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Sample records for syndrome diagnostic criteria

  1. Diagnostic criteria for Susac syndrome

    NARCIS (Netherlands)

    Kleffner, Ilka; Dörr, Jan; Ringelstein, Marius; Gross, Catharina C; Böckenfeld, Yvonne; Schwindt, Wolfram; Sundermann, Benedikt; Lohmann, Hubertus; Wersching, Heike; Promesberger, Julia; von Königsmarck, Natascha; Alex, Anne; Guthoff, Rainer; Frijns, Catharina J M; Kappelle, L Jaap; Jarius, Sven; Wildemann, Brigitte; Aktas, Orhan; Paul, Friedemann; Wiendl, Heinz; Duning, Thomas

    2016-01-01

    BACKGROUND: Susac syndrome is characterised by the triad of encephalopathy with or without focal neurological signs, branch retinal artery occlusions and hearing loss. Establishment of the diagnosis is often delayed because the triad is complete only in a minority of patients at disease onset. This

  2. Rett Syndrome: Revised Diagnostic Criteria and Nomenclature

    Science.gov (United States)

    Neul, Jeffrey L.; Kaufmann, Walter E.; Glaze, Daniel G.; Christodoulou, John; Clarke, Angus J.; Bahi-Buisson, Nadia; Leonard, Helen; Bailey, Mark E. S.; Schanen, N. Carolyn; Zappella, Michele; Renieri, Alessandra; Huppke, Peter; Percy, Alan K.

    2010-01-01

    Objective Rett syndrome (RTT) is a severe neurodevelopmental disease that affects approximately 1 in 10,000 live female births and is often caused by mutations in Methyl-CpG-binding protein 2 (MECP2). Despite distinct clinical features, the accumulation of clinical and molecular information in recent years has generated considerable confusion regarding the diagnosis of RTT. The purpose of this work was revise and clarify 2002 consensus criteria for the diagnosis of RTT in anticipation of treatment trials. Method RettSearch members, representing the majority of the international clinical RTT specialists, participated in an iterative process to come to a consensus on a revised and simplified clinical diagnostic criteria for RTT. Results The clinical criteria required for the diagnosis of classic and atypical RTT were clarified and simplified. Guidelines for the diagnosis and molecular evaluation of specific variant forms of RTT were developed. Interpretation These revised criteria provide clarity regarding the key features required for the diagnosis of RTT and reinforce the concept that RTT is a clinical diagnosis based on distinct clinical criteria, independent of molecular findings. We recommend that these criteria and guidelines be utilized in any proposed clinical research. PMID:21154482

  3. Revised diagnostic criteria for the Marfan syndrome

    NARCIS (Netherlands)

    de Paepe, A.; Devereux, R. B.; Dietz, H. C.; Hennekam, R. C.; Pyeritz, R. E.

    1996-01-01

    In 1986, the diagnosis of the Marfan syndrome was codified on the basis of clinical criteria in the Berlin nosology [Beighton et al., 1988]. Over time, weaknesses have emerged in these criteria, a problem accentuated by the advent of molecular testing. In this paper, we propose a revision of

  4. Diagnostic criteria for constitutional mismatch repair deficiency syndrome

    DEFF Research Database (Denmark)

    Wimmer, Katharina; Kratz, Christian P; Vasen, Hans F A

    2014-01-01

    Constitutional mismatch repair deficiency (CMMRD) syndrome is a distinct childhood cancer predisposition syndrome that results from biallelic germline mutations in one of the four MMR genes, MLH1, MSH2, MSH6 or PMS2. The tumour spectrum is very broad, including mainly haematological, brain...... and intestinal tract tumours. Patients show a variety of non-malignant features that are indicative of CMMRD. However, currently no criteria that should entail diagnostic evaluation of CMMRD exist. We present a three-point scoring system for the suspected diagnosis CMMRD in a paediatric/young adult cancer....... They include multiple hyperpigmented and hypopigmented skin areas, brain malformations, pilomatricomas, a second childhood malignancy, a Lynch syndrome (LS)-associated tumour in a relative and parental consanguinity. According to the scoring system, CMMRD should be suspected in any cancer patient who reaches...

  5. Validation of proposed diagnostic criteria (the "Budapest Criteria") for Complex Regional Pain Syndrome

    NARCIS (Netherlands)

    Harden, R.N.; Bruehl, S.; Perez, R.S.G.M.; Birklein, F.; Marinus, J.; Maihofner, C.; Lubenow, T.; Buvanendran, A.; Mackey, S.; Graciosa, J.; Mogilevski, M.; Ramsden, C.; Chont, M.; Vatine, J.J.

    2010-01-01

    Current IASP diagnostic criteria for CRPS have low specificity, potentially leading to overdiagnosis. This validation study compared current IASP diagnostic criteria for CRPS to proposed new diagnostic criteria (the "Budapest Criteria") regarding diagnostic accuracy. Structured evaluations of

  6. Olfactory Reference Syndrome: Diagnostic Criteria and Differential Diagnosis

    Directory of Open Access Journals (Sweden)

    Lochner C

    2003-01-01

    Full Text Available Olfactory reference syndrome (ORS has been defined as a psychiatric condition characterized by persistent preoccupation about body odour accompanied by shame, embarrassment, significant distress, avoidance behaviour and social isolation. ORS has however not been included in the Diagnostic and Statistical Manual of Mental Disorders (4th edition (DSM-IV and, given that its primary symptoms may be found in various other disorders, differential diagnosis can be problematic. Using an illustrative case of ORS, we propose diagnostic criteria for ORS. We also argue that ORS represents a unique cluster of symptoms that can be delineated as a separate diagnostic entity, and that ORS falls on a spectrum of social anxiety disorders that includes social anxiety disorder, taijin kyofusho, and body dysmorphic disorder.

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

    Science.gov (United States)

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

    2013-12-01

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

  8. Neurogenic thoracic outlet syndrome: current diagnostic criteria and advances in MRI diagnostics.

    Science.gov (United States)

    Magill, Stephen T; Brus-Ramer, Marcel; Weinstein, Philip R; Chin, Cynthia T; Jacques, Line

    2015-09-01

    Neurogenic thoracic outlet syndrome (nTOS) is caused by compression of the brachial plexus as it traverses from the thoracic outlet to the axilla. Diagnosing nTOS can be difficult because of overlap with other complex pain and entrapment syndromes. An nTOS diagnosis is made based on patient history, physical exam, electrodiagnostic studies, and, more recently, interpretation of MR neurograms with tractography. Advances in high-resolution MRI and tractography can confirm an nTOS diagnosis and identify the location of nerve compression, allowing tailored surgical decompression. In this report, the authors review the current diagnostic criteria, present an update on advances in MRI, and provide case examples demonstrating how MR neurography (MRN) can aid in diagnosing nTOS. The authors conclude that improved high-resolution MRN and tractography are valuable tools for identifying the source of nerve compression in patients with nTOS and can augment current diagnostic modalities for this syndrome.

  9. Polycystic Ovary Syndrome (PCOS), Diagnostic Criteria, and AMH

    OpenAIRE

    Mohammad, Majid Bani; Seghinsara, Abbas Majdi

    2017-01-01

    The polycystic ovary syndrome (PCOS) is the most common cause of anovulatory infertility and a notable proportion of women of reproductive age are affected. It may constitute a risk factor for cancer development. Different factors could result in different manifestations and many of these are related to predispositions. It is essential to establish criteria to achieve an exact diagnosis of PCOS, especially among adolescent patients because of the overlap between features of PCO syndrome and p...

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

    DEFF Research Database (Denmark)

    Pedersen, A.M.; Nauntofte, Birgitte

    2001-01-01

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

  11. Validation of proposed diagnostic criteria (the "Budapest Criteria") for Complex Regional Pain Syndrome.

    Science.gov (United States)

    Harden, R Norman; Bruehl, Stephen; Perez, Roberto S G M; Birklein, Frank; Marinus, Johan; Maihofner, Christian; Lubenow, Timothy; Buvanendran, Asokumar; Mackey, Sean; Graciosa, Joseph; Mogilevski, Mila; Ramsden, Christopher; Chont, Melissa; Vatine, Jean-Jacques

    2010-08-01

    Current IASP diagnostic criteria for CRPS have low specificity, potentially leading to overdiagnosis. This validation study compared current IASP diagnostic criteria for CRPS to proposed new diagnostic criteria (the "Budapest Criteria") regarding diagnostic accuracy. Structured evaluations of CRPS-related signs and symptoms were conducted in 113 CRPS-I and 47 non-CRPS neuropathic pain patients. Discriminating between diagnostic groups based on presence of signs or symptoms meeting IASP criteria showed high diagnostic sensitivity (1.00), but poor specificity (0.41), replicating prior work. In comparison, the Budapest clinical criteria retained the exceptional sensitivity of the IASP criteria (0.99), but greatly improved upon the specificity (0.68). As designed, the Budapest research criteria resulted in the highest specificity (0.79), again replicating prior work. Analyses indicated that inclusion of four distinct CRPS components in the Budapest Criteria contributed to enhanced specificity. Overall, results corroborate the validity of the Budapest Criteria and suggest they improve upon existing IASP diagnostic criteria for CRPS. Copyright (c) 2010 International Association for the Study of Pain. Published by Elsevier B.V. All rights reserved.

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

    Directory of Open Access Journals (Sweden)

    Agata Horecka-Lewitowicz

    2014-04-01

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

  13. Polycystic Ovary Syndrome (PCOS), Diagnostic Criteria, and AMH

    Science.gov (United States)

    Bani Mohammad, Majid; Majdi Seghinsara, Abbas

    2017-01-01

    The polycystic ovary syndrome (PCOS) is the most common cause of anovulatory infertility and a notable proportion of women of reproductive age are affected. It may constitute a risk factor for cancer development. Different factors could result in different manifestations and many of these are related to predispositions. It is essential to establish criteria to achieve an exact diagnosis of PCOS, especially among adolescent patients because of the overlap between features of PCO syndrome and physiological findings in puberty. Day by day the technology of ultrasonography is improving and accuracy is increasing, but remains dependent on the specific equipment available. Some factors are inter-related in determining PCOS prognosis. Serum AMH is synthesized by small antral follicles, which are precisely those seen on ultrasound and could help us to diagnose PCOS but there are many aspects that still require elucidation. In this mini- review we have attempted to identify some of these correlations. Creative Commons Attribution License

  14. Metabolic syndrome in obese adolescents: a comparison of three different diagnostic criteria.

    Science.gov (United States)

    Costa, Roberto F; Santos, Natalia S; Goldraich, Noemia P; Barski, Thiele Filikoski; Andrade, Kauana Silva de; Kruel, Luiz F M

    2012-07-01

    To investigate the difference in the proportion of adolescents with metabolic syndrome diagnosed based on three different criteria, as well as the use of insulin resistance instead of fasting glucose. Cross-sectional study with 121 obese adolescents, between 10 and 14 years old, from public schools of the city of Porto Alegre, Brazil, in 2011. Anthropometric, blood pressure, and biochemical variables were assessed. Metabolic syndrome was defined using three different diagnostic criteria: the International Diabetes Federation (IDF), Cook and de Ferranti. All of them include five components: waist circumference, blood pressure, high-density lipoprotein (HDL) cholesterol, triglycerides and fasting glucose, and there should be at least three abnormal results for the diagnosis of the syndrome. The Homeostasis Model Assessment - Insuline Resistance (HOMA-IR) was used for the characterization of insulin resistance. The analysis of agreement among the criteria was performed using Kappa statistics. Metabolic syndrome was diagnosed in 39.7, 51.2, and 74.4% of adolescents, according to the IDF, Cook and de Ferranti criteria, respectively. There was agreement for the three diagnostic criteria in 60.3% of the sample. Waist circumference was the most prevalent component (81.0, 81.0, and 96.7%), whereas high fasting glucose was the least prevalent (7.4, 1.7, and 1.7%). The use of HOMA-IR significantly increased the proportion of positive diagnoses for the syndrome. The results showed significant differences between the three diagnostic criteria. While there is no consensus on the diagnostic criteria for metabolic syndrome, differences in the prevalence of the disease in pediatric population will be frequent.

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

    NARCIS (Netherlands)

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

    2017-01-01

    Cryopyrin-associated periodic syndrome (CAPS) is a rare, heterogeneous disease entity associated with NLRP3 gene mutations and increased interleukin-1 (IL-1) secretion. Early diagnosis and rapid initiation of IL-1 inhibition prevent organ damage. The aim of the study was to develop and validate

  16. Complex regional pain syndrome: are the IASP diagnostic criteria valid and sufficiently comprehensive?

    Science.gov (United States)

    Harden, R N; Bruehl, S; Galer, B S; Saltz, S; Bertram, M; Backonja, M; Gayles, R; Rudin, N; Bhugra, M K; Stanton-Hicks, M

    1999-11-01

    This is a multisite study examining the internal validity and comprehensiveness of the International Association for the Study of Pain (IASP) diagnostic criteria for Complex Regional Pain Syndrome (CRPS). A standardized sign/symptom checklist was used in patient evaluations to obtain data on CRPS-related signs and symptoms in a series of 123 patients meeting IASP criteria for CRPS. Principal components factor analysis (PCA) was used to detect statistical groupings of signs/symptoms (factors). CRPS signs and symptoms grouped together statistically in a manner somewhat different than in current IASP/CRPS criteria. As in current criteria, a separate pain/sensation criterion was supported. However, unlike in current criteria, PCA indicated that vasomotor symptoms form a factor distinct from a sudomotor/edema factor. Changes in range of motion, motor dysfunction, and trophic changes, which are not included in the IASP criteria, formed a distinct fourth factor. Scores on the pain/sensation factor correlated positively with pain duration (PIASP/CRPS criteria could be improved by separating vasomotor signs/symptoms (e.g. temperature and skin color asymmetry) from those reflecting sudomotor dysfunction (e.g. sweating changes) and edema. Results also indicate motor and trophic changes may be an important and distinct component of CRPS which is not currently incorporated in the IASP criteria. An experimental revision of CRPS diagnostic criteria for research purposes is proposed. Implications for diagnostic sensitivity and specificity are discussed.

  17. Do Different Diagnostic Criteria Impact Polycystic Ovary Syndrome Diagnosis for Adolescents?

    Science.gov (United States)

    Akgül, Sinem; Düzçeker, Yasemin; Kanbur, Nuray; Derman, Orhan

    2017-12-09

    Although early diagnosis of polycystic ovary syndrome (PCOS) in adolescents might allow for earlier treatment and prevention of chronic disorders, incorrect or premature diagnosis carries risks of unnecessary treatment and psychological distress. There is no consensus concerning which diagnostic criteria to use for adolescents and current criteria vary. The objective of this study was to determine whether using different diagnostic criteria will affect PCOS diagnosis in adolescents. Fifty-two patients aged 13-18 years with at least 2 of the following criteria were included in the study: (1) oligomenorrhea or amenorrhea; (2) Clinical or biochemical hyperandrogenism; and (3) polycystic ovaries on ultrasonography. Patients were then categorized according to the 6 different criteria for PCOS. National Institutes of Health, Rotterdam criteria, Androgen Excess Society, Amsterdam criteria, Endocrine Society criteria, and the Pediatric Endocrine Society criteria. The characteristics of adolescents who were diagnosed with PCOS were also evaluated. Forty-one patients out of 52 (78.8%) received diagnosis with National Institutes of Health and Endocrine Society criteria, all with Rotterdam criteria, 45/52 (86.5%) with Androgen Excess Society criteria, 36/52 (69.2%) with Amsterdam criteria and 34/52 (65.4%) with the Pediatric Endocrine Society criteria. This study shows that the choice of guideline used does have a great effect on whether an adolescent received the PCOS diagnosis or not. For physicians using the broader criteria, care should be taken to ensure the patient does not receive diagnosis because of the physiological changes seen during puberty, which might mimic PCOS. For those using stricter criteria, close monitoring of patients who do not receive diagnosis is necessary to prevent chronic complications. Copyright © 2017 North American Society for Pediatric and Adolescent Gynecology. Published by Elsevier Inc. All rights reserved.

  18. Metabolic syndrome in peritoneal dialysis patients: choice of diagnostic criteria and prognostic implications.

    Science.gov (United States)

    Szeto, Cheuk-Chun; Kwan, Bonnie Ching-Ha; Chow, Kai-Ming; Leung, Chi-Bon; Cheng, Mei-Shan; Law, Man-Ching; Li, Philip Kam-Tao

    2014-04-01

    In the general population, metabolic syndrome (MES) is associated with cardiovascular risk. However, the definition of MES and its prognostic implication among patients undergoing peritoneal dialysis (PD) remain controversial. We studied 329 prevalent PD patients from April 2008 to April 2011 and compared four sets of diagnostic criteria: the original World Health Organization (WHO) criteria, the International Diabetes Federation (IDF) criteria, the original National Cholesterol Education Program (NCEP) criteria, and the modified NCEP criteria. Nutritional status, body composition, and arterial pulse-wave velocity were measured. Patients were followed for 31.7 ± 15.5 months. Among the 329 patients, 175 (53.2%) fulfilled the WHO criteria, 177 (53.8%) the IDF criteria, 199 (60.5%) the original NCEP criteria, and 218 (66.3%) the modified NCEP criteria. The agreement among the four sets of criteria was fair to moderate (Cohen κ=0.35-0.58). Patients with MES defined by all four criteria had higher adipose tissue mass than the others, although the difference in adipose tissue mass was most pronounced with the IDF criteria (MES versus no MES, 18.2 ± 7.9 versus 10.7 ± 5.9 kg; Pdefinition or clinical scoring system for risk stratification of PD patients.

  19. Proposed minimal diagnostic criteria for myelodysplastic syndromes (MDS) and potential pre-MDS conditions.

    Science.gov (United States)

    Valent, Peter; Orazi, Attilio; Steensma, David P; Ebert, Benjamin L; Haase, Detlef; Malcovati, Luca; van de Loosdrecht, Arjan A; Haferlach, Torsten; Westers, Theresia M; Wells, Denise A; Giagounidis, Aristoteles; Loken, Michael; Orfao, Alberto; Lübbert, Michael; Ganser, Arnold; Hofmann, Wolf-Karsten; Ogata, Kiyoyuki; Schanz, Julie; Béné, Marie C; Hoermann, Gregor; Sperr, Wolfgang R; Sotlar, Karl; Bettelheim, Peter; Stauder, Reinhard; Pfeilstöcker, Michael; Horny, Hans-Peter; Germing, Ulrich; Greenberg, Peter; Bennett, John M

    2017-09-26

    Myelodysplastic syndromes (MDS) comprise a heterogeneous group of myeloid neoplasms characterized by peripheral cytopenia, dysplasia, and a variable clinical course with about 30% risk to transform to secondary acute myeloid leukemia (AML). In the past 15 years, diagnostic evaluations, prognostication, and treatment of MDS have improved substantially. However, with the discovery of molecular markers and advent of novel targeted therapies, new challenges have emerged in the complex field of MDS. For example, MDS-related molecular lesions may be detectable in healthy individuals and increase in prevalence with age. Other patients exhibit persistent cytopenia of unknown etiology without dysplasia. Although these conditions are potential pre-phases of MDS they may also transform into other bone marrow neoplasms. Recently identified molecular, cytogenetic, and flow-based parameters may add in the delineation and prognostication of these conditions. However, no generally accepted integrated classification and no related criteria are as yet available. In an attempt to address this challenge, an international consensus group discussed these issues in a working conference in July 2016. The outcomes of this conference are summarized in the present article which includes criteria and a proposal for the classification of pre-MDS conditions as well as updated minimal diagnostic criteria of MDS. Moreover, we propose diagnostic standards to delineate between ´normal´, pre-MDS, and MDS. These standards and criteria should facilitate diagnostic and prognostic evaluations in clinical studies as well as in clinical practice.

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

    Science.gov (United States)

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

    2017-01-01

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

  1. Proposed diagnostic criteria for cerebellar ataxia with neuropathy and vestibular areflexia syndrome (CANVAS).

    Science.gov (United States)

    Szmulewicz, David J; Roberts, Leslie; McLean, Catriona A; MacDougall, Hamish G; Halmagyi, G Michael; Storey, Elsdon

    2016-02-01

    Diagnosis of ataxic disorders is an important clinical challenge upon which prognostication, management, patient solace, and, above all, the hope of future treatment all rely. Heritable diseases and the possibility of affected offspring carry the added burden of portending adverse health, social and financial ramifications. Cerebellar ataxia with neuropathy and vestibular areflexia syndrome (CANVAS) is an inherited multisystem ataxia compromising cerebellar, vestibular, and sensory function. It is not uncommon, but despite early attempts the genetic defect is yet to be identified. As the search for the causative gene continues, we have found it useful to further define this syndrome in terms of its likely phenotype. We propose staged diagnostic criteria based on the identified pathology in CANVAS. We envisage that these criteria will aid the clinician in diagnosing CANVAS and the researcher in further elucidating this complex disorder.

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

    Science.gov (United States)

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

    2015-01-01

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

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

    Science.gov (United States)

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

    2014-08-01

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

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

    International Nuclear Information System (INIS)

    Saad, Maria Auxiliadora Nogueira; Cardoso, Gilberto Perez; Martins, Wolney de Andrade; Velarde, Luis Guillermo Coca; Cruz, Rubens Antunes Filho da

    2014-01-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2014-03-15

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

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

    Science.gov (United States)

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

    2014-01-01

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

  7. New diagnostic criteria of adrenal subclinical Cushing's syndrome: opinion from the Japan Endocrine Society.

    Science.gov (United States)

    Yanase, Toshihiko; Oki, Yutaka; Katabami, Takuyuki; Otsuki, Michio; Kageyama, Kazunori; Tanaka, Tomoaki; Kawate, Hisaya; Tanabe, Makito; Doi, Masaru; Akehi, Yuko; Ichijo, Takamasa

    2018-03-23

    New diagnostic criteria and the treatment policy for adrenal subclinical Cushing's syndrome (SCS) are proposed on behalf of the Japan Endocrine Society. The Japanese version has been published, and the essential contents are presented in this English-language version. The current diagnostic criteria for SCS have elicited two main problems: (i) the relatively low reliability of a low range of serum cortisol essential for the diagnosis by an overnight 1-mg dexamethasone suppression test (DST); (ii) different cutoff values for serum cortisol after a 1-mg DST compared with those of other countries. Thus, new criteria are needed. In the new criteria, three hierarchical cortisol cutoff values, 5.0, 3.0 and 1.8 μg/dL, after a 1-mg DST are presented. Serum cortisol ≥5 μg/dL after a 1-mg DST alone is considered sufficient to judge autonomous cortisol secretion for the diagnosis of SCS, and the current criterion based on serum cortisol ≥3 μg/dL after a 1-mg DST can continue to be used. Clinical evidence suggests that serum cortisol ≥1.8-2.9 μg/dL after a 1-mg DST is not always normal, so cases who meet the cutoff value as well as a basal adrenocorticotropic hormone (ACTH) level DST (or are disheartened by treatment-resistant problems) or suspicious cases of adrenal cancer according to tumor imaging.

  8. External validation of IASP diagnostic criteria for Complex Regional Pain Syndrome and proposed research diagnostic criteria. International Association for the Study of Pain.

    Science.gov (United States)

    Bruehl, S; Harden, R N; Galer, B S; Saltz, S; Bertram, M; Backonja, M; Gayles, R; Rudin, N; Bhugra, M K; Stanton-Hicks, M

    1999-05-01

    Recent work in our research consortium has raised internal validity concerns regarding the current IASP criteria for Complex Regional Pain Syndrome (CRPS), suggesting problems with inadequate sensitivity and specificity. The current study explored the external validity of these IASP criteria for CRPS. A standardized evaluation of signs and symptoms of CRPS was conducted by study physicians in 117 patients meeting IASP criteria for CRPS, and 43 patients experiencing neuropathic pain with established non-CRPS etiology (e.g. diabetic neuropathy, post-herpetic neuralgia). Multiple discriminant function analyses were used to test the ability of the IASP diagnostic criteria and decision rules, as well as proposed research modifications of these criteria, to discriminate between CRPS patients and those experiencing non-CRPS neuropathic pain. Current IASP criteria and decision rules (e.g. signs or symptoms of edema, or color changes or sweating changes satisfy criterion 3) discriminated significantly between groups (P IASP criteria for CRPS have inadequate specificity and are likely to lead to overdiagnosis. Proposed modifications to these criteria substantially improve their external validity and merit further evaluation.

  9. Diagnostic criteria for congenital long QT syndrome in the era of molecular genetics: do we need a scoring system?

    NARCIS (Netherlands)

    Hofman, Nynke; Wilde, Arthur A. M.; Kääb, Stefan; van Langen, Irene M.; Tanck, Michael W. T.; Mannens, Marcel M. A. M.; Hinterseer, Martin; Beckmann, Britt-Maria; Tan, Hanno L.

    2007-01-01

    AIMS: Previously published diagnostic systems, based on ECG analysis and clinical parameters (Schwartz criteria and Keating criteria), have been used to estimate the probability of inherited long QT syndrome (LQTS). Nowadays, a certain diagnosis can often be made by DNA testing. We aimed to

  10. Diagnostic criteria for congenital long QT syndrome in the era of molecular genetics: Do we need a scoring system?

    NARCIS (Netherlands)

    Hofman, Nynke; Wilde, Arthur A.M.; Kääb, Stefan; Van Langen, Irene M.; Tanck, Michael W.T.; Mannens, Marcel M.A.M.; Hinterseer, Martin; Beckmann, Britt-Maria; Tan, Hanno L.

    2007-01-01

    Aims: Previously published diagnostic systems, based on ECG analysis and clinical parameters (Schwartz criteria and Keating criteria), have been used to estimate the probability of inherited long QT syndrome (LQTS). Nowadays, a certain diagnosis can often be made by DNA testing. We aimed to

  11. Validation of proposed diagnostic criteria (the “Budapest Criteria”) for Complex Regional Pain Syndrome

    Science.gov (United States)

    Harden, R. Norman; Bruehl, Stephen; Perez, Roberto S.G.M.; Birklein, Frank; Marinus, Johan; Maihofner, Christian; Lubenow, Timothy; Buvanendran, Asokumar; Mackey, Sean; Graciosa, Joseph; Mogilevski, Mila; Ramsden, Christopher; Chont, Melissa; Vatine, Jean-Jacques

    2010-01-01

    Current IASP diagnostic criteria for CRPS have low specificity, potentially leading to overdiagnosis. This validation study compared current IASP diagnostic criteria for CRPS to proposed new diagnostic criteria (the “Budapest Criteria”) regarding diagnostic accuracy. Structured evaluations of CRPS-related signs and symptoms were conducted in 113 CRPS-I and 47 non-CRPS neuropathic pain patients. Discriminating between diagnostic groups based on presence of signs or symptoms meeting IASP criteria showed high diagnostic sensitivity (1.00), but poor specificity (0.41), replicating prior work. In comparison, the Budapest clinical criteria retained the exceptional sensitivity of the IASP criteria (0.99), but greatly improved upon the specificity (0.68). As designed, the Budapest research criteria resulted in the highest specificity (0.79), again replicating prior work. Analyses indicated that inclusion of four distinct CRPS components in the Budapest Criteria contributed to enhanced specificity. Overall, results corroborate the validity of the Budapest Criteria and suggest they improve upon existing IASP diagnostic criteria for CRPS. PMID:20493633

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

    DEFF Research Database (Denmark)

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

    2008-01-01

    might be performed according to findings at cystoscopy with hydrodistention and morphologic findings in bladder biopsies. The presence of other organ symptoms as well as cognitive, behavioral, emotional, and sexual symptoms, should be addressed. Conclusions: The name IC has become misleading......Objectives: Because the term ''interstitial cystitis'' (IC) has different meanings in different centers and different parts of the world, the European Society for the Study of Interstitial Cystitis (ESSIC) has worked to create a consensus on definitions, diagnosis, and classification in an attempt...... to overcome the lack of international agreement on various aspects of IC. Methods: ESSIC has discussed definitions, diagnostic criteria, and disease classification in four meetings and extended e-mail correspondence. Results: It was agreed to name the disease bladder pain syndrome (BPS) BPS would be diagnosed...

  13. Diagnostic criteria patterns of U.S. children with Metabolic Syndrome: NHANES 1999–2002

    Directory of Open Access Journals (Sweden)

    Wagstaff David A

    2007-11-01

    Full Text Available Abstract Background As childhood obesity increases in the U.S., the Metabolic Syndrome (MS can be assumed to be increasing in the pediatric population as well. To date, there is lack of information on the most prevalent risk factors of MS in children and the patterns of risk factors present in children met the criteria for MS. Methods Anthropometric and medical data of children 2–18 years old of a nationally representative data set (NHANES 1999–2002 were obtained and the diagnostic criteria of Cook et al. employed to determine MS prevalence. Three samples were examined: a Children 2–18 years old with non-missing data on at least three of the five diagnostic criteria but missing blood glucose data (n = 5,172, b a subsample of 12–18 year olds also providing fasting glucose data but who were not overweight or obese using the International Obesity Task Force (IOTF standards (n = 1,064, and c 12–18 year olds with blood glucose data who were overweight or obese (n = 641. Results Disease prevalence estimates were 2%, 0.7%, and 23% in the three populations. More than 10% of the children providing fasting blood levels had hyperglycemia. 2% of the overweight or obese 12–18 year olds with fasting blood glucose data met all five diagnostic criteria for MS. In all groups, elevated total triglycerides but low high density lipoprotein (HDL level affected a large proportion of the population. Conclusion Results indicate a reason for concern, since the prevalence of MS risk factors in children was high. Dyslipidemia (concurrent high total triglyceride levels and low HDL levels were prevalent in large portions of the population, even in the non-overweight. Thus, chronic disease prevention efforts in the pediatric population should not only encourage healthy body weight but also include dietary recommendations to consume diets moderately low in fat with emphasis on polyunsaturated and monounsaturated fats within recommended ratios of omega-6 and omega

  14. Asthma-COPD overlap syndrome: recent advances in diagnostic criteria and prognostic significance.

    Science.gov (United States)

    Sorino, Claudio; Scichilone, Nicola; D'Amato, Maria; Patella, Vincenzo; DI Marco, Fabiano

    2017-06-01

    The term asthma-chronic obstructive pulmonary disease (COPD) overlap syndrome (ACOS) has been proposed for individuals with features of both asthma and COPD. Several attempts have been done to define ACOS on the basis of medical history, symptoms, and functional findings. The main diagnostic criteria include airflow obstruction with a strong although incomplete reversibility to bronchodilation tests, a significant exposure to cigarette or biomass smoke, and a history of atopy or asthma. Additional diagnostic elements include eosinophilic airway and systemic inflammation, a good response to corticosteroid treatment, and a high concentration of exhaled nitric oxide. ACOS should be distinguished from asthma with not fully reversible bronchial obstruction due to airway remodeling, thus the lack of smoking exposure should exclude the diagnosis of ACOS. In patients without a documented history of asthma before 40 years of age, an increase in FEV1 after bronchodilator >400 mL should be required to diagnose ACOS. ACOS has been found to be associated with impaired physical performance, functional ability, and health-related quality of life. The prevalence of ACOS increases with aging, then it is relatively stable in elderly individuals (>65 years). Long-term mortality of subjects with ACOS is similar to COPD, and worse than asthma and healthy controls. Future research is still needed to improve the understanding and management of ACOS.

  15. Emotion Perception in Asperger's Syndrome and High-Functioning Autism: The Importance of Diagnostic Criteria and Cue Intensity

    Science.gov (United States)

    Mazefsky, Carla A.; Oswald, Donald P.

    2007-01-01

    This study compared emotion perception accuracy between children with Asperger's syndrome (AS) and high-functioning autism (HFA). Thirty children were diagnosed with AS or HFA based on empirically supported diagnostic criteria and administered an emotion perception test consisting of facial expressions and tone of voice cues that varied in…

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

    Directory of Open Access Journals (Sweden)

    Manzar Vakili

    2015-01-01

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

  17. Delineation and Diagnostic Criteria of Oral-Facial-Digital Syndrome Type VI

    Directory of Open Access Journals (Sweden)

    Poretti Andrea

    2012-01-01

    Full Text Available Abstract Oral-Facial-Digital Syndrome type VI (OFD VI represents a rare phenotypic subtype of Joubert syndrome and related disorders (JSRD. In the original report polydactyly, oral findings, intellectual disability, and absence of the cerebellar vermis at post-mortem characterized the syndrome. Subsequently, the molar tooth sign (MTS has been found in patients with OFD VI, prompting the inclusion of OFD VI in JSRD. We studied the clinical, neurodevelopmental, neuroimaging, and genetic findings in a cohort of 16 patients with OFD VI. We derived the following inclusion criteria from the literature: 1 MTS and one oral finding and polydactyly, or 2 MTS and more than one typical oral finding. The OFD VI neuroimaging pattern was found to be more severe than in other JSRD subgroups and includes severe hypoplasia of the cerebellar vermis, hypoplastic and dysplastic cerebellar hemispheres, marked enlargement of the posterior fossa, increased retrocerebellar collection of cerebrospinal fluid, abnormal brainstem, and frequently supratentorial abnormalities that occasionally include characteristic hypothalamic hamartomas. Additionally, two new JSRD neuroimaging findings (ascending superior cerebellar peduncles and fused thalami have been identified. Tongue hamartomas, additional frenula, upper lip notch, and mesoaxial polydactyly are specific findings in OFD VI, while cleft lip/palate and other types of polydactyly of hands and feet are not specific. Involvement of other organs may include ocular findings, particularly colobomas. The majority of the patients have absent motor development and profound cognitive impairment. In OFD VI, normal cognitive functions are possible, but exceptional. Sequencing of known JSRD genes in most patients failed to detect pathogenetic mutations, therefore the genetic basis of OFD VI remains unknown. Compared with other JSRD subgroups, the neurological findings and impairment of motor development and cognitive functions in OFD

  18. Performance of different diagnostic criteria of overweight and obesity as predictors of metabolic syndrome in adolescents

    Directory of Open Access Journals (Sweden)

    Raphael Gonçalves de Oliveira

    2017-09-01

    Conclusions: Overweight and obesity using BMI showed a moderate association with MetS, regardless of the diagnostic criteria used. However, the IOTF criterion showed better predictive capacity for the presence of MetS than the WHO and the Conde and Monteiro criteria.

  19. Diagnostic Performance of Three Phase Bone Scan for Complex Regional Pain Syndrome Type 1 with Optimally Modified Image Criteria

    Energy Technology Data Exchange (ETDEWEB)

    Kwon, Hyun Woo; Paeng, Jin Chul; Nahm, Francins Sahngun; Kim, Seog Gyun; Zehra, Tanzeel; Oh, So Won; Lee, Hyo Sang; Kang, Keon Wook; Chung, June Key; Lee, Myung Chul; Lee, Dong Soo [Seoul National Univ. College of Medicine, Seoul (Korea, Republic of)

    2011-12-15

    Although the three phase bone scan (TBPS) is one of the widely used imaging studies for diagnosing complex regional pain syndrome type 1 (CRPS 1), there is some controversy regarding the TPBS image criteria for CRPS 1. In this study, we modified the image criteria using image pattern and quantitative analysis in the patients diagnosed using the most recent consensus clinical diagnostic criteria. The study included 140 patients with suspected CRPS 1 (CRPS 1, n=79; non CRPS, n=61; mean age 39{+-}15 years) who underwent TPBS. The clinical diagnostic criteria for CRPS 1 revised by the Budapest consensus group were used for confirmative diagnosis. Patients were classified according to flow/pool and delayed uptake (DU) image patterns, and the time interval between the initiating event and TPBS (TI{sup eventscan)}. Quantitative analysis for lesion to contralateral ratio (LCR) was performed. Modified TPBS image criteria were created and evaluated for optimal diagnostic performance. Both increased and decreased periarticular DU were significant image findings for CRPS 1 (CRPS 1 positive rate=73% in the increased DU group, 75% in the decreased DU group). The TI{sup eventscand}id not differ significantly between the different image pattern groups. Quantitative analysis revealed an LCR of 1.43 was the optimal cutoff value for CRPS 1 and diagnostic performance was significantly improved in the increased DU group (area under the curve=0.732). Given the modified image criteria, the sensitivity and specificity of TPBS for diagnosing CRPS 1 were 80% and 72%, respectively. Optimally modified TPBS image criteria for CRPS 1 were suggested using image pattern and quantitative analysis. With the criteria, TPBS is an effective imaging study for CRPS 1 even with the most recent consensus clinical diagnostic criteria.

  20. Diagnostic Performance of Three Phase Bone Scan for Complex Regional Pain Syndrome Type 1 with Optimally Modified Image Criteria

    International Nuclear Information System (INIS)

    Kwon, Hyun Woo; Paeng, Jin Chul; Nahm, Francins Sahngun; Kim, Seog Gyun; Zehra, Tanzeel; Oh, So Won; Lee, Hyo Sang; Kang, Keon Wook; Chung, June Key; Lee, Myung Chul; Lee, Dong Soo

    2011-01-01

    Although the three phase bone scan (TBPS) is one of the widely used imaging studies for diagnosing complex regional pain syndrome type 1 (CRPS 1), there is some controversy regarding the TPBS image criteria for CRPS 1. In this study, we modified the image criteria using image pattern and quantitative analysis in the patients diagnosed using the most recent consensus clinical diagnostic criteria. The study included 140 patients with suspected CRPS 1 (CRPS 1, n=79; non CRPS, n=61; mean age 39±15 years) who underwent TPBS. The clinical diagnostic criteria for CRPS 1 revised by the Budapest consensus group were used for confirmative diagnosis. Patients were classified according to flow/pool and delayed uptake (DU) image patterns, and the time interval between the initiating event and TPBS (TI eventscan) . Quantitative analysis for lesion to contralateral ratio (LCR) was performed. Modified TPBS image criteria were created and evaluated for optimal diagnostic performance. Both increased and decreased periarticular DU were significant image findings for CRPS 1 (CRPS 1 positive rate=73% in the increased DU group, 75% in the decreased DU group). The TI eventscand id not differ significantly between the different image pattern groups. Quantitative analysis revealed an LCR of 1.43 was the optimal cutoff value for CRPS 1 and diagnostic performance was significantly improved in the increased DU group (area under the curve=0.732). Given the modified image criteria, the sensitivity and specificity of TPBS for diagnosing CRPS 1 were 80% and 72%, respectively. Optimally modified TPBS image criteria for CRPS 1 were suggested using image pattern and quantitative analysis. With the criteria, TPBS is an effective imaging study for CRPS 1 even with the most recent consensus clinical diagnostic criteria.

  1. Periventricular lesions and MS diagnostic criteria in young adults with typical clinically isolated syndromes.

    Science.gov (United States)

    Brownlee, Wallace J; Miszkiel, Katherine A; Altmann, Daniel R; Ciccarelli, Olga; Miller, David H

    2017-06-01

    In patients who present with a clinically isolated syndrome (CIS), whose features are suggestive of multiple sclerosis (MS), fulfilling McDonald 2010 magnetic resonance imaging (MRI) criteria for dissemination in space (DIS) and dissemination in time (DIT) enables a diagnosis of MS. While ⩾1 periventricular lesion is included in the 2010 DIS criteria, earlier McDonald criteria required ⩾3 periventricular lesions to confirm DIS and recent Magnetic Resonance Imaging in Multiple Sclerosis (MAGNIMS)-recommended DIS criteria also require ⩾3 lesions. We investigated the effect of varying the required number of periventricular lesions and found that the best combination of specificity and sensitivity for clinically definite MS was seen for ⩾1 periventricular lesion using both the McDonald 2010 and MAGNIMS 2016 criteria.

  2. IASP diagnostic criteria for complex regional pain syndrome: a preliminary empirical validation study. International Association for the Study of Pain.

    Science.gov (United States)

    Galer, B S; Bruehl, S; Harden, R N

    1998-03-01

    To assess the ability of the International Association for the Study of Pain Complex Regional Pain Syndrome (CRPS) diagnostic criteria and associated features to discriminate between CRPS patients and patients with painful diabetic neuropathy. Prospective assessment of signs and symptoms in a series of CRPS and diabetic neuropathy patients. University of Washington Multidisciplinary Pain Center. A consecutive series of 18 CRPS patients and 30 diabetic neuropathy patients. Patients completed a 10-item patient history questionnaire assessing symptoms of CRPS prior to medical evaluation. The evaluating physician completed a 10-item patient examination questionnaire assessing objective signs of CRPS. The analyses conducted were designed to test the ability of CRPS signs and symptoms and associated features to discriminate between CRPS patients and diabetic neuropathy patients. Data analysis suggested that CRPS decision rules may lead to overdiagnosis of the disorder. Diagnosis based on self-reported symptoms can be diagnostically useful in some circumstances. The addition of trophic tissue changes, range of motion changes, and "burning" quality of pain did not improve diagnostic accuracy, but the addition of motor neglect signs did. Test of a CRPS scoring system resulted in improved accuracy relative to current criteria and decision rules. Poorly understood disorders lacking prototypical signs/symptoms and diagnostic laboratory testing must rely on the development of reliable diagnostic guidelines. The results of this study should assist in the further refinement of the CRPS diagnostic criteria.

  3. [Diagnostic criteria in acute neuromyelitis].

    Science.gov (United States)

    Panea, Cristina; Petrescu, Simona; Monica, Pop; Voinea, Liliana; Dascălu, Ana-Maria; Nicolae, Miruna; Ungureanu, E; Panca, Aida; Grădinaru, Sânziana

    2007-01-01

    Neuromyelitis optica, also known as Devic disease, was identified in the 19th century, is one of the inflammatory idiopathic demyelinating diseases of the central nervous system, often mistaken for severe multiple sclerosis. In 1999 it had been proposed diagnostic criteria for neuromyelitis optica, but in 2006 these criteria were revised by Dean Wingerchuck. These criteria are 99% sensitive and 90% specific for differentiating neuromyelitis optica from multiple sclerosis that present with optic neuritis or a myelitis syndrome. In the following article we present clinical, spinal and cerebral MR imaging, serological and aspects of cerebrospinal fluid examination features of neuromyelitis optica and the revised criteria of neuromyelitis optica established in 2006. The recently identified serum antibody biomarker: neuromyelitis optica immunoglobulin G (NMO Ig G), which target aquaporin 4 water channel, distinguish neuromyelitis optica from multiple sclerosis, is one of the revised criteria of neuromyelitis optica.

  4. What is in a name? Comparing diagnostic criteria for chronic fatigue syndrome with or without fibromyalgia.

    Science.gov (United States)

    Meeus, Mira; Ickmans, Kelly; Struyf, Filip; Kos, Daphne; Lambrecht, Luc; Willekens, Barbara; Cras, Patrick; Nijs, Jo

    2016-01-01

    The current study had two objectives. (1) to compare objective and self-report measures in patients with chronic fatigue syndrome (CFS) according to the 1994 Center for Disease Control (CDC) criteria, patients with multiple sclerosis (MS), and healthy controls, and (2) to contrast CFS patients who only fulfill CDC criteria to those who also fulfill the criteria for myalgic encephalomyelitis (ME), the 2003 Canadian criteria for ME/CFS, or the comorbid diagnosis of fibromyalgia (FM). One hundred six participants (48 CFS patients diagnosed following the 1994 CDC criteria, 19 MS patients, and 39 healthy controls) completed questionnaires assessing symptom severity, quality of life, daily functioning, and psychological factors. Objective measures consisted of activity monitoring, evaluation of maximal voluntary contraction and muscle recovery, and cognitive performance. CFS patients were screened whether they also fulfilled ME criteria, the Canadian criteria, and the diagnosis of FM. CFS patients scored higher on symptom severity, lower on quality of life, and higher on depression and kinesiophobia and worse on MVC, muscle recovery, and cognitive performance compared to the MS patients and the healthy subjects. Daily activity levels were also lower compared to healthy subjects. Only one difference was found between those fulfilling the ME criteria and those who did not regarding the degree of kinesiophobia (lower in ME), while comorbidity for FM significantly increased the symptom burden. CFS patients report more severe symptoms and are more disabled compared to MS patients and healthy controls. Based on the present study, fulfillment of the ME or Canadian criteria did not seem to give a clinically different picture, whereas a diagnosis of comorbid FM selected symptomatically worse and more disabled patients.

  5. Metabolic Syndrome in People Living with Human Immunodeficiency Virus: An Assessment of the Prevalence and the Agreement between Diagnostic Criteria

    Directory of Open Access Journals (Sweden)

    Kim Anh Nguyen

    2017-01-01

    Full Text Available Objectives. We determined metabolic syndrome (MetS prevalence and assessed the agreement between different diagnostic criteria in HIV-infected South Africans. Method. A random sample included 748 HIV-infected adult patients (79% women across 17 HIV healthcare facilities in the Western Cape Province. MetS was defined using the Joint Interim Statement (JIS 2009, International Diabetes Federation (IDF 2005, and Adult Treatment Panel III (ATPIII 2005 criteria. Results. Median values were 38 years (age, 5 years (diagnosed HIV duration, and 392 cells/mm3 (CD4 count, and 93% of the participants were on antiretroviral therapy (ART. MetS prevalence was 28.2% (95%CI: 25–31.4, 26.5% (23.3–29.6, and 24.1% (21–27.1 by the JIS, IDF, and ATPIII 2005 criteria, respectively. Prevalence was always higher in women than in men (all p<0.001, in participants with longer duration of diagnosed HIV (all p≤0.003, and in ART users not receiving 1st-line regimens (all p≤0.039. The agreement among the three criteria was very good overall and in most subgroups (all kappa≥0.81. Conclusions. The three most popular diagnostic criteria yielded similarly high MetS prevalence in this relatively young population receiving care for HIV infection. Very good levels of agreement between criteria are unaffected by some HIV-specific features highlighting the likely comparable diagnostic utility of those criteria in routine HIV care settings.

  6. Atypical Alstrom syndrome with novel ALMS1 mutations precluded by current diagnostic criteria.

    LENUS (Irish Health Repository)

    Casey, Jillian

    2014-02-01

    We report on clinical and genetic studies in a non-consanguineous Irish sib-pair with infantile dilated cardiomyopathy and retinopathy. A diagnosis of Alström Syndrome (AS) was considered and diagnostic testing pursued. The Alströms gene (ALMS1) is very large (23 exons) and diagnostic testing of mutational hotspots (exon 6, 8 and 10) was negative. Furthermore the siblings were tall and did not have the typical phenotype of nystagmus, photophobia, obesity or hearing loss and so the AS diagnosis was removed. We then sought to identify the causative gene in this family using whole exome sequencing. Unexpectedly, the exome analysis identified novel compound heterozygous ALMS1 mutations in exon 5 (c.777delT:p.D260fs*26) and exon 20 (c.12145_12146insC:p.S4049fs*36) that segregated with the phenotype. Although the siblings show some clinical overlap with AS, their phenotype is not classical. It is plausible that their atypical presentation may be due to the location of the ALMS1 mutations outside the usual mutational hotspots. Our findings show how atypical cases of AS may be missed under the current diagnostic guidelines and support consideration of complete ALMS1 sequencing in children with two or more features, even if all of the core clinical features of AS are not present.

  7. Clinical features, diagnostic criteria, and management of Coffin-Siris syndrome.

    Science.gov (United States)

    Vergano, Samantha S; Deardorff, Matthew A

    2014-09-01

    Coffin-Siris syndrome (OMIM#135900) is a multiple congenital anomaly syndrome classically characterized by hypo- or aplasia of the fifth digit nails or phalanges, as well as coarse facial features, sparse scalp hair, and moderate to severe cognitive and/or developmental delay. The recent identification of molecular etiologies has served to effectively characterize a large set of patients who have been described with Coffin-Siris between the time of its initial description and the present. However, despite recent advances, a number of patients who traditionally fit the diagnosis have yet to have identified causes. This could be due to patients who lie outside the defined phenotype, or alternatively, to additional as yet unidentified genes which may play roles. Here we outline the range of clinical features described in the broader diagnostic category, review the continuing phenotypic challenges and note those subsets of patients for whom molecular causes have yet to be clarified. Finally, we discuss recommendations for clinical management of these individuals. © 2014 Wiley Periodicals, Inc.

  8. Consensus on the integrated traditional Chinese and Western medicine criteria of diagnostic classification in polycystic ovary syndrome (draft).

    Science.gov (United States)

    Yu, Jin; Yu, Chao-Qin; Cao, Qi; Wang, Li; Wang, Wen-Jun; Zhou, Li-Rong; Li, Jing; Qian, Qiao-Hong

    2017-03-01

    Polycystic ovary syndrome (PCOS) is the most common endocrine and metabolic disorder of women, with complex pathogenesis and heterogeneous manifestations. Professor Jin Yu recently wrote an article entitled "Proposal of Diagnosis and Diagnostic Classification of PCOS in Integrated Traditional Chinese and Western Medicine."From this, the Obstetrics and Gynecology branches of the Chinese Association of Integrative Medicine and the China Association of Chinese Medicine collaborated with the Gynecology branch of the Chinese Association for Research and Advancement of Chinese Medicine to draft a report on the consensus of criteria for the diagnosis and classification of PCOS in integrated traditional Chinese and Western medicine. The diagnosis for PCOS includes all three features: (1) oligo-ovulation or anovulation; (2) clinical and/or laboratory evidence of hyperandrogenism;(3) PCOS is classified into four types: types Ia,Ib, IIa, and IIb. Syndrome differentiation types for PCOS in traditional Chinese medicine are as follows: Kidney deficiency with phlegm blockage syndrome, Kidney Yin deficiency with phlegm blockage and blood stasis syndrome, and Kidney deficiency with Liver Qi stagnation syndrome.

  9. Delineation and Diagnostic Criteria of Oral-Facial-Digital Syndrome Type VI

    NARCIS (Netherlands)

    Poretti, Andrea; Vitiello, Giuseppina; Hennekam, Raoul C. M.; Arrigoni, Filippo; Bertini, Enrico; Borgatti, Renato; Brancati, Francesco; D'Arrigo, Stefano; Faravelli, Francesca; Giordano, Lucio; Huisman, Thierry A. G. M.; Iannicelli, Miriam; Kluger, Gerhard; Kyllerman, Marten; Landgren, Magnus; Lees, Melissa M.; Pinelli, Lorenzo; Romaniello, Romina; Scheer, Ianina; Schwarz, Christoph E.; Spiegel, Ronen; Tibussek, Daniel; Valente, Enza Maria; Boltshauser, Eugen

    2012-01-01

    Oral-Facial-Digital Syndrome type VI (OFD VI) represents a rare phenotypic subtype of Joubert syndrome and related disorders (JSRD). In the original report polydactyly, oral findings, intellectual disability, and absence of the cerebellar vermis at post-mortem characterized the syndrome.

  10. [Predictive capacity of the diagnostic criteria of metabolic syndrome on the insulin-resistance and the coronary risk].

    Science.gov (United States)

    Martínez Candela, Juan; Franch Nadal, Josep; Romero Ortiz, Josefa; Cánovas Domínguez, Carmen; Gallardo Martín, Arístides; López Yepes, María Luisa

    2007-11-03

    Since at present several diagnostic criteria of the metabolic syndrome (MS) exist, the objective of the study is to verify the utility of the criteria of the International Diabetes Federation (IDF) to diagnose the MS, their agreement with other previous definitions and the insulin resistance (IR). It also studies its relation with the coronary risk (CR). Design of a cross-sectional descriptive study in the scope of the primary care of Yecla (Murcia). We studied 317 selected people from a stratified random sampling (age and sex) of 424 from a population of 18,059 with sanitary card and aged > or = 30 years. Socio-demographic, anthropometric and analytical (lipids, microalbuminuria, hemoglobin A1c and insulinemia) variables were registered. Criteria from the World Health Organization (WHO), Third Report of National Cholesterol Education Program (NCEP-III), European Group for the Study of Insuline Resistance (EGIR) and IDF were used to diagnose the MS. We defined IR when index HOMA > or = 3.8. The agreement between definitions of MS was determined by the kappa statistic. The CR was quantified according to Anderson (1991) method. The prevalence of the MS was: WHO, 35.3% (95% confidence interval [CI], 29.8-40.8); NCEP, 20.2% (95% CI, 15.6-24.8); EGIR, 24% (95% CI, 19.1-28.9), and IDF, 28.9% (95% CI, 23.8-34). The prevalence of IR was 27.7% (95% CI, 22.6-32.8). The agreement between the most clinical criteria (NCEP, IDF) and the biochemists (WHO, EGIR, HOMA) was lower (kappa < 0.50). A 58.2% (WHO), 66.1% (NCEP), 50% (EGIR) and 57% (IDF) of subjects with MS presented a CR greater than 20%. A high prevalence of the MS in Yecla exists, with a good agreement between the most clinical definitions of the syndrome (NCEP and IDF), that are associated with greater CR.

  11. Complex regional pain syndrome type I : Use of the International Association for the Study of Pain diagnostic criteria defined in 1994

    NARCIS (Netherlands)

    Reinders, M.F.; Geertzen, J.H.B.; Dijkstra, P.U.

    2002-01-01

    Objectives: The objective was to assess the reported use in recent publications of the diagnostic criteria for complex regional pain syndrome type I (CRPS 1) proposed by the International Association for the Study of Pain (IASP) in 1994. Methods: A literature search of MEDLINE (January 1996 to July

  12. Body mass index cutoff point estimation as obesity diagnostic criteria in Down syndrome adolescents.

    Science.gov (United States)

    Samur San-Matín, Juan Eduardo; Gonçalves, Ezequiel Moreira; Bertapelli, Fabio; Mendes, Roberto Teixeira; Guerra-Júnior, Gil

    2016-09-20

    Adolescents with Down syndrome (DS) show high rate of overweight and tend to accumulate high amount of fat compared to the same people without the syndrome. To estimate the cutoff point of the Body Mass Index (BMI) for the diagnosis of obesity in adolescents with DS according to different references for BMI in relation to the percentage of body fat (%BF) measured by dual-energy X-ray absorptiometry (DXA). The sample was composed of 34 adolescents with DS (aged: 10 to 17 years old). BMI was evaluated according to the references of the International Obesity Task Force (IOTF), the World Health Organization (WHO) for the general population, and Myrelid et al. and Styles et al. for people with DS. The %BF was assessed by whole body DXA and classified according to National Health And Nutrition Examination Survey (NHANES, 2011). The boys were significantly taller than the girls and this %BF higher than boys. All references who have used BMI to assess obesity was positively associated with %BF measured by DXA in the diagnosis of obesity. Using the ROC curve in relation to %BF by DXA, all references showed high sensitivity, but the z-score of BMI by WHO showed better specificity, with the value of the accuracy of 0.82 for the cutoff point above 2.14. All the references used for the diagnosis of obesity were associated with %BF measured by DXA, and the cutoff point of z-scores above 2.14 by WHO showed better specificity.

  13. Pathological features and proposed diagnostic criteria of porcine periweaning failure-to-thrive syndrome.

    Science.gov (United States)

    Huang, Y; Harding, J C S

    2015-05-01

    Porcine periweaning failure-to-thrive syndrome (PFTS) is a clinical syndrome characterized by anorexia and progressive debilitation of newly weaned pigs. The objectives of the current case-control study were to describe the histopathologic features of PFTS in North America and test for selected pathogens in case and control pigs on 8 farms allegedly fulfilling the clinical definition of PFTS. Based on observations during farm visits, 5 farms fully met the case definition (PFTS farms), whereas 3 farms only partially fulfilled the definition (NON-PFTS farms). Necropsy and histopathologic examination were performed on case (n = 8 or 9) and control (n = 4) pigs from each farm. Superficial gastritis, which was mainly localized in the fundus and characterized by attenuation of superficial foveolar cells, was significantly more frequent in case pigs from PFTS farms compared with all the other pigs (odds ratio [OR], 16.7). The same was found for thymic atrophy (OR, 30.1) and small intestinal (SI) villous atrophy in the duodenum (OR, 28.7), jejunum (OR, 67.4), and ileum (OR, 56.3). All pigs with PFTS had at least 2 of these 3 lesions: gastritis, thymic atrophy, and SI villous atrophy. PFTS was not associated with any relevant porcine pathogen tested. We propose the diagnosis of PFTS be based on the fulfillment of the clinical case definition, the presence of the above lesions, and exclusion of other common swine diseases and pathogens. However, PFTS can be ruled out if debilitated pigs do not have at least 2 of the above 3 lesions. © The Author(s) 2014.

  14. Marfan Syndrome: new diagnostic criteria, same anesthesia care? Case report and review.

    Science.gov (United States)

    Araújo, Maria Rita; Marques, Céline; Freitas, Sara; Santa-Bárbara, Rita; Alves, Joana; Xavier, Célia

    2016-01-01

    Marfan's Syndrome (MFS) is a disorder of connective tissue, mainly involving the cardiovascular, musculoskeletal, and ocular systems. The most severe problems include aortic root dilatation and dissection. Anesthetic management is vital for the improvement on perioperative morbidity. 61-year-old male with MFS, presenting mainly with pectus carinatum, scoliosis, ectopia lens, previous spontaneous pneumothorax and aortal aneurysm and dissection submitted to thoracoabdominal aortic prosthesis placement. Underwent routine laparoscopic cholecystectomy due to lithiasis. Important findings on preoperative examination were thoracolumbar kyphoscoliosis, metallic murmur on cardiac exam. Chest radiograph revealed Cobb angle of 70°. Echocardiogram showed evidence of aortic mechanical prosthesis with no deficits. Preoperative evaluation should focus on cardiopulmonary abnormalities. The anesthesiologist should be prepared for a potentially difficult intubation. Proper positioning and limb support prior to induction is crucial in order to avoid joint injuries. Consider antibiotic prophylaxis for subacute bacterial endocarditis. The patient should be carefully positioned to avoid joint injuries. Intraoperatively cardiovascular monitoring is mandatory: avoid maneuvers that can lead to tachycardia or hypertension, control airway pressure to prevent pneumothorax and maintain an adequate volemia to decrease chances of prolapse, especially if considering laparoscopic surgery. No single intraoperative anesthetic agent or technique has demonstrated superiority. Adequate postoperative pain management is vitally important to avoid the detrimental effects of hypertension and tachycardia. Copyright © 2014 Sociedade Brasileira de Anestesiologia. Published by Elsevier Editora Ltda. All rights reserved.

  15. Marfan Syndrome: new diagnostic criteria, same anesthesia care? Case report and review

    Directory of Open Access Journals (Sweden)

    Maria Rita Araújo

    Full Text Available Abstract Background: Marfan's Syndrome (MFS is a disorder of connective tissue, mainly involving the cardiovascular, musculoskeletal, and ocular systems. The most severe problems include aortic root dilatation and dissection. Anesthetic management is vital for the improvement on perioperative morbidity. Case report: 61-year-old male with MFS, presenting mainly with pectus carinatum, scoliosis, ectopia lens, previous spontaneous pneumothorax and aortal aneurysm and dissection submitted to thoracoabdominal aortic prosthesis placement. Underwent routine laparoscopic cholecystectomy due to lithiasis. Important findings on preoperative examination were thoracolumbar kyphoscoliosis, metallic murmur on cardiac exam. Chest radiograph revealed Cobb angle of 70°. Echocardiogram showed evidence of aortic mechanical prosthesis with no deficits. Discussion: Preoperative evaluation should focus on cardiopulmonary abnormalities. The anesthesiologist should be prepared for a potentially difficult intubation. Proper positioning and limb support prior to induction is crucial in order to avoid joint injuries. Consider antibiotic prophylaxis for subacute bacterial endocarditis. The patient should be carefully positioned to avoid joint injuries. Intraoperatively cardiovascular monitoring is mandatory: avoid maneuvers that can lead to tachycardia or hypertension, control airway pressure to prevent pneumothorax and maintain an adequate volemia to decrease chances of prolapse, especially if considering laparoscopic surgery. No single intraoperative anesthetic agent or technique has demonstrated superiority. Adequate postoperative pain management is vitally important to avoid the detrimental effects of hypertension and tachycardia.

  16. CLINICAL AND ELECTROCARDIOGRAPHIC SYNDROMES ASSOCIATED WITH THE RISKOF SUDDENCARDIAC DEATH: PATHOGENESIS, CLINICAL MANIFESTATIONS, DIAGNOSTIC CRITERIA, INDICATIONS FORGENETIC RESEARCHAND TREATMENT

    Directory of Open Access Journals (Sweden)

    V. V. Rezvan

    2013-01-01

    Full Text Available PURPOSE. The problem of sudden cardiac death (SCD is the most relevant in the modern cardiology , and if organic heart diseases exist, treatment strategy and prevention of SCD is developed , this problem is not solved in the patients without organic changes. Currently, a group of diseases, clinical and electrocardiographic syndromes, has emerged, that are closely associated with the formation of fatal arrhythmias. Special hazard of the course of these pathological conditions is due to the high risk of SCD, especially in young people. These diseases are not accompanied by structural changes in the myocardium and manifest themselves mainly by electrophysiological abnormalities in cardiomyocytes. Mutations in genes encoding ion channel proteins expressed in the myocardium, and their modulators, is the basis of these diseases. This fact is accounted for the unification of these diseases in the group of «channelopathies». The article presents the current diagnostic criteria for these diseases and treatments. In 2011 Guidelines of the European Society of Cardiology for genetic research in channelopathies and cardiomyopathies that have defined the indications for genetic research in this pathology, were issued. 

  17. Diagnostic criteria for vascular dementia

    NARCIS (Netherlands)

    Scheltens, P.; Hijdra, A. H.

    1998-01-01

    The term vascular dementia implies the presence of a clinical syndrome (dementia) caused by, or at least assumed to be caused by, a specific disorder (cerebrovascular disease). In this review, the various sets of criteria used to define vascular dementia are outlined. The various sets of criteria

  18. Diagnostic criteria for atypical hemolytic uremic syndrome proposed by the Joint Committee of the Japanese Society of Nephrology and the Japan Pediatric Society.

    Science.gov (United States)

    Sawai, Toshihiro; Nangaku, Masaomi; Ashida, Akira; Fujimaru, Rika; Hataya, Hiroshi; Hidaka, Yoshihiko; Kaname, Shinya; Okada, Hirokazu; Sato, Waichi; Yasuda, Takashi; Yoshida, Yoko; Fujimura, Yoshihiro; Hattori, Motoshi; Kagami, Shoji

    2014-02-01

    Atypical hemolytic uremic syndrome (aHUS) is rare and comprises the triad of microangiopathic hemolytic anemia, thrombocytopenia, and acute kidney injury. Recently, abnormalities in the mechanisms underlying complement regulation have been focused upon as causes of aHUS. The prognosis for patients who present with aHUS is very poor, with the first aHUS attack being associated with a mortality rate of ~25 %, and with ~50 % of cases resulting in end-stage renal disease requiring dialysis. If treatment is delayed, there is a high risk of this syndrome progressing to renal failure. Therefore, we have developed diagnostic criteria for aHUS to enable its early diagnosis and to facilitate the timely initiation of appropriate treatment. We hope these diagnostic criteria will be disseminated to as many clinicians as possible and that they will be used widely.

  19. Fibromyalgia diagnosis and diagnostic criteria.

    Science.gov (United States)

    Wolfe, Frederick; Häuser, Winfried

    2011-11-01

    Abstract Criteria for fibromyalgia developed from the conceptualization and hypotheses of Smythe and Moldofsky in 1977 and gradually evolved to a set of classification criteria endorsed by the American College of Rheumatology that emphasized tender points and widespread pain, measures of decreased pain threshold. In 2010, American College of Rheumatology fibromyalgia diagnostic criteria were published that abandoned the tender point count and placed increased emphasis of patient symptoms. The 2010 criteria also contained severity scales and offered physicians the opportunity to assess polysymptomatic distress on a continuous scale. This enabled physicians who were opposed to the idea of fibromyalgia to also assess and diagnose patients using an alternative nomenclature.

  20. Metabolic syndrome in type 2 diabetes: comparative prevalence according to two sets of diagnostic criteria in sub-Saharan Africans

    Directory of Open Access Journals (Sweden)

    Kengne Andre P

    2012-05-01

    Full Text Available Abstract Background Available definition criteria for metabolic syndrome (MS have similarities and inconsistencies. The aim of this study was to determine the prevalence of MS in a group of Cameroonians with type 2 diabetes, according to the International Diabetes Federation (IDF and the National Cholesterol Education Programme Adult Treatment Panel III (NCEP-ATP III criteria, and to assess the concordance between both criteria, and the implications of combining them. Methods We collected clinical and biochemical data for 308 patients with type 2 diabetes (men 157 at the National Obesity Center of the Yaounde Central Hospital, Cameroon. Concordance was assessed with the use of the Kappa statistic. Results Mean age (standard deviation was 55.8 (10.5 years and the median duration of diagnosed diabetes (25th–75th percentiles was 3 years (0.5–5.0, similarly among men and women. The prevalence of MS was 71.7% according to the IDF criteria and 60.4% according to NCEP-ATP III criteria. The prevalence was significantly higher in women than in men independently of the criteria used (both p  Conclusions The IDF and NCEP-ATP III criteria do not always diagnose the same group of diabetic individuals with MS and combining them merely increases the yield beyond that provided by the IDF definition alone. This study highlights the importance of having a single unifying definition for MS in our setting.

  1. Clinical subtypes of chronic traumatic encephalopathy: literature review and proposed research diagnostic criteria for traumatic encephalopathy syndrome.

    Science.gov (United States)

    Montenigro, Philip H; Baugh, Christine M; Daneshvar, Daniel H; Mez, Jesse; Budson, Andrew E; Au, Rhoda; Katz, Douglas I; Cantu, Robert C; Stern, Robert A

    2014-01-01

    The long-term consequences of repetitive head impacts have been described since the early 20th century. Terms such as punch drunk and dementia pugilistica were first used to describe the clinical syndromes experienced by boxers. A more generic designation, chronic traumatic encephalopathy (CTE), has been employed since the mid-1900s and has been used in recent years to describe a neurodegenerative disease found not just in boxers but in American football players, other contact sport athletes, military veterans, and others with histories of repetitive brain trauma, including concussions and subconcussive trauma. This article reviews the literature of the clinical manifestations of CTE from 202 published cases. The clinical features include impairments in mood (for example, depression and hopelessness), behavior (for example, explosivity and violence), cognition (for example, impaired memory, executive functioning, attention, and dementia), and, less commonly, motor functioning (for example, parkinsonism, ataxia, and dysarthria). We present proposed research criteria for traumatic encephalopathy syndrome (TES) which consist of four variants or subtypes (TES behavioral/mood variant, TES cognitive variant, TES mixed variant, and TES dementia) as well as classifications of 'probable CTE' and 'possible CTE'. These proposed criteria are expected to be modified and updated as new research findings become available. They are not meant to be used for a clinical diagnosis. Rather, they should be viewed as research criteria that can be employed in studies of the underlying causes, risk factors, differential diagnosis, prevention, and treatment of CTE and related disorders.

  2. The Prevalence of Constipation and Irritable Bowel Syndrome in Parkinson's Disease Patients According to Rome III Diagnostic Criteria.

    Science.gov (United States)

    Mishima, Takayasu; Fukae, Jiro; Fujioka, Shinsuke; Inoue, Kotoe; Tsuboi, Yoshio

    2017-01-01

    Gastrointestinal symptoms are one of the most common non-motor features of Parkinson's disease (PD). Recently, a report from Taiwan revealed that irritable bowel syndrome (IBS) may be associated with an increased risk of developing PD; however, the prevalence of IBS in PD patients has not been fully evaluated. Rome III criteria are widely assessed with a questionnaire to determine functional gastrointestinal disorders. We assessed the prevalence of constipation and IBS in PD patients in our cohort using Rome III criteria. Between October 2014 and April 2015, 118 patients with PD were treated at Fukuoka University Hospital and were enrolled in this study. Rome III criteria were used to diagnose constipation and IBS. Constipation and IBS were detected in 32 (27.1%) and 20 patients (17.0%), respectively. The most common symptom related to constipation was straining during defecation (77.1%). Among constipation symptoms, patients' self-awareness of constipation was mostly related to straining during defecation (odds ratio 5.27, 95% confidence interval 1.475-18.811). The number of constipation symptoms was correlated with the severity of the Hoehn-Yahr Stage (p constipation based on Rome III criteria was much lower than that reported in previous studies. Further studies are warranted to evaluate gastrointestinal symptoms in PD patients using comparable questionnaires.

  3. Proposed Diagnostic Criteria for Smartphone Addiction.

    Science.gov (United States)

    Lin, Yu-Hsuan; Chiang, Chih-Lin; Lin, Po-Hsien; Chang, Li-Ren; Ko, Chih-Hung; Lee, Yang-Han; Lin, Sheng-Hsuan

    2016-01-01

    Global smartphone penetration has led to unprecedented addictive behaviors. The aims of this study are to develop diagnostic criteria of smartphone addiction and to examine the discriminative ability and the validity of the diagnostic criteria. We developed twelve candidate criteria for characteristic symptoms of smartphone addiction and four criteria for functional impairment caused by excessive smartphone use. The participants consisted of 281 college students. Each participant was systematically assessed for smartphone-using behaviors by psychiatrist's structured diagnostic interview. The sensitivity, specificity, and diagnostic accuracy of the candidate symptom criteria were analyzed with reference to the psychiatrists' clinical global impression. The optimal model selection with its cutoff point of the diagnostic criteria differentiating the smartphone addicted subjects from non-addicted subjects was then determined by the best diagnostic accuracy. Six symptom criteria model with optimal cutoff point were determined based on the maximal diagnostic accuracy. The proposed smartphone addiction diagnostic criteria consisted of (1) six symptom criteria, (2) four functional impairment criteria and (3) exclusion criteria. Setting three symptom criteria as the cutoff point resulted in the highest diagnostic accuracy (84.3%), while the sensitivity and specificity were 79.4% and 87.5%, respectively. We suggested determining the functional impairment by two or more of the four domains considering the high accessibility and penetration of smartphone use. The diagnostic criteria of smartphone addiction demonstrated the core symptoms "impaired control" paralleled with substance related and addictive disorders. The functional impairment involved multiple domains provide a strict standard for clinical assessment.

  4. Bouveret's Syndrome: diagnostic considerations

    International Nuclear Information System (INIS)

    Cooper, S.G.; Sherman, S.B.; Steinhardt, J.E.; Wilson, J.M. Jr.; Richman, A.H.

    1987-01-01

    Bouveret's syndrome is a rare disease entity manifested by the formation of a cholecystoduodenal or choledochoduodenal fistula with passage of a gallstone into the duodenal bulb and subsequent obstruction of the gastric outlet. To date, no report of this entity using computed tomographic (CT) imaging is available. This article presents a case of Bouveret's syndrome with the classic findings on upper gastrointestinal (GI) tract series and a description of the CT manifestations. The literature is reviewed with discussion of the diagnostic approach to patients with Bouveret's syndrome

  5. Interstitial cystitis/painful bladder syndrome: the influence of modern diagnostic criteria on epidemiology and on Internet search activity by the public

    Science.gov (United States)

    Gnanappiragasam, Sanjith; Thornhill, John A.

    2015-01-01

    Interstitial cystitis/painful bladder syndrome (IC/PBS) is a chronic debilitating condition that is characterised by suprapubic pain and urinary symptoms such as urgency, nocturia and urinary frequency. The prevalence of the condition is increasing due to more inclusive diagnostic criteria. Herein, we review the evolving epidemiology of IC/PBS and investigate health seeking behaviour for the condition through Internet search activity. Study selection was performed in accordance with PRISMA. In addition, global search trends for the terms ‘Interstitial Cystitis’ and ‘Painful Bladder Syndrome’ from 2005 to 2015 were also evaluated using the ‘Google Trends’ search application. The mean search activity per month was recorded and mean activity at annual intervals calculated. Regional search activity by country and city was also measured. Prevalence rates for IC/PBS vary according to diagnostic criteria and range from 2% to 17.3% among the general population. Increased prevalence is associated with female gender and females with one first-degree relative affected. There has been an increase in global mean search activity for IC/PBS on an annual basis since 2005. The greatest increase in search activity was in USA, Canada, United Kingdom, Australia, Ireland and India respectively. The top five cities for search activity for IC/PBS were in the USA. As diagnostic criteria for IC/PBS continues to become more inclusive it is likely that the prevalence will continue to increase. This is particularly true for the USA and Canada as these regions have demonstrated the greatest increase in Internet search activity for IC/ PBS. PMID:26816850

  6. HEPATORENAL SYNDROME: DIAGNOSTIC AND THERAPEUTIC MANAGEMENT

    Directory of Open Access Journals (Sweden)

    I. G. Bakulin

    2014-01-01

    Full Text Available The practical guidelines on diagnosis and management of hepatorenal syndrome, which could be useful for general medical practitioners, gastroenterologists, and hepatologists, are considered in this paper. Selected recommendations are based on integrated clinical data, international recommendations and results of clinical trials. Beginning from theoretical grounds of hepatorenal syndrome (its definition, diagnostic criteria, and classification, acute kidney injury, and spontaneous bacterial peritonitis, the paper contains diagnostic algorithms (in particular, in ascites, for early revealing hepatorenal syndrome, and main approaches to therapy and prevention. The efficacy criteria and monitoring rules for the terlipressin-based therapy are listed.

  7. Proposed Diagnostic Criteria for Smartphone Addiction

    OpenAIRE

    Lin, Yu-Hsuan; Chiang, Chih-Lin; Lin, Po-Hsien; Chang, Li-Ren; Ko, Chih-Hung; Lee, Yang-Han; Lin, Sheng-Hsuan

    2016-01-01

    Background Global smartphone penetration has led to unprecedented addictive behaviors. The aims of this study are to develop diagnostic criteria of smartphone addiction and to examine the discriminative ability and the validity of the diagnostic criteria. Methods We developed twelve candidate criteria for characteristic symptoms of smartphone addiction and four criteria for functional impairment caused by excessive smartphone use. The participants consisted of 281 college students. Each parti...

  8. Proposed Diagnostic Criteria for Smartphone Addiction.

    Directory of Open Access Journals (Sweden)

    Yu-Hsuan Lin

    Full Text Available Global smartphone penetration has led to unprecedented addictive behaviors. The aims of this study are to develop diagnostic criteria of smartphone addiction and to examine the discriminative ability and the validity of the diagnostic criteria.We developed twelve candidate criteria for characteristic symptoms of smartphone addiction and four criteria for functional impairment caused by excessive smartphone use. The participants consisted of 281 college students. Each participant was systematically assessed for smartphone-using behaviors by psychiatrist's structured diagnostic interview. The sensitivity, specificity, and diagnostic accuracy of the candidate symptom criteria were analyzed with reference to the psychiatrists' clinical global impression. The optimal model selection with its cutoff point of the diagnostic criteria differentiating the smartphone addicted subjects from non-addicted subjects was then determined by the best diagnostic accuracy.Six symptom criteria model with optimal cutoff point were determined based on the maximal diagnostic accuracy. The proposed smartphone addiction diagnostic criteria consisted of (1 six symptom criteria, (2 four functional impairment criteria and (3 exclusion criteria. Setting three symptom criteria as the cutoff point resulted in the highest diagnostic accuracy (84.3%, while the sensitivity and specificity were 79.4% and 87.5%, respectively. We suggested determining the functional impairment by two or more of the four domains considering the high accessibility and penetration of smartphone use.The diagnostic criteria of smartphone addiction demonstrated the core symptoms "impaired control" paralleled with substance related and addictive disorders. The functional impairment involved multiple domains provide a strict standard for clinical assessment.

  9. Proposed Diagnostic Criteria for Smartphone Addiction

    Science.gov (United States)

    Lin, Yu-Hsuan; Chiang, Chih-Lin; Lin, Po-Hsien; Chang, Li-Ren; Ko, Chih-Hung; Lee, Yang-Han

    2016-01-01

    Background Global smartphone penetration has led to unprecedented addictive behaviors. The aims of this study are to develop diagnostic criteria of smartphone addiction and to examine the discriminative ability and the validity of the diagnostic criteria. Methods We developed twelve candidate criteria for characteristic symptoms of smartphone addiction and four criteria for functional impairment caused by excessive smartphone use. The participants consisted of 281 college students. Each participant was systematically assessed for smartphone-using behaviors by psychiatrist’s structured diagnostic interview. The sensitivity, specificity, and diagnostic accuracy of the candidate symptom criteria were analyzed with reference to the psychiatrists’ clinical global impression. The optimal model selection with its cutoff point of the diagnostic criteria differentiating the smartphone addicted subjects from non-addicted subjects was then determined by the best diagnostic accuracy. Results Six symptom criteria model with optimal cutoff point were determined based on the maximal diagnostic accuracy. The proposed smartphone addiction diagnostic criteria consisted of (1) six symptom criteria, (2) four functional impairment criteria and (3) exclusion criteria. Setting three symptom criteria as the cutoff point resulted in the highest diagnostic accuracy (84.3%), while the sensitivity and specificity were 79.4% and 87.5%, respectively. We suggested determining the functional impairment by two or more of the four domains considering the high accessibility and penetration of smartphone use. Conclusion The diagnostic criteria of smartphone addiction demonstrated the core symptoms “impaired control” paralleled with substance related and addictive disorders. The functional impairment involved multiple domains provide a strict standard for clinical assessment. PMID:27846211

  10. Diagnostic criteria for sarcopenia and physical performance

    NARCIS (Netherlands)

    Bijlsma, A.Y.; Meskers, C.G.M.; van den Eshof, N.; Westendorp, R.G.; Sipila, S.; Stenroth, L.; Sillanpaa, E.; McPhee, J.S.; Jones, D.A.; Narici, M.V.; Gapeyeva, H.; Paasuke, M.; Voit, T.; Barnouin, Y.; Hogrel, J.Y.; Butler-Browne, G.; Maier, A.B.

    2014-01-01

    Relative and absolute muscle mass and muscle strength are used as diagnostic criteria for sarcopenia.We aimed to assess which diagnostic criteria are most associated with physical performance in 180 young (18-30 years) and 281 healthy old participants (69-81 years) of the European study MYOAGE.

  11. Proposed diagnostic criteria for internet addiction.

    Science.gov (United States)

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

    2010-03-01

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

  12. [Atypical Guillain-Barre syndrome clustering: is it necessary to reconsider the diagnostic criteria and microbiological protocol?

    Science.gov (United States)

    Dominguez-Mayoral, A; Gutierrez, C; Lopez-Dominguez, J M; Eichau, S; Abril, J; Navarro-Mascarell, G; Quesada-Garcia, M A; Ramos, M; Alvarez-Lopez, M; Menendez-De Leon, C; Izquierdo, G

    2017-05-01

    Guillain-Barre syndrome is classically defined as a symmetrical ascending acute polyradiculoneuropathy, although there are atypical variants that make diagnosis difficult. The medical data of six patients in our hospital area are collected during the first quarter of 2013. Lumbar punctures, imaging, neurophysiological studies, ganglioside antibodies and serologies have been proposed in all cases. We focus on the atypical features as late hyporeflexia, increased frequency of asymmetry and distal paresis and initial fever. From a neurophysiological point of view, all patients presented sensorimotor axonal forms. The most consistent datas in early studies is the F wave's alteration. A Miller Fisher variant associated with faciocervicobraquial paresis and cerebral reversible vasoconstriction syndrome has been detected. A bilateral brachial paresis and lumbar polyradiculopathy in the context of influenza A infection is other interesting case. The saltatory variant with cranial nerve involvement and lower limbs paresis has been demonstrated in one patient. Bands in cerebrospinal fluid are positive in three cases and anti-ganglioside antibodies in one patient. The syndrome of inappropriate secretion of antidiuretic hormone may explain some of the hyponatremias registered. The first line of treatment are inmunoglobulins in all patients. Plasmapheresis exchanges has been used as an additional therapy in four cases. These clusters of six axonal cases with atypical clinical features justifies the need for knowledge of these variants in order to achieve an early treatment. Late hyporeflexia and brachialfaciocervico, saltatory and lumbar forms should be considered in the spectrum of Guillain-Barre syndrome. The etiological study should rule out a lots of pathogens as influenza A.

  13. AAPT Diagnostic Criteria for Central Neuropathic Pain

    DEFF Research Database (Denmark)

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

    2017-01-01

    ) initiative, invited a working group to develop diagnostic criteria for central neuropathic pain. The criteria for central neuropathic pain that were developed expand upon existing criteria for neuropathic pain and the International Classification of Diseases 11th Revision draft criteria to ensure consistency......: The AAPT chronic central neuropathic pain taxonomy provides a classification for central pain associated with spinal cord injury, stroke, and multiple sclerosis. The diagnostic criteria are organized according to the AAPT multidimensional framework, specifically: 1) core diagnostic criteria, 2) common......Central neuropathic pain, which is pain caused by a lesion or disease of the central somatosensory nervous system, is a serious consequence of spinal cord injury, stroke, multiple sclerosis, and other conditions affecting the central nervous system. A collaborative effort between the Analgesic...

  14. The DSM diagnostic criteria for pedophilia.

    Science.gov (United States)

    Blanchard, Ray

    2010-04-01

    This paper contains the author's report on pedophilia, submitted on June 2, 2008, to the work group charged with revising the diagnoses concerning sexual and gender identity disorders for the fifth edition of the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders (DSM). The author reviews the previously published criticisms and empirical research concerning the diagnostic criteria for pedophilia and presents criticism and relevant research of his own. The review shows that the DSM diagnostic criteria for pedophilia have repeatedly been criticized as unsatisfactory on logical or conceptual grounds, and that published empirical studies on the reliability and validity of these criteria have produced ambiguous results. It therefore seems that the current (i.e., DSM-IV-TR) diagnostic criteria need to be examined with an openness to major changes in the DSM-V.

  15. Characteristics of complex regional pain syndrome in patients referred to a tertiary pain clinic by community physicians, assessed by the Budapest clinical diagnostic criteria.

    Science.gov (United States)

    Mailis-Gagnon, Angela; Lakha, Shehnaz Fatima; Allen, Matti D; Deshpande, Amol; Harden, Robert Norman

    2014-11-01

    The aim of this study was to describe the characteristics of patients referred with complex regional pain syndrome (CRPS) diagnosis to a tertiary care pain center. Descriptive chart review study of all patients referred by family physicians or community specialists as having CRPS (2006-2010). Data extraction included demographics, pain ratings, and diagnosis utilizing the Budapest CRPS criteria. The study population consisted of 54 subjects (male [M] =7, female [F] =47). Only 27.7% were classified as CRPS by the clinical expert. Four additional subjects carrying other diagnoses but found to have CRPS were added to the analysis. The non-CRPS group consisted of 39 subjects (M=8, F=31) and the CRPS group of 19 (M=2, F=17). CRPS patients were statistically significantly more likely to 1) have suffered a fracture; 2) report symptoms in each of the four symptom categories, as well as signs in three or four categories collectively; and 3) have allodynia/hyperalgesia alone or in combination (85/90%) as compared with the non-CRPS group (23/25%, respectively). The non-CRPS group was much more likely to report no symptoms or signs at all in the different symptom and sign categories. Of the 39 non-CRPS patients, 74% had other diagnosable entities (1/3 suffering from specific neuropathic pain conditions, e.g., radiculopathy, diabetic neuropathy, etc. and 2/3 from discreet musculoskeletal entities), while 18% were diagnosed with psychogenic pain disorders including conversion reaction associated with immobility or paralysis. Besides fulfilling the Budapest CRPS diagnostic criteria, the most important other factor for diagnosing CRPS is the exclusion of a neuropathic, musculoskeletal, or non-biomedical condition accounting for the presentation. Wiley Periodicals, Inc.

  16. 2016 Revisions to the 2010/2011 fibromyalgia diagnostic criteria.

    Science.gov (United States)

    Wolfe, Frederick; Clauw, Daniel J; Fitzcharles, Mary-Ann; Goldenberg, Don L; Häuser, Winfried; Katz, Robert L; Mease, Philip J; Russell, Anthony S; Russell, Irwin Jon; Walitt, Brian

    2016-12-01

    The provisional criteria of the American College of Rheumatology (ACR) 2010 and the 2011 self-report modification for survey and clinical research are widely used for fibromyalgia diagnosis. To determine the validity, usefulness, potential problems, and modifications required for the criteria, we assessed multiple research reports published in 2010-2016 in order to provide a 2016 update to the criteria. We reviewed 14 validation studies that compared 2010/2011 criteria with ACR 1990 classification and clinical criteria, as well as epidemiology, clinical, and databank studies that addressed important criteria-level variables. Based on definitional differences between 1990 and 2010/2011 criteria, we interpreted 85% sensitivity and 90% specificity as excellent agreement. Against 1990 and clinical criteria, the median sensitivity and specificity of the 2010/2011 criteria were 86% and 90%, respectively. The 2010/2011 criteria led to misclassification when applied to regional pain syndromes, but when a modified widespread pain criterion (the "generalized pain criterion") was added misclassification was eliminated. Based on the above data and clinic usage data, we developed a (2016) revision to the 2010/2011 fibromyalgia criteria. Fibromyalgia may now be diagnosed in adults when all of the following criteria are met: CONCLUSIONS: The fibromyalgia criteria have good sensitivity and specificity. This revision combines physician and questionnaire criteria, minimizes misclassification of regional pain disorders, and eliminates the previously confusing recommendation regarding diagnostic exclusions. The physician-based criteria are valid for individual patient diagnosis. The self-report version of the criteria is not valid for clinical diagnosis in individual patients but is valid for research studies. These changes allow the criteria to function as diagnostic criteria, while still being useful for classification. Copyright © 2016 Elsevier Inc. All rights reserved.

  17. AAPT Diagnostic Criteria for Chronic Cancer Pain Conditions.

    Science.gov (United States)

    Paice, Judith A; Mulvey, Matt; Bennett, Michael; Dougherty, Patrick M; Farrar, John T; Mantyh, Patrick W; Miaskowski, Christine; Schmidt, Brian; Smith, Thomas J

    2017-03-01

    Chronic cancer pain is a serious complication of malignancy or its treatment. Currently, no comprehensive, universally accepted cancer pain classification system exists. Clarity in classification of common cancer pain syndromes would improve clinical assessment and management. Moreover, an evidence-based taxonomy would enhance cancer pain research efforts by providing consistent diagnostic criteria, ensuring comparability across clinical trials. As part of a collaborative effort between the Analgesic, Anesthetic, and Addiction Clinical Trial Translations, Innovations, Opportunities, and Networks (ACTTION) and the American Pain Society (APS), the ACTTION-APS Pain Taxonomy initiative worked to develop the characteristics of an optimal diagnostic system. After the establishment of these characteristics, a working group consisting of clinicians and clinical and basic scientists with expertise in cancer and cancer-related pain was convened to generate core diagnostic criteria for an illustrative sample of 3 chronic pain syndromes associated with cancer (ie, bone pain and pancreatic cancer pain as models of pain related to a tumor) or its treatment (ie, chemotherapy-induced peripheral neuropathy). A systematic review and synthesis was conducted to provide evidence for the dimensions that comprise this cancer pain taxonomy. Future efforts will subject these diagnostic categories and criteria to systematic empirical evaluation of their feasibility, reliability, and validity and extension to other cancer-related pain syndromes. The ACTTION-APS chronic cancer pain taxonomy provides an evidence-based classification for 3 prevalent syndromes, namely malignant bone pain, pancreatic cancer pain, and chemotherapy-induced peripheral neuropathy. This taxonomy provides consistent diagnostic criteria, common features, comorbidities, consequences, and putative mechanisms for these potentially serious cancer pain conditions that can be extended and applied with other cancer

  18. Phenomenology of Schizophrenia and the Representativeness of Modern Diagnostic Criteria.

    Science.gov (United States)

    Kendler, Kenneth S

    2016-10-01

    This article aims to determine the degree to which modern operationalized diagnostic criteria for schizophrenia reflect the main clinical features of the disorder as described historically by diagnostic experts. Amazon.com, the National Library of Medicine, and Forgottenbooks.com were searched for articles written or translated into English from 1900 to 1960. Clinical descriptions of schizophrenia or dementia praecox appearing in 16 textbooks or review articles published between 1899 and 1956 were reviewed and compared with the criteria for schizophrenia from 6 modern US operationalized diagnostic systems. Twenty prominent symptoms and signs were reported by 5 or more authors. A strong association was seen between the frequency with which the symptoms/signs were reported and the likelihood of their presence in modern diagnostic systems. Of these 20 symptoms/signs, 3 (thought disorder, delusions, and hallucinations) were included in all diagnostic systems and were among the 4 most frequently reported. Three symptoms/signs were added then kept in subsequent criteria: emotional blunting, changes in volition, and changes in social life. Three symptoms/signs were added but then dropped: bizarre delusions, passivity symptoms, and mood incongruity. Eleven symptoms/signs were never included in any diagnostic system. Compared with historical authors, modern criteria favored symptoms over signs. Odd movements and postures, noted by 16 of 18 historical authors, were absent from all modern criteria. DSM-5 criteria contain 6 of the 20 historically noted symptoms/signs. Although modern operationalized criteria for schizophrenia reflect symptoms and signs commonly reported by historical experts, many clinical features emphasized by these experts are absent from modern criteria. This is not necessarily problematic as diagnostic criteria are meant to index rather than thoroughly describe syndromes. However, the lack of correspondence in schizophrenia between historically important

  19. Surgical criteria for femoroacetabular impingement syndrome

    DEFF Research Database (Denmark)

    Peters, Scott; Laing, Alisha; Emerson, Courtney

    2017-01-01

    BACKGROUND: The purpose of this review was to analyse and report criteria used for open and arthroscopic surgical treatment of femoroacetabular impingement syndrome (FAIS). METHODS: A librarian-assisted computer search of Medline, CINAHL and Embase for studies related to criterion for FAIS surgery......% of studies described previously failed treatment (non-surgical or physiotherapist-led rehabilitation) as a criterion for surgery. Only 56% of included studies utilised the combination of symptoms, clinical signs and diagnostic imaging combined for diagnosis of FAIS as suggested by the Warwick Agreement...... on FAIS meeting. CONCLUSION: Diagnostic imaging evidence of FAIS was the most commonly reported criterion for surgery. Only 56% of included studies utilised the combination of symptoms, clinical signs and diagnostic imaging for diagnosis of FAIS as suggested by the Warwick Agreement on FAIS meeting...

  20. Combining the IADPSG criteria with the WHO diagnostic criteria for ...

    African Journals Online (AJOL)

    Background: Gestational diabetes mellitus (GDM) is associated with adverse pregnancy outcomes, yet there are no universally accepted diagnostic ... pregnancy outcome than a diagnosis that meets only WHO or IADPSG criteria. Key words: .... GDM, hypertensive disorder, maternal age, maternal obesity, family history of ...

  1. Combining the IADPSG criteria with the WHO diagnostic criteria for ...

    African Journals Online (AJOL)

    glucose, 1‑hour and 2‑hour serum glucose. Serum glucose was analysed on the Roche/Hitachi 902 automatic analyzer. The women were classified as gestational diabetics and non‑gestational diabetic according to the WHO and IADPSG diagnostic criteria. Five pregnancy outcome parameters were observed during the ...

  2. AAPT Diagnostic Criteria for Chronic Cancer Pain Conditions

    OpenAIRE

    Paice, Judith A.; Mulvey, Matt; Bennett, Michael; Dougherty, Patrick M.; Farrar, John T.; Mantyh, Patrick W.; Miaskowski, Christine; Schmidt, Brian; Smith, Thomas J.

    2016-01-01

    Chronic cancer pain is a serious complication of malignancy or its treatment. Currently, no comprehensive, universally accepted cancer pain classification system exists. Clarity in classification of common cancer pain syndromes would improve clinical assessment and management. Moreover, an evidence-based taxonomy would enhance cancer pain research efforts by providing consistent diagnostic criteria, ensuring comparability across clinical trials. As part of a collaborative effort between the A...

  3. Exome sequencing for syndrome diagnostics

    DEFF Research Database (Denmark)

    Østergaard, Elsebet; Risom, Lotte; Ek, Jakob

    2017-01-01

    The majority of rare congenital disorders and syndromes have a genetic cause, but the diagnostic rate using standard workup is only around 50%. Whole exome and whole genome sequencing methods have improved the genetic diagnosis of syndromes during the latest few years. This article...

  4. Mitochondrial encephalopathy, lactic acidosis, and stroke-like episodes syndrome (MELAS: diagnostic criteria, features of epileptic seizures, and treatment approaches by the example of a clinical case

    Directory of Open Access Journals (Sweden)

    M. A. Yamin

    2017-01-01

    Full Text Available The paper describes a patient with mitochondrial encephalopathy, lactic acidosis, and stroke-like episodes syndrome (MELAS. The features of  the course and therapy of epilepsy in MELAS are discussed. The disease  is known for its late diagnosis when years elapse from the onset of the  clinical manifestations to diagnosis. The paper presents clinical criteria  for the diagnosis of MELAS and the specific features of brain neuroimaging changes that allow identification of the disease at an early stage.

  5. The DSM diagnostic criteria for dyspareunia.

    Science.gov (United States)

    Binik, Yitzchak M

    2010-04-01

    The DSM-IV-TR attempted to create a unitary category of dyspareunia based on the criterion of genital pain that interfered with sexual intercourse. This classificatory emphasis of interference with intercourse is reviewed and evaluated from both theoretical and empirical points of view. Neither of these points of view was found to support the notion of dyspareunia as a unitary disorder or its inclusion in the DSM-V as a sexual dysfunction. It seems highly likely that there are different syndromes of dyspareunia and that what is currently termed "superficial dyspareunia" cannot be differentiated reliably from vaginismus. It is proposed that the diagnoses of vaginismus and dyspareunia be collapsed into a single diagnostic entity called genito-pelvic pain/penetration disorder. This diagnostic category is defined according to five dimensions: percentage success of vaginal penetration; pain with vaginal penetration; fear of vaginal penetration or of genito-pelvic pain during vaginal penetration; pelvic floor muscle dysfunction; medical co-morbidity.

  6. Diagnosis and diagnostic tests for fibromyalgia (syndrome).

    Science.gov (United States)

    Häuser, W; Wolfe, F

    2012-09-28

    To present diagnostic criteria for the clinical diagnosis of fibromyalgia syndrome (FMS) and to offer a scheme for diagnostic work-up in clinical practice. Narrative review of the literature, consensus documents by the American College of Rheumatology (ACR), evidence-based interdisciplinary German guidelines on the diagnosis and management of FMS. The ACR 1990 classification criteria emphasized tender points and widespread pain as the key features of FMS. In 2010, the ACR proposed preliminary diagnostic criteria for fibromyalgia that abandoned the tender point count and placed increased emphasis of patient symptoms. A later modification of the ACR 2010 criteria for use in surveys employed a self-report questionnaire (Fibromyalgia Survey Questionnaire FSQ) to assess patient symptoms. The FSQ can be used to assist physician's diagnosis of FMS. We recommend a stepwise diagnostic work-up of patients with chronic widespread pain (CWP) in primary care: Complete medical history including medication, complete medical examination, basic laboratory tests to screen for inflammatory or endocrinology diseases, referral to specialists only in case of suspected somatic diseases, assessment of limitations of daily functioning, screening for other functional somatic symptoms and mental disorders, and referring to mental health specialists in case of mental disorder. The diagnosis of FMS is easy in most patients with CWP and does not ordinarily require a rheumatologist. A rheumatologist's expertise might be needed to exclude difficult to diagnose or concomitant inflammatory rheumatic diseases. In the presence of mental illness referral to a mental health specialist for evaluation is recommended.

  7. [Diagnostic criteria for Non-ABCDE hepatitis].

    Science.gov (United States)

    Yatsuhashi, H; Inoue, O; Koga, M; Yano, M

    1997-03-01

    Hepatitis viruses A, B, C, D and E are all well-characterized, molecularly defined agents with unequivocal disease association. Usual diagnosis for these virus infections are established by serological markers which are specific antigens or antibodies for these virus infections. But serological diagnosis occasionally shows pseudonegative results because this method is indirect diagnosis. In contrast, molecular diagnosis catches directly components of viral structure. Molecular diagnosis is also able to show the appearance and disappearance of these hepatitis viruses. Diagnostic criteria for Non-ABCDE hepatitis is the exclusion of hepatitis viruses A, B, C, D and E infections by using not only serological diagnosis but also molecular diagnosis.

  8. Criteria and suspension levels in diagnostic radiology

    International Nuclear Information System (INIS)

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

    2013-01-01

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

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

    Science.gov (United States)

    Wilfley, Denise E; Citrome, Leslie; Herman, Barry K

    2016-01-01

    The objective of this review was to examine the evidentiary basis for binge eating disorder (BED) with reference to the Diagnostic and Statistical Manual of Mental Disorders – Fifth Edition (DSM-5) diagnostic criteria for BED. A PubMed search restricted to titles and abstracts of English-language reviews, meta-analyses, clinical trials, randomized controlled trials, journal articles, and letters using human participants was conducted on August 7, 2015, using keywords that included “binge eating disorder,” DSM-5, DSM-IV, guilt, shame, embarrassment, quantity, psychological, behavior, and “shape and weight concerns.” Of the 257 retrieved publications, 60 publications were considered relevant to discussions related to DSM-5 diagnostic criteria and were included in the current review, and 20 additional references were also included on the basis of the authors’ knowledge and/or on a review of the reference lists from relevant articles obtained through the literature search. Evidence supports the duration/frequency criterion for BED and the primary importance of loss of control and marked distress in identifying individuals with BED. Although overvaluation of shape/weight is not a diagnostic criterion, its relationship to the severity of BED psychopathology may identify a unique subset of individuals with BED. Additionally, individuals with BED often exhibit a clinical profile consisting of psychiatric (eg, mood, obsessive–compulsive, and impulsive disorders) and medical (eg, gastrointestinal symptoms, metabolic syndrome, and type 2 diabetes) comorbidities and behavioral profiles (eg, overconsumption of calories outside of a binge eating episode and emotional eating). Future revisions of the BED diagnostic criteria should consider the inclusion of BED subtypes, perhaps based on the overvaluation of shape/weight, and an evidence-based reassessment of severity criteria. PMID:27621631

  10. Diagnostic criteria for headache attributed to temporomandibular disorders

    DEFF Research Database (Denmark)

    Schiffman, Eric; Ohrbach, Richard; List, Thomas

    2012-01-01

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

  11. Metabolic syndrome criteria as predictors of insulin resistance, inflammation and mortality in chronic hemodialysis patients.

    Science.gov (United States)

    Vogt, Barbara Perez; Souza, Priscilla L; Minicucci, Marcos Ferreira; Martin, Luis Cuadrado; Barretti, Pasqual; Caramori, Jacqueline Teixeira

    2014-10-01

    Abstract Background: Chronic kidney disease (CKD) and metabolic syndrome are characterized by overlapping disorders, including glucose intolerance, hypertension, dyslipidemia, and, in some cases, obesity. However, there are no specific criteria for the diagnosis of metabolic syndrome in CKD. Metabolic syndrome can also be associated with increased risk of mortality. Some traditional risk factors may protect dialysis patients from mortality, known as "reverse epidemiology." Metabolic syndrome might undergo reverse epidemiology. The objectives were to detect differences in frequency and metabolic characteristics associated with three sets of diagnostic criteria for metabolic syndrome, to evaluate the accuracy of insulin resistance (IR) and inflammation to identify patients with metabolic syndrome, and to investigate the effects of metabolic syndrome by three sets of diagnostic criteria on mortality in chronic hemodialysis patients. An observational study was conducted. Diagnostic criteria for metabolic syndrome proposed by National Cholesterol Education Program Adult Treatment Panel III (NCEP ATP III), International Diabetes Federation (IDF), and Harmonizing the Metabolic Syndrome (HMetS) statement were applied to 98 hemodialysis patients. The prevalence of metabolic syndrome was 51%, 66.3%, and 75.3% according to NCEP ATP III, IDF, and HMetS criteria, respectively. Diagnosis of metabolic syndrome by HMetS was simultaneously capable of revealing both inflammation and IR, whereas NCEP ATP III and IDF criteria were only able to identify IR. Mortality risk increased in the presence of metabolic syndrome regardless of the criteria used. The prevalence of metabolic syndrome in hemodialysis varies according to the diagnostic criteria used. IR and inflammation predict metabolic syndrome only when diagnosed by HMetS criteria. HMetS was the diagnostic criteria that can predict the highest risk of mortality.

  12. Establishing diagnostic criteria for severe combined immunodeficiency disease (SCID), leaky SCID, and Omenn syndrome: the Primary Immune Deficiency Treatment Consortium experience.

    Science.gov (United States)

    Shearer, William T; Dunn, Elizabeth; Notarangelo, Luigi D; Dvorak, Christopher C; Puck, Jennifer M; Logan, Brent R; Griffith, Linda M; Kohn, Donald B; O'Reilly, Richard J; Fleisher, Thomas A; Pai, Sung-Yun; Martinez, Caridad A; Buckley, Rebecca H; Cowan, Morton J

    2014-04-01

    The approach to the diagnosis of severe combined immunodeficiency disease (SCID) and related disorders varies among institutions and countries. The Primary Immune Deficiency Treatment Consortium attempted to develop a uniform set of criteria for diagnosing SCID and related disorders and has evaluated the results as part of a retrospective study of SCID in North America. Clinical records from 2000 through 2009 at 27 centers in North America were collected on 332 children treated with hematopoietic stem cell transplantation (HCT), enzyme replacement therapy, or gene therapy for SCID and related disorders. Eligibility for inclusion in the study and classification into disease groups were established by using set criteria and applied by an expert review group. Two hundred eighty-five (86%) of the patients were determined to be eligible, and 47 (14%) were not eligible. Of the 285 eligible patients, 84% were classified as having typical SCID; 13% were classified as having leaky SCID, Omenn syndrome, or reticular dysgenesis; and 3% had a history of enzyme replacement or gene therapy. Detection of a genotype predicting an SCID phenotype was accepted for eligibility. Reasons for noneligibility were failure to demonstrate either impaired lymphocyte proliferation or maternal T-cell engraftment. Overall (n = 332) rates of testing were as follows: proliferation to PHA, 77%; maternal engraftment, 35%; and genotype, 79% (mutation identified in 62%). Lack of complete laboratory evaluation of patients before HCT presents a significant barrier to definitive diagnosis of SCID and related disorders and prevented inclusion of subjects in our observational HCT study. This lesson is critical for patient care, as well as the design of future prospective treatment studies for such children because a well-defined and consistent study population is important for precision in outcomes analysis. Published by Mosby, Inc.

  13. Diagnosis and diagnostic tests for fibromyalgia (syndrome

    Directory of Open Access Journals (Sweden)

    F. Wolfe

    2012-09-01

    Full Text Available Objectives: To present diagnostic criteria for the clinical diagnosis of fibromyalgia syndrome (FMS and to offer a scheme for diagnostic work-up in clinical practice. Methods: Narrative review of the literature, consensus documents by the American College of Rheumatology (ACR, evidence-based interdisciplinary German guidelines on the diagnosis and management of FMS. Results: The ACR 1990 classification criteria emphasized tender points and widespread pain as the key features of FMS. In 2010, the ACR proposed preliminary diagnostic criteria for fibromyalgia that abandoned the tender point count and placed increased emphasis of patient symptoms. A later modification of the ACR 2010 criteria for use in surveys employed a self-report questionnaire (Fibromyalgia Survey Questionnaire FSQ to assess patient symptoms. The FSQ can be used to assist physician’s diagnosis of FMS. We recommend a stepwise diagnostic work-up of patients with chronic widespread pain (CWP in primary care: Complete medical history including medication, complete medical examination, basic laboratory tests to screen for inflammatory or endocrinology diseases, referral to specialists only in case of suspected somatic diseases, assessment of limitations of daily functioning, screening for other functional somatic symptoms and mental disorders, and referring to mental health specialists in case of mental disorder. Conclusions: The diagnosis of FMS is easy in most patients with CWP and does not ordinarily require a rheumatologist. A rheumatologist’s expertise might be needed to exclude difficult to diagnose or concomitant inflammatory rheumatic diseases. In the presence of mental illness referral to a mental health specialist for evaluation is recommended.

  14. Aggressive periodontitis: case definition and diagnostic criteria.

    Science.gov (United States)

    Albandar, Jasim M

    2014-06-01

    Aggressive periodontitis is a destructive disease characterized by the following: the involvement of multiple teeth with a distinctive pattern of periodontal tissue loss; a high rate of disease progression; an early age of onset; and the absence of systemic diseases. In some patients periodontal tissue loss may commence before puberty, whereas in most patients the age of onset is during or somewhat after the circumpubertal period. Besides infection with specific microorganisms, a host predisposition seems to play a key role in the pathogenesis of aggressive periodontitis, as evidenced by the familial aggregation of the disease. In this article we review the historical background of the diagnostic criteria of aggressive periodontitis, present a contemporary case definition and describe the clinical parameters of the disease. At present, the diagnosis of aggressive periodontitis is achieved using case history, clinical examination and radiographic evaluation. The data gathered using these methods are prone to relatively high measurement errors. Besides, this diagnostic approach measures past disease history and may not reliably measure existing disease activity or accurately predict future tissue loss. A diagnosis is often made years after the onset of the disease, partly because current assessment methods detect established disease more readily and reliably than they detect incipient or initial lesions where the tissue loss is minimal and usually below the detection threshold of present examination methods. Future advancements in understanding the pathogenesis of this disease may contribute to an earlier diagnosis. Insofar, future case definitions may involve the identification of key etiologic and risk factors, combined with high-precision methodologies that enable the early detection of initial lesions. This may significantly enhance the predictive value of these tests and detect cases of aggressive periodontitis before significant tissue loss develops. © 2014

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

    Directory of Open Access Journals (Sweden)

    Masahiro Maruyama

    2013-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Wilfley DE

    2016-08-01

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

  17. Combining the IADPSG criteria with the WHO diagnostic criteria for ...

    African Journals Online (AJOL)

    Five pregnancy outcomes were observed, namely, pre‑eclampsia, shoulder dystocia or birth injury, birth weight ≥4.0 kg, clinical neonatal hypoglycaemia and birth asphyxia. Results: Twenty‑eight participants (21.5%) had GDM by the IADPSG criteria (GDMIADPSG) and 21 (16.2%) women had GDM by the WHO criteria ...

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

    Science.gov (United States)

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

    2016-05-10

    The syndrome known as nocturnal frontal lobe epilepsy is recognized worldwide and has been studied in a wide range of clinical and scientific settings (epilepsy, sleep medicine, neurosurgery, pediatric neurology, epidemiology, genetics). Though uncommon, it is of considerable interest to practicing neurologists because of complexity in differential diagnosis from more common, benign sleep disorders such as parasomnias, or other disorders like psychogenic nonepileptic seizures. Moreover, misdiagnosis can have substantial adverse consequences on patients' lives. At present, there is no consensus definition of this disorder and disagreement persists about its core electroclinical features and the spectrum of etiologies involved. To improve the definition of the disorder and establish diagnostic criteria with levels of certainty, a consensus conference using formal recommended methodology was held in Bologna in September 2014. It was recommended that the name be changed to sleep-related hypermotor epilepsy (SHE), reflecting evidence that the attacks are associated with sleep rather than time of day, the seizures may arise from extrafrontal sites, and the motor aspects of the seizures are characteristic. The etiology may be genetic or due to structural pathology, but in most cases remains unknown. Diagnostic criteria were developed with 3 levels of certainty: witnessed (possible) SHE, video-documented (clinical) SHE, and video-EEG-documented (confirmed) SHE. The main research gaps involve epidemiology, pathophysiology, treatment, and prognosis. © 2016 American Academy of Neurology.

  19. Diagnostic criteria in invasive pituitary adenomas

    Directory of Open Access Journals (Sweden)

    Moldovan Ioana-Maria

    2016-09-01

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

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

    Directory of Open Access Journals (Sweden)

    O. A. Antelava

    2014-01-01

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

  1. New Diagnostic and Treatment Modalities for Neurogenic Thoracic Outlet Syndrome

    Science.gov (United States)

    Weaver, M. Libby; Lum, Ying Wei

    2017-01-01

    Neurogenic thoracic outlet syndrome is a widely recognized, yet controversial, syndrome. The lack of specific objective diagnostic modalities makes diagnosis difficult. This is compounded by a lack of agreed upon definitive criteria to confirm diagnosis. Recent efforts have been made to more clearly define a set of diagnostic criteria that will bring consistency to the diagnosis of neurogenic thoracic syndrome. Additionally, advancements have been made in the quality and techniques of various imaging modalities that may aid in providing more accurate diagnoses. Surgical decompression remains the mainstay of operative treatment; and minimally invasive techniques are currently in development to further minimize the risks of this procedure. Medical management continues to be refined to provide non-operative treatment modalities for certain patients, as well. The aim of the present work is to review these updates in the diagnosis and treatment of neurogenic thoracic outlet syndrome. PMID:28555024

  2. The impact of different diagnostic criteria on PTSD prevalence

    DEFF Research Database (Denmark)

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

    2007-01-01

    The diagnostic criteria for PTSD have undergone several changes in the last two decades. This may in part explain the great variance in PTSD prevalence found in existing research. The objective of this study is to investigate the influence of different diagnostic criteria and different combinations...... of criteria on PTSD prevalence. A sample of 242 Danish social work students (M =29.2 years) completed a list of potentially traumatizing events, major life events and the Harvard Trauma Questionnaire. A considerable difference in PTSD prevalence as a result of different diagnostic criteria of PTSD was found...

  3. MRI criteria for MS in patients with clinically isolated syndromes

    DEFF Research Database (Denmark)

    Montalban, X.; Tintore, M.; Swanton, J.

    2010-01-01

    In recent years, criteria for the diagnosis of multiple sclerosis (MS) have changed, mainly due to the incorporation of new MRI criteria. While the new criteria are a logical step forward, they are complex and-not surprisingly-a good working knowledge of them is not always evident among neurologi...... false positive diagnoses. New data that are now published were reviewed and discussed and together with a new proposal are integrated in this position paper. Neurology(R) 2010;74:427-434...... isolated syndrome. Within the European multicenter collaborative research network that studies MRI in MS (MAGNIMS), a workshop was held in London in November 2007 to review information that may simplify the existing MS diagnostic criteria, while maintaining a high specificity that is essential to minimize...

  4. Diagnostic criteria for DCD : Past and future

    NARCIS (Netherlands)

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

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

  5. The Diagnostic Accuracy of Clinical Diagnostic Tests for Thoracic Outlet Syndrome.

    Science.gov (United States)

    Hixson, Krista M; Horris, Hannah B; McLeod, Tamara C Valovich; Bacon, Cailee E Welch

    2017-09-01

    Clinical Scenario: Thoracic outlet syndrome is quite challenging to diagnose. Currently, there are myriad diagnostic procedures used in the diagnosis of all types of thoracic outlet syndrome. However, controversy exists over which diagnostic procedures produce accurate findings. Can clinical diagnostic tests accurately diagnose patients presenting with symptoms of thoracic outlet syndrome? Summary of Key Findings: A thorough literature search returned 6 possible studies; 3 studies met the inclusion criteria and were included. Two studies supported the use of clinical diagnostic tests for the diagnosis of thoracic outlet syndrome. One study reported high false-positive rates among clinical diagnostic tests for thoracic outlet syndrome. One study reported that clinical diagnostic test findings correlate to provocative positioned magnetic resonance imaging findings. Clinical Bottom Line: There is moderate evidence to support the use of the Halstead maneuver (also known as the costoclavicular maneuver or exaggerated military brace test), Wright's test, Cyriax Release test, and supraclavicular pressure test to have good diagnostic accuracy for the provocation of symptoms in patients presenting with upper extremity pathology. However, these clinical diagnostic tests do not appear to allow for the differential diagnosis of thoracic outlet syndrome exclusively. The use of the Adson's test and Roos test should be discontinued for the differential diagnosis of thoracic outlet syndrome. Strength of Recommendation: Grade B evidence exists to support the accuracy of the Halstead maneuver, Wright's test, Cyriax Release test, and supraclavicular pressure test for the diagnosis of upper extremity pathology in general. Grade C evidence exists for the use of these clinical diagnostic tests to exclusively diagnose thoracic outlet syndrome.

  6. The DSM diagnostic criteria for vaginismus.

    Science.gov (United States)

    Binik, Yitzchak M

    2010-04-01

    Vaginal spasm has been considered the defining diagnostic characteristic of vaginismus for approximately 150 years. This remarkable consensus, based primarily on expert clinical opinion, is preserved in the DSM-IV-TR. The available empirical research, however, does not support this definition nor does it support the validity of the DSM-IV-TR distinction between vaginismus and dyspareunia. The small body of research concerning other possible ways or methods of diagnosing vaginismus is critically reviewed. Based on this review, it is proposed that the diagnoses of vaginismus and dyspareunia be collapsed into a single diagnostic entity called "genito-pelvic pain/penetration disorder." This diagnostic category is defined according to the following five dimensions: percentage success of vaginal penetration; pain with vaginal penetration; fear of vaginal penetration or of genito-pelvic pain during vaginal penetration; pelvic floor muscle dysfunction; medical co-morbidity.

  7. Radiological diagnostics in CUP syndrome

    International Nuclear Information System (INIS)

    Kazmierczak, P.M.; Nikolaou, K.; Graser, A.; Reiser, M.F.; Cyran, C.C.; Rominger, A.

    2014-01-01

    , diffusion), e.g. investigation of breast carcinoma or prostate carcinoma. Whole body staging stands at the beginning of the diagnostic algorithm in CUP syndrome to localize a potential primary tumor. Clinically, contrast-enhanced CT of the neck, thorax and abdomen is frequently applied; however, many studies have demonstrated augmented sensitivity of 18 F-FDG PET-CT for the detection of primary tumors and metastatic tumor manifestations. (orig.) [de

  8. Posttraumatic stress disorder diagnostic criteria and suicidal ...

    African Journals Online (AJOL)

    4Faculty of Social Sciences, Anambra State University, Igbariam Campus, Anambra State, Nigeria. Abstract. Objective: Exposure to traumatic events may precipitate suicidal ideation. Once an individual is diagnosed with PTSD, a suicide risk assessment often follows. This study explores how PTSD symptom criteria ...

  9. Posttraumatic stress disorder diagnostic criteria and suicidal ...

    African Journals Online (AJOL)

    Objective: Exposure to traumatic events may precipitate suicidal ideation. Once an individual is diagnosed with PTSD, a suicide risk assessment often follows. This study explores how PTSD symptom criteria correlate with suicidal ideation in a sample of police officers. While the psychometric measures of PTSD often mirror ...

  10. Harmonized diagnostic criteria for Alzheimer's disease

    DEFF Research Database (Denmark)

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

    2014-01-01

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

  11. Diagnostic criteria for sarcopenia relate differently to insulin resistance

    NARCIS (Netherlands)

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

    2013-01-01

    Skeletal muscle is important in insulinstimulated glucose uptake. Sarcopenia is, therefore, a possible risk factor for insulin resistance. Currently, different diagnostic criteria for sarcopenia include low muscle mass, muscle strength, and walking speed. We assessed these muscle characteristics in

  12. DIAGNOSTIC CRITERIA FOR PROLIFERATIVE THYROID LESIONS IN BONY FISHES

    Science.gov (United States)

    Thyroid proliferative lesions are rather common in bony fishes but disagreement exists in the fish pathology community concerning diagnostic criteria for hyperplastic versus neoplastic lesions. To simplify the diagnosis of proliferative thyroid lesions and to reduce confusion reg...

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

    Science.gov (United States)

    Robins, L N

    1989-02-01

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

  14. Diagnostic criteria for headache attributed to temporomandibular disorders.

    Science.gov (United States)

    Schiffman, Eric; Ohrbach, Richard; List, Thomas; Anderson, Gary; Jensen, Rigmor; John, Mike T; Nixdorf, Donald; Goulet, Jean-Paul; Kang, Wenjun; Truelove, Ed; Clavel, Al; Fricton, James; Look, John

    2012-07-01

    We assessed and compared the diagnostic accuracy of two sets of diagnostic criteria for headache secondary to temporomandibular disorders (TMD). In 373 headache subjects with TMD, a TMD headache reference standard was defined as: self-reported temple headache, consensus diagnosis of painful TMD and replication of the temple headache using TMD-based provocation tests. Revised diagnostic criteria for Headache attributed to TMD were selected using the RPART (recursive partitioning and regression trees) procedure, and refined in half of the data set. Using the remaining half of the data, the diagnostic accuracy of the revised criteria was compared to that of the International Headache Society's International Classification of Headache Diseases (ICHD)-II criteria A to C for Headache or facial pain attributed to temporomandibular joint (TMJ) disorder. Relative to the TMD headache reference standard, ICHD-II criteria showed sensitivity of 84% and specificity of 33%. The revised criteria for Headache attributed to TMD had sensitivity of 89% with improved specificity of 87% (p headache that is changed with jaw movement, function or parafunction and (2) provocation of that headache by temporalis muscle palpation or jaw movement. Having significantly better specificity than the ICHD-II criteria A to C, the revised criteria are recommended to diagnose headache secondary to TMD.

  15. MDS clinical diagnostic criteria for Parkinson's disease in China.

    Science.gov (United States)

    Li, Jun; Jin, Miao; Wang, Li; Qin, Bin; Wang, Kang

    2017-03-01

    The Movement Disorder Society Clinical Diagnostic Criteria for Parkinson's disease (MDS-PD Criteria) was introduced by the Movement Disorder Society in 2015 for research purposes. However, its use for clinical diagnosis of Parkinson disease still needs further revision. This study compares the UK-Criteria versus MDS-PD Criteria in the clinical diagnosis of Parkinson disease referred to the China-Japan Friendship Hospital of Beijing, China. To compare the MDS-PD Criteria with the UK-Criteria and discuss the feasibility of the clinical application of MDS-PD Criteria as a general guide to clinical diagnosis of PD in Chinese PD patients. 150 patients of neurology clinic of China-Japan Friendship Hospital of Beijing were recruited in our research. They were divided into three groups: UK-Criteria group, MDS-PD Criteria group and a combined group of UK and MDS-PD Criteria. Clinical history was collected while physical and auxiliary examinations were done by a trained neurologist according to the corresponding criteria. An interrater reliability analysis using the Kappa statistic claimed substantial agreement (κ = 0.626) between the MDS-PD Criteria and the UK-Criteria. The differences between the diagnostic results of these two criteria were statistically significant by paired Chi-square test (p = 0.000). It was found that levodopa-induced dyskinesia had a good positive predictive value, while early bulbar impairment and inspiratory dysfunction presented a negative predictive value. The MDS-PD Criteria emphasize the importance of non-motor symptoms, keeping the motor symptoms as the core for the clinical diagnosis of PD, and establish categories of diagnosis features and levels of certainty which are more complete and organized to be used and replicated by non specialized physicians to evaluated patients with Parkinsonism. The higher sensitivity of MDS-PD Criteria compared with UK-Criteria is worth being widely used in clinical work.

  16. [Diagnostics, classification and prognostic criteria of acute myeloid leukemia].

    Science.gov (United States)

    Heilmeier, Bernhard; Buske, Christian; Spiekermann, Karsten; Bohlander, Stefan; Feuring-Buske, Michaela; Hiddemann, Wolfgang; Braess, Jan

    2007-04-15

    The continuously growing knowledge about criteria important for biology, pathogenesis, prognosis and treatment of acute myeloid leukemia (AML) necessitates a broad spectrum of diagnostic methods for first diagnosis and for the further course of the disease. Relevant diagnostic techniques (cytomorphology with cytochemistry, immunophenotyping, cytogenetics and molecular genetics, DNA array) are described - with a focus on their mode of operation as well on their clinical significance. Due to the high clinical relevance and growing complexity, AML diagnostics should be performed in specialized laboratories. Compared to the FAB classification which is based primarily on morphological criteria, the classification recommended in 2001 by the WHO additionally takes cytogenetics, molecular genetics and further clinical factors into consideration. Both classifications are described. A wide range of prognostic criteria of AML is discussed on the basis of currently available clinical data. The most important criteria are the karyotype of the leukemic clone and the patient's age.

  17. Approaches to Demonstrating the Reliability and Validity of Core Diagnostic Criteria for Chronic Pain.

    Science.gov (United States)

    Bruehl, Stephen; Ohrbach, Richard; Sharma, Sonia; Widerstrom-Noga, Eva; Dworkin, Robert H; Fillingim, Roger B; Turk, Dennis C

    2016-09-01

    The Analgesic, Anesthetic, and Addiction Clinical Trial Translations, Innovations, Opportunities, and Networks-American Pain Society Pain Taxonomy (AAPT) is designed to be an evidence-based multidimensional chronic pain classification system that will facilitate more comprehensive and consistent chronic pain diagnoses, and thereby enhance research, clinical communication, and ultimately patient care. Core diagnostic criteria (dimension 1) for individual chronic pain conditions included in the initial version of AAPT will be the focus of subsequent empirical research to evaluate and provide evidence for their reliability and validity. Challenges to validating diagnostic criteria in the absence of clear and identifiable pathophysiological mechanisms are described. Based in part on previous experience regarding the development of evidence-based diagnostic criteria for psychiatric disorders, headache, and specific chronic pain conditions (fibromyalgia, complex regional pain syndrome, temporomandibular disorders, pain associated with spinal cord injuries), several potential approaches for documentation of the reliability and validity of the AAPT diagnostic criteria are summarized. The AAPT is designed to be an evidence-based multidimensional chronic pain classification system. Conceptual and methodological issues related to demonstrating the reliability and validity of the proposed AAPT chronic pain diagnostic criteria are discussed. Copyright © 2016 American Pain Society. Published by Elsevier Inc. All rights reserved.

  18. [Differential diagnostics of peripheral vestibular and brainstem-cerebellar syndrome].

    Science.gov (United States)

    Likhachev, S A; Tarasevich, N M

    2013-01-01

    The objective of the present study was to develop criteria for differential diagnostics of peripheral vestibular and brainstem-cerebellar syndrome based on the analysis of characteristics of evoked vestibular myogenic potentials. A total of 59 patients presenting with unilateral peripheral vestibular syndrome (PVS), 60 patients with demyelinizing disease of CNS, and 20 healthy subjects were available for the examination by the method of evoked vestibular myogenic potentials. The values of representativity and latency parameters PI, N1, PINI and amplitude parameters PI, NI, PINI were obtained. It was shown that latency PI in the patients with demyelinizing disease of CNS is higher than in those with PVS.

  19. Evidence for the diagnostic criteria of delirium: an update.

    Science.gov (United States)

    Blazer, Dan G; van Nieuwenhuizen, Adrienne O

    2012-05-01

    Since the publication of DSM-III in 1980, the essential criteria for delirium have been reduced progressively through DSM-III-R to DSM-IV. As the field moves toward DSM-V and ICD-11, new data can shed light on the nosological changes that are needed so that diagnostic criteria can reflect empirical data. In this study, we reassess the existing or potential criteria for delirium. Phenomenological studies in recent years have informed the criteria for delirium, including the appropriateness of the term 'consciousness' as a core symptom of the diagnosis, additional symptoms of delirium that are frequent but are not currently part of the diagnostic criteria, subsyndromal delirium, motoric subtypes of delirium (hyperactive, hypoactive), and the association of delirium with dementia. Recent studies suggest that motoric subtypes should be included as a subtype for delirium but that subsyndromal delirium, although a useful research construct, should not be included in clinical diagnostic criteria given the frequent fluctuation in symptoms over short periods. In addition, though the core symptoms are probably adequate to make the diagnosis, clinicians must be aware of the frequency of other symptoms, for symptoms such as profound sleep disturbance or psychotic symptoms may dominate the clinical picture.

  20. Diagnostic criteria in renal and hepatic cyst infection

    NARCIS (Netherlands)

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

    2015-01-01

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

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

    NARCIS (Netherlands)

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

    2014-01-01

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

  2. Diagnosing antiphospholipid syndrome: 'extra-criteria' manifestations and technical advances.

    Science.gov (United States)

    Sciascia, Savino; Amigo, Mary-Carmen; Roccatello, Dario; Khamashta, Munther

    2017-09-01

    First described in the early 1980s, antiphospholipid syndrome (APS) is a unique form of acquired autoimmune thrombophilia in which patients present with clinical features of recurrent thrombosis and pregnancy morbidity and persistently test positive for the presence of antiphospholipid antibodies (aPL). At least one clinical (vascular thrombosis or pregnancy morbidity) and one lab-based (positive test result for lupus anticoagulant, anticardiolipin antibodies and/or anti-β2-glycoprotein 1 antibodies) criterion have to be met for a patient to be classified as having APS. However, the clinical spectrum of APS encompasses additional manifestations that can affect many organs and cannot be explained exclusively by patients being in a prothrombotic state; clinical manifestations not listed in the classification criteria (known as extra-criteria manifestations) include neurologic manifestations (chorea, myelitis and migraine), haematologic manifestations (thrombocytopenia and haemolytic anaemia), livedo reticularis, nephropathy and valvular heart disease. Increasingly, research interest has focused on the development of novel assays that might be more specific for APS than the current aPL tests. This Review focuses on the current classification criteria for APS, presenting the role of extra-criteria manifestations and lab-based tests. Diagnostic approaches to difficult cases, including so-called seronegative APS, are also discussed.

  3. New diagnostic criteria for neurocysticercosis: Reliability and validity

    Science.gov (United States)

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

    2016-01-01

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

  4. Diagnostic criteria and reporting procedures for pre-eclampsia

    DEFF Research Database (Denmark)

    Klemmensen, Ase K; Olsen, Sjurdur F.; Wengel, Christina M

    2005-01-01

    OBJECTIVE: A precondition for the rational use of obstetric databases in biomedical research is detailed knowledge on how data are being generated. We identified the diagnostic procedures and criteria for pre-eclampsia (PE) and assessed the level of obstetric training of the personnel responsible...... of pregnancy diagnoses to the National Patient Registry differed widely in training. For complicated pregnancies, departments ranged from having only specialists reporting all cases to secretaries reporting up to 50%. Cut off limits of blood pressure (BP) and protein loss used to diagnose pre-eclampsia showed...... large differences across departments. The diagnoses given to three case stories showed little correlation to the criteria the departments reported using. CONCLUSION: Even in a small country like Denmark with 34 obstetrical departments, there was little consensus on the diagnostic criteria for pre-eclampsia...

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

    DEFF Research Database (Denmark)

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

    2014-01-01

    There is a need to expand the current temporomandibular disorders' (TMDs) classification to include less common but clinically important disorders. The immediate aim was to develop a consensus-based classification system and associated diagnostic criteria that have clinical and research utility...... for less common TMDs. The long-term aim was to establish a foundation, vis-à-vis this classification system, that will stimulate data collection, validity testing and further criteria refinement. A working group [members of the International RDC/TMD Consortium Network of the International Association...... in the expanded taxonomy and were placed into the following four categories: temporomandibular joint disorders, masticatory muscle disorders, headache disorders and disorders affecting associated structures. Those excluded were extremely uncommon, lacking operationalised diagnostic criteria, not clearly related...

  6. Advances in progressive supranuclear palsy: new diagnostic criteria, biomarkers, and therapeutic approaches.

    Science.gov (United States)

    Boxer, Adam L; Yu, Jin-Tai; Golbe, Lawrence I; Litvan, Irene; Lang, Anthony E; Höglinger, Günter U

    2017-07-01

    Progressive supranuclear palsy (PSP), previously believed to be a common cause of atypical parkinsonism, is now recognised as a range of motor and behavioural syndromes that are associated with a characteristic 4-repeat tau neuropathology. New research criteria that recognise early presentations of PSP and operationalise diagnosis of the full spectrum of clinical phenotypes have been reported. The Movement Disorders Society PSP diagnostic criteria include syndromes with few or mild symptoms that are suggestive of underlying PSP pathology and could provide an opportunity for earlier therapeutic interventions in the future. These criteria also include definitions for variant PSP syndromes with different patterns of movement, language, or behavioural features than have been conclusively associated with PSP pathology. Data from new diagnostic biomarkers can be combined with the clinical features of disease to increase the specificity of the new criteria for underlying PSP pathology. Because PSP is associated with tau protein abnormalities, there is growing interest in clinical trials of new tau-directed therapies. These therapies are hypothesised to have disease-modifying effects by reducing the concentration of toxic forms of tau in the brain or by compensating for loss of tau function. Since tau pathology is also central to Alzheimer's disease and chronic traumatic encephalopathy, a successful tau therapeutic for PSP might inform treatment of other neurodegenerative diseases. Copyright © 2017 Elsevier Ltd. All rights reserved.

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

    Science.gov (United States)

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

    2014-01-01

    There is a need to expand the current temporomandibular disorders' (TMDs) classification to include less common but clinically important disorders. The immediate aim was to develop a consensus-based classification system and associated diagnostic criteria that have clinical and research utility for less common TMDs. The long-term aim was to establish a foundation, vis-à-vis this classification system, that will stimulate data collection, validity testing and further criteria refinement. A working group [members of the International RDC/TMD Consortium Network of the International Association for Dental Research (IADR), members of the Orofacial Pain Special Interest Group (SIG) of the International Association for the Study of Pain (IASP), and members from other professional societies] reviewed disorders for inclusion based on clinical significance, the availability of plausible diagnostic criteria and the ability to operationalise and study the criteria. The disorders were derived from the literature when possible and based on expert opinion as necessary. The expanded TMDs taxonomy was presented for feedback at international meetings. Of 56 disorders considered, 37 were included in the expanded taxonomy and were placed into the following four categories: temporomandibular joint disorders, masticatory muscle disorders, headache disorders and disorders affecting associated structures. Those excluded were extremely uncommon, lacking operationalised diagnostic criteria, not clearly related to TMDs, or not sufficiently distinct from disorders already included within the taxonomy. The expanded TMDs taxonomy offers an integrated approach to clinical diagnosis and provides a framework for further research to operationalise and test the proposed taxonomy and diagnostic criteria. © 2014 John Wiley & Sons Ltd.

  8. Differential diagnostic of the burnout syndrome.

    Science.gov (United States)

    Korczak, Dieter; Huber, Beate; Kister, Christine

    2010-07-05

    significant others (for example patients). There is no evidence for stigmatization of persons with burnout. The evidence of the majority of the studies is predominantly low. Most of the studies are descriptive and explorative. Self-assessment tools are mainly used, overall the Maslach Burnout Inventory (MBI). Objective data like medical parameters, health status, sick notes or judgements by third persons are extremely seldomly included in the studies. The sample construction is coincidental in the majority of cases, response rates are often low. Almost no longitudinal studies are available. There are insufficient results on the stability and the duration of related symptoms. The ambiguity of the burnout diagnosis is regularly neglected in the studies. The authors conclude, that (1) further research, particularly high-quality studies are needed, to broaden the understanding of the burnout syndrome. Equally (2) a definition of the burnout syndrome has to be found which goes beyond the published understanding of burnout and is based on common scientific consent. Furthermore, there is a need (3) for finding a standardized, international accepted and valid procedure for the differentiated diagnostics of burnout and for (4) developing a third party assessment tool for the diagnosis of burnout. Finally, (5) the economic effects and implication of burnout diagnostics on the economy, the health insurances and the patients have to be analysed.

  9. Differential diagnostic of the burnout syndrome

    Directory of Open Access Journals (Sweden)

    Kister, Christine

    2010-01-01

    derogation of work performance it can have also negative effects on significant others (for example patients. There is no evidence for stigmatization of persons with burnout. Discussion: The evidence of the majority of the studies is predominantly low. Most of the studies are descriptive and explorative. Self-assessment tools are mainly used, overall the Maslach Burnout Inventory (MBI. Objective data like medical parameters, health status, sick notes or judgements by third persons are extremely seldomly included in the studies. The sample construction is coincidental in the majority of cases, response rates are often low. Almost no longitudinal studies are available. There are insufficient results on the stability and the duration of related symptoms. The ambiguity of the burnout diagnosis is regularly neglected in the studies. Conclusions: The authors conclude, that (1 further research, particularly high-quality studies are needed, to broaden the understanding of the burnout syndrome. Equally (2 a definition of the burnout syndrome has to be found which goes beyond the published understanding of burnout and is based on common scientific consent. Furthermore, there is a need (3 for finding a standardized, international accepted and valid procedure for the differentiated diagnostics of burnout and for (4 developing a third party assessment tool for the diagnosis of burnout. Finally, (5 the economic effects and implication of burnout diagnostics on the economy, the health insurances and the patients have to be analysed.

  10. Bouveret's Syndrome: diagnostic considerations

    Energy Technology Data Exchange (ETDEWEB)

    Cooper, S.G.; Sherman, S.B.; Steinhardt, J.E.; Wilson, J.M. Jr.; Richman, A.H.

    1987-07-10

    Bouveret's syndrome is a rare disease entity manifested by the formation of a cholecystoduodenal or choledochoduodenal fistula with passage of a gallstone into the duodenal bulb and subsequent obstruction of the gastric outlet. To date, no report of this entity using computed tomographic (CT) imaging is available. This article presents a case of Bouveret's syndrome with the classic findings on upper gastrointestinal (GI) tract series and a description of the CT manifestations. The literature is reviewed with discussion of the diagnostic approach to patients with Bouveret's syndrome.

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

    Science.gov (United States)

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

    2015-06-01

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

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

    Directory of Open Access Journals (Sweden)

    Fatemeh Shirani

    2017-01-01

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

  13. Irritable bowel syndrome: diagnostic approaches in clinical practice

    Directory of Open Access Journals (Sweden)

    Eugene J Burbige

    2010-09-01

    Full Text Available Eugene J BurbigeDivision of Gastroenterology, Gastrointestinal and Liver Research, John Muir Medical Center, Concord, CA, USABackground: Irritable bowel syndrome (IBS, a functional gastrointestinal disorder long considered a diagnosis of exclusion, has chronic symptoms that vary over time and overlap with those of non-IBS disorders. Traditional symptom-based criteria effectively identify IBS patients but are not easily applied in clinical practice, leaving >40% of patients to experience symptoms up to 5 years before diagnosis.Objective: To review the diagnostic evaluation of patients with suspected IBS, strengths and weaknesses of current methodologies, and newer diagnostic tools that can augment current symptom-based criteria.Methods: The peer-reviewed literature (PubMed was searched for primary reports and reviews using the limiters of date (1999–2009 and English language and the search terms irritable bowel syndrome, diagnosis, gastrointestinal disease, symptom-based criteria, outcome, serology, and fecal markers. Abstracts from Digestive Disease Week 2008–2009 and reference lists of identified articles were reviewed.Results: A disconnect is apparent between practice guidelines and clinical practice. The American Gastroenterological Association and American College of Gastroenterology recommend diagnosing IBS in patients without alarm features of organic disease using symptom-based criteria (eg, Rome. However, physicians report confidence in a symptom-based diagnosis without further testing only up to 42% of the time; many order laboratory tests and perform sigmoidoscopies or colonoscopies despite good evidence showing no utility for this work-up in uncomplicated cases. In the absence of diagnostic criteria easily usable in a busy practice, newer diagnostic methods, such as stool-form examination, fecal inflammatory markers, and serum biomarkers, have been proposed as adjunctive tools to aid in an IBS diagnosis by increasing physicians

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

    NARCIS (Netherlands)

    Dubois, B; Feldman, H.H.; Jacova, C.; Hampel, H.; Molinuevo, J.L.; Blennow, K.; Dekosky, S.T.; Gauthier, S.; Selkoe, D.; Bateman, R.; Cappa, S.; Crutch, S.; Engelborghs, S.; Frisoni, G. B.; Fox, N.C.; Galasko, D.; Habert, M.O.; Jicha, G.A.; Nordberg, A.; Pasquier, F.; Rabinovici, G.; Robert, P.; Rowe, C.; Salloway, S.; Sarazin, M.; Epelbaum, S.; de Souza, L.C.; Vellas, B.; Visser, P.J.; Schneider, L.; Stern, Y.; Scheltens, P.; Cummings, J.L.

    2014-01-01

    In the past 8 years, both the International Working Group (IWG) and the US National Institute on Aging-Alzheimer's Association have contributed criteria for the diagnosis of Alzheimer's disease (AD) that better define clinical phenotypes and integrate biomarkers into the diagnostic process, covering

  15. Elimination of pain improves specificity of clinical diagnostic criteria for adult chronic rhinosinusitis.

    Science.gov (United States)

    Hirsch, Scott D; Reiter, Evan R; DiNardo, Laurence J; Wan, Wen; Schuman, Theodore A

    2017-05-01

    Determine whether the elimination of pain improves accuracy of clinical diagnostic criteria for adult chronic rhinosinusitis. Retrospective cohort study. History, symptoms, nasal endoscopy, and computed tomography (CT) results were analyzed for 1,186 adults referred to an academic otolaryngology clinic with presumptive diagnosis of chronic rhinosinusitis. Clinical diagnosis was rendered using the 1997 Rhinosinusitis Taskforce (RSTF) Guidelines and a modified version eliminating facial pain, ear pain, dental pain, and headache. Four hundred seventy-nine subjects (40%) met inclusion criteria. Among subjects positive by RSTF guidelines, 45% lacked objective evidence of sinonasal inflammation by CT, 48% by endoscopy, and 34% by either modality. Applying modified RSTF diagnostic criteria, 39% lacked sinonasal inflammation by CT, 38% by endoscopy, and 24% by either modality. Using either abnormal CT or endoscopy as the reference standard, modified diagnostic criteria yielded a statistically significant increase in specificity from 37.1% to 65.1%, with a nonsignificant decrease in sensitivity from 79.2% to 70.3%. Analysis of comorbidities revealed temporomandibular joint disorder, chronic cervical pain, depression/anxiety, and psychiatric medication use to be negatively associated with objective inflammation on CT or endoscopy. Clinical diagnostic criteria overestimate the prevalence of chronic rhinosinusitis. Removing facial pain, ear pain, dental pain, and headache increased specificity without a concordant loss in sensitivity. Given the high prevalence of sinusitis, improved clinical diagnostic criteria may assist primary care providers in more accurately predicting the presence of inflammation, thereby reducing inappropriate antibiotic use or delayed referral for evaluation of primary headache syndromes. 4. Laryngoscope, 127:1011-1016, 2017. © 2017 The American Laryngological, Rhinological and Otological Society, Inc.

  16. Diagnostic Criteria for the Treatment of Caries-Induced Pulpitis.

    Science.gov (United States)

    1981-03-01

    histologically as irreversible pulpitis . The clinical usefulness of these responses as diagnostic criteria can best be visualized if they are ranked...89.9%) for treatable pulpitis . Evidence of PDL enlargement is not an absolute indicator of irreversible pulp disease, but is a useful criterion, with...456, 1960. Table 1. Frequency distribution and predictive values of pain history variables for diagnosing reversible and irreversible pulpitis

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

    Science.gov (United States)

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

    2015-01-01

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

  18. Irritable bowel syndrome--prognosis and diagnostic safety. A 5-year follow-up study

    DEFF Research Database (Denmark)

    Svendsen, Jesper Hastrup; Munck, L K; Andersen, J R

    1985-01-01

    with irritable bowel syndrome as the final and only abdominal diagnosis in the period 1977-79 were followed up in 1984. Seventeen patients died during the follow-up period; two of these were considered diagnostic failures (chronic pancreatitis and pancreatic cancer). Of the remaining 95 patients, 93 were......The irritable bowel syndrome is the commonest diagnosis in gastroenterological clinics, although diagnostic criteria and investigatory programs vary. To elucidate the diagnostic safety and prognosis of the syndrome, a retrospective study was conducted. One hundred and twelve consecutive patients...

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

    Directory of Open Access Journals (Sweden)

    Xia-wei LIU

    2015-07-01

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

  20. Are current chronic fatigue syndrome criteria diagnosing different disease phenotypes?

    Directory of Open Access Journals (Sweden)

    Laura Maclachlan

    Full Text Available Chronic fatigue syndrome (CFS is characterised by a constellation of symptoms diagnosed with a number of different polythetic criteria. Heterogeneity across these diagnostic criteria is likely to be confounding research into the as-yet-unknown pathophysiology underlying this stigmatised and debilitating condition and may diagnose a disease spectrum with significant implications for clinical management. No studies to date have objectively investigated this possibility using a validated measure of CFS symptoms-the DePaul Symptom Questionnaire (DSQ.To examine whether current CFS diagnostic criteria are identifying different disease phenotypes using the DSQ.Case control study.Clinical Research Facility of the Royal Victoria Infirmary, Newcastle upon Tyne, UK.49 CFS subjects and ten matched, sedentary community controls, excluded for co-morbid depression.Self-reported autonomic and cognitive features were assessed with the Composite Autonomic Symptom Score (COMPASS and Cognitive Failures Questionnaire (COGFAIL respectively. Objective autonomic cardiovascular parameters were examined using the Task Force® Monitor and a battery of neuropsychological tests administered for objective cognitive assessment.Self-reported autonomic and cognitive symptoms were significantly greater in CFS subjects compared to controls. There were no statistically significant differences in objective autonomic measures between CFS and controls. There were clinically significant differences between DSQ subgroups on objective autonomic testing. Visuospatial memory, verbal memory and psychomotor speed were significantly different between DSQ subgroups.The finding of no significant differences in objective autonomic testing between CFS and control subjects may reflect the inclusion of sedentary controls or exclusion for co-morbid depression. Consistent exclusion criteria would enable better delineation of these two conditions and their presenting symptoms. Findings across CFS

  1. Standardized diagnostic interviews, criteria, and algorithms for mental disorders: garbage in, garbage out.

    Science.gov (United States)

    Linden, Michael; Muschalla, Beate

    2012-09-01

    There is a general consensus that diagnoses for mental disorders should be based on criteria and algorithms as given in ICD or DSM. Standardized clinical interviews are recommended as diagnostic methods. In ICD and DSM, much emphasis is put on algorithms, while the underlying criteria get much less attention. The question is how valid are the criteria that are collected by structured diagnostic interviews. 209 patients from a cardiology inpatient unit were interviewed with the Mini International Neuropsychiatric Interview (MINI). 32 (15.3%) were diagnosed as suffering from a major depressive episode or dysthymia. Additionally, a thorough clinical examination was done by a psychiatric expert in 15 patients. The standardized diagnosis of present major depression was reaffirmed in one. In total, four patients were suffering from some kind of depressive disorder presently or life time. Two patients were suffering from anxiety disorders, two from adjustment disorders, and four from different types of organic brain disorders. Most important, there are 3 out of 15 who are not mentally ill. Our observations show that standardized diagnostic interviews cannot be used to make specific differential diagnoses, but rather catch unspecific syndromes. This is partly due to the fact that the wording, definition, and understanding of the underlying criteria is rather vague. This is an even greater problem if there is any somatic comorbidity. In the revision of ICD and DSM, a glossary of psychopathological terms and guidelines for the training of clinicians should be included.

  2. Quality criteria in diagnostic radiology of the skull

    International Nuclear Information System (INIS)

    Friedmann, G.

    1985-01-01

    Diagnostic survey radiology of the skull relies on pictures to be taken if indicated and to meet all conceivable requirements. Those radiograph directions and projections were selected out of the profusion of known and described ones which allow both as small a number of pictures and as comprehensive a demonstration of all skull sections and1structures as possible. With this in mind, quality criteria for plain radiographs of the skull taken laterally and sagittably, for partial radiographs of the visceral cranium including orbit and of the base of the skull including petrons bone are described. (orig./MG) [de

  3. Explanation of diagnostic criteria for radiation thyroid diseases

    International Nuclear Information System (INIS)

    Liu Libo; Luo Yunxiao; Wang Jianfeng; Chen Dawei; Cheng Guanghui; Jin Yuke

    2012-01-01

    National occupational health standard-Diagnostic Criteria for Radiation Thyroid Diseases has been approved and issued by the Ministry of Health. Based on the extensive research of literature, this standard was enacted according to the relevant laws and regulations. It is mainly used for diagnosis of thyroid diseases caused by occupational radiation, and it also can serve as a guide to diagnose thyroid disease induced by medical radiation. To implement this standard, and to diagnose and treat the radiation thyroid diseases patient correctly and timely, the contents of this standard were interpreted in this article. (authors)

  4. Primary biliary cirrhosis-autoimmune hepatitis overlap syndrome: simplified criteria may be effective in the diagnosis in Chinese patients.

    Science.gov (United States)

    Liu, Fang; Pan, Zhen Guo; Ye, Jin; Xu, Dong; Guo, Hui; Li, Gang Ping; Xu, Ke Shu; Hou, Xiao Hua; Song, Yu Hu

    2014-12-01

    To evaluate the Paris criteria, the revised diagnostic criteria and the simplified diagnostic scoring system in the diagnosis of primary biliary cirrhosis (PBC)-autoimmune hepatitis (AIH) overlap syndrome in Chinese patients. Medical records of the patients who were diagnosed with PBC at the Union Hospital and Tongji Hospital, Tongji Medical University, Huazhong University of Science and Technology (Wuhan, Hubei Province, China) from 2003 to 2012 were retrospectively reviewed. The overlap syndrome was diagnosed based on the Paris criteria, the revised criteria and the simplified criteria, respectively. Patients' clinical characteristics, laboratory examination results and histological findings were collected. The sensitivity and specificity of the three criteria for diagnosing PBC-AIH overlap syndrome were calculated. PBC-AIH overlap syndrome was diagnosed in 2, 13 and 10 patients with PBC based on the Paris, the revised and the simplified criteria, respectively. The sensitivity and specificity of the simplified criteria in diagnosing the overlap syndrome was 90.0% and 98.2%, which were the highest among the three criteria, followed by the revised criteria. The Paris criteria showed a high specificity (100%) but a relatively low sensitivity (20.0%). In addition, some patients who did not fulfil the Paris criteria still benefited from the immunosuppressive agents. For Chinese patients with the PBC-AIH overlap syndrome, the simplified criteria appear to be the most efficacious compared with the Paris criteria and the revised criteria. Further studies should be performed to confirm these observations with respect to long-term outcomes and therapeutic implications. © 2014 Chinese Medical Association Shanghai Branch, Chinese Society of Gastroenterology, Renji Hospital Affiliated to Shanghai Jiaotong University School of Medicine and Wiley Publishing Asia Pty Ltd.

  5. Prevalence of Metabolic Syndrome and Individual Criteria in College Students

    Science.gov (United States)

    Fernandes, Jill; Lofgren, Ingrid E.

    2011-01-01

    Metabolic syndrome (MetS) is present in young adults and because coronary heart disease (CHD) is likely, screening to determine MetS prevalence and its criteria is critical. Objective: To determine MetS prevalence and most prevalent criteria in a sample of first-year college students. Participants: First-year college students between 18 and 24…

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

    Science.gov (United States)

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

    2017-05-01

    Pain in sickle cell disease (SCD) is associated with increased morbidity, mortality, and high health care costs. Although episodic acute pain is the hallmark of this disorder, there is an increasing awareness that chronic pain is part of the pain experience of many older adolescents and adults. A common set of criteria for classifying chronic pain associated with SCD would enhance SCD pain research efforts in epidemiology, pain mechanisms, and clinical trials of pain management interventions, and ultimately improve clinical assessment and management. As part of the collaborative effort between the Analgesic, Anesthetic, and Addiction Clinical Trial Translations Innovations Opportunities and Networks public-private partnership with the U.S. Food and Drug Administration and the American Pain Society, the Analgesic, Anesthetic, and Addiction Clinical Trial Translations Innovations Opportunities and Networks-American Pain Society Pain Taxonomy initiative developed the outline of an optimal diagnostic system for chronic pain conditions. Subsequently, a working group of experts in SCD pain was convened to generate core diagnostic criteria for chronic pain associated with SCD. The working group synthesized available literature to provide evidence for the dimensions of this disease-specific pain taxonomy. A single pain condition labeled chronic SCD pain was derived with 3 modifiers reflecting different clinical features. Future systematic research is needed to evaluate the feasibility, validity, and reliability of these criteria. An evidence-based classification system for chronic SCD pain was constructed for the Analgesic, Anesthetic, and Addiction Clinical Trial Translations Innovations Opportunities and Networks-American Pain Society Pain Taxonomy initiative. Applying this taxonomy may improve assessment and management of SCD pain and accelerate research on epidemiology, mechanisms, and treatments for chronic SCD pain. Copyright © 2017 The Authors. Published by

  7. Noninvasive diagnostic tools for pelvic congestion syndrome: a systematic review.

    Science.gov (United States)

    Steenbeek, Miranda P; van der Vleuten, Carine J M; Schultze Kool, Leo J; Nieboer, Theodoor E

    2018-01-30

    In the work-up of patients with suspected pelvic congestion syndrome, venography is currently the gold standard. Yet if non-invasive diagnostic tools are found to be accurate, invasive venography might no longer be indicated as necessary. A literature search in Pubmed and EMBASE was performed from inception until May 6th 2017. Studies comparing non-invasive diagnostic tools to a reference standard in the work-up of patients with (suspected) pelvic congestion syndrome were included. Relevant data were extracted and methodological quality of individual included studies was assessed by the Quality Assessment of Diagnostic Accuracy Studies (QUADAS-2) tool. Nine studies matched our inclusion criteria. Six studies compared ultrasonography to venography and three studies described a magnetic resonance imaging technique. In using transvaginal ultrasonography, the occurrence of a vein greater than five mm crossing the uterine body had a specificity of 91% (95% CI; 77-98%) and occurrence of pelvic varicoceles a sensitivity and specificity of 100% (95% CI; 89-100%) and 83-100% (95% CI; 66-93%), respectively. In transabdominal ultrasonography, reversed caudal flow in the ovarian vein accounted for a sensitivity of 100% (95% CI; 84-100%). Detection of pelvic congestion syndrome with magnetic resonance imaging techniques resulted in a sensitivity varying from 88 to 100%. The sensitivity of ultrasonography and magnetic resonance imaging seem to be adequate, which indicates a role for both tests in an early stage of the diagnostic workup. However, due to methodological flaws and diversity in outcome parameters, more high standard research is necessary to establish a clear advice for clinical practice. © 2018 The Authors. Acta Obstetricia et Gynecologica Scandinavica published by John Wiley & Sons Ltd on behalf of Nordic Federation of Societies of Obstetrics and Gynecology (NFOG).

  8. IRRITABLE BOWEL SYNDROME IN CHILDREN: DIAGNOSTICS AND MODERN APPROACHES TO THERAPY

    Directory of Open Access Journals (Sweden)

    S.Yu. Tereshchenko

    2006-01-01

    Full Text Available In the article modern data on prevalence, diagnostic criteria and approaches to the treatment of irritable bowel in children are presented. The issues of the terminology and classification of recurrent abdominal pains in children are clarified, the basic pathophysiological mechanisms of the disease are indicated. Particular emphasis has been placed on the efficient therapy of the different clinical variants of irritable bowel syndrome. The role of modern spasmolytic drugs in the treatment of abdominal pain syndrome and the rational usage of laxatives in constipation in children is shown.Key words: children, irritable bowel syndrome, diagnostics, treatment.

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

    Science.gov (United States)

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

    2009-01-01

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

  10. Irritable bowel syndrome--prognosis and diagnostic safety. A 5-year follow-up study

    DEFF Research Database (Denmark)

    Svendsen, J H; Munck, Lars K; Andersen, J R

    1985-01-01

    The irritable bowel syndrome is the commonest diagnosis in gastroenterological clinics, although diagnostic criteria and investigatory programs vary. To elucidate the diagnostic safety and prognosis of the syndrome, a retrospective study was conducted. One hundred and twelve consecutive patients...... with irritable bowel syndrome as the final and only abdominal diagnosis in the period 1977-79 were followed up in 1984. Seventeen patients died during the follow-up period; two of these were considered diagnostic failures (chronic pancreatitis and pancreatic cancer). Of the remaining 95 patients, 93 were...... available for the follow-up study. Three diagnostic failures were found (gallbladder stones, kidney stone, thyrotoxicosis). The diagnostic failure rate was accordingly 4.5% (5/110). Half of the patients had unchanged or aggravated symptoms at the follow-up study, independent of treatment. The only predictor...

  11. Antiphospholipid Syndrome Laboratory Testing and Diagnostic Strategies

    Science.gov (United States)

    Ortel, Thomas L.

    2016-01-01

    The Antiphospholipid Syndrome (APS) is diagnosed in patients with recurrent thromboembolic events and/or pregnancy loss in the presence of persistent laboratory evidence for antiphospholipid antibodies. Diagnostic tests for the detection of antiphospholipid antibodies include laboratory assays that detect anticardiolipin antibodies, lupus anticoagulants, and anti-β2-glycoprotein I antibodies. These assays have their origins beginning more than sixty years ago, with the identification of the biologic false positive test for syphilis, the observation of ‘circulating anticoagulants’ in certain patients with systemic lupus erythematosus, the identification of cardiolipin as a key component in the serologic test for syphilis, and the recognition and characterization of a ‘cofactor’ for antibody binding to phospholipids. Although these assays have been used clinically for many years, there are still problems with the accurate diagnosis of patients with this syndrome. For example, lupus anticoagulant testing can be difficult to interpret in patients receiving anticoagulant therapy, but most patients with a thromboembolic event will already be anticoagulated before the decision to perform the tests has been made. In addition to understanding limitations of the assays, clinicians also need to be aware of which patients should be tested and not obtain testing on patients unlikely to have APS. New tests and diagnostic strategies are in various stages of development and should help improve our ability to accurately diagnose this important clinical disorder. PMID:22473619

  12. To Create a Consensus on Malnutrition Diagnostic Criteria.

    Science.gov (United States)

    Cederholm, Tommy; Jensen, Gordon L

    2017-03-01

    During the European Society for Clinical Nutrition and Metabolism (ESPEN) Congress in Copenhagen, Denmark (September 2016), representatives of the 4 largest global parenteral and enteral nutrition (PEN) societies from Europe (ESPEN), the United States (American Society for Parenteral and Enteral Nutrition [ASPEN]), Asia (Parenteral and Enteral Nutrition Society of Asia [PENSA]), and Latin America (Latin American Federation of Parenteral and Enteral Nutrition [FELANPE]) and from national PEN societies around the world met to continue the conversation on how to diagnose malnutrition that started during the Clinical Nutrition Week, Austin, Texas (February 2016). Current thinking on diagnostic approaches was shared; ESPEN suggested a grading approach that could encompass various types of signs, symptoms, and etiologies to support diagnosis. ASPEN emphasized where the parties agree; that is, that the 3 major published approaches (ESPEN, ASPEN-Academy of Nutrition and Dietetics, and Subjective Global Assessment [SGA]) all propose weight loss as a key indicator for malnutrition. FELANPE suggested that the anticipated consensus approach needs to prioritize a diagnostic method that is available for everybody since resources differ globally. PENSA highlighted that body mass index varies by ethnicity/race and that sarcopenia/muscle mass evaluation is important for the diagnosis of malnutrition. A Core Working Committee of the Global Leadership Initiative on Malnutrition has been established (comprising 2 representatives each from the 4 largest PEN societies) that will lead consensus development in collaboration with a larger working group with broad global representation, using e-mail, telephone conferences, and face-to-face meetings during the upcoming ASPEN and ESPEN congresses. Transparency and external input will be sought. Objectives include (1) consensus development around evidence-based criteria for broad application, (2) promotion of global dissemination of the

  13. Diagnostic criteria for mass lesions differentiating in electrical impedance mammography

    International Nuclear Information System (INIS)

    Karpov A; Korotkova M

    2013-01-01

    The purpose of this research was to determine the diagnostic criteria for differentiating volumetric lesions in the mammary gland in electrical impedance mammography. The research was carried out utilizing the electrical impedance computer mammograph ||MEIK v.5.6>>®, which enables to acquire images of 3-D conductivity distribution layers within mamma's tissues up to 5 cm depth. The weighted reciprocal projection method was employed to reconstruct the 3-D electric conductivity distribution of the examined organ. The results of 3,710 electrical impedance examinations were analyzed. The analysis of a volumetric lesion included assessment of its shape, contour, internal electrical structure and changes of the surrounding tissues. Moreover, mammary gland status was evaluated with the help of comparative and age-related electrical conductivity curves. The diagnostic chart is provided. Each criterion is measured in points. Using the numerical score for evaluation of mass and non-volumetric lesions within the mammary gland in electrical impedance mammography allowed comparing this information to BI-RADS categories developed by American College of Radiology experts. The article is illustrated with electrical impedance mammograms and tables.

  14. Diagnostic criteria for mass lesions differentiating in electrical impedance mammography

    Science.gov (United States)

    A, Karpov; M, Korotkova

    2013-04-01

    The purpose of this research was to determine the diagnostic criteria for differentiating volumetric lesions in the mammary gland in electrical impedance mammography. The research was carried out utilizing the electrical impedance computer mammograph llMEIK v.5.6gg®, which enables to acquire images of 3-D conductivity distribution layers within mamma's tissues up to 5 cm depth. The weighted reciprocal projection method was employed to reconstruct the 3-D electric conductivity distribution of the examined organ. The results of 3,710 electrical impedance examinations were analyzed. The analysis of a volumetric lesion included assessment of its shape, contour, internal electrical structure and changes of the surrounding tissues. Moreover, mammary gland status was evaluated with the help of comparative and age-related electrical conductivity curves. The diagnostic chart is provided. Each criterion is measured in points. Using the numerical score for evaluation of mass and non-volumetric lesions within the mammary gland in electrical impedance mammography allowed comparing this information to BI-RADS categories developed by American College of Radiology experts. The article is illustrated with electrical impedance mammograms and tables.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2009-07-01

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

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

    Science.gov (United States)

    Kafka, Martin P

    2010-04-01

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

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

    Science.gov (United States)

    Bradford, Jennifer; Fischer, Gayle

    2010-10-01

    To describe alternate diagnostic protocols and describe the differential diagnosis for desquamative inflammatory vaginitis (DIV). One hundred one cases of DIV were audited retrospectively. All patients were seen exclusively by the authors in their private practices using diagnostic criteria applicable to local practice limitations. Other potential etiologies (infection, contact irritant vaginitis, fixed drug eruptions, immunobullous diseases, estrogen hypersensitivity vulvovaginitis, and graft-vs-host disease) were excluded by history, examination, and focused trials of treatment. Historical triggers in the study cohort and a control group of 75 women with lichen planus also drawn from the authors' private practice were compared. Patients were treated with 4 to 6 weeks of topical vaginal antibiotics, 94% with clindamycin, and response to treatment was recorded at subsequent follow-up. All patients were white. Of 101 patients, 57 (56%) had historical triggers, most frequently diarrhea or antibiotic treatment. Of the 75 women in the control group with vaginal lichen planus, 11 had historical triggers (15%, p treatment. Of this group, 10 patients who had triggers for their vaginitis, which were ongoing, were cured when their triggers were finally controlled or cured, leaving 35 patients who required long-term maintenance therapy. Desquamative inflammatory vaginitis seems to be a distinct entity of vaginitis that, in an office setting, can be distinguished from other diagnostic possibilities by careful clinical evaluation and focused trials of treatment. The majority of women responded promptly to intravaginal antibiotics, with approximately 35% of cases requiring maintenance therapy. More than half the cases have an historical trigger. We postulate that DIV occurs when a trigger causes shifts in vaginal homeostasis, resulting in an inflammatory response associated with increased epithelial cell turnover.

  18. Operationalization of diagnostic criteria of DSM-5 somatic symptom disorders.

    Science.gov (United States)

    Xiong, Nana; Zhang, Yaoyin; Wei, Jing; Leonhart, Rainer; Fritzsche, Kurt; Mewes, Ricarda; Hong, Xia; Cao, Jinya; Li, Tao; Jiang, Jing; Zhao, Xudong; Zhang, Lan; Schaefert, Rainer

    2017-11-07

    The aim of this study was to test the operationalization of DSM-5 somatic symptom disorder (SSD) psychological criteria among Chinese general hospital outpatients. This multicenter, cross-sectional study enrolled 491 patients from 10 general hospital outpatient departments. The structured clinical "interview about cognitive, affective, and behavioral features associated with somatic complaints" was used to operationalize the SSD criteria B. For comparison, DSM-IV somatoform disorders were assessed with the Mini International Neuropsychiatric Interview plus. Cohen's к scores were given to illustrate the agreement of the diagnoses. A three-structure model of the interview, within which items were classified as respectively assessing the cognitive (B1), affective (B2), and behavioral (B3) features, was examined. According to percentages of screening-positive persons and the receiver operator characteristic (ROC) analysis, a cut-off point of 2 was recommended for each subscale of the interview. With the operationalization, the frequency of DSM-5 SSD was estimated as 36.5% in our sample, and that of DSM-IV somatoform disorders was 8.2%. The agreement between them was small (Cohen's к = 0.152). Comparisons of sociodemographic features of SSD patients with different severity levels (mild, moderate, severe) showed that mild SSD patients were better-off in terms of financial and employment status, and that the severity subtypes were congruent with the level of depression, anxiety, quality of life impairment, and the frequency of doctor visits. The operationalization of the diagnosis and severity specifications of SSD was valid, but the diagnostic agreement between DSM-5 SSD and DSM-IV somatoform disorders was small. The interpretation the SSD criteria should be made cautiously, so that the diagnosis would not became over-inclusive.

  19. Are diagnostic criteria for eating disorders markers of medical severity?

    Science.gov (United States)

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

    2010-05-01

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

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

    Science.gov (United States)

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

    2017-02-01

    Benign paroxysmal positional vertigo (BPPV) is the most common peripheral vertigo and the posterior and/or lateral semicircular canals are usually affected. BPPV is characterized by brief attacks of rotatory vertigo associated with positional and/or positioning nystagmus, which are elicited by specific head positions or changes in head position relative to gravity. In patients with the posterior-canal-type of BPPV, torsional nystagmus is induced by the Dix-Hallpike maneuver. In patients with the lateral-canal-type of BPPV, horizontal geotropic or apogeotropic nystagmus is induced by the supine roll test. The pathophysiology of BPPV is canalolithiasis comprising free-floating otoconial debris within the endolymph of a semicircular canal, or cupulolithiasis comprising otoconial debris adherent to the cupula. The observation of positional and/or positioning nystagmus is essential for the diagnosis of BPPV. BPPV is treated with the canalith repositioning procedure (CRP). Through a series of head position changes, the CRP moves otoconial debris from the affected semicircular canal to the utricle. In this review, we provide the classification, diagnostic criteria, and examinations for the diagnosis, and specific and non-specific treatments of BPPV in accordance with the Japanese practical guidelines on BPPV published by the Japan Society for Equilibrium Research. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  1. MRI criteria for MS in patients with clinically isolated syndromes

    DEFF Research Database (Denmark)

    Montalban, X.; Tintore, M.; Swanton, J.

    2010-01-01

    In recent years, criteria for the diagnosis of multiple sclerosis (MS) have changed, mainly due to the incorporation of new MRI criteria. While the new criteria are a logical step forward, they are complex and-not surprisingly-a good working knowledge of them is not always evident among...... neurologists and neuroradiologists. In some circumstances, several MRI examinations are needed to achieve an accurate and prompt diagnosis. This provides an incentive for continued efforts to refine the incorporation of MRI-derived information into the diagnostic workup of patients presenting with a clinically...

  2. Radiological, sonographic and radionuclide diagnostics in headache syndrome

    International Nuclear Information System (INIS)

    Scheibler, C.; Pink, V.; Luettschwager, L.; Zur, C.

    1987-01-01

    The complex diagnostics of the headache syndrome is taken as an example for the necessity to apply imaging procedures in a purposeful way in diagnostic strategy. Cooperation of the clinical partners involved is of particular importance in control of the diagnostic process

  3. Importance of nuclear medicine diagnostics in CUP syndrome

    International Nuclear Information System (INIS)

    Winter, M.C.; Haberkorn, U.; Kratochwil, C.

    2014-01-01

    The diagnostic work-up in patients with carcinoma of unknown primary (CUP) syndrome is extensive, highly time-consuming and cost-intensive and ultimately often fails to detect a primary site. In this context chest X-ray and computed tomography (CT) have been used as standard imaging modalities in CUP syndrome. Since the introduction of positron emission tomography (PET) evaluation of tumor vitality has become possible. Furthermore, PET-CT hybrid scanners allow the combination of functional and morphological imaging. Several meta-analyses have reported an additional overall detection rate between 24.5 % and 44 % by either PET or PET-CT. Metastatic localization (cervical versus extracervical) did not influence the performance. The sensitivity was usually high (> 80 %) but specificity was moderate ranging from 68 % to 88 % at best. If mentioned, the results obtained by fluorodeoxyglucose (FDG)-PET significantly changed the clinical management in approximately one third of the patients studied. In a direct comparison with PET alone, PET-CT did not depict significantly more primary tumors but was able to reduce false positive findings. To determine the real additional value of PET-CT in the diagnosis of CUP syndrome large prospective studies with more uniform inclusion criteria are needed. Despite the capabilities of FDG-PET-CT there is as yet no evidence that a potentially improved diagnostic algorithm is translated into a better patient outcome. Nevertheless, FDG-PET-CT should be performed in all CUP patients where conventional imaging failed to detect a primary site or the results are equivocal. In CUP patients with cervical lymph node metastases PET-CT should be carried out prior to panendoscopy to reduce the number of false negative biopsies. (orig.) [de

  4. Perspectives on the revised Ghent criteria for the diagnosis of Marfan syndrome

    Science.gov (United States)

    von Kodolitsch, Yskert; De Backer, Julie; Schüler, Helke; Bannas, Peter; Behzadi, Cyrus; Bernhardt, Alexander M; Hillebrand, Mathias; Fuisting, Bettina; Sheikhzadeh, Sara; Rybczynski, Meike; Kölbel, Tilo; Püschel, Klaus; Blankenberg, Stefan; Robinson, Peter N

    2015-01-01

    Three international nosologies have been proposed for the diagnosis of Marfan syndrome (MFS): the Berlin nosology in 1988; the Ghent nosology in 1996 (Ghent-1); and the revised Ghent nosology in 2010 (Ghent-2). We reviewed the literature and discussed the challenges and concepts of diagnosing MFS in adults. Ghent-1 proposed more stringent clinical criteria, which led to the confirmation of MFS in only 32%–53% of patients formerly diagnosed with MFS according to the Berlin nosology. Conversely, both the Ghent-1 and Ghent-2 nosologies diagnosed MFS, and both yielded similar frequencies of MFS in persons with a causative FBN1 mutation (90% for Ghent-1 versus 92% for Ghent-2) and in persons not having a causative FBN1 mutation (15% versus 13%). Quality criteria for diagnostic methods include objectivity, reliability, and validity. However, the nosology-based diagnosis of MFS lacks a diagnostic reference standard and, hence, quality criteria such as sensitivity, specificity, or accuracy cannot be assessed. Medical utility of diagnosis implies congruency with the historical criteria of MFS, as well as with information about the etiology, pathogenesis, diagnostic triggers, prognostic triggers, and potential complications of MFS. In addition, social and psychological utilities of diagnostic criteria include acceptance by patients, patient organizations, clinicians and scientists, practicability, costs, and the reduction of anxiety. Since the utility of a diagnosis or exclusion of MFS is context-dependent, prioritization of utilities is a strategic decision in the process of nosology development. Screening tests for MFS should be used to identify persons with MFS. To confirm the diagnosis of MFS, Ghent-1 and Ghent-2 perform similarly, but Ghent-2 is easier to use. To maximize the utility of the diagnostic criteria of MFS, a fair and transparent process of nosology development is essential. PMID:26124674

  5. Perspectives on the revised Ghent criteria for the diagnosis of Marfan syndrome.

    Science.gov (United States)

    von Kodolitsch, Yskert; De Backer, Julie; Schüler, Helke; Bannas, Peter; Behzadi, Cyrus; Bernhardt, Alexander M; Hillebrand, Mathias; Fuisting, Bettina; Sheikhzadeh, Sara; Rybczynski, Meike; Kölbel, Tilo; Püschel, Klaus; Blankenberg, Stefan; Robinson, Peter N

    2015-01-01

    Three international nosologies have been proposed for the diagnosis of Marfan syndrome (MFS): the Berlin nosology in 1988; the Ghent nosology in 1996 (Ghent-1); and the revised Ghent nosology in 2010 (Ghent-2). We reviewed the literature and discussed the challenges and concepts of diagnosing MFS in adults. Ghent-1 proposed more stringent clinical criteria, which led to the confirmation of MFS in only 32%-53% of patients formerly diagnosed with MFS according to the Berlin nosology. Conversely, both the Ghent-1 and Ghent-2 nosologies diagnosed MFS, and both yielded similar frequencies of MFS in persons with a causative FBN1 mutation (90% for Ghent-1 versus 92% for Ghent-2) and in persons not having a causative FBN1 mutation (15% versus 13%). Quality criteria for diagnostic methods include objectivity, reliability, and validity. However, the nosology-based diagnosis of MFS lacks a diagnostic reference standard and, hence, quality criteria such as sensitivity, specificity, or accuracy cannot be assessed. Medical utility of diagnosis implies congruency with the historical criteria of MFS, as well as with information about the etiology, pathogenesis, diagnostic triggers, prognostic triggers, and potential complications of MFS. In addition, social and psychological utilities of diagnostic criteria include acceptance by patients, patient organizations, clinicians and scientists, practicability, costs, and the reduction of anxiety. Since the utility of a diagnosis or exclusion of MFS is context-dependent, prioritization of utilities is a strategic decision in the process of nosology development. Screening tests for MFS should be used to identify persons with MFS. To confirm the diagnosis of MFS, Ghent-1 and Ghent-2 perform similarly, but Ghent-2 is easier to use. To maximize the utility of the diagnostic criteria of MFS, a fair and transparent process of nosology development is essential.

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

    Science.gov (United States)

    Wakefield, Jerome C

    2011-01-01

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

  7. Metabolic syndrome in children and adolescents - criteria for diagnosis

    Science.gov (United States)

    Mancini, Marcio C

    2009-01-01

    In recent years, there has been a greater concern about the presence of obesity and metabolic syndrome in children and adolescents. However, there is no consensus regarding the diagnosis of metabolic syndrome in children and adolescents. It is evident that each component of the syndrome must be identified as early as possible in order to prevent definitive lesions. The question is how to do this and which cut-offs must be adopted for this diagnosis. For a matter of convenience, the definition chosen as the most appropriate is the one proposed by the IDF, with cut-offs fixed for pressure, lipids and glycemia, and abdominal circumference points assessed by percentile. Although on the one hand this definition could fail to include some children in the diagnosis of Metabolic Syndrome, on the other hand, it would be of easier acceptance as it does not use multiple tables to assess several anthropometric and metabolic criteria. PMID:19840386

  8. Diagnostic Approaches to Sjögren’s Syndrome: a Literature Review and Own Clinical Experience

    Directory of Open Access Journals (Sweden)

    Pedro de Sousa Gomes

    2012-03-01

    Full Text Available Objectives: The purpose of present paper is to critically address the recent advances on diagnostic procedures of Sjögren’s syndrome, taking into account the attained local and systemic features of the disease. Material and Methods: A comprehensive review of the available literature regarding to the diagnostic approaches to Sjögren’s syndrome was conducted. Eligible studies were identified by searching the electronic literature PubMed, Medline, Embase, and ScienceDirect databases for relevant reports (last search update January 2012 combining the MESH heading term “Sjögren’s syndrome”, with the words "diagnosis, diagnostic procedures, salivary gland function, ocular tests, histopathology, salivary gland imaging, serology". The authors checked the references of the selected articles to identify additional eligible publications and contacted the authors, if necessary. Results: Presented article addresses the established diagnostic criteria for Sjögren’s syndrome and critically evaluates the most commonly used diagnostic procedures, presenting data from author’s own clinical experience. Diagnostic criteria for Sjögren’s syndrome are required both by healthcare professionals and patients, namely in order to provide a rational basis for the assessment of the symptoms, establish an individual disease prognosis, and orientate the therapeutic intervention. Conclusions: Sjögren’s syndrome is quite a common autoimmune disease of which the diagnosis and treatment are not easily established. Due to its systemic involvement, it can exhibit a wide range of clinical manifestations that contribute to confusion and delay in diagnosis. The use of proper diagnostic modalities will help to reduce the time to diagnosis and preserve the health and quality of life of patients with Sjögren’s syndrome.

  9. Las diferencias en los criterios diagnósticos de síndrome metabólico son útiles para identificar sujetos en riesgo, pero pierden relevancia en pacientes con enfermedad coronaria Differences in metabolic syndrome diagnostic criteria are useful for identifying risk subjects, but loose relevance in patients with coronary disease

    Directory of Open Access Journals (Sweden)

    Patricio López-Jaramillo

    2006-08-01

    if there exist differences in the frequency of metabolic syndrome diagnosis when applying the Adult Treatment Panel III (ATPIII and the International Diabetes Federation (IDF in the Latin-American population with or without atherosclerotic coronary disease. Design - Method: in a cross sectional study, 265 men were included. 166 of them had no coronary heart disease (-CHD and 99 had suggestive clinical manifestations of coronary disease (+CHD. 36.3% of these had angiographic demonstration of luminal coronary artery disease. Complete physical examinations, determination of glycemia and lipid profile were performed. The ATPIII and IDF criteria were applied for the metabolic syndrome diagnosis and its frequency in each group was calculated. Results: in both groups studied, the application of the ATPIII criteria registered lower frequencies of metabolic syndrome than with the IDF criteria. Nevertheless, this difference was significant only in the group of patients without antecedents of coronary heart disease (-CHD. (IDF=33.1% vs. ATPIII=47.2% p = 0.2. Conclusions: These results show that the incorporation of central obesity into the diagnostic criteria of metabolic syndrome and the definition of the cutting points proper for each region are important in the identification of Latin-Americans with metabolic syndrome.

  10. Eagle Syndrome: diagnostic imaging and therapy

    International Nuclear Information System (INIS)

    Nickel, J.; Andresen, R.; Sonnenburg, M.; Scheufler, O.

    2004-01-01

    In the case of clinical symptoms such as dysphagia, foreign-body sensation and chronic neck or facial pain close to the ear, an Eagle syndrome should be considered in the differential diagnosis. Rational diagnostics and therapy are elucidated on the basis of four case reports. Four patients presented in the out-patients clinic with chronic complaints on chewing and a foreign-body sensation in the tonsil region. Upon specific palpation below the mandibular angle, pain radiating into the ear region intensified. In all patients, local anaesthesia with lidocaine only led to a temporary remission of symptoms. Imaging diagnostics then performed initially included cranial survey radiograms according to Clementschitsch as well as in the lateral ray path and an OPTG. An axial spiral-CT was then performed using the thin-layer technique with subsequent 3-D reconstruction. Therapy consisted of elective resection with a lateral external incision from the retromandibular. From a symptomatic point of view, the cranial survey radiograms and the OPTG revealed hypertrophic styloid processes. The geometrically corrected addition of the axial CT images produced an absolute length of 51-58 mm. The 3-D reconstruction made it possible to visualise the exact spatial orientation of the styloid processes. An ossification of the stylohyoid ligament could definitely be ruled out on the basis of the imaging procedures. After resection of the megastyloid, the patients were completely free of symptoms. Spiral-CT with subsequent 3-D reconstruction is the method of choice for exact determination of the localisation and size of a megastyloid, while cranial survey radiograms according to Clementschitsch and in the lateral ray path or an OPTG can provide initial information. The therapy of choice is considered to be resection of the megastyloid, whereby an external lateral incision has proved effective. (orig.) [de

  11. Development of criteria for a diagnosis: lessons from the night eating syndrome

    Science.gov (United States)

    Stunkard, Albert J.; Allison, Kelly C.; Geliebter, Allan; Lundgren, Jennifer D.; Gluck, Marci E.; O’Reardon, John P.

    2013-01-01

    Criteria for inclusion of diagnoses of Axis I disorders in the forthcoming Diagnostic and Statistical Manual (DSM-V) of the American Psychiatric Association are being considered. The 5 criteria that were proposed by Blashfield et al as necessary for inclusion in DSM-IV are reviewed and are met by the night eating syndrome (NES). Seventy-seven publications in refereed journals in the last decade indicate growing recognition of NES. Two core diagnostic criteria have been established: evening hyperphagia (consumption of at least 25% of daily food intake after the evening meal) and/or the presence of nocturnal awakenings with ingestions. These criteria have been validated in studies that used self-reports, structured interviews, and symptom scales. Night eating syndrome can be distinguished from binge eating disorder and sleep-related eating disorder. Four additional features attest to the usefulness of the diagnosis of NES: (1) its prevalence, (2) its association with obesity, (3) its extensive comorbidity, and (4) its biological aspects. In conclusion, research on NES supports the validity of the diagnosis and its inclusion in DSM-V. PMID:19683608

  12. Examining DSM criteria for trichotillomania in a dimensional framework: implications for DSM-5 and diagnostic practice.

    Science.gov (United States)

    Houghton, David C; Balsis, Steve; Stein, Dan J; Compton, Scott N; Twohig, Michael P; Saunders, Stephen M; Franklin, Martin E; Neal-Barnett, Angela M; Woods, Douglas W

    2015-07-01

    Diagnosis of trichotillomania (TTM) requires meeting several criteria that aim to embody the core pathology of the disorder. These criteria are traditionally interpreted monothetically, in that they are all equally necessary for diagnosis. Alternatively, a dimensional conceptualization of psychopathology allows for examination of the relatedness of each criterion to the TTM latent continuum. First, to examine the ability of recently removed criteria (B and C) to identify the latent dimensions of TTM psychopathology, such that they discriminate between individuals with low and high degrees of hair pulling severity. Second, to determine the impact of removing criteria B and C on the information content of remaining diagnostic criteria. Third, to determine the psychometric properties of remaining TTM diagnostic criteria that remain largely unchanged in DSM-5; that is, whether they measure distinct or overlapping levels of TTM psychopathology. Fourth, to determine whether information content derived from diagnostic criteria aid in the prediction of disease trajectory (i.e., can relapse propensity be predicted from criteria endorsement patterns). Statistics derived from item response theory were used to examine diagnostic criteria endorsement in 91 adults with TTM who underwent psychotherapy. The removal of two criteria in DSM-5 and psychometric validity of remaining criteria was supported. Additionally, individual trait parameters were used to predict treatment progress, uncovering predictive power where none previously existed. Diagnostic criteria for TTM should be examined in dimensional models, which allow for nuanced and sensitive measurement of core symptomology in treatment contexts. Copyright © 2015 Elsevier Inc. All rights reserved.

  13. Patch testers' opinions regarding diagnostic criteria for metal hypersensitivity reactions to metallic implants

    DEFF Research Database (Denmark)

    Schalock, Peter C; Thyssen, Jacob P

    2013-01-01

    Metal hypersensitivity reactions to implanted devices remain a challenging and controversial topic. Diagnostic criteria and methods are not well delineated.......Metal hypersensitivity reactions to implanted devices remain a challenging and controversial topic. Diagnostic criteria and methods are not well delineated....

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

    Science.gov (United States)

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

    2016-01-01

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

  15. Delusional disorder-jealous type: how inclusive are the DSM-IV diagnostic criteria?

    Science.gov (United States)

    Easton, Judith A; Shackelford, Todd K; Schipper, Lucas D

    2008-03-01

    Delusional disorder-jealous type is a new diagnostic category in the Diagnostic and Statistical Manual for Disorders, Fourth Edition, Text Revision (DSM-IV-TR; American Psychiatric Association, 2000) in which delusions concerning a partner's infidelity must be present. Therefore, patients who experience a jealousy disorder, but do not experience delusions will not fit the diagnostic criteria. Using a database of 398 case histories of jealousy disorders reported in the literature from 1940-2002, we examined the percentage of these cases that met the diagnostic criteria for delusional disorder-jealous type. Only 4% of the cases met all diagnostic criteria. This is the first systematic comparison of the prevalence of these disorders. The results provide evidence that the diagnostic criteria are not inclusive, as most individuals suffering with a jealousy disorder were excluded from the diagnosis.

  16. Perspectives on the revised Ghent criteria for the diagnosis of Marfan syndrome

    Directory of Open Access Journals (Sweden)

    von Kodolitsch Y

    2015-06-01

    Full Text Available Yskert von Kodolitsch,1 Julie De Backer,2 Helke Schüler,1 Peter Bannas,3 Cyrus Behzadi,3 Alexander M Bernhardt,1 Mathias Hillebrand,1 Bettina Fuisting,4 Sara Sheikhzadeh,1 Meike Rybczynski,1 Tilo Kölbel,1 Klaus Püschel,5 Stefan Blankenberg,1 Peter N Robinson61Centre of Cardiology, University Hospital Eppendorf, Hamburg, Germany; 2Centre for Medical Genetics, University Hospital Ghent, Ghent, Belgium; 3Diagnostic and Interventional Radiology Department and Clinic, 4Department of Ophthalmology, 5Department of Legal Medicine, University Hospital Eppendorf, Hamburg, Germany; 6Institute of Medical Genetics and Human Genetics, Charité Universitätsmedizin, Berlin, Germany Abstract: Three international nosologies have been proposed for the diagnosis of Marfan syndrome (MFS: the Berlin nosology in 1988; the Ghent nosology in 1996 (Ghent-1; and the revised Ghent nosology in 2010 (Ghent-2. We reviewed the literature and discussed the challenges and concepts of diagnosing MFS in adults. Ghent-1 proposed more stringent clinical criteria, which led to the confirmation of MFS in only 32%–53% of patients formerly diagnosed with MFS according to the Berlin nosology. Conversely, both the Ghent-1 and Ghent-2 nosologies diagnosed MFS, and both yielded similar frequencies of MFS in persons with a causative FBN1 mutation (90% for Ghent-1 versus 92% for Ghent-2 and in persons not having a causative FBN1 mutation (15% versus 13%. Quality criteria for diagnostic methods include objectivity, reliability, and validity. However, the nosology-based diagnosis of MFS lacks a diagnostic reference standard and, hence, quality criteria such as sensitivity, specificity, or accuracy cannot be assessed. Medical utility of diagnosis implies congruency with the historical criteria of MFS, as well as with information about the etiology, pathogenesis, diagnostic triggers, prognostic triggers, and potential complications of MFS. In addition, social and psychological utilities of

  17. A search for new MRI criteria for dissemination in space in subjects with a clinically isolated syndrome

    Energy Technology Data Exchange (ETDEWEB)

    Korteweg, T.; Barkhof, F. [VU University Medical Centre, Department of Radiology, De Boelelaan 1118, HV, Amsterdam (Netherlands); Tintore, M.; Montalban, X. [Hospital Vall d' Hebron, Department of Neuroimmunology, Barcelona (Spain); Uitdehaag, B.M.J. [VU University Medical Centre, Department of Clinical Epidemiology and Biostatistics, Amsterdam (Netherlands); VU University Medical Centre, Department of Neurology, Amsterdam (Netherlands); Knol, D.L. [VU University Medical Centre, Department of Clinical Epidemiology and Biostatistics, Amsterdam (Netherlands); Vrenken, H. [VU University Medical Centre, Department of Physics and Medical Technology, Amsterdam (Netherlands); Rovira, A. [Magnetic Resonance Unit, Department of Radiology, Barcelona (Spain); Frederiksen, J. [University of Copenhagen, The MS Clinic, Department of Neurology, Copenhagen (Denmark); Miller, D.H.; Fernando, K. [University College London, MS NMR Research Unit, Department of Neuroinflammation, Institute of Neurology, London (United Kingdom); Filippi, M.; Agosta, F.; Rocca, M.A. [Scientific Institute and University Ospedale San Raffaele, Neuroimaging Research Unit, Department of Neurology, Milan (Italy); Fazekas, F.; Enzinger, C. [Medical University Graz, Department of Neurology, Graz (Austria); Parry, A. [University of Oxford, Department of Clinical Neurology, Oxford (United Kingdom); Polman, C.H. [VU University Medical Centre, Department of Neurology, Amsterdam (Netherlands)

    2009-09-15

    The International Panel on the Diagnosis of Multiple Sclerosis (MS) incorporated the Barkhof/Tintore (B/T) magnetic resonance criteria into their diagnostic scheme to provide evidence of dissemination in space of central nervous system lesions, a prerequisite for diagnosing MS in patients who present with clinically isolated syndromes (CIS). Although specific for MS, the B/T criteria were criticised for their low sensitivity and relative complexity in clinical use. We used lesion characteristics at onset from 349 CIS patients in logistic regression and recursive partitioning modelling in a search for simpler and more sensitive criteria, while maintaining current specificity. The resulting models, all based on the presence of periventricular and deep white matter lesions, performed roughly in agreement with the B/T criteria, but were unable to provide higher diagnostic accuracy based on information from a single scan. Apparently, findings from contrast-enhanced and follow-up magnetic resonance scans are needed to improve the diagnostic algorithm. (orig.)

  18. Diagnostic and Therapeutic Management of a First Unprovoked Seizure in Children and Adolescents With a Focus on the Revised Diagnostic Criteria for Epilepsy.

    Science.gov (United States)

    Sansevere, Arnold J; Avalone, Jennifer; Strauss, Lauren Doyle; Patel, Archana A; Pinto, Anna; Ramachandran, Maya; Fernandez, Ivan Sanchez; Bergin, Ann M; Kimia, Amir; Pearl, Phillip L; Loddenkemper, Tobias

    2017-07-01

    By definition, unprovoked seizures are not precipitated by an identifiable factor, such as fever or trauma. A thorough history and physical examination are essential to caring for pediatric patients with a potential first unprovoked seizure. Differential diagnosis, EEG, neuroimaging, laboratory tests, and initiation of treatment will be reviewed. Treatment is typically initiated after 2 unprovoked seizures, or after 1 seizure in select patients with distinct epilepsy syndromes. Recent expansion of the definition of epilepsy by the ILAE allows for the diagnosis of epilepsy to be made after the first seizure if the clinical presentation and supporting diagnostic studies suggest a greater than 60% chance of a second seizure. This review summarizes the current literature on the diagnostic and therapeutic management of first unprovoked seizure in children and adolescents while taking into consideration the revised diagnostic criteria of epilepsy.

  19. BELLY DANCER'S SYNDROME - A DIAGNOSTIC CHALLANGE

    Directory of Open Access Journals (Sweden)

    Ana Raquel Moreira

    2017-04-01

    Discussion: This clinical presentation of this syndrome is quite unusual, which may lead to late diagnosis or ineffective treatments. We report a case of traumatic Belly Dancer’s syndrome that improved significantly with stabilization of the lesion.

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

    Directory of Open Access Journals (Sweden)

    Rondalyn Varney Whitney Ph.D., OT/L

    2012-11-01

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

  1. The effect of increasingly stringent diagnostic criteria on sex ...

    African Journals Online (AJOL)

    Sex differences in premorbid function and symptomatology were examined as increasingly stringent criteria for schizophrenia were applied to 182 male and 139 female . psychotic patients. The male/female ratio rose from 1.6 among those meeting the CATEGO 'broad' criteria for schizophrenia to 3.7 among those satisfying ...

  2. Management of cirrhotic ascites in children. Review and recommendations. Part 1: Pathophysiology, diagnostic evaluation, hospitalization criteria, treatment, nutritional management.

    Science.gov (United States)

    Bes, David F; Fernández, M Cristina; Malla, Ivone; Repetto, Horacio A; Buamsch, Daniel; López, Susana; Martinitto, Roxana; Cuarterolo, Miriam; Álvarez, Fernando

    2017-08-01

    Ascites is a major complication of cirrhosis. There are several evidence-based articles and guidelines for the management of adults, but few data have been published in relation to children. In the case of pediatric patients with cirrhotic ascites (PPCA), the following questions are raised: How are the clinical assessment and ancillary tests performed? When is ascites considered refractory? How is it treated? Should fresh plasma and platelets be infused before abdominal paracentesis to prevent bleeding? What are the hospitalization criteria? What are the indicated treatments? What complications can patients develop? When and how should hyponatremia be treated? What are the diagnostic criteria for spontaneous bacterial peritonitis? How is it treated? What is hepatorenal syndrome? How is it treated? When should albumin be infused? When should fluid intake be restricted? The recommendations made here are based on pathophysiology and suggest the preferred approach to its diagnostic and therapeutic aspects, and preventive care. Sociedad Argentina de Pediatría.

  3. Developing diagnostic guidelines for the acute radiation syndrome

    International Nuclear Information System (INIS)

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

    1996-01-01

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

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

    DEFF Research Database (Denmark)

    Schiffman, Eric; Ohrbach, Richard; Truelove, Edmond

    2014-01-01

    AIMS: The original Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) Axis I diagnostic algorithms have been demonstrated to be reliable. However, the Validation Project determined that the RDC/TMD Axis I validity was below the target sensitivity of ≥ 0.70 and specificity of ≥ 0...... of the literature providing valid instruments that, relative to the RDC/TMD, are shorter in length, are available in the public domain, and currently are being used in medical settings. RESULTS: The newly recommended Diagnostic Criteria for TMD (DC/TMD) Axis I protocol includes both a valid screener for detecting...... any pain-related TMD as well as valid diagnostic criteria for differentiating the most common pain-related TMD (sensitivity ≥ 0.86, specificity ≥ 0.98) and for one intra-articular disorder (sensitivity of 0.80 and specificity of 0.97). Diagnostic criteria for other common intra-articular disorders...

  5. Evaluating Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition Posttraumatic Stress Disorder Diagnostic Criteria in Older Children and Adolescents.

    Science.gov (United States)

    Mikolajewski, Amy J; Scheeringa, Michael S; Weems, Carl F

    2017-05-01

    Few studies have assessed how the diagnostic criteria for posttraumatic stress disorder (PTSD) apply to older children and adolescents. With the introduction of a new, developmentally sensitive set of criteria for very young children (age 6 years and younger) in Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-5), this raises new questions about the validity of the criteria for older children and adolescents. The current study investigated how diagnostic changes in DSM-5 impact diagnosis rates in 7-18-year olds. PTSD, impairment, and comorbid psychopathology were assessed in 135 trauma-exposed, treatment-seeking participants. Children (ages 7-12) were examined separately from adolescents (ages 13-18) to assess for potential developmental differences. A significantly higher proportion of 7-12-year-old children met criteria for DSM-5 diagnosis (53%) compared to Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM-IV) (37%). However, among 13-18-year-old adolescents, the proportions diagnosed with DSM-5 (73%) and DSM-IV (74%) did not differ. Participants who met criteria for DSM-5 only (17%) did not differ from those diagnosed with DSM-IV in terms impairment or comorbidity. Using the newly accepted age 6 years and younger criteria resulted in a significantly higher proportion of 7-12-year-old (but not 13-18-year olds) children meeting criteria compared to DSM-IV or DSM-5. However, these children showed less impairment and comorbidity than those diagnosed with DSM-IV. These findings suggest that DSM-5 criteria may be more developmentally sensitive than DSM-IV criteria, and may lead to higher prevalence rates of PTSD for 7-12-year-old children, but not for adolescents. Using the very young children criteria for 7-12-year-old children may further increase prevalence, but capture children with less severe psychopathology.

  6. Diagnostic criteria and severity assessment of acute cholangitis: Tokyo Guidelines

    NARCIS (Netherlands)

    Wada, Keita; Takada, Tadahiro; Kawarada, Yoshifumi; Nimura, Yuji; Miura, Fumihiko; Yoshida, Masahiro; Mayumi, Toshihiko; Strasberg, Steven; Pitt, Henry A.; Gadacz, Thomas R.; Buechler, Markus W.; Belghiti, Jacques; de Santibanes, Eduardo; Gouma, Dirk J.; Neuhaus, Horst; Dervenis, Christos; Fan, Sheung-Tat; Chen, Miin-Fu; Ker, Chen-Guo; Bornman, Philippus C.; Hilvano, Serafin C.; Kim, Sun-Whe; Liau, Kui-Hin; Kim, Myung-Hwan

    2007-01-01

    Because acute cholangitis sometimes rapidly progresses to a severe form accompanied by organ dysfunction, caused by the systemic inflammatory response syndrome (SIRS) and/or sepsis, prompt diagnosis and severity assessment are necessary for appropriate management, including intensive care with organ

  7. Diagnostic criteria for depression in type 2 diabetes: a data-driven approach.

    Directory of Open Access Journals (Sweden)

    Sergio E Starkstein

    Full Text Available BACKGROUND: While depression is a frequent psychiatric comorbid condition in diabetes and has significant clinical impact, the syndromal profile of depression and anxiety symptoms has not been examined in detail. AIMS: To determine the syndromal pattern of the depression and anxiety spectrum in a large series of patients with type 2 diabetes, as determined using a data-driven approach based on latent class analysis (LCA. METHOD: Type 2 diabetes participants from the observational community-based Fremantle Diabetes Study Phase II underwent assessment of lifetime depression using the Brief Lifetime Depression Scale, the Patient Health Questionnaire 9-item version (PHQ-9 for current depression symptoms, and the Generalized Anxiety Disorder Scale that was specifically developed and validated for this study. The main outcome measure was classes of patients with a specific syndromal profile of depression and anxiety symptoms based on LCA. RESULTS: LCA identified four classes that were interpreted as "major anxious depression", "minor anxious depression", "subclinical anxiety", and "no anxious depression". All nine DSM-IV/5 diagnostic criteria for major depression identified a class with a high frequency of major depression. All symptoms of anxiety had similar high probabilities as symptoms of depression for the "major depression-anxiety" class. There were significant differences between classes in terms of history of depression and anxiety, use of psychoactive medication, and diabetes-related variables. CONCLUSIONS: Patients with type 2 diabetes show specific profiles of depression and anxiety. Anxiety symptoms are an integral part of major depression in type 2 diabetes. The different classes identified here provide empirically validated phenotypes for future research.

  8. Diagnostic features of polycystic ovary syndrome

    African Journals Online (AJOL)

    2006-02-17

    Feb 17, 2006 ... Polycystic ovary syndrome (PCOS) is one of the commonest endocrinopathies in women.1 It was first described by Stein and Leventhal2 in 1935, as the association of infertility, obesity, hirsutism and bilateral enlarged polycystic ovaries. As a syndrome, PCOS has had an interesting history, with much ...

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

    Directory of Open Access Journals (Sweden)

    Tina In-Albon

    2013-01-01

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

  10. Impact of diagnostic criteria on the prevalence of COPD

    DEFF Research Database (Denmark)

    Çolak, Yunus; Løkke, Anders; Marott, Jacob Louis

    2012-01-01

    of normal (LLN) is eagerly discussed. The aim of this paper was to examine the impact of these two diagnostic measures on the prevalence of COPD using data from the fourth examination of The Copenhagen City Heart Study (CCHS4). MATERIALS AND METHODOLOGY: A total of 6237 subjects participated in CCHS4 from...

  11. Evolution of diagnostic criteria for gestational diabetes mellitus

    DEFF Research Database (Denmark)

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

    2013-01-01

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

  12. Diagnostic Clast-Texture Criteria for Recognition of Impact Deposits

    Science.gov (United States)

    Marshall, J. R.; Bratton, C.; Pope, K. O.; Ocampo, A. C.

    1999-01-01

    It is difficult to find definitive evidence for impact in the geological record because there are many endogenous geological processes that can produce diamictites similar to those generated by impact ejecta. The classic impact criteria of shock fabrics in certain minerals, and iridium layers, for example, may be either difficult to find, or long-since erased from the impact site (shock fabrics also anneal with time). It is important to be able to recognize impact-generated materials in order to understand earth's crustal development and biological evolution. In future exploration of Mars and other solar-system bodies, recognition of impact materials will be important for elucidating planetary evolution, planetary volatile inventories, and exobiological issues. The cobble depicted is typical of many that have been found in diamictite deposits in Belize generated by the Chicxulub K-T impact event. The pebbles are roughly-hewn in general shape with smoothed corners and edges. Surfaces are almost uniformly frosted (on both protuberances and hollows), but some asperities are glazed. Optical microscopy and thin-section petrographic microscopy reveal the frosting to be only a few microns thick, with a well-defined granular structure; grains are the same size as those composing the bulk of the limestone, but their clearer appearance may represent annealing. One or two adjacent pebble faces are often decorated with striated gouges and closely-spaced hemispherical depressions representing indentation hollows produced by well-rounded impacting clasts of up to 0.5 cm in diameter. Some of the impactors are still embedded in the cobble surface. Non-destructive x-ray diffraction techniques showed the impactors to be of the same mineralogy as the target cobble. We believe this unusual glazing and frosting to be related to the impact event, but this must be reconciled with its survival for over 60 my. since it is composed of one of the most alterable substances, CaCO3. We focus

  13. Diagnostic criteria and severity assessment of acute cholecystitis: Tokyo Guidelines

    NARCIS (Netherlands)

    Hirota, Masahiko; Takada, Tadahiro; Kawarada, Yoshifumi; Nimura, Yuji; Miura, Fumihiko; Hirata, Koichi; Mayumi, Toshihiko; Yoshida, Masahiro; Strasberg, Steven; Pitt, Henry; Gadacz, Thomas R.; de Santibanes, Eduardo; Gouma, Dirk J.; Solomkin, Joseph S.; Belghiti, Jacques; Neuhaus, Horst; Buechler, Markus W.; Fan, Sheung-Tat; Ker, Chen-Guo; Padbury, Robert T.; Liau, Kui-Hin; Hilvano, Serafin C.; Belli, Giulio; Windsor, John A.; Dervenis, Christos

    2007-01-01

    The aim of this article is to propose new criteria for the diagnosis and severity assessment of acute cholecystitis, based on a systematic review of the literature and a consensus of experts. A working group reviewed articles with regard to the diagnosis and treatment of acute cholecystitis and

  14. Emotional competence in children with autism: Diagnostic criteria and empirical evidence

    NARCIS (Netherlands)

    Begeer, S.; Koot, H.M.; Rieffe, C.J.; Meerum Terwogt, M.; Stegge, G.T.M.

    2008-01-01

    The diagnostic criteria of autism spectrum disorders (ASD) include emotional impairments. However, scientific evidence for these impairments is varied and subtle. In this contribution, recent empirical studies that examined the emotional competence in children and adolescents with ASD are reviewed.

  15. Imaging and diagnostic criteria for multiple sclerosis: are we there yet?

    International Nuclear Information System (INIS)

    Josey, Lawrence; Curley, Michael; Mousavi, Foroogh Jafari; Taylor, Bruce V.; Lucas, Robyn; Coulthard, Alan

    2012-01-01

    Excluding post traumatic injury, Multiple Sclerosis (MS) is the most common disabling neurological disorder of young adults. Although the effect on mortality is limited, the association of a young demographic and significant morbidity combine to make MS a devastating disease. Since MS was given its first detailed description in 1868, diagnostic criteria continue to evolve. Recently, there has been an international commitment to combine both clinical and paraclinical tests to arrive at an earlier diagnosis. Widespread acceptance of the use of MRI in diagnosis, monitoring and research has made the role of the radiologist more critical than ever in this disease. The primary diagnostic criteria for MS are the International Panel criteria, commonly referred to as the McDonald criteria and it is essential that the radiology community is aware of the work preceding these criteria, so that they are understood in the correct context and the importance acknowledged. Literature review utilising key word search to obtain the historical and current context of magnetic resonance imaging in the diagnosis of MS. A succinct description of the evolution of criteria for the diagnosis of MS. Radiologists must recognise that there are specific diagnostic criteria for MS that continue to evolve as a result of new research, improved technology and clinical experience and it is crucial that these criteria be applied in daily practice. It should be evident that diagnostic imaging criteria for MS will be most effective when combined with standardised MRI protocols such as those published by the international Consortium of Multiple Sclerosis Centres.

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

    DEFF Research Database (Denmark)

    Basu, Neil; Watts, Richard; Bajema, Ingeborg

    2010-01-01

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

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

    OpenAIRE

    Wilfley, Denise E; Citrome, Leslie; Herman, Barry K

    2016-01-01

    Denise E Wilfley,1 Leslie Citrome,2 Barry K Herman3 1Department of Psychiatry, Washington University School of Medicine, St Louis, MO, 2Department of Psychiatry & Behavioral Sciences, New York Medical College, Valhalla, NY, 3Global Medical Affairs, Shire, Lexington, MA, USA Abstract: The objective of this review was to examine the evidentiary basis for binge eating disorder (BED) with reference to the Diagnostic and Statistical Manual of Mental Disorders – Fifth Edition (D...

  18. Diagnostic utility of attention measures in postconcussion syndrome.

    Science.gov (United States)

    Cicerone, Keith D; Azulay, Joanne

    2002-08-01

    Neuropsychological evaluation may be of particular relevance in the detection of subtle cognitive impairments after mild traumatic brain injury (MTBI), including the subgroup of MTBI patients with a persistent postconcussion syndrome (PCS). Attention measures may be the most sensitive indicators of dysfunction associated with MTBI; however, previous studies have typically relied on the analysis of overall group differences, which may not reflect the diagnostic accuracy of attention measures when applied to individuals with MTBI. In the present study, subjects with persistent symptoms at least 3 months following a mild traumatic brain injury were compared with a sample of community living, normal control subjects in order to evaluate the sensitivity, specificity, and diagnostic accuracy of attention measures. Patients with PCS, screened with conservative inclusion and exclusion criteria, and a matched normal control group were administered six clinical tests of attention: Digit Span, Trail Making Test, Part A and Part B, Stroop Color-Word Test, Continuous Performance Test of Attention (CPTA), Paced Auditory Serial Addition Test (PASAT), and Ruff 2 & 7 Selective Attention Test. Consistent with prior research, these measures exhibited a wide range of sensitivity and specificity to possible cognitive impairment among patients. Attention measures may be the most sensitive indicators of dysfunction associated with PCS. Measures with high specificity (e.g., Stroop Color, and 2 & 7 Processing Speed) were shown to have strong positive predictive value, while measures with high sensitivity (e.g., CPTA) demonstrated strong negative predictive value for diagnosing PCS. Examination of the Odds Ratios indicated that measures assessing processing speed had a reliable, positive association with PCS, while measures without a processing speed component did not. Implications for making informed clinical decisions are discussed.

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

    DEFF Research Database (Denmark)

    Schiffman, Eric; Ohrbach, Richard; Truelove, Edmond

    2014-01-01

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

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

    NARCIS (Netherlands)

    E.J. Thoomes (Erik); G.G.M. Scholten-Peeters (Gwendolijne); A.J. de Boer (Alice); R.A. Olsthoorn (Remy); K. Verkerk (Karin); C.-W.C. Lin (Chung-Wei Christine); A.P. Verhagen (Arianne)

    2012-01-01

    textabstractPurpose: Cervical radiculopathy (CR) is a common diagnosis. It is unclear if intervention studies use uniform definitions and criteria for patient selection. Our objective was to assess the uniformity of diagnostic criteria and definitions used in intervention studies to select patients

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

    NARCIS (Netherlands)

    Thoomes, Erik J; Scholten-Peeters, Gwendolijne G M; de Boer, Alice J; Olsthoorn, Remy A; Verkerk, Karin; Lin, Christine; Verhagen, Arianne P

    PURPOSE: Cervical radiculopathy (CR) is a common diagnosis. It is unclear if intervention studies use uniform definitions and criteria for patient selection. Our objective was to assess the uniformity of diagnostic criteria and definitions used in intervention studies to select patients with CR.

  2. [Hemophagocytic syndrome in a patient with adult-onset Still's disease: diagnostic problems].

    Science.gov (United States)

    Zakharova, A Yu; Mutovina, Z Yu; Gordeev, A V; Shestakova, I N

    2015-01-01

    Hemophagocytic syndrome (HPS) is a rare life-threatening condition caused by massive cytokine release from activated macrophages and lymphocytes. The paper depicts the development of HPS in different infections, malignancies, and autoimmune diseases. It describes a clinical case of hemophagocytic syndrome in a 63-year-old female patient with adult-onset Still's disease and high fever accompanied by neutrophil leukocytosis and a drastic left leukocyte count shift, high procalcitonin levels, hepatosplenomegaly, edematous syndrome, and progressive multiple organ dysfunction with the development of disseminated intravascular coagulation and adult respiratory distress syndrome. The diagnosis of HPS was established according to the diagnostic criteria and verified by autopsy: phagocytes in liver and lung tissues.

  3. Study on diagnosis criteria of fire-heat syndrome based on receiver operating characteristic curve and principal component analysis.

    Science.gov (United States)

    Liu, Si-jun; Huang, Zhao-sheng; Wu, Qing-guang; Huang, Zhang-jie; Wu, Li-rong; Yan, Wen-li; Wang, Qi; Wang, Zong-wei; Chang, David Lungpao; Yang, Zheng

    2016-04-01

    To establish the diagnostic quantitative criteria for fire-heat syndrome (FHS) of Chinese medicine (CM) based on the receiver operating characteristic (ROC) curve and principal component analysis (PCA). The symptoms and signs of FHS cases and healthy subjects from Guangzhou, Henan and Hunan of China were collected through questionnaire, and the diagnostic quantitative score tables were established for the three regions, respectively, with the method of maximum likelihood analysis. The homogeneity test was then performed on the diagnostic score tables for the three regions with ROC curve, and the diagnostic efficiency of diagnostic score tables for the three regions was compared with the prospective test and retrospective test. The method of PCA was adopted to obtain the analysis matrix for classifying the tapes of FHS. Twenty-seven elements of FHS were confirmed through Chi-square test, and the diagnostic score tables for the three regions were established with the method of maximum likelihood analysis on the basis of the collected case data. According to the ROC curve test, the areas under ROC curve of Guangzhou diagnostic score table assessment with candidates in Guangzhou, Henan and Hunan were 0.998, 0.961 and 0.956, respectively. It showed that the diagnostic efficiency of Guangzhou diagnostic score tables was the highest one. With the prospective test, the area under ROC of Guangzhou diagnostic score table was 0.949, and more than any other diagnostic score table. By PCA, FHS was classified into excess fire and deficiency fire, and then classified into syndrome of flaring up of Heart (Xin) fire, syndrome of Lung (Fei)-Stomach (Wei) excess fire, syndrome of deficiency of Liver (Gan)-yin and Kidney (Shen)-yin, and syndrome of deficiency of Lung-yin from the view of viscera. In the retrospective test, the consistency with clinicians' diagnosis was 69.4%, and in the prospective test, it was 70.1%. The Guangzhou diagnostic score table could be used as the

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

    Science.gov (United States)

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

    2001-05-01

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

  5. Impact of new diagnostic criteria of diabetes mellitus

    International Nuclear Information System (INIS)

    Khan, M.N.A.; Khan, F.A.; Sultan, S.; Ijaz, A.

    2007-01-01

    To compare the frequency of diabetic individuals diagnosed by fasting plasma glucose (FPG) 7.0 mmol/L with previous value i.e. 7.8 mmol/L and to determine the diagnostic accuracy of FPG 7.0 mmol/L. FPG of 5250 subjects was checked to compare the frequency of diabetic subjects diagnosed by FPG 7.0 mmol/L with 7.8 mmol/L. Of them, 301 symptom-free subjects were subjected to 75 g Oral Glucose Tolerance Test (OGTT) and their 2 hours post glucose (2-h PG) challenge level was taken as gold standard to determine the diagnostic accuracy of FPG at 7.0 mmol/L. By lowering the cut off point of FPG from 7.8 mmol/L to 7.0 mmol/L, the percentage of diagnosed diabetic subjects increased from 35% to 42%. Statistical analysis revealed a significant increase (p 7.0 mmol/L, will greatly facilitate the early diagnosis of diabetes mellitus (DM). An early diagnosis can be further facilitated by a combination of FPG and 2-h PG estimation. (author)

  6. Forearm interosseous membrane trauma: MRI diagnostic criteria and injury patterns

    Energy Technology Data Exchange (ETDEWEB)

    McGinley, Joseph C. [Stanford University Medical Center, Department of Radiology, Stanford, CA (United States); Roach, Neil [Hospital of the University of Pennsylvania, Department of Radiology, Philadelphia, PA (United States); Hopgood, Brendon C. [Albert Einstein Medical Center, Department of Surgery, Philadelphia, PA (United States); Limmer, Karl [Temple University School of Medicine, Philadelphia, PA (United States); Kozin, Scott H. [Shriners Hospital for Children, Temple University and Pediatric Hand and Upper Extremity Surgeon, Philadelphia, PA (United States)

    2006-05-15

    Define criteria for interosseous membrane (IOM) injury diagnosis using MRI, and characterize patterns of IOM disruption following forearm trauma. Our hypothesis is that most IOM injuries occur along the ulnar insertion, and MRI should be obtained following forearm trauma to assess IOM competency. Sixteen cadaver forearms were subjected to longitudinal impact trauma. Prior to and following injury, MR images were examined by a board-certified musculoskeletal radiologist using pre-defined criteria for determining IOM integrity. Each specimen was dissected and the viability/pattern of injury examined. The MRI and dissection results were compared using a double-blinded methodology. Eight of the 16 specimens demonstrated IOM trauma. Seven specimens demonstrated complete IOM disruption from the ulnar insertion, and one revealed a mid-substance tear with intact origin and insertion. The dorsal oblique bundle was disrupted in four specimens. MRI analysis identified IOM injury in seven of the eight forearms. The injury location was correctly identified in six specimens when compared to dissection observations. MRI determination of IOM injury demonstrated a positive predictive value of 100%, a negative predictive value of 89%, a sensitivity of 87.5% and a specificity of 100%. (orig.)

  7. Síndrome de insuficiência androgênica: critérios diagnósticos e terapêuticos Androgen insufficiency syndrome: diagnostic and therapeutic criteria

    Directory of Open Access Journals (Sweden)

    César Eduardo Fernandes

    2006-01-01

    Full Text Available A síndrome da insuficiência androgênica na mulher (SIA desperta, mesmo nos dias atuais, muitas discussões e encerra muitas controvérsias. Sabe-se, no entanto, que os níveis plasmáticos de testosterona declinam progressivamente ao longo do período reprodutivo. Conceitua-se a SIA como o conjunto de sintomas clínicos, a presença de biodisponibilidade diminuída de testosterona e os níveis normais de estrogênios. Entre os principais sintomas, citam-se o comprometimento do bem-estar, o humor disfórico, a fadiga sem causa aparente, o comprometimento do desejo sexual, o emagrecimento e a instabilidade vasomotora em mulheres pós-menopáusicas sob terapêutica estrogênica. Esses sintomas, no entanto, são potencialmente atribuíveis a diferentes etiologias e dificultam o correto diagnóstico na maioria dos casos, ainda que ele seja lembrado com freqüência em pacientes que se submetem à ooforectomia bilateral. O diagnóstico da SIA parece ser essencialmente clínico, não havendo a necessidade das dosagens laboratoriais para a sua comprovação. Não se deve indicar a terapêutica androgênica (TA em pacientes que não estejam adequadamente estrogenizadas. Considera-se a testosterona o hormônio ideal para a TA. As pacientes com sintomas sugestivos de SIA, excluídas outras causas identificáveis, especialmente se pós-menopáusicas, são candidatas à TA. Não existem dados de segurança sobre a TA em usuárias em longo prazo. A via transdérmica - através de adesivos, cremes e gel - parece ser preferível à oral.The women’s androgen insufficiency syndrome (AIS arises, even nowadays, many debates and clears a lot of controversies. It is known, however, that the plasmatic levels of testosterone gradually decline through the reproductive period. AIS is appraised as a set of clinical symptoms, bioavailability presence diminished of testosterone and normal levels of estrogen. Among the main symptoms that remind the diagnosis are the

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

    Science.gov (United States)

    Starcevic, Vladan

    2017-06-01

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

  9. Screening for Internet dependence: do the proposed diagnostic criteria differentiate normal from dependent Internet use?

    Science.gov (United States)

    Dowling, Nicki A; Quirk, Kelly L

    2009-02-01

    There is continued discussion of including Internet dependence as a diagnosis in future editions of the Diagnostic and Statistical Manual of Mental Disorders. The primary aim of the study was to evaluate the utility of the proposed diagnostic criteria for Internet dependence as measured by Young's Diagnostic Questionnaire (YDQ). Although the YDQ does not provide any measure of severity, there is emerging recognition that some Internet users may display less severe or at risk Internet dependence. The degree to which the cutoff of 5 out of 8 criteria is appropriate to differentiate nondependent from dependent Internet use was evaluated by comparing the Internet usage and psychological dysfunction of 424 university students endorsing 3 and 4 diagnostic criteria (at-risk Internet dependence) to those endorsing less than 3 criteria (nondependent) and those endorsing 5 or more criteria (Internet dependence). The findings suggest that the proposed diagnostic criteria do not adequately discriminate individuals scoring 3 or 4 from those currently classified as Internet dependent. The implications of the findings for the assessment, diagnosis, and treatment of Internet dependence are discussed.

  10. Explanation of diagnostic criteria for radiation-induced nervous system disease

    International Nuclear Information System (INIS)

    Xing Zhiwei; Jiang Enhai

    2012-01-01

    National occupational health standard-Diagnostic Criteria for Radiation-Induced Nervous System Disease has been issued and implemented by the Ministry of health. This standard contained three independent criteria of the brain, spinal cord and peripheral nerve injury. These three kinds of disease often go together in clinic,therefore,the three diagnostic criteria were merged into radioactive nervous system disease diagnostic criteria for entirety and maneuverability of the standard. This standard was formulated based on collection of the clinical practice experience, extensive research of relevant literature and foreign relevant publications. It is mainly applied to diagnosis and treatment of occupational radiation-induced nervous system diseases, and to nervous system diseases caused by medical radiation exposure as well. In order to properly implement this standard, also to correctly deal with radioactive nervous system injury, the main contents of this standard including dose threshold, clinical manifestation, indexing standard and treatment principle were interpreted in this article. (authors)

  11. PANDAS: The Need to Use Definitive Diagnostic Criteria

    Directory of Open Access Journals (Sweden)

    Harvey S. Singer

    2015-07-01

    Full Text Available The entity Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal infections (PANDAS was initially proposed in 1998 (Swedo, et al. 1998. The formal diagnosis required that the affected individual meet five specific criteria: prepubertal onset, obsessive compulsive disorder (OCD and/or a tic disorder, the dramatic sudden explosive onset of symptoms, a relapsing and remitting course of symptoms that are temporally associated with Group A beta-hemolytic streptococcal (GABHS infection, and the presence of other neuropsychiatric abnormalities (hyperactivity, emotional lability, anxiety, or piano-playing choreiform movements. Since that original report, the PANDAS hypothesis has remained controversial based on both clinical grounds and the failure to confirm a definitive immune process.  This editorial was written in response to:Helm CE, Blackwood RA. Pediatric autoimmune neuropsychiatric disorder associated with streptococcal infections (PANDAS: Experience at a tertiary referral center. Tremor Other Hyperkinet Mov. 2015; 5. doi: 10.7916/D8348JCX 

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

    Science.gov (United States)

    Ouyang, X Y

    2017-02-09

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

  13. Primary graft dysfunction of the liver: definitions, diagnostic criteria and risk factors.

    Science.gov (United States)

    Neves, Douglas Bastos; Rusi, Marcela Balbo; Diaz, Luiz Gustavo Guedes; Salvalaggio, Paolo

    2016-01-01

    Primary graft dysfunction is a multifactorial syndrome with great impact on liver transplantation outcomes. This review article was based on studies published between January 1980 and June 2015 and retrieved from PubMed database using the following search terms: "primary graft dysfunction", "early allograft dysfunction", "primary non-function" and "liver transplantation". Graft dysfunction describes different grades of graft ischemia-reperfusion injury and can manifest as early allograft dysfunction or primary graft non-function, its most severe form. Donor-, surgery- and recipient-related factors have been associated with this syndrome. Primary graft dysfunction definition, diagnostic criteria and risk factors differ between studies. RESUMO A disfunção primária do enxerto hepático é uma síndrome multifatorial com grande impacto no resultado do transplante de fígado. Foi realizada uma ampla revisão da literatura, consultando a base de dados PubMed, em busca de estudos publicados entre janeiro de 1980 e junho de 2015. Os termos descritivos utilizados foram: "primary graft dysfunction", "early allograft dysfunction", "primary non-function" e "liver transplantation". A disfunção traduz graus diferentes da lesão de isquemia e reperfusão do órgão, e pode se manifestar como disfunção precoce ou, na forma mais grave, pelo não funcionamento primário do enxerto. Fatores relacionados ao doador, ao transplante e ao receptor contribuem para essa síndrome. Existem definições diferentes na literatura quanto ao diagnóstico e aos fatores de risco associados à disfunção primária.

  14. Reviewing the diagnostic criteria for acute-on-chronic liver failure.

    Science.gov (United States)

    Jindal, Ankur; Rastogi, Archana; Sarin, Shiv Kumar

    2016-12-01

    For over 20 years, acute-on-chronic liver failure (ACLF) has taken multiple definitions and/or classifications. The definition outlines the acute and chronic insults to include a homogenous patient group with liver failure and an expected outcome in a specific time frame. Early and accurate diagnosis is essential as this inflammation of the liver may tilt the balance of liver destruction and regeneration adversely. Various factors such as superadded systemic sepsis, liver reserve, cause of primary chronic liver disease, state of immune system or the state of gut microbial flora might determine the ultimate prognosis. Areas covered: To date, there has been no universally accepted definition of ACLF. In this review, we discuss the strengths and weaknesses, controversies and basis for early identification and accurate diagnosis of ACLF. PubMed and Google scholar database searches were conducted, search terms included 'acute on chronic liver failure,' 'ACLF,' and 'diagnostic criteria.' Expert commentary: With recent advances in the management of advanced cirrhosis, research will gradually shift towards ACLF in the near future, focusing on the pathogenesis, new treatment options and improving survival. Once we improve understanding of this syndrome, newer definitions will evolve, thereby enabling earlier diagnosis and novel therapeutic avenues.

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

    Directory of Open Access Journals (Sweden)

    Hansson Emma

    2012-04-01

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

  16. The DSM diagnostic criteria for sexual aversion disorder.

    Science.gov (United States)

    Brotto, Lori A

    2010-04-01

    Sexual Aversion Disorder (SAD) is one of two Sexual Desire Disorders in the Diagnostic and Statistical Manual of Mental Disorders (DSM) and is defined as a "persistent or recurrent extreme aversion to, and avoidance of, all or almost all, genital sexual contact with a sexual partner" which causes distress or interpersonal difficulty. This paper reviews the short history of the diagnosis of SAD as well as the existing literature on its prevalence and etiology. Kaplan (1987) emphasized the phobic qualities of individuals with SAD who are highly avoidant of all forms of sexual contact. Much has also been written about the overlap between SAD and panic states, and the more obvious similarities between SAD and anxiety as opposed to sexual desire are described. There has been very little new published data on SAD since the publication of DSM-IV and the precise prevalence remains unknown. This paper critiques the placement of SAD as a Sexual Dysfunction and argues that it might more appropriately be placed within the Specific Phobia grouping as an Anxiety Disorder.

  17. Commentary on pedophilia diagnostic criteria in DSM-5.

    Science.gov (United States)

    Berlin, Fred S

    2011-01-01

    Human beings differ in sexual makeup. Most adults are not sexually attracted to prepubescent children, but some are. Societal values can be of relevance in determining whether such a difference is considered to be a psychiatric condition. Were a society to believe that adult-child sexual interactions should not be prohibited, such a difference might not be viewed as a disorder. According to Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR), a difference in sexual makeup can be considered a disorder when it causes interpersonal difficulty or marked distress. In contemporary society, pedophilia can do both. According to DSM-IV-TR, for a diagnosis of pedophilia, there must be both a qualitative difference in sexual makeup (i.e., sexualized urges directed toward children) and a quantitative difference (i.e., the sexualized urges must be intense). However, just as a heterosexual man with low (i.e., nonintense) sexual urges is still heterosexual, DSM-5 should similarly allow that individuals with low sexual urges in response to children qualify for a diagnosis of pedophilia.

  18. Interstitial Cystitis—Epidemiology, Diagnostic Criteria, Clinical Markers

    Science.gov (United States)

    Hanno, Philip M

    2002-01-01

    Knowledge of the epidemiology of interstitial cystitis (IC), the burden of the disease in the population, and the identification of possible risk factors remains largely fragmentary. The most reliable information comes from the few population-based studies that have appeared in the literature over the past 25 years, but two major issues urgently need to be addressed by appropriate epidemiologic studies: although studies find that only 10% of IC occurs in men, the hallmark symptoms of chronic prostatitis—pelvic pain, voiding dysfunction, and pain associated with sexual activity—overlap with those in men who carry the IC diagnosis. In addition, it is not known whether children suffer from the condition. The definition of IC is grounded in the symptomatology of pelvic pain and urinary frequency of a chronic nature and unexplained by any known urologic or other system pathology, but undue reliance on cystoscopic criteria has undoubtedly led to significant underdiagnosis. Efforts to identify clinical markers for diagnosis of IC are continuing and may lead the way to ascertaining the etiology and pathophysiology of IC. PMID:16986032

  19. Tumour forms and microcalcifications as radiological diagnostic criteria of mammography

    International Nuclear Information System (INIS)

    Cullmann, H.

    1979-01-01

    289 cases of breast carcinoma which had occurred over a period of 7 years were examined at mammograms and histological preparations. Especially in view were the frequency of radiologically visible criteria of malignancy with special stress laid on microcalcifications, typical radiological forms of imaging the various sorts of carcinoma, and a statement on the definiteness of diagnoses made with mammography. The exactness of diagnoses of breast cancer established by means of mammography can be states as 96.9% in 289 cases of carcinoma. 81.7% were assessed as definitely malignant and 15.2% were suspected to be malignant. In these cases, surgery confirmed the teutative diagnosis. 3.1% of the cases must be seen as mammographic false diagnoses in the sense of ''false negative''. These percentages are in correspondence with those obtained by other examiners. The radiologically visible growth form of breast cancer often typically reflect the histomorphological sort of the cancer. In 174 (67.1%) of 259 cases, the histological type of carcinoma could be recognized from the radiologically visible growth form. (orig./MG) [de

  20. Classification criteria of syndromes by latent variable models

    DEFF Research Database (Denmark)

    Petersen, Janne

    2010-01-01

    The thesis has two parts; one clinical part: studying the dimensions of human immunodeficiency virus associated lipodystrophy syndrome (HALS) by latent class models, and a more statistical part: investigating how to predict scores of latent variables so these can be used in subsequent regression...... analyses. Part 1: HALS engages different phenotypic changes of peripheral lipoatrophy and central lipohypertrophy.  There are several different definitions of HALS and no consensus on the number of phenotypes. Many of the definitions consist of counting fulfilled criteria on markers and do not include...... patient's characteristics. These methods may erroneously reduce multiplicity either by combining markers of different phenotypes or by mixing HALS with other processes such as aging. Latent class models identify homogenous groups of patients based on sets of variables, for example symptoms. As no gold...

  1. Equine metabolic syndrome: Etiopathogenesis, diagnostics and therapy

    Directory of Open Access Journals (Sweden)

    Trailović Dragiša R.

    2015-01-01

    Full Text Available Equine metabolic syndrome (EMS is a term adopted in 2002 in aim to define the complex pathology involving obesity, insulin resistance and laminitis in horses and ponies. The EMS was terminologically derived upon similar condition in humans. The metabolic disturbance in equines is developed sequentially to the primary chronic overfeeding, i.e. intake of surplus food to individual needs combined with insufficient activity of animal. The syndrome has been reported more frequently in ponies than in other breeds although genetic background of EMS has not been confirmed. The characteristic symptoms include regional collection of adipose tissue under the skin often distributed regionally i.e. in crest (neck from pool to withers, behind the shoulders, at the dock of the tail and in prepuce in males or in the udder in mares; as well as impaired locomotion and/or lameness in all four limbs and cycling disturbance in mares.

  2. Lethal midline granuloma syndrome: a diagnostic dilemma

    Energy Technology Data Exchange (ETDEWEB)

    Ribeiro, Bruno Niemeyer de Freitas; Bahia, Paulo Roberto Valle [Radiology, Hospital Universitario Clementino Fraga Filho - Universidade Federal do Rio de Janeiro (HUCFF-UFRJ), Rio de Janeiro, RJ (Brazil); Oliveira, Ana Luiza Vianna Sobral de Magalhaes [Resident of Medical Practice, Hospital Federal da Lagoa, Rio de Janeiro, RJ (Brazil); Marchon Junior, Joao Luiz [Unit of Computed Tomography, Hospital Federal da Lagoa, Rio de Janeiro, RJ (Brazil)

    2012-11-15

    The rare lethal midline granuloma syndrome is difficult to diagnose because of the wide array of related diseases and lack of knowledge by the majority of physicians. In the present report, the authors describe the case of a patient with this disease, caused by squamous cell carcinoma, drawing attention to differential diagnoses and to clinical and radiological findings that may be useful to define the diagnosis. (author)

  3. Diagnostic criteria for selenium toxicosis in aquatic birds: histologic lesions

    Science.gov (United States)

    Green, D.E.; Albers, P.H.

    1997-01-01

    Chronic selenium toxicosis was induced in 1-year-old male mallard ducks (Anas platyrhynchos) by feeding selenium, as seleno-DL-methionine, in amounts of 0, 10, 20, 40, and 80 parts per million (ppm) to five groups of 21 ducks each for 16 wk during March to July 1988. All mallards in the 80 ppm group, three in the 40 ppm group, and one in the 20 ppm group died. Histologic lesions in mallards that died of selenosis were hepatocellular vacuolar degeneration progressing to centrolobular and panlobular necrosis, nephrosis, apoptosis of pancreatic exocrine cells, hypermaturity and avascularity of contour feathers of the head with atrophy of feather follicles, lymphocytic necrosis and atrophy of lymphoid organs (spleen, gut-associated lymphoid tissue, and lumbar lymph nodes), and severe atrophy and degeneration of fat. Histologic lesions in surviving mallards in the 40 ppm group, which had tissue residues of selenium comparable to mallards that died, were fewer and much milder than mallards that died; lesions consisted of atrophy of lymphoid tissue, hyalinogranular swelling of hepatocytes, atrophy of seminiferous tubules, and senescence of feathers. No significant histologic lesions were detected in euthanized mallards in the 0, 10 and 20 ppm groups. Based on tissue residues and histologic findings, primarily in the liver, there was a threshold of selenium accumulation above which pathophysiologic changes were rapid and fatal. Pathognomonic histologic lesions of fatal and nonfatal selenosis were not detected. Criteria for diagnosis of fatal selenosis in aquatic birds include consistent histologic lesions in the liver, kidneys, and organs of the immune system. Although histologic changes were present in cases of chronic non-fatal selenosis, these were inconsistent. Consistent features of fatal and non-fatal chronic selenosis were marked weight loss and elevated concentrations of selenium in organs.

  4. Diagnostic criteria for depression in Parkinson's disease: a study of symptom patterns using latent class analysis.

    Science.gov (United States)

    Starkstein, Sergio; Dragovic, Milan; Jorge, Ricardo; Brockman, Simone; Merello, Marcelo; Robinson, Robert G; Bruce, David; Wilson, Mark

    2011-10-01

    Although major depression is one of the most frequent psychiatric disorders among patients with Parkinson's disease, diagnostic criteria have yet to be validated. The main aim of our study was to validate depressive symptoms using latent class analysis for use as diagnostic criteria for major depression in Parkinson's disease. We examined a consecutive series of 259 patients with Parkinson's disease admitted to 2 movement disorders clinics for regular follow-ups. All patients were assessed with a comprehensive psychiatric interview that included structured assessments for depression, anxiety, and apathy. The main finding was that all 9 Diagnostic and Statistical Manual (4th edition) diagnostic criteria for major depression (ie, depressed mood, diminished interest or pleasure, weight or appetite changes, sleep changes, psychomotor changes, loss of energy, feelings of worthlessness or inappropriate guilt, poor concentration, and suicidal ideation) identified a patient class (severe depression group) with high statistical significance. Latent class analysis also demonstrated a patient class with minimal depressive symptoms (no-depression group), and a third patient class with intermediate depressive symptoms (moderate depression). Anxiety and apathy were both significant comorbid conditions of moderate and severe depression. Taken together, our findings support the use of the full Diagnostic and Statistical Manual (4th edition) criteria for major depression for use in clinical practice and research in Parkinson's disease and suggest that anxiety may be included as an additional diagnostic criterion. Copyright © 2011 Movement Disorder Society.

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

    Science.gov (United States)

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

    2009-01-01

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

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

    Science.gov (United States)

    Paddick, Stella-Maria; Longdon, Anna R; Kisoli, Aloyce; Dotchin, Catherine; Gray, William K; Dewhurst, Felicity; Chaote, Paul; Kalaria, Raj; Jusabani, Ahmed M; Walker, Richard

    2013-04-03

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

  7. Chronic fatigue syndrome and sleep disorders: clinical associations and diagnostic difficulties.

    Science.gov (United States)

    Ferré, A

    2016-02-11

    Chronic fatigue syndrome (CFS) is characterised by the presence of intractable fatigue and non-restorative sleep, symptoms which are also very prevalent in multiple diseases and appear as side effects of different drugs. Numerous studies have shown a high prevalence of sleep disorders in patients with CFS. However, non-restorative sleep and fatigue are frequently symptoms of the sleep disorders themselves, so primary sleep disorders have to be ruled out in many cases of CFS. This review was performed using a structured search of the MeSH terms ([Sleep]+[Chronic fatigue syndrome]) in the PubMed database. Identifying primary sleep disorders in patients meeting diagnostic criteria for CFS will allow for a more comprehensive treatment approach involving new diagnostic and therapeutic strategies that may improve quality of life for these patients. Copyright © 2016 Sociedad Española de Neurología. Published by Elsevier España, S.L.U. All rights reserved.

  8. Differential diagnostic of the burnout syndrome

    OpenAIRE

    Kister, Christine; Huber, Beate; Korczak, Dieter

    2010-01-01

    Introduction There is no consistent definition of burnout. It is neither a defined diagn osi s in ICD-10 nor in DSM-IV. Yet it is diagnosed by office-based doctors and clinicians. Mainly due to reimbursement reasons, diagnoses like depression are used instead of burnout diagnoses. Therefore burnout has a very high individual, social and economic impact. Objectives How is burnout diagnosed? Which criteria are relevant? How valid and reliable are the used tools? What kind of disorders in c...

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

    DEFF Research Database (Denmark)

    Benhalima, Katrien; Mathieu, Chantal; Damm, Peter

    2015-01-01

    Group (DPSG) associated with the EASD, to develop a proposal for the use of uniform diagnostic criteria for GDM in Europe. A proposal has been developed and has now been approved by the Council of the EBCOG. The current proposal is to screen for overt diabetes at the first prenatal contact using cut......-off values for diabetes outside pregnancy, with particular efforts made to screen high-risk groups. When screening for GDM is performed at 24 weeks' gestation or later, the proposal is now to use the 75 g OGTT with the new WHO diagnostic criteria for GDM. However, more research is necessary to evaluate......Screening and diagnostic criteria for gestational diabetes (GDM) are inconsistent across Europe, and the development of a uniform GDM screening strategy is necessary. Such a strategy would create opportunities for more women to receive timely treatment for GDM. Developing a consensus on screening...

  10. Comparison of diagnostic classification systems for delirium with new research criteria that incorporate the three core domains.

    Science.gov (United States)

    Trzepacz, Paula T; Meagher, David J; Franco, José G

    2016-05-01

    Diagnostic classification systems do not incorporate phenomenological research findings about the three core symptom domains of delirium (Attentional/Cognitive, Circadian, Higher Level Thinking). We evaluated classification performances of novel Trzepacz, Meagher, and Franco research diagnostic criteria (TMF) that incorporate those domains and ICD-10, DSM-III-R, DSM-IV, and DSM-5. Primary data analysis of 641 patients with mixed neuropsychiatric profiles. Delirium (n=429) and nondelirium (n=212) reference standard groups were identified using cluster analysis of symptoms assessed using the Delirium Rating Scale-Revised-98. Accuracy, sensitivity, specificity, positive and negative predictive values (PPV, NPV), and likelihood ratios (LR+, LR-) are reported. TMF criteria had high sensitivity and specificity (87.4% and 89.2%), more balanced than DSM-III-R (100% and 31.6%), DSM-IV (97.7% and 74.1%), DSM-5 (97.7% and 72.6%), and ICD-10 (66.2% and 100%). PPV of DSM-III-R, DSM-IV, and DSM-5 were 90%. ICD-10 had the lowest NPV (59.4%). TMF had the highest LR+ (8.06) and DSM-III-R the lowest LR- (0.0). Overall, values for DSM-IV and DSM-5 were similar, whereas for ICD-10 and DSM-III-R were inverse of each other. In the pre-existing cognitive impairment/dementia subsample (n=128), TMF retained its highest LR+ though specificity (58.3%) became less well balanced with sensitivity (87.9%), which still exceeded that of DSM. TMF research diagnostic criteria performed well, with more balanced sensitivity and specificity and the highest likelihood ratio for delirium identification. Reflecting the three core domains of delirium, TMF criteria may have advantages in biological research where delineation of this syndrome is important. Copyright © 2016. Published by Elsevier Inc.

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

    DEFF Research Database (Denmark)

    Schiffman, Eric; Ohrbach, Richard; Truelove, Edmond

    2014-01-01

    .95. Consequently, these empirical results supported the development of revised RDC/TMD Axis I diagnostic algorithms that were subsequently demonstrated to be valid for the most common pain-related TMD and for one temporomandibular joint (TMJ) intra-articular disorder. The original RDC/TMD Axis II instruments were...... and symposia, a panel of clinical and basic science pain experts modified the revised RDC/TMD Axis I algorithms by using comprehensive searches of published TMD diagnostic literature followed by review and consensus via a formal structured process. The panel's recommendations for further revision of the Axis I...... any pain-related TMD as well as valid diagnostic criteria for differentiating the most common pain-related TMD (sensitivity ≥ 0.86, specificity ≥ 0.98) and for one intra-articular disorder (sensitivity of 0.80 and specificity of 0.97). Diagnostic criteria for other common intra-articular disorders...

  12. Review of diagnostic instruments for the restless legs syndrome/Willis-Ekbom Disease (RLS/WED): critique and recommendations.

    Science.gov (United States)

    Walters, Arthur S; Frauscher, Birgit; Allen, Richard; Benes, Heike; Chaudhuri, K Ray; Garcia-Borreguero, Diego; Lee, Hochang B; Picchietti, Daniel L; Trenkwalder, Claudia; Martinez-Martin, Pablo; Stebbins, Glenn T; Schrag, Anette

    2014-12-15

    Over the last decade, increased research on therapy, pathogenesis, epidemiological and genetic aspects of restless legs syndrome/Willis-Ekbom Disease (RLS/WED) has necessitated development of diagnostic instruments specific to RLS. The Movement Disorder Society commissioned a task force to formally evaluate the available evidence on diagnostic instruments in RLS. A literature search identified 4 instruments specific to RLS. Each instrument was evaluated by 3 criteria, which included (a) use in RLS, (b) use by groups other than the group that developed the instrument, and (c) formal validation and adequate clinimetric properties. Instruments were then qualified as "Recommended" when all 3 criteria were met, "Suggested" when used for RLS but only one of the other criteria are met, and "Listed" when used in RLS but there is absence of the other 2 criteria. Details regarding the development, use, and clinimetric properties of each instrument are summarized, along with the recommendations of the committee. The Recommended diagnostic instruments are the Hening Telephone Diagnostic Interview (HTDI), the Cambridge-Hopkins diagnostic questionnaire for RLS (CH-RLSq), and the RLS Diagnostic Index (RLS-DI). An unmet need is the development of a diagnostic instrument for pediatric RLS. Diagnostic instruments are particularly useful in studies where patients are not personally interviewed or examined in the office setting. © 2014 American Academy of Sleep Medicine.

  13. Diagnosis of Guillain-Barré syndrome in children and validation of the Brighton criteria.

    Science.gov (United States)

    Roodbol, Joyce; de Wit, Marie-Claire Y; van den Berg, Bianca; Kahlmann, Vivienne; Drenthen, Judith; Catsman-Berrevoets, Coriene E; Jacobs, Bart C

    2017-05-01

    To describe the key diagnostic features of pediatric Guillain-Barré syndrome (GBS) and validate the Brighton criteria. Retrospective cohort study of all children (Children's Hospital, Erasmus MC, Rotterdam. Clinical information was collected and the sensitivity of the Brighton criteria was calculated. 67 children (35 boys) were included, with a median age of 5.0 years [interquartile range (IQR) 3.0-10.0 years]. Bilateral limb weakness was present at hospital admission in 93% of children, and at nadir in all patients. Children presented with tetraparesis in 70% or with paraparesis in 23%. Reduced reflexes in paretic limbs were observed at hospital admission in 82% and during follow-up in all children. The progressive phase lasted median 6 days (IQR 3-8 days) and less than 4 weeks in all children. A monophasic disease course was seen in 97%, including 5 children with a treatment-related fluctuation. Two children had a later relapse at 9 weeks and 19 weeks after onset. 77% of the children showed an elevated protein level in CSF. Nerve conduction studies showed evidence for a poly(radiculo)neuropathy in 91% of the children. 46 children had a complete data set, the sensitivity of the Brighton criteria level 1 was 72% (95% CI 57-84) and 96% (95% CI 85-99) for level 2 and 98% (95% CI 88-100) for level 3. The majority of the pediatric GBS patients presented in this cohort fulfilled the current diagnostic criteria.

  14. The diagnostic value of a modified Neer test in identifying subacromial impingement syndrome.

    Science.gov (United States)

    Guosheng, Yu; Chongxi, Ren; Guoqing, Cui; Junling, Xu; Hailong, Ji

    2017-12-01

    Subacromial impingement syndrome (SAIS) is characterized by pain experienced through an arc of elevation as the shoulder abducts and diagnosed commonly by Neer test (NT). However, the diagnostic accuracy of NT for SAIS is still limited. Here, a modified Neer test (MNT) was introduced to improve the accuracy of the clinical examination in diagnosing SAIS and differentiating it from frozen shoulder. The aim of this study was to investigate the diagnostic values of MNT in diagnosing SAIS and differentiating it from frozen shoulder. Between January 2015 and June 2015, a prospective study assessed 85 shoulders among 82 patients with shoulder joint disease; 42 patients underwent arthroscopic surgery, and all 82 patients received X-rays, magnetic resonance imaging (MRI) or MRI contrast examinations. The diagnostic criteria are based on arthroscopy and MRI scanning. Using clinical epidemiology and diagnostic tests, we calculated the sensitivity, specificity, positive predictive value, negative predictive value and degree of accuracy of MNT in diagnosing SAIS. The diagnostic accuracy rate of MNT in identifying shoulder SAIS was 90.59%, and the specificity was 95.56%. In the diagnosis of SAIS, MNT is a reliable and highly accurate maneuver and seems useful to distinguish this syndrome from frozen shoulder.

  15. Are all criteria of metabolic syndrome equally harmful?

    Science.gov (United States)

    Ivanovic, Branislava A; Tadic, Marijana V; Simic, Dragan V

    2011-04-01

    The metabolic syndrome (MS) is associated with subclinical damage of different organs.The aim of this study was to determine which risk factors of MS were independently associated with left ventricular structure and function (diastolic and global). The study included 204 subjects with MS and 88 control subjects with no risk factors. The metabolic syndrome was defined by the presence of three or more of ATP-NCEP III criteria. All subjects underwent laboratory blood tests, and complete two-dimensional echocardiography which also included tissue Doppler. The echocardiography was used to assess left ventricular (LV) structure (LVmass/Ht2.7), systolic (LVEF, Ssepptal, Slateral) and diastolic function, by pulse-wave Doppler (E/A ratio) and tissue Doppler imaging (E/e'average), and global function (Tei index). Appropriate time intervals for the estimation of the Tei index were obtained by tissue Doppler. The LV mass index, E/e'average and Tei index were significantly higher in the MS group, whereas there was no difference in LV systolic function. Multiple regression analysis showed that LVmass/Ht2 was independently associated with systolic blood pressure (beta = 0.41, P < 0.001) and waist circumference (beta = 0.22, P = 0.016).The same analysis revealed that E/e'verage was independently associated with systolic blood pressure (3 = 0.35, P < 0.001), waist circumference (beta = 0.24,P = 0.004) and triglycerides level (3 = 0.21,P = 0.012); while theTei index was independently associated with systolic blood pressure (beta = 0.42, P < 0.001) and fasting glucose (beta = 0.31, P < 0.001). MS impairs left ventricular structure and diastolic and global function. Systolic blood pressure was the only MS criterion which was, at the same time, independently associated with LVmass/Ht27, E/e'averag3, and the Tei index.

  16. Characteristics of acute pain attacks in patients with irritable bowel syndrome meeting Rome III criteria

    DEFF Research Database (Denmark)

    Hellström, P.M.; Saito, Y.A.; Bytzer, P.

    2011-01-01

    the survey were women with a mean age of 41 years and time since IBS diagnosis of 5 years. The median pain attack frequency was 5.4 attacks per month and was significantly higher in the IBS with diarrhea (IBS-D, 6.4 per month) group vs. the IBS with constipation (4.4 per month) and the IBS with mixed pattern......Objectives: An international multicenter, prospective, non-interventional, 2-month study characterized acute pain attacks in patients with irritable bowel syndrome (IBS). Methods: Adult patients meeting the Rome III IBS diagnostic criteria with a history of 3 pain attacks per month participated...... in a survey that captured daily and episodic information regarding IBS symptoms and pain attacks for 2 months. Acute pain attacks were defined as a sudden onset or increase in the intensity of IBS abdominal pain with a minimum intensity of 4 (0-10 scale). Results: The majority (84%) of the 158 patients taking...

  17. Metabolic Syndrome in Paediatric Population: Is it Time to Think Back on Diagnosis Criteria?

    Directory of Open Access Journals (Sweden)

    Claudia Della Corte

    2015-01-01

    Full Text Available Metabolic syndrome (MetS represents an emerging disease in the paediatric population; it is characterised by a cluster of cardiometabolic abnormalities, including visceral obesity, dyslipidaemia, hypertension, and Type 2 diabetes mellitus, that directly increase the risk of developing cardiovascular disease and diabetes. Currently, several definitions of MetS are available in the paediatric setting, causing confusion and discrepancy in the identification of these patients. Moreover, in recent years, several other comorbidities, besides those traditionally used to define MetS, which are also linked to the disease have been identified, making its definition even more difficult. Among these, mainly non-alcoholic fatty liver disease and obstructive sleep disorders have been strictly linked to MetS. In this review, we discuss the importance to re-evaluate diagnostic criteria for MetS, in order to uniformly define this disease in children, considering also the inclusion of the other emerging clinical features.

  18. Different prevalence and clinical characteristics of asthma-chronic obstructive pulmonary disease overlap syndrome according to accepted criteria.

    Science.gov (United States)

    Jo, Yong Suk; Lee, Jinwoo; Yoon, Ho Il; Kim, Deog Kyeom; Yoo, Chul-Gyu; Lee, Chang-Hoon

    2017-06-01

    A unified definition of asthma-chronic obstructive pulmonary disease overlap syndrome (ACOS) is not available, which makes it difficult to evaluate the prevalence and clinical features of patients with ACOS. To investigate the prevalence and clinical characteristics of ACOS according to the updated widely accepted diagnostic criteria. Participants were enrolled from a prospective cohort study conducted between April 2013 and November 2016 in South Korea. We adopted 4 criteria of ACOS: modified Spanish, American Thoracic Society (ATS) Roundtable criteria, the Latin American Project for the Investigation of Obstructive Lung Disease (PLATINO), and the Global Initiative for Asthma/Global Initiative for Chronic Obstructive Lung Disease (GINA/GOLD) criteria. The prevalence, clinical characteristics, and exacerbations of ACOS were investigated. Among 301 patients with chronic obstructive pulmonary disease, 31.3%, 11.9%, 48.3%, and 46.15% were diagnosed with ACOS according to the modified Spanish, ATS Roundtable criteria, PLATINO, and GINA/GOLD criteria, respectively. Compared with other criteria, patients with ACOS diagnosed according to the modified Spanish criteria had better exercise capacity and lung function at baseline but higher risk of moderate to severe (adjusted hazard ratio, 1.97; 95% confidence interval, 1.14-3.41; P = .01) and total (adjusted odds ratio, 2.10; 95% confidence interval, 1.33-3.31; P < .01) exacerbations during at least a 1-year follow-up period than patients without ACOS. The prevalence of ACOS varied according to the diagnostic criteria. Among the different criteria, the modified Spanish criteria could identify patients with more asthmatic features and higher risk of exacerbation. ClinicalTrials.gov Identifier: NCT02527486. Copyright © 2017 American College of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

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

    Science.gov (United States)

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

    2011-12-01

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

  20. Diagnostic Criteria

    Directory of Open Access Journals (Sweden)

    Narender P. Van Orshoven

    2010-01-01

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

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

    Science.gov (United States)

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

    2012-01-01

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

  2. About article "Construct and predictive validity of clinical caries diagnostic criteria assessing lesion activity."

    NARCIS (Netherlands)

    Bosch, Jaap J. ten; Huysmans, Marie-Charlotte D.N.J.M.

    2003-01-01

    Letter to the editor about article: Nyvad B, Machiulskiene V, Baelum V (2003). Construct and predictive validity of clinical caries diagnostic criteria assessing lesion activity. J Dent Res 82:117-122. Published in: J Dent Res 82(11):862-863, 2003

  3. New diagnostic criteria and severity assessment of acute cholecystitis in revised Tokyo guidelines

    NARCIS (Netherlands)

    Yokoe, Masamichi; Takada, Tadahiro; Strasberg, Steven M.; Solomkin, Joseph S.; Mayumi, Toshihiko; Gomi, Harumi; Pitt, Henry A.; Gouma, Dirk J.; Garden, O. James; Büchler, Markus W.; Kiriyama, Seiki; Kimura, Yasutoshi; Tsuyuguchi, Toshio; Itoi, Takao; Yoshida, Masahiro; Miura, Fumihiko; Yamashita, Yuichi; Okamoto, Kohji; Gabata, Toshifumi; Hata, Jiro; Higuchi, Ryota; Windsor, John A.; Bornman, Philippus C.; Fan, Sheung-Tat; Singh, Harijt; de Santibanes, Eduardo; Kusachi, Shinya; Murata, Atsuhiko; Chen, Xiao-Ping; Jagannath, Palepu; Lee, Sunggyu; Padbury, Robert; Chen, Miin-Fu

    2012-01-01

    Background The Tokyo Guidelines for the management of acute cholangitis and cholecystitis (TG07) were published in 2007 as the world's first guidelines for acute cholangitis and cholecystitis. The diagnostic criteria and severity assessment of acute cholecystitis have since been widely used all over

  4. Temporal stability of diagnostic criteria for antisocial personality disorder in male alcohol dependent patients

    NARCIS (Netherlands)

    Verheul, R.; van den Brink, W.; Koeter, M. W.

    1998-01-01

    We evaluated the temporal stability of diagnostic criteria for antisocial personality disorder in 432 male alcohol dependent patients. Indicators for temporal stability were criterion continuation (i.e., the proportion of current or recent diagnoses among those with a lifetime diagnosis) and

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

    NARCIS (Netherlands)

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

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

  6. Diagnostic validity of criteria for sacroiliac joint pain: a systematic review

    NARCIS (Netherlands)

    Szadek, K.M.; van der Wurff, P.; van Tulder, M.W.; Zuurmond, W.W.A.; Perez, R.S.G.M.

    2009-01-01

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

  7. Diagnostic criteria for pedophilia: clinical, legal and socio-cultural issues

    Directory of Open Access Journals (Sweden)

    Demidova L.Yu.

    2014-12-01

    Full Text Available This article analyzes the diagnostic criteria for pedophilia (paedophilic disorder in the context of developing the 11th version of the International Classification of Diseases and the recently released Guide to the Diagnostic and Statistical Mental Disorders, 5th revision. The paper discusses the feasibility of existing criteria and their impact on clinical diagnosis, assessment of public danger and socio-cultural values. We revealed that the second diagnostic criterion excludes from the field of view of the whole spectrum of specialists psychosexual pathology, where it is expedient to provide medical care, including the prevention of the worsening of symptoms and the commission of illegal acts. We also highlighted the problem of expert diagnosis of pedophilia (paedophilic disorder, which leads to such a formulation of the criteria, as well as the unreasonableness of such a formulation in terms of the public interest. We concluded that maintaining the new classification of these diagnostic criteria unchanged is rather the result of a desire to avoid unnecessary stigmatization of individuals with pedophilia.

  8. Analysis of Chronic Temporomandibular Disorders Based on the Latest Diagnostic Criteria

    Directory of Open Access Journals (Sweden)

    Svechtarov V.

    2015-05-01

    Full Text Available The objective of this study is to analyze the distribution of the most common diagnoses observed in patients with chronic temporomandibular disorders, based on the new diagnostic criteria (DC/TMD adopted in 2014. The previous Research Diagnostic Criteria (RDC/TMD adopted in 1992, consisted of three main groups of eight diagnostic subgroups and is currently transformed into two main groups and twelve subgroups, respectively. All subgroups correspond to the nomenclature of the ICD-10. The new clinical diagnostic indices are also modified. The analysis showed a prevalence of Pain-Related TMD compared with that of intra-articular disorders in ratio 57.89% to 42.10%. In Pain-Related TMD arthralgia was represented in 55% of cases; local myalgia - in 12%, myofascial pain - in 18%, myofascial pain with referral - in 14%, headache attributed to TMD - in 1%. In Intra-articular TMD disc displacement with reduction was found in 23% of the cases, disc displacement with reduction with intermittent locking - in 3%, disc displacement without reduction with limited opening - in 25%, disc displacement without reduction and without limited opening - in 8%. Degenerative diseases were found in 14.28%, and hypermobility and subluxations - in 26.98%. These analyzes differ and can only partly be compared with previous analyzes based on RDC system. The changes in the diagnostic criteria require new clinical studies in order to refine the picture of temporomandibular pathology in accordance with the modern views on the matter.

  9. The prevalence of coeliac disease in patients fulfilling Rome III criteria for irritable bowel syndrome.

    Science.gov (United States)

    Shalaby, Sayed A; Sayed, Moataz M; Ibrahim, Wesam A; Abdelhakam, Sara M; Rushdy, Marwa

    2016-06-01

    The clinical presentation of coeliac disease can vary from a classical malabsorption syndrome to more subtle atypical gastrointestinal manifestations similar to irritable bowel syndrome (IBS). The aim of this study was to investigate the prevalence of coeliac disease in Egyptian patients with clinically diagnosed diarrhoea-predominant IBS (according to Rome III criteria). This study was conducted on 100 patients with clinically diagnosed diarrhoea-predominant IBS (fulfilling Rome III criteria). They were subjected to complete clinical evaluation, routine laboratory investigations, abdominal ultrasonography and serum anti-tissue transglutaminase antibody (anti-tTG) test as a predictor marker for coeliac disease. All patients who tested positive for serum anti-tTG underwent upper gastrointestinal endoscopy with four to eight biopsy samples collected from the second part of the duodenum. All of the studied 100 patients presented with abdominal pain or discomfort, flatulence and diarrhoea. Eight patients (8%) exhibited high levels of serum anti-tTG, and their duodenal biopsy samples satisfied the histopathological criteria of coeliac disease. The studied patients were divided into two groups: Group I comprising 92 patients with IBS and negative anti-tTG results and Group II comprising eight patients with IBS and positive anti-tTG results. A non-significant difference was noted between the two groups in age, gender and duration of abdominal pain (p>0.05). The haemoglobin level was found to be significantly reduced in anti-tTG-positive patients (pcoeliac disease and IBS. A lack of awareness may lead to a diagnostic delay in these patients. Copyright © 2016 Arab Journal of Gastroenterology. Published by Elsevier B.V. All rights reserved.

  10. Expanding the Taxonomy of the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD)

    Science.gov (United States)

    Peck, Christopher C.; Goulet, Jean-Paul; Lobbezoo, Frank; Schiffman, Eric L.; Alstergren, Per; Anderson, Gary C.; de Leeuw, Reny; Jensen, Rigmor; Michelotti, Ambra; Ohrbach, Richard; Petersson, Arne; List, Thomas

    2014-01-01

    Background There is a need to expand the current temporomandibular disorder (TMD) classification to include less common, but clinically important disorders. The immediate aim was to develop a consensus-based classification system and associated diagnostic criteria that have clinical and research utility for less common TMDs. The long-term aim was to establish a foundation, vis-à-vis this classification system, that will stimulate data collection, validity testing, and further criteria refinement. Methods A working group [members of the International RDC/TMD Consortium Network of the International Association for Dental Research (IADR), members of the Orofacial Pain Special Interest Group (SIG) of the International Association for the Study of Pain (IASP), and members from other professional societies] reviewed disorders for inclusion based on clinical significance, the availability of plausible diagnostic criteria, and the ability to operationalize and study the criteria. The disorders were derived from the literature when possible and based on expert opinion as necessary. The expanded TMD taxonomy was presented for feedback at international meetings. Results Of 56 disorders considered, 37 were included in the expanded taxonomy and were placed into the following four categories: temporomandibular joint disorders, masticatory muscle disorders, headache disorders, and disorders affecting associated structures. Those excluded were extremely uncommon, lacking operationalized diagnostic criteria, not clearly related to TMDs, or not sufficiently distinct from disorders already included within the taxonomy. Conclusions The expanded TMD taxonomy offers an integrated approach to clinical diagnosis and provides a framework for further research to operationalize and test the proposed taxonomy and diagnostic criteria. PMID:24443898

  11. Validation of an algorithm for the diagnosis of Restless Legs Syndrome: The Restless Legs Syndrome-Diagnostic Index (RLS-DI).

    Science.gov (United States)

    Benes, Heike; Kohnen, Ralf

    2009-05-01

    There is a need for structured methods to improve sensitivity and specificity of diagnostic decision making in Restless Legs Syndrome (RLS). We present the RLS-Diagnostic Index (RLS-DI), a diagnostic algorithm which combines essential and supportive diagnostic criteria from patient interviews, polysomnography and neurological examination in an adaptive procedure. The RLS-DI consists of 10 items which are related to the essential diagnostic criteria established by the International RLS Study Group (five items) as well as their supportive criteria (3 items) and features associated with RLS (2 items). Items have to be completed using three categories per item that address frequency of occurrence of symptoms or certainty of presence or absence of other diagnostic information. Negative weights were given when the clinically most relevant items were not present. The RLS-DI was administered in a telephone interview to 179 patients (86 with RLS, 93 with other sleep disorders) of the 21 month cohort of one sleep center in Germany. With receiver-operating characteristics, a cut-off of >or= 11 points on a scale ranging from -22 (no RLS) to 20 (definite RLS) was identified by comparing the RLS-DI total score to the diagnosis of two independent sleep experts. Sensitivity was 93.0%, specificity was 98.9%, and 96.1% of the patients could be correctly diagnosed. Specificity was higher in items related to supportive or associated diagnostic information (95.7%) than in those related to the essential diagnostic criteria (81.7%). Patients with RLS scored a higher RLS-DI than those with primary insomnia or other neurological or psychiatric disorders (p RLS-DI demonstrated the ability to validly diagnose an actual and persistently present Restless Legs Syndrome in patients of a sleep lab population and to exclude those patients whose sleep disturbances have other causes.

  12. The diagnostic significance of apoB/apoAⅠ for metabolic syndrome in patients with polycystic ovary syndrome

    Directory of Open Access Journals (Sweden)

    Yu-ting LI

    2013-07-01

    Full Text Available Objective To analyze the diagnostic significance of apoB/apoAⅠ for metabolic syndrome (MS in patients with polycystic ovary syndrome (PCOS. Methods Endocrinic, metabolic and anthropometric parameters were collected from 185 women diagnosed as PCOS based on the 2003 Rotterdam criteria. Results The incidence of MS was 19.46%, and 56.76% of these patients had at least one abnormal component of MS. ApoB/apoAⅠ had a statistically significant positive correlation with BMI and LDL-C, but a negative correlation with HDL-C, and the ratio went up as the number of abnormal MS components increased. There was also a quite good diagnostic value of apoB/apoAⅠ for MS with a threshold value of 0.66, accompanied by a sensitivity of 91.7% and specificity of 70.0%. Conclusion ApoB/apoAⅠ is quite a valuable diagnostic index for MS in patients with PCOS.

  13. The concept of incomplete fibromyalgia syndrome: comparison of incomplete fibromyalgia syndrome with fibromyalgia syndrome by 1990 ACR classification criteria and its implications for newer criteria and clinical practice.

    Science.gov (United States)

    Yunus, Muhammad B; Aldag, Jean C

    2012-03-01

    The 1990 American College of Rheumatology (ACR) classification criteria for fibromyalgia/fibromyalgia syndrome (FMS) has 2 components: (a) widespread pain (WSP) and (b) presence of 11 or more tender points (TP) among possible 18 sites. Some clinic patients fulfill 1 component but not the other. We have considered these patients to have incomplete FMS (IFMS). The purpose of this study was to examine the clinical and psychological differences between IFMS and FMS (by 1990 ACR criteria) because such comparison may be helpful to diagnose patients in the clinic. Six hundred consecutive patients referred to our rheumatology clinic with a diagnosis of FMS were examined by a standard protocol to determine whether they fulfilled the 1990 criteria for FMS. Both IFMS and FMS groups were compared in demographic, clinical, and psychological variables using appropriate statistical methods. One hundred twelve (18.7%) patients did not satisfy the 1990 ACR criteria and were classified as IFMS. Symptoms in IFMS and FMS were similar, generally with less frequent and less severe symptoms in the IFMS group. In IFMS, no significant difference was found among the WSP and TP component subgroups. Both TP and WSP were correlated with important features of FMS. Fulfillment of the ACR 1990 criteria is not necessary for a diagnosis of FMS in the clinic. For diagnosis and management of FMS in the clinical setting, IFMS patients, along with consideration of the total clinical picture, may be considered to have FMS, albeit generally mild.

  14. Diagnostics and treatment of patients with polycystic ovary syndrome

    Directory of Open Access Journals (Sweden)

    Nataša Vrhkar

    2018-02-01

    Full Text Available Background. Polycystic ovary syndrome (PCOS is the most common female endocrinopathy of reproductive age affecting 15–22 % of women according to European standards. It is a multisystem reproductive-metabolic disorder and its diagnostics and treatment remain controversial. Women with PCOS are at increased risk of developing type II diabetes, metabolic syndrome, cardiovascular disease, depression, non-alcoholic fatty liver disease, endometrial hyperplasia and cancer and few other types of carcinoma. Due to all above, early correct diagnosis, treatment and permanent surveillance of PCOS are of great importance. The main difficulty with diagnosis of PCOS was until recently lack of clear diagnostic criteria. In 2003 the European Society for Human Reproduction and Embryology and the American Society for Reproductive Medicine published a definition of PCOS. For a diagnosis of PCOS two of three criteria have to be met: oligo- or chronic anovulation (less than 8 menses per year or menses that occur at intervals greater than 35 days, clinical or biochemical signs of hyperandrogenism (alopecia, hirsutism, seborrhoea, acne, virilism, polycystyc ovaries seen on vaginal ultrasound (VUS (presence of 12 or more follicles in both ovaries measuring 2–9 mm in diameter and/or ovarian volume larger than 10 cm3 of either or both ovaries. Exclusion of other diseases with similar clinical presentation is necessary. Treatment depends on the age of the patient, predominating clinical signs and aim we try to achieve. First-line treatment for all patients includes life-style changes and weight reduction in obese patients. Management of adolescent patients is aimed at abolishment of menses irregularity and endometrial protection, treatment of hyperandrogenism, obesity, and insulin resistance (IR. In the first-line treatment we also recommend oral hormonal contraceptives (OHC with non-androgenic gestagens (NG with or without antiandrogens (AA and topical dermatological

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

    Science.gov (United States)

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

    2014-05-01

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

  16. Agreement between Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, and the proposed DSM-V attention deficit hyperactivity disorder diagnostic criteria: an exploratory study.

    Science.gov (United States)

    Ghanizadeh, Ahmad

    2013-01-01

    There is no empirical literature about the American Psychiatry Association proposed new diagnostic criteria for attention deficit hyperactivity disorder (ADHD). This study examined the agreement between ADHD diagnosis derived from Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV), and DSM-V diagnostic criteria. It also reports sensitivity, specificity, and agreement for ADHD diagnosis. A clinical sample of 246 children and adolescents were interviewed face to face using both ADHD diagnostic criteria for DSM-V and DSM-IV by interviewing clinician. Comorbid psychiatric disorders were screened using DSM-IV criteria. The rate of ADHD diagnosis using DSM-V was significantly higher than the rate detected by using DSM-IV diagnostic criteria. The sensitivity of DSM-V diagnostic criteria was 100%, while its specificity was 71.1%. The kappa agreement between DSM-IV and DSM-V was 0.75. In addition, positive predictive value was 85.1%. All the four newly added symptoms to ADHD diagnostic criteria are statistically more common in the children with ADHD than those in the comparison group. However, these symptoms are also very common in the children without ADHD. It is expected that the rate of ADHD would increase using the proposed ADHD DSM-V criteria. Moreover, the newly added symptoms have a low specificity for ADHD diagnosis. Copyright © 2013 Elsevier Inc. All rights reserved.

  17. Updated ultrasound criteria for polycystic ovary syndrome: reliable thresholds for elevated follicle population and ovarian volume.

    Science.gov (United States)

    Lujan, Marla E; Jarrett, Brittany Y; Brooks, Eric D; Reines, Jonathan K; Peppin, Andrew K; Muhn, Narry; Haider, Ehsan; Pierson, Roger A; Chizen, Donna R

    2013-05-01

    Do the ultrasonographic criteria for polycystic ovaries supported by the 2003 Rotterdam consensus adequately discriminate between the normal and polycystic ovary syndrome (PCOS) condition in light of recent advancements in imaging technology and reliable methods for estimating follicle populations in PCOS? Using newer ultrasound technology and a reliable grid system approach to count follicles, we concluded that a substantially higher threshold of follicle counts throughout the entire ovary (FNPO)-26 versus 12 follicles-is required to distinguish among women with PCOS and healthy women from the general population. The Rotterdam consensus defined the polycystic ovary as having 12 or more follicles, measuring between 2 and 9 mm (FNPO), and/or an ovarian volume (OV) >10 cm(3). Since their initial proposal in 2003, a heightened prevalence of polycystic ovaries has been described in healthy women with regular menstrual cycles, which has questioned the accuracy of these criteria and marginalized the specificity of polycystic ovaries as a diagnostic criterion for PCOS. A diagnostic test study was performed using cross-sectional data, collected from 2006 to 2011, from 168 women prospectively evaluated by transvaginal ultrasonography. Receiver operating characteristic (ROC) curve analyses were performed to determine the appropriate diagnostic thresholds for: (i) FNPO, (ii) follicle counts in a single cross section (FNPS) and (iii) OV. The levels of intra- and inter-observer reliability when five observers used the proposed criteria on 100 ultrasound cases were also determined. Ninety-eight women diagnosed with PCOS by the National Institutes of Health criteria as having both oligo-amenorrhea and hyperandrogenism and 70 healthy female volunteers recruited from the general population. Participants were evaluated by transvaginal ultrasonography at the Royal University Hospital within the Department of Obstetrics, Gynecology and Reproductive Sciences, University of Saskatchewan

  18. Creutzfeldt-Jakob disease: updated diagnostic criteria, treatment algorithm, and the utility of brain biopsy.

    Science.gov (United States)

    Manix, Marc; Kalakoti, Piyush; Henry, Miriam; Thakur, Jai; Menger, Richard; Guthikonda, Bharat; Nanda, Anil

    2015-11-01

    Creutzfeldt-Jakob disease (CJD) is a rare neurodegenerative condition with a rapid disease course and a mortality rate of 100%. Several forms of the disease have been described, and the most common is the sporadic type. The most challenging aspect of this disease is its diagnosis-the gold standard for definitive diagnosis is considered to be histopathological confirmation-but newer tests are providing means for an antemortem diagnosis in ways less invasive than brain biopsy. Imaging studies, electroencephalography, and biomarkers are used in conjunction with the clinical picture to try to make the diagnosis of CJD without brain tissue samples, and all of these are reviewed in this article. The current diagnostic criteria are limited; test sensitivity and specificity varies with the genetics of the disease as well as the clinical stage. Physicians may be unsure of all diagnostic testing available, and may order outdated tests or prematurely request a brain biopsy when the diagnostic workup is incomplete. The authors review CJD, discuss the role of brain biopsy in this patient population, provide a diagnostic pathway for the patient presenting with rapidly progressive dementia, and propose newer diagnostic criteria.

  19. The reliability and validity of the Turkish version of fibromyalgia survey diagnostic criteria and symptom severity scale.

    Science.gov (United States)

    Yanmaz, Muyesser Nergiz; Atar, Sevgi; Biçer, Mualla

    2016-04-27

    The fibromyalgia survey diagnostic criteria and severity scale (FSDC) is a self-reported version of 2010 preliminary diagnostic criteria for fibromyalgia syndrome (FMS). FSDC not only facilitates to diagnose FMS, it measures pain (the Widespread Pain Index (WPI)/FSDC Section 3), the Symptom Severity (SS)/FSDC Sections 1 and 2, and provides a score, polysymptomatic distress (PSD)/FSDC Total score in patients with FMS. The purpose of our study is to evaluate the reliability and validity of Turkish version of FSDC in Turkish patients with FMS. The Turkish version FSDC was obtained by two forward translations of the instrument into Turkish by two bilingual Turkish individuals, one of them was a physician. They were then back translated into English by two different bilingual individuals; another Turkish physician and a backtranslator whose mother tongue was English. The original version of FSDC, the two Turkish forward translations, and English back translations were then reviewed by the individuals involved in translations, and the last experimental Turkish version was created. This last version of Turkish FSDC studied on patients with newly diagnosed FMS by using American College of Rheumatology (ACR) 1990 classification criteria. Patients filled validated Turkish revised fibromyalgia impact questionnaire (rFIQ), our nonvalidated experimental Turkish FSDC; marked Visual Analog Scale (VAS) for pain and the disease severity. In 7 to 15 days, they have filled the nonvalidated Turkish FSDC for the second time. In 132 patients, by the test to retest reliability analysis of nonvalidated Turkish FSDC, for the 25 single items, correlation coefficients ranged 0.383 to 0.818 (all p< 0.01). There were significant correlations between nonvalidated Turkish FSDC assessment 1 and assessment 2 for Section 1+2 (SS) (r = 0.748), Section 3 (WPI) (r = 0.775), and the total scores (PSD) (r = 0.821) (all p< 0.01). Cronbach alpha was 0.766 for the nonvalidated Turkish FSDC assessment 1

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

    Science.gov (United States)

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

    2008-08-01

    This article reviews literature on the validity and performance characteristics of the Diagnostic and Statistical Manual of Mental Disorders (4th ed.; DSM-IV; American Psychiatric Association, 1994) diagnostic criteria for substance use disorders (SUDs) and recommends changes in these criteria that should be considered for the next edition of the DSM (DSM-V). Substantial data indicate that DSM-IV substance abuse and substance dependence are not distinct categories and that SUD criteria are best modeled as reflecting a unidimensional continuum of substance-problem severity. The conceptually and empirically problematic substance abuse diagnosis should be abandoned in the DSM-V, with substance dependence defined by a single set of criteria. Data also indicate that various individual SUD criteria should be revised, dropped, or considered for inclusion in the DSM-V. The DSM-V should provide a framework that allows the integration of categorical and dimensional approaches to diagnosis. Important areas for further research are noted. Copyright (c) 2008 APA, all rights reserved.

  1. [Electrodiagnostic criteria for childhood Guillain-Barre syndrome. Eight years' experience].

    Science.gov (United States)

    Lopez-Esteban, Pilar; Gallego, Isabel; Gil-Ferrer, Victoria

    2013-03-01

    INTRODUCTION. The Guillan-Barre syndrome is the most frequent case of acute flacid paralysis in children. The diagnostic criteria differ according to the demyelinating or axonal variant and the prevalence by geographical area. The electro-myographic study permits identifying variants, evaluating the prognosis and predicting the evolution, is in addition an objective tool for the monitoring. AIM. To describe the electromyographic characteristics of the Guillain-Barre syndrome evaluated in hospital and its classification by physiopathological pattern. PATIENTS AND METHODS. All the cases diagnosed between 2005 and 2012 are included. Studies of motor and sensitive nervous conduction and F waves in 14 girls and 11 boys between 1 and 13 years of age. RESULTS. 19 cases of acute inflammatory demyelinating polyneuropathy (AIDP) and five of acute motor axonal neuropathy (AMAN) were diagnosed. The electromyogram was performed between 1 and 30 days after the beginning of symptoms. In AIDP cases, multifocal demyelination, four of them with the preserved sural and 13 with alteration and absence of F wave were objectified. In the cases of AMAN, four had low amplitude potential and in one of them they were not evoked. CONCLUSIONS. The demyelinating form of the illness is the most frequent although the high number of AMAN cases stands out, probably related to the population object of study. The evolution was favorable in three cases of motor axonal neuropathy and in 15 accute demyelinating polyneuropathy. In four cases the symptoms became chronic; three of them with persistent demyelination a similar occurrence in other studies with children.

  2. MRI criteria for MS in patients with clinically isolated syndromes

    NARCIS (Netherlands)

    Montalban, X.; Tintore, M.; Swanton, J.; Barkhof, F.; Fazekas, F.; Filippi, M.; Frederiksen, J.; Kappos, L.; Palace, J.; Polman, C.H.; Rovaris, M.; De Stefano, N.; Thompson, A.; Yousry, T.; Rovira, A.; Miller, D. H.

    2010-01-01

    In recent years, criteria for the diagnosis of multiple sclerosis (MS) have changed, mainly due to the incorporation of new MRI criteria. While the new criteria are a logical step forward, they are complex and-not surprisingly-a good working knowledge of them is not always evident among neurologists

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

    DEFF Research Database (Denmark)

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

    2015-01-01

    INTRODUCTION: We aimed to field-test the beta version of the third edition of the International Classification of Headache Disorders (ICHD-3 beta) diagnostic criteria for classical trigeminal neuralgia (TN). The proposed beta draft of the 11th version of the International Classification of Diseases...... (ICD-11 beta) is almost exclusively based on the ICHD-3 beta classification structure although slightly abbreviated. We compared sensitivity and specificity to ICHD-2 criteria, and evaluated the needs for revision. METHODS: Clinical characteristics were systematically and prospectively collected from...

  4. Analysis of Steel Wire Rope Diagnostic Data Applying Multi-Criteria Methods

    Directory of Open Access Journals (Sweden)

    Audrius Čereška

    2018-02-01

    Full Text Available Steel ropes are complex flexible structures used in many technical applications, such as elevators, cable cars, and funicular cabs. Due to the specific design and critical safety requirements, diagnostics of ropes remains an important issue. Broken wire number in the steel ropes is limited by safety standards when they are used in the human lifting and carrying installations. There are some practical issues on loose wires—firstly, it shows end of lifetime of the entire rope, independently of wear, lubrication or wrong winding on the drums or through pulleys; and, secondly, it can stick in the tight pulley—support gaps and cause deterioration of rope structure up to birdcage formations. Normal rope operation should not generate broken wires, so increasing of their number shows a need for rope installation maintenance. This paper presents a methodology of steel rope diagnostics and the results of analysis using multi-criteria analysis methods. The experimental part of the research was performed using an original test bench to detect broken wires on the rope surface by its vibrations. Diagnostics was performed in the range of frequencies from 60 to 560 Hz with a pitch of 50 Hz. The obtained amplitudes of the broken rope wire vibrations, different from the entire rope surface vibration parameters, was the significant outcome. Later analysis of the obtained experimental results revealed the most significant values of the diagnostic parameters. The evaluation of the power of the diagnostics was implemented by using multi-criteria decision-making (MCDM methods. Various decision-making methods are necessary due to unknown efficiencies with respect to the physical phenomena of the evaluated processes. The significance of the methods was evaluated using objective methods from the structure of the presented data. Some of these methods were proposed by authors of this paper. Implementation of MCDM in diagnostic data analysis and definition of the

  5. Approach to autism spectrum disorder: Using the new DSM-V diagnostic criteria and the CanMEDS-FM framework.

    Science.gov (United States)

    Lee, Patrick F; Thomas, Roger E; Lee, Patricia A

    2015-05-01

    To review the diagnostic criteria for autism spectrum disorder (ASD) from the Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-V), and to develop an approach to managing ASD using the CanMEDS- Family Medicine (CanMEDS-FM) framework. The DSM-V from the American Psychiatric Association, published in May 2013, provides new diagnostic criteria for ASD. The College of Family Physicians of Canada's CanMEDS-FM framework provides a blueprint that can guide the complex management of ASD. We used data from the Centers for Disease Control and Prevention to determine the prevalence of ASD, and we used the comprehensive systematic review and meta-analysis completed by the UK National Institute for Health and Care Excellence for their guidelines on ASD to assess the evidence for more than 100 interventions. The prevalence of ASD was 1 in 88 in 2008 in the United States according to data from the Centers for Disease Control and Prevention. The ASD classification in the fourth edition of the DSM included autism, Asperger syndrome, pervasive developmental disorder, and childhood disintegrative disorder. The new DSM-V revision incorporates all these disorders into one ASD umbrella term with different severity levels. The management of ASD is complex and requires a multidisciplinary team effort and continuity of care. The CanMEDS-FM roles provide a framework for management. Family physicians are the key leaders of the multidisciplinary care team for ASD, and the CanMEDS-FM framework provides a comprehensive guide to help manage a child with ASD and to help the child's family. Copyright© the College of Family Physicians of Canada.

  6. Advances in diagnostic and treatment options in patients with fibromyalgia syndrome

    Directory of Open Access Journals (Sweden)

    Ali Gur

    2009-12-01

    Full Text Available Ali Gur1, Pelin Oktayoglu21Department of Physical Medicine and Rehabilitation, Medical Faculty, Gaziantep University, Gaziantep, Turkey; 2Department of Physical Medicine and Rehabilitation, Batman State Hospital, Batman, TurkeyAbstract: Fibromyalgia (FM is characterized as a chronic, painful, noninflammatory syndrome affecting the musculoskeletal system. In addition to pain, common co-morbid symptoms associated with FM include sleep disturbances, fatigue, morning stiffness, affective disorders, chronic daily headache, dyscognition, irritable bowel syndrome, and irritable bladder. Fibromyalgia is usually classified by application of the American College of Rheumatology (ACR criteria. Although these criteria are accepted among investigators who agree with the concept of fibromyalgia, they do so with some reservations. Tender points and widespread pain alone does not describe the esence of fibromyalgia. New diagnostic tools including either clinical or radiological components are studied to diminish these problems. Although various pharmacological solutions have been studied for treating fibromyalgia, no single drug or groups of drugs have proved to be useful in treating fibromyalgia patients. Recently, three drugs, pregabalin, duloxetine and milnacipran, were approved for the treatment of FM by the US Food and Drug Administration (FDA. Novel therapeutic approaches to the management of FM include cannabinoids, sodium channel blockade and new generation antiepileptics. This review evaluates both new diagnostic tools, including clinical or radiological regimes, and tries to highlight the efficacy of medicinal and nonmedicinal treatments with new therapeutic approaches in the management of FM with a wide perspective.Keywords: diagnosis, fibromyalgia, rehabilitation, treatment

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

    DEFF Research Database (Denmark)

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

    2010-01-01

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

  8. Catatonia versus neuroleptic malignant syndrome: the diagnostic dilemma and treatment.

    Science.gov (United States)

    Sahoo, Manoj Kumar; Agarwal, Sanjay; Biswas, Harshita

    2014-01-01

    Catatonia is a syndrome, comprised of symptoms such as motor immobility, excessive motor activity, extreme negativism, and stereotyped movements. Neuroleptic is able to induce catatonia like symptoms, that is, the neuroleptic malignant syndrome (NMS). In NMS, patients typically show symptoms such as an altered mental state, muscle rigidity, tremor, tachycardia, hyperpyrexia, leukocytosis, and elevated serum creatine phosphorous kinase. Several researchers have reported studies on catatonia and the association between catatonia and NMS, but none were from this part of the eastern India. In our case, we observed overlapping symptoms of catatonia and NMS; we wish to present a case of this diagnostic dilemma in a patient with catatonia, where a detailed history, investigation, and symptom management added as a great contribution to the patient's rapid improvement.

  9. Catatonia versus neuroleptic malignant syndrome: the diagnostic dilemma and treatment

    Directory of Open Access Journals (Sweden)

    Manoj Kumar Sahoo

    2014-01-01

    Full Text Available Catatonia is a syndrome, comprised of symptoms such as motor immobility, excessive motor activity, extreme negativism, and stereotyped movements. Neuroleptic is able to induce catatonia like symptoms, that is, the neuroleptic malignant syndrome (NMS. In NMS, patients typically show symptoms such as an altered mental state, muscle rigidity, tremor, tachycardia, hyperpyrexia, leukocytosis, and elevated serum creatine phosphorous kinase. Several researchers have reported studies on catatonia and the association between catatonia and NMS, but none were from this part of the eastern India. In our case, we observed overlapping symptoms of catatonia and NMS; we wish to present a case of this diagnostic dilemma in a patient with catatonia, where a detailed history, investigation, and symptom management added as a great contribution to the patient′s rapid improvement.

  10. The dilemma of diagnostic testing for Prader-Willi syndrome

    Science.gov (United States)

    Hung, Dorothy

    2017-01-01

    Although Prader-Willi syndrome (PWS) is a well-described clinical dysmorphic syndrome, DNA testing is required for a definitive diagnosis. A definitive diagnosis can be made in approximately 99% of cases using DNA testing; there are a number of DNA tests that can be used for this purpose, although there is no set standard algorithm of testing. The dilemma arises because of the complex genetic mechanisms at the basis of PWS, which need to be elucidated. To establish the molecular mechanism with a complete work up, involves at least 2 tests. Here we discuss the commonly used tests currently available and suggest a cost—effective approach to diagnostic testing. PMID:28164030

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

    DEFF Research Database (Denmark)

    Schiffman, Eric; Ohrbach, Richard; Truelove, Edmond

    2014-01-01

    , assess in further detail jaw functional limitations and psychological distress as well as additional constructs of anxiety and presence of comorbid pain conditions. CONCLUSION: The recommended evidence-based new DC/TMD protocol is appropriate for use in both clinical and research settings. More......AIMS: The original Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) Axis I diagnostic algorithms have been demonstrated to be reliable. However, the Validation Project determined that the RDC/TMD Axis I validity was below the target sensitivity of ≥ 0.70 and specificity of ≥ 0...... shown to be both reliable and valid. Working from these findings and revisions, two international consensus workshops were convened, from which recommendations were obtained for the finalization of new Axis I diagnostic algorithms and new Axis II instruments. METHODS: Through a series of workshops...

  12. Scrotal infrared digital thermography in assessment of varicocele--pilot study to assess diagnostic criteria.

    Science.gov (United States)

    Kulis, T; Kolaric, D; Karlovic, K; Knezevic, M; Antonini, S; Kastelan, Z

    2012-05-01

    The aim of this study was to assess scrotal thermography in diagnostics of varicocele and suggest potential diagnostic criteria. Twelve patients with clinically diagnosed varicocele were examined with scrotal infrared digital thermography, physical examination and ultrasound/doppler. The main outcome measure was evaluation of thermography diagnostic criteria for varicocele. Mean temperature at left pampiniform plexus was ≥ 34 °C in 83%, and at right pampiniform plexus in all cases was ≤ 34 °C. In 92% of patients, temperature at the left testicle was ≥ 32 °C, whereas at the right testicle it was >32 °C in 50% patients. Temperatures between left and right pampiniform plexus and between left and right testicle were significantly different with P thermography presents feasible, short and low cost diagnostic method for varicocele. Further study on a larger number of patients and healthy participants is needed to evaluate sensitivity and specificity of this method. © 2011 Blackwell Verlag GmbH.

  13. Diagnostic indicators for blood stasis syndrome patients with gynaecological diseases.

    Science.gov (United States)

    Jung, Jeeyoun; Ko, Mi Mi; Lee, Myeong Soo; Lee, So Min; Lee, Ju Ah

    2017-06-20

    To investigate the important diagnostic indicators for blood stasis syndrome (BSS) in patients of childbearing age with gynaecological diseases. A partial least squared-discriminant analysis (PLS-DA) were applied to BSS symptoms data of patients with gynaecological diseases, and the diagnostic indicators used by doctors of Korean medicine (DKMs) among BSS patients with gynaecological diseases were also investigated. A total of 103 patients of childbearing age with gynaecological diseases and 40 healthy controls were enrolled. Among the 103 patients, 63 (61.7%) and 40 (38.8%) were diagnosed with BSS and non-BSS, respectively, and BSS patients exhibited a more severe extent of disease. A score plot of PLS-DA showed clearly different patterns among the 3 groups. Based on the variable importance on projection of PLS-DA model, menstrual pains, dark lumps in the menstrual blood, ileocoecal tenderness and resistance, sharp pains, and sublingual varicosities were selected as the top fifive most important indicators. Moreover, more than 75% of DKMs chose dark lumps in menstrual blood, menstrual pain, and dark menstrual blood as the diagnostic indicators of BSS in patients with gynaecological diseases, and more than 49% of them also considered sharp pains, dark red tongue, sublingual varicosities, and tendency to bruise easily as diagnostic indicators of BSS. DKMs focused on menstrual symptoms and certain gynaecological symptoms to diagnose BSS patients of childbearing age with female diseases.

  14. Multidimensional Diagnostic Criteria for Chronic Pain: Introduction to the ACTTION-American Pain Society Pain Taxonomy (AAPT).

    Science.gov (United States)

    Dworkin, Robert H; Bruehl, Stephen; Fillingim, Roger B; Loeser, John D; Terman, Gregory W; Turk, Dennis C

    2016-09-01

    A variety of approaches have been used to develop diagnostic criteria for chronic pain. The published evidence of the reliability and validity of existing diagnostic criteria is limited, and these criteria have typically not been used in clinical practice. The availability of a widely accepted, consistently applied, and evidence-based taxonomy of diagnostic criteria would improve the quality of clinical research on chronic pain and would be of great value in clinical practice. To address the need for evidence-based diagnostic criteria for the major chronic pain conditions, the Analgesic, Anesthetic, and Addiction Clinical Trial Translations, Innovations, Opportunities, and Networks (ACTTION) public-private partnership with the US Food and Drug Administration and the American Pain Society (APS) have collaborated on the development of the ACTTION-APS Pain Taxonomy (AAPT). AAPT provides a multidimensional framework that is applied systematically in the development of diagnostic criteria. This article (1) describes the background and rationale for AAPT; (2) presents the AAPT taxonomy and the specific conditions for which diagnostic criteria have been developed (to be published separately); (3) briefly reviews the 5 dimensions that constitute the AAPT multidimensional framework and describes the 7 accompanying articles that discuss these dimensions and other important issues involving AAPT; and (4) provides an overview of next steps, specifically, the general processes by which the initial set of diagnostic criteria (for which the evidence base has been drawn from the literature, systematic reviews, and secondary analyses of existing databases) will undergo additional assessments of reliability and validity. To address the need for evidence-based diagnostic criteria for the major chronic pain conditions, the AAPT provides a multidimensional framework that is applied systematically in the development of diagnostic criteria. The long-term objective of AAPT is to advance

  15. Diagnostic test for prenatal identification of Down's syndrome and mental retardation and gene therapy therefor

    Science.gov (United States)

    Smith, Desmond J.; Rubin, Edward M.

    2000-01-01

    A a diagnostic test useful for prenatal identification of Down syndrome and mental retardation. A method for gene therapy for correction and treatment of Down syndrome. DYRK gene involved in the ability to learn. A method for diagnosing Down's syndrome and mental retardation and an assay therefor. A pharmaceutical composition for treatment of Down's syndrome mental retardation.

  16. The DSM diagnostic criteria for Hypoactive Sexual Desire Disorder in men.

    Science.gov (United States)

    Brotto, Lori A

    2010-06-01

    Hypoactive Sexual Desire Disorder (HSDD) is one of two sexual desire disorders in the Diagnostic and Statistical Manual of Mental Disorders (DSM) and is defined by two criteria: A-"persistently or recurrently deficient (or absent) sexual fantasies and desire for sexual activity" and B-"marked distress or interpersonal difficulty." This paper reviews the prevalence and correlates of low desire in men and qualitative and quantitative research on the experience of sexual desire in men and women. A literature search of Medline, PudMed, and PsychInfo was used to identify any publication on low desire in men. The strength of empirical findings was used as a basis for making proposed revisions to the diagnostic criteria for HSDD in men. The dilemma of whether desire and arousal can be reliably differentiated in men is discussed, and parallels to the literature in women are drawn. Finally, I consider three options for the diagnosis of low desire in men for DSM-5. Option 1 proposes that the DSM-IV-TR name and criteria are preserved for men in DSM-5. Option 2 proposes that the recently proposed criteria for Sexual Interest/Arousal Disorder in women are also adopted for men, which would result in one gender-neutral category. Option 3 proposes that the criteria for Sexual Interest/Arousal Disorder also be applied to men, with a minor modification to one criterion (i.e., that absent or reduced genital and/or nongenital physical changes not be included as a criterion); this diagnosis would then be applied only to men. The evidence supporting each of these proposals is presented and critiqued. It is concluded that the proposal for DSM-5 should be made on the basis of field testing of new criteria.

  17. Determination of optimal diagnostic criteria for purulent vaginal discharge and cytological endometritis in dairy cows.

    Science.gov (United States)

    Denis-Robichaud, J; Dubuc, J

    2015-10-01

    The objectives of this observational study were to identify the optimal diagnostic criteria for purulent vaginal discharge (PVD) and cytological endometritis (ENDO) using vaginal discharge, endometrial cytology, and leukocyte esterase (LE) tests, and to quantify their effect on subsequent reproductive performance. Data generated from 1,099 untreated Holstein cows (28 herds) enrolled in a randomized clinical trial were used in this study. Cows were examined at 35 (± 7) d in milk for PVD using vaginal discharge scoring and for ENDO using endometrial cytology and LE testing. Optimal combinations of diagnostic criteria were determined based on the lowest Akaike information criterion (AIC) to predict pregnancy status at first service. Once identified, these criteria were used to quantify the effect of PVD and ENDO on pregnancy risk at first service and on pregnancy hazard until 200 d in milk (survival analysis). Predicting ability of these diagnostic criteria was determined using area under the curve (AUC) values. The prevalence of PVD and ENDO was calculated as well as the agreement between endometrial cytology and LE. The optimal diagnostic criteria (lowest AIC) identified in this study were purulent vaginal discharge or worse (≥ 4), ≥ 6% polymorphonuclear leukocytes (PMNL) by endometrial cytology, and small amounts of leukocytes or worse (≥ 1) by LE testing. When using the combination of vaginal discharge and PMNL percentage as diagnostic tools (n = 1,099), the prevalences of PVD and ENDO were 17.1 and 36.2%, respectively. When using the combination of vaginal discharge and LE (n = 915), the prevalences of PVD and ENDO were 17.1 and 48.4%. The optimal strategies for predicting pregnancy status at first service were the use of LE only (AUC = 0.578) and PMNL percentage only (AUC = 0.575). Cows affected by PVD and ENDO had 0.36 and 0.32 times the odds, respectively, of being pregnant at first service when using PMNL percentage compared with that of unaffected

  18. The criteria for metabolic syndrome and the national health screening and education system in Japan.

    Science.gov (United States)

    Yamagishi, Kazumasa; Iso, Hiroyasu

    2017-01-01

    Two major definitions of metabolic syndrome have been proposed. One focuses on the accumulation of risk factors, a measure used by the American Heart Association (AHA) and the National Heart, Lung, and Blood Institute (NHLBI); the other focuses on abdominal obesity, a measure used by the International Diabetes Federation (IDF) and the Japanese government. The latter definition takes waist circumference (WC) into consideration as an obligatory component, whereas the former does not. In 2009, the IDF, NHLBI, AHA, and other organizations attempted to unify these criteria; as a result, WC is no longer an obligatory component of those systems, while it remains obligatory in the Japanese criteria. In 2008, a new Japanese cardiovascular screening and education system focused on metabolic syndrome was launched. People undergoing screening are classified into three groups according to the presence of abdominal obesity and the number of metabolic risk factors, and receive health educational support from insurers. This system has yielded several beneficial outcomes: the visibility of metabolic syndrome at the population level has drastically improved; preventive measures have been directed toward metabolic syndrome, which is expected to become more prevalent in future generations; and a post-screening education system has been established. However, several problems with the current system have been identified and are under debate. In this review, we discuss topics related to metabolic syndrome, including (1) the Japanese criteria for metabolic syndrome; (2) metabolic syndrome and the universal health screening and education system; and (3) recent debates about Japanese criteria for metabolic syndrome.

  19. The criteria for metabolic syndrome and the national health screening and education system in Japan

    Directory of Open Access Journals (Sweden)

    Kazumasa Yamagishi

    2017-01-01

    Full Text Available Two major definitions of metabolic syndrome have been proposed. One focuses on the accumulation of risk factors, a measure used by the American Heart Association (AHA and the National Heart, Lung, and Blood Institute (NHLBI; the other focuses on abdominal obesity, a measure used by the International Diabetes Federation (IDF and the Japanese government. The latter definition takes waist circumference (WC into consideration as an obligatory component, whereas the former does not. In 2009, the IDF, NHLBI, AHA, and other organizations attempted to unify these criteria; as a result, WC is no longer an obligatory component of those systems, while it remains obligatory in the Japanese criteria. In 2008, a new Japanese cardiovascular screening and education system focused on metabolic syndrome was launched. People undergoing screening are classified into three groups according to the presence of abdominal obesity and the number of metabolic risk factors, and receive health educational support from insurers. This system has yielded several beneficial outcomes: the visibility of metabolic syndrome at the population level has drastically improved; preventive measures have been directed toward metabolic syndrome, which is expected to become more prevalent in future generations; and a post-screening education system has been established. However, several problems with the current system have been identified and are under debate. In this review, we discuss topics related to metabolic syndrome, including (1 the Japanese criteria for metabolic syndrome; (2 metabolic syndrome and the universal health screening and education system; and (3 recent debates about Japanese criteria for metabolic syndrome.

  20. Metabolic syndrome in children and adolescents - criteria for diagnosis

    OpenAIRE

    Mancini, Marcio C

    2009-01-01

    Abstract In recent years, there has been a greater concern about the presence of obesity and metabolic syndrome in children and adolescents. However, there is no consensus regarding the diagnosis of metabolic syndrome in children and adolescents. It is evident that each component of the syndrome must be identified as early as possible in order to prevent definitive lesions. The question is how to do this and which cut-offs must be adopted for this diagnosis. For a matter of convenience, the d...

  1. Subgroups of fibromyalgia patients using the 1990 American College of Rheumatology criteria and the modified 2010 preliminary diagnostic criteria: the al-Ándalus project.

    Science.gov (United States)

    Segura-Jiménez, Víctor; Soriano-Maldonado, Alberto; Álvarez-Gallardo, Inmaculada C; Estévez-López, Fernando; Carbonell-Baeza, Ana; Delgado-Fernández, Manuel

    2016-01-01

    We aimed to investigate the symptom profiles in subsets of fibromyalgia patients according to the subgroups created from the satisfaction of the 1990 American College of Rheumatology (ACR) diagnostic criteria (1990c) and/or the modified 2010 ACR preliminary diagnostic criteria (m-2010c). A total of 913 (84 men) participants took part in this cross-sectional study. Participants were grouped as follows: i) 285 who did not fulfil any ACR diagnostic criteria (non-fibromyalgia); ii) 73 who fulfilled the 1990c only; iii) 96 who fulfilled the m-2010c only; iv) 459 who fulfilled both ACR diagnostic criteria. Experimental and clinical pain, chronic pain self-efficacy, pain catastrophising, fibromyalgia severity, fatigue, health-related quality of life, depression, state anxiety and physical fitness were assessed by means of several questionnaires and tests. Overall, the differences were consistent across all study outcomes (all, overall psubgroup fulfilling both diagnostic criteria had the worst profile of all the subgroups, whereas those fulfilling any diagnostic criteria (non-fibromyalgia participants) had the most favourable results. Furthermore, the subgroup fulfilling the m-2010c only had a worse profile than the subgroup fulfilling the 1990c only, and presented similar but slightly better results than those fulfilling both diagnostic criteria. Our results reinforce the understanding of fibromyalgia as a heterogeneous condition. Subgrouping of fibromyalgia patients is highly recommendable, since these subgroups show diverse clinical pictures and therefore treatment options should be individually tailored to their specific profile. The combination of 1990c and the m-2010c is potentially useful to identify subgroups of fibromyalgia patients.

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

    Science.gov (United States)

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

    2011-01-01

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

  3. Diagnostic algorithm for relapsing acquired demyelinating syndromes in children.

    Science.gov (United States)

    Hacohen, Yael; Mankad, Kshitij; Chong, W K; Barkhof, Frederik; Vincent, Angela; Lim, Ming; Wassmer, Evangeline; Ciccarelli, Olga; Hemingway, Cheryl

    2017-07-18

    To establish whether children with relapsing acquired demyelinating syndromes (RDS) and myelin oligodendrocyte glycoprotein antibodies (MOG-Ab) show distinctive clinical and radiologic features and to generate a diagnostic algorithm for the main RDS for clinical use. A panel reviewed the clinical characteristics, MOG-Ab and aquaporin-4 (AQP4) Ab, intrathecal oligoclonal bands, and Epstein-Barr virus serology results of 110 children with RDS. A neuroradiologist blinded to the diagnosis scored the MRI scans. Clinical, radiologic, and serologic tests results were compared. The findings showed that 56.4% of children were diagnosed with multiple sclerosis (MS), 25.4% with neuromyelitis optica spectrum disorder (NMOSD), 12.7% with multiphasic disseminated encephalomyelitis (MDEM), and 5.5% with relapsing optic neuritis (RON). Blinded analysis defined baseline MRI as typical of MS in 93.5% of children with MS. Acute disseminated encephalomyelitis presentation was seen only in the non-MS group. Of NMOSD cases, 30.7% were AQP4-Ab positive. MOG-Ab were found in 83.3% of AQP4-Ab-negative NMOSD, 100% of MDEM, and 33.3% of RON. Children with MOG-Ab were younger, were less likely to present with area postrema syndrome, and had lower disability, longer time to relapse, and more cerebellar peduncle lesions than children with AQP4-Ab NMOSD. A diagnostic algorithm applicable to any episode of CNS demyelination leads to 4 main phenotypes: MS, AQP4-Ab NMOSD, MOG-Ab-associated disease, and antibody-negative RDS. Children with MS and AQP4-Ab NMOSD showed features typical of adult cases. Because MOG-Ab-positive children showed notable and distinctive clinical and MRI features, they were grouped into a unified phenotype (MOG-Ab-associated disease), included in a new diagnostic algorithm. © 2017 American Academy of Neurology.

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

    Science.gov (United States)

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

    2012-01-01

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

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

    Science.gov (United States)

    Coccaro, Emil F

    2011-01-01

    This study was designed to develop a revised diagnostic criteria set for intermittent explosive disorder (IED) for consideration for inclusion in Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-V). This revised criteria set was developed by integrating previous research criteria with elements from the current DSM-IV set of diagnostic criteria. Evidence supporting the reliability and validity of IED-IR ("IED Integrated Criteria") in a new and well-characterized group of subjects with personality disorder is presented. Clinical, phenomenologic, and diagnostic data from 201 individuals with personality disorder were reviewed. All IED diagnoses were assigned using a best-estimate process (eg, kappa for IED-IR >0.85). In addition, subjects meeting IED-IR criteria had higher scores on dimensional measures of aggression and had lower global functioning scores than non-IED-IR subjects, even when related variables were controlled. The IED-IR criteria were more sensitive than the DSM-IV criteria only in identifying subjects with significant impulsive-aggressive behavior by a factor of 16. We conclude that the IED-IR criteria can be reliably applied and have sufficient validity to warrant consideration as DSM-V criteria for IED. Copyright © 2011 Elsevier Inc. All rights reserved.

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

    Directory of Open Access Journals (Sweden)

    Alina Coutinho Rodrigues Feitosa

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

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

    Science.gov (United States)

    Feitosa, Alina Coutinho Rodrigues; Barreto, Luciana Tedgue; da Silva, Isabela Matos; da Silva, Felipe Freire; Feitosa Filho, Gilson Soares

    2017-01-01

    Background There is a physiologic elevation of total cholesterol (TC) and triglycerides (TG) during pregnancy. Some authors define dyslipidemia (DLP) in pregnant women when TC, LDL and TG concentrations are above the 95th percentile (p95%) and HDL concentration is below the 5th percentile (P5%) for gestational age (GA). Objective To compare the prevalence of DLP in pregnant women using percentiles criteria with the V Brazilian Guidelines on Dyslipidemia and the association with maternal and fetal outcomes. Results Pregnant women with high-risk conditions, aged 18-50 years, and at least one lipid profile during pregnancy was classified as the presence of DLP by two diagnostic criteria. Clinical and laboratorial data of mothers and newborns were evaluated. Conclusion 433 pregnant women aged 32.9 ± 6.5 years were studied. Most (54.6%) had lipid profile collected during third trimester. The prevalence of any lipid abnormalities according to the criteria of the National Guidelines was 83.8%: TC ≥ 200 mg/dL was found in 49.9%; LDL ≥ 160 mg/dL, in 14.3%, HDL ≤ 50 mg/dL in 44.4% and TG ≥ 150 mg/dL in 65.3%. Any changes of lipid according to percentiles criteria was found in 19.6%: elevation above the P95% for TC was found in 0.7%; for LDL, 1.7%; for TG 6.4% and HDL lower than the P5% in 13%. The frequency of comorbidity: hypertension, diabetes, smoking, obesity and preeclampsia was similar among pregnant women when DLP was compared by both criteria. Conclusion The prevalence of DLP during pregnancy varies significantly depending on the criteria used, however none demonstrated superiority in association with comorbidities. PMID:28591252

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

    International Nuclear Information System (INIS)

    Malone, J.; Faulkner, K.; Christofides, S.; Lillicrap, S.; Horton, P.

    2013-01-01

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

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

    Directory of Open Access Journals (Sweden)

    M. A. Gromova

    2016-01-01

    Full Text Available Objective: to establish features of a chronic pain syndrome disorders in patients with rheumatoid arthritis, to reveal correlation with psychoemotional disorders and to develop the differential approach to maintaining patients. Materials and methods. 101 patients at the age of 60.6 ± 11.8 years, 92 % of women, with reliable rheumatoid arthritis (American College of Rheumatology – ACR, 1987, were examined. The visual analog scale was used for an assessment of pain strength at the moment; the Van Korff’s questionnaire – for determination of pain strength at the moment and retrospectively for the last half a year with an assessment of disadaptation level and disability, ranging of a chronic pain syndrome on classes; the McGill Pain Questionnaire – for the characteristic of touchsensitive and emotional components of pain. Neuropathic pain was revealed by DN4 questionnaire. Anxiety and depression were determined by the Hospital Anxiety and Depression Scale (HADS. Fibromyalgia diagnosed by criteria of ACR, (1990. Results. Pain estimated by various scales and questionnaires varied from moderated to intensive. According to Van Korff’s questionnaire it was characterized by average level of disadaptation and easy disability that corresponded to the second class of chronic pain. The Rank pain index of the McGill Pain Questionnaire touch scale testified that pain was described by a smaller number of definitions on a touch scale than on emotional. This indicates a moderate impact of pain syndrome on a state of mind. Neuropathic pain is diagnosed for 37.3 % of patients with tunnel syndrome, mononeuritis and touch polyneuropathy. The secondary fibromyalgia is revealed for 2 % of patients with early rheumatoid arthritis of high activity. According to HADS anxiety and depression was revealed for 58 and 59 % of patients correspondingly. This demanded psychotherapeutic consultation and additional correction. We proposed the algorithm of diagnostic and

  10. Placing symptoms in context: the role of contextual criteria in reducing false positives in Diagnostic and Statistical Manual of Mental Disorders diagnoses.

    Science.gov (United States)

    Wakefield, Jerome C; First, Michael B

    2012-02-01

    The Diagnostic and Statistical Manual of Mental Disorders (DSM) definition of mental disorder requires that symptoms be caused by a dysfunction in the individual; when dysfunction is absent, symptoms represent normal-range distress or eccentricity and, if diagnosed as a mental disorder, are false positives. We hypothesized that because of psychiatry's lack of direct laboratory tests to distinguish dysfunction from normal-range distress, the context in which symptoms occur (eg, lack of imminent danger in a panic attack) is often essential to determining whether symptoms are caused by a dysfunction. If this is right, then the DSM diagnostic criteria should include many contextual criteria added to symptom syndromes to prevent dysfunction false positives. Despite their potential importance, such contextual criteria have not been previously reviewed. We, thus, systematically reviewed DSM categories to establish the extent of such uses of contextual criteria and created a typology of such uses. Of 111 sampled categories, 68 (61%) used context to prevent dysfunction false positives. Contextual criteria fell into 7 types: (1) exclusion of specific false-positive scenarios; (2) requiring that patients experience preconditions for normal responses (eg, requiring that individuals experience adequate sexual stimulation before being diagnosed with sexual dysfunctions); (3) requiring that symptoms be disproportionate relative to circumstances; (4) for childhood disorders, requiring that symptoms be developmentally inappropriate; (5) requiring that symptoms occur in multiple contexts; (6) requiring a substantial discrepancy between beliefs and reality; and (7) a residual category. Most DSM categories include contextual criteria to eliminate false-positive diagnoses and increase validity of descriptive criteria. Future revisions should systematically evaluate each category's need for contextual criteria. Copyright © 2012 Elsevier Inc. All rights reserved.

  11. SPECT in the Kleine-Levin syndrome, a possible diagnostic and prognostic aid?

    Directory of Open Access Journals (Sweden)

    Patrick Emanuel Vigren

    2014-09-01

    Full Text Available INTRODUCTION: Kleine-Levin syndrome (KLS is a rare syndrome of periodic hypersomnia and behavioral and cognitive symptoms based on clinical criteria. In the setting of differential diagnosis of hypersomnia disorders, an objective diagnostic aid is desirable. A promising modality is single photon emission computed tomography (SPECT. As intraepisodal investigations are difficult to perform, an interepisodal investigation would be very helpful. Another aim of the study was to correlate SPECT findings to prognosis. METHODS AND MATERIAL: 24 KLS-patients were categorized as severe or non-severe based on clinical characteristics. The clinical characteristics were analyzed in relation to SPECT-examinations performed between hypersomnia periods (interepisodal or after remission, as a clinical routine investigation.RESULTS: 48% of the KLS-patients have hypoperfusion in the temporal or fronto-temporal regions. In patients that have undergone remission, 56% show that pattern. There were no specific findings related to prognosis.DISCUSSION/CONCLUSION: SPECT might be a diagnostic aid, in a setting of hypersomnia experience. With a sensitivity of 48%, interepisodal SPECT alone cannot be used for diagnosing KLS.

  12. A case of pervasive refusal syndrome: a diagnostic conundrum.

    LENUS (Irish Health Repository)

    McNicholas, Fiona

    2013-01-01

    A case is presented of an 11-year-old girl with pervasive refusal syndrome (PRS) who ultimately recovered acutely and completely after an 18-month paediatric hospitalisation. There was an apparent absence of previously proposed important aetiological factors in PRS, such as family pathology and markedly traumatic or abusive experiences, and her recovery was sudden and complete. The authors consider the differential diagnoses of PRS paying particular attention to the possibility of a conversion disorder or catatonia, given the absence of PRS in the North American literature. Consideration of catatonia is important as it has a diagnostic test and responds rapidly to appropriate treatment, in contrast to conventional treatment for PRS and conversion disorder.

  13. Diagnostic markers of Sjögren's syndrome.

    Science.gov (United States)

    Witte, Torsten

    2010-01-01

    Establishing a diagnosis of Sjögren's syndrome (SS) has been difficult without sensitive laboratory markers, and in light of the non-specificity of the symptoms of dry eyes and mouth. Rather than complaints about dry eyes or dry mouth, objective symptoms and extraglandular manifestations should raise suspicion of SS. This evaluation requires the detection of antibodies against Ro (SSA) and La (SSB) or a pathologic salivary gland biopsy. Since an invasive biopsy is not always performed, further diagnostic markers are required. Recently antibodies against alpha-fodrin have been shown to be present in the majority of untreated patients, and can be used in the screening process of SS as an additional marker. Copyright 2010 S. Karger AG, Basel.

  14. Classification criteria of syndromes by latent variable models

    DEFF Research Database (Denmark)

    Petersen, Janne

    2010-01-01

    are shown to be superior depending on whether the latent variable is a dependent or an independent variable. Both these types of scores are extended to the situation of differential item functioning. Analytically I have showed that the scores result in consistent estimates when used properly in subsequent...... of the syndrome. Thus, the results suggested that peripheral lipoatrophy and central lipohypertophy are interrelated phenotypes rather than two independent phenotypes. Part 2: Latent class regression relates explanatory variables to latent classes. In this model no measure of the latent class variable is obtained......The thesis has two parts; one clinical part: studying the dimensions of human immunodeficiency virus associated lipodystrophy syndrome (HALS) by latent class models, and a more statistical part: investigating how to predict scores of latent variables so these can be used in subsequent regression...

  15. Upper flow-regime structures in a Pleistocene carbonate ramp (Favignana, Italy): diagnostic criteria and implications

    Science.gov (United States)

    Slootman, Arnoud; Cartigny, Matthieu; de Boer, Poppe; Moscariello, Andrea

    2017-04-01

    This work presents key diagnostic criteria for the recognition of upper flow-regime sedimentary structures in clastic cool-water carbonate accumulations, illustrated by the excellent exposures of the Pleistocene carbonate ramp succession of Favignana Island (Italy). Cool-water carbonate sedimentation has dominated Mediterranean shelves since the Early Pliocene. Of the various types of marine limestones, cool-water carbonates behave most similar to siliciclastics. They typically develop ramp morphologies with skeletal sand and gravel, consisting of the remains of heterozoan organisms. Resedimentation of this loose carbonate debris during high-energy events such as storms and, more rarely, tsunamis is the norm. Off-ramp supercritical sediment density flows are important contributors to basinward sediment transport as evidenced by the prevalence of backset-stratification bounded by composite erosion surfaces, locally defining spoon-shaped scours-fills, in beds exceeding several metres in thickness. Sedimentary structures created by upper flow-regime bedforms like antidunes, chute-and-pools and cyclic steps as seen on Favignana Island, which form in association with in-phase waves and hydraulic jumps, are not commonly mentioned in carbonate ramp depositional models. For each of the bedforms we present diagnostic criteria to explain otherwise enigmatic sedimentary structures. Thick beds deposited by supercritical sediment density flows have major implications for the distribution of porosity and permeability in carbonate sandstone bodies, especially where they host hydrocarbon and/or water accumulations. The correct identification of upper flow-regime sedimentary structures in carbonate ramp accumulations is therefore important.

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

    NARCIS (Netherlands)

    Leckman, James F.; Denys, Damiaan; Simpson, H. Blair; Mataix-Cols, David; Hollander, Eric; Saxena, Sanjaya; Miguel, Euripedes C.; Rauch, Scott L.; Goodman, Wayne K.; Phillips, Katharine A.; Stein, Dan J.

    2010-01-01

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

  17. Assessing electronic health record phenotypes against gold-standard diagnostic criteria for diabetes mellitus.

    Science.gov (United States)

    Spratt, Susan E; Pereira, Katherine; Granger, Bradi B; Batch, Bryan C; Phelan, Matthew; Pencina, Michael; Miranda, Marie Lynn; Boulware, Ebony; Lucas, Joseph E; Nelson, Charlotte L; Neely, Benjamin; Goldstein, Benjamin A; Barth, Pamela; Richesson, Rachel L; Riley, Isaretta L; Corsino, Leonor; McPeek Hinz, Eugenia R; Rusincovitch, Shelley; Green, Jennifer; Barton, Anna Beth; Kelley, Carly; Hyland, Kristen; Tang, Monica; Elliott, Amanda; Ruel, Ewa; Clark, Alexander; Mabrey, Melanie; Morrissey, Kay Lyn; Rao, Jyothi; Hong, Beatrice; Pierre-Louis, Marjorie; Kelly, Katherine; Jelesoff, Nicole

    2017-04-01

    We assessed the sensitivity and specificity of 8 electronic health record (EHR)-based phenotypes for diabetes mellitus against gold-standard American Diabetes Association (ADA) diagnostic criteria via chart review by clinical experts. We identified EHR-based diabetes phenotype definitions that were developed for various purposes by a variety of users, including academic medical centers, Medicare, the New York City Health Department, and pharmacy benefit managers. We applied these definitions to a sample of 173 503 patients with records in the Duke Health System Enterprise Data Warehouse and at least 1 visit over a 5-year period (2007-2011). Of these patients, 22 679 (13%) met the criteria of 1 or more of the selected diabetes phenotype definitions. A statistically balanced sample of these patients was selected for chart review by clinical experts to determine the presence or absence of type 2 diabetes in the sample. The sensitivity (62-94%) and specificity (95-99%) of EHR-based type 2 diabetes phenotypes (compared with the gold standard ADA criteria via chart review) varied depending on the component criteria and timing of observations and measurements. Researchers using EHR-based phenotype definitions should clearly specify the characteristics that comprise the definition, variations of ADA criteria, and how different phenotype definitions and components impact the patient populations retrieved and the intended application. Careful attention to phenotype definitions is critical if the promise of leveraging EHR data to improve individual and population health is to be fulfilled. © The Author 2016. Published by Oxford University Press on behalf of the American Medical Informatics Association. All rights reserved. For Permissions, please email: journals.permissions@oup.com

  18. The American College of Rheumatology preliminary diagnostic criteria for fibromyalgia and measurement of symptom severity.

    Science.gov (United States)

    Wolfe, Frederick; Clauw, Daniel J; Fitzcharles, Mary-Ann; Goldenberg, Don L; Katz, Robert S; Mease, Philip; Russell, Anthony S; Russell, I Jon; Winfield, John B; Yunus, Muhammad B

    2010-05-01

    To develop simple, practical criteria for clinical diagnosis of fibromyalgia that are suitable for use in primary and specialty care and that do not require a tender point examination, and to provide a severity scale for characteristic fibromyalgia symptoms. We performed a multicenter study of 829 previously diagnosed fibromyalgia patients and controls using physician physical and interview examinations, including a widespread pain index (WPI), a measure of the number of painful body regions. Random forest and recursive partitioning analyses were used to guide the development of a case definition of fibromyalgia, to develop criteria, and to construct a symptom severity (SS) scale. Approximately 25% of fibromyalgia patients did not satisfy the American College of Rheumatology (ACR) 1990 classification criteria at the time of the study. The most important diagnostic variables were WPI and categorical scales for cognitive symptoms, unrefreshed sleep, fatigue, and number of somatic symptoms. The categorical scales were summed to create an SS scale. We combined the SS scale and the WPI to recommend a new case definition of fibromyalgia: (WPI > or =7 AND SS > or =5) OR (WPI 3-6 AND SS > or =9). This simple clinical case definition of fibromyalgia correctly classifies 88.1% of cases classified by the ACR classification criteria, and does not require a physical or tender point examination. The SS scale enables assessment of fibromyalgia symptom severity in persons with current or previous fibromyalgia, and in those to whom the criteria have not been applied. It will be especially useful in the longitudinal evaluation of patients with marked symptom variability.

  19. Inter-rater reliability of diagnostic criteria for sacroiliac joint-, disc- and facet joint pain.

    Science.gov (United States)

    van Tilburg, Cornelis W J; Groeneweg, Johannes G; Stronks, Dirk L; Huygen, Frank J P M

    2017-01-01

    Several diagnostic criteria sets are described in the literature to identify low back pain subtypes, but very little is known about the inter-rater reliability of these criteria. We conducted a study to determine the reliability of diagnostic tests that point towards SI joint-, disc- or facet joint pain. Inter-rater reliability study alongside three randomized clinical trials. Multidisciplinary pain center of general hospital. Patients aged 18 or more with medical history and physical examination suggestive of sacroiliac joint-, disc- and facet joint pain on lumbar level. Making use of nowadays most common used diagnostic criteria, a physical examination is taken independently by three physicians (two pain physicians and one orthopedic surgeon). Inter-rater reliability (Kappa (κ) measure of agreement) and significance (p) between raters are presented. Strengths of agreement, indicated with κ values above 0,20, are presented in order of agreement. One hundred patients were included. None of the parameters from the physical investigation had κ values of more than 0.21 (fair) in all pairs of raters. Between two raters (C and D), there was an almost perfect agreement on three parameters, more specifically ``Abnormal sensory and motor examination, hyperactive or diminished reflexes'', ``Sitting exam shows no reflex, motor or sensory signs in the legs'' and ``Straight leg raising (Laségue) negative between 30 and 70 degrees of flexion''. The ``Drop test positive'' parameters had moderate strength of agreement between raters A and D and fair strength between raters A and B. The ``Digital interspinous pressure test positive'' had moderate strength of agreement between raters C and D and fair strength of agreement between raters A and B as well as raters B and C. Three other parameters had a fair strength of agreement between two raters, all other parameters had a slight or poor strength of agreement. Inter-rater reliability, confidence intervals and significance of

  20. Clinical characteristics of migraine and episodic tension-type headache in relation to old and new diagnostic criteria

    DEFF Research Database (Denmark)

    Iversen, Helle Klingenberg; Langemark, M; Andersson, P G

    1990-01-01

    Eighty-one patients were diagnosed as having migraine, tension headache or both according to previously used criteria. Then we performed a standardized interview to determine the frequency and severity of headache characteristics used in the new operational diagnostic criteria of the International...... Headache Society (IHS). In every patient the original diagnosis fulfilled also the IHS criteria, but in 9 patients the criteria were only fulfilled in half or less of the attacks, and applying the IHS criteria they also achieved an additional diagnosis. In one patient these attacks did not fulfill the pain...

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

    Science.gov (United States)

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

    2012-01-01

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

  2. Proposed diagnostic criteria for apathy in Alzheimer's disease and other neuropsychiatric disorders.

    Science.gov (United States)

    Robert, P; Onyike, C U; Leentjens, A F G; Dujardin, K; Aalten, P; Starkstein, S; Verhey, F R J; Yessavage, J; Clement, J P; Drapier, D; Bayle, F; Benoit, M; Boyer, P; Lorca, P M; Thibaut, F; Gauthier, S; Grossberg, G; Vellas, B; Byrne, J

    2009-03-01

    There is wide acknowledgement that apathy is an important behavioural syndrome in Alzheimer's disease and in various neuropsychiatric disorders. In light of recent research and the renewed interest in the correlates and impacts of apathy, and in its treatments, it is important to develop criteria for apathy that will be widely accepted, have clear operational steps, and that will be easily applied in practice and research settings. Meeting these needs is the focus of the task force work reported here. The task force includes members of the Association Française de Psychiatrie Biologique, the European Psychiatric Association, the European Alzheimer's Disease Consortium and experts from Europe, Australia and North America. An advanced draft was discussed at the consensus meeting (during the EPA conference in April 7th 2008) and a final agreement reached concerning operational definitions and hierarchy of the criteria. Apathy is defined as a disorder of motivation that persists over time and should meet the following requirements. Firstly, the core feature of apathy, diminished motivation, must be present for at least four weeks; secondly two of the three dimensions of apathy (reduced goal-directed behaviour, goal-directed cognitive activity, and emotions) must also be present; thirdly there should be identifiable functional impairments attributable to the apathy. Finally, exclusion criteria are specified to exclude symptoms and states that mimic apathy.

  3. Why not use the HbA1c as a criterion of dysglycemia in the new definition of the metabolic syndrome? Impact of the new criteria in the prevalence of the metabolic syndrome in a Mediterranean urban population from Southern Europe (IMAP study. Multidisciplinary intervention in primary care).

    Science.gov (United States)

    Bernal-Lopez, M Rosa; Villalobos-Sanchez, Aurora; Mancera-Romero, Jose; Jansen-Chaparro, Sergio; Baca-Osorio, Antonio J; Lopez-Carmona, Maria Dolores; Tinahones, Francisco J; Gomez-Huelgas, Ricardo

    2011-08-01

    We analysed the prevalence of metabolic syndrome (MS) of the new diagnostic criteria and the HbA1c to diagnose dysglycemia. We studied 2006 adults without cardiovascular disease or diabetes. The use of the new criteria and the HbA1c resulted in an increase in the population prevalence of MS. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

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

    Science.gov (United States)

    Mader, Edward C.; El-Abassi, Rima; Villemarette-Pittman, Nicole R.; Santana-Gould, Lenay; Olejniczak, Piotr W.; England, John D.

    2013-01-01

    The clinical diagnosis of Creutzfeldt-Jakob disease (CJD) is largely based on the 1998 World Health Organization diagnostic criteria. Unfortunately, rigid compliance with these criteria may result in failure to recognize sporadic CJD (sCJD), especially early in its course when focal findings predominate and traditional red flags are not yet present. A 61-year-old man presented with a 3-week history of epilepsia partialis continua (jerking of the left upper extremity) and a 2-week history of forgetfulness and left hemiparesis; left hemisensory neglect was also detected on admission. Repeated brain magnetic resonance imaging (MRI) showed areas of restricted diffusion in the cerebral cortex, initially on the right but later spreading to the left. Electroence-phalography (EEG) on hospital days 7, 10, and 14 showed right-sided periodic lateralized epileptiform discharges. On day 20, the EEG showed periodic sharp wave complexes leading to a diagnosis of probable sCJD and subsequently to definite sCJD with brain biopsy. Neurological decline was relatively fast with generalized myoclonus and akinetic mutism developing within 7 weeks from the onset of illness. CJD was not immediately recognized because of the patient's focal/lateralized manifestations. Focal/lateralized clinical, EEG, and MRI findings are not uncommon in sCJD and EEG/MRI results may not be diagnostic in the early stages of sCJD. Familiarity with these caveats and with the most current criteria for diagnosing probable sCJD (University of California San Francisco 2007, MRI-CJD Consortium 2009) will enhance the ability to recognize sCJD and implement early safety measures. PMID:23717780

  5. Will new diagnostic criteria for diabetes mellitus change phenotype of patients with diabetes? Reanalysis of European epidemiological data

    OpenAIRE

    1998-01-01

    Objective: To evaluate the impact of the revised diagnostic criteria for diabetes mellitus adopted by the American Diabetes Association on prevalence of diabetes and on classification of patients. For epidemiological purposes the American criteria use a fasting plasma glucose concentration ⩾7.0 mmol/l in contrast with the current World Health Organisation criteria of 2 hour glucose concentration ⩾11.1 mmol/l.

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

    Science.gov (United States)

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

    2012-01-01

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

  7. Proposed diagnostic criteria and classification of basophilic leukemias and related disorders.

    Science.gov (United States)

    Valent, P; Sotlar, K; Blatt, K; Hartmann, K; Reiter, A; Sadovnik, I; Sperr, W R; Bettelheim, P; Akin, C; Bauer, K; George, T I; Hadzijusufovic, E; Wolf, D; Gotlib, J; Mahon, F-X; Metcalfe, D D; Horny, H-P; Arock, M

    2017-04-01

    Basophils form a distinct cell lineage within the hematopoietic cell family. In various myeloid neoplasms, including chronic myeloid leukemia, basophilia is frequently seen. Acute and chronic basophilic leukemias, albeit rare, have also been described. However, no generally accepted criteria and classification of basophilic leukemias have been presented to date. To address this unmet need, a series of Working Conferences and other meetings were organized between March 2015 and March 2016. The current article provides a summary of consensus statements from these meetings, together with proposed criteria to delineate acute basophilic leukemia (ABL) from chronic basophilic leukemia (CBL) and primary forms of the disease where no preceding myeloid malignancy is detected, from the more common 'secondary' variants. Moreover, the term hyperbasophilia (HB) is proposed for cases with a persistent peripheral basophil count ⩾1000 per μl of blood. This condition, HB, is highly indicative of the presence of an underlying myeloid neoplasm. Therefore, HB is an important checkpoint in the diagnostic algorithm and requires a detailed hematologic investigation. In these patients, an underlying myeloid malignancy is often found and is then labeled with the appendix -baso, whereas primary cases of ABL or CBL are very rare. The criteria and classification proposed in this article should facilitate the diagnosis and management of patients with unexplained basophilia and basophil neoplasms in routine practice, and in clinical studies.

  8. Re-evaluation of the diagnostic criteria for Wilson disease in children with mild liver disease.

    Science.gov (United States)

    Nicastro, Emanuele; Ranucci, Giusy; Vajro, Pietro; Vegnente, Angela; Iorio, Raffaele

    2010-12-01

    The diagnosis of Wilson disease (WD) is challenging, especially in children. Early detection is desirable in order to avoid dramatic disease progression. The aim of our study was to re-evaluate in WD children with mild liver disease the conventional diagnostic criteria and the WD scoring system proposed by an international consensus in 2001. Forty children with WD (26 boys and 14 girls, age range = 1.1-20.9 years) and 58 age-matched and sex-matched patients with a liver disease other than WD were evaluated. Both groups were symptom-free and had elevated aminotransferases as predominant signs of liver disease. In all WD patients, the diagnosis was supported by molecular analysis, the liver copper content, or both. A receiver operating characteristic (ROC) analysis of ceruloplasmin at the cutoff value of 20 mg/dL showed a sensitivity of 95% [95% confidence interval (CI) = 83%-99.4%] and a specificity of 84.5% (95% CI = 72.6%-92.6%). The optimal basal urinary copper diagnostic cutoff value was found to be 40 μg/24 hours (sensitivity = 78.9%, 95% CI = 62.7%-90.4%; specificity = 87.9%, 95% CI = 76.7%-95%). Urinary copper values after penicillamine challenge did not significantly differ between WD patients and control subjects, and the ROC analysis showed a sensitivity of only 12%. The WD scoring system was proved to have positive and negative predictive values of 93% and 91.6%, respectively. Urinary copper excretion greater than 40 μg/24 hours is suggestive of WD in asymptomatic children, whereas the penicillamine challenge test does not have a diagnostic role in this subset of patients. The WD scoring system provides good diagnostic accuracy. Copyright © 2010 American Association for the Study of Liver Diseases.

  9. High sensitivity and specificity in proposed clinical diagnostic criteria for anti-N-methyl-D-aspartate receptor encephalitis.

    Science.gov (United States)

    Ho, Alvin C C; Mohammad, Shekeeb S; Pillai, Sekhar C; Tantsis, Esther; Jones, Hannah; Ho, Reena; Lim, Ming; Hacohen, Yael; Vincent, Angela; Dale, Russell C

    2017-12-01

    To determine the validity of the proposed clinical diagnostic criteria for anti-N-methyl-d-aspartate receptor (NMDAR) encephalitis in paediatric patients. The diagnostic criteria for anti-NMDAR encephalitis proposed by Graus et al. (2016) use clinical features and conventional investigations to facilitate early immunotherapy before antibody status is available. The criteria are satisfied if patients develop four out of six symptom groups within 3 months, together with at least one abnormal investigation (electroencephalography/cerebrospinal fluid) and reasonable exclusion of other disorders. We evaluated the validity of the criteria using a retrospective cohort of paediatric patients with encephalitis. Twenty-nine patients with anti-NMDAR encephalitis and 74 comparison children with encephalitis were included. As expected, the percentage of patients with anti-NMDAR encephalitis who fulfilled the clinical criteria increased over time. During the hospital inpatient admission, most patients (26/29, 90%) with anti-NMDAR encephalitis fulfilled the criteria, significantly more than the comparison group (3/74, 4%) (panti-NMDAR encephalitis was 2 weeks from first symptom onset (range 1-6). The sensitivity of the criteria was 90% (95% confidence interval 73-98) and the specificity was 96% (95% confidence interval 89-99). The proposed diagnostic criteria for anti-NMDAR encephalitis have good sensitivity and specificity. Incomplete criteria do not exclude the diagnosis. The proposed clinical diagnostic criteria for anti-N-methyl-d-aspartate receptor (NMDAR) encephalitis by Graus et al. (2016) have high sensitivity and specificity in paediatric patients. The median time of fulfilling the criteria in patients with anti-NMDAR was 2 weeks from first symptom onset. © 2017 Mac Keith Press.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2017-03-15

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

  11. METABOLIC SYNDROME IN PATIENTS WITH PSYCHOTIC DISORDERS: diagnostic issues, comorbidity and side effects of antipsychotics

    OpenAIRE

    Kozumplik, Oliver; Uzun, Suzana; Jakovljević, Miro

    2010-01-01

    Background: Metabolic syndrome and other cardiovascular risk factors are highly prevalent in people with schizophrenia. Metabolic syndrome can contribute to significant morbidity and premature mortality and should be accounted for in the treatment of mental disorders. Along with results of numerous investigations regarding metabolic syndrome, different issues have occurred. The aim of this article is to review literature regarding diagnostic and treatment of metabolic syndrome and po...

  12. Isolated clinic hypertension: diagnostic criteria based on 24-h blood pressure definition.

    Science.gov (United States)

    Vinyoles, Ernest; Rodriguez-Blanco, Teresa; de la Sierra, Alejandro; Felip, Angela; Banegas, José R; de la Cruz, Juan J; Gorostidi, Manuel; Sobrino, Javier; Segura, Julián; Roca-Cusachs, Alex; Ruilope, Luís M

    2010-12-01

    The use of diagnostic criteria based on 24-h ambulatory blood pressure (BP) values could improve prognostic value by incorporating night BP, minimize biases and improve the diagnostic reproducibility of isolated clinic hypertension (ICH). We estimate the 24-h BP cut-off points that best discriminate and predict the two diagnostic thresholds of mean daytime BP for ICH (135/85 and 130/80 mmHg). Cross-sectional, comparative, multicentre study in 6176 untreated hypertensive patients, whose BP was measured by ambulatory BP monitoring. ICH was defined with an office BP of ≥140/≥90 mmHg and a daytime BP of <135/<85 mmHg (ICH1) or <130/80 mmHg (ICH2). Sensitivity, specificity, positive likelihood ratio (LR+), odds ratio (OR), error rate, predictive values, κ values and 95% confidence interval were calculated for each possible cut-off point for ICH1 and ICH2. One thousand eight hundred and seven patients (29.2%) and 960 patients (15.5%) met ICH1 and ICH2 criteria, respectively. The 24-h BP cut-off points that best predict ICH1 and ICH2 are less than 132/82 mmHg (sensitivity: 93.6%, specificity: 94.3%, LR+: 16.6, OR: 1367.1, error rate: 5.9, κ 0.86) and less than 127/77 mmHg (sensitivity: 90.8%, specificity: 97.4%, LR+: 34.6, OR: 1041.5, error rate: 3.6,κ 0.86), respectively. These values achieved the best balance of sensitivity and specificity, together with the highest values of LR+ and OR and the lowest error rate. The 24-h BP cut-off point that best predicts the daytime criterion of less than 135/85 and less than 130/80 mmHg are 132/82 and 127/77 mmHg, respectively. These 24-h cut-off points may add value to ambulatory blood pressure monitoring for both diagnostic and management future decisions.

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

    Science.gov (United States)

    Gernhardt, Christian R

    2013-03-01

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

  14. [Difficulties in classifying body cavity fluids into transudate/ exudate depending on the various diagnostic criteria].

    Science.gov (United States)

    Koper, Olga M; Kamińska, Joanna; Pańkowska, Katarzyna; Matosek, Anna; Suchodoła, Edyta; Sprawka, Karolina; Tenderenda, Anna; Brania, Paulina; Statkiewicz, Agnieszka; Kemona, Halina

    2017-11-23

    Disease processes may impair the production and reabsorption of fluid from in the body cavities, which results in its excessive accumulation. The aim of the study was the evaluation of difficulties regarding the classification of fluids from the body cavities into transudate/exudate observing the following: Light's criteria, total fluid protein concentration, and total protein ratio (TP ratio) and lactate dehydrogenase ratio (LDH ratio). Retrospective analysis was conducted on pleural (N=314), peritoneal (N=114) and pericardial (N=10) fluids, which were tested for the total protein concentration and LDH activity both in fluid and serum and calculated on TP ratio and LDH ratio. Based on the total protein concentration, 278 fluids from pleural cavity were classified as an exudate; 36 as a transudate. Applying the Light's criteria 240 fluids were classified as an exudate; the remaining 74 fluids were classified as a transudate. Based on TP and LDH ratios, 229 fluids from pleural cavity were classified as an exudate; 85 as a transudate. Depending on the total protein concentration, 35 fluids from the peritoneal cavity were classified as an exudate; 79 as a transudate. Applying the Light's criteria 54 fluids were classified as an exudate; the remaining 60 fluids were classified as a transudate. Based on TP and LDH ratios, 22 fluids from peritoneal cavity were classified as an exudate; 92 as a transudate. Analysis of pericardial fluids, depending on the total protein concentration classified 9 of them as an exudate and 1 as a transudate. The same results were obtained by applying Light's criteria. Based on TP and LDH ratios, 7 fluids from pericardial cavity were classified as an exudate; 3 - as a transudate. Applying the Light's criteria or the total protein concentration in differential diagnostics of fluids from the body cavities resulted in qualification more of them as an exudates as compared to the analysis of the same fluids depending on the TP and LDH ratios. It

  15. Diagnostic Overlap between Fanconi Anemia and the Cohesinopathies: Roberts Syndrome and Warsaw Breakage Syndrome

    Directory of Open Access Journals (Sweden)

    Petra van der Lelij

    2010-01-01

    Full Text Available Fanconi anemia (FA is a recessively inherited disease characterized by multiple symptoms including growth retardation, skeletal abnormalities, and bone marrow failure. The FA diagnosis is complicated due to the fact that the clinical manifestations are both diverse and variable. A chromosomal breakage test using a DNA cross-linking agent, in which cells from an FA patient typically exhibit an extraordinarily sensitive response, has been considered the gold standard for the ultimate diagnosis of FA. In the majority of FA patients the test results are unambiguous, although in some cases the presence of hematopoietic mosaicism may complicate interpretation of the data. However, some diagnostic overlap with other syndromes has previously been noted in cases with Nijmegen breakage syndrome. Here we present results showing that misdiagnosis may also occur with patients suffering from two of the three currently known cohesinopathies, that is, Roberts syndrome (RBS and Warsaw breakage syndrome (WABS. This complication may be avoided by scoring metaphase chromosomes—in addition to chromosomal breakage—for spontaneously occurring premature centromere division, which is characteristic for RBS and WABS, but not for FA.

  16. Classification criteria of syndromes by latent variable models

    DEFF Research Database (Denmark)

    Petersen, Janne

    2010-01-01

    analyses. Part 1: HALS engages different phenotypic changes of peripheral lipoatrophy and central lipohypertrophy.  There are several different definitions of HALS and no consensus on the number of phenotypes. Many of the definitions consist of counting fulfilled criteria on markers and do not include......, although this is often desired. I have proposed a new method for predicting class membership that, in contrast to methods based on posterior probabilities of class membership, yields consistent estimates when regressed on explanatory variables in a subsequent analysis. There are four different basic models...... within latent variable models: factor analysis, latent class analysis, latent profile analysis and latent trait analysis. I have given a general overview of how to predict scores of latent variables so these can be used in subsequent regression models. Two different principles of predicting scores...

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

    Science.gov (United States)

    Krogh, Carmen ME

    2014-01-01

    Summary In an effort to address climate change, governments have pursued policies that seek to reduce greenhouse gases. Alternative energy, including wind power, has been proposed by some as the preferred approach. Few would debate the need to reduce air pollution, but the means of achieving this reduction is important not only for efficiency but also for health protection. The topic of adverse health effects in the environs of industrial wind turbines (AHE/IWT) has proven to be controversial and can present physicians with challenges regarding the management of an exposure to IWT. Rural physicians in particular must be aware of the possibility of people presenting to their practices with a variety of sometimes confusing complaints. An earlier version of the diagnostic criteria for AHE/IWT was published in August 2011. A revised case definition and a model for a study to establish a confirmed diagnosis is proposed. PMID:25383200

  18. Ancillary testing, diagnostic/classification criteria and severity grading in Behçet disease.

    Science.gov (United States)

    Okada, Annabelle A; Stanford, Miles; Tabbara, Khalid

    2012-12-01

    Since there is no pathognomonic clinical sign or laboratory test to distinguish Behçet disease from other uveitic entities, the diagnosis must be made based on characteristic ocular and systemic findings in the absence of evidence of other disease that can explain the findings. Ancillary tests, including ocular and brain imaging studies, are used to assess the severity of intraocular inflammation and systemic manifestations of Behçet disease, to identify latent infections and other medical conditions that might worsen with systemic treatment, and to monitor for adverse effects of drugs used. There are two diagnostic or classification criteria in general use by the uveitis community, one from Japan and one from an international group; both rely on a minimum number and/or combination of clinical findings to identify Behçet disease. Finally, several grading schemes have been proposed to assess severity of ocular disease and response to treatment.

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

    Science.gov (United States)

    McMurtry, Robert Y; Krogh, Carmen Me

    2014-10-01

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

  20. Criteria of Clinical Diagnostics and Choice of Treatment Strategy in Children with Disoders of Sexual Development

    Directory of Open Access Journals (Sweden)

    N.V. Bolotova

    2010-03-01

    Full Text Available The number of patients with disorders of sexual development (DSD has increased in 3.54 times during the last three years. The aim is to define the structure of intersexual disorders in children from Saratov, criteria of gender assignment and surgical approach. During the period of three years (from 2006 till 2008 58 children with DSD aged 0 - 17 were examined. Assessment of external genitals, cytogenetic investigation, hormonal tests were performed. Imaging studies included ultrasonography, cystourethroscopy and laparoscopy with histological investigation. Considering the data DSD in children from Saratov compose sex chromosome DSD - 21,4 %, Gonadal dysgenesis - 26,2%, ovotesticular DSD - 2,3%, 46,ХХ testicular DSD - 2,3 %, complete androgen insensitivity syndrome - 4,7%. The criteria of gender assignment and surgical approach have been described in the article. The research concludes that the infants with intersexual genitels should be examined in special care centers by multispecialty team. It is nessesary to perform the karyotype test and ultrasonic study in newborns to detect the genetic and gonadal gender of the child

  1. The usefulness of ultrasound in the diagnostics of Sjögren’s syndrome

    Directory of Open Access Journals (Sweden)

    Fadhil Saied

    2013-06-01

    Full Text Available Sjögren’s syndrome is an autoimmune exocrinopathy which manifests itself with dryness of the eyes and the oral cavity. These symptoms comprise a so-called sicca syndrome (xerostomia and xerophthalmia. Two forms of this disease may be distinguished: primary Sjögren’s syndrome which affects salivary glands and secondary Sjögren’s syndrome with other autoimmune diseases present such as rheumatoid arthritis, systemic lupus erythematosus or systemic scleroderma. The diagnosis is based on the classification criteria established in 2002 by a group of American and European scientists (American-European Consensus Group, which involve the interview and physical examination as well as serological, histopathological and radiological tests. Most of these examinations show some limitations such as invasiveness, expensiveness or limited accessibility. The latest research suggests that ultrasound examination may appear promising in the diagnostics of the main salivary glands: submandibular and parotid glands. It is an accessible and relatively cheap examination with high sensitivity and specificity values which are comparable to those obtained via conventional means used in the diagnostics of this disease, i.e. biopsy of the minor salivary glands, sialography and scintigraphy, as well as superior to those obtained in sialometry and Schirmer’s test. Additionally, ultrasonography correlates with the results of magnetic resonance imaging. Therefore, a number of authors claim that US examination should be included in the classification criteria of Sjögren’s syndrome. The aim of this article is to present the diagnostic capacity of the US examination in Sjögren’s syndrome using the current ultrasound classification systems based on the grey-scale, Doppler and contrast-enhanced examinations. The latest research confirms that the most valuable diagnostic criterion in Sjögren’s syndrome is the heterogeneity of the

  2. Diagnostic accuracy of modified kenneth jones scoring criteria (mkjsc) in confirmed cases of tuberculosis in children

    International Nuclear Information System (INIS)

    Farid, A.; Iqbal, S.M.J.; Hanif, A.

    2013-01-01

    Background: Tuberculosis (TB) is a granulomatous disease caused by Mycobacterium tuberculosis. The gold standard for the diagnosis of tuberculosis is detection of Mycobacterium tubercle bacilli. However, clinical scoring systems are most widely used for the diagnosis of TB in children. Objective: To determine the diagnostic accuracy of modified Kenneth Jones scoring criteria (MKJSC) in conformed cases of tuberculosis. Methodology: This cross-sectional comparative study was conducted in the department of Paediatrics, King Edward Medical University / Mayo Hospital, Lahore from January to June 2007. One hundred children below 15 years of age were enrolled. They were diagnosed as suspected cases of TB on the basis of fever and cough for more than 15 days. MKJSC was applied and each child was subjected to confirmatory test for TB. Results: There was an overall male preponderance of 54%. The mean age of study population was 1.8 +- 0.7 years. Out of 100 children, 66% were diagnosed as TB cases (23 with confirmatory tests and 43 with MKJSC of 5 or more). Sensitivity, specificity, positive and negative predictive value of MKJSC was 73.91%, 44.16%, 28.33%, and 85% respectively. Diagnostic accuracy of MKJSC was 51%. Conclusion: Present study does not support the hypothesis that MKJSC is a good alternative to confirmatory tests to diagnose tuberculosis in children. However, MKJSC is a simple tool, which can be applied to improve the case detection rate in the absence of sophisticated tests. (author)

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

    Science.gov (United States)

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

    2014-01-01

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

  4. Efficacy of clinical diagnostic criteria for familial hypercholesterolemia genetic testing in Poland.

    Science.gov (United States)

    Mickiewicz, Agnieszka; Chmara, Magdalena; Futema, Marta; Fijalkowski, Marcin; Chlebus, Krzysztof; Galaska, Rafał; Bandurski, Tomasz; Pajkowski, Marcin; Zuk, Monika; Wasag, Bartosz; Limon, Janusz; Rynkiewicz, Andrzej; Gruchala, Marcin

    2016-06-01

    Familial hypercholesterolemia (FH), which leads to premature cardiovascular events, still remains underrecognized and undertreated in most countries. Untreated FH individuals aged 20-39 years are at 100-fold higher risk of mortality from coronary heart disease compared to those of a general population. Therefore, special efforts should be implemented to diagnose FH patients at early stages of life. The aim of this study was to evaluate the efficacy of the revised Dutch Lipid Clinic Network (DLCN) criteria proposed by the Polish Lipid Experts Forum to select index FH patients for DNA mutational analysis in Poland. The study included 193 unrelated adult patients (mean age 48 ± 13 years) with clinical diagnosis of FH based on the revised DLCN score, tested sequentially for mutations in LDLR and APOB genes using bidirectional Sanger sequencing and MLPA techniques. The cut-off points of the clinical FH criteria score were assessed by ROC statistics to identify patients with the highest probability of carrying an FH-causing mutation. The causal heterozygous LDLR or APOB mutation was identified in 41% (80/193) of probands. Adults aged <40 years were more likely to carry an FH-causing mutation compared to subjects aged ≥40 years (65% vs. 33%; p < 0.001). LDL-C thresholds for the molecular diagnosis of FH were 5.79 mmol/l for individuals aged<40 and 6.7 mmol/l for subjects ≥40 years old. The threshold values of the clinical diagnostic score for efficient selection of patients for genetic testing were 5 and 7 points for individuals aged <40 and ≥40 years, respectively. The study validated the efficacy of proposed clinical FH criteria for the disease diagnosis in Poland. The clinical criteria score thresholds for positive FH molecular diagnosis differ depending on age (<40 and ≥40 years). We propose that in the healthcare systems with limited genetic testing resources individuals younger than 40 years, who fulfill the clinical criteria for possible

  5. Guidelines and algorithms: strategies for standardization of referral criteria in diagnostic radiology

    International Nuclear Information System (INIS)

    Kainberger, Franz; Pokieser, Peter; Imhof, Herwig; Czembirek, Heinrich; Fruehwald, Franz

    2002-01-01

    Guidelines can be regarded as special forms of algorithms and have been shown to be useful tools for supporting medical decision making. With the Council Directive 97/43/Euratom recommendations concerning referral criteria for medical exposure have to be implemented into national law of all EU member states. The time- and cost-consuming efforts of developing, implementing, and updating such guidelines are balanced by the acceptance in clinical practice and eventual better health outcomes. Clearly defined objectives with special attention drawn on national and regional differences among potential users, support from organisations with expertise in evidence-based medicine, separated development of the evidence component and the recommendations component, and large-scale strategies for distribution and implementation are necessary. Editors as well as users of guidelines for referral criteria have to be aware which expectations can be met and which cannot be fulfilled with this instrument; thus, dealing with guidelines requires a new form of ''diagnostic reasoning'' based on medical ethics. (orig.)

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

    Science.gov (United States)

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

    2016-01-01

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

  7. [Sjögren's syndrome (SS), a review of the subject and saliva as a diagnostic method].

    Science.gov (United States)

    Riega-Torres, Janett Carmen Luzmila; Villarreal-Gonzalez, Antonio Jaime; Ceceñas-Falcon, Luis Ángel; Salas-Alanis, Julio Cesar

    2016-01-01

    Sjögren's syndrome is a chronic autoimmune disease whose main clinical manifestation is oral dryness (xerostomia) and ocular dryness (xerophthalmia). It is characterized by progressive mononuclear infiltration of the exocrine glands and can affect a variety of organ systems. The prevalence of primary Sjögren's syndrome varies from 0.01 up to 4.8%; this variability reflects differences in definition, application of diagnostic criteria, and geographic differences in age groups. The etiology of primary Sjögren's syndrome is unknown, but the interaction between genetic and environmental factors (viruses, hormones, vitamins, stress) is important. There are few reported cases of concordance in monozygotic twins, and it is common for patients with primary Sjögren's syndrome to have relatives with other autoimmune diseases such as systemic lupus erythematosus, rheumatoid arthritis, thyroid disease, psoriasis, and multiple sclerosis. Among the most common findings is hypergammaglobulinemia. Elevated levels of γ-globulins contain autoantibodies directed against nonspecific antigens such as rheumatoid factor, antinuclear antibodies, and cellular antigens SS-A/Ro and SS-B/La. Regarding diagnosis, there have been 11 different published criteria for Sjögren's syndrome since 1965; none have been approved by the American College of Rheumatology or the European League Against Rheumatism. The current criteria were published in 2012 jointly with the progressive advance in the knowledge of the human salivary proteome that has gained wide acceptance in Sjögren's syndrome, with the possibility of using saliva as a useful tool in both diagnosis and prognosis in this field because the analysis of salivary proteins may reflect the state of locally underlying disease of the salivary glands, which are the target organs in this disease.

  8. Diagnostic Utility of Neuregulin for Acute Coronary Syndrome

    Directory of Open Access Journals (Sweden)

    Maame Yaa A. B. Yiadom

    2016-01-01

    Full Text Available The purpose of this study was to determine the diagnostic test characteristics of serum neuregulin-1β (NRG-1β for the detection of acute coronary syndrome (ACS. We recruited emergency department patients presenting with signs and symptoms prompting an evaluation for ACS. Serum troponin and neuregulin-1β levels were compared between those who had a final discharge diagnosis of myocardial infarction (STEMI and NSTEMI and those who did not, as well as those who more broadly had a final discharge diagnosis of ACS (STEMI, NSTEMI, and unstable angina. Of 319 study participants, 11% had evidence of myocardial infarction, and 19.7% had a final diagnosis of ACS. Patients with MI had median neuregulin levels of 0.16 ng/mL (IQR [0.16–24.54]. Compared to the median of those without MI, 1.46 ng/mL (IQR [0.16–15.02], there was no significant difference in the distribution of results (P=0.63. Median neuregulin levels for patients with ACS were 0.65 ng/mL (IQR [0.16–24.54]. There was no statistical significance compared to those without ACS who had a median of 1.40 ng/mL (IQR [0.16–14.19] (P=0.95. Neuregulin did not perform successfully as a biomarker for acute MI or ACS in the emergency department.

  9. Epidemiology of general joint hypermobility and basis for the proposed criteria for benign joint hypermobility syndrome: review of the literature

    DEFF Research Database (Denmark)

    Remvig, Lars; Jensen, Dorte V; Ward, Robert C

    2007-01-01

    This literature review of generalized joint hypermobility (GJH) syndromes discusses information regarding sex-, age-, and race-related factors from publications that specifically document validated GJH criteria.......This literature review of generalized joint hypermobility (GJH) syndromes discusses information regarding sex-, age-, and race-related factors from publications that specifically document validated GJH criteria....

  10. A Positive Diagnostic Strategy Is Noninferior to a Strategy of Exclusion for Patients With Irritable Bowel Syndrome

    DEFF Research Database (Denmark)

    Begtrup, Luise M; Engsbro, Anne Line; Kjeldsen, Jens

    2013-01-01

    BACKGROUND & AIMS: Guidelines recommend a positive strategy based on symptom criteria to diagnose patients with irritable bowel syndrome (IBS). We conducted a randomized noninferiority trial to determine whether a positive diagnostic strategy is noninferior to a strategy of exclusion, with regard...... by a strategy of exclusion (analyses of blood, stool samples for intestinal parasites, and sigmoidoscopies with biopsies) or a positive strategy (analyses of blood cell count and C-reactive protein). Patients were followed for 1 year. The primary end point was difference in change of HRQOL from baseline to 1...

  11. Diagnostic value of mean platelet volume (MPV) to troponin T inpatients with acute coronary syndrome

    Science.gov (United States)

    Aryanto, D.; Isnanta, R.; Safri, Z.; Hasan, R.

    2018-03-01

    Acute Coronary Syndrome (ACS) is used to describe the spectrum of coronary artery disease (CAD). Troponin T is the determinant of the most sensitive marker of ACS, but there aren’t all hospitals have this because of expensiveness. Mean Platelet Volume (MPV) is one of the components of a complete blood routine examination and relatively cheap as a marker in ACS. Determining the sensitivity and specificity of MPV in detecting cases of the acute coronary syndrome, 325 subjects’ medical records were from the period of July 2013 to June 2014; 228 ACS patients met the inclusion criteria. 228 subjects showed a risk factor for age ≥45years of more 195 (85.5%). 122 subjects with hypertension (53.5%) and subjects who smoked 118 (51.8%) that suffered most ACS. Subjects with risk factors for diabetes mellitus, obesity, menopause and dyslipidemia in this study was lower than non-diabetic 161 (70.6%), obese189 (82.9%), nonmenopause 196 (86%) and normal lipid 210 (92.1%). But there was norelation between risk factor with MPV and troponin T statistically. The results of diagnostic tests MPV for the evaluation of patients with ACS, sensitivity 92%, specificity 71%, positive predictive value 95% and negative predictive value 58%.

  12. Complex Regional Pain Syndrome: Practical Diagnostic and Treatment Guidelines, 4th Edition

    NARCIS (Netherlands)

    Harden, R.; Oaklander, A.L.; Burton, A.W.; Perez, R.S.G.M.; Richardson, K.; Swan, M.; Barthel, J.; Costa, B.; Graciosa, J.R.; Bruehl, S.

    2013-01-01

    Objective: This is the fourth edition of diagnostic and treatment guidelines for complex regional pain syndrome (CRPS; aka reflex sympathetic dystrophy). Methods: Expert practitioners in each discipline traditionally utilized in the treatment of CRPS systematically reviewed the available and

  13. Diagnostic Value of Ultrasound Compared to Electro Diagnosis in Carpal Tunnel Syndrome

    Directory of Open Access Journals (Sweden)

    Seyed Mansour Rayegani

    2014-10-01

    Full Text Available Introduction: Carpal Tunnel Syndrome (CTS is one of the main causes of disability. The diagnosis of CTS confirm by electrodiagnostic tests. Sonography is an alternative method for diagnosis of CTS that can investigate anatomy and probable pathology. The aim of this study is to investigate the multiple sonographic diagnostic criteria and compare its diagnostic value with electrodiagnosis. Materials and Methods:In this descriptive-cross sectional study, 84 wrists (42 patients with CTS and 42 individuals without any clinical signs in upper limb were investigated. Symptomatic patients underwent clinical examination, standard electrodiagnostic evaluation of upper limb and sonographic investigation of median nerve in forearm and wrist. The control group underwent sonographic investigation. Results: Cross Sectional Area (CSA of Median nerve at distal wrist crease, at the level of Hamate hook and Trapezium, the amount of flexor retinaculum bowing, ratio of CSA at the forearm to distal wrist crease and ratio of CSA at the Pisiform level to distal wrist crease had significant difference in the case group compared to the control group (P-value

  14. Metabolic consequences of obesity and insulin resistance in polycystic ovary syndrome: diagnostic and methodological challenges.

    Science.gov (United States)

    Jeanes, Yvonne M; Reeves, Sue

    2017-06-01

    Women with polycystic ovary syndrome (PCOS) have a considerable risk of metabolic dysfunction. This review aims to present contemporary knowledge on obesity, insulin resistance and PCOS with emphasis on the diagnostic and methodological challenges encountered in research and clinical practice. Variable diagnostic criteria for PCOS and associated phenotypes are frequently published. Targeted searches were conducted to identify all available data concerning the association of obesity and insulin resistance with PCOS up to September 2016. Articles were considered if they were peer reviewed, in English and included women with PCOS. Obesity is more prevalent in women with PCOS, but studies rarely reported accurate assessments of adiposity, nor split the study population by PCOS phenotypes. Many women with PCOS have insulin resistance, though there is considerable variation reported in part due to not distinguishing subgroups known to have an impact on insulin resistance as well as limited methodology to measure insulin resistance. Inflammatory markers are positively correlated with androgen levels, but detailed interactions need to be identified. Weight management is the primary therapy; specific advice to reduce the glycaemic load of the diet and reduce the intake of pro-inflammatory SFA and advanced glycation endproducts have provided promising results. It is important that women with PCOS are educated about their increased risk of metabolic complications in order to make timely and appropriate lifestyle modifications. Furthermore, well-designed robust studies are needed to evaluate the mechanisms behind the improvements observed with dietary interventions.

  15. Diagnostic performance of Contrast-enhanced CT in Pyrrolizidine Alkaloids-induced Hepatic Sinusoidal Obstructive Syndrome

    Science.gov (United States)

    Kan, Xuefeng; Ye, Jin; Rong, Xinxin; Lu, Zhiwen; Li, Xin; Wang, Yong; Yang, Ling; Xu, Keshu; Song, Yuhu; Hou, Xiaohua

    2016-01-01

    Hepatic sinusoidal obstruction syndrome (HSOS) can be caused by pyrrolizidine alkaloids(PAs)-containing herbals. Since PAs exposure is obscure and clinical presentation of HSOS is unspecific, it is challenge to establish the diagnosis of PAs-induced HSOS. Gynura segetum is one of the most wide-use herbals containing PAs. The aim of our study is to describe the features of contrast-enhanced computed tomography (CT) in gynura segetum-induced HSOS, and then determine diagnostic performance of radiological signs. We retrospectively analyzed medical records and CT images of HSOS patients (71 cases) and the controls (222 cases) enrolled from January 1, 2008, to Oct 31, 2015. The common findings of contrast CT in PAs-induced HSOS included: ascites (100%), hepatomegaly (78.87%), gallbladder wall thickening (86.96%), pleural effusion (70.42%), hepatic vein narrowing (87.32%), patchy liver enhancement (92.96%), and heterogeneous hypoattenuation (100%); of these signs, patchy enhancement and heterogeneous hypoattenuation were valuable features. Then, the result of diagnostic performance demonstrated that contrast CT possessed better performance in diagnosing PAs-induced HSOS compared with various parameters of Seattle criteria. In conclusion, the patients with PAs-induced HSOS display distinct radiologic features at CT-scan, which reveals that contrast-enhanced CT provides an effective noninvasive method for diagnosing PAs-induced HSOS. PMID:27897243

  16. Metabolic syndrome and left ventricular function: Is the number of criteria actually important?

    Science.gov (United States)

    Tadic, Marijana; Ivanovic, Branislava; Kostic, Nada; Simic, Dragan; Matic, Danica; Celic, Vera

    2012-01-01

    Summary Background Metabolic syndrome (MS) is a clustering of cardiovascular risk factors responsible for the development of target organ damage. The aim of this study was to determine the effect of the increasing number of MS risk factors on left ventricular function assessed by noninvasive methods. Material/Methods The study included 204 subjects with MS and 76 controls with no MS risk factors. MS was defined by the presence of 3 or more of ATP-NCEP III criteria. MS subjects were grouped according to the number of criteria they fulfilled: 3 criteria (n=91), 4 criteria (n=65) and 5 criteria (n=48). All subjects underwent laboratory blood tests, complete 2-dimensional, pulse and tissue Doppler echocardiography. Echocardiography was used to assess systolic (LVEF, sseptal), diastolic function, by pulse-wave Doppler (E/A ratio) and tissue Doppler imaging (E/e′average), and global left ventricular function (Tei index). Appropriate time intervals for the estimation of the Tei index were obtained by tissue Doppler. Results Transmitral E/A ratio decreased significantly and progressively from the 3 criteria to the 5 criteria group (0.82±0.25 vs. 0.79±0.24 vs. 0.67±0.14, p<0.001). The transmitral E/E′average ratio was significantly and gradually increased from the 3 criteria to the 5 criteria group (7.76±1.81 vs. 9.44±2.35 vs. 10.82±2.56, p<0.001). The left ventricle Tei index progressively increased from the 3 criteria to the 5 criteria group (0.43±0.11 vs. 0.48±0.10 vs. 0.54±0.12, p<0.001). Conclusions The increasing number of MS criteria is associated with cardiac diastolic dysfunction. PMID:22534707

  17. A comparison of DSM-5 and DSM-IV diagnostic criteria for posttraumatic stress disorder in traumatized refugees

    OpenAIRE

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

    2015-01-01

    The aim of this study was to compare the prevalence rate and factor structure of posttraumatic stress disorder (PTSD) based on the diagnostic criteria of the fourth and fifth editions of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV; DSM-5; American Psychiatric Association, , ) in traumatized refugees. There were 134 adult treatment-seeking, severely and multiply traumatized patients from various refugee backgrounds were assessed in their mother tongue using a computerized...

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

    Science.gov (United States)

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

    2014-01-01

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

  19. Diagnostic Criteria for Problematic Internet Use among U.S. University Students: A Mixed-Methods Evaluation

    OpenAIRE

    Li, Wen; O?Brien, Jennifer E.; Snyder, Susan M.; Howard, Matthew O.

    2016-01-01

    Empirical studies have identified increasing rates of problematic Internet use worldwide and a host of related negative consequences. However, researchers disagree as to whether problematic Internet use is a subtype of behavioral addiction. Thus, there are not yet widely accepted and validated diagnostic criteria for problematic Internet use. To address this gap, we used mixed-methods to examine the extent to which signs and symptoms of problematic Internet use mirror DSM-5 diagnostic criteri...

  20. Neurofibromatosis type 2 (NF 2) or schwannomatosis?--Case report study and diagnostic criteria.

    Science.gov (United States)

    Radek, Maciej; Tomasik, Bartłomiej; Wojdyn, Maciej; Snopkowska-Wiaderna, Dorota; Błaszczyk, Maciej; Radek, Andrzej

    2016-01-01

    Neurofibromatosis type 2 (NF2) and schwannomatosis are entities that may, due to the similarity of clinical symptoms, cause diagnostic difficulties. Incidence rate of both diseases is similar and estimated between 1:25,000 and 1:40,000. The genes associated with the development of the aforementioned disorders are located on chromosome 22 and lay in proxmity. Schwannomatosis is characterized by an incomplete penetrance and the risk of its transmission to the offspring is significantly lower than in the case of NF 2. Schwannomatosis clinical characteristic is similar to the NF2, however vestibular schwannomas are not present. Therefore the imaging studies evaluated by an experienced radiologist play a key role in the diagnostic process. Forty two-year-old female hospitalized three times because of the tumors of the spinal canal was admitted to the Department of Neurosurgery and Peripheral Nerve Surgery in 2008 because of the cervical pain syndrome with concomitant headache. She was diagnosed with a schwannomatosis, recently distinguished, the third form of neurofibromatosis. MRI imaging revealed craniocervical junction tumor. Suboccipital craniectomy with concomitant C1-C2 laminectomy was done in order to remove the lesion. After the surgery the patient did not present any deficits in neurological examination and was discharged from hospital in good general condition. The patient was diagnosed with schwannomatosis, recently established neurofibromatosis entity which may resemble NF2 clinically. In patients after the age of 30, in whom we observe multiple schwannomas without the concomitant hearing impairment, the diagnosis of schwannomatosis is very likely. Copyright © 2016 Polish Neurological Society. Published by Elsevier Urban & Partner Sp. z o.o. All rights reserved.

  1. [Waardenburg syndrome--ophthalmic findings and criteria for diagnosis: case reports].

    Science.gov (United States)

    Nasser, Luciano Sólia; Paranaíba, Lívia Maris Ribeiro; Frota, Ana Cláudia; Gomes, Andreia; Versiani, Gisele; Martelli Júnior, Hercílio

    2012-10-01

    To describe the clinical and imaginological features of two families with Waardenburg syndrome: type I and II, with emphasis on ophthalmic manifestations, as well as the pattern of genetic inheritance. We conducted a clinical study involving two families affected by Waardenburg syndrome, and through the pedigree, determined the present pattern of genetic inheritance. Analyses were performed including the measurement of visual acuity, the presence of dystopia cantorum (telecanthus), evaluation of iris color and retinal mapping, as well as dermatological and otological examinations. The pedigree of the family affected by the Waardenburg syndrome type I showed an autosomal dominant mode of transmission. The syndrome was present at 85.71% of patients. The dystopia cantorum was the most frequent feature, followed by the white streak on the skin of the forehead, hypopigmentation of the iris and retina and deafness. The Waardenburg syndrome family type II had 33.33% of family members affected by the syndrome. No member had dystopia cantorum and hypopigmentation of the iris. Three patients had sensorineural hearing loss (12.5%), associated with white forelock and achromatic spots confluent by the body. This study shows the importance of the ophthalmologist in aiding the diagnosis of this rare genetic condition, since it includes ocular disorders such as telecanthus, hypopigmentation of the iris and retina. The cantorum dystopia is the main diagnostic criterion to differentiate type I and II syndrome and should be done by a trained ophthalmologist. The families are in medical monitoring, receiving genetic guidelines and care related to eye protection.

  2. Differential diagnosis and diagnostic flow chart of joint hypermobility syndrome/ehlers-danlos syndrome hypermobility type compared to other heritable connective tissue disorders.

    Science.gov (United States)

    Colombi, Marina; Dordoni, Chiara; Chiarelli, Nicola; Ritelli, Marco

    2015-03-01

    Joint hypermobility syndrome/Ehlers-Danlos syndrome hypermobility type (JHS/EDS-HT) is an evolving and protean disorder mostly recognized by generalized joint hypermobility and without a defined molecular basis. JHS/EDS-HT also presents with other connective tissue features affecting a variety of structures and organs, such as skin, eye, bone, and internal organs. However, most of these signs are present in variable combinations and severity in many other heritable connective tissue disorders. Accordingly, JHS/EDS-HT is an "exclusion" diagnosis which needs the absence of any consistent feature indicative of other partially overlapping connective tissue disorders. While both Villefranche and Brighton criteria include such an exclusion as a mandatory item, a systematic approach for reaching a stringent clinical diagnosis of JHS/EDS-HT is still lacking. The absence of a consensus on the diagnostic approach to JHS/EDS-HT concerning its clinical boundaries with similar conditions contribute to limit our actual understanding of the pathologic and molecular bases of this disorder. In this review, we revise the differential diagnosis of JHS/EDS-HT with those heritable connective tissue disorders which show a significant overlap with the former and mostly include EDS classic, vascular and kyphoscoliotic types, osteogenesis imperfecta, Marfan syndrome, Loeys-Dietz syndrome, arterial tortuosity syndrome, and lateral meningocele syndrome. A diagnostic flow chart is also offered with the attempt to support the less experienced clinician in stringently recognizing JHS/EDS-HT and stimulate the debate in the scientific community for both management and research purposes. © 2015 Wiley Periodicals, Inc.

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

    Directory of Open Access Journals (Sweden)

    Kazuichi Okazaki

    2012-01-01

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

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

    Directory of Open Access Journals (Sweden)

    L.A. Ivanova

    2016-04-01

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

  5. Ovarian borderline tumors in the 2014 WHO classification: evolving concepts and diagnostic criteria.

    Science.gov (United States)

    Hauptmann, Steffen; Friedrich, Katrin; Redline, Raymond; Avril, Stefanie

    2017-02-01

    Borderline ovarian tumors (BOT) are uncommon but not rare epithelial ovarian neoplasms, intermediate between benign and malignant categories. Since BOT were first identified >40 years ago, they have inspired controversies disproportionate to their incidence. This review discusses diagnostic criteria for the histologic subtypes of BOT, highlighting areas of diagnostic challenges, ongoing controversies, and changes in terminology implemented by the recent 2014 WHO Classification of Tumours of the Female Genital Organs. Emerging knowledge supports the notion that subtypes of borderline ovarian tumors comprise distinct biologic, pathogenetic, and molecular entities, precluding a single unifying concept for BOT. Serous borderline tumors (SBT) share molecular and genetic alterations with low-grade serous carcinomas and can present at higher stages with peritoneal implants and/or lymph node involvement, which validates their borderline malignant potential. All other (non-serous) subtypes of BOT commonly present at stage I confined to the ovary(ies) and are associated with overall survival approaching that of the general population. An important change in the WHO 2014 classification is the new terminology of non-invasive implants associated with SBT, as any invasive foci (previously called "invasive implants") are now in line with their biological behavior considered peritoneal low-grade serous carcinoma (LGSC). The controversy regarding the terminology of non-serous borderline tumors, called by some pathologists "atypical proliferative tumor" in view of their largely benign behavior, has not been resolved. The concepts of intraepithelial carcinoma and microinvasion may evolve in further studies, as their presence appears to have no prognostic impact and is subject to considerable inter-observer variability.

  6. Mutations in STAT3 and diagnostic guidelines for hyper-IgE syndrome.

    Science.gov (United States)

    Woellner, Cristina; Gertz, E Michael; Schäffer, Alejandro A; Lagos, Macarena; Perro, Mario; Glocker, Erik-Oliver; Pietrogrande, Maria C; Cossu, Fausto; Franco, José L; Matamoros, Nuria; Pietrucha, Barbara; Heropolitańska-Pliszka, Edyta; Yeganeh, Mehdi; Moin, Mostafa; Español, Teresa; Ehl, Stephan; Gennery, Andrew R; Abinun, Mario; Breborowicz, Anna; Niehues, Tim; Kilic, Sara Sebnem; Junker, Anne; Turvey, Stuart E; Plebani, Alessandro; Sánchez, Berta; Garty, Ben-Zion; Pignata, Claudio; Cancrini, Caterina; Litzman, Jiri; Sanal, Ozden; Baumann, Ulrich; Bacchetta, Rosa; Hsu, Amy P; Davis, Joie N; Hammarström, Lennart; Davies, E Graham; Eren, Efrem; Arkwright, Peter D; Moilanen, Jukka S; Viemann, Dorothee; Khan, Sujoy; Maródi, László; Cant, Andrew J; Freeman, Alexandra F; Puck, Jennifer M; Holland, Steven M; Grimbacher, Bodo

    2010-02-01

    The hyper-IgE syndrome (HIES) is a primary immunodeficiency characterized by infections of the lung and skin, elevated serum IgE, and involvement of the soft and bony tissues. Recently, HIES has been associated with heterozygous dominant-negative mutations in the signal transducer and activator of transcription 3 (STAT3) and severe reductions of T(H)17 cells. To determine whether there is a correlation between the genotype and the phenotype of patients with HIES and to establish diagnostic criteria to distinguish between STAT3 mutated and STAT3 wild-type patients. We collected clinical data, determined T(H)17 cell numbers, and sequenced STAT3 in 100 patients with a strong clinical suspicion of HIES and serum IgE >1000 IU/mL. We explored diagnostic criteria by using a machine-learning approach to identify which features best predict a STAT3 mutation. In 64 patients, we identified 31 different STAT3 mutations, 18 of which were novel. These included mutations at splice sites and outside the previously implicated DNA-binding and Src homology 2 domains. A combination of 5 clinical features predicted STAT3 mutations with 85% accuracy. T(H)17 cells were profoundly reduced in patients harboring STAT3 mutations, whereas 10 of 13 patients without mutations had low (1000IU/mL plus a weighted score of clinical features >30 based on recurrent pneumonia, newborn rash, pathologic bone fractures, characteristic face, and high palate. Probable: These characteristics plus lack of T(H)17 cells or a family history for definitive HIES. Definitive: These characteristics plus a dominant-negative heterozygous mutation in STAT3. Copyright 2010 American Academy of Allergy, Asthma & Immunology. Published by Mosby, Inc. All rights reserved.

  7. Neonatal abstinence syndrome: Diagnostic dilemmas in the maternity ward

    Directory of Open Access Journals (Sweden)

    Lazić-Mitrović Tanja

    2015-01-01

    Full Text Available Introduction. Neonatal abstinence syndrome (NAS refers to a newborn neurological, gastrointestinal and/or respiratory disorder if a newborn was exposed to psychoactive substances in the intrauterine period. NAS is difficult to diagnose due to unreliability of the data on addictive substances use during pregnancy, limited possibilities of the prenatal exposure diagnosis and postnatal substance detection, which all lead to diagnostic dilemmas. Objective. The aim of this study was to indicate the problems in patients with early NAS diagnosis in the maternity ward and the importance of clinical presentation used as a guide toward the diagnosis. Methods. This retrospective study included five term eutrophic newborns with high Apgar score, good adaptation in the first day and with clinical presentation of NAS during the second day of life. The clinical presentation was dominated by irritability, increased wakefulness, increased muscle tone, shrilly crying, tremors, problems with accepting food, tachypnea, subfebrility and hyperhidrosis. Finnegan scale was introduced in order to diagnose NAS and apply the therapy. Single-medication therapy of phenobarbitone was applied in four cases and a combination of phenobarbitone and morphine in one case. For toxicological analysis newborns’ urine samples were used. Results. Conditions such as perinatal asphyxia, infection, hunger, polycythemia, hypoglycemia or hypocalcemia were excluded. Finnegan score implied that pharmacological treatment had to be administered. The discrepancy between the NAS anamnesis and toxicological analysis existed. Response to the treatment was positive in all cases. Conclusion. NAS is a multisystemic disorder and should be suspected when it is noticed that children exhibit characteristic signs. However, other pathological conditions have to be excluded. Quantification according to the adopted scales for NAS leads toward appropriate treatment and recovery of the newborns.

  8. The diagnostic value of the EEG in Angelman and Rett syndrome at a young age

    NARCIS (Netherlands)

    Laan, LAEM; Brouwer, OF; Begeer, CH; Zwinderman, AH; van Dijk, JG

    We determined the diagnostic value of the EEG in young children with Angelman syndrome (AS) and Rett syndrome (RS). EEGs, recorded before 5 years of age, of 10 patients with AS, 10 with RS and 10 with mental retardation of other origin were studied blindly by two examiners for the presence of the

  9. Metabolic syndrome in Mexican children: Low effectiveness of diagnostic definitions.

    Science.gov (United States)

    Peña-Espinoza, Barbara Itzel; Granados-Silvestre, María de Los Ángeles; Sánchez-Pozos, Katy; Ortiz-López, María Guadalupe; Menjivar, Marta

    Early identification of children with metabolic syndrome (MS) is essential to decrease the risk of developing diabetes and cardiovascular disease in adulthood. Detection of MS is however challenging because of the different definitions for diagnosis; as a result, preventive actions are not taken in some children at risk. The study objective was therefore to compare prevalence of MS in children according to the IDF, NCEP-ATP-III, Cook, de Ferranti and Weiss definitions, considering insulin resistance (IR) markers such as HOMA-IR and/or metabolic index (MI). A total of 508 Mexican children (aged 9 to 13 years) from seven schools were enrolled in a cross-sectional study. Somatometric, biochemical, and hormonal measurements were evaluated. Frequency of MS was 2.4-45.9% depending on the definition used. Frequency of IR in children not diagnosed with MS was 12.4-25.2% using HOMA-IR and 4.0-16.3% using MI. When HOMA-IR or MI was included in each of the definitions, frequency of MS was 8.5-50.2% and 7.7-46.9% respectively. The kappa value including HOMA-IR and/or MI was greater than 0.8. This study demonstrated the poor effectiveness of the current criteria used to diagnose MS in Mexican children, as shown by the variability in the definitions and by the presence of IR in children who not diagnosed with MS. Inclusion of HOMA-IR and/or MI in definitions of MS (thus increasing agreement between them) decreases the chance of excluding children at risk and allows for MS prevalence between populations. Copyright © 2017 SEEN y SED. Publicado por Elsevier España, S.L.U. All rights reserved.

  10. EFFICACY AND SAFETY OF ACCELERATED DIAGNOSTIC PROTOCOL USE IN PATIENTS WITH SUSPECTED ACUTE CORONARY SYNDROME

    Directory of Open Access Journals (Sweden)

    O. V. Baturina

    2014-01-01

    Full Text Available The use of modern accelerated diagnostic protocols in patients with suspected acute coronary syndrome is discussed. Evidence base that can give occasion to selection of acceptable accelerated diagnostic protocol for safe exclusion of acute myocardial infarction early after seeking medical attention is presented. Advantages and disadvantages of certain protocols are discussed.

  11. Shoulder impingement syndrome: a systematic review of clinical trial participant selection criteria.

    Science.gov (United States)

    Watts, Amy R; Williams, Ben; Kim, Susan W; Bramwell, Donald C; Krishnan, Jeganath

    2017-01-01

    Shoulder impingement syndrome (SIS) is a common diagnosis for patients with pain and dysfunction of the shoulder. Variations in the signs and symptoms might lead to uncertainty regarding the definition of SIS. The aim of this review is to explore the participant selection criteria used in the literature when investigating SIS and to assess differences in criteria among treating professions. This is a PRISMA systematic review of publications from 2009 to 2014 from MEDLINE, PubMed, The Cochrane Library, Embase, Scopus and CINAHL. Ninety-seven articles met inclusion criteria for this review. Twenty-five different surgical and nonsurgical treatments were investigated. Impingement-specific index tests were used in all studies. Exclusion index tests were used in 62% of studies. Twenty index tests were identified. Radiological investigations were reported in 53% of all studies, of which a further 53% reported using two or more radiological investigations. This systematic review has illustrated that studies investigating SIS test for various signs and symptoms, which is in keeping with describing the condition as a 'syndrome'. However, there are inconsistencies in participant selection criteria between health disciplines, highlighting a need for harmonization of the selection criteria in the form of an international editorial consensus.

  12. Tourette's: syndrome, disorder or spectrum? Classificatory challenges and an appraisal of the DSM criteria.

    Science.gov (United States)

    Robertson, Mary May; Eapen, Valsamma

    2014-10-01

    The fifth version of the Diagnostic and statistical manual of mental disorders (DSM-5) was released in May 2013 after 14 years of development and almost two decades after the last edition DSM-IV was published in 1994. We review the DSM journey with regards to Tourette Syndrome from the original publication of DSM 1 in 1952 till date. In terms of changes in DSM 5, the major shift has come in the placement of Tourette Syndrome under the 'Neurodevelopmental Disorders' alongside other disorders with a developmental origin. This review provides an overview of the changes in DSM-5 highlighting key points for clinical practice and research along with a snap shot of the current use of DSM as a classificatory system in different parts of the world and suggestions for improving the subtyping and the diagnostic confidence. Copyright © 2014 Elsevier B.V. All rights reserved.

  13. CEC quality criteria for diagnostic radiographic images and patient exposure trial

    International Nuclear Information System (INIS)

    Nahrstedt, U.; Wall, B.; Maccia, C.; Moores, B.M.; Padovani, R.

    1990-01-01

    The intention of this report has been to present the results of a multinational trial set up by a study group of the radiation protection programme of the CEC. In view of proceeding towards the harmonization and the optimization of the radiological techniques commonly used in different European countries, the relevance of quality criteria for radiographic images together with dose requirements were checked on about 900 examined patients. Due to the type of X-ray projections considered, more than 1 200 questionnaires concerning the real X-ray films were therefore collected and evaluated through a scoring system. Such an approach was relevant and contributed to providing practical considerations on how to reduce and optimize patient received dose while keeping the essential medical information imaged on the film. Indeed the results obtained allowed identification of technical modalities corresponding to that objective. Furthermore, analysis of results revealed two main areas which should be further taken into consideration: - personnel training in radiation protection (radiologists and radiographers), establishment of quality assurance programmes in diagnostic radiology (good usage of radiological equipment and reduction of wasted films)

  14. Effectiveness of Gaalas Phototherapy According to Diagnostic Criteria for Tемрoromandibular Disorders

    Directory of Open Access Journals (Sweden)

    Nencheva-Sveshtarova Savina

    2015-11-01

    Full Text Available The objective of this study was to test the clinical effectiveness of the combined gallium-aluminum-arsenide laser (GaAlAs; 785 nm and superluminiscent diods (SLD; 633 nm phototherapy (MedX 1100 device for the treatment of 62 patients with 7 of the most common pain-related temporomandibular disorders with highest sensitivity and specificity according to diagnostic criteria DC/TMD. Using paired samples t-test a positive effect in the pain relief for all tested conditions was demonstrated. The most manifested and statistically significant reduction of pain was found in arthralgia attributed to osteoarthritis and systemic (rheumatoid arthritis (p = 0.0000001, and disc displacement without reduction with limited opening (p = 0.0000002. Similar levels of pain reduction were found in arthralgia attributed to subluxation, myofascial pain with referral, local myalgia (p values vary between 0.000001 and 0.000284; the lowest values were recorded for myofascial pain (p = 0.001789 and hypermobility-related myalgia (p = 0.018443. The combined laser and SLD phototherapy can be defined as very effective treatment option particularly in pain reduction of internal derangement disorders as well as in some myogenic-related pain conditions affected by TMJ dysfunction.

  15. Critical analysis of diagnostic criteria (ICHD-3 beta about migraine in childhood and adolescence

    Directory of Open Access Journals (Sweden)

    Márcia Maria Ferreira Lima

    2015-01-01

    Full Text Available Objective The objective of this study was to prospectively evaluate the International Classification of Headache Disorders I (ICHD-I diagnostic criteria for migraine in children and adolescents.Methods 150 pain diaries were analyzed during an initial consultation. The duration of migraine headache attacks were divided into 2 groups: Group I, for attacks lasting > 2 hours, and Group II, for attacks lasting < 2 hours.The two groups were statistically compared using Fisher’s exact test (p < 0.05.Results In this study, 51(34% subjects were male and 99 (66% were female, aged 7–15 years. Fisher’s exact test demonstrated that the ICHD-3 beta had a 58% sensitivity for Group I diagnoses and a 94% sensitivity for Group II diagnoses (p < 0.001.Conclusion The current ICHD-3 beta classification improves and advances migraine diagnosis in children and adolescents; however, more research is needed to identify additional characteristics of headache in this age group.

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

    Science.gov (United States)

    Dunn, Thomas M; Bratman, Steven

    2016-04-01

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

  17. Smoldering (asymptomatic) multiple myeloma: current diagnostic criteria, new predictors of outcome, and follow-up recommendations.

    Science.gov (United States)

    Bladé, Joan; Dimopoulos, Meletios; Rosiñol, Laura; Rajkumar, S Vincent; Kyle, Robert A

    2010-02-01

    To provide an overview on smoldering (asymptomatic) multiple myeloma (SMM) including current diagnostic criteria, predictors of progression, pattern of progression, and outcome. A comprehensive review of the literature on risk factors for progression, treatment attempts to delay progression and outcome in patients with SMM. The risk factors for progression of SMM include: plasma cell mass including M-protein size and percentage of bone marrow clonal plasma cells (BMPC), abnormal free light chain ratio, proportion of phenotypically abnormal BMPC, immunoparesis, evolution pattern (evolving v nonevolving), and pattern of magnetic resonance imaging abnormalities. Most patients with SMM progress with anemia and/or skeletal involvement. Immediate therapy with cytotoxic agents, such as melphalan/prednisone has not resulted in improved outcome. Patients should not be treated until progressive disease with end-organ damage occurs. Increasing anemia is the most reliable indicator of progression. These recently recognized predictors of outcome may be helpful for better disease monitoring and for investigation of new treatment approaches. Thus, recommendations for follow-up every to 3 to 6 months depending on the risk of progression are suggested, and clinical trials with new noncytotoxic biologically derived agents to delay progression, particularly in high-risk patients, are ongoing.

  18. Genome-wide significant locus for Research Diagnostic Criteria Schizoaffective Disorder Bipolar type.

    Science.gov (United States)

    Green, Elaine K; Di Florio, Arianna; Forty, Liz; Gordon-Smith, Katherine; Grozeva, Detelina; Fraser, Christine; Richards, Alexander L; Moran, Jennifer L; Purcell, Shaun; Sklar, Pamela; Kirov, George; Owen, Michael J; O'Donovan, Michael C; Craddock, Nick; Jones, Lisa; Jones, Ian R

    2017-12-01

    Studies have suggested that Research Diagnostic Criteria for Schizoaffective Disorder Bipolar type (RDC-SABP) might identify a more genetically homogenous subgroup of bipolar disorder. Aiming to identify loci associated with RDC-SABP, we have performed a replication study using independent RDC-SABP cases (n = 144) and controls (n = 6,559), focusing on the 10 loci that reached a p-value bipolar disorder sample. Combining the WTCCC and replication datasets by meta-analysis (combined RDC-SABP, n = 423, controls, n = 9,494), we observed genome-wide significant association at one SNP, rs2352974, located within the intron of the gene TRAIP on chromosome 3p21.31 (p-value, 4.37 × 10 -8 ). This locus did not reach genome-wide significance in bipolar disorder or schizophrenia large Psychiatric Genomic Consortium datasets, suggesting that it may represent a relatively specific genetic risk for the bipolar subtype of schizoaffective disorder. © 2017 Wiley Periodicals, Inc.

  19. Diagnostic criteria and treatment of discogenic pain: a systematic review of recent clinical literature.

    Science.gov (United States)

    Malik, Khalid M; Cohen, Steven P; Walega, David R; Benzon, Honorio T

    2013-11-01

    Pain innate to intervertebral disc, often referred to as discogenic pain, is suspected by some authors to be the major source of chronic low back and neck pain. Current management of suspected discogenic pain lacks standardized diagnosis, treatment, and terminology. In an attempt to determine whether patterns existed that may facilitate standardization of care, we sought to analyze the terminologies used and the various modes of diagnosis and treatment of suspected discogenic pain. A systematic review of the recent literature. A Medline search was performed using the terms degenerative disc disease, discogenic pain, internal disc disruption while using the limits of human studies, English language, and clinical trials, for the last 10 years. The search led to a total of 149 distinct citations, of which 53 articles, where the intervertebral disc itself was considered the principal source of patient's pain and was the main target of the treatment, were retained for further analysis. The results of this review confirm and help quantify the significant differences that existed in the terminology and all the areas of diagnosis and treatment of presumed discogenic pain. Our findings show that suspected discogenic pain, despite its extensive affirmation in the literature and enormous resources regularly devoted to it, currently lacks clear diagnostic criteria and uniform treatment or terminology. Copyright © 2013 Elsevier Inc. All rights reserved.

  20. Translating the Research Diagnostic Criteria for Temporomandibular Disorders into Malay: evaluation of content and process.

    Science.gov (United States)

    Khoo, Suan-Phaik; Yap, Adrian U Jin; Chan, Yiong Huak; Bulgiba, Awang M

    2008-01-01

    To develop a Malay-language version of the Axis II Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) through a formal translation/back-translation process and to summarize available data about the psychometric properties of the translated scales. To cross-culturally adapt the instrument, the RDC/TMD underwent translation using a forward-backward method. Subjects were recruited to test the congruency between translated and original versions of the RDC/TMD. The psychometric properties of 3 domains (Graded Chronic Pain Scale, Nonspecific Physical Symptoms, and Depression) of the RDC/TMD were examined, and the literature on this topic was reviewed. All the items scored 93% to 100% congruency. Cronbach's alphas for Graded Chronic Pain Scale, Nonspecific Physical Symptoms, and Depression were 0.77, 0.71, and 0.88, respectively (n = 40). The test-retest reliability of scores (intraclass correlation coefficient [ICC]) and levels (Spearman's rho) for these domains showed ICCs of 0.97, 0.94, and 0.95, respectively, with a lowest ICC value of 0.84 (n = 40); the Spearman's rho values were 0.93, 0.74, and 0.74, respectively. The discriminant validity between patients with pain symptoms (n = 40) and normal pain-free controls (n = 40) were statistically significant (P cultural adaptation of the RDC/TMD into the Malay language is suitable for use in Malaysia.

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

    Science.gov (United States)

    Worley, Julie A.; Matson, Johnny L.

    2012-01-01

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

  2. New diagnostic criteria for gestational diabetes mellitus and their impact on the number of diagnoses and pregnancy outcomes

    NARCIS (Netherlands)

    Koning, Sarah H.; van Zanden, Jelmer J.; Hoogenberg, Klaas; Lutgers, Helen L.; Klomp, Alberdina W.; Korteweg, Fleurisca J.; van Loon, Aren J.; Wolffenbuttel, Bruce H. R.; van den Berg, Paul P.

    Aims/hypothesis Detection and management of gestational diabetes mellitus (GDM) are crucial to reduce the risk of pregnancy-related complications for both mother and child. In 2013, the WHO adopted new diagnostic criteria for GDM to improve pregnancy outcomes. However, the evidence supporting these

  3. The impact of the new National Bone Health Alliance (NBHA) diagnostic criteria on the prevalence of osteoporosis in the USA

    Science.gov (United States)

    Summary: We evaluated the prevalence of osteoporosis using the osteoporosis diagnostic criteria developed by the National Bone Health Alliance (NBHA), which includes qualified fractures, FRAX score in addition to bone mineral density (BMD). The expanded definition increases the prevalence compared t...

  4. Henoch-Schönlein purpura in children: An epidemiological study among Dutch paediatricians on incidence and diagnostic criteria

    NARCIS (Netherlands)

    Aalberse, J.; Dolman, K.; Ramnath, G.; Pereira, R.R.; Davin, J.C.

    2007-01-01

    Background: The aim of the present study on the occurrence of Henoch-Schönlein Purpura (HSP) in Dutch children is to give some insight into the epidemiology of HSP in the Netherlands, to record the diagnostic criteria used by Dutch paediatricians and to evaluate the accuracy of the latter using the

  5. Defining sarcopenia : The impact of different diagnostic criteria on the prevalence of sarcopenia in a large middle aged cohort

    NARCIS (Netherlands)

    Bijlsma, A. Y.; Meskers, C. G M; Ling, C. H Y; Narici, M.; Kurrle, S. E.; Cameron, I. D.; Westendorp, R. G J; Maier, A. B.

    Sarcopenia, low muscle mass, is an increasing problem in our ageing society. The prevalence of sarcopenia varies extremely between elderly cohorts ranging from 7% to over 50%. Without consensus on the definition of sarcopenia, a variety of diagnostic criteria are being used. We assessed the degree

  6. Guideline for the diagnosis, treatment and response criteria for Bing-Neel syndrome.

    Science.gov (United States)

    Minnema, Monique C; Kimby, Eva; D'Sa, Shirley; Fornecker, Luc-Matthieu; Poulain, Stéphanie; Snijders, Tom J; Kastritis, Efstathios; Kremer, Stéphane; Fitsiori, Aikaterini; Simon, Laurence; Davi, Frédéric; Lunn, Michael; Castillo, Jorge J; Patterson, Christopher J; Le Garff-Tavernier, Magali; Costopoulos, Myrto; Leblond, Véronique; Kersten, Marie-José; Dimopoulos, Meletios A; Treon, Steven P

    2017-01-01

    Bing Neel syndrome is a rare disease manifestation of Waldenström's macroglobulinemia that results from infiltration of the central nervous system by malignant lymphoplasmacytic cells. In this guideline we describe the clinical symptoms, as well as the appropriate laboratory and radiological studies, that can aid in the diagnosis. The presentation of Bing Neel syndrome may be very diverse, and includes headaches, cognitive deficits, paresis, and psychiatric symptoms. The syndrome can present in patients with known Waldenström's macroglobulinemia, even in the absence of systemic progression, but also in previously undiagnosed patients. Diagnostic work-up should include cerebral spinal fluid analysis with multiparameter flow cytometry to establish B-cell clonality, protein electrophoresis and immunofixation for the detection and classification of a monoclonal protein as well as molecular diagnostic testing for immunoglobulin gene rearrangement and mutated MYD88. MRI of the brain and spinal cord is also essential. The second challenge is to expand our knowledge of prognosis and treatment outcome. Prospective clinical trials on Bing Neel syndrome patients that employ uniform treatment along with appropriate laboratory cerebral spinal fluid assessments and standardized MRI protocols will be invaluable, constituting a significant step forward in delineating treatment outcome for this intriguing disease manifestation. Copyright© Ferrata Storti Foundation.

  7. [The impact of broadened diagnostic criteria on the prevalence of hypertension, hyperlipidemia and diabetes mellitus in China].

    Science.gov (United States)

    Hu, X F; Han, X R; Yang, Z Y; Hu, Y H; Tang, J L

    2017-05-06

    Objective: The burden of chronic disease has been continuously increasing in China since the early 1980s. Besides the worsening of risk factors, the change in diagnostic criteria is very likely an important explanation for the increase in the prevalence of hypertension, hyperlipidemia and diabetes mellitus, three commonest, major chronic conditions that can lead to major vascular events and deaths. This study aims to estimate the contribution of changes in diagnostic criteria to the increase in the prevalence of the three conditions in China. Methods: The data from two representative nation-wide surveys in China in 2002 and 2009, with 145 254 and 8 813 adults included respectively, were used to estimate the prevalence rate of the three conditions and the proportion attributable to the change in diagnostic criteria around year 2000. The new and old cutoff values for hypertension, hyperlipidemia, and hyperglycemia were 140/90 and 160/95 mmHg (1 mmHg=0.133 kPa), 5.7 and 6.2 mmol/L, and 7.0 and 7.8 mmol/L, respectively. The prevalence was standardized according to the distribution of age, sex and rural-urban residence of the 2000 national census of the country so as to compare between the old and new diagnostic criteria and project the situation for the entire country. Results: The standardized prevalence of hypertension, hyperlipidemia, and diabetes mellitus for the entire Chinese adult population in 2002 was 8.21%, 1.71% and 1.43% according to the immediate previous diagnostic criteria, and 19.18%, 3.53% and 2.66% according to the new criteria. In 2009, the prevalence was 11.89%, 9.34% and 4.29% according to the old criteria, and 24.78%, 18.36% and 6.55% according to the new criteria. The total cumulative prevalence of the three conditions was increased by 124% in 2002 and 95% in 2009 as a result of change in diagnostic criteria. Put it differently, the change in diagnostic criteria increased the number of the three conditions from 2002 to 2009 by approximately 359

  8. Rationale for revision and proposed changes of the WHO diagnostic criteria for polycythemia vera, essential thrombocythemia and primary myelofibrosis.

    Science.gov (United States)

    Barbui, T; Thiele, J; Vannucchi, A M; Tefferi, A

    2015-08-14

    The 2001/2008 World Health Organization (WHO)-based diagnostic criteria for polycythemia vera (PV), essential thrombocythemia (ET) and primary myelofibrosis (PMF) were recently revised to accomodate new information on disease-specific mutations and underscore distinguishing morphologic features. In this context, it seems to be reasonable to compare first major diagnostic criteria of the former WHO classifications for myeloproliferative neoplasm (MPN) and then to focus on details that have been discussed and will be proposed for the upcoming revision of diagnostic guidelines. In PV, a characteristic bone marrow (BM) morphology was added as one of three major diagnostic criteria, which allowed lowering of the hemoglobin/hematocrit threshold for diagnosis, which is another major criterion, to 16.5 g/dl/49% in men and 16 g/dl/48% in women. The presence of a JAK2 mutation remains the third major diagnostic criterion in PV. Subnormal serum erythropoietin level is now the only minor criterion in PV and is used to capture JAK2-unmutated cases. In ET and PMF, mutations that are considered to confirm clonality and specific diagnosis now include CALR, in addition to JAK2 and MPL. Also in the 2015 discussed revision, overtly fibrotic PMF is clearly distinguished from early/prefibrotic PMF and each PMF variant now includes a separate list of diagnostic criteria. The main rationale for these changes was to enhance the distinction between so-called masked PV and JAK2-mutated ET and between ET and prefibrotic early PMF. The proposed changes also underscore the complementary role, as well as limitations of mutation analysis in morphologic diagnosis. On the other hand, discovery of new biological markers may probably be expected in the future to enhance discrimination of the different MPN subtypes in accordance with the histological BM patterns and corresponding clinical features.

  9. The diagnostic performance of radiographic criteria to detect aseptic acetabular component loosening after revision total hip arthroplasty.

    Science.gov (United States)

    Abrahams, J M; Kim, Y S; Callary, S A; De Ieso, C; Costi, K; Howie, D W; Solomon, L B

    2017-04-01

    This study aimed to determine the diagnostic performance of radiographic criteria to detect aseptic acetabular loosening after revision total hip arthroplasty (THA). Secondary aims were to determine the predictive values of different thresholds of migration and to determine the predictive values of radiolucency criteria. Acetabular component migration to re-revision was measured retrospectively using Ein-Bild-Rontgen-Analyse (EBRA-Cup) and manual measurements (Sutherland method) in two groups: Group A, 52 components (48 patients) found not loose at re-revision and Group B, 42 components (36 patients) found loose at re-revision between 1980 and 2015. The presence and extent of radiolucent lines was also assessed. Using EBRA, both proximal translation and sagittal rotation were excellent diagnostic tests for detecting aseptic loosening. The area under the receiver operating characteristic (ROC) curves was 0.94 and 0.93, respectively. The thresholds of 2.5 mm proximal translation or 2° sagittal rotation (EBRA) in combination with radiolucency criteria had a sensitivity of 93% and specificity of 88% to detect aseptic loosening. The sensitivity, specificity, positive predictive value and negative predictive value (NPV) of radiolucency criteria were 41%, 100%, 100% and 68% respectively. Manual measurements of both proximal translation and sagittal rotation were very good diagnostic tests. The area under the ROC curve was 0.86 and 0.92 respectively. However, manual measurements had a decreased specificity compared with EBRA. Radiolucency criteria had a poor sensitivity and NPV of 41% and 68% respectively. This study shows that EBRA and manual migration measurements can be used as accurate diagnostic tools to detect aseptic loosening of cementless acetabular components used at revision THA. Radiolucency criteria should not be used in isolation to exclude loosening of cementless acetabular components used at revision THA given their poor sensitivity and NPV. Cite this

  10. Validity of proposed DSM-5 diagnostic criteria for nicotine use disorder: results from 734 Israeli lifetime smokers

    Science.gov (United States)

    Shmulewitz, D.; Wall, M.M.; Aharonovich, E.; Spivak, B.; Weizman, A.; Frisch, A.; Grant, B. F.; Hasin, D.

    2013-01-01

    Background The fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) proposes aligning nicotine use disorder (NUD) criteria with those for other substances, by including the current DSM fourth edition (DSM-IV) nicotine dependence (ND) criteria, three abuse criteria (neglect roles, hazardous use, interpersonal problems) and craving. Although NUD criteria indicate one latent trait, evidence is lacking on: (1) validity of each criterion; (2) validity of the criteria as a set; (3) comparative validity between DSM-5 NUD and DSM-IV ND criterion sets; and (4) NUD prevalence. Method Nicotine criteria (DSM-IV ND, abuse and craving) and external validators (e.g. smoking soon after awakening, number of cigarettes per day) were assessed with a structured interview in 734 lifetime smokers from an Israeli household sample. Regression analysis evaluated the association between validators and each criterion. Receiver operating characteristic analysis assessed the association of the validators with the DSM-5 NUD set (number of criteria endorsed) and tested whether DSM-5 or DSM-IV provided the most discriminating criterion set. Changes in prevalence were examined. Results Each DSM-5 NUD criterion was significantly associated with the validators, with strength of associations similar across the criteria. As a set, DSM-5 criteria were significantly associated with the validators, were significantly more discriminating than DSM-IV ND criteria, and led to increased prevalence of binary NUD (two or more criteria) over ND. Conclusions All findings address previous concerns about the DSM-IV nicotine diagnosis and its criteria and support the proposed changes for DSM-5 NUD, which should result in improved diagnosis of nicotine disorders. PMID:23312475

  11. An Update on Neurofibromatosis Type 1: Not Just Café-au-Lait Spots, Freckling, and Neurofibromas. An Update. Part I. Dermatological Clinical Criteria Diagnostic of the Disease.

    Science.gov (United States)

    Hernández-Martín, A; Duat-Rodríguez, A

    2016-01-01

    Neurofibromatosis type 1 (NF1) is the most common neurocutaneous syndrome and probably the one best known to dermatologists, who are generally the first physicians to suspect its diagnosis. Although the genetic locus of NF1 was identified on chromosome 17 in 1987, diagnosis of the disease is still mainly based on clinical observations and the diagnostic criteria of the National Institute of Health, dating from 1988. Cutaneous manifestations are particularly important because café-au-lait spots, freckling on flexural areas, and cutaneous neurofibromas comprise 3 of the 7 clinical diagnostic criteria. However, café-au-lait spots and freckling can also be present in other diseases. These manifestations are therefore not pathognomonic and are insufficient for definitive diagnosis in the early years of life. NF1 is a multisystemic disease associated with a predisposition to cancer. A multidisciplinary follow-up is necessary and dermatologists play an important role. Copyright © 2016 AEDV. Published by Elsevier España, S.L.U. All rights reserved.

  12. Which Diagnostic Criteria are Most Useful in Discriminating Between Social Gamblers and Individuals with Gambling Problems? An Examination of DSM-IV and DSM-5 Criteria.

    Science.gov (United States)

    Temcheff, Caroline E; Paskus, Thomas S; Potenza, Marc N; Derevensky, Jeffrey L

    2016-09-01

    The current study sought to identify which diagnostic criteria for gambling disorder have the greatest ability to differentiate between social and problem gamblers. This study was conducted on a sample of male and female college student athletes across the U.S. (n = 8674). Classification and regression tree analysis represents an appropriate technique when addressing the question of an item's diagnostic value, as it sequentially selects variables to isolate sets of observations with similar outcomes. The current results suggest that the item related to preoccupation ("Have there been periods in the past year where you spent a lot of time thinking about gambling?") was the DSM-5 item best able to differentiate between male and female social and problem gamblers in this sample. When considering only the nine criteria retained in the DSM-5, three criteria were identified as key for distinguishing between social and disordered gamblers among men, and one criterion was identified for distinguishing between groups of women. In addition, these results do not support the notion that the illegal acts criterion has a particularly low base rate and found that it can be an important indicator of disordered gambling in a college-aged sample.

  13. Delirium diagnosis defined by cluster analysis of symptoms versus diagnosis by DSM and ICD criteria: diagnostic accuracy study.

    Science.gov (United States)

    Sepulveda, Esteban; Franco, José G; Trzepacz, Paula T; Gaviria, Ana M; Meagher, David J; Palma, José; Viñuelas, Eva; Grau, Imma; Vilella, Elisabet; de Pablo, Joan

    2016-05-26

    Information on validity and reliability of delirium criteria is necessary for clinicians, researchers, and further developments of DSM or ICD. We compare four DSM and ICD delirium diagnostic criteria versions, which were developed by consensus of experts, with a phenomenology-based natural diagnosis delineated using cluster analysis of delirium features in a sample with a high prevalence of dementia. We also measured inter-rater reliability of each system when applied by two evaluators from distinct disciplines. Cross-sectional analysis of 200 consecutive patients admitted to a skilled nursing facility, independently assessed within 24-48 h after admission with the Delirium Rating Scale-Revised-98 (DRS-R98) and for DSM-III-R, DSM-IV, DSM-5, and ICD-10 criteria for delirium. Cluster analysis (CA) delineated natural delirium and nondelirium reference groups using DRS-R98 items and then diagnostic systems' performance were evaluated against the CA-defined groups using logistic regression and crosstabs for discriminant analysis (sensitivity, specificity, percentage of subjects correctly classified by each diagnostic system and their individual criteria, and performance for each system when excluding each individual criterion are reported). Kappa Index (K) was used to report inter-rater reliability for delirium diagnostic systems and their individual criteria. 117 (58.5 %) patients had preexisting dementia according to the Informant Questionnaire on Cognitive Decline in the Elderly. CA delineated 49 delirium subjects and 151 nondelirium. Against these CA groups, delirium diagnosis accuracy was highest using DSM-III-R (87.5 %) followed closely by DSM-IV (86.0 %), ICD-10 (85.5 %) and DSM-5 (84.5 %). ICD-10 had the highest specificity (96.0 %) but lowest sensitivity (53.1 %). DSM-III-R had the best sensitivity (81.6 %) and the best sensitivity-specificity balance. DSM-5 had the highest inter-rater reliability (K =0.73) while DSM-III-R criteria were the least

  14. Fragile X Syndrome in Males: Diagnostic, Behavioral, and Educational Implications.

    Science.gov (United States)

    Bellinger, Diane; And Others

    This paper reviews the research on fragile X syndrome, the second most common cause of mental retardation related to chromosomal anomaly. It notes that far more males than females are affected by the fragile X syndrome, which typically results in craniofacial changes, delays in growth and development, speech/language difficulties, and cognitive…

  15. Primary sialoangiectasia - a diagnostic pitfall in Sjogren's syndrome - Case report

    NARCIS (Netherlands)

    Kalk, WWI; Vissink, A; Spijkervet, FKL; Bootsma, H

    A case of primary sialoangiectasia, which in this case was initially misdiagnosed as Sjogren's syndrome, is described. Other diseases, including HIV infection, psoriatic arthritis, and acute parotitis, may cause glandular changes similar to the changes found in the syndrome. Therefore, sialography

  16. Prevalence of metabolic syndrome according to Adult Treatment Panel III and International Diabetes Federation criteria: a population-based study.

    Science.gov (United States)

    Bener, Abdulbari; Zirie, Mahmoud; Musallam, Manal; Khader, Yousef S; Al-Hamaq, Abdulla O A A

    2009-06-01

    The objective of the study was to examine the prevalence of metabolic syndrome among adult Qatari population according to the revised criteria of the National Cholesterol Education Program Adult Treatment Panel III (NCEP ATP III) and the International Diabetes Federation (IDF), assess which component contributed to the increased risk of the metabolic syndrome, and identify the characteristics of the subjects with metabolic syndrome. This was a cross-sectional study. The survey was carried out in urban and semiurban primary health-care centers. The survey was conducted from January, 2007, to July, 2008, among Qatari nationals above 20 years of age. Of the 1496 subjects who were approached to participate in the study, 1204 (80.5%) gave their consent. Face-to-face interviews were conducted using a structured questionnaire followed by laboratory tests. Metabolic syndrome was defined using the NCEP ATP III as well as IDF criteria. The overall prevalence of metabolic syndrome in studied subjects was 26.5% and 33.7% according to ATP III and IDF criteria (P education and physical activity. Also, the prevalence of metabolic syndrome was more common in women. Among the components of metabolic syndrome, central obesity was significantly higher in the studied subjects. The IDF definition of metabolic syndrome gave a higher prevalence in all age groups. The overall prevalence of metabolic syndrome and its components according to IDF criteria was higher in the studied subjects than the estimates given by the ATP III. Multivariate logistics regression analysis (ATP III and IDF) showed that age and BMI were significant contributors for metabolic syndrome. Both definitions strongly supported age and obesity as associated factors for metabolic syndrome. The current study found a high prevalence of metabolic syndrome among Qataris. There was a steady increase in the prevalence of metabolic syndrome through the decades, independent of the definition. Age and BMI were important

  17. How many published cases of serious adverse events after yellow fever vaccination meet Brighton Collaboration diagnostic criteria?

    Science.gov (United States)

    Thomas, Roger E; Spragins, Wendy; Lorenzetti, Diane L

    2013-12-16

    To perform a systematic review of all serious adverse events (SAEs) after yellow fever vaccination and to assess them according to Brighton Collaboration criteria. Nine electronic databases were searched with the terms "yellow fever vaccine" and "adverse events" to 10 July 2013 (no language/date limits). Two reviewers independently assessed studies, entered data, and assessed cases with Brighton Collaboration criteria. One hundred and thirty-one cases met Brighton Collaboration criteria: 32 anaphylaxis, 41 neurologic (one death), 56 viscerotropic (24 deaths), and 2 both neurologic and viscerotropic criteria. All SAEs occurred following first yellow fever (YF) vaccination. Two additional cases which met Brighton Collaboration criteria were proven due to wild virus. An additional 345 cases were presented with insufficient detail to meet Brighton Collaboration criteria:173 neurological, 68 viscerotropic (24 deaths), 67 anaphylaxis, and 34 cases from a UK database and 3 from a Swiss database described as "serious adverse events" but not further classified into neurologic or viscerotropic. A further 253 cases were excluded as presenting insufficient data to be regarded as yellow fever vaccine (YFV) related SAEs. One hundred and thirty-one cases met Brighton Collaboration criteria for serious adverse events after yellow fever vaccination. Another 345 cases did not meet Brighton criteria and 253 were excluded as presenting insufficient data to be regarded as serious adverse events after YFV. There are likely to be cases in areas that are remote or with insufficient diagnostic resources that are neither correctly assessed nor not published. Copyright © 2013 Elsevier Ltd. All rights reserved.

  18. Risk factors for coronary heart disease and actual diagnostic criteria for diabetes mellitus

    Directory of Open Access Journals (Sweden)

    Mitrović-Perišić Nataša

    2009-01-01

    Full Text Available Background/Aim. Recent studies indicate that the prevalence of diabetes mellitus (DM type 2 is increasing in the world. Chronic hyperglycemia in DM is associated with a long term damage, dysfunction and failure of various organs, especially retina, kidney, nerves and, in addition, with an increased risk of cardiovasclar disease. For a long time the illness has been unknown. Early diagnosis of diabetes could suspend the development of diabetic complications. The aim of the study was to establish risk for the development of coronary disease in the patients evaluated by the use of new diagnostic criteria for DM. Methods. The study included 930 participants without diagnosis of DM, hypertension, dyslipidemia, nor coronary heart disease two years before the study. The patients went through measuring of fasting plasma glycemia, erythrocytes, hematocrit, cholesterol, triglycerides, high-density lipoprotein cholesterol (HDL-C, low-density lipoprotein cholesterol, aspartate aminotransferase and alanine aminotransferase. In the group with hyperglycemia the 2-hour oral glucose tolerance test was performed. We analyzed ECG and made blood pressure monitoring, and also measured body mass, height, waist and hip circumference. We analyzed life style, especially smoking, and exercise and family history. Results. Diabetes prevalence was 2.68%, and prevalences of impaired fasting glucose, impaired glucose tolerance and DM were 12.15%. Average age of males and females was 38 and 45 years, respectively. In the healthy population there was higher frequency of smokers (55% vs 42%, but in the population with hyperglycemia there were more obesity (23% vs 10.5%, hypertension (39% vs 9%, hypercholesterolemia (76% vs 44.1%, lower HDL-C (52.2% vs 25.7%. Cummulative risk factor in healthy subjects, and those with hyperglycemia were 5.6% and 14%, respectively. Conclusion. Subjects with hyperglicemia without diagnosis of DM have higher risk factors for coronary heart disease.

  19. Algorithm for the Diagnosis of Scleroderma. Early Systemic Sclerosis: Definitions and diagnostic criteria

    Directory of Open Access Journals (Sweden)

    Domenico Galasso

    2013-04-01

    Full Text Available Introduction: The term scleroderma derives from the Greek words skleros, which means hard, and derma, which means skin. It refers to an acquired systemic inflammatory disease of the connective tissue –also known as systemic sclerosis (SSc– characterized by excessive collagen deposition in the skin and the internal organs that results in fibrosis. The typical vascular lesion in SSc leads to narrowing of the vessel lumen, intimal thickening, medial hypotrophy, and adventitial fibrosis of small muscular vessels, collagen deposition in the other matrix components of interstice, and the Raynaud phenomenon secondary to these widespread microvascular abnormalities. All these characteristics lead to a connective tissue re-modeling. Discussion: Several clinical studies utilize the American Rheumatology Association’s 1980 classification. However, these diagnostic criteria are unsatisfactory because they fail to take into consideration part of the disease spectrum. Early-phase SSc is characterized by the Raynaud phenomenon (in 90% of all patients, sclerodactyly, and positivity for SSc-specific autoantibodies (antinuclear antibodies, anti-topoisomerase I antibodies, anti-RNA polymerase I and III antibodies, anti-centromere antibodies, anti-fibrillarin antibodies, anti-PM-SCL antibodies.. It is necessary to reduce delays in the diagnosis of SSc. Conclusions: Patients with red-flag positivity (Raynaud phenomenon and digital edema require Phase I SSc screening, which consists in capillaroscopic assessment of possible microvascular abnormalities. The work-up will then focus on inflammatory indices, renal function tests, and internal organ involvement (echocardiography, high-resolution computed tomography of the chest, diffusing capacity of the lungs for carbon monoxide.

  20. Post electrical or lightning injury syndrome: a proposal for an American Psychiatric Association's Diagnostic and Statistical Manual formulation with implications for treatment.

    Science.gov (United States)

    Andrews, Christopher J; Reisner, Andrew D; Cooper, Mary Ann

    2017-09-01

    In the past, victims of electrical and lightning injuries have been assessed in a manner lacking a systematic formulation, and against ad hoc criteria, particularly in the area of neuropsychological disability. In this manner patients have, for example, only been partially treated, been poorly or incorrectly diagnosed, and have been denied the full benefit of compensation for their injuries. This paper contains a proposal for diagnostic criteria particularly for the neuropsychological aspects of the post injury syndrome. It pays attention to widely published consistent descriptions of the syndrome, and a new cluster analysis of post electrical injury patients. It formulates a proposal which could be incorporated into future editions of the American Psychiatric Association's Diagnostic and Statistical Manual (DSM). The major neuropsychological consequences include neurocognitive dysfunction, and memory subgroup dysfunction, with ongoing consequences, and sometimes including progressive or delayed psychiatric, cognitive, and/or neurological symptoms. The proposed diagnostic criteria insist on a demonstrated context for the injury, both specifying the shock circumstance, and also physical consequences. It allows for a certain delay in onset of symptoms. It recognizes exclusory conditions. The outcome is a proposal for a DSM classification for the post electrical or lightning injury syndrome. This proposal is considered important for grounding patient treatment, and for further treatment trials. Options for treatment in electrical or lightning injury are summarised, and future trials are foreshadowed.

  1. Diagnostic and pathogenetic role of café-au-lait macules in nevoid basal cell carcinoma syndrome

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    Ponti Giovanni

    2012-10-01

    Full Text Available Abstract Café au lait spots (CALS are common dermatologic findings that can at the same time arise in a variety of pathologic conditions such as Neurofibromatosis type 1 (NF1, together with numerous hereditary syndromes for which they represent either diagnostic criteria or associated elements (McCune Albright, Silver-Russell, LEOPARD, Ataxia-Telangiectasia. A review of the literature also revealed two cases of association with NBCCS. We report here the case of a female proband with CALS associated to Nevoid Basal Cell Carcinoma Syndrome (NBCCS with known PTCH1 germline mutation (C.1348-2A>G who had been misdiagnosed with NF1 in her childhood because of 5 CALS and cutaneous nodules. The patient presented a giant cell tumor of the skin, palmar and calcaneal epidermoidal cystic nodules, odontogenic keratocystic tumors and deformity of the jaw profile. Her family history brought both her brother and father to our attention because of the presence of KCOTs diagnosed at early age: after genetic testing, the same PTCH1 germline mutation was identified in the three family members. Clinical criteria are used for discerning NF1 diagnosis (size, number and onset age, while there are no definite guidelines concerning CALS except for their presence. In our experience, we have noted an association of CALS with NBCCS; this seems interesting because we already know clinical criteria are a dynamic entity and can be modified by epidemiologic evidences.

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

    Science.gov (United States)

    Feitosa, Alina Coutinho Rodrigues; Barreto, Luciana Tedgue; Silva, Isabela Matos da; Silva, Felipe Freire da; Feitosa, Gilson Soares

    2017-07-01

    There is a physiologic elevation of total cholesterol (TC) and triglycerides (TG) during pregnancy. Some authors define dyslipidemia (DLP) in pregnant women when TC, LDL and TG concentrations are above the 95th percentile (p95%) and HDL concentration is below the 5th percentile (P5%) for gestational age (GA). To compare the prevalence of DLP in pregnant women using percentiles criteria with the V Brazilian Guidelines on Dyslipidemia and the association with maternal and fetal outcomes. Pregnant women with high-risk conditions, aged 18-50 years, and at least one lipid profile during pregnancy was classified as the presence of DLP by two diagnostic criteria. Clinical and laboratorial data of mothers and newborns were evaluated. 433 pregnant women aged 32.9 ± 6.5 years were studied. Most (54.6%) had lipid profile collected during third trimester. The prevalence of any lipid abnormalities according to the criteria of the National Guidelines was 83.8%: TC ≥ 200 mg/dL was found in 49.9%; LDL ≥ 160 mg/dL, in 14.3%, HDL ≤ 50 mg/dL in 44.4% and TG ≥ 150 mg/dL in 65.3%. Any changes of lipid according to percentiles criteria was found in 19.6%: elevation above the P95% for TC was found in 0.7%; for LDL, 1.7%; for TG 6.4% and HDL lower than the P5% in 13%. The frequency of comorbidity: hypertension, diabetes, smoking, obesity and preeclampsia was similar among pregnant women when DLP was compared by both criteria. The prevalence of DLP during pregnancy varies significantly depending on the criteria used, however none demonstrated superiority in association with comorbidities. Durante a gestação ocorrem, fisiologicamente, elevações do colesterol total (CT) e triglicerídios (TG). Alguns autores definem dislipidemia (DLP) gestacional quando as concentrações de CT, LDL e TG são superiores ao percentil 95 (P95%) e de HDL, inferiores ao percentil 5 (P5%) para a idade gestacional. Comparar a prevalência da DLP em gestantes conforme critério por percentis com o da V

  3. Factorial structure and diagnostic efficiency of DSM-IV criteria for avoidant personality disorder in patients with binge eating disorder.

    Science.gov (United States)

    Grilo, Carlos M

    2004-10-01

    This study examined the factorial structure and diagnostic efficiency of the DSM-IV criteria for avoidant personality disorder (AVPD). Two hundred and twenty-eight consecutive outpatients (181 females and 47 males) with a primary diagnosis of binge eating disorder were reliably assessed with diagnostic interviews. Internal consistency of AVPD criteria was good, as suggested by coefficient alpha of 0.87, the pattern of inter-item correlations (range 0.41 to 0.64), and the lack of changes in alpha if any criteria are deleted. Exploratory factor analysis revealed a one-factor solution (56% of variance) supporting the unidimensionality of the AVPD criteria. Diagnostic efficiency indices (conditional probabilities, total predictive power, and kappa coefficients) were calculated for each AVPD criterion, for the entire study group and separately by gender. Overall, the best inclusion criterion was 'fears being ridiculed,' which was also the best predictor overall. These psychometric findings did not differ by gender. The findings support certain important aspects of the AVPD diagnosis.

  4. Comparison of the different definition criteria for the diagnosis of the metabolic syndrome in elderly women.

    Science.gov (United States)

    Paula, Hudsara Aparecida de Almeida; Ribeiro, Rita de Cássia Lanes; Rosado, Lina Enriqueta Frandsen Paez de Lima; Pereira, Renan Salazar Ferreira; Franceschini, Sylvia do Carmo Castro

    2010-09-01

    The criteria for best defining the metabolic syndrome (MS), especially in the elderly population, are still little known, and the understanding is increasingly necessary. Compare the four MS definition proposals, two official ones (National Cholesterol Education Program's Adult Treatment Panel III/NCEP-ATPIII and International Diabetes Federation/IDF) and two proposed definitions (Metabolic Syndrome - National Cholesterol Education Program's Adult Treatment Panel III - modified/MS-ATPM and Metabolic Syndrome - International Diabetes Federation - modified/MS-IDFM), derived from the changes in the official criteria. A total of 113 women (60-83 years old) participated in this study; they were submitted to anthropometric, blood pressure, lipid profile, fasting glycemia tests and answered questions related to life style habits and health conditions. Statistical analyses were performed using the chi-square test and Kappa coefficient determination. The frequency of the high pressure levels was similar in the two official definitions (54.8%), with a reduction in the two proposed definitions (33.6%). The homeostasis change of the glucose was higher as per the IDF and MS-IDFM (30.1%). The hypertriglyceridemia and the low levels of HDL-c were similar in all the definitions (35.4%). In relation to the abdominal obesity, the higher occurrence was registered by the IDF criteria (88.5%). The presence of the metabolic syndrome presented higher and lower frequencies as per the IDF proposal (45.1%) and MS-IDFM (22.1%), respectively. Higher agreement was found between the modified definition MS-ATPM with NCEP-ATPIII and MS-IDFM (Kappa: 0.79 and 0.77; p < 0.00001). The MS-ATPM proposal was found more adequate for the MS detection in the evaluated elderly women.

  5. A case report of burning mouth syndrome: A diagnostic dilemma

    Directory of Open Access Journals (Sweden)

    Ghassan M Al-Iryani

    2016-01-01

    Full Text Available Oral dysaesthesia syndrome called burning mouth syndrome (BMS causes chronic pain in the orofacial region without presence of any of the detectable organic causes. Common features of BMS are burning sensation in the mouth, xerostomia, dysgeusia, etc. These symptoms ideally show a diurnal pattern, were they are less in the morning and worsen as the day progresses and classically subside at the night time. BMS have multifactorial etiology. This report describes a case of burning mouth syndrome in a 60 year old female patient.

  6. COMPLEX REGIONAL PAIN SYNDROME – CLINIC, DIAGNOSTICS, TREATMENT

    Directory of Open Access Journals (Sweden)

    N. A. Shostak

    2014-07-01

    Full Text Available The problem of pain today remains one of the fundamental issues of medical care. It is known that the pain is the leading cause of treatmentto the doctor. Among pain syndromes, a special place belongs to the complex regional pain syndromes. They are distinguished by the multidisciplinary problem, the presence of explicit nature of the pain, difficulty of diagnosis and nature of the treatment. The article presentsmodern data on the diagnosis and treatment of the complex regional pain syndromes.

  7. Comparison of DSM-IV versus proposed DSM-5 diagnostic criteria for eating disorders in a Japanese sample.

    Science.gov (United States)

    Nakai, Yoshikatsu; Fukushima, Mitsuo; Taniguchi, Ataru; Nin, Kazuko; Teramukai, Satoshi

    2013-01-01

    The purpose of this study was to compare the Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM-IV) and the proposed Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-5) diagnostic criteria in terms of the number of cases of eating disorder not otherwise specified (EDNOS) and to see which diagnostic system can effectively capture variance in psychiatric symptoms in a Japanese sample. One thousand and twenty-nine women with an eating disorder (ED) participated in this study. Assessment methods included structured clinical interviews and administration of the Eating Attitudes Test and the Eating Disorder Inventory. Relaxing the diagnostic criteria for anorexia nervosa and bulimia nervosa and recognizing binge ED decreased the proportion of EDNOS (from 45.1% to 26.1%). The DSM-5 categorization of patients was better able to capture variance in psychopathology scales. The proposed revisions to EDs in the DSM-5 partially reduced reliance on EDNOS. The DSM-5 may differentiate ED groups more effectively than the DSM-IV. Copyright © 2012 John Wiley & Sons, Ltd and Eating Disorders Association.

  8. Screening panoramic radiography of new adult patients: diagnostic yield when combined with bitewing radiography and identification of selection criteria.

    Science.gov (United States)

    Rushton, V E; Horner, K; Worthington, H V

    2002-03-09

    To measure the radiological diagnostic yield on screening panoramic radiographs taken of new adult patients and to identify selection criteria for panoramic radiography of new adult patients. Survey of 1,817 consecutive panoramic radiographs taken as 'routine' on new patients with statistical analysis of clinical and radiological findings. All radiographs were obtained from 41 general dental practitioners (GDPs). The GDPs provided the clinical information about the patient obtained by history and examination. Collection of material occurred in 1998/1999. Two dental radiologists recorded the radiological findings on each of 1,817 panoramic radiographs by consensus. Those findings that would have been identified from bilateral posterior bitewing radiographs of each patient were then excluded to give modified figures for radiological findings. Indices of diagnostic yield were devised and calculated for each radiograph from the data on radiological findings. Total diagnostic yield (DY) and modified diagnostic yield (MDY), after exclusion of findings identifiable on bitewing radiographs, were both calculated. Clinical indicators of a high MDY were identified using stepwise multiple regression analysis. MDY was 0 for 17% of the radiographs (all patients) and 23% of the radiographs when the asymptomatic group were considered. The clinical variables for which the significance was high (p panoramic radiography. Using clinical factors derived from the history and examination as radiographic selection criteria modestly improves the odds of achieving a high diagnostic yield from panoramic radiography.

  9. A female with hemihypertrophy and chylous ascites - Klippel-Trenaunay syndrome or Proteus syndrome: a diagnostic dilemma.

    Science.gov (United States)

    Gupta, Neerja; Kabra, Madhulika; Ramesh, Konanki; Garg, Garima; Kaur, Dilpreet; Gupta, Arun; Bal, Chandra Shekhar

    2006-10-01

    Asymmetric overgrowth has many differential diagnoses with considerable overlap, posing a diagnostic dilemma. The presence of chylous ascites, though unreported, might be expected as a manifestation of overgrowth syndromes with lymphatic involvement. We present a patient with hemihypertrophy who presented with chylous ascites at birth.

  10. Media hype, diagnostic fad or genuine disorder? Professionals' opinions about night eating syndrome, orthorexia, muscle dysmorphia, and emetophobia.

    Science.gov (United States)

    Vandereycken, Walter

    2011-01-01

    Many "new" syndromes have been proposed for inclusion in the DSM-V. Some disorders acquired popularity through the Internet, but will they be taken seriously and get accepted by the scientific community? We organized an opinion poll among professionals in the field of eating disorders by presenting them a provisional set of diagnostic criteria of four "new" disorders: Night Eating Syndrome, Orthorexia, Muscle Dysmorphia, and Emetophobia. In general, the opinions did not differ much according to the characteristics of the 111 respondents. Among these professionals, Orthorexia is the best known and Night Eating Syndrome the least. Although the majority is familiar with the concept of Muscle Dysmorphia, it is most often viewed as a creation of the popular media and rarely observed in daily practice. In contrast, the other three disorders seem to be taken more seriously in the sense of "genuine" syndromes, which should receive more attention in research and clinical practice. Emetophobia appears to be the least "fashionable" of the four. The findings are discussed in the light of medialization and medicalization.

  11. McDonald Criteria 2010 and 2005 Compared: Persistence of High Oligoclonal Band Prevalence Despite Almost Doubled Diagnostic Sensitivity

    Directory of Open Access Journals (Sweden)

    Philipp Schwenkenbecher

    2016-09-01

    Full Text Available The 2010 McDonald criteria were developed to allow a more rapid diagnosis of relapsing-remitting multiple sclerosis (MS by only one MRI of the brain. Although cerebrospinal fluid (CSF is not a mandatory part of the latest criteria, the evidence of an intrathecal humoral immunoreaction in the form of oligoclonal bands (OCB is crucial in the diagnostic workup. To date, the impact of the 2010 McDonald criteria on the prevalence of OCB has not been investigated. We retrospectively evaluated data of 325 patients with a clinical relapse suggestive of demyelination that were treated in a German university hospital between 2010 and 2015. One hundred thirty-six patients (42% were diagnosed with MS and 189 patients with CIS when the criteria of 2010 were applied. The criteria of 2005 allowed only 70 patients (22% to be designated as MS. In contrast, the prevalence of OCB was marginal affected in MS patients with 96% for the criteria of 2010 and 98.5% for the criteria of 2005. In conclusion, OCB are prevalent in most MS patients and reflect the chronic inflammatory nature of the disease. We recommend CSF examination to exclude alternative diagnoses and reevaluation of the diagnosis MS in patients with negative OCB.

  12. Validation of the U.K. Working Party diagnostic criteria for atopic eczema in a Xhosa-speaking African population.

    Science.gov (United States)

    Chalmers, D A; Todd, G; Saxe, N; Milne, J T; Tolosana, S; Ngcelwane, P N; Hlaba, B N; Mngomeni, L N; Nonxuba, T G; Williams, H C

    2007-01-01

    Reliable diagnostic criteria for eczema are important for epidemiological comparisons. Although the U.K. diagnostic criteria for atopic eczema have performed well in an English language setting, limited data are available from other countries where cultural and linguistic factors may affect their validity. We sought to determine the validity of the U.K. criteria for eczema in relation to clinical assessment by a dermatologist in a Xhosa-speaking South African population. A cross-sectional survey of 3067 children aged 3-11 years was conducted in rural, peri-urban and urban settings in South Africa. The prevalence of atopic eczema was determined using the U.K. diagnostic criteria and a clinical assessment by a dermatologist. Questions were translated into the local language (Xhosa). Trained researchers administered the questions to the children's parents or carers. The validity of the U.K. criteria was then determined by calculating the sensitivity, specificity, positive and negative predictive values, and Youden's Index in relation to the dermatologist's examination. The point prevalence of atopic eczema according to a dermatologist was 1.0% [95% confidence interval (CI) 0.6-1.4], while the prevalence of visible flexural eczema according to the U.K. protocol was 1.8% (95% CI 1.3-2.2). The sensitivity and specificity of the U.K. criteria in this setting was 43.7% (95% CI 26.3-62.3) and 97.9% (97.3-98.4), respectively. The positive and negative predictive values of the U.K. criteria were 18.4% (95% CI 10.4-28.9) and 99.4% (95% CI 99.0-99.6), respectively. The presence of visible flexural eczema according to the U.K. photographic protocol was the best predictor of atopic eczema, with a sensitivity and specificity of 81.2% (95% CI 63.5-92.7) and 99.0% (95% CI 98.6-99.3), respectively, and a positive and negative predictive value of 48.1% (95% CI 34.3-62.1) and 99.8% (95% CI 99.5-99.9), respectively. The validity of the full question-based version of the U.K. diagnostic

  13. Relationship Between Carotid Intima-Media Thickness Using Ultrasonography and Diagnostic Indices of Metabolic Syndrome

    Energy Technology Data Exchange (ETDEWEB)

    Ko, Kyung Sun; Heo, Kyung Hwa; Won, Yong Lim; Kim, Ki Woong [Center for Occupational Disease Reserach, Occupational Safety and Health Research Insurance, KOSHA, Incheon (Korea, Republic of)

    2009-09-15

    The aim of the present study was undertaken to investigate the association between diagnostic indices of metabolic syndrome(MetS) with carotid intima-media thickness using ultrasonography. The participants in the study were 315 male employees without carotid atherosclerosis and other cardiovascular disease. This study was approved by the Institutional Review Board of Occupational Safety and Health Research Institute. Written informed consent for the participants in this study was obtained from all individuals. Anthropometric parameters and biochemical characteristics were done using each specific equipment and the NCEP-ATP III criteria were used to define MetS. They were examined by B-mode ultrasound to measure the carotid intima-media thickness(carotid IMT) at the near and far walls of common carotid and bifurcation(bulb). The mean carotid IMT was 0.739{+-}0.137 mm and it's thickness significantly increased with the increase in age. Also, amounts of systolic and diastolic blood pressure, triglyceride and fasting glucose were significantly increased with the increase in age. Carotid IMT were significantly correlated with BMI(r=0.170, p=0.004), systolic(r=0.148, p=0.011) and diastolic blood pressure(r=0.123, p=0.036) and HDL-cholesterol(r=-0.164, p=0.005). On multiple logistic regression analysis for the diagnostic indices of MetS, carotid IMT were significantly associated with blood pressure(OR=4.220, p<0.01) and MetS(OR=1.301, p<0.05). The results indicate that blood pressure and MetS are important risk factors for carotid atherosclerosis.

  14. Patients Suspected of Irritable Bowel Syndrome-Cross-Sectional Study Exploring the Sensitivity of Rome III Criteria in Primary Care

    DEFF Research Database (Denmark)

    Engsbro, Anne Line; Begtrup, Luise Mølenberg; Kjeldsen, Jens

    2013-01-01

    The Rome III criteria for irritable bowel syndrome (IBS) are recommended by guidelines to help identify the syndrome. The majority of IBS patients are managed in primary care, where a pragmatic approach to diagnosis is usually adopted, using clinical judgment and knowledge about the patient. Many...

  15. NCEP-ATP III and IDF criteria for metabolic syndrome predict type 2 diabetes mellitus

    Directory of Open Access Journals (Sweden)

    Eva Sulistiowati

    2016-05-01

    Full Text Available Background Subjects with metabolic syndrome (MetS have a greater risk for acquiring type 2 diabetes mellitus (type 2 DM. The MetS criteria usually used are those of the National Cholesterol Education Program Expert Panel (NCEP and Adult Treatment Panel III (ATP III and of the International Diabetes Federation (IDF. This study aimed to evaluate the modified NCEP-ATP III and IDF criteria as predictor of type 2 DM among subjects with MetS.   Methods A cohort study was conducted among 4240 subjects with MetS. MetS was determined according to the modified NCEP-ATP III and IDF criteria. The study followed up 3324 non-diabetic subjects of the cohort study of non-communicable disease (NCD risk factors (NCD study during a 2-year period. Type 2 DM was determined from the diagnosis by health personnel or from fasting blood glucose of ≥126 mg/dL or blood glucose of ≥200 mg/dL, 2 hours after 75g glucose loading.   Results The MetS prevalence based on modified NCEP ATP III and IDF criteria in non-DM subjects was 17.1% and 15.6%, respectively. The risk for DM in subjects with MetS using modified NCEP ATP III and IDF criteria was 4.7 (CI 95%: 3.4-6.5 and 4.1 (CI 95%: 3.0-5.7, respectively.   Conclusions Both MetS criteria can be used as predictors of the occurrence of DM type 2, but the modified NCEP-ATP III is more properly applied than the IDF criteria in subjects with MetS. Screening programs and routine monitoring of MetS components are required for early detection of type 2 DM.

  16. An examination of cancer-related fatigue through proposed diagnostic criteria in a sample of cancer patients in Taiwan

    Directory of Open Access Journals (Sweden)

    Su Wei-Ju

    2011-09-01

    Full Text Available Abstract Background Fatigue among cancer patients has often been reported in the literature; however, great variations have been documented, ranging from 15% to 90%, probably due to the lack of a widely accepted definition and established diagnostic criteria for cancer-related fatigue. The objective of this study was to evaluate the proposed International Statistical Classification of Diseases and Related Health Problems (10th revision (ICD-10 criteria in a sample of cancer patients from a medical center and a regional teaching hospital in northern Taiwan. More accurate prevalence estimates of CRF may result in improved diagnoses and management of one of the most common symptoms associated with cancer and its treatment. Methods Since self-reporting from patients is the most effective and efficient method to measure fatigue, the ICD-10 criteria for fatigue were used. The ICD-10 criteria questionnaire was translated into Chinese and was approved by experts. Patients were recruited from outpatient palliative and oncology clinics and from palliative and oncology inpatient units. Results Of the 265 cancer patients that were interviewed between 21 October 2008 and 28 October 2009, 228 (86% reported having at least 2 weeks of fatigue in the past month, and further evaluation with the ICD-10 criteria showed that 132 (49.8% had cancer-related fatigue. Internal consistency was very good, which was indicated by a Cronbach alpha of 0.843. Conclusion The prevalence of diagnosable CRF in the patients in this sample, of whom most were under palliative treatment, was 49.8%, which was probably somewhat lower than in some of the previous reports that have used less-strict criteria. In addition, among the various criteria of the proposed diagnostic criteria, the most frequently reported symptoms in our sample populations were regarding sleep disturbance and physical factors. Although they will require further replication in other samples, these formal diagnostic

  17. Diagnostics and complex treatment of pain dysfunction syndrome of temporomandibular joint

    Directory of Open Access Journals (Sweden)

    Tlustenko V.P.

    2013-09-01

    Full Text Available Research objective is to increase quality of diagnostics and treatment of patients with a pain dysfunction syndrome of temporomandibular joint by the choice of diagnostic and medical actions. Material and Methods: 172 patients with a syndrome of pain dysfunction of temporomandibular joint have been underthe survey. All patients have been examined according to the scheme including subjective, objective and express methods. Results of the research allowed to reveal that at 30% of patients the syndrome of pain dysfunction of temporomandibular joint has been caused by disk dislocation. Upon termination of the treatment which has been carried out by the scheme, the normalization of relationship of joint elements has been observed. Conclusion: When the diagnosis of syndrome of pain dysfunction of temporomandibular joint is proved, it is necessary to apply complex treatment.

  18. Diagnostic value of hepatobiliary sequence scintigraphy in patients with postcholecystectomy syndrome

    International Nuclear Information System (INIS)

    Frey, H.; Jorke, D.; Gottschild, D.; Langbein, T.; Zinner, G.; Kob, D.

    1992-01-01

    The autors report about the possibility of registration from functionally disturbances of gall fluid with the help of hepatobiliary sequence-scintigraphy in patients with postcholecystectomy-syndrome. The diagnostic importance of this methode and the meaning of other usually procedures is discussed. A selection of patients succeed in objective manner with hepatobiliary sequence-scintigraphy together with clinically dates of laboratory. In patients with postcholecystectomy-syndrome the procedure can show functionally disturbances in the area of extrahepatic gall ways. (orig.) [de

  19. Impact of Periodontal Disease on the Quality of Life of Diabetics Based on Different Clinical Diagnostic Criteria

    Directory of Open Access Journals (Sweden)

    Aline Mendes Silva de Pinho

    2012-01-01

    Full Text Available The aim of this study was to determine the impact of periodontal disease on the quality of life of individuals with diabetes according to different clinical criteria (I-AAP, II-Beck, III-Machtei, IV-Lopez, V-Albandar, VI-Tonetti, and VII-CPI. This cross-sectional study sampled 300 individuals in Belo Horizonte, Brazil. The Oral Health Impact Profile was used to measure the impact of periodontal disease on quality of life. Prevalence of periodontal disease was 35.3%, 30.7%, 35.0%, 9.7%, 92.3%, 25.3%, and 75.3% using criteria I, II, III, IV, V, VI, and VII, respectively. The III-Machtei (P=0.043 and IV-Lopez (P<0.001 criteria were associated with OHIP-14; functional limitation was associated with IV-Lopez (P=0.006 and V-Albandar (P=0.018 criteria. Pain was only associated with V-Albandar criteria (P<0.001. Psychological discomfort was associated with the IV-Lopez (P=0.018 criteria. Physical disability was associated with the IV-Lopez (P=0.047 and V-Tonetti (P=0.046 criteria. Being handicapped was associated with the I-AAP (P=0.025 and II-Beck (P=0.041 criteria. Concepts of health and disease determined by clinical diagnostic criteria may influence the assessment of the impact of periodontal disease on diabetics' quality of life.

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

    Science.gov (United States)

    Leckman, James F; Denys, Damiaan; Simpson, H Blair; Mataix-Cols, David; Hollander, Eric; Saxena, Sanjaya; Miguel, Euripedes C; Rauch, Scott L; Goodman, Wayne K; Phillips, Katharine A; Stein, Dan J

    2010-06-01

    Since the publication of the DSM-IV in 1994, research on obsessive-compulsive disorder (OCD) has continued to expand. It is timely to reconsider the nosology of this disorder, assessing whether changes to diagnostic criteria as well as subtypes and specifiers may improve diagnostic validity and clinical utility. The existing criteria were evaluated. Key issues were identified. Electronic databases of PubMed, ScienceDirect, and PsycINFO were searched for relevant studies. This review presents a number of options and preliminary recommendations to be considered for DSM-V. These include: (1) clarifying and simplifying the definition of obsessions and compulsions (criterion A); (2) possibly deleting the requirement that people recognize that their obsessions or compulsions are excessive or unreasonable (criterion B); (3) rethinking the clinical significance criterion (criterion C) and, in the interim, possibly adjusting what is considered "time-consuming" for OCD; (4) listing additional disorders to help with the differential diagnosis (criterion D); (5) rethinking the medical exclusion criterion (criterion E) and clarifying what is meant by a "general medical condition"; (6) revising the specifiers (i.e., clarifying that OCD can involve a range of insight, in addition to "poor insight," and adding "tic-related OCD"); and (7) highlighting in the DSM-V text important clinical features of OCD that are not currently mentioned in the criteria (e.g., the major symptom dimensions). A number of changes to the existing diagnostic criteria for OCD are proposed. These proposed criteria may change as the DSM-V process progresses. (c) 2010 Wiley-Liss, Inc.

  1. Gilbert’s syndrome: clinical features, diagnostics, differential diagnosis and treatment (part 2

    Directory of Open Access Journals (Sweden)

    T.V. Sorokman

    2017-02-01

    Full Text Available We searched for published and unpublished research using PubMed as the search engine by the keywords: “Gilbert’s syndrome”, “clinical manifestation”, “diagnosis”, “treatment”, taking into consideration studies conducted in the last 10 years, citation review of relevant primary and review articles, conference abstracts, personal files, and contact with expert informants. The criterion for the selection of articles for the study was based on their close relevance to the topic, thus, out of 75 analyzed articles, the findings of the researches covered in 28 articles were crucial. Clinical manifestations of Gilbert’s syndrome (GS are possible both in homozygous for UGT1A1, and in heterozygous status. A latent variant of the disease prevails in individuals with heterozygous status. Up to 30 % of homozygous for the defective gene of GS individuals have an asymptomatic course of the disease. Clinical types of GS: dyspeptic — 43.2 %, asthenovegetative — 15.9 %, icteric — 14.8 % and asymptomatic — 26.1 %. Dietary deviations, mental fatigue, stress, trauma, acute infections, including hepatitis, certain medications intake are the triggers for GS. In 86.4 % of children with GS, the pathology of the upper digestive tract was detected: duodenitis — in 58 % of cases, gastritis — in 56.8 %, esophagitis — in 12.5 %, duodenal ulcer — in 2.3 %, in 39.7 % of patients sphincter disorders were registered (duodenogastric and gastroesophageal bile reflux. The GS is characterized by reduced detoxification function of the liver, in particular in 2/3 of patients decreased hepatocyte metabolic activity was observed, the excretory function of liver cell suffers in another half of patients, the biliary tract disorders and increased risk of gallstones formation are described in 88 % of cases. Some patients with GS have certain psychological disorders, including anxiety. Diagnostic criteria for GS: 1. A peculiar pale yellowish

  2. Clinical radiation diagnostics of shoulder joint impingement syndrome

    International Nuclear Information System (INIS)

    Litvin, Yu.P.; Logvinenko, V.V.

    2014-01-01

    46 patients about an impingement are investigated by a syndrome of a humeral joint. Among them men was 28 (60,9 %) the person, women 18 (39,1 %). Middle age of the surveyed has made 52,6 ± 2,0 year. The traditional roentgenography is executed to all patients, a spiral computer tomography - 5 (10,9 %), an ultrasonography - 44 (95,7 %), a magnetic resonance imaging - 11 (23,9 %). Operative treatment is spent 16 (34,8 %) by the patient. Direct radial symptoms are what specify an impingement of a syndrome of a humeral joint in the reasons, indirect - symptoms of an inflammation both degenerate and dystrophic changes of structures of area of a humeral joint which are involved in pathological process. The best results are given by complex radial research at which it is possible to find out direct and indirect symptoms a syndrome impingement

  3. Cardiorenal Syndrome Type 1: Definition, Etiopathogenesis, Diagnostics and Treatment

    Directory of Open Access Journals (Sweden)

    Nikolic Tomislav

    2018-03-01

    Full Text Available Cardiorenal Syndrome Type 1 (CRS-1 is defined as an acute worsening of heart function leading to acute kidney injury and/or dysfunction. It is an important cause of hospitalization which affects the diagnosis as well as the prognosis and treatment of patients. The purpose of this paper is to analyze causes that lead to the development of cardiorenal syndrome type 1 and its clinical consequences, as well as to emphasize the clinical importance of its early detection. The clinical studies and professional papers dealing with etiopathogenesis, diagnosis and treatment of cardiorenal syndrome type 1, have been analyzed. The most important role in the occurrence of cardio renal syndrome type 1 is played by hemodynamic mechanisms, activation of neurohumoral systems, inflammation and imbalance between the production of reactive oxygen species (ROS and nitric oxide (NO. Diagnosis of cardiorenal syndrome type 1 involves biomarkers of acute renal injury among which the most important are: neutrophil gelatinaseassociated lipocalin (NGAL, cystatin C, kidney injury molecule 1 (KIM-1, liver-type fatty acid binding protein (L-FABP, IL-18 and the values of nitrogen compounds in serum. In addition to a pharmacological therapy, various modalities of extracorporeal ultrafiltration are applied in treatment of CRS-1, particularly if there is resistance to the use of diuretic therapy. As opposed to the experimental models, in clinical practice acute renal injury is often diagnosed late so that the measures taken do not give the expected results and the protective role shown in experimental conditions do not give the same results. For all these reasons, it is necessary to analyze the pathophysiology of renal impairment in cardiorenal syndrome as well as detect early indicators of kidney injury that could have clinical benefit and positive impact on reducing the cost of treatment.

  4. Diagnostic value of anti-annexin A5 antibodies in seropositive versus seronegative antiphospholipid syndrome patients

    Directory of Open Access Journals (Sweden)

    Gihan Omar

    2018-04-01

    Full Text Available Background: Current laboratory criteria for antiphospholipid syndrome (APS classification recommend testing positive for antiphospholipid (aPL antibodies. However, there appears to be a subset of patients with classical APS manifestations who test negative. Aim of the work: To analyze the potential clinical usefulness of testing for anti-annexin A5 antibodies in patients with APS and to study the effectiveness of testing for non-criteria aPLs in an attempt to increase the diagnostic yield, particularly in seronegative APS. Patients and methods: 60 APS patients were divided into two groups; 30 seropositive (SP-APS (group I and 30 age and sex matched seronegative (sN-APS testing negative for aPL antibodies. Serum assay for detection of isotypes of anti-annexin A5 antibodies (IgG and IgM were conducted. Results: The mean age of the patients was 32.9 ± 5.8 years, female:male 57:3 and disease duration in SP-APS versus sN-APS (10.17 ± 4.9 years versus 9.6 ± 5.5 years respectively. Secondary APS was present in 16(53.3% patients in group I compared to 3(10% in group II (p < 0.0001. The mean anti-AnxA5 IgG level was 10.7 ± 5.6 U/ml and IgM was 11.2 ± 7.1 U/ml and were comparable between the 2 groups. The obstetric and thrombotic morbidity had no significant differences between SP and sN-APS. The IgG and IgM levels significantly correlated with the pregnancy morbidity, venous and arterial thrombosis events and showed reasonable sensitivities in their prediction (IgG:71.2%,72.8% and 75.8%; IgM: 68%,67.8% and 71.4% respectively and specificities (IgG:75.9%,77.8% and 81.5%; IgM: 70.9%,73.1% and 73.7% respectively. Conclusion: anti-annexinA5 antibodies are promising for detecting obstetric and thrombotic morbidity in both SP- and sN-APS patients. Keywords: Antiphospholipid syndrome, Seropositive APS (SP-APS, Seronegative APS (sN-APS, Anti-annexin A5 antibodies

  5. [Enlarged vestibular aqueduct syndrome: etiology, clinical features, diagnostics, and rehabilitation of the patients].

    Science.gov (United States)

    Zelikovich, E I; Tropchina, L V; Kurilenkov, G V

    2015-01-01

    This publication was designed to describe the clinical manifestations of the enlarged vestibular aqueduct syndrome (EVAS), the currently employed methods for its diagnostics, and the strategy for the rehabilitation of the patients presenting with this pathological condition. In addition, the article provides information about the topographic anatomy and X-ray anatomy of the vestibular aqueduct, the specific clinical features of EVAS, the modern algorithm of its diagnostics, and the facilities for hearing rehabilitation in this group of patients.

  6. Comparison of the established definition criteria for diagnosing metabolic syndrome between overweight and obese children in Vojvodina

    Directory of Open Access Journals (Sweden)

    Vorgučin Ivana

    2011-01-01

    Full Text Available Background/Aim. Metabolic syndrome is a clinical term which encompasses obesity, insulin resistance, dyslipidemia, hypertension, as well as an increased risk of the development of diabetes mellitus type 2 and cardiovascular disorders in early adulthood. The prevalence of metabolic syndrome is increasing and directly related to the obesity rate among children. The aim of the research was to compare the established definition of the criteria for diagnosing metabolic syndrome in a sample group consisting of overweight and obese children in Vojvodina. Methods. The research was performed as a cross study analysis of 206 examinees. In terms of the sample group (25% children and 75% adolescents, 74% were obese and 26% overweight according to the body mass index (BMI. Two sets of criteria for diagnosing metabolic syndrome were applied in the sample of adolescents: the criteria for adults, specifically adapted for children, and the criteria defined by the International Diabetes Federation (IDF for children and adolescents. The research included the analysis of the following criteria: BMI, waist circumference, blood pressure, triglycerides, HDL cholesterol, glycemia and insulinemia during the oral glucose tolerance test (OGTT. Results. By applying the specific criteria for diagnosing the metabolic syndrome in children and adolescents on the whole sample, it was established that the metabolic syndrome was present in 41% of the examinees, while the application of the criteria defined by the IDF confirmed the diagnosis in 22% of the examinees. An analysis of the metabolic syndrome risk factors established that among the defined specific criteria the most frequent factors present were elevated BMI and the pathological results of the OGTT, while the least frequent was low HDL cholesterol. Among the criteria listed by the IDF, the most frequent metabolic syndrome factors were waist circumference and increased blood pressure, while the least frequent was

  7. [Comparison of the established definition criteria for diagnosing metabolic syndrome between overweight and obese children in Vojvodina].

    Science.gov (United States)

    Vorgucin, Ivana; Vlaski, Jovan; Naumović, Nada; Katanić, Dragan

    2011-06-01

    Metabolic syndrome is a clinical term which encompasses obesity, insulin resistance, dyslipidemia, hypertension, as well as an increased risk of the development of diabetes mellitus type 2 and cardiovascular disorders in early adulthood. The prevalence of metabolic syndrome is increasing and directly related to the obesity rate among children. The aim of the research was to compare the established definition of the criteria for diagnosing metabolic syndrome in a sample group consisting of overweight and obese children in Vojvodina. The research was performed as a cross study analysis of 206 examinees. In terms of the sample group (25% children and 75% adolescents), 74% were obese and 26% overweight according to the body mass index (BMI). Two sets of criteria for diagnosing metabolic syndrome were applied in the sample of adolescents: the criteria for adults, specifically adapted for children, and the criteria defined by the International Diabetes Federation (IDF) for children and adolescents. The research included the analysis of the following criteria: BMI, waist circumference, blood pressure, triglycerides, HDL cholesterol, glycemia and insulinemia during the oral glucose tolerance test (OGTT). By applying the specific criteria for diagnosing the metabolic syndrome in children and adolescents on the whole sample, it was established that the metabolic syndrome was present in 41% of the examinees, while the application of the criteria defined by the IDF confirmed the diagnosis in 22% of the examinees. An analysis of the metabolic syndrome risk fac- tors established that among the defined specific criteria the most frequent factors present were elevated BMI and the pathological results of the OGTT, while the least frequent was low HDL cholesterol. Among the criteria listed by the IDF, the most frequent metabolic syndrome factors were waist circumference and increased blood pressure, while the least frequent was elevated fasting glucose. Metabolic syndrome in

  8. Poor agreement in questionnaire-based diagnostic criteria for adult atopic dermatitis is a challenge when examining cardiovascular comorbidity

    DEFF Research Database (Denmark)

    Andersen, Y M F; Egeberg, A; Hamann, C R

    2018-01-01

    versions of the UK Working Party Diagnostic Criteria. Associations between AD status and cardio-metabolic endpoints were estimated using survey weighted logistic and linear regression analysis. RESULTS: We identified 462 (4.8%) adults with self-reported physician-diagnosed AD, whereas 903 (9.4%) and 226 (2.......3%) had AD according to the UK Working Party Criteria when at least 2 and 3of 4 minor criteria were fulfilled. The populations were not comparable in terms of occurrence of cardio-metabolic risk factors. For example, the prevalence of obesity was lower in participants with physician-diagnosed AD......BACKGROUND: The association between atopic dermatitis (AD) and cardio-metabolic risk factors is not yet established. Furthermore, no validated questionnaire-based method of identifying adults with AD is currently available. OBJECTIVES: To assess the cardio-metabolic risk in adults with a history...

  9. A new diagnostic approach to popliteal artery entrapment syndrome

    Energy Technology Data Exchange (ETDEWEB)

    Williams, Charles; Kennedy, Dominic; Bastian-Jordan, Matthew; Hislop, Matthew; Cramp, Brendan; Dhupelia, Sanjay [Queensland X-Ray, Sunnybank, Queensland, 4109 (Australia)

    2015-09-15

    A new method of diagnosing and defining functional popliteal artery entrapment syndrome is described. By combining ultrasonography and magnetic resonance imaging techniques with dynamic plantarflexion of the ankle against resistance, functional entrapment can be demonstrated and the location of the arterial occlusion identified. This combination of imaging modalities will also define muscular anatomy for guiding intervention such as surgery or Botox injection.

  10. Radiation syndrome - pathogenesis, course, diagnostic and therapeutic measures

    International Nuclear Information System (INIS)

    Trott, K.R.

    1981-01-01

    Owing to lack of practical experience, schemes for medical aid in cases of reactor accidents are based on theoretical models and the results of radiation biology and tumor research. The chances for medical assistance are deduced from the course of the radiation syndrome in affected persons. (DG) [de

  11. Radiological diagnostics in CUP syndrome; Radiologische Diagnostik des CUP-Syndroms

    Energy Technology Data Exchange (ETDEWEB)

    Kazmierczak, P.M.; Nikolaou, K.; Graser, A.; Reiser, M.F.; Cyran, C.C. [Klinikum der Ludwig-Maximilians-Universitaet, Campus Grosshadern, Institut fuer Klinische Radiologie, Muenchen (Germany); Rominger, A. [Klinikum der Ludwig-Maximilians-Universitaet, Campus Grosshadern, Klinik und Poliklinik fuer Nuklearmedizin, Muenchen (Germany)

    2014-02-15

    , diffusion), e.g. investigation of breast carcinoma or prostate carcinoma. Whole body staging stands at the beginning of the diagnostic algorithm in CUP syndrome to localize a potential primary tumor. Clinically, contrast-enhanced CT of the neck, thorax and abdomen is frequently applied; however, many studies have demonstrated augmented sensitivity of {sup 18}F-FDG PET-CT for the detection of primary tumors and metastatic tumor manifestations. (orig.) [German] Im therapeutischen Management des Cancer-of-unknown-primary(CUP)-Syndroms spielt die bildgebende Diagnostik eine zentrale Rolle zur Lokalisation des Primaertumors, zur Identifikation von Tumoren, fuer die ein dediziertes Behandlungsschema zur Verfuegung steht, sowie zur Charakterisierung klinisch-pathologischer Subentitaeten, die das weitere diagnostische und therapeutische Procedere bestimmen und eine Einschaetzung der Prognose erlauben. Zur Verfuegung stehende radiologische Modalitaeten umfassen die Projektionsradiographie, die Computertomographie (CT), die Magnetresonanztomographie (MRT) und die Sonographie sowie die Hybridverfahren Positronenemissionstomographie(PET)-CT und MR-PET. In der Ganzkoerperbildgebung hat die CT eine hohe Sensitivitaet fuer Tumoren, die haeufig als metastasierte Tumorerkrankung auftreten. Nach aktueller Literatur ist die CT bei Patienten mit Pankreaskarzinom in 86% der Faelle diagnostisch, bei Patienten mit Kolonkarzinom in 36% und bei Patienten mit Bronchialkarzinom in 74%. Des Weiteren zeigte eine Metaanalyse, dass bei Patienten mit Plattenepithelkarzinom und zervikalen Lymphknotenmetastasen die CT in 22% der Faelle den Primaertumor lokalisieren konnte, im Vergleich zu 36% Detektionsrate der MRT und 28-57% der PET-CT mit {sup 18}F-FDG (Fluordesoxyglukose). Der MRT kommt auf Grund des hohen Weichteilkontrasts und der Moeglichkeit zur funktionellen Bildgebung besondere Bedeutung bei der Lokalisation primaer okkulter Tumoren bei Organuntersuchungen zu, z. B. beim Mamma- oder dem

  12. Atlantic Diabetes in Pregnancy (DIP): the prevalence and outcomes of gestational diabetes mellitus using new diagnostic criteria.

    LENUS (Irish Health Repository)

    O'Sullivan, E P

    2012-01-31

    AIMS\\/HYPOTHESIS: New diagnostic criteria for gestational diabetes mellitus (GDM) have recently been published. We wished to evaluate what impact these new criteria would have on GDM prevalence and outcomes in a predominantly European population. METHODS: The Atlantic Diabetes In Pregnancy (DIP) programme performed screening for GDM in 5,500 women with an oral glucose tolerance test at 24-28 weeks. GDM was defined according to the new International Association of Diabetes and Pregnancy Study Groups (IADPSG) criteria and compared with previous WHO criteria; maternal and neonatal adverse outcomes were prospectively recorded. RESULTS: Of the participants, 12.4% and 9.4% were diagnosed with GDM using IADPSG and WHO criteria, respectively. IADPSG GDM pregnancies were associated with a statistically significant increased incidence of adverse maternal outcomes (gestational hypertension, polyhydramnios and Caesarean section) and neonatal outcomes (prematurity, large for gestational age, neonatal unit admission, neonatal hypoglycaemia and respiratory distress). The odds ratio for the development of these adverse outcomes remained significant after adjustment for maternal age, body mass index and non-European ethnicity. Those women who were classified as having normal glucose tolerance by WHO criteria but as having GDM by IADPSG criteria also had significant adverse pregnancy outcomes. CONCLUSIONS\\/INTERPRETATION: GDM prevalence is higher when using newer IADPSG, compared with WHO, criteria, and these women and their offspring experience significant adverse pregnancy outcomes. Higher rates of GDM pose a challenge to healthcare systems, but improved screening provides an opportunity to attempt to reduce the associated morbidity for mother and child.

  13. Metabolic syndrome in Type 2 diabetes: Comparison of WHO, modified ATPIII and IDF criteria

    International Nuclear Information System (INIS)

    Ahmed, A.; Khan, T.E.; Yasmeen, T.; Awan, S.; Islam, N.

    2012-01-01

    Objectives: To determine the frequency of metabolic syndrome in type 2 diabetes according to three commonly used operational definitions (World Health Organization(WHO), National Cholesterol Education Program Adult Treatment Panel( NCEP ATP III) and International Diabetes Federation( IDF)). To evaluate the agreement between these classifications in the Pakistani cohort. Methods: Data was collected retrospectively of 210 patients with type 2 diabetes visiting outpatient clinics of one of the large tertiary care hospitals at Karachi, Pakistan between June 2008 to November 2008. Results: The prevalence of metabolic syndrome was found to be 81.4% (WHO), 86.7 %( IDF) and 91.9 %( NCEP ATPIII). The degree of agreement (kappa statistic) was found to be highest among IDF and NCEP ATPIII (0.728) as compared to (0.436 and 0.417) between WHO and ATP and WHO and IDF respectively. The most significant predictors for metabolic syndrome were found out to be female gender OR= 8.74 95% CI 1.51-50.53, low HDL cholesterol levels OR= 0.89 95% CI 0.84-0.94 and high systolic blood pressure OR= 1.06 95% CI 1.009-1.11. Conclusion: Our study results suggested that NCEP ATPIII and IDF are the most reliable criteria for diagnosing metabolic syndrome in type 2 diabetic patients, with NECP capturing more patients in comparison to IDF definition. The alarmingly high frequency of metabolic syndrome in type 2 diabetes found in this study suggests that primary prevention strategies should be initiated earlier and early in this ethnic group and our health care system should be geared up to cope with this deadly quartet. (author)

  14. Metabolic syndrome in type 2 diabetes: comparison of WHO, modified ATPIII & IDF criteria.

    Science.gov (United States)

    Ahmed, Asma; Khan, Talha Ehsan; Yasmeen, Tahira; Awan, Safia; Islam, Najmul

    2012-06-01

    To determine the frequency of metabolic syndrome in type 2 diabetes according to three commonly used operational definitions {World Health Organization (WHO), National Cholesterol Education Program Adult Treatment Panel (NCEP ATP III) and International Diabetes Federation( IDF)}. To evaluate the agreement between these classifications in the Pakistani cohort. Data was collected retrospectively of 210 patients with type 2 diabetes visiting outpatient clinics of one of the large tertiary care hospitals at Karachi, Pakistan between June 2008 to November 2008. The prevalence of metabolic syndrome was found to be 81.4% (WHO), 86.7 % (IDF) and 91.9 % (NCEP ATPIII). The degree of agreement (kappa statistic) was found to be highest among IDF & NCEP ATPIII (0.728) as compared to (0.436 & 0.417) between WHO & ATP and WHO & IDF respectively. The most significant predictors for metabolic syndrome were found out to be female gender OR= 8.74 95% CI 1.51-50.53, low HDL cholesterol levels OR = 0.89 95% CI 0.84-0.94 and high systolic blood pressure OR= 1.06 95% CI 1.009-1.11. Our study results suggested that NCEP ATPIII and IDF are the most reliable criteria for diagnosing metabolic syndrome in type 2 diabetic patients, with NECP capturing more patients in comparison to IDF definition. The alarmingly high frequency of metabolic syndrome in type 2 diabetes found in this study suggests that primary prevention strategies should be initiated earlier and early in this ethnic group and our health care system should be geared up to cope with this deadly quartet.

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

    DEFF Research Database (Denmark)

    Basu, Neil; Watts, Richard; Bajema, Ingeborg

    2010-01-01

    The systemic vasculitides are multiorgan diseases where early diagnosis and treatment can significantly improve outcomes. Robust nomenclature reduces diagnostic delay. However, key aspects of current nomenclature are widely perceived to be out of date, these include disease definitions, classific...

  16. Explicit diagnostic criteria for transient ischemic attacks to differentiate it from migraine with aura

    DEFF Research Database (Denmark)

    Lebedeva, Elena R; Gurary, Natalia M; Gilev, Denis V

    2018-01-01

    and for specificity against migraine with aura. Methods The proposed criteria were developed using the format of the international headache classification. We drew upon the existing literature about clinical characteristics and diagnosis of migraine with aura and transient ischemic attacks. We tested the criteria...... diagnosed according to the International Classification of Headache Disorders edition 3 (beta). Results The sensitivity of the proposed criteria was 99% in patients with transient ischemic attacks. The specificity was 95% in the Danish material of patients with migraine with aura and 96% in the Russian...

  17. Behcet's syndrome involving the gastrointestinal tract - a diagnostic dilemma in childhood

    International Nuclear Information System (INIS)

    Stringer, D.A.; Daneman, A.; Cleghorn, G.J.; Durie, P.R.; Hamilton, J.R.

    1986-01-01

    Behcet's syndrome is very rare in children, especially those under 10 years of age. Clinical and radiological features are described in 4 children, including 2 under the age of 5 years, with the syndrome. As in other pediatric cases reported, the incomplete form of Behcet's syndrome was present in each case. All 4 patients had oral and genital mucosal effects, arthritis and gastrointestinal and dermatological manifestations. Ophthalmological symptoms occurred in only 1 patient. Radiologically, the 4 cases demonstrated the spectrum of gastrointestinal involvement, from minimal irregularity and thickening of the terminal ileum to gross irregularity and deformity of the terminal ileum and cecum. Because of the difficulty in differentiating Behcet's syndrome from other forms of inflammatory bowel disease it is suggested that in children with gastrointestinal involvement, 3 major criteria be present before the diagnosis of Behcet's syndrome is made. (orig.)

  18. Development of diagnostic criteria for serious non-AIDS events in HIV clinical trials

    DEFF Research Database (Denmark)

    Lifson, Alan R; Belloso, Waldo H; Davey, Richard T

    2010-01-01

    (ESPRIT). RESULTS: Final criteria are presented for acute myocardial infarction, congestive heart failure, coronary artery disease requiring drug treatment, coronary revascularization, decompensated liver disease, deep vein thrombosis, diabetes mellitus, end-stage renal disease, non-AIDS cancer......PURPOSE: Serious non-AIDS (SNA) diseases are important causes of morbidity and mortality in the HAART era. We describe development of standard criteria for 12 SNA events for Endpoint Review Committee (ERC) use in START, a multicenter international HIV clinical trial. METHODS: SNA definitions were...... developed based upon the following: (1) criteria from a previous trial (SMART), (2) review of published literature, (3) an iterative consultation and review process with the ERC and other content experts, and (4) evaluation of draft SNA criteria using retrospectively collected reports in another trial...

  19. Eagle Syndrome: diagnostic imaging and therapy; Eagle Syndrom - Bildgebende Diagnostik und Therapie

    Energy Technology Data Exchange (ETDEWEB)

    Nickel, J.; Andresen, R. [Abt. fuer Bildgebende Diagnostik und Interventionelle Radiologie, Guestrower Krankenhaus, Akademisches Lehrkrankenhaus der Univ. Rostock (Germany); Sonnenburg, M. [Fachbelegarztpraxis fuer Mund, Kiefer, Gesichtschirurgie und Plastische Operationen, Guestrower Krankenhaus, Akademisches Lehrkrankenhaus der Univ. Rostock (Germany); Scheufler, O. [Klinik fuer Plastische, Wiederherstellungs- und Handchirurgie, Markus Krankenhaus, Akademisches Lehrkrankenhaus der Goethe Univ. Frankfurt am Main (Germany)

    2004-07-01

    In the case of clinical symptoms such as dysphagia, foreign-body sensation and chronic neck or facial pain close to the ear, an Eagle syndrome should be considered in the differential diagnosis. Rational diagnostics and therapy are elucidated on the basis of four case reports. Four patients presented in the out-patients clinic with chronic complaints on chewing and a foreign-body sensation in the tonsil region. Upon specific palpation below the mandibular angle, pain radiating into the ear region intensified. In all patients, local anaesthesia with lidocaine only led to a temporary remission of symptoms. Imaging diagnostics then performed initially included cranial survey radiograms according to Clementschitsch as well as in the lateral ray path and an OPTG. An axial spiral-CT was then performed using the thin-layer technique with subsequent 3-D reconstruction. Therapy consisted of elective resection with a lateral external incision from the retromandibular. From a symptomatic point of view, the cranial survey radiograms and the OPTG revealed hypertrophic styloid processes. The geometrically corrected addition of the axial CT images produced an absolute length of 51-58 mm. The 3-D reconstruction made it possible to visualise the exact spatial orientation of the styloid processes. An ossification of the stylohyoid ligament could definitely be ruled out on the basis of the imaging procedures. After resection of the megastyloid, the patients were completely free of symptoms. Spiral-CT with subsequent 3-D reconstruction is the method of choice for exact determination of the localisation and size of a megastyloid, while cranial survey radiograms according to Clementschitsch and in the lateral ray path or an OPTG can provide initial information. The therapy of choice is considered to be resection of the megastyloid, whereby an external lateral incision has proved effective. (orig.) [German] Bei klinischen Beschwerden wie Dysphagie, Fremdkoerpergefuehl und chronischen

  20. Evaluation of the radiological criteria to diagnose large vestibular aqueduct syndrome.

    Science.gov (United States)

    El-Badry, Mohamed M; Osman, Nasr M; Mohamed, Haytham Mamdouh; Rafaat, Fatma M

    2016-02-01

    The main objective of the current work is to increase the sensitivity of the radiological diagnosis of the large vestibular aqueduct syndrome (LVAS). The specific aims were to compare between the two famous criteria to diagnose large vestibular aqueduct (LVA), (i.e., Valvassori and Cincinnati), to correlate between vestibular aqueduct (VA) measurements in the axial view and those in 45° oblique reformate in children with LVAS, and to define radiological criteria to diagnose LVA in the 45° oblique reformate. The study group included 61 children with LVAS according to Cincinnati criteria (greater than 0.9mm at the midpoint or greater than 1.9mm at the operculum in the axial view). All participants were subjected to full Audiological evaluation and CT scanning in axial plane. The axial data were then transferred to workstation for post-processing with 3D reformatting software (Baxara 3D) in order to obtain the 45° oblique reformates. VA measurements were done at 4 points: midpoint and operculum in both the axial plane and the 45° oblique reformate. Only 81% of ears of children with LVAS (99 ears) fit Valvassori criterion (i.e., larger than 1.5mm at midpoint), while 19% (23 ears) of them were missed. There were statistically significant correlations among the diameters of the VA in the axial view (both in the midpoint and operculum) and their counterparts in the 45° oblique reformate. Values equal to or greater than 1.2mm in the midpoint and 1.3mm in the operculum are proposed to be the criteria to diagnose LVA in the 45° oblique reformate. Finally, no significant correlations were found between the degree of hearing loss and VA diameters at the axial or 45° oblique reformate. Cincinnati criteria are more sensitive than Valvassori criterin in the diagnosis of LVAS. We recommend the application of Cincinnati criteria instead of Valvassori criteria in order not miss cases with LVAS. Measurement of VA in the 45° oblique reformate is a reliable method to diagnose

  1. Irritable bowel syndrome--prognosis and diagnostic safety. A 5-year follow-up study

    DEFF Research Database (Denmark)

    Svendsen, J H; Munck, Lars K; Andersen, J R

    1985-01-01

    with irritable bowel syndrome as the final and only abdominal diagnosis in the period 1977-79 were followed up in 1984. Seventeen patients died during the follow-up period; two of these were considered diagnostic failures (chronic pancreatitis and pancreatic cancer). Of the remaining 95 patients, 93 were...

  2. Differential diagnostics of different nosological forms of the temporomandibular joint pain dysfunction syndrome

    Directory of Open Access Journals (Sweden)

    Kameneva L.A.

    2014-09-01

    Full Text Available Research objective: to carry out differential diagnostics of various nosological forms of a temporal and temporomandibular joint pain dysfunction syndrome. Material and methods. On clinical base of orthopedic odontology chair of SamSMU inspection of 244 patients with temporomandibular joint pain dysfunction syndrome was performed. Diagnostics was carried out according to the special card of inspection which was developed on orthopedic odontology chair of SamSMU and included subjective, objective and special methods of research. As a result of research it is taped: 71 — an occlusal-articulation dysfunctional syndrome, 44 — a neuromuscular dysfunctional syndrome, 76 patients have a hardly set dislocation of intra joint disk and 53 — a habitual dislocation and a subluxation of a temporomandibular joint. We used Yu.A. Petrosov's classification as it displays most precisely the processes happening at pathology of the intra joint relations. Conclusion: On the basis of the obtained data the table of differential diagnostics of various nosological forms of temporomandibular joint pain dysfunction syndrome has been made.

  3. Hepatorenal syndrome in patients with cirrhosis of liver according to 2007 international ascites club criteria

    International Nuclear Information System (INIS)

    Seetlani, N.K.; Memon, A.R.; Iftikhar, F.; Fazel, P.A.

    2016-01-01

    Heptorenal syndrome is a complication of cirrhosis of liver and is characterized by progressive renal failure. This study was done to determine the frequency of hepatorenal syndrome according to 2007 international ascites club criteria among patients of cirrhosis attending Medical Units of Civil hospital Karachi. Methods: This is a cross-sectional study conducted on the hospitalized patients in the Department of Medicine-Civil Hospital Karachi from 01-04-2014 to 30-09-2014 where total 265 patients of either gender, age >18 years and <60 years and diagnosed case of CLD were included. Patients with shock, SIRS, sepsis, known cases of intrinsic renal diseases, or history of diabetes mellitus, Hypertension or connective tissue diseases were excluded. Mean±SD were expressed for continuous variable like, age, duration of CLD. Frequency and percentages of other categorical variables, i.e., gender, residence were expressed. Effect modification was tested through Chi-square with p-value <0.05 significant. Results: The mean±SD age of patient was 48.23+-7.87 years with range 18-60 years. Mean±SD duration of chronic liver disease was 5.60±1.92 years with a range of 3-12 years. More than 155 (58%) participants in this study were male and females were 110 (41.51%). More than 36 (13%) were of age less than and equal to 40 years; 121 (45.67%) were from 41-50 years, while 108 (40.75%) were from age 51-60 years. More than 176 (66.41%) belonged to rural areas while only 89 (33.58%) belonged to urban areas. The study observed that according to IAC 2007 criteria of diagnosis of hepatorenal syndrome 15.09% of patients with cirrhosis were found to have HRS. Conclusion: Hepatorenal syndrome represents the end stage of a sequence of reduction of renal perfusion induced by advanced liver failure. Almost every seventh patient of Cirrhosis can develop hepatorenal Syndrome. This should be looked up at an early stage so that it can be prevented. (author)

  4. Ehlers-Danlos' Syndrom

    DEFF Research Database (Denmark)

    Leganger, Julie; Søborg, Marie-Louise Kulas; Farholt, Stense

    2016-01-01

    Ehlers-Danlos syndrome (EDS) comprises a group of diseases characterized by connective tissue fragility. The clinical symptoms primarily involve the skin, joints, blood vessels and internal organs. Diagnosing EDS is complicated because of the clinical variability, imprecise diagnostic criteria...

  5. Allergic bronchopulmonary aspergillosis in Italian cystic fibrosis patients: Prevalence and percentage of positive tests in the employed diagnostic criteria

    International Nuclear Information System (INIS)

    Taccetti, Giovanni; Procopio, Elena; Marianelli, Lore; Campana, Silvia

    2000-01-01

    The prevalence of allergic bronchopulmonary aspergillosis (ABPA) in cystic fibrosis (CF) patients is difficult to determine because the data in the literature are not homogeneous or comparable. ABPA and CF have similar clinical symptoms which make diagnosis difficult and underestimate the real dimensions of the problem. We conducted an epidemiological study on 3089 Italian CF patients to determine the prevalence of ABPA in Italy and verify the percentage of positive tests in the employed diagnostic criteria. Our results indicate that the prevalence of ABPA in Italian CF patients is 6.18%, mainly in adolescents and young adults. ABPA is diagnosed using clinical symptoms (presence of episodic bronchial obstructions or typical radiographic features) and on the basis of other criteria which can only be partially fulfilled in paediatric patients. Among the diagnostic tests the most sensitive are the total IgE (84.5%), specific IgE anti-Aspergillus fumigatus (81.6%) and the prick test (68.3%). In the absence of clinical symptoms and gold standard diagnostic tests, serological positivity and/or the skin test are not sufficient evidence to confirm the presence of ABPA

  6. Task Force on Catastrophic Antiphospholipid Syndrome (APS) and Non-criteria APS Manifestations (II): thrombocytopenia and skin manifestations.

    Science.gov (United States)

    Cervera, R; Tektonidou, M G; Espinosa, G; Cabral, A R; González, E B; Erkan, D; Vadya, S; Adrogué, H E; Solomon, M; Zandman-Goddard, G; Shoenfeld, Y

    2011-02-01

    The objectives of the 'Task Force on Catastrophic Antiphospholipid Syndrome (APS) and Non-criteria APS Manifestations' were to assess the clinical utility of the international consensus statement on classification criteria and treatment guidelines for the catastrophic APS, to identify and grade the studies that analyze the relationship between the antiphospholipid antibodies and the non-criteria APS manifestations, and to present the current evidence regarding the accuracy of these non-criteria APS manifestations for the detection of patients with APS. This article summarizes the studies analyzed on thrombocytopenia and skin manifestations, and presents the recommendations elaborated by the Task Force after this analysis.

  7. Cycloid psychoses and schizoaffective psychoses--a comparison of different diagnostic classification systems and criteria.

    Science.gov (United States)

    Zaudig, M

    1990-01-01

    In current psychopathological research there are at least two major groups of concepts in the field of psychoses with good prognosis: the more traditional concepts of 'bouffée délirante', cycloid psychoses and Kasanin's 'schizoaffectives'--on the other hand the modern idea of 'concurrent schizoaffective psychoses' like the operational criteria of Kendell, Welner, RDC, DSM-IIIR and ICD-10. Reviewing previous studies, 'bouffée délirante' and cycloid psychosis were found to form a homogeneous group which is very well delineated from affective and schizophrenic psychosis--to some extent also from the modern criteria of 'concurrent schizoaffective psychoses'.

  8. Stable coronary syndromes: pathophysiology, diagnostic advances and therapeutic need

    Science.gov (United States)

    Corcoran, David

    2018-01-01

    The diagnostic management of patients with angina pectoris typically centres on the detection of obstructive epicardial CAD, which aligns with evidence-based treatment options that include medical therapy and myocardial revascularisation. This clinical paradigm fails to account for the considerable proportion (approximately one-third) of patients with angina in whom obstructive CAD is excluded. This common scenario presents a diagnostic conundrum whereby angina occurs but there is no obstructive CAD (ischaemia and no obstructive coronary artery disease—INOCA). We review new insights into the pathophysiology of angina whereby myocardial ischaemia results from a deficient supply of oxygenated blood to the myocardium, due to various combinations of focal or diffuse epicardial disease (macrovascular), microvascular dysfunction or both. Macrovascular disease may be due to the presence of obstructive CAD secondary to atherosclerosis, or may be dynamic due to a functional disorder (eg, coronary artery spasm, myocardial bridging). Pathophysiology of coronary microvascular disease may involve anatomical abnormalities resulting in increased coronary resistance, or functional abnormalities resulting in abnormal vasomotor tone. We consider novel clinical diagnostic techniques enabling new insights into the causes of angina and appraise the need for improved therapeutic options for patients with INOCA. We conclude that the taxonomy of stable CAD could improve to better reflect the heterogeneous pathophysiology of the coronary circulation. We propose the term ‘stable coronary syndromes’ (SCS), which aligns with the well-established terminology for ‘acute coronary syndromes’. SCS subtends a clinically relevant classification that more fully encompasses the different diseases of the epicardial and microvascular coronary circulation. PMID:29030424

  9. Dual-Objective Item Selection Criteria in Cognitive Diagnostic Computerized Adaptive Testing

    Science.gov (United States)

    Kang, Hyeon-Ah; Zhang, Susu; Chang, Hua-Hua

    2017-01-01

    The development of cognitive diagnostic-computerized adaptive testing (CD-CAT) has provided a new perspective for gaining information about examinees' mastery on a set of cognitive attributes. This study proposes a new item selection method within the framework of dual-objective CD-CAT that simultaneously addresses examinees' attribute mastery…

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

    NARCIS (Netherlands)

    IJzerman, Maarten Joost; Hummel, J. Marjan

    2010-01-01

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

  11. INTERSTITIAL CYSTITIS IN THE NETHERLANDS - PREVALENCE, DIAGNOSTIC-CRITERIA AND THERAPEUTIC PREFERENCES

    NARCIS (Netherlands)

    BADE, JJ; RIJCKEN, B; MENSINK, HJA

    1995-01-01

    Purpose: We determine the prevalence of interstitial cystitis in The Netherlands, and analyze the most common diagnostic and therapeutic approaches among Dutch urologists. Materials and Methods: A questionnaire was completed by urologists and analyzed with the help of a statistical computer program.

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

    NARCIS (Netherlands)

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

    The definition of anorexia nervosa was revised for the Fifth Edition of the Diagnostic and Statistical Manual (DSM-5). We examined the impact of these changes on the prevalence and prognosis of anorexia nervosa. In a nationwide longitudinal study of Finnish twins born 1975-1979, the women (N = 2825)

  13. Diagnostic Criteria for Problematic Internet Use among U.S. University Students: A Mixed-Methods Evaluation

    Science.gov (United States)

    Li, Wen; O’Brien, Jennifer E.; Snyder, Susan M.; Howard, Matthew O.

    2016-01-01

    Empirical studies have identified increasing rates of problematic Internet use worldwide and a host of related negative consequences. However, researchers disagree as to whether problematic Internet use is a subtype of behavioral addiction. Thus, there are not yet widely accepted and validated diagnostic criteria for problematic Internet use. To address this gap, we used mixed-methods to examine the extent to which signs and symptoms of problematic Internet use mirror DSM-5 diagnostic criteria for substance use disorder, gambling disorder, and Internet gaming disorder. A total of 27 university students, who self-identified as intensive Internet users and who reported Internet-use-associated health and/or psychosocial problems were recruited. Students completed two measures that assess problematic Internet use (Young’s Diagnostic Questionnaire and the Compulsive Internet Use Scale) and participated in focus groups exploring their experiences with problematic Internet use. Results of standardized measures and focus group discussions indicated substantial overlap between students’ experiences of problematic Internet use and the signs and symptoms reflected in the DSM-5 criteria for substance use disorder, gambling disorder, and Internet gaming disorder. These signs and symptoms included: a) use Internet longer than intended, b) preoccupation with the Internet, c) withdrawal symptoms when unable to access the Internet, d) unsuccessful attempts to stop or reduce Internet use, e) craving, f) loss of interest in hobbies or activities other than the Internet, g) excessive Internet use despite the knowledge of related problems, g) use of the Internet to escape or relieve a negative mood, and h) lying about Internet use. Tolerance, withdrawal symptoms, and recurrent Internet use in hazardous situations were uniquely manifested in the context of problematic Internet use. Implications for research and practice are discussed. PMID:26751569

  14. Cervical spondylotic myelopathy in the young adult: a review of the literature and clinical diagnostic criteria in an uncommon demographic.

    Science.gov (United States)

    Amenta, Peter S; Ghobrial, George M; Krespan, Kelly; Nguyen, Phi; Ali, Muhammed; Harrop, James S

    2014-05-01

    Cervical spondylotic myelopathy (CSM) is typically encountered in the elderly population. Significant inconsistencies currently exist regarding the definition of the disorder, the true incidence of CSM in younger populations, and the established diagnostic criteria. To highlight the lack of standardization in the definition and diagnosis of CSM. A PubMed literature search was conducted spanning the years 2001-2011. The search was limited by the following terms: (1) English language, (2) adults (19-44 years old), and (3) "cervical spondylotic myelopathy." Each article was reviewed to determine if the presence of the definition of CSM existed in the article. The clinical characteristics used to make the diagnosis of CSM were recorded for each article. Cochran's Q statistic was used to determine whether some clinical characteristics were more frequently used than others. Ninety-three papers were reviewed in detail and 16 case reports, reviews, and articles concerning less than 3 patients were excluded, resulting in 77 articles in the final analysis. The most common clinical definitions were gait disturbance (22/77 articles (28.6%)), upper limb paresthesias or sensory disturbance (21/77 (27.3%)), and clumsy hands (15/77 (19.5%)). Hyperreflexia, spasticity, and pathologically increased reflexes were identified as diagnostic criteria in a minority of patients. The literature employs a wide range of neurologic signs and symptoms to make the diagnosis of CSM, with a majority of studies failing to rely on strict diagnostic criteria. The clinician should not discount CSM as an explanation for the aforementioned findings, as it is well-reported in the literature among the ages 18-44. Copyright © 2014 Elsevier B.V. All rights reserved.

  15. Diagnostic Criteria for Problematic Internet Use among U.S. University Students: A Mixed-Methods Evaluation.

    Directory of Open Access Journals (Sweden)

    Wen Li

    Full Text Available Empirical studies have identified increasing rates of problematic Internet use worldwide and a host of related negative consequences. However, researchers disagree as to whether problematic Internet use is a subtype of behavioral addiction. Thus, there are not yet widely accepted and validated diagnostic criteria for problematic Internet use. To address this gap, we used mixed-methods to examine the extent to which signs and symptoms of problematic Internet use mirror DSM-5 diagnostic criteria for substance use disorder, gambling disorder, and Internet gaming disorder. A total of 27 university students, who self-identified as intensive Internet users and who reported Internet-use-associated health and/or psychosocial problems were recruited. Students completed two measures that assess problematic Internet use (Young's Diagnostic Questionnaire and the Compulsive Internet Use Scale and participated in focus groups exploring their experiences with problematic Internet use. Results of standardized measures and focus group discussions indicated substantial overlap between students' experiences of problematic Internet use and the signs and symptoms reflected in the DSM-5 criteria for substance use disorder, gambling disorder, and Internet gaming disorder. These signs and symptoms included: a use Internet longer than intended, b preoccupation with the Internet, c withdrawal symptoms when unable to access the Internet, d unsuccessful attempts to stop or reduce Internet use, e craving, f loss of interest in hobbies or activities other than the Internet, g excessive Internet use despite the knowledge of related problems, g use of the Internet to escape or relieve a negative mood, and h lying about Internet use. Tolerance, withdrawal symptoms, and recurrent Internet use in hazardous situations were uniquely manifested in the context of problematic Internet use. Implications for research and practice are discussed.

  16. Diagnostic Criteria for Problematic Internet Use among U.S. University Students: A Mixed-Methods Evaluation.

    Science.gov (United States)

    Li, Wen; O'Brien, Jennifer E; Snyder, Susan M; Howard, Matthew O

    2016-01-01

    Empirical studies have identified increasing rates of problematic Internet use worldwide and a host of related negative consequences. However, researchers disagree as to whether problematic Internet use is a subtype of behavioral addiction. Thus, there are not yet widely accepted and validated diagnostic criteria for problematic Internet use. To address this gap, we used mixed-methods to examine the extent to which signs and symptoms of problematic Internet use mirror DSM-5 diagnostic criteria for substance use disorder, gambling disorder, and Internet gaming disorder. A total of 27 university students, who self-identified as intensive Internet users and who reported Internet-use-associated health and/or psychosocial problems were recruited. Students completed two measures that assess problematic Internet use (Young's Diagnostic Questionnaire and the Compulsive Internet Use Scale) and participated in focus groups exploring their experiences with problematic Internet use. Results of standardized measures and focus group discussions indicated substantial overlap between students' experiences of problematic Internet use and the signs and symptoms reflected in the DSM-5 criteria for substance use disorder, gambling disorder, and Internet gaming disorder. These signs and symptoms included: a) use Internet longer than intended, b) preoccupation with the Internet, c) withdrawal symptoms when unable to access the Internet, d) unsuccessful attempts to stop or reduce Internet use, e) craving, f) loss of interest in hobbies or activities other than the Internet, g) excessive Internet use despite the knowledge of related problems, g) use of the Internet to escape or relieve a negative mood, and h) lying about Internet use. Tolerance, withdrawal symptoms, and recurrent Internet use in hazardous situations were uniquely manifested in the context of problematic Internet use. Implications for research and practice are discussed.

  17. [The compensatory and adaptive e reactions of the respiratory system as the diagnostic criteria for histological studies in forensic medicine].

    Science.gov (United States)

    Os'minkin, V A; Os'minkin, S V

    2015-01-01

    The objective of the present study was to characterize the structural changes in the respiratory system equivalent to its compensatory and adaptive reactions in response to the action of various factors under the normal and extreme conditions for the assessment of the possibility of their further use for the purpose of diagnostics. The action of various factors on the tissues obtained from the human respiratory system for forensic medical examination was shown to cause combined histomorphological alterations that refelect a wide spectrum of protective, compensatory, and adaptive reactions. The range of potential morphological and functional changes in the respiratory system depends on the characteristics of endogenous and exogenous factors influencing the organism of the affected subjects. It is concluded that the use of the proposed approach to morphological diagnostics may be useful for the development of criteria for the evaluation of various variants of tanatogenesis with their objective confirmation by mathematical models.

  18. Diagnostic contribution of quantitative analysis of salivary scintigraphy in patients with suspected Sjögren's syndrome.

    Science.gov (United States)

    Infante, J R; García, L; Rayo, J I; Serrano, J; Domínguez, M L; Moreno, M

    2016-01-01

    The evaluation of the salivary scintigraphy is part of the classification criteria of Sjögren's syndrome (SS). The aim of the study was to determine a method of quantitative evaluation of this technique with easy application and high diagnostic accuracy. A review was carried out on a total of 111 patients with clinical suspicion of SS, referred to our department over the last 4 years (94 women, range 14-82 years). Thirty-minute dynamic studies were performed after injection of (99m)Tc-pertechnetate, with secretory stimulus at 15 minutes. After drawing regions of interest in both parotids, submandibular glands, and in the background, quantitative parameters were determined. These included the ejection fraction, uptake ratio at 15 min, and the percentage uptake (PC). Based on the definitive diagnosis, the subjects were classified into patients with SS, with sicca syndrome, and healthy subjects. Significant differences were found between the SS group and healthy subjects in the 3 quantitative parameters for the 4 glands. Significant differences in the PC parameter were observed between the group with sicca syndrome and healthy subjects. ROC analysis showed that the best differentiation parameter for the 3 groups was the PC in both parotid and submandibular glands. The quantitative analysis of salivary scintigraphy has proved to be a useful method and easy to apply in daily practice to differentiate patients with SS from healthy subjects, with the PC, both in parotid and submandibular glands, being the parameter with highest diagnostic accuracy. Copyright © 2015 Elsevier España, S.L.U. y SEMNIM. All rights reserved.

  19. The DSM Diagnostic Criteria for Gender Identity Disorder in Adolescents and Adults

    NARCIS (Netherlands)

    Cohen-Kettenis, P.T.; Pfafflin, F.

    2010-01-01

    Apart from some general issues related to the Gender Identity Disorder (GID) diagnosis, such as whether it should stay in the DSM-V or not, a number of problems specifically relate to the current criteria of the GID diagnosis for adolescents and adults. These problems concern the confusion caused by

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

    Science.gov (United States)

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

    2015-01-01

    Controversy exists regarding the "DSM-5" criteria for ASD. This study tested the psychometric properties of the "DSM-5" model and determined how well it performed across different gender, IQ, and "DSM-IV-TR" sub-type, using clinically collected data on 227 subjects (median age = 3.95 years, majority had IQ > 70).…

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

    NARCIS (Netherlands)

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

    The aim of this review was to investigate the selection criteria used in the past in studies of children with developmental motor problems (excluding those suffering from neurological dysfunctions such as cerebral palsy, muscular dystrophy, etc.). We therefore conducted an extensive analysis of 176

  2. Low diagnostic accuracy of selective screening criteria for asymptomatic Chlamydia trachomatis infections in the general population

    NARCIS (Netherlands)

    van Valkengoed, I. G.; Morré, S. A.; van den Brule, A. J.; Meijer, C. J.; Devillé, W.; Bouter, L. M.; Boeke, A. J.

    2000-01-01

    OBJECTIVES: To develop and validate selective screening criteria for asymptomatic Chlamydia trachomatis infections in the general population. METHODS: 11,505 people, aged 15-40 years, registered in 16 general practices in Amsterdam were invited to return by mail a home obtained first void urine

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

    DEFF Research Database (Denmark)

    Schiffman, Eric; Ohrbach, Richard; Truelove, Edmond

    2014-01-01

    lack adequate validity for clinical diagnoses but can be used for screening purposes. Inter-examiner reliability for the clinical assessment associated with the validated DC/TMD criteria for pain-related TMD is excellent (kappa ≥ 0.85). Finally, a comprehensive classification system that includes both...

  4. Diagnostic criterions of the postradiation encephalopathy in remote period of the acute radiation syndrome

    International Nuclear Information System (INIS)

    Nyagu, A.I.; Loganovskij, K.N.; Vashchenko, E.A.

    1998-01-01

    Development of post-radiation encephalopathy diagnostic criteria on the base of neuro psychic, neuro- and psychofisiological research in patients who suffered with acute radiation disease after Chernobyl catastrophe was the aim of this work. 110 persons of 20-75 years age were investigated. 55 refs., 6 tab., 6 figs

  5. Gender-related differential item functioning in DSM-IV/DSM-5-III (alternative model) diagnostic criteria for borderline personality disorder.

    Science.gov (United States)

    Benson, Kathryn T; Donnellan, M Brent; Morey, Leslie C

    2017-01-01

    A number of studies have evaluated the possibility of bias in the diagnostic criteria in borderline personality disorder as an explanation of gender differences in prevalence. Previous studies have used both regression and latent trait approaches but the results have been inconsistent. The current study extended prior investigations in testing differential function of Borderline diagnostic criteria using both regression and latent-trait methods in the same sample, examining both Diagnostic and Statistical Manual of Mental Disorders (4th ed.; DSM-IV ) and DSM-5 alternative model criteria for borderline personality. Data were obtained from a national sample of 337 clinicians providing diagnostic information on 1 of their target patients. Chronic feelings of emptiness was the only criterion that demonstrated consistent evidence of potential differential functioning across methods and diagnostic models. Implications of these results for the conceptualization of borderline personality are discussed. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

  6. RETT SYNDROME: DIFFICULTIES OF DIAGNOSTICS (CLINICAL AND PSYCHOPATHOLOGICAL ASPECTS

    Directory of Open Access Journals (Sweden)

    E. V. Malinina

    2016-01-01

    Full Text Available Showed a rare case of atypical forms of Rett syndrome in girl adolescent. The peculiarity of the disease was in the late manifestation of clinical symptoms (6 years old, when there was autistic behavior and regression in development, as well as rare stereotypical hand movements, with characteristic changes in the EEG as benign epileptiform patterns of childhood. In adolescence (12 years there were episodes of hyperventilation and arrest breathing, deformation of the back, inappropriate laughter and screams. Was found mutation in the heterozygous state (s.674>G / N in the gene MECP2 (exons 1–4 by the method of direct automatic sequencing.

  7. Congenital central hypoventilation syndrome: diagnostic and management challenges

    Directory of Open Access Journals (Sweden)

    Kasi AS

    2016-08-01

    Full Text Available Ajay S Kasi,1 Iris A Perez,1,2 Sheila S Kun,1 Thomas G Keens1,2 1Division of Pediatric Pulmonology and Sleep Medicine, Children’s Hospital Los Angeles, 2Keck School of Medicine of the University of Southern California, Los Angeles, CA, USA Abstract: Congenital central hypoventilation syndrome (CCHS is a rare genetic disorder with failure of central control of breathing and of the autonomic nervous system function due to a mutation in the paired-like homeobox 2B (PHOX2B gene. Affected patients have absent or negligible ventilatory sensitivity to hypercapnia and hypoxemia, and they do not exhibit signs of respiratory distress when challenged with hypercarbia or hypoxia. The diagnosis of CCHS must be confirmed with PHOX2B gene mutation. Generally, the PHOX2B mutation genotype can aid in anticipating the severity of the phenotype. They require ventilatory support for life. Home assisted ventilation options include positive pressure ventilation via tracheostomy, noninvasive positive pressure ventilation, and diaphragm pacing via phrenic nerve stimulation, but each strategy has its associated limitations and challenges. Since all the clinical manifestations of CCHS may not manifest at birth, periodic monitoring and early intervention are necessary to prevent complications and improve outcome. Life-threatening arrhythmias can manifest at different ages and a normal cardiac monitoring study does not exclude future occurrences leading to the dilemma of timing and frequency of cardiac rhythm monitoring and treatment. Given the rare incidence of CCHS, most health care professionals are not experienced with managing CCHS patients, particularly those with diaphragm pacers. With early diagnosis and advances in home mechanical ventilation and monitoring strategies, many CCHS children are surviving into adulthood presenting new challenges in their care. Keywords: congenital central hypoventilation syndrome, PHOX2B, home mechanical ventilation, diaphragm

  8. Developmentally sensitive diagnostic criteria for mental health disorders in early childhood: the diagnostic and statistical manual of mental disorders-IV, the research diagnostic criteria-preschool age, and the diagnostic classification of mental health and developmental disorders of infancy and early childhood-revised.

    Science.gov (United States)

    Egger, Helen L; Emde, Robert N

    2011-01-01

    As the infant mental health field has turned its focus to the presentation, course, and treatment of clinically significant mental health disorders, the need for reliable and valid criteria for identifying and assessing mental health symptoms and disorders in early childhood has become urgent. In this article we offer a critical perspective on diagnostic classification of mental health disorders in young children. We place the issue of early childhood diagnosis within the context of classification of psychopathology at other ages and describe, in some detail, diagnostic classifications that have been developed specifically for young children, including the Diagnostic Classification of Mental Health and Developmental Disorders of Infancy and Early Childhood (DC:0-3R; ZERO TO THREE, 2005), a diagnostic classification for mental health symptoms and disorders in infants, toddlers, and preschoolers. We briefly outline the role of diagnostic classification in clinical assessment and treatment planning. Last, we review the limitations of current approaches to the diagnostic classification of mental health disorders in young children. PsycINFO Database Record (c) 2010 APA, all rights reserved.

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

    DEFF Research Database (Denmark)

    Schiffman, Eric; Ohrbach, Richard; Truelove, Edmond

    2014-01-01

    .95. Consequently, these empirical results supported the development of revised RDC/TMD Axis I diagnostic algorithms that were subsequently demonstrated to be valid for the most common pain-related TMD and for one temporomandibular joint (TMJ) intra-articular disorder. The original RDC/TMD Axis II instruments were...... shown to be both reliable and valid. Working from these findings and revisions, two international consensus workshops were convened, from which recommendations were obtained for the finalization of new Axis I diagnostic algorithms and new Axis II instruments. METHODS: Through a series of workshops...... the common and less common TMD is also presented. The Axis II protocol retains selected original RDC/TMD screening instruments augmented with new instruments to assess jaw function as well as behavioral and additional psychosocial factors. The Axis II protocol is divided into screening and comprehensive self...

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

    OpenAIRE

    Hansen, Maj; Hyland, Philip; Karstoft, Karen-Inge; Bramsen, Rikke Holm; Vægter, Henrik Bjarke; Armour, Cherie; Sternhagen, Anni; Andersen, S. B.; Larsen, Simone; Hørbye, Mette; Andersen, Tonny Elmose

    2017-01-01

    Clinicians and researchers are becoming increasingly aware of the difficult decision that they are likely to be making within the next years; deciding between the use of two rather different descriptions of the posttraumatic stress disorder (PTSD) diagnosis. The Diagnostic and Statistical Manual of Mental Disorders 5th edition (DSM-5), which describes PTSD as a diagnosis comprised of 20 symptoms belonging to four symptom clusters, and the World Health Organization’s proposed 11th revision of ...

  11. INSTRUMENTAL AND DIAGNOSTIC CRITERIA OF HEMODYNAMIC DISORDERS AND ENDOTHELIAL DYSFUNCTION CORRECTION IN PREGNANTS WITH ARTERIAL HYPERTENSION

    OpenAIRE

    S. M. Heryak; I. Ye. Humenna

    2014-01-01

    Background. According to the WHO, hypertension is associated with 20-33 % of maternal death during pregnancy within extragenital pathology statistics. There are complications of the fetus and newborn associated with hypertension at 140/90 mm Hg and higher. Objective. A comparative analysis of antihypertensive therapy effectiveness in pregnants with arterial hypertension was performed using modern clinical and instrumental methods of endothelial function diagnostic, central and utero-placen...

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

    OpenAIRE

    Gernhardt, Christian R.

    2012-01-01

    Objectives Although dentin hypersensitivity is a common clinical condition and is generally reported by the patient after experiencing a sharp, short pain caused by one of several different external stimuli, it is often inadequately understood. The purpose of this paper is to discuss different available diagnostic approaches and assessment methods used in order to suggest a basis to diagnose, monitor, and measure these challenging painful conditions related to dentin hypersensitivity in daily...

  13. Palmar dermatoglyphics as diagnostic tool: Mayer-rokintansky-kuster-hauser syndrome

    Directory of Open Access Journals (Sweden)

    Kumar A

    2003-03-01

    Full Text Available The congential anomalies involving Mullerian duct dysgenesis, the MRKH (Mayer-Rokitansky-Kuster-Hauser syndrome overlaps a ′community of syndromes′ which share, apart from a complete absence of uterus and vagina, associated presentations that include developmental abnormalities of skeletal, renal, dental and other dysmorphias. First described more than 400 years ago, this complement of anomalies now rechristened, the MRKH syndrome has been extensively studied. Found to occur once in every 4000 females; estimated on its incidence vary from 1/5000 to 1/20,000. Despite its fairly wide prevalence, this syndrome has remained largely underdiagnosed or cryptic. Social and cultural perceptions have perforce driven, the wide existence of the very personal handicap underground and unacceptable. Accidentally discovered during routine examination, during secondarily associated medical problems, the mullerian agenecies syndrome has been subject of a wide range of clinical and laboratory investigations. The oddity in the syndrome is that the patient appears absolutely normal and that it presents with no genetic marker. We herein report the palmar dermatoglyphic and doctylographic features of a patient with MRKH syndrome. However interpretation, show conclusively, at least in this single case that the MRKH syndrome can be diagnosed through its characteristic dermatography patterns. In our view, routine dermatographic study of all live females births may lead to not only an early but also a cost effective diagnostic method.

  14. Proposals for new standardized general diagnostic criteria for the secondary headaches

    DEFF Research Database (Denmark)

    Olesen, J; Steiner, T; Bousser, M-G

    2009-01-01

    Headache classification is a dynamic process through clinical testing and re-testing of current and proposed criteria. After publication of the second edition of the International Classification of Headache Disorders (ICHD-II), need arose for revisions in the classification of medication overuse...... into the internet-based version of the appendix of ICHD-II. During 2009 the Classification Committee will apply the general criteria to all the specific types of secondary headaches. These, and other changes, will be included in a revision of the entire classification entitled ICHD-IIR, expected to be published...... in 2010. ICHD-IIR will be printed and posted on the website and will be the official classification of the International Headache Society. Unfortunately, it will be necessary to translate ICHD-IIR into the many languages of the world, but the good news is that no major changes to the headache...

  15. Cholestasis in patients with Cockayne syndrome and suggested modified criteria for clinical diagnosis

    Directory of Open Access Journals (Sweden)

    Elsobky Ezzat S

    2011-04-01

    Full Text Available Abstract Background Cockayne syndrome is a rare autosomal recessive neurodegenerative disease characterized by low-to-normal birth weight; growth failure; brain dysmyelination with calcium deposits, cutaneous photosensitivity; pigmentary retinopathy, cataract, and sensorineural hearing loss. To the best of our knowledge, cholestatic liver disease was not previously reported in these patients. Aim To highlight the presence of cholestasis and liver dysfunction in this group of patients and to suggest modified criteria for clinical diagnosis. Methods The study included nine patients with Cockayne from four different families (five males and four females in which Cockayne was suspected clinically. In all patients chromosomal breakage studies revealed mild (45% to moderate (60% increase in frequency of chromatid and chromosome gaps and breaks versus 25% in normal controls. Diagnosis was confirmed by DNA repair assay. Results During routine follow up of these patients, seven of them had evident liver affection ranging from mild elevation in liver enzymes to cholestatic liver disease and liver cell failure. The attacks were recurrent in two patients and were sometimes preceded by infection. The attack may lead to deterioration of neurological and/or liver condition. It may end in liver cell failure that either recovers completely or may lead to death. Conclusions liver disease could be considered common in Egyptian patients with Cockayne with the cholestatic form being the most evident. The syndrome should be included in the list of causes of cholestatic liver disease. Chromosomal breakage study and positive family history should be included as major criteria for clinical diagnosis of Cockayne especially in a population like ours where consanguineous marriage is very high and molecular testing and UV sensitivity tests are considered unaffordable.

  16. The DSM diagnostic criteria for gender identity disorder in adolescents and adults.

    Science.gov (United States)

    Cohen-Kettenis, Peggy T; Pfäfflin, Friedemann

    2010-04-01

    Apart from some general issues related to the Gender Identity Disorder (GID) diagnosis, such as whether it should stay in the DSM-V or not, a number of problems specifically relate to the current criteria of the GID diagnosis for adolescents and adults. These problems concern the confusion caused by similarities and differences of the terms transsexualism and GID, the inability of the current criteria to capture the whole spectrum of gender variance phenomena, the potential risk of unnecessary physically invasive examinations to rule out intersex conditions (disorders of sex development), the necessity of the D criterion (distress and impairment), and the fact that the diagnosis still applies to those who already had hormonal and surgical treatment. If the diagnosis should not be deleted from the DSM, most of the criticism could be addressed in the DSM-V if the diagnosis would be renamed, the criteria would be adjusted in wording, and made more stringent. However, this would imply that the diagnosis would still be dichotomous and similar to earlier DSM versions. Another option is to follow a more dimensional approach, allowing for different degrees of gender dysphoria depending on the number of indicators. Considering the strong resistance against sexuality related specifiers, and the relative difficulty assessing sexual orientation in individuals pursuing hormonal and surgical interventions to change physical sex characteristics, it should be investigated whether other potentially relevant specifiers (e.g., onset age) are more appropriate.

  17. Amyotrophic lateral sclerosis - frontotemporal spectrum disorder (ALS-FTSD): Revised diagnostic criteria.

    Science.gov (United States)

    Strong, Michael J; Abrahams, Sharon; Goldstein, Laura H; Woolley, Susan; Mclaughlin, Paula; Snowden, Julie; Mioshi, Eneida; Roberts-South, Angie; Benatar, Michael; HortobáGyi, Tibor; Rosenfeld, Jeffrey; Silani, Vincenzo; Ince, Paul G; Turner, Martin R

    2017-05-01

    This article presents the revised consensus criteria for the diagnosis of frontotemporal dysfunction in amyotrophic lateral sclerosis (ALS) based on an international research workshop on frontotemporal dementia (FTD) and ALS held in London, Canada in June 2015. Since the publication of the Strong criteria, there have been considerable advances in the understanding of the neuropsychological profile of patients with ALS. Not only is the breadth and depth of neuropsychological findings broader than previously recognised - - including deficits in social cognition and language - but mixed deficits may also occur. Evidence now shows that the neuropsychological deficits in ALS are extremely heterogeneous, affecting over 50% of persons with ALS. When present, these deficits significantly and adversely impact patient survival. It is the recognition of this clinical heterogeneity in association with neuroimaging, genetic and neuropathological advances that has led to the current re-conceptualisation that neuropsychological deficits in ALS fall along a spectrum. These revised consensus criteria expand upon those of 2009 and embrace the concept of the frontotemporal spectrum disorder of ALS (ALS-FTSD).

  18. Esophageal involvement is frequent in lichen planus: study in 32 patients with suggestion of clinicopathologic diagnostic criteria and therapeutic implications.

    Science.gov (United States)

    Kern, Johannes S; Technau-Hafsi, Kristin; Schwacha, Henning; Kuhlmann, Jan; Hirsch, Gunther; Brass, Volker; Deibert, Peter; Schmitt-Graeff, Anette; Kreisel, Wolfgang

    2016-12-01

    Lichen planus (LP) is a classic skin disease that can involve the skin, hair, and nails, as well as the oral and genital mucosa. Histopathology is characterized by a T-lymphocytic, lichenoid, and interface dermatitis. Multiple case reports and small case series have shown that LP can involve the esophagus. However, the diagnostic criteria, incidence, and best treatment options remain uncertain. This study aimed to refine the diagnostic criteria, estimate prevalence, and present an outlook on treatment options to prevent long-term sequelae. Thirty-two consecutive patients with LP of the skin, hair, nails, oral mucosa, and/or genital mucosa underwent a comprehensive clinicopathologic assessment. Esophagogastroduodenoscopy was performed, and biopsies were evaluated histologically, immunohistochemically, and by direct immunofluorescence. Patients diagnosed with esophageal lichen planus (ELP) were followed up prospectively where possible. In total, 20 of 32 patients had ELP. Ten of these 20 patients were classified as having proven ELP, with clear-cut endoscopically visible lesions; the other 10 were classified as having probable ELP. Eight of 10 patients with proven ELP were started on new or additional therapy because of esophageal findings. Treatment with a topical budesonide formulation or systemic corticosteroids was successful in most patients with proven ELP and reversed functional esophageal stenosis. ELP can be found in more than 50% of patients with proven mucocutaneous LP when clinical and pathologic findings are correlated carefully. Topical or systemic corticosteroids are the first-line therapy for ELP. Timely medical therapy seems to prevent scarring stenosis of the esophagus.

  19. The inclusion of child pornography in the DSM-5 diagnostic criteria for pedophilia: conceptual and practical problems.

    Science.gov (United States)

    First, Michael B

    2011-01-01

    The proposal to add use of child pornography to Criterion B of pedophilia is in direct conflict with the newly proposed distinction between paraphilia and paraphilic disorder, muddying rather than clarifying the diagnostic definition of pedophilia. The proposal to distinguish paraphilic disorder from paraphilia derives from the fact that the diagnostic criteria for the paraphilias have two components: Criterion A, defining the presence of a paraphilic erotic interest, and Criterion B, requiring clinically significant distress, impairment, or acting out the paraphilia with a nonconsenting person. Meeting Criteria A and B is necessary for a diagnosis of paraphilic disorder; meeting only Criterion A indicates a paraphilia. Use of pornography is better placed within Criterion A, perhaps as an example of a behavioral manifestation of pedophilia. If the Sexual and Gender Identity Disorders Work Group's true intent was to add a third prong to Criterion B, then the criterion must be modified to restrict it to the use of illegal forms of pornography (i.e., visual depictions of real children), excluding written or aural forms or virtual images.

  20. Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) for clinical and research applications: recommendations of the international RDC/TMD consortium network and orofacial pain special interest group

    NARCIS (Netherlands)

    Schiffman, E.; Ohrbach, R.; Truelove, E.; Look, J.; Anderson, G.; Goulet, J.P.; List, T.; Svensson, P.; Gonzalez, Y.; Lobbezoo, F.; Michelotti, A.; Brooks, S.L.; Ceusters, W.; Drangsholt, M.; Ettlin, D.; Gaul, C.; Goldberg, L.J.; Haythornthwaite, J.A.; Hollender, L.; Jensen, R.; John, M.T.; De Laat, A.; de Leeuw, R.; Maixner, W.; van der Meulen, M.; Murray, G.M.; Nixdorf, D.R.; Palla, S.; Petersson, A.; Pionchon, P.; Smith, B.; Visscher, C.M.; Zakrzewska, J.; Dworkin, S.F.

    2014-01-01

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

  1. Variations in diabetes remission rates after bariatric surgery in Spanish adults according to the use of different diagnostic criteria for diabetes.

    Science.gov (United States)

    Alhambra-Expósito, María R; Molina-Puerta, María J; Prior-Sánchez, María I; Manzano-García, Gregorio; Calañas-Continente, Alfonso; Gálvez-Moreno, María A

    2017-08-15

    There are multiple criteria to define remission of type 2 diabetes (DM2) after bariatric surgery but there is not a specific one widely accepted. Our objectives were to compare diagnostic criteria for DM2 remission after bariatric surgery: Criteria from Spanish scientific associations (SEEN/SEEDO/SED) and from the American Diabetes Association (ADA). We also aim to analyse the degree of correlation between these sets of criteria. Retrospective observational study in 127 patients undergoing bariatric surgery in a single centre (Hospital Universitario Reina Sofía, Córdoba, Spain) between January 2001 and December 2009. We analysed DM2 remission following bariatric surgery comparing DM2 diagnostic criteria approved by Spanish scientific associations and ADA criteria. In total, 62.2% of patients were women; mean age was 47.1 years. Following surgery, 52% achieved complete remission according to ADA criteria, and 63.8% following the criteria approved by Spanish associations (p = 0.001);18.9 and 8.7%, respectively, showed partial remission (p = 0.007), and 29.1 and 27.6% no remission, according to the criteria approved by each association (p = 0.003). There was good correlation between both sets of criteria (Rho 0.781; p DM2 remission (ADA criteria) results in a lower rate of remission, although we found a a high degree of correlation between both sets of criteria.

  2. Diagnostic dilemma: Sturge-Weber syndrome, without facial nevus

    Directory of Open Access Journals (Sweden)

    Paresh Zanzmera

    2015-01-01

    Full Text Available Sturge-Weber syndrome (SWS, a rare sporadic neurocutaneous disease, is characterized by a congenital unilateral port-wine nevus affecting the area innervated by V1, ipsilateral leptomeningeal angiomatosis, and calcification in the occipital or frontoparietal region and glaucoma/vascular eye abnormality. Three types of SWS have been described in literature: Type I (classic demonstrates facial and leptomeningeal angioma, often with glaucoma; type II has facial angioma and glaucoma, with no evidence of intracranial lesions; and type III (rarest presents with only leptomeningeal angioma. Only a few cases of type III SWS have been reported. Here, we report a case of a seven-year-old boy with focal complex partial seizure, who was diagnosed with SWS without facial nevus. Recognition of this type of SWS is important, as our patient had been misdiagnosed and received inappropriate antiepileptic drugs for six years. We suggest that in the appropriate clinical scenario, the diagnosis of SWS without facial nevus should be considered before labelling idiopathic or cryptogenic localization-related epilepsy, and gadolinium-enhanced magnetic resonance imaging (MRI should be done in clinically suspicious cases of SWS, without facial nevus.

  3. Congenital central hypoventilation syndrome: diagnostic and management challenges.

    Science.gov (United States)

    Kasi, Ajay S; Perez, Iris A; Kun, Sheila S; Keens, Thomas G

    2016-01-01

    Congenital central hypoventilation syndrome (CCHS) is a rare genetic disorder with failure of central control of breathing and of the autonomic nervous system function due to a mutation in the paired-like homeobox 2B (PHOX2B) gene. Affected patients have absent or negligible ventilatory sensitivity to hypercapnia and hypoxemia, and they do not exhibit signs of respiratory distress when challenged with hypercarbia or hypoxia. The diagnosis of CCHS must be confirmed with PHOX2B gene mutation. Generally, the PHOX2B mutation genotype can aid in anticipating the severity of the phenotype. They require ventilatory support for life. Home assisted ventilation options include positive pressure ventilation via tracheostomy, noninvasive positive pressure ventilation, and diaphragm pacing via phrenic nerve stimulation, but each strategy has its associated limitations and challenges. Since all the clinical manifestations of CCHS may not manifest at birth, periodic monitoring and early intervention are necessary to prevent complications and improve outcome. Life-threatening arrhythmias can manifest at different ages and a normal cardiac monitoring study does not exclude future occurrences leading to the dilemma of timing and frequency of cardiac rhythm monitoring and treatment. Given the rare incidence of CCHS, most health care professionals are not experienced with managing CCHS patients, particularly those with diaphragm pacers. With early diagnosis and advances in home mechanical ventilation and monitoring strategies, many CCHS children are surviving into adulthood presenting new challenges in their care.

  4. Diagnostic yield of molecular autopsy in patients with sudden arrhythmic death syndrome using targeted exome sequencing

    DEFF Research Database (Denmark)

    Nunn, Laurence M; Lopes, Luis R; Syrris, Petros

    2016-01-01

    AIMS: The targeted genetic screening of Sudden Arrhythmic Death Syndrome (SADS) probands in a molecular autopsy has a diagnostic yield of up to 35%. Exome sequencing has the potential to improve this yield. The primary aim of this study is to examine the feasibility and diagnostic utility...... previously published rare (0.02-0.5%) candidate mutations-a total yield of 29%. Co-segregation fully confirmed two private SCN5A Na channel mutations. Variants of unknown significance were detected in a further 34% of probands. CONCLUSION: Molecular autopsy using targeted exome sequencing has a relatively...

  5. Clinico-pathological study to evaluate oral lichen planus for the establishment of clinical and histopathological diagnostic criteria.

    Science.gov (United States)

    Hiremath, Santhosh; Kale, Alka D; Hallikerimath, Seema

    2015-01-01

    Lichen planus and lichenoid lesions affecting the oral cavity show similar clinico-pathological features creating a diagnostic dilemma. Hence, the aim of the present study was to establish a clinical and histopathological correlation in the diagnosis of oral lichen planus, based on the modified WHO diagnostic criteria of oral lichen planus and oral lichenoid lesions proposed by Van der Meij and Van der Waal in 2003. In the present study, 100 cases of oral lichen planus were clinically and histopathologically analyzed. Out of the 100 cases, 50 were prospective and 50 were retrospective cases. Prospective cases were collected based on the clinical diagnosis of oral lichen planus and oral lichenoid lesion. Retrospective cases were collected based on the histopathological diagnosis of oral lichen planus. Both the clinical and histopathological analyses were performed based on a proposal for a set of modified diagnostic criteria of oral lichen planus and oral lichenoid lesion. A final diagnosis of oral lichen planus was made only after the correlation of the clinical diagnosis with the histopathological diagnosis. The interobserver agreement among three observers for both prospective and retrospective cases in the final diagnosis of oral lichen planus was found to be "good" to "very good" indicating high reproducibility. However, the final diagnoses of true oral lichen planus after clinico-pathological correlation in prospective and retrospective study groups appeared to be 38.0% and 54.0% respectively. The results of the present study revealed mild to moderate clinico-pathological correlation in the final diagnosis of oral lichen planus for the prospective and retrospective study groups respectively.

  6. How many different symptom combinations fulfil the diagnostic criteria for major depressive disorder? Results from the CRESCEND study.

    Science.gov (United States)

    Park, Seon-Cheol; Kim, Jae-Min; Jun, Tae-Youn; Lee, Min-Soo; Kim, Jung-Bum; Yim, Hyeon-Woo; Park, Yong Chon

    2017-04-01

    The polythetic nature of major depressive disorder (MDD) in DSM- IV and DSM-5 inevitably leads to diagnostic heterogeneity. This study aimed to identify the number of depressive symptom combinations actually fulfilling the DSM-IV diagnostic criteria that can be found in Korean MDD patients and the relative frequencies of each combination. Using the data from the Clinical Research Center for Depression (CRESCEND) study in South Korea, we enrolled 853 MDD patients diagnosed using DSM-IV and scored as 8 or more on the Hamilton Depression Rating Scale (HAMD). Descriptive statistical analyses were performed to reveal the degree of diagnostic heterogeneity of the MDD. This study identified 119 different depressive symptom combinations. The most common combination consisted of all nine depressive symptom profiles, and nine different combinations were each present in more than 3% of the patients. The findings support the criticism that the diagnosis of MDD is not based on a single mental process, but on a set of 'family resemblances'.

  7. Hantavirus pulmonary syndrome in Brasilia periphery: a diagnostic challenge.

    Science.gov (United States)

    Santos, Vitorino Modesto dos; Rocha de Sá, Diana Aristótelis; Turra, Thiago Zavascki; Ferreira Borges, Nancy Mendonça; Nascimento, Ulisses Mariano; Damasceno, Emanuel Adelino Medeiros

    2009-09-15

    Hantavirus pulmonary syndrome (HPS) is an emerging rodent-borne disease in the American continent, characterized by acute respiratory distress and a high case-fatality ratio. The present work describes a case of HPS, with favorable outcome, whose initial features were mistaken for leptospirosis or other less severe acute infections. The case of a 32-year-old male with an uneventful course of HPS is reported. He was inadvertently infected at work by exposure to a rodent-contaminated environment in Brasília, Federal District vicinity, during May 2008. Fever, headache and myalgia after exposure to a rodent-contaminated environment raised clinical suspicion. Non-cardiac pulmonary edema, hydrothorax, neutrophilia with band forms 26%, high hematocrit, thrombocytopenia, and elevated liver enzymes were observed. Leptospirosis and dengue were the main differential diagnoses because both pathogens are endemic in the area. Hantavirus IgM antibody-capture ELISA was positive, while tests for dengue, leptospirosis and yellow fever were negative. The prognosis for HPS is ominous and misdiagnoses may increase mortality. Better chances of survival depend on prompt intensive care support. Reports of moderate or less typical cases can raise the suspicion index among primary care and hospital-based physicians about this uncommon but severe condition that often affects previously healthy young individuals from developing countries, and subjects who interact with rodent-infested environments in North America. High awareness of HPS allowed successful management of the patient, even before establishing the diagnosis, by serological tests at the reference laboratory of the Ministry of Health. Clinical suspicion favored warning local health authorities about a new case of HPS.

  8. Rett Syndrome: A Comprehensive Review of the Literature.

    Science.gov (United States)

    Perry, Adrienne

    1991-01-01

    This nontechnical review of the literature on Rett Syndrome, a developmental disability found only in females, examines the syndrome's history, diagnostic criteria, clinical stages, incidence, differential diagnosis, etiology, genetics, treatment approaches, and prognosis. (Author/DB)

  9. The Symptomatology and Diagnosis of Gilles de la Tourette's Syndrome

    Science.gov (United States)

    Shapiro, Arthur; And Others

    1973-01-01

    The symptomatology of 34 patients with Gilles de la Tourette's syndrome was described in detail. The purpose was to clarify the diagnostic criteria for Tourette's syndrome by describing the type, variety, and frequency of symptoms in this illness. (Author)

  10. Effect of amitriptyline in treatment interstitial cystitis or bladder pain syndrome according to two criteria: does ESSIC criteria change the response rate?

    Science.gov (United States)

    Sun, Yaofei; Fang, Zujun; Ding, Qiang; Zheng, Jie

    2014-03-01

    The European Society for the Study of Interstitial Cystitis (ESSIC) recommended that interstitial cystitis (IC) should be replaced by bladder pain syndrome (BPS), which focused more attention on the painful or discomfort feeling related to bladder and weakened the importance of cystoscopy in diagnosis process. Our study aimed to explore whether this alteration changed the treatment outcomes of amitriptyline and whether cystoscopy was meaningful for the treatment of this disease. We conducted a retrospective study including 25 IC patients fulfilled the National Institute of Diabetes and Digestive and Kidney Disease (NIDDK) criteria and 42 BPS patients diagnosed according to ESSIC criteria. All the patients received amitriptyline with a self-uptitration protocol. We compared the response rates of two groups by a patient reported global response assessment after 3 months and reclassified all the 67 patients according to ESSIC criteria, the response rates of different BPS types were also assessed. There was no significant difference of response rate between IC patients (12/25, 48%) and BPS patients (19/42, 45.2%) according to different criteria (P = 0.337). The response rate of BPS type 1 (13/30, 43.3%) was similar to that of type 2 or 3 (18/37, 48.6%) (P = 0.664). ESSIC criteria did not decrease the response rate of amitriptyline treatment for BPS patients compared to IC patients with complaint of bladder pain or discomfort. Cystoscopy showed no predictive effect for the treatment outcome of amitriptyline. © 2013 Wiley Periodicals, Inc.

  11. Diagnostic criteria, specific mutations, and genetic predisposition in gastrointestinal stromal tumors

    Science.gov (United States)

    Bachet, Jean-Baptiste; Emile, Jean-François

    2010-01-01

    In 1998, gastrointestinal stromal tumor (GIST) emerged as a distinct oncogenetic entity and subsequently became a paradigm of targeted therapies in solid tumors. Diagnosis of GIST relies on both histology and immunohistochemistry. Ninety-five percent of GISTs express either KIT or DOG-1. Approximately 80%–90% of GISTs harbor gain-of-function mutations of either KIT or platelet-derived growth factor receptor alpha polypeptide (PDGFRA) receptor tyrosine kinase (RTK). More than 100 different mutations have been described, some of which are associated with specific clinical and/or histological characteristics. Detection of KIT or PDGFRA mutations is recommended in advanced GISTs because they are highly predictive of tumor response to RTK inhibitors, as well as in KIT-negative cases to confirm diagnosis. In most cases, GISTs are sporadic, but in rare cases, they are related with genetic predisposition, such as neurofibromatosis type 1, Carney triad, Carney–Stratakis syndrome, and inherited KIT or PDGFRA germline mutations. PMID:23776354

  12. INSTRUMENTAL AND DIAGNOSTIC CRITERIA OF HEMODYNAMIC DISORDERS AND ENDOTHELIAL DYSFUNCTION CORRECTION IN PREGNANTS WITH ARTERIAL HYPERTENSION

    Directory of Open Access Journals (Sweden)

    S. M. Heryak

    2014-12-01

    Conclusions. It was found that the brachial artery ultrasound measuring and occlusive plethysmography procedure by Dietz is an early and safe method of endothelial dysfunction diagnostic in pregnants with hypertension. Doppler ultrasound of blood flow in uterine, umbilical arteries, and middle cerebral arteries of the fetus allows timely diagnosis of the side effect of antihypertensive drugs on the fetus. The therapy of choice for pregnants with Stage II Arterial Hypertension should be based on methyldopa and calcium channel antagonists or selective beta-blockers combination. Highly selective beta-blockers with vasodilative effect (nebivolol hydrochloride and L-arginine (Tivortin allow to prevent perinatal adverse effects of antihypertensive therapy, to correct hemodynamic disorders and endothelial dysfunction in pregnants with arterial hypertension. KEY WORDS: arterial hypertension, uterine-placental hemodynamics, endothelial dysfunction

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

    DEFF Research Database (Denmark)

    Schiffman, Eric; Ohrbach, Richard; Truelove, Edmond

    2014-01-01

    the common and less common TMD is also presented. The Axis II protocol retains selected original RDC/TMD screening instruments augmented with new instruments to assess jaw function as well as behavioral and additional psychosocial factors. The Axis II protocol is divided into screening and comprehensive self...... report instrument sets. The screening instruments' 41 questions assess pain intensity, pain-related disability, psychological distress, jaw functional limitations, and parafunctional behaviors, and a pain drawing is used to assess locations of pain. The comprehensive instruments, composed of 81 questions...... diagnostic algorithms were assessed for validity by using the Validation Project's data set, and for reliability by using newly collected data from the ongoing TMJ Impact Project-the follow-up study to the Validation Project. New Axis II instruments were identified through a comprehensive search...