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Sample records for ptsd diagnostic criteria

  1. The impact of different diagnostic criteria on PTSD prevalence

    DEFF Research Database (Denmark)

    O'Connor, Maja; Lasgaard, Mathias; Spindler, Helle

    2007-01-01

    The diagnostic criteria for PTSD have undergone several changes in the last two decades. This may in part explain the great variance in PTSD prevalence found in existing research. The objective of this study is to investigate the influence of different diagnostic criteria and different combinatio...

  2. The impact of different diagnostic criteria on PTSD prevalence

    DEFF Research Database (Denmark)

    O'Connor, Maja; Lasgaard, Mathias; Spindler, Helle

    2007-01-01

    The diagnostic criteria for PTSD have undergone several changes in the last two decades. This may in part explain the great variance in PTSD prevalence found in existing research. The objective of this study is to investigate the influence of different diagnostic criteria and different combinatio...

  3. Consequences of the Diagnostic Criteria Proposed for the ICD-11 on the Prevalence of PTSD in Children and Adolescents.

    Science.gov (United States)

    Sachser, Cedric; Goldbeck, Lutz

    2016-04-01

    In 2013, a working group of the World Health Organization (WHO) proposed a reformulation of the posttraumatic stress disorder (PTSD) diagnostic criteria for the upcoming 11(th) edition of the International Classification of Diseases (ICD-11; Maercker, Brewin, Bryant, Cloitre, van Ommeren, et al., 2013). This study investigated the consequences of the proposed ICD-11 PTSD symptom reduction on the prevalence of PTSD in children and adolescents. Prevalence rates of PTSD in a clinical sample of 159 traumatized children and adolescents were compared applying criteria according to the 4(th) edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV; American Psychiatric Association, 1994), the ICD-10 (WHO, 1992), and the ICD-11. The prevalence rate was 76.1% using DSM-IV, 88.1% using ICD-10, and 61.0% using ICD-11. The use of the criteria proposed for ICD-11 resulted in 27.1% less positive cases compared with ICD-10 and 15.1% less positive cases compared with DSM-IV. Our results showed that in a clinical sample of children and adolescents the prevalence of PTSD was significantly affected by the use of different diagnostic systems. This will constitute a major challenge for research and practice because, depending on the algorithm used, different groups of patients will be included in studies and different groups of individuals will be able to access medical care and therapy.

  4. Does size really matter? A multisite study assessing the latent structure of the proposed ICD-11 and the DSM-5 diagnostic criteria for PTSD

    DEFF Research Database (Denmark)

    Hansen, Maj; Hyland, Philip; Karstoft, Karen-Inge

    2017-01-01

    ,213), chronic pain patients (N = 573), and military personnel (N = 118). Results. Diagnostic rates of PTSD were significantly lower according to the proposed ICD-11 criteria in the university sample, but no significant differences were found for chronic pain patients and military personnel. The proposed ICD-11...... diagnostic criteria only the ICD-11 model can reflect the configuration of symptoms satisfactorily. Thus, size does matter when assessing PTSD....

  5. Psychophysiological assessment of PTSD: a potential research domain criteria construct.

    Science.gov (United States)

    Bauer, Margaret R; Ruef, Anna M; Pineles, Suzanne L; Japuntich, Sandra J; Macklin, Michael L; Lasko, Natasha B; Orr, Scott P

    2013-09-01

    Most research on posttraumatic stress disorder (PTSD) relies on clinician-administered interview and self-report measures to establish the presence/absence and severity of the disorder. Accurate diagnosis of PTSD is made challenging by the presence of symptoms shared with other psychopathologies and the subjective nature of patients' descriptions of their symptoms. A physiological assessment capable of reliably "diagnosing" PTSD could provide adjunctive information that might mitigate these diagnostic limitations. In the present study, we examined the construct validity of a potential psychophysiological measure of PTSD, that is, psychophysiological reactivity to script-driven imagery (SDI-PR), as measured against the current diagnostic "gold-standard" for PTSD, the Clinician-Administered PTSD Scale (CAPS). Convergent and predictive validity and stability were examined. Thirty-six individuals completed an SDI-PR procedure, the CAPS, and self-report measures of mental and physical health at their initial visit and approximately 6 months later. SDI-PR and the CAPS demonstrated excellent stability across measurement occasions. SDI-PR showed moderately strong convergent validity with the CAPS. After adjusting for self-reported depression, predictive validity for the CAPS, with regard to health sequelae, was reduced, whereas it remained mostly unchanged for SDI-PR. Findings support SDI-PR as a valid and stable measure of PTSD that captures a pathophysiologic process in individuals with PTSD. Results are discussed with regard to the research domain criteria framework.

  6. PTSD or not PTSD? Comparing the proposed ICD-11 and the DSM-5 PTSD criteria among young survivors of the 2011 Norway attacks and their parents.

    Science.gov (United States)

    Hafstad, G S; Thoresen, S; Wentzel-Larsen, T; Maercker, A; Dyb, G

    2017-05-01

    The conceptualization of post-traumatic stress disorder (PTSD) in the upcoming International Classification of Diseases (ICD)-11 differs in many respects from the diagnostic criteria in the Diagnostic and Statistical Manual for Mental Disorders, fifth edition (DSM-5). The consequences of these differences for individuals and for estimation of prevalence rates are largely unknown. This study investigated the concordance of the two diagnostic systems in two separate samples at two separate waves. Young survivors of the 2011 Norway attacks (n = 325) and their parents (n = 451) were interviewed at 4-6 months (wave 1) and 15-18 months (wave 2) after the shooting. PTSD was assessed with the UCLA PTSD Reaction Index for DSM-IV adapted for DSM-5, and a subset was used as diagnostic criteria for ICD-11. In survivors, PTSD prevalence did not differ significantly at any time point, but in parents, the DSM-5 algorithm produced significantly higher prevalence rates than the ICD-11 criteria. The overlap was fair for survivors, but amongst parents a large proportion of individuals met the criteria for only one of the diagnostic systems. No systematic differences were found between ICD-11 and DSM-5 in predictive validity. The proposed ICD-11 criteria and the DSM-5 criteria performed equally well when identifying individuals in distress. Nevertheless, the overlap between those meeting the PTSD diagnosis for both ICD-11 and DSM-5 was disturbingly low, with the ICD-11 criteria identifying fewer people than the DSM-5. This represents a major challenge in identifying individuals suffering from PTSD worldwide, possibly resulting in overtreatment or unmet needs for trauma-specific treatment, depending on the area of the world in which patients are being diagnosed.

  7. An evaluation of ICD-11 PTSD and complex PTSD criteria in a sample of adult survivors of childhood institutional abuse

    Directory of Open Access Journals (Sweden)

    Matthias Knefel

    2013-12-01

    Full Text Available Background : The WHO recently launched the proposal for the 11th version of the International Classification of Diseases (ICD-11 that also includes two diagnoses related to traumatic stress. In contrast to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5, ICD-11 will probably, in addition to posttraumatic stress disorder (PTSD, also define a new diagnosis termed “complex posttraumatic stress disorder” (CPTSD. Objective : We aimed to apply the proposed ICD-11 criteria for PTSD and CPTSD and to compare their prevalence to the ICD-10 (International Classification of Diseases [10th revision] PTSD prevalence. In addition, we compiled a list of symptoms for CPTSD based on subthreshold PTSD so as to include a wider group of individuals. Methods : To evaluate the appropriateness of the WHO ICD-11 proposal compared to the criteria of ICD-10, we applied the newly introduced criteria for PTSD and CPTSD deriving from the Posttraumatic Stress Disorder Checklist – Civilian Version (PCL-C and the Brief Symptom Inventory (BSI scales, to a sample of adult survivors (N=229 of childhood institutional abuse. We evaluated the construct validity of CPTSD using confirmatory factor analysis (CFA. Results : More individuals fulfilled the criteria for PTSD according to ICD-10 (52.8% than the ICD-11 proposal (17% for PTSD only; 38.4% if combined with complex PTSD. The new version of PTSD neutralized the gender effects. The prevalence of CPTSD was 21.4%, and women had a significantly higher rate of CPTSD than men (40.4 and 15.8%, respectively. Those survivors who were diagnosed with CPTSD experienced institutional abuse for a longer time. CFA showed a strong model fit. Conclusion : CPTSD is a highly relevant classification for individuals with complex trauma history, but surprisingly, effects of gender were apparent. Further research should thus address gender effects.

  8. PTSD or not PTSD? Comparing the proposed ICD-11 and the DSM-5 PTSD criteria among young survivors of the 2011 Norway attacks and their parents

    OpenAIRE

    Hafstad, G S; Thoresen, S.; Wentzel-Larsen, T; Maercker, Andreas; Dyb, G

    2017-01-01

    BACKGROUND The conceptualization of post-traumatic stress disorder (PTSD) in the upcoming International Classification of Diseases (ICD)-11 differs in many respects from the diagnostic criteria in the Diagnostic and Statistical Manual for Mental Disorders, fifth edition (DSM-5). The consequences of these differences for individuals and for estimation of prevalence rates are largely unknown. This study investigated the concordance of the two diagnostic systems in two separate samples at two...

  9. [Assessment of complex PTSD - internal and external validity of a diagnostic interview].

    Science.gov (United States)

    Boroske-Leiner, Katja; Hofmann, Arne; Sack, Martin

    2008-05-01

    The diagnostic construct of complex posttraumatic stress disorder (complex PTSD) describes the consequences of early onset and long-term persisting psychological traumatizations. The interview for complex PTSD (I-kPTBS) - is the German adaptation of the structured interview for disorders of extreme stress (SIDES). The present study reports first data regarding the internal validity of the I-kPTBS as well as on the external validity of the diagnosis of complex PTSD. The I-kPTBS was applied in 72 consecutive patients of a specialized outpatient clinic. 31 patients fulfilled the criteria of the diagnosis complex PTSD. 25 suffered from a PTSD but did not fulfil the diagnostic criteria of complex PTSD. Both groups where compared regarding their symptoms, resources and reports of childhood events. Internal consistence of the I-kPTBS regarding the sample was good to excellent (alpha = 0.88). As expected, patients with the diagnosis of complex PTSD showed more severe dissociative, depressive and general anxiety symptoms than patients with PTSD alone. Patients fulfilling the criteria of complex PTSD reported a lower age at their first traumatic event, more multiple traumatizations and more often a dissociative disorder as comorbid diagnosis. Patients with complex PTSD show a higher traumaload in childhood and a lower level of compensatory resources. The interview for complex PTSD (I-kPTBS) describes a consistent diagnostic construct. The results demonstrate that the diagnosis of complex PTSD selects a specific group of patients with early childhood trauma and high symptom level. Specific criteria can differentiate this patient group well from patients that suffer from PTSD alone.

  10. DSM-5 Criteria and Its Implications for Diagnosing PTSD in Military Service Members and Veterans.

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    Guina, Jeffrey; Welton, Randon S; Broderick, Pamela J; Correll, Terry L; Peirson, Ryan P

    2016-05-01

    This review addresses how changes in the Diagnostic and Statistical Manual of Mental Disorders (DSM)-5 posttraumatic stress disorder (PTSD) criteria has the potential to affect the care and careers of those who have served in the military, where the diagnosis often determines fitness for duty and veterans' benefits. PTSD criteria changes were intended to integrate new knowledge acquired since previous DSM editions. Many believe the changes will improve diagnosis and treatment, but some worry these could have negative clinical, occupational, and legal consequences. We analyze the changes in classification, trauma definition, symptoms, symptom clusters, and subtypes and possible impacts on the military (e.g., over- and under-diagnosis, "drone" video exposure, subthreshold PTSD, and secondary PTSD). We also discuss critiques and proposals for future changes. Our objectives are to improve the screening, diagnosis, and treatment of those service members who have survived trauma and to improve policies related to the military mental healthcare and disability systems.

  11. Approximating a DSM-5 Diagnosis of PTSD Using DSM-IV Criteria

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    Rosellini, Anthony J.; Stein, Murray B.; Colpe, Lisa J.; Heeringa, Steven G.; Petukhova, Maria V.; Sampson, Nancy A.; Schoenbaum, Michael; Ursano, Robert J.; Kessler, Ronald C.

    2015-01-01

    Background Diagnostic criteria for DSM-5 posttraumatic stress disorder (PTSD) are in many ways similar to DSM-IV criteria, raising the possibility that it might be possible to closely approximate DSM-5 diagnoses using DSM-IV symptoms. If so, the resulting transformation rules could be used to pool research data based on the two criteria sets. Methods The Pre-Post Deployment Study (PPDS) of the Army Study to Assess Risk and Resilience in Servicemembers (Army STARRS) administered a blended 30-day DSM-IV and DSM-5 PTSD symptom assessment based on the civilian PTSD Checklist for DSM-IV (PCL-C) and the PTSD Checklist for DSM-5 (PCL-5). This assessment was completed by 9,193 soldiers from three US Army Brigade Combat Teams approximately three months after returning from Afghanistan. PCL-C items were used to operationalize conservative and broad approximations of DSM-5 PTSD diagnoses. The operating characteristics of these approximations were examined compared to diagnoses based on actual DSM-5 criteria. Results The estimated 30-day prevalence of DSM-5 PTSD based on conservative (4.3%) and broad (4.7%) approximations of DSM-5 criteria using DSM-IV symptom assessments were similar to estimates based on actual DSM-5 criteria (4.6%). Both approximations had excellent sensitivity (92.6-95.5%), specificity (99.6-99.9%), total classification accuracy (99.4-99.6%), and area under the receiver operating characteristic curve (0.96-0.98). Conclusions DSM-IV symptoms can be used to approximate DSM-5 diagnoses of PTSD among recently-deployed soldiers, making it possible to recode symptom-level data from earlier DSM-IV studies to draw inferences about DSM-5 PTSD. However, replication is needed in broader trauma-exposed samples to evaluate the external validity of this finding. PMID:25845710

  12. The impact of endorsing Spitzer's proposed criteria for PTSD in the forthcoming DSM-V on male and female Veterans.

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    Miller, Lyndsey N; Chard, Kathleen M; Schumm, Jeremiah A; O'Brien, Carol

    2011-06-01

    This study explored differences between Spitzer's proposed model of posttraumatic stress disorder (PTSD) and the current DSM-IV diagnostic classification scheme in 353 Veterans. The majority of Veterans (89%) diagnosed with PTSD as specified in the DSM-IV also met Spitzer's proposed criteria. Veterans who met both DSM-IV and Spitzer's proposed criteria had significantly higher Clinician Administered PTSD Scale severity scores than Veterans only meeting DSM-IV criteria. Logistic regression indicated that being African American and having no comorbid diagnosis of major depressive disorder or history of a substance use disorder were found to predict those Veterans who met current, but not proposed criteria. These findings have important implications regarding proposed changes to the diagnostic classification criteria for PTSD in the forthcoming DSM-V.

  13. Alternative models of DSM-5 PTSD: Examining diagnostic implications.

    Science.gov (United States)

    Murphy, Siobhan; Hansen, Maj; Elklit, Ask; Yong Chen, Yoke; Raudzah Ghazali, Siti; Shevlin, Mark

    2017-09-09

    The factor structure of DSM-5 posttraumatic stress disorder (PTSD) has been extensively debated with evidence supporting the recently proposed seven-factor Hybrid model. However, despite myriad studies examining PTSD symptom structure few have assessed the diagnostic implications of these proposed models. This study aimed to generate PTSD prevalence estimates derived from the 7 alternative factor models and assess whether pre-established risk factors associated with PTSD (e.g., transportation accidents and sexual victimisation) produce consistent risk estimates. Seven alternative models were estimated within a confirmatory factor analytic framework using the PTSD Checklist for DSM-5 (PCL-5). Data were analysed from a Malaysian adolescent community sample (n = 481) of which 61.7% were female, with a mean age of 17.03 years. The results indicated that all models provided satisfactory model fit with statistical superiority for the Externalising Behaviours and seven-factor Hybrid models. The PTSD prevalence estimates varied substantially ranging from 21.8% for the DSM-5 model to 10.0% for the Hybrid model. Estimates of risk associated with PTSD were inconsistent across the alternative models, with substantial variation emerging for sexual victimisation. These findings have important implications for research and practice and highlight that more research attention is needed to examine the diagnostic implications emerging from the alternative models of PTSD. Copyright © 2017. Published by Elsevier B.V.

  14. [BMW diagnostic criteria for IBS].

    Science.gov (United States)

    Matsueda, Kei

    2006-08-01

    Rome I diagnostic criteria for IBS was published in 1992 and it became a global diagnostic criteria. However, the criteria was not practical and somewhat complicated. Moreover, its symptomatic duration was too long (defined as more than 3 months) to be introduced in clinical practice. Therefore, Japanese member of BMW(Bowel Motility Workshop) tried to develop a new diagnostic criteria for IBS and it was established in 1995 by way of the Delphi method. The criteria was named as BMW diagnostic criteria and it was shown below: BMW diagnostic criteria for IBS (1995) At least one month or more of repetitive symptoms of the following 1) and 2) and no evidence of organic disease that likely to explain the symptoms. 1) Existence of abdominal pain, abdominal discomfort or abdominal distension 2) Existence of abnormal bowel movement (diarrhea, constipation) Abnormal bowel movement includes at least one of the below; (1) Abnormal stool frequency (2) Abnormal stool form (lumpy/hard or loose/wartery stool) Moreover, the following test should be performed as a rule to exclude organic diseases. (1) Urinalysis, fecal occult blood testing, CBC, chemistry (2) Barium enema or colonofiberscopic examination The other diagnostic criteria for IBS was also reviewed and their characteristics were compared with BMW diagnostic criteria.

  15. Alternative models of DSM-5 PTSD: Examining diagnostic implications

    DEFF Research Database (Denmark)

    Murphy, Siobhan; Hansen, Maj; Elklit, Ask

    2017-01-01

    The factor structure of DSM-5 posttraumatic stress disorder (PTSD) has been extensively debated with evidence supporting the recently proposed seven-factor Hybrid model. However, despite myriad studies examining PTSD symptom structure few have assessed the diagnostic implications of these proposed...... estimated within a confirmatory factor analytic framework using the PTSD Checklist for DSM-5 (PCL-5). Data were analysed from a Malaysian adolescent community sample (n=481) of which 61.7% were female, with a mean age of 17.03 years. The results indicated that all models provided satisfactory model fit...... with statistical superiority for the Externalizing Behaviours and seven-factor Hybrid models. The PTSD prevalence estimates varied substantially ranging from 21.8% for the DSM-5 model to 10.0% for the Hybrid model. Estimates of risk associated with PTSD were inconsistent across the alternative models...

  16. Diagnostic Criteria for Pediatric MS

    Directory of Open Access Journals (Sweden)

    J Gordon Millichap

    2013-06-01

    Full Text Available Investigators at Northwestern University Feinberg School of Medicine and Ann & Robert H. Lurie Children’s Hospital of Chicago review the diagnostic criteria for pediatric multiple sclerosis, the differential diagnosis, the 2010 McDonald criteria, and Callen criteria.

  17. Exploratory Factor Analysis of Diagnostic and Statistical Manual, 5th Edition, Criteria for Posttraumatic Stress Disorder.

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    McSweeney, Lauren B; Koch, Ellen I; Saules, Karen K; Jefferson, Stephen

    2016-01-01

    One change to the posttraumatic stress disorder (PTSD) nomenclature highlighted in the Diagnostic and Statistical Manual, 5th Edition (DSM-5; American Psychiatric Association, 2013) is the conceptualization of PTSD as a diagnostic category with four distinct symptom clusters. This article presents exploratory factor analysis to test the structural validity of the DSM-5 conceptualization of PTSD via an online survey that included the PTSD Checklist-5. The study utilized a sample of 113 college students from a large Midwestern university and 177 Amazon Mechanical Turk users. Participants were primarily female, Caucasian, single, and heterosexual with an average age of 32 years. Approximately 30% to 35% of participants met diagnostic criteria for PTSD based on two different scoring criteria. Results of the exploratory factor analysis revealed five distinct symptom clusters. The implications for the classification of PTSD are discussed.

  18. National estimates of exposure to traumatic events and PTSD prevalence using DSM-IV and DSM-5 criteria.

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    Kilpatrick, Dean G; Resnick, Heidi S; Milanak, Melissa E; Miller, Mark W; Keyes, Katherine M; Friedman, Matthew J

    2013-10-01

    Prevalence of posttraumatic stress disorder (PTSD) defined according to the American Psychiatric Association's Diagnostic and Statistical Manual fifth edition (DSM-5; 2013) and fourth edition (DSM-IV; 1994) was compared in a national sample of U.S. adults (N = 2,953) recruited from an online panel. Exposure to traumatic events, PTSD symptoms, and functional impairment were assessed online using a highly structured, self-administered survey. Traumatic event exposure using DSM-5 criteria was high (89.7%), and exposure to multiple traumatic event types was the norm. PTSD caseness was determined using Same Event (i.e., all symptom criteria met to the same event type) and Composite Event (i.e., symptom criteria met to a combination of event types) definitions. Lifetime, past-12-month, and past 6-month PTSD prevalence using the Same Event definition for DSM-5 was 8.3%, 4.7%, and 3.8% respectively. All 6 DSM-5 prevalence estimates were slightly lower than their DSM-IV counterparts, although only 2 of these differences were statistically significant. DSM-5 PTSD prevalence was higher among women than among men, and prevalence increased with greater traumatic event exposure. Major reasons individuals met DSM-IV criteria, but not DSM-5 criteria were the exclusion of nonaccidental, nonviolent deaths from Criterion A, and the new requirement of at least 1 active avoidance symptom.

  19. National Estimates of Exposure to Traumatic Events and PTSD Prevalence Using DSM-IV and DSM-5 Criteria

    Science.gov (United States)

    Kilpatrick, Dean G.; Resnick, Heidi S.; Milanak, Melissa E.; Miller, Mark W.; Keyes, Katherine M.; Friedman, Matthew J.

    2014-01-01

    Prevalence of posttraumatic stress disorder (PTSD) defined according to the American Psychiatric Association’s Diagnostic and Statistical Manual fifth edition (DSM-5; 2013) and fourth edition (DSM-IV; 1994) was compared in a national sample of U.S. adults (N = 2,953) recruited from an online panel. Exposure to traumatic events, PTSD symptoms, and functional impairment were assessed online using a highly structured, self-administered survey. Traumatic event exposure using DSM-5 criteria was high (89.7%), and exposure to multiple traumatic event types was the norm. PTSD caseness was determined using Same Event (i.e., all symptom criteria met to the same event type) and Composite Event (i.e., symptom criteria met to a combination of event types) definitions. Lifetime, past-12-month, and past 6-month PTSD prevalence using the Same Event definition for DSM-5 was 8.3%, 4.7%, and 3.8% respectively. All 6 DSM-5 prevalence estimates were slightly lower than their DSM-IV counterparts, although only 2 of these differences were statistically significant. DSM-5 PTSD prevalence was higher among women than among men, and prevalence increased with greater traumatic event exposure. Major reasons individuals met DSM-IV criteria, but not DSM-5 criteria were the exclusion of nonaccidental, nonviolent deaths from Criterion A, and the new requirement of at least 1 active avoidance symptom. PMID:24151000

  20. The Impact of PTSD on Functioning in Patients Seeking Treatment for Chronic Pain and Validation of the Posttraumatic Diagnostic Scale.

    Science.gov (United States)

    Åkerblom, Sophia; Perrin, Sean; Rivano Fischer, Marcelo; McCracken, Lance M

    2017-04-01

    The purpose of this study was to assess the psychometric properties of a Swedish version of the Posttraumatic Diagnostic Scale (PDS); to investigate the prevalence of traumatic experiences, trauma types, and posttraumatic stress disorder (PTSD) in a sample of patients seeking treatment for chronic pain; and to examine how indices of pain-related functioning vary with a history of traumatic exposure and PTSD diagnostic status. Participants were 463 consecutive patients with chronic pain referred for assessment at the Pain Rehabilitation Unit at Skåne University Hospital. The translated version of the PDS demonstrated high levels of internal consistency and a factor structure similar to that reported in previous validation studies using samples identified because of trauma exposure (not chronic pain), both of which provide preliminary support for the validity of this translated version. Based on their responses to the PDS, most patients (71.8%) reported one or more traumatic events with 28.9% fulfilling criteria for a current PTSD diagnosis. The patients with PTSD also reported significantly higher levels of pain interference, kinesiophobia, anxiety, and depression and significantly lower levels of life control, compared to patients exposed to trauma and not fulfilling criteria for PTSD and patients with no history of traumatic exposure. Consistent with previous research, a significant proportion of patients seeking treatment for chronic pain reported a history of traumatic exposure and nearly one third of these met current criteria for PTSD according to a standardized self-report measure. The presence of PTSD was associated with multiple indictors of poorer functioning and greater treatment need and provides further evidence that routine screening of chronic pain patients for PTSD is warranted. Self-report measures like the PDS appear to be valid for use in chronic pain samples and offer a relative low-cost method for screening for PTSD.

  1. Update to an evaluation of ICD-11 PTSD and complex PTSD criteria in a sample of adult survivors of childhood institutional abuse by Knefel & Lueger-Schuster (2013: a latent profile analysis

    Directory of Open Access Journals (Sweden)

    Matthias Knefel

    2015-01-01

    Full Text Available Background: The World Health Organization (WHO International Classification of Diseases, 11th version (ICD-11, has proposed a trauma-related diagnosis of complex posttraumatic stress disorder (CPTSD separate and distinct from posttraumatic stress disorder (PTSD. Objective: To determine whether the symptoms endorsed by individuals who had experienced childhood institutional abuse form classes that are consistent with diagnostic criteria for ICD-11 CPTSD as distinct from PTSD. Methods: A latent profile analysis (LPA was conducted on 229 adult survivors of institutional abuse using the Brief Symptom Inventory and the PTSD Checklist—Civilian Version to assess current psychopathological symptoms. Results: The LPA revealed four classes of individuals: (1 a class with elevated symptoms of CPTSD (PTSD symptoms and disturbances in self-organization; (2 a class with elevated symptoms of PTSD and low disturbances in self-organization; (3 a class with elevated disturbances in self-organization symptoms and some elevated PTSD symptoms; and (4 a class with low symptoms. Conclusions: The results support the existence of a distinct group in our sample, that could be described by the proposed diagnostic category termed CPTSD more precisely than by normal PTSD. In addition, there seems to be a group of persons that do not fulfill the criteria for a trauma-related disorder but yet suffer from psychopathological symptoms.

  2. Diagnostic criteria for autoimmune chronic pancreatitis revisited

    Institute of Scientific and Technical Information of China (English)

    Kyu-Pyo Kim; Myung-Hwan Kim; Jong Cheol Kim; Sang Soo Lee; Dong Wan Seo; Sung Koo Lee

    2006-01-01

    Autoimmune chronic pancreatitis (AIP) is increasingly being recognized worldwidely, as knowledge of this entity builds up. Above all, AIP is a very attractive disease to clinicians in terms of its dramatic response to the oral steroid therapy in contrast to ordinary chronic pancreatitis. Although many characteristic findings of AIP have been described, definite diagnostic criteria have not been fully established. In the year 2002, the Japan Pancreas Society published the diagnostic criteria of AIP and many clinicians around the world use these criteria for the diagnosis of AIP. The diagnostic criteria proposed by the Japan Pancreas Society, however, are not completely satisfactory and some groups use their own criteria in reporting AIP. This review discusses several potential limitations of current diagnostic criteria for this increasingly recognized condition. The manuscript is organized to emphasize the need for convening a consensus to develop improved diagnostic criteria.

  3. Proposed diagnostic criteria for internet addiction.

    Science.gov (United States)

    Tao, Ran; Huang, Xiuqin; Wang, Jinan; Zhang, Huimin; Zhang, Ying; Li, Mengchen

    2010-03-01

    The objective of this study was to develop diagnostic criteria for internet addiction disorder (IAD) and to evaluate the validity of our proposed diagnostic criteria for discriminating non-dependent from dependent internet use in the general population. This study was conducted in three stages: the developmental stage (110 subjects in the survey group; 408 subjects in the training group), where items of the proposed diagnostic criteria were developed and tested; the validation stage (n = 405), where the proposed criteria were evaluated for criterion-related validity; and the clinical stage (n = 150), where the criteria and the global clinical impression of IAD were evaluated by more than one psychiatrist to determine inter-rater reliability. The proposed internet addiction diagnostic criteria consisted of symptom criterion (seven clinical symptoms of IAD), clinically significant impairment criterion (functional and psychosocial impairments), course criterion (duration of addiction lasting at least 3 months, with at least 6 hours of non-essential internet usage per day) and exclusion criterion (exclusion of dependency attributed to psychotic disorders). A diagnostic score of 2 + 1, where the first two symptoms (preoccupation and withdrawal symptoms) and at least one of the five other symptoms (tolerance, lack of control, continued excessive use despite knowledge of negative effects/affects, loss of interests excluding internet, and use of the internet to escape or relieve a dysphoric mood) was established. Inter-rater reliability was 98%. Our findings suggest that the proposed diagnostic criteria may be useful for the standardization of diagnostic criteria for IAD.

  4. MDS clinical diagnostic criteria for Parkinson's disease

    NARCIS (Netherlands)

    Postuma, R.B.; Berg, D; Stern, M.; Poewe, W.; Olanow, C.W.; Oertel, W.; Obeso, J.; Marek, K.; Litvan, I.; Lang, A.E.; Halliday, G.; Goetz, C.G.; Gasser, T.; Dubois, B.; Chan, P.; Bloem, B.R.; Adler, C.H.; Deuschl, G.

    2015-01-01

    This document presents the Movement Disorder Society Clinical Diagnostic Criteria for Parkinson's disease (PD). The Movement Disorder Society PD Criteria are intended for use in clinical research but also may be used to guide clinical diagnosis. The benchmark for these criteria is expert clinical di

  5. Diagnostic criteria of autoimmune hepatitis.

    Science.gov (United States)

    Liberal, Rodrigo; Grant, Charlotte R; Longhi, Maria Serena; Mieli-Vergani, Giorgina; Vergani, Diego

    2014-01-01

    Autoimmune hepatitis (AIH) is a chronic immune-mediated liver disorder characterised by female preponderance, elevated transaminase and immunoglobulin G levels, seropositivity for autoantibodies and interface hepatitis. Presentation is highly variable, therefore AIH should be considered during the diagnostic workup of any increase in liver enzyme levels. A set of inclusion and exclusion criteria for the diagnosis of AIH have been established by the International Autoimmune Hepatitis Group (IAIHG). There are two main types of AIH: type 1, positive for anti-nuclear (ANA) and/or anti-smooth muscle antibodies (SMAs) and type 2, defined by the presence of anti-liver kidney microsomal antibody type 1 (LKM-1) and/or anti-liver cytosol type 1 (LC-1) autoantibodies. The central role of autoantibodies in the diagnosis of AIH has led the IAIHG to produce a consensus statement detailing appropriate and effective methods for their detection. Autoantibodies should be tested by indirect immunofluorescence at an initial dilution of 1/40 in adults and 1/10 in children on a freshly prepared rodent substrate that includes kidney, liver and stomach sections to allow for the simultaneous detection of all reactivities relevant to AIH. Anti-LKM-1 is often confused with anti-mitochondrial antibody (AMA) if rodent kidney is used as the sole immunofluorescence substrate. The identification of the molecular targets of anti-LKM-1 and AMA has led to the establishment of immuno-assays based on the use of the recombinant or purified autoantigens. Perinuclear anti-nuclear neutrophil antibody (p-ANNA) is an additional marker of AIH-1; anti soluble liver antigen (SLA) antibodies are specific for autoimmune liver disease, can be present in AIH-1 and AIH-2 and are associated with a more severe clinical course. Anti-SLA are detectable by ELISA or radio-immuno-assays, but not by immunofluorescence. AIH is exquisitely responsive to immunosuppressive treatment, which should be instituted promptly to

  6. Diagnostic criteria in proliferative verrucous leukoplakia: Evaluation

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    García-Chías, Begoña; Casado-De La Cruz, Laura; Esparza-Gómez, Germán C.

    2014-01-01

    Objectives: to evaluate the ability of the diagnostic criteria proposed by Cerero et al in 2010 to perform an early diagnose in patients with proliferative verrucous leukoplakia. Study Design: retrospective study with patients diagnosed with leukoplakia at Oral Medicine Service at Oral Medicine and Surgery Department at Dentistry Faculty at Universidad Complutense of Madrid. Results: the criteria were applied in 116 patients, turning positive in 40 cases. Out of these, 24 (60%) had been previously diagnosed with PVL. Most frequent criteria were major criteria A and E, concerning lesion’s site and histopathology, and minor criteria b and c, concerning sex and smoking habit. Conclusions: diagnostic criteria developed by Cerero et al can be a useful tool for an early diagnose of PVL, as in 60% of the cases, the criteria would have allowed to make an early diagnose of the disease. Key words:Proliferative verrucous leukoplakia, criteria, diagnose, early. PMID:24608210

  7. [Diagnostic criteria for neuromyelitisoptica spectrum disorders].

    Science.gov (United States)

    Belova, A N; Boiko, A N; Belova, E M

    2016-01-01

    The review is devoted to revised international diagnostic criteria for neuromyelitisoptica spectrum disorders (NMOSD).Current diagnostic criteria allow NMOSD diagnosis not only for serum aquaporin-4 immunoglobulin G antibodies (AQP4-IgG)-seropositive patients but for AQP4-IgG-seronegative patients as well. New criteria are expected to make NMOSD diagnosis earlier and more accurate as well as to facilitate the differentiation with multiple sclerosis. Furthermore, unify international criteria should help to perform comparable epidemiologic studies and clinical trials of new drugs for NMOSD.

  8. Diagnostic criteria in proliferative verrucous leukoplakia: evaluation.

    Science.gov (United States)

    García-Chías, Begoña; Casado-De La Cruz, Laura; Esparza-Gómez, Germán-Carlos; Cerero-Lapiedra, Rocío

    2014-07-01

    to evaluate the ability of the diagnostic criteria proposed by Cerero et al in 2010 to perform an early diagnose in patients with proliferative verrucous leukoplakia. retrospective study with patients diagnosed with leukoplakia at Oral Medicine Service at Oral Medicine and Surgery Department at Dentistry Faculty at Universidad Complutense of Madrid. the criteria were applied in 116 patients, turning positive in 40 cases. Out of these, 24 (60%) had been previously diagnosed with PVL. Most frequent criteria were major criteria A and E, concerning lesion's site and histopathology, and minor criteria b and c, concerning sex and smoking habit. diagnostic criteria developed by Cerero et al can be a useful tool for an early diagnose of PVL, as in 60% of the cases, the criteria would have allowed to make an early diagnose of the disease.

  9. Diagnostic criteria of familial Mediterranean fever.

    Science.gov (United States)

    Berkun, Yackov; Eisenstein, Eli M

    2014-01-01

    Familial Mediterranean fever (FMF) is the most prevalent monogenic autoinflammatory disease, mainly affecting ethnic groups living at Mediterranean basin. FMF is characterized by recurrent, self-limited episodes of fever and serositis. The diagnosis is difficult in the presence of atypical signs, which may result in significant delay in initiating treatment. As autoinflammatory diseases may have overlapping symptoms, strict diagnostic criteria are essential. Since the discovery that mutations in the gene MEFV underlie FMF, molecular genetic testing has been used as a diagnostic adjunct, especially in atypical cases. However, despite progress in the understanding of FMF disease mechanisms during the past 15 years; the diagnosis is still based on clinical criteria. Several sets of diagnostic criteria have been proposed and used. Existing diagnostic criteria should be modified to include genetic data, and need to be more widely validated. Copyright © 2014 Elsevier B.V. All rights reserved.

  10. MDS clinical diagnostic criteria for Parkinson's disease.

    Science.gov (United States)

    Postuma, Ronald B; Berg, Daniela; Stern, Matthew; Poewe, Werner; Olanow, C Warren; Oertel, Wolfgang; Obeso, José; Marek, Kenneth; Litvan, Irene; Lang, Anthony E; Halliday, Glenda; Goetz, Christopher G; Gasser, Thomas; Dubois, Bruno; Chan, Piu; Bloem, Bastiaan R; Adler, Charles H; Deuschl, Günther

    2015-10-01

    This document presents the Movement Disorder Society Clinical Diagnostic Criteria for Parkinson's disease (PD). The Movement Disorder Society PD Criteria are intended for use in clinical research but also may be used to guide clinical diagnosis. The benchmark for these criteria is expert clinical diagnosis; the criteria aim to systematize the diagnostic process, to make it reproducible across centers and applicable by clinicians with less expertise in PD diagnosis. Although motor abnormalities remain central, increasing recognition has been given to nonmotor manifestations; these are incorporated into both the current criteria and particularly into separate criteria for prodromal PD. Similar to previous criteria, the Movement Disorder Society PD Criteria retain motor parkinsonism as the core feature of the disease, defined as bradykinesia plus rest tremor or rigidity. Explicit instructions for defining these cardinal features are included. After documentation of parkinsonism, determination of PD as the cause of parkinsonism relies on three categories of diagnostic features: absolute exclusion criteria (which rule out PD), red flags (which must be counterbalanced by additional supportive criteria to allow diagnosis of PD), and supportive criteria (positive features that increase confidence of the PD diagnosis). Two levels of certainty are delineated: clinically established PD (maximizing specificity at the expense of reduced sensitivity) and probable PD (which balances sensitivity and specificity). The Movement Disorder Society criteria retain elements proven valuable in previous criteria and omit aspects that are no longer justified, thereby encapsulating diagnosis according to current knowledge. As understanding of PD expands, the Movement Disorder Society criteria will need continuous revision to accommodate these advances. © 2015 International Parkinson and Movement Disorder Society.

  11. The underlying dimensionality of PTSD in the diagnostic and statistical manual of mental disorders: where are we going?

    Directory of Open Access Journals (Sweden)

    Cherie Armour

    2015-05-01

    Full Text Available There has been a substantial body of literature devoted to answering one question: Which latent model of posttraumatic stress disorder (PTSD best represents PTSD's underlying dimensionality? This research summary will, therefore, focus on the literature pertaining to PTSD's latent structure as represented in the fourth (DSM-IV, 1994 to the fifth (DSM-5, 2013 edition of the DSM. This article will begin by providing a clear rationale as to why this is a pertinent research area, then the body of literature pertaining to the DSM-IV and DSM-IV-TR will be summarised, and this will be followed by a summary of the literature pertaining to the recently published DSM-5. To conclude, there will be a discussion with recommendations for future research directions, namely that researchers must investigate the applicability of the new DSM-5 criteria and the newly created DSM-5 symptom sets to trauma survivors. In addition, researchers must continue to endeavour to identify the “correct” constellations of symptoms within symptom sets to ensure that diagnostic algorithms are appropriate and aid in the development of targeted treatment approaches and interventions. In particular, the newly proposed DSM-5 anhedonia model, externalising behaviours model, and hybrid models must be further investigated. It is also important that researchers follow up on the idea that a more parsimonious latent structure of PTSD may exist.

  12. The underlying dimensionality of PTSD in the diagnostic and statistical manual of mental disorders: where are we going?

    Science.gov (United States)

    Armour, Cherie

    2015-01-01

    There has been a substantial body of literature devoted to answering one question: Which latent model of posttraumatic stress disorder (PTSD) best represents PTSD's underlying dimensionality? This research summary will, therefore, focus on the literature pertaining to PTSD's latent structure as represented in the fourth (DSM-IV, 1994) to the fifth (DSM-5, 2013) edition of the DSM. This article will begin by providing a clear rationale as to why this is a pertinent research area, then the body of literature pertaining to the DSM-IV and DSM-IV-TR will be summarised, and this will be followed by a summary of the literature pertaining to the recently published DSM-5. To conclude, there will be a discussion with recommendations for future research directions, namely that researchers must investigate the applicability of the new DSM-5 criteria and the newly created DSM-5 symptom sets to trauma survivors. In addition, researchers must continue to endeavour to identify the “correct” constellations of symptoms within symptom sets to ensure that diagnostic algorithms are appropriate and aid in the development of targeted treatment approaches and interventions. In particular, the newly proposed DSM-5 anhedonia model, externalising behaviours model, and hybrid models must be further investigated. It is also important that researchers follow up on the idea that a more parsimonious latent structure of PTSD may exist. PMID:25994027

  13. AAPT Diagnostic Criteria for Central Neuropathic Pain.

    Science.gov (United States)

    Widerström-Noga, Eva; Loeser, John D; Jensen, Troels Staehelin; Finnerup, Nanna Brix

    2017-06-27

    Central neuropathic pain, which is pain caused by a lesion or disease of the central somatosensory nervous system, is a serious consequence of spinal cord injury, stroke, multiple sclerosis, and other conditions affecting the central nervous system. A collaborative effort between the Analgesic, Anesthetic, and Addiction Clinical Trial Translations, Innovations, Opportunities, and Networks public-private partnership and the American Pain Society, the Analgesic, Anesthetic, and Addiction Clinical Trial Translations, Innovations, Opportunities, and Networks-American Pain Society Pain Taxonomy (AAPT) initiative, invited a working group to develop diagnostic criteria for central neuropathic pain. The criteria for central neuropathic pain that were developed expand upon existing criteria for neuropathic pain and the International Classification of Diseases 11th Revision draft criteria to ensure consistency. This article focuses on central neuropathic pain associated with spinal cord injury, stroke, and multiple sclerosis, but the AAPT framework can be extended to central pain due to other causes such as traumatic brain injury. The classification of central neuropathic pain is organized according to the AAPT multidimensional framework, specifically: 1) core diagnostic criteria, 2) common features, 3) common medical and psychiatric comorbidities, 4) neurobiological, psychosocial, and functional consequences, and 5) putative neurobiological and psychosocial mechanisms, risk factors, and protective factors. The AAPT chronic central neuropathic pain taxonomy provides a classification for central pain associated with spinal cord injury, stroke, and multiple sclerosis. The diagnostic criteria are organized according to the AAPT multidimensional framework, specifically: 1) core diagnostic criteria, 2) common features, 3) common medical and psychiatric comorbidities, 4) neurobiological, psychosocial, and functional consequences, and 5) putative neurobiological and psychosocial

  14. Autoimmune Hepatitis: Clinical Manifestations and Diagnostic Criteria

    Directory of Open Access Journals (Sweden)

    Ian G Mcfarlane

    2001-01-01

    Full Text Available In 1998, the International Autoimmune Hepatitis Group - a panel of 40 hepatologists and hepatopathologists from 17 countries who have a particular interest in autoimmune hepatitis (AIH - undertook a review, in light of subsequent experience, of the descriptive criteria and diagnostic scoring system that it had proposed in 1993 for the diagnosis of AIH. This review (published in 1999 noted that the original descriptive criteria appeared to be quite robust and required only relatively minor modifications to bring them up to date with developments and experience in diagnostic modalities for liver disease in general. Analysis of published data on the application of the original criteria in nearly 1000 patients revealed that the diagnostic scoring system had an overall diagnostic accuracy of 89.8%, with a sensitivity of 98.0%. Specificity for excluding definite AIH in patients with chronic viral hepatitis and circulating autoantibodies or patients with overlapping cholestatic syndromes was 98% to 100%, but specificity for excluding probable AIH in these disorders ranged from only 60% to 80%. Modifications, including adjustments to the weightings against biochemical and histological cholestatic features, have been made to the scoring system to improve its specificity.

  15. AAPT Diagnostic Criteria for Central Neuropathic Pain

    DEFF Research Database (Denmark)

    Widerstrom-Noga, Eva; Loeser, John D.; Jensen, Troels Staehelin

    2017-01-01

    framework can be extended to central pain due to other causes such as traumatic brain injury. The classification of central neuropathic pain is organized according to the AAPT multidimensional framework, specifically (1) core diagnostic criteria; (2) common features; (3) common medical and psychiatric......Central neuropathic pain, which is pain caused by a lesion or disease of the central somatosensory nervous system, is a serious consequence of spinal cord injury, stroke, multiple sclerosis and other conditions affecting the central nervous system. A collaborative effort between the Analgesic......, Anesthetic, and Addiction Clinical Trial Translations, Innovations, Opportunities, and Networks (ACTTION) public-private partnership and the American Pain Society (APS), the ACTTION-APS Pain Taxonomy (AAPT) initiative, invited a working group to develop diagnostic criteria for central neuropathic pain...

  16. Evolving diagnostic criteria for multiple myeloma.

    Science.gov (United States)

    Rajkumar, S Vincent

    2015-01-01

    Multiple myeloma (MM) is a plasma cell malignancy historically defined by the presence of end-organ damage, specifically, hypercalcemia, renal failure, anemia, and bone lesions (CRAB features) that can be attributed to the neoplastic process. In 2014, the International Myeloma Working Group (IMWG) updated the diagnostic criteria for MM to add specific biomarkers that can be used to make the diagnosis of the disease in patients who did not have CRAB features. In addition, the update allows modern imaging methods including computed tomography (CT) and positron emission tomography-CT to diagnose MM bone disease. These changes enable early diagnosis, and allow the initiation of effective therapy to prevent the development of end-organ damage in patients who are at the highest risk. This article reviews these and several other clarifications and revisions that were made to the diagnostic criteria for MM and related disorders. The updated disease definition for MM also automatically resulted in a revision to the diagnostic criteria for the asymptomatic phase of the disease termed smoldering MM (SMM). Thus the current diagnosis and risk-stratification of SMM is also reviewed in this article. Using specific prognostic factors, it is possible to identify a subset of patients with SMM who have a risk of progression to MM of 25% per year (high-risk SMM). An approach to the management of patients with low- and high-risk SMM is discussed.

  17. A Comparison of DSM-5 and DSM-IV Diagnostic Criteria for Posttraumatic Stress Disorder in Traumatized Refugees.

    Science.gov (United States)

    Schnyder, Ulrich; Müller, Julia; Morina, Naser; Schick, Matthis; Bryant, Richard A; Nickerson, Angela

    2015-08-01

    The aim of this study was to compare the prevalence rate and factor structure of posttraumatic stress disorder (PTSD) based on the diagnostic criteria of the fourth and fifth editions of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV; DSM-5; American Psychiatric Association, , ) in traumatized refugees. There were 134 adult treatment-seeking, severely and multiply traumatized patients from various refugee backgrounds were assessed in their mother tongue using a computerized set of questionnaires consisting of a trauma list, the Posttraumatic Diagnostic Scale, and the new PTSD items that had been suggested by the DSM-5 Task Force of the American Psychiatric Association. Using DSM-IV, 60.4% of participants met diagnostic criteria for PTSD; using DSM-5, only 49.3% fulfilled all criteria (p power, and negative predictive power. The DSM-5 symptom structure appears to be applicable to traumatized refugees. Negative alterations in cognitions and mood may be especially useful for clinicians, not only to determine the extent to which an individual refugee is likely to meet criteria for PTSD, but also in providing targets for clinical intervention. Copyright © 2015 Wiley Periodicals, Inc., A Wiley Company.

  18. Traumatic events, PTSD, and psychiatric comorbidity in forensic patients – assessed by questionnaires and diagnostic interview

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    Elbert Thomas

    2006-04-01

    Full Text Available Abstract Background Relationships between posttraumatic stress disorder (PTSD, comorbid illness and experiences of traumatic stressors have been reported for large and different groups. The present study investigated this relationship specifically for patients with psychiatric disorders admitted to a forensic ward because of criminal behavior. Methods In sixteen German and fifteen Sudanese forensic patients the prevalence of PTSD and comorbid symptoms of anxiety and depression were assessed and related to traumatic experiences, emotional distress, and stressful life events over four developmental periods. Results In the total sample, subjects had experienced an average of five traumatic events, the first one occurring early in childhood, and 39% met criteria of current, 55% of lifetime PTSD, the diagnosis being more likely in patients with a greater number of reported traumatic experiences. Neglect and emotional abuse in childhood were associated with current PTSD diagnosis. As reported for other populations, comorbid symptoms were frequent with 60% of the sample displaying comorbid anxiety symptoms and 64% comorbid depression. PTSD and comorbidity did not differ between cultures. Conclusion Results suggest that forensic patients experience multiple traumatic events, usually beginning early in development, so that the assessment of PTSD and comorbid anxiety and depression is recommended for the clinical evaluation. Further studies have to substantiate, whether traumatic stress during developmental stages interact with other factors leading to routes of forensic psychopathology.

  19. Testing the validity of the proposed ICD-11 PTSD and complex PTSD criteria using a sample from Northern Uganda

    Directory of Open Access Journals (Sweden)

    Siobhan Murphy

    2016-09-01

    Full Text Available Background: The International Classification of Diseases (ICD-11 is currently under development with proposed changes recommended for the posttraumatic stress disorder (PTSD diagnosis and the inclusion of a separate complex PTSD (CPTSD disorder. Empirical studies support the distinction between PTSD and CPTSD; however, less research has focused on non-western populations. Objective: The aim of this study was to investigate whether distinct PTSD and CPTSD symptom classes emerged and to identify potential risk factors and the severity of impairment associated with resultant classes. Methods: A latent class analysis (LCA and related analyses were conducted on 314 young adults from Northern Uganda. Fifty-one percent were female and participants were aged between 18 and 25 years. Forty percent of the participants were former child soldiers (n=124 while the remaining participants were civilians (n=190. Results: The LCA revealed three classes: a CPTSD class (40.2%, a PTSD class (43.8%, and a low symptom class (16%. Child soldier status was a significant predictor of both CPTSD and PTSD classes (OR=5.96 and 2.82, respectively. Classes differed significantly on measures of anxiety/depression, conduct problems, somatic complaints, and war experiences. Conclusions: To conclude, this study provides preliminary support for the proposed distinction between PTSD and CPTSD in a young adult sample from Northern Uganda. However, future studies are needed using larger samples to test alternative models before firm conclusions can be made.

  20. A case-study of PTSD in infancy: diagnostic, neurophysiological, developmental and therapeutic aspects.

    Science.gov (United States)

    Keren, M; Tyano, S

    2000-01-01

    Post-traumatic Stress Disorder of Infancy has become accepted as a nosological entity. Assessment guidelines and diagnostic criteria have been defined, taking into account the impact of development on the expression of post-traumatic symptoms. Therapeutic reenactment has been considered the cornerstone of the therapeutic process. The issue of deciding what is the optimal time for therapist-induced reenactment of the trauma remains ill-defined. The less verbal and the more avoidant the traumatized infant is, the more directive the therapist needs to be, meaning he will not necessarily get clues from the infant of his readiness for reenactment. The therapist will need to introduce the trauma, at the risk of provoking a massive "flight or fight" reaction, as is illustrated by the case study of a two-and-a-half-year-old post-traumatic preverbal boy and his mother. Issues relating to conditions under which reenactment stops causing reactivation of the trauma and starts being a process of therapeutic desensitization are raised. We suggest that integration of psychodynamic and neurodevelopmental concepts might be useful in deepening the understanding of the impact of therapeutic reenactment in PTSD of Infancy.

  1. Criteria and suspension levels in diagnostic radiology.

    Science.gov (United States)

    Malone, J; Baldelli, P; Balter, S; Bischof, N; Bosmans, H; Dowling, A; Edyvean, S; Gallagher, A; Faulkner, K; Horner, K; Malone, L; Mclean, I D; O'Connor, U; Schreiner, A; Vassileva, J; Vano, E; Zoetelief, J

    2013-02-01

    The EC (European Council) Directive on radiation protection of patients requires that criteria for acceptability of equipment in diagnostic radiology, nuclear medicine and radiotherapy be established throughout the member states. This study reviews the background to this requirement and to its implementation in practice. It notes and considers parallel requirements in the EC medical devices directive and International Electrotechnical Commission standards that it is also important to consider and that both sets of requirements should ideally be harmonised due to the global nature of the equipment industry. The study further reviews the types of criteria that can be well applied for the above purposes, and defines qualitative criteria and suspension levels suitable for application. Both are defined and relationships with other acceptance processes are considered (including acceptance testing at the time of purchase, commissioning and the issue of second-hand equipment). Suspension levels are divided into four types, A, B, C and D, depending on the quality of evidence and consensus they are based on. Exceptional situations involving, for example, new or rapidly evolving technology are also considered. The publication and paper focuses on the role of the holder of the equipment and related staff, particularly the medical physics expert and the practitioner. Advice on how the criteria should be created and implemented is provided for these groups and how this might be coordinated with the supplier. Additional advice on the role of the regulator is provided.

  2. Proposed Diagnostic Criteria for the DSM-5 of Nonsuicidal Self-Injury in Female Adolescents: Diagnostic and Clinical Correlates

    Directory of Open Access Journals (Sweden)

    Tina In-Albon

    2013-01-01

    Full Text Available Nonsuicidal self-injury (NSSI is included as conditions for further study in the DSM-5. Therefore, it is necessary to investigate the proposed diagnostic criteria and the diagnostic and clinical correlates for the validity of a diagnostic entity. The authors investigated the characteristics of NSSI disorder and the proposed diagnostic criteria. A sample of 73 female inpatient adolescents and 37 nonclinical adolescents (aged 13 to 19 years was recruited. Patients were classified into 4 groups (adolescents with NSSI disorder, adolescents with NSSI without impairment/distress, clinical controls without NSSI, and nonclinical controls. Adolescents were compared on self-reported psychopathology and diagnostic cooccurrences. Results indicate that adolescents with NSSI disorder have a higher level of impairment than adolescents with other mental disorders without NSSI. Most common comorbid diagnoses were major depression, social phobia, and PTSD. There was some overlap of adolescents with NSSI disorder and suicidal behaviour and borderline personality disorder, but there were also important differences. Results further suggest that the proposed DSM-5 diagnostic criteria for NSSI are useful and necessary. In conclusion, NSSI is a highly impairing disorder characterized by high comorbidity with various disorders, providing further evidence that NSSI should be a distinct diagnostic entity.

  3. Diagnostic criteria for headache attributed to temporomandibular disorders

    DEFF Research Database (Denmark)

    Schiffman, Eric; Ohrbach, Richard; List, Thomas;

    2012-01-01

    We assessed and compared the diagnostic accuracy of two sets of diagnostic criteria for headache secondary to temporomandibular disorders (TMD).......We assessed and compared the diagnostic accuracy of two sets of diagnostic criteria for headache secondary to temporomandibular disorders (TMD)....

  4. The diagnostic criteria of pityriasis rosea and Gianotti-Crosti syndrome - a protocol to establish diagnostic criteria of skin diseases.

    Science.gov (United States)

    Chuh, A; Zawar, V; Sciallis, G F; Lee, A

    2015-01-01

    We established and validated diagnostic criteria for pityriasis rosea and Gianotti-Crosti syndrome. In this paper, we compare and contrast both diagnostic criteria to formulate a protocol in establishing diagnostic criteria for other dermatological diseases. The diagnostic criteria are similar in employing clear dividing lines and conjunctions ('and/or') to assure high reliability. Both sets of criteria should be applicable for all ethnic groups. Spontaneous remission is not included, so diagnosis is not delayed while waiting for disease remission. Laboratory investigations are not enlisted, so that the criteria can be used in medical care systems in different parts of the world. The diagnostic criteria are different in that pathognomonic clinical manifestations exist for pityriasis rosea, such as the herald patch and the orientation of lesions along the lines of skin cleavages. These features, however, score low for sensitivity. These specific manifestations are not seen in Gianotti-Crosti syndrome. Such differences led to different categorisation of clinical features. Atypical variants are more common for pityriasis rosea. The diagnostic criteria for pityriasis rosea therefore do not include a list of differential diagnoses, while diagnostic criteria for Gianotti-Crosti syndrome do. Using this comparison, we constructed a protocol to establish diagnostic criteria for other skin diseases. We advocate the need to justify the establishment of diagnostic criteria, that multiple diagnostic criteria for the same disease should be avoided, that diagnostic criteria should be compatible with the disease classification if applicable, and that the scope should be well-delineated with regard to clinical variants. We outline the need for validation studies to assess the criteria-related validity, test-retest intra-clinician reliability, and inter-clinician reliability. We emphasise that the establishment of diagnostic criteria should not be a generic process. We also

  5. Comparing the dimensional structure and diagnostic algorithms between DSM-5 and ICD-11 PTSD in children and adolescents.

    Science.gov (United States)

    Sachser, Cedric; Berliner, Lucy; Holt, Tonje; Jensen, Tine; Jungbluth, Nathaniel; Risch, Elizabeth; Rosner, Rita; Goldbeck, Lutz

    2017-07-31

    In contrast to the DSM-5, which expanded the posttraumatic stress disorder (PTSD) symptom profile to 20 symptoms, a workgroup of the upcoming ICD-11 suggested a reduced symptom profile with six symptoms for PTSD. Therefore, the objective of the study was to investigate the dimensional structure of DSM-5 and ICD-11 PTSD in a clinical sample of trauma-exposed children and adolescents and to compare the diagnostic rates of PTSD between diagnostic systems. The study sample consisted of 475 self-reports and 424 caregiver-reports on the child and adolescent trauma screen (CATS), which were collected at pediatric mental health clinics in the US, Norway and Germany. The factor structure of the PTSD construct as defined in the DSM-5 and in alternative models of both DSM-5 and ICD-11 was investigated using confirmatory factor analyses (CFA). To evaluate differences in PTSD prevalence, McNemar's tests for correlated proportions were used. CFA results demonstrated excellent model fit for the proposed ICD-11 model of PTSD. For the DSM-5 models we found the best fit for the hybrid model. Diagnostic rates were significantly lower according to ICD-11 (self-report: 23.4%; caregiver-report: 16.5%) compared with the DSM-5 (self-report: 37.8%; caregiver-report: 31.8%). Agreement was low between diagnostic systems. Study findings provide support for an alternative latent dimensionality of DSM-5 PTSD in children and adolescents. The conceptualization of ICD-11 PTSD shows an excellent fit. Inconsistent PTSD constructs and significantly diverging diagnostic rates between DSM-5 and the ICD-11 will result in major challenges for researchers and clinicians in the field of psychotraumatology.

  6. Capability and Limitations of Recent Diagnostic Criteria for Autoimmune Pancreatitis

    Directory of Open Access Journals (Sweden)

    Taku Tabata

    2013-01-01

    Full Text Available Because a diagnostic serological marker is unavailable, autoimmune pancreatitis (AIP is diagnosed based on unique features. The diagnostic capabilities and potential limitations of four sets of diagnostic criteria for AIP (Japanese diagnostic criteria 2006 and 2011, Asian diagnostic criteria, and international consensus diagnostic criteria (ICDC were compared among 85 patients who were diagnosed AIP according to at least one of the four sets. AIP was diagnosed in 87%, 95%, 95%, and 95% of the patients according to the Japanese 2006, Asian, ICDC, and Japanese 2011 criteria, respectively. The ICDC can diagnose types 1 and 2 AIP independently and show high sensitivity for diagnosis of AIP. However, as the ICDC are rather complex, diagnostic criteria for AIP should perhaps be revised and tailored to each country based on the ICDC.

  7. Diagnostic criteria and laboratory tests for disseminated intravascular coagulation.

    Science.gov (United States)

    Wada, Hideo; Matsumoto, Takeshi; Hatada, Tuyoshi

    2012-12-01

    Three diagnostic criteria for disseminated intravascular coagulation (DIC) have been established by the Japanese Ministry of Health, Labor and Welfare, the International Society on Thrombosis and Hemostasis (ISTH) and the Japanese Association for Acute Medicine. The diagnostic criteria involving global coagulation tests, such as the Japanese Ministry of Health, Labor and Welfare criteria and the ISTH overt diagnostic criteria, are first-generation DIC diagnostic criteria, those involving global coagulation tests and changes in these tests such as the Japanese Association for Acute Medicine criteria, are second-generation DIC diagnostic criteria, and those including non-overt DIC diagnostic criteria involving global coagulation tests, changes in these tests and hemostatic molecular markers will be the future (third-generation) DIC diagnostic criteria. There are no significant differences in the three diagnostic criteria with respect to predicting poor outcomes. Therefore, the third generation of diagnostic criteria including hemostatic molecular markers is expected to be established. Standardization and the determination of adequate cutoff values should be required for each laboratory test.

  8. Lack of cortisol response in patients with posttraumatic stress disorder (PTSD undergoing a diagnostic interview

    Directory of Open Access Journals (Sweden)

    de Quervain Dominique JF

    2007-10-01

    groups performed poorly in the DMS task, which is consistent with memory and concentration problems demonstrated in patients with PTSD. Conclusion A comprehensive diagnostic interview including questions about traumatic events does not trigger an HPA-axis based alarm response or changes in psychological measures, even for persons with severe PTSD, such as survivors of torture. Thus, addressing traumatic experiences within a safe and empathic environment appears to impose no unacceptable additional load to the patient.

  9. International Consensus Diagnostic Criteria for Autoimmune Pancreatitis and Its Japanese Amendment Have Improved Diagnostic Ability over Existing Criteria

    Directory of Open Access Journals (Sweden)

    Masahiro Maruyama

    2013-01-01

    Full Text Available Objectives. The recent International Consensus Diagnostic Criteria (ICDC for autoimmune pancreatitis (AIP and its Japanese amendment developed by the Japanese Pancreas Society (JPS 2011 may have overcome the drawbacks of earlier criteria and achieved a higher diagnostic ability for AIP. The aim of the present study is to evaluate this possibility and identify the underlying causes of this change. Methods. We compared the diagnostic abilities of the ICDC and JPS 2011 with those of the Japanese diagnostic criteria 2006 (JPS 2006, Korean diagnostic criteria (Korean, Asian diagnostic criteria (Asian, and HISORt diagnostic criteria in 110 patients with AIP and 31 patients with malignant pancreatic cancer. Results. The ICDC achieved the highest diagnostic ability in terms of accuracy (95.0%, followed by JPS 2011 (92.9%, Korean (92.2%, HISORt (88.7%, Asian (87.2%, and JPS 2006 (85.1%. Nearly all criteria systems exhibited a high specificity of 100%, indicating that the enhanced diagnostic ability of the ICDC and JPS 2011 likely stemmed from increased sensitivity brought about by inclusion of diagnostic items requiring no endoscopic retrograde pancreatography. The diagnostic ability of JPS 2011 was nearly equivalent to that of the ICDC. Conclusions. The ICDC and JPS 2011 have improved diagnostic ability as compared with earlier criteria sets because of an increase in sensitivity.

  10. Restless Legs Syndrome with Current Diagnostic Criteria

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    Meral Bilgilisoy Filiz

    2015-08-01

    Full Text Available Restless legs syndrome (RLS, also known as Willis-Ekbom disease, is a chronic movement disorder, characterized by an urge to move legs usually accompanied by uncomfortable sensations and sleep disorders. The prevalence of the syndrome ranges from 1% to 15% in the general population, and about 2% during childhood. RLS is the most common movement disorder in pregnancy. However RLS still remains underdiagnosed probably due to lack of accurate information about the disease. Family history is positive in 50-70% of the primary RLS patients. The secondary form of the syndrome is associated with iron deficiency, renal failure, pregnancy, diabetes mellitus and many rheumatologic disorders. Secondary forms generally manifest at older ages and have a rapid progression with a poorer prognosis. The pathophysiology of RLS is focused on the dopaminergic system, reduced central nervous system iron levels and genetic linkages. Diagnosis is based on clinical features and the diagnostic criteria suggested by International RLS Study Group. Secondary causes must be carefully investigated before the treatment. In mild forms of the disease non-pharmacologic therapies might be useful, while in moderate or severe forms of the disease generally pharmacologic therapies such as dopamine agonists, anticonvulsants, opioids and benzodiazepines are required. (Turkish Journal of Osteoporosis 2015;21: 87-95

  11. Diagnostic criteria in invasive pituitary adenomas

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    Moldovan Ioana-Maria

    2016-09-01

    Full Text Available Pituitary adenomas are benign pituitary primary tumors, the most frequent type of tumor in the pituitary fossa. An important part, around 1/3 of the pituitary adenomas manifests an aggressive behavior, growing faster and invading into parasellar areas (cavernous sinus, neural tissues and bones. Objectives: the first aim of this paper is to review the last findings about invasiveness diagnostic criteria, imagistic and biomarkers, which can be used in the classification of pituitary tumors and also to predict the probability of invasiveness, tumor recurrence and suspicion of malignancy. The second aim is to highlight the morphological and clinic types of invasive pituitary adenomas. Materials and methods: we performed a systematic review and analysis of the published articles, searching PubMed between January 1985 and December 2015. There were selected articles published in English, reviews and abstracts. During the advanced search type in PubMed, combinations of the following keywords were used: “pituitary adenoma”, “invasive”, “aggressive”, “biomarkers”, “classification”, “histological subtypes”, ‘”immunohistochemical markers”. Results: 215 articles were selected, regarding diagnostic, prognostic and therapeutic aspects. There were some histological subtypes of pituitary adenomas known as having an aggressive clinical behavior. Several biomarkers were identified as being associated with the invasive feature: proliferation markers (Ki-67 index, number of mitoses, p53 & p27 expression, microvascularization density, telomerase, topoisomerase 2 Alpha, matrix metalloproteinases, protein kinase C, cyclooxygenase-2, E-cadherin, transcription Factors, genetic alterations (PTTG gene, Galectin-3 protein/ LGALS3 gene, apoptosis markers. Based on their invasion and proliferation characteristics, pituitary tumors are proposed to be classified into five grades (1a, 1b, 2a, 2b, 3, the grade 2b tumor with high risk of recurrence

  12. Posttraumatic stress disorder according to DSM-5 and DSM-IV diagnostic criteria: a comparison in a sample of Congolese ex-combatants

    Directory of Open Access Journals (Sweden)

    Susanne Schaal

    2015-02-01

    Full Text Available Background: Compared to DSM-IV, the criteria for diagnosing posttraumatic stress disorder (PTSD have been modified in DSM-5. Objective: The first aim of this study was to examine how these modifications impact rates of PTSD in a sample of Congolese ex-combatants. The second goal of this study was to investigate whether PTSD symptoms were associated with perpetrator-related acts or victim-related traumatic events. Method: Ninety-five male ex-combatants in the eastern Democratic Republic of Congo were interviewed. Both the DSM-IV and the DSM-5 PTSD symptom criteria were assessed. Results: The DSM-5 symptom criteria yielded a PTSD rate of 50% (n=47, whereas the DSM-IV symptom criteria were met by 44% (n=42. If the DSM-5 would be set as the current “gold standard,” then DSM-IV would have produced more false negatives (8% than false positives (3%. A minority of participants (19%, n=18 indicated an event during which they were involved as a perpetrator as their most stressful event. Results of a regression analysis (R 2=0.40 showed that, after accounting for the number of types of traumatic events, perpetrated violent acts were not associated with the symptom severity of PTSD. Conclusions: The findings demonstrate that more diagnostic cases were produced with the DSM-5 diagnostic rules than were dropped resulting in an increase in PTSD rates compared to the DSM-IV system. The missing association between PTSD symptoms and perpetrated violent acts might be explained by a potential fascinating and excited perception of these acts.

  13. Posttraumatic stress disorder according to DSM-5 and DSM-IV diagnostic criteria: a comparison in a sample of Congolese ex-combatants

    Science.gov (United States)

    Schaal, Susanne; Koebach, Anke; Hinkel, Harald; Elbert, Thomas

    2015-01-01

    Background Compared to DSM-IV, the criteria for diagnosing posttraumatic stress disorder (PTSD) have been modified in DSM-5. Objective The first aim of this study was to examine how these modifications impact rates of PTSD in a sample of Congolese ex-combatants. The second goal of this study was to investigate whether PTSD symptoms were associated with perpetrator-related acts or victim-related traumatic events. Method Ninety-five male ex-combatants in the eastern Democratic Republic of Congo were interviewed. Both the DSM-IV and the DSM-5 PTSD symptom criteria were assessed. Results The DSM-5 symptom criteria yielded a PTSD rate of 50% (n=47), whereas the DSM-IV symptom criteria were met by 44% (n=42). If the DSM-5 would be set as the current “gold standard,” then DSM-IV would have produced more false negatives (8%) than false positives (3%). A minority of participants (19%, n=18) indicated an event during which they were involved as a perpetrator as their most stressful event. Results of a regression analysis (R 2=0.40) showed that, after accounting for the number of types of traumatic events, perpetrated violent acts were not associated with the symptom severity of PTSD. Conclusions The findings demonstrate that more diagnostic cases were produced with the DSM-5 diagnostic rules than were dropped resulting in an increase in PTSD rates compared to the DSM-IV system. The missing association between PTSD symptoms and perpetrated violent acts might be explained by a potential fascinating and excited perception of these acts. PMID:25720994

  14. Distinguishing PTSD, Complex PTSD, and Borderline Personality Disorder: A latent class analysis

    Directory of Open Access Journals (Sweden)

    Marylène Cloitre

    2014-09-01

    Full Text Available Background: There has been debate regarding whether Complex Posttraumatic Stress Disorder (Complex PTSD is distinct from Borderline Personality Disorder (BPD when the latter is comorbid with PTSD. Objective: To determine whether the patterns of symptoms endorsed by women seeking treatment for childhood abuse form classes that are consistent with diagnostic criteria for PTSD, Complex PTSD, and BPD. Method: A latent class analysis (LCA was conducted on an archival dataset of 280 women with histories of childhood abuse assessed for enrollment in a clinical trial for PTSD. Results: The LCA revealed four distinct classes of individuals: a Low Symptom class characterized by low endorsements on all symptoms; a PTSD class characterized by elevated symptoms of PTSD but low endorsement of symptoms that define the Complex PTSD and BPD diagnoses; a Complex PTSD class characterized by elevated symptoms of PTSD and self-organization symptoms that defined the Complex PTSD diagnosis but low on the symptoms of BPD; and a BPD class characterized by symptoms of BPD. Four BPD symptoms were found to greatly increase the odds of being in the BPD compared to the Complex PTSD class: frantic efforts to avoid abandonment, unstable sense of self, unstable and intense interpersonal relationships, and impulsiveness. Conclusions: Findings supported the construct validity of Complex PTSD as distinguishable from BPD. Key symptoms that distinguished between the disorders were identified, which may aid in differential diagnosis and treatment planning.

  15. Diagnostic criteria for DCD : Past and future

    NARCIS (Netherlands)

    Smits-Engelsman, Bouwien; Schoemaker, Marina; Delabastita, Tijs; Hoskens, Jasmine; Geuze, Reint

    The aim of this review was to gather information on how well authors comply to DSM criteria in their description and selection of children with DCD. We investigated which selection criteria were used in experimental and intervention studies published in the last 5 years (2010-2014). Results on 176

  16. Diagnostic criteria for DCD : Past and future

    NARCIS (Netherlands)

    Smits-Engelsman, Bouwien; Schoemaker, Marina; Delabastita, Tijs; Hoskens, Jasmine; Geuze, Reint

    2015-01-01

    The aim of this review was to gather information on how well authors comply to DSM criteria in their description and selection of children with DCD. We investigated which selection criteria were used in experimental and intervention studies published in the last 5 years (2010-2014). Results on 176 p

  17. Diagnostic criteria for DCD: Past and future.

    Science.gov (United States)

    Smits-Engelsman, Bouwien; Schoemaker, Marina; Delabastita, Tijs; Hoskens, Jasmine; Geuze, Reint

    2015-08-01

    The aim of this review was to gather information on how well authors comply to DSM criteria in their description and selection of children with DCD. We investigated which selection criteria were used in experimental and intervention studies published in the last 5 years (2010-2014). Results on 176 papers are summarized. Compliance to the DSM criteria has improved over this time period. In general, detailed information was provided on motor performance using standardized test scores and cut-off values are reported. Method sections were far less detailed about other DSM criteria (i.e., whether motor coordination problems interfered with activities of daily living and how IQ, other medical conditions or co-occurring disorders were checked). Views on how the new DSM-5 criteria could be specified for clinical and research use are discussed.

  18. Diagnostic accuracy of consensus diagnostic criteria for frontotemporal dementia in a memory clinic population

    NARCIS (Netherlands)

    Y. Pijnenburg (Yolande); J.L. Mulder (Jacqueline); J.C. van Swieten (John); B.M. Uitdehaag (Bernard); M. Stevens (Martijn); P. Scheltens (Philip); C. Jonker (Cees)

    2008-01-01

    textabstractBackground/Aims: The goal of the present study was to evaluate the diagnostic accuracy of the core diagnostic criteria for frontotemporal dementia (FTD) [Neary D, et al: Neurology 1998;51:1546-1554] within a memory clinic population. Methods: The 5 core diagnostic criteria for FTD were o

  19. The validity of the DSM-IV PTSD criteria in children and adolescents: a review

    NARCIS (Netherlands)

    Blom, M.; Oberink, R.

    2012-01-01

    Objective: DSM-V is on its way and doubts have been raised regarding the validity of pediatric PTSD. It is the goal of the current review to critically review the empirical literature on PTSD in youth. Method: A search of PsycINFO, PubMed and reference lists was conducted. Empirical information cons

  20. Developmental trauma disorder: pros and cons of including formal criteria in the psychiatric diagnostic systems

    Directory of Open Access Journals (Sweden)

    Schmid Marc

    2013-01-01

    Full Text Available Abstract Background This article reviews the current debate on developmental trauma disorder (DTD with respect to formalizing its diagnostic criteria. Victims of abuse, neglect, and maltreatment in childhood often develop a wide range of age-dependent psychopathologies with various mental comorbidities. The supporters of a formal DTD diagnosis argue that post-traumatic stress disorder (PTSD does not cover all consequences of severe and complex traumatization in childhood. Discussion Traumatized individuals are difficult to treat, but clinical experience has shown that they tend to benefit from specific trauma therapy. A main argument against inclusion of formal DTD criteria into existing diagnostic systems is that emphasis on the etiology of the disorder might force current diagnostic systems to deviate from their purely descriptive nature. Furthermore, comorbidities and biological aspects of the disorder may be underdiagnosed using the DTD criteria. Summary Here, we discuss arguments for and against the proposal of DTD criteria and address implications and consequences for the clinical practice.

  1. Arrhythmogenic right ventricular dysplasia/cardiomyopathy diagnostic task force criteria: impact of new task force criteria

    NARCIS (Netherlands)

    M.G.P.J. Cox; J.J. van der Smagt; M. Noorman; A.C. Wiesfeld; P.G.A. Volders; I.M. van Langen; D.E. Atsma; D. Dooijes; A.C. Houweling; P. Loh; L. Jordaens; Y. Arens; M.J. Cramer; P.A. Doevendans; J.P. van Tintelen; A.A.M. Wilde; R.N.W. Hauer

    2010-01-01

    BACKGROUND: Arrhythmogenic Right Ventricular Dysplasia/Cardiomyopathy (ARVD/C) Diagnostic Task Force Criteria (TFC) proposed in 1994 are highly specific but lack sensitivity. A new international task force modified criteria to improve diagnostic yield. A comparison of diagnosis by 1994 TFC versus ne

  2. Harmonized diagnostic criteria for Alzheimer's disease

    DEFF Research Database (Denmark)

    Morris, J C; Blennow, K; Froelich, L

    2014-01-01

    BACKGROUND: Two major sets of criteria for the clinical diagnosis of Alzheimer's disease (AD) recently have been published, one from an International Working Group (IWG) and the other from working groups convened by the National Institute on Aging (NIA) and the Alzheimer's Association (AA...

  3. Critical appraisal of the 1977 diagnostic criteria for Minamata disease.

    Science.gov (United States)

    Yorifuji, Takashi; Tsuda, Toshihide; Inoue, Sachiko; Takao, Soshi; Harada, Masazumi; Kawachi, Ichiro

    2013-01-01

    Large-scale food poisoning caused by methylmercury was identified in Minamata, Japan, in the 1950s (Minamata disease). Although the diagnostic criteria for the disease remain current, few studies have been carried out to assess the diagnostic accuracy of the criteria. From a 1971 population-based investigation, data from 2 villages were selected: Minamata (high-exposure area; n = 779) and Ariake (low-exposure area; n = 755). The authors examined the prevalence of neurologic signs characteristic of methylmercury poisoning and the validity of the criteria. A substantial number of residents in the exposed area exhibited neurologic signs even after excluding officially certified patients. Using paresthesia of the extremities as the gold standard of diagnosis, the criteria had a sensitivity of 66%. The current diagnostic criteria as well as the official certification system substantially underestimate the incidence of Minamata disease.

  4. Diagnostic grammar and assessment: translating criteria into questions.

    Science.gov (United States)

    Robins, L N

    1989-02-01

    There has been concern about whether standardized psychiatric interviews make valid diagnoses. Agreements between the Diagnostic Interview Schedule (DIS), as an example of a standardized interview, with independent assessments by a clinician are reasonably high in most studies, but the clinical assessment is itself of uncertain validity. Using predictive ability is an alternative way of judging validity. Data are presented to show that the DIS is almost as good at prediction as a clinician's assessment, but here too there are problems. Because prediction is probabilistic (i.e. the same disorder can have multiple outcomes, and different disorders can share outcomes), it is not possible to say how good prediction has to be to demonstrate perfect validity. Across varied methods of validity assessment, some disorders are regularly found more validly diagnosed than others, suggesting that part of the source of invalidity lies in the diagnostic grammar of the systems whose criteria standardized interviews evaluate. Sources of invalidity inherent in the content and structure of a variety of diagnoses in DSM-III and its heir, DSM-III-R, are reviewed and illustrated, in part with results from the Epidemiological Catchment Area study. The relationship between diagnostic criteria and standardized interviews is symbiotic. While attempts to adhere closely to existing diagnostic criteria contribute to the diagnostic accuracy of standardized interviews, the exercise of translating official diagnostic criteria into standardized questions highlights problems in the system's diagnostic grammar, enabling standardized interviews to contribute to improvements in diagnostic nosology.

  5. Rett syndrome diagnostic criteria: Lessons from the Natural History Study

    Science.gov (United States)

    Analysis of 819 participants enrolled in the Rett syndrome (RTT) Natural History Study, validates recently revised diagnostic criteria. Seven hundred sixty-five females fulfilled 2002 consensus criteria for classic (653/85.4%) or variant (112/14.6%) RTT. All participants classified as classic RTT fu...

  6. Diagnostic criteria for autoimmune pancreatitis in Japan

    Institute of Scientific and Technical Information of China (English)

    Terumi Kamisawa; Kazuichi Okazaki; Shigeyuki Kawa

    2008-01-01

    Autoimmune pancreatitis (AIP) is a particular type of pancreatitis of presumed autoimmune etiology.Currently, AIP should be diagnosed based on combination of clinical, serological, morphological,and hisLopathological features. When diagnosing AlP,it is most Jmportant to differentiate it from pancreatic cancer. DJagnostic criteria for AIP, proposed by the Japan Pancreas Society in 2002 first in the world,were revised in 2006. The criteria are based on the minimum consensus of AIP and aim to avoid misdiagnosing pancreatic cancer as far as possible,but not for screening AIP. The criteria consist of the following radiological, serological, and histopathological items: (1) radiological imaging showing narrowing of the main pancreatic duct and enlargement of the pancreas, which are characteristic of the disease; (2)laboratory data showing abnormally elevated levels of serum γ-globulin, IgG or IgG4, or the presence of autoantibodies; (3) histopathological examJnation of the pancreas demonstrating marked fibrosis and prominent infiltration of lymphocytes and plasma cells, which is called lymphoplasmacytic sclerosing pancreatitis (LPSP). For a diagnosis of AIP, criterion 1 must be present, together with criterion 2 and/or criterion 3. However, it is necessary to exclude malignant diseases such as pancreatic or biliary cancer.

  7. Diagnostic criteria of acute rheumatic fever.

    Science.gov (United States)

    Burke, Rebecca J; Chang, Christopher

    2014-01-01

    Acute rheumatic fever is an inflammatory sequela of Group A Streptococcal pharyngitis that affects multiple organ systems. The incidence of acute rheumatic fever has been declining even before the use of antibiotics became widespread, however the disease remains a significant cause of morbidity and mortality in children, particularly in developing countries and has been estimated to affect 19 per 100,000 children worldwide. Acute rheumatic fever is a clinical diagnosis, and therefore subject to the judgment of the clinician. Because of the variable presentation, the Jones criteria were first developed in 1944 to aid clinicians in the diagnosis of acute rheumatic fever. The Jones criteria have been modified throughout the years, most recently in 1992 to aid clinicians in the diagnosis of initial attacks of acute rheumatic fever and to minimize overdiagnosis of the disease. Diagnosis of acute rheumatic fever is based on the presence of documented preceding Group A Streptococcal infection, in addition to the presence of two major manifestations or one major and two minor manifestations of the Jones criteria. Without documentation of antecedent Group A Streptococcal infection, the diagnosis is much less likely except in a few rare scenarios. Carditis, polyarthritis and Sydenham's chorea are the most common major manifestations of acute rheumatic fever. However, despite the predominance of these major manifestations of acute rheumatic fever, there can be significant overlap with other disorders such as Lyme disease, serum sickness, drug reactions, and post-Streptococcal reactive arthritis. This overlap between disease processes has led to continued investigation of the pathophysiology as well as development of new biomarkers and laboratory studies to aid in the diagnosis of acute rheumatic fever and distinction from other disease processes.

  8. The DSM diagnostic criteria for fetishism.

    Science.gov (United States)

    Kafka, Martin P

    2010-04-01

    The historical definitions of sexual Fetishism are reviewed. Prior to the advent of DSM-III-R (American Psychiatric Association, 1987), Fetishism was typically operationally described as persistent preferential sexual arousal in association with non-living objects, an over-inclusive focus on (typically non-sexual) body parts (e.g., feet, hands) and body secretions. In the DSM-III-R, Partialism, an "exclusive focus on part of the body," was cleaved from Fetishism and added to the Paraphilia Not Otherwise Specified category. The current literature reviewed suggests that Partialism and Fetishism are related, can be co-associated, and are non-exclusive domains of sexual behavior. The author suggests that since the advent and elaboration of the clinical significance criterion (Criterion B) for designating a psychiatric disorder in DSM-IV (American Psychiatric Association, 1994), a diagnostic distinction between Partialism and Fetishism is no longer clinically meaningful or necessary. It is recommended that the diagnostic Criterion A for Fetishism be modified to reflect the reintegration of Partialism and that a fetishistic focus on non-sexual body parts be a specifier of Fetishism.

  9. Complex PTSD, affect dysregulation, and borderline personality disorder.

    Science.gov (United States)

    Ford, Julian D; Courtois, Christine A

    2014-01-01

    Complex PTSD (cPTSD) was formulated to include, in addition to the core PTSD symptoms, dysregulation in three psychobiological areas: (1) emotion processing, (2) self-organization (including bodily integrity), and (3) relational security. The overlap of diagnostic criteria for cPTSD and borderline personality disorder (BPD) raises questions about the scientific integrity and clinical utility of the cPTSD construct/diagnosis, as well as opportunities to achieve an increasingly nuanced understanding of the role of psychological trauma in BPD. We review clinical and scientific findings regarding comorbidity, clinical phenomenology and neurobiology of BPD, PTSD, and cPTSD, and the role of traumatic victimization (in general and specific to primary caregivers), dissociation, and affect dysregulation. Findings suggest that BPD may involve heterogeneity related to psychological trauma that includes, but extends beyond, comorbidity with PTSD and potentially involves childhood victimization-related dissociation and affect dysregulation consistent with cPTSD. Although BPD and cPTSD overlap substantially, it is unwarranted to conceptualize cPTSD either as a replacement for BPD, or simply as a sub-type of BPD. We conclude with implications for clinical practice and scientific research based on a better differentiated view of cPTSD, BPD and PTSD.

  10. Expanding the taxonomy of the diagnostic criteria for temporomandibular disorders.

    Science.gov (United States)

    Peck, C C; Goulet, J-P; Lobbezoo, F; Schiffman, E L; Alstergren, P; Anderson, G C; de Leeuw, R; Jensen, R; Michelotti, A; Ohrbach, R; Petersson, A; List, T

    2014-01-01

    There is a need to expand the current temporomandibular disorders' (TMDs) classification to include less common but clinically important disorders. The immediate aim was to develop a consensus-based classification system and associated diagnostic criteria that have clinical and research utility for less common TMDs. The long-term aim was to establish a foundation, vis-à-vis this classification system, that will stimulate data collection, validity testing and further criteria refinement. A working group [members of the International RDC/TMD Consortium Network of the International Association for Dental Research (IADR), members of the Orofacial Pain Special Interest Group (SIG) of the International Association for the Study of Pain (IASP), and members from other professional societies] reviewed disorders for inclusion based on clinical significance, the availability of plausible diagnostic criteria and the ability to operationalise and study the criteria. The disorders were derived from the literature when possible and based on expert opinion as necessary. The expanded TMDs taxonomy was presented for feedback at international meetings. Of 56 disorders considered, 37 were included in the expanded taxonomy and were placed into the following four categories: temporomandibular joint disorders, masticatory muscle disorders, headache disorders and disorders affecting associated structures. Those excluded were extremely uncommon, lacking operationalised diagnostic criteria, not clearly related to TMDs, or not sufficiently distinct from disorders already included within the taxonomy. The expanded TMDs taxonomy offers an integrated approach to clinical diagnosis and provides a framework for further research to operationalise and test the proposed taxonomy and diagnostic criteria.

  11. The DSM diagnostic criteria for female sexual arousal disorder.

    Science.gov (United States)

    Graham, Cynthia A

    2010-04-01

    This article reviews and critiques the DSM-IV-TR diagnostic criteria for Female Sexual Arousal Disorder (FSAD). An overview of how the diagnostic criteria for FSAD have evolved over previous editions of the DSM is presented and research on prevalence and etiology of FSAD is briefly reviewed. Problems with the essential feature of the DSM-IV-TR diagnosis-"an inability to attain, or to maintain...an adequate lubrication-swelling response of sexual excitement"-are identified. The significant overlap between "arousal" and "desire" disorders is highlighted. Finally, specific recommendations for revision of the criteria for DSM-V are made, including use of a polythetic approach to the diagnosis and the addition of duration and severity criteria.

  12. Finding NMO: The Evolving Diagnostic Criteria of Neuromyelitis Optica

    Science.gov (United States)

    Bennett, Jeffrey L.

    2016-01-01

    Neuromyelitis optica (NMO) is an autoimmune demyelinating disorder of the central nervous system (CNS) with predilection for the optic nerves and spinal cord. Since its emergence in the medical literature in the late 1800’s, the diagnostic criteria for NMO has slowly evolved from the simultaneous presentation of neurologic and ophthalmic signs to a relapsing or monophasic CNS disorder defined by clinical, neuroimaging, and laboratory criteria. Due to the identification of a specific autoantibody response against the astrocyte water channel aquaporin-4 (AQP4) in the vast majority of affected individuals, the clinical spectrum of NMO has greatly expanded necessitating the development of new international criteria for the diagnosis of NMO spectrum disorder (NMOSD). The routine application of new diagnostic criteria for NMOSD in clinical practice will be critical for future refinement and correlation with therapeutic outcomes. PMID:27529327

  13. Diagnostic criteria for vascular cognitive disorders: a VASCOG statement

    Science.gov (United States)

    Sachdev, Perminder; Kalaria, Raj; O’Brien, John; Skoog, Ingmar; Alladi, Suvarna; Black, Sandra E; Blacker, Deborah; Blazer, Dan; Chen, Christopher; Chui, Helena; Ganguli, Mary; Jellinger, Kurt; Jeste, Dilip V.; Pasquier, Florence; Paulsen, Jane; Prins, Niels; Rockwood, Kenneth; Roman, Gustavo; Scheltens, Philip

    2014-01-01

    Background Several sets of diagnostic criteria have been published for vascular dementia (VaD) since the 1960s. The continuing ambiguity in VaD definition warrants a critical re-examination. Methods Participants at a special symposium of the International Society for Vascular Behavioral and Cognitive Disorders (VASCOG) in 2009 critiqued the current criteria. They drafted a proposal for a new set of criteria, later reviewed through multiple drafts by the group, including additional experts and the members of the Neurocognitive Disorders Work Group of the DSM-5 Task Force. Results Cognitive disorders of vascular etiology are a heterogeneous group of disorders with diverse pathologies and clinical manifestations, discussed broadly under the rubric of vascular cognitive disorders (VCD). The continuum of vascular cognitive impairment is recognized by the categories of Mild Vascular Cognitive Disorder, and Vascular Dementia or Major Vascular Cognitive Disorder. Diagnostic thresholds are defined. Clinical and neuroimaging criteria are proposed for establishing vascular etiology. Subtypes of VCD are described, and the frequent co-occurrence of Alzheimer’s disease pathology emphasized. Conclusions The proposed criteria for VCD provide a coherent approach to the diagnosis of this diverse group of disorders, with a view to stimulating clinical and pathological validation studies. These criteria can be harmonized with the DSM-5 criteria such that an international consensus on the criteria for VCD may be achieved. PMID:24632990

  14. Improving diagnostic criteria for Propionibacterium acnes osteomyelitis: a retrospective analysis.

    Science.gov (United States)

    Asseray, Nathalie; Papin, Christophe; Touchais, Sophie; Bemer, Pascale; Lambert, Chantal; Boutoille, David; Tequi, Brigitte; Gouin, François; Raffi, François; Passuti, Norbert; Potel, Gilles

    2010-07-01

    The identification of Propionibacterium acnes in cultures of bone and joint samples is always difficult to interpret because of the ubiquity of this microorganism. The aim of this study was to propose a diagnostic strategy to distinguish infections from contaminations. This was a retrospective analysis of all patient charts of those patients with >or=1 deep samples culture-positive for P. acnes. Every criterion was tested for sensitivity, specificity, and positive likelihood ratio, and then the diagnostic probability of combinations of criteria was calculated. Among 65 patients, 52 (80%) were considered truly infected with P. acnes, a diagnosis based on a multidisciplinary process. The most valuable diagnostic criteria were: >or=2 positive deep samples, peri-operative findings (necrosis, hardware loosening, etc.), and >or=2 surgical procedures. However, no single criterion was sufficient to ascertain the diagnosis. The following combinations of criteria had a diagnostic probability of >90%: >or=2 positive cultures + 1 criterion among: peri-operative findings, local signs of infection, >or=2 previous operations, orthopaedic devices; 1 positive culture + 3 criteria among: peri-operative findings, local signs of infection, >or=2 previous surgical operations, orthopaedic devices, inflammatory syndrome. The diagnosis of P. acnes osteomyelitis was greatly improved by combining different criteria, allowing differentiation between infection and contamination.

  15. Considering PTSD for DSM-5.

    Science.gov (United States)

    Friedman, Matthew J; Resick, Patricia A; Bryant, Richard A; Brewin, Chris R

    2011-09-01

    This is a review of the relevant empirical literature concerning the DSM-IV-TR diagnostic criteria for PTSD. Most of this work has focused on Criteria A1 and A2, the two components of the A (Stressor) Criterion. With regard to A1, the review considers: (a) whether A1 is etiologically or temporally related to the PTSD symptoms; (b) whether it is possible to distinguish "traumatic" from "non-traumatic" stressors; and (c) whether A1 should be eliminated from DSM-5. Empirical literature regarding the utility of the A2 criterion indicates that there is little support for keeping the A2 criterion in DSM-5. The B (reexperiencing), C (avoidance/numbing) and D (hyperarousal) criteria are also reviewed. Confirmatory factor analyses suggest that the latent structure of PTSD appears to consist of four distinct symptom clusters rather than the three-cluster structure found in DSM-IV. It has also been shown that in addition to the fear-based symptoms emphasized in DSM-IV, traumatic exposure is also followed by dysphoric, anhedonic symptoms, aggressive/externalizing symptoms, guilt/shame symptoms, dissociative symptoms, and negative appraisals about oneself and the world. A new set of diagnostic criteria is proposed for DSM-5 that: (a) attempts to sharpen the A1 criterion; (b) eliminates the A2 criterion; (c) proposes four rather than three symptom clusters; and (d) expands the scope of the B-E criteria beyond a fear-based context. The final sections of this review consider: (a) partial/subsyndromal PTSD; (b) disorders of extreme stress not otherwise specified (DESNOS)/complex PTSD; (c) cross- cultural factors; (d) developmental factors; and (e) subtypes of PTSD. © 2010 Wiley-Liss, Inc.

  16. Diagnostic criteria for atopic dermatitis in adult Thai population

    Directory of Open Access Journals (Sweden)

    Wanitphakdeedecha Rungsima

    2007-01-01

    Full Text Available Context: Atopic dermatitis is a common disease that is diagnosed by use of Hanifin, Lobitz and Rajka′s criteria based on patient history and clinical features. However these criteria are not suitable for population-based studies. Aims: The purpose of this study is to develop a minimum list of diagnostic criteria for atopic dermatitis that is sensitive, specific, reproducible, noninvasive, applicable to adult Thai population and easy to perform in population-based studies. Settings and Design: This study was conducted at Department of Dermatology, Faculty of Medicine Siriraj Hospital Mahidol University, Bangkok, Thailand. Materials and Methods: The new cases of typical mild to moderate atopic dermatitis and exactly age-matched and sex-matched controls presenting with an inflammatory skin disease other than atopic dermatitis were selected from Department of Dermatology, Faculty of Medicine Siriraj Hospital. Each subject was examined with reference to 31 clinically diagnostic features of atopic dermatitis proposed by Hanifin and Rajka. One hundred and forty patients (70 cases and 70 controls were studied. Statistical Analysis Used: Sensitivity and specificity of each criterion was calculated using the dermatologist′s diagnosis as the standard. Regression techniques were then used to derive a minimum set of diagnostic criteria. Results: Using multiple logistic regression techniques, a minimum set of diagnostic criteria for atopic dermatitis was derived: visible flexural dermatitis, history of flexural dermatitis, duration of rash> 6 months and visible dry skin. Conclusions: A minimum list of diagnostic criteria for atopic dermatitis was derived that should be of use in Thai population-based studies.

  17. A systematic literature review of PTSD's latent structure in the Diagnostic and Statistical Manual of Mental Disorders: DSM-IV to DSM-5.

    Science.gov (United States)

    Armour, Cherie; Műllerová, Jana; Elhai, Jon D

    2016-03-01

    The factor structure of posttraumatic stress disorder (PTSD) has been widely researched, but consensus regarding the exact number and nature of factors is yet to be reached. The aim of the current study was to systematically review the extant literature on PTSD's latent structure in the Diagnostic and Statistical Manual of Mental Disorders (DSM) in order to identify the best-fitting model. One hundred and twelve research papers published after 1994 using confirmatory factor analysis and DSM-based measures of PTSD were included in the review. In the DSM-IV literature, four-factor models received substantial support, but the five-factor Dysphoric arousal model demonstrated the best fit, regardless of gender, measurement instrument or trauma type. The recently proposed DSM-5 PTSD model was found to be a good representation of PTSD's latent structure, but studies analysing the six- and seven-factor models suggest that the DSM-5 PTSD factor structure may need further alterations.

  18. Expanding the taxonomy of the diagnostic criteria for temporomandibular disorders

    NARCIS (Netherlands)

    Peck, C.C.; Goulet, J-P; Lobbezoo, F.; Schiffman, E.L.; Alstergren, P.; Anderson, G.C.; De Leeuw, R.; Jensen, R.; Michelotti, A.; Ohrbach, R.; Petersson, A.; List, T.

    2014-01-01

    There is a need to expand the current temporomandibular disorders' (TMDs) classification to include less common but clinically important disorders. The immediate aim was to develop a consensus-based classification system and associated diagnostic criteria that have clinical and research utility for

  19. Different diagnostic criteria for Parkinson disease: what are the pitfalls?

    Science.gov (United States)

    Bhidayasiri, Roongroj; Reichmann, Heinz

    2013-04-01

    As there are no definite diagnostic tests or reliable biomarkers for Parkinson disease (PD), its diagnosis still relies on the presence of a combination of cardinal motor features, along with the exclusion of other causes of Parkinsonism and the presence of some of supportive features. To date, several diagnostic criteria have been developed for different purposes through expert opinions or comprehensive review of the literature. However, none of them are without limitations. In this article, we review different diagnostic criteria for PD which have been published in the English medical literature, highlighting specific limitations and pitfalls. With considerable progress in the understanding of PD, particularly in a view of diverse clinical symptomatology and its evolution, it will be difficult to establish a single criterion that is capable of capturing all cases at different disease stages. Rather, we should aim to develop a set of criteria which include a consensus on clinical gold standard or reliable biomarkers at different levels of diagnostic certainty for different purposes. Despite a more refined set of criteria that may aid in the recognition of PD, the accuracy of its diagnosis still largely depends on the observational skills and clinical sensitivity of the treating physician.

  20. Diagnostic criteria in renal and hepatic cyst infection

    NARCIS (Netherlands)

    Lantinga, M.A.; Drenth, J.P.H.; Gevers, T.J.

    2015-01-01

    Cyst infection is a severe complication of renal and hepatic cystic disease that frequently leads to hospitalization. In most cases the diagnosis of cyst infection is made empirically as a cyst aspirate is frequently unavailable. This study aims to evaluate diagnostic criteria, microbiological findi

  1. New diagnostic criteria for neurocysticercosis: Reliability and validity

    Science.gov (United States)

    Fleury, Agnès; Romo, Matthew L.; Abraham, Ronaldo; Fandiño, Jaime; Durán, Juan C.; Cárdenas, Graciela; Moncayo, Jorge; Leite Rodrigues, Cleonísio; San‐Juan, Daniel; Serrano‐Dueñas, Marcos; Takayanagui, Oswaldo; Sander, Josemir W.

    2016-01-01

    Objective The diagnosis of neurocysticercosis (NCC) remains problematic because of the heterogeneity of its clinical, immunological, and imaging characteristics. Our aim was to develop and assess a new set of diagnostic criteria for NCC, which might allow for the accurate detection of, and differentiation between, parenchymal and extraparenchymal disease. Methods A group of Latin American NCC experts developed by consensus a new set of diagnostic criteria for NCC. A multicenter, retrospective study was then conducted to validate it. The reference standard for diagnosis of active NCC was the disappearance or reduction of cysts after anthelmintic treatment. In total, three pairs of independent neurologists blinded to the diagnosis evaluated 93 cases (with NCC) and 93 controls (without NCC) using the new diagnostic criteria. Mixed‐effects logistic regression models were used to estimate sensitivity and specificity. Results Inter‐rater reliability (kappa) of diagnosis among evaluators was 0.60. For diagnosis of NCC versus no NCC, the new criteria had a sensitivity of 93.2% and specificity of 81.4%. For parenchymal NCC, the new criteria had a sensitivity of 89.8% and specificity of 80.7% and for extraparenchymal NCC, the new criteria had a sensitivity of 65.9% and specificity of 94.9%. Interpretation These criteria have acceptable reliability and validity and could be a new tool for clinicians and researchers. An advantage of the new criteria is that they consider parasite location (ie, parenchymal or extraparenchymal), which is an important factor determining the clinical, immunological, and radiological presentation of the disease, and importantly, its treatment and prognosis. Ann Neurol 2016;80:434–442 PMID:27438337

  2. New diagnostic criteria for neurocysticercosis: Reliability and validity.

    Science.gov (United States)

    Carpio, Arturo; Fleury, Agnès; Romo, Matthew L; Abraham, Ronaldo; Fandiño, Jaime; Durán, Juan C; Cárdenas, Graciela; Moncayo, Jorge; Leite Rodrigues, Cleonísio; San-Juan, Daniel; Serrano-Dueñas, Marcos; Takayanagui, Oswaldo; Sander, Josemir W

    2016-09-01

    The diagnosis of neurocysticercosis (NCC) remains problematic because of the heterogeneity of its clinical, immunological, and imaging characteristics. Our aim was to develop and assess a new set of diagnostic criteria for NCC, which might allow for the accurate detection of, and differentiation between, parenchymal and extraparenchymal disease. A group of Latin American NCC experts developed by consensus a new set of diagnostic criteria for NCC. A multicenter, retrospective study was then conducted to validate it. The reference standard for diagnosis of active NCC was the disappearance or reduction of cysts after anthelmintic treatment. In total, three pairs of independent neurologists blinded to the diagnosis evaluated 93 cases (with NCC) and 93 controls (without NCC) using the new diagnostic criteria. Mixed-effects logistic regression models were used to estimate sensitivity and specificity. Inter-rater reliability (kappa) of diagnosis among evaluators was 0.60. For diagnosis of NCC versus no NCC, the new criteria had a sensitivity of 93.2% and specificity of 81.4%. For parenchymal NCC, the new criteria had a sensitivity of 89.8% and specificity of 80.7% and for extraparenchymal NCC, the new criteria had a sensitivity of 65.9% and specificity of 94.9%. These criteria have acceptable reliability and validity and could be a new tool for clinicians and researchers. An advantage of the new criteria is that they consider parasite location (ie, parenchymal or extraparenchymal), which is an important factor determining the clinical, immunological, and radiological presentation of the disease, and importantly, its treatment and prognosis. Ann Neurol 2016;80:434-442. © 2016 The Authors. Annals of Neurology published by Wiley Periodicals, Inc. on behalf of American Neurological Association.

  3. Metabolic syndrome: Performance of five different diagnostic criterias

    Directory of Open Access Journals (Sweden)

    S Ogedengbe Onesi

    2014-01-01

    Full Text Available Background: The aim of this study is to describe the metabolic syndrome (MS and to evaluate five diagnostic criteria of the MS with respect to their sensitivity and specificity in patients with type 2 diabetes mellitus (T2DM. Materials and Methods: It is a cross-sectional case control study of T2DM patients and their first degree relatives (FDRs recruited using convenience sampling and data collected through questionnaire administered technique. Variables of interest included anthropometric indices, blood pressure, serum lipid profile, fasting blood sugar (FBS, proteinuria, and microalbuminuria. The Chi-square test was used for comparison of proportions. A P value of less than 0.05 was taken as statistically significant. Kappa statistic was used to test the degree of agreement between the diagnostic criteria. Results: The World Health Organization (WHO, International Diabetes Federation (IDF, revised National Cholesterol Education Program (NCEP-R, NCEP Adult Treatment Panel (ATP-III, and American Association of Clinical Endocrinologists (AACE criteria reported a prevalence of 87.1, 64.5, 61.3, 55.6, and 22.6%, respectively in persons with T2DM. Using the WHO criteria as a reference or gold standard, the sensitivity of the IDF, NCEP-R, NCEP ATP-III, and AACE criteria among persons with T2DM were 71.3, 67.6, 61.1, and 25.9% respectively. Using the WHO criteria as a reference or gold standard, the specificity of the IDF, NCEP-R, NCEP ATP-III, and AACE criteria among persons with T2DM were 81.3, 81.3, 81.3, and 100%, respectively. Using the WHO criteria as a reference or gold standard, the level of agreement of the IDF, NCEP-R, NCEP ATP-III, and AACE criteria with the WHO criteria among persons with T2DM (as estimated by the kappa statistics were 0.30, 0.26, 0.21, and 0.08 respectively. Conclusion: The level of agreement appears to be generally poor, though the IDF criteria showed a fair level of agreement with the WHO criteria: Therefore the IDF

  4. MIGRAINE IN IRANIAN CHILDREN; WHICH CRITERIA ARE THE BEST DIAGNOSTIC CRITERIA?

    Directory of Open Access Journals (Sweden)

    A. Chitsaz

    2007-11-01

    Full Text Available ObjectiveThe aim of this study was to identify the best criteria for diagnosis of migraine in our pediatric population. Materials and MethodsA total of 85 children aged below 15 years who had been referred to the Neurology Clinic of Al-Zahra Hospital with headache as their chief complaint, were enrolled. Validated questionnaires were completed by them. The patients were evaluated using five sets of diagnostic criteria including the Vahlquist, the Prensky, the International Headache Society (IHS, the IHS-Revised (IHS-R, and the Maytal criteria; the sensitivity of each set of criteria was assessed. ResultsOf the 85 children, clinically diagnosed as having migraine, 61 (72%, 73 (86%, 75 (88%, 76 (89.5%, and 76 (89.5% met the criteria of IHS, Vahlquist, Prensky, IHS-R, and Maytal, respectively. Both the IHS-R and Maytal criteria had the highest, while the IHS criteria had the lowest sensitivity. Fifty-four children (63.5% were positive for all five sets of criteria. The application of IHS criteria for diagnosing pediatric migraine led to a smaller percentage of children with migraine being identified.ConclusionAssessment of the sensitivity of the five sets of criteria for the diagnosis of migraine revealed the inadequacies and limitations of the IHS criteria in the diagnosis of pediatric migraine.

  5. MIGRAINE IN IRANIAN CHILDREN; WHICH CRITERIA ARE THE BEST DIAGNOSTIC CRITERIA?

    Directory of Open Access Journals (Sweden)

    A. Chitsaz

    2008-11-01

    Full Text Available ObjectiveThe aim of this study was to identify the best criteria for diagnosis of migraine in our pediatric population.Materials and MethodsA total of 85 children aged below 15 years who had been referred to the Neurology Clinic of Al-Zahra Hospital with headache as their chief complaint, were enrolled. Validated questionnaires were completed by them. The patients were evaluated using five sets of diagnostic criteria including the Vahlquist, the Prensky, the International Headache Society (IHS, the IHS-Revised (IHS-R, and the Maytal criteria; the sensitivity of each set of criteria was assessed.ResultsOf the 85 children, clinically diagnosed as having migraine, 61 (72%, 73 (86%, 75 (88%, 76 (89.5%, and 76 (89.5% met the criteria of IHS, Vahlquist, Prensky, IHS-R, and Maytal, respectively. Both the IHS-R and Maytal criteria had the highest, while the IHS criteria had the lowest sensitivity. Fifty-four children (63.5% were positive for all five sets of criteria. The application of IHS criteria for diagnosing pediatric migraine led to a smaller percentage of children with migraine being identified.ConclusionAssessment of the sensitivity of the five sets of criteria for the diagnosis of migraine revealed the inadequacies and limitations of the IHS criteria in the diagnosis of pediatric migraine.Key words:Migraine, Child, Diagnosis, Headache

  6. Canine atopic dermatitis diagnostic criteria: evaluation of four sets of published criteria among veterinary students.

    Science.gov (United States)

    Le Roy, Lucile; Le Poder, Sophie; Desquilbet, Loïc; Perrot, Sebastien; Cavana, Paola; Marignac, Geneviève

    2015-01-01

    Canine atopic dermatitis (cAD) is a major teaching point as its diagnosis and treatment are difficult. During 11 weeks, 140 dogs and students (third, fourth, and fifth years) were recruited and paired. One of the four lists of diagnostic criteria was randomly attributed to each student. Concordance results, calculated with Cohen's kappa, ranged from slight (κ=0.07) to moderate (κ=0.53). Favrot's diagnostic criteria received the best results. It has been observed that results are improved with clinical experience. We observed that students often forgot that Favrot's criteria apply only to pruritic dogs and that the fulfillment of the criteria allows only a suspicion, not a diagnosis, of cAD. Primary pruritus and corticosteroid-responsive pruritus were often misunderstood.

  7. Examining the diagnostic criteria for Internet addiction: Expert validation.

    Science.gov (United States)

    Hsu, Wen-Yu; Lin, Sunny S J; Chang, Shan-Mei; Tseng, Yin-Hsing; Chiu, Nan-Ying

    2015-06-01

    Internet addiction is the coming problem around the world. The diagnostic criteria for Internet addiction among adolescents (DC-IA-A) has become a widely used measure for assessing the presence of Internet addiction in Taiwan. This study examined the diagnosis criteria for Internet addiction in adolescents by expert evaluation. Twenty psychiatrists rated the adequacy of each criterion in DC-IA-A. The content validity and homogeneity reliability proposed by Aiken were calculated. The coefficients content validity and homogeneity reliability showed twenty psychiatrists agreed on each of DC-IA-A as relevant to the diagnosis of Internet addiction, though several criteria need improvements. Two criteria "excessive time spent on Internet activities and leaving the Internet" and "excessive effort spent on activities necessary to obtain access to the Internet" should be omitted, and the criteria of "tolerance" should be modified. The diagnostic criteria for Internet addiction among adolescents should be revised to meet the real condition of this population. Copyright © 2014. Published by Elsevier B.V.

  8. Comparing new diagnostic criteria of 2010 ACR/EULAR with 1987 ACR criteria in rheumatoid arthritis

    Directory of Open Access Journals (Sweden)

    Fatemeh Shirani

    2017-01-01

    Full Text Available Background: Rheumatoid Arthritis (RA is a chronic inflammatory disease presenting with inflammation, tenderness and destruction of the synovial joints, resulting in severe disability and early death due to complication of disease. Previous diagnostic criteria are not useful for identifying patients who need early treatment. Thus, new diagnostic criteria for faster diagnosis of disease are introduced in 2010. The aim of this study was to compared 1987 ACR (American College of Rheumatology criteria and 2010 ACR/EULAR (European League Against Rheumatism classification criteria for diagnosis of rheumatoid arthritis. Methods: In this Cohort prospective study, patients with early arthritis were evaluated   according to the old and new diagnostic criteria and followed-up every two monthly for one year (2012-2013 in Hazrat-e Rasool University Hospital, Tehran. Inclusion criteria of this study were age more than 18 year and indefinite diagnosis of arthritis. For all of patients physical examination by expert rheumatologist was done and lab data include erythrocyte sedimentation rate (ESR, C-reactive protein (CRP, anti-cyclic citrullinated peptide (Anti-CCP and rheumatoid factor was requested. The sensitivity, specificity, positive and negative predictive values were then determined for each diagnostic criteria. Results: In this study 104 patients including 28 males (26.9% and 76 females (73.1% with the mean age of 44.2±13.7 years were included. At the end of one year follow-up, 82 were diagnosed to have RA while other 22 patients were not categorized as RA. Sensitivity for ESR, CRP, Anti-CCP and rheumatoid factor in 2010 ACR/EULAR criteria was 52%, 19%, 48%, 28% and specificity for them was 45%, 71%, 27%, 79% respectively. Number of small and large joint arthritis were more in patients with Rheumatoid Arthritis (RA rather than other arthritis (P=0.0001. Sensitivity and specificity for small joints involvement was 87% and 54% and for large joints

  9. PTSD: National Center for PTSD

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    Full Text Available ... Menu PTSD PTSD Home For the Public Public Section Home PTSD Overview PTSD Basics Return from War ... Web Links PTSD Site Search For Professionals Professional Section Home PTSD Overview Types of Trauma Trauma Basics ...

  10. Examining PTSD Treatment Choice Among Individuals with Subthreshold PTSD

    OpenAIRE

    Bergman, Hannah E.; Kline, Alexander C.; Feeny, Norah C.; Zoellner, Lori A.

    2015-01-01

    Subthreshold posttraumatic stress disorder (PTSD) is associated with impairment and has a prevalence rate comparable to full PTSD. Yet, little is known regarding treatment preferences among individuals with subthreshold PTSD, even though they seek trauma-related treatment at a similar rate to those with full PTSD. This study explored subthreshold diagnostic PTSD diagnostic category and treatment preference in undergraduate (N = 439) and trauma-exposed community (N = 203) samples. Participants...

  11. Diagnostic criteria for sarcopenia relate differently to insulin resistance

    OpenAIRE

    Bijlsma, A. Y.; Meskers, C. G. M.; van Heemst, D.; Westendorp, R. G. J.; de Craen, A. J. M.; Maier, A. B.

    2013-01-01

    Skeletal muscle is important in insulin-stimulated glucose uptake. Sarcopenia is, therefore, a possible risk factor for insulin resistance. Currently, different diagnostic criteria for sarcopenia include low muscle mass, muscle strength, and walking speed. We assessed these muscle characteristics in relation to insulin resistance in nondiabetics. This cross-sectional study included 301 nondiabetics, mean age 65.9 years. Area under curve (AUC) calculations of insulin and glucose from a 2-h ora...

  12. Recommended Diagnostic Criteria for Occupational Chronic Lead Poisoning

    Institute of Scientific and Technical Information of China (English)

    SUNJIN-BAI; WANGJIN-PING

    1995-01-01

    The present study aims to recommend the normal upper limit,the acceptable upper limit,the subclinical lead absorption and intoxication diagnostic criteria in an effort to re-evaluate the current national diagnostic criteria for the occupational chronic lead poisoning.The study was conducted on 330 lead exposed workers and 100 non-exposed controls based on the determination of blood and urinary lead,porphyrin metabolism indices,as well as other indices under a nationwide quality control program.The data were subsequently treated by the curve fitting,multi-step transformation to Gauss distribution,and discriminant analysis with the aid of a SAS software package.The relationships between the air lead and blood lead level with certain biological parameters indicative of excessive lead exposure and poisoning were well established.The sensitivity,specificity,accuracy,false positive and false negative results of these critical values were also fully evaluated.This study would be useful for the amendment of the new edition of the national diagnostic criteria for the occupational chronic lead poisoning in China and would provide new approaches for similar investigations.

  13. [SCAN system--semi-structured interview based on diagnostic criteria].

    Science.gov (United States)

    Adamowski, Tomasz; Kiejna, Andrzej; Hadryś, Tomasz

    2006-01-01

    This paper presents the main features of contemporary diagnostic systems which are implemented into the SCAN--modern and semi-structured diagnostic interview. The concepts of further development of the classifications, rationale for operationalized diagnostic criteria and for the divisional approach to mental diagnoses will be in focus. The structure and components of SCAN ver. 2.1 (WHO), i.e. Present State Examination--10th edition, Item Group Checklist, Clinical History Schedule, Glossary of Definitions and computer software with the diagnostic algorithm: I-Shell, as well as rules for a reliable use of diagnostic rating scales, will be discussed within the scope of this paper. The materials and training sets necessary for the learning of proper use of the SCAN, especially training sets for SCAN Training Centers and the Reference Manual--a form of guidebook for SCAN shall be introduced. Finally the paper will present evidence that SCAN is an instrument feasible in different cultural settings. Reliability and validity data of SCAN will also be dealt with indicating that SCAN could be widely used in research studies as well as in everyday clinical practice facilitating more detailed diagnostic approach to a patient.

  14. New diagnostic criteria for fibromyalgia: Here to stay?

    Science.gov (United States)

    Moyano, Sebastián; Kilstein, Jorge Guillermo; Alegre de Miguel, Cayetano

    2015-01-01

    To assess the percentage of patients that fulfill the American College of Rheumatology (ACR) 1990 as well as the ACR 2010 classification criteria, to evaluate whether there is a correlation between tender points and the Widespread Pain Index (WPI) as well as signs and symptoms that predict a fibromyalgia (FM) subtype and to identify those which have greater impact on functioning. We performed a cross-sectional comparative study of 206 patients with previous clinical diagnosis of FM. The studied variables were age, sex, years of disease, tender points, control points, WPI, Symptom Severity Score, subtype of FM, presence of other rheumatic disorders and the Fibromyalgia Impact Questionnaire (FIQ) score. The new diagnostic criteria of FM correctly classified 87,03% of patients who satisfied the ACR 1990 criteria. Both criteria were equally effective in assessing the impact of the disease. FM had a severe impact on the quality of life in 74,87% of patients. Somatoform disorder was the predominant subtype. Hyperalgesic FM had a significantly lower FIQ score than the somatoform disorder and depressive subtypes. The ACR 2010 criteria are a simple evaluation tool to use in the primary care setting, that incorporate both peripheral pain and somatic symptoms. New and old criteria should coexist; they enable a major comprehension and ease the management of this prevalent disease. Copyright © 2014 Elsevier España, S.L.U. All rights reserved.

  15. Contribution of criterion A2 to PTSD screening in the presence of traumatic events.

    Science.gov (United States)

    Pereda, Noemí; Forero, Carlos G

    2012-10-01

    Criterion A2 according to the Diagnostic and Statistical Manual of Mental Disorders (4(th) ed.; DSM-IV; American Psychiatric Association [APA], 1994) for posttraumatic stress disorder (PTSD) aims to assess the individual's subjective appraisal of an event, but it has been claimed that it might not be sufficiently specific for diagnostic purposes. We analyse the contribution of Criterion A2 and DSM-IV criteria to detect PTSD for the most distressing life events experienced by our subjects. Young adults (N = 1,033) reported their most distressing life events, together with PTSD criteria (Criteria A2, B, C, D, E, and F). PTSD prevalence and criterion specificity and agreement with probable diagnoses were estimated. Our results indicate 80.30% of the individuals experienced traumatic events and met one or more PTSD criteria; 13.22% cases received a positive diagnosis of PTSD. Criterion A2 showed poor agreement with the final probable PTSD diagnosis (correlation with PTSD .13, specificity = .10); excluding it from PTSD diagnosis did not the change the estimated disorder prevalence significantly. Based on these findings it appears that Criterion A2 is scarcely specific and provides little information to confirm a probable PTSD case.

  16. Advancing research diagnostic criteria for Alzheimer's disease: the IWG-2 criteria.

    Science.gov (United States)

    Dubois, Bruno; Feldman, Howard H; Jacova, Claudia; Hampel, Harald; Molinuevo, José Luis; Blennow, Kaj; DeKosky, Steven T; Gauthier, Serge; Selkoe, Dennis; Bateman, Randall; Cappa, Stefano; Crutch, Sebastian; Engelborghs, Sebastiaan; Frisoni, Giovanni B; Fox, Nick C; Galasko, Douglas; Habert, Marie-Odile; Jicha, Gregory A; Nordberg, Agneta; Pasquier, Florence; Rabinovici, Gil; Robert, Philippe; Rowe, Christopher; Salloway, Stephen; Sarazin, Marie; Epelbaum, Stéphane; de Souza, Leonardo C; Vellas, Bruno; Visser, Pieter J; Schneider, Lon; Stern, Yaakov; Scheltens, Philip; Cummings, Jeffrey L

    2014-06-01

    In the past 8 years, both the International Working Group (IWG) and the US National Institute on Aging-Alzheimer's Association have contributed criteria for the diagnosis of Alzheimer's disease (AD) that better define clinical phenotypes and integrate biomarkers into the diagnostic process, covering the full staging of the disease. This Position Paper considers the strengths and limitations of the IWG research diagnostic criteria and proposes advances to improve the diagnostic framework. On the basis of these refinements, the diagnosis of AD can be simplified, requiring the presence of an appropriate clinical AD phenotype (typical or atypical) and a pathophysiological biomarker consistent with the presence of Alzheimer's pathology. We propose that downstream topographical biomarkers of the disease, such as volumetric MRI and fluorodeoxyglucose PET, might better serve in the measurement and monitoring of the course of disease. This paper also elaborates on the specific diagnostic criteria for atypical forms of AD, for mixed AD, and for the preclinical states of AD. Copyright © 2014 Elsevier Ltd. All rights reserved.

  17. DSM-5 criteria for PTSD in parents of pediatric patients with epilepsy: What are the changes with respect to DSM-IV-TR?

    Science.gov (United States)

    Carmassi, Claudia; Corsi, Martina; Gesi, Camilla; Bertelloni, Carlo Antonio; Faggioni, Francesco; Calderani, Enrico; Massimetti, Gabriele; Saggese, Giuseppe; Bonuccelli, Alice; Orsini, Alessandro; Dell'Osso, Liliana

    2017-04-13

    Increasing literature suggests the need to explore for post-traumatic stress disorder (PTSD) and post-traumatic stress symptoms in parents and caregivers of children with acute and chronic illnesses but scant data are available on epilepsy. The aim of the present study was to estimate full and partial PTSD rates among parents of children with epilepsy comparing DSM-5 and DSM-IV-TR criteria. Further, the aim of the present study was to examine possible gender differences between mothers and fathers. Results showed 9.1% and 12.1% PTSD rates in the total sample, according to DSM-5 or DSM-IV-TR criteria, respectively, with an overall consistency of 92.9% (Kohen's K=0.628, p=.453). Significant gender differences emerged for Avoidance/Numbing and Hyperarousal symptoms diagnosed by means of DSM-IV-TR criteria, as well as for Negative alterations in cognitions/mood and Hyperarousal symptoms, when adopting DSM-5 criteria. This study underscores the relevance of detecting PTSD in parents of children with a chronic illness such as epilepsy.

  18. Psychometric properties of the IES-R in traumatized substance dependent individuals with and without PTSD.

    Science.gov (United States)

    Rash, Carla J; Coffey, Scott F; Baschnagel, Joseph S; Drobes, David J; Saladin, Michael E

    2008-08-01

    Posttraumatic stress disorder (PTSD) is common among treatment-seeking substance abusers. Despite the high prevalence of these co-occurring conditions, few PTSD screening tools have been evaluated for their utility in identifying PTSD in substance use disorder (SUD) populations. The present study evaluated the psychometric properties of the Impact of Event Scale-Revised (IES-R) in a sample of 124 substance dependent individuals. All participants had a history of a DSM-IV Criterion A traumatic event, and 71 individuals met diagnostic criteria for PTSD. Participants with comorbid PTSD reported significantly more symptoms of anxiety, depression, and PTSD compared to substance dependent individuals without PTSD. Acceptable internal consistency and convergent validity of the IES-R were established among a substance dependent sample. Examination of diagnostic effectiveness suggested a cutoff value of 22 as optimal for a substance using population, resulting in adequate classification accuracy, sensitivity, and specificity.

  19. Characteristics of binge eating disorder in relation to diagnostic criteria

    Directory of Open Access Journals (Sweden)

    Wilfley DE

    2016-08-01

    Full Text Available Denise E Wilfley,1 Leslie Citrome,2 Barry K Herman3 1Department of Psychiatry, Washington University School of Medicine, St Louis, MO, 2Department of Psychiatry & Behavioral Sciences, New York Medical College, Valhalla, NY, 3Global Medical Affairs, Shire, Lexington, MA, USA Abstract: The objective of this review was to examine the evidentiary basis for binge eating disorder (BED with reference to the Diagnostic and Statistical Manual of Mental Disorders – Fifth Edition (DSM-5 diagnostic criteria for BED. A PubMed search restricted to titles and abstracts of English-language reviews, meta-analyses, clinical trials, randomized controlled trials, journal articles, and letters using human participants was conducted on August 7, 2015, using keywords that included “binge eating disorder,” DSM-5, DSM-IV, guilt, shame, embarrassment, quantity, psychological, behavior, and “shape and weight concerns.” Of the 257 retrieved publications, 60 publications were considered relevant to discussions related to DSM-5 diagnostic criteria and were included in the current review, and 20 additional references were also included on the basis of the authors’ knowledge and/or on a review of the reference lists from relevant articles obtained through the literature search. Evidence supports the duration/frequency criterion for BED and the primary importance of loss of control and marked distress in identifying individuals with BED. Although overvaluation of shape/weight is not a diagnostic criterion, its relationship to the severity of BED psychopathology may identify a unique subset of individuals with BED. Additionally, individuals with BED often exhibit a clinical profile consisting of psychiatric (eg, mood, obsessive–compulsive, and impulsive disorders and medical (eg, gastrointestinal symptoms, metabolic syndrome, and type 2 diabetes comorbidities and behavioral profiles (eg, overconsumption of calories outside of a binge eating episode and emotional

  20. Waardenburg syndrome type II: phenotypic findings and diagnostic criteria.

    Science.gov (United States)

    Liu, X Z; Newton, V E; Read, A P

    1995-01-02

    The Waardenburg syndrome (WS) consists of at least two distinct autosomal dominant hereditary disorders. WS Type I has been mapped to the distal part of chromosome 2q and the gene identified as PAX3. Other gene(s) are responsible for WS Type II. Mapping WS Type II requires accurate diagnosis within affected families. To establish diagnostic criteria for WS Type II, 81 individuals from 21 families with Type II WS were personally studied, and compared with 60 personally studied patients from 8 families with Type I and 253 cases of WS (Type I or II) from the literature. Sensorineural hearing loss (77%) and heterochromia iridum (47%) were the two most important diagnostic indicators for WS Type II. Both were more common in Type II than in Type I. Other clinical manifestations, such as white forelock and skin patches, were more frequent in Type I. We estimate the frequency of phenotypic traits and propose diagnostic criteria for WS Type II. In practice, a diagnosis of WS Type II can be made with confidence given a family history of congenital hearing loss and pigmentary disorders, where individuals have been accurately measured for ocular distances to exclude dystopia canthorum.

  1. AAPT Diagnostic Criteria for Chronic Sickle Cell Disease Pain.

    Science.gov (United States)

    Dampier, Carlton; Palermo, Tonya M; Darbari, Deepika S; Hassell, Kathryn; Smith, Wally; Zempsky, William

    2017-01-05

    Pain in sickle cell disease (SCD) is associated with increased morbidity, mortality, and high health care costs. Although episodic acute pain is the hallmark of this disorder, there is an increasing awareness that chronic pain is part of the pain experience of many older adolescents and adults. A common set of criteria for classifying chronic pain associated with SCD would enhance SCD pain research efforts in epidemiology, pain mechanisms, and clinical trials of pain management interventions, and ultimately improve clinical assessment and management. As part of the collaborative effort between the Analgesic, Anesthetic, and Addiction Clinical Trial Translations Innovations Opportunities and Networks public-private partnership with the U.S. Food and Drug Administration and the American Pain Society, the Analgesic, Anesthetic, and Addiction Clinical Trial Translations Innovations Opportunities and Networks-American Pain Society Pain Taxonomy initiative developed the outline of an optimal diagnostic system for chronic pain conditions. Subsequently, a working group of experts in SCD pain was convened to generate core diagnostic criteria for chronic pain associated with SCD. The working group synthesized available literature to provide evidence for the dimensions of this disease-specific pain taxonomy. A single pain condition labeled chronic SCD pain was derived with 3 modifiers reflecting different clinical features. Future systematic research is needed to evaluate the feasibility, validity, and reliability of these criteria.

  2. Evidence for current diagnostic criteria of diabetes mellitus

    Institute of Scientific and Technical Information of China (English)

    Ritesh; Kumar[1; Lakshmana; Perumal; Nandhini[1; Sadishkumar; Kamalanathan[1; Jayaprakash; Sahoo[1; Muthupillai; Vivekanadan[1

    2016-01-01

    Diabetes mellitus is a non-communicable metabolic derangement afflicting several millions of individuals globally. It is associated with several micro and macrovascular complications and is also a leading cause of mortality. The unresolved issue is that of definition of the diagnostic threshold for diabetes. The World Health Organization and the American Diabetes Association (ADA) have laid down several diagnostic criteria for diagnosing diabetes and prediabetes based on the accumulating body of evidence.This review has attempted to analyse the scientific evidence supporting the justification of these differing criteria. The evidence for diagnosing diabetes is strong, and there is a concordance between the two professional bodies.The controversy arises when describing the normal lower limit of fasting plasma glucose (FPG) with little evidence favouring the reduction of the FPG by the ADA. Several studies have also shown the development of complications specific for diabetes in patients with prediabetes as defined by the current criteria though there is a significant overlap of such prevalence in individuals with normoglycemia. Large multinational longitudinal prospective studies involving subjects without diabetes and retinopathy at baseline will ideally help identify the threshold of glycemic measurements for future development of diabetes and its complications.

  3. Evidence for current diagnostic criteria of diabetes mellitus

    Science.gov (United States)

    Kumar, Ritesh; Nandhini, Lakshmana Perumal; Kamalanathan, Sadishkumar; Sahoo, Jayaprakash; Vivekanadan, Muthupillai

    2016-01-01

    Diabetes mellitus is a non-communicable metabolic derangement afflicting several millions of individuals globally. It is associated with several micro and macrovascular complications and is also a leading cause of mortality. The unresolved issue is that of definition of the diagnostic threshold for diabetes. The World Health Organization and the American Diabetes Association (ADA) have laid down several diagnostic criteria for diagnosing diabetes and prediabetes based on the accumulating body of evidence.This review has attempted to analyse the scientific evidence supporting the justification of these differing criteria. The evidence for diagnosing diabetes is strong, and there is a concordance between the two professional bodies. The controversy arises when describing the normal lower limit of fasting plasma glucose (FPG) with little evidence favouring the reduction of the FPG by the ADA. Several studies have also shown the development of complications specific for diabetes in patients with prediabetes as defined by the current criteria though there is a significant overlap of such prevalence in individuals with normoglycemia. Large multinational longitudinal prospective studies involving subjects without diabetes and retinopathy at baseline will ideally help identify the threshold of glycemic measurements for future development of diabetes and its complications. PMID:27660696

  4. International consensus diagnostic criteria for neuromyelitis optica spectrum disorders

    Science.gov (United States)

    Banwell, Brenda; Bennett, Jeffrey L.; Cabre, Philippe; Carroll, William; Chitnis, Tanuja; de Seze, Jérôme; Fujihara, Kazuo; Greenberg, Benjamin; Jacob, Anu; Jarius, Sven; Lana-Peixoto, Marco; Levy, Michael; Simon, Jack H.; Tenembaum, Silvia; Traboulsee, Anthony L.; Waters, Patrick; Wellik, Kay E.

    2015-01-01

    Neuromyelitis optica (NMO) is an inflammatory CNS syndrome distinct from multiple sclerosis (MS) that is associated with serum aquaporin-4 immunoglobulin G antibodies (AQP4-IgG). Prior NMO diagnostic criteria required optic nerve and spinal cord involvement but more restricted or more extensive CNS involvement may occur. The International Panel for NMO Diagnosis (IPND) was convened to develop revised diagnostic criteria using systematic literature reviews and electronic surveys to facilitate consensus. The new nomenclature defines the unifying term NMO spectrum disorders (NMOSD), which is stratified further by serologic testing (NMOSD with or without AQP4-IgG). The core clinical characteristics required for patients with NMOSD with AQP4-IgG include clinical syndromes or MRI findings related to optic nerve, spinal cord, area postrema, other brainstem, diencephalic, or cerebral presentations. More stringent clinical criteria, with additional neuroimaging findings, are required for diagnosis of NMOSD without AQP4-IgG or when serologic testing is unavailable. The IPND also proposed validation strategies and achieved consensus on pediatric NMOSD diagnosis and the concepts of monophasic NMOSD and opticospinal MS. PMID:26092914

  5. Diagnostic criteria for cryopyrin-associated periodic syndrome (CAPS).

    Science.gov (United States)

    Kuemmerle-Deschner, Jasmin B; Ozen, Seza; Tyrrell, Pascal N; Kone-Paut, Isabelle; Goldbach-Mansky, Raphaela; Lachmann, Helen; Blank, Norbert; Hoffman, Hal M; Weissbarth-Riedel, Elisabeth; Hugle, Boris; Kallinich, Tilmann; Gattorno, Marco; Gul, Ahmet; Ter Haar, Nienke; Oswald, Marlen; Dedeoglu, Fatma; Cantarini, Luca; Benseler, Susanne M

    2016-10-04

    Cryopyrin-associated periodic syndrome (CAPS) is a rare, heterogeneous disease entity associated with NLRP3 gene mutations and increased interleukin-1 (IL-1) secretion. Early diagnosis and rapid initiation of IL-1 inhibition prevent organ damage. The aim of the study was to develop and validate diagnostic criteria for CAPS. An innovative process was followed including interdisciplinary team building, item generation: review of CAPS registries, systematic literature review, expert surveys, consensus conferences for item refinement, item reduction and weighting using 1000Minds decision software. Resulting CAPS criteria were tested in large cohorts of CAPS cases and controls using correspondence analysis. Diagnostic models were explored using sensitivity analyses. The international team included 16 experts. Systematic literature and registry review identified 33 CAPS-typical items; the consensus conferences reduced these to 14. 1000Minds exercises ranked variables based on importance for the diagnosis. Correspondence analysis determined variables consistently associated with the diagnosis of CAPS using 284 cases and 837 controls. Seven variables were significantly associated with CAPS (pCAPS-typical symptoms: urticaria-like rash, cold-triggered episodes, sensorineural hearing loss, musculoskeletal symptoms, chronic aseptic meningitis and skeletal abnormalities. Sensitivity was 81%, specificity 94%. It performed well for all CAPS subtypes and regardless of NLRP3 mutation. The novel approach integrated traditional methods of evidence synthesis with expert consensus, web-based decision tools and innovative statistical methods and may serve as model for other rare diseases. These criteria will enable a rapid diagnosis for children and adults with CAPS.

  6. PTSD: National Center for PTSD

    Medline Plus

    Full Text Available ... Service Organizations Whistleblower Rights & Protections Media Room Inside the Media Room Public Affairs News Releases Speeches Videos ... for PTSD Menu Menu PTSD PTSD Home For the Public Public Section Home PTSD Overview PTSD Basics ...

  7. PTSD: National Center for PTSD

    Medline Plus

    Full Text Available ... Organizations Whistleblower Rights & Protections Transparency Media Room Inside the Media Room Public Affairs News Releases Speeches Videos ... for PTSD Menu Menu PTSD PTSD Home For the Public Public Section Home PTSD Overview PTSD Basics ...

  8. What happened to harmonization of the PTSD diagnosis? The divergence of ICD11 and DSM5.

    Science.gov (United States)

    Bisson, J I

    2013-09-01

    The development of ICD11 and DSM5 was seen as an opportunity to harmonize the two major classification systems for mental disorders. The proposed ICD11 and DSM5 diagnostic criteria for PTSD are markedly different. The implications of this remain to be seen, but have the potential to cause confusion to PTSD sufferers, clinicians, researchers and others impacted on by the condition.

  9. Cognitive-Behavioral Therapy for PTSD in Children and Adolescents: A Preliminary Randomized Controlled Trial

    Science.gov (United States)

    Smith, Patrick; Yule, William; Perrin, Sean; Tranah, Troy; Dagleish, Tim; Clark, David M.

    2007-01-01

    Objective: To evaluate the efficacy of individual trauma-focused cognitive-behavioral therapy (CBT) for treating posttraumatic stress disorder (PTSD) in children and young people. Method: Following a 4-week symptom-monitoring baseline period, 24 children and young people (8-18 years old) who met full "DSM-IV" PTSD diagnostic criteria after…

  10. [Neurodegenerative disorders: review of current classification and diagnostic neuropathological criteria].

    Science.gov (United States)

    Matej, R; Rusina, R

    2012-04-01

    Neurodegenerative disorders are progressive diseases characterized by loss of specific neuronal populations followed by a clinical picture of a different neurodegenerative entity. Current classification of these diseases respects the names of the main pathophysiological processes involved in the groups of disorders. This is the reason why key proteins which represent neuropathological and biochemical hallmarks of diseases are found in their names. Neuropathological diagnosis is a synthesis of neurohistological changes in the brain and spinal cord and identification of pathological proteinaceous aggregates in neurons and/or glial cells. These inclusions are predominant diagnostic micromorphological and biochemical markers of disease. In the text, there is a brief summary of current knowledge about pathophysiology of neurodegenerations and diagnostic criteria for the most frequent entities.

  11. The classification and diagnostic criteria of ankylosing spondylitis.

    Science.gov (United States)

    Raychaudhuri, Siba P; Deodhar, Atul

    2014-01-01

    Ankylosing spondylitis is the prototype of immune-mediated inflammatory rheumatic diseases grouped under the term spondyloarthritis (SpA). An early diagnosis has now become increasingly important because effective therapies are available and anti-TNF drugs are even more effective if used in early stages of the disease. In ankylosing spondylitis, the 1984 modified New York criteria have been used widely in clinical studies and daily practice but are not applicable in early disease when the characteristic radiographic signs of sacroiliitis are not visible but active sacroiliitis is readily detectable by magnetic resonance imaging (MRI). Thus there has been a need for new classification or diagnostic criteria to identify inflammatory spondyloarthritis at early stage of the disease. This led to the concept of axial SpA to include the entire spectrum of patients with axial disease both, with and without radiographic damage. New classification criteria for the wider group of SpA have been proposed by ASAS (Assessment of Spondylo Arthritis International Society); and the patients are sub-grouped into (1) a predominantly axial disease, termed axial SpA including AS and non-radiographic axial SpA; (2) peripheral SpA. The clinical course and disease process of non-radiographic axial spondyloarthritis remains unclear. However the development of the SpA criteria by ASAS particularly for axial SpA, is an important step for early diagnosis and better management of these patients.

  12. Definition and diagnostic criteria of sleep-related hypermotor epilepsy.

    Science.gov (United States)

    Tinuper, Paolo; Bisulli, Francesca; Cross, J H; Hesdorffer, Dale; Kahane, Philippe; Nobili, Lino; Provini, Federica; Scheffer, Ingrid E; Tassi, Laura; Vignatelli, Luca; Bassetti, Claudio; Cirignotta, Fabio; Derry, Christopher; Gambardella, Antonio; Guerrini, Renzo; Halasz, Peter; Licchetta, Laura; Mahowald, Mark; Manni, Raffaele; Marini, Carla; Mostacci, Barbara; Naldi, Ilaria; Parrino, Liborio; Picard, Fabienne; Pugliatti, Maura; Ryvlin, Philippe; Vigevano, Federico; Zucconi, Marco; Berkovic, Samuel; Ottman, Ruth

    2016-05-10

    The syndrome known as nocturnal frontal lobe epilepsy is recognized worldwide and has been studied in a wide range of clinical and scientific settings (epilepsy, sleep medicine, neurosurgery, pediatric neurology, epidemiology, genetics). Though uncommon, it is of considerable interest to practicing neurologists because of complexity in differential diagnosis from more common, benign sleep disorders such as parasomnias, or other disorders like psychogenic nonepileptic seizures. Moreover, misdiagnosis can have substantial adverse consequences on patients' lives. At present, there is no consensus definition of this disorder and disagreement persists about its core electroclinical features and the spectrum of etiologies involved. To improve the definition of the disorder and establish diagnostic criteria with levels of certainty, a consensus conference using formal recommended methodology was held in Bologna in September 2014. It was recommended that the name be changed to sleep-related hypermotor epilepsy (SHE), reflecting evidence that the attacks are associated with sleep rather than time of day, the seizures may arise from extrafrontal sites, and the motor aspects of the seizures are characteristic. The etiology may be genetic or due to structural pathology, but in most cases remains unknown. Diagnostic criteria were developed with 3 levels of certainty: witnessed (possible) SHE, video-documented (clinical) SHE, and video-EEG-documented (confirmed) SHE. The main research gaps involve epidemiology, pathophysiology, treatment, and prognosis.

  13. Diagnostic criteria for idiopathic inflammatory myopathies. Problems of their optimization

    Directory of Open Access Journals (Sweden)

    O. A. Antelava

    2014-01-01

    Full Text Available The paper deals with the problems of optimizing the diagnostic criteria for idiopathic inflammatory myopathies (IIM, a group of heterogeneous rare autoimmune diseases characterized by inflammatory lesion in the skeletal muscles. The representatives of this group are traditionally considered to be polymyositis (PM, dermatomyositis (DM, and inclusion-body myositis. The authors detail the history of classification criteria for IIM from those proposed by T.A. Medsger et al. (1970 relying on its clinical picture, laboratory data and instrumental findings, as well as the criteria (including the first introduced exclusion ones elaborated by A. Bohan and J.B. Peter in 1975, which remain fundamental in both clinical practice and researches. The basis for the clinical and serological criteria proposed by Y. Troyanov et al. (2005 for IIM is the identification of myositis-overlap syndromes. The classificational (subtype identification and therapeutic value of the criteria based on clinical and serological characteristics was supported by the Hungarian investigators A. Vancsa et al. (2010 who investigated the relationship between the clinical and therapeutic characteristics of IIM and positivity for myositis-specific and myositis-associated antibodies. The criteria developed by M.C. Dalakas (1991, 2003 are based on the specific immunopathological features of a histological pattern, which allow the differentiation of DM, PM, and inclusion-body myositis from other myopathic syndromes. The 2004 European Neuromuscular Center (ENMC criteria first identify necrotizing autoimmune myopathy and nonspecific myositis as individual subtypes. The serological classification of IIM, which is based onthe assessment of autoantibodies that play an important role in the pathogenesis of the disease, is of indubitable interest. There is an obvious need for the correct and timely diagnosis of both IIM as a whole and its subtypes in particular, which is complicated by

  14. Research Diagnostic criteria for Temporomandibular Disorders: current status & future relevance.

    Science.gov (United States)

    Dworkin, S F

    2010-10-01

    The Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD), published in 1992, was based on international expert recommendations and available empirical data. The major rationale was to offer a putative diagnostic and classification system whose reliability, validity and clinical usefulness for TMD diagnosis and classification could be scientifically evaluated and then revised using an evidence-based model for successive iterations. The present journal issue attests to the accomplishment of that major objective: the RDC/TMD has been translated into 18 languages and used very extensively in international research. One important component of that research has been to yield reliable and valid data resulting in an evidence-based revision of the RDC/TMD now available for continuing research and clinical application. The present article offers recommendations and speculations regarding how the RDC/TMD may continue to serve the function of guiding future research and, most importantly, serve as an evidence-based diagnostic and classification system to aid in the rational choice of clinical care for TMD sufferers around the world.

  15. CT-diagnosis of optic nerve lesions. Differential diagnostic criteria

    Energy Technology Data Exchange (ETDEWEB)

    Unsoeld, R.

    1982-01-01

    Computed tomograms of 166 optic nerve lesions were analyzed: 97 were mainly orbital and 69 mainly intracranial. The criteria were clinical course, size, density and delineation of the optic nerve shadow, orbital and cerebral soft tissue abnormalities, and bony changes in the optic canal. Characteristic CT features are described of individual disease entities such as optic gliomas, optic nerve sheath meningiomas, neoplastic and inflammatory infiltrations. The differential diagnostic importance of individual CT criteria is evaluated and discussed. Simultaneous visualization of orbital and intracranial soft tissue changes as well as bony changes in the optic canal allow the location and identification of the majority of optic nerve lesions based on the criteria mentioned above, and optic nerve tumors can be differentiated. In 9 patients with optic neuritis due to clinically proven encephalitis and in 17 patients with total optic atrophy, no changes in the size of the optic nerve could be found. CT evaluation of the intraorbital portion of the optic nerve requires special examination techniques. Oblique computer reformations through the optic canal provide excellent visualization of bony changes in the optic canal. The exclusion of intracranial causes of optic nerve lesions requires intravenous injection of contrast material.

  16. Updated clinical diagnostic criteria for sporadic Creutzfeldt-Jakob disease

    Science.gov (United States)

    Kallenberg, K.; Summers, D. M.; Romero, C.; Taratuto, A.; Heinemann, U.; Breithaupt, M.; Varges, D.; Meissner, B.; Ladogana, A.; Schuur, M.; Haik, S.; Collins, S. J.; Jansen, Gerard H.; Stokin, G. B.; Pimentel, J.; Hewer, E.; Collie, D.; Smith, P.; Roberts, H.; Brandel, J. P.; van Duijn, C.; Pocchiari, M.; Begue, C.; Cras, P.; Will, R. G.; Sanchez-Juan, P.

    2009-01-01

    Several molecular subtypes of sporadic Creutzfeldt–Jakob disease have been identified and electroencephalogram and cerebrospinal fluid biomarkers have been reported to support clinical diagnosis but with variable utility according to subtype. In recent years, a series of publications have demonstrated a potentially important role for magnetic resonance imaging in the pre-mortem diagnosis of sporadic Creutzfeldt–Jakob disease. Magnetic resonance imaging signal alterations correlate with distinct sporadic Creutzfeldt–Jakob disease molecular subtypes and thus might contribute to the earlier identification of the whole spectrum of sporadic Creutzfeldt–Jakob disease cases. This multi-centre international study aimed to provide a rationale for the amendment of the clinical diagnostic criteria for sporadic Creutzfeldt–Jakob disease. Patients with sporadic Creutzfeldt–Jakob disease and fluid attenuated inversion recovery or diffusion-weight imaging were recruited from 12 countries. Patients referred as ‘suspected sporadic Creutzfeldt–Jakob disease’ but with an alternative diagnosis after thorough follow up, were analysed as controls. All magnetic resonance imaging scans were assessed for signal changes according to a standard protocol encompassing seven cortical regions, basal ganglia, thalamus and cerebellum. Magnetic resonance imaging scans were evaluated in 436 sporadic Creutzfeldt–Jakob disease patients and 141 controls. The pattern of high signal intensity with the best sensitivity and specificity in the differential diagnosis of sporadic Creutzfeldt–Jakob disease was identified. The optimum diagnostic accuracy in the differential diagnosis of rapid progressive dementia was obtained when either at least two cortical regions (temporal, parietal or occipital) or both caudate nucleus and putamen displayed a high signal in fluid attenuated inversion recovery or diffusion-weight imaging magnetic resonance imaging. Based on our analyses, magnetic

  17. [Causes and pathophysiology of pediatric obesity and its diagnostic criteria].

    Science.gov (United States)

    Ohzeki, Takehiko

    2013-02-01

    Recently, obesity has been listed as important health problems not only in adults but also in children. Prevalence of pediatric obesity has been rising in the last half century in most of the developed countries including Japan. In addition to changes in lifestyle, which are shown to have contributed greatly to promote weight gain in recent years, patients with some syndromes or diseases may have obesity as one of the manifestations of the disorders especially in childhood. Obese individuals are commonly accompanied by derangement in various organs, such as metabolic and cardiovascular systems, in children as well as adults. Diagnostic criteria for obesity-disease and metabolic syndrome were proposed on the basis of data obtained from Japanese children.

  18. Right ventricular sarcoidosis: is it time for updated diagnostic criteria?

    Science.gov (United States)

    Vakil, Kairav; Minami, Elina; Fishbein, Daniel P

    2014-04-01

    A 55-year-old woman with a history of complete heart block, atrial flutter, and progressive right ventricular failure was referred to our tertiary care center to be evaluated for cardiac transplantation. The patient's clinical course included worsening right ventricular dysfunction for 3 years before the current evaluation. Our clinical findings raised concerns about arrhythmogenic right ventricular cardiomyopathy. Noninvasive imaging, including a positron emission tomographic scan, did not reveal obvious myocardial pathologic conditions. Given the end-stage nature of the patient's right ventricular failure and her dependence on inotropic agents, she underwent urgent listing and subsequent heart transplantation. Pathologic examination of the explanted heart revealed isolated right ventricular sarcoidosis with replacement fibrosis. Biopsy samples of the cardiac allograft 6 months after transplantation showed no recurrence of sarcoidosis. This atypical presentation of isolated cardiac sarcoidosis posed a considerable diagnostic challenge. In addition to discussing the patient's case, we review the relevant medical literature and discuss the need for updated differential diagnostic criteria for end-stage right ventricular failure that mimics arrhythmogenic right ventricular cardiomyopathy.

  19. Pediatric patients: criteria for radiopharmaceuticals activities in diagnostic procedures

    Energy Technology Data Exchange (ETDEWEB)

    Santos, Felipe Simas dos; Oliveira, Silvia M. Velasques de, E-mail: simas@ird.gov.b, E-mail: silvia@ird.gov.b [Instituto de Radioprotecao e Dosimetria (IRD/CNEN-RJ), Rio de Janeiro, RJ (Brazil)

    2009-07-01

    Recent studies recommend new criteria to determine radiopharmaceuticals activities per diagnostic procedures for children and teenagers. In USA, the criteria are: minimum and maximum activity and activity per body weight. The minimum activity is necessary for assuring the quality image due to the minimum requested statistical counting. The reduction of maximum activities minimizes the probability of detriment of radiation. In the European Union (EU), the Pediatric Dosage Card (PDC) proposes combined parameters: category of radiopharmaceutical, patient body weight and minimum activity per procedure. The PDC classifies the radiopharmaceuticals according to their biodistribution in the most sensitive organs. In Brazil, an investigation evaluated radiopharmaceuticals activities administered to 2,411 pediatric patients in sixteen institutions. The Brazilian mean activities per body weight, minimum and maximum activities used per institutions were compared with similar parameters surveyed in thirteen American hospitals. It was also used the PDC model to calculate the minimum activities per radiopharmaceuticals using recorded Brazilian patients corporal masses. The wider differences between Brazilian and USA installations were noticed for minimum activities by as much as a factor of 2 and 8. For {sup 67}Ga Citrate, the ranges of activities per patient corporal mass were by as much as a factor of 2 and 9 than activities used in USA. The range of maximum activities presented fewer differences, varying between 0.5 and 2 times for the radiopharmaceuticals studied. The present work needs the collaboration of the professional staff for discussion of the results, to promote regional surveys and to optimize pediatric patient protocols (author)

  20. The DSM diagnostic criteria for paraphilia not otherwise specified.

    Science.gov (United States)

    Kafka, Martin P

    2010-04-01

    The category of "Not Otherwise Specified" (NOS) for DSM-based psychiatric diagnosis has typically retained diagnoses whose rarity, empirical criterion validation or symptomatic expression has been insufficient to be codified. This article reviews the literature on Telephone Scatologia, Necrophilia, Zoophilia, Urophilia, Coprophilia, and Partialism. Based on extant data, no changes are suggested except for the status of Partialism. Partialism, sexual arousal characterized by "an exclusive focus on part of the body," had historically been subsumed as a type of Fetishism until the advent of DSM-III-R. The rationale for considering the removal of Partialism from Paraphilia NOS and its reintegration as a specifier for Fetishism is discussed here and in a companion review on the DSM diagnostic criteria for fetishism (Kafka, 2009). In the DSM-IV and DSM-IV-TR, the essential features of a Paraphilia are recurrent, intense sexually arousing fantasies, sexual urges or behaviors generally involving nonhuman objects, the suffering or humiliation of oneself or one's partner, or children or other nonconsenting persons that occur over a period of at least 6 months (Criterion A). Given consideration for the erotic focus of Partialism and Autoerotic Asphyxia, amending the operational criteria for Paraphilia should be considered to include an atypical focus involving human subjects (self or others).

  1. [Categorical and dimensional diagnostic approach to acute psychosis in view of operational diagnostic criteria].

    Science.gov (United States)

    Sakamoto, Kaoru

    2011-01-01

    "Acute psychosis" is the tentative diagnosis made for the patients presenting acute onset of delusion, hallucination, confusion and emotional instability. "Acute psychosis" was focused in view of operational diagnostic criteria, ie, DSM-IV-TR and ICD-10. The diagnostic categories in the DSM-IV-TR corresponding to "acute psychosis" were brief psychotic disorder, schizophreniform disorder, schizo-affective disorder and mood disorder with psychotic features. Although brief psychotic disorder is representative of "acute psychosis" in the DSM-TR, it lacks in clinical usefulness, because its diagnostic criteria, based on no historical background, lack clinical validity in terms of symptom definition and duration (1 month>). On the other hand, in the ICD-10, a diagnostic category of acute transient psychotic disorder was based on the traditional "acute psychosis" concept that has been bred in the European Psychiatry. Among the acute transient psychotic disorders, acute polymorphic psychotic disorder is the diagnostic category made according to traditional concept of "bouffées délirantes" and cycloid psychosis. It is a clinically useful diagnostic category, because it could predict favorable episode outcome, if a person with fairly good premorbid social adaptation presents acute onset of polymorphic psychotic symptoms. One of the most prominent points of the revision of DSM-IV-TR to DSM-5 is the adoption of dimensional approach evaluation (diagnosis) in a disorder-crossing fashion. In addition to insomnia, depressive mood and anxiety, symptomatic domain such as acute onset, bipolarity, polymorphism of psychotic symptoms, and furthermore such domain as premorbid social adaptation, life event and episode outcome should be evaluated in the course of treatment, contributing to the clinical practice of the patients with acute psychosis.

  2. Desquamative inflammatory vaginitis: differential diagnosis and alternate diagnostic criteria.

    Science.gov (United States)

    Bradford, Jennifer; Fischer, Gayle

    2010-10-01

    To describe alternate diagnostic protocols and describe the differential diagnosis for desquamative inflammatory vaginitis (DIV). One hundred one cases of DIV were audited retrospectively. All patients were seen exclusively by the authors in their private practices using diagnostic criteria applicable to local practice limitations. Other potential etiologies (infection, contact irritant vaginitis, fixed drug eruptions, immunobullous diseases, estrogen hypersensitivity vulvovaginitis, and graft-vs-host disease) were excluded by history, examination, and focused trials of treatment. Historical triggers in the study cohort and a control group of 75 women with lichen planus also drawn from the authors' private practice were compared. Patients were treated with 4 to 6 weeks of topical vaginal antibiotics, 94% with clindamycin, and response to treatment was recorded at subsequent follow-up. All patients were white. Of 101 patients, 57 (56%) had historical triggers, most frequently diarrhea or antibiotic treatment. Of the 75 women in the control group with vaginal lichen planus, 11 had historical triggers (15%, p vaginitis, which were ongoing, were cured when their triggers were finally controlled or cured, leaving 35 patients who required long-term maintenance therapy. Desquamative inflammatory vaginitis seems to be a distinct entity of vaginitis that, in an office setting, can be distinguished from other diagnostic possibilities by careful clinical evaluation and focused trials of treatment. The majority of women responded promptly to intravaginal antibiotics, with approximately 35% of cases requiring maintenance therapy. More than half the cases have an historical trigger. We postulate that DIV occurs when a trigger causes shifts in vaginal homeostasis, resulting in an inflammatory response associated with increased epithelial cell turnover.

  3. Diagnostic criteria for acute liver failure due to Wilson disease

    Institute of Scientific and Technical Information of China (English)

    Christoph Eisenbach; Olivia Sieg; Wolfgang Stremmel; Jens Encke; Uta Merle

    2007-01-01

    AIM: To describe the diagnostic criteria for acute liver failure due to Wilson disease (WD), which is an uncommon cause of acute liver failure (ALF).METHODS: We compared findings of patients presenting with ALF due to WD to those with ALF of other etiologies.RESULTS: Previously described criteria, such as low alkaline phosphatase activity, ratio of low alkaline phosphatase to total bilirubin or ratio of high aspartate aminotransferase (AST) to alanine aminotransferase (ALT), failed to identify patients with ALF due to WD. There were significant differences in low ALT and AST activities (53 ± 43 vs 1982 ± 938, P < 0.0001 and 87 ± 44 vs 2756 ± 2941, P = 0.037, respectively), low choline esterase activity (1.79 ± 1.2 vs 4.30 ± 1.2, P = 0.009), high urine copper concentrations (93.4 ± 144.0 vs 3.5 ± 1.8, P = 0.001) and low hemoglobin (7.0 ± 2.2 vs 12.6 ± 1.8, P < 0.0001) in patients with ALF caused by WD as compared with other etiologies. Interestingly, 4 of 7 patients with ALF due to WD survived without liver transplantation.CONCLUSION: In ALF, these criteria can help establish a diagnosis of WD. Where applicable, slit-lamp examination for presence of Kayser-Fleischer rings and liver biopsy for determination of hepatic copper concentration still remain important for the diagnosis of ALF due to WD. The need for liver transplantation should be evaluated carefully as the prognosis is not necessarily fatal.

  4. PTSD: National Center for PTSD

    Medline Plus

    Full Text Available ... for PTSD What We Do Mission and Overview Goals and Objectives Looking Ahead Annual Reports Research Initiatives Education Initiatives ... for PTSD, Know Your Options . × What is PTSD? Right Click here to download "What is PTSD?" (30. ...

  5. Finalizing PTSD in DSM-5: getting here from there and where to go next.

    Science.gov (United States)

    Friedman, Matthew J

    2013-10-01

    The process that resulted in the diagnostic criteria for posttraumatic stress disorder (PTSD) in the Diagnostic and Statistical Manual of Mental Disorders (5th ed.; DSM-5; American Psychiatric Association; ) was empirically based and rigorous. There was a high threshold for any changes in any DSM-IV diagnostic criterion. The process is described in this article. The rationale is presented that led to the creation of the new chapter, "Trauma- and Stressor-Related Disorders," within the DSM-5 metastructure. Specific issues discussed about the DSM-5 PTSD criteria themselves include a broad versus narrow PTSD construct, the decisions regarding Criterion A, the evidence supporting other PTSD symptom clusters and specifiers, the addition of the dissociative and preschool subtypes, research on the new criteria from both Internet surveys and the DSM-5 field trials, the addition of PTSD subtypes, the noninclusion of complex PTSD, and comparisons between DSM-5 versus the World Health Association's forthcoming International Classification of Diseases (ICD-11) criteria for PTSD. The PTSD construct continues to evolve. In DSM-5, it has moved beyond a narrow fear-based anxiety disorder to include dysphoric/anhedonic and externalizing PTSD phenotypes. The dissociative subtype may open the way to a fresh approach to complex PTSD. The preschool subtype incorporates important developmental factors affecting the expression of PTSD in young children. Finally, the very different approaches taken by DSM-5 and ICD-11 should have a profound effect on future research and practice. Published 2013. This article is a US Government work and is in the public domain in the USA.

  6. The usefulness of the consensus clinical diagnostic criteria in Brugada syndrome

    NARCIS (Netherlands)

    Sarkozy, A.; Paparella, G.; Boussy, T.; Casado-Arroyo, R.; Yazaki, Y.; Chierchia, G.B.; Asmundis, C. de; Bayrak, F.; Namdar, M.; Richter, S.; Brugada, J.; Brugada, P.

    2013-01-01

    BACKGROUND: Consensus statements were proposed for the diagnosis of Brugada syndrome (BS). The clinical diagnostic criteria were defined as documented ventricular fibrillation or ventricular tachycardia (VT), family history of sudden cardiac death at <45 years, diagnostic ECGs of family members,

  7. Classification, diagnostic criteria and management of benign paroxysmal positional vertigo.

    Science.gov (United States)

    Imai, Takao; Takeda, Noriaki; Ikezono, Tetsuo; Shigeno, Kohichiro; Asai, Masatsugu; Watanabe, Yukio; Suzuki, Mamoru

    2017-02-01

    Benign paroxysmal positional vertigo (BPPV) is the most common peripheral vertigo and the posterior and/or lateral semicircular canals are usually affected. BPPV is characterized by brief attacks of rotatory vertigo associated with positional and/or positioning nystagmus, which are elicited by specific head positions or changes in head position relative to gravity. In patients with the posterior-canal-type of BPPV, torsional nystagmus is induced by the Dix-Hallpike maneuver. In patients with the lateral-canal-type of BPPV, horizontal geotropic or apogeotropic nystagmus is induced by the supine roll test. The pathophysiology of BPPV is canalolithiasis comprising free-floating otoconial debris within the endolymph of a semicircular canal, or cupulolithiasis comprising otoconial debris adherent to the cupula. The observation of positional and/or positioning nystagmus is essential for the diagnosis of BPPV. BPPV is treated with the canalith repositioning procedure (CRP). Through a series of head position changes, the CRP moves otoconial debris from the affected semicircular canal to the utricle. In this review, we provide the classification, diagnostic criteria, and examinations for the diagnosis, and specific and non-specific treatments of BPPV in accordance with the Japanese practical guidelines on BPPV published by the Japan Society for Equilibrium Research.

  8. Does Size really matter? A multisite study of competing diagnostic criteria

    DEFF Research Database (Denmark)

    Hansen, Maj; Hyland, Philip; Karstoft, Karen-Inge

    of Mental Disorders 5th edition (DSM-5), which describes PTSD as a diagnosis comprised of 20 symptoms belonging to four symptom clusters, and the World Health Organization’s proposed 11th revision of the International Classification of Diseases (ICD-11) set for release in 2018 in which PTSD is comprised...... by only 6-7 symptoms belonging to three symptom clusters. Numerous studies have supported the latent structure of PTSD according to different models of the DSM-5 and the ICD-11 proposal. The few studies investigating the ICD-11 and the DSM-5 in the same populations appear to suggest that the ICD-11 model...... may result in better fit than the DSM-5 based models. At the same time, there is also a tendency for ICD-11 to produce lower estimated PTSD prevalence rates than the DSM-5 criteria, which may ultimately affect who is offered treatment. Of note, it is important to stress that there is a lack of studies...

  9. The traumatised chronic pain patient—Prevalence of posttraumatic stress disorder - PTSD and pain sensitisation in two Scandinavian samples referred for pain rehabilitation

    DEFF Research Database (Denmark)

    Andersen, Tonny Elmose; Andersen, Per Grünwald; Vakkala, Merja Annika;

    2012-01-01

    levels of pain, and disability. Furthermore, the diagnostic criteria for PTSD has changed dramatically in the last two decades which has had a profound impact on the reported prevalence rates of PTSD in chronic pain samples. To our knowledge, no study has employed the DSM-IV criteria for estimating...... the prevalence of PTSD in chronic pain patients referred consecutively for multidisciplinary pain rehabilitation. Aim: The aim of the present study was to assess the prevalence of significant traumatic stressors and PTSD in chronic pain patients referred consecutively to multidisciplinary pain rehabilitation. We...... were asked to report if cold, brush, and pinprick mechanical stimulation resulted in decreased or increased sensation or pain. Results: A high prevalence of PTSD was found in both consecutive samples. Using the DSM-IV criteria, 23% fulfilled the criteria for a possible PTSD diagnosis. There were...

  10. DSM-5 proposed diagnostic criteria for sexual paraphilias: tensions between diagnostic validity and forensic utility.

    Science.gov (United States)

    Wakefield, Jerome C

    2011-01-01

    In order to prevent sexual crimes, "sexual predator" laws now allow indefinite preventive civil commitment of criminals who have completed their prison sentences but are judged to have a paraphilic mental disorder that makes them likely to commit another crime. Such proceedings can bypass the usual protections of criminal law as long as the basis for incarceration is the attribution of a mental disorder. Thus, the difficult conceptual distinction between deviant sexual desires that are mental disorders versus those that are normal variations in sexual preference (even if they are eccentric, repugnant, or illegal if acted upon) has attained critical forensic significance. Yet, the concept of paraphilic disorders - called "perversions" in earlier times - is inherently fuzzy and controversial and thus open to conceptual abuse for social control purposes. Consequently, the criteria used in diagnosing paraphilic disorders deserve careful scrutiny. The DSM-5 sexual disorders work group is proposing substantial revisions to the paraphilia diagnostic criteria in the DSM-5 nosology. It is claimed that the new criteria provide a reconceptualization that clarifies the distinction between normal variation and paraphilic disorder in a way relevant to forensic settings. In this article, after considering the logic of the concept of a paraphilic disorder, I examine each of the proposed changes to the DSM-5 paraphilia criteria and assess their conceptual validity. I argue that the DSM-5 proposals, while containing a kernel of an advance in distinguishing paraphilias from paraphilic disorders, nonetheless would yield criteria for paraphilic disorders that are conceptually invalid in ways open to serious forensic abuse. Copyright © 2011 Elsevier Ltd. All rights reserved.

  11. PTSD in the DSM-5: reply to Brewin (2013), Kilpatrick (2013), and Maercker and Perkonigg (2013).

    Science.gov (United States)

    Friedman, Matthew J

    2013-10-01

    The greater emphasis on scientific evidence and the high threshold for changing any criterion in the Diagnostic and Statistical Manual for Mental Disorders (4th ed., DSM-IV) probably account for many key differences between the DSM-5 and the International Classification of Diseases and Related Health Problems (11th ver.; ICD-11) with regard to diagnostic criteria for posttraumatic stress disorder (PTSD). Important questions about PTSD remain that can only be settled by future research. Additional research is also needed on subthreshold PTSD, a dissociative subtype described in the DSM-5; complex PTSD, included in the ICD-11; bereavement-related disorders; and adjustment disorders. We can all look forward to such scientific advances to inform our ongoing efforts to develop the best diagnostic criteria for trauma- and stressor-related disorders. Published 2013. This article is a US Government work and is in the public domain in the USA.

  12. Validity of the Research Diagnostic Criteria for Temporomandibular Disorders Axis I in clinical and research settings.

    NARCIS (Netherlands)

    Steenks, M.H.; Wijer, A. de

    2009-01-01

    The lack of standardized diagnostic criteria for defining clinical subtypes of temporomandibular disorders (TMD) was the main motive to create the Research Diagnostic Criteria for TMD (RDC/TMD), which were provided to allow standardization and replication of research into the most common forms of mu

  13. PTSD: National Center for PTSD

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    Full Text Available ... Adult Self Report Child Measures Deployment Measures DSM-5 Measures PTSD Screens Trauma Exposure Measures Assessment Request ... Click here to download "What is PTSD?" (30.5 MB) Close × PTSD Treatment: Know Your Options Right ...

  14. PTSD: National Center for PTSD

    Medline Plus

    Full Text Available ... Kit Logos and Badges Materials for Printing PTSD Awareness About the Website Site Map Content Inventory Accessibility ... Links Linking Policies Small Business POC Subscribe PTSD Awareness PTSD Consultation More Health Care Veterans Health Administration ...

  15. PTSD: National Center for PTSD

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    Full Text Available ... PTSD Awareness About the Website Site Map Content Inventory Accessibility Privacy and Security Updating of Web Site Web Site Policies Important Links Linking Policies Small Business POC Subscribe PTSD Awareness PTSD Consultation More Health ...

  16. PTSD: National Center for PTSD

    Medline Plus

    Full Text Available ... and Coping Treatment Self-Help and Coping PTSD Research Where to Get Help for PTSD Help with ... Articles by Center Staff Clinician’s Trauma Update PTSD Research Quarterly Publications Search Using the PILOTS Database What ...

  17. PTSD: National Center for PTSD

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    Full Text Available ... Directory Grants Management Services Veterans Service Organizations Whistleblower Rights & Protections Media Room Inside the Media Room Public ... for PTSD, Know Your Options . × What is PTSD? Right Click here to download "What is PTSD?" (30. ...

  18. PTSD: National Center for PTSD

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    Full Text Available ... VA PTSD Care or Benefits Other Common Problems Family and Friends PTSD and Communities Paginas en Espanol ... Cultural Considerations Women Children Older Adults Working with Families PTSD Consultation For Specific Providers VA Providers and ...

  19. PTSD: National Center for PTSD

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    Full Text Available ... Search How to Obtain Articles Alerts User Guide Purpose and Scope Find Assessment Measures Instrument Authority List ... for PTSD, Know Your Options . × What is PTSD? Right Click here to download "What is PTSD?" (30. ...

  20. PTSD: National Center for PTSD

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    Full Text Available ... Directory Grants Management Services Veterans Service Organizations Whistleblower Rights & Protections Transparency Media Room Inside the Media Room ... for PTSD, Know Your Options . × What is PTSD? Right Click here to download "What is PTSD?" (30. ...

  1. PTSD: National Center for PTSD

    Medline Plus

    Full Text Available ... VA PTSD Care or Benefits Other Common Problems Family and Friends PTSD and Communities Paginas en Espanol ... Cultural Considerations Women Children Older Adults Working with Families PTSD Consultation For Specific Providers VA Providers and ...

  2. How Should We Revise Diagnostic Criteria for Substance Use Disorders in the DSM—V?

    OpenAIRE

    Martin, Christopher S.; Chung, Tammy; LANGENBUCHER, JAMES W.

    2008-01-01

    This article reviews literature on the validity and performance characteristics of the Diagnostic and Statistical Manual of Mental Disorders (4th ed.; DSM—IV; American Psychiatric Association, 1994) diagnostic criteria for substance use disorders (SUDs) and recommends changes in these criteria that should be considered for the next edition of the DSM (DSM—V). Substantial data indicate that DSM—IV substance abuse and substance dependence are not distinct categories and that SUD criteria are be...

  3. PTSD: National Center for PTSD

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    Full Text Available ... Accessibility Privacy and Security Updating of Web Site Web Site Policies Important Links Linking Policies Small Business POC Subscribe PTSD Awareness PTSD Consultation More Health ...

  4. Prioritisation criteria for the selection of new diagnostic technologies for evaluation

    Directory of Open Access Journals (Sweden)

    Linden-Phillips Luan

    2010-05-01

    Full Text Available Abstract Background Currently there is no framework for those involved in the identification, evaluation and prioritisation of new diagnostic technologies. Therefore we aimed to develop prioritisation criteria for the assessment of new diagnostic technologies, by gaining international consensus on not only which criteria should be used, but also their relative importance. Methods A two-round Delphi process was used to generate consensus amongst an international panel of twenty-six experts on priority criteria for diagnostic health technology assessment. Participants represented a range of health care and related professions, including government, industry, health services and academia. Results Based on the responses to the first questionnaire 18 criteria were placed into three categories: high, intermediate and moderate priority. For 16 of the 18 criteria, agreement with the categorisation of the criteria into the high, intermediate and moderate categories was high at ≥ 70% (10 had agreement ≥ 80%. A further questionnaire and panel discussion reduced the criteria to 16 and two categories; seven were classified as high priority and nine intermediate. Conclusions This study proposes an objective structure of prioritisation criteria to use when assessing new diagnostic technologies, based on an expert consensus process. The value of these criteria is that no one single component should be used as the decisive driver for prioritisation of new diagnostic technologies for adoption in healthcare settings. Future studies should be directed at establishing the value of these prioritisation criteria across a range of healthcare settings.

  5. Expanding the taxonomy of the diagnostic criteria for temporomandibular disorders

    DEFF Research Database (Denmark)

    Peck, C C; Goulet, J-P; Lobbezoo, F

    2014-01-01

    criteria and the ability to operationalise and study the criteria. The disorders were derived from the literature when possible and based on expert opinion as necessary. The expanded TMDs taxonomy was presented for feedback at international meetings. Of 56 disorders considered, 37 were included...

  6. Efficacy of structured approach therapy in reducing PTSD in returning veterans: A randomized clinical trial.

    Science.gov (United States)

    Sautter, Frederic J; Glynn, Shirley M; Cretu, Julia Becker; Senturk, Damla; Vaught, Amanda S

    2015-08-01

    The U.S. military deployed in support to Operation Iraqi Freedom (OIF) and Operation Enduring Freedom (OEF) show high rates of posttraumatic stress disorder (PTSD) and relationship, partner, and parenting distress. Given the pervasive effect of combat-related PTSD on returning veterans and its effect on their loved ones, the investigators have developed a couples-based treatment, structured approach therapy (SAT), to reduce PTSD while simultaneously decreasing relationship and partner distress. This study presents treatment outcome data measuring PTSD and relationship outcomes from a randomized clinical trial (RCT) comparing SAT, a manualized 12-session novel couples-based PTSD treatment, to a manualized 12-session couples-based educational intervention (PTSD Family Education [PFE]). Data were collected from 57 returning veterans meeting Diagnostic and Statistical Manual of Mental Disorders (fourth edition, text revision; DSM-IV-TR) criteria for PTSD and their cohabiting partners; data collection was scheduled for pretreatment, posttreatment, and 3-month follow-up. Findings from an intent-to-treat analysis revealed that veterans receiving SAT showed significantly greater reductions in self-rated (PTSD Checklist; p < .0006) and Clinician-Administered PTSD Scale (CAPS)-rated PTSD (p < .0001) through the 3-month follow-up compared with veterans receiving PFE; 15 of 29 (52%) veterans receiving SAT and 2 of 28 (7%) receiving PFE no longer met DSM-IV-TR criteria for PTSD. Furthermore, SAT was associated with significant improvements in veteran relationship adjustment, attachment avoidance, and state anxiety. Partners showed significant reductions in attachment anxiety. This couples-based treatment for combat-related PTSD appears to have a strong therapeutic effect on combat-related PTSD in recently returned veterans.

  7. Diagnostic Statistical Manual 5 Changes to the Autism Diagnostic Criteria: A Critical Moment for Occupational Therapists

    Directory of Open Access Journals (Sweden)

    Rondalyn Varney Whitney Ph.D., OT/L

    2012-11-01

    Full Text Available Changes in the soon to be released Diagnostic Statistical Manual (DSM – 5 (American Psychiatric Association, 2012 bring new opportunities for occupational therapy, but the profession must prepare for the impact these changes forecast. While well positioned to capitalize on newly defined specifications of Autism Spectrum Disorders (ASD and the elevation of sensory processing difficulties to a core feature of the disorder, the profession must be alert to the potential downside of the pending changes. The more stringentdiagnostic rubric will likely exclude a significant number of individuals currently eligible for therapeutic and academic services. Autism will be defined as a neurodevelopmental disorder that must be identifiable before early childhood (age 5, even if it is not detected until later as a result of environmental factors (minimal social demands, support from caretakers, etc.. The new diagnostic criteria will add the explicit recognition of sensory behaviors within a subdomain of stereotyped motor, verbal, and sensory-based behaviors and researchers suggest only 60% of those who currently meet the threshold for an autism spectrum diagnosis will continue to meet criteria under the new categorization. The proposed changes will likely encourage researchers to use greater specificity when recruiting sample populations and, as a result, help to determine interventions that are most advantageous for specific subtypes. Addressing sensory processing in thediagnostic criteria may authorize interventions aimed specifically towards reduction of sensory-related disabilities through remediation, environmental support, or parent education while simultaneously calling upon us to deliver evidence for Ayres’ sensory integration® (ASI approaches. The change also presents anurgent call to our profession to promote the unique scientific contributions occupational therapy makes for individuals with ASD, their families, and their educational contexts

  8. PTSD's risky behavior criterion: Relation with DSM-5 PTSD symptom clusters and psychopathology.

    Science.gov (United States)

    Contractor, Ateka A; Weiss, Nicole H; Dranger, Paula; Ruggero, Camilo; Armour, Cherie

    2017-06-01

    A new symptom criterion of reckless and self-destructive behaviors (E2) was recently added to posttraumatic stress disorder's (PTSD) diagnostic criteria in DSM-5, which is unsurprising given the well-established relation between PTSD and risky behaviors. Researchers have questioned the significance and incremental validity of this symptom criterion within PTSD's symptomatology. Unprecedented to our knowledge, we aim to compare trauma-exposed groups differing on their endorsement status of the risky behavior symptom on several psychopathology constructs (PTSD, depression, distress tolerance, rumination, anger). The sample included 123 trauma-exposed participants seeking mental health treatment (M age=35.70; 68.30% female) who completed self-report questionnaires assessing PTSD symptoms, depression, rumination, distress tolerance, and anger. Results of independent samples t-tests indicated that participants who endorsed the E2 criterion at a clinically significant level reported significantly greater PTSD subscale severity; depression severity; rumination facets of repetitive thoughts, counterfactual thinking, and problem-focused thinking; and anger reactions; and significantly less absorption and regulation (distress tolerance facets) compared to participants who did not endorse the E2 criterion at a clinically significant level. Results indicate the utility of the E2 criterion in identifying trauma-exposed individual with greater posttraumatic distress, and emphasize the importance of targeting such behaviors in treatment. Copyright © 2017 Elsevier Ireland Ltd. All rights reserved.

  9. Gender incongruence: a comparative study using ICD-10 and DSM-5 diagnostic criteria.

    Science.gov (United States)

    Soll, Bianca M; Robles-García, Rebeca; Brandelli-Costa, Angelo; Mori, Daniel; Mueller, Andressa; Vaitses-Fontanari, Anna M; Cardoso-da-Silva, Dhiordan; Schwarz, Karine; Abel-Schneider, Maiko; Saadeh, Alexandre; Lobato, Maria-Inês-Rodrigues

    2017-10-02

    To compare the presence of criteria listed in the DSM-5 and ICD-10 diagnostic manuals in a Brazilian sample of transgender persons seeking health services specifically for physical transition. This multicenter cross-sectional study included a sample of 103 subjects who sought services for gender identity disorder in two main reference centers in Brazil. The method involved a structured interview encompassing the diagnostic criteria in the two manuals. The results revealed that despite theoretical disagreement about the criteria, the manuals overlap regarding diagnosis confirmation; the DSM-5 was more inclusive (97.1%) than the ICD-10 (93.2%) in this population. Although there is no consensus on diagnostic criteria on transgenderism in the diversity of social and cultural contexts, more comprehensive diagnostic criteria are evolving due to society's increasing inclusivity.

  10. Pediatric restless legs syndrome diagnostic criteria: an update by the International Restless Legs Syndrome Study Group.

    Science.gov (United States)

    Picchietti, Daniel L; Bruni, Oliviero; de Weerd, Al; Durmer, Jeffrey S; Kotagal, Suresh; Owens, Judith A; Simakajornboon, Narong

    2013-12-01

    Specific diagnostic criteria for pediatric restless legs syndrome (RLS) were published in 2003 following a workshop at the National Institutes of Health. Due to substantial new research and revision of the adult RLS diagnostic criteria, a task force was chosen by the International Restless Legs Syndrome Study Group (IRLSSG) to consider updates to the pediatric diagnostic criteria. A committee of seven pediatric RLS experts developed a set of 15 consensus questions to review, conducted a comprehensive literature search, and extensively discussed potential revisions. The committee recommendations were approved by the IRLSSG executive committee and reviewed by the IRLSSG membership. The pediatric RLS diagnostic criteria were simplified and integrated with the newly revised adult RLS criteria. Specific recommendations were developed for pediatric application of the criteria, including consideration of typical words used by children to describe their symptoms. Pediatric aspects of differential diagnosis, comorbidity, and clinical significance were then defined. In addition, the research criteria for probable and possible pediatric RLS were updated and criteria for a related condition, periodic limb movement disorder (PLMD), were clarified. Revised diagnostic criteria for pediatric RLS have been developed, which are intended to improve clinical practice and promote further research. Copyright © 2013 The Authors. Published by Elsevier B.V. All rights reserved.

  11. Diagnostic criteria for gestational diabetes mellitus (WS 331-2011)

    Institute of Scientific and Technical Information of China (English)

    Medical Service Specialty Standard Committee of Mi

    2012-01-01

    The criteria provide the screening and diagnosis for gestational diabetes mellitus and it should be applied to all medical institutions and health care practitioners for gestational diabetes mellitus (DM) diagnosis in China.

  12. Cardiac-disease-induced PTSD (CDI-PTSD): A systematic review.

    Science.gov (United States)

    Vilchinsky, Noa; Ginzburg, Karni; Fait, Keren; Foa, Edna B

    2017-07-01

    The goal of the current systematic review was to provide an overview of the findings in the field of Cardiac-Disease-Induced Posttraumatic Stress Disorder (CDI-PTSD) in order to establish CDI-PTSD as a valid diagnostic entity for a wide spectrum of cardiac diseases and related medical procedures. In accordance with PRISMA guidelines, we conducted a systematic electronic literature search. Of the 3202 citations identified, 150 studies meeting the selection criteria were reviewed. Our main findings were that the prevalence of CDI-PTSD ranged between 0% and 38% (averaging at 12%) and was highly dependent on the assessment tool used. The most consistent risk factors are of a psychological nature (e.g., pre-morbid distress). The consequences of CDI-PTSD range from psychosocial difficulties to lack of adherence and heightened mortality rates. Much inconsistency in the field was found with regard to patients who present with diagnoses other than acute coronary syndrome (e.g., cardiac arrest) and who undergo potentially traumatic medical procedures (e.g., defibrillator implantation). Yet the current review seems to strengthen the conceptualization of CDI-PTSD as a valid diagnostic entity, at least with regard to acute cardiac events. Copyright © 2017 Elsevier Ltd. All rights reserved.

  13. PTSD: National Center for PTSD

    Medline Plus

    Full Text Available ... Section: Prescribing for PTSD, Know Your Options . × What is PTSD? Right Click here to download "What is PTSD?" (30.5 MB) Close × PTSD Treatment: Know ... Help page. Date this content was last updated is at the bottom of the page. Share this ...

  14. PTSD: National Center for PTSD

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    Full Text Available ... here to download "What is PTSD?" (30.5 MB) Close × PTSD Treatment: Know Your Options Right Click ... download "PTSD Treatment: Know Your Options" (29.5 MB) Close × Cognitive Processing Therapy for PTSD Right Click ...

  15. Primary Sjögren's syndrome: oral aspects on pathogenesis, diagnostic criteria, clinical features and approaches for therapy

    DEFF Research Database (Denmark)

    Pedersen, A.M.; Nauntofte, Birgitte

    2001-01-01

    diagnostic criteria, labial salivary gland histopathology, primary Sjögren's syndrome, salivary gland function, therapy, xerostomia......diagnostic criteria, labial salivary gland histopathology, primary Sjögren's syndrome, salivary gland function, therapy, xerostomia...

  16. A Pilot Study on Modeling of Diagnostic Criteria Using OWL and SWRL.

    Science.gov (United States)

    Hong, Na; Jiang, Guoqian; Pathak, Jyotishiman; Chute, Christopher G

    2015-01-01

    The objective of this study is to describe our efforts in a pilot study on modeling diagnostic criteria using a Semantic Web-based approach. We reused the basic framework of the ICD-11 content model and refined it into an operational model in the Web Ontology Language (OWL). The refinement is based on a bottom-up analysis method, in which we analyzed data elements (including value sets) in a collection (n=20) of randomly selected diagnostic criteria. We also performed a case study to formalize rule logic in the diagnostic criteria of metabolic syndrome using the Semantic Web Rule Language (SWRL). The results demonstrated that it is feasible to use OWL and SWRL to formalize the diagnostic criteria knowledge, and to execute the rules through reasoning.

  17. CLASSIFICATION OF TEMPOROMANDIBULAR-JOINT OSTEOARTHROSIS AND INTERNAL DERANGEMENT .2. SPECIFIC DIAGNOSTIC-CRITERIA

    NARCIS (Netherlands)

    STEGENGA, B; DEBONT, LGM; BOERING, G

    1992-01-01

    Separate entities of temporomandibular joint osteoarthrosis and internal derangement are operationally defined. Criteria are based on an analysis of the diagnostic significance of symptoms and signs, principles of synovial joint pathology in general, and on therapeutic considerations. The primary go

  18. Training in Structured Diagnostic Assessment Using DSM-IV Criteria

    Science.gov (United States)

    Ponniah, Kathryn; Weissman, Myrna M.; Bledsoe, Sarah E.; Verdeli, Helen; Gameroff, Marc J.; Mufson, Laura; Fitterling, Heidi; Wickramaratne, Priya

    2011-01-01

    Objectives: Determining a patient's psychiatric diagnosis is an important first step for the selection of empirically supported treatments and a critical component of evidence-based practice. Structured diagnostic assessment covers the range of psychiatric diagnoses and is usually more complete and accurate than unstructured assessment. Method: We…

  19. Training in Structured Diagnostic Assessment Using DSM-IV Criteria

    Science.gov (United States)

    Ponniah, Kathryn; Weissman, Myrna M.; Bledsoe, Sarah E.; Verdeli, Helen; Gameroff, Marc J.; Mufson, Laura; Fitterling, Heidi; Wickramaratne, Priya

    2011-01-01

    Objectives: Determining a patient's psychiatric diagnosis is an important first step for the selection of empirically supported treatments and a critical component of evidence-based practice. Structured diagnostic assessment covers the range of psychiatric diagnoses and is usually more complete and accurate than unstructured assessment. Method: We…

  20. Evolution of diagnostic criteria for gestational diabetes mellitus

    DEFF Research Database (Denmark)

    Houshmand, Azadeh; Jensen, Dorte Møller; Mathiesen, Elisabeth R

    2013-01-01

    The establishment of universal diagnostic guidelines for gestational diabetes mellitus has been a long time coming. The lack of consensus and uniformity in procedures for diagnosing this disease has been a problem ever since its existence was recognized. The USA, European countries, and Australia...

  1. Normative warrant in diagnostic criteria: the case of DSM-IV-TR personality disorders.

    Science.gov (United States)

    Sadler, John Z; Fulford, Bill

    2006-04-01

    This article focuses on the kinds of evaluative judgments made when applying DSM-IV-TR diagnostic criteria within the diagnostic interview between clinician and patient. The authors name these kinds of value judgments in diagnosis "normative warrant" because they involve one or more justifications (warrants) for standard-bearing (normative) elements involved in applying diagnostic criteria to actual patients. Seven types of normative warrant judgments are described (Type 1, Semantic-Phenomenal Matching; Type 2, Solicitation Choice; Type 3, Sociocultural Context; Type 4, Performance-Context Matching; Type 5, Deviance Threshold; Type 6, Threshold Characterization; Type 7, Disvalue characterization) and the typology is illustrated by applying it to various DSM-IV-TR personality disorder criteria. A research and clinical understanding of normative warrant may well contribute to the refinement of criteria sets as well as the refinement of the clinical use of criteria sets.

  2. EULAR points to consider in the development of classification and diagnostic criteria in systemic vasculitis

    DEFF Research Database (Denmark)

    Basu, Neil; Watts, Richard; Bajema, Ingeborg;

    2010-01-01

    The systemic vasculitides are multiorgan diseases where early diagnosis and treatment can significantly improve outcomes. Robust nomenclature reduces diagnostic delay. However, key aspects of current nomenclature are widely perceived to be out of date, these include disease definitions, classific......, classification and diagnostic criteria. Therefore, the aim of the present work was to identify deficiencies and provide contemporary points to consider for the development of future definitions and criteria in systemic vasculitis....

  3. Cognitive therapy of trauma related guilt in patients with PTSD

    Directory of Open Access Journals (Sweden)

    Popiel, Agnieszka

    2014-06-01

    Full Text Available Various aspects of guilt are frequent problems of patients suffering from PTSD, though they have been included into the diagnostic criteria for PTSD just in the present version DSM-5. Some studies indicate limitation of effectiveness of exposure therapy in PTSD patients with predominant emotions of anger or guilt. The aim of this paper is to present cognitive conceptualization of guilt in PTSD proposed by Kubany, and a treatment protocol resulting from this conceptualization. The clinical application of the protocol is illustrated with preliminary results of systematic observation of 8 patients with moderate to severe PTSD who were treated with cognitive therapy for guilt followed by a standard prolonged exposure protocol. The cognitive therapy of guilt can be a valuable supplement for treatment of PTSD. This protocol can also be an inspiration for therapists working with patients with dysfunctional guilt as a problem in other than PTSD disorders – like depression or adjustment disorders. In discussion the place of guilt in treatment according to different (PE-Foa et al.; CPT-Resick et al.; CT-Ehlers and Clark trauma focused therapy approaches is addressed, and the need for further studies is underlined.

  4. Fetal alcohol syndrome – causes, diagnostic criteria and prevalence

    Directory of Open Access Journals (Sweden)

    Agata Horecka-Lewitowicz

    2014-04-01

    Full Text Available Fetal alcohol syndrome (FAS is the outcome of alcohol exposition in the prenatal period. It is irreversible. In Poland, FAS is becoming more and more common, the diagnostic tools are limited though. It is recommended to use the 4-Digit Diagnostic Code, which evaluates the 4 basic FAS symptoms: growth retardation, dysmorphic appearance, damage to the central nervous system and prenatal alcohol exposure. It has been confirmed that there is no safe amount of alcohol for a mother to drink while carrying a baby. To put it another way, only a complete lack of alcohol consumption is a guarantee that the baby will not suffer from FAS. It is necessary for society to know that even the smallest amount of alcohol is bad for the foetus. A number of people still believe that, for example, red wine is good and healthy for both the mother and child.

  5. Painful diabetic neuropathies, cases report and diagnostic criteria

    OpenAIRE

    Marco Lacerenza

    2006-01-01

    Painful diabetic neuropathy is a model for the investigation of drug’s efficacy in neuropathic pain. Diabetes, through multiple pathophysiological mechanisms causes several painful neuropathies. In this paper two clinical cases of painful diabetic neuropathic conditions are described and clinical and neurophysiological criteria to make the correct diagnosis are examined. Diabetes causes different painful diabetic neuropathies, at times even in a single patient. Different types of pai...

  6. Standards and standardization in mastocytosis: Consensus statements on diagnostics, treatment recommendations and response criteria

    NARCIS (Netherlands)

    Valent, P.; Akin, C.; Escribano, L.; Fodinger, M.; Hartmann, K.; Brockow, K.; Castells, M.; Sperr, W.R.; Kluin-Nelemans, Hanneke; Hamdy, N.A.T.; Lortholary, O.; Robyn, J.; van Doormaal, J.; Sotlar, K.; Hauswirth, A.W.; Arock, M.; Hermine, O.; Hellmann, A.; Triggiani, M.; Niedoszytko, M.; Schwartz, L.B.; Orfao, A.; Horny, H.P.; Metcalfe, D.D.

    2007-01-01

    Although a classification for mastocytosis and diagnostic criteria are available, there remains a need to define standards for the application of diagnostic tests, clinical evaluations, and treatment responses. To address these demands, leading experts discussed current issues and standards in masto

  7. Standards and standardization in mastocytosis : Consensus statements on diagnostics, treatment recommendations and response criteria

    NARCIS (Netherlands)

    Valent, P.; Akin, C.; Escribano, L.; Foedinger, M.; Hartmann, K.; Brockow, K.; Castells, M.; Sperr, W. R.; Kluin-Nelemans, H. C.; Hamdy, N. A. T.; Lortholary, O.; Robyn, J.; van Doormaal, J.; Sotlar, K.; Hauswirth, A. W.; Arock, M.; Hermine, O.; Hellmann, A.; Triggiani, M.; Niedoszytko, M.; Schwartz, L. B.; Orfao, A.; Horny, H.-P.; Metcalfe, D. D.

    2007-01-01

    Although a classification for mastocytosis and diagnostic criteria are available, there remains a need to define standards for the application of diagnostic tests, clinical evaluations, and treatment responses. To address these demands, leading experts discussed current issues and standards in masto

  8. Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) for Clinical and Research Applications

    DEFF Research Database (Denmark)

    Schiffman, Eric; Ohrbach, Richard; Truelove, Edmond

    2014-01-01

    AIMS: The original Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) Axis I diagnostic algorithms have been demonstrated to be reliable. However, the Validation Project determined that the RDC/TMD Axis I validity was below the target sensitivity of ≥ 0.70 and specificity of ≥...

  9. Diagnostic criteria for mild cognitive impairment in Parkinson's disease: Movement Disorder Society Task Force guidelines

    NARCIS (Netherlands)

    Litvan, I.; Goldman, J.G.; Tröster, A.I.; Schmand, B.A.; Weintraub, D.; Petersen, R.C.; Mollenhauer, B.; Adler, C.H.; Marder, K.; Williams-Gray, C.H.; Aarsland, D.; Kulisevsky, J.; Rodriguez-Oroz, M.C.; Burn, D.J.; Barker, R.A.; Emre, M.

    2012-01-01

    Mild cognitive impairment is common in nondemented Parkinson's disease (PD) patients and may be a harbinger of dementia. In view of its importance, the Movement Disorder Society commissioned a task force to delineate diagnostic criteria for mild cognitive impairment in PD. The proposed diagnostic cr

  10. Diagnostic accuracy of the Salzburg EEG criteria for non-convulsive status epilepticus

    DEFF Research Database (Denmark)

    Leitinger, Markus; Trinka, Eugen; Gardella, Elena

    2016-01-01

    Background Several EEG criteria have been proposed for diagnosis of non-convulsive status epilepticus (NCSE), but none have been clinically validated. We aimed to assess the diagnostic accuracy of the EEG criteria proposed by a panel of experts at the fourth London–Innsbruck Colloquium on Status...

  11. Comparative Capabilities of Clinical Assessment, Diagnostic Criteria, and Polysomnography in Detecting Sleep Bruxism

    Science.gov (United States)

    Palinkas, Marcelo; De Luca Canto, Graziela; Rodrigues, Laíse Angélica Mendes; Bataglion, César; Siéssere, Selma; Semprini, Marisa; Regalo, Simone Cecilio Hallak

    2015-01-01

    Objective: To evaluate the diagnostic capability of signs and symptoms of sleep bruxism (SB) as per the American Academy of Sleep Medicine (AASM) criteria and a diagnostic grading system proposed by international experts for assessing SB. Methods: The study was conducted in three phases (interview, physical examination, and sleep studies). Subjects were asked about self-reported tooth grinding sounds occurring during sleep, muscle fatigue, temporal headaches, jaw muscle pain, and jaw locking. A visual examination was conducted to check for presence of abnormal tooth wear. A full-night polysomnography (PSG) was performed. After three phases, the subjects were divided into two groups matched by age and gender: Case Group, 45 SB subjects, and Control Group, 45 non-SB subjects. Diagnostic accuracy measurements were calculated for each sign or symptom individually and for the two diagnostic criteria analyzed. Results: Muscle fatigue, temporal headaches, and AASM criteria were associated with highest sensitivity (78%, 67%, 58%, respectively) and also with highest diagnostic odds ratio (OR = 9.63, 9.25, 6.33, respectively). Jaw locking, muscle pain, and the criterion of “probable SB” were associated with the worst sensitivity (16%, 18%, 22%, respectively). Conclusions: Presence of muscle fatigue and temporal headaches can be considered good tools to screen SB patients. None of the diagnostic criteria evaluated was able to accurately identify patients with SB. AASM criteria had the strongest diagnostic capabilities and—although they do not attain diagnostic values high enough to replace the current gold standard (PSG)—should be used as a screening tool to identify SB. Citation: Palinkas M, De Luca Canto G, Rodrigues LA, Bataglion C, Siéssere S, Semprini M, Regalo SC. Comparative capabilities of clinical assessment, diagnostic criteria, and polysomnography in detecting sleep bruxism. J Clin Sleep Med 2015;11(11):1319–1325. PMID:26235152

  12. Applicability of the ICD-11 proposal for PTSD: a comparison of prevalence and comorbidity rates with the DSM-IV PTSD classification in two post-conflict samples.

    Science.gov (United States)

    Stammel, Nadine; Abbing, Eva M; Heeke, Carina; Knaevelsrud, Christine

    2015-01-01

    The World Health Organization recently proposed significant changes to the posttraumatic stress disorder (PTSD) diagnostic criteria in the 11th edition of the International Classification of Diseases (ICD-11). The present study investigated the impact of these changes in two different post-conflict samples. Prevalence and rates of concurrent depression and anxiety, socio-demographic characteristics, and indicators of clinical severity according to ICD-11 in 1,075 Cambodian and 453 Colombian civilians exposed to civil war and genocide were compared to those according to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV). Results indicated significantly lower prevalence rates under the ICD-11 proposal (8.1% Cambodian sample and 44.4% Colombian sample) compared to the DSM-IV (11.2% Cambodian sample and 55.0% Colombian sample). Participants meeting a PTSD diagnosis only under the ICD-11 proposal had significantly lower rates of concurrent depression and a lower concurrent total score (depression and anxiety) compared to participants meeting only DSM-IV diagnostic criteria. There were no significant differences in socio-demographic characteristics and indicators of clinical severity between these two groups. The lower prevalence of PTSD according to the ICD-11 proposal in our samples of persons exposed to a high number of traumatic events may counter criticism of previous PTSD classifications to overuse the PTSD diagnosis in populations exposed to extreme stressors. Also another goal, to better distinguish PTSD from comorbid disorders could be supported with our data.

  13. Painful diabetic neuropathies, cases report and diagnostic criteria

    Directory of Open Access Journals (Sweden)

    Marco Lacerenza

    2006-12-01

    Full Text Available Painful diabetic neuropathy is a model for the investigation of drug’s efficacy in neuropathic pain. Diabetes, through multiple pathophysiological mechanisms causes several painful neuropathies. In this paper two clinical cases of painful diabetic neuropathic conditions are described and clinical and neurophysiological criteria to make the correct diagnosis are examined. Diabetes causes different painful diabetic neuropathies, at times even in a single patient. Different types of pains may originate from different nerve injuries, and harbour different pathophysiological mechanisms. A comprehensive and accurate evaluation of clinical and neurophysiological abnormalities in painful diabetic neuropathies provides insight on the pathophysiological mechanism and directs the clinician towards rational treatment strategies.

  14. European guidelines on quality criteria for diagnostic images

    Energy Technology Data Exchange (ETDEWEB)

    Blanc, D

    1998-03-01

    The quality control has an important part in hospitals services using ionizing radiations. This report deals with the radiation protection of patients, the aim being to reduce the exposure, as much as possible, insofar as the information stays optimal, considering the fact that, this time, children are concerned. Quality criteria are defined for different age groups: new-born, babies, five years old children, ten years old children. For every kind of examination are examined the characteristics allowing to give the maximal protection to the young patient. (N.C.)

  15. Internet gaming disorder: Inadequate diagnostic criteria wrapped in a constraining conceptual model.

    Science.gov (United States)

    Starcevic, Vladan

    2017-03-17

    Background and aims The paper "Chaos and confusion in DSM-5 diagnosis of Internet Gaming Disorder: Issues, concerns, and recommendations for clarity in the field" by Kuss, Griffiths, and Pontes (in press) critically examines the DSM-5 diagnostic criteria for Internet gaming disorder (IGD) and addresses the issue of whether IGD should be reconceptualized as gaming disorder, regardless of whether video games are played online or offline. This commentary provides additional critical perspectives on the concept of IGD. Methods The focus of this commentary is on the addiction model on which the concept of IGD is based, the nature of the DSM-5 criteria for IGD, and the inclusion of withdrawal symptoms and tolerance as the diagnostic criteria for IGD. Results The addiction framework on which the DSM-5 concept of IGD is based is not without problems and represents only one of multiple theoretical approaches to problematic gaming. The polythetic, non-hierarchical DSM-5 diagnostic criteria for IGD make the concept of IGD unacceptably heterogeneous. There is no support for maintaining withdrawal symptoms and tolerance as the diagnostic criteria for IGD without their substantial revision. Conclusions The addiction model of IGD is constraining and does not contribute to a better understanding of the various patterns of problematic gaming. The corresponding diagnostic criteria need a thorough overhaul, which should be based on a model of problematic gaming that can accommodate its disparate aspects.

  16. The Primary Care PTSD Screen for DSM-5 (PC-PTSD-5): Development and Evaluation Within a Veteran Primary Care Sample.

    Science.gov (United States)

    Prins, Annabel; Bovin, Michelle J; Smolenski, Derek J; Marx, Brian P; Kimerling, Rachel; Jenkins-Guarnieri, Michael A; Kaloupek, Danny G; Schnurr, Paula P; Kaiser, Anica Pless; Leyva, Yani E; Tiet, Quyen Q

    2016-10-01

    Posttraumatic Stress Disorder (PTSD) is associated with increased health care utilization, medical morbidity, and tobacco and alcohol use. Consequently, screening for PTSD has become increasingly common in primary care clinics, especially in Veteran healthcare settings where trauma exposure among patients is common. The objective of this study was to revise the Primary Care PTSD screen (PC-PTSD) to reflect the new Diagnostic and Statistical Manual of Mental Disorders (DSM-5) criteria for PTSD (PC-PTSD-5) and to examine both the diagnostic accuracy and the patient acceptability of the revised measure. We compared the PC-PTSD-5 results with those from a brief psychiatric interview for PTSD. Participants also rated screening preferences and acceptability of the PC-PTSD-5. A convenience sample of 398 Veterans participated in the study (response rate = 41 %). Most of the participants were male, in their 60s, and the majority identified as non-Hispanic White. The PC-PTSD-5 was used as the screening measure, a modified version of the PTSD module of the MINI-International Neuropsychiatric Interview was used to diagnose DSM-5 PTSD, and five brief survey items were used to assess acceptability and preferences. The PC-PTSD-5 demonstrated excellent diagnostic accuracy (AUC = 0.941; 95 % C.I.: 0.912- 0.969). Whereas a cut score of 3 maximized sensitivity (κ[1]) = 0.93; SE = .041; 95 % C.I.: 0.849-1.00), a cut score of 4 maximized efficiency (κ[0.5] = 0.63; SE = 0.052; 95 % C.I.: 0.527-0.731), and a cut score of 5 maximized specificity (κ[0] = 0.70; SE = 0.077; 95 % C.I.: 0.550-0.853). Patients found the screen acceptable and indicated a preference for administration by their primary care providers as opposed to by other providers or via self-report. The PC-PTSD-5 demonstrated strong preliminary results for diagnostic accuracy, and was broadly acceptable to patients.

  17. Clinical comparison of human and canine atopic dermatitis using human diagnostic criteria (Japanese Dermatological Association, 2009): proposal of provisional diagnostic criteria for canine atopic dermatitis.

    Science.gov (United States)

    Terada, Yuri; Nagata, Masahiko; Murayama, Nobuo; Nanko, Hiroko; Furue, Masutaka

    2011-08-01

    Atopic dermatitis (AD) is a common skin disease encountered in both humans and dogs. Canine AD can be used in the analysis of naturally occurring AD; however, details of clinical comparison have been lacking. The purpose of this study is to compare those clinical features using the human diagnostic criteria (Japanese Dermatological Association, 2009). Fifty-one dogs with canine AD were evaluated by the human criteria. Prior to this study, canine AD was basically diagnosed by the fulfillment of two authentic canine AD criteria and a positive reaction against Dermatophagoides farinae in serum immunoglobulin E levels and/or in intradermal tests. Among the human AD criteria items, behavior corresponding to pruritus was observed in all 51 dogs. Skin lesions corresponding to eczematous dermatitis were seen in 50 dogs, and symmetrical distribution of skin lesions was noted in all 51 dogs. A chronic or chronically relapsing course was observed in 50 dogs. Based on these results, the concordance rate for the criteria was 96% (49/51). Differential diagnoses of AD were also investigated in the same manner. The concordance rate for the criteria was 0% (0/69) in scabies, 2% (1/50) in pyoderma, 0% (0/50) in demodicosis, 0% (0/9) in cutaneous lymphoma, 0% (0/2) in ichthyosis, 25% (2/7) in flea allergy, 48% (24/50) in seborrheic dermatitis and 75% (3/4) in food allergy. Canine AD is thus indicated as a valuable counterpart to human AD in clinical aspects. In addition, the human AD criteria could be applicable, with some modification, as provisional diagnostic criteria for canine AD.

  18. Sensitivity of revised diagnostic criteria for the behavioural variant of frontotemporal dementia.

    Science.gov (United States)

    Rascovsky, Katya; Hodges, John R; Knopman, David; Mendez, Mario F; Kramer, Joel H; Neuhaus, John; van Swieten, John C; Seelaar, Harro; Dopper, Elise G P; Onyike, Chiadi U; Hillis, Argye E; Josephs, Keith A; Boeve, Bradley F; Kertesz, Andrew; Seeley, William W; Rankin, Katherine P; Johnson, Julene K; Gorno-Tempini, Maria-Luisa; Rosen, Howard; Prioleau-Latham, Caroline E; Lee, Albert; Kipps, Christopher M; Lillo, Patricia; Piguet, Olivier; Rohrer, Jonathan D; Rossor, Martin N; Warren, Jason D; Fox, Nick C; Galasko, Douglas; Salmon, David P; Black, Sandra E; Mesulam, Marsel; Weintraub, Sandra; Dickerson, Brad C; Diehl-Schmid, Janine; Pasquier, Florence; Deramecourt, Vincent; Lebert, Florence; Pijnenburg, Yolande; Chow, Tiffany W; Manes, Facundo; Grafman, Jordan; Cappa, Stefano F; Freedman, Morris; Grossman, Murray; Miller, Bruce L

    2011-09-01

    and most had atypical presentations with marked memory impairment. In conclusion, the revised criteria for behavioural variant frontotemporal dementia improve diagnostic accuracy compared with previously established criteria in a sample with known frontotemporal lobar degeneration. Greater sensitivity of the proposed criteria may reflect the optimized diagnostic features, less restrictive exclusion features and a flexible structure that accommodates different initial clinical presentations. Future studies will be needed to establish the reliability and specificity of these revised diagnostic guidelines.

  19. Dynamic light scattering in veterinary medicine: refinement of diagnostic criteria

    Science.gov (United States)

    Dubin, Stephen; Zietz, Stanley; Gabriel, Karl L.; Gabriel, David; DellaVecchia, Michael A.; Ansari, Rafat R.

    2001-05-01

    In dynamic light scattering (DLS), the structure or material of interest, suspended in a fluid, is illuminated by a beam of laser light and the scattered light is interpreted in terms of diffusion coefficient, particle size or its distribution. DLS has shown clear promise as a non-invasive, objective and precise diagnostic modality for investigation of lens opacity (cataract) and other medical and toxicological problems. The clinical potential of LDS has been demonstrated in several species both in vivo and in vitro. In many clinical cases, discernment between normal and diseased patients is possible by simple inspection of the particle size distribution. However a more rigorous and sensitive classification scheme is needed, particularly for evaluation of therapy and estimation of tissue injury. The data supplied by DLS investigation is inherently multivariate and its most efficient interpretation requires a multivariate approach which includes the variability among specimens as well as any correlation among the variables (e.g. across the particle size distribution). We present a brief review of DLS methodology, illustrative data and our efforts toward a diagnostic classification scheme. In particular we will describe application of the Mahalanobis distance and related statistical methods to DLS data.

  20. The clinical features of mania and their representation in modern diagnostic criteria.

    Science.gov (United States)

    Kendler, K S

    2017-04-01

    This review seeks to determine the degree to which modern operationalized diagnostic criteria for mania reflect the clinical features of mania described historically by expert textbook authors. Clinical descriptions of mania appearing in 18 textbooks published between 1899 and 1956 were reviewed and compared to the criteria for mania from six modern operationalized diagnostic systems. Twenty-two prominent symptoms and signs were reported by five or more authors. Two symptoms (elevated mood and grandiosity) and four signs (hyperactivity, pressured speech, irritability, and new activities with painful consequences) were reported by every author. A strong relationship was seen between the frequency with which the clinical features were reported and the likelihood of their inclusion in modern diagnostic systems. However, many symptoms and signs including impulsivity, hypersexuality, mood lability, altered moral standards, increased humor, hypergraphia, and a vigorous physical appearance were not included in any modern criteria. Indeed, DSM-5 contains only eight of the historically noted clinical features. We conclude that modern operationalized criteria for mania well reflect symptoms and signs frequently reported by historical experts. This suggests that the clinical construct of mania has been relatively stable in western Psychiatry since the turn of the 20th century. However, many useful clinical features of mania described in these textbooks are missing from these criteria thereby illustrating the limitations of clinical evaluations restricted to the assessment of only current diagnostic criteria. The disorders we study and treat are considerably richer clinically than is reflected in the DSM criteria which we use to diagnose them.

  1. Empirical evaluation of the accuracy of diagnostic criteria for Restless Legs Syndrome.

    Science.gov (United States)

    Benes, Heike; von Eye, Alexander; Kohnen, Ralf

    2009-05-01

    In accordance with the diagnostic criteria of the International Restless Legs Syndrome (RLS) Study Group, the diagnosis of RLS is exclusively based on subjective information. Patients must report an urge to move the legs (and arms) with or without unpleasant sensations which is engendered by rest, relieved by movement, and worse in the evening or at night than during the day (essential criteria). Objective information such as excessive periodic leg movements, positive response to dopaminergic medication, family history of RLS or findings of a neurological examination cannot substitute any of the essential criteria but are considered both supportive for the RLS diagnosis and important for decisions on differential diagnoses. In this article, we report a systematic empirical analysis of the accuracy of diagnostic decisions based on all diagnostic criteria being either "essential" or "non-essential." We re-analyzed data from a validation study for the RLS Diagnostic Index, in which ten items related to diagnostic criteria were compared with an expert diagnosis of RLS (n = 86) and other sleep-related diagnoses (n = 93). The value of individual diagnostic criteria and features of RLS predictive of the expert diagnoses were analyzed with logistic regression models by increasing the set of diagnostic criteria stepwise based on delta-chi(2) tests. The essential diagnostic criteria share a large amount of variance in the prediction of the expert diagnosis. Three of the four essential criteria (urge to move the legs, which is engendered by rest and worse in the evening) almost completely determine the expert diagnosis. However, adding response to dopaminergic medication to the set of the essential criteria increased the effect size in the logistic regression model from 69.4% to 88.4%, indicating a relevant improvement of the accuracy in supporting or excluding the diagnosis of RLS. On the basis of our exploratory empirical analysis we conclude that the accuracy of diagnostic

  2. Pupil Response to Threat in Trauma-Exposed Individuals With or Without PTSD.

    Science.gov (United States)

    Cascardi, Michele; Armstrong, Davine; Chung, Leeyup; Paré, Denis

    2015-08-01

    An infrequently studied and potentially promising physiological marker for posttraumatic stress disorder (PTSD) is pupil response. This study tested the hypothesis that pupil responses to threat would be significantly larger in trauma-exposed individuals with PTSD compared to those without PTSD. Eye-tracking technology was used to evaluate pupil response to threatening and neutral images. Recruited for participation were 40 trauma-exposed individuals; 40.0% (n = 16) met diagnostic criteria for PTSD. Individuals with PTSD showed significantly more pupil dilation to threat-relevant stimuli compared to the neutral elements (Cohen's d = 0.76), and to trauma-exposed controls (Cohen's d = 0.75). Pupil dilation significantly accounted for 12% of variability in PTSD after time elapsed since most recent trauma, cumulative violence exposure, and trait anxiety were statistically adjusted. The final logistic regression model was associated with 85% of variability in PTSD status and correctly classified 93.8% of individuals with PTSD and 95.8% of those without. Pupil reactivity showed promise as a physiological marker for PTSD.

  3. [State of the art diagnostic criteria of severe periodontitis].

    Science.gov (United States)

    Ouyang, X Y

    2017-02-09

    Periodontitis could be categorized as mild, moderate, and severe according to the severity of the disease. This categorizing system could also be used together with other classification systems. The present article introduced the status about the case definition of severe periodontitis, including the standard of case definitions for surveillance of periodontitis reported by the Centers for Disease Control and Prevention (CDC) in partnership with the American Academy of Periodontology (AAP) and the consensus report on the definition of periodontitis case for use in risk factor research by Europe workshop. A consensus on the state of the art definition of severe periodontitis for use in clinical work was gained base on the expertise of Chinese Society of Periodontology, Chinese Association of Stomatology. The background of this consensus and the significance of the criteria for the case definition were discussed.

  4. Post-load hyperglycaemia and diagnostic criteria for diabetes

    Institute of Scientific and Technical Information of China (English)

    Qing Qiao

    2008-01-01

    The evolution of 2 h post-load glucose tolerance test for diagnosis of diabetes and its clinical implication was reviewed and discussed.Post-load hyperglycemia is a risk factor for both micro-and macro-vascular diseases.According to its relationship with retinopathy,the current cut-off values for diabetes was defined since 1979.Recently,strong evidence has shown that post-load hyperglycemia is also an important risk factor for cardiovascular disease(CVD),the relation is linear and no a threshold was found.There are large discrepancies between fasting and 2 h glucose criteria in the classification of diabetes and impaired glucose tolerance(IGT)/impaired fasting glucose(IFG).For early diagnosis and intervention administrating a 2 h OGTT to suspect individuals is necessary.

  5. How should we revise diagnostic criteria for substance use disorders in the DSM-V?

    Science.gov (United States)

    Martin, Christopher S; Chung, Tammy; Langenbucher, James W

    2008-08-01

    This article reviews literature on the validity and performance characteristics of the Diagnostic and Statistical Manual of Mental Disorders (4th ed.; DSM-IV; American Psychiatric Association, 1994) diagnostic criteria for substance use disorders (SUDs) and recommends changes in these criteria that should be considered for the next edition of the DSM (DSM-V). Substantial data indicate that DSM-IV substance abuse and substance dependence are not distinct categories and that SUD criteria are best modeled as reflecting a unidimensional continuum of substance-problem severity. The conceptually and empirically problematic substance abuse diagnosis should be abandoned in the DSM-V, with substance dependence defined by a single set of criteria. Data also indicate that various individual SUD criteria should be revised, dropped, or considered for inclusion in the DSM-V. The DSM-V should provide a framework that allows the integration of categorical and dimensional approaches to diagnosis. Important areas for further research are noted.

  6. PTSD: National Center for PTSD

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    Full Text Available ... not provide direct clinical care, individual referrals or benefits information. For help please see: Where to Get ... PTSD or Get Help with VA PTSD Care, Benefits, or Claims For Web site help: Web Policies ...

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    Full Text Available ... Women Types of Trauma War Terrorism Violence and Abuse Disasters Is it PTSD? Treatment and Coping Treatment ... Mental Health Mental Health Home Suicide Prevention Substance Abuse Military Sexual Trauma PTSD Research (MIRECC) Military Exposures ...

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  19. PTSD: National Center for PTSD

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  1. PTSD: National Center for PTSD

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  7. Clinical and research diagnostic criteria for developmental coordination disorder: a review and discussion.

    Science.gov (United States)

    Gueze, R H; Jongmans, M J; Schoemaker, M M; Smits-Engelsman, B C

    2001-03-01

    The aim of this review was to investigate the selection criteria used in the past in studies of children with developmental motor problems (excluding those suffering from neurological dysfunctions such as cerebral palsy, muscular dystrophy, etc.). We therefore conducted an extensive analysis of 176 publications. First, an overview of the main characteristics of these studies (terminology, population, type and purpose) and the selection criteria that are reported in these publications are presented. Following this, the DSM-IV selection criteria for developmental coordination disorder (DCD) are contrasted with the selection criteria reported in 41 publications that have used this terminology to classify the children. The results of this comparison show that the inclusion criteria are largely followed, albeit with little consistency concerning selection instruments and quantitative cut-offs, while adherence to the exclusion criteria is not common practice. Strengths and weaknesses of the DSM-IV criteria, complementary to the previous discussion by Henderson and Barnett in the HMS special issue on DCD in 1998 on this same topic, are discussed. The results of the review also show that many studies have used additional selection criteria related to the specific research questions of the study concerned. In the broader context of clinical practice as well as basic research, the latter result suggests the usefulness of a distinction between Clinical Diagnostic Criteria and Research Diagnostic Criteria. This distinction helps to develop a unifying view on the use of diagnostic criteria for research and clinical practice. We conclude with a number of recommendations concerning the selection criteria for children with DCD.

  8. Review of Dercum’s disease and proposal of diagnostic criteria, diagnostic methods, classification and management

    Science.gov (United States)

    2012-01-01

    Definition and clinical picture We propose the minimal definition of Dercum’s disease to be generalised overweight or obesity in combination with painful adipose tissue. The associated symptoms in Dercum’s disease include fatty deposits, easy bruisability, sleep disturbances, impaired memory, depression, difficulty concentrating, anxiety, rapid heartbeat, shortness of breath, diabetes, bloating, constipation, fatigue, weakness and joint aches. Classification We suggest that Dercum’s disease is classified into: I. Generalised diffuse form A form with diffusely widespread painful adipose tissue without clear lipomas, II. Generalised nodular form - a form with general pain in adipose tissue and intense pain in and around multiple lipomas, and III. Localised nodular form - a form with pain in and around multiple lipomas IV. Juxtaarticular form - a form with solitary deposits of excess fat for example at the medial aspect of the knee. Epidemiology Dercum’s disease most commonly appears between the ages of 35 and 50 years and is five to thirty times more common in women than in men. The prevalence of Dercum’s disease has not yet been exactly established. Aetiology Proposed, but unconfirmed aetiologies include: nervous system dysfunction, mechanical pressure on nerves, adipose tissue dysfunction and trauma. Diagnosis and diagnostic methods Diagnosis is based on clinical criteria and should be made by systematic physical examination and thorough exclusion of differential diagnoses. Advisably, the diagnosis should be made by a physician with a broad experience of patients with painful conditions and knowledge of family medicine, internal medicine or pain management. The diagnosis should only be made when the differential diagnoses have been excluded. Differential diagnosis Differential diagnoses include: fibromyalgia, lipoedema, panniculitis, endocrine disorders, primary psychiatric disorders, multiple symmetric lipomatosis, familial multiple lipomatosis, and

  9. Review of Dercum’s disease and proposal of diagnostic criteria, diagnostic methods, classification and management

    Directory of Open Access Journals (Sweden)

    Hansson Emma

    2012-04-01

    Full Text Available Abstract Definition and clinical picture We propose the minimal definition of Dercum’s disease to be generalised overweight or obesity in combination with painful adipose tissue. The associated symptoms in Dercum’s disease include fatty deposits, easy bruisability, sleep disturbances, impaired memory, depression, difficulty concentrating, anxiety, rapid heartbeat, shortness of breath, diabetes, bloating, constipation, fatigue, weakness and joint aches. Classification We suggest that Dercum’s disease is classified into: I. Generalised diffuse form A form with diffusely widespread painful adipose tissue without clear lipomas, II. Generalised nodular form - a form with general pain in adipose tissue and intense pain in and around multiple lipomas, and III. Localised nodular form - a form with pain in and around multiple lipomas IV. Juxtaarticular form - a form with solitary deposits of excess fat for example at the medial aspect of the knee. Epidemiology Dercum’s disease most commonly appears between the ages of 35 and 50 years and is five to thirty times more common in women than in men. The prevalence of Dercum’s disease has not yet been exactly established. Aetiology Proposed, but unconfirmed aetiologies include: nervous system dysfunction, mechanical pressure on nerves, adipose tissue dysfunction and trauma. Diagnosis and diagnostic methods Diagnosis is based on clinical criteria and should be made by systematic physical examination and thorough exclusion of differential diagnoses. Advisably, the diagnosis should be made by a physician with a broad experience of patients with painful conditions and knowledge of family medicine, internal medicine or pain management. The diagnosis should only be made when the differential diagnoses have been excluded. Differential diagnosis Differential diagnoses include: fibromyalgia, lipoedema, panniculitis, endocrine disorders, primary psychiatric disorders, multiple symmetric lipomatosis, familial

  10. Paroxysmal sympathetic hyperactivity after acquired brain injury: consensus on conceptual definition, nomenclature, and diagnostic criteria.

    Science.gov (United States)

    Baguley, Ian J; Perkes, Iain E; Fernandez-Ortega, Juan-Francisco; Rabinstein, Alejandro A; Dolce, Giuliano; Hendricks, Henk T

    2014-09-01

    A syndrome of paroxysmal, episodic sympathetic hyperactivity after acquired brain injury has been recognized for almost 60 years. This project sought to simplify the confused nomenclature for the condition (>31 eponyms) and simplify the nine overlapping sets of diagnostic criteria. A consensus-developed questionnaire based on a systematic review of the literature was circulated to a widely representative, international expert group utilizing a Delphi approach. Diagnostic criteria were dropped if group consensus failed to agree on their relative importance, with a goal of reaching a Cronbach α of 0.8 (suitable for research purposes). The resulting criteria were combined into an assessment measure for clinical and research settings. The consensus group recommend that the term "paroxysmal sympathetic hyperactivity" replace previous terms to describe the "syndrome, recognised in a subgroup of survivors of severe acquired brain injury, of simultaneous, paroxysmal transient increases in sympathetic [elevated heart rate, blood pressure, respiratory rate, temperature, sweating] and motor [posturing] activity." An 11 point probabilistic diagnostic scale was developed with reference to published criteria, yielding an acceptable Cronbach α of 0.8. These 11 items were proceduralized and combined with a symptom severity index to produce a diagnostic tool for use with adults (the paroxysmal sympathetic hyperactivity assessment measure [PSH-AM]). Development of a pediatric version of the scale and further research into the validity of the PSH-AM is recommended. The consensus position builds on previous literature to establish diagnostic definitions and criteria, an important move to standardize research and management of this condition.

  11. PTSD: National Center for PTSD

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  17. Gestational diabetes mellitus: An update on the currentinternational diagnostic criteria

    Institute of Scientific and Technical Information of China (English)

    2015-01-01

    The approach to screening and diagnosis of gestationaldiabetes mellitus (GDM) around the world is disorderly.The protocols for diagnosis vary not only in-betweencountries, but also within countries. Furthermore, in anycountry, this disparity occurs in-between its hospitalsand often exists within a single hospital. There aremany reasons for these differences. There is the lack ofan international consensus among preeminent healthorganizations (e.g. , American College of Gynecologistsand World Health Organization). Often there is adisagreement between the country's national diabetesorganization, its local health society and its regionalobstetric organization with each one recommending adifferent option for approaching GDM. Sometimes thecauses for following an alternate approach are veryobvious, e.g. , a resource strapped hospital is unable tofollow the ivory-tower demanding recommendation ofits obstetric organization. But more often than not, therationale for following or not following a guideline, orfollowing different guideline within the same geographicarea is without any perceivable explanation. This reviewis an attempt to understand the problems afflictingthe screening and diagnosis of GDM globally. It tracesthe major temporal changes in the diagnostic criteriaof (1) some respected health organizations; and (2) afew selected countries. With an understanding of thereasons for this disparity, a way forward can be foundto reach the ultimate goal a single global guideline forGDM followed worldwide.

  18. DERMOSCOPIC DIAGNOSTIC CRITERIA IN DIFFERENT MORPHOLOGICAL TYPES OF BASALIOMA

    Directory of Open Access Journals (Sweden)

    A. N. Khlebnikova

    2014-01-01

    Full Text Available Background: Basal cell carcinoma of the skin (BCC, basalioma is one of the most common malignant skin tumors. Dermoscopy is the most available today method of non-invasive diagnosis of skin tumors. Though, its usability is limited due to absence of prognostic dermoscopic criteria associated with different morphological variants of basalioma. Aim: To define dermoscopic features of different histological types of BCC. Materials and methods: 35 biopsy specimens from BCC lesions were evaluated. After clinical examination, superficial basalioma was diagnosed in 18 patients and nodular form in 17 patients. Results: Vascular structures were detected in 100% of cases. In patients with superficial multicentric type of basalioma, presence of all vascular types was a significant prognostic factor; predictive values of point- and spike-shaped vessels were 100 and 71.4%, respectively. Absence of point-shaped vessels and presence of other vascular types were associated with the prognosis of nodular basalioma. In patients with infiltrative type of basalioma, dendriform, tortuous and linear vessels in combination with short tiny teleangiectases and absence of spike-, comma-, point- or glome-like vessels had positive prognostic value. In patients with superficial multicentric and nodular types of basalioma, homogenous white and rose zones were most prevalent: in 53.8 and 57.1% of cases, respectively. In infiltrative type, this feature was typically absent (р<0,04. Conclusion: Different morphological types of basaliomas are characterized by different dermoscopic features. Vascular structures are most strongly associated with the prognosis of the disease.

  19. New diagnostic reporting format for endometrial cytology based on cytoarchitectural criteria

    Science.gov (United States)

    Yanoh, K; Norimatsu, Y; Hirai, Y; Takeshima, N; Kamimori, A; Nakamura, Y; Shimizu, K; Kobayashi, T K; Murata, T; Shiraishi, T

    2009-01-01

    Objective: The aim of this study was to develop a new reporting format for endometrial cytology that would standardize the diagnostic criteria and the terminology used for reporting. Methods: In previous studies, cytoarchitectural criteria were found to be useful for the cytological assessment of endometrial lesions. To apply these criteria, an appropriate cytological specimen is imperative. In this article, the requirements of an adequate endometrial cytological specimen for the new diagnostic criteria are first discussed. Then, the diagnostic criteria, standardized on a combination of conventional and cytoarchitectural criteria, are presented. Third, terminology that could be used, not only for reporting the histopathological diagnosis, but also for providing better guidance for the gynaecologist to determine further clinical action, is introduced. The proposed reporting format was investigated using endometrial cytology of 58 cases that were cytologically underestimated or overestimated compared to the histopathological diagnosis made on the subsequent endometrial biopsy or surgical specimens. Results: Of the 58 cases, 12 were reassessed as being unsatisfactory for evaluation. Among the remaining 46 cases, 25 of the 27 cases, which had been underestimated and subsequently diagnosed as having endometrial carcinoma or a precursor stage on histopathological examination,were reassessed as recommended for endometrial biopsy. On the other hand, 19 cases overestimated by cytology were all reassessed as not requiring biopsy. Conclusions: The reporting format for endometrial cytology proposed in this article may improve diagnostic accuracy and reduce the number of patients managed inappropriately. PMID:18657157

  20. Dementia prevalence estimates in sub-Saharan Africa: comparison of two diagnostic criteria

    Directory of Open Access Journals (Sweden)

    Stella-Maria Paddick

    2013-04-01

    Full Text Available Background: We have previously reported the prevalence of dementia in older adults living in the rural Hai district of Tanzania according to the Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM-IV criteria. The aim of this study was to compare prevalence rates using the DSM-IV criteria with those obtained using the 10/66 diagnostic criteria, which is specifically designed for use in low- and middle-income countries. Methods: In phase I, 1,198 people aged 70 and older were screened for dementia. A stratified sample of 296 was then clinically assessed for dementia according to the DSM-IV criteria. In addition, data were collected according to the protocol of the 10/66 Dementia Research Group, which allowed a separate diagnosis of dementia according to these criteria to be established. Results: The age-standardised prevalence of clinical DSM-IV dementia was 6.4% (95% confidence interval [CI] 4.9–7.9% and of ‘10/66 dementia’ was 21.6% (95% CI 17.5–25.7%. Education was a significant predictor of ‘10/66 dementia’, but not of DSM-IV dementia. Conclusions: There are large discrepancies in dementia prevalence rates depending on which diagnostic system is used. In rural sub-Saharan Africa, it is not clear whether the association between education and dementia using the 10/66 criteria is a genuine effect or the result of an educational bias within the diagnostic instrument. Despite its possible flaws, the DSM-IV criteria represent an international standard for dementia diagnosis. The 10/66 diagnostic criteria may be more appropriate when identification of early and mild cognitive impairment is required.

  1. Restless legs syndrome/Willis Ekbom disease: new diagnostic criteria according to different nosology.

    Science.gov (United States)

    Marelli, Sara; Galbiati, Andrea; Rinaldi, Fabrizio; Giora, Enrico; Oldani, Alessandro; Ferini Strambi, Luigi; Zucconi, Marco

    2015-01-01

    Restless Legs Syndrome/Willis Ekbom Disease (RLS/WED) is a common neurological disorder characterized by uncomfortable and unpleasant sensations in the legs, with an urge to move. The symptoms typically begin or worsen during periods of rest, in particular during the evening and at night, while the activity may typically relieve them. The majority of patients complains of poor sleep. Recent studies reported the prevalence is ranging from 5 to 10%. RLS/WED can be divided into primary (patients without associated conditions that may explain the symptoms) and secondary forms (mostly iron deficiency). RLS/WED is typically a chronic condition. The clinical course varies according to the age of onset. A great load of accumulating research and clinical data have led to an extended consensus for a need to enhance the diagnostic criteria. The aim of this paper is to provide a critical comparison among different diagnostic criteria, taking into account respectively the International Classification of Sleep Disorders (ICSD), the International RLS Study Group (IRLSSG) and the Diagnostic and Statistical Manual of Mental Disorders (DSM). There are several remarkable distinctions between the IRLSSG revised criteria, ICSD-3 and DSM-V. Contrary to the DSM-V criteria, ICSD-3 diagnostic criteria are more aligned to the IRLSSG ones. In fact, the five essential criteria of the IRLSSG are also required for the diagnosis of RLS/WED according to ICSD-3. The new IRLSSG criteria provide a more rigorous approach to case ascertainment and a better characterization of patients by specifying clinical significance and course. Future ascertainment of correct diagnosis should include documentation that all five diagnostic criteria are considered.

  2. Diagnostic performance of various tests and criteria employed in allergic bronchopulmonary aspergillosis: a latent class analysis.

    Directory of Open Access Journals (Sweden)

    Ritesh Agarwal

    Full Text Available AIM: The efficiency of various investigations and diagnostic criteria used in diagnosis of allergic bronchopulmonary aspergillosis (ABPA remain unknown, primarily because of the lack of a gold standard. Latent class analysis (LCA can provide estimates of sensitivity and specificity in absence of gold standard. Herein, we report the performance of various investigations and criteria employed in diagnosis of ABPA. METHODS: Consecutive subjects with asthma underwent all the following investigations Aspergillus skin test, IgE levels (total and A.fumigatus specific, Aspergillus precipitins, eosinophil count, chest radiograph, and high-resolution computed tomography (HRCT of the chest. We used LCA to estimate the performance of various diagnostic tests and criteria in identification of ABPA. RESULTS: There were 372 asthmatics with a mean age of 35.9 years. The prevalence of Aspergillus sensitization was 53.2%. The sensitivity and specificity of various tests were Aspergillus skin test positivity (94.7%, 79.7%; IgE levels>1000 IU/mL (97.1%, 37.7%; A.fumigatus specific IgE levels>0.35 kUA/L (100%, 69.3%; Aspergillus precipitins (42.7%, 97.1%; eosinophil count>1000 cells/µL (29.5%, 93.1%; chest radiographic opacities (36.1%, 92.5%; bronchiectasis (91.9%, 80.9%; and, high-attenuation mucus (39.7%, 100%. The most accurate criteria was the Patterson criteria using six components followed by the Agarwal criteria. However, there was substantial decline in accuracy of the Patterson criteria if components of the criteria were either increased or decreased from six. CONCLUSIONS: A.fumigatus specific IgE levels and high-attenuation mucus were found to be the most sensitive and specific test respectively in diagnosis of ABPA. The Patterson criteria remain the best diagnostic criteria however they have good veridicality only if six criteria are used.

  3. Systematic review of diagnostic criteria for IBS demonstrates poor validity and utilization of Rome III.

    Science.gov (United States)

    Dang, J; Ardila-Hani, A; Amichai, M M; Chua, K; Pimentel, M

    2012-09-01

    In the absence of a clear biomarker for irritable bowel syndrome (IBS), clinical criteria are used. In this study, we conduct a systematic review to examine the validation and utilization of IBS criteria. A systematic review was performed in two stages. The first was a review of literature from 1978 validating IBS diagnostic criteria. The second stage of review was to select studies published in IBS between 1992 and 2011. This time period was divided into three segments (Rome I era from 1992 to 1999, Rome II era from 2000 to 2006, and Rome III era from 2007 to 2011). The number and type of study (RCT or other) and criteria used were evaluated for each era. The first stage of the systematic review identified only 14 published studies validating diagnostic tests for IBS (with three studies evaluating more than one criterion). There were eight validations for Manning, three validations for Kruis, four validations for Rome I, three validations for Rome II, and no validation for Rome III. In the second review of utilization of Rome criteria, only 25.7% of published IBS papers used Rome III criteria during the Rome III era (Rome II was used most in 64.8% of studies). This review identified that comparator groups varied widely between studies making comparison of criteria impossible. Manning criteria are the most valid and accurate criteria. More importantly, Rome III is not validated and is poorly adopted in clinical research trial enrollment. © 2012 Blackwell Publishing Ltd.

  4. Diagnostic criteria for malnutrition - An ESPEN Consensus Statement.

    Science.gov (United States)

    Cederholm, T; Bosaeus, I; Barazzoni, R; Bauer, J; Van Gossum, A; Klek, S; Muscaritoli, M; Nyulasi, I; Ockenga, J; Schneider, S M; de van der Schueren, M A E; Singer, P

    2015-06-01

    To provide a consensus-based minimum set of criteria for the diagnosis of malnutrition to be applied independent of clinical setting and aetiology, and to unify international terminology. The European Society of Clinical Nutrition and Metabolism (ESPEN) appointed a group of clinical scientists to perform a modified Delphi process, encompassing e-mail communications, face-to-face meetings, in group questionnaires and ballots, as well as a ballot for the ESPEN membership. First, ESPEN recommends that subjects at risk of malnutrition are identified by validated screening tools, and should be assessed and treated accordingly. Risk of malnutrition should have its own ICD Code. Second, a unanimous consensus was reached to advocate two options for the diagnosis of malnutrition. Option one requires body mass index (BMI, kg/m(2)) malnutrition. Option two requires the combined finding of unintentional weight loss (mandatory) and at least one of either reduced BMI or a low fat free mass index (FFMI). Weight loss could be either >10% of habitual weight indefinite of time, or >5% over 3 months. Reduced BMI is 75% agreed; i.e. indicated ≥7 on a 10-graded scale of acceptance, to this definition. In individuals identified by screening as at risk of malnutrition, the diagnosis of malnutrition should be based on either a low BMI (<18.5 kg/m(2)), or on the combined finding of weight loss together with either reduced BMI (age-specific) or a low FFMI using sex-specific cut-offs. Copyright © 2015 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.

  5. Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) for Clinical and Research Applications

    DEFF Research Database (Denmark)

    Schiffman, Eric; Ohrbach, Richard; Truelove, Edmond

    2014-01-01

    AIMS: The original Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) Axis I diagnostic algorithms have been demonstrated to be reliable. However, the Validation Project determined that the RDC/TMD Axis I validity was below the target sensitivity of ≥ 0.70 and specificity of ≥ 0...... shown to be both reliable and valid. Working from these findings and revisions, two international consensus workshops were convened, from which recommendations were obtained for the finalization of new Axis I diagnostic algorithms and new Axis II instruments. METHODS: Through a series of workshops...... of the literature providing valid instruments that, relative to the RDC/TMD, are shorter in length, are available in the public domain, and currently are being used in medical settings. RESULTS: The newly recommended Diagnostic Criteria for TMD (DC/TMD) Axis I protocol includes both a valid screener for detecting...

  6. Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) for Clinical and Research Applications

    DEFF Research Database (Denmark)

    Schiffman, Eric; Ohrbach, Richard; Truelove, Edmond

    2014-01-01

    AIMS: The original Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) Axis I diagnostic algorithms have been demonstrated to be reliable. However, the Validation Project determined that the RDC/TMD Axis I validity was below the target sensitivity of ≥ 0.70 and specificity of ≥ 0...... shown to be both reliable and valid. Working from these findings and revisions, two international consensus workshops were convened, from which recommendations were obtained for the finalization of new Axis I diagnostic algorithms and new Axis II instruments. METHODS: Through a series of workshops...... of the literature providing valid instruments that, relative to the RDC/TMD, are shorter in length, are available in the public domain, and currently are being used in medical settings. RESULTS: The newly recommended Diagnostic Criteria for TMD (DC/TMD) Axis I protocol includes both a valid screener for detecting...

  7. Diagnostic criteria for autoimmune hepatitis in children:A challenge for pediatric hepatologists

    Institute of Scientific and Technical Information of China (English)

    Priscila Menezes Ferri; Alexandre Rodrigues Ferreira; Débora Marques Miranda; Ana Cristina Sim(o)es e Silva

    2012-01-01

    Autoimmune hepatitis (AIH) is a progressive inflammatory liver disorder that is rare in children and adolescents.AIH has a broad clinical spectrum and a quick response to treatment with corticosteroids and immunosuppressive medication.The available diagnosis criteria have limitations and should be evaluated in pediatric populations.Recently,some studies reported that the 2008 simplified diagnostic criteria for AIH could be used in children with high sensibility and specificity.In addition,the authors reported that globulin and immunoglobulin G levels can be used interchangeably for diagnostic purposes.They also demonstrated that the 2008 simplified criteria fail in identifying patients with fulminant hepatic failure.Here,we discuss the limitations of the use of these criteria in pediatric patients and the requirement of more studies to improve the diagnosis of AIH in children.

  8. Evaluation of diagnostic criteria of DSM-IV-TR for diagnosis of internet addiction disorder

    OpenAIRE

    2011-01-01

    Background: The latest version of Diagnostic and Statistical Manual for Mental Disorder (DSM-IV-TR), classified internet addiction disorder under "impulse control disorder not elsewhere classified". This study evaluates diagnostic criteria of DSM-IV-TR for diagnosis of IAD correspondence with Iranian society and culture.Materials and Method: This is a descriptive-analytical and cross-sectional research. For these purpose 400 students of Isfahan universities were entered into the study. Sampli...

  9. Lack of uniform diagnostic criteria for cervical radiculopathy in conservative intervention studies: a systematic review

    OpenAIRE

    2012-01-01

    Purpose Cervical radiculopathy (CR) is a common diagnosis. It is unclear if intervention studies use uniform definitions and criteria for patient selection. Our objective was to assess the uniformity of diagnostic criteria and definitions used in intervention studies to select patients with CR. Methods We electronically searched the Cochrane Controlled Trials Register, MEDLINE, EMBASE and CINAHL. Studies were included when evaluating conservative interventions in randomised clinical trials (R...

  10. Evidence-based medical research on diagnostic criteria and screening technique of vascular mild cognitive impairment

    Directory of Open Access Journals (Sweden)

    Xia-wei LIU

    2015-07-01

    Full Text Available Background Vascular mild cognitive impairment (VaMCI is the prodromal syndrome of vascular dementia (VaD and key target for drug treatment. There is controversy over the diagnostic criteria and screening tools of VaMCI, which affects its clinical diagnosis. This paper aims to explore the clinical features, diagnostic criteria and screening technique of VaMCI.  Methods Taking "vascular mild cognitive impairment OR vascular cognitive impairment no dementia" as retrieval terms, search in PubMed database from January 1997 to March 2015 and screen relevant literatures concerning VaMCI. According to Guidance for the Preparation of Neurological Management Guidelines revised by European Federation of Neurological Societies (EFNS in 2004, evidence grading was performed on literatures. Results A total of 32 literatures in English were selected according to inclusion and exclusion criteria, including 3 guidelines and consensus and 29 clinical studies. Seven literatures (2 on Level Ⅰ, 5 on Level Ⅱ studied on neuropsychological features in VaMCI patients and found reduced processing speed and executive function impairment were main features. Two literatures reported the diagnostic criteria of VaMCI, including VaMCI criteria published by American Heart Association (AHA/American Stroke Association (ASA in 2011 and "Diagnostic Criteria for Vascular Cognitive Disorders" published by International Society for Vascular Behavioral and Cognitive Disorders (VASCOG in 2014. Fifteen literatures (4 on LevelⅠ, 11 on Level Ⅱ described the diagnostic criteria of VaMCI used in clinical research, from which 6 operational diagnostic items were extracted. Fourteen literatures (4 on Level Ⅰ, 10 on Level Ⅱ described neuropsychological assessment tools for VaMCI screening, and found the 5-minute protocol recommended by National Institute of Neurological Disorders and Stroke-Canadian Stroke Network (NINDS-CSN was being good consistency with other neuropsychological

  11. Riluzole treatment, survival and diagnostic criteria in Parkinson plus disorders: the NNIPPS study.

    Science.gov (United States)

    Bensimon, Gilbert; Ludolph, Albert; Agid, Yves; Vidailhet, Marie; Payan, Christine; Leigh, P Nigel

    2009-01-01

    Parkinson plus diseases, comprising mainly progressive supranuclear palsy (PSP) and multiple system atrophy (MSA) are rare neurodegenerative conditions. We designed a double-blind randomized placebo-controlled trial of riluzole as a potential disease-modifying agent in Parkinson plus disorders (NNIPPS: Neuroprotection and Natural History in Parkinson Plus Syndromes). We analysed the accuracy of our clinical diagnostic criteria, and studied prognostic factors for survival. Patients with an akinetic-rigid syndrome diagnosed as having PSP or MSA according to modified consensus diagnostic criteria were considered for inclusion. The psychometric validity (convergent and predictive) of the NNIPPS diagnostic criteria were tested prospectively by clinical and pathological assessments. The study was powered to detect a 40% decrease in relative risk of death within PSP or MSA strata. Patients were randomized to riluzole or matched placebo daily and followed up to 36 months. The primary endpoint was survival. Secondary efficacy outcomes were rates of disease progression assessed by functional measures. A total of 767 patients were randomized and 760 qualified for the Intent to Treat (ITT) analysis, stratified at entry as PSP (362 patients) or MSA (398 patients). Median follow-up was 1095 days (range 249-1095). During the study, 342 patients died and 112 brains were examined for pathology. NNIPPS diagnostic criteria showed for both PSP and MSA excellent convergent validity with the investigators' assessment of diagnostic probability (point-biserial correlation: MSA r(pb) = 0.93, P diagnostic criteria were consistent and valid. They can be used to distinguish between PSP and MSA with high accuracy, and should facilitate research into these conditions relatively early in their evolution.

  12. Testing the validity and acceptability of the diagnostic criteria for Hoarding Disorder: a DSM-5 survey.

    Science.gov (United States)

    Mataix-Cols, D; Fernández de la Cruz, L; Nakao, T; Pertusa, A

    2011-12-01

    The DSM-5 Obsessive-Compulsive Spectrum Sub-Workgroup is recommending the creation of a new diagnostic category named Hoarding Disorder (HD). The validity and acceptability of the proposed diagnostic criteria have yet to be formally tested. Obsessive-compulsive disorder/hoarding experts and random members of the American Psychiatric Association (APA) were shown eight brief clinical vignettes (four cases meeting criteria for HD, three with hoarding behaviour secondary to other mental disorders, and one with subclinical hoarding behaviour) and asked to decide the most appropriate diagnosis in each case. Participants were also asked about the perceived acceptability of the criteria and whether they supported the inclusion of HD in the main manual. Altogether, 211 experts and 48 APA members completed the survey (30% and 10% response rates, respectively). The sensitivity and specificity of the HD diagnosis and the individual criteria were high (80-90%) across various types of professionals, irrespective of their experience with hoarding cases. About 90% of participants in both samples thought the criteria would be very/somewhat acceptable for professionals and sufferers. Most experts (70%) supported the inclusion of HD in the main manual, whereas only 50% of the APA members did. The proposed criteria for HD have high sensitivity and specificity. The criteria are also deemed acceptable for professionals and sufferers alike. Training of professionals and the development and validation of semi-structured diagnostic instruments should improve diagnostic accuracy even further. A field trial is now needed to confirm these encouraging findings with real patients in real clinical settings.

  13. Examination of the interrelations between the factors of PTSD, major depression, and generalized anxiety disorder in a heterogeneous trauma-exposed sample using DSM 5 criteria.

    Science.gov (United States)

    Price, Matthew; van Stolk-Cooke, Katherine

    2015-11-01

    Exposure to traumatic events places individuals at high risk for multiple psychiatric disorders, including posttraumatic stress disorder (PTSD), major depressive disorder (MDD), and generalized anxiety disorder (GAD). The high rates of comorbidity among these conditions merit evaluation in order to improve diagnosis and treatment approaches. The current study evaluated the association between PTSD, MDD, and GAD factors as presented in the DSM 5. 602 trauma-exposed individuals who experienced an event that met Criterion A for the DSM 5 PTSD diagnosis were recruited through Amazon.com, Inc.'s Mechanical Turk (MTurk) to complete an assessment of the impact of stressful events on their lives. High interrelations were detected among the 4 PTSD factors, 2 MDD factors that corresponded to somatic and affective symptoms, and the single GAD factor. The affective factor of MDD was most strongly related to the emotional numbing factor of PTSD, whereas the somatic factor of MDD was most strongly related to the hyperarousal factor of PTSD. The GAD factor was most strongly related to the hyperarousal factor of PTSD, relative to the other PTSD factors. The strength of the interrelations between factors of the three disorders is largely a function of the overlap in symptoms and calls into question the uniqueness of negative affective symptoms of PTSD, MDD and GAD. Results suggest that improved understanding of the trauma reaction requires a focus on the unique presentation of each individual and assessment of multiple disorders.

  14. Screening for PTSD among detained adolescents: Implications of the changes in the DSM-5.

    Science.gov (United States)

    Modrowski, Crosby A; Bennett, Diana C; Chaplo, Shannon D; Kerig, Patricia K

    2017-01-01

    Screening for posttraumatic stress disorder (PTSD) is highly relevant for youth involved in the juvenile justice system given their high rates of trauma exposure and posttraumatic stress symptoms. However, to date, no studies have investigated the implications of the recent revisions to the Diagnostic and Statistical Manual for Mental Disorders (5th ed., DSM-5; American Psychiatric Association [APA], 2013) diagnostic criteria for PTSD for screening in this population. To this end, the present study compared PTSD screening rates using the Diagnostic and Statistical Manual of Mental Disorders (4th ed., text rev., DSM-IV-TR; APA, 2013) versus DSM-5 criteria in a group of detained adolescents. Participants included 209 youth (60 girls) aged 13-19 (M = 15.97, SD = 1.24). Youth completed measures of lifetime trauma exposure and past-month posttraumatic stress symptoms. Over 95% of youth in the sample reported exposure to at least 1 type of traumatic event. Approximately 19.60% of the sample screened positive for PTSD according to the DSM-5 compared to 17.70% according to the DSM-IV-TR. Girls were more likely than boys to screen positive for PTSD according to the DSM-IV-TR compared to the DSM-5. The main factors accounting for the differences in screening rates across the versions of PTSD criteria involved the removal of Criterion A2 from the DSM-5, the separation of avoidance symptoms (Criterion C) into their own cluster, the addition of a cluster involving negative alterations in cognitions and mood (Criterion D), and revisions to the cluster of arousal symptoms (Criterion E). Future research should continue to investigate gender differences in PTSD symptoms in youth and consider the implications of these diagnostic changes for the accurate diagnosis and referral to treatment of adolescents who demonstrate posttraumatic stress reactions. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

  15. Reconciling disparate prevalence rates of PTSD in large samples of US male Vietnam veterans and their controls

    Directory of Open Access Journals (Sweden)

    Gottesman Irving I

    2006-05-01

    Full Text Available Abstract Background Two large independent studies funded by the US government have assessed the impact of the Vietnam War on the prevalence of PTSD in US veterans. The National Vietnam Veterans Readjustment Study (NVVRS estimated the current PTSD prevalence to be 15.2% while the Vietnam Experience Study (VES estimated the prevalence to be 2.2%. We compared alternative criteria for estimating the prevalence of PTSD using the NVVRS and VES public use data sets collected more than 10 years after the United States withdrew troops from Vietnam. Methods We applied uniform diagnostic procedures to the male veterans from the NVVRS and VES to estimate PTSD prevalences based on varying criteria including one-month and lifetime prevalence estimates, combat and non-combat prevalence estimates, and prevalence estimates using both single and multiple indicator models. Results Using a narrow and specific set of criteria, we derived current prevalence estimates for combat-related PTSD of 2.5% and 2.9% for the VES and the NVVRS, respectively. Using a more broad and sensitive set of criteria, we derived current prevalence estimates for combat-related PTSD of 12.2% and 15.8% for the VES and NVVRS, respectively. Conclusion When comparable methods were applied to available data we reconciled disparate results and estimated similar current prevalences for both narrow and broad definitions of combat-related diagnoses of PTSD.

  16. Epidemiologic variability of chronic inflammatory demyelinating polyneuropathy with different diagnostic criteria: study of a UK population.

    Science.gov (United States)

    Rajabally, Yusuf A; Simpson, Benjamin S; Beri, Sushil; Bankart, John; Gosalakkal, Jayaprakash A

    2009-04-01

    Epidemiologic data on chronic inflammatory demyelinating polyneuropathy (CIDP) is limited, and previous studies have shown variable results. The frequencies of CIDP subtypes remain unknown. Variations due to use of different diagnostic criteria have not been studied. We examined the prevalence and incidence of CIDP in Leicestershire and Rutland, UK (population 963,600). Prevalence day was 1 May 2008. The prevalence of CIDP fulfilling the 2006 clinical and electrophysiologic European Federation of Neurological Societies/Peripheral Nerve Society (EFNS/PNS) criteria was 4.77 per 100,000 (95% confidence interval [CI] 3.49-6.37). Using the 1991 American Academy of Neurology (AAN) criteria, the prevalence was 1.97 per 100,000 in this population (95% CI 1.19-3.08). Lewis-Sumner syndrome was diagnosed in 15.2% of patients, and 23.9% had pure sensory onset. Over 40% required no immunotherapy, and 84.6% of those treated responded. More than 80% of the AAN criteria-negative but EFNS/PNS criteria-positive patients were responsive to treatment. Both sets of criteria were equally likely to identify patients who required therapy. The mean annual incidence rate over the 3 years preceding the prevalence day was 0.70 per 100,000/year using EFNS/PNS criteria (95% CI 0.43-1.08), and 0.35 per 100,000/year using AAN criteria (95% CI 0.17-0.64). We conclude that the AAN criteria may underestimate prevalence and incidence of the disease. The EFNS/PNS criteria provide higher diagnostic sensitivity and are of greater clinical relevance, and they also offer a useful breakdown of the epidemiologic data for CIDP subtypes.

  17. Sensitivity of revised diagnostic criteria for the behavioural variant of frontotemporal dementia

    Science.gov (United States)

    Hodges, John R.; Knopman, David; Mendez, Mario F.; Kramer, Joel H.; Neuhaus, John; van Swieten, John C.; Seelaar, Harro; Dopper, Elise G. P.; Onyike, Chiadi U.; Hillis, Argye E.; Josephs, Keith A.; Boeve, Bradley F.; Kertesz, Andrew; Seeley, William W.; Rankin, Katherine P.; Johnson, Julene K.; Gorno-Tempini, Maria-Luisa; Rosen, Howard; Prioleau-Latham, Caroline E.; Lee, Albert; Kipps, Christopher M.; Lillo, Patricia; Piguet, Olivier; Rohrer, Jonathan D.; Rossor, Martin N.; Warren, Jason D.; Fox, Nick C.; Galasko, Douglas; Salmon, David P.; Black, Sandra E.; Mesulam, Marsel; Weintraub, Sandra; Dickerson, Brad C.; Diehl-Schmid, Janine; Pasquier, Florence; Deramecourt, Vincent; Lebert, Florence; Pijnenburg, Yolande; Chow, Tiffany W.; Manes, Facundo; Grafman, Jordan; Cappa, Stefano F.; Freedman, Morris; Grossman, Murray; Miller, Bruce L.

    2011-01-01

    criteria were significantly older and most had atypical presentations with marked memory impairment. In conclusion, the revised criteria for behavioural variant frontotemporal dementia improve diagnostic accuracy compared with previously established criteria in a sample with known frontotemporal lobar degeneration. Greater sensitivity of the proposed criteria may reflect the optimized diagnostic features, less restrictive exclusion features and a flexible structure that accommodates different initial clinical presentations. Future studies will be needed to establish the reliability and specificity of these revised diagnostic guidelines. PMID:21810890

  18. [Epidemiology of Minamata Disease--Focus on the Clinical Features Related to the 1977 Diagnostic Criteria].

    Science.gov (United States)

    Futatsuka, Makoto

    2015-01-01

    Large-scale food poisoning caused by methylmercury was identified in Minamata, Japan, in the 1950s (Minamata Disease). Although the diagnostic criteria for the disease was controversial and difficult during that time, we, the Kumamoto University Study Group, carried out a large-scale study to assess the clinical features in 1972-1973. The author tried to reassess the results of that study to appraise the diagnostic criteria established in 1977 on the basis of those results. A substantial number of residents in the exposed area exhibited neurologic signs, especially paresthesia of only the extremities, namely, the male residents of Minamata City showed a positive predictive value of 0.73 and a negative predictive value of 0.23. The relative risks of paresthesia only were 2.6 (2.0-3.3) and 1.2 (0.9-1.5), in Minamata and Goshonoura related to Ariake (control), respectively. At least until 1977, the diagnostic criteria remained valid, although it was inadequate. Nevertheless, presently, a follow-up study of the certified patients may lead to the development of efficient new diagnostic criteria.

  19. Scientific statement on the diagnostic criteria, epidemiology, pathophysiology, and molecular genetics of polycystic ovary syndrome

    NARCIS (Netherlands)

    D. Dumesic (Daniel); S.E. Oberfield (Sharon E.); E. Stener-Victorin (Elisabet); J.C. Marshall (John C.); J.S.E. Laven (Joop); R.S. Legro (Richard)

    2015-01-01

    textabstractPolycystic ovary syndrome (PCOS) is a heterogeneous and complex disorder that has both adverse reproductive and metabolic implications for affected women. However, there is generally poor understanding of its etiology. Varying expert-based diagnostic criteria utilize some combination of

  20. A critical review of diagnostic criteria for evaluating patients with symptomatic stress urinary incontinence.

    NARCIS (Netherlands)

    Chapple, C.R.; Wein, A.J.; Artibani, W.; Brubaker, L.; Haab, F.; Heesakkers, J.P.; Lightner, D.

    2005-01-01

    The first paper in this section is a review by several highly respected authors of diagnostic criteria for evaluating patients with symptomatic stress urinary incontinence, and is followed by a review of the role of urgency and its measurement in the overactive bladder symptom syndrome, with emphasi

  1. Research diagnostic criteria for temporomandibular disorders: a systematic review of axis I epidemiologic findings

    NARCIS (Netherlands)

    Manfredini, D.; Guarda-Nardini, L.; Winocur, E.; Piccotti, F.; Ahlberg, J.; Lobbezoo, F.

    2011-01-01

    Objectives. The aim of this study was to summarize and systematically review the literature on the prevalence of different research diagnostic criteria for temporomandibular disorders (RDC/TMD) version 1.0 axis I diagnoses in patient and in the general populations. Study design. For each of the rele

  2. Field-testing of the ICHD-3 beta diagnostic criteria for classical trigeminal neuralgia

    DEFF Research Database (Denmark)

    Maarbjerg, Stine; Sørensen, Morten Togo; Gozalov, Aydin

    2015-01-01

    INTRODUCTION: We aimed to field-test the beta version of the third edition of the International Classification of Headache Disorders (ICHD-3 beta) diagnostic criteria for classical trigeminal neuralgia (TN). The proposed beta draft of the 11th version of the International Classification of Diseases...

  3. Scientific statement on the diagnostic criteria, epidemiology, pathophysiology, and molecular genetics of polycystic ovary syndrome

    NARCIS (Netherlands)

    D. Dumesic (Daniel); S.E. Oberfield (Sharon E.); E. Stener-Victorin (Elisabet); J.C. Marshall (John C.); J.S.E. Laven (Joop); R.S. Legro (Richard)

    2015-01-01

    textabstractPolycystic ovary syndrome (PCOS) is a heterogeneous and complex disorder that has both adverse reproductive and metabolic implications for affected women. However, there is generally poor understanding of its etiology. Varying expert-based diagnostic criteria utilize some combination of

  4. Sensitivity and Specificity of Proposed "DSM-5" Diagnostic Criteria for Autism Spectrum Disorder

    Science.gov (United States)

    McPartland, James C.; Reichow, Brian; Volkmar, Fred R.

    2012-01-01

    Objective: This study evaluated the potential impact of proposed "DSM-5" diagnostic criteria for autism spectrum disorder (ASD). Method: The study focused on a sample of 933 participants evaluated during the "DSM-IV" field trial; 657 carried a clinical diagnosis of an ASD, and 276 were diagnosed with a non-autistic disorder. Sensitivity and…

  5. Diagnostic Validity of Criteria for Sacroiliac Joint Pain : A Systematic Review

    NARCIS (Netherlands)

    Szadek, Karolina M.; van der Wurff, Peter; van Tulder, Maurits W.; Zuurmond, Wouter W.; Perez, Roberto S. G. M.

    2009-01-01

    A systematic literature review was conducted to determine the diagnostic validity of the criteria for sacroiliac (SI) joint pain as proposed by the International Association for the Study of Pain (IASP). Databases were searched up to September 2007. Quality of the studies was assessed using a Qualit

  6. Sensitivity and Specificity of Proposed "DSM-5" Diagnostic Criteria for Autism Spectrum Disorder

    Science.gov (United States)

    McPartland, James C.; Reichow, Brian; Volkmar, Fred R.

    2012-01-01

    Objective: This study evaluated the potential impact of proposed "DSM-5" diagnostic criteria for autism spectrum disorder (ASD). Method: The study focused on a sample of 933 participants evaluated during the "DSM-IV" field trial; 657 carried a clinical diagnosis of an ASD, and 276 were diagnosed with a non-autistic disorder. Sensitivity and…

  7. Clinicians' perspective of the current diagnostic criteria for myofascial pain syndrome.

    Science.gov (United States)

    Grosman-Rimon, Liza; Clarke, Hance; Chan, Aaron K; Mills, Patricia Branco; Rathbone, Alasdair Timothy Llewelyn; Kumbhare, Dinesh

    2017-01-01

    Myofascial pain syndrome (MPS) is one of the most common chronic musculoskeletal pain disorders. However, MPS is often under-diagnosed. The purpose of this study was to characterize practicing clinicians' perspectives of the current diagnostic criteria for MPS. A cross-sectional study design was used with a self-administered questionnaire. The questionnaire evaluated clinicians' perspective of the current diagnostic criteria for MPS. The sample population (n= 119) consisted of 40% family physicians, 31% physical medicine (PM) and rehabilitation specialists, 11% rheumatologists, 10% emergency room (ER) physicians, and 8% anesthesiologists specializing in chronic pain. Our findings demonstrated that participating clinicians agree that ``point tenderness'' and ``pain reproduction'' are criteria for MPS. In contrast, the clinicians do not consider ``autonomic symptoms'' as an important criterion for MPS. The anesthesiologists view ``restricted range of motion'' as a criterion for MPS more than the other groups, and they tend to consider ``referred pain'' and ``pain reproduction'' as criteria. Physical medicine and rehabilitation specialists and anesthesiologists tend to view ``local twitch response'' more as a criterion for MPS compared with the other groups. Most groups of clinicians consider ``weakness without atrophy'' as an important MPS criterion except for family physicians. It is important to note that ``poor sleep'', ``daytime fatigue'' and ``cognitive symptoms'', which are not considered as MPS symptoms, are often mistaken for MPS among practicing clinicians. Our findings suggest that the diagnostic criteria are not well known, highlighting the need for an expert consensus to determine the importance of each criterion for MPS diagnosis.

  8. Post-craniotomy headache: a proposed revision of IHS diagnostic criteria.

    Science.gov (United States)

    Rocha-Filho, P A S; Gherpelli, J L D; de Siqueira, J T T; Rabello, G D

    2010-05-01

    Seventy-nine patients with intracranial aneurysms were evaluated in the presurgical period, and followed up to 6 months after surgery. We compare patients who fulfilled with those that did not post-craniotomy headache (PCH) diagnostic criteria, according to the International Classification of Headache Disorders. Semistructured interviews, headache diaries, Short Form-36 and McGill Pain Questionnaire were used. Seventy-two patients (91%) had headaches during the follow-up period. The incidence of PCH according to the International Headache Society diagnostic criteria was 40%. Age, sex, type of surgery, temporomandibular disorder, vasospasm, presence and type of previous headaches, and subarachnoid haemorrhage were not related to headache classification. There were no differences in the quality of life, headache frequency and characteristics or pain intensity between patients with headache that fulfilled or not PCH criteria. We proposed a revision of the diagnostic criteria for PCH, extending the headache outset after surgery from 7 to 30 days, and including the presence of headaches after surgery in patients with no past history of headaches, or an increase in headache frequency during the first 30 days of the postsurgical period followed by a decrease over time. Using these criteria we would classify 65% of our patients as having PCH.

  9. Improving the diagnostic criteria for alcohol use disorders through survey methodology and cognitive interviewing.

    Science.gov (United States)

    Mewton, Louise; Slade, Tim; Teesson, Maree; Memedovic, Sonja; Krueger, Robert F

    2014-09-01

    This study aims to identify problems in the structure and wording of questions designed to operationalize four DSM-IV diagnostic criteria for alcohol use disorders (AUDs): (1) use of alcohol in hazardous situations (hazard); (2) tolerance; (3) use of alcohol in larger amounts/longer periods than intended (larger/longer); (4) unsuccessful attempts to cut down or control alcohol use (quit/cut down). Ten experts appraised the questions related to these criteria in the WMH-CIDI according to a standardized checklist. These experts identified three main problems: (1) the double-barrelled nature of some of the questions; (2) definitional issues; and (3) unclear thresholds for criterion endorsement. Cognitive interviews of 100 young adult drinkers aged 18-24 were then conducted. The double-barrelled nature of the DSM-IV criteria led to their subsequent over- or under-endorsement. Key terms in the questions under investigation were defined inconsistently. There was also a large amount of variability in the thresholds at which larger/longer and quit/cut down were endorsed. Many of these problems could be linked back to the DSM-IV text. The findings raise questions as to the validity of AUD diagnoses when established via structured diagnostic interview. Further research should focus on testing alternative structure and wording of key AUD criteria to ensure accurate operationalizations of these criteria in structured diagnostic interviews.

  10. Finding What Works in a Complicated Transition: Considerations for Soldiers with PTSD and mTBI

    Science.gov (United States)

    2014-06-13

    railway or workplace accidents. In the 1890s Sigmund Freud proposed a theory on seduction; he later abandoned the theory, however he created a paradigm...historical evolution of PTSD diagnostic criteria: from Freud to DSM-IV. The Journal of Traumatic Stress 7, no. 4 (October): 681-698. X4I-OIF/OEF

  11. Diagnostic Criteria

    Directory of Open Access Journals (Sweden)

    Narender P. Van Orshoven

    2010-01-01

    Full Text Available The aims of this study were to find out whether Postprandial hypotension (PPH occurs more frequently in patients admitted to a geriatric ward than in healthy elderly individuals, what the optimal interval between blood pressure measurements is in order to diagnose PPH and how often it is associated with symptoms.The result of this study indicates that PPH is present in a high number of frail elderly, but also in a few healthy older persons. Measuring blood pressure at least every 10 minutes for 60 minutes after breakfast will adequately diagnose PPH, defined as >20 mmHg systolic fall, in most patients. However with definition of PPH as >30 mmHg systolic fall, measuring blood pressure every 10 minutes will miss PPH in one of three patients. With the latter definition of PPH the presence of postprandial complaints is not associated with the existence of PPH.

  12. PTSD: National Center for PTSD

    Medline Plus

    Full Text Available ... Z) Hepatitis HIV Mental Health Mental Health Home Suicide Prevention Substance Abuse Military Sexual Trauma PTSD Research (MIRECC) Military Exposures Polytrauma Rehabilitation Spinal Cord Injury ...

  13. PTSD: National Center for PTSD

    Medline Plus

    Full Text Available ... Treatments (A-Z) Hepatitis HIV Mental Health Mental Health Home Suicide Prevention Substance Abuse Military Sexual Trauma PTSD Research (MIRECC) Military Exposures Polytrauma Rehabilitation ...

  14. Depression in the elderly community: I. Prevalence by different diagnostic criteria and clinical profile

    Directory of Open Access Journals (Sweden)

    Concepción de la Cámara

    2008-09-01

    Full Text Available Background and Objectives: Depression is one of the most intriguing disorders in the elderly. We conjecture that prevalence of depression in the community vary according to the diagnostic criteria used. Furthermore, we anticipate that important proportions of depression go untreated or inadequately treated in a Southern European city. Metodology: This report is part of the Zaragoza Study (or ZARADEMP 0, an epidemiological project to document psychiatric morbidity in a representative sample of the elderly. A two - phase design was completed in a sample of n= 1080 elderly (65+ years. Standardized instruments were used, and the Geratric Mental State (GMS was the main instrument. Cases of depression were diagnosed with three different sets of diagnostic criteria: AGECAT syndrome, AGECAT diagnosis and DSM - IV criteria. Descriptive statistics were used. Results: In support of the working hypothesis, the prevalence of depression tended to be lower when stringent diagnostic criteria were used. It was 7.0 % with AGECAT syndrome, 5.7% with AGECAT diagnosis among the cases, 4.8% with DSM - IV criteria. Anxiety, co - morbid syndromes were frequent among the cases (45.5% and 18.2% of them had co - morbid AGECAT organic syndromes. Differential psychopathological profiles are observed between cases of major and minor depression. Undertreament or inadequate treatment was very frequent, and only 54.5% of major depression cases were on antidepressants. Conclusions: The prevalence of depression in the elderly varies according to diagnostic criteria used, and does not increase with age. Co-morbid anxiety and "organic" syndromes are common, and only half the major depressive cases were on antidepressants.

  15. A comprehensive electrocardiographic, molecular, and echocardiographic study of Brugada syndrome: validation of the 2013 diagnostic criteria.

    Science.gov (United States)

    Savastano, Simone; Rordorf, Roberto; Vicentini, Alessandro; Petracci, Barbara; Taravelli, Erika; Castelletti, Silvia; D'Errico, Alessandra; Torchio, Margherita; Dossena, Cinzia; Novara, Paola; Dagradi, Federica; Landolina, Maurizio; Spazzolini, Carla; Crotti, Lia; Schwartz, Peter J

    2014-07-01

    The debate on the diagnostic value of high intercostal spaces (ICSs) and of the number of diagnostic leads in Brugada syndrome (BrS) has been settled by a recent expert consensus statement. To test the validity, and the underlying anatomy, of the new electrocardiographic (ECG) diagnostic criteria using echocardiographic, molecular, and clinical evidence in 1 clinical study population with BrS. We analyzed 114 patients with BrS and with a spontaneous or drug-induced type 1 ECG pattern recorded in 1 or more right precordial leads in fourth, third, and second ICSs. The right ventricular outflow tract (RVOT) was localized by using echocardiography. All probands were screened on the SCN5A gene. The percentage of mutation carriers (MCs) and the event rate were similar regardless of the diagnostic ICS (fourth vs high ICSs: MCs 23% vs 19%; event rate 22% vs 28%) and the number of diagnostic leads (1 vs ≥2: MCs 20% vs 22%; event rate 22% vs 27%). The concordance between RVOT anatomical location and the diagnostic ICSs was 86%. The percentage of the diagnostic ECG pattern recorded was significantly increased by the exploration of the ICSs showing RVOT by echocardiography (echocardiography-guided approach vs conventional approach 100% vs 43%; P < .001). The high ICSs are not inferior to the standard fourth ICS for the ECG diagnosis of BrS, and the interindividual variability depends on the anatomical location of the RVOT as assessed by using echocardiography. This approach significantly increases diagnostic sensitivity without decreasing specificity and fully supports the recently published new diagnostic criteria. Copyright © 2014 Heart Rhythm Society. Published by Elsevier Inc. All rights reserved.

  16. Prevalence of Metabolic Syndrome in Elderly and Agreement among Four Diagnostic Criteria

    Energy Technology Data Exchange (ETDEWEB)

    Saad, Maria Auxiliadora Nogueira, E-mail: auxiliadorasaad@yahoo.com.br [Fundação Municipal de Saúde de Niterói, Niterói, RJ (Brazil); Cardoso, Gilberto Perez; Martins, Wolney de Andrade; Velarde, Luis Guillermo Coca; Cruz, Rubens Antunes Filho da [Universidade Federal Fluminense, Niterói, RJ (Brazil)

    2014-03-15

    Metabolic syndrome (MS) is an aggregation of risk factors that increase the incidence of cardiovascular events and diabetes mellitus (DM). Population aging is accompanied by higher prevalence of MS, which varies depending on the population studied and the diagnostic criteria used. To determine prevalence of MS in the elderly using four diagnostic criteria and agreement between them. Cross-sectional study on 243 patients older than 60 years (180 women) in Niterói, RJ. They were evaluated by clinical examination, fasting glucose, fasting insulin, lipid profile and anthropometric measurements - weight, height, waist circumference and waist/hip ratio. Prevalence of MS was estimated by World Health Organization (WHO) modified, National Cholesterol Education Program - Adult Treatment Panel III (NCEP-ATP III), International Diabetes Federation (IDF) and Joint Interim Statement (JIS) criteria. Prevalence was high with the four criteria WHO (51.9%), NCEP-ATPIII (45.2%), IDF (64.1%) and JIS (69.1%), and agreement between criteria by kappa was moderate in almost all comparisons WHO vs. IDF (k = 0.47;95% confidence interval (CI), 0.35 to 0.58); WHO vs. NCEP-ATPIII (k = 0.51; 95% CI, 0.40 to 0.61); WHO vs. JIS (k = 0.45; 95% CI, 0.33 to 0.56); IDF vs. NCEP-ATPIII (k = 0.55; 95% CI, 0.45 to 0.65) and NCEP-ATPIII vs. JIS (k = 0.53; 95% CI, 0.43-0.64), except between IDF vs. JIS (K = 0.89;95% CI, 0.83 to 0.95), which was considered good. Prevalence of MS was high with the four diagnostic criteria, mainly by JIS. There was good agreement between JIS and IDF criteria and moderate among the others.

  17. Evaluation of the diagnostic criteria of Internet gaming disorder in the DSM-5 among young adults in Taiwan.

    Science.gov (United States)

    Ko, Chih-Hung; Yen, Ju-Yu; Chen, Sue-Huei; Wang, Peng-Wei; Chen, Cheng-Sheng; Yen, Cheng-Fang

    2014-06-01

    The DSM-5 proposed the diagnostic criteria of Internet gaming disorder (IGD) and suggested that more evidence is necessary before it is included as a standard disorder in the DSM system. The aims of this study were to: 1) evaluate the diagnostic validity of individual criteria of IGD in the DSM-5 and the criteria of craving and irritability; 2) determine the optimal cut-off point for the IGD criteria in the DSM-5. We recruited 75 subjects with IGD, 75 without IGD, and 75 in remission from IGD based on the Diagnostic Criteria of Internet Addiction for College Students (DC-IA-C). All participants underwent a diagnostic interview based on the diagnostic criteria of IGD in the DSM-5 and completed the CIAS and QGU-B. Except for the "deceiving" and "escape" criteria, all criteria of IGD had diagnostic accuracy ranging from 77.3% to 94.7% to differentiate university students with IGD from remitted students. The criterion of craving had diagnostic accuracy of 88% and the criteria of irritability had an accuracy of 68.7%. Fulfilling 5 or more criteria of IGD in the DSM-5 was the best cut-off point to differentiate young adults with IGD from healthy or remitted users.

  18. The potential impact of new diagnostic criteria on the frequency of gestational diabetes mellitus in Sweden.

    Science.gov (United States)

    Claesson, Rickard; Ekelund, Magnus; Berntorp, Kerstin

    2013-10-01

    The International Association of Diabetes and Pregnancy Study Groups (IADPSG) has suggested new diagnostic criteria for gestational diabetes mellitus. Many centers in Europe still use the World Health Organization (WHO) criteria. In southern Sweden we use the 2-h threshold of the European Association for the Study of Diabetes criteria based on universal screening with a 75-g oral glucose tolerance test. We have retrospectively scrutinized oral glucose tolerance tests in a subset of 174 women included in a previous study, diagnosed with gestational diabetes mellitus 1996-1999. A complete repeat oral glucose tolerance test was performed directly after diagnosis in 120 women. When applying the current Swedish criteria, and the IADPSG and the WHO criteria to the material, gestational diabetes mellitus was confirmed in 67% (80/120), 84% (101/120), and 80% (96/120), respectively. Hence, 26% (101/80) more women were identified by the IADPSG criteria and 20% (96/80) more women by the WHO criteria, compared with the criteria presently in use.

  19. Evaluation of diagnostic criteria of DSM-IV-TR for diagnosis of internet addiction disorder

    Directory of Open Access Journals (Sweden)

    S.Salman Alavi

    2011-11-01

    Full Text Available Background: The latest version of Diagnostic and Statistical Manual for Mental Disorder (DSM-IV-TR, classified internet addiction disorder under "impulse control disorder not elsewhere classified". This study evaluates diagnostic criteria of DSM-IV-TR for diagnosis of IAD correspondence with Iranian society and culture.Materials and Method: This is a descriptive-analytical and cross-sectional research. For these purpose 400 students of Isfahan universities were entered into the study. Sampling method was quota sampling. At first we performed clinical interview (based on DSM-IV-TR for all cases, then the interviews reevaluated by another specialist. Data analysis has been done by content validity, inter-scorer reliability (Kappa coefficient and test-retest with SPSS1-14 software.Results: Content validity of diagnostic interviews match with DSM-IV-TR criteria and their content is appropriate, two items including "chatroom pathological use" and "monthly fees for internet" were added to promote its validity. Internal reliability (Kappa was 0.80 and test –retest reliability was r=0.74(p<0.01.Conclusion: Results suggest that diagnostic criteria of DSM-IV-TR are valid and reliable for internet addiction diagnosis and with this clinical interview. We have a more effective way to diagnose internet addiction in the future studies

  20. Intramuscular compartment pressure measurement in chronic exertional compartment syndrome: new and improved diagnostic criteria.

    Science.gov (United States)

    Roscoe, David; Roberts, Andrew J; Hulse, David

    2015-02-01

    Patients with chronic exertional compartment syndrome (CECS) have pain during exercise that subsides with rest. Diagnosis is usually confirmed by intramuscular compartment pressure (IMCP) measurement. Controversy exists regarding the accuracy of existing diagnostic criteria. (1) To compare dynamic IMCP measurement and anthropometric factors between patients with CECS and asymptomatic controls and (2) to establish the diagnostic utility of dynamic IMCP measurement. Cohort study (diagnosis); Level of evidence, 2. A total of 40 men aged 21 to 40 years were included in the study: 20 with symptoms of CECS of the anterior compartment and 20 asymptomatic controls. Diagnoses other than CECS were excluded with rigorous inclusion criteria and magnetic resonance imaging. The IMCP was measured continuously before, during, and after participants exercised on a treadmill, wearing identical footwear and carrying a 15-kg load. Pain experienced by study subjects increased incrementally as the study progressed (P compartment IMCP is elevated immediately upon standing at rest in subjects with CECS. In patients with symptoms consistent with CECS, diagnostic utility of IMCP measurement is improved when measured continuously during exercise. A cutoff of 105 mm Hg in phase 2 provides better diagnostic accuracy than do the Pedowitz criteria of 30 mm Hg and 20 mm Hg at 1 and 5 minutes after exercise, respectively. © 2014 The Author(s).

  1. Quantifying heterogeneity attributable to polythetic diagnostic criteria: theoretical framework and empirical application.

    Science.gov (United States)

    Olbert, Charles M; Gala, Gary J; Tupler, Larry A

    2014-05-01

    Heterogeneity within psychiatric disorders is both theoretically and practically problematic: For many disorders, it is possible for 2 individuals to share very few or even no symptoms in common yet share the same diagnosis. Polythetic diagnostic criteria have long been recognized to contribute to this heterogeneity, yet no unified theoretical understanding of the coherence of symptom criteria sets currently exists. A general framework for analyzing the logical and mathematical structure, coherence, and diversity of Diagnostic and Statistical Manual diagnostic categories (DSM-5 and DSM-IV-TR) is proposed, drawing from combinatorial mathematics, set theory, and information theory. Theoretical application of this framework to 18 diagnostic categories indicates that in most categories, 2 individuals with the same diagnosis may share no symptoms in common, and that any 2 theoretically possible symptom combinations will share on average less than half their symptoms. Application of this framework to 2 large empirical datasets indicates that patients who meet symptom criteria for major depressive disorder and posttraumatic stress disorder tend to share approximately three-fifths of symptoms in common. For both disorders in each of the datasets, pairs of individuals who shared no common symptoms were observed. Any 2 individuals with either diagnosis were unlikely to exhibit identical symptomatology. The theoretical and empirical results stemming from this approach have substantive implications for etiological research into, and measurement of, psychiatric disorders.

  2. Diagnosing major depressive disorder III: can some symptoms be eliminated from the diagnostic criteria?

    Science.gov (United States)

    Zimmerman, Mark; McGlinchey, Joseph B; Young, Diane; Chelminski, Iwona

    2006-05-01

    All criteria used to diagnose a psychiatric disorder should contribute to distinguishing cases from noncases. The principal of parsimony argues for defining a disorder with as few criteria as possible. Thus, criteria that do not contribute to the case-noncase distinction should be eliminated from the list of defining features because they unnecessarily increase the complexity of the definition of the disorder. In polythetically defined disorders such as major depressive disorder (MDD), diagnosis is based on the presence of a minimum number of features from a list. For a criterion to be retained on such a list, it should contribute to distinguishing between individuals with and without MDD. Simply demonstrating that a criterion is significantly more common in individuals with MDD than individuals without MDD is not a sufficient demonstration of its necessity. Rather, to demonstrate an impact on diagnosis, it should be shown that eliminating the criterion from the list results in individuals being reclassified from a case to a noncase. A criterion does not contribute to determining caseness if its elimination does not result in diagnostic reclassification. The goal of this report from the Rhode Island Hospital Methods to Improve Diagnostic Assessment and Services project was to determine if any of the criteria of MDD are candidates for elimination because of their lack of impact on diagnosis. The results indicated that the symptoms of increased weight, decreased weight, and indecisiveness rarely influenced diagnostic classification and thus are candidates for elimination.

  3. [Primary ciliary dyskinesia, immotile cilia syndrome, and Kartagener syndrome: diagnostic criteria].

    Science.gov (United States)

    Dombi, V H; Walt, H

    1996-03-16

    Primary ciliary dyskinesia is the generic term for a heterogeneous group of inherited diseases in which ciliary ultrastructure is defective and as a consequence ciliary motility is disturbed. An international consensus on the diagnostic criteria has not yet been reached. This paper reviews some recent findings which are useful in the diagnosis of the disease and attempts to establish the best diagnostic criteria. The marker symptoms are chronic bronchitis, otitis, and sinusitis since childhood. Additionally, one or more of the following criteria must be present: Kartagener syndrome, a dextrocardia situation, markedly reduced frequency in ciliary motility, or an essential ultrastructure deviation in more than 20% of the square cuts (e.g. reduced number of dynein arms). Biopsy of the ciliated mucosa is usually required for the above criteria and is studied by vital microscopy and transmission electron microscopy. Primary and secondary ciliary dyskinesia can be distinguished by these methods and the rare case of PCD without ultrastructure deficiency ruled out. In special cases a cell culture is recommended for the diagnosis. Practical aspects of the sampling methods and diagnostic pitfalls are reviewed.

  4. PTSD: National Center for PTSD

    Medline Plus

    Full Text Available ... Inventory Accessibility Privacy and Security Updating of Web Site Web Site Policies Important Links Linking Policies Small Business ... VA PTSD Care, Benefits, or Claims For Web site help: Web Policies PTSD Information Voice Mail: (802) 296-6300 ...

  5. PTSD: National Center for PTSD

    Medline Plus

    Full Text Available ... The following short animated videos use hand-drawn images to help you learn about PTSD and effective treatments. What is PTSD? Treatment: Know Your Options "Evidence-based" Treatment Cognitive Processing Therapy Prolonged Exposure Watch our whiteboard video for ...

  6. The underlying dimensionality of PTSD in the diagnostic and statistical manual of mental disorders: where are we going?

    OpenAIRE

    Armour, Cherie

    2015-01-01

    There has been a substantial body of literature devoted to answering one question: Which latent model of posttraumatic stress disorder (PTSD) best represents PTSD’s underlying dimensionality? This research summary will, therefore, focus on the literature pertaining to PTSD’s latent structure as represented in the fourth (DSM-IV, 1994) to the fifth (DSM-5, 2013) edition of the DSM. This article will begin by providing a clear rationale as to why this is a pertinent research area, then the body...

  7. Diagnostic Criteria for Adult-Onset Periodic Fever, Aphthous Stomatitis, Pharyngitis, and Cervical Adenitis (PFAPA Syndrome

    Directory of Open Access Journals (Sweden)

    Luca Cantarini

    2017-08-01

    Full Text Available ObjectiveTo identify a set of variables that could discriminate patients with adult-onset periodic fever, aphthous stomatitis, pharyngitis, and cervical adenitis (PFAPA syndrome from subjects with fever of unknown origin (FUO.MethodsWe enrolled 74 adults diagnosed with PFAPA syndrome according to the currently used pediatric diagnostic criteria and 62 additional patients with FUO. After having collected clinical and laboratory data from both groups, univariate and multivariate analyses were performed to identify the variables associated with PFAPA diagnosis. Odds ratio (OR values, their statistical significance, and corresponding 95% confidence interval (CI were evaluated for each diagnostic factor both at the univariate and multivariate analyses. Diagnostic accuracy was evaluated by the area under receiver operating characteristic (ROC curve, while the leave-one-out cross-validation procedure was used to ensure that the model maintains the same diagnostic power when applied to new data.ResultsAccording to the multivariate analysis, the clinical variables that discriminated PFAPA patients were: fever episodes associated with cervical lymphadenitis (OR = 92; p < 0.0001, fever attacks associated with erythematous pharyngitis (OR = 231; p < 0.0001, increased inflammatory markers during fever attacks (OR = 588; p = 0.001, and the lack of clinical and laboratory signs of inflammation between flares (OR = 1202; p < 0.0001. These variables were considered for a diagnostic model which accounted for their OR values. The diagnostic accuracy of the proposed set of criteria corresponded to an area under ROC curve of 0.978 (95% CI 0.958–0.998, with a model sensitivity and specificity equal to 93.4% (95% CI 87.5–96.5% and 91.7% (95% CI 82.8–96.7%, respectively.Conclusionwe have provided herein a set of clinical diagnostic criteria for adult-onset PFAPA syndrome. Our criteria represent an easy-to-use diagnostic tool aimed

  8. A proposal for the use of uniform diagnostic criteria for gestational diabetes in Europe

    DEFF Research Database (Denmark)

    Benhalima, Katrien; Mathieu, Chantal; Damm, Peter;

    2015-01-01

    -off values for diabetes outside pregnancy, with particular efforts made to screen high-risk groups. When screening for GDM is performed at 24 weeks' gestation or later, the proposal is now to use the 75 g OGTT with the new WHO diagnostic criteria for GDM. However, more research is necessary to evaluate...... the best GDM screening strategy for different populations in Europe. Therefore, no clear recommendation has been made on whether a universal one-step, two-step or a risk-factor-based screening approach should be used. The use of the same WHO diagnostic GDM criteria across Europe will be an important step...... for GDM in Europe is challenging, as populations are diverse and healthcare delivery systems also differ. The European Board & College of Obstetrics and Gynaecology (EBCOG) has responded to this challenge by appointing a steering committee, including members of the EBCOG and the Diabetic Pregnancy Study...

  9. Diagnostic Criteria, Classification and Treatment Goals in Multiple Sclerosis: The Chronicles of Time and Space.

    Science.gov (United States)

    Ntranos, Achilles; Lublin, Fred

    2016-10-01

    Multiple sclerosis (MS) is one of the most diverse human diseases. Since its first description by Charcot in the nineteenth century, the diagnostic criteria, clinical course classification, and treatment goals for MS have been constantly revised and updated to improve diagnostic accuracy, physician communication, and clinical trial design. These changes have improved the clinical outcomes and quality of life for patients with the disease. Recent technological and research breakthroughs will almost certainly further change how we diagnose, classify, and treat MS in the future. In this review, we summarize the key events in the history of MS, explain the reasoning behind the current criteria for MS diagnosis, classification, and treatment, and provide suggestions for further improvements that will keep enhancing the clinical practice of MS.

  10. Diabetic neuropathies: update on definitions, diagnostic criteria, estimation of severity, and treatments.

    Science.gov (United States)

    Tesfaye, Solomon; Boulton, Andrew J M; Dyck, Peter J; Freeman, Roy; Horowitz, Michael; Kempler, Peter; Lauria, Giuseppe; Malik, Rayaz A; Spallone, Vincenza; Vinik, Aaron; Bernardi, Luciano; Valensi, Paul

    2010-10-01

    Preceding the joint meeting of the 19th annual Diabetic Neuropathy Study Group of the European Association for the Study of Diabetes (NEURODIAB) and the 8th International Symposium on Diabetic Neuropathy in Toronto, Canada, 13-18 October 2009, expert panels were convened to provide updates on classification, definitions, diagnostic criteria, and treatments of diabetic peripheral neuropathies (DPNs), autonomic neuropathy, painful DPNs, and structural alterations in DPNs.

  11. Diabetic neuropathies: update on definitions, diagnostic criteria, estimation of severity, and treatments

    DEFF Research Database (Denmark)

    Tesfaye, Solomon; Boulton, Andrew J M; Dyck, Peter J

    2010-01-01

    Preceding the joint meeting of the 19th annual Diabetic Neuropathy Study Group of the European Association for the Study of Diabetes (NEURODIAB) and the 8th International Symposium on Diabetic Neuropathy in Toronto, Canada, 13-18 October 2009, expert panels were convened to provide updates...... on classification, definitions, diagnostic criteria, and treatments of diabetic peripheral neuropathies (DPNs), autonomic neuropathy, painful DPNs, and structural alterations in DPNs....

  12. Meckel-Gruber syndrome: pathologic manifestations, minimal diagnostic criteria, and differential diagnosis.

    Science.gov (United States)

    Alexiev, Borislav A; Lin, Xiaoqing; Sun, Chen-Chih; Brenner, David S

    2006-08-01

    This article provides an overview of the major pathologic manifestations of Meckel-Gruber syndrome, current knowledge about its pathogenesis, minimal diagnostic criteria, and differential diagnosis. Typical sonographic findings (occipital encephalocele, postaxial polydactyly, and cystic enlargement of the kidneys) allow for diagnosis of most cases before the 14th week of gestation, but the pathologist may encounter clinically unsuspected or atypical cases that require morphologic confirmation. In these cases, a meticulous autopsy is necessary to establish the diagnosis of Meckel-Gruber syndrome.

  13. Comparison of DSM-IV and proposed ICD-11 formulations of PTSD among civilian survivors of war and war veterans.

    Science.gov (United States)

    Morina, Nexhmedin; van Emmerik, Arnold A P; Andrews, Bernice; Brewin, Chris R

    2014-12-01

    The World Health Organization recently proposed a reformulation of posttraumatic stress disorder (PTSD) for the 11(th) edition of the International Classification of Diseases (ICD-11), employing only 6 symptoms. The aim of this study was to investigate the impact of this reformulation of PTSD as compared to criteria according to Diagnostic and Statistical Manual of Mental Disorders (4th ed., DSM-IV; American Psychiatric Association, 1994) on the prevalence of current PTSD as well as comorbid major depressive episode and anxiety disorders other than PTSD. Study 1 involved previously collected interviews with 560 Kosovar civilian war survivors; Study 2 employed a previously collected sample of 142 British war veterans. Results revealed no change in the diagnostic status under the criteria proposed for ICD-11 in 87.5% of civilian war survivors and 91.5% of war veterans. Participants who only met the newly proposed criteria showed lower rates of comorbid major depressive episode than participants who only met DSM-IV criteria (13.6% vs. 43.8% respectively). Rates of comorbid anxiety disorders did not significantly differ between participants who lost or gained a PTSD diagnosis under the proposed criteria. Copyright © 2014 International Society for Traumatic Stress Studies.

  14. Less is more? Assessing the validity of the ICD-11 model of PTSD across multiple trauma samples

    Directory of Open Access Journals (Sweden)

    Maj Hansen

    2015-10-01

    Full Text Available Background: In the 5th edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5, the symptom profile of posttraumatic stress disorder (PTSD was expanded to include 20 symptoms. An alternative model of PTSD is outlined in the proposed 11th edition of the International Classification of Diseases (ICD-11 that includes just six symptoms. Objectives and method: The objectives of the current study are: 1 to independently investigate the fit of the ICD-11 model of PTSD, and three DSM-5-based models of PTSD, across seven different trauma samples (N=3,746 using confirmatory factor analysis; 2 to assess the concurrent validity of the ICD-11 model of PTSD; and 3 to determine if there are significant differences in diagnostic rates between the ICD-11 guidelines and the DSM-5 criteria. Results: The ICD-11 model of PTSD was found to provide excellent model fit in six of the seven trauma samples, and tests of factorial invariance showed that the model performs equally well for males and females. DSM-5 models provided poor fit of the data. Concurrent validity was established as the ICD-11 PTSD factors were all moderately to strongly correlated with scores of depression, anxiety, dissociation, and aggression. Levels of association were similar for ICD-11 and DSM-5 suggesting that explanatory power is not affected due to the limited number of items included in the ICD-11 model. Diagnostic rates were significantly lower according to ICD-11 guidelines compared to the DSM-5 criteria. Conclusions: The proposed factor structure of the ICD-11 model of PTSD appears valid across multiple trauma types, possesses good concurrent validity, and is more stringent in terms of diagnosis compared to the DSM-5 criteria.

  15. Reliability and diagnostic performance of CT imaging criteria in the diagnosis of tuberculous meningitis.

    Directory of Open Access Journals (Sweden)

    Hugo Botha

    Full Text Available INTRODUCTION: Abnormalities on CT imaging may contribute to the diagnosis of tuberculous meningitis (TBM. Recently, an expert consensus case definition (CCD and set of imaging criteria for diagnosing basal meningeal enhancement (BME have been proposed. This study aimed to evaluate the sensitivity, specificity and reliability of these in a prospective cohort of adult meningitis patients. METHODS: Initial diagnoses were based on the CCD, classifying patients into: 'Definite TBM' (microbiological confirmation, 'Probable TBM' (diagnostic score ≥10, 'Possible TBM' (diagnostic score 6-9, 'Not TBM' (confirmation of an alternative diagnosis or 'Uncertain' (diagnostic score of <6. CT images were evaluated independently on two occasions by four experienced reviewers. Intra-rater and inter-rater agreement were calculated using the kappa statistic. Sensitivities and specificities were calculated using both 'Definite TBM' and either 'Definite TBM' or 'Probable TBM' as gold standards. RESULTS: CT scan criteria for BME had good intra-rater agreement (κ range 0.35-0.78 and fair to moderate inter-rater agreement (κ range 0.20-0.52. Intra- and inter-rater agreement on the CCD components were good to fair (κ  =  ranges 0.47-0.81 and 0.21-0.63. Using 'Definite TBM' as a gold standard, the criteria for BME were very specific (61.5%-100%, but insensitive (5.9%-29.4%. Similarly, the imaging components of the CCD were highly specific (69.2-100% but lacked sensitivity (0-56.7%. Similar values were found when using 'Definite TBM' or 'Probable TBM' as a gold standard. DISCUSSION: The fair to moderate inter-rater agreement and poor sensitivities of the criteria for BME suggest that little reliance should be placed in these features in isolation. While the presence of the CCD criteria of acute infarction or tuberculoma(s appears useful as rule-in criteria, their absence is of little help in excluding TBM. The CCD and criteria for BME, as well as any new criteria

  16. Comparing Diagnostic Outcomes of Autism Spectrum Disorder Using DSM-IV-TR and DSM-5 Criteria.

    Science.gov (United States)

    Harstad, Elizabeth B; Fogler, Jason; Sideridis, Georgios; Weas, Sarah; Mauras, Carrie; Barbaresi, William J

    2015-05-01

    Controversy exists regarding the DSM-5 criteria for ASD. This study tested the psychometric properties of the DSM-5 model and determined how well it performed across different gender, IQ, and DSM-IV-TR sub-type, using clinically collected data on 227 subjects (median age = 3.95 years, majority had IQ > 70). DSM-5 was psychometrically superior to the DSM-IV-TR model (Comparative Fit Index of 0.970 vs 0.879, respectively). Measurement invariance revealed good model fit across gender and IQ. Younger children tended to meet fewer diagnostic criteria. Those with autistic disorder were more likely to meet social communication and repetitive behaviors criteria (p < .001) than those with PDD-NOS. DSM-5 is a robust model but will identify a different, albeit overlapping population of individuals compared to DSM-IV-TR.

  17. Diagnostic criteria for the characterization of quasireversible electron transfer reactions by cyclic square wave voltammetry.

    Science.gov (United States)

    Mann, Megan A; Helfrick, John C; Bottomley, Lawrence A

    2014-08-19

    Theory for cyclic square wave voltammetry of quasireversible electron transfer reactions is presented and experimentally verified. The impact of empirical parameters on the shape of the current-voltage curve is examined. From the trends, diagnostic criteria enabling the use of this waveform as a tool for mechanistic analysis of electrode reaction processes are presented. These criteria were experimentally confirmed using Eu(3+)/Eu(2+), a well-established quasireversible analyte. Using cyclic square wave voltammetry, both the electron transfer coefficient and rate were calculated for this analyte and found to be in excellent agreement with literature. When properly applied, these criteria will enable nonexperts in voltammetry to assign the electrode reaction mechanism and accurately measure electrode reaction kinetics.

  18. Diagnostic accuracy of ACR/EULAR 2010 criteria for rheumatoid arthritis in a 2-year cohort.

    Science.gov (United States)

    Varache, Sophie; Cornec, Divi; Morvan, Johanne; Devauchelle-Pensec, Valérie; Berthelot, Jean-Marie; Le Henaff-Bourhis, Catherine; Hoang, Sylvie; Thorel, Jean-Baptiste; Martin, Antoine; Chalès, Gérard; Nowak, Emmanuel; Jousse-Joulin, Sandrine; Youinou, Pierre; Saraux, Alain

    2011-07-01

    To evaluate the diagnostic accuracy of the 2010 American College of Rheumatology/European League Against Rheumatism (ACR/EULAR) and 1987 ACR criteria for rheumatoid arthritis (RA), and the respective role of the algorithm and scoring of the ACR/EULAR. In total, 270 patients with recent-onset arthritis of EULAR scoring, and in the overall population classified according the full tree. At baseline, 111 of the 270 patients had better alternative diagnoses and 16 had erosions typical for RA; of the 143 remaining patients, 52 had more than 6 ACR/EULAR 2010 points (indicating definite RA) and 91 had fewer than 6 points. After 2 years, 11/16 patients with erosions and 40/52 with more than 6 points had RA. 100 of the 270 patients met the reference standard for RA. Sensitivity, specificity, PPV, and NPV of the ACR/EULAR (full tree) were 51/100 (51%), 153/170 (90%), 51/68 (75.4%), and 153/202 (75.7%), respectively. Diagnostic accuracies of the ACR/EULAR score and ACR 1987 criteria were not statistically different. Much of the improvement of the ACR/EULAR criteria was ascribable to the use of exclusion criteria in the algorithm.

  19. The problem of obesity among adolescents in Hong Kong: a comparison using various diagnostic criteria

    Directory of Open Access Journals (Sweden)

    Ho Chung-Shun

    2008-03-01

    Full Text Available Abstract Background Obesity is now a global epidemic. In this study, we aimed to assess the rates of obesity using several major diagnostic criteria in Chinese school adolescents in Hong Kong. Methods This is a cross-sectional study. Using a computer-generated coding system, we randomly selected schools from different geographical regions in Hong Kong to obtain a representative sample. Subjects aged 11–18 years of age were randomly selected from different class of the schools. Their rates of obesity according to four different international and local criteria were compared [International Obesity Task Force (IOTF 2000 criterion; the Group of China Obesity Task Force (COTF 2004 criterion; Centers for Disease Control and Prevention (CDC 2000 Growth Charts and the Hong Kong Growth Survey (HKGS charts in 1993]. Results Of the 2098 adolescents [982 (46.8% boys and 1116 (53.2% girls], the mean age (± SD was 15.1 ± 1.8 years (range: 11–18 years; median: 15.0 years. The crude rates of obesity were similar based on IOTF, COTF or CDC criteria (boys: 3.9–6.0%, girls: 1.8–3.7%, however, the rate increased to 11–27% if the HKGS charts were used. Obesity rate varied markedly according to age. It decreased from 8–10% among those aged 12–13 years to 2–4% among those aged 17–18 years. Conclusion The prevalence of obesity in Hong Kong adolescents using various diagnostic criteria were similar except for the 1993 HKGS criteria, which gave an exceeding high figure. Using the IOTF, COTF or CDC criteria, the adolescent obesity in Hong Kong varied from 1.8% to 6.0%.

  20. Diagnostic and differential diagnostic criteria of lymphoid neoplasms in bone marrow trephine biopsies: a study of 87 cases.

    Science.gov (United States)

    Horváth, Emoke; Mezei, T; Pávai, Z; Turcu, M; Demian, Smaranda; Tóth, Erika; Chira, Liliana; Jung, I

    2009-01-01

    The aim of this study is to present the diagnostic and differential diagnostic criteria of the bone marrow specimen involved by lymphomas based on the histomorphological immunophenotype features and clonality of the tumor cells, patterns of lymphoproliferation and diagnostic pitfalls. BMB material obtained from the right posterior iliac crest was represented from 87 untreated and treated patients with BM involving malignant lymphoma, stained with Hematoxylin-Eosin, Giemsa, Periodic Acid Schiff and Gömöri's Silver. In order to perform immunohistochemistry examination we used a large antibody panel. B-cell clonality was determined in six cases. We found eight reactive lymphoproliferative responses and 79 lymphoid neoplasms of which 45 were diagnosed as de novo lymphoma, the rest of 34 samples being examined for staging. The predominant lymphoma was CLL (30 cases), over followed by DLBCL (18 cases). The most frequent patterns of involvement were the interstitial (29%) and mixed (15%) ones. In eight cases, we found reactive lymphoid aggregates. The B-cell clonality test showed four monoclonal, one oligoclonal and one polyclonal diseases form. Diagnosis of lymphoma versus reactive aggregate has been based on the combination of a lot of antibodies and involvement pattern. Although investigation of gene rearrangement was necessary for the establishment of the correct diagnosis in only 6.9% of cases, it should be emphasized that it is of great importance in disease monitoring.

  1. Effectiveness of Group-Delivered Cognitive Therapy and Treatment Length in Women Veterans with PTSD

    Directory of Open Access Journals (Sweden)

    Diane T. Castillo

    2014-01-01

    Full Text Available The effectiveness and length of group-delivered cognitive treatment for Posttraumatic Stress Disorder (PTSD was examined in a sample of women veterans. The sample included 271 primarily non-Hispanic white (61% and Hispanic (25% women veterans treated in 8-, 10-, or 12-group length sessions with manualized cognitive therapy for PTSD. Outcome was measured with the PTSD Symptom Checklist (PCL in an intention-to-treat analysis (N = 271, in completer subjects (n = 172, and with group as the unit of analysis (n = 47 groups. Significant decreases in PTSD were found in the full sample (effect size [ES] range = 0.27 to 0.38, completers (ES range = 0.37 to 0.54, and group as the unit of analysis (ES range = 0.71 to 0.92, suggesting effectiveness of cognitive group treatment for PTSD. PCL scores significantly improved in the 8, 10, and 12 group lengths, with no differences between each. Clinical improvement showed a third decreasing 10 or more PCL points and 22% no longer meeting PTSD diagnostic criteria, with the best results in the 10-session group. The results suggest group-delivered cognitive therapy is an effective, efficient, time-limited treatment for PTSD.

  2. The relationship between PTSD and chronic pain: mediating role of coping strategies and depression.

    Science.gov (United States)

    Morasco, Benjamin J; Lovejoy, Travis I; Lu, Mary; Turk, Dennis C; Lewis, Lynsey; Dobscha, Steven K

    2013-04-01

    People with chronic pain and comorbid posttraumatic stress disorder (PTSD) report more severe pain and poorer quality of life than those with chronic pain alone. This study evaluated the extent to which associations between PTSD and chronic pain interference and severity are mediated by pain-related coping strategies and depressive symptoms. Veterans with chronic pain were divided into 2 groups, those with (n=65) and those without (n=136) concurrent PTSD. All participants completed measures of pain severity, interference, emotional functioning, and coping strategies. Those with current PTSD reported significantly greater pain severity and pain interference, had more symptoms of depression, and were more likely to meet diagnostic criteria for a current alcohol or substance use disorder (all p-values self-statements. Illness-focused pain coping (i.e., guarding, resting, and asking for assistance) and depressive symptoms jointly mediated the relationship between PTSD and both pain interference (total indirect effect=0.194, p<.001) and pain severity (total indirect effect=0.153, p=.004). Illness-focused pain coping also evidenced specific mediating effects, independent of depression. In summary, specific pain coping strategies and depressive symptoms partially mediated the relationship between PTSD and both pain interference and severity. Future research should examine whether changes in types of coping strategies after targeted treatments predict improvements in pain-related function for chronic pain patients with concurrent PTSD.

  3. New DSM-5 PTSD guilt and shame symptoms among Italian earthquake survivors: Impact on maladaptive behaviors.

    Science.gov (United States)

    Carmassi, Claudia; Bertelloni, Carlo Antonio; Gesi, Camilla; Conversano, Ciro; Stratta, Paolo; Massimetti, Gabriele; Rossi, Alessandro; Dell'Osso, Liliana

    2017-05-01

    Important changes were introduced concerning posttraumatic-stress disorder (PTSD) by the DSM-5 recognizing the role of negative emotions such as guilt and shame, but little evidence is yet available on their prevalence in population assessed by means of DSM-5 criteria. In this study we explored the rates of guilt and shame DSM-5 PTSD diagnostic symptoms among Italian survivors to a massive earthquake and their possible correlation with PTSD and maladaptive behaviors. 869 residents of the town of L'Aquila exposed to the earthquake of April 6th, 2009 were investigated by the Trauma and Loss Spectrum-Self Report (TALS-SR) with particular attention to guilt and shame feelings. DSM-5 symptomatological PTSD was reported by 41.7% of survivors, further 11.6% endorsed at least one guilt/shame symptoms, with significantly higher rates of endorsement were in PTSD respect to No-PTSD subjects, and in the subgroup with at least one maladaptive behavior respect to those with none. There was a significant main effects of PTSD and at least one guilt/shame symptom on TALS-SR symptomatological domains. Mean TALS-SR Maladaptive coping domain score appeared significantly higher in the subgroup with at least one guilt/shame symptom. Further study are needed to investigate guilt and shame feelings in survivors to a natural disaster. Copyright © 2017 Elsevier Ireland Ltd. All rights reserved.

  4. PTSD: National Center for PTSD

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  19. Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD): Development of Image Analysis Criteria and Examiner Reliability for Image Analysis

    Science.gov (United States)

    Ahmad, Mansur; Hollender, Lars; Odont; Anderson, Quentin; Kartha, Krishnan; Ohrbach, Richard K.; Truelove, Edmond L.; John, Mike T.; Schiffman, Eric L.

    2011-01-01

    Introduction As a part of a multi-site RDC/TMD Validation Project, comprehensive TMJ diagnostic criteria were developed for image analysis using panoramic radiography, magnetic resonance imaging (MRI), and computed tomography (CT). Methods Inter-examiner reliability was estimated using the kappa (k) statistic, and agreement between rater pairs was characterized by overall, positive, and negative percent agreement. CT was the reference standard for assessing validity of other imaging modalities for detecting osteoarthritis (OA). Results For the radiological diagnosis of OA, reliability of the three examiners was poor for panoramic radiography (k = 0.16), fair for MRI (k = 0.46), and close to the threshold for excellent for CT (k = 0.71). Using MRI, reliability was excellent for diagnosing disc displacements (DD) with reduction (k = 0.78) and for DD without reduction (k = 0.94), and was good for effusion (k = 0.64). Overall percent agreement for pair-wise ratings was ≥ 82% for all conditions. Positive percent agreement for diagnosing OA was 19% for panoramic radiography, 59% for MRI, and 84% for CT. Using MRI, positive percent agreement for diagnoses of any DD was 95% and for effusion was 81%. Negative percent agreement was ≥ 88% for all conditions. Compared to CT, panoramic radiography and MRI had poor to marginal sensitivity, respectively, but excellent specificity, in detecting OA. Conclusion Comprehensive image analysis criteria for RDC/TMD Validation Project were developed, which can reliably be employed for assessing OA using CT, and for disc position and effusion using MRI. PMID:19464658

  20. Validation of secondary data sources to identify Parkinson disease against clinical diagnostic criteria.

    Science.gov (United States)

    Jain, Samay; Himali, Jayandra; Beiser, Alexa; Ton, Thanh G N; Kelly-Hayes, Margaret; Biggs, Mary Lou; Delaney, Joseph A C; Rosano, Caterina; Seshadri, Sudha; Frank, Samuel A

    2015-02-01

    Parkinson disease (PD) is the second most common neurodegenerative disorder. Its diagnosis relies solely on a clinical examination and is not straightforward because no diagnostic test exists. Large, population-based, prospective cohort studies designed to examine other outcomes that are more common than PD might provide cost-efficient alternatives for studying the disease. However, most cohort studies have not implemented rigorous systematic screening for PD. A majority of epidemiologic studies that utilize population-based prospective designs rely on secondary data sources to identify PD cases. Direct validation of these secondary sources against clinical diagnostic criteria is lacking. The Framingham Heart Study has prospectively screened and evaluated participants for PD based on clinical diagnostic criteria. We assessed the predictive value of secondary sources for PD identification relative to clinical diagnostic criteria in the Framingham Heart Study (2001-2012). We found positive predictive values of 1.0 (95% confidence interval: 0.868, 1.0), 1.0 (95% confidence interval: 0.839, 1.0), and 0.50 (95% confidence interval: 0.307, 0.694) for PD identified from self-report, use of antiparkinsonian medications, and Medicare claims, respectively. The negative predictive values were all higher than 0.99. Our results highlight the limitations of using only Medicare claims data and suggest that population-based cohorts may be utilized for the study of PD determined via self-report or medication inventories while preserving a high degree of confidence in the validity of PD case identification.

  1. Serum IL-7 as diagnostic biomarker for rheumatoid arthritis, validation with EULAR 2010 classification criteria.

    Science.gov (United States)

    Burska, Agata N; Neilan, Jessica; Chisman, Ruth E; Pitaksalee, Rujiraporn; Hodgett, Richard; Marzo-Ortega, Helena; Conaghan, Philip G; West, Robert; Emery, Paul; Ponchel, Frederique

    2017-09-15

    Despite the well-established value of currently used classification criteria for the early diagnosis of rheumatoid arthritis (RA) there is a constant demand for novel biomarkers notably in autoantibody-negative patients. Interleukin 7 (IL-7) has been reported as a candidate diagnostic biomarker based on ACR-1987 criteria. However, clinical practice has moved to using the EULAR 2010 classification criteria. Therefore, to advance the use of IL-7 alongside the RA biomarker pipeline, we repeated the original study in a new cohort. 255 patients were recruited. IL-7 was quantified by ELISA. Univariate and regression analyses were used to model RA diagnosis. 123 patients were diagnosed with RA (EULAR 2010) while 132 were classified as non-RA. In univariate analysis, RA was associated with autoantibodies and SE-positivity, higher joint counts, DAS28 (all pEULAR 2010 criteria although the predictive power associated with IL-7 is lower than in the study using ACR 1987 criteria (both French/UK cohorts). IL-7 remains a potential biomarker for ACPA-negative RA although further validation with larger numbers of ACPA-negative patients is still needed notably to translate these results into clinical applicability.

  2. Analysis of diagnostic criteria in adamantiades-behçet disease: a retrospective study.

    Science.gov (United States)

    di Meo, Nicola; Bergamo, S; Vidimari, P; Bonin, S; Trevisan, G

    2013-07-01

    Adamantiades-Behçet's disease (ABD) is a chronic-relapsing, inflammatory and multi-systemic disease. Any organ or system may be involved: ABD presents a great variety of cutaneous and mucosal lesions, ocular manifestations, central and peripheral nervous system abnormalities, joint as well as gastrointestinal involvement. Since clear pathognomonic clinical features and laboratory tests are lacking, the diagnosis of ABD mainly relies on the characteristic clinical features. Several sets of diagnostic criteria have been used. The International Study Group for Behçet Disease (ISGBD) in 1990 formulated a set of criteria to warrant uniformity of both diagnosis and classification. Therefore, in 2006, a new set was proposed by the International Team for the Revision of the International Criteria for Behçet's Disease (ITR-ICBD) not only to uniform the previous criteria but also to establish best accuracy, along with an optimum sensivity and specificity. The aims of this study are both to analyze the clinical features of ABD patients and to validate the ISGBD and ITR-ICDB criteria for the diagnosis of ABD in our cohort.

  3. Trauma exposure and PTSD among older adolescents in foster care.

    Science.gov (United States)

    Salazar, Amy M; Keller, Thomas E; Gowen, L Kris; Courtney, Mark E

    2013-04-01

    Youth in foster care represent a highly traumatized population. However, trauma research on this population has focused primarily on maltreatment rather than the full spectrum of trauma experiences identified within the DSM-IV. The current study aims to fill this gap by reporting the prevalence of exposure to specific types of traumatic events for a large sample of youth with foster care experience. The study also reports the likelihood of lifetime PTSD diagnoses associated with each specific type of trauma. Data are from a longitudinal panel study of 732 adolescents aged 17 and 18 who were in foster care. Lifetime trauma exposure and PTSD diagnosis were assessed using the Composite International Diagnostic Interview. Statistical comparisons were made using logistic regressions. The majority of respondents had experienced at least one trauma in their lifetime. While overall trauma prevalence did not differ by gender, males were more likely to experience interpersonal violence and environmental trauma, while females were more likely to experience sexual trauma. Caucasian participants reported higher rates of trauma exposure than African-American participants did. The types of trauma associated with the highest probability of a lifetime PTSD diagnosis were rape, being tortured or a victim of terrorists, and molestation. Youth in foster care are a highly traumatized population and meet diagnostic criteria for PTSD at higher rates than general youth populations. The ongoing impact of trauma may be particularly problematic for these young people given their abrupt transition to independence.

  4. Intermittent explosive disorder: development of integrated research criteria for Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition.

    Science.gov (United States)

    Coccaro, Emil F

    2011-01-01

    This study was designed to develop a revised diagnostic criteria set for intermittent explosive disorder (IED) for consideration for inclusion in Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-V). This revised criteria set was developed by integrating previous research criteria with elements from the current DSM-IV set of diagnostic criteria. Evidence supporting the reliability and validity of IED-IR ("IED Integrated Criteria") in a new and well-characterized group of subjects with personality disorder is presented. Clinical, phenomenologic, and diagnostic data from 201 individuals with personality disorder were reviewed. All IED diagnoses were assigned using a best-estimate process (eg, kappa for IED-IR >0.85). In addition, subjects meeting IED-IR criteria had higher scores on dimensional measures of aggression and had lower global functioning scores than non-IED-IR subjects, even when related variables were controlled. The IED-IR criteria were more sensitive than the DSM-IV criteria only in identifying subjects with significant impulsive-aggressive behavior by a factor of 16. We conclude that the IED-IR criteria can be reliably applied and have sufficient validity to warrant consideration as DSM-V criteria for IED.

  5. Restless legs syndrome/Willis-Ekbom disease diagnostic criteria: updated International Restless Legs Syndrome Study Group (IRLSSG) consensus criteria--history, rationale, description, and significance.

    Science.gov (United States)

    Allen, Richard P; Picchietti, Daniel L; Garcia-Borreguero, Diego; Ondo, William G; Walters, Arthur S; Winkelman, John W; Zucconi, Marco; Ferri, Raffaele; Trenkwalder, Claudia; Lee, Hochang B

    2014-08-01

    In 2003, following a workshop at the National Institutes of Health, the International Restless Legs Syndrome Study Group (IRLSSG) developed updated diagnostic criteria for restless legs syndrome/Willis-Ekbom disease (RLS/WED). These criteria were integral to major advances in research, notably in epidemiology, biology, and treatment of RLS/WED. However, extensive review of accumulating literature based on the 2003 NIH/IRLSSG criteria led to efforts to improve the diagnostic criteria further. The clinical standards workshop, sponsored by the WED Foundation and IRLSSG in 2008, started a four-year process for updating the diagnostic criteria. That process included a rigorous review of research advances and input from clinical experts across multiple disciplines. After broad consensus was attained, the criteria were formally approved by the IRLSSG executive committee and membership. Major changes are: (i) addition of a fifth essential criterion, differential diagnosis, to improve specificity by requiring that RLS/WED symptoms not be confused with similar symptoms from other conditions; (ii) addition of a specifier to delineate clinically significant RLS/WED; (iii) addition of course specifiers to classify RLS/WED as chronic-persistent or intermittent; and (iv) merging of the pediatric with the adult diagnostic criteria. Also discussed are supportive features and clinical aspects that are important in the diagnostic evaluation. The IRLSSG consensus criteria for RLS/WED represent an international, interdisciplinary, and collaborative effort intended to improve clinical practice and promote further research. Copyright © 2014 The Authors. Published by Elsevier B.V. All rights reserved.

  6. Biomarkers of Alzheimer disease: current and future applications to diagnostic criteria.

    Science.gov (United States)

    Sperling, Reisa; Johnson, Keith

    2013-04-01

    This article reviews recent advances in imaging and fluid biomarkers for Alzheimer disease (AD) and their application to newly proposed diagnostic criteria across the continuum of AD. There have been remarkable developments in neuroimaging markers for AD over the past decade, most notably the advent of positron emission tomography (PET) amyloid imaging using radiotracers that label fibrillar forms of amyloid-β (Aβ). Similarly, new research in CSF markers suggests CSF levels of Aβ1-42 and phosphorylated tau may be useful in the early diagnosis of AD and prediction of cognitive decline. The National Institute on Aging and the Alzheimer's Association recently convened three workgroups to develop joint recommendations for new diagnostic guidelines across the spectrum of AD. These recommendations incorporate biomarkers and propose updated criteria for the previously recognized stage of AD dementia, the evolving definition of mild cognitive impairment, and a newly proposed concept of stages of preclinical AD. Recent advances in AD biomarkers have increased the ability to detect evidence of early AD pathology in vivo. These biomarkers have been incorporated into new diagnostic recommendations, but a number of challenges remain for the biomarkers to become widely applied in clinical practice.

  7. DSM-V diagnostic criteria for bereavement-related disorders in children and adolescents: developmental considerations.

    Science.gov (United States)

    Kaplow, Julie B; Layne, Christopher M; Pynoos, Robert S; Cohen, Judith A; Lieberman, Alicia

    2012-01-01

    Two bereavement-related disorders are proposed for the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-V): Adjustment Disorder Related to Bereavement, to be located in the main body of the text as an official diagnostic entity; and Bereavement-Related Disorder, including a Traumatic Death Specifier, to be located in the Appendix as an invitation for further research. These diagnoses currently do not include developmentally informed criteria, despite the importance of developmental processes in the ways children and adolescents grieve. In this article, we draw upon a selective review of the empirical literature and expert clinical knowledge to recommend developmentally informed modifications and specifiers of the proposed criteria for both bereavement disorders and strategies to improve future research. This article is derived from an invited report submitted to the DSM-V Posttraumatic Stress Disorder, Trauma, and Dissociative Disorders Sub-Work Group, and suggested modifications have received preliminary approval to be incorporated into the DSM-V at the time of this writing. Adoption of these proposals will have far-reaching consequences, given that DSM-V criteria will influence both critical treatment choices for bereaved youth and the next generation of research studies.

  8. Type 2 diabetes after gestational diabetes: The influence ofchanging diagnostic criteria

    Institute of Scientific and Technical Information of China (English)

    Eoin Noctor; Fidelma P Dunne

    2015-01-01

    A previous diagnosis of gestational diabetes (GDM) carries a lifetime risk of progression to type 2 diabetes of up to 60%. Identification of those women at higher risk of progression to diabetes allows the timely introduction of measures to delay or prevent diabetes onset. However, there is a large degree of variability in the literature with regard to the proportion ofwomen with a history of GDM who go on to developdiabetes. Heterogeneity between cohorts with regardto diagnostic criteria used, duration of follow-up, andthe characteristics of the study population limit theability to make meaningful comparisons across studies.As the new International Association for Diabetesin Pregnancy Study Group criteria are increasinglyadopted worldwide, the prevalence of GDM is set toincrease by two-to three-fold. Here, we review theliterature to examine the evolution of diagnostic criteriafor GDM, the implications of changing criteria on theproportion of women with previous GDM progressingto diabetes, and how the use of different diagnosticcriteria may influence the development of appropriatefollow-up strategies.

  9. Post-traumatic Stress Disorder Post Partum: The Impact of Birth on the Prevalence of Post-traumatic Stress Disorder (PTSD) in Multiparous Women.

    Science.gov (United States)

    Schwab, W; Marth, C; Bergant, A M

    2012-01-01

    Traumatic birth experiences may lead to serious psychological impairment. Recent studies show that a considerable number of women can develop post-traumatic stress disorder (PTSD), in some cases in a subsyndromal form. Until now, the possibility that postpartum psychological symptoms might be a continuum of a pre-existing disorder in pregnancy has rarely been considered. This study therefore aimed to evaluate the proportion of women who develop post-traumatic stress disorder as a result of childbirth. Materials and Methods: 56 multiparous women were recruited for the study. The diagnosis of PTSD was made according to the criteria for psychological disorders in the DSM-IV (Diagnostics and Statistical Manual of Mental Disorders). The data were collected in structured interviews in the 30th to 38th week of gestation and in the 6th week post partum. Results: Of the 56 women participating, 52 (93 %) completed the survey. Uncontrolled results showed that 21.15 % of the multiparous women met the full diagnostic PTSD criteria in the 6th week post partum. After the exclusion of all cases already characterised by all criteria or a subsyndromal form of PTSD caused by previous traumatisation, the PTSD rate was below 8 % at 6 weeks postpartum (= incidence rate of PTSD post partum). Conclusions: The present study is the first prospective longitudinal study to demonstrate the occurrence of full criteria PTSD in multiparous women as a result of childbirth after having excluded pre-existing PTSD. The results of our study show a high prevalence rate of PTSD during pregnancy. A number of women report all aspects of post-traumatic stress disorder as a result of childbirth.

  10. Diagnostic performance of the ACR/EULAR 2010 criteria for rheumatoid arthritis and two diagnostic algorithms in an early arthritis clinic (REACH)

    NARCIS (Netherlands)

    C. Alves (Celina); J.J. Luime (Jolanda); D. van Zeben (Derkjen); M.A.M. Huisman (Margriet); A.E.A.M. Weel (Angelique); P.J. Barendregt (Pieternella); J.M.W. Hazes (Mieke)

    2011-01-01

    textabstractIntroduction: An ACR/EULAR task force released new criteria to classify rheumatoid arthritis at an early stage. This study evaluates the diagnostic performance of these criteria and algorithms by van der Helm and Visser in REACH. Methods: Patients with symptoms ≤12 months from REACH were

  11. Validation of post-traumatic stress disorder (PTSD) and complex PTSD using the International Trauma Questionnaire.

    Science.gov (United States)

    Hyland, P; Shevlin, M; Brewin, C R; Cloitre, M; Downes, A J; Jumbe, S; Karatzias, T; Bisson, J I; Roberts, N P

    2017-09-01

    The 11th version of the International Classification of Diseases (ICD-11) has proposed two related trauma diagnoses: Post-traumatic stress disorder (PTSD) and Complex PTSD (CPTSD). Using a newly developed, disorder-specific measure of PTSD and CPTSD called the International Trauma Questionnaire (ITQ) the current study will (i) assess the factorial validity of ICD-11 PTSD and CPTSD; (ii) provide the first test of the discriminant validity of these constructs; and (iii) provide the first comparison of ICD-11, and Diagnostic and Statistical Manual, Fifth Edition (DSM-5), PTSD diagnostic rates using disorder-specific measures. ICD-11 and DSM-5 PTSD-specific measures were completed by a British clinical sample of trauma-exposed patients (N = 171). The structure and validity of ICD-11 PTSD and CPTSD were assessed by means of factor analysis and assessing relationships with criterion variables. Diagnostic rates under ICD-11 were significantly lower than those under DSM-5. A two-factor second-order model reflecting the distinction between PTSD and CPTSD best represented the data from the ITQ; and the PTSD and CPTSD factors differentially predicted multiple psychological variables. The factorial and discriminant validity of ICD-11 PTSD and CPTSD was supported, and ICD-11 produces fewer diagnostic cases than DSM-5. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  12. Validation of the clinical diagnostic criteria for temporomandibular disorders for the diagnostic subgroup of degenerative joint disease.

    Science.gov (United States)

    Brandlmaier, I; Grüner, S; Rudisch, A; Bertram, S; Emshoff, R

    2003-04-01

    Research is needed to assess the validity of the Clinical Diagnostic Criteria for Temporomandibular Disorders (CDC/TMD). The purpose of this study was to test the reliability of the clinical diagnosis of temporomandibular joint (TMJ) degenerative joint disease (DJD) as compared with the magnetic resonance imaging (MRI) 'gold standard'. The TMJ DJD group comprised 48 joints in 24 consecutive patients who were assigned a clinical bilateral diagnosis of TMJ DJD. The TMJ non-DJD group consisted of 82 joints in 41 consecutive patients without a TMJ-related diagnosis of TMD. Bilateral sagittal and coronal MR images were obtained subsequently to establish the corresponding diagnosis of degenerative joint changes. An MRI diagnosis of osteoarthrosis (OA) was defined by the presence of flattening, subchondral sclerosis, surface irregularities, and erosion of the condyle or presence of condylar deformities associated with flattening, subchondral sclerosis, surface irregularities, erosion and osteophyte. For the CDC/TMD interpretations, the positive predictive of DJD for OA was 67%, and for the presence of degenerative joint changes 88%. The overall diagnostic agreement for DJD was 44.6% with a corresponding K-value of 0.01. Most of the disagreement was due to false-negative interpretations of asymptomatic joints. The results suggest CDC/TMD to be predictive for degenerative joint changes but insufficient for determination of OA. Patients assigned a clinical TMJ-related diagnosis of DJD may need to be supplemented by evidence from MRI to determine the presence or absence of OA.

  13. The DSM-5 diagnostic criteria for anorexia nervosa may change its population prevalence and prognostic value.

    Science.gov (United States)

    Mustelin, Linda; Silén, Yasmina; Raevuori, Anu; Hoek, Hans W; Kaprio, Jaakko; Keski-Rahkonen, Anna

    2016-06-01

    The definition of anorexia nervosa was revised for the Fifth Edition of the Diagnostic and Statistical Manual (DSM-5). We examined the impact of these changes on the prevalence and prognosis of anorexia nervosa. In a nationwide longitudinal study of Finnish twins born 1975-1979, the women (N = 2825) underwent a 2-stage screening for eating disorders at mean age 24. Fifty-five women fulfilled DSM-IV criteria for lifetime anorexia nervosa. When we recoded the interviews using DSM-5 criteria, we detected 37 new cases. We contrasted new DSM-5 vs. DSM-IV cases to assess their clinical characteristics and prognosis. We also estimated lifetime prevalences and incidences and tested the association of minimum BMI with prognosis. We observed a 60% increase in the lifetime prevalence of anorexia nervosa using the new diagnostic boundaries, from 2.2% to 3.6%. The new cases had a later age of onset (18.8 y vs. 16.5, p = 0.002), higher minimum BMI (16.9 vs. 15.5 kg/m(2), p = 0.0004), a shorter duration of illness (one year vs. three years, p = 0.002), and a higher 5-year probability or recovery (81% vs. 67%, p = 0.002). Minimum BMI was not associated with prognosis. It therefore appears that the substantial increase in prevalence of anorexia nervosa is offset by a more benign course of illness in new cases. Increased diagnostic heterogeneity underscores the need for reliable indicators of disease severity. Our findings indicate that BMI may not be an ideal severity marker, but should be complemented by prognostically informative criteria. Future studies should focus on identifying such factors in prospective settings.

  14. Scientific Statement on the Diagnostic Criteria, Epidemiology, Pathophysiology, and Molecular Genetics of Polycystic Ovary Syndrome.

    Science.gov (United States)

    Dumesic, Daniel A; Oberfield, Sharon E; Stener-Victorin, Elisabet; Marshall, John C; Laven, Joop S; Legro, Richard S

    2015-10-01

    Polycystic ovary syndrome (PCOS) is a heterogeneous and complex disorder that has both adverse reproductive and metabolic implications for affected women. However, there is generally poor understanding of its etiology. Varying expert-based diagnostic criteria utilize some combination of oligo-ovulation, hyperandrogenism, and the presence of polycystic ovaries. Criteria that require hyperandrogenism tend to identify a more severe reproductive and metabolic phenotype. The phenotype can vary by race and ethnicity, is difficult to define in the perimenarchal and perimenopausal period, and is exacerbated by obesity. The pathophysiology involves abnormal gonadotropin secretion from a reduced hypothalamic feedback response to circulating sex steroids, altered ovarian morphology and functional changes, and disordered insulin action in a variety of target tissues. PCOS clusters in families and both female and male relatives can show stigmata of the syndrome, including metabolic abnormalities. Genome-wide association studies have identified a number of candidate regions, although their role in contributing to PCOS is still largely unknown.

  15. Scientific Statement on the Diagnostic Criteria, Epidemiology, Pathophysiology, and Molecular Genetics of Polycystic Ovary Syndrome

    Science.gov (United States)

    Dumesic, Daniel A.; Oberfield, Sharon E.; Stener-Victorin, Elisabet; Marshall, John C.; Laven, Joop S.

    2015-01-01

    Polycystic ovary syndrome (PCOS) is a heterogeneous and complex disorder that has both adverse reproductive and metabolic implications for affected women. However, there is generally poor understanding of its etiology. Varying expert-based diagnostic criteria utilize some combination of oligo-ovulation, hyperandrogenism, and the presence of polycystic ovaries. Criteria that require hyperandrogenism tend to identify a more severe reproductive and metabolic phenotype. The phenotype can vary by race and ethnicity, is difficult to define in the perimenarchal and perimenopausal period, and is exacerbated by obesity. The pathophysiology involves abnormal gonadotropin secretion from a reduced hypothalamic feedback response to circulating sex steroids, altered ovarian morphology and functional changes, and disordered insulin action in a variety of target tissues. PCOS clusters in families and both female and male relatives can show stigmata of the syndrome, including metabolic abnormalities. Genome-wide association studies have identified a number of candidate regions, although their role in contributing to PCOS is still largely unknown. PMID:26426951

  16. Impact of the Use of Different Diagnostic Criteria in the Prevalence of Dyslipidemia in Pregnant Women

    Directory of Open Access Journals (Sweden)

    Alina Coutinho Rodrigues Feitosa

    Full Text Available Abstract Background: There is a physiologic elevation of total cholesterol (TC and triglycerides (TG during pregnancy. Some authors define dyslipidemia (DLP in pregnant women when TC, LDL and TG concentrations are above the 95th percentile (p95% and HDL concentration is below the 5th percentile (P5% for gestational age (GA. Objective: To compare the prevalence of DLP in pregnant women using percentiles criteria with the V Brazilian Guidelines on Dyslipidemia and the association with maternal and fetal outcomes. Results: Pregnant women with high-risk conditions, aged 18-50 years, and at least one lipid profile during pregnancy was classified as the presence of DLP by two diagnostic criteria. Clinical and laboratorial data of mothers and newborns were evaluated. Conclusion: 433 pregnant women aged 32.9 ± 6.5 years were studied. Most (54.6% had lipid profile collected during third trimester. The prevalence of any lipid abnormalities according to the criteria of the National Guidelines was 83.8%: TC ≥ 200 mg/dL was found in 49.9%; LDL ≥ 160 mg/dL, in 14.3%, HDL ≤ 50 mg/dL in 44.4% and TG ≥ 150 mg/dL in 65.3%. Any changes of lipid according to percentiles criteria was found in 19.6%: elevation above the P95% for TC was found in 0.7%; for LDL, 1.7%; for TG 6.4% and HDL lower than the P5% in 13%. The frequency of comorbidity: hypertension, diabetes, smoking, obesity and preeclampsia was similar among pregnant women when DLP was compared by both criteria. Conclusion: The prevalence of DLP during pregnancy varies significantly depending on the criteria used, however none demonstrated superiority in association with comorbidities.

  17. Applicability of the ICD-11 proposal for PTSD: a comparison of prevalence and comorbidity rates with the DSM-IV PTSD classification in two post-conflict samples

    Directory of Open Access Journals (Sweden)

    Nadine Stammel

    2015-05-01

    Full Text Available Background: The World Health Organization recently proposed significant changes to the posttraumatic stress disorder (PTSD diagnostic criteria in the 11th edition of the International Classification of Diseases (ICD-11. Objective: The present study investigated the impact of these changes in two different post-conflict samples. Method: Prevalence and rates of concurrent depression and anxiety, socio-demographic characteristics, and indicators of clinical severity according to ICD-11 in 1,075 Cambodian and 453 Colombian civilians exposed to civil war and genocide were compared to those according to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV. Results: Results indicated significantly lower prevalence rates under the ICD-11 proposal (8.1% Cambodian sample and 44.4% Colombian sample compared to the DSM-IV (11.2% Cambodian sample and 55.0% Colombian sample. Participants meeting a PTSD diagnosis only under the ICD-11 proposal had significantly lower rates of concurrent depression and a lower concurrent total score (depression and anxiety compared to participants meeting only DSM-IV diagnostic criteria. There were no significant differences in socio-demographic characteristics and indicators of clinical severity between these two groups. Conclusions: The lower prevalence of PTSD according to the ICD-11 proposal in our samples of persons exposed to a high number of traumatic events may counter criticism of previous PTSD classifications to overuse the PTSD diagnosis in populations exposed to extreme stressors. Also another goal, to better distinguish PTSD from comorbid disorders could be supported with our data.

  18. [Myocardial infarction and acute coronary syndrome: definitions, classification, and diagnostic criteria].

    Science.gov (United States)

    Zaĭrat'iants, O V; Mishnev, O D; Kakturskiĭ, L V

    2014-01-01

    The review gives the definitions and classification of and diagnostic criteria for myocardial infarction and acute coronary syndrome in accordance with the "The third universal definition of myocardial infarction" adopted in 2012 (Joint ESC/ACCF/AHA/WHF Task Force for the Universal Definition of Myocardial Infarction, 2012). It also discusses the clinical and morphological comparisons of and the problems in the differential diagnosis of myocardial infarction as a nosological entity within coronary heart disease with other coronarogenic and non-coronarogenic necroses of the myocardium.

  19. The DSM diagnostic criteria for hypoactive sexual desire disorder in women.

    Science.gov (United States)

    Brotto, Lori A

    2010-04-01

    Hypoactive Sexual Desire Disorder (HSDD) is one of two sexual desire disorders in the Diagnostic and Statistical Manual of Mental Disorders (DSM) and is defined by the monosymptomatic criterion "persistently or recurrently deficient (or absent) sexual fantasies and desire for sexual activity" that causes "marked distress or interpersonal difficulty." This article reviews the diagnosis of HSDD in prior and current (DSM-IV-TR) editions of the DSM, critiques the existing criteria, and proposes criteria for consideration in DSM-V. Problems in coming to a clear operational definition of desire, the fact that sexual activity often occurs in the absence of desire for women, conceptual issues in understanding untriggered versus responsive desire, the relative infrequency of unprovoked sexual fantasies in women, and the significant overlap between desire and arousal are reviewed and highlight the need for revised DSM criteria for HSDD that accurately reflect women's experiences. The article concludes with the recommendation that desire and arousal be combined into one disorder with polythetic criteria.

  20. Scene setting: criteria for acceptability and suspension levels in diagnostic radiology, nuclear medicine and radiotherapy.

    Science.gov (United States)

    Malone, Jim; Faulkner, Keith; Christofides, Stelios; Lillicrap, Stephen; Horton, Patrick

    2013-02-01

    The EC (European Commission) Directive on radiation protection of patients requires that Criteria for Acceptability of Equipment in Diagnostic Radiology, Nuclear Medicine and Radiotherapy be established throughout the member states. This paper reviews the background to this requirement and to its implementation in practice. It notes parallel requirements in the EC medical devices directive and International Electrotechnical Commission standards. It is also important to be aware and that both sets of requirements should ideally be harmonised due to the global nature of the equipment industry. The paper further reviews the type of criteria that can be well applied for the above purposes, and defines qualitative criteria and suspension levels suitable for application. Both are defined and relationships with other acceptance processes are considered (including acceptance testing at the time of purchase, commissioning and the issue of second-hand equipment). Suspension levels are divided into four types, A, B, C and D, depending on the quality of evidence and consensus on which they are based. Exceptional situations involving, for example, new or rapidly evolving technology are also considered. The publication and paper focuses on the role of the holder of the equipment and related staff, particularly the medical physics expert and the practitioner. Advice on how the criteria should be created and implemented and how this might be coordinated with the supplier is provided for these groups. Additional advice on the role of the regulator is provided.

  1. Riluzole treatment, survival and diagnostic criteria in Parkinson plus disorders: The NNIPPS Study

    Science.gov (United States)

    Bensimon, Gilbert; Ludolph, Albert; Agid, Yves; Vidailhet, Marie; Payan, Christine; Leigh, P. Nigel

    2009-01-01

    Parkinson plus diseases, comprising mainly progressive supranuclear palsy (PSP) and multiple system atrophy (MSA) are rare neurodegenerative conditions. We designed a double-blind randomized placebo-controlled trial of riluzole as a potential disease-modifying agent in Parkinson plus disorders (NNIPPS: Neuroprotection and Natural History in Parkinson Plus Syndromes). We analysed the accuracy of our clinical diagnostic criteria, and studied prognostic factors for survival. Patients with an akinetic-rigid syndrome diagnosed as having PSP or MSA according to modified consensus diagnostic criteria were considered for inclusion. The psychometric validity (convergent and predictive) of the NNIPPS diagnostic criteria were tested prospectively by clinical and pathological assessments. The study was powered to detect a 40% decrease in relative risk of death within PSP or MSA strata. Patients were randomized to riluzole or matched placebo daily and followed up to 36 months. The primary endpoint was survival. Secondary efficacy outcomes were rates of disease progression assessed by functional measures. A total of 767 patients were randomized and 760 qualified for the Intent to Treat (ITT) analysis, stratified at entry as PSP (362 patients) or MSA (398 patients). Median follow-up was 1095 days (range 249–1095). During the study, 342 patients died and 112 brains were examined for pathology. NNIPPS diagnostic criteria showed for both PSP and MSA excellent convergent validity with the investigators’ assessment of diagnostic probability (point-biserial correlation: MSA rpb = 0.93, P < 0.0001; PSP, rpb = 0.95, P < 0.0001), and excellent predictive validity against histopathology [sensitivity and specificity (95% CI) for PSP 0.95 (0.88–0.98) and 0.84 (0.77–0.87); and for MSA 0.96 (0.88–0.99) and 0.91 (0.86–0.93)]. There was no evidence of a drug effect on survival in the PSP or MSA strata (3 year Kaplan–Meier estimates PSP-riluzole: 0.51, PSP-placebo: 0.50; MSA

  2. Normative life events and PTSD in children: how easy stress can affect children's brain.

    Science.gov (United States)

    Kousha, Maryam; Mehdizadeh Tehrani, Shervin

    2013-01-01

    Exposure to traumatic events is common in children and adolescent. Post traumatic stress disorder (PTSD) is an emotional reaction to traumatic events, which is increasingly recognized to be a prevalent and disabling disorder. The aim of this study is to determine the distribution of normative life events which predicts PTSD in youth who referred to an outpatient clinic in Rasht, Iran. This study is a cross-sectional descriptive study. The samples of children and adolescents ranging from 1-18 yr old who were diagnosed PTSD based on DSM-IV criteria in psychiatric interview and K-SADS (Kiddie-schedule for affective disorder and schizophrenia for school age children) semi-structured diagnostic interview, from 2005 until 2008.The information consist of: age, sex, comorbidity with PTSD, events accompanying with PTSD, and time interval between events and visit. Eighty four youth who met the diagnosis of PTSD and their parents participated in the survey. Half of PTSD youth were 6-11 years old and admitted to clinic in the first 3 months after events. The most common events were witnessing violent or fearful scenes on TV followed by witnessing someone's death or funeral ceremony. The most comorbidity with PTSD included: attention deficit hyperactivity disorder, depression and anxiety. Our results indicate that youth exposure to violent or fearful scenes on TV could be very traumatic for them. Informing parents about the potential effect of low-magnitude stressors such as violent or fearful scenes on TV and funeral ceremony can decrease the prevalence of PTSD in youth.

  3. Obsessive-compulsive disorder: a review of the diagnostic criteria and possible subtypes and dimensional specifiers for DSM-V

    NARCIS (Netherlands)

    J.F. Leckman; D. Denys; H.B. Simpson; D. Mataix-Cols; E. Hollander; S. Saxena; E.C. Miguel; S.L. Rauch; W.K. Goodman; K.A. Phillips; D.J. Stein

    2010-01-01

    BACKGROUND: Since the publication of the DSM-IV in 1994, research on obsessive-compulsive disorder (OCD) has continued to expand. It is timely to reconsider the nosology of this disorder, assessing whether changes to diagnostic criteria as well as subtypes and specifiers may improve diagnostic valid

  4. A Prospective Study of the Concordance of DSM-IV and DSM-5 Diagnostic Criteria for Autism Spectrum Disorder.

    Science.gov (United States)

    Mazurek, Micah O; Lu, Frances; Symecko, Heather; Butter, Eric; Bing, Nicole M; Hundley, Rachel J; Poulsen, Marie; Kanne, Stephen M; Macklin, Eric A; Handen, Benjamin L

    2017-06-16

    The transition from DSM-IV to DSM-5 criteria for autism spectrum disorder (ASD) sparked considerable concern about the potential implications of these changes. This study was designed to address limitations of prior studies by prospectively examining the concordance of DSM-IV and final DSM-5 criteria on a consecutive sample of 439 children referred for autism diagnostic evaluations. Concordance and discordance were assessed using a consistent diagnostic battery. DSM-5 criteria demonstrated excellent overall specificity and good sensitivity relative to DSM-IV criteria. Sensitivity and specificity were strongest for children meeting DSM-IV criteria for autistic disorder, but poor for those meeting criteria for Asperger's disorder and pervasive developmental disorder. Higher IQ, older age, female sex, and less pronounced ASD symptoms were associated with greater discordance.

  5. Performance of Different Diagnostic Criteria for Familial Mediterranean Fever in Children with Periodic Fevers : Results from a Multicenter International Registry

    NARCIS (Netherlands)

    Demirkaya, Erkan; Saglam, Celal; Turker, Turker; Koné-Paut, Isabelle; Woo, Pat; Doglio, Matteo; Amaryan, Gayane; Frenkel, Joost; Uziel, Yosef; Insalaco, Antonella; Cantarini, Luca; Hofer, Michael; Boiu, Sorina; Duzova, Ali; Modesto, Consuelo; Bryant, Annette; Rigante, Donato; Papadopoulou-Alataki, Efimia; Guillaume-Czitrom, Severine; Kuemmerle-Deschner, Jasmine; Neven, Bénédicte; Lachmann, Helen; Martini, Alberto; Ruperto, Nicolino; Gattorno, Marco; Ozen, Seza

    2015-01-01

    OBJECTIVE: Our aims were to validate the pediatric diagnostic criteria in a large international registry and to compare them with the performance of previous criteria for the diagnosis of familial Mediterranean fever (FMF). METHODS: Pediatric patients with FMF from the Eurofever registry were used

  6. Variability among Research Diagnostic Interview Instruments in the Application of "DSM-IV-TR" Criteria for Pediatric Bipolar Disorder

    Science.gov (United States)

    Galanter, Cathryn A.; Hundt, Stephanie R.; Goyal, Parag; Le, Jenna; Fisher, Prudence W.

    2012-01-01

    Objective: The "DSM-IV-TR "criteria for a manic episode and bipolar disorder (BD) were developed for adults but are used for children. The manner in which clinicians and researchers interpret these criteria may have contributed to the increase in BD diagnoses given to youth. Research interviews are designed to improve diagnostic reliability and…

  7. Performance of Different Diagnostic Criteria for Familial Mediterranean Fever in Children with Periodic Fevers : Results from a Multicenter International Registry

    NARCIS (Netherlands)

    Demirkaya, Erkan; Saglam, Celal; Turker, Turker; Koné-Paut, Isabelle; Woo, Pat; Doglio, Matteo; Amaryan, Gayane; Frenkel, Joost; Uziel, Yosef; Insalaco, Antonella; Cantarini, Luca; Hofer, Michael; Boiu, Sorina; Duzova, Ali; Modesto, Consuelo; Bryant, Annette; Rigante, Donato; Papadopoulou-Alataki, Efimia; Guillaume-Czitrom, Severine; Kuemmerle-Deschner, Jasmine; Neven, Bénédicte; Lachmann, Helen; Martini, Alberto; Ruperto, Nicolino; Gattorno, Marco; Ozen, Seza

    2015-01-01

    OBJECTIVE: Our aims were to validate the pediatric diagnostic criteria in a large international registry and to compare them with the performance of previous criteria for the diagnosis of familial Mediterranean fever (FMF). METHODS: Pediatric patients with FMF from the Eurofever registry were used f

  8. Variability among Research Diagnostic Interview Instruments in the Application of "DSM-IV-TR" Criteria for Pediatric Bipolar Disorder

    Science.gov (United States)

    Galanter, Cathryn A.; Hundt, Stephanie R.; Goyal, Parag; Le, Jenna; Fisher, Prudence W.

    2012-01-01

    Objective: The "DSM-IV-TR "criteria for a manic episode and bipolar disorder (BD) were developed for adults but are used for children. The manner in which clinicians and researchers interpret these criteria may have contributed to the increase in BD diagnoses given to youth. Research interviews are designed to improve diagnostic reliability and…

  9. The shape of the polarization curve and diagnostic criteria for control of the metal electrodeposition process

    Directory of Open Access Journals (Sweden)

    Popov Konstantin I.

    2016-01-01

    Full Text Available The simulated shapes of the polarization curves were correlated with the type of metal electrodeposition process control in a function of the exchange current density to the limiting diffusion current density (j0/jL ratios. Diagnostic criteria based on the j0/jL ratios were established. For j0/jL> 100, the system is under the ohmic control. In the range 1 < j0/jL ≤ 100 there is the mixed ohmic-diffusion control. The pure diffusion control appears in the range 0.1 < j0/jL £ 1. For j0/jL £ 0.1, the system is activation controlled at the low overpotentials. The proposed diagnostic criteria were verified by comparison of the simulated curves with experimentally recorded ones and by morphological analysis of deposits obtained in the different types of metal electrodeposition process control. [Projekat Ministarstva nauke Republike Srbije, br. 172046: Electrochemical synthesis and characterization of nanostructured functional materials for application in new technologies

  10. Methods, Diagnostic Criteria, Cutoff Points, and Prevalence of Sarcopenia among Older People

    Directory of Open Access Journals (Sweden)

    Valéria Pagotto

    2014-01-01

    Full Text Available Aim. To identify methods, index, diagnostic criteria, and corresponding cutoff points used to estimate the prevalence of sarcopenia in older people in different countries. Methods. A systematic review was carried out in accordance with PRISMA Statement. The search encompassed the MEDLINE and LILACS databases and was executed during March 2012 using the keyword sarcopenia. Results. A total of 671 studies were identified by the search strategy, and 30 meet all inclusion criteria. Specifically for dual-X-ray absorptiometry, prevalence ranged from 2.2% to 95% in men and from 0.1% to 33.9% in women. For bioelectrical impedance analysis, the range was from 6.2% to 85.4% in men and 2.8% to 23.6% in women. Regarding anthropometric and computed tomography, prevalence rates were, respectively, 14.1% and 55.9%. Conclusions. Heterogeneity in prevalence of sarcopenia was identified, due to diagnostic method choice, cutoff points, and, characteristics of the population as well as reference population. These factors should be considered in research designs to enable comparison and validation of results. Despite the limitations of most studies that indicated high prevalence rates, the results indicate the need for early detection of this syndrome.

  11. Sporadic Creutzfeldt-Jakob disease with focal findings: caveats to current diagnostic criteria

    Directory of Open Access Journals (Sweden)

    Edward C. Mader

    2013-02-01

    Full Text Available The clinical diagnosis of Creutzfeldt-Jakob disease (CJD is largely based on the 1998 World Health Organization diagnostic criteria. Unfortunately, rigid compliance with these criteria may result in failure to recognize sporadic CJD (sCJD, especially early in its course when focal findings predominate and traditional red flags are not yet present. A 61-year-old man presented with a 3-week history of epilepsia partialis continua (jerking of the left upper extremity and a 2-week history of forgetfulness and left hemiparesis; left hemisensory neglect was also detected on admission. Repeated brain magnetic resonance imaging (MRI showed areas of restricted diffusion in the cerebral cortex, initially on the right but later spreading to the left. Electroencephalography (EEG on hospital days 7, 10, and 14 showed right-sided periodic lateralized epileptiform discharges. On day 20, the EEG showed periodic sharp wave complexes leading to a diagnosis of probable sCJD and subsequently to definite sCJD with brain biopsy. Neurological decline was relatively fast with generalized myoclonus and akinetic mutism developing within 7 weeks from the onset of illness. CJD was not immediately recognized because of the patient’s focal/lateralized manifestations. Focal/lateralized clinical, EEG, and MRI findings are not uncommon in sCJD and EEG/MRI results may not be diagnostic in the early stages of sCJD. Familiarity with these caveats and with the most current criteria for diagnosing probable sCJD (University of California San Francisco 2007, MRI-CJD Consortium 2009 will enhance the ability to recognize sCJD and implement early safety measures.

  12. A critical review of ADHD diagnostic criteria: what to address in the DSM-V.

    Science.gov (United States)

    Bell, Allison S

    2011-01-01

    ADHD is an impairing psychological disorder that predominantly affects children, but also adults to a lesser extent. As a result, a considerable amount of research has been completed in recent years to better understand the nature of the disorder to best treat individuals experiencing symptoms of ADHD. Especially with the publication of the Diagnostic and Statistical Manual of Mental Disorders (5th ed.) (DSM-V) on the horizon, substantial empirical work has been analyzing current ADHD diagnostic criteria and what upcoming changes should be made. Among child and adult populations, adjusting or completely eradicating the age of onset criterion is well supported. With specifically adult populations, amending symptoms to be more developmentally and environmentally appropriate also appears necessary. Even though research additionally questions the state of ADHD subtypes (with both child and adult populations) and other general diagnostic issues (model for diagnosis and level of impairment), continued research is needed to better clarify what other changes should be made in the DSM-V and beyond.

  13. Revisiting neurofibromatosis type 2 diagnostic criteria to exclude LZTR1-related schwannomatosis.

    Science.gov (United States)

    Smith, Miriam J; Bowers, Naomi L; Bulman, Michael; Gokhale, Carolyn; Wallace, Andrew J; King, Andrew T; Lloyd, Simon K L; Rutherford, Scott A; Hammerbeck-Ward, Charlotte L; Freeman, Simon R; Evans, D Gareth

    2017-01-03

    To determine the specificity of the current clinical diagnostic criteria for neurofibromatosis type 2 (NF2) relative to the requirement for unilateral vestibular schwannoma (VS) and at least 2 other NF2-related tumors. We interrogated our Manchester NF2 database, which contained 205 individuals meeting NF2 criteria who initially presented with a unilateral VS. Of these, 83 (40.7%) went on to develop a contralateral VS. We concentrated our genetic analysis on a group of 70 who initially fulfilled NF2 criteria with a unilateral vestibular schwannoma and at least 2 additional nonintradermal schwannomas. Overall, 5/70 (7%) individuals with unilateral VS and at least 2 other schwannomas had a pathogenic or likely pathogenic LZTR1 mutation. Twenty of the 70 subsequently developed bilateral disease. Of the remaining 50, 5 (10%) had a germline LZTR1 mutation, equivalent to the number (n = 5) with a germline NF2 mutation. The most common etiology for unilateral VS and 2 additional NF2-associated tumors in this cohort was mosaic NF2. Germline LZTR1 and germline NF2 mutations were equally common in our cohort. This indicates that LZTR1 must be considered when making a diagnosis of NF2 in the presence of unilateral VS in individuals without a germline NF2 mutation. © 2016 American Academy of Neurology.

  14. Test-retest reliability of the proposed DSM-5 eating disorder diagnostic criteria

    Science.gov (United States)

    Sysko, Robyn; Roberto, Christina A.; Barnes, Rachel D.; Grilo, Carlos M.; Attia, Evelyn; Walsh, B. Timothy

    2012-01-01

    The proposed DSM-5 classification scheme for eating disorders includes both major and minor changes to the existing DSM-IV diagnostic criteria. It is not known what effect these modifications will have on the ability to make reliable diagnoses. Two studies were conducted to evaluate the short-term test-retest reliability of the proposed DSM-5 eating disorder diagnoses: anorexia nervosa, bulimia nervosa, binge eating disorder, and feeding and eating conditions not elsewhere classified. Participants completed two independent telephone interviews with research assessors (n=70 Study 1; n=55 Study 2). Fair to substantial agreements (κ= 0.80 and 0.54) were observed across eating disorder diagnoses in Study 1 and Study 2, respectively. Acceptable rates of agreement were identified for the individual eating disorder diagnoses, including DSM-5 anorexia nervosa (κ’s of 0.81 to 0.97), bulimia nervosa (κ=0.84), binge eating disorder (κ’s of 0.75 and 0.61), and feeding and eating disorders not elsewhere classified (κ’s of 0.70 and 0.46). Further, improved short-term test-retest reliability was noted when using the DSM-5, in comparison to DSM-IV, criteria for binge eating disorder. Thus, these studies found that trained interviewers can reliably diagnose eating disorders using the proposed DSM-5 criteria; however, additional data from general practice settings and community samples are needed. PMID:22401974

  15. Taxometric Investigation of PTSD: Data from Two Nationally Representative Samples

    Science.gov (United States)

    Broman-Fulks, Joshua J.; Ruggiero, Kenneth J.; Green, Bradley A.; Kilpatrick, Dean G.; Danielson, Carla Kmett; Resnick, Heidi S.; Saunders, Benjamin E.

    2006-01-01

    Current psychiatric nosology depicts posttraumatic stress disorder (PTSD) as a discrete diagnostic category. However, only one study has examined the latent structure of PTSD, and this study suggested that PTSD may be more accurately conceptualized as an extreme reaction to traumatic life events rather than a discrete clinical syndrome. To build…

  16. Taxometric Investigation of PTSD: Data from Two Nationally Representative Samples

    Science.gov (United States)

    Broman-Fulks, Joshua J.; Ruggiero, Kenneth J.; Green, Bradley A.; Kilpatrick, Dean G.; Danielson, Carla Kmett; Resnick, Heidi S.; Saunders, Benjamin E.

    2006-01-01

    Current psychiatric nosology depicts posttraumatic stress disorder (PTSD) as a discrete diagnostic category. However, only one study has examined the latent structure of PTSD, and this study suggested that PTSD may be more accurately conceptualized as an extreme reaction to traumatic life events rather than a discrete clinical syndrome. To build…

  17. Diagnostic performance of the ACR/EULAR 2010 criteria for rheumatoid arthritis and two diagnostic algorithms in an early arthritis clinic (REACH).

    Science.gov (United States)

    Alves, Celina; Luime, Jolanda Jacoba; van Zeben, Derkjen; Huisman, Anne-Margriet; Weel, Angelique Elisabeth Adriana Maria; Barendregt, Pieternella Johanna; Hazes, Johanna Maria Wilhelmina

    2011-09-01

    An ACR/EULAR task force released new criteria to classify rheumatoid arthritis at an early stage. This study evaluates the diagnostic performance of these criteria and algorithms by van der Helm and Visser in REACH. Patients with symptoms ≤12 months from REACH were used. Algorithms were tested on discrimination, calibration and diagnostic accuracy of proposed cut-points. Two patient sets were defined to test robustness; undifferentiated arthritis (UA) (n=231) and all patients including those without synovitis (n=513). The outcomes evaluated were methotrexate use and persistent disease at 12 months. In UA patients all algorithms had good areas under the curve 0.79, 95% CI 0.73 to 0.83 for the ACR/EULAR criteria, 0.80, 95% CI 0.74 to 0.87 for van der Helm and 0.83, 95% CI 0.77 to 0.88 for Visser. All calibrated well. Sensitivity and specificity were 0.74 and 0.66 for the ACR/EULAR criteria, 0.1 and 1.0 for van der Helm and 0.59 and 0.93 for Visser. Similar results were found in all patients indicating robustness. The ACR/EULAR 2010 criteria showed good diagnostic properties in an early arthritis cohort reflecting daily practice, as did the van der Helm and Visser algorithms. All were robust. To promote uniformity and comparability the ACR/EULAR 2010 criteria should be used in future diagnostic studies.

  18. Acute Respiratory Distress Syndrome diagnosis after coronary artery bypass: comparison between diagnostic criteria and clinical picture.

    Directory of Open Access Journals (Sweden)

    Manzar Vakili

    2015-01-01

    Full Text Available Acute Respiratory Distress Syndrome (ARDS is a potential complication of cardiac surgery, given that patients undergoing CABG frequently have hypoxemia and pulmonary dysfunction during initial hours after surgery. Thus, ARDS criteria in these patients are more likely to be positive while these criteria may not match the patient`s clinical picture. We aimed to investigate frequency of rapid onset hypoxemia in Pressure of Arterial Oxygen to Fractional Inspired Oxygen Concentration (PaO2/FiO2 less than 200 and diffuse pulmonary infiltrates as two diagnostic criteria forwards and compared these criteria with the clinical picture of the patients after Coronary Artery Bypass Graft (CABG in this study. The study was prospective case series which carried out in about six months. All patients admitted to intensive care unit of Tehran Heart Center, who had undergone CABG on cardiopulmonary pump (CPB recruited in the study. After considering inclusion criteria, age, sex, duration of intubation, arterial blood gas and chest radiography, on 24 hours and 48 hours after admission to the ICU were recorded. Then, patients with rapid onset of hypoxemia (PaO2/FiO2≤200mmHg and diffuse pulmonary infiltrates and without sign or symptoms of obvious heart failure (probable positive ARDS cases criteria were recorded and comparison between these probable positive cases with clinician`s clinical diagnosis (blinded to the study was performed. In this study, a total of 300 patients after on-pump coronary artery bypass surgery were included. Postoperatively, 2 (0.66 % in the 24 hours and 4 (1.33% patients in 48 hours after surgery were positive for the two ARDS criteria according to the checklists, but; nobody had saved persistently ARDS criteria persistently during 48 hours after surgery. At the same time, clinician did not report any case of ARDS among 300 patients. In this study patients with ARDS criteria had no significant differences in age (P.value=0.937 and sex (P

  19. Applicability of the ICD-11 proposal for PTSD: a comparison of prevalence and comorbidity rates with the DSM-IV PTSD classification in two post-conflict samples

    OpenAIRE

    Stammel, Nadine; Abbing, Eva M.; Heeke, Carina; Knaevelsrud, Christine

    2015-01-01

    Background: The World Health Organization recently proposed significant changes to the posttraumatic stress disorder (PTSD) diagnostic criteria in the 11th edition of the International Classification of Diseases (ICD-11).Objective: The present study investigated the impact of these changes in two different post-conflict samples.Method: Prevalence and rates of concurrent depression and anxiety, socio-demographic characteristics, and indicators of clinical severity according to ICD-11 in 1,075 ...

  20. Applicability of the ICD-11 proposal for PTSD: a comparison of prevalence and comorbidity rates with the DSM-IV PTSD classification in two post-conflict samples

    OpenAIRE

    Stammel, Nadine; Abbing, Eva M.; Heeke, Carina; Knaevelsrud, Christine

    2015-01-01

    Background: The World Health Organization recently proposed significant changes to the posttraumatic stress disorder (PTSD) diagnostic criteria in the 11th edition of the International Classification of Diseases (ICD-11).Objective: The present study investigated the impact of these changes in two different post-conflict samples.Method: Prevalence and rates of concurrent depression and anxiety, socio-demographic characteristics, and indicators of clinical severity according to ICD-11 in 1,075 ...

  1. PTSD: National Center for PTSD

    Medline Plus

    Full Text Available ... Divisions Executive Behavioral Science Clinical Neurosciences Dissemination & Training Evaluation Pacific Islands Women’s Health Sciences Positions Available Press & Promotion Contacts for the Media AboutFace Media Kit Logos and Badges Materials for Printing PTSD Awareness About the Website Site ...

  2. PTSD: National Center for PTSD

    Medline Plus

    Full Text Available ... map [a-z] More VA More VA Health Health Care Information A-Z Health Topic Finder My Health e Vet Prescriptions Refills Crisis Prevention Mental Health PTSD Public Health Veterans Access, Choice & Accountability Act ... Compensation Pension GI Bill ® Vocational Rehabilitation & Employment ...

  3. PTSD: National Center for PTSD

    Medline Plus

    Full Text Available ... menus on this page please perform the following steps. 1. Please switch auto forms mode to off. 2. Hit enter to expand a main menu option (Health, Benefits, ... Self Report Child Measures Deployment Measures DSM-5 Measures PTSD Screens ...

  4. Prevalence and Course of Symptom-Defined PTSD in Individuals Directly or Indirectly Exposed to Terror: A Longitudinal Study.

    Science.gov (United States)

    Hansen, Marianne Bang; Birkeland, Marianne Skogbrott; Nissen, Alexander; Blix, Ines; Solberg, Øivind; Heir, Trond

    2017-01-01

    It is well established that direct exposure to terrorism can result in posttraumatic stress disorder (PTSD). However, individuals indirectly exposed to terrorism may also develop symptoms of PTSD. This study examined the prevalence and course of symptom-defined PTSD in employees who were present and not present at the site of a workplace terror attack. Survey data from ministerial employees were collected 10, 22, and 34 months after the 2011 bombing in the government district of Oslo. A total of 3,520 employees were initially invited to the study. Response rates of eligible participants were 56% (N = 1,974) at T1, 55% (N = 1,780) at T2, and 54% (N = 1,578) at T3. PTSD was measured using the Post-traumatic Stress Disorder Checklist-Specific (PCL-S). Symptom-defined PTSD was specified as meeting the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR), B, C, and D criteria. Our findings showed a low and declining prevalence of symptom-defined PTSD in employees indirectly exposed to a workplace terror attack (4%, 3%, and 2% at the three respective times). In employees present at the site of the explosion, PTSD was six- to eightfold more prevalent (24%, 17%, and 17%). Individuals indirectly exposed to terrorism may develop long-lasting posttraumatic stress reactions fulfilling PTSD symptom criteria. Due to the large number of individuals that may be indirectly exposed to terrorism, even a low risk of PTSD may result in high numbers of individuals with substantial posttraumatic stress. Our findings have implications for the planning and implementation of health care services beyond those directly exposed after large-scale terror events.

  5. The structure of PTSD symptoms according to DSM-5 and IDC-11 proposal: A multi-sample analysis.

    Science.gov (United States)

    Cyniak-Cieciura, M; Staniaszek, K; Popiel, A; Pragłowska, E; Zawadzki, B

    2017-07-01

    Posttraumatic stress disorder (PTSD) symptoms structure is a subject of ongoing debate since its inclusion in DSM-III classification in 1980. Different research on PTSD symptoms structure proved the better fit of four-factor and five-factor models comparing to the one proposed by DSM-IV. With the publication of DSM-5 classification, which introduced significant changes to PTSD diagnosis, the question arises about the adequacy of the proposed criteria to the real structure of disorder symptoms. Recent analyses suggest that seven-factor hybrid model is the best reflection of symptoms structure proposed to date. At the same time, some researchers and ICD-11 classification postulate a simplification of PTSD diagnosis restricting it to only three core criteria and adding additional diagnostic unit of complex-PTSD. This research aimed at checking symptoms' structure according to well-known and supported four-, five-, six- and seven-factor models based on DSM-5 symptoms and the conceptualization proposed by the ICD-11 as well as examining the relation between PTSD symptoms categories with borderline personality disorder. Four different trauma populations were examined with self-reported Posttraumatic Diagnostic Scale for DSM-5 (PDS-5) measure. The results suggest that six- and seven-factor hybrid model as well as three-factor ICD-11 concept fits the data better than other models. The core PTSD symptoms were less related to borderline personality disorder than other, broader, symptoms categories only in one sample. Combination of ICD-11 simplified PTSD diagnosis with the more complex approach (e.g. basing on a seven-factor model) may be an attractive proposal for both scientists and practitioners, however does not necessarily lower its comorbidity with borderline personality disorder. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

  6. Diagnostic criteria in MR neurography; Diagnostische Kriterien in der MR-Neurographie

    Energy Technology Data Exchange (ETDEWEB)

    Baeumer, P. [Deutsches Krebsforschungszentrum, Allgemeinradiologie, Heidelberg (Germany); Universitaetsklinikum Heidelberg, Abteilung fuer Neuroradiologie, Heidelberg (Germany)

    2017-03-15

    Peripheral neuropathies are frequent and can mostly be correctly diagnosed by clinical examination and electrophysiology; however, diagnostically difficult cases are sometimes encountered especially with respect to precise localization of nerve lesions. Imaging of the peripheral nervous system has been shown to provide additional useful diagnostic information. In addition to the more widely available nerve sonography, magnetic resonance neurography (MRN) is the method of choice in diagnostically complex cases. The most important pulse sequence is a T2-weighted fat-saturated pulse sequence with high in-plane resolution and detects increased T2-weighted signals of nerve fascicles as a highly sensitive sign for nerve lesions. Further established diagnostic criteria are nerve caliber and, less commonly used, contrast agent uptake. The spatial pattern of nerve lesions aids in the diagnostic classification of neuropathies. Functional imaging techniques, such as diffusion tensor imaging (DTI) and nerve perfusion are currently under examination with respect to the clinical potential. If all other diagnostic methods, including clinical examination, electrophysiology and nerve sonography do not arrive at an unambiguous diagnosis of a peripheral neuropathy, MRN should be used. The special value of MRN is demonstrated particularly in complex nerve lesions, such as traumatic plexopathies and in partial fascicular neuropathies and many other indications. (orig.) [German] Periphere Neuropathien sind haeufig und meist gut mithilfe klinischer Untersuchung und Elektrophysiologie zu diagnostizieren. Immer wieder gibt es jedoch diagnostisch schwierige Faelle, insbesondere auch hinsichtlich der praezisen Lokalisation von Nervenlaesionen. Die Etablierung bildgebender Verfahren auch fuer das periphere Nervensystem hat sich als hilfreiche zusaetzliche Diagnostik erwiesen. Neben der breiter verfuegbaren Nervensonographie ist die MR-Neurographie (MRN) Methode der Wahl bei der Diagnostik

  7. Psychometric properties of the child PTSD checklist in a community sample of South African children and adolescents.

    Directory of Open Access Journals (Sweden)

    Mark E Boyes

    Full Text Available OBJECTIVE: The current study assessed the basic psychometric properties of the Child PTSD Checklist and examined the structure of symptoms of posttraumatic stress disorder (PTSD in a large sample of South African youth. METHODOLOGY: The checklist was completed by 1025 (540 male; 485 female South African youth (aged between 10 and 19 years. The factor structure of the scale was assessed with a combination of confirmatory and exploratory techniques. Internal consistencies for the full scale and all subscales were evaluated with Cronbach's alpha and McDonald's omega. Validity was assessed by comparing PTSD scores obtained by children who had and had not experienced a traumatic event, and by examining associations between total PTSD scores and known correlates of PTSD. RESULTS: Scores on the Child PTSD Checklist clearly discriminated between youth who had experienced a traumatic event and those who had not. Internal consistencies for the full scale (and all subscales were acceptable to good and hypothesized correlations between PTSD, depression, anxiety, somatic symptoms, and age were observed. Two of the reported fit statistics for the tripartite DSM-IV-TR model of PTSD did not meet traditional criteria and further exploratory analyses revealed a four-factor structure (broadly consistent with Simms and colleagues' Dysphoria Model of PTSD symptoms which provided a better fit to the observed data. CONCLUSION: Given the continued use of the Child PTSD Checklist in South Africa, findings offer an important first step in establishing the reliability and validity of the checklist for use with South African youth. However, further evaluation of the checklist in South African samples is clearly required before conclusions regarding its use as diagnostic tool in this context can be made.

  8. How valid and applicable are current diagnostic criteria and assessment methods for dentin hypersensitivity? An overview.

    Science.gov (United States)

    Gernhardt, Christian R

    2013-03-01

    Although dentin hypersensitivity is a common clinical condition and is generally reported by the patient after experiencing a sharp, short pain caused by one of several different external stimuli, it is often inadequately understood. The purpose of this paper is to discuss different available diagnostic approaches and assessment methods used in order to suggest a basis to diagnose, monitor, and measure these challenging painful conditions related to dentin hypersensitivity in daily practice and scientific projects properly. A PubMed literature search strategy including the following MeSH terms were used as follows: "dentin sensitivity"[MeSH Terms] OR "dentin"[All Fields] AND "sensitivity"[All Fields] OR "dentin sensitivity"[All Fields] OR "dentin"[All Fields] AND "hypersensitivity"[All Fields] OR "dentin hypersensitivity"[All Fields] AND "diagnosis"[Subheading] OR "diagnosis"[All Fields] OR "diagnosis"[MeSH Terms] AND "assessment"[All Fields] AND ("methods"[Subheading] OR "methods"[All Fields] OR "methods"[MeSH Terms]. Furthermore, alternative terms such as "validity," "reliability," "root," "cervical," "diagnostic criteria," and "hypersensitivities" were additionally evaluated. The literature search, also including the alternative terms and journals, revealed only a small number of specific papers related to valid diagnosis, diagnostic criteria, and assessment methods of dentin hypersensitivity. Outcomes from these publications showed that the response to different stimuli varies substantially from one person to another and is, due to individual factors, often difficult to assess correctly. Furthermore, the cause of the reported pain can vary, and the patient's description of the history, symptoms, and discomfort might be different from one to another, not allowing a reliable and valid diagnosis. The dental practitioner, using a variety of diagnostic and measurement techniques each day, will often have difficulties in differentiating dentin hypersensitivity from

  9. Charles Bonnet syndrome: a literature review into diagnostic criteria, treatment and implications for nursing practice.

    Science.gov (United States)

    Hughes, D F

    2013-03-01

    Charles Bonnet syndrome is a disease of vision which may be mistakenly identified as manifestations of psychosis and consequently be treated by psychiatrists and mental health nurses rather than ophthalmologists. This literature review considers current understanding of the syndrome, its treatment and the role of mental health nurses. The two main findings of the review are that despite a long recognition of the syndrome, diagnostic criteria are not established and that there is no recognized evidence-based medical treatment. As well as this, two novel treatments which may offer future benefits are discussed. Current best practice is identified as identifying the condition and providing reassurance and education, a role that mental health nurses that are aware of Charles Bonnet syndrome can fulfil perhaps better than any other discipline.

  10. Diagnostic criteria for adverse health effects in the environs of wind turbines.

    Science.gov (United States)

    McMurtry, Robert Y; Krogh, Carmen Me

    2014-10-01

    In an effort to address climate change, governments have pursued policies that seek to reduce greenhouse gases. Alternative energy, including wind power, has been proposed by some as the preferred approach. Few would debate the need to reduce air pollution, but the means of achieving this reduction is important not only for efficiency but also for health protection. The topic of adverse health effects in the environs of industrial wind turbines (AHE/IWT) has proven to be controversial and can present physicians with challenges regarding the management of an exposure to IWT. Rural physicians in particular must be aware of the possibility of people presenting to their practices with a variety of sometimes confusing complaints. An earlier version of the diagnostic criteria for AHE/IWT was published in August 2011. A revised case definition and a model for a study to establish a confirmed diagnosis is proposed.

  11. Proposed Diagnostic Criteria, Classification Schema, and Review of Literature of Notochord-Derived Ecchordosis Physaliphora.

    Science.gov (United States)

    Lagman, Carlito; Varshneya, Kunal; Sarmiento, J Manuel; Turtz, Alan R; Chitale, Rohan V

    2016-03-30

    Ecchordosis physaliphora (EP) is a benign notochordal remnant derived from ectopic nests found along the craniospinal axis. It typically presents asymptomatically and is diagnosed using classic radiologic features, particularly location, T1-hypointensity, T2-hyperintensity, and lack of enhancement following gadolinium (Gd) contrast administration. Distinguishing EP from its malignant counterpart, chordoma, is of paramount importance, given the aggressive nature of the latter. Advances in imaging and immunohistochemistry have aided in diagnosis to an extent but, to our knowledge, identification of the genetic fingerprint of EP has yet to take place. Further cytological analysis of these lesions in search of a genetic link is warranted. We propose here a set of diagnostic criteria based on features consistently cited in the literature. In this literature review, 23 case reports were identified and collated into a summary of symptomatic cases of ecchordosis physaliphora. An illustrative case report of two patients was also included.

  12. Diagnostic criteria, classification, and nomenclature for painful bladder syndrome/interstitial cystitis: An ESSIC proposal

    DEFF Research Database (Denmark)

    Merwe, J.P.V. de; Nordling, J.; Bouchelouche, P.;

    2008-01-01

    to overcome the lack of international agreement on various aspects of IC. Methods: ESSIC has discussed definitions, diagnostic criteria, and disease classification in four meetings and extended e-mail correspondence. Results: It was agreed to name the disease bladder pain syndrome (BPS) BPS would be diagnosed...... on the basis of chronic pelvic pain, pressure, or discomfort perceived to be related to the urinary bladder accompanied by at least one other urinary symptom such as persistent urge to void or urinary frequency. Confusable diseases as the cause of the symptoms must be excluded. Classification of BPS types...... might be performed according to findings at cystoscopy with hydrodistention and morphologic findings in bladder biopsies. The presence of other organ symptoms as well as cognitive, behavioral, emotional, and sexual symptoms, should be addressed. Conclusions: The name IC has become misleading...

  13. Evaluation of the International Society on Thrombosis and Haemostasis and institutional diagnostic criteria of disseminated intravascular coagulation in pediatric patients.

    Science.gov (United States)

    Soundar, Esther P; Jariwala, Purviben; Nguyen, Trung C; Eldin, Karen W; Teruya, Jun

    2013-06-01

    Globally, adult intensive care units routinely use the International Society on Thrombosis and Haemostasis (ISTH) scoring system for identifying overt disseminated intravascular coagulation (DIC). However, in our pediatric intensive care unit, a modified diagnostic criterion (Texas Children's Hospital [TCH] criteria) that requires serial monitoring of the coagulation variables is employed. A retrospective analysis of 2,136 DIC panels from 130 patients who had at least 4 DIC panels during 1 admission to a pediatric intensive care unit was done to compare the diagnostic utility of the TCH criteria with the ISTH scoring method in children. Both scoring systems were evaluated against the gold standard diagnostic method of autopsy confirmation of DIC in the subset of children who died. Receiver operating characteristic analysis indicates that TCH diagnostic criteria are comparable to the ISTH scoring method (area under the curve of 0.878 for TCH and 0.950 for ISTH). On the contrary, TCH diagnostic criteria perform better, with a sensitivity significantly higher than the ISTH scoring method when tested against the gold standard (P coagulation parameters is recommended for improved sensitivity when applying ISTH criteria to pediatric populations.

  14. High-Dimensional Medial Lobe Morphometry: An Automated MRI Biomarker for the New AD Diagnostic Criteria

    Directory of Open Access Journals (Sweden)

    Simon Duchesne

    2014-01-01

    Full Text Available Introduction. Medial temporal lobe atrophy assessment via magnetic resonance imaging (MRI has been proposed in recent criteria as an in vivo diagnostic biomarker of Alzheimer’s disease (AD. However, practical application of these criteria in a clinical setting will require automated MRI analysis techniques. To this end, we wished to validate our automated, high-dimensional morphometry technique to the hypothetical prediction of future clinical status from baseline data in a cohort of subjects in a large, multicentric setting, compared to currently known clinical status for these subjects. Materials and Methods. The study group consisted of 214 controls, 371 mild cognitive impairment (147 having progressed to probable AD and 224 stable, and 181 probable AD from the Alzheimer’s Disease Neuroimaging Initiative, with data acquired on 58 different 1.5 T scanners. We measured the sensitivity and specificity of our technique in a hierarchical fashion, first testing the effect of intensity standardization, then between different volumes of interest, and finally its generalizability for a large, multicentric cohort. Results. We obtained 73.2% prediction accuracy with 79.5% sensitivity for the prediction of MCI progression to clinically probable AD. The positive predictive value was 81.6% for MCI progressing on average within 1.5 (0.3 s.d. year. Conclusion. With high accuracy, the technique’s ability to identify discriminant medial temporal lobe atrophy has been demonstrated in a large, multicentric environment. It is suitable as an aid for clinical diagnostic of AD.

  15. Prostate dynamic contrast-enhanced MRI with simple visual diagnostic criteria: is it reasonable?

    Energy Technology Data Exchange (ETDEWEB)

    Girouin, Nicolas; Tonina Senes, Alejandro [Hopital Edouard Herriot, Hospices Civils de Lyon, Department of Urinary and Vascular Radiology, Lyon (France); Mege-Lechevallier, Florence [Hopital Edouard Herriot, Hospices Civils de Lyon, Department of Histopathology, Lyon (France); Bissery, Alvine; Rabilloud, Muriel [Department of Biostatistics, Hospices Civils de Lyon, Lyon (France); Lyon, F-69003, France; Universite de Lyon 1, Laboratoire Biostatistiques-Sante, Universite de Lyon, Pierre-Benite (France); Marechal, Jean-Marie [Hopital Edouard Herriot, Hospices Civils de Lyon, Department of Urology, Lyon (France); Colombel, Marc [Hopital Edouard Herriot, Hospices Civils de Lyon, Department of Urology, Lyon (France); Lyon, F-69003, France; Universite de Lyon 1, Faculte de Medecine Lyon Nord, Universite de Lyon, Lyon (France); Lyonnet, Denis; Rouviere, Olivier [Hopital Edouard Herriot, Hospices Civils de Lyon, Department of Urinary and Vascular Radiology, Lyon (France); Lyon, F-69003, France; Universite de Lyon 1, Faculte de Medecine Lyon Nord, Universite de Lyon, Lyon (France); Inserm, U556, Lyon (France)

    2007-06-15

    The purpose of this study was to evaluate the accuracy of prostate cancer localization with simple visual diagnostic criteria using dynamic contrast-enhanced (DCE) magnetic resonance imaging (MRI). A total of 46 consecutive patients with biopsy-proven prostate cancer underwent prostate 1.5 T MRI with pelvic phased-array coils before prostatectomy. Besides the usual T2-weighted sequences, a 30-s DCE sequence was acquired three times after gadoterate injection. On DCE images, all early enhancing lesions of the peripheral zone were considered malignant. In the central gland, only early enhancing lesions appearing homogeneous or invading the peripheral zone were considered malignant. Three readers specified the presence of cancer in 20 prostate sectors and the location of distinct tumors. Results were compared with histology; p < 0.05 was considered significant. For localization of cancer in the sectors, DCE imaging had a significantly higher sensitivity [logistic regression, odds ratio (OR): 3.9, p < 0.0001] and a slightly but significantly lower specificity (OR: 0.57, p < 0.0001). Of the tumors >0.3 cc, 50-60% and 78-81% were correctly depicted with T2-weighted and DCE imaging, respectively. For both techniques, the depiction rate of tumors >0.3 cc was significantly influenced by the Gleason score (most Gleason {<=}6 tumors were overlooked), but not by the tumor volume. DCE-MRI using pelvic phased-array coils and simple visual diagnostic criteria is more sensitive for tumor localization than T2-weighted imaging. (orig.)

  16. International Harmonization of Nomenclature and Diagnostic Criteria (INHAND) progress to date and future plans.

    Science.gov (United States)

    Keenan, Charlotte M; Baker, Julia F; Bradley, Alys E; Goodman, Dawn G; Harada, Takanori; Herbert, Ronald; Kaufmann, Wolfgang; Kellner, Rupert; Mahler, Beth; Meseck, Emily; Nolte, Thomas; Rittinghausen, Susanne; Vahle, John; Yoshizawa, Katsuhiko

    2015-01-01

    The INHAND Proposal (International Harmonization of Nomenclature and Diagnostic Criteria for Lesions in Rats and Mice) has been operational since 2005. A Global Editorial Steering Committee (GESC) manages the overall objectives of the project and the development of harmonized terminology for each organ system is the responsibility of the Organ Working Groups (OWG), drawing upon experts from North America, Europe and Japan.Great progress has been made with 9 systems published to date - Respiratory, Hepatobiliary, Urinary, Central/Peripheral Nervous Systems, Male Reproductive and Mammary, Zymbals, Clitoral and Preputial Glands in Toxicologic Pathology and the Integument and Soft Tissue and Female Reproductive System in the Journal of Toxicologic Pathology as supplements and on a web site - www.goreni.org. INHAND nomenclature guides offer diagnostic criteria and guidelines for recording lesions observed in rodent toxicity and carcinogenicity studies. The guides provide representative photo-micrographs of morphologic changes, information regarding pathogenesis, and key references. During 2012, INHAND GESC representatives attended meetings with representatives of the FDA Center for Drug Evaluation and Research (CDER), Clinical Data Interchange Standards Consortium (CDISC), and the National Cancer Institute (NCI) Enterprise Vocabulary Services (EVS) to begin incorporation of INHAND terminology as preferred terminology for SEND (Standard for Exchange of Nonclinical Data) submissions to the FDA. The interest in utilizing the INHAND nomenclature, based on input from industry and government toxicologists as well as information technology specialists, suggests that there will be wide acceptance of this nomenclature. The purpose of this publication is to provide an update on the progress of INHAND.

  17. Clinical relevance of the proposed sexual addiction diagnostic criteria: relation to the Sexual Addiction Screening Test-Revised.

    Science.gov (United States)

    Carnes, Patrick J; Hopkins, Tiffany A; Green, Bradley A

    2014-01-01

    The present article examines and compares the various diagnostic rubrics proposed to codify symptoms of sexual addiction, and then briefly summarizes the ongoing controversy on whether sexual addiction is a valid construct. Using the diagnostic criteria proposed by , the prevalence rate of each criterion is examined in terms of scores on the Sexual Addiction Screening Test-Revised scales (). Differences in diagnostic criteria endorsement associated with sex, sexual orientation, and setting were also explored. Results from a clinical sample of men and women seeking treatment for sexual addiction demonstrated clinical relevance of the criteria, in that all but 3 criteria are endorsed at more than 50% of participants screening positive for sexual addiction on the Sexual Addiction Screening Test-Revised. Sex differences were also noted for endorsement rates of several of the criteria. Finally, several proposed criteria may pose a higher clinical threshold and thus be utilized by clinicians to identify patients with increased pathology. Results are discussed in the context of existing diagnostic frameworks across etiological perspectives.

  18. Classification of anthropogenic soils by new diagnostic criteria involved in the Slovak Soil Classification System (2014)

    Science.gov (United States)

    Sobocká, Jaroslava; Balkovič, Juraj; Bedrna, Zoltán

    2017-04-01

    Anthropogenic soils can be found mostly in SUITMA areas. The issue of adequate and correct description and classification of these soils occurs very often and can result in inconsistent even in contradictory opinions. In the new version of the anthropogenic soil classification system in Slovakia some new diagnostics criteria were involved and applied for better understanding the inherent nature of these soils. The group of the former anthropogenic soils was divided following scheme of soil reference groups in the WRB 2014 (Anthrozem and Technozem). According to the new version of the Slovak anthropogenic soils classification (2014) there have been distinguished 2 groups of anthropogenic soils: 1) cultivated soils group including 2 soil types (in Slovak terminology): Kultizem and Hortizem and 2) technogenic soils group having 2 soil types: Antrozem and Technozem. Cultivated soil group represents soils developing or forming "in-situ" with diagnostic horizons characterized by human deeply influenced cultivated processes. Technogenic soil group are soils developing like "ex-situ" soils. The key features recognizing technogenic soil group are human-transported and altered material (HTAM = ex-situ aspect), and artefacts content. Diagnostic horizons (top and subsoil) were described as various material affected by physical-mechanical excavation, transportation and spread, mixing, and containing artefacts (the new diagnostic feature). Kultizems are differentiated by cultivated horizon(s) and Technozems by anthropogenic horizon(s). Cultivated horizons are mostly well-known described horizon in many scientific references. Anthropogenic horizons for Technozem are developed from the human-induced transported and altered material which origin is from the other ecological locality that adjacent area. Materials (or substrates) can consist of various material (natural, technogenic or their mixing) with thickness ≥ 60 cm. Artefacts are the second diagnostic feature which presence

  19. How Preclinical Models Evolved to Resemble the Diagnostic Criteria of Drug Addiction.

    Science.gov (United States)

    Belin-Rauscent, Aude; Fouyssac, Maxime; Bonci, Antonello; Belin, David

    2016-01-01

    Drug addiction is a complex neuropsychiatric disorder that affects a subset of the individuals who take drugs. It is characterized by maladaptive drug-seeking habits that are maintained despite adverse consequences and intense drug craving. The pathophysiology and etiology of addiction is only partially understood despite extensive research because of the gap between current preclinical models of addiction and the clinical criteria of the disorder. This review presents a brief overview, based on selected methodologies, of how behavioral models have evolved over the last 50 years to the development of recent preclinical models of addiction that more closely mimic diagnostic criteria of addiction. It is hoped that these new models will increase our understanding of the complex neurobiological mechanisms whereby some individuals switch from controlled drug use to compulsive drug-seeking habits and relapse to these maladaptive habits. Additionally, by paving the way to bridge the gap that exists between biobehavioral research on addiction and the human situation, these models may provide new perspectives for the development of novel and effective therapeutic strategies for drug addiction. Published by Elsevier Inc.

  20. Redefined clinical features and diagnostic criteria in autoimmune polyendocrinopathy-candidiasis-ectodermal dystrophy

    Science.gov (United States)

    Ferre, Elise M.N.; Rose, Stacey R.; Rosenzweig, Sergio D.; Burbelo, Peter D.; Romito, Kimberly R.; Niemela, Julie E.; Rosen, Lindsey B.; Break, Timothy J.; Gu, Wenjuan; Hunsberger, Sally; Browne, Sarah K.; Hsu, Amy P.; Rampertaap, Shakuntala; Swamydas, Muthulekha; Collar, Amanda L.; Kong, Heidi H.; Chascsa, David; Simcox, Thomas; Pham, Angela; Bondici, Anamaria; Natarajan, Mukil; Monsale, Joseph; Kleiner, David E.; Quezado, Martha; Alevizos, Ilias; Moutsopoulos, Niki M.; Yockey, Lynne; Frein, Cathleen; Soldatos, Ariane; Calvo, Katherine R.; Adjemian, Jennifer; Similuk, Morgan N.; Lang, David M.; Stone, Kelly D.; Uzel, Gulbu; Bishop, Rachel J.; Holland, Steven M.; Olivier, Kenneth N.; Fleisher, Thomas A.; Heller, Theo; Winer, Karen K.

    2016-01-01

    Autoimmune polyendocrinopathy-candidiasis-ectodermal dystrophy (APECED) is a rare primary immunodeficiency disorder typically caused by homozygous AIRE mutations. It classically presents with chronic mucocutaneous candidiasis and autoimmunity that primarily targets endocrine tissues; hypoparathyroidism and adrenal insufficiency are most common. Developing any two of these classic triad manifestations establishes the diagnosis. Although widely recognized in Europe, where nonendocrine autoimmune manifestations are uncommon, APECED is less defined in patients from the Western Hemisphere. We enrolled 35 consecutive American APECED patients (33 from the US) in a prospective observational natural history study and systematically examined their genetic, clinical, autoantibody, and immunological characteristics. Most patients were compound heterozygous; the most common AIRE mutation was c.967_979del13. All but one patient had anti–IFN-ω autoantibodies, including 4 of 5 patients without biallelic AIRE mutations. Urticarial eruption, hepatitis, gastritis, intestinal dysfunction, pneumonitis, and Sjögren’s-like syndrome, uncommon entities in European APECED cohorts, affected 40%–80% of American cases. Development of a classic diagnostic dyad was delayed at mean 7.38 years. Eighty percent of patients developed a median of 3 non-triad manifestations before a diagnostic dyad. Only 20% of patients had their first two manifestations among the classic triad. Urticarial eruption, intestinal dysfunction, and enamel hypoplasia were prominent among early manifestations. Patients exhibited expanded peripheral CD4+ T cells and CD21loCD38lo B lymphocytes. In summary, American APECED patients develop a diverse syndrome, with dramatic enrichment in organ-specific nonendocrine manifestations starting early in life, compared with European patients. Incorporation of these new manifestations into American diagnostic criteria would accelerate diagnosis by approximately 4 years and

  1. Proposed diagnostic criteria for the case definition of amniotic fluid embolism in research studies.

    Science.gov (United States)

    Clark, Steven L; Romero, Roberto; Dildy, Gary A; Callaghan, William M; Smiley, Richard M; Bracey, Arthur W; Hankins, Gary D; D'Alton, Mary E; Foley, Mike; Pacheco, Luis D; Vadhera, Rakesh B; Herlihy, J Patrick; Berkowitz, Richard L; Belfort, Michael A

    2016-10-01

    Amniotic fluid embolism is a leading cause of maternal mortality in developed countries. Our understanding of risk factors, diagnosis, treatment, and prognosis is hampered by a lack of uniform clinical case definition; neither histologic nor laboratory findings have been identified unique to this condition. Amniotic fluid embolism is often overdiagnosed in critically ill peripartum women, particularly when an element of coagulopathy is involved. Previously proposed case definitions for amniotic fluid embolism are nonspecific, and when viewed through the eyes of individuals with experience in critical care obstetrics, would include women with a number of medical conditions much more common than amniotic fluid embolism. We convened a working group under the auspices of a committee of the Society for Maternal-Fetal Medicine and the Amniotic Fluid Embolism Foundation whose task was to develop uniform diagnostic criteria for the research reporting of amniotic fluid embolism. These criteria rely on the presence of the classic triad of hemodynamic and respiratory compromise accompanied by strictly defined disseminated intravascular coagulopathy. It is anticipated that limiting research reports involving amniotic fluid embolism to women who meet these criteria will enhance the validity of published data and assist in the identification of risk factors, effective treatments, and possibly useful biomarkers for this condition. A registry has been established in conjunction with the Perinatal Research Branch of the Eunice Kennedy Shriver National Institute of Child Health and Human Development to collect both clinical information and laboratory specimens of women with suspected amniotic fluid embolism in the hopes of identifying unique biomarkers of this condition.

  2. Complex PTSD as Proposed for ICD-11: Validation of a New Disorder in Children and Adolescents and Their Response to Trauma-Focused Cognitive Behavioral Therapy

    Science.gov (United States)

    Sachser, Cedric; Keller, Ferdinand; Goldbeck, Lutz

    2017-01-01

    Background: To evaluate whether the symptoms of children and adolescents with clinically significant posttraumatic stress symptoms (PTSS) form classes consistent with the diagnostic criteria of complex PTSD (CPTSD) as proposed for the ICD-11, and to relate the emerging classes with treatment outcome of Trauma-Focused Cognitive Behavioral Therapy…

  3. Complex PTSD as Proposed for ICD-11: Validation of a New Disorder in Children and Adolescents and Their Response to Trauma-Focused Cognitive Behavioral Therapy

    Science.gov (United States)

    Sachser, Cedric; Keller, Ferdinand; Goldbeck, Lutz

    2017-01-01

    Background: To evaluate whether the symptoms of children and adolescents with clinically significant posttraumatic stress symptoms (PTSS) form classes consistent with the diagnostic criteria of complex PTSD (CPTSD) as proposed for the ICD-11, and to relate the emerging classes with treatment outcome of Trauma-Focused Cognitive Behavioral Therapy…

  4. Validation of three early ejaculation diagnostic tools: a composite measure is accurate and more adequate for diagnosis by updated diagnostic criteria.

    Directory of Open Access Journals (Sweden)

    Patrick Jern

    Full Text Available PURPOSE: To validate three early ejaculation diagnostic tools, and propose a new tool for diagnosis in line with proposed changes to diagnostic criteria. Significant changes to diagnostic criteria are expected in the near future. Available screening tools do not necessarily reflect proposed changes. MATERIALS AND METHODS: Data from 148 diagnosed early ejaculation patients (M age = 42.8 and 892 controls (M age = 33.1 years from a population-based sample were used. Participants responded to three different questionnaires (Premature Ejaculation Profile; Premature Ejaculation Diagnostic Tool; Multiple Indicators of Premature Ejaculation. Stopwatch measured ejaculation latency times were collected from a subsample of early ejaculation patients. We used two types of responses to the questionnaires depending on the treatment status of the patients 1 responses regarding the situation before starting pharmacological treatment and 2 responses regarding current situation. Logistic regressions and Receiver Operating Characteristics were used to assess ability of both the instruments and individual items to differentiate between patients and controls. RESULTS: All instruments had very good precision (Areas under the Curve ranging from .93-.98. A new five-item instrument (named CHecklist for Early Ejaculation Symptoms - CHEES consisting of high-performance variables selected from the three instruments had validity (Nagelkerke R (2 range .51-.79 for backwards/forwards logistic regression equal to or slightly better than any individual instrument (i.e., had slightly higher validity statistics, but these differences did not achieve statistical significance. Importantly, however, this instrument was more in line with proposed changes to diagnostic criteria. CONCLUSIONS: All three screening tools had good validity. A new 5-item diagnostic tool (CHEES based on the three instruments had equal or somewhat more favorable validity statistics compared to the other three

  5. Performance of Different Diagnostic Criteria for Familial Mediterranean Fever in Children with Periodic Fevers: Results from a Multicenter International Registry.

    Science.gov (United States)

    Demirkaya, Erkan; Saglam, Celal; Turker, Turker; Koné-Paut, Isabelle; Woo, Pat; Doglio, Matteo; Amaryan, Gayane; Frenkel, Joost; Uziel, Yosef; Insalaco, Antonella; Cantarini, Luca; Hofer, Michael; Boiu, Sorina; Duzova, Ali; Modesto, Consuelo; Bryant, Annette; Rigante, Donato; Papadopoulou-Alataki, Efimia; Guillaume-Czitrom, Severine; Kuemmerle-Deschner, Jasmine; Neven, Bénédicte; Lachmann, Helen; Martini, Alberto; Ruperto, Nicolino; Gattorno, Marco; Ozen, Seza

    2016-01-01

    Our aims were to validate the pediatric diagnostic criteria in a large international registry and to compare them with the performance of previous criteria for the diagnosis of familial Mediterranean fever (FMF). Pediatric patients with FMF from the Eurofever registry were used for the validation of the existing criteria. The other periodic fevers served as controls: mevalonate kinase deficiency (MKD), tumor necrosis factor receptor-associated periodic syndrome (TRAPS), cryopyrin-associated periodic syndrome (CAPS), aphthous stomatitis, pharyngitis, adenitis syndrome (PFAPA), and undefined periodic fever from the same registry. The performances of Tel Hashomer, Livneh, and the Yalcinkaya-Ozen criteria were assessed. The FMF group included 339 patients. The control group consisted of 377 patients (53 TRAPS, 45 MKD, 32 CAPS, 160 PFAPA, 87 undefined periodic fevers). Patients with FMF were correctly diagnosed using the Yalcinkaya-Ozen criteria with a sensitivity rate of 87.4% and a specificity rate of 40.7%. On the other hand, Tel Hashomer and Livneh criteria displayed a sensitivity of 45.0 and 77.3%, respectively. Both of the latter criteria displayed a better specificity than the Yalcinkaya-Ozen criteria: 97.2 and 41.1% for the Tel Hashomer and Livneh criteria, respectively. The overall accuracy for the Yalcinkaya-Ozen criteria was 65 and 69.6% (using 2 and 3 criteria), respectively. Ethnicity and residence had no effect on the performance of the Yalcinkaya-Ozen criteria. The Yalcinkaya-Ozen criteria yielded a better sensitivity than the other criteria in this international cohort of patients and thus can be used as a tool for FMF diagnosis in pediatric patients from either the European or eastern Mediterranean region. However, the specificity was lower than the previously suggested adult criteria.

  6. Capillary malformation--arteriovenous malformation syndrome: review of the literature, proposed diagnostic criteria, and recommendations for management.

    Science.gov (United States)

    Orme, Charisse M; Boyden, Lynn M; Choate, Keith A; Antaya, Richard J; King, Brett A

    2013-01-01

    Capillary malformation-arteriovenous malformation syndrome is an autosomal dominant disorder caused by mutations in the RASA1 gene and characterized by multiple small, round to oval capillary malformations with or without arteriovenous malformations. Ateriovenous malformations occur in up to one-third of patients and may involve the brain and spine. Although making the diagnosis is straightforward in some patients, there are other patients for whom diagnostic criteria may be helpful in their evaluation. Here we review the literature regarding capillary malformation-arteriovenous malformation syndrome, propose diagnostic criteria, and discuss the care of patients with this condition.

  7. Is a new perspective for definition and diagnostic criteria of fibromyalgia in early stage cancer patients necessary?

    Science.gov (United States)

    Tanriverdi, Ozgur

    2014-04-01

    Fibromyalgia is a most common pain syndrome characterized by the presence of chronic widespread pain and tenderness with manual palpation. However there is no enough data about frequent of fibromyalgia syndrome in patients with cancer. How often FM is being used in oncological practice and how we are managing this case by medical oncologists. Widespread pain index and symptom severity scale are not clear enough in patients with cancer when ACR-2010 diagnostic criteria for FM are considered. In conclusion, there is it may more prevalence of fibromyalgia in patients with cancer. For the diagnosis of fibromyalgia, be new diagnostic criteria for early-stage cancer patients.

  8. Is there any evidence for the validity of diagnostic criteria used for accommodative and nonstrabismic binocular dysfunctions?

    Science.gov (United States)

    Cacho-Martínez, Pilar; García-Muñoz, Ángel; Ruiz-Cantero, María Teresa

    2014-01-01

    To analyze the diagnostic criteria used in the scientific literature published in the past 25 years for accommodative and nonstrabismic binocular dysfunctions and to explore if the epidemiological analysis of diagnostic validity has been used to propose which clinical criteria should be used for diagnostic purposes. We carried out a systematic review of papers on accommodative and non-strabic binocular disorders published from 1986 to 2012 analysing the MEDLINE, CINAHL, PsycINFO and FRANCIS databases. We admitted original articles about diagnosis of these anomalies in any population. We identified 839 articles and 12 studies were included. The quality of included articles was assessed using the QUADAS-2 tool. The review shows a wide range of clinical signs and cut-off points between authors. Only 3 studies (regarding accommodative anomalies) assessed diagnostic accuracy of clinical signs. Their results suggest using the accommodative amplitude and monocular accommodative facility for diagnosing accommodative insufficiency and a high positive relative accommodation for accommodative excess. The remaining 9 articles did not analyze diagnostic accuracy, assessing a diagnosis with the criteria the authors considered. We also found differences between studies in the way of considering patients' symptomatology. 3 studies of 12 analyzed, performed a validation of a symptom survey used for convergence insufficiency. Scientific literature reveals differences between authors according to diagnostic criteria for accommodative and nonstrabismic binocular dysfunctions. Diagnostic accuracy studies show that there is only certain evidence for accommodative conditions. For binocular anomalies there is only evidence about a validated questionnaire for convergence insufficiency with no data of diagnostic accuracy. Copyright © 2012 Spanish General Council of Optometry. Published by Elsevier Espana. All rights reserved.

  9. Are Classification Criteria for IgG4-RD Now Possible? The Concept of IgG4-Related Disease and Proposal of Comprehensive Diagnostic Criteria in Japan

    Directory of Open Access Journals (Sweden)

    Kazuichi Okazaki

    2012-01-01

    Full Text Available Recent studies suggest simultaneous or metachronous lesions in multiorgans characterized by elevated serum levels of IgG4 and abundant infiltration of IgG4-positive plasma cells with various degrees of fibrosis. Two Japanese research committees for IgG4-RD, one from fibrosclerosis (Okazaki team and the other from lymph proliferation (Umehara team supported by the “Research Program for Intractable Disease” of the Ministry of Health, Labor, and Welfare of Japan, have agreed with the unified nomenclature as “IgG4-RD” and proposed the comprehensive diagnostic criteria (CDC for IgG4-RD. Validation of the CDC demonstrated satisfactory sensitivity for the practical use of general physicians and nonspecialists but low sensitivity in the organs to be difficult in taking biopsy specimens such as type1 autoimmune pancreatitis (IgG4-related AIP, compared with IgG4-related sialadenitis/dacryoadenitis (Mikulicz's disease and IgG4-related kidney disease. Although the diagnostic criteria covering all IgG4-RD are hard to be established, combination with the CDC and organ-specific diagnostic criteria should improve sensitivity.

  10. Сlinical and Sonographic Indices as Diagnostic Criteria of Infectious Mononucleosis in Children

    Directory of Open Access Journals (Sweden)

    L.A. Ivanova

    2016-07-01

    Full Text Available Introduction. Significant polymorphism of clinical manifestations of infectious mononucleosis, multisystemic lesions, frequent lack of clear clinical and paraclinical criteria and delayed results of available laboratory tests, and sometimes impossibility of their execution complicate the diagnosis of the disease in prehospital stage and on admission to hospital. Objective of the study: to optimize the diagnosis and treatment of infectious mononucleosis in children by examining current features of the course and analyzing the diagnostic value of clinical and instrumental parameters in the verification of the disease. Materials and methods. On the basis of infectious boxed unit of respiratory infections of Municipal Healthcare Institution «Regional Children’s Hospital» (Chernivtsi, there were examined 65 children with infectious mononucleosis, who were hospitalized in the period of 2014–2015. The first clinical group (I consisted of 42 children, the final clinical diagnosis of the disease in them was verified on the basis of comprehensive clinical and hematological criteria, the second (II clinical group included 23 patients with serologically confirmed infectious mononucleosis. In terms of the main clinical signs, the observation groups were not significantly different. Results. It was found that for children with infectious mononucleosis, such clinical features are typical: sudden onset of the disease (in 93.8 % with fever higher than 37.5 °C (80 %, the presence of exudative tonsillitis (81.6 %, submandibular and cervical lymphadenopathy (in 90.7 %, difficulty in nasal breathing (in 78.4 %, and nasal voice (in 73.8 %. In confirmation of Epstein-Barr virus infectious mononucleosis, phenomena of exudative tonsillitis and lymphadenopathy were highly sensitive (90 and 95 %, respectively, but with a high proportion of false positive results. Conclusion. Thus, given the lack of diagnostic value of clinical-anamnestic and sonographic

  11. A knowledge based system for evaluation of CIDP diagnostic criteria in a database with 26,000 nerve conduction studies: computer aided creation of heuristic rules and discovery of new diagnostic criteria.

    Directory of Open Access Journals (Sweden)

    Francesco eBonadonna

    2015-12-01

    Full Text Available This paper describes the implementation and the evaluation of 19 Chronic Inflammatory Demyelinating Polyneuropathy (CIDP diagnostic criteria in a Hospital Information System (HIS that contains more than 26,000 Motor Nerve Conduction Studies (MNCS, integrated with a Knowledge Based System (KBS that contains and applies neurological knowledge, including the CIDP criteria. The comparison, conducted on 3750 manual reviewed cases, gave very different results in terms of sensibility and specificity with no one single criterion satisfying for both. Based on personal experience, variations of these CIDP criteria were tried, but the results were not improved. Then a radically different approach was developed, programming the HIS-KBS to discover better criteria in order of their ability to comply with the manual review of cases. The result was a strong reduction of false positives with minimal loss of sensibility. By reverse engineering of the computer generated criteria it was possible to obtain some new interesting neurologic suggestions such as the role of H reflex. In conclusion, four points appear of general interest: 1 a large HIS-KBS is fundamental for developing and testing diagnostic criteria and medical procedures, particularly when they are complex; 2 Computer aided discovery may create rules that allows the KBS to replicate the human expertise; 3 reverse engineering on computer generated rules may suggest new physiopathological considerations; 4 this methodology has general application to many other fields of medicine.

  12. Diagnostic accuracy of referral criteria for head circumference to detect hydrocephalus in the first year of life

    NARCIS (Netherlands)

    Dommelen, P. van; Deurloo, J.A.; Gooskens, R.H.; Verkerk, P.H.

    2015-01-01

    Background Increased head circumference is often the first and main sign leading to the diagnosis of hydrocephalus. Our aim is to investigate the diagnostic accuracy of referral criteria for head circumference to detect hydrocephalus in the first year of life. Methods A reference group with longitud

  13. Diagnostic criteria and reporting procedures for pre-eclampsia: a national survey among obstetrical departments in Denmark

    DEFF Research Database (Denmark)

    Klemmensen, Åse Kathrine; Olsen, SF; Wengel, CM

    2005-01-01

    OBJECTIVE: A precondition for the rational use of obstetric databases in biomedical research is detailed knowledge on how data are being generated. We identified the diagnostic procedures and criteria for pre-eclampsia (PE) and assessed the level of obstetric training of the personnel responsible...

  14. Diagnostic Criteria and Accuracy of Categorizing Malignant Thyroid Nodules by Ultrasonography and Ultrasound Elastography with Pathologic Correlation.

    Science.gov (United States)

    Elsayed, Naglaa Mostafa; Elkhatib, Yasser Atta

    2016-03-01

    Thyroid nodules are a common medical and surgical concern. Thyroid ultrasound (US) is the primary imaging modality used for initial evaluation and assortment of nodules for fine needle aspiration (FNA) cytology/biopsy. Ultrasound elastography (USE) is believed to improve the diagnostic accuracy of US in distinguishing benign from malignant nodules. The aim of the work described here is to evaluate the diagnostic criteria and accuracy of US and USE in the diagnosis of malignant thyroid nodules. A prospective study of 88 patients who have thyroid nodules was performed. US, color Doppler, and USE were evaluated using a Philips iU22 equipped with a 5 to 12 MHz, linear transducer, followed by FNA of the each scanned nodule. The most sensitive US criteria for malignant nodules were a height-to-width ratio greater than one and the absence of a halo sign (sensitivity 0.875% and 1.000%, respectively). The most specific criteria for malignancy were a spiculated/blurred margin and the presence of microcalcifications (specificity 0.968% and 0.888%, respectively). The receiver operating characteristic curve showed that the cutoff diagnostic criteria of malignancy are two US characteristics and an elastography score of 4. The diagnostic accuracy of US for malignant thyroid nodules increases by combining US and USE.

  15. The difference in diagnosis rate of different diagnostic criteria of autoimmune pancreatitis and its major influential factors

    Institute of Scientific and Technical Information of China (English)

    王珏磊

    2013-01-01

    Objective To discuss the difference in diagnostic criteria of autoimmune pancreatitis (AIP) and its major influential factors,so as to provide guidance for AIP diagnosis and treatment.Methods The clinical data of 561cases of chronic pancreatitis admitted to PLA General Hospital from June,2008 to January,2013 were

  16. Diagnostic accuracy of referral criteria for head circumference to detect hydrocephalus in the first year of life

    NARCIS (Netherlands)

    Dommelen, P. van; Deurloo, J.A.; Gooskens, R.H.; Verkerk, P.H.

    2015-01-01

    Background Increased head circumference is often the first and main sign leading to the diagnosis of hydrocephalus. Our aim is to investigate the diagnostic accuracy of referral criteria for head circumference to detect hydrocephalus in the first year of life. Methods A reference group with

  17. Posttraumatic stress disorder: An exploratory study examining rates of trauma and PTSD and its effect on client outcomes in community mental health

    Directory of Open Access Journals (Sweden)

    Yellowlees Peter

    2005-04-01

    Full Text Available Abstract Background Rates of trauma and Posttraumatic Stress Disorder (PTSD were examined in order to compare the profile in clients of an Australian Public Mental Health Service with that reported in the international literature for clients with major mental illness and to explore the effect of this on client health outcomes. Potential factors contributing to increased levels of trauma/PTSD in this group of clients and the issue of causality between PTSD and subsequent mental illness was also explored. Methods A convenience sample of 29 clients was screened for trauma and PTSD using the Posttraumatic Stress Diagnostic Scale™ (PDS and selected outcome measures. Paired and independent samples t-test and ANOVA were applied to the data. Results High levels of undocumented trauma and PTSD were found. Twenty clients, (74% reported exposure to multiple traumatic events; 33.3% (9 met DSM IV diagnostic criteria for PTSD. Significant difference was found for PTSD symptomatology, severity and impairment and for client and clinician-rated scores of Quality of Life (QOL outcomes in the PTSD group. No effect for PTSD symptomatology on the Working Alliance (WA was found. Factors that may influence higher rates of PTSD in this group were identified and included issues associated with the population studied, the predominance of assaultive violence found, and vulnerability and risks factors associated with re-traumatisation within the social and treating environments. Conclusion A similar trauma and PTSD profile to that reported in the international literature, including greater levels of trauma and PTSD and a poorer QOL, was found in this small sample of clients. It is postulated that the increased levels of trauma/PTSD as reported for persons with major mental illness, including those found in the current study, are primarily related to the characteristics of the population that access public mainstream psychiatric services and that these factors have

  18. The diagnostic criteria for iron deficiency in infants should be reevaluated.

    Science.gov (United States)

    Domellöf, Magnus; Dewey, Kathryn G; Lönnerdal, Bo; Cohen, Roberta J; Hernell, Olle

    2002-12-01

    Diagnostic criteria for iron deficiency (ID) and iron deficiency anemia (IDA) in infants are poorly defined. Our aim was to establish appropriate cut-off values for hemoglobin (Hb), plasma ferritin, erythrocyte mean cell volume (MCV), zinc protoporphyrin (ZPP) and soluble transferrin receptors (TfR) in infancy. Exclusively breast-fed infants (n = 263) in Honduras and Sweden were randomly assigned to receive iron supplementation or placebo, and blood samples were obtained at 4, 6 and 9 mo of age. Reference ranges were determined using three different approaches for defining iron-replete infants. The usefulness of several variables for predicting the Hb response to iron was evaluated. We found the following 2 SD cut-off values in iron-replete infants: Hb 75 micro mol/mol heme at 4-6 mo and >90 micro mol/mol heme at 9 mo; ferritin 11 mg/L at 4-9 mo. The Hb response to iron was not a useful definition of IDA at 4 mo of age. Hb, MCV and ZPP at 6 mo as well as growth variables predicted the Hb response at 6-9 mo, but ferritin and TfR at 6 mo did not. We conclude that there is need for a reevaluation of the definitions of ID and IDA in infants.

  19. [Diagnostic criteria for fetal alcohol syndrome and fetal alcohol spectrum disorders].

    Science.gov (United States)

    Evrard, Sergio Gustavo

    2010-02-01

    Prenatal ethanol exposure, in our professional practice, is an almost neglected condition as an important etiological factor for the induction of a wide spectrum of neuropsychiatric diseases that may appear during childhood, adolescence or adulthood. Children born to alcoholic mothers may show a profound mental retardation ranging to an apparent normality, and extending through epilepsy, attention deficit disorders with or without hyperactivity, autism and pervasive developmental disorders, and different types of learning disorders. When adolescents, they may develop different kinds of personality disorders and substance abuse disorders. Finally, in adulthood, they may suffer from different types of affective and psychotic disorders, among others. A great number of those children may not develop their full mental and social potentiality as free individuals. They usually have diverse types of cognitive, attentional, mnemonic and affective impairments. Not infrequently, they engage in antisocial behaviors or have school or work troubles. In this work, the present clinical classifications and diagnostic criteria for the disorders emerging from a prenatal ethanol exposure are reviewed in order to call attention to the medical pediatric and neuropsychiatric community about the increasingly, although underdiagnosed, frequency of these disorders in our country.

  20. Prevalence of Sarcopenic Obesity in Adults with Class II/III Obesity Using Different Diagnostic Criteria

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    Carlene A. Johnson Stoklossa

    2017-01-01

    Full Text Available Background/Objective. Sarcopenic obesity (SO is a hidden condition of reduced lean soft tissue (LST in context of excess adiposity. SO is most commonly reported in older adults and both its risk and prevalence increase with age. A variety of body composition indices and cut points have been used to define this condition, leading to conflicting prevalence and risk prediction. Here, we investigate variability in the prevalence of SO in an adult sample of individuals with class II/III obesity (BMI ≥ 35 kg/m2 using different diagnostic criteria. Methods. SO definitions were identified from a literature review of studies using dual-energy X-ray absorptiometry (DXA to assess LST. Demographics, anthropometrics, and body composition (by DXA were measured in n=120, 86% female (46.9 ± 11.1 years. Results. LST was extremely variable in individuals, even with similar body sizes, and observed across the age spectrum. The prevalence of SO ranged from 0 to 84.5% in females and 0 to 100% in males, depending upon the definition applied, with higher prevalence among definitions accounting for measures of body size or fat mass. Conclusion. SO is present, yet variable, in adults with class II/III obesity. Accounting for body mass or fat mass may identify a higher number of individuals with SO, although risk prediction remains to be studied.

  1. ALS diagnostic criteria, El Escorial, and Philip II of Spain: a historical perspective.

    Science.gov (United States)

    Belsh, J M

    1999-12-01

    El Escorial, a magnificent palace-monastery in central Spain, was the setting in 1990 for a meeting of ALS experts who developed a consensus document called the El Escorial ALS Diagnostic Criteria. El Escorial was originally conceived by the Spanish Habsburg monarch, Philip II (1527-1598), as an elaborate burial place for his parents, Emperor Charles V and Isabella. It soon became a symbol of the Spanish empire and Philip's Catholic leadership of the Counter-Reformation. El Escorial included a monastery, palace, basilica, mausoleum, seminary, library, and hospital. Nothing was spared by Philip in obtaining the finest examples of religious art, architecture, music, and books. Philip, as absolute monarch, inherited a vast empire which stretched over Europe, Asia, North Africa, and the New World. His style of personal micro-management and poor economic planning hampered his ability to manage both national and foreign affairs. Philip had a special interest in medicine, including royal hospitals, improved government standards for physicians, medicinal plants, and the health benefits of alchemy and sacred relics. El Escorial's grand scale has generated both illustrious praise and critical condemnation over the last four centuries. Its place in Spanish and world history is assured.

  2. On orthorexia nervosa: A review of the literature and proposed diagnostic criteria.

    Science.gov (United States)

    Dunn, Thomas M; Bratman, Steven

    2016-04-01

    There has been a growing interest among clinicians and researchers about a condition where people restrict their diet based not on quantity of food they consume, but based on its quality. Bratman (1997) coined the term "orthorexia nervosa" to describe people whose extreme diets - intended for health reasons - are in fact leading to malnutrition and/or impairment of daily functioning. There has also recently been intense media interest in people whose highly restrictive "healthy" diet leads to disordered eating. Despite this condition being first described in the U.S., and receiving recent media interest here, orthorexia has largely gone unnoticed in the North American literature. This review article details the literature of orthorexia nervosa, describing its emergence as a condition first described by a physician in a yoga magazine, to its being discussed in the scientific literature. It also reviews prevalence studies and discusses marked shortcomings in the literature. Finally, diagnostic criteria are proposed, as are future directions for research. Copyright © 2015 Elsevier Ltd. All rights reserved.

  3. Comparing Symptoms of Autism Spectrum Disorders Using the Current "DSM-IV-TR" Diagnostic Criteria and the Proposed "DSM-V" Diagnostic Criteria

    Science.gov (United States)

    Worley, Julie A.; Matson, Johnny L.

    2012-01-01

    The American Psychiatric Association has proposed major revisions for the diagnostic category encompassing Autism Spectrum Disorders (ASD), which will reportedly increase the specificity and maintain the sensitivity of diagnoses. As a result, the aim of the current study was to compare symptoms of ASD in children and adolescents (N = 208) who met…

  4. Comparing Symptoms of Autism Spectrum Disorders Using the Current "DSM-IV-TR" Diagnostic Criteria and the Proposed "DSM-V" Diagnostic Criteria

    Science.gov (United States)

    Worley, Julie A.; Matson, Johnny L.

    2012-01-01

    The American Psychiatric Association has proposed major revisions for the diagnostic category encompassing Autism Spectrum Disorders (ASD), which will reportedly increase the specificity and maintain the sensitivity of diagnoses. As a result, the aim of the current study was to compare symptoms of ASD in children and adolescents (N = 208) who met…

  5. Diagnostic criteria and reporting procedures for pre-eclampsia: a national survey among obstetrical departments in Denmark

    DEFF Research Database (Denmark)

    Klemmensen, Åse Kathrine; Olsen, SF; Wengel, CM;

    2005-01-01

    OBJECTIVE: A precondition for the rational use of obstetric databases in biomedical research is detailed knowledge on how data are being generated. We identified the diagnostic procedures and criteria for pre-eclampsia (PE) and assessed the level of obstetric training of the personnel responsible...... of pregnancy diagnoses to the National Patient Registry differed widely in training. For complicated pregnancies, departments ranged from having only specialists reporting all cases to secretaries reporting up to 50%. Cut off limits of blood pressure (BP) and protein loss used to diagnose pre-eclampsia showed...... large differences across departments. The diagnoses given to three case stories showed little correlation to the criteria the departments reported using. CONCLUSION: Even in a small country like Denmark with 34 obstetrical departments, there was little consensus on the diagnostic criteria for pre-eclampsia...

  6. Validity of proposed DSM-5 diagnostic criteria for nicotine use disorder: results from 734 Israeli lifetime smokers

    Science.gov (United States)

    Shmulewitz, D.; Wall, M.M.; Aharonovich, E.; Spivak, B.; Weizman, A.; Frisch, A.; Grant, B. F.; Hasin, D.

    2013-01-01

    Background The fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) proposes aligning nicotine use disorder (NUD) criteria with those for other substances, by including the current DSM fourth edition (DSM-IV) nicotine dependence (ND) criteria, three abuse criteria (neglect roles, hazardous use, interpersonal problems) and craving. Although NUD criteria indicate one latent trait, evidence is lacking on: (1) validity of each criterion; (2) validity of the criteria as a set; (3) comparative validity between DSM-5 NUD and DSM-IV ND criterion sets; and (4) NUD prevalence. Method Nicotine criteria (DSM-IV ND, abuse and craving) and external validators (e.g. smoking soon after awakening, number of cigarettes per day) were assessed with a structured interview in 734 lifetime smokers from an Israeli household sample. Regression analysis evaluated the association between validators and each criterion. Receiver operating characteristic analysis assessed the association of the validators with the DSM-5 NUD set (number of criteria endorsed) and tested whether DSM-5 or DSM-IV provided the most discriminating criterion set. Changes in prevalence were examined. Results Each DSM-5 NUD criterion was significantly associated with the validators, with strength of associations similar across the criteria. As a set, DSM-5 criteria were significantly associated with the validators, were significantly more discriminating than DSM-IV ND criteria, and led to increased prevalence of binary NUD (two or more criteria) over ND. Conclusions All findings address previous concerns about the DSM-IV nicotine diagnosis and its criteria and support the proposed changes for DSM-5 NUD, which should result in improved diagnosis of nicotine disorders. PMID:23312475

  7. Should A2 be a diagnostic requirement for posttraumatic stress disorder in DSM-V?

    Science.gov (United States)

    O'Donnell, Meaghan L; Creamer, Mark; McFarlane, Alexander C; Silove, Derrick; Bryant, Richard A

    2010-04-30

    The requirement that trauma survivors experience fear, helplessness or horror (Criterion A2) as a part of their posttraumatic stress disorder (PTSD) diagnosis was introduced into DSM-IV. The imminent re-definition of PTSD in DSM-V highlights the need for empirical studies to validate the utility of the A2 requirement. We aimed to identify (i) how often A2 was associated with PTSD (B-F criteria) at 3 months after trauma and (ii) what was the peritraumatic emotional experience for those who met PTSD criteria but were A2 negative. In a prospective design cohort study we assessed the peritraumatic emotional experience of 535 injury patients in four Australian hospitals. These patients were followed up 3 months later and assessed for PTSD using a structured clinical interview. The majority of those who developed PTSD (B-F criterion) at 3 months met A2 criteria. A substantial minority, however (23%), did not meet A2 criteria. Those PTSD patients who were A2 negative fell into three groups: (i) those who experienced subthreshold levels of A2; (ii) those who experienced intense peritrauma emotional responses other than fear, helplessness or horror; and (iii) those who were amnesic to their peritrauma emotional experience. These findings do not support the inclusion of A2 as diagnostic requirement for DSM-V.

  8. Which Diagnostic Criteria are Most Useful in Discriminating Between Social Gamblers and Individuals with Gambling Problems? An Examination of DSM-IV and DSM-5 Criteria.

    Science.gov (United States)

    Temcheff, Caroline E; Paskus, Thomas S; Potenza, Marc N; Derevensky, Jeffrey L

    2016-09-01

    The current study sought to identify which diagnostic criteria for gambling disorder have the greatest ability to differentiate between social and problem gamblers. This study was conducted on a sample of male and female college student athletes across the U.S. (n = 8674). Classification and regression tree analysis represents an appropriate technique when addressing the question of an item's diagnostic value, as it sequentially selects variables to isolate sets of observations with similar outcomes. The current results suggest that the item related to preoccupation ("Have there been periods in the past year where you spent a lot of time thinking about gambling?") was the DSM-5 item best able to differentiate between male and female social and problem gamblers in this sample. When considering only the nine criteria retained in the DSM-5, three criteria were identified as key for distinguishing between social and disordered gamblers among men, and one criterion was identified for distinguishing between groups of women. In addition, these results do not support the notion that the illegal acts criterion has a particularly low base rate and found that it can be an important indicator of disordered gambling in a college-aged sample.

  9. Prevalence and correlates of posttrauma distorted beliefs: evaluating DSM-5 PTSD expanded cognitive symptoms in a national sample.

    Science.gov (United States)

    Cox, Keith S; Resnick, Heidi S; Kilpatrick, Dean G

    2014-06-01

    The fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5; American Psychiatric Association [APA], 2013) modified the diagnostic criteria for posttraumatic stress disorder (PTSD), including expanding the scope of dysfunctional, posttrauma changes in belief (symptoms D2-persistent negative beliefs and expectations about oneself or the world, and D3-persistent distorted blame of self or others for the cause or consequences of the traumatic event). D2 and D3 were investigated using a national sample of U.S. adults (N = 2,498) recruited from an online panel. The prevalence of D2 and D3 was substantially higher among those with lifetime PTSD than among trauma-exposed individuals without lifetime PTSD (D2: 74.6% vs 23.9%; D3: 80.6% vs 35.7%). In multivariate analyses, the strongest associates of D2 were interpersonal assault (OR = 2.39), witnessing interpersonal assault (OR = 1.63), gender (female, OR = 2.11), and number of reported traumatic events (OR = 1.88). The strongest correlates of D3 were interpersonal assault (OR = 3.08), witnessing interpersonal assault (OR = 1.57), gender (female, OR = 2.30), and number of reported traumatic events (OR = 1.91). The findings suggested the expanded cognitive symptoms in the DSM-5 diagnostic criteria better capture the cognitive complexity of PTSD than those of the DSM-IV.

  10. Diagnostic Criteria for Adult-onset Leukoencephalopathy With Axonal Spheroids and Pigmented Glia Due to CSF1R mutation.

    Science.gov (United States)

    Konno, Takuya; Yoshida, Kunihiro; Mizuta, Ikuko; Mizuno, Toshiki; Kawarai, Toshitaka; Tada, Masayoshi; Nozaki, Hiroaki; Ikeda, Shu-Ichi; Onodera, Osamu; Wszolek, Zbigniew K; Ikeuchi, Takeshi

    2017-09-18

    To establish and validate diagnostic criteria for adult-onset leukoencephalopathy with axonal spheroids and pigmented glia (ALSP) due to colony stimulating factor 1 receptor (CSF1R) mutation. We developed diagnostic criteria for ALSP based on a recent analysis of the clinical characteristics of ALSP. These criteria provide "probable" and "possible" designations for patients who do not have a genetic diagnosis. To verify its sensitivity and specificity, we retrospectively applied our criteria to 83 ALSP cases who had CSF1R mutations (24 of these were analyzed at our institutions, and the others were identified from the literature), 53 cases who had CSF1R mutation-negative leukoencephalopathies, and 32 cases who had cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL) with NOTCH3 mutations. Among the CSF1R mutation-positive cases, 50 cases (60%) were diagnosed as "probable" and 32 (39%) were diagnosed as "possible," leading to a sensitivity of 99% if calculated as a ratio of the combined number of cases who fulfilled "probable" or "possible" to the total number of cases. With regard to specificity, 22 cases (42%) with mutation-negative leukoencephalopathies and 28 (88%) with CADASIL were correctly excluded using these criteria. These diagnostic criteria are very sensitive for diagnosing ALSP with sufficient specificity for differentiating from CADASIL and moderate specificity for other leukoencephalopathies. Our results suggest that these criteria are useful for the clinical diagnosis of ALSP. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

  11. Multiple sclerosis: imaging, diagnostic criteria and differential diagnosis; Bildgebung, Diagnosekriterien und Differenzialdiagnose der Multiplen Sklerose

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    Harting, I.; Sartor, K. [Abt. Neuroradiologie, Neurologische Klinik, Universitaetsklinikum Heidelberg (Germany); Sellner, J.; Meyding-Lamade, U. [Abt. Neurologie, Neurologische Klinik, Universitaetsklinikum Heidelberg (Germany)

    2003-05-01

    Multiple sclerosis (MS) is the most common demyelinating inflammatory disease of the central nervous system (CNS), presenting with multifocal, disseminated inflammatory lesions referred to as plaques. Magnetic resonance imaging (MRI) typically depicts multiple, round to oval, circumscript lesions predominantly involving periventricular and subcortical white matter, brainstem and cerebellum. More recent investigations have demonstrated that the macroscopically visible plaques only present the tip of the iceberg: Already early in its course, MS causes neuroaxonal damage and diffusely involves the entire brain parenchyma including normal appearing white matter. These changes are reflected by strongly T{sub 1}w hypointense lesions and atrophy of early onset, by reduction of the neuronal Marker N-acetylaspartate (NAA) on spectroscopy, by a decrease of the magnetization transfer ratio (MTR), by an increased in diffusibility and decreased anisotropy on diffusion-weighted imaging (DWI). MRI imaging is an important tool in the diagnosis of MS by revealing the characteristic spatial and temporal dissemination of the cerebral and spinal manifestations of this disease. Diagnostic criteria increase the diagnostic specificity and allow better differentiation from other diseases with multifocal white matter abnormalities. (orig.) [German] Die multiple sklerose (MS) ist die haeufigste entzuendliche, demyelinisierende Erkrankung des zentralen Nervensystems (ZNS) Sie ist durch multifokale, disseminierte Entzuendungsherde, sogenannte Plaques, in den myelinhaltigen Strukturen des ZNS charakterisiert. In der Magnetresonanztomographie (MRT) sind multiple umschriebene, rundlich-ovale Laesionen der weissen Substanz charakteristisch, die bevorzugt im periventrikulaeren Marklager, an der Mark-Rindengrenze, im Hirnstamm und im Kleinhirn lokalisiert sind. Neuere Untersuchungen zeigen, dass die sichtbaren Entmarkungsherde nur die Spitze des Eisbergs sind: Bereits fruehzeitig verursacht die MS

  12. Is the pleural fluid transudate or exudate? A revisit of the diagnostic criteria

    Science.gov (United States)

    Joseph, J; Badrinath, P; Basran, G; Sahn, S

    2001-01-01

    BACKGROUND—Pleural effusions are classified into transudates and exudates based on criteria developed in the 1970s. However, their accuracy has not been evaluated. We compared the performance of the pleural fluid absolute lactic dehydrogenase level (FLDH), fluid to serum ratio of LDH (LDHR), and fluid to serum ratio of total protein (TPR). TPR has been used instead of the absolute value of fluid protein based on the observation that fluid protein is influenced by changes in the serum protein concentration. However, the rationale for using LDHR remains unexplored.
METHODS—Of 212 consecutive patients with pleural effusions, four with multiple causes and eight with an uncertain diagnosis were excluded. ROC curves were generated using sensitivity and 1-specificity values for TPR, FLDH, and LDHR and positive likelihood ratios (LR +ve) were computed using the optimum cut off values. The correlation between pleural fluid and serum concentrations of total protein and LDH was also estimated.
RESULTS—Of 200 effusions studied, 156 were exudates and 44 were transudates. The optimum cut off levels were: FLDH 163 IU/l, TPR 0.5,LDHR 0.6, and the FLDH-TPR combination 163 and 0.4, respectively. The area under the curve (AUC) with 95% confidence interval (CI) was: 0.89 (0.86 to 0.96) for FLDH, 0.86 (0.80 to 0.91) for TPR, 0.82 (0.77 to 0.89) for LDHR, and 0.90 (0.86 to 95) for FLDH-TPR. A significant correlation was observed between serum and pleural fluid protein levels in transudates and exudates (r=0.5 and 0.6,respectively), but the correlation between serum and pleural fluid LDH levels was insignificant.
CONCLUSION—FLDH is the most accurate marker for the diagnostic separation of transudates and exudates and LDHR has no role in this process. Combining TPR with FLDH appears to improve the diagnostic accuracy slightly.

 PMID:11641512

  13. Sleep alterations following exposure to stress predict fear-associated memory impairments in a rodent model of PTSD.

    Science.gov (United States)

    Vanderheyden, William M; George, Sophie A; Urpa, Lea; Kehoe, Michaela; Liberzon, Israel; Poe, Gina R

    2015-08-01

    Sleep abnormalities, such as insomnia, nightmares, hyper-arousal, and difficulty initiating or maintaining sleep, are diagnostic criteria of posttraumatic stress disorder (PTSD). The vivid dream state, rapid eye movement (REM) sleep, has been implicated in processing emotional memories. We have hypothesized that REM sleep is maladaptive in those suffering from PTSD. However, the precise neurobiological mechanisms regulating sleep disturbances following trauma exposure are poorly understood. Using single prolonged stress (SPS), a well-validated rodent model of PTSD, we measured sleep alterations in response to stressor exposure and over a subsequent 7-day isolation period during which the PTSD-like phenotype develops. SPS resulted in acute increases in REM sleep and transition to REM sleep, and decreased waking in addition to alterations in sleep architecture. The severity of the PTSD-like phenotype was later assessed by measuring freezing levels on a fear-associated memory test. Interestingly, the change in REM sleep following SPS was significantly correlated with freezing behavior during extinction recall assessed more than a week later. Reductions in theta (4-10 Hz) and sigma (10-15 Hz) band power during transition to REM sleep also correlated with impaired fear-associated memory processing. These data reveal that changes in REM sleep, transition to REM sleep, waking, and theta and sigma power may serve as sleep biomarkers to identify individuals with increased susceptibility to PTSD following trauma exposure.

  14. Persistent Complex Bereavement Disorder Symptom Domains Relate Differentially to PTSD and Depression: A Study of War-Exposed Bosnian Adolescents.

    Science.gov (United States)

    Claycomb, Meredith A; Charak, Ruby; Kaplow, Julie; Layne, Christopher M; Pynoos, Robert; Elhai, Jon D

    2016-10-01

    Persistent Complex Bereavement Disorder (PCBD) is a newly proposed diagnosis placed in the Appendix of the 5th edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) as an invitation for further research. To date, no studies have examined the dimensionality of PCBD or explored whether different PCBD criteria domains relate in similar, versus differential, ways to other psychological conditions common to war-exposed bereaved youth, including symptoms of Posttraumatic Stress Disorder (PTSD) and depression. We evaluated the dimensionality of proposed PCBD B and C symptom domains, and their respective relations with measures of PTSD and depression, in 1142 bereaved Bosnian adolescents exposed to the 1992-1995 Bosnian civil war. Instruments included the UCLA PTSD Reaction Index, the Depression Self-Rating Scale, and the UCLA Grief Screening Scale (a prototype measure of PCBD symptoms). We investigated potential differences in grief, PTSD, and depression scores as a function of cause of death. We then examined hypothesized differential relations between PCBD B and C symptom domain subscales and selected external correlates, specifically measures of depression and the four-factor emotional numbing model of PTSD. Results of both analyses provide preliminary evidence of a multidimensional structure for PCBD in this population, in that the PCBD Criterion C subscale score covaried more strongly with each of the four PTSD factors and with depression than did PCBD Criterion B. We conclude by discussing theoretical, methodological, clinical, and policy-related implications linked to the ongoing study of essential features of PCBD.

  15. Diagnostic criteria and follow-up in neuroendocrine cell hyperplasia of infancy: a case series

    Directory of Open Access Journals (Sweden)

    Vivianne Calheiros Chaves Gomes

    2013-09-01

    Full Text Available OBJECTIVE: Neuroendocrine cell hyperplasia of infancy (NEHI is a form of childhood interstitial lung disease characterized by tachypnea, retractions, crackles, and hypoxia. The aim of this study was to report and discuss the clinical, imaging, and histopathological findings in a series of NEHI cases at a tertiary pediatric hospital, with an emphasis on diagnostic criteria and clinical outcomes. METHODS: Between 2003 and 2011, 12 full-term infants were diagnosed with NEHI, based on clinical and tomographic findings. Those infants were followed for 1-91 months. Four infants were biopsied, and the histopathological specimens were stained with bombesin antibody. RESULTS: In this case series, symptoms appeared at birth in 6 infants and by 3 months of age in the remaining 6. In all of the cases, NEHI was associated with acute respiratory infection. The most common initial chest HRCT findings were ground-glass opacities that were in the middle lobe/lingula in 12 patients and in other medullary areas in 10. Air trapping was the second most common finding, being observed in 7 patients. Follow-up HRCT scans (performed in 10 patients revealed normal results in 1 patient and improvement in 9. The biopsy findings were nonspecific, and the staining was positive for bombesin in all samples. Confirmation of NEHI was primarily based on clinical and tomographic findings. Symptoms improved during the follow-up period (mean, 41 months. A clinical cure was achieved in 4 patients. CONCLUSIONS: In this sample of patients, the diagnosis of NEHI was made on the basis of the clinical and tomographic findings, independent of the lung biopsy results. Most of the patients showed clinical improvement and persistent tomographic changes during the follow-up period, regardless of the initial severity of the disease or type of treatment.

  16. Primary graft dysfunction of the liver: definitions, diagnostic criteria and risk factors.

    Science.gov (United States)

    Neves, Douglas Bastos; Rusi, Marcela Balbo; Diaz, Luiz Gustavo Guedes; Salvalaggio, Paolo

    2016-01-01

    Primary graft dysfunction is a multifactorial syndrome with great impact on liver transplantation outcomes. This review article was based on studies published between January 1980 and June 2015 and retrieved from PubMed database using the following search terms: "primary graft dysfunction", "early allograft dysfunction", "primary non-function" and "liver transplantation". Graft dysfunction describes different grades of graft ischemia-reperfusion injury and can manifest as early allograft dysfunction or primary graft non-function, its most severe form. Donor-, surgery- and recipient-related factors have been associated with this syndrome. Primary graft dysfunction definition, diagnostic criteria and risk factors differ between studies. RESUMO A disfunção primária do enxerto hepático é uma síndrome multifatorial com grande impacto no resultado do transplante de fígado. Foi realizada uma ampla revisão da literatura, consultando a base de dados PubMed, em busca de estudos publicados entre janeiro de 1980 e junho de 2015. Os termos descritivos utilizados foram: "primary graft dysfunction", "early allograft dysfunction", "primary non-function" e "liver transplantation". A disfunção traduz graus diferentes da lesão de isquemia e reperfusão do órgão, e pode se manifestar como disfunção precoce ou, na forma mais grave, pelo não funcionamento primário do enxerto. Fatores relacionados ao doador, ao transplante e ao receptor contribuem para essa síndrome. Existem definições diferentes na literatura quanto ao diagnóstico e aos fatores de risco associados à disfunção primária.

  17. Risk factors for coronary heart disease and actual diagnostic criteria for diabetes mellitus

    Directory of Open Access Journals (Sweden)

    Mitrović-Perišić Nataša

    2009-01-01

    Full Text Available Background/Aim. Recent studies indicate that the prevalence of diabetes mellitus (DM type 2 is increasing in the world. Chronic hyperglycemia in DM is associated with a long term damage, dysfunction and failure of various organs, especially retina, kidney, nerves and, in addition, with an increased risk of cardiovasclar disease. For a long time the illness has been unknown. Early diagnosis of diabetes could suspend the development of diabetic complications. The aim of the study was to establish risk for the development of coronary disease in the patients evaluated by the use of new diagnostic criteria for DM. Methods. The study included 930 participants without diagnosis of DM, hypertension, dyslipidemia, nor coronary heart disease two years before the study. The patients went through measuring of fasting plasma glycemia, erythrocytes, hematocrit, cholesterol, triglycerides, high-density lipoprotein cholesterol (HDL-C, low-density lipoprotein cholesterol, aspartate aminotransferase and alanine aminotransferase. In the group with hyperglycemia the 2-hour oral glucose tolerance test was performed. We analyzed ECG and made blood pressure monitoring, and also measured body mass, height, waist and hip circumference. We analyzed life style, especially smoking, and exercise and family history. Results. Diabetes prevalence was 2.68%, and prevalences of impaired fasting glucose, impaired glucose tolerance and DM were 12.15%. Average age of males and females was 38 and 45 years, respectively. In the healthy population there was higher frequency of smokers (55% vs 42%, but in the population with hyperglycemia there were more obesity (23% vs 10.5%, hypertension (39% vs 9%, hypercholesterolemia (76% vs 44.1%, lower HDL-C (52.2% vs 25.7%. Cummulative risk factor in healthy subjects, and those with hyperglycemia were 5.6% and 14%, respectively. Conclusion. Subjects with hyperglicemia without diagnosis of DM have higher risk factors for coronary heart disease.

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

    Directory of Open Access Journals (Sweden)

    Domenico Galasso

    2013-04-01

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

  19. ESPEN diagnostic criteria for malnutrition - A validation study in hospitalized patients.

    Science.gov (United States)

    Guerra, Rita S; Fonseca, Isabel; Sousa, Ana S; Jesus, Alison; Pichel, Fernando; Amaral, Teresa F

    2017-10-01

    The European Society for Clinical Nutrition and Metabolism (ESPEN) released a consensus statement for undernutrition diagnosis: ESPEN diagnostic criteria for malnutrition (EDC). The EDC lacks validation and therefore, the present study aims to assess the concurrent and predictive validity of this tool in a cohort of inpatients. A prospective observational study took place in a university hospital. Concurrent validity of EDC was evaluated using the Patient Generated Subjective Global Assessment (PG-SGA) nutrition status classification as the reference method. Sensitivity, specificity, positive and negative predictive values were determined. The EDC predictive validity was assessed by its independent association with length of hospital stay (LOS), applying Cox proportional hazards ratio method. Of the 632 included patients, 455 participants (72%) were nutritionally-at-risk (Nutritional Risk Screening initial screening). For those that had screened positive, 260 (57.1%) and 55 participants (12.1%) were undernourished according to PG-SGA and to EDC, respectively. Compared to PG-SGA, the EDC revealed a sensitivity of 17.1% and a specificity of 98.3%. Positive and negative predictive values were respectively 89.1% and 58.9%. Undernutrition evaluated by EDC was independently associated with lower hazard ratio for being discharged home over time, 0.695 (95% confidence interval: 0.509; 0.950). The EDC could be used in clinical settings to confirm undernutrition suggested by other methods. The independent association of undernutrition by EDC with LOS shows this method is of clinical relevance. Copyright © 2016 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.

  20. Impact of the Use of Different Diagnostic Criteria in the Prevalence of Dyslipidemia in Pregnant Women.

    Science.gov (United States)

    Feitosa, Alina Coutinho Rodrigues; Barreto, Luciana Tedgue; Silva, Isabela Matos da; Silva, Felipe Freire da; Feitosa, Gilson Soares

    2017-07-01

    There is a physiologic elevation of total cholesterol (TC) and triglycerides (TG) during pregnancy. Some authors define dyslipidemia (DLP) in pregnant women when TC, LDL and TG concentrations are above the 95th percentile (p95%) and HDL concentration is below the 5th percentile (P5%) for gestational age (GA). To compare the prevalence of DLP in pregnant women using percentiles criteria with the V Brazilian Guidelines on Dyslipidemia and the association with maternal and fetal outcomes. Pregnant women with high-risk conditions, aged 18-50 years, and at least one lipid profile during pregnancy was classified as the presence of DLP by two diagnostic criteria. Clinical and laboratorial data of mothers and newborns were evaluated. 433 pregnant women aged 32.9 ± 6.5 years were studied. Most (54.6%) had lipid profile collected during third trimester. The prevalence of any lipid abnormalities according to the criteria of the National Guidelines was 83.8%: TC ≥ 200 mg/dL was found in 49.9%; LDL ≥ 160 mg/dL, in 14.3%, HDL ≤ 50 mg/dL in 44.4% and TG ≥ 150 mg/dL in 65.3%. Any changes of lipid according to percentiles criteria was found in 19.6%: elevation above the P95% for TC was found in 0.7%; for LDL, 1.7%; for TG 6.4% and HDL lower than the P5% in 13%. The frequency of comorbidity: hypertension, diabetes, smoking, obesity and preeclampsia was similar among pregnant women when DLP was compared by both criteria. The prevalence of DLP during pregnancy varies significantly depending on the criteria used, however none demonstrated superiority in association with comorbidities. Durante a gestação ocorrem, fisiologicamente, elevações do colesterol total (CT) e triglicerídios (TG). Alguns autores definem dislipidemia (DLP) gestacional quando as concentrações de CT, LDL e TG são superiores ao percentil 95 (P95%) e de HDL, inferiores ao percentil 5 (P5%) para a idade gestacional. Comparar a prevalência da DLP em gestantes conforme critério por percentis com o da V

  1. Treating PTSD in patients with psychosis: a within-group controlled feasibility study examining the efficacy and safety of evidence-based PE and EMDR protocols.

    Science.gov (United States)

    de Bont, Paul A J M; van Minnen, Agnes; de Jongh, Ad

    2013-12-01

    The present study uses a within-group controlled design to examine the efficacy and safety of two psychological approaches to posttraumatic stress disorder (PTSD) in 10 patients with a concurrent psychotic disorder. Patients were randomly assigned either to prolonged exposure (PE; N=5) or eye movement desensitization and reprocessing (EMDR; N=5). Before, during, and after treatment, a total of 20 weekly assessments of PTSD symptoms, hallucinations, and delusions were carried out. Twelve weekly assessments of adverse events took place during the treatment phase. PTSD diagnosis, level of social functioning, psychosis-prone thinking, and general psychopathology were assessed pretreatment, posttreatment, and at three-month follow-up. Throughout the treatment, adverse events were monitored at each session. An intention-to-treat analysis of the 10 patients starting treatment showed that the PTSD treatment protocols of PE and EMDR significantly reduced PTSD symptom severity; PE and EMDR were equally effective and safe. Eight of the 10 patients completed the full intervention period. Seven of the 10 patients (70%) no longer met the diagnostic criteria for PTSD at follow-up. No serious adverse events occurred, nor did patients show any worsening of hallucinations, delusions, psychosis proneness, general psychopathology, or social functioning. The results of this feasibility trial suggest that PTSD patients with comorbid psychotic disorders benefit from trauma-focused treatment approaches such as PE and EMDR.

  2. McDonald Criteria 2010 and 2005 Compared: Persistence of High Oligoclonal Band Prevalence Despite Almost Doubled Diagnostic Sensitivity

    Directory of Open Access Journals (Sweden)

    Philipp Schwenkenbecher

    2016-09-01

    Full Text Available The 2010 McDonald criteria were developed to allow a more rapid diagnosis of relapsing-remitting multiple sclerosis (MS by only one MRI of the brain. Although cerebrospinal fluid (CSF is not a mandatory part of the latest criteria, the evidence of an intrathecal humoral immunoreaction in the form of oligoclonal bands (OCB is crucial in the diagnostic workup. To date, the impact of the 2010 McDonald criteria on the prevalence of OCB has not been investigated. We retrospectively evaluated data of 325 patients with a clinical relapse suggestive of demyelination that were treated in a German university hospital between 2010 and 2015. One hundred thirty-six patients (42% were diagnosed with MS and 189 patients with CIS when the criteria of 2010 were applied. The criteria of 2005 allowed only 70 patients (22% to be designated as MS. In contrast, the prevalence of OCB was marginal affected in MS patients with 96% for the criteria of 2010 and 98.5% for the criteria of 2005. In conclusion, OCB are prevalent in most MS patients and reflect the chronic inflammatory nature of the disease. We recommend CSF examination to exclude alternative diagnoses and reevaluation of the diagnosis MS in patients with negative OCB.

  3. Changes in hospitalization rate and mortality after acute myocardial infarction in Denmark after diagnostic criteria and methods changed

    DEFF Research Database (Denmark)

    Abildstrøm, Steen Zabell; Rasmussen, Søren; Madsen, Mette

    2004-01-01

    AIMS: To analyse the effect of the change in diagnostic criteria for acute myocardial infarction (AMI) and the use of troponin as a diagnostic marker on the hospitalization rate and mortality of hospitalized AMI patients from 1994 to 2001. METHODS AND RESULTS: Patients (> or =30 years) admitted.......9%) for men and from 1648 to 2020 per million inhabitants (22.6%) for women. Troponin use was associated with a significant 14% increase in hospitalization rate in this period [rate ratio 1.14, 95% confidence interval (CI) 1.11-1.18]. The effect of troponin was greatest among patients 70 years and older (rate...

  4. Validation of the U.K. Working Party diagnostic criteria for atopic eczema in a Xhosa-speaking African population.

    Science.gov (United States)

    Chalmers, D A; Todd, G; Saxe, N; Milne, J T; Tolosana, S; Ngcelwane, P N; Hlaba, B N; Mngomeni, L N; Nonxuba, T G; Williams, H C

    2007-01-01

    Reliable diagnostic criteria for eczema are important for epidemiological comparisons. Although the U.K. diagnostic criteria for atopic eczema have performed well in an English language setting, limited data are available from other countries where cultural and linguistic factors may affect their validity. We sought to determine the validity of the U.K. criteria for eczema in relation to clinical assessment by a dermatologist in a Xhosa-speaking South African population. A cross-sectional survey of 3067 children aged 3-11 years was conducted in rural, peri-urban and urban settings in South Africa. The prevalence of atopic eczema was determined using the U.K. diagnostic criteria and a clinical assessment by a dermatologist. Questions were translated into the local language (Xhosa). Trained researchers administered the questions to the children's parents or carers. The validity of the U.K. criteria was then determined by calculating the sensitivity, specificity, positive and negative predictive values, and Youden's Index in relation to the dermatologist's examination. The point prevalence of atopic eczema according to a dermatologist was 1.0% [95% confidence interval (CI) 0.6-1.4], while the prevalence of visible flexural eczema according to the U.K. protocol was 1.8% (95% CI 1.3-2.2). The sensitivity and specificity of the U.K. criteria in this setting was 43.7% (95% CI 26.3-62.3) and 97.9% (97.3-98.4), respectively. The positive and negative predictive values of the U.K. criteria were 18.4% (95% CI 10.4-28.9) and 99.4% (95% CI 99.0-99.6), respectively. The presence of visible flexural eczema according to the U.K. photographic protocol was the best predictor of atopic eczema, with a sensitivity and specificity of 81.2% (95% CI 63.5-92.7) and 99.0% (95% CI 98.6-99.3), respectively, and a positive and negative predictive value of 48.1% (95% CI 34.3-62.1) and 99.8% (95% CI 99.5-99.9), respectively. The validity of the full question-based version of the U.K. diagnostic

  5. PTSD prevalence and associated risk factors after a fire disaster that broke out in a paediatric hospital: a cross-sectional study.

    Science.gov (United States)

    Zaffina, S; Camisa, V; Monducci, Elena; Vinci, Maria Rosaria; Vicari, S; Bergamaschi, A

    2014-01-01

    Several studies have shown a higher risk of psychological problems in health care workers exposed to serious occupational stressors. The aim of the present study was to assess the presence of Post-traumatic Stress Disorder (PTSD) and possible risk factors in a sample of 32 workers who were at the same time rescuers and victims of a fire that broke out in the neonatal intensive care unit of a large paediatric hospital. Immediately and six months after the event, the subjects underwent a study protocol aimed at the diagnostic assessment of PTSD, investigated via the Clinician-Administered PTSD Scale (CAPS) and the Impact of Event Scale-Revised (IES-R). Out of the 30 subjects examined (two were missing), six showed the diagnostic criteria for a current PTSD. Risk factors for PTSD onset were a prior psychiatric disorder, the level of involvement in the fire disaster and the presence of phobias in the days immediately after the event. Gender and level of education approached statistical significance. The high prevalence of PTSD found in this sample was due to the fact that the risk of death or serious injury involved infants.

  6. An examination of cancer-related fatigue through proposed diagnostic criteria in a sample of cancer patients in Taiwan

    Directory of Open Access Journals (Sweden)

    Su Wei-Ju

    2011-09-01

    Full Text Available Abstract Background Fatigue among cancer patients has often been reported in the literature; however, great variations have been documented, ranging from 15% to 90%, probably due to the lack of a widely accepted definition and established diagnostic criteria for cancer-related fatigue. The objective of this study was to evaluate the proposed International Statistical Classification of Diseases and Related Health Problems (10th revision (ICD-10 criteria in a sample of cancer patients from a medical center and a regional teaching hospital in northern Taiwan. More accurate prevalence estimates of CRF may result in improved diagnoses and management of one of the most common symptoms associated with cancer and its treatment. Methods Since self-reporting from patients is the most effective and efficient method to measure fatigue, the ICD-10 criteria for fatigue were used. The ICD-10 criteria questionnaire was translated into Chinese and was approved by experts. Patients were recruited from outpatient palliative and oncology clinics and from palliative and oncology inpatient units. Results Of the 265 cancer patients that were interviewed between 21 October 2008 and 28 October 2009, 228 (86% reported having at least 2 weeks of fatigue in the past month, and further evaluation with the ICD-10 criteria showed that 132 (49.8% had cancer-related fatigue. Internal consistency was very good, which was indicated by a Cronbach alpha of 0.843. Conclusion The prevalence of diagnosable CRF in the patients in this sample, of whom most were under palliative treatment, was 49.8%, which was probably somewhat lower than in some of the previous reports that have used less-strict criteria. In addition, among the various criteria of the proposed diagnostic criteria, the most frequently reported symptoms in our sample populations were regarding sleep disturbance and physical factors. Although they will require further replication in other samples, these formal diagnostic

  7. Diagnostic criteria and reporting procedures for pre-eclampsia: a national survey among obstetrical departments in Denmark

    DEFF Research Database (Denmark)

    Klemmensen, Åse Kathrine; Olsen, SF; Wengel, CM;

    2005-01-01

    OBJECTIVE: A precondition for the rational use of obstetric databases in biomedical research is detailed knowledge on how data are being generated. We identified the diagnostic procedures and criteria for pre-eclampsia (PE) and assessed the level of obstetric training of the personnel responsible...... of pregnancy diagnoses to the National Patient Registry differed widely in training. For complicated pregnancies, departments ranged from having only specialists reporting all cases to secretaries reporting up to 50%. Cut off limits of blood pressure (BP) and protein loss used to diagnose pre-eclampsia showed......-eclampsia. The findings emphasize the need for standardizing diagnostic criteria and reporting practice and may have implications on how to interpret data regarding pre-eclampsia....

  8. Revised diagnostic criteria and classification for the autoimmune lymphoproliferative syndrome (ALPS): report from the 2009 NIH International Workshop

    OpenAIRE

    Oliveira, Joao B.; Bleesing, Jack J.; Dianzani, Umberto; Fleisher, Thomas A.; Jaffe, Elaine S.; Lenardo, Michael J.; Rieux-Laucat, Frederic; Siegel, Richard M.; Su, Helen C.; Teachey, David T.; Rao, V. Koneti

    2010-01-01

    Lymphadenopathy in children for which no infectious or malignant cause can be ascertained constitutes a challenging diagnostic dilemma. Autoimmune lymphoproliferative syndrome (ALPS) is a human genetic disorder of lymphocyte apoptosis resulting in an accumulation of lymphocytes and childhood onset chronic lymphadenopathy, splenomegaly, multilineage cytopenias, and an increased risk of B-cell lymphoma. In 1999, investigators at the National Institutes of Health (NIH) suggested criteria to esta...

  9. Impact of Periodontal Disease on the Quality of Life of Diabetics Based on Different Clinical Diagnostic Criteria

    Directory of Open Access Journals (Sweden)

    Aline Mendes Silva de Pinho

    2012-01-01

    Full Text Available The aim of this study was to determine the impact of periodontal disease on the quality of life of individuals with diabetes according to different clinical criteria (I-AAP, II-Beck, III-Machtei, IV-Lopez, V-Albandar, VI-Tonetti, and VII-CPI. This cross-sectional study sampled 300 individuals in Belo Horizonte, Brazil. The Oral Health Impact Profile was used to measure the impact of periodontal disease on quality of life. Prevalence of periodontal disease was 35.3%, 30.7%, 35.0%, 9.7%, 92.3%, 25.3%, and 75.3% using criteria I, II, III, IV, V, VI, and VII, respectively. The III-Machtei (P=0.043 and IV-Lopez (P<0.001 criteria were associated with OHIP-14; functional limitation was associated with IV-Lopez (P=0.006 and V-Albandar (P=0.018 criteria. Pain was only associated with V-Albandar criteria (P<0.001. Psychological discomfort was associated with the IV-Lopez (P=0.018 criteria. Physical disability was associated with the IV-Lopez (P=0.047 and V-Tonetti (P=0.046 criteria. Being handicapped was associated with the I-AAP (P=0.025 and II-Beck (P=0.041 criteria. Concepts of health and disease determined by clinical diagnostic criteria may influence the assessment of the impact of periodontal disease on diabetics' quality of life.

  10. Stress Detection for PTSD via the StartleMart Game

    DEFF Research Database (Denmark)

    Holmgard, C.; Yannakakis, Georgios; Karstoft, K.I.

    2013-01-01

    , we couple game design and game technology with stress detection for the automatic profiling and the personalized treatment of PTSD via game-based exposure therapy and stress inoculation training. The PTSD treatment game we designed forces the player to go through various stressful experiences while...... a stress detection mechanism profiles the severity and type of PTSD via skin conductance responses to those in-game stress elicitors. The initial study and analysis of 14 PTSD-diagnosed veteran soldiers presented in this paper reveals clear correspondence between diagnostic standard measures of PTSD...... for stress inoculation training. This points to future avenues of research toward discerning between degrees and types of PTSD using game-based diagnostic and treatment tools. I....

  11. Stress Detection for PTSD via the StartleMart Game

    DEFF Research Database (Denmark)

    Holmgård, Christoffer; Yannakakis, Georgios; Karstoft, Karen-Inge

    2013-01-01

    Computer games have recently shown promise as a diagnostic and treatment tool for psychiatric rehabilitation. This paper examines the positive impact of affect detection and advanced game technology on the treatment of mental diagnoses such as Post Traumatic Stress Disorder (PTSD). For that purpose......, we couple game design and game technology with stress detection for the automatic profiling and the personalized treatment of PTSD via game-based exposure therapy and stress inoculation training. The PTSD treatment game we designed forces the player to go through various stressful experiences while...... a stress detection mechanism profiles the severity and type of PTSD via skin conductance responses to those in-game stress elicitors. The initial study and analysis of 14 PTSD-diagnosed veteran soldiers presented in this paper reveals clear correspondence between diagnostic standard measures of PTSD...

  12. OBSESSIVE–COMPULSIVE DISORDER: A REVIEW OF THE DIAGNOSTIC CRITERIA AND POSSIBLE SUBTYPES AND DIMENSIONAL SPECIFIERS FOR DSM-V

    Science.gov (United States)

    Leckman, James F.; Denys, Damiaan; Simpson, H. Blair; Mataix-Cols, David; Hollander, Eric; Saxena, Sanjaya; Miguel, Euripedes C.; Rauch, Scott L.; Goodman, Wayne K.; Phillips, Katharine A.; Stein, Dan J.

    2014-01-01

    Background Since the publication of the DSM-IV in 1994, research on obsessive–compulsive disorder (OCD) has continued to expand. It is timely to reconsider the nosology of this disorder, assessing whether changes to diagnostic criteria as well as subtypes and specifiers may improve diagnostic validity and clinical utility. Methods The existing criteria were evaluated. Key issues were identified. Electronic databases of PubMed, ScienceDirect, and PsycINFO were searched for relevant studies. Results This review presents a number of options and preliminary recommendations to be considered for DSM-V. These include: (1) clarifying and simplifying the definition of obsessions and compulsions(criterion A); (2) possibly deleting the requirement that people recognize that their obsessions or compulsions are excessive or unreasonable (criterion B); (3) rethinking the clinical significance criterion (criterion C) and, in the interim, possibly adjusting what is considered “time-consuming” for OCD; (4) listing additional disorders to help with the differential diagnosis (criterion D); (5) rethinking the medical exclusion criterion (criterion E) and clarifying what is meant by a “general medical condition”; (6) revising the specifiers (i.e., clarifying that OCD can involve a range of insight, in addition to “poor insight,” and adding “tic-related OCD”); and (7) highlighting in the DSM-V text important clinical features of OCD that are not currently mentioned in the criteria (e.g., the major symptom dimensions). Conclusions A number of changes to the existing diagnostic criteria for OCD are proposed. These proposed criteria may change as the DSM-V process progresses. PMID:20217853

  13. PTSD Treatment Options

    Science.gov (United States)

    ... Elements of Cognitive Behavioral Therapies Cognitive behavioral therapies (CBTs) for PTSD involve a relatively structured, short-term treatment that ... time does it take? A usual course of CBT for PTSD lasts about eight to 20 sessions but can ...

  14. PTSD: Symptoms, Diagnosis, Treatment

    Science.gov (United States)

    ... Bar Home Current Issue Past Issues Feature PTSD Symptoms, Diagnosis , Treatment Past Issues / Winter 2009 Table of Contents ... version of this page please turn Javascript on. Symptoms As with mild traumatic brain injury (TBI), PTSD ...

  15. Sensitivity of revised diagnostic criteria for the behavioural variant of frontotemporal dementia

    OpenAIRE

    Rascovsky, Katya; Hodges, John R.; Knopman, David; Mario F. Mendez; Kramer, Joel H.; Neuhaus, John; John C. van Swieten; Seelaar, Harro; Elise G P Dopper; Onyike, Chiadi U.; Hillis, Argye E.; Josephs, Keith A.; Boeve, Bradley F.; Kertesz, Andrew; Seeley, William W.

    2011-01-01

    Based on the recent literature and collective experience, an international consortium developed revised guidelines for the diagnosis of behavioural variant frontotemporal dementia. The validation process retrospectively reviewed clinical records and compared the sensitivity of proposed and earlier criteria in a multi-site sample of patients with pathologically verified frontotemporal lobar degeneration. According to the revised criteria, ‘possible’ behavioural variant frontotemporal dementia ...

  16. New diagnostic criteria for infective endocarditis. A study of sensitivity and specificity.

    Science.gov (United States)

    Cecchi, E; Parrini, I; Chinaglia, A; Pomari, F; Brusasco, G; Bobbio, M; Trinchero, R; Brusca, A

    1997-07-01

    The purpose of this study was to determine the sensitivity and specificity of new criteria proposed by Duke University for case definition of infective endocarditis as compared to the previously accepted Von Reyn criteria. A total of 143 consecutive suspected cases of infective endocarditis in 137 febrile patients were included. Of these, 69 had infective endocarditis, pathologically proven in 28, but with only a clinical diagnosis in 41. In the remaining 74 cases, the diagnosis of infective endocarditis was rejected after a follow-up of at least 3 months. The sensitivity of Duke's criteria was significantly higher, both when patients with possible infective endocarditis were considered as true-positive (definition 1; 100% vs 69%, P < 0.001) and when possible cases were considered as rejected (definition 2; 76% vs 51%, P < 0.01). Specificity was very high with both criteria: 92% Von Reyn vs 88% Duke (ns) with definition 1 and 99% Von Reyn vs 97% Duke (ns) with definition 2. The overall accuracy of the Duke criteria in the entire population was significantly higher with both definitions (0.94 vs 0.81 definition 1, P < 0.001; 0.87 vs 0.75, P = 0.015 definition 2). Duke's criteria for defining infective endocarditis has been shown to be more sensitive than previously adopted criteria, while maintaining a high degree of specificity. Therefore, they must be accepted as a substitute for previous criteria.

  17. Sensitivity of revised diagnostic criteria for the behavioural variant of frontotemporal dementia

    OpenAIRE

    Rascovsky, Katya; Hodges, John R.; Knopman, David; Mario F. Mendez; Kramer, Joel H.; Neuhaus, John; van Swieten, John C.; Seelaar, Harro; Dopper, Elise G.P.; Onyike, Chiadi U.; Argye E. Hillis; Josephs, Keith A.; Boeve, Bradley F.; Kertesz, Andrew; Seeley, William W.

    2011-01-01

    Based on the recent literature and collective experience, an international consortium developed revised guidelines for the diagnosis of behavioural variant frontotemporal dementia. The validation process retrospectively reviewed clinical records and compared the sensitivity of proposed and earlier criteria in a multi-site sample of patients with pathologically verified frontotemporal lobar degeneration. According to the revised criteria, ‘possible’ behavioural variant frontotemporal dementia ...

  18. The Clinician-Administered PTSD Scale for DSM-5 (CAPS-5): Development and Initial Psychometric Evaluation in Military Veterans.

    Science.gov (United States)

    Weathers, Frank W; Bovin, Michelle J; Lee, Daniel J; Sloan, Denise M; Schnurr, Paula P; Kaloupek, Danny G; Keane, Terence M; Marx, Brian P

    2017-05-11

    The Clinician-Administered PTSD Scale (CAPS) is an extensively validated and widely used structured diagnostic interview for posttraumatic stress disorder (PTSD). The CAPS was recently revised to correspond with PTSD criteria in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5; American Psychiatric Association, 2013). This article describes the development of the CAPS for DSM-5 (CAPS-5) and presents the results of an initial psychometric evaluation of CAPS-5 scores in 2 samples of military veterans (Ns = 165 and 207). CAPS-5 diagnosis demonstrated strong interrater reliability (к = .78 to 1.00, depending on the scoring rule) and test-retest reliability (к = .83), as well as strong correspondence with a diagnosis based on the CAPS for DSM-IV (CAPS-IV; к = .84 when optimally calibrated). CAPS-5 total severity score demonstrated high internal consistency (α = .88) and interrater reliability (ICC = .91) and good test-retest reliability (ICC = .78). It also demonstrated good convergent validity with total severity score on the CAPS-IV (r = .83) and PTSD Checklist for DSM-5 (r = .66) and good discriminant validity with measures of anxiety, depression, somatization, functional impairment, psychopathy, and alcohol abuse (rs = .02 to .54). Overall, these results indicate that the CAPS-5 is a psychometrically sound measure of DSM-5 PTSD diagnosis and symptom severity. Importantly, the CAPS-5 strongly corresponds with the CAPS-IV, which suggests that backward compatibility with the CAPS-IV was maintained and that the CAPS-5 provides continuity in evidence-based assessment of PTSD in the transition from DSM-IV to DSM-5 criteria. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

  19. Atlantic Diabetes in Pregnancy (DIP): the prevalence and outcomes of gestational diabetes mellitus using new diagnostic criteria.

    LENUS (Irish Health Repository)

    O'Sullivan, E P

    2012-01-31

    AIMS\\/HYPOTHESIS: New diagnostic criteria for gestational diabetes mellitus (GDM) have recently been published. We wished to evaluate what impact these new criteria would have on GDM prevalence and outcomes in a predominantly European population. METHODS: The Atlantic Diabetes In Pregnancy (DIP) programme performed screening for GDM in 5,500 women with an oral glucose tolerance test at 24-28 weeks. GDM was defined according to the new International Association of Diabetes and Pregnancy Study Groups (IADPSG) criteria and compared with previous WHO criteria; maternal and neonatal adverse outcomes were prospectively recorded. RESULTS: Of the participants, 12.4% and 9.4% were diagnosed with GDM using IADPSG and WHO criteria, respectively. IADPSG GDM pregnancies were associated with a statistically significant increased incidence of adverse maternal outcomes (gestational hypertension, polyhydramnios and Caesarean section) and neonatal outcomes (prematurity, large for gestational age, neonatal unit admission, neonatal hypoglycaemia and respiratory distress). The odds ratio for the development of these adverse outcomes remained significant after adjustment for maternal age, body mass index and non-European ethnicity. Those women who were classified as having normal glucose tolerance by WHO criteria but as having GDM by IADPSG criteria also had significant adverse pregnancy outcomes. CONCLUSIONS\\/INTERPRETATION: GDM prevalence is higher when using newer IADPSG, compared with WHO, criteria, and these women and their offspring experience significant adverse pregnancy outcomes. Higher rates of GDM pose a challenge to healthcare systems, but improved screening provides an opportunity to attempt to reduce the associated morbidity for mother and child.

  20. What is in a name? Comparing diagnostic criteria for chronic fatigue syndrome with or without fibromyalgia.

    Science.gov (United States)

    Meeus, Mira; Ickmans, Kelly; Struyf, Filip; Kos, Daphne; Lambrecht, Luc; Willekens, Barbara; Cras, Patrick; Nijs, Jo

    2016-01-01

    The current study had two objectives. (1) to compare objective and self-report measures in patients with chronic fatigue syndrome (CFS) according to the 1994 Center for Disease Control (CDC) criteria, patients with multiple sclerosis (MS), and healthy controls, and (2) to contrast CFS patients who only fulfill CDC criteria to those who also fulfill the criteria for myalgic encephalomyelitis (ME), the 2003 Canadian criteria for ME/CFS, or the comorbid diagnosis of fibromyalgia (FM). One hundred six participants (48 CFS patients diagnosed following the 1994 CDC criteria, 19 MS patients, and 39 healthy controls) completed questionnaires assessing symptom severity, quality of life, daily functioning, and psychological factors. Objective measures consisted of activity monitoring, evaluation of maximal voluntary contraction and muscle recovery, and cognitive performance. CFS patients were screened whether they also fulfilled ME criteria, the Canadian criteria, and the diagnosis of FM. CFS patients scored higher on symptom severity, lower on quality of life, and higher on depression and kinesiophobia and worse on MVC, muscle recovery, and cognitive performance compared to the MS patients and the healthy subjects. Daily activity levels were also lower compared to healthy subjects. Only one difference was found between those fulfilling the ME criteria and those who did not regarding the degree of kinesiophobia (lower in ME), while comorbidity for FM significantly increased the symptom burden. CFS patients report more severe symptoms and are more disabled compared to MS patients and healthy controls. Based on the present study, fulfillment of the ME or Canadian criteria did not seem to give a clinically different picture, whereas a diagnosis of comorbid FM selected symptomatically worse and more disabled patients.

  1. Reliability, Validity, and Classification Accuracy of the DSM-5 Diagnostic Criteria for Gambling Disorder and Comparison to DSM-IV.

    Science.gov (United States)

    Stinchfield, Randy; McCready, John; Turner, Nigel E; Jimenez-Murcia, Susana; Petry, Nancy M; Grant, Jon; Welte, John; Chapman, Heather; Winters, Ken C

    2016-09-01

    The DSM-5 was published in 2013 and it included two substantive revisions for gambling disorder (GD). These changes are the reduction in the threshold from five to four criteria and elimination of the illegal activities criterion. The purpose of this study was to twofold. First, to assess the reliability, validity and classification accuracy of the DSM-5 diagnostic criteria for GD. Second, to compare the DSM-5-DSM-IV on reliability, validity, and classification accuracy, including an examination of the effect of the elimination of the illegal acts criterion on diagnostic accuracy. To compare DSM-5 and DSM-IV, eight datasets from three different countries (Canada, USA, and Spain; total N = 3247) were used. All datasets were based on similar research methods. Participants were recruited from outpatient gambling treatment services to represent the group with a GD and from the community to represent the group without a GD. All participants were administered a standardized measure of diagnostic criteria. The DSM-5 yielded satisfactory reliability, validity and classification accuracy. In comparing the DSM-5 to the DSM-IV, most comparisons of reliability, validity and classification accuracy showed more similarities than differences. There was evidence of modest improvements in classification accuracy for DSM-5 over DSM-IV, particularly in reduction of false negative errors. This reduction in false negative errors was largely a function of lowering the cut score from five to four and this revision is an improvement over DSM-IV. From a statistical standpoint, eliminating the illegal acts criterion did not make a significant impact on diagnostic accuracy. From a clinical standpoint, illegal acts can still be addressed in the context of the DSM-5 criterion of lying to others.

  2. EULAR points to consider in the development of classification and diagnostic criteria in systemic vasculitis

    DEFF Research Database (Denmark)

    Basu, Neil; Watts, Richard; Bajema, Ingeborg;

    2010-01-01

    The systemic vasculitides are multiorgan diseases where early diagnosis and treatment can significantly improve outcomes. Robust nomenclature reduces diagnostic delay. However, key aspects of current nomenclature are widely perceived to be out of date, these include disease definitions, classific...

  3. [Validity of the diagnostic criteria of the acute respiratory distress syndrome].

    Science.gov (United States)

    Peñuelas, O; Esteban, A; Frutos-Vivar, F; Aramburu, J

    2006-01-01

    Acute respiratory distress syndrome (ARDS) is defined according to the criteria of the 1994 consensus conference. These criteria aim to . However, the histological criteria that correspond to ARDS are the criteria of diffuse alveolar damage described in 1976 by Katzenstein et al., which are still valid at present. In the last decade, different studies have been published that have tried to correlate the clinical syndrome with the histological findings. These studies have been basically done in experimental animals, but also by the description of the pulmonary biopsy findings and post-mortem study findings. The present article aims to show discrepancy between clinical and histological diagnosis of the acute pulmonary lesion, basically having an effect on the difficulty of the ARDS diagnosis when its origin is pulmonary and the implications of this discrepancy in the clinical practice and research.

  4. Effect of diagnostic criteria on prevalence of frontotemporal dementia in the elderly.

    Science.gov (United States)

    Gislason, Thorsteinn B; Östling, Svante; Börjesson-Hanson, Anne; Sjögren, Magnus; Simoni, Michela; Pantoni, Leonardo; Skoog, Ingmar

    2015-04-01

    Frontotemporal dementia (FTD) is believed to be rare in the elderly, and the influence of different criteria on the prevalence of FTD is unclear. Population-based samples of 70- to 95-year-olds (n = 2462) in Gothenburg, Sweden, underwent neuropsychiatric examinations. Behavioral variant FTD (bvFTD) was diagnosed according to the International Behavioural Variant FTD Criteria Consortium (FTDC), the Frontotemporal Lobe Degeneration Consensus criteria, and the Lund-Manchester Research Criteria. A subset (n = 1074) underwent computerized tomography (CT) of the brain. The prevalence of bvFTD varied between 0.2% and 0.5% at age 70 to 79 years, between 2.5% and 3.6% at age 80 to 89 years, and between 1.7% and 2.2% at age 90 to 95 years. The agreement between different criteria was low to moderate (κ = 0.20-0.42). Among those with bvFTD according to FTDC, 93.3% had frontal and/or temporal lobar atrophy on CT, compared with 12.6% of those without bvFTD (P < .001). The prevalence of bvFTD was higher than expected in this population. To a large extent, different criteria captured different individuals. Copyright © 2015 The Alzheimer's Association. Published by Elsevier Inc. All rights reserved.

  5. Clinical Diagnosis of the Dampness and Mold Hypersensitivity Syndrome: Review of the Literature and Suggested Diagnostic Criteria

    Directory of Open Access Journals (Sweden)

    Ville Valtonen

    2017-08-01

    Full Text Available A great variety of non-specific symptoms may occur in patients living or working in moisture-damaged buildings. In the beginning, these symptoms are usually reversible, mild, and present irritation of mucosa and increased morbidity due to respiratory tract infections and asthma-like symptoms. Later, the disease may become chronic and a patient is referred to a doctor where the assessment of dampness and mold hypersensitivity syndrome (DMHS often presents diagnostic challenges. Currently, unanimously accepted laboratory tests are not yet available. Therefore, the diagnosis of DMHS is clinical and is based on the patient’s history and careful examination. In this publication, I reviewed contemporary knowledge on clinical presentations, laboratory methods, and clinical assessment of DMHS. From the literature, I have not found any proposed diagnostic clinical criteria. Therefore, I propose five clinical criteria to diagnose DMHS: (1 the history of mold exposure in water-damaged buildings, (2 increased morbidity to due infections, (3 sick building syndrome, (4 multiple chemical sensitivity, and (5 enhanced scent sensitivity. If all the five criteria are met, the patient has a very probable DMHS. To resolve the current problems in assigning correct DMHS diagnosis, we also need novel assays to estimate potential risks of developing DMHS.

  6. Chronic daily headache in a tertiary care population: correlation between the International Headache Society diagnostic criteria and proposed revisions of criteria for chronic daily headache.

    Science.gov (United States)

    Bigal, M E; Sheftell, F D; Rapoport, A M; Lipton, R B; Tepper, S J

    2002-07-01

    The International Headache Society (IHS) has been criticized for its approach to classification of chronic daily headache (CDH); Silberstein and Lipton criteria provide an alternative to this approach. The aim of this study is to apply the alternative diagnostic approaches to a sample of CDH patients consulting in specialty care. Our sample consisted of 638 patients with CDH. Patients were classified according to both classification systems. Patients were predominantly female (65.0%), with ages ranging from 11 to 88 years. According to the Silberstein and Lipton classification, we found eight different diagnoses. The most common diagnosis was chronic migraine (87.4%), followed by new daily persistent headache (10.8%). Just six patients had chronic tension-type headache (CTTH). Applying the IHS criteria we found 14 different diagnoses. Migraine was found in 576 (90.2%) patients. CTTH occurred in 621 (97.3%), with only 10 (1.57%) having this as the sole diagnosis. We conclude that both systems allow for the classification of most patients with CDH when daily headache diaries are available. The main difference is that the IHS classification is cumbersome and requires multiple diagnoses. The Silberstein and Lipton system is easier to apply, and more parsimonious. These findings support revision of the IHS classification system to include chronic migraine.

  7. Validation of two screening instruments for PTSD in Dutch substance use disorder inpatients

    NARCIS (Netherlands)

    Kok, T.; Haan, H.A. de; Velden, H.J.W. van der; Meer, M. van der; Jong, C.A.J. de

    2013-01-01

    Posttraumatic stress disorder (PTSD) is highly prevalent in substance use disorder (SUD) populations. Because resources for extensive and thorough diagnostic assessment are often limited, reliable screening instruments for PTSD are needed. The aim of the current study was to test two short PTSD meas

  8. Posttraumatic stress disorder in early childhood: classification and diagnostic issues

    Directory of Open Access Journals (Sweden)

    Alessandra Simonelli

    2013-12-01

    Full Text Available The 0–3 diagnostic classification of infant mental health, on the basis of DSM-IV-R, describes posttraumatic stress disorder (PTSD as a pattern of symptoms that may be shown by children who have experienced a single traumatic event, a series of connected traumatic events, or chronic, enduring stress situations. This definition, related to young children, needs the consideration of several factors to understand the child's symptoms, organize the diagnostic process, and realize clinical interventions. In this sense, the clinician must appreciate the classification criteria of PTSD in early childhood in the context of the child's age, temperament, and developmental level. This report presents a review of the research in the domain of the PTSD in early childhood with particular attention to the developmental considerations to define critical diagnostic criteria, specifically organized on the child characteristics, competences, and needs. Along this line, it will describe two proposed modifications of the diagnostic classification in childhood: the Post Traumatic Stress Disorder Alternative Algorithm (PTSD-AA and the definition of developmental trauma disorder (DTD.For the abstract or full text in other languages, please see Supplementary files under Article Tools online

  9. Diagnostic Criteria for Problematic Internet Use among U.S. University Students: A Mixed-Methods Evaluation.

    Directory of Open Access Journals (Sweden)

    Wen Li

    Full Text Available Empirical studies have identified increasing rates of problematic Internet use worldwide and a host of related negative consequences. However, researchers disagree as to whether problematic Internet use is a subtype of behavioral addiction. Thus, there are not yet widely accepted and validated diagnostic criteria for problematic Internet use. To address this gap, we used mixed-methods to examine the extent to which signs and symptoms of problematic Internet use mirror DSM-5 diagnostic criteria for substance use disorder, gambling disorder, and Internet gaming disorder. A total of 27 university students, who self-identified as intensive Internet users and who reported Internet-use-associated health and/or psychosocial problems were recruited. Students completed two measures that assess problematic Internet use (Young's Diagnostic Questionnaire and the Compulsive Internet Use Scale and participated in focus groups exploring their experiences with problematic Internet use. Results of standardized measures and focus group discussions indicated substantial overlap between students' experiences of problematic Internet use and the signs and symptoms reflected in the DSM-5 criteria for substance use disorder, gambling disorder, and Internet gaming disorder. These signs and symptoms included: a use Internet longer than intended, b preoccupation with the Internet, c withdrawal symptoms when unable to access the Internet, d unsuccessful attempts to stop or reduce Internet use, e craving, f loss of interest in hobbies or activities other than the Internet, g excessive Internet use despite the knowledge of related problems, g use of the Internet to escape or relieve a negative mood, and h lying about Internet use. Tolerance, withdrawal symptoms, and recurrent Internet use in hazardous situations were uniquely manifested in the context of problematic Internet use. Implications for research and practice are discussed.

  10. Diagnostic Criteria for Problematic Internet Use among U.S. University Students: A Mixed-Methods Evaluation.

    Science.gov (United States)

    Li, Wen; O'Brien, Jennifer E; Snyder, Susan M; Howard, Matthew O

    2016-01-01

    Empirical studies have identified increasing rates of problematic Internet use worldwide and a host of related negative consequences. However, researchers disagree as to whether problematic Internet use is a subtype of behavioral addiction. Thus, there are not yet widely accepted and validated diagnostic criteria for problematic Internet use. To address this gap, we used mixed-methods to examine the extent to which signs and symptoms of problematic Internet use mirror DSM-5 diagnostic criteria for substance use disorder, gambling disorder, and Internet gaming disorder. A total of 27 university students, who self-identified as intensive Internet users and who reported Internet-use-associated health and/or psychosocial problems were recruited. Students completed two measures that assess problematic Internet use (Young's Diagnostic Questionnaire and the Compulsive Internet Use Scale) and participated in focus groups exploring their experiences with problematic Internet use. Results of standardized measures and focus group discussions indicated substantial overlap between students' experiences of problematic Internet use and the signs and symptoms reflected in the DSM-5 criteria for substance use disorder, gambling disorder, and Internet gaming disorder. These signs and symptoms included: a) use Internet longer than intended, b) preoccupation with the Internet, c) withdrawal symptoms when unable to access the Internet, d) unsuccessful attempts to stop or reduce Internet use, e) craving, f) loss of interest in hobbies or activities other than the Internet, g) excessive Internet use despite the knowledge of related problems, g) use of the Internet to escape or relieve a negative mood, and h) lying about Internet use. Tolerance, withdrawal symptoms, and recurrent Internet use in hazardous situations were uniquely manifested in the context of problematic Internet use. Implications for research and practice are discussed.

  11. Prevalence of premorbid metabolic syndrome in Spanish adult workers using IDF and ATPIII diagnostic criteria: relationship with cardiovascular risk factors.

    Directory of Open Access Journals (Sweden)

    Pedro Tauler

    Full Text Available BACKGROUND: Metabolic Syndrome (MetS is a complex disorder defined as a cluster of interconnected risk factors such as hypertension, dyslipidemia, obesity and high blood glucose levels. Premorbid metabolic syndrome (PMetS is defined by excluding patients with previously diagnosed cardiovascular disease or diabetes mellitus from those suffering MetS. We aimed to determine the prevalence of PMetS in a working population, and to analyse the relationship between the diagnostic criteria of the International Diabetes Federation (IDF and of the National Cholesterol Education Program Adult Treatment Panel III (ATPIII. The relationship between the presence of PMetS and cardiovascular risk factors was also analysed. RESEARCH METHODOLOGY/FINDINGS: A cross-sectional study was conducted in 24,529 male and 18,736 female Spanish (white western European adult workers (20-65 years randomly selected during their work health periodic examinations. Anthropometrics, blood pressure and serum parameters were measured. The presence of MetS and PMetS was ascertained using ATPIII and IDF criteria. Cardiovascular risk was determined using the Framingham-REGICOR equation. The results showed MetS had an adjusted global prevalence of 12.39% using ATPIII criteria and 16.46% using IDF criteria. The prevalence of PMetS was slightly lower (11.21% using ATPIII criteria and 14.72% using IDF criteria. Prevalence in males was always higher than in females. Participants with PMetS displayed higher values of BMI, waist circumference, blood pressure, glucose and triglycerides, and lower HDL-cholesterol levels. Logistic regression models reported lower PMetS risk for females, non-obese subjects, non-smokers and younger participants. Cardiovascular risk determined with Framingham-REGICOR was higher in participants with PMetS. CONCLUSIONS: PMetS could be a reliable tool for the early identification of apparently healthy individuals who have a significant risk for developing cardiovascular

  12. Brief migraine episodes in children and adolescents-a modification to International Headache Society pediatric migraine (without aura) diagnostic criteria.

    Science.gov (United States)

    Francis, Muttamthottil Varghese

    2013-12-01

    The international Headache Society (I H S) diagnostic criteria (International classification of headache disorders edition 2- ICHD 2) for headache in children and adults improved the accuracy of migraine diagnoses. However many short duration headaches in children, receive an atypical migraine diagnosis. This study is to diagnose children and adolescents who presented with such atypical migraines of less than one hour duration. 1402 children and adolescents aged 5 to 15 years who presented with recurrent brief activity affected head pain, were studied. Known and common migraine triggers and family history of migraine were recorded in all. All the children studied had moderate to severe headache lasting 5 to 45 minutes which forced them motionless during the attacks (thus fulfilling 2 diagnostic pain features). At least one of the ICHD2 pediatric migraine diagnostic symptoms (nausea / vomiting / photophobia / phonophobia) were present in all. Two additional features were diagnostic of brief migraines in all of them- one of the parents or siblings was a migrainer and one of the common migraine triggers as a precipitating factor. This study concludes that if duration of head pain is less than one hour ,two additional features to be included to diagnose definitive migraine in children and adolescents - one migraine parent or sibling and one of the migraine triggers precipitating the head pain.

  13. Borderline Personality Disorder Diagnostic Criteria as Risk Factors for Suicidal Behavior Through the Lens of the Interpersonal Theory of Suicide.

    Science.gov (United States)

    Rogers, Megan L; Joiner, Thomas E

    2016-01-01

    Borderline personality disorder diagnostic criteria, particularly affective dysregulation and behavioral dysregulation, are avenues through which suicide risk is conferred, though pathways are not well understood. The interpersonal theory of suicide may help elucidate these associations. The current study examined indirect relationships between affective and behavioral dysregulation and suicidal ideation through perceived burdensomeness, thwarted belongingness, and the acquired capability for suicide. 169 outpatients completed measures prior to their intake assessment. Perceived burdensomeness accounted for the relationship between affective dysregulation and suicidal ideation. The acquired capability did not explain the association between behavioral dysregulation and suicide attempt history. Affective and behavioral dysregulation may be key targets in treatment for reducing suicide risk.

  14. Major Salivary Gland Ultrasonography in the Diagnosis of Sjögren's Syndrome: A Place in the Diagnostic Criteria?

    Science.gov (United States)

    Jonsson, Malin V; Baldini, Chiara

    2016-08-01

    Major salivary gland (SG) ultrasonography (US) represents a noninvasive, nonirradiating imaging modality for evaluation of the major SGs in the diagnosis and follow-up of primary and secondary Sjögren syndrome. Structural changes can be visualized as hyperechogenic and hypoechogenic areas, inhomogeneity, and altered echogenicity in general. The reliability of SG-US is poorly investigated, and the definition of US abnormalities varies in previously published studies. Recent studies have shown correlations between SG-US findings and focus score in the minor SGs; however further studies are needed to validate a US criterion in updated classification/diagnostic criteria.

  15. Fear conditioning and early life vulnerabilities: two distinct pathways of emotional dysregulation and brain dysfunction in PTSD

    Directory of Open Access Journals (Sweden)

    Ruth A. Lanius

    2010-12-01

    Full Text Available The newly proposed criteria for posttraumatic stress disorder (PTSD in the Diagnostic and Statistical Manual (DSM-V include dysregulation of a variety of emotional states including fear, anger, guilt, and shame, in addition to dissociation and numbing. Consistent with these revisions, we postulate two models of emotion dysregulation in PTSD in which fear is not the prevailing emotion but is only one of several components implicated in a dysregulated emotional system that also mediates problems regulating anger, guilt, shame, dissociation, and numbing.We discuss whether there is a relationship between fear and other emotion regulation systems that may help further our understanding of PTSD and its underlying neurocircuitry. Two pathways describing the relationship between fear and other emotion regulation systems in PTSD are proposed. The first pathway describes emotion dysregulation as an outcome of fear conditioning through stress sensitization and kindling. The second pathway views emotion dysregulation as a distal vulnerability factor and hypothesizes a further exacerbation of fear and other emotion regulatory problems, including the development of PTSD after exposure to one or several traumatic event(s later in life. Future research and treatment implications are discussed.

  16. Colon polyps: epidemiology, risk factors, diagnostic criteria and courses of treatment

    Directory of Open Access Journals (Sweden)

    Lapteva Е.А.

    2013-06-01

    Full Text Available Article focuses on the intestinal polyps. Intestinal polyps are considered to be obligatory precancerous diseases of the colon. Risk factors, epidemiology, clinical manifestations and diagnostic methods of polyps have been analyzed. The courses of treatment of colon polyps have been revealed.

  17. Comparison of the Minnesota Percepto-Diagnostic Test and Bender-Gestalt: Relationship with Achievement Criteria.

    Science.gov (United States)

    Fuller, Gerald B.; Wallbrown, Fred H.

    1983-01-01

    Compared the Bender Gestalt (BD) and Minnesota Percepto-Diagnostic Test (MPD) in predicting academic achievement for younger children (N=69). Results suggested that the MPD is more sensitive than the Bender in identifying visual-motor perception areas of achievement performance problems. (LLL)

  18. INTERSTITIAL CYSTITIS IN THE NETHERLANDS - PREVALENCE, DIAGNOSTIC-CRITERIA AND THERAPEUTIC PREFERENCES

    NARCIS (Netherlands)

    BADE, JJ; RIJCKEN, B; MENSINK, HJA

    1995-01-01

    Purpose: We determine the prevalence of interstitial cystitis in The Netherlands, and analyze the most common diagnostic and therapeutic approaches among Dutch urologists. Materials and Methods: A questionnaire was completed by urologists and analyzed with the help of a statistical computer program.

  19. Establishment of diagnostic criteria for feline nonflea-induced hypersensitivity dermatitis.

    Science.gov (United States)

    Favrot, Claude; Steffan, Jean; Seewald, Wolfgang; Hobi, Stefan; Linek, Monika; Marignac, Geneviève; Olivry, Thierry; Beco, Luc; Nett, Claudia; Fontaine, Jacques; Roosje, Petra; Bergvall, Kerstin; Belova, Svetlana; Koebrich, Stefanie; Pin, Didier; Kovalik, Marcel; Meury, Sabrina; Wilhelm, Sylvia

    2012-02-01

    Hypersensitivity dermatitides (HD) are commonly seen in cats, and they are usually caused by environmental, food and/or flea allergens. Affected cats normally present with one of the following clinical reaction patterns: head and neck excoriations, usually symmetrical self-induced alopecia, eosinophilic skin lesions or miliary dermatitis. Importantly, none of these clinical presentations is considered to be pathognomonic for HD skin diseases, and the diagnosis of HD is usually based on the exclusion of other pruritic diseases and on a positive response to therapy. The objectives of this study were to propose sets of criteria for the diagnosis of nonflea-induced HD (NFHD). We recruited 501 cats with pruritus and skin lesions and compared clinical parameters between cats with NFHD (encompassing those with nonflea, nonfood HD and those with food HD), flea HD and other pruritic conditions. Using simulated annealing techniques, we established two sets of proposed criteria for the following two different clinical situations: (i) the diagnosis of NFHD in a population of pruritic cats; and (ii) the diagnosis of NFHD after exclusion of cats with flea HD. These criteria sets were associated with good sensitivity and specificity and may be useful for homogeneity of enrolment in clinical trials and to evaluate the probability of diagnosis of NFHD in clinical practice. Finally, these criteria were not useful to differentiate cats with NFHD from those with food HD.

  20. Comparing Diagnostic Outcomes of Autism Spectrum Disorder Using "DSM-IV-TR" and "DSM-5" Criteria

    Science.gov (United States)

    Harstad, Elizabeth B.; Fogler, Jason; Sideridis, Georgios; Weas, Sarah; Mauras, Carrie; Barbaresi, William J.

    2015-01-01

    Controversy exists regarding the "DSM-5" criteria for ASD. This study tested the psychometric properties of the "DSM-5" model and determined how well it performed across different gender, IQ, and "DSM-IV-TR" sub-type, using clinically collected data on 227 subjects (median age = 3.95 years, majority had IQ > 70).…

  1. Comparing Diagnostic Outcomes of Autism Spectrum Disorder Using "DSM-IV-TR" and "DSM-5" Criteria

    Science.gov (United States)

    Harstad, Elizabeth B.; Fogler, Jason; Sideridis, Georgios; Weas, Sarah; Mauras, Carrie; Barbaresi, William J.

    2015-01-01

    Controversy exists regarding the "DSM-5" criteria for ASD. This study tested the psychometric properties of the "DSM-5" model and determined how well it performed across different gender, IQ, and "DSM-IV-TR" sub-type, using clinically collected data on 227 subjects (median age = 3.95 years, majority had IQ > 70).…

  2. Is the evidence strong enough to change the diagnostic criteria for gestational diabetes now?

    NARCIS (Netherlands)

    Visser, Gerard H. A.; de Valk, Harold W.

    2013-01-01

    The International Association of the Diabetes and Pregnancy Study Groups has proposed new thresholds for oral glucose tolerance tests that are based on the large observational Hyperglycemia and Adverse Pregnancy Outcomes study. By using these criteria about 18% of pregnant women will be diagnosed as

  3. Clinical and research diagnostic criteria for developmental coordination disorder : a review and discussion

    NARCIS (Netherlands)

    Geuze, R.H.; Jongmans, M.J; Schoemaker, M.M.; Smits-Engelsman, B.C M

    2001-01-01

    The aim of this review was to investigate the selection criteria used in the past in studies of children with developmental motor problems (excluding those suffering from neurological dysfunctions such as cerebral palsy, muscular dystrophy, etc.). We therefore conducted an extensive analysis of 176

  4. A new diagnostic algorithm for vascular cognitive impairment: the proposed criteria and evaluation of its reliability and validity

    Institute of Scientific and Technical Information of China (English)

    ZHAO Qian-lu; ZHOU Yong; WANG Yi-long; DONG Ke-hui; WANG Yong-jun

    2010-01-01

    Background Vascular cognitive impairment (VCI) is considered to be the most common pattern of cognitive impairment. We aimed to devise a diagnostic algorithm for VCI, and evaluate the reliability and validity of our proposed criteria.Methods We based our new algorithm on previous literature, a Delphi consensus method, and preliminary testing. First, successive 100 patients with cerebrovascular disease (CVD) in hospital underwent a structured medical examination. Twenty-five case vignettes fulfilled the proposed criteria of diagnosis for probable or possible VCI were divided into three subtype categories: vascular cognitive impairment, no dementia (VCIND), vascular dementia (VaD) or mixed VCI/Alzheimer's disease (AD). Inter-raters reliability was assessed using a Fleiss kappa analysis. Convergent validity was also evaluated by correlation coefficients (r) between the proposed key points for each subtype and the currently accepted criteria. Forty-five patients with probable VCI were examined to determine the accuracy of identification for each subtype.Results The proposed criteria showed clinical diagnostic validity for VCI, and were able to define probable, possible and definite VCI, three VCI subtypes, and vascular causes. There was good consensus between experts (Cronbach's α=0.96 for both rounds). Significant moderate to good items-total correlations were found for two questionnaires (50-r range, 0.40-0.97 and 0.41-0.99, respectively). Significant slight and moderate inter-raters reliability were obtained for VCI (k=0.13) and three VCI subtypes (k=0.45). Furthermore, good convergent validity was observed in a comparison of significant correlations between criteria: good (4-r range, 0.75-0.92) to perfect (3-r=1.00) validity for the VCIND subtype, and moderate to good validity for the VaD subtype (1-r=0.46; 5-r range, 0.76-0.92) and for the mixed VCI/AD subtype (r=0.92 and 1.00; 4-r range, 0.47-0.70). Importantly, the area under receiver operating characteristic

  5. Cognitive behavioral therapy for PTSD and somatization: an open trial.

    Science.gov (United States)

    Pérez Benítez, Carlos I; Zlotnick, Caron; Gomez, Judelysse; Rendón, Maria J; Swanson, Amelia

    2013-06-01

    No treatment, to date, has been developed to improve both posttraumatic stress disorder (PTSD) and medically unexplained physical symptoms (MUPS), despite mounting evidence of high comorbidity between PTSD and MUPS. This study assessed the feasibility, acceptability, and treatment outcomes of an adapted cognitive behavioral therapy for PTSD and abridged somatization in a sample of eight participants. Fifteen percent of completers did not meet PTSD criteria after treatment completion and 62.5% improved their somatic symptoms. There was a significant difference between pre- and post-treatment depression symptoms, as well as in psychological and physical functioning measures. Results indicated a small to moderate effect size (d = 0.27-0.78) in PTSD severity scores, and moderate to large effect size in depression symptoms and psychosocial and physical functioning variables (d = 0.39-1.12). Preliminary evidence of acceptability indicates that the current CBT intervention may be suitable for Latinos individuals with PTSD and MUPS.

  6. Accuracy of Current Diagnostic Criteria for Acute Bacterial Infection in Older Adults in the Emergency Department.

    Science.gov (United States)

    Caterino, Jeffrey M; Leininger, Robert; Kline, David M; Southerland, Lauren T; Khaliqdina, Salman; Baugh, Christopher W; Pallin, Daniel J; Stevenson, Kurt B

    2017-08-01

    To compare the accuracy of the Loeb criteria, emergency department (ED) physicians' diagnoses, and Centers for Disease Control and Prevention (CDC) guidelines for acute bacterial infection in older adults with a criterion standard expert review. Prospective, observational study. Urban, tertiary-care ED. Individuals aged 65 and older in the ED, excluding those who were incarcerated, underwent a trauma, did not speak English, or were unable to consent. Two physician experts identified bacterial infections using clinical judgement, participant surveys, and medical records; a third adjudicated in cases of disagreement. Agreement and test characteristics were measured for ED physician diagnosis, Loeb criteria, and CDC surveillance guidelines. Criterion-standard review identified bacterial infection in 77 of 424 participants (18%) (18 (4.2%) lower respiratory, 19 (4.5%) urinary tract (UTI), 22 (5.2%) gastrointestinal, 15 (3.5%) skin and soft tissue). ED physicians diagnosed infection in 71 (17%), but there were 33 with under- and 27 with overdiagnosis. Physician agreement with the criterion standard was moderate for infection overall and each infection type (κ = 0.48-0.59), but sensitivity was low (<67%), and the negative likelihood ratio (LR(-)) was greater than 0.30 for all infections. The Loeb criteria had poor sensitivity, agreement, and LR(-) for lower respiratory (50%, κ = 0.55; 0.51) and urinary tract infection (26%, κ = 0.34; 0.74), but 87% sensitivity (κ = 0.78; LR(-) 0.14) for skin and soft tissue infections. CDC guidelines had moderate agreement but poor sensitivity and LR(-). Emergency physicians often under- and overdiagnose infections in older adults. The Loeb criteria are useful only for diagnosing skin and soft tissue infections. CDC guidelines are inadequate in the ED. New criteria are needed to aid ED physicians in accurately diagnosing infection in older adults. © 2017, Copyright the Authors Journal compilation © 2017, The American Geriatrics

  7. The impact of proposed changes to ICD-11 on estimates of PTSD prevalence and comorbidity.

    Science.gov (United States)

    Wisco, Blair E; Miller, Mark W; Wolf, Erika J; Kilpatrick, Dean; Resnick, Heidi S; Badour, Christal L; Marx, Brian P; Keane, Terence M; Rosen, Raymond C; Friedman, Matthew J

    2016-06-30

    The World Health Organization's posttraumatic stress disorder (PTSD) work group has published a proposal for the forthcoming edition of the International Classification of Diseases (ICD-11) that would yield a very different diagnosis relative to DSM-5. This study examined the impact of the proposed ICD-11 changes on PTSD prevalence relative to the ICD-10 and DSM-5 definitions and also evaluated the extent to which these changes would accomplish the stated aim of reducing the comorbidity associated with PTSD. Diagnostic prevalence estimates were compared using a U.S. national community sample and two U.S. Department of Veterans Affairs clinical samples. The ICD-11 definition yielded prevalence estimates 10-30% lower than DSM-5 and 25% and 50% lower than ICD-10 with no reduction in the prevalence of common comorbidities. Findings suggest that by constraining the diagnosis to a narrower set of symptoms, the proposed ICD-11 criteria set would substantially reduce the number of individuals with the disorder. These findings raise doubt about the extent to which the ICD-11 proposal would achieve the aim of reducing comorbidity associated with PTSD and highlight the public health and policy implications of such a redefinition.

  8. Maternal age at Holocaust exposure and maternal PTSD independently influence urinary cortisol levels in adult offspring

    OpenAIRE

    2014-01-01

    Background: Parental traumatization has been associated with increased risk for the expression of psychopathology in offspring, and maternal PTSD appears to increase the risk for the development of offspring PTSD. In this study, Holocaust-related maternal age of exposure and PTSD were evaluated for their association with offspring ambient cortisol and PTSD-associated symptom expression. Method: 95 Holocaust offspring and Jewish comparison subjects received diagnostic and psychological evaluat...

  9. Comparison Study of Memory Status in War-PTSD Veterans With Depression and Non- Veterans Depressed Patient

    Directory of Open Access Journals (Sweden)

    Anvari SS

    2012-03-01

    Full Text Available Background: Cognitive problems in patients with post-traumatic stress disorder (PTSD include poor concentration and impaired memory. Prevalence of PTSD in all aspects of life is 8% in USA. Regarding the importance of memory in functional levels, this study was performed to review memory status in these patients. Methods: Fifty male war veterans with PTSD and major depression and 50 male non-veterans with depression participated in this study performed at psychiatric outpatient ward in Baqiyatallah hospital during 2008-2009. The patients met the DSM-IV diagnostic criteria. Depression severity, sex, age, educational level, and marital status were matched in both groups. A psychologist completed demographic and Mississippi questionnaires, PTSD checklist (PCL, beck depression Inventory and wechsler memory scale. The collected data were analyzed using SPSS software (version 11.0. A P-value smaller than 0.05 was considered significant.Results: The mean age of the veterans and non-veterans was 43.9±4.7 and 42±9.4 years, respectively. Memory status did not differ between the two groups (P>0.05. There was no statistically significant correlation between duration and severity of PTSD with memory impairment (P>0.05. A negative correlation was found between personal and general information with re-experiencing in the veterans (P<0.05. Impaired memory was correlated with age greater than 45, educational level lower than high school diploma, severity of depression and longer participation in war. Conclusion: Although both PTSD and major depression affected memory, but memory status did not differ between patients with PTSD and depression and patients with chronic depression.

  10. Gender differences in developmental dyscalculia depend on diagnostic criteria.

    Science.gov (United States)

    Devine, Amy; Soltész, Fruzsina; Nobes, Alison; Goswami, Usha; Szűcs, Dénes

    2013-10-01

    Developmental dyscalculia (DD) is a learning difficulty specific to mathematics learning. The prevalence of DD may be equivalent to that of dyslexia, posing an important challenge for effective educational provision. Nevertheless, there is no agreed definition of DD and there are controversies surrounding cutoff decisions, specificity and gender differences. In the current study, 1004 British primary school children completed mathematics and reading assessments. The prevalence of DD and gender ratio were estimated in this sample using different criteria. When using absolute thresholds, the prevalence of DD was the same for both genders regardless of the cutoff criteria applied, however gender differences emerged when using a mathematics-reading discrepancy definition. Correlations between mathematics performance and the control measures selected to identify a specific learning difficulty affect both prevalence estimates and whether a gender difference is in fact identified. Educational implications are discussed.

  11. Diagnostic criteria of the state of the distributed brain stem regulatory structures in cerebrovascular diseases

    Directory of Open Access Journals (Sweden)

    Pogorelov A.V.

    2014-11-01

    Full Text Available The clinical-neurophysiological study of 62 patients with history of subtentorial ischemic stroke was carried out in order to determine the criteria of dysfunction of morphologically distributed stem regulatory structures. It was revealed that these disorders are sustainable with the possibility of recourse and influence on the course of stroke. It was marked the influence of this disorders on the levels of consciousness, severity of state, recovery rate, asthenia level, sleep function. Manifestations of cerebral cardiac syndrome, impaired attention, orientation reaction, speed of sensomotoric acts are also marked. Patients with these disorders have low rates of recovery of functions. Neurophysiological criteria of these disorders are the lack of expressive reactions in electroencephalography, reduction of their overall level, instability of rhythm - generating structures and others.

  12. Development of diagnostic criteria for serious non-AIDS events in HIV clinical trials

    DEFF Research Database (Denmark)

    Lifson, Alan R; Belloso, Waldo H; Davey, Richard T

    2010-01-01

    PURPOSE: Serious non-AIDS (SNA) diseases are important causes of morbidity and mortality in the HAART era. We describe development of standard criteria for 12 SNA events for Endpoint Review Committee (ERC) use in START, a multicenter international HIV clinical trial. METHODS: SNA definitions were...... was reached. CONCLUSION: HIV clinical trials that include SNA diseases as clinical outcomes should have standardized SNA definitions to optimize event reporting and validation and should have review by an experienced ERC with opportunities for adjudication....

  13. Histopathology of valves in infective endocarditis, diagnostic criteria and treatment considerations.

    Science.gov (United States)

    Brandão, Tatiana J D; Januario-da-Silva, Carolina A; Correia, Marcelo G; Zappa, Monica; Abrantes, Jaime A; Dantas, Angela M R; Golebiovski, Wilma; Barbosa, Giovanna Ianini F; Weksler, Clara; Lamas, Cristiane C

    2017-04-01

    Infective endocarditis (IE) is a severe disease. Pathogen isolation is fundamental so as to treat effectively and reduce morbidity and mortality. Blood and valve culture and histopathology (HP) are routinely employed for this purpose. Valve HP is the gold standard for diagnosis. To determine the sensitivity and specificity of clinical criteria for IE (the modified Duke and the St Thomas' minor modifications, STH) of blood and valve culture compared to valve HP, and to evaluate antibiotic treatment duration. Prospective case series of patients, from 2006 to 2014 with surgically treated IE. Statistical analysis was done by the R software. There were 136 clinically definite episodes of IE in 133 patients. Mean age ± SD was 43 ± 15.6 years and IE was left sided in 81.6 %. HP was definite in 96 valves examined, which were used as gold standard. Sensitivity of blood culture was 61 % (CI 0.51, 0.71) and of valve culture 15 % (CI 0.07, 0.26). The modified Duke criteria were 65 % (CI 0.55, 0.75) sensitive and 33 % specific, while the STH's sensitivity was 72 % (CI 0.61, 0.80) with similar specificity. In multivariate analysis and logistic regression, the only variable with statistical significance was duration of antibiotic therapy postoperatively. Valve HP had high sensitivity and valve culture low sensitivity in the diagnosis of IE. The STH's criteria were more sensitive than the modified Duke criteria. Valve HP should guide duration of postoperative antibiotic treatment.

  14. Square-Wave Voltammetry of Cathodic Stripping Reactions. Diagnostic Criteria, Redox Kinetic Measurements, and Analytical Applications

    OpenAIRE

    Gulaboski, Rubin; Mirceski, Valentin; Komorsky-Lovrić, Šebojka; Lovrić, Milivoj

    2004-01-01

    A comparative study of different types of cathodic stripping reactions under conditions of square-wave voltammetry is presented. Cathodic stripping processes involving reactions of second order as well as reactions coupled by adsorption of the reacting ligand are analyzed The inherent parameters, controlling the overall voltammetric behavior of each cathodic stripping electrode reaction are derived. The criteria for qualitative distinguishing of each mechanism are established as w...

  15. Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) for clinical and research applications: recommendations of the international RDC/TMD consortium network and orofacial pain special interest group

    NARCIS (Netherlands)

    Schiffman, E.; Ohrbach, R.; Truelove, E.; Look, J.; Anderson, G.; Goulet, J.P.; List, T.; Svensson, P.; Gonzalez, Y.; Lobbezoo, F.; Michelotti, A.; Brooks, S.L.; Ceusters, W.; Drangsholt, M.; Ettlin, D.; Gaul, C.; Goldberg, L.J.; Haythornthwaite, J.A.; Hollender, L.; Jensen, R.; John, M.T.; De Laat, A.; de Leeuw, R.; Maixner, W.; van der Meulen, M.; Murray, G.M.; Nixdorf, D.R.; Palla, S.; Petersson, A.; Pionchon, P.; Smith, B.; Visscher, C.M.; Zakrzewska, J.; Dworkin, S.F.

    2014-01-01

    AIMS: The original Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) Axis I diagnostic algorithms have been demonstrated to be reliable. However, the Validation Project determined that the RDC/TMD Axis I validity was below the target sensitivity of ≥ 0.70 and specificity of ≥ 0.

  16. Atypical Alstrom syndrome with novel ALMS1 mutations precluded by current diagnostic criteria.

    LENUS (Irish Health Repository)

    Casey, Jillian

    2014-02-01

    We report on clinical and genetic studies in a non-consanguineous Irish sib-pair with infantile dilated cardiomyopathy and retinopathy. A diagnosis of Alström Syndrome (AS) was considered and diagnostic testing pursued. The Alströms gene (ALMS1) is very large (23 exons) and diagnostic testing of mutational hotspots (exon 6, 8 and 10) was negative. Furthermore the siblings were tall and did not have the typical phenotype of nystagmus, photophobia, obesity or hearing loss and so the AS diagnosis was removed. We then sought to identify the causative gene in this family using whole exome sequencing. Unexpectedly, the exome analysis identified novel compound heterozygous ALMS1 mutations in exon 5 (c.777delT:p.D260fs*26) and exon 20 (c.12145_12146insC:p.S4049fs*36) that segregated with the phenotype. Although the siblings show some clinical overlap with AS, their phenotype is not classical. It is plausible that their atypical presentation may be due to the location of the ALMS1 mutations outside the usual mutational hotspots. Our findings show how atypical cases of AS may be missed under the current diagnostic guidelines and support consideration of complete ALMS1 sequencing in children with two or more features, even if all of the core clinical features of AS are not present.

  17. Establishing the diagnostic criteria for eruption disorders based on genetic and clinical data.

    Science.gov (United States)

    Rhoads, Stephanie Golubic; Hendricks, Heather M; Frazier-Bowers, Sylvia A

    2013-08-01

    Proper diagnosis and management of eruption disturbances remains challenging but is critical to a functional occlusion. The objective of this study was to establish definitive criteria to differentiate and diagnose eruption disorders, specifically primary failure of eruption (PFE) and ankylosis. Sixty-four affected persons were placed into 3 cohorts: PFE diagnosed through confirmed PTH1R mutation (n = 11), PFE diagnosed based on clinical criteria (n = 47), and ankylosis diagnosed based on clinical criteria (n = 6). These groups were assessed to identify clinical features that differentiate PFE and ankylosis. Ninety-three percent of the subjects in the genetic and clinical PFE cohorts combined (n = 58) and 100% in the genetic PFE cohort had at least 1 infraoccluded first permanent molar. Additionally, a novel functional PTH1R mutation, 1092delG, was identified and linked to PFE in the deciduous dentition. An infraoccluded, supracrestal first molar is a hallmark of PFE, often involving both arches in the permanent or deciduous dentition, and with unilateral or bilateral affection, infraoccluded second premolar or second molar, and multiple affected adjacent teeth. Our results further suggest that PFE and ankylosis might be clinically indistinguishable without knowledge of prior trauma, treatment history, genetic information, or obliteration of the periodontal ligament space. Copyright © 2013 American Association of Orthodontists. Published by Mosby, Inc. All rights reserved.

  18. Revised diagnostic criteria and classification for the autoimmune lymphoproliferative syndrome (ALPS): report from the 2009 NIH International Workshop.

    Science.gov (United States)

    Oliveira, Joao B; Bleesing, Jack J; Dianzani, Umberto; Fleisher, Thomas A; Jaffe, Elaine S; Lenardo, Michael J; Rieux-Laucat, Frederic; Siegel, Richard M; Su, Helen C; Teachey, David T; Rao, V Koneti

    2010-10-07

    Lymphadenopathy in children for which no infectious or malignant cause can be ascertained constitutes a challenging diagnostic dilemma. Autoimmune lymphoproliferative syndrome (ALPS) is a human genetic disorder of lymphocyte apoptosis resulting in an accumulation of lymphocytes and childhood onset chronic lymphadenopathy, splenomegaly, multilineage cytopenias, and an increased risk of B-cell lymphoma. In 1999, investigators at the National Institutes of Health (NIH) suggested criteria to establish the diagnosis of ALPS. Since then, with approximately 500 patients with ALPS studied worldwide, significant advances in our understanding of the disease have prompted the need for revisions to the existing diagnostic criteria and classification scheme. The rationale and recommendations outlined here stem from an international workshop held at NIH on September 21 and 22, 2009, attended by investigators from the United States, Europe, and Australia engaged in clinical and basic science research on ALPS and related disorders. It is hoped that harmonizing the diagnosis and classification of ALPS will foster collaborative research and better understanding of the pathogenesis of autoimmune cytopenias and B-cell lymphomas.

  19. PTSD in ICD-10 and proposed ICD-11 in elderly with childhood trauma: prevalence, factor structure, and symptom profiles

    OpenAIRE

    Glück, Tobias M.; Knefel, Matthias; Tran, Ulrich S.; Lueger-Schuster, Brigitte

    2016-01-01

    Background: The proposal for ICD-11 postulates major changes for posttraumatic stress disorder (PTSD) diagnosis, which needs investigation in different samples.Aims: To investigate differences of PTSD prevalence and diagnostic agreement between ICD-10 and ICD-11, factor structure of proposed ICD-11 PTSD, and diagnostic value of PTSD symptom severity classes.Method: Confirmatory factor analysis and latent profile analysis were used on data of elderly survivors of childhood trauma (>60 years...

  20. A wait-list controlled pilot study of eye movement desensitization and reprocessing (EMDR) for children with post-traumatic stress disorder (PTSD) symptoms from motor vehicle accidents.

    Science.gov (United States)

    Kemp, Michael; Drummond, Peter; McDermott, Brett

    2010-01-01

    The present study investigated the efficacy of four EMDR sessions in comparison to a six-week wait-list control condition in the treatment of 27 children (aged 6 to 12 years) suffering from persistent PTSD symptoms after a motor vehicle accident. An effect for EMDR was identified on primary outcome and process measures including the Child Post-Traumatic Stress-Reaction Index, clinician rated diagnostic criteria for PTSD, Subjective Units of Disturbance and Validity of Cognition scales. All participants initially met two or more PTSD criteria. After EMDR treatment, this decreased to 25% in the EMDR group but remained at 100% in the wait-list group. Parent ratings of their child's PTSD symptoms showed no improvement, nor did a range of non-trauma child self-report and parent-reported symptoms. Treatment gains were maintained at three and 12 month follow-up. These findings support the use of EMDR for treating symptoms of PTSD in children, although further replication and comparison studies are required.

  1. Exploring the Gold-Standard: Evidence for a Two-Factor Model of the Clinician Administered PTSD Scale for the DSM-5.

    Science.gov (United States)

    Hunt, Joshua C; Chesney, Samantha A; Jorgensen, Terrence D; Schumann, Nicholas R; deRoon-Cassini, Terri A

    2017-08-10

    The latent factor structure of posttraumatic stress disorder (PTSD) remains a source of considerable variability. The current study compared several a priori factor structures, as well as a novel 2-factor structure of posttraumatic psychological distress as measured by the Clinician Administered PTSD scale for the DSM-5 (CAPS-5). In addition, variability in diagnostic rates according to the divergent DSM-5 and ICD-11 criteria were explored. The setting for this study was a Level 1 trauma center in a U.S. metropolitan city. Data were pooled from 2 studies (N = 309) and participants were administered the CAPS-5 at 1 (n = 139) or 6 months postinjury (n = 170). Confirmatory factor analysis (CFA) was used to compare several factor models, and prevalence rates based on DSM-5 and ICD-11 criteria were compared via z tests and kappa. CFAs of 5 factor structures indicated good fit for all models. A novel 2-factor model based on competing models of PTSD symptoms and modification indices was then tested. The 2-factor model of the CAPS-5 performed as well or better on most indices compared to a 7-factor hybrid. Comparisons of PTSD prevalence rates found no significant differences, but agreement was variable. These findings indicate that the CAPS-5 can be seen as measuring 2 distinct phenomena: posttraumatic stress disorder and general posttraumatic dysphoria. This is an important contribution to the current debate on which latent factors constitute PTSD and may reduce discordance. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

  2. CRITERIA AND DIAGNOSTIC TOOLS FOR MONITORING QUALITY ASSESSMENT OF PRE-SERVICE TEACHERS’ TRAINING FOR PRACTICE-ORIENTED RESEARCH ACTIVITY

    Directory of Open Access Journals (Sweden)

    Tamara А. Strokova

    2016-01-01

    Full Text Available The purpose of the present publication is to disclose the contents of the monitoring initial stage including theoretical understanding of observed object, comprehension of its essence, definition of assessment criteria, the choice of diagnostic means and sources of information. Methods. The problem analysis of scientific prerequisites for pedagogical interpretation of education quality phenomenon, comparison and assessment of various approaches in definition of its essence are carried out from the system approach; the author’s understanding of quality of future teachers training to research activity and criteria of its assessment is proved. The studying and analysis of official documents, educational programs and scientific publications, systematization, substantial generalization, structuring, differentiation and expert assessment are used while the problem solution of main research actions for scientific and pedagogical search selection, which are essential result of high school training. Results. Criteria and estimated complex of quality of learners training to research activity, developed according to requirements of the monitoring assessment, reflecting its intrinsic properties (quality of educational process, quality of its conditions, quality of the received results and their specific indicators are proposed. Stage-by-stage procedure of research actions selection is developed. Diagnostic means and sources of information are defined. Scientific novelty. Definition of the concepts «education quality», in terms of its understanding as a set of intrinsic aspect characteristics and the quality principle of process and its conditions quality reflection (A. I. Subetto, and the «practice-oriented research activity» defined as a set of the research actions reflecting its subject contents which are carried out in the context of the scientific solution of actual professional and pedagogical tasks is given. The list of research actions for

  3. Impact of new society of radiologists in ultrasound early first-trimester diagnostic criteria for nonviable pregnancy.

    Science.gov (United States)

    Hu, Maowen; Poder, Liina; Filly, Roy A

    2014-09-01

    New early first-trimester diagnostic criteria for nonviable pregnancy recommended by the Society of Radiologists in Ultrasound via a multispecialty consensus panel extended the diagnostic size criteria of crown-rump length from 5 to 7 mm for embryos without a heartbeat and mean sac diameter from 16 to 25 mm for "empty" sacs. Our study assessed the potential impact of the new criteria on the number of additional follow-up sonograms these changes would engender. A retrospective study of all first-trimester sonograms in women with first trimester bleeding from 1999 to 2008 was conducted. Everyone included in the study had a visible gestational sac in the uterus. There were no pregnancies of unknown location or ectopic pregnancies included in this study cohort. Pregnancy of unknown location was used to describe cases in which there were no signs of pregnancy inside or outside the uterus on transvaginal sonography despite a positive pregnancy test result. A total of 1013 patients met the inclusion criteria. Seven hundred fifty-two patients (74%) had identifiable embryos, and 261 (26%) did not. Of those with an identifiable embryo, 286 (38%) had no detectable embryonic cardiac activity. The breakdown of crown-rump lengths in this group was as follows: 100 measuring less than 5 mm, 36 measuring 5 to 7 mm, and 150 measuring 7 mm or greater. The breakdown of mean sac diameters in those without a visible embryo was as follows: 120 measuring less than 16 mm, 90 measuring 16 to 25 mm, and 51 measuring 25 mm or greater. When diagnosing a failed pregnancy, there can be no room for error. Only 126 of 1013 early pregnancies threatening to abort (12%) fell into the more conservative zones defined by the new compared to the former size criteria (crown-rump length, 5-7 mm; mean sac diameter, 16-25 mm). Therefore, the potential impact of the new guidelines on follow-up sonograms does not appear inordinate. © 2014 by the American Institute of Ultrasound in Medicine.

  4. Ultrasound criteria and guided fine-needle aspiration diagnostic yields in small animal peritoneal, mesenteric and omental disease.

    Science.gov (United States)

    Feeney, Daniel A; Ober, Christopher P; Snyder, Laura A; Hill, Sara A; Jessen, Carl R

    2013-01-01

    Peritoneal, mesenteric, and omental diseases are important causes of morbidity and mortality in humans and animals, although information in the veterinary literature is limited. The purposes of this retrospective study were to determine whether objectively applied ultrasound interpretive criteria are statistically useful in differentiating among cytologically defined normal, inflammatory, and neoplastic peritoneal conditions in dogs and cats. A second goal was to determine the cytologically interpretable yield on ultrasound-guided, fine-needle sampling of peritoneal, mesenteric, or omental structures. Sonographic criteria agreed upon by the authors were retrospectively and independently applied by two radiologists to the available ultrasound images without knowledge of the cytologic diagnosis and statistically compared to the ultrasound-guided, fine-needle aspiration cytologic interpretations. A total of 72 dogs and 49 cats with abdominal peritoneal, mesenteric, or omental (peritoneal) surface or effusive disease and 17 dogs and 3 cats with no cytologic evidence of inflammation or neoplasia were included. The optimized, ultrasound criteria-based statistical model created independently for each radiologist yielded an equation-based diagnostic category placement accuracy of 63.2-69.9% across the two involved radiologists. Regional organ-associated masses or nodules as well as aggregated bowel and peritoneal thickening were more associated with peritoneal neoplasia whereas localized, severely complex fluid collections were more associated with inflammatory peritoneal disease. The cytologically interpretable yield for ultrasound-guided fine-needle sampling was 72.3% with no difference between species, making this a worthwhile clinical procedure.

  5. Proposals for new standardized general diagnostic criteria for the secondary headaches

    DEFF Research Database (Denmark)

    Olesen, J; Steiner, T; Bousser, M-G

    2009-01-01

    Headache classification is a dynamic process through clinical testing and re-testing of current and proposed criteria. After publication of the second edition of the International Classification of Headache Disorders (ICHD-II), need arose for revisions in the classification of medication overuse...... in 2010. ICHD-IIR will be printed and posted on the website and will be the official classification of the International Headache Society. Unfortunately, it will be necessary to translate ICHD-IIR into the many languages of the world, but the good news is that no major changes to the headache...

  6. Sideroblastic anemias: variations on imprecision in diagnostic criteria, proposal for an extended classification of sideroblastic anemias.

    Science.gov (United States)

    Koc, S; Harris, J W

    1998-01-01

    Sideroblastic anemias are caused by a diversity of hereditary, congenital, or acquired disorders. Criteria used in describing sideroblastic anemias vary widely among standard medical textbooks and even so have been imprecisely applied in the literature. Recent discoveries concerning the basic pathophysiologic mechanisms involving the molecular biology of nuclear and mitochondrial DNA, erythroid ALA synthase (ALAS-2), and iron transport have made the classification of sideroblastic anemias very complex. We recommend a more precise evaluation and documentation of the components that characterize the sideroblastic abnormality and propose an extended classification of the sideroblastic anemias.

  7. Waldenström macroglobulinemia. Development of diagnostic criteria and identification of prognostic factors.

    Science.gov (United States)

    Owen, R G; Barrans, S L; Richards, S J; O'Connor, S J; Child, J A; Parapia, L A; Morgan, G J; Jack, A S

    2001-09-01

    To establish whether a combination of morphologic and immunophenotypic criteria could be developed to more precisely define Waldenström macroglobulinemia (WM) and prognostic factors, we retrospectively assessed the clinical and laboratory features of 111 cases of WM. Bone marrow infiltration by small lymphocytes was documented in each case; and diffuse, interstitial, nodular, and paratrabecular patterns of infiltration were documented in 58%, 32%, 6%, and 4% of cases, respectively. Ninety percent were characterized by a surface immunoglobulin-positive, CD19+CD20+CD5-CD10-CD23- immunophenotype. The median overall survival from diagnosis was 60 months; univariate analysis revealed the following adverse prognostic factors: older than 60 years, performance status more than 1, platelet count less than 100 x 10(3)/microL (< 100 x 10(9)/L), pancytopenia, and diffuse bone marrow infiltration. Associated median survival was 40, 38, 46, 28, and 59 months, respectively. Multivariate analysis revealed age, performance status, and platelet count as prognostically significant, but stratification of patients according to the International Prognostic Index had limited value. We suggest defining WM by the following criteria: IgM monoclonal gammopathy; bone marrow infiltration by small lymphocytes, plasmacytoid cells, and plasma cells in a diffuse, interstitial, or nodular pattern; and a surface immunoglobulin-positive, CD19+CD20+CD5-CD10-CD23- immunophenotype.

  8. [Reactive airway dysfunction syndrome: more flexible application of diagnostic criteria are important for occupational accident victims].

    Science.gov (United States)

    Testud, F; Lambert-Chhum, R

    2004-06-01

    Reactive airway dysfunction syndrome (RADS), or Brooks syndrome, is a complication observed after inhalation of caustic or highly irritating substances. The diagnosis is based on a group of criteria which include the absence of prior respiratory disease. Strict application of these criteria could have a prejudicial effect for certain victims. Three serious cases of RADS were observed in workers who were exposed to massive inhalation of caustic substances. The products implicated (phosphoric oxychloride, titanium tetrachloride, and trichloroacetyl chloride) hydrolyze to hydrochloric acid when they come in contact with the airway mucosa. After an initial period of acute respiratory distress, the patients encountered serious difficulties in achieving an appropriate diagnosis, and in having their sequellae recognized as resulting from an occupational accident. The problem was that these patients had a history of cured allergic asthma or smoking-related COPD. The presence of prior respiratory disorders must not exclude the diagnosis of RADS. A prior respiratory disorder cannot be used as an argument to exclude such victims from indemnities for occupational accident sequelae.

  9. Functional neuroimaging with default mode network regions distinguishes PTSD from TBI in a military veteran population.

    Science.gov (United States)

    Raji, Cyrus A; Willeumier, Kristen; Taylor, Derek; Tarzwell, Robert; Newberg, Andrew; Henderson, Theodore A; Amen, Daniel G

    2015-09-01

    PTSD and TBI are two common conditions in veteran populations that can be difficult to distinguish clinically. The default mode network (DMN) is abnormal in a multitude of neurological and psychiatric disorders. We hypothesize that brain perfusion SPECT can be applied to diagnostically separate PTSD from TBI reliably in a veteran cohort using DMN regions. A group of 196 veterans (36 with PTSD, 115 with TBI, 45 with PTSD/TBI) were selected from a large multi-site population cohort of individuals with psychiatric disease. Inclusion criteria were peacetime or wartime veterans regardless of branch of service and included those for whom the traumatic brain injury was not service related. SPECT imaging was performed on this group both at rest and during a concentration task. These measures, as well as the baseline-concentration difference, were then inputted from DMN regions into separate binary logistic regression models controlling for age, gender, race, clinic site, co-morbid psychiatric diseases, TBI severity, whether or not the TBI was service related, and branch of armed service. Predicted probabilities were then inputted into a receiver operating characteristic analysis to compute sensitivity, specificity, and accuracy. Compared to PSTD, persons with TBI were older, male, and had higher rates of bipolar and major depressive disorder (p TBI in the veterans with 92 % sensitivity, 85 % specificity, and 94 % accuracy. With concentration scans, there was 85 % sensitivity, 83 % specificity and 89 % accuracy. Baseline-concentration (the difference metric between the two scans) scans were 85 % sensitivity, 80 % specificity, and 87 % accuracy. In separating TBI from PTSD/TBI visual readings of baseline scans had 85 % sensitivity, 81 % specificity, and 83 % accuracy. Concentration scans had 80 % sensitivity, 65 % specificity, and 79 % accuracy. Baseline-concentration scans had 82 % sensitivity, 69 % specificity, and 81 % accuracy. For separating PTSD

  10. INSTRUMENTAL AND DIAGNOSTIC CRITERIA OF HEMODYNAMIC DISORDERS AND ENDOTHELIAL DYSFUNCTION CORRECTION IN PREGNANTS WITH ARTERIAL HYPERTENSION

    Directory of Open Access Journals (Sweden)

    S. M. Heryak

    2014-12-01

    Conclusions. It was found that the brachial artery ultrasound measuring and occlusive plethysmography procedure by Dietz is an early and safe method of endothelial dysfunction diagnostic in pregnants with hypertension. Doppler ultrasound of blood flow in uterine, umbilical arteries, and middle cerebral arteries of the fetus allows timely diagnosis of the side effect of antihypertensive drugs on the fetus. The therapy of choice for pregnants with Stage II Arterial Hypertension should be based on methyldopa and calcium channel antagonists or selective beta-blockers combination. Highly selective beta-blockers with vasodilative effect (nebivolol hydrochloride and L-arginine (Tivortin allow to prevent perinatal adverse effects of antihypertensive therapy, to correct hemodynamic disorders and endothelial dysfunction in pregnants with arterial hypertension. KEY WORDS: arterial hypertension, uterine-placental hemodynamics, endothelial dysfunction

  11. DIAGNOSTIC CRITERIA OF FLATFOOT AND WAYS OF REHABILITATION THERAPY IN CHILDREN

    Directory of Open Access Journals (Sweden)

    MUROD ZOKIRHODJAEV

    2011-08-01

    Full Text Available Computer, roentgenologic, myographic, podometric, biochemical studies in 1427 children from 1 to 14 years old in 182 cases revealed the flatfoot; it had a straight proportional dependence from age and sexual differences. Suggested differential diagnostic table allows in short time to mark out the level of flatfoot on the base of taken results. Being reflected in scores, taken results are summed up, and, by general total, the level of flatfoot is determined. Determination of oxiproline (collagen element in urine serves as the confirmation of involution connective tissue at flatfoot. According to age changes of connecting tissue, a complex of conservative treatment, including physiotherapeutic means, TPE, plaster of Paris bandage, balneologic treatments, wearing insoles in shoes, taking multivitamin drugs, are offered

  12. Spinal cord cavities; Differential-diagnostic criteria in magnetic resonance imaging

    Energy Technology Data Exchange (ETDEWEB)

    Schubeus, P.; Schoerner, W.; Hosten, N.; Felix, R. (Free University of Berlin, University Clinic Rudolf Virchow, Charlottenburg (Germany). Department of Radiology)

    MRI examinations of 30 patients with idiopathic syringomyelia and 10 patients with cavities associated with an intramedullary neoplasm were evaluated with respect to typical MRI features in both groups. Al tumor-associated cases resembled the idiopathic syringomyelias in some portions of the cavity. At the tumor site, however, tumor-associated cases demonstrated typical findings; the cavities showed abrupt changes of diameter (10/10) and position (8/10) and the surrounding spinal cord demonstrated an uneven thickness (10/10), an increased signal intensity on T2-weighted images (10/10) and pathological contrast enhancement (7/7). Displacement of cerebellar tonsils below the level of the foramen magnum (921/30) and enlargement of the spinal canal (97/29) were characteristic features of idiopathic cases. In conclusion, MRI provides valuable criteria to differentiate between idiopathic and tumor-associated cavities. (author). 19 refs.; 4 figs.; 1 tab.

  13. Post craniotomy extra-ventricular drain (EVD) associated nosocomial meningitis: CSF diagnostic criteria.

    Science.gov (United States)

    Muñoz-Gómez, Sigridh; Wirkowski, Elizabeth; Cunha, Burke A

    2015-01-01

    Because external ventricular drains (EVDs) provide access to cerebrospinal fluid (CSF), there is potential for EVD associated acute bacterial meningitis (EVD-AM). Post-craniotomy, in patients with EVDs, one or more CSF abnormalities are commonly present making the diagnosis of EVD-AM problematic. EVD-AM was defined as elevated CSF lactic acid (>6 nmol/L), plus CSF marked pleocytosis (>50 WBCs/mm(3)), plus a positive Gram stain (same morphology as CSF isolate), plus a positive CSF culture of neuropathogen (same morphology as Gram stained organism). We reviewed 22 adults with EVDs to determine if our four CSF parameters combined accurately identified EVD-AM. No single or combination of <4 CSF parameters correctly diagnosed or ruled out EVD-AM. Combined our four CSF parameters clearly differentiated EVD-AM from one case of pseudomeningitis due to E. cloacae. We conclude that our four CSF criteria combined are useful in diagnosing EVD-AM in adults.

  14. EAACI taskforce position paper: evidence for autoimmune urticaria and proposal for defining diagnostic criteria.

    Science.gov (United States)

    Konstantinou, G N; Asero, R; Ferrer, M; Knol, E F; Maurer, M; Raap, U; Schmid-Grendelmeier, P; Skov, P S; Grattan, C E H

    2013-01-01

    An autoimmune subset of chronic spontaneous urticaria is increasingly being recognized internationally, based on laboratory and clinical evidence that has accrued over the last 20 years. This evidence has been reviewed by a taskforce of the Dermatology section of the European Academy of Allergy and Clinical Immunology. Functional autoantibodies in chronic urticaria (CU) patient sera have been demonstrated against IgE and FcεRIα by basophil and mast cell histamine release assays and by basophil activation assays. Antibody specificity has been confirmed by immunoassay, but there is a poor correlation between functionality and immunoreactivity. Approximately 25% of CU patients have a positive basophil histamine release assay and show autoreactivity (a positive autologous serum skin test), whereas 50% are negative regarding both. Functionality of CU sera appears to be complement dependent on mast cells but not exclusively on basophils. Basophil activation by CU sera is predominantly restricted to IgG1 and IgG3 subclasses. Circumstantial evidence for CU being an autoimmune disease comes from an observed association with other autoimmune diseases, a strong association between serum functionality and HLA-DR4 haplotype and the good response of CU patients to immunotherapies. It was proposed that a study should be undertaken to prospectively validate potentially relevant clinical criteria (from the history, examination and routinely available clinical investigations) against a new 'gold standard' for the diagnosis of ACU (positive autoreactivity, functional bioassay and immunoassay) to define preliminary criteria sets for the diagnosis of ACU based on clinical and laboratory features with highest individual sensitivity and specificity.

  15. [Doppler ultrasonography in the diagnosis of ovarian cysts: indications, pertinence and diagnostic criteria].

    Science.gov (United States)

    Marret, H

    2001-11-01

    To discriminate ovarian lesions is of particular importance in gynecological practice. Two main problems need answers: discrimination of benign and malignant adnexal masses and choice of the appropriate surgical treatment if necessary. Nearly 2% of the adnexal masses are ovarian carcinomas or border line tumors. It is now well established that ultrasonography is the gold standard for ovarian cyst diagnosis. The purpose of this work was to review the literature and to establish, with the evidence based medicine model, which parameters and existing diagnostic models using ultrasound and Doppler performs best in the evaluation of adnexal masses. Transvaginal sonography has demonstrated considerable advantage over conventional transabdominal sonography. However, transparietal sonography is still useful in large tumors. It is no longer reasonable to subject all patients undergoing pelvic sonography to bladder distension. Functional ovarian cyst characterization seems easy using sonography and Doppler. In case of complication, discrimination of such functional cyst may be difficult but spontaneous regression confirms usually the expectative management. Dermoid cysts and endometriomas seem to be easier to discriminate from other adnexal masses. Papillary formations on the inside of the cyst wall and masses with a non hyperechoic solid component are the most statistically significant predictors of a malignant ovarian mass. Ultrasound and morphologic parameters have a sensitivity of 80% and a specificity of 93%, that make this exam the gold standard for ovarian masses diagnosis. Another parameter is important: experienced hands with subjective evaluation seems to be one of the best ultrasound method for adnexal masses discrimination. Scoring system help differentiate benign from malignant masses (sensitivity 90%, VPP 50%). Doppler flow measurement and assessment of tumor vascularity by doppler energy increase the confidence with which a correct diagnosis is made. Moreover

  16. EVALUATION OF THE DIAGNOSTIC CRITERIA FOR THE LOCALIZATION OF ACQUIRED ARTERIOVENOUS FISTULAS BY COLOR DOPPLER FLOW IMAGING

    Institute of Scientific and Technical Information of China (English)

    李建初; 蔡胜; 姜玉新; 张缙熙; 王岩青

    2001-01-01

    Objective. To evaluate the diagnostic criteria for the localization of acquired arteriovenous fistulas (AVFs)by color Doppler flow imaging (CDFI) based on the features of their hemodynamic changes.Methods. The shape and hemodynamic changes of involved vessels which could be helpful to localize thesites of fistulas were studied according to the observation of 10 cases of acquired AVFs.Results. The s tes of the fistulas could be shown by two-dimensional ultrasonography and color flow imagingin 40% and 80% tases, respectively. In all cases, turbulent high-velocity flow was present at the sites of thefistulas, low resistant flow was present in the arteries proximal to the fistulas, and artery-like flow was detected inthe veins.Conclusion. C OFt was accurate for the localization of acquired AVFs, which were mainly localized by theirhemodynamic changes shown by pulse Doppler ultrasound.``

  17. Comparison of the Minnesota Percepto-Diagnostic Test and Bender-Gestalt: relationship with achievement criteria.

    Science.gov (United States)

    Fuller, G B; Wallbrown, F H

    1983-11-01

    Administered the Bender-Gestalt (BG) and Minnesota Percepto-Diagnostic Test (MPD) to 69 first-grade children prior to administration of the California Achievement Test (CAT). Order of administration for the BG and MPD was counterbalanced to control for practice effects. Correlations (rs) were computed between the 9 CAT subtests and scores from the BG and MPD. The DD score from the MPD correlated significantly with all 9 CAT subtests. The SpCD score from the MPD correlated significantly with 6 of the 9 CAT subtests. The BG Koppitz score correlated significantly with 6 of the 9 CAT subtests. Both the DD and SpCD scores showed a significantly higher negative r with Reading Vocabulary, Total Reading, and Arithmetic Computation than the BG. Furthermore, both types of MPD scores showed a much higher average r with the 9 CAT subtests than was evident for the BG. These findings suggest that DD and SpCD scores from the MPD provide a more sensitive measure of deficits in visual-motor perception than the Koppitz score from the BG.

  18. Should DSM-V include dimensional diagnostic criteria for alcohol use disorders?

    Science.gov (United States)

    Helzer, John E; Bucholz, Kathleen K; Bierut, Laura Jean; Regier, Darrel A; Schuckit, Marc A; Guth, Sarah E

    2006-02-01

    This program calls attention to the upcoming timetable for the revision of the Diagnostic and Statistical Manual (DSM)-IV and the publication of DSM-V. It is vitally important for Research Society of Alcoholism members to be aware of the current discussions of the important scientific questions related to the next DSM revision and to use the opportunity for input. The title of the symposium highlights 1 key question, i.e., whether the DSM definitions should remain strictly categorical as in the past or whether a dimensional component should be included in this revision. Two substantive and 1 conceptual paper are included in this portion of the symposium. The fourth and final presentation detailing the revision timetable and the opportunities for input is by Dr. Darrel Regier. Dr. Regier is the director of American Psychiatric Institute for Research and Education the research and education branch of the American Psychiatric Association and the organization within the APA that will oversee the DSM revision. The discussion is by Marc Schuckit, who was chair of the Substance Use disorders (SUD) Committee for DSM-IV and cochair of the international group of experts reviewing the SUD definitions for DSM-V.

  19. Pelvic actinomycosis associated with the use of intrauterine devices. Diagnostic and therapeutic criteria.

    Science.gov (United States)

    Surico, N; Tavassoli, K; Porcelli, A; Wierdis, T

    1987-01-01

    The association between IUD use and the occurrence of pelvic infections caused by actinomyces was investigated in 221 IUD users at a University of Turin clinic. Pelvic actinomycosis is chronic and progressive, and diagnostic error and/or inappropriate treatment often lead symptoms to persist for years. Each study participant had a Papanicolaou smear both before IUD insertion and during IUD use. No Pap smear was positive for actinomyces before IUD insertion; however, during IUD use, this microorganism was identified in 30 patients (14%). There was no correlation between infection and socioeconomic status, a history of prior abortion, or IUD size. There was no significant difference between infection rates in nulliparae (12%) and primiparae (14%). Infection was found in 8% of Papanicolaou class I patients and in 15% of class II subjects. The mean duration of IUD use in women with positive Actinomyces vaginal smears was 32.1 months compared with 23.2 months for patients with negative findings. Finally, the risk of infection was higher among acceptors of plastic rather than copper IUDs. These findings confirm the association between IUD use and pelvic actinomycosis; a review of the literature reveals 395 such cases. When actinomycotic infection is discovered, immediate removal of the IUD is necessary and targetted antibiotic treatment should be commenced.

  20. Diagnostic criteria for distinguishing endometrial adenocarcinoma from complex atypical endometrial hyperplasia.

    Science.gov (United States)

    Mittal, Khush; Salem, Amira; Lo, Andy

    2014-01-01

    Morphologic criteria for distinguishing endometrial adenocarcinoma from complex atypical endometrial hyperplasia have been described previously, but they have not been examined extensively for their individual ability for predicting endometrial adenocarcinoma as determined by subsequent hysterectomy. We examined endometrial biopsies diagnosed in the spectrum of complex atypical endometrial hyperplasia to well-differentiated endometrial adenocarcinoma for various morphologic features that may be predictive for the presence of myoinvasive endometrial adenocarcinoma in subsequent hysterectomy. Cases diagnosed as FIGO grade I endometrial adenocarcinoma or complex atypical endometrial hyperplasia in endometrial biopsies seen at New York University Medical Center from 2003 to 2006 were analyzed for the presence of various morphologic features without the knowledge of hysterectomy findings. Only those cases with subsequent hysterectomy were included in the study. The data were analyzed to identify features with high specificity for a finding of myoinvasive endometrial adenocarcinoma in subsequent hysterectomy. Extreme glandular crowding (95% or greater area with glands, aggregate size 3 mm or greater) and cribriform foci of any size were found to have high sensitivity and specificity for the finding of myoinvasive carcinoma in subsequent hysterectomy (P < .0001).