On thermoeconomics of energy systems at variable load conditions: Integrated optimization of plant design and operation

International Nuclear Information System (INIS)

Piacentino, A.; Cardona, F.

2007-01-01

Thermoeconomics has been assuming a growing role among the disciplines oriented to the analysis of energy systems, its different methodologies allowing solution of problems in the fields of cost accounting, plant design optimisation and diagnostic of malfunctions. However, the thermoeconomic methodologies as such are particularly appropriate to analyse large industrial systems at steady or quasi-steady operation, but they can be hardly applied to small to medium scale units operating in unsteady conditions to cover a variable energy demand. In this paper, the fundamentals of thermoeconomics for systems operated at variable load are discussed, examining the cost formation process and, separately, the cost fractions related to capital depreciation (which require additional distinctions with respect to plants in steady operation) and to exergy consumption. The relevant effects of the efficiency penalty due to off design operation on the exergetic cost of internal flows are also examined. An original algorithm is proposed for the integrated optimization of plant design and operation based on an analytical solution by the Lagrange multipliers method and on a multi-objective decision function, expressed either in terms of net cash flow or primary energy saving. The method is suitable for application in complex energy systems, such as 'facilities of components of a same product' connected to external networks for power or heat distribution. For demonstrative purposes, the proposed thermoeconomically aided optimization is performed for a grid connected trigeneration system to be installed in a large hotel

Thermo-economic multi-objective optimization of solar dish-Stirling engine by implementing evolutionary algorithm

International Nuclear Information System (INIS)

Ahmadi, Mohammad H.; Sayyaadi, Hoseyn; Mohammadi, Amir H.; Barranco-Jimenez, Marco A.

2013-01-01

Highlights: • Thermo-economic multi-objective optimization of solar dish-Stirling engine is studied. • Application of the evolutionary algorithm is investigated. • Error analysis is done to find out the error through investigation. - Abstract: In the recent years, remarkable attention is drawn to Stirling engine due to noticeable advantages, for instance a lot of resources such as biomass, fossil fuels and solar energy can be applied as heat source. Great number of studies are conducted on Stirling engine and finite time thermo-economic is one of them. In the present study, the dimensionless thermo-economic objective function, thermal efficiency and dimensionless power output are optimized for a dish-Stirling system using finite time thermo-economic analysis and NSGA-II algorithm. Optimized answers are chosen from the results using three decision-making methods. Error analysis is done to find out the error through investigation

Thermodynamics, thermoeconomic and economic analysis of ...

African Journals Online (AJOL)

The thermoeconomic analysis proposes the distribution of costs based on thermodynamic concepts, enabling the evaluation of reflection of the investment costs and fuel in the cost of products (steam and electricity). The economic analysis acts as a deciding factor for acceptance or project rejection. Keywords: Cogeneration ...

A thermo-economic analysis of the separation process of an ethylene plant

International Nuclear Information System (INIS)

Yi, T.; Jan-Min, S.

1989-01-01

This study has established a model of thermo-economic balance for chemical processes. The general rules to form the exergy-price constraint equation and the equations of some major types of the units have been proposed. With this model, a thermo-economic analysis for the separation process of an Ethylene Plant has been studied. The paper has made an analysis for the effects of different boundary exergy prices on the process evaluation. The result shows that the thermo-economic analysis for a process, using the method advanced in here, merely depends on the process construction and the ratio of supplying exergy-prices. As soon as the ratio is well-matched, a similar analogic analysis may be set up for the same type of processes in different economic environments

Optimal thermoeconomic performance of an irreversible regenerative ferromagnetic Ericsson refrigeration cycle

International Nuclear Information System (INIS)

Xu, Zhichao; Guo, Juncheng; Lin, Guoxing; Chen, Jincan

2016-01-01

On the basis of the Langevin theory of classical statistical mechanics, the magnetization, entropy, and iso-field heat capacity of ferromagnetic materials are analyzed and their mathematical expressions are derived. An irreversible regenerative Ericsson refrigeration cycle by using a ferromagnetic material as the working substance is established, in which finite heat capacity rates of low and high temperature reservoirs, non-perfect regenerative heat of the refrigeration cycle, additional regenerative heat loss, etc. are taken into account. Based on the regenerative refrigeration cycle model, a thermoeconomic function is introduced as one objective function and optimized with respect to the temperatures of the working substance in the two iso-thermal processes. By means of numerical calculation, the effects of the effective factor of the heat exchangers in high/low temperature reservoir sides, efficiency of the regenerator, heat capacity rate of the low temperature reservoir, and applied magnetic field on the optimal thermoeconomic function as well as the corresponding cooling rate and coefficient of performance are revealed. The results obtained in this paper can provide some theoretical guidance for the optimal design of actual regenerative magnetic refrigerator cycle. - Highlights: • Thermodynamic performance of ferromagnetic material is analyzed. • An irreversible regenerative ferromagnetic Ericsson refrigeration cycle is set up. • The thermoeconomic objective function is introduced and optimized. • Impacts of the thermoeconomic and other parameters are discussed.

On Thermoeconomic Diagnosis of a Fouled Direct Expansion Coil: Effects of Induced Malfunctions on Quantitative Performance of the Diagnostic Technique

Directory of Open Access Journals (Sweden)

Antonio Piacentino

2017-06-01

Full Text Available Thermoeconomic diagnosis represents a promising technique for the detection ofcommon faults in refrigeration systems, which are responsible of degradation in theirenergetic performance. Recently, the authors have carried out a sensitivity analysis of theperformance of this method to the thermodynamic conditions of inlet air and to thegeometry of the direct expansion coil, in case of degradation induced by evaporatorfouling. The analysis showed that the method is able to detect this fault, but sometimes itsquantitative assessments are not satisfactory. In order to understand more in-depth theorigin of such results and identify margins for refinement of the technique, this paper isaimed at evaluating at what extent changes in the exergetic performance of faults-freecomponents may negatively influence the model capability to detect the fouledevaporator and quantify the consequent additional exergy consumption. The resultssuggest that the method is particularly sensitive to the cost of “induced malfunctions” onthe compressor and the condenser, especially when low coil depth or high relativehumidity of inlet air are considered.

Thermoeconomic studies applied to maintenance of power plants

International Nuclear Information System (INIS)

Carvalho, F.R.; Horta Nogueira, L.A.

1996-01-01

The thermoeconomic method is an important tool aiming to improve maintenance activities in steam power plants, becoming possible to share the irreversibilities costs to each equipment, as boilers, turbines and heat exchangers. Furthermore, the effects related to changes in operational and design parameters can be studied in a detailed way, evaluating the local and distributed effects. In this work, after a brief review of power plant maintenance costs concepts and values, one address a methodology for maintenance costs estimation and develops a case study of thermoeconomics of a hypothetical plant, presenting the exergy flows, exergy losses and maintenance costs distribution. Also is presented an evaluation of exergoeconomic maintenance cost, evaluating their significance, at equipment level, related to overall maintenance cost, aiming to help the maintenance activities planning. 10 refs, 3 figs, 12 tabs

Thermoeconomic optimization of subcooled and superheated vapor compression refrigeration cycle

International Nuclear Information System (INIS)

Selbas, Resat; Kizilkan, Onder; Sencan, Arzu

2006-01-01

An exergy-based thermoeconomic optimization application is applied to a subcooled and superheated vapor compression refrigeration system. The advantage of using the exergy method of thermoeconomic optimization is that various elements of the system-i.e., condenser, evaporator, subcooling and superheating heat exchangers-can be optimized on their own. The application consists of determining the optimum heat exchanger areas with the corresponding optimum subcooling and superheating temperatures. A cost function is specified for the optimum conditions. All calculations are made for three refrigerants: R22, R134a, and R407c. Thermodynamic properties of refrigerants are formulated using the Artificial Neural Network methodology

Investigating the effect of non-similar fins in thermoeconomic optimization of plate fin heat exchanger

International Nuclear Information System (INIS)

Hajabdollahi, Hassan

2015-01-01

Thermoeconomic optimization of plate fin heat exchanger with similar (SF) and different (DF) or non-similar fin in each side is presented in this work. For this purpose, both heat exchanger effectiveness and total annual cost (TAC) are optimized simultaneously using multi-objective particle swarm optimization algorithm. The above procedure is performed for various mass flow rates in each side. The optimum results reveal that no thermoeconomic improvement is observed in the case of same mass flow rate in each side while both effectiveness and TAC are improved in the case of different mass flow rate. For example, effectiveness and TAC are improved 0.95% and 10.17% respectively, for the DF compared with SF. In fact, the fin configuration should be selected more compact in a side with lower mass flow rate compared with the other side in the thermoeconomic viewpoint. Furthermore, for the thermodynamic optimization viewpoint both SF and DF have the same optimum result while for the economic (or thermoeconomic) optimization viewpoint, the significant decrease in TAC is accessible in the case of DF compared with SF. - Highlights: • Thermoeconomic modeling of compact heat exchanger. • Selection of fin and heat exchanger geometries as nine decision variables. • Applying MOPSO algorithm for multi objective optimization. • Considering the similar and different fin specification in each side. • Investigation of optimum design parameters for various mass flow rates

Thermoeconomic analysis of power plants. Final report

Energy Technology Data Exchange (ETDEWEB)

Tsatsaronis, G.; Winhold, M.

1984-08-01

In this report, the concept of exergy and the general methodology of the exergetic analysis and the thermoeconomic (combined exergetic and economic) analysis of energy conversion systems are presented. The THESIS (THermodynamic and Economc SImulation System) computer program used for these analyses is briefly described. Detailed mass, energy, exergy and money balances for a reference steam power plant (Harry Allen Station) are shown. The effect of the most important process parameters on the overall efficiency is investigated. A year-by-year and a levelized revenue requirement analysis are presented. The costs of exergy losses are compared with the capital costs and other expenses due to owning and operating each particular plant component. The question whether it is profitable to reduce the exergy losses by increasing these costs and vice versa is investigated. A cost sensitivity analysis including the effect of coal price and average annual capacity factor is performed. The methodology applied in this report appears to be useful in analyzing and evaluating energy conversion systems. The analyses presented here allow identification and evaluation of the inefficiencies and the opportunities for improvement of an energy conversion process. Results indicate that modifications in certain process parameters can lead to a decrease in the cost of electricity produced by the reference plant.

Thermoeconomic optimization of Solar Heating and Cooling systems

International Nuclear Information System (INIS)

Calise, F.; D'Accadia, M. Dentice; Vanoli, L.

2011-01-01

In the paper, the optimal thermoeconomic configuration of Solar Heating and Cooling systems (SHC) is investigated. In particular, a case study is presented, referred to an office building located in Naples (south Italy); for such building, three different SHC configurations were analyzed: the first one is based on the coupling of evacuated solar collectors with a single-stage LiBr-H 2 O absorption chiller equipped with a water-to-water electrical heat pump, to be used in case of insufficient solar radiation; in the second case, a similar layout is considered, but the capacities of the absorption chiller and the solar field are smaller, since they are requested to balance just a fraction of the total cooling load of the building selected for the case study; finally, in the third case, the electric heat pump is replaced by an auxiliary gas-fired heater. A zero-dimensional transient simulation model, developed in TRNSYS, was used to analyze each layout from both thermodynamic and economic points of view. In particular, a cost model was developed in order to assess the owning and operating costs for each plant layout. Furthermore, a mixed heuristic-deterministic optimization algorithm was implemented in order to determine the set of the synthesis/design variables able to maximize the overall thermo-economic performance of the systems under analysis. For this purpose, two different objective functions were selected: the Pay-Back Period and the overall annual cost. Possible public funding, in terms of Capital Cost Contributions and/or feed-in tariff, were also considered. The results are presented on monthly and weekly basis, paying special attention to the energy and monetary flows in the optimal configurations. In particular, the thermoeconomic analysis and optimization showed that a good funding policy for the promotion of such technologies should combine a feed-in tariff with a slight Capital Cost Contribution, allowing to achieve satisfactory Pay-Back Periods.

Thermo-economic analysis and selection of working fluid for solar organic Rankine cycle

International Nuclear Information System (INIS)

Desai, Nishith B.; Bandyopadhyay, Santanu

2016-01-01

Highlights: • Concentrating solar power plant with organic Rankine cycle. • Thermo-economic analysis of solar organic Rankine cycle. • Performance evaluation for different working fluids. • Comparison diagram to select appropriate working fluid. - Graphical Abstract: Display Omitted - Abstract: Organic Rankine cycle (ORC), powered by line-focusing concentrating solar collectors (parabolic trough collector and linear Fresnel reflector), is a promising option for modular scale. ORC based power block, with dry working fluids, offers higher design and part-load efficiencies compared to steam Rankine cycle (SRC) in small-medium scale, with temperature sources up to 400 °C. However, the cost of ORC power block is higher compared to the SRC power block. Similarly, parabolic trough collector (PTC) system has higher optical efficiency and higher cost compared to linear Fresnel reflector (LFR) system. The thermodynamic efficiencies and power block costs also vary with working fluids of the Rankine cycle. In this paper, thermo-economic comparisons of organic Rankine and steam Rankine cycles powered by line-focusing concentrating solar collectors are reported. A simple selection methodology, based on thermo-economic analysis, and a comparison diagram for working fluids of power generating cycles are also proposed. Concentrating solar power plants with any collector technology and any power generating cycle can be compared using the proposed methodology.

Applying the principles of thermoeconomics to the organic Rankine Cycle for low temperature waste heat recovery

International Nuclear Information System (INIS)

Xiao, F.; Lilun, Q.; Changsun, S.

1989-01-01

In this paper, thermoeconomic principle is used to study the selection of working fluids and the option of the cycle parameters in the organic Rankine cycle of low temperature waste heat recovery. The parameter ξ, the product of the ratio of waste heat recovery and real cycle thermal efficiency, is suggested as a unified thermodynamic criterion for the selection of the working fluids. The mathematical expressions are developed to determine the optimal boiling temperature and the optimal pin point temperature difference in the heat recovery exchanger by way of thermoeconomic principle

Thermoeconomic Analysis of Biodiesel Production from Used Cooking Oils

Directory of Open Access Journals (Sweden)

Emilio Font de Mora

2015-05-01

Full Text Available Biodiesel from used cooking oil (UCO is one of the most sustainable solutions to replace conventional fossil fuels in the transport sector. It can achieve greenhouse gas savings up to 88% and at the same time reducing the disposal of a polluting waste. In addition, it does not provoke potential negative impacts that conventional biofuels may eventually cause linked to the use of arable land. For this reason, most policy frameworks favor its consumption. This is the case of the EU policy that double-counters the use of residue and waste use to achieve the renewable energy target in the transport sector. According to different sources, biodiesel produced from UCO could replace around 1.5%–1.8% of the EU-27 diesel consumption. This paper presents an in-depth thermoeconomic analysis of the UCO biodiesel life cycle to understand its cost formation process. It calculates the ExROI value (exergy return on investment and renewability factor, and it demonstrates that thermoeconomics is a useful tool to assess life cycles of renewable energy systems. It also shows that UCO life cycle biodiesel production is more sustainable than biodiesel produced from vegetable oils.

Hydro-methane and methanol combined production from hydroelectricity and biomass: Thermo-economic analysis in Paraguay

International Nuclear Information System (INIS)

Rivarolo, M.; Bellotti, D.; Mendieta, A.; Massardo, A.F.

2014-01-01

Highlights: • We investigate H 2 /O 2 production from large hydraulic plant by water electrolysis. • We produce methanol and hydro-methane from H 2 /O 2 obtained. • We investigate two different configurations of the plant. • We perform a thermo-economic analysis for three scenarios in Paraguay. • We find plants optimal size using a time-dependent thermo-economic approach. - Abstract: A thermo-economic analysis regarding large scale hydro-methane and methanol production from renewable sources (biomass and renewable electricity) is performed. The study is carried out investigating hydrogen and oxygen generation by water electrolysis, mainly employing the hydraulic energy produced from the 14 GW Itaipu Binacional Plant, owned by Paraguay and Brazil. Oxygen is employed in biomass gasification to synthesize methanol; the significant amount of CO 2 separated in the process is mixed with hydrogen produced by electrolysis in chemical reactors to produce hydro-methane. Hydro-methane is employed to supply natural gas vehicles in Paraguay, methanol is sold to Brazil, that is the largest consumer in South America. The analysis is performed employing time-dependent hydraulic energy related to the water that would normally not be used by the plant, named “spilled energy”, when available; in the remaining periods, electricity is acquired at higher cost by the national grid. For the different plant lay-outs, a thermo-economic analysis has been performed employing two different software, one for the design point and one for the time-dependent one entire year optimization, since spilled energy is strongly variable throughout the year. Optimal sizes for the generation plants have been determined, investigating the influence of electricity cost, size and plant configuration

Thermoeconomic optimization of a combined-cycle solar tower power plant

International Nuclear Information System (INIS)

Spelling, James; Favrat, Daniel; Martin, Andrew; Augsburger, Germain

2012-01-01

A dynamic model of a pure-solar combined-cycle power plant has been developed in order to allow determination of the thermodynamic and economic performance of the plant for a variety of operating conditions and superstructure layouts. The model was then used for multi-objective thermoeconomic optimization of both the power plant performance and cost, using a population-based evolutionary algorithm. In order to examine the trade-offs that must be made, two conflicting objectives will be considered, namely minimal investment costs and minimal levelized electricity costs. It was shown that efficiencies in the region of 18–24% can be achieved, and this for levelized electricity costs in the region of 12–24 UScts/kWh e , depending on the magnitude of the initial investment, making the system competitive with current solar thermal technology. -- Highlights: ► Pure-solar combined-cycle studied using thermoeconomic tools. ► Multi-objective optimization conducted to determine Pareto-optimal power plant designs. ► Levelised costs between 12 and 24 UScts/kWhe predicted. ► Efficiencies between 18 and 24% predicted.

Finite-Time Thermoeconomic Optimization of a Solar-Driven Heat Engine Model

Directory of Open Access Journals (Sweden)

Fernando Angulo-Brown

2011-01-01

Full Text Available In the present paper, the thermoeconomic optimization of an irreversible solar-driven heat engine model has been carried out by using finite-time/finite-size thermodynamic theory. In our study we take into account losses due to heat transfer across finite time temperature differences, heat leakage between thermal reservoirs and internal irreversibilities in terms of a parameter which comes from the Clausius inequality. In the considered heat engine model, the heat transfer from the hot reservoir to the working fluid is assumed to be Dulong-Petit type and the heat transfer to the cold reservoir is assumed of the Newtonian type. In this work, the optimum performance and two design parameters have been investigated under two objective functions: the power output per unit total cost and the ecological function per unit total cost. The effects of the technical and economical parameters on the thermoeconomic performance have been also discussed under the aforementioned two criteria of performance.

Optimum design of dual pressure heat recovery steam generator using non-dimensional parameters based on thermodynamic and thermoeconomic approaches

International Nuclear Information System (INIS)

Naemi, Sanaz; Saffar-Avval, Majid; Behboodi Kalhori, Sahand; Mansoori, Zohreh

2013-01-01

The thermodynamic and thermoeconomic analyses are investigated to achieve the optimum operating parameters of a dual pressure heat recovery steam generator (HRSG), coupled with a heavy duty gas turbine. In this regard, the thermodynamic objective function including the exergy waste and the exergy destruction, is defined in such a way to find the optimum pinch point, and consequently to minimize the objective function by using non-dimensional operating parameters. The results indicated that, the optimum pinch point from thermodynamic viewpoint is 2.5 °C and 2.1 °C for HRSGs with live steam at 75 bar and 90 bar respectively. Since thermodynamic analysis is not able to consider economic factors, another objective function including annualized installation cost and annual cost of irreversibilities is proposed. To find the irreversibility cost, electricity price and also fuel price are considered independently. The optimum pinch point from thermoeconomic viewpoint on basis of electricity price is 20.6 °C (75 bar) and 19.2 °C (90 bar), whereas according to the fuel price it is 25.4 °C and 23.7 °C. Finally, an extensive sensitivity analysis is performed to compare optimum pinch point for different electricity and fuel prices. -- Highlights: ► Presenting thermodynamic and thermoeconomic optimization of a heat recovery steam generator. ► Defining an objective function consists of exergy waste and exergy destruction. ► Defining an objective function including capital cost and cost of irreversibilities. ► Obtaining the optimized operating parameters of a dual pressure heat recovery boiler. ► Computing the optimum pinch point using non-dimensional operating parameters

Thermo-economic design optimization of parabolic trough solar plants for industrial process heat applications with memetic algorithms

International Nuclear Information System (INIS)

Silva, R.; Berenguel, M.; Pérez, M.; Fernández-Garcia, A.

2014-01-01

Highlights: • A thermo-economic optimization of a parabolic-trough solar plant for industrial process heat applications is developed. • An analysis of the influence of economic cost functions on optimal design point location is presented. • A multi-objective optimization approach to the design routine is proposed. • A sensitivity analysis of the optimal point location to economic, operational, and ambient conditions is developed. • Design optimization of a parabolic trough plant for a reference industrial application is developed. - Abstract: A thermo-economic design optimization of a parabolic trough solar plant for industrial processes with memetic algorithms is developed. The design domain variables considered in the optimization routine are the number of collectors in series, number of collector rows, row spacing, and storage volume. Life cycle savings, levelized cost of energy, and payback time objective functions are compared to study the influence on optimal design point location. Furthermore a multi-objective optimization approach is proposed to analyze the design problem from a multi-economic criteria point of view. An extensive set of optimization cases are performed to estimate the influence of fuel price trend, plant location, demand profile, operation conditions, solar field orientation, and radiation uncertainty on optimal design. The results allow quantifying as thermo-economic design optimization based on short term criteria as the payback time leads to smaller plants with higher solar field efficiencies and smaller solar fractions, while the consideration of optimization criteria based on long term performance of the plants, as life cycle savings based optimization, leads to the reverse conclusion. The role of plant location and future evolution of gas prices in the thermo-economic performance of the solar plant has been also analyzed. Thermo-economic optimization of a parabolic trough solar plant design for the reference industrial

Exergy and thermoeconomic evaluation of hydrogen production from natural gas; Avaliacao exergetica e termo-economica da producao de hidrogenio a partir do gas natural

Energy Technology Data Exchange (ETDEWEB)

Cruz, Flavio Eduardo da [PROMON Engenharia Ltda., Sao Paulo, SP (Brazil); Oliveira Junior, Silvio de [Universidade de Sao Paulo (USP), SP (Brazil). Escola Politecnica

2008-07-01

Some specific processes are required to obtain pure hydrogen and the most usual one is the natural gas reforming, where natural gas reacts with superheated steam producing H{sub 2}, CO, CO{sub 2} and H{sub 2}O. This paper presents exergy and thermoeconomic analysis of a complete hydrogen production unit of a petroleum refinery. The hydrogen production unit analysed in this paper has to supply 550,000 Nm{sup 3} of hydrogen per day to purify diesel oil. Based on a synthesis plant of the hydrogen production unit, the exergy efficiency of each component and of the overall plant are calculated. The hydrogen production cost is determined by means of a thermoeconomic analysis in which the equality cost partition method is employed, including capital and operational costs, in order to determine the production cost of hydrogen and other products of the plant.(author)

Thermo-economic analysis of combined power plants with changing economic parameters

International Nuclear Information System (INIS)

Bidini, G.; Desideri, U.; Facchini, B.

1991-01-01

A method of thermo-economic analysis for the choice of optimal thermodynamic parameters of steam bottoming cycles in combined cycle power plants is presented. By keeping the thermodynamic aspects separated from the economic aspects, this method allows designers to easily perform a sensitivity analysis of the change in the economic parameters

Thermo-economic analysis of an integrated solar power generation system using nanofluids

International Nuclear Information System (INIS)

Alashkar, Adnan; Gadalla, Mohamed

2017-01-01

Highlights: • Develop a thermo-economic analysis of an integrated solar-power generation system. • A thermodynamic optimization is proposed to maximize system performance. • Select the optimum nanofluid to replace conventional heating fluids inside a PTSC. • Study the effect of thermal energy storage on performance and cost of the system. • Perform monthly and daily analyses to analyze system behavior using nanofluids. - Abstract: In this paper, a thermo-economic analysis of an Integrated Solar Regenerative Rankine Cycle (ISRRC) is performed. The ISRRC consists of a nanofluid-based Parabolic Trough Solar Collector (PTSC), and a Thermal Energy Storage System (TES) integrated with a Regenerative Rankine Cycle. The effect of dispersing metallic and non-metallic nanoparticles into conventional heating fluids on the output performance and cost of the ISRRC is studied for different volume fractions and for three modes of operation. The first mode assumes no storage, while the second and the third assume a storage system with a storage period of 7.5 h and 10 h respectively. For the modes of operation with the TES, the charging and discharging cycles are explained. The results show that the presence of the nanoparticles leads to an increase in the overall energy produced by the ISRRC for all modes of operation, causing a decrease in the Levelized Cost of Electricity (LEC), and an increase in the net savings of the ISRRC. After comparing the three modes of operation, it is established that the existence of a storage system leads to a higher power generation, and a lower LEC; however, the efficiency of the cycle drops. It is seen that the maximum increase in the annual energy output of the ISRRC caused by the addition of Cu nanoparticles to Syltherm 800 is approximately 3.1%, while the maximum increase in the net savings is about 2.4%.

Thermoeconomic model of a commercial transcritical booster refrigeration system

DEFF Research Database (Denmark)

Ommen, Torben Schmidt; Elmegaard, Brian

2011-01-01

For cooling applications in supermarkets, booster refrigeration systems operating in both transcritical and subcritical conditions are increasingly used. A thermodynamic model of a transcritical booster refrigeration plant is tailored to match the new generation of commercial refrigeration plants...... of exergy for cooling. Second law analysis is needed to illustrate the characteristics of the plant at different load rates, according to the alternating load profile and corresponding to outdoor conditions. With the detailed model, different uses of the analysis are possible, including thermoeconomic...

Scope-oriented thermoeconomic analysis of energy systems. Part I: Looking for a non-postulated cost accounting for the dissipative devices of a vapour compression chiller. Is it feasible?

Energy Technology Data Exchange (ETDEWEB)

Piacentino, Antonio; Cardona, Fabio [DREAM - Department of Energy and Environmental Researches, University of Palermo, Viale delle Scienze, 90128 Palermo (Italy)

2010-03-15

The authors of the main thermoeconomic methodologies developed in the last two decades have recently focused their efforts on the analysis of dissipative devices, i.e. those components whose productive purpose is neither intuitive nor easy to define. Coherent and unanimously accepted cost structures have been identified for dissipative components, while ambiguities still exist as concerns the cost allocation principles to be adopted. Being this aspect evidently cost-influencing, accurate analyses focused on the subjectivity of results are needed. This paper is structured in two parts. In the Part I an in-depth study of some critical issues arising from the thermoeconomic analysis of a 1.5 MW{sub c} industrial chiller is presented. The attention is focused on the role of the condenser and the throttling valve (considered as a limit condition for an expander with very low isentropic efficiency); marginal analyses performed on the condensation pressure and the isentropic efficiency of the expander provided elements to assess the rational of the cost allocation principles. Attempting to refugee any cost allocation criterion based on postulates, the concept of Scope is identified as a possible non-arbitrary basis for cost allocation in dissipative devices; consequently, a new topology is defined, abandoning the conventional classification between dissipative and productive units, toward a new distinction between Product Makers and Product Takers functions. The proposed approach is applied to the cost accounting of the examined chiller, revealing inadequate and less explicative than the conventional thermoeconomic approaches due to its ''intrinsically differential'' nature. In the Part II of this paper the proposed approach will be applied to an Optimization problem, revealing very flexible and insightful. (author)

Standard GAX versus hybrid GAX absorption refrigeration cycle: From the view point of thermoeconomics

International Nuclear Information System (INIS)

Mehr, A.S.; Zare, V.; Mahmoudi, S.M.S.

2013-01-01

Highlights: • The SGAX cycle is found to be thermoeconomically efficient compared to HGAX cycle. • The HGAX cycle has higher COP and exergy efficiency compared to SGAX cycle. • Minimum product cost is found 180.5 $/GJ and 159.1 $/GJ for HGAX and SGAX, respectively. - Abstract: The main goal of this research is to compare thermoeconomic performance of a GAX absorption cycle and a hybrid GAX absorption cycle in which a compressor is employed to raise the absorber pressure. In order to do this, the ammonia–water standard GAX (SGAX) and hybrid GAX (HGAX) absorption refrigeration cycles are investigated and optimized from the viewpoints of thermodynamics and economics. Parametric studies are carried out and with the help of genetic algorithm (GA), the cycles’ performance is optimized based on the COP and exergy efficiency as well as the cost of unit product. Results indicate that although, compared to the GAX cycle, the HGAX cycle demonstrates a better performance from the view points of both the first and second laws of thermodynamics, the unit product cost for the HGAX cycle is higher. At the optimum operating conditions, the cost of unit product for the HGAX cycle is calculated as 180.5 $/GJ while the corresponding value for the SGAX cycle is obtained as 159.1 $/GJ. Also, the exergoeconomic analyses unfold that the condenser has the lowest exergoeconomic factor, f, in both the systems. In addition, inspired from nature, a new graphical plot is proposed to illustrate the fuel cost, product cost, capital investment and operating and maintenance cost and cost rates associated with the exergy destruction and losses within the system’s components

Thermoeconomic evaluation of air conditioning system with chilled water storage

International Nuclear Information System (INIS)

Lin, Hu; Li, Xin-hong; Cheng, Peng-sheng; Xu, Bu-gong

2014-01-01

Highlights: • A new thermoeconomic evaluation methodology has been presented. • The relationship between thermodynamic and economic performances has been revealed. • A key point for thermal storage technology further application is discovered. • A system has been analyzed via the new method and EUD method. - Abstract: As a good load shifting technology for power grid, chilled energy storage has been paid more and more attention, but it always consumes more energy than traditional air conditioning system, and the performance analysis is mostly from the viewpoint of peak-valley power price to get cost saving. The paper presents a thermoeconomic evaluation methodology for the system with chilled energy storage, by which thermodynamic performance influence on cost saving has been revealed. And a system with chilled storage has been analyzed, which can save more than 15% of power cost with no energy consumption increment, and just certain difference between peak and valley power prices can make the technology for good economic application. The results show that difference between peak and valley power prices is not the only factor on economic performance, thermodynamic performance of the storage system is the more important factor, and too big price difference is a barrier for its application, instead of for more cost saving. All of these give a new direction for thermal storage technology application

Thermoeconomic evaluation and optimization of a Brayton–Rankine–Kalina combined triple power cycle

International Nuclear Information System (INIS)

Singh, Omendra Kumar; Kaushik, S.C.

2013-01-01

Highlights: • Combustion chamber performance can improve much by investment in efficient design. • Steam turbine performance would also improve by investment in efficient design. • Minimum total cost rate of plant found at gas cycle pressure ratio of around 14. • Total cost rate decreases significantly by decreasing the inlet air temperature. • Total cost rate decreases a little by increasing the inlet air relative humidity. - Abstract: This paper presents thermoeconomic analysis and optimization of a Brayton–Rankine–Kalina combined triple power cycle using Specific Exergy Costing (SPECO) methodology. Cost-balance and auxiliary equations are formulated for each component and for each node and solved through a MATLAB program to get the average cost per unit exergy at different state points. To evaluate the cost effectiveness of the system, the values of thermoeconomic variables for each component are calculated. Large relative cost difference is observed in the steam turbine, HRSG’s, combustion chambers, compressors, recuperators and ammonia–water evaporator. Therefore, these components require greater attention. The performance of steam turbine, combustion chambers, recuperators and ammonia–water evaporator can be appreciably improved by capital investment into more efficient design due to their low values of exergoeconomic factor. The performance of HRSG’s can be improved only marginally due to slightly higher value of exergoeconomic factor but no such recommendation can be made for the compressors which have a quite high value of exergoeconomic factor. The objective function of the thermoeconomic optimization is the minimization of the total cost rate for the whole plant. Its minimum value is found to occur at a gas cycle pressure ratio of around 14. Decreasing inlet air temperature decreases this objective function parameter significantly while increasing relative humidity causes a small decrease in it

Thermoeconomic comparison of industrial heat pumps

DEFF Research Database (Denmark)

Ommen, Torben Schmidt; Markussen, Christen Malte; Reinholdt, L.

2011-01-01

Four natural working fluids in various heat pump cycles are expected to cover the heating range between 50oC and 150°C. The different thermodynamic cycles are the Condensing Vapour, Transcritical and Compression/Absorption. As the considered technologies have significant differences in application......, limitations and design, a generic comparison is used. To establish the optimal individual temperature range of operation, a thermoeconomic evaluation is performed, with heat price as the decision parameter. Each individual heat pump is favourable in specific temperature intervals, which will vary according...... to the temperature lift between sink and source. At temperature lifts below 30°C the entire temperature range is covered. Exceeding this temperature lift, the range of sink temperatures is not completely covered above 125°C. Three of the heat pumps prove very cost competitive when compared to heating with natural...

Thermoeconomic and environmental assessment of a crude oil distillation unit of a Nigerian refinery

International Nuclear Information System (INIS)

Waheed, M.A.; Oni, A.O.; Adejuyigbe, S.B.; Adewumi, B.A.

2014-01-01

The renovation of refineries should be aimed at achieving the highest possible technical efficiencies at a considerable investment cost and not only at replacing damaged components to attain full capacity utilisation. This study examined a crude distillation unit (CDU) of a Nigerian refinery plant comprising the atmospheric distillation unit (ADU), vacuum distillation unit (VDU), preflash unit (PFU), splitter unit (SPU), stabiliser unit (SBU) and heat exchanger network (HEN) to determine critical areas of inefficiencies as the plant managements plan renovation. Using real plant data, the CDU was simulated with Aspen Hysys ® and the thermoeconomic and environmental analyses were carried out. The results show that the energy and exergy efficiencies of the CDU were 9.0 and 4.0% respectively. The specific CO 2 emission was 3.67 kg CO 2 /bbl. The highly inefficient subunits accounting for 77.4 and 90.0% of the overall energy and exergy losses respectively and 60.3% of the emission released were the PFU, ADU and HEN. The highly inefficient components are the furnaces which accounted for 51.6% of the overall exergy losses. The environmental and economic analysis also indicated that these components are the most potent for improvement. The columns of the PFU and ADU should be revamped to reduce their energy demands and the HEN should be modified to minimise effluent losses. - Highlights: •The assessment of a crude distillation unit (CDU) in Nigeria was carried out. •The assessment considered thermodynamic, thermoeconomic and environment analysis. •The assessment revealed areas with poor performance in the CDU. •Large thermodynamic and economic losses are responsible for the poor performance. •Areas with large losses and emission rate should be targeted for improvement

Thermoeconomic and environmental assessment of a crude oil distillation unit of a Nigerian refinery

Energy Technology Data Exchange (ETDEWEB)

Waheed, M. A. [Department of Mechanical Engineering, Federal University of Agriculture, Abeokuta, P.M.B. 2240, Abeokuta, Ogun State (Nigeria); Oni, A.O., E-mail: fem2day@yahoo.com [Department of Mechanical Engineering, Federal University of Agriculture, Abeokuta, P.M.B. 2240, Abeokuta, Ogun State (Nigeria); Adejuyigbe, S. B. [Department of Mechanical Engineering, Federal University of Agriculture, Abeokuta, P.M.B. 2240, Abeokuta, Ogun State (Nigeria); Adewumi, B. A. [Department of Agricultural Engineering, Federal University of Agriculture, Abeokuta, P.M.B. 2240, Abeokuta, Ogun State (Nigeria)

2014-05-01

The renovation of refineries should be aimed at achieving the highest possible technical efficiencies at a considerable investment cost and not only at replacing damaged components to attain full capacity utilisation. This study examined a crude distillation unit (CDU) of a Nigerian refinery plant comprising the atmospheric distillation unit (ADU), vacuum distillation unit (VDU), preflash unit (PFU), splitter unit (SPU), stabiliser unit (SBU) and heat exchanger network (HEN) to determine critical areas of inefficiencies as the plant managements plan renovation. Using real plant data, the CDU was simulated with Aspen Hysys{sup ®} and the thermoeconomic and environmental analyses were carried out. The results show that the energy and exergy efficiencies of the CDU were 9.0 and 4.0% respectively. The specific CO{sub 2} emission was 3.67 kg CO{sub 2}/bbl. The highly inefficient subunits accounting for 77.4 and 90.0% of the overall energy and exergy losses respectively and 60.3% of the emission released were the PFU, ADU and HEN. The highly inefficient components are the furnaces which accounted for 51.6% of the overall exergy losses. The environmental and economic analysis also indicated that these components are the most potent for improvement. The columns of the PFU and ADU should be revamped to reduce their energy demands and the HEN should be modified to minimise effluent losses. - Highlights: •The assessment of a crude distillation unit (CDU) in Nigeria was carried out. •The assessment considered thermodynamic, thermoeconomic and environment analysis. •The assessment revealed areas with poor performance in the CDU. •Large thermodynamic and economic losses are responsible for the poor performance. •Areas with large losses and emission rate should be targeted for improvement.

Thermoeconomic analysis of an integrated multi-effect desalination thermal vapor compression (MED-TVC) system with a trigeneration system using triple-pressure HRSG

Science.gov (United States)

Ghaebi, Hadi; Abbaspour, Ghader

2018-05-01

In this research, thermoeconomic analysis of a multi-effect desalination thermal vapor compression (MED-TVC) system integrated with a trigeneration system with a gas turbine prime mover is carried out. The integrated system comprises of a compressor, a combustion chamber, a gas turbine, a triple-pressure (low, medium and high pressures) heat recovery steam generator (HRSG) system, an absorption chiller cycle (ACC), and a multi-effect desalination (MED) system. Low pressure steam produced in the HRSG is used to drive absorption chiller cycle, medium pressure is used in desalination system and high pressure superheated steam is used for heating purposes. For thermodynamic and thermoeconomic analysis of the proposed integrated system, Engineering Equation Solver (EES) is used by employing mass, energy, exergy, and cost balance equations for each component of system. The results of the modeling showed that with the new design, the exergy efficiency in the base design will increase to 57.5%. In addition, thermoeconomic analysis revealed that the net power, heating, fresh water and cooling have the highest production cost, respectively.

Exergetic analysis and thermoeconomic study for a container-housed engine

Energy Technology Data Exchange (ETDEWEB)

Sala, J.M.; Eguia, J.; Flores, I. [Escuela Superior de Ingenieros Industriales de Bilbao, Universidad del Pais Vasco, Alameda de Urquijo, s/n 48013 Bilbao, Bizkaia (Spain); Lopez-Gonzalez, L.M.; Ruiz de Adana, M. [Escuela Tecnica Superior de Ingenieria Industrial, Universidad de La Rioja, C/Luis de Ulloa, 20. E-26004 Logrono, La Rioja (Spain); Miguez, J.L. [Universidad de Vigo, Escuela Tecnica Superior de Ingenieros Industriales, C/Lagoas-Marcosende, s/n 36200 Vigo, Pontevedra (Spain)

2006-11-15

This paper presents the engineering design and theoretical exergetic analyses for a container-housed reciprocating engine. The exergy analysis conducted was based on the first and second laws of thermodynamics for power generation systems. Using thermographic inspection, the heat dissipated by each one of the 28 elements under consideration in the engine container was assessed, together with the mass flow rate of air supplied to the cab and the air temperature at the inlet and outlet. This information is essential for the proper design of the ventilation system needed to disseminate the heat generated inside the container-housed unit. The energy balance and corresponding exergy balance were drawn up using the values thus obtained and the information available on the engine. The engine efficiency rates were evaluated on both an energy and exergy basis, taking into account that heat from the cooling circuit and exhaust fumes are used for CHP. Finally, thermoeconomics was applied to calculate the costs of the electricity and useful heat energy produced by the engine. The result of this study should be to optimize the design of container-housed CHP systems, showing where exergy losses occur and identifying areas of improvement. (author)

Exergetic analysis and thermoeconomic study for a container-housed engine

International Nuclear Information System (INIS)

Sala, J.M.; Lopez-Gonzalez, L.M.; Ruiz de Adana, M.; Miguez, J.L.; Eguia, J.; Flores, I.

2006-01-01

This paper presents the engineering design and theoretical exergetic analyses for a container-housed reciprocating engine. The exergy analysis conducted was based on the first and second laws of thermodynamics for power generation systems. Using thermographic inspection, the heat dissipated by each one of the 28 elements under consideration in the engine container was assessed, together with the mass flow rate of air supplied to the cab and the air temperature at the inlet and outlet. This information is essential for the proper design of the ventilation system needed to disseminate the heat generated inside the container-housed unit. The energy balance and corresponding exergy balance were drawn up using the values thus obtained and the information available on the engine. The engine efficiency rates were evaluated on both an energy and exergy basis, taking into account that heat from the cooling circuit and exhaust fumes are used for CHP. Finally, thermoeconomics was applied to calculate the costs of the electricity and useful heat energy produced by the engine. The result of this study should be to optimize the design of container-housed CHP systems, showing where exergy losses occur and identifying areas of improvement

Thermo-economic evaluation of ORCs for various working fluids

International Nuclear Information System (INIS)

Garg, Pardeep; Orosz, Matthew S.; Kumar, Pramod

2016-01-01

An inclusive component-level technical and economic assessment procedure for the general design and operating strategy of Organic Rankine Cycles (ORC) for use across major application categories (waste heat recovery, solar thermal, geothermal) and sub-MW scales can be an important tool for leveraging the cost-effective deployment of low and medium temperature power cycles. Previous analyses and design approaches tended to focus on thermodynamic efficiency rather than financial performance. To bridge this gap, a general thermo-economic optimization of sub 500 kWe ORCs is developed using a 7-dimensional design space with minimum investment cost per unit of nameplate electricity production as an objective function. Parameters used include working fluid, heat source temperature, pinch in condenser, boiler (HEX) and regenerator, expander inlet pressure and air cooled condenser area. Optimized power block configurations are presented for the application of ORCs with waste or “free” heat sources and solar heat input for power scales of 5, 50 and 500 kWe to facilitate rapid selection of design parameters across a wide range of thermal regimes. While R152a yields the lowest cost ORCs in the case of the former, isopentane is found to be more cost effective in the latter case for heat source temperatures between 125 and 275 °C.

Thermodynamic and thermoeconomic analysis of a system with biomass gasification, solid oxide fuel cell (SOFC) and Stirling engine

International Nuclear Information System (INIS)

Rokni, Masoud

2014-01-01

Thermodynamic and thermoeconomic investigations of a small-scale integrated gasification solid oxide fuel cell (SOFC) and Stirling engine for combined heat and power (CHP) with a net electric capacity of 120 kW e have been performed. Woodchips are used as gasification feedstock to produce syngas, which is then utilized to feed the anode side of the SOFC stacks. A thermal efficiency of 0.424 LHV (lower heating value) for the plant is found to use 89.4 kg/h of feedstock to produce the above mentioned electricity. Thermoeconomic analysis shows that the production price of electricity is 0.1204 $/kWh. Furthermore, hot water is considered as a by-product, and the cost of hot water is found to be 0.0214 $/kWh. When compared to other renewable systems of similar scales, this result shows that if both SOFC and Stirling engine technology enter the commercialization phase, then they can deliver electricity at a cost that is competitive with the corresponding renewable systems of the same size. - Highlights: • A 120 kW e integrated gasification SOFC–Stirling CHP is presented. • Effect of important parameters on plant characteristic and economy are studied. • A modest thermal efficiency of 0.41 is found after thermoeconomic optimization. • Reducing stack numbers cuts cost of electricity at expense of thermal efficiency. • The plant cost is estimated to be about 3433 $/kW when disposal costs are neglected

Thermoeconomic analysis and optimization of an ammonia–water power/cooling cogeneration cycle

International Nuclear Information System (INIS)

Zare, V.; Mahmoudi, S.M.S.; Yari, M.; Amidpour, M.

2012-01-01

The performance of an ammonia–water power/cooling cogeneration cycle is investigated and optimized paying more attention on the economic point of view. Thermodynamic and thermoeconomic models are developed in order to investigate the thermodynamic performance of the cycle and assess the unit cost of products. A parametric study is carried out and the cycle performance is optimized based on the thermal and exergy efficiencies as well as the sum of the unit costs of the system products. The results show that the sum of the unit cost of the cycle products obtained through thermoeconomic optimization is less than by around 18.6% and 25.9% compared to the cases when the cycle is optimized from the viewpoints of first and second laws of thermodynamics, respectively. It is also concluded that for each increase of $3/ton in unit cost of the steam as the heat source, the unit cost of the output power and cooling is increased by around $7.6/GJ and $15–19/GJ, respectively. -- Highlights: ► The theory of exergetic cost is applied to the case of ammonia–water power/cooling cycle. ► The cycle is optimized from the viewpoints of thermodynamics and economics. ► The economic optimization leads to a considerable reduction in the system product costs.

Thermoeconomic Optimization of an Irreversible Novikov Plant Model under Different Regimes of Performance

Directory of Open Access Journals (Sweden)

Juan Carlos Pacheco-Paez

2017-03-01

Full Text Available The so-called Novikov power plant model has been widely used to represent some actual power plants, such as nuclear electric power generators. In the present work, a thermo-economic study of a Novikov power plant model is presented under three different regimes of performance: maximum power (MP, maximum ecological function (ME and maximum efficient power (EP. In this study, different heat transfer laws are used: The Newton’s law of cooling, the Stefan–Boltzmann radiation law, the Dulong–Petit’s law and another phenomenological heat transfer law. For the thermoeconomic optimization of power plant models, a benefit function defined as the quotient of an objective function and the total economical costs is commonly employed. Usually, the total costs take into account two contributions: a cost related to the investment and another stemming from the fuel consumption. In this work, a new cost associated to the maintenance of the power plant is also considered. With these new total costs, it is shown that under the maximum ecological function regime the plant improves its economic and energetic performance in comparison with the other two regimes. The methodology used in this paper is within the context of finite-time thermodynamics.

Thermo-Economic Assessment of Advanced,High-Temperature CANDU Reactors

International Nuclear Information System (INIS)

Spinks, Norman J.; Pontikakis, Nikos; Duffey, Romney B.

2002-01-01

Research underway on the advanced CANDU examines new, innovative, reactor concepts with the aim of significant cost reduction and resource sustainability through improved thermodynamic efficiency and plant simplification. The so-called CANDU-X concept retains the key elements of the current CANDU designs, including heavy-water moderator that provides a passive heat sink and horizontal pressure tubes. Improvement in thermodynamic efficiency is sought via substantial increases in both pressure and temperature of the reactor coolant. Following on from the new Next Generation (NG) CANDU, which is ready for markets in 2005 and beyond, the reactor coolant is chosen to be light water but at supercritical operating conditions. Two different temperature regimes are being studied, Mark 1 and Mark 2, based respectively on continued use of zirconium or on stainless-steel-based fuel cladding. Three distinct cycle options have been proposed for Mark 1: the High-Pressure Steam Generator (HPSG) cycle, the Dual cycle, and the Direct cycle. For Mark 2, the focus is on simplification via a Direct cycle. This paper presents comparative thermo-economic assessments of the CANDU-X cycle options, with the ultimate goal of ascertaining which particular cycle option is the best overall in terms of thermodynamics and economics. A similar assessment was already performed for the NG CANDU. The economic analyses entail obtaining cost estimates of major plant components, such as heat exchangers, turbines and pumps. (authors)

Scope Oriented Thermoeconomic analysis of energy systems. Part II: Formation Structure of Optimality for robust design

International Nuclear Information System (INIS)

Piacentino, Antonio; Cardona, Ennio

2010-01-01

This paper represents the Part II of a paper in two parts. In Part I the fundamentals of Scope Oriented Thermoeconomics have been introduced, showing a scarce potential for the cost accounting of existing plants; in this Part II the same concepts are applied to the optimization of a small set of design variables for a vapour compression chiller. The method overcomes the limit of most conventional optimization techniques, which are usually based on hermetic algorithms not enabling the energy analyst to recognize all the margins for improvement. The Scope Oriented Thermoeconomic optimization allows us to disassemble the optimization process, thus recognizing the Formation Structure of Optimality, i.e. the specific influence of any thermodynamic and economic parameter in the path toward the optimal design. Finally, the potential applications of such an in-depth understanding of the inner driving forces of the optimization are discussed in the paper, with a particular focus on the sensitivity analysis to the variation of energy and capital costs and on the actual operation-oriented design.

Optimization of thermal systems based on finite-time thermodynamics and thermoeconomics

Energy Technology Data Exchange (ETDEWEB)

Durmayaz, A. [Istanbul Technical University (Turkey). Department of Mechanical Engineering; Sogut, O.S. [Istanbul Technical University, Maslak (Turkey). Department of Naval Architecture and Ocean Engineering; Sahin, B. [Yildiz Technical University, Besiktas, Istanbul (Turkey). Department of Naval Architecture; Yavuz, H. [Istanbul Technical University, Maslak (Turkey). Institute of Energy

2004-07-01

The irreversibilities originating from finite-time and finite-size constraints are important in the real thermal system optimization. Since classical thermodynamic analysis based on thermodynamic equilibrium do not consider these constraints directly, it is necessary to consider the energy transfer between the system and its surroundings in the rate form. Finite-time thermodynamics provides a fundamental starting point for the optimization of real thermal systems including the fundamental concepts of heat transfer and fluid mechanics to classical thermodynamics. In this study, optimization studies of thermal systems, that consider various objective functions, based on finite-time thermodynamics and thermoeconomics are reviewed. (author)

Thermoeconomic Evaluation of Modular Organic Rankine Cycles for Waste Heat Recovery over a Broad Range of Heat Source Temperatures and Capacities

Directory of Open Access Journals (Sweden)

Markus Preißinger

2017-02-01

Full Text Available Industrial waste heat recovery by means of an Organic Rankine Cycle (ORC can contribute to the reduction of CO2 emissions from industries. Before market penetration, high efficiency modular concepts have to be developed to achieve appropriate economic value for industrial decision makers. This paper aims to investigate modularly designed ORC systems from a thermoeconomic point of view. The main goal is a recommendation for a suitable chemical class of working fluids, preferable ORC design and a range of heat source temperatures and thermal capacities in which modular ORCs can be economically feasible. For this purpose, a thermoeconomic model has been developed which is based on size and complexity parameters of the ORC components. Special emphasis has been laid on the turbine model. The paper reveals that alkylbenzenes lead to higher exergetic efficiencies compared to alkanes and siloxanes. However, based on the thermoeconomic model, the payback periods of the chemical classes are almost identical. With the ORC design, the developed model and the boundary conditions of this study, hexamethyldisiloxane is a suitable working fluid and leads to a payback period of less than 5 years for a heat source temperature of 400 to 600 °C and a mass flow rate of the gaseous waste heat stream of more than 4 kg/s.

Thermodynamic and Thermoeconomic investigation of an Integrated Gasification SOFC and Stirling Engine

DEFF Research Database (Denmark)

Rokni, Masoud

2013-01-01

Thermodynamic and thermoeconomic investigation of a small scale Integrated Gasification Solid Oxide Fuel Cell (SOFC) and Stirling engine for combined heat and power (CHP) with a net electric capacity of 120kW have been performed. Woodchips are used as gasification feedstock to produce syngas which......-product and the cost of hot water was found to be 0.0214$/kWh. When compared to other renewable systems at similar scale, it shows that if both SOFC and Stirling engine technology emerges enter commercialization phase, then they can deliver electricity at a cost rate which is competitive with corresponding renewable...

Thermo-economic optimization of the impact of renewable generators on poly-generation smart-grids including hot thermal storage

International Nuclear Information System (INIS)

Rivarolo, M.; Greco, A.; Massardo, A.F.

2013-01-01

Highlights: ► We model a poly-generation grid including thermal storage and renewable generators. ► We analyze the impact of random renewable generators on the grid performance. ► We carry out the grid optimization using a time-dependent thermo-economic approach. ► We present the importance of the storage system to optimize the RES impact. - Abstract: In this paper, the impact of not controllable renewable energy generators (wind turbines and solar photovoltaic panels) on the thermo-economic optimum performance of poly-generation smart grids is investigated using an original time dependent hierarchical approach. The grid used for the analysis is the one installed at the University of Genoa for research activities. It is based on different prime movers: (i) 100 kWe micro gas turbine, (ii) 20 kWe internal combustion engine powered by gases to produce both electrical and thermal (hot water) energy and (iii) a 100 kWth adsorption chiller to produce cooling (cold water) energy. The grid includes thermal storage tanks to manage the thermal demand load during the year. The plant under analysis is also equipped with two renewable non-controllable generators: a small size wind turbine and photovoltaic solar panels. The size and the management of the system studied in this work have been optimized, in order to minimize both capital and variable costs. A time-dependent thermo-economic hierarchical approach developed by the authors has been used, considering the time-dependent electrical, thermal and cooling load demands during the year as problem constraints. The results are presented and discussed in depth and show the strong interaction between fossil and renewable resources, and the importance of an appropriate storage system to optimize the RES impact taking into account the multiproduct character of the grid under investigation.

Thermoeconomic and environmental analyses of a low water consumption combined steam power plant and refrigeration chillers – Part 1: Energy and economic modelling and analysis

International Nuclear Information System (INIS)

Ifaei, Pouya; Rashidi, Jouan; Yoo, ChangKyoo

2016-01-01

Highlights: • Proposing two energy systems by combining refrigeration chillers and power plants. • Model-based comparison of the systems through energy and economic standpoints. • Reducing total annual costs of the base system up to 4.7% by process integration. • Decreasing the water loss in wet cooling towers by up to 18% in the proposed system. • Suggesting a water-fuel economic management strategy based on parametric analysis. - Abstract: Two novel configurations are proposed to replace the conventional Rankine cycle based steam power plants (SPP) with natural draft wet cooling towers (NDWCT) as cooling units. Closed feedwater heater unit of the base SPP-NDWCT system is eliminated in order to combine a vapor compression refrigeration (VCR) and an absorption heat pump (ABHP) with the base SPP-NDWCT system. Both VCR-SPP-NDWCT and ABHP-SPP-NDWCT systems are integrated to decrease the NDWCT load which could result in water losses decrease. In part one of the presented two-part paper, model-based energy and economic analyses are performed to compare systems performance and applicability. The temperature difference at pinch point and temperature difference between the hot and cold sides of the heat exchangers which were used for systems integration in VCR-SPP-NDWCT, and the absorber pressure and temperature in ABHP-SPP-NDWCT system are studied using parametric analysis procedure. A water-fuel management strategy is also introduced for the ABHP-SPP-NDWCT system according to the influence of the absorber pressure changes on system water and fuel consumption. In part 2, environmental and thermoeconomic analyses are performed to complete a comprehensive study on designing steam power plants. The results of part 1 showed that water losses and total annual costs decreased by 1–18% and 0–4.7% for the ABHP-SPP-NDWCT system but increased by 11% and 60% for the VCR-SPP-NDWCT system, respectively.

FUZZY THERMOECONOMIC APPROACH TO NANOFLUID SELECTION IN VAPOR COMPRESSION REFRIGERATION CYCLE

Directory of Open Access Journals (Sweden)

D. Kuleshov

2014-06-01

Full Text Available The working fluid selection in the vapour compression refrigeration cycles has been studied as a fuzzy thermoeconomic optimization problem. Three criteria: thermodynamic (COP Coefficient Of Performance, economic (LCC Life Cycle Cost, and ecologic (GWP – Global Warming Potential are chosen as target functions. The decision variables X as an information characteristics of desired refrigerant are presented by its critical parameters and normal boiling temperature. Local criteria are expressed via thermodynamic properties restored from information characteristics of refrigerant X, as well as life cycle costs are calculated by the standard economic relationships. GWP values are taken from the refrigerant database. Class of substances under consideration is presented by the natural refrigerant R600a embedded with nanostructured materials.

A thermoeconomic model of a photovoltaic heat pump

International Nuclear Information System (INIS)

Mastrullo, R.; Renno, C.

2010-01-01

In this paper the model of a heat pump whose evaporator operates as a photovoltaic collector, is studied. The energy balance equations have been used for some heat pump components, and for each layer of the photovoltaic evaporator: covering glaze, photovoltaic modules, thermal absorber plate, refrigerant tube and insulator. The model has been solved by means of a program using proper simplifications. The system input is represented by the solar radiation intensity and the environment temperature, that influence the output electric power of the photovoltaic modules and the evaporation power. The model results have been obtained referring to the photovoltaic evaporator and the plant operating as heat pump, in terms of the photovoltaic evaporator layers temperatures, the refrigerant fluid properties values in the cycle fundamental points, the thermal and mechanical powers, the efficiencies that characterize the plant performances from the energy, exergy and economic point of view. This study allows to realize a thermoeconomic comparison between a photovoltaic heat pump and a traditional heat pump under the same working conditions.

Hydrogen and methane generation from large hydraulic plant: Thermo-economic multi-level time-dependent optimization

International Nuclear Information System (INIS)

Rivarolo, M.; Magistri, L.; Massardo, A.F.

2014-01-01

Highlights: • We investigate H 2 and CH 4 production from very large hydraulic plant (14 GW). • We employ only “spilled energy”, not used by hydraulic plant, for H 2 production. • We consider the integration with energy taken from the grid at different prices. • We consider hydrogen conversion in chemical reactors to produce methane. • We find plants optimal size using a time-dependent thermo-economic approach. - Abstract: This paper investigates hydrogen and methane generation from large hydraulic plant, using an original multilevel thermo-economic optimization approach developed by the authors. Hydrogen is produced by water electrolysis employing time-dependent hydraulic energy related to the water which is not normally used by the plant, known as “spilled water electricity”. Both the demand for spilled energy and the electrical grid load vary widely by time of year, therefore a time-dependent hour-by-hour one complete year analysis has been carried out, in order to define the optimal plant size. This time period analysis is necessary to take into account spilled energy and electrical load profiles variability during the year. The hydrogen generation plant is based on 1 MWe water electrolysers fuelled with the “spilled water electricity”, when available; in the remaining periods, in order to assure a regular H 2 production, the energy is taken from the electrical grid, at higher cost. To perform the production plant size optimization, two hierarchical levels have been considered over a one year time period, in order to minimize capital and variable costs. After the optimization of the hydrogen production plant size, a further analysis is carried out, with a view to converting the produced H 2 into methane in a chemical reactor, starting from H 2 and CO 2 which is obtained with CCS plants and/or carried by ships. For this plant, the optimal electrolysers and chemical reactors system size is defined. For both of the two solutions, thermo-economic

A methodology for thermo-economic modeling and optimization of solid oxide fuel cell systems

International Nuclear Information System (INIS)

Palazzi, Francesca; Autissier, Nordahl; Marechal, Francois M.A.; Favrat, Daniel

2007-01-01

In the context of stationary power generation, fuel cell-based systems are being foreseen as a valuable alternative to thermodynamic cycle-based power plants, especially in small scale applications. As the technology is not yet established, many aspects of fuel cell development are currently investigated worldwide. Part of the research focuses on integrating the fuel cell in a system that is both efficient and economically attractive. To address this problem, we present in this paper a thermo-economic optimization method that systematically generates the most attractive configurations of an integrated system. In the developed methodology, the energy flows are computed using conventional process simulation software. The system is integrated using the pinch based methods that rely on optimization techniques. This defines the minimum of energy required and sets the basis to design the ideal heat exchanger network. A thermo-economic method is then used to compute the integrated system performances, sizes and costs. This allows performing the optimization of the system with regard to two objectives: minimize the specific cost and maximize the efficiency. A solid oxide fuel cell (SOFC) system of 50 kW integrating a planar SOFC is modeled and optimized leading to designs with efficiencies ranging from 34% to 44%. The multi-objective optimization strategy identifies interesting system configurations and their performance for the developed SOFC system model. The methods proves to be an attractive tool to be used both as an advanced analysis tool and as support to decision makers when designing new systems

Thermoeconomic analysis of a fuel cell hybrid power system from the fuel cell experimental data

Energy Technology Data Exchange (ETDEWEB)

Alvarez, Tomas [Endesa Generacion, Ribera del Loira, 60, 28042 Madrid (Spain)]. E-mail: talvarez@endesa.es; Valero, Antonio [Fundacion CIRCE, Centro Politecnico Superior, Maria de Luna, 3, 50018 Zaragoza (Spain); Montes, Jose M. [ETSIMM-Universidad Politecnica de.Madrid, Rios Rosas, 21, 28003 Madrid (Spain)

2006-08-15

An innovative configuration of fuel cell technology is proposed based on a hybrid fuel cell system that integrates a turbogenerator to overcome the intrinsic limitations of fuel cells in conventional operation. An analysis is done of the application of molten carbonate fuel cell technology at the Guadalix Fuel Cell Test Facility, for the assessment of the performance of the fuel cell prototype to be integrated in the Hybrid Fuel Cell System. This is completed with a thermoeconomic analysis of the 100 kW cogeneration fuel cell power plant which was subsequently built. The operational results and design limitations are evaluated, together with the operational limits and thermodynamic inefficiencies (exergy destruction and losses) of the 100 kW fuel cell. This leads to the design of a hybrid system in order to demonstrate the possibilities and benefits of the new hybrid configuration. The results are quantified through a thermoeconomic analysis in order to get the most cost-effective plant configuration. One promising configuration is the MCFC topper where the fuel cell in the power plant behaves as a combustor for the turbogenerator. The latter behaves as the balance of plant for the fuel cell. The combined efficiency increased to 57% and NOx emissions are essentially eliminated. The synergy of the fuel cell/turbine hybrids lies mainly in the use of the rejected thermal energy and residual fuel from the fuel cell to drive the turbogenerator in a 500 kW hybrid system.

A novel solar-assisted heat pump driven by photovoltaic/thermal collectors: Dynamic simulation and thermoeconomic optimization

International Nuclear Information System (INIS)

Calise, Francesco; Dentice d'Accadia, Massimo; Figaj, Rafal Damian; Vanoli, Laura

2016-01-01

This paper presents a dynamic simulation model and a thermo-economic analysis of a novel polygeneration system based on a solar-assisted heat pump and an adsorption chiller, both driven by PVT (photovoltaic/thermal) collectors. The aim of this work is to design and dynamically simulate a novel ultra-high efficient solar heating and cooling system. The overall plant layout is designed to supply electricity, space heating and cooling and domestic hot water for a small residential building. The system combines solar cooling, solar-assisted heat pump and photovoltaic/thermal collector technologies in a novel solar polygeneration system. In fact, the polygeneration system is based on a PVT solar field, coupled with a water-to-water electric heat pump or to an adsorption chiller. PVT collectors simultaneously produce electricity and thermal energy. During the winter, hot water produced by PVT collectors primarily supplies the evaporator of the heat pump, whereas in summer, solar energy supplies an adsorption chiller providing the required space cooling. All year long, solar thermal energy in excess is converted into DHW (domestic hot water). The system model was developed in TRNSYS environment. 1-year dynamic simulations are performed for different case studies in various weather conditions. The results are analysed on different time bases presenting energetic, environmental and economic performance data. Finally, a sensitivity analysis and a thermoeconomic optimization were performed, in order to determine the set of system design/control parameters that minimize the simple pay-back period. The results showed a total energy efficiency of the PVT of 49%, a heat pump yearly coefficient of performance for heating mode above 4 and a coefficient of performance of the adsorption chiller of 0.55. Finally, it is also concluded that system performance is highly sensitive to the PVT field area. The system is profitable when a capital investment subsidy of 50% is considered

Thermo-economic optimization of Regenerative Organic Rankine Cycle for waste heat recovery applications

International Nuclear Information System (INIS)

Imran, Muhammad; Park, Byung Sik; Kim, Hyouck Ju; Lee, Dong Hyun; Usman, Muhammad; Heo, Manki

2014-01-01

Highlights: • Thermo-economic optimization of regenerative ORC is performed. • Optimization is performed using multi objective genetic algorithm. • Objective function is maximum cycle efficiency and minimum specific investment. • Evaporation pressure, pinch point and superheat are decision variables. • Sensitivity analysis is performed to investigate effect of decision variables. - Abstract: Organic Rankine Cycle (ORC) is low grade and waste heat conversion technology. The current article deal with the thermo-economic optimization of basic ORC and regenerative ORC for waste heat recovery applications under constant heat source condition. Thermal efficiency and specific investment cost of basic ORC, single stage regenerative and double stage regenerative ORC has been optimized by using Non-dominated Sorting Genetic Algorithm-II (NSGA-II). Maximum thermal efficiency and minimum specific investment cost were selected as objective functions and relative increase in thermal efficiency and cost has been analyzed taking the basic ORC as base case. The constraint set consist of evaporation pressure, superheat, pinch point temperature difference in evaporator and condenser. The optimization was performed for five different working fluids. The optimization result show that R245fa is best working under considered conditions and basic ORC has low specific investment cost and thermal efficiency compared to regenerative ORC. R245fa is low boiling organic fluid, which has high degree of thermal stability and compatible with common construction materials of ORC. The average increase in thermal efficiency from basic ORC to single stage regenerative ORC was 1.01% with an additional cost of 187 $/kW while from basic ORC to double stage regenerative ORC was 1.45% with an average increase in cost of 297 $/kW. The sensitivity analysis was also performed to investigate the effect of operating conditions which show that evaporation pressure has promising effect on thermal

Thermochemical production of liquid fuels from biomass: Thermo-economic modeling, process design and process integration analysis

International Nuclear Information System (INIS)

Tock, Laurence; Gassner, Martin; Marechal, Francois

2010-01-01

A detailed thermo-economic model combining thermodynamics with economic analysis and considering different technological alternatives for the thermochemical production of liquid fuels from lignocellulosic biomass is presented. Energetic and economic models for the production of Fischer-Tropsch fuel (FT), methanol (MeOH) and dimethyl ether (DME) by means of biomass drying with steam or flue gas, directly or indirectly heated fluidized bed or entrained flow gasification, hot or cold gas cleaning, fuel synthesis and upgrading are reviewed and developed. The process is integrated and the optimal utility system is computed. The competitiveness of the different process options is compared systematically with regard to energetic, economic and environmental considerations. At several examples, it is highlighted that process integration is a key element that allows for considerably increasing the performance by optimal utility integration and energy conversion. The performance computations of some exemplary technology scenarios of integrated plants yield overall energy efficiencies of 59.8% (crude FT-fuel), 52.5% (MeOH) and 53.5% (DME), and production costs of 89, 128 and 113 Euro MWh -1 on fuel basis. The applied process design approach allows to evaluate the economic competitiveness compared to fossil fuels, to study the influence of the biomass and electricity price and to project for different plant capacities. Process integration reveals in particular potential energy savings and waste heat valorization. Based on this work, the most promising options for the polygeneration of fuel, power and heat will be determined in a future thermo-economic optimization.

Thermoeconomic Analysis of Hybrid Power Plant Concepts for Geothermal Combined Heat and Power Generation

Directory of Open Access Journals (Sweden)

Florian Heberle

2014-07-01

Full Text Available We present a thermo-economic analysis for a low-temperature Organic Rankine Cycle (ORC in a combined heat and power generation (CHP case. For the hybrid power plant, thermal energy input is provided by a geothermal resource coupled with the exhaust gases of a biogas engine. A comparison to alternative geothermal CHP concepts is performed by considering variable parameters like ORC working fluid, supply temperature of the heating network or geothermal water temperature. Second law efficiency as well as economic parameters show that hybrid power plants are more efficient compared to conventional CHP concepts or separate use of the energy sources.

Experimental and Thermoeconomic Analysis of Small-Scale Solar Organic Rankine Cycle (SORC System

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Suresh Baral

2015-04-01

Full Text Available A small-scale solar organic Rankine cycle (ORC is a promising renewable energy-driven power generation technology that can be used in the rural areas of developing countries. A prototype was developed and tested for its performance characteristics under a range of solar source temperatures. The solar ORC system power output was calculated based on the thermal and solar collector efficiency. The maximum solar power output was observed in April. The solar ORC unit power output ranged from 0.4 kW to 1.38 kW during the year. The highest power output was obtained when the expander inlet pressure was 13 bar and the solar source temperature was 120 °C. The area of the collector for the investigation was calculated based on the meteorological conditions of Busan City (South Korea. In the second part, economic and thermoeconomic analyses were carried out to determine the cost of energy per kWh from the solar ORC. The selling price of electricity generation was found to be $0.68/kWh and $0.39/kWh for the prototype and low cost solar ORC, respectively. The sensitivity analysis was carried out in order to find the influencing economic parameters for the change in NPV. Finally, the sustainability index was calculated to assess the sustainable development of the solar ORC system.

Thermoeconomic Analysis Of a Gasification Plant Fed By Woodchips And Integrated With SOFC And STIG Cycles

DEFF Research Database (Denmark)

Mazzucco, Andrea; Rokni, Masoud

2013-01-01

of the influence of SOFC stack cost on the generation cost is also presented. In order to discuss the investment cost, an economic analysis has been carried out by involving main parameters such as Net Present Value (NPV), Internal Rate of Return (IRR), Time of Return of Investment (TIR) are calculated...... above 53% and 43% respectively which are significantly greater than conventional 10 MWe plants fed by biomass. Thermo-economic analysis provides an average cost of electricity for best performing layouts close to 6.4 and 9.4 c€/kWe which is competitive within the market. A sensitivity analysis...

Thermo-Economic Evaluation of Organic Rankine Cycles for Geothermal Power Generation Using Zeotropic Mixtures

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Florian Heberle

2015-03-01

Full Text Available We present a thermo-economic evaluation of binary power plants based on the Organic Rankine Cycle (ORC for geothermal power generation. The focus of this study is to analyse if an efficiency increase by using zeotropic mixtures as working fluid overcompensates additional requirements regarding the major power plant components. The optimization approach is compared to systems with pure media. Based on process simulations, heat exchange equipment is designed and cost estimations are performed. For heat source temperatures between 100 and 180 °C selected zeotropic mixtures lead to an increase in second law efficiency of up to 20.6% compared to pure fluids. Especially for temperatures about 160 °C, mixtures like propane/isobutane, isobutane/isopentane, or R227ea/R245fa show lower electricity generation costs compared to the most efficient pure fluid. In case of a geothermal fluid temperature of 120 °C, R227ea and propane/isobutane are cost-efficient working fluids. The uncertainties regarding fluid properties of zeotropic mixtures, mainly affect the heat exchange surface. However, the influence on the determined economic parameter is marginal. In general, zeotropic mixtures are a promising approach to improve the economics of geothermal ORC systems. Additionally, the use of mixtures increases the spectrum of potential working fluids, which is important in context of present and future legal requirements considering fluorinated refrigerants.

Thermo-Economic Analysis of Zeotropic Mixtures and Pure Working Fluids in Organic Rankine Cycles for Waste Heat Recovery

Directory of Open Access Journals (Sweden)

Florian Heberle

2016-03-01

Full Text Available We present a thermo-economic analysis of an Organic Rankine Cycle (ORC for waste heat recovery. A case study for a heat source temperature of 150 °C and a subcritical, saturated cycle is performed. As working fluids R245fa, isobutane, isopentane, and the mixture of isobutane and isopentane are considered. The minimal temperature difference in the evaporator and the condenser, as well as the mixture composition are chosen as variables in order to identify the most suitable working fluid in combination with optimal process parameters under thermo-economic criteria. In general, the results show that cost-effective systems have a high minimal temperature difference ΔTPP,C at the pinch-point of the condenser and a low minimal temperature difference ΔTPP,E at the pinch-point of the evaporator. Choosing isobutane as the working fluid leads to the lowest costs per unit exergy with 52.0 €/GJ (ΔTPP,E = 1.2 K; ΔTPP,C = 14 K. Considering the major components of the ORC, specific costs range between 1150 €/kW and 2250 €/kW. For the zeotropic mixture, a mole fraction of 90% isobutane leads to the lowest specific costs per unit exergy. A further analysis of the ORC system using isobutane shows high sensitivity of the costs per unit exergy for the selected cost estimation methods and for the isentropic efficiency of the turbine.

Thermoeconomic analysis of a novel zero-CO2-emission high-efficiency power cycle using LNG coldness

International Nuclear Information System (INIS)

Liu, Meng; Lior, Noam; Zhang, Na; Han, Wei

2009-01-01

This paper presents a thermoeconomic analysis aimed at the optimization of a novel zero-CO 2 and other emissions and high-efficiency power and refrigeration cogeneration system, COOLCEP-S (Patent pending), which uses the liquefied natural gas (LNG) coldness during its revaporization. It was predicted that at the turbine inlet temperature (TIT) of 900 C, the energy efficiency of the COOLCEP-S system reaches 59%. The thermoeconomic analysis determines the specific cost, the cost of electricity, the system payback period and the total net revenue. The optimization started by performing a thermodynamic sensitivity analysis, which has shown that for a fixed TIT and pressure ratio, the pinch point temperature difference in the recuperator, (delta)T p1 , and that in the condenser, (delta)T p2 are the most significant unconstrained variables to have a significant effect on the thermal performance of novel cycle. The payback period of this novel cycle (with fixed net power output of 20 MW and plant life of 40 years) was ∝5.9 years at most, and would be reduced to ∝3.1 years at most when there is a market for the refrigeration byproduct. The capital investment cost of the economically optimized plant is estimated to be about 1000 /kWe, and the cost of electricity is estimated to be 0.34-0.37 CNY/kWh (∝0.04 USD/kWh). These values are much lower than those of conventional coal power plants being installed at this time in China, which, in contrast to COOLCEP-S, do produce CO 2 emissions at that. (author)

Condition monitoring and thermoeconomic optimization of operation for a hybrid plant using artificial neural networks; Tillstaandsoevervakning och termoekonomisk driftoptimering av en hybridanlaeggning med artificiella neurala naetverk

Energy Technology Data Exchange (ETDEWEB)

Fast, Magnus; Assadi, Mohsen

2007-12-15

The project aim is to model the hybrid plant at Vaesthamnsverket in Helsingborg using artificial neural networks (ANN) and integrating the ANN models, for online condition monitoring and thermoeconomic optimization, at Vaesthamnsverket. The definition of a hybrid plant is that it uses more than one fuel, in this case a natural gas fuelled gas turbine with heat recovery steam generator (HRSG) and a biomass fuelled steam boiler with steam turbine. The project is a continuation of previous projects where ANN training was done with operational data from the plant. The ANN models have, if required, been updated to better suit the purpose of this project. The thermoeconomic optimization takes into account current electricity prices, taxes, fuel prices etc. and calculates the current production cost along with the 'predicted' production cost. The tool also has a built in feature of predicting when a compressor wash is economically beneficial. The user interface is developed together with co-workers at Vaesthamnsverket to ensure its usefulness. The user interface includes functions for warnings and alarms when possible deviations in operation occur and also includes a feature for plotting parameter trends in optional time intervals, both measured values and predicted. The target group is the plant owners and the original equipment manufacturers (OEM). The power plant owners want to acquire a product for condition monitoring and thermoeconomic optimization of e.g. maintenance. The OEMs main interest lies in investigating the possibilities of delivering ANN models along with their new gas turbines. The project has been carried out at Lund University, Department of Energy Sciences, with support from Vaesthamnsverket and Siemens. Vaesthamnsverket have contributed with operational data from the plant as well as support in plant related questions. They have also been involved in the implementation of the ANN models in their computer system and the development of the

Comparison between regenerative organic Rankine cycle (RORC) and basic organic Rankine cycle (BORC) based on thermoeconomic multi-objective optimization considering exergy efficiency and levelized energy cost (LEC)

International Nuclear Information System (INIS)

Feng, Yongqiang; Zhang, Yaning; Li, Bingxi; Yang, Jinfu; Shi, Yang

2015-01-01

Highlights: • The thermoeconomic comparison of regenerative RORC and BORC is investigated. • The Pareto frontier solution with bi-objective compares with the corresponding single-objective solutions. • The three-objective optimization of the RORC and BORC is studied. • The RORC owns 8.1% higher exergy efficiency and 21.1% more LEC than the BORC under the Pareto-optimal solution. - Abstract: Based on the thermoeconomic multi-objective optimization by using non-dominated sorting genetic algorithm (NSGA-II), considering both thermodynamic performance and economic factors, the thermoeconomic comparison of regenerative organic Rankine cycles (RORC) and basic organic Rankine cycles (BORC) are investigated. The effects of five key parameters including evaporator outlet temperature, condenser temperature, degree of superheat, pinch point temperature difference and degree of supercooling on the exergy efficiency and levelized energy cost (LEC) are examined. Meanwhile, the Pareto frontier solution with bi-objective for maximizing exergy efficiency and minimizing LEC is obtained and compared with the corresponding single-objective solutions. Research demonstrates that there is a significant negative correlation between thermodynamic performance and economic factors. And the optimum exergy efficiency and LEC for the Pareto-optimal solution of the RORC are 55.97% and 0.142 $/kW h, respectively, which are 8.1% higher exergy efficiency and 21.1% more LEC than that of the BORC under considered condition. Highest exergy and thermal efficiencies are accompanied with lowest net power output and worst economic performance. Furthermore, taking the net power output into account, detailed investigation on the three-objective optimization for maximizing exergy efficiency, maximizing net power output and minimizing LEC is discussed

Load sharing with a local thermal network fed by a microcogenerator: Thermo-economic optimization by means of dynamic simulations

International Nuclear Information System (INIS)

Angrisani, Giovanni; Canelli, Michele; Rosato, Antonio; Roselli, Carlo; Sasso, Maurizio; Sibilio, Sergio

2014-01-01

The cogeneration is the combined production of electric and/or mechanical and thermal energy starting by a single energy source; in particular in this paper the analysis will be focused on a cogeneration system with electric power lower than 15 kW (micro-cogeneration). The paper analyzes a system consisting of a natural gas-fired micro-cogeneration unit (MCHP), a heat storage and a peak boiler. The system provides thermal and electric energy to two end-users, the former is a tertiary building (office), where the generation system is located, and the latter is a residential building connected to the former through a district heating micro-grid. In order to analyze the influence of climatic conditions, two different geographical locations in Italy (Benevento and Milano) are considered, that are also characterized by different natural gas and electricity tariffs. Particular attention is paid to the choice of the users, in order to obtain more stable and continuous electric and thermal loads (load sharing approach) and to increase the operating hours per year of the MCHP unit. The operation of the MCHP is governed by a control system, aimed to optimize a thermo-economic objective function. The models representing the components, the thermo-economic objective function and the buildings have been implemented in a widely used commercial software for building simulations. The models are calibrated and validated through data obtained from experimental tests carried out in the laboratory of the University of Sannio (Benevento). The results of the simulations highlight the potential benefits of the thermal load sharing approach. In particular, this study shows that an MCHP unit connected by means of a thermal micro-grid to different users in “load sharing mode” can obtain a high number of operating hours as well as significant energy (Primary Energy Saving) and environmental (avoided CO 2 equivalent emissions) benefits with respect to an appropriate reference system

Decomposition with thermoeconomic isolation applied to the optimal synthesis/design and operation of an advanced tactical aircraft system

International Nuclear Information System (INIS)

Rancruel, Diego F.; Spakovsky, Michael R. von

2006-01-01

A decomposition methodology based on the concept of 'thermoeconomic isolation' and applied to the synthesis/design and operational optimization of an advanced tactical fighter aircraft is the focus of this paper. The total system is composed of six sub-systems of which five participate with degrees of freedom (493) in the optimization. They are the propulsion sub-system (PS), the environmental control sub-system (ECS), the fuel loop subsystem (FLS), the vapor compression and Polyalphaolefin (PAO) loops sub-system (VC/PAOS), and the airframe sub-system (AFS). The sixth subsystem comprises the expendable and permanent payloads as well as the equipment group. For each of the first five, detailed thermodynamic, geometric, physical, and aerodynamic models at both design and off-design were formulated and implemented. The most promising set of aircraft sub-system and system configurations were then determined based on both an energy integration and aerodynamic performance analysis at each stage of the mission (including the transient ones). Conceptual, time, and physical decomposition were subsequently applied to the synthesis/design and operational optimization of these aircraft configurations as well as to the highly dynamic process of heat generation and dissipation internal to the subsystems. The physical decomposition strategy used (i.e. Iterative Local-Global Optimization-ILGO) is the first to successfully closely approach the theoretical condition of 'thermoeconomic isolation' when applied to highly complex, highly dynamic non-linear systems. Developed at our Center for Energy Systems research, it has been effectively applied to a number of complex stationary and transportation applications

Decomposition with thermoeconomic isolation applied to the optimal synthesis/design and operation of an advanced tactical aircraft system

Energy Technology Data Exchange (ETDEWEB)

Rancruel, Diego F. [Center for Energy Systems Research, Department of Mechanical Engineering, Virginia Polytechnic Institute and State University, Blacksburg, VA 24060 (United States); Spakovsky, Michael R. von [Center for Energy Systems Research, Department of Mechanical Engineering, Virginia Polytechnic Institute and State University, Blacksburg, VA 24060 (United States)]. E-mail: vonspako@vt.edu

2006-12-15

A decomposition methodology based on the concept of 'thermoeconomic isolation' and applied to the synthesis/design and operational optimization of an advanced tactical fighter aircraft is the focus of this paper. The total system is composed of six sub-systems of which five participate with degrees of freedom (493) in the optimization. They are the propulsion sub-system (PS), the environmental control sub-system (ECS), the fuel loop subsystem (FLS), the vapor compression and Polyalphaolefin (PAO) loops sub-system (VC/PAOS), and the airframe sub-system (AFS). The sixth subsystem comprises the expendable and permanent payloads as well as the equipment group. For each of the first five, detailed thermodynamic, geometric, physical, and aerodynamic models at both design and off-design were formulated and implemented. The most promising set of aircraft sub-system and system configurations were then determined based on both an energy integration and aerodynamic performance analysis at each stage of the mission (including the transient ones). Conceptual, time, and physical decomposition were subsequently applied to the synthesis/design and operational optimization of these aircraft configurations as well as to the highly dynamic process of heat generation and dissipation internal to the subsystems. The physical decomposition strategy used (i.e. Iterative Local-Global Optimization-ILGO) is the first to successfully closely approach the theoretical condition of 'thermoeconomic isolation' when applied to highly complex, highly dynamic non-linear systems. Developed at our Center for Energy Systems research, it has been effectively applied to a number of complex stationary and transportation applications.

Thermoeconomic analysis of a novel zero-CO{sub 2}-emission high-efficiency power cycle using LNG coldness

Energy Technology Data Exchange (ETDEWEB)

Liu, Meng [China National Institute of Standardization, Beijing 100088 (China); Lior, Noam [Department of Mechanical Engineering and Applied Mechanics, University of Pennsylvania, Philadelphia, PA 19104-6315 (United States); Zhang, Na; Han, Wei [Institute of Engineering Thermophysics, Chinese Academy of Sciences, P.O. Box 2706, Beijing 100190 (China)

2009-11-15

This paper presents a thermoeconomic analysis aimed at the optimization of a novel zero-CO{sub 2} and other emissions and high-efficiency power and refrigeration cogeneration system, COOLCEP-S (Patent pending), which uses the liquefied natural gas (LNG) coldness during its revaporization. It was predicted that at the turbine inlet temperature (TIT) of 900 C, the energy efficiency of the COOLCEP-S system reaches 59%. The thermoeconomic analysis determines the specific cost, the cost of electricity, the system payback period and the total net revenue. The optimization started by performing a thermodynamic sensitivity analysis, which has shown that for a fixed TIT and pressure ratio, the pinch point temperature difference in the recuperator, {delta}T{sub p1}, and that in the condenser, {delta}T{sub p2} are the most significant unconstrained variables to have a significant effect on the thermal performance of novel cycle. The payback period of this novel cycle (with fixed net power output of 20 MW and plant life of 40 years) was {proportional_to}5.9 years at most, and would be reduced to {proportional_to}3.1 years at most when there is a market for the refrigeration byproduct. The capital investment cost of the economically optimized plant is estimated to be about 1000 /kWe, and the cost of electricity is estimated to be 0.34-0.37 CNY/kWh ({proportional_to}0.04 USD/kWh). These values are much lower than those of conventional coal power plants being installed at this time in China, which, in contrast to COOLCEP-S, do produce CO{sub 2} emissions at that. (author)

Thermoeconomic analysis of a novel zero-CO{sub 2}-emission high-efficiency power cycle using LNG coldness

Energy Technology Data Exchange (ETDEWEB)

Liu Meng [China National Institute of Standardization, Beijing 100088 (China)], E-mail: liumeng@cnis.gov.cn; Lior, Noam [Department of Mechanical Engineering and Applied Mechanics, University of Pennsylvania, Philadelphia, PA 19104-6315 (United States)], E-mail: lior@seas.upenn.edu; Zhang Na; Han Wei [Institute of Engineering Thermophysics, Chinese Academy of Sciences, P.O. Box 2706, Beijing 100190 (China)

2009-11-15

This paper presents a thermoeconomic analysis aimed at the optimization of a novel zero-CO{sub 2} and other emissions and high-efficiency power and refrigeration cogeneration system, COOLCEP-S (Patent pending), which uses the liquefied natural gas (LNG) coldness during its revaporization. It was predicted that at the turbine inlet temperature (TIT) of 900 deg. C, the energy efficiency of the COOLCEP-S system reaches 59%. The thermoeconomic analysis determines the specific cost, the cost of electricity, the system payback period and the total net revenue. The optimization started by performing a thermodynamic sensitivity analysis, which has shown that for a fixed TIT and pressure ratio, the pinch point temperature difference in the recuperator, {delta}T{sub p1}, and that in the condenser, {delta}T{sub p2} are the most significant unconstrained variables to have a significant effect on the thermal performance of novel cycle. The payback period of this novel cycle (with fixed net power output of 20 MW and plant life of 40 years) was {approx}5.9 years at most, and would be reduced to {approx}3.1 years at most when there is a market for the refrigeration byproduct. The capital investment cost of the economically optimized plant is estimated to be about 1000 $/kWe, and the cost of electricity is estimated to be 0.34-0.37 CNY/kWh ({approx}0.04 $/kWh). These values are much lower than those of conventional coal power plants being installed at this time in China, which, in contrast to COOLCEP-S, do produce CO{sub 2} emissions at that.

Thermodynamic and thermoeconomic analysis of a system with biomass gasification, solid oxide fuel cell (SOFC) and Stirling engine

DEFF Research Database (Denmark)

Rokni, Masoud

2014-01-01

Thermodynamic and thermoeconomic investigations of a small-scale integrated gasification solid oxide fuel cell (SOFC) and Stirling engine for combined heat and power (CHP) with a net electric capacity of 120kWe have been performed. Woodchips are used as gasification feedstock to produce syngas......Wh. Furthermore, hot water is considered as a by-product, and the cost of hot water is found to be 0.0214$/kWh. When compared to other renewable systems of similar scales, this result shows that if both SOFC and Stirling engine technology enter the commercialization phase, then they can deliver electricity...

An application of the Proper Orthogonal Decomposition method to the thermo-economic optimization of a dual pressure, combined cycle powerplant

International Nuclear Information System (INIS)

Melli, Roberto; Sciubba, Enrico; Toro, Claudia

2014-01-01

Highlights: • The CCGT is modelled and simulated in CAMEL-Pro. • Economic costs of the system product are computed. • The POD–RBF procedure is applied to the thermoeconomic optimization of a CCGT power plant. • Economic optimal configuration is identified with POD–RBF procedure. - Abstract: This paper presents a thermo-economic optimization of a combined cycle power plant obtained via the Proper Orthogonal Decomposition–Radial Basis Functions (POD–RBF) procedure. POD, also known as “Karhunen–Loewe decomposition” or as “Method of Snapshots” is a powerful mathematical method for the low-order approximation of highly dimensional processes for which a set of initial data is known in the form of a discrete and finite set of experimental (or simulated) data: the procedure consists in constructing an approximated representation of a matricial operator that optimally “represents” the original data set on the basis of the eigenvalues and eigenvectors of the properly re-assembled data set. By combining POD and RBF it is possible to construct, by interpolation, a functional (parametric) approximation of such a representation. In this paper the set of starting data for the POD–RBF procedure has been obtained by the CAMEL-Pro™ process simulator. The proposed procedure does not require the generation of a complete simulated set of results at each iteration step of the optimization, because POD constructs a very accurate approximation to the function described by a relatively small number of initial simulations, and thus “new” points in design space can be extrapolated without recurring to additional and expensive process simulations. Thus, the often taxing computational effort needed to iteratively generate numerical process simulations of incrementally different configurations is substantially reduced by replacing much of it by easy-to-perform matrix operations. The object of the study was a fossil-fuelled, combined cycle powerplant of

Thermo-economic evaluation and optimization of the thermo-chemical conversion of biomass into methanol

International Nuclear Information System (INIS)

Peduzzi, Emanuela; Tock, Laurence; Boissonnet, Guillaume; Maréchal, François

2013-01-01

In a carbon and resources constrained world, thermo-chemical conversion of lignocellulosic biomass into fuels and chemicals is regarded as a promising alternative to fossil resources derived products. Methanol is one potential product which can be used for the synthesis of various chemicals or as a fuel in fuel cells and internal combustion engines. This study focuses on the evaluation and optimization of the thermodynamic and economic performance of methanol production from biomass by applying process integration and optimization techniques. Results reveal the importance of the energy integration and in particular of the cogeneration of electricity for the efficient use of biomass. - Highlights: • A thermo-economic model for biomass conversion into methanol is developed. • Process integration and multi-objective optimization techniques are applied. • Results reveal the importance of energy integration for electricity co-generation

Thermo-economic analysis of a solid oxide fuel cell and steam injected gas turbine plant integrated with woodchips gasification

DEFF Research Database (Denmark)

Mazzucco, Andrea; Rokni, Masoud

2014-01-01

cost on the generation cost is also presented. In order to discuss the investment cost, an economic analysis has been carried out and main parameters such as Net Present Value (NPV), internal rate of return (IRR) and Time of Return of Investment (TIR) are calculated and discussed.......% respectively which are significantly greater than conventional 10 MWe plants fed by biomass. Thermo-economic analysis provides an average cost of electricity for best performing layouts close to 6.4 and 9.4 c€/kWe which is competitive within the market. A sensitivity analysis of the influence of SOFC stack...

Thermo-economic performance of inclined solar water distillation systems

Directory of Open Access Journals (Sweden)

Agboola Phillips O.

2015-01-01

Full Text Available This study investigates the thermo-economic performance of different configurations of inclined solar water desalination for parameters such as daily production, efficiency, system cost and distilled water production cost. The four different configurations considered for this study are as follows; 1. Inclined solar water distillation with bare absorber plate (IISWD with daily production of 5.46 kg/m2 day and daily efficiency of 48.3%. 2. Inclined solar water distillation with wick on absorber plate (IISWDW with daily production of 6.41kg/m2 day and daily efficiency 50.3%. 3. Inclined solar water distillation with wire mesh on absorber plate (IISWDWM with daily production n of 3.03 kg/m2 day and daily efficiency 32.6%. 4. Inclined solar water distillation with bare absorber plate (ISWD. (Control System with daily production of 3.25 kg/m2 day and daily efficiency of 40.1%. The systems potable water cost price ranges from 0.03 $/L for IISWDW to 0.06$/L for IISWDWM System. All the systems are economically and technically feasible as a solar distillation system for potable water in Northern Cyprus. The price of potable water from water vendors/hawkers ranges from 0.11-0.16 $/L. It is more economically viable to have the rooftop inclined solar water desalination system than procuring potable water from vendors.`

Thermoeconomic analysis of a solar enhanced energy storage concept based on thermodynamic cycles

International Nuclear Information System (INIS)

Henchoz, Samuel; Buchter, Florian; Favrat, Daniel; Morandin, Matteo; Mercangöz, Mehmet

2012-01-01

Large scale energy storage may play an increasingly important role in the power generation and distribution sector, especially when large shares of renewable energies will have to be integrated into the electrical grid. Pumped-hydro is the only large scale storage technology that has been widely used. However the spread of this technology is limited by geographic constraints. In the present work, a particular implementation of a storage concept based on thermodynamic cycles, invented by ABB Switzerland ltd. Corporate Research, has been analysed thermoeconomically. A variant using solar thermal collectors is presented. It benefits from the synergy between daily variations in solar irradiance and in electricity demand. This results in an effective increase of the electric energy storage efficiency. A steady state multi-objective optimization of a 50 MW plant was done; minimizing the investment costs and maximizing the energy storage efficiency. Several types of cold storage substances have been implemented in the formulation and two different types of solar collector were investigated. A storage efficiency of 57% at a cost of 1200 USD/kW was calculated for an optimized plant using solar energy. Finally, a computation of the behaviour of the plant along the year showed a yearly availability of 84.4%. -- Highlights: ► A variant of electric energy storage based on thermodynamic cycles is presented. ► It uses solar collectors to improve the energy storage efficiency. ► An optimization minimizing capital cost and maximizing energy storage efficiency, was carried out. ► Capital costs lie between 982 and 3192 USD/kW and efficiency between 43.8% and 84.4%.

Thermoeconomic analysis of a power/water cogeneration plant

International Nuclear Information System (INIS)

Hamed, Osman A.; Al-Washmi, Hamed A.; Al-Otaibi, Holayil A.

2006-01-01

Cogeneration plants for simultaneous production of water and electricity are widely used in the Arabian Gulf region. They have proven to be more thermodynamically efficient and economically feasible than single purpose power generation and water production plants. Yet, there is no standard or universally applied methodology for determining unit cost of electric power generation and desalinated water production by dual purpose plants. A comprehensive literature survey to critically assess and evaluate different methods for cost application in power/water cogeneration plants is reported in this paper. Based on this analysis, an in-depth thermoeconomic study is carried out on a selected power/water cogeneration plant that employs a regenerative Rankine cycle. The system incorporates a boiler, back pressure turbine (supplying steam to two MSF distillers), a deaerator and two feed water heaters. The turbine generation is rated at 118 MW, while MSF distiller is rated at 7.7 MIGD at a top brine temperature of 105 deg. C. An appropriate costing procedure based on the available energy accounting method which divides benefits of the cogeneration configuration equitably between electricity generation and water production is used to determine the unit costs of electricity and water. Capital charges of common equipment such as the boiler, deaerator and feed water heaters as well as boiler fuel costs are distributed between power generated and desalinated water according to available energy consumption of the major subsystems. A detailed sensitivity analysis was performed to examine the impact of the variation of fuel cost, load and availability factors in addition to capital recovery factor on electricity and water production costs

Thermo-economic assessment of externally fired micro-gas turbine fired by natural gas and biomass: Applications in Italy

International Nuclear Information System (INIS)

Pantaleo, A.M.; Camporeale, S.M.; Shah, N.

2013-01-01

Highlights: • A thermo-economic analysis of natural gas/biomass fired microturbine is proposed. • Energy efficiency, capex, opex and electricity revenues trade-offs are assessed. • The optimal biomass energy input is 70% of total CHP consumption. • Industrial/tertiary heat demand and baseload/heat driven operation is assessed. • The main barriers of small scale CHP systems in Italy are overviewed. - Abstract: This paper proposes a thermo-economic assessment of small scale (100 kWe) combined heat and power (CHP) plants fired by natural gas and solid biomass. The focus is on dual fuel gas turbine cycle, where compressed air is heated in a high temperature heat exchanger (HTHE) using the hot gases produced in a biomass furnace, before entering the gas combustion chamber. The hot air expands in the turbine and then feeds the internal pre-heater recuperator, Various biomass/natural gas energy input ratios are modeled, ranging from 100% natural gas to 100% biomass. The research assesses the trade-offs between: (i) lower energy conversion efficiency and higher investment cost of high biomass input rate and (ii) higher primary energy savings and revenues from bio-electricity feed-in tariff in case of high biomass input rate. The influence of fuel mix and biomass furnace temperature on energy conversion efficiencies, primary energy savings and profitability of investments is assessed. The scenarios of industrial vs. tertiary heat demand and baseload vs. heat driven plant operation are also compared. On the basis of the incentives available in Italy for biomass electricity and for high efficiency cogeneration (HEC), the maximum investment profitability is achieved for 70% input biomass percentage. The main barriers of these embedded cogeneration systems in Italy are also discussed

Multi-Objective Thermo-Economic Optimization Strategy for ORCs Applied to Subcritical and Transcritical Cycles for Waste Heat Recovery

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Steven Lecompte

2015-04-01

Full Text Available Organic Rankine cycles (ORCs are an established technology to convert waste heat to electricity. Although several commercial implementations exist, there is still considerable potential for thermo-economic optimization. As such, a novel framework for designing optimized ORC systems is proposed based on a multi-objective optimization scheme in combination with financial appraisal in a post-processing step. The suggested methodology provides the flexibility to quickly assess several economic scenarios and this without the need of knowing the complex design procedure. This novel way of optimizing and interpreting results is applied to a waste heat recovery case. Both the transcritical ORC and subcritical ORC are investigated and compared using the suggested optimization strategy.

Thermo-economic analysis of integrated membrane-SMR ITM-oxy-combustion hydrogen and power production plant

International Nuclear Information System (INIS)

Sanusi, Yinka S.; Mokheimer, Esmail M.A.; Habib, Mohamed A.

2017-01-01

Highlights: •A methane reforming reactor integrated to an oxy-combustion plant is proposed. •Co-production of power and hydrogen was investigated and presented. •Optimal thermo-economic operating conditions of the system were identified and presented. •The ion transport membrane oxygen separation unit has the highest capital cost. •The combustor has the highest exergy destruction. -- Abstract: The demand for hydrogen has greatly increased in the last decade due to the stringent regulations enacted to address environmental pollution concerns. Natural gas reforming is currently the most mature technology for large-scale hydrogen production. However, it is usually associated with greenhouse gas emissions. As part of the strategies to reduce greenhouse gas emissions, new designs need to be developed to integrate hydrogen production facilities that are based on natural gas reforming with carbon capture facilities. In this study, we carried out energy, exergy and economic analysis of hydrogen production in a steam methane reforming reactor integrated with an oxy-combustion plant for co-production of power and hydrogen. The results show that the overall system efficiency and hydrogen production efficiency monotonically increase with increasing the combustor exit temperature (CET), increasing the amount of hydrogen extracted and decreasing the auxiliary fuel added to the system. The optimal thermo-economic operating conditions of the system were obtained as reformer pressure of 15 bar, auxiliary fuel factor of 0.8 and hydrogen extraction factor of 0.6. The production cost of hydrogen using the proposed system, under these optimal operating conditions, is within the range suggested by the International Energy Agency (IEA). Further analysis shows that the capital cost of the membrane-air separation unit (ITM) has the major share in the total investment cost of the system and constitutes 37% of the total capital cost of the system at the CET of 1500 K. The exergy

Thermoeconomical analysis of a non-endoreversible Novikov power plant model under different regimes of performance

International Nuclear Information System (INIS)

Pacheco-Páez, J C; Angulo-Brown, F; Barranco-Jiménez, M A

2015-01-01

In this work, we study the thermoeconomics of a non-endoreversible simplified thermal power plant model, the so-called Novikov engine. Our study is made by means of the maximization of objective functions defined by the quotient of the characteristic functions (power output, efficient power and ecological function) and the total costs considered in the performance of the power plant. In our study three different costs are considered: a capital cost that is proportional to the investment and, therefore, to the size of the plant, a fuel cost that is proportional to the fuel consumption and a cost associated to maintenance of the power plant; that is, proportional to the power output of the plant. It is shown that under ecological conditions the plant dramatically reduces the amount of heat rejected to the environment, and a loss of profits is translated in an usage of fuels that dramatically reduces the heat rejected towards the environment in comparison to that obtained by means of maximum power regime

Response surface method applied to the thermoeconomic optimization of a complex cogeneration system modeled in a process simulator

International Nuclear Information System (INIS)

Pires, Thiago S.; Cruz, Manuel E.; Colaço, Marcelo J.

2013-01-01

This work presents the application of a surrogate model – a response surface – to replace the objective function to be minimized in the thermoeconomic optimization of a complex thermal system modeled with the aid of an expert process simulator. The objective function accounts for fuel, capital, operation and maintenance costs of the thermal system, and depends on nine decision variables. The minimization task is performed through the computational integration of two professional programs, a process simulator and a mathematical platform. Five algorithms are used to perform the optimization: the pattern search and genetic algorithms, both available in the mathematical platform, plus three custom-coded algorithms, differential evolution, particle swarm and simulated annealing. A comparative analysis of the performance of all five methods is presented, together with a critical appraisal of the surrogate model effectiveness. In the course of the optimization procedure, the process simulator computes the thermodynamic properties of all flows of the thermal system and solves the mass and energy balances each time the objective function has to be evaluated. By handling a set of radial basis functions as an approximation model to the original computationally expensive objective function, it is found here that the number of function evaluations can be appreciably reduced without significant deviation of the optimal value. The present study indicates that, for a thermoeconomic system optimization problem with a large number of decision variables and/or a costly objective function, the application of the response surface surrogate may prove more efficient than the original simulation model, reducing substantially the computational time involved in the optimization. - Highlights: ► A successful response surface method was proposed. ► The surrogate model may be more efficient than the original simulation model. ► Relative differences of less than 5% were found for the

Thermoeconomic multi-objective optimization of an organic Rankine cycle for exhaust waste heat recovery of a diesel engine

International Nuclear Information System (INIS)

Yang, Fubin; Zhang, Hongguang; Song, Songsong; Bei, Chen; Wang, Hongjin; Wang, Enhua

2015-01-01

In this paper, the ORC (Organic Rankine cycle) technology is adopted to recover the exhaust waste heat of diesel engine. The thermodynamic, economic and optimization models of the ORC system are established, respectively. Firstly, the effects of four key parameters, including evaporation pressure, superheat degree, condensation temperature and exhaust temperature at the outlet of the evaporator on the thermodynamic performances and economic indicators of the ORC system are investigated. Subsequently, based on the established optimization model, GA (genetic algorithm) is employed to solve the Pareto solution of the thermodynamic performances and economic indicators for maximizing net power output and minimizing total investment cost under diesel engine various operating conditions using R600, R600a, R601a, R245fa, R1234yf and R1234ze as working fluids. The most suitable working fluid used in the ORC system for diesel engine waste heat recovery is screened out, and then the corresponding optimal parameter regions are analyzed. The results show that thermodynamic performance of the ORC system is improved at the expense of economic performance. Among these working fluids, R245fa is considered as the most suitable working fluid for the ORC waste heat application of the diesel engine with comprehensive consideration of thermoeconomic performances, environmental impacts and safety levels. Under the various operating conditions of the diesel engine, the optimal evaporation pressure is in the range of 1.1 MPa–2.1 MPa. In addition, the optimal superheat degree and the exhaust temperature at the outlet of the evaporator are mainly influenced by the operating conditions of the diesel engine. The optimal condensation temperature keeps a nearly constant value of 298.15 K. - Highlights: • Thermoeconomic multi-objective optimization of an ORC (Organic Rankine cycle) system is conducted. • Sensitivity analysis of the decision variables is performed. • Genetic algorithm

Thermo-economic analysis of proton exchange membrane fuel cell fuelled with methanol and methane

International Nuclear Information System (INIS)

Suleiman, B.; Abdulkareem, A.S.; Musa, U.; Mohammed, I.A.; Olutoye, M.A.; Abdullahi, Y.I.

2016-01-01

Highlights: • Modified proton exchange membrane fuel cell was reported. • Thermolib software was used for the simulation of PEM fuel cell configurations. • Optimal operating parameters at 50 kW output of each process were determined. • Thermo-economic analysis is the most efficient way of process selection. • Methane system configuration has been identified as the best preferred PEM fuel cell. - Abstract: Exergy and economic analysis is often used to find and identify the most efficient process configuration for proton exchange membrane fuel cell from the thermo-economic point of view. This work gives an explicit account of the synergetic effect of exergetic and economic analysis of proton exchange membrane fuel cell (PEMFC) using methanol and methane as fuel sources. This was carried out through computer simulation using Thermolib simulation toolbox. Data generated from the simulated model were subsequently used for the thermodynamic and economic analysis. Analysis of energy requirement for the two selected processes revealed that the methane fuelled system requires the lower amount of energy (4.578 kJ/s) in comparison to the methanol fuelled configuration which requires 180.719 J/s. Energy analysis of both configurations showed that the principle of energy conservation was satisfied while the result of the exergy analysis showed high exergetic efficiency around major equipment (heat exchangers, compressors and pumps) of methane fuelled configuration. Higher irreversibility rate were observed around the burner, stack, and steam reformer. These trends of exergetic efficiency and irreversibility rate were observed around equipment in the methanol fuelled system but with lower performance when compared with the methane fuelled process configuration. On the basis of overall exergetic efficiency and lost work, the methanol system was more efficient with lower irreversibility rate of 547.27 kJ/s and exergetic efficiency of 34.44% in comparison with the methane

Thermoeconomic analysis incorporating the concept of ecological efficiency; Analise termoeconomica incorporando o conceito de eficiencia ecologica

Energy Technology Data Exchange (ETDEWEB)

Villela, I.A.C. [University of Sao Paulo (EEL/USP), Lorena, SP (Brazil). Coll. of Engineering. Dept. of Environment Science ], Email: iraides@debas.eel.usp.br; Silveira, J.L. [Universidade Estadual Paulista (UNESP), Guaratingueta, SP (Brazil). Dept. of Energy], Email: joseluz@feg.unesp.br

2009-07-01

A comparative analysis of the pollution resulting from the natural gas combustion for a thermoelectric power plant (230 MW) by utilizing the combined cycle (CC) and recovering kettle, with no burning and with fuel complementary burning. Initially the CO{sub 2}, SO{sub 2}, NO{sub x} and Particulate Matter emission levels are determined. Later, the thermoelectric power plant environmental impact is evaluated through the utilization of a methodology based on the ecological efficiency ({epsilon}), parameter that integrates in a single coefficient the aspects that define the environmental impact intensity, with basis on the fuel utilized, combustion technology, pollution index and power plant thermodynamic efficiency. The objective is to apply the concept of ecological efficiency in a thermoeconomic analysis method which utilizes function diagram and allows the estimation of the electricity production cost. It is concluded that the use of a system with no complementary burning is better than the one with complementary burning, both from the ecological and the economical points of view. (author)

Thermoeconomic Analysis and Optimization of a New Combined Supercritical Carbon Dioxide Recompression Brayton/Kalina Cycle

Directory of Open Access Journals (Sweden)

S. Mohammad S. Mahmoudi

2016-10-01

Full Text Available A new combined supercritical CO2 recompression Brayton/Kalina cycle (SCRB/KC is proposed. In the proposed system, waste heat from a supercritical CO2 recompression Brayton cycle (SCRBC is recovered by a Kalina cycle (KC to generate additional electrical power. The performances of the two cycles are simulated and compared using mass, energy and exergy balances of the overall systems and their components. Using the SPECO (Specific Exergy Costing approach and employing selected cost balance equations for the components of each system, the total product unit costs of the cycles are obtained. Parametric studies are performed to investigate the effects on the SCRB/KC and SCRBC thermodynamic and thermoeconomic performances of key decision parameters. In addition, considering the exergy efficiency and total product unit cost as criteria, optimization is performed for the SCRBC and SCRB/KC using Engineering Equation Solver software. The results indicate that the maximum exergy efficiency of the SCRB/KC is higher than that of the SCRBC by up to 10%, and that the minimum total product unit cost of the SCRB/KC is lower than that of the SCRBC by up to 4.9%.

Performance comparison of low-grade ORCs (organic Rankine cycles) using R245fa, pentane and their mixtures based on the thermoeconomic multi-objective optimization and decision makings

International Nuclear Information System (INIS)

Feng, Yongqiang; Hung, TzuChen; Zhang, Yaning; Li, Bingxi; Yang, Jinfu; Shi, Yang

2015-01-01

Based on the thermoeconomic multi-objective optimization and decision makings, considering both exergy efficiency and LEC (levelized energy cost), the performance comparison of low-grade ORCs (organic Rankine cycles) using R245fa, pentane and their mixtures has been investigated. The effects of mass fraction of R245fa and four key parameters on the exergy efficiency and LEC are examined. The Pareto-optimal solutions are selected from the Pareto optimal frontier obtained by NSGA-II algorithm using three decision makings, including Shannon Entropy, LINMAP and TOPSIS. The deviation index is introduced to evaluate different decision makings. Research demonstrates that as the mass fraction of R245fa increasing, the exergy efficiency decreases first and then increases, while LEC presents a reverse trend. The optimum values from TOPSIS decision making are selected as the preferred Pareto-optimal solution for its lowest deviation index. The Pareto-optimal solutions for pentane, R245fa, and 0.5pentane/0.5R245fa in pairs of (exergy efficiency, LEC) are (0.5425, 0.104), (0.5502, 0.111), and (0.5212, 0.108), respectively. The mixture working fluids present lower thermodynamic performance and moderate economic performance than the pure working fluids under the Pareto optimization. - Highlights: • The thermoeconomic comparison between pure and mixture working fluids is investigated. • The Pareto-optimal solutions with bi-objective function using three decision makings are obtained. • The optimum values from TOPSIS decision making are selected as the preferred Pareto-optimal solution. • The mixture yields lower thermodynamic performance and moderate economic performance.

Thermoeconomic Optimization of Cascade Refrigeration System Using Mixed Carbon Dioxide and Hydrocarbons at Low Temperature Circuit

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Nasruddin Nasruddin

2016-12-01

Full Text Available Many applications and industrial processes require very low cooling temperature, such as cold storage in the biomedical field, requiring temperature below -80 °C. However,single-cycle refrigeration systems can only achieve the effective cooling temperature of -40 °C and, also, the performance of the cycle will decrease drastically for cooling temperatures lower than -35°C. Currently, most of cascade refrigeration systems use refrigerants that have ozone depletion potential (ODP and global warming potential (GWP, therefore, in this study, a cascade system is simulated using a mixture of environmentally friendly refrigerants, namely, carbon dioxide and a hydrocarbon (propane, ethane or ethylene as the refrigerant of the low temperature circuit. A thermodynamic analysis is performed to determine the optimal composition of the mixture of carbon dioxide and hydrocarbons in the scope of certain operating parameters. In addition, an economic analysis was also performed to determine the annual cost to be incurred from the cascade refrigeration system. The multi-objective/thermoeconomic optimization points out optimal operating parameter values of the system, to addressing both exergy efficiency and its relation to the costs to be incurred.

Exergy based methods for economic and risk design optimization of energy systems: Application to a gas turbine

International Nuclear Information System (INIS)

Cassetti, G.; Rocco, M.V.; Colombo, E.

2014-01-01

Exergy based analyses are considered by the scientific community appropriate tools for the design and the performance evaluation and improvements of energy systems. Moreover, they are today recognized as proper instruments to assess economic, environmental and social externalities of energy systems. This paper presents the results of a study in which different exergy analysis methods are adopted to determine the optimal design configuration of a gas turbine operating in simple Joule Brayton cycle. Standard exergy and Thermoeconomic analyses are performed to identify the highest thermodynamic efficiency and minimum economic cost configurations of the system, while for the environmental analysis Authors propose an innovative method in which the exergy analysis is combined with a Risk Analysis. With this method the total risk associated to the system is used as objective function in the same way as monetary cost is for standard Thermoeconomic analysis. These three methods aims therefore to determine the optimal design configurations of the system with respect to their specific objective functions, respectively: exergy cost (J/J), monetary (exergoeconomic) cost (€/J) and risk (injured/J) of the product. Results lead to three different optimal design parameters for the system, according to the objective of each analysis procedure. - Highlights: • An original implementation of Thermoeconomic framework is proposed. • Standard Exergy and Thermoeconomic analysis are performed on a case study. • A new model using exergy as allocation criteria for Risk Analysis is performed. • Different optimal configurations are obtained and compared

Modeling and thermo-economic optimization of heat recovery heat exchangers using a multimodal genetic algorithm

International Nuclear Information System (INIS)

Ghazi, M.; Ahmadi, P.; Sotoodeh, A.F.; Taherkhani, A.

2012-01-01

Highlights: ► Comprehensive thermodynamic modeling of a dual pressure HRSG with duct burners. ► Thermoeconomic performance assessment of the system. ► To find the best design parameters of the HRSG using a genetic algorithm. - Abstract: In the present study a comprehensive thermodynamic modeling of a dual pressure combined cycle power plant is performed. Moreover, an optimization study to find the best design parameters is carried out. Total cost per unit of produced steam exergy is defined as the objective function. The objective function includes capital or investment cost, operational and maintenance cost, and the corresponding cost of the exergy destruction. This objective function is minimized while satisfying a group of constraints. For this study, design variables are high and low drum pressures, steam mass flow rates, pinch point temperature differences and the duct burner fuel consumption flow rate. The variations of design parameters with the inlet hot gas enthalpy and exergy unit price are also shown. Finally the sensitivity analysis of change in design parameters with change in fuel and investment cost is performed. The results show that with increasing the exergy unit cost, the optimum values of design parameters are selected such that to decrease the objective function. Furthermore it is found that at higher inlet gas enthalpy, the required heat transfer surface area (and its corresponding capital cost) increases

Thermoeconomic analysis of Biomass Integrated Gasification Gas Turbine Combined Cycle (BIG GT CC) cogeneration plant

Energy Technology Data Exchange (ETDEWEB)

Arrieta, Felipe Raul Ponce; Lora, Electo Silva [Escola Federal de Engenharia de Itajuba, MG (Brazil). Nucleo de Estudos de Sistemas Termicos]. E-mails: aponce@iem.efei.br; electo@iem.efei.br; Perez, Silvia Azucena Nebra de [Universidade Estadual de Campinas, SP (Brazil). Faculdade de Engenharia Mecanica. Dept. de Energia]. E-mail: sanebra@fem. unicamp.br

2000-07-01

Using thermoeconomics as a tool to identify the location and magnitude of the real thermodynamic losses (energy waste, or exergy destruction and exergy losses) it is possible to assess the production costs of each product (electric power and heat) and the exergetic and exergoeconomic cost of each flow in a cogeneration plant to assist in decision-marketing procedures concerning to plant design, investment, operation and allocations of research funds. Thermo economic analysis of Biomass Integrated Gasification Gas Turbine Combined Cycle (BIG GT CC) cogeneration plant for its applications in sugar cane mills brings the following results: the global exergetic efficiency is low; the highest irreversibilities occur in the following equipment, by order: scrubber (38%), gas turbine (16%), dryer (12%), gasifier and HRSG (6%); due to the adopted cost distribution methodology, the unit exergetic cost of the heat (4,11) is lower than electricity (4,71); the lower market price of biomass is one of the most sensible parameter in the possible implementation of BIG-GT technology in sugar cane industry; the production costs are 31 US$/MWh and 32 US$/MWh for electricity and heat, respectively. The electricity cost is, after all, competitive with the actual market price. The electricity and heat costs are lower or almost equal than other values reported for actual Rankine cycle cogeneration plants. (author)

Comparisons of system benefits and thermo-economics for exhaust energy recovery applied on a heavy-duty diesel engine and a light-duty vehicle gasoline engine

International Nuclear Information System (INIS)

Wang, Tianyou; Zhang, Yajun; Zhang, Jie; Peng, Zhijun; Shu, Gequn

2014-01-01

Highlights: • Comparisons of exhaust energy recovery are launched between two types of engine. • System performances are analyzed in terms of benefits and thermo-economics. • Diesel engine system presents superior to gasoline type in economic applicability. • Only diesel engine system using water under full load meets the economic demand. - Abstract: Exhaust energy recovery system (EERS) based on Rankine cycle (RC) in internal combustion engines have been studied mainly on heavy-duty diesel engines (D) and light-duty vehicle gasoline engines (G), however, little information available on systematical comparisons and evaluations between the two applications, which is a particularly necessary summary for clarifying the differences. In this paper, the two particular systems are compared quantitatively using water, R141b, R123 and R245fa as working fluids. The influences of evaporating pressure, engine type and load on the system performances are analyzed with multi-objectives, including the thermal efficiency improvement, the reduced CO 2 emission, the total heat transfer area per net power output (APP), the electricity production cost (EPC) and the payback period (PBP). The results reveal that higher pressure and engine load would be attractive for better performances. R141b shows the best performances in system benefits for the D-EERS, while water exhibits the largest contributions in the G-EERS. Besides, water performs the best thermo-economics, and R245fa serves as the most uneconomical fluid. The D-EERS presents superior to the G-EERS in the economic applicability as well as much more CO 2 emission reductions, although with slightly lower thermal efficiency improvement, and only the D-EERS with water under the full load meets the economic demand. Therefore the EERS based on RC serve more applicable on the heavy-duty diesel engine, while it might be feasible for the light-duty vehicle gasoline engine as the state-of-the art technologies are developed in the

Energetic, exergetic, thermoeconomic and environmental analysis of various systems for the cogeneration of biogas produced by an urban wastewater treatment plant UWTP

Energy Technology Data Exchange (ETDEWEB)

Coble, J.J. [Nebrija Univ., Madrid (Spain). Industrial Engineering Dept.; Contreras, A. [Industrial Engineering College, Madrid (Spain). Chemistry Dept.

2010-07-01

General awareness that the world's energy resources are limited has meant that it is increasingly important to examine energy-saving devices and fuels more closely, in order to use our limited available resources in a more sustainable manner. With this in mind, we studied biogas from a UWTP, because it is a renewable fuel with a neutral contribution to CO2 emissions. We compared two technologies for using biogas as an energy source: cogeneration using either motor-generators or phosphoric acid fuel cells. The comparison was made from the energetic, exergetic, thermo-economic and environmental points of view, internalizing all the costs involved in each case. We used data supplied by the UWTP at the City of Madrid Plant Nursery, which uses motor-generators, and the UWTPs in Portland, Oregon, and in Red Hook, New York, which use a phosphoric acid fuel cell. The joint work carried out has been divided into three parts for publication purposes, and we present here the first of these, which refers to the energy analysis. (orig.)

Simulation and thermoeconomic analysis of different configurations of gas turbine (GT)-based dual-purpose power and desalination plants (DPPDP) and hybrid plants (HP)

International Nuclear Information System (INIS)

Rensonnet, Thibaut; Uche, Javier; Serra, Luis

2007-01-01

This paper contains a simulation and a thermoeconomic analysis of several configurations of gas turbine (GT)-based dual-purpose power and desalination plants (DPPDP): Gas turbine with reverse osmosis (GT+RO), combined cycle with reverse osmosis (CC+RO), combined cycle with multi-effect distillation (CC+MED) and two different hybrid plant (HP) arrangements combining CC, MED and RO (CC+MED+RO, CC+MED+RO bis ). The last two configurations only differ from the feed solution to the MED units (raw seawater or brine coming from the RO discharge). A complete thermodynamic simulation at both design and at part load conditions has been made, as well as an exergy and an exergo-economic (thermoeconomic) analysis of each configuration, in order to compare the evolution of the water and electricity cost for different arrangements. The results show that even for a significantly reduced fuel cost (1.42 $/GJ), the CC is much more profitable than a GT operating in open cycle, with electricity cost values of 1.647 and 2.166 c$/kWh, respectively. As was expected, RO is more efficient and profitable than MED desalination processes, the difference in the obtained desalted water cost being significant. In the hybrid configuration with MED fed by the RO brine discharge, a decrease in the equivalent electrical consumption of nearly 2 kWh/m 3 was achieved, but even in this case RO was more efficient (14.15 vs. 4.048 kWh/m 3 ). The evolution of electricity cost in each configuration is more similar at part load operation than at full load, but in the case of water cost, RO is once again more profitable and less sensitive to load variations. Costs given in this paper correspond to investment and fuel costs. Further, profitability and operation strategies of HP, i.e., DPPDP combining distillation and membrane processes, are also analyzed. It is shown that HP can be more profitable than RO plants in the case of increasing the water production capacity of existing DPPDP, because the profit

Sensitivity analysis and thermoeconomic comparison of ORCs (organic Rankine cycles) for low temperature waste heat recovery

International Nuclear Information System (INIS)

Feng, Yongqiang; Zhang, Yaning; Li, Bingxi; Yang, Jinfu; Shi, Yang

2015-01-01

The sensitivity analysis for low temperature ORCs (organic Rankine cycles), as well as the thermoeconomic comparison between the basic ORC and regenerative ORC using Non-dominated sorting genetic algorithm-II (NSGA-II), are conducted in this paper. The derivatives of five system parameters on system performance are used to evaluate the parametric sensitiveness. The exergy efficiency and the APR (heat exchanger area per unit net power output) are selected as the objective functions for multi-objective optimization using R123 under the low temperature heat source of 423 K. The Pareto frontier solution with bi-objective for maximizing exergy efficiency and minimizing APR is obtained and compared with the corresponding single-objective solutions. The results indicate that the prior consideration of improving thermal efficiency and exergy efficiency is to increase the evaporator outlet temperature. A fitting curve can be yielded from the Pareto frontier between the thermodynamic performance and economic factor. The optimum exergy efficiency and APR of the regenerative ORC obtained from the Pareto-optimal solution are 59.93% and 3.07 m 2 /kW, which are 8.10% higher and 15.89% lower than that of the basic ORC, respectively. The Pareto optimization compromises the thermodynamic performance and economic factor, therefore being more suitable for decision making. - Highlights: • The sensitivity analysis of the basic ORC is conducted. • The Pareto-optimal solution is compared with the single-objective solutions. • Evaporator outlet temperature should be preferentially considered. • 8.10% higher exergy efficiency and 15.89% lower APR for the regenerative ORC

Thermal economical analysis of plants configuration proposed for expansion of a thermoelectric power plant; Analise termoeconomica de configuracoes de plantas propostas para a expansao de uma usina termoeletrica

Energy Technology Data Exchange (ETDEWEB)

Branco, Fabiano P.; Romao Junior, Ricardo A.; Mashiba, Marcos H.S.; Dib, Fernando H.; Maia, Cassio R.M.; Ramos, Ricardo A.V. [Universidade Estadual Paulista (UNESP), Ilha Solteira, SP (Brazil). Faculdade de Engenharia de Ilha Solteira (FEIS). Dept. de Engenharia Mecanica]. E-mails: pagliosa@dem.feis.unesp.br; fhdib@aluno.feis.unesp.br; rarjunior@aluno.feis.unesp.br; mashiba@dem.feis.unesp.br; cassio@dem.feis.unesp.br; ramos@dem.feis.unesp.br

2006-07-01

This paper performs thermodynamic and thermoeconomic analyses applied to a thermoelectric natural gas primarily open cycle power plant and posteriorly operating at combined cycle, with heat recovery steam generator with 1, 2 and 3 pressure level respectively. For the system thermodynamic, mass conservation, entropy and exergy balance equations are applied, considering a control volume for each equipment composing the plant. Using thermoeconomic analysis it is possible to evaluate the reflexes of the capital and fuel costs on the composition of the electricity generated, through the exergy fluxes, the exergy unitary costs and the exergoeconomic costs (US$/MWh), besides the costs for the produced powers. The plant is still submitted to known techniques of investment analysis for economical viability verification taking into account the investment and natural gas costs and the energy sales.

Thermo-economic optimization of heat recovery steam generator for a range of gas turbine exhaust temperatures

International Nuclear Information System (INIS)

Nadir, Mahmoud; Ghenaiet, Adel; Carcasci, Carlo

2016-01-01

Highlights: • Thermo-economic optimization of HRSG configurations. • The maximum value of the net present value was targeted for the economic optimization. • Three level HRSG is the best option in respect of power output and high priced medium. • Two level HRSG is the best for net benefit in low and intermediate priced mediums. - Abstract: This paper illustrates the effect of selling price on the optimum design parameters of a heat recovery steam generator (HRSG) and the selection of its ideal configuration for an outlet temperature range of 350–650 °C. The Particle Swarm Optimization (PSO) method was used, considering the steam cycle specific work as an objective to be maximized, the net present value as another objective to be maximized for the economic optimization and a combination of both. Three configurations of heat recovery steam generators are considered with one, two and three pressure levels and a reheat. The results show that, the three pressure level system is the best configuration from a thermodynamic point of view, but with respect to the economical aspect the two pressure levels is the best configuration for the low and medium selling prices (0.04 $/kW h, 0.08 $/kW h and 0.2 $/kW h), whereas the three pressure level configuration would only be interesting for a high selling price of 0.3 $/kW h and a temperature range 450–600 °C. For a temperature of 650 °C, the high cost of the three level system leads to a decrease in the net present value. As the selling price increases the optimized design parameters of the three pressure level HRSG based on economic or thermodynamic optimization are similar. The obtained results are used to elaborate a new correlation relating the net present value with the gas turbine outlet temperature, gas mass flow rate, number of levels of HRSG and selling price.

NUMERICAL MODELLING AS NON-DESTRUCTIVE METHOD FOR THE ANALYSES AND DIAGNOSIS OF STONE STRUCTURES: MODELS AND POSSIBILITIES

Directory of Open Access Journals (Sweden)

Nataša Štambuk-Cvitanović

1999-12-01

Full Text Available Assuming the necessity of analysis, diagnosis and preservation of existing valuable stone masonry structures and ancient monuments in today European urban cores, numerical modelling become an efficient tool for the structural behaviour investigation. It should be supported by experimentally found input data and taken as a part of general combined approach, particularly non-destructive techniques on the structure/model within it. For the structures or their detail which may require more complex analyses three numerical models based upon finite elements technique are suggested: (1 standard linear model; (2 linear model with contact (interface elements; and (3 non-linear elasto-plastic and orthotropic model. The applicability of these models depend upon the accuracy of the approach or type of the problem, and will be presented on some characteristic samples.

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

Science.gov (United States)

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

2011-08-01

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

Micro gas turbine thermodynamic and economic analysis up to 500 kWe size

International Nuclear Information System (INIS)

Galanti, Leandro; Massardo, Aristide F.

2011-01-01

Highlights: → Thermoeconomic analysis and optimization of micro gas turbines up to 500 kWe. → Analysis carried out for both regenerative and intercooled regenerative cycles. → Focus on thermodynamic, geometric and cost parameters of the main MGT devices. → ICR cycle has an interesting reduction in capital and electricity costs, rising size. → Complete thermoeconomic investigation is essential to support thermodynamic analysis. -- Abstract: In this paper a thermoeconomic analysis and optimization of micro gas turbines (MGT) up to 500 kWe is presented. This analysis is strongly related to the need of minimizing specific capital cost, still high for MGT large market penetration, and optimizing MGT size to match market needs. The analysis was carried out for both existing regenerative MGT cycles and new inter-cooled regenerative cycles, using the Web-based ThermoEconomic Modular Program by the University of Genoa. The attention is mainly focused on the basis of thermodynamic, geometric and capital cost parameters of the main MGT devices (such as recuperator size, material and effectiveness, turbine inlet temperature, and compressor pressure ratio) and on economic scenario (fuel cost, cost of electricity, etc.) for different MGT size in the range 25-500 kWe.

Neurobiological support to the diagnosis of ADHD in stimulant-naïve adults: pattern recognition analyses of MRI data.

Science.gov (United States)

Chaim-Avancini, T M; Doshi, J; Zanetti, M V; Erus, G; Silva, M A; Duran, F L S; Cavallet, M; Serpa, M H; Caetano, S C; Louza, M R; Davatzikos, C; Busatto, G F

2017-12-01

In adulthood, the diagnosis of attention-deficit/hyperactivity disorder (ADHD) has been subject of recent controversy. We searched for a neuroanatomical signature associated with ADHD spectrum symptoms in adults by applying, for the first time, machine learning-based pattern classification methods to structural MRI and diffusion tensor imaging (DTI) data obtained from stimulant-naïve adults with childhood-onset ADHD and healthy controls (HC). Sixty-seven ADHD patients and 66 HC underwent high-resolution T1-weighted and DTI acquisitions. A support vector machine (SVM) classifier with a non-linear kernel was applied on multimodal image features extracted on regions of interest placed across the whole brain. The discrimination between a mixed-gender ADHD subgroup and individually matched HC (n = 58 each) yielded area-under-the-curve (AUC) and diagnostic accuracy (DA) values of up to 0.71% and 66% (P = 0.003) respectively. AUC and DA values increased to 0.74% and 74% (P = 0.0001) when analyses were restricted to males (52 ADHD vs. 44 HC). Introvert personality traits showed independent risk effects on suicidality regardless of diagnosis status. Among high risk individuals with suicidal thoughts, higher neuroticism tendency is further associated with increased risk of suicide attempt. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Thermodynamic, economic and thermo-economic optimization of a new proposed organic Rankine cycle for energy production from geothermal resources

International Nuclear Information System (INIS)

Kazemi, Neda; Samadi, Fereshteh

2016-01-01

Highlights: • A new cycle was designed to improve basic organic Rankine cycle performance. • Peng Robinson equation of state was used to obtain properties of working fluids. • Operating parameters were optimized with three different objective functions. • Efficiency of new organic Rankine cycle is higher than other considered cycles. • Return on investment of new cycle for Iran is more than France and America. - Abstract: The main goal of this study is to propose and investigate a new organic Rankine cycle based on three considered configurations: basic organic Rankine cycle, regenerative organic Rankine cycle and two-stage evaporator organic Rankine cycle in order to increase electricity generation from geothermal sources. To analyze the considered cycles’ performance, thermodynamic (energy and exergy based on the first and second laws of thermodynamics) and economic (specific investment cost) models are investigated. Also, a comparison of cycles modeling results is carried out in optimum conditions according to different optimization which consist thermodynamic, economic and thermo-economic objective functions for maximizing exergy efficiency, minimizing specific investment cost and applying a multi-objective function in order to maximize exergy efficiency and minimize specific investment cost, respectively. Optimized operating parameters of cycles include evaporators and regenerative temperatures, pinch point temperature difference of evaporators and degree of superheat. Furthermore, Peng Robinson equation of state is used to obtain thermodynamic properties of isobutane and R123 which are selected as dry and isentropic working fluids, respectively. The results of optimization indicate that, thermal and exergy efficiencies increase and exergy destruction decrease especially in evaporators for both working fluids in new proposed organic Rankine cycle compared to the basic organic Rankine cycle. Moreover, the amount of specific investment cost in new

CT on diagnosis and differential diagnosis of adrenal neuroblastoma from nephroblastoma in children

International Nuclear Information System (INIS)

Han Jingtian; Shen Guoqiang; Yang Huayuan

2000-01-01

Objective: To evaluate the effect of CT on diagnosis and differential diagnosis of children's adrenal neuroblastoma from nephroblastoma. Materials and Method: To analyse the CT manifestations on 36 cases of adrenal neuroblastoma and 32 cases of nephroblastoma both confirmed by postoperative pathologic diagnosis. Results: The adrenal neuroblastoma is a kind of extrarenal tumor, so the kidney kept its original form and showed some compressive features. The incidence of tumor calcification appeared mostly in rough and speckle-piece form was high. While the nephroblastoma is a renal tumor. The surrounding renal parenchyma showed a specific 'new-moon shape' intensification. Conclusion: CT is one of the most valuable and effective means of examination to diagnose adrenal neuroblastoma and differentiate it from nephroblastoma. It can provide important information for making correct diagnosis, planning proper therapy and assessing prognosis

Multi-objective optimization of a vertical ground source heat pump using evolutionary algorithm

International Nuclear Information System (INIS)

Sayyaadi, Hoseyn; Amlashi, Emad Hadaddi; Amidpour, Majid

2009-01-01

Thermodynamic and thermoeconomic optimization of a vertical ground source heat pump system has been studied. A model based on the energy and exergy analysis is presented here. An economic model of the system is developed according to the Total Revenue Requirement (TRR) method. The objective functions based on the thermodynamic and thermoeconomic analysis are developed. The proposed vertical ground source heat pump system including eight decision variables is considered for optimization. An artificial intelligence technique known as evolutionary algorithm (EA) has been utilized as an optimization method. This approach has been applied to minimize either the total levelized cost of the system product or the exergy destruction of the system. Three levels of optimization including thermodynamic single objective, thermoeconomic single objective and multi-objective optimizations are performed. In Multi-objective optimization, both thermodynamic and thermoeconomic objectives are considered, simultaneously. In the case of multi-objective optimization, an example of decision-making process for selection of the final solution from available optimal points on Pareto frontier is presented. The results obtained using the various optimization approaches are compared and discussed. Further, the sensitivity of optimized systems to the interest rate, to the annual number of operating hours and to the electricity cost are studied in detail.

Technical-economical diagnosis to schedule the maintenance shut downs of thermal power stations departing from behavior, economic engineering and thermo-economic tests; Diagnostico tecnico economico para programar las salidas a mantenimiento de centrales termicas a partir de pruebas de comportamiento, ingenieria economica y termo economia

Energy Technology Data Exchange (ETDEWEB)

Arreguin Arredondo, Antonio

2002-08-01

The thesis work develops a methodology to determine when it is convenient, technically and economically to provide maintenance to a thermal electric unit and the type of maintenance to be performed, all this sustained in an economic analysis taking into account the variation of the production costs, of the interest rates, of the fuel prices and of the electric energy prices, the maintenance costs and the degradation of the unit in the time. Once analyzed the previous matters a thermo-economic test model and reference (values provided by the manufacturer) is performed and they are compared to determine in what equipment or system of the process of electric energy generation is required to focus on the material resources as well as on the human resources, in order to obtain the best results from the maintenance and recover the greatest possible efficiency of the unit. [Spanish] El trabajo de tesis desarrolla una metodologia para determinar cuando conviene, tecnica y economicamente proporcionar mantenimiento a una unidad termica y el tiempo de mantenimiento a realizar, todo esto sustentado en un analisis economico tomando en cuenta la variacion de los costos de produccion de las tasas de interes, de los precios del combustible y de la energia electrica, el costo de mantenimiento y la degradacion de la unidad en el tiempo. Una vez analizado lo anterior se realiza un modelo termoeconomico de prueba y referencia (valores proporcionados por el fabricante) y se comparan para determinar en que equipos o sistema del proceso de generacion de energia electrica se requiere enfocar tanto los recursos materiales como humanos, con el fin de obtener mejores resultados del mantenimiento y recuperar lo mayor posible la eficiencia de la unidad.

New insights into survival trend analyses in cancer population-based studies: the SUDCAN methodology.

Science.gov (United States)

Uhry, Zoé; Bossard, Nadine; Remontet, Laurent; Iwaz, Jean; Roche, Laurent

2017-01-01

The main objective of the SUDCAN study was to compare, for 15 cancer sites, the trends in net survival and excess mortality rates from cancer 5 years after diagnosis between six European Latin countries (Belgium, France, Italy, Portugal, Spain and Switzerland). The data were extracted from the EUROCARE-5 database. The study period ranged from 6 (Portugal, 2000-2005) to 18 years (Switzerland, 1989-2007). Trend analyses were carried out separately for each country and cancer site; the number of cases ranged from 1500 to 104 000 cases. We developed an original flexible excess rate modelling strategy that accounts for the continuous effects of age, year of diagnosis, time since diagnosis and their interactions. Nineteen models were constructed; they differed in the modelling of the effect of the year of diagnosis in terms of linearity, proportionality and interaction with age. The final model was chosen according to the Akaike Information Criterion. The fit was assessed graphically by comparing model estimates versus nonparametric (Pohar-Perme) net survival estimates. Out of the 90 analyses carried out, the effect of the year of diagnosis on the excess mortality rate depended on age in 61 and was nonproportional in 64; it was nonlinear in 27 out of the 75 analyses where this effect was considered. The model fit was overall satisfactory. We analysed successfully 15 cancer sites in six countries. The refined methodology proved necessary for detailed trend analyses. It is hoped that three-dimensional parametric modelling will be used more widely in net survival trend studies as it has major advantages over stratified analyses.

Diagnosis and Fault-tolerant Control

DEFF Research Database (Denmark)

Blanke, Mogens; Kinnaert, Michel; Lunze, Jan

the applicability of the presented methods. The theoretical results are illustrated by two running examples which are used throughout the book. The book addresses engineering students, engineers in industry and researchers who wish to get a survey over the variety of approaches to process diagnosis and fault......The book presents effective model-based analysis and design methods for fault diagnosis and fault-tolerant control. Architectural and structural models are used to analyse the propagation of the fault through the process, to test the fault detectability and to find the redundancies in the process...

Problematic diagnosis of bronchial foreign bodies in children

International Nuclear Information System (INIS)

Myllylae, V.; Paeivaensalo, M.; Seppaenen, U.; Hyrynkangas, K.; Linna, O.; Kortelainen, M.L.

1987-01-01

Bronchial foreign bodies by children are dangerous and require immediate therapeutic measures. Findings and significance of chest film in the diagnosis of bronchial foreign bodies in 24 children were analysed. All patients were symptomatic. 18 patients had an abnormal and 6 normal auscultation finding. In three cases the physician did not suspect aspiration, and the diagnosis was delayed, which caused the death of one child. Roentgenpositive foreign bodies were found in 8 and -negative in 16 cases. Secondary changes (obstructive emphysema, atelectasis, pneumonia) were seen in 16 cases. In emergency cases the chest films were analysed by physician and later by a radiologist, who found 88% of them to be abnormal. Fluoroscopy of expiratory chest film helps to detect the unilateral emphysema more distinctly. The diagnosis must always be confirmed with bronchoscopy and extraction thereby is the adequate treatment of bronchial bodies. (orig.) [de

A review of recent research on the use of zeotropic mixtures in power generation systems

DEFF Research Database (Denmark)

Modi, Anish; Haglind, Fredrik

2017-01-01

but there are some studies which also consider the economic aspects through the investigation of capital investment costs or through a thermoeconomic analysis. The reviewed literature in this paper is divided based on the various applications such as solar energy based power systems, geothermal heat based power...... with low grade heat as the energy source. This paper presents a review of the recent research on power cycles with zeotropic mixtures as the working fluid. The available literature primarily discusses the thermodynamic performance of the mixture power cycles through energy and exergy analyses...

Learning Disability: Experience of Diagnosis

Science.gov (United States)

Kenyon, Elinor; Beail, Nigel; Jackson, Tom

2014-01-01

Studies have focused on the experience of diagnosis from the perspectives of parents of children with learning disabilities, but there has been limited methodologically rigorous investigation into the experience for the person themselves. Eight participants were recruited from a range of different backgrounds. Interviews were analysed using…

Granulomas at initial diagnosis of Crohn's disease signal a poor ...

African Journals Online (AJOL)

CD patients (n=101) with uncomplicated non-stricturing, non-penetrating disease at diagnosis, and with follow-up >5 years, were retrospectively analysed using a predefined definition of severe CD (SCD) over the disease course. Clinical, demographic, laboratory and histological factors at diagnosis associated with SCD ...

Ultrasound Elastography in Breast Cancer Diagnosis

DEFF Research Database (Denmark)

Carlsen, J.; Ewertsen, C; Sletting, S

2015-01-01

Ultrasound elastography is an established method for characterization of focal lesions in the breast. Different techniques and analyses of the images may be used for the characterization. This article addresses the use of ultrasound elastography in breast cancer diagnosis. In the first part...

The diagnosis of psychopathy between psychiatry, Adlerian psychology and policy

OpenAIRE

Kölch, Michael

2010-01-01

The thesis analyses the beginning of child and adolescent psychiatric services in Berlin be-tween 1918 and 1935. Using methods of history of sciences, social history, and history of institutions the conceptualisation of the “psychopathy” as a specific diagnosis for children with behaviour problems was examined. This diagnosis was the core diagnosis for the devel-opment of early psychiatry for children. By this theoretical concept of “psychopathy” the vari-ous scientific models about psychiatr...

Memory Vulnerability Diagnosis for Binary Program

Directory of Open Access Journals (Sweden)

Tang Feng-Yi

2016-01-01

Full Text Available Vulnerability diagnosis is important for program security analysis. It is a further step to understand the vulnerability after it is detected, as well as a preparatory step for vulnerability repair or exploitation. This paper mainly analyses the inner theories of major memory vulnerabilities and the threats of them. And then suggests some methods to diagnose several types of memory vulnerabilities for the binary programs, which is a difficult task due to the lack of source code. The diagnosis methods target at buffer overflow, use after free (UAF and format string vulnerabilities. We carried out some tests on the Linux platform to validate the effectiveness of the diagnosis methods. It is proved that the methods can judge the type of the vulnerability given a binary program.

PARAMETRIC STUDY OF ENERGY, EXERGY AND THERMOECONOMIC ANALYSES ON VAPOR-COMPRESSION SYSTEM CASCADED WITH LIBR/WATER AND NH3/WATER ABSORBTION CASCADE REFRIGERATION CYCLE

Directory of Open Access Journals (Sweden)

ahmet selim dalkilic

2017-03-01

Full Text Available Energy savings on cooling systems can be performed by using novel refrigeration cycles. For this aim, vapour compression-vapour absorption cascade refrigeration systems can be considered as substitute to single-stage vapour compression refrigeration systems. Renewable energy sources of geothermal and solar heat, waste heat of processes have been used by these cycles to provide cooling and they also require less electrical energy than vapour compression cycles having alternative refrigerants. In this study, a vapour compression (VC and vapour absorption (VA cascade systems are analysed with the second law analysis for varied cooling capacities. While lithium bromide-water and NH3/H2O are the working fluids in VA part, various refrigerants are used in VC section. The refrigerants of R134a and R600a, R410A and R407C are tested as drop in alternatives for R12 and R22, respectively. The effects of alteration in cooling capacity, superheating and sub cooling in VC part, temperature in the generator and absorber, and degree of overlap in cascade condenser in VA part on the coefficient of system performance are studied. Validation of the results have been performed by the values given in the literature. Improvement in COP of VC, VA and cascade system are obtained separately. According to the analyses, cascade systems’ COP values increase with increasing the temperatures of generator and evaporator and they also increase with decreasing the condenser and absorber temperatures. Moreover, the generator has the highest exergy destruction rates, second and third one were the condenser and absorber, respectively. Electricity consumption and payback period are also determined considering the various parameters of the study.

Radioimmunoassays for tumor diagnosis

International Nuclear Information System (INIS)

Dressler, J.

1983-01-01

Aside from imaging techniques several (radio-)immunological analyses are used for tumor diagnosis. Oncofetal antigens, for instance the carcinoembryonic antigen (CEA) and alpha-fetoprotein (AFP), have become the most important substances for many malignancies. However, nearly all of the so-called tumor markers are not suitable for early diagnosis or screening either because of low sensitivity or low tumor specifity. On the other hand follow-up measurements give a very sensitive index of the success of treatment and may indicate tumor progression when other signs are still not present. In some carcinomas and under some clinical circumstances tumorspecific markers are available and mandatory for detection and/or staging: AFP in hepatoma, acid phosphatase in metastasizing carcinoma of the prostate and serum thyreoglobulin in differentiated thyroid cancer. (orig.) [de

Gliomatosis cerebri--an appropriate diagnosis? Case reports

DEFF Research Database (Denmark)

Fallentin, E; Skriver, E; Herning, Gudrun Margrethe

1997-01-01

PURPOSE: To evaluate the premises for the diagnosis gliomatosis cerebri in relation to diffuse astrocytomas. MATERIAL AND METHODS: CT, MR images and pathological analyses were used to assess the cases of 4 patients with diffusely infiltrating astrocytic tumours that radiologically, clinically and...

Engine gearbox fault diagnosis using empirical mode ...

Indian Academy of Sciences (India)

Kiran Vernekar

Department of Mechanical Engineering, National Institute of Technology Karnataka,. Surathkal ... proposed approach is an effective method for engine fault diagnosis. Keywords. Engine fault ... (DAQ) card and analysed using LabVIEW software from. Figure 1. .... and reduce numerical difficulties during the calculation. T.

Thermo-economic analysis of zeotropic mixtures based on siloxanes for engine waste heat recovery using a dual-loop organic Rankine cycle (DORC)

International Nuclear Information System (INIS)

Tian, Hua; Chang, Liwen; Gao, Yuanyuan; Shu, Gequn; Zhao, Mingru; Yan, Nanhua

2017-01-01

Highlights: • Various mixtures based on siloxanes used in the DORC system are proposed. • Thermo-economic analysis is conducted to explore mixtures’ application potential. • Cycle performances of D4/R123 (0.3/0.7) and MD2M/R123 (0.35/0.65) are superior. - Abstract: Siloxanes are usually used in the high temperature organic Rankine cycle (ORC) for engine waste heat recovery, but their flammability limits the practical application. Besides, blending siloxanes with retardants often brings a great temperature glide, causing the large condensation heat and the reduction in net output power. In view of this, the zeotropic mixtures based on siloxanes used in a dual-loop organic Rankine cycle (DORC) system are proposed in this paper. Three kinds of binary zeotropic mixtures consisting of R123 and various siloxanes (octamethylcyclotetrasiloxane ‘D4’, octamethyltrisiloxane ‘MDM’, decamethyltetrasiloxane ‘MD2M’), represented by D4/R123, MDM/R123 and MD2M/R123, are selected as the working fluid of the high temperature (HT) cycle. Meanwhile, R123 is always used in the low temperature (LT) cycle. The net output power and utilization of heat source are considered as the evaluation indexes to select the optimal mixture ratios for further analysis. Based on the thermodynamic and economic model, net output power, thermal efficiency, exergy efficiency, exergy destruction and electricity production cost (EPC) of the DORC system using the selected mixtures have been investigated under different operating parameters. According to the results, the DORC based on D4/R123 (0.3/0.7) shows the best thermodynamic performance with the largest net power of 21.66 kW and the highest thermal efficiency of 22.84%. It also has the largest exergy efficiency of 48.6% and the smallest total exergy destruction of 19.64 kW. The DORC using MD2M/R123 (0.35/0.65) represents the most economic system with the smallest EPC of 0.603 $/kW h. Besides, the irreversibility in the internal heat

Multi-objective optimization of a bottoming Organic Rankine Cycle (ORC) of gasoline engine using swash-plate expander

International Nuclear Information System (INIS)

Galindo, J.; Climent, H.; Dolz, V.; Royo-Pascual, L.

2016-01-01

Highlights: • A thermo-economic and sizing model of an ORC in a gasoline engine is carried out. • A multi-objective optimization method to design an ORC for vehicle WHR is presented. • A multiple attribute decision-making method is implemented to select the solution. - Abstract: This paper presents a mathematical model of a bottoming Organic Rankine Cycle coupled to a 2 l turbocharged gasoline engine to optimize the cycle from a thermo-economic and sizing point of view. These criteria were optimized with different cycle values. Therefore, a methodology to optimize the ORC coupled to Waste Heat Recovery systems in vehicle applications is presented using a multi-objective optimization algorithm. Multi-objective optimization results show that the optimum solution depend on the importance of each objective to the final solution. Considering thermo-economic criteria as the main objective, greater sizes will be required. Considering sizing criteria as the main objective, higher thermo-economic parameters will be obtained. Therefore, in order to select a single-solution from the Pareto frontier, a multiple attribute decision-making method (TOPSIS) was implemented in order to take into account the preferences of the Decision Maker. Considering the weight factors 0.5 for Specific Investment Cost (SIC), 0.3 for the area of the heat exchangers (A tot ) and 0.2 for Volume Coefficient (VC) and the boundaries of this particular application, the result is optimized with values of 0.48 m 2 (A tot ), 2515 €/kW (SIC) and 2.62 MJ/m 3 (VC). Moreover, the profitability of the project by means of the Net Present Value and the Payback has been estimated.

Accuracy of nursing diagnosis "readiness for enhanced hope" in patients with chronic kidney disease.

Science.gov (United States)

Silva, Renan Alves; Melo, Geórgia Alcântara Alencar; Caetano, Joselany Áfio; Lopes, Marcos Venícios Oliveira; Butcher, Howard Karl; Silva, Viviane Martins da

2017-07-06

To analyse the accuracy of the nursing diagnosis readiness for enhanced hope in patients with chronic kidney disease. This is a cross-sectional study with 62 patients in the haemodialysis clinic conducted from August to November 2015. The Hearth Hope Scale was used to create definitions of the defining characteristics of the North American Nursing Diagnosis Association International. We analysed the measures of sensitivity, specificity, predictive value, likelihood ratio, and odds ratio of the defining characteristics of the diagnosis. Of the characteristics, 82.22% presented the diagnosis. The defining characteristics "Expresses the desire to enhance congruency of expectations with desires" and "Expresses the desire to enhance problem solving to meet goals" increased the chance of having the diagnosis by eleven and five, respectively. The characteristics, "Expresses desire to enhance congruency of expectations with desires" and "Expresses desire to enhance problem solving to meet goals" had good accuracy measures.

Layered clustering multi-fault diagnosis for hydraulic piston pump

Science.gov (United States)

Du, Jun; Wang, Shaoping; Zhang, Haiyan

2013-04-01

Efficient diagnosis is very important for improving reliability and performance of aircraft hydraulic piston pump, and it is one of the key technologies in prognostic and health management system. In practice, due to harsh working environment and heavy working loads, multiple faults of an aircraft hydraulic pump may occur simultaneously after long time operations. However, most existing diagnosis methods can only distinguish pump faults that occur individually. Therefore, new method needs to be developed to realize effective diagnosis of simultaneous multiple faults on aircraft hydraulic pump. In this paper, a new method based on the layered clustering algorithm is proposed to diagnose multiple faults of an aircraft hydraulic pump that occur simultaneously. The intensive failure mechanism analyses of the five main types of faults are carried out, and based on these analyses the optimal combination and layout of diagnostic sensors is attained. The three layered diagnosis reasoning engine is designed according to the faults' risk priority number and the characteristics of different fault feature extraction methods. The most serious failures are first distinguished with the individual signal processing. To the desultory faults, i.e., swash plate eccentricity and incremental clearance increases between piston and slipper, the clustering diagnosis algorithm based on the statistical average relative power difference (ARPD) is proposed. By effectively enhancing the fault features of these two faults, the ARPDs calculated from vibration signals are employed to complete the hypothesis testing. The ARPDs of the different faults follow different probability distributions. Compared with the classical fast Fourier transform-based spectrum diagnosis method, the experimental results demonstrate that the proposed algorithm can diagnose the multiple faults, which occur synchronously, with higher precision and reliability.

Thermal performance analysis of Brayton cycle with waste heat recovery boiler for diesel engines of offshore oil production facilities

International Nuclear Information System (INIS)

Liu, Xianglong; Gong, Guangcai; Wu, Yi; Li, Hangxin

2016-01-01

Highlights: • Comparison of Brayton cycle with WHRB adopted in diesel engines with and without fans by thermal performance. • Waste heat recovery technology for FPSO. • The thermoeconomic analysis for the heat recovery for FPSO. - Abstract: This paper presents the theoretical analysis and on-site testing on the thermal performance of the waste heat recovery system for offshore oil production facilities, including the components of diesel engines, thermal boilers and waste heat boilers. We use the ideal air standard Brayton cycle to analyse the thermal performance. In comparison with the traditional design, the fans at the engine outlet of the waste heat recovery boiler is removed due to the limited space of the offshore platform. The cases with fan and without fan are compared in terms of thermal dynamics performance, energy efficiency and thermo-economic index of the system. The results show that the application of the WHRB increases the energy efficiency of the whole system, but increases the flow resistance in the duct. It is proved that as the waste heat recovery boiler takes the place of the thermal boiler, the energy efficiency of whole system without fan is slightly reduced but heat recovery efficiency is improved. This research provides an important guidance to improve the waste heat recovery for offshore oil production facilities.

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

Science.gov (United States)

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

2013-05-01

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

Simulation of Polygeneration Systems

Directory of Open Access Journals (Sweden)

Francesco Calise

2016-11-01

Full Text Available This Special Issue aims at collecting the recent studies dealing with polygeneration systems, with a special focus on the possible integration of different technologies into a single system, able to convert one or multiple energy sources into energy services (electricity, heat and cooling and other useful products (e.g., desalinized water, hydrogen, glycerin, ammonia, etc.. Renewable sources (solar, wind, hydro, biomass and geothermal, as well as fossil fuels, feeding advanced energy systems such as fuel cells and cogeneration systems, are considered. Special attention is paid to control strategies and to the management of the systems in general. Studies including thermoeconomic analyses and system optimizations are presented.

Themoeconomic optimization of triple pressure heat recovery steam generator operating parameters for combined cycle plants

Directory of Open Access Journals (Sweden)

Mohammd Mohammed S.

2015-01-01

Full Text Available The aim of this work is to develop a method for optimization of operating parameters of a triple pressure heat recovery steam generator. Two types of optimization: (a thermodynamic and (b thermoeconomic were preformed. The purpose of the thermodynamic optimization is to maximize the efficiency of the plant. The selected objective for this purpose is minimization of the exergy destruction in the heat recovery steam generator (HRSG. The purpose of the thermoeconomic optimization is to decrease the production cost of electricity. Here, the total annual cost of HRSG, defined as a sum of annual values of the capital costs and the cost of the exergy destruction, is selected as the objective function. The optimal values of the most influencing variables are obtained by minimizing the objective function while satisfying a group of constraints. The optimization algorithm is developed and tested on a case of CCGT plant with complex configuration. Six operating parameters were subject of optimization: pressures and pinch point temperatures of every three (high, intermediate and low pressure steam stream in the HRSG. The influence of these variables on the objective function and production cost are investigated in detail. The differences between results of thermodynamic and the thermoeconomic optimization are discussed.

Kinematic gait analyses in healthy Golden Retrievers

OpenAIRE

Silva, Gabriela C.A.; Cardoso, Mariana Trés; Gaiad, Thais P.; Brolio, Marina P.; Oliveira, Vanessa C.; Assis Neto, Antonio; Martins, Daniele S.; Ambrósio, Carlos E.

2014-01-01

Kinematic analysis relates to the relative movement between rigid bodies and finds application in gait analysis and other body movements, interpretation of their data when there is change, determines the choice of treatment to be instituted. The objective of this study was to standardize the march of Dog Golden Retriever Healthy to assist in the diagnosis and treatment of musculoskeletal disorders. We used a kinematic analysis system to analyse the gait of seven dogs Golden Retriever, female,...

Recent patents and technology transfer for molecular diagnosis of β-thalassemia and other hemoglobinopathies.

Science.gov (United States)

Breveglieri, Giulia; Finotti, Alessia; Borgatti, Monica; Gambari, Roberto

2015-01-01

Biological tests and genetic analyses for diagnosis and characterization of hematological diseases in health laboratories are designed with the aim of meeting the major medical needs of hospitals and pharmaceutical companies involved in this field of applied biomedicine. Genetic testing approaches to perform diagnosis consist of molecular techniques, which should be absolutely reproducible, fast, sensitive, cheap, and portable. Biological tests analyzed involve adult/newborn subjects, whereas genetic analyses involve adult thalassemia patients, newborns, embryos/fetuses (including non-invasive prenatal diagnosis), pre-implantation embryos, and pre-fertilization oocytes. The most recent findings in the diagnostic approach for β-thalassemias are related to three major fields of investigation: moving towards ultrasensitive methodologies for effective detection of the primary causative mutation of β-thalassemia, including the development of polymerase chain reaction-free approaches and non-invasive prenatal diagnosis; comparing analyses of the genotype of β-thalassemia patients to high-HbF-associated polymorphisms; introducing whole genome association assays and next-generation sequencing. All these issues should be considered and discussed in the context of several aspects, including regulatory, ethical and social issues. DNA sequence data aligned with the identification of genes central to the induction, development, progression, and outcome of β-thalassemia will be a key point for directing personalized therapy.

Cyanobacteria and Microalgae: Thermoeconomic Considerations in Biofuel Production

Directory of Open Access Journals (Sweden)

Umberto Lucia

2018-01-01

Full Text Available In thermodynamics, the useful work in any process can be evaluated by using the exergy quantity. The analyses of irreversibility are fundamental in the engineering design and in the productive processes’ development in order to obtain the economic growth. Recently, the use has been improved also in the thermodynamic analysis of the socio-economic context. Consequently, the exergy lost is linked to the energy cost required to maintain the productive processes themselves. The fundamental role of the fluxes and the interaction between systems and their environment is highlighted. The equivalent wasted primary resource value for the work-hour is proposed as an indicator to support the economic considerations on the biofuel production by using biomass and bacteria. The equivalent wasted primary resource value for the work-hour is proposed as an indicator to support the economic considerations of the biofuel production by using biomass and bacteria. Moreover, the technological considerations can be developed by using the exergy inefficiency. Consequently, bacteria use can be compared with other means of biofuel production, taking into account both the technologies and the economic considerations. Cyanobacteria results as the better organism for biofuel production.

Decision tree and PCA-based fault diagnosis of rotating machinery

Science.gov (United States)

Sun, Weixiang; Chen, Jin; Li, Jiaqing

2007-04-01

After analysing the flaws of conventional fault diagnosis methods, data mining technology is introduced to fault diagnosis field, and a new method based on C4.5 decision tree and principal component analysis (PCA) is proposed. In this method, PCA is used to reduce features after data collection, preprocessing and feature extraction. Then, C4.5 is trained by using the samples to generate a decision tree model with diagnosis knowledge. At last the tree model is used to make diagnosis analysis. To validate the method proposed, six kinds of running states (normal or without any defect, unbalance, rotor radial rub, oil whirl, shaft crack and a simultaneous state of unbalance and radial rub), are simulated on Bently Rotor Kit RK4 to test C4.5 and PCA-based method and back-propagation neural network (BPNN). The result shows that C4.5 and PCA-based diagnosis method has higher accuracy and needs less training time than BPNN.

Metrics and tools for consistent cohort discovery and financial analyses post-transition to ICD-10-CM.

Science.gov (United States)

Boyd, Andrew D; Li, Jianrong John; Kenost, Colleen; Joese, Binoy; Yang, Young Min; Kalagidis, Olympia A; Zenku, Ilir; Saner, Donald; Bahroos, Neil; Lussier, Yves A

2015-05-01

In the United States, International Classification of Disease Clinical Modification (ICD-9-CM, the ninth revision) diagnosis codes are commonly used to identify patient cohorts and to conduct financial analyses related to disease. In October 2015, the healthcare system of the United States will transition to ICD-10-CM (the tenth revision) diagnosis codes. One challenge posed to clinical researchers and other analysts is conducting diagnosis-related queries across datasets containing both coding schemes. Further, healthcare administrators will manage growth, trends, and strategic planning with these dually-coded datasets. The majority of the ICD-9-CM to ICD-10-CM translations are complex and nonreciprocal, creating convoluted representations and meanings. Similarly, mapping back from ICD-10-CM to ICD-9-CM is equally complex, yet different from mapping forward, as relationships are likewise nonreciprocal. Indeed, 10 of the 21 top clinical categories are complex as 78% of their diagnosis codes are labeled as "convoluted" by our analyses. Analysis and research related to external causes of morbidity, injury, and poisoning will face the greatest challenges due to 41 745 (90%) convolutions and a decrease in the number of codes. We created a web portal tool and translation tables to list all ICD-9-CM diagnosis codes related to the specific input of ICD-10-CM diagnosis codes and their level of complexity: "identity" (reciprocal), "class-to-subclass," "subclass-to-class," "convoluted," or "no mapping." These tools provide guidance on ambiguous and complex translations to reveal where reports or analyses may be challenging to impossible.Web portal: http://www.lussierlab.org/transition-to-ICD9CM/Tables annotated with levels of translation complexity: http://www.lussierlab.org/publications/ICD10to9. © The Author 2015. Published by Oxford University Press on behalf of the American Medical Informatics Association.

A multi-method evaluation of a training course on dual diagnosis.

LENUS (Irish Health Repository)

Rani, S

2012-08-01

A training course on dual diagnosis was developed within the Irish forensic mental health service, to bridge the gap in the lack of training on dual diagnosis in Ireland. The course was designed for service providers within mental health and addiction services. Twenty participants involving nursing, social work, police and social welfare disciplines attended the first training course. A mixed methodology research design was adapted to describe participants\\' evaluation of the training course. Data were collected using multiple methods: pre- and post-test, daily evaluation and focus group interviews. Quantitative data were analysed using the spss Version 16.0 and qualitative data were analysed thematically. Findings from the pre- and post-test suggest an increase in participants\\' knowledge of dual diagnosis and an increase in confidence in conducting groups. Daily evaluation indicates that the course content largely met participants\\' needs. Finally, three themes emerged from the focus group interview: increased confidence, the training course\\/teaching methods and personal\\/organizational challenges. This study implies that service providers within mental health and addiction services benefit from inter-professional, needs and skills based courses incorporating a variety of teaching methods. The way forward for future dual diagnosis training course developments would be working in partnership with service users and carers.

Factors Associated with Delayed Cancer Diagnosis in Egyptian Children

Directory of Open Access Journals (Sweden)

E.R. Abdelkhalek

2014-01-01

Full Text Available Background Despite tremendous importance of early cancer diagnosis in children, few studies on this topic have been conducted in Egypt. Early stage diagnosis can have a positive effect on prognoses and the quality of life of children with cancer. We investigated delays in the diagnosis of childhood cancers in Egypt and determined the factors associated with these delays. Methods This retrospective study included 172 children with cancer from two pediatric oncology units. The interval between symptoms onset and final diagnosis for each child was estimated and examined by univariate and multivariate analyses to determine correlations with the child's sex, age at diagnosis, type and site of malignancy, family residence, socioeconomic status, and parental educational level. Findings The median total diagnosis delay period was 47 days caused by patients and/or parents (8 days and diagnosis (28 days. Statistically significant patient factors associated with delayed diagnosis were age (<5 years, lower parental education, and socioeconomic status. Sex residence and family size were not significant. Malignancy type and tumor site significantly affected the time for diagnosis. The lowest median value was associated with germ cell tumors (GCTs and leukemia, and the highest value was in children with brain tumor. Missed diagnoses were initially recorded in 39.5% of the patients and were associated with patient and tumor factors. Interpretation Delayed diagnosis of childhood cancer is related to age, family, socioeconomic status and parental education, and cancer type and site. Efforts should be made to promote awareness, develop effective steps to eliminate possible contributing factors, and determine the best intervention method.

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

Science.gov (United States)

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

2016-08-07

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

Reassessing the reliability of the salivary cortisol assay for the diagnosis of Cushing syndrome.

Science.gov (United States)

Zhang, Qian; Dou, Jingtao; Gu, Weijun; Yang, Guoqing; Lu, Juming

2013-10-01

The cortisol concentration in saliva is 10-fold lower than total serum cortisol and accurately reflects the serum concentration, both levels being lowest around midnight. The salivary cortisol assay measures free cortisol and is unaffected by confounding factors. This study analysed published data on the sensitivity and specificity of salivary cortisol levels in the diagnosis of Cushing syndrome. Data from studies on the use of different salivary cortisol assay techniques in the diagnosis of Cushing syndrome, published between 1998 and 2012 and retrieved using Ovid MEDLINE®, were analysed for variance and correlation. For the 11 studies analysed, mean sensitivity and specificity of the salivary cortisol assay were both >90%. Repeated measurements were easily made with this assay, enabling improved diagnostic accuracy in comparison with total serum cortisol measurements. This analysis confirms the reliability of the saliva cortisol assay as pragmatic tool for the accurate diagnosis of Cushing syndrome. With many countries reporting a rising prevalence of metabolic syndrome, diabetes and obesity--in which there is often a high circulating cortisol level--salivary cortisol measurement will help distinguish these states from Cushing syndrome.

Exergoeconomic analysis of small-scale biomass steam cogeneration

Energy Technology Data Exchange (ETDEWEB)

Rodriguez Sotomonte, Cesar Adolfo; Lora, Electo Eduardo Silva [Universidade Federal de Itajuba, MG (Brazil)], e-mails: c.rodriguez32@unifei.edu.br, electo@unifei.edu.br; Venturini, Osvaldo Jose; Escobar, Jose Carlos [Universidad Federal de Itajuba, MG (Brazil)], e-mail: osvaldo@unifei.edu.br

2010-07-01

The principal objective of this work is to develop a calculation process, based on the second law of thermodynamics, for evaluating the thermoeconomic potential of a small steam cogeneration plant using waste from pulp processing and/or sawmills as fuel. Four different configurations are presented and assessed. The exergetic efficiency of the cycles that use condensing turbines is found to be around 11%, which has almost 3 percent higher efficiency than cycles with back pressure turbines. The thermoeconomic equations used in this paper estimated the production costs varying the fuel price. The main results show that present cost of technologies in a small-scale steam cycle cogeneration do not justify the implementation of more efficient systems for biomass prices less than 100 R$/t. (author)

Prenatal diagnosis in Sweden: organisation and current issues.

Science.gov (United States)

Bui, T H; Kristoffersson, U

1997-01-01

Invasive prenatal diagnosis was introduced in Sweden in the early 1970s and is an integral part of the public health care system. Funding is provided by taxation; the patient only pays a consultation fee. Genetic analyses on a broad range of cytogenetic and molecular disorders are performed at the 6 university-affiliated hospitals and in 1 county hospital. About 6% of all newborns have been cytogenetically screened during pregnancy, and about 90% of the analyses are performed after amniocentesis. The main indication is chromosome analysis because of advanced maternal age.

Invasive candidiasis: future directions in non-culture based diagnosis.

Science.gov (United States)

Posch, Wilfried; Heimdörfer, David; Wilflingseder, Doris; Lass-Flörl, Cornelia

2017-09-01

Delayed initial antifungal therapy is associated with high mortality rates caused by invasive candida infections, since accurate detection of the opportunistic pathogenic yeast and its identification display a diagnostic challenge. diagnosis of candida infections relies on time-consuming methods such as blood cultures, serologic and histopathologic examination. to allow for fast detection and characterization of invasive candidiasis, there is a need to improve diagnostic tools. trends in diagnostics switch to non-culture-based methods, which allow specified diagnosis within significantly shorter periods of time in order to provide early and appropriate antifungal treatment. Areas covered: within this review comprise novel pathogen- and host-related testing methods, e.g. multiplex-PCR analyses, T2 magnetic resonance, fungus-specific DNA microarrays, microRNA characterization or analyses of IL-17 as biomarker for early detection of invasive candidiasis. Expert commentary: Early recognition and diagnosis of fungal infections is a key issue for improved patient management. As shown in this review, a broad range of novel molecular based tests for the detection and identification of Candida species is available. However, several assays are in-house assays and lack standardization, clinical validation as well as data on sensitivity and specificity. This underscores the need for the development of faster and more accurate diagnostic tests.

Radiation diagnosis in fibroadenomas of various histological structure

International Nuclear Information System (INIS)

Kharchenko, V.P.; Rozhkova, N.I.; Meskikh, E.V.

1999-01-01

To improve the efficiency of preoperational diagnosis of fibroadenomas of different histological structure the results of examination of 500 women with mammary gland diseases are generalized. Manifestations of fibroadenomas depending on different diagnostic techniques used are studied as well as their morphological features. Potentialities and results of surgical treatment are analysed [ru

A model of energy management analysis, case study of a sugar ...

Indian Academy of Sciences (India)

Tolga Taner

2018-03-19

Mar 19, 2018 ... 1 Department of Motor Vehicles and Transportation Technology, Vocational School of Technical Sciences,. Aksaray .... energy performance data as being important to national ...... definition is the key of thermoeconomic.

Thermo-economic assessment of the integration of steam cycles on offshore platforms

DEFF Research Database (Denmark)

Nguyen, Tuong-Van; Tock, Laurence; Breuhaus, Peter

2014-01-01

thermodynamic and economic performance indicators. The results illustrate the benefits of converting the gas turbines into a combined cycle. Using seawater results in smaller power generation and greater CO2-emissions than using process water, as the additional power generation in the combined cycle......The integration of steam bottoming cycles on oil platforms is often seen as a possible route to mitigate the CO2-emissions offshore. In this paper, a North Sea platform and its energy requirements are systematically analysed. The site-scale integration of steam networks is assessed by using...... is compensated by the significant pumping demand. This work emphasises that energy improvement efforts should be analysed at the scale of the overall site and not solely at the level of the combined cycle....

Application of power spectrum, cepstrum, higher order spectrum and neural network analyses for induction motor fault diagnosis

Science.gov (United States)

Liang, B.; Iwnicki, S. D.; Zhao, Y.

2013-08-01

The power spectrum is defined as the square of the magnitude of the Fourier transform (FT) of a signal. The advantage of FT analysis is that it allows the decomposition of a signal into individual periodic frequency components and establishes the relative intensity of each component. It is the most commonly used signal processing technique today. If the same principle is applied for the detection of periodicity components in a Fourier spectrum, the process is called the cepstrum analysis. Cepstrum analysis is a very useful tool for detection families of harmonics with uniform spacing or the families of sidebands commonly found in gearbox, bearing and engine vibration fault spectra. Higher order spectra (HOS) (also known as polyspectra) consist of higher order moment of spectra which are able to detect non-linear interactions between frequency components. For HOS, the most commonly used is the bispectrum. The bispectrum is the third-order frequency domain measure, which contains information that standard power spectral analysis techniques cannot provide. It is well known that neural networks can represent complex non-linear relationships, and therefore they are extremely useful for fault identification and classification. This paper presents an application of power spectrum, cepstrum, bispectrum and neural network for fault pattern extraction of induction motors. The potential for using the power spectrum, cepstrum, bispectrum and neural network as a means for differentiating between healthy and faulty induction motor operation is examined. A series of experiments is done and the advantages and disadvantages between them are discussed. It has been found that a combination of power spectrum, cepstrum and bispectrum plus neural network analyses could be a very useful tool for condition monitoring and fault diagnosis of induction motors.

Educational Needs and Causes of False Diagnosis of Atypical ...

African Journals Online (AJOL)

Erah

The entity of atypical squamous cells of undetermined significance (ASCUS) in The Bethesda System 2001 for reporting cervical cytology is characterized by equivocal diagnosis, poor reproducibility and debatable management. This retrospective study was done to analyse the causes of false ASCUS if any and identify the ...

Chronic and episodic stress predict physical symptom bother following breast cancer diagnosis.

Science.gov (United States)

Harris, Lauren N; Bauer, Margaret R; Wiley, Joshua F; Hammen, Constance; Krull, Jennifer L; Crespi, Catherine M; Weihs, Karen L; Stanton, Annette L

2017-12-01

Breast cancer patients often experience adverse physical side effects of medical treatments. According to the biobehavioral model of cancer stress and disease, life stress during diagnosis and treatment may negatively influence the trajectory of women's physical health-related adjustment to breast cancer. This longitudinal study examined chronic and episodic stress as predictors of bothersome physical symptoms during the year after breast cancer diagnosis. Women diagnosed with breast cancer in the previous 4 months (N = 460) completed a life stress interview for contextual assessment of chronic and episodic stress severity at study entry and 9 months later. Physical symptom bother (e.g., pain, fatigue) was measured at study entry, every 6 weeks through 6 months, and at nine and 12 months. In multilevel structural equation modeling (MSEM) analyses, both chronic stress and episodic stress occurring shortly after diagnosis predicted greater physical symptom bother over the study period. Episodic stress reported to have occurred prior to diagnosis did not predict symptom bother in MSEM analyses, and the interaction between chronic and episodic stress on symptom bother was not significant. Results suggest that ongoing chronic stress and episodic stress occurring shortly after breast cancer diagnosis are important predictors of bothersome symptoms during and after cancer treatment. Screening for chronic stress and recent stressful life events in the months following diagnosis may help to identify breast cancer patients at risk for persistent and bothersome physical symptoms. Interventions to prevent or ameliorate treatment-related physical symptoms may confer added benefit by addressing ongoing non-cancer-related stress in women's lives.

Molecular diagnosis of multiple endocrine neoplasia type 2A ...

African Journals Online (AJOL)

Molecular diagnosis of multiple endocrine neoplasia type 2A. RJ Pegoraro, DJ Hacking, RH Buck, L Rom, PA Lanning, GMB Berger. Abstract. Objective. To identify by means of genetic analyses individuals who are at risk of developing medullary thyroid cancer that is a component of multiple endocrine neoplasia. Subjects.

Diagnosis and fault-tolerant control

CERN Document Server

Blanke, Mogens; Lunze, Jan; Staroswiecki, Marcel

2016-01-01

Fault-tolerant control aims at a gradual shutdown response in automated systems when faults occur. It satisfies the industrial demand for enhanced availability and safety, in contrast to traditional reactions to faults, which bring about sudden shutdowns and loss of availability. The book presents effective model-based analysis and design methods for fault diagnosis and fault-tolerant control. Architectural and structural models are used to analyse the propagation of the fault through the process, to test the fault detectability and to find the redundancies in the process that can be used to ensure fault tolerance. It also introduces design methods suitable for diagnostic systems and fault-tolerant controllers for continuous processes that are described by analytical models of discrete-event systems represented by automata. The book is suitable for engineering students, engineers in industry and researchers who wish to get an overview of the variety of approaches to process diagnosis and fault-tolerant contro...

Alternative energies updates on progress

CERN Document Server

Ferreira, Germán

2013-01-01

This book examines the key pillars of alternative energy, including biomass, hydrogen, solar and geothermal. It features life cycle assessment and thermoeconomic analysis as tools for evaluating and optimising environmental and cost subjects.

Clinical diagnosis versus autopsy diagnosis in head trauma

Directory of Open Access Journals (Sweden)

Velnic Andreea-Alexandra

2017-12-01

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

Molecular analysis for diagnosis of Marfan syndrome and Marfan-associated disorders

Institute of Scientific and Technical Information of China (English)

GAO Ling-gen; YAO Xiu-ping; ZHANG Lin; HUI Ru-tai; ZHOU Xian-liang

2011-01-01

Marfan syndrome is a systemic disorder of connective tissue, caused by mutations in the FBN1, TGFBR1 or TGFBR2 genes. This syndrome is characterized by involvement of three major systems, skeletal, ocular, and cardiovascular. The continuing improvements in molecular biology and increasing availability of molecular diagnosis in clinical practice allow recognition of Marfan syndrome in patients with incomplete phenotypes. Additionally, molecular analyses could also be used for preimplantation genetic diagnosis. The identification of a mutation allows for early diagnosis, prognosis, genetic counseling, preventive management of carriers and reassurance for unaffected relatives. The importance of knowing in advance the location of the putative family mutation is highlighted by its straightforward application to prenatal and postnatal screening.

Anterior chamber paracentesis to improve diagnosis and treatment of infectious uveitis in South Africa.

Science.gov (United States)

Schaftenaar, Erik; Lecuona, Karin; Baarsma, Seerp; Meenken, Christina; Verjans, Georges; McIntyre, James; Peters, Remco

2015-09-22

Infectious uveitis is a significant cause of blindness in South Africa, especially among HIV-infected individuals. The visual outcome of uveitis depends on early clinical and laboratory diagnosis to guide therapeutic intervention. Analyses of aqueous humor, obtained by anterior chamber paracentesis, directs the differential diagnosis in infectious uveitis. However, although safe and potentially cost-effective, diagnostic anterior chamber paracentesis is not common practice in ophthalmic care across Africa. We seek to draw attention to this important procedure that could improve the diagnosis and prognosis of infectious uveitis.

[Methods, challenges and opportunities for big data analyses of microbiome].

Science.gov (United States)

Sheng, Hua-Fang; Zhou, Hong-Wei

2015-07-01

Microbiome is a novel research field related with a variety of chronic inflamatory diseases. Technically, there are two major approaches to analysis of microbiome: metataxonome by sequencing the 16S rRNA variable tags, and metagenome by shot-gun sequencing of the total microbial (mainly bacterial) genome mixture. The 16S rRNA sequencing analyses pipeline includes sequence quality control, diversity analyses, taxonomy and statistics; metagenome analyses further includes gene annotation and functional analyses. With the development of the sequencing techniques, the cost of sequencing will decrease, and big data analyses will become the central task. Data standardization, accumulation, modeling and disease prediction are crucial for future exploit of these data. Meanwhile, the information property in these data, and the functional verification with culture-dependent and culture-independent experiments remain the focus in future research. Studies of human microbiome will bring a better understanding of the relations between the human body and the microbiome, especially in the context of disease diagnosis and therapy, which promise rich research opportunities.

Diagnosis of moderate acute radiation sickness

International Nuclear Information System (INIS)

Yu Shoucheng; Chen Zhijian; Chen Youxin

1989-01-01

Forty patients with malignant lymphoma were given 60 Co TLI. 21 cases received 6 Gy and 19 received 8 Gy. It was estimated that a single TLI of 6 and 8 Gy would correspond to TBI of 3.55 Gy and 4.25 Gy (average values) by analysing peripheral blood cell chromosome aberrations and 1.85-2.37 Gy by measuring red bone marrow stem cells clinically. Moderate acute radiation sickness with digestive tract reaction and hemopoietic and immunologic depression was observed. WBC and platelets decreased rapidly. Lymphocytes showed quantitative and qualitative changes even at early stage. All these indexes are significant for diagnosis. Besides, the degree of labial stimulation response, levels of C-reactive protein, corticoid, and urinal nucleoside and alkaloid base presented great changes both pre-and post-irradiation. Early diagnosis of moderate acute radiation sickness could be made in cancer patients subjected to 6-8 Gy TLI

Stages of syphilis in South China - a multilevel analysis of early diagnosis.

Science.gov (United States)

Wong, Ngai Sze; Huang, Shujie; Zheng, Heping; Chen, Lei; Zhao, Peizhen; Tucker, Joseph D; Yang, Li Gang; Goh, Beng Tin; Yang, Bin

2017-01-31

Early diagnosis of syphilis and timely treatment can effectively reduce ongoing syphilis transmission and morbidity. We examined the factors associated with the early diagnosis of syphilis to inform syphilis screening strategic planning. In an observational study, we analyzed reported syphilis cases in Guangdong Province, China (from 2014 to mid-2015) accessed from the national case-based surveillance system. We categorized primary and secondary syphilis cases as early diagnosis and categorized latent and tertiary syphilis as delayed diagnosis. Univariate analyses and multivariable logistic regressions were performed to identify the factors associated with early diagnosis. We also examined the factors associated with early diagnosis at the individual and city levels in multilevel logistic regression models with cases nested by city (n = 21), adjusted for age at diagnosis and gender. Among 83,944 diagnosed syphilis cases, 22% were early diagnoses. The city-level early diagnosis rate ranged from 7 to 46%, consistent with substantial geographic variation as shown in the multilevel model. Early diagnosis was associated with cases presenting to specialist clinics for screening, being male and attaining higher education level. Cases received syphilis testing in institutions and hospitals, and diagnosed in hospitals were less likely to be in early diagnosis. At the city-level, cases living in a city equipped with more hospitals per capita were less likely to be early diagnosis. To enhance early diagnosis of syphilis, city-specific syphilis screening strategies with a mix of passive and client/provider-initiated testing might be a useful approach.

Urinary Tract Infections in Pregnancy - Diagnosis, Treatment and Prevention

OpenAIRE

Figueiredo, A; Gomes, G; Campos, A

2012-01-01

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

Preimplantation Genetic Diagnosis: The Situation in France and in Other European Countries.

Science.gov (United States)

Duguet, Anne-Marie; Boyer-Beviere, Bénédicte

2017-04-01

Preimplantation genetic diagnosis (PGD) relates exclusively to in vitro fertilisation techniques (IVF) that aim to prevent transmission of a serious genetic abnormality to the child. The genetic characteristics of the embryo created through IVF are analysed, and only the embryos free of the genetic abnormality are implanted in the womb. Performed worldwide since 1990, this technique has raised many legal and ethical debates due to the very wide variations of lawgiving between countries. This is shown by the report of the UNESCO IBC (2003), which described the techniques and the issues raised by preimplantation genetic diagnosis. In this article, the authors present the differences between prenatal diagnosis and preimplantation genetic diagnosis, the French legislation, then the range of legislation in Europe and finally the position of the European Court of Human Rights which sanctioned Italy and Latvia for refusing access to PGD.

Mirizzi syndrome: A sonographic diagnosis

International Nuclear Information System (INIS)

Tscholakoff, D.; Salomonowitz, E.; Czembirek, H.; Leitner, H.; Haller, J.; Wittich, G.; Vienna Univ.

1984-01-01

The ultrasound appearances of 11 patients with operatively confirmed Mirizzi syndrome have been analysed. The trio 'dilated intrahepatic bile ducts, concretions in the neighbourhood of the dilated common hepatic duct with a normal distal duct' permit the diagnosis of the Mirizzi syndrome with considerable certainty. In five patients these features were found by sonography and no other diagnostic procedure was necessary. In six patients, ERC was carried out in order to evaluate the distal common bile duct. In one case PTC was carried out, since the liver hilum could not be seen on sonography. (orig.) [de

The Preimplantation Genetic Diagnosis: Legal Aspects in the Spanish Law

Directory of Open Access Journals (Sweden)

Marina Moya González

2018-03-01

Full Text Available This paper analyses the preimplantation genetic diagnosis (PGD in Spain, and the legal aspects. It exposes the technical characteristics, as well as the ethical and social consequences. It compares the different rules of law about assisted human reproduction techniques in Spain, and those in some European countries.

Hydrogen production system from photovoltaic panels: experimental characterization and size optimization

International Nuclear Information System (INIS)

Ferrari, M.L.; Rivarolo, M.; Massardo, A.F.

2016-01-01

Highlights: • Plant optimization for hydrogen generation from renewable sources. • Experimental tests on a 42 kW alkaline electrolyser. • Time-dependent hierarchical thermo-economic optimization. • Italian case for electricity costs and solar irradiation (Savona). - Abstract: In this paper an approach for the determination of the optimal size and management of a plant for hydrogen production from renewable source (photovoltaic panels) is presented. Hydrogen is produced by a pressurized alkaline electrolyser (42 kW) installed at the University Campus of Savona (Italy) in 2014 and fed by electrical energy produced by photovoltaic panels. Experimental tests have been carried out in order to analyze the performance curve of the electrolyser in different operative conditions, investigating the influence of the different parameters on the efficiency. The results have been implemented in a software tool in order to describe the behavior of the systems in off-design conditions. Since the electrical energy produced by photovoltaic panels and used to feed the electrolyser is strongly variable because of the random nature of the solar irradiance, a time-dependent hierarchical thermo-economic analysis is carried out to evaluate both the optimal size and the management approach related to the system, considering a fixed size of 1 MW for the photovoltaic panels. The thermo-economic analysis is performed with the software tool W-ECoMP, developed by the authors’ research group: the Italian energy scenario is considered, investigating the impact of electricity cost on the results as well.

Diagnosis of condensation-induced waterhammer: Case studies

International Nuclear Information System (INIS)

Izenson, M.G.; Rothe, P.H.; Wallis, G.B.

1988-10-01

This guidebook provides reference material and diagnostic procedures concerning condensation-induced waterhammer in nuclear power plants. Condensation-induced waterhammer is the most damaging form of waterhammer, and its diagnosis is complicated by the complex nature of the underlying phenomena. In Volume 1, the guidebook groups condensation-induced waterhammers into five event classes which have similar phenomena and levels of damage. Diagnostic guidelines focus on locating the event center where condensation and slug acceleration take place. Diagnosis is described in three stages: an initial assessment, detailed evaluation and final confirmation. Graphical scoping analyses are provided to evaluate whether an event from one of the event classes could have occurred at the event center. Examples are provided for each type of waterhammer. Special instructions are provided for walking down damaged piping and evaluating damage due to waterhammer. To illustrate the diagnostic methods and document past experience, six case studies have been compiled in Volume 2. These case studies, based on actual condensation-induced waterhammer events at nuclear plants, present detailed data and work through the event diagnosis using the tools introduced in the first volume. 20 refs., 21 figs., 6 tabs

Psychiatric diagnosis and aggression before acute hospitalisation.

Science.gov (United States)

Colasanti, A; Natoli, A; Moliterno, D; Rossattini, M; De Gaspari, I F; Mauri, M C

2008-09-01

To examine the predictors of aggressive behaviours occurring before acute hospitalisation. We analysed 350 acute admissions to a psychiatric ward during a 12-month period. The diagnoses were formulated according to the DSM IV axis I and II criteria. Aggressive behaviours occurring in the week before admission were retrospectively assessed using the modified overt aggression scale. The patients' clinical and sociodemographic variables, concurrent drug or alcohol abuse, and admission status were recorded at the time of admission. Aggressive and violent behaviours were highly prevalent, respectively, in 45% and 33% of the cases. Violence before admission was independently associated with drug abuse, involuntary admission status, and severe psychopathology. A diagnosis of a psychotic disorder did not increase the risk of aggression or violence, compared to the other psychiatric diagnoses. Personality disorders were significantly more associated to aggressive behaviours than psychotic disorders. The diagnosis of psychotic disorder is a poor predictor of aggression in a sample of psychiatric patients. Other clinical and non-clinical variables are associated to aggression before hospitalisation: they include drug abuse, involuntary admission status, general severity of symptoms, and diagnosis of personality disorder.

Diagnosis of Swimming Induced Pulmonary Edema—A Review

Science.gov (United States)

Grünig, Hannes; Nikolaidis, Pantelis T.; Moon, Richard E.; Knechtle, Beat

2017-01-01

Swimming induced pulmonary edema (SIPE) is a complication that can occur during exercise with the possibility of misdiagnosis and can quickly become life threatening; however, medical literature infrequently describes SIPE. Therefore, the aim of this review was to analyse all individual cases diagnosed with SIPE as reported in scientific sources, with an emphasis on the diagnostic pathways and the key facts resulting in its diagnosis. Due to a multifactorial and complicated pathophysiology, the diagnosis could be difficult. Based on the actual literature, we try to point out important findings regarding history, conditions, clinical findings, and diagnostic testing helping to confirm the diagnosis of SIPE. Thirty-eight cases from seventeen articles reporting the diagnosis of SIPE were selected. We found remarkable differences in the individual described diagnostic pathways. A total of 100% of the cases suffered from an acute onset of breathing problems, occasionally accompanied by hemoptysis. A total of 73% showed initial hypoxemia. In most of the cases (89%), an initial chest X-Ray or chest CT was available, of which one-third (71%) showed radiological signs of pulmonary edema. The majority of the cases (82%) experienced a rapid resolution of symptoms within 48 h, the diagnostic hallmark of SIPE. Due to a foreseeable increase in participation in swimming competitions and endurance competitions with a swimming component, diagnosis of SIPE will be important, especially for medical teams caring for these athletes. PMID:28912730

Clinical diagnosis and computer analysis of headache symptoms.

OpenAIRE

Drummond, P D; Lance, J W

1984-01-01

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

Life-cycle cost analysis of adsorption cycles for desalination

KAUST Repository

Thu, Kyaw; Chakraborty, A.; Saha, B.B.; Chun, Won Gee; Ng, K.C.

2010-01-01

This paper presents the thermo-economic analysis of the adsorption desalination (AD) cycle that is driven by low-temperature waste heat from exhaust of industrial processes or renewable sources. The AD cycle uses an adsorbent such as the silica gel

Rolling Bearing Fault Diagnosis Based on an Improved HTT Transform.

Science.gov (United States)

Pang, Bin; Tang, Guiji; Tian, Tian; Zhou, Chong

2018-04-14

When rolling bearing failure occurs, vibration signals generally contain different signal components, such as impulsive fault feature signals, background noise and harmonic interference signals. One of the most challenging aspects of rolling bearing fault diagnosis is how to inhibit noise and harmonic interference signals, while enhancing impulsive fault feature signals. This paper presents a novel bearing fault diagnosis method, namely an improved Hilbert time-time (IHTT) transform, by combining a Hilbert time-time (HTT) transform with principal component analysis (PCA). Firstly, the HTT transform was performed on vibration signals to derive a HTT transform matrix. Then, PCA was employed to de-noise the HTT transform matrix in order to improve the robustness of the HTT transform. Finally, the diagonal time series of the de-noised HTT transform matrix was extracted as the enhanced impulsive fault feature signal and the contained fault characteristic information was identified through further analyses of amplitude and envelope spectrums. Both simulated and experimental analyses validated the superiority of the presented method for detecting bearing failures.

Mastocytosis and insect venom allergy : diagnosis, safety and efficacy of venom immunotherapy

NARCIS (Netherlands)

Niedoszytko, M.; de Monchy, J.; van Doormaal, J. J.; Jassem, E.; Oude Elberink, J. N. G.

The most important causative factor for anaphylaxis in mastocytosis are insect stings. The purpose of this review is to analyse the available data concerning prevalence, diagnosis, safety and effectiveness of venom immunotherapy (VIT) in mastocytosis patients. If data were unclear, authors were

[Molecular diagnostic methods of respiratory infections. Has the scheme diagnosis changed?].

Science.gov (United States)

Vila Estapé, Jordi; Zboromyrska, Yuliya; Vergara Gómez, Andrea; Alejo Cancho, Izaskun; Rubio García, Elisa; Álvarez-Martínez, Miriam José; la Bellacasa Brugada, Jorge Puig de; Marcos Maeso, M Ángeles

2016-07-01

Lower respiratory tract infections remain one of the most common causes of mortality worldwide, which is why early diagnosis is crucial. Traditionally the microbiological diagnosis of these infections has been based on conventional methods including culture on artificial media for isolation of bacteria and fungi and cell cultures for virus and antibody or antigen detection using antigen-antibody reactions. The main drawback of the above mentioned methods is the time needed for an etiological diagnosis of the infection. The techniques based on molecular biology have drawn much attention in recent decades as tools for rapid diagnosis of infections. Some techniques are very expensive, especially those that can detect various microorganisms in the same reaction, therefore the question that arises is whether the cost of such testing is justified by the information obtained and by the clinical impact that its implementation will determine. In this article we make a review of the various techniques of molecular biology applied to the diagnosis of pneumonia and focus primarily on analysing the impact they may have on the management of patients with acute respiratory tract infections. Copyright © 2016 Elsevier España, S.L.U. All rights reserved.

Hospital diagnosis of malnutrition: a call for action.

Science.gov (United States)

Bocock, Mary Ann; Keller, Heather H

2009-01-01

The Canadian Institute for Health Information (CIHI) provides accurate health information needed to establish sound health care policies. The CIHI mandate is to develop and co-ordinate a uniform approach to health care information in Canada. The institute uses the International Classification of Diseases (ICD) system to record the most responsible diagnosis for each hospital admission. This investigation was conducted to determine if six ICD protein-calorie malnutrition (PCM) codes could be used for health care utilization analyses. Aggregate data (1996 to 2000) from the CIHI discharge abstract database were used. The data analyzed were the most responsible diagnoses data for the six PCM codes and a single summary statistic for all other "non-malnutrition" diagnoses for all long-term care facility residents aged 65 or older who were transferred to an acute care facility. In this population, fewer than five hospital admissions per year were assigned a PCM code. There were too few PCM cases to do trend analyses for morbidity or mortality. This study suggests a lack of recognition and documentation of PCM as a specific health condition in older adults. Lack of tracking of this diagnosis prevents documentation that could lead to policy changes to support older adults' nutrition.

Logarithmic Similarity Measure between Interval-Valued Fuzzy Sets and Its Fault Diagnosis Method

Directory of Open Access Journals (Sweden)

Zhikang Lu

2018-02-01

Full Text Available Fault diagnosis is an important task for the normal operation and maintenance of equipment. In many real situations, the diagnosis data cannot provide deterministic values and are usually imprecise or uncertain. Thus, interval-valued fuzzy sets (IVFSs are very suitable for expressing imprecise or uncertain fault information in real problems. However, existing literature scarcely deals with fault diagnosis problems, such as gasoline engines and steam turbines with IVFSs. However, the similarity measure is one of the important tools in fault diagnoses. Therefore, this paper proposes a new similarity measure of IVFSs based on logarithmic function and its fault diagnosis method for the first time. By the logarithmic similarity measure between the fault knowledge and some diagnosis-testing samples with interval-valued fuzzy information and its relation indices, we can determine the fault type and ranking order of faults corresponding to the relation indices. Then, the misfire fault diagnosis of the gasoline engine and the vibrational fault diagnosis of a turbine are presented to demonstrate the simplicity and effectiveness of the proposed diagnosis method. The fault diagnosis results of gasoline engine and steam turbine show that the proposed diagnosis method not only gives the main fault types of the gasoline engine and steam turbine but also provides useful information for multi-fault analyses and predicting future fault trends. Hence, the logarithmic similarity measure and its fault diagnosis method are main contributions in this study and they provide a useful new way for the fault diagnosis with interval-valued fuzzy information.

Stages of syphilis in South China – a multilevel analysis of early diagnosis

Directory of Open Access Journals (Sweden)

Ngai Sze Wong

2017-01-01

Full Text Available Abstract Background Early diagnosis of syphilis and timely treatment can effectively reduce ongoing syphilis transmission and morbidity. We examined the factors associated with the early diagnosis of syphilis to inform syphilis screening strategic planning. Methods In an observational study, we analyzed reported syphilis cases in Guangdong Province, China (from 2014 to mid-2015 accessed from the national case-based surveillance system. We categorized primary and secondary syphilis cases as early diagnosis and categorized latent and tertiary syphilis as delayed diagnosis. Univariate analyses and multivariable logistic regressions were performed to identify the factors associated with early diagnosis. We also examined the factors associated with early diagnosis at the individual and city levels in multilevel logistic regression models with cases nested by city (n = 21, adjusted for age at diagnosis and gender. Results Among 83,944 diagnosed syphilis cases, 22% were early diagnoses. The city-level early diagnosis rate ranged from 7 to 46%, consistent with substantial geographic variation as shown in the multilevel model. Early diagnosis was associated with cases presenting to specialist clinics for screening, being male and attaining higher education level. Cases received syphilis testing in institutions and hospitals, and diagnosed in hospitals were less likely to be in early diagnosis. At the city-level, cases living in a city equipped with more hospitals per capita were less likely to be early diagnosis. Conclusions To enhance early diagnosis of syphilis, city-specific syphilis screening strategies with a mix of passive and client/provider-initiated testing might be a useful approach.

Ultrasonographic diagnosis of acute appendicitis

International Nuclear Information System (INIS)

Lee, Sang Hun; Chang, Young Duk; Kim, Dae Ho; Lee, Hae Kyung; Kwon, Kui Hyang; Kim, Ki Jung

1988-01-01

Acute appendicitis is the most common surgical disease of acute abdomen, But the diagnosis of acute appendicitis is often difficult, and not in frequently, operation for appendicitis is performed only to find a normal appendix. Various radiological examinations have been proposed to improve diagnostic accuracy of appendicitis. The purpose of this study was to improve the diagnostic accuracy of appendicitis, and to decline negative exploration. High resolution real time ultrasonographical examination using graded compression was performed in 57 consecutive patients who were clinically suspected of appendicitis. Autors analysed ultrasonographical, surgical, and clinical follow up findings. The results were are follows: 1. Ultrasonographical finding of acute appendicitis was visualization of appendix as a tubular structure with one bline end, or target phenomenon. 2. Hypoechoic area over the appendix was thought to be a sign of periappendiceal abscess. 3. The sensitivity of US diagnosis of acute appendicitis in this study was 92.8% with a specificity of 93.1%. The overall accuracy was 93.0%. 4. In control group of 50 individuals, the abnormal appendix was not visualized. 5. In cases of clinically suspected appendicitis, the US evaluation with graded compression technique is very accurate and effective examination.

Under-diagnosis of mood disorders in Canada.

Science.gov (United States)

Pelletier, L; O'Donnell, S; Dykxhoorn, J; McRae, L; Patten, S B

2017-08-01

Under-diagnosis of mood disorders occurs worldwide. In this study, we characterized and compared Canadians with symptoms compatible with a mood disorder by diagnosis status; and described the associated health impacts, use of health services and perceived need for care. Respondents to the 2012 Canadian Community Health Survey - Mental Health, a nationally representative sample of Canadians age ≥15 years were assessed for symptoms compatible with mood disorders based on a Canadian adaptation of the World Health Organization Composite International Diagnostic Interview (n = 23 504). Descriptive and multivariate regression analyses were performed. In 2012, an estimated 5.4% (1.5 million) Canadians aged 15 years and older reported symptoms compatible with a mood disorder, of which only half reported having been professionally diagnosed. The undiagnosed individuals were more likely to be younger (mean age: 36.2 v. 41.8), to be single (49.5 v. 32.7%), to have less than a post-secondary graduation (49.8 v. 41.1%) and to have no physical co-morbidities (56.4 v. 35.7%), and less likely to be part of the two lower income quintiles (49.6 v. 62.7%) compared with those with a previous diagnosis. Upon controlling for all socio-demographic and health characteristics, the associations with age and marital status disappeared. While those with a previous diagnosis reported significantly greater health impacts and were more likely to have consulted a health professional for their emotional and mental health problems in the previous 12 months compared with those undiagnosed (79.4 v. 31.0%), about a third of both groups reported that their health care needs were only partially met or not met at all. Mood disorders are prevalent and can profoundly impact the life of those affected, however, their diagnosis remains suboptimal and health care use falls short of apparent needs. Improvements in mental health literacy, help-seeking behaviours and diagnosis are needed. In light of the

Diagnosis of primary ciliary dyskinesia: potential options for resource-limited countries

Directory of Open Access Journals (Sweden)

Nisreen Rumman

2017-01-01

Full Text Available Primary ciliary dyskinesia is a genetic disease of ciliary function leading to chronic upper and lower respiratory tract symptoms. The diagnosis is frequently overlooked because the symptoms are nonspecific and the knowledge about the disease in the primary care setting is poor. Additionally, none of the available tests is accurate enough to be used in isolation. These tests are expensive, and need sophisticated equipment and expertise to analyse and interpret results; diagnosis is therefore only available at highly specialised centres. The diagnosis is particularly challenging in countries with limited resources due to the lack of such costly equipment and expertise. In this review, we discuss the importance of early and accurate diagnosis especially for countries where the disease is clinically prevalent but diagnostic tests are lacking. We review the diagnostic tests available in specialised centres (nasal nitric oxide, high-speed video microscopy, transmission electron microscopy, immunofluorescence and genetics. We then consider modifications that might be considered in less well-resourced countries whilst maintaining acceptable accuracy.

Emergency electroencephalogram: Usefulness in the diagnosis of nonconvulsive status epilepticus by the on-call neurologist.

Science.gov (United States)

Máñez Miró, J U; Díaz de Terán, F J; Alonso Singer, P; Aguilar-Amat Prior, M J

2018-03-01

We aim to describe the use of emergency electroencephalogram (EmEEG) by the on-call neurologist when nonconvulsive status epilepticus (NCSE) is suspected, and in other indications, in a tertiary hospital. Observational retrospective cohort study of emergency EEG (EmEEG) recordings with 8-channel systems performed and analysed by the on-call neurologist in the emergency department and in-hospital wards between July 2013 and May 2015. Variables recorded were sex, age, symptoms, first diagnosis, previous seizure and cause, previous stroke, cancer, brain computed tomography, diagnosis after EEG, treatment, patient progress, routine control EEG (rEEG), and final diagnosis. We analysed frequency data, sensitivity, and specificity in the diagnosis of NCSE. The study included 135 EEG recordings performed in 129 patients; 51.4% were men and their median age was 69 years. In 112 cases (83%), doctors ruled out suspected NCSE because of altered level of consciousness in 42 (37.5%), behavioural abnormalities in 38 (33.9%), and aphasia in 32 (28.5%). The EmEEG diagnosis was NCSE in 37 patients (33%), and this was confirmed in 35 (94.6%) as the final diagnosis. In 3 other cases, NCSE was the diagnosis on discharge as confirmed by rEEG although the EmEEG missed this condition at first. EmEEG performed to rule out NCSE showed 92.1% sensitivity, 97.2% specificity, a positive predictive value of 94.6%, and a negative predictive value of 96%. Our experience finds that, in an appropriate clinical context, EmEEG performed by the on-call neurologist is a sensitive and specific tool for diagnosing NCSE. Copyright © 2016 Sociedad Española de Neurología. Publicado por Elsevier España, S.L.U. All rights reserved.

Diagnosis of condensation-induced waterhammer: Methods and background

International Nuclear Information System (INIS)

Izenson, M.G.; Rothe, P.H.; Wallis, G.B.

1988-10-01

This guidebook provides reference material and diagnostic procedures concerning condensation-induced waterhammer in nuclear power plants. Condensation-induced waterhammer is the most damaging form of waterhammer and its diagnosis is complicated by the complex nature of the underlying phenomena. In Volume 1, the guidebook groups condensation-induced waterhammers into five event classes which have similar phenomena and levels of damage. Diagnostic guidelines focus on locating the event center where condensation and slug acceleration take place. Diagnosis is described in three stages: an initial assessment, detailed evaluation and final confirmation. Graphical scoping analyses are provided to evaluate whether an event from one of the event classes could have occurred at the event center. Examples are provided for each type of waterhammer. Special instructions are provided for walking down damaged piping and evaluating damage due to waterhammer. To illustrate the diagnostic methods and document past experience, six case studies have been compiled in Volume 2. These case studies, based on actual condensation-induced waterhammer events at nuclear plants, present detailed data and work through the event diagnosis using the tools introduced in the first volume. 65 figs., 8 tabs

Broken-Rotor-Bar Diagnosis for Induction Motors

International Nuclear Information System (INIS)

Wang Jinjiang; Gao, Robert X; Yan Ruqiang

2011-01-01

Broken rotor bar is one of the commonly encountered induction motor faults that may cause serious motor damage to the motor if not detected timely. Past efforts on broken rotor bar diagnosis have been focused on current signature analysis using spectral analysis and wavelet transform. These methods require accurate slip estimation to localize fault-related frequency. This paper presents a new approach to broken rotor bar diagnosis without slip estimation, based on the ensemble empirical mode decomposition (EEMD) and the Hilbert transform. Specifically, the Hilbert transform first extracts the envelope of the motor current signal, which contains broken rotor fault-related frequency information. Subsequently, the envelope signal is adaptively decomposed into a number of intrinsic mode functions (IMFs) by the EEMD algorithm. Two criteria based on the energy and correlation analyses have been investigated to automate the IMF selection. Numerical and experimental studies have confirmed that the proposed approach is effective in diagnosing broken rotor bar faults for improved induction motor condition monitoring and damage assessment.

Brain MR Contribution to the Differential Diagnosis of Parkinsonian Syndromes: An Update

Directory of Open Access Journals (Sweden)

Giovanni Rizzo

2016-01-01

Full Text Available Brain magnetic resonance (MR represents a useful and feasible tool for the differential diagnosis of Parkinson’s disease. Conventional MR may reveal secondary forms of parkinsonism and may show peculiar brain alterations of atypical parkinsonian syndromes. Furthermore, advanced MR techniques, such as morphometric-volumetric analyses, diffusion-weighted imaging, diffusion tensor imaging, tractography, proton MR spectroscopy, and iron-content sensitive imaging, have been used to obtain quantitative parameters useful to increase the diagnostic accuracy. Currently, many MR studies have provided both qualitative and quantitative findings, reflecting the underlying neuropathological pattern of the different degenerative parkinsonian syndromes. Although the variability in the methods and results across the studies limits the conclusion about which technique is the best, specific radiologic phenotypes may be identified. Qualitative/quantitative MR changes in the substantia nigra do not discriminate between different parkinsonisms. In the absence of extranigral abnormalities, the diagnosis of PD is more probable, whereas basal ganglia changes (mainly in the putamen suggest the diagnosis of an atypical parkinsonian syndrome. In this context, changes in pons, middle cerebellar peduncles, and cerebellum suggest the diagnosis of MSA, in midbrain and superior cerebellar peduncles the diagnosis of PSP, and in whole cerebral hemispheres (mainly in frontoparietal cortex with asymmetric distribution the diagnosis of Corticobasal Syndrome.

2010 International consensus algorithm for the diagnosis, therapy and management of hereditary angioedema

Directory of Open Access Journals (Sweden)

Bowen Tom

2010-07-01

Full Text Available Abstract Background We published the Canadian 2003 International Consensus Algorithm for the Diagnosis, Therapy, and Management of Hereditary Angioedema (HAE; C1 inhibitor [C1-INH] deficiency and updated this as Hereditary angioedema: a current state-of-the-art review: Canadian Hungarian 2007 International Consensus Algorithm for the Diagnosis, Therapy, and Management of Hereditary Angioedema. Objective To update the International Consensus Algorithm for the Diagnosis, Therapy and Management of Hereditary Angioedema (circa 2010. Methods The Canadian Hereditary Angioedema Network (CHAEN/Réseau Canadien d'angioédème héréditaire (RCAH http://www.haecanada.com and cosponsors University of Calgary and the Canadian Society of Allergy and Clinical Immunology (with an unrestricted educational grant from CSL Behring held our third Conference May 15th to 16th, 2010 in Toronto Canada to update our consensus approach. The Consensus document was reviewed at the meeting and then circulated for review. Results This manuscript is the 2010 International Consensus Algorithm for the Diagnosis, Therapy and Management of Hereditary Angioedema that resulted from that conference. Conclusions Consensus approach is only an interim guide to a complex disorder such as HAE and should be replaced as soon as possible with large phase III and IV clinical trials, meta analyses, and using data base registry validation of approaches including quality of life and cost benefit analyses, followed by large head-to-head clinical trials and then evidence-based guidelines and standards for HAE disease management.

A Scintillation Camera and 1600-Channel Analyser for the Diagnosis of Metastatic Cancer of the Liver

Energy Technology Data Exchange (ETDEWEB)

Jasinski, W. K.; Malinowska, J.; Mackiewicz, H.; Siwicki, H.; Tolwinski, J. [Institute of Oncology, Warsaw (Poland)

1969-05-15

A series of 59 consecutive cases of histologically proven breast cancer were admitted.for radiotherapy. The group was mostly composed of stage III/TNM. The patients were studied with a scintillation camera and a 1600-channel analyser after i. v. injection of 2mCi of colloidal {sup 99m}Tc. Up to 104 counts were accumulated in one of the elements of the analyser matrix and were then transferred to computer-compatible punched tape. The data could be presented immediately in a number of different ways: (a) as conventional scintigraphic pictures on the camera's oscilloscope; (b) as nine pictures from the analyser's oscilloscope with 10, 20, 30... 90% of the counts erased; and (c) as one picture with those four selected levels of erase which were considered best, for a given case. In addition, progressive increase of exposure and defocusing of each level was possible. Examination with colloidal {sup 99m}Tc was found to be a safe method for the detection of malignant secondaries in the liver because of the low irradiation dose to the patient. The high radioactivity accumulated in the liver means a short examination time and the elimination of statistical fluctuations. Furthermore, the stored information enables the time-consuming work to be done in the patient's absence. (author)

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

NARCIS (Netherlands)

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

2012-01-01

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

[Noonan syndrome can be diagnosed clinically and through molecular genetic analyses].

Science.gov (United States)

Henningsen, Marie Krab; Jelsig, Anne Marie; Andersen, Helle; Brusgaard, Klaus; Ousager, Lilian Bomme; Hertz, Jens Michael

2015-08-03

Noonan syndrome is part of the group of RASopathies caused by germ line mutations in genes involved in the RAS/MAPK pathway. There is substantial phenotypic overlap among the RASopathies. Diagnosis of Noonan syndrome is often based on clinical features including dysmorphic facial features, short stature and congenital heart disease. Rapid advances in sequencing technology have made molecular genetic analyses a helpful tool in diagnosing and distinguishing Noonan syndrome from other RASopathies.

Diagnosis and Change or Change and Diagnosis.

Science.gov (United States)

Cammann, Cortlandt

Organizational consultation is often viewed as a four-stage process: entry, diagnosis, intervention, and evaluation. A fifth stage, preparation of organizations to conduct diagnosis and change, is frequently neglected. In the preparation stage, organizational consultants must deal with resistance by creating conditions for the consideration of the…

Social Capital is Associated With Late HIV Diagnosis: An Ecological Analysis.

Science.gov (United States)

Ransome, Yusuf; Galea, Sandro; Pabayo, Roman; Kawachi, Ichiro; Braunstein, Sarah; Nash, Denis

2016-10-01

Late HIV diagnosis is associated with higher medical costs, early mortality among individuals, and HIV transmission in the population. Even under optimal configurations of stable or declining HIV incidence and increase in HIV case findings, no change in proportion of late HIV diagnosis is projected after year 2019. We investigated the association among social capital, gender, and late HIV diagnosis. We conduct ecological analyses (ZIP code, N = 166) using negative binomial regression of gender-specific rates of late HIV diagnoses (an AIDS defining illness or a CD4 count ≤200 cell/μL within 12 months of a new HIV diagnosis) in 2005 and 2006 obtained from the New York City HIV Surveillance Registry, and social capital indicators (civic engagement, political participation, social cohesion, and informal social control) from the New York Social Indicators Survey, 2004. Overall, low to high political participation and social cohesion corresponded with significant (P social control [RR = 0.67, 95% CI: (0.48 to 0.93)] among men only and moderate social cohesion [RR = 0.71, 95% CI: (0.55 to 0.92)] among women only were associated with the outcome adjusting for social fragmentation, income inequality, and racial composition. The magnitude of association between social capital and late HIV diagnosis varies by gender and by social capital indicator.

Fault diagnosis

Science.gov (United States)

Abbott, Kathy

1990-01-01

The objective of the research in this area of fault management is to develop and implement a decision aiding concept for diagnosing faults, especially faults which are difficult for pilots to identify, and to develop methods for presenting the diagnosis information to the flight crew in a timely and comprehensible manner. The requirements for the diagnosis concept were identified by interviewing pilots, analyzing actual incident and accident cases, and examining psychology literature on how humans perform diagnosis. The diagnosis decision aiding concept developed based on those requirements takes abnormal sensor readings as input, as identified by a fault monitor. Based on these abnormal sensor readings, the diagnosis concept identifies the cause or source of the fault and all components affected by the fault. This concept was implemented for diagnosis of aircraft propulsion and hydraulic subsystems in a computer program called Draphys (Diagnostic Reasoning About Physical Systems). Draphys is unique in two important ways. First, it uses models of both functional and physical relationships in the subsystems. Using both models enables the diagnostic reasoning to identify the fault propagation as the faulted system continues to operate, and to diagnose physical damage. Draphys also reasons about behavior of the faulted system over time, to eliminate possibilities as more information becomes available, and to update the system status as more components are affected by the fault. The crew interface research is examining display issues associated with presenting diagnosis information to the flight crew. One study examined issues for presenting system status information. One lesson learned from that study was that pilots found fault situations to be more complex if they involved multiple subsystems. Another was pilots could identify the faulted systems more quickly if the system status was presented in pictorial or text format. Another study is currently under way to

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

Science.gov (United States)

Lindop, E; Cannon, S

2001-06-01

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

Evolutionary algorithms for multi-objective energetic and economic optimization in thermal system design

International Nuclear Information System (INIS)

Toffolo, A.; Lazzaretto, A.

2002-01-01

Thermoeconomic analyses in thermal system design are always focused on the economic objective. However, knowledge of only the economic minimum may not be sufficient in the decision making process, since solutions with a higher thermodynamic efficiency, in spite of small increases in total costs, may result in much more interesting designs due to changes in energy market prices or in energy policies. This paper suggests how to perform a multi-objective optimization in order to find solutions that simultaneously satisfy exergetic and economic objectives. This corresponds to a search for the set of Pareto optimal solutions with respect to the two competing objectives. The optimization process is carried out by an evolutionary algorithm, that features a new diversity preserving mechanism using as a test case the well-known CGAM problem. (author)

Psychosocial Characteristics of Women with a Delayed Diagnosis of Turner Syndrome.

Science.gov (United States)

Reimann, Gabrielle E; Bernad Perman, Martha M; Ho, Pei-Shu; Parks, Rebecca A; Comis, Leora E

2018-05-09

To characterize the psychosocial profiles of adult women diagnosed with Turner syndrome before (early diagnosis) and at or after (late diagnosis) 13 years of age. Women with Turner syndrome ages 22 and older at evaluation (n = 110) participated in a cross-sectional study at the National Institutes of Health. Researchers performed nonparametric and logistic regression analyses to assess early and late diagnosis cohorts on measures of depression, substance use, and perceptions of competence and identity. Of study participants, 47% received a Turner syndrome diagnosis at or after age 13 years. Median age at diagnosis was 12.0 years (range, 0-43). Covariate-adjusted models revealed that women with late diagnoses had an increased likelihood of developing mild to severe depressive symptoms (OR,  7.36) and a decreased likelihood of being perceived as competent (OR, 0.26). Women with a late diagnosis also exhibited more frequent substance use compared with women with early diagnoses. These data suggest that Turner syndrome diagnoses received at or after age 13 years may contribute to adverse outcomes related to depression, substance use, and perceptions of competence. Delayed Turner syndrome diagnoses may place women and girls at risk for negative psychosocial development extending into adulthood. These findings indicate it is important for pediatricians to evaluate psychosocial domains in girls with Turner syndrome regularly, particularly among those diagnosed at age 13 years or older. ClinicalTrials.gov: NCT00006334. Published by Elsevier Inc.

Systematic methodology for diagnosis of water hammer in LWR power plants

International Nuclear Information System (INIS)

Safwat, H.H.; Arastu, A.H.; Husaini, S.M.

1990-01-01

The paper gives the dimensions of the knowledge base that is necessary to carry out a diagnosis of water hammer susceptibility/root cause analyses for Pressurized Water Reactor (PWR) and Boiling Water Reactor (BWR) nuclear power plant systems. After introducing some fundamentals, water hammer phenomena are described. Situations where each phenomenon is encountered are given and analytical models capable of simulating the phenomena are referenced. Water hammer events in operating plants and their inclusion in the knowledge base is discussed. The diagnostic methodology is presented through an application on a system in a typical light water reactor plant. The methodology presented serves as a possible foundation for the creation of an expert water hammer diagnosis system. (orig.)

Feelings of Women With Strong Family Histories Who Subsequent to Their Breast Cancer Diagnosis Tested BRCA Positive.

Science.gov (United States)

Joseph, Meera; Rab, Faiza; Panabaker, Karen; Nisker, Jeff

2015-05-01

Family physicians in Canada as reported in several studies do not recognize the importance of family history in relation to breast/ovarian cancer and thus Canadian women with strong family histories continue to develop early-onset breast cancer without the knowledge of or ability to make choices regarding increased surveillance or preventative strategies. This study explored the feelings of women who learned about their hereditary risk only after their diagnosis younger than 52 years and who eventually tested positive for a BRCA gene mutation. Thirty-four such women were mailed an invitation to participate in this research including a letter of information, consent form, and discussion prompts for their written narrative response. Rigorous mixed method analyses were performed using Charmaz-based qualitative analyses as well as quantitative analyses. Thirteen women (38.2%) responded with narratives for qualitative analysis from which 4 themes were coconstructed as follows: I, types of emotions; II, emotional response; III, coping with emotions; and IV, advice to women at similar risk. Women felt they should have learned about their hereditary risk from their family physician and through public education before their diagnosis. Although not experienced at the time of diagnosis, anger, frustration, and regret were experienced after receiving their BRCA results. These emotions arose from our research participants' lack of opportunity for prior genetic counseling and testing opportunity for genetic counseling and testing. With increased public and physician education, it is hoped that women with significant family histories of breast/ovarian cancer will be identified before diagnosis and given options regarding cancer surveillance and risk reduction strategies.

Plant diagnosis device

International Nuclear Information System (INIS)

Tozuka, Shin-ichi.

1996-01-01

Standard data approximately defined are inputted as 1:1 functional data between at least two or more plant data and each of plant data are inputted. Diagnosis data corresponding to each of process data are formed based on the functional data. Limit value data to be a threshold value which determines whether the diagnosis data are in a predetermined state or not are formed. The diagnosis data and the limit value data are displayed in a recognizable state. If diagnosis data of a plurality of plants are displayed simultaneously, all of the plant data are substantially the same value with one standard datum if the plant is in a normal state. When abnormality should occur in the plant, the difference between the diagnosis data and the standard data is remarkable, and the difference between the diagnosis data of other normal plant data and the standard data are also made remarkably, accordingly, the display of a plurality of diagnosis data is scattered thereby capable of diagnosing the abnormality of the plant. (N.H.)

Celiac Disease: Diagnosis.

Science.gov (United States)

Byrne, Greg; Feighery, Conleth F

2015-01-01

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

Diagnosis and differential diagnosis of hydrocephalus in adults

International Nuclear Information System (INIS)

Langner, Soenke; Mensel, Birger; Kuehn, Jens Peter; Kirsch, Michael; Fleck, Steffen; Baldauf, Joerg

2017-01-01

Hydrocephalus is caused by an imbalance of production and absorption of cerebrospinal fluid (CSF) or obstruction of its pathways, resulting in ventricular dilatation and increased intracranial pressure. Imaging plays a crucial role in the diagnosis, differential diagnosis and planning of treatment. This review article presents the different types of hydrocephalus und their typical imaging appearance, describes imaging techniques, and discusses differential diagnoses of the different forms of hydrocephalus. Imaging plays a central role in the diagnosis of hydrocephalus. While magnetic resonance (MR) imaging is the first-line imaging modality, computed tomography (CT) is often the first-line imaging test in emergency patients.

[The Cagliari (Italy) Court authorizes the preimplantation genetic diagnosis].

Science.gov (United States)

Jorqui Azofra, María

2007-01-01

Today, preimplantation genetic diagnosis (PGD) has been greatly accepted within the framework of positive law of many European countries. Nevertheless, in other countries, such as Italy, it is forbidden by law. The ruling of the Civil Court of Cagliari which has authorized its use to a Sardinian couple, has opened, in this way, a small crack to be able to asses possible modifications to the Italian regulation on this matter. This article analyses the ruling of the Civil Court of Cagliari (Italy) from an ethical and legal perspective. The criteria which is used to analyse the legitimacy or illegitimacy of the practice of PGD is analysed. That is, on reasons which could justify or not the transfer of embryos in vitro to the woman. With this objective in mind, the Italian and Spanish normative models which regulates this controversial subject are looked at. As a conclusion, a critical evaluation of the arguments presented is made.

Importance of molecular diagnosis in the accurate diagnosis of ...

Indian Academy of Sciences (India)

1Department of Health and Environmental Sciences, Kyoto University Graduate School of Medicine, Yoshida Konoecho, ... of molecular diagnosis in the accurate diagnosis of systemic carnitine deficiency. .... 'affecting protein function' by SIFT.

Diagnosis of Clostridium difficile

DEFF Research Database (Denmark)

Jensen, M B F; Olsen, K E P; Nielsen, X C

2015-01-01

The diagnosis of Clostridium difficile infection (CDI) requires the detection of toxigenic C. difficile or its toxins and a clinical assessment. We evaluated the performance of four nucleic acid amplification tests (NAATs) detecting toxigenic C. difficile directly from faeces compared to routine...... ribotyping and toxinotyping (TT) were performed on culture-positive samples. In parallel, the samples were analysed by four NAATs; two targeting tcdA or tcdB (illumigene® C. difficile and PCRFast® C. difficile A/B) and two multi-target real-time (RT) PCR assays also targeting cdt and tcdC alleles...... characteristic of epidemic and potentially more virulent PCR ribotypes 027, 066 and 078 (GeneXpert® C. difficile/Epi and an 'in-house RT PCR' two-step algorithm). The multi-target assays were significantly more sensitive compared to routine toxigenic culture (p 

Clinical aspects of personality disorder diagnosis in the DSM-5

OpenAIRE

Francesco Modica

2015-01-01

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

Redefining diagnosis-related groups (DRGs) for palliative care - a cross-sectional study in two German centres.

Science.gov (United States)

Vogl, Matthias; Schildmann, Eva; Leidl, Reiner; Hodiamont, Farina; Kalies, Helen; Maier, Bernd Oliver; Schlemmer, Marcus; Roller, Susanne; Bausewein, Claudia

2018-04-05

Hospital costs and cost drivers in palliative care are poorly analysed. It remains unknown whether current German Diagnosis-Related Groups, mainly relying on main diagnosis or procedure, reproduce costs adequately. The aim of this study was therefore to analyse costs and reimbursement for inpatient palliative care and to identify relevant cost drivers. Two-center, standardised micro-costing approach with patient-level cost calculations and analysis of the reimbursement situation for patients receiving palliative care at two German hospitals (7/2012-12/2013). Data were analysed for the total group receiving hospital care covering, but not exclusively, palliative care (group A) and the subgroup receiving palliative care only (group B). Patient and care characteristics predictive of inpatient costs of palliative care were derived by generalised linear models and investigated by classification and regression tree analysis. Between 7/2012 and 12/2013, 2151 patients received care in the two hospitals including, but not exclusively, on the PCUs (group A). In 2013, 784 patients received care on the two PCUs only (group B). Mean total costs per case were € 7392 (SD 7897) (group A) and € 5763 (SD 3664) (group B), mean total reimbursement per case € 5155 (SD 6347) (group A) and € 4278 (SD 2194) (group B). For group A/B on the ward, 58%/67% of the overall costs and 48%/53%, 65%/82% and 64%/72% of costs for nursing, physicians and infrastructure were reimbursed, respectively. Main diagnosis did not significantly influence costs. However, duration of palliative care and total length of stay were (related to the cost calculation method) identified as significant cost drivers. Related to the cost calculation method, total length of stay and duration of palliative care were identified as significant cost drivers. In contrast, main diagnosis did not reflect costs. In addition, results show that reimbursement within the German Diagnosis-Related Groups system does not

Breast Density Notification Legislation and Breast Cancer Stage at Diagnosis: Early Evidence from the SEER Registry.

Science.gov (United States)

Richman, Ilana; Asch, Steven M; Bendavid, Eran; Bhattacharya, Jay; Owens, Douglas K

2017-06-01

Twenty-eight states have passed breast density notification laws, which require physicians to inform women of a finding of dense breasts on mammography. To evaluate changes in breast cancer stage at diagnosis after enactment of breast density notification legislation. Using a difference-in-differences analysis, we examined changes in stage at diagnosis among women with breast cancer in Connecticut, the first state to enact legislation, compared to changes among women in control states. We used data from the Surveillance, Epidemiology, and End Results Program (SEER) registry, 2005-2013. Women ages 40-74 with breast cancer. Breast density notification legislation, enacted in Connecticut in October of 2009. Breast cancer stage at diagnosis. Our study included 466,930 women, 25,592 of whom lived in Connecticut. Legislation was associated with a 1.38-percentage-point (95 % CI 0.12 to 2.63) increase in the proportion of women in Connecticut versus control states who had localized invasive cancer at the time of diagnosis, and a 1.12-percentage-point (95 % CI -2.21 to -0.08) decline in the proportion of women with ductal carcinoma in situ at diagnosis. Breast density notification legislation was not associated with a change in the proportion of women in Connecticut versus control states with regional-stage (-0.09 percentage points, 95 % CI -1.01 to 1.02) or metastatic disease (-0.24, 95 % CI -0.75 to 0.28). County-level analyses and analyses limited to women younger than 50 found no statistically significant associations. Single intervention state, limited follow-up, potential confounding from unobserved trends. Breast density notification legislation in Connecticut was associated with a small increase in the proportion of women diagnosed with localized invasive breast cancer in individual-level but not county-level analyses. Whether this finding reflects potentially beneficial early detection or potentially harmful overdiagnosis is not known. Legislation was not

Diagnosis of vulvovaginitis: comparison of clinical and microbiological diagnosis.

Science.gov (United States)

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

2010-11-01

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

Elementwise Business Diagnosis of Enterprise Activity

Directory of Open Access Journals (Sweden)

Skrynkovskyy Ruslan M.

2016-02-01

Full Text Available The article presents methodological and indicator apparatus for elementwise business diagnosis of enterprise activity directed at achieving such elementwise diagnostic objectives: diagnosis of return on assets; diagnosis of return on equity capital; diagnosis of production profitability; diagnosis of gross profit margin of product sales; diagnosis of operating margin of product sales; diagnosis of net margin of product sales; diagnosis of absolute liquidity; diagnosis of instant liquidity; diagnosis of overall liquidity; diagnosis of coverage; diagnosis of financial independence; diagnosis of equity capital maneuverability; diagnosis of financial leverage; diagnosis of the long-term investment structure; diagnosis of accounts payable turnover; diagnosis of the accounts payable repayment period, diagnosis of receivables turnover; diagnosis of receivables repayment period; diagnosis of assets turnover; diagnosis of inventories turnover; diagnosis of the inventories turnover period; diagnosis of equity capital turnover; diagnosis of fixed assets turnover (return on assets; diagnosis of capital coefficient; diagnosis of the ratio of output value to the materials cost; diagnosis of material consumption; diagnosis of the total production cost; diagnosis of enterprise market share; diagnosis of fixed assets wear; diagnosis of fixed assets renewal; diagnosis of fixed assets retirement; performance diagnosis; diagnosis of labor intensity, diagnosis of the capital-labour ratio; diagnosis of efficiency; diagnosis of conducting the business; diagnosis of business relations; diagnosis of administrative-legal relations; diagnosis of knowledge management. The elementwise diagnostic objectives of the enterprise system of diagnostic objectives are aimed at a narrow highly detailed diagnostics of individual indicators of the enterprise activity, i.e. the evaluation of specific analytical indicators,monitoring (research of their dynamics, comparison of the planned

Diagnosis in progressive hirsutism

Energy Technology Data Exchange (ETDEWEB)

Soerensen, R.; Moltz, L.

1981-09-01

Catheterization of adrenal and ovarian veins in combination with hormone concentration analyses was performed in seventy hirsute women. There was suspicion of tumor in 30 cases because of excess androgen production (plasma testosterone more than 1.5 ng/ml and/or plasma dehydroepiandrosterone sulfate more than 7000 ng/ml in peripheral blood samplings). Catheterization and blood sampling was done with a femoro-visceral catheter by the transfemoral approach. Contributary blood flows from many different venous systems were found to be more often to the right ovarian and to the left adrenal veins in comparison to the other side. Catheterization of the wrong vessels occurred without being recognized immediately (circumaortic renal collar, inferior phrenic vein, ascending lumbar vein). These pitfalls might falsify blood samplings. There were no significant complications. Seven ovarian tumors were localized. Their size ranged from 0.5 to 2.5 cm in diameter. They were not recognized during laparoscopy. There were 10 hyperthecoses, four adrenogenital syndromes, one abortive testis, one adrenal adenoma, one Cushing's syndrome and one Cushing's disease due to an adenoma of the picture gland. In five patients a diagnosis could not be made. Tumor was excluded in forty patients. Their virilization was of adrenal origin in 32%, of ovarian origin in 29%, and of both adrenal and ovarian origin in 22%. In 17% a source of the excess androgen production was not found. This differential diagnosis is not important for the patient therapy.

Exergy costing for energy saving in combined heating and cooling applications

International Nuclear Information System (INIS)

Nguyen, Chan; Veje, Christian T.; Willatzen, Morten; Andersen, Peer

2014-01-01

Highlights: • We investigate the basis for cost apportioning of simultaneous heating and cooling. • Two thermoeconomic methods based on energy and exergy costing is demonstrated. • The unit cost of heating and cooling for a heat pump system is found and compared. • Energy costing may obstruct efficient use of energy. • Exergy costing provides the most rational cost apportioning for energy saving. - Abstract: The aim of this study is to provide a price model that motivates energy saving for a combined district heating and cooling system. A novel analysis using two thermoeconomic methods for apportioning the costs to heating and cooling provided simultaneously by an ammonia heat pump is demonstrated. In the first method, referred to as energy costing, a conventional thermoeconomic analysis is used. Here the ammonia heat pump is subject to a thermodynamic analysis with mass and energy balance equations. In the second method referred to as exergy costing, an exergy based economic analysis is used, where exergy balance equations are used in conjunction with mass and energy balance equations. In both costing methods the thermodynamic analysis is followed by an economic analysis which includes investment and operating costs. For both methods the unit costs of heating and cooling are found and compared. The analysis shows that the two methods yield significantly different results. Rather surprisingly, it is demonstrated that the exergy costing method results in about three times higher unit cost for heating than for cooling as opposed to equal unit costs when using the energy method. Further the exergy-based cost for heating changes considerably with the heating temperature while that of cooling is much less affected

Thermoecological cost of electricity production in the natural gas pressure reduction process

International Nuclear Information System (INIS)

Kostowski, Wojciech J.; Usón, Sergio; Stanek, Wojciech; Bargiel, Paweł

2014-01-01

The paper presents a novel concept for thermodynamic evaluation of a selected energy system. The presented method has been developed by integration of the Thermo-Economic Analysis with the theory of Thermo-Ecological Cost. It can be applied as a thermodynamic evaluation method of rational resources management within any production system. It takes into account both the interrelation of irreversibility within the analyzed system and its influence on the global effects related to the depletion of non-renewable natural resources. The proposed method has been applied to evaluate the production of electricity in the process of natural gas transmission at pressure reduction stations. The expansion system is based on an existing plant integrated with a CHP module, characterized by a performance ratio of 89.5% and exergy efficiency of 49.2%. Within the paper, this expansion plant is supplied with natural gas transported from a natural deposit through a case-study transmission system with 4 compressor stations. The TEC (thermoecological cost) method was applied in conjunction with thermoeconomic analysis. As a result, TEC of the electricity generated in the expanders was determined at 2.42 kJ/kJ, TEC of electricity from the CHP module is 1.77, and the TEC of medium-pressure natural gas distributed to consumers is 1.022. - Highlights: • The chain of NG transmission with an exergy recovery expansion plant was analyzed. • New methodology coupling the TEC (thermoecological cost) and thermoeconomics. • Decomposition of the TEC formation process. • Case-study transmission system yields TEC of natural gas = 1.0222. • Expansion plant yields TEC of electricity 2.42 (expanders) and 1.77 (CHP module)

Autism: Diagnosis

Science.gov (United States)

... Information Publications Awards Partners Contact Us ¿Qué es Autismo? Donate Home What is Autism? What is Autism? ... Information Publications Awards Partners Contact Us ¿Qué es Autismo? Diagnosis Home / What is Autism? / Diagnosis Expand Medical ...

Prenatal diagnosis--principles of diagnostic procedures and genetic counseling.

Directory of Open Access Journals (Sweden)

Ryszard Slezak

2008-04-01

Full Text Available The frequency of inherited malformations as well as genetic disorders in newborns account for around 3-5%. These frequency is much higher in early stages of pregnancy, because serious malformations and genetic disorders usually lead to spontaneous abortion. Prenatal diagnosis allowed identification of malformations and/or some genetic syndromes in fetuses during the first trimester of pregnancy. Thereafter, taking into account the severity of the disorders the decision should be taken in regard of subsequent course of the pregnancy taking into account a possibilities of treatment, parent's acceptation of a handicapped child but also, in some cases the possibility of termination of the pregnancy. In prenatal testing, both screening and diagnostic procedures are included. Screening procedures such as first and second trimester biochemical and/or ultrasound screening, first trimester combined ultrasound/biochemical screening and integrated screening should be widely offered to pregnant women. However, interpretation of screening results requires awareness of both sensitivity and predictive value of these procedures. In prenatal diagnosis ultrasound/MRI searching as well as genetic procedures are offered to pregnant women. A variety of approaches for genetic prenatal analyses are now available, including preimplantation diagnosis, chorion villi sampling, amniocentesis, fetal blood sampling as well as promising experimental procedures (e.g. fetal cell and DNA isolation from maternal blood. An incredible progress in genetic methods opened new possibilities for valuable genetic diagnosis. Although karyotyping is widely accepted as golden standard, the discussion is ongoing throughout Europe concerning shifting to new genetic techniques which allow obtaining rapid results in prenatal diagnosis of aneuploidy (e.g. RAPID-FISH, MLPA, quantitative PCR.

The significance of Bartonella henselae bacterias for oncological diagnosis in children.

Science.gov (United States)

Mazur-Melewska, Katarzyna; Jończyk-Potoczna, Katarzyna; Mania, Anna; Kemnitz, Paweł; Szydłowski, Jarosław; Służewski, Wojciech; Figlerowicz, Magdalena

2015-01-01

Cat-scratch disease (CSD) is a common infection in children; however, the wide spectrum of its clinical picture may lead to delayed diagnosis. An unusual presentation of CSD includes in the differential diagnosis malignant diseases, Epstein-Barr and cytomegalovirus infections, tuberculosis, and mycobacterioses. The diagnostic procedure is difficult, and it is important to consider CSD as the etiology of untypical lesion. We present the analysis of 22 immunocompetent children treated with the clinical diagnosis of CSD in our hospital. Their ages were 2 to 16 years (mean 9.15 ± 2.2 years). Four of them presented classical papulas at admission time. Asymmetric, local lymphadenopathy was present in 16 patients. Five children, who presented an untypical course of CSD mimicking the oncological process, were analysed carefully. There were 3 patients with skull osteomyelitis, 1 with inflammation of the parotid gland, and 1 with an extra peripharyngeal mass. The diagnosis in these children was based on epidemiological, radiological, serological, and histological factors. About 25 % of children with bartonellosis present an untypical spectrum of symptoms, including the lack of documented cat contact, primary lesions, or peripheral lymphadenopathy. Radiological methods like USG, CT, MRI present the unspecific masses, but they are not enough to distinguish the Bartonella inflammatory and oncological process. The final diagnosis was based on a histological method with additional polymerase chain reaction test. CSD should be considered in differential diagnosis of any patient with untypical lesions located on the head, neck, and upper extremities.

Repeatability of Pulse Diagnosis and Body Constitution Diagnosis in Traditional Indian Ayurveda Medicine

Science.gov (United States)

Waagepetersen, Rasmus; Toft, Egon; Prasad, Ramjee; Raturi, Lokesh

2012-01-01

In Ayurveda, pulse diagnosis and body constitution diagnosis have a long historical use; still, there is lack of quantitative measure of the reliability of these diagnostic methods. Reliability means consistency of information. Consistent diagnosis leads to consistent treatment and is important for clinical practice, education, and research. The objective of this study is to study the methodology to evaluate the test-retest reliability (repeatability) of pulse diagnosis and body constitution diagnosis. A double-blinded, controlled, clinical trial was conducted in Copenhagen. The same doctor, an expert in Ayurvedic pulse diagnosis, examined the pulse and body constitution of 17 healthy participants twice, in random order without seeing them. A metric on pulse and body constitution variables was developed. Cohen's weighted kappa statistic was used as a measure of intra-rater reliability. Permutation tests were used to test the hypothesis of homogeneous diagnosis (ie, the doctor's diagnosis does not depend on the subject). The hypothesis of homogeneous classification was rejected on the 5% significance level (P values of .02 and .001, respectively, for pulse and body constitution diagnosis). According to the Landis and Koch scale, values of the weighted kappa for pulse diagnosis (P = .42) and body constitution diagnosis (P = .65) correspond to “moderate” and “substantial” agreement, respectively. There was a reasonable level of consistency between 2 pulse and body constitution diagnoses. Further studies are required to quantify inter-subject and intra-subject agreement for greater understanding of reliability of pulse and body constitution diagnosis. PMID:27257530

Role of CT in the Diagnosis of Nonspecific Abdominal Pain: A Multicenter Analysis.

Science.gov (United States)

Eisenberg, Jonathan D; Reisner, Andrew T; Binder, William D; Zaheer, Atif; Gunn, Martin L; Linnau, Ken F; Miller, Chad M; Tramontano, Angela C; Herring, Maurice S; Dowling, Emily C; Halpern, Elkan F; Donelan, Karen; Gazelle, G Scott; Pandharipande, Pari V

2017-03-01

The objective of our study was to determine whether specific patient and physician factors-known before CT-are associated with a diagnosis of nonspecific abdominal pain (NSAP) after CT in the emergency department (ED). We analyzed data originally collected in a prospective multicenter study. In the parent study, we identified ED patients referred to CT for evaluation of abdominal pain. We surveyed their physicians before and after CT to identify changes in leading diagnoses, diagnostic confidence, and admission decisions. In the current study, we conducted a multiple regression analysis to identify whether the following were associated with a post-CT diagnosis of NSAP: patient age; patient sex; physicians' years of experience; physicians' pre-CT diagnostic confidence; and physicians' pre-CT admission decision if CT had not been available. We analyzed patients with and those without a pre-CT diagnosis of NSAP separately. For the sensitivity analysis, we excluded patients with different physicians before and after CT. In total, 544 patients were included: 10% (52/544) with a pre-CT diagnosis of NSAP and 90% (492/544) with a pre-CT diagnosis other than NSAP. The leading diagnoses changed after CT in a large proportion of patients with a pre-CT diagnosis of NSAP (38%, 20/52). In regression analysis, we found that physicians' pre-CT diagnostic confidence was inversely associated with a post-CT diagnosis of NSAP in patients with a pre-CT diagnosis other than NSAP (p = 0.0001). No other associations were significant in both primary and sensitivity analyses. With the exception of physicians' pre-CT diagnostic confidence, the factors evaluated were not associated with a post-CT diagnosis of NSAP.

Diagnosis and Differential Diagnosis of Hydrocephalus in Adults.

Science.gov (United States)

Langner, Sönke; Fleck, Steffen; Baldauf, Jörg; Mensel, Birger; Kühn, Jens Peter; Kirsch, Michael

2017-08-01

Purpose  Hydrocephalus is caused by an imbalance of production and absorption of cerebrospinal fluid (CSF) or obstruction of its pathways, resulting in ventricular dilatation and increased intracranial pressure. Imaging plays a crucial role in the diagnosis, differential diagnosis and planning of treatment. Methods  This review article presents the different types of hydrocephalus und their typical imaging appearance, describes imaging techniques, and discusses differential diagnoses of the different forms of hydrocephalus. Results and Conclusion  Imaging plays a central role in the diagnosis of hydrocephalus. While magnetic resonance (MR) imaging is the first-line imaging modality, computed tomography (CT) is often the first-line imaging test in emergency patients. Key points   · Occlusive hydrocephalus is caused by obstruction of CSF pathways.. · Malabsorptive hydrocephalus is caused by impaired CSF absorption.. · The MR imaging protocol should always include sagittal high-resolution T2-weighted images.. · When an inflammatory etiology is suspected, imaging with contrast agent administration is necessary.. Citation Format · Langner S, Fleck S, Baldauf J et al. Diagnosis and Differential Diagnosis of Hydrocephalus in Adults. Fortschr Röntgenstr 2017; 189: 728 - 739. © Georg Thieme Verlag KG Stuttgart · New York.

Wilson's Disease: a challenge of diagnosis. The 5-year experience of a tertiary centre.

Science.gov (United States)

Gheorghe, Liana; Popescu, Irinel; Iacob, Speranta; Gheorghe, Cristian; Vaidan, Roxana; Constantinescu, Alexandra; Iacob, Razvan; Becheanu, Gabriel; Angelescu, Corina; Diculescu, Mircea

2004-09-01

Because molecular diagnosis is considered impractical and no patognomonic features have been described, diagnosis of Wilson's disease (WD) using clinical and biochemical findings is still challenging. We analysed predictive factors for the diagnosis in 55 patients with WD diagnosed in our centre between 1st January 1999 and 1st April 2004. All patients presented predominant liver disease classified as: 1) asymptomatic, found incidentally, 2) chronic hepatitis or cirrhosis, or 3) fulminant hepatic failure. Diagnosis was considered as classic (two out of the three following criteria: 1) serum ceruloplasmin 250 mg/g dry weight liver tissue), and non-classic (clinical manifestations plus laboratory parameters suggesting impaired copper metabolism). The association between the predictive factors and non-classic diagnosis was assessed based on the level of statistical significance (p value18 years (p=0.03), increased copper excretion (p<0.0001), Coombs-negative hemolysis (p=0.03), absence of neurological manifestations (p<0.0001). Multivariate analysis identified age over 18 years, increased urinary copper, and isolated hepatic involvement as independent predictors. In clinical practice, WD should be considered also in patients who do not fulfil classic criteria. Independent factors associated with non-classic diagnosis were age over 18 years, increased cupruresis and isolated liver disease.

Clinical aspects of personality disorder diagnosis in the DSM-5

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Francesco Modica

2015-05-01

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

Nutritional diagnosis for eucalypt by DRIS, M-DRIS, and CND

Directory of Open Access Journals (Sweden)

Silva Gualter Guenther Costa da

2004-01-01

Full Text Available The evaluation of the nutritional status in eucalypt (Eucalyptus grandis W. Hill ex Maid. forests through vegetal tissue analyses what reflects water and nutrient flows in the system, and represents a complementary tool to soil analysis can be helpful to raise and maintain the forest productivity at high levels. This study compared the use of the Diagnosis and Recommendation Integrated System (DRIS, Modified-DRIS (M-DRIS, and Compositional Nutrient Diagnosis (CND diagnose methods in eucalypt stands in Central-Eastern Minas Gerais State, Brazil. Data of productivity and of N, P, K, Ca, and Mg leaf contents in 993 Eucalyptus grandis stands aging between 72 and 153 months, planted on six sites in 3 ´ 2 m spacing, were used. The nutritional status was diagnosed by the DRIS, M-DRIS, and CND methods, and validated by the chi-square (c² test applied to the nutrients diagnosed as primary limiting by deficiency. These three methods were compared to each other based on the diagnosis concordance frequency (DCF derived from the fertilization response potential (FRP by the criteria considering each nutrient separately; from all (5 to none (0; and only the primary limiting nutrients by either deficiency or excess. The diagnosis concordance level among the methods was procedure-dependent, and varied according to the nutrient concentration in trees.

Diagnosis-Related Groups (DRG and Hospital Business Performance Management

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Szynkiewicz Piotr

2014-12-01

Full Text Available The goal of this article is to present the possibility of using Diagnosis- Related Groups (DRG in the hospital management process and to analyse the need for business performance management on the part of hospital management staff. The following research methods were used: literature analysis, case studies, and poll analysis. It is not possible to increase the effectiveness of operation of healthcare entities without increasing the importance of IT systems and using DRG more effectively in the management process. Training users in IT and the use of DRGs is important to achieving hospital effectiveness. The increased importance of analyses and planning in a hospital should be reflected in the organisational structure of service providers. Hospital controllers should have a similar role to those present in most companies in other industries.

Statistical approaches to assessing single and multiple outcome measures in dry eye therapy and diagnosis.

Science.gov (United States)

Tomlinson, Alan; Hair, Mario; McFadyen, Angus

2013-10-01

Dry eye is a multifactorial disease which would require a broad spectrum of test measures in the monitoring of its treatment and diagnosis. However, studies have typically reported improvements in individual measures with treatment. Alternative approaches involve multiple, combined outcomes being assessed by different statistical analyses. In order to assess the effect of various statistical approaches to the use of single and combined test measures in dry eye, this review reanalyzed measures from two previous studies (osmolarity, evaporation, tear turnover rate, and lipid film quality). These analyses assessed the measures as single variables within groups, pre- and post-intervention with a lubricant supplement, by creating combinations of these variables and by validating these combinations with the combined sample of data from all groups of dry eye subjects. The effectiveness of single measures and combinations in diagnosis of dry eye was also considered. Copyright © 2013. Published by Elsevier Inc.

Adolescence and polycystic ovary syndrome: current concepts on diagnosis and treatment.

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Spritzer, P M; Motta, A B

2015-11-01

Adolescence is a time characterised by changes in reproductive hormones and menstrual patterns, which makes it difficult to diagnose polycystic ovary syndrome (PCOS) in this population. The diagnosis of PCOS has a great physical and psychosocial impact on the young person. Despite the importance of a diagnosis of PCOS at adolescence, data available are limited. This review focuses on analysing markers of PCOS diagnosis and possible treatments in adolescence. Although, during adolescence, diagnosis criteria of PCOS overlap with physiological changes including clinical manifestations of hyperandrogenism (acne and hirsutism), oligo/amenorrhoea, anovulation and ovarian microcysts, there is agreement that irregular menses and hyperandrogenaemia should be used to diagnose PCOS in this population. Moreover, considering that PCOS phenotype could change through the reproductive age and that adolescents display heterogeneous ovarian morphology, it has been proposed that diagnosis of PCOS should be confirmed after the age of 18. The first-line treatment for menstrual irregularity and hirsutism are oral contraceptive pills (OCPs) and for obesity and metabolic abnormalities are lifestyle changes. Insulin-sensitizer drugs, such as metformin, may be added to the treatment in the presence of metabolic alterations. Antiandrogen drugs may also be associated for treating moderate to severe hirsutism. During adolescence, physiological changes overlap with signs and symptoms of PCOS; thus the diagnosis criteria should be carefully considered. Regarding the treatment of adolescents with PCOS, non-pharmacological interventions include lifestyle changes. Pharmacological treatments comprise OCPs, antiandrogens and metformin, used isolated or combined. During adolescence, physiological changes overlap with signs and symptoms of PCOS; thus the diagnosis criteria should be carefully considered. Regarding the treatment of adolescents with PCOS, non-pharmacological interventions include

Cost-Effectiveness Analysis Comparing Pre-diagnosis Autism Spectrum Disorder (ASD)-Targeted Intervention with Ontario's Autism Intervention Program.

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Penner, Melanie; Rayar, Meera; Bashir, Naazish; Roberts, S Wendy; Hancock-Howard, Rebecca L; Coyte, Peter C

2015-09-01

Novel management strategies for autism spectrum disorder (ASD) propose providing interventions before diagnosis. We performed a cost-effectiveness analysis comparing the costs and dependency-free life years (DFLYs) generated by pre-diagnosis intensive Early Start Denver Model (ESDM-I); pre-diagnosis parent-delivered ESDM (ESDM-PD); and the Ontario Status Quo (SQ). The analyses took government and societal perspectives to age 65. We assigned probabilities of Independent, Semi-dependent or Dependent living based on projected IQ. Costs per person (in Canadian dollars) were ascribed to each living setting. From a government perspective, the ESDM-PD produced an additional 0.17 DFLYs for $8600 less than SQ. From a societal perspective, the ESDM-I produced an additional 0.53 DFLYs for $45,000 less than SQ. Pre-diagnosis interventions targeting ASD symptoms warrant further investigation.

Computational diagnosis of canine lymphoma

Science.gov (United States)

Mirkes, E. M.; Alexandrakis, I.; Slater, K.; Tuli, R.; Gorban, A. N.

2014-03-01

One out of four dogs will develop cancer in their lifetime and 20% of those will be lymphoma cases. PetScreen developed a lymphoma blood test using serum samples collected from several veterinary practices. The samples were fractionated and analysed by mass spectrometry. Two protein peaks, with the highest diagnostic power, were selected and further identified as acute phase proteins, C-Reactive Protein and Haptoglobin. Data mining methods were then applied to the collected data for the development of an online computer-assisted veterinary diagnostic tool. The generated software can be used as a diagnostic, monitoring and screening tool. Initially, the diagnosis of lymphoma was formulated as a classification problem and then later refined as a lymphoma risk estimation. Three methods, decision trees, kNN and probability density evaluation, were used for classification and risk estimation and several preprocessing approaches were implemented to create the diagnostic system. For the differential diagnosis the best solution gave a sensitivity and specificity of 83.5% and 77%, respectively (using three input features, CRP, Haptoglobin and standard clinical symptom). For the screening task, the decision tree method provided the best result, with sensitivity and specificity of 81.4% and >99%, respectively (using the same input features). Furthermore, the development and application of new techniques for the generation of risk maps allowed their user-friendly visualization.

Laboratory Diagnosis of Carbohydrate Metabolism Disorders. Diagnosis Algorithm in Hyperglycemic States

Directory of Open Access Journals (Sweden)

V.I. Pankiv

2014-04-01

Full Text Available The article is devoted to the laboratory diagnosis of disorders of carbohydrate metabolism. Presents criteria for diagnosis of diabetes, an algorithm for oral glucose tolerance test, determine type of diabetes based on clinical and laboratory data. The article also raised the issues of diagnosis of gestational diabetes and a diagnostic algorithm of hyperglycemia conditions during pregnancy.

Statin use before diabetes diagnosis and risk of microvascular disease

DEFF Research Database (Denmark)

Nielsen, Sune F; Nordestgaard, Børge G

2014-01-01

BACKGROUND: The role of statins in the development of microvascular disease in patients with diabetes is unknown. We tested the hypothesis that statin use increases the risk of diabetic retinopathy, diabetic neuropathy, diabetic nephropathy, and gangrene of the foot in individuals with diabetes...... the cumulative incidence of diabetic retinopathy, diabetic neuropathy, diabetic nephropathy, or gangrene of the foot in statin users versus non-statin users. We analysed data with Cox regression models, adjusted for covariates including sex, age at diabetes diagnosis, and method of diabetes diagnosis. To address...... diabetic neuropathy, 1248 developed diabetic nephropathy, and 2392 developed gangrene of the foot. Compared with non-statin users, statin users had a lower cumulative incidence of diabetic retinopathy (hazard ratio 0·60, 95% CI 0·54-0·66; pdiabetic neuropathy (0·66, 0·57-0·75; p

Evaluation of the contribution of radiological imaging to the final diagnosis in medical case reports

International Nuclear Information System (INIS)

Wiesinger, Isabel; Scharf, Gregor; Platz, Natascha; Dendl, Lena M.; Stroszczynski, Christian; Schreyer, Andreas G.; Pawlik, Michael T.

2015-01-01

To evaluate the clinical value and impact of radiological imaging in published medial case reports. We analysed 671 consecutively published case reports of a peer-reviewed medical journal for case reports. The general use of radiological imaging as well as the specific imaging modality used in each case (ultrasound, x-ray, fluoroscopy, CT, MRI) was documented, and most importantly the 'final problem solver', i.e. the diagnostic modality giving the final clue to the patient's diagnosis, was identified. In 511 of 671 (76.1 %) analysed case reports at least one radiological modality was used in the diagnostic cascade. In 28.6 % of all cases the final diagnosis was achieved by radiological imaging. All other cases were solved by the patient's history and physical examination (15.2 %), histology (12.4 %), and blood analysis (9.6 %). When radiology was the 'final problem solver', it was mainly CT (51.6 %) and MRI (30.6 %). In 52.2 % of the case reports the radiological image was included in the article. In case reports published in a prominent general medical journal radiological imaging is an important key player in the diagnostic process. In many cases, it is also the diagnostic tool which ultimately leads to determining the final diagnosis. (orig.)

Evaluation of the contribution of radiological imaging to the final diagnosis in medical case reports

Energy Technology Data Exchange (ETDEWEB)

Wiesinger, Isabel; Scharf, Gregor; Platz, Natascha; Dendl, Lena M.; Stroszczynski, Christian; Schreyer, Andreas G. [University Hospital Regensburg, Institute of Radiology, Regensburg (Germany); Pawlik, Michael T. [Intensive Care and Emergency Medicine, Institute of Anaesthesiology, Regensburg (Germany)

2015-05-01

To evaluate the clinical value and impact of radiological imaging in published medial case reports. We analysed 671 consecutively published case reports of a peer-reviewed medical journal for case reports. The general use of radiological imaging as well as the specific imaging modality used in each case (ultrasound, x-ray, fluoroscopy, CT, MRI) was documented, and most importantly the 'final problem solver', i.e. the diagnostic modality giving the final clue to the patient's diagnosis, was identified. In 511 of 671 (76.1 %) analysed case reports at least one radiological modality was used in the diagnostic cascade. In 28.6 % of all cases the final diagnosis was achieved by radiological imaging. All other cases were solved by the patient's history and physical examination (15.2 %), histology (12.4 %), and blood analysis (9.6 %). When radiology was the 'final problem solver', it was mainly CT (51.6 %) and MRI (30.6 %). In 52.2 % of the case reports the radiological image was included in the article. In case reports published in a prominent general medical journal radiological imaging is an important key player in the diagnostic process. In many cases, it is also the diagnostic tool which ultimately leads to determining the final diagnosis. (orig.)

The evidence base regarding the experiences of and attitudes to preimplantation genetic diagnosis in prospective parents.

Science.gov (United States)

Cunningham, Jenny; Goldsmith, Lesley; Skirton, Heather

2015-02-01

Preimplantation genetic diagnosis was developed as an alternative to prenatal diagnosis for couples with a family history of genetic disease. After in vitro fertilization, the embryos can be analysed to ensure that only healthy embryos are transferred to the uterus. Past studies have suggested that couples who wish to avoid having a child with an inherited genetic condition look favourably on preimplantation genetic diagnosis as it prevents the need for termination of pregnancy following prenatal diagnosis of an affected fetus. However, it is important to understand the experiences of couples who have used or consider using this technique. To ascertain the current evidence base on this topic, we conducted a mixed methods systematic review. Four databases were searched for relevant peer-reviewed papers published between 2000 and 2013. Of 453 papers, nine satisfied the inclusion criteria and were assessed for quality. Results of nine papers were analysed and synthesised using a narrative approach. Three main themes emerged: (1) motivating factors; (2) emotional labour; (3) choices and uncertainty. The review has identified an emotional and difficult journey for couples pursuing preimplantation genetic diagnosis. While use of the technique gives hope to families who wish to prevent transmission of a genetic disease this is not without hard decision-making and periods of uncertainty. Lack of information was perceived as a barrier to access this reproductive option. Recommendations include: training and education in genetics for midwives who are the first point of contact for pregnant women; clinics to use a decision-making tool to emphasise the uncertainty involved in PGD and improved communication and psychological support to couples. Copyright © 2014 Elsevier Ltd. All rights reserved.

Chylothorax diagnosis: can the clinical chemistry laboratory do more?

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Gibbons, Stephen M; Ahmed, Farhan

2015-01-01

Chylothorax is a rare anatomical disruption of the thoracic duct associated with a significant degree of morbidity and mortality. Diagnosis usually relies upon lipid analysis and visual inspection of the pleural fluid. However, this may be subject to incorrect interpretation. The aim of this study was to compare pleural fluid lipid analysis and visual inspection against lipoprotein electrophoresis. Nine pleural effusion samples suspected of being chylothorax were analysed. A combination of fluid lipid analysis and visual inspection was compared with lipoprotein electrophoresis for the detection of chylothorax. There was 89% concordance between the two methods. Using lipoprotein electrophoresis as gold standard, calculated sensitivity, specificity, negative predictive value and positive predictive value for lipid analysis/visual inspection were 83%, 100%, 100% and 75%, respectively. Examination of pleural effusion samples by lipoprotein electrophoresis may provide important additional information in the diagnosis of chylothorax. © The Author(s) 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

Cerebrospinal fluid biomarker supported diagnosis of Creutzfeldt–Jakob disease and rapid dementias: a longitudinal multicentre study over 10 years

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Sanchez-Juan, Pascual; Gawinecka, Joanna; Green, Alison; Ladogana, Anna; Pocchiari, Maurizio; Sanchez-Valle, Raquel; Mitrova, Eva; Sklaviadis, Theodor; Kulczycki, Jerzy; Slivarichova, Dana; Saiz, Albert; Calero, Miguel; Knight, Richard; Aguzzi, Adriano; Laplanche, Jean-Louis; Peoc’h, Katell; Schelzke, Gabi; Karch, Andre; van Duijn, Cornelia M.; Zerr, Inga

2012-01-01

To date, cerebrospinal fluid analysis, particularly protein 14-3-3 testing, presents an important approach in the identification of Creutzfeldt–Jakob disease cases. However, one special point of criticism of 14-3-3 testing is the specificity in the differential diagnosis of rapid dementia. The constant observation of increased cerebrospinal fluid referrals in the national surveillance centres over the last years raises the concern of declining specificity due to higher number of cerebrospinal fluid tests performed in various neurological conditions. Within the framework of a European Community supported longitudinal multicentre study (‘cerebrospinal fluid markers’) we analysed the spectrum of rapid progressive dementia diagnoses, their potential influence on 14-3-3 specificity as well as results of other dementia markers (tau, phosphorylated tau and amyloid-β1–42) and evaluated the specificity of 14-3-3 in Creutzfeldt–Jakob disease diagnosis for the years 1998–2008. A total of 29 022 cerebrospinal fluid samples were analysed for 14-3-3 protein and other cerebrospinal fluid dementia markers in patients with rapid dementia and suspected Creutzfeldt–Jakob disease in the participating centres. In 10 731 patients a definite diagnosis could be obtained. Protein 14-3-3 specificity was analysed for Creutzfeldt–Jakob disease with respect to increasing cerebrospinal fluid tests per year and spectrum of differential diagnosis. Ring trials were performed to ensure the comparability between centres during the reported time period. Protein 14-3-3 test specificity remained high and stable in the diagnosis of Creutzfeldt–Jakob disease during the observed time period across centres (total specificity 92%; when compared with patients with definite diagnoses only: specificity 90%). However, test specificity varied with respect to differential diagnosis. A high 14-3-3 specificity was obtained in differentiation to other neurodegenerative diseases (95–97%) and non

Cerebrospinal fluid biomarker supported diagnosis of Creutzfeldt-Jakob disease and rapid dementias: a longitudinal multicentre study over 10 years.

Science.gov (United States)

Stoeck, Katharina; Sanchez-Juan, Pascual; Gawinecka, Joanna; Green, Alison; Ladogana, Anna; Pocchiari, Maurizio; Sanchez-Valle, Raquel; Mitrova, Eva; Sklaviadis, Theodor; Kulczycki, Jerzy; Slivarichova, Dana; Saiz, Albert; Calero, Miguel; Knight, Richard; Aguzzi, Adriano; Laplanche, Jean-Louis; Peoc'h, Katell; Schelzke, Gabi; Karch, Andre; van Duijn, Cornelia M; Zerr, Inga

2012-10-01

To date, cerebrospinal fluid analysis, particularly protein 14-3-3 testing, presents an important approach in the identification of Creutzfeldt-Jakob disease cases. However, one special point of criticism of 14-3-3 testing is the specificity in the differential diagnosis of rapid dementia. The constant observation of increased cerebrospinal fluid referrals in the national surveillance centres over the last years raises the concern of declining specificity due to higher number of cerebrospinal fluid tests performed in various neurological conditions. Within the framework of a European Community supported longitudinal multicentre study ('cerebrospinal fluid markers') we analysed the spectrum of rapid progressive dementia diagnoses, their potential influence on 14-3-3 specificity as well as results of other dementia markers (tau, phosphorylated tau and amyloid-β(1-42)) and evaluated the specificity of 14-3-3 in Creutzfeldt-Jakob disease diagnosis for the years 1998-2008. A total of 29 022 cerebrospinal fluid samples were analysed for 14-3-3 protein and other cerebrospinal fluid dementia markers in patients with rapid dementia and suspected Creutzfeldt-Jakob disease in the participating centres. In 10 731 patients a definite diagnosis could be obtained. Protein 14-3-3 specificity was analysed for Creutzfeldt-Jakob disease with respect to increasing cerebrospinal fluid tests per year and spectrum of differential diagnosis. Ring trials were performed to ensure the comparability between centres during the reported time period. Protein 14-3-3 test specificity remained high and stable in the diagnosis of Creutzfeldt-Jakob disease during the observed time period across centres (total specificity 92%; when compared with patients with definite diagnoses only: specificity 90%). However, test specificity varied with respect to differential diagnosis. A high 14-3-3 specificity was obtained in differentiation to other neurodegenerative diseases (95-97%) and non

CT diagnosis of pancreatic carcinoma and chronic pancreatitis

International Nuclear Information System (INIS)

Luan Baoqing; Jin Erhu; Zhang Lizhen; Jiang Haibin

1997-01-01

To improve the diagnostic accuracy of pancreatic carcinoma and chronic pancreatitis. The CT findings of 154 cases with pancreatic carcinoma, chronic pancreatitis and mis-diagnosed other pancreatic diseases proven clinically and pathologically were analysed. Slice thickness of 8 mm and slice interval of 8 mm were used and thin-section scan and enhancement study were performed in some cases. The main signs in degassing and differential diagnosis between pancreatic carcinoma and chronic pancreatitis included: (1) focal or diffuse enlargement and density abnormality of pancreas; (2) dilated common bile duct was suddenly obstructed, peripancreatic blood vessels were invaded and cancerous thrombus was revealed, enlargement of abdominal lymph nodes and metastasis in the liver were discovered; (3) calcium deposit in the pancreatic duct area and dilated pancreatic duct which passed through the lesion or not; (4) presence and location of pancreatic cyst and its relationship to pancreatic contour. CT is the imaging modality of choice in the diagnosis of pancreatic carcinoma and chronic pancreatitis at present. The diagnostic accuracy of CT was over 90% in this series

Final height in survivors of childhood cancer compared with Height Standard Deviation Scores at diagnosis.

Science.gov (United States)

Knijnenburg, S L; Raemaekers, S; van den Berg, H; van Dijk, I W E M; Lieverst, J A; van der Pal, H J; Jaspers, M W M; Caron, H N; Kremer, L C; van Santen, H M

2013-04-01

Our study aimed to evaluate final height in a cohort of Dutch childhood cancer survivors (CCS) and assess possible determinants of final height, including height at diagnosis. We calculated standard deviation scores (SDS) for height at initial cancer diagnosis and height in adulthood in a cohort of 573 CCS. Multivariable regression analyses were carried out to estimate the influence of different determinants on height SDS at follow-up. Overall, survivors had a normal height SDS at cancer diagnosis. However, at follow-up in adulthood, 8.9% had a height ≤-2 SDS. Height SDS at diagnosis was an important determinant for adult height SDS. Children treated with (higher doses of) radiotherapy showed significantly reduced final height SDS. Survivors treated with total body irradiation (TBI) and craniospinal radiation had the greatest loss in height (-1.56 and -1.37 SDS, respectively). Younger age at diagnosis contributed negatively to final height. Height at diagnosis was an important determinant for height SDS at follow-up. Survivors treated with TBI, cranial and craniospinal irradiation should be monitored periodically for adequate linear growth, to enable treatment on time if necessary. For correct interpretation of treatment-related late effects studies in CCS, pre-treatment data should always be included.

Association between Age at Diagnosis of Graves' Disease and Variants in Genes Involved in Immune Response

Science.gov (United States)

Jurecka-Lubieniecka, Beata; Ploski, Rafal; Kula, Dorota; Krol, Aleksandra; Bednarczuk, Tomasz; Kolosza, Zofia; Tukiendorf, Andrzej; Szpak-Ulczok, Sylwia; Stanjek-Cichoracka, Anita; Polanska, Joanna; Jarzab, Barbara

2013-01-01

Background Graves' disease (GD) is a complex disease in which genetic predisposition is modified by environmental factors. The aim of the study was to examine the association between genetic variants in genes encoding proteins involved in immune response and the age at diagnosis of GD. Methods 735 GD patients and 1216 healthy controls from Poland were included into the study. Eight genetic variants in the HLA-DRB1, TNF, CTLA4, CD40, NFKb, PTPN22, IL4 and IL10 genes were genotyped. Patients were stratified by the age at diagnosis of GD and the association with genotype was analysed. Results Polymorphism in the HLA-DRB1, TNF and CTLA4 genes were associated with GD. The carriers of the HLA DRB1*03 allele were more frequent in patients with age at GD diagnosis ≤30 years than in patients with older age at GD diagnosis. Conclusions HLADRB1*03 allele is associated with young age at diagnosis of Graves' disease in polish population. PMID:23544060

Prenatal Diagnosis

Directory of Open Access Journals (Sweden)

Ozge Ozalp Yuregir

2012-02-01

Full Text Available Prenatal diagnosis is the process of determining the health or disease status of the fetus or embryo before birth. The purpose is early detection of diseases and early intervention when required. Prenatal genetic tests comprise of cytogenetic (chromosome assessment and molecular (DNA mutation analysis tests. Prenatal testing enables the early diagnosis of many diseases in risky pregnancies. Furthermore, in the event of a disease, diagnosing prenatally will facilitate the planning of necessary precautions and treatments, both before and after birth. Upon prenatal diagnosis of some diseases, termination of the pregnancy could be possible according to the family's wishes and within the legal frameworks. [Archives Medical Review Journal 2012; 21(1.000: 80-94

Transfer between hospitals as a predictor of delay in diagnosis and treatment of patients with Non-Small Cell Lung Cancer

DEFF Research Database (Denmark)

Iachina, Maria; Jakobsen, Erik; Fallesen, Anne Kudsk

2017-01-01

with treatment facilities during the care pathway. We wanted to investigate whether this organizational set-up influenced the time that patients wait for the diagnosis and treatment. Therefore, the objective of this study was to uncover the impact of transfer between hospitals on the delay in the diagnosis......BACKGROUND: Lung cancer is the second most frequent cancer diagnosis in Denmark. Although improved during the last decade, the prognosis of lung cancer is still poor with an overall 5-year survival rate of approximately 12%. Delay in diagnosis and treatment of lung cancer has been suggested...... and incomplete data on the dates of referral, diagnosis and treatment were excluded. RESULTS: A total of 11 273 patients were included for further analyses. Transfer patients waited longer for treatment after the diagnosis, (Hazard ratio (HR) 0.81 (0.68-0.96)) and in total time from referral to treatment (HR 0...

Radiation diagnosis of stomach cancer. A critical analysis of deeply rooted misconceptions

International Nuclear Information System (INIS)

Vlasov, P.V.

2000-01-01

Present notions on the problem of early diagnosis of stomach carcinoma are presented. Achievements in the field of realizing preventive examinations for early identification of stomach carcinoma are shown. Technique for biomedical radiography study is described, local and organ semiotics of stomach carcinoma are presented. Potentialities of present techniques (computerized tomography, ultrasonography, video-laparoscopy) in the assessment of spreading and staging of stomach carcinoma are analysed [ru

CT diagnosis of simple renal cysts

International Nuclear Information System (INIS)

Nanakawa, Seito; Yasunaga, Tadamasa; Tsuchigame, Tadatoshi; Kawano, Shoji; Takahashi, Mutsumasa; Fukui, Koutaro.

1987-01-01

CT is indispensable in the evaluation of renal masses, providing noninvasive and clear transverse images. With wider clinical application of CT, renal cysts have been found more frequently. CT examinations on 500 patients, who underwent CT for the diagnosis of renal diseases except for renal cysts, have been reviewed and analysed. The incidence of renal cysts was 9.6 % without prediction for sexes, but the incidence and sizes of the cysts increased with the advancing age. The upper portion of the kidneys was more frequently involved, but there was no relationship between number, sex and age of the patients. Since renal cysts produce mass effect in the kidneys, understanding of the nature and incidence of the renal cysts is important in diagnosing renal mass lesions. (author)

State of radionuclide diagnosis in the USSR (according to the data of science analysis)

International Nuclear Information System (INIS)

Arnautov, A.K.; Artamonova, N.O.; Busygina, N.A.; Kornienko, V.V.

1986-01-01

Comparison of the results analysing dynamics of publications by radionuclide diagnosis for the late 10-12 years in the occupational magazine ''Medical radiology'', ''Medical abstract magazine'', ''Radiology, roentgenology, oncology'' has been carried out. When comparing publications in ''Medical radiology'', ''Medical abstract magazine'', the expansion of fields for application of radionuclide methods for examination and increase of a number of papers on this subject in allied magazines is detected. According to the specialists' opinion, the further development of radionuclide diagnosis should take the road of development and wide provision of specialized medical institutions with high-sensitive radiometric and dosimetric equipment, short- and ultrashort-living radiopharmaceuticals

Novel technologies emerging for preimplantation genetic diagnosis and preimplantation genetic testing for aneuploidy.

Science.gov (United States)

Sermon, Karen

2017-01-01

Preimplantation genetic diagnosis (PGD) was introduced as an alternative to prenatal diagnosis: embryos cultured in vitro were analysed for a monogenic disease and only disease-free embryos were transferred to the mother, to avoid the termination of pregnancy with an affected foetus. It soon transpired that human embryos show a great deal of acquired chromosomal abnormalities, thought to explain the low success rate of IVF - hence preimplantation genetic testing for aneuploidy (PGT-A) was developed to select euploid embryos for transfer. Areas covered: PGD has followed the tremendous evolution in genetic analysis, with only a slight delay due to adaptations for diagnosis on small samples. Currently, next generation sequencing combining chromosome with single-base pair analysis is on the verge of becoming the golden standard in PGD and PGT-A. Papers highlighting the different steps in the evolution of PGD/PGT-A were selected. Expert commentary: Different methodologies used in PGD/PGT-A with their pros and cons are discussed.

Surgical resection of highly suspicious pulmonary nodules without a tissue diagnosis

International Nuclear Information System (INIS)

Heo, Eun-Young; Lee, Kyung-Won; Jheon, Sanghoon; Lee, Jae-Ho; Lee, Choon-Taek; Yoon, Ho-II

2011-01-01

The safety and efficacy of surgical resection of lung nodule without tissue diagnosis is controversial. We evaluated direct surgical resection of highly suspicious pulmonary nodules and the clinical and radiological predictors of malignancy. Retrospective analyses were performed on 113 patients who underwent surgical resection without prior tissue diagnosis for highly suspicious pulmonary nodules. Clinical and radiological characteristics were compared between histologically proven benign and malignant nodules after resection. Total costs, length of hospitalization and waiting time to surgery were compared with those of patients who had tissue diagnosis prior to surgery. Among 280 patients with pulmonary nodules suspicious for lung cancer, 113 (40.4%) underwent operation without prior tissue diagnosis. Lung nodules were diagnosed as malignant in 96 (85%) of the 113 patients. Except for forced expiratory volume in 1 s, clinical characteristics were not significantly different according to the pathologic results. Forty-five (90%) of 50 patients with ground-glass opacity nodules had a malignancy. Mixed ground-glass opacity, bubble lucency, irregular margin and larger size correlated with malignancy in ground-glass opacity nodules (P<0.05). Fifty-one (81%) of 67 patients with solid nodules had a malignancy. Spiculation, pre-contrast attenuation and contrast enhancement significantly correlated with malignancy in solid nodules (P<0.05). Surgical resection without tissue diagnosis significantly decreased total costs, hospital stay and waiting time (P<0.05). Direct surgical resection of highly suspicious pulmonary nodules can be a valid procedure. However, careful patient selection and further investigations are required to justify direct surgical resection. (author)

Parent-child communication patterns during the first year after a parent's cancer diagnosis: the effect on parents' functioning.

Science.gov (United States)

Gazendam-Donofrio, Stacey; Hoekstra, Harald; van der Graaf, Winette; van de Wiel, Harry; Visser, Annemieke; Huizinga, Gea; Hoekstra-Weebers, Josette

2009-09-15

Good parent-child communication is thought to help families adjust more easily during stressful events such as parental cancer. Families dealing with cancer who communicate openly have reported less psychological distress. The first year after diagnosis may be particularly stressful. The authors investigated parents' quality of life (QOL) and stress-response symptoms and parent-child communication during the first year after diagnosis and examined possible relationships between communication and parents' functioning. Recently-diagnosed cancer patients (N=70) and spouses (N=55) participated within 4 months of diagnosis (T1) and 6 months (T2) and 12 months later (T3). Parents reported on communication with the children (PACS) and on their own physical and psychosocial functioning (RAND-36) and stress-response symptoms (IES). Parent-child communication remained stable throughout the first year after diagnosis and was similar to communication in families 1 year to 5 years after diagnosis. Patients' functioning improved and cancer-related distress decreased significantly. Spouses' cancer-related distress decreased; their functioning fluctuated through the year. In concurrent analyses, patients' open communication with the children related only to T1 intrusion. Spouses' open communication related to T3 psychosocial functioning; problem communication related to T1 and T2 psychosocial functioning and T2 avoidance. In prospective analyses, no significant relationships were found between parent-child communication and change in parents' functioning. Communication between parents and children remained stable over time; patients' and spouses' functioning improved. Parent-child communication seems to have a limited affect on parents' functioning. Copyright (c) 2009 American Cancer Society.

Does the medical diagnosis of occupational asthma coincide with the legal diagnosis?

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Çelebi Sözener, Zeynep; Aydın, Ömür; Demirel, Yavuz Selim; Soyyiğit, Şadan; Çerçi, Pamir; Kendirlinan, Reşat; Bavbek, Sevim; Çelik, Gülfem Elif; Misirligil, Zeynep; Sin, Betül Ayşe; Keleşoğlu, Arif; Mungan, Dilşad

2017-11-01

The incidence of occupational asthma (OA) is increasing worldwide. In this study, we first aimed to document the rate of diagnosis of OA among patients who were referred to our clinic from the Social Security Institution and the factors that affected diagnosis; secondly, we aimed to assess the consistency of the medical and legal diagnoses. The study involved 132 consecutive patients who were referred to our clinic for the evaluation of OA between 2010 and 2015. Detailed workplace history, the tools used in the diagnosis such as peak expiratory flow (PEF) monitoring and bronchial provocation tests, and the final medical diagnosis were recorded from case files. Asthma was diagnosed in 75% (n = 99) of the patients. Among them, 22.2% were diagnosed as having OA. The diagnosis was confirmed by serial PEF measurements, non-specific bronchial hyperreactivity assessment or both of the tests both at work and off-work periods. OA diagnosis was mostly established in active workers (72.7%). The legal diagnosis period was completed in 54.5% of these 22 patients, and 50% (n = 11) were officially diagnosed as having OA with a 91.6% concordance with medical diagnosis. This study verifies the importance of diagnosing asthma correctly as a first step in the evaluation of OA. Diagnostic tests other than specific provocation tests could be preferential in patients who still work in the same field. We believe that cooperation with the patient's occupational physician and adequate recognition of the work environment will improve the consistency of legal and medical diagnoses.

The role of dual diagnosis in health-related quality of life among treatment-seeking patients in Spain.

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Daigre, Constanza; Grau-López, Lara; Rodríguez-Cintas, Laia; Ros-Cucurull, Elena; Sorribes-Puertas, Marta; Esculies, Oriol; Bones-Rocha, Katia; Roncero, Carlos

2017-12-01

The comorbidity of any substance use disorder and another mental disorder is defined as dual diagnosis. Dual diagnosis is very common and clinical and therapeutic consequences have been described. This cross-sectional study aimed to analyse health-related quality of life (HRQoL) according to clinical characteristics and psychiatric comorbidities in patients with substance dependence. A total of 1276 substance-dependent patients seeking treatment were recruited. HRQoL was evaluated by the Short-Form 36 (SF-36) questionnaire. The SCID-I, SCID-II and Conners' adult ADHD diagnostic interview were used to evaluate dual diagnosis. A visual analogue scale was used to measure craving. Bivariate and multivariate analyses were performed, and correction for multiple tests was conducted. Substance-dependent patients had impaired quality of life, especially in the mental component. SF-36 physical and mental component scores were 47.7 ± 10.9 and 36.1 ± 14.1, respectively. Furthermore, 65% of the patients had dual diagnosis, 51% had an Axis I DSM-IV-TR mental disorder and 35% had some personality disorder. Impaired physical quality of life was independently associated with medical condition, age, being female, depressive disorder and anxiety disorder. Depression disorder, any personality disorder, active consumption last month, Attention deficit hyperactivity disorder, anxiety disorder, suicide attempt were independently associated with worse mental quality of life. These findings emphasize the significance of dual diagnosis in the impairment of HRQoL in substance-dependent patients, particularly with regard to mental component. In addicted patients with low scores on SF-36, psychiatric comorbidity should be evaluated and treated in an integrated approach.

The contribution of cell blocks in the diagnosis of mediastinal masses and hilar adenopathy samples from echobronchoscopy.

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Lourido-Cebreiro, Tamara; Leiro-Fernández, Virginia; Tardio-Baiges, Antoni; Botana-Rial, Maribel; Núñez-Delgado, Manuel; Álvarez-Martín, M Jesús; Fernández-Villar, Alberto

2014-07-01

Cell block material from puncture can be obtained with endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) in many cases. The aim of this study was to analyse the value of additional information from cell blocks obtained with EBUS-TBNA samples from mediastinal and hilar lymph nodes and masses. Review of pathology reports with a specific diagnosis obtained from EBUS-TBNA samples of mediastinal or hilar lesions, prospectively obtained over a two-year period. The generation of cell blocks from cytology needle samples, the contribution to morphological diagnosis, and the possible use of samples for immunohistochemistry were analysed. One hundred and twenty-nine samples corresponding to 110 patients were reviewed. The diagnosis was lung cancer in 81% of cases, extrapulmonary carcinoma in 10%, sarcoidosis in 4%, lymphoma in 2.7%, and tuberculosis in 0.9%. Cell blocks could be obtained in 72% of cases. Immunohistochemistry studies on the cell blocks were significantly easier to perform than on conventional smears (52.6% vs. 14%, P<.0001). In 4cases, the cell block provided an exclusive morphological diagnosis (3sarcoidosis and one metastasis from prostatic carcinoma) and in 3carcinomas, subtype and origin could be identified. Exclusive diagnoses from the cell block were significantly more frequent in benign disease than in malignant disease (25% vs 0.9%, P=.002). Cell blocks were obtained from 72% of EBUS-TBNA diagnostic procedures. The main contributions of cell blocks to pathology examinations were the possibility of carrying out immunohistochemical staining for the better classification of neoplasms, especially extrapulmonary metastatic tumours, and the improved diagnosis of benign lesions. Copyright © 2013 SEPAR. Published by Elsevier Espana. All rights reserved.

Extending Ansoff’s Strategic Diagnosis Model

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Daniel Kipley

2012-01-01

Full Text Available Given the complex and disruptive open-ended dynamics in the current dynamic global environment, senior management recognizes the need for a formalized, consistent, and comprehensive framework to analyze the firm’s strategic posture. Modern assessment tools, such as H. Igor Ansoff’s seminal contributions to strategic diagnosis, primarily focused on identifying and enhancing the firm’s strategic performance potential through the analysis of the industry’s environmental turbulence level relative to the firm’s aggressiveness and responsiveness of capability. Other epistemic modeling techniques envisage Porter’s generic strategic positions, Strengths, Weaknesses, Opportunities, Threats (SWOT, and Resource-Based View as useful methodologies to aid in the planning process. All are complex and involve multiple managerial perspectives. Over the last two decades, attempts have been made to comprehensively classify the firm’s future competitive position. Most of these proposals utilized matrices to depict the position, such as the Boston Consulting Group, point positioning, and dispersed positioning. The GE/McKinsey later enhanced this typology by expanding to 3 × 3, contributing to management’s deeper understanding of the firm’s position. Both types of assessments, Ansoff’s strategic diagnosis and positional matrices, are invaluable strategic tools for firms. However, it could be argued that these positional analyses singularly reflect a blind spot in modeling the firm’s future strategic performance potential, as neither considers the interactions of the other. This article is conceptual and takes a different approach from earlier methodologies. Although conceptual, the article aims to present a robust model combining Ansoff’s strategic diagnosis with elements of the performance matrices to provide the management with an enriched capability to evaluate the firm’s current and future performance position.

Effects of integrated designs of alarm and process information on diagnosis performance in digital nuclear power plants.

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Wu, Xiaojun; She, Manrong; Li, Zhizhong; Song, Fei; Sang, Wei

2017-12-01

In the main control rooms of nuclear power plants (NPPs), operators frequently switch between alarm displays and system-information displays to incorporate information from different screens. In this study, we investigated two integrated designs of alarm and process information - integrating alarm information into process displays (denoted as Alarm2Process integration) and integrating process information into alarm displays (denoted as Process2Alarm integration). To analyse the effects of the two integration approaches and time pressure on the diagnosis performance, a laboratory experiment was conducted with ninety-six students. The results show that compared with the non-integrated case, Process2Alarm integration yields better diagnosis performance in terms of diagnosis accuracy, time required to generate correct hypothesis and completion time. In contrast, the Alarm2Process integration leads to higher levels of workload, with no improvement in diagnosis performance. The diagnosis performance of Process2Alarm integration was consistently better than that of Alarm2Process integration, regardless of the levels of time pressure. Practitioner Summary: To facilitate operator's synthesis of NPP information when performing diagnosis tasks, we proposed to integrate process information into alarm displays. The laboratory validation shows that the integration approach significantly improves the diagnosis performance for both low and high time-pressure levels.

Rare chromosome abnormalities, prevalence and prenatal diagnosis rates from population-based congenital anomaly registers in Europe

NARCIS (Netherlands)

Wellesley, Diana; Dolk, Helen; Boyd, Patricia A.; Greenlees, Ruth; Haeusler, Martin; Nelen, Vera; Garne, Ester; Khoshnood, Babak; Doray, Berenice; Rissmann, Anke; Mullaney, Carmel; Calzolari, Elisa; Bakker, Marian; Salvador, Joaquin; Addor, Marie-Claude; Draper, Elizabeth; Rankin, Judith; Tucker, David

The aim of this study is to quantify the prevalence and types of rare chromosome abnormalities (RCAs) in Europe for 2000-2006 inclusive, and to describe prenatal diagnosis rates and pregnancy outcome. Data held by the European Surveillance of Congenital Anomalies database were analysed on all the

HHT diagnosis by Mid-infrared spectroscopy and artificial neural network analysis.

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Lux, Andreas; Müller, Ralf; Tulk, Mark; Olivieri, Carla; Zarrabeita, Roberto; Salonikios, Theresia; Wirnitzer, Bernhard

2013-06-27

The vascular disorder Hereditary Hemorrhagic Telangiectasia (HHT) is in general an inherited disease caused by mutations in the TGF-β/BMP receptors endoglin or ALK1 or in rare cases by mutations of the TGF-β signal transducer protein Smad4 leading to the combined syndrome of juvenile polyposis and HHT. HHT is characterized by several clinical symptoms like spontaneous and recurrent epistaxis, multiple telangiectases at sites like lips, oral cavity, fingers, nose, and visceral lesions like gastrointestinal telangiectasia, pulmonary, hepatic, cerebral or spinal arteriovenous malformations. The disease shows an inter- and intra-family variability in penetrance as well as symptoms from mild to life threatening. Penetrance is also depending on age. Diagnosis of the disease is based on the presence of some of the listed symptoms or by genetic testing. HHT diagnosis is laborious, time consuming, costly and sometimes uncertain. Not all typical symptoms may be present, especially at a younger age, and genetic testing does not always identify the disease causing mutation. Infrared (IR) spectroscopy was investigated as a potential alternative to the current diagnostic methods. IR-spectra were obtained by Fourier-transform Mid-IR spectroscopy from blood plasma from HHT patients and a healthy control group. Spectral data were mathematically processed and subsequently classified and analysed by artificial neural network (ANN) analyses and by visual analysis of scatter plots of the dominant principal components. The analyses showed that for HHT a disease specific IR-spectrum exists that is significantly different from the control group. Furthermore, at the current stage with the here used methods, HHT can be diagnosed by Mid-IR-spectroscopy in combination with ANN analysis with a sensitivity and specificity of at least 95%. Visual analysis of PCA scatter plots revealed an inter class variation of the HHT group. IR-spectroscopy in combination with ANN analysis can be considered

MAT FOR LEPTOSPIROSIS DIAGNOSIS

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Esti Rahardianingtyas.

2014-06-01

Full Text Available Leptospirosis is a disease caused by bacterial infection leptospira interrogans.Leptospira bacteria is a spiral bacterium with solid strands with two flagella periplasmik.Septicaemic phase patient samples taken from the blood and cerebrospinal fluid, whereassamples taken at phase immune extracted from urine. The diagnosis of leptospirosis occurdirectly or indirectly. Diagnosis is done by directly isolate and identify the causative agents ofthe agent. Diagnosis is done indirectly by detecting specific antibodies from the patient's body.Gold Standard of the diagnosis of leptospirosis is MAT. Mat made by reacting antibodies toleptospira antigen. Positive results seen with clump formed.Key words: Leptospirosis, Leptospirosis Diagnostic, MAT (Microscopic Agglutination Test Leptospirosis merupakan penyakit yang disebabkan karena infeksi bakteri leptospirainterrogans. Bakteri leptospira merupakan bakteri spiral dengan untaian yang padat dengan duaflagella periplasmik. Sampel pasien pada fase septicaemic diambil dari darah dan cairanserebrospinal, sedangkan sampel yang diambil pada fase immune diambil dari urine. Diagnosisleptospirosis dilakukan secara langsung maupun tidak langsung. Diagnosis secara langsungdilakukan dengan cara mengisolasi agen penyebab dan mengidentifikasi agen tersebut. Diagnosissecara tidak langsung dilakukan dengan cara mendeteksi antibodi spesiflk dari dalam tubuhpasien. Gold Standart dari diagnosis leptospirosis adalah MAT. Mat dilakukan dengan caramereaksikan antibodi dengan antigen leptospira. Hasil positif dilihat dengan terbentuk gumpalanagglutinasiKata kunci: Leptospirosis, Leptospira, Leptospirosis Diagnosis.

Lung cancer stage at diagnosis: Individual associations in the prospective VITamins and lifestyle (VITAL cohort

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Au David H

2011-06-01

Full Text Available Abstract Background Lung cancer is the leading cause of cancer death in the United States. Identifying factors associated with stage of diagnosis can improve our understanding of biologic and behavioral pathways of lung cancer development and detection. We used data from a prospective cohort study to evaluate associations of demographic, health history, and health behaviors with early versus late stage at diagnosis of non-small cell lung cancer (NSCLC. Methods We calculated odds ratios (ORs for the association of patient-level characteristics with advanced stage of diagnosis for NSCLC. The OR's were then adjusted for age, gender, race/ethnicity, smoking status, income, education, chronic obstructive pulmonary disease, and a comorbidity index. Results We identified 612 cases of NSCLC among 77,719 adults, aged 50 to 76 years from Washington State recruited in 2000-2002, with followup through December 2007. In univariate analyses, subjects who quit smoking Conclusions Smoking status, education, and a screening activity were associated with stage at diagnosis of NSCLC. These results may guide future studies of the underlying mechanisms that influence how NSCLC is detected and diagnosed.

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

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

2015-02-01

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

Diagnosis and treatment of radioactive poisoning. Proceedings of the scientific meeting on the diagnosis and treatment of radioactive poisoning

International Nuclear Information System (INIS)

1963-01-01

The increasing use of atomic energy generated by nuclear fission is necessarily accompanied by the production of large quantities of radioactive isotopes. This, together with the growing use of radioactive materials in many fields, has given added importance to practical considerations of how best to deal with accidents - should they occur - involving radioactive contamination of individuals. Such considerations require knowledge of the metabolic behaviour of various radionuclides in man and of methods of increasing their elimination from the body. Information of this type is limited, and it is therefore essential to make maximum use of those data which, are available. Analyses of earlier accidents are one important source of such data; another is experience gained from the medical administration of radioisotopes for therapeutic or diagnostic purposes. The World Health Organization and the International Atomic Energy Agency jointly sponsored a scientific meeting on the Diagnosis and Treatment of Radioactive Poisoning, in Vienna from 15 to 18 October 1962. The aim of the meeting, which followed an earlier one (The Diagnosis and Treatment of Acute Radiation Injury) sponsored by the two organizations in 1960 on another aspect of radiation protection, was to review the present state of knowledge on the diagnosis, evaluation and treatment of persons who have accidentally incorporated radioactive materials. It brought together three groups of persons: those experienced in various methods of diagnosis and treatment of patients who have been exposed (occupationally or accidentally) to radioactive material; those engaged in the clinical administration of radionuclides and the study of their behaviour in man; and those working on related problems with experimental animals. In view of the great interest of many of the topics discussed at the meeting, it was felt desirable that the information presented in the papers and brought out in the ensuing discussions should be

Electrical machines diagnosis

CERN Document Server

Trigeassou, Jean-Claude

2013-01-01

Monitoring and diagnosis of electrical machine faults is a scientific and economic issue which is motivated by objectives for reliability and serviceability in electrical drives.This book provides a survey of the techniques used to detect the faults occurring in electrical drives: electrical, thermal and mechanical faults of the electrical machine, faults of the static converter and faults of the energy storage unit.Diagnosis of faults occurring in electrical drives is an essential part of a global monitoring system used to improve reliability and serviceability. This diagnosis is perf

Diagnosis of secondary amyloidosis in alkaptonuria.

Science.gov (United States)

Millucci, Lia; Ghezzi, Lorenzo; Bernardini, Giulia; Braconi, Daniela; Lupetti, Pietro; Perfetto, Federico; Orlandini, Maurizio; Santucci, Annalisa

2014-09-26

Alkaptonuria (AKU) is an inborn error of catabolism due to a deficient activity of homogentisate 1,2-dioxygenase. Patients suffer from a severe arthropathy, cardiovascular and kidney disease but other organs are affected, too. We found secondary amyloidosis as a life-threatening complication in AKU, thus opening new perspectives for its treatment. We proved that methotrexate and anti-oxidants have an excellent efficacy to inhibit the production of amyloid in AKU model chondrocytes. Owing to the progressive and intractable condition, it seems important to detect amyloid deposits at an early phase in AKU and the choice of specimens for a correct diagnosis is crucial. Ten AKU subjects were examined for amyloidosis; abdominal fat pad aspirates, labial salivary gland, cartilage and synovia specimens were analysed by CR, Th-T, IF, TEM. Amyloid was detected in only one abdominal fat pad specimen. However, all subjects demonstrated amyloid deposition in salivary glands and in other organ biopsies, indicating salivary gland as the ideal specimen for early amyloid detection in AKU. This is, at the best of our knowledge, the first report providing correct indications on the diagnosis of amyloidosis in AKU, thus offering the possibility of treatment of such co-morbidity to AKU patients. The virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/13000_2014_185.

Improved multimodal biomarkers for Alzheimer's disease and mild cognitive impairment diagnosis: data from ADNI

Science.gov (United States)

Martinez-Torteya, Antonio; Treviño-Alvarado, Víctor; Tamez-Peña, José

2013-02-01

The accurate diagnosis of Alzheimer's disease (AD) and mild cognitive impairment (MCI) confers many clinical research and patient care benefits. Studies have shown that multimodal biomarkers provide better diagnosis accuracy of AD and MCI than unimodal biomarkers, but their construction has been based on traditional statistical approaches. The objective of this work was the creation of accurate AD and MCI diagnostic multimodal biomarkers using advanced bioinformatics tools. The biomarkers were created by exploring multimodal combinations of features using machine learning techniques. Data was obtained from the ADNI database. The baseline information (e.g. MRI analyses, PET analyses and laboratory essays) from AD, MCI and healthy control (HC) subjects with available diagnosis up to June 2012 was mined for case/controls candidates. The data mining yielded 47 HC, 83 MCI and 43 AD subjects for biomarker creation. Each subject was characterized by at least 980 ADNI features. A genetic algorithm feature selection strategy was used to obtain compact and accurate cross-validated nearest centroid biomarkers. The biomarkers achieved training classification accuracies of 0.983, 0.871 and 0.917 for HC vs. AD, HC vs. MCI and MCI vs. AD respectively. The constructed biomarkers were relatively compact: from 5 to 11 features. Those multimodal biomarkers included several widely accepted univariate biomarkers and novel image and biochemical features. Multimodal biomarkers constructed from previously and non-previously AD associated features showed improved diagnostic performance when compared to those based solely on previously AD associated features.

Parental communication and children's behaviour following diagnosis of childhood leukaemia.

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Clarke, Sally-Ann; Davies, Helena; Jenney, Meriel; Glaser, Adam; Eiser, Christine

2005-04-01

Many parents find decisions about what to tell their child with cancer difficult. Open communication is generally considered the best policy and most health care professionals encourage parents to talk openly and honestly about the illness. However, parents differ in their views about what to tell the child. In this study 55 parents of children (36 boys and 19 girls, mean age = 7.33 years) newly diagnosed with acute lymphoblastic leukaemia (ALL) were interviewed about (i) the child's reactions and behaviour following diagnosis, (ii) their views about what to tell their child and (iii) factors influencing parents' communication with the child. Interviews were analysed using thematic analysis. Most children showed behavioural and mood difficulties after diagnosis. Older children were given more information. In addition, parents' perceptions of childhood cancer affect the way they communicate with their child. These findings may be used to inform training packages in order to facilitate improved communication amongst health professionals. Copyright 2004 John Wiley & Sons, Ltd.

Tools for monitoring and diagnosis of power Transformers

International Nuclear Information System (INIS)

Borsi, H.; Gockenbach, E.

1999-05-01

For an optimised maintenance as well as damage prevention and a prediction of further life expectancy the knowledge of the insulation condition of power transformers can be estimated using monitoring systems. In this paper a monitoring method based on a new system for an on-line measurement of P D and undissolved gases on transformers is presented. A modular structured system is introduced which is able to analyse the statistical characteristics of broadband measured P D-pulses by using digital signal processing. Furthermore a new developed electronic Buchholzrelay for the detection of undissolved gases will be described which allows a diagnosis of the insulation and a protection of the transformer

Cellular Blue Nevus Diagnosed following Excision of Melanoma: A Challenge in Diagnosis

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Nives Jonjić

2016-01-01

Full Text Available A case of a 41-year-old woman with a history of nodular melanoma (NM, associated with an indurated dome-shaped blue-black nodule with a diameter of 1.2 cm in the gluteal region, is presented. Clinical diagnosis of the lesion, present from birth, was blue nevus. Recently, the nodule has been showing a mild enlargement and thus complete resection was performed. Histological analysis revealed a pigmented lesion with an expansive pattern of extension into the dermis and the subcutaneous adipose tissue. The lesion displayed an alveolar pattern as well as a pigmented dendritic cell pattern. The histology was consistent with cellular blue nevus (CBN; however, the history of NM which was excised one year earlier, as well as the clinical information about the slow growing lesion, included a differential diagnosis of CBN, borderline melanocytic tumor, and malignant blue nevus. Additional immunohistochemical (HMB-45, p16, and Ki-67 and molecular (BRAF V600E mutation analyses were performed on both lesions: the CBN-like and the previously excised NM. Along with lesion history and histological analyses, p16 staining and BRAF were useful diagnostic tools for confirming the benign nature of CBN in this case.

Steroid hormone analysis in diagnosis and treatment of DSD: position paper of EU COST Action BM 1303 'DSDnet'

NARCIS (Netherlands)

Kulle, A.; N.P. Krone (Nils); P-M. Holterhus (Paul-Martin); G. Schuler (Gerhard); Greaves, R.F.; A. Juul (Anders); Y.B. de Rijke (Yolanda); Hartmann, M.F.; Saba, A.; O. Hiort (Olaf); S.A. Wudy (Stefan)

2017-01-01

textabstractDisorders or differences in sex development (DSD) comprise a heterogeneous group of conditions with an atypical sex development. For optimal diagnosis, highly specialised laboratory analyses are required across European countries. Working group 3 of EU COST (European Cooperation in

Death by suicide and other externally caused injuries following a cancer diagnosis: the Japan Public Health Center-based Prospective Study.

Science.gov (United States)

Yamauchi, Takashi; Inagaki, Masatoshi; Yonemoto, Naohiro; Iwasaki, Motoki; Inoue, Manami; Akechi, Tatsuo; Iso, Hiroyasu; Tsugane, Shoichiro

2014-09-01

There have been very few population-based prospective studies that have investigated the risks of deaths by suicide and other externally caused injuries (ECIs) among cancer patients in an Asian population. This study investigated whether the risk of death by both suicide and ECIs increases during the first year following the initial diagnosis of cancer. Data were analyzed from a population-based cohort of Japanese residents between 1990 and 2010, collected during the Japan Public Health Center-based Prospective Study. Poisson regression models were used to calculate adjusted risk ratios (RRs) for both suicide and ECI deaths. To adjust for unmeasured confounding factors, case-crossover analyses were conducted for all patients with cancer who died by suicide and ECIs. A population-based cohort of 102,843 Japanese residents was established. During the follow-up period, there were 34 suicides and 48 ECI deaths among patients with cancer, as compared with 527 suicides and 707 ECI deaths among those who did not have cancer. Analyses revealed that those who were newly diagnosed with cancer were at a greatly increased risk of death by suicide and ECIs within the first year after their diagnosis (suicide RR = 23.9, 95% CI: 13.8-41.6; ECI RR = 18.8, 95% CI: 11.4-31.0). Furthermore, the case-crossover analyses generally confirmed the results of the Poisson regressions. The risks of suicide and ECI deaths within the first year after a cancer diagnosis were higher than those among cancer-free populations. A diagnosis of cancer is a critical experience that may increase the risk of fatal outcomes. Copyright © 2014 John Wiley & Sons, Ltd.

Delays in the diagnosis of pulmonary tuberculosis in Coahuila, Mexico.

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Salinas, J; Calvillo, S; Caylà, J; Nedel, F B; Martín, M; Navarro, A

2012-09-01

To determine diagnostic delay in pulmonary tuberculosis (PTB) cases and analyse associated factors. New PTB cases were studied in Coahuila, Northern Mexico, between 2008 and 2009. We obtained census data and data on residential address, symptoms and diagnosis from the national patient database; sociodemographic variables were obtained during home visits. Bivariate analyses used the Kaplan-Meier method; multivariate analysis consisted of modelling survival. We studied 458 subjects (median age 48 years), who were predominantly males (56.1%); the median years of schooling was 6.0 years, 83.4% were urban residents, 50.3% were unemployed, and 87.7% suffered from food poverty. The median delay between the onset of symptoms and the first medical consultation was 53.5 days. Lack of formal education (P = 0.050) and living ≥5 km from a health unit (P = 0.034) were associated with longer delays and consequently with severe symptoms (cough ≥2 weeks, P = 0.001; chest pain, P = 0.032; malnutrition, P = 0.003). Mean health system delay (between first consultation and smear test result) was 18.5 days, and was significantly longer when the first consultation was with a private physician (P < 0.001) and when patient age was ≥46 years (P = 0.001). In Coahuila, lack of formal education, living ≥5 km from a health unit, first consultation with a private physician, and being aged ≥46 years contributed to delays in PTB diagnosis.

The Relationship between Neighborhood Immigrant Composition, Limited English Proficiency, and Late-Stage Colorectal Cancer Diagnosis in California

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Cynthia M. Mojica

2015-01-01

Full Text Available Despite the availability of effective early detection technologies, more than half (61% of colorectal cancers in the United States and 55% in California are identified at an advanced stage. Data on colorectal cancer patients (N=35,030 diagnosed from 2005 to 2007 were obtained from the California Cancer Registry. Multivariate analyses found a relationship among neighborhood concentration of recent immigrants, neighborhood rates of limited English proficiency, and late-stage colorectal cancer diagnosis. Hispanics living in neighborhoods with a greater percentage of recent immigrants (compared to the lowest percentage had greater odds (OR 1.57, 95% CI 1.22, 2.02 of late-stage diagnosis whereas Hispanics living in neighborhoods with the highest percentage of limited English proficiency (compared to the lowest percentage had lower odds (OR .71, 95% CI .51, .99 of late-stage diagnosis. These relationships were not observed for other ethnic groups. Results highlight the complex relationship among race/ethnicity, neighborhood characteristics, and colorectal cancer stage at diagnosis.

Consistency between referral diagnosis and post-ENMG diagnosis in children

International Nuclear Information System (INIS)

Komur, M.; Okuyaz, C.; Makharoblidze, K.

2014-01-01

Objective: To evaluate the degree of consistency between the referral diagnosis and that based on electroneuromyography. Methods: The retrospective study was conducted at the Paediatric Neurology Laboratory of Mersin University School of Medicine, Turkey, and comprised all electroneuromyographies carried out between January 2005 and December 2010. Demographic data, referral diagnosis and post-procedure diagnosis were recorded for each patient, and were classified into groups. Consistency between the two groups was compared using SPSS 13. Results: Of the total 294 patients, polyneuropathy was the reason for referral in 104 (35.4%), peripheral nerve injury in 54 (18.4%), brachial plexus injury in 52 (17.7%), myopathy in 52 (17.7%), hypotonia in 23 (7.8%), and facial paralysis in 9 (3.0%) patients. There was consistency between the two diagnoses in 179 (60.9%) patients. Conclusion: Electroneuromyography is an uneasy, painful and stressfull procedure for children, and, therefore, it should be recommended only in cases where the result may be beneficial in the diagnosis, treatment and follow-up of a patient. (author)

Florbetaben PET in the Early Diagnosis of Alzheimer's Disease: A Discrete Event Simulation to Explore Its Potential Value and Key Data Gaps

Science.gov (United States)

Guo, Shien; Getsios, Denis; Hernandez, Luis; Cho, Kelly; Lawler, Elizabeth; Altincatal, Arman; Lanes, Stephan; Blankenburg, Michael

2012-01-01

The growing understanding of the use of biomarkers in Alzheimer's disease (AD) may enable physicians to make more accurate and timely diagnoses. Florbetaben, a beta-amyloid tracer used with positron emission tomography (PET), is one of these diagnostic biomarkers. This analysis was undertaken to explore the potential value of florbetaben PET in the diagnosis of AD among patients with suspected dementia and to identify key data that are needed to further substantiate its value. A discrete event simulation was developed to conduct exploratory analyses from both US payer and societal perspectives. The model simulates the lifetime course of disease progression for individuals, evaluating the impact of their patient management from initial diagnostic work-up to final diagnosis. Model inputs were obtained from specific analyses of a large longitudinal dataset from the New England Veterans Healthcare System and supplemented with data from public data sources and assumptions. The analyses indicate that florbetaben PET has the potential to improve patient outcomes and reduce costs under certain scenarios. Key data on the use of florbetaben PET, such as its influence on time to confirmation of final diagnosis, treatment uptake, and treatment persistency, are unavailable and would be required to confirm its value. PMID:23326754

Florbetaben PET in the Early Diagnosis of Alzheimer's Disease: A Discrete Event Simulation to Explore Its Potential Value and Key Data Gaps

Directory of Open Access Journals (Sweden)

Shien Guo

2012-01-01

Full Text Available The growing understanding of the use of biomarkers in Alzheimer's disease (AD may enable physicians to make more accurate and timely diagnoses. Florbetaben, a beta-amyloid tracer used with positron emission tomography (PET, is one of these diagnostic biomarkers. This analysis was undertaken to explore the potential value of florbetaben PET in the diagnosis of AD among patients with suspected dementia and to identify key data that are needed to further substantiate its value. A discrete event simulation was developed to conduct exploratory analyses from both US payer and societal perspectives. The model simulates the lifetime course of disease progression for individuals, evaluating the impact of their patient management from initial diagnostic work-up to final diagnosis. Model inputs were obtained from specific analyses of a large longitudinal dataset from the New England Veterans Healthcare System and supplemented with data from public data sources and assumptions. The analyses indicate that florbetaben PET has the potential to improve patient outcomes and reduce costs under certain scenarios. Key data on the use of florbetaben PET, such as its influence on time to confirmation of final diagnosis, treatment uptake, and treatment persistency, are unavailable and would be required to confirm its value.

Ileocecal endometriosis: diagnosis and management

Directory of Open Access Journals (Sweden)

Ana López Carrasco

2017-04-01

Conclusion: Variability in symptoms hinders diagnosis. The gold standard for diagnosis is MRI, but clinical suspicion optimizes imaging test diagnosis. Segmental resection should be indicated in the majority of the cases.

Reporting studies on time to diagnosis: proposal of a guideline by an international panel (REST).

Science.gov (United States)

Launay, Elise; Cohen, Jérémie F; Bossuyt, Patrick M; Buekens, Pierre; Deeks, Jonathan; Dye, Timothy; Feltbower, Richard; Ferrari, Andrea; Kramer, Michael; Leeflang, Mariska; Moher, David; Moons, Karel G; von Elm, Erik; Ravaud, Philippe; Chalumeau, Martin

2016-09-27

Studies on time to diagnosis are an increasing field of clinical research that may help to plan corrective actions and identify inequities in access to healthcare. Specific features of time to diagnosis studies, such as how participants were selected and how time to diagnosis was defined and measured, are poorly reported. The present study aims to derive a reporting guideline for studies on time to diagnosis. Each item of a list previously used to evaluate the completeness of reporting of studies on time to diagnosis was independently evaluated by a core panel of international experts (n = 11) for relevance and readability before an open electronic discussion allowed consensus to be reached on a refined list. The list was then submitted with an explanatory document to first, last and/or corresponding authors (n = 98) of published systematic reviews on time to diagnosis (n = 45) for relevance and readability, and finally approved by the core expert panel. The refined reporting guideline consists of a 19-item checklist: six items are about the process of participant selection (with a suggested flowchart), six about the definition and measurement of time to diagnosis, and three about optional analyses of associations between time to diagnosis and participant characteristics and health outcomes. Of 24 responding authors of systematic reviews, more than 21 (≥88 %) rated the items as relevant, and more than 17 (≥70 %) as readable; 19 of 22 (86 %) authors stated that they would potentially use the reporting guideline in the future. We propose a reporting guideline (REST) that could help authors, reviewers, and editors of time to diagnosis study reports to improve the completeness and the accuracy of their reporting.

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

Directory of Open Access Journals (Sweden)

Fariba Yadegari

2003-12-01

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

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

Science.gov (United States)

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

2015-05-01

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

Locomotor activity measures in the diagnosis of Attention Deficit Hyperactivity Disorder: Meta-analyses and new findings

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Murillo, Lourdes García; Cortese, Samuele; Anderson, David; Martino, Adriana Di; Castellanos, Francisco Xavier

2015-01-01

Introduction Our aim was to assess differences in movement measures in Attention-Deficit/Hyperactivity Disorder (ADHD) vs. typically developing (TD) controls. Methods We performed meta-analyses of published studies on motion measures contrasting ADHD with controls. We also conducted a case-control study with children/adolescents (n=61 TD, n=62 ADHD) and adults (n=30 TD, n=19 ADHD) using the McLean Motion Activity Test, semi-structured diagnostic interviews and the Behavior Rating Inventory of Executive Function and Conners (Parent, Teacher; Self) Rating Scales. Results Meta-analyses revealed medium-to-large effect sizes for actigraph (standardized mean difference [SMD]: 0.64, 95% Confidence interval (CI): 0.43, 0.85) and motion tracking systems (SDM: 0.92, 95% CI: 0.65, 1.20) measures in differentiating individuals with ADHD from controls. Effects sizes were similar in studies of children/adolescents ([SMD]:0.75, 95% CI: 0.50, 1.01) and of adults ([SMD]: 0.73, 95% CI: 0.46, 1.00). In our sample, ADHD groups differed significantly in number of Head Movements (p=0.02 in children; p=0.002 in adults), Displacement (p=0.009/pADHD (d=0.45, 95% CI: 0.08, 0.82). In the concurrent go/no-go task, reaction time variability was significantly greater in ADHD (pADHD even in adults. Our results suggest that objective locomotion measures may be particularly useful in evaluating adults with possible ADHD. PMID:25770940

The nature and correlates of change in depressive symptoms with cancer diagnosis: reaction and adaptation.

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Infurna, Frank J; Gerstorf, Denis; Ram, Nilam

2013-06-01

Major life events trigger change processes in mental health. We examined how depressive symptoms change in conjunction with cancer diagnosis during adulthood and old age, and whether sociodemographic variables, cognitive and health resources, and cancer-specific mortality risks moderate event-related reaction and adaptation. Specifically, we applied multiphase growth models to prospective longitudinal data from 2,848 participants (age at diagnosis: M = 69, SD = 9.91; 46% women) in the Health and Retirement Study (HRS) who reported receiving a cancer diagnosis while enrolled in the study. On average, individuals experienced a significant increase in depressive symptoms within 2 years of cancer diagnosis, still-elevated levels 2 years postdiagnosis, and smaller increases in depressive symptoms postdiagnosis relative to the increases observed prediagnosis. Better memory and lower cancer-specific mortality risks were protective against increases in depressive symptoms within 2 years of diagnosis and were associated with reporting fewer depressive symptoms 2 years postdiagnosis. Findings suggest that diagnosis-related changes in depressive symptoms are typically characterized by a multiphase pattern, but tremendous between-person differences also emerged within each phase. Follow-up analyses comparing a matched group (N = 2,272) who did not experience cancer provided an additional layer of evidence supporting our inferences. Results indicate that, on average, people adapt and adjust to the challenges accompanying a cancer diagnosis, and illustrate the utility of using natural experiments such as major life events as a paradigm for studying developmental change processes. PsycINFO Database Record (c) 2013 APA, all rights reserved.

DIAGNOSIS OF PITCH AND LOAD DEFECTS

DEFF Research Database (Denmark)

2009-01-01

The invention relates to a method, system and computer readable code for diagnosis of pitch and/or load defects of e.g. wind turbines as well as wind turbines using said diagnosis method and/or comprising said diagnosis system.......The invention relates to a method, system and computer readable code for diagnosis of pitch and/or load defects of e.g. wind turbines as well as wind turbines using said diagnosis method and/or comprising said diagnosis system....

Leukoencephalopathy with swelling in children and adolescents: MRI patterns and differential diagnosis

International Nuclear Information System (INIS)

Knaap, M.S. van der; Valk, J.; Barth, P.G.; Smit, L.M.E.; Engelen, B.G.M. van; Tortori Donati, P.

1995-01-01

In children, several neurological disorders are characterised by spongiform leukoencephalopathy. MRI of the brain typically shows white matter swelling, but does not enable differentiation of the various underlying disorders. The aim of this article is optimisation of the diagnostic value of MRI in leukoencephalopathy accompanied by swelling. MRI-based inclusion criteria were met by 20 patients in our database. The images were analysed using a detailed scoring list. In 13 of the 20 patients the clinical diagnosis was known (11 definite and 2 probable diagnoses). Characteristic MRI abnormalities could be defined in these patients. Of the 7 patients without a diagnosis, 5 had identical MRI abnormalities: diffuse hemisphere swelling and typical cysts in frontoparietal subcortical white matter and the tips of the temporal lobes. The clinical picture was also similar in these patients, suggesting a similar disease. (orig.). With 10 figs., 2 tabs

Radiological diagnosis in AIDS - associated diseases: survey and differential diagnosis

International Nuclear Information System (INIS)

Rademaker, J.; Frahm, C.

1997-01-01

Acute manifestations of illnesses in patients with HIV-infection or AIDS will benefit from rapid diagnosis. Radiologic examinations provide substantial information to narrow the differential diagnosis. This article reviews clinically important HIV-associated diseases for the radiologist. The braod spectrum of possible manifestations is illustrated by the accompanying case reports that typify the complexity of diagnoses in this growing problem worldwide. (orig.) [de

Diagnosis and differential diagnosis of cerebro-vascular malformations by CT

International Nuclear Information System (INIS)

Schumacher, M.; Stoeter, P.; Voigt, K.

1980-01-01

In 38 patients, the diagnosis of a cerebrovascular malformation (17 arteriovenous angiomas including one low-flow- and two venous angiomas; 10 aneurysms; 4 arteriovenous fistulae of the cavernous sinus, the tentorium and one of the Great Vein of Galen; 6 megadolical basilar arteries) was initially made by computertomographic (CT) examination, including contrast enhancement. The characteristic and pathognomonic CT findings are described and compared with those of cerebral angiography also done in these cases. The problems of differential diagnosis and the reasons for a false CT diagnosis in 5 other patients with a cerebro-vascular malformation are investigated; and the diagnostic value of cerebral angiography and CT is discussed and their complementary functions are being pointed out. (orig.) 891 MG/orig. 892 MKO [de

Global manipulation of digital images can lead to variation in cytological diagnosis.

Science.gov (United States)

Prasad, H; Wanjari, Sangeeta; Parwani, Rajkumar

2011-03-31

With the adoption of a completely electronic workflow by several journals and the advent of telepathology, digital imaging has become an integral part of every scientific research. However, manipulating digital images is very easy, and it can lead to misinterpretations. To analyse the impact of manipulating digital images on their diagnosis. Digital images were obtained from Papanicolaou-stained smears of dysplastic and normal oral epithelium. They were manipulated using GNU Image Manipulation Program (GIMP) to alter their brightness and contrast and color levels. A Power Point presentation composed of slides of these manipulated images along with the unaltered originals arranged randomly was created. The presentation was shown to five observers individually who rated the images as normal, mild, moderate or severe dysplasia. Weighted κ statistics was used to measure and assess the levels of agreement between observers. Levels of agreement between manipulated images and original images varied greatly among observers. Variation in diagnosis was in the form of overdiagnosis or under-diagnosis, usually by one grade. Global manipulations of digital images of cytological slides can significantly affect their interpretation. Such manipulations should therefore be kept to a minimum, and avoided wherever possible.

Limitations of Gram staining for the diagnosis of infections following total hip or knee arthroplasty.

Science.gov (United States)

Ouyang, Zhengxiao; Zhai, Zanjing; Qin, A N; Li, Haowei; Liu, Xuqiang; Qu, Xinhua; Dai, Kerong

2015-05-01

The diagnosis of prosthetic joint infection (PJI) following total joint arthroplasty is difficult for clinicians to make decisions due to the similar symptoms presented by aseptic loosening and infection. Gram staining (GS) is a widely used test but its value remains controversial due to conflicting results in the diagnosis of PJI. The aim of the present study was therefore to evaluate the value of GS in the diagnosis of PJI. Searches using MEDLINE, EMBASE and OVID databases were conducted for data published between January 1990 and December 2013. Meta-analysis was used to pool the sensitivity, specificity, diagnostic odd ratios (DORs), area under the receiver-operating characteristic curve (AUC), positive-likelihood ratios (PLRs), negative-likelihood ratios (NLRs) and post-test probability. The heterogeneity and publication bias were assessed, and subgroup and meta-regression analyses were conducted. A total of 18 studies, including a total of 4,647 patients, were selected for analysis. The pooled sensitivity and specificity values for the diagnosis of PJI were 0.19 and 1.00, respectively. The AUC, PLR and NLR were 0.89, 41.6 and 0.82, respectively. Subgroup analyses indicated that the sensitivity/specificity for total hip arthroplasty was 0.14/0.99, whereas that for total knee arthroplasty was 0.14/1.00. Synovial fluid best reflected accurate GS-based diagnoses, with the highest DOR of 242, whereas tissue had the highest AUC of 0.96 (95% CI, 0.94-0.97). GS had a poor clinically acceptable diagnostic value for detecting PJI. These data do not support the routine use of GS, without additional proof of infection, for diagnosing PJI; instead, GS could be used as an adjuvant tool to support the results of other investigations.

A new and standardized method to sample and analyse vitreous samples by the Cellient automated cell block system.

Science.gov (United States)

Van Ginderdeuren, Rita; Van Calster, Joachim; Stalmans, Peter; Van den Oord, Joost

2014-08-01

In this prospective study, a universal protocol for sampling and analysing vitreous material was investigated. Vitreous biopsies are difficult to handle because of the paucity of cells and the gelatinous structure of the vitreous. Histopathological analysis of the vitreous is useful in difficult uveitis cases to differentiate uveitis from lymphoma or infection and to define the type of cellular reaction. Hundred consecutive vitreous samples were analysed with the Cellient tissue processor (Hologic). This machine is a fully automated processor starting from a specified container with PreservCyt (fixative fluid) with cells to paraffin. Cytology was compared with fixatives Cytolyt (contains a mucolyticum) and PreservCyt. Routine histochemical and immunostainings were evaluated. In 92% of the cases, sufficient material was found for diagnosis. In 14%, a Cytolyt wash was necessary to prevent clotting of the tubes in the Cellient due to the viscosity of the sample. In 23%, the diagnosis was an acute inflammation (presence of granulocytes); in 33%, chronic active inflammation (presence of T lymphocytes); in 33%, low-grade inflammation (presence of CD68 cells, without T lymphocytes); and in 3%, a malignant process. A standardized protocol for sampling and handling vitreous biopsies, fixing in PreservCyt and processing by the Cellient gives a satisfactory result in morphology, number of cells and possibility of immuno-histochemical stainings. The diagnosis can be established or confirmed in more than 90% of cases. © 2014 Acta Ophthalmologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.

Differential diagnosis of radiation injury

Energy Technology Data Exchange (ETDEWEB)

Wendt, F

1971-04-01

A single haematological alteration is not sufficient to diagnose whether it is a radiation-induced change or not. For the differential diagnosis of possibly radiation-induced changes in the peripheral blood and blood-forming organs, information on the radiation exposure in terms of time, quality, quantity and localization, and the clinical symptoms have to be taken into account. Ionizing radiation within the dosage range considered here produces cell division delay, mitotic inhibition, chromosomal damage or interphase cell death; it thereby interferes with the steady-state equilibria in the cell-renewal systems of the organism (Bond et al., 1965; Little, 1968). The cause of haematological changes appearing immediately after a short-term, external whole-body radiation exposure has been described and analysed elsewhere in this Manual. The critical cell component is the 'stem cell compartment' which is highly radiosensitive and suffers damage but, because stem cells cannot be identified morphologically, a direct study of stem cell injury is not possible.

Rapid diagnosis of aneuploidy using segmental duplication quantitative fluorescent PCR.

Directory of Open Access Journals (Sweden)

Xiangdong Kong

Full Text Available The aim of this study was use a simple and rapid procedure, called segmental duplication quantitative fluorescent polymerase chain reaction (SD-QF-PCR, for the prenatal diagnosis of fetal chromosomal aneuploidies. This method is based on the co-amplification of segmental duplications located on two different chromosomes using a single pair of fluorescent primers. The PCR products of different sizes were subsequently analyzed through capillary electrophoresis, and the aneuploidies were determined based on the relative dosage between the two chromosomes. Each primer set, containing five pairs of primers, was designed to simultaneously detect aneuploidies located on chromosomes 21, 18, 13, X and Y in a single reaction. We applied these two primer sets to DNA samples isolated from individuals with trisomy 21 (n = 36; trisomy 18 (n = 6; trisomy 13 (n = 4; 45, X (n = 5; 47, XXX (n = 3; 48, XXYY (n = 2; and unaffected controls (n = 40. We evaluated the performance of this method using the karyotyping results. A correct and unambiguous diagnosis with 100% sensitivity and 100% specificity, was achieved for clinical samples examined. Thus, the present study demonstrates that SD-QF-PCR is a robust, rapid and sensitive method for the diagnosis of common aneuploidies, and these analyses can be performed in less than 4 hours for a single sample, providing a competitive alternative for routine use.

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

Science.gov (United States)

Larner, A J

2007-07-01

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

Role of physical activity and diet after colorectal cancer diagnosis.

Science.gov (United States)

Van Blarigan, Erin L; Meyerhardt, Jeffrey A

2015-06-01

This review summarizes the evidence regarding physical activity and diet after colorectal cancer diagnosis in relation to quality of life, disease recurrence, and survival. There have been extensive reports on adiposity, inactivity, and certain diets, particularly those high in red and processed meats, and increased risk of colorectal cancer. Only in the past decade have data emerged on how such lifestyle factors are associated with outcomes in colorectal cancer survivors. Prospective observational studies have consistently reported that physical activity after colorectal cancer diagnosis reduces mortality. A meta-analysis estimated that each 15 metabolic equivalent task-hour per week increase in physical activity after colorectal cancer diagnosis was associated with a 38% lower risk of mortality. No randomized controlled trials have been completed to confirm that physical activity lowers risk of mortality among colorectal cancer survivors; however, trials have shown that physical activity, including structured exercise, is safe for colorectal cancer survivors (localized to metastatic stage, during and after treatment) and improves cardiorespiratory fitness and physical function. In addition, prospective observational studies have suggested that a Western dietary pattern, high carbohydrate intake, and consuming sugar-sweetened beverages after diagnosis may increase risk of colorectal cancer recurrence and mortality, but these data are limited to single analyses from one of two US cohorts. Additional data from prospective studies and randomized controlled trials are needed. Nonetheless, on the basis of the available evidence, it is reasonable to counsel colorectal cancer survivors to engage in regular physical activity and limit consumption of refined carbohydrates, red and processed meats, and sugar-sweetened beverages. © 2015 by American Society of Clinical Oncology.

Optical coherence tomography for the diagnosis of malignant skin tumors: a meta-analysis

Science.gov (United States)

Xiong, Yi-Quan; Mo, Yun; Wen, Yu-Qi; Cheng, Ming-Ji; Huo, Shu-Ting; Chen, Xue-Jiao; Chen, Qing

2018-02-01

Optical coherence tomography (OCT) is an emergent imaging tool used for noninvasive diagnosis of skin diseases. The present meta-analysis was carried out to assess the accuracy of OCT for the diagnosis of skin cancer. We conducted a systematic literature search though EMBASE, Medline, PubMed, the Cochrane Library, and Web of Science database for relevant articles published up to June 6, 2017. The quality of the included studies was assessed using the QUADAS-2 tool and the Oxford Levels of Evidence Scale. Statistical analyses were conducted using the software Meta-Disc version 1.4 and STATA version 12.0. A total of 14 studies involving more than 813 patients with a total of 1958 lesions were included in our analyses. The pooled sensitivity and specificity of OCT for skin cancer diagnoses were 91.8% and 86.7%, respectively. Subgroup analysis showed that the pooled sensitivities of OCT for detecting basal cell carcinoma (BCC), squamous cell carcinoma (SCC), actinic keratosis, and malignant melanoma were 92.4%, 92.3%, 73.8%, and 81.0%, respectively. The pooled specificities were 86.9%, 99.5%, 91.5%, and 93.8%, respectively. OCT appears to be useful for the detection of BCC and SCC. It is a valuable diagnostic method when screening for early skin cancers.

Dual Diagnosis - Multiple Languages

Science.gov (United States)

... National Library of Medicine Comorbidity or dual diagnosis - Opioid addiction, part 9 - English PDF Comorbidity or dual diagnosis - Opioid addiction, part 9 - español (Spanish) PDF Comorbidity or dual ...

Gram staining of protected pulmonary specimens in the early diagnosis of ventilator-associated pneumonia.

Science.gov (United States)

Mimoz, O; Karim, A; Mazoit, J X; Edouard, A; Leprince, S; Nordmann, P

2000-11-01

We evaluated prospectively the use of Gram staining of protected pulmonary specimens to allow the early diagnosis of ventilator-associated pneumonia (VAP), compared with the use of 60 bronchoscopic protected specimen brushes (PSB) and 126 blinded plugged telescopic catheters (PTC) obtained from 134 patients. Gram stains were from Cytospin slides; they were studied for the presence of microorganisms in 10 and 50 fields by two independent observers and classified according to their Gram stain morphology. Quantitative cultures were performed after serial dilution and plating on appropriate culture medium. A final diagnosis of VAP, based on a culture of > or = 10(3) c.f.u. ml-1, was established after 81 (44%) samplings. When 10 fields were analysed, a strong relationship was found between the presence of bacteria on Gram staining and the final diagnosis of VAP (for PSB and PTC respectively: sensitivity 74 and 81%, specificity 94 and 100%, positive predictive value 91 and 100%, negative predictive value 82 and 88%). The correlation was less when we compared the morphology of microorganisms observed on Gram staining with those of bacteria obtained from quantitative cultures (for PSB and PTC respectively: sensitivity 54 and 69%, specificity 86 and 89%, positive predictive value 72 and 78%, negative predictive value 74 and 84%). Increasing the number of fields read to 50 was associated with a slight decrease in specificity and positive predictive value of Gram staining, but with a small increase in its sensitivity and negative predictive value. The results obtained by the two observers were similar to each other for both numbers of fields analysed. Gram staining of protected pulmonary specimens performed on 10 fields predicted the presence of VAP and partially identified (using Gram stain morphology) the microorganisms growing at significant concentrations, and could help in the early choice of the treatment of VAP. Increasing the number of fields read or having the Gram

Diagnosis of Ewing's sarcoma in the thoracic spine - problems in differential diagnosis

International Nuclear Information System (INIS)

Schaub, T.; Dittrich, H.M.; Gutjahr, P.; Antoniadis, A.; Wolff, P.

1986-01-01

Spinal Ewing's sarcomas are rare and cause problems in differential diagnosis. The radiologic, nuclear medicine and CT findings in two children with histologically proven Ewing's sarcoma are presented and problems in differential diagnosis discussed. Biopsy should be done early. (orig.) [de

The Autism Simplex Collection : an international, expertly phenotyped autism sample for genetic and phenotypic analyses

OpenAIRE

Buxbaum, Joseph D.; Bolshakova, Nadia; Brownfeld, Jessica M.; Anney, Richard J. L.; Bender, Patrick; Bernier, Raphael; Cook, Edwin H.; Coon, Hilary; Cuccaro, Michael L.; Freitag, Christine M.; Hallmayer, Joachim; Geschwind, Daniel H.; Klauck, Sabine M.; Nurnberger, John I.; Oliveira, Guiomar

2014-01-01

Background: There is an urgent need for expanding and enhancing autism spectrum disorder (ASD) samples, in order to better understand causes of ASD. Methods: In a unique public-private partnership, 13 sites with extensive experience in both the assessment and diagnosis of ASD embarked on an ambitious, 2-year program to collect samples for genetic and phenotypic research and begin analyses on these samples. The program was called The Autism Simplex Collection (TASC). TASC sample collection ...

Eating disorders in adolescents: how does the DSM-5 change the diagnosis?

Science.gov (United States)

Fisher, Martin; Gonzalez, Marisol; Malizio, Joan

2015-11-01

This study aimed to determine the changes in diagnosis that occur in making the transition from Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) to Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) criteria in an adolescent medicine eating disorder program. During the months of September 2011 through December 2012, a data sheet was completed at the end of each new outpatient eating disorder evaluation listing the patient's gender, age, ethnicity, weight, height, DSM-IV diagnosis, and proposed DSM-5 diagnosis. Distributions were calculated using the Mann-Whitney and Wilcoxon rank sum analyses to determine differences between diagnostic groups. There were 309 patients evaluated during the 16-month period. DSM-IV diagnoses were as follows: anorexia nervosa, 81 patients (26.2%); bulimia nervosa, 29 patients (9.4%); binge eating disorder, 1 patient (0.3%); and eating disorder not otherwise specified (EDNOS), 198 patients (64.6%). By contrast, DSM-5 diagnoses were as follows: anorexia nervosa, 100 patients; atypical anorexia nervosa, 93 patients; avoidant/restrictive food intake disorder, 60 patients; bulimia nervosa, 29 patients; purging disorder, 18 patients; unspecified feeding or eating disorder, 4 patients; subthreshold bulimia nervosa, 2 patients; subthreshold binge eating disorder, 2 patients; and binge eating disorder, 1 patient. Almost two thirds (64.6%) of the 309 patients had a diagnosis of EDNOS based on the DSM-IV criteria. By contrast, only four patients had a diagnosis of unspecified feeding or eating disorder based on the DSM-5 criteria. These data demonstrate that the goal of providing more specific diagnoses for patients with eating disorders has been accomplished very successfully by the new DSM-5 criteria.

Diagnosis checking of statistical analysis in RCTs indexed in PubMed.

Science.gov (United States)

Lee, Paul H; Tse, Andy C Y

2017-11-01

Statistical analysis is essential for reporting of the results of randomized controlled trials (RCTs), as well as evaluating their effectiveness. However, the validity of a statistical analysis also depends on whether the assumptions of that analysis are valid. To review all RCTs published in journals indexed in PubMed during December 2014 to provide a complete picture of how RCTs handle assumptions of statistical analysis. We reviewed all RCTs published in December 2014 that appeared in journals indexed in PubMed using the Cochrane highly sensitive search strategy. The 2014 impact factors of the journals were used as proxies for their quality. The type of statistical analysis used and whether the assumptions of the analysis were tested were reviewed. In total, 451 papers were included. Of the 278 papers that reported a crude analysis for the primary outcomes, 31 (27·2%) reported whether the outcome was normally distributed. Of the 172 papers that reported an adjusted analysis for the primary outcomes, diagnosis checking was rarely conducted, with only 20%, 8·6% and 7% checked for generalized linear model, Cox proportional hazard model and multilevel model, respectively. Study characteristics (study type, drug trial, funding sources, journal type and endorsement of CONSORT guidelines) were not associated with the reporting of diagnosis checking. The diagnosis of statistical analyses in RCTs published in PubMed-indexed journals was usually absent. Journals should provide guidelines about the reporting of a diagnosis of assumptions. © 2017 Stichting European Society for Clinical Investigation Journal Foundation.

Thermo-economic and environmental analyses based multi-objective optimization of vapor compression–absorption cascaded refrigeration system using NSGA-II technique

International Nuclear Information System (INIS)

Jain, Vaibhav; Sachdeva, Gulshan; Kachhwaha, Surendra Singh; Patel, Bhavesh

2016-01-01

Highlights: • It addresses multi-objective optimization study on cascaded refrigeration system. • Cascaded system is a promising decarburizing and energy efficient technology. • NSGA-II technique is used for multi-objective optimization. • Total annual product cost and irreversibility rate are simultaneously optimized. - Abstract: Present work optimizes the performance of 170 kW vapor compression–absorption cascaded refrigeration system (VCACRS) based on combined thermodynamic, economic and environmental parameters using Non-dominated Sort Genetic Algorithm-II (NSGA-II) technique. Two objective functions including the total irreversibility rate (as a thermodynamic criterion) and the total product cost (as an economic criterion) of the system are considered simultaneously for multi-objective optimization of VCACRS. The capital and maintenance costs of the system components, the operational cost, and the penalty cost due to CO_2 emission are included in the total product cost of the system. Three optimized systems including a single-objective thermodynamic optimized, a single-objective economic optimized and a multi-objective optimized are analyzed and compared. The results showed that the multi-objective design considers the combined thermodynamic and total product cost criteria better than the two individual single-objective thermodynamic and total product cost optimized designs.

A Novel Method for Inverter Faults Detection and Diagnosis in PMSM Drives of HEVs based on Discrete Wavelet Transform

Directory of Open Access Journals (Sweden)

AKTAS, M.

2012-11-01

Full Text Available The paper proposes a novel method, based on wavelet decomposition, for detection and diagnosis of faults (switch short-circuits and switch open-circuits in the driving systems with Field Oriented Controlled Permanent Magnet Synchro?nous Motors (PMSM of Hybrid Electric Vehicles. The fault behaviour of the analyzed system was simulated by Matlab/SIMULINK R2010a. The stator currents during transients were analysed up to the sixth level detail wavelet decomposition by Symlet2 wavelet. The results prove that the proposed fault diagnosis system have very good capabilities.

A new Brief computerized cognitive screening battery (CompCogs for early diagnosis of Alzheimer's disease

Directory of Open Access Journals (Sweden)

Helenice Charchat Fichman

Full Text Available Abstract Screening tests for early diagnosis of dementia are of great clinical relevance. The ideal test set must be brief and reliable, and should probe cognitive components impaired in Alzheimer's disease (AD. Objectives: To develop a new Computerized Cognitive Screening test (CompCogs, and to investigate its validity for the early diagnosis of AD, and evaluate its heuristic value in understanding the processing of information in AD. Methods: The computerized neuropsychological performance battery, originally including six tests, was applied in forty seven patients with probable mild AD and 97 controls matched for age and education. This computerized neuropsychological test battery, developed with MEL Professional, allows control of timing and order of stimuli presentation, as well as recording of response type and latency. A brief-screening version, CompCogs, was selected using the most discriminative neuropsychological test variables derived from logistic regression analysis. Full battery administration lasted about 40 minutes, while the CompCogs took only 15 minutes. Results: CompCogs included the Face test (correct response and Word and Forms with Short term memory tests (reaction time. CompCogs presented 91.8% sensitivity and 93.6% specificity for the diagnosis of AD using ROC analyses of AD diagnosis probability derived by logistic regression. Conclusions: CompCogs showed high validity for AD early diagnosis and, therefore, may be a useful alternative screening instrument.

Time-varying singular value decomposition for periodic transient identification in bearing fault diagnosis

Science.gov (United States)

Zhang, Shangbin; Lu, Siliang; He, Qingbo; Kong, Fanrang

2016-09-01

For rotating machines, the defective faults of bearings generally are represented as periodic transient impulses in acquired signals. The extraction of transient features from signals has been a key issue for fault diagnosis. However, the background noise reduces identification performance of periodic faults in practice. This paper proposes a time-varying singular value decomposition (TSVD) method to enhance the identification of periodic faults. The proposed method is inspired by the sliding window method. By applying singular value decomposition (SVD) to the signal under a sliding window, we can obtain a time-varying singular value matrix (TSVM). Each column in the TSVM is occupied by the singular values of the corresponding sliding window, and each row represents the intrinsic structure of the raw signal, namely time-singular-value-sequence (TSVS). Theoretical and experimental analyses show that the frequency of TSVS is exactly twice that of the corresponding intrinsic structure. Moreover, the signal-to-noise ratio (SNR) of TSVS is improved significantly in comparison with the raw signal. The proposed method takes advantages of the TSVS in noise suppression and feature extraction to enhance fault frequency for diagnosis. The effectiveness of the TSVD is verified by means of simulation studies and applications to diagnosis of bearing faults. Results indicate that the proposed method is superior to traditional methods for bearing fault diagnosis.

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

LENUS (Irish Health Repository)

Kelly, S B

2012-02-01

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

Diagnosis and Management of Polycythemia Vera in a Ferret (Mustela putorius furo).

Science.gov (United States)

Le, Kim; Beaufrère, Hugues; Bassel, Laura L; Wills, Sarah; Laniesse, Delphine; Blois, Shauna L; Smith, Dale A

2016-12-01

A 5-y-old female ferret (Mustela putorius furo) was evaluated for diarrhea, anorexia, and lethargy for 1 wk. Only mild dehydration was detected on physical examination. CBC analysis revealed marked erythrocytosis with an unremarkable plasma biochemistry panel; follow-up CBC analyses revealed a consistent primary erythrocytosis. Whole-body radiographs and abdominal ultrasonography were unremarkable except for a small nephrolith in the right kidney and a small cyst in the left kidney. The plasma erythropoietin level was 17.0 mIU/mL and considered normal. In light of the diagnostic work-up and consistent erythrocytosis, a diagnosis of polycythemia vera (primary erythrocytosis) was made. The initial presentation of diarrhea resolved after treatment with oral metronidazole (20 mg/kg PO BID for 7 d). Treatment for the polycythemia consisted of a phlebotomy initially followed by chemotherapy with hydroxyurea (10 mg/kg PO BID). During the subsequent 12 mo, the hydroxyurea dose adjusted according to follow-up CBC results, and finding an optimal dosage regimen proved to be challenging. One year after the initial diagnosis, the ferret presented to an emergency clinic for acute and severe hemorrhagic diarrhea and died shortly thereafter. The postmortem diagnosis was acute venous infarction of the small and large intestine. To our knowledge, this report is the first to describe the diagnosis and long-term management of polycythemia vera in a ferret and the use of hydroxyurea for this purpose.

A novel case-control design to estimate the extent of over-diagnosis of breast cancer due to organised population-based mammography screening.

Science.gov (United States)

Beckmann, Kerri R; Lynch, John W; Hiller, Janet E; Farshid, Gelareh; Houssami, Nehmat; Duffy, Stephen W; Roder, David M

2015-03-15

Debate about the extent of breast cancer over-diagnosis due to mammography screening has continued for over a decade, without consensus. Estimates range from 0 to 54%, but many studies have been criticized for having flawed methodology. In this study we used a novel study design to estimate over-diagnosis due to organised mammography screening in South Australia (SA). To estimate breast cancer incidence at and following screening we used a population-based, age-matched case-control design involving 4,931 breast cancer cases and 22,914 controls to obtain OR for yearly time intervals since women's last screening mammogram. The level of over-diagnosis was estimated by comparing the cumulative breast cancer incidence with and without screening. The former was derived by applying ORs for each time window to incidence rates in the absence of screening, and the latter, by projecting pre-screening incidence rates. Sensitivity analyses were undertaken to assess potential biases. Over-diagnosis was estimated to be 8% (95%CI 2-14%) and 14% (95%CI 8-19%) among SA women aged 45 to 85 years from 2006-2010, for invasive breast cancer and all breast cancer respectively. These estimates were robust when applying various sensitivity analyses, except for adjustment for potential confounding assuming higher risk among screened than non-screened women, which reduced levels of over-diagnosis to 1% (95%CI 5-7%) and 8% (95%CI 2-14%) respectively when incidence rates for screening participants were adjusted by 10%. Our results indicate that the level of over-diagnosis due to mammography screening is modest and considerably lower than many previous estimates, including others for Australia. © 2014 UICC.

Microanalysis in cancer diagnosis

Energy Technology Data Exchange (ETDEWEB)

Tkacheva, G A [Akademiya Meditsinskikh Nauk SSSR, Moscow. Onkologicheskij Nauchnyj Tsentr

1984-11-01

An analysis of the diagnosis accuracy of malignant gastric, rectal, liver and prostatic tumors was performed with relation to the sensitivity and specificity of radioimmunological and immunoenzyme commercial kits of reagents manufactured by different companies and used to determine the concentration of the carcinoembryonic antigen, ..cap alpha..-fetoprotein and acid phosphatase of the prostate. With an increase of the test specificity its diagnostic sensitivity decreases, i.e. the percentage of false-negative results increases. The use of highly specific monoclonal antibodies in serological tests results in a marked decrease of the accuracy of tumor diagnosis. It is necessary to strictly determine indications for the use of the serological and immunodiagnostic kits: for the identification of risk populations, early diagnosis of tumors, differential diagnosis or the monitoring of patients.

Laparoscopic diagnosis of endometriosis.

Science.gov (United States)

Wood, Carl; Kuhn, Raphael; Tsaltas, Jim

2002-08-01

To consider and explain the possibility of difficulties in diagnosis of endometriosis at previous laparoscopy Retrospective patient record review. The Endometriosis Care Centre of Australia and the private practices of authors. Two hundred and fifteen patients with clinical evidence of endometriosis examined laparoscopically between March 1999 and May 2001. Confirmation of endometriosis by histological biopsy. Endometriosis was confirmed in 168 of the 215 women. Of these women 38 had a previous negative laparoscopy within 12 months of the current laparoscopy. It is possible that in some of the patients, who previously had a negative laparoscopy, endometriosis was not recognised. Possible reasons for difficulty in diagnosis have been identified and techniques to improve diagnosis suggested. This retrospective study was performed to consider and explain the possibility of difficulties in diagnosis of endometriosis at previous laparoscopy.

Performance assessment and optimization of an irreversible nano-scale Stirling engine cycle operating with Maxwell-Boltzmann gas

Science.gov (United States)

Ahmadi, Mohammad H.; Ahmadi, Mohammad-Ali; Pourfayaz, Fathollah

2015-09-01

Developing new technologies like nano-technology improves the performance of the energy industries. Consequently, emerging new groups of thermal cycles in nano-scale can revolutionize the energy systems' future. This paper presents a thermo-dynamical study of a nano-scale irreversible Stirling engine cycle with the aim of optimizing the performance of the Stirling engine cycle. In the Stirling engine cycle the working fluid is an Ideal Maxwell-Boltzmann gas. Moreover, two different strategies are proposed for a multi-objective optimization issue, and the outcomes of each strategy are evaluated separately. The first strategy is proposed to maximize the ecological coefficient of performance (ECOP), the dimensionless ecological function (ecf) and the dimensionless thermo-economic objective function ( F . Furthermore, the second strategy is suggested to maximize the thermal efficiency ( η), the dimensionless ecological function (ecf) and the dimensionless thermo-economic objective function ( F). All the strategies in the present work are executed via a multi-objective evolutionary algorithms based on NSGA∥ method. Finally, to achieve the final answer in each strategy, three well-known decision makers are executed. Lastly, deviations of the outcomes gained in each strategy and each decision maker are evaluated separately.

Optimization of the triple-pressure combined cycle power plant

Directory of Open Access Journals (Sweden)

Alus Muammer

2012-01-01

Full Text Available The aim of this work was to develop a new system for optimization of parameters for combined cycle power plants (CCGTs with triple-pressure heat recovery steam generator (HRSG. Thermodynamic and thermoeconomic optimizations were carried out. The objective of the thermodynamic optimization is to enhance the efficiency of the CCGTs and to maximize the power production in the steam cycle (steam turbine gross power. Improvement of the efficiency of the CCGT plants is achieved through optimization of the operating parameters: temperature difference between the gas and steam (pinch point P.P. and the steam pressure in the HRSG. The objective of the thermoeconomic optimization is to minimize the production costs per unit of the generated electricity. Defining the optimal P.P. was the first step in the optimization procedure. Then, through the developed optimization process, other optimal operating parameters (steam pressure and condenser pressure were identified. The developed system was demonstrated for the case of a 282 MW CCGT power plant with a typical design for commercial combined cycle power plants. The optimized combined cycle was compared with the regular CCGT plant.

Conceptual design and system analysis of a poly-generation system for power and olefin production from natural gas

International Nuclear Information System (INIS)

Qian Yu; Liu Jingyao; Huang Zhixian; Kraslawski, Andrzej; Cui Jian; Huang Yinlun

2009-01-01

In this paper, a novel poly-generation system for olefin and power production from natural gas is proposed, which integrates hydrocarbon production and the combined cycle power generation. Economic and technological evaluation based on the internal rate of return (IRR) and exergy efficiency is performed. The energy integration results in the proposed poly-generation system for simultaneous production of chemical products (ethylene and propylene) and electricity being more thermodynamically efficient and economically viable than single purpose power generation and chemical products production plants. IRR and exergy efficiency of the proposed poly-generation system are higher than that of natural gas methanol to olefin (NGMTO) system, 18.9% and 49.9%, respectively. The biggest exergy destruction segments, their causes, and possible measures for improvement are investigated simulation and thermodynamic analysis. To analyze the effect of unreacted syngas recycle on the exergy efficiency and economic gains from the proposed poly-generation system, its thermoeconomic optimization model is built by combining economic with thermodynamic analysis. Optimization analysis shows that when 78% of the unreacted syngas is recycled back to the reactor in the methanol synthesization process, the thermoeconomic performance of the poly-generation system is at its optimum.

Big Five personality and depression diagnosis, severity and age of onset in older adults.

Science.gov (United States)

Koorevaar, A M L; Comijs, H C; Dhondt, A D F; van Marwijk, H W J; van der Mast, R C; Naarding, P; Oude Voshaar, R C; Stek, M L

2013-10-01

Personality may play an important role in late-life depression. The aim of this study is to examine the association between the Big Five personality domains and the diagnosis, severity and age of onset of late-life depression. The NEO-Five Factor Inventory (NEO-FFI) was cross-sectionally used in 352 depressed and 125 non-depressed older adults participating in the Netherlands Study of Depression in Older Persons (NESDO). Depression diagnosis was determined by the Composite International Diagnostic Interview (CIDI). Severity of depression was assessed by the Inventory of Depressive Symptomatology (IDS). Logistic and linear regression analyses were applied. Adjustments were made for sociodemographic, cognitive, health and psychosocial variables. Both the presence of a depression diagnosis and severity of depression were significantly associated with higher Neuroticism (OR=1.35, 95% CI=1.28-1.43 and B=1.06, ppersonality measures. This study confirms an association between personality and late-life depression. Remarkable is the association found between high Openness and earlier age of depression onset. © 2013 Elsevier B.V. All rights reserved.

Observer agreement in the diagnosis of interstitial lung diseases based on HRCT scans

International Nuclear Information System (INIS)

Antunes, Viviane Baptista; Meirelles, Gustavo de Souza Portes; Jasinowodolinski, Dany; Verrastro, Carlos Gustavo Yuji; Torlai, Fabiola Goda

2010-01-01

Objective: to determine the interobserver and intraobserver agreement in the diagnosis of interstitial lung diseases (ILDs) based on HRCT scans and the impact of observer expertise, clinical data and confidence level on such agreement. Methods: two thoracic radiologists and two general radiologists independently reviewed the HRCT images of 58 patients with ILDs on two distinct occasions: prior to and after the clinical anamnesis. The radiologists selected up to three diagnostic hypotheses for each patient and defined the confidence level for these hypotheses. One of the thoracic and one of the general radiologists re-evaluated the same images up to three months after the first readings. In the coefficient analyses, the kappa statistic was used. Results: the thoracic and general radiologists, respectively, agreed on at least one diagnosis for each patient in 91.4% and 82.8% of the patients. The thoracic radiologists agreed on the most likely diagnosis in 48.3% (κ = 0.42) and 62.1% (κ = 0.58) of the cases, respectively, prior to and after the clinical anamnesis; likewise, the general radiologists agreed on the most likely diagnosis in 37.9% (κ 0.32) and 36.2% (κ = 0.30) of the cases. For the thoracic radiologist, the intraobserver agreement on the most likely diagnosis was 0.73 and 0.63 prior to and after the clinical anamnesis, respectively. That for the general radiologist was 0.38 and 0.42.The thoracic radiologists presented almost perfect agreement for the diagnostic hypotheses defined with the high confidence level. Conclusions: Interobserver and intraobserver agreement in the diagnosis of ILDs based on HRCT scans ranged from fair to almost perfect and was influenced by radiologist expertise, clinical history and confidence level. (author)

Diagnosis of the ulcerous and erosive gastroduodenal lesions with radioisotopes

International Nuclear Information System (INIS)

Zuccaro, A.M.; Rocha, A.F.G. da; Palencia, I.I.B.

1989-01-01

The use of gastric scintigraphy with technetium 99-m labeled sucralfate is analysed in a study of 25 cases evolving: controls (five), duodenal ulcer (six case), gastric ulcer (four), gastric and duodenal ulcer (two) and gastric mucous acute erosive lesion (eight). All patients were previously submitted to endoscopy and biopsy. Changes in the techniques of other authors were performed. An accurate diagnosis was achieved in 95% of the cases with a specificity of 100%. It is concluded that the method is indicated for the investigation of critical patients, elderly patients, children for the control of lesions identified through endoscopy. (author)

Digital breast tomosynthesis for breast cancer screening and diagnosis in women with dense breasts - a systematic review and meta-analysis

NARCIS (Netherlands)

Phi, Xuan-Anh; Tagliafico, Alberto; Houssami, Nehmat; Greuter, Marcel J. W.; de Bock, Geertruida H.

2018-01-01

Background: This study aimed to systematically review and to meta-analyse the accuracy of digital breast tomosynthesis (DBT) versus digital mammography (DM) in women with mammographically dense breasts in screening and diagnosis. Methods: Two independent reviewers identified screening or diagnostic

Digital breast tomosynthesis for breast cancer screening and diagnosis in women with dense breasts - a systematic review and meta-analysis

NARCIS (Netherlands)

Phi, Xuan-Anh; Tagliafico, Alberto; Houssami, Nehmat; Greuter, Marcel J W; de Bock, Geertruida H

2018-01-01

BACKGROUND: This study aimed to systematically review and to meta-analyse the accuracy of digital breast tomosynthesis (DBT) versus digital mammography (DM) in women with mammographically dense breasts in screening and diagnosis. METHODS: Two independent reviewers identified screening or diagnostic

First diagnosis of septic arthritis in a dinosaur.

Science.gov (United States)

Anné, Jennifer; Hedrick, Brandon P; Schein, Jason P

2016-08-01

Identification and interpretation of pathologies in the fossil record allows for unique insights into the life histories of extinct organisms. However, the rarity of such finds limits not only the sample size for palaeopathologic studies, but also the types of analyses that may be performed. In this study, we present the first occurrence of a palaeopathology in a vertebrate from the Mesozoic of the East Coast of North America (Appalachia), a pathologic ulna and radius of an indeterminate hadrosaur from the Navesink Formation (New Jersey). X-ray microtomography allowed for both detailed and more accurate diagnosis of the pathologic condition as well as virtual conservation of the specimen. Based on extant archosaurian comparisons, the hadrosaur was diagnosed with severe septic arthritis affecting the proximal ulna and radius. Diagnosis was based on erosion of the joint and highly reactive periosteal bone growth and fusion of the elements. To the best of our knowledge, this is the first recorded account of septic arthritis in dinosaurs. The severity of the pathology suggests the animal suffered with this condition for some time before death. Unfortunately, only the ulna and radius were found. Thus, the extent to which the condition spread to other parts of the body is unknown.

First diagnosis of septic arthritis in a dinosaur

Science.gov (United States)

Anné, Jennifer; Hedrick, Brandon P.; Schein, Jason P.

2016-08-01

Identification and interpretation of pathologies in the fossil record allows for unique insights into the life histories of extinct organisms. However, the rarity of such finds limits not only the sample size for palaeopathologic studies, but also the types of analyses that may be performed. In this study, we present the first occurrence of a palaeopathology in a vertebrate from the Mesozoic of the East Coast of North America (Appalachia), a pathologic ulna and radius of an indeterminate hadrosaur from the Navesink Formation (New Jersey). X-ray microtomography allowed for both detailed and more accurate diagnosis of the pathologic condition as well as virtual conservation of the specimen. Based on extant archosaurian comparisons, the hadrosaur was diagnosed with severe septic arthritis affecting the proximal ulna and radius. Diagnosis was based on erosion of the joint and highly reactive periosteal bone growth and fusion of the elements. To the best of our knowledge, this is the first recorded account of septic arthritis in dinosaurs. The severity of the pathology suggests the animal suffered with this condition for some time before death. Unfortunately, only the ulna and radius were found. Thus, the extent to which the condition spread to other parts of the body is unknown.

Evaluation of pathological effects in people occupationally exposed to radioiodine and problems of differential diagnosis

International Nuclear Information System (INIS)

Stojanovic, D.; Milivojevic, K.; Vracaric, Lj.; Veljkovic, D.; Ubovic, Z.; Trajkovic, M.; Djukic, Z.

1983-01-01

The results of medical supervision of people occupationally exposed for 20 years to low-level radiation are presented. The study group was selected according to characteristics of work (production of radioiodine in the Boris Kidric Institute and applications in medicine and radiation research), occupation, sex, age, and dosimetric data. Medical controls included a general clinical examination of physiological systems with special regard to the thyroid gland and its hormone measurements (triiodothyronine, thyroxine); biochemical analyses; haematologic examinations for quantitative changes of leucocytes, erythrocytes and platelets; incidence of cytomorphological aberrations in white blood cells; changes in values of haemoglobin and haematocryte; and radiotoxicological procedures for evaluation of internal contamination with 131 I. The problems of differential diagnosis of some states and diseases according to the physiological systems were analysed with special attention to focuses in the organism which can give morphological and functional changes or as far as their look is concerned that could be very similar to changes caused by effects of ionizing radiation. The analysis included also the incidence of diseases of the thyroid gland performed by clinical and laboratory criteria for diagnosis. (author)

Radiological diagnosis of fractures

International Nuclear Information System (INIS)

Finlay, D.B.L.; Allen, M.J.

1984-01-01

This book is about radiology of fractures. While it contains sections of clinical features it is not intended that readers should rely entirely upon these for the diagnosis and management of the injured patient. As in the diagnosis and treatment of all medical problems, fracture management must be carried out in a logical step-by-step fashion - namely, history, examination, investigation, differential diagnosis, diagnosis and then treatment. Each section deals with a specific anatomical area and begins with line drawings of the normal radiographs demonstrating the anatomy. Accessory views that may be requested, and the indications for these, are included. Any radiological pitfalls for the area in general are then described. The fractures in adults are then examined in turn, their radiological features described, and any pitfalls in their diagnosis discussed. A brief note of important clinical findings is included. A brief mention is made of pediatric fractures which are of significance and their differences to the adult pattern indicated. Although fractures can be classified into types with different characteristics, in life every fracture is individual. Fractures by and large follow common patterns, but many have variations

Missed diagnosis-persistent delirium

Directory of Open Access Journals (Sweden)

Aseem Mehra

2014-01-01

Full Text Available Delirium is in general considered as an acute short lasting reversible neuropsychiatric syndrome. However, there is some evidence to suggest that in a small proportion of cases delirium may be a chronic or persistent condition. However, making this diagnosis requires clinical suspicion and ruling other differential diagnosis. In this report, we present a case of a 55-year-old man who had cognitive symptoms, psychotic symptoms and depressive symptoms along with persistent hypokalemia and glucose intolerance. He was seen by 3 psychiatrists with these symptoms and was initially diagnosed as having depressive disorder and later diagnosis of bipolar affective disorder (current episode mania, and psychosis were considered by the third psychiatrist. However, despite the presence of persistent neurocognitive deficits, evening worsening of symptoms, hypokalemia and glucose intolerance diagnosis of delirium was not suspected.

Design for testability and diagnosis at the system-level

Science.gov (United States)

Simpson, William R.; Sheppard, John W.

1993-01-01

The growing complexity of full-scale systems has surpassed the capabilities of most simulation software to provide detailed models or gate-level failure analyses. The process of system-level diagnosis approaches the fault-isolation problem in a manner that differs significantly from the traditional and exhaustive failure mode search. System-level diagnosis is based on a functional representation of the system. For example, one can exercise one portion of a radar algorithm (the Fast Fourier Transform (FFT) function) by injecting several standard input patterns and comparing the results to standardized output results. An anomalous output would point to one of several items (including the FFT circuit) without specifying the gate or failure mode. For system-level repair, identifying an anomalous chip is sufficient. We describe here an information theoretic and dependency modeling approach that discards much of the detailed physical knowledge about the system and analyzes its information flow and functional interrelationships. The approach relies on group and flow associations and, as such, is hierarchical. Its hierarchical nature allows the approach to be applicable to any level of complexity and to any repair level. This approach has been incorporated in a product called STAMP (System Testability and Maintenance Program) which was developed and refined through more than 10 years of field-level applications to complex system diagnosis. The results have been outstanding, even spectacular in some cases. In this paper we describe system-level testability, system-level diagnoses, and the STAMP analysis approach, as well as a few STAMP applications.

Discrete event systems diagnosis and diagnosability

CERN Document Server

Sayed-Mouchaweh, Moamar

2014-01-01

Discrete Event Systems: Diagnosis and Diagnosability addresses the problem of fault diagnosis of Discrete Event Systems (DES). This book provides the basic techniques and approaches necessary for the design of an efficient fault diagnosis system for a wide range of modern engineering applications. The different techniques and approaches are classified according to several criteria such as: modeling tools (Automata, Petri nets) that is used to construct the model; the information (qualitative based on events occurrences and/or states outputs, quantitative based on signal processing and data analysis) that is needed to analyze and achieve the diagnosis; the decision structure (centralized, decentralized) that is required to achieve the diagnosis. The goal of this classification is to select the efficient method to achieve the fault diagnosis according to the application constraints. This book focuses on the centralized and decentralized event based diagnosis approaches using formal language and automata as mode...

Whole-exome sequencing identified a variant in EFTUD2 gene in establishing a genetic diagnosis.

Science.gov (United States)

Rengasamy Venugopalan, S; Farrow, E G; Lypka, M

2017-06-01

Craniofacial anomalies are complex and have an overlapping phenotype. Mandibulofacial Dysostosis and Oculo-Auriculo-Vertebral Spectrum are conditions that share common craniofacial phenotype and present a challenge in arriving at a diagnosis. In this report, we present a case of female proband who was given a differential diagnosis of Treacher Collins syndrome or Hemifacial Microsomia without certainty. Prior genetic testing reported negative for 22q deletion and FGFR screenings. The objective of this study was to demonstrate the critical role of whole-exome sequencing in establishing a genetic diagnosis of the proband. The participants were 14½-year-old affected female proband/parent trio. Proband/parent trio were enrolled in the study. Surgical tissue sample from the proband and parental blood samples were collected and prepared for whole-exome sequencing. Illumina HiSeq 2500 instrument was used for sequencing (125 nucleotide reads/84X coverage). Analyses of variants were performed using custom-developed software, RUNES and VIKING. Variant analyses following whole-exome sequencing identified a heterozygous de novo pathogenic variant, c.259C>T (p.Gln87*), in EFTUD2 (NM_004247.3) gene in the proband. Previous studies have reported that the variants in EFTUD2 gene were associated with Mandibulofacial Dysostosis with Microcephaly. Patients with facial asymmetry, micrognathia, choanal atresia and microcephaly should be analyzed for variants in EFTUD2 gene. Next-generation sequencing techniques, such as whole-exome sequencing offer great promise to improve the understanding of etiologies of sporadic genetic diseases. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Optimum length of finned pipe for waste heat recovery

International Nuclear Information System (INIS)

Soeylemez, M.S.

2008-01-01

A thermoeconomic feasibility analysis is presented yielding a simple algebraic optimization formula for estimating the optimum length of a finned pipe that is used for waste heat recovery. A simple economic optimization method is used in the present study by combining it with an integrated overall heat balance method based on fin effectiveness for calculating the maximum savings from a waste heat recovery system

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

Directory of Open Access Journals (Sweden)

Gunilla Westman Andersson

2013-01-01

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

Impact of a training course on the quality of malaria diagnosis by microscopy in Angola.

Science.gov (United States)

Moura, Sofia; Fançony, Cláudia; Mirante, Clara; Neves, Marcela; Bernardino, Luís; Fortes, Filomeno; Sambo, Maria do Rosário; Brito, Miguel

2014-11-18

In Angola, malaria is an endemic disease having a major impact on the economy. The WHO recommends testing for all suspected malaria cases, to avoid the presumptive treatment of this disease. In malaria endemic regions laboratory technicians must be very comfortable with microscopy, the golden standard for malaria diagnosis, to avoid the incorrect diagnosis. The improper use of medication promotes drug resistance and undesirable side effects. The present study aims to assess the impact of a three-day refresher course on the knowledge of technicians, quality of blood smears preparation and accuracy of microscopy malaria diagnosis, using qPCR as reference method. This study was implemented in laboratories from three hospitals in different provinces of Angola: Bengo, Benguela and Luanda. In each laboratory samples were collected before and after the training course (slide with thin and thick blood smears, a dried blood spot and a form). The impact of the intervention was evaluated through a written test, the quality of slide preparation and the performance of microscopy. It was found a significant increase on the written test median score, from 52.5% to 65.0%. A total of 973 slides were analysed to evaluate the quality of thick and thin blood smears. Considering all laboratories there was a significant increase in quality of thick and thin blood smears. To determine the performance of microscopy using qPCR as the reference method we used 1,028 samples. Benguela presented the highest values for specificity, 92.9% and 98.8% pre and post-course, respectively and for sensitivity the best pre-course was Benguela (75.9%) and post-course Luanda (75.0%). However, no significant increase in sensitivity and specificity after the training course was registered in any laboratory analysed. The findings of this study support the need of continuous refresher training for microscopists and other laboratory staff. The laboratories should have a quality control programme to supervise

Dengue fever: diagnosis and treatment.

Science.gov (United States)

Wiwanitkit, Viroj

2010-07-01

Dengue fever is a common tropical infection. This acute febrile illness can be a deadly infection in cases of severe manifestation, causing dengue hemorrhagic shock. In this brief article, I will summarize and discuss the diagnosis and treatment of this disease. For diagnosis of dengue, most tropical doctors make use of presumptive diagnosis; however, the definite diagnosis should be based on immunodiagnosis or viral study. Focusing on treatment, symptomatic and supportive treatment is the main therapeutic approach. The role of antiviral drugs in the treatment of dengue fever has been limited, but is currently widely studied.

Living with a diagnosis of non-small cell lung cancer: patients' lived experiences.

LENUS (Irish Health Repository)

McCarthy, Ita

2012-01-31

The aim of this study was to explore patients\\' experience of living with non-small cell lung cancer (NSCLC). Patients diagnosed with NSCLC know that their treatment is not with curative intent and can expect distressing symptoms. In this phenomenological study, six adults with a diagnosis of NSCLC were interviewed. Data was analysed guided by van Manen\\'s six-step process. Four main themes were interpreted: \\'Maintaining my life\\'; \\'The enemy within\\'; \\'Staying on the train\\

Analysing patient queue system in an imaging department: a step toward total quality management

International Nuclear Information System (INIS)

Kumar, Pratik; Pandey, A.K.

2008-01-01

Medical imaging has become an inevitable part of any diagnosis and/or management of the disease. This has put tremendous work-load on the medical imaging machines. The crowd of waiting patients at any busy imaging centre or rooms has become a common scene. This is especially true for any Government hospital or medical college in India since they cater to bulk of patients. As a part of total quality management we attempted to record, investigate, analyse and suggest on the state of patients' queue system at radiological imaging rooms

Skin-deep diagnosis: affective bias and zebra retreat complicating the diagnosis of systemic sclerosis.

Science.gov (United States)

Miller, Chad S

2013-01-01

Nearly half of medical errors can be attributed to an error of clinical reasoning or decision making. It is estimated that the correct diagnosis is missed or delayed in between 5% and 14% of acute hospital admissions. Through understanding why and how physicians make these errors, it is hoped that strategies can be developed to decrease the number of these errors. In the present case, a patient presented with dyspnea, gastrointestinal symptoms and weight loss; the diagnosis was initially missed when the treating physicians took mental short cuts and used heuristics as in this case. Heuristics have an inherent bias that can lead to faulty reasoning or conclusions, especially in complex or difficult cases. Affective bias, which is the overinvolvement of emotion in clinical decision making, limited the available information for diagnosis because of the hesitancy to acquire a full history and perform a complete physical examination in this patient. Zebra retreat, another type of bias, is when a rare diagnosis figures prominently on the differential diagnosis but the physician retreats for various reasons. Zebra retreat also factored in the delayed diagnosis. Through the description of these clinical reasoning errors in an actual case, it is hoped that future errors can be prevented or inspiration for additional research in this area will develop.

Global manipulation of digital images can lead to variation in cytological diagnosis

Directory of Open Access Journals (Sweden)

H Prasad

2011-01-01

Full Text Available Background: With the adoption of a completely electronic workflow by several journals and the advent of telepathology, digital imaging has become an integral part of every scientific research. However, manipulating digital images is very easy, and it can lead to misinterpretations. Aim: To analyse the impact of manipulating digital images on their diagnosis. Design: Digital images were obtained from Papanicolaou-stained smears of dysplastic and normal oral epithelium. They were manipulated using GNU Image Manipulation Program (GIMP to alter their brightness and contrast and color levels. A Power Point presentation composed of slides of these manipulated images along with the unaltered originals arranged randomly was created. The presentation was shown to five observers individually who rated the images as normal, mild, moderate or severe dysplasia. Weighted k statistics was used to measure and assess the levels of agreement between observers. Results: Levels of agreement between manipulated images and original images varied greatly among observers. Variation in diagnosis was in the form of overdiagnosis or under-diagnosis, usually by one grade. Conclusion: Global manipulations of digital images of cytological slides can significantly affect their interpretation. Such manipulations should therefore be kept to a minimum, and avoided wherever possible.

Prevalence of endocrine diseases and abnormal glucose tolerance tests in 340 caucasian premenopausal women with hirsutism as the referral diagnosis

DEFF Research Database (Denmark)

Glintborg, Dorte; Henriksen, Jan Erik; Andersen, Marianne

2004-01-01

with hirsutism as the referral diagnosis. INTERVENTION(S): Hormone analyses and ACTH tests during cycle days 2-8, 2 hours of oral glucose tolerance test (OGTT), and vaginal ultrasound. MAIN OUTCOME MEASURE(S): End diagnosis, fasting, 30-, 60-, and 120-minute oral glucose-stimulated levels of insulin....... During OGTT, 4.9% (13 of 263) had previously undiagnosed diabetes; no significant difference in diabetes prevalence was found between idiopathic hirsutism and PCOS. For 50.8%, fasting insulin values were in the upper quartile for a reference population. CONCLUSION(S): Initial evaluation of hirsute...

Efficiency mark of the two-product power complex of nuclear power plant

Science.gov (United States)

Khrustalev, V. A.; Suchkov, V. M.

2017-11-01

The article discusses the combining nuclear power plants (NPP) with pressurized water reactors and distillation-desalination plants (DDP), their joint mode of operation during periods of coating failures of the electric power load graphs and thermo-economical efficiency. Along with the release of heat and generation of electric energy a desalination complex with the nuclear power plant produces distillate. Part of the selected steam “irretrievably lost” with a mix of condensation of this vapor in a desalination machine with a flow of water for distillation. It means that this steam transforms into condition of acquired product - distillate. The article presents technical solutions for the return of the working fluid for turbine К-1000-60/1500-2 и К-1200-6,8/50, as well as permissible part of low pressure regime according to the number of desalination units for each turbine. Patent for the proposed two-product energy complex, obtained by Gagarin State Technical University is analyzed. The energy complex has such system advantages as increasing the capacity factor of a nuclear reactor and also allows to solve the problem of shortage of fresh water. Thermo-economics effectiveness of this complex is determined by introducing a factor-“thermo-economic index”. During analyzing of the results of the calculations of a thermo-economic index we can see a strong influence of the cost factor of the distillate on the market. Then higher participation of the desalination plant in coverage of the failures of the graphs of the electric loading then smaller the payback period of the NPP. It is manifested more clearly, as it’s shown in the article, when pricing options depend on time of day and the configuration of the daily electric load diagram. In the geographical locations of the NPPs with PWR the Russian performance in a number of regions with low freshwater resources and weak internal electrical connections combined with DDP might be one of the ways to improve the

Efficient thermal desalination technologies with renewable energy systems: A state-of-the-art review

Energy Technology Data Exchange (ETDEWEB)

Esfahani, Iman Janghorban; Rashidi, Jouan; Ifaei, Pouya; Yoo, ChangKyoo [Center for Environmental Studies, Kyung Hee University, Yongin (Korea, Republic of)

2016-02-15

Due to the current fossil fuel crisis and associated adverse environmental impacts, renewable energy sources (RES) have drawn interest as alternatives to fossil fuels for powering water desalination systems. Over the last few decades the utility of renewable energy sources such as solar, geothermal, and wind to run desalination processes has been explored. However, the expansion of these technologies to larger scales is hampered by techno-economic and thermo-economic challenges. This paper reviews the state-of-the-art in the field of renewable energy-powered thermal desalination systems (RE-PTD) to compare their productivity and efficiency through thermodynamic, economic, and environmental analyses. We performed a comparative study using published data to classify RE-PTD systems technologies on the basis of the energy collection systems that they use. Among RE-PTD systems, solar energy powered-thermal desalination systems demonstrate high thermo-environ-economic efficiency to produce fresh water to meet various scales of demand.

Efficient thermal desalination technologies with renewable energy systems: A state-of-the-art review

International Nuclear Information System (INIS)

Esfahani, Iman Janghorban; Rashidi, Jouan; Ifaei, Pouya; Yoo, ChangKyoo

2016-01-01

Due to the current fossil fuel crisis and associated adverse environmental impacts, renewable energy sources (RES) have drawn interest as alternatives to fossil fuels for powering water desalination systems. Over the last few decades the utility of renewable energy sources such as solar, geothermal, and wind to run desalination processes has been explored. However, the expansion of these technologies to larger scales is hampered by techno-economic and thermo-economic challenges. This paper reviews the state-of-the-art in the field of renewable energy-powered thermal desalination systems (RE-PTD) to compare their productivity and efficiency through thermodynamic, economic, and environmental analyses. We performed a comparative study using published data to classify RE-PTD systems technologies on the basis of the energy collection systems that they use. Among RE-PTD systems, solar energy powered-thermal desalination systems demonstrate high thermo-environ-economic efficiency to produce fresh water to meet various scales of demand.

Differential diagnosis diphtheria adults

Directory of Open Access Journals (Sweden)

Yu. I. Liashenko

2010-01-01

Full Text Available A total of 1,824 human cases of diphtheria, treated at the Clinical Infectious Diseases Hospital SP Botkin (St. Petersburg during 1993, as well as 19 deaths in 1994. It is known that early diagnosis of infectious diseases, especially diphtheria, contributes to the favorable outcome of the disease. The diagnosis of diphtheria at the prehospital stage is always difficult. Presented in detail the differential diagnosis of the disease, clinically similar to diphtheria: Lacunal angina, angina Simanovsky, infectious mononucleosis, angina Ludwig’s angina Dugue, syphilis, non-infectious with clinical «masks» of diphtheria and other. Diphtheria epidemic of 1993–1994 in Russia and, in particular, in St. Petersburg, showed that the late admission of patients with diphtheria infection in hospitals, usually associated with irregular differential diagnosis of this dangerous disease.

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

Directory of Open Access Journals (Sweden)

Fernell E

2013-02-01

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

Diagnosis, treatment and long-term outcome in fetal hydrocephalus

International Nuclear Information System (INIS)

Yamasaki, Mami; Nonaka, Masahiro; Bamba, Yohei; Teramoto, Chika; Ban, Chiaki; Pooh, Ritsuko

2011-01-01

The objective of this study was to evaluate the method of prenatally estimating an appropriate clinical outcome in fetal hydrocephalus. Retrospective study, single institute (Osaka National Hospital). Hundred and seventeen cases with fetal hydrocephalus treated at Osaka National Hospital from 1992 to 2010 were analysed. Of the 117 cases analysed, 38% are diagnosed as isolated ventriculomegaly (IVM), 51% as other types of malformation (30 cases of myelomeningocele, 4 cases of holoprosencephaly, 4 of Dandy Walker syndrome, 10 of arachnoid cyst and 6 of encephalocele etc.) and 11% as secondary hydrocephalus. They are diagnosed between 17 and 40 weeks of gestation (average 27 weeks), 17% diagnosed between 17 and 21 weeks, 30% between 22 and 27 weeks and 53% after 28 weeks. With the exception of 9 aborted cases and 30 unknown cases too young to be evaluated or lost due to lack of follow-up, final outcome was analyzed in 78 cases. Of these 78 cases, 15% died in utero or after birth, 23% showed severe retardation, 17% moderate retardation, 26% mild retardation, and 19% showed good outcome. Long term consequences were mostly influenced by basic disease and accompanied anomalies. Hydrocephalus associated with arachnoid cyst, atresia of Monro, corpus callosum agenesis and hydrocephalus due to fetal intracranial hemorrhage are categorized in the good outcome group. On the other hand, holoprosencephaly, hydrocephalus associated with encephalocele, syndromic hydrocephalus and hydrocephalus due to fetal virus infection are categorized in the poor outcome group. In order to accurate diagnosis and proper counseling, establishment of diagnosis protocol and treatment policy for fetal hydrocephalus including not only fetal sonography, fetal MRI, toxoplasma, rubella, cytomegalovirus, herpes simplex (TORCH) screening test but also chromosomal and gene testing is required. (author)

Information Based Fault Diagnosis

DEFF Research Database (Denmark)

Niemann, Hans Henrik; Poulsen, Niels Kjølstad

2008-01-01

Fault detection and isolation, (FDI) of parametric faults in dynamic systems will be considered in this paper. An active fault diagnosis (AFD) approach is applied. The fault diagnosis will be investigated with respect to different information levels from the external inputs to the systems. These ...

Human prenatal diagnosis

International Nuclear Information System (INIS)

Filkins, K.; Russo, R.J.

1985-01-01

The multiauthor text is written as a ''guide to rationalize and clarify certain aspects of diagnosis, general counseling and intervention'' for ''health professionals who provide care to pregnant women.'' The text is not aimed at the ultrasonographer but rather at the physicians who are clinically responsible for patient management. Chapters of relevance to radiologists include an overview of prenatal screening and counseling, diagnosis of neural tube defects, ultrasonographic (US) scanning of fetal disorders in the first and second trimesters of pregnancy, US scanning in the third trimester, multiple gestation and selective termination, fetal echo and Doppler studies, and fetal therapy. Also included are overviews of virtually all currently utilized prenatal diagnostic techniques including amniocentesis, fetal blood sampling, fetoscopy, recombinant DNA detection of hemoglobinopathies, chorionic villus sampling, embryoscopy, legal issues, and diagnosis of Mendelian disorders by DNA analysis

Study on diagnosis of HD

International Nuclear Information System (INIS)

Chen Shuran; Yang Yumei; Zhang Guangli

1994-01-01

The study suggests a three-step diagnostic method for diagnosing HD. The first step is to make TgA, TmA examination; the second step is to make differential diagnosis for the cases of negative TgA, TmA through FNAB examination; the third step is to make TgA, TmA and FNAB examination for dynamic observation of controversial cases left over in the former two steps to achieve accurate diagnosis. Differential diagnosis has been made with the method in 87 cases of HD (clinical diagnosis only). The result shows that 7 cases have been diagnosed as thyropathy through comprehensive evaluation; definite diagnosis of HD has been made in 62 cases through TgA, TmA and in 77 cases through FNAB; 3 cases of negative TgA and TmA failed to accept FNAB examination, and were later diagnosed as HD through operation pathology or clinical treatment

Variations in cardiovascular disease under-diagnosis in England: national cross-sectional spatial analysis

Directory of Open Access Journals (Sweden)

Walford Hannah

2011-03-01

Full Text Available Abstract Background There is under-diagnosis of cardiovascular disease (CVD in the English population, despite financial incentives to encourage general practices to register new cases. We compared the modelled (expected and diagnosed (observed prevalence of three cardiovascular conditions- coronary heart disease (CHD, hypertension and stroke- at local level, their geographical variation, and population and healthcare predictors which might influence diagnosis. Methods Cross-sectional observational study in all English local authorities (351 and general practices (8,372 comparing model-based expected prevalence with diagnosed prevalence on practice disease registers. Spatial analyses were used to identify geographic clusters and variation in regression relationships. Results A total of 9,682,176 patients were on practice CHD, stroke and transient ischaemic attack, and hypertension registers. There was wide spatial variation in observed: expected prevalence ratios for all three diseases, with less than five per cent of expected cases diagnosed in some areas. London and the surrounding area showed statistically significant discrepancies in observed: expected prevalence ratios, with observed prevalence much lower than the epidemiological models predicted. The addition of general practitioner supply as a variable yielded stronger regression results for all three conditions. Conclusions Despite almost universal access to free primary healthcare, there may be significant and highly variable under-diagnosis of CVD across England, which can be partially explained by persistent inequity in GP supply. Disease management studies should consider the possible impact of under-diagnosis on population health outcomes. Compared to classical regression modelling, spatial analytic techniques can provide additional information on risk factors for under-diagnosis, and can suggest where healthcare resources may be most needed.

Laboratory Diagnosis of Infective Endocarditis

Science.gov (United States)

Liesman, Rachael M.; Pritt, Bobbi S.; Maleszewski, Joseph J.

2017-01-01

ABSTRACT Infective endocarditis is life-threatening; identification of the underlying etiology informs optimized individual patient management. Changing epidemiology, advances in blood culture techniques, and new diagnostics guide the application of laboratory testing for diagnosis of endocarditis. Blood cultures remain the standard test for microbial diagnosis, with directed serological testing (i.e., Q fever serology, Bartonella serology) in culture-negative cases. Histopathology and molecular diagnostics (e.g., 16S rRNA gene PCR/sequencing, Tropheryma whipplei PCR) may be applied to resected valves to aid in diagnosis. Herein, we summarize recent knowledge in this area and propose a microbiologic and pathological algorithm for endocarditis diagnosis. PMID:28659319

Repeatability of pulse diagnosis and body constitution diagnosis in traditional Indian Ayurveda medicine

DEFF Research Database (Denmark)

Kurande, Vrinda; Waagepetersen, Rasmus; Toft, Egon

2012-01-01

In Ayurveda, pulse and body constitution diagnosis have a long historical use; still there is lack of quantitative measure on e.g. reliability of this diagnostic method. Reliability means consistency of information. Consistent diagnosis leads to consistent treatment and is important for clinical ...

Diagnosis of Cognitive Impairment Compatible with Early Diagnosis of Alzheimer's Disease. A Bayesian Network Model based on the Analysis of Oral Definitions of Semantic Categories.

Science.gov (United States)

Guerrero, J M; Martínez-Tomás, R; Rincón, M; Peraita, H

2016-01-01

Early detection of Alzheimer's disease (AD) has become one of the principal focuses of research in medicine, particularly when the disease is incipient or even prodromic, because treatments are more effective in these stages. Lexical-semantic-conceptual deficit (LSCD) in the oral definitions of semantic categories for basic objects is an important early indicator in the evaluation of the cognitive state of patients. The objective of this research is to define an economic procedure for cognitive impairment (CI) diagnosis, which may be associated with early stages of AD, by analysing cognitive alterations affecting declarative semantic memory. Because of its low cost, it could be used for routine clinical evaluations or screenings, leading to more expensive and selective tests that confirm or rule out the disease accurately. It should necessarily be an explanatory procedure, which would allow us to study the evolution of the disease in relation to CI, the irregularities in different semantic categories, and other neurodegenerative diseases. On the basis of these requirements, we hypothesise that Bayesian networks (BNs) are the most appropriate tool for this purpose. We have developed a BN for CI diagnosis in mild and moderate AD patients by analysing the oral production of semantic features. The BN causal model represents LSCD in certain semantic categories, both of living things (dog, pine, and apple) and non-living things (chair, car, and trousers), as symptoms of CI. The model structure, the qualitative part of the model, uses domain knowledge obtained from psychology experts and epidemiological studies. Further, the model parameters, the quantitative part of the model, are learnt automatically from epidemiological studies and Peraita and Grasso's linguistic corpus of oral definitions. This corpus was prepared with an incidental sampling and included the analysis of the oral linguistic production of 81 participants (42 cognitively healthy elderly people and 39

CT in diagnosis of recurrent vertebral disc hernias after preceding lumbar disc prolapse surgery

International Nuclear Information System (INIS)

Burval, S.; Nekula, J.; Vaverka, M.; Veliskova, J.

1992-01-01

20 patients with recurrent symptoms following operations for disc prolapse and resistant to treatment were studied by CT, using plain and enhanced images. The results have been analysed. In 10 patients a recurrence of disc prolapse was diagnosed, and this was confirmed surgically in 8 cases. In 2 patients there was epidural scarring. The findings indicate that differential diagnosis between scarring and recurring prolapse can by accurately made by this technique. (orig.) [de

Diagnostic accuracy of computed tomography and histopathology in the diagnosis of usual interstitial pneumonia

International Nuclear Information System (INIS)

Aaloekken, Trond Mogens; Mynarek, Georg; Kolbenstvedt, Alf; Naalsund, Anne; Elnaes Berstad, Audun; Solberg, Steinar; Stroem, Erik H.; Scott, Helge; Soeyseth, Vidar

2012-01-01

Background: The relative clinical benefit of histopathology and computed tomography (CT) in patients with idiopathic interstitial pneumonia (IIP) is under debate. Purpose: To analyze thin-section CT features and histopathologic findings in patients with usual interstitial pneumonia (UIP) in the clinical context of idiopathic pulmonary fibrosis (IPF), and to evaluate and compare diagnostic accuracy of the two methods among patients with an appropriate spectrum of IIP. Material and Methods: The study included 91 patients (49 men; mean age 53.2 years; median follow-up 7.2 years) with clinically suspected interstitial lung disease. All underwent surgical lung biopsy and thin-section CT. Two independent readers retrospectively assessed the CT images for the extent and pattern of abnormality and made a first-choice diagnosis. Two pathologists retrospectively assessed the histopathologic slides. In 64 patients with IIP, a retrospective composite reference standard identified 41 patients with UIP. CT characteristics of UIP and IIPs other than UIP were compared with univariate and multivariate analyses. Results: There was good agreement between the readers for the correct first-choice CT diagnosis of UIP (κ = 0.79). The sensitivity, specificity, and positive predictive value of the CT diagnosis of UIP were 63%, 96%, and 96%, respectively. The sensitivity, specificity, and positive predictive value of the histological diagnosis of UIP were 73%, 74%, and 83%, respectively. The CT feature that best differentiated UIP from IIPs other than UIP was the extent of reticular pattern (odds ratio, 5.1). Conclusion: Surgical lung biopsy may not be warranted in patients with thin-section CT diagnosis of UIP

Diagnostic accuracy of computed tomography and histopathology in the diagnosis of usual interstitial pneumonia

Energy Technology Data Exchange (ETDEWEB)

Aaloekken, Trond Mogens; Mynarek, Georg; Kolbenstvedt, Alf (Dept. of Radiology, Oslo Univ. Hospital Rikshospitalet, Oslo (Norway)), Email: trond.mogens.aalokken@rikshospitalet.no; Naalsund, Anne (Dept. of Pulmonology, Oslo Univ. Hospital Rikshospitalet (Norway)); Elnaes Berstad, Audun (Dept. of Radiology, Oslo Univ. Hospital Rikshospitalet, Oslo (Norway); Univ. of Oslo (Norway)); Solberg, Steinar (Dept. of Thoracic Surgery, Oslo Univ. Hospital Rikshospitalet (Norway)); Stroem, Erik H.; Scott, Helge (Dept. of Pathology, Oslo Univ. Hospital Rikshospitalet (Norway)); Soeyseth, Vidar (Univ. of Oslo (Norway); Depts. of Pulmonology, Akershus Univ. Hospital, Loerenskog (Norway))

2012-04-15

Background: The relative clinical benefit of histopathology and computed tomography (CT) in patients with idiopathic interstitial pneumonia (IIP) is under debate. Purpose: To analyze thin-section CT features and histopathologic findings in patients with usual interstitial pneumonia (UIP) in the clinical context of idiopathic pulmonary fibrosis (IPF), and to evaluate and compare diagnostic accuracy of the two methods among patients with an appropriate spectrum of IIP. Material and Methods: The study included 91 patients (49 men; mean age 53.2 years; median follow-up 7.2 years) with clinically suspected interstitial lung disease. All underwent surgical lung biopsy and thin-section CT. Two independent readers retrospectively assessed the CT images for the extent and pattern of abnormality and made a first-choice diagnosis. Two pathologists retrospectively assessed the histopathologic slides. In 64 patients with IIP, a retrospective composite reference standard identified 41 patients with UIP. CT characteristics of UIP and IIPs other than UIP were compared with univariate and multivariate analyses. Results: There was good agreement between the readers for the correct first-choice CT diagnosis of UIP (kappa = 0.79). The sensitivity, specificity, and positive predictive value of the CT diagnosis of UIP were 63%, 96%, and 96%, respectively. The sensitivity, specificity, and positive predictive value of the histological diagnosis of UIP were 73%, 74%, and 83%, respectively. The CT feature that best differentiated UIP from IIPs other than UIP was the extent of reticular pattern (odds ratio, 5.1). Conclusion: Surgical lung biopsy may not be warranted in patients with thin-section CT diagnosis of UIP

Cost-effectiveness analysis of FET PET-guided target selection for the diagnosis of gliomas

International Nuclear Information System (INIS)

Heinzel, Alexander; Stock, Stephanie; Mueller, Dirk; Langen, Karl-Josef

2012-01-01

Several diagnostic trials have indicated that the combined use of 18 F-fluoroethyl-l-tyrosine (FET) PET and MRI may be superior to MRI alone in selecting the biopsy site for the diagnosis of gliomas. We estimated the cost-effectiveness of the use of amino acid PET compared to MRI alone from the perspective of the German statutory health insurance. To evaluate the incremental cost-effectiveness of the use of amino acid PET, a decision tree model was built. The effectiveness of FET PET was determined by the probability of a correct diagnosis. Costs were estimated for a baseline scenario and for a more expensive scenario in which disease severity was considered. The robustness of the results was tested using deterministic and probabilistic sensitivity analyses. The combined use of PET and MRI resulted in an increase of 18.5% in the likelihood of a correct diagnosis. The incremental cost-effectiveness ratio for one additional correct diagnosis using FET PET was EUR6,405 for the baseline scenario and EUR9,114 for the scenario based on higher disease severity. The probabilistic sensitivity analysis confirmed the robustness of the results. The model indicates that the use of amino acid PET may be cost-effective in patients with glioma. As a result of several limitations in the data used for the model, further studies are needed to confirm the results. (orig.)

Cost-effectiveness analysis of FET PET-guided target selection for the diagnosis of gliomas

Energy Technology Data Exchange (ETDEWEB)

Heinzel, Alexander [Research Centre Juelich, Department of Nuclear Medicine of the Heinrich-Heine University of Duesseldorf, Juelich (Germany); Stock, Stephanie; Mueller, Dirk [University Hospital of Cologne, Institute for Health Economics and Clinical Epidemiology, Cologne (Germany); Langen, Karl-Josef [Research Centre Juelich, Institute for Neuroscience and Medicine 4, Juelich (Germany)

2012-07-15

Several diagnostic trials have indicated that the combined use of {sup 18}F-fluoroethyl-l-tyrosine (FET) PET and MRI may be superior to MRI alone in selecting the biopsy site for the diagnosis of gliomas. We estimated the cost-effectiveness of the use of amino acid PET compared to MRI alone from the perspective of the German statutory health insurance. To evaluate the incremental cost-effectiveness of the use of amino acid PET, a decision tree model was built. The effectiveness of FET PET was determined by the probability of a correct diagnosis. Costs were estimated for a baseline scenario and for a more expensive scenario in which disease severity was considered. The robustness of the results was tested using deterministic and probabilistic sensitivity analyses. The combined use of PET and MRI resulted in an increase of 18.5% in the likelihood of a correct diagnosis. The incremental cost-effectiveness ratio for one additional correct diagnosis using FET PET was EUR6,405 for the baseline scenario and EUR9,114 for the scenario based on higher disease severity. The probabilistic sensitivity analysis confirmed the robustness of the results. The model indicates that the use of amino acid PET may be cost-effective in patients with glioma. As a result of several limitations in the data used for the model, further studies are needed to confirm the results. (orig.)

Molecular Diagnosis of Tuberculosis.

Science.gov (United States)

Nurwidya, Fariz; Handayani, Diah; Burhan, Erlina; Yunus, Faisal

2018-01-01

Tuberculosis (TB) is one of the leading causes of adult death in the Asia-Pacific Region, including Indonesia. As an infectious disease caused by Mycobacterium tuberculosis (MTB), TB remains a major public health issue especially in developing nations due to the lack of adequate diagnostic testing facilities. Diagnosis of TB has entered an era of molecular detection that provides faster and more cost-effective methods to diagnose and confirm drug resistance in TB cases, meanwhile, diagnosis by conventional culture systems requires several weeks. New advances in the molecular detection of TB, including the faster and simpler nucleic acid amplification test (NAAT) and whole-genome sequencing (WGS), have resulted in a shorter time for diagnosis and, therefore, faster TB treatments. In this review, we explored the current findings on molecular diagnosis of TB and drug-resistant TB to see how this advancement could be integrated into public health systems in order to control TB.

Physical examination tests for screening and diagnosis of cervicogenic headache: A systematic review.

Science.gov (United States)

Rubio-Ochoa, J; Benítez-Martínez, J; Lluch, E; Santacruz-Zaragozá, S; Gómez-Contreras, P; Cook, C E

2016-02-01

It has been suggested that differential diagnosis of headaches should consist of a robust subjective examination and a detailed physical examination of the cervical spine. Cervicogenic headache (CGH) is a form of headache that involves referred pain from the neck. To our knowledge, no studies have summarized the reliability and diagnostic accuracy of physical examination tests for CGH. The aim of this study was to summarize the reliability and diagnostic accuracy of physical examination tests used to diagnose CGH. A systematic review following PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines was performed in four electronic databases (MEDLINE, Web of Science, Embase and Scopus). Full text reports concerning physical tests for the diagnosis of CGH which reported the clinometric properties for assessment of CGH, were included and screened for methodological quality. Quality Appraisal for Reliability Studies (QAREL) and Quality Assessment of Studies of Diagnostic Accuracy (QUADAS-2) scores were completed to assess article quality. Eight articles were retrieved for quality assessment and data extraction. Studies investigating diagnostic reliability of physical examination tests for CGH scored poorer on methodological quality (higher risk of bias) than those of diagnostic accuracy. There is sufficient evidence showing high levels of reliability and diagnostic accuracy of the selected physical examination tests for the diagnosis of CGH. The cervical flexion-rotation test (CFRT) exhibited both the highest reliability and the strongest diagnostic accuracy for the diagnosis of CGH. Copyright © 2015 Elsevier Ltd. All rights reserved.

On the thermoeconomics of heat transfer

International Nuclear Information System (INIS)

El-Sayed, Y.M.

1991-01-01

The cost effectiveness of improving the thermodynamics of heat transfer in an energy system is investigated by considering steam power systems bottoming a given gas turbine. Higher efficiencies are basically achieved by improving the temperature match of the heat addition process using both structural and parametric modes of change. The heat transfer surfaces, when expressed solely in terms of efficiency, indicate the existence of an envelope bounding them. The envelope can be approximated by a simple continuous function. Minimum surface for a given efficiency is on or closest to the envelope. Similar features apply to capital cost and to the cost objective function. In this paper the generalization and the limitations of the envelopment concept are discussed as well as the relevance to artificial intelligence

Energy systems Diagnosis in developing countries

International Nuclear Information System (INIS)

Girod, J.

1991-01-01

Energy systems diagnosis is necessary to allow evaluation of energy balance by administration and political authorities of a country. First, the author describes the principle stages of energetic diagnosis. Then this work is divided into three parts: First part: Energy consumption diagnosis in several districts (families, utilities, agriculture, transport, industry) Second part: Energy supplies diagnosis (energy markets). Third part: Interactions between energy consumption and energy supply. 28 figs.; 52 tabs.; 107 refs

Use of Self-Care and Practitioner-Based Forms of Complementary and Alternative Medicine before and after a Diagnosis of Breast Cancer

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Alissa R. Link

2013-01-01

Full Text Available Purpose. We examine factors associated with self-care, use of practitioner-based complementary and alternative medicine (CAM, and their timing in a cohort of women with breast cancer. Methods. Study participants were women with breast cancer who participated in the Long Island Breast Cancer Study Project. Self-care is defined as the use of multivitamins, single vitamins, botanicals, other dietary supplements, mind-body practices, special diets, support groups, and prayer. Within each modality, study participants were categorized as continuous users (before and after diagnosis, starters (only after diagnosis, quitters (only before diagnosis, or never users. Multivariable logistic regression was used for the main analyses. Results. Of 764 women who provided complete data, 513 (67.2% initiated a new form of self-care following breast cancer diagnosis. The most popular modalities were those that are ingestible, and they were commonly used in combination. The strongest predictor of continuous use of one type of self-care was continuous use of other types of self-care. Healthy behaviors, including high fruit/vegetable intake and exercise, were more strongly associated with continuously using self-care than starting self-care after diagnosis. Conclusions. Breast cancer diagnosis was associated with subsequent behavioral changes, and the majority of women undertook new forms of self-care after diagnosis. Few women discontinued use of modalities they used prior to diagnosis.

Prenatal Diagnosis of Osteogenesis Imperfecta

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Özgür Özyüncü

2010-04-01

Full Text Available Skeletal dysplasias are a group of diseases with a wide spectrum related to bone and cartilage. Some forms are lethal whereas some forms have milder clinical progression. Prenatal diagnosis of skeletal dysplasias may be possible especially when there is an index case in the family. Ultrasonography plays the central role in prenatal diagnosis and most common sonographic features are angulation of long bones, bending of femur or bowing signin the long bones. We present a case whose follow up for fetal short extremities ended with termination of pregnancy. The differential diagnosis is hard and depend especially on the fetal x-ray. Final diagnosis was lethal type osteogenesis imperfecta.

Signs for early diagnosis of heart failure in primary health care

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Devroey D

2011-09-01

Full Text Available Dirk Devroey1,2, Viviane Van Casteren11Scientific Institute of Public Health, Unit of Epidemiology, Brussels, Belgium; 2Vrije Universiteit Brussel (VUB, Department of Family Medicine, Brussels, BelgiumObjective: The current guidelines for the diagnosis of heart failure (HF are based on studies of hospital-based patients. The aim of this study is to describe the symptoms, clinical signs, and diagnostic procedures confirming the diagnosis of HF in primary health care.Materials/subjects and methods: Data were prospectively collected during a 2-year period by a nationwide network of sentinel practices. All adult patients without known HF, for which the diagnosis of HF was clinically suspected for the first time, were registered. When diagnosed, HF was confirmed after 1 month.Results: 754 patients with a suspicion of HF were recorded. The diagnosis of HF was confirmed for 74% of the patients. The average age of the patients with confirmed HF was 77.7 years, and for those without HF 75.6 years (P = 0.018. From a logistic regression, breathlessness on exercise (P < 0.001, limitations of physical activity (P = 0.003, and orthopnea (P = 0.040 were the symptoms most associated with HF. The clinical signs most associated with HF, were pulmonary rales (P < 0.001, peripheral edema (P < 0.001, and raised jugular venous pressure (P = 0.039. An electrocardiogram was performed in 75% of the cases, blood analyses in 68%, echocardiogram in 63%, chest X-ray in 61%, and determination of natriuretic peptides in 11% of the cases.Conclusion: Many clinical signs may occur in patients with HF. However, the occurrence of peripheral edema, breathlessness on exercise, or pulmonary rales, are highly suggestive for HF when diagnosed in primary health care, as is the case in hospital-admitted patients. The diagnosis of HF was often left unconfirmed by an echocardiogram and/or an electrocardiogram.Keywords: heart failure, primary health care, diagnostic clinical signs

Microscopic colitis - a missed diagnosis in diarrhea-predominant irritable bowel syndrome.

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Stoicescu, Adriana; Becheanu, Gabriel; Dumbrava, Mona; Gheorghe, Cristian; Diculescu, Mircea

2012-01-01

Clinical presentation in microscopic colitis (MC) is similar in many cases to that of diarrhea-predominent irritable bowel syndrome (IBS-D). The proper differential diagnosis requires total colonoscopy with multiple biopsies from normal-appearing mucosa and a detailed histopathological exam. Specific treatment may improve symptomatology. To evaluate the prevalence of MC in patients with an initial diagnosis of IBS-D, to analyse demographic and clinical features of MC patients and to assess the efficacy of specific treatment. Our retrospective study analyzed patients diagnosed with microscopic colitis in clinic during a three-year period. Diagnosis was established on histological exams of the samples obtained during colonoscopy in patients previously thought to have IBS-D. We evaluated clinical manifestations, time lapsed from their onset to definitive diagnosis, the association of MC with autoimmune diseases or with prior medication and the efficacy of treatment with budesonide or mesalazine. From 247 patients considered to have IBS-D, 15 patients (6.07%) had actually MC (13 lymphocytic colitis and 2 collagenous colitis). MC was associated with nonsteroidal antiinflammatory drugs (3 patients), Lansoprazole (2 patients) and autoimmune diseases (6 patients). Watery, non-bloody diarrhea was present in all patients with MC. Other frequent complaints were nocturnal diarrhea (11 patients), abdominal pain (8 patients), abdominal bloating and flatulence (8 patients) and slight weight loss (6 patients). The diagnostic samples were obtained from the right colon in 6 cases and from rectosigmoid or transverse colon in 9 patients. Treatment was initial symptomatic in all patients, but there were 5 patients that required mesalazine and/or Budesonide, with favourable outcome. All the patients thought to have diarrhea-irritable bowel syndrome should be evaluated for microscopic colitis. Symptomatology is almost superimposable, but a few distinct features can be noticed. The proper

Laboratory Diagnosis Of Sarcoidosis

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Dutta S.K

2001-01-01

Full Text Available Sarcoidosis is not an uncommon disease. Unfortunately, the awareness amongst clinicians is lacking and due to overwhelming prevalence of tuberculosis, a disease with many similar features, the diagnosis is missed and often delayed. The gold standard investigation finding in the diagnosis of sarcoidosis is the presence of noncaseating tuberculoid granuloma, also known as sarcoid or sarcoid-like granuloma. Some classical chest X-ray findings, clinico-radiological dissociation. Suggestive organ lesions, negative Mantoux test (MT, development of MT site granuloma, hypercalcemia, hypercalciuria and raised serum angiotensin converting enzyme (SACE value and negative tests for tuberculosis are usually hekpful in the diagnosis of sarcoidosis.

Forensic tools for the diagnosis of electrocution death: Case study and literature review.

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Mondello, Cristina; Micali, Antonio; Cardia, Luigi; Argo, Antonina; Zerbo, Stefania; Spagnolo, Elvira Ventura

2018-06-01

Diagnosis of death by electrocution may be difficult when electric marking is not visible or unclear. Accordingly, the body of a man who appeared to have died from accidental electrocution was carefully forensically analysed. Macroscopic and microscopic analysis of the current mark was carried out using a variable-pressure scanning electron microscope equipped with energy dispersive X-ray microanalyser to highlight skin metallisation, indicating the presence of iron and zinc. The histological findings of electrocution myocardial damage were supported by the results of biochemical analysis which demonstrated the creatine kinase-MB and cardiac troponin I elevation. The effects of electric current flow were also highlighted by perforations of endothelial surface of a pulmonary artery using scanning electron microscope, and all the results were analysed by the main tools suggested in the literature.

Five misconceptions in cancer diagnosis

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Hamilton, William

2009-01-01

Much investment has been put into facilities for early cancer diagnosis. It is difficult to know how successful this investment has been. New facilities for rapid investigation in the UK have not reduced mortality, and may cause delays in diagnosis of patients with low-risk, or atypical, symptoms. In part, the failure of new facilities to translate into mortality benefits can be explained by five misconceptions. These are described, along with suggested research and organisational remedies. The first misconception is that cancer is diagnosed in hospitals. Consequently, secondary care data have been used to drive primary care decisions. Second, GPs are thought to be poor at cancer diagnosis, yet the type of education on offer to improve this may not be what is needed. Third, symptomatic cancer diagnosis has been downgraded in importance with the introduction of screening, yet screening identifies only a small minority of cancers. Fourth, pressure is put on GPs to make referrals for those with an individual high risk of cancer — disenfranchising those with ‘low-risk but not no-risk’ symptoms. Finally, considerable nihilism exists about the value of early diagnosis, despite considerable observational evidence that earlier diagnosis of symptomatic cancer is beneficial. PMID:19520027

Diagnosis as a social determinant: the development of prosocial behaviour before and after an autism spectrum diagnosis.

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Russell, Ginny; Kelly, Susan E; Ford, Tamsin; Steer, Colin

2012-11-01

Jutel and Nettleton (2011) discuss diagnosis as not only a major classification tool for medicine but also an interactive social process that itself may have ramifications for health. Consideration of diagnosis as a social determinant of health outcomes led to the formulation of our research question: Can we detect a change in the development of prosocial symptoms before and after an Autism Spectrum Disorder (ASD) diagnosis? We examined the developmental trajectory of prosocial skills of children, as impairment in social skills is given as a core symptom for children with ASD. We used a validated scale measuring prosocial behaviour for a sample of 57 children where the measure was repeatedly recorded over ten years. We plotted the developmental trajectory of the prosocial trait in this sample who were enrolled in a longitudinal birth cohort study based in South West England. Multi-factorial fixed effect modelling suggests that the developmental trajectory of this measure of behaviour was not significantly altered by ASD diagnosis, or the consequences of diagnosis, either for better or worse. Further analysis was conducted on a subset of 33 of the children who had both pre-diagnosis and post-diagnosis information, and the same result obtained. The results indicate that prosocial behaviours may be resistant to typical 'treatments': provision of educational and specialist health services triggered by a clinical ASD diagnosis. The implications of this for considering diagnosis as a social determinant are discussed. Copyright © 2012 Elsevier Ltd. All rights reserved.

Xpert® MTB/RIF: Usefulness for the diagnosis of tuberculosis and resistance to rifampicin.

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Vergara Gómez, Andrea; González-Martín, Julià; García-Basteiro, Alberto L

2017-11-09

The advent of the Xpert® MTB/RIF technique was a revolution in the diagnosis of tuberculosis, especially in areas with high incidence and low resources. It allows the detection of Mycobacterium tuberculosis complex and simultaneously the most common resistance mutations to rifampicin in less than 2h. For respiratory samples the sensitivity is very high, but it decreases for extrapulmonary samples and children. Although it is faster and simpler than conventional methods, it presents some limitations and new and better techniques are needed to reduce the number of cases and deaths caused by tuberculosis. This review aims to assess the scientific evidence around the diagnostic performance of Xpert® MTB/RIF in different types of samples and populations, as well as analyse its strengths and limitations for TB diagnosis. Copyright © 2017 Elsevier España, S.L.U. All rights reserved.

Molecular diagnosis and immunotherapy.

Science.gov (United States)

Sastre, Joaquín; Sastre-Ibañez, Marina

2016-12-01

To describe recent insights into how molecular diagnosis can improve indication and selection of suitable allergens for specific immunotherapy and increase the safety of this therapy. As specific allergen immunotherapy targets specific allergens, identification of the disease-eliciting allergen is a prerequisite for accurate prescription of treatment. In areas of complex sensitization to aeroallergens or in cases of hymenoptera venom allergy, the use of molecular diagnosis has demonstrated that it may lead to a change in indication and selection of allergens for immunotherapy in a large proportion of patients when compared with diagnosis based on skin prick testing and/or specific IgE determination with commercial extracts. These changes in immunotherapy prescription aided by molecular diagnosis have been demonstrated to be cost-effective in some scenarios. Certain patterns of sensitization to grass or olive pollen and bee allergens may identify patients with higher risk of adverse reaction during immunotherapy. Molecular diagnosis, when used with other tools and patients' clinical records, can help clinicians better to select the most appropriate patients and allergens for specific immunotherapy and, in some cases, predict the risk of adverse reactions. The pattern of sensitization to allergens could potentially predict the efficacy of allergen immunotherapy provided that these immunotherapy products contain a sufficient amount of these allergens. Nevertheless, multiplex assay remains a third-level approach, not to be used as screening method in current practice.

Current status of prenatal diagnosis in Cuba: causes of low prevalence of Down syndrome.

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Méndez-Rosado, L A; Hechavarría-Estenoz, D; de la Torre, M E; Pimentel-Benitez, H; Hernández-Gil, J; Perez, B; Barrios-Martínez, A; Morales-Rodriguez, E; Soriano-Torres, M; Garcia, M; Suarez-Mayedo, U; Cedeño-Aparicio, N; Blanco, I; Díaz-Véliz, P; Vidal-Hernández, B; Mitjans-Torres, M; Miñoso, S; Alvarez-Espinosa, D; Reyes-Hernández, E; Angulo-Cebada, E; Torres-Palacios, M; Lozano-Lezcano, L; Lima-Rodriguez, U; Mayeta, M; Noblet, M; Benítez, Y; Lardoeyt-Ferrer, R; Yosela-Martin, S; Carbonell, P; Pérez-Ramos, M; de León, N; Perez, M; Carbonell, J

2014-11-01

To analyze trends in cytogenetic prenatal diagnosis in Cuba and to analyze possible causes leading to a low Down syndrome prevalence in a country where the triple test is not available. An analysis of the Cuban program in prenatal cytogenetic diagnosis from 1984 to 2012 was conducted. Results are described, with particular emphasis on indications, abnormal results, types of invasive procedures, and terminations of pregnancy. Cytogenetic prenatal diagnostic analyses (n = 75,095) were conducted; maternal age was the indication for 77.9% of the amniocenteses and chorionic villus samplings. The detection rate of chromosomally abnormal pregnancies was 2.3% for maternal age and increased to 8-9% for other indications. When a chromosomal abnormality was identified, 88.5% terminated the pregnancy. In 2002, the live birth prevalence of Down syndrome was 8.4 per 10,000 live births, and in 2012, 7 per 10,000. Prenatal diagnosis in Cuba has contributed to a significant reduction in chromosomal aberrations. The impact increased because of the demographic trends of the population, the high index of terminations of pregnancy, and the establishment of a network of cytogenetic laboratories throughout Cuba. © 2014 John Wiley & Sons, Ltd.

Diagnosis delay in Libyan female breast cancer.

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Ermiah, Eramah; Abdalla, Fathi; Buhmeida, Abdelbaset; Larbesh, Entesar; Pyrhönen, Seppo; Collan, Yrjö

2012-08-21

To study the diagnosis delay and its impact on stage of disease among women with breast cancer on Libya. 200 women, aged 22 to 75 years with breast cancer diagnosed during 2008-2009 were interviewed about the period from the first symptoms to the final histological diagnosis of breast cancer. This period (diagnosis time) was categorized into 3 periods: 6 months. If diagnosis time was longer than 3 months, the diagnosis was considered delayed (diagnosis delay). Consultation time was the time taken to visit the general practitioner after the first symptoms. Retrospective preclinical and clinical data were collected on a form (questionnaire) during an interview with each patient and from medical records. The median of diagnosis time was 7.5 months. Only 30.0% of patients were diagnosed within 3 months after symptoms. 14% of patients were diagnosed within 3-6 months and 56% within a period longer than 6 months. A number of factors predicted diagnosis delay: Symptoms were not considered serious in 27% of patients. Alternative therapy (therapy not associated with cancer) was applied in 13.0% of the patients. Fear and shame prevented the visit to the doctor in 10% and 4.5% of patients, respectively. Inappropriate reassurance that the lump was benign was an important reason for prolongation of the diagnosis time. Diagnosis delay was associated with initial breast symptom(s) that did not include a lump (p diagnosis, the clinical stage distribution was as follows: 9.0% stage I, 25.5% stage II, 54.0% stage III and 11.5% stage IV.Diagnosis delay was associated with bigger tumour size (p Diagnosis delay is very serious problem in Libya. Diagnosis delay was associated with complex interactions between several factors and with advanced stages. There is a need for improving breast cancer awareness and training of general practitioners to reduce breast cancer mortality by promoting early detection. The treatment guidelines should pay more attention to the early phases of breast

CT diagnosis of hepatoma

Energy Technology Data Exchange (ETDEWEB)

Itai, Yuji [Tokyo Univ. (Japan). Faculty of Medicine

1982-04-01

In hepatocellular carcinoma, present status of CT diagnosis was discussed. Hepatocellular carcinoma is sometimes imaged in same concentration as that of surrounding tissues, and the detection rate ranged from 79 to 94%. The rate of differential diagnosis between primary and metastatic carcinoma was only 83% (includes 22% of false diagnosis) using contrast enhancement. The rates of detection of hepatocellular carcinoma and metastatic one were also only 87% and 75%, respectively, even by the combined use of arterial infusion CT and dynamic CT. However, the CT images is reproducible, and is supplemented by the information of US. Thus, the combination of these methods is useful in diagnosing the presence, extension, and nature of liver carcinoma.

The Diagnosis of Gastric Mucosa-associated Lymphoid Tissue Lymphoma by Flow Cytometry and Fluorescence in situ Hybridization of Biopsy Specimens.

Science.gov (United States)

Matsueda, Katsunori; Omote, Sizuma; Sakata, Masahiro; Fujita, Isao; Horii, Jouichiro; Toyokawa, Tatsuya

2018-04-15

Mucosa-associated lymphoid tissue (MALT) lymphoma and reactive inflammatory lymphoid changes are frequently difficult to distinguish based on a routine histological differential diagnosis. We were unable to diagnose gastric MALT lymphoma histologically using specimens obtained by endoscopy, although a flow cytometry (FCM) analysis demonstrated clonality of neoplastic cells by separating cells by CD45 gating. Furthermore, a fluorescence in situ hybridization (FISH) analysis showed trisomy 18. We therefore diagnosed gastric MALT lymphoma with trisomy 18. We recommend that FCM and FISH analyses of biopsy specimens be considered for diagnosing gastric MALT lymphoma if this diagnosis is suspected based on endoscopic findings.

Seasonal Allergies: Diagnosis, Treatment & Research

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... this page please turn JavaScript on. Feature: Seasonal Allergies Diagnosis, Treatment & Research Past Issues / Spring 2015 Table of Contents Diagnosis Testing for Allergies Knowing exactly what you are allergic to can ...

Diagnosis and pathology of endocrine diseases

International Nuclear Information System (INIS)

Shriver, B.D.

1988-01-01

This book contains 22 papers under the headings of Diagnosis and Pathology of endocrine diseases. Topics covered include: Laboratory tests in the diagnosis and management of thyroid disorders, Pathology of thyroid diseases, Diagnosis of adrenourtical disease, Radiologic techniques in evaluating endocrine disorders; and the Pituitary and adrenal glands

Diagnosis and pathology of endocrine diseases

Energy Technology Data Exchange (ETDEWEB)

Shriver, B.D.

1988-01-01

This book contains 22 papers under the headings of Diagnosis and Pathology of endocrine diseases. Topics covered include: Laboratory tests in the diagnosis and management of thyroid disorders, Pathology of thyroid diseases, Diagnosis of adrenourtical disease, Radiologic techniques in evaluating endocrine disorders; and the Pituitary and adrenal glands.

Morbidity before and after the Diagnosis of Hyperthyroidism: A Nationwide Register-Based Study

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Brandt, Frans; Thvilum, Marianne; Almind, Dorthe; Christensen, Kaare; Green, Anders; Hegedüs, Laszlo; Brix, Thomas Heiberg

2013-01-01

Background Hyperthyroidism has been linked with different morbidities, like atrial fibrillation, stroke and diabetes mellitus. However, our knowledge regarding the extent and temporal relation between hyperthyroidism and other diseases is fragmented. Here, we aimed at evaluating various morbidities before and after the diagnosis of hyperthyroidism. Methods Observational cohort study. From nationwide Danish health registers 2631 hyperthyroid singletons and 375 twin pairs discordant for hyperthyroidism were identified and followed for an average of 6 years (range 0–13). Data on the occurrence of cardiovascular diseases, lung diseases, diabetes mellitus, rheumatic diseases and malignant diseases was obtained by person-to-person record linkage with the National Danish Patient Register and/or the Danish National Prescription Registry (lung diseases and diabetes mellitus). Logistic and Cox regression models were used to assess the risk of morbidity before and after the diagnosis of hyperthyroidism, respectively. All Cox regression analyses were adjusted for the degree of co-morbidity preceding the diagnosis of hyperthyroidism, using the Charlson score. Results Hyperthyroid individuals had a significantly higher risk of being diagnosed with cardiovascular diseases (odds ratio (OR) 1.65; 95% confidence interval (CI): 1.45–1.87), lung diseases (OR 1.53; 95% CI: 1.29–1.60), and diabetes mellitus (OR 1.43, 95% CI: 1.20–1.72), but not with malignant diseases (OR 1.16, 95% CI: 0.99–1.36) prior to the diagnosis of hyperthyroidism. After the diagnosis of hyperthyroidism, subjects had a significantly higher risk of being diagnosed with cardiovascular diseases (hazard ratio (HR) 1.34; 95% CI: 1.15–1.56), lung diseases (HR 1.28; 95% CI: 1.10–1.49), and diabetes mellitus (HR 1.46; 95% CI: 1.16–1.84), but not with rheumatic diseases (HR 1.39, 95% CI: 0.92–2.09) or malignant diseases (HR 1.18, 95% CI 0.97–1.42). Conclusions We demonstrate a significantly increased

Advances in Raman spectroscopy for the diagnosis of Alzheimer's disease

Science.gov (United States)

Sudworth, Caroline D.; Archer, John K. J.; Black, Richard A.; Mann, David

2006-02-01

Within the next 50 years Alzheimer's disease is expected to affect 100 million people worldwide. The progressive decline in the mental health of the patient is caused by severe brain atrophy generated by the breakdown and aggregation of proteins, resulting in β-amyloid plaques and neurofibrillary tangles. The greatest challenge to Alzheimer's disease lies in the pursuit of an early and definitive diagnosis, in order that suitable treatment can be administered. At the present time, definitive diagnosis is restricted to post-mortem examination. Alzheimer's disease also remains without a long-term cure. This research demonstrates the potential role of Raman spectroscopy, combined with principle components analysis (PCA), as a diagnostic method. Analyses of ethically approved ex vivo post-mortem brain tissues (originating from frontal and occipital lobes) from control (3 normal elderly subjects and 3 Huntingdon's disease subjects) and Alzheimer's disease (12 subjects) brain sections, and a further set of 12 blinded samples are presented. Spectra originating from these tissues are highly reproducible, and initial results indicate a vital difference in protein content and conformation, relating to the abnormally high levels of aggregated proteins in the diseased tissues. Further examination of these spectra using PCA allows for the separation of control from diseased tissues. The validation of the PCA models using blinded samples also displays promise for the identification of Alzheimer's disease, in conjunction with secondary information regarding other brain diseases and dementias. These results provide a route for Raman spectroscopy as a possible non-invasive, non-destructive tool for the early diagnosis of Alzheimer's disease.

A human reliability analysis (HRA) method for identifying and assessing the error of commission (EOC) from a diagnosis failure

Energy Technology Data Exchange (ETDEWEB)

Kim, Jae Whan; Jung, Won Dea; Park, Jin Yun; Kang, Dae Il

2005-01-01

The study deals with a method for systematically identifying and assessing the EOC events that might be caused from a diagnosis failure or misdiagnosis of the expected events in accident scenarios of nuclear power plants. The method for EOC identification and assessment consists of three steps: analysis of the potential for a diagnosis failure (or misdiagnosis), identification of the EOC events from the diagnosis failure, quantitative assessment of the identified EOC events. As a tool for analysing a diagnosis failure, the MisDiagnosis Tree Analysis (MDTA) technique is proposed with the taxonomy of misdiagnosis causes. Also, the guidance on the identification of EOC events and the classification system and data are given for quantitiative assessment. As an applicaton of the proposed method, the EOCs identification and assessment for Younggwang 3 and 4 plants and their impact on the plant risk were performed. As the result, six events or event sequences were considered for diagnosis failures and about 20 new Human Failure Events (HFEs) involving EOCs were identified. According to the assessment of the risk impact of the identified HFEs, they increase the CDF by 11.4 % of the current CDF value, which corresponds to 10.2 % of the new CDF. The small loss of coolant accident (SLOCA) turned out to be a major contributor to the increase of CDF resulting in 9.2 % increaseof the current CDF.

General knowledge structure for diagnosis

International Nuclear Information System (INIS)

Steinar Brendeford, T.

1996-01-01

At the OECD Halden Reactor Project work has been going on for several years in the field of automatic fault diagnosis for nuclear power plants. Continuing this work, studies are now carried out to combine different diagnostic systems within the same framework. The goal is to establish a general knowledge structure for diagnosis applied to a NPP process. Such a consistent and generic storage of knowledge will lighten the task of combining different diagnosis techniques. An integration like this is expected to increase the robustness and widen the scope of the diagnosis. Further, verification of system reliability and on-line explanations of hypotheses can be helped. Last but not least there is a potential in reuse of both specific and generic knowledge. The general knowledge framework is also a prerequisite for a successful integration of computerized operator support systems within the process supervision and control complex. Consistency, verification and reuse are keywords also in this respect. Systems that should be considered for integration are; automatic control, computerized operator procedures, alarm - and alarm filtering, signal validation, diagnosis and condition based maintenance. This paper presents three prototype diagnosis systems developed at the OECD Halden Reactor Project. A software arrangement for process simulation with these three systems attached in parallel is briefly described. The central part of this setup is a 'blackboard' system to be used for representing shared knowledge. Examples of such knowledge representations are included in the paper. The conclusions so far in this line of work are only tentative. The studies of existing methodologies for diagnosis, however, show a potential for several generalizations to be made in knowledge representation and use. (author). 14 refs, 6 figs

General knowledge structure for diagnosis

Energy Technology Data Exchange (ETDEWEB)

Steinar Brendeford, T [Institutt for Energiteknikk, Halden (Norway). OECD Halden Reaktor Projekt

1997-12-31

At the OECD Halden Reactor Project work has been going on for several years in the field of automatic fault diagnosis for nuclear power plants. Continuing this work, studies are now carried out to combine different diagnostic systems within the same framework. The goal is to establish a general knowledge structure for diagnosis applied to a NPP process. Such a consistent and generic storage of knowledge will lighten the task of combining different diagnosis techniques. An integration like this is expected to increase the robustness and widen the scope of the diagnosis. Further, verification of system reliability and on-line explanations of hypotheses can be helped. Last but not least there is a potential in reuse of both specific and generic knowledge. The general knowledge framework is also a prerequisite for a successful integration of computerized operator support systems within the process supervision and control complex. Consistency, verification and reuse are keywords also in this respect. Systems that should be considered for integration are; automatic control, computerized operator procedures, alarm - and alarm filtering, signal validation, diagnosis and condition based maintenance. This paper presents three prototype diagnosis systems developed at the OECD Halden Reactor Project. A software arrangement for process simulation with these three systems attached in parallel is briefly described. The central part of this setup is a `blackboard` system to be used for representing shared knowledge. Examples of such knowledge representations are included in the paper. The conclusions so far in this line of work are only tentative. The studies of existing methodologies for diagnosis, however, show a potential for several generalizations to be made in knowledge representation and use. (author). 14 refs, 6 figs.

Morquio syndrome: A radiological diagnosis

Directory of Open Access Journals (Sweden)

Sadhanandham Shrinuvasan

2015-01-01

Full Text Available Mucopolysaccharidoses (MPS are a family of inherited metabolic diseases that results from the deficiency of lysosomal enzymes involved in the degradation of the glycosaminoglycans (MPS. We report here a 7-year-old female child who presented with complaints of short stature, skeletal deformities, and difficulty in walking with normal intelligence. A clinical diagnosis with differential diagnosis of achondroplasia/rickets was considered. Skeletal survey showed radiological features characteristic of Morquio syndrome (MPS IV which lead to diagnosis in this case.

Diagnosis of thyroid diseases. The diagnosis value of the various methods of examination

Energy Technology Data Exchange (ETDEWEB)

Pfannenstiel, P [Stiftung Deutsche Klinik fuer Diagnostik, Wiesbaden (Germany, F.R.). Fachbereich Nuklearmedizin

1980-03-01

The recommendations of the thyroid section of the Deutsche Gesellschaft fuer Endokrinologie take account of practical requirements and serve as a basis for assessing the indications of the various diagnostic methods in view of their value, expenditure, and hazards. Progress in methodology and recent scientific findings have been taken into account as well as economic aspects and the available equipment. In spite of all the possibilities offered by modern laboratory diagnosis, the diagnosis and theory of thyroid diseases should always depend on a special anamnesis and a physical examination of the patient. The measured values must agree with the patient's complaints and with clinical findings. In diagnoses involving several steps, one should always start with simple in-vitro techniques in order to spare the patient stress. Functional diagnosis of thyroid diseases are supplemented by thyroid scintiscanning with short-lived radionuclides and by thyroid cytology. Experience and precise knowledge help to 'save expense and radiation'. Of course, uncertain diagnoses and untypical findings require a more extensive use of diagnostic means than diagnosis that are more or less clinically proved.

[Microbiological diagnosis of HIV infection].

Science.gov (United States)

López-Bernaldo de Quirós, Juan Carlos; Delgado, Rafael; García, Federico; Eiros, José M; Ortiz de Lejarazu, Raúl

2007-12-01

Currently, there are around 150,000 HIV-infected patients in Spain. This number, together with the fact that this disease is now a chronic condition since the introduction of antiretroviral therapy, has generated an increasing demand on the clinical microbiology laboratories in our hospitals. This increase has occurred not only in the diagnosis and treatment of opportunistic diseases, but also in tests related to the diagnosis and therapeutic management of HIV infection. To meet this demand, the Sociedad de Enfermedades Infecciosas y Microbiología Clinica (Spanish Society of Infectious Diseases and Clinical Microbiology) has updated its standard Procedure for the microbiological diagnosis of HIV infection. The main advances related to serological diagnosis, plasma viral load, and detection of resistance to antiretroviral drugs are reviewed in this version of the Procedure.

Diagnosis-Prescription in the Context of Instructional Management.

Science.gov (United States)

Besel, Ronald

The usage of the terms "diagnosis" and "prescription" in the fields of medicine and electronic troubleshooting is reviewed, and a common structure for diagnosis-prescription is proposed. The diagnosis-prescription decision sequence is outlined. Prescription-without-diagnosis and diagnosis-without-prescription in education is discussed. The…

Diagnosis delay in Libyan female breast cancer

Directory of Open Access Journals (Sweden)

Ermiah Eramah

2012-08-01

Full Text Available Abstract Aims To study the diagnosis delay and its impact on stage of disease among women with breast cancer on Libya. Methods 200 women, aged 22 to 75 years with breast cancer diagnosed during 2008–2009 were interviewed about the period from the first symptoms to the final histological diagnosis of breast cancer. This period (diagnosis time was categorized into 3 periods: 6 months. If diagnosis time was longer than 3 months, the diagnosis was considered delayed (diagnosis delay. Consultation time was the time taken to visit the general practitioner after the first symptoms. Retrospective preclinical and clinical data were collected on a form (questionnaire during an interview with each patient and from medical records. Results The median of diagnosis time was 7.5 months. Only 30.0% of patients were diagnosed within 3 months after symptoms. 14% of patients were diagnosed within 3–6 months and 56% within a period longer than 6 months. A number of factors predicted diagnosis delay: Symptoms were not considered serious in 27% of patients. Alternative therapy (therapy not associated with cancer was applied in 13.0% of the patients. Fear and shame prevented the visit to the doctor in 10% and 4.5% of patients, respectively. Inappropriate reassurance that the lump was benign was an important reason for prolongation of the diagnosis time. Diagnosis delay was associated with initial breast symptom(s that did not include a lump (p  Diagnosis delay was associated with bigger tumour size (p Conclusions Diagnosis delay is very serious problem in Libya. Diagnosis delay was associated with complex interactions between several factors and with advanced stages. There is a need for improving breast cancer awareness and training of general practitioners to reduce breast cancer mortality by promoting early detection. The treatment guidelines should pay more attention to the early phases of breast cancer. Especially, guidelines for good practices in managing

The potential use of Raman spectroscopy for the diagnosis of Alzheimer's disease

Science.gov (United States)

Sudworth, Caroline D.; Archer, John K. J.; Mann, David

2005-09-01

Alzheimer's disease currently affects over 800,000 people in the UK, and this figure is set to exceed 1.5 million by 2050. The disease causes a severe breakdown of the brain, resulting in the progressive decline in the mental health of the patient. It also remains without a long-term cure. A definitive diagnosis of the disease can only be gained at post-mortem, whilst other technologies are limited to monitoring the physical breakdown of the brain. The early identification of the chemicals responsible for the disease, and their structure, is therefore essential for improved diagnosis, treatment and care. This research demonstrates the use of Raman spectroscopy, and principle components analysis, as a method for the diagnosis, and examination of, the specific proteins responsible for Alzheimer's disease. Analyses of ethically approved ex vivo brain tissues from normal elderly (n=3), Alzheimer's disease (n=12) and Huntingdon's disease (n=3) brain sections (from the frontal and occipital lobes) are presented. Subsequently, a further 12 blinded individual samples were examined and the preliminary results are presented. Spectra originating from these tissues are highly reproducible, and results indicate a vital difference in protein content and protein conformation, relating to the abnormally high levels of aggregated proteins in the diseased tissues. Principle components analysis has been shown to differentiate normal elderly tissues from diseased tissues. These results show great promise for the early identification of Alzheimer's disease, and secondary information regarding other brain diseases and dementias. These results demonstrate the potential use of Raman spectroscopy as a possible non-invasive, non-destructive tool for the early diagnosis of Alzheimer's disease.

Network Fault Diagnosis Using DSM

Institute of Scientific and Technical Information of China (English)

Jiang Hao; Yan Pu-liu; Chen Xiao; Wu Jing

2004-01-01

Difference similitude matrix (DSM) is effective in reducing information system with its higher reduction rate and higher validity. We use DSM method to analyze the fault data of computer networks and obtain the fault diagnosis rules. Through discretizing the relative value of fault data, we get the information system of the fault data. DSM method reduces the information system and gets the diagnosis rules. The simulation with the actual scenario shows that the fault diagnosis based on DSM can obtain few and effective rules.

Associations between DSM-IV mental disorders and subsequent self-reported diagnosis of cancer

Science.gov (United States)

O'Neill, Siobhan; Posada-Villa, Jose; Medina-Mora, Maria Elena; Al-Hamzawi, Ali Obaid; Piazza, Marina; Tachimori, Hisateru; Hu, Chiyi; Lim, Carmen; Bruffaerts, Ronny; Lépine, Jean-Pierre; Matschinger, Herbert; de Girolamo, Giovanni; de Jonge, Peter; Alonso, Jordi; Caldas-de-Almeida, Jose Miguel; Florescu, Silvia; Kiejna, Andrzej; Levinson, Daphna; Kessler, Ronald C.; Scott, Kate M.

2016-01-01

Objective The associations between mental disorders and cancer remain unclear. It is also unknown whether any associations vary according to life stage or gender. This paper examines these research questions using data from the World Mental Health Survey Initiative. Methods The World Health Organization Composite International Diagnostic Interview retrospectively assessed the lifetime prevalence of 16 DSM-IV mental disorders in face-to-face household population surveys in nineteen countries (n = 52,095). Cancer was indicated by self-report of diagnosis. Smoking was assessed in questions about current and past tobacco use. Survival analyses estimated associations between first onset of mental disorders and subsequently reported cancer. Results After adjustment for comorbidity, panic disorder, specific phobia and alcohol abuse were associated with a subsequently self-reported diagnosis of cancer. There was an association between number of mental disorders and the likelihood of reporting a cancer diagnosis following the onset of the mental disorder. This suggests that the associations between mental disorders and cancer risk may be generalised, rather than specific to a particular disorder. Depression is more strongly associated with self-reported cancers diagnosed early in life and in women. PTSD is also associated with cancers diagnosed early in life. Conclusion This study reports the magnitude of the associations between mental disorders and a self-reported diagnosis of cancer and provides information about the relevance of comorbidity, gender and the impact at different stages of life. The findings point to a link between the two conditions and lend support to arguments for early identification and treatment of mental disorders. PMID:24529039

New technologies in diagnosis of preinvasive cervical lesions

Directory of Open Access Journals (Sweden)

I. P. Aminodova

2015-01-01

Full Text Available Results of efficiency assessment of different diagnosis for preinvasive cervical lesions are represented in the article. During investigation the retrospective analysis of 353 patient histories of women with cervical intraepithelial neoplasia (primary and recurrent, who have been observed in Ivanovskiy regional oncological dispensary from 2002 to 2011, was performed. The accuracy rates of diagnosis of cervical intraepithelial neoplasia for one or several methods including cytological study, colposcopy and fluorescence cystoscopy were compared. Fluorescence diagnosis was performed with drug fotoditazin (LLC «VETA-GRAND», marketing authorisation №LS 001246 at dose of 1,0 mg/kg body weight. The final diagnosis was determined by results of histological study. The accuracy of cytological study accounted for 67,5–80,7%. Using colposcopy the exact diagnosis was determined in 67,9–74,4% of cases. Combination of cytological study with colposcopy improved the accuracy of diagnosis up to 82.1–88.9%. The superior results were for concurrent use of cytological study with colposcopy and fluorescence diagnosis – in such case the diagnosis was correct in 92,0–96,7% of patients. The analysis of results showed that using all methods of diagnosis the accuracy of diagnosis for recurrent cervical intraepithelial neoplasia was lower than for primary lesions. The decrease of diagnosis accuracy is probably related to previous diagnosis and therapeutic manipulations on cervix. Thus, multimodal diagnosis investigation with methods of fluorescence spectroscopy allows to improve accuracy of diagnosis for preinvasive cervical lesions. 

Social barriers to diagnosis and treatment of breast cancer in patients presenting at a teaching hospital in Ibadan, Nigeria.

Science.gov (United States)

Pruitt, Liese; Mumuni, Tolulope; Raikhel, Eugene; Ademola, Adeyinka; Ogundiran, Temidayo; Adenipekun, Adeniyi; Morhason-Bello, Imran; Ojengbede, Oladosu A; Olopade, Olufunmilayo I

2015-01-01

Globally, breast cancer is the most frequent malignancy in women, and stage at diagnosis is a key determinant of outcome. In low- to middle-income countries, including Nigeria, advanced stage diagnosis and delayed treatment represent a significant problem. That social barriers contribute to delay has been noted in previous research; however, few specific factors have been studied. Using semi-structured interviews, this study identifies social barriers to diagnosis and treatment for patients who presented at University College Hospital Ibadan, Nigeria. Transcripts from the interviews were coded and analysed thematically. Thirty-one patients and five physicians were interviewed. The median age of patients was 51 (range: 28 to above 80), 83% were Christian and 17% were Muslim. Preliminary analysis showed that delays in diagnosis reflected a lack of education as well as the utilisation of non-physician medical services such as pharmacists. Delays in treatment were often due to fear of unanticipated surgery and cost. The majority of women did not know the cause of their breast cancer, but some believed it was caused by a spiritual affliction. This study suggests that further education and awareness of breast cancer for both patients and providers is needed in order to increase early stage diagnosis.

Echography in appendicitis acute diagnosis

International Nuclear Information System (INIS)

Ripolles Gonzalez, T.; Sanguesa Nebot, C.; Ambit Capdevila, S.; Lazaro y de Molina, S.

1993-01-01

Over an 18-month period, high resolution ultrasound was used to assess 220 patients with doubtful clinical diagnosis of acute appendicitis. The ultrasonographic findings were correlated with the surgical results and the pathological results in 115 cases, and with clinical follow-up in the rest. This technique has been found to be effective in the diagnosis of acute appendicitis, with a sensitivity of 90.4%, and similar specificity and reliability (90.2%). The positive predictive value of the test was 89% and the negative predictive value, 91%. The ultrasonographic criteria applied for the diagnosis of acute appendicitis was the detection of an understood appendix measuring over 6 mm. All cases with perforation were correctly diagnosed as acute appendicitis. The observation of an accumulation of fluid pooled in DIF in patients with ultrasonographic findings suggestive of appendicitis points to a diagnosis of perforation or complicated (gangrenous) appendicitis. A relationship between complicated appendicitis and the detection of appendicoliths within the enlarged appendix was also observed. The results obtained demonstrate that high resolution ultrasound is indicated in the diagnosis of acute appendicitis in all cases in which the clinical findings are doubtful

Nucleomedical diagnosis of lung cancer

Energy Technology Data Exchange (ETDEWEB)

Ito, Yasuhiko [Kawasaki Medical School, Kurashiki, Okayama (Japan)

1982-06-01

/sup 67/Ga citrate is most often used in the diagnosis of lung cancer. As judged from reported cases, the accuracy rate was 90%, with a false negative rate being about 5%. Lung ventilation and blood flow scintigraphy are valuable in assessing the degree of damage to lung function and the therapeutic effect rather than in finding lung cancer. In aerosol scintigraphy, sup(99m)Tc labelled aerosols with different particle size depending on the purpose of diagnosis are used; the large particles deposit at the center of the trachea and small size aerosols on the periphery. Aerosol-inhaled scintigraphy is highly valuable for the diagnosis of hilus lung cancer. sup(99m)Tc methylene diphosphate is used in bone scintigraphy to detect bone metastasis. But it sometimes gives false positive results such as in the case of senile bone changes. Another valuable method of diagnosis is emission CT by which various substances having affinity for the tumor can be detected by labelling them with a proton emitting nuclear species such as 11 C, /sup 13/N, /sup 15/O and /sup 18/F. Some cases of lung cancer, and the radionuclide methods used in the diagnosis are shown.

Alternative energies. Updates on progress

Energy Technology Data Exchange (ETDEWEB)

Ferreira, German (ed.) [CIRCE - Centre of Research for Energy Resources and Consumption, Zaragoza (Spain)

2013-07-01

Presents fundamental and applied research of alternative energies. Address key pillars in the alternative energy field, such as: biomass energy, hydrogen energy, solar energy, wind energy, hydroelectric power, geothermal energy and their environmental implications, with the most updated progress. Includes the life cycle assessment and thermoeconomic analysis as tools for evaluating and optimising environmental and cost subjects. This book presents nine chapters based on fundamental and applied research of alternative energies. At the present time, the challenge is that technology has to come up with solutions that can provide environmentally friendly energy supply options that are able to cover the current world energy demand. Experts around the world are working on these issues for providing new solutions that will break the existing technological barriers. This book aims to address key pillars in the alternative energy field, such as: biomass energy, hydrogen energy, solar energy, wind energy, hydroelectric power, geothermal energy and their environmental implications, with the most updated progress for each pillar. It also includes the life cycle assessment (LCA) and thermoeconomic analysis (TA) as tools for evaluating and optimising environmental and cost subjects. Chapters are organized into fundamental research, applied research and future trends; and written for engineers, academic researches and scientists.

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

Energy Technology Data Exchange (ETDEWEB)

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

2012-08-15

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

Diagnosis of antenatal Bartter syndrome.

Science.gov (United States)

Narayan, R; Peres, M; Kesby, G

2016-01-01

Bartter syndrome is a rare heterogeneous group of autosomal-recessive salt-losing renal tubular disorders that can present in fetal life (antenatal Bartter syndrome; ABS) as "unexplained" early-onset polyhydramnios, often associated with growth restriction. Prenatal diagnosis of the condition involves assessment of amniotic fluid biochemistry in a setting of polyuric polyhydramnios; with elevated chloride levels considered a consistent and diagnostic finding. Other amniotic fluid biochemical markers have been described, notably increased aldosterone levels, and low total protein levels. NOVEL INSIGHT: Antenatal Bartter syndrome is a heterogeneous group of renal disorders. While certain biochemical features in amniotic fluid might heighten suspicion, final diagnosis can only be made in the postnatal setting. In the setting of unexplained severe polyhydramnios, clinicians should continue to entertain the diagnosis of antenatal Bartter Syndrome and maintain neonatal surveillance, even if amniotic fluid markers do not support the diagnosis.

Decision aids for improved accuracy and standardization of mammographic diagnosis

International Nuclear Information System (INIS)

D'Orsi, C.J.; Getty, D.J.; Swets, J.A.; Pickett, R.M.; Seltzer, S.E.; McNeil, B.J.

1990-01-01

This paper examines the gains in the accuracy of mammographic diagnosis of breast cancer achievable from a pair of decision aids. Twenty-three potentially relevant perceptual features of mammograms were identified through interviews, psychometric tests, and consensus meetings with mammography specialists. Statistical analyses determined the 12 independent features that were most information diagnostically and assigned a weight to each according to its importance. Two decision aids were developed: a checklist that solicits a scale value from the radiologist for each feature and a computer program that merges those values optimally in an advisory estimate of the probability of malignancy. Six radiologists read a set of 150 cases, first in their usual way and later with the aids

Fetal tachycardia : diagnosis and treatment

NARCIS (Netherlands)

Oudijk, Martijn Alexander

2003-01-01

Part I: Fetal tachyarrhythmias Diagnosis Fetal tachycardia is a serious condition warranting specialized evaluation. In chapter 2, methods of diagnosis of fetal tachycardia are described, including doppler and M-mode echocardiography and fetal magnetocardiography. The study presented in chapter 3

Microscopic Colitis – A Missed Diagnosis in Diarrhea-Predominant Irritable Bowel Syndrome

Science.gov (United States)

STOICESCU, Adriana; BECHEANU, Gabriel; DUMBRAVA, Mona; GHEORGHE, Cristian; DICULESCU, Mircea

2012-01-01

ABSTRACT Background: Clinical presentation in microscopic colitis (MC) is similar in many cases to that of diarrhea-predominent irritable bowel syndrome (IBS-D). The proper differential diagnosis requires total colonoscopy with multiple biopsies from normal-appearing mucosa and a detailed histopathological exam. Specific treatment may improve symptomatology. Aim: To evaluate the prevalence of MC in patients with an initial diagnosis of IBS-D, to analyse demographic and clinical features of MC patients and to assess the efficacy of specific treatment. Material and methods: Our retrospective study analyzed patients diagnosed with microscopic colitis in clinic during a three-year period. Diagnosis was established on histological exams of the samples obtained during colonoscopy in patients previously thought to have IBS-D. We evaluated clinical manifestations, time lapsed from their onset to definitive diagnosis, the association of MC with autoimmune diseases or with prior medication and the efficacy of treatment with budesonide or mesalazine. Results: From 247 patients considered to have IBS-D, 15 patients (6.07%) had actually MC (13 lymphocytic colitis and 2 collagenous colitis). MC was associated with nonsteroidal antiinflammatory drugs (3 patients), Lansoprazole (2 patients) and autoimmune diseases (6 patients). Watery, non-bloody diarrhea was present in all patients with MC. Other frequent complaints were nocturnal diarrhea (11 patients), abdominal pain (8 patients), abdominal bloating and flatulence (8 patients) and slight weight loss (6 patients). The diagnostic samples were obtained from the right colon in 6 cases and from rectosigmoid or transverse colon in 9 patients. Treatment was initial symptomatic in all patients, but there were 5 patients that required mesalazine and/or Budesonide, with favourable outcome. Conclusions: All the patients thought to have diarrhea-irritable bowel syndrome should be evaluated for microscopic colitis. Symptomatology is almost

Evaluation of pulse oximeter derived photoplethysmographic signals for obstructive sleep apnea diagnosis.

Science.gov (United States)

Li, Yan; Gao, He; Ma, Yan

2017-05-01

High prevalence of obstructive sleep apnea (OSA) has increased the demands for more convenient and accessible diagnostic devices other than standard in-lab polysomnography (PSG). Despite the increasing utility of photoplethysmograph (PPG), it remains understudied in underserved populations. This study aimed to evaluate the reliability of a standard pulse oximeter system with an automated analysis based on the PPG signal for the diagnosis of OSA, as compared with PSG derived measures.Consecutive out-patients with suspect OSA completed a PPG monitoring simultaneous with an overnight in-lab standard PSG. Forty-nine OSA patients (38 males, age 43.5 ± 16.9 years, BMI 26.9 ± 0.5 kg/m) were included in this study. Automated analyses were based on PPG and oximetry signals only. The PPG calculated measures were compared with PSG derived measures for agreement tests.Respiratory events index derived from PPG significantly correlated with PSG-derived apnea-hypopnea index (r = 0.935, P oximeter system with PPG recording can be used for the diagnosis or screening of OSA in high risk population.

[Prenatal diagnosis of sirenomelia].

Science.gov (United States)

Ladure, H; D'hervé, D; Loget, P; Poulain, P

2006-04-01

Sirenomelia sequence associates a fusion of inferior legs with renal anomalies until bilateral agenesis. It is a rare and lethal polymalformation. The purpose of the ultrasonographic study is to identify the sirenomelia as early as possible during pregnancy and to differentiate it from caudal regression syndrome. A case of sirenomelia diagnosed early is reported together with a review of the literature. The ultrasonographic diagnosis, associated defects, the interest of color Doppler study of abdominal vasculature are discussed. Antenatal ultrasonographic diagnosis should be obtained as early as possible, before 20th gestational week at the latest. Color Doppler is helpful to confirm the diagnosis in case of bilateral renal agenesis. The main differences between sirenomelia and caudal regression syndrome (which requires a very different genetic counselling) are summarized in a table.

Social integration and survival after diagnosis of colorectal cancer.

Science.gov (United States)

Sarma, Elizabeth A; Kawachi, Ichiro; Poole, Elizabeth M; Tworoger, Shelley S; Giovannucci, Edward L; Fuchs, Charles S; Bao, Ying

2018-02-15

Although larger social networks have been associated with lower all-cause mortality, few studies have examined whether social integration predicts survival outcomes among patients with colorectal cancer (CRC). The authors examined the association between social ties and survival after CRC diagnosis in a prospective cohort study. Participants included 896 women in the Nurses' Health Study who were diagnosed with stage I, II, or III CRC between 1992 and 2012. Stage was assigned using the American Joint Committee on Cancer criteria. Social integration was assessed every 4 years since 1992 using the Berkman-Syme Social Network Index, which included marital status, social network size, contact frequency, religious participation, and other social group participation. During follow-up, there were 380 total deaths, 167 of which were due to CRC. In multivariable analyses, women who were socially integrated before diagnosis had a subsequent reduced risk of all-cause mortality (hazard ratio [HR], 0.65; 95% confidence interval [95% CI], 0.46-0.92) and CRC mortality (HR, 0.63; 95% CI, 0.38-1.06) compared with women who were socially isolated. In particular, women with more intimate ties (family and friends) had lower all-cause mortality (HR, 0.61; 95% CI, 0.42-0.88) and CRC mortality (HR, 0.59; 95% CI, 0.34-1.03) compared with those with few intimate ties. Participation in religious or community activities was not found to be related to outcomes. The analysis of postdiagnosis social integration yielded similar results. Socially integrated women were found to have better survival after a diagnosis of CRC, possibly due to beneficial caregiving from their family and friends. Interventions aimed at strengthening social network structures to ensure access to care may be valuable programmatic tools in the management of patients with CRC. Cancer 2018;124:833-40. © 2017 American Cancer Society. © 2017 American Cancer Society.

[Modern Diagnosis and Therapy of the rhinitis allergica].

Science.gov (United States)

Hauswald, B; Yarin, Y M

2015-05-01

The prevalence of allergic diseases is increasing worldwide. The highest increase rate is observed in rhinitis allergica. Apart from the anamnesis, the diagnosis relies mainly on skin tests, laboratory analyses and if necessary provocation tests. Symptomatic and causal therapy with abstention and specific immunotherapy are available as therapeutic means. Specific immunotherapy should be aspired as the method of choice. It is comprised of subcutane and sublingular immunity therapy. Usually native allergens and allergoids are used as therapeutics. Recombinant allergens are currently under development. Modern therapy procedures involving these drugs consist of year-round or pre- and co-seasonal treatment which spans at least 3-4 years. In cases of polyvalent allergy, different types of drugs and therapy procedures can be combined. The future of rhinitis allergica treatment lies in further development of specific immunotherapy. © Georg Thieme Verlag KG Stuttgart · New York.

Computer tomographic diagnosis of echinococcosis

Energy Technology Data Exchange (ETDEWEB)

Haertel, M.; Fretz, C.; Fuchs, W.A.

1980-08-01

The computer tomographic appearances and differential diagnosis in 22 patients with echinococcosis are described; of these, twelve were of the cystic and ten of the alveolar type. The computer tomographic appearances are characterised by the presence of daughter cysts (66%) within the sharply demarkated parasitic cyst of water density. In the absence of daughter cysts, a definite aetiological diagnosis cannot be made, although there is a tendency to clasification of the occassionally multiple echinococcus cysts. The computer tomographic appearances of advanced alveolar echinococcosis are characterised by partial collequative necrosis, with clacification around the necrotic areas (90%). The absence of CT evidence of partial necrosis and calsification of the pseudotumour makes it difficult to establish a specific diagnosis. The conclusive and non-invasive character of the procedure and its reproducibility makes computer tomography the method of choice for the diagnosis and follow-up of echinococcosis.

The association between socioeconomic status and the symptoms at diagnosis of celiac disease: a retrospective cohort study.

Science.gov (United States)

Roy, Abhik; Mehra, Shilpa; Kelly, Ciarán P; Tariq, Sohaib; Pallav, Kumar; Dennis, Melinda; Peer, Ann; Lebwohl, Benjamin; Green, Peter H R; Leffler, Daniel A

2016-07-01

There are little data on patient factors that impact diagnosis rates of celiac disease. This study aims to evaluate the association between patient socioeconomic status and the symptoms at diagnosis of celiac disease. A total of 872 patients with biopsy-proven celiac disease were categorized based on the presence or absence of (1) diarrhea and (2) any gastrointestinal symptoms at diagnosis. Univariate and multivariate analyses were used to assess the association between socioeconomic status and symptoms. Patients without diarrhea at presentation had a higher mean per capita income (US$34,469 versus US$32,237, p = 0.02), and patients without any gastrointestinal symptoms had a higher mean per capita income (US$36,738 versus US$31,758, p symptoms. On multivariable analysis adjusting for sex, age, autoimmune or psychiatric comorbidities, and income, per capita income remained a significant predictor of diagnosis without gastrointestinal symptoms (odds ratio: 1.71, 95% confidence interval: 1.17-2.50, p symptoms of celiac disease are less likely to be diagnosed if they are of lower socioeconomic status. Celiac disease may be under-recognized in this population due to socioeconomic factors that possibly include lower rates of health-seeking behavior and access to healthcare.

[Relation of psychological distress after diagnosis of gastric cancer at a cancer screening center with psychological support from public health nurses and family members].

Science.gov (United States)

Fukui, Sakiko; Ozawa, Harumi

2003-07-01

The objectives of this study were to examine the degree of psychological distress during the first 6 months after diagnosis of gastric cancer and investigate the relation to psychological support from public health nurses and family members. One hundred and five patients with stomach, colorectal, or esophagus cancer were mailed a questionnaire. They were asked questions concerning the level of shock on the day of diagnosis, at 1-week after the diagnosis, and at 6 months post diagnosis. In addition, their physical and psychological status was assessed at the 6-month time point. They were also asked about perceived psychological support from public health nurses and family members. The relation between psychological distress and such psychological support was then assessed using multiple regression analyses. The levels of shock on the day of diagnosis and after 1-week were both significantly related to the psychological support from public health nurses. Physical and psychological status at 6 months post diagnosis was significantly related to the level of psychological support from the patient's family members. The study revealed that psychological support from public health nurses improves the level of patient psychological distress during the first 1 week after the cancer diagnosis. Psychological support from family members facilitates the physical and psychological adjustment at 6 months post diagnosis. The results indicate that psychological support is important just after cancer diagnosis and for longer term adjustment, pointing to a major role of health care professionals alleviating problems associated with cancer diagnosis.

Thermo-Economic Modelling and Process Integration of CO2-Mitigation Options on Oil and Gas Platforms

DEFF Research Database (Denmark)

Nguyen, Tuong-Van; Tock, Laurence; Breuhaus, Peter

2014-01-01

recovering CO2 that can be used for enhanced oil recovery. In this paper, a North Sea platform is considered as case study, and the site-scale retrofit integration of these three options is analysed, considering thermodynamic, economic and environmental performance indicators. The results illustrate......The offshore extraction of oil and gas is an energy-intensive process associated with large CO2 and CH4 emissions to the atmosphere and chemicals to the sea. The taxation of these emissions has encouraged the development of more energy-efficient and environmental-friendly solutions, of which three...

Pre-natal counselling and diagnosis in Down's syndrome.

Science.gov (United States)

Papp, Z

1973-01-01

Today Down's syndrome is recognizable on the basis of its clinical c haracteristics in infants. According to present knowledge, Down's syndr ome can be classified cytogenetically into 4 groups: regular trisomy, translocational trisomy, mosaic forms and double trisomies. Knowledge of the karyotype is used in genetic counselling for further prevention of Down's syndrome in unborn fetuses. Prenatal chromosome analyses, a form of intrauterine diagnosis, has been used in Hungary since 1968. The average incidence of Down's syndrome has been estimated at 1.5:1000 among newborns. The mother's age and genetic deviations are determinant s in whether or not the syndrome will occur. The risk of Down's syndrome increases from 1 per 1000 in mothers under 30 to 10-20 per 1000 in mothers over 45. Since risk increases with the mother's age amniocen tesis should be routinely performed in pregnancies of older mothers. In the case of trisomy verified by intrauterine diagnosis, termination of pregnancy is advised. If population cytogenetic investigations are practiced, the carriers of the balanced translocation will be revealed and within a few years there will be only 3 indications for amniocentesis: 1) in cases of mother's advanced age, 2) in cases of bala nced translocation carrier and 3) in cases of a previously affected chil d disregarding the parental karyotypes. The expected risk of Down's syn drome predictable from available data if higher than 1-5% justifies intr auterine chromosome analysis.

Rapid molecular detection of rifampicin resistance facilitates early diagnosis and treatment of multi-drug resistant tuberculosis: case control study.

Directory of Open Access Journals (Sweden)

Philly O'Riordan

2008-09-01

Full Text Available Multi-drug resistant tuberculosis (MDR-TB is a major public health concern since diagnosis is often delayed, increasing the risk of spread to the community and health care workers. Treatment is prolonged, and the total cost of treating a single case is high. Diagnosis has traditionally relied upon clinical suspicion, based on risk factors and culture with sensitivity testing, a process that can take weeks or months. Rapid diagnostic molecular techniques have the potential to shorten the time to commencing appropriate therapy, but have not been put to the test under field conditions.This retrospective case-control study aimed to identify risk factors for MDR-TB, and analyse the impact of testing for rifampicin resistance using RNA polymerase B (rpoB mutations as a surrogate for MDR-TB. Forty two MDR-TB cases and 84 fully sensitive TB controls were matched by date of diagnosis; and factors including demographics, clinical presentation, microbiology findings, management and outcome were analysed using their medical records. Conventionally recognised risk factors for MDR-TB were absent in almost half (43% of the cases, and 15% of cases were asymptomatic. A significant number of MDR-TB cases were identified in new entrants to the country. Using rpoB mutation testing, the time to diagnosis of MDR-TB was dramatically shortened by a median of 6 weeks, allowing patients to be commenced on appropriate therapy a median of 51days earlier than those diagnosed by conventional culture and sensitivity testing.MDR-TB is frequently an unexpected finding, may be asymptomatic, and is particularly prevalent among TB infected new entrants to the country. Molecular resistance testing of all acid fast bacilli positive specimens has the potential to rapidly identify MDR-TB patients and commence them on appropriate therapy significantly earlier than by conventional methods.

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

Directory of Open Access Journals (Sweden)

Lauren Bell

2018-04-01

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

Anthrax: Diagnosis

Science.gov (United States)

... Diagnosis Language: English (US) Español (Spanish) Recommend on Facebook Tweet Share Compartir Doctors in the United States rarely see a patient with anthrax. CDC Guidance and case definitions are available to help doctors diagnose anthrax, take ...

Working With Chinese Triad Youth Gangs: Correct Diagnosis and Strategic Intervention.

Science.gov (United States)

Lo, T Wing; Tam, H L

2018-02-01

Across the world, youth workers have been active in helping vulnerable youth groups. In Hong Kong, government-funded youth services are conducted by professional social workers to help vulnerable youths. This article adopted a case study approach to investigate a youth group who committed a murder. Nine murderers and two social workers were interviewed. It aims to uncover the structure and activities of the group and analyse the gang intervention prior to the murder to find out what had gone wrong and identify the lessons that social workers can learn from the murder. Four misconceptions in gang intervention have been identified. First, because of the Triad (Chinese-organised crime) affiliation, this is not just a group of deviant youths but a youth gang. Second, because it is a gang, the social workers should not group them but should instead degroup them to avoid contamination. Third, diagnosis is different from labelling. With the right diagnosis, services can be tailor-made to delabel them. Fourth, when the youths are diagnosed as a gang, outreach work instead of centre work should be provided-social workers should reach out to the gangland to uncover the youths' gang participation and crime involvement.

Arthroscopy in the diagnosis of chondromalacia patellae.

Science.gov (United States)

Leslie, I J; Bentley, G

1978-01-01

Chondromalacia patellae is difficult to diagnosis clinically with accuracy. In order to clarify the relevant symptoms and signs, 78 patients presenting with a clinical diagnosis of chondromalacia were examined by arthroscopy. In 49% of the knees no abnormalities were found. Presenting symptoms were similar in the normal and abnormal groups. Physical signs were more helpful in diagnosis and it is considered that the presence of an effusion, quadriceps wasting, and patello-femoral crepitus are the most important clinical findings in the diagnosis of chondromalacia patellae. The arthroscope is valuable instrument in establishing the diagnosis of chondromalacia patellae especially in the teenage female. Images PMID:749700

Systematic review of dermoscopy and digital dermoscopy/ artificial intelligence for the diagnosis of melanoma.

Science.gov (United States)

Rajpara, S M; Botello, A P; Townend, J; Ormerod, A D

2009-09-01

Dermoscopy improves diagnostic accuracy of the unaided eye for melanoma, and digital dermoscopy with artificial intelligence or computer diagnosis has also been shown useful for the diagnosis of melanoma. At present there is no clear evidence regarding the diagnostic accuracy of dermoscopy compared with artificial intelligence. To evaluate the diagnostic accuracy of dermoscopy and digital dermoscopy/artificial intelligence for melanoma diagnosis and to compare the diagnostic accuracy of the different dermoscopic algorithms with each other and with digital dermoscopy/artificial intelligence for the detection of melanoma. A literature search on dermoscopy and digital dermoscopy/artificial intelligence for melanoma diagnosis was performed using several databases. Titles and abstracts of the retrieved articles were screened using a literature evaluation form. A quality assessment form was developed to assess the quality of the included studies. Heterogeneity among the studies was assessed. Pooled data were analysed using meta-analytical methods and comparisons between different algorithms were performed. Of 765 articles retrieved, 30 studies were eligible for meta-analysis. Pooled sensitivity for artificial intelligence was slightly higher than for dermoscopy (91% vs. 88%; P = 0.076). Pooled specificity for dermoscopy was significantly better than artificial intelligence (86% vs. 79%; P artificial intelligence, which were not significantly different (P = 0.783). There were no significance differences in diagnostic odds ratio among the different dermoscopic diagnostic algorithms. Dermoscopy and artificial intelligence performed equally well for diagnosis of melanocytic skin lesions. There was no significant difference in the diagnostic performance of various dermoscopy algorithms. The three-point checklist, the seven-point checklist and Menzies score had better diagnostic odds ratios than the others; however, these results need to be confirmed by a large-scale high

Prenatal diagnosis of chorionicity in twins.

LENUS (Irish Health Repository)

Hassan, T

2012-02-01

The aim of this audit was to assess the accuracy of transabdominal ultrasound scan in predicting chorionicity in twin pregnancies in our unit. The presence or absence of lambda sign, T-sign, dividing membrane thickness and number of placentae were used to determine chorionicity. We retrospectively analysed these antenatal markers in 268 sets of twins delivered over a 5 year period and compared it with the postpartum placental histology and neonatal gender. Of 268 twin deliveries, 204 (76%) had both chorionicity and placental histology to compare. 67 of 84 (80%) were correctly diagnosed antenatally as monochorionic and 137 of 151 (91%) as dichorionic. In 31 cases (15%) the ultrasound diagnosis of chorionicity didn\\'t match placental histology. Seventeen were thought to be monochorionic antenatally but were confirmed dichorionic on placental histology. Overall chorionicity was correctly diagnosed in 171\\/204 (84%) using transabdominal ultrasound scan (USS) in all trimesters. However the sensitivity and specificity of USS was much higher for dichorionic twins when carried out before 14 weeks of gestation.

Serological diagnosis of brucellosis.

Science.gov (United States)

Nielsen, K; Yu, W L

2010-01-01

To present a review and to describe the most widely used laboratory tests for serology diagnosis of brucellosis along with their pros and cons. Review the recent literature on brucellosis serology diagnostic tests. The choice of the testing strategy depends on the prevailing brucellosis epidemiological situation and the goal of testing. The 'gold standard' for the diagnosis of brucellosis is isolation and identification of the causative bacterium, a member of Brucella sp. Isolation of Brucella sp. requires high security laboratory facilities (biological containment level 3), highly skilled personnel, an extended turnaround time for results and it is considered a hazardous procedure. Hence brucellosis is generally diagnosed by detection of an elevated level of antibody in serum or other body fluid. This is a presumptive diagnosis as other microorganisms and perhaps environmental factors can also cause increased antibody levels. A large number of serological tests for brucellosis have been devised over the 100+ years since its initial isolation, starting with a simple agglutination test and progressing to sophisticated primary binding assays available today. However, no test devised to date is 100% accurate so generally serological diagnosis consists of testing sera by several tests, usually a screening test of high sensitivity, followed by a confirmatory test of high specificity.

Sonographic diagnosis of pneumothorax

Directory of Open Access Journals (Sweden)

Lubna F Husain

2012-01-01

Full Text Available Lung sonography has rapidly emerged as a reliable technique in the evaluation of various thoracic diseases. One important, well-established application is the diagnosis of a pneumothorax. Prompt and accurate diagnosis of a pneumothorax in the management of a critical patient can prevent the progression into a life-threatening situation. Sonographic signs, including ′lung sliding′, ′B-lines′ or ′comet tail artifacts′, ′A-lines′, and ′the lung point sign′ can help in the diagnosis of a pneumothorax. Ultrasound has a higher sensitivity than the traditional upright anteroposterior chest radiography (CXR for the detection of a pneumothorax. Small occult pneumothoraces may be missed on CXR during a busy trauma scenario, and CXR may not always be feasible in critically ill patients. Computed tomography, the gold standard for the detection of pneumothorax, requires patients to be transported out of the clinical area, compromising their hemodynamic stability and delaying the diagnosis. As ultrasound machines have become more portable and easier to use, lung sonography now allows a rapid evaluation of an unstable patient, at the bedside. These advantages combined with the low cost and ease of use, have allowed thoracic sonography to become a useful modality in many clinical settings.

"How Can a Chord Be Weird if It Expresses Your Soul?" Some Critical Reflections on the Diagnosis of Aspergers Syndrome

Science.gov (United States)

Moloney, Paul

2010-01-01

This paper questions the way in which the diagnosis of Aspergers syndrome has come to be widely accepted and used as an essentially medical category. It does so by drawing upon sociological and historical analyses of society, psychiatry and psychology, as well as the writings of service users, other practitioners in the autistic spectrum disorder…

To what extent does diagnosis matter? Dementia diagnosis, trouble interpretation and caregiving network dynamics.

Science.gov (United States)

Brossard, Baptiste; Carpentier, Normand

2017-05-01

Contemporary research into health and mental health treats diagnosis as a central step in understanding illness management and trajectory; consequently, in the last two decades, sociology of diagnosis has attained increasing influence within medical sociology. Deeply embedded in social constructionism, the set of research divides between those who focus on the social and historical construction of diagnoses as categories, and those who see diagnosis as a process. Regarding the latter, this approach explores the constitution of the medical production, highlighting how it constitutes a starting point for entering a 'sick role', for being labelled, for naming one's problem and by extension, for framing one's illness narrative. © 2016 Foundation for the Sociology of Health & Illness.

EVALUATION OF ANAEMIA USING RED CELL AND RETICULOCYTE PARAMETERS USING AUTOMATED HAEMATOLOGY ANALYSER

Directory of Open Access Journals (Sweden)

Vidyadhar Rao

2016-06-01

Full Text Available Use of current models of Automated Haematology Analysers help in calculating the haemoglobin contents of the mature Red cells, Reticulocytes and percentages of Microcytic and hypochromic Red cells. This has helped the clinician in reaching early diagnosis and management of Different haemopoietic disorders like Iron Deficiency Anaemia, Thalassaemia and anaemia of chronic diseases. AIM This study is conducted using an Automated Haematology Analyser to evaluate anaemia using the Red Cell and Reticulocyte parameters. Three types of anaemia were evaluated; iron deficiency anaemia, anaemia of long duration and anaemia associated with chronic disease and Iron deficiency. MATERIALS AND METHODS The blood samples were collected from 287 adult patients with anaemia differentiated depending upon their iron status, haemoglobinopathies and inflammatory activity. Iron deficiency anaemia (n=132, anaemia of long duration (ACD, (n=97 and anaemia associated with chronic disease with iron deficiency (ACD Combi, (n=58. Microcytic Red cells, hypochromic red cells percentage and levels of haemoglobin in reticulocytes and matured RBCs were calculated. The accuracy of the parameters was analysed using receiver operating characteristic analyser to differentiate between the types of anaemia. OBSERVATIONS AND RESULTS There was no difference in parameters between the iron deficiency group or anaemia associated with chronic disease and iron deficiency. The hypochromic red cells percentage was the best parameter in differentiating anaemia of chronic disease with or without absolute iron deficiency with a sensitivity of 72.7% and a specificity of 70.4%. CONCLUSIONS The parameters of red cells and reticulocytes were of reasonably good indicators in differentiating the absolute iron deficiency anaemia with chronic disease.

Pediatric Hypothyroidism: Diagnosis and Treatment.

Science.gov (United States)

Wassner, Ari J

2017-08-01

Thyroid hormone has important physiologic functions in nearly every organ system. The critical role of thyroid hormone in growth and in physical and neurologic development lends particular importance to the prompt diagnosis and appropriate treatment of hypothyroidism in infants and children. Congenital hypothyroidism is common and has potentially devastating neurologic consequences. While the approach to diagnosis and treatment of severe congenital hypothyroidism is well established, data continue to emerge about the genetic causes, clinical significance, and prognosis of the milder forms of congenital hypothyroidism that are increasingly being diagnosed by newborn screening. Similarly, the diagnosis and treatment of severe acquired hypothyroidism is straightforward and clearly of clinical benefit, but uncertainty remains about the optimal management of mild subclinical hypothyroidism. This review summarizes current knowledge of the causes, clinical manifestations, diagnosis, treatment, and prognosis of hypothyroidism in infants and children, with a focus on recent developments and areas of uncertainty in this field.

Simultaneous preimplantation genetic diagnosis for Tay-Sachs and Gaucher disease.

Science.gov (United States)

Altarescu, Gheona; Brooks, Barry; Margalioth, Ehud; Eldar Geva, Talia; Levy-Lahad, Ephrat; Renbaum, Paul

2007-07-01

Preimplantation genetic diagnosis (PGD) for single gene defects is described for a family in which each parent is a carrier of both Tay-Sachs (TS) and Gaucher disease (GD). A multiplex fluorescent polymerase chain reaction protocol was developed that simultaneously amplified all four familial mutations and 10 informative microsatellite markers. In one PGD cycle, seven blastomeres were analysed, reaching a conclusive diagnosis in six out of seven embryos for TS and in five out of seven embryos for GD. Of the six diagnosed embryos, one was wild type for both TS and GD, and three were wild type for GD and carriers of TS. Two remaining embryos were compound heterozygotes for TS. Two transferable embryos developed into blastocysts (wt/wt and wt GD/carrier TS) and both were transferred on day 5. This single cycle of PGD resulted in a healthy live child. Allele drop-out (ADO) was observed in three of 34 reactions, yielding an 8% ADO rate. The occurrence of ADO in single cell analysis and undetected recombination events are primary causes of misdiagnosis in PGD and emphasize the need to use multiple polymorphic markers. So far as is known, this is the first report of concomitant PGD for two frequent Ashkenazi Jewish recessive disorders.

Multivariable Discriminant Analysis for the Differential Diagnosis of Microcytic Anemia

Directory of Open Access Journals (Sweden)

Eloísa Urrechaga

2013-01-01

Full Text Available Introduction. Iron deficiency anemia and thalassemia are the most common causes of microcytic anemia. Powerful statistical computer programming enables sensitive discriminant analyses to aid in the diagnosis. We aimed at investigating the performance of the multiple discriminant analysis (MDA to the differential diagnosis of microcytic anemia. Methods. The training group was composed of 200 β-thalassemia carriers, 65 α-thalassemia carriers, 170 iron deficiency anemia (IDA, and 45 mixed cases of thalassemia and acute phase response or iron deficiency. A set of potential predictor parameters that could detect differences among groups were selected: Red Blood Cells (RBC, hemoglobin (Hb, mean cell volume (MCV, mean cell hemoglobin (MCH, and RBC distribution width (RDW. The functions obtained with MDA analysis were applied to a set of 628 consecutive patients with microcytic anemia. Results. For classifying patients into two groups (genetic anemia and acquired anemia, only one function was needed; 87.9% β-thalassemia carriers, and 83.3% α-thalassemia carriers, and 72.1% in the mixed group were correctly classified. Conclusion. Linear discriminant functions based on hemogram data can aid in differentiating between IDA and thalassemia, so samples can be efficiently selected for further analysis to confirm the presence of genetic anemia.

Differential diagnosis of Jakob-Creutzfeldt disease.

Science.gov (United States)

Paterson, Ross W; Torres-Chae, Charles C; Kuo, Amy L; Ando, Tim; Nguyen, Elizabeth A; Wong, Katherine; DeArmond, Stephen J; Haman, Aissa; Garcia, Paul; Johnson, David Y; Miller, Bruce L; Geschwind, Michael D

2012-12-01

To identify the misdiagnoses of patients with sporadic Jakob-Creutzfeldt disease (sCJD) during the course of their disease and determine which medical specialties saw patients with sCJD prior to the correct diagnosis being made and at what point in the disease course a correct diagnosis was made. Retrospective medical record review. A specialty referral center of a tertiary academic medical center. One hundred sixty-three serial patients over a 5.5-year period who ultimately had pathologically proven sCJD. The study used the subset of 97 patients for whom we had adequate medical records. Other diagnoses considered in the differential diagnosis and types of medical specialties assessing patients with sCJD. Ninety-seven subjects' records were used in the final analysis. The most common disease categories of misdiagnosis were neurodegenerative, autoimmune/paraneoplastic, infectious, and toxic/metabolic disorders. The most common individual misdiagnoses were viral encephalitis, paraneoplastic disorder, depression, vertigo, Alzheimer disease, stroke, unspecified dementia, central nervous system vasculitis, peripheral neuropathy, and Hashimoto encephalopathy. The physicians who most commonly made these misdiagnoses were primary care physicians and neurologists; in the 18% of patients who were diagnosed correctly at their first assessment, the diagnosis was almost always by a neurologist. The mean time from onset to diagnosis was 7.9 months, an average of two-thirds of the way through their disease course. Diagnosis of sCJD is quite delayed. When evaluating patients with rapidly progressive dementia with suspected neurodegenerative, autoimmune, infectious, or toxic/metabolic etiology, sCJD should also be included in the differential diagnosis, and appropriate diagnostic tests, such as diffusion brain magnetic resonance imaging, should be considered. Primary care physicians and neurologists need improved training in sCJD diagnosis.

Diagnosis in the Enterprise Management System

Directory of Open Access Journals (Sweden)

Skrynkovskyy Ruslan M.

2016-08-01

Full Text Available The aim of the article is to define the role and place of the diagnosis management system in the structure of the task system of the enterprise diagnosis. There suggested the essence of the concept of «diagnosis of the enterprise», which is understood as the process of identification, analysis and evaluation of the enterprise state and trends in its changes (changes of the state on the basis of relevant business indicators in order to develop recommendations on the elimination of problematic points and weaknesses in the functioning of the enterprise to ensure a qualitatively new level of its development and formation of prospects with consideration to the consequences of violation of the legislation in the field of economics and enterprise management and law (legal responsibility for the violation of the labor law, tax law, law on protection of economic competition, law on trade secret, etc.. It was found that the diagnosis in the system of enterprise management: 1 is a structural component (or a partial diagnosis task in a group of private diagnosis tasks in the system of diagnosis task of the enterprise activity; 2 as a sub-function of the control function (as a general function of management includes such components as: assessment (identification of key features, characteristics, parameters (indexes, indicators, properties; analysis (a thorough study of the structure, dynamics, trends, etc.; identification (involves determination of deviations of parameters from the criteria and/or standards, formulation of diagnosis. Prospects for further research in this direction are the development of methods for quantitative assessment of the effectiveness of the management system with the purpose of its introducing in practical activities of enterprises, namely in the processes of decision-making.

Functional brain imaging in the dementias: role in early detection, differential diagnosis, and longitudinal studies

Energy Technology Data Exchange (ETDEWEB)

Devous, M.D. Sr. [Nuclear Medicine Center and Department of Radiology, The University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd., Dallas, TX (United States)

2002-12-01

This review considers the role of functional brain imaging techniques in the dementias. The substantial assistance that especially single-photon emission tomography and positron emission tomography can play in the initial diagnosis of dementia and in the differential diagnosis of the specific dementing disorder is discussed. These techniques alone essentially match the sensitivity and specificity of clinical diagnoses in distinguishing Alzheimer's dementia (AD) from age-matched controls, from frontal lobe dementia and vascular dementia, and even from Lewy body dementia. Newer analytic techniques such as voxel-based correlational analyses and discriminant function analyses enhance the power of such differential diagnoses. Functional brain imaging techniques can also significantly assist in patient screening for clinical trials. The correlation of the observed deficits with specific patterns of cognitive abnormalities permits enhanced patient management and treatment planning and improved longitudinal assessment of outcome. It is also noteworthy that the classic abnormalities of temporoparietal and posterior cingulate hypoperfusion or hypometabolism appear to be present prior to symptom onset. These abnormalities predict progression to AD in the presence of the earliest of symptoms, and are present even in cognitively normal but at-risk subjects, with a severity proportional to the risk status. Even greater predictive ability for progression to AD is obtained by combining measures of perfusion or metabolism with risk factors, tau protein levels, hippocampal N-Acetyl aspartate concentrations, or hippocampal volume measures. (orig.)

Functional brain imaging in the dementias: role in early detection, differential diagnosis, and longitudinal studies

International Nuclear Information System (INIS)

Devous, M.D. Sr.

2002-01-01

This review considers the role of functional brain imaging techniques in the dementias. The substantial assistance that especially single-photon emission tomography and positron emission tomography can play in the initial diagnosis of dementia and in the differential diagnosis of the specific dementing disorder is discussed. These techniques alone essentially match the sensitivity and specificity of clinical diagnoses in distinguishing Alzheimer's dementia (AD) from age-matched controls, from frontal lobe dementia and vascular dementia, and even from Lewy body dementia. Newer analytic techniques such as voxel-based correlational analyses and discriminant function analyses enhance the power of such differential diagnoses. Functional brain imaging techniques can also significantly assist in patient screening for clinical trials. The correlation of the observed deficits with specific patterns of cognitive abnormalities permits enhanced patient management and treatment planning and improved longitudinal assessment of outcome. It is also noteworthy that the classic abnormalities of temporoparietal and posterior cingulate hypoperfusion or hypometabolism appear to be present prior to symptom onset. These abnormalities predict progression to AD in the presence of the earliest of symptoms, and are present even in cognitively normal but at-risk subjects, with a severity proportional to the risk status. Even greater predictive ability for progression to AD is obtained by combining measures of perfusion or metabolism with risk factors, tau protein levels, hippocampal N-Acetyl aspartate concentrations, or hippocampal volume measures. (orig.)

Communication issues in migraine diagnosis.

Science.gov (United States)

Edmeads, John

2002-06-01

To examine the importance of good communication when informing the patient of the diagnosis of migraine; to review the essentials of successful communication between physician and patient on the aspect of diagnosis; to survey learning resources for physicians on communicating information to patients. This paper is based on observations made by the author of the successful interactions of numerous international "headache experts" with their patients, on a review of the medical education literature pertaining to the teaching of communication skills, and on 30 years of not always successful communication with patients. Communicating the diagnosis of migraine is an opportunity to educate and reassure the patient, to lay the foundation for rational treatment and to help establish the successful doctor-patient relationship which is essential for effective management. No matter how accurate the diagnosis, failure to communicate it effectively to the patient (and often to significant others) may impair interactions with the patient and compromise therapy. Effective communication of a diagnosis requires clarity, relevance to the patient, a positive attitude, and reinforcement through repetition, questioning and dialogue. In terms of using the diagnosis to lay a foundation for therapy, it is useful to explain the symptoms as transient physical dysfunction of normal tissues, to indicate that there are multiple mechanisms underlying the dysfunction of which only some may presently be susceptible to treatment and to stress the relevance of emotions as factors which may powerfully affect, for better or worse, the underlying disturbed physiology of migraine. Into this model can be "plugged" all the relevant therapies for migraine. This is the ideal, but every day experience in the headache consultant's office suggest that in both primary care and specialist practice, it is infrequently attained. There are scant resources other than example for physicians to learn communication of

Diagnosis of Peripheral Lung Lesions via Conventional Flexible Bronchoscopy with Multiplanar CT Planning

Directory of Open Access Journals (Sweden)

Marianne Anastasia De Roza

2016-01-01

Full Text Available Background. Conventional flexible bronchoscopy has limited sensitivity in the diagnosis of peripheral lung lesions and is dependent on lesion size. However, advancement of CT imaging offers multiplanar reconstruction facilitating enhanced preprocedure planning. This study aims to report efficacy and safety while considering the impact of patient selection and multiplanar CT planning. Method. Prospective case series of patients with peripheral lung lesions suspected of having lung cancer who underwent flexible bronchoscopy (forceps biopsy and lavage. Endobronchial lesions were excluded. Patients with negative results underwent CT-guided transthoracic needle aspiration, surgical biopsy, or clinical-radiological surveillance to establish the final diagnosis. Results. 226 patients were analysed. The diagnostic yield of bronchoscopy was 80.1% (181/226 with a sensitivity of 84.2% and specificity of 100%. In patients with a positive CT-Bronchus sign, the diagnostic yield was 82.4% compared to 72.8% with negative CT-Bronchus sign (p=0.116. Diagnostic yield was 84.9% in lesions > 20 mm and 63.0% in lesions ≤ 20 mm (p=0.001. Six (2.7% patients had transient hypoxia and 2 (0.9% had pneumothorax. There were no serious adverse events. Conclusion. Flexible bronchoscopy with appropriate patient selection and preprocedure planning is more efficacious in obtaining a diagnosis in peripheral lung lesions compared to historical data. This trial is registered with ClinicalTrials.gov Identifier: NCT01374542.

Diagnosis and differential diagnosis of hydrocephalus in adults; Diagnostik und Differenzialdiagnostik des Hydrozephalus beim Erwachsenen

Energy Technology Data Exchange (ETDEWEB)

Langner, Soenke; Mensel, Birger; Kuehn, Jens Peter; Kirsch, Michael [Univ. Medicine Greifswald (Germany). Inst. for Diagnostic Radiology and Neuroradiology; Fleck, Steffen; Baldauf, Joerg [Univ. Medicine Greifswald (Germany). Dept. of Neurosurgery

2017-08-15

Hydrocephalus is caused by an imbalance of production and absorption of cerebrospinal fluid (CSF) or obstruction of its pathways, resulting in ventricular dilatation and increased intracranial pressure. Imaging plays a crucial role in the diagnosis, differential diagnosis and planning of treatment. This review article presents the different types of hydrocephalus und their typical imaging appearance, describes imaging techniques, and discusses differential diagnoses of the different forms of hydrocephalus. Imaging plays a central role in the diagnosis of hydrocephalus. While magnetic resonance (MR) imaging is the first-line imaging modality, computed tomography (CT) is often the first-line imaging test in emergency patients.

Impact of multidetector computed tomography on the diagnosis and treatment of patients with systemic inflammatory response syndrome or sepsis

Energy Technology Data Exchange (ETDEWEB)

Schleder, S.; Luerken, L.; Dendl, L.M.; Stroszczynski, C.; Schreyer, A.G. [University Medical Centre Regensburg, Department of Radiology, Regensburg (Germany); Redel, A. [University Medical Centre Regensburg, Department of Anaesthesiology, Regensburg (Germany); Selgrad, M. [University Medical Centre Regensburg, Department of Internal Medicine I, Regensburg (Germany); Renner, P. [University Medical Centre Regensburg, Department of Surgery, Regensburg (Germany)

2017-11-15

To evaluate the impact of CT scans on diagnosis or change of therapy in patients with systemic inflammatory response syndrome (SIRS) or sepsis and obscure clinical infection. CT records of patients with obscure clinical infection and SIRS or sepsis were retrospectively evaluated. Both confirmation of and changes in the diagnosis or therapy based on CT findings were analysed by means of the hospital information system and radiological information system. A sub-group analysis included differences with regard to anatomical region, medical history and referring department. Of 525 consecutive patients evaluated, 59% had been referred from internal medicine and 41% from surgery. CT examination had confirmed the suspected diagnosis in 26% and had resulted in a different diagnosis in 33% and a change of therapy in 32%. Abdominal scans yielded a significantly higher (p=0.013) change of therapy rate (42%) than thoracic scans (22%). Therapy was changed significantly more often (p=0.016) in surgical patients (38%) than in patients referred from internal medicine (28%). CT examination for detecting an unknown infection focus in patients with SIRS or sepsis is highly beneficial and should be conducted in patients with obscure clinical infection. (orig.)

SARS - Diagnosis

Indian Academy of Sciences (India)

SARS - Diagnosis. Mainly by exclusion of known causes of atypical pneumonia; * X ray Chest; * PCR on body fluids- primers defined by WHO centres available from website.-ve result does not exclude SARS. * Sequencing of amplicons; * Viral Cultures – demanding; * Antibody tests.

Recommendations for research design and reporting in computer-assisted diagnosis to facilitate meta-analysis.

Science.gov (United States)

Eadie, Leila H; Taylor, Paul; Gibson, Adam P

2012-04-01

Computer-assisted diagnosis (CAD) describes a diverse, heterogeneous range of applications rather than a single entity. The aims and functions of CAD systems vary considerably and comparing studies and systems is challenging due to methodological and design differences. In addition, poor study quality and reporting can reduce the value of some publications. Meta-analyses of CAD are therefore difficult and may not provide reliable conclusions. Aiming to determine the major sources of heterogeneity and thereby what CAD researchers could change to allow this sort of assessment, this study reviews a sample of 147 papers concerning CAD used with imaging for cancer diagnosis. It discusses sources of variability, including the goal of the CAD system, learning methodology, study population, design, outcome measures, inclusion of radiologists, and study quality. Based upon this evidence, recommendations are made to help researchers optimize the quality and comparability of their trial design and reporting. Copyright © 2011 Elsevier Inc. All rights reserved.

Content validation of the nursing diagnosis Nausea

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Daniele Alcalá Pompeo

2014-02-01

Full Text Available This study aimed to evaluate the content validity of the nursing diagnosis of nausea in the immediate post-operative period, considering Fehring’s model. Descriptive study with 52 nurses experts who responded an instrument containing identification and validation of nausea diagnosis data. Most experts considered the domain 12 (Comfort, Class 1 (Physical Comfort and the statement (Nausea adequate to the diagnosis. Modifications were suggested in the current definition of this nursing diagnosis. Four defining characteristics were considered primary (reported nausea, increased salivation, aversion to food and vomiting sensation and eight secondary (increased swallowing, sour taste in the mouth, pallor, tachycardia, diaphoresis, sensation of hot and cold, changes in blood pressure and pupil dilation. The total score for the diagnosis of nausea was 0.79. Reports of nausea, vomiting sensation, increased salivation and aversion to food are strong predictors of nursing diagnosis of nausea.

Impact of stereotactic 11-g vacuum-assisted breast biopsy on cost of diagnosis in Austria

International Nuclear Information System (INIS)

Gruber, R.; Walter, E.; Helbich, T.H.

2011-01-01

Purpose: To determine the frequency with which stereotactic 11-g vacuum-assisted breast biopsy (11-g SVAB) obviates an open surgical biopsy (OSB), to compare the costs of these two biopsy methods, and to estimate the potential cost savings attributable to 11-g SVAB in the diagnosis of suspicious breast lesions in patients in Austria. Materials and methods: We retrospectively reviewed 318 consecutive breast lesions of BI-RADS categories IV and V (microcalcifications n = 166; masses n = 152) on which 11-g SVAB and OSB were performed. Cost savings were calculated using nationally allowed flat rates and patient charges. Costs were measured from a hospital and a socioeconomic perspective. Common clinical scenarios and sensitivity analyses assessed the extent of achievable cost savings. Results: 11-g SVAB obviated the need for an OSB in 93 (29%) of 318 women. Overall cost savings per 11-g SVAB over OSB were Euro 242 per case from a hospital perspective, and Euro 422 per case from a socioeconomic perspective. The use of 11-g SVAB decreased the cost of diagnosis by 7% from a hospital perspective, and by 10% from a socioeconomic perspective. Conclusion: In Austria, annual national savings of over 5 million Euro could be realized with the use of 11-g SVAB for the diagnosis of suspicious breast lesions. Although savings per case are modest, the national health care system realizes significant cost reduction as women benefit from a faster and less invasive approach to diagnosis.

Impact of stereotactic 11-g vacuum-assisted breast biopsy on cost of diagnosis in Austria.

Science.gov (United States)

Gruber, R; Walter, E; Helbich, T H

2011-01-01

To determine the frequency with which stereotactic 11-g vacuum-assisted breast biopsy (11-g SVAB) obviates an open surgical biopsy (OSB), to compare the costs of these two biopsy methods, and to estimate the potential cost savings attributable to 11-g SVAB in the diagnosis of suspicious breast lesions in patients in Austria. We retrospectively reviewed 318 consecutive breast lesions of BI-RADS categories IV and V (microcalcifications n=166; masses n=152) on which 11-g SVAB and OSB were performed. Cost savings were calculated using nationally allowed flat rates and patient charges. Costs were measured from a hospital and a socioeconomic perspective. Common clinical scenarios and sensitivity analyses assessed the extent of achievable cost savings. 11-g SVAB obviated the need for an OSB in 93 (29%) of 318 women. Overall cost savings per 11-g SVAB over OSB were € 242 per case from a hospital perspective, and € 422 per case from a socioeconomic perspective. The use of 11-g SVAB decreased the cost of diagnosis by 7% from a hospital perspective, and by 10% from a socioeconomic perspective. In Austria, annual national savings of over 5 million Euro could be realized with the use of 11-g SVAB for the diagnosis of suspicious breast lesions. Although savings per case are modest, the national health care system realizes significant cost reduction as women benefit from a faster and less invasive approach to diagnosis. Copyright © 2009 Elsevier Ireland Ltd. All rights reserved.

Impact of stereotactic 11-g vacuum-assisted breast biopsy on cost of diagnosis in Austria

Energy Technology Data Exchange (ETDEWEB)

Gruber, R., E-mail: renate.gruber@meduniwien.ac.at [Medical University of Vienna, Department of Radiology, Division of Molecular and Gender Imaging, Waehringer Guertel 18-20, A-1090 Vienna (Austria); Walter, E. [Institute of Pharmacoeconomic Research, Wolfengasse 4/7, A-1010 Vienna (Austria); Helbich, T.H. [Medical University of Vienna, Department of Radiology, Division of Molecular and Gender Imaging, Waehringer Guertel 18-20, A-1090 Vienna (Austria)

2011-01-15

Purpose: To determine the frequency with which stereotactic 11-g vacuum-assisted breast biopsy (11-g SVAB) obviates an open surgical biopsy (OSB), to compare the costs of these two biopsy methods, and to estimate the potential cost savings attributable to 11-g SVAB in the diagnosis of suspicious breast lesions in patients in Austria. Materials and methods: We retrospectively reviewed 318 consecutive breast lesions of BI-RADS categories IV and V (microcalcifications n = 166; masses n = 152) on which 11-g SVAB and OSB were performed. Cost savings were calculated using nationally allowed flat rates and patient charges. Costs were measured from a hospital and a socioeconomic perspective. Common clinical scenarios and sensitivity analyses assessed the extent of achievable cost savings. Results: 11-g SVAB obviated the need for an OSB in 93 (29%) of 318 women. Overall cost savings per 11-g SVAB over OSB were Euro 242 per case from a hospital perspective, and Euro 422 per case from a socioeconomic perspective. The use of 11-g SVAB decreased the cost of diagnosis by 7% from a hospital perspective, and by 10% from a socioeconomic perspective. Conclusion: In Austria, annual national savings of over 5 million Euro could be realized with the use of 11-g SVAB for the diagnosis of suspicious breast lesions. Although savings per case are modest, the national health care system realizes significant cost reduction as women benefit from a faster and less invasive approach to diagnosis.

failures diagnosis. Theory and practice for industrial systems

International Nuclear Information System (INIS)

Zwingelstein, G.

1995-01-01

Failure diagnosis methods represent appreciable tools for the maintenance and the improvement of availability and safety in complex industrial installations. The industrial diagnosis can be assimilated to a deterministic causality relation between the cause and the effect. This book describes the methodology associated to the resolution of the diagnosis problem applied to complex industrial system failures, and evaluates the principles of the main diagnosis methods. The introduction presents the terminology and norms used in the industry to situate the diagnosis context in the possession cost of a product. After a formulation of the diagnosis in the form of the resolution of inverse problems, the author gives details about the inductive and deductive methods and about internal and external diagnosis methods. Each method is illustrated with examples taken in the industry with recommendations about their operating limitations. Finally, a guideline summarizes the principal criteria for the selection of an industrial diagnosis method according to the available informations. (J.S.). 168 refs., 294 figs., 22 tabs., 1 annexe

Current approaches on non-invasive prenatal diagnosis: Prenatal genomics, transcriptomics, personalized fetal diagnosis

Directory of Open Access Journals (Sweden)

Tuba Günel

2014-12-01

Full Text Available Recent developments in molecular genetics improved our knowledge on fetal genome and physiology. Novel scientific innovations in prenatal diagnosis have accelerated in the last decade changing our vision immensely. Data obtained from fetal genomic studies brought new insights to fetal medicine and by the advances in fetal DNA and RNA sequencing technology novel treatment strategies has evolved. Non-invasive prenatal diagnosis found ground in genetics and the results are widely studied in scientific arena. When Lo and colleges proved fetal genetic material can be extracted from maternal plasma and fetal DNA can be isolated from maternal serum, the gate to many exciting discoveries was open. Microarray technology and advances in sequencing helped fetal diagnosis as well as other areas of medicine. Today it is a very crucial prerequisite for physicians practicing prenatal diagnosis to have a profound knowledge in genetics. Prevailing practical use and application of fetal genomic tests in maternal and fetal medicine mandates obstetricians to update their knowledge in genetics. The purpose of this review is to assist physicians to understand and update their knowledge in fetal genetic testing from maternal blood, individualized prenatal counseling and advancements on the subject by sharing our experiences as İstanbul University Fetal Nucleic Acid Research Group.

Unemployment risk and income change after testicular cancer diagnosis: A population-based study.

Science.gov (United States)

Rottenberg, Yakir; Ratzon, Navah Z; Jacobs, Jeremy M; Cohen, Miraim; Peretz, Tamar; de Boer, Angela G E M

2016-01-01

Among patients with cancer, returning to full working may serve as an indicator for return to normal lifestyle following illness, as opposed to unemployment or shifting to part-time work. The aim of the project was to clarify the association between unemployment risk and decreased income at 4 years after the diagnosis of testicular cancer (TC). A case control in a cohort study includes baseline measurement of people participating in the Israeli Central Bureau of Statistics 1995 National Census, and follow-up until 2011. Cancer incidence, employment status, and income level were ascertained through the Israel Cancer Registry and Tax Authority, respectively. A matched group was sampled from the population in the census. Binary logistic regression analyses were used to assess odds ratios (ORs) for study׳s outcomes, while controlling for age, ethnicity, education, and socioeconomic and employment status at 2 years before diagnosis. A total of 113 cases of TC and 468 persons in the matched group were included in the study after excluding persons who died during the study period. No association was found between TC and subsequent risk after the 4 years of unemployment (OR = 1.12, 95% CI: 0.65-1.95) or decreased income (OR = 1.41, 95% CI: 0.84-2.36). Predictors of subsequent unemployment were unemployment 2 years before diagnosis (OR = 6.91, 95% CI: 4.39-10.86) and increasing age (OR = 1.03 per year, 95% CI: 1.01-1.06). TC survivorship is not associated with subsequent unemployment or decreased income at 4 years after diagnosis. Copyright © 2016 Elsevier Inc. All rights reserved.

[A new approach to clinical and laboratory diagnosis of systemic and local soft tissue infections].

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Barkhatova, N A

2009-01-01

Dynamic measurements of blood TNF-a, IL-IRA, CRP, oligopeptide, and lactoferrin levels in patients with systemic and local soft tissue infections revealed direct correlation between them which allowed to use these indicators for the diagnosis of systemic infections. Results of clinical and laboratory analyses provided a basis for distinguishing short-term systemic inflammatory response syndrome and sepsis and developing relevant diagnostic criteria. Sepsis combined with systemic inflammatory response syndrome persisting for more than 72 hours after the onset of adequate therapy was characterized by CRP levels > 30 mg/l, oligopeptides > 0.34 U, lactoferrin > 1900 ng/ml, TNF-a > 6 pg/ml, ILL-IRA systemic inflammatory response syndrome for less than 72 hours had lower TNF-a, CRP, oligopeptide, and lactoferrin levels with IL-IRA > 1500 pg/ml. This new approach to early diagnosis of systemic infections makes it possible to optimize their treatment and thereby enhance its efficiency.

Thermoeconomic analysis of configuration methods for modular Organic Rankine Cycle units in low-temperature applications

International Nuclear Information System (INIS)

Preißinger, Markus; Schatz, Sabrina; Vogl, Anne; König-Haagen, Andreas; Brüggemann, Dieter

2016-01-01

Highlights: • Two configuration methods for modular ORC design are presented. • Thermodynamic analysis cover the low-temperature range up to 190 °C. • Four commonly knows working fluids from two chemical classes are investigated. • Economic analysis cover payback period and cash flow under realistic boundary conditions. • Suggestions for ORC manufacturer are given concerning configuration method. - Abstract: Organic Rankine Cycle (ORC) is a promising technology for the utilization of low-grade waste heat. However, due to tailor-made power plants for different heat source temperatures, specific investment costs are still too high to be profitable. This study compares two different methods to configure a modular ORC in the temperature range of 373–463 K. The first method assumes a simple adaption of the mass flow rate within the ORC (mass flow method). In the second method, simultaneous adaption of mass flow rate and working pressure (combined method) take place. The common purpose of both methods is the optimization of the net power output for heat source temperatures lower and higher than the reference plant. Analyses are carried out for common fluorinated refrigerants (R227ea and R236ea) as well as for iso-alkanes (isobutane and isopentane). It is shown that within a wide range of temperatures the deviation in net power output between the simpler mass flow method and the more sophisticated combined method is below 10%. However, the deviation strongly depends on the location of the pinch point and on the choice of the working fluid. In general, it is shown that the mass flow method in combination with a working fluid, for which the pinch point is located at the beginning of the preheating, is thermodynamically favorable for plant manufacturers. Economic analyses subsequently compare both methods with respect to payback period and cash flow. Additional investment costs for the combined method are allowed to be up to 10% in order to reach higher

Unraveling Executive Functioning in Dual Diagnosis.

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Duijkers, Judith C L M; Vissers, Constance Th W M; Egger, Jos I M

2016-01-01

In mental health, the term dual-diagnosis is used for the co-occurrence of Substance Use Disorder (SUD) with another mental disorder. These co-occurring disorders can have a shared cause, and can cause/intensify each other's expression. Forming a threat to health and society, dual-diagnosis is associated with relapses in addiction-related behavior and a destructive lifestyle. This is due to a persistent failure to control impulses and the maintaining of inadequate self-regulatory behavior in daily life. Thus, several aspects of executive functioning like inhibitory, shifting and updating processes seem impaired in dual-diagnosis. Executive (dys-)function is currently even seen as a shared underlying key component of most mental disorders. However, the number of studies on diverse aspects of executive functioning in dual-diagnosis is limited. In the present review, a systematic overview of various aspects of executive functioning in dual-diagnosis is presented, striving for a prototypical profile of patients with dual-diagnosis. Looking at empirical results, inhibitory and shifting processes appear to be impaired for SUD combined with schizophrenia, bipolar disorder or cluster B personality disorders. Studies involving updating process tasks for dual-diagnosis were limited. More research that zooms in to the full diversity of these executive functions is needed in order to strengthen these findings. Detailed insight in the profile of strengths and weaknesses that underlies one's behavior and is related to diagnostic classifications, can lead to tailor-made assessment and indications for treatment, pointing out which aspects need attention and/or training in one's self-regulative abilities.

Work related physical activity and risk of a hospital discharge diagnosis of atrial fibrillation or flutter

DEFF Research Database (Denmark)

Frost, L; Frost, P; Vestergaard, P

2005-01-01

of atrial fibrillation or flutter associated with sedentary work in a standing position, light workload, or heavy workload in men or women. CONCLUSION: No evidence was found of an association between physical activities during working hours and risk of a hospital discharge diagnosis of atrial fibrillation......, Cancer, and Health Study. The physical strain during working hours was categorised as sedentary, light, or heavy, and analysed using proportional hazard models. Subjects were followed up in the Danish National Registry of Patients and in the Danish Civil Registration System. RESULTS: During follow up...... (mean 5.7 years) a hospital discharge diagnosis of atrial fibrillation or flutter occurred in 305 men and 113 women. When using the risk of atrial fibrillation or flutter associated with sedentary work at a sitting position as a reference, no excess risk (unadjusted as well as adjusted) was found...

Different communication strategies for disclosing a diagnosis of schizophrenia and related disorders.

Science.gov (United States)

Farooq, Saeed; Johal, Rupinder K; Ziff, Charlotte; Naeem, Farooq

2017-10-24

communication regarding the treatment options available and prognosis). Review authors independently examined all reports from the searches for any relevant studies. We planned to extract data independently. For binary outcomes, we would have calculated risk ratio (RR) and its 95% confidence interval (CI), on an intention-to-treat basis. For continuous data, we would have estimated the mean difference (MD) between groups and its 95% CI. We would have employed a random-effects model for analyses. We planned to assess risk of bias for included studies. We created a 'Summary of findings' table using GRADE. The searches identified 44 records which appeared to be relevant to the aims of the review. We obtained full reports for seven potential studies; however, after close inspection none of these studies met the inclusion criteria. Good communication of diagnosis can affect treatment planning, compliance and patient outcomes, especially in the case of conditions such as schizophrenia, which has the potential to cause serious life disruption for both people with schizophrenia and their carers. Currently, there is no evidence based on findings from RCTs assessing the effects of communication strategies for disclosing the diagnosis of schizophrenia and related disorders. Research is required.

[Diagnosis: synovial fluid analysis].

Science.gov (United States)

Gallo Vallejo, Francisco Javier; Giner Ruiz, Vicente

2014-01-01

Synovial fluid analysis in rheumatological diseases allows a more accurate diagnosis in some entities, mainly infectious and microcrystalline arthritis. Examination of synovial fluid in patients with osteoarthritis is useful if a differential diagnosis will be performed with other processes and to distinguish between inflammatory and non-inflammatory forms. Joint aspiration is a diagnostic and sometimes therapeutic procedure that is available to primary care physicians. Copyright © 2014 Elsevier España, S.L. All rights reserved.

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

Science.gov (United States)

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

2015-01-01

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

Knowledge-based diagnosis for aerospace systems

Science.gov (United States)

Atkinson, David J.

1988-01-01

The need for automated diagnosis in aerospace systems and the approach of using knowledge-based systems are examined. Research issues in knowledge-based diagnosis which are important for aerospace applications are treated along with a review of recent relevant research developments in Artificial Intelligence. The design and operation of some existing knowledge-based diagnosis systems are described. The systems described and compared include the LES expert system for liquid oxygen loading at NASA Kennedy Space Center, the FAITH diagnosis system developed at the Jet Propulsion Laboratory, the PES procedural expert system developed at SRI International, the CSRL approach developed at Ohio State University, the StarPlan system developed by Ford Aerospace, the IDM integrated diagnostic model, and the DRAPhys diagnostic system developed at NASA Langley Research Center.

Diagnosis of adolescent polycystic ovary syndrome.

Science.gov (United States)

Hardy, Tristan S E; Norman, Robert J

2013-08-01

Polycystic ovary syndrome (PCOS) is the most common endocrinopathy affecting women of reproductive age and is increasingly recognized as a disorder manifesting in the peripubertal and adolescent period. Diagnosis in the adolescent is difficult due to the high background rate of menstrual irregularity, the high prevalence of polycystic ovarian morphology and hyperandrogenic features in this population. Recent guidelines suggest that menstrual irregularity for over two years, reduced reliance on ultrasound diagnosis of polycystic ovarian morphology, and accurate assessment of hyperandrogenic and metabolic features are suitable strategies for the diagnosis of PCOS in the adolescent. Accurate diagnosis is important given the long-term implications of the disorder, with increasing emphasis on metabolic sequelae. Copyright © 2013 Elsevier Inc. All rights reserved.

Gap analysis of Mycoplasma bovis disease, diagnosis and control: An aid to identify future development requirements.

Science.gov (United States)

Calcutt, M J; Lysnyansky, I; Sachse, K; Fox, L K; Nicholas, R A J; Ayling, R D

2018-05-01

There is a worldwide problem of disease caused by Mycoplasma (M.) bovis in cattle; it has a significant detrimental economic and animal welfare impact on cattle rearing. Infection can manifest as a plethora of clinical signs including mastitis, pneumonia, arthritis, keratoconjunctivitis, otitis media and genital disorders that may result in infertility and abortion. Current diagnosis and control information are reviewed and analysed to identify gaps in knowledge of the causative organism in respect of the disease pathology, diagnosis and control methods. The main considerations are as follows: no vaccines are commercially available; antimicrobial resistance is increasing; diagnostic and antimicrobial sensitivity testing needs to be improved; and a pen-side test would facilitate more rapid diagnosis and implementation of treatment with antimicrobials. More data on host susceptibility, stress factors, immune response and infectious dose levels are required. The impact of asymptomatic carriers, M. bovis survival in the environment and the role of wildlife in transmitting the disease also needs investigation. To facilitate development of vaccines, further analysis of more M. bovis genomes, its pathogenic mechanisms, including variable surface proteins, is required, along with reproducible disease models. © 2018 Blackwell Verlag GmbH.

38 CFR 4.125 - Diagnosis of mental disorders.

Science.gov (United States)

2010-07-01

... SCHEDULE FOR RATING DISABILITIES Disability Ratings Mental Disorders § 4.125 Diagnosis of mental disorders. (a) If the diagnosis of a mental disorder does not conform to DSM-IV or is not supported by the... substantiate the diagnosis. (b) If the diagnosis of a mental disorder is changed, the rating agency shall...

Experimental mesenteric ischemia. Radioisotopic diagnosis

International Nuclear Information System (INIS)

Alberti, Carlos; Dallaglio, Juan; Sarra, Luis; Obiols, Eugenio; Rodriguez Santos, Emilio; Delgado, Eduardo; Castelleti, Luis

1995-01-01

A non-invasive radionuclide technique with 99-Tc-DMP for the early diagnosis of small bowel infarction due to mesenteric artery compression, was evaluated. The usefulness of 99-Tc-DMP and critical pressure of mesenteric artery were demonstrated. The diagnosis was performed before one hour had passed from the beginning of the ischemia

Clinical Perspectives of Genetic Analyses on Dyslipidemia and Coronary Artery Disease

Science.gov (United States)

Kawashiri, Masa-aki; Yamagishi, Masakazu

2017-01-01

We have learned that low-density lipoprotein (LDL) cholesterol is the cause of atherosclerosis from various aspects, including a single case with familial hypercholesterolemia, other cases with different types of Mendelian dyslipidemias, large-scale randomized controlled trials using LDL cholesterol lowering therapies, and Mendelian randomization studies using common as well as rare variants associated with LDL cholesterol levels. There is no doubt that determinations of genotypes in lipid-associated genes have contributed not only to the genetic diagnosis for Mendelian dyslipidemias but also to the discoveries of novel therapeutic targets. Furthermore, recent studies have shown that such genetic information could provide useful clues for the risk prediction as well as risk stratification in general and in particular population. We provide the current understanding of genetic analyses relating to plasma lipids and coronary artery disease. PMID:28250266

Diagnosis of pediatric urinary tract infections

Directory of Open Access Journals (Sweden)

Jeng-Daw Tsai

2016-09-01

Full Text Available Urinary tract infection (UTI is the second common infection in children. The diagnosis of UTI in infants and children can be difficult. Good history taking and physical examination are corner stones of good care of UTI. In addition, this article reviewed current evident on the methods of urine specimen collection and various diagnostic criteria to reach the diagnosis of UTI. Asian Guideline for UTI in children is highlighted to increase consensus of the diagnosis of UTI.

Diagnosis of pediatric urinary tract infections

OpenAIRE

Jeng-Daw Tsai; Chun-Chen Lin; Stephan S. Yang

2016-01-01

Urinary tract infection (UTI) is the second common infection in children. The diagnosis of UTI in infants and children can be difficult. Good history taking and physical examination are corner stones of good care of UTI. In addition, this article reviewed current evident on the methods of urine specimen collection and various diagnostic criteria to reach the diagnosis of UTI. Asian Guideline for UTI in children is highlighted to increase consensus of the diagnosis of UTI.

Pathways to diagnosis: exploring the experiences of problem recognition and obtaining a dementia diagnosis among Anglo-Canadians.

Science.gov (United States)

Leung, Karen K; Finlay, Juli; Silvius, James L; Koehn, Sharon; McCleary, Lynn; Cohen, Carole A; Hum, Susan; Garcia, Linda; Dalziel, William; Emerson, Victor F; Pimlott, Nicholas J G; Persaud, Malini; Kozak, Jean; Drummond, Neil

2011-07-01

Increasing evidence suggests that early diagnosis and management of dementia-related symptoms may improve the quality of life for patients and their families. However, individuals may wait from 1-3 years from the onset of symptoms before receiving a diagnosis. The objective of this qualitative study was to explore the perceptions and experiences of problem recognition, and the process of obtaining a diagnosis among individuals with early-stage dementia and their primary carers. From 2006-2009, six Anglo-Canadians with dementia and seven of their carers were recruited from the Alzheimer's Society of Calgary to participate in semi-structured interviews. Using an inductive, thematic approach to the analysis, five major themes were identified: becoming aware of memory problems, attributing meanings to symptoms, initiating help-seeking, acknowledging the severity of cognitive changes and finally obtaining a definitive diagnosis. Individuals with dementia reported noticing memory difficulties earlier than their carers. However, initial symptoms were perceived as ambiguous, and were normalised and attributed to concurrent health problems. The diagnostic process was typically characterised by multiple visits and interactions with health professionals, and a diagnosis was obtained as more severe cognitive deficits emerged. Throughout the diagnostic pathway, carers played dynamic roles. Carers initially served as a source of encouragement to seek help, but they eventually became actively involved over concerns about alternative diagnoses and illness management. A better understanding of the pre-diagnosis period, and the complex interactions between people's beliefs and attributions about symptoms, may elucidate some of the barriers as well as strategies to promote a timelier dementia diagnosis. © 2011 Blackwell Publishing Ltd.

Laboratory Diagnosis of Pertussis

Science.gov (United States)

Schellekens, Joop F. P.; Mooi, Frits R.

2015-01-01

SUMMARY The introduction of vaccination in the 1950s significantly reduced the morbidity and mortality of pertussis. However, since the 1990s, a resurgence of pertussis has been observed in vaccinated populations, and a number of causes have been proposed for this phenomenon, including improved diagnostics, increased awareness, waning immunity, and pathogen adaptation. The resurgence of pertussis highlights the importance of standardized, sensitive, and specific laboratory diagnoses, the lack of which is responsible for the large differences in pertussis notifications between countries. Accurate laboratory diagnosis is also important for distinguishing between the several etiologic agents of pertussis-like diseases, which involve both viruses and bacteria. If pertussis is diagnosed in a timely manner, antibiotic treatment of the patient can mitigate the symptoms and prevent transmission. During an outbreak, timely diagnosis of pertussis allows prophylactic treatment of infants too young to be (fully) vaccinated, for whom pertussis is a severe, sometimes fatal disease. Finally, reliable diagnosis of pertussis is required to reveal trends in the (age-specific) disease incidence, which may point to changes in vaccine efficacy, waning immunity, and the emergence of vaccine-adapted strains. Here we review current approaches to the diagnosis of pertussis and discuss their limitations and strengths. In particular, we emphasize that the optimal diagnostic procedure depends on the stage of the disease, the age of the patient, and the vaccination status of the patient. PMID:26354823

[Autoimmune hepatitis: Immunological diagnosis].

Science.gov (United States)

Brahim, Imane; Brahim, Ikram; Hazime, Raja; Admou, Brahim

2017-11-01

Autoimmune hepatopathies (AIHT) including autoimmune hepatitis (AIH), primary biliary cirrhosis (PBC), primary sclerosing cholangitis (PSC) and autoimmune cholangitis (AIC), represent an impressive entities in clinical practice. Their pathogenesis is not perfectly elucidated. Several factors are involved in the initiation of hepatic autoimmune and inflammatory phenomena such as genetic predisposition, molecular mimicry and/or abnormalities of T-regulatory lymphocytes. AIHT have a wide spectrum of presentation, ranging from asymptomatic forms to severe acute liver failure. The diagnosis of AIHT is based on the presence of hyperglobulinemia, cytolysis, cholestasis, typical even specific circulating auto-antibodies, distinctive of AIH or PBC, and histological abnormalities as well as necrosis and inflammation. Anti-F actin, anti-LKM1, anti-LC1 antibodies permit to distinguish between AIH type 1 and AIH type 2. Anti-SLA/LP antibodies are rather associated to more severe hepatitis, and particularly useful for the diagnosis of seronegative AIH for other the antibodies. Due to the relevant diagnostic value of anti-M2, anti-Sp100, and anti-gp210 antibodies, the diagnosis of PBC is more affordable than that of PSC and AIC. Based on clinical data, the immunological diagnosis of AIHT takes advantage of the various specialized laboratory techniques including immunofluorescence, immunodot or blot, and the Elisa systems, provided of a closer collaboration between the biologist and the physician. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

Time to diagnosis and mortality in colorectal cancer: a cohort study in primary care

DEFF Research Database (Denmark)

Tørring, Marie Louise; Frydenberg, Morten; Hansen, Rikke Pilegaard

2011-01-01

with CRC were included in a prospective, population-based study in a Danish county. The diagnostic interval was defined as the time from first presentation of symptoms until diagnosis. We analysed patients separately according to the general practitioner’s interpretation of symptoms. Logistic regression...... years decreased with diagnostic intervals up to 5 weeks and then increased (P=0.002). In patients presenting with vague symptoms, the association was reverse, although not statistically significant. CONCLUSION: Detecting cancer in primary care is two sided: aimed at expediting ill patients while...

Brazilian Medical Association guidelines for the diagnosis and differential diagnosis of panic disorder

Directory of Open Access Journals (Sweden)

Michelle Nigri Levitan

2013-12-01

Full Text Available Objective: To present the most relevant findings regarding the Brazilian Medical Association guidelines for the diagnosis and differential diagnosis of panic disorder. Methods: We used the methodology proposed by the Brazilian Medical Association for the Diretrizes Project. The MEDLINE (PubMed, Scopus, Web of Science, and LILACS online databases were queried for articles published from 1980 to 2012. Searchable questions were structured using the PICO format (acronym for “patient” [or population], “intervention” [or exposure], “comparison” [or control], and “outcome”. Results: We present data on clinical manifestations and implications of panic disorder and its association with depression, drug abuse, dependence and anxiety disorders. In addition, discussions were held on the main psychiatric and clinical differential diagnoses. Conclusions: The guidelines are proposed to serve as a reference for the general practitioner and specialist to assist in and facilitate the diagnosis of panic disorder.

Penitentiary Diagnosis of Crime Offenders

Directory of Open Access Journals (Sweden)

Wiola Friedrich

2015-06-01

Full Text Available One of the basic standards of serving the punishment of imprisonment is its individualization, which means varying interactions consisting in adjusting them to the personality of the offender and the purposes of executing the sentence. A properly served psychological diagnosis, especially the penitentiary diagnosis, should describe the studied phenomenon well. The content of the penitentiary diagnosis should include a description of the clinical picture of an imprisoned person and basic social rehabilitation indications. The paper was written on the basis of literature on the subject, legislation and available research results. The aim of this paper is to characterize the diagnosis performed for the needs of justice, which is continuous and should be performed at every stage of imprisonment. The effect of a properly formed psychological and penitentiary decision should be the placement of a prisoner in a suitable type, kind of prison and appropriate system of serving imprisonment, followed by the correct selection of educational measures which may imply the efficiency and effectiveness of the punishment of imprisonment.

Differential X-ray diagnosis of disseminated pulmonary tuberculosis and certain collagenoses

Energy Technology Data Exchange (ETDEWEB)

Sokolov, V.A. (Sverdlovskij Meditsinskij Inst. (USSR))

X-ray picture has been analysed in patients of 2 groups. The 1st group included 120 patients with disseminated tuberculosis, the 2 nd one 56 patients with systemic diseases (lupus erythematosus and scleroderma). The disease initial diagnosis was erroneous in 8 cases (4.5%), i.e. in 5 patients tuberculosis was unrecognized, and in 3 the systemic disease. It is marked, that x-ray pulmonary alterations bore interstitial character in collagenoses, and focal in tuberculosis. Predominant apical posterior lung segment lesion was detected in 95% of cases in tuberculosis, while caverns were diagnosed in 65.8%. Besides, radiographic features of the gastrointestinal tract, the skeleton, and the heart damage were established in 82.9% of systemic scleroderma patients.

FINANCIAL DIAGNOSIS OF A COMPANY’S ACTIVITIES

Directory of Open Access Journals (Sweden)

SUCIU GHEORGHE

2013-12-01

Full Text Available Financial diagnosis consists of a number of instruments and methods which help to evaluate a company’s financial situation and performances. The financial diagnosis identifies the favourable and unfavourable factors which will affect the company’s future activity. The purpose of financial diagnosis is to draw a comparison with similar companies, in order to establish risk, profitability, and value parameters, by estimating the cost of capital (discount rate. The financial diagnosis helps to appreciate the past and present financial situation, and based on them to make projections for the future.

Implications of storing urinary DNA from different populations for molecular analyses.

Directory of Open Access Journals (Sweden)

Angela Cannas

2009-09-01

Full Text Available Molecular diagnosis using urine is established for many sexually transmitted diseases and is increasingly used to diagnose tumours and other infectious diseases. Storage of urine prior to analysis, whether due to home collection or bio-banking, is increasingly advocated yet no best practice has emerged. Here, we examined the stability of DNA in stored urine in two populations over 28 days.Urine from 40 (20 male healthy volunteers from two populations, Italy and Zambia, was stored at four different temperatures (RT, 4 degrees C, -20 degrees C & -80 degrees C with and without EDTA preservative solution. Urines were extracted at days 0, 1, 3, 7 and 28 after storage. Human DNA content was measured using multi-copy (ALU J and single copy (TLR2 targets by quantitative real-time PCR. Zambian and Italian samples contained comparable DNA quantity at time zero. Generally, two trends were observed during storage; no degradation, or rapid degradation from days 0 to 7 followed by little further degradation to 28 days. The biphasic degradation was always observed in Zambia regardless of storage conditions, but only twice in Italy.Site-specific differences in urine composition significantly affect the stability of DNA during storage. Assessing the quality of stored urine for molecular analysis, by using the type of strategy described here, is paramount before these samples are used for molecular prognostic monitoring, genetic analyses and disease diagnosis.

[Diagnosis. History and physical examination].

Science.gov (United States)

Pérez Martín, Álvaro

2014-01-01

Family physicians play a key role in the diagnosis and management of patients with osteoarthritis. Diagnosis is mainly clinical and radiological. A complete history should be taken with meticulous physical examination of the joints. The history-taking should aim to detect risk factors and compatible clinical symptoms. Pain characteristics should be identified, distinguishing between mechanical and inflammatory pain, and an exhaustive examination of the joints should be performed, with evaluation of the presence of pain, deformity, mobility restrictions (both active and passive), crepitus, joint effusion, and inflammation. A differential diagnosis should be made with all diseases that affect the joints and/or produce joint stiffness. Copyright © 2014 Elsevier España, S.L. All rights reserved.

Early Diagnosis of Autism Spectrum Disorder: Stability and Change in Clinical Diagnosis and Symptom Presentation

Science.gov (United States)

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

2013-01-01

Background: Although a diagnosis of autism spectrum disorder (ASD) appears to be stable in children as young as age three, few studies have explored stability of a diagnosis in younger children. Predictive value of diagnostic tools for toddlers and patterns of symptom change are important considerations for clinicians making early diagnoses. Most…

COLORECTAL CANCER: factors related to late diagnosis in users of the public health system treated at an Universitary Hospital in Curitiba, Paraná State, Brazil.

Science.gov (United States)

Souza, Rosa Helena Silva; Maluf, Eliane Mara Cesário Pereira; Sartor, Maria Cristina; Carvalho, Denise Siqueira de

2016-01-01

- The fourth most frequent tumor in the world, colorectal cancer is commonly diagnosed at an advanced stage. - To analyze factors that interfere in the diagnosis of colorectal cancer in users of the Public Health System treated at an universitary hospital in Curitiba, Paraná State, Brazil. - Cross-sectional, quantitative and descriptive study with 120 patients treated at the institution between 2012 and 2013. Data collection, carried out by means of medical record appointments and patients' interviews, addressed sociodemographic variables; clinical profile; timespan between symptoms, examination, diagnosis, treatment onset and difficulties encountered. Statistical analyses were performed by means of Stata 8.0. - Abdominal pain was the most frequent complaint and rectal bleeding presented the highest chance of advanced colorectal cancer diagnosis. From 52.5% of patients with late diagnosis of colorectal cancer, 81% reported difficulties in the health system. - Results suggest that late diagnosis is due to symptom absence in the early stage of the disease, patients' lack of perception about the severity of the symptoms, need of better of health teams to search early diagnosis. Educational interventions are deemed necessary to the population and health teams, besides actions prioritizing the access to diagnostic testing for serious illnesses.

Diagnosis of venous disorders

International Nuclear Information System (INIS)

Minar, E.

1993-01-01

Limited accuracy in the clinic diagnosis of deep vein thrombosis (VT) makes such diagnostic tests such as duplex sonography or venography necessary. Exact information on the age and extent of the thrombus are necessary for the clinician to optimize the therapeutric management. The correct diagnosis of calf vein thrombosis and of recurrent VT in patients with postphlebitis changes also has implications for treatment. After exclusion of thrombosis, the radiologist should evaluate the leg for other possible causes of symptoms besides VT. Investigation of the venous sytem also has a role in the diagnosis in patients with suspected pulmonary embolism. In patients with chronic venous insuffficiency the deep venous system should assessed for patency and venous valve function. The superficial veins should be differentiated in segments with sufficient or insufficient venous valves, and it is also necessary to look for insufficiency of the perforrating veins. In patients with superficial phlebitis there is risk of propagation into the deep venous system. (orig.) [de

FINANCIAL DIAGNOSIS OF STOCKS

Directory of Open Access Journals (Sweden)

SUCIU GHEORGHE

2014-12-01

Full Text Available Financial diagnosis is a part of a company’s general diagnosis. The role of the financial diagnosis is to establish the situation of the company at a given time, to see if it is viable, to help the decision-makers to take the best measures to continue or cease the activity, or to sell, buy or liquidate the company. Each entity is unique and arbitrarily applying some analysis models used by other companies can lead to significant errors. One cannot analyze in the same way a company that produces household products and a trade company. In the first one, the working capital must be positive, because permanent capitals must finance the fixed assets which have a high value, and the working capital will finance the operating cycle. In case of a trade company, a negative working capital might represent a positive activity, because the duration of the operating cycle is much shorter, and short term sources can also finance the company’s tangible assets.

Creep-Fatigue Failure Diagnosis

Science.gov (United States)

Holdsworth, Stuart

2015-01-01

Failure diagnosis invariably involves consideration of both associated material condition and the results of a mechanical analysis of prior operating history. This Review focuses on these aspects with particular reference to creep-fatigue failure diagnosis. Creep-fatigue cracking can be due to a spectrum of loading conditions ranging from pure cyclic to mainly steady loading with infrequent off-load transients. These require a range of mechanical analysis approaches, a number of which are reviewed. The microstructural information revealing material condition can vary with alloy class. In practice, the detail of the consequent cracking mechanism(s) can be camouflaged by oxidation at high temperatures, although the presence of oxide on fracture surfaces can be used to date events leading to failure. Routine laboratory specimen post-test examination is strongly recommended to characterise the detail of deformation and damage accumulation under known and well-controlled loading conditions to improve the effectiveness and efficiency of failure diagnosis. PMID:28793676

Exergetic and Economic Assessment of Distillation Hybrid Configurations for Bioethanol Refining

OpenAIRE

Suleiman, Bilyaminu; Olawale, Adegboyega Surajudeen; Mohammed, Saidu Waziri

2014-01-01

Thermo-economics analysis was used to identify the most economic distillation hybrid configuration to dehydrate bioethanol mash (12 wt%) to fuel grade (99.5 wt%) based on economic objective of minimization of operating cost in this work. Three different hybrids of THIDC with azeotropic and, extractive distillation units were assessed using similar feed and product specifications of 1200 kmol/h (12 % by weight ethanol) and 55 kmol/h (99.5 % by weight ethanol) respectively . The six hybrid conf...

BRAIN DEATH DIAGNOSIS

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Calixto Machado

2009-10-01

Full Text Available Brain death (BD diagnosis should be established based on the following set of principles, i.e. excluding major confusing factors, identifying the cause of coma, determining irreversibility, and precisely testing brainstem reflexes at all levels of the brainstem. Nonetheless, most criteria for BD diagnosis do not mention that this is not the only way of diagnosing death. The Cuban Commission for the Determination of Death has emphasized the aforesaid three possible situations for diagnosing death: a outside intensive care environment (without life support physicians apply the cardio-circulatory and respiratory criteria; b in forensic medicine circumstances, physicians utilize cadaveric signs (they do not even need a stethoscope; c in the intensive care environment (with life support when cardiorespiratory arrest occurs physicians utilize the cardio-circulatory and respiratory criteria. This methodology of diagnosing death, based on finding any of the death signs, is not related to the concept that there are different types of death. The irreversible loss of cardio-circulatory and respiratory functions can only cause death when ischemia and anoxia are prolonged enough to produce an irreversible destruction of the brain. The sign of irreversible loss of brain functions, that is to say BD diagnosis, is fully reviewed.

HIV Positive Diagnosis During Pregnancy Increases Risk of IPV Postpartum Among Women with No History of IPV in Their Relationship.

Science.gov (United States)

Groves, Allison K; Reyes, H Luz McNaughton; Moodley, Dhayendre; Maman, Suzanne

2017-07-24

There has been limited study of whether and for whom physical intimate partner violence (IPV) is a consequence of an HIV-positive diagnosis. Per the diathesis stress model, the consequences of HIV infection may be worse for women with a history of IPV. We hypothesize that the positive association between HIV diagnosis in pregnancy and postpartum IPV will be exacerbated for women with a history of IPV. Data come from a prospective cohort study with 1015 participants who completed a baseline antenatal and 9-month postpartum visit. Using logistic regression analyses, we found a statistically significant interaction between HIV diagnosis, history of IPV and postpartum IPV (AOR: 0.40, 95% CI 0.17-0.96). The findings were in the opposite direction as expected: HIV-diagnosis was not associated with IPV for women with a history of IPV (AOR: 2.17, 95% CI 1.06, 4.42). However, HIV-positive women without a history of IPV faced more than two times the risk of incident postpartum IPV than HIV-negative women (AOR: 2.17, 95% CI 1.06, 4.42). Interventions to reduce incident and ongoing IPV during the perinatal period are needed.

Optimal Cut-Off Points for the Short-Negative Act Questionnaire and Their Association with Depressive Symptoms and Diagnosis of Depression

DEFF Research Database (Denmark)

Conway, Paul Maurice; Høgh (Hogh), Annie; Nabe-Nielsen, Kirsten

2018-01-01

to depressive symptoms and diagnosis of depression. Methods The study was based on a sample of 4882 participants from the Danish MODENA cohort study (year 2011), which included both the S-NAQ (score range 9–45) and a one-item measure applying the self-labelling method with a definition to assess occasional...... its criterion validity in relation to depressive symptoms (N = 4071) and diagnosis of depression (N = 4844). Results The S-NAQ cut-off points obtained were ≥12 and ≥16 when using occasional and frequent bullying as reference standards, respectively. Both cut-off points showed high classification.......44–1.86) were significantly associated with depressive symptoms. In the adjusted logistic regression analyses, both the first (odds ratio [OR] = 3.55, 95% CI = 1.98–6.38) and the second threshold of exposure (OR = 5.90, 95% CI = 2.93–11.88) were significantly associated with diagnosis of depression. Conclusions...

An intelligent system based on fuzzy probabilities for medical diagnosis – a study in aphasia diagnosis

Directory of Open Access Journals (Sweden)

Majid Moshtagh Khorasani

2009-04-01

Full Text Available

• BACKGROUND: Aphasia diagnosis is particularly challenging due to the linguistic uncertainty and vagueness, inconsistencies in the definition of aphasic syndromes, large number of measurements with  mprecision, natural diversity and subjectivity in test objects as well as in opinions of experts who diagnose the disease.
• METHODS: Fuzzy probability is proposed here as the basic framework for handling the uncertainties in medical diagnosis and particularly aphasia diagnosis. To efficiently construct this fuzzy probabilistic mapping, statistical analysis is performed that constructs input membership functions as well as determines an effective set of input features.
• RESULTS: Considering the high sensitivity of performance measures to different distribution of testing/training sets, a statistical t-test of significance is applied to compare fuzzy approach results with NN  esults as well as author’s earlier work using fuzzy logic. The proposed fuzzy probability estimator approach clearly provides better diagnosis for both classes of data sets. Specifically, for the first and second type of fuzzy probability classifiers, i.e. spontaneous speech and comprehensive model, P-values are 2.24E-08 and 0.0059, espectively, strongly rejecting the null hypothesis.
• CONCLUSIONS: The technique is applied and compared on both comprehensive and spontaneous speech test data for diagnosis of four Aphasia types: Anomic, Broca, Global and Wernicke. Statistical analysis confirms that the proposed approach can significantly improve accuracy using fewer Aphasia features.
• KEYWORDS: Aphasia, fuzzy probability, fuzzy logic, medical diagnosis, fuzzy rules.

[Clinical scores for the venous thromboembolic disease: an aid for the diagnosis and the treatment?].

Science.gov (United States)

Junod, A

2015-03-04

The venous thromboembolic disease includes a wide range of conditions from well defined medical entities (pulmonary embolism, deep venous thrombosis), their diagnosis and prognosis, as well as the risk of developping a venous thromboembolic disease in association with hospitalisation for acute medical illness and with cancer. The assessment of the risk of treatment with anticoagulants is also itaken into account. For all these medical situations, numerous (approximately 50) clinical scores have been reported. They will be presented and critically analysed in the next series of 6 articles.

[Laboratory diagnosis of mucormycosis].

Science.gov (United States)

Garcia-Hermoso, Dea

2013-03-01

Mucormycosis are deep infections caused by ubiquitous filamentous fungi of the order of Mucorales. The disease occurs mostly in immunocompromised, diabetic or solid organ transplant recipients. There are currently no specific diagnostic guidelines for mucormycosis. The histological examination and culture of the clinical sample remain the most useful approaches for diagnosis. Furthermore, alternative methods to the fungal culture are yet to be standardized. Here we review the current microbiological approaches used for the diagnosis and identification of Mucorales. © 2013 médecine/sciences – Inserm / SRMS.

The quality of diagnosis and management of migraine and tension-type headache in three social groups in Russia.

Science.gov (United States)

Lebedeva, Elena R; Kobzeva, Natalia R; Gilev, Denis V; Olesen, Jes

2017-03-01

Background Three successive editions of the International Classification of Headache Disorders and multiple guideline papers on headache care have described evidence based diagnosis and treatment of headache disorders. It remains unknown, however, to which extent this has improved the diagnosis and management of headache. That was the aim of our study in which we also analysed differences between three social groups in Russia. Methods We studied 1042 students (719 females, 323 males, mean age 20.6, age range 17-40), 1075 workers (146 females, 929 males, mean age 40.4, age range 21-67) and 1007 blood donors (484 females, 523 males, mean age 34.1, age range 18-64). We conducted a semi-structured, validated, face-to-face professional interview. Data on prevalence and associated factors have previously been published. A section of the interview focused on previous diagnosis and treatment, the topic of this paper. Results Only 496 of 2110 participants (23%) with headache in Russia had consulted because of headache. Students consulted more frequently (35%), workers and blood donors less often (13% and 14%). Only 12% of the patients with ICHD-3beta diagnosis of migraine and 11.7% with ICHD-3beta diagnosis of tension-type headache (TTH) had previously been correctly diagnosed. Triptans were used by only 6% of migraine patients. Only 0.4% of migraine patients and no TTH patients had received prophylactic treatment. Conclusion Despite existing guidelines about diagnosis and treatment, both remain poor in Russia. According to the literature this is only slightly better in Europe and America. Dissemination of existing knowledge should have higher priority in the future.

Diagnosis Lost: Differences between Children who Had and who Currently Have an Autism Spectrum Disorder Diagnosis

Science.gov (United States)

Blumberg, Stephen J; Zablotsky, Benjamin; Avila, Rosa M; Colpe, Lisa J; Pringle, Beverly A; Kogan, Michael D

2016-01-01

Autism spectrum disorder (ASD) diagnoses sometimes change due to misdiagnosis, maturation, or treatment. This study uses a probability-based national survey—the Survey of Pathways to Diagnosis and Services—to compare currently diagnosed (n=1420) and previously diagnosed (n=187) children aged 6–17 years based on retrospective parental reports of early concerns about their children’s development, responses to those concerns by doctors and other health care providers, the type of provider who made the first ASD diagnosis, and the ASD subtype diagnoses received (if any). Propensity score matching was used to control for differences between the groups on children’s current level of functioning and other current characteristics that may have been related to diagnosis loss. Approximately 13% of the children ever diagnosed with ASD were estimated to have lost the diagnosis, and parents of 74% of them believe it was changed due to new information. Previously diagnosed children were less likely to have parents with early concerns about verbal skills, nonverbal communication, learning, and unusual gestures or movements. They were also less likely to have been referred to and diagnosed by a specialist. Previously diagnosed children were less likely to have ever received a diagnosis of Asperger’s disorder or autistic disorder. PMID:26489772

A dynamic integrated fault diagnosis method for power transformers.

Science.gov (United States)

Gao, Wensheng; Bai, Cuifen; Liu, Tong

2015-01-01

In order to diagnose transformer fault efficiently and accurately, a dynamic integrated fault diagnosis method based on Bayesian network is proposed in this paper. First, an integrated fault diagnosis model is established based on the causal relationship among abnormal working conditions, failure modes, and failure symptoms of transformers, aimed at obtaining the most possible failure mode. And then considering the evidence input into the diagnosis model is gradually acquired and the fault diagnosis process in reality is multistep, a dynamic fault diagnosis mechanism is proposed based on the integrated fault diagnosis model. Different from the existing one-step diagnosis mechanism, it includes a multistep evidence-selection process, which gives the most effective diagnostic test to be performed in next step. Therefore, it can reduce unnecessary diagnostic tests and improve the accuracy and efficiency of diagnosis. Finally, the dynamic integrated fault diagnosis method is applied to actual cases, and the validity of this method is verified.

A Dynamic Integrated Fault Diagnosis Method for Power Transformers

Science.gov (United States)

Gao, Wensheng; Liu, Tong

2015-01-01

In order to diagnose transformer fault efficiently and accurately, a dynamic integrated fault diagnosis method based on Bayesian network is proposed in this paper. First, an integrated fault diagnosis model is established based on the causal relationship among abnormal working conditions, failure modes, and failure symptoms of transformers, aimed at obtaining the most possible failure mode. And then considering the evidence input into the diagnosis model is gradually acquired and the fault diagnosis process in reality is multistep, a dynamic fault diagnosis mechanism is proposed based on the integrated fault diagnosis model. Different from the existing one-step diagnosis mechanism, it includes a multistep evidence-selection process, which gives the most effective diagnostic test to be performed in next step. Therefore, it can reduce unnecessary diagnostic tests and improve the accuracy and efficiency of diagnosis. Finally, the dynamic integrated fault diagnosis method is applied to actual cases, and the validity of this method is verified. PMID:25685841

Biomarkers in routine diagnosis of pleural effusions

Directory of Open Access Journals (Sweden)

Tiva Nemanič

2018-03-01

Full Text Available Background: Pleural fluid biochemical analysis is the first step in pleural effusion (PE diagnostics. Our purpose was to analyse the utility of the biomarkers used at our clinic in the routine diagnosis of PE. Methods: We retrospectively reviewed the PE levels of proteins, lactate dehydrogenase (LDH, alpha amylase (AA, pH and glucose in 433 patients who were treated at the University Clinic Golnik in a one-year period and compared these values with the final identified aetiology of the effusions. Results: The majority of the effusions were determined to be a consequence of malignancy (n = 154 or infection (n = 108. In 94 cases the aetiology of the effusions was heart failure and in 54 cases other diseases, while 23 effusions remained aetiologically undetermined. Considering Light’s criteria, the vast majority of the effusions were correctly classified as exudates or transudates (97.1 %. Comparing paramalignant and malignant effusions, we detected significantly lower values of pleural fluid LDH (p < 0.0005 and proteins (p < 0.0005, and higher pH (p < 0.0005 values in the paramalignant effusions. Conclusion: We have found that pleural LDH and proteins are the most helpful biochemical parameters in our routine diagnosis of pleural effusions and helped us to correctly narrow the aetiological spectrum. Furthermore, significantly higher pleural LDH and protein values and a pH below 7.32 additionally facilitated distinguishing between malignant and paramalignant effusions. Parameters such as glucose and AA are useful in selected cases and have a limited role in routine diagnostics.

Fault Diagnosis for Electrical Distribution Systems using Structural Analysis

DEFF Research Database (Denmark)

Knüppel, Thyge; Blanke, Mogens; Østergaard, Jacob

2014-01-01

redundancies in large sets of equations only from the structure (topology) of the equations. A salient feature is automated generation of redundancy relations. The method is indeed feasible in electrical networks where circuit theory and network topology together formulate the constraints that define...... relations (ARR) are likely to change. The algorithms used for diagnosis may need to change accordingly, and finding efficient methods to ARR generation is essential to employ fault-tolerant methods in the grid. Structural analysis (SA) is based on graph-theoretical results, that offer to find analytic...... a structure graph. This paper shows how three-phase networks are modelled and analysed using structural methods, and it extends earlier results by showing how physical faults can be identified such that adequate remedial actions can be taken. The paper illustrates a feasible modelling technique for structural...

Quality of diagnosis and monitoring of tuberculosis in Northern Ethiopia: medical records-based retrospective study.

Science.gov (United States)

Mala, George; Spigt, Mark G; Gidding, Luc G; Blanco, Roman; Dinant, Geert-Jan

2015-10-01

To determine quality of diagnosis and monitoring of treatment response of patients with smear-negative pulmonary tuberculosis (TB) compared with smear-positive cases in Ethiopia. A retrospective analysis of medical records of newly diagnosed pulmonary TB cases that were registered for taking anti-TB medication and had completed treatment between 2010 and 2012. We evaluated the percentage of cases that were managed according to the International Standards of Tuberculosis Care (ISTC) and compared smear-negative with smear-positive cases. We analysed 1168 cases of which 742 (64%) were sputum smear-negative cases. Chest radiography examination at diagnosis and microbiological testing at the end of the intensive phase of treatment was performed in a smaller proportion than in smear-positive TB cases (70% vs. 79%, P value ISTC are of greatest importance in minimising pitfalls in care of smear-negative TB yet were performed less often in smear-negative than smear-positive TB cases. © The Author(s) 2015.

Pancreatic arterial calcium stimulation in the diagnosis and localisation of persistent hyperinsulinemic hypoglycaemia of infancy

Energy Technology Data Exchange (ETDEWEB)

Chigot, V.; Brunelle, F. [Department of Radiology, Hopital des Enfants Malades, Paris (France); Lonlay, P. de; Nassogne, M.-C.; Delagne, V.; Saudubray, J.-M. [Dept. of Paediatrics, Hopital des Enfants Malades, Paris (France); Laborde, K. [Dept. of Biology, Hopital des Enfants Malades, Paris (France); Fournet, J.-C. [Dept. of Pathology, Hopital des Enfants Malades, Paris (France); Nihoul-Fekete, C. [Department of Surgery, Hopital des Enfants Malades, Paris (France)

2001-09-01

Persistent hyperinsulinemic hypoglycaemia of infancy (PHHI) is often resistant to medical therapy. Surgery is therefore necessary. It is due to focal adenomatous islet-cell hyperplasia treatable by partial pancreatectomy, or diffuse beta-cell hyperfunction, which requires near-total pancreatectomy. Pancreatic venous sampling (PVS) is the reference technique for the preoperative diagnosis and localization of focal forms of PHHI in the pancreas. However, hypoglycaemia is necessary to analyse the results and PVS is technically challenging. Pancreatic arterial calcium stimulation (PACS) is technically easier and does not require hypoglycaemia. To study the accuracy in the diagnosis and localization of PHHI. Materials and methods: PACS was performed in 12 patients and correlated with histology. The accuracy of PACS is poor in diffuse lesions since only two of six cases were correctly identified by this test. Five of six focal lesions were correctly recognized and located. PACS is less accurate than PVS in PHHI. Currently, it should be performed only when PVS fails. (orig.)

Pancreatic arterial calcium stimulation in the diagnosis and localisation of persistent hyperinsulinemic hypoglycaemia of infancy

International Nuclear Information System (INIS)

Chigot, V.; Brunelle, F.; Lonlay, P. de; Nassogne, M.-C.; Delagne, V.; Saudubray, J.-M.; Laborde, K.; Fournet, J.-C.; Nihoul-Fekete, C.

2001-01-01

Persistent hyperinsulinemic hypoglycaemia of infancy (PHHI) is often resistant to medical therapy. Surgery is therefore necessary. It is due to focal adenomatous islet-cell hyperplasia treatable by partial pancreatectomy, or diffuse beta-cell hyperfunction, which requires near-total pancreatectomy. Pancreatic venous sampling (PVS) is the reference technique for the preoperative diagnosis and localization of focal forms of PHHI in the pancreas. However, hypoglycaemia is necessary to analyse the results and PVS is technically challenging. Pancreatic arterial calcium stimulation (PACS) is technically easier and does not require hypoglycaemia. To study the accuracy in the diagnosis and localization of PHHI. Materials and methods: PACS was performed in 12 patients and correlated with histology. The accuracy of PACS is poor in diffuse lesions since only two of six cases were correctly identified by this test. Five of six focal lesions were correctly recognized and located. PACS is less accurate than PVS in PHHI. Currently, it should be performed only when PVS fails. (orig.)

Direct versus indirect molecular diagnosis of fragile X mental retardation in 40 German families at risk.

Science.gov (United States)

Knobloch, O; Pelz, F; Wick, U; Nelson, D L; Zoll, B

1993-03-01

In order to test whether the direct molecular diagnostic approach for fragile X mental retardation (Martin-Bell syndrome, MBS) really makes diagnosis of this disease more precise, we evaluated the results of direct diagnosis in 40 German families at risk together with the results of an earlier study with closely linked flanking markers in the same families. Of 84 men analysed, 43 showed clinical signs. In 39 of these affected men the disease could be confirmed by direct diagnosis. Compared to cytogenetic data, one man was false negative and two were false positive. Two men, whose status could not be determined by means of RFLP data, proved to be normal transmitting males (NTMs). However, the possibility of being an NTM had to be rejected in one case on RFLP data. Fragile X syndrome could be confirmed in 10 of the 13 women with clinical signs. Compared to cytogenetic data there were three cases of false negative results and one of false positive. All 36 obligate carrier women were detected by the direct approach. In addition, 22 women were newly identified as normal transmitting females (NTFs), among them one woman who could not be identified by cytogenetic means or by analysis with closely linked markers. These findings are discussed in view of the relative reliability of the three diagnostic approaches to MBS. Special attention is drawn to the significance of false negative and false positive results in direct diagnosis.

Cystic Fibrosis: Prenatal Screening and Diagnosis

Science.gov (United States)

... your own sperm and eggs, and then use preimplantation genetic diagnosis to see if the fertilized egg has CF ... that can be passed from parent to child. Preimplantation Genetic Diagnosis: A type of genetic testing that can be ...

Imaging diagnosis of chondromyxoid fibroma

International Nuclear Information System (INIS)

Guo Maofeng; Li Li; Xie Daohai; Zhang Wen

2003-01-01

Objective: To study the value of imaging diagnosis of chondromyxoid fibroma. Methods: Eight cases verified by surgery and pathology were respectively evaluated. Results: The important characters were as follows: (1) the age of incidence was in the 2nd decade of life; (2) the lesion located at the metaphysics of the long tubular bone (6/8); (3) the shape of lesion was round or geographic bone destruction, some had compartment (3/8); (4) the border of some cases had sclerotic rim (mainly the face close to morrow); (5) CT, MR were helpful in finding punctuate calcification and soft tissue mass. Conclusion: Authors' results suggest that pathological and imaging diagnosis combined with clinical diagnosis could be an ideal way to diagnose chondromyxoid fibroma in clinical practice

Diagnosis and differential diagnosis of Graves' orbitopathy in MRI

International Nuclear Information System (INIS)

Daubner, D.; Spieth, S.; Engellandt, K.; Kummer, R. von

2012-01-01

Imaging of Graves' orbitopathy (GO) includes radiological and nuclear medicine procedures. Depending on the method used they provide information about the distribution and activity of the disease. Magnetic resonance imaging (MRI) is not only a helpful tool for making the diagnosis it also enables differentiation of the active and inactive forms of GO due to intramuscular edema. The modality is therefore appropriate to evaluate the disease activity and the course of therapy. The disease leads to the typical enlargement of the muscle bodies of the extraocular muscles. The inferior rectus, medial rectus and levator palpebrae muscles are mostly involved. Signal changes of the intraconal and extraconal fat tissue are possible and a bilateral manifestation is common. The differential diagnosis includes inflammatory diseases and tumors, of which orbital pseudotumor (idiopathic, unspecific orbital inflammation), ocular myositis and orbital lymphoma are the most important. The specific patterns (localization, involvement of orbital structures and signal changes) can be differentiated by MRI. (orig.) [de

CT diagnosis and differential diagnosis of malignant pleural mesothelioma

International Nuclear Information System (INIS)

Xiong Juxin; Yang Zenian; Luo Zhongyao

2008-01-01

Objective: To study the CT features of malignant pleural mesothelioma and improve diagnostic accuracy. Methods: The CT findings of 14 patients with malignant pleural mesothelioma proven by surgery or histopathology were analyzed retrospectively. CT plain scan was performed in all cases, 9 cases received both CT plain scan and contrast CT scan. Results: All the cases demonstrated various pleural thickening including diffuse pleural thickening (n=10). Among all the cases, there were nodular pleural thickening (n=4), lumpy pleural thickening (n=7), ring-like pleural thickening (n=3). Pleural thickness which was more than 1.0 cm was found in 12 cases. Pleural effusion (n=10), mediastinum immobilization (n=10) and thoracic cavity stricture in the trouble side (n=10) were also revealed. Conclusion: Obvious characteristics in cases with malignant pleural mesothelioma was showed in CT examination, which plays an important role in the diagnosis and differential diagnosis of this disease. (authors)

Factors Affecting Age at ASD Diagnosis in UK: No Evidence That Diagnosis Age Has Decreased between 2004 and 2014

Science.gov (United States)

Brett, Denise; Warnell, Frances; McConachie, Helen; Parr, Jeremy R.

2016-01-01

Clinical initiatives have aimed to reduce the age at ASD diagnosis in the UK. This study investigated whether the median age at diagnosis in childhood has reduced in recent years, and identified the factors associated with earlier diagnosis in the UK. Data on 2,134 children with ASD came from two large family databases. Results showed that the age…

Diagnosis of gastric cancers by CT

International Nuclear Information System (INIS)

Zhu Jianbing; Gong Jianping; Huan Jian

1999-01-01

Forty two cases of gastric cancers were reviewed. The cancer had been examined by CT and was confirmed by operation and pathology. The diagnostic results of gastric cancers obtained by CT were compared with that from GI and fibro-gastroscopy examination. The results showed that the preparation of gastrointestinal tract before CT examination was important in the CT diagnosis of gastric cancer. CT in diagnosis of focus of gastric cancer and organ invasion is better than Gl and Fibro-gastroscopy and accuracy in diagnosis of gastric cancers is near to that of GI examination

[Perianal condylomes and diagnosis of syphilis].

Science.gov (United States)

Pedersen, Anders Elm; Knudsen, Troels Bygum; Sand, Carsten

2012-01-30

Syphilis is still a serious disease with diagnostic difficulties. In the present clinical case a patient had a routine serology screen for syphilis and HIV at a venerology clinic. He had previously presented with anogenital tumors, but the diagnosis was uncertain. A polymerase chain reaction (PCR) analysis was performed in addition to serology, and the diagnosis of syphilis in the secondary stage was confirmed. This case demonstrates how PCR technology can assist in the diagnosis of syphilis at early stages and underlines the importance of syphilis screening in homosexual men presenting with anogenital complaints.

YouTube provides irrelevant information for the diagnosis and treatment of hip arthritis.

Science.gov (United States)

Koller, Ulrich; Waldstein, Wenzel; Schatz, Klaus-Dieter; Windhager, Reinhard

2016-10-01

YouTube is increasingly becoming a key source for people to satisfy the need for additional information concerning their medical condition. This study analyses the completeness of accurate information found on YouTube pertaining to hip arthritis. The present study analyzed 133 YouTube videos using the search terms: hip arthritis, hip arthritis symptoms, hip arthritis diagnosis, hip arthritis treatment and hip replacement. Two quality assessment checklists with a scale of 0 to 12 points were developed to evaluate available video content for the diagnosis and the treatment of hip arthritis. Videos were grouped into poor quality (grade 0-3), moderate quality (grade 4-7) and excellent quality (grade 8-12), respectively. Three independent observers assessed all videos using the new grading system and independently scored all videos. Discrepancies regarding the categories were clarified by consensus discussion. For intra-observer reliabilities, grading was performed at two occasions separated by four weeks. Eighty-four percent (n = 112) had a poor diagnostic information quality, 14% (n = 19) a moderate quality and only 2% (n = 2) an excellent quality, respectively. In 86% (n = 114), videos provided poor treatment information quality. Eleven percent (n = 15) of videos had a moderate quality and only 3% (n = 4) an excellent quality, respectively. The present study demonstrates that YouTube is a poor source for accurate information pertaining to the diagnosis and treatment of hip arthritis. These finding are of high relevance for clinicians as videos are going to become the primary source of information for patients. Therefore, high quality educational videos are needed to further guide patients on the way from the diagnosis of hip arthritis to its proper treatment.

Hospital of Diagnosis Influences the Probability of Receiving Curative Treatment for Esophageal Cancer.

Science.gov (United States)

van Putten, Margreet; Koëter, Marijn; van Laarhoven, Hanneke W M; Lemmens, Valery E P P; Siersema, Peter D; Hulshof, Maarten C C M; Verhoeven, Rob H A; Nieuwenhuijzen, Grard A P

2018-02-01

The aim of this article was to study the influence of hospital of diagnosis on the probability of receiving curative treatment and its impact on survival among patients with esophageal cancer (EC). Although EC surgery is centralized in the Netherlands, the disease is often diagnosed in hospitals that do not perform this procedure. Patients with potentially curable esophageal or gastroesophageal junction tumors diagnosed between 2005 and 2013 who were potentially curable (cT1-3,X, any N, M0,X) were selected from the Netherlands Cancer Registry. Multilevel logistic regression was performed to examine the probability to undergo curative treatment (resection with or without neoadjuvant treatment, definitive chemoradiotherapy, or local tumor excision) according to hospital of diagnosis. Effects of variation in probability of undergoing curative treatment among these hospitals on survival were investigated by Cox regression. All 13,017 patients with potentially curable EC, diagnosed in 91 hospitals, were included. The proportion of patients receiving curative treatment ranged from 37% to 83% and from 45% to 86% in the periods 2005-2009 and 2010-2013, respectively, depending on hospital of diagnosis. After adjustment for patient- and hospital-related characteristics these proportions ranged from 41% to 77% and from 50% to 82%, respectively (both P < 0.001). Multivariable survival analyses showed that patients diagnosed in hospitals with a low probability of undergoing curative treatment had a worse overall survival (hazard ratio = 1.13, 95% confidence interval 1.06-1.20; hazard ratio = 1.15, 95% confidence interval 1.07-1.24). The variation in probability of undergoing potentially curative treatment for EC between hospitals of diagnosis and its impact on survival indicates that treatment decision making in EC may be improved.

Diagnosis of epitheliod leiomyoma

International Nuclear Information System (INIS)

Tret'yakov, A.E.; Shevyakov, V.V.

1992-01-01

Epithelioid leiomyoma (EL) is unusual and rarely met tumor of the stomach. From International histological classification it belongs to benign tumors of smooth muscular tissue. As other nonepithelial tumors EL can grow endogastral, intramural and exogastral. Exogastral type of tumor growth presents difficulties for diagnosis as changes of mucous and sometimes muscular layers of stomach wall are absent. An observation was given of a patient with mentioned disease. Primary diagnosis was mechanical jaundice, chronic cholecystitis. Tumor formation (10x8x9 sm) was revealed in the stomach during operation

Diagnosis of Pompe disease

DEFF Research Database (Denmark)

Vissing, John; Lukacs, Zoltan; Straub, Volker

2013-01-01

The diagnosis of Pompe disease (acid maltase deficiency, glycogen storage disease type II) in children and adults can be challenging because of the heterogeneous clinical presentation and considerable overlap of signs and symptoms found in other neuromuscular diseases. This review evaluates some...... to identify late-onset Pompe disease often leads to false-negative results and subsequent delays in identification and treatment of the disorder. Serum creatine kinase level can be normal or only mildly elevated in late-onset Pompe disease and is not very helpful alone to suggest the diagnosis...

Structural analysis for Diagnosis

DEFF Research Database (Denmark)

Izadi-Zamanabadi, Roozbeh; Blanke, M.

2001-01-01

Aiming at design of algorithms for fault diagnosis, structural analysis of systems offers concise yet easy overall analysis. Graph-based matching, which is the essential technique to obtain redundant information for diagnosis, is re-considered in this paper. Matching is re-formulated as a problem...... of relating faults to known parameters and measurements of a system. Using explicit fault modelling, minimal over-determined subsystems are shown to provide necessary redundancy relations from the matching. Details of the method are presented and a realistic example used to clearly describe individual steps...

Structural analysis for diagnosis

DEFF Research Database (Denmark)

Izadi-Zamanabadi, Roozbeh; Blanke, M.

2002-01-01

Aiming at design of algorithms for fault diagnosis, structural analysis of systems offers concise yet easy overall analysis. Graph-based matching, which is the essential tech-nique to obtain redundant information for diagnosis, is reconsidered in this paper. Matching is reformulated as a problem...... of relating faults to known parameters and measurements of a system. Using explicit fault modelling, minimal overdetermined subsystems are shown to provide necessary redundancy relations from the matching. Details of the method are presented and a realistic example used to clearly describe individual steps....

Rare chromosome abnormalities, prevalence and prenatal diagnosis rates from population-based congenital anomaly registers in Europe

DEFF Research Database (Denmark)

Wellesley, Diana; Dolk, Helen; Boyd, Patricia A

2012-01-01

The aim of this study is to quantify the prevalence and types of rare chromosome abnormalities (RCAs) in Europe for 2000-2006 inclusive, and to describe prenatal diagnosis rates and pregnancy outcome. Data held by the European Surveillance of Congenital Anomalies database were analysed on all the...... currently requiring specialised genetic counselling services in the perinatal period for these conditions and, for some, long-term care.European Journal of Human Genetics advance online publication, 11 January 2012; doi:10.1038/ejhg.2011.246....

Microscopic observation drug susceptibility assay (MODS for early diagnosis of tuberculosis in children.

Directory of Open Access Journals (Sweden)

Dang Thi Minh Ha

2009-12-01

Full Text Available MODS is a novel liquid culture based technique that has been shown to be effective and rapid for early diagnosis of tuberculosis (TB. We evaluated the MODS assay for diagnosis of TB in children in Viet Nam. 217 consecutive samples including sputum (n = 132, gastric fluid (n = 50, CSF (n = 32 and pleural fluid (n = 3 collected from 96 children with suspected TB, were tested by smear, MODS and MGIT. When test results were aggregated by patient, the sensitivity and specificity of smear, MGIT and MODS against "clinical diagnosis" (confirmed and probable groups as the gold standard were 28.2% and 100%, 42.3% and 100%, 39.7% and 94.4%, respectively. The sensitivity of MGIT and MODS was not significantly different in this analysis (P = 0.5, but MGIT was more sensitive than MODS when analysed on the sample level using a marginal model (P = 0.03. The median time to detection of MODS and MGIT were 8 days and 13 days, respectively, and the time to detection was significantly shorter for MODS in samples where both tests were positive (P<0.001. An analysis of time-dependent sensitivity showed that the detection rates were significantly higher for MODS than for MGIT by day 7 or day 14 (P<0.001 and P = 0.04, respectively. MODS is a rapid and sensitive alternative method for the isolation of M.tuberculosis from children.

OPTICAL AND DIELECTRIC SENSORS BASED ON ANTIMICROBIAL PEPTIDES FOR MICROORGANISMS DIAGNOSIS

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Rafael Ramos Silva

2014-08-01

Full Text Available Antimicrobial peptides (AMPs are natural compounds isolated from a wide variety of organisms that include microorganisms, insects, amphibians, plants and humans. These biomolecules are considered as part of the innate immune system and are known as natural antibiotics, presenting a broad spectrum of activities against bacteria, fungi and/or viruses. Technological innovations have enabled AMPs to be utilized for the development of novel biodetection devices. Advances in nanotechnology, such as the synthesis of nanocomposites, nanoparticles, and nanotubes have permitted the development of nanostructured platforms with biocompatibility and greater surface areas for the immobilization of biocomponents, arising as additional tools for obtaining more efficient biosensors. Diverse AMPs have been used as biological recognition elements for obtaining biosensors with more specificity and lower detection limits, whose analytical response can be evaluated through electrochemical impedance and fluorescence spectroscopies. AMP-based biosensors have shown potential for applications such as supplementary tools for conventional diagnosis methods of microorganisms. In this review, conventional methods for microorganism diagnosis as well new strategies using AMPs for the development of impedimetric and fluorescent biosensors are highlighted. AMP-based biosensors show promise as methods for diagnosing infections and bacterial contaminations as well as applications in quality control for clinical analyses and microbiological laboratories.

Prenatal ultrasound diagnosis of omphalocele

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Rio Romero, Luskenia del; Blanco Figueredo, Nadia; Rodriguez Dominguez, Zulay

2014-01-01

Omphalocele is an abdominal wall defect at the midline characterized by herniation of abdominal contents and covered by peritoneum and amnion. The aim of this paper is to present a case of omphalocele with gestational age of 23 weeks and prenatal diagnosis by ultrasonography. Using ultrasound diagnosis in a patient inquest made 40 years of age in the second trimester (gestational age 23 weeks) showed a level of the anterior fetal echogenic image that sticks through the abdominal wall and then locate the cord umbilical. Stomach is seen displaced and loss of normal anatomy of the abdominal circumference. Genetic counseling was conducted at the Municipal Center for Genetics of Manzanillo. Pathologically the fetus presented short and wide neck, low-set ears, defect omphalomesenteric of ductal closure, hernia sac occupied by the caudate lobe of the liver and gallbladder bed, wide base heart dissection showing cava-cava absence of interventricular septum was observed pulmonary valve stenosis most dilation of supravalvular pulmonary artery, large defect and aorta intraventricular septum ride, which speaks in favor of a heart rate troncoconal fallop trilogy over the omphalocele. Prenatal diagnosis by ultrasonography is an efficient and reliable method for prenatal diagnosis of omphalocele

Enzyme-linked immunoassay for plasma-free metanephrines in the biochemical diagnosis of phaeochromocytoma in adults is not ideal.