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Sample records for sounds clinical diagnosis

  1. Software development for the analysis of heartbeat sounds with LabVIEW in diagnosis of cardiovascular disease.

    Science.gov (United States)

    Topal, Taner; Polat, Hüseyin; Güler, Inan

    2008-10-01

    In this paper, a time-frequency spectral analysis software (Heart Sound Analyzer) for the computer-aided analysis of cardiac sounds has been developed with LabVIEW. Software modules reveal important information for cardiovascular disorders, it can also assist to general physicians to come up with more accurate and reliable diagnosis at early stages. Heart sound analyzer (HSA) software can overcome the deficiency of expert doctors and help them in rural as well as urban clinics and hospitals. HSA has two main blocks: data acquisition and preprocessing, time-frequency spectral analyses. The heart sounds are first acquired using a modified stethoscope which has an electret microphone in it. Then, the signals are analysed using the time-frequency/scale spectral analysis techniques such as STFT, Wigner-Ville distribution and wavelet transforms. HSA modules have been tested with real heart sounds from 35 volunteers and proved to be quite efficient and robust while dealing with a large variety of pathological conditions.

  2. Research of Control System and Fault Diagnosis of the Sound-absorbing Board Production Line

    Directory of Open Access Journals (Sweden)

    Yanjun Xiao

    2014-08-01

    Full Text Available Programmable Logic Controller is the core of the control system of the sound- absorbing board production line and the design of fault diagnosis is an essential modules in the sound- absorbing board production line. The article discourses the application of PLC in the control system of the production line, and designs the methods of grading treatment and prevention of troubles, which makes use of PLC’S logic functions. The method has good expansibility, and has good guidance to the fault diagnosis in other automation equipments.

  3. Clinical diagnosis versus autopsy diagnosis in head trauma

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    Velnic Andreea-Alexandra

    2017-12-01

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

  4. Differential Diagnosis of Speech Sound Disorder (Phonological Disorder): Audiological Assessment beyond the Pure-tone Audiogram.

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    Iliadou, Vasiliki Vivian; Chermak, Gail D; Bamiou, Doris-Eva

    2015-04-01

    According to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, diagnosis of speech sound disorder (SSD) requires a determination that it is not the result of other congenital or acquired conditions, including hearing loss or neurological conditions that may present with similar symptomatology. To examine peripheral and central auditory function for the purpose of determining whether a peripheral or central auditory disorder was an underlying factor or contributed to the child's SSD. Central auditory processing disorder clinic pediatric case reports. Three clinical cases are reviewed of children with diagnosed SSD who were referred for audiological evaluation by their speech-language pathologists as a result of slower than expected progress in therapy. Audiological testing revealed auditory deficits involving peripheral auditory function or the central auditory nervous system. These cases demonstrate the importance of increasing awareness among professionals of the need to fully evaluate the auditory system to identify auditory deficits that could contribute to a patient's speech sound (phonological) disorder. Audiological assessment in cases of suspected SSD should not be limited to pure-tone audiometry given its limitations in revealing the full range of peripheral and central auditory deficits, deficits which can compromise treatment of SSD. American Academy of Audiology.

  5. Usefulness of bowel sound auscultation: a prospective evaluation.

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    Felder, Seth; Margel, David; Murrell, Zuri; Fleshner, Phillip

    2014-01-01

    Although the auscultation of bowel sounds is considered an essential component of an adequate physical examination, its clinical value remains largely unstudied and subjective. The aim of this study was to determine whether an accurate diagnosis of normal controls, mechanical small bowel obstruction (SBO), or postoperative ileus (POI) is possible based on bowel sound characteristics. Prospectively collected recordings of bowel sounds from patients with normal gastrointestinal motility, SBO diagnosed by computed tomography and confirmed at surgery, and POI diagnosed by clinical symptoms and a computed tomography without a transition point. Study clinicians were instructed to categorize the patient recording as normal, obstructed, ileus, or not sure. Using an electronic stethoscope, bowel sounds of healthy volunteers (n = 177), patients with SBO (n = 19), and patients with POI (n = 15) were recorded. A total of 10 recordings randomly selected from each category were replayed through speakers, with 15 of the recordings duplicated to surgical and internal medicine clinicians (n = 41) blinded to the clinical scenario. The sensitivity, positive predictive value, and intra-rater variability were determined based on the clinician's ability to properly categorize the bowel sound recording when blinded to additional clinical information. Secondary outcomes were the clinician's perceived level of expertise in interpreting bowel sounds. The overall sensitivity for normal, SBO, and POI recordings was 32%, 22%, and 22%, respectively. The positive predictive value of normal, SBO, and POI recordings was 23%, 28%, and 44%, respectively. Intra-rater reliability of duplicated recordings was 59%, 52%, and 53% for normal, SBO, and POI, respectively. No statistically significant differences were found between the surgical and internal medicine clinicians for sensitivity, positive predictive value, or intra-rater variability. Overall, 44% of clinicians reported that they rarely listened

  6. Diagnosis of vulvovaginitis: comparison of clinical and microbiological diagnosis.

    Science.gov (United States)

    Esim Buyukbayrak, Esra; Kars, Bulent; Karsidag, Ayse Yasemin Karageyim; Karadeniz, Bernan Ilkay; Kaymaz, Ozge; Gencer, Serap; Pirimoglu, Zehra Meltem; Unal, Orhan; Turan, Mehmet Cem

    2010-11-01

    The purpose of the present study was to compare the current diagnostic clinical and laboratory approaches to women with vulvovaginal discharge complaint. The secondary outcomes were to determine the prevalence of infections in our setting and to look for the relation between vulvovaginal infections and predisposing factors if present. Premenopausal women applying to our gynecology outpatient clinic with vaginal discharge complaint were enrolled prospectively into the study. Each patient evaluated clinically with direct observation of vaginal secretions, wet mount examination, whiff test, vaginal pH testing and chlamydia rapid antigen test. Each patient also evaluated microbiologically with vaginal discharge culture and gram staining. Clinical diagnosis was compared with the microbiological diagnosis (the gold standard). Diagnostic accuracy was measured with sensitivity, specificity, positive (ppv) and negative predictive values (npv). 460 patients were included in the study. 89.8% of patients received a clinical diagnosis whereas only 36% of them had microbiological diagnosis. The sensitivity, specificity, ppv, npv of clinical diagnosis over microbiological culture results were 95, 13, 38, 82%, respectively. The most commonly encountered microorganisms by culture were Candida species (17.4%) and Gardnerella vaginalis (10.2%). Clinically, the most commonly made diagnoses were mixed infection (34.1%), bacterial vaginosis (32.4%) and fungal infection (14.1%). Symptoms did not predict laboratory results. Predisposing factors (DM, vaginal douching practice, presence of IUD and usage of oral contraceptive pills) were not found to be statistically important influencing factors for vaginal infections. Clinical diagnosis based on combining symptoms with office-based testing improves diagnostic accuracy but is insufficient. The most effective approach also incorporates laboratory testing as an adjunct when a diagnosis is in question or treatment is failing.

  7. International perception of lung sounds: a comparison of classification across some European borders

    OpenAIRE

    Aviles Solis, Juan Carlos; Vanbelle, Sophie; Halvorsen, Peder Andreas; Francis, Nick; Cals, Jochem W L; Andreeva, Elena A; Marques, Alda; Piirila, Paivi; Pasterkamp, Hans; Melbye, Hasse

    2017-01-01

    Source at http://dx.doi.org/10.1136/bmjresp-2017-000250 Introduction: Lung auscultation is helpful in the diagnosis of lung and heart diseases; however, the diagnostic value of lung sounds may be questioned due to interobserver variation. This situation may also impair clinical research in this area to generate evidence-based knowledge about the role that chest auscultation has in a modern clinical setting. The recording and visual display of lung sounds is a method that is both repeatab...

  8. Design of Wearable Breathing Sound Monitoring System for Real-Time Wheeze Detection

    Directory of Open Access Journals (Sweden)

    Shih-Hong Li

    2017-01-01

    Full Text Available In the clinic, the wheezing sound is usually considered as an indicator symptom to reflect the degree of airway obstruction. The auscultation approach is the most common way to diagnose wheezing sounds, but it subjectively depends on the experience of the physician. Several previous studies attempted to extract the features of breathing sounds to detect wheezing sounds automatically. However, there is still a lack of suitable monitoring systems for real-time wheeze detection in daily life. In this study, a wearable and wireless breathing sound monitoring system for real-time wheeze detection was proposed. Moreover, a breathing sounds analysis algorithm was designed to continuously extract and analyze the features of breathing sounds to provide the objectively quantitative information of breathing sounds to professional physicians. Here, normalized spectral integration (NSI was also designed and applied in wheeze detection. The proposed algorithm required only short-term data of breathing sounds and lower computational complexity to perform real-time wheeze detection, and is suitable to be implemented in a commercial portable device, which contains relatively low computing power and memory. From the experimental results, the proposed system could provide good performance on wheeze detection exactly and might be a useful assisting tool for analysis of breathing sounds in clinical diagnosis.

  9. Clinical application of noninvasive diagnosis of liver fibrosis

    Directory of Open Access Journals (Sweden)

    ZHU Chuanlong

    2015-03-01

    Full Text Available Hepatic fibrosis is the common outcome of chronic liver diseases of various causes. At present, liver biopsy is the “gold standard” for the diagnosis of liver fibrosis, but it has limitations and is invasive, which leads to the development of noninvasive assessment of liver fibrosis. The article mainly introduces the technology and application of noninvasive diagnosis of liver fibrosis from the aspects of clinical manifestation, serology, and radiology. It has pointed out the clinical value of these noninvasive diagnosis techniques, and it discusses the progress in clinical research and its limitations for noninvasive diagnosis of liver fibrosis.

  10. Efficiency of clinical and combined diagnosis of breast cancer

    International Nuclear Information System (INIS)

    Solov'ev, I.E.

    1986-01-01

    Problems on clinical, instrumental, laboratory diagnosis of mammary glands cancer are described. Efficiency of clinical examination, mammography, cytological examination, ultrasonic, radioisotopic diagnosis, some biochemical tests are estimated. The conclusion concerning advisability of complex diagnosis of mammary glands cancer especially its early forms is made. Perspectivity of application of polyamine test in diagnosis of primary cancer of the mammary gland is mark to estimate efficiency of its treatment

  11. International perception of lung sounds : a comparison of classification across some European borders

    NARCIS (Netherlands)

    Aviles-Solis, Juan Carlos; Vanbelle, Sophie; Halvorsen, Peder A; Francis, Nick; Cals, Jochen W L; Andreeva, Elena A; Marques, Alda; Piirilä, Päivi; Pasterkamp, Hans; Melbye, Hasse

    2017-01-01

    Introduction: Lung auscultation is helpful in the diagnosis of lung and heart diseases; however, the diagnostic value of lung sounds may be questioned due to interobserver variation. This situation may also impair clinical research in this area to generate evidence-based knowledge about the role

  12. Parameterizing Sound: Design Considerations for an Environmental Sound Database

    Science.gov (United States)

    2015-04-01

    associated with, or produced by, a physical event or human activity and 2) sound sources that are common in the environment. Reproductions or sound...Rogers S. Confrontation naming of environmental sounds. Journal of Clinical and Experimental Neuropsychology . 2000;22(6):830–864. 14 VanDerveer NJ

  13. Speech Sound Disorders in Preschool Children: Correspondence between Clinical Diagnosis and Teacher and Parent Report

    Science.gov (United States)

    Harrison, Linda J.; McLeod, Sharynne; McAllister, Lindy; McCormack, Jane

    2017-01-01

    This study sought to assess the level of correspondence between parent and teacher report of concern about young children's speech and specialist assessment of speech sound disorders (SSD). A sample of 157 children aged 4-5 years was recruited in preschools and long day care centres in Victoria and New South Wales (NSW). SSD was assessed…

  14. Evidence for the treatment of co-occurring stuttering and speech sound disorder: A clinical case series.

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    Unicomb, Rachael; Hewat, Sally; Spencer, Elizabeth; Harrison, Elisabeth

    2017-06-01

    There is a paucity of evidence to guide treatment for children with co-occurring stuttering and speech sound disorder. Some guidelines suggest treating the two disorders simultaneously using indirect treatment approaches; however, the research supporting these recommendations is over 20 years old. In this clinical case series, we investigate whether these co-occurring disorders could be treated concurrently using direct treatment approaches supported by up-to-date, high-level evidence, and whether this could be done in an efficacious, safe and efficient manner. Five pre-school-aged participants received individual concurrent, direct intervention for both stuttering and speech sound disorder. All participants used the Lidcombe Program, as manualised. Direct treatment for speech sound disorder was individualised based on analysis of each child's sound system. At 12 months post commencement of treatment, all except one participant had completed the Lidcombe Program, and were less than 1.0% syllables stuttered on samples gathered within and beyond the clinic. These four participants completed Stage 1 of the Lidcombe Program in between 14 and 22 clinic visits, consistent with current benchmark data for this programme. At the same assessment point, all five participants exhibited significant increases in percentage of consonants correct and were in alignment with age-expected estimates of this measure. Further, they were treated in an average number of clinic visits that compares favourably with other research on treatment for speech sound disorder. These preliminary results indicate that young children with co-occurring stuttering and speech sound disorder may be treated concurrently using direct treatment approaches. This method of service delivery may have implications for cost and time efficiency and may also address the crucial need for early intervention in both disorders. These positive findings highlight the need for further research in the area and contribute to

  15. Laser and caries diagnosis: the state of the art and evaluation in vitro of the differences of the fluorescence between sound, carious and demineralized enamel

    International Nuclear Information System (INIS)

    Mendonca, Maria Angelica Lopes Chaves

    2001-01-01

    The aim of this study was to evaluate the methods for establishing dental caries diagnosis that make use of Laser light as source of illumination, establishing the 'state of the art'. Experimental observation of the differences among fluorescence of sound, demineralized and carious enamel by visible luminescent spectroscopy was also done. Six human teeth, extracted for clinical reasons were studied, and the results showed that the spectrum of carious enamel is different from the sound and demineralized ones. The differences are more evident relative to sond enamel and carious enamel, the same occurring between demineralized and carious enamel. The review of the literature aimed to make comparative considerations between QLF, LF and DELF; their effectiveness relative to traditional methods such as visual, visual with probe, radiography. It was verified that DELF was more sensitive, but could not discriminate between different degrees of mineral loss. QLF, compared to DIAGNOdent has the same sensitivity, but it is better for scientific purposes. The experimental part of the present study used on argon ion Laser to illuminated the teeth and signs of emission of fluorescence were captured by a PMT and then analyzed by a computer system with EG and G software. The results showed that the spectrum of carious enamel is different from the sound and demineralized. The differences are more evident in relation to sound and carious enamel, the same occurs between demineralized and carious enamel. (author)

  16. Spectral analysis of bowel sounds in intestinal obstruction using an electronic stethoscope.

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    Ching, Siok Siong; Tan, Yih Kai

    2012-09-07

    To determine the value of bowel sounds analysis using an electronic stethoscope to support a clinical diagnosis of intestinal obstruction. Subjects were patients who presented with a diagnosis of possible intestinal obstruction based on symptoms, signs, and radiological findings. A 3M™ Littmann(®) Model 4100 electronic stethoscope was used in this study. With the patients lying supine, six 8-second recordings of bowel sounds were taken from each patient from the lower abdomen. The recordings were analysed for sound duration, sound-to-sound interval, dominant frequency, and peak frequency. Clinical and radiological data were reviewed and the patients were classified as having either acute, subacute, or no bowel obstruction. Comparison of bowel sound characteristics was made between these subgroups of patients. In the presence of an obstruction, the site of obstruction was identified and bowel calibre was also measured to correlate with bowel sounds. A total of 71 patients were studied during the period July 2009 to January 2011. Forty patients had acute bowel obstruction (27 small bowel obstruction and 13 large bowel obstruction), 11 had subacute bowel obstruction (eight in the small bowel and three in large bowel) and 20 had no bowel obstruction (diagnoses of other conditions were made). Twenty-five patients received surgical intervention (35.2%) during the same admission for acute abdominal conditions. A total of 426 recordings were made and 420 recordings were used for analysis. There was no significant difference in sound-to-sound interval, dominant frequency, and peak frequency among patients with acute bowel obstruction, subacute bowel obstruction, and no bowel obstruction. In acute large bowel obstruction, the sound duration was significantly longer (median 0.81 s vs 0.55 s, P = 0.021) and the dominant frequency was significantly higher (median 440 Hz vs 288 Hz, P = 0.003) when compared to acute small bowel obstruction. No significant difference was seen

  17. Urological diagnosis using clinical PACS

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    Mills, Stephen F.; Spetz, Kevin S.; Dwyer, Samuel J., III

    1995-05-01

    Urological diagnosis using fluoroscopy images has traditionally been performed using radiographic films. Images are generally acquired in conjunction with the application of a contrast agent, processed to create analog films, and inspected to ensure satisfactory image quality prior to being provided to a radiologist for reading. In the case of errors the entire process must be repeated. In addition, the radiologist must then often go to a particular reading room, possibly in a remote part of the healthcare facility, to read the images. The integration of digital fluoroscopy modalities with clinical PACS has the potential to significantly improve the urological diagnosis process by providing high-speed access to images at a variety of locations within a healthcare facility without costly film processing. The PACS additionally provides a cost-effective and reliable means of long-term storage and allows several medical users to simultaneously view the same images at different locations. The installation of a digital data interface between the existing clinically operational PACS at the University of Virginia Health Sciences Center and a digital urology fluoroscope is described. Preliminary user interviews that have been conducted to determine the clinical effectiveness of PACS workstations for urological diagnosis are discussed. The specific suitability of the workstation medium is discussed, as are overall advantages and disadvantages of the hardcopy and softcopy media in terms of efficiency, timeliness and cost. Throughput metrics and some specific parameters of gray-scale viewing stations and the expected system impacts resulting from the integration of a urology fluoroscope with PACS are also discussed.

  18. [Diagnosis of MODY - brief overview for clinical practice].

    Science.gov (United States)

    Urbanová, Jana; Brunerová, Ludmila; Brož, Jan

    2018-01-01

    Maturity Onset Diabetes of the Young (MODY) comprises inherited forms of diabetes mellitus caused by the mutations in the genes involved in the development, differentiation and function of beta-cells. The majority of patients with MODY remains misdiagnosed and erroneously classified as type 1 or type 2 diabetic patients. Correct MODY diagnosis is, however, essential since it enables individualization of treatment, assessment of the prognosis and identification of diabetes among patient´s relatives. Clinical presentation of MODY is highly variable and it could resemble other types of diabetes, thus identification of MODY patients might be difficult. In this review, we describe typical clinical presentation of the most common MODY subtypes, we summarize current diagnostic guidelines in confirmation of MODY and we raise the question of possible need for extension of current clinical criteria indicating a patient for molecular-genetic testing.Key words: clinical course - diagnosis - differential diagnosis - glucokinase - hepatocyte nuclear factors - MODY.

  19. Chronic diarrhea. Diagnosis and clinical evaluation

    International Nuclear Information System (INIS)

    Pineda O, Luis F; Otero R, William; Arbelaez M, Victor

    2004-01-01

    Chronic diarrhea is a syndrome of great clinical complexity, which is frequently encountered by general physicians, internists and gastroenterologists. Differential diagnosis is very broad and sometime finding the precise cause can be difficult, expensive and frustration. Literature published about this topic lack, in general, adequate controlled studies and for this reason recommendations for diagnostic evaluation and treatment are based upon series of cases, experience of the institutions or expert opinion and not on reasonable evidence. On the other hand, many of the classical diagnostic tests that have survived until now were designed over physiologic foundations and have not been validated extensively with the precision of a clinical test. This limits its acceptance, application and standardization in the daily practice. There is not a general agreement about diagnosis and treatment of chronic diarrhea and many of the experts divert recommendation about their recommendations. The purpose of this paper is to define some general guidelines about the clinical evaluation of patients with chronic diarrhea that lead us to a rational approach based upon clinical trials and the appropriate use of the many different tests

  20. Ichthyophonus in Puget Sound rockfish from the San Juan Islands archipelago and Puget Sound, Washington, USA

    Science.gov (United States)

    Halos, D.; Hart, S.A.; Hershberger, P.; Kocan, R.

    2005-01-01

    In vitro explant cultures identified Ichthyophonus in 10.9% of 302 Puget Sound rockfish Sebastes emphaeus sampled from five sites in the San Juan Islands archipelago and Puget Sound, Washington, in 2003. None of the infected fish exhibited visible lesions and only a single fish was histologically positive. Significantly more females were infected (12.4%) than males (6.8%), and while infected males were only detected at two of the five sites, infected females were identified at all sites, with no significant differences in infection prevalence. Genomic sequences of Ichthyophonus isolates obtained from Puget Sound rockfish, Pacific herring Clupea pallasii, and Yukon River Chinook salmon Oncorhynchus tshawytscha were identical in both the A and B regions of the small subunit 18S ribosomal DNA but were different from Ichthyophonus sequences previously isolated from four different species of rockfish from the northeastern Pacific Ocean. Ichthyophonus in Puget Sound rockfish may not have been previously detected because the infection is subclinical in this species and earlier investigators did not utilize in vitro techniques for diagnosis of ichthyophoniasis. However, since clinical ichthyophoniasis has recently been identified in several other species of northeast Pacific rockfishes, it is hypothesized that this either is an emerging disease resulting from changing marine conditions or the result of introduction by infected southern species that appear during periodic El Nin??o events. ?? Copyright by the American Fisheries Society 2005.

  1. Developing optimal search strategies for detecting clinically sound prognostic studies in MEDLINE: an analytic survey

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    Haynes R Brian

    2004-06-01

    Full Text Available Abstract Background Clinical end users of MEDLINE have a difficult time retrieving articles that are both scientifically sound and directly relevant to clinical practice. Search filters have been developed to assist end users in increasing the success of their searches. Many filters have been developed for the literature on therapy and reviews but little has been done in the area of prognosis. The objective of this study is to determine how well various methodologic textwords, Medical Subject Headings, and their Boolean combinations retrieve methodologically sound literature on the prognosis of health disorders in MEDLINE. Methods An analytic survey was conducted, comparing hand searches of journals with retrievals from MEDLINE for candidate search terms and combinations. Six research assistants read all issues of 161 journals for the publishing year 2000. All articles were rated using purpose and quality indicators and categorized into clinically relevant original studies, review articles, general papers, or case reports. The original and review articles were then categorized as 'pass' or 'fail' for methodologic rigor in the areas of prognosis and other clinical topics. Candidate search strategies were developed for prognosis and run in MEDLINE – the retrievals being compared with the hand search data. The sensitivity, specificity, precision, and accuracy of the search strategies were calculated. Results 12% of studies classified as prognosis met basic criteria for scientific merit for testing clinical applications. Combinations of terms reached peak sensitivities of 90%. Compared with the best single term, multiple terms increased sensitivity for sound studies by 25.2% (absolute increase, and increased specificity, but by a much smaller amount (1.1% when sensitivity was maximized. Combining terms to optimize both sensitivity and specificity achieved sensitivities and specificities of approximately 83% for each. Conclusion Empirically derived

  2. The schizoaffective disorder diagnosis: a conundrum in the clinical setting.

    Science.gov (United States)

    Wilson, Jo Ellen; Nian, Hui; Heckers, Stephan

    2014-02-01

    The term schizoaffective was introduced to describe the co-occurrence of both psychotic and affective symptoms. Overtime, as the diagnosis schizoaffective disorder was added to diagnostic manuals, significant concerns were raised as to the reliability and clinical utility of the diagnosis. We recruited 134 psychiatrically hospitalized subjects who had received a diagnosis of schizophrenia, schizoaffective disorder or bipolar disorder with psychotic features by their treating clinician. The subjects were also diagnosed by trained research personnel with the Structured Clinical Interview of the DSM-IV-TR, employing an explicit time threshold for criterion C of the schizoaffective disorder diagnosis. We found significant differences between the clinical and research diagnoses. Clinicians diagnosed 48 patients (36%) with schizophrenia, 50 patients (37%) with schizoaffective disorder and 36 patients (27%) with psychotic bipolar disorder. In contrast, researchers diagnosed 64 patients (48%) with schizophrenia, 38 patients (28%) with schizoaffective disorder and 32 patients (24%) with psychotic bipolar disorder. This was a statistically significant disagreement between the research and clinical diagnoses (p = 0.003) and indicates that clinicians choose the less severe diagnosis for psychotic patients. We conclude that a more stringent criterion C for the schizoaffective disorder diagnosis will address an implicit bias in clinical practice and will affect the prevalence of the psychotic disorder diagnoses.

  3. Plague: Clinics, Diagnosis and Treatment.

    Science.gov (United States)

    Nikiforov, Vladimir V; Gao, He; Zhou, Lei; Anisimov, Andrey

    2016-01-01

    Plague still poses a significant threat to human health and as a reemerging infection is unfamiliar to the majority of the modern medical doctors. In this chapter, the plague is described according to Dr. Nikiforov's experiences in the diagnosis and treatment of patients, and also a review of the relevant literature on this subject is provided. The main modern methods and criteria for laboratory diagnosis of plague are briefly described. The clinical presentations include the bubonic and pneumonic form, septicemia, rarely pharyngitis, and meningitis. Early diagnosis and the prompt initiation of treatment reduce the mortality rate associated with bubonic plague and septicemic plague to 5-50 %; although a delay of more than 24 h in the administration of antibiotics and antishock treatment can be fatal for plague patients. Most human cases can successfully be treated with antibiotics.

  4. Clinical diagnosis and treatment of olfactory meningioma

    International Nuclear Information System (INIS)

    Li Xiangdong; Wang Zhong; Zhang Shiming; Zhu Fengqing; Zhou Dai; Hui Guozhen

    2005-01-01

    Objective: To analyze the clinical diagnosis and treatment of olfactory meningioma. Methods: In this group 17 olfactory meningiomas were operated, and the clinical presentations and the surgery results were obtained. Results: The symptoms of psychiatrical disorder, visual disturbances and eclipse at presentation was higher. In 16 cases the grade of resection was Simpson II, 1 case Simpson III, most of the cases had a good recovery. Conclusion: Attention should be paid to the early symptom at presentation such as psychiatrical disorder to obtain an early diagnosis. Microsurgery is useful in the treatment of olfactory meningioma. (authors)

  5. Noise detection during heart sound recording using periodicity signatures

    International Nuclear Information System (INIS)

    Kumar, D; Carvalho, P; Paiva, R P; Henriques, J; Antunes, M

    2011-01-01

    Heart sound is a valuable biosignal for diagnosis of a large set of cardiac diseases. Ambient and physiological noise interference is one of the most usual and highly probable incidents during heart sound acquisition. It tends to change the morphological characteristics of heart sound that may carry important information for heart disease diagnosis. In this paper, we propose a new method applicable in real time to detect ambient and internal body noises manifested in heart sound during acquisition. The algorithm is developed on the basis of the periodic nature of heart sounds and physiologically inspired criteria. A small segment of uncontaminated heart sound exhibiting periodicity in time as well as in the time-frequency domain is first detected and applied as a reference signal in discriminating noise from the sound. The proposed technique has been tested with a database of heart sounds collected from 71 subjects with several types of heart disease inducing several noises during recording. The achieved average sensitivity and specificity are 95.88% and 97.56%, respectively

  6. Clinical application of noninvasive diagnosis of liver fibrosis

    OpenAIRE

    ZHU Chuanlong

    2015-01-01

    Hepatic fibrosis is the common outcome of chronic liver diseases of various causes. At present, liver biopsy is the “gold standard” for the diagnosis of liver fibrosis, but it has limitations and is invasive, which leads to the development of noninvasive assessment of liver fibrosis. The article mainly introduces the technology and application of noninvasive diagnosis of liver fibrosis from the aspects of clinical manifestation, serology, and radiology. It has pointed out the clinical value o...

  7. Clinical guideline for diagnosis and management of melioidosis

    Directory of Open Access Journals (Sweden)

    Inglis Timothy J.J.

    2006-01-01

    Full Text Available Melioidosis is an emerging infection in Brazil and neighbouring South American countries. The wide range of clinical presentations include severe community-acquired pneumonia, septicaemia, central nervous system infection and less severe soft tissue infection. Diagnosis depends heavily on the clinical microbiology laboratory for culture. Burkholderia pseudomallei, the bacterial cause of melioidosis, is easily cultured from blood, sputum and other clinical samples. However, B. pseudomallei can be difficult to identify reliably, and can be confused with closely related bacteria, some of which may be dismissed as insignificant culture contaminants. Serological tests can help to support a diagnosis of melioidosis, but by themselves do not provide a definitive diagnosis. The use of a laboratory discovery pathway can help reduce the risk of missing atypical B. pseudomallei isolates. Recommended antibiotic treatment for severe infection is either intravenous Ceftazidime or Meropenem for several weeks, followed by up to 20 weeks oral treatment with a combination of trimethoprim-sulphamethoxazole and doxycycline. Consistent use of diagnostic microbiology to confirm the diagnosis, and rigorous treatment of severe infection with the correct antibiotics in two stages; acute and eradication, will contribute to a reduction in mortality from melioidosis.

  8. Clinical diagnosis and treatment of thyroid microcarcinoma

    International Nuclear Information System (INIS)

    Gao Xuemei; Zhang Yajing; Gao Zairong

    2013-01-01

    Thyroid cancer is the most common malignant carcinoma in the endocrine system. With the increasing incidence of thyroid cancer, the incidence of thyroid microcarcinoma has been elevating gradually. But there is still a large ambiguity on thyroid microcarcinoma about the diagnosis and treatment. The epidemiology, clinical diagnosis, biological behavior and treatment programs of thyroid microcarcinoma were reviewed in this article. (authors)

  9. Lung and Heart Sounds Analysis: State-of-the-Art and Future Trends.

    Science.gov (United States)

    Padilla-Ortiz, Ana L; Ibarra, David

    2018-01-01

    Lung sounds, which include all sounds that are produced during the mechanism of respiration, may be classified into normal breath sounds and adventitious sounds. Normal breath sounds occur when no respiratory problems exist, whereas adventitious lung sounds (wheeze, rhonchi, crackle, etc.) are usually associated with certain pulmonary pathologies. Heart and lung sounds that are heard using a stethoscope are the result of mechanical interactions that indicate operation of cardiac and respiratory systems, respectively. In this article, we review the research conducted during the last six years on lung and heart sounds, instrumentation and data sources (sensors and databases), technological advances, and perspectives in processing and data analysis. Our review suggests that chronic obstructive pulmonary disease (COPD) and asthma are the most common respiratory diseases reported on in the literature; related diseases that are less analyzed include chronic bronchitis, idiopathic pulmonary fibrosis, congestive heart failure, and parenchymal pathology. Some new findings regarding the methodologies associated with advances in the electronic stethoscope have been presented for the auscultatory heart sound signaling process, including analysis and clarification of resulting sounds to create a diagnosis based on a quantifiable medical assessment. The availability of automatic interpretation of high precision of heart and lung sounds opens interesting possibilities for cardiovascular diagnosis as well as potential for intelligent diagnosis of heart and lung diseases.

  10. Parkinsonian syndroms: Clinical phenotype, differential diagnosis and disease progression

    International Nuclear Information System (INIS)

    Storch, A.

    2002-01-01

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

  11. ENDOCRINE OPHTHALMOPATHY: ETIOLOGY, PATHOGENESIS, CLINICAL PICTURE, DIAGNOSIS

    Directory of Open Access Journals (Sweden)

    Nikonova L. V.

    2018-03-01

    Full Text Available The relevance of the study of endocrine ophthalmopathy is due to the high prevalence of this disease and a high risk of developing impaired vision that leads to disability of patients. This lecture presents the main genetic, immunological, clinical manifestations of endocrine ophthalmopathy in order to improve the diagnosis and treatment of this pathology. The clinical picture of endocrine ophthalmopathy is various, unique for every patient and depends on the activity and severity of the process, which requires combined etiopathogenetic therapy. The importance of timely diagnosis for endocrine ophthalmopathy with an assessment of the activity of the process for choosing the right tactics for managing patients is very high.

  12. EVALUATION OF THE PRECISION OF CLINICAL DIAGNOSIS IN PULPOPATHIES

    Directory of Open Access Journals (Sweden)

    Raluca Mihaela Rosca

    2011-09-01

    Full Text Available Most clinicians universally acknowledge the difficulty of establishing a precise clinical diagnosis of the pathological status of the pulpal-dentinary organ, considering both the diversity of the etiological factors and especially the different histopatological forms that may characterize the same lesion. The aim of the present investigation is to identify and quantify the precision of the presumtive diagnosis established on the basis of clinical data and of paraclinical exams, comparatively with the results of the morphopathological work, which establishes the final diagnosis. There have been analyzed 45 teeth, 43 of which with various inflammatory pulpal problems, and 2 clinically-healthy teeth, extracted from orthodontic reasons. Taking advantage of the fact that, along with the development of the treatment, the dental pulp was also available, after its taking over, the surgical piece was prepared and microscopically examined, which permitted an undisputable morphopathological dignosis. To attain scientifically valid results, both the clinically and the morphopathologically obtained results were statistically interpreted by the non-parametric Wilcoxon test. If, from a clinical perspective, most of the cases were classified as mild hyperemia and partially serous acute pulpitis, the morphopathological examination viewed them as irreversible pulpitis, with major supurative and necrotic modifications. The actual diagnosis means cannot establish whether the pulpitis is a serous, a purulent or a combined manifestation in the various pulp sections.

  13. [Artificial intelligence to assist clinical diagnosis in medicine].

    Science.gov (United States)

    Lugo-Reyes, Saúl Oswaldo; Maldonado-Colín, Guadalupe; Murata, Chiharu

    2014-01-01

    Medicine is one of the fields of knowledge that would most benefit from a closer interaction with Computer studies and Mathematics by optimizing complex, imperfect processes such as differential diagnosis; this is the domain of Machine Learning, a branch of Artificial Intelligence that builds and studies systems capable of learning from a set of training data, in order to optimize classification and prediction processes. In Mexico during the last few years, progress has been made on the implementation of electronic clinical records, so that the National Institutes of Health already have accumulated a wealth of stored data. For those data to become knowledge, they need to be processed and analyzed through complex statistical methods, as it is already being done in other countries, employing: case-based reasoning, artificial neural networks, Bayesian classifiers, multivariate logistic regression, or support vector machines, among other methodologies; to assist the clinical diagnosis of acute appendicitis, breast cancer and chronic liver disease, among a wide array of maladies. In this review we shift through concepts, antecedents, current examples and methodologies of machine learning-assisted clinical diagnosis.

  14. To evaluate the efficacy of ultrasonography compared to clinical diagnosis, radiography and histopathological findings in the diagnosis of maxillofacial swellings

    Energy Technology Data Exchange (ETDEWEB)

    Pallagatti, Shambulingappa, E-mail: dr.shambulingappa@gmail.com [Department of Oral Medicine and Radiology, M.M. College of Dental Sciences and Research, Mullana, Ambala, Haryana (India); Sheikh, Soheyl; Puri, Nidhi; Mittal, Amit; Singh, Balwinder [Department of Oral Medicine and Radiology, M.M. College of Dental Sciences and Research, Mullana, Ambala, Haryana (India)

    2012-08-15

    Aim: To evaluate the efficacy of Ultrasonography compared to clinical diagnosis, radiography and histopathological findings in the diagnosis of maxillofacial swellings. Material and methods: The study was conducted on forty-five patients with maxillofacial swellings. The clinical diagnosis, radiographic diagnosis and ultrasonographic diagnosis were made which was compared to the histopathological diagnosis. The maxillofacial swellings included cystic lesions, benign swellings, malignant swellings, lymphadenopathies and abscesses and space infections. Results: The diagnostic accuracy and contingency coefficient was evaluated considering histopathology as gold standard. The diagnostic accuracy of ultrasound was found to be 92.30% in the diagnosis of cystic lesions, 87.5% in benign tumors, 81.8% in malignant tumors, 100% in lymphadenopathies and 90% in space infections and abscesses. The contingency coefficient of 0.934 was obtained when ultrasonography was compared to the histopathology, which was highly significant. Similar significant results were obtained comparing ultrasonography with clinical diagnosis (0.895) and radiographic diagnosis (0.889). Conclusion: Ultrasonography provides accurate imaging of the head and neck region and provides information about the nature of the lesion, its extent, and relationship with the surrounding structures. As the conventional and digital radiography enable the diagnosis of the presence of the disease, but do not give any indication of its nature. So, together with clinical and histopathological examinations, real time ultrasound imaging works out as a valuable adjunct in the diagnosis of orofacial swellings.

  15. The role of fluorescence diagnosis in clinical practice

    Directory of Open Access Journals (Sweden)

    Sieroń A

    2013-07-01

    Full Text Available Aleksander Sieroń,1 Karolina Sieroń-Stołtny,1 Aleksandra Kawczyk-Krupka,1 Wojciech Latos,1 Sebastian Kwiatek,1 Dariusz Straszak,1 Andrzej M Bugaj1,2 1Clinical Department of Internal Diseases, Angiology and Physical Medicine, Center for Laser Diagnostics and Therapy, Silesian Medical University, Bytom, 2College of Health, Beauty Care and Education, Poznan, Poland Abstract: Fluorescence diagnosis is a fast, easy, noninvasive, selective, and sensitive diagnostic tool for estimation of treatment results in oncology. In clinical practice the use of photodynamic diagnosis is focused on five targets: detection for prevention of malignant transformation precancerous changes, detection of neoplasmatic tissue in the early stages for fast removal, prevention of expansion and detection of recurrence of the cancer, monitoring therapy, and the possibility of excluding neoplasmatic disease. In this article, selected applications of fluorescence diagnosis at the Center for Laser Diagnostics and Therapy in Bytom, Poland, for each of these targets are presented. Keywords: autofluorescence, cancer, fluorescence, imaging, photodynamic diagnosis, photodynamic therapy 

  16. Clinical manifestations and diagnosis of acromegaly.

    Science.gov (United States)

    Lugo, Gloria; Pena, Lara; Cordido, Fernando

    2012-01-01

    Acromegaly and gigantism are due to excess GH production, usually as a result of a pituitary adenoma. The incidence of acromegaly is 5 cases per million per year and the prevalence is 60 cases per million. Clinical manifestations in each patient depend on the levels of GH and IGF-I, age, tumor size, and the delay in diagnosis. Manifestations of acromegaly are varied and include acral and soft tissue overgrowth, joint pain, diabetes mellitus, hypertension, and heart and respiratory failure. Acromegaly is a disabling disease that is associated with increased morbidity and reduced life expectancy. The diagnosis is based primarily on clinical features and confirmed by measuring GH levels after oral glucose loading and the estimation of IGF-I. It has been suggested that the rate of mortality in patients with acromegaly is correlated with the degree of control of GH. Adequately treated, the relative mortality risk can be markedly reduced towards normal.

  17. Clinical Manifestations and Diagnosis of Acromegaly

    Directory of Open Access Journals (Sweden)

    Gloria Lugo

    2012-01-01

    Full Text Available Acromegaly and gigantism are due to excess GH production, usually as a result of a pituitary adenoma. The incidence of acromegaly is 5 cases per million per year and the prevalence is 60 cases per million. Clinical manifestations in each patient depend on the levels of GH and IGF-I, age, tumor size, and the delay in diagnosis. Manifestations of acromegaly are varied and include acral and soft tissue overgrowth, joint pain, diabetes mellitus, hypertension, and heart and respiratory failure. Acromegaly is a disabling disease that is associated with increased morbidity and reduced life expectancy. The diagnosis is based primarily on clinical features and confirmed by measuring GH levels after oral glucose loading and the estimation of IGF-I. It has been suggested that the rate of mortality in patients with acromegaly is correlated with the degree of control of GH. Adequately treated, the relative mortality risk can be markedly reduced towards normal.

  18. Clinical diagnosis and computer analysis of headache symptoms.

    OpenAIRE

    Drummond, P D; Lance, J W

    1984-01-01

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

  19. Fibroadenoma: Accuracy of clinical diagnosis in females aged 25 years or less.

    Science.gov (United States)

    Egwuonwu, O A; Anyanwu, Snc; Chianakwana, G U; Ihekwoaba, E C

    2016-01-01

    Accurate clinical diagnosis of fibroadenoma in young females is desirable because of the possibility of nonoperative treatment for those desiring it. To determine the accuracy of the clinical diagnosis of fibroadenoma in patients aged ≤ 25 years. A prospective study of all patients with breast disease presenting to the breast clinic was conducted from January 2004 to December 2008. During the study period, 145 patients aged ≤25 years presented with breast lumps. In this group, a clinical diagnosis of fibroadenoma was made in 100 (69.0%), fibrocystic disease in 32 (22.1%), breast cancer in 4 (0.03%) patients, the remaining were benign lesions. Excision biopsy was done for 81 (55.9%) patients. Of these 81 patients, only 62 (76.5%) returned with histology report. The histological diagnosis was fibroadenoma in 45 (72.5%) patients with a mean age of 21.4 years. Their ages range from 18 to 25 years. The histological diagnosis was fibrocystic disease in 9 (14.5%) and malignant phyllodes in 1 (1.6%) patient. The remaining 7 (11.3%) patients had other types of benign lesions. For fibroadenoma, true positive cases were 42, false positive 7 and false negative 3, and true negative 10. Therefore, the sensitivity of clinical diagnosis of fibroadenoma was 93.3%, while specificity was 58.8%. The sensitivity of clinical diagnosis of fibroadenoma in patients aged ≤25 years was good, though specificity is low.

  20. Clinical diagnosis of hyposalivation in hospitalized patients

    Directory of Open Access Journals (Sweden)

    Soraya de Azambuja Berti-Couto

    2012-04-01

    Full Text Available OBJECTIVE: The aim of this study was to evaluate the effectiveness of clinical criteria for the diagnosis of hyposalivation in hospitalized patients. MATERIAL AND METHODS: A clinical study was carried out on 145 subjects (48 males; 97 females; aged 20 to 90 years. Each subject was clinically examined, in the morning and in the afternoon, along 1 day. A focused anamnesis allowed identifying symptoms of hyposalivation, like xerostomia complaints (considered as a reference symptom, chewing difficulty, dysphagia and increased frequency of liquid intake. Afterwards, dryness of the mucosa of the cheecks and floor of the mouth, as well as salivary secretion during parotid gland stimulation were assessed during oral examination. RESULTS: Results obtained with Chi-square tests showed that 71 patients (48.9% presented xerostomia complaints, with a significant correlation with all hyposalivation symptoms (p <0.05. Furthermore, xerostomia was also significantly correlated with all data obtained during oral examination in both periods of evaluation (p<0.05. CONCLUSION: Clinical diagnosis of hyposalivation in hospitalized patients is feasible and can provide an immediate and appropriate therapy avoiding further problems and improving their quality of life.

  1. Cytologic diagnosis: expression of probability by clinical pathologists.

    Science.gov (United States)

    Christopher, Mary M; Hotz, Christine S

    2004-01-01

    Clinical pathologists use descriptive terms or modifiers to express the probability or likelihood of a cytologic diagnosis. Words are imprecise in meaning, however, and may be used and interpreted differently by pathologists and clinicians. The goals of this study were to 1) assess the frequency of use of 18 modifiers, 2) determine the probability of a positive diagnosis implied by the modifiers, 3) identify preferred modifiers for different levels of probability, 4) ascertain the importance of factors that affect expression of diagnostic certainty, and 5) evaluate differences based on gender, employment, and experience. We surveyed 202 clinical pathologists who were board-certified by the American College of Veterinary Pathologists (Clinical Pathology). Surveys were distributed in October 2001 and returned by e-mail, fax, or surface mail over a 2-month period. Results were analyzed by parametric and nonparametric tests. Survey response rate was 47.5% (n = 96) and primarily included clinical pathologists at veterinary schools (n = 58) and diagnostic laboratories (n = 31). Eleven of 18 terms were used "often" or "sometimes" by >/= 50% of respondents. Broad variability was found in the probability assigned to each term, especially those with median values of 75 to 90%. Preferred modifiers for 7 numerical probabilities ranging from 0 to 100% included 68 unique terms; however, a set of 10 terms was used by >/= 50% of respondents. Cellularity and quality of the sample, experience of the pathologist, and implications of the diagnosis were the most important factors affecting the expression of probability. Because of wide discrepancy in the implied likelihood of a diagnosis using words, defined terminology and controlled vocabulary may be useful in improving communication and the quality of data in cytology reporting.

  2. Artificial Intelligence to Assist Clinical Diagnosis in Medicine

    Directory of Open Access Journals (Sweden)

    Saúl Oswaldo Lugo-Reyes

    2014-03-01

    Full Text Available Medicine is one of the elds of knowledge that would most bene t from a closer interaction with Computer studies and Mathematics by optimizing complex, imperfect processes such as differential diagnosis; this is the domain of Machine Learning, a branch of Arti cial Intelligence that builds and studies systems capable of learning from a set of training data, in order to optimize classi cation and prediction processes. In Mexico during the last few years, progress has been made on the implementation of electronic clinical records, so that the National Institutes of Health already have accumulated a wealth of stored data. For those data to become knowledge, they need to be processed and analyzed through complex statistical methods, as it is already being done in other countries, employing: case-based reasoning, artificial neural networks, Bayesian classi ers, multivariate logistic regression, or support vector machines, among other methodologies; to assist the clinical diagnosis of acute appendicitis, breast cancer and chronic liver disease, among a wide array of maladies. In this review we sift through concepts, antecedents, current examples and methodologies of machine learning-assisted clinical diagnosis.

  3. The new vestibular stimuli: sound and vibration-anatomical, physiological and clinical evidence.

    Science.gov (United States)

    Curthoys, Ian S

    2017-04-01

    The classical view of the otoliths-as flat plates of fairly uniform receptors activated by linear acceleration dragging on otoconia and so deflecting the receptor hair bundles-has been replaced by new anatomical and physiological evidence which shows that the maculae are much more complex. There is anatomical spatial differentiation across the macula in terms of receptor types, hair bundle heights, stiffness and attachment to the overlying otolithic membrane. This anatomical spatial differentiation corresponds to the neural spatial differentiation of response dynamics from the receptors and afferents from different regions of the otolithic maculae. Specifically, receptors in a specialized band of cells, the striola, are predominantly type I receptors, with short, stiff hair bundles and looser attachment to the overlying otoconial membrane than extrastriolar receptors. At the striola the hair bundles project into holes in the otolithic membrane, allowing for fluid displacement to deflect the hair bundles and activate the cell. This review shows the anatomical and physiological evidence supporting the hypothesis that fluid displacement, generated by sound or vibration, deflects the short stiff hair bundles of type I receptors at the striola, resulting in neural activation of the irregular afferents innervating them. So these afferents are activated by sound or vibration and show phase-locking to individual cycles of the sound or vibration stimulus up to frequencies above 2000 Hz, underpinning the use of sound and vibration for clinical tests of vestibular function.

  4. Oral candidiasis: pathogenesis, clinical presentation, diagnosis and treatment strategies.

    Science.gov (United States)

    Lalla, Rajesh V; Patton, Lauren L; Dongari-Bagtzoglou, Anna

    2013-04-01

    Oral candidiasis is a clinical fungal infection that is the most common opportunistic infection affecting the human oral cavity. This article reviews the pathogenesis, clinical presentations, diagnosis and treatmentstrategies for oral candidiasis.

  5. [Comparison of clinical and histological diagnosis in kidney post-transplantation period].

    Science.gov (United States)

    de Castro, M C; Chocair, P R; Saldanha, L B; Nahas, W; Arap, S; Sabbaga, E; Ianhez, L E

    1998-01-01

    To assess the agreement between clinical and histopathological diagnosis in a renal transplantation center, 40 episodes of acute renal failure were studied. Kidney biopsies were performed at the moment that a clinical diagnosis was made by the staff. Nineteen episodes of acute tubular necrosis (ATN), eighteen episodes of acute cellular rejection (ACR), 2 humoral rejections and 1 acute cyclosporin nephrotoxicity episodes were diagnosed. ATN episodes were confirmed by renal biopsy in 84.21%, ACR episodes in 83.33%, humoral rejections in 100%. Renal biopsy showed ATN in the occurrence of clinical cyclosporin nephrotoxicity. Total agreement was 82.5%. There is a good relationship between clinical and histopathological diagnosis in the post-transplantation period. Diagnostic mistakes occurred mainly when oliguria was present.

  6. Clinical and x-ray diagnosis of pulmonary aspergilloma

    International Nuclear Information System (INIS)

    Alyazov, S.I.; Manafov, S.S.; Gurbanaliev, I.G.

    1981-01-01

    Clinical and X-ray peculiarities of pulmonary alterations in patients with aspergilloma are analyzed. The diagnosis of pulmonary aspergilloma is shown to be based on the sum of characte-- ristic clinical and X-ray symptoms and data of mycologic sputum investigations and diffuse precipitation reaction according to Ouchterloni [ru

  7. The influence of (central) auditory processing disorder in speech sound disorders.

    Science.gov (United States)

    Barrozo, Tatiane Faria; Pagan-Neves, Luciana de Oliveira; Vilela, Nadia; Carvallo, Renata Mota Mamede; Wertzner, Haydée Fiszbein

    2016-01-01

    Considering the importance of auditory information for the acquisition and organization of phonological rules, the assessment of (central) auditory processing contributes to both the diagnosis and targeting of speech therapy in children with speech sound disorders. To study phonological measures and (central) auditory processing of children with speech sound disorder. Clinical and experimental study, with 21 subjects with speech sound disorder aged between 7.0 and 9.11 years, divided into two groups according to their (central) auditory processing disorder. The assessment comprised tests of phonology, speech inconsistency, and metalinguistic abilities. The group with (central) auditory processing disorder demonstrated greater severity of speech sound disorder. The cutoff value obtained for the process density index was the one that best characterized the occurrence of phonological processes for children above 7 years of age. The comparison among the tests evaluated between the two groups showed differences in some phonological and metalinguistic abilities. Children with an index value above 0.54 demonstrated strong tendencies towards presenting a (central) auditory processing disorder, and this measure was effective to indicate the need for evaluation in children with speech sound disorder. Copyright © 2015 Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial. Published by Elsevier Editora Ltda. All rights reserved.

  8. [Clinical diagnosis of dyslexia].

    Science.gov (United States)

    Martínez Hermosillo, A; Balderas Gil, A

    1980-01-01

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

  9. CT of jejunal diverticulitis: imaging findings, differential diagnosis, and clinical management

    International Nuclear Information System (INIS)

    Macari, M.; Faust, M.; Liang, H.; Pachter, H.L.

    2007-01-01

    Aim: To describe the imaging findings of jejunal diverticulitis as depicted at contrast-enhanced computed tomography (CT) and review the differential diagnosis and clinical management. Materials and Methods: CT and pathology databases were searched for the diagnosis of jejunal diverticulitis. Three cases were identified and the imaging and clinical findings correlated. Results: Jejunal diverticulitis presents as a focal inflammatory mass involving the proximal small bowel. A trial of medical management with antibiotics may be attempted. Surgical resection may be required if medical management is unsuccessful. Conclusion: The imaging findings at MDCT may allow a specific diagnosis of jejunal diverticulitis to be considered and may affect the clinical management of the patient

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

    Science.gov (United States)

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

    2017-01-01

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

  11. Amblyaudia: Review of Pathophysiology, Clinical Presentation, and Treatment of a New Diagnosis.

    Science.gov (United States)

    Kaplan, Alyson B; Kozin, Elliott D; Remenschneider, Aaron; Eftekhari, Kian; Jung, David H; Polley, Daniel B; Lee, Daniel J

    2016-02-01

    Similar to amblyopia in the visual system, "amblyaudia" is a term used to describe persistent hearing difficulty experienced by individuals with a history of asymmetric hearing loss (AHL) during a critical window of brain development. Few clinical reports have described this phenomenon and its consequent effects on central auditory processing. We aim to (1) define the concept of amblyaudia and (2) review contemporary research on its pathophysiology and emerging clinical relevance. PubMed, Embase, and Cochrane databases. A systematic literature search was performed with combinations of search terms: "amblyaudia," "conductive hearing loss," "sensorineural hearing loss," "asymmetric," "pediatric," "auditory deprivation," and "auditory development." Relevant articles were considered for inclusion, including basic and clinical studies, case series, and major reviews. During critical periods of infant brain development, imbalanced auditory input associated with AHL may lead to abnormalities in binaural processing. Patients with amblyaudia can demonstrate long-term deficits in auditory perception even with correction or resolution of AHL. The greatest impact is in sound localization and hearing in noisy environments, both of which rely on bilateral auditory cues. Diagnosis and quantification of amblyaudia remain controversial and poorly defined. Prevention of amblyaudia may be possible through early identification and timely management of reversible causes of AHL. Otolaryngologists, audiologists, and pediatricians should be aware of emerging data supporting amblyaudia as a diagnostic entity and be cognizant of the potential for lasting consequences of AHL. Prevention of long-term auditory deficits may be possible through rapid identification and correction. © American Academy of Otolaryngology—Head and Neck Surgery Foundation 2015.

  12. Diagnosis and clinical management of urinary tract infection

    OpenAIRE

    Heilberg, Ita Pfeferman; Schor, Nestor

    2003-01-01

    A review about recent aspects on diagnosis and clinical management of urinary tract infection (UTI) is presented. There is a wide variation in clinical presentation of UTI which include different forms as cystitis, pyelonephritis, urethral syndrome and the clinical relevance of asymptomatic bacteriuria and low-count bacteriuria that must be distinguished from contamination. Pathogenetic aspects concerning bacterial virulence as well as host factors in susceptibility to UTI as urinary tract ob...

  13. [Diagnosis and clinical management of urinary tract infection].

    Science.gov (United States)

    Heilberg, Ita Pfeferman; Schor, Nestor

    2003-01-01

    A review about recent aspects on diagnosis and clinical management of urinary tract infection (UTI) is presented. There is a wide variation in clinical presentation of UTI which include different forms as cystitis, pyelonephritis, urethral syndrome and the clinical relevance of asymptomatic bacteriuria and low-count bacteriuria that must be distinguished from contamination. Pathogenetic aspects concerning bacterial virulence as well as host factors in susceptibility to UTI as urinary tract obstruction, vesicoureteral reflux, indwelling bladder catheters, pregnancy, diabetes mellitus, sexual activity, contraceptive methods, prostatism, menopause, advanced age and renal transplantation are discussed. Diagnostic criteria and the most common tests utilized for differentiation between lower and upper UTI have been reviewed. The authors conclude that a careful evaluation of the underlying factors is required for the correct diagnosis of UTI and to prevent recurrence and that appropriate strategies and specific therapeutic regimens may maximize the benefit while reducing costs and adverse reactions.

  14. Pre-operative diagnosis of thyroid cancer: Clinical, radiological and ...

    African Journals Online (AJOL)

    The diagnosis or exclusion of cancer in the thyroid nodule remains a clinical dilemma for general surgeons and endocrinologists. Nodular disease of the thyroid is very common, while cancer is rare; a definite diagnosis of either is difficult to make. The general prevalence of thyroid nodules is very high. They are detectable ...

  15. Clinical diagnosis of stroke: need for audit | Imam | Annals of African ...

    African Journals Online (AJOL)

    Background: Stroke is a common disease and in developing countries its diagnosis relies heavily on clinical features because of the dearth of radiological facilities. To ensure that the diagnosis of stroke is as accurate as possible, it is imperative that clinical skills are kept at the optimum. One such method of doing this is by ...

  16. [Computer-aided Diagnosis and New Electronic Stethoscope].

    Science.gov (United States)

    Huang, Mei; Liu, Hongying; Pi, Xitian; Ao, Yilu; Wang, Zi

    2017-05-30

    Auscultation is an important method in early-diagnosis of cardiovascular disease and respiratory system disease. This paper presents a computer-aided diagnosis of new electronic auscultation system. It has developed an electronic stethoscope based on condenser microphone and the relevant intelligent analysis software. It has implemented many functions that combined with Bluetooth, OLED, SD card storage technologies, such as real-time heart and lung sounds auscultation in three modes, recording and playback, auscultation volume control, wireless transmission. The intelligent analysis software based on PC computer utilizes C# programming language and adopts SQL Server as the background database. It has realized play and waveform display of the auscultation sound. By calculating the heart rate, extracting the characteristic parameters of T1, T2, T12, T11, it can analyze whether the heart sound is normal, and then generate diagnosis report. Finally the auscultation sound and diagnosis report can be sent to mailbox of other doctors, which can carry out remote diagnosis. The whole system has features of fully function, high portability, good user experience, and it is beneficial to promote the use of electronic stethoscope in the hospital, at the same time, the system can also be applied to auscultate teaching and other occasions.

  17. Clinical case definition for the diagnosis of acute intussusception.

    Science.gov (United States)

    Bines, Julie E; Ivanoff, Bernard; Justice, Frances; Mulholland, Kim

    2004-11-01

    Because of the reported association between intussusception and a rotavirus vaccine, future clinical trials of rotavirus vaccines will need to include intussusception surveillance in the evaluation of vaccine safety. The aim of this study is to develop and validate a clinical case definition for the diagnosis of acute intussusception. A clinical case definition for the diagnosis of acute intussusception was developed by analysis of an extensive literature review that defined the clinical presentation of intussusception in 70 developed and developing countries. The clinical case definition was then assessed for sensitivity and specificity using a retrospective chart review of hospital admissions. Sensitivity of the clinical case definition was assessed in children diagnosed with intussusception over a 6.5-year period. Specificity was assessed in patients aged clinical case definition accurately identified 185 of 191 assessable cases as "probable" intussusception and six cases as "possible" intussusception (sensitivity, 97%). No case of radiologic or surgically proven intussusception failed to be identified by the clinical case definition. The specificity of the definition in correctly identifying patients who did not have intussusception ranged from 87% to 91%. The clinical case definition for intussusception may assist in the prompt identification of patients with intussusception and may provide an important tool for the future trials of enteric vaccines.

  18. Early diagnosis of Alzheimer's disease. Clinical significance and future perspectives

    International Nuclear Information System (INIS)

    Buerger, K.; Teipel, S.J.; Hampel, H.

    2000-01-01

    Early diagnosis of Alzheimer's disease describes the recognition and diagnosis in patients with very mild dementia. Internationally accepted diagnostic criteria support the diagnosis based on clinical evaluation. Recent advances in structural and functional neuroimaging as well as studies on specific proteins in the cerebro-spinal fluid that are related to distinct pathophysiological disease processes are most promising approaches to defining biological markers of Alzheimer's disease. (orig.) [de

  19. Clinical diagnosis of malignant pleural mesothelioma

    International Nuclear Information System (INIS)

    Nishi, Hideyuki; Washio, Kazuhiro; Mano, Masayuki

    2008-01-01

    We evaluated clinical and thoracoscopic findings of cases that underwent thoracoscopic biopsy for the diagnosis of malignant pleural mesothelioma. We reviewed 32 cases suspected of having malignant pleural mesothelioma from 2003 to 2006. We made a diagnosis of malignant pleural mesothelioma via thoracoscopic biopsy (19 cases). The cut-off level of hyaluronic acid in malignant effusions, selected on the basis of the best diagnostic efficacy, was 100 μg/ml. We can decrease the incidence of false negative cases by the combination of CT findings and the presence of hyaluronic acid in pleural effusion. In the pleural thickening type of thoracoscopic appearance, the parietal pleurae were thickened, and small nodules were rare. As for this type, tumor cells were histologically absent or confined to the submesothelial tissue. We considered that determinations of specific sites were difficult. Adequate tissue samples obtained via video-assisted thoracoscopy were necessary for diagnosis. We can decrease the incidence of false negative cases by the combination of the presence of hyaluronic acid in pleural effusion and thoracoscopic biopsy. (author)

  20. Sound as a supportive design intervention for improving health care experience in the clinical ecosystem: A qualitative study.

    Science.gov (United States)

    Iyendo, Timothy Onosahwo

    2017-11-01

    Most prior hospital noise research usually deals with sound in its noise facet and is based merely on sound level abatement, rather than as an informative or orientational element. This paper stimulates scientific research into the effect of sound interventions on physical and mental health care in the clinical environment. Data sources comprised relevant World Health Organization guidelines and the results of a literature search of ISI Web of Science, ProQuest Central, MEDLINE, PubMed, Scopus, JSTOR and Google Scholar. Noise induces stress and impedes the recovery process. Pleasant natural sound intervention which includes singing birds, gentle wind and ocean waves, revealed benefits that contribute to perceived restoration of attention and stress recovery in patients and staff. Clinicians should consider pleasant natural sounds perception as a low-risk non-pharmacological and unobtrusive intervention that should be implemented in their routine care for speedier recovery of patients undergoing medical procedures. Copyright © 2017 Elsevier Ltd. All rights reserved.

  1. Preoperative diagnosis of pelvic actinomycosis by clinical cytology

    Directory of Open Access Journals (Sweden)

    Matsuda K

    2012-09-01

    Full Text Available Katsuya Matsuda,1 Hisayoshi Nakajima,2 Khaleque N Khan,1 Terumi Tanigawa,1 Daisuke Hamaguchi,1 Michio Kitajima,1 Koichi Hiraki,1 Shingo Moriyama,3 Hideaki Masuzaki11Department of Obstetrics and Gynecology, Nagasaki University Graduate School of Biomedical Sciences, 2Department of Health Sciences, Nagasaki University Graduate School of Biomedical Sciences, 3Shimabara Maternity Clinic, Nagasaki, JapanBackground: The purpose of this work was to investigate whether clinical cytology could be useful in the preoperative diagnosis of pelvic actinomycosis.Methods: This study involved the prospective collection of samples derived from the endometrium and the uterine cervix, and retrospective data analysis. Nine patients with clinically diagnosed pelvic actinomycosis were enrolled. The clinical and hematological characteristics of patients were recorded, and detection of actinomyces was performed by cytology, pathology, and bacteriological culture of samples and by imprint intrauterine contraceptive device (IUD cytology.Results: The detection rate of actinomyces was 77.7% by combined cervical and endometrial cytology, 50.0% by pathology, and 11.1% by bacterial culture.Conclusion: The higher detection rate of actinomyces by cytology than by pathology or bacteriology suggests that careful cytological examination may be clinically useful in the preoperative diagnosis of pelvic actinomycosis.Keywords: actinomycosis, cytology, pathology, intrauterine contraceptive device, pelvic inflammatory disease

  2. Association between temporomandibular joint symptoms, signs, and clinical diagnosis using the RDC/TMD and radiographic findings in temporomandibular joint tomograms.

    Science.gov (United States)

    Wiese, Mie; Svensson, Peter; Bakke, Merete; List, Thomas; Hintze, Hanne; Petersson, Arne; Knutsson, Kerstin; Wenzel, Ann

    2008-01-01

    To identify associations between clinical symptoms of temporomandibular joint disorders and radiographic findings. Two hundred four adult patients (156 women, 48 men, mean age 40 years) with temporomandibular joint (TMJ) pain/sounds or changes in mandibular motion were examined according to the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD). Bilateral sagittal corrected TMJ tomograms in closed and open positions were assessed for the presence of flattening, erosion, osteophytes, and sclerosis in the joint components and the range of mandibular motion. Logistic regression analyses were performed with the radiographic findings as the dependent variables and the following clinical variables as independent variables: opening pattern, maximal jaw opening, TMJ sounds, number of painful muscle/TMJ sites, duration of pain, presence of arthritic disease, depression and somatization scores, graded chronic pain, and age and gender. Coarse crepitus on opening/closing (odds ratio [OR] > or = 3.12), on lateral excursions (odds ratio > or = 4.06), and on protrusion (OR > or = 5.30) was associated with increased risk of degenerative findings in tomograms. A clinical diagnosis of osteoarthritis increased the risk of radiographic findings (OR > or = 2.95) and so did increasing age (OR > or = 1.03 per year) and the female gender (OR > or = 2.36). Maximal assisted opening and maximal opening without pain (position (OR > or = 2.60). No other significant associations were observed. Age, gender, and coarse crepitus, but no pain-related variables, were associated with increased risk of degenerative findings in TMJ tomograms. Maximal opening < 40 mm was associated with a posterior condyle-to-articular tubercle relation on opening.

  3. Developing a reference of normal lung sounds in healthy Peruvian children.

    Science.gov (United States)

    Ellington, Laura E; Emmanouilidou, Dimitra; Elhilali, Mounya; Gilman, Robert H; Tielsch, James M; Chavez, Miguel A; Marin-Concha, Julio; Figueroa, Dante; West, James; Checkley, William

    2014-10-01

    Lung auscultation has long been a standard of care for the diagnosis of respiratory diseases. Recent advances in electronic auscultation and signal processing have yet to find clinical acceptance; however, computerized lung sound analysis may be ideal for pediatric populations in settings, where skilled healthcare providers are commonly unavailable. We described features of normal lung sounds in young children using a novel signal processing approach to lay a foundation for identifying pathologic respiratory sounds. 186 healthy children with normal pulmonary exams and without respiratory complaints were enrolled at a tertiary care hospital in Lima, Peru. Lung sounds were recorded at eight thoracic sites using a digital stethoscope. 151 (81%) of the recordings were eligible for further analysis. Heavy-crying segments were automatically rejected and features extracted from spectral and temporal signal representations contributed to profiling of lung sounds. Mean age, height, and weight among study participants were 2.2 years (SD 1.4), 84.7 cm (SD 13.2), and 12.0 kg (SD 3.6), respectively; and, 47% were boys. We identified ten distinct spectral and spectro-temporal signal parameters and most demonstrated linear relationships with age, height, and weight, while no differences with genders were noted. Older children had a faster decaying spectrum than younger ones. Features like spectral peak width, lower-frequency Mel-frequency cepstral coefficients, and spectro-temporal modulations also showed variations with recording site. Lung sound extracted features varied significantly with child characteristics and lung site. A comparison with adult studies revealed differences in the extracted features for children. While sound-reduction techniques will improve analysis, we offer a novel, reproducible tool for sound analysis in real-world environments.

  4. SoleSound

    DEFF Research Database (Denmark)

    Zanotto, Damiano; Turchet, Luca; Boggs, Emily Marie

    2014-01-01

    This paper introduces the design of SoleSound, a wearable system designed to deliver ecological, audio-tactile, underfoot feedback. The device, which primarily targets clinical applications, uses an audio-tactile footstep synthesis engine informed by the readings of pressure and inertial sensors...... embedded in the footwear to integrate enhanced feedback modalities into the authors' previously developed instrumented footwear. The synthesis models currently implemented in the SoleSound simulate different ground surface interactions. Unlike similar devices, the system presented here is fully portable...

  5. A system for heart sounds classification.

    Directory of Open Access Journals (Sweden)

    Grzegorz Redlarski

    Full Text Available The future of quick and efficient disease diagnosis lays in the development of reliable non-invasive methods. As for the cardiac diseases - one of the major causes of death around the globe - a concept of an electronic stethoscope equipped with an automatic heart tone identification system appears to be the best solution. Thanks to the advancement in technology, the quality of phonocardiography signals is no longer an issue. However, appropriate algorithms for auto-diagnosis systems of heart diseases that could be capable of distinguishing most of known pathological states have not been yet developed. The main issue is non-stationary character of phonocardiography signals as well as a wide range of distinguishable pathological heart sounds. In this paper a new heart sound classification technique, which might find use in medical diagnostic systems, is presented. It is shown that by combining Linear Predictive Coding coefficients, used for future extraction, with a classifier built upon combining Support Vector Machine and Modified Cuckoo Search algorithm, an improvement in performance of the diagnostic system, in terms of accuracy, complexity and range of distinguishable heart sounds, can be made. The developed system achieved accuracy above 93% for all considered cases including simultaneous identification of twelve different heart sound classes. The respective system is compared with four different major classification methods, proving its reliability.

  6. Clinical and histopathological differential diagnosis of eosinophilic pustular folliculitis.

    Science.gov (United States)

    Fujiyama, Toshiharu; Tokura, Yoshiki

    2013-06-01

    Eosinophilic pustular folliculitis (EPF) is an inflammatory disease characterized by repeated pruritic follicular papules and pustules arranged in arcuate plaques, and folliculotropic infiltration of eosinophils. The diagnosis of EPF is occasionally difficult and problematic because EPF may share the clinical appearance and histological findings with other diseases. Moreover, EPF has several clinical subtypes, including the classical type, infantile type and immunosuppression-associated type. Because the therapies of EPF are relatively specific as compared to eczematous disorders, accurate diagnosis is essential for the management of EPF. Clinical differential diagnoses include tinea, acne, rosacea, eczematous dermatitis, granuloma faciale, autoimmune annular erythema, infestations and pustular dermatosis. Histologically, cutaneous diseases with eosinophilic infiltrates can be differentially diagnosed. Follicular mucinosis, mycosis fungoides and other cutaneous T-cell lymphomas are the most important differential diagnoses both clinically and histopathologically. It should be kept in mind particularly that the initial lesions of cutaneous T-cell lymphoma resemble EPF. © 2013 Japanese Dermatological Association.

  7. pancreatic steatosis: diagnosis and clinical significance

    Directory of Open Access Journals (Sweden)

    Murat Daðdeviren

    2017-03-01

    Full Text Available Pancreatic steatosis (PS, with increased use of abdominal imaging in recent years generally appears as incidental. But it is a condition that is often overlooked. The reason for this is not yet fully demonstrated the clinical significance of PS while. However, in recent years, there are some studies conducted on the relationship with ps and other disease such as diabetes, metabolic syndrome, acute and chronic pancreatitis and pancreatic cancer. In this review, the etiology, diagnosis, treatment and clinical characteristics of ps were evaluated in the light of recent literature and current approaches. [J Contemp Med 2017; 7(1.000: 107-112

  8. Fatal pulmonary embolism in hospitalized patients. Clinical diagnosis versus pathological confirmation

    Directory of Open Access Journals (Sweden)

    Cláudio Tinoco Mesquita

    1999-09-01

    Full Text Available OBJECTIVE - To assess the incidence of fatal pulmonary embolism (FPE, the accuracy of clinical diagnosis, and the profile of patients who suffered an FPE in a tertiary University Hospital. METHODS - Analysis of the records of 3,890 autopsies performed at the Department of General Pathology from January 1980 to December 1990. RESULTS - Among the 3,980 autopsies, 109 were cases of clinically suspected FPE; of these, 28 cases of FPE were confirmed. FPE accounted for 114 deaths, with clinical suspicion in 28 cases. The incidence of FPE was 2.86%. No difference in sex distribution was noted. Patients in the 6th decade of life were most affected. The following conditions were more commonly related to FPE: neoplasias (20% and heart failure (18.5%. The conditions most commonly misdiagnosed as FPE were pulmonary edema (16%, pneumonia (15% and myocardial infarction (10%. The clinical diagnosis of FPE showed a sensitivity of 25.6%, a specificity of 97.9%, and an accuracy of 95.6%. CONCLUSION - The diagnosis of pulmonary embolism made on clinical grounds still has considerable limitations.

  9. Accuracy of family history of cancer : clinical genetic implications

    NARCIS (Netherlands)

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

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

  10. Idiopathic Pulmonary Fibrosis: Diagnosis and Clinical Manifestations

    Science.gov (United States)

    Nakamura, Yutaro; Suda, Takafumi

    2015-01-01

    Idiopathic pulmonary fibrosis (IPF) is a parenchymal lung disease characterized by progressive interstitial fibrosis. The clinical course of IPF can be unpredictable and may be punctuated by acute exacerbations. Although much progress is being made in unraveling the mechanisms underlying IPF, effective therapy for improving survival remains elusive. Longitudinal disease profiling, especially in terms of clinical manifestations in a large cohort of patients, should lead to proper management of the patients and development of new treatments for IPF. Appropriate multidisciplinary assessment in ongoing registries is required to achieve this. This review summarizes the current status of the diagnosis and clinical manifestations of IPF. PMID:27625576

  11. Analysis of adventitious lung sounds originating from pulmonary tuberculosis.

    Science.gov (United States)

    Becker, K W; Scheffer, C; Blanckenberg, M M; Diacon, A H

    2013-01-01

    Tuberculosis is a common and potentially deadly infectious disease, usually affecting the respiratory system and causing the sound properties of symptomatic infected lungs to differ from non-infected lungs. Auscultation is often ruled out as a reliable diagnostic technique for TB due to the random distribution of the infection and the varying severity of damage to the lungs. However, advancements in signal processing techniques for respiratory sounds can improve the potential of auscultation far beyond the capabilities of the conventional mechanical stethoscope. Though computer-based signal analysis of respiratory sounds has produced a significant body of research, there have not been any recent investigations into the computer-aided analysis of lung sounds associated with pulmonary Tuberculosis (TB), despite the severity of the disease in many countries. In this paper, respiratory sounds were recorded from 14 locations around the posterior and anterior chest walls of healthy volunteers and patients infected with pulmonary TB. The most significant signal features in both the time and frequency domains associated with the presence of TB, were identified by using the statistical overlap factor (SOF). These features were then employed to train a neural network to automatically classify the auscultation recordings into their respective healthy or TB-origin categories. The neural network yielded a diagnostic accuracy of 73%, but it is believed that automated filtering of the noise in the clinics, more training samples and perhaps other signal processing methods can improve the results of future studies. This work demonstrates the potential of computer-aided auscultation as an aid for the diagnosis and treatment of TB.

  12. Clinical Presentation and Diagnosis of Neuroendocrine Tumors.

    Science.gov (United States)

    Vinik, Aaron I; Chaya, Celine

    2016-02-01

    Neuroendocrine tumors (NETs) are slow-growing neoplasms capable of storing and secreting different peptides and neuroamines. Some of these substances cause specific symptom complexes, whereas others are silent. They usually have episodic expression, and the diagnosis is often made at a late stage. Although considered rare, the incidence of NETs is increasing. For these reasons, a high index of suspicion is needed. In this article, the different clinical syndromes and the pathophysiology of each tumor as well as the new and emerging biochemical markers and imaging techniques that should be used to facilitate an early diagnosis, follow-up, and prognosis are reviewed. Copyright © 2016 Elsevier Inc. All rights reserved.

  13. Clinical and videofluoroscopic diagnosis of dysphagia in chronic encephalopathy of childhood*

    Science.gov (United States)

    Araújo, Brenda Carla Lima; Motta, Maria Eugênia Almeida; de Castro, Adriana Guerra; de Araújo, Claudia Marina Tavares

    2014-01-01

    Objective To evaluate the contribution of deglutition videofluoroscopy in the clinical diagnosis of dysphagia in chronic encephalopathy of childhood. Materials and Methods The study sample consisted of 93 children diagnosed with chronic encephalopathy, in the age range between two and five years, selected by convenience among patients referred to the authors' institution by speech therapists, neurologists and gastroenterologists in the period from March 2010 to September 2011. The data collection was made at two different moments, by different investigators who were blind to each other. Results The method presented low sensitivity for detecting aspiration with puree consistency (p = 0.04). Specificity and negative predictive value were high for clinical diagnosis of dysphagia with puree consistency. Conclusion In the present study, the value for sensitivity in the clinical diagnosis of dysphagia demonstrates that this diagnostic procedure may not detect any change in the swallowing process regardless of the food consistency used during the investigation. Thus, the addition of the videofluoroscopic method can significantly contribute to the diagnosis of dysphagia. PMID:25741054

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

    Directory of Open Access Journals (Sweden)

    Jenny G H Low

    Full Text Available BACKGROUND: The emergence of dengue throughout the tropical world is affecting an increasing proportion of adult cases. The clinical features of dengue in different age groups have not been well examined, especially in the context of early clinical diagnosis. METHODOLOGY/PRINCIPAL FINDINGS: We structured a prospective study of adults (≥ 18 years of age presenting with acute febrile illness within 72 hours from illness onset upon informed consent. Patients were followed up over a 3-4 week period to determine the clinical outcome. A total of 2,129 adults were enrolled in the study, of which 250 (11.7% had dengue. Differences in the rates of dengue-associated symptoms resulted in high sensitivities when the WHO 1997 or 2009 classification schemes for probable dengue fever were applied to the cohort. However, when the cases were stratified into age groups, fewer older adults reported symptoms such as myalgia, arthralgia, retro-orbital pain and mucosal bleeding, resulting in reduced sensitivity of the WHO classification schemes. On the other hand, the risks of severe dengue and hospitalization were not diminished in older adults, indicating that this group of patients can benefit from early diagnosis, especially when an antiviral drug becomes available. Our data also suggests that older adults who present with fever and leukopenia should be tested for dengue, even in the absence of other symptoms. CONCLUSION: Early clinical diagnosis based on previously defined symptoms that are associated with dengue, even when used in the schematics of both the WHO 1997 and 2009 classifications, is difficult in older adults.

  15. [Abnormal vaginal secretion: sensitivity, specificity and concordance between clinical and cytological diagnosis].

    Science.gov (United States)

    de Camargo, Kélvia Cristina; Alves, Rosane Ribeiro Figueiredo; Baylão, Luciano Augusto; Ribeiro, Andrea Alves; Araujo, Nadja Lindany Alves de Souza; Tavares, Suelene Brito do Nascimento; dos Santos, Sílvia Helena Rabelo

    2015-05-01

    To estimate the prevalence of bacterial vaginosis (BV), candidiasis and trichomoniasis and compare the findings of physical examination of the vaginal secretion with the microbiological diagnosis obtained by cytology study of a vaginal smear using the Papanicolaou method. A cross-sectional study of 302 women aged 20 to 87 years, interviewed and submitted to a gynecology test for the evaluation of vaginal secretion and collection of a cytology smear, from June 2012 to May 2013. Sensitivity analyses were carried out and specificity, positive predictive value (PPV) and negative predictive value (NPV) with their respective 95%CI were determined to assess the accuracy of the characteristics of vaginal secretion in relation to the microbiological diagnosis of the cytology smear . The kappa index (k) was used to assess the degree of agreement between the clinical features of vaginal secretion and the microbiological findings obtained by cytology. RESULTS The prevalence of BV, candidiasis and trichomoniasis was 25.5, 9.3 and 2.0%, respectively. The sensitivity, specificity, PPV and NPV of the clinical characteristics of vaginal secretion for the cytological diagnosis of BV were 74, 78.6, 54.3 and 89.9%, respectively. The sensitivity, specificity, PPV and the NPV of the clinical characteristics of vaginal secretion for the cytological diagnosis of candidiasis were 46.4, 86.2, 25.5 and 94%, respectively. The correlation between the clinical evaluation of vaginal secretion and the microbiological diagnosis of BV, candidiasis and trichomoniasis, assessed by the kappa index, was 0.47, 0.23 and 0.28, respectively. CONCLUSION The most common cause of abnormal vaginal secretion was BV. The clinical evaluation of vaginal secretion presented amoderate to weak agreement with the microbiological diagnosis, indicating the need for complementary investigation of the clinical findings of abnormal vaginal secretion.

  16. [Advances of Molecular Diagnostic Techniques Application in Clinical Diagnosis.

    Science.gov (United States)

    Ying, Bin-Wu

    2016-11-01

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

  17. Prevalence and concordance between the clinical and the post-mortem diagnosis of dementia in a psychogeriatric clinic.

    Science.gov (United States)

    Grandal Leiros, B; Pérez Méndez, L I; Zelaya Huerta, M V; Moreno Eguinoa, L; García-Bragado, F; Tuñón Álvarez, T; Roldán Larreta, J J

    The aim of our study is to describe the types of dementia found in a series of patients and to estimate the level of agreement between the clinical diagnosis and post-mortem diagnosis. We conducted a descriptive analysis of the prevalence of the types of dementia found in our series and we established the level of concordance between the clinical and the post-mortem diagnoses. The diagnosis was made based on current diagnostic criteria. 114 cases were included. The most common clinical diagnoses both at a clinical and autopsy level were Alzheimer disease and mixed dementia but the prevalence was quite different. While at a clinical level, prevalence was 39% for Alzheimer disease and 18% for mixed dementia, in the autopsy level, prevalence was 22% and 34%, respectively. The agreement between the clinical and the autopsy diagnoses was 62% (95% CI 53-72%). Almost a third of our patients were not correctly diagnosed in vivo. The most common mistake was the underdiagnosis of cerebrovascular pathology. Copyright © 2016 Sociedad Española de Neurología. Publicado por Elsevier España, S.L.U. All rights reserved.

  18. CLINIC, DIFFERENTIAL DIAGNOSIS AND TREATMENT OF GALACTOSEMIA

    Directory of Open Access Journals (Sweden)

    N.V. Zhurkova

    2008-01-01

    Full Text Available The data of different firms of hereditary galactosemia was analyzed in this article. Clinical and biochemical characteristics and molecular and genetic features of diagnostics of this disease were described. The information about differential diagnosis and problems, related with hereditary galactozemia screening in Russia was given.Key words: children, galactosemia, treatment, screening.

  19. HIV-associated salivary gland disease--clinical or imaging diagnosis?

    Science.gov (United States)

    da Silva Rath, Inês Beatriz; Beltrame, Ana Paula C A; Carvalho, Aroldo P; Schaeffer, Marcela B; Almeida, Izabel C S

    2015-07-01

    This work aimed at studying the salivary gland disease (SGD) as it relates to associated factors, such as persistent generalised lymphadenopathy (PGL), lymphocytic interstitial pneumonia (LIP), clinical and immunological features of AIDS, and salivary flow rate and pH, as well as at exploring the relationship between the clinical diagnosis and the imaging diagnosis by ultrasound (US) examination of the parotid glands. Information regarding the observation of parotid gland enlargement, PGL, LIP, and clinical and immunological features of AIDS was gathered from medical records, and a saliva sample for unstimulated salivary flow rate and pH measurement was collected from 142 children aged 3 through 10 years treated at the Department of Infectious Diseases of Joana de Gusmão Children's Hospital, Florianópolis, SC, Brazil. High-resolution ultrasonography was performed in 58 children. Pearson's chi-square test and t-test were used to evaluate the association between the variables. A significant association was found between SGD and LIP. Ultrasound revealed a 50% higher incidence of SGD that was not reported in the patients' records. US examination proved to be essential for the correct diagnosis and monitoring of the progression of HIV/SGD. © 2014 BSPD, IAPD and John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  20. Artificial neural networks for breathing and snoring episode detection in sleep sounds

    International Nuclear Information System (INIS)

    Emoto, Takahiro; Akutagawa, Masatake; Kinouchi, Yohsuke; Abeyratne, Udantha R; Chen, Yongjian; Kawata, Ikuji

    2012-01-01

    Obstructive sleep apnea (OSA) is a serious disorder characterized by intermittent events of upper airway collapse during sleep. Snoring is the most common nocturnal symptom of OSA. Almost all OSA patients snore, but not all snorers have the disease. Recently, researchers have attempted to develop automated snore analysis technology for the purpose of OSA diagnosis. These technologies commonly require, as the first step, the automated identification of snore/breathing episodes (SBE) in sleep sound recordings. Snore intensity may occupy a wide dynamic range (>95 dB) spanning from the barely audible to loud sounds. Low-intensity SBE sounds are sometimes seen buried within the background noise floor, even in high-fidelity sound recordings made within a sleep laboratory. The complexity of SBE sounds makes it a challenging task to develop automated snore segmentation algorithms, especially in the presence of background noise. In this paper, we propose a fundamentally novel approach based on artificial neural network (ANN) technology to detect SBEs. Working on clinical data, we show that the proposed method can detect SBE at a sensitivity and specificity exceeding 0.892 and 0.874 respectively, even when the signal is completely buried in background noise (SNR <0 dB). We compare the performance of the proposed technology with those of the existing methods (short-term energy, zero-crossing rates) and illustrate that the proposed method vastly outperforms conventional techniques. (paper)

  1. Cugini's syndrome: its clinical history and diagnosis

    Directory of Open Access Journals (Sweden)

    Laura Gasbarrone

    2013-09-01

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

  2. Developing a Reference of Normal Lung Sounds in Healthy Peruvian Children

    Science.gov (United States)

    Ellington, Laura E.; Emmanouilidou, Dimitra; Elhilali, Mounya; Gilman, Robert H.; Tielsch, James M.; Chavez, Miguel A.; Marin-Concha, Julio; Figueroa, Dante; West, James

    2018-01-01

    Purpose Lung auscultation has long been a standard of care for the diagnosis of respiratory diseases. Recent advances in electronic auscultation and signal processing have yet to find clinical acceptance; however, computerized lung sound analysis may be ideal for pediatric populations in settings, where skilled healthcare providers are commonly unavailable. We described features of normal lung sounds in young children using a novel signal processing approach to lay a foundation for identifying pathologic respiratory sounds. Methods 186 healthy children with normal pulmonary exams and without respiratory complaints were enrolled at a tertiary care hospital in Lima, Peru. Lung sounds were recorded at eight thoracic sites using a digital stethoscope. 151 (81 %) of the recordings were eligible for further analysis. Heavy-crying segments were automatically rejected and features extracted from spectral and temporal signal representations contributed to profiling of lung sounds. Results Mean age, height, and weight among study participants were 2.2 years (SD 1.4), 84.7 cm (SD 13.2), and 12.0 kg (SD 3.6), respectively; and, 47 % were boys. We identified ten distinct spectral and spectro-temporal signal parameters and most demonstrated linear relationships with age, height, and weight, while no differences with genders were noted. Older children had a faster decaying spectrum than younger ones. Features like spectral peak width, lower-frequency Mel-frequency cepstral coefficients, and spectro-temporal modulations also showed variations with recording site. Conclusions Lung sound extracted features varied significantly with child characteristics and lung site. A comparison with adult studies revealed differences in the extracted features for children. While sound-reduction techniques will improve analysis, we offer a novel, reproducible tool for sound analysis in real-world environments. PMID:24943262

  3. Integrating Preclinical and Clinical Oral Diagnosis and Radiology.

    Science.gov (United States)

    Rhodus, Nelson L.; Brand, John W.

    1988-01-01

    A program providing second-year dental students with early experience in direct patient contact in an oral diagnosis/oral radiology clinic was well received by both students and faculty and was found to develop desirable skills and qualities in the students participating. (MSE)

  4. Noonan syndrome: clinical features, diagnosis, and management guidelines.

    Science.gov (United States)

    Romano, Alicia A; Allanson, Judith E; Dahlgren, Jovanna; Gelb, Bruce D; Hall, Bryan; Pierpont, Mary Ella; Roberts, Amy E; Robinson, Wanda; Takemoto, Clifford M; Noonan, Jacqueline A

    2010-10-01

    Noonan syndrome (NS) is a common, clinically and genetically heterogeneous condition characterized by distinctive facial features, short stature, chest deformity, congenital heart disease, and other comorbidities. Gene mutations identified in individuals with the NS phenotype are involved in the Ras/MAPK (mitogen-activated protein kinase) signal transduction pathway and currently explain ∼61% of NS cases. Thus, NS frequently remains a clinical diagnosis. Because of the variability in presentation and the need for multidisciplinary care, it is essential that the condition be identified and managed comprehensively. The Noonan Syndrome Support Group (NSSG) is a nonprofit organization committed to providing support, current information, and understanding to those affected by NS. The NSSG convened a conference of health care providers, all involved in various aspects of NS, to develop these guidelines for use by pediatricians in the diagnosis and management of individuals with NS and to provide updated genetic findings.

  5. Systematic Approach toward the Clinical Diagnosis of Functional Dyspepsia

    Directory of Open Access Journals (Sweden)

    Pierre Paré

    1999-01-01

    Full Text Available Functional dyspepsia (FD is the most common condition in patients consulting with upper gastrointestinal tract symptoms, resulting in up to 5% of visits to family physicians. By definition, patients with FD have no clinical, biochemical or endoscopic evidence of an organic disease that is likely to explain their symptoms. The process to be used in a structured interview for establishing a clinical diagnosis of FD is presented. The steps are as follows: determine the duration and the course of the disease; characterize the current syndrome and review the alarm symptoms; elicit the patient-perceived dominant symptom and/or condition; and identify the patient’s reason for consulting and address the psychosocial factors. According to the clinical characteristics of the three most frequent causes of dyspepsia (peptic ulcer, gastroesophageal reflux and FD and acknowledging that these conditions may coexist rather than overlap in some patients, an algorithm is suggested for establishing a working diagnosis of FD and indications for investigation, and initiating a management strategy.

  6. Research and Implementation of Heart Sound Denoising

    Science.gov (United States)

    Liu, Feng; Wang, Yutai; Wang, Yanxiang

    Heart sound is one of the most important signals. However, the process of getting heart sound signal can be interfered with many factors outside. Heart sound is weak electric signal and even weak external noise may lead to the misjudgment of pathological and physiological information in this signal, thus causing the misjudgment of disease diagnosis. As a result, it is a key to remove the noise which is mixed with heart sound. In this paper, a more systematic research and analysis which is involved in heart sound denoising based on matlab has been made. The study of heart sound denoising based on matlab firstly use the powerful image processing function of matlab to transform heart sound signals with noise into the wavelet domain through wavelet transform and decomposition these signals in muli-level. Then for the detail coefficient, soft thresholding is made using wavelet transform thresholding to eliminate noise, so that a signal denoising is significantly improved. The reconstructed signals are gained with stepwise coefficient reconstruction for the processed detail coefficient. Lastly, 50HZ power frequency and 35 Hz mechanical and electrical interference signals are eliminated using a notch filter.

  7. Multi-feature snore sound analysis in obstructive sleep apnea–hypopnea syndrome

    International Nuclear Information System (INIS)

    Karunajeewa, Asela S; Abeyratne, Udantha R; Hukins, Craig

    2011-01-01

    Snoring is the most common symptom of obstructive sleep apnea hypopnea syndrome (OSAHS), which is a serious disease with high community prevalence. The standard method of OSAHS diagnosis, known as polysomnography (PSG), is expensive and time consuming. There is evidence suggesting that snore-related sounds (SRS) carry sufficient information to diagnose OSAHS. In this paper we present a technique for diagnosing OSAHS based solely on snore sound analysis. The method comprises a logistic regression model fed with snore parameters derived from its features such as the pitch and total airway response (TAR) estimated using a higher order statistics (HOS)-based algorithm. Pitch represents a time domain characteristic of the airway vibrations and the TAR represents the acoustical changes brought about by the collapsing upper airways. The performance of the proposed method was evaluated using the technique of K-fold cross validation, on a clinical database consisting of overnight snoring sounds of 41 subjects. The method achieved 89.3% sensitivity with 92.3% specificity (the area under the ROC curve was 0.96). These results establish the feasibility of developing a snore-based OSAHS community-screening device, which does not require any contact measurements

  8. Sound and sound sources

    DEFF Research Database (Denmark)

    Larsen, Ole Næsbye; Wahlberg, Magnus

    2017-01-01

    There is no difference in principle between the infrasonic and ultrasonic sounds, which are inaudible to humans (or other animals) and the sounds that we can hear. In all cases, sound is a wave of pressure and particle oscillations propagating through an elastic medium, such as air. This chapter...... is about the physical laws that govern how animals produce sound signals and how physical principles determine the signals’ frequency content and sound level, the nature of the sound field (sound pressure versus particle vibrations) as well as directional properties of the emitted signal. Many...... of these properties are dictated by simple physical relationships between the size of the sound emitter and the wavelength of emitted sound. The wavelengths of the signals need to be sufficiently short in relation to the size of the emitter to allow for the efficient production of propagating sound pressure waves...

  9. Sound therapies for tinnitus management.

    Science.gov (United States)

    Jastreboff, Margaret M

    2007-01-01

    Many people with bothersome (suffering) tinnitus notice that their tinnitus changes in different acoustical surroundings, it is more intrusive in silence and less profound in the sound enriched environments. This observation led to the development of treatment methods for tinnitus utilizing sound. Many of these methods are still under investigation in respect to their specific protocol and effectiveness and only some have been objectively evaluated in clinical trials. This chapter will review therapies for tinnitus using sound stimulation.

  10. Clinical utility of FDG-PET for the clinical diagnosis in MCI.

    Science.gov (United States)

    Arbizu, Javier; Festari, Cristina; Altomare, Daniele; Walker, Zuzana; Bouwman, Femke; Rivolta, Jasmine; Orini, Stefania; Barthel, Henryk; Agosta, Federica; Drzezga, Alexander; Nestor, Peter; Boccardi, Marina; Frisoni, Giovanni Battista; Nobili, Flavio

    2018-04-27

    We aim to report the quality of accuracy studies investigating the utility of [ 18 F]fluorodeoxyglucose (FDG)-PET in supporting the diagnosis of prodromal Alzheimer's Disease (AD), frontotemporal lobar degeneration (FTLD) and prodromal dementia with Lewy bodies (DLB) in mild cognitive impairment (MCI) subjects, and the corresponding recommendations made by a panel of experts. Seven panellist, four from the European Association of Nuclear Medicine, and three from the European Academy of Neurology, produced recommendations taking into consideration the incremental value of FDG-PET, as added on clinical-neuropsychological examination, to ascertain the aetiology of MCI (AD, FTLD or DLB). A literature search using harmonized population, intervention, comparison, and outcome (PICO) strings was performed, and an evidence assessment consistent with the European Federation of Neurological Societies guidance was provided. The consensual recommendation was achieved based on Delphi rounds. Fifty-four papers reported the comparison of interest. The selected papers allowed the identification of FDG patterns that characterized MCI due to AD, FTLD and DLB. While clinical outcome studies supporting the diagnosis of MCI due to AD showed varying accuracies (ranging from 58 to 100%) and varying areas under the receiver-operator characteristic curves (0.66 to 0.97), no respective data were identified for MCI due to FTLD or for MCI due to DLB. However, the high negative predictive value of FDG-PET and the existence of different disease-specific patterns of hypometabolism support the consensus recommendations for the clinical use of this imaging technique in MCI subjects. FDG-PET has clinical utility on a fair level of evidence in detecting MCI due to AD. Although promising also in detecting MCI due to FTLD and MCI due to DLB, more research is needed to ultimately judge the clinical utility of FDG-PET in these entities.

  11. Lyme disease: clinical diagnosis and treatment

    Science.gov (United States)

    Hatchette, TF; Davis, I; Johnston, BL

    2014-01-01

    Background Lyme disease is an emerging zoonotic infection in Canada. As the Ixodes tick expands its range, more Canadians will be exposed to Borrelia burgdorferi, the bacterium that causes Lyme disease. Objective To review the clinical diagnosis and treatment of Lyme disease for front-line clinicians. Methods A literature search using PubMed and restricted to articles published in English between 1977 and 2014. Results Individuals in Lyme-endemic areas are at greatest risk, but not all tick bites transmit Lyme disease. The diagnosis is predominantly clinical. Patients with Lyme disease may present with early disease that is characterized by a “bull’s eye rash”, fever and myalgias or with early disseminated disease that can manifest with arthralgias, cardiac conduction abnormalities or neurologic symptoms. Late Lyme disease in North America typically manifests with oligoarticular arthritis but can present with a subacute encephalopathy. Antibiotic treatment is effective against Lyme disease and works best when given early in the infection. Prophylaxis with doxycyline may be indicated in certain circumstances. While a minority of patients may have persistent symptoms, evidence does not demonstrate that prolonged courses of antibiotics improve outcome. Conclusion Clinicians need to be aware of the signs and symptoms of Lyme disease. Knowing the regions where Borrelia infection is endemic in North America is important for recognizing patients at risk and informing the need for treatment. PMID:29769842

  12. Multiple sclerosis, from referral to confirmed diagnosis: an audit of clinical practice.

    LENUS (Irish Health Repository)

    Kelly, S B

    2012-02-01

    BACKGROUND: The National Institute for Health and Clinical Excellence (NICE) guidelines recommend a timeline of 6 weeks from referral to neurology consultation and then 6 weeks to a diagnosis of multiple sclerosis (MS). OBJECTIVES: We audited the clinical management of all new outpatient referrals diagnosed with MS between January 2007 and May 2010. METHODS: We analysed the timelines from referral to first clinic visit, to MRI studies and lumbar puncture (LP) (if performed) and the overall interval from first visit to the time the diagnosis was given to the patient. RESULTS: Of the 119 diagnoses of MS\\/Clinically Isolated Syndrome (CIS), 93 (78%) were seen within 6 weeks of referral. MRI was performed before first visit in 61% and within 6 weeks in a further 27%. A lumbar puncture (LP) was performed in 83% of all patients and was done within 6 weeks in 78%. In total, 63 (53%) patients received their final diagnosis within 6 weeks of their first clinic visit, with 57 (48%) patients having their diagnosis delayed. The main rate-limiting steps were the availability of imaging and LP, and administrative issues. CONCLUSIONS: We conclude that, even with careful scheduling, it is difficult for a specialist service to obtain MRI scans and LP results so as to fulfil NICE guidelines within the optimal six-week period. An improved service would require MRI scans to be arranged before the first clinic visit in all patients with suspected MS.

  13. Retinal Diseases Caused by Mutations in Genes Not Specifically Associated with the Clinical Diagnosis.

    Directory of Open Access Journals (Sweden)

    Xia Wang

    Full Text Available When seeking a confirmed molecular diagnosis in the research setting, patients with one descriptive diagnosis of retinal disease could carry pathogenic variants in genes not specifically associated with that description. However, this event has not been evaluated systematically in clinical diagnostic laboratories that validate fully all target genes to minimize false negatives/positives.We performed targeted next-generation sequencing analysis on 207 ocular disease-related genes for 42 patients whose DNA had been tested negative for disease-specific panels of genes known to be associated with retinitis pigmentosa, Leber congenital amaurosis, or exudative vitreoretinopathy.Pathogenic variants, including single nucleotide variations and copy number variations, were identified in 9 patients, including 6 with variants in syndromic retinal disease genes and 3 whose molecular diagnosis could not be distinguished easily from their submitted clinical diagnosis, accounting for 21% (9/42 of the unsolved cases.Our study underscores the clinical and genetic heterogeneity of retinal disorders and provides valuable reference to estimate the fraction of clinical samples whose retinal disorders could be explained by genes not specifically associated with the corresponding clinical diagnosis. Our data suggest that sequencing a larger set of retinal disorder related genes can increase the molecular diagnostic yield, especially for clinically hard-to-distinguish cases.

  14. Statistical Analysis for Subjective and Objective Evaluations of Dental Drill Sounds.

    Directory of Open Access Journals (Sweden)

    Tomomi Yamada

    Full Text Available The sound produced by a dental air turbine handpiece (dental drill can markedly influence the sound environment in a dental clinic. Indeed, many patients report that the sound of a dental drill elicits an unpleasant feeling. Although several manufacturers have attempted to reduce the sound pressure levels produced by dental drills during idling based on ISO 14457, the sound emitted by such drills under active drilling conditions may negatively influence the dental clinic sound environment. The physical metrics related to the unpleasant impressions associated with dental drill sounds have not been determined. In the present study, psychological measurements of dental drill sounds were conducted with the aim of facilitating improvement of the sound environment at dental clinics. Specifically, we examined the impressions elicited by the sounds of 12 types of dental drills in idling and drilling conditions using a semantic differential. The analysis revealed that the impressions of dental drill sounds varied considerably between idling and drilling conditions and among the examined drills. This finding suggests that measuring the sound of a dental drill in idling conditions alone may be insufficient for evaluating the effects of the sound. We related the results of the psychological evaluations to those of measurements of the physical metrics of equivalent continuous A-weighted sound pressure levels (LAeq and sharpness. Factor analysis indicated that impressions of the dental drill sounds consisted of two factors: "metallic and unpleasant" and "powerful". LAeq had a strong relationship with "powerful impression", calculated sharpness was positively related to "metallic impression", and "unpleasant impression" was predicted by the combination of both LAeq and calculated sharpness. The present analyses indicate that, in addition to a reduction in sound pressure level, refining the frequency components of dental drill sounds is important for creating a

  15. Clinical Manifestations and Diagnosis of Acromegaly

    OpenAIRE

    Lugo, Gloria; Pena, Lara; Cordido, Fernando

    2012-01-01

    Acromegaly and gigantism are due to excess GH production, usually as a result of a pituitary adenoma. The incidence of acromegaly is 5 cases per million per year and the prevalence is 60 cases per million. Clinical manifestations in each patient depend on the levels of GH and IGF-I, age, tumor size, and the delay in diagnosis. Manifestations of acromegaly are varied and include acral and soft tissue overgrowth, joint pain, diabetes mellitus, hypertension, and heart and respiratory failure. Ac...

  16. HYPERCORTISOLISM: CLASSIFICATION, PATHOGENESIS, CLINICAL MANIFESTATIONS. DIAGNOSIS OF ENDOGENOUS HYPERCORTISOLISM

    Directory of Open Access Journals (Sweden)

    Nikonova L. V.

    2017-02-01

    Full Text Available The relevance of the study of Cushing's syndrome with different etiology as well as the states of hypercorticism, which is not associated with endogenous hypercortisolism, is due to the difficulty of the diagnosis of this disease. Accurate knowledge of the classification criteria for the diagnosis of hypercorticism enables subsequently to establish the correct diagnosis and to administer the appropriate treatment. It was found that the cause of hypercorticism can be endogenous and exogenous factors. There is a particular group of patients requiring screening for hypercorticism using special diagnostic tests. Only a clear understanding of etiopathogenesis of hypercorticism and its clinical manifestations by the specialist, the correct interpretation of diagnostic results make it possible to establish the diagnosis, to administer the appropriate treatment and significantly reduce the morbidity and mortality of patients of this profile and improve their quality of life.

  17. Clinical Presentation and Diagnosis of Non-traumatic Sub ...

    African Journals Online (AJOL)

    Background: Subarachnoid haemorrhage (SAH) is a grave condition with high morbidity and mortality. This condition may easily be confused with other clinical conditions such as bacterial or viral meningitis. Diagnosis to date has depended on high index of suspicion. Misdiagnosis of SAH does not only delay definitive ...

  18. International perception of lung sounds: a comparison of classification across some European borders.

    Science.gov (United States)

    Aviles-Solis, Juan Carlos; Vanbelle, Sophie; Halvorsen, Peder A; Francis, Nick; Cals, Jochen W L; Andreeva, Elena A; Marques, Alda; Piirilä, Päivi; Pasterkamp, Hans; Melbye, Hasse

    2017-01-01

    Lung auscultation is helpful in the diagnosis of lung and heart diseases; however, the diagnostic value of lung sounds may be questioned due to interobserver variation. This situation may also impair clinical research in this area to generate evidence-based knowledge about the role that chest auscultation has in a modern clinical setting. The recording and visual display of lung sounds is a method that is both repeatable and feasible to use in large samples, and the aim of this study was to evaluate interobserver agreement using this method. With a microphone in a stethoscope tube, we collected digital recordings of lung sounds from six sites on the chest surface in 20 subjects aged 40 years or older with and without lung and heart diseases. A total of 120 recordings and their spectrograms were independently classified by 28 observers from seven different countries. We employed absolute agreement and kappa coefficients to explore interobserver agreement in classifying crackles and wheezes within and between subgroups of four observers. When evaluating agreement on crackles (inspiratory or expiratory) in each subgroup, observers agreed on between 65% and 87% of the cases. Conger's kappa ranged from 0.20 to 0.58 and four out of seven groups reached a kappa of ≥0.49. In the classification of wheezes, we observed a probability of agreement between 69% and 99.6% and kappa values from 0.09 to 0.97. Four out of seven groups reached a kappa ≥0.62. The kappa values we observed in our study ranged widely but, when addressing its limitations, we find the method of recording and presenting lung sounds with spectrograms sufficient for both clinic and research. Standardisation of terminology across countries would improve international communication on lung auscultation findings.

  19. Validity of prototype diagnosis for mood and anxiety disorders.

    Science.gov (United States)

    DeFife, Jared A; Peart, Joanne; Bradley, Bekh; Ressler, Kerry; Drill, Rebecca; Westen, Drew

    2013-02-01

    CONTEXT With growing recognition that most forms of psychopathology are best represented as dimensions or spectra, a central question becomes how to implement dimensional diagnosis in a way that is empirically sound and clinically useful. Prototype matching, which involves comparing a patient's clinical presentation with a prototypical description of the disorder, is an approach to diagnosis that has gained increasing attention with forthcoming revisions to both the DSM and the International Classification of Diseases. OBJECTIVE To examine prototype diagnosis for mood and anxiety disorders. DESIGN, SETTING, AND PATIENTS In the first study, we examined clinicians' DSM-IV and prototype diagnoses with their ratings of the patients' adaptive functioning and patients' self-reported symptoms. In the second study, independent interviewers made prototype diagnoses following either a systematic clinical interview or a structured diagnostic interview. A third interviewer provided independent ratings of global adaptive functioning. Patients were recruited as outpatients (study 1; N = 84) and from primary care clinics (study 2; N = 143). MAIN OUTCOME MEASURES Patients' self-reported mood, anxiety, and externalizing symptoms along with independent clinical ratings of adaptive functioning. RESULTS Clinicians' prototype diagnoses showed small to moderate correlations with patient-reported psychopathology and performed as well as or better than DSM-IV diagnoses. Prototype diagnoses from independent interviewers correlated on average r = .50 and showed substantial incremental validity over DSM-IV diagnoses in predicting adaptive functioning. CONCLUSIONS Prototype matching is a viable alternative for psychiatric diagnosis. As in research on personality disorders, mood and anxiety disorder prototypes outperformed DSM-IV decision rules in predicting psychopathology and global functioning. Prototype matching has multiple advantages, including ease of use in clinical practice, reduced

  20. Evaluating a mobile application for improving clinical laboratory test ordering and diagnosis.

    Science.gov (United States)

    Meyer, Ashley N D; Thompson, Pamela J; Khanna, Arushi; Desai, Samir; Mathews, Benji K; Yousef, Elham; Kusnoor, Anita V; Singh, Hardeep

    2018-04-20

    Mobile applications for improving diagnostic decision making often lack clinical evaluation. We evaluated if a mobile application improves generalist physicians' appropriate laboratory test ordering and diagnosis decisions and assessed if physicians perceive it as useful for learning. In an experimental, vignette study, physicians diagnosed 8 patient vignettes with normal prothrombin times (PT) and abnormal partial thromboplastin times (PTT). Physicians made test ordering and diagnosis decisions for 4 vignettes using each resource: a mobile app, PTT Advisor, developed by the Centers for Disease Control and Prevention (CDC)'s Clinical Laboratory Integration into Healthcare Collaborative (CLIHC); and usual clinical decision support. Then, physicians answered questions regarding their perceptions of the app's usefulness for diagnostic decision making and learning using a modified Kirkpatrick Training Evaluation Framework. Data from 368 vignettes solved by 46 physicians at 7 US health care institutions show advantages for using PTT Advisor over usual clinical decision support on test ordering and diagnostic decision accuracy (82.6 vs 70.2% correct; P < .001), confidence in decisions (7.5 vs 6.3 out of 10; P < .001), and vignette completion time (3:02 vs 3:53 min.; P = .06). Physicians reported positive perceptions of the app's potential for improved clinical decision making, and recommended it be used to address broader diagnostic challenges. A mobile app, PTT Advisor, may contribute to better test ordering and diagnosis, serve as a learning tool for diagnostic evaluation of certain clinical disorders, and improve patient outcomes. Similar methods could be useful for evaluating apps aimed at improving testing and diagnosis for other conditions.

  1. What's in a Label? Is Diagnosis the Start or the End of Clinical Reasoning?

    Science.gov (United States)

    Ilgen, Jonathan S; Eva, Kevin W; Regehr, Glenn

    2016-04-01

    Diagnostic reasoning has received substantial attention in the literature, yet what we mean by "diagnosis" may vary. Diagnosis can align with assignment of a "label," where a constellation of signs, symptoms, and test results is unified into a solution at a single point in time. This "diagnostic labeling" conceptualization is embodied in our case-based learning curricula, published case reports, and research studies, all of which treat diagnostic accuracy as the primary outcome. However, this conceptualization may oversimplify the richly iterative and evolutionary nature of clinical reasoning in many settings. Diagnosis can also represent a process of guiding one's thoughts by "making meaning" from data that are intrinsically dynamic, experienced idiosyncratically, negotiated among team members, and rich with opportunities for exploration. Thus, there are two complementary constructions of diagnosis: 1) the correct solution resulting from a diagnostic reasoning process, and 2) a dynamic aid to an ongoing clinical reasoning process. This article discusses the importance of recognizing these two conceptualizations of "diagnosis," outlines the unintended consequences of emphasizing diagnostic labeling as the primary goal of clinical reasoning, and suggests how framing diagnosis as an ongoing process of meaning-making might change how we think about teaching and assessing clinical reasoning.

  2. Pertussis: clinical and bacteriological diagnosis of six cases

    Directory of Open Access Journals (Sweden)

    Arellano Penagos Mario

    2014-07-01

    Full Text Available ertussis is an endemic disease in our population. Every 3 to 4 years, pertussis has an epidemic pattern even in countries with good health conditions. Antipertussis vaccine first dose is adminis- tered at the age of 2 months; a second and third dose are given at 4 and 6 months of age. This vaccine has an 8 to 10 year protective effect, for which reason it is suggested that pregnant women in the third trimester should be vaccinated in order to prevent pertussis in newborns. It should also be administered to older people to avoid turning them into asymptomatic carriers. Clinic manifestations are easily identifiable due to respiratory symptoms, especially to the particular characteristics of the cough. The diagnosis is supported by the presence of leukocytosis (predominantly lymphocytes and by certain thoracic radiologic findings. The diagnosis is confirmed with a positive culture for Bordetella pertussis or with a polymerase chain reaction (PCR. In a non complicated clinic course macrolides are still the best therapeutic choice. Nonetheless clinic observation is highly recom- mended in order to avoid complications. Redefinition of vaccine programs against Bordetella pertussis in Mexican population is recommended and also to notify the presence of the disease to the corresponding health authorities.

  3. Current Role for Biomarkers in Clinical Diagnosis of Alzheimer Disease and Frontotemporal Dementia.

    Science.gov (United States)

    Sheikh-Bahaei, Nasim; Sajjadi, Seyed Ahmad; Pierce, Aimee L

    2017-11-14

    Purpose of review Alzheimer's disease (AD) and frontotemporal dementia can often be diagnosed accurately with careful clinical history, cognitive testing, neurological examination, and structural brain MRI. However, there are certain circumstances wherein detection of specific biomarkers of neurodegeneration or underlying AD pathology will impact the clinical diagnosis or treatment plan. We will review the currently available biomarkers for AD and frontotemporal dementia (FTD) and discuss their clinical importance. Recent findings With the advent of 18 F-labeled tracers that bind amyloid plaques, amyloid PET is now clinically available for the detection of amyloid pathology and to aid in a biomarker-supported diagnosis of AD or mild cognitive impairment (MCI) due to AD. It is not yet possible to test for the specific FTD pathologies (tau or TDP-43); however, a diagnosis of FTD may be "imaging supported" based upon specific MRI or FDG-PET findings. Cerebrospinal fluid measures of amyloid-beta, total-tau, and phospho-tau are clinically available and allow detection of both of the cardinal pathologies of AD: amyloid and tau pathology. Summary It is appropriate to pursue biomarker testing in cases of MCI and dementia when there remains diagnostic uncertainty and the result will impact diagnosis or treatment. Practically speaking, due to the rising prevalence of amyloid positivity with advancing age, measurement of biomarkers in cases of MCI and dementia is most helpful in early-onset patients, patients with atypical clinical presentations, or when considering referral for AD clinical trials.

  4. Marfan syndrome: clinical diagnosis and management.

    Science.gov (United States)

    Dean, John C S

    2007-07-01

    Marfan syndrome is a multisystem connective tissue disorder usually associated with mutation in fibrillin, and occasionally with mutation in TGFBR1 or 2. The clinical diagnosis is made using the Ghent nosology, which will unequivocally diagnose or exclude Marfan syndrome in 86% of cases. Use of a care pathway can help implementation of the nosology in the clinic. The penetrance of some features is age dependent, so the nosology must be used with caution in children. Molecular testing may be helpful in this context. The nosology cannot be used in families with isolated aortic dissection, or with related conditions such as Loeys-Dietz syndrome, although it may help identify families for further diagnostic evaluation because they do not fulfill the nosology, despite a history of aneurysm. Prophylactic medical (eg beta-blockade) and surgical intervention is important in reducing the cardiovascular complications of Marfan syndrome. Musculoskeletal symptoms are common, although the pathophysiology is less clear--for example, the correlation between dural ectasia and back pain is uncertain. Symptoms in other systems require specialist review such as ophthalmology assessment of refractive errors and ectopia lentis. Pregnancy is a time of increased cardiovascular risk for women with Marfan syndrome, particularly if the aortic root exceeds 4 cm at the start of pregnancy. High-intensity static exercise should be discouraged although low-moderate intensity dynamic exercise may be beneficial. The diagnosis and management of Marfan syndrome requires a multidisciplinary team approach, in view of its multisystem effects and phenotypic variability.

  5. [Clinical, ureteroscopic and photodynamic diagnosis of urothelial carcinomas of the upper tract: state-of-the art review for the yearly scientific report of the French National Association of Urology].

    Science.gov (United States)

    Nison, L; Bozzini, G; Rouprêt, M; Traxer, O; Colin, P

    2014-11-01

    To propose a state-of-the art of current knowledge about clinical, ureteroscopic and photodynamic for the diagnosis of the upper urinary tract cancer (UTUC). A systematic review of the literature search was performed from the database Medline (NLM, Pubmed), focused on the following keywords: urothelial carcinomas; upper urinary tract; ureter; renal pelvis; diagnosis; fluorescence; ureteroscopy; photodynamic technique; biopsy; cytology. Gross hematuria and flank pain are the two main clinical symptoms revealing a UTUC in daily clinical practice. Urinary cystoscopy and cystoscopy are mandatory to rule out a concomittant synchronous bladder tumour. Flexible ureteroscopy has revolutionized the management of UTUC by allowing a full exploration of upper urinary tract, an endoscopi vizualization of the tumour and assessment of grade with biopsies. A flexible ureteroscopy is mandatory in diagnostic evaluation of UTUC as soon as a conservative management is being considered. New investigation technologies such as fluorescence, narrow band imaging and optical coherence tomography (± combined with ultra sound), are promising for a near future. It has to be understood that the diagnostic work-up of a UTUC has to be exhaustive and particularly the search of another urothelial carcinoma within the urinary tract. Flexible ureterosocopy has revolutionized the diagnosis and management of UTUC and belongs fully to its initial evaluation. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

  6. Clinical findings in 16 patients with tomographic diagnosis of schizencephaly

    Energy Technology Data Exchange (ETDEWEB)

    Rodrigues, Maria do Carmo de Souza [Universidade Federal do Espirito Santo, Vitoria, ES (Brazil). Hospital Universitario Cassiano Antonio Moraes]. E-mail: rodriguesmcs@yahoo.com.br; Monteiro, Alexandra Maria Vieira [Universidade do Estado do Rio de Janeiro, RJ (Brazil). Faculdade de Ciencias Medicas; Llerena Junior, Juan Clinton [Fundacao Oswaldo Cruz, Rio de Janeiro, RJ (Brazil). Instituto Fernandes Figueira. Centro de Genetica Medica; Fernandes, Alexandre Ribeiro [Universidade Gama Filho, Rio de Janeiro, RJ (Brazil). Dept. de Pediatria

    2006-09-15

    Objective: to establish a correlation between clinical features in a group of children with tomographic diagnosis of schizencephaly and clefts extent and localization. Materials and methods: retrospective study of dossiers from the archives of Neurology and Medical Genetics Services at Instituto Fernandes Figueira/FIOCRUZ and Hospital Municipal Jesus, Rio de Janeiro, RJ, Brazil, in the period between 2000 and 2003. The study included 16 patients, nine female and seven male, with tomographic diagnosis of schizencephaly investigated for clinical findings, psychomotor development, motor/cognitive deficits and epilepsy. Results: predominance of bilateral clefts in 10:16 patients, open-lip schizencephaly type in 23:27 patients, and small lips in 11:27 patients. As regards anomalies associated with schizencephaly, pellucid septum absence was the most frequent one (10:16 patients). As regards clinical findings, 15 patients presented with developmental delay and motor deficit, six patients with cognitive deficit and ten with epilepsy. In three patients, we observed discordant clinical findings and cleft sizes, although the clefts were small, the clinical features severity was high because of other cerebral anomalies. Conclusion: the clinical features of schizencephaly are related to the size of the clefts, regardless laterality, presenting higher severity when associated with other cerebral anomalies. (author)

  7. Clinical findings in 16 patients with tomographic diagnosis of schizencephaly

    International Nuclear Information System (INIS)

    Rodrigues, Maria do Carmo de Souza; Monteiro, Alexandra Maria Vieira; Llerena Junior, Juan Clinton; Fernandes, Alexandre Ribeiro

    2006-01-01

    Objective: to establish a correlation between clinical features in a group of children with tomographic diagnosis of schizencephaly and clefts extent and localization. Materials and methods: retrospective study of dossiers from the archives of Neurology and Medical Genetics Services at Instituto Fernandes Figueira/FIOCRUZ and Hospital Municipal Jesus, Rio de Janeiro, RJ, Brazil, in the period between 2000 and 2003. The study included 16 patients, nine female and seven male, with tomographic diagnosis of schizencephaly investigated for clinical findings, psychomotor development, motor/cognitive deficits and epilepsy. Results: predominance of bilateral clefts in 10:16 patients, open-lip schizencephaly type in 23:27 patients, and small lips in 11:27 patients. As regards anomalies associated with schizencephaly, pellucid septum absence was the most frequent one (10:16 patients). As regards clinical findings, 15 patients presented with developmental delay and motor deficit, six patients with cognitive deficit and ten with epilepsy. In three patients, we observed discordant clinical findings and cleft sizes, although the clefts were small, the clinical features severity was high because of other cerebral anomalies. Conclusion: the clinical features of schizencephaly are related to the size of the clefts, regardless laterality, presenting higher severity when associated with other cerebral anomalies. (author)

  8. Cancer diagnosis in a ''breast clinic''

    International Nuclear Information System (INIS)

    Ghys, R.

    1987-01-01

    Conflicting opinions have been expressed in the world literature over the last 15 years about the value of radiological techniques in breast cancer diagnosis. We reviewed 111 breast cancers which we diagnosed between 1971 and 1985, in unselected patients, by the combined use of palpation, thermography and mammography, complemented, since 1980, by diaphanoscopy. Considerable clinical experience is necessary to interpret both mammograms and thermograms. Each of these approaches, when rated independently, has a very high false negative rate ranging from 41% for clinical examination to 32% for mammography. In cases which are not clinically obvious, diaphanoscopy ''retrieves'' the most cancers, with thermography a close second (definitely malignant in 35% of the cases over the whole age range). Mammography comes third and its efficacy drops to 12.5% in premenopausal women. However, by combining this information with the one derived from anamnesis, the ACDTM scoring system gives us a false negative rate - before biopsy - of 5.5% and a false positive rate of <1%. This approach also drastically reduces the number of unnecessary biopsies

  9. Clinical diagnosis of syphilis: a ten-year retrospective analysis in a South Australian urban sexual health clinic.

    Science.gov (United States)

    Forrest, C E; Ward, A

    2016-12-01

    National notifications for infectious syphilis in Australia have increased in recent years. Outside of sexual health clinics, junior clinicians seldom encounter this disease in its infectious stage (primary, secondary and early latent). With such a variable clinical presentation, textbook teaching is no substitute for real-life experience. The importance of accurate classification and staging of disease is relevant to the risk of transmission and determines treatment duration. In this article, the authors review the clinical presentation of syphilis over ten years in an urban sexual health clinic with a focus on the clinical presentation and diagnosis of infectious syphilis, in particular secondary syphilis, compared with that outlined in the Australian National Notifiable Diseases Surveillance System guidelines. This retrospective review of all patients diagnosed with syphilis at an urban sexual health clinic showed that between 2005 and 2015, 226 cases of syphilis were diagnosed. Documentation of impression of clinical staging of disease was present in 46% of the cases. Seventeen of these cases were recorded as secondary syphilis. The criteria used by clinicians to diagnose the secondary syphilis cases were consistent with criteria defined by the Australian National Notifiable Diseases Surveillance System. All cases of secondary syphilis had at least one cutaneous manifestation of disease. The demographic of the cohort of syphilis cases was consistent with that recorded in the literature. This review showed that the clinician's diagnosis of secondary syphilis in this service is consistent with the National Notifiable Diseases Surveillance System guidelines. Continuing education of junior medical staff is important to facilitate diagnosis and improve documentation of clinical staging, minimise disease transmission and ensure appropriate treatment. © The Author(s) 2016.

  10. [Clinical symptomps, diagnosis and therapy of feline allergic dermatitis].

    Science.gov (United States)

    Favrot, C; Rostaher, A; Fischer, N

    2014-07-01

    Allergies are often suspected in cats and they are mainly hypersensitivity reactions against insect bites, food- or environmental allergens. Cats, with non flea induced atopic dermatitis, normally present with one oft he following reaction patterns: miliary dermatitis, eosinophilic dermatitis, selfinduced alopecia or head and neck excoriations. None of these reaction patterns is nevertheless pathognomonic for allergic dermatitis, therefore the diagnosis is based on the one hand on the exclusion of similar diseases on the other hand on the successful response on a certain therapy. Recently a study on the clinical presentation of cats with non flea induced atopic dermatitis was published. In this study certain criteria for diagnosing atopy in cats were proposed. For therapy of allergic cats cyclosporin, glucocorticoids, antihistamines, hypoallergenic diets and allergen specific immunotherapy are used. This article should provide a recent overview on the clinical symptoms, diagnosis and therapy of feline allergic dermatitis.

  11. Clinical Assistant Diagnosis for Electronic Medical Record Based on Convolutional Neural Network.

    Science.gov (United States)

    Yang, Zhongliang; Huang, Yongfeng; Jiang, Yiran; Sun, Yuxi; Zhang, Yu-Jin; Luo, Pengcheng

    2018-04-20

    Automatically extracting useful information from electronic medical records along with conducting disease diagnoses is a promising task for both clinical decision support(CDS) and neural language processing(NLP). Most of the existing systems are based on artificially constructed knowledge bases, and then auxiliary diagnosis is done by rule matching. In this study, we present a clinical intelligent decision approach based on Convolutional Neural Networks(CNN), which can automatically extract high-level semantic information of electronic medical records and then perform automatic diagnosis without artificial construction of rules or knowledge bases. We use collected 18,590 copies of the real-world clinical electronic medical records to train and test the proposed model. Experimental results show that the proposed model can achieve 98.67% accuracy and 96.02% recall, which strongly supports that using convolutional neural network to automatically learn high-level semantic features of electronic medical records and then conduct assist diagnosis is feasible and effective.

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

    International Nuclear Information System (INIS)

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

    1985-01-01

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

  13. Tuberculous meningits in adults in Turkey: Epidemiology, diagnosis, clinic and laboratory

    International Nuclear Information System (INIS)

    Hosoglu, S.; Geyik, M.F.; Balik, I.; Aygen, B.; Erol, S.; Aygencel, S.G.; Mert, A.; Saltoglu, N.; Doekmetas, I.; Felek, S.; Suembuel, M.; Irmak, H.; Aydin, K.; Ayaz, C.; Koekoglu, O.F.; Ucmak, H.; Satilmis, S.

    2003-01-01

    A retrospective study was performed to assess the epidemiology, diagnosis, clinic, and laboratory of the patients with tuberculous meningitis (TBM) in a multicentral study. The medical records of adult cases with TBM treated at 12 university hospitals throughout Turkey, between 1985 and 1998 were reviewed using a standardized protocol. The diagnosis of TMB was established with the clinical and laboratory findings and/or microbiological confirmation in cerebrospinal fluid (CSF). The non-microbiologically confirmed cases were diagnosed with five diagnostic sub-criteria which CSF findings, radiological findings, extra-neural tuberculosis, epidemiological findings and response to antituberculous therapy. A total of 469 patients were included in this study. Majority of the patients were from Southeast Anatolia (164 patients, 35.0%) and (108 patients, 23.0%) from East Anatolia regions. There was a close contact with a tuberculous patient in 88 of 341 patients (25.8%) and with a tuberculous family member in 53 of 288 patients (18.4%). BCG scar was positive in 161 of 392 patients (41.1%). Tuberculin skin test was done in 233 patients and was found to be negative in 75. Totally 115 patients died (24.5%) of whom 23 died in 24 hour after admittance. The diagnosis was confirmed with clinical findings and CSF culture and/or Ziehl-Nelson staining in 88 patients (18.8%). Besides clinical criteria, there were three or more diagnostic sub-criteria in 252 cases (53.7%), two diagnostic sub-criteria in 99 cases (21.1%), and any diagnostic sub-criteria in 30 patients (6.4%). Since TBM is a very critical disease, early diagnosis and treatment may reduce fatal outcome and morbidity

  14. Diagnosis of Polycystic Ovary Syndrome: AMH in combination with clinical symptoms.

    Science.gov (United States)

    Sahmay, Sezai; Aydin, Yavuz; Oncul, Mahmut; Senturk, Levent M

    2014-02-01

    We assessed the utility of using anti-Müllerian hormone (AMH) and clinical features of polycystic ovary syndrome (PCOS), polycystic ovarian morphology (PCOM), oligo/amenorrhea (OA), and hyperandrogenism (HA) for diagnosing PCOS, and compared their diagnostic accuracy with those of classical diagnostic systems. A total of 606 females were admitted to a university hospital with menstrual irregularities or symptoms of hyperandrogenism were enrolled in this cross-sectional study. Fasting blood samples were collected. Pelvic and/or abdominal ultrasonography and clinical examination were performed. Patients were evaluated for the presence of PCOS according to conventional diagnostic criteria. The diagnostic performance of using serum AMH levels alone and in various combinations with the clinical features of PCOM, OA, and HA were investigated. For the diagnosis of PCOS, the combination of OA and/or HA with AMH showed 83% sensitivity and 100% specificity according to the Rotterdam criteria; 83% sensitivity and 89% specificity according to the National Institutes of Health (NIH) criteria; and 82% sensitivity and 93.5% specificity according to the Androgen Excess Society (AES) criteria. The serum AMH level is a useful diagnostic marker for PCOS and is correlated with conventional diagnostic criteria. The combination of AMH level with OA and/or HA markedly increased the clinical scope for PCOS diagnosis and can be introduced as a possible objective criterion for the diagnosis of this disease.

  15. Computer-aided diagnosis and artificial intelligence in clinical imaging.

    Science.gov (United States)

    Shiraishi, Junji; Li, Qiang; Appelbaum, Daniel; Doi, Kunio

    2011-11-01

    Computer-aided diagnosis (CAD) is rapidly entering the radiology mainstream. It has already become a part of the routine clinical work for the detection of breast cancer with mammograms. The computer output is used as a "second opinion" in assisting radiologists' image interpretations. The computer algorithm generally consists of several steps that may include image processing, image feature analysis, and data classification via the use of tools such as artificial neural networks (ANN). In this article, we will explore these and other current processes that have come to be referred to as "artificial intelligence." One element of CAD, temporal subtraction, has been applied for enhancing interval changes and for suppressing unchanged structures (eg, normal structures) between 2 successive radiologic images. To reduce misregistration artifacts on the temporal subtraction images, a nonlinear image warping technique for matching the previous image to the current one has been developed. Development of the temporal subtraction method originated with chest radiographs, with the method subsequently being applied to chest computed tomography (CT) and nuclear medicine bone scans. The usefulness of the temporal subtraction method for bone scans was demonstrated by an observer study in which reading times and diagnostic accuracy improved significantly. An additional prospective clinical study verified that the temporal subtraction image could be used as a "second opinion" by radiologists with negligible detrimental effects. ANN was first used in 1990 for computerized differential diagnosis of interstitial lung diseases in CAD. Since then, ANN has been widely used in CAD schemes for the detection and diagnosis of various diseases in different imaging modalities, including the differential diagnosis of lung nodules and interstitial lung diseases in chest radiography, CT, and position emission tomography/CT. It is likely that CAD will be integrated into picture archiving and

  16. Technology for enhancing chest auscultation in clinical simulation.

    Science.gov (United States)

    Ward, Jeffrey J; Wattier, Bryan A

    2011-06-01

    The ability to use an acoustic stethoscope to detect lung and/or heart sounds, and then to then communicate one's interpretation of those sounds is an essential skill for many medical professionals. Interpretation of lung and heart sounds, in the context of history and other examination findings, often aids the differential diagnosis. Bedside assessment of changing auscultation findings may also guide treatment. Learning lung and heart auscultation skills typically involves listening to pre-recorded normal and adventitious sounds, often followed by laboratory instruction to guide stethoscope placement, and finally correlating the sounds with the associated pathophysiology and pathology. Recently, medical simulation has become an important tool for teaching prior to clinical practice, and for evaluating bedside auscultation skills. When simulating cardiovascular or pulmonary problems, high-quality lung and heart sounds should be able to accurately corroborate other findings such as vital signs, arterial blood gas values, or imaging. Digital audio technology, the Internet, and high-fidelity simulators have increased opportunities for educators and learners. We review the application of these technologies and describe options for reproducing lung and heart sounds, as well as their advantages and potential limitations.

  17. Accuracy of clinical tests in the diagnosis of anterior cruciate ligament injury: A systematic review

    NARCIS (Netherlands)

    M.S. Swain (Michael S.); N. Henschke (Nicholas); S.J. Kamper (Steven); A.S. Downie (Aron S.); B.W. Koes (Bart); C. Maher (Chris)

    2014-01-01

    textabstractBackground: Numerous clinical tests are used in the diagnosis of anterior cruciate ligament (ACL) injury but their accuracy is unclear. The purpose of this study is to evaluate the diagnostic accuracy of clinical tests for the diagnosis of ACL injury.Methods: Study Design: Systematic

  18. MERRF Classification: Implications for Diagnosis and Clinical Trials.

    Science.gov (United States)

    Finsterer, Josef; Zarrouk-Mahjoub, Sinda; Shoffner, John M

    2018-03-01

    Given the etiologic heterogeneity of disease classification using clinical phenomenology, we employed contemporary criteria to classify variants associated with myoclonic epilepsy with ragged-red fibers (MERRF) syndrome and to assess the strength of evidence of gene-disease associations. Standardized approaches are used to clarify the definition of MERRF, which is essential for patient diagnosis, patient classification, and clinical trial design. Systematic literature and database search with application of standardized assessment of gene-disease relationships using modified Smith criteria and of variants reported to be associated with MERRF using modified Yarham criteria. Review of available evidence supports a gene-disease association for two MT-tRNAs and for POLG. Using modified Smith criteria, definitive evidence of a MERRF gene-disease association is identified for MT-TK. Strong gene-disease evidence is present for MT-TL1 and POLG. Functional assays that directly associate variants with oxidative phosphorylation impairment were critical to mtDNA variant classification. In silico analysis was of limited utility to the assessment of individual MT-tRNA variants. With the use of contemporary classification criteria, several mtDNA variants previously reported as pathogenic or possibly pathogenic are reclassified as neutral variants. MERRF is primarily an MT-TK disease, with pathogenic variants in this gene accounting for ~90% of MERRF patients. Although MERRF is phenotypically and genotypically heterogeneous, myoclonic epilepsy is the clinical feature that distinguishes MERRF from other categories of mitochondrial disorders. Given its low frequency in mitochondrial disorders, myoclonic epilepsy is not explained simply by an impairment of cellular energetics. Although MERRF phenocopies can occur in other genes, additional data are needed to establish a MERRF disease-gene association. This approach to MERRF emphasizes standardized classification rather than clinical

  19. Clinical features and differential diagnosis of type 2 diabetes mellitus in children

    Directory of Open Access Journals (Sweden)

    Tamara Leonidovna Kuraeva

    2009-09-01

    Full Text Available This review was designed to evaluate prevalence, specific clinical features, and differential diagnosis of type 2 diabetes mellitus (DM2 in childrenand adolescents. Special emphasis is laid on the importance of immunological and molecular-genetic studies for the verification of diagnosis and activecase detection in h groups.

  20. Artificial intelligence techniques used in respiratory sound analysis--a systematic review.

    Science.gov (United States)

    Palaniappan, Rajkumar; Sundaraj, Kenneth; Sundaraj, Sebastian

    2014-02-01

    Artificial intelligence (AI) has recently been established as an alternative method to many conventional methods. The implementation of AI techniques for respiratory sound analysis can assist medical professionals in the diagnosis of lung pathologies. This article highlights the importance of AI techniques in the implementation of computer-based respiratory sound analysis. Articles on computer-based respiratory sound analysis using AI techniques were identified by searches conducted on various electronic resources, such as the IEEE, Springer, Elsevier, PubMed, and ACM digital library databases. Brief descriptions of the types of respiratory sounds and their respective characteristics are provided. We then analyzed each of the previous studies to determine the specific respiratory sounds/pathology analyzed, the number of subjects, the signal processing method used, the AI techniques used, and the performance of the AI technique used in the analysis of respiratory sounds. A detailed description of each of these studies is provided. In conclusion, this article provides recommendations for further advancements in respiratory sound analysis.

  1. Cancer diagnosis program

    International Nuclear Information System (INIS)

    Hackett, A.J.; Smith, H.S.; Sartorius, O.W.; Snow, L.; Stampfer, M.R.

    1981-01-01

    The Peralta Cancer Research Institute has organized the Breast Diagnostic Center (BDC) to make available to women information about the breast, and to conduct clinical research to improve methods for early diagnosis and treatment of breast disease. Women entering the center are educated about the anatomy and physiology of the breast, signs of both benign and malignant disease, and factors that influence the risk of developing cancer. The BDC program proposes to demonstrate that the combined use of various diagnostic modalities, when each modality is used at maximum potential, can detect cancers at an earlier stage. Emphasis is placed on the physical examination, using nipple aspiration cytology, contrast ductography, fine-needle aspirations, and mammography. With the financial participation of the Clorox Company, it is shown that the concept of the BDC is economically sound and fills a need in the community

  2. Foley Sounds vs Real Sounds

    DEFF Research Database (Denmark)

    Trento, Stefano; Götzen, Amalia De

    2011-01-01

    This paper is an initial attempt to study the world of sound effects for motion pictures, also known as Foley sounds. Throughout several audio and audio-video tests we have compared both Foley and real sounds originated by an identical action. The main purpose was to evaluate if sound effects...

  3. Synthesis of vibroarthrographic signals in knee osteoarthritis diagnosis training.

    Science.gov (United States)

    Shieh, Chin-Shiuh; Tseng, Chin-Dar; Chang, Li-Yun; Lin, Wei-Chun; Wu, Li-Fu; Wang, Hung-Yu; Chao, Pei-Ju; Chiu, Chien-Liang; Lee, Tsair-Fwu

    2016-07-19

    Vibroarthrographic (VAG) signals are used as useful indicators of knee osteoarthritis (OA) status. The objective was to build a template database of knee crepitus sounds. Internships can practice in the template database to shorten the time of training for diagnosis of OA. A knee sound signal was obtained using an innovative stethoscope device with a goniometer. Each knee sound signal was recorded with a Kellgren-Lawrence (KL) grade. The sound signal was segmented according to the goniometer data. The signal was Fourier transformed on the correlated frequency segment. An inverse Fourier transform was performed to obtain the time-domain signal. Haar wavelet transform was then done. The median and mean of the wavelet coefficients were chosen to inverse transform the synthesized signal in each KL category. The quality of the synthesized signal was assessed by a clinician. The sample signals were evaluated using different algorithms (median and mean). The accuracy rate of the median coefficient algorithm (93 %) was better than the mean coefficient algorithm (88 %) for cross-validation by a clinician using synthesis of VAG. The artificial signal we synthesized has the potential to build a learning system for medical students, internships and para-medical personnel for the diagnosis of OA. Therefore, our method provides a feasible way to evaluate crepitus sounds that may assist in the diagnosis of knee OA.

  4. 78 FR 13869 - Puget Sound Energy, Inc.; Puget Sound Energy, Inc.; Puget Sound Energy, Inc.; Puget Sound Energy...

    Science.gov (United States)

    2013-03-01

    ...-123-LNG; 12-128-NG; 12-148-NG; 12- 158-NG] Puget Sound Energy, Inc.; Puget Sound Energy, Inc.; Puget Sound Energy, Inc.; Puget Sound Energy, Inc.; Puget Sound Energy, Inc.; CE FLNG, LLC; Consolidated...-NG Puget Sound Energy, Inc Order granting long- term authority to import/export natural gas from/to...

  5. Diagnosis of clinical samples spotted on FTA cards using PCR-based methods.

    Science.gov (United States)

    Jamjoom, Manal; Sultan, Amal H

    2009-04-01

    The broad clinical presentation of Leishmaniasis makes the diagnosis of current and past cases of this disease rather difficult. Differential diagnosis is important because diseases caused by other aetiologies and a clinical spectrum similar to that of leishmaniasis (e.g. leprosy, skin cancers and tuberculosis for CL; malaria and schistosomiasis for VL) are often present in endemic areas of endemicity. Presently, a variety of methods have been developed and tested to aid the identification and diagnosis of Leishmania. The advent of the PCR technology has opened new channels for the diagnosis of leishmaniasis in a variety of clinical materials. PCR is a simple, rapid procedure that has been adapted for diagnosis of leishmaniasis. A range of tools is currently available for the diagnosis and identification of leishmaniasis and Leishmania species, respectively. However, none of these diagnostic tools are examined and tested using samples spotted on FTA cards. Three different PCR-based approaches were examined including: kDNA minicircle, Leishmania 18S rRNA gene and PCR-RFLP of Intergenic region of ribosomal protein. PCR primers were designed that sit within the coding sequences of genes (relatively well conserved) but which amplify across the intervening intergenic sequence (relatively variable). These were used in PCR-RFLP on reference isolates of 10 of the most important Leishmania species: L. donovani, L. infantum, L. major & L. tropica. Digestion of PCR products with restriction enzymes produced species-specific restriction patterns allowed discrimination of reference isolates. The kDNA minicircle primers are highly sensitive in diagnosis of both bone marrow and skin smears from FTA cards. Leishmania 18S rRNA gene conserved region is sensitive in identification of bone marrow smear but less sensitive in diagnosing skin smears. The intergenic nested PCR-RFLP using P5 & P6 as well as P1 & P2 newly designed primers showed high level of reproducibility and sensitivity

  6. Clinical diagnosis of uncomplicated malaria in Sri Lanka.

    Science.gov (United States)

    van der Hoek, W; Premasiri, D A; Wickremasinghe, A R

    1998-06-01

    To assess the possibility of developing a protocol for the clinical diagnosis of malaria, a study was done at the regional laboratory of the Anti-Malaria Campaign in Puttalam, Sri Lanka. Of a group of 502 patients, who suspected they were suffering from malaria, 97 had a positive blood film for malaria parasites (71 Plasmodium vivax and 26 P. falciparum). There were no important differences in signs and symptoms between those with positive and those with negative blood films. It is argued that it is unlikely that health workers can improve on the diagnosis of malaria made by the patients themselves, if laboratory facilities are not available. For Sri Lanka the best option is to expand the number of facilities where microscopic examination for malaria parasites can take place.

  7. [Familial Mediterranean fever - clinical picture, diagnosis and treatment].

    Science.gov (United States)

    Dallos, Tomáš; Ilenčíková, Denisa; Kovács, László

    2014-01-01

    Familial mediterranean fever (FMF) is the most prevalent genetically determined autoinflammatory disease. FMF significantly decreases the quality of life and limits life expectancy due to the development of amyloidosis in affected individuals. Prevalence of FMF is highest in the south-eastern Mediterraneans. In other parts of the world, its occurance is often restricted to high-risk ethnic goups. In Central Europe, experience with FMF is scarse. As for Slovakia, we have reported the first cases of FMF in ethnic Slovaks only recently. Along with their complicated fates, this has lead us to compile a comprehensive overview of the clinical picture, diagnosis and treatment of this elusive disease. Hereby we hope to be able to promote the awareness about this disease and possibly aid the diagnosis in new patients.

  8. Source Separation of Heartbeat Sounds for Effective E-Auscultation

    Science.gov (United States)

    Geethu, R. S.; Krishnakumar, M.; Pramod, K. V.; George, Sudhish N.

    2016-03-01

    This paper proposes a cost effective solution for improving the effectiveness of e-auscultation. Auscultation is the most difficult skill for a doctor, since it can be acquired only through experience. The heart sound mixtures are captured by placing the four numbers of sensors at appropriate auscultation area in the body. These sound mixtures are separated to its relevant components by a statistical method independent component analysis. The separated heartbeat sounds can be further processed or can be stored for future reference. This idea can be used for making a low cost, easy to use portable instrument which will be beneficial to people living in remote areas and are unable to take the advantage of advanced diagnosis methods.

  9. PSORIATIC ARTHRITIS: CLASSIFICATION, CLINICAL PRESENTATION, DIAGNOSIS, TREATMENT

    Directory of Open Access Journals (Sweden)

    T. V. Korotaev

    2018-01-01

    Full Text Available soriatic arthritis (PsA is a chronic inflammatory disease of the joints, spine and entheses from a group of spondyloarthritis (SpA, which is usually observed in patients with psoriasis (Ps. The diagnosis of PsA is based on the CASPAR criteria for psoriatic arthritis. The disease results from interactions between genetic, immunological and environmental factors. The main clinical manifestations of PsA include peripheral arthritis, enthesitis, dactylitis, and spondylitis. PsA must be differentiated from rheumatoid arthritis, gout, reactive arthritis, osteoarthritis, and ankylosing spondylitis. Due to the fact that PsA is a clinically heterogeneous disease, its activity is assessed using complex indices, by taking into account that the patient has arthritis, enthesitis, dactylitis, and spondylitis. The goal of treatment for PsA is to achieve remission or minimal activity of the main clinical manifestations of the disease, to slow down or prevent radiographic progression, to increase life expectancy and quality of life in the patients, and to reduce the risk of comorbidities, which is achieved through a wide range of drugs of different classes. Therapy should be chosen based on the clinical manifestations of PsA and comorbidities in the patients. 

  10. Diagnosis of depression in children and adolescents. Clinical pointers to a difficult diagnosis.

    Science.gov (United States)

    2010-04-01

    It is now accepted that depression can also affect children and adolescents, but its diagnosis is not straightforward. We examined review articles published on this subject over the last 15 years by large specialist groups and multidisciplinary teams. Most studies of symptoms of psychological distress and depression in children are mainly based on clinical experience of specialists and therefore provide only modest evidence. Isolated, transient unhappiness is not in itself a symptom of depression, but recurrent and persistent mood disorders constitute important warning signs. A French consensus jury recommended attentive listening to potentially depressed children, and those closest to them, focusing on phrases that might reflect a loss of interest, enjoyment, self-esteem and self-confidence; feelings of guilt, shame, loss of affection and hope; and morbid or suicidal ideas. British clinical practice guidelines recommend evaluating the severity of a depressive episode on the basis of the type and number of symptoms, and the family context. Scores designed to diagnose depression and assess its severity are controversial. In practice, diagnosis of depression in children and adolescents with persistent psychological distress is not based on a simple list of symptoms. In difficult cases, it is better to adopt a multidisciplinary approach in order to gauge severity and to determine the most appropriate treatment, which, in most cases, does not involve the use of drugs.

  11. Pyogenic sacroiliitis: diagnosis, management and clinical outcome

    Energy Technology Data Exchange (ETDEWEB)

    Kucera, Tomas; Sponer, Pavel [Charles University in Prague, Faculty of Medicine and University Hospital in Hradec Kralove, Department of Orthopaedic Surgery, Hradec Kralove (Czech Republic); Brtkova, Jindra [Charles University in Prague, Faculty of Medicine and University Hospital in Hradec Kralove, Department of Diagnostic Radiology, Hradec Kralove (Czech Republic); Ryskova, Lenka [Charles University in Prague, Faculty of Medicine and University Hospital in Hradec Kralove, Department of Clinical Microbiology, Hradec Kralove (Czech Republic); Popper, Eduard [Charles University in Prague, Faculty of Medicine and University Hospital in Hradec Kralove, Department of Rehabilitation, Hradec Kralove (Czech Republic); Frank, Martin [Charles University in Prague, Faculty of Medicine and University Hospital in Hradec Kralove, Department of Surgery, Hradec Kralove (Czech Republic); Kucerova, Marie [Regional Hospital in Pardubice, Department of Neurosurgery, Hradec Kralove (Czech Republic)

    2015-01-15

    The purpose of the present study was to evaluate the role of diagnostic tools and management options for patients with pyogenic sacroiliitis, including potential complications. This retrospective study included 16 patients with pyogenic sacroiliitis who were admitted to a single orthopaedic centre between 2007 and 2012. The following data were collected: demographics, history, radiography, magnetic resonance images (MRI), biological data, type of pathogenic agent, abscess formation, type of management, and clinical outcome. Our study demonstrated that only one-fifth of the patients with lumbogluteal or hip pain had established diagnoses of suspected pyogenic sacroiliitis upon admission. MRIs confirmed this diagnosis in all cases. MRI examinations revealed joint fluid in the sacroiliac joint and significant oedema of the adjacent bone and soft tissues. In 12 of the 16 cases, erosions of the subchondral bone were encountered. Contrast-enhanced MRI revealed that 9 patients had abscesses. All patients received antibiotic therapy. Antibiotic treatment was only successful in 9 cases. The other 7 patients underwent computed tomography (CT)-guided abscess drainage. Drainage was sufficient for 4 patients, but 3 patients required open surgery. One patient required sacroiliac arthrodesis. The clinical outcomes included minimal disability (n = 10), moderate disability (n = 5), and full disability (n = 1) of the spine. Contrast-enhanced MRI is mandatory for a reliable diagnosis. Abscess formation was observed in approximately half of the MRI-diagnosed sacroiliitis cases and required minimally invasive drainage under CT guidance or frequently open surgery. (orig.)

  12. Pyogenic sacroiliitis: diagnosis, management and clinical outcome

    International Nuclear Information System (INIS)

    Kucera, Tomas; Sponer, Pavel; Brtkova, Jindra; Ryskova, Lenka; Popper, Eduard; Frank, Martin; Kucerova, Marie

    2015-01-01

    The purpose of the present study was to evaluate the role of diagnostic tools and management options for patients with pyogenic sacroiliitis, including potential complications. This retrospective study included 16 patients with pyogenic sacroiliitis who were admitted to a single orthopaedic centre between 2007 and 2012. The following data were collected: demographics, history, radiography, magnetic resonance images (MRI), biological data, type of pathogenic agent, abscess formation, type of management, and clinical outcome. Our study demonstrated that only one-fifth of the patients with lumbogluteal or hip pain had established diagnoses of suspected pyogenic sacroiliitis upon admission. MRIs confirmed this diagnosis in all cases. MRI examinations revealed joint fluid in the sacroiliac joint and significant oedema of the adjacent bone and soft tissues. In 12 of the 16 cases, erosions of the subchondral bone were encountered. Contrast-enhanced MRI revealed that 9 patients had abscesses. All patients received antibiotic therapy. Antibiotic treatment was only successful in 9 cases. The other 7 patients underwent computed tomography (CT)-guided abscess drainage. Drainage was sufficient for 4 patients, but 3 patients required open surgery. One patient required sacroiliac arthrodesis. The clinical outcomes included minimal disability (n = 10), moderate disability (n = 5), and full disability (n = 1) of the spine. Contrast-enhanced MRI is mandatory for a reliable diagnosis. Abscess formation was observed in approximately half of the MRI-diagnosed sacroiliitis cases and required minimally invasive drainage under CT guidance or frequently open surgery. (orig.)

  13. The clinical application of lymphoscintigraphy for the diagnosis in hematological diseases

    International Nuclear Information System (INIS)

    Zhu Jun; Zhu Ruisen; Zhu Jifang; Jin Changqing; Yu Jianfang

    2000-01-01

    Results of lymphoscintigraphy in 78 patients with clinically suspected malignant lymphoma and leukemia were reported and its clinical value for in diagnosis of hematological diseases were evaluated. Confirmed by pathological examination, 30 cases were diagnosed as malignant lymphoma and 24 cases non-malignant lymphoma. In malignant lymphoma, the sensitivity of lymphoscintigraphy was 83.3% and the specificity 62.5%, where the sensitivity of CT and ultrasound, were 83.3%, 66.7% and 22.2% respectively. Confirmed by bone marrow biopsy, leukemia was found in 9 cases and non-leukemia in 15. In leukemia, the sensitivity of lymphoscintigraphy was 88.9% and specificity 53.3%. Whereas the sensitivity of CT, was 50%. Therefore, the lymphoscintigraphy have comparatively high sensitivity for the diagnosis of malignant lymphoma and leukemia

  14. Clinical application of antenatal genetic diagnosis of osteogenesis imperfecta type IV.

    Science.gov (United States)

    Yuan, Jing; Li, Song; Xu, YeYe; Cong, Lin

    2015-04-02

    Clinical analysis and genetic testing of a family with osteogenesis imperfecta type IV were conducted, aiming to discuss antenatal genetic diagnosis of osteogenesis imperfecta type IV. Preliminary genotyping was performed based on clinical characteristics of the family members and then high-throughput sequencing was applied to rapidly and accurately detect the changes in candidate genes. Genetic testing of the III5 fetus and other family members revealed missense mutation in c.2746G>A, pGly916Arg in COL1A2 gene coding region and missense and synonymous mutation in COL1A1 gene coding region. Application of antenatal genetic diagnosis provides fast and accurate genetic counseling and eugenics suggestions for patients with osteogenesis imperfecta type IV and their families.

  15. Diagnostic accuracy of the defining characteristics of the excessive fluid volume diagnosis in hemodialysis patients

    Directory of Open Access Journals (Sweden)

    Maria Isabel da Conceição Dias Fernandes

    2015-12-01

    Full Text Available Objective: to evaluate the accuracy of the defining characteristics of the excess fluid volume nursing diagnosis of NANDA International, in patients undergoing hemodialysis. Method: this was a study of diagnostic accuracy, with a cross-sectional design, performed in two stages. The first, involving 100 patients from a dialysis clinic and a university hospital in northeastern Brazil, investigated the presence and absence of the defining characteristics of excess fluid volume. In the second step, these characteristics were evaluated by diagnostic nurses, who judged the presence or absence of the diagnosis. To analyze the measures of accuracy, sensitivity, specificity, and positive and negative predictive values were calculated. Approval was given by the Research Ethics Committee under authorization No. 148.428. Results: the most sensitive indicator was edema and most specific were pulmonary congestion, adventitious breath sounds and restlessness. Conclusion: the more accurate defining characteristics, considered valid for the diagnostic inference of excess fluid volume in patients undergoing hemodialysis were edema, pulmonary congestion, adventitious breath sounds and restlessness. Thus, in the presence of these, the nurse may safely assume the presence of the diagnosis studied.

  16. Personalized Clinical Diagnosis in Data Bases for Treatment Support in Phthisiology.

    Science.gov (United States)

    Lugovkina, T K; Skornyakov, S N; Golubev, D N; Egorov, E A; Medvinsky, I D

    2016-01-01

    The decision-making is a key event in the clinical practice. The program products with clinical decision support models in electronic data-base as well as with fixed decision moments of the real clinical practice and treatment results are very actual instruments for improving phthisiological practice and may be useful in the severe cases caused by the resistant strains of Mycobacterium tuberculosis. The methodology for gathering and structuring of useful information (critical clinical signals for decisions) is described. Additional coding of clinical diagnosis characteristics was implemented for numeric reflection of the personal situations. The created methodology for systematization and coding Clinical Events allowed to improve the clinical decision models for better clinical results.

  17. Clinical Value of Treponema pallidum Real-Time PCR for Diagnosis of Syphilis

    NARCIS (Netherlands)

    Heymans, R.; van der Helm, J. J.; de Vries, H. J. C.; Fennema, H. S. A.; Coutinho, R. A.; Bruisten, S. M.

    2010-01-01

    The diagnosis of syphilis can be complicated when it is based on diverse clinical manifestations, dark-field microscopy, and serology. In the present study, therefore, we examined the additional clinical value of a Treponema pallidum real-time TaqMan PCR for the detection of primary and secondary

  18. Fibroadenoma: Accuracy of clinical diagnosis in females aged 25 ...

    African Journals Online (AJOL)

    In this group, a clinical diagnosis of fibroadenoma was made in 100 (69.0%), fibrocystic disease in 32 (22.1%), breast cancer in 4 (0.03%) patients, the remaining were benign lesions. Excision biopsy was done for 81 (55.9%) patients. Of these 81 patients, only 62 (76.5%) returned with histology report. The histological ...

  19. A Study on the Clinical Diagnosis of Hyperthyroidism

    International Nuclear Information System (INIS)

    Ku, In Soo; Koh, Chang Soon; Lee, Mun Ho

    1973-01-01

    To attain a simple and reliable method of evaluating the thyroid function the reliability of the clinical manifestation and the conventional thyroid function tests in diagnosing the hyperthyroidism was studied. The subjects included 184 patients with hyperthyroidism and 66 cases with euthyroidism, who were treated at the Thyroid Clinic, Seoul National University Hospital, from July 1971 through August 1972. The observed results were as follows: l. In the cases of hyperthyroidism, 19% of the patients were male and 81% female; in the cases of euthyroidism, 7. 6% of the patients were male and 92. 4% female. The majority of the patients were in 2nd to 4th decades of their lives. 2. There were objective signs clearly manifested in hyperthyroidism which were rare or absent in the euthyroid state. These clinical signs included wide pulse pressure, tachycardia, systolic murmur, exophthalmos, tremor, and warm skin. In the hyperthyroid state 91. 3% of the cases manifested two or more of the above signs, whereas in the euthyroid state no patients manifested any two of the above signs. 3. The most frequent complaints of the patients with thyroid disease were palpitation, weight low, increased appetite, heat intolerance, perspiration, hunger feeling; nervousness, exertional dyapnea, etc. There was no clear difference in the incidence of the symptoms between hyperthyroidism and euthyroidism. 4. In the diagnosis of hyperthyroidism, the reliability of thyroid function tests was as follows: T 7 was 92. 4% reliable, 125 IT 3 resin uptake rate 91. 6% reliable, 131 I thyroid uptake rate in 24 hrs. 89. 4% reliable, serum T 4 level 85. 9% reliable and BMR 75. 5% reliable. Therefore the careful observation of the clinical manifestation of the disease is a simple and reliable way of making a correct diagnosis of either hyperthyroidism or euthymidism. 5. In hyperthyroidism there shows no correlationship between the results of the thyroid function test and clinical signs but a high BMR was

  20. A Study on the Clinical Diagnosis of Hyperthyroidism

    Energy Technology Data Exchange (ETDEWEB)

    Ku, In Soo; Koh, Chang Soon; Lee, Mun Ho [Seoul National University College of Medicine, Seoul (Korea, Republic of)

    1973-03-15

    To attain a simple and reliable method of evaluating the thyroid function the reliability of the clinical manifestation and the conventional thyroid function tests in diagnosing the hyperthyroidism was studied. The subjects included 184 patients with hyperthyroidism and 66 cases with euthyroidism, who were treated at the Thyroid Clinic, Seoul National University Hospital, from July 1971 through August 1972. The observed results were as follows: l. In the cases of hyperthyroidism, 19% of the patients were male and 81% female; in the cases of euthyroidism, 7. 6% of the patients were male and 92. 4% female. The majority of the patients were in 2nd to 4th decades of their lives. 2. There were objective signs clearly manifested in hyperthyroidism which were rare or absent in the euthyroid state. These clinical signs included wide pulse pressure, tachycardia, systolic murmur, exophthalmos, tremor, and warm skin. In the hyperthyroid state 91. 3% of the cases manifested two or more of the above signs, whereas in the euthyroid state no patients manifested any two of the above signs. 3. The most frequent complaints of the patients with thyroid disease were palpitation, weight low, increased appetite, heat intolerance, perspiration, hunger feeling; nervousness, exertional dyapnea, etc. There was no clear difference in the incidence of the symptoms between hyperthyroidism and euthyroidism. 4. In the diagnosis of hyperthyroidism, the reliability of thyroid function tests was as follows: T{sub 7} was 92. 4% reliable, {sup 125}IT{sub 3} resin uptake rate 91. 6% reliable, {sup 131}I thyroid uptake rate in 24 hrs. 89. 4% reliable, serum T{sub 4} level 85. 9% reliable and BMR 75. 5% reliable. Therefore the careful observation of the clinical manifestation of the disease is a simple and reliable way of making a correct diagnosis of either hyperthyroidism or euthymidism. 5. In hyperthyroidism there shows no correlationship between the results of the thyroid function test and clinical

  1. The validity of clinical findings for diagnosing temporomandibular disorders in patients from different age and gender groups

    International Nuclear Information System (INIS)

    Igarashi, Chinami

    2008-01-01

    This study was to clarify the diagnostic accuracy of clinical findings for internal derangement of the temporomandibular joint (TMJ) compared with that of magnetic resonance imaging. A series of 4559 patients (879 male and 3680 female, mean age 32.7 years; range 8-85 years;) with temporomandibular disorders were clinically examined by un unspecified number of dentists. All patients underwent magnetic resonance imaging (MRI). The clinical findings that characterize disc displacement, anterior disc displacement with reduction (ADDwR) and anterior disc displacement without reduction (ADDwoR) are pain, clicking sound and limitation of maximum mouth opening. These clinical findings were compared to the MRI interpretation, which was used as the gold standard for diagnosis of temporomandibular disorders to define the diagnostic accuracy, specificity, sensitivity, positive predictive value and negative predictive value of clinical findings. The prevalence of clinical finding was 3990 joints (43%) with pain, 2775 joints (30%) with clicking sound and 1731 patients (38%) with limitation of opening. Three thousands forty seven joints were diagnosed as having a normal disc position, 510 joints with sideways disc displacement, 2312 joints with ADDwR, 3239 joints with ADDwoR on MR image. The sensitivity of clinical findings was considerably low: sensitivity was 0.48 for pain versus internal derangement, 0.51 for clicking sound versus ADDwR, 0.62 for limitation of opening versus ADDwoR. The sensitivity was higher in the younger group for clicking sound versus ADDwR, but sensitivity was higher in the older group for limitation of opening versus ADDwoR. The diagnostic accuracy based on clinical findings of internal derangement of TMJ was found to be correlated with age. This study has been that the overall diagnostic accuracy of the clinical findings to determine the status of the joint is about 50-60%. The status of the joint could not be accurately determined by clinical findings

  2. Added Diagnostic Value of 11C-PiB-PET in Memory Clinic Patients with Uncertain Diagnosis

    Directory of Open Access Journals (Sweden)

    K.S. Frederiksen

    2012-12-01

    Full Text Available Introduction: The added diagnostic value of 11C-PiB-PET for the assessment of the accumulation of cortical beta-amyloid in memory clinic patients with uncertain diagnosis remains undetermined. Methods: All patients who underwent PiB-PET at the Copenhagen Memory Clinic between March 2008 and November 2011 were included in this uncontrolled, retrospective study. The standard diagnostic evaluation program included physical and neurological examination, cognitive and functional assessment, a cranial CT or MRI, functional imaging and cerebrospinal fluid sampling. Based on anonymized case reports, three experienced clinicians reached a consensus diagnosis and rated their confidence in the diagnosis before and after disclosure of PiB-PET ratings. PiB-PET scans were rated as either positive or negative. Results: A total of 57 patients (17 females, 30 males; age 65.7 years, range 44.2–82.6 were included in the study. Twenty-seven had a positive PiB-PET scan. At the first diagnostic evaluation, 16 patients were given a clinical Alheimer’s disease diagnosis (14 PiB positive. Of the 57 patients, 13 (23% were diagnostically reclassified after PiB-PET ratings were disclosed. The clinicians’ overall confidence in their diagnosis increased in 28 (49% patients. Conclusion: PiB-PET adds to the specialist clinical evaluation and other supplemental diagnostic investigations in the diagnostic classification of patients with uncertain diagnosis in a specialized memory clinic.

  3. Early diagnosis of amyotrophic lateral sclerosis mimic syndromes: pros and cons of current clinical diagnostic criteria.

    Science.gov (United States)

    Cortés-Vicente, Elena; Pradas, Jesús; Marín-Lahoz, Juan; De Luna, Noemi; Clarimón, Jordi; Turon-Sans, Janina; Gelpí, Ellen; Díaz-Manera, Jordi; Illa, Isabel; Rojas-Garcia, Ricard

    2017-08-01

    To describe the frequency and clinical characteristics of patients referred to a tertiary neuromuscular clinic as having amyotrophic lateral sclerosis (ALS) but who were re-diagnosed as having an ALS mimic syndrome, and to identify the reasons that led to the revision of the diagnosis. We reviewed the final diagnosis of all patients prospectively registered in the Sant Pau-MND register from 1 January 2004 to 31 December 2015. A detailed clinical evaluation and a clinically-guided electrophysiological study were performed at first evaluation. Twenty of 314 (6.4%) patients included were re-diagnosed as having a condition other than ALS, in 18 cases already at first evaluation. An alternative specific diagnosis was identified in 17 of those 20, consisting of a wide range of conditions. The main finding leading to an alternative diagnosis was the result of the electrophysiological study. Fifty per cent did not fulfil the El Escorial revised criteria (EECr) for ALS. The most common clinical phenotype at onset in patients with ALS mimic syndromes was progressive muscular atrophy (PMA). Misdiagnosing ALS is still a common problem. Early identification of ALS mimic syndromes is possible based on atypical clinical features and a clinically-guided electrophysiological study. Patients should be attended in specialised centres. The application of EECr helps to identify ALS misdiagnoses.

  4. Dactylitis in psoriatic arthritis: clinical features, diagnosis, immunopathogenesis, and treatment

    Directory of Open Access Journals (Sweden)

    T. V. Korotaeva

    2018-01-01

    Full Text Available When dactylitis is detected in a patient with psoriatic arthritis (PsA, it is necessary to use active treatment as soon as possible, since in the absence of therapy the disease progresses to joint erosion and  functional disorders. The paper considers the clinical signs and  diagnosis of PsA and notes the importance of differential diagnosis in this sign with other joint inflammatory diseases. It points to the  necessity of elaborating common approaches to an objective  assessment of the severity of dactylitis. Its immunopathogenesis and main treatment areas, including the use of biological agents (BAs,  are detailed. There are data of clinical trials that have evaluated the  efficiency of treatment for dactylitis and established that in most  cases, the use of BAs considerably reduce not only the severity of its clinical signs, but also concomitant bone marrow edema. It is noted  that the development of new pathogenetic treatments targeting a number of currently established biologically active molecules that  play an important role in the pathogenesis of dactylitis will enhance  the efficiency of treatment in patients with PsA.

  5. Early diagnosis of autism spectrum disorder: stability and change in clinical diagnosis and symptom presentation.

    Science.gov (United States)

    Guthrie, Whitney; Swineford, Lauren B; Nottke, Charly; Wetherby, Amy M

    2013-05-01

    Although a diagnosis of autism spectrum disorder (ASD) appears to be stable in children as young as age three, few studies have explored stability of a diagnosis in younger children. Predictive value of diagnostic tools for toddlers and patterns of symptom change are important considerations for clinicians making early diagnoses. Most findings come from high-risk samples, but reports on children screened in community settings are also needed. Stability of diagnosis and Autism Diagnostic Observation Schedule – Toddler Module (ADOS-T) classifications and scores was examined across two time points in a sample of 82 children identified through the FIRST WORDS Project.Children received two comprehensive diagnostic evaluations at average ages of 19.39 (SD = 2.12) and 36.89 (SD = 3.85) months. Stability was 100% when confirming and ruling out a diagnosis of ASD based on a comprehensive diagnostic evaluation that included clinic and home observations,although diagnosis was initially deferred for 17% of the sample. Receiver Operating Characteristic curves revealed excellent sensitivity and acceptable specificity for the ADOS-T compared to concurrent diagnosis. Logistic regressions indicated good predictive value of initial ADOS-T scores for follow-up diagnosis. Finally, both ASD and Non-ASD children demonstrated a decrease in Social Affect scores (i.e.,improvement), whereas children with ASD demonstrated an increase in Restricted and Repetitive Behavior scores (i.e., worsening), changes that were accounted for by nonverbal developmental level in mixed model analyses. Short-term stability was documented for children diagnosed at 19 months on average, although a minority of children initially showed unclear diagnostic presentations.Findings highlight utility of the ADOS-T in making early diagnoses and predicting follow-up diagnoses. Children with ASD demonstrated improvement in social communication behaviors and unfolding of repetitive behaviors, suggesting that certain

  6. Novel electrophysiological approaches to clinical epilepsy. Diagnosis and treatment

    International Nuclear Information System (INIS)

    Kanazawa, Kyoko; Matsumoto, Riki; Ikeda, Akio; Kinoshita, Masako

    2011-01-01

    Seizure onset zone (SOZ) is currently defined by ictal epileptiform discharges, which are most commonly recorded as regional low-voltage fast waves or repetitive spikes. Interictal epileptiform discharges, on the other hand, are not specific enough for SOZ as they are recorded at zones other than the SOZ; they are also recorded from areas that do not generate the ictal pattern and from areas to which ictal discharges propagate. Besides spikes and sharp waves, a novel index of human epileptogenicity has been investigated in association with wide-band electroencephalography (EEG) analysis. We primarily noted the following during clinical neurophysiological analysis for clinical epilepsy. Recent development of digital EEG technology enabled us to record wide-band EEG in a clinical setting. Thus, high frequency (>200 Hz) and low frequency (<1 Hz) components can be reliably recorded using subdural electrodes. Direct current shift, slow shift, ripple, and fast ripple can be well delineated, and they will be potentially useful in the diagnosis and management of epileptic patients. Fiber tractography (morphological parameter) and cortico-cortical-evoked potentials with single cortical stimulation (electrophysiological parameter) elucidated cortico-cortical connections in human brain. The data thus obtained can help us understand the mechanism of seizure propagation and normal cortical functional connectivity. Non-invasive simultaneous recording of EEG and functional magnetic resonance imaging (fMRI) provided information on the roles of deep brain structures associated with scalp-recorded epileptiform discharges. Interventional neurophysiology can shed light on the non-pharmacological treatment of epilepsy. In this report, we discuss these novel electrophysiological approaches to the diagnosis and treatment of clinical epilepsy. (author)

  7. Clinical and radiological diagnosis of chronic pneumonia in pneumoconiosis and dust bronchitis

    International Nuclear Information System (INIS)

    Shniger, N.U.; Blokhina, L.M.

    1983-01-01

    Clinical and radiologic symptomatology of chronic pneumonia is described for pneumoconiosis and chronic dust bronchitis. Combined X-ray methods of examination permit the physicians to discover this complication in dust diseases of the lungs in the presence of diffuse pneumosclerotic changes in 76.5+-3 % of cases. These data approach the values of chronic pneumonia incidence among the population. Chronic pneumonia diagnosis should be complex. If no less than 2 to 3 X-ray signs of the disease have been found simultaneously, the significance of radiologic diagnosis of chronic pneumonia in dust pathology of the lungs, rises. Radiologic examination, supported by clinical, anamnestic and laboratory data, allows one to differentiate chronic pneumonia from coniotuberculosis. Chest X-rays in dust pathology of the lungs, complicated by chronic pneumonia, should be carried out with regard to clinical indications

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

    Directory of Open Access Journals (Sweden)

    P Corrêa-Faria

    2011-01-01

    Full Text Available Palatal radicular groove is a discreet alteration in tooth morphology, characterized by an invagination that begins near the cingulum of the tooth and moves in an apical direction. Clinically, palatal radicular groove may be associated with periodontal and/or endodontic problems. This paper describes a clinical case of a young patient with palatal radicular groove with no signs of periodontal disease or endodontic impairment. An early diagnosis was made and treatment consisted of surgical sealing of the defect. After a 2-year period, reexaminations demonstrated adequate hygiene, maintenance of tooth vitality and periodontal health. The early diagnosis and sealing of the groove observed surgically made the root surface smooth, avoiding subgingival bacterial plaque buildup, and preventing possible periodontal and/or pulp impairment stemming from the defect.

  9. Risk of incident clinical diagnosis of AD-type dementia attributable to pathology-confirmed vascular disease

    Science.gov (United States)

    Dodge, Hiroko H.; Zhu, Jian; Woltjer, Randy; Nelson, Peter T.; Bennett, David A.; Cairns, Nigel J.; Fardo, David W.; Kaye, Jeffrey A.; Lyons, Deniz-Erten; Mattek, Nora; Schneider, Julie A; Silbert, Lisa C.; Xiong, Chengjie; Yu, Lei; Schmitt, Frederick A.; Kryscio, Richard J.; Abner, Erin L.

    2016-01-01

    Introduction Presence of cerebrovascular pathology may increase the risk of clinical diagnosis of AD. Methods We examined excess risk of incident clinical diagnosis of AD (probable and possible AD) posed by the presence of lacunes and large infarcts beyond AD pathology using data from the Statistical Modelling of Aging and Risk of Transition (SMART) study, a consortium of longitudinal cohort studies with over 2000 autopsies. We created six mutually exclusive pathology patterns combining three levels of AD pathology (low, moderate or high AD pathology) and two levels of vascular pathology (without lacunes and large infarcts or with lacunes and/or large infarcts). Results The coexistence of lacunes and large infarcts results in higher likelihood of clinical diagnosis of AD only when AD pathology burden is low. Discussion Our results reinforce the diagnostic importance of AD pathology in clinical AD. Further harmonization of assessment approaches for vascular pathologies is required. PMID:28017827

  10. Hypertrophic pachymeningitis: Current criteria for diagnosis and differentiation (Clinical case and review of literature

    Directory of Open Access Journals (Sweden)

    E. G. Mendelevich

    2015-01-01

    Full Text Available The paper describes a 44-year-old male patient with an about 6-year history of hypertrophic pachymeningitis. The major clinical symptoms were characterized by headache, exophthalmos, and blindness in one eye. The data for differential diagnosis of the disease are given. The current literature on the clinical manifestations of hypertrophic pachymeningitis, its differential diagnosis, and the results of magnetic resonance imaging (MRI is reviewed. Diagnostic difficulties at the stage of a clinical observation are due to the nonspecificity of neurological manifestations and the need for a comprehensive examination to detect a somatic disease. MRI can diagnose the disease-specific phenomenon of damage to the meninges, which calls for further careful differentiation. Clinicians must be familiar with alternative differential diagnosis, as a rapid specific therapeutic approach will help avoid long-term or irreversible neurological complications.

  11. Acromegaly: clinical features at diagnosis.

    Science.gov (United States)

    Vilar, Lucio; Vilar, Clarice Freitas; Lyra, Ruy; Lyra, Raissa; Naves, Luciana A

    2017-02-01

    Acromegaly is a rare and underdiagnosed disorder caused, in more than 95% of cases, by a growth hormone (GH)-secreting pituitary adenoma. The GH hypersecretion leads to overproduction of insulin-like growth factor 1 (IGF-1) which results in a multisystem disease characterized by somatic overgrowth, multiple comorbidities, physical disfigurement, and increased mortality. This article aims to review the clinical features of acromegaly at diagnosis. Acromegaly affects both males and females equally and the average age at diagnosis ranges from 40 to 50 years (up to 5% of cases acromegaly is often diagnosed five to more than ten years after its onset. The typical coarsening of facial features include furrowing of fronthead, pronounced brow protrusion, enlargement of the nose and the ears, thickening of the lips, skin wrinkles and nasolabial folds, as well as mandibular prognathism that leads to dental malocclusion and increased interdental spacing. Excessive growth of hands and feet (predominantly due to soft tissue swelling) is present in the vast majority of acromegalic patients. Gigantism accounts for up to 5% of cases and occurs when the excess of GH becomes manifest in the young, before the epiphyseal fusion. The disease also has rheumatologic, cardiovascular, respiratory, neoplastic, neurological, and metabolic manifestations which negatively impact its prognosis and patients quality of life. Less than 15% of acromegalic patients actively seek medical attention for change in appearance or enlargement of the extremities. The presentation of acromegaly is more often related to its systemic comorbidities or to local tumor effects.

  12. Multi-centre retrospective analysis of clinical diagnosis and treatment for chronic cough

    Directory of Open Access Journals (Sweden)

    Xiao-ming CHENG

    2011-02-01

    Full Text Available Objective To explore the clinical characteristics and the present status of diagnosis and treatment of chronic cough.Methods The clinical data of 238 in-patients and out-patients of Departments of Respiratory Diseases from 4 teaching hospitals of Chongqing Municipality were collected from Oct.2008 to Dec.2009,and their clinical characteristics,diagnosis and therapeutic effects were retrospectively analyzed.Results A total of 238 patients were enrolled,most of them complained of dry cough and night cough.Throat symptoms were most common,including itching or foreign body sensation,throat discomfort and gastro-oesophageal reflux.Congestion of pharynx and cobblestone like changes in posterior pharyngeal wall were the most common signs in patients with chronic cough.Among all the supplementary examinations,bronchial provocation test resulted in highest positive rate.Etiological diagnosis was done in a total of 254 case-times for diseases leading to chronic cough,among them upper airway cough syndrome(UACS was suspected in 115 case-times.cough variant asthma(CVA in 42 case-times,and cough due to gastroesophageal reflux(GERC in 53 case-times.After the specific treatment targeting UACS,CVA and GERC,in 152 case-times improvement was found after follow-up,including 56,27 and 21 case-times,respectively,with an effective rate of 68.4%(104/152.The final diagnosis for the other 44 case-times with chronic cough was chronic tonsillitis,chronic bronchitis,eosinophilic bronchitis and angiotensin converting enzyme inhibitor(ACEI induced cough.A definite diagnosis was finally made in 148 out of a total of 254 casses,with a diagnostic rate of 58.3%(148/254.Conclusion The final diagnostic rate in etiology of chronic cough is still poor nowadays in our country,and empirical treatment is still the main practice for chronic cough.

  13. Clinical Assessment of a Nocardia PCR-Based Assay for Diagnosis of Nocardiosis.

    Science.gov (United States)

    Rouzaud, Claire; Rodriguez-Nava, Véronica; Catherinot, Emilie; Méchaï, Frédéric; Bergeron, Emmanuelle; Farfour, Eric; Scemla, Anne; Poirée, Sylvain; Delavaud, Christophe; Mathieu, Daniel; Durupt, Stéphane; Larosa, Fabrice; Lengelé, Jean-Philippe; Christophe, Jean-Louis; Suarez, Felipe; Lortholary, Olivier; Lebeaux, David

    2018-06-01

    The diagnosis of nocardiosis, a severe opportunistic infection, is challenging. We assessed the specificity and sensitivity of a 16S rRNA Nocardia PCR-based assay performed on clinical samples. In this multicenter study (January 2014 to April 2015), patients who were admitted to three hospitals and had an underlying condition favoring nocardiosis, clinical and radiological signs consistent with nocardiosis, and a Nocardia PCR assay result for a clinical sample were included. Patients were classified as negative control (NC) (negative Nocardia culture results and proven alternative diagnosis or improvement at 6 months without anti- Nocardia treatment), positive control (PC) (positive Nocardia culture results), or probable nocardiosis (positive Nocardia PCR results, negative Nocardia culture results, and no alternative diagnosis). Sixty-eight patients were included; 47 were classified as NC, 8 as PC, and 13 as probable nocardiosis. PCR results were negative for 35/47 NC patients (74%). For the 12 NC patients with positive PCR results, the PCR assay had been performed with respiratory samples. These NC patients had chronic bronchopulmonary disease more frequently than did the NC patients with negative PCR results (8/12 patients [67%] versus 11/35 patients [31%]; P = 0.044). PCR results were positive for 7/8 PC patients (88%). There were 13 cases of probable nocardiosis, diagnosed solely using the PCR results; 9 of those patients (69%) had lung involvement (consolidation or nodule). Nocardia PCR testing had a specificity of 74% and a sensitivity of 88% for the diagnosis of nocardiosis. Nocardia PCR testing may be helpful for the diagnosis of nocardiosis in immunocompromised patients but interpretation of PCR results from respiratory samples is difficult, because the PCR assay may also detect colonization. Copyright © 2018 American Society for Microbiology.

  14. Serum Lipase as Clinical Laboratory Index for Chronic Renal Failure Diagnosis.

    Science.gov (United States)

    Zhu, Ying; Dong, Jing; Wang, Ping; Huang, Huifang; Jin, Xiaohua; Zhou, Jingou; Shi, Jingfang; Gu, Guohao; Chen, Jun; Xu, Jun; Song, Yanhui

    2016-07-01

    Measuring the level of serum lipase has been used for the clinical diagnosis of acute pancreatitis. Reports showed that the serum lipase level increased in patients of clinical renal failure. In this study, we aimed to measure the change of serum lipase levels in chronic kidney diseases and determine whether it could serve as a clinical laboratory index for clinical renal failure diagnosis. Materials: The OLYMPUS AU5400 automatic biochemical analyzer was used to determine the serum levels of lipase and creatinine. The study included 120 cases in the clinical renal failure group, 76 cases in the nephrotic syndrome group, 81 cases in the chronic nephritis group, and 80 healthy controls from our hospital volunteers in the same period. We then compared the lipase levels and conducted statistical analyses among these groups. The serum lipase levels were 15.3 U/L, 79.8 U/L, 45.1 U/L, and 51.0 U/L in the normal control, clinical renal failure, nephrotic syndrome, and chronic nephritis groups, respectively. The lipase levels in the groups with diseases were significantly different compared with that of the normal control group (p renal failure group was significantly higher than that of the nephrotic syndrome group and chronic nephritis group (p chronic nephritis group (p > 0.05) was observed. Moreover, an association of the serum lipase with disease progression was observed in the study. Serum lipase is an effective serological index which can reflect the clinical changes in the clinical renal failure and tends to increase through the progression of renal dysfunction.

  15. Segmentation of heart sound recordings by a duration-dependent hidden Markov model

    International Nuclear Information System (INIS)

    Schmidt, S E; Graff, C; Toft, E; Struijk, J J; Holst-Hansen, C

    2010-01-01

    Digital stethoscopes offer new opportunities for computerized analysis of heart sounds. Segmentation of heart sound recordings into periods related to the first and second heart sound (S1 and S2) is fundamental in the analysis process. However, segmentation of heart sounds recorded with handheld stethoscopes in clinical environments is often complicated by background noise. A duration-dependent hidden Markov model (DHMM) is proposed for robust segmentation of heart sounds. The DHMM identifies the most likely sequence of physiological heart sounds, based on duration of the events, the amplitude of the signal envelope and a predefined model structure. The DHMM model was developed and tested with heart sounds recorded bedside with a commercially available handheld stethoscope from a population of patients referred for coronary arterioangiography. The DHMM identified 890 S1 and S2 sounds out of 901 which corresponds to 98.8% (CI: 97.8–99.3%) sensitivity in 73 test patients and 13 misplaced sounds out of 903 identified sounds which corresponds to 98.6% (CI: 97.6–99.1%) positive predictivity. These results indicate that the DHMM is an appropriate model of the heart cycle and suitable for segmentation of clinically recorded heart sounds

  16. Subtyping Children with Speech Sound Disorders by Endophenotypes

    Science.gov (United States)

    Lewis, Barbara A.; Avrich, Allison A.; Freebairn, Lisa A.; Taylor, H. Gerry; Iyengar, Sudha K.; Stein, Catherine M.

    2011-01-01

    Purpose: The present study examined associations of 5 endophenotypes (i.e., measurable skills that are closely associated with speech sound disorders and are useful in detecting genetic influences on speech sound production), oral motor skills, phonological memory, phonological awareness, vocabulary, and speeded naming, with 3 clinical criteria…

  17. New ICPMS based strategies for clinical diagnosis

    International Nuclear Information System (INIS)

    Montes-Bayon, M.; Del Castillo, M.E.; Sanz-Medel, A.

    2009-01-01

    Full text: Glycosylation is the enzymatic process that links saccharides to produce glycans, either free or attached to proteins. This is an enzyme-directed site-specific process, as opposed to the chemical reaction of glycation which is the result of addition of a sugar molecule to a protein or lipid molecule without the controlling action of an enzyme. Both protein modifications, however, can be used as clinical biomarkers for a variety of disorders including chronic alcoholism, diabetes or congenital disorders of glycosylation. The potential of ICPMS as a tool in the diagnosis of such diseases will be illustrated in the presentation. (author)

  18. Diffevential Diagnosis of Frimary Stuttering and Normal Nonfluency in Children Referring to Saba Clinic

    Directory of Open Access Journals (Sweden)

    Fariba Yadegari

    2003-12-01

    Full Text Available Objective: Early Diagnosis and intervention of primary stuttering is the key for prevention of chronic developmental stuttering. Normal nonfluency of children under 5 years old is an important differential diagnosis of primary stuttering. The goals of this research are finding accuracy of diagnoses on children referred to Saba speech therapy Clinic labeled as normal nonfluency and introducing move precise methods of differential diagnosis.  Materials & Methods: The research method is case series study in which through simple sampling procedure stuttering children referring to SabA Clinic during 1382 & 83 were studied. 10. Research tools and data collection consist of: questionnair, spontaneous speech sample recording and determining VOT using laryngograph processor. It should be noted that because normative date of stutteres VOT the lack of the normal subjects VOT are analysed and comared with stutterers. Results: Based on numerical criteria, our findings indicate that only one of stutterers was normal nonfluent and the others were stutteres. VOT data of stutteres also were compared to that of normal matched children. The results revealed that all of stutterers had significantly (P<0.05 longer VOT than normal subjects . Conclusion: This study provides a good numeric and clinical index for speech language pathologists for diagnosis of primary stuttering and normal nonfluency. Morover,. using VOT would help accurate diagnosis.

  19. Cardiovascular autonomic neuropathy in diabetes: clinical impact, assessment, diagnosis, and management.

    Science.gov (United States)

    Spallone, Vincenza; Ziegler, Dan; Freeman, Roy; Bernardi, Luciano; Frontoni, Simona; Pop-Busui, Rodica; Stevens, Martin; Kempler, Peter; Hilsted, Jannik; Tesfaye, Solomon; Low, Phillip; Valensi, Paul

    2011-10-01

    The Cardiovascular Autonomic Neuropathy (CAN) Subcommittee of the Toronto Consensus Panel on Diabetic Neuropathy worked to update CAN guidelines, with regard to epidemiology, clinical impact, diagnosis, usefulness of CAN testing, and management. CAN is the impairment of cardiovascular autonomic control in the setting of diabetes after exclusion of other causes. The prevalence of confirmed CAN is around 20%, and increases up to 65% with age and diabetes duration. Established risk factors for CAN are glycaemic control in type 1 and a combination of hypertension, dyslipidaemia, obesity, and glycaemic control in type 2 diabetes. CAN is a risk marker of mortality and cardiovascular morbidity, and possibly a progression promoter of diabetic nephropathy. Criteria for CAN diagnosis and staging are: (1) one abnormal cardiovagal test result identifies possible or early CAN; (2) at least two abnormal cardiovagal test results are required for definite or confirmed CAN; and (3) the presence of orthostatic hypotension in addition to abnormal heart rate test results identifies severe or advanced CAN. Progressive stages of CAN are associated with increasingly worse prognosis. CAN assessment is relevant in clinical practice for (1) diagnosis of CAN clinical forms, (2) detection and tailored treatment of CAN clinical correlates (e.g. tachycardia, orthostatic hypotension, non-dipping, QT interval prolongation), (3) risk stratification for diabetic complications and cardiovascular morbidity and mortality, and (4) modulation of targets of diabetes therapy. Evidence on the cost-effectiveness of CAN testing is lacking. Apart from the preventive role of intensive glycaemic control in type 1 diabetes, recommendations cannot be made for most therapeutic approaches to CAN. Copyright © 2011 John Wiley & Sons, Ltd.

  20. Clinical symptoms, diagnosis and course of chronic T-cell-type lymphadenosis

    International Nuclear Information System (INIS)

    Becher, C.

    1982-01-01

    The clinical course of T-lymphadenosis is illustrated by the example of 5 patients and compared with the case studies in relevant publications. The latency period between initial anamnesis and diagnosis was 4 to 6 months, the patients' mean age 65 years, and the male/female ratio 4:1. Of the clinical symptoms, splenomegaly was observed in 80% of all cases, while the lymph nodes were only slightly enlarged in 46% of the cases. One third of the patients presented with diffuse, erythroderma-type skin infiltrations with lymphatic elements. Of the hematological findings, excessive leukocytosis with an average of 300 000/μl and a lymphocyte fraction of 93% was the most frequent. Detailed information can be obtained by immunological lymphocyte differentiation. The disease is rapidly progressive, with an exponential lymphocyte growth rate. The individual lymphocyte doubling time is well correlated with the forecasts. Both chemotherapy and radiotherapy require high doses and have no significant effect on the course of the disease. The mean survival time after diagnosis is 8.1 mon. Differential diagnosis is made possible by the cytochemical and immunological cell parameters described. (orig./MG) [de

  1. Diagnosis of antiphospholipid syndrome in routine clinical practice

    Science.gov (United States)

    Hills, J; Machin, SJ; Cohen, H

    2013-01-01

    The updated international consensus criteria for definite antiphospholipid syndrome (APS) are useful for scientific clinical studies. However, there remains a need for diagnostic criteria for routine clinical use. We audited the results of routine antiphospholipid antibodies (aPLs) in a cohort of 193 consecutive patients with aPL positivity-based testing for lupus anticoagulant (LA), IgG and IgM anticardiolipin (aCL) and anti-ß2glycoprotein-1 antibodies (aß2GPI). Medium/high-titre aCL/aβ2GPI was defined as >99th percentile. Low-titre aCL/aβ2GPI positivity (>95th < 99th percentile) was considered positive for obstetric but not for thrombotic APS. One hundred of the 145 patients fulfilled both clinical and laboratory criteria for definite APS. Twenty-six women with purely obstetric APS had persistent low-titre aCL and/or aβ2GPI. With the inclusion of these patients, 126 of the 145 patients were considered to have APS. Sixty-seven out of 126 patients were LA-negative, of whom 12 had aCL only, 37 had aβ2GPI only and 18 positive were for both. The omission of aCL or aβ2GPI testing from investigation of APS would have led to a failure to diagnose APS in 9.5% and 29.4% of patients, respectively. Our data suggest that LA, aCL and aβ2GPI testing are all required for the accurate diagnosis of APS and that low-titre antibodies should be included in the diagnosis of obstetric APS. PMID:22988029

  2. The clinical diagnosis and misdiagnosis of senile dementia of Lewy body type (SDLT).

    Science.gov (United States)

    McKeith, I G; Fairbairn, A F; Perry, R H; Thompson, P

    1994-09-01

    Current clinical classifications do not contain specific diagnostic categories for patients with senile dementia of the Lewy body type (SDLT), recently proposed as the second commonest neuropathological cause of dementia in the elderly. This study determines how existing clinical diagnosis systems label SDLT patients and suggests how such patients may be identified. A range of clinical diagnostic criteria for dementia were applied to case notes of autopsy-confirmed SDLT (n = 20), dementia of Alzheimer type (DAT; n = 21) and multi-infarct dementia (MID; n = 9) patients who had received psychogeriatric assessment. The predictive validity of each set of clinical criteria was calculated against the external criterion of neuropathological diagnosis. Many SDLT patients erroneously met criteria for MID (35% with Hachinski scores > or = 7) or for DAT (15% by NINCDS 'probable AD', 35% by DSM-III-R DAT and 50% by NINCDS 'possible AD'). Up to 85% of SDLT cases could be correctly identified using recently published specific criteria. SDLT usually has a discernible clinical syndrome and existing clinical classifications may need revision to diagnose correctly such patients.

  3. Construction and Potential Applications of Biosensors for Proteins in Clinical Laboratory Diagnosis.

    Science.gov (United States)

    Liu, Xuan; Jiang, Hui

    2017-12-04

    Biosensors for proteins have shown attractive advantages compared to traditional techniques in clinical laboratory diagnosis. In virtue of modern fabrication modes and detection techniques, various immunosensing platforms have been reported on basis of the specific recognition between antigen-antibody pairs. In addition to profit from the development of nanotechnology and molecular biology, diverse fabrication and signal amplification strategies have been designed for detection of protein antigens, which has led to great achievements in fast quantitative and simultaneous testing with extremely high sensitivity and specificity. Besides antigens, determination of antibodies also possesses great significance for clinical laboratory diagnosis. In this review, we will categorize recent immunosensors for proteins by different detection techniques. The basic conception of detection techniques, sensing mechanisms, and the relevant signal amplification strategies are introduced. Since antibodies and antigens have an equal position to each other in immunosensing, all biosensing strategies for antigens can be extended to antibodies under appropriate optimizations. Biosensors for antibodies are summarized, focusing on potential applications in clinical laboratory diagnosis, such as a series of biomarkers for infectious diseases and autoimmune diseases, and an evaluation of vaccine immunity. The excellent performances of these biosensors provide a prospective space for future antibody-detection-based disease serodiagnosis.

  4. Idiopathic granulomatus lobular mastitis. A forgotten clinical diagnosis.

    Science.gov (United States)

    Al Nazer, Mona A

    2003-12-01

    To review clinicopathological features of all cases diagnosed as idiopathic granulomatous lobular mastitis (IGLM) in our hospital and compare them with other data from the Kingdom of Saudi Arabia. Reports of all breast specimens received in histopathology laboratory in Qatif Central Hospital, Kingdom of Saudi Arabia over a 14 year period (1988 through to 2002) were collected and those diagnosed as IGLM were selected for analysis of both pathological material and clinical data. Eleven patients representing 1.6% of all breast specimens were diagnosed as IGLM. The mean age was 35 years (range 25-50). Both breasts were equally affected. The most frequent presenting symptom was a breast mass of 2-22 weeks duration. The most common clinical diagnosis was chronic abscess (5 patients). Relation to pregnancy, lactation or oral contraceptives pills was elicited in 4 patients. Recurrence at different time intervals occurred in 3 patients. Microscopically there was an evident granulomatous inflammation mostly in lobular distribution. Ductal inflammation with epithelial changes was noted in most cases. Staining and cultures were negative for both mycobacterium and fungal organisms. Granulomatous mastitis is not unheard of and clinicians should keep it in their list of differential diagnosis of breast lumps so appropriate handling of breast specimens including microbiological studies can be pursued. Utility of fine needle aspiration biopsy as a diagnostic tool is to be considered.

  5. Comparison of clinical causes of death with autopsy diagnosis using discrepency classification.

    Science.gov (United States)

    Ullah, Khalil; Alamgir, Wasim

    2006-12-01

    To determine the usefulness of autopsy findings in the quality improvement of patients care. An observational study. Departments of Pathology and Medicine, Combined Military Hospital (CMH) Kharian, a tertiary care hospital, from January 2001 to December 2003. The clinical and necropsy findings of all the cases, who died in hospital and had undergone autopsy examination at CMH, Kharian, from January 2001 to December 2003, were retrieved from record of clinical case sheet data and autopsy record of the hospital. The two were analyzed and compared according to the discrepancy classification. The exclusion and inclusion criteria, the international classification of disease (ICD) to code deaths, the global burden of disease (GBD) system to classify and group diseases, and the Goldman discrepancy classification to compare clinical and autopsy diagnosis and classify the discrepancies, were used as described. The death rate varied from 0.94% to 1.29% and autopsy rate from 4.69% to 10.10% annually between January 2001 and December 2003. The number of cases classified according to GBD system was 3 (5%) in Group 1, 26 (43.33 %) in Group 2 and 31 (51.66 %) in Group 3. The discrepancy classes included 9 (15 %) class I major discrepancies and 3 (5 %) class II major discrepancies. Non-discrepant diagnosis was seen in 37 cases (61.66 %) and 11 cases (18.32 %) were non-classifiable. This study showed the usefulness of autopsy findings in the quality improvement of the diagnosis and management of the disease by showing only a minority of cases with discrepant diagnosis of the cause of death.

  6. Effect of real-time teledermatology on diagnosis, treatment and clinical improvement.

    Science.gov (United States)

    Al Quran, Hanadi A; Khader, Yousef Saleh; Ellauzi, Ziad Mohd; Shdaifat, Amjad

    2015-03-01

    We assessed the effect of real-time teledermatology consultations on diagnosis and disease management, patients' quality of life and time- and cost-savings. All consecutive patients with skin diseases attending teledermatology clinics at two rural hospitals in Jordan were included in the study. Patients were interviewed at their initial visit and again after eight weeks. Various questionnaires and forms, including quality of life questionnaires, were used to collect the data. Ninety teledermatology consultations were performed for 88 patients between September 2013 and January 2014. A diagnosis was established as part of the teledermatology consultation in 43% of patients and changed from that of the referring provider in 19% of patients. The treatment plan was established for 67% of patients and changed for 9% patients. The mean SF-8 score increased significantly (P < 0.005). The mean DLQI score decreased significantly (P < 0.005) indicating that there had been an improvement in the patients' quality of life since baseline. Most patients perceived that the visit to the teledermatology clinic required less travel time (96%), shorter waiting time (83%) and less cost (96%) than a visit to the specialist clinic at the main hospital. The patients' mean satisfaction score was 90.5 (SD 8.5), indicating a high level of satisfaction. Teledermatology resulted in changes in the patients' diagnosis and treatment plan, and was associated with improved health state and quality of life. © The Author(s) 2015 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

  7. Development of an Amplifier for Electronic Stethoscope System and Heart Sound Analysis

    Energy Technology Data Exchange (ETDEWEB)

    Kim, D. J.; Kang, D. K. [Chongju University, Chongju (Korea)

    2001-05-01

    The conventional stethoscope can not store its stethoscopic sounds. Therefore a doctor diagnoses a patient with instantaneous stethoscopic sounds at that time, and he can not remember the state of the patient's stethoscopic sounds on the next. This prevent accurate and objective diagnosis. If the electronic stethoscope, which can store the stethoscopic sound, is developed, the auscultation will be greatly improved. This study describes an amplifier for electronic stethoscope system that can extract heart sounds of fetus as well as adult and allow us hear and record the sounds. Using the developed stethoscopic amplifier, clean heart sounds of fetus and adult can be heard in noisy environment, such as a consultation room of a university hospital, a laboratory of a university. Surprisingly, the heart sound of a 22-week fetus was heard through the developed electronic stethoscope. Pitch detection experiments using the detected heart sounds showed that the signal represents distinct periodicity. It can be expected that the developed electronic stethoscope can substitute for conventional stethoscopes and if proper analysis method for the stethoscopic signal is developed, a good electronic stethoscope system can be produced. (author). 17 refs., 6 figs.

  8. Clinical application of positron emission tomography for diagnosis of dementia

    International Nuclear Information System (INIS)

    Ishii, Kazunari

    2002-01-01

    Clinical applications of PET studies for dementia are reviewed in this paper. At the mild and moderate stages of Alzheimer's disease (AD), glucose metabolism is reduced not only in the parietotemporal region but also in the posterior cingulate and precuneus. At the advanced stage of AD, there is also a metabolic reduction in the frontal region. In AD patients, glucose metabolism is relatively preserved in the pons, sensorimotor cortices, primary visual cortices, basal ganglia, thalamus and cerebellum. In patients with dementia with Lewy bodies, glucose metabolism in the primary visual cortices is reduced, and this reduction appears to be associated with the reduction pattern in AD patients. In patients with frontotemporal dementia, reduced metabolism in the frontotemporal region is the main feature of this disease, but reduced metabolism in the basal ganglia, and/or parietal metabolic reduction can be associated with the frontotemporal reduction. When corticobasal degeneration is associated with dementia, the reduction pattern of dementia is similar to the reduction pattern in AD and the hallmarks of diagnosing corticobasal degeneration associated with dementia are a reduced metabolism in the primary sensorimotor region and/or basal ganglia and an asymmetric reduction in the two hemispheres. FDG-PET is a very useful tool for the diagnosis of early AD and for the differential diagnosis of dementia. I also describe clinical applications of PET for the diagnosis of dementia in Japan. (author)

  9. Sound

    CERN Document Server

    Robertson, William C

    2003-01-01

    Muddled about what makes music? Stuck on the study of harmonics? Dumbfounded by how sound gets around? Now you no longer have to struggle to teach concepts you really don t grasp yourself. Sound takes an intentionally light touch to help out all those adults science teachers, parents wanting to help with homework, home-schoolers seeking necessary scientific background to teach middle school physics with confidence. The book introduces sound waves and uses that model to explain sound-related occurrences. Starting with the basics of what causes sound and how it travels, you'll learn how musical instruments work, how sound waves add and subtract, how the human ear works, and even why you can sound like a Munchkin when you inhale helium. Sound is the fourth book in the award-winning Stop Faking It! Series, published by NSTA Press. Like the other popular volumes, it is written by irreverent educator Bill Robertson, who offers this Sound recommendation: One of the coolest activities is whacking a spinning metal rod...

  10. Diagnosis of foot-and-mouth disease of clinically infected cattle ...

    African Journals Online (AJOL)

    Clinical diagnosis was made using signs of oral and feet lesions causing severe anorexia and lameness respectively in affected animals and calves. Feet lesions were found to be similar to those in exotic animals with sloughing of hoof unlike in indigenous cattle that often are interdigital granulomatous lesions. Mortality ...

  11. In vivo breast sound-speed imaging with ultrasound tomography

    Energy Technology Data Exchange (ETDEWEB)

    Huang, Lianjie [Los Alamos National Laboratory; Li, Cuiping [KARMANOS CANCER INSTITUTE; Duric, Neb [KARMANOS CANCER INSTITUTE; Littrup, Peter [KARMONOS CANCER INSTITUTE

    2009-01-01

    We discuss a bent-ray ultrasound tomography algorithm with total-variation (TV) regularization. We have applied this algorithm to 61 in vivo breast datasets collected with our in-house clinical prototype for imaging sound-speed distributions in the breast. Our analysis showed that TV regularization could preserve sharper lesion edges than the classic Tikhonov regularization. Furthermore, the image quality of our TV bent-ray sound-speed tomograms was superior to that of the straight-ray counterparts for all types of breasts within BI-RADS density categories 1-4. For all four breast types from fatty to dense, the improvements for average sharpness (in the unit of (m{center_dot} s) {sup -1}) of lesion edges in our TV bent-ray tomograms are between 2.1 to 3.4 fold compared to the straight ray tomograms. Reconstructed sound-speed tomograms illustrated that our algorithm could successfully image fatty and glandular tissues within the breast. We calculated the mean sound-speed values for fatty tissue and breast parenchyma as 1422 {+-} 9 mls (mean{+-} SD) and1487 {+-} 21 mls, respectively. Based on 32 lesions in a cohort of 61 patients, we also found that the mean sound-speed for malignant breast lesions (1548{+-}17 mls) was higher, on average, than that of benign ones (1513{+-}27 mls) (one-sided pclinically, sound-speed tomograms can be used to assess breast density (, and therefore, breast cancer risk), as well as detect and help differentiate breast lesions. Finally, our sound-speed tomograms may also be a useful tool to monitor clinical response of breast cancer patients to neo-adjuvant chemotherapy.

  12. Pulp Inflammation Diagnosis from Clinical to Inflammatory Mediators: A Systematic Review.

    Science.gov (United States)

    Zanini, Marjorie; Meyer, Elisabeth; Simon, Stéphane

    2017-07-01

    Similar to other tissues, the dental pulp mounts an inflammatory reaction as a way to eliminate pathogens and stimulate repair. Pulp inflammation is prerequisite for dentin pulp complex repair and regeneration; otherwise, chronic disease or pulp necrosis occurs. Evaluation of pulp inflammation severity is necessary to predict the clinical success of maintaining pulp vitality. Clinical limitations to evaluating in situ inflammatory status are well-described. A molecular approach that aids clinical distinction between reversible and irreversible pulpitis could improve the success rate of vital pulp therapy. The aim of this article is to review inflammatory mediator expression in the context of clinical diagnosis. We searched PubMed and Cochrane databases for articles published between 1970 and December 2016. Only published studies of inflammatory mediator expression related to clinical diagnosis were eligible for inclusion and analysis. Thirty-two articles were analyzed. Two molecular approaches were described by study methods, protein expression analysis and gene expression analysis. Our review indicates that interleukin-8, matrix metalloproteinase 9, tumor necrosis factor-α, and receptor for advanced glycation end products expression increase at both the gene and protein levels during inflammation. Clinical irreversible pulpitis is related to specific levels of inflammatory mediator expression. The difference in expression between reversible and irreversible disease is both quantitative and qualitative. On the basis of our analysis, in situ quantification of inflammatory mediators may aid in the clinical distinction between reversible and irreversible pulpitis. Copyright © 2017 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

  13. Clinical diagnosis of Graves’ or non-Graves’ hyperthyroidism compared to TSH receptor antibody test

    Directory of Open Access Journals (Sweden)

    Lauren Bell

    2018-04-01

    Full Text Available Background: TSH receptor antibody (TRAb is considered the gold standard diagnostic test for the autoimmunity of Graves’ disease (GD, which is commonly diagnosed clinically. Aim: To evaluate the true positive (sensitivity and true negative (specificity rates of clinical diagnosis of GD or non-GD hyperthyroidism compared to the TRAb test. Setting: University teaching hospital in North West England. Participants: Patients in the Endocrinology service who had a TRAb measurement between December 2009 and October 2015. Methods: Electronic patient records were studied retrospectively for a pre-TRAb clinical diagnosis of GD or non-GD hyperthyroidism. We examined descriptive statistics and binary classification tests; Fisher exact test was used to analyse contingency tables. Results: We identified 316 patients with a mean age of 45 (range, 17–89 years; 247 (78% were women. Compared to the TRAb result, clinical diagnosis had a sensitivity of 88%, specificity 66%, positive predictive value 72%, negative predictive value 84%, false negative rate 12%, false positive rate 34%, positive likelihood ratio 2.6 and negative likelihood ratio 0.2 (P < 0.0001. Conclusions: Clinicians were liable to both over- and under-diagnose GD. The TRAb test can help reduce the number of incorrect or unknown diagnoses in the initial clinical assessment of patients presenting with hyperthyroidism.

  14. Hearing Loss Signals Need for Diagnosis

    Science.gov (United States)

    ... Products For Consumers Home For Consumers Consumer Updates Hearing Loss Signals Need for Diagnosis Share Tweet Linkedin ... you’re talking loudly? Thinking about ordering a hearing aid or sound amplifier from a magazine or ...

  15. Cardiovascular Sound and the Stethoscope, 1816 to 2016

    Science.gov (United States)

    Segall, Harold N.

    1963-01-01

    Cardiovascular sound escaped attention until Laennec invented and demonstrated the usefulness of the stethoscope. Accuracy of diagnosis using cardiovascular sounds as clues increased with improvement in knowledge of the physiology of circulation. Nearly all currently acceptable clinicopathological correlations were established by physicians who used the simplest of stethoscopes or listened with the bare ear. Certain refinements followed the use of modern methods which afford greater precision in timing cardiovascular sounds. These methods contribute to educating the human ear, so that those advantages may be applied which accrue from auscultation, plus the method of writing quantitative symbols to describe what is heard, by focusing the sense of hearing on each segment of the cardiac cycle in turn. By the year 2016, electronic systems of collecting and analyzing data about the cardiovascular system may render the stethoscope obsolete. ImagesFig. 1Fig. 2Fig. 3Fig. 5Fig. 8 PMID:13987676

  16. Heart sound segmentation of pediatric auscultations using wavelet analysis.

    Science.gov (United States)

    Castro, Ana; Vinhoza, Tiago T V; Mattos, Sandra S; Coimbra, Miguel T

    2013-01-01

    Auscultation is widely applied in clinical activity, nonetheless sound interpretation is dependent on clinician training and experience. Heart sound features such as spatial loudness, relative amplitude, murmurs, and localization of each component may be indicative of pathology. In this study we propose a segmentation algorithm to extract heart sound components (S1 and S2) based on it's time and frequency characteristics. This algorithm takes advantage of the knowledge of the heart cycle times (systolic and diastolic periods) and of the spectral characteristics of each component, through wavelet analysis. Data collected in a clinical environment, and annotated by a clinician was used to assess algorithm's performance. Heart sound components were correctly identified in 99.5% of the annotated events. S1 and S2 detection rates were 90.9% and 93.3% respectively. The median difference between annotated and detected events was of 33.9 ms.

  17. Questioning diagnoses in clinical practice: a thematic analysis of clinical psychologists' accounts of working beyond diagnosis in the United Kingdom.

    Science.gov (United States)

    Randall-James, James; Coles, Steven

    2018-02-08

    The British Psychological Society proposes that clinical psychologists are well placed to move beyond psychiatric diagnoses and develop alternative practices. This study sought to explore what the application of these guiding principles looks like in clinical practice, the challenges faced and possible routes forward. A purpose-designed survey was completed by 305 respondents and a thematic analysis completed. Thematic analysis was used to identify five superordinate themes relating to individuals, relational, others, structures and society, comprising of a total of 21 group themes. The presented group themes highlight an array of approaches to practicing beyond diagnosis and factors that help and hinder such action; from scaffolding change, becoming leaders, relating to the multi-disciplinary team, restructuring services and the processes of change. A key concept was "playing the diagnostic game". "Playing the diagnostic game" enables psychologists to manage an array of tensions and anxieties: conflicts between belief and practice, relationships with colleagues, and dilemmas of position and power. It also potentially limits a concerted questioning of diagnosis and consideration of alternatives. An alternative conceptual framework for non-diagnostic practice is needed to aid the collective efforts of clinical psychologists developing their practice beyond diagnosis, some of which have been highlighted in this study. Until then, ways of mitigating the perceived threats to questioning diagnosis need further exploration, theorising and backing.

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

    Science.gov (United States)

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

    2011-08-01

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

  19. Ovarian tumors: pathogenia, clinical pattern, echographic and histopathological diagnosis

    International Nuclear Information System (INIS)

    Pons Porrata, Laura Maria; Garcia Gomez, Odalis; Salmon Cruzata, Acelia

    2012-01-01

    Two case reports of young patients, who were treated in the Otolaryngology Department from 'Dr. Joaquin Castillo Duany' Teaching Clinical Surgical Hospital in Santiago de Cuba are presented. One of the cases presented nasal obstruction, rhinorrhoea and facial pain, for 7 months; the other one presented an increase of volume in the right ocular globe. In both, the results of the biopsy confirmed the diagnosis of differentiated nasosinusal epidermoid carcinoma

  20. Noise detection in heart sound recordings.

    Science.gov (United States)

    Zia, Mohammad K; Griffel, Benjamin; Fridman, Vladimir; Saponieri, Cesare; Semmlow, John L

    2011-01-01

    Coronary artery disease (CAD) is the leading cause of death in the United States. Although progression of CAD can be controlled using drugs and diet, it is usually detected in advanced stages when invasive treatment is required. Current methods to detect CAD are invasive and/or costly, hence not suitable as a regular screening tool to detect CAD in early stages. Currently, we are developing a noninvasive and cost-effective system to detect CAD using the acoustic approach. This method identifies sounds generated by turbulent flow through partially narrowed coronary arteries to detect CAD. The limiting factor of this method is sensitivity to noises commonly encountered in the clinical setting. Because the CAD sounds are faint, these noises can easily obscure the CAD sounds and make detection impossible. In this paper, we propose a method to detect and eliminate noise encountered in the clinical setting using a reference channel. We show that our method is effective in detecting noise, which is essential to the success of the acoustic approach.

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

    Science.gov (United States)

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

    2010-02-26

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

  2. Imaging diagnosis in relapsing polychondritis and correlation with clinical and serological data

    International Nuclear Information System (INIS)

    Thaiss, W.M.; Nikolaou, K.; Horger, M.; Spengler, W.; Xenitidis, T.; Henes, J.; Spira, D.

    2016-01-01

    We hypothesize that imaging findings from CT and MRI correlate better with clinical markers for assessment of disease activity in patients with the rare relapsing polychondritis (RPC) than with serological inflammatory markers. Retrospective database search at our institution identified 28 patients (13 females; age 49.0 years ± 15.0 SD) with RP between September 2004 and March 2014. Institutional review board approval was obtained for this retrospective data analysis. All patients had clinically proven RPC with at least two episodes of active disease. Of those, 18 patients were examined with CT- and MRI and presented all morphologic features of RPC like bronchial/laryngeal/auricular cartilage thickness, contrast enhancement, increased T2-signal intensity. Imaging data was subsequently correlated with corresponding clinical symptoms like fever, dyspnea, stridor, uveitis, pain, hearing impairment as well as with acute-phase-inflammatory parameters like C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR). The clinical parameters were in good agreement with imaging findings and clinical symptoms such as tracheal wall thickening and dyspnea (r =0.65 p = 0.05), joint synovitis on MRI and a higher McAdam score (r = 0.84 p < 0.001). No correlations were found between inflammatory laboratory markers, imaging findings and clinical features. Imaging diagnosis in RPC using CT and/or MRI delivers information about the degree of disease activity that correlates better with clinical features than unspecific inflammatory laboratory markers. Additionally, clinically unapparent cartilage involvement can be assessed adding value to the clinical diagnosis and therapy planning in this rare disease. (orig.)

  3. Imaging diagnosis in relapsing polychondritis and correlation with clinical and serological data

    Energy Technology Data Exchange (ETDEWEB)

    Thaiss, W.M.; Nikolaou, K.; Horger, M. [Eberhard Karls University, Department of Radiology, Diagnostic and Interventional Radiology, Tuebingen (Germany); Spengler, W.; Xenitidis, T.; Henes, J. [Eberhard Karls University, Department of Internal Medicine II, Tuebingen (Germany); Spira, D. [Eberhard Karls University, Department of Radiology, Diagnostic and Interventional Radiology, Tuebingen (Germany); University Medical Center Heidelberg, Diagnostic and Interventional Radiology, Heidelberg (Germany)

    2016-03-15

    We hypothesize that imaging findings from CT and MRI correlate better with clinical markers for assessment of disease activity in patients with the rare relapsing polychondritis (RPC) than with serological inflammatory markers. Retrospective database search at our institution identified 28 patients (13 females; age 49.0 years ± 15.0 SD) with RP between September 2004 and March 2014. Institutional review board approval was obtained for this retrospective data analysis. All patients had clinically proven RPC with at least two episodes of active disease. Of those, 18 patients were examined with CT- and MRI and presented all morphologic features of RPC like bronchial/laryngeal/auricular cartilage thickness, contrast enhancement, increased T2-signal intensity. Imaging data was subsequently correlated with corresponding clinical symptoms like fever, dyspnea, stridor, uveitis, pain, hearing impairment as well as with acute-phase-inflammatory parameters like C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR). The clinical parameters were in good agreement with imaging findings and clinical symptoms such as tracheal wall thickening and dyspnea (r =0.65 p = 0.05), joint synovitis on MRI and a higher McAdam score (r = 0.84 p < 0.001). No correlations were found between inflammatory laboratory markers, imaging findings and clinical features. Imaging diagnosis in RPC using CT and/or MRI delivers information about the degree of disease activity that correlates better with clinical features than unspecific inflammatory laboratory markers. Additionally, clinically unapparent cartilage involvement can be assessed adding value to the clinical diagnosis and therapy planning in this rare disease. (orig.)

  4. Clinical application of positron emission tomography for diagnosis of dementia

    Energy Technology Data Exchange (ETDEWEB)

    Ishii, Kazunari [Hyogo Brain and Heart Center, Himeji (Japan)

    2002-12-01

    Clinical applications of PET studies for dementia are reviewed in this paper. At the mild and moderate stages of Alzheimer's disease (AD), glucose metabolism is reduced not only in the parietotemporal region but also in the posterior cingulate and precuneus. At the advanced stage of AD, there is also a metabolic reduction in the frontal region. In AD patients, glucose metabolism is relatively preserved in the pons, sensorimotor cortices, primary visual cortices, basal ganglia, thalamus and cerebellum. In patients with dementia with Lewy bodies, glucose metabolism in the primary visual cortices is reduced, and this reduction appears to be associated with the reduction pattern in AD patients. In patients with frontotemporal dementia, reduced metabolism in the frontotemporal region is the main feature of this disease, but reduced metabolism in the basal ganglia, and/or parietal metabolic reduction can be associated with the frontotemporal reduction. When corticobasal degeneration is associated with dementia, the reduction pattern of dementia is similar to the reduction pattern in AD and the hallmarks of diagnosing corticobasal degeneration associated with dementia are a reduced metabolism in the primary sensorimotor region and/or basal ganglia and an asymmetric reduction in the two hemispheres. FDG-PET is a very useful tool for the diagnosis of early AD and for the differential diagnosis of dementia. I also describe clinical applications of PET for the diagnosis of dementia in Japan. (author)

  5. [Sarcoptic mange of dogs: biology of the organism, epidemiology, pathogenesis, clinical aspect, diagnosis and treatment].

    Science.gov (United States)

    Kraiss, A; Kraft, W; Gothe, R

    1987-01-01

    A review is presented on the biology of the causative agent, epidemiology, pathogenesis, clinical features, diagnosis and therapy of canine Sarcoptes scabiei infestation. This survey includes also clinical data of the period 1978-1986 in the Small Animal Hospital, Munich Veterinary Faculty. Several skin scrapings are usually necessary for diagnosis. For therapy application of acaricides once a week, altogether at least three times is sufficient. Simultaneously a decontamination of the dog's surroundings should be carried out.

  6. Progressive multifocal leukoencephalopathy. Epidemiology, clinical pictures, diagnosis and therapy

    International Nuclear Information System (INIS)

    Kishida, Shuji

    2007-01-01

    Progressive multifocal leukoencephalopathy (PML) is a demyelinating disease of the central nervous system caused by the reactivation of a ubiquitous polyomavirus JC (JCV). PML was for many years a rare disease occurring only in patients with underlying severe impaired immunity. Over the past three decades, the incidence of PML has significantly increased related to the AIDS (acquired immunodeficiency syndrome) pandemic and, more recently, to the growing use of immunosuppressive drugs. The clinical presentation of PML is variable with neurological symptoms corresponding to affected cerebral areas. Usually, the clinical outcome of patients with PML is poor with an inexorable progression to death within 6 months of symptom onset. Although PML usually requires a brain biopsy or autopsy for confirmation, radiological imaging and a demonstration of JCV-DNA in the CSF (cerebrospinal fluid) provide supportive evidence for the diagnosis. Although there is no proven effective therapy for PML, patients with HIV (human immunodeficeincy virus)-related PML may benefit significantly from HAART (highly active antiretroviral therapy). In this article the author reviews the epidemiology, especially in Japan, current challenges in the diagnosis and the treatment guidelines of patients with PML based on recent advances in the understanding of the JC virus biology. (author)

  7. A Signal Processing Module for the Analysis of Heart Sounds and Heart Murmurs

    International Nuclear Information System (INIS)

    Javed, Faizan; Venkatachalam, P A; H, Ahmad Fadzil M

    2006-01-01

    In this paper a Signal Processing Module (SPM) for the computer-aided analysis of heart sounds has been developed. The module reveals important information of cardiovascular disorders and can assist general physician to come up with more accurate and reliable diagnosis at early stages. It can overcome the deficiency of expert doctors in rural as well as urban clinics and hospitals. The module has five main blocks: Data Acquisition and Pre-processing, Segmentation, Feature Extraction, Murmur Detection and Murmur Classification. The heart sounds are first acquired using an electronic stethoscope which has the capability of transferring these signals to the near by workstation using wireless media. Then the signals are segmented into individual cycles as well as individual components using the spectral analysis of heart without using any reference signal like ECG. Then the features are extracted from the individual components using Spectrogram and are used as an input to a MLP (Multiple Layer Perceptron) Neural Network that is trained to detect the presence of heart murmurs. Once the murmur is detected they are classified into seven classes depending on their timing within the cardiac cycle using Smoothed Pseudo Wigner-Ville distribution. The module has been tested with real heart sounds from 40 patients and has proved to be quite efficient and robust while dealing with a large variety of pathological conditions

  8. A Signal Processing Module for the Analysis of Heart Sounds and Heart Murmurs

    Energy Technology Data Exchange (ETDEWEB)

    Javed, Faizan; Venkatachalam, P A; H, Ahmad Fadzil M [Signal and Imaging Processing and Tele-Medicine Technology Research Group, Department of Electrical and Electronics Engineering, Universiti Teknologi PETRONAS, 31750 Tronoh, Perak (Malaysia)

    2006-04-01

    In this paper a Signal Processing Module (SPM) for the computer-aided analysis of heart sounds has been developed. The module reveals important information of cardiovascular disorders and can assist general physician to come up with more accurate and reliable diagnosis at early stages. It can overcome the deficiency of expert doctors in rural as well as urban clinics and hospitals. The module has five main blocks: Data Acquisition and Pre-processing, Segmentation, Feature Extraction, Murmur Detection and Murmur Classification. The heart sounds are first acquired using an electronic stethoscope which has the capability of transferring these signals to the near by workstation using wireless media. Then the signals are segmented into individual cycles as well as individual components using the spectral analysis of heart without using any reference signal like ECG. Then the features are extracted from the individual components using Spectrogram and are used as an input to a MLP (Multiple Layer Perceptron) Neural Network that is trained to detect the presence of heart murmurs. Once the murmur is detected they are classified into seven classes depending on their timing within the cardiac cycle using Smoothed Pseudo Wigner-Ville distribution. The module has been tested with real heart sounds from 40 patients and has proved to be quite efficient and robust while dealing with a large variety of pathological conditions.

  9. Clinical value of SPECT/CT imaging in the diagnosis of bone metastasis

    International Nuclear Information System (INIS)

    Wang Xinhua; Zhao Yanping; Lu Haijian; Dong Zhanfei

    2010-01-01

    Objective: To evaluate the clinical value of 99 Tc m -methylene diphosphonic acid (MDP) SPECT/CT imaging for the diagnosis of bone metastasis. Methods: Patients suspected for bone metastasis and with bone pain of unknown origin were included in this study (n=237). All cases underwent SPECT and CT imaging at 180 min after 99 Tc m -MDP injection. Diagnosis was confirmed by pathology (n=21), more than 2 kinds of radiologieal imaging (MRI, CT, X-ray) (n=106), and clinical follow up in 2 years (n=110). χ 2 -test was used to compare the results of planar and SPECT/CT imaging using SAS 6.12 software. Results: In 237 patients, planar imaging of 142 cases matched the final diagnosis in which 72 had benign lesions and 70 had bone metastases. The definite coincidence rate was 95.30% (142/149). SPECT/CT imaging of 224 cases matched the final diagnosis in which 104 had benign lesions and 120 cases diagnosed as bone metastases. The coincidence and definite coincidence rates were 94.51% (224/237), and 99.48% (192/193). Difference in the definite coincidence rate between planar and SPECT/CT imaging was statistically significant (χ 2 = 5.37, P=0.024). Conclusion: SPECT/CT imaging is valuable for accurate localization of osseous pathology and for improvement of diagnosing bone metastasis. (authors)

  10. A clinical approach to the diagnosis of retinal vasculitis.

    Science.gov (United States)

    El-Asrar, Ahmed M Abu; Herbort, Carl P; Tabbara, Khalid F

    2010-04-01

    Retinal vasculitis is a sight-threatening inflammatory eye condition that involves the retinal vessels. Detection of retinal vasculitis is made clinically, and is confirmed with the help of fundus fluorescein angiography. Active vascular disease is characterized by exudates around retinal vessels resulting in white sheathing or cuffing of the affected vessels. In this review, a practical approach to the diagnosis of retinal vasculitis is discussed based on ophthalmoscopic and fundus fluorescein angiographic findings.

  11. Wheezing recognition algorithm using recordings of respiratory sounds at the mouth in a pediatric population.

    Science.gov (United States)

    Bokov, Plamen; Mahut, Bruno; Flaud, Patrice; Delclaux, Christophe

    2016-03-01

    Respiratory diseases in children are a common reason for physician visits. A diagnostic difficulty arises when parents hear wheezing that is no longer present during the medical consultation. Thus, an outpatient objective tool for recognition of wheezing is of clinical value. We developed a wheezing recognition algorithm from recorded respiratory sounds with a Smartphone placed near the mouth. A total of 186 recordings were obtained in a pediatric emergency department, mostly in toddlers (mean age 20 months). After exclusion of recordings with artefacts and those with a single clinical operator auscultation, 95 recordings with the agreement of two operators on auscultation diagnosis (27 with wheezing and 68 without) were subjected to a two phase algorithm (signal analysis and pattern classifier using machine learning algorithms) to classify records. The best performance (71.4% sensitivity and 88.9% specificity) was observed with a Support Vector Machine-based algorithm. We further tested the algorithm over a set of 39 recordings having a single operator and found a fair agreement (kappa=0.28, CI95% [0.12, 0.45]) between the algorithm and the operator. The main advantage of such an algorithm is its use in contact-free sound recording, thus valuable in the pediatric population. Copyright © 2016 Elsevier Ltd. All rights reserved.

  12. Clinical validation of immunoglobulin A nephropathy diagnosis in Swedish biopsy registers

    Directory of Open Access Journals (Sweden)

    Jarrick S

    2017-01-01

    Full Text Available Simon Jarrick,1,2 Sigrid Lundberg,3,4 Adina Welander,5,6 C Michael Fored,6 Jonas F Ludvigsson2,7,8 1Department of Pediatrics, Faculty of Health and Medicine, Örebro University, 2Department of Pediatrics, Örebro University Hospital, Örebro, 3Department of Nephrology, Karolinska University Hospital, 4Department of Clinical Science, Intervention and Technology, Karolinska Institutet, 5Boston Consulting Group, 6Clinical Epidemiology Unit, Department of Medicine, 7Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden; 8Division of Epidemiology and Public Health, School of Medicine, University of Nottingham, Nottingham, UK Aims: The aims of this study were to validate the diagnosis of IgA nephropathy (IgAN in Swedish biopsy registers against patient charts and to describe the clinical characteristics of patients with a biopsy indicating IgAN. Methods: This is a population-based cohort study. Out of 4,069 individuals with a renal biopsy consistent with IgAN (biopsies performed in 1974–2011, this study reviewed patient charts of a random subset of 127 individuals. Clinical and biopsy characteristics at the time of biopsy were evaluated, and positive predictive values (PPV were calculated with 95% confidence intervals (CI. Results: Out of 127 individuals with a renal biopsy consistent with IgAN, 121 had a likely or confirmed clinical diagnosis of IgAN, primary or secondary to Henoch–Schönlein purpura, yielding a PPV of 95% (95% CI =92%–99%. The median age at biopsy was 39 years (range: 4–79 years; seven patients (6% were <16 years. The male to female ratio was 2.8:1. The most common causes for consultation were macroscopic hematuria (n=37; 29%, screening (n=33; 26%, and purpura (n=14, 11%. In patients with available data, the median creatinine level was 104 µmol/L (range 26–986 µmol/L, n=110 and glomerular filtration rate 75 mL/min/1.73m² (range 5–173 mL/min/1.73m², n=114. Hypertension was

  13. ETIOLOGY, PATHOGENESIS AND CLINICAL DIAGNOSIS OF PEYRONIE’S DISEASE

    Directory of Open Access Journals (Sweden)

    Тарас Валерьевич Шатылко

    2017-03-01

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

  14. A declining CD4 count and diagnosis of HIV-associated Hodgkin lymphoma: do prior clinical symptoms and laboratory abnormalities aid diagnosis?

    Science.gov (United States)

    Gupta, Ravindra K; Marks, Michael; Edwards, Simon G; Smith, Katie; Fletcher, Katie; Lee, Siow-Ming; Ramsay, Alan; Copas, Andrew J; Miller, Robert F

    2014-01-01

    The incidence of Hodgkin lymphoma (HL) among HIV-infected individuals remains unchanged since the introduction of combination antiretroviral therapy (cART). Recent epidemiological data suggest that CD4 count decline over a year is associated with subsequent diagnosis of HL. In an era of economic austerity monitoring the efficacy of cART by CD4 counts may no longer be required where CD4 count>350 cells/µl and viral load is suppressed (HIV outpatient cohort whether a CD4 count decline prior to diagnosis of HL, whether any decline was greater than in patients without the diagnosis, and also whether other clinical or biochemical indices were reliably associated with the diagnosis. Twenty-nine patients with a diagnosis of HL were identified. Among 15 individuals on cART with viral load symptoms had been present for a median of three months (range one-12) before diagnosis of HL. The CD4 count decline in the 12 months prior to diagnosis of Hodgkin lymphoma among HIV-infected individuals with VLsymptoms and/or new palpable lymphadenopathy, suggesting that CD4 count monitoring if performed less frequently, or not at all, among those virologically suppressed individuals with CD4 counts >350 may not have delayed diagnosis.

  15. Clinical application of fluorescence in situ hybridization for prenatal diagnosis

    Directory of Open Access Journals (Sweden)

    Shu-fang JIANG

    2012-07-01

    Full Text Available Objective To establish and optimize the procedures of fluorescence in situ hybridization(FISH), and evaluate its clinical value in rapid prenatal diagnosis of fetal numerical abnormality of chromosomes 21, 18, 13, X, Y. Methods Amniotic fluid or fetal blood was sampled by routine invasive procedures. After the amniotic fluid cells or fetal blood cells were separated and sequentially processed with hypotonic solution, fixation solution, smear and high temperature, they were hybridized in situ with two panels of specific fluorescence probes to detect numerical abnormality of chromosomes 21, 18, 13, X, Y. All the samples were also cultured and analyzed for their karyotype by conventional methods. Results When it was used as a diagnostic criterion of chromosomal number that the fluorescence signals were observed in ≥90% cells, GLP 13/GLP 21 probe panel showed 2 green/2 red fluorescence signals and CSP18/CSP X/CSP Y probe panel showed 2 blue/2 yellow (female or 2 blue/1 yellow/1 red fluorescence signals (male under normal condition. The test reports of all 196 cases were sent out in 72-96 hours, and 7 cases of Down syndrome, 2 cases of trisomy 18 and 1 case of sex chromosomal numerical abnormality were detected, which were accordant with karyotype analysis results reported one month later. Conclusions FISH has potential for clinical application, and is applicable to rapid prenatal diagnosis of fetal numerical abnormality of chromosomes 21, 18, 13, X, Y. The rapid FISH, together with conventional karyotyping, offer a valuable means for prenatal diagnosis of fetal aneuploidies.

  16. The detection, diagnosis, therapy, and pre-clinical biology of breast cancer

    International Nuclear Information System (INIS)

    1978-01-01

    The Cancergram covers clinical aspects of cancers of the mammary glands, the fat pads and the supporting tissues. Abstracts included concern certain specific types of neoplasms which occur in the breast, and in ancillary tissues related to the breast (axillary lymph nodes, etc.). Also included are selected studies on receptors and the physiological aspects of lactation, pregnancy, and ontogeny related to cancer of the breast. The topic includes clinically relevant aspects of the prevention, detection, diagnosis, evaluation, and therapy of breast cancer. With certain exceptions, pre-clinical studies of tissue culture systems or animal model studies which are not directly related to primary human disease are excluded

  17. Sound algorithms

    OpenAIRE

    De Götzen , Amalia; Mion , Luca; Tache , Olivier

    2007-01-01

    International audience; We call sound algorithms the categories of algorithms that deal with digital sound signal. Sound algorithms appeared in the very infancy of computer. Sound algorithms present strong specificities that are the consequence of two dual considerations: the properties of the digital sound signal itself and its uses, and the properties of auditory perception.

  18. Unsupervised Feature Learning for Heart Sounds Classification Using Autoencoder

    Science.gov (United States)

    Hu, Wei; Lv, Jiancheng; Liu, Dongbo; Chen, Yao

    2018-04-01

    Cardiovascular disease seriously threatens the health of many people. It is usually diagnosed during cardiac auscultation, which is a fast and efficient method of cardiovascular disease diagnosis. In recent years, deep learning approach using unsupervised learning has made significant breakthroughs in many fields. However, to our knowledge, deep learning has not yet been used for heart sound classification. In this paper, we first use the average Shannon energy to extract the envelope of the heart sounds, then find the highest point of S1 to extract the cardiac cycle. We convert the time-domain signals of the cardiac cycle into spectrograms and apply principal component analysis whitening to reduce the dimensionality of the spectrogram. Finally, we apply a two-layer autoencoder to extract the features of the spectrogram. The experimental results demonstrate that the features from the autoencoder are suitable for heart sound classification.

  19. Laser and caries diagnosis: the state of the art and evaluation in vitro of the differences of the fluorescence between sound, carious and demineralized enamel; Laser e diagnostico de caries: estado da arte e avaliacao in vitro das diferencas de fluorescencia entre esmalte sadio, cariado e desmineralizado

    Energy Technology Data Exchange (ETDEWEB)

    Mendonca, Maria Angelica Lopes Chaves

    2001-07-01

    The aim of this study was to evaluate the methods for establishing dental caries diagnosis that make use of Laser light as source of illumination, establishing the 'state of the art'. Experimental observation of the differences among fluorescence of sound, demineralized and carious enamel by visible luminescent spectroscopy was also done. Six human teeth, extracted for clinical reasons were studied, and the results showed that the spectrum of carious enamel is different from the sound and demineralized ones. The differences are more evident relative to sond enamel and carious enamel, the same occurring between demineralized and carious enamel. The review of the literature aimed to make comparative considerations between QLF, LF and DELF; their effectiveness relative to traditional methods such as visual, visual with probe, radiography. It was verified that DELF was more sensitive, but could not discriminate between different degrees of mineral loss. QLF, compared to DIAGNOdent has the same sensitivity, but it is better for scientific purposes. The experimental part of the present study used on argon ion Laser to illuminated the teeth and signs of emission of fluorescence were captured by a PMT and then analyzed by a computer system with EG and G software. The results showed that the spectrum of carious enamel is different from the sound and demineralized. The differences are more evident in relation to sound and carious enamel, the same occurs between demineralized and carious enamel. (author)

  20. Laser and caries diagnosis: the state of the art and evaluation in vitro of the differences of the fluorescence between sound, carious and demineralized enamel; Laser e diagnostico de caries: estado da arte e avaliacao in vitro das diferencas de fluorescencia entre esmalte sadio, cariado e desmineralizado

    Energy Technology Data Exchange (ETDEWEB)

    Mendonca, Maria Angelica Lopes Chaves

    2001-07-01

    The aim of this study was to evaluate the methods for establishing dental caries diagnosis that make use of Laser light as source of illumination, establishing the 'state of the art'. Experimental observation of the differences among fluorescence of sound, demineralized and carious enamel by visible luminescent spectroscopy was also done. Six human teeth, extracted for clinical reasons were studied, and the results showed that the spectrum of carious enamel is different from the sound and demineralized ones. The differences are more evident relative to sond enamel and carious enamel, the same occurring between demineralized and carious enamel. The review of the literature aimed to make comparative considerations between QLF, LF and DELF; their effectiveness relative to traditional methods such as visual, visual with probe, radiography. It was verified that DELF was more sensitive, but could not discriminate between different degrees of mineral loss. QLF, compared to DIAGNOdent has the same sensitivity, but it is better for scientific purposes. The experimental part of the present study used on argon ion Laser to illuminated the teeth and signs of emission of fluorescence were captured by a PMT and then analyzed by a computer system with EG and G software. The results showed that the spectrum of carious enamel is different from the sound and demineralized. The differences are more evident in relation to sound and carious enamel, the same occurs between demineralized and carious enamel. (author)

  1. Creatinine concentrations of accumulated intrauterine fluid to confirm the clinical diagnosis of urometra in mares.

    Science.gov (United States)

    Schnobrich, M R; Gordon, D L; Scoggin, C F; Bradecamp, E A; Canisso, I F

    2017-03-25

    Urine pooling, as a persistent condition, is a cause of infertility in mares due to endometrial inflammation and sperm toxicity. Identification of urometra can be challenging in mares presenting with the condition intermittently, or when urine flows into the uterus but is undetectable in the vagina. Currently, there are no reported objective methods to confirm the clinical diagnosis of urine contamination in intrauterine-fluid accumulations. Since creatinine is present in high concentrations in urine and does not diffuse across cell membranes, creatinine concentration should be increased in mares with urometra, but negligible in normal and mares with intrauterine fluid accumulation (non-urometra cases). To test this hypothesis, creatinine concentrations of intrauterine fluid were measured in mares with a clinical diagnosis of urine accumulation (n=9) or intrauterine fluid containing no urine (n=10). Results showed that creatinine concentrations (mg/dl) were significantly higher in mares that had a clinical diagnosis of urometra (42.8±12.6, range 4.1-109.2) compared with those that did not (0.38±0.1, range 0-0.9). Also, two mares after urethral extension surgery demonstrated a remarkable reduction in creatinine concentrations. This study highlights an undocumented approach to confirm a clinical diagnosis of urometra in mares; the authors anticipate that testing for creatinine in the uterine fluid of mares may become a standard tool for identifying urometra in mares and confirming the success of urogenital surgeries. British Veterinary Association.

  2. 46 CFR 7.20 - Nantucket Sound, Vineyard Sound, Buzzards Bay, Narragansett Bay, MA, Block Island Sound and...

    Science.gov (United States)

    2010-10-01

    ... 46 Shipping 1 2010-10-01 2010-10-01 false Nantucket Sound, Vineyard Sound, Buzzards Bay, Narragansett Bay, MA, Block Island Sound and easterly entrance to Long Island Sound, NY. 7.20 Section 7.20... Atlantic Coast § 7.20 Nantucket Sound, Vineyard Sound, Buzzards Bay, Narragansett Bay, MA, Block Island...

  3. The CanPain SCI Clinical Practice Guidelines for Rehabilitation Management of Neuropathic Pain after Spinal Cord: screening and diagnosis recommendations.

    Science.gov (United States)

    Mehta, S; Guy, S D; Bryce, T N; Craven, B C; Finnerup, N B; Hitzig, S L; Orenczuk, S; Siddall, P J; Widerström-Noga, E; Casalino, A; Côté, I; Harvey, D; Kras-Dupuis, A; Lau, B; Middleton, J W; Moulin, D E; O'Connell, C; Parrent, A G; Potter, P; Short, C; Teasell, R; Townson, A; Truchon, C; Wolfe, D; Bradbury, C L; Loh, E

    2016-08-01

    Clinical practice guidelines. To develop the first Canadian clinical practice guidelines for screening and diagnosis of neuropathic pain in people with spinal cord injury (SCI). The guidelines are relevant for inpatient and outpatient SCI rehabilitation settings in Canada. The CanPainSCI Working Group reviewed evidence to address clinical questions regarding screening and diagnosis of neuropathic pain after SCI. A consensus process was followed to achieve agreement on recommendations and clinical considerations. Twelve recommendations, based on expert consensus, were developed for the screening and diagnosis of neuropathic pain after SCI. The recommendations address methods for assessment, documentation tools, team member accountability, frequency of screening and considerations for diagnostic investigation. Important clinical considerations accompany each recommendation. The expert Working Group developed recommendations for the screening and diagnosis of neuropathic pain after SCI that should be used to inform practice.

  4. Acute Rotavirus-Induced Diarrhea in Children: Clinical Picture, Diagnosis, Treatment

    Directory of Open Access Journals (Sweden)

    S.L. Niankovskyi

    2015-09-01

    Full Text Available The paper considers the current aspects of epidemiology, diagnosis, clinical picture and treatment of acute rotavirus-induced diarrhea in children. There are presented the basic thesis of ESPGHAN consensus (2014 about acute diarrheas. There was analyzed the effectiveness of probiotic Subalin producing interferon for the treatment of acute rotavirus-induced diarrhea. It was demonstrated its effectiveness according to the literature review and own data.

  5. The effect of an educational intervention, based on clinical simulation, on the diagnosis of rheumatoid arthritis and osteoarthritis.

    Science.gov (United States)

    Fernández-Ávila, Daniel G; Ruiz, Álvaro J; Gil, Fabián; Mora, Sergio A; Tobar, Carlos; Gutiérrez, Juan M; Rosselli, Diego

    2018-03-01

    The aim of the present study was to evaluate the effectiveness of an educational tool for general physicians, based on rheumatological clinical simulation, for the diagnosis of rheumatoid arthritis and osteoarthritis. A randomized clinical study was carried out, in which the physician research subjects were assigned to one of two groups: the experimental group (educational intervention for rheumatoid arthritis with clinical simulation) or the control group (educational intervention for the basic aspects of the diagnosis and treatment of osteoporosis). Four weeks after the educational intervention, the members of both groups completed an examination that included four clinical cases with real patients, two clinical cases with two clinical simulation models and six virtual clinical cases. In this examination, the participants noted clinical findings, established a diagnosis and defined the complementary tests they would request, if necessary, to corroborate their diagnosis. A total of 160 doctors participated (80 in the active educational intervention for rheumatoid arthritis and 80 in the control group), of whom 89 were women (56%). The mean age was 35 (standard deviation 7.7) years. Success was defined as a physician correctly diagnosing at least 10 of the 12 cases presented. A significant difference of 81.3% (95% confidence interval 72-90%; p educational intervention based on clinical simulation to improve the diagnostic approach to rheumatoid arthritis and osteoarthritis. The results open a new horizon in the teaching of rheumatology. Copyright © 2017 John Wiley & Sons, Ltd.

  6. MRI findings in the patients with the presumptive clinical diagnosis of Tolosa-Hunt syndrome

    Energy Technology Data Exchange (ETDEWEB)

    Cakirer, Sinan [Department of Radiology, Neuroradiology Section, Istanbul Sisli Etfal Hospital, 81120 Istanbul (Turkey)

    2003-01-01

    The aim of this study was to present our experience in MRI diagnosis of 23 patients with the clinical findings suggesting Tolosa-Hunt syndrome (THS). Cranial MRI studies of the patients with a clinical history of at least one episode of unilateral or bilateral orbital and periorbital pain, and associated paresis of one or more of third to sixth cranial nerves, were performed on a 1.5-T MRI scanner. Whereas 5 patients had the diagnosis of THS, paracavernous meningiomas in 4 patients, pituitary macroadenomas with cavernous sinus infiltration in 3 patients, Meckel's cave neurinoma in 1 patient, and suprasellar epidermoid in 1 patient were surgically proven MRI findings. Other pathological MRI findings were leptomeningeal metastases in 3 patients, granulomatous pachymeningitis sequelae in 2 patients, and aneurysm with compression on cavernous sinus in 1 patient. Three patients had normal MRI findings. The incidence of radiologically proven diagnosis of THS among the patients with the clinical findings suggesting THS seemed to be low in our study. In conclusion, MRI is the most valuable imaging technique to distinguish THS from other THS-like entities, and permits a precise assessment, management, and therapeutic planning of the underlying pathological conditions. (orig.)

  7. A multisite study of the clinical diagnosis of different autism spectrum disorders.

    Science.gov (United States)

    Lord, Catherine; Petkova, Eva; Hus, Vanessa; Gan, Weijin; Lu, Feihan; Martin, Donna M; Ousley, Opal; Guy, Lisa; Bernier, Raphael; Gerdts, Jennifer; Algermissen, Molly; Whitaker, Agnes; Sutcliffe, James S; Warren, Zachary; Klin, Ami; Saulnier, Celine; Hanson, Ellen; Hundley, Rachel; Piggot, Judith; Fombonne, Eric; Steiman, Mandy; Miles, Judith; Kanne, Stephen M; Goin-Kochel, Robin P; Peters, Sarika U; Cook, Edwin H; Guter, Stephen; Tjernagel, Jennifer; Green-Snyder, Lee Anne; Bishop, Somer; Esler, Amy; Gotham, Katherine; Luyster, Rhiannon; Miller, Fiona; Olson, Jennifer; Richler, Jennifer; Risi, Susan

    2012-03-01

    Best-estimate clinical diagnoses of specific autism spectrum disorders (autistic disorder, pervasive developmental disorder-not otherwise specified, and Asperger syndrome) have been used as the diagnostic gold standard, even when information from standardized instruments is available. To determine whether the relationships between behavioral phenotypes and clinical diagnoses of different autism spectrum disorders vary across 12 university-based sites. Multisite observational study collecting clinical phenotype data (diagnostic, developmental, and demographic) for genetic research. Classification trees were used to identify characteristics that predicted diagnosis across and within sites. Participants were recruited through 12 university-based autism service providers into a genetic study of autism. A total of 2102 probands (1814 male probands) between 4 and 18 years of age (mean [SD] age, 8.93 [3.5] years) who met autism spectrum criteria on the Autism Diagnostic Interview-Revised and the Autism Diagnostic Observation Schedule and who had a clinical diagnosis of an autism spectrum disorder. Best-estimate clinical diagnoses predicted by standardized scores from diagnostic, cognitive, and behavioral measures. Although distributions of scores on standardized measures were similar across sites, significant site differences emerged in best-estimate clinical diagnoses of specific autism spectrum disorders. Relationships between clinical diagnoses and standardized scores, particularly verbal IQ, language level, and core diagnostic features, varied across sites in weighting of information and cutoffs. Clinical distinctions among categorical diagnostic subtypes of autism spectrum disorders were not reliable even across sites with well-documented fidelity using standardized diagnostic instruments. Results support the move from existing subgroupings of autism spectrum disorders to dimensional descriptions of core features of social affect and fixated, repetitive behaviors

  8. The clinical significance of CT in the preoperative diagnosis of colon and rectal cancer

    International Nuclear Information System (INIS)

    Itano, Satoshi; Fuchimoto, Sadanori; Hamada, Fumihiro; Kimura, Takanobu; Orita, Kunzo

    1986-01-01

    The clinical significance of CT in the preoperative diagnosis of colon and rectal cancer was studied. Thirty four patients were investigated in this series. The diagnostic criteria of the CT examination were previously established in a study of wall invasion (S factor), lymph node metastasis (N factor), liver metastasis (H factor) and peritoneal dissemination (P factor). The CT diagnosis was done prospectively according to these criteria, and the CT diagnosis was compared with the macroscopic and histological diagnosis. The accuracy of the prospective diagnosis as to H, S, N and P factors was 79.4 %, 55.9 %, 41.2 % and 20.6 %, respectively. The diagnostic value of CT seemed to be acceptable as to the H factor, but limited to some extent to the S and N factors. (author)

  9. Artificial intelligence in diagnosis of obstructive lung disease: current status and future potential.

    Science.gov (United States)

    Das, Nilakash; Topalovic, Marko; Janssens, Wim

    2018-03-01

    The application of artificial intelligence in the diagnosis of obstructive lung diseases is an exciting phenomenon. Artificial intelligence algorithms work by finding patterns in data obtained from diagnostic tests, which can be used to predict clinical outcomes or to detect obstructive phenotypes. The purpose of this review is to describe the latest trends and to discuss the future potential of artificial intelligence in the diagnosis of obstructive lung diseases. Machine learning has been successfully used in automated interpretation of pulmonary function tests for differential diagnosis of obstructive lung diseases. Deep learning models such as convolutional neural network are state-of-the art for obstructive pattern recognition in computed tomography. Machine learning has also been applied in other diagnostic approaches such as forced oscillation test, breath analysis, lung sound analysis and telemedicine with promising results in small-scale studies. Overall, the application of artificial intelligence has produced encouraging results in the diagnosis of obstructive lung diseases. However, large-scale studies are still required to validate current findings and to boost its adoption by the medical community.

  10. [Clinical guidelines for the screening and the diagnosis of autism and pervasive developmental disorders].

    Science.gov (United States)

    Baghdadli, A; Beuzon, S; Bursztejn, C; Constant, J; Desguerre, I; Rogé, B; Squillante, M; Voisin, J; Aussilloux, C

    2006-04-01

    Autism is the best defined category among PDD. Its high prevalence, its onset in very young children and its persistence in adulthood arise many questions about early screening and early diagnosis. The aim of the study was to identify professional best practices about screening and diagnosis of autism in order to propose clinical guidelines and actions for the future. Scientific experts and parents take part to this procedure. Literature and previous guidelines were analyzed, experts in various fields were interviewed, a national study about the medical practices of the diagnosis of autism was made and questionnaires were send to 1600 psychiatrists and pediatricians. Guidelines built around 2 levels were proposed about screening and diagnosis. Diagnosis needs a multidisciplinary approach, validated instruments and more communication between professionals and parents. Finally one of the more important aims of the diagnosis of autism is to facilitate intervention program.

  11. PCR diagnosis and characterization of Leishmania in local and imported clinical samples

    NARCIS (Netherlands)

    Schönian, Gabriele; Nasereddin, Abedelmajeed; Dinse, Nicole; Schweynoch, Carola; Schallig, Henk D. F. H.; Presber, Wolfgang; Jaffe, Charles L.

    2003-01-01

    Leishmaniasis diagnosis in regions where multiple species exist should identify each species directly in the clinical sample without parasite culturing. The sensitivity of two PCR approaches which amplify part of the ssu rRNA gene and the ribosomal internal transcribed spacer (ITS), respectively,

  12. Clinical Value of Thyrotropin Receptor Antibodies for the Differential Diagnosis of Interferon Induced Thyroiditis.

    Science.gov (United States)

    Benaiges, D; Garcia-Retortillo, M; Mas, A; Cañete, N; Broquetas, T; Puigvehi, M; Chillarón, J J; Flores-Le Roux, J A; Sagarra, E; Cabrero, B; Zaffalon, D; Solà, R; Pedro-Botet, J; Carrión, J A

    2016-01-01

    The clinical value of thyrotropin receptor antibodies for the differential diagnosis of thyrotoxicosis induced by pegylated interferon-alpha remains unknown. We analyzed the diagnostic accuracy of thyrotropin receptor antibodies in the differential diagnosis of thyrotoxicosis in patients with chronic hepatitis C (CHC) receiving pegylated interferon-alpha plus ribavirin. Retrospective analysis of 274 patients with CHC receiving pegylated interferon-alpha plus ribavirin. Interferon-induced thyrotoxicosis was classified according to clinical guidelines as Graves disease, autoimmune and non- autoimmune destructive thyroiditis. 48 (17.5%) patients developed hypothyroidism, 17 (6.2%) thyrotoxicosis (6 non- autoimmune destructive thyroiditis, 8 autoimmune destructive thyroiditis and 3 Graves disease) and 22 "de novo" thyrotropin receptor antibodies (all Graves disease, 2 of the 8 autoimmune destructive thyroiditis and 17 with normal thyroid function). The sensitivity and specificity of thyrotropin receptor antibodies for Graves disease diagnosis in patients with thyrotoxicosis were 100 and 85%, respectively. Patients with destructive thyroiditis developed hypothyroidism in 87.5% of autoimmune cases and in none of those with a non- autoimmune etiology (pthyroid scintigraphy for the differential diagnosis of thyrotoxicosis in CHC patients treated with pegylated interferon. © Georg Thieme Verlag KG Stuttgart · New York.

  13. Hyperthyroidism in adults: variable clinical presentations and approaches to diagnosis.

    Science.gov (United States)

    Knudson, P B

    1995-01-01

    Hyperthyroidism is a disease that has various symptoms and can present in many ways. In the elderly patient hyperthyroidism often is not expressed in the classical manner. A case report of a middle-aged man who had hyperthyroidism with only one symptom is detailed. A literature review utilizing MEDLINE files from 1988 to the present, as well as current textbooks of medicine and endocrinology, was used to prepare this report. Keywords for the search were "hyperthyroidism," "symptoms," "unintentional weight loss," and "differential diagnosis." The clinical presentation of hyperthyroidism can vary from almost asymptomatic to apathetic in appearance to a marked hyperdynamic physiologic response. Family physicians must be well informed of this variation in disease expression. Overlooking the diagnosis of this relatively easily treated condition can be detrimental to patient care and expensive.

  14. Clinical aspects of personality disorder diagnosis in the DSM-5

    Directory of Open Access Journals (Sweden)

    Francesco Modica

    2015-05-01

    Full Text Available Abstract: Personality disorders represent psychopathological conditions hard to be diagnosed. The Author highlights the clinical aspects of personality disorder diagnosis according to the criteria of the DSM-5. In this study, some of the numerous definitions of personality are mentioned; afterwards, some of the theories on the development of personality shall be. Later on, concepts of temperament, character and personality get analysed. Then, the current approach to personality disorders according to the two models of DSM-5 is reported. The first model is included in the Section II of DSM-5; while in the Section III there exists a proposal for a so-called alternate model. The first one suggests a qualitative or categorical kind of approach to personality disorders, whereas the alternate model proposes a dimensional or quantitative kind of approach and aims to formulate, as well as a diagnosis for general alterations of the personological functioning, even a trait-based personality disorder diagnosis, which can be formulated when a personality disorder is there but doesn't fit criteria for a specific disorder. Ultimately, it can be so claimed: 1 diagnostic criteria of the first model are similar to those of DSM-IV with its respective strenghts and weaknesses, and namely high probability in diagnosis, where  there, of personality disorder, yet insufficient sensitivity in the specification of the disorder; 2 the alternate model, despite criticism, thanks to the possibility of delivering a trait-based personality disorder diagnosis, seems to be more equipped both in the identification of the personality disorder and further specifications.

  15. [The development of clinical guidelines for the diagnosis and treatment of chronic periodontitis in Belgium].

    Science.gov (United States)

    Cosyn, Jan; De Bruyn, Hugo

    2008-01-01

    In many disciplines of medicine guidelines are developed for the diagnosis and treatment of disease. These are essentially intended to standardize care and to optimize communication between the general practitioner and the specialist. Guidelines have already been described in the literature for chronic periodontitis. However, given the unique conditions in Belgium, these may not be appropriate for the average dental practice. In this manuscript the development of Belgian clinical guidelines for the diagnosis and treatment of chronic periodontitis is described. Basically, ten clinical questions were used as a basis for a thorough literature search. Evidence-based clinical guidelines were developed and adapted during three peer review sessions. In the final session Belgian specialists, who had all been invited, participated. This made sure that the scientific input was sufficiently transformed into clinical guidelines which are actually feasible today in Belgium.

  16. A Cough-Based Algorithm for Automatic Diagnosis of Pertussis

    Science.gov (United States)

    Pramono, Renard Xaviero Adhi; Imtiaz, Syed Anas; Rodriguez-Villegas, Esther

    2016-01-01

    Pertussis is a contagious respiratory disease which mainly affects young children and can be fatal if left untreated. The World Health Organization estimates 16 million pertussis cases annually worldwide resulting in over 200,000 deaths. It is prevalent mainly in developing countries where it is difficult to diagnose due to the lack of healthcare facilities and medical professionals. Hence, a low-cost, quick and easily accessible solution is needed to provide pertussis diagnosis in such areas to contain an outbreak. In this paper we present an algorithm for automated diagnosis of pertussis using audio signals by analyzing cough and whoop sounds. The algorithm consists of three main blocks to perform automatic cough detection, cough classification and whooping sound detection. Each of these extract relevant features from the audio signal and subsequently classify them using a logistic regression model. The output from these blocks is collated to provide a pertussis likelihood diagnosis. The performance of the proposed algorithm is evaluated using audio recordings from 38 patients. The algorithm is able to diagnose all pertussis successfully from all audio recordings without any false diagnosis. It can also automatically detect individual cough sounds with 92% accuracy and PPV of 97%. The low complexity of the proposed algorithm coupled with its high accuracy demonstrates that it can be readily deployed using smartphones and can be extremely useful for quick identification or early screening of pertussis and for infection outbreaks control. PMID:27583523

  17. Pneumococcal pneumonia: clinical features, diagnosis and management in HIV-infected and HIV noninfected patients.

    Science.gov (United States)

    Madeddu, Giordano; Fois, Alessandro Giuseppe; Pirina, Pietro; Mura, Maria Stella

    2009-05-01

    In this review, we focus on the clinical features, diagnosis and management of pneumococcal pneumonia in HIV-infected and noninfected patients, with particular attention to the most recent advances in this area. Classical clinical features are found in young adults, whereas atypical forms occur in immunocompromised patients including HIV-infected individuals. Bacteremic pneumococcal pneumonia is more frequently observed in HIV-infected and also in low-risk patients, according to the Pneumonia Severity Index (PSI). Pneumococcal pneumonia diagnostic process includes physical examination, radiologic findings and microbiologic diagnosis. However, etiologic diagnosis using traditional culture methods is difficult to obtain. In this setting, urinary antigen test, which recognizes Streptococcus pneumoniae cell wall C-polysaccharide, increases the probability of etiologic diagnosis. A correct management approach is crucial in reducing pneumococcal pneumonia mortality. The use of the PSI helps clinicians in deciding between inpatient and outpatient management in immunocompetent individuals, according to Infectious Diseases Society of America (IDSA)-American Thoracic Society (ATS) guidelines. Recent findings support PSI utility also in HIV-infected patients. Recently, efficacy of pneumococcal vaccine in reducing pneumococcal disease incidence has been evidenced in both HIV-infected and noninfected individuals. Rapid diagnosis and correct management together with implementation of preventive measures are crucial in order to reduce pneumococcal pneumonia related incidence and mortality in HIV-infected and noninfected patients.

  18. Clinical pitfalls in the diagnosis of ataque de nervios: a case study.

    Science.gov (United States)

    Lizardi, Dana; Oquendo, Maria A; Graver, Ruth

    2009-09-01

    Ataque de nervios (attack of nerves) is an idiom of distress generally thought of in relation to Caribbean Hispanics. The following case study discusses the presentation of ataque de nervios in a Colombian female. This case study provides insight into a different presentation of ataque de nervios in a new population that clinicians should be aware of in order to ensure accurate diagnosis. Ataque de nervios is a distinct syndrome that does not fully correspond with any single DSM-IV diagnosis. However, there is overlap between symptoms in this condition and those in conventional clinical diagnoses. Common problems in deriving an accurate differential diagnosis are discussed. Implications for treatment are also reviewed, with an emphasis on a comprehensive approach to treatment that supports the client's norms and values.

  19. Timely diagnosis of dairy calf respiratory disease using a standardized scoring system.

    Science.gov (United States)

    McGuirk, Sheila M; Peek, Simon F

    2014-12-01

    Respiratory disease of young dairy calves is a significant cause of morbidity, mortality, economic loss, and animal welfare concern but there is no gold standard diagnostic test for antemortem diagnosis. Clinical signs typically used to make a diagnosis of respiratory disease of calves are fever, cough, ocular or nasal discharge, abnormal breathing, and auscultation of abnormal lung sounds. Unfortunately, routine screening of calves for respiratory disease on the farm is rarely performed and until more comprehensive, practical and affordable respiratory disease-screening tools such as accelerometers, pedometers, appetite monitors, feed consumption detection systems, remote temperature recording devices, radiant heat detectors, electronic stethoscopes, and thoracic ultrasound are validated, timely diagnosis of respiratory disease can be facilitated using a standardized scoring system. We have developed a scoring system that attributes severity scores to each of four clinical parameters; rectal temperature, cough, nasal discharge, ocular discharge or ear position. A total respiratory score of five points or higher (provided that at least two abnormal parameters are observed) can be used to distinguish affected from unaffected calves. This can be applied as a screening tool twice-weekly to identify pre-weaned calves with respiratory disease thereby facilitating early detection. Coupled with effective treatment protocols, this scoring system will reduce post-weaning pneumonia, chronic pneumonia, and otitis media.

  20. Granulomatous slack skin. Histopathology diagnosis preceding clinical manifestations by 12 years.

    Science.gov (United States)

    Goldsztajn, Karen O; Moritz Trope, Beatriz; Ribeiro Lenzi, Maria Elisa; Cuzzi, Tullia; Ramos-E-Silva, Marcia

    2012-12-31

    Granulomatous slack skin is a very rare subtype of T-cell cutaneous lymphoma, characterized by the slow development of cutaneous sagging, especially on flexural areas. Its behavior is indolent and the treatment, in the majority of cases, disappointing. We report a 54-year-old black patient with granulomatous slack skin, who at the beginning of the investigation showed intense xeroderma and generalized lymph node enlargement. The diagnosis was established based on histopathologic findings long before the disease's characteristic clinical presentation appeared. During the twelve years of follow-up, the clinical manifestation evolved to marked skin looseness, most predominant in flexural regions, illustrating the clinical hallmark of granulomatous slack skin, long after first histological abnormalities were observed.

  1. Clinical aspects of personality disorder diagnosis in the DSM-5

    OpenAIRE

    Francesco Modica

    2015-01-01

    Abstract: Personality disorders represent psychopathological conditions hard to be diagnosed. The Author highlights the clinical aspects of personality disorder diagnosis according to the criteria of the DSM-5. In this study, some of the numerous definitions of personality are mentioned; afterwards, some of the theories on the development of personality shall be. Later on, concepts of temperament, character and personality get analysed. Then, the current approach to personality disorders acco...

  2. [Synchronous playing and acquiring of heart sounds and electrocardiogram based on labVIEW].

    Science.gov (United States)

    Dan, Chunmei; He, Wei; Zhou, Jing; Que, Xiaosheng

    2008-12-01

    In this paper is described a comprehensive system, which can acquire heart sounds and electrocardiogram (ECG) in parallel, synchronize the display; and play of heart sound and make auscultation and check phonocardiogram to tie in. The hardware system with C8051F340 as the core acquires the heart sound and ECG synchronously, and then sends them to indicators, respectively. Heart sounds are displayed and played simultaneously by controlling the moment of writing to indicator and sound output device. In clinical testing, heart sounds can be successfully located with ECG and real-time played.

  3. Differential diagnosis and clinical management of periapical radiopaque/hyperdense jaw lesions

    Directory of Open Access Journals (Sweden)

    Brunno Santos Freitas SILVA

    2017-07-01

    Full Text Available Abstract Great attention has been given to the study of radiolucent periapical lesions to avert possible misdiagnosis of apical periodontitis associated with certain radiolucent non-endodontic lesions. However, there are a significant number of radiopaque lesions found in the periapical region, which could be equally relevant to endodontic practice. The diagnosis and management of these radiopaque/hyperdense lesions could be challenging to the endodontist. These bone alterations could be neoplastic, dysplastic or of metabolic origin. In the context of the more widespread use of cone-beam CT, a detailed review of radiopaque inflammatory and non-inflammatory lesions is timely and may aid clinicians perform a differential diagnosis of these lesions. Distinguishing between inflammatory and non-inflammatory lesions simplifies diagnosis and consequently aids in choosing the correct therapeutic regimen. This review discusses the literature regarding the clinical, radiographic, histological and management aspects of radiopaque/hyperdense lesions, and illustrates the differential diagnoses of these lesions.

  4. Demographic and Clinical Correlates of Autism Symptom Domains and Autism Spectrum Diagnosis

    Science.gov (United States)

    Frazier, Thomas W.; Youngstrom, Eric A.; Embacher, Rebecca; Hardan, Antonio Y.; Constantino, John N.; Law, Paul; Findling, Robert L.; Eng, Charis

    2014-01-01

    Demographic and clinical factors may influence assessment of autism symptoms. This study evaluated these correlates and also examined whether social communication and interaction and restricted/repetitive behavior provided unique prediction of autism spectrum disorder diagnosis. We analyzed data from 7352 siblings included in the Interactive…

  5. Clinical Validation of the "Sedentary Lifestyle" Nursing Diagnosis in Secondary School Students

    Science.gov (United States)

    de Oliveira, Marcos Renato; da Silva, Viviane Martins; Guedes, Nirla Gomes; de Oliveira Lopes, Marcos Venícios

    2016-01-01

    This study clinically validated the nursing diagnosis of "sedentary lifestyle" (SL) among 564 Brazilian adolescents. Measures of diagnostic accuracy were calculated for defining characteristics, and Mantel--Haenszel analysis was used to identify related factors. The measures of diagnostic accuracy showed that the following defining…

  6. The degradation diagnosis of low voltage cables used at nuclear power plants

    International Nuclear Information System (INIS)

    Yamamoto, Toshio; Ashida, Tetsuya; Ikeda, Takeshi; Yasuhara, Takeshi; Takechi, Kei; Araki, Shogo

    2001-01-01

    Low voltage cables which have been used for the supply of electric power and the propagation of control signals in nuclear power plants must be sound for safe and stable operation. The long use of nuclear power plants has been reviewed, and the degradation diagnosis to estimate the soundness of low voltage cables has been emphasized. Mitsubishi Cable Industries has established a degradation diagnosis method of cables which convert the velocity of ultrasonic wave in the surface layer of the cable insulation or jacket into breaking elongation, and has developed a degradation diagnosis equipment of low voltage cables used at nuclear power plants in cooperation with Mitsubishi Heavy Industries. This equipment can be moved by an ultrasonic probe by sequential control and measure the ultrasonic velocity automatically. It is capable of a fast an sensitive diagnosis of the cables. We report the outline of this degradation diagnosis equipment and an example of the adaptability estimation at an actual nuclear power plant. (author)

  7. How does additional diagnostic testing influence the initial diagnosis in patients with cognitive complaints in a memory clinic setting?

    Science.gov (United States)

    Meijs, Anouk P; Claassen, Jurgen A H R; Rikkert, Marcel G M Olde; Schalk, Bianca W M; Meulenbroek, Olga; Kessels, Roy P C; Melis, René J F

    2015-01-01

    patients suspected of dementia frequently undergo additional diagnostic testing (e.g. brain imaging or neuropsychological assessment) after standard clinical assessment at a memory clinic. This study investigates the use of additional testing in an academic outpatient memory clinic and how it influences the initial diagnosis. the initial diagnosis after standard clinical assessment (history, laboratory tests, cognitive screening and physical and neurological examination) and the final diagnosis after additional testing of 752 memory clinic patients were collected. We specifically registered if, and what type of, additional testing was requested. additional testing was performed in 518 patients (69%), 67% of whom underwent magnetic resonance imaging, 45% had neuropsychological assessment, 14% had cerebrospinal fluid analysis and 49% had (combinations of) other tests. This led to a modification of the initial diagnosis in 17% of the patients. The frequency of change was highest in patients with an initial non-Alzheimer's disease (AD) dementia diagnosis (54%, compared with 11 and 14% in patients with AD and 'no dementia'; P testing 44% was diagnosed with AD, 9% with non-AD dementia and 47% with 'no dementia'. additional testing should especially be considered in non-AD patients. In the large group of patients with an initial AD or 'no dementia' diagnosis, additional tests have little diagnostic impact and may perhaps be used with more restraint. © The Author 2014. Published by Oxford University Press on behalf of the British Geriatrics Society. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  8. Antenatal diagnosis of congenital deafness.

    Science.gov (United States)

    Isaacson, G

    1988-01-01

    Advances in the field of antenatal diagnosis have made possible the detection of profound sensorineural hearing loss prior to birth. Fetal motion in response to sound and auditory evoked potential testing can determine the presence of fetal hearing in the third trimester of pregnancy. Imaging modalities including ultrasound, computed tomography, and magnetic resonance imaging hold promise for the diagnosis of some forms of congenital deafness in the second trimester fetus. The methods by which congenital deafness soon may be diagnosed and the implications for the otologist are discussed.

  9. Clinical Forms of Chronic Epstein — Barr Virus Infection: Questions of Modern Diagnosis and Treatment

    Directory of Open Access Journals (Sweden)

    O.K. Duda

    2015-02-01

    Full Text Available The article discussed in detail the questions of clinical picture, diagnosis and treatment of Epstein — Barr virus infection. The basic methods of modern laboratory diagnosis of this disease are given, and the list of examinations which must be indicated to a patient with suspected Epstein — Barr virus infection is provided.

  10. CT diagnosis and clinical of leukoaraosis (with 145 cases report)

    International Nuclear Information System (INIS)

    Yang Minzheng

    2005-01-01

    Objective: To investigate pathogenesis of leukoaraosis, the correlation between CT presentation and clinical symptom and to provide useful evidence for clinical diagnosis and treatment. Methods: CT presentation and clinical symptoms in the Leukoaraosis of 145 cases were retrospectively analyzed. Results: Leukoaraosis manifested symmetrical hypo-dense lesion adjacent to frontal horn and/or occipital horn of bilateral ventricles; symmetrical hypo-dense peri-ventricle patches; or diffuse hypo-dense white matter. Lacunar infarction or hemorrhage of basal ganglion and/or thalamus may also be revealed. Conclusion: Leukoaraosis often involves the white matter adjacent to the frontal horn and occipital horn of bilateral ventricles. And entire peri-ventricle white matter may be affected in severe cases. The pathology of the disease is related to demyelination of brain white matter, resulting in the characteristic vascularity in white matter, which may alter under hypertension. (authors)

  11. Is diagnosis enough to guide interventions in mental health? Using case formulation in clinical practice

    Directory of Open Access Journals (Sweden)

    Macneil Craig A

    2012-09-01

    Full Text Available Abstract While diagnosis has traditionally been viewed as an essential concept in medicine, particularly when selecting treatments, we suggest that the use of diagnosis alone may be limited, particularly within mental health. The concept of clinical case formulation advocates for collaboratively working with patients to identify idiosyncratic aspects of their presentation and select interventions on this basis. Identifying individualized contributing factors, and how these could influence the person's presentation, in addition to attending to personal strengths, may allow the clinician a deeper understanding of a patient, result in a more personalized treatment approach, and potentially provide a better clinical outcome.

  12. Reliability of diagnosis and clinical efficacy of visceral osteopathy: a systematic review.

    Science.gov (United States)

    Guillaud, Albin; Darbois, Nelly; Monvoisin, Richard; Pinsault, Nicolas

    2018-02-17

    In 2010, the World Health Organization published benchmarks for training in osteopathy in which osteopathic visceral techniques are included. The purpose of this study was to identify and critically appraise the scientific literature concerning the reliability of diagnosis and the clinical efficacy of techniques used in visceral osteopathy. Databases MEDLINE, OSTMED.DR, the Cochrane Library, Osteopathic Research Web, Google Scholar, Journal of American Osteopathic Association (JAOA) website, International Journal of Osteopathic Medicine (IJOM) website, and the catalog of Académie d'ostéopathie de France website were searched through December 2017. Only inter-rater reliability studies including at least two raters or the intra-rater reliability studies including at least two assessments by the same rater were included. For efficacy studies, only randomized-controlled-trials (RCT) or crossover studies on unhealthy subjects (any condition, duration and outcome) were included. Risk of bias was determined using a modified version of the quality appraisal tool for studies of diagnostic reliability (QAREL) in reliability studies. For the efficacy studies, the Cochrane risk of bias tool was used to assess their methodological design. Two authors performed data extraction and analysis. Eight reliability studies and six efficacy studies were included. The analysis of reliability studies shows that the diagnostic techniques used in visceral osteopathy are unreliable. Regarding efficacy studies, the least biased study shows no significant difference for the main outcome. The main risks of bias found in the included studies were due to the absence of blinding of the examiners, an unsuitable statistical method or an absence of primary study outcome. The results of the systematic review lead us to conclude that well-conducted and sound evidence on the reliability and the efficacy of techniques in visceral osteopathy is absent. The review is registered PROSPERO 12th of December

  13. Comparison of clinical samples for visceral Leishmaniasis diagnosis in asymptomatic dogs by PCR hybridization

    International Nuclear Information System (INIS)

    Ferreira, Sidney A.; Ituassu, Leonardo T.; Melo, Maria N.

    2009-01-01

    The canine visceral leishmaniasis (CVL) diagnosis still represents a challenge because of complexity of this disease. The aim of present study was to compare different clinical samples for diagnosis of CVL by Polymerase Chain Reaction (PCR) combined with hybridization of 32 P labeled probes. Bone marrow (BM), skin biopsy (SB), peripheral blood (PB) and conjunctival swab (CS) were used in this work. With this purpose 40 asymptomatic dogs, all positive by parasitological test, were obtained. From each animal were collected SB with sterile punches from ear internal surface, 1.0 mL of PB, BM aspirates from sternum and CS from both lower eyelid. Each clinical sample was submitted to suitable DNA purification process and PCR-hybridization assays. The positive results obtained with PCR were 55%, 25%, 30% and 22.5% for CS, BM, SB and PB respectively while the PCR followed by hybridization showed a positivity of 87.5%, 50%, 45% and 27.5% respectively. The hybridization assay was able to increase the PCR positivity in all kinds of clinical samples. The best performance was obtained using CS samples. We concluded that the PCR associated with DNA radioactive probes was a very sensitive tool for diagnosis of CVL in asymptomatic dogs and the CS has an important potential for regular screening of dogs. (author)

  14. The sensitivity of clinical diagnostic methods in the diagnosis of diabetic neuropathy.

    Science.gov (United States)

    Onde, M E; Ozge, A; Senol, M G; Togrol, E; Ozdag, F; Saracoglu, M; Misirli, H

    2008-01-01

    This study assessed the sensitivity of various methods for the clinical diagnosis of diabetic peripheral neuropathy. A total of 147 randomly selected patients with diabetes mellitus and 65 age- and sex-matched healthy controls were evaluated by various clinical (the neuropathy symptom score [NSS], the neuropathy disability score [NDS], vibration perception thresholds [VPTs], Tinel's sign and Phalen's sign), laboratory (fasting plasma glucose and glycosylated haemoglobin levels) and electro-physiological (nerve conduction studies, H-reflex and F-wave measurements) methods. In the patient group, 8.2% had an abnormal NSS, 28.5% had a positive Phalen's sign, 32.6% had a positive Tinel's sign, 42.8% had an abnormal VPT and 57.1% had an abnormal NDS. Significant correlations were found between electro-physiologically confirmed neuropathy and the two provocation tests and abnormal VPTs. In conclusion, assessment with a complete neurological examination and standard electrophysiological tests is very important for the diagnosis of diabetic peripheral neuropathy and the prevention of morbidity in patients with or without symptoms.

  15. Automated identification of diagnosis and co-morbidity in clinical records.

    Science.gov (United States)

    Cano, C; Blanco, A; Peshkin, L

    2009-01-01

    Automated understanding of clinical records is a challenging task involving various legal and technical difficulties. Clinical free text is inherently redundant, unstructured, and full of acronyms, abbreviations and domain-specific language which make it challenging to mine automatically. There is much effort in the field focused on creating specialized ontology, lexicons and heuristics based on expert knowledge of the domain. However, ad-hoc solutions poorly generalize across diseases or diagnoses. This paper presents a successful approach for a rapid prototyping of a diagnosis classifier based on a popular computational linguistics platform. The corpus consists of several hundred of full length discharge summaries provided by Partners Healthcare. The goal is to identify a diagnosis and assign co-morbidi-ty. Our approach is based on the rapid implementation of a logistic regression classifier using an existing toolkit: LingPipe (http://alias-i.com/lingpipe). We implement and compare three different classifiers. The baseline approach uses character 5-grams as features. The second approach uses a bag-of-words representation enriched with a small additional set of features. The third approach reduces a feature set to the most informative features according to the information content. The proposed systems achieve high performance (average F-micro 0.92) for the task. We discuss the relative merit of the three classifiers. Supplementary material with detailed results is available at: http:// decsai.ugr.es/~ccano/LR/supplementary_ material/ We show that our methodology for rapid prototyping of a domain-unaware system is effective for building an accurate classifier for clinical records.

  16. Problems in nonlinear acoustics: Scattering of sound by sound, parametric receiving arrays, nonlinear effects in asymmetric sound beams and pulsed finite amplitude sound beams

    Science.gov (United States)

    Hamilton, Mark F.

    1989-08-01

    Four projects are discussed in this annual summary report, all of which involve basic research in nonlinear acoustics: Scattering of Sound by Sound, a theoretical study of two nonconlinear Gaussian beams which interact to produce sum and difference frequency sound; Parametric Receiving Arrays, a theoretical study of parametric reception in a reverberant environment; Nonlinear Effects in Asymmetric Sound Beams, a numerical study of two dimensional finite amplitude sound fields; and Pulsed Finite Amplitude Sound Beams, a numerical time domain solution of the KZK equation.

  17. Diagnosis, imaging and clinical management of aortic coarctation.

    Science.gov (United States)

    Dijkema, Elles J; Leiner, Tim; Grotenhuis, Heynric B

    2017-08-01

    Coarctation of the aorta (CoA ) is a well-known congenital heart disease (CHD) , which is often associated with several other cardiac and vascular anomalies, such as bicuspid aortic valve (BAV), ventricular septal defect, patent ductus arteriosus and aortic arch hypoplasia. Despite echocardiographic screening, prenatal diagnosis of C o A remains difficult. Most patients with CoA present in infancy with absent, delayed or reduced femoral pulses, a supine arm-leg blood pressure gradient (> 20 mm Hg), or a murmur due to rapid blood flow across the CoA or associated lesions (BAV). Transthoracic echocardiography is the primary imaging modality for suspected CoA. However, cardiac magnetic resonance imaging is the preferred advanced imaging modality for non-invasive diagnosis and follow-up of CoA. Adequate and timely diagnosis of CoA is crucial for good prognosis, as early treatment is associated with lower risks of long-term morbidity and mortality. Numerous surgical and transcatheter treatment strategies have been reported for CoA. Surgical resection is the treatment of choice in neonates, infants and young children. In older children (> 25 kg) and adults, transcatheter treatment is the treatment of choice. In the current era, patients with CoA continue to have a reduced life expectancy and an increased risk of cardiovascular sequelae later in life, despite adequate relief of the aortic stenosis. Intensive and adequate follow-up of the left ventricular function, valvular function, blood pressure and the anatomy of the heart and the aorta are , therefore, critical in the management of CoA. This review provides an overview of the current state-of-the-art clinical diagnosis, diagnostic imaging algori thms, treatment and follow-up of patients with CoA. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  18. PREFACE: Aerodynamic sound Aerodynamic sound

    Science.gov (United States)

    Akishita, Sadao

    2010-02-01

    The modern theory of aerodynamic sound originates from Lighthill's two papers in 1952 and 1954, as is well known. I have heard that Lighthill was motivated in writing the papers by the jet-noise emitted by the newly commercialized jet-engined airplanes at that time. The technology of aerodynamic sound is destined for environmental problems. Therefore the theory should always be applied to newly emerged public nuisances. This issue of Fluid Dynamics Research (FDR) reflects problems of environmental sound in present Japanese technology. The Japanese community studying aerodynamic sound has held an annual symposium since 29 years ago when the late Professor S Kotake and Professor S Kaji of Teikyo University organized the symposium. Most of the Japanese authors in this issue are members of the annual symposium. I should note the contribution of the two professors cited above in establishing the Japanese community of aerodynamic sound research. It is my pleasure to present the publication in this issue of ten papers discussed at the annual symposium. I would like to express many thanks to the Editorial Board of FDR for giving us the chance to contribute these papers. We have a review paper by T Suzuki on the study of jet noise, which continues to be important nowadays, and is expected to reform the theoretical model of generating mechanisms. Professor M S Howe and R S McGowan contribute an analytical paper, a valuable study in today's fluid dynamics research. They apply hydrodynamics to solve the compressible flow generated in the vocal cords of the human body. Experimental study continues to be the main methodology in aerodynamic sound, and it is expected to explore new horizons. H Fujita's study on the Aeolian tone provides a new viewpoint on major, longstanding sound problems. The paper by M Nishimura and T Goto on textile fabrics describes new technology for the effective reduction of bluff-body noise. The paper by T Sueki et al also reports new technology for the

  19. High frequency analysis of cough sounds in pediatric patients with respiratory diseases.

    Science.gov (United States)

    Kosasih, K; Abeyratne, U R; Swarnkar, V

    2012-01-01

    Cough is a common symptom in a range of respiratory diseases and is considered a natural defense mechanism of the body. Despite its critical importance in the diagnosis of illness, there are no golden methods to objectively assess cough. In a typical consultation session, a physician may briefly listen to the cough sounds using a stethoscope placed against the chest. The physician may also listen to spontaneous cough sounds via naked ears, as they naturally propagate through air. Cough sounds carry vital information on the state of the respiratory system but the field of cough analysis in clinical medicine is in its infancy. All existing cough analysis approaches are severely handicapped by the limitations of the human hearing range and simplified analysis techniques. In this paper, we address these problems, and explore the use of frequencies covering a range well beyond the human perception (up to 90 kHz) and use wavelet analysis to extract diagnostically important information from coughs. Our data set comes from a pediatric respiratory ward in Indonesia, from subjects diagnosed with asthma, pneumonia and rhinopharyngitis. We analyzed over 90 cough samples from 4 patients and explored if high frequencies carried useful information in separating these disease groups. Multiple regression analysis resulted in coefficients of determination (R(2)) of 77-82% at high frequencies (15 kHz-90 kHz) indicating that they carry useful information. When the high frequencies were combined with frequencies below 15kHz, the R(2) performance increased to 85-90%.

  20. Comparison of clinical and paraclinical parameters as tools for early diagnosis of classical swine fever

    DEFF Research Database (Denmark)

    Lohse, Louise; Uttenthal, Åse; Nielsen, Jens

    Comparison of clinical and paraclinical parameters as tools for early diagnosis of classical swine fever. Louise Lohse, Åse Uttenthal, Jens Nielsen. National Veterinary Institute, Division of Virology, Lindholm, Technical University of Denmark. Introduction: In order to limit the far-reaching socio......-economic as well as the animal welfare consequences of an outbreak of classical swine fever (CSF), early diagnosis is essential. However, host-virus interactions strongly influence the course of CSF disease, and the clinical feature is not clear, thus complicating the diagnostic perspective. At the National...... Veterinary Institute, in Denmark, we are conducting a series of animal experiments under standardized conditions in order to investigate new parameters of clinical as well as paraclinical nature that holds the potential as diagnostic tools to improve early detection of CSF. In three recent studies, weaned...

  1. Clinical stage of oral cancer patients at the time of initial diagnosis

    International Nuclear Information System (INIS)

    Shah, I.; Sefvan, O.; Luqman, Z.; Ibrahim, W.; Mehmood, S.

    2010-01-01

    Background: Squamous cell carcinoma is the most common oral cancer. Early diagnosis ensures better prognosis. Late diagnosis is however common around the world and contributes to the high morbidity and mortality related to oral cancer. The objective of this study was to determine the clinical stage of oral cancer patients at the time of diagnosis. Methods: This retrospective study was carried out on 334 oral cancer patients who presented to the outdoor departments of Armed Forces Institute of Dentistry, and Armed Forces Institute of Pathology, Rawalpindi from July 2008 to December 2009. The records that were reviewed included history and clinical examination findings, OPG and CT scans of the head and neck region, chest X-rays, abdominal ultrasounds and liver function tests. Size of the primary tumour, the size, number and laterality of the involved cervical lymph nodes and the presence/absence of distant metastases were documented and statistically analysed using SPSS-17. Results: Out of the 334 patients, 203 (60.8%) were males and 131 (39.2%) females. The age range was from 21 to 88 years. Buccal mucosa was the most commonly involved site (32 %). The primary tumour was 4 Cm or more in size, (T3/T4) 71.25% of the cases. Cervical lymph nodes were involved in 211 patients (63.2%) and distant metastases were present in 39 patients (11.7%). Overall, clinical stage IV was the most common (57.18%) followed by stage III(24.55%), stage II (13.77%) and stage I (4.49%). Conclusion: Oral cancers are diagnosed late (Stage III and IV) in Pakistan and need immediate public and professional attention. (author)

  2. Clinical stage of oral cancer patients at the time of initial diagnosis.

    Science.gov (United States)

    Shah, Irfan; Sefvan, Omer; Luqman, Uzair; Ibrahim, Waseem; Mehmood, Sana; Alamgir, Wajiha

    2010-01-01

    Squamous cell carcinoma is the most common oral cancer. Early diagnosis ensures better prognosis. Late diagnosis is however common around the world and contributes to the high morbidity and mortality related to oral cancer. The objective of this study was to determine the clinical stage of oral cancer patients at the time of diagnosis. This retrospective study was carried out on 334 oral cancer patients who presented to the outdoor departments of Armed Forces Institute of Dentistry, and Armed Forces Institute of Pathology, Rawalpindi from July 2008 to December 2009. The records that were reviewed included history and clinical examination findings. OPG and CT scans of the head and neck region, chest X-rays, abdominal ultrasounds and liver function tests. Size of the primary tumour, the size, number and laterality of the involved cervical lymph nodes and the presence/absence of distant metastases were documented and statistically analysed using SPSS-17. Out of the 334 patients, 203 (60.8%) were males and 131 (39.2%) females. The age range was from 21 to 88 years. Buccal mucosa was the most commonly involved site (32%). The primary tumour was 4 Cm or more in size, (T3/T4) 71.25% of the cases. Cervical lymph nodes were involved in 211 patients (63.2%) and distant metastases were present in 39 patients (11.7%). Overall, clinical stage IV was the most common (57.18%) followed by stage III (24.55%), stage II (13.77%) and stage I (4.49%). Oral cancers are diagnosed late (Stage III and IV) in Pakistan and need immediate public and professional attention.

  3. Targeted NGS meets expert clinical characterization: Efficient diagnosis of spastic paraplegia type 11

    Directory of Open Access Journals (Sweden)

    Cristina Castro-Fernández

    2015-06-01

    Full Text Available Next generation sequencing (NGS is transforming the diagnostic approach for neurological disorders, since it allows simultaneous analysis of hundreds of genes, even based on just a broad, syndromic patient categorization. However, such an approach bears a high risk of incidental and uncertain genetic findings. We report a patient with spastic paraplegia whose comprehensive neurological and imaging examination raised a high clinical suspicion of SPG11. Thus, although our NGS pipeline for this group of disorders includes gene panel and exome sequencing, in this sample only the spatacsin gene region was captured and subsequently searched for mutations. Two probably pathogenic variants were quickly and clearly identified, confirming the diagnosis of SPG11. This case illustrates how combination of expert clinical characterization with highly oriented NGS protocols leads to a fast, cost-efficient diagnosis, minimizing the risk of findings with unclear significance.

  4. Clinical impact of confocal laser endomicroscopy in the management of gastrointestinal lesions with an uncertain diagnosis.

    Science.gov (United States)

    Robles-Medranda, Carlos; Vargas, Maria; Ospina, Jesenia; Puga-Tejada, Miguel; Valero, Manuel; Soria, Miguel; Bravo, Gladys; Robles-Jara, Carlos; Lukashok, Hannah Pitanga

    2017-08-16

    To evaluate the clinical impact of confocal laser endomicroscopy (CLE) in the diagnosis and management of patients with an uncertain diagnosis. A retrospective chart review was performed. Patients who underwent CLE between November 2013 and October 2015 and exhibited a poor correlation between endoscopic and histological findings were included. Baseline characteristics, indications, previous diagnostic studies, findings at the time of CLE, clinical management and histological results were analyzed. Interventions based on CLE findings were also analyzed. We compared the diagnostic accuracy of CLE and target biopsies of surgical specimens. A total of 144 patients were included. Of these, 51% (74/144) were female. The mean age was 51 years old. In all, 41/144 (28.4%) lesions were neoplastic (13 bile duct, 10 gastric, 8 esophageal, 6 colonic, 1 duodenal, 1 rectal, 1 ampulloma and 1 pancreatic). The sensitivity, specificity, positive predictive value, negative predictive value, and observed agreement when CLE was used to detect N-lesions were 85.37%, 87.38%, 72.92%, 93.75% and 86.81%, respectively. Cohen's Kappa was 69.20%, thus indicating good agreement. Changes in management were observed in 54% of the cases. CLE is a new diagnostic tool that has a significant clinical impact on the diagnosis and treatment of patients with uncertain diagnosis.

  5. Acute disseminated encephalomyelitis in children: differential diagnosis from multiple sclerosis on the basis of clinical course

    Directory of Open Access Journals (Sweden)

    Yun Jin Lee

    2011-06-01

    Full Text Available Acute disseminated encephalomyelitis (ADEM is a demyelinating disease of the central nervous system (CNS that typically presents as a monophasic disorder associated with multifocal neurologic symptoms and encephalopathy. ADEM is considered an autoimmune disorder that is triggered by an environmental stimulus in genetically susceptible individuals. The diagnosis of ADEM is based on clinical and radiological features. Most children with ADEM initially present with fever, meningeal signs, and acute encephalopathy. The level of consciousness ranges from lethargy to frank coma. Deep and subcortical white-matter lesions and gray-matter lesions such as thalami and basal ganglia on magnetic resonance imaging (MRI are associated with ADEM. In a child who presents with signs of encephalitis, bacterial and viral meningitis or encephalitis must be ruled out. Sequential MRI is required to confirm the diagnosis of ADEM, as relapses with the appearance of new lesions on MRI may suggest either multiphasic ADEM or multiple sclerosis (MS. Pediatric MS, defined as onset of MS before the age of 16, is being increasingly recognized. MS is characterized by recurrent episodes of demyelination in the CNS separated in space and time. The McDonald criteria for diagnosis of MS include evidence from MRI and allow the clinician to make a diagnosis of clinically definite MS on the basis of the interval preceding the development of new white matter lesions, even in the absence of new clinical findings. The most important alternative diagnosis to MS is ADEM. At the initial presentation, the 2 disorders cannot be distinguished with certainty. Therefore, prolonged follow-up is needed to establish a diagnosis.

  6. An open access database for the evaluation of heart sound algorithms.

    Science.gov (United States)

    Liu, Chengyu; Springer, David; Li, Qiao; Moody, Benjamin; Juan, Ricardo Abad; Chorro, Francisco J; Castells, Francisco; Roig, José Millet; Silva, Ikaro; Johnson, Alistair E W; Syed, Zeeshan; Schmidt, Samuel E; Papadaniil, Chrysa D; Hadjileontiadis, Leontios; Naseri, Hosein; Moukadem, Ali; Dieterlen, Alain; Brandt, Christian; Tang, Hong; Samieinasab, Maryam; Samieinasab, Mohammad Reza; Sameni, Reza; Mark, Roger G; Clifford, Gari D

    2016-12-01

    In the past few decades, analysis of heart sound signals (i.e. the phonocardiogram or PCG), especially for automated heart sound segmentation and classification, has been widely studied and has been reported to have the potential value to detect pathology accurately in clinical applications. However, comparative analyses of algorithms in the literature have been hindered by the lack of high-quality, rigorously validated, and standardized open databases of heart sound recordings. This paper describes a public heart sound database, assembled for an international competition, the PhysioNet/Computing in Cardiology (CinC) Challenge 2016. The archive comprises nine different heart sound databases sourced from multiple research groups around the world. It includes 2435 heart sound recordings in total collected from 1297 healthy subjects and patients with a variety of conditions, including heart valve disease and coronary artery disease. The recordings were collected from a variety of clinical or nonclinical (such as in-home visits) environments and equipment. The length of recording varied from several seconds to several minutes. This article reports detailed information about the subjects/patients including demographics (number, age, gender), recordings (number, location, state and time length), associated synchronously recorded signals, sampling frequency and sensor type used. We also provide a brief summary of the commonly used heart sound segmentation and classification methods, including open source code provided concurrently for the Challenge. A description of the PhysioNet/CinC Challenge 2016, including the main aims, the training and test sets, the hand corrected annotations for different heart sound states, the scoring mechanism, and associated open source code are provided. In addition, several potential benefits from the public heart sound database are discussed.

  7. Clinical review: Current state and future perspectives in the diagnosis of diabetes insipidus: a clinical review.

    Science.gov (United States)

    Fenske, Wiebke; Allolio, Bruno

    2012-10-01

    The differential diagnosis of diabetes insipidus (DI) is often challenging but essential, because treatment may vary substantially. This article analyzes the database and performance of currently used differential diagnostic tests for DI and discusses future perspectives for diagnostic improvement. A review of electronic and print data comprising original and review articles retrieved from the PubMed or Cochrane Library database up to January 2012 was conducted. The search term "polyuria polydipsia syndrome" was cross-referenced with underlying forms of disease and associated clinical, diagnostic, and therapeutic MeSH terms. In addition, references from review articles and textbook chapters were screened for papers containing original data. Search results were narrowed to articles containing primary data with a description of criteria for the differential diagnosis of DI. Fifteen articles on differential diagnosis of DI were identified, mainly consisting of small series of patients, and mostly covering only part of the differential diagnostic spectrum of DI. Test protocols differed, and prospective validation of diagnostic criteria was consistently missing. Inconsistent data were reported on the diagnostic superiority of direct plasma arginine vasopressin determination over the indirect water deprivation test. Both test methods revealed limitations, especially in the differentiation of disorders with a milder phenotype. The available data demonstrate limitations of current biochemical tests for the differential diagnosis of DI, potentially leading to incorrect diagnosis and treatment. The newly available assay for copeptin, the C terminus of the vasopressin precursor, holds promise for a higher diagnostic specificity and simplification of the differential diagnostic protocol in DI.

  8. Computerized Respiratory Sounds: Novel Outcomes for Pulmonary Rehabilitation in COPD.

    Science.gov (United States)

    Jácome, Cristina; Marques, Alda

    2017-02-01

    Computerized respiratory sounds are a simple and noninvasive measure to assess lung function. Nevertheless, their potential to detect changes after pulmonary rehabilitation (PR) is unknown and needs clarification if respiratory acoustics are to be used in clinical practice. Thus, this study investigated the short- and mid-term effects of PR on computerized respiratory sounds in subjects with COPD. Forty-one subjects with COPD completed a 12-week PR program and a 3-month follow-up. Secondary outcome measures included dyspnea, self-reported sputum, FEV 1 , exercise tolerance, self-reported physical activity, health-related quality of life, and peripheral muscle strength. Computerized respiratory sounds, the primary outcomes, were recorded at right/left posterior chest using 2 stethoscopes. Air flow was recorded with a pneumotachograph. Normal respiratory sounds, crackles, and wheezes were analyzed with validated algorithms. There was a significant effect over time in all secondary outcomes, with the exception of FEV 1 and of the impact domain of the St George Respiratory Questionnaire. Inspiratory and expiratory median frequencies of normal respiratory sounds in the 100-300 Hz band were significantly lower immediately (-2.3 Hz [95% CI -4 to -0.7] and -1.9 Hz [95% CI -3.3 to -0.5]) and at 3 months (-2.1 Hz [95% CI -3.6 to -0.7] and -2 Hz [95% CI -3.6 to -0.5]) post-PR. The mean number of expiratory crackles (-0.8, 95% CI -1.3 to -0.3) and inspiratory wheeze occupation rate (median 5.9 vs 0) were significantly lower immediately post-PR. Computerized respiratory sounds were sensitive to short- and mid-term effects of PR in subjects with COPD. These findings are encouraging for the clinical use of respiratory acoustics. Future research is needed to strengthen these findings and explore the potential of computerized respiratory sounds to assess the effectiveness of other clinical interventions in COPD. Copyright © 2017 by Daedalus Enterprises.

  9. Discriminant analysis to predict the clinical diagnosis of primary immunodeficiencies: a preliminary report

    Directory of Open Access Journals (Sweden)

    Chiharu Murata

    2015-04-01

    Conclusions: In general, the selection of features has clinical plausibility, and the practical advantage of utilizing only clinical attributes, infecting germs and routine lab results (blood cell counts and serum immunoglobulins. The performance of the model as a diagnostic tool was acceptable. The study’s main limitations are a limited sample size and a lack of cross validation. This is only the first step in the construction of a machine learning system, with a wider approach that includes a larger database and different methodologies, to assist the clinical diagnosis of primary immunodeficiencies.

  10. Celiac Disease: Diagnosis.

    Science.gov (United States)

    Byrne, Greg; Feighery, Conleth F

    2015-01-01

    Historically the diagnosis of celiac disease has relied upon clinical, serological, and histological evidence. In recent years the use of sensitive serological methods has meant an increase in the diagnosis of celiac disease. The heterogeneous nature of the disorder presents a challenge in the study and diagnosis of the disease with patients varying from subclinical or latent disease to patients with overt symptoms. Furthermore the related gluten-sensitive disease dermatitis herpetiformis, while distinct in some respects, shares clinical and serological features with celiac disease. Here we summarize current best practice for the diagnosis of celiac disease and briefly discuss newer approaches. The advent of next-generation assays for diagnosis and newer clinical protocols may result in more sensitive screening and ultimately the possible replacement of the intestinal biopsy as the gold standard for celiac disease diagnosis.

  11. Pre-Hospital Fast Positive Cases Identified by DFB Ambulance Paramedics – Final Clinical Diagnosis

    LENUS (Irish Health Repository)

    Feeney, A

    2016-04-01

    Ischaemic stroke clinical outcomes are improved by earlier treatment with intravenous thrombolysis. An existing pathway at the Mater University Hospital for assessment of suspected acute stroke in the Emergency Department was updated, aiming to shorten ‘door to needle time’. This study examines the final clinical diagnosis of Dublin Fire Brigade Ambulance Paramedic identified Face Arm Speech Test (FAST) positive patients presenting to the Emergency Department over a 7 month period. A retrospective analysis was carried out of 177 consecutive FAST positive patients presenting between March and November 2014. The final clinical diagnosis was acute stroke in 57.1% (n=101) of patients. Of these, 76 were ischaemic strokes of whom 56.5% (n=43) were thrombolysed. In the pre-hospital setting Ambulance Paramedics can identify, with reasonable accuracy, acute stroke using the FAST test. Over half of the ischaemic stroke patients presenting via this pathway can be treated with intravenous thrombolysis

  12. Comparison of clinical causes of deth with autopsy diagnosis using discrepancy classification

    International Nuclear Information System (INIS)

    Ullah, K.; Alamgir, W.

    2006-01-01

    To determine the usefulness of autopsy findings in the quality improvement of patients care. The clinical and necropsy findings of all the cases, who died in hospital and had undergone autopsy examination at CMH, Kharian, from January 2001 to December 2003, were retrieved from record of clinical case sheet data and autopsy record of the hospital. The two were analyzed and compared according to the discrepancy classification. The exclusion and inclusion criteria, the international classification of disease (ICD) to code deaths, the global burden of disease (GBD) system to classify and group diseases, and the Goldman discrepancy classification to compare clinical and autopsy diagnosis and classify the discrepancies, were used as described. The death rate varied from 0.94% to 1.29% and autopsy rate from 4.69% to 10.10% annually between January 2001 and December 2003. The number of cases classified according to GBD system was 3 (5%) in Group 1, 26 (43.33 %) in Group 2 and 31 (51.66 %) in Group 3. The discrepancy classes included 9 (15 %) class I major discrepancies and 3 (5 %) class II major discrepancies. Non-discrepant diagnosis was seen in 37 cases (61.66 %) and 11 cases (18.32 %) were non classifiable. (author)

  13. The clinical features, diagnosis, and treatment of cognitive impairments in Parkinson's disease

    Directory of Open Access Journals (Sweden)

    G. N. Akhmadeeva

    2017-01-01

    Full Text Available The review presents the data of recent studies dealing with cognitive impairments (CI in patients with Parkinson's disease (PD and gives their characteristics and epidemiology, the specific features of the pathogenesis and clinical manifestations, as well as current methods for their diagnosis and treatment. Moderate CIs (MCIs occur in 18.9–55% of patients with PD; the prevalence of dementia during a cross-sectional study approaches 30%. The 2007 Movement Disorder Society criteria and algorithm for the diagnosis of dementia in PD and the 2012 criteria and the algorithm for the diagnosis of MCIs allow one to maximally accurately identify these disorders. Only rivastigmine is now recognized as effective in treating CI in PD and recommended for use. Overall, therapies for CI in PD have been inadequately investigated, making it necessary to conduct further large-scale studies.

  14. Experiences of women with a diagnosis of breast cancer: a clinical pathway approach.

    Science.gov (United States)

    Lindop, E; Cannon, S

    2001-06-01

    The study presented in this paper formed the first part of a large survey of breast cancer patients in one health authority in England, UK looking at individual needs expressed by women with a diagnosis of breast cancer. The paper provides an account of the experiences of 12 women with a diagnosis of breast cancer. The women represent a wide age range and different stages of illness. The transcribed accounts of the women were analysed by means of Qualitative Solutions and Research, Non-Numerical Unstructured Data Indexing Searching and Theorising (QSR*NUDIST). The study examined the individual experiences of women with a diagnosis of breast cancer and its aftermath as they passed through different stages related to it. The women's experiences are presented within the conceptual framework of the clinical pathway and their accounts represent their journey along the pathway. Various significant points in this journey are portrayed representing the women's reactions to diagnosis, treatment, femininity and body image, support, family and friends, information and after care.

  15. Deterministic versus evidence-based attitude towards clinical diagnosis.

    Science.gov (United States)

    Soltani, Akbar; Moayyeri, Alireza

    2007-08-01

    Generally, two basic classes have been proposed for scientific explanation of events. Deductive reasoning emphasizes on reaching conclusions about a hypothesis based on verification of universal laws pertinent to that hypothesis, while inductive or probabilistic reasoning explains an event by calculation of some probabilities for that event to be related to a given hypothesis. Although both types of reasoning are used in clinical practice, evidence-based medicine stresses on the advantages of the second approach for most instances in medical decision making. While 'probabilistic or evidence-based' reasoning seems to involve more mathematical formulas at the first look, this attitude is more dynamic and less imprisoned by the rigidity of mathematics comparing with 'deterministic or mathematical attitude'. In the field of medical diagnosis, appreciation of uncertainty in clinical encounters and utilization of likelihood ratio as measure of accuracy seem to be the most important characteristics of evidence-based doctors. Other characteristics include use of series of tests for refining probability, changing diagnostic thresholds considering external evidences and nature of the disease, and attention to confidence intervals to estimate uncertainty of research-derived parameters.

  16. PSORIATIC ARTHRITIS: CLASSIFICATION, CLINICAL PRESENTATION, DIAGNOSIS, TREATMENT

    Directory of Open Access Journals (Sweden)

    T. V. Korotaeva

    2014-01-01

    Full Text Available The lecture gives basic information about psoriatic arthritis (PsA, a chronic inflammatory disease of the joints, spine, and enthesises from a group of spondyloarthritis. It describes the epidemiology of the disease and considers current ideas on its pathogenesis and factors influencing the development of PsA in psoriatic patients. The classification and clinical forms of PsA are presented. The major clinical manifestations of the disease are indicated to include peripheral arthritis, enthesitis, dactylitis, and spondylitis. The diagnosis of the disease is noted to be established on the basis of its detected typical clinical and radiological signs, by applying the CASPAR criteria. A dermatologist, rheumatologist, and general practitioner screen PsA, by actively detecting complaints, characteristic clinical and radiological signs of damage to the joints, and/or spine, and/or enthesises and by using screening questionnaires. There are data that patients with PsA are observed to be at higher risk for a number of diseases type 2 diabetes mellitus hypertension, coronary heart disease, obesity, metabolic syndrome, inflammatory bowel diseases, etc. The aim of current pharmacotherapy for PsA is to achieve remission or minimal activity of clinical manifestations of the disease, to delay or prevent its X-ray progression, to increase survival, to improve quality of life in patients, and to reduce the risk of comorbidities. The paper considers groups of medicines used to treat the disease, among other issues, information about biological agents (BA registered in the Russian Federation for the treatment of PsA. Most patients are mentioned to show a good response to this therapy option just 3–6 months after treatment initiation; however, some of them develop primary inefficiency. In this case, switching one BA to another is recommended. Some patients using a BA develop secondary treatment inefficiency, which is firstly due to the appearance of

  17. Clinical diagnosis versus autopsy findings in polytrauma fatalities

    Directory of Open Access Journals (Sweden)

    Fakler Johannes K

    2010-10-01

    Full Text Available Abstract Objectives The aim of the study was to determine if differences in clinical diagnosis versus autopsy findings concerning the cause of death in polytrauma fatalities would be detected in 19 cases of fatal polytrauma from a Level 1 trauma centre. Methods Clinical diagnoses determining the cause of death in 19 cases of fatal polytrauma (2007 - 2008 from a Level 1 trauma centre were correlated with autopsy findings. Results In 13 cases (68%, the clinical cause of death and the cause of death as determined by autopsy were congruent. Marginal differences occurred in three (16% patients while obvious differences in interpreting the cause of death were found in another three (16% cases. Five fatalities (three with obvious differences and two with marginal differences were remarked as early death (1-4 h after trauma and one fatality with marginal differences as late death (>1 week after trauma. Obvious and marginal discrepancies mostly occurred in the early phase of treatment, especially when severely injured patients were admitted to the emergency room undergoing continued cardiopulmonary resuscitation, i. e. limiting diagnostic procedures, and thus the clinical cause of death was essentially determined by basic emergency diagnostics. Conclusions Autopsy as golden standard to define the cause of death in fatal polytrauma varies from the clinical point of view, depending on the patient's pre-existing condition, mechanism of polytrauma, necessity of traumatic cardiopulmonary resuscitation, survival time, and thus the possibility to perform emergency diagnostics. An autopsy should be performed at least in cases of early fatal polytrauma to help establishing the definite cause of death. Moreover, autopsy data should be included in trauma registries as a quality assessment tool.

  18. Comparison of clinical samples for visceral Leishmaniasis diagnosis in asymptomatic dogs by PCR hybridization

    Energy Technology Data Exchange (ETDEWEB)

    Ferreira, Sidney A.; Ituassu, Leonardo T.; Melo, Maria N. [Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG (Brazil). Dept. de Parasitologia], e-mail: saninoalmeida@gmail.com, e-mail: Itituassu@yahoo.com.br, e-mail: melo@icb.ufmg.br; Leite, Rodrigo S.; Andrade, Antero S.R. [Centro de Desenvolvimento da Tecnologia Nuclear (CDTN-CNEN/MG), Belo Horizonte, MG (Brazil)], e-mail: rleite2005@gmail.com, e-mail: antero@cdtn.br

    2009-07-01

    The canine visceral leishmaniasis (CVL) diagnosis still represents a challenge because of complexity of this disease. The aim of present study was to compare different clinical samples for diagnosis of CVL by Polymerase Chain Reaction (PCR) combined with hybridization of {sup 32}P labeled probes. Bone marrow (BM), skin biopsy (SB), peripheral blood (PB) and conjunctival swab (CS) were used in this work. With this purpose 40 asymptomatic dogs, all positive by parasitological test, were obtained. From each animal were collected SB with sterile punches from ear internal surface, 1.0 mL of PB, BM aspirates from sternum and CS from both lower eyelid. Each clinical sample was submitted to suitable DNA purification process and PCR-hybridization assays. The positive results obtained with PCR were 55%, 25%, 30% and 22.5% for CS, BM, SB and PB respectively while the PCR followed by hybridization showed a positivity of 87.5%, 50%, 45% and 27.5% respectively. The hybridization assay was able to increase the PCR positivity in all kinds of clinical samples. The best performance was obtained using CS samples. We concluded that the PCR associated with DNA radioactive probes was a very sensitive tool for diagnosis of CVL in asymptomatic dogs and the CS has an important potential for regular screening of dogs. (author)

  19. MRI diagnosis of pituitary abscess and its clinical significance

    International Nuclear Information System (INIS)

    Chen Shuang; Qian Ruiling; Tang Zhiwei; Liu Ke; Huang Yong; Li Xi

    2007-01-01

    Objective: To investigate the MR features of pituitary abscess. Methods: The MR features of 14 eases of pituitary abscess proved by surgical pathology and clinical treatments were analyzed retrospectively. Results: Pre-contrast MR showed hypointense heterogeneous intensity on T 1 WI in 12 cases and iso-hyperintense on T 1 WI in 2 cases, hyperintense on T 2 WI in all cases. Post-gadolinium MR showed the ring-like enhancement around the uneven edge of abscess and the surrounding enhanced meninges connecting to the focus. The normal pituitary could not be identified in all 14 cases. The MR specific findings include the fluid-fluid level, nodule on the edge and the enhanced patchy shadow. Conclusions: The pituitary abscess has specific findings on MR examination, which can be used to combine with clinical symptoms to achieve the diagnosis before operation, so that the cases could be treated with antibiotic without operation. (authors)

  20. Relationship between breast sound speed and mammographic percent density

    Science.gov (United States)

    Sak, Mark; Duric, Nebojsa; Boyd, Norman; Littrup, Peter; Myc, Lukasz; Faiz, Muhammad; Li, Cuiping; Bey-Knight, Lisa

    2011-03-01

    Despite some shortcomings, mammography is currently the standard of care for breast cancer screening and diagnosis. However, breast ultrasound tomography is a rapidly developing imaging modality that has the potential to overcome the drawbacks of mammography. It is known that women with high breast densities have a greater risk of developing breast cancer. Measuring breast density is accomplished through the use of mammographic percent density, defined as the ratio of fibroglandular to total breast area. Using an ultrasound tomography (UST) prototype, we created sound speed images of the patient's breast, motivated by the fact that sound speed in a tissue is proportional to the density of the tissue. The purpose of this work is to compare the acoustic performance of the UST system with the measurement of mammographic percent density. A cohort of 251 patients was studied using both imaging modalities and the results suggest that the volume averaged breast sound speed is significantly related to mammographic percent density. The Spearman correlation coefficient was found to be 0.73 for the 175 film mammograms and 0.69 for the 76 digital mammograms obtained. Since sound speed measurements do not require ionizing radiation or physical compression, they have the potential to form the basis of a safe, more accurate surrogate marker of breast density.

  1. Imagining Sound

    DEFF Research Database (Denmark)

    Grimshaw, Mark; Garner, Tom Alexander

    2014-01-01

    We make the case in this essay that sound that is imagined is both a perception and as much a sound as that perceived through external stimulation. To argue this, we look at the evidence from auditory science, neuroscience, and philosophy, briefly present some new conceptual thinking on sound...... that accounts for this view, and then use this to look at what the future might hold in the context of imagining sound and developing technology....

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

    Science.gov (United States)

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

    2017-01-01

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

  3. Aeroionic Diagnosis of Nutritional Disorders in the Clinical Practice

    Directory of Open Access Journals (Sweden)

    Yu.I. Reshetilov

    2016-08-01

    Full Text Available The article presents the results of a study of air ions in the exhaled air in 310 patients with combined patho­logy of the digestive system. The data are presented on the new non-invasive method of diagnosis and individualization of a comprehensive treatment of patients, in particular diet therapy. There is substantiated the selection of food in accordance with the basic electrochemical characteristics. The prospects of ­using the method of aeroionic testing in the clinical practice as a technology for primary screening and non-invasive monitoring of treatment outcomes were evaluated.

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

    Science.gov (United States)

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

    2017-10-01

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

  5. Vulnerability to the Irrelevant Sound Effect in Adult ADHD.

    Science.gov (United States)

    Pelletier, Marie-France; Hodgetts, Helen M; Lafleur, Martin F; Vincent, Annick; Tremblay, Sébastien

    2016-04-01

    An ecologically valid adaptation of the irrelevant sound effect paradigm was employed to examine the relative roles of short-term memory, selective attention, and sustained attention in ADHD. In all, 32 adults with ADHD and 32 control participants completed a serial recall task in silence or while ignoring irrelevant background sound. Serial recall performance in adults with ADHD was reduced relative to controls in both conditions. The degree of interference due to irrelevant sound was greater for adults with ADHD. Furthermore, a positive correlation was observed between task performance under conditions of irrelevant sound and the extent of attentional problems reported by patients on a clinical symptom scale. The results demonstrate that adults with ADHD exhibit impaired short-term memory and a low resistance to distraction; however, their capacity for sustained attention is preserved as the impact of irrelevant sound diminished over the course of the task. © The Author(s) 2013.

  6. A diagnosis-based clinical decision rule for spinal pain part 2: review of the literature

    Directory of Open Access Journals (Sweden)

    Hurwitz Eric L

    2008-08-01

    Full Text Available Abstract Background Spinal pain is a common and often disabling problem. The research on various treatments for spinal pain has, for the most part, suggested that while several interventions have demonstrated mild to moderate short-term benefit, no single treatment has a major impact on either pain or disability. There is great need for more accurate diagnosis in patients with spinal pain. In a previous paper, the theoretical model of a diagnosis-based clinical decision rule was presented. The approach is designed to provide the clinician with a strategy for arriving at a specific working diagnosis from which treatment decisions can be made. It is based on three questions of diagnosis. In the current paper, the literature on the reliability and validity of the assessment procedures that are included in the diagnosis-based clinical decision rule is presented. Methods The databases of Medline, Cinahl, Embase and MANTIS were searched for studies that evaluated the reliability and validity of clinic-based diagnostic procedures for patients with spinal pain that have relevance for questions 2 (which investigates characteristics of the pain source and 3 (which investigates perpetuating factors of the pain experience. In addition, the reference list of identified papers and authors' libraries were searched. Results A total of 1769 articles were retrieved, of which 138 were deemed relevant. Fifty-one studies related to reliability and 76 related to validity. One study evaluated both reliability and validity. Conclusion Regarding some aspects of the DBCDR, there are a number of studies that allow the clinician to have a reasonable degree of confidence in his or her findings. This is particularly true for centralization signs, neurodynamic signs and psychological perpetuating factors. There are other aspects of the DBCDR in which a lesser degree of confidence is warranted, and in which further research is needed.

  7. Neuroendocrine tumors: a review of the clinical aspects, diagnosis and treatment

    International Nuclear Information System (INIS)

    Rodriguez Fernandez, Lisbet; Hernandez Yero, Arturo; Pina Rivera, Yordanka; Yanes Quesada, Marelys

    2008-01-01

    The study of neuroendocrine tumors has been object of interests by medical science. Different methods have been developed for their diagnosis, treatment and prognosis, each of them with its advantages and inconveniences. The published results are based on the experience of other countries, and it would be very useful to apply them in our country to get closer to the real incidence of these tumors in our environment and to have an adequate treatment of the patients affected with this disease. The objective of this paper is to offer a view of the current trends as regards the clinical aspects, the diagnosis and treatment of the neuroendocrine tumors that serves as a working tool for medical practice and for the teaching activity of the physicians related to this topic

  8. Accuracy of clinical pallor in the diagnosis of anaemia in children: a meta-analysis

    Science.gov (United States)

    Chalco, Juan P; Huicho, Luis; Alamo, Carlos; Carreazo, Nilton Y; Bada, Carlos A

    2005-01-01

    Background Anaemia is highly prevalent in children of developing countries. It is associated with impaired physical growth and mental development. Palmar pallor is recommended at primary level for diagnosing it, on the basis of few studies. The objective of the study was to systematically assess the accuracy of clinical signs in the diagnosis of anaemia in children. Methods A systematic review on the accuracy of clinical signs of anaemia in children. We performed an Internet search in various databases and an additional reference tracking. Studies had to be on performance of clinical signs in the diagnosis of anaemia, using haemoglobin as the gold standard. We calculated pooled diagnostic likelihood ratios (LR's) and odds ratios (DOR's) for each clinical sign at different haemoglobin thresholds. Results Eleven articles met the inclusion criteria. Most studies were performed in Africa, in children underfive. Chi-square test for proportions and Cochran Q for DOR's and for LR's showed heterogeneity. Type of observer and haemoglobin technique influenced the results. Pooling was done using the random effects model. Pooled DOR at haemoglobin outliers. Conclusion This meta-analysis did not document a highly accurate clinical sign of anaemia. In view of poor performance of clinical signs, universal iron supplementation may be an adequate control strategy in high prevalence areas. Further well-designed studies are needed in settings other than Africa. They should assess inter-observer variation, performance of combined clinical signs, phenotypic differences, and different degrees of anaemia. PMID:16336667

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

    African Journals Online (AJOL)

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

  10. Using K-Nearest Neighbor Classification to Diagnose Abnormal Lung Sounds

    Directory of Open Access Journals (Sweden)

    Chin-Hsing Chen

    2015-06-01

    Full Text Available A reported 30% of people worldwide have abnormal lung sounds, including crackles, rhonchi, and wheezes. To date, the traditional stethoscope remains the most popular tool used by physicians to diagnose such abnormal lung sounds, however, many problems arise with the use of a stethoscope, including the effects of environmental noise, the inability to record and store lung sounds for follow-up or tracking, and the physician’s subjective diagnostic experience. This study has developed a digital stethoscope to help physicians overcome these problems when diagnosing abnormal lung sounds. In this digital system, mel-frequency cepstral coefficients (MFCCs were used to extract the features of lung sounds, and then the K-means algorithm was used for feature clustering, to reduce the amount of data for computation. Finally, the K-nearest neighbor method was used to classify the lung sounds. The proposed system can also be used for home care: if the percentage of abnormal lung sound frames is > 30% of the whole test signal, the system can automatically warn the user to visit a physician for diagnosis. We also used bend sensors together with an amplification circuit, Bluetooth, and a microcontroller to implement a respiration detector. The respiratory signal extracted by the bend sensors can be transmitted to the computer via Bluetooth to calculate the respiratory cycle, for real-time assessment. If an abnormal status is detected, the device will warn the user automatically. Experimental results indicated that the error in respiratory cycles between measured and actual values was only 6.8%, illustrating the potential of our detector for home care applications.

  11. Automatic Speech Signal Analysis for Clinical Diagnosis and Assessment of Speech Disorders

    CERN Document Server

    Baghai-Ravary, Ladan

    2013-01-01

    Automatic Speech Signal Analysis for Clinical Diagnosis and Assessment of Speech Disorders provides a survey of methods designed to aid clinicians in the diagnosis and monitoring of speech disorders such as dysarthria and dyspraxia, with an emphasis on the signal processing techniques, statistical validity of the results presented in the literature, and the appropriateness of methods that do not require specialized equipment, rigorously controlled recording procedures or highly skilled personnel to interpret results. Such techniques offer the promise of a simple and cost-effective, yet objective, assessment of a range of medical conditions, which would be of great value to clinicians. The ideal scenario would begin with the collection of examples of the clients’ speech, either over the phone or using portable recording devices operated by non-specialist nursing staff. The recordings could then be analyzed initially to aid diagnosis of conditions, and subsequently to monitor the clients’ progress and res...

  12. Basal Cell Carcinoma: Pathogenesis, Epidemiology, Clinical Features, Diagnosis, Histopathology, and Management

    Science.gov (United States)

    Marzuka, Alexander G.; Book, Samuel E.

    2015-01-01

    Basal cell carcinoma (BCC) is the most common malignancy. Exposure to sunlight is the most important risk factor. Most, if not all, cases of BCC demonstrate overactive Hedgehog signaling. A variety of treatment modalities exist and are selected based on recurrence risk, importance of tissue preservation, patient preference, and extent of disease. The pathogenesis, epidemiology, clinical features, diagnosis, histopathology, and management of BCC will be discussed in this review. PMID:26029015

  13. Risk of complications in coeliac patients depends on age at diagnosis and type of clinical presentation.

    Science.gov (United States)

    Biagi, Federico; Schiepatti, Annalisa; Maiorano, Gregorio; Fraternale, Giacomo; Agazzi, Simona; Zingone, Fabiana; Ciacci, Carolina; Volta, Umberto; Caio, Giacomo; Tortora, Raffaella; Klersy, Catherine; Corazza, Gino R

    2018-06-01

    Coeliac disease is characterised by an increased mortality mostly due to its complications. To study the risk of developing complications according to clinical presentation and age at diagnosis, a combined retrospective-prospective longitudinal study was performed in three Italian centres. Incidence of complications and mortality rates were calculated using type and age at diagnosis of coeliac disease, sex, and centre of diagnosis as predictors. Patients referred after being found to suffer from coeliac disease elsewhere were excluded. Between 01/1999 and 06/2015, 2225 adult coeliac patients were directly diagnosed in our centres. 17 of them developed a complication and 29 died. In patients older than 60 years at diagnosis of coeliac disease, the risk of complication is 18 times higher than in patients diagnosed at 18-40 years and 9 times higher than in patients diagnosed at 40-60 years. Classical presentation increases the risk of complications by 7 times compared to non-classical presentation; in asymptomatic patients the risk of complication is virtually absent. The risk of developing complications in coeliac patients is linked to age at diagnosis of coeliac disease and type of clinical presentation. Follow-up methods of coeliac patients should be tailored according to these parameters. Copyright © 2017. Published by Elsevier Ltd.

  14. Sound radiation contrast in MR phase images. Method for the representation of elasticity, sound damping, and sound impedance changes

    International Nuclear Information System (INIS)

    Radicke, Marcus

    2009-01-01

    The method presented in this thesis combines ultrasound techniques with the magnetic-resonance tomography (MRT). An ultrasonic wave generates in absorbing media a static force in sound-propagation direction. The force leads at sound intensities of some W/cm 2 and a sound frequency in the lower MHz range to a tissue shift in the micrometer range. This tissue shift depends on the sound power, the sound frequency, the sound absorption, and the elastic properties of the tissue. A MRT sequence of the Siemens Healthcare AG was modified so that it measures (indirectly) the tissue shift, codes as grey values, and presents as 2D picture. By means of the grey values the sound-beam slope in the tissue can be visualized, and so additionally sound obstacles (changes of the sound impedance) can be detected. By the MRT images token up spatial changes of the tissue parameters sound absorption and elasticity can be detected. In this thesis measurements are presented, which show the feasibility and future chances of this method especially for the mammary-cancer diagnostics. [de

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

    Science.gov (United States)

    Mostafavi, Ehsan; Pourhossein, Behzad; Chinikar, Sadegh

    2014-07-01

    Crimean-Congo hemorrhagic fever (CCHF) is a zoonotic disease, which is usually transmitted to humans by tick bites or contact with blood or other infected tissues of livestock. Patients suffering from CCHF demonstrate an extensive spectrum of clinical symptoms. As it can take considerable time from suspecting the disease in hospital until reaching a definitive diagnosis in the laboratory, understanding the clinical symptoms and laboratory findings of CCHF patients is of paramount importance for clinicians. The data were collected from patients who were referred to the Laboratory of Arboviruses and Viral Hemorrhagic Fevers at the Pasteur institute of Iran with a primary diagnosis of CCHF between 1999 and 2012 and were assessed by molecular and serologic tests. Referred patients were divided into two groups: patients with a CCHF positive result and patients with a CCHF negative result. The laboratory and clinical findings of these two groups were then compared. Two-thousand five hundred thirty-six probable cases of CCHF were referred to the laboratory, of which 871 cases (34.3%) were confirmed to be CCHF. Contact with infected humans and animals increased the CCHF infection risk (P important role in patient survival and the application of the findings of this study can prove helpful as a key for early diagnosis. © 2014 Wiley Periodicals, Inc.

  16. Potential Immune Biomarkers in Diagnosis and Clinical Management for Systemic Lupus Erythematosus

    Directory of Open Access Journals (Sweden)

    Zecevic Lamija

    2018-04-01

    Full Text Available Background: There is still no reliable, specific biomarker for precision diagnosis and clinical monitoring of systemic lupus erythematosus. The aim of this study was to investigate the importance of the determination of immunofenotypic profiles (T, B lymphocytes and NK cells and serum cytokine concentrations (IL-17 and IFN-alpha as potential biomarkers for this disease.

  17. UNMASKING MASKED HYPERTENSION: PREVALENCE, CLINICAL IMPLICATIONS, DIAGNOSIS, CORRELATES, AND FUTURE DIRECTIONS

    Science.gov (United States)

    Peacock, James; Diaz, Keith M.; Viera, Anthony J.; Schwartz, Joseph E.; Shimbo, Daichi

    2014-01-01

    ‘Masked hypertension’ is defined as having non-elevated clinic blood pressure (BP) with elevated out-of-clinic average BP, typically determined by ambulatory BP monitoring. Approximately 15–30% of adults with non-elevated clinic BP have masked hypertension. Masked hypertension is associated with increased risks of cardiovascular morbidity and mortality compared to sustained normotension (non-elevated clinic and ambulatory BP), which is similar to or approaching the risk associated with sustained hypertension (elevated clinic and ambulatory BP). The confluence of increased cardiovascular risk and a failure to be diagnosed by the conventional approach of clinic BP measurement makes masked hypertension a significant public health concern. However, many important questions remain. First, the definition of masked hypertension varies across studies. Further, the best approach in the clinical setting to exclude masked hypertension also remains unknown. It is unclear whether home BP monitoring is an adequate substitute for ambulatory BP monitoring in identifying masked hypertension. Few studies have examined the mechanistic pathways that may explain masked hypertension. Finally, scarce data are available on the best approach to treating individuals with masked hypertension. Herein, we review the current literature on masked hypertension including definition, prevalence, clinical implications, special patient populations, correlates, issues related to diagnosis, treatment, and areas for future research. PMID:24573133

  18. Free Recall Episodic Memory Performance Predicts Dementia Ten Years prior to Clinical Diagnosis: Findings from the Betula Longitudinal Study

    Directory of Open Access Journals (Sweden)

    Carl-Johan Boraxbekk

    2015-05-01

    Full Text Available Background/Aims: Early dementia diagnosis is a considerable challenge. The present study examined the predictive value of cognitive performance for a future clinical diagnosis of late-onset Alzheimer's disease or vascular dementia in a random population sample. Methods: Cognitive performance was retrospectively compared between three groups of participants from the Betula longitudinal cohort. Group 1 developed dementia 11-22 years after baseline testing (n = 111 and group 2 after 1-10 years (n = 280; group 3 showed no deterioration towards dementia during the study period (n = 2,855. Multinomial logistic regression analysis was used to investigate the predictive value of tests reflecting episodic memory performance, semantic memory performance, visuospatial ability, and prospective memory performance. Results: Age- and education-corrected performance on two free recall episodic memory tests significantly predicted dementia 10 years prior to clinical diagnosis. Free recall performance also predicted dementia 11-22 years prior to diagnosis when controlling for education, but not when age was added to the model. Conclusion: The present results support the suggestion that two free recall-based tests of episodic memory function may be useful for detecting individuals at risk of developing dementia 10 years prior to clinical diagnosis.

  19. Clinical and electromyographic criteria for the diagnosis of hereditary myotonic syndromes

    Directory of Open Access Journals (Sweden)

    V. P. Fedotov

    2012-01-01

    Full Text Available Hereditary myotonic syndromes (HMS are a group of genetically heterogeneous diseases of the chlorine and sodium ion channels (channelopathies with evident clinical polymorphism and high prevalence in the population. The differential diagnosis of early‑stage NMS poses a challenge to clinicians to this day. The investigation has attempted to elaborate informative differentiating criteria on the basis of a clinical and electromyographic study of 2 groups of patients with hereditary Thomsen or Becker myotonia (n = 45 and myotonic dystrophy type 1 (n = 39 verified by DNA analysis of the CLCN1 and DMPK genes. Along with the clinical symptoms, there may be the value of M‑response amplitude decrement in rhythmic stimulation of the n. ulnaris and the duration of myotonic discharges at pin electromyography of the m. tibialis anterior.

  20. Diagnosis of breast cancer using elastic-scattering spectroscopy: preliminary clinical results

    Science.gov (United States)

    Bigio, Irving J.; Brown, Stephen G.; Briggs, Gavin M.; Kelley, Christine; Lakhani, Sunil; Pickard, David; Ripley, Paul M.; Rose, Ian; Saunders, Christobel

    2000-04-01

    We report on the first stages of a clinical study designed to test elastic-scattering spectroscopy, medicated by fiberoptic probes, for three specific clinical applications in breast-tissue diagnosis: (1) a transdermal-needle (interstitial) measurement for instant diagnosis with minimal invasiveness similar to fine-needle aspiration but with sensitivity to a larger tissue volume, (2) a hand-held diagnostic probe for use in assessing tumor/resection margins during open surgery, and (3) use of the same probe for real-time assessment of the `sentinel' node during surgery to determine the presence or absence of tumor (metastatic). Preliminary results from in vivo measurements on 31 women are encouraging. Optical spectra were measured on 72 histology sites in breast tissue, and 54 histology sites in sentinel nodes. Two different artificial intelligence methods of spectral classification were studied. Artificial neural networks yielded sensitivities of 69% and 58%, and specificities of 85% and 93%, for breast tissue and sentinel nodes, respectively. Hierarchical cluster analysis yielded sensitivities of 67% and 91%, and specificities of 79% and 77%, for breast tissue and sentinel nodes, respectively. These values are expected to improve as the data sets continue to grow and more sophisticated data preprocessing is employed. The study will enroll up to 400 patients over the next two years.

  1. Rudimentary horn pregnancy in the first trimester; importance of ultrasound and clinical suspicion in early diagnosis: A case report

    Directory of Open Access Journals (Sweden)

    Hasan Terzi

    2014-09-01

    Full Text Available We aimed to present 7-8 weeks rudimentary horn pregnancy detected preoperatively. A 37-year-old woman, gravida 3, para 2, at 7-8 weeks’ gestation referred to our clinic with a complaint of abdominal pain. The patient was primarily infertile, and she had unicornuate uterus detected during infertility investigation. Due to abnormal ultrasonographic image, rudimentary horn pregnancy was considered. Accurate diagnosis was made by laparoscopy, and rudimentary horn excision was performed. Prerupture diagnosis is very difficult in rudimentary horn pregnancies. The key role in preoperative diagnosis is suspicion. Ultrasonographic examination and clinical suspicion are sufficient in most cases.

  2. Development of Prediction Tool for Sound Absorption and Sound Insulation for Sound Proof Properties

    OpenAIRE

    Yoshio Kurosawa; Takao Yamaguchi

    2015-01-01

    High frequency automotive interior noise above 500 Hz considerably affects automotive passenger comfort. To reduce this noise, sound insulation material is often laminated on body panels or interior trim panels. For a more effective noise reduction, the sound reduction properties of this laminated structure need to be estimated. We have developed a new calculate tool that can roughly calculate the sound absorption and insulation properties of laminate structure and handy ...

  3. The impact of MRI combined with visual rating scales on the clinical diagnosis of dementia: a prospective study

    Energy Technology Data Exchange (ETDEWEB)

    Verhagen, Martijn V.; Guit, Gerard L. [Spaarne Gasthuis, Department of Radiology, Haarlem (Netherlands); Hafkamp, Gerrit Jan; Kalisvaart, Kees [Spaarne Gasthuis, Department of Geriatrics, Haarlem (Netherlands)

    2016-06-15

    Dementia is foremost a clinical diagnosis. However, in diagnosing dementia, it is advocated to perform at least one neuroimaging study. This has two purposes: to rule out potential reversible dementia (PRD), and to help determine the dementia subtype. Our first goal was to establish if MRI combined with visual rating scales changes the clinical diagnosis. The second goal was to demonstrate if MRI contributes to a geriatrician's confidence in the diagnosis. The dementia subtype was determined prior to and after MRI. Scoring scales used were: global cortical atrophy (GCA), medial temporal atrophy (MTA), and white matter hyperintensity measured according to the Fazekas scale. The confidence level of the geriatrician was determined using a visual analogue scale. One hundred and thirty-five patients were included. After MRI, the diagnosis changed in 23.7 % (CI 17.0 %-31.1 %) of patients. Change was due to vascular aetiology in 13.3 % of patients. PRD was found in 2.2 % of all patients. The confidence level in the diagnosis increased significantly after MRI (p = 0.001). MRI, combined with visual rating scales, has a significant impact on dementia subtype diagnosis and on a geriatrician's confidence in the final diagnosis. (orig.)

  4. The impact of MRI combined with visual rating scales on the clinical diagnosis of dementia: a prospective study

    International Nuclear Information System (INIS)

    Verhagen, Martijn V.; Guit, Gerard L.; Hafkamp, Gerrit Jan; Kalisvaart, Kees

    2016-01-01

    Dementia is foremost a clinical diagnosis. However, in diagnosing dementia, it is advocated to perform at least one neuroimaging study. This has two purposes: to rule out potential reversible dementia (PRD), and to help determine the dementia subtype. Our first goal was to establish if MRI combined with visual rating scales changes the clinical diagnosis. The second goal was to demonstrate if MRI contributes to a geriatrician's confidence in the diagnosis. The dementia subtype was determined prior to and after MRI. Scoring scales used were: global cortical atrophy (GCA), medial temporal atrophy (MTA), and white matter hyperintensity measured according to the Fazekas scale. The confidence level of the geriatrician was determined using a visual analogue scale. One hundred and thirty-five patients were included. After MRI, the diagnosis changed in 23.7 % (CI 17.0 %-31.1 %) of patients. Change was due to vascular aetiology in 13.3 % of patients. PRD was found in 2.2 % of all patients. The confidence level in the diagnosis increased significantly after MRI (p = 0.001). MRI, combined with visual rating scales, has a significant impact on dementia subtype diagnosis and on a geriatrician's confidence in the final diagnosis. (orig.)

  5. Clinical, radiological and molecular diagnosis correlation in serum samples from patients with osteoarticular tuberculosis

    Directory of Open Access Journals (Sweden)

    Guadalupe García-Elorriaga

    2014-07-01

    Conclusions: Nested PCR in serum samples is a rapid, highly sensitive and specific modality for OTB detection. PCR should be performed in addition to clinical evaluation, imaging studies, acid-fast bacilli staining, culture and histopathology diagnosis, if possible.

  6. Tinnitus retraining therapy for patients with tinnitus and decreased sound tolerance.

    Science.gov (United States)

    Jastreboff, Pawel J; Jastreboff, Margaret M

    2003-04-01

    Our experience has revealed the following: (1) TRT is applicable for all types of tinnitus, as well as for decreased sound tolerance, with significant improvement of tinnitus occurring in over 80% of the cases, and at least equal success rate for decreased sound tolerance. (2) TRT can provide cure for decreased sound tolerance. (3) TRT does not require frequent clinic visits and has no side effects; however, (4) Special training of health providers involved in this treatment is required for this treatment to be effective.

  7. Diagnosis of genital herpes simplex virus infection in the clinical laboratory

    Science.gov (United States)

    2014-01-01

    Since the type of herpes simplex virus (HSV) infection affects prognosis and subsequent counseling, type-specific testing to distinguish HSV-1 from HSV-2 is always recommended. Although PCR has been the diagnostic standard method for HSV infections of the central nervous system, until now viral culture has been the test of choice for HSV genital infection. However, HSV PCR, with its consistently and substantially higher rate of HSV detection, could replace viral culture as the gold standard for the diagnosis of genital herpes in people with active mucocutaneous lesions, regardless of anatomic location or viral type. Alternatively, antigen detection—an immunofluorescence test or enzyme immunoassay from samples from symptomatic patients--could be employed, but HSV type determination is of importance. Type-specific serology based on glycoprotein G should be used for detecting asymptomatic individuals but widespread screening for HSV antibodies is not recommended. In conclusion, rapid and accurate laboratory diagnosis of HSV is now become a necessity, given the difficulty in making the clinical diagnosis of HSV, the growing worldwide prevalence of genital herpes and the availability of effective antiviral therapy. PMID:24885431

  8. BLINCK?A diagnostic algorithm for skin cancer diagnosis combining clinical features with dermatoscopy findings

    OpenAIRE

    Bourne, Peter; Rosendahl, Cliff; Keir, Jeff; Cameron, Alan

    2012-01-01

    Background: Deciding whether a skin lesion requires biopsy to exclude skin cancer is often challenging for primary care clinicians in Australia. There are several published algorithms designed to assist with the diagnosis of skin cancer but apart from the clinical ABCD rule, these algorithms only evaluate the dermatoscopic features of a lesion. Objectives: The BLINCK algorithm explores the effect of combining clinical history and examination with fundamental dermatoscopic assessment in primar...

  9. Hybrid silica materials for detection of toxic species and clinical diagnosis

    OpenAIRE

    Pascual Vidal, Lluís

    2017-01-01

    The present PhD thesis entitled "Silica Hybrid Materials for detection of toxic species and clinical diagnosis" is focused on the design and synthesis of new hybrid materials, using different silica supports as inorganic scaffolds, with applications in recognition, sensing and diagnostic protocols. The first chapter of the PhD thesis is devoted to the definition and classification of hybrid materials, relying on concepts of Nanotechnology, Supramolecular and Materials Chemistry. State o...

  10. Making fictions sound real - On film sound, perceptual realism and genre

    Directory of Open Access Journals (Sweden)

    Birger Langkjær

    2010-05-01

    Full Text Available This article examines the role that sound plays in making fictions perceptually real to film audiences, whether these fictions are realist or non-realist in content and narrative form. I will argue that some aspects of film sound practices and the kind of experiences they trigger are related to basic rules of human perception, whereas others are more properly explained in relation to how aesthetic devices, including sound, are used to characterise the fiction and thereby make it perceptually real to its audience. Finally, I will argue that not all genres can be defined by a simple taxonomy of sounds. Apart from an account of the kinds of sounds that typically appear in a specific genre, a genre analysis of sound may also benefit from a functionalist approach that focuses on how sounds can make both realist and non-realist aspects of genres sound real to audiences.

  11. Making fictions sound real - On film sound, perceptual realism and genre

    Directory of Open Access Journals (Sweden)

    Birger Langkjær

    2009-09-01

    Full Text Available This article examines the role that sound plays in making fictions perceptually real to film audiences, whether these fictions are realist or non-realist in content and narrative form. I will argue that some aspects of film sound practices and the kind of experiences they trigger are related to basic rules of human perception, whereas others are more properly explained in relation to how aesthetic devices, including sound, are used to characterise the fiction and thereby make it perceptually real to its audience. Finally, I will argue that not all genres can be defined by a simple taxonomy of sounds. Apart from an account of the kinds of sounds that typically appear in a specific genre, a genre analysis of sound may also benefit from a functionalist approach that focuses on how sounds can make both realist and non-realist aspects of genres sound real to audiences.

  12. Lymphogranuloma Venereum 2015: Clinical Presentation, Diagnosis, and Treatment.

    Science.gov (United States)

    Stoner, Bradley P; Cohen, Stephanie E

    2015-12-15

    Lymphogranuloma venereum (LGV) has emerged as an important cause of proctitis and proctocolitis in men who have sex with men; classical inguinal presentation is now increasingly uncommon. We report summary findings of an extensive literature review on LGV clinical presentation, diagnosis, and treatment that form the evidence base for the 2015 Centers for Disease Control and Prevention treatment guidelines for sexually transmitted diseases. Proctitis and proctocolitis are now the most commonly reported clinical manifestations of LGV, with symptoms resembling those of inflammatory bowel disease. Newer molecular tests to confirm LGV infection are sensitive and specific, but are generally restricted to research laboratory or public health settings. Doxycycline (100 mg twice daily for 21 days) remains the treatment of choice for LGV. Patients with rectal chlamydial infection and signs or symptoms of proctitis should be tested for LGV, or if confirmatory testing is not available, should be treated empirically with a recommended regimen to cover LGV infection. © The Author 2015. Published by Oxford University Press on behalf of the Infectious Diseases Society of America. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

  13. Allergic Rhinitis in Children: Principles of Early Diagnosis and Effective Therapy. Overview of Clinical Recommendations

    Directory of Open Access Journals (Sweden)

    Alexander A. Baranov

    2017-01-01

    Full Text Available The article briefly summarizes the key provisions of the clinical recommendations on medical care delivery for children with allergic rhinitis: modern approaches to diagnosis and therapy. The current document was developed by the professional association of pediatric specialists —the Union of Pediatricians of Russia — together with the leading experts of the Russian Association of Allergists and Clinical Immunologists. The recommendations are regularly updated due to the latest evidence-based results of effectiveness and safety of various medical interventions. The article presents information on the epidemiology of allergic rhinitis in children, specific diagnostic features which provide the opportunity for the timely and correct diagnosis and an effective therapy with personal approach.

  14. Tinnitus and sound intolerance: evidence and experience of a Brazilian group.

    Science.gov (United States)

    Onishi, Ektor Tsuneo; Coelho, Cláudia Couto de Barros; Oiticica, Jeanne; Figueiredo, Ricardo Rodrigues; Guimarães, Rita de Cassia Cassou; Sanchez, Tanit Ganz; Gürtler, Adriana Lima; Venosa, Alessandra Ramos; Sampaio, André Luiz Lopes; Azevedo, Andreia Aparecida; Pires, Anna Paula Batista de Ávila; Barros, Bruno Borges de Carvalho; Oliveira, Carlos Augusto Costa Pires de; Saba, Clarice; Yonamine, Fernando Kaoru; Medeiros, Ítalo Roberto Torres de; Rosito, Letícia Petersen Schmidt; Rates, Marcelo José Abras; Kii, Márcia Akemi; Fávero, Mariana Lopes; Santos, Mônica Alcantara de Oliveira; Person, Osmar Clayton; Ciminelli, Patrícia; Marcondes, Renata de Almeida; Moreira, Ronaldo Kennedy de Paula; Torres, Sandro de Menezes Santos

    Tinnitus and sound intolerance are frequent and subjective complaints that may have an impact on a patient's quality of life. To present a review of the salient points including concepts, pathophysiology, diagnosis and approach of the patient with tinnitus and sensitivity to sounds. Literature review with bibliographic survey in LILACS, SciELO, Pubmed and MEDLINE database. Articles and book chapters on tinnitus and sound sensitivity were selected. The several topics were discussed by a group of Brazilian professionals and the conclusions were described. The prevalence of tinnitus has increased over the years, often associated with hearing loss, metabolic factors and inadequate diet. Medical evaluation should be performed carefully to guide the request of subsidiary exams. Currently available treatments range from medications to the use of sounds with specific characteristics and meditation techniques, with variable results. A review on tinnitus and auditory sensitivity was presented, allowing the reader a broad view of the approach to these patients, based on scientific evidence and national experience. Copyright © 2017 Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial. Published by Elsevier Editora Ltda. All rights reserved.

  15. Clinical evaluation of ischemic heart diagnosis

    International Nuclear Information System (INIS)

    Kamei, Fumio

    1983-01-01

    Attempt were made to detect the existence of myocardial ischemia by means of both radiographic and scintigraphic techniques. Firstly, a new polygraph was especially designed for selecting the arbitrary phases in a cardiac cycle at which the corresponding radiogram should be synchronously obtained. A comparative investigation on the difference between end-systolic and-diastolic cardiac transverse diameters revealed a remarkable difference of 3.6% in normal subjects and 0.6% in patients with ischemic heart disease. These data indicating the difference of overall heart size was reflected in local dyskinesis documentation of recently developed techniques. For daily clinical purposes, radiography of the chest based on synchronously selected phases would contribute to accurate diagnosis and treatment of heart disease. Secondly, scintigraphic display using intravenously injected thallium-201 was clinically applied. For detection of ischemia, comparative study was performed of initial image relative to selective coronary cineangiography and stress scintigraphy. The former indicated a good correlation of 90%, whereas the latter served to enhnace sensitivity. Sequential images (initial and delayed) facilitated the distinction of normal, necrotic, and ischemic areas. Scintigram was used for objective evaluation of coronary dilator (dilazep), either at immediate or follow-up stage. In the same way, it was also possible to indicate the effectiveness of sublingually given nitroglycerin by myocardial scintigram, where by significant increase of uptake was observed 20 minutes after administration. Rehabilitation after acute heart disease was discussed, especially on the peripheral effect. Ratio of the thigh muscle to myocardium shown in this study was useful fer objective evaluation. Another preliminary study is to separate normal coronary arteries from myocardial necrosis. (J.P.N.)

  16. Clinical evaluation of ischemic heart diagnosis

    Energy Technology Data Exchange (ETDEWEB)

    Kamei, Fumio [Sendai Railway Hospital (Japan)

    1983-09-01

    Attempt were made to detect the existence of myocardial ischemia by means of both radiographic and scintigraphic techniques. Firstly, a new polygraph was especially designed for selecting the arbitrary phases in a cardiac cycle at which the corresponding radiogram should be synchronously obtained. A comparative investigation on the difference between end-systolic and-diastolic cardiac transverse diameters revealed a remarkable difference of 3.6% in normal subjects and 0.6% in patients with ischemic heart disease. These data indicating the difference of overall heart size was reflected in local dyskinesis documentation of recently developed techniques. For daily clinical purposes, radiography of the chest based on synchronously selected phases would contribute to accurate diagnosis and treatment of heart disease. Secondly, scintigraphic display using intravenously injected thallium-201 was clinically applied. For detection of ischemia, comparative study was performed of initial image relative to selective coronary cineangiography and stress scintigraphy. The former indicated a good correlation of 90%, whereas the latter served to enhance sensitivity. Sequential images (initial and delayed) facilitated the distinction of normal, necrotic, and ischemic areas. Scintigram was used for objective evaluation of coronary dilator (dilazep), either at immediate or follow-up stage. In the same way, it was also possible to indicate the effectiveness of sublingually given nitroglycerin by myocardial scintigram, where by significant increase of uptake was observed 20 minutes after administration. Rehabilitation after acute heart disease was discussed, especially on the peripheral effect. Ratio of the thigh muscle to myocardium shown in this study was useful for objective evaluation. Another preliminary study is to separate normal coronary arteries from myocardial necrosis.

  17. Sound Absorbers

    Science.gov (United States)

    Fuchs, H. V.; Möser, M.

    Sound absorption indicates the transformation of sound energy into heat. It is, for instance, employed to design the acoustics in rooms. The noise emitted by machinery and plants shall be reduced before arriving at a workplace; auditoria such as lecture rooms or concert halls require a certain reverberation time. Such design goals are realised by installing absorbing components at the walls with well-defined absorption characteristics, which are adjusted for corresponding demands. Sound absorbers also play an important role in acoustic capsules, ducts and screens to avoid sound immission from noise intensive environments into the neighbourhood.

  18. [Hemoglobinopathies--clinical symptoms and diagnosis of thalassemia and abnormal hemoglobins].

    Science.gov (United States)

    Herklotz, R; Risch, L; Huber, A R

    2006-01-01

    Haemoglobinopathies constitute entities that are generated by either an abnormal haemoglobin or thalassaemias. While abnormal haemoglobins are caused by a qualitative structural abnormality of the haemoglobin molecule, thalassaemias result by diminished synthesis of the globin chain. Due to increased immigration from Asia, Africa and the Mediterranean to Northern Europe, haemoglobin S, haemoglobin C, haemoglobin E are also encountered commonly in Switzerland, while other abnormal haemoglobins are rare, yet can cause clinically relevant symptoms. This include haemolysis, polyglobulia, cyanosis or a combination thereof Thalassaemia-syndroms constitute with two million affected individuals to the most prelevant monogenetic diseases worldwide. Due to migration into Switzerland, they are also found quite commonly among our patients with 10-15 per cent of all hypochromic, microcytic, anemia second only to iron deficiency. Importantly, thalassaemias and haemoglobinopathies can occur concomitantly sometimes even with a normal haemoglobin variant. This results in wide-spread presentations, making diagnosis and clinical judgement difficult. We describe in this article not only physiological mechanisms and clinical presentation but also propose a step-wise diagnostic algorithm including selective use of molecular biology methods.

  19. Cancer diagnosis in a ''breast clinic''. A 15 years retrospection

    Energy Technology Data Exchange (ETDEWEB)

    Ghys, R

    1987-01-01

    Conflicting opinions have been expressed in the world literature over the last 15 years about the value of radiological techniques in breast cancer diagnosis. We reviewed 111 breast cancers which we diagnosed between 1971 and 1985, in unselected patients, by the combined use of palpation, thermography and mammography, complemented, since 1980, by diaphanoscopy. Considerable clinical experience is necessary to interpret both mammograms and thermograms. Each of these approaches, when rated independently, has a very high false negative rate ranging from 41% for clinical examination to 32% for mammography. In cases which are not clinically obvious, diaphanoscopy ''retrieves'' the most cancers, with thermography a close second (definitely malignant in 35% of the cases over the whole age range). Mammography comes third and its efficacy drops to 12.5% in premenopausal women. However, by combining this information with the one derived from anamnesis, the ACDTM scoring system gives us a false negative rate - before biopsy - of 5.5% and a false positive rate of <1%. This approach also drastically reduces the number of unnecessary biopsies.

  20. Computed tomography image of the mediastinal and axillary lymph nodes in clinically sound Rottweilers

    Directory of Open Access Journals (Sweden)

    Ana Carolina B. Fonseca Pinto

    2013-03-01

    Full Text Available Trough computed tomography (CT, it is possible to evaluate lymph nodes in detail and to detect changes in these structures earlier than with radiographs and ultrasound. Lack of information in the veterinary literature directed the focus of this report to normal aspects of the axillary and mediastinal lymph nodes of adult dogs on CT imaging. A CT scan of 15 normal adult male and female Rottweilers was done. To define them as clinically sound, anamnesis, physical examination, complete blood count, renal and hepatic biochemistry, ECG, and thoracic radiographs were performed. After the intravenous injection of hydrosoluble ionic iodine contrast medium contiguous 10mm in thickness thoracic transverse images were obtained with an axial scanner. In the obtained images mediastinal and axillary lymph nodes were sought and when found measured in their smallest diameter and their attenuation was compared to musculature. Mean and standard deviation of: age, weight, body length and the smallest diameter of the axillary and mediastinal lymph nodes were determined. Mean and standard deviation of parameters: age 3.87±2.03 years, weight 41.13±5.12, and body length 89.61±2.63cm. Axillary lymph nodes were seen in 60% of the animals, mean of the smallest diameter was 3.58mm with a standard deviation of 2.02 and a minimum value of 1mm and a maximum value of 7mm. From 13 observed lymph nodes 61.53% were hypopodense when compared with musculature, and 30.77% were isodense. Mediastinal lymph nodes were identified in 73.33% of the dogs; mean measure of the smallest diameter was 4.71mm with a standard deviation of 2.61mm and a minimum value of 1mm, and a maximum value of 8mm. From 14 observed lymph nodes 85.71% were isodense when compared with musculature and 14.28% were hypodense. The results show that it is possible to visualize axillary and mediastinal lymph nodes in adult clinically sound Rottweilers with CT using a slice thickness and interval of 10mm. The

  1. Compliance between clinical and genetic diagnosis of choroidal hypoplasia in 103 Norwegian Border Collie puppies.

    Science.gov (United States)

    Grosås, Siv; Lingaas, Frode; Prestrud, Kristin Wear; Ropstad, Ernst-Otto

    2017-11-07

    To describe the frequency of the nonhomologous end-joining factor 1 (NHEJ1) mutation and the compliance between clinical and genetic diagnosis of choroidal hypoplasia (CH) in a group of Norwegian Border Collies. Border collie puppies in the age from 5 to 8 weeks. Puppies included in the study had a complete ophthalmological examination. All findings were recorded, and an ECVO scheme form was issued for each puppy. DNA samples were achieved from buccal swabs. Genetic typing was performed for the 7.8-kb deletion in the gene encoding NHEJ1. Dogs with none, one, or two copies of the mutated allele were classified as free, carriers, and affected, respectively. 103 Border Collie puppies from 16 litters, 52 females and 51 males, were included in the study. Ages ranged from 5.1 to 8.9 weeks. One puppy had clinical findings consistent with CH and optic nerve coloboma compatible with the diagnosis Collie Eye Anomaly (CEA). Findings on ophthalmological examination of the remaining puppies were within normal limits. On genetic testing, 85 puppies were clear of the mutation in the NHEJ1 gene, 17 puppies were carriers, and one puppy was genetically affected. A good compliance between the clinical diagnosis and the genetic test results was found in all of the puppies examined. The allele frequency of the mutation was 6.3%. © 2017 American College of Veterinary Ophthalmologists.

  2. Making Sound Connections

    Science.gov (United States)

    Deal, Walter F., III

    2007-01-01

    Sound provides and offers amazing insights into the world. Sound waves may be defined as mechanical energy that moves through air or other medium as a longitudinal wave and consists of pressure fluctuations. Humans and animals alike use sound as a means of communication and a tool for survival. Mammals, such as bats, use ultrasonic sound waves to…

  3. Clinical practice guideline on diagnosis and treatment of hyponatraemia.

    Science.gov (United States)

    Spasovski, Goce; Vanholder, Raymond; Allolio, Bruno; Annane, Djillali; Ball, Steve; Bichet, Daniel; Decaux, Guy; Fenske, Wiebke; Hoorn, Ewout J; Ichai, Carole; Joannidis, Michael; Soupart, Alain; Zietse, Robert; Haller, Maria; van der Veer, Sabine; Van Biesen, Wim; Nagler, Evi

    2014-03-01

    Hyponatraemia, defined as a serum sodium concentration <135 mmol/l, is the most common disorder of body fluid and electrolyte balance encountered in clinical practice. It can lead to a wide spectrum of clinical symptoms, from subtle to severe or even life threatening, and is associated with increased mortality, morbidity and length of hospital stay in patients presenting with a range of conditions. Despite this, the management of patients remains problematic. The prevalence of hyponatraemia in widely different conditions and the fact that hyponatraemia is managed by clinicians with a broad variety of backgrounds have fostered diverse institution- and speciality-based approaches to diagnosis and treatment. To obtain a common and holistic view, the European Society of Intensive Care Medicine (ESICM), the European Society of Endocrinology (ESE) and the European Renal Association - European Dialysis and Transplant Association (ERA-EDTA), represented by European Renal Best Practice (ERBP), have developed the Clinical Practice Guideline on the diagnostic approach and treatment of hyponatraemia as a joint venture of three societies representing specialists with a natural interest in hyponatraemia. In addition to a rigorous approach to methodology and evaluation, we were keen to ensure that the document focused on patient-important outcomes and included utility for clinicians involved in everyday practice.

  4. Branchial cleft anomalies: accuracy of pre-operative diagnosis, clinical presentation and management.

    Science.gov (United States)

    Guldfred, L-A; Philipsen, B B; Siim, C

    2012-06-01

    To examine the accuracy of the pre-operative diagnosis of branchial cleft anomalies, and also to describe their occurrence, clinical presentation and management. Retrospective review of the records of patients diagnosed with a branchial cleft anomaly between 1997 and 2006. One hundred and twenty-six patients were included. Pre-operative diagnosis had a positive predictive value of 0.856 (95 per cent confidence interval, 0.771-0.918) and a sensitivity of 0.944 (95 per cent confidence interval, 0.869-0.979). These patients' demographic data, investigations, findings and management are presented, along with a possible strategy for dealing with solitary cystic masses in the neck. As pre-operative diagnosis has a positive predictive value of 86 per cent, cystic lesions in the neck should be presumed to be carcinomatous until proven otherwise. Branchial fistulae and sinuses seem to be a disease of childhood, while branchial cysts occur mainly in adults. Branchial cleft anomalies are equally frequent in men and women, and equally distributed on the left and right side of the neck.

  5. How well do second-year students learn physical diagnosis? Observational study of an objective structured clinical examination (OSCE

    Directory of Open Access Journals (Sweden)

    Simon Steven R

    2002-01-01

    Full Text Available Abstract Background Little is known about using the Objective Structured Clinical Examination (OSCE in physical diagnosis courses. The purpose of this study was to describe student performance on an OSCE in a physical diagnosis course. Methods Cross-sectional study at Harvard Medical School, 1997–1999, for 489 second-year students. Results Average total OSCE score was 57% (range 39–75%. Among clinical skills, students scored highest on patient interaction (72%, followed by examination technique (65%, abnormality identification (62%, history-taking (60%, patient presentation (60%, physical examination knowledge (47%, and differential diagnosis (40% (p Conclusions Students scored higher on interpersonal and technical skills than on interpretive or integrative skills. Station scores identified specific content that needs improved teaching.

  6. Abnormal sound detection device

    International Nuclear Information System (INIS)

    Yamada, Izumi; Matsui, Yuji.

    1995-01-01

    Only components synchronized with rotation of pumps are sampled from detected acoustic sounds, to judge the presence or absence of abnormality based on the magnitude of the synchronized components. A synchronized component sampling means can remove resonance sounds and other acoustic sounds generated at a synchronously with the rotation based on the knowledge that generated acoustic components in a normal state are a sort of resonance sounds and are not precisely synchronized with the number of rotation. On the other hand, abnormal sounds of a rotating body are often caused by compulsory force accompanying the rotation as a generation source, and the abnormal sounds can be detected by extracting only the rotation-synchronized components. Since components of normal acoustic sounds generated at present are discriminated from the detected sounds, reduction of the abnormal sounds due to a signal processing can be avoided and, as a result, abnormal sound detection sensitivity can be improved. Further, since it is adapted to discriminate the occurrence of the abnormal sound from the actually detected sounds, the other frequency components which are forecast but not generated actually are not removed, so that it is further effective for the improvement of detection sensitivity. (N.H.)

  7. Demographic and clinical correlates of autism symptom domains and autism spectrum diagnosis

    OpenAIRE

    Frazier, Thomas W; Youngstrom, Eric A; Embacher, Rebecca; Hardan, Antonio Y; Constantino, John N; Law, Paul; Findling, Robert L; Eng, Charis

    2013-01-01

    Demographic and clinical factors may influence assessment of autism symptoms. This study evaluated these correlates and also examined whether social communication and interaction and restricted/repetitive behavior provided unique prediction of autism spectrum disorder diagnosis. We analyzed data from 7352 siblings included in the Interactive Autism Network registry. Social communication and interaction and restricted/repetitive behavior symptoms were obtained using caregiver-reports on the So...

  8. Multilingual Aspects of Speech Sound Disorders in Children. Communication Disorders across Languages

    Science.gov (United States)

    McLeod, Sharynne; Goldstein, Brian

    2012-01-01

    Multilingual Aspects of Speech Sound Disorders in Children explores both multilingual and multicultural aspects of children with speech sound disorders. The 30 chapters have been written by 44 authors from 16 different countries about 112 languages and dialects. The book is designed to translate research into clinical practice. It is divided into…

  9. Diagnosis of Clostridium difficile Infection: an Ongoing Conundrum for Clinicians and for Clinical Laboratories

    Science.gov (United States)

    Carroll, Karen C.

    2013-01-01

    SUMMARY Clostridium difficile is a formidable nosocomial and community-acquired pathogen, causing clinical presentations ranging from asymptomatic colonization to self-limiting diarrhea to toxic megacolon and fulminant colitis. Since the early 2000s, the incidence of C. difficile disease has increased dramatically, and this is thought to be due to the emergence of new strain types. For many years, the mainstay of C. difficile disease diagnosis was enzyme immunoassays for detection of the C. difficile toxin(s), although it is now generally accepted that these assays lack sensitivity. A number of molecular assays are commercially available for the detection of C. difficile. This review covers the history and biology of C. difficile and provides an in-depth discussion of the laboratory methods used for the diagnosis of C. difficile infection (CDI). In addition, strain typing methods for C. difficile and the evolving epidemiology of colonization and infection with this organism are discussed. Finally, considerations for diagnosing C. difficile disease in special patient populations, such as children, oncology patients, transplant patients, and patients with inflammatory bowel disease, are described. As detection of C. difficile in clinical specimens does not always equate with disease, the diagnosis of C. difficile infection continues to be a challenge for both laboratories and clinicians. PMID:23824374

  10. [Clinical characteristics and preimplantation genetic diagnosis for male Robertsonian translocations].

    Science.gov (United States)

    Huang, Jin; Lian, Ying; Qiao, Jie; Liu, Ping

    2012-08-18

    To explore the clinical characteristics and the preimplantation genetic diagnosis (PGD) for male Robertsonian translocations. From Jan 2005 to Oct 2011, 96 PGD cycles of 80 male Robertsonian translocations were performed at the Center of Reproductive Medicine of Peking University Third Hospital, Beijing. All the couples were involved in assisted reproductive therapy because of oligozoospermia or repeated abortions. Pregnancy results and clinical characteristics were analyzed in this study. Of all the 80 Robertsonian translocation couples, 62 (77.50%, 62/80) couples suffered from primary infertility due to severe oligoospermia and 8 (10%, 8/80) couples suffered from secondary infertility due to oligoospermia. Moreover, 10 (12.50%, 10/80) couples had recurrent spontaneous abortion. Of all the 80 male Robertsonian translocations, 50 were (13; 14) translocations and 15 (14; 21) translocations. The study showed that 79 PGD cycles had the balanced embryos to transfer and 25 cycles resulted in clinical pregnancies. The clinical pregnancy rate per transfer cycle was 31.65% (25 of 79). Now, 18 couples had 21 viable infants and 3 were ongoing pregnant. Oligozoospermia is the main factor for the infertility of the male Robertsonian translocations. Artificial reproductive techniques can solve their reproductive problems. Moreover, PGD will decrease the risk of recurrent spontaneous abortion and the malformations.

  11. Dental Pulp: Correspondences and Contradictions between Clinical and Histological Diagnosis

    Science.gov (United States)

    Giuroiu, Cristian Levente; Căruntu, Irina-Draga; Lozneanu, Ludmila; Melian, Anca; Vataman, Maria; Andrian, Sorin

    2015-01-01

    Dental pulp represents a specialized connective tissue enclosed by dentin and enamel, the most highly mineralized tissues of the body. Consequently, the direct examination as well as pathological evaluation of dental pulp is difficult. Within this anatomical context, our study aimed to evaluate the correlation between dental pulp lesions and clinical diagnosis. Pulpectomies were performed for 54 patients with acute and chronic irreversible pulpitides and for 5 patients (control group) with orthodontic extractions. The morphological features were semiquantitatively assessed by specific score values. The clinical and morphological correspondence was noted for 35 cases (68.62%), whereas inconsistency was recorded for 16 cases (31.38%). The results of the statistical analysis revealed the correlations between clinically and pathologically diagnosed acute/chronic pulpitides. No significant differences were established between the score values for inflammatory infiltrate intensity, collagen depositions, calcifications and necrosis, and acute, respectively chronic pulpitides. We also obtained significant differences between acute pulpitides and inflammatory infiltrate and calcifications and between chronic pulpitides and inflammatory infiltrate, collagen deposition, and calcifications. On the basis of the predominant pathological aspects, namely, acute and chronic pulpitis, we consider that the classification schemes can be simplified by adequately reducing the number of clinical entities. PMID:26078972

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

    Science.gov (United States)

    Selecman, Audrey M; Ahuja, Swati A

    2018-02-08

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

  13. Differential diagnosis of Bartter syndrome, Gitelman syndrome, and pseudo-Bartter/Gitelman syndrome based on clinical characteristics.

    Science.gov (United States)

    Matsunoshita, Natsuki; Nozu, Kandai; Shono, Akemi; Nozu, Yoshimi; Fu, Xue Jun; Morisada, Naoya; Kamiyoshi, Naohiro; Ohtsubo, Hiromi; Ninchoji, Takeshi; Minamikawa, Shogo; Yamamura, Tomohiko; Nakanishi, Koichi; Yoshikawa, Norishige; Shima, Yuko; Kaito, Hiroshi; Iijima, Kazumoto

    2016-02-01

    Phenotypic overlap exists among type III Bartter syndrome (BS), Gitelman syndrome (GS), and pseudo-BS/GS (p-BS/GS), which are clinically difficult to distinguish. We aimed to clarify the differences between these diseases, allowing accurate diagnosis based on their clinical features. A total of 163 patients with genetically defined type III BS (n = 30), GS (n = 90), and p-BS/GS (n = 43) were included. Age at diagnosis, sex, body mass index, estimated glomerular filtration rate, and serum and urine electrolyte concentrations were determined. Patients with p-BS/GS were significantly older at diagnosis than those with type III BS and GS. Patients with p-BS/GS included a significantly higher percentage of women and had a lower body mass index and estimated glomerular filtration rate than did patients with GS. Although hypomagnesemia and hypocalciuria were predominant biochemical findings in patients with GS, 17 and 23% of patients with type III BS and p-BS/GS, respectively, also showed these abnormalities. Of patients with type III BS, GS, and p-BS/GS, 40, 12, and 63%, respectively, presented with chronic kidney disease. This study clarified the clinical differences between BS, GS, and p-BS/GS for the first time, which will help clinicians establish differential diagnoses for these three conditions.

  14. Clinical evaluation of echography in diagnosis of thyroid disease

    International Nuclear Information System (INIS)

    Fritzsche, H.; Braendle, J.

    1983-01-01

    In 63 patients echography of thyroid was performed additionally to case history, palpation, scintigraphy and hormone tests for evaluating clinical significance of this method. The benefit of this technique is rapid measurement of thyroid size, demonstration of nodules in palpable diffuse goiters and differentiating of solid or cystic nodules of the thyroid. For diagnosis of autonomous areas in the thyroid scintigrahy remains the method of choice. Also there is no correlation of ultrasound findings and thyroid function. In routine diagnostic procedure of thyroid disease echography may replace scintigraphy only in diffuse goiter and if radionuclide imaging is not possible. Nevertheless ultrasonic evaluation of the thyroid is an important additional method in diagnostic of thyroid diseases. (Author)

  15. Sound Search Engine Concept

    DEFF Research Database (Denmark)

    2006-01-01

    Sound search is provided by the major search engines, however, indexing is text based, not sound based. We will establish a dedicated sound search services with based on sound feature indexing. The current demo shows the concept of the sound search engine. The first engine will be realased June...

  16. Pyrexia in cats: Retrospective analysis of signalment, clinical investigations, diagnosis and influence of prior treatment in 106 referred cases.

    Science.gov (United States)

    Spencer, Sarah E; Knowles, Toby; Ramsey, Ian K; Tasker, Séverine

    2017-11-01

    The main aim of the study was to describe the features and diagnoses of a population of cats referred with pyrexia. Other aims were to report and evaluate the utility of clinical investigations performed, and describe any effect of treatment before referral on temperature at presentation and ability to make a diagnosis. Clinical records of cats with pyrexia (⩾39.2°C) documented at least twice were retrospectively reviewed. Cases were assigned to disease categories (infectious, inflammatory, immune-mediated, neoplastic, miscellaneous and no diagnosis [pyrexia of unknown origin, PUO]) based on diagnosis. The overall value of clinical investigations was assessed by classifying them as 'enabling', 'assisting' or 'no assistance' in achieving each diagnosis. The effect of treatment before referral was assessed for any association with temperature at presentation and ability to make a diagnosis (PUO vs other disease categories). One hundred and six cases were identified. The most common cause of pyrexia was feline infectious peritonitis (22 cats, 20.8%) and the largest disease category was infectious (41/106, 38.7%). Inflammatory conditions were found in 19 (17.9%) cats, neoplasia in 13 (12.3%), miscellaneous causes in 11 (10.4%) and immune-mediated disease in six (5.7%). No diagnosis was reached in 16 (15.0%) cats, often despite extensive diagnostic investigations. Cytology and histopathology most often 'enabled' or 'assisted' in obtaining a diagnosis. Most cats (91, 85.8%) received treatment before referral, with antimicrobial treatment given to 87 (82.1%). Prior treatment before referral was not associated with temperature at presentation nor with success in establishing a diagnosis. This is the first study investigating causes of pyrexia in cats. Infectious diseases were most common and immune-mediated diseases were comparatively rare.

  17. Oral Lichen Planus: An Update on Etiology, Pathogenesis, Clinical Presentation, Diagnosis and Management

    Science.gov (United States)

    Gupta, Sonia; Jawanda, Manveen Kaur

    2015-01-01

    The mouth is a mirror of health or disease, a sentinel or early warning system. The oral cavity might well be thought as a window to the body because oral manifestations accompany many systemic diseases. In many instances, oral involvement precedes the appearance of other symptoms or lesions at other locations. Oral lichen planus (OLP) is a chronic mucocutaneous disorder of stratified squamous epithelium of uncertain etiology that affects oral and genital mucous membranes, skin, nails, and scalp. LP is estimated to affect 0.5% to 2.0% of the general population. This disease has most often been reported in middle-aged patients with 30-60 years of age and is more common in females than in males. The disease seems to be mediated by an antigen-specific mechanism, activating cytotoxic T cells, and non-specific mechanisms like mast cell degranulation and matrix metalloproteinase activation. A proper understanding of the pathogenesis, clinical presentation, diagnosis of the disease becomes important for providing the right treatment. This article discusses the prevalence, etiology, clinical features, oral manifestations, diagnosis, complications and treatment of oral LP. PMID:26120146

  18. Novel perspectives on diagnosis and clinical significance of the post-thrombotic syndrome in children.

    Science.gov (United States)

    Jones, Sophie; Newall, Fiona; Monagle, Paul

    2016-10-01

    Given the increase in venous thromboembolic events (VTE) in children, the incidence, diagnosis and management of post thrombotic syndrome (PTS) in children is of increasing interest. Current challenges facing clinicians caring for children with VTE is the limited evidence of the long-term outcomes for this cohort; specifically the significance and potential functional impairment associated with PTS. This paper reviews the current evidence to elucidate the risk factors for PTS in children, methods for diagnosis and management of PTS in children (aged less than 18 years). Medline, Cinahl and PsycINFO database searches were undertaken using key search terms. Priority areas in need of further research are highlighted. Expert commentary: The two paediatric PTS assessment tools currently in use have been acknowledged to overcall the incidence of mild PTS in children. A PTS tool's ability to distinguish between clinically significant PTS and mild PTS is crucial. Variation in how PTS has been reported in children across the literature suggests that the real incidence of moderate and /or clinically significant PTS in children is unknown. Furthermore, evidence is lacking about the functional impairment experienced by children with clinically significant PTS and what this means for their long-term health.

  19. The sound manifesto

    Science.gov (United States)

    O'Donnell, Michael J.; Bisnovatyi, Ilia

    2000-11-01

    Computing practice today depends on visual output to drive almost all user interaction. Other senses, such as audition, may be totally neglected, or used tangentially, or used in highly restricted specialized ways. We have excellent audio rendering through D-A conversion, but we lack rich general facilities for modeling and manipulating sound comparable in quality and flexibility to graphics. We need coordinated research in several disciplines to improve the use of sound as an interactive information channel. Incremental and separate improvements in synthesis, analysis, speech processing, audiology, acoustics, music, etc. will not alone produce the radical progress that we seek in sonic practice. We also need to create a new central topic of study in digital audio research. The new topic will assimilate the contributions of different disciplines on a common foundation. The key central concept that we lack is sound as a general-purpose information channel. We must investigate the structure of this information channel, which is driven by the cooperative development of auditory perception and physical sound production. Particular audible encodings, such as speech and music, illuminate sonic information by example, but they are no more sufficient for a characterization than typography is sufficient for characterization of visual information. To develop this new conceptual topic of sonic information structure, we need to integrate insights from a number of different disciplines that deal with sound. In particular, we need to coordinate central and foundational studies of the representational models of sound with specific applications that illuminate the good and bad qualities of these models. Each natural or artificial process that generates informative sound, and each perceptual mechanism that derives information from sound, will teach us something about the right structure to attribute to the sound itself. The new Sound topic will combine the work of computer

  20. Unsound Sound

    DEFF Research Database (Denmark)

    Knakkergaard, Martin

    2016-01-01

    This article discusses the change in premise that digitally produced sound brings about and how digital technologies more generally have changed our relationship to the musical artifact, not simply in degree but in kind. It demonstrates how our acoustical conceptions are thoroughly challenged...... by the digital production of sound and, by questioning the ontological basis for digital sound, turns our understanding of the core term substance upside down....

  1. Customized Versus Noncustomized Sound Therapy for Treatment of Tinnitus: A Randomized Crossover Clinical Trial.

    Science.gov (United States)

    Mahboubi, Hossein; Haidar, Yarah M; Kiumehr, Saman; Ziai, Kasra; Djalilian, Hamid R

    2017-10-01

    To determine the effectiveness of a customized sound therapy and compare its effectiveness to that of masking with broadband noise. Subjects were randomized to receive either customized sound therapy or broadband noise for 2 hours per day for 3 months and then switched to the other treatment after a washout period. The outcome variables were tinnitus loudness (scored 0-10), Tinnitus Handicap Inventory (THI), Beck Anxiety Inventory (BAI), minimum masking levels (MML), and residual inhibition (RI). Eighteen subjects completed the study. Mean age was 53 ± 11 years, and mean tinnitus duration was 118 ± 99 months. With customized sound therapy, mean loudness decreased from 6.4 ± 2.0 to 4.9 ± 1.9 ( P = .001), mean THI decreased from 42.8 ± 21.6 to 31.5 ± 20.3 ( P tinnitus patients, and the results may be superior to broadband noise.

  2. Early Sound Symbolism for Vowel Sounds

    Directory of Open Access Journals (Sweden)

    Ferrinne Spector

    2013-06-01

    Full Text Available Children and adults consistently match some words (e.g., kiki to jagged shapes and other words (e.g., bouba to rounded shapes, providing evidence for non-arbitrary sound–shape mapping. In this study, we investigated the influence of vowels on sound–shape matching in toddlers, using four contrasting pairs of nonsense words differing in vowel sound (/i/ as in feet vs. /o/ as in boat and four rounded–jagged shape pairs. Crucially, we used reduplicated syllables (e.g., kiki vs. koko rather than confounding vowel sound with consonant context and syllable variability (e.g., kiki vs. bouba. Toddlers consistently matched words with /o/ to rounded shapes and words with /i/ to jagged shapes (p < 0.01. The results suggest that there may be naturally biased correspondences between vowel sound and shape.

  3. Sound Art and Spatial Practices: Situating Sound Installation Art Since 1958

    OpenAIRE

    Ouzounian, Gascia

    2008-01-01

    This dissertation examines the emergence and development ofsound installation art, an under-recognized tradition that hasdeveloped between music, architecture, and media art practicessince the late 1950s. Unlike many musical works, which are concernedwith organizing sounds in time, sound installations organize sounds inspace; they thus necessitate new theoretical and analytical modelsthat take into consideration the spatial situated-ness of sound. Existingdiscourses on “spatial sound” privile...

  4. Validity and Reliability of Clinical Examination in the Diagnosis of Myofascial Pain Syndrome and Myofascial Trigger Points in Upper Quarter Muscles.

    Science.gov (United States)

    Mayoral Del Moral, Orlando; Torres Lacomba, María; Russell, I Jon; Sánchez Méndez, Óscar; Sánchez Sánchez, Beatriz

    2017-12-15

    To determine whether two independent examiners can agree on a diagnosis of myofascial pain syndrome (MPS). To evaluate interexaminer reliability in identifying myofascial trigger points in upper quarter muscles. To evaluate the reliability of clinical diagnostic criteria for the diagnosis of MPS. To evaluate the validity of clinical diagnostic criteria for the diagnosis of MPS. Validity and reliability study. Provincial Hospital. Toledo, Spain. Twenty myofascial pain syndrome patients and 20 healthy, normal control subjects, enrolled by a trained and experienced examiner. Ten bilateral muscles from the upper quarter were evaluated by two experienced examiners. The second examiner was blinded to the diagnosis group. The MPS diagnosis required at least one muscle to have an active myofascial trigger point. Three to four days separated the two examinations. The primary outcome measure was the frequency with which the two examiners agreed on the classification of the subjects as patients or as healthy controls. The kappa statistic (K) was used to determine the level of agreement between both examinations, interpreted as very good (0.81-1.00), good (0.61-0.80), moderate (0.41-0.60), fair (0.21-0.40), or poor (≤0.20). Interexaminer reliability for identifying subjects with MPS was very good (K = 1.0). Interexaminer reliability for identifying muscles leading to a diagnosis of MPS was also very good (K = 0.81). Sensitivity and specificity showed high values for most examination tests in all muscles, which confirms the validity of clinical diagnostic criteria in the diagnosis of MPS. Interrater reliability between two expert examiners identifying subjects with MPS involving upper quarter muscles exhibited substantial agreement. These results suggest that clinical criteria can be valid and reliable in the diagnosis of this condition. © 2017 American Academy of Pain Medicine. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

  5. Association of Previous Clinical Breast Examination With Reduced Delays and Earlier-Stage Breast Cancer Diagnosis Among Women in Peru.

    Science.gov (United States)

    Romanoff, Anya; Constant, Tara Hayes; Johnson, Kay M; Guadiamos, Manuel Cedano; Vega, Ana María Burga; Zunt, Joseph; Anderson, Benjamin O

    2017-11-01

    Mammographic screening is impractical in most of the world where breast cancers are first identified based on clinical signs and symptoms. Clinical breast examination may improve early diagnosis directly by finding breast cancers at earlier stages or indirectly by heightening women's awareness of breast health concerns. To investigate factors that influence time to presentation and stage at diagnosis among patients with breast cancer to determine whether history of previous clinical breast examination is associated with earlier presentation and/or earlier cancer stage at diagnosis. In this cross-sectional analysis of individual patient interviews using a validated Breast Cancer Delay Questionnaire, 113 (71.1%) of 159 women with breast cancer treated at a federally funded tertiary care referral cancer center in Trujillo, Peru, from February 1 through May 31, 2015, were studied. Method of breast cancer detection and factors that influence time to and stage at diagnosis. Of 113 women with diagnosed cancer (mean [SD] age, 54 [10.8] years; age range, 32-82 years), 105 (92.9%) had self-detected disease. Of the 93 women for whom stage was documented, 45 (48.4%) were diagnosed with early-stage disease (American Joint Committee on Cancer [AJCC] stage 0, I, or II), and 48 (51.6%) were diagnosed with late-stage disease (AJCC stage III or IV). Mean (SD) total delay from symptom onset to initiation of treatment was 407 (665) days because of patient (mean [SD], 198 [449] days) and health care system (mean [SD], 241 [556] days) delay. Fifty-two women (46.0%) had a history of clinical breast examination, and 23 (20.4%) had undergone previous mammography. Women who underwent a previous clinical breast examination were more likely to have shorter delays from symptom development to presentation compared with women who had never undergone a previous clinical breast examination (odds ratio, 2.92; 95% CI, 1.30-6.60; P = .01). Women diagnosed with shorter patient delay were more

  6. Magnetic resonance imaging in the differential diagnosis of true placenta accreta: a clinical case

    Directory of Open Access Journals (Sweden)

    E. V. Tarachkova

    2016-01-01

    Full Text Available True placenta accreta is the attachment of chorionic villi to the myometrium, possibly penetrating into the thickness of the myometrium and its outside, including through the serous tunic. The main current diagnostic techniques are considered to be ultrasonography, laboratory diagnosis (elevated human chorionic gonadotropin and placental lactogen levels, and clinical data (pain and vaginal discharge. Magnetic resonance imaging is deemed to be an adjuvant technique. By using a clinical example, this paper considers the capabilities of magnetic resonance imaging to diagnose this abnormality and to choose a right treatment policy. The abnormality is compared with the conditions (trophoblastic tumor and myoma with lysis that are similar in their diagnosis and magnetic resonance pattern. The disorder in question is rather rare and its detailed consideration, determination of the capabilities of various techniques, and comparison with externally similar cases areimportant for the development of diagnostic opportunities.

  7. Gorlin syndrome: Importance of clinical signs and danger of delayed diagnosis - A case report with eight years follow-up

    Directory of Open Access Journals (Sweden)

    Erica Dorigatti de-Avila

    2015-02-01

    Full Text Available Nevoid basal cell carcinoma (NBCCS or Gorlin-Goltz syndrome (GS is a multidisciplinary problem, the early diagnosis of which allows secondary prophylaxis that follows an appropriate regimen to delay progression of the syndrome. The aim of this study was to present a case of delayed diagnosis of GS in a young patient who received multidisciplinary treatment 5 years after onset. The patient presented for evaluation with painless swelling of the left maxilla. Histological examination confirmed the diagnosis of a keratocyst odontogenic tumor (KOT that was enucleated. On presentation, the patient's symptoms and clinical signs were not related to complications of GS, and the possibility of GS was initially rejected, as he did not have a family history of the syndrome. Four years after the first surgery to remove the lesion, the patient came to our clinic with a brown, pigmented lesion. Computed tomography revealed ectopic lamellar calcification of the falx cerebri, which was the conclusive factor for the diagnosis of GS. It is important that clinicians recognize the clinical signs of GS, which mainly manifests itself as multiple basal cell carcinomas in the skin. [Arch Clin Exp Surg 2015; 4(1.000: 49-53

  8. Health-related quality of life in patients with dual diagnosis: clinical correlates

    Directory of Open Access Journals (Sweden)

    Benaiges Irina

    2012-09-01

    Full Text Available Abstract Background Although the studies published so far have found an affectation in the Health Related Quality of Life (HRQOL in both psychiatric and substance use dependence disorders, very few studies have applied HRQOL as an assessment measure in patients suffering both comorbid conditions, or Dual Diagnosis. The aim of the current study was to assess HRQOL in a group of patients with Dual Diagnosis compared to two other non-comorbid groups and to determine what clinical factors are related to HRQOL. Methods Cross-sectional assessment of three experimental groups was made through the Short Form – 36 Item Health Survey (SF-36. The sample consisted of a group with Dual Diagnosis (DD; N = 35, one with Severe Mental Illness alone (SMI; N = 35 and another one with Substance Use Dependence alone (SUD; N = 35. The sample was composed only by males. To assess the clinical correlates of SF-36 HRQOL, lineal regression analyses were carried out. Results The DD group showed lower scores in most of the subscales, and in the mental health domain. The group with SUD showed in general a better state in the HRQOL while the group with SMI held an intermediate position with respect to the other two groups. Daily medication, suicidal attempts and daily number of coffees were significantly associated to HRQOL, especially in the DD group. Conclusions The DD group showed lower self-reported mental health quality of life. Assessment of HRQOL in dual patients allows to identify specific needs in this population, and may help to establish therapeutic goals to improve interventions.

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

    Science.gov (United States)

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

    2015-01-01

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

  10. Autism in Preschoolers: Does Individual Clinician’s First Visit Diagnosis Agree with Final Comprehensive Diagnosis?

    Directory of Open Access Journals (Sweden)

    Gunilla Westman Andersson

    2013-01-01

    Full Text Available Comprehensive clinical diagnosis based on all available information is considered the “gold standard” in autism spectrum disorders (ASD. We examined agreement across independent assessments (clinical judgment of 34 young children (age 24–46 months with suspected ASD, assessed by a multidisciplinary team, and final comprehensive clinical diagnosis. Agreement across settings and between each clinician’s assessment and final diagnosis was moderate. The poorest fit was found at assessment in connection with psychological evaluation and the best with preschool observation and parent interview. Some individual clinicians had good and others had poor fit with final diagnosis. Disagreement across assessments was pronounced for girls. The findings suggest that multidisciplinary assessments remain important and that comprehensive clinical diagnosis should still be regarded as the gold standard in ASD.

  11. Clinical and imaging diagnosis of IgG4-related disease in the head and neck

    International Nuclear Information System (INIS)

    Yu Changliang; Liu Bin; Yu Yongqiang

    2013-01-01

    IgG4-related disease in the head and neck is a newly recognized multi-organ system disease characterized by elevated serum IgG4, infiltration of numerous IgG4-positive plasma cells, tissue fibrosis, and dramatic response to corticosteroid treatment. IgG4-related disease of the head and neck has some relative characteristics on CT and MRI, which can provide valuable information for the diagnosis and differential diagnosis, and are helpful for the clinical treatment, evaluation of therapeutic effects and prediction of prognosis. (authors)

  12. Evaluation of clinical and serological findings for diagnosis of cutaneous anthrax infection after an outbreak.

    Science.gov (United States)

    Gulseren, Duygu; Süzük-Yıldız, Serap; Çelebi, Bekir; Kılıç, Selçuk

    2017-09-01

    Anthrax, caused by the bacterium Bacillus anthracis, is one of the oldest documented infectious diseases in both livestock and humans. We aimed to evaluate clinical findings and risk factors of patients with cutaneous anthrax infection and report anti-lethal factor (LF) IgG and anti-protective antigen (PA) IgG titers in the serologic diagnosis of disease. In this study, serum samples of 18 cutaneous anthrax patients were collected and anti-LF IgG and anti-PA IgG titers were measured by enzyme-linked immunosorbent assay (ELISA). Twelve (67%) males and 6 (33%) females, with a mean age of 36.06 ± 16.58 years were included in the study. Risk factors identified in the patient population studied were slaughtering (28%), flaying (56%), chopping meat (67%), burying diseased animal corpses (17%) and milking (6%) livestock. Black eschar formation (94%), pruritus (78%) and painful lymphadenopathy (61%) were first three common clinical signs and symptoms, respectively. Fourteen (78%) patients produced a positive IgG response against PA, 11 (61%) patients produced against LF. Three (17%) patients had no response to either antigen. A detailed history of contact with sick animals or animal products along with clinical findings should be taken at the first step for the diagnosis of cutaneous anthrax infection. Serologic detection of anti-LF IgG and anti-PA IgG with ELISA may be useful auxillary method for establishing the diagnosis.

  13. Usher syndrome: an effective sequencing approach to establish a genetic and clinical diagnosis.

    Science.gov (United States)

    Lenarduzzi, S; Vozzi, D; Morgan, A; Rubinato, E; D'Eustacchio, A; Osland, T M; Rossi, C; Graziano, C; Castorina, P; Ambrosetti, U; Morgutti, M; Girotto, G

    2015-02-01

    Usher syndrome is an autosomal recessive disorder characterized by retinitis pigmentosa, sensorineural hearing loss and, in some cases, vestibular dysfunction. The disorder is clinically and genetically heterogeneous and, to date, mutations in 11 genes have been described. This finding makes difficult to get a precise molecular diagnosis and offer patients accurate genetic counselling. To overcome this problem and to increase our knowledge of the molecular basis of Usher syndrome, we designed a targeted resequencing custom panel. In a first validation step a series of 16 Italian patients with known molecular diagnosis were analysed and 31 out of 32 alleles were detected (97% of accuracy). After this step, 31 patients without a molecular diagnosis were enrolled in the study. Three out of them with an uncertain Usher diagnosis were excluded. One causative allele was detected in 24 out 28 patients (86%) while the presence of both causative alleles characterized 19 patients out 28 (68%). Sixteen novel and 27 known alleles were found in the following genes: USH2A (50%), MYO7A (7%), CDH23 (11%), PCDH15 (7%) and USH1G (2%). Overall, on the 44 patients the protocol was able to characterize 74 alleles out of 88 (84%). These results suggest that our panel is an effective approach for the genetic diagnosis of Usher syndrome leading to: 1) an accurate molecular diagnosis, 2) better genetic counselling, 3) more precise molecular epidemiology data fundamental for future interventional plans. Copyright © 2014 Elsevier B.V. All rights reserved.

  14. Sound a very short introduction

    CERN Document Server

    Goldsmith, Mike

    2015-01-01

    Sound is integral to how we experience the world, in the form of noise as well as music. But what is sound? What is the physical basis of pitch and harmony? And how are sound waves exploited in musical instruments? Sound: A Very Short Introduction looks at the science of sound and the behaviour of sound waves with their different frequencies. It also explores sound in different contexts, covering the audible and inaudible, sound underground and underwater, acoustic and electronic sound, and hearing in humans and animals. It concludes with the problem of sound out of place—noise and its reduction.

  15. Diagnosis and Managment of Maxillary Incisor with Vertical Root Fracture: A Clinical Report with Three-Year Follow-Up

    Directory of Open Access Journals (Sweden)

    Ines Kallel

    2018-01-01

    Full Text Available According to the American Association of Endodontists, “a ‘true’ vertical root fracture is defined as a complete or incomplete fracture initiated from the root at any level, usually directed buccolingually.” Vertical root fracture (VRF usually starts from an internal dentinal crack and develops over time, due to masticatory forces and occlusal loads. When they occur in teeth, those types of fractures can present difficulties in diagnosis, and there are however many clinic and radiographical signs which can guide clinicians to the existence of the fracture. Prognosis, most often, is hopeless, and differential diagnosis from other etiologies may be difficult sometimes. In this paper, we present a case of VRF diagnosed after surgical exploration; the enlarged fracture line was filled with a fluid resin. A 36-month clinical and radiological follow-up showed an asymptomatic tooth, reduction of the periodontal probing depth from 7 mm prior to treatment to 4 mm with no signs of ankylosis. In this work, the diagnosis and treatment alternatives of vertical root fracture were discussed through the presented clinical case.

  16. Diagnosis and Managment of Maxillary Incisor with Vertical Root Fracture: A Clinical Report with Three-Year Follow-Up.

    Science.gov (United States)

    Kallel, Ines; Moussaoui, Eya; Chtioui, Fadwa; Douki, Nabiha

    2018-01-01

    According to the American Association of Endodontists, "a 'true' vertical root fracture is defined as a complete or incomplete fracture initiated from the root at any level, usually directed buccolingually." Vertical root fracture (VRF) usually starts from an internal dentinal crack and develops over time, due to masticatory forces and occlusal loads. When they occur in teeth, those types of fractures can present difficulties in diagnosis, and there are however many clinic and radiographical signs which can guide clinicians to the existence of the fracture. Prognosis, most often, is hopeless, and differential diagnosis from other etiologies may be difficult sometimes. In this paper, we present a case of VRF diagnosed after surgical exploration; the enlarged fracture line was filled with a fluid resin. A 36-month clinical and radiological follow-up showed an asymptomatic tooth, reduction of the periodontal probing depth from 7 mm prior to treatment to 4 mm with no signs of ankylosis. In this work, the diagnosis and treatment alternatives of vertical root fracture were discussed through the presented clinical case.

  17. [Clinical analyses of the diagnosis and treatment of invasive fungal rhinosinusitis: report of 14 cases].

    Science.gov (United States)

    Shi, G G; Shi, L; Zhang, Z Y; Wan, Y Z; Li, B; Yu, L; Zhang, E P; Ju, H S; He, M Q; Ji, H Z

    2016-08-07

    Through the retrospective analysis of the clinical data in 14 cases of invasive fungal rhinosinusitis (IFRS), the clinical characteristics, diagnosis and treatment of this disease were evaluated. Fourteen clinically confirmed cases of IFRS since January 2008 to October 2015 were evaluated.collected, the clinical features, diagnosis, treatment and prognosis were analyzed to obtain a more comprehensive understanding for clinical reference. Fourteen patients were confirmed by pathological examination as IFRS, including 9 cases of aspergillus, 4 cases of mucor, and 1 case of rhinocerebral zygomycosis; including 5 cases of acute IFRS, 9 cases of chronic IFRS. All patients were treated with endoscopic surgery and intravenous antifungal therapy. Nine cases of chronic IFRS (including 1 case of mucor, 7 cases of aspergillus and 1 case of rhinocerebral zygomycosis) were cured, but the vision loss, diplopia or blindness, hard palate perforation remained. Five cases of acute IFRS included 3 cases of mucor and 2 cases of aspergillus. Among the 3 cases of mucor, 2 cases were died and 1 case was cured. Among the 2 cases of aspergillus, 1 patient was cured and the other patient died of electrolyte disorder after discharge from hospital. Patients with IFRS usually have diabetes. After the active surgical cleaning of lesion tissue and the systematic antifungal treatment with adequate dosage, these patients would have a better result. IFRS caused by mucor is ofen dangerous.

  18. Clinical application of brain imaging for the diagnosis of mood disorders: the current state of play.

    Science.gov (United States)

    Savitz, J B; Rauch, S L; Drevets, W C

    2013-05-01

    In response to queries about whether brain imaging technology has reached the point where it is useful for making a clinical diagnosis and for helping to guide treatment selection, the American Psychiatric Association (APA) has recently written a position paper on the Clinical Application of Brain Imaging in Psychiatry. The following perspective piece is based on our contribution to this APA position paper, which specifically emphasized the application of neuroimaging in mood disorders. We present an introductory overview of the challenges faced by researchers in developing valid and reliable biomarkers for psychiatric disorders, followed by a synopsis of the extant neuroimaging findings in mood disorders, and an evidence-based review of the current research on brain imaging biomarkers in adult mood disorders. Although there are a number of promising results, by the standards proposed below, we argue that there are currently no brain imaging biomarkers that are clinically useful for establishing diagnosis or predicting treatment outcome in mood disorders.

  19. Clinical application of brain imaging for the diagnosis of mood disorders: the current state of play

    Science.gov (United States)

    Savitz, J B; Rauch, S L; Drevets, W C

    2013-01-01

    In response to queries about whether brain imaging technology has reached the point where it is useful for making a clinical diagnosis and for helping to guide treatment selection, the American Psychiatric Association (APA) has recently written a position paper on the Clinical Application of Brain Imaging in Psychiatry. The following perspective piece is based on our contribution to this APA position paper, which specifically emphasized the application of neuroimaging in mood disorders. We present an introductory overview of the challenges faced by researchers in developing valid and reliable biomarkers for psychiatric disorders, followed by a synopsis of the extant neuroimaging findings in mood disorders, and an evidence-based review of the current research on brain imaging biomarkers in adult mood disorders. Although there are a number of promising results, by the standards proposed below, we argue that there are currently no brain imaging biomarkers that are clinically useful for establishing diagnosis or predicting treatment outcome in mood disorders. PMID:23546169

  20. Estimation of Direct Melanoma-related Costs by Disease Stage and by Phase of Diagnosis and Treatment According to Clinical Guidelines

    Directory of Open Access Journals (Sweden)

    Alessandra Buja

    2017-11-01

    Full Text Available Cutaneous melanoma is a major concern in terms of healthcare systems and economics. The aim of this study was to estimate the direct costs of melanoma by disease stage, phase of diagnosis, and treatment according to the pre-set clinical guidelines drafted by the AIOM (Italian Medical Oncological Association. Based on the AIOM guidelines for malignant cutaneous melanoma, a highly detailed decision-making model was developed describing the patient’s pathway from diagnosis through the subsequent phases of disease staging, surgical and medical treatment, and follow-up. The model associates each phase potentially involving medical procedures with a likelihood measure and a cost, thus enabling an estimation of the expected costs by disease stage and clinical phase of melanoma diagnosis and treatment according to the clinical guidelines. The mean per-patient cost of the whole melanoma pathway (including one year of follow-up ranged from €149 for stage 0 disease to €66,950 for stage IV disease. The costs relating to each phase of the disease’s diagnosis and treatment depended on disease stage. It is essential to calculate the direct costs of managing malignant cutaneous melanoma according to clinical guidelines in order to estimate the economic burden of this disease and to enable policy-makers to allocate appropriate resources.

  1. Clinical Diagnosis of Bordetella Pertussis Infection: A Systematic Review.

    Science.gov (United States)

    Ebell, Mark H; Marchello, Christian; Callahan, Maria

    2017-01-01

    Bordetella pertussis (BP) is a common cause of prolonged cough. Our objective was to perform an updated systematic review of the clinical diagnosis of BP without restriction by patient age. We identified prospective cohort studies of patients with cough or suspected pertussis and assessed study quality using QUADAS-2. We performed bivariate meta-analysis to calculate summary estimates of accuracy and created summary receiver operating characteristic curves to explore heterogeneity by vaccination status and age. Of 381 studies initially identified, 22 met our inclusion criteria, of which 14 had a low risk of bias. The overall clinical impression was the most accurate predictor of BP (positive likelihood ratio [LR+], 3.3; negative likelihood ratio [LR-], 0.63). The presence of whooping cough (LR+, 2.1) and posttussive vomiting (LR+, 1.7) somewhat increased the likelihood of BP, whereas the absence of paroxysmal cough (LR-, 0.58) and the absence of sputum (LR-, 0.63) decreased it. Whooping cough and posttussive vomiting have lower sensitivity in adults. Clinical criteria defined by the Centers for Disease Control and Prevention were sensitive (0.90) but nonspecific. Typical signs and symptoms of BP may be more sensitive but less specific in vaccinated patients. The clinician's overall impression was the most accurate way to determine the likelihood of BP infection when a patient initially presented. Clinical decision rules that combine signs, symptoms, and point-of-care tests have not yet been developed or validated. © Copyright 2017 by the American Board of Family Medicine.

  2. Polycystic ovarian syndrome: clinical and biological diagnosis.

    Science.gov (United States)

    Bachelot, Anne

    2016-12-01

    Polycystic ovary syndrome (PCOS) is the most common ovarian disorder associated with androgen excess in women, which justifies the growing interest of endocrinologists. This syndrome leads to clinical hyperandrogenism and/or a biological dysovulation and infertility. Its diagnosis is based on consensual diagnostic criteria, but which are likely to change in the near future with the rise of the interest of new markers such as AMH. Diagnostic tools of PCOS are also discussed, with emphasis on the laboratory evaluation of androgens and other potential biomarkers of ovarian and metabolic dysfunctions. The exact etiology of PCOS is unknown and is likely multifactorial. Many studies indicate that PCOS results from originally ovarian abnormalities. In some patients, secondary hyperinsulinemia with insulin resistance plays a role in the pathophysiology. In addition, the relevant impact of metabolic issues, specifically insulin resistance and obesity, on the pathogenesis of PCOS, and the susceptibility to develop earlier than expected glucose intolerance states, including type 2 diabetes, has supported the notion that these aspects should be considered when defining the PCOS phenotype and planning potential therapeutic strategies in an affected subject.

  3. [Alzheimer's disease cerebro-spinal fluid biomarkers: A clinical research tool sometimes useful in daily clinical practice of memory clinics for the diagnosis of complex cases].

    Science.gov (United States)

    Magnin, E; Dumurgier, J; Bouaziz-Amar, E; Bombois, S; Wallon, D; Gabelle, A; Lehmann, S; Blanc, F; Bousiges, O; Hannequin, D; Jung, B; Miguet-Alfonsi, C; Quillard, M; Pasquier, F; Peoc'h, K; Laplanche, J-L; Hugon, J; Paquet, C

    2017-04-01

    The role of biomarkers in clinical research was recently highlighted in the new criteria for the diagnosis of Alzheimer's disease. Cerebro-spinal fluid (CSF) biomarkers (total Tau protein, threonine 181 phosphorylated Tau protein and amyloid Aβ1-42 peptide) are associated with cerebral neuropathological lesions observed in Alzheimer's disease (neuronal death, neurofibrillary tangle with abnormal Tau deposits and amyloid plaque). Aβ1-40 amyloid peptide dosage helps to interpret Aβ1-42 results. As suggested in the latest international criteria and the French HAS (Haute Autorité de santé) recommendations, using theses CSF biomarkers should not be systematic but sometimes could be performed to improve confidence about the diagnostic of Alzheimer's disease in young subjects or in complex clinical situations. Future biomarkers actually in development will additionally help in diagnostic process (differential diagnosis) and in prognostic evaluation of neurodegenerative diseases. Copyright © 2016 Société Nationale Française de Médecine Interne (SNFMI). Published by Elsevier SAS. All rights reserved.

  4. ACG clinical guidelines: diagnosis and management of celiac disease.

    Science.gov (United States)

    Rubio-Tapia, Alberto; Hill, Ivor D; Kelly, Ciarán P; Calderwood, Audrey H; Murray, Joseph A

    2013-05-01

    This guideline presents recommendations for the diagnosis and management of patients with celiac disease. Celiac disease is an immune-based reaction to dietary gluten (storage protein for wheat, barley, and rye) that primarily affects the small intestine in those with a genetic predisposition and resolves with exclusion of gluten from the diet. There has been a substantial increase in the prevalence of celiac disease over the last 50 years and an increase in the rate of diagnosis in the last 10 years. Celiac disease can present with many symptoms, including typical gastrointestinal symptoms (e.g., diarrhea, steatorrhea, weight loss, bloating, flatulence, abdominal pain) and also non-gastrointestinal abnormalities (e.g., abnormal liver function tests, iron deficiency anemia, bone disease, skin disorders, and many other protean manifestations). Indeed, many individuals with celiac disease may have no symptoms at all. Celiac disease is usually detected by serologic testing of celiac-specific antibodies. The diagnosis is confirmed by duodenal mucosal biopsies. Both serology and biopsy should be performed on a gluten-containing diet. The treatment for celiac disease is primarily a gluten-free diet (GFD), which requires significant patient education, motivation, and follow-up. Non-responsive celiac disease occurs frequently, particularly in those diagnosed in adulthood. Persistent or recurring symptoms should lead to a review of the patient's original diagnosis to exclude alternative diagnoses, a review of the GFD to ensure there is no obvious gluten contamination, and serologic testing to confirm adherence with the GFD. In addition, evaluation for disorders associated with celiac disease that could cause persistent symptoms, such as microscopic colitis, pancreatic exocrine dysfunction, and complications of celiac disease, such as enteropathy-associated lymphoma or refractory celiac disease, should be entertained. Newer therapeutic modalities are being studied in

  5. Usher syndrome (sensorineural deafness and retinitis pigmentosa): pathogenesis, molecular diagnosis and therapeutic approaches.

    Science.gov (United States)

    Bonnet, Crystel; El-Amraoui, Aziz

    2012-02-01

    Usher syndrome (USH) is the most prevalent cause of hereditary deafness-blindness in humans. In this review, we pinpoint new insights regarding the molecular mechanisms defective in this syndrome, its molecular diagnosis and prospective therapies. Animal models wherein USH proteins were targeted at different maturation stages of the auditory hair cells have been engineered, shedding new light on the development and functioning of the hair bundle, the sound receptive structure. Improved protocols and guidelines for early molecular diagnosis of USH (USH genotyping microarrays, otochips and complete Sanger sequencing of the 366 coding exons of identified USH genes) have been developed. Approaches to alleviate or cure hearing and visual impairments have been initiated, leading to various degrees of functional rescuing. Whereas the mechanisms underlying hearing impairment in USH patients are being unraveled, showing in particular that USH1 proteins are involved in the shaping of the hair bundle and the functioning of the mechanoelectrical transduction machinery, the mechanisms underlying the retinal defects are still unclear. Efforts to improve clinical diagnosis have been successful. Yet, despite some encouraging results, further development of therapeutic approaches is necessary to ultimately treat this dual sensory defect.

  6. Conventional radiography or ultra sound for rib fracture diagnosis: a literature review

    Directory of Open Access Journals (Sweden)

    Elham Pishbin

    2014-08-01

    Full Text Available Blunt chest trauma accounts for the majority of mortalities and morbidities in traumatized patients. Rib fractures are one of the most common chest wall injuries due to blunt chest trauma, which is estimated to occur in 10% of all traumatic injuries. Conventional radiography and ultra-sonography are two commonly methods used for rib fracture diagnosis with different accuracy. In this study, we described different methods used in diagnosis of injuries related to blunt chest trauma and we aimed to review several studies compared the diagnostic value of these methods.

  7. Clinical polymorphism of Allgrove (triple-A syndrome in children: Possibilities for early diagnosis and approaches to therapy

    Directory of Open Access Journals (Sweden)

    E. V. Tozliyan

    2016-01-01

    Full Text Available The paper gives the data available in the literature, which reflect the manifestations, diagnosis, and treatments of the rare inherited disease Allgrove syndrome in children. Emphasis is placed on major difficulties in the differential and true diagnosis of this severe disease. The authors describe their clinical cases. Particular emphasis is laid on the clinical symptoms of the disease and on its diagnostic methods, among which the DNA diagnosis is of most importance. The probands were found to have mutations in the AAAS gene: in one case there was a mutation (c.856 C> T, p.Arg286Term in homozygous state, which is described in the International Human Mutation Database (CM 10151; in other case there was a change in nucleotide sequence (c.709 delC, which is undescribed in the mutation and polymorphism databases and which leads to premature termination of the protein. It is shown that awareness of Allgrove syndrome among clinicians is low and the interdisciplinary approach is of importance.

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

    International Nuclear Information System (INIS)

    Lam, Daniel; Egan, Ingrid; Baird, Marilyn

    2004-01-01

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

  9. What is Sound?

    OpenAIRE

    Nelson, Peter

    2014-01-01

    What is sound? This question is posed in contradiction to the every-day understanding that sound is a phenomenon apart from us, to be heard, made, shaped and organised. Thinking through the history of computer music, and considering the current configuration of digital communi-cations, sound is reconfigured as a type of network. This network is envisaged as non-hierarchical, in keeping with currents of thought that refuse to prioritise the human in the world. The relationship of sound to musi...

  10. Broadcast sound technology

    CERN Document Server

    Talbot-Smith, Michael

    1990-01-01

    Broadcast Sound Technology provides an explanation of the underlying principles of modern audio technology. Organized into 21 chapters, the book first describes the basic sound; behavior of sound waves; aspects of hearing, harming, and charming the ear; room acoustics; reverberation; microphones; phantom power; loudspeakers; basic stereo; and monitoring of audio signal. Subsequent chapters explore the processing of audio signal, sockets, sound desks, and digital audio. Analogue and digital tape recording and reproduction, as well as noise reduction, are also explained.

  11. Propagation of sound

    DEFF Research Database (Denmark)

    Wahlberg, Magnus; Larsen, Ole Næsbye

    2017-01-01

    properties can be modified by sound absorption, refraction, and interference from multi paths caused by reflections.The path from the source to the receiver may be bent due to refraction. Besides geometrical attenuation, the ground effect and turbulence are the most important mechanisms to influence...... communication sounds for airborne acoustics and bottom and surface effects for underwater sounds. Refraction becomes very important close to shadow zones. For echolocation signals, geometric attenuation and sound absorption have the largest effects on the signals....

  12. Clinical advances of SPECT rCBF and interventional imaging applied in the diagnosis of dementias

    International Nuclear Information System (INIS)

    Zhang Kaijun

    2002-01-01

    Brain perfusion SPECT is a functional and noninvasive neuroimaging technique that allow the investigation of physiological and physiopathologic events in the human brain, including cerebral perfusion and function. Interventional rCBF imaging can also evaluate cerebrovascular reserve. In clinically, rCBF imaging play an important role in the diagnosis and differential diagnosis of dementias, especially vascular and Alzheimer's dementia. If etiology of some types of dementias is determined so that it can be early diagnosed, treated and taken prevention; the partial patients with dementia can get recovery or remission

  13. Cataplectic facies: clinical marker in the diagnosis of childhood narcolepsy-report of two cases.

    Science.gov (United States)

    Prasad, Manish; Setty, Gururaj; Ponnusamy, Athi; Hussain, Nahin; Desurkar, Archana

    2014-05-01

    Narcolepsy is a chronic disease and is commonly diagnosed in adulthood. However, more than half of the patients have onset of symptoms in childhood and/or adolescence. The full spectrum of clinical manifestations, namely excessive daytime sleepiness, cataplexy, hypnagogic hallucinations, and sleep paralysis, is usually not present at disease onset, delaying diagnosis during childhood. Mean delay in diagnosis since symptom onset is known to be several years. Initial manifestations can sometimes be as subtle as only partial drooping of eyelids leading to confusion with a myasthenic condition. We present two children who presented with "cataplectic facies," an unusual facial feature only recently described in children with narcolepsy with cataplexy. The diagnosis of narcolepsy was confirmed by multiple sleep latency test along with human leukocyte antigen typing and cerebrospinal fluid hypocretin assay. The diagnosis of narcolepsy with cataplexy at onset can be challenging in young children. With more awareness of subtle signs such as cataplectic facies, earlier diagnosis is possible. To date, only 11 children between 6 and 18 years of age presenting with typical cataplectic facies have been reported in the literature. We present two patients, one of whom is the youngest individual (4 years old) yet described with the typical cataplectic facies. Copyright © 2014 Elsevier Inc. All rights reserved.

  14. Cognitive impairment and dementia in Parkinson’s disease: clinical features, diagnosis, and management

    Directory of Open Access Journals (Sweden)

    Joana eMeireles

    2012-05-01

    Full Text Available Parkinson’s disease (PD is a common, disabling, neurodegenerative disorder. In addition to classical motor symptoms, nonmotor features are now widely accepted as part of the clinical picture, and cognitive decline is a very important aspect of the disease, as it brings an additional significant burden for the patient and caregivers. The diagnosis of cognitive decline in PD, namely mild cognitive impairment and dementia, can be extremely challenging, remaining largely based on clinical and cognitive assessments. Diagnostic criteria and methods for PD dementia and mild cognitive impairment have been recently issued by expert work groups. This manuscript has synthesized relevant data in order to obtain a pragmatic and updated review regarding cognitive decline in PD, from milder stages to dementia. This text will summarize clinical features, diagnostic methodology, and therapeutic issues of clinical decline in Parkinson’s disease. Relevant clinical genetic issues, including recent advances, will also be approached.

  15. Making fictions sound real

    DEFF Research Database (Denmark)

    Langkjær, Birger

    2010-01-01

    This article examines the role that sound plays in making fictions perceptually real to film audiences, whether these fictions are realist or non-realist in content and narrative form. I will argue that some aspects of film sound practices and the kind of experiences they trigger are related...... to basic rules of human perception, whereas others are more properly explained in relation to how aesthetic devices, including sound, are used to characterise the fiction and thereby make it perceptually real to its audience. Finally, I will argue that not all genres can be defined by a simple taxonomy...... of sounds. Apart from an account of the kinds of sounds that typically appear in a specific genre, a genre analysis of sound may also benefit from a functionalist approach that focuses on how sounds can make both realist and non-realist aspects of genres sound real to audiences....

  16. Celiac disease in Saudi children. Evaluation of clinical features and diagnosis

    Directory of Open Access Journals (Sweden)

    Anjum Saeed

    2017-09-01

    Full Text Available Objectives: To characterize the clinical presentations and diagnosis including serological tests and histopathological findings in children with celiac disease. Methods: All children (less than 18 years with confirmed celiac disease diagnosed over a 6 year period at a private tertiary care health care center in Riyadh, Saudi Arabia were studied retrospectively. Information collected included demographics, clinical presentation and diagnostic modalities with serology and small intestinal histology reported by Marsh grading. Results: A total of 59 children had confirmed celiac disease. Thirty (50.8% were male. Median age was 8 years (range 1 to 16 years. The mean duration of symptoms before diagnosis was 2.3 (±1.5 years. Classical disease was present only in 30.5%, whereas 69.5% had either non-classical presentations or belonged to high risk groups for celiac disease such as those with type-1 diabetes, autoimmune thyroiditis, Down syndrome and siblings. Failure to thrive was the most common presentation followed by short stature, abdominal pain and chronic diarrhea. Anti-tissue transglutaminase antibody was positive in 91.5%, and titers were no different between those with classical and non-classical disease. All had Marsh-graded biopsy findings consistent with celiac disease. Conclusion: Children with celiac disease usually present with non-classical features. A high index of suspicion needs to be maintained to consider this disorder in the diagnostic workup of pediatric patients. High risk group should be screened early to avoid complications associated with untreated celiac disease.

  17. Addenbrooke's Cognitive Examination (ACE) for the diagnosis and differential diagnosis of dementia.

    Science.gov (United States)

    Larner, A J

    2007-07-01

    The Addenbrooke's Cognitive Examination (ACE) is reported to be a highly sensitive and specific "bedside" test for the diagnosis of dementia, but large pragmatic studies of its use in day-to-day clinical practice are lacking. This study measured diagnostic accuracy of ACE in a large cohort of consecutive patients referred to a dedicated Cognitive Function Clinic. Consecutive new referrals over a 3.5-year period were administered the ACE (n=285). ACE scores and subscores (VLOM ratio) were compared to clinical diagnoses of dementia and dementia subtype, established on the basis of widely accepted diagnostic criteria and at least 12-month follow-up. ACE had good sensitivity, specificity, and positive predictive value for the diagnosis of dementia, with excellent diagnostic accuracy as measured by area under the receiver operating characteristic curve. However, a lower cutoff than that used in the index paper was required for optimum test sensitivity and specificity. ACE VLOM ratio subscore for the differential diagnosis of Alzheimer's disease and frontotemporal dementia proved less accurate. This study suggests that ACE is useful for the diagnosis of dementia in routine clinical practice but that other instruments may be required for the differential diagnosis of the dementia syndrome.

  18. Toward a Model of Pediatric Speech Sound Disorders (SSD) for Differential Diagnosis and Therapy Planning

    NARCIS (Netherlands)

    Terband, Hayo; Maassen, Bernardus; Maas, Edwin; van Lieshout, Pascal; Maassen, Ben; Terband, Hayo

    2016-01-01

    The classification and differentiation of pediatric speech sound disorders (SSD) is one of the main questions in the field of speech- and language pathology. Terms for classifying childhood and SSD and motor speech disorders (MSD) refer to speech production processes, and a variety of methods of

  19. AME evidence series 001—The Society for Translational Medicine: clinical practice guidelines for diagnosis and early identification of sepsis in the hospital

    OpenAIRE

    Zhang, Zhongheng; Smischney, Nathan J.; Zhang, Haibo; Van Poucke, Sven; Tsirigotis, Panagiotis; Rello, Jordi; Honore, Patrick M.; Sen Kuan, Win; Ray, Juliet June; Zhou, Jiancang; Shang, You; Yu, Yuetian; Jung, Christian; Robba, Chiara; Taccone, Fabio Silvio

    2016-01-01

    Sepsis is a heterogeneous disease caused by an infection stimulus that triggers several complex local and systemic immuno-inflammatory reactions, which results in multiple organ dysfunction and significant morbidity and mortality. The diagnosis of sepsis is challenging because there is no gold standard for diagnosis. As a result, the clinical diagnosis of sepsis is ever changing to meet the clinical and research requirements. Moreover, although there are many novel biomarkers and screening to...

  20. A Diagnostic Model for Dementia in Clinical Practice-Case Methodology Assisting Dementia Diagnosis.

    Science.gov (United States)

    Londos, Elisabet

    2015-04-02

    Dementia diagnosis is important for many different reasons. Firstly, to separate dementia, or major neurocognitive disorder, from MCI (mild cognitive impairment), mild neurocognitive disorder. Secondly, to define the specific underlying brain disorder to aid treatment, prognosis and decisions regarding care needs and assistance. The diagnostic method of dementias is a puzzle of different data pieces to be fitted together in the best possible way to reach a clinical diagnosis. Using a modified case methodology concept, risk factors affecting cognitive reserve and symptoms constituting the basis of the brain damage hypothesis, can be visualized, balanced and reflected against test results as well as structural and biochemical markers. The model's origin is the case method initially described in Harvard business school, here modified to serve dementia diagnostics.

  1. Sound sensitivity of neurons in rat hippocampus during performance of a sound-guided task

    Science.gov (United States)

    Vinnik, Ekaterina; Honey, Christian; Schnupp, Jan; Diamond, Mathew E.

    2012-01-01

    To investigate how hippocampal neurons encode sound stimuli, and the conjunction of sound stimuli with the animal's position in space, we recorded from neurons in the CA1 region of hippocampus in rats while they performed a sound discrimination task. Four different sounds were used, two associated with water reward on the right side of the animal and the other two with water reward on the left side. This allowed us to separate neuronal activity related to sound identity from activity related to response direction. To test the effect of spatial context on sound coding, we trained rats to carry out the task on two identical testing platforms at different locations in the same room. Twenty-one percent of the recorded neurons exhibited sensitivity to sound identity, as quantified by the difference in firing rate for the two sounds associated with the same response direction. Sensitivity to sound identity was often observed on only one of the two testing platforms, indicating an effect of spatial context on sensory responses. Forty-three percent of the neurons were sensitive to response direction, and the probability that any one neuron was sensitive to response direction was statistically independent from its sensitivity to sound identity. There was no significant coding for sound identity when the rats heard the same sounds outside the behavioral task. These results suggest that CA1 neurons encode sound stimuli, but only when those sounds are associated with actions. PMID:22219030

  2. Clinical outcomes for couples containing a reciprocal chromosome translocation carrier without preimplantation genetic diagnosis.

    Science.gov (United States)

    Yin, Biao; Zhu, Yuanchang; Wu, Tonghua; Shen, Shuqiu; Zeng, Yong; Liang, Desheng

    2017-03-01

    To evaluate the pregnancy outcomes of couples containing a carrier of a reciprocal chromosome translocation (RCT) after assisted reproductive technology without preimplantation genetic diagnosis. A retrospective study was performed using data for couples with an RCT carrier and control couples with a normal karyotype (1:4 ratio) who underwent assisted reproductive technology cycles at a Chinese fertility center in 2010-2011. The embryos were fertilized via in vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI). Only the first pick-up cycles were used for analysis. Clinical variables were compared. Compared with the control group (n=164), the RCT group (n=41) had a marginally lower clinical pregnancy rate (46.3% [19/41] vs 54.3% [89/164]), implantation rate (21.7% [23/106] vs 26.9% [118/438]), multiple-gestation pregnancy rate (21.1% [4/19] vs 32.6% [29/89]), and delivery rate (36.6% [15/41] vs 47.6% [78/164]), whereas the spontaneous abortion rate was slightly higher (21.1% [4/19] vs 12.4% [11/89]). However, none of these differences were significant. The clinical outcomes for RCT carriers were acceptable after IVF/ICSI without performing preimplantation genetic diagnosis, indicating that this approach might comprise a feasible alternative fertility treatment for RCT carriers. © 2016 International Federation of Gynecology and Obstetrics.

  3. Cutaneous epidermoid carcinoma (spinocellular carcinoma): clinical practice recommendations for diagnosis and therapy. Full report

    International Nuclear Information System (INIS)

    Martin, Ludovic; Bonerandi, Jean-Jacques; Brugneaux, Julie; Beauvillain, Claude; Chassagne, Jean-Francois; Clavere, Pierre; Grolleau, Jean-Louis; Grossin, Maggy; Sei, Jean-Francois; Caquant, Ludovic; Chaussade, Veronique; Desouches, Christophe; Garnier, Francois; Jourdain, Alain; Lemonnier, Jean-Yves; Maillard, Herve; Ortonne, Nicolas; Rio, Emmanuel; Simon, Etienne

    2009-01-01

    This guide aims at providing practitioners taking into care patients presenting a cutaneous cancer with recommendations based on scientific evidences or expert agreements. More precisely, the objectives are to clarify the terminology used to describe the different forms of cutaneous epidermoid carcinoma (CEC) and of their precursors (actinic keratosis, Bowen's disease), to propose a prognosis classification of CECs adapted to the previously identified prognosis factors, to optimise the diagnosis and therapy of actinic keratosis and Bowen's disease according to recent publications, and to recall the principles of a primary prevention of CECs and of their precursors, and of screening of high risk individuals. Thus, the different parts of this report address the following issues: anatomic-clinical forms and epidemiology of CECs and of their precursors, prognosis factors of CECs, means of treatment of CECs and of their precursors (medical, physical, surgical, radiation-based, and chemical treatments). Radiotherapy notably comprises external radiotherapy and interstitial brachytherapy. Indications for radiotherapy are discussed with respect to existing guides and to the clinical situation. The authors address the care of CECs and of their precursors (prevention, screening and clinical diagnosis, care of invasive CECs, keratoacanthoma treatment). They finally discuss quality criteria aimed at practice improvement, and perspectives regarding the evolution of this guide and studies to be performed

  4. Memory for product sounds: the effect of sound and label type.

    Science.gov (United States)

    Ozcan, Elif; van Egmond, René

    2007-11-01

    The (mnemonic) interactions between auditory, visual, and the semantic systems have been investigated using structurally complex auditory stimuli (i.e., product sounds). Six types of product sounds (air, alarm, cyclic, impact, liquid, mechanical) that vary in spectral-temporal structure were presented in four label type conditions: self-generated text, text, image, and pictogram. A memory paradigm that incorporated free recall, recognition, and matching tasks was employed. The results for the sound type suggest that the amount of spectral-temporal structure in a sound can be indicative for memory performance. Findings related to label type suggest that 'self' creates a strong bias for the retrieval and the recognition of sounds that were self-labeled; the density and the complexity of the visual information (i.e., pictograms) hinders the memory performance ('visual' overshadowing effect); and image labeling has an additive effect on the recall and matching tasks (dual coding). Thus, the findings suggest that the memory performances for product sounds are task-dependent.

  5. 33 CFR 167.1702 - In Prince William Sound: Prince William Sound Traffic Separation Scheme.

    Science.gov (United States)

    2010-07-01

    ... 33 Navigation and Navigable Waters 2 2010-07-01 2010-07-01 false In Prince William Sound: Prince William Sound Traffic Separation Scheme. 167.1702 Section 167.1702 Navigation and Navigable Waters COAST....1702 In Prince William Sound: Prince William Sound Traffic Separation Scheme. The Prince William Sound...

  6. Clinical Significance of Detection of Serum TBA and ALP in Diagnosis of Intrahepatic Cholestasis of Pregnancy

    International Nuclear Information System (INIS)

    Xiong Chuanzheng; Zhu Haibo; Deng jianping

    2009-01-01

    To investigate the clinical value of serum total bile acid (TBA) and alkaline phosphatase (ALP) in diagnosis of intahrpatic cholestasis of pregnancy (ICP), the serum levels of TBA, ALP and cholyglycine (CG) in 47 cases with intahrpatic cholestasis of pregnancy and 60 normal pregnant women were tested by biochemistry analysis and radioimmunoassay. The results showed that the serum levels of TBA and ALP in patients with intahrpatic cholestasis of pregnancy were significantly higher than that of normal pregnancy women. There was a positively correlation between TBA and ALP with CG. The combined determination of serum TBA and ALP could be useful in the diagnosis of intahrpatic cholestasis of pregnancy. Automatic biochemistry analysis of TBA and ALP is more simple and rapid than CG detected by radioimmunoassay,and it is suitable for clinical laboratory application. (authors)

  7. From Diagnosis to Treatment: Clinical Applications of Nanotechnology in Thoracic Surgery

    Science.gov (United States)

    Digesu, Christopher S.; Hofferberth, Sophie C.; Grinstaff, Mark W.; Colson, Yolonda L.

    2016-01-01

    Synopsis Nanotechnology is an emerging field of medicine with significant potential to become a powerful adjunct to cancer therapy, and in particular, thoracic surgery. Using the unique properties of several different nanometer-sized platforms, therapy can be delivered to tumors in a more targeted fashion, with less of the systemic toxicity associated with traditional chemotherapeutics. In addition to the packaged delivery of chemotherapeutic drugs, nanoparticles show potential to aid in the diagnosis, pre-operative characterization, and intraoperative localization of thoracic tumors and their lymphatics. With increasing interest in their clinical application, there is a rapid expansion of in vitro and in vivo studies being conducted that provide a better understanding of potential toxicities and hopes of broader clinical translation. Focused research into nanotechnology’s ability to deliver both diagnostics and therapeutics has led to the development of a field known as nanotheranostics which promises to improve the treatment of thoracic malignancies through enhanced tumor targeting, controlled drug delivery, and therapeutic monitoring. This article reviews the various types of nanoplatforms, their unique properties, and the potential for clinical application in thoracic surgery. PMID:27112260

  8. Challenge in Clinical Diagnosis and Treatment of Leptospirosis

    Directory of Open Access Journals (Sweden)

    Dora I. Ríos

    2015-01-01

    Full Text Available Abstract: Introduction: Leptospirosis is an acute febrile disease caused by the leptospira. It is considered a zoonosis that affects a variety of animals, both wild and domestic (mainly rodents. Humans become infected accidentally by contact with urine or tissues from infected animals. This pathology has variable clinical manifestations, ranging from inapparent infections and aseptic meningitis, to severe forms such as the Weil syndrome. Development: We present the case of a young patient of 22 years old with fever quantified peaks of 40° C, chills, profuse sweating, headache, muscle and joint pain in knees and malleoli, retroorbital and retrosternal pain; and appetite loss. The symptoms occurred after 20 days of having practiced extreme water sports. Conclusion: The late diagnosis of the patient and hospital readmission are the result of several factors; First, the homology with other infectious diseases that present acute febrile illness with similar symptoms as dengue , malaria, influenza , yellow fever , brucellosis; and secondly the lack of expertise and poor contact with patients who present this disease by the medical staff. Correct antibiotic treatment and proper support reduce morbidity and mortality. The objective of this article is to describe a case of human leptospirosis and make a review of the literature in order to analyze the epidemiological characteristics and relevant clinical manifestations.

  9. Sounds Exaggerate Visual Shape

    Science.gov (United States)

    Sweeny, Timothy D.; Guzman-Martinez, Emmanuel; Ortega, Laura; Grabowecky, Marcia; Suzuki, Satoru

    2012-01-01

    While perceiving speech, people see mouth shapes that are systematically associated with sounds. In particular, a vertically stretched mouth produces a /woo/ sound, whereas a horizontally stretched mouth produces a /wee/ sound. We demonstrate that hearing these speech sounds alters how we see aspect ratio, a basic visual feature that contributes…

  10. Sound Zones

    DEFF Research Database (Denmark)

    Møller, Martin Bo; Olsen, Martin

    2017-01-01

    Sound zones, i.e. spatially confined regions of individual audio content, can be created by appropriate filtering of the desired audio signals reproduced by an array of loudspeakers. The challenge of designing filters for sound zones is twofold: First, the filtered responses should generate...... an acoustic separation between the control regions. Secondly, the pre- and post-ringing as well as spectral deterioration introduced by the filters should be minimized. The tradeoff between acoustic separation and filter ringing is the focus of this paper. A weighted L2-norm penalty is introduced in the sound...

  11. Current approach to masked hypertension: From diagnosis to clinical management.

    LENUS (Irish Health Repository)

    Dolan, Eamon

    2013-11-28

    The term masked hypertension phenomenon was first described by the late Professor Thomas Pickering and is commonly defined as having a normal clinic blood pressure (BP) but an elevated "out of office" reading. In the main these elevated readings have been provided through ambulatory blood pressure monitoring (ABPM) but sometimes home BP monitoring is used. It is now largely accepted that ABPM gives a better classification of risk than clinic BP. Thus the elevated ABPM levels should relate to higher cardiovascular risk and it follows that these people might be regarded as being genuinely hypertensive and at higher cardiovascular risk. The problem for clinical practice is how to identify and manage these subjects. The phenomenon should be suspected in subjects who have had an elevated clinic BP at some time, in young subjects with normal or normal-high clinic BP who have early left ventricular hypertrophy, in subjects with a family history of hypertension in both parents, patients with multiple risks for cardiovascular disease and perhaps diabetic patients. It appears to be more prevalent in subjects of male gender, with younger age, higher heart rate, obesity or high cholesterol levels and in smokers. Those with masked hypertension are at higher risk of events such as stroke and have a higher prevalence of target organ damage, for example, nephropathy. In conclusion most of the debate around this topic relates to its reliable identification. Given the higher ambulatory readings there is an increases cardiovascular risk making this diagnosis important. This article is protected by copyright. All rights reserved.

  12. Can road traffic mask sound from wind turbines? Response to wind turbine sound at different levels of road traffic sound

    International Nuclear Information System (INIS)

    Pedersen, Eja; Berg, Frits van den; Bakker, Roel; Bouma, Jelte

    2010-01-01

    Wind turbines are favoured in the switch-over to renewable energy. Suitable sites for further developments could be difficult to find as the sound emitted from the rotor blades calls for a sufficient distance to residents to avoid negative effects. The aim of this study was to explore if road traffic sound could mask wind turbine sound or, in contrast, increases annoyance due to wind turbine noise. Annoyance of road traffic and wind turbine noise was measured in the WINDFARMperception survey in the Netherlands in 2007 (n=725) and related to calculated levels of sound. The presence of road traffic sound did not in general decrease annoyance with wind turbine noise, except when levels of wind turbine sound were moderate (35-40 dB(A) Lden) and road traffic sound level exceeded that level with at least 20 dB(A). Annoyance with both noises was intercorrelated but this correlation was probably due to the influence of individual factors. Furthermore, visibility and attitude towards wind turbines were significantly related to noise annoyance of modern wind turbines. The results can be used for the selection of suitable sites, possibly favouring already noise exposed areas if wind turbine sound levels are sufficiently low.

  13. A Sound Therapy-Based Intervention to Expand the Auditory Dynamic Range for Loudness among Persons with Sensorineural Hearing Losses: A Randomized Placebo-Controlled Clinical Trial

    Science.gov (United States)

    Formby, Craig; Hawley, Monica L.; Sherlock, LaGuinn P.; Gold, Susan; Payne, JoAnne; Brooks, Rebecca; Parton, Jason M.; Juneau, Roger; Desporte, Edward J.; Siegle, Gregory R.

    2015-01-01

    The primary aim of this research was to evaluate the validity, efficacy, and generalization of principles underlying a sound therapy–based treatment for promoting expansion of the auditory dynamic range (DR) for loudness. The basic sound therapy principles, originally devised for treatment of hyperacusis among patients with tinnitus, were evaluated in this study in a target sample of unsuccessfully fit and/or problematic prospective hearing aid users with diminished DRs (owing to their elevated audiometric thresholds and reduced sound tolerance). Secondary aims included: (1) delineation of the treatment contributions from the counseling and sound therapy components to the full-treatment protocol and, in turn, the isolated treatment effects from each of these individual components to intervention success; and (2) characterization of the respective dynamics for full, partial, and control treatments. Thirty-six participants with bilateral sensorineural hearing losses and reduced DRs, which affected their actual or perceived ability to use hearing aids, were enrolled in and completed a placebo-controlled (for sound therapy) randomized clinical trial. The 2 × 2 factorial trial design was implemented with or without various assignments of counseling and sound therapy. Specifically, participants were assigned randomly to one of four treatment groups (nine participants per group), including: (1) group 1—full treatment achieved with scripted counseling plus sound therapy implemented with binaural sound generators; (2) group 2—partial treatment achieved with counseling and placebo sound generators (PSGs); (3) group 3—partial treatment achieved with binaural sound generators alone; and (4) group 4—a neutral control treatment implemented with the PSGs alone. Repeated measurements of categorical loudness judgments served as the primary outcome measure. The full-treatment categorical-loudness judgments for group 1, measured at treatment termination, were

  14. Nursing Diagnosis Risk for falls: prevalence and clinical profile of hospitalized patients.

    Science.gov (United States)

    Luzia, Melissa de Freitas; Victor, Marco Antonio de Goes; Lucena, Amália de Fátima

    2014-01-01

    to identify the prevalence of the Nursing Diagnosis (ND) Risk for falls in the hospitalizations of adult patients in clinical and surgical units, to characterize the clinical profile and to identify the risk factors of the patients with this ND. a cross-sectional study with 174 patients. The data was collected from the computerized nursing care prescriptions system and on-line hospital records, and analyzed statistically. the prevalence of the ND Risk for falls was 4%. The patients' profile indicated older adults, males (57%), those hospitalized in the clinical units (63.2%), with a median length of hospitalization of 20 (10-24) days, with neurological illnesses (26%), cardio-vascular illnesses (74.1%) and various co-morbidities (3±1.8). The prevalent risk factors were neurological alterations (43.1%), impaired mobility (35.6%) and extremes of age (10.3%). the findings contributed to evidencing the profile of the patients with a risk of falling hospitalized in clinical and surgical wards, which favors the planning of interventions for preventing this adverse event.

  15. Trichotillomania: a case report with clinical and dermatoscopic differential diagnosis with alopecia areata.

    Science.gov (United States)

    Pinto, Ana Cecília Versiani Duarte; Andrade, Tatiana Cristina Pedro Cordeiro de; Brito, Fernanda Freitas de; Silva, Gardênia Viana da; Cavalcante, Maria Lopes Lamenha Lins; Martelli, Antonio Carlos Ceribelli

    2017-01-01

    Trichotillomania is a psychodermatologic disorder characterized by uncontrollable urge to pull one's own hair. Differential diagnoses include the most common forms of alopecia such as alopecia areata. It is usually associated with depression and obsessive-compulsive disorder. Trichotillomania treatment standardization is a gap in the medical literature. Recent studies demonstrated the efficacy of N-acetylcysteine (a glutamate modulator) for the treatment of the disease. We report the clinical case of a 12-year-old female patient who received the initial diagnosis of alopecia areata, but presented with clinical and dermoscopic features of trichotillomania. She was treated with the combination of psychotropic drugs and N-acetylcysteine with good clinical response. Due to the chronic and recurring nature of trichotillomania, more studies need to be conducted for the establishment of a formal treatment algorithm.

  16. [Functional neuroimaging in the diagnosis of patients with Parkinsonism: Update and recommendations for clinical use].

    Science.gov (United States)

    Arbizu, J; Luquin, M R; Abella, J; de la Fuente-Fernández, R; Fernandez-Torrón, R; García-Solís, D; Garrastachu, P; Jiménez-Hoyuela, J M; Llaneza, M; Lomeña, F; Lorenzo-Bosquet, C; Martí, M J; Martinez-Castrillo, J C; Mir, P; Mitjavila, M; Ruiz-Martínez, J; Vela, L

    2014-01-01

    Functional Neuroimaging has been traditionally used in research for patients with different Parkinsonian syndromes. However, the emergence of commercial radiotracers together with the availability of single photon emission computed tomography (SPECT) and, more recently, positron emission tomography (PET) have made them available for clinical practice. Particularly, the development of clinical evidence achieved by functional neuroimaging techniques over the past two decades have motivated a progressive inclusion of several biomarkers in the clinical diagnostic criteria for neurodegenerative diseases that occur with Parkinsonism. However, the wide range of radiotracers designed to assess the involvement of different pathways in the neurodegenerative process underlying Parkinsonian syndromes (dopaminergic nigrostriatal pathway integrity, basal ganglia and cortical neuronal activity, myocardial sympathetic innervation), and the different neuroimaging techniques currently available (scintigraphy, SPECT and PET), have generated some controversy concerning the best neuroimaging test that should be indicated for the differential diagnosis of Parkinsonism. In this article, a panel of nuclear medicine and neurology experts has evaluated the functional neuroimaging techniques emphazising practical considerations related to the diagnosis of patients with uncertain origin parkinsonism and the assessment Parkinson's disease progression. Copyright © 2014 Elsevier España, S.L. and SEMNIM. All rights reserved.

  17. Secondary Diabetes Mellitus in Patients with Endogenous Cushing’s Syndrome - Clinical Characteristics at Diagnosis

    OpenAIRE

    Căpăţînă Cristina; Baciu Ionela; Greere Daniela; Caragheorgheopol Andra; Poiană Cătălina

    2018-01-01

    Background and aims. Endogenous Cushing’s syndrome is a rare disease associated with severe morbidity and increased mortality if untreated. Diabetes mellitus is a frequent initial complaint of these patients. Our aim was to investigate the clinical characteristics at the time of diagnosis in a cohort of patients with endogenous Cushing’s syndrome (CS).

  18. The importance of acoustic radiation force impulse (ARFI) elastography in the diagnosis and clinical course of acute pancreatitis.

    Science.gov (United States)

    Kaya, Muhsin; Değirmenci, Serdar; Göya, Cemil; Tuncel, Elif Tuba; Uçmak, Feyzullah; Kaplan, Mehmet Ali

    2018-05-01

    Acute pancreatitis (AP) is characterized by acute inflammation of the pancreas and it has a highly variable clinical course. The aim of our study was to evaluate the value of acoustic radiation force impulse (ARFI) elastography in the diagnosis and clinical course of AP. Consecutive patients with a diagnosis of AP (patients group) and healthy subject (control group) were prospectively enrolled to the study. Demographic features and clinical, laboratory, and radiological data were recorded. Virtual Touch Tissue Quantification (VTQ) was used to implement ARFI elastography. The tissue elasticity is proportional to the square of the wave velocity (SWV). A total of 108 patients (age, 57±1.8 y) and 79 healthy subjects (age, 53.6±1.81 y) were included in the study. There were 100 (92.5%) edematous and 8 (7.4%) necrotizing AP. The mean SWV was significantly higher in the patient group than in the control group (2.43±0.08 vs. 1.27±0.025 m/s, p < 0.001). There was not significant difference between patient and control group regarding age and gender. SWV cutoff value of 1.63 m/s was associated with 100% sensitivity and 98% specificity for the diagnosis of AP. There was not significant difference between patients with and without complications and patients with edematous and necrotizing AP regarding mean SWV value. There was also not significant correlation between mean SWV value and age, mean length of hospital stay, and mean amylase level. ARFI elastography may be a feasible method for the diagnosis of AP, but it has no value for the prediction of clinical course of AP.

  19. Structure-borne sound structural vibrations and sound radiation at audio frequencies

    CERN Document Server

    Cremer, L; Petersson, Björn AT

    2005-01-01

    Structure-Borne Sound"" is a thorough introduction to structural vibrations with emphasis on audio frequencies and the associated radiation of sound. The book presents in-depth discussions of fundamental principles and basic problems, in order to enable the reader to understand and solve his own problems. It includes chapters dealing with measurement and generation of vibrations and sound, various types of structural wave motion, structural damping and its effects, impedances and vibration responses of the important types of structures, as well as with attenuation of vibrations, and sound radi

  20. Comparison of parameters of 123I-metaiodobenzylguanidine scintigraphy for differential diagnosis in patients with parkinsonism. Correlation with clinical features

    International Nuclear Information System (INIS)

    Uchiyama, Yumiko; Momose, Mitsuru; Kondo, Chisato; Kusakabe, Kiyoko; Uchiyama, Shinichiro

    2011-01-01

    The purpose of this study was to estimate the diagnostic accuracy of 123 I-metaiodobenzylguanidine (MIBG) scintigraphy to diagnose Lewy body disease (LBD), including Parkinson's disease (PD) and dementia with Lewy bodies, and to clarify the relationship between MIBG parameters and the clinical findings. One hundred-and-forty-four patients with parkinsonism without diabetes mellitus or a history of cardiac disease were retrospectively selected in the study. Clinical diagnosis was confirmed by follow-up during more than 6 months by neurologists. All patients underwent MIBG imaging at 15 min (initial) and 4 h (delayed) after the tracer injection, and clinical features such as Hoehn and Yahr (H-Y) classification or symptoms specific to parkinsonism were also investigated. The heart to mediastinum ratio (H/M) and the washout ratio (WR) of MIBG were calculated, and correlation with the clinical features was analyzed. Ninety-seven and 47 patients were diagnosed as LBD and Parkinson's syndrome (PS), respectively. Initial and delayed H/M were significantly lower and WR was significantly higher in LBD than in PS (p<0.0001). The initial H/M was independently correlated with tremor (F value 10.45), hesitation (F=4.49), and hallucinations (F=5.09) (p<0.0001). The sensitivity and specificity for the diagnosis of LBD were 64.9 and 87.2% with initial H/M, 78.4 and 68.1% with delayed H/M, and 80.4 and 61.7% with WR, respectively. Using multivariate analysis, initial H/M (F=39.33) and tremor (F=10.46) were independently correlated to the diagnosis of LBD (r=0.562, p<0.0001) among the MIBG and various clinical parameters. The initial H/M was the most useful of the 3 different parameters of MIBG for the diagnosis of LBD, but had low sensitivity. WR and delayed H/M had no incremental value to initial H/M for the diagnosis of PD. Careful long-term follow-up is needed for patients with parkinsonism who are clinically diagnosed as LBD with normal initial H/M, or diagnosed as no LBD with

  1. Impact of the clinical context on the 14-3-3 test for the diagnosis of sporadic CJD

    Directory of Open Access Journals (Sweden)

    Sierra-Moros Maríajosé

    2006-07-01

    Full Text Available Abstract Background The 14-3-3 test appears to be a valuable aid for the clinical diagnosis of sporadic Creutzfeldt-Jakob disease (sCJD in selected populations. However, its usefulness in routine practice has been challenged. In this study, the influence of the clinical context on the performance of the 14-3-3 test for the diagnosis of sCJD is investigated through the analysis of a large prospective clinical series. Methods Six hundred seventy-two Spanish patients with clinically suspected sCJD were analyzed. Clinical classification at sample reception according to the World Health Organization's (WHO criteria (excluding the 14-3-3 test result was used to explore the influence of the clinical context on the pre-test probabilities, and positive (PPV and negative (NPV predictive values of the 14-3-3 test. Results Predictive values of the test varied greatly according to the initial clinical classification: PPV of 98.8%, 96.5% and 45.0%, and NPV of 26.1%, 66.6% and 100% for probable sCJDi (n = 115, possible sCJDi (n = 73 and non-sCJDi (n = 484 cases, respectively. According to multivariate and Bayesian analyses, these values represent an improvement of diagnostic certainty compared to clinical data alone. Conclusion In three different contexts of sCJD suspicion, the 14-3-3 assay provides useful information complementary to clinical and electroencephalographic (EEG data. The test is most useful supporting a clinical impression, whilst it may show deceptive when it is not in agreement with clinical data.

  2. Precision diagnosis: a view of the clinical decision support systems (CDSS) landscape through the lens of critical care.

    Science.gov (United States)

    Belard, Arnaud; Buchman, Timothy; Forsberg, Jonathan; Potter, Benjamin K; Dente, Christopher J; Kirk, Allan; Elster, Eric

    2017-04-01

    Improving diagnosis and treatment depends on clinical monitoring and computing. Clinical decision support systems (CDSS) have been in existence for over 50 years. While the literature points to positive impacts on quality and patient safety, outcomes, and the avoidance of medical errors, technical and regulatory challenges continue to retard their rate of integration into clinical care processes and thus delay the refinement of diagnoses towards personalized care. We conducted a systematic review of pertinent articles in the MEDLINE, US Department of Health and Human Services, Agency for Health Research and Quality, and US Food and Drug Administration databases, using a Boolean approach to combine terms germane to the discussion (clinical decision support, tools, systems, critical care, trauma, outcome, cost savings, NSQIP, APACHE, SOFA, ICU, and diagnostics). References were selected on the basis of both temporal and thematic relevance, and subsequently aggregated around four distinct themes: the uses of CDSS in the critical and surgical care settings, clinical insertion challenges, utilization leading to cost-savings, and regulatory concerns. Precision diagnosis is the accurate and timely explanation of each patient's health problem and further requires communication of that explanation to patients and surrogate decision-makers. Both accuracy and timeliness are essential to critical care, yet computed decision support systems (CDSS) are scarce. The limitation arises from the technical complexity associated with integrating and filtering large data sets from diverse sources. Provider mistrust and resistance coupled with the absence of clear guidance from regulatory bodies further retard acceptance of CDSS. While challenges to develop and deploy CDSS are substantial, the clinical, quality, and economic impacts warrant the effort, especially in disciplines requiring complex decision-making, such as critical and surgical care. Improving diagnosis in health care

  3. InfoSound

    DEFF Research Database (Denmark)

    Sonnenwald, Diane H.; Gopinath, B.; Haberman, Gary O.

    1990-01-01

    The authors explore ways to enhance users' comprehension of complex applications using music and sound effects to present application-program events that are difficult to detect visually. A prototype system, Infosound, allows developers to create and store musical sequences and sound effects with...

  4. The Sound of Science

    Science.gov (United States)

    Merwade, Venkatesh; Eichinger, David; Harriger, Bradley; Doherty, Erin; Habben, Ryan

    2014-01-01

    While the science of sound can be taught by explaining the concept of sound waves and vibrations, the authors of this article focused their efforts on creating a more engaging way to teach the science of sound--through engineering design. In this article they share the experience of teaching sound to third graders through an engineering challenge…

  5. Attitudes of palliative care clinical staff toward prolonged grief disorder diagnosis and grief interventions.

    Science.gov (United States)

    Davis, Esther L; Deane, Frank P; Barclay, Gregory D; Bourne, Joan; Connolly, Vivienne

    2017-07-03

    The provision of psychological support to caregivers is an important part of the role of the clinical staff working in palliative care. Staff knowledge and attitudes may determine their openness to referring caregivers to a psychological intervention. We recently developed a self-help intervention for grief and psychological distress among caregivers and were interested in exploring the extent to which staff knowledge and attitudes might affect future implementation. The aims of our study were to: (1) examine the acceptability of self-help psychological intervention for caregivers among palliative care clinical staff; (2) examine potential attitudinal barriers toward prolonged grief disorder (PGD) as a diagnosis and interventions for grief; and (3) bolster staff confidence in skills and knowledge in identifying and managing caregiver psychological distress. An anonymous survey was distributed among clinical staff at two inpatient units and two community health services that assessed the acceptability of self-help interventions for caregivers, attitudes about PGD diagnosis and grief intervention, and staff confidence in skills and knowledge in assessing caregiver psychological distress. Overall, clinical staff were positively oriented toward self-help for caregivers and intervention for grief. They were also basically confident in their skills and knowledge. While it was positive PGD attitudes that were associated with acceptability of self-help for caregivers, it was both positive and negative PGD attitudes that were associated more specifically with a willingness to refer caregivers to such an intervention. Our findings are useful in highlighting the issues to be considered in the implementation of a self-help intervention within the healthcare service. Clinical staff seemed positively oriented toward engaging with a psychological intervention for caregivers and likely to act as key allies in implementation.

  6. Clinical and radiographic assessment of approximal carious lesions

    International Nuclear Information System (INIS)

    Espelid, I.; Tveit, A.B.

    1986-01-01

    The aim of the study was to compare the radiographic diagnosis of approximal carious lesions with visual observations of the approximal surfaces and within drilled Class II cavities (made into the pulp). Sound (n=28) and carious (n=123) approximal surfaces of extracted premolars and molars were radiographed. The radiographs were studied by seven observers to diagnose caries. Lesions without cavitation were most often classified as sound (61.3%). When lesions had cavities, the rate of detection increased to 89.1%. Sound surfaces were erroneously classified as carious in 15.7% of cases. Statistically, about 6 our of every 10 qualitative assessments of lesion depth on the basis of radiographs, correctly recorded lesions as being in enamel or extending into dentin. The interexaminer variation in radiographic caries diagnosis were mostly due to difference in diagnostic criteria, whereas differences in diagnostic capability were less important

  7. [Clinical application evaluation of Guidelines for Diagnosis and Treatment of Common Diseases of Otolaryngology in Traditional Chinese Medicine].

    Science.gov (United States)

    Liu, Yu-Qi; Liu, Meng-Yu; Li, Chun; Shi, Nan-Nan; Wang, Yue-Xi; Wang, Li-Ying; Zhao, Xue-Yao; Kou, Shuang; Han, Xue-Jie; Wang, Yan-Ping

    2017-09-01

    This study is to assess the Guidelines for Diagnosis and Treatment of Common Diseases of Otolaryngology in Traditional Chinese Medicine in clinical application and provide evidence for further guideline revision. The assessment was divided into applicability assessment and practicability assessment. The applicability assessment based on questionnaire survey and the traditional Chinese medicine (TCM) practitioners were asked to independently fill the Questionnaire for Applicability Assessment on the Guidelines for Diagnosis and Treatment in Traditional Chinese Medicine. The practicability assessment was based on prospective case investigation and analysis method and the TCM practitioners-in-charge filled the Case Investigation Questionnaire for Practicability Assessment on the Guidelines for Diagnosis and Treatment in Traditional Chinese Medicine. The data were analyzed in descriptive statistics. 151 questionnaires were investigated for applicability assessment and 1 016 patients were included for practicability assessment. The results showed that 88.74% of them were familiar with the guidelines and 45.70% used them. The guidelines quality and related items were similar in applicability assessment and practicability assessment, and scored highly as more than 85.00% except the "recuperating and prevention". The results suggested that the quality of Guidelines for Diagnosis and Treatment of Common Diseases of Otolaryngology in Traditional Chinese Medicine was high and could better guide the clinical practice. The "recuperating and prevention" part should be improved and the evidence data should be included in future guideline revision, so that the clinical utilization rate could be increased. Copyright© by the Chinese Pharmaceutical Association.

  8. Celiac disease in Saudi children. Evaluation of clinical features and diagnosis.

    Science.gov (United States)

    Saeed, Anjum; Assiri, Asaad; Assiri, Hebah; Ullah, Anhar; Rashid, Mohsin

    2017-09-01

     Objectives: To characterize the clinical presentations and diagnosis including serological tests and histopathological findings in children with celiac disease. Methods: All children (less than 18 years) with confirmed celiac disease diagnosed over a 6 year period at a private tertiary care health care center in Riyadh,  Saudi Arabia were studied retrospectively. Information collected included demographics, clinical presentation and diagnostic modalities with serology and small intestinal histology reported by Marsh grading. Results: A total of 59 children had confirmed celiac disease. Thirty (50.8%) were male. Median age was 8 years (range 1 to 16 years). The mean duration of symptoms before diagnosis was 2.3 (±1.5) years. Classical disease was present only in 30.5%, whereas 69.5% had either non-classical presentations or belonged to high risk groups for celiac disease such as those with type-1 diabetes, autoimmune thyroiditis, Down syndrome and siblings. Failure to thrive was the most common presentation followed by short stature, abdominal pain and chronic diarrhea. Anti-tissue transglutaminase antibody was positive in 91.5%, and titers were no different between those with classical and non-classical disease. All had Marsh-graded biopsy findings consistent with celiac disease. Conclusion: Children with celiac disease usually present with non-classical features. A high index of suspicion needs to be maintained to consider this disorder in the diagnostic workup of pediatric patients. High risk group should be screened early to avoid complications associated with untreated celiac disease.

  9. Correlation between sonographic diagnosis and histopathological results ofgallbladder poliposis in Good Hope Clinic 2008-2014

    Directory of Open Access Journals (Sweden)

    Emiliano Contreras Castro

    2016-02-01

    Full Text Available Objective: To determine the correlation between sonographic diagnosis and histopathological results of gallbladder polyposis and find the positive predictive value of ultrasound in the diagnosis of this pathology. Material and Methods: It is a non experimental, transversal, descriptive and correlational study with a sample composed of all patients operated with a diagnosis of gallbladder polyps in the Good Hope Clinic between the years 2008 and 2014. A total of 128 patients were observed. Histopathological and sonographic reports of these patients were reviewed and the statistical correlation of both studies was sought by the test of Spearman. Results: Reveals that 67,2% were females and 32,8% were males; the average age was 43,4 years; 74,2% presented polyps by histopathological examination, of which 94,7% were pseudopolyps, with 82 % cases of cholesterolpolyps, only 5,3% were true polyps (adenomas and none of them were malignant. The positive predictive value of ultrasound in the diagnosis of gallbladder polyposis was 74,21%. According to the Spearman coefficient the correlation between the number of polyps by ultrasonography and histopathology was low, direct and significant (Rho = 0,189; p = 0,032. Conclusions: We conclude that there is a correlation between the ultrasound diagnosis and histopathological result of gallbladder polyps and ultrasound can be considered a reliable method for the diagnosis of gallbladder polyps.

  10. Narcolepsy: etiology, clinical features, diagnosis and treatment

    Directory of Open Access Journals (Sweden)

    Jolanta B. Zawilska

    2012-10-01

    Full Text Available [u][/u] Narcolepsy is a chronic hypersomnia characterized by excessive daytime sleepiness (EDS and manifestations of disrupted rapid eye movement sleep stage (cataplexy, sleep paralysis, and hypnagogic/hypnopompic hallucinations. Mechanisms underlying narcolepsy are not fully understood. Experimental data indicate that the disease is caused by a loss of hypocretin neurons in the hypothalamus, likely due to an autoimmune process triggered by environmental factors in susceptible individuals. Most patients with narcolepsy and cataplexy have very low hypocretin-1 levels in the cerebrospinal fluid. An appropriate clinical history, polysomnogram, and multiple sleep latency test are necessary for diagnosis of the disease. Additionally, two biological markers, i.e., cerebrospinal fluid hypocretin-1 levels and expression of the DQB1*0602 gene, are used. The treatment of narcolepsy is aimed at the different symptoms that the patient manifests. Excessive daytime sleepiness is treated with psychostimulants (amphetamine-like, modafinil and armodafinil. Cataplexy is treated with sodium oxybate (GHB, tricyclic antidepressants, or selective serotonin and noradrenaline reuptake inhibitors. Sleep paralysis, hallucinations, and fragmented sleep may be treated with sodium oxybate. Patients with narcolepsy should follow proper sleep hygiene and avoid strong emotions.

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

    Science.gov (United States)

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

    2008-04-01

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

  12. Clinical Analysis about Diagnosis and Treatment of 86 Hand Paresthesia Cases Using MPS Theory and Pharmacopuncture Therapy

    Directory of Open Access Journals (Sweden)

    Sung-Won Oh

    2007-12-01

    Full Text Available Objectives : Hand paresthesia is common syndrome and the cause is more unknown than known reason. The Purpose of this study were investigated the effects of Myofacial Pain Syndrome theory to make diagnosis and treatment by Pharmacopuncture for the patients of hand paresthesia. Method : This study was carried out to established the clinical criteria of hand parethesia. The patients who had past history of diabeics, neuropathy induced by alcohol or drug were excluded, and 86 patients who had hand paresthesia related with unknown-reason was selected by the interview process. And the effects of Pharmacopuncture theory were analyzed using VAS score before and after treatment. Results and conclusions : 56.9% of unknown-reason patients are positive at diagnosis by MPS theory. While positive group decrease from 62.81±14.27 to 25.28±15.97, negative group decrease from 55.88±10.92 to 48.28±14.01 by VAS scores. Positive group was accordingly more effective than negative group. So diagnosis and treatment for hand numbness patients by MPS theory was useful in clinical.

  13. The effect of methacholine-induced acute airway narrowing on lung sounds in normal and asthmatic subjects

    NARCIS (Netherlands)

    Schreur, H. J.; Vanderschoot, J.; Zwinderman, A. H.; Dijkman, J. H.; Sterk, P. J.

    1995-01-01

    The association between lung sound alterations and airways obstruction has long been recognized in clinical practice, but the precise pathophysiological mechanisms of this relationship have not been determined. Therefore, we examined the changes in lung sounds at well-defined levels of

  14. Clinical practice guidelines for the diagnosis and management of acute otitis media (AOM) in children in Japan - 2013 update.

    Science.gov (United States)

    Kitamura, Ken; Iino, Yukiko; Kamide, Yosuke; Kudo, Fumiyo; Nakayama, Takeo; Suzuki, Kenji; Taiji, Hidenobu; Takahashi, Haruo; Yamanaka, Noboru; Uno, Yoshifumi

    2015-04-01

    To (1) indicate methods of diagnosis and testing for childhood (otitis media (AOM) and (2) recommend methods of treatment in accordance with the evidence-based consensus reached by the Subcommittee of Clinical Practice Guideline for Diagnosis and Management of AOM in Children (Subcommittee of Clinical Practice Guideline), in light of the causative bacteria and their drug sensitivity of AOM in Japan. We investigated the most recently detected bacteria causing childhood AOM in Japan as well as antibacterial sensitivity and the worldwide distinct progress of vaccination, produced Clinical Questions concerning the diagnosis, testing methods, and treatment of AOM, searched literature published during 2000-2004, and issued the 2006 Guidelines. In the 2009 and 2013 Guidelines, we performed the same investigation with the addition of literature, which were not included in the 2006 Guidelines and published during 2005-2008 and during 2009-2012, respectively. We categorized AOM as mild, moderate, or severe on the basis of tympanic membrane findings and clinical symptoms, and presented recommended treatment for each degree of severity. Accurate assessment of tympanic membrane findings is important for judging the degree of severity and selecting a method of treatment. Some of new antimicrobial agents and pneumococcal vaccination are recommended as new treatment options. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  15. Light and Sound

    CERN Document Server

    Karam, P Andrew

    2010-01-01

    Our world is largely defined by what we see and hear-but our uses for light and sound go far beyond simply seeing a photo or hearing a song. A concentrated beam of light, lasers are powerful tools used in industry, research, and medicine, as well as in everyday electronics like DVD and CD players. Ultrasound, sound emitted at a high frequency, helps create images of a developing baby, cleans teeth, and much more. Light and Sound teaches how light and sound work, how they are used in our day-to-day lives, and how they can be used to learn about the universe at large.

  16. Atopic Dermatitis in Children: Current Clinical Guidelines for Diagnosis and Therapy

    Directory of Open Access Journals (Sweden)

    Leyla S. Namazova-Baranova

    2016-01-01

    Full Text Available Atopic dermatitis is a chronic multifactorial skin disease that is common enough in childhood. The article presents the current data on epidemiology and dynamics of incidence of pathological symptoms, pathogenesis basics, and key factors of the disease development, shows the current classification of the disease. The authors consider in detail the key principles of the diagnosis and peculiarities of a clinical aspect depending on age. Algorithms of a therapeutic approach, as well as basics of an individual hypoallergenic diet are proposed. General recommendations and possible prognosis for pediatric patients with atopic dermatitis are given.

  17. The Textile Form of Sound

    DEFF Research Database (Denmark)

    Bendixen, Cecilie

    Sound is a part of architecture, and sound is complex. Upon this, sound is invisible. How is it then possible to design visual objects that interact with the sound? This paper addresses the problem of how to get access to the complexity of sound and how to make textile material revealing the form...... goemetry by analysing the sound pattern at a specific spot. This analysis is done theoretically with algorithmic systems and practical with waves in water. The paper describes the experiments and the findings, and explains how an analysis of sound can be catched in a textile form....

  18. Multiple sclerosis presented as clinically isolated syndrome: the need for early diagnosis and treatment

    Directory of Open Access Journals (Sweden)

    Sigliti-Henrietta Pelidou

    2008-06-01

    Full Text Available Sigliti-Henrietta Pelidou, Sotirios Giannopoulos, Sotiria Tzavidi, Georgios Lagos, Athanassios P KyritsisDepartment of Neurology, University of Ioannina School of Medicine, GreeceObjective: To aid in the timely diagnosis of patients who present with clinically isolated syndrome (CIS.Patients and methods: We studied 25 patients (18 women, 7 men, originally presented in our clinic with a CIS suggestive of multiple sclerosis (MS. All patients underwent the full investigation procedure including routine tests, serology, cerebrospinal fluid (CSF examinations, evoked potentials (EPs, and magnetic resonance imaging (MRI of brain and cervical spinal cord. Patients were imaged at baseline, and every three months thereafter up to a year.Results: The CIS was consisted of optic neuritis in 12 cases, incomplete transverse myelitis (ITM in 7 cases, Lhermitte sign in 2 cases, internuclear ophthalmoplegia (INO in 2 cases, mild brainstem syndrome in 1 case, and tonic-clonic seizures in 1 case. Using the baseline and three-month scans 18/25 (72% patients developed definite MS in one year of follow up while 7 (28% had no further findings during this observation period. Immunomodulatory treatments were applied to all definite MS patients.Conclusion: In light of new treatments available, MRIs at 3 month intervals are helpful to obtain the definite diagnosis of MS as early as possible.Keywords: multiple sclerosis, clinically isolated syndrome, optic neuritis, transverse myelitis

  19. Reduction of heart sound interference from lung sound signals using empirical mode decomposition technique.

    Science.gov (United States)

    Mondal, Ashok; Bhattacharya, P S; Saha, Goutam

    2011-01-01

    During the recording time of lung sound (LS) signals from the chest wall of a subject, there is always heart sound (HS) signal interfering with it. This obscures the features of lung sound signals and creates confusion on pathological states, if any, of the lungs. A novel method based on empirical mode decomposition (EMD) technique is proposed in this paper for reducing the undesired heart sound interference from the desired lung sound signals. In this, the mixed signal is split into several components. Some of these components contain larger proportions of interfering signals like heart sound, environmental noise etc. and are filtered out. Experiments have been conducted on simulated and real-time recorded mixed signals of heart sound and lung sound. The proposed method is found to be superior in terms of time domain, frequency domain, and time-frequency domain representations and also in listening test performed by pulmonologist.

  20. Strategies and challenges for communicating the diagnosis of cancer in cross-cultural clinical settings-Perspectives from South African healthcare professionals.

    Science.gov (United States)

    Brown, Ottilia; Goliath, Veonna; van Rooyen, Dalena R M; Aldous, Colleen; Marais, Leonard Charles

    2017-01-01

    Communicating the diagnosis of cancer in cross-cultural clinical settings is a complex task. This qualitative research article describes the content and process of informing Zulu patients in South Africa of the diagnosis of cancer, using osteosarcoma as the index diagnosis. We used a descriptive research design with census sampling and focus group interviews. We used an iterative thematic data analysis process and Guba's model of trustworthiness to ensure scientific rigor. Our results reinforced the use of well-accepted strategies for communicating the diagnosis of cancer. In addition, new strategies emerged which may be useful in other cross-cultural settings. These strategies included using the stages of cancer to explain the disease and its progression and instilling hope using a multidisciplinary team care model. We identified several patients, professionals, and organizational factors that complicate cross-cultural communication. We conclude by recommending the development of protocols for communication in these cross-cultural clinical settings.

  1. Diagnosis, clinical staging, and treatment of breast cancer: a retrospective multiyear study of a large controlled population.

    Science.gov (United States)

    Legorreta, Antonio P; Chernicoff, Helen O; Trinh, Jennifer B; Parker, Robert G

    2004-04-01

    This study compares diagnosis, staging, and treatment of newly diagnosed breast cancer cases over a several-year period. The study design was a retrospective, multiyear comparison between new breast cancer cases diagnosed in 1995 (n = 827) and 1997 (n = 815). Cases were identified through claims data, and medical record abstraction was used to verify each case and to identify clinical staging and type of treatment. All medical records were reviewed by one physician to maximize internal reliability. Both cohorts were predominantly 40 and older, white, married, and postmenopausal. The latter cohort (1997) had a higher proportion of women aged 70 to 79 and a lower proportion of women aged 40 to 49. In both cohorts, women age 40 and older were likely to be diagnosed with breast cancer at the time of mammographic screening, while women younger than 40 were more likely to be diagnosed by clinical breast examination. In logistic regression analyses, controlling for confounding factors such as age, undergoing mammographic screening increased the likelihood of having a low cancer stage at diagnosis by more than three and a half times. Mammographic screening was statistically significantly positively associated with having eligibility for breast-conserving treatment (BCT); however, although an increase in BCT eligibility was observed, actual use of BCT did not change. Mammography leads to a lower clinical stage as well as a greater likelihood of BCT eligibility at time of breast cancer diagnosis, but may not have a substantial effect on treatment choice (lumpectomy vs. mastectomy). Between 1995 and 1997, a trend was observed toward downstaging of disease at diagnosis; further research is warranted to observe whether this trend continues over time.

  2. Reach on sound: a key to object permanence in visually impaired children.

    Science.gov (United States)

    Fazzi, Elisa; Signorini, Sabrina Giovanna; Bomba, Monica; Luparia, Antonella; Lanners, Josée; Balottin, Umberto

    2011-04-01

    The capacity to reach an object presented through sound clue indicates, in the blind child, the acquisition of object permanence and gives information over his/her cognitive development. To assess cognitive development in congenitally blind children with or without multiple disabilities. Cohort study. Thirty-seven congenitally blind subjects (17 with associated multiple disabilities, 20 mainly blind) were enrolled. We used Bigelow's protocol to evaluate "reach on sound" capacity over time (at 6, 12, 18, 24, and 36 months), and a battery of clinical, neurophysiological and cognitive instruments to assess clinical features. Tasks n.1 to 5 were acquired by most of the mainly blind children by 12 months of age. Task 6 coincided with a drop in performance, and the acquisition of the subsequent tasks showed a less agehomogeneous pattern. In blind children with multiple disabilities, task acquisition rates were lower, with the curves dipping in relation to the more complex tasks. The mainly blind subjects managed to overcome Fraiberg's "conceptual problem"--i.e., they acquired the ability to attribute an external object with identity and substance even when it manifested its presence through sound only--and thus developed the ability to reach an object presented through sound. Instead, most of the blind children with multiple disabilities presented poor performances on the "reach on sound" protocol and were unable, before 36 months of age, to develop the strategies needed to resolve Fraiberg's "conceptual problem". Copyright © 2011 Elsevier Ltd. All rights reserved.

  3. Sound generator

    NARCIS (Netherlands)

    Berkhoff, Arthur P.

    2008-01-01

    A sound generator, particularly a loudspeaker, configured to emit sound, comprising a rigid element (2) enclosing a plurality of air compartments (3), wherein the rigid element (2) has a back side (B) comprising apertures (4), and a front side (F) that is closed, wherein the generator is provided

  4. Sound generator

    NARCIS (Netherlands)

    Berkhoff, Arthur P.

    2010-01-01

    A sound generator, particularly a loudspeaker, configured to emit sound, comprising a rigid element (2) enclosing a plurality of air compartments (3), wherein the rigid element (2) has a back side (B) comprising apertures (4), and a front side (F) that is closed, wherein the generator is provided

  5. Sound generator

    NARCIS (Netherlands)

    Berkhoff, Arthur P.

    2007-01-01

    A sound generator, particularly a loudspeaker, configured to emit sound, comprising a rigid element (2) enclosing a plurality of air compartments (3), wherein the rigid element (2) has a back side (B) comprising apertures (4), and a front side (F) that is closed, wherein the generator is provided

  6. NASA Space Sounds API

    Data.gov (United States)

    National Aeronautics and Space Administration — NASA has released a series of space sounds via sound cloud. We have abstracted away some of the hassle in accessing these sounds, so that developers can play with...

  7. Systematic unenhanced CT for acute abdominal symptoms in the elderly patients improves both emergency department diagnosis and prompt clinical management

    International Nuclear Information System (INIS)

    Millet, Ingrid; Pages-Bouic, Emma; Curros-Doyon, Fernanda; Taourel, Patrice; Sebbane, Mustapha; Molinari, Nicolas; Riou, Bruno

    2017-01-01

    To assess the added-value of systematic unenhanced abdominal computed tomography (CT) on emergency department (ED) diagnosis and management accuracy compared to current practice, in elderly patients with non-traumatic acute abdominal symptoms. Institutional review board approval and informed consent were obtained. This prospective study included 401 consecutive patients 75 years of age or older, admitted to the ED with acute abdominal symptoms, and investigated by early systematic unenhanced abdominal CT scan. ED diagnosis and intended management before CT, after unenhanced CT, and after contrast CT if requested, were recorded. Diagnosis and management accuracies were evaluated and compared before CT (clinical strategy) and for two conditional strategies (current practice and systematic unenhanced CT). An expert clinical panel assigned a final diagnosis and management after a 3-month follow-up. Systematic unenhanced CT significantly improved the accurate diagnosis (76.8% to 85%, p=1.1 x 10 -6 ) and management (88.5% to 95.8%, p=2.6 x 10 -6 ) rates compared to current practice. It allowed diagnosing 30.3% of acute unsuspected pathologies, 3.4% of which were unexpected surgical procedure requirement. Systematic unenhanced abdominal CT improves ED diagnosis accuracy and appropriate management in elderly patients presenting with acute abdominal symptoms compared to current practice. (orig.)

  8. Systematic unenhanced CT for acute abdominal symptoms in the elderly patients improves both emergency department diagnosis and prompt clinical management

    Energy Technology Data Exchange (ETDEWEB)

    Millet, Ingrid; Pages-Bouic, Emma; Curros-Doyon, Fernanda; Taourel, Patrice [CHU Lapeyronie, Department of Medical Imaging, Montpellier Cedex 5 (France); Sebbane, Mustapha [Department of Emergency Medicine, CHU Lapeyronie, Montpellier (France); Molinari, Nicolas [Department of Medical Information and Statistics, CHU Montpellier (France); Riou, Bruno [GH Pitie-Salpetriere, APHP, Department of Emergency Medicine and Surgery, Paris (France)

    2017-02-15

    To assess the added-value of systematic unenhanced abdominal computed tomography (CT) on emergency department (ED) diagnosis and management accuracy compared to current practice, in elderly patients with non-traumatic acute abdominal symptoms. Institutional review board approval and informed consent were obtained. This prospective study included 401 consecutive patients 75 years of age or older, admitted to the ED with acute abdominal symptoms, and investigated by early systematic unenhanced abdominal CT scan. ED diagnosis and intended management before CT, after unenhanced CT, and after contrast CT if requested, were recorded. Diagnosis and management accuracies were evaluated and compared before CT (clinical strategy) and for two conditional strategies (current practice and systematic unenhanced CT). An expert clinical panel assigned a final diagnosis and management after a 3-month follow-up. Systematic unenhanced CT significantly improved the accurate diagnosis (76.8% to 85%, p=1.1 x 10{sup -6}) and management (88.5% to 95.8%, p=2.6 x 10{sup -6}) rates compared to current practice. It allowed diagnosing 30.3% of acute unsuspected pathologies, 3.4% of which were unexpected surgical procedure requirement. Systematic unenhanced abdominal CT improves ED diagnosis accuracy and appropriate management in elderly patients presenting with acute abdominal symptoms compared to current practice. (orig.)

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

    Science.gov (United States)

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

    2016-08-01

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

  10. Clinical Diagnosis of Dental Caries in the 21st Century: Introductory Paper - ORCA Saturday Afternoon Symposium, 2016.

    Science.gov (United States)

    Machiulskiene, Vita; Carvalho, Joana Christina

    2018-03-05

    Classifications employed to measure dental caries should first of all reflect the dynamics of the disease, in order to provide a solid basis for subsequent treatment decisions and for further monitoring of dental health of individual patients and populations. The contemporary philosophy of dental caries management implies that nonoperative treatment of caries lesions should be implemented whenever possible, limiting operative interventions to the severe and irreversible cases. The ORCA Saturday Afternoon Symposium 2016, held back-to-back to the 63rd ORCA Congress in Athens, Greece, was intended to provide an update on general requirements for clinical caries diagnosis and to overview caries diagnostic classifications including their rationale, validation, advantages, and limitations. Clinical caries diagnostic criteria and caries management outcomes are interrelated, and any diagnostic classification disregarding this concept is outdated, according to the current understanding of oral health care. Choosing clinical caries diagnostic classifications that assess the activity status of detected lesions should be a priority for dental professionals since these classifications favor the best clinical practice directed towards nonoperative interventions. The choice of clinical caries diagnostic classifications in research, in clinical practice, and in public health services should be guided by the best available scientific evidence. The clinical caries diagnostic classifications should be universally applicable in all these fields. Policy making in oral health care and the underlying policy analyses should follow the same standards. Any clinical caries diagnostic classification disregarding the universality of its use is of limited or no interest in the context of the clinical caries diagnosis of today. © 2018 S. Karger AG, Basel.

  11. Improving auscultatory proficiency using computer simulated heart sounds

    Directory of Open Access Journals (Sweden)

    Hanan Salah EL-Deen Mohamed EL-Halawany

    2016-09-01

    Full Text Available This study aimed to examine the effects of 'Heart Sounds', a web-based program on improving fifth-year medical students' auscultation skill in a medical school in Egypt. This program was designed for medical students to master cardiac auscultation skills in addition to their usual clinical medical courses. Pre- and post-tests were performed to assess students' auscultation skill improvement. Upon completing the training, students were required to complete a questionnaire to reflect on the learning experience they developed through 'Heart Sounds' program. Results from pre- and post-tests revealed a significant improvement in students' auscultation skills. In examining male and female students' pre- and post-test results, we found that both of male and female students had achieved a remarkable improvement in their auscultation skills. On the other hand, students stated clearly that the learning experience they had with 'Heart Sounds' program was different than any other traditional ways of teaching. They stressed that the program had significantly improved their auscultation skills and enhanced their self-confidence in their ability to practice those skills. It is also recommended that 'Heart Sounds' program learning experience should be extended by assessing students' practical improvement in real life situations.

  12. Improvement of a Clinical Score for Necrotizing Fasciitis: 'Pain Out of Proportion' and High CRP Levels Aid the Diagnosis.

    Science.gov (United States)

    Borschitz, Thomas; Schlicht, Svenja; Siegel, Ekkehard; Hanke, Eric; von Stebut, Esther

    2015-01-01

    Necrotizing fasciitis (NF) is a rare mono-/polymicrobial skin infection that spreads to underlying tissues. NF is quickly progressing and leads to life threatening situations. Immediate surgical debridement together with i.v. antibiotic administration is required to avoid fatal outcome. Early diagnosis is often delayed due to underestimation or confusion with cellulitis. We now compared the initial clinical and laboratory presentation of NF and cellulitis in detail to assess if a typical pattern can be identified that aids timely diagnosis of NF and avoidance of fatal outcome. 138 different clinical and laboratory features of 29 NF patients were compared to those of 59 age- and gender matched patients with severe erysipelas requiring a subsequent hospitalization time of ≥10 days. Differences in clinical presentation were not obvious; however, NF patients suffered significantly more often from strong pain. NF patients exhibited dramatically elevated CRP levels (5-fold, p>0.001). The overall laboratory risk indicator for necrotizing fasciitis (LRINEC) score was significantly higher in NF patients as compared to cellulitis. However, a modification of the score (alteration of laboratory parameters, addition of clinical parameters) led to a clear improvement of the score with a higher positive predictive value without losing specificity. In summary, clinical differentiation of NF from cellulitis appears to be hard. 'Pain out of proportion' may be an early sign for NF. An improvement of the LRINEC score emphasizing only relevant laboratory and clinical findings as suggested may aid the early diagnosis of NF in the future leading to improvement of disease outcome by enabling rapid adequate therapy.

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

    International Nuclear Information System (INIS)

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

    2016-01-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2016-03-15

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

  15. Neurophysiological criteria in the diagnosis of different clinical types of Guillain-Barre syndrome.

    Science.gov (United States)

    Kalita, J; Misra, U K; Das, M

    2008-03-01

    The diagnostic yield of various neurophysiological criteria may vary in different subforms of Guillain-Barre syndrome (GBS), whose prevalence varies in different geographical areas. To evaluate the sensitivity of various neurophysiological criteria in different clinical subtypes of GBS, and their relationship with severity, duration and outcome. Consecutive patients with GBS underwent detailed clinical evaluation. Severity was graded on a scale from 0 to 10. Motor and sensory nerve conductions and F wave studies were performed. The diagnostic sensitivity of Albers et al (set 1), Cornblath (set 2), Ho et al (set 3), Dutch GBS study group (set 4), Italian GBS study group (set 5) and Albers and Kelly (set 6) criteria were evaluated and correlated with clinical subtypes of GBS, duration, severity and outcome. There were 51 patients. Mean disability was 6.8; 34 patients were bedridden and five needed a ventilator. Clinical presentation was pure motor in 31, motorsensory in 18 and pure sensory in two patients. The sensitivity of nerve conduction study in the diagnosis of GBS was highest in set 1 (88.2%) followed by set 3 (86.3%) and set 4 (82.4%) and lowest in set 2 (39.2%). The diagnostic yield of sets 1, 3 and 4 were also higher than sets 2, 5 and 6 in different clinical subtypes of GBS. As per Ho et al, patients could be categorised into acute inflammatory demyelinating polyradiculoneuropathy (44 (86.3%)), acute motor axonal neuropathy (4 (7.8%)) and acute motor sensory axonal neuropathy (3 (5.9%)). One (2%) patient died, 22.4% had complete, 57.1% partial and 18.4% poor recovery at 3 months. Outcome was related to severity of illness and compound muscle action potential (CMAP) amplitude. The sensitivity of different neurophysiological criteria in the diagnosis of Indian GBS patients varied from 39.2% to 88.2%. The outcome was related to severity of illness and CMAP amplitude.

  16. Sound Insulation between Dwellings

    DEFF Research Database (Denmark)

    Rasmussen, Birgit

    2011-01-01

    Regulatory sound insulation requirements for dwellings exist in more than 30 countries in Europe. In some countries, requirements have existed since the 1950s. Findings from comparative studies show that sound insulation descriptors and requirements represent a high degree of diversity...... and initiate – where needed – improvement of sound insulation of new and existing dwellings in Europe to the benefit of the inhabitants and the society. A European COST Action TU0901 "Integrating and Harmonizing Sound Insulation Aspects in Sustainable Urban Housing Constructions", has been established and runs...... 2009-2013. The main objectives of TU0901 are to prepare proposals for harmonized sound insulation descriptors and for a European sound classification scheme with a number of quality classes for dwellings. Findings from the studies provide input for the discussions in COST TU0901. Data collected from 24...

  17. Differential diagnosis diphtheria adults

    Directory of Open Access Journals (Sweden)

    Yu. I. Liashenko

    2010-01-01

    Full Text Available A total of 1,824 human cases of diphtheria, treated at the Clinical Infectious Diseases Hospital SP Botkin (St. Petersburg during 1993, as well as 19 deaths in 1994. It is known that early diagnosis of infectious diseases, especially diphtheria, contributes to the favorable outcome of the disease. The diagnosis of diphtheria at the prehospital stage is always difficult. Presented in detail the differential diagnosis of the disease, clinically similar to diphtheria: Lacunal angina, angina Simanovsky, infectious mononucleosis, angina Ludwig’s angina Dugue, syphilis, non-infectious with clinical «masks» of diphtheria and other. Diphtheria epidemic of 1993–1994 in Russia and, in particular, in St. Petersburg, showed that the late admission of patients with diphtheria infection in hospitals, usually associated with irregular differential diagnosis of this dangerous disease.

  18. Clinical presentation, diagnosis and treatment of vulvovaginitis in girls: a current approach and review of the literature.

    Science.gov (United States)

    Beyitler, İlke; Kavukcu, Salih

    2017-04-01

    Vulvovaginitis is the most common cause of gynecological complaints in children and young girls. Some of the factors which cause vulvovaginitis include hypoestrogenism, the anatomical proximity of rectum and delicate vulvar skin and vaginal mucosa. We made a literature search with Pubmed, Medline and Cochrane database from January 2002 to May 2015 in English language using the key words vulvovaginitis, children, clinical, diagnosis and treatment. Vulvovaginitis in girls is usually caused by non-specific factors and hygiene measures, bioyoghurt and avoidance of chemical irritants are generally useful. Weight control if necessary and prevention of voiding dysfunction are effective. Vaginal flora is important in girls and results should be interpreted with clinical features to decide whether an isolated microorganism is part of the normal microflora or is the cause of symptomatic vulvovaginitis. Specific treatment is generally considered in case of a detected pathogen microorganism. Isolation of a sexually transmitted organism requires further investigation. Persistent disease may not always indicate a foreign body but it must be taken into account. Girls and parents are encouraged psychologically in all steps of evaluation, diagnosis and treatment. Probiotics, nanotechnology and petroleum jelly are other important treatment options used in vulvovaginitis. In this review, we present current approach to the presentation and management of vulvovaginitis in childhood. This disorder requires a comprehensive evaluation in all steps of diagnosis, differential diagnosis and treatment.

  19. Remembering that big things sound big: Sound symbolism and associative memory.

    Science.gov (United States)

    Preziosi, Melissa A; Coane, Jennifer H

    2017-01-01

    According to sound symbolism theory, individual sounds or clusters of sounds can convey meaning. To examine the role of sound symbolic effects on processing and memory for nonwords, we developed a novel set of 100 nonwords to convey largeness (nonwords containing plosive consonants and back vowels) and smallness (nonwords containing fricative consonants and front vowels). In Experiments 1A and 1B, participants rated the size of the 100 nonwords and provided definitions to them as if they were products. Nonwords composed of fricative/front vowels were rated as smaller than those composed of plosive/back vowels. In Experiment 2, participants studied sound symbolic congruent and incongruent nonword and participant-generated definition pairings. Definitions paired with nonwords that matched the size and participant-generated meanings were recalled better than those that did not match. When the participant-generated definitions were re-paired with other nonwords, this mnemonic advantage was reduced, although still reliable. In a final free association study, the possibility that plosive/back vowel and fricative/front vowel nonwords elicit sound symbolic size effects due to mediation from word neighbors was ruled out. Together, these results suggest that definitions that are sound symbolically congruent with a nonword are more memorable than incongruent definition-nonword pairings. This work has implications for the creation of brand names and how to create brand names that not only convey desired product characteristics, but also are memorable for consumers.

  20. An Antropologist of Sound

    DEFF Research Database (Denmark)

    Groth, Sanne Krogh

    2015-01-01

    PROFESSOR PORTRAIT: Sanne Krogh Groth met Holger Schulze, newly appointed professor in Musicology at the Department for Arts and Cultural Studies, University of Copenhagen, to a talk about anthropology of sound, sound studies, musical canons and ideology.......PROFESSOR PORTRAIT: Sanne Krogh Groth met Holger Schulze, newly appointed professor in Musicology at the Department for Arts and Cultural Studies, University of Copenhagen, to a talk about anthropology of sound, sound studies, musical canons and ideology....

  1. Laboratory Diagnosis of Carbohydrate Metabolism Disorders. Diagnosis Algorithm in Hyperglycemic States

    Directory of Open Access Journals (Sweden)

    V.I. Pankiv

    2014-04-01

    Full Text Available The article is devoted to the laboratory diagnosis of disorders of carbohydrate metabolism. Presents criteria for diagnosis of diabetes, an algorithm for oral glucose tolerance test, determine type of diabetes based on clinical and laboratory data. The article also raised the issues of diagnosis of gestational diabetes and a diagnostic algorithm of hyperglycemia conditions during pregnancy.

  2. Definition of ambulatory blood pressure targets for diagnosis and treatment of hypertension in relation to clinic blood pressure: prospective cohort study.

    Science.gov (United States)

    Head, Geoffrey A; Mihailidou, Anastasia S; Duggan, Karen A; Beilin, Lawrence J; Berry, Narelle; Brown, Mark A; Bune, Alex J; Cowley, Diane; Chalmers, John P; Howe, Peter R C; Hodgson, Jonathan; Ludbrook, John; Mangoni, Arduino A; McGrath, Barry P; Nelson, Mark R; Sharman, James E; Stowasser, Michael

    2010-04-14

    Twenty-four hour ambulatory blood pressure thresholds have been defined for the diagnosis of mild hypertension but not for its treatment or for other blood pressure thresholds used in the diagnosis of moderate to severe hypertension. We aimed to derive age and sex related ambulatory blood pressure equivalents to clinic blood pressure thresholds for diagnosis and treatment of hypertension. We collated 24 hour ambulatory blood pressure data, recorded with validated devices, from 11 centres across six Australian states (n=8575). We used least product regression to assess the relation between these measurements and clinic blood pressure measured by trained staff and in a smaller cohort by doctors (n=1693). Mean age of participants was 56 years (SD 15) with mean body mass index 28.9 (5.5) and mean clinic systolic/diastolic blood pressure 142/82 mm Hg (19/12); 4626 (54%) were women. Average clinic measurements by trained staff were 6/3 mm Hg higher than daytime ambulatory blood pressure and 10/5 mm Hg higher than 24 hour blood pressure, but 9/7 mm Hg lower than clinic values measured by doctors. Daytime ambulatory equivalents derived from trained staff clinic measurements were 4/3 mm Hg less than the 140/90 mm Hg clinic threshold (lower limit of grade 1 hypertension), 2/2 mm Hg less than the 130/80 mm Hg threshold (target upper limit for patients with associated conditions), and 1/1 mm Hg less than the 125/75 mm Hg threshold. Equivalents were 1/2 mm Hg lower for women and 3/1 mm Hg lower in older people compared with the combined group. Our study provides daytime ambulatory blood pressure thresholds that are slightly lower than equivalent clinic values. Clinic blood pressure measurements taken by doctors were considerably higher than those taken by trained staff and therefore gave inappropriate estimates of ambulatory thresholds. These results provide a framework for the diagnosis and management of hypertension using ambulatory blood pressure values.

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

    International Nuclear Information System (INIS)

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

    2007-01-01

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

  4. Prevalence, Clinical Presentation, and Differential Diagnosis of Pediatric Bipolar Disorder

    Science.gov (United States)

    Goldstein, Benjamin I.; Birmaher, Boris

    2016-01-01

    Background Over the past 20 years, the evidence regarding pediatric bipolar disorder (BP) has increased substantially. As a result, recent concerns have focused primarily on prevalence and differential diagnosis. Method Selective review of the literature. Results BP as defined by rigorously applying diagnostic criteria has been observed among children and especially adolescents in numerous countries. In contrast to increasing diagnoses in clinical settings, prevalence in epidemiologic studies has not recently changed. BP-spectrum conditions among youth are highly impairing and confer high risk for conversion to BP-I and BP-II. Compared to adults, youth with BP have more mixed symptoms, more changes in mood polarity, are more often symptomatic and seem to have worse prognosis. The course, clinical characteristics, and comorbidities of BP among children and adolescents are in many ways otherwise similar to those of adults with BP. Nonetheless, many youth with BP receive no treatment and most do not receive BP-specific treatment. Conclusion Despite increased evidence supporting the validity of pediatric BP, discrepancies between clinical and epidemiologic findings suggest that diagnostic misapplication may be common. Simultaneously, low rates of treatment of youth with BP suggest that withholding of BP diagnoses may also be common. Clinicians should apply diagnostic criteria rigorously in order to optimize diagnostic accuracy and ensure appropriate treatment. PMID:22652925

  5. Ileocecal endometriosis: diagnosis and management

    Directory of Open Access Journals (Sweden)

    Ana López Carrasco

    2017-04-01

    Conclusion: Variability in symptoms hinders diagnosis. The gold standard for diagnosis is MRI, but clinical suspicion optimizes imaging test diagnosis. Segmental resection should be indicated in the majority of the cases.

  6. The diagnosis of silicone breast-implant rupture: clinical findings compared with findings at magnetic resonance imaging

    DEFF Research Database (Denmark)

    Hölmich, Lisbet Rosenkrantz; Fryzek, Jon P; Kjøller, Kim

    2005-01-01

    The objective was to evaluate the usefulness of clinical examination in the evaluation of breast-implant integrity, using the diagnosis at magnetic resonance imaging (MRI) as the "gold standard." Fifty-five women with 109 implants underwent a breast examination either just before or shortly after...

  7. Sound specificity effects in spoken word recognition: The effect of integrality between words and sounds

    DEFF Research Database (Denmark)

    Strori, Dorina; Zaar, Johannes; Cooke, Martin

    2017-01-01

    Recent evidence has shown that nonlinguistic sounds co-occurring with spoken words may be retained in memory and affect later retrieval of the words. This sound-specificity effect shares many characteristics with the classic voice-specificity effect. In this study, we argue that the sound......-specificity effect is conditional upon the context in which the word and sound coexist. Specifically, we argue that, besides co-occurrence, integrality between words and sounds is a crucial factor in the emergence of the effect. In two recognition-memory experiments, we compared the emergence of voice and sound...... from a mere co-occurrence context effect by removing the intensity modulation. The absence of integrality led to the disappearance of the sound-specificity effect. Taken together, the results suggest that the assimilation of background sounds into memory cannot be reduced to a simple context effect...

  8. Active sound reduction system and method

    NARCIS (Netherlands)

    2016-01-01

    The present invention refers to an active sound reduction system and method for attenuation of sound emitted by a primary sound source, especially for attenuation of snoring sounds emitted by a human being. This system comprises a primary sound source, at least one speaker as a secondary sound

  9. MR diagnosis and clinical management of whiplash injury syndrome of spinal cord

    International Nuclear Information System (INIS)

    Lin Shixu; Lin Daiying; Wu Xianheng; Zeng Xianting

    2003-01-01

    Objective: To study the MR manifestations of whiplash injury syndrome of spinal cord. Methods: MR images of 21 cases diagnosed as whiplash injury syndrome were retrospectively studied. Those images included transverse and sagittal views and coronal scan had been performed in some cases. Results: MRI inspection safely and objectively reveals the extent of the spinal injury, and helps the anticipation of the prognosis. Conclusion: MRI is the first choice of the imaging modalities assessing the whiplash injury syndrome of the spinal cord. An early diagnosis is valuable to clinical management and rehabilitation

  10. Sound Symbolism in Basic Vocabulary

    Directory of Open Access Journals (Sweden)

    Søren Wichmann

    2010-04-01

    Full Text Available The relationship between meanings of words and their sound shapes is to a large extent arbitrary, but it is well known that languages exhibit sound symbolism effects violating arbitrariness. Evidence for sound symbolism is typically anecdotal, however. Here we present a systematic approach. Using a selection of basic vocabulary in nearly one half of the world’s languages we find commonalities among sound shapes for words referring to same concepts. These are interpreted as due to sound symbolism. Studying the effects of sound symbolism cross-linguistically is of key importance for the understanding of language evolution.

  11. Optimizing sound quality with AACHENHEAD {sup trademark} -technology; Optimierung der Geraeuschqualitaet mit der AACHENHEAD {sup trademark} -Technologie

    Energy Technology Data Exchange (ETDEWEB)

    Krohn, C. [HEAD acoustics GmbH (Germany)

    1997-08-01

    The sound quality of interior and exterior vehicle noise is gaining more and more importance. Not only that modern vehicles show a considerably lower noise level, the characteristic sound of a vehicle influences the buyer`s choice of a car. The acoustic engineer is faced with a complex task. In addition to reducing the noise level he has to make sure that the sound design goes along with the product. This is where aurally-adequate sound diagnosis is needed. Conventional methods, e.g. measuring the noise level or third-octave spectrum, alone cannot solve this specific task. HEAD acoustics offers the full range of aurally-adequate measurement and analysis systems, starting with the Artificial Head Measurement System and making the recorded data available for further analysis with the Binaural Analysis System BAS or the Mobile Sound Quality Laboratory SQlab. This full range of systems helps the acoustic engineer to solve his tasks for improving sound quality in a fast and cost-effective way. (orig.) [Deutsch] Kaum jemand wuerde ein Geraeusch mit verschlossenen Ohren beurteilen. Dennoch ist dies in der Praxis durchaus noch ueblich. Konventionelle Analyseverfahren in der Akustik und Schwingungsmesstechnik verlassen sich ausschliesslich auf den Augenschein. Dieser Aufsatz zeigt neue Wege von HEAD acoustics in diesem Bereich der Messtechnik. (orig.)

  12. From Diagnosis to Treatment: Clinical Applications of Nanotechnology in Thoracic Surgery.

    Science.gov (United States)

    Digesu, Christopher S; Hofferberth, Sophie C; Grinstaff, Mark W; Colson, Yolonda L

    2016-05-01

    Nanotechnology is an emerging field with potential as an adjunct to cancer therapy, particularly thoracic surgery. Therapy can be delivered to tumors in a more targeted fashion, with less systemic toxicity. Nanoparticles may aid in diagnosis, preoperative characterization, and intraoperative localization of thoracic tumors and their lymphatics. Focused research into nanotechnology's ability to deliver both diagnostics and therapeutics has led to the development of nanotheranostics, which promises to improve the treatment of thoracic malignancies through enhanced tumor targeting, controlled drug delivery, and therapeutic monitoring. This article reviews nanoplatforms, their unique properties, and the potential for clinical application in thoracic surgery. Copyright © 2016 Elsevier Inc. All rights reserved.

  13. Digital stethoscopes compared to standard auscultation for detecting abnormal paediatric breath sounds.

    Science.gov (United States)

    Kevat, Ajay C; Kalirajah, Anaath; Roseby, Robert

    2017-07-01

    Our study aimed to objectively describe the audiological characteristics of wheeze and crackles in children by using digital stethoscope (DS) auscultation, as well as assess concordance between standard auscultation and two different DS devices in their ability to detect pathological breath sounds. Twenty children were auscultated by a paediatric consultant doctor and digitally recorded using the Littman™ 3200 Digital Electronic Stethoscope and a Clinicloud™ DS with smart device. Using spectrographic analysis, we found those with clinically described wheeze had prominent periodic waveform segments spanning expiration for a period of 0.03-1.2 s at frequencies of 100-1050 Hz, and occasionally spanning shorter inspiratory segments; paediatric crackles were brief discontinuous sounds with a distinguishing waveform. There was moderate concordance with respect to wheeze detection between digital and standard binaural stethoscopes, and 100% concordance for crackle detection. Importantly, DS devices were more sensitive than clinician auscultation in detecting wheeze in our study. Objective definition of audio characteristics of abnormal paediatric breath sounds was achieved using DS technology. We demonstrated superiority of our DS method compared to traditional auscultation for detection of wheeze. What is Known: • The audiological characteristics of abnormal breath sounds have been well-described in adult populations but not in children. • Inter-observer agreement for detection of pathological breath sounds using standard auscultation has been shown to be poor, but the clinical value of now easily available digital stethoscopes has not been sufficiently examined. What is New: • Digital stethoscopes can objectively define the nature of pathological breath sounds such as wheeze and crackles in children. • Paediatric wheeze was better detected by digital stethoscopes than by standard auscultation performed by an expert paediatric clinician.

  14. Sounding the Alarm: An Introduction to Ecological Sound Art

    Directory of Open Access Journals (Sweden)

    Jonathan Gilmurray

    2016-12-01

    Full Text Available In recent years, a number of sound artists have begun engaging with ecological issues through their work, forming a growing movement of ˝ecological sound art˝. This paper traces its development, examines its influences, and provides examples of the artists whose work is currently defining this important and timely new field.

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

    Science.gov (United States)

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

    2015-01-01

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

  16. Gynaecomastia in 786 Adult Men - Clinical and Biochemical findings

    DEFF Research Database (Denmark)

    Mieritz, Mikkel G; Christiansen, Peter; Jensen, Martin Blomberg

    2017-01-01

    Objective - Gynaecomastia is a benign proliferation of glandular tissue of the breast, however, it is an important clinical observation because it can be the first symptom of an underlying disease. Some controversy exists concerning the clinical importance of an in-depth investigation of men who...... develop gynaecomastia. We hypothesize that a thorough work-up is required in adult men with gynaecomastia. Design- All adult men (n=818) referred to a secondary level andrological department at Rigshospitalet in Copenhagen, Denmark in a four-year period (2008-2011) under the diagnosis of gynaecomastia...... (ICD-10: N62) were included. Methods - Thirty-two men did not have gynaecomastia when examined were excluded; leaving 786 men for final analyses. They went through an andrological examination, ultra sound of the testicles and analysis of endogenous serum hormones levels. Results - In 45% of men...

  17. Sound Stuff? Naïve materialism in middle-school students' conceptions of sound

    Science.gov (United States)

    Eshach, Haim; Schwartz, Judah L.

    2006-06-01

    Few studies have dealt with students’ preconceptions of sounds. The current research employs Reiner et al. (2000) substance schema to reveal new insights about students’ difficulties in understanding this fundamental topic. It aims not only to detect whether the substance schema is present in middle school students’ thinking, but also examines how students use the schema’s properties. It asks, moreover, whether the substance schema properties are used as islands of local consistency or whether one can identify more global coherent consistencies among the properties that the students use to explain the sound phenomena. In-depth standardized open-ended interviews were conducted with ten middle school students. Consistent with the substance schema, sound was perceived by our participants as being pushable, frictional, containable, or transitional. However, sound was also viewed as a substance different from the ordinary with respect to its stability, corpuscular nature, additive properties, and inertial characteristics. In other words, students’ conceptions of sound do not seem to fit Reiner et al.’s schema in all respects. Our results also indicate that students’ conceptualization of sound lack internal consistency. Analyzing our results with respect to local and global coherence, we found students’ conception of sound is close to diSessa’s “loosely connected, fragmented collection of ideas.” The notion that sound is perceived only as a “sort of a material,” we believe, requires some revision of the substance schema as it applies to sound. The article closes with a discussion concerning the implications of the results for instruction.

  18. Sound symbolism: the role of word sound in meaning.

    Science.gov (United States)

    Svantesson, Jan-Olof

    2017-09-01

    The question whether there is a natural connection between sound and meaning or if they are related only by convention has been debated since antiquity. In linguistics, it is usually taken for granted that 'the linguistic sign is arbitrary,' and exceptions like onomatopoeia have been regarded as marginal phenomena. However, it is becoming more and more clear that motivated relations between sound and meaning are more common and important than has been thought. There is now a large and rapidly growing literature on subjects as ideophones (or expressives), words that describe how a speaker perceives a situation with the senses, and phonaesthemes, units like English gl-, which occur in many words that share a meaning component (in this case 'light': gleam, glitter, etc.). Furthermore, psychological experiments have shown that sound symbolism in one language can be understood by speakers of other languages, suggesting that some kinds of sound symbolism are universal. WIREs Cogn Sci 2017, 8:e1441. doi: 10.1002/wcs.1441 For further resources related to this article, please visit the WIREs website. © 2017 Wiley Periodicals, Inc.

  19. Arthroscopy in the diagnosis of chondromalacia patellae.

    Science.gov (United States)

    Leslie, I J; Bentley, G

    1978-01-01

    Chondromalacia patellae is difficult to diagnosis clinically with accuracy. In order to clarify the relevant symptoms and signs, 78 patients presenting with a clinical diagnosis of chondromalacia were examined by arthroscopy. In 49% of the knees no abnormalities were found. Presenting symptoms were similar in the normal and abnormal groups. Physical signs were more helpful in diagnosis and it is considered that the presence of an effusion, quadriceps wasting, and patello-femoral crepitus are the most important clinical findings in the diagnosis of chondromalacia patellae. The arthroscope is valuable instrument in establishing the diagnosis of chondromalacia patellae especially in the teenage female. Images PMID:749700

  20. Nursing Diagnosis Risk for falls: prevalence and clinical profile of hospitalized patients1

    Science.gov (United States)

    Luzia, Melissa de Freitas; Victor, Marco Antonio de Goes; Lucena, Amália de Fátima

    2014-01-01

    Objectives to identify the prevalence of the Nursing Diagnosis (ND) Risk for falls in the hospitalizations of adult patients in clinical and surgical units, to characterize the clinical profile and to identify the risk factors of the patients with this ND. Method a cross-sectional study with 174 patients. The data was collected from the computerized nursing care prescriptions system and on-line hospital records, and analyzed statistically. Results the prevalence of the ND Risk for falls was 4%. The patients' profile indicated older adults, males (57%), those hospitalized in the clinical units (63.2%), with a median length of hospitalization of 20 (10-24) days, with neurological illnesses (26%), cardio-vascular illnesses (74.1%) and various co-morbidities (3±1.8). The prevalent risk factors were neurological alterations (43.1%), impaired mobility (35.6%) and extremes of age (10.3%). Conclusion the findings contributed to evidencing the profile of the patients with a risk of falling hospitalized in clinical and surgical wards, which favors the planning of interventions for preventing this adverse event. PMID:26107834

  1. Exploring the effect of sound and music on health in hospital settings: A narrative review.

    Science.gov (United States)

    Iyendo, Timothy Onosahwo

    2016-11-01

    Sound in hospital space has traditionally been considered in negative terms as both intrusive and unwanted, and based mainly on sound levels. However, sound level is only one aspect of the soundscape. There is strong evidence that exploring the positive aspect of sound in a hospital context can evoke positive feelings in both patients and nurses. Music psychology studies have also shown that music intervention in health care can have a positive effect on patient's emotions and recuperating processes. In this way, hospital spaces have the potential to reduce anxiety and stress, and make patients feel comfortable and secure. This paper describes a review of the literature exploring sound perception and its effect on health care. This review sorted the literature and main issues into themes concerning sound in health care spaces; sound, stress and health; positive soundscape; psychological perspective of music and emotion; music as a complementary medicine for improving health care; contradicting arguments concerning the use of music in health care; and implications for clinical practice. Using Web of Science, PubMed, Scopus, ProQuest Central, MEDLINE, and Google, a literature search on sound levels, sound sources and the impression of a soundscape was conducted. The review focused on the role and use of music on health care in clinical environments. In addition, other pertinent related materials in shaping the understanding of the field were retrieved, scanned and added into this review. The result indicated that not all noises give a negative impression within healthcare soundscapes. Listening to soothing music was shown to reduce stress, blood pressure and post-operative trauma when compared to silence. Much of the sound conveys meaningful information that is positive for both patients and nurses, in terms of soft wind, bird twitter, and ocean sounds. Music perception was demonstrated to bring about positive change in patient-reported outcomes such as eliciting

  2. Sound-by-sound thalamic stimulation modulates midbrain auditory excitability and relative binaural sensitivity in frogs.

    Science.gov (United States)

    Ponnath, Abhilash; Farris, Hamilton E

    2014-01-01

    Descending circuitry can modulate auditory processing, biasing sensitivity to particular stimulus parameters and locations. Using awake in vivo single unit recordings, this study tested whether electrical stimulation of the thalamus modulates auditory excitability and relative binaural sensitivity in neurons of the amphibian midbrain. In addition, by using electrical stimuli that were either longer than the acoustic stimuli (i.e., seconds) or presented on a sound-by-sound basis (ms), experiments addressed whether the form of modulation depended on the temporal structure of the electrical stimulus. Following long duration electrical stimulation (3-10 s of 20 Hz square pulses), excitability (spikes/acoustic stimulus) to free-field noise stimuli decreased by 32%, but returned over 600 s. In contrast, sound-by-sound electrical stimulation using a single 2 ms duration electrical pulse 25 ms before each noise stimulus caused faster and varied forms of modulation: modulation lasted sound-by-sound electrical stimulation varied between different acoustic stimuli, including for different male calls, suggesting modulation is specific to certain stimulus attributes. For binaural units, modulation depended on the ear of input, as sound-by-sound electrical stimulation preceding dichotic acoustic stimulation caused asymmetric modulatory effects: sensitivity shifted for sounds at only one ear, or by different relative amounts for both ears. This caused a change in the relative difference in binaural sensitivity. Thus, sound-by-sound electrical stimulation revealed fast and ear-specific (i.e., lateralized) auditory modulation that is potentially suited to shifts in auditory attention during sound segregation in the auditory scene.

  3. Sound specificity effects in spoken word recognition: The effect of integrality between words and sounds.

    Science.gov (United States)

    Strori, Dorina; Zaar, Johannes; Cooke, Martin; Mattys, Sven L

    2018-01-01

    Recent evidence has shown that nonlinguistic sounds co-occurring with spoken words may be retained in memory and affect later retrieval of the words. This sound-specificity effect shares many characteristics with the classic voice-specificity effect. In this study, we argue that the sound-specificity effect is conditional upon the context in which the word and sound coexist. Specifically, we argue that, besides co-occurrence, integrality between words and sounds is a crucial factor in the emergence of the effect. In two recognition-memory experiments, we compared the emergence of voice and sound specificity effects. In Experiment 1 , we examined two conditions where integrality is high. Namely, the classic voice-specificity effect (Exp. 1a) was compared with a condition in which the intensity envelope of a background sound was modulated along the intensity envelope of the accompanying spoken word (Exp. 1b). Results revealed a robust voice-specificity effect and, critically, a comparable sound-specificity effect: A change in the paired sound from exposure to test led to a decrease in word-recognition performance. In the second experiment, we sought to disentangle the contribution of integrality from a mere co-occurrence context effect by removing the intensity modulation. The absence of integrality led to the disappearance of the sound-specificity effect. Taken together, the results suggest that the assimilation of background sounds into memory cannot be reduced to a simple context effect. Rather, it is conditioned by the extent to which words and sounds are perceived as integral as opposed to distinct auditory objects.

  4. Analysis, Synthesis, and Perception of Musical Sounds The Sound of Music

    CERN Document Server

    Beauchamp, James W

    2007-01-01

    Analysis, Synthesis, and Perception of Musical Sounds contains a detailed treatment of basic methods for analysis and synthesis of musical sounds, including the phase vocoder method, the McAulay-Quatieri frequency-tracking method, the constant-Q transform, and methods for pitch tracking with several examples shown. Various aspects of musical sound spectra such as spectral envelope, spectral centroid, spectral flux, and spectral irregularity are defined and discussed. One chapter is devoted to the control and synthesis of spectral envelopes. Two advanced methods of analysis/synthesis are given: "Sines Plus Transients Plus Noise" and "Spectrotemporal Reassignment" are covered. Methods for timbre morphing are given. The last two chapters discuss the perception of musical sounds based on discrimination and multidimensional scaling timbre models.

  5. A comparison of clinical diagnosis and serological diagnosis in an epidemic of Crimean-Congo Hemorrhagic Fever

    International Nuclear Information System (INIS)

    Nadeem, M.; Ali, N.; Anwar, M.

    2003-01-01

    Crimean Congo Hemorrhagic Fever (CCHF) is the life-threatening disease caused by Nairovirus of genus Bunya virus caused by tick bite of Hayalomma species or by direct contact of the blood/sera of the patient and animals suffering from this disease. Epidemics have been occurring in Balochistan province of Pakistan and neighboring Afghanistan and Iran from time to time with this mortality. Aim: In the absence of facilities for detection of serological markers of CCHF (IgM Et IgG antibodies and PCR for viral RNA), a study was designed to diagnose and treat cases of CCHF reporting to a specialist unit hospital situated at Quetta, Pakistan. The aim was to compare the clinical features, complications and outcome of both groups of patients: one detecting the disease clinically only and the other depending upon serological tests for the diagnosis. Methods: Thirty-four patients having fever of less than two weeks of duration with features of bleeding from the skin and various orifices were included in this study from June 2001 to September 2001 after hospitalization. Index case and some of the consecutive cases were subjected to detection of serological markers. Rest of the cases were diagnosed on clinical ground and baseline laboratory investigations only. Difference in both the group was noted carefully. All the patients were given Ribavirin and blood products as and when required. Results: Statistically there was no obvious difference in clinical manifestations (fever, body aches, purpuric spots, ecchymosis, epistaxis, gum bleed etc. ) and laboratory findings (blood picture, serum ALT, serum urea and electrolytes, PT, APTT, etc). There was also no difference in mortality of the two groups studied. Conclusion: In an on ongoing outbreak of CCHF, history, clinical findings and supportive baseline, laboratory investigations may be sufficient for early detection and treatment of CCHF cases. However for documentation of start of epidemic, serological markers should be done

  6. Michael Jackson's Sound Stages

    OpenAIRE

    Morten Michelsen

    2012-01-01

    In order to discuss analytically spatial aspects of recorded sound William Moylan’s concept of ‘sound stage’ is developed within a musicological framework as part of a sound paradigm which includes timbre, texture and sound stage. Two Michael Jackson songs (‘The Lady in My Life’ from 1982 and ‘Scream’ from 1995) are used to: a) demonstrate the value of such a conceptualisation, and b) demonstrate that the model has its limits, as record producers in the 1990s began ignoring the conventions of...

  7. [Clinical features, diagnosis and surgical treatment of solitary air cysts of the lungs].

    Science.gov (United States)

    Gudovskiĭ, L M; Platov, I I; Korenev, A E

    2001-01-01

    86 cases of solitary air cysts of the lung (6.83% of all maldevelopments) were analyzed. This maldevelopment of bronchial tree is found most often in men (10:7) and more often in the right lung than in the left (18:13). There were no clinical symptoms in 33 (38.37%) patients. Uncomplicated course of the disease was in 51 (59.3%) patients, the disease was complicated by infection in 28 (32.56%) patients. Solitary bronchial cysts were complicated by spontaneous pneumothorax in 8.14% cases, by hemoptysis--in 6.98%. Roentgenography of the chest thorax on two projections and tomography (including CT) are enough for diagnosis of solitary air bronchial cysts. Bronchoscopy, bronchography and APG are not much informative in diagnosis of cysts and should be used on special indications. Cystectomy or cystectomy with partial resection of lung tissue were performed in 67.14% patients with good results.

  8. Clinical experiences of NBI laryngoscope in diagnosis of laryngeal lesions

    Science.gov (United States)

    Qi, Xinmeng; Yu, Dan; Zhao, Xue; Jin, Chunshun; Sun, Changling; Liu, Xueshibojie; Cheng, Jinzhang; Zhang, Dejun

    2014-01-01

    Endoscopy is essential for the diagnosis and treatment of cancers derived from the larynx. However, a laryngoscope with conventional white light (CWL) has technical limitations in detecting small or superficial lesions on the mucosa. Narrow band imaging especially combined with magnifying endoscopy (ME) is useful for the detection of superficial squamous cell carcinoma (SCC) within the oropharynx, hypopharynx, and oral cavity. A total of 3675 patients who have come to the outpatient clinic and complained of inspiratory stridor, dyspnea, phonation problems or foreign body sensation, were enrolled in this study. We describe the glottic conditions of the patients. All 3675 patients underwent laryngoscopy equipped with conventional white light (CWL) and NBI system. 1149 patients received a biopsy process. And 1153 lesions were classified into different groups according to their histopathological results. Among all the 1149 patients, 346 patients (312 males, 34 females; mean age 62.2±10.5 years) were suspected of having a total of 347 precancerous or cancerous (T1 or T2 without lymphnode involvement) lesions of the larynx under the CWL. Thus, we expected to attain a complete vision of what laryngeal lesions look like under the NBI view of a laryngoscope. The aim was to develop a complete description list of each laryngeal conditions (e.g. polyps, papilloma, leukoplakia, etc.), which can serve as a criteria for further laryngoscopic examinations and diagnosis. PMID:25419362

  9. Using the modified Delphi method to establish clinical consensus for the diagnosis and treatment of patients with rotator cuff pathology

    Directory of Open Access Journals (Sweden)

    Breda H. Eubank

    2016-05-01

    Full Text Available Abstract Background Patients presenting to the healthcare system with rotator cuff pathology do not always receive high quality care. High quality care occurs when a patient receives care that is accessible, appropriate, acceptable, effective, efficient, and safe. The aim of this study was twofold: 1 to develop a clinical pathway algorithm that sets forth a stepwise process for making decisions about the diagnosis and treatment of rotator cuff pathology presenting to primary, secondary, and tertiary healthcare settings; and 2 to establish clinical practice guidelines for the diagnosis and treatment of rotator cuff pathology to inform decision-making processes within the algorithm. Methods A three-step modified Delphi method was used to establish consensus. Fourteen experts representing athletic therapy, physiotherapy, sport medicine, and orthopaedic surgery were invited to participate as the expert panel. In round 1, 123 best practice statements were distributed to the panel. Panel members were asked to mark “agree” or “disagree” beside each statement, and provide comments. The same voting method was again used for round 2. Round 3 consisted of a final face-to-face meeting. Results In round 1, statements were grouped and reduced to 44 statements that met consensus. In round 2, five statements reached consensus. In round 3, ten statements reached consensus. Consensus was reached for 59 statements representing five domains: screening, diagnosis, physical examination, investigations, and treatment. The final face-to-face meeting was also used to develop clinical pathway algorithms (i.e., clinical care pathways for three types of rotator cuff pathology: acute, chronic, and acute-on-chronic. Conclusion This consensus guideline will help to standardize care, provide guidance on the diagnosis and treatment of rotator cuff pathology, and assist in clinical decision-making for all healthcare professionals.

  10. Using the modified Delphi method to establish clinical consensus for the diagnosis and treatment of patients with rotator cuff pathology.

    Science.gov (United States)

    Eubank, Breda H; Mohtadi, Nicholas G; Lafave, Mark R; Wiley, J Preston; Bois, Aaron J; Boorman, Richard S; Sheps, David M

    2016-05-20

    Patients presenting to the healthcare system with rotator cuff pathology do not always receive high quality care. High quality care occurs when a patient receives care that is accessible, appropriate, acceptable, effective, efficient, and safe. The aim of this study was twofold: 1) to develop a clinical pathway algorithm that sets forth a stepwise process for making decisions about the diagnosis and treatment of rotator cuff pathology presenting to primary, secondary, and tertiary healthcare settings; and 2) to establish clinical practice guidelines for the diagnosis and treatment of rotator cuff pathology to inform decision-making processes within the algorithm. A three-step modified Delphi method was used to establish consensus. Fourteen experts representing athletic therapy, physiotherapy, sport medicine, and orthopaedic surgery were invited to participate as the expert panel. In round 1, 123 best practice statements were distributed to the panel. Panel members were asked to mark "agree" or "disagree" beside each statement, and provide comments. The same voting method was again used for round 2. Round 3 consisted of a final face-to-face meeting. In round 1, statements were grouped and reduced to 44 statements that met consensus. In round 2, five statements reached consensus. In round 3, ten statements reached consensus. Consensus was reached for 59 statements representing five domains: screening, diagnosis, physical examination, investigations, and treatment. The final face-to-face meeting was also used to develop clinical pathway algorithms (i.e., clinical care pathways) for three types of rotator cuff pathology: acute, chronic, and acute-on-chronic. This consensus guideline will help to standardize care, provide guidance on the diagnosis and treatment of rotator cuff pathology, and assist in clinical decision-making for all healthcare professionals.

  11. ABOUT SOUNDS IN VIDEO GAMES

    Directory of Open Access Journals (Sweden)

    Denikin Anton A.

    2012-12-01

    Full Text Available The article considers the aesthetical and practical possibilities for sounds (sound design in video games and interactive applications. Outlines the key features of the game sound, such as simulation, representativeness, interactivity, immersion, randomization, and audio-visuality. The author defines the basic terminology in study of game audio, as well as identifies significant aesthetic differences between film sounds and sounds in video game projects. It is an attempt to determine the techniques of art analysis for the approaches in study of video games including aesthetics of their sounds. The article offers a range of research methods, considering the video game scoring as a contemporary creative practice.

  12. Clinical signs, diagnosis, and case reports of Vaccinia virus infections

    Directory of Open Access Journals (Sweden)

    Daniela Carla Medeiros Silva

    Full Text Available Vaccinia virus is responsible for a zoonosis that usually affects cattle and human beings in Brazil. The initial clinical signs of the infection are focal red skin areas, fever, and general symptoms similar to those of a cold. Then, pustules and ulcerated lesions surrounded by edema and erythema follow, as well as local lymphadenopathy that can last for weeks. Cure and healing of the lesions occur over several weeks, leaving a typical scar in the skin of people and animals affected. The infection definitive diagnosis is made through morphological characterization of the virus by use of electron microscopy, followed by PCR for specific viral genes. Since 1963, circulating orthopoxviruses in infectious outbreaks in several regions of Brazil have been reported. Later, the etiological agent of those infections was characterized as samples of Vaccinia virus. In addition, the widespread use of those viruses in research laboratories and mass vaccination of militaries have contributed to increase the cases of those infections worldwide. Thus, several epidemiological and clinical studies are required, as well as studies of viral immunology, public health, and economic impact, because little is known about those Vaccinia virus outbreaks in Brazil.

  13. Specific features of the clinical and laboratory diagnosis of Lesch—Nyhan syndrome and current therapy options

    Directory of Open Access Journals (Sweden)

    M. I. Yablonskaya

    2015-01-01

    Full Text Available The rare hereditary diseases encountered in the practice of pediatricians, pediatric neurologists, and geneticists include Lesch—Nyhan syndrome associated with purine metabolic disorders caused by mutations in the HPRT1 gene encoding the enzyme hypoxanthine-guanine phosphoribosyltransferase (HGPRT. HGPRT deficiency gives rise to hyperuricemia, hyperuricemic nephropathy, and a CNS lesion reminiscent of dystonic or hyperkinetic infantile cerebral paralysis concurrent with a propensity to have autoaggressive behavior. The diagnosis is based on a range of history data, characteristic neurological symptoms, the detection of high blood and urine uric acid levels, and the identification of pathogenic mutagens in the HPRT1 gene. Early diagnosis contributes to timely therapy and assists in medical genetic counseling. The paper describes a clinical case of a boy with Lesch-Nyhan syndrome and elucidates the problems of diagnosis and treatment of this disease.

  14. Nano-hydroxyapatite and calcium-enriched mixture for pulp capping of sound primary teeth: a randomized clinical trial.

    Science.gov (United States)

    Haghgoo, Roza; Asgary, Saeed; Mashhadi Abbas, Fatemeh; Montazeri Hedeshi, Roshanak

    2015-01-01

    Nano-hydroxyapatite (NHA) has been used for regeneration of osseous defects. Calcium-enriched mixture (CEM) cement is also used for various dental treatments. This trial compared the efficacy of NHA and CEM cement for direct pulp capping (DPC) of sound primary teeth. In this randomized clinical trial with split-mouth design, after attaining informed consent, 20 sound primary canines scheduled for orthodontic extraction, were selected. After mechanical pulp exposure, the exposed site was capped with either NHA or CEM cement and then immediately restored with glass-ionomer and resin composite. The teeth were extracted after two months and examined histologically. Parameters of hard tissue bridge (HTB) formation, its type and quality as well as pulpal inflammation scores were compared between the two experimental groups. The data were analyzed using the Mann Whitney U and Fisher's exact test. The level of significance was set at 0.001. All CEM specimens showed inflammation score of 0 (less than 10%). However, in NHA group, inflammation scores of 0 (less than 10%), 1 (10%-30%) and 2 (30%-50%) were observed in 2 (20%), 4 (40%) and 4 (40%) specimens, respectively (P<0.001). HTB was formed in all CEM specimens while it was developed in 2 specimens of NHA (20%; P<0.001). All CEM specimens showed normal pulp; only two cases in NHA group (20%) demonstrated uninflamed normal pulp. CEM cement was superior to NHA as a DPC agent in terms of HTB formation and pulp inflammation scores. It is a suitable material for the DPC of primary teeth.

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

    Directory of Open Access Journals (Sweden)

    A. N. Semyachkina

    2016-01-01

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

  16. Clinical Use of Next-Generation Sequencing in the Diagnosis of Wilson’s Disease

    Directory of Open Access Journals (Sweden)

    Dániel Németh

    2016-01-01

    Full Text Available Objective. Wilson’s disease is a disorder of copper metabolism which is fatal without treatment. The great number of disease-causing ATP7B gene mutations and the variable clinical presentation of WD may cause a real diagnostic challenge. The emergence of next-generation sequencing provides a time-saving, cost-effective method for full sequencing of the whole ATP7B gene compared to the traditional Sanger sequencing. This is the first report on the clinical use of NGS to examine ATP7B gene. Materials and Methods. We used Ion Torrent Personal Genome Machine in four heterozygous patients for the identification of the other mutations and also in two patients with no known mutation. One patient with acute on chronic liver failure was a candidate for acute liver transplantation. The results were validated by Sanger sequencing. Results. In each case, the diagnosis of Wilson’s disease was confirmed by identifying the mutations in both alleles within 48 hours. One novel mutation (p.Ala1270Ile was found beyond the eight other known ones. The rapid detection of the mutations made possible the prompt diagnosis of WD in a patient with acute liver failure. Conclusions. According to our results we found next-generation sequencing a very useful, reliable, time-saving, and cost-effective method for diagnosing Wilson’s disease in selected cases.

  17. Sound [signal] noise

    DEFF Research Database (Denmark)

    Bjørnsten, Thomas

    2012-01-01

    The article discusses the intricate relationship between sound and signification through notions of noise. The emergence of new fields of sonic artistic practices has generated several questions of how to approach sound as aesthetic form and material. During the past decade an increased attention...... has been paid to, for instance, a category such as ‘sound art’ together with an equally strengthened interest in phenomena and concepts that fall outside the accepted aesthetic procedures and constructions of what we traditionally would term as musical sound – a recurring example being ‘noise’....

  18. Clinical diagnosis by computed tomography on Alzheimer type dementia

    Energy Technology Data Exchange (ETDEWEB)

    Imai, Yukimichi

    1983-09-01

    The relationships of CT findings, intellectual impairment by psychological assessment and severity of dementia by clinical evaluation were studied on 109 patients with clinical diagnosis of Alzheimer type dementia (AD) and 43 controls. CT examinations were carried out on three tomographic sections, that is, a section through anterior and posterior horns of lateral ventricles, a section through cellae mediae of lateral ventricles and a section through cortex with intracranial space of 60-80 cm/sup 2/. In the three tomographic sections, CSF space percent and half width full max (HWFM) in the histogram corresponding to brain tissue were employed as indexes of brain atrophy by CT. Psychological evaluation of dementia was made by using Hasegawa's dementia scale (HDS). The present study revealed the following findings. though CSF% in the sections through lateral ventricles significantly correlated with age, it was more significantly correlated with HDS and CDR(clinical dementia rating) scores, respectively. This finding seems to mean that the effect of dementia is so great as to override the effect of dementia. In the cortex slice, the correlations between CSF% and HDS and CDR scores were very low, though they were significant. HWFM in the same slice, showed the moderate and significant correlations with HDS and CDR scores, respectively, comparing with no relationship between HWFM and age. Concerning mean CSF% and HWFM of each group according to CDR staging, they increased with advancement of dementia. The significant differences between the groups by CDR, however, were not always obtained. According to CT indexes as independent variable, the normal subject were discriminated from the demented subjects in 82.6% of the total by discriminat analysis. (J.P.N.).

  19. Clinical diagnosis by computed tomography on Alzheimer type dementia

    International Nuclear Information System (INIS)

    Imai, Yukimichi

    1983-01-01

    The relationships of CT findings, intellectual impairment by psychological assessment and severity of dementia by clinical evaluation were studied on 109 patients with clinical diagnosis of Alzheimer type dementia (AD) and 43 controls. CT examinations were carried out on three tomographic sections, that is, a section through anterior and posterior horns of lateral ventricles, a section through cellae mediae of lateral ventricles and a section through cortex with intracranial space of 60-80 cm 2 . In the three tomographic sections, CSF space percent and half width full max (HWFM) in the histogram corresponding to brain tissue were employed as indexes of brain atrophy by CT. Psychological evaluation of dementia was made by using Hasegawa's dementia scale (HDS). The present study revealed the following findings. though CSF% in the sections through lateral ventricles significantly correlated with age, it was more significantly correlated with HDS and CDR(clinical dementia rating) scores, respectively. This finding seems to mean that the effect of dementia is so great as to override the effect of dementia. In the cortex slice, the correlations between CSF% and HDS and CDR scores were very low, though they were significant. HWFM in the same slice, showed the moderate and significant correlations with HDS and CDR scores, respectively, comparing with no relationship between HWFM and age. Concerning mean CSF% and HWFM of each group according to CDR staging, they increased with advancement of dementia. The significant differences between the groups by CDR, however, were not always obtained. According to CT indexes as independent variable, the normal subject were discriminated from the demented subjects in 82.6% of the total by discriminat analysis. (J.P.N.)

  20. Beneath sci-fi sound: primer, science fiction sound design, and American independent cinema

    OpenAIRE

    Johnston, Nessa

    2012-01-01

    Primer is a very low budget science-fiction film that deals with the subject of time travel; however, it looks and sounds quite distinctively different from other films associated with the genre. While Hollywood blockbuster sci-fi relies on “sound spectacle” as a key attraction, in contrast Primer sounds “lo-fi” and screen-centred, mixed to two channel stereo rather than the now industry-standard 5.1 surround sound. Although this is partly a consequence of the economics of its production, the...

  1. The cost effectiveness of 123I-FP-CIT SPECT imaging in patients with an uncertain clinical diagnosis of parkinsonism

    International Nuclear Information System (INIS)

    Laere, Koen van; Everaert, Ludwig; Annemans, Lieven; Gonce, Michel; Vandenberghe, Wim; Vander Borght, Thierry

    2008-01-01

    123 I-N-ω-fluoropropyl-2-β-carboxymethoxy-3β-(4-iodophenyl )nortropane ( 123 I-FP-CIT) Single-photon emission computed tomography (SPECT) has been suggested to be a useful diagnostic adjunct in patients with clinically uncertain parkinsonism. We developed a pharmaco-economic (PE) model, evaluating the cost effectiveness of adding 123 I-FP-CIT SPECT to the diagnostic workup. As the model was developed before application of the diagnostic technique in real practice, a predictive validity assessment was performed based on data from a large nationwide patient registry in these patients. A PE model, using a Markov state transition model, was created, based on literature-derived and clinical expert panel data. Effects were expressed as adequately treated years (ATY). Key input data were compared to the real-life patterns in a nationwide multi-centre clinical setting, based on a complete national registry of 1,701 consecutive patients. The change in initial diagnosis and alteration of management of the patient after SPECT were registered. In the PE model, it was calculated that management would change in 48.5% of patients by SPECT and that, over a 5-year period, 1.2 ATYs could be gained at a yearly additional cost of EUR72. From the studied 1,701 patients, nigrostriatal degeneration was observed in 59.8%, the initial diagnosis was changed in 51.5%, management was altered in 49%, and cost effectiveness was increased to EUR358 per ATY. Good correspondence between assumed and observed changes in patient management was found, indicating that 123 I-FP-CIT SPECT is influential in diagnosis and management of patients with uncertain clinical diagnosis of parkinsonism. This can be achieved at a marginal added cost to the health insurance and leads to a significant gain in ATY. (orig.)

  2. A description of externally recorded womb sounds in human subjects during gestation.

    Science.gov (United States)

    Parga, Joanna J; Daland, Robert; Kesavan, Kalpashri; Macey, Paul M; Zeltzer, Lonnie; Harper, Ronald M

    2018-01-01

    Reducing environmental noise benefits premature infants in neonatal intensive care units (NICU), but excessive reduction may lead to sensory deprivation, compromising development. Instead of minimal noise levels, environments that mimic intrauterine soundscapes may facilitate infant development by providing a sound environment reflecting fetal life. This soundscape may support autonomic and emotional development in preterm infants. We aimed to assess the efficacy and feasibility of external non-invasive recordings in pregnant women, endeavoring to capture intra-abdominal or womb sounds during pregnancy with electronic stethoscopes and build a womb sound library to assess sound trends with gestational development. We also compared these sounds to popular commercial womb sounds marketed to new parents. Intra-abdominal sounds from 50 mothers in their second and third trimester (13 to 40 weeks) of pregnancy were recorded for 6 minutes in a quiet clinic room with 4 electronic stethoscopes, placed in the right upper and lower quadrants, and left upper and lower quadrants of the abdomen. These recording were partitioned into 2-minute intervals in three different positions: standing, sitting and lying supine. Maternal and gestational age, Body Mass Index (BMI) and time since last meal were collected during recordings. Recordings were analyzed using long-term average spectral and waveform analysis, and compared to sounds from non-pregnant abdomens and commercially-marketed womb sounds selected for their availability, popularity, and claims they mimic the intrauterine environment. Maternal sounds shared certain common characteristics, but varied with gestational age. With fetal development, the maternal abdomen filtered high (500-5,000 Hz) and mid-frequency (100-500 Hz) energy bands, but no change appeared in contributions from low-frequency signals (10-100 Hz) with gestational age. Variation appeared between mothers, suggesting a resonant chamber role for intra

  3. Sound classification of dwellings

    DEFF Research Database (Denmark)

    Rasmussen, Birgit

    2012-01-01

    National schemes for sound classification of dwellings exist in more than ten countries in Europe, typically published as national standards. The schemes define quality classes reflecting different levels of acoustical comfort. Main criteria concern airborne and impact sound insulation between...... dwellings, facade sound insulation and installation noise. The schemes have been developed, implemented and revised gradually since the early 1990s. However, due to lack of coordination between countries, there are significant discrepancies, and new standards and revisions continue to increase the diversity...... is needed, and a European COST Action TU0901 "Integrating and Harmonizing Sound Insulation Aspects in Sustainable Urban Housing Constructions", has been established and runs 2009-2013, one of the main objectives being to prepare a proposal for a European sound classification scheme with a number of quality...

  4. Clinically distinct trajectories of fatigue and their longitudinal relationship with the disturbance of personal goals following a cancer diagnosis.

    Science.gov (United States)

    Müller, Fabiola; Tuinman, Marrit A; Janse, Moniek; Almansa, Josué; Sprangers, Mirjam A G; Smink, Ans; Ranchor, Adelita V; Fleer, Joke; Hagedoorn, Mariët

    2017-09-01

    Most studies on fatigue in patients with cancer aggregate its prevalence and severity on a group level, ignoring the possibility that subgroups of patients may differ widely in their development of fatigue. This study aimed to identify subgroups of patients with clinically distinct trajectories of fatigue from diagnosis to 18 months post-diagnosis. As fatigue might trigger goal disturbance, the study also identified trajectories of concrete and abstract goal disturbance and longitudinally examined their co-occurrence with fatigue. Prospective design with quantitative and qualitative method of data collection. Patients with colorectal cancer (n = 183) reported on their levels of fatigue and goal disturbance shortly after diagnosis (T 1 ) and at 7 months (T 2 ) and 18 months (T 3 ) post-diagnosis. Growth mixture model analyses were performed to identify trajectories of fatigue and goal disturbance. Guidelines for the clinical relevance of fatigue were applied. Four clinically distinct trajectories of fatigue were identified as follows: (1) persistent severe fatigue (25.4%), (2) moderate fatigue (56.1%), (3) no fatigue (13.8%), and (4) rapidly improving fatigue (4.7%). The majority of patients with cancer reported high disturbance of their concrete goals, while high disturbance of abstract goals was less evident. Fatigue and concrete goal disturbance co-occurred longitudinally. The fatigue and goal disturbance experienced from diagnosis to 18 months post-diagnosis differ considerably for subgroups of patients with cancer. Fatigue and concrete goal disturbance are persistent burdens in the majority of patients. Investigating symptom burden beyond average trends can guide clinicians to identify patients most in need for treatment. Targeting goal disturbance might benefit the psychological well-being in patients suffering from persistent symptoms. Statement of contribution What is already known on this subject? Fatigue is a common and distressing symptom at all

  5. Vocal Imitations of Non-Vocal Sounds

    Science.gov (United States)

    Houix, Olivier; Voisin, Frédéric; Misdariis, Nicolas; Susini, Patrick

    2016-01-01

    Imitative behaviors are widespread in humans, in particular whenever two persons communicate and interact. Several tokens of spoken languages (onomatopoeias, ideophones, and phonesthemes) also display different degrees of iconicity between the sound of a word and what it refers to. Thus, it probably comes at no surprise that human speakers use a lot of imitative vocalizations and gestures when they communicate about sounds, as sounds are notably difficult to describe. What is more surprising is that vocal imitations of non-vocal everyday sounds (e.g. the sound of a car passing by) are in practice very effective: listeners identify sounds better with vocal imitations than with verbal descriptions, despite the fact that vocal imitations are inaccurate reproductions of a sound created by a particular mechanical system (e.g. a car driving by) through a different system (the voice apparatus). The present study investigated the semantic representations evoked by vocal imitations of sounds by experimentally quantifying how well listeners could match sounds to category labels. The experiment used three different types of sounds: recordings of easily identifiable sounds (sounds of human actions and manufactured products), human vocal imitations, and computational “auditory sketches” (created by algorithmic computations). The results show that performance with the best vocal imitations was similar to the best auditory sketches for most categories of sounds, and even to the referent sounds themselves in some cases. More detailed analyses showed that the acoustic distance between a vocal imitation and a referent sound is not sufficient to account for such performance. Analyses suggested that instead of trying to reproduce the referent sound as accurately as vocally possible, vocal imitations focus on a few important features, which depend on each particular sound category. These results offer perspectives for understanding how human listeners store and access long

  6. The Clinical Value of Prenatal 3D Ultrasonic Diagnosis on Fetus Hemivertebra Deformity- A Preliminary Study.

    Science.gov (United States)

    Wen, Yanting; Xiang, Guishuang; Liang, Xiaoqiu; Tong, Xiaoqian

    2018-02-01

    The present study is planned to discuss the clinical value of prenatal 3D ultra-sonic diagnosis on fetus hemivertebra deformity through the retrospective analysis of clinical data of fetus hemivertebra deformity. Selected 9 fetus hemivertebra deformity cases, which have been admitted to our hospital during the period from January, 2010 to January, 2016 as study samples, and analyzed their 2D and 3D ultrasonic examination data. 4 cases of the fetus hemivertebra deformity occurred at lumbar vertebra, 3 cases at thoracic vertebra, and 2 cases at thoracolumbar vertebra. There were scoliosis and opened spine bifida (OSB). In 7 cases, there was absence of ribs in fetus. The 2D ultrasonic image showed that: The echo at the center of fetus vertebral arch lesion was blurred or lost. The coronal section showed the deformity of the spine. There was obvious loss of the ossification center. From the cross section, we could see that the vertebral body of the fetus was shrinking and the edges were relatively blurred. The 3D ultrasonic image showed that: the echo at the ossification center of the fetus vertebra was relatively blurred, or even lost. The image also indicated scoliosis deformity of the spine. The vertebral body lesion could be accurately located. 9 cases of fetus hemivertebra deformity have been detected through examination. Labor inductions have been carried out after getting the permission from the family members. The X-ray examination of the fetus after labor induction showed that the diagnosis was correct. Prenatal ultra-sonic examination holds strong potential for the diagnosis of fetus hemivertebra deformity quite early and deserves further clinical evaluation with large sample size.

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

    Science.gov (United States)

    Cottin, Vincent; Richeldi, Luca

    2014-03-01

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

  8. Sound Art Situations

    DEFF Research Database (Denmark)

    Krogh Groth, Sanne; Samson, Kristine

    2017-01-01

    and combine theories from several fields. Aspects of sound art studies, performance studies and contemporary art studies are presented in order to theoretically explore the very diverse dimensions of the two sound art pieces: Visual, auditory, performative, social, spatial and durational dimensions become......This article is an analysis of two sound art performances that took place June 2015 in outdoor public spaces in the social housing area Urbanplanen in Copenhagen, Denmark. The two performances were On the production of a poor acoustics by Brandon LaBelle and Green Interactive Biofeedback...... Environments (GIBE) by Jeremy Woodruff. In order to investigate the complex situation that arises when sound art is staged in such contexts, the authors of this article suggest exploring the events through approaching them as ‘situations’ (Doherty 2009). With this approach it becomes possible to engage...

  9. SLAP lesions: Anatomy, clinical presentation, MR imaging diagnosis and characterization

    Energy Technology Data Exchange (ETDEWEB)

    Chang, Debra [University of California San Diego, Department of Radiology, 200 W. Arbor Drive, San Diego, CA 92103 (United States); VA Healthcare System San Diego, Department of Radiology, 3350 La Jolla Village Drive, La Jolla, CA 92161 (United States); MedRay Imaging and Fraser Health Authority, Vancouver, BC (Canada)], E-mail: cbchung@ucsd.edu; Mohana-Borges, Aurea; Borso, Maya; Chung, Christine B. [University of California San Diego, Department of Radiology, 200 W. Arbor Drive, San Diego, CA 92103 (United States); VA Healthcare System San Diego, Department of Radiology, 3350 La Jolla Village Drive, La Jolla, CA 92161 (United States)

    2008-10-15

    ABSTRACT: Superior labral anterior posterior (SLAP) tears are an abnormality of the superior labrum usually centered on the attachment of the long head of the biceps tendon. Tears are commonly caused by repetitive overhead motion or fall on an outstretched arm. SLAP lesions can lead to shoulder pain and instability. Clinical diagnosis is difficult thus imaging plays a key diagnostic role. The normal anatomic variability of the capsulolabral complex can make SLAP lesions a diagnostic challenge. Concurrent shoulder injuries are often present including rotator cuff tears, cystic changes or marrow edema in the humeral head, capsular laxity, Hill-Sachs or Bankart lesion. The relevant anatomy, capsulolabral anatomic variants, primary and secondary findings of SLAP tears including MR arthrography findings, types of SLAP lesions and a practical approach to labral lesions are reviewed.

  10. Clinical manifestations in patients with computerized tomography diagnosis of neurocysticercosis

    International Nuclear Information System (INIS)

    Pfuetzenreiter, Marcia Regina; Avila-Pires, Fernando Dias de

    1999-01-01

    A survey was conducted in the urban area of Lages using patients who had been submitted to a computed tomography of the skull in the period of March-December, 1996, for different reasons. Forty-two patients with a provisional diagnosis of neurocysticercosis, and 57 negatives were personally interviewed by one of the authors (Pfuetzenreiter), using a semi-structured procedure. More individuals with a provisional diagnostic of neurocysticercosis reported clinical manifestations related to this infection than those found negative. this difference is more marked among women, except in relation to convulsions, more frequently reported by men (19.05%) than by women (7.14%). The greater percentage of inactive forms (83.33%0 and a longer history of perceived symptoms among those positives suggest that the condition is not new. (author)

  11. Update on Mastocytosis (Part 1): Pathophysiology, Clinical Features, and Diagnosis.

    Science.gov (United States)

    Azaña, J M; Torrelo, A; Matito, A

    2016-01-01

    Mastocytosis is a term used to describe a heterogeneous group of disorders characterized by clonal proliferation of mast cells in various organs. The organ most often affected is the skin. Mastocytosis is a relatively rare disorder that affects both sexes equally. It can occur at any age, although it tends to appear in the first decade of life, or later, between the second and fifth decades. Our understanding of the pathophysiology of mastocytosis has improved greatly in recent years, with the discovery that somatic c-kit mutations and aberrant immunophenotypic features have an important role. The clinical manifestations of mastocytosis are diverse, and skin lesions are the key to diagnosis in most patients. Copyright © 2015 Elsevier España, S.L.U. and AEDV. All rights reserved.

  12. A comparison of benefit and economic value between two sound therapy tinnitus management options.

    Science.gov (United States)

    Newman, Craig W; Sandridge, Sharon A

    2012-02-01

    Sound therapy coupled with appropriate counseling has gained widespread acceptance in the audiological management of tinnitus. For many years, ear level sound generators (SGs) have been used to provide masking relief and to promote tinnitus habituation. More recently, an alternative treatment device was introduced, the Neuromonics Tinnitus Treatment (NTT), which employs spectrally-modified music in an acoustic desensitization approach in order to help patients overcome the disturbing consequences of tinnitus. It is unknown, however, if one treatment plan is more efficacious and cost-effective in comparison to the other. In today's economic climate, it has become critical that clinicians justify the value of tinnitus treatment devices in relation to observed benefit. To determine perceived benefit from, and economic value associated with, two forms of sound therapy, namely, SGs and NTT. Retrospective between-subject clinical study. A sample of convenience comprised of 56 patients drawn from the Tinnitus Management Clinic at the Cleveland Clinic participated. Twenty-three patients selected SGs, and 33 patients selected NTT as their preferred sound therapy treatment option. Sound therapy benefit was quantified using the Tinnitus Handicap Inventory (THI). The questionnaire was administered before and 6 mo after initiation of tinnitus treatment. Prior to device fitting, all patients participated in a 1.5 hr group education session about tinnitus and its management. Economic value comparisons between sound therapy options were made using a cost-effectiveness analysis (CEA) and cost-utility analysis (CUA). THI scores indicated a significant improvement (p 0.05) between the treatment alternatives at baseline or 6 mo postfitting. The magnitude of improvement for both SGs and NTT was dependent on initial perceived tinnitus handicap. Based on the CEA and CUA economic analyses alone, it appears that the SGs may be the more cost-effective alternative; however, the magnitude of

  13. Clinical Utility of Amyloid PET Imaging in the Differential Diagnosis of Atypical Dementias and Its Impact on Caregivers.

    Science.gov (United States)

    Bensaïdane, Mohamed Reda; Beauregard, Jean-Mathieu; Poulin, Stéphane; Buteau, François-Alexandre; Guimond, Jean; Bergeron, David; Verret, Louis; Fortin, Marie-Pierre; Houde, Michèle; Bouchard, Rémi W; Soucy, Jean-Paul; Laforce, Robert

    2016-04-18

    Recent studies have supported a role for amyloid positron emission tomography (PET) imaging in distinguishing Alzheimer's disease (AD) pathology from other pathological protein accumulations leading to dementia. We investigated the clinical utility of amyloid PET in the differential diagnosis of atypical dementia cases and its impact on caregivers. Using the amyloid tracer 18F-NAV4694, we prospectively scanned 28 patients (mean age 59.3 y, s.d. 5.8; mean MMSE 21.4, s.d. 6.0) with an atypical dementia syndrome. Following a comprehensive diagnostic workup (i.e., history taking, neurological examination, blood tests, neuropsychological evaluation, MRI, and FDG-PET), no certain diagnosis could be arrived at. Amyloid PET was then conducted and classified as positive or negative. Attending physicians were asked to evaluate whether this result led to a change in diagnosis or altered management. They also reported their degree of confidence in the diagnosis. Caregivers were met after disclosure of amyloid PET results and completed a questionnaire/interview to assess the impact of the scan. Our cohort was evenly divided between positive (14/28) and negative (14/28) 18F-NAV4694 cases. Amyloid PET resulted in a diagnostic change in 9/28 cases (32.1%: 17.8% changed from AD to non-AD, 14.3% from non-AD to AD). There was a 44% increase in diagnostic confidence. Altered management occurred in 71.4% (20/28) of cases. Knowledge of amyloid status improved caregivers' outcomes in all domains (anxiety, depression, disease perception, future anticipation, and quality of life). This study suggests a useful additive role for amyloid PET in atypical cases with an unclear diagnosis beyond the extensive workup of a tertiary memory clinic. Amyloid PET increased diagnostic confidence and led to clinically significant alterations in management. The information gained from that test was well received by caregivers and encouraged spending quality time with their loved ones.

  14. Characteristic sounds facilitate visual search.

    Science.gov (United States)

    Iordanescu, Lucica; Guzman-Martinez, Emmanuel; Grabowecky, Marcia; Suzuki, Satoru

    2008-06-01

    In a natural environment, objects that we look for often make characteristic sounds. A hiding cat may meow, or the keys in the cluttered drawer may jingle when moved. Using a visual search paradigm, we demonstrated that characteristic sounds facilitated visual localization of objects, even when the sounds carried no location information. For example, finding a cat was faster when participants heard a meow sound. In contrast, sounds had no effect when participants searched for names rather than pictures of objects. For example, hearing "meow" did not facilitate localization of the word cat. These results suggest that characteristic sounds cross-modally enhance visual (rather than conceptual) processing of the corresponding objects. Our behavioral demonstration of object-based cross-modal enhancement complements the extensive literature on space-based cross-modal interactions. When looking for your keys next time, you might want to play jingling sounds.

  15. Repeatability of Pulse Diagnosis and Body Constitution Diagnosis in Traditional Indian Ayurveda Medicine

    Science.gov (United States)

    Waagepetersen, Rasmus; Toft, Egon; Prasad, Ramjee; Raturi, Lokesh

    2012-01-01

    In Ayurveda, pulse diagnosis and body constitution diagnosis have a long historical use; still, there is lack of quantitative measure of the reliability of these diagnostic methods. Reliability means consistency of information. Consistent diagnosis leads to consistent treatment and is important for clinical practice, education, and research. The objective of this study is to study the methodology to evaluate the test-retest reliability (repeatability) of pulse diagnosis and body constitution diagnosis. A double-blinded, controlled, clinical trial was conducted in Copenhagen. The same doctor, an expert in Ayurvedic pulse diagnosis, examined the pulse and body constitution of 17 healthy participants twice, in random order without seeing them. A metric on pulse and body constitution variables was developed. Cohen's weighted kappa statistic was used as a measure of intra-rater reliability. Permutation tests were used to test the hypothesis of homogeneous diagnosis (ie, the doctor's diagnosis does not depend on the subject). The hypothesis of homogeneous classification was rejected on the 5% significance level (P values of .02 and .001, respectively, for pulse and body constitution diagnosis). According to the Landis and Koch scale, values of the weighted kappa for pulse diagnosis (P = .42) and body constitution diagnosis (P = .65) correspond to “moderate” and “substantial” agreement, respectively. There was a reasonable level of consistency between 2 pulse and body constitution diagnoses. Further studies are required to quantify inter-subject and intra-subject agreement for greater understanding of reliability of pulse and body constitution diagnosis. PMID:27257530

  16. Design, development and test of the gearbox condition monitoring system using sound signal processing

    Directory of Open Access Journals (Sweden)

    M Zamani

    2016-09-01

    Full Text Available Introduction One of the ways used for minimizing the cost of maintenance and repairs of rotating industrial equipment is condition monitoring using acoustic analysis. One of the most important problems which always have been under consideration in industrial equipment application is confidence possibility. Each dynamic, electrical, hydraulic or thermal system has certain characteristics which show the normal condition of the machine during function. Any changes of the characteristics can be a signal of a problem in the machine. The aim of condition monitoring is system condition determination using measurements of the signals of characteristics and using this information for system impairment prognostication. There are a lot of ways for condition monitoring of different systems, but sound analysis is accepted and used extensively as a method for condition investigation of rotating machines. The aim of this research is the design and construction of considered gearbox and using of obtaining data in frequency and time spectrum in order to analyze the sound and diagnosis. Materials and Methods This research was conducted at the department of mechanical biosystem workshop at Aboureihan College at Tehran University in February 15th.2015. In this research, in order to investigate the trend of diagnosis and gearbox condition, a system was designed and then constructed. The sound of correct and damaged gearbox was investigated by audiometer and stored in computer for data analysis. Sound measurement was done in three pinions speed of 749, 1050 and 1496 rpm and for correct gearboxes, damage of the fracture of a tooth and a tooth wear. Gearbox design and construction: In order to conduct the research, a gearbox with simple gearwheels was designed according to current needs. Then mentioned gearbox and its accessories were modeled in CATIA V5-R20 software and then the system was constructed. Gearbox is a machine that is used for mechanical power transition

  17. Demystifying the Clinical Diagnosis of Greater Trochanteric Pain Syndrome in Women.

    Science.gov (United States)

    Ganderton, Charlotte; Semciw, Adam; Cook, Jill; Pizzari, Tania

    2017-06-01

    To evaluate the diagnostic accuracy of 10 clinical tests that can be used in the diagnosis of greater trochanteric pain syndrome (GTPS) in women, and to compare these clinical tests to magnetic resonance imaging (MRI) findings. Twenty-eight participants with GTPS (49.5 ± 22.0 years) and 18 asymptomatic participants (mean age ± standard deviation [SD], 52.5 ± 22.8 years) were included. A blinded physiotherapist performed 10 pain provocation tests potentially diagnostic for GTPS-palpation of the greater trochanter, resisted external derotation test, modified resisted external derotation test, standard and modified Ober's tests, Patrick's or FABER test, resisted hip abduction, single-leg stance test, and the resisted hip internal rotation test. A sample of 16 symptomatic and 17 asymptomatic women undertook a hip MRI scan. Gluteal tendons were evaluated and categorized as no pathology, mild tendinosis, moderate tendinosis/partial tear, or full-thickness tear. Clinical test analyses show high specificity, high positive predictive value, low to moderate sensitivity, and negative predictive value for most clinical tests. All symptomatic and 88% of asymptomatic participants had pathological gluteal tendon changes on MRI, from mild tendinosis to full-thickness tear. The study found the Patrick's or FABER test, palpation of the greater trochanter, resisted hip abduction, and the resisted external derotation test to have the highest diagnostic test accuracy for GTPS. Tendon pathology on MRI is seen in both symptomatic and asymptomatic women.

  18. Determining the speed of sound in the air by sound wave interference

    Science.gov (United States)

    Silva, Abel A.

    2017-07-01

    Mechanical waves propagate through material media. Sound is an example of a mechanical wave. In fluids like air, sound waves propagate through successive longitudinal perturbations of compression and decompression. Audible sound frequencies for human ears range from 20 to 20 000 Hz. In this study, the speed of sound v in the air is determined using the identification of maxima of interference from two synchronous waves at frequency f. The values of v were correct to 0 °C. The experimental average value of {\\bar{ν }}\\exp =336 +/- 4 {{m}} {{{s}}}-1 was found. It is 1.5% larger than the reference value. The standard deviation of 4 m s-1 (1.2% of {\\bar{ν }}\\exp ) is an improved value by the use of the concept of the central limit theorem. The proposed procedure to determine the speed of sound in the air aims to be an academic activity for physics classes of scientific and technological courses in college.

  19. Fluid Sounds

    DEFF Research Database (Denmark)

    Explorations and analysis of soundscapes have, since Canadian R. Murray Schafer's work during the early 1970's, developed into various established research - and artistic disciplines. The interest in sonic environments is today present within a broad range of contemporary art projects and in arch......Explorations and analysis of soundscapes have, since Canadian R. Murray Schafer's work during the early 1970's, developed into various established research - and artistic disciplines. The interest in sonic environments is today present within a broad range of contemporary art projects...... and in architectural design. Aesthetics, psychoacoustics, perception, and cognition are all present in this expanding field embracing such categories as soundscape composition, sound art, sonic art, sound design, sound studies and auditory culture. Of greatest significance to the overall field is the investigation...

  20. The influence of environmental sound training on the perception of spectrally degraded speech and environmental sounds.

    Science.gov (United States)

    Shafiro, Valeriy; Sheft, Stanley; Gygi, Brian; Ho, Kim Thien N

    2012-06-01

    Perceptual training with spectrally degraded environmental sounds results in improved environmental sound identification, with benefits shown to extend to untrained speech perception as well. The present study extended those findings to examine longer-term training effects as well as effects of mere repeated exposure to sounds over time. Participants received two pretests (1 week apart) prior to a week-long environmental sound training regimen, which was followed by two posttest sessions, separated by another week without training. Spectrally degraded stimuli, processed with a four-channel vocoder, consisted of a 160-item environmental sound test, word and sentence tests, and a battery of basic auditory abilities and cognitive tests. Results indicated significant improvements in all speech and environmental sound scores between the initial pretest and the last posttest with performance increments following both exposure and training. For environmental sounds (the stimulus class that was trained), the magnitude of positive change that accompanied training was much greater than that due to exposure alone, with improvement for untrained sounds roughly comparable to the speech benefit from exposure. Additional tests of auditory and cognitive abilities showed that speech and environmental sound performance were differentially correlated with tests of spectral and temporal-fine-structure processing, whereas working memory and executive function were correlated with speech, but not environmental sound perception. These findings indicate generalizability of environmental sound training and provide a basis for implementing environmental sound training programs for cochlear implant (CI) patients.

  1. Sound Surfing Network (SSN): Mobile Phone-based Sound Spatialization with Audience Collaboration

    OpenAIRE

    Park, Saebyul; Ban, Seonghoon; Hong, Dae Ryong; Yeo, Woon Seung

    2013-01-01

    SSN (Sound Surfing Network) is a performance system that provides a new musicalexperience by incorporating mobile phone-based spatial sound control tocollaborative music performance. SSN enables both the performer and theaudience to manipulate the spatial distribution of sound using the smartphonesof the audience as distributed speaker system. Proposing a new perspective tothe social aspect music appreciation, SSN will provide a new possibility tomobile music performances in the context of in...

  2. Clinical Guidelines for the Diagnosis and Treatment of Cushing's Disease in Korea

    Directory of Open Access Journals (Sweden)

    Kyu Yeon Hur

    2015-03-01

    Full Text Available Cushing's disease (CD is a rare disorder characterized by the overproduction of adrenocorticotropic hormone due to a pituitary adenoma that ultimately stimulates excessive cortisol secretion from the adrenal glands. Prior to the detection of pituitary adenomas, various clinical signs of CD such as central obesity, moon face, hirsutism, and facial plethora are usually already present. Uncontrolled hypercortisolism is associated with metabolic, cardiovascular, and psychological disorders that result in increased mortality. Hence, the early detection and treatment of CD are not only important but mandatory. Because its clinical manifestations vary from patient to patient and are common in other obesity-related conditions, the precise diagnosis of CD can be problematic. Thus, the present set of guidelines was compiled by Korean experts in this field to assist clinicians with the screening, diagnoses, and treatment of patients with CD using currently available tests and treatment modalities.

  3. Sound Exposure of Symphony Orchestra Musicians

    DEFF Research Database (Denmark)

    Schmidt, Jesper Hvass; Pedersen, Ellen Raben; Juhl, Peter Møller

    2011-01-01

    dBA and their left ear was exposed 4.6 dB more than the right ear. Percussionists were exposed to high sound peaks >115 dBC but less continuous sound exposure was observed in this group. Musicians were exposed up to LAeq8h of 92 dB and a majority of musicians were exposed to sound levels exceeding......Background: Assessment of sound exposure by noise dosimetry can be challenging especially when measuring the exposure of classical orchestra musicians where sound originate from many different instruments. A new measurement method of bilateral sound exposure of classical musicians was developed...... and used to characterize sound exposure of the left and right ear simultaneously in two different symphony orchestras.Objectives: To measure binaural sound exposure of professional classical musicians and to identify possible exposure risk factors of specific musicians.Methods: Sound exposure was measured...

  4. 10 Hz Amplitude Modulated Sounds Induce Short-Term Tinnitus Suppression

    Directory of Open Access Journals (Sweden)

    Patrick Neff

    2017-05-01

    Full Text Available Objectives: Acoustic stimulation or sound therapy is proposed as a main treatment option for chronic subjective tinnitus. To further probe the field of acoustic stimulations for tinnitus therapy, this exploratory study compared 10 Hz amplitude modulated (AM sounds (two pure tones, noise, music, and frequency modulated (FM sounds and unmodulated sounds (pure tone, noise regarding their temporary suppression of tinnitus loudness. First, it was hypothesized that modulated sounds elicit larger temporary loudness suppression (residual inhibition than unmodulated sounds. Second, with manipulation of stimulus loudness and duration of the modulated sounds weaker or stronger effects of loudness suppression were expected, respectively.Methods: We recruited 29 participants with chronic tonal tinnitus from the multidisciplinary Tinnitus Clinic of the University of Regensburg. Participants underwent audiometric, psychometric and tinnitus pitch matching assessments followed by an acoustic stimulation experiment with a tinnitus loudness growth paradigm. In a first block participants were stimulated with all of the sounds for 3 min each and rated their subjective tinnitus loudness to the pre-stimulus loudness every 30 s after stimulus offset. The same procedure was deployed in the second block with the pure tone AM stimuli matched to the tinnitus frequency, manipulated in length (6 min, and loudness (reduced by 30 dB and linear fade out. Repeated measures mixed model analyses of variance (ANOVA were calculated to assess differences in loudness growth between the stimuli for each block separately.Results: First, we found that all sounds elicit a short-term suppression of tinnitus loudness (seconds to minutes with strongest suppression right after stimulus offset [F(6, 1331 = 3.74, p < 0.01]. Second, similar to previous findings we found that AM sounds near the tinnitus frequency produce significantly stronger tinnitus loudness suppression than noise [vs. Pink

  5. Silence–breathing–snore classification from snore-related sounds

    International Nuclear Information System (INIS)

    Karunajeewa, Asela S; Abeyratne, Udantha R; Hukins, Craig

    2008-01-01

    Obstructive sleep apnea (OSA) is a highly prevalent disease in which upper airways are collapsed during sleep, leading to serious consequences. Snoring is the earliest symptom of OSA, but its potential in clinical diagnosis is not fully recognized yet. The first task in the automatic analysis of snore-related sounds (SRS) is to segment the SRS data as accurately as possible into three main classes: snoring (voiced non-silence), breathing (unvoiced non-silence) and silence. SRS data are generally contaminated with background noise. In this paper, we present classification performance of a new segmentation algorithm based on pattern recognition. We considered four features derived from SRS to classify samples of SRS into three classes. The features—number of zero crossings, energy of the signal, normalized autocorrelation coefficient at 1 ms delay and the first predictor coefficient of linear predictive coding (LPC) analysis—in combination were able to achieve a classification accuracy of 90.74% in classifying a set of test data. We also investigated the performance of the algorithm when three commonly used noise reduction (NR) techniques in speech processing—amplitude spectral subtraction (ASS), power spectral subtraction (PSS) and short time spectral amplitude (STSA) estimation—are used for noise reduction. We found that noise reduction together with a proper choice of features could improve the classification accuracy to 96.78%, making the automated analysis a possibility

  6. Early diagnosis of sub-clinical stage of diabetic retinopathy

    Directory of Open Access Journals (Sweden)

    Xing-Hui Xu

    2014-12-01

    Full Text Available AIM: To evaluate the early diagnosis of sub-clinic stage of diabetic retinopathy.METHODS: This was cross sectional study,multifocal retina electroretinogram(mf-ERG, contrast sensitivity(CSand central retinal artery color Doppler examination were recorded from 30 cases(30 eyesmatched control subjects, 35 cases(35 eyeswith type 2 diabetes mellitus(DMwithout diabetic retinopathy(NDRand 38 cases(38 eyeswith non-prolifera tive diabetic retinopathy(NPDR. One-way ANOVA and SNK-q test were used for data analysis.RESULTS: P1 response density of NDR patients were found decrease, N1 implicit time were delayed. Which were related with the degree of retinopathy(PPPP>0.05, The differences between normal group, NDR group and NPDR group were found statistically significant(PCONCLUSION: mf-ERG and CS are sensitive indexes for early evaluation of visual function in patients with diabetes mellitus, with development of the disease, CRA blood flow also appears to decline.

  7. Letter-Sound Reading: Teaching Preschool Children Print-to-Sound Processing

    Science.gov (United States)

    Wolf, Gail Marie

    2016-01-01

    This intervention study investigated the growth of letter sound reading and growth of consonant-vowel-consonant (CVC) word decoding abilities for a representative sample of 41 US children in preschool settings. Specifically, the study evaluated the effectiveness of a 3-step letter-sound teaching intervention in teaching preschool children to…

  8. Biochemical Benefits, Diagnosis, and Clinical Risks Evaluation of Kratom

    Directory of Open Access Journals (Sweden)

    Dimy Fluyau

    2017-04-01

    Full Text Available BackgroundKratom (Mitragyna speciosa is a tropical tree with a long history of traditional use in parts of Africa and Southeast Asia. Kratom is also known as Thom, Thang, and Biak. Its leaves and the teas brewed from them have long been used by people in that region to manage pain and opioid withdrawal and to stave off fatigue. Kratom is actually consumed throughout the world for its stimulant effects and as an opioid substitute (in form of tea, chewed, smoked, or ingested in capsules. Some case reports have associated kratom exposure with psychosis, seizures, intrahepatic cholestasis, other medical conditions, and deaths. The clinical manifestations of kratom effects are not well defined and the clinical studies are limited. Data research suggest that both stimulant and sedative dose-dependent effects do exist, in addition to antinociceptive, antidepressant activity, anxiolytic-like effects, and anorectic effects, but a growing concern for the drug’s effects and safety of use has resulted in national and international attention primarily due to an increase in hospital visits and deaths in several countries that are believed to have been caused by extracts of the plant. There is a dearth of double blind controlled studies. In this study, we aim to use existing literature to clarify both benefits and risks of kratom as well as its diagnosis evaluation as kratom misuse is an emerging trend in the Western world.MethodsLiterature review using databases such as Embase, Medline, PubMed, Cochrane Library, and Mendeley from 2007 to 2017 were evaluated by all authors to analyze current state on benefits, risks, and diagnosis evaluation of kratom (M. speciosa.ResultsData analysis suggested that kratom possesses some benefits such as stimulant and sedative effects as wells as antinociceptive effects. It seems to inhibit pro-inflammatory mediator release and vascular permeability and can enhance immunity. In addition, it may be an antidepressant and

  9. Clinical Significance of Reticulocyte Hemoglobin Content in the Diagnosis of Iron Deficiency Anemia

    Directory of Open Access Journals (Sweden)

    Mustafa Karagülle

    2013-06-01

    Full Text Available OBJECTIVE: The aim of this study was to evaluate the clinical significance of reticulocyte hemoglobin content (CHr in the diagnosis of iron deficiency anemia (IDA and to compare it with other conventional iron parameters. METHODS: A total of 32 female patients with IDA (serum hemoglobin 120 g/L and serum ferritin <20 ng/mL were enrolled. RESULTS: CHr was 24.95±3.92 pg in female patients with IDA and 29.93±2.96 pg in female patients with iron deficiency. CHr showed a significant positive correlation with hemoglobin, mean corpuscular volume, mean corpuscular hemoglobin, mean corpuscular hemoglobin concentration, serum iron, and transferrin saturation and a significant negative correlation with transferrin and total iron-binding capacity. The cut-off value of CHr for detecting IDA was 29 pg. CONCLUSION: Our data demonstrate that CHr is a useful parameter that can be confidently used in the diagnosis of IDA, and a CHr cut-off value of 29 pg predicts IDA.

  10. Classification and Clinical Diagnosis of Fibromyalgia Syndrome: Recommendations of Recent Evidence-Based Interdisciplinary Guidelines

    Directory of Open Access Journals (Sweden)

    Mary-Ann Fitzcharles

    2013-01-01

    Full Text Available Objectives. Fibromyalgia syndrome (FMS, characterized by subjective complaints without physical or biomarker abnormality, courts controversy. Recommendations in recent guidelines addressing classification and diagnosis were examined for consistencies or differences. Methods. Systematic searches from January 2008 to February 2013 of the US-American National Guideline Clearing House, the Scottish Intercollegiate Guidelines Network, Guidelines International Network, and Medline for evidence-based guidelines for the management of FMS were conducted. Results. Three evidence-based interdisciplinary guidelines, independently developed in Canada, Germany, and Israel, recommended that FMS can be clinically diagnosed by a typical cluster of symptoms following a defined evaluation including history, physical examination, and selected laboratory tests, to exclude another somatic disease. Specialist referral is only recommended when some other physical or mental illness is reasonably suspected. The diagnosis can be based on the (modified preliminary American College of Rheumatology (ACR 2010 diagnostic criteria. Discussion. Guidelines from three continents showed remarkable consistency regarding the clinical concept of FMS, acknowledging that FMS is neither a distinct rheumatic nor mental disorder, but rather a cluster of symptoms, not explained by another somatic disease. While FMS remains an integral part of rheumatology, it is not an exclusive rheumatic condition and spans a broad range of medical disciplines.

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

    Science.gov (United States)

    Miller, Chad S

    2013-01-01

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

  12. Computerized respiratory sounds: a comparison between patients with stable and exacerbated COPD.

    Science.gov (United States)

    Jácome, Cristina; Oliveira, Ana; Marques, Alda

    2017-09-01

    Diagnosis of acute exacerbations of chronic obstructive pulmonary disease (AECOPD) is often challenging as it relies on patients' clinical presentation. Computerized respiratory sounds (CRS), namely crackles and wheezes, may have the potential to contribute for the objective diagnosis/monitoring of an AECOPD. This study explored if CRS differ during stable and exacerbation periods in patients with COPD. 13 patients with stable COPD and 14 with AECOPD were enrolled. CRS were recorded simultaneously at trachea, anterior, lateral and posterior chest locations using seven stethoscopes. Airflow (0.4-0.6l/s) was recorded with a pneumotachograph. Breathing phases were detected using airflow signals; crackles and wheezes with validated algorithms. At trachea, anterior and lateral chest, no significant differences were found between the two groups in the number of inspiratory/expiratory crackles or inspiratory wheeze occupation rate. At posterior chest, the number of crackles (median 2.97-3.17 vs. 0.83-1.2, P < 0.001) and wheeze occupation rate (median 3.28%-3.8% vs. 1.12%-1.77%, P = 0.014-0.016) during both inspiration and expiration were significantly higher in patients with AECOPD than in stable patients. During expiration, wheeze occupation rate was also significantly higher in patients with AECOPD at trachea (median 3.12% vs. 0.79%, P < 0.001) and anterior chest (median 3.55% vs. 1.28%, P < 0.001). Crackles and wheezes are more frequent in patients with AECOPD than in stable patients, particularly at posterior chest. These findings suggest that these CRS can contribute to the objective diagnosis/monitoring of AECOPD, which is especially valuable considering that they can be obtained by integrating computerized techniques with pulmonary auscultation, a noninvasive method that is a component of patients' physical examination. © 2015 John Wiley & Sons Ltd.

  13. Modelling Hyperboloid Sound Scattering

    DEFF Research Database (Denmark)

    Burry, Jane; Davis, Daniel; Peters, Brady

    2011-01-01

    The Responsive Acoustic Surfaces workshop project described here sought new understandings about the interaction between geometry and sound in the arena of sound scattering. This paper reports on the challenges associated with modelling, simulating, fabricating and measuring this phenomenon using...... both physical and digital models at three distinct scales. The results suggest hyperboloid geometry, while difficult to fabricate, facilitates sound scattering....

  14. Comparison of clinical judgment and diagnostic ultrasonography in the diagnosis of acute appendicitis

    DEFF Research Database (Denmark)

    Jahn, H; Mathiesen, F K; Neckelmann, K

    1997-01-01

    , and diagnostic aids are desirable to reduce the negative appendicectomy rate. Diagnostic US performed poorly as a routine procedure. Application of an up to date scoring system might be of some help to patients with a high or low probability of acute appendicitis, but any conclusion about its clinical......OBJECTIVE: To evaluate the diagnostic accuracy of clinical judgment and diagnostic ultrasonography (US) used routinely and to create a scoring system to aid diagnosis. DESIGN: Prospective, double-blind study. SETTING: University hospital, Denmark. SUBJECTS: 222 Consecutive patients suspected...... of having acute appendicitis admitted between 0800 and midnight from June 1990 to June 1992. INTERVENTIONS: 148 Patients (67%) underwent appendicectomy and the remaining 74 patients were observed. 193 Patients (87%) had a diagnostic US examination. 21 Predictive variables were collected prospectively...

  15. The influence of ski helmets on sound perception and sound localisation on the ski slope

    Directory of Open Access Journals (Sweden)

    Lana Ružić

    2015-04-01

    Full Text Available Objectives: The aim of the study was to investigate whether a ski helmet interferes with the sound localization and the time of sound perception in the frontal plane. Material and Methods: Twenty-three participants (age 30.7±10.2 were tested on the slope in 2 conditions, with and without wearing the ski helmet, by 6 different spatially distributed sound stimuli per each condition. Each of the subjects had to react when hearing the sound as soon as possible and to signalize the correct side of the sound arrival. Results: The results showed a significant difference in the ability to localize the specific ski sounds; 72.5±15.6% of correct answers without a helmet vs. 61.3±16.2% with a helmet (p < 0.01. However, the performance on this test did not depend on whether they were used to wearing a helmet (p = 0.89. In identifying the timing, at which the sound was firstly perceived, the results were also in favor of the subjects not wearing a helmet. The subjects reported hearing the ski sound clues at 73.4±5.56 m without a helmet vs. 60.29±6.34 m with a helmet (p < 0.001. In that case the results did depend on previously used helmets (p < 0.05, meaning that that regular usage of helmets might help to diminish the attenuation of the sound identification that occurs because of the helmets. Conclusions: Ski helmets might limit the ability of a skier to localize the direction of the sounds of danger and might interfere with the moment, in which the sound is firstly heard.

  16. Miscellaneous conditions of the shoulder: Anatomical, clinical, and pictorial review emphasizing potential pitfalls in imaging diagnosis

    International Nuclear Information System (INIS)

    Farid, Nikdokht; Bruce, Dean; Chung, Christine B.

    2008-01-01

    The purpose of this article is to review the key imaging findings in major categories of pathology affecting the shoulder joint including hydroxyapatite deposition disease, rotator cuff interval pathology, acromioclavicular joint pathology, glenohumeral osteoarthrosis, and synovial inflammatory processes, with specific emphasis on findings that have associated pitfalls in imaging diagnosis. The pathophysiology and clinical manifestations of the above mentioned categories of pathology will be reviewed, followed in each section by a detailed pictorial review of the key imaging findings in each category including plain film, computed tomography, and magnetic resonance imaging findings as applicable. Imaging challenges that relate to both diagnosis and characterization will be addressed with each type of pathology. The goal is that after reading this article, the reader will be able to recognize the key imaging findings in major categories of pathology affecting the shoulder joint and will become familiar with the potential pitfalls in their imaging diagnosis

  17. Miscellaneous conditions of the shoulder: Anatomical, clinical, and pictorial review emphasizing potential pitfalls in imaging diagnosis

    Energy Technology Data Exchange (ETDEWEB)

    Farid, Nikdokht [University of California San Diego, Department of Radiology, 200 West Arbor Drive, San Diego, CA 92103 (United States); VA Healthcare System San Diego, Department of Radiology, 3350 La Jolla Village Drive, La Jolla, CA 92161 (United States); Bruce, Dean [University of California San Diego, Department of Radiology, 200 West Arbor Drive, San Diego, CA 92103 (United States); VA Healthcare System San Diego, Department of Radiology, 3350 La Jolla Village Drive, La Jolla, CA 92161 (United States); University of Alberta, Edmonton, Alberta (Canada); Chung, Christine B. [University of California San Diego, Department of Radiology, 200 West Arbor Drive, San Diego, CA 92103 (United States); VA Healthcare System San Diego, Department of Radiology, 3350 La Jolla Village Drive, La Jolla, CA 92161 (United States)], E-mail: cbchung@ucsd.edu

    2008-10-15

    The purpose of this article is to review the key imaging findings in major categories of pathology affecting the shoulder joint including hydroxyapatite deposition disease, rotator cuff interval pathology, acromioclavicular joint pathology, glenohumeral osteoarthrosis, and synovial inflammatory processes, with specific emphasis on findings that have associated pitfalls in imaging diagnosis. The pathophysiology and clinical manifestations of the above mentioned categories of pathology will be reviewed, followed in each section by a detailed pictorial review of the key imaging findings in each category including plain film, computed tomography, and magnetic resonance imaging findings as applicable. Imaging challenges that relate to both diagnosis and characterization will be addressed with each type of pathology. The goal is that after reading this article, the reader will be able to recognize the key imaging findings in major categories of pathology affecting the shoulder joint and will become familiar with the potential pitfalls in their imaging diagnosis.

  18. Validation of a clinical practice-based algorithm for the diagnosis of autosomal recessive cerebellar ataxias based on NGS identified cases.

    Science.gov (United States)

    Mallaret, Martial; Renaud, Mathilde; Redin, Claire; Drouot, Nathalie; Muller, Jean; Severac, Francois; Mandel, Jean Louis; Hamza, Wahiba; Benhassine, Traki; Ali-Pacha, Lamia; Tazir, Meriem; Durr, Alexandra; Monin, Marie-Lorraine; Mignot, Cyril; Charles, Perrine; Van Maldergem, Lionel; Chamard, Ludivine; Thauvin-Robinet, Christel; Laugel, Vincent; Burglen, Lydie; Calvas, Patrick; Fleury, Marie-Céline; Tranchant, Christine; Anheim, Mathieu; Koenig, Michel

    2016-07-01

    Establishing a molecular diagnosis of autosomal recessive cerebellar ataxias (ARCA) is challenging due to phenotype and genotype heterogeneity. We report the validation of a previously published clinical practice-based algorithm to diagnose ARCA. Two assessors performed a blind analysis to determine the most probable mutated gene based on comprehensive clinical and paraclinical data, without knowing the molecular diagnosis of 23 patients diagnosed by targeted capture of 57 ataxia genes and high-throughput sequencing coming from a 145 patients series. The correct gene was predicted in 61 and 78 % of the cases by the two assessors, respectively. There was a high inter-rater agreement [K = 0.85 (0.55-0.98) p < 0.001] confirming the algorithm's reproducibility. Phenotyping patients with proper clinical examination, imaging, biochemical investigations and nerve conduction studies remain crucial for the guidance of molecular analysis and to interpret next generation sequencing results. The proposed algorithm should be helpful for diagnosing ARCA in clinical practice.

  19. The Personality Inventory Scales: a self-rating clinical instrument for diagnosis of personality disorder.

    Science.gov (United States)

    Burgess, J W

    1991-12-01

    A personality inventory was developed as an aid in securing history and beliefs relevant to the assessment of personality structure and the diagnosis of personality disorders. The inventory was developed by restating DSM diagnostic criteria in everyday language, rewording the resulting statements in the form of True/False questions, and placing these questions in a short, self-paced booklet which subjects could complete in about 15 minutes. The following assessments were made and discussed: construct validity, split-half reliability, test-retest reliability, comparison with a standardized interview, and comparison with actual clinical assessments. The personality inventory is discussed as a useful accompaniment to the diagnostic interview in clinical settings and for research into personality structure and personality disorders.

  20. Adaptive Wavelet Threshold Denoising Method for Machinery Sound Based on Improved Fruit Fly Optimization Algorithm

    Directory of Open Access Journals (Sweden)

    Jing Xu

    2016-07-01

    Full Text Available As the sound signal of a machine contains abundant information and is easy to measure, acoustic-based monitoring or diagnosis systems exhibit obvious superiority, especially in some extreme conditions. However, the sound directly collected from industrial field is always polluted. In order to eliminate noise components from machinery sound, a wavelet threshold denoising method optimized by an improved fruit fly optimization algorithm (WTD-IFOA is proposed in this paper. The sound is firstly decomposed by wavelet transform (WT to obtain coefficients of each level. As the wavelet threshold functions proposed by Donoho were discontinuous, many modified functions with continuous first and second order derivative were presented to realize adaptively denoising. However, the function-based denoising process is time-consuming and it is difficult to find optimal thresholds. To overcome these problems, fruit fly optimization algorithm (FOA was introduced to the process. Moreover, to avoid falling into local extremes, an improved fly distance range obeying normal distribution was proposed on the basis of original FOA. Then, sound signal of a motor was recorded in a soundproof laboratory, and Gauss white noise was added into the signal. The simulation results illustrated the effectiveness and superiority of the proposed approach by a comprehensive comparison among five typical methods. Finally, an industrial application on a shearer in coal mining working face was performed to demonstrate the practical effect.