine medical check-up at the Federal Medical Centre using diagnostic x-rays. This paper is based on a study to determine the entrance surface doses per radiograph of 108 patients that had diagnostic examinations at the Federal Medical Centre Makurdi. The examinations considered in this study are chest x-ray examinations, abdomen, skull and other extremities, for both adults and children. The results show that the mean entrance surface doses of PA chest x-ray for female range between 237-275μGy, for male is between 1183-297μGy, and for children range between 47-237μGy. The AP chest x-ray for female range between 1943-3440μGy, for male is between 1583-3484μGy and for children it ranges between 177-451μGy. The PA examination of the skull for adult female ranged between 117-787μGy, for male it ranged between 117-532μGy and children from 472-948μGy. Also for the AP examination for skull the adult female mean entrance surface doses range from 129-798μGy, for the male it range from 145-178μGy and for children 138-650μGy. The AP abdomen for adult female produces a mean entrance surface doses range between 620-682μGy, for the male is between 105-930μGy, and children it range between 144-398μGy. In the case of extremities AP examination are between the range of 173-468μGy for adult female, 300-595μGy for adult male and between 254-887μGy for the children. In the case of extremities PA examination mean entrance surface doses are between the range of 145-517μGy for adult female, 363-517μGy for adult male and between 130-566μGy for the children. The data shows that the entrance surface doses due to the x-ray examination for adult and children are within the ICRP guidance levels. These guidance levels of dose for diagnostic radiography for a typical adult patient are 10 mGy for AP abdomen, 0.4 mGy PA chest, 7 mGy for AP chest and 5 mGy for PA skull

An analysis of cancer death risk among medical diagnostic X-ray workers in China, 1950-1995

International Nuclear Information System (INIS)

Zhao Yongcheng; Wang Jixian; Zhang Wei; Li Benxiao; Fan Tiqiang; Zhang Jingyuan

2002-01-01

Objective: To investigate effects of occupational radiation exposure on cancer death among medical diagnostic X-ray workers. Methods: A cohort study on medical diagnostic X-ray workers and non-X-ray medical workers was carried out and a risk analysis of cancer death between 1950 and 1995 was conducted with the O/E system. Results: A significant enhancement in cancer death risk for X-ray workers was found, especially those engaged in X-ray work in early calendar years. The overall cancer RR was 1.26, (95 % CI: 1.14 - 1.38), for leukemia it was 2.48, (95% CI: 1.68-3.51 ); for esophagus cancer, 3.18, (95% CI: 2.02 -4.77); for liver cancer, 1.54, (95 % CI: 1.27 - 1.86); and for bone cancer, 2.48, (95 % CI: 1.00 - 5.40). In the late calendar year cohort a significant enhancement of cancer death was seen only in esophagus cancer (RR = 4.19, 95 % CI: 1.80 - 8.25) and lung cancer (RR = 1.60, 95% CI:1.10-2.25). Conclusion: Long-term occupational X-ray irradiation can enhance the risk of cancer death when the cumulative dose reached a certain level. The significant enhancement of cancer death for leukemia and some solid cancers may be related to the occupational exposure to X-rays

The evaluation of the irradiation of medical team in critical X-ray diagnostic techniques

Energy Technology Data Exchange (ETDEWEB)

Markovic, S; Pavlovic, R [Inst. of Nuclear Science Vinca, Belgrade (Yugoslavia). Radiation and Environmental Protection Lab.; Boreli, F [Fac. of Electrical Engineering, Belgrade (Yugoslavia)

1996-12-31

A good realized assessment of the irradiation for any exposed group of population serves as the base for the radiation protection measures (emergency radiation preparedness, radiation protection optimization etc.). This is especially important, by the radiation protection point of view, in contrast X-ray diagnostic techniques - angiographies. This paper presents the way for the realization of the medical team irradiation assessment, based on originally derived simple equations for the scattered radiation field around patient. (author) 1 fig., 3 figs.

PEROXISOME PROLIFERATOR-ACTIVATED RECEPTOR (PPAR) AGONISTS AS PROMISING NEW MEDICATIONS FOR DRUG ADDICTION: PRECLINICAL EVIDENCE

Science.gov (United States)

Foll, Bernard Le; Ciano, Patricia Di; Panlilio, Leigh V.; Goldberg, Steven R.; Ciccocioppo, Roberto

2013-01-01

This review examines the growing literature on the role of peroxisome proliferator-activated receptors (PPARs) in addiction. There are two subtypes of PPAR receptors that have been studied in addiction: PPAR-α and PPAR-γ. The role of each PPAR subtype in common models of addictive behavior, mainly pre-clinical models, is summarized. In particular, studies are reviewed that investigated the effects of PPAR-α agonists on relapse, sensitization, conditioned place preference, withdrawal and drug intake, and effects of PPAR-γ agonists on relapse, withdrawal and drug intake. Finally, studies that investigated the effects of PPAR agonists on neural pathways of addiction are reviewed. Taken together this preclinical data indicates that PPAR agonists are promising new medications for drug addiction treatment. PMID:23614675

Use of antihypertensive medications and diagnostic tests among privately insured adolescents and young adults with primary versus secondary hypertension.

Science.gov (United States)

Yoon, Esther Y; Cohn, Lisa; Freed, Gary; Rocchini, Albert; Kershaw, David; Ascione, Frank; Clark, Sarah

2014-07-01

To compare the use of antihypertensive medications and diagnostic tests among adolescents and young adults with primary versus secondary hypertension. We conducted retrospective cohort analysis of claims data for adolescents and young adults (12-21 years of age) with ≥3 years of insurance coverage (≥11 months/year) in a large private managed care plan during 2003-2009 with diagnosis of primary hypertension or secondary hypertension. We examined their use of antihypertensive medications and identified demographic characteristics and the presence of obesity-related comorbidities. For the subset receiving antihypertensive medications, we examined their diagnostic test use (echocardiograms, renal ultrasounds, and electrocardiograms). The study sample included 1,232 adolescents and young adults; 84% had primary hypertension and 16% had secondary hypertension. The overall prevalence rate of hypertension was 2.6%. One quarter (28%) with primary hypertension had one or more antihypertensive medications, whereas 65% with secondary hypertension had one or more antihypertensive medications. Leading prescribers of antihypertensives for subjects with primary hypertension were primary care physicians (80%), whereas antihypertensive medications were equally prescribed by primary care physicians (43%) and sub-specialists (37%) for subjects with secondary hypertension. The predominant hypertension diagnosis among adolescents and young adults is primary hypertension. Antihypertensive medication use was higher among those with secondary hypertension compared with those with primary hypertension. Further study is needed to determine treatment effectiveness and patient outcomes associated with differential treatment patterns used for adolescents and young adults with primary versus secondary hypertension. Copyright © 2014 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

{sup 90}Y microspheres prepared by sol-gel method, promising medical material for radioembolization of liver malignancies

Energy Technology Data Exchange (ETDEWEB)

Łada, Wiesława, E-mail: w.lada@ichtj.waw.pl [Institute of Nuclear Chemistry and Technology, 03-195 Warsaw, Dorodna 16 (Poland); Iller, Edward [National Centre for Nuclear Research, Radioisotope Centre POLATOM, 05-400 Otwock, Andrzej Sołtan 7 (Poland); Wawszczak, Danuta [Institute of Nuclear Chemistry and Technology, 03-195 Warsaw, Dorodna 16 (Poland); Konior, Marcin, E-mail: marcin.konior@polatom.pl [National Centre for Nuclear Research, Radioisotope Centre POLATOM, 05-400 Otwock, Andrzej Sołtan 7 (Poland); Dziel, Tomasz [National Centre for Nuclear Research, Radioisotope Centre POLATOM, 05-400 Otwock, Andrzej Sołtan 7 (Poland)

2016-10-01

A new technology for the production of radiopharmaceutical {sup 90}Y microspheres in the form of spherical yttrium oxide grains obtained by sol-gel method has been described. The authors present and discuss the results of investigations performed in the development of new production technology of yttrium microspheres and determination of their physic-chemical properties. The final product has the structure of spherical yttrium oxide grains with a diameter 25–100 μm, is stable and free from contaminants. Irradiation of 20 mg samples of grains with diameter of 20–50 μm in the thermal neutron flux of 1.7 × 10{sup 14} cm{sup −2} s{sup −1} at the core of MARIA research nuclear reactor allowed to obtain microspheres labelled with the {sup 90}Y isotope on the way of the nuclear reaction {sup 89}Y(n, γ){sup 90}Y. Specific activity of irradiated microspheres has been determined by application of absolute triple to double coincidence ratio method (TDCR) and has been evaluated at 190 MBq/mg Y. {sup 90}Y microspheres prepared by the proposed technique can be regarded as a promising medical material for radioembolization of liver malignancies. - Highlights: • Sol-gel methods for preparation of spherical yttrium trioxide grains have been proposed. • Determination condition for irradiation {sup 89}Y{sub 2}O{sub 3} grains in nuclear reactor • Evaluation of specific activity of {sup 90}Y microspheres • Estimation of {sup 90}Y microspheres as promising medical material for radioembolization.

Investigation of radiation protection of medical staff performing medical diagnostic examinations by using PET/CT technique

International Nuclear Information System (INIS)

Wrzesień, Małgorzata; Napolska, Katarzyna

2015-01-01

Positron emission tomography (PET) is now one of the most important methods in the diagnosis of cancer diseases. Due to the rapid growth of PET/CT centres in Poland in less than a decade, radiation protection and, consequently, the assessment of worker exposure to ionising radiation, emitted mainly by the isotope 18 F, have become essential issues. The main aim of the study was to analyse the doses received by workers employed in the Medical Diagnostic Centre. The analysis comprises a physicist, three nurses, three physicians, three technicians, as well as two administrative staff employees. High-sensitivity thermoluminescent detectors (TLDs) were used to measure the doses for medical staff. The personnel was classified into categories, among them employees having direct contact with the ‘source of radiation’— 18 FDG. The TLDs were placed on the fingertips of both hands and they were also attached at the level of eye lenses, thyroid and gonads depending on the assigned category. The highest dose of radiation was observed during the administration of the 18 FDG to the patients. In the case of the physicist, the highest dose was recorded during preparation of the radiopharmaceutical— 18 FDG. The body parts most exposed to ionizing radiation are the fingertips of the thumb, index and middle finger. (paper)

Investigation of radiation protection of medical staff performing medical diagnostic examinations by using PET/CT technique.

Science.gov (United States)

Wrzesień, Małgorzata; Napolska, Katarzyna

2015-03-01

Positron emission tomography (PET) is now one of the most important methods in the diagnosis of cancer diseases. Due to the rapid growth of PET/CT centres in Poland in less than a decade, radiation protection and, consequently, the assessment of worker exposure to ionising radiation, emitted mainly by the isotope (18)F, have become essential issues. The main aim of the study was to analyse the doses received by workers employed in the Medical Diagnostic Centre. The analysis comprises a physicist, three nurses, three physicians, three technicians, as well as two administrative staff employees. High-sensitivity thermoluminescent detectors (TLDs) were used to measure the doses for medical staff. The personnel was classified into categories, among them employees having direct contact with the 'source of radiation'-(18)FDG. The TLDs were placed on the fingertips of both hands and they were also attached at the level of eye lenses, thyroid and gonads depending on the assigned category. The highest dose of radiation was observed during the administration of the (18)FDG to the patients. In the case of the physicist, the highest dose was recorded during preparation of the radiopharmaceutical-(18)FDG. The body parts most exposed to ionizing radiation are the fingertips of the thumb, index and middle finger.

Cost Benefit Optimization of the Israeli Medical Diagnostic X-Ray Exposure

International Nuclear Information System (INIS)

Ben-Shlomo, A.; Shlesinger, T.; Shani, G.; Kushilevsky, A.

1999-01-01

Diagnostic and therapeutic radiology is playing a major role in modern medicine. A preliminary survey was carried out during 1997 on 3 major Israeli hospitals in order to assess the extent of exposure of the population to medical x-rays (1). The survey has found that the annual collective dose of the Israeli population to x-ray medical imaging procedures (excluding radio-therapy) is about 7,500 Man-Sv. The results of the survey were analyzed in order to. 1. Carry out a cost-benefit optimization procedure related to the means that should be used to reduce the exposure of the Israeli patients under x-ray procedures. 2. Establish a set of practical recommendations to reduce the x-ray radiation exposure of patients and to increase the image quality. . Establish a number of basic rules to be utilized by health policy makers in Israel. Based on the ICRP-60 linear model risk assessments (2), the extent of the annual risk arising A.om the 7,500 Man-Sv medical x-ray collective dose in Israel has been found to be the potential addition of 567 cancer cases per year, 244 of which to be fatal, and a potential additional birth of 3-4 children with severe genetic damage per year. This assessment take into account the differential risk and the collective dose according to the age distribution in the Israeli exposed population, and excludes patients with chronic diseases

Radiological safety status and quality assurance audit of medical X-ray diagnostic installations in India.

Science.gov (United States)

Sonawane, A U; Singh, Meghraj; Sunil Kumar, J V K; Kulkarni, Arti; Shirva, V K; Pradhan, A S

2010-10-01

We conducted a radiological safety and quality assurance (QA) audit of 118 medical X-ray diagnostic machines installed in 45 major hospitals in India. The main objective of the audit was to verify compliance with the regulatory requirements stipulated by the national regulatory body. The audit mainly covered accuracy check of accelerating potential (kVp), linearity of tube current (mA station) and timer, congruence of radiation and optical field, and total filtration; in addition, we also reviewed medical X-ray diagnostic installations with reference to room layout of X-ray machines and conduct of radiological protection survey. A QA kit consisting of a kVp Test-O-Meter (ToM) (Model RAD/FLU-9001), dose Test-O-Meter (ToM) (Model 6001), ionization chamber-based radiation survey meter model Gun Monitor and other standard accessories were used for the required measurements. The important areas where there was noncompliance with the national safety code were: inaccuracy of kVp calibration (23%), lack of congruence of radiation and optical field (23%), nonlinearity of mA station (16%) and timer (9%), improper collimator/diaphragm (19.6%), faulty adjustor knob for alignment of field size (4%), nonavailability of warning light (red light) at the entrance of the X-ray room (29%), and use of mobile protective barriers without lead glass viewing window (14%). The present study on the radiological safety status of diagnostic X-ray installations may be a reasonably good representation of the situation in the country as a whole. The study contributes significantly to the improvement of radiological safety by the way of the steps already taken and by providing a vital feed back to the national regulatory body.

Raman spectroscopy for medical diagnostics--From in-vitro biofluid assays to in-vivo cancer detection.

Science.gov (United States)

Kong, Kenny; Kendall, Catherine; Stone, Nicholas; Notingher, Ioan

2015-07-15

Raman spectroscopy is an optical technique based on inelastic scattering of light by vibrating molecules and can provide chemical fingerprints of cells, tissues or biofluids. The high chemical specificity, minimal or lack of sample preparation and the ability to use advanced optical technologies in the visible or near-infrared spectral range (lasers, microscopes, fibre-optics) have recently led to an increase in medical diagnostic applications of Raman spectroscopy. The key hypothesis underpinning this field is that molecular changes in cells, tissues or biofluids, that are either the cause or the effect of diseases, can be detected and quantified by Raman spectroscopy. Furthermore, multivariate calibration and classification models based on Raman spectra can be developed on large "training" datasets and used subsequently on samples from new patients to obtain quantitative and objective diagnosis. Historically, spontaneous Raman spectroscopy has been known as a low signal technique requiring relatively long acquisition times. Nevertheless, new strategies have been developed recently to overcome these issues: non-linear optical effects and metallic nanoparticles can be used to enhance the Raman signals, optimised fibre-optic Raman probes can be used for real-time in-vivo single-point measurements, while multimodal integration with other optical techniques can guide the Raman measurements to increase the acquisition speed and spatial accuracy of diagnosis. These recent efforts have advanced Raman spectroscopy to the point where the diagnostic accuracy and speed are compatible with clinical use. This paper reviews the main Raman spectroscopy techniques used in medical diagnostics and provides an overview of various applications. Copyright © 2015 The Authors. Published by Elsevier B.V. All rights reserved.

Radiological safety status and quality assurance audit of medical X-ray diagnostic installations in India

International Nuclear Information System (INIS)

Sonawane, A.U.; Singh, Meghraj; Sunil Kumar, J.V.K.; Kulkarni, Arti; Shirva, V.K.; Pradhan, A.S.

2010-01-01

We conducted a radiological safety and quality assurance (QA) audit of 118 medical X-ray diagnostic machines installed in 45 major hospitals in India. The main objective of the audit was to verify compliance with the regulatory requirements stipulated by the national regulatory body. The audit mainly covered accuracy check of accelerating potential (kVp), linearity of tube current (mA station) and timer, congruence of radiation and optical field, and total filtration; in addition, we also reviewed medical X-ray diagnostic installations with reference to room layout of X-ray machines and conduct of radiological protection survey. A QA kit consisting of a kVp Test-O-Meter (ToM) (Model RAD/FLU-9001), dose Test-O-Meter (ToM) (Model 6001), ionization chamber-based radiation survey meter model Gun Monitor and other standard accessories were used for the required measurements. The important areas where there was noncompliance with the national safety code were: inaccuracy of kVp calibration (23%), lack of congruence of radiation and optical field (23%), nonlinearity of mA station (16%) and timer (9%), improper collimator/diaphragm (19.6%), faulty adjustor knob for alignment of field size (4%), nonavailability of warning light (red light) at the entrance of the X-ray room (29%), and use of mobile protective barriers without lead glass viewing window (14%). The present study on the radiological safety status of diagnostic X-ray installations may be a reasonably good representation of the situation in the country as a whole. The study contributes significantly to the improvement of radiological safety by the way of the steps already taken and by providing a vital feed back to the national regulatory body. (author)

[The characteristics of medical technologies in emergency medical care hospital].

Science.gov (United States)

Murakhovskiĭ, A G; Babenko, A I; Bravve, Iu I; Tataurova, E A

2013-01-01

The article analyzes the implementation of major 12 diagnostic and 17 treatment technologies applied during medical care of patients with 12 key nosology forms of diseases in departments of the emergency medical care hospital No 2 of Omsk. It is established that key groups of technologies in the implementation of diagnostic process are the laboratory clinical diagnostic analyses and common diagnostic activities at reception into hospital and corresponding departments. The percentage of this kind of activities is about 78.3% of all diagnostic technologies. During the realization of treatment process the priority technologies are common curative and rehabilitation activities, intensive therapy activities and clinical diagnostic monitoring activities. All of them consist 80.1% of all curative technologies.

The diagnostic accuracy of three rapid diagnostic tests for typhoid fever at Chittagong Medical College Hospital, Chittagong, Bangladesh.

Science.gov (United States)

Maude, Rapeephan R; de Jong, Hanna K; Wijedoru, Lalith; Fukushima, Masako; Ghose, Aniruddha; Samad, Rasheda; Hossain, Mohammed Amir; Karim, Mohammed Rezaul; Faiz, Mohammed Abul; Parry, Christopher M

2015-10-01

To determine the diagnostic accuracy of three rapid diagnostic tests (RDTs) for typhoid fever in febrile hospitalised patients in Bangladesh. Febrile adults and children admitted to Chittagong Medical College Hospital, Bangladesh, were investigated with Bact/Alert(®) blood cultures and real-time PCR to detect Salmonella enterica Typhi and Paratyphi A and assays for Rickettsia, leptospirosis and dengue fever. Acute serum samples were examined with the LifeAssay (LA) Test-it™ Typhoid IgM lateral flow assay detecting IgM antibodies against S. Typhi O antigen, CTKBiotech Onsite Typhoid IgG/IgM Combo Rapid-test cassette lateral flow assay detecting IgG and IgM antibodies against S. Typhi O and H antigens and SD Bioline line assay for IgG and IgM antibodies against S. Typhi proteins. In 300 malaria smear-negative febrile patients [median (IQR) age of 13.5 (5-31) years], 34 (11.3%) had confirmed typhoid fever: 19 positive by blood culture for S. Typhi (three blood PCR positive) and 15 blood culture negative but PCR positive for S. Typhi in blood. The respective sensitivity and specificity of the three RDTs in patients using a composite reference standard of blood culture and/or PCR-confirmed typhoid fever were 59% and 61% for LifeAssay, 59% and 74% for the CTK IgM and/or IgG, and 24% and 96% for the SD Bioline RDT IgM and/or IgG. The LifeAssay RDT had a sensitivity of 63% and a specificity of 91% when modified with a positive cut-off of ≥2+ and analysed using a Bayesian latent class model. These typhoid RDTs demonstrated moderate diagnostic accuracies, and better tests are needed. © 2015 The Authors. Tropical Medicine & International Health Published by John Wiley & Sons Ltd.

Rapid detection of chromosome rearrangement in medical diagnostic X-ray workers by using fluorescence in situ hybridization and study on dose estimation

International Nuclear Information System (INIS)

Wang Zhiquan; Sun Yuanming; Li Jin

1998-01-01

Objective: Biological doses were estimated for medical diagnostic X-ray workers. Methods: Chromosome rearrangements in X-ray workers were analysed by fluorescence in situ hybridization (FISH) with composite whole chromosome paintings number 4 and number 7. Results: The frequency of translocation in medical diagnostic X-ray workers was much higher than that in control group (P<0.01). The biological doses to individual X-ray workers were calculated by their translocation frequency. The translocation frequencies of both FISH and G-banding were in good agreement. Conclusion: The biological doses to X-ray workers are estimated by FISH first when their dosimetry records are not documented

Optimization of working conditions of medical staff of isotopic diagnostic departments. Optimizatsiya uslovij truda meditsinskogo personala radiodiagnosticheskikh otdelenij

Energy Technology Data Exchange (ETDEWEB)

Ovsyannikov, A S [Akademiya Meditsinskikh Nauk SSSR, Moscow (USSR). Inst. Gigieny Truda i Professional' nykh Zabolevanij

1989-01-01

The study was undertaken to analyze the characteristics of the work of medical staff of isotopic diagnostic departments during use of {sup 99m}Tc isotope generators. The data on the functional load of physicians and paramedical staff were given along with the description of radiation doses and dose rates at various stages of work. The measures on optimization of labour conditions by means of the appropriate department's design, improvement of the regime of nurses' work and adequate allocation and utilization of medical equipment were developed.

Radiological safety status and quality assurance audit of medical X-ray diagnostic installations in India

Directory of Open Access Journals (Sweden)

Sonawane A

2010-01-01

Full Text Available We conducted a radiological safety and quality assurance (QA audit of 118 medical X-ray diagnostic machines installed in 45 major hospitals in India. The main objective of the audit was to verify compliance with the regulatory requirements stipulated by the national regulatory body. The audit mainly covered accuracy check of accelerating potential (kVp, linearity of tube current (mA station and timer, congruence of radiation and optical field, and total filtration; in addition, we also reviewed medical X-ray diagnostic installations with reference to room layout of X-ray machines and conduct of radiological protection survey. A QA kit consisting of a kVp Test-O-Meter (ToM (Model RAD/FLU-9001, dose Test-O-Meter (ToM (Model 6001, ionization chamber-based radiation survey meter model Gun Monitor and other standard accessories were used for the required measurements. The important areas where there was noncompliance with the national safety code were: inaccuracy of kVp calibration (23%, lack of congruence of radiation and optical field (23%, nonlinearity of mA station (16% and timer (9%, improper collimator/diaphragm (19.6%, faulty adjustor knob for alignment of field size (4%, nonavailability of warning light (red light at the entrance of the X-ray room (29%, and use of mobile protective barriers without lead glass viewing window (14%. The present study on the radiological safety status of diagnostic X-ray installations may be a reasonably good representation of the situation in the country as a whole. The study contributes significantly to the improvement of radiological safety by the way of the steps already taken and by providing a vital feed back to the national regulatory body.

The future of medical diagnostics: review paper

LENUS (Irish Health Repository)

Jerjes, Waseem K

2011-08-23

Abstract While histopathology of excised tissue remains the gold standard for diagnosis, several new, non-invasive diagnostic techniques are being developed. They rely on physical and biochemical changes that precede and mirror malignant change within tissue. The basic principle involves simple optical techniques of tissue interrogation. Their accuracy, expressed as sensitivity and specificity, are reported in a number of studies suggests that they have a potential for cost effective, real-time, in situ diagnosis. We review the Third Scientific Meeting of the Head and Neck Optical Diagnostics Society held in Congress Innsbruck, Innsbruck, Austria on the 11th May 2011. For the first time the HNODS Annual Scientific Meeting was held in association with the International Photodynamic Association (IPA) and the European Platform for Photodynamic Medicine (EPPM). The aim was to enhance the interdisciplinary aspects of optical diagnostics and other photodynamic applications. The meeting included 2 sections: oral communication sessions running in parallel to the IPA programme and poster presentation sessions combined with the IPA and EPPM posters sessions.

Lyme disease: the promise of Big Data, companion diagnostics and precision medicine

Science.gov (United States)

Stricker, Raphael B; Johnson, Lorraine

2016-01-01

Lyme disease caused by the spirochete Borrelia burgdorferi has become a major worldwide epidemic. Recent studies based on Big Data registries show that >300,000 people are diagnosed with Lyme disease each year in the USA, and up to two-thirds of individuals infected with B. burgdorferi will fail conventional 30-year-old antibiotic therapy for Lyme disease. In addition, animal and human evidence suggests that sexual transmission of the Lyme spirochete may occur. Improved companion diagnostic tests for Lyme disease need to be implemented, and novel treatment approaches are urgently needed to combat the epidemic. In particular, therapies based on the principles of precision medicine could be modeled on successful “designer drug” treatment for HIV/AIDS and hepatitis C virus infection featuring targeted protease inhibitors. The use of Big Data registries, companion diagnostics and precision medicine will revolutionize the diagnosis and treatment of Lyme disease. PMID:27672336

21 CFR 1000.50 - Recommendation for the use of specific area gonad shielding on patients during medical diagnostic...

Science.gov (United States)

2010-04-01

... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Recommendation for the use of specific area gonad shielding on patients during medical diagnostic x-ray procedures. 1000.50 Section 1000.50 Food and Drugs... GENERAL Radiation Protection Recommendations § 1000.50 Recommendation for the use of specific area gonad...

SPECIFICITY OF MANIFACTURING PROCESS VALIDATION FOR DIAGNOSTIC SEROLOGICAL DEVICES

Directory of Open Access Journals (Sweden)

O. Yu. Galkin

2018-02-01

Full Text Available The aim of this research was to analyze recent scientific literature, as well as national and international legislature on manifacturing process validation of biopharmaceutical production, in particular devices for serological diagnostics. Technology validation in the field of medical devices for serological diagnostics is most influenced by the Technical Regulation for Medical Devices for in vitro Diagnostics State Standards of Ukraine – SSU EN ISO 13485:2015 “Medical devices. Quality management system. Requirements for regulation”, SSU EN ISO 14971:2015 “Medical devices. Instructions for risk management”, Instruction ST-N of the Ministry of Healthcare of Ukraine 42-4.0:2014 “Medications. Suitable industrial practice”, State Pharmacopoeia of Ukraine and Instruction ICH Q9 on risk management. Current recommendations for validations of drugs manufacturing process, including biotechnological manufacturing, can not be directly applied to medical devices for in vitro diagnostics. It was shown that the specifics of application and raw materials require individual validation parameters and process validations for serological diagnostics devices. Critical parameters to consider in validation plans were provided for every typical stage of production of in vitro diagnostics devices on the example of immunoassay kits, such as obtaining protein antigens, including recombinant ones, preparations of mono- and polyclonal antibodies, immunoenzyme conjugates and immunosorbents, chemical reagents etc. The bottlenecks of technologies for in vitro diagnostics devices were analyzed from the bioethical and biosafety points of view.

Molecular diagnostics: the changing culture of medical microbiology.

Science.gov (United States)

Bullman, Susan; Lucey, Brigid; Sleator, Roy D

2012-01-01

Diagnostic molecular biology is arguably the fastest growing area in current laboratory-based medicine. Growth of the so called 'omics' technologies has, over the last decade, led to a gradual migration away from the 'one test, one pathogen' paradigm, toward multiplex approaches to infectious disease diagnosis, which have led to significant improvements in clinical diagnostics and ultimately improved patient care.

Comparison of 3MP medical-grade to 1MP office grade LCD monitors in mammographic diagnostic and perceptual performance

International Nuclear Information System (INIS)

Ong, Aaron; Tan, Shu.; Gledhill, Samuel; Hennessy, Oliver; Lui, Belinda; Lee, Alan; Lemish, Wayne; Styles, Colin; Pun, Emma; Padmanabhan, Meenakshi; Pitman, Alexander G.; Tauro, Paul; Waugh, Paul

2011-01-01

Full text: Picture archiving and communication systems images designed to be viewed on high-resolution medical-grade monitors are routinely viewed on office-grade monitors on the wards or at home. This study aimed to determine whether a statistically significant difference in diagnostic (cancer detection) and perceptual (microcalcification detection) performance exists between 3MP grade and 1MP office-grade monitors. 3MP Dome medical-grade liquid crystal display (LCD) monitors (Planar, Beaverton, OR, USA) were compared to 1MP Dell office-grade LCD monitors (Dell Inc, Round Rock, TX, USA). Eight radiologists (reader experi ence 8-30 years) read the same set of 100 mammograms (23/100 with proven cancers and 52/100 with microcalcifications) presented in random order on three occasions separated by two time intervals of 12 weeks. Reads 1 and 3 utilised 3MP monitors and formed the baseline read. Read 2 utilised 1MP monitors and constituted the experimental read. Reading conditions were standardised. Readers were aware of which monitors they were using. Mul tivariate logistic regression analysis (to account for reader variability and monitor impact) was performed to assess for statistical significance. At a = 5%, confidence intervals analysis comparing the measured parameters between 1MP to 3MP monitors demonstrated no statistically significant difference in diagnostic and perceptual performance for the reader group. In cancer detection (the diagnostic task), reader accuracy remained high irrespective of monitor type. Regression analysis comparing performance with 1MP against 3MP monitors found P values of 0.693 and 0.324 for diagnostic and perceptual performance, respectively. There were no statistically and clinically significant differences between 3MP and 1MP monitors in mammographic diagnostic and perceptual performance. Comparable performance may be due to compensatory behav iour by readers.

Iodine-123 (123I) is promising radiopharmaceutical in the radionuclide diagnostics

International Nuclear Information System (INIS)

Tazhedinov, I.T.

2003-01-01

In the paper some advantages of the radiopharmaceuticals with 123 I against 99m Tc preparations are shown. It is noted that the 123 I is the most favourable among cyclotron radionuclides for radionuclide diagnostics by it nuclear-physical characteristics. With application of 123 I it is possible to attain a significant progress in the thyroid examination. 123 I labelled preparations should have a high bond strength providing the high information valuation of examinations

21 CFR 886.1380 - Diagnostic condensing lens.

Science.gov (United States)

2010-04-01

... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Diagnostic condensing lens. 886.1380 Section 886...) MEDICAL DEVICES OPHTHALMIC DEVICES Diagnostic Devices § 886.1380 Diagnostic condensing lens. (a) Identification. A diagnostic condensing lens is a device used in binocular indirect ophthalmoscopy (a procedure...

Exposure of the French paediatric population to ionising radiation from diagnostic medical procedures in 2010

International Nuclear Information System (INIS)

Etard, Cecile; Aubert, Bernard; Mezzarobba, Myriam; Bernier, Marie-Odile

2014-01-01

Medical examination is the main source of artificial radiation exposure. Because children present an increased sensitivity to ionising radiation, radiology practices at a national level in paediatrics should be monitored. This study describes the ionising radiation exposure from diagnostic medical examinations of the French paediatric population in 2010. Data on frequency of examinations were provided by the French National Health Insurance through a representative sample including 107,627 children ages 0-15 years. Effective doses for each type of procedure were obtained from the published French literature. Median and mean effective doses were calculated for the studied population. About a third of the children were exposed to at least one examination using ionising radiation in 2010. Conventional radiology, dental exams, CT scans and nuclear medicine and interventional radiology represent respectively 55.3%, 42.3%, 2.1% and 0.3% of the procedures. Children 10-15 years old and babies from birth to 1 year are the most exposed populations, with respectively 1,098 and 734 examinations per 1,000 children per year. Before 1 year of age, chest and pelvis radiographs are the most common imaging tests, 54% and 32%, respectively. Only 1% of the studied population is exposed to CT scan, with 62% of these children exposed to a head-and-neck procedure. The annual median and mean effective doses were respectively 0.03 mSv and 0.7 mSv for the exposed children. This study gives updated reference data on French paediatric exposure to medical ionising radiation that can be used for public health or epidemiological purposes. Paediatric diagnostic use appears much lower than that of the whole French population as estimated in a previous study. (orig.)

Exposure of the French paediatric population to ionising radiation from diagnostic medical procedures in 2010

Energy Technology Data Exchange (ETDEWEB)

Etard, Cecile; Aubert, Bernard [Institut de Radioprotection et de Surete Nucleaire, Medical Expertise Unit, Fontenay-aux-Roses (France); Mezzarobba, Myriam [Institut de Radioprotection et de Surete Nucleaire, Laboratory of Epidemiology, Fontenay-aux-Roses (France); Bernier, Marie-Odile [Institut de Radioprotection et de Surete Nucleaire, Laboratory of Epidemiology, Fontenay-aux-Roses (France); Institut de Radioprotection et de Surete Nucleaire, IRSN/PRP-HOM/SRBE/LEPID, Laboratoire d' Epidemiologie, Fontenay-aux-Roses (France)

2014-12-15

Medical examination is the main source of artificial radiation exposure. Because children present an increased sensitivity to ionising radiation, radiology practices at a national level in paediatrics should be monitored. This study describes the ionising radiation exposure from diagnostic medical examinations of the French paediatric population in 2010. Data on frequency of examinations were provided by the French National Health Insurance through a representative sample including 107,627 children ages 0-15 years. Effective doses for each type of procedure were obtained from the published French literature. Median and mean effective doses were calculated for the studied population. About a third of the children were exposed to at least one examination using ionising radiation in 2010. Conventional radiology, dental exams, CT scans and nuclear medicine and interventional radiology represent respectively 55.3%, 42.3%, 2.1% and 0.3% of the procedures. Children 10-15 years old and babies from birth to 1 year are the most exposed populations, with respectively 1,098 and 734 examinations per 1,000 children per year. Before 1 year of age, chest and pelvis radiographs are the most common imaging tests, 54% and 32%, respectively. Only 1% of the studied population is exposed to CT scan, with 62% of these children exposed to a head-and-neck procedure. The annual median and mean effective doses were respectively 0.03 mSv and 0.7 mSv for the exposed children. This study gives updated reference data on French paediatric exposure to medical ionising radiation that can be used for public health or epidemiological purposes. Paediatric diagnostic use appears much lower than that of the whole French population as estimated in a previous study. (orig.)

Diagnostic performance of 64-slice multidetector coronary computed tomographic angiography in women.

Science.gov (United States)

Jug, Borut; Gupta, Mohit; Papazian, Jenny; Li, Dong; Tsang, Janet; Bhatia, Harpreet; Karlsberg, Ronald; Budoff, Matthew

2012-12-01

Diagnostic approach to chest pain in women is challenging, but still under-investigated. The purpose of this study was to assess the diagnostic performance of 64-slice multidetector coronary computed tomographic angiography (CCTA) in women with chest pain. We included 606 patients--255 women and 351 men (mean age 61 ± 12 years for both)--who had been referred for a CCTA and an invasive coronary angiography (diagnostic standard) because of chest pain, either as part of clinical work-up in two urban medical centers or as part of the multicenter ACCURACY trial. On a patient-based model, the sensitivity, specificity, and positive predictive value (PPV) and negative predictive value to detect ≥50% and ≥70% stenosis were 98%, 84%, 87%, and 97% and 96%, 83%, 77%, and 97%, respectively, for women and 97%, 83%, 89%, and 95% and 94%, 91%, 90%, and 94%, respectively, for men. There were no statistically significant differences between men and women in diagnostic performance measures except for the PPV of detecting a ≥70% stenosis (P = .007). In women with chest pain, 64-slice multidetector CCTA is at least as sensitive and specific as in men. Our findings suggest that CCTA is a promising diagnostic tool for timely detection and/or exclusion of CAD in symptomatic intermediate-risk female populations.

[Biochemical diagnostics of fatal opium intoxication].

Science.gov (United States)

Papyshev, I P; Astashkina, O G; Tuchik, E S; Nikolaev, B S; Cherniaev, A L

2013-01-01

Biochemical diagnostics of fatal opium intoxication remains a topical problem in forensic medical science and practice. We investigated materials obtained in the course of forensic medical expertise of the cases of fatal opium intoxication. The study revealed significant differences between myoglobin levels in blood, urine, myocardium, and skeletal muscles. The proposed approach to biochemical diagnostics of fatal opium intoxication enhances the accuracy and the level of evidence of expert conclusions.

Summary from working group on noninterceptive diagnostics

International Nuclear Information System (INIS)

Chamberlin, D.D.

1985-01-01

The working group for noninterceptive diagnostics spent much of its time comparing diagnostic techniques from different fields and their possible application to high-power injectors. The group included backgrounds from electron beam diagnostics, fusion power diagnostics, cw ion source and transport design, and ion beam of diagnostics. The probability of success for adapting techniques from these different areas is quite difficult to judge, short of a detailed examination of each application. Unexpected flaws or unforeseen noise sources can eliminate an idea that would otherwise appear promising. The report presents several ideas that were discussed, with an indication of those ideas most likely to succeed if implemented

21 CFR 874.1925 - Toynbee diagnostic tube.

Science.gov (United States)

2010-04-01

... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Toynbee diagnostic tube. 874.1925 Section 874.1925...) MEDICAL DEVICES EAR, NOSE, AND THROAT DEVICES Diagnostic Devices § 874.1925 Toynbee diagnostic tube. (a) Identification. The toynbee diagnostic tube is a listening device intended to determine the degree of openness of...

A study of radiological protection for women of reproductive age in diagnostic radiology. Questionnaire for medical radiation technologists

International Nuclear Information System (INIS)

Tsubone, Chie; Ban, Nobuhiko; Kai, Michiaki

2005-01-01

There has been great concern regarding the radiation protection for women of reproductive age when exposed to diagnostic radiation. The 10-day-rule proposed by the ICRP has not been recommended since 1983 because the risk to embryo and fetus within four weeks after menstruation may be small. However, some expects see that incomplete abandon of the 10-day-rule might cause confusion among the medical doctors and patients, and consequently unwarranted abortion happens. This paper surveyed the views of radiation technologies in hospitals and discussed how radiation exposure of women of reproductive age in medicine should be controlled. We found that the views to be 10-day-rule were spilt 50:50 and that radiation technologists do not necessarily think the 10-day-rule should be abandoned. Even the radiation technologists who are supposed to be able to explain to the patients the health risk following diagnostic exposure do not fully understand the risk involved. In conclusion, although a low-dose risk of diagnostic exposure should be sufficiently educated in order to obtain an exact understanding, the 10-day-rule may be useful in order to actually avoid any trouble in diagnostic radiology. (author)

CAPITAL STRUCTURE ANALYSIS OF THE MEDICAL DIAGNOSTIC-CONSULTATIVE CENTERS IN VARNA (absolute indicators

Directory of Open Access Journals (Sweden)

Lyubomira Koeva-Dimitrova

2016-08-01

Full Text Available The capital structure analysis of medical institutions is related to the assessment of their financial sustainability. The degree of their financial sustainability indicates the extent to which the medical institution is exposed to financial risk. This financial risk is related to the use of foreign capital (debts, loans, etc. and it is defined as the probability of insolvency and possible bankruptcy due to the existence of debts which could not be repaid at some point in the foreseeable future. Objective: To analyze the capital structure of the medical diagnostic-consultative centers in Varna city and on this basis to assess their long-term solvency and existence of financial risk. Materials and Methods: The materials for the study are the published annual financial statements (up to 05. 01. 2016 in the Commercial Register for the period from year 2008 to 2014 of all MDCCs (Medical Diagnostic Consultative centers, registered in Varna - 9 in total. In the study are applied logical-mathematical methods (comparison, grouping, detail, graphical method; financial and accounting analysis (balance sheet analysis; analysis of absolute ratios for financial sustainability. Results: Upon analysis of the capital structure of MDCC's are studied the main absolute indicators characterizing the conditions for financial sustainability and the existence of financial risk regarding the solvency. A table represents the overall assessment of the degree of financial sustainability of the companies according to the type and structure of the fulfilled criteria. It was ascertained that for year 2014, DCC 3, 4, 5 and 8 have met all the conditions and according to them these hospitals have very high financial sustainability. DCC 7 has an average financial sustainability, DCC 1 and 2 are in a financial crisis and DCC 6 and 9 are facing bankruptcy. It must be emphasized that nearly half of the studied health care organizations (DCC 1, 2, 6 and 9 need urgent intervention by

Myasthenia Gravis: Tests and Diagnostic Methods

Science.gov (United States)

... Focus on MG Newsletter MG Quarterly Test & Diagnostic methods In addition to a complete medical and neurological ... How can I help? About MGFA Test & Diagnostic methods Treatment for MG FAQ's Upcoming Events 2018 MG ...

Molecular diagnostics of neurodegenerative disorders

Directory of Open Access Journals (Sweden)

Megha eAgrawal

2015-09-01

Full Text Available Molecular diagnostics provide a powerful method to detect and diagnose various neurological diseases such as Alzheimer’s and Parkinson’s disease. The confirmation of such diagnosis allows early detection and subsequent medical counseling that help specific patients to undergo clinically important drug trials. This provides a medical pathway to have better insight of neurogenesis and eventual cure of the neurodegenerative diseases. In this short review, we present recent advances in molecular diagnostics especially biomarkers and imaging spectroscopy for neurological diseases. We describe advances made in Alzheimer’s disease, Parkinson’s disease, Amyotrophic lateral sclerosis and Huntington’s disease, and finally present a perspective on the future directions to provide a framework for further developments and refinements of molecular diagnostics to combat neurodegenerative disorders.

Molecular diagnostics of neurodegenerative disorders.

Science.gov (United States)

Agrawal, Megha; Biswas, Abhijit

2015-01-01

Molecular diagnostics provide a powerful method to detect and diagnose various neurological diseases such as Alzheimer's and Parkinson's disease. The confirmation of such diagnosis allows early detection and subsequent medical counseling that help specific patients to undergo clinically important drug trials. This provides a medical pathway to have better insight of neurogenesis and eventual cure of the neurodegenerative diseases. In this short review, we present recent advances in molecular diagnostics especially biomarkers and imaging spectroscopy for neurological diseases. We describe advances made in Alzheimer's disease (AD), Parkinson's disease (PD), Amyotrophic lateral sclerosis (ALS) and Huntington's disease (HD), and finally present a perspective on the future directions to provide a framework for further developments and refinements of molecular diagnostics to combat neurodegenerative disorders.

Three-dimensional imaging technology offers promise in medicine.

Science.gov (United States)

Karako, Kenji; Wu, Qiong; Gao, Jianjun

2014-04-01

Medical imaging plays an increasingly important role in the diagnosis and treatment of disease. Currently, medical equipment mainly has two-dimensional (2D) imaging systems. Although this conventional imaging largely satisfies clinical requirements, it cannot depict pathologic changes in 3 dimensions. The development of three-dimensional (3D) imaging technology has encouraged advances in medical imaging. Three-dimensional imaging technology offers doctors much more information on a pathology than 2D imaging, thus significantly improving diagnostic capability and the quality of treatment. Moreover, the combination of 3D imaging with augmented reality significantly improves surgical navigation process. The advantages of 3D imaging technology have made it an important component of technological progress in the field of medical imaging.

Fluorescence spectroscopy for medical and environmental diagnostics

International Nuclear Information System (INIS)

Johansson, Jonas.

1993-09-01

Fluorescence spectroscopy can be used for diagnostics in medical and environmental applications. The many aspects of fluorescence emission are utilized to enhance the accuracy of the diagnosis. A fluorescence detection system, based on nitrogen laser or dye laser excitation and optical multichannel detection, was constructed, and fluorescence spectra from human malignant tumours of various origins, were recorded. Tumour demarcation was observed using exogenous chromophores, as well as the endogenous tissue fluorescence. In particular, δ-amino levulinic acid was found to provide very good tumour demarcation. A multi-colour imaging system capable of simultaneous recording of four fluorescence images at selected wavelengths, was developed. Examples of processed images, based on the four sub-images, are shown for malignant tumours. In addition, data from photodynamic treatment of human malignant tumours are presented. Autofluorescence spectra from excised pieces of human atherosclerotic aorta and atherosclerotic coronary segment were found to be different from those of non-diseased vessels. Furthermore, fluorescence decay curves from atherosclerotic samples were found to differ from those of non-diseased samples. It is concluded that both spectral and temporal information should be utilized to enhance the demarcation. Methods for obtaining fluorescence data free from interference from blood, with applications to in vivo laser angioplasty of atherosclerosis, are discussed. The optical multichannel system and the multi-colour imaging system were integrated with a remote sensing system, originally used for environmental measurements, to obtain fluorescence spectra as well as fluorescence images of plants at a distance of up to 100 m. The fluorescence data from plants subject to environmental stress or senescent plants were found to differ from those obtained from healthy vegetation. 359 refs

A thermal technique for local ultrasound intensity measurement: part 2. Application to exposimetry on a medical diagnostic device

International Nuclear Information System (INIS)

Wilkens, V

2010-01-01

Acoustic output measurements on medical ultrasound equipment are usually performed using radiation force balances to determine the output power and using hydrophones to determine pressure and intensity parameters. The local temporal-average ultrasound intensity can be measured alternatively by thermal sensors. The technique was described and prototype sensors were characterized in a preceding paper. Here, the application of such a thermal intensity sensor to the output beam characterization of a typical medical diagnostic device is described. Two transducers, a 7.5 MHz linear array and a 3.5 MHz convex array were investigated in different operating modes. For comparison, hydrophone measurements were also performed. If the spatial averaging effect is taken into account, good agreement is found between both measurement methods. The maximum deviations of the spatial-peak temporal-average intensities I SPTA obtained with the thermal sensor from the corresponding hydrophone-based results were below 12%. The simple thermal technique offers advantages for intensity measurements especially in the case of scanning and combined modes of the diagnostic device, where the synchronization between hydrophone measurements and the complex pulse emission pattern can be difficult

Pocket book on setting techniques for medical imaging. X-ray diagnostics, angiography, CT, MRT. 4. rev. and enl. ed.; Taschenatlas Einstelltechnik. Roentgendiagnostik, Angiografie, CT, MRT

Energy Technology Data Exchange (ETDEWEB)

Moeller, Torsten B.; Reif, Emil [Caritas-Krankenhaus, Dillingen/Saar (Germany)

2009-07-01

The pocketbook on setting techniques for medical imaging is concerned with the problem to prepare appropriate images for diagnostic purposes using modern high-technology instruments like x-ray diagnostics, angiography, computerized tomography and magnetic resonance tomography. The following issues are covered: Head, spinal column, upper extremities, lower extremities, thorax, gastrointestinal tract, intravenous organ examination, angiography, computerized tomography, NMR imaging.

Complications in diagnostic imaging. 2. ed.

International Nuclear Information System (INIS)

Ansell, G.; Wilkins, R.A.; Medical Research Council, Harrow

1987-01-01

Thirty-seven chapters review various complications which may arise for patients and staff in medical diagnostic imaging. Five of these chapters are indexed separately covering topics on the complications of using radiopharmaceuticals, safety considerations in magnetic resonance imaging, radiation hazards of diagnostic radiology and medico-legal problems involving diagnostic radiology in both the UK and the USA. (UK)

Advancing the research agenda for diagnostic error reduction.

Science.gov (United States)

Zwaan, Laura; Schiff, Gordon D; Singh, Hardeep

2013-10-01

Diagnostic errors remain an underemphasised and understudied area of patient safety research. We briefly summarise the methods that have been used to conduct research on epidemiology, contributing factors and interventions related to diagnostic error and outline directions for future research. Research methods that have studied epidemiology of diagnostic error provide some estimate on diagnostic error rates. However, there appears to be a large variability in the reported rates due to the heterogeneity of definitions and study methods used. Thus, future methods should focus on obtaining more precise estimates in different settings of care. This would lay the foundation for measuring error rates over time to evaluate improvements. Research methods have studied contributing factors for diagnostic error in both naturalistic and experimental settings. Both approaches have revealed important and complementary information. Newer conceptual models from outside healthcare are needed to advance the depth and rigour of analysis of systems and cognitive insights of causes of error. While the literature has suggested many potentially fruitful interventions for reducing diagnostic errors, most have not been systematically evaluated and/or widely implemented in practice. Research is needed to study promising intervention areas such as enhanced patient involvement in diagnosis, improving diagnosis through the use of electronic tools and identification and reduction of specific diagnostic process 'pitfalls' (eg, failure to conduct appropriate diagnostic evaluation of a breast lump after a 'normal' mammogram). The last decade of research on diagnostic error has made promising steps and laid a foundation for more rigorous methods to advance the field.

Diagnostic performance of combined noninvasive coronary angiography and myocardial perfusion imaging using 320 row detector computed tomography

DEFF Research Database (Denmark)

Vavere, Andrea L; Simon, Gregory G; George, Richard T

2013-01-01

Multidetector coronary computed tomography angiography (CTA) is a promising modality for widespread clinical application because of its noninvasive nature and high diagnostic accuracy as found in previous studies using 64 to 320 simultaneous detector rows. It is, however, limited in its ability...... to detect myocardial ischemia. In this article, we describe the design of the CORE320 study ("Combined coronary atherosclerosis and myocardial perfusion evaluation using 320 detector row computed tomography"). This prospective, multicenter, multinational study is unique in that it is designed to assess...... the diagnostic performance of combined 320-row CTA and myocardial CT perfusion imaging (CTP) in comparison with the combination of invasive coronary angiography and single-photon emission computed tomography myocardial perfusion imaging (SPECT-MPI). The trial is being performed at 16 medical centers located in 8...

Optical spectra analysis for breast cancer diagnostics

Science.gov (United States)

Belkov, S. A.; Kochemasov, G. G.; Lyubynskaya, T. E.; Maslov, N. V.; Nuzhny, A. S.; da Silva, L. B.; Rubenchik, A.

2011-11-01

Minimally invasive probe and optical biopsy system based on optical spectra recording and analysis seem to be a promising tool for early diagnostics of breast cancer. Light scattering and absorption spectra are generated continuously as far as the needle-like probe with one emitting and several collecting optical fibers penetrates through the tissues toward to the suspicious area. That allows analyzing not only the state of local site, but also the structure of tissues along the needle trace. The suggested method has the advantages of automated on-line diagnosing and minimal tissue destruction and in parallel with the conventional diagnostic procedures provides the ground for decision-making. 165 medical trials were completed in Nizhny Novgorod Regional Oncology Centre, Russia. Independent diagnoses were the results of fine biopsy and histology. Application of wavelet expansion and clasterization techniques for spectra analysis revealed several main spectral types for malignant and benign tumors. Automatic classification algorithm demonstrated specificity ˜90% and sensitivity ˜91%. Large amount of information, fuzziness in criteria and data noisiness make neural networks to be an attractive analytic tool. The model based on three-layer perceptron was tested over the sample of 29 `cancer' and 29 `non-cancer' cases and demonstrated total separation.

Quality Control in Diagnostic Radiology: Experiences and Achievements

International Nuclear Information System (INIS)

Mohd Khalid Matori; Husaini Salleh; Muhammad Jamal Md Isa

2015-01-01

Malaysian Nuclear Agency through its Medical Physics Group has been providing Quality Control (QC) services for medical X-ray apparatus used in diagnostic radiology to private clinics and hospitals since the year 1997. The Medical Physics Groups services is endorsed by the Malaysian Ministry Of Health (MOH) and is in accordance with the Malaysian Standard MS 838 and the Atomic Energy Licensing Act, 1984. Until today, the scopes of testing services also include all types of medical x-ray apparatus. The quality control (QC) in diagnostic radiology is considered as part of quality assurance program which provide accurate diagnostic information at the lowest cost and the least exposure of the patients to radiation. Many experience and obstacles were faced by Medical Physics Group. This paper will discuss the experiences and achievements of providing QC service from early stage until now so that it can be shared by the citizens of the Malaysian Nuclear Agency. The results of quality assurance inspection of all types of X-ray apparatus for medical conducted by Agency Nuclear Malaysia will be presented in brief. (author)

21 CFR 886.1390 - Flexible diagnostic Fresnel lens.

Science.gov (United States)

2010-04-01

... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Flexible diagnostic Fresnel lens. 886.1390 Section... (CONTINUED) MEDICAL DEVICES OPHTHALMIC DEVICES Diagnostic Devices § 886.1390 Flexible diagnostic Fresnel lens. (a) Identification. A flexible diagnostic Fresnel lens is a device that is a very thin lens which has...

SMS-Based Medical Diagnostic Telemetry Data Transmission Protocol for Medical Sensors

Science.gov (United States)

Townsend, Ben; Abawajy, Jemal; Kim, Tai-Hoon

2011-01-01

People with special medical monitoring needs can, these days, be sent home and remotely monitored through the use of data logging medical sensors and a transmission base-station. While this can improve quality of life by allowing the patient to spend most of their time at home, most current technologies rely on hardwired landline technology or expensive mobile data transmissions to transmit data to a medical facility. The aim of this paper is to investigate and develop an approach to increase the freedom of a monitored patient and decrease costs by utilising mobile technologies and SMS messaging to transmit data from patient to medico. To this end, we evaluated the capabilities of SMS and propose a generic communications protocol which can work within the constraints of the SMS format, but provide the necessary redundancy and robustness to be used for the transmission of non-critical medical telemetry from data logging medical sensors. PMID:22163845

SMS-Based Medical Diagnostic Telemetry Data Transmission Protocol for Medical Sensors

Directory of Open Access Journals (Sweden)

Tai-Hoon Kim

2011-04-01

Full Text Available People with special medical monitoring needs can, these days, be sent home and remotely monitored through the use of data logging medical sensors and a transmission base-station. While this can improve quality of life by allowing the patient to spend most of their time at home, most current technologies rely on hardwired landline technology or expensive mobile data transmissions to transmit data to a medical facility. The aim of this paper is to investigate and develop an approach to increase the freedom of a monitored patient and decrease costs by utilising mobile technologies and SMS messaging to transmit data from patient to medico. To this end, we evaluated the capabilities of SMS and propose a generic communications protocol which can work within the constraints of the SMS format, but provide the necessary redundancy and robustness to be used for the transmission of non-critical medical telemetry from data logging medical sensors.

CRC Handbook of Medical Physics, vol. 3

International Nuclear Information System (INIS)

Waggener, R.G.; Kereiakes, J.G.; Shalek, R.J.

1984-01-01

In this work, the care and testing of measurement and diagnostic instruments are described in detail. Difficulties encountered with therapeutic and diagnostic calibrations are explored and solutions are suggested. VOLUME III Physics Teaching for Radiologic Technologists, Physics Teaching for Diagnostic Radiology Residents, Physics Teaching for Nuclear Medicine Residents, Physics Teaching for Radiotherapy Residents, Degree Programs in Medical Physics, Radiobiology Teaching, Non-Degree Medical Physics Training and American Board of Radiology Certifications, Radioactivity and Production of Medical Isotopes, Practical Medical Physics Consulting, Radiologic Terminology, Nuclear Medicine Imaging Techniques, Description of Radiotherapy Procedures, Medical Applications of Ultrasonography and Thermography, Glossary of Medical and Anatomical Terms Used in Medical Physics, Equipment List for Medical Physics and Acquisition Priority. Bibliography of Reference Materials. Index

X-ray diagnostics - benefits and risks

International Nuclear Information System (INIS)

Bartholomaeus, Melanie

2016-01-01

The brochure on benefits and risks of X-ray diagnostics discusses the following issues: X radiation - a pioneering discovery and medical sensation, fundamentals of X radiation, frequency of X-ray examinations in Germany in relation to CT imaging, radiation doses resulting from X-ray diagnostics, benefits of X-ray diagnostics - indication and examples, risks - measures for radiation exposure reductions, avoidance of unnecessary examinations.

The future of medical diagnostics: Review paper

NARCIS (Netherlands)

W.K. Jerjes (Waseem K.); T. Upile (Tahwinder); B.J. Wong (Brian J.); C.S. Betz (Christian S.); H.J.C.M. Sterenborg (Dick); M.J.H. Witjes (Max); K. Svanberg (Katarina); R. van Veen (Robert); M.A. Biel (Merrill A.); A.K. El-Naggar (Adel K.); C.A. Mosse (Charles A.); M. Olivo (Malini); R. Richards-Kortum (Rebecca); D.J. Robinson (Dominic); P.J. Rosen (Peter J.); A.G. Yodh (Arjun G.); C. Kendall (Catherine); J.F. Ilgner (Justus F.); A. Amelink (Arjen); V. Bagnato (Vanderlei); H. Barr (Hugh); L. Bolotine (Lina); I. Bigio (Irving); Z. Chen (Zhiyi); L.P. Choo-Smith; A.K. D'Cruz (Anil K.); A. Gillenwater (Ann); A. Leunig (Andreas); A.J. MacRobert (Alexander J.); G. McKenzie (Gordon); A. Sandison (Ann); K.C. Soo (Khee Chee); H. Stepp (Herbert); J.R.N. Stone; I.B. Tan (I. Bing); B.C. Wilson (Brian C.); H. Wolfsen (Herbert); C. Hopper (Colin)

2011-01-01

textabstractWhile histopathology of excised tissue remains the gold standard for diagnosis, several new, non-invasive diagnostic techniques are being developed. They rely on physical and biochemical changes that precede and mirror malignant change within tissue. The basic principle involves simple

The future of medical diagnostics : review paper

NARCIS (Netherlands)

Jerjes, Waseem K.; Upile, Tahwinder; Wong, Brian J.; Betz, Christian S.; Sterenborg, Henricus J.; Witjes, Max J.; Berg, Kristian; van Veen, Robert; Biel, Merrill A.; El-Naggar, Adel K.; Mosse, Charles A.; Olivo, Malini; Richards-Kortum, Rebecca; Robinson, Dominic J.; Rosen, Jennifer; Yodh, Arjun G.; Kendall, Catherine; Ilgner, Justus F.; Amelink, Arjen; Bagnato, Vanderlei; Barr, Hugh; Bolotine, Lina; Bigio, Irving; Chen, Zhongping; Choo-Smith, Lin-Ping; D'Cruz, Anil K.; Gillenwater, Ann; Leunig, Andreas; MacRobert, Alexander J.; McKenzie, Gordon; Sandison, Ann; Soo, Khee C.; Stepp, Herbert; Stone, Nicholas; Svanberg, Katarina; Tan, I. Bing; Wilson, Brian C.; Wolfsen, Herbert; Hopper, Colin

2011-01-01

While histopathology of excised tissue remains the gold standard for diagnosis, several new, non-invasive diagnostic techniques are being developed. They rely on physical and biochemical changes that precede and mirror malignant change within tissue. The basic principle involves simple optical

The future of medical diagnostics: review paper

NARCIS (Netherlands)

Jerjes, Waseem K.; Upile, Tahwinder; Wong, Brian J.; Betz, Christian S.; Sterenborg, Henricus J.; Witjes, Max J.; Berg, Kristian; van Veen, Robert; Biel, Merrill A.; El-Naggar, Adel K.; Mosse, Charles A.; Olivo, Malini; Richards-Kortum, Rebecca; Robinson, Dominic J.; Rosen, Jennifer; Yodh, Arjun G.; Kendall, Catherine; Ilgner, Justus F.; Amelink, Arjen; Bagnato, Vanderlei; Barr, Hugh; Bolotine, Lina; Bigio, Irving; Chen, Zhongping; Choo-Smith, Lin-Ping; D'Cruz, Anil K.; Gillenwater, Ann; Leunig, Andreas; MacRobert, Alexander J.; McKenzie, Gordon; Sandison, Ann; Soo, Khee C.; Stepp, Herbert; Stone, Nicholas; Svanberg, Katarina; Tan, I. Bing; Wilson, Brian C.; Wolfsen, Herbert; Hopper, Colin

2011-01-01

While histopathology of excised tissue remains the gold standard for diagnosis, several new, non-invasive diagnostic techniques are being developed. They rely on physical and biochemical changes that precede and mirror malignant change within tissue. The basic principle involves simple optical

Evidence assessing the diagnostic performance of medical smartphone apps: a systematic review and exploratory meta-analysis.

Science.gov (United States)

Buechi, Rahel; Faes, Livia; Bachmann, Lucas M; Thiel, Michael A; Bodmer, Nicolas S; Schmid, Martin K; Job, Oliver; Lienhard, Kenny R

2017-12-14

The number of mobile applications addressing health topics is increasing. Whether these apps underwent scientific evaluation is unclear. We comprehensively assessed papers investigating the diagnostic value of available diagnostic health applications using inbuilt smartphone sensors. Systematic Review-MEDLINE, Scopus, Web of Science inclusive Medical Informatics and Business Source Premier (by citation of reference) were searched from inception until 15 December 2016. Checking of reference lists of review articles and of included articles complemented electronic searches. We included all studies investigating a health application that used inbuilt sensors of a smartphone for diagnosis of disease. The methodological quality of 11 studies used in an exploratory meta-analysis was assessed with the Quality Assessment of Diagnostic Accuracy Studies 2 tool and the reporting quality with the 'STAndards for the Reporting of Diagnostic accuracy studies' (STARD) statement. Sensitivity and specificity of studies reporting two-by-two tables were calculated and summarised. We screened 3296 references for eligibility. Eleven studies, most of them assessing melanoma screening apps, reported 17 two-by-two tables. Quality assessment revealed high risk of bias in all studies. Included papers studied 1048 subjects (758 with the target conditions and 290 healthy volunteers). Overall, the summary estimate for sensitivity was 0.82 (95 % CI 0.56 to 0.94) and 0.89 (95 %CI 0.70 to 0.97) for specificity. The diagnostic evidence of available health apps on Apple's and Google's app stores is scarce. Consumers and healthcare professionals should be aware of this when using or recommending them. 42016033049. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Clinical Training of Medical Physicists Specializing in Diagnostic Radiology (Spanish Edition); Capacitacion clinica de fisicos medicos especialistas en radiodiagnostico

Energy Technology Data Exchange (ETDEWEB)

NONE

2013-01-15

The application of radiation in human health, for both diagnosis and treatment of disease, is an important component of the work of the IAEA. The responsibility for the increasing technical aspects of this work is undertaken by the medical physicist. To ensure good practice in this vital area, structured clinical training programmes are required to complement academic learning. This publication is intended to be a guide to the practical implementation of such a programme for diagnostic radiology. There is a general and growing awareness that radiation medicine is increasingly dependent on well trained medical physicists based in the clinical setting. However, an analysis of the availability of medical physicists indicates a large shortfall of qualified and capable professionals. This is particularly evident in developing countries. While strategies to increase academic educational opportunities are critical to such countries, the need for guidance on structured clinical training was recognized by the members of the Regional Cooperative Agreement (RCA) for Research, Development and Training related to Nuclear Sciences for Asia and the Pacific. Consequently, a technical cooperation regional project (RAS6038) under the RCA programme was formulated to address this need in the Asia-Pacific region by developing suitable material and establishing its viability. Development of a clinical training guide for medical physicists specializing in diagnostic radiology started in 2007 with the appointment of a core drafting committee of regional and international experts. The publication drew on the experiences of clinical training programmes in Australia and New Zealand, the UK and the USA, and was moderated by physicists working in the Asian region. This publication follows the approach of the IAEA publication Training Course Series No. 37, Clinical Training of Medical Physicists specializing in Radiation Oncology. This approach to clinical training has been successfully tested

Interpretation of microbiota-based diagnostics by explaining individual classifier decisions

NARCIS (Netherlands)

Eck, A.; Zintgraf, L.M.; de Groot, E.F.J.; de Meij, T.G.J.; Cohen, T.S.; Savelkoul, P.H.M.; Welling, M.; Budding, A.E.

2017-01-01

Background The human microbiota is associated with various disease states and holds a great promise for non-invasive diagnostics. However, microbiota data is challenging for traditional diagnostic approaches: It is high-dimensional, sparse and comprises of high inter-personal variation. State of the

Small business development for molecular diagnostics.

Science.gov (United States)

Anagostou, Anthanasia; Liotta, Lance A

2012-01-01

Molecular profiling, which is the application of molecular diagnostics technology to tissue and blood -specimens, is an integral element in the new era of molecular medicine and individualized therapy. Molecular diagnostics is a fertile ground for small business development because it can generate products that meet immediate demands in the health-care sector: (a) Detection of disease risk, or early-stage disease, with a higher specificity and sensitivity compared to previous testing methods, and (b) "Companion diagnostics" for stratifying patients to receive a treatment choice optimized to their individual disease. This chapter reviews the promise and challenges of business development in this field. Guidelines are provided for the creation of a business model and the generation of a marketing plan around a candidate molecular diagnostic product. Steps to commercialization are outlined using existing molecular diagnostics companies as learning examples.

21 CFR 886.1395 - Diagnostic Hruby fundus lens.

Science.gov (United States)

2010-04-01

... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Diagnostic Hruby fundus lens. 886.1395 Section 886...) MEDICAL DEVICES OPHTHALMIC DEVICES Diagnostic Devices § 886.1395 Diagnostic Hruby fundus lens. (a) Identification. A diagnostic Hruby fundus lens is a device that is a 55 diopter lens intended for use in the...

Total picture archiving communication system for medical use at medium-sized hospitals

International Nuclear Information System (INIS)

Kabata, Shun; Goto, Kazuhiko; Yamada, Kazumi; Okaniwa, Hiroshi.

1991-01-01

An increasingly widespread use of diagnostic imaging systems has seen a concomitant rise in the number of medical images. Picture archiving and communication system (PACS) allows filmless storage by digitizing images to record and store into the optical disk, and allows the rapid data retrieval and transmission. It is anticipated that PACS may be a promising approach to the medical routine practice. In January 1991, Hitachi PACS was introduced in Tokyo Hitachi Hospital. In this paper, the experience with PACS in the clinical setting is presented. The process of improvement in PACS is given in terms of the following: the flow of images, image deletion in the image workstation, and the number of sequential images to be observed. (N.K.)

Magnetically-driven medical robots: An analytical magnetic model for endoscopic capsules design

Science.gov (United States)

Li, Jing; Barjuei, Erfan Shojaei; Ciuti, Gastone; Hao, Yang; Zhang, Peisen; Menciassi, Arianna; Huang, Qiang; Dario, Paolo

2018-04-01

Magnetic-based approaches are highly promising to provide innovative solutions for the design of medical devices for diagnostic and therapeutic procedures, such as in the endoluminal districts. Due to the intrinsic magnetic properties (no current needed) and the high strength-to-size ratio compared with electromagnetic solutions, permanent magnets are usually embedded in medical devices. In this paper, a set of analytical formulas have been derived to model the magnetic forces and torques which are exerted by an arbitrary external magnetic field on a permanent magnetic source embedded in a medical robot. In particular, the authors modelled cylindrical permanent magnets as general solution often used and embedded in magnetically-driven medical devices. The analytical model can be applied to axially and diametrically magnetized, solid and annular cylindrical permanent magnets in the absence of the severe calculation complexity. Using a cylindrical permanent magnet as a selected solution, the model has been applied to a robotic endoscopic capsule as a pilot study in the design of magnetically-driven robots.

Diagnostic image quality of mammograms in German outpatient medical care

International Nuclear Information System (INIS)

Pfandzelter, R.; Wuelfing, U.; Boedeker, B.

2010-01-01

Purpose: A total of 79 115 mammograms from statutory health insurance (SHI) physicians within German outpatient care were evaluated with respect to the diagnostic image quality. Materials and Methods: Mammograms were randomly selected between 2006 and 2008 by the regional Associations of Statutory Health Insurance Physicians and submitted to regional boards of experts for external evaluation. The mammogram quality was evaluated using a 3-point scale (adequate, borderline, failure) and documented using a nationally standardized protocol. Results: 87.6 % of the mammograms were classified as adequate, 11.0 % as borderline and 1.4 % as failure. Mediolateral oblique mammograms (mlo) had worse ratings than craniocaudal mammograms (cc). Main reasons for classifying the mammograms as borderline or failure were 'inframammary fold not adequately visualized' (mlo), 'pectoral muscle not in the correct angle or not to the level with the nipple' (mlo), 'the nipple not in profile' (mlo, cc) and 'breast not completely or not adequately visualized' (cc). Conclusion: The results show a good overall quality of mammograms in German outpatient medical care. Failures can be associated predominantly with incorrect positioning of the breast. More precisely defined quality criteria using objective measures are recommended, especially for craniocaudal mammograms (cc). (orig.)

Quality control in diagnostic radiology: experience and challenges

International Nuclear Information System (INIS)

Abd Aziz Mhd Ramli; Mohd Ramli Arshad; Mohd Khalid Matori; Muhammad Jamal Md Isa; Husaini Salleh; Abdullah Tahir Aliyasak; Zainal Jamaluddin; Hasrul Hisham Hussain

2005-01-01

Malaysian Institute for Nuclear Technology Research through its Medical Physics Group has been providing Quality Control (QC) services for medical x-ray apparatus used in diagnostic radiology to private clinics and hospitals since the year 1997. The quality control (QC) in diagnostic radiology is considered as part of quality assurance program which provide accurate diagnostic information at the lowest cost and the least exposure of the patients to radiation. Many experience and obstacles were faced by Medical Physics Group. This paper will discuss on some of the experiences and challenges that could be shared together with MINT staff especially in the safety aspect related to electrical and mechanical, radiation protection, performance and standard. The challenging in administrative aspect also will discuss. (Author)

SMS-Based Medical Diagnostic Telemetry Data Transmission Protocol for Medical Sensors

OpenAIRE

Townsend, Ben; Abawajy, Jemal; Kim, Tai-Hoon

2011-01-01

People with special medical monitoring needs can, these days, be sent home and remotely monitored through the use of data logging medical sensors and a transmission base-station. While this can improve quality of life by allowing the patient to spend most of their time at home, most current technologies rely on hardwired landline technology or expensive mobile data transmissions to transmit data to a medical facility. The aim of this paper is to investigate and develop an approach to increase...

In-vitro diagnostic devices introduction to current point-of-care diagnostic devices

CERN Document Server

Cheng, Chao-Min; Chen, Chien-Fu

2016-01-01

Addressing the origin, current status, and future development of point-of-care diagnostics, and serving to integrate knowledge and tools from Analytical Chemistry, Bioengineering, Biomaterials, and Nanotechnology, this book focusses on addressing the collective and combined needs of industry and academia (including medical schools) to effectively conduct interdisciplinary research. In addition to summarizing and detailing developed diagnostic devices, this book will attempt to point out the possible future trends of development for point-of-care diagnostics using both scientifically based research and practical engineering needs with the aim to help novices comprehensively understand the development of point-of-care diagnostics. This includes demonstrating several common but critical principles and mechanisms used in point-of-care diagnostics that address practical needs (e.g., disease or healthcare monitoring) using two well-developed examples so far: 1) blood glucose meters (via electrochemistry); and, 2) p...

Diagnostic imaging in pregraduate integrated curricula

International Nuclear Information System (INIS)

Kainberger, F.; Kletter, K.

2007-01-01

Pregraduate medical curricula are currently undergoing a reform process that is moving away from a traditional discipline-related structure and towards problem-based integrated forms of teaching. Imaging sciences, with their inherently technical advances, are specifically influenced by the effects of paradigm shifts in medical education. The teaching of diagnostic radiology should be based on the definition of three core competencies: in vivo visualization of normal and abnormal morphology and function, diagnostic reasoning, and interventional treatment. On the basis of these goals, adequate teaching methods and e-learning tools should be implemented by focusing on case-based teaching. Teaching materials used in the fields of normal anatomy, pathology, and clinical diagnosis may help diagnostic radiology to play a central role in modern pregraduate curricula. (orig.)

[Diagnostic imaging in pregraduate integrated curricula].

Science.gov (United States)

Kainberger, F; Kletter, K

2007-11-01

Pregraduate medical curricula are currently undergoing a reform process that is moving away from a traditional discipline-related structure and towards problem-based integrated forms of teaching. Imaging sciences, with their inherently technical advances, are specifically influenced by the effects of paradigm shifts in medical education. The teaching of diagnostic radiology should be based on the definition of three core competencies: in vivo visualization of normal and abnormal morphology and function, diagnostic reasoning, and interventional treatment. On the basis of these goals, adequate teaching methods and e-learning tools should be implemented by focusing on case-based teaching. Teaching materials used in the fields of normal anatomy, pathology, and clinical diagnosis may help diagnostic radiology to play a central role in modern pregraduate curricula.

[Cognitive errors in diagnostic decision making].

Science.gov (United States)

Gäbler, Martin

2017-10-01

Approximately 10-15% of our diagnostic decisions are faulty and may lead to unfavorable and dangerous outcomes, which could be avoided. These diagnostic errors are mainly caused by cognitive biases in the diagnostic reasoning process.Our medical diagnostic decision-making is based on intuitive "System 1" and analytical "System 2" diagnostic decision-making and can be deviated by unconscious cognitive biases.These deviations can be positively influenced on a systemic and an individual level. For the individual, metacognition (internal withdrawal from the decision-making process) and debiasing strategies, such as verification, falsification and rule out worst-case scenarios, can lead to improved diagnostic decisions making.

Mobile diagnostics: next-generation technologies for in vitro diagnostics.

Science.gov (United States)

Shin, Joonchul; Chakravarty, Sudesna; Choi, Wooseok; Lee, Kyungyeon; Han, Dongsik; Hwang, Hyundoo; Choi, Jaekyu; Jung, Hyo-Il

2018-03-26

The emergence of a wide range of applications of smartphones along with advances in 'liquid biopsy' has significantly propelled medical research particularly in the field of in vitro diagnostics (IVD). Herein, we have presented a detailed analysis of IVD, its associated critical concerns and probable solutions. It also demonstrates the transition in terms of analytes from minimally invasive (blood) to non-invasive (urine, saliva and sweat) and depicts how the different features of a smartphone can be integrated for specific diagnostic purposes. This review basically highlights recent advances in the applications of smartphone-based biosensors in IVD taking into account the following factors: accuracy and portability; quantitative and qualitative analysis; and centralization and decentralization tests. Furthermore, the critical concerns and future direction of diagnostics based on smartphones are also discussed.

Integration of interactive three-dimensional image post-processing software into undergraduate radiology education effectively improves diagnostic skills and visual-spatial ability.

Science.gov (United States)

Rengier, Fabian; Häfner, Matthias F; Unterhinninghofen, Roland; Nawrotzki, Ralph; Kirsch, Joachim; Kauczor, Hans-Ulrich; Giesel, Frederik L

2013-08-01

Integrating interactive three-dimensional post-processing software into undergraduate radiology teaching might be a promising approach to synergistically improve both visual-spatial ability and radiological skills, thereby reducing students' deficiencies in image interpretation. The purpose of this study was to test our hypothesis that a hands-on radiology course for medical students using interactive three-dimensional image post-processing software improves radiological knowledge, diagnostic skills and visual-spatial ability. A hands-on radiology course was developed using interactive three-dimensional image post-processing software. The course consisted of seven seminars held on a weekly basis. The 25 participating fourth- and fifth-year medical students learnt to systematically analyse cross-sectional imaging data and correlated the two-dimensional images with three-dimensional reconstructions. They were instructed by experienced radiologists and collegiate tutors. The improvement in radiological knowledge, diagnostic skills and visual-spatial ability was assessed immediately before and after the course by multiple-choice tests comprising 64 questions each. Wilcoxon signed rank test for paired samples was applied. The total number of correctly answered questions improved from 36.9±4.8 to 49.5±5.4 (pability by 11.3% (psoftware into undergraduate radiology education effectively improves radiological reasoning, diagnostic skills and visual-spatial ability, and thereby even diagnostic skills for imaging modalities not included in the course. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

21 CFR 892.1000 - Magnetic resonance diagnostic device.

Science.gov (United States)

2010-04-01

... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Magnetic resonance diagnostic device. 892.1000 Section 892.1000 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES RADIOLOGY DEVICES Diagnostic Devices § 892.1000 Magnetic resonance diagnostic...

A survey of medical diagnostic imaging technologies

Energy Technology Data Exchange (ETDEWEB)

Heese, V.; Gmuer, N.; Thomlinson, W.

1991-10-01

The fields of medical imaging and medical imaging instrumentation are increasingly important. The state-of-the-art continues to advance at a very rapid pace. In fact, various medical imaging modalities are under development at the National Synchrotron Light Source (such as MECT and Transvenous Angiography.) It is important to understand how these techniques compare with today`s more conventional imaging modalities. The purpose of this report is to provide some basic information about the various medical imaging technologies currently in use and their potential developments as a basis for this comparison. This report is by no means an in-depth study of the physics and instrumentation of the various imaging modalities; instead, it is an attempt to provide an explanation of the physical bases of these techniques and their principal clinical and research capabilities.

A survey of medical diagnostic imaging technologies

International Nuclear Information System (INIS)

Heese, V.; Gmuer, N.; Thomlinson, W.

1991-10-01

The fields of medical imaging and medical imaging instrumentation are increasingly important. The state-of-the-art continues to advance at a very rapid pace. In fact, various medical imaging modalities are under development at the National Synchrotron Light Source (such as MECT and Transvenous Angiography.) It is important to understand how these techniques compare with today's more conventional imaging modalities. The purpose of this report is to provide some basic information about the various medical imaging technologies currently in use and their potential developments as a basis for this comparison. This report is by no means an in-depth study of the physics and instrumentation of the various imaging modalities; instead, it is an attempt to provide an explanation of the physical bases of these techniques and their principal clinical and research capabilities

Frontiers in medical imaging technology

International Nuclear Information System (INIS)

Iinuma, Takeshi

1992-01-01

At present many medical images are used for diagnostics and treatment. After the advent of X-ray computer tomography (XCT), the violent development of medical images has continued. Medical imaging technology can be defined as the field of technology that deals with the production, processing, display, transmission, evaluation and so on of medical images, and it can be said that the present development of medical imaging diagnostics has been led by medical imaging technology. In this report, the most advanced technology of medical imaging is explained. The principle of XCT is shown. The feature of XCT is that it can image the delicate difference in the X-ray absorption factor of the cross section being measured. The technical development has been advanced to reduce the time for imaging and to heighten the resolution. The technology which brings about a large impact to future imaging diagnostics is computed radiography. Magnetic resonance imaging is the method of imaging the distribution of protons in human bodies. Positron CT is the method of measurement by injecting a positron-emitting RI. These methods are explained. (K.I.)

Assessment of Diagnostic and Prognostic Role of Copeptin in the Clinical Setting of Sepsis

Directory of Open Access Journals (Sweden)

Stefania Battista

2016-01-01

Full Text Available The diagnostic and prognostic usefulness of copeptin were evaluated in septic patients, as compared to procalcitonin assessment. In this single centre and observational study 105 patients were enrolled: 24 with sepsis, 25 with severe sepsis, 15 with septic shock, and 41 controls, divided in two subgroups (15 patients with gastrointestinal bleeding and 26 with suspected SIRS secondary to trauma, acute coronary syndrome, and pulmonary embolism. Biomarkers were determined at the first medical evaluation and thereafter 24, 48, and 72 hours after admission. Definitive diagnosis and in-hospital survival rates at 30 days were obtained through analysis of medical records. At entry, copeptin proved to be able to distinguish cases from controls and also sepsis group from septic shock group, while procalcitonin could distinguish also severe sepsis from septic shock group. Areas under the ROC curve for copeptin and procalcitonin were 0.845 and 0.861, respectively. Noteworthy, patients with copeptin concentrations higher than the threshold value (23.2 pmol/L, calculated from the ROC curve, at admission presented higher 30-day mortality. No significant differences were found in copeptin temporal profile among different subgroups. Copeptin showed promising diagnostic and prognostic role in the management of sepsis, together with its possible role in monitoring the response to treatment.

Assessment of Diagnostic and Prognostic Role of Copeptin in the Clinical Setting of Sepsis.

Science.gov (United States)

Battista, Stefania; Audisio, Umberto; Galluzzo, Claudia; Maggiorotto, Matteo; Masoero, Monica; Forno, Daniela; Pizzolato, Elisa; Ulla, Marco; Lucchiari, Manuela; Vitale, Annarita; Moiraghi, Corrado; Lupia, Enrico; Settanni, Fabio; Mengozzi, Giulio

2016-01-01

The diagnostic and prognostic usefulness of copeptin were evaluated in septic patients, as compared to procalcitonin assessment. In this single centre and observational study 105 patients were enrolled: 24 with sepsis, 25 with severe sepsis, 15 with septic shock, and 41 controls, divided in two subgroups (15 patients with gastrointestinal bleeding and 26 with suspected SIRS secondary to trauma, acute coronary syndrome, and pulmonary embolism). Biomarkers were determined at the first medical evaluation and thereafter 24, 48, and 72 hours after admission. Definitive diagnosis and in-hospital survival rates at 30 days were obtained through analysis of medical records. At entry, copeptin proved to be able to distinguish cases from controls and also sepsis group from septic shock group, while procalcitonin could distinguish also severe sepsis from septic shock group. Areas under the ROC curve for copeptin and procalcitonin were 0.845 and 0.861, respectively. Noteworthy, patients with copeptin concentrations higher than the threshold value (23.2 pmol/L), calculated from the ROC curve, at admission presented higher 30-day mortality. No significant differences were found in copeptin temporal profile among different subgroups. Copeptin showed promising diagnostic and prognostic role in the management of sepsis, together with its possible role in monitoring the response to treatment.

Integrating nursing diagnostic concepts into the medical entities dictionary using the ISO Reference Terminology Model for Nursing Diagnosis.

Science.gov (United States)

Hwang, Jee-In; Cimino, James J; Bakken, Suzanne

2003-01-01

The purposes of the study were (1) to evaluate the usefulness of the International Standards Organization (ISO) Reference Terminology Model for Nursing Diagnoses as a terminology model for defining nursing diagnostic concepts in the Medical Entities Dictionary (MED) and (2) to create the additional hierarchical structures required for integration of nursing diagnostic concepts into the MED. The authors dissected nursing diagnostic terms from two source terminologies (Home Health Care Classification and the Omaha System) into the semantic categories of the ISO model. Consistent with the ISO model, they selected Focus and Judgment as required semantic categories for creating intensional definitions of nursing diagnostic concepts in the MED. Because the MED does not include Focus and Judgment hierarchies, the authors developed them to define the nursing diagnostic concepts. The ISO model was sufficient for dissecting the source terminologies into atomic terms. The authors identified 162 unique focus concepts from the 266 nursing diagnosis terms for inclusion in the Focus hierarchy. For the Judgment hierarchy, the authors precoordinated Judgment and Potentiality instead of using Potentiality as a qualifier of Judgment as in the ISO model. Impairment and Alteration were the most frequently occurring judgments. Nursing care represents a large proportion of health care activities; thus, it is vital that terms used by nurses are integrated into concept-oriented terminologies that provide broad coverage for the domain of health care. This study supports the utility of the ISO Reference Terminology Model for Nursing Diagnoses as a facilitator for the integration process.

A survey of medical diagnostic imaging technologies

Energy Technology Data Exchange (ETDEWEB)

Heese, V.; Gmuer, N.; Thomlinson, W.

1991-10-01

The fields of medical imaging and medical imaging instrumentation are increasingly important. The state-of-the-art continues to advance at a very rapid pace. In fact, various medical imaging modalities are under development at the National Synchrotron Light Source (such as MECT and Transvenous Angiography.) It is important to understand how these techniques compare with today's more conventional imaging modalities. The purpose of this report is to provide some basic information about the various medical imaging technologies currently in use and their potential developments as a basis for this comparison. This report is by no means an in-depth study of the physics and instrumentation of the various imaging modalities; instead, it is an attempt to provide an explanation of the physical bases of these techniques and their principal clinical and research capabilities.

Capturing and displaying microscopic images used in medical diagnostics and forensic science using 4K video resolution - an application in higher education.

Science.gov (United States)

Maier, Hans; de Heer, Gert; Ortac, Ajda; Kuijten, Jan

2015-11-01

To analyze, interpret and evaluate microscopic images, used in medical diagnostics and forensic science, video images for educational purposes were made with a very high resolution of 4096 × 2160 pixels (4K), which is four times as many pixels as High-Definition Video (1920 × 1080 pixels). The unprecedented high resolution makes it possible to see details that remain invisible to any other video format. The images of the specimens (blood cells, tissue sections, hair, fibre, etc.) are recorded using a 4K video camera which is attached to a light microscope. After processing, this resulted in very sharp and highly detailed images. This material was then used in education for classroom discussion. Spoken explanation by experts in the field of medical diagnostics and forensic science was also added to the high-resolution video images to make it suitable for self-study. © 2015 The Authors. Journal of Microscopy published by John Wiley & Sons Ltd on behalf of Royal Microscopical Society.

Radiation education in medical and Co-medical schools

International Nuclear Information System (INIS)

Koga, Sukehiko

2005-01-01

In the medical field, ionizing radiation is very widely in diagnostic and therapeutic procedures, Around 60% of environmental radiation, including natural background and man-made sources of radiation, is caused from medical exposure in Japan. Education of radiation in medical ad co-medical schools are mainly aimed to how effectively use the radiation, and the time shared to fundamental physics, biology and safety or protection of radiation is not so much. (author)

Microwave imaging for plasma diagnostics and its applications

International Nuclear Information System (INIS)

Mase, A.; Kogi, Y.; Ito, N.

2007-01-01

Microwave to millimeter-wave diagnostic techniques such as interferometry, reflectometry, scattering, and radiometry have been powerful tools for diagnosing magnetically confined plasmas. Important plasma parameters were measured to clarify the physics issues such as stability, wave phenomena, and fluctuation-induced transport. Recent advances in microwave and millimeter-wave technology together with computer technology have enabled the development of advanced diagnostics for visualization of 2D and 3D structures of plasmas. Microwave/millimeter-wave imaging is expected to be one of the most promising diagnostic methods for this purpose. We report here on the representative microwave diagnostics and their industrial applications as well as application to magnetically-confined plasmas. (author)

ASIC design of a digital fuzzy system on chip for medical diagnostic applications.

Science.gov (United States)

Roy Chowdhury, Shubhajit; Roy, Aniruddha; Saha, Hiranmay

2011-04-01

The paper presents the ASIC design of a digital fuzzy logic circuit for medical diagnostic applications. The system on chip under consideration uses fuzzifier, memory and defuzzifier for fuzzifying the patient data, storing the membership function values and defuzzifying the membership function values to get the output decision. The proposed circuit uses triangular trapezoidal membership functions for fuzzification patients' data. For minimizing the transistor count, the proposed circuit uses 3T XOR gates and 8T adders for its design. The entire work has been carried out using TSMC 0.35 µm CMOS process. Post layout TSPICE simulation of the whole circuit indicates a delay of 31.27 ns and the average power dissipation of the system on chip is 123.49 mW which indicates a less delay and less power dissipation than the comparable embedded systems reported earlier.

Delivering Diagnostic Quality Video over Mobile Wireless Networks for Telemedicine

Directory of Open Access Journals (Sweden)

Sira P. Rao

2009-01-01

Full Text Available In real-time remote diagnosis of emergency medical events, mobility can be enabled by wireless video communications. However, clinical use of this potential advance will depend on definitive and compelling demonstrations of the reliability of diagnostic quality video. Because the medical domain has its own fidelity criteria, it is important to incorporate diagnostic video quality criteria into any video compression system design. To this end, we used flexible algorithms for region-of-interest (ROI video compression and obtained feedback from medical experts to develop criteria for diagnostically lossless (DL quality. The design of the system occurred in three steps-measurement of bit rate at which DL quality is achieved through evaluation of videos by medical experts, incorporation of that information into a flexible video encoder through the notion of encoder states, and an encoder state update option based on a built-in quality criterion. Medical experts then evaluated our system for the diagnostic quality of the video, allowing us to verify that it is possible to realize DL quality in the ROI at practical communication data transfer rates, enabling mobile medical assessment over bit-rate limited wireless channels. This work lays the scientific foundation for additional validation through prototyped technology, field testing, and clinical trials.

Towards first principle medical diagnostics: on the importance of disease-disease and sign-sign interactions

Science.gov (United States)

Ramezanpour, Abolfazl; Mashaghi, Alireza

2017-07-01

A fundamental problem in medicine and biology is to assign states, e.g. healthy or diseased, to cells, organs or individuals. State assignment or making a diagnosis is often a nontrivial and challenging process and, with the advent of omics technologies, the diagnostic challenge is becoming more and more serious. The challenge lies not only in the increasing number of measured properties and dynamics of the system (e.g. cell or human body) but also in the co-evolution of multiple states and overlapping properties, and degeneracy of states. We develop, from first principles, a generic rational framework for state assignment in cell biology and medicine, and demonstrate its applicability with a few simple theoretical case studies from medical diagnostics. We show how disease-related statistical information can be used to build a comprehensive model that includes the relevant dependencies between clinical and laboratory findings (signs) and diseases. In particular, we include disease-disease and sign-sign interactions and study how one can infer the probability of a disease in a patient with given signs. We perform comparative analysis with simple benchmark models to check the performances of our models. We find that including interactions can significantly change the statistical importance of the signs and diseases. This first principles approach, as we show, facilitates the early diagnosis of disease by taking interactions into accounts, and enables the construction of consensus diagnostic flow charts. Additionally, we envision that our approach will find applications in systems biology, and in particular, in characterizing the phenome via the metabolome, the proteome, the transcriptome, and the genome.

Nuclear medical diagnostic with ventricular aneurysm

International Nuclear Information System (INIS)

Litter, H.

1987-01-01

In the diagnostic of ventricular aneurysms myocardial scintigraphy and above all radionuclide ventriculography (RNV) have special importance. Because of the non-invasive method and the as a result safe and easy use even with stress studies, RNV can provide a very valuable aid with aneurysm patients in early diagnosis, evaluation of the operability and as well as in the prognosis. It must be noted, however, that the differentiation of multivascular diseases and sometimes ventricular aneurysms can be difficult and the inclusion of an angiocardiograph as a radiological invasive examination procedure seems fitting. (orig./MG) [de

A review of m-health in medical imaging.

Science.gov (United States)

Perera, Chandrashan Mahendra; Chakrabarti, Rahul

2015-02-01

The increasing capabilities of camera-equipped mobile phones have led to a growing body of evidence regarding their use in medical imaging across a broad range of medical specialties. This article reviews the current evidence for the use of mobile health (m-health) in medical imaging. We performed a structured review of the published literature regarding m-health in medical imaging using the Medline, PubMed, and Web of Science databases (January 2002-August 2013). The two authors independently extracted data regarding type of specialty, purpose, and study design of publications. In total, 235 articles were identified. The majority of studies were case reports or noncomparative product validation studies. The greatest volume of publications originated in the fields of radiology (21%), dermatology (15%), laboratory techniques (15%), and plastic surgery (12%). Among these studies, m-health was used as diagnostic aids, for patient monitoring, and to improve communication between health practitioners. With the growing use of mobile phones for medical imaging, considerations need to be given to informed consent, privacy, image storage and transfer, and guidelines for healthcare workers and patients. There are several novel uses of mobile devices for medical imaging that show promise across a variety of areas and subspecialties of healthcare. Currently, studies are mostly exploratory in nature. To validate these devices, studies with higher methodological rigor are required.

[Advances of Molecular Diagnostic Techniques Application in Clinical Diagnosis.

Science.gov (United States)

Ying, Bin-Wu

2016-11-01

Over the past 20 years,clinical molecular diagnostic technology has made rapid development,and became the most promising field in clinical laboratory medicine.In particular,with the development of genomics,clinical molecular diagnostic methods will reveal the nature of clinical diseases in a deeper level,thus guiding the clinical diagnosis and treatments.Many molecular diagnostic projects have been routinely applied in clinical works.This paper reviews the advances on application of clinical diagnostic techniques in infectious disease,tumor and genetic disorders,including nucleic acid amplification,biochip,next-generation sequencing,and automation molecular system,and so on.

21 CFR 801.119 - In vitro diagnostic products.

Science.gov (United States)

2010-04-01

... 21 Food and Drugs 8 2010-04-01 2010-04-01 false In vitro diagnostic products. 801.119 Section 801...) MEDICAL DEVICES LABELING Exemptions From Adequate Directions for Use § 801.119 In vitro diagnostic products. A product intended for use in the diagnosis of disease and which is an in vitro diagnostic...

Better Tests, Better Care: Improved Diagnostics for Infectious Diseases

Science.gov (United States)

Caliendo, Angela M.; Gilbert, David N.; Ginocchio, Christine C.; Hanson, Kimberly E.; May, Larissa; Quinn, Thomas C.; Tenover, Fred C.; Alland, David; Blaschke, Anne J.; Bonomo, Robert A.; Carroll, Karen C.; Ferraro, Mary Jane; Hirschhorn, Lisa R.; Joseph, W. Patrick; Karchmer, Tobi; MacIntyre, Ann T.; Reller, L. Barth; Jackson, Audrey F.

2013-01-01

In this IDSA policy paper, we review the current diagnostic landscape, including unmet needs and emerging technologies, and assess the challenges to the development and clinical integration of improved tests. To fulfill the promise of emerging diagnostics, IDSA presents recommendations that address a host of identified barriers. Achieving these goals will require the engagement and coordination of a number of stakeholders, including Congress, funding and regulatory bodies, public health agencies, the diagnostics industry, healthcare systems, professional societies, and individual clinicians. PMID:24200831

Handheld Diagnostic Device Delivers Quick Medical Readings

Science.gov (United States)

2014-01-01

To monitor astronauts' health remotely, Glenn Research Center awarded SBIR funding to Cambridge, Massachusetts-based DNA Medical Institute, which developed a device capable of analyzing blood cell counts and a variety of medical biomarkers. The technology will prove especially useful in rural areas without easy access to labs.

Smartphone-Based Food Diagnostic Technologies: A Review

Science.gov (United States)

Rateni, Giovanni; Dario, Paolo; Cavallo, Filippo

2017-01-01

A new generation of mobile sensing approaches offers significant advantages over traditional platforms in terms of test speed, control, low cost, ease-of-operation, and data management, and requires minimal equipment and user involvement. The marriage of novel sensing technologies with cellphones enables the development of powerful lab-on-smartphone platforms for many important applications including medical diagnosis, environmental monitoring, and food safety analysis. This paper reviews the recent advancements and developments in the field of smartphone-based food diagnostic technologies, with an emphasis on custom modules to enhance smartphone sensing capabilities. These devices typically comprise multiple components such as detectors, sample processors, disposable chips, batteries and software, which are integrated with a commercial smartphone. One of the most important aspects of developing these systems is the integration of these components onto a compact and lightweight platform that requires minimal power. To date, researchers have demonstrated several promising approaches employing various sensing techniques and device configurations. We aim to provide a systematic classification according to the detection strategy, providing a critical discussion of strengths and weaknesses. We have also extended the analysis to the food scanning devices that are increasingly populating the Internet of Things (IoT) market, demonstrating how this field is indeed promising, as the research outputs are quickly capitalized on new start-up companies. PMID:28632188

Smartphone-Based Food Diagnostic Technologies: A Review.

Science.gov (United States)

Rateni, Giovanni; Dario, Paolo; Cavallo, Filippo

2017-06-20

A new generation of mobile sensing approaches offers significant advantages over traditional platforms in terms of test speed, control, low cost, ease-of-operation, and data management, and requires minimal equipment and user involvement. The marriage of novel sensing technologies with cellphones enables the development of powerful lab-on-smartphone platforms for many important applications including medical diagnosis, environmental monitoring, and food safety analysis. This paper reviews the recent advancements and developments in the field of smartphone-based food diagnostic technologies, with an emphasis on custom modules to enhance smartphone sensing capabilities. These devices typically comprise multiple components such as detectors, sample processors, disposable chips, batteries and software, which are integrated with a commercial smartphone. One of the most important aspects of developing these systems is the integration of these components onto a compact and lightweight platform that requires minimal power. To date, researchers have demonstrated several promising approaches employing various sensing techniques and device configurations. We aim to provide a systematic classification according to the detection strategy, providing a critical discussion of strengths and weaknesses. We have also extended the analysis to the food scanning devices that are increasingly populating the Internet of Things (IoT) market, demonstrating how this field is indeed promising, as the research outputs are quickly capitalized on new start-up companies.

Smartphone-Based Food Diagnostic Technologies: A Review

Directory of Open Access Journals (Sweden)

Giovanni Rateni

2017-06-01

Full Text Available A new generation of mobile sensing approaches offers significant advantages over traditional platforms in terms of test speed, control, low cost, ease-of-operation, and data management, and requires minimal equipment and user involvement. The marriage of novel sensing technologies with cellphones enables the development of powerful lab-on-smartphone platforms for many important applications including medical diagnosis, environmental monitoring, and food safety analysis. This paper reviews the recent advancements and developments in the field of smartphone-based food diagnostic technologies, with an emphasis on custom modules to enhance smartphone sensing capabilities. These devices typically comprise multiple components such as detectors, sample processors, disposable chips, batteries and software, which are integrated with a commercial smartphone. One of the most important aspects of developing these systems is the integration of these components onto a compact and lightweight platform that requires minimal power. To date, researchers have demonstrated several promising approaches employing various sensing techniques and device configurations. We aim to provide a systematic classification according to the detection strategy, providing a critical discussion of strengths and weaknesses. We have also extended the analysis to the food scanning devices that are increasingly populating the Internet of Things (IoT market, demonstrating how this field is indeed promising, as the research outputs are quickly capitalized on new start-up companies.

Mammary carcinoma diagnostics and therapy

International Nuclear Information System (INIS)

Fischer, Uwe; Baum, Friedemann

2014-01-01

The book on mammary carcinoma diagnostics and therapy covers the following issues: development, anatomy and physiology of the mammary glands, pathology of benign and malign mammary gland changes, non-imaging diagnostics; mammography; ultrasonic mammography; magnetic resonance tomography of the mammary glands; imaging diagnostics findings; mammary interventions; examination concepts; operative therapy of the mammary carcinoma; chemotherapy of the mammary carcinoma; radio-oncological therapy of the mammary carcinoma; logistics in a medical center for mammary gland diseases; logistics in an interdisciplinary center for mammary diseases; dialogue conduction and psycho-social attendance.

The diagnostic suitability of a xerostomia questionnaire and the association between xerostomia, hyposalivation and medication use in a group of nursing home residents

NARCIS (Netherlands)

Putten, Gerard van der; Brand, H.S.; Schols, J.M.; Baat, C. de

2011-01-01

The study objective was to explore the diagnostic suitability of the Xerostomia Inventory and the association between xerostomia, hyposalivation and medication use in a group of nursing home residents. A cross-sectional study was carried out in 50 physically impaired nursing home residents (20 men)

Total quality management (TQM) in diagnostic radiology

International Nuclear Information System (INIS)

Rehani, M.M.

1995-01-01

The branch of quality assurance is now taking a new direction towards total quality management (TQM). Being of industrial origin, the concepts and terminologies in TQM are alien to medical and paramedical professionals. However, the impetus it has already made in other areas of health sciences makes medical physicists left out when diagnostic radiology does not encompass TQM. The purpose of this paper is to introduce the terms used in TQM and some aspects of its application to diagnostic radiology. (author). 12 refs., 1 tab

Childhood leukaemia following medical diagnostic exposure to ionizing radiation in utero or after birth

International Nuclear Information System (INIS)

Wakeford, R.

2008-01-01

A statistical association between childhood leukaemia and an abdominal X-ray examination of the pregnant mother was first reported in 1956 from a case-control study of childhood cancer mortality conducted in Great Britain. This study, later called the Oxford Survey of Childhood Cancers (OSCC), was continued and eventually showed a highly statistically significant ∼50% proportional increase in the risk of childhood leukaemia associated with antenatal diagnostic radiography. The association has been confirmed by many case-control studies carried out around the world, the appropriately combined results of which show a highly statistically significant increase in risk that is compatible with the OSCC finding. There is no doubt about the reality of the statistical association, but a causal interpretation has been questioned. On balance, however, the evidence points to low-level irradiation of the fetus increasing the risk of leukaemia in childhood, with an excess relative risk coefficient of around 50 Gy -1 (equivalent to an excess absolute risk coefficient of about 3% Gy -1 ), although the uncertainty associated with these coefficients is considerable and they are likely to be overestimates. In contrast to exposure in utero, the evidence from case-control studies for an association between childhood leukaemia and postnatal exposure to medical diagnostic irradiation is equivocal and sometimes conflicting. Since standard radiation risk models predict that low-level exposure in the early years of life should produce an increased risk of childhood leukaemia that is roughly similar to that arising from fetal exposure, this absence of persuasive evidence is likely to be due to various problems with the studies. This is unfortunate given the rise in relatively high dose diagnostic procedures (e.g. paediatric CT scans) that would be predicted to materially increase the relative risk of childhood leukaemia. (authors)

Recent trend of diagnostic radiology

International Nuclear Information System (INIS)

Kim, S.Y.; Kim, H.K.

1979-01-01

Present status and recent trend of diagnostic radiology have been reviewed. The interrelationships and Characteristics of various fields of radiology such as computed tomography, X-ray radiology, and nuclear medicine were discussed. The mevit of computed tomography and the promising use of short lived, accelerator produced radionuclides, and radiotherapy in nuclear medicine were emphasized. (author)

Radiological protection and quality control for diagnostic radiology in China

International Nuclear Information System (INIS)

Baorong, Yue

2008-01-01

Full text: There are 43,000 diagnostic departments, nearly 70,000 X-ray diagnostic facilities, 7,000 CT, 250 million for the annual total numbers of X-ray examinations, 120,000 occupationally exposed workers in diagnostic radiology. 'Basic standards for protection against ionizing radiation and for the safety of radiation sources' is promulgated on October, 2002. This basic standard follows the BSS. 'Rule on the administration of radio-diagnosis and radiotherapy', as a order of the Ministry of Health No. 46, is promulgated by Minister of Health on January 24, 2006. It includes general provisions, requirements and practice, establishment and approval of radio-diagnosis and radiotherapy services, safeguards and quality assurance, and so on. There are a series of radiological protection standards and quality control standards in diagnostic radiology, including 'radiological protection standard for the examination in X-ray diagnosis', 'radiological health protection standards for X-ray examination of child-bearing age women and pregnant women', 'radiological protection standards for the children in X-ray diagnosis', 'standards for radiological protection in medical X-ray diagnosis', 'specification for radiological protection monitoring in medical X-ray diagnosis', 'guide for reasonable application of medical X-ray diagnosis', 'general aspects for quality assurance in medical X-ray image of diagnosis', 'specification of image quality control test for the medical X-ray diagnostic equipment', 'specification of image quality assurance test for X-ray equipment for computed tomography', 'specification for testing of quality control in computed radiography (CR)' and 'specification for testing of quality control in X-ray mammography'. With the X-ray diagnostic equipment, there are acceptant tests, status tests and routing tests in large hospitals. It is poor for routing test in middle and smaller hospitals. CT is used widely in diagnostic radiology, however most workers in CT

Nanodevices in diagnostics

Science.gov (United States)

Hu, Ye; Fine, Daniel H.; Tasciotti, Ennio; Bouamrani, Ali; Ferrari, Mauro

2010-01-01

The real-time, personalized and highly sensitive early-stage diagnosis of disease remains an important challenge in modern medicine. With the ability to interact with matter at the nanoscale, the development of nanotechnology architectures and materials could potentially extend subcellular and molecular detection beyond the limits of conventional diagnostic modalities. At the very least, nanotechnology should be able to dramatically accelerate biomarker discovery, as well as facilitate disease monitoring, especially of maladies presenting a high degree of molecular and compositional heterogeneity. This article gives an overview of several of the most promising nanodevices and nanomaterials along with their applications in clinical practice. Significant work to adapt nanoscale materials and devices to clinical applications involving large interdisciplinary collaborations is already underway with the potential for nanotechnology to become an important enabling diagnostic technology. PMID:20229595

[Diagnostic imaging and acute abdominal pain].

Science.gov (United States)

Liljekvist, Mads Svane; Pommergaard, Hans-Christian; Burcharth, Jakob; Rosenberg, Jacob

2015-01-19

Acute abdominal pain is a common clinical condition. Clinical signs and symptoms can be difficult to interpret, and diagnostic imaging may help to identify intra-abdominal disease. Conventional X-ray, ultrasound (US) and computed tomography (CT) of the abdomen vary in usability between common surgical causes of acute abdominal pain. Overall, conventional X-ray cannot confidently diagnose or rule out disease. US and CT are equally trustworthy for most diseases. US with subsequent CT may enhance diagnostic precision. Magnetic resonance seems promising for future use in acute abdominal imaging.

Laser-induced fluorescence for medical diagnostics

International Nuclear Information System (INIS)

Andersson Engels, S.

1989-12-01

Laser-induced fluorescence as a tool for tissue diagnostics is discussed. Both spectrally and time-resolved fluorescence signals are studied to optimize the demarcation of diseased lesions from normal tissue. The presentation is focused on two fields of application: the identification of malignant tumours and atherosclerotic plaques. Tissue autofluorescence as well as fluorescence from administered drugs have been utilized in diseased tissue diagnosis. The fluorescence criterion for tissue diagnosis is, as far as possible, chosen to be independent of unknown fluorescence parameters, which are not correlated to the type of tissue investigated. Both a dependence on biological parameters, such as light absorption in blood, and instrumental characteristics, such as excitation pulse fluctuations and detection geometry, can be minimized. Several chemical compounds have been studied in animal experiments after intraveneous injection to verify their capacity as malignant tumour marking drugs under laser excitation and fluorescence detection. Another objective of these studies was to improve our understanding of the mechanism and chemistry behind the retention of the various drugs in tissue. The properties of a chemical which maximize its selective retention in tumours are discussed. In order to utilize this diagnostic modality, three different clinically adapted sets of instrumentation have been developed and are presented. Two of the systems are nitrogen-laser-based fluorosensors; one is a point-monitoring system with full spectral resolution and the other one is an imaging system with up to four simultaneously recorded images in different spectral bands. The third system is a low-cost point-monitoring mercury-lamp-based fluoroscence emission as well as reflection characteristics of tissue. (author)

Review of medical discharge summaries and medical documentation in a metropolitan hospital: impact on diagnostic-related groups and Weighted Inlier Equivalent Separation.

Science.gov (United States)

Chin, N; Perera, P; Roberts, A; Nagappan, R

2013-07-01

Accurate and comprehensive clinical documentation is crucial for effective ongoing patient care, follow up and to optimise case mix-based funding. Each Diagnostic Related Group (DRG) is assigned a 'weight', leading to Weighted Inlier Equivalent Separation (WIES), a system many public and private hospitals in Australia subscribe to. To identify the top DRG in a general medical inpatient service, the completeness of medical discharge documentation, commonly missed comorbidities and system-related issues and subsequent impact on DRG and WIES allocation. One hundred and fifty completed discharge summaries were randomly selected from the top 10 medical DRG in our health service. From a detailed review of the clinical documentation, principal diagnoses, associated comorbidities and complications, where appropriate, the DRG and WIES were modified. Seventy-two (48%) of the 150 reviewed admissions resulted in a revision of DRG and WIES equivalent to an increase of AUD 142,000. Respiratory-based DRG generated the largest revision of DRG and WIES, while 'Cellulitis' DRG had the largest relative change. Twenty-seven per cent of summaries reviewed necessitated a change in coding with no subsequent change in DRG allocation or WIES. Acute renal failure, anaemia and electrolyte disturbances were the most commonly underrepresented entities in clinical discharge documentation. Seven patients had their WIES downgraded. Comprehensive documentation of principal diagnosis/diagnoses, comorbidities and their complications is imperative to optimal DRG and WIES allocation. Regular meetings between clinical and coding staff improve the quality and timeliness of medical documentation, ensure adequate communication with general practitioners and lead to appropriate funding. © 2013 The Authors; Internal Medicine Journal © 2013 Royal Australasian College of Physicians.

[Dealing with diagnostic uncertainty in general practice].

Science.gov (United States)

Wübken, Magdalena; Oswald, Jana; Schneider, Antonius

2013-01-01

In general, the prevalence of diseases is low in primary care. Therefore, the positive predictive value of diagnostic tests is lower than in hospitals where patients are highly selected. In addition, the patients present with milder forms of disease; and many diseases might hide behind the initial symptom(s). These facts lead to diagnostic uncertainty which is somewhat inherent to general practice. This narrative review discusses different sources of and reasons for uncertainty and strategies to deal with it in the context of the current literature. Fear of uncertainty correlates with higher diagnostic activities. The attitude towards uncertainty correlates with the choice of medical speciality by vocational trainees or medical students. An intolerance of uncertainty, which still increases as medicine is making steady progress, might partly explain the growing shortage of general practitioners. The bio-psycho-social context appears to be important to diagnostic decision-making. The effect of intuition and heuristics are investigated by cognitive psychologists. It is still unclear whether these aspects are prone to bias or useful, which might depend on the context of medical decisions. Good communication is of great importance to share uncertainty with the patients in a transparent way and to alleviate shared decision-making. Dealing with uncertainty should be seen as an important core component of general practice and needs to be investigated in more detail to improve the respective medical decisions. Copyright © 2013. Published by Elsevier GmbH.

Diagnostic imaging in intensive care patients

International Nuclear Information System (INIS)

Afione, Cristina; Binda, Maria del C.

2004-01-01

Purpose: To determine the role of imaging diagnostic methods in the location of infection causes of unknown origin in the critical care patient. Material and methods: A comprehensive medical literature search has been done. Recommendations for the diagnostic imaging of septic focus in intensive care patients are presented for each case, with analysis based on evidence. The degree of evidence utilized has been that of Oxford Center for Evidence-based Medicine. Results: Nosocomial infection is the most frequent complication in the intensive care unit (25 to 33%) with high sepsis incidence rate. In order to locate the infection focus, imaging methods play an important role, as a diagnostic tool and to guide therapeutic procedures. The most frequent causes of infection are: ventilation associated pneumonia, sinusitis, intra-abdominal infections and an acute acalculous cholecystitis. This paper analyses the diagnostic imaging of hospital infection, with the evaluation of choice methods for each one and proposes an algorithm to assess the septic patient. Conclusion: There are evidences, with different degrees of recommendation, for the use of diagnostic imaging methods for infectious focuses in critical care patients. The studies have been selected based on their diagnostic precision, on the capacity of the medical team and on the availability of resources, considering the risk-benefit balance for the best safety of the patient. (author)

Diagnostic values for skin temperature assessment to detect diabetes-related foot complications

NARCIS (Netherlands)

van Netten, Jaap J.; Prijs, Miranda; van Baal, Jeff G.; Liu, Chanjuan; van der Heijden, Ferdi; Bus, Sicco A.

2014-01-01

Abstract Background: Skin temperature assessment is a promising modality for early detection of diabetic foot problems, but its diagnostic value has not been studied. Our aims were to investigate the diagnostic value of different cutoff skin temperature values for detecting diabetes-related foot

Reducing Diagnostic Errors through Effective Communication: Harnessing the Power of Information Technology

Science.gov (United States)

Naik, Aanand Dinkar; Rao, Raghuram; Petersen, Laura Ann

2008-01-01

Diagnostic errors are poorly understood despite being a frequent cause of medical errors. Recent efforts have aimed to advance the "basic science" of diagnostic error prevention by tracing errors to their most basic origins. Although a refined theory of diagnostic error prevention will take years to formulate, we focus on communication breakdown, a major contributor to diagnostic errors and an increasingly recognized preventable factor in medical mishaps. We describe a comprehensive framework that integrates the potential sources of communication breakdowns within the diagnostic process and identifies vulnerable steps in the diagnostic process where various types of communication breakdowns can precipitate error. We then discuss potential information technology-based interventions that may have efficacy in preventing one or more forms of these breakdowns. These possible intervention strategies include using new technologies to enhance communication between health providers and health systems, improve patient involvement, and facilitate management of information in the medical record. PMID:18373151

Developing a semantic web model for medical differential diagnosis recommendation.

Science.gov (United States)

Mohammed, Osama; Benlamri, Rachid

2014-10-01

In this paper we describe a novel model for differential diagnosis designed to make recommendations by utilizing semantic web technologies. The model is a response to a number of requirements, ranging from incorporating essential clinical diagnostic semantics to the integration of data mining for the process of identifying candidate diseases that best explain a set of clinical features. We introduce two major components, which we find essential to the construction of an integral differential diagnosis recommendation model: the evidence-based recommender component and the proximity-based recommender component. Both approaches are driven by disease diagnosis ontologies designed specifically to enable the process of generating diagnostic recommendations. These ontologies are the disease symptom ontology and the patient ontology. The evidence-based diagnosis process develops dynamic rules based on standardized clinical pathways. The proximity-based component employs data mining to provide clinicians with diagnosis predictions, as well as generates new diagnosis rules from provided training datasets. This article describes the integration between these two components along with the developed diagnosis ontologies to form a novel medical differential diagnosis recommendation model. This article also provides test cases from the implementation of the overall model, which shows quite promising diagnostic recommendation results.

Evaluation of a diagnostic flow chart applying medical thoracoscopy, adenosine deaminase and T-SPOT.TB in diagnosis of tuberculous pleural effusion.

Science.gov (United States)

He, Y; Zhang, W; Huang, T; Wang, X; Wang, M

2015-10-01

To evaluate a diagnostic flow chart applying medical thoracoscoy (MT), adenosine deaminase (ADA) and T-SPOT.TB in diagnosis of tuberculous pleural effusion (TPE) at a high TB burden country. 136 patients with pleural effusion (PE) were enrolled and divided into TPE and Non-TPE group. MT (histology), PE ADA and T-SPOT.TB were conducted on all patients. ROC analysis was performed for the best cut-off value of PE ADA in detection of TPE. The diagnostic flow chart applying MT, ADA and T-SPOT.TB was evaluated for improving the limitations of each diagnostic method. ROC analysis showed that the best cut-off value of PE ADA was 30U/L. The sensitivity and specificity of these tests were calculated respectively to be: 71.4% (58.5%-81.6%) and 100% (95.4-100.0%) for MT, 92.9% (83.0-97.2%) and 68.8% (57.9-77.9%) for T-SPOT.TB, and 80.0% (69.6-88.1%) and 92.9% (82.7-98.0%) for PE ADA. The sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, positive predictive value and negative predictive value of the diagnostic flow chart were 96.4% (87.9-99.0%), 96.3% (89.6-98.7%), 25.714, 0.037, 97.4 and 94.9, respectively. The diagnostic flow chart applying MT, ADA and T-SPOT.TB is an accurate and rapid diagnostic method in detection of TPE.

Medical X-ray techniques in diagnostic radiography. 4. ed.

International Nuclear Information System (INIS)

Plaats, G.J. van der; Vijlbrief, P.

1980-01-01

A step by step account is given of every aspect of the technical factors involved in the production of X-ray images. Chapter titles include, methods of image formation and laws of projection, sharpness and unsharpness, contrast, perceptibility of detail in the radiographic image-image quality, properties of fluoroscopic screens, radiographic films, intensifying screens and cassettes, image intensification and X-ray television, processing technique, fluoroscopy and radiographic technique in general, special radiographic techniques, radiographic examinations using contrast media, exposure and exposure tables and automatic density control, diagnostic X-ray apparatus, and diagnostic stands and accessories. (C.F.)

WE-AB-206-01: Diagnostic Ultrasound Imaging Quality Assurance

Energy Technology Data Exchange (ETDEWEB)

Zagzebski, J. [University of Wisconsin (United States)

2016-06-15

The involvement of medical physicists in diagnostic ultrasound imaging service is increasing due to QC and accreditation requirements. The goal of this ultrasound hands-on workshop is to demonstrate quality control (QC) testing in diagnostic ultrasound and to provide updates in ACR ultrasound accreditation requirements. The first half of this workshop will include two presentations reviewing diagnostic ultrasound QA/QC and ACR ultrasound accreditation requirements. The second half of the workshop will include live demonstrations of basic QC tests. An array of ultrasound testing phantoms and ultrasound scanners will be available for attendees to learn diagnostic ultrasound QC in a hands-on environment with live demonstrations and on-site instructors. The targeted attendees are medical physicists in diagnostic imaging. Learning Objectives: Gain familiarity with common elements of a QA/QC program for diagnostic ultrasound imaging dentify QC tools available for testing diagnostic ultrasound systems and learn how to use these tools Learn ACR ultrasound accreditation requirements Jennifer Walter is an employee of American College of Radiology on Ultrasound Accreditation.

WE-AB-206-01: Diagnostic Ultrasound Imaging Quality Assurance

International Nuclear Information System (INIS)

Zagzebski, J.

2016-01-01

The involvement of medical physicists in diagnostic ultrasound imaging service is increasing due to QC and accreditation requirements. The goal of this ultrasound hands-on workshop is to demonstrate quality control (QC) testing in diagnostic ultrasound and to provide updates in ACR ultrasound accreditation requirements. The first half of this workshop will include two presentations reviewing diagnostic ultrasound QA/QC and ACR ultrasound accreditation requirements. The second half of the workshop will include live demonstrations of basic QC tests. An array of ultrasound testing phantoms and ultrasound scanners will be available for attendees to learn diagnostic ultrasound QC in a hands-on environment with live demonstrations and on-site instructors. The targeted attendees are medical physicists in diagnostic imaging. Learning Objectives: Gain familiarity with common elements of a QA/QC program for diagnostic ultrasound imaging dentify QC tools available for testing diagnostic ultrasound systems and learn how to use these tools Learn ACR ultrasound accreditation requirements Jennifer Walter is an employee of American College of Radiology on Ultrasound Accreditation.

Radiation genetic effects among medical diagnostic X-ray workers in China

International Nuclear Information System (INIS)

Wang Jixian

1984-01-01

A survey of the birth status and offspring's congenital malformations and hereditary diseases of medical diagnostic X-ray workers during 1950-1980 was carried out in 25 provinces of China. The physicians and surgeons in the same hospitals, not exposed to X-rays, were observed as the control group. Analysis was made of the data of 13056 persons and 32348 pregnancies in the irradiated group, and 16925 persons and 41120 pregnancies in the control group. The results show that the main factors which influence the fertility in the irradiated group are much the same as in the control group. The differences of fertility and infertility rate and sex ratio of live births between the two groups are not statistically significant. The spontaneous abortion rate, multiple pregnancy rate and neonatal mortality rate are significantly higher in the irradiated group than those in the control group. The total incidence of 20 kinds of congenital malformations and hereditary diseases among the children of X-ray workers is significantly higher than that among the children of non-X-ray workers (9.19% for the formers and 4.27% for the latters). (Author)

Diagnostics of parasitic diseases. Myths of the present

Directory of Open Access Journals (Sweden)

S. S. Kozlov

2011-01-01

Full Text Available Diagnostics of parasitic diseases in many medical laboratories is carried out with a bad quality. Principal causes are the low level of qualification of laboratorians and a small amount of laboratory methods which are used. The majority of practising doctors has bad knowledge about diseases. All this serves as base for occurrence in the market of medical services of various pseudoscientific methods of diagnostics of parasitic diseases, such as Voll-method and its analogues, including a method of bioresonant diagnostics, scanning of the crushed drop of blood, including a dark field method, diagnostics on pulse, detection of toxins of parasites in salivaric crystal amilase and others. These methods cannot be scientific to be the methods of demonstrative medicine often lead to development of parasitic phobias of patients.

21 CFR 892.1700 - Diagnostic x-ray high voltage generator.

Science.gov (United States)

2010-04-01

... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Diagnostic x-ray high voltage generator. 892.1700... (CONTINUED) MEDICAL DEVICES RADIOLOGY DEVICES Diagnostic Devices § 892.1700 Diagnostic x-ray high voltage generator. (a) Identification. A diagnostic x-ray high voltage generator is a device that is intended to...

Alternative diagnostic technique for carpal tunnel syndrome

International Nuclear Information System (INIS)

Hayakawa, Katsuhiko; Nakane, Takashi; Kobayashi, Shigeru; Shibata, Kunio

2002-01-01

Compressive and entrapment neuropathies are common clinical syndromes characterized by neurologic deficits due to mechanical or dynamic compression of peripheral nerves. However, the definitive diagnosis based on clinical symptoms alone is difficult in many cases, and the electrophysiological diagnostic method is solely used as a supplementary diagnostic method at present. As a new diagnostic method for entrapment neuropathy, the present study investigated the usefulness of gadolinium-enhanced MRI in carpal tunnel syndrome. On enhanced MRI of idiopathic carpal tunnel syndrome, contrast-enhancement in the median nerve was found in 30 of 34 hands (88.2%). Enhanced MRI allows to visualize intraneural edema in the nerve easily on the naked eye. Therefore, this technique supplied useful information for making definitive diagnosis and is promising as a non-invasive diagnostic method for entrapment neuropathy. (author)

Alternative diagnostic technique for carpal tunnel syndrome

Energy Technology Data Exchange (ETDEWEB)

Hayakawa, Katsuhiko; Nakane, Takashi [Aiko Orthopaedic Hospital, Nagoya (Japan); Kobayashi, Shigeru; Shibata, Kunio [Fujita Health Univ., Toyoake, Aichi (Japan). School of Medicine

2002-10-01

Compressive and entrapment neuropathies are common clinical syndromes characterized by neurologic deficits due to mechanical or dynamic compression of peripheral nerves. However, the definitive diagnosis based on clinical symptoms alone is difficult in many cases, and the electrophysiological diagnostic method is solely used as a supplementary diagnostic method at present. As a new diagnostic method for entrapment neuropathy, the present study investigated the usefulness of gadolinium-enhanced MRI in carpal tunnel syndrome. On enhanced MRI of idiopathic carpal tunnel syndrome, contrast-enhancement in the median nerve was found in 30 of 34 hands (88.2%). Enhanced MRI allows to visualize intraneural edema in the nerve easily on the naked eye. Therefore, this technique supplied useful information for making definitive diagnosis and is promising as a non-invasive diagnostic method for entrapment neuropathy. (author)

Understanding the promises and premises of online health platforms

NARCIS (Netherlands)

van Dijck, J.; Poell, T.

2016-01-01

This article investigates the claims and complexities involved in the platform-based economics of health and fitness apps. We examine a double-edged logic inscribed in these platforms, promising to offer personal solutions to medical problems while also contributing to the public good. On the one

Improving the Accessibility and Efficiency of Point-of-Care Diagnostics Services in Low- and Middle-Income Countries: Lean and Agile Supply Chain Management.

Science.gov (United States)

Kuupiel, Desmond; Bawontuo, Vitalis; Mashamba-Thompson, Tivani P

2017-11-29

Access to point-of-care (POC) diagnostics services is essential for ensuring rapid disease diagnosis, management, control, and surveillance. POC testing services can improve access to healthcare especially where healthcare infrastructure is weak and access to quality and timely medical care is a challenge. Improving the accessibility and efficiency of POC diagnostics services, particularly in resource-limited settings, may be a promising route to improving healthcare outcomes. In this review, the accessibility of POC testing is defined as the distance/proximity to the nearest healthcare facility for POC diagnostics service. This review provides an overview of the impact of POC diagnostics on healthcare outcomes in low- and middle-income countries (LMICs) and factors contributing to the accessibility of POC testing services in LMICs, focusing on characteristics of the supply chain management and quality systems management, characteristics of the geographical location, health infrastructure, and an enabling policy framework for POC diagnostics services. Barriers and challenges related to the accessibility of POC diagnostics in LMICs were also discussed. Bearing in mind the reported barriers and challenges as well as the disease epidemiology in LMICs, we propose a lean and agile supply chain management framework for improving the accessibility and efficiency of POC diagnostics services in these settings.

Improving the Accessibility and Efficiency of Point-of-Care Diagnostics Services in Low- and Middle-Income Countries: Lean and Agile Supply Chain Management

Directory of Open Access Journals (Sweden)

Desmond Kuupiel

2017-11-01

Full Text Available Access to point-of-care (POC diagnostics services is essential for ensuring rapid disease diagnosis, management, control, and surveillance. POC testing services can improve access to healthcare especially where healthcare infrastructure is weak and access to quality and timely medical care is a challenge. Improving the accessibility and efficiency of POC diagnostics services, particularly in resource-limited settings, may be a promising route to improving healthcare outcomes. In this review, the accessibility of POC testing is defined as the distance/proximity to the nearest healthcare facility for POC diagnostics service. This review provides an overview of the impact of POC diagnostics on healthcare outcomes in low- and middle-income countries (LMICs and factors contributing to the accessibility of POC testing services in LMICs, focusing on characteristics of the supply chain management and quality systems management, characteristics of the geographical location, health infrastructure, and an enabling policy framework for POC diagnostics services. Barriers and challenges related to the accessibility of POC diagnostics in LMICs were also discussed. Bearing in mind the reported barriers and challenges as well as the disease epidemiology in LMICs, we propose a lean and agile supply chain management framework for improving the accessibility and efficiency of POC diagnostics services in these settings.

Capturing and displaying microscopic images used in medical diagnostics and forensic science using 4K video resolution – an application in higher education

NARCIS (Netherlands)

Jan Kuijten; Ajda Ortac; Hans Maier; Gert de Heer

2015-01-01

To analyze, interpret and evaluate microscopic images, used in medical diagnostics and forensic science, video images for educational purposes were made with a very high resolution of 4096 × 2160 pixels (4K), which is four times as many pixels as High-Definition Video (1920 × 1080 pixels).

Diagnostic values for skin temperature assessment to detect diabetes-related foot complications

NARCIS (Netherlands)

van Netten, Jaap J.; Prijs, Miranda; van Baal, Jeff G.; Liu, C.; van der Heijden, Ferdinand; Bus, Sicco A.

2014-01-01

Skin temperature assessment is a promising modality for early detection of diabetic foot problems, but its diagnostic value has not been studied. Our aims were to investigate the diagnostic value of different cutoff skin temperature values for detecting diabetes-related foot complications such as

Toward First Principle Medical Diagnostics: On the Importance of Disease-Disease and Sign-Sign Interactions

Directory of Open Access Journals (Sweden)

Abolfazl Ramezanpour

2017-07-01

Full Text Available A fundamental problem in medicine and biology is to assign states, e.g., healthy or diseased, to cells, organs or individuals. State assignment or making a diagnosis is often a nontrivial and challenging process and, with the advent of omics technologies, the diagnostic challenge is becoming more and more serious. The challenge lies not only in the increasing number of measured properties and dynamics of the system (e.g., cell or human body but also in the co-evolution of multiple states and overlapping properties, and degeneracy of states. We develop, from first principles, a generic rational framework for state assignment in cell biology and medicine, and demonstrate its applicability with a few simple theoretical case studies from medical diagnostics. We show how disease–related statistical information can be used to build a comprehensive model that includes the relevant dependencies between clinical and laboratory findings (signs and diseases. In particular, we include disease-disease and sign–sign interactions and study how one can infer the probability of a disease in a patient with given signs. We perform comparative analysis with simple benchmark models to check the performances of our models. We find that including interactions can significantly change the statistical importance of the signs and diseases. This first principles approach, as we show, facilitates the early diagnosis of disease by taking interactions into accounts, and enables the construction of consensus diagnostic flow charts. Additionally, we envision that our approach will find applications in systems biology, and in particular, in characterizing the phenome via the metabolome, the proteome, the transcriptome, and the genome.

Fast and sensitive medical diagnostic protocol based on integrating circular current lines for magnetic washing and optical detection of fluorescent magnetic nanobeads

Directory of Open Access Journals (Sweden)

Jaiyam Sharma

2016-07-01

Full Text Available Magnetic nanoparticles (MNPs are increasingly being used as ‘magnetic labels’ in medical diagnostics. Practical applications of MNPs necessitate reducing their non-specific interactions with sensor surfaces that result in noise in measurements. Here we describe the design and implementation of a sensing platform that incorporates circular shaped current lines that reduce non-specific binding by enabling the “magnetic washing” of loosely attached MNPs attached to the senor surface. Generating magnetic fields by passing electrical currents through the circular shaped current lines enabled the capture and collection of fluorescent MNPs that was more efficient and effective than straight current lines reported to-date. The use of fluorescent MNPs allows their optical detection rather than with widely used magnetoresistive sensors. As a result our approach is not affected by magnetic noise due to the flow of currents. Our design is expected to improve the speed, accuracy, and sensitivity of MNPs based medical diagnostics. Keywords: Biosensors, Magnetic beads, Fluorescent magnetic nanoparticles, Lab on chip, Point of care testing

MEDIC: medical embedded device for individualized care.

Science.gov (United States)

Wu, Winston H; Bui, Alex A T; Batalin, Maxim A; Au, Lawrence K; Binney, Jonathan D; Kaiser, William J

2008-02-01

Presented work highlights the development and initial validation of a medical embedded device for individualized care (MEDIC), which is based on a novel software architecture, enabling sensor management and disease prediction capabilities, and commercially available microelectronic components, sensors and conventional personal digital assistant (PDA) (or a cell phone). In this paper, we present a general architecture for a wearable sensor system that can be customized to an individual patient's needs. This architecture is based on embedded artificial intelligence that permits autonomous operation, sensor management and inference, and may be applied to a general purpose wearable medical diagnostics. A prototype of the system has been developed based on a standard PDA and wireless sensor nodes equipped with commercially available Bluetooth radio components, permitting real-time streaming of high-bandwidth data from various physiological and contextual sensors. We also present the results of abnormal gait diagnosis using the complete system from our evaluation, and illustrate how the wearable system and its operation can be remotely configured and managed by either enterprise systems or medical personnel at centralized locations. By using commercially available hardware components and software architecture presented in this paper, the MEDIC system can be rapidly configured, providing medical researchers with broadband sensor data from remote patients and platform access to best adapt operation for diagnostic operation objectives.

Diagnostic value of medical thoracoscopy in malignant pleural effusion induced by non-Hodgkin's lymphoma.

Science.gov (United States)

Wang, Zhen; Wu, Yan-Bing; Xu, Li-Li; Jin, Mu-Lan; Diao, Xiao-Li; Wang, Xiao-Juan; Tong, Zhao-Hui; Shi, Huan-Zhong

2017-12-01

Malignant pleural effusion (MPE) appears in up to 20% of patients with non-Hodgkin's lymphoma (NHL). The present study aimed to assess the efficacy of medical thoracoscopy (MT) in the diagnosis of patients with MPE induced by NHL. Between July 2005 and June 2014, 833 patients with pleural effusions of unknown etiology underwent MT in Beijing Chaoyang Hospital (Beijing, China), where diagnostic thoracocentesis or/and blind pleural biopsy had failed to yield an answer. Demographic, radiographic, thoracoscopic, histological and immunophenotyping data of 10 NHL patients with MPE were then retrospectively analyzed. Under medical thoracoscopy, pleural nodules (in n=6 patients), hyperemia (n=5), plaque-like lesions (n=4), pleural thickening (n=3), cellulose (n=3), ulcer (n=2), adhesion (n=2), and scattered hemorrhagic spots (n=1) were observed on the surface of parietal pleura. Histopathological and immunohistochemical analysis of pleural biopsy samples led to a correct diagnosis of B-cell NHL in 7 patients and T-lymphoblastic NHL in 2 patients. Data from the present study demonstrated that pleural biopsy through MT achieved a definite diagnosis of NHL in 9 out of 10 (90%) patients with MPE induced by NHL. Therefore, MT is a useful method for diagnosing MPE induced by NHL.

Medical exposures. Annex G

International Nuclear Information System (INIS)

1982-01-01

This Annex examines medical irradiation of the human body done in the course of diagnostic x ray procedures, in diagnostic nuclear medicine by internally administered radionuclides, and in radiation therapy. Doses to patients from various medical procedures have been assessed, both in order to follow trends and to make it possible to see which procedures are most significant with regard to possible radiation risks. This Annex also presents data on the distribution of doses among irradiated persons.

International telepathology consultation: Three years of experience between the University of Pittsburgh Medical Center and KingMed Diagnostics in China

Directory of Open Access Journals (Sweden)

Chengquan Zhao

2015-01-01

Full Text Available Background: Telepathology is increasingly being employed to support diagnostic consultation services. Prior publications have addressed technology aspects for telepathology, whereas this paper will address the clinical telepathology experience of KingMed Diagnostics, the largest independent pathology medical laboratory in China. Beginning in 2012 the University of Pittsburgh Medical Center (UPMC and KingMed Diagnostics partnered to establish an international telepathology consultation service. Materials and Methods: This is a retrospective study that summarizes the telepathology experience and diagnostic consultation results between UPMC and KingMed over a period of 3 years from January 2012 to December 2014. Results: A total of 1561 cases were submitted for telepathology consultation including 144 cases in 2012, 614 cases in 2013, and 803 in 2014. Most of the cases (61.4% submitted were referred by pathologists, 36.9% by clinicians, and 1.7% by patients in China. Hematopathology received the most cases (23.7%, followed by bone/soft tissue (21.0% and gynecologic/breast (20.2% subspecialties. Average turnaround time (TAT per case was 5.4 days, which decreased from 6.8 days in 2012 to 5.0 days in 2014. Immunostains were required for most of the cases. For some difficult cases, more than one round of immunostains was needed, which extended the TAT. Among 855 cases (54.7% where a primary diagnosis or impression was provided by the referring local hospitals in China, the final diagnoses rendered by UPMC pathologists were identical in 25.6% of cases and significantly modified (treatment plan altered in 50.8% of cases. Conclusion: These results indicate that international telepathology consultation can significantly improve patient care by facilitating access to pathology expertise. The success of this international digital consultation service was dependent on strong commitment and support from leadership, information technology expertise, and

Current practice in laboratory diagnostics of autoimmune diseases in Croatia. 
Survey of the Working group for laboratory diagnostics of autoimmune diseases of the Croatian Society of Medical Biochemistry and Laboratory Medicine.

Science.gov (United States)

Kuna, Andrea Tešija; Đerek, Lovorka; Kozmar, Ana; Drvar, Vedrana

2016-10-15

With the trend of increasing incidence of autoimmune diseases, laboratories are faced with exponential growth of the requests for tests relating the diagnosis of these diseases. Unfortunately, the lack of laboratory personnel experienced in this specific discipline of laboratory diagnostic, as well as an unawareness of a method limitation often results in confusion for clinicians. The aim was to gain insight into number and type of Croatian laboratories that perform humoral diagnostics with the final goal to improve and harmonize laboratory diagnostics of autoimmune diseases in Croatia. In order to get insight into current laboratory practice two questionnaires, consisting of 42 questions in total, were created. Surveys were conducted using SurveyMonkey application and were sent to 88 medical biochemistry laboratories in Croatia for the first survey. Out of 33 laboratories that declared to perform diagnostic from the scope, 19 were selected for the second survey based on the tests they pleaded to perform. The survey comprised questions regarding autoantibody hallmarks of systemic autoimmune diseases while regarding organ-specific autoimmune diseases was limited to diseases of liver, gastrointestinal and nervous system. Response rate was high with 80 / 88 (91%) laboratories which answered the first questionnaire, and 19 / 19 (1.0) for the second questionnaire. Obtained results of surveys indicate high heterogeneity in the performance of autoantibody testing among laboratories in Croatia. Results indicate the need of creating recommendations and algorithms in order to harmonize the approach to laboratory diagnostics of autoimmune diseases in Croatia.

Statistical physics of medical diagnostics: Study of a probabilistic model.

Science.gov (United States)

Mashaghi, Alireza; Ramezanpour, Abolfazl

2018-03-01

We study a diagnostic strategy which is based on the anticipation of the diagnostic process by simulation of the dynamical process starting from the initial findings. We show that such a strategy could result in more accurate diagnoses compared to a strategy that is solely based on the direct implications of the initial observations. We demonstrate this by employing the mean-field approximation of statistical physics to compute the posterior disease probabilities for a given subset of observed signs (symptoms) in a probabilistic model of signs and diseases. A Monte Carlo optimization algorithm is then used to maximize an objective function of the sequence of observations, which favors the more decisive observations resulting in more polarized disease probabilities. We see how the observed signs change the nature of the macroscopic (Gibbs) states of the sign and disease probability distributions. The structure of these macroscopic states in the configuration space of the variables affects the quality of any approximate inference algorithm (so the diagnostic performance) which tries to estimate the sign-disease marginal probabilities. In particular, we find that the simulation (or extrapolation) of the diagnostic process is helpful when the disease landscape is not trivial and the system undergoes a phase transition to an ordered phase.

Statistical physics of medical diagnostics: Study of a probabilistic model

Science.gov (United States)

Mashaghi, Alireza; Ramezanpour, Abolfazl

2018-03-01

We study a diagnostic strategy which is based on the anticipation of the diagnostic process by simulation of the dynamical process starting from the initial findings. We show that such a strategy could result in more accurate diagnoses compared to a strategy that is solely based on the direct implications of the initial observations. We demonstrate this by employing the mean-field approximation of statistical physics to compute the posterior disease probabilities for a given subset of observed signs (symptoms) in a probabilistic model of signs and diseases. A Monte Carlo optimization algorithm is then used to maximize an objective function of the sequence of observations, which favors the more decisive observations resulting in more polarized disease probabilities. We see how the observed signs change the nature of the macroscopic (Gibbs) states of the sign and disease probability distributions. The structure of these macroscopic states in the configuration space of the variables affects the quality of any approximate inference algorithm (so the diagnostic performance) which tries to estimate the sign-disease marginal probabilities. In particular, we find that the simulation (or extrapolation) of the diagnostic process is helpful when the disease landscape is not trivial and the system undergoes a phase transition to an ordered phase.

Hungarian medical physics MSc education

International Nuclear Information System (INIS)

Legrady, D.; Czifrus, Z.; Zarand, P.; Aszodi, A.; Pesznyak, C.; Major, T.

2012-01-01

The medical physics specialisation aims at providing high level interdisciplinary theoretical and practical knowledge and readily applicable skills, which can put into action in both the clinical and the R and D field. The first competence based gradual medical physics course in the B.Sc./M.Sc. system in Hungary was launched two years ago at the Faculty of Natural Sciences of Budapest University of Technology and Economics managed by the Institute of Nuclear Techniques. The MSc programme was compiled on the base of EFOMP, IPEM, AAPM and IAEA recommendations. The course curriculum comprises fundamental physical subjects (atomic and molecular physics, nuclear physics and particle physics) as well as fundamental medical knowledge (anatomy, physiology and radiobiology) required for subjects of diagnostic and therapy. Students of this MSc branch may chose further subjects from a 'compulsory optional' set of subjects, which contains medical imaging, X-ray diagnostics, radiation therapy, magnetic resonance imaging, radiation protection, Monte Carlo calculation and its clinical applications, ultrasound diagnostics and nuclear medicine. (authors)

Converting Radiology Operations in a Six-Hospital Healthcare System from Film-Based to Digital: Another Leadership Role for the Diagnostic Medical Physicist

International Nuclear Information System (INIS)

Arreola, Manuel M.; Rill, Lynn N.

2004-01-01

As medical facilities across the United States continue to convert their radiology operations from film-based to digital environments, partially accomplished and failed endeavors are frequent because of the lack of competent and knowledgeable leadership. The diagnostic medical physicist is, without a doubt, in a privileged position to take such a leadership role, not only because of her/his understanding of the basics principles of new imaging modalities, but also because of her/his inherent participation in workflow design and educational/training activities. A well-structured approach by the physicist will certainly lead the project to a successful completion, opening, in turn, new opportunities for the medical physicist to become an active participant in the decision-making process for an institution

Converting Radiology Operations in a Six-Hospital Healthcare System from Film-Based to Digital: Another Leadership Role for the Diagnostic Medical Physicist

Science.gov (United States)

Arreola, Manuel M.; Rill, Lynn N.

2004-09-01

As medical facilities across the United States continue to convert their radiology operations from film-based to digital environments, partially accomplished and failed endeavors are frequent because of the lack of competent and knowledgeable leadership. The diagnostic medical physicist is, without a doubt, in a privileged position to take such a leadership role, not only because of her/his understanding of the basics principles of new imaging modalities, but also because of her/his inherent participation in workflow design and educational/training activities. A well-structured approach by the physicist will certainly lead the project to a successful completion, opening, in turn, new opportunities for the medical physicist to become an active participant in the decision-making process for an institution.

Medical radiation exposure and usage for diagnostic radiology in Malaysia

International Nuclear Information System (INIS)

Ng, Kwan-Hoong; Rassiah, Premavathy; Abdullah, B.J.J.; Wang, Hwee-Beng; Shariff Hambali, Ahmad; Muthuvelu, Pirunthavany; Sivalingam, S.

2001-01-01

A national dose survey of routine X-ray examinations in Malaysia (a Level II country) from 1993 to 1995 had established baseline data for seven common types of x-ray examinations. A total of 12 randomly selected public hospitals and 867 patients were included in this survey. Survey results are generally comparable with those reported in the UK, USA and IAEA. The findings support the importance of the ongoing national quality assurance programme to ensure doses are kept to a level consistent with optimum image quality. The data was useful in the formulation of national guidance levels as recommended by the IAEA. The medical radiation exposure and usage for diagnostic radiology (1990-1994) enabled a comparison to be made for the first time with the UNSCEAR 2000 Report. In 1994, the number of physicians, radiologists, x-ray units and x-ray examinations per 1000 population was 0.45, 0.005, 0.065 and 183, respectively; 3.6 million x-ray examinations were performed; the annual effective dose per capita was 0.05 mSv and collective dose was 1000 person-Sv. Chest examinations contributed 63% of the total. Almost all examinations experienced increasing frequency except for barium studies, cholecystography, and intravenous urography (-23%, -36%, -51%). Notable increases were observed in computed tomography (161%), cardiac procedures (190%), and mammography (240%). (author)

Cancer among medical diagnostic x-ray workers in China

International Nuclear Information System (INIS)

Wang, J.X.; Boice, J.D. Jr.; Li, B.X.; Zhang, J.Y.; Fraumeni, J.F. Jr.

1988-01-01

Cancer incidence among 27,011 diagnostic x-ray workers was compared to that of 25,782 other medical specialists employed between 1950 and 1980 in China. X-ray workers had a 50% higher risk of developing cancer than the other specialists [relative risk (RR) = 1.5; 95% CI = 1.3-1.7]. Leukemia was strongly linked to radiation work (RR = 3.5, n = 30). Cancers of the breast (RR = 1.4, n = 11), thyroid (RR = 2.1, n = 7), and skin (RR = 1.5, n = 6) were increased among x-ray workers employed for 10 or more years. High risks of cancers of the esophagus (RR = 3.5, n = 15) and liver (RR = 2.4, n = 48) were not consistent with a radiation effect since risk did not vary by duration of employment. This finding suggested that some differences might exist between groups of hospital workers in social class, alcohol intake, dietary habits, and other risk factors. No excess lung cancer (RR = 0.9, n = 22) or multiple myeloma (n = 0) was observed. Significant excesses of leukemia and cancers of the breast and thyroid occurred among x-ray workers first employed prior to 1960 when radiation exposures in China were high. In fact, it was not uncommon for employees to be given time off from x-ray work because their wbc count was severely depressed. These data indicated that repeated exposure to x-rays over many years can increase the risk of leukemia and several other tumors but apparently not that of lung cancer

Performance of Physical Examination Skills in Medical Students during Diagnostic Medicine Course in a University Hospital of Northwest China

Science.gov (United States)

Li, Yan; Li, Na; Han, Qunying; He, Shuixiang; Bae, Ricard S.; Liu, Zhengwen; Lv, Yi; Shi, Bingyin

2014-01-01

This study was conducted to evaluate the performance of physical examination (PE) skills during our diagnostic medicine course and analyze the characteristics of the data collected to provide information for practical guidance to improve the quality of teaching. Seventy-two fourth-year medical students were enrolled in the study. All received an assessment of PE skills after receiving a 17-week formal training course and systematic teaching. Their performance was evaluated and recorded in detail using a checklist, which included 5 aspects of PE skills: examination techniques, communication and care skills, content items, appropriateness of examination sequence, and time taken. Error frequency and type were designated as the assessment parameters in the survey. The results showed that the distribution and the percentage in examination errors between male and female students and among the different body parts examined were significantly different (pexaminations was higher than in abdominal (0.867) and head, neck and nervous system examinations (0.917). Female students had a lower average error frequency than males in cardiac examinations (p = 0.041). Additionally, error in examination techniques was the highest type of error among the 5 aspects of PE skills irrespective of participant gender and assessment content (pexaminations and examination techniques may be included in the main focus of improving the teaching of diagnostics in these medical students. PMID:25329685

Stochastic risk estimation from medical x-ray diagnostic examinations, 2. Risk estimates of individuals from x-ray diagnosis

Energy Technology Data Exchange (ETDEWEB)

Hashizume, T; Maruyama, T; Noda, Y; Iwai, K; Tateno, Y [National Inst. of Radiological Sciences, Chiba (Japan); Nishizawa, K

1981-01-01

The risks of genetic, leukemia and malignant diseases from medical X-ray diagnostic examinations were estimated using the frequency of radiographic and fluoroscopic exposures per diagnostic examination, child expectancy, leukemia and malignancy significant factors, and using a weighting factor determined on the basis of data concerning the cancer mortality among atomic bomb survivors in Nagasaki and of a recommendation of International Commission of Radiological Protection. The organ or tissue doses with respect to the stochastic risks were determined with ionization chambers and thermoluminescent dosimeters placed at the positions of the organs or tissues in a RANDO woman phantom which was exposed to diagnostic X-rays according to technical factors of typical radiographic and fluoroscopic examinations obtained from a nationwide survey. The resultant risks by age-group and type of radiographic and fluoroscopic examination are tabulated in terms of risk level of 10/sup -6/. In general, the total risk defined as the sum of genetic, leukemia and malignant risks was a high value for the X-ray diagnosis of digestive organs involving barium meal and barium enema. For example, the total risk for young age-group was 100 to 200 x 10/sup -6/ for the X-ray diagnosis of digestive organs. The total risk from the chest radiography was lower value as compared with the risk from the X-ray diagnosis of other organs or tissues. On the contrary, the risk from the chest tomography was comparable to the risk from the diagnosis of digestive organs. The total risk decreased with increasing of age for every X-ray diagnostic examination.

Diagnostic value of history taking in reflex syncope

NARCIS (Netherlands)

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

2004-01-01

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

The Promises of Biology and the Biology of Promises

DEFF Research Database (Denmark)

Lee, Jieun

2015-01-01

commitments with differently imagined futures. I argue that promises are constitutive of the stem cell biology, rather than being derivative of it. Since the biological concept of stem cells is predicated on the future that they promise, the biological life of stem cells is inextricably intertwined...... patients’ bodies in anticipation of materializing the promises of stem cell biology, they are produced as a new form of biovaluable. The promises of biology move beyond the closed circuit of scientific knowledge production, and proliferate in the speculative marketplaces of promises. Part II looks at how...... of technologized biology and biological time can appear promising with the backdrop of the imagined intransigence of social, political, and economic order in the Korean society....

Beyond the Margins: Reflective Writing and Development of Reflective Capacity in Medical Education

Science.gov (United States)

Reis, Shmuel P.

2010-01-01

Reflective capacity has been described as an essential characteristic of professionally competent clinical practice, core to ACGME competencies. Reflection has been recently linked to promoting effective use of feedback in medical education and associated with improved diagnostic accuracy, suggesting promising outcomes. There has been a proliferation of reflective writing pedagogy within medical education to foster development of reflective capacity, extend empathy with deepened understanding of patients’ experience of illness, and promote practitioner well-being. At Alpert Med, “interactive” reflective writing with guided individualized feedback from interdisciplinary faculty to students’ reflective writing has been implemented in a Doctoring course and Family Medicine clerkship as an educational method to achieve these aims. Such initiatives, however, raise fundamental questions of reflection definition, program design, efficacy of methods, and outcomes assessment. Within this article, we consider opportunities and challenges associated with implementation of reflective writing curricula for promotion of reflective capacity within medical education. We reflect upon reflection. PMID:20407840

Topical aspects of nuclear medical diagnostics in dermatology

International Nuclear Information System (INIS)

Wehrenberg, O.

1985-01-01

The diagnostic value of soft tissue and bone scintigraphy in various dermatological diseases is discussed. We received new knowledge about frequency, dimension and validity of psoriatic osteoarthropathia by using scintigraphic methods. Bone scintigraphy is more sensitive than clinical and radiological investigation and there is an earlier detection of arthropathy in psoriasis. Whole body scintigraphy using bone seeking radiopharmaceuticals has proven to be a sensitive diagnostic tool in the detection of bone and joint involvement in collagen diseases. These methods can also be of great value in the evaluation and clinical management of diseases with possible generalized or multiple bone lesions (e. g. syphilis; dermatomyositis; sarcoidosis; malignant melanoma). Since the discovery of hybridoma technique for the production of monoclonal antibodies it became apparent that this new class of immunoglobulins may represent a new useful tool in the diagnosis and in the therapy of malignant diseases. In this paper we discuss the application of murine and human monoclonal antibodies in experimental and clinical oncology. (orig.) [de

Medical physics 1981

International Nuclear Information System (INIS)

Bunde, E.

1982-01-01

This volume continues the series of congress publications with which the Deutsche Gesellschaft fuer Medizinische Physik has been completely documenting its annual meetings for some years. The meeting was aimed to show the complexity not only of the scientific specialty medical physics but also of the practical activities of medical physicists, or at least give some idea of it. The conference was centred on the following points: Possibilities of optimization and methods for re-examination of techniques used in X-ray diagnostics, nuclear diagnostics and ultrasonographic diagnostics; bases of dosimetry in practical radiotherapy, especially with a view to the plans to make gauging of therapeutical dosemeters compulsory; current state of neutron therapy and dosimetry; safety and constancy of irradiation devices in operation; planning and equipment of modern radiotherapy departments. Furthermore topics from medical optics and nuclearbiological research were dealt with. Reports were given on the clinical use of whole-body counters. Climatology and surgical research were marginally dealt with in two synoptical papers. Short reports on work currently under way completed the subject groups given and allowed insight into further topical fields of work of medical physicists in science and practice. Finally, the question of education received particular interest. (orig./MG) [de

Shift Work and Related Health Problems among Medical and Diagnostic Staff of the General Teaching Hospitals Affiliated to Shiraz University of Medical Sciences, 2012

Directory of Open Access Journals (Sweden)

Zahra Sajjadnia

2015-07-01

Full Text Available Introduction:Today, shift work is considered as a necessity in many jobs and for some 24-hour services the use of shift-work is growing. However, shift work can lead to physiological and psycho-social problems for shift workers. This study aimed to determine the effects of shift work on the associated health problems, together with the demographic and job characteristics underlying the problems, among the medical and diagnostic staff of the general teaching hospitals affiliated to Shiraz University of Medical Sciences in 2012. Method:This study was an applied, cross-sectional and descriptive-analytical one. The study employed a sample of 205 employees from the medical and diagnostic staff using stratified sampling proportional to the size and simple random sampling methods. Data were collected using the Survey of Shift workers (SOS questionnaire, validity and reliability of which have already been confirmed. Finally, the collected data were analyzed using SPSS 16.0 software through ANOVA, Chi-square, Independent-Samples T-Test, as well as Pearson Correlation Coefficient. A P<0.05 was considered statistically significant. Results: The results showed that among the demographic and job characteristics studied, the individual, family and social problems had significant associations with work schedules, shift work and job satisfaction. In addition, there were significant associations between musculoskeletal disorders and the satisfaction of shift work; cardiovascular disorders and marital status and occupation; digestive disorders and the work schedules; sleep disorders and the satisfaction of shift work; musculoskeletal disorders, cardiovascular disorders and sleep disorders and age, job experience and shift work experience. And finally, there were significant associations among sleep disorders and age, job experience and the shift work experience. Conclusion: Based on the findings of this study, demographic characteristics such as age, marital

X-ray application in diagnostics and therapeutics

International Nuclear Information System (INIS)

Braun, H.

1975-01-01

The lecture gives a general survey on the present possibilities of application of X-rays and radio-isotopes in medical diagnostics and therapeutics. The possibility of decreasing the radiation exposure by using image intensifiers and television is particularly indicated. The advantages of scintiscanning in diagnostics are presented by means of a series of examples. The increasing significance of telecurie equipment and particle accelerators are refered to in therapeutics. Finally, the radiation risk due to the medical application of radiation to the patient and the personnel is discussed and compared to the natural radiation exposure. (ORU/LH) [de

[Differentiation Study of Chinese Medical Syndrome Typing for Diarrhea-predominant Irritable Bowel Syndrome Based on Information of Four Chinese Medical Diagnostic Methods and Brain-gut Peptides].

Science.gov (United States)

Wu, Hao-meng; Xu, Zhi-wei; Ao, Hai-qing; Shi, Ya-fei; Hu, Hai-yan; Ji, Yun-peng

2015-10-01

To establish discriminant functions of diarrhea-predominant irritable bowel syndrome (IBS-D) by studying it from quantitative diagnosis angle, hoping to reduce interference of subjective factors in diagnosing and differentially diagnosing Chinese medical syndromes of IBS-D. A Chinese medical clinical epidemiological survey was carried out in 439 IBS-D patients using Clinical Information Collection Table of IBS. Initial syndromes were obtained by cluster analysis. They were analyzed using step-by-step discrimination by taking information of four Chinese medical diagnostic methods and serum brain-gut peptides (BGP) as variables. Clustering results were Gan stagnation Pi deficiency syndrome (GSPDS), Pi-Wei weakness syndrome (PWWS), Gan stagnation qi stasis syndrome (GSQSS), Pi-Shen yang deficiency syndrome (PSYDS), Pi-Wei damp-heat syndrome (PWDHS), cold-damp disturbing Pi syndrome (CDDPS). Of them, GSPDS was mostly often seen with effective percentage of 34. 2%, while CDDPS was the least often seen with effective percentage of 5.5%. A total of 5 discriminant functions for GSPDS, PWWS, GSQSS, PSYDS, and PWDHS were obtained by step-by-step dis- crimination method. The retrospective misjudgment rate was 4.1% (16/390), while the cross-validation misjudgment rate was 15.4% (60/390). The establishment of discriminant functions is of value in objectively diagnosing and differentially diagnosing Chinese medical syndromes of IBS-D.

Spectrum of diagnostic errors in radiology.

Science.gov (United States)

Pinto, Antonio; Brunese, Luca

2010-10-28

Diagnostic errors are important in all branches of medicine because they are an indication of poor patient care. Since the early 1970s, physicians have been subjected to an increasing number of medical malpractice claims. Radiology is one of the specialties most liable to claims of medical negligence. Most often, a plaintiff's complaint against a radiologist will focus on a failure to diagnose. The etiology of radiological error is multi-factorial. Errors fall into recurrent patterns. Errors arise from poor technique, failures of perception, lack of knowledge and misjudgments. The work of diagnostic radiology consists of the complete detection of all abnormalities in an imaging examination and their accurate diagnosis. Every radiologist should understand the sources of error in diagnostic radiology as well as the elements of negligence that form the basis of malpractice litigation. Error traps need to be uncovered and highlighted, in order to prevent repetition of the same mistakes. This article focuses on the spectrum of diagnostic errors in radiology, including a classification of the errors, and stresses the malpractice issues in mammography, chest radiology and obstetric sonography. Missed fractures in emergency and communication issues between radiologists and physicians are also discussed.

Integration of interactive three-dimensional image post-processing software into undergraduate radiology education effectively improves diagnostic skills and visual-spatial ability

Energy Technology Data Exchange (ETDEWEB)

Rengier, Fabian, E-mail: fabian.rengier@web.de [University Hospital Heidelberg, Department of Diagnostic and Interventional Radiology, Im Neuenheimer Feld 110, 69120 Heidelberg (Germany); Häfner, Matthias F. [University Hospital Heidelberg, Department of Radiation Oncology, Im Neuenheimer Feld 400, 69120 Heidelberg (Germany); Unterhinninghofen, Roland [Karlsruhe Institute of Technology (KIT), Institute for Anthropomatics, Department of Informatics, Adenauerring 2, 76131 Karlsruhe (Germany); Nawrotzki, Ralph; Kirsch, Joachim [University of Heidelberg, Institute of Anatomy and Cell Biology, Im Neuenheimer Feld 307, 69120 Heidelberg (Germany); Kauczor, Hans-Ulrich [University Hospital Heidelberg, Department of Diagnostic and Interventional Radiology, Im Neuenheimer Feld 110, 69120 Heidelberg (Germany); Giesel, Frederik L. [University of Heidelberg, Institute of Anatomy and Cell Biology, Im Neuenheimer Feld 307, 69120 Heidelberg (Germany); University Hospital Heidelberg, Department of Nuclear Medicine, Im Neuenheimer Feld 400, 69120 Heidelberg (Germany)

2013-08-15

Purpose: Integrating interactive three-dimensional post-processing software into undergraduate radiology teaching might be a promising approach to synergistically improve both visual-spatial ability and radiological skills, thereby reducing students’ deficiencies in image interpretation. The purpose of this study was to test our hypothesis that a hands-on radiology course for medical students using interactive three-dimensional image post-processing software improves radiological knowledge, diagnostic skills and visual-spatial ability. Materials and methods: A hands-on radiology course was developed using interactive three-dimensional image post-processing software. The course consisted of seven seminars held on a weekly basis. The 25 participating fourth- and fifth-year medical students learnt to systematically analyse cross-sectional imaging data and correlated the two-dimensional images with three-dimensional reconstructions. They were instructed by experienced radiologists and collegiate tutors. The improvement in radiological knowledge, diagnostic skills and visual-spatial ability was assessed immediately before and after the course by multiple-choice tests comprising 64 questions each. Wilcoxon signed rank test for paired samples was applied. Results: The total number of correctly answered questions improved from 36.9 ± 4.8 to 49.5 ± 5.4 (p < 0.001) which corresponded to a mean improvement of 12.6 (95% confidence interval 9.9–15.3) or 19.8%. Radiological knowledge improved by 36.0% (p < 0.001), diagnostic skills for cross-sectional imaging by 38.7% (p < 0.001), diagnostic skills for other imaging modalities – which were not included in the course – by 14.0% (p = 0.001), and visual-spatial ability by 11.3% (p < 0.001). Conclusion: The integration of interactive three-dimensional image post-processing software into undergraduate radiology education effectively improves radiological reasoning, diagnostic skills and visual-spatial ability, and thereby

Integration of interactive three-dimensional image post-processing software into undergraduate radiology education effectively improves diagnostic skills and visual-spatial ability

International Nuclear Information System (INIS)

Rengier, Fabian; Häfner, Matthias F.; Unterhinninghofen, Roland; Nawrotzki, Ralph; Kirsch, Joachim; Kauczor, Hans-Ulrich; Giesel, Frederik L.

2013-01-01

Purpose: Integrating interactive three-dimensional post-processing software into undergraduate radiology teaching might be a promising approach to synergistically improve both visual-spatial ability and radiological skills, thereby reducing students’ deficiencies in image interpretation. The purpose of this study was to test our hypothesis that a hands-on radiology course for medical students using interactive three-dimensional image post-processing software improves radiological knowledge, diagnostic skills and visual-spatial ability. Materials and methods: A hands-on radiology course was developed using interactive three-dimensional image post-processing software. The course consisted of seven seminars held on a weekly basis. The 25 participating fourth- and fifth-year medical students learnt to systematically analyse cross-sectional imaging data and correlated the two-dimensional images with three-dimensional reconstructions. They were instructed by experienced radiologists and collegiate tutors. The improvement in radiological knowledge, diagnostic skills and visual-spatial ability was assessed immediately before and after the course by multiple-choice tests comprising 64 questions each. Wilcoxon signed rank test for paired samples was applied. Results: The total number of correctly answered questions improved from 36.9 ± 4.8 to 49.5 ± 5.4 (p < 0.001) which corresponded to a mean improvement of 12.6 (95% confidence interval 9.9–15.3) or 19.8%. Radiological knowledge improved by 36.0% (p < 0.001), diagnostic skills for cross-sectional imaging by 38.7% (p < 0.001), diagnostic skills for other imaging modalities – which were not included in the course – by 14.0% (p = 0.001), and visual-spatial ability by 11.3% (p < 0.001). Conclusion: The integration of interactive three-dimensional image post-processing software into undergraduate radiology education effectively improves radiological reasoning, diagnostic skills and visual-spatial ability, and thereby

Analysis of licensed South African diagnostic imaging equipment ...

African Journals Online (AJOL)

Analysis of licensed South African diagnostic imaging equipment. ... Pan African Medical Journal ... Introduction: Objective: To conduct an analysis of all registered South Africa (SA) diagnostic radiology equipment, assess the number of equipment units per capita by imaging modality, and compare SA figures with published ...

Tattoos: the relationship of diagnostic and semantic meaning.

Science.gov (United States)

Romaniuk, A; Tatsenko, N; Smeyanov, V; Movchan, D; Moskalenko, R

2014-01-01

This article investigates a tattoo as a component of non-verbal semiotics of medical discourse in pathological anatomy. The purpose is to estimate the diagnostic value of tattoos on the body of patients as semiotic and symbolic aspect of medical communication. Tattoos are classified into three types: image tattoos, feature tattoos, and conventional tattoos (symbolic tattoos). Conventional tattoos are the most informative component of medical discourse symbolics because of their diagnostic value. During the investigation it has been found out that criminal tattoos have the greatest value because of their structuring, clear connection with certain diseases (tuberculosis, liver cirrhosis), and also valuable are tattoos related to drug and alcohol addiction, which are characteristic for patients with viral hepatitis, osteomyelitis.

Medical imaging

International Nuclear Information System (INIS)

Elliott, Alex

2005-01-01

Diagnostic medical imaging is a fundamental part of the practice of modern medicine and is responsible for the expenditure of considerable amounts of capital and revenue monies in healthcare systems around the world. Much research and development work is carried out, both by commercial companies and the academic community. This paper reviews briefly each of the major diagnostic medical imaging techniques-X-ray (planar and CT), ultrasound, nuclear medicine (planar, SPECT and PET) and magnetic resonance. The technical challenges facing each are highlighted, with some of the most recent developments. In terms of the future, interventional/peri-operative imaging, the advancement of molecular medicine and gene therapy are identified as potential areas of expansion

THE ROLE AND PLACE OF LOGISTIC REGRESSION AND ROC ANALYSIS IN SOLVING MEDICAL DIAGNOSTIC TASK

Directory of Open Access Journals (Sweden)

S. G. Grigoryev

2016-01-01

Full Text Available Diagnostics, equally with  prevention and  treatment, is a basis of medical science and practice. For its history the medicine  has accumulated a great variety  of diagnostic methods for different diseases and  pathologic conditions. Nevertheless, new  tests,  methods and  tools are being  developed and recommended to application nowadays. Such  indicators as sensitivity and  specificity which  are defined on the basis  of fourfold contingency  tables   construction or  ROC-analysis method with  ROC  – curve  modelling (Receiver operating characteristic are used  as the  methods to estimate the  diagnostic capability. Fourfold  table  is used  with  the purpose to estimate the method which confirms or denies the diagnosis, i.e. a quality indicator. ROC-curve, being a graph, allows making the estimation of model  quality by subdivision of two classes  on the  basis  of identifying the  point  of cutting off a continuous or discrete quantitative attribute.The method of logistic regression technique is introduced as a tool to develop some  mathematical-statistical forecasting model  of probability of the event the researcher is interested in if there are two possible variants of the outcome. The method of ROC-analysis is chosen and described in detail as a tool to estimate the  model  quality. The capabilities of the named methods are demonstrated by a real example of creation  and  efficiency estimation (sensitivity and  specificity of a forecasting model  of probability of complication development in the form of pyodermatitis in children with  atopic dermatitis.

The IDEA Assessment Tool: Assessing the Reporting, Diagnostic Reasoning, and Decision-Making Skills Demonstrated in Medical Students' Hospital Admission Notes.

Science.gov (United States)

Baker, Elizabeth A; Ledford, Cynthia H; Fogg, Louis; Way, David P; Park, Yoon Soo

2015-01-01

Construct: Clinical skills are used in the care of patients, including reporting, diagnostic reasoning, and decision-making skills. Written comprehensive new patient admission notes (H&Ps) are a ubiquitous part of student education but are underutilized in the assessment of clinical skills. The interpretive summary, differential diagnosis, explanation of reasoning, and alternatives (IDEA) assessment tool was developed to assess students' clinical skills using written comprehensive new patient admission notes. The validity evidence for assessment of clinical skills using clinical documentation following authentic patient encounters has not been well documented. Diagnostic justification tools and postencounter notes are described in the literature (1,2) but are based on standardized patient encounters. To our knowledge, the IDEA assessment tool is the first published tool that uses medical students' H&Ps to rate students' clinical skills. The IDEA assessment tool is a 15-item instrument that asks evaluators to rate students' reporting, diagnostic reasoning, and decision-making skills based on medical students' new patient admission notes. This study presents validity evidence in support of the IDEA assessment tool using Messick's unified framework, including content (theoretical framework), response process (interrater reliability), internal structure (factor analysis and internal-consistency reliability), and relationship to other variables. Validity evidence is based on results from four studies conducted between 2010 and 2013. First, the factor analysis (2010, n = 216) yielded a three-factor solution, measuring patient story, IDEA, and completeness, with reliabilities of .79, .88, and .79, respectively. Second, an initial interrater reliability study (2010) involving two raters demonstrated fair to moderate consensus (κ = .21-.56, ρ =.42-.79). Third, a second interrater reliability study (2011) with 22 trained raters also demonstrated fair to moderate agreement

Pediatric radiological diagnostics in suspected child abuse

International Nuclear Information System (INIS)

Erfurt, C.; Schmidt, U.; Hahn, G.; Roesner, D.

2009-01-01

Advanced and specialized radiological diagnostics are essential in the case of clinical suspicion of pediatric injuries to the head, thorax, abdomen, and extremities when there is no case history or when ''battered child syndrome'' is assumed on the basis of inadequate trauma. In particular, the aim of this sophisticated diagnostic procedure is the detection of lesions of the central nervous system (CNS) in order to initiate prompt medical treatment. If diagnostic imaging shows typical findings of child abuse, accurate documented evidence of the diagnostic results is required to prevent further endangerment of the child's welfare. (orig.) [de

Some Cognitive Components of the Diagnostic Thinking Process.

Science.gov (United States)

Gale, Janet

1982-01-01

Identifies 14 cognitive components of the diagnostic thinking process in clinical problem solving. Analyzes the differences between medical students, hospital house officers, and hospital registrars in London, England, on the relative use of such thinking processes. Suggests that diagnostic thinking processes cannot be incorporated into medical…

Self-Explanation, An Instructional Strategy to Foster Clinical Reasoning in Medical Students

Directory of Open Access Journals (Sweden)

Martine Chamberland

2015-12-01

positive effect of self-explanation gets stronger when students׳ diagnostic performance is tested on far-transfer clinical cases, suggesting that deeper understanding and meaningful learning do occur. Self-explanation is a practical and inexpensive technique which could be incorporated into learning activities using clinical problems to promote diagnostic reasoning of medical students. Even though self-explanation is a promising learning technique, further studies are needed to explore other conditions that could maximise its benefit on learning clinical reasoning.

The next organizational challenge: finding and addressing diagnostic error.

Science.gov (United States)

Graber, Mark L; Trowbridge, Robert; Myers, Jennifer S; Umscheid, Craig A; Strull, William; Kanter, Michael H

2014-03-01

Although health care organizations (HCOs) are intensely focused on improving the safety of health care, efforts to date have almost exclusively targeted treatment-related issues. The literature confirms that the approaches HCOs use to identify adverse medical events are not effective in finding diagnostic errors, so the initial challenge is to identify cases of diagnostic error. WHY HEALTH CARE ORGANIZATIONS NEED TO GET INVOLVED: HCOs are preoccupied with many quality- and safety-related operational and clinical issues, including performance measures. The case for paying attention to diagnostic errors, however, is based on the following four points: (1) diagnostic errors are common and harmful, (2) high-quality health care requires high-quality diagnosis, (3) diagnostic errors are costly, and (4) HCOs are well positioned to lead the way in reducing diagnostic error. FINDING DIAGNOSTIC ERRORS: Current approaches to identifying diagnostic errors, such as occurrence screens, incident reports, autopsy, and peer review, were not designed to detect diagnostic issues (or problems of omission in general) and/or rely on voluntary reporting. The realization that the existing tools are inadequate has spurred efforts to identify novel tools that could be used to discover diagnostic errors or breakdowns in the diagnostic process that are associated with errors. New approaches--Maine Medical Center's case-finding of diagnostic errors by facilitating direct reports from physicians and Kaiser Permanente's electronic health record--based reports that detect process breakdowns in the followup of abnormal findings--are described in case studies. By raising awareness and implementing targeted programs that address diagnostic error, HCOs may begin to play an important role in addressing the problem of diagnostic error.

Clinical Approach to the Standardization of Oriental Medical Diagnostic Pattern Identification in Stroke Patients

Directory of Open Access Journals (Sweden)

Han Jung Kim

2011-01-01

Full Text Available In Korea, many stroke patients receive oriental medical care, in which pattern-identification plays a major role. Pattern-identification is Oriental Medicine's unique diagnostic system. This study attempted to standardize oriental medical pattern-identification for stroke patients. This was a community-based multicenter study that enrolled stroke patients within 30 days after their ictus. We assessed the patients' general characteristics and symptoms related to pattern-identification. Each patient's pattern was determined when two doctors had the same opinion. To determine which variables affect the pattern-identification, binary logistic regression analysis was used with the backward method. A total of 806 stroke patients were enrolled. Among 480 patients who were identified as having a certain pattern, 100 patients exhibited the Fire Heat Pattern, 210 patients the Phlegm Dampness Pattern, nine patients the Blood Stasis Pattern, 110 patients the Qi Deficiency Pattern, and 51 patients the Yin Deficiency Pattern. After the regression analysis, the predictive logistic equations for the Fire Heat, Phlegm Dampness, Qi Deficiency, and Yin Deficiency patterns were determined. The Blood Stasis Pattern was omitted because the sample size was too small. Predictive logistic equations were suggested for four of the patterns. These criteria would be useful in determining each stroke patient's pattern in clinics. However, further studies with large samples are necessary to validate and confirm these criteria.

Asthma-like symptoms, diagnostic tests, and asthma medication use in children and adolescents: a population-based nationwide survey.

Science.gov (United States)

Ferreira-Magalhães, Manuel; Sá-Sousa, Ana; Morais-Almeida, Mário; Pité, Helena; Azevedo, Luis Filipe; Azevedo, Maria Inês; Bugalho-Almeida, António; Fonseca, João Almeida

2016-01-01

This study aimed to estimate the prevalence of asthma-like symptoms, current asthma (CA), asthma diagnostic tests, and inhaled medication use in a nationwide pediatric population (Pediatric-specific data from a cross-sectional, population-based telephone survey (INAsma study) in Portugal were analyzed. CA was defined as lifetime asthma and (1) wheezing, (2) waking with breathlessness, or (3) asthma attack in the previous 12 months, and/or (4) taking asthma medication at the time of the interview. In total, 716 children were included. The prevalence of asthma-like symptoms was 39.4% [95% confidence interval (95% CI): 35.7-43.3]. The most common symptoms were waking with cough (30.9%) and wheezing (19.1%). The prevalence of CA was 8.4% (95% CI: 6.6-10.7). Among children with CA, 79.9% and 52.9% reported prior allergy testing and pulmonary function testing (PFT), respectively. Inhaled medication use in the previous 12 months was reported by 67.6% (reliever inhalers, 40.1%; controller inhalers, 41.5%). Those who only used inhaled reliever medications experienced more asthma attacks [odds ratio (OR): 2.69]. Significantly fewer children with CA living in rural areas than those living in urban areas had undergone PFT or used inhaled medication (OR: 0.06 for PFT, 0.20 for medication]. The prevalence of CA in the Portuguese pediatric population was 8.4%. Only half of children with CA had ever undergone PFT; more than half did not use controller inhalers, and those who only used reliever inhalers reported more asthma attacks. These findings suggest that asthma management has been substandard, mainly in rural areas.

Plenoptic Imaging for Three-Dimensional Particle Field Diagnostics.

Energy Technology Data Exchange (ETDEWEB)

Guildenbecher, Daniel Robert [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Hall, Elise Munz [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States)

2017-06-01

Plenoptic imaging is a promising emerging technology for single-camera, 3D diagnostics of particle fields. In this work, recent developments towards quantitative measurements of particle size, positions, and velocities are discussed. First, the technique is proven viable with measurements of the particle field generated by the impact of a water drop on a thin film of water. Next, well cont rolled experiments are used to verify diagnostic uncertainty. Finally, an example is presented of 3D plenoptic imaging of a laboratory scale, explosively generated fragment field.

Diagnostic accuracy in virtual dermatopathology

DEFF Research Database (Denmark)

Mooney, E.; Kempf, W.; Jemec, G.B.E.

2012-01-01

Background Virtual microscopy is used for teaching medical students and residents and for in-training and certification examinations in the United States. However, no existing studies compare diagnostic accuracy using virtual slides and photomicrographs. The objective of this study was to compare...... diagnostic accuracy of dermatopathologists and pathologists using photomicrographs vs. digitized images, through a self-assessment examination, and to elucidate assessment of virtual dermatopathology. Methods Forty-five dermatopathologists and pathologists received a randomized combination of 15 virtual...... slides and photomicrographs with corresponding clinical photographs and information in a self-assessment examination format. Descriptive data analysis and comparison of groups were performed using a chi-square test. Results Diagnostic accuracy in dermatopathology using virtual dermatopathology...

Correlation diagnostics of random spatially nonuniform optical fields

International Nuclear Information System (INIS)

Angel'skii, O.V.

1992-01-01

This review examines some questions concerning the capabilities of interference and polarization-interference correlation diagnostics of the amplitude-phase characteristics of random optical fields for the purpose of identifying these fields and then studying the corresponding objects. The diagnostics of random phase objects is discussed separately in the case in which the phase dispersion of the inhomogeneities is less than and greater than one. The outlook is promising for the use of the correlation dimensionality of chaos in a field as a diagnostic parameter. It is also shown that the use of interference principles for a parallel processing of large data files can substantially increase the speed of processing systems. 32 refs., 8 figs

[The early medical textbooks in Korea: medical textbooks published at Je Joong Won-Severance Hospital Medical School].

Science.gov (United States)

Park, H W

1998-01-01

Kwang Hye Won(Je Joong Won), the first western hospital in Korea, was founded in 1885. The first western Medical School in Korea was open in 1886 under the hospital management. Dr. O. R. Avison, who came to Korea in 1893, resumed the medical education there, which was interrupted for some time before his arrival in Korea. He inaugurated translating and publishing medical textbooks with the help of Kim Pil Soon who later became one of the first seven graduates in Severance Hospital Medical School. The first western medical textbook translated into Korean was Henry Gray's Anatomy. However, these twice-translated manuscripts were never to be published on account of being lost and burnt down. The existing early anatomy textbooks, the editions of 1906 and 1909, are not the translation of Gray's Anatomy, but that of Japanese anatomy textbook of Gonda. The remaining oldest medical textbook in Korean is Inorganic Materia Medica published in 1905. This book is unique among its kind that O. R. Avison is the only translator of the book and it contains the prefaces of O. R. Avison and Kim Pil Soon. The publication of medical textbook was animated by the participation of other medical students, such as Hong Suk Hoo and Hong Jong Eun. The list of medical textbooks published includes almost all the field of medicine. The medical textbooks in actual existence are as follows: Inorganic Materia Medica (1905), Inorganic Chemistry (1906), Anatomy I (1906), Physiology (1906), Diagnostics I (1906), Diagnostics II (1907), Obstetrics (1908), Organic Chemistry (1909), Anatomy (1909), and Surgery (1910).

Clinical errors and medical negligence.

Science.gov (United States)

Oyebode, Femi

2013-01-01

This paper discusses the definition, nature and origins of clinical errors including their prevention. The relationship between clinical errors and medical negligence is examined as are the characteristics of litigants and events that are the source of litigation. The pattern of malpractice claims in different specialties and settings is examined. Among hospitalized patients worldwide, 3-16% suffer injury as a result of medical intervention, the most common being the adverse effects of drugs. The frequency of adverse drug effects appears superficially to be higher in intensive care units and emergency departments but once rates have been corrected for volume of patients, comorbidity of conditions and number of drugs prescribed, the difference is not significant. It is concluded that probably no more than 1 in 7 adverse events in medicine result in a malpractice claim and the factors that predict that a patient will resort to litigation include a prior poor relationship with the clinician and the feeling that the patient is not being kept informed. Methods for preventing clinical errors are still in their infancy. The most promising include new technologies such as electronic prescribing systems, diagnostic and clinical decision-making aids and error-resistant systems. Copyright © 2013 S. Karger AG, Basel.

Quality Control in Diagnostic Radiology in the Netherlands (invited paper)

International Nuclear Information System (INIS)

Zoetelief, J.

1998-01-01

Application of the general principles of radiation protection to medical diagnostic radiology implies that each procedure using X rays or radionuclides is to be justified and optimised. Optimisation in diagnostic radiology implies that the radiation burden to the patient should be as low as possible, but compatible with the image quality necessary to obtain an adequate diagnosis or to guide treatment. Quality control of equipment is a prerequisite for achieving optimisation in diagnostic radiology. This was especially recognised for mammography as employed for breast cancer screening. Existing legislation in the Netherlands includes only a few criteria for equipment used in diagnostic radiology. In addition, the criteria are not all operational and measurement methods are lacking. Therefore, upon the initiative of the Dutch Ministry of Health, Welfare and Sports, the relevant professional societies, in collaboration with the former TNO Centre for Radiological Protection and Dosimetry, formulated eleven guidelines for quality control of equipment used in diagnostic radiology, including test procedures, test frequencies and limiting values. The implementation of quality control of equipment was included in the 1984 European Directive (84/466/Euratom) laying down basic measures for the radiation protection of persons undergoing medical examination or treatment. In the most recent European Directive on medical exposure (97/43/Euratom) the importance of quality control is stressed. In addition, the latter EC directive proposes the use of diagnostic reference levels for limiting the risks for patients undergoing diagnostic radiology. In the Netherlands preliminary reference levels for various procedures employed in diagnostic radiology are suggested. Finally, methods applied in the Netherlands for assessment of image quality are discussed. (author)

Estimation of population doses from diagnostic medical examinations in Japan, 1974. II. Estimation of genetically significant dose

Energy Technology Data Exchange (ETDEWEB)

Hashizume, T; Maruyama, T; Kumamoto, Y [National Inst. of Radiological Sciences, Chiba (Japan)

1976-03-01

The genetically significant dose from radiographic and fluoroscopic examination in Japan has been estimated based on a 1974 nation wide survey of randomly sampled hospitals and clinics. The gonad dose during x-ray diagnosis was determined with an ionization chamber placed at the positions of ovary and testis in a Rando phantom. The instrumented phantom was irradiated with medical diagnostic x-rays on the basis of the exposure data on the patients selected in the nation wide survey. In the calculation of the genetically significant dose, the child expectancy of the patients that undergo each particular type of examination was assumed to be same as that of the general population. The resultant genetically significant dose was 11.1 and 5.43 mrad per person per year for radiography and fluoroscopy, respectively. These values were compared with those of 1960 and 1969. Though the number of examinations per year shows a yearly increase, the genetically significant dose is gradually on the decrease. This may be due to technical improvements in medical radiological practices.

Evaluation Of The Diagnostic Performance Of A Multimedia Medical Communications System.

Science.gov (United States)

Robertson, John G.; Coristine, Marjorie; Goldberg, Morris; Beeton, Carolyn; Belanger, Garry; Tombaugh, Jo W.; Hickey, Nancy M.; Millward, Steven F.; Davis, Michael; Whittingham, David

1989-05-01

The central concern of radiologists when evaluating Picture Archiving Communication System (PACS) is the diagnostic performance of digital images compared to the original analog versions of the same images. Considerable work has been done comparing the ROC curves of various types of digital systems to the corresponding analog systems for the detection of specific phantoms or diseases. Although the studies may notify the radiologists that for a specific lesion a digital system may perform as well as the analog system, it tells the radiologists very little about the impact on diagnostic performance of a digital system in the general practice of radiology. We describe in this paper an alternative method for evaluating the diagnostic performance of a digital system and a preliminary experiment we conducted to test the methodology.

Diagnostic imaging in internal medicine

International Nuclear Information System (INIS)

Eisenberg, R.L.

1985-01-01

This book examines medical diagnostic techniques. Topics considered include biological considerations in the approach to clinical medicines; infectious diseases; disorders of the heart; disorders of the vascular system; disorders of the respiratory system; diseases of the kidneys and urinary tract; disorders of the alimentary tract; disorders of the hepatobiliary system and pancreas; disorders of the hematopoietic system; disorders of bone and bone mineralization; disorders of the joints, connective tissues, and striated muscles; disorders of the nervous system; miscellaneous disorders; and procedures in diagnostic imaging

Medical Community of Inquiry: A Diagnostic Tool for Learning, Assessment, and Research

Directory of Open Access Journals (Sweden)

Rakefet Ackerman

2017-01-01

Full Text Available Aim/Purpose: These days educators are expected to integrate technological tools into classes. Although they acquire relevant skills, they are often reluctant to use these tools. Background:\tWe incorporated online forums for generating a Community of Inquiry (CoI in a faculty development program. Extending the Technology, Pedagogy, and Content Knowledge (TPACK model with Assessment Knowledge and content analysis of forum discourse and reflection after each CoI, we offer the Diagnostic Tool for Learning, Assessment, and Research (DTLAR. Methodology: This study spanned over two cycles of a development program for medical faculty. Contribution: This study demonstrates how the DTLAR supports in-depth examination of the benefits and challenges of using CoIs for learning and teaching. Findings: Before the program, participants had little experience with, and were reluctant to use, CoIs in classes. At the program completion, many were willing to adopt CoIs and appreciated this method’s contribution. Both CoIs discourse and reflections included positive attitudes regarding cognitive and teacher awareness categories. However, negative attitudes regarding affective aspects and time-consuming aspects of CoIs were exposed. Participants who experienced facilitating a CoI gained additional insights into its usefulness. Recommendations for Practitioners\t: The DTLAR allows analyzing adaption of online forums for learning and teaching. Recommendation for Researchers: The DTLAR allows analyzing factors that affect the acceptance of online fo-rums for learning and teaching. Impact on Society\t: While the tool was implemented in the context of medical education, it can be readily applied in other adult learning programs. Future Research: The study includes several design aspects that probably affected the improve-ment and challenges we found. Future research is called for providing guidelines for identifying boundary conditions and potential for further

Emerging applications of fluorescence spectroscopy in medical microbiology field.

Science.gov (United States)

Shahzad, Aamir; Köhler, Gottfried; Knapp, Martin; Gaubitzer, Erwin; Puchinger, Martin; Edetsberger, Michael

2009-11-26

There are many diagnostic techniques and methods available for diagnosis of medically important microorganisms like bacteria, viruses, fungi and parasites. But, almost all these techniques and methods have some limitations or inconvenience. Most of these techniques are laborious, time consuming and with chances of false positive or false negative results. It warrants the need of a diagnostic technique which can overcome these limitations and problems. At present, there is emerging trend to use Fluorescence spectroscopy as a diagnostic as well as research tool in many fields of medical sciences. Here, we will critically discuss research studies which propose that Fluorescence spectroscopy may be an excellent diagnostic as well as excellent research tool in medical microbiology field with high sensitivity and specificity.

Emerging applications of fluorescence spectroscopy in medical microbiology field

Directory of Open Access Journals (Sweden)

Gaubitzer Erwin

2009-11-01

Full Text Available Abstract There are many diagnostic techniques and methods available for diagnosis of medically important microorganisms like bacteria, viruses, fungi and parasites. But, almost all these techniques and methods have some limitations or inconvenience. Most of these techniques are laborious, time consuming and with chances of false positive or false negative results. It warrants the need of a diagnostic technique which can overcome these limitations and problems. At present, there is emerging trend to use Fluorescence spectroscopy as a diagnostic as well as research tool in many fields of medical sciences. Here, we will critically discuss research studies which propose that Fluorescence spectroscopy may be an excellent diagnostic as well as excellent research tool in medical microbiology field with high sensitivity and specificity.

Integrated Artificial Intelligence Approaches for Disease Diagnostics.

Science.gov (United States)

Vashistha, Rajat; Chhabra, Deepak; Shukla, Pratyoosh

2018-06-01

Mechanocomputational techniques in conjunction with artificial intelligence (AI) are revolutionizing the interpretations of the crucial information from the medical data and converting it into optimized and organized information for diagnostics. It is possible due to valuable perfection in artificial intelligence, computer aided diagnostics, virtual assistant, robotic surgery, augmented reality and genome editing (based on AI) technologies. Such techniques are serving as the products for diagnosing emerging microbial or non microbial diseases. This article represents a combinatory approach of using such approaches and providing therapeutic solutions towards utilizing these techniques in disease diagnostics.

Radionuclide diagnostics in St. Petersburg: сurrent status and development challenges

Directory of Open Access Journals (Sweden)

I. A. Zvonova

2015-01-01

Full Text Available This work aims at radionuclide diagnostics analyses in the Russian Federation city of St. Petersburg over 2005–2014. The study covers trends and development challenges , availability of radionuclide diagnostics for population needs, exposure doses for patients.This work aims at radionuclide diagnostics analyses in the Russian Federation city of St. Petersburg over 2005–2014. The study covers trends and development challenges , availability of radionuclide diagnostics for population needs, exposure doses for patients.Materials and methods. The radionuclide diagnostics temporal and structural changes’ analysis was based on Federal state statistical observation forms No.3-DOZ for St. Petersburg and on the results of radionuclide diagnostics subdivision surveys with radiology physicians’ questionnaires on the amount and composition of conducted examinations, dosages of introduced radioactivity of radiopharmaceticals and patients’ doses.The results. Since the end of 1990s until 2012 the amount of radionuclide diagnostics procedures had been steadily reducing. 74000 procedures were conducted in 2005 and 35500 in 2012. The number of radionuclide diagnostics procedures per one thousand residents reduced from 16 to 7.2. Both indicators slightly grew in 2013. In 2014 the total number of radiodiagnostic proceduress amounted up to 42000 and 8.2 tests per 1000 residents. Since 2011 the diagnostic equipment was upgraded. Four medical institutions received SPECT (single photon emission computed tomography or SPECT/CT, two new PET ( positron emission tomographs – centers were set up, three medical institutions had acquired positron emission tomographs (PET and are conducting PET – diagnostics receiving radiofarmaceuticals from external PET – center. At the same time one a third of radiodiagnostic units still has been operating obsolete and depreciated equipment dating back to 1980–1990 .Inspection results indicated that St. Petersburg

On Informatics Diagnostics and Informatics Therapeutics - Good Medical Informatics Research Is Needed Here.

Science.gov (United States)

Haux, Reinhold

2017-01-01

In the era of digitization some new procedures play an increasing role for diagnosis as well as for therapy: informatics diagnostics and informatics therapeutics. Challenges for such procedures are described. It is discussed, when research on such diagnostics and therapeutics can be regarded as good research. Examples are mentioned for informatics diagnostics and informatics therapeutics, which are based on health-enabling technologies.

The Promise of E-Platform Technology in Medical Education | Dawd ...

African Journals Online (AJOL)

Increasing the number as well as improving the capacity and quality of medical professionals to achieve an equitable health care for all is a global priority and a global challenge. In developing countries, which are facing the largest burden of disease, to achieve the above stated objective, there is a big need for more ...

Fuzzy promises

DEFF Research Database (Denmark)

Anker, Thomas Boysen; Kappel, Klemens; Eadie, Douglas

2012-01-01

as narrative material to communicate self-identity. Finally, (c) we propose that brands deliver fuzzy experiential promises through effectively motivating consumers to adopt and play a social role implicitly suggested and facilitated by the brand. A promise is an inherently ethical concept and the article...... concludes with an in-depth discussion of fuzzy brand promises as two-way ethical commitments that put requirements on both brands and consumers....

Appropriate use of diagnostic imaging

Energy Technology Data Exchange (ETDEWEB)

Palmer, P.E.S.; Cockshott, W.P.

1984-11-16

This article discusses ways in which more appropriate use can be made of roentgenography with a resulting decrease in radiation doses to the patient population. The authors recommend that fewer films be made and that traditional roentgenography be replaced with endoscopy, ultrasound, computerized tomography, or angiography where appropriate. They also recommend that medical schools and medical subspecialty groups study the World Health Organization document which provides indications for diagnostic imaging, the choice of procedure and the limitations of each.

Medical Ethics and Protection from Excessive Radiation

International Nuclear Information System (INIS)

Ruzicka, I.

1998-01-01

Among artificial sources of ionic radiation people are most often exposed to those emanating from X-ray diagnostic equipment. However, responsible usage of X-ray diagnostic methods may considerably reduce the general exposure to radiation. A research on rational access to X-ray diagnostic methods conducted at the X-ray Cabinet of the Tresnjevka Health Center was followed by a control survey eight years later of the rational methods applied, which showed that the number of unnecessary diagnostic examining was reduced for 34 % and the diagnostic indications were 10-40 $ more precise. The results therefore proved that radiation problems were reduced accordingly. The measures applied consisted of additional training organized for health care workers and a better education of the population. The basic element was then the awareness of both health care workers and the patients that excessive radiation should be avoided. The condition for achieving this lies in the moral responsibility of protecting the patients' health. A radiologist, being the person that promotes and carries out this moral responsibility, should organize and hold continual additional training of medical doctors, as well as education for the patients, and apply modern equipment. The basis of such an approach should be established by implementing medical ethics at all medical schools and faculties, together with the promotion of a wider intellectual and moral integrity of each medical doctor. (author)

Highlights from the 7th European Meeting on Molecular Diagnostics

NARCIS (Netherlands)

Dr. A.J.C. van den Brule, van den; Drs A.J.M. Loonen; Dr. R. Schuurman

2012-01-01

This report presents the highlights of the 7th European Meeting on Molecular Diagnostics held in Scheveningen, The Hague, The Netherlands, 12-14 October 2011. The areas covered included molecular diagnostics applications in medical microbiology, virology, pathology, hemato-oncology,clinical genetics

Doses from Medical Radiation Sources

Science.gov (United States)

... Medical Radiation Sources Michael G. Stabin, PhD, CHP Introduction Radiation exposures from diagnostic medical examinations are generally ... of exposure annually to natural background radiation. Plain Film X Rays Single Radiographs Effective Dose, mSv Skull ( ...

X-ray diagnostics - benefits and risks; Roentgendiagnostik - Nutzen und Risiken

Energy Technology Data Exchange (ETDEWEB)

Bartholomaeus, Melanie (comp.)

2016-10-15

The brochure on benefits and risks of X-ray diagnostics discusses the following issues: X radiation - a pioneering discovery and medical sensation, fundamentals of X radiation, frequency of X-ray examinations in Germany in relation to CT imaging, radiation doses resulting from X-ray diagnostics, benefits of X-ray diagnostics - indication and examples, risks - measures for radiation exposure reductions, avoidance of unnecessary examinations.

The design of diagnostic medical facilities using ionizing radiation

International Nuclear Information System (INIS)

1988-03-01

This Code, setting out the general principles of radiological protection as applied to diagnostic radiation facilities in hospitals and clinics, is intended as a guide to architects and to works departments concerned with their design and construction, and with the modification of existing units

Announcement of the Diagnostics 2016 Junior Scientists Travel Award

OpenAIRE

2016-01-01

With the goal of recognizing outstanding contributions to the field of medical diagnostics by early-career investigators, including assistant professors, postdoctoral students and PhD students, and assisting them in attending international conferences in 2016, early this year Diagnostics accepted nominations for the Junior Scientists Travel Award 2016.

Influence of promised rewards on conflict resolution in healthy participants and patients with Parkinson's disease.

Science.gov (United States)

Houvenaghel, Jean-François; Duprez, Joan; Naudet, Florian; Argaud, Soizic; Dondaine, Thibaut; Drapier, Sophie; Robert, Gabriel Hadrien; Drapier, Dominique; Vérin, Marc; Sauleau, Paul

2016-08-15

The influence of promised rewards on conflict resolution processes is not clearly defined in the literature, and the underlying mechanisms are poorly understood. Some studies have shown no effect of reward, while others have demonstrated a beneficial influence. In addition, although the basal ganglia are known to play a critical role in the association between motivation and cognition, the influence of promised rewards on conflict resolution processes in Parkinson's disease (PD) has received little attention. In this context, we assessed the influence of promised rewards on both impulse activation and suppression in 36 healthy participants and 36 patients with PD, using a rewarded Simon task. Analysis of performances revealed that promised rewards worsened the overall congruence effect, but only in healthy participants. Although the incentive context did not modulate the congruence effect in patients, by using the activation-suppression model, we were able to show that promised rewards did influence impulse suppression in patients-but not in healthy participants. Suppressing inappropriate response activation in an incentive context appears to be harder in medically treated Parkinson's disease. This indicates that incentive motivation can modulate at least one cognitive process involved in cognitive action control in patients with medically treated PD. The activation-suppression model provides essential additional information concerning the influence of promised rewards on conflict resolution processes in a pathological population. Copyright © 2016 Elsevier B.V. All rights reserved.

Evaluation of dose to tooth enamel from medical diagnostic X-ray examinations at Mayak PA

Energy Technology Data Exchange (ETDEWEB)

Wieser, A., E-mail: wieser@helmholtz-muenchen.de [Helmholtz Zentrum Muenchen - German Research Center for Environmental Health, Institute of Radiation Protection, D-85764 Neuherberg (Germany); Vasilenko, E. [Mayak Production Association, 456780 Ozyorsk (Russian Federation); Zankl, M.; Greiter, M.; Ulanovsky, A. [Helmholtz Zentrum Muenchen - German Research Center for Environmental Health, Institute of Radiation Protection, D-85764 Neuherberg (Germany); Sabayev, A.; Knyazev, V.; Zahrov, P. [Mayak Production Association, 456780 Ozyorsk (Russian Federation)

2011-09-15

The nuclear workers of the Mayak Production Association had regular check-ups including medical diagnostic X-ray examinations since start of the production lines in 1948. Doses from diagnostic examinations need to be considered in reconstruction of occupational doses of the workers with electron paramagnetic resonance (EPR) of tooth enamel. The numbers and types of examinations of an individual worker can be assessed from the Mayak PA archives but no information was available on doses delivered to teeth by a single specific examination. Of the twenty one applied examination procedures only three affected the teeth, these being X-ray examinations of teeth, skull and cervical spine. For these three kinds of examinations operational procedures and operating modes of X-ray units were compiled from the archive and photon spectra were obtained from a catalog of spectral data for diagnostic X-rays. Entrance doses in air kerma were calculated using the fluence of photon spectra and absorbed dose in tooth enamel for various tooth positions and exposure geometry was then calculated using dose conversion coefficients obtained from Monte Carlo simulations. Doses were calculated for examinations in 1948-2000. Except for examination of the skull, absorbed doses in enamel of incisors were found to be about twice as large as in enamel of molars. In the period before 1970 the largest mean absorbed doses in tooth enamel were due to X-ray examination of teeth, with 64 mGy and 34 mGy calculated for incisors and molars, respectively. In the same period the lowest mean doses were due to X-ray examination of the skull, with 11 mGy and 12 mGy calculated for incisors and molars, respectively. In the period from 1970 to 2000, largest mean doses in enamel were due to X-ray examination of cervical spine, with 23 mGy and 12 mGy calculated for incisors and molars, respectively.

A preliminary examination of the diagnostic value of deep learning in hip osteoarthritis.

Directory of Open Access Journals (Sweden)

Yanping Xue

Full Text Available Hip Osteoarthritis (OA is a common disease among the middle-aged and elderly people. Conventionally, hip OA is diagnosed by manually assessing X-ray images. This study took the hip joint as the object of observation and explored the diagnostic value of deep learning in hip osteoarthritis. A deep convolutional neural network (CNN was trained and tested on 420 hip X-ray images to automatically diagnose hip OA. This CNN model achieved a balance of high sensitivity of 95.0% and high specificity of 90.7%, as well as an accuracy of 92.8% compared to the chief physicians. The CNN model performance is comparable to an attending physician with 10 years of experience. The results of this study indicate that deep learning has promising potential in the field of intelligent medical image diagnosis practice.

Feasibility and Diagnostic Accuracy of Point-of-Care Abdominal Sonography by Pocket-Sized Imaging Devices, Performed by Medical Residents.

Science.gov (United States)

Kjesbu, Ingunn E; Laursen, Christian B; Graven, Torbjørn; Holden, Hans Martin; Rømo, Bjørnar; Newton Andersen, Garrett; Mjølstad, Ole Christian; Lassen, Annmarie; Dalen, Håvard

2017-06-01

We aimed to study the feasibility and diagnostic performance of bedside ultrasound by examination of the liver, gallbladder, kidneys, and abdominal aorta performed by medical residents with limited experience in ultrasound, on emergency admissions using pocket-sized imaging devices (PSIDs). A total of 199 patients admitted acutely to the medical department at the non-university Levanger Hospital, Norway, during the period from April 4 to June 23, 2011, were consecutively included. Six medical residents, selected by drawing, examined these patients with a PSID at admission. Reference imaging was performed and/or judged at the Department of Radiology. Each resident performed a median of 28 examinations (interquartile range 24-46). Imaging of the kidneys and liver were feasible in 85 and 82% of the cases, and the corresponding values for the gallbladder and abdominal aorta were 79 and 50%, respectively. The sensitivity of medical residents to detect organ pathology with the aid of PSID, ranged between 54% (95% confidence interval [CI]: 29-77%) and 74% (95% CI: 51-88%). Assessment of the aortic dimension showed moderate correlation, with r = 0.38. Examination by PSID by inexperienced residents may allow for early detection of abdominal pathology, but do not appear to be accurate enough to rule out pathology in the abdominal organs. © 2017 by the American Institute of Ultrasound in Medicine.

Ionizing radiations used in medical diagnostics as a source of radiation exposure of the Bulgarian population

International Nuclear Information System (INIS)

Ingilizova, K.; Vasilev, G.

1998-01-01

X-ray and radionuclide application in medical diagnosing is the major sources of Bulgarian population exposure to ionizing radiations exceeding the radiation background. The number of X-ray examination on a nationwide scale shows an increase from 1600 thousand annually in 1950 to 10300 thousand in 1980 and decreases to about 4700 thousand annually for the period 1992-1993. The frequency for the above mentioned time intervals varies in the range 0.22 to 1.17 examinations per capita annually and decreases to 0.56. The roentgenoscopy to roentgenography ratio varies from 2.5:1 to 0.9:1 (1975) and increases to 2.0:1 (1993). The number of radioisotope examinations increased from 34 thousand in 1970 to 170 thousand annually in 1985 and decreased to about thousand annually in 1992-1993 with a number of studies per capita varying from 0.004 to 0.020 and decreasing to 0.010. In 1993 the annual collective effective dose due to X-ray diagnostics amounts to about 7000 man-Sv/a which exceeds the radiation background exposure by 76%. Radioisotope diagnostics in the period reviewed accounted for nearly 700 man-Sv/a with an exposure exceeding the radiation background by 7.7%. The major problems relating to patient protection and benefit/risk ratio improvement are discussed. (author)

Family-Based Treatment for Adolescent Anorexia Nervosa: A Promising Approach?

Science.gov (United States)

Le Grange, Daniel

2004-01-01

Despite the fact that anorexia nervosa is a debilitating disorder with serious psychological and medical sequelae, few psychological treatments have been studied. Of these, interventions that involve the parents of the adolescent have proved to be most promising. This is especially true for those cases with a short duration of illness (less than 3…

Teaching diagnostic approach to a patient through cinema.

Science.gov (United States)

Kalra, Gurvinder

2011-11-01

Films are produced with the aim of entertaining people, but recently there has been increasing use of films to educate medical trainees about various disorders, symptoms of these disorders, patient-therapist interactions, and various other medical and psychiatric issues. Discussions in academic circles have moved from criticism of negative portrayals of mental illness in earlier films to their use in teaching sessions. Films can be used either in full length or clip format to conduct training modules. Use of the film Stigmata to train residents about diagnostic dilemmas and taking a diagnostic approach to patients is discussed. Copyright © 2011 Elsevier Inc. All rights reserved.

HINT for Squint: A Computer Reliant Diagnostic Aid for Strabismus

OpenAIRE

Gieszl, Louis R.; Morris, Jacqueline; Guyton, David L.

1983-01-01

This paper provides an outline of methods used for the implementation of a computer reliant diagnostic aid in the medical specialty of Ophthalmology. Some problems have been associated with many previous diagnostic models. A careful review indicates that the most serious problems were:

Appraising and applying evidence about a diagnostic test during a performance-based assessment

Directory of Open Access Journals (Sweden)

Franklin Ellen

2004-10-01

Full Text Available Abstract Background The practice of Evidence-based Medicine requires that clinicians assess the validity of published research and then apply the results to patient care. We wanted to assess whether our soon-to-graduate medical students could appraise and apply research about a diagnostic test within a clinical context and to compare our students with peers trained at other institutions. Methods 4th year medical students who previously had demonstrated competency at probability revision and just starting first-year Internal Medicine residents were used for this research. Following an encounter with a simulated patient, subjects critically appraised a paper about an applicable diagnostic test and revised the patient's pretest probability given the test result. Results The medical students and residents demonstrated similar skills at critical appraisal, correctly answering 4.7 and 4.9, respectively, of 6 questions (p = 0.67. Only one out of 28 (3% medical students and none of the 15 residents were able to correctly complete the probability revision task (p = 1.00. Conclusions This study found that most students completing medical school are able to appraise an article about a diagnostic test but few are able to apply the information from the article to a patient. These findings raise questions about the clinical usefulness of the EBM skills possessed by graduating medical students within the area of diagnostic testing.

Survey of radiation doses and health effects in medical diagnostic X-ray workers in China

International Nuclear Information System (INIS)

Wang Jixian; Zhang Liangan; Liu Jinzhong; Zhang Jingyuan

1984-01-01

The results of a nationwide survey of radiation doses and health effects in 26983 medical diagnostic X-ray workers in 28 provinces of China were reported. The control group was composed of 25785 non-X-ray medical workers in the same hospitals where the investigated X-ray workers worked. Of the radiological workers surveyed 75.3% received cumulative radiation doses below 50 mGy, only 2.7% received doses greater than 500 mGy, the average cumulative dose being 45.0 mGy. The average length of service was 11 years. The main radiation effects relating to radiation doses were the increase of frequencies of both chromosomal aberrations and micronuclei in peripheral blood lymphocytes, which were 0.362% and 0.0358% in the irradiated group, and 0.122% and 0.0138% in the control group, respectively. The incidence and mortality rate of leukemias increased significantly in the irradiated group. The incidence and standardized incidence of leukemias were 9.61 . 10 -5 and 9.67 . 10 -5 in the irradiated group and 2.74 . 10 -5 and 2.77 . 10 -5 in the control group. The leukemia mortality rates in the two groups were 8.60 . 10 -5 and 1.24 . 10 -5 respectively, and the standardized mortality rates were 8.60 . 10 -5 and 1.27 . 10 -5 respectively. (Author)

Corporal diagnostic work and diagnostic spaces: clinicians' use of space and bodies during diagnosis.

Science.gov (United States)

Gardner, John; Williams, Clare

2015-06-01

An emerging body of literature in sociology has demonstrated that diagnosis is a useful focal point for understanding the social dimensions of health and illness. This article contributes to this work by drawing attention to the relationship between diagnostic spaces and the way in which clinicians use their own bodies during the diagnostic process. As a case study, we draw upon fieldwork conducted with a multidisciplinary clinical team providing deep brain stimulation (DBS) to treat children with a movement disorder called dystonia. Interviews were conducted with team members and diagnostic examinations were observed. We illustrate that clinicians use communicative body work and verbal communication to transform a material terrain into diagnostic space, and we illustrate how this diagnostic space configures forms of embodied 'sensing-and-acting' within. We argue that a 'diagnosis' can be conceptualised as emerging from an interaction in which space, the clinician-body, and the patient-body (or body-part) mutually configure one another. By conceptualising diagnosis in this way, this article draws attention to the corporal bases of diagnostic power and counters Cartesian-like accounts of clinical work in which the patient-body is objectified by a disembodied medical discourse. © 2015 The Authors. Sociology of Health & Illness © 2015 Foundation for the Sociology of Health & Illness.

Convergence diagnostics for Eigenvalue problems with linear regression model

International Nuclear Information System (INIS)

Shi, Bo; Petrovic, Bojan

2011-01-01

Although the Monte Carlo method has been extensively used for criticality/Eigenvalue problems, a reliable, robust, and efficient convergence diagnostics method is still desired. Most methods are based on integral parameters (multiplication factor, entropy) and either condense the local distribution information into a single value (e.g., entropy) or even disregard it. We propose to employ the detailed cycle-by-cycle local flux evolution obtained by using mesh tally mechanism to assess the source and flux convergence. By applying a linear regression model to each individual mesh in a mesh tally for convergence diagnostics, a global convergence criterion can be obtained. We exemplify this method on two problems and obtain promising diagnostics results. (author)

Authentication and recovery of medical diagnostic image using dual reversible digital watermarking.

Science.gov (United States)

Deng, Xiaohong; Chen, Zhigang; Zeng, Feng; Zhang, Yaoping; Mao, Yimin

2013-03-01

This paper proposes a new region-based tampering detection and recovering method that utilizes both reversible digital watermarking and quad-tree decomposition for medical diagnostic image's authentication. Firstly, the quad-tree decomposition is used to divide the original image into blocks with high homogeneity, and then we computer pixels' linear interpolation as each block's recovery feature. Secondly, these recovery features as the first layer watermarking information is embedded by using simple invertible integer transformation. In order to enhance the proposed method's security, the logistic chaotic map is exploited to choose each block's reference pixel. The second layer watermark comprises by the quad-tree information and essential parameters for extraction are embedded by LSB replacement. In the authentication phase, the embedded watermark is extracted and the source image is recovered, and the similar linear interpolation technique is utilized to get each block's feature. Therefore, the tampering detection and localization can be achieved through comparing the extracted feature with the recomputed one, and the extracted feature can be used to recover those tampered regions with high similarity to their original state. Experimental results show that, compared with previous similar existing scheme, the proposed method not only achieves high embedding capacity and good visual quality of marked and restored image, but also has more accuracy for tampering detection.

Exposure from diagnostic nuclear medicine procedures

International Nuclear Information System (INIS)

Iacob, O.; Diaconescu, C.; Isac, R.

2002-01-01

According to our last national study on population exposures from natural and artificial sources of ionizing radiation, 16% of overall annual collective effective dose represent the contribution of diagnostic medical exposures. Of this value, 92% is due to diagnostic X-ray examinations and only 8% arise from diagnostic nuclear medicine procedures. This small contribution to collective dose is mainly the result of their lower frequency compared to that of the X-ray examinations, doses delivered to patients being, on average, ten times higher. The purpose of this review was to reassess the population exposure from in vivo diagnostic nuclear medicine procedures and to evaluate the temporal trends of diagnostic usage of radiopharmaceuticals in Romania. The current survey is the third one conducted in the last decade. As in the previous ones (1990 and 1995), the contribution of the Radiation Hygiene Laboratories Network of the Ministry of Health and Family in collecting data from nuclear medicine departments in hospitals was very important

Cell Analysis and Early Diagnostics

NARCIS (Netherlands)

Subramaniam, Vinod; Jones, Val

2006-01-01

In an era of aging populations and rising health-care costs, the shift of medical paradigms towards rapid, accurate, early diagnoses of diseases is inevitable. In addition to further development of ultrasensitive in vitro tests, the focus of attention in both diagnostics and the early drug discovery

Diagnostic Categories in Autobiographical Accounts of Illness.

Science.gov (United States)

Kelly, Michael P

2015-01-01

Working within frameworks drawn from the writings of Immanuel Kant, Alfred Schutz, and Kenneth Burke, this article examines the role that diagnostic categories play in autobiographical accounts of illness, with a special focus on chronic disease. Four lay diagnostic categories, each with different connections to formal medical diagnostic categories, serve as typifications to make sense of the way the lifeworld changes over the course of chronic illness. These diagnostic categories are used in conjunction with another set of typifications: lay epidemiologies, lay etiologies, lay prognostics, and lay therapeutics. Together these serve to construct and reconstruct the self at the center of the lifeworld. Embedded within the lay diagnostic categories are narratives of progression, regression, or stability, forms of typification derived from literary and storytelling genres. These narratives are developed by the self in autobiographical accounts of illness.

The relationship between hypochondriasis and medical illness.

Science.gov (United States)

Barsky, A J; Wyshak, G; Latham, K S; Klerman, G L

1991-01-01

Forty-one Diagnostic and Statistical Manual of Mental Disorders-III-Revised hypochondriacs were accrued from a primary care practice. Seventy-five control subjects were selected at random from among the remainder of the patients in the same clinic. All subjects completed a structured diagnostic interview and standardized self-report questionnaires. Medical morbidity was assessed with a medical record audit and with primary physicians' ratings. The hypochondriacal and comparison samples did not differ in aggregate medical morbidity, although the hypochondriacal sample had more undiagnosed complaints and nonspecific findings in their medical records. Within the comparison sample, higher levels of medical morbidity were associated with higher levels of hypochondriacal symptoms. This occurred primarily because the most serious medical disorders were associated with more bodily preoccupation, disease conviction, and somatization. Within the hypochondriacal sample, no correlation was found between the degree of hypochondriasis and the extent of medical morbidity.

Structure of the medical digital image

International Nuclear Information System (INIS)

Baltadzhiev, D.

1997-01-01

In up-to-date medical practice diagnostic imaging techniques are the most powerful tools available to clinicians. The modern medical equipment is entirely based on digital technology. In this article the principle of generating medical images is presented. The concept for gray scale where medical images are commonly presented is described. The patterns of gray images transformation into colour scale are likewise outlined. Basic notions from medical imaging terminology such as image matrix, pixel, spatial and contrast resolution power, bit, byte and the like are explained. Also an example is given of how the binary system treats images. On the basis of digital technology the obtained medical images lend themselves readily to additional processing, reconstruction (including 3D) and storage for subsequent utilization. The ceaseless progress of computerized communications promote easy and prompt access for clinicians to the diagnostic images needed as well as realization of expert consultations by teleconference contact (author)

Monitoring the Diagnostic Process on an Inpatient Neurology Service.

Science.gov (United States)

Dhand, Amar; Bucelli, Robert; Varadhachary, Arun; Tsiaklides, Michael; de Bruin, Gabriela; Dhaliwal, Gurpreet

2017-07-01

The Institute of Medicine report Improving Diagnosis in Health Care called for tools to monitor physicians' diagnostic process. We addressed this need by developing a tool for clinicians to record and analyze their diagnostic process. The tool was a secure web application in which clinicians used a structured grading system to assess the relative impact of clinical, laboratory, and neuroimaging data for every new diagnosis. Four neurohospitalists used the tool for 6.5 months on a general neurology ward service at a single tertiary-level teaching hospital. Process measures of tool use included number of diagnoses entered, time spent on each data entry, and concordance of diagnoses compared to the medical record. We also aggregated the data across clinicians to examine the average process scores across common inpatient disorders. The 4 clinicians entered 254 new diagnoses that took approximately 3 minutes per patient. In 50 randomly chosen cases, the neurohospitalists' diagnoses entered into the tool agreed with 92% of diagnoses in the medical record, which was better than the agreement between billing code and medical record diagnoses (74%). The diagnostic process varied across disease categories, showing a spectrum of clinical-dominant (eg, headache), laboratory-dominant (eg, encephalitis), and neuroimaging-dominant (eg, stroke) disorders. This study demonstrated the feasibility of a clinician-driven diagnostic process monitoring system, along with preliminary characterization of the process for common disorders. The tracking of diagnostic process has the potential to promote reflection on clinical practice, deconstruct neurologists' clinical decision-making, and improve health-care safety.

PROspective Multicenter Imaging Study for Evaluation of chest pain: rationale and design of the PROMISE trial.

Science.gov (United States)

Douglas, Pamela S; Hoffmann, Udo; Lee, Kerry L; Mark, Daniel B; Al-Khalidi, Hussein R; Anstrom, Kevin; Dolor, Rowena J; Kosinski, Andrzej; Krucoff, Mitchell W; Mudrick, Daniel W; Patel, Manesh R; Picard, Michael H; Udelson, James E; Velazquez, Eric J; Cooper, Lawton

2014-06-01

Suspected coronary artery disease (CAD) is one of the most common, potentially life-threatening diagnostic problems clinicians encounter. However, no large outcome-based randomized trials have been performed to guide the selection of diagnostic strategies for these patients. The PROMISE study is a prospective, randomized trial comparing the effectiveness of 2 initial diagnostic strategies in patients with symptoms suspicious for CAD. Patients are randomized to either (1) functional testing (exercise electrocardiogram, stress nuclear imaging, or stress echocardiogram) or (2) anatomical testing with ≥64-slice multidetector coronary computed tomographic angiography. Tests are interpreted locally in real time by subspecialty certified physicians, and all subsequent care decisions are made by the clinical care team. Sites are provided results of central core laboratory quality and completeness assessment. All subjects are followed up for ≥1 year. The primary end point is the time to occurrence of the composite of death, myocardial infarction, major procedural complications (stroke, major bleeding, anaphylaxis, and renal failure), or hospitalization for unstable angina. More than 10,000 symptomatic subjects were randomized in 3.2 years at 193 US and Canadian cardiology, radiology, primary care, urgent care, and anesthesiology sites. Multispecialty community practice enrollment into a large pragmatic trial of diagnostic testing strategies is both feasible and efficient. The PROMISE trial will compare the clinical effectiveness of an initial strategy of functional testing against an initial strategy of anatomical testing in symptomatic patients with suspected CAD. Quality of life, resource use, cost-effectiveness, and radiation exposure will be assessed. Copyright © 2014 Mosby, Inc. All rights reserved.

Gut feelings as a third track in general practitioners' diagnostic reasoning.

Science.gov (United States)

Stolper, Erik; Van de Wiel, Margje; Van Royen, Paul; Van Bokhoven, Marloes; Van der Weijden, Trudy; Dinant, Geert Jan

2011-02-01

General practitioners (GPs) are often faced with complicated, vague problems in situations of uncertainty that they have to solve at short notice. In such situations, gut feelings seem to play a substantial role in their diagnostic process. Qualitative research distinguished a sense of alarm and a sense of reassurance. However, not every GP trusted their gut feelings, since a scientific explanation is lacking. This paper explains how gut feelings arise and function in GPs' diagnostic reasoning. The paper reviews literature from medical, psychological and neuroscientific perspectives. Gut feelings in general practice are based on the interaction between patient information and a GP's knowledge and experience. This is visualized in a knowledge-based model of GPs' diagnostic reasoning emphasizing that this complex task combines analytical and non-analytical cognitive processes. The model integrates the two well-known diagnostic reasoning tracks of medical decision-making and medical problem-solving, and adds gut feelings as a third track. Analytical and non-analytical diagnostic reasoning interacts continuously, and GPs use elements of all three tracks, depending on the task and the situation. In this dual process theory, gut feelings emerge as a consequence of non-analytical processing of the available information and knowledge, either reassuring GPs or alerting them that something is wrong and action is required. The role of affect as a heuristic within the physician's knowledge network explains how gut feelings may help GPs to navigate in a mostly efficient way in the often complex and uncertain diagnostic situations of general practice. Emotion research and neuroscientific data support the unmistakable role of affect in the process of making decisions and explain the bodily sensation of gut feelings.The implications for health care practice and medical education are discussed.

Medical radiation

International Nuclear Information System (INIS)

1992-01-01

This leaflet in the At-a-Glance Series describes the medical use of X-rays, how X-rays help in diagnosis, radiation protection of the patient, staff protection, how radioactive materials in nuclear medicine examinations help in diagnosis and the use of radiation in radiotherapy. Magnetic resonance imaging, a diagnostic technique involving no ionizing radiation, is also briefly examined. The role of the NRPB in the medical use of radiation is outlined. (UK)

Medical applications of radioactive material

International Nuclear Information System (INIS)

Seidel, C.W.

1990-01-01

Hospitals, clinics and other medical complexes are probably the most extensive users of radioactive solutions of Tc-99m, Tl-201, Ga-67, I-123, Xe-133 and radiopharmaceuticals as diagnostic tools to evaluate the dynamic function of various organs in the body, detect cancerous tumors, sites of infection or other bodily dysfunctions. Examples of monitoring blood flow to a stressed heart and to the brain of a cocaine addict are shown. Short-lived positron emitting radionuclides (C-11, N-13, O-15 and F-18) are produced right in a hospital. Other radionuclides are used as therapeutics to reduce tumor size or kill diseased cells. Radioimmunoassay (RIA) is another medical diagnostic tool that is useful in the early detection of the AIDS virus and cancer as well as many other illnesses. Biological researchers, using radioactive biological compounds, have developed many of todays medical diagnostic procedures. Most of the recent Nobel Laureates in the life sciences have used radiolabeled compounds in their research. A brief review of these applications with several examples is presented

Quality assurance programme for isotope diagnostic laboratories

International Nuclear Information System (INIS)

Krasznai, Istvan

1987-01-01

Quality assurance systems are suggested to be introduced in laboratories, in accordance with the recommendations of IAEA and WHO, taking local circumstances into consideration. It is emphasized that a quantitative enhancement of work must not endanger its quality; diagnostic information must be undistorted, reproducible, and gathered with the minimum of radiation burden. National authorities are requested to strengthen their supervision. Recommendations for quality assurance methods are given for medical isotope diagnostic laboratories. (author)

Should we confirm our clinical diagnostic certainty by autopsies?

Science.gov (United States)

Podbregar, M; Voga, G; Krivec, B; Skale, R; Pareznik, R; Gabrscek, L

2001-11-01

To evaluate the frequency of diagnostic errors assessed by autopsies. Retrospective review of medical and pathological records in an 11-bed closed medical intensive care unit (ICU) at a 860-bed general hospital. Patients who died in the ICU between January 1998 and December 1999. Medical diagnoses were rated into three levels of clinical diagnostic certainty: complete certainty (group L1), minor diagnostic uncertainty (group L2), and major diagnostic uncertainty (group L3). The patients were divided into three error groups: group A, the autopsy confirmed the clinical diagnosis; group B, the autopsy demonstrated a new relevant diagnosis which would probably not have influenced the therapy and outcome; group C, the autopsy demonstrated a new relevant diagnosis which would probably have changed the therapy and outcome. The overall mortality was 20.3% (270/1331 patients). Autopsies were performed in 126 patients (46.9% of deaths), more often in younger patients (66.6+/-13.9 years vs 72.7+/-12.0 years, p<0.001), in patients with shorter ICU stay (4.7+/-5.6 days vs 6.7+/-8.7 days, p=0.054), and in patients in group L3 without chronic diseases (15/126 vs 1/144, p<0.001). Fatal but potentially treatable errors [group C, 12 patients (9.5%)] were found in 8.7%, 10.0%, and 10.5% of patients in groups L1, L2, and L3, respectively (NS between groups). An ICU length of stay shorter than 24 h was not related to the frequency of group C errors. Autopsies are performed more often in younger patients without chronic disease and in patients with a low clinical diagnostic certainty. No level of clinical diagnostic certainty could predict the pathological findings.

Coronary CT angiography: Diagnostic value and clinical challenges.

Science.gov (United States)

Sabarudin, Akmal; Sun, Zhonghua

2013-12-26

Coronary computed tomography (CT) angiography has been increasingly used in the diagnosis of coronary artery disease due to improved spatial and temporal resolution with high diagnostic value being reported when compared to invasive coronary angiography. Diagnostic performance of coronary CT angiography has been significantly improved with the technological developments in multislice CT scanners from the early generation of 4-slice CT to the latest 320- slice CT scanners. Despite the promising diagnostic value, coronary CT angiography is still limited in some areas, such as inferior temporal resolution, motion-related artifacts and high false positive results due to severe calcification. The aim of this review is to present an overview of the technical developments of multislice CT and diagnostic value of coronary CT angiography in coronary artery disease based on different generations of multislice CT scanners. Prognostic value of coronary CT angiography in coronary artery disease is also discussed, while limitations and challenges of coronary CT angiography are highlighted.

Single-cell proteomics: potential implications for cancer diagnostics.

Science.gov (United States)

Gavasso, Sonia; Gullaksen, Stein-Erik; Skavland, Jørn; Gjertsen, Bjørn T

2016-01-01

Single-cell proteomics in cancer is evolving and promises to provide more accurate diagnoses based on detailed molecular features of cells within tumors. This review focuses on technologies that allow for collection of complex data from single cells, but also highlights methods that are adaptable to routine cancer diagnostics. Current diagnostics rely on histopathological analysis, complemented by mutational detection and clinical imaging. Though crucial, the information gained is often not directly transferable to defined therapeutic strategies, and predicting therapy response in a patient is difficult. In cancer, cellular states revealed through perturbed intracellular signaling pathways can identify functional mutations recurrent in cancer subsets. Single-cell proteomics remains to be validated in clinical trials where serial samples before and during treatment can reveal excessive clonal evolution and therapy failure; its use in clinical trials is anticipated to ignite a diagnostic revolution that will better align diagnostics with the current biological understanding of cancer.

Diagnostic grand rounds: A new teaching concept to train diagnostic reasoning

International Nuclear Information System (INIS)

Stieger, Stefan; Praschinger, Andrea; Kletter, Kurt; Kainberger, Franz

2011-01-01

Introduction: Diagnostic reasoning is a core skill in teaching and learning in undergraduate curricula. Diagnostic grand rounds (DGRs) as a subform of grand rounds are intended to train the students' skills in the selection of appropriate tests and in the interpretation of test results. The aim of this study was to test DGRs for their ability to improve diagnostic reasoning by using a pre-post-test design. Methods: During one winter term, all 398 fifth-year students (36.1% male, 63.9% female) solved 23 clinical cases presented in 8 DGRs. In an online questionnaire, a Diagnostic Thinking Inventory (DTI) with 41 items was evaluated for flexibility in thinking and structure of knowledge in memory. Results were correlated with those from a summative multiple-choice knowledge test and of the learning objectives in a logbook. Results: The students' DTI scores in the post-test were significantly higher than those reported in the pre-test. DTI scores at either testing time did not correlate with medical knowledge as assessed by a multiple-choice knowledge test. Abilities acquired during clinical clerkships as documented in a logbook could only account for a small proportion of the increase in the flexibility subscale score. This effect still remained significant after accounting for potential confounders. Conclusion: Establishing DGRs proofed to be an effective way of successfully improving both students' diagnostic reasoning and the ability to select the appropriate test method in routine clinical practice.

Diagnostic grand rounds: A new teaching concept to train diagnostic reasoning

Energy Technology Data Exchange (ETDEWEB)

Stieger, Stefan, E-mail: stefan.stieger@univie.ac.at [Department of Basic Psychological Research, School of Psychology, University of Vienna, Liebiggasse 5, A-1010 Vienna (Austria); Praschinger, Andrea, E-mail: andrea.praschinger@meduniwien.ac.at [Core Unit for Medical Education (BEMAW), Medical University of Vienna, Spitalgasse 23, BT87, P.O. 10, A-1097 Vienna (Austria); Kletter, Kurt, E-mail: kurt.kletter@meduniwien.ac.at [Department of Nuclear Medicine, General Hospital of Vienna, Waehringer Guertel 18-20, A-1090 Vienna (Austria); Kainberger, Franz, E-mail: franz.kainberger@meduniwien.ac.at [Department of Radiology, General Hospital of Vienna, Waehringer Guertel 18-20, A-1090 Vienna (Austria)

2011-06-15

Introduction: Diagnostic reasoning is a core skill in teaching and learning in undergraduate curricula. Diagnostic grand rounds (DGRs) as a subform of grand rounds are intended to train the students' skills in the selection of appropriate tests and in the interpretation of test results. The aim of this study was to test DGRs for their ability to improve diagnostic reasoning by using a pre-post-test design. Methods: During one winter term, all 398 fifth-year students (36.1% male, 63.9% female) solved 23 clinical cases presented in 8 DGRs. In an online questionnaire, a Diagnostic Thinking Inventory (DTI) with 41 items was evaluated for flexibility in thinking and structure of knowledge in memory. Results were correlated with those from a summative multiple-choice knowledge test and of the learning objectives in a logbook. Results: The students' DTI scores in the post-test were significantly higher than those reported in the pre-test. DTI scores at either testing time did not correlate with medical knowledge as assessed by a multiple-choice knowledge test. Abilities acquired during clinical clerkships as documented in a logbook could only account for a small proportion of the increase in the flexibility subscale score. This effect still remained significant after accounting for potential confounders. Conclusion: Establishing DGRs proofed to be an effective way of successfully improving both students' diagnostic reasoning and the ability to select the appropriate test method in routine clinical practice.

Quality assurance in medical radiation applications. The medical and dental appointment

International Nuclear Information System (INIS)

Ernst-Elz, Andreas

2017-01-01

Medical radiation applications cause averaged over the German population an annual exposure of almost 2 mSv. Medical authorities have the assignment to assure and control the diagnostic and therapeutic quality of these applications and to provide recommendations for operators with respect to dose reductions and radiation protection, including guidance for radiotherapy planning aimed to questions of dose and therapy optimization.

Nanobiosensors in diagnostics

Directory of Open Access Journals (Sweden)

Alejandro Chamorro-Garcia

2016-11-01

Full Text Available Medical diagnosis has been greatly improved thanks to the development of new techniques capable of performing very sensitive detection and quantifying certain parameters. These parameters can be correlated with the presence of specific molecules and their quantity. Unfortunately, these techniques are demanding, expensive, and often complicated. On the other side, progress in other fields of science and technology has contributed to the rapid growth of nanotechnology. Although being an emerging discipline, nanotechnology has raised huge interest and expectations. Most of the enthusiasm comes from new possibilities and properties of nanomaterials. Biosensors (simple, robust, sensitive, cost-effective combined with nanomaterials, also called nanobiosensors, are serving as bridge between advanced detection/diagnostics and daily/routine tests. Here we review some of the latest applications of nanobiosensors in diagnostics field.

Review of Safety of Diagnostic Ultrasound in Medical Practice ...

African Journals Online (AJOL)

In Nigeria, there is a dearth of scientific literature about the safety of ultrasound as a diagnostic modality. Because of its low cost, real-time image display and lack of evidence of bio-effects, ultrasound is a fast growing imaging modality. The impact of ultrasound in the care of women and children is most obvious. Information ...

Far infrared fusion plasma diagnostics

Energy Technology Data Exchange (ETDEWEB)

Luhmann, N.C. Jr.; Peebles, W.A.

1990-01-01

Over the last several years, reflectometry has grown in importance as a diagnostic for both steady-state density Profiles as well as for the investigation of density fluctuations and turbulence. As a diagnostic for density profile measurement, it is generally believed to be well understood in the tokamak environment. However, its use as a fluctuation diagnostic is hampered by a lack of quantitative experimental understanding of its wavenumber sensitivity and spatial resolution. Several researchers, have theoretically investigated these questions. However, prior to the UCLA laboratory investigation, no group has experimentally investigated these questions. Because of the reflectometer's importance to the world effort in understanding plasma turbulence and transport, UCLA has, over the last year, made its primary Task IIIA effort the resolution of these questions. UCLA has taken the lead in a quantitative experimental understanding of reflectometer data as applied to the measurement of density fluctuations. In addition to this, work has proceeded on the design, construction, and installation of a reflectometer system on UCLA's CCT tokamak. This effort will allow a comparison between the improved confinement regimes (H-mode) observed on both the DIII-D and CCT machines with the goal of achieving a physics understanding of the phenomena. Preliminary investigation of a new diagnostic technique to measure density profiles as a function of time has been initiated at UCLA. The technique promises to be a valuable addition to the range of available plasma diagnostics. Work on advanced holographic reflectometry technique as applied to fluctuation diagnostics has awaited a better understanding of the reflectometer signal itself as discussed above. Efforts to ensure the transfer of the diagnostic developments have continued with particular attention devoted to the preliminary design of a multichannel FIR interferometer for MST.

The microeconomics of personalized medicine: today's challenge and tomorrow's promise.

Science.gov (United States)

Davis, Jerel C; Furstenthal, Laura; Desai, Amar A; Norris, Troy; Sutaria, Saumya; Fleming, Edd; Ma, Philip

2009-04-01

'Personalized medicine' promises to increase the quality of clinical care and, in some cases, decrease health-care costs. Despite this, only a handful of diagnostic tests have made it to market, with mixed success. Historically, the challenges in this field were scientific. However, as discussed in this article, with the maturation of the '-omics' sciences, it now seems that the major barriers are increasingly related to economics. Overcoming the poor microeconomic alignment of incentives among key stakeholders is therefore crucial to catalysing the further development and adoption of personalized medicine, and we propose several actions that could help achieve this goal.

Medical ethics in an era of bioethics: resetting the medical profession's compass.

Science.gov (United States)

Pellegrino, Edmund D

2012-02-01

What it means to be a medical professional has been defined by medical ethicists throughout history and remains a contemporary concern addressed by this paper. A medical professional is generally considered to be one who makes a public promise to fulfill the ethical obligations expressed in the Hippocratic Code. This presentation summarizes the history of medical professionalism and refocuses attention on the interpersonal relationship of doctor and patient. This keynote address was delivered at the Founders of Bioethics International Congress (June, 2010).

Thematic plan on diagnostic radiology

International Nuclear Information System (INIS)

2003-01-01

Due to the vital importance of diagnostic radiology in both the diagnosis and management of disease processes, there is a need for a greater coherent international effort to help the developing nations create strategies for the incorporation of imaging into their healthcare systems. To meet the needs of such countries, a comprehensive programme is required to take into consideration the availability of local expertise (medical and technical), the infrastructure (stable electrical supply, water and air-conditioning) and the disease pattern or burden. In short, the total solution requires coordinating the International Atomic Energy Agency efforts with those of other partners. The Agency already has programmes in nuclear medicine and radiation therapy supported by activities in dosimetry and medical physics. Through the Technical Co-operation fund the Agency already supports projects in some areas of diagnostic imaging, dosimetry and radiation protection, but it lacks a comprehensive programme to provide a systematic approach focusing on the medical aspects of imaging science and including all the imaging technologies. Member States require the Agency's assistance in this area since no single UN organisation has the resources or the expertise to do the entire job without help. This document presents the proposed programme strategy and action plan

CONGENITAL MALFORMATIONS: PRENATAL DIAGNOSTICS AND NOVEL CONCEPTION OF MEDICAL HELP TO NEWBORNS

Directory of Open Access Journals (Sweden)

Yu.F. Isakov

2007-01-01

Full Text Available Current views on basic prenatal diagnostics techniques, as ultrasound, maternal serum biochemical markers (alpha fetoprotein, human chorionic gonadotropin, and unconjugated estriol, and fetal biologic material (chorionic villus sampling, placenta, amniotic liquid, fetal blood, obtained with invasive techniques (chorion biopsy, amniocentesis, cordocentesis, its' efficacy and possible practical application are given in the article. These new conception announce to consolidate three branches providing maternal and children — welfare should consolidate maternal welfare outpatient clinics, maternal hospital and newborn surgery hospital — into one institute, thus allowing to success work of all stages, to avoid transportation and late surgical treatment, to reduce lethal outcomes following surgical treatment of congenital malformations. Primary results of implementation of this conception are presented in the article.Key words: prenatal diagnostics, newborns, congenital mal formations, prevention and prophylactics, diagnostics.

Complete diagnostics of pyroactive structures for smart systems of optoelectronics

Science.gov (United States)

Bravina, Svetlana L.; Morozovsky, Nicholas V.

1998-04-01

The results of study of pyroelectric phenomena in ferroelectric materials for evidence of the possibility to embody the functions promising for creation of smart systems for optoelectronic applications are presented. Designing such systems requires the development of methods for non- destructive complete diagnostics preferably by developing the self-diagnostic ability inherent in materials with the features of smart/intelligent ones. The complex method of complete non-destructive qualification of pyroactive materials based on the method of dynamic photopyroelectric effect allows the determination of pyroelectric, piezoelectric, ferroelectric, dielectric and thermophysical characteristics. The measuring system which allows the study of these characteristics and also memory effects, switching effects, fatigue and degradation process, self-repair process and others is presented. Sample pyroactive system with increased intelligence, such as systems with built-in adaptive controllable domain structure promising for functional optics are developed and peculiarities of their characterization are discussed.

Medical negligence.

OpenAIRE

Rosen, M.

1992-01-01

The progress made in diagnostic and therapeutic medicine has resulted in an increase in the number of malpractice suits brought against medical practitioners. To constitute negligence it must be shown that the conduct of the accused did not measure up to the standard of care the law required of him in the particular circumstances and that he acted with guilt and therefore can be blamed for the deed. This paper describes medical practitioner negligence and reviews relevant cases.

Injuries of deciduous and permanent teeth in children (diagnostic measures, medical tactics

Directory of Open Access Journals (Sweden)

Yakovenko L.N.

2016-12-01

Full Text Available A retrospective analysis of 1147 patients’ records from the clinic of the department of surgical dentistry and maxillofacial surgery of childhood of NMU Bogomolets and 944 case histories of patients with traumatic injuries of maxillofacial region in the clinic of the department of pediatric dentistry of SE «Dnepropetrovsk medical academy of Health Ministry of Ukraine» has shown that traumatic damages to teeth make up 18.8% of all injuries in maxillofacial region. It was found that in most cases the cause of injury is fall of a child - 60%, punching on the face - 19%, other causes – 21%. Most often maxillary central incisors are affected - about 70-80%, lateral - 10-20% both in temporary and in shift bite. Lower incisors are injured only in 1-6% of cases. Injuries of the temporary teeth were observed in 30-45% of cases. The aim of the study was to determine the major diagnostic methods and therapeutic measures that have been used in trauma of permanent and temporary teeth in children of different ages. Diagnostic measures included clinical and instrumental studies. Of the additional survey methods of dental trauma in 90% of cases back-side X-ray, in 7-8% – orthopanto­mography, in 1-2% - CT were performed. In dislocations of temporary teeth X-ray examination was carried out only in impacted dislocation. Algorithm of treatment tactics for almost all kinds of temporary teeth dislocations was to remove it, not taking into account the degree of formation of the tooth root and functional ability of the tooth, that involves the development of the indications for their preservation. Most often, for the immobilization of the injured permanent teeth a smooth splin-clamp (85% was used, it is cheap, easy to manufacture, reliable for fixing, individual as for adaptation, but when applied it leads to injury of periodontal tissues, the development of inflammatory processes in them. Alternative methods of fixation were splint systems, splint-caps and

EAMJ The Diagnostic Sep 09.indd

African Journals Online (AJOL)

East African Medical Journal Vol. 86 No. 9 September 2009. DIAGNOSTIC VALUES OF DIGITAL RECTAL EXAMINATION, PROSTATE SPECIFIC ANTIGEN AND TRANS-RECTAL. ULTRASOUND IN MEN WITH PROSTATISM. J. P. Manyahi, MD, MMed (Surg), MSc (Urol), Peramiho Hospital, P. O. Box 19, Peramiho.

Spectrum of diagnostic errors in radiology

OpenAIRE

Pinto, Antonio; Brunese, Luca

2010-01-01

Diagnostic errors are important in all branches of medicine because they are an indication of poor patient care. Since the early 1970s, physicians have been subjected to an increasing number of medical malpractice claims. Radiology is one of the specialties most liable to claims of medical negligence. Most often, a plaintiff’s complaint against a radiologist will focus on a failure to diagnose. The etiology of radiological error is multi-factorial. Errors fall into recurrent patterns. Errors ...

Promises and challenges for the implementation of computational medical imaging (radiomics) in oncology.

Science.gov (United States)

Limkin, E J; Sun, R; Dercle, L; Zacharaki, E I; Robert, C; Reuzé, S; Schernberg, A; Paragios, N; Deutsch, E; Ferté, C

2017-06-01

Medical image processing and analysis (also known as Radiomics) is a rapidly growing discipline that maps digital medical images into quantitative data, with the end goal of generating imaging biomarkers as decision support tools for clinical practice. The use of imaging data from routine clinical work-up has tremendous potential in improving cancer care by heightening understanding of tumor biology and aiding in the implementation of precision medicine. As a noninvasive method of assessing the tumor and its microenvironment in their entirety, radiomics allows the evaluation and monitoring of tumor characteristics such as temporal and spatial heterogeneity. One can observe a rapid increase in the number of computational medical imaging publications-milestones that have highlighted the utility of imaging biomarkers in oncology. Nevertheless, the use of radiomics as clinical biomarkers still necessitates amelioration and standardization in order to achieve routine clinical adoption. This Review addresses the critical issues to ensure the proper development of radiomics as a biomarker and facilitate its implementation in clinical practice. © The Author 2017. Published by Oxford University Press on behalf of the European Society for Medical Oncology. All rights reserved. For permissions, please email: journals.permissions@oup.com.

Quantum correlated imaging is a promising new technique in medical imaging

Institute of Scientific and Technical Information of China (English)

Nan Zhang; Zhaohua Yang

2017-01-01

Cardio-cerebral vascular diseases are common and frequently occurring serious diseases that threaten humans. In recent years, Digital Subtraction Angiography (DSA) has played a vital role in the diagnosis and treatment of cardio-cerebral vascular diseases. However, DSA is not able to visualize intravascular structures in real time, and it is especially difficult to evaluate each layer of the vascular wall and the composition of atherosclerotic plaques with DSA. Quantum correlated imaging is a new technique that can be used to perform real-time online imaging of intravascular flow, vascular wall structure, and atherosclerotic plaque composition. Quantum correlated imaging is a promising new technique that will soon be used in the diagnosis and treatment of cardio-cerebral vascular diseases.

The Development Of A Diagnostic Reading Test Of English For The Students Of Medical Faculty, Brawijaya University

Directory of Open Access Journals (Sweden)

Indah Winarni

2003-01-01

Full Text Available This paper describes the development of a diagnostic test of multiple choice reading comprehension as an initial stage in developing teaching materials for medical students learning English. Sample texts were collected from all the departments in the faculty. Selection of relevant texts involved the participation of some subject lecturers. Sixty one items were developed from fifteen texts to be reduced to forty items after pilot testing. Face validity was improved. The main trial was carried out to twenty nine students and item analysis was carried out. The test showed low level of concurrent validity and the internal consistency showed a moderate level of reliability. The low level of concurrent validity was suspected to result from the test being too difficult for the testees as the item analysis had revealed.

When Diagnostic Labels Mask Trauma

Science.gov (United States)

Foltz, Robert; Dang, Sidney; Daniels, Brian; Doyle, Hillary; McFee, Scott; Quisenberry, Carolyn

2013-01-01

A growing body of research shows that many seriously troubled children and adolescents are reacting to adverse life experiences. Yet traditional diagnostic labels are based on checklists of surface symptoms. Distracted by disruptive behavior, the common response is to medicate, punish, or exclude rather than respond to needs of youth who have…

Identification of factors associated with diagnostic error in primary care.

Science.gov (United States)

Minué, Sergio; Bermúdez-Tamayo, Clara; Fernández, Alberto; Martín-Martín, José Jesús; Benítez, Vivian; Melguizo, Miguel; Caro, Araceli; Orgaz, María José; Prados, Miguel Angel; Díaz, José Enrique; Montoro, Rafael

2014-05-12

Missed, delayed or incorrect diagnoses are considered to be diagnostic errors. The aim of this paper is to describe the methodology of a study to analyse cognitive aspects of the process by which primary care (PC) physicians diagnose dyspnoea. It examines the possible links between the use of heuristics, suboptimal cognitive acts and diagnostic errors, using Reason's taxonomy of human error (slips, lapses, mistakes and violations). The influence of situational factors (professional experience, perceived overwork and fatigue) is also analysed. Cohort study of new episodes of dyspnoea in patients receiving care from family physicians and residents at PC centres in Granada (Spain). With an initial expected diagnostic error rate of 20%, and a sampling error of 3%, 384 episodes of dyspnoea are calculated to be required. In addition to filling out the electronic medical record of the patients attended, each physician fills out 2 specially designed questionnaires about the diagnostic process performed in each case of dyspnoea. The first questionnaire includes questions on the physician's initial diagnostic impression, the 3 most likely diagnoses (in order of likelihood), and the diagnosis reached after the initial medical history and physical examination. It also includes items on the physicians' perceived overwork and fatigue during patient care. The second questionnaire records the confirmed diagnosis once it is reached. The complete diagnostic process is peer-reviewed to identify and classify the diagnostic errors. The possible use of heuristics of representativeness, availability, and anchoring and adjustment in each diagnostic process is also analysed. Each audit is reviewed with the physician responsible for the diagnostic process. Finally, logistic regression models are used to determine if there are differences in the diagnostic error variables based on the heuristics identified. This work sets out a new approach to studying the diagnostic decision-making process

Requirements for the special examination of isotope diagnostic specialists

International Nuclear Information System (INIS)

Csakany, Gyoergy

1986-01-01

Isotope diagnostic specialists are required to possess general paraclinical knowledge about nuclear physical principles, basic radiological measuring methods including up-to-date ones such as scintiscanning and tomography, as well as about radiopharmacology, radiation biology, health physics, radiation protection and organizational and economic aspects of the examinations. Clinical isotope diagnostic requirements comprise the proper selection among different radiological methods, the correct application of certain diagnostic procedures in practise, and the evaluation of the results in accordance with the symptoms on various fields of medical science. (V.N.)

Advance of the National Program of Radiological Protection and Safety for medical diagnostic with X-rays; Avance del Programa Nacional de Proteccion y Seguridad Radiologica para diagnostico medico con rayos X

Energy Technology Data Exchange (ETDEWEB)

Verdejo S, M. [Direccion de Riesgos Radiologicos, Direccion General de Salud Ambiental (Mexico)

1999-07-01

The National Program of Radiological Protection and Safety for medical diagnostic with X-ray (Programa Nacional de Proteccion y Seguridad Radiologica para diagnostico medico con rayos X) was initiated in the General Direction of Environmental Health (Direccion General de Salud Ambiental) in 1995. Task coordinated with different dependences of the Public Sector in collaboration between the Secretary of Health (Secretaria de Salud), the National Commission of Nuclear Safety and Safeguards (Comision Nacional de Seguridad Nuclear y Salvaguardias) and, the National Institute of Nuclear Research (Instituto Nacional de Investigaciones Nucleares). The surveillance to the fulfilment of the standardization in matter of Radiological Protection and Safety in the medical diagnostic with X-rays has been obtained for an important advance in the Public sector and it has been arousing interest in the Private sector. (Author)

21 CFR 892.2040 - Medical image hardcopy device.

Science.gov (United States)

2010-04-01

... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Medical image hardcopy device. 892.2040 Section... (CONTINUED) MEDICAL DEVICES RADIOLOGY DEVICES Diagnostic Devices § 892.2040 Medical image hardcopy device. (a) Identification. A medical image hardcopy device is a device that produces a visible printed record of a medical...

MO-AB-210-00: Diagnostic Ultrasound Imaging Quality Control and High Intensity Focused Ultrasound Therapy Hands-On Workshop

International Nuclear Information System (INIS)

2015-01-01

The goal of this ultrasound hands-on workshop is to demonstrate advancements in high intensity focused ultrasound (HIFU) and to demonstrate quality control (QC) testing in diagnostic ultrasound. HIFU is a therapeutic modality that uses ultrasound waves as carriers of energy. HIFU is used to focus a beam of ultrasound energy into a small volume at specific target locations within the body. The focused beam causes localized high temperatures and produces a well-defined regions of necrosis. This completely non-invasive technology has great potential for tumor ablation and targeted drug delivery. At the workshop, attendees will see configurations, applications, and hands-on demonstrations with on-site instructors at separate stations. The involvement of medical physicists in diagnostic ultrasound imaging service is increasing due to QC and accreditation requirements. At the workshop, an array of ultrasound testing phantoms and ultrasound scanners will be provided for attendees to learn diagnostic ultrasound QC in a hands-on environment with live demonstrations of the techniques. Target audience: Medical physicists and other medical professionals in diagnostic imaging and radiation oncology with interest in high-intensity focused ultrasound and in diagnostic ultrasound QC. Learning Objectives: Learn ultrasound physics and safety for HIFU applications through live demonstrations Get an overview of the state-of-the art in HIFU technologies and equipment Gain familiarity with common elements of a quality control program for diagnostic ultrasound imaging Identify QC tools available for testing diagnostic ultrasound systems and learn how to use these tools List of supporting vendors for HIFU and diagnostic ultrasound QC hands-on workshop: Philips Healthcare Alpinion Medical Systems Verasonics, Inc Zonare Medical Systems, Inc Computerized Imaging Reference Systems (CIRS), Inc. GAMMEX, Inc., Cablon Medical BV Steffen Sammet: NIH/NCI grant 5R25CA132822, NIH/NINDS grant 5R25NS

MO-AB-210-00: Diagnostic Ultrasound Imaging Quality Control and High Intensity Focused Ultrasound Therapy Hands-On Workshop

Energy Technology Data Exchange (ETDEWEB)

NONE

2015-06-15

The goal of this ultrasound hands-on workshop is to demonstrate advancements in high intensity focused ultrasound (HIFU) and to demonstrate quality control (QC) testing in diagnostic ultrasound. HIFU is a therapeutic modality that uses ultrasound waves as carriers of energy. HIFU is used to focus a beam of ultrasound energy into a small volume at specific target locations within the body. The focused beam causes localized high temperatures and produces a well-defined regions of necrosis. This completely non-invasive technology has great potential for tumor ablation and targeted drug delivery. At the workshop, attendees will see configurations, applications, and hands-on demonstrations with on-site instructors at separate stations. The involvement of medical physicists in diagnostic ultrasound imaging service is increasing due to QC and accreditation requirements. At the workshop, an array of ultrasound testing phantoms and ultrasound scanners will be provided for attendees to learn diagnostic ultrasound QC in a hands-on environment with live demonstrations of the techniques. Target audience: Medical physicists and other medical professionals in diagnostic imaging and radiation oncology with interest in high-intensity focused ultrasound and in diagnostic ultrasound QC. Learning Objectives: Learn ultrasound physics and safety for HIFU applications through live demonstrations Get an overview of the state-of-the art in HIFU technologies and equipment Gain familiarity with common elements of a quality control program for diagnostic ultrasound imaging Identify QC tools available for testing diagnostic ultrasound systems and learn how to use these tools List of supporting vendors for HIFU and diagnostic ultrasound QC hands-on workshop: Philips Healthcare Alpinion Medical Systems Verasonics, Inc Zonare Medical Systems, Inc Computerized Imaging Reference Systems (CIRS), Inc. GAMMEX, Inc., Cablon Medical BV Steffen Sammet: NIH/NCI grant 5R25CA132822, NIH/NINDS grant 5R25NS

Inadequate Diagnostic Evaluation in Young Patients Registered with a Diagnosis of Dementia

DEFF Research Database (Denmark)

Salem, Lise Cronberg; Andersen, Birgitte Bo; Nielsen, T Rune

2014-01-01

BACKGROUND: Establishing a diagnosis of dementia in young patients may be complex and have significant implications for the patient. The aim of this study was to evaluate the quality of the diagnostic work-up in young patients diagnosed with dementia in the clinical routine. METHODS: Two hundred...... patients were randomly selected from 891 patients aged ≤65 years registered with a diagnosis of dementia for the first time in 2008 in Danish hospitals, and 159 medical records were available for review. Three raters evaluated their medical records for the completeness of the diagnostic work-up on which...... the diagnosis of dementia had been based, using evidence-based guidelines for the diagnostic evaluation of dementia as reference standards. RESULTS: According to the rater review, only 111 (70%) patients met the clinical criteria for dementia. An acceptable diagnostic work-up including all items of recommended...

Vibrational spectroscopy: a clinical tool for cancer diagnostics.

Science.gov (United States)

Kendall, Catherine; Isabelle, Martin; Bazant-Hegemark, Florian; Hutchings, Joanne; Orr, Linda; Babrah, Jaspreet; Baker, Rebecca; Stone, Nicholas

2009-06-01

Vibrational spectroscopy techniques have demonstrated potential to provide non-destructive, rapid, clinically relevant diagnostic information. Early detection is the most important factor in the prevention of cancer. Raman and infrared spectroscopy enable the biochemical signatures from biological tissues to be extracted and analysed. In conjunction with advanced chemometrics such measurements can contribute to the diagnostic assessment of biological material. This paper also illustrates the complementary advantage of using Raman and FTIR spectroscopy technologies together. Clinical requirements are increasingly met by technological developments which show promise to become a clinical reality. This review summarises recent advances in vibrational spectroscopy and their impact on the diagnosis of cancer.

FEATURES OF THE CHRONIC PAIN SYNDROME IN PATIENTS WITH RHEUMATOID ARTHRITIS AND MEDICAL DIAGNOSTIC TACTICS

Directory of Open Access Journals (Sweden)

M. A. Gromova

2016-01-01

medical tactics for rheumatoid arthritis patients with a chronic pain syndrome in therapeutic practice based on pain strength gradation, assessment of chronic pain syndrome variations, definition of anxiety and depression signs. All this allows to validate consultation of medical specialists and to differentiate treatment. Conclusions. The integrated approach to diagnostics of a chronic pain syndrome for rheumatoid arthritis allows to estimate pain strengths in dynamics of disease development, to reveal existence of pain variations, anxiety and depression. It enables usage of patient maintenance tactics and increases efficiency of treatment in therapeutic practice. 

E.A.O. guidelines for the use of diagnostic imaging in implant dentistry 2011. A consensus workshop organized by the European Association for Osseointegration at the Medical University of Warsaw.

LENUS (Irish Health Repository)

Harris, David

2012-11-01

Diagnostics imaging is an essential component of patient selection and treatment planning in oral rehabilitation by means of osseointegrated implants. In 2002, the EAO produced and published guidelines on the use of diagnostic imaging in implant dentistry. Since that time, there have been significant developments in both the application of cone beam computed tomography as well as in the range of surgical and prosthetic applications that can potentially benefit from its use. However, medical exposure to ionizing radiation must always be justified and result in a net benefit to the patient. The as low a dose as is reasonably achievable principle must also be applied taking into account any alternative techniques that might achieve the same objectives. This paper reports on current EAO recommendations arising from a consensus meeting held at the Medical University of Warsaw (2011) to update these guidelines. Radiological considerations are detailed, including justification and optimization, with a special emphasis on the obligations that arise for those who prescribe or undertake such investigations. The paper pays special attention to clinical indications and radiographic diagnostic considerations as well as to future developments and trends.

Diagnostic radiation risks

Energy Technology Data Exchange (ETDEWEB)

Sherwood, T [Addenbrooke' s Hospital, Cambridge (UK)

1980-04-01

A brief discussion on diagnostic radiation risks is given. First some fundamental facts on the concepts and units of radiation measurement are clarified. Medical diagnostic radiation doses are also compared to the radiation doses received annually by man from natural background radiation. The controversy concerning the '10-day rule' in X-raying women of child-bearing age is discussed; it would appear that the risk of malformation in an unborn child due to X-radiation is very much less than the natural level of risk of malformation. The differences in the radiographic techniques and thus the different X-ray doses needed to make adequate X-ray images of different parts of the body are considered. The radiation burden of nuclear medicine investigations compared to X-ray procedures is also discussed. Finally, the problems of using volunteers in radiation research are aired.

Effective doses and standardised risk factors from paediatric diagnostic medical radiation exposures: Information for radiation risk communication

International Nuclear Information System (INIS)

Bibbo, Giovanni

2018-01-01

In the paediatric medical radiation setting, there is no consistency on the radiation risk information conveyed to the consumer (patient/carer). Each communicator may convey different information about the level of risk for the same radiation procedure, leaving the consumer confused and frustrated. There is a need to standardise risks resulting from medical radiation exposures. In this study, paediatric radiographic, fluoroscopic, CT and nuclear medicine examination data have been analysed to provide (i) effective doses and radiation induced cancer risk factors from common radiological and nuclear medicine diagnostic procedures in standardised formats, (II) awareness of the difficulties that may be encountered in communicating risks to the layperson, and (iii) an overview of the deleterious effects of ionising radiation so that the risk communicator can convey with confidence the risks resulting from medical radiation exposures. Paediatric patient dose data from general radiographic, computed tomography, fluoroscopic and nuclear medicine databases have been analysed in age groups 0 to <5 years, 5 to <10 years, 10 to <15 years and 15 to <18 years to determine standardised risk factors. Mean, minimum and maximum effective doses and the corresponding mean lifetime risks for general radiographic, fluoroscopic, CT and nuclear medicine examinations for different age groups have been calculated. For all examinations, the mean lifetime cancer induction risk is provided in three formats: statistical, fraction and category. Standardised risk factors for different radiological and nuclear medicine examinations and an overview of the deleterious effects of ionising radiation and the difficulties encountered in communicating the risks should facilitate risk communication to the patient/carer.

Diagnostic and therapeutic peroral cholangioscopy

Directory of Open Access Journals (Sweden)

Jong Ho Moon

2012-01-01

Full Text Available Peroral cholangioscopy (POC provides direct visualization of the bile duct and facilitates diagnostic or therapeutic intervention. The currently available single-operator POC systems are "Mother-baby" scope system, SpyGlass direct visualization system, and direct POC using a regular ultra-slim upper endoscope. Direct POC using an ultra-slim upper endoscope having a larger 2-mm working channel can provide a valuable and economic solution for evaluating bile-duct lesions. Main diagnostic procedures under direct POC are visual characterization and optically guided target biopsy for the indeterminate bile duct lesion. Image-enhanced endoscopy such as narrow-band imaging has shown promise for more detailed evaluation of mucosal abnormality and can be performed under direct POC. Intracorporeal lithotripsy such as electrohydraulic lithotripsy or laser lithotripsy is a main therapeutic intervention of direct POC for patients with bile duct stones that are resistant to conventional endoscopic stone-removal procedures. Besides, tumor ablation therapy, such as photodynamic therapy and argon plasma coagulation may be also performed using direct POC. Further developments of the endoscope and specialized accessories or devices are expected to facilitate diagnostic and therapeutic role of this cholangioscopic procedure.

Analytical modeling of worldwide medical radiation use

International Nuclear Information System (INIS)

Mettler, F.A. Jr.; Davis, M.; Kelsey, C.A.; Rosenberg, R.; Williams, A.

1987-01-01

An analytical model was developed to estimate the availability and frequency of medical radiation use on a worldwide basis. This model includes medical and dental x-ray, nuclear medicine, and radiation therapy. The development of an analytical model is necessary as the first step in estimating the radiation dose to the world's population from this source. Since there is no data about the frequency of medical radiation use in more than half the countries in the world and only fragmentary data in an additional one-fourth of the world's countries, such a model can be used to predict the uses of medical radiation in these countries. The model indicates that there are approximately 400,000 medical x-ray machines worldwide and that approximately 1.2 billion diagnostic medical x-ray examinations are performed annually. Dental x-ray examinations are estimated at 315 million annually and approximately 22 million in-vivo diagnostic nuclear medicine examinations. Approximately 4 million radiation therapy procedures or courses of treatment are undertaken annually

Problems of Formation of Diagnostic Features in the Diagnosis of Aircraft Engines

Directory of Open Access Journals (Sweden)

Pronyakin V.I.

2017-01-01

Full Text Available The article is devoted to the evaluation of current technical condition of aircraft engines. Deals with the choice of the detection method of diagnostic features required for degradation assessment, emergency protection and detection of incipient defects on the example of cyclic machines and mechanisms. For the formation of diagnostic features in the diagnosis of aircraft engines use different physical effects (vibration, shock, heat radiation, electrodynamic and thermal processes, wear debris in oil, etc.. Classification of defects and requirements for the development of diagnostics systems is formed based on them. The article describes the requirements for diagnostic signs. The article provides a promising phase method that allows obtaining stable diagnostic characters in exploitation. The result of applying the method is shown. Diagnostic signs are formed. In mathematical modeling it was used the traditional theory of the description of rotary mechanisms. The data obtained are compared with experimental data.

Diagnostic x-ray equipment compliance and facility survey. Recommended procedures for equipment and facility testing

International Nuclear Information System (INIS)

1994-01-01

The Radiation Protection Bureau has set out guidelines for the testing of diagnostic x-ray equipment and facilities. This guide provides information for the x-ray inspector, test engineer, technologist, medical physicist and any other person responsible for verifying the regulatory compliance or safety of diagnostic x-ray equipment and facilities. Diagnostic x-radiation is an essential part of present day medical practice. The largest contributor of irradiation to the general population comes from diagnostic x-radiation. Although individual irradiations are usually small, there is a concern of possible excess cancer risk when large populations are irradiated. Unnecessary irradiations to patients from radiological procedures can be significantly reduced with little or no decrease in the value of medical diagnostic information. This can be achieved by using well designed x-ray equipment which is installed, used and maintained by trained personnel, and by the adoption of standardized procedures. In general, when patient surface dose is reduced, there is a corresponding decrease in dose to x-ray equipment operators and other health care personnel. 2 tabs., 4 figs

Diagnostic x-ray equipment compliance and facility survey. Recommended procedures for equipment and facility testing

Energy Technology Data Exchange (ETDEWEB)

NONE

1994-12-31

The Radiation Protection Bureau has set out guidelines for the testing of diagnostic x-ray equipment and facilities. This guide provides information for the x-ray inspector, test engineer, technologist, medical physicist and any other person responsible for verifying the regulatory compliance or safety of diagnostic x-ray equipment and facilities. Diagnostic x-radiation is an essential part of present day medical practice. The largest contributor of irradiation to the general population comes from diagnostic x-radiation. Although individual irradiations are usually small, there is a concern of possible excess cancer risk when large populations are irradiated. Unnecessary irradiations to patients from radiological procedures can be significantly reduced with little or no decrease in the value of medical diagnostic information. This can be achieved by using well designed x-ray equipment which is installed, used and maintained by trained personnel, and by the adoption of standardized procedures. In general, when patient surface dose is reduced, there is a corresponding decrease in dose to x-ray equipment operators and other health care personnel. 2 tabs., 4 figs.

New possibilities of complex "Thermodyn" application for contactless remote diagnostics in medical practice

Science.gov (United States)

Belov, M. Ye.; Shayko-Shaykovskiy, O. G.; Makhrova, Ye. G.; Kramar, V. M.; Oleksuik, I. S.

2018-01-01

We represent here the theoretical justifications, block scheme and experimental sample of a new automated complex "Thermodyn" for remote contactless diagnostics of inflammatory processes of the surfaces and in subcutaneous areas of human body. Also we described here the methods and results of diagnostic measurements, and results of practical applications of this complex.

Imaging techniques for medical diagnosis

International Nuclear Information System (INIS)

Gudden, F.

1982-01-01

In the last few decades, science, engineering and medicine have combinded to improve the quality of our lives to a level previously unimagined. Within the framework of medical engineering - the field of activity of the Medical Engineering Group of Siemens AG - diagnostic image-generating systems have played an important role in effecting these changes and improvements. The importance of these systems to the success of the Group is clearly evident. Diagnostic imaging systems account for 65% of the sales achieved by this Group. In this article an overview is presented of the major innovations and the aims of developments in the field of imaging systems. (orig.)

Relevance of protection quantities in medical exposures

International Nuclear Information System (INIS)

Pradhan, A.S.

2008-01-01

International Commission on Radiological Protection (ICRP) continues to classify the exposures to radiation in three categories; namely 1- occupational exposure, 2- public exposure, and 3- medical exposure. Protection quantities are primarily meant for the regulatory purpose in radiological protection for controlling and limiting stochastic risks in occupational and public exposures. These are based on two basic assumptions of 1- linear no-threshold dose-effect relationship (LNT) at low doses and 2- long-term additivity of low doses. Medical exposure are predominantly delivered to individuals (patients) undergoing diagnostic examinations, interventional procedures and radiation therapy but also include individual caring for or comforting patients incurring exposure and the volunteers of biomedical medical research programmes. Radiation protection is as relevant to occupational and public exposure as to medical exposures except that the dose limits set for the formers are not applicable to medical exposure but reference levels and dose constrains are recommended for diagnostic and interventional medical procedures. In medical institutions, both the occupational and medical exposure takes place. Since the doses in diagnostic examinations are low, it has been observed that not only the protection quantities are often used in such cases but these are extended to estimate the number of cancer deaths due to such practices. One of the striking features of the new ICRP recommendations has been to elaborate the concepts of the dosimetric quantities. The limitation of protection quantities ((Effective dose, E=Σ RT D TR .W T .W R and Equivalent Dose H T =Σ RT D TR .W R ) have been brought out and this has raised a great concern and initiated debates on the use of these quantities in medical exposures. Consequently, ICRP has set a task group to provide more details and the recommendations. It has, therefore, became important to draw the attention of medical physics community

Evaluation of Diagnostic Tests Using Information Theory for Multi-Class Diagnostic Problems and its Application for the Detection of Occlusal Caries Lesions

Directory of Open Access Journals (Sweden)

Umut Arslan

2014-09-01

Full Text Available Background: Several methods are available to evaluate the performance of the tests when the purpose of the diagnostic test is to discriminate between two possible disease states. However multi-class diagnostic problems frequently appear in many areas of medical science. Hence, there is a need for methods which will enable us to characterize the accuracy of diagnostic tests when there are more than two possible disease states. Aims: To show that two information theory measures, information content (IC and proportional reduction in diagnostic uncertainty (PRDU, can be used for the evaluation of the performance of diagnostic tests for multi-class diagnostic problems that may appear in different areas of medical science. Study Design: Diagnostic accuracy study. Methods: Sixty freshly extracted permanent human molar and premolar teeth suspected to have occlusal caries lesions were selected for the study and were assessed by two experienced examiners. Each examiner performed two evaluations. Histological examination was used as the gold standard. The scores of the histological examination were defined as sound (n=11, enamel caries (n=22 and dentin caries (n=27. Diagnostic performance of i visual inspection, ii radiography, iii laser fluorescence (LF and iv micro-computed tomography (M-CT caries detection methods was evaluated by calculating IC and PRDU. Results: Micro-computed tomography examination was the best method among the diagnostic techniques for the diagnosis of occlusal caries in terms of both IC and PRDU. M-CT examination supplied the maximum diagnostic information about the diagnosis of occlusal caries in the first (IC: 1.056; p<0.05, (PRDU: 70.5% and second evaluation (IC: 1.105; p<0.05, (PRDU: 73.8% for the first examiner. M-CT examination was the best method among the diagnostic techniques for the second examiner in both the first (IC:1.105; p<0.05, (PRDU:73.8% and second evaluation (IC:1.061; p<0.05, (PRDU:70.8%. IC and PRDU were

Diagnostic utility of medical thoracoscopy in peripheral parenchymal pulmonary lesions

Directory of Open Access Journals (Sweden)

E. Hatata

2015-07-01

Conclusions: Among patients with peripheral parenchymal pulmonary lesions remaining undiagnosed after usual initial investigation and even transthoracic needle biopsies, thoracoscopy done under local anaesthesia is a rapid, safe, and well-tolerated procedure with an excellent diagnostic yield that is equivalent to that of thoracotomy.

Implementation of Targeted Next Generation Sequencing in Clinical Diagnostics

DEFF Research Database (Denmark)

Larsen, Martin Jakob; Burton, Mark; Thomassen, Mads

Accurate mutation detection is essential in clinical genetic diagnostics of monogenic hereditary diseases. Targeted next generation sequencing (NGS) provides a promising and cost-effective alternative to Sanger sequencing and MLPA analysis currently used in most diagnostic laboratories. One...... of mutation positive controls previously characterized by Sanger/MLPA analysis. Agilent SureSelect Target-Enrichment kits were used for capturing a set of genes associated with hereditary breast and ovarian cancer syndrome and a compilation of genes involved in multiple rare single gene disorders......, respectively. For diagnostics, the sequencing coverage is essential, wherefore a minimum coverage of 30x per nucleotide in the coding regions was used as our primary quality criterion. For the majority of the included genes, we obtained adequate gene coverage, in which we were able to detect 100% of the known...

DICOM standard in computer-aided medical technologies

International Nuclear Information System (INIS)

Plotnikov, A.V.; Prilutskij, D.A.; Selishchev, S.V.

1997-01-01

The paper outlines one of the promising standards to transmit images in medicine, in radiology in particular. the essence of the standard DICOM is disclosed and promises of its introduction into computer-aided medical technologies

An assessment of diagnostic efficiency by Taguchi/DEA methods.

Science.gov (United States)

Taner, Mehmet Tolga; Sezen, Bulent

2009-01-01

The aim of this paper is to propose a new, objective and consistent method for the calculation of the diagnostic efficiency in medical applications. In this study, a hybrid method of Taguchi and DEA is proposed. This method reflects the diversity of inputs and outputs by incorporating the stepwise application of sensitivity, specificity, leveling threshold, and efficiency score. A hypothetical case study is given which involves eight readers of X-ray films in clinical radiology. The selected pairs of sensitivity and specificity yielded two efficient readers. After super efficiency analysis, Reader 6 is found to be the most efficient reader. The paper presents a new, objective and consistent method for the calculation of the diagnostic efficiency in medical applications.

University of Saskatchewan Radiology Courseware (USRC): an assessment of its utility for teaching diagnostic imaging in the medical school curriculum.

Science.gov (United States)

Burbridge, Brent; Kalra, Neil; Malin, Greg; Trinder, Krista; Pinelle, David

2015-01-01

We have found it very challenging to integrate images from our radiology digital imaging repository into the curriculum of our local medical school. Thus, it has been difficult to convey important knowledge related to viewing and interpreting diagnostic radiology images. We sought to determine if we could create a solution for this problem and evaluate whether students exposed to this solution were able to learn imaging concepts pertinent to medical practice. We developed University of Saskatchewan Radiology Courseware (USRC), a novel interactive web application that enables preclinical medical students to acquire image interpretation skills fundamental to clinical practice. This web application reformats content stored in Medical Imaging Resource Center teaching cases for BlackBoard Learn™, a popular learning management system. We have deployed this solution for 2 successive years in a 1st-year basic sciences medical school course at the College of Medicine, University of Saskatchewan. The "courseware" content covers both normal anatomy and common clinical pathologies in five distinct modules. We created two cohorts of learners consisting of an intervention cohort of students who had used USRC for their 1st academic year, whereas the nonintervention cohort was students who had not been exposed to this learning opportunity. To assess the learning experience of the users we designed an online questionnaire and image review quiz delivered to both of the student groups. Comparisons between the groups revealed statistically significant differences in both confidence with image interpretation and the ability to answer knowledge-based questions. Students were satisfied with the overall usability, functions, and capabilities of USRC. USRC is an innovative technology that provides integration between Medical Imaging Resource Center, a teaching solution used in radiology, and a Learning Management System.

[EBOLA HEMORRHAGIC FEVER: DIAGNOSTICS, ETIOTROPIC AND PATHOGENETIC THERAPY, PREVENTION].

Science.gov (United States)

Zhdanov, K V; Zakharenko, S M; Kovalenko, A N; Semenov, A V; Fisun, A Ya

2015-01-01

The data on diagnostics, etiotropic and pathogenetic therapy, prevention of Ebola hemorrhagic fever are presented including diagnostic algorithms for different clinical situations. Fundamentals of pathogenetic therapy are described. Various groups of medications used for antiviral therapy of conditions caused by Ebola virus are characterized. Experimental drugs at different stages of clinical studies are considered along with candidate vaccines being developed for the prevention of the disease.

A Hybrid Neural Network-Genetic Algorithm Technique for Aircraft Engine Performance Diagnostics

Science.gov (United States)

Kobayashi, Takahisa; Simon, Donald L.

2001-01-01

In this paper, a model-based diagnostic method, which utilizes Neural Networks and Genetic Algorithms, is investigated. Neural networks are applied to estimate the engine internal health, and Genetic Algorithms are applied for sensor bias detection and estimation. This hybrid approach takes advantage of the nonlinear estimation capability provided by neural networks while improving the robustness to measurement uncertainty through the application of Genetic Algorithms. The hybrid diagnostic technique also has the ability to rank multiple potential solutions for a given set of anomalous sensor measurements in order to reduce false alarms and missed detections. The performance of the hybrid diagnostic technique is evaluated through some case studies derived from a turbofan engine simulation. The results show this approach is promising for reliable diagnostics of aircraft engines.

Diagnostic value of MRI in meniscus injury. Comparison of MRI and arthrography

International Nuclear Information System (INIS)

Iso, Yoshinori; Nozaki, Hiroyuki; Emoto, Mari; Miyairi, Taro; Hirata, Aya; Hirasawa, Seiichi; Suguro, Toru; Igata, Atsuomi; Kudo, Yukihiko.

1995-01-01

Magnetic resonance imaging (MRI) and arthrography were performed on 90 knees to compare the diagnostic value for meniscus injury with these techniques. The diagnostic accuracy of MRI and arthrography was 89.1% and 87.1%, respectively. Imaging of the medial meniscus was somewhat better with arthrography, and delineation of the lateral meniscus was somewhat better with MRI. MRI was superior in diagnoses of horizontal and degenerative lacerations, but showed the shape of the injuries less clearly than arthrography. The diagnostic accuracy of MRI decreased with the age of the patients and was inferior to arthrography for patients in their forties or older. In conclusion, MRI is a less invasive approach with high diagnostic accuracy for meniscus injury and is a promising substitute for arthrography. (author)

Calibration of diagnostic x-ray machines using radiation exposure and radiographic parameters

International Nuclear Information System (INIS)

Agba, E.H.; Uloko, P. I.; Tyovenda, A. A.

2011-01-01

Calibration of diagnostic x-ray machines using radiation exposure and radiographic parameters of the x-ray machines has been carried out. Three phase diagnostic x-ray machines situated at Federal Medical Centre, Makurdi, General Hospital, Otukpo and Christian Hospital, Mkar were used for the calibration work. The radiation meter was used to measure x-ray radiation exposure. The result of this work demonstrates mR/mAs=C(KV p ) that there exist a power law relation of the form between the radiation exposure and the radiographic parameters of diagnostic x-ray machines, which can be used to estimate patient exposure during routine x-ray diagnostic examinations for wide range of operating parameters. The values of the power exponent n, constant c and total filtrations of the diagnostic x-ray machines have been estimated. These values for the diagnostic x-ray machines at the Federal Medical Centre, Makurdi are: 2.14, 0.88 and 2.77 respectively, for the one at the General Hospital, Otukpo are: 2.07, 0.76 and 2.68 respectively and that of the Christian Hospital, Mkar are: 2.01,0.69 and 2.61 respectively.

Changes in IEC standards related to diagnostic radiology

International Nuclear Information System (INIS)

Porubszky, T.; Barsai, J.

2007-01-01

Complete test of publication follows. Purposes. Technical Committee TC62 of International Electrotechnical Commission (IEC) deals with medical electrical equipment (i.e. medical devices using electricity). Standardization concerning diagnostic radiology equipment is task of its Sub-Committee SC62B. An outlook of its activities and present situation, and especially of radiation protection aspects, is given. Materials and methods. Third edition of basic safety standard for medical electrical equipment IEC 60601-1 was issued in 2005. Elaboration of new collateral and particular standards - applicable together with it - is in progress. These standards are generally at the same time also European - EN - and national standards. There is a great importance of radiation protection in diagnostic X-ray equipment. Collateral standard IEC 6060-1-3 about it was at first issued in 1994. Rapid development of imaging technology demands updating of requirements. SC62B in 2003 founded a maintenance team MT37 for preparation of the second edition of this standard. According to new safety philosophy of IEC all modality specific requirements are to be collected in 'safety and essential performance' particular standards. A new working group WG42 - founded in 2006 - elaborates a new particular standard IEC 60601-2-54 for radiographic and radioscopic equipment. Maintenance team MT32 deals with safety and performance standards for X-ray tube assemblies. The authors actively participate in these activities. Results and discussion. Present and future system of diagnostic radiology IEC standards and some interesting details are presented. Conclusions. International standards - although they are not 'obligatory' - are generally the basis of safety and performance certification of diagnostic radiology equipment and often also of their quality assurance.

De Novo Human Cardiac Myocytes for Medical Research: Promises and Challenges

Directory of Open Access Journals (Sweden)

Veronique Hamel

2017-01-01

Full Text Available The advent of cellular reprogramming technology has revolutionized biomedical research. De novo human cardiac myocytes can now be obtained from direct reprogramming of somatic cells (such as fibroblasts, from induced pluripotent stem cells (iPSCs, which are reprogrammed from somatic cells, and from human embryonic stem cells (hESCs. Such de novo human cardiac myocytes hold great promise for in vitro disease modeling and drug screening and in vivo cell therapy of heart disease. Here, we review the technique advancements for generating de novo human cardiac myocytes. We also discuss several challenges for the use of such cells in research and regenerative medicine, such as the immature phenotype and heterogeneity of de novo cardiac myocytes obtained with existing protocols. We focus on the recent advancements in addressing such challenges.

Fundamentals of Medical Ultrasonics

CERN Document Server

Postema, Michiel

2011-01-01

This book sets out the physical and engineering principles of acoustics and ultrasound as used for medical applications. It covers the basics of linear acoustics, wave propagation, non-linear acoustics, acoustic properties of tissue, transducer components, and ultrasonic imaging modes, as well as the most common diagnostic and therapeutic applications. It offers students and professionals in medical physics and engineering a detailed overview of the technical aspects of medical ultrasonic imaging, whilst serving as a reference for clinical and research staff.

HEPATORENAL SYNDROME: DIAGNOSTIC AND THERAPEUTIC MANAGEMENT

Directory of Open Access Journals (Sweden)

I. G. Bakulin

2014-01-01

Full Text Available The practical guidelines on diagnosis and management of hepatorenal syndrome, which could be useful for general medical practitioners, gastroenterologists, and hepatologists, are considered in this paper. Selected recommendations are based on integrated clinical data, international recommendations and results of clinical trials. Beginning from theoretical grounds of hepatorenal syndrome (its definition, diagnostic criteria, and classification, acute kidney injury, and spontaneous bacterial peritonitis, the paper contains diagnostic algorithms (in particular, in ascites, for early revealing hepatorenal syndrome, and main approaches to therapy and prevention. The efficacy criteria and monitoring rules for the terlipressin-based therapy are listed.

Accuracy of abdominal lymph node scintigraphy in tumor diagnostics

International Nuclear Information System (INIS)

Kucharczyk, D.

1978-01-01

In view of the diagnostical correspondence between lymph node scintigraphy and X-ray lymphograpy, this dissertation, which is based on 110 systematic comparative evaluations, examines the diagnostical weight of the scintigraphic criteria for tumor growth, discusses diagnostical discrepancies and confirms the efficacy of lymph node scintigraphy in detecting malignomas. In discussing the diagnostical results in the light of previous experience, the shortcomings of the nuclear medical method in tumor diagnostics are shown to be attributable to the uncertainty of the individual scintigraphic criteria. Owing to the variability of the lymph node system as to topography, anatomy and retention rate and the fact that it cannot morphologically be well differentiated in the scintigram, X-ray lymphography to verify the scintigraphic result and preclude misinterpretation remains an indispensable measure. (orig.) [de

The two types of stethoscope systems for respiration system diagnostics of the human body

Science.gov (United States)

Abashkin, Vladimir; Achimova, Elena

2003-12-01

An acoustic multimode fiber optic sensors for medical diagnostics based upon the shutter principle has been elaborated with semiconductor laser diode as light source. The construction and the method of component preparation are described. Other type of stethoscope is electrical one. Both stethoscopes are four channels. The kinetics and dynamic vibrations and sounds of the human body can be detected, acquired and then processing by personal computer for medical diagnostics.

Cognitive and system factors contributing to diagnostic errors in radiology.

Science.gov (United States)

Lee, Cindy S; Nagy, Paul G; Weaver, Sallie J; Newman-Toker, David E

2013-09-01

In this article, we describe some of the cognitive and system-based sources of detection and interpretation errors in diagnostic radiology and discuss potential approaches to help reduce misdiagnoses. Every radiologist worries about missing a diagnosis or giving a false-positive reading. The retrospective error rate among radiologic examinations is approximately 30%, with real-time errors in daily radiology practice averaging 3-5%. Nearly 75% of all medical malpractice claims against radiologists are related to diagnostic errors. As medical reimbursement trends downward, radiologists attempt to compensate by undertaking additional responsibilities to increase productivity. The increased workload, rising quality expectations, cognitive biases, and poor system factors all contribute to diagnostic errors in radiology. Diagnostic errors are underrecognized and underappreciated in radiology practice. This is due to the inability to obtain reliable national estimates of the impact, the difficulty in evaluating effectiveness of potential interventions, and the poor response to systemwide solutions. Most of our clinical work is executed through type 1 processes to minimize cost, anxiety, and delay; however, type 1 processes are also vulnerable to errors. Instead of trying to completely eliminate cognitive shortcuts that serve us well most of the time, becoming aware of common biases and using metacognitive strategies to mitigate the effects have the potential to create sustainable improvement in diagnostic errors.

Genetic Determinants of Drug Resistance in Mycobacterium tuberculosis and Their Diagnostic Value

NARCIS (Netherlands)

Farhat, M.R.; Sultana, R.; Iartchouk, O.; Bozeman, S.; Galagan, J.; Sisk, P.; Stolte, C.; Nebenzahl-Guimaraes, H.; Jacobson, K.; Sloutsky, A.; Kaur, D.; Posey, J.; Kreiswirth, B.N.; Kurepina, N.; Rigouts, L.; Streicher, E.M.; Victor, T.C.; Warren, R.M.; Soolingen, D. van; Murray, M.

2016-01-01

RATIONALE: The development of molecular diagnostics that detect both the presence of Mycobacterium tuberculosis in clinical samples and drug resistance-conferring mutations promises to revolutionize patient care and interrupt transmission by ensuring early diagnosis. However, these tools require the

[Approaches to development and implementation of the medical information system for military-medical commission of the multidisciplinary military-medical organisation].

Science.gov (United States)

Kuvshinov, K E; Klipak, V M; Chaplyuk, A L; Moskovko, V M; Belyshev, D V; Zherebko, O A

2015-06-01

The current task of the implementation of medical information systems in the military and medical organizations is an automation of the military-medical expertise as one of the most important activities. In this regard, noteworthy experience of the 9th Medical Diagnostic Centre (9th MDC), where on the basis of medical information system "Interi PROMIS" for the first time was implemented the automation of the work of military medical commission. The given paper presents an algorithm for constructing of the information system for the military-medical examination; detailed description of its elements is given. According to military servicemen the implementation of the Military Medical Commission (MMC) subsystem of the medical information system implemented into the 9th MDC has reduced the time required for the MMC and paperwork, greatly facilitate the work of physicians and medical specialists on military servicemen examination. This software can be widely applied in ambulatory and hospital practice, especially in case of mass military-medical examinations.

DEVELOPMENT OF DIAGNOSTIC REFERENCE LEVELS (DRL OF PATIENTS X-RAY EXPOSURE IN DIAGNOSTIC RADIOLOGY

Directory of Open Access Journals (Sweden)

A. V. Vodovatov

2013-01-01

Full Text Available We introduce a system of Diagnostic Reference Levels (DRLs for patients medical exposure for national health care practice implementation. DRLs are an effective way of the patient radiation protection through the optimization of the medical exposure. The paper discusses and compares different methods of determining the DRLs based on measured and/or calculated quantities of patient’s dose: dose area product (DAP, entrance surface dose (ESD and an effective dose. Distributions of different dose quantities in different Saint-Petersburg clinics are shown on the example of chest PA examinations. The results are compared with the data from other sources. Regional DRLs for Saint-Petersburg are proposed.

Nucleic acid-based diagnostics for infectious diseases in public health affairs.

Science.gov (United States)

Yu, Albert Cheung-Hoi; Vatcher, Greg; Yue, Xin; Dong, Yan; Li, Mao Hua; Tam, Patrick H K; Tsang, Parker Y L; Wong, April K Y; Hui, Michael H K; Yang, Bin; Tang, Hao; Lau, Lok-Ting

2012-06-01

Infectious diseases, mostly caused by bacteria and viruses but also a result of fungal and parasitic infection, have been one of the most important public health concerns throughout human history. The first step in combating these pathogens is to get a timely and accurate diagnosis at an affordable cost. Many kinds of diagnostics have been developed, such as pathogen culture, biochemical tests and serological tests, to help detect and fight against the causative agents of diseases. However, these diagnostic tests are generally unsatisfactory because they are not particularly sensitive and specific and are unable to deliver speedy results. Nucleic acid-based diagnostics, detecting pathogens through the identification of their genomic sequences, have shown promise to overcome the above limitations and become more widely adopted in clinical tests. Here we review some of the most popular nucleic acid-based diagnostics and focus on their adaptability and applicability to routine clinical usage. We also compare and contrast the characteristics of different types of nucleic acid-based diagnostics.

Modeling sequential context effects in diagnostic interpretation of screening mammograms.

Science.gov (United States)

Alamudun, Folami; Paulus, Paige; Yoon, Hong-Jun; Tourassi, Georgia

2018-07-01

Prior research has shown that physicians' medical decisions can be influenced by sequential context, particularly in cases where successive stimuli exhibit similar characteristics when analyzing medical images. This type of systematic error is known to psychophysicists as sequential context effect as it indicates that judgments are influenced by features of and decisions about the preceding case in the sequence of examined cases, rather than being based solely on the peculiarities unique to the present case. We determine if radiologists experience some form of context bias, using screening mammography as the use case. To this end, we explore correlations between previous perceptual behavior and diagnostic decisions and current decisions. We hypothesize that a radiologist's visual search pattern and diagnostic decisions in previous cases are predictive of the radiologist's current diagnostic decisions. To test our hypothesis, we tasked 10 radiologists of varied experience to conduct blind reviews of 100 four-view screening mammograms. Eye-tracking data and diagnostic decisions were collected from each radiologist under conditions mimicking clinical practice. Perceptual behavior was quantified using the fractal dimension of gaze scanpath, which was computed using the Minkowski-Bouligand box-counting method. To test the effect of previous behavior and decisions, we conducted a multifactor fixed-effects ANOVA. Further, to examine the predictive value of previous perceptual behavior and decisions, we trained and evaluated a predictive model for radiologists' current diagnostic decisions. ANOVA tests showed that previous visual behavior, characterized by fractal analysis, previous diagnostic decisions, and image characteristics of previous cases are significant predictors of current diagnostic decisions. Additionally, predictive modeling of diagnostic decisions showed an overall improvement in prediction error when the model is trained on additional information about

Male bladder outlet obstruction: Time to re-evaluate the definition and reconsider our diagnostic pathway? ICI-RS 2015.

Science.gov (United States)

Rademakers, Kevin; Drake, Marcus J; Gammie, Andrew; Djurhuus, Jens C; Rosier, Peter F W M; Abrams, Paul; Harding, Christopher

2017-04-01

The diagnosis of bladder outlet obstruction (BOO) in the male is dependent on measurements of pressure and flow made during urodynamic studies. The procedure of urodynamics and the indices used to delineate BOO are well standardized largely as a result of the work of the International Continence Society. The clinical utility of the diagnosis of BOO is however, less well defined and there are several shortcomings and gaps in the currently available medical literature. Consequently the International Consultation on Incontinence Research Society (ICI-RS) held a think tank session in 2015 entitled "Male bladder outlet obstruction: Time to re-evaluate the definition and reconsider our diagnostic pathway?" This manuscript details the discussions that took place within that think tank setting out the pros and cons of the current definition of BOO and exploring alternative clinical tests (alone or in combination) which may be useful in the future investigation of male patients with lower urinary tract symptoms. The think tank panel concluded that pressure-flow studies remain the diagnostic gold-standard for BOO although there is still a lack of high quality evidence. Newer, less invasive, investigations have shown promise in terms of diagnostic accuracy for BOO but similar criticisms can be levelled against these tests. Therefore, the think tank suggests further research with regard to these alternative indicators to determine their clinical utility. © 2017 Wiley Periodicals, Inc.

The use of magnetic resonance tomography in gastrointestinal diagnostics

International Nuclear Information System (INIS)

Geitung, Jonn Terje

2000-01-01

Background: Magnetic resonance imaging (MRI) is a promising method for examination of the gastrointestinal tract. In this article we present the present status and potential of MRI. Material and method: The review is based on personal experience and selected published, international papers. Results: Magnetic resonance cholangio-pancreatography (MRCP) and MRI of the liver are well documented examinations which are widely performed. These examinations partly replace existing modalities such as CT and ERCP and represent additional possibilities for examining this anatomic area. MRI is not as yet accepted as the standard examination of the pancreas, but it is regarded as comparable to CT. The adrenals may be examined even more accurately with MRI than with CT. MRI examinations of the oesophagus and gastric ventricle seem promising, but it should be said that they are in an early and not well document phase. MRI of the small and large bowels is not common. With the exception of preoperative staging of rectal cancers, it is still experimental. MR angiography, functional MRI studies and perfusion studies are not yet common in abdominal diseases. We may, however, believe that they will become important diagnostic tools. Interpretation: MRI is rapidly increasing its share of gastrointestinal imaging examinations. This is mainly due to the increased speed of newer machines. The diagnostic quality has improved and will improve more. It is thus likely that MRI will, in a large amount of abdominal imaging, replace CT and to some extent other diagnostic modalities. It is, however, not possible to replace CT for emergencies and we will probably look forward to more and better imaging with more diagnostic modalities in the future

Diagnostic Error in Medical Education: Where Wrongs Can Make Rights

Science.gov (United States)

Eva, Kevin W.

2009-01-01

This paper examines diagnostic error from an educational perspective. Rather than addressing the question of how educators in the health professions can help learners avoid error, however, the literature reviewed leads to the conclusion that educators should be working to induce error in learners, leading them to short term pain for long term…

The Promise of E-Platform Technology in Medical Education.

Science.gov (United States)

Dawd, Siraj

2016-03-01

Increasing the number as well as improving the capacity and quality of medical professionals to achieve an equitable health care for all is a global priority and a global challenge. In developing countries, which are facing the largest burden of disease, to achieve the above stated objective, there is a big need for more well-trained, competent and dedicated health care providers. Currently, there is a well-documented shortage of trained health workers globally, with the poorest countries having the greatest shortfalls. The time tested, traditional approach of training health care force by importing professionals from overseas is not only prohibitively expensive but also not sufficient to achieve the scale and pace of the required human capacity building. Considering this fact, distance learning programs, which include m-Health as well as other information technology (IT) platforms and tools, can provide unique, timely, cost-effective, easily scalable and valuable opportunities to expand access to training health care manpower in developing countries where the shortage is critical.

Do promises matter? An exploration of the role of promises in psychological contract breach.

Science.gov (United States)

Montes, Samantha D; Zweig, David

2009-09-01

Promises are positioned centrally in the study of psychological contract breach and are argued to distinguish psychological contracts from related constructs, such as employee expectations. However, because the effects of promises and delivered inducements are confounded in most research, the role of promises in perceptions of, and reactions to, breach remains unclear. If promises are not an important determinant of employee perceptions, emotions, and behavioral intentions, this would suggest that the psychological contract breach construct might lack utility. To assess the unique role of promises, the authors manipulated promises and delivered inducements separately in hypothetical scenarios in Studies 1 (558 undergraduates) and 2 (441 employees), and they measured them separately (longitudinally) in Study 3 (383 employees). The authors' results indicate that breach perceptions do not represent a discrepancy between what employees believe they were promised and were given. In fact, breach perceptions can exist in the absence of promises. Further, promises play a negligible role in predicting feelings of violation and behavioral intentions. Contrary to the extant literature, the authors' findings suggest that promises may matter little; employees are concerned primarily with what the organization delivers.

Identification of factors associated with diagnostic error in primary care

Science.gov (United States)

2014-01-01

Background Missed, delayed or incorrect diagnoses are considered to be diagnostic errors. The aim of this paper is to describe the methodology of a study to analyse cognitive aspects of the process by which primary care (PC) physicians diagnose dyspnoea. It examines the possible links between the use of heuristics, suboptimal cognitive acts and diagnostic errors, using Reason’s taxonomy of human error (slips, lapses, mistakes and violations). The influence of situational factors (professional experience, perceived overwork and fatigue) is also analysed. Methods Cohort study of new episodes of dyspnoea in patients receiving care from family physicians and residents at PC centres in Granada (Spain). With an initial expected diagnostic error rate of 20%, and a sampling error of 3%, 384 episodes of dyspnoea are calculated to be required. In addition to filling out the electronic medical record of the patients attended, each physician fills out 2 specially designed questionnaires about the diagnostic process performed in each case of dyspnoea. The first questionnaire includes questions on the physician’s initial diagnostic impression, the 3 most likely diagnoses (in order of likelihood), and the diagnosis reached after the initial medical history and physical examination. It also includes items on the physicians’ perceived overwork and fatigue during patient care. The second questionnaire records the confirmed diagnosis once it is reached. The complete diagnostic process is peer-reviewed to identify and classify the diagnostic errors. The possible use of heuristics of representativeness, availability, and anchoring and adjustment in each diagnostic process is also analysed. Each audit is reviewed with the physician responsible for the diagnostic process. Finally, logistic regression models are used to determine if there are differences in the diagnostic error variables based on the heuristics identified. Discussion This work sets out a new approach to studying the

The DSM diagnostic criteria for vaginismus.

Science.gov (United States)

Binik, Yitzchak M

2010-04-01

Vaginal spasm has been considered the defining diagnostic characteristic of vaginismus for approximately 150 years. This remarkable consensus, based primarily on expert clinical opinion, is preserved in the DSM-IV-TR. The available empirical research, however, does not support this definition nor does it support the validity of the DSM-IV-TR distinction between vaginismus and dyspareunia. The small body of research concerning other possible ways or methods of diagnosing vaginismus is critically reviewed. Based on this review, it is proposed that the diagnoses of vaginismus and dyspareunia be collapsed into a single diagnostic entity called "genito-pelvic pain/penetration disorder." This diagnostic category is defined according to the following five dimensions: percentage success of vaginal penetration; pain with vaginal penetration; fear of vaginal penetration or of genito-pelvic pain during vaginal penetration; pelvic floor muscle dysfunction; medical co-morbidity.

Accuracy of Assessment of Eligibility for Early Medical Abortion by Community Health Workers in Ethiopia, India and South Africa.

Science.gov (United States)

Johnston, Heidi Bart; Ganatra, Bela; Nguyen, My Huong; Habib, Ndema; Afework, Mesganaw Fantahun; Harries, Jane; Iyengar, Kirti; Moodley, Jennifer; Lema, Hailu Yeneneh; Constant, Deborah; Sen, Swapnaleen

2016-01-01

To assess the accuracy of assessment of eligibility for early medical abortion by community health workers using a simple checklist toolkit. Diagnostic accuracy study. Ethiopia, India and South Africa. Two hundred seventeen women in Ethiopia, 258 in India and 236 in South Africa were enrolled into the study. A checklist toolkit to determine eligibility for early medical abortion was validated by comparing results of clinician and community health worker assessment of eligibility using the checklist toolkit with the reference standard exam. Accuracy was over 90% and the negative likelihood ratio India and 6.3 in South Africa. When used by community health workers the overall accuracy of the toolkit was 92% in Ethiopia, 80% in India and 77% in South Africa negative likelihood ratios were 0.08 in Ethiopia, 0.25 in India and 0.22 in South Africa and positive likelihood ratios were 5.9 in Ethiopia and 2.0 in India and South Africa. The checklist toolkit, as used by clinicians, was excellent at ruling out participants who were not eligible, and moderately effective at ruling in participants who were eligible for medical abortion. Results were promising when used by community health workers particularly in Ethiopia where they had more prior experience with use of diagnostic aids and longer professional training. The checklist toolkit assessments resulted in some participants being wrongly assessed as eligible for medical abortion which is an area of concern. Further research is needed to streamline the components of the tool, explore optimal duration and content of training for community health workers, and test feasibility and acceptability.

A national medical cyclotron facility: report to the Minister of Health by the Medical Cyclotron Committee

International Nuclear Information System (INIS)

1985-01-01

Research and training in nuclear medicine in Australia are both limited by the lack of a medical cyclotron facility. The Committee recommends the establishment of a national medical cyclotron to provide a supply of short-lived radioisotopes for research in relevant fields of medicine, and for diagnostic use in nuclear medicine

ELECTRICALLY CONDUCTIVE OF NANOCOMPOSITES FOR SYSTEMS DIAGNOSTICS OF THE ENVELOPE WALLS TECHNICAL CONDITION OF NPP

Directory of Open Access Journals (Sweden)

BOLSHAKOV V. I.

2016-05-01

Full Text Available Raising of the problem. Enveloped concrete wall type structures of localizing safety systems for restaint and localization of radioactive decay products or in the case of special natural or man-made impacts on the power unit is one of the most important components to ensure the safety of nuclear power. The promising direction for the development of the NPP technical system monitoring is to use conductive nanocomposites as primary elements of information. The purpose of the article is to review the theoretical background and experience in the conductive nanocomposites creating for diagnostics of localizing nuclear safety systems. Conclusions. A promising area for the development of diagnostic systems of localizing nuclear safety systems is the use of electrically conductive nanocomposites (conductive concrete - bethels, plasters, paint coatings. A mechanism for conductive nanocomposites creating is the use of the filler metal and carbon nanoparticles. As binders is promising to use nanocomposites of the mineral binders (cement and water glass.

[Methodologic inconsistency in anamnesis education at medical schools].

Science.gov (United States)

Zago, M A

1989-01-01

Some relevant points of the process of obtaining the medical anamnesis and physical examination, and the formulation of diagnostic hypotheses are analyzed. The main methodological features include: preponderance of qualitative data, absence of preselected hypotheses, direct involvement of the observer (physician) with the data source (patient), and selection of hypotheses and changes of the patient during the process. Thus, diagnostic investigation does not follow the paradigm of quantitative scientific method, rooted on the logic positivism, which dominates medical research and education.

Medical negligence

African Journals Online (AJOL)

Enrique

19. SA JOURNAL OF RADIOLOGY • August 2004. Abstract. The progress made in diagnostic and therapeutic medicine has resulted in an increase in the number of malprac- tice suits brought against medical practitioners. To constitute negligence it must be shown that the conduct of the accused did not measure up to the.

Dose evaluation in medical staff during diagnostics procedures in interventional radiology; Avaliacao da dose na equipe medica durante procedimentos diagnoticos de radiologia intervencionista

Energy Technology Data Exchange (ETDEWEB)

Bacchim Neto, Fernando A.; Alves, Allan F.F.; Rosa, Maria E.D.; Miranda, Jose R.A. [Universidade Estadual Paulista Julio de Mesquita Filho (UNESP), Botucatu, SP (Brazil). Instituto de Biociencias. Departamento de Fisica e Biofisica; Moura, Regina [Faculdade de Medicina de Botucatu, SP (Brazil). Departamento de Cirurgia e Ortopedia; Pina, Diana R., E-mail: bacchim@ibb.unesp.br [Universidade Estadual Paulista Julio de Mesquita Filho (UNESP), Botucatu, SP (Brazil). Faculdade de Medicina. Departamento de Doencas Tropicais e Diagnostico por Imagem

2014-08-15

Studies show that personal dosimeters may underestimate the dose values in interventional physicians, especially in extremities and crystalline. The objective of this work was to study the radiation exposure levels of medical staff in diagnostic interventional radiology procedures. For this purpose LiF:Mg,Ti (TLD-100) dosimeters were placed in different regions of the physician body. When comparing with reference dose levels, the maximum numbers of annual procedures were found. This information is essential to ensure the radiological protection of those professionals. (author)

Exposure of the bulgarian population from diagnostic radiology during 2001/2006 y

International Nuclear Information System (INIS)

Kostova-Lefterova, D.; Ingilizova, K.

2008-01-01

Each Member State of the European Union is currently committed to produce national legislation, demonstrating conformity with the European Directive on medical exposures. According to the Directive, each country shall estimate the medical exposure of its population. For this purpose it is necessary to calculate the individual effective dose from each type of diagnostic radiology examination and the frequency of the examinations. The collective effective dose (CED) is disputable indicator for the medical exposures but it is a criterion for the level of the country on the radiation protection of persons undergoing medical exposure. The individual effective doses from each type of diagnostic radiology examination will depend on the patient's age, sex, weight, the number and type of images, the screening time and also the equipment used. Some mean values can be obtained through surveys of patient dose and compared with the national or European reference doses for 'standard sized' patients. The aim of this investigation is to assess the exposure of Bulgarian population undergoing diagnostic radiology examinations. The diagnostic radiology procedures are in 30 positions, distributed in 3 age groups: 0 - 17 y., 17 - 45 y. and over 45 y. For the assessment of the CED the generally accepted formula has been applied. The individual effective doses have been established on the basis of standard tablegrams for the radiographic diagnostic examinations and the results from the national research project 'Phare' in 2002. Presented data are: average number of examinations 3848.92x10 3 , frequency in thousands 500, annual effective individual dose 0.89 mSv/y and average annual collective effective dose - 3314.59 man.Sv/y. The mean effective dose per caput of population for medical exposures can then be compared with that of other countries having similar levels of health care. Comparisons can also be made with exposure of the population from other sources of radiation. The dynamics

MOLECULAR DIAGNOSTICS OF YERSINIA RUCKERI

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Yu. Rud

2014-06-01

Full Text Available Purpose. The analysis of nucleotide sequences of the 16S rDNA gene of virulent strains of Yersinia ruckeri and to develop the method of molecular diagnostic of enteric redmouth disease. Methodology. By the method of CLUSTALW algorithm in MEGA software version 6.0 the nucleotide sequences of the 16S rDNA gene of virulent strains of Yersinia ruckeri were analysed. For development of molecular diagnostic of Y. ruckeri the method of polymerase chain reaction (PCR was used. Primer selection was carried out in software VectorNTI11 and on-line-service BLAST. The PCR products were investigated by the methods of sequencing and nucleotide analysis. Findings. Based on PCR assay the method of molecular diagnostic of enteric redmouth disease agent, bacterium Y. ruckeri was developed. It was shown that specific oligonucleotide primers generated PCR products in size of 600 base pairs. PCR products were investigated by the sequencing that showed right targeting of primers in reaction. Originality. Among high-conservative gene of 16S rDNA of Y. ruckeri the fragment of DNA was determined to which the specific primers for rapid diagnostic of virulent strains were selected. Practical Value. Rapid diagnostic of yersiniosis will allow to identify an agent of this infectious disease, bacterium Y. ruckeri, and to provide the prophylactic or medical measures in the fish farming of Ukraine.

Advanced diagnostic approaches and current medical management of insulinomas and adrenocortical disease in ferrets (Mustela putorius furo).

Science.gov (United States)

Chen, Sue

2010-09-01

Endocrine neoplasia is the most common tumor type in domestic ferrets, especially in middle-aged to older ferrets. Islet cell tumors and adrenocortical tumors constitute the major types of endocrine neoplasms. Insulinoma is a tumor that produces and releases excessive amounts of insulin. Evaluation of fasted blood glucose levels provides a quick diagnostic assessment for the detection of insulinomas. Use of glucocorticoids, diazoxide, and diet modification are some of the medical treatment options for insulinomas. Adrenocortical neoplasia in ferrets usually overproduces one or more sex hormones. Sex hormones which can result in progressive alopecia, vulvar swelling in females, and prostagomegaly in males. Abdominal ultrasonography and sex hormone assays can be used to diagnose adrenocortical neoplasms. Drugs such as leuprolide acetate, deslorelin acetate, and the hormone melatonin can be used to treat adrenocortical neoplasms in ferrets when surgery is not an option. Copyright 2010 Elsevier Inc. All rights reserved.