WorldWideScience

Sample records for underrecognition diagnosis underdiagnosis

  1. 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.

  2. Socio-demographic factors related to under-diagnosis of childhood asthma in Upper Silesia, Poland.

    Science.gov (United States)

    Zejda, Jan E; Farnik, Małgorzata; Smółka, Irena; Lawson, Joshua; Brożek, Grzegorz M

    2017-06-07

    Introduction. The presented study of 4,535 children aged 7-17 years in the Upper Silesian region of Poland yielded 186 cases of previously known asthma, and 44 children with newly diagnosed asthma. The aim of the presented study was to identify non-medical factors that could explain why children with a newly established diagnosis ('undiagnosed asthma') had not been diagnosed in the past. Materials and method. The study was performed according to a case-control design. Parents of the children answered questionnaires on socio-economic status and family-related factors. Statistical determinants of undiagnosed asthma were explored using raw (OR) and logistic odds ratios with their 95% confidence intervals (logOR, 95%CI). Results. Children with undiagnosed asthma were younger compared to the group with previously known asthma (11.3±2.1 vs. 12.6±2.5 years; p=0.0008). Newly diagnosed cases were more frequent in children who had less parental attention (less than 1 hour/day spent by parent with child - OR=4.36; 95%CI: 1.76-10.81) and who were not registered with specialized health care (OR=2.20; 95%CI: 0.95-5.06). Results of logistic regression analysis suggest that under-diagnosis of asthma is related to age below 12 years - logOR = 3.59 (95%CI: 1.28-10.36), distance to a health centre > 5 km - logOR = 3.45 (95%CI: 1.05-11.36), time spent with child Conclusion. Among non-medical determinants of undiagnosed asthma the age of a child plays a major role. Another factors of importance is the large distance between residence and health centre, and low parental attention at home.

  3. Overweight and obesity may lead to under-diagnosis of airflow limitation

    DEFF Research Database (Denmark)

    Çolak, Yunus; Marott, Jacob Louis; Vestbo, Jørgen

    2015-01-01

    BACKGROUND: The prevalence of obesity has increased during the last decades and varies from 10-20% in most European countries to approximately 32% in the United States. However, data on how obesity affects the presence of airflow limitation (AFL) defined as a reduced ratio between forced expirato......-diagnosis and under-treatment of COPD among individuals with overweight and obesity....

  4. Under-diagnosis of alcohol-related problems and depression in a family practice in Japan

    OpenAIRE

    Yamada, Kenshi; Maeno, Tetsuhiro; Waza, Kazuhiro; Sato, Takeshi

    2008-01-01

    Abstract Aim The aim of this survey was to assess the accuracy of a family physician's diagnosis of depression and alcoholism. Methods Consecutive new adult patients attending a family practice in Japan between April 2004 and August 2006 were enrolled. Excluded were those with dementia or visual disturbance, and emergency cases. Participants completed a questionnaire regarding their complaints and socio-demographics. A research nurse conducted the Japanese version of the Mini-International Ne...

  5. Under-diagnosis of alcohol-related problems and depression in a family practice in Japan

    Directory of Open Access Journals (Sweden)

    Yamada Kenshi

    2008-09-01

    Full Text Available Abstract Aim The aim of this survey was to assess the accuracy of a family physician's diagnosis of depression and alcoholism. Methods Consecutive new adult patients attending a family practice in Japan between April 2004 and August 2006 were enrolled. Excluded were those with dementia or visual disturbance, and emergency cases. Participants completed a questionnaire regarding their complaints and socio-demographics. A research nurse conducted the Japanese version of the Mini-International Neuropsychiatric Interview (J-MINI in the interview room. The doctor independently performed usual practice and recorded his own clinical diagnoses. A researcher listed the clinical diagnoses and complaints, including J-MINI or clinically-diagnosed alcoholism and depression, using the International Classifications for Primary Care, Second Edition (ICPC-2 and calculated kappa statistics between the J-MINI and clinical diagnoses. Results Of the 120 adult first-visit patients attending the clinics, 112 patients consented to participate in the survey and were enrolled. Fifty-one subjects were male and 61 female, and the average age was 40.7 ± 13.2 years. Eight alcohol-related disorders and five major depressions were diagnosed using the J-MINI, whereas no cases of alcoholism and eight depressions were diagnosed by the physician. Clinically overlooked patients tended to have acute illnesses like a common cold. Concordance between the clinical and research diagnosis was achieved only for three episodes of Major depression, resulting in a kappa statistic of 0.43. Conclusion Although almost half of the major depressions were identified, all alcoholism was missed. A mental health screening instrument might be beneficial in family practice, especially to detect alcoholism.

  6. Inaccuracy of Death Certificate Diagnosis of Tuberculosis and Potential Underdiagnosis of TB in a Region of High HIV Prevalence

    Directory of Open Access Journals (Sweden)

    Theresa T. Liu

    2012-01-01

    Full Text Available Despite the South African antiretroviral therapy rollout, which should reduce the incidence of HIV-associated tuberculosis (TB, the number of TB-attributable deaths in KwaZuluNatal (KZN remains high. TB is often diagnosed clinically, without microbiologic confirmation, leading to inaccurate estimates of TB-attributed deaths. This may contribute to avoidable deaths, and impact population-based TB mortality estimates. Objectives. (1 To measure the number of cases with microbiologically confirmed TB in a retrospective cohort of deceased inpatients with TB-attributed hospital deaths. (2 To estimate the rates of multi-drug resistant (MDR and extensively drug resistant (XDR TB in this cohort. Results. Of 2752 deaths at EDH between September 2006 and March 2007, 403 (15% were attributed to TB on the death certificate. 176 of the TB-attributed deaths (44% had a specimen sent for smear or culture; only 64 (36% had a TB diagnosis confirmed by either test. Of the 39 culture-confirmed cases, 27/39 (69% had fully susceptible TB and 27/39 (69% had smear-negative culture-positive TB (SNTB. Two patients had drug monoresistance, three patients had MDR-TB, and one had XDR-TB. Conclusions. Most TB-attributed deaths in this cohort were not microbiologically confirmed. Of confirmed cases, most were smear-negative, culture positive and were susceptible to all first line drugs.

  7. Prevalence, correlates and under-diagnosis of clinical depression among adults on highly active antiretroviral therapy in a Tertiary Health Institution in northeastern Nigeria

    Directory of Open Access Journals (Sweden)

    Abdu Wakawa Ibrahim

    2014-11-01

    Full Text Available Clinical depression is a highly debilitating illness, which is often under-diagnosed and negatively impacts on the quality of life of its sufferers. When it co-exists with other medical conditions, its effect is even more incapacitating. Undiagnosed depression in the context of HIV infection leads to accelerated decline in CD4+ cell counts with concomitant increase in the viral load and poor adherence to the antiretroviral medications which lead to viral mutation and the evolution of resistant strains. This study examined the prevalence of depression, its correlates and the frequency of the diagnosis of the condition among HIV+ subjects on highly active antiretroviral therapy (HAART by the internists and general physicians at the University of Maiduguri Teaching Hospital in Northeastern Nigeria. Three hundred and fifty representative samples of HIV+ adults on HAART were drawn from the Antiretroviral Therapy Clinic of the Institution. Diagnosis of depression was made using the International Classification of Diseases-10 criteria based on Composite International Diagnostic Interview generated data. Socio-demographic and clinical variables were also analyzed for their correlation with depression in the subjects. About 20% of the respondents were diagnosed with clinical depression and no diagnosis of the condition was hitherto entertained in all the respondents. The independent determinants of depression in the participants were: female gender [odds ratio (OR=3.87 (95% confidence interval, CI: 2.089-7.183], past history of psychiatric illness [OR=43.81 (95% CI: 9.731-197.30] and family history of psychiatric illness in first-degree relatives of the subjects [OR=14.364 (95% CI=5.327- 38.729]. Depression is a relatively common psychiatric condition among adults on HAART, there is therefore the need for routine screening of this condition among HIV+ subjects in order to optimize patient care and improve clinical outcomes.

  8. [Mental disorders and their underdiagnosis in primary care].

    Science.gov (United States)

    Cabrera Mateos, J L; Touriño González, R; Núñez González, E

    2017-05-12

    Despite its high prevalence, mental disorders are often underdiagnosed. To determine the magnitude of the underdiagnosis mental disorders and its associated characteristics. A descriptive cross-sectional study performed in Lanzarote (2011) on 310 patients selected by cluster random sampling. A self-completed questionnaire was used that contained the General Health Questionnaire-28, as well as structured interview using the Mini International Neuropsychiatric Interview to confirm the diagnosis of mental disorder. The current diagnosis registered in the DRAGO-AP electronic medical record was also recorded. Of the 75 patients detected with the interview, 14 (18.67%) had a diagnosis recorded in the medical record (sensitivity=0.19; IC 95% CI; 0.09-28). The positive predictive value of being in the medical record was 0.56. With respect to sensitivity, only the "number of visits made to the health centre in the last 3 months" was significantly higher in the group of patients also with a diagnosis of any mental disorder in the medical record (5 vs. 2.77; p=.002). There is an important underdiagnosis of the mental disorders in our environment. More visits to the health centre are associated with this diagnosis. Copyright © 2017 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España, S.L.U. All rights reserved.

  9. Underdiagnosis of asthma and COPD: is the general practitioner to blame?

    NARCIS (Netherlands)

    Weel, C. van

    2002-01-01

    This paper analyses, on the basis of a series of general practice studies, the under-diagnosis of asthma and chronic obstructive pulmonary disease (COPD) in terms of the magnitude of the problem, and the implications and factors that contribute to adequate diagnosis. Most patients with chronic or

  10. Social phobia in Brazilian university students: prevalence, under-recognition and academic impairment in women.

    Science.gov (United States)

    Baptista, Carlos Alberto; Loureiro, Sonia Regina; de Lima Osório, Flávia; Zuardi, Antonio Waldo; Magalhães, Pedro V; Kapczinski, Flávio; Filho, Alaor Santos; Freitas-Ferrari, Maria Cecília; Crippa, José Alexandre S

    2012-02-01

    Despite the fact that public speaking is a common academic activity and that social phobia has been associated with lower educational achievement and impaired academic performance, little research has examined the prevalence of social phobia in college students. The aim of this study was to evaluate the prevalence of social phobia in a large sample of Brazilian college students and to examine the academic impact of this disorder. The Social Phobia Inventory (SPIN) and the MINI-SPIN, used as the indicator of social phobia in the screening phase, were applied to 2319 randomly selected students from two Brazilian universities. For the second phase (diagnostic confirmation), four psychiatrists and one clinical psychologist administered the SCID-IV to subjects with MINI-SPIN scores of 6 or higher. The prevalence of social phobia among the university students was 11.6%. Women with social phobia had significantly lower grades than those without the disorder. Fear of public speaking was the most common social fear. Only two of the 237 students with social phobia (0.8%) had previously received a diagnosis of social phobia and were under treatment. Social phobia comorbidities were not evaluated in this study. The methods of assessment employed by the universities (written exams) may mask the presence of social phobia. This was not a population-based study, and thus the results are not generalizable to the entire population with social phobia. Preventive strategies are recommended to reduce the under-recognition and the adverse impact of social phobia on academic performance and overall quality of life of university students. Copyright © 2011 Elsevier B.V. All rights reserved.

  11. Depression underdiagnosis and the effects on quality of life in ...

    African Journals Online (AJOL)

    The study aimed to determine the frequency of depressive disorder in a sample of patients with HIV and its level of underdiagnosis by attending physicians. The study also explored the effect of depressive disorder on the quality of life (QOL) of patients with HIV. A sociodemographic questionnaire was administered to ...

  12. Diagnostic Prevalence of Ankylosing Spondylitis Using Computerized Health Care Data, 1996 to 2009: Underrecognition in a US Health Care Setting.

    Science.gov (United States)

    Curtis, Jeffrey R; Harrold, Leslie R; Asgari, Maryam M; Deodhar, Atul; Salman, Craig; Gelfand, Joel M; Wu, Jashin J; Herrinton, Lisa J

    2016-01-01

    Few studies have assessed the prevalence and features of axial spondyloarthritis (axSpA) and ankylosing spondylitis in diverse, population-based, community settings. We used computerized diagnoses to estimate the prevalence of axSpA and ankylosing spondylitis in Kaiser Permanente Northern California (KPNC). We identified persons aged 18 years or older with 1 or more International Classification of Diseases, Ninth Revision (ICD-9) diagnosis Code 720.X (ankylosing spondylitis and other inflammatory spondylopathies) in clinical encounter data from 1996 through 2009 to estimate the prevalence of axSpA and ankylosing spondylitis. We reviewed medical records to confirm the diagnosis in a random sample and estimated the positive predictive value of computerized data to identify confirmed cases using various case definitions. In the computerized data, 5568 adults had diagnostic codes indicating axSpA. On the basis of our case-finding approach using a single physician diagnosis code for ICD-9 720.X, the point prevalence of these conditions, standardized to the 2000 US Census, was 2.26 per 1000 persons for axSpA and 1.07 per 1000 for ankylosing spondylitis. Less than half of suspected cases saw a rheumatologist. The most specific algorithm for confirmed ankylosing spondylitis required 2 or more computerized diagnoses assigned by a rheumatologist, with 67% sensitivity (95% confidence interval, 64%-69%) and 81% positive predictive value (95% confidence interval, 79%-83%). Observed prevalence in the KPNC population, compared with national estimates for axSpA and ankylosing spondylitis, suggests there is substantial underrecognition of these conditions in routine clinical practice. However, use of computerized data is able to identify true cases of ankylosing spondylitis, facilitating population-based research.

  13. Underrecognition of Dengue during 2013 Epidemic in Luanda, Angola.

    Science.gov (United States)

    Sharp, Tyler M; Moreira, Rosa; Soares, Maria José; Miguel da Costa, Lúis; Mann, Jennifer; DeLorey, Mark; Hunsperger, Elizabeth; Muñoz-Jordán, Jorge L; Colón, Candimar; Margolis, Harold S; de Caravalho, Adelaide; Tomashek, Kay M

    2015-08-01

    During the 2013 dengue epidemic in Luanda, Angola, 811 dengue rapid diagnostic test-positive cases were reported to the Ministry of Health. To better understand the magnitude of the epidemic and identify risk factors for dengue virus (DENV) infection, we conducted cluster surveys around households of case-patients and randomly selected households 6 weeks after the peak of the epidemic. Of 173 case cluster participants, 16 (9%) exhibited evidence of recent DENV infection. Of 247 random cluster participants, 25 (10%) had evidence of recent DENV infection. Of 13 recently infected participants who had a recent febrile illness, 7 (54%) had sought medical care, and 1 (14%) was hospitalized with symptoms consistent with severe dengue; however, none received a diagnosis of dengue. Behavior associated with protection from DENV infection included recent use of mosquito repellent or a bed net. These findings suggest that the 2013 dengue epidemic was larger than indicated by passive surveillance data.

  14. Evidence of underdiagnosis and markers of high blood pressure risk in children aged 6 to 13 years

    Directory of Open Access Journals (Sweden)

    Jeanne Teixeira Bessa Fuly

    2014-01-01

    Conclusions: Overweight and family history constitute the main risk markers of high BP in children. The low frequency of BP measurement in children observed in this municipality contributes to the underdiagnosis of the disease, with irreversible consequences for these individuals.

  15. Underdiagnosis and prognosis of chronic obstructive pulmonary disease after percutaneous coronary intervention: a prospective study

    Directory of Open Access Journals (Sweden)

    Almagro P

    2015-07-01

    Full Text Available Pere Almagro,1 Anna Lapuente,2 Julia Pareja,1 Sergi Yun,1 Maria Estela Garcia,3 Ferrán Padilla,4 Josep Ll Heredia,2 Alex De la Sierra,1 Joan B Soriano5 1Department of Internal Medicine, 2Pneumology Service, Mutua de Terrassa University Hospital, Terrassa, Spain; 3Medical Department, Menarini Pharmaceutical, Barcelona, Spain; 4Cardiology Service, Mutua de Terrassa University Hospital, Terrassa, Spain; 5Instituto de Investigación Sanitaria Princesa (IP, Universidad Autónoma de Madrid, Madrid, Spain Background: Retrospective studies based on clinical data and without spirometric confirmation suggest a poorer prognosis of patients with ischemic heart disease (IHD and chronic obstructive pulmonary disease (COPD following percutaneous coronary intervention (PCI. The impact of undiagnosed COPD in these patients is unknown. We aimed to evaluate the prognostic impact of COPD – previously or newly diagnosed – in patients with IHD treated with PCI.Methods: Patients with IHD confirmed by PCI were consecutively included. After PCI they underwent forced spirometry and evaluation for cardiovascular risk factors. All-cause mortality, new cardiovascular events, and their combined endpoint were analyzed.Results: A total of 133 patients (78% male, with a mean (SD age of 63 (10.12 years were included. Of these, 33 (24.8% met the spirometric criteria for COPD, of whom 81.8% were undiagnosed. IHD patients with COPD were older, had more coronary vessels affected, and a greater history of previous myocardial infarction. Median follow-up was 934 days (interquartile range [25%–75%]: 546–1,160. COPD patients had greater mortality (P=0.008; hazard ratio [HR]: 8.85; 95% confidence interval [CI]: 1.76–44.47 and number of cardiovascular events (P=0.024; HR: 1.87; 95% CI: 1.04–3.33, even those without a previous diagnosis of COPD (P=0.01; HR: 1.78; 95% CI: 1.12–2.83. These differences remained after adjustment for sex, age, number of coronary vessels affected

  16. Over- and under-diagnosis of dementia in ethnic minorities: a nationwide register-based study

    DEFF Research Database (Denmark)

    Nielsen, T R; Vogel, A; Phung, Tien Kieu

    2011-01-01

    -diagnosed to a greater extent among ethnic minorities in the age group 60 years and older but is over-diagnosed in the age group younger than 60 years. Several factors may contribute to this pattern, including cultural differences in help-seeking behaviour, and problems in navigating the health-care system. Furthermore...... dementia cases for three main ethnic minorities were identified. Age- and gender-specific prevalence rates for dementia were calculated and compared to previously published data for the general population. RESULTS: The study population consisted of 68 219 persons aged 20 and older. A total of 174 dementia......, cross-cultural assessment of dementia can be difficult because of language barriers and cultural differences. Copyright © 2010 John Wiley & Sons, Ltd....

  17. Socio-demographic factors related to under-diagnosis of childhood asthma in Upper Silesia, Poland

    Directory of Open Access Journals (Sweden)

    Jan E. Zejda

    2017-06-01

    Among non-medical determinants of undiagnosed asthma the age of a child plays a major role. Another factors of importance is the large distance between residence and health centre, and low parental attention at home.

  18. Underrecognition of pathologist contributions to articles published in a major multidisciplinary medical journal.

    Science.gov (United States)

    Franko, Angela D; Wright, James R; Trotter, Martin J

    2012-10-01

    The Canadian Medical Association Journal (CMAJ) is a high-impact multidisciplinary medical journal. We have observed instances in which a pathology diagnosis, documented with gross or microscopic images, forms an integral part of a CMAJ article, but a pathologist is neither an author nor acknowledged as a contributor. To examine the hypothesis that pathologist contributions are underrecognized and/or underdocumented, we reviewed all CMAJ articles over a 6-year period (September 2003-2009), and correlated the use of pathology images with pathologist authorship or contribution. For each article containing pathology images, department affiliations of authors were determined, and acknowledgments were assessed. Although only 1.7% of articles contained pathology images, 47% (26/55) of these articles did not include a pathologist as either an author or a contributor. We conclude that important intellectual contributions of pathologists are underrecognized and suggest that the scientific credibility of pathology data is in doubt when pathologists do not take on full responsibility of authorship or are not acknowledged as contributors.

  19. Prevalence and underdiagnosis of airway obstruction among middle-aged adults in northern France: The ELISABET study 2011-2013.

    Science.gov (United States)

    Quach, Alexandre; Giovannelli, Jonathan; Chérot-Kornobis, Natalie; Ciuchete, Alina; Clément, Guillaume; Matran, Régis; Amouyel, Philippe; Edmé, Jean-Louis; Dauchet, Luc

    2015-12-01

    Airway obstruction (AO), mainly due to chronic obstructive pulmonary disease (COPD) in adults, is a major cause of mortality and poor quality of life. However, few data are available for France. This study was designed to calculate the prevalence AO among middle-aged adults in northern France, explore the associated risk factors and evaluate the underdiagnosis. The Enquête Littoral Souffle Air Biologie Environnement (ELISABET) was a cross-sectional study of a representative sample of 3276 adults aged from 40 to 64 in two urban areas in northern France (Lille and Dunkirk). Participants filled out a questionnaire and performed spirometry testing, without a reversibility test. The age-standardized estimated prevalence [95% confidence interval] of AO was 16.0% [13.9; 17.9] in Lille and 13.7% [11.7; 15.7] in Dunkirk with the Global initiative for chronic Obstructive Lung Disease (GOLD) definition and 10.8% [9.2; 12.5] and 9.5% [7.9; 11.2] respectively with the lower limit of normal calculated with the Global Lung Initiative (GLI) 2012 equations. AO was associated with age, male gender, tobacco consumption and low body mass index. The underdiagnosis rate was greater than 70%. Previously undiagnosed participants with AO displayed more respiratory symptoms compared with participants without AO and less than participants with previously diagnosed AO. The prevalence of AO in northern France ranged from 9.5 to 16.0%, depending on the centre and definition used. The high underdiagnosis rate observed here suggests that greater efforts should be made to identify individuals presenting with the symptoms and/or risk factors associated with AO. Copyright © 2015 Elsevier Ltd. All rights reserved.

  20. Diagnosis of personality disorders by the Millon Clinical Multiaxial Inventory.

    Science.gov (United States)

    Wetzler, S; Dubro, A

    1990-04-01

    The diagnostic efficiency of the Millon Clinical Multiaxial Inventory (MCMI) was examined with regard to the diagnosis of DSM-III axis II personality disorders by practicing psychiatrists. The MCMI displayed fairly good sensitivity but poor specificity and predictive power regarding the diagnosis of any personality disorder. Two possible explanations were offered: a) axis I psychopathology inflates scores on the MCMI personality disorder scales and causes an overdiagnosis of personality disorders by the test; or b) there is an under-recognition of axis II personality disorders (especially in the context of obvious axis I psychopathology) by the average practicing clinician.

  1. The hanta hunting study: underdiagnosis of Puumala hantavirus infections in symptomatic non-travelling leptospirosis-suspected patients in the Netherlands, in 2010 and April to November 2011.

    Science.gov (United States)

    Goeijenbier, M; Hartskeerl, R A; Reimerink, J; Verner-Carlsson, J; Wagenaar, J F; Goris, M G; Martina, B E; Lundkvist, Å; Koopmans, M; Osterhaus, A D; van Gorp, E C; Reusken, C B

    2014-08-14

    Leptospirosis and haemorrhagic fever with renal syndrome (HFRS) are hard to distinguish clinically since these two important rodent-borne zoonoses share hallmark symptoms such as renal failure and haemorrhage. Leptospirosis is caused by infection with a spirochete while HFRS is the result of an infection with certain hantaviruses. Both diseases are relatively rare in the Netherlands. Increased incidence of HFRS has been observed since 2007 in countries that border the Netherlands. Since a similar rise in incidence has not been registered in the Netherlands, we hypothesise that due to overlapping clinical manifestations, hantavirus infections may be confused with leptospirosis, leading to underdiagnosis. Therefore, we tested a cohort of non-travelling Dutch patients with symptoms compatible with leptospirosis, but with a negative diagnosis, during 2010 and from April to November 2011. Sera were screened with pan-hantavirus IgG and IgM enzyme-linked immunosorbent assays (ELISAs). Sera with IgM reactivity were tested by immunofluorescence assay (IFA). ELISA (IgM positive) and IFA results were confirmed using focus reduction neutralisation tests (FRNTs). We found hantavirus-specific IgG and/or IgM antibodies in 4.3% (11/255) of samples taken in 2010 and in 4.1% (6/146) of the samples during the 2011 period. After FRNT confirmation, seven patients were classed as having acute Puumala virus infections. A review of hantavirus diagnostic requests revealed that at least three of the seven confirmed acute cases as well as seven probable acute cases of hantavirus infection were missed in the Netherlands during the study period.

  2. Clinical characteristics and mutation spectrum of GLA in Korean patients with Fabry disease by a nationwide survey: Underdiagnosis of late-onset phenotype.

    Science.gov (United States)

    Choi, Jin-Ho; Lee, Beom Hee; Heo, Sun Hee; Kim, Gu-Hwan; Kim, Yoo-Mi; Kim, Dae-Seong; Ko, Jung Min; Sohn, Young Bae; Hong, Yong Hee; Lee, Dong-Hwan; Kook, Hoon; Lim, Han Hyuk; Kim, Kyung Hee; Kim, Woo-Shik; Hong, Geu-Ru; Kim, Su-Hyun; Park, Sang Hyun; Kim, Chan-Duck; Kim, So Mi; Seo, Jeong-Sook; Yoo, Han-Wook

    2017-07-01

    Fabry disease is a rare X-linked lysosomal storage disorder caused by an α-galactosidase A deficiency. The progressive accumulation of globotriaosylceramide (GL-3) results in life-threatening complications, including renal, cardiac, and cerebrovascular diseases. This study investigated the phenotypic and molecular spectra of GLA mutations in Korean patients with Fabry disease using a nationwide survey.This study included 94 patients from 46 independent pedigrees: 38 adult males, 46 symptomatic females, and 10 pediatric males. Each diagnosis was based on an enzyme assay and GLA gene mutation analysis.The mean age at presentation was 24 years (range, 5-65 years); however, the diagnoses were delayed by 21 ± 19 years after the onset of symptoms. Those patients with late-onset Fabry disease were diagnosed by family screening or milder symptoms at a later age. Forty different mutations were identified: 20 missense (50%), 10 nonsense (25%), 8 frameshift (20%), and 2 splice site (5%) mutations. Five of them were novel. IVS4+919G>A (c.936+919 G>A) was not detected among the 6505 alleles via newborn screening using dried blood spots. Enzyme replacement therapy (ERT) was performed in all the males and pediatric patients, whereas 75% of the symptomatic females underwent ERT for 4.2 ± 3.6 years.This study described the demographic data, wide clinical spectrum of phenotypes, and GLA mutation spectrum of Fabry disease in Korea. Most of the patients had classical Fabry disease, with a 4 times higher incidence than that of late-onset Fabry disease, indicating an underdiagnosis of mild, late-onset Fabry disease.

  3. Underdiagnosis of Attention-Deficit/Hyperactivity Disorder in Adult Patients: A Review of the Literature

    OpenAIRE

    Ginsberg, Ylva; Quintero, Javier; Anand, Ernie; Casillas, Marta; Upadhyaya, Himanshu P.

    2014-01-01

    Objective: To raise awareness of attention-deficit/hyperactivity disorder (ADHD) as an underdiagnosed, undertreated, often comorbid, and debilitating condition in adults. Data Sources: PubMed was searched using combinations of keywords, including ADHD, adult, diagnosis, identify, prevalence, and comorbid, to find articles published between 1976 and 2013. Study Selection: In total, 99 articles were selected for inclusion on the basis of their relevance to the objective and importance to and re...

  4. Midventricular Hypertrophic Cardiomyopathy with Apical Aneurysm: Potential for Underdiagnosis and Value of Multimodality Imaging

    Directory of Open Access Journals (Sweden)

    Archana Sivanandam

    2016-01-01

    Full Text Available We illustrate a case of midventricle obstructive HCM and apical aneurysm diagnosed with appropriate use of multimodality imaging. A 75-year-old African American woman presented with a 3-day history of chest pain and dyspnea with elevated troponins. Her electrocardiogram showed sinus rhythm, left atrial enlargement, left ventricular hypertrophy, prolonged QT, and occasional ectopy. After medical therapy optimization, she underwent coronary angiography for an initial diagnosis of non-ST segment elevation myocardial infarction. Her coronaries were unremarkable for significant disease but her left ventriculogram showed hyperdynamic contractility of the midportion of the ventricle along with a large dyskinetic aneurysmal apical sac. A subsequent transthoracic echocardiogram provided poor visualization of the apical region of the ventricle but contrast enhancement identified an aneurysmal pouch distal to the midventricular obstruction. To further clarify the diagnosis, cardiac magnetic resonance imaging with contrast was performed confirming the diagnosis of midventricular hypertrophic cardiomyopathy with apical aneurysm and fibrosis consistent with apical scar on delayed enhancement. The patient was medically treated and subsequently underwent elective implantable defibrillator placement in the ensuing months for recurrent nonsustained ventricular tachycardia and was initiated on prophylactic oral anticoagulation with warfarin for thromboembolic risk reduction.

  5. A hospital-based survey of primary hyperparathyroidism in the AsirRegion: Low prevalence or underdiagnosis

    International Nuclear Information System (INIS)

    Al-Shehri, Mohammed Y.

    1999-01-01

    The number of patients with primary hyperparathyroidism (PHP) seen at theAsir Central Hospital (ACH) is remarkably low. This observation has raisedthe question of whether there is a low prevalence of PHP in the Asir region,whether it is underdiagnosed, or perhaps a combination of other both factors.A survey of 15 hospitals in the Asir region was conducted for the cases ofPHP. All case notes of the patients with PHP are seen at ACH were reviewed.Also a sample of patients seen at ACH was chosen randomly. The charts ofthose found to have hypercalcemia were reviewed for the inclusion of PHP inthe diagnostic work-up. Only 13 patients with PHP were discovered. The eightpatients with PHP seen at ACH had advanced bone manifestations and seven ofthem had renal manifestations. Hypercalcemia was found in 39 out of 655patients seen at ACH. None of these had been investigated for PHP. The numberof patients with PHP seen in hospitals in the Asir region is very low.Underdiagnosis seems to be an important factor. Therefore, it is felt thatthere is a need for greater awareness of disease in the region. Furthermore,there is a need for national survey to measure the prevalence of PHP in SaudiArabia. (author)

  6. Childhood survival of atlantooccipital dislocation: underdiagnosis, recognition, treatment, and review of the literature.

    Science.gov (United States)

    Donahue, D J; Muhlbauer, M S; Kaufman, R A; Warner, W C; Sanford, R A

    1994-01-01

    Traumatic childhood atlantooccipital dislocation (AOD) may be overlooked, especially in patients with concomitant closed head injury and multiple trauma. We diagnosed and treated 4 children with traumatic AOD seen in less than a 2-year period. We found published descriptions of only 15 other survivors of childhood traumatic AOD in the literature. Clinical histories, radiographic findings, treatment, outcome, and complications in these 15 children as well as our 4 patients were reviewed. The age distribution of childhood AOD survivors (average age 6.8 years) closely resembles that of pediatric multiple trauma patients. Early diagnosis of traumatic AOD hinges on precise interpretation of the lateral cervical radiograph. Longitudinal AOD was seen most often. Usually these children presented with cranial nerve palsies, major motor deficits, and depressed level of consciousness. Most underwent posterior atlantooccipital fusion. Outcome varied from normal neurological function to prolonged ventilator dependency and delayed demise. AOD must be diagnosed early to avoid attributing potentially reversible neurologic changes to irreversible injuries since closed head injury and high spinal cord dysfunction may be confused clinically and the outcome of a patient with AOD is unpredictable.

  7. Underdiagnosis of Attention-Deficit/Hyperactivity Disorder in Adult Patients: A Review of the Literature

    Science.gov (United States)

    Quintero, Javier; Anand, Ernie; Casillas, Marta; Upadhyaya, Himanshu P.

    2014-01-01

    Objective: To raise awareness of attention-deficit/hyperactivity disorder (ADHD) as an underdiagnosed, undertreated, often comorbid, and debilitating condition in adults. Data Sources: PubMed was searched using combinations of keywords, including ADHD, adult, diagnosis, identify, prevalence, and comorbid, to find articles published between 1976 and 2013. Study Selection: In total, 99 articles were selected for inclusion on the basis of their relevance to the objective and importance to and representation of ADHD research, including international guidelines for adults with ADHD. Results: In a large proportion of children with ADHD, symptoms persist into adulthood. However, although adults with ADHD often experience chaotic lifestyles, with impaired educational and vocational achievement and higher risks of substance abuse and imprisonment, many remain undiagnosed and/or untreated. ADHD is usually accompanied by other psychiatric comorbidities (such as major depressive disorder, anxiety disorder, and alcohol abuse). Indeed, adults with ADHD are more likely to present to a psychiatric clinic for treatment of their comorbid disorders than for ADHD, and their ADHD symptoms are often mistaken for those of their comorbidities. Untreated ADHD in adults with psychiatric comorbidities leads to poor clinical and functional outcomes for the patient even if comorbidities are treated. Effective treatment of adults’ ADHD improves symptoms, emotional lability, and patient functioning, often leading to favorable outcomes (eg, safer driving, reduced criminality). A few medications have now been approved for use in adults with ADHD, while a multimodal approach involving psychotherapy has also shown promising results. Conclusions General psychiatrists should familiarize themselves with the symptoms of ADHD in adults in order to diagnose and manage ADHD and comorbidities appropriately in these patients. PMID:25317367

  8. Evidence of underdiagnosis and markers of high blood pressure risk in children aged 6 to 13 years

    Directory of Open Access Journals (Sweden)

    Jeanne Teixeira Bessa Fuly

    2014-01-01

    Full Text Available OBJECTIVE: To estimate the prevalence of high blood pressure (BP in school children, as well as the reported frequency of previous measurements of BP in these children, and to identify high BP risk markers in the sample. METHODS: This was a cross-sectional study involving 794 children aged 6 to 13 years, enrolled in public elementary schools. A questionnaire was given to parents/guardians, consisting of perinatal, socioeconomic data, and information on previous measurements of BP in these children. Anthropometric measurements included weight, height, waist, hip, and arm and neck circumference, in addition to the three BP measurements. Classification of BP levels was carried out according to current international recommendations, established in 2004. RESULTS: The prevalence of high BP (hypertension or prehypertension was 7%. Only 21.7% of children had previously undergone BP measurements. The odds ratio of high BP among children with and without overweight was 2.9 (95% CI = 1.7 to 5.0, p < 0.001. None of the anthropometric measurements was superior to the Z-score of BMI as a predictor of high BP. History of hypertension during pregnancy (p < 0.001, prematurity (p = 0.006, maternal hypertension (p = 0.01, and paternal hypertension (p = 0.008 were also correlated with the presence of high BP in children. CONCLUSIONS: Overweight and family history constitute the main risk markers of high BP in children. The low frequency of BP measurement in children observed in this municipality contributes to the underdiagnosis of the disease, with irreversible consequences for these individuals.

  9. The Challenge in Diagnosis and Current Treatment of Chronic Thromboembolic Pulmonary Hypertension

    Directory of Open Access Journals (Sweden)

    Anggoro Budi Hartopo

    2017-04-01

    Full Text Available Chronic thromboembolic pulmonary hypertension (CTEPH is currently underdiagnosis and consequently undertreatment in the clinical practice. A deficient in diagnostic modality and treatment availability especially in developing countries makes the CTEPH diagnosis unlikely to confirm. However, high index of clinical suspicion of CTEPH will lead to proper diagnosis and correct treatment  with significant reduction in morbidity and mortality. Left untreated, the mean survival time is 6.8 years and the three year mortality rate may be as high as 90 %. The pathophysiology, diagnosis and treatment of CTEPH are necessary to be shared among internists and primary care physicians, in order to improve the overall outcome of the patients.

  10. Under-diagnosis of mental disorder in people with intellectual disabilities: study of prevalence in population with different degrees of intellectual disability

    Directory of Open Access Journals (Sweden)

    Carlos PEÑA SALAZAR

    2018-03-01

    Full Text Available There are a few studies in the literature analyzing the prevalence of mental illness in people with intellectual disabilities (ID. This study explores the prevalence of mental disorders in adults without previous mental disorder and different degrees of ID. We assessed 142 individuals with varying degrees of ID and with unknown previous psychiatric disorder. We applied the diagnostic battery PAS-ADD based on criteria ICD-10 and DSM-IV TR to analyzed the prevalence of mental disorders in people with mild / moderate ID. We applied the Spanish version of the scale DASH-II to analyze the prevalence of mental disorders in people with severe and profound ID. We found a psychiatric disorder previously undiagnosed in 29.57% of our sample. In people with mild/ moderate ID the most common psychiatric disorder was depressive disorder (33.3%, but in people with severe and profound ID was the anxiety disorder. The most prevalent medical comorbidity was epilepsy (22.5% of the total sample and 39.2% in the population with severe / profound intellectual disabilities. Psychiatric disorders seem to be more common in the population with ID than in the general population, increasing their prevalence and medical comorbidity in severe and profound ID.

  11. Underdiagnosis and Lower Rates of Office Visits for Overweight/Obese Pediatric Patients in Rural Compared with Urban Areas.

    Science.gov (United States)

    SanGiovanni, Christine; McElligott, James; Morella, Kristen; Basco, William

    2017-07-01

    This study compared the number of children enrolled in Medicaid in rural and urban areas of South Carolina with an overweight/obesity diagnosis and the mean rates of office visits with overweight/obesity diagnosed. Medicaid claims data from 2012 for children in three South Carolina counties, categorized as urban, rural high resource, and rural low resource, were used to identify those who had been diagnosed as being overweight/obese during any encounter. Logistic and Poisson regressions were performed to predict whether overweight/obese children in each county would receive an overweight/obesity visit diagnosis and to calculate the mean rate of total office visits with an overweight/obesity diagnosis in each county. A total of 1233 children enrolled in Medicaid were diagnosed as being overweight/obese at any encounter in the designated counties. Well visits with overweight/obesity diagnosed varied significantly, with 42.6%, 28%, and 11% in urban, rural high-resource counties, and rural low-resource counties, respectively ( P overweight/obese at a well visit. All of the children had a low number of total office visits with overweight/obesity diagnosed. When comparing the counties, urban children (1.22 visits per year) had more visits than rural low-resource children (0.75 visits per year, P Overweight/obesity is underdiagnosed in rural children enrolled in Medicaid in South Carolina, which affects the number of children who receive help to manage their weight. Interventions to overcome barriers of diagnosis and management are necessary to address childhood obesity properly.

  12. Food protein-induced enterocolitis syndrome: pitfalls in the diagnosis.

    Science.gov (United States)

    Guibas, George V; Tsabouri, Sophia; Makris, Michael; Priftis, Kostas N

    2014-11-01

    Food protein-induced enterocolitis syndrome (FPIES) represents the severe end of the spectrum of gastrointestinal food hypersensitivity; its acute episodes can culminate in severe dehydration and hypovolemic shock, and its chronic form entails considerable morbidity associated with feeding difficulty and failure to thrive. Nevertheless, awareness for this syndrome remains rather low. Many factors hamper the establishment of FPIES diagnosis. Such factors pertain to the pathophysiological mechanism of the syndrome, causal food proteins, clinical manifestations, diagnostic procedures, differential diagnosis considerations, and prevailing perceptions which may require critical appraisal. Throughout this review, we will present and discuss these issues and put the focus on factors that could lead to under-diagnosis of FPIES, cause numerous acute episodes, and substantially increase the diseases morbidity and financial burden. We will also address other issues that are clinically relevant to FPIES. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  13. Hypothyroidism after a cancer diagnosis: etiology, diagnosis, complications, and management.

    Science.gov (United States)

    Carter, Yvette; Sippel, Rebecca S; Chen, Herbert

    2014-01-01

    Hypothyroidism is a common disease that is easily treated in the majority of cases, when readily diagnosed; however, presentation of an aggregate of its symptoms is often clinically overlooked or attributed to another disease and can potentially be lethal. Already prevalent in older women, its occurrence in younger patients is rising as a result of radiation therapy, radioactive iodine therapy, and newer antineoplastic agents used to manage various malignancies. The presence of nonspecific constitutional symptoms and neuropsychiatric complaints in cancer patients can be attributed to a myriad of other diagnoses and therapies. Thyroid dysfunction can be easily overlooked in cancer patients because of the complexity of cancer's clinical picture, particularly in the pediatric population. Underdiagnosis can have important consequences for the management of both hypothyroidism and the malignancy. At minimum, quality of life is adversely affected. Untreated hypothyroidism can lead to heart failure, psychosis, and coma and can reduce the effectiveness of potentially life-saving cancer therapies, whereas iatrogenic causes can provoke atrial fibrillation and osteoporosis. Consequently, the diagnosis and treatment of hypothyroidism in cancer patients are pertinent. We summarize the history, epidemiology, pathophysiology, clinical diagnosis, and management of hypothyroidism in cancer patients.

  14. Hypothyroidism After a Cancer Diagnosis: Etiology, Diagnosis, Complications, and Management

    Science.gov (United States)

    Carter, Yvette; Sippel, Rebecca S.

    2014-01-01

    Hypothyroidism is a common disease that is easily treated in the majority of cases, when readily diagnosed; however, presentation of an aggregate of its symptoms is often clinically overlooked or attributed to another disease and can potentially be lethal. Already prevalent in older women, its occurrence in younger patients is rising as a result of radiation therapy, radioactive iodine therapy, and newer antineoplastic agents used to manage various malignancies. The presence of nonspecific constitutional symptoms and neuropsychiatric complaints in cancer patients can be attributed to a myriad of other diagnoses and therapies. Thyroid dysfunction can be easily overlooked in cancer patients because of the complexity of cancer’s clinical picture, particularly in the pediatric population. Underdiagnosis can have important consequences for the management of both hypothyroidism and the malignancy. At minimum, quality of life is adversely affected. Untreated hypothyroidism can lead to heart failure, psychosis, and coma and can reduce the effectiveness of potentially life-saving cancer therapies, whereas iatrogenic causes can provoke atrial fibrillation and osteoporosis. Consequently, the diagnosis and treatment of hypothyroidism in cancer patients are pertinent. We summarize the history, epidemiology, pathophysiology, clinical diagnosis, and management of hypothyroidism in cancer patients. PMID:24309982

  15. Subdiagnóstico de DPOC na atenção primária em Aparecida de Goiânia, Goiás Underdiagnosis of COPD at primary health care clinics in the city of Aparecida de Goiânia, Brazil

    Directory of Open Access Journals (Sweden)

    Maria Conceição de Castro Antonelli Monteiro de Queiroz

    2012-12-01

    seeking medical attention at one of the selected PHCCs. All subjects included in the study underwent spirometry for the diagnosis of COPD. RESULTS: We successfully evaluated 200 individuals, mostly males. The mean age was 65.9 ± 10.5 years. The diagnosis of COPD was confirmed in 63 individuals, only 18 of whom had been previously diagnosed with COPD (underdiagnosis rate, 71.4%. There were no significant differences between the subgroups with and without a previous diagnosis of COPD in relation to demographics and risk factors. However, there were significant differences between these subgroups for the presence of expectoration, wheezing, and dyspnea (p = 0.047; p = 0.005; and p = 0.047, respectively. The FEV1 and FEV1/FVC ratio, expressed as percentages of the predicted values, were significantly lower in the subjects with a previous diagnosis of COPD, which was predominantly mild or moderate in both subgroups. CONCLUSIONS: The rate of underdiagnosis of COPD was high at the PHCCs studied. One third of the patients with risk factors for COPD met the clinical and functional criteria for the disease. It seems that spirometry is underutilized at such facilities.

  16. Knowledge of causes, clinical features and diagnosis of common zoonoses among medical practitioners in Tanzania

    Science.gov (United States)

    John, Kunda; Kazwala, Rudovic; Mfinanga, Godfrey S

    2008-01-01

    Background Many factors have been mentioned as contributing to under-diagnosis and under-reporting of zoonotic diseases particularly in the sub-Sahara African region. These include poor disease surveillance coverage, poor diagnostic capacity, the geographical distribution of those most affected and lack of clear strategies to address the plight of zoonotic diseases. The current study investigates the knowledge of medical practitioners of zoonotic diseases as a potential contributing factor to their under-diagnosis and hence under-reporting. Methods The study was designed as a cross-sectional survey. Semi-structured open-ended questionnaire was administered to medical practitioners to establish the knowledge of anthrax, rabies, brucellosis, trypanosomiasis, echinococcosis and bovine tuberculosis in selected health facilities within urban and rural settings in Tanzania between April and May 2005. Frequency data were analyzed using likelihood ratio chi-square in Minitab version 14 to compare practitioners' knowledge of transmission, clinical features and diagnosis of the zoonoses in the two settings. For each analysis, likelihood ratio chi-square p-value of less than 0.05 was considered to be significant. Fisher's exact test was used where expected results were less than five. Results Medical practitioners in rural health facilities had poor knowledge of transmission of sleeping sickness and clinical features of anthrax and rabies in humans compared to their urban counterparts. In both areas the practitioners had poor knowledge of how echinococcosis is transmitted to humans, clinical features of echinococcosis in humans, and diagnosis of bovine tuberculosis in humans. Conclusion Knowledge of medical practitioners of zoonotic diseases could be a contributing factor to their under-diagnosis and under-reporting in Tanzania. Refresher courses on zoonotic diseases should be conducted particularly to practitioners in rural areas. More emphasis should be put on zoonotic

  17. A Review of 20 Years of Research on Overdiagnosis and Underdiagnosis in the Rhode Island Methods to Improve Diagnostic Assessment and Services (MIDAS) Project.

    Science.gov (United States)

    Zimmerman, Mark

    2016-02-01

    The Rhode Island Methods to Improve Diagnostic Assessment and Services (MIDAS) project represents an integration of research methodology into a community-based outpatient practice affiliated with an academic medical centre. The MIDAS project is the largest clinical epidemiological study using semi-structured interviews to assess a wide range of psychiatric disorders in a general clinical outpatient practice. In an early report from the MIDAS project, we found that across diagnostic categories clinicians using unstandardized, unstructured clinical interviews underrecognized diagnostic comorbidity, compared with the results of semi-structured interviews. Moreover, we found that the patients often wanted treatment for symptoms of disorders that were diagnosed as comorbid, rather than principal, conditions. This highlighted the importance, from the patient's perspective, of conducting thorough diagnostic interviews to diagnose disorders that are not related to the patient's chief complaint because patients often desire treatment for these additional diagnoses. While several of the initial papers from the MIDAS project identified problems with the detection of comorbid disorders in clinical practice, regarding the diagnosis of bipolar disorder we observed the emergence of an opposite phenomenon-clinician overdiagnosis. The results from the MIDAS project, along with other studies of diagnosis in routine clinical practice, have brought to the forefront the problem with diagnosis in routine clinical practice. An important question is what do these findings suggest about the community standard of care in making psychiatric diagnoses, and whether and how the standard of care should be changed? The implications are discussed. © The Author(s) 2016.

  18. First Two Cases of Bloom Syndrome in Russia: Lack of Skin Manifestations in aBLMc.1642C>T (p.Q548X) Homozygote as a Likely Cause of Underdiagnosis.

    Science.gov (United States)

    Suspitsin, Evgeny N; Sibgatullina, Farida I; Lyazina, Lydia V; Imyanitov, Evgeny N

    2017-03-01

    Bloom syndrome (BS) is an exceptionally rare hereditary disease. Typical manifestations of BS usually include growth deficiency, a characteristic facial appearance, skin hypersensitivity to ultraviolet irradiation, and a strong predisposition to early-onset cancers. We have previously described a recurrent BLM c.1642C>T (p.Q548X) mutation, which is present in heterozygous state in 0.2-0.6% of individuals of Slavic origin. Despite the high occurrence of this founder allele, BS has not yet been described in patients of Slavic ethnicity. Here, we present 2 cases of BS, which were missed by standard genetic counseling and were eventually identified entirely due to chance. Our patients show the need for further investigations to confirm whether the atypical appearance of BS is indeed characteristic for biallelic carriers of the c.1642C>T (p.Q548X) allele and whether the absence of skin manifestations contributes to the underdiagnosis of the disease in Russia. Therefore, we suggest that all Slavic patients with only one single clinical feature of BS are to be screened for this allele and subjected to further analysis wherever appropriate. In addition to identifying new BS patients, this effort will help to clarify the frequency of "atypical BS" with incomplete phenotypic manifestations.

  19. Carrier Diagnosis

    Science.gov (United States)

    ... Inheritance of Hemophilia Definitions & Terminology Bleeding Symptoms Carrier Diagnosis When to Test for Carrier Status Family Planning and Pregnancy Conception Options Prenatal Diagnosis Fetal Sex ...

  20. Contemporary Understanding of Diagnosis and Treatment of Children with Cystic Fibrosi

    Directory of Open Access Journals (Sweden)

    A. A. Baranov

    2015-01-01

    Full Text Available The issue of contemporary diagnosis and correct management of patients with cystic fibrosis is relevant not only for Russia, but for the entire world. Despite achievements of the contemporary medical science, underdiagnosis of this systemic genetic disorder leading to severe incapacitation and death of pulmonary and heart failure in the vast majority of cases is still observed. The burden induced by this disease is so severe that neonatal screening has been introduced to suspect and detect disease and start pathogenetic treatment capable of stopping or slowing progression of the disease as soon as possible. Apart from the contemporary classification and diagnostic criteria, the article presents treatment goals and components requiring a multidisciplinary approach in detail. Specific attention is given to methods of kinesitherapy, use of antibacterial drugs and enzyme replacement therapy, which primarily determine prognosis of the disease. 

  1. Diagnosis of polymyalgia rheumatica usually means a favourable outcome for your patient

    Directory of Open Access Journals (Sweden)

    Marcin Milchert

    2017-01-01

    Full Text Available Polymyalgia rheumatica (PMR is a unique disease of elderly people, traditionally diagnosed based on a clinical picture. A typical case is a combination of severe musculoskeletal symptoms and systemic inflammatory response with spectacular response to corticosteroids treatment. The severity of symptoms may be surprising in older patients where immunosenescence is normally expected. However, PMR may be diagnosed in haste if there is a temptation to use this diagnosis as a shortcut to achieve rapid therapeutic success. Overdiagnosis of PMR may cause more problems compared to underdiagnosis. The 2012 PMR criteria proposed by European League against Rheumatism/American College of Rheumatology aim to minimize the role of clinical intuition and build on more objective features. However, questions arise if this is possible in PMR. This has been discussed in this review.

  2. Borderline Ovarian Tumors and Diagnostic Dilemma of Intraoperative Diagnosis: Could Preoperative He4 Assay and ROMA Score Assessment Increase the Frozen Section Accuracy? A Multicenter Case-Control Study

    Science.gov (United States)

    Gizzo, Salvatore; Berretta, Roberto; Di Gangi, Stefania; Guido, Maria; Zanni, Giuliano Carlo; Franceschetti, Ilaria; Quaranta, Michela; Plebani, Mario; Nardelli, Giovanni Battista; Patrelli, Tito Silvio

    2014-01-01

    The aim of our study was to assess the value of a preoperative He4-serum-assay and ROMA-score assessment in improving the accuracy of frozen section histology in the diagnosis of borderline ovarian tumors (BOT). 113 women presenting with a unilateral ovarian mass diagnosed as serous/mucinous BOT at frozen-section-histology (FS) and/or confirmed on final pathology were recruited. Pathologists were informed of the results of preoperative clinical/instrumental assessment of all patients. For Group_A patients, additional information regarding He4, CA125, and ROMA score was available (in Group_B only CA125 was known). The comparison between Group A and Group B in terms of FS accuracy, demonstrated a consensual diagnosis in 62.8% versus 58.6% (P: n.s.), underdiagnosis in 25.6% versus 41.4% (P < 0.05), and overdiagnosis in 11.6% versus 0% (P < 0.01). Low FS diagnostic accuracy was associated with menopausal status (OR: 2.13), laparoscopic approach (OR: 2.18), mucinous histotype (OR: 2.23), low grading (OR: 1.30), and FIGO stage I (OR: 2.53). Ultrasound detection of papillae (OR: 0.29), septa (OR: 0.39), atypical vascularization (OR: 0.34), serum He4 assay (OR: 0.39), and ROMA score assessment (OR: 0.44) decreased the probability of underdiagnosis. A combined preoperative assessment through serum markers and ultrasonographic features may potentially reduce the risk of underdiagnosis of BOTs on FS while likely increasing the concomitant incidence of false-positive events. PMID:25431767

  3. Borderline Ovarian Tumors and Diagnostic Dilemma of Intraoperative Diagnosis: Could Preoperative He4 Assay and ROMA Score Assessment Increase the Frozen Section Accuracy? A Multicenter Case-Control Study

    Directory of Open Access Journals (Sweden)

    Salvatore Gizzo

    2014-01-01

    Full Text Available The aim of our study was to assess the value of a preoperative He4-serum-assay and ROMA-score assessment in improving the accuracy of frozen section histology in the diagnosis of borderline ovarian tumors (BOT. 113 women presenting with a unilateral ovarian mass diagnosed as serous/mucinous BOT at frozen-section-histology (FS and/or confirmed on final pathology were recruited. Pathologists were informed of the results of preoperative clinical/instrumental assessment of all patients. For Group_A patients, additional information regarding He4, CA125, and ROMA score was available (in Group_B only CA125 was known. The comparison between Group A and Group B in terms of FS accuracy, demonstrated a consensual diagnosis in 62.8% versus 58.6% (P: n.s., underdiagnosis in 25.6% versus 41.4% (P<0.05, and overdiagnosis in 11.6% versus 0% (P<0.01. Low FS diagnostic accuracy was associated with menopausal status (OR: 2.13, laparoscopic approach (OR: 2.18, mucinous histotype (OR: 2.23, low grading (OR: 1.30, and FIGO stage I (OR: 2.53. Ultrasound detection of papillae (OR: 0.29, septa (OR: 0.39, atypical vascularization (OR: 0.34, serum He4 assay (OR: 0.39, and ROMA score assessment (OR: 0.44 decreased the probability of underdiagnosis. A combined preoperative assessment through serum markers and ultrasonographic features may potentially reduce the risk of underdiagnosis of BOTs on FS while likely increasing the concomitant incidence of false-positive events.

  4. 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 ...

  5. Dual Diagnosis

    Science.gov (United States)

    A person with dual diagnosis has both a mental disorder and an alcohol or drug problem. These conditions occur together frequently. In particular, ... to emotional and mental problems. Someone with a dual diagnosis must treat both conditions. For the treatment ...

  6. Underdiagnosis of Mild Congenital Anorectal Malformations

    NARCIS (Netherlands)

    Jonker, Jara E.; Trzpis, Monika; Broens, Paul M. A.

    Objective: To determine whether the frequency and severity of congenital anorectal malformations (CARMs) differs by sex. Study design: We included 129 patients (0-319 weeks old) diagnosed with CARMs, who had been referred to our Department of Pediatric Surgery between 2004 and 2013. Rectoperineal

  7. Screening of alcohol use disorders in psychiatric outpatients: influence of gender, age, and psychiatric diagnosis.

    Science.gov (United States)

    Sánchez Autet, Mónica; Garriga, Marina; Zamora, Francisco Javier; González, Idilio; Usall, Judith; Tolosa, Leticia; Benítez, Concepción; Puertas, Raquel; Arranz, Belén

    2017-07-14

    Alcohol use disorders (AUD) are 2 times higher among psychiatric patients than in the general population. The under-recognition of this dual diagnosis can entail several negative outcomes. Early assessment with a screening tool like the CAGE questionnaire could be an opportunity to improve patients' prognoses. The objective of this study is to assess AUD risk in an outpatient psychiatric sample with a modified CAGE, considering the influence of age, gender and clinical psychiatric diagnosis. An observational, multicentric, descriptive study was carried out. The 4-item CAGE scale, camouflaged in a healthy lifestyle questionnaire, was implemented, using a cut-off point of one. 559 outpatients were assessed. 54% were female and the average age was 50.07 years. 182 patients presented a CAGE score ≥1 (45.1% of men and 21.9% of women). Gender was the strongest predictor of a positive result in CAGE, as men were 3.03 times more likely to score ≥1 on the CAGE questionnaire (p < .001, 95% CI: 0.22-0.49). Patients with bipolar and personality disorders had the highest rates of CAGE scores ≥1 (45.2 and 44.9%, respectively), with a significant association between diagnosis and a positive score (p = .002). Patients above 60 years were 2.5 times less likely to score ≥1 on the CAGE (p = .017, 95% CI: 0.19-0.85). Specific screening questionnaires, like the CAGE scale, can be an easy and useful tool in the assessment of AUD risk in psychiatric outpatients. Male patients with a bipolar or personality disorder present a higher risk of AUD.

  8. Clinical efficacy of magnetic resonance cholangiopancreatography in the diagnosis of biliary tract diseases

    Energy Technology Data Exchange (ETDEWEB)

    Ito, Kei; Fujita, Naotaka; Noda, Yutaka [Sendai City Medical Center (Japan)] (and others)

    2001-10-01

    This study was carried out to clarify the efficacy of magnetic resonance cholangiopancreatography (MRCP) in the diagnosis of biliary tract diseases. Three hundred and eleven patients who underwent MRCP and ERCP during the period from January 1999 to December 1999 at our institution were included in the study. Two gastroenterologists who were blinded to results of direct cholangiography and final diagnoses interpreted MRCP images prospectively. The biliary duct was visualized by MRCP and ERCP in 99.4% and 89.5% of the cases, respectively. The sensitivity, specificity, and accuracy of MRCP in the diagnosis of choledocholithiasis were 95%, 97%, and 97%, respectively. MRCP depicted the presence of strictures with a sensitivity, specificity, and accuracy of 97%, 96%, and 96%, respectively. There were three false-positive cases because of artifacts from arterial compression. The accuracy of MRCP and ERCP in differentiation of benign strictures from malignant ones was 85% and 96%, respectively. Based on these results, it is concluded that MRCP has high capability in visualization of the biliary tree, and in detection of stones and strictures. To avoid over and under-diagnosis, awareness of some pitfalls inherent in, MRCP is important. We suggest that MRCP should be recommended for patients with suspicion of biliary tract diseases in the initial stage of making diagnosis. (author)

  9. Underrecognition and undertreatment of asthma in Cape Town ...

    African Journals Online (AJOL)

    1955 parents of sub B pupils from 16 schools completed a questionnaire, followed by: (f) an interview of parents of 348 symptomatic children; and (if) bronchial responsiveness testing on 254 children. the final case group consisted of 242 children with reported asthma or multiple asthma symptoms on both questionnaires.

  10. 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.

  11. 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.

  12. 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

  13. 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

  14. Preimplantation diagnosis.

    Science.gov (United States)

    Delhanty, J D

    1994-12-01

    Research towards preimplantation diagnosis of genetic disease was initiated in the UK in the mid 1980s with the aim of helping those couples who would prefer selection to occur at this stage rather than during pregnancy. Following in vitro fertilisation, (IVF), biopsy and removal of 1 or 2 of the totipotent cells from the cleavage stage 3 day old embryo provides the material for molecular genetic diagnosis without interfering with development. Earliest applications were in the avoidance of X-linked disease by sexing embryos and selecting females for transfer to the mother. Initially, polymerase chain reaction (PCR) amplification of DNA from the biopsied blastomeres was performed using primers specific for sequences derived from the Y chromosome and this led to the birth of several normal girls. To reduce the risk of misdiagnosis due to amplification failure, PCR based methods for sexing the embryo now employ both X and Y specific sequences, but the preferred method is currently considered to be fluorescent in situ hybridisation (FISH) with fluorochrome labelled DNA probes to the embryonic nuclei that have been fixed and spread on slides. Dual FISH with probes from X and Y chromosomes allows unequivocal diagnosis of sex and determination of chromosome copy number, avoiding transfer of embryos with abnormal numbers of sex chromosomes, including those with only the maternal X that would be at 50% risk for the X-linked disease. The application of FISH for preimplantation diagnosis has also led to the realisation that chromosomal mosaicism is common at the cleavage stage of development, a finding that has important implications for diagnosis of both dominant single gene disorders and trisomies, as well as for our understanding of early human development. Cloning and sequencing of the relevant genes has enabled the development of methods for the diagnosis of certain recessive single gene disorders in cleavage stage embryos. PCR based methods have to be developed for each

  15. 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.

  16. [GPs' Perceptions of Strengths and Shortcomings of the ICD-10 for Diagnosis of depression].

    Science.gov (United States)

    Kammerer, K; Falk, K; Döpfmer, S; Heintze, C

    2018-01-01

    For the health care of people with depressive disorders, general practitioners are important contact persons. Some investigations have shown an under-diagnosis of these patients in GPs' surgeries. The significance of the ICD-10 for the diagnosis of depression is disputed. The BMBF-funded study "PSYTIA - Psychotherapy in old age" engages, among others, with the treatment of older people with depression in GPs' surgeries. This study presents the strengths and shortcomings of the ICD-10 for diagnosis of depression from the point of view of GPs. With the help of a questionnaire, 402 teaching GPs were asked how they diagnose and treat elderly people (60+) with depressive disorders in their practices. The response rate was 23.6%. 2 open-ended questions dealt with GPs' perceptions of strengths and shortcomings of ICD-10 for the diagnosis of depression. The responses were matched to inductively developed overarching categories. About three-quarters of the respondents answered the 2 questions. While nearly one-fifth of the respondents did not state any opinion about the suitability of ICD-10 as a diagnostic instrument for depressive disorders, 41% of the respondents mentioned the shortcomings and one-third the strengths of ICD-10. Shortcomings and strengths relate primarily to the complexity of the instrument and its manageability in everyday practice. The results show that application of ICD-10 in a GP's surgery depends on a holistic, hermeneutical approach to the case in family practice, a need for efficient practice management, and billing. These different perceptions explain the heterogeneous and ambivalent assessment of the suitability of ICD-10 for the diagnosis of depression. © Georg Thieme Verlag KG Stuttgart · New York.

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

    Science.gov (United States)

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

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

  18. Improving screening and diagnosis of exercise-induced bronchoconstriction: a call to action.

    Science.gov (United States)

    Weiler, John M; Hallstrand, Teal S; Parsons, Jonathan P; Randolph, Christopher; Silvers, William S; Storms, William W; Bronstone, Amy

    2014-01-01

    This article summarizes the findings of an expert panel of nationally recognized allergists and pulmonologists who met to discuss how to improve detection and diagnosis of exercise-induced bronchoconstriction (EIB), a transient airway narrowing that occurs during and most often after exercise in people with and without underlying asthma. EIB is both commonly underdiagnosed and overdiagnosed. EIB underdiagnosis may result in habitual avoidance of sports and physical activity, chronic deconditioning, weight gain, poor asthma control, low self-esteem, and reduced quality of life. Routine use of a reliable and valid self-administered EIB screening questionnaire by professionals best positioned to screen large numbers of people could substantially improve the detection of EIB. The authors conducted a systematic review of the literature that evaluated the accuracy of EIB screening questionnaires that might be adopted for widespread EIB screening in the general population. Results of this review indicated that no existing EIB screening questionnaire had adequate sensitivity and specificity for this purpose. The authors present a call to action to develop a new EIB screening questionnaire, and discuss the rigorous qualitative and quantitative research necessary to develop and validate such an instrument, including key methodological pitfalls that must be avoided. Copyright © 2014 American Academy of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

  19. Current concepts and controversies in the diagnosis and treatment of attention deficit hyperactivity disorder.

    Science.gov (United States)

    Jensen, P S

    2000-04-01

    Concerns about possible over-diagnosis and over-treatment of attention deficit hyperactivity disorder (ADHD) have been prominent in media reports, as have various competing claims about the safety and efficacy of the various treatments for ADHD. Drawing upon the results of the recent National Institutes of Health Consensus Conference, this paper reviews the evidence concerning these controversial areas. Although there do appear to be pockets of over-prescribing in selected communities, the best available evidence suggests that across the United States substantial underdiagnosis continues to occur, and only 50% of all children with ADHD are being treated with stimulant medications. Among those who are treated with stimulant medications, inadequate treatment is quite common. Substantial evidence suggests that for ADHD symptoms, stimulants are more effective than behavioral therapies in head-to-head comparisons. Combined medication and behavioral treatments do not offer any meaningful advantages over medication treatments alone for ADHD symptoms. For other areas of functioning, however (social skills, academic performance, etc.), combined treatments appear to offer some modest advantages over single treatment approaches. Although research findings show that ADHD can indeed be rigorously and reliably diagnosed under optimal conditions, and that carefully delivered treatments can yield substantial benefits, such best practices do not appear to be taking place in the real world. Thus, although the above controversies are facing some resolution in principal, in practice much remains to be done.

  20. Fuzzy diagnosis

    International Nuclear Information System (INIS)

    Watanabe, K.

    1990-01-01

    Studies have been made on fuzzy diagnosis using inverse problem solutions of the fuzzy relational equation of ao R=b, where a is the failure vector, R the fuzzy relation matrix and b the sympton vector. Four phases of analyses were carried out in this study. First, fault tree analysis was undertaken to investigate what kind of causes produce fall of water level in a steam drum of ATR (Advanced Thermal Reactor), which is heavy-water-moderated boiling-water-cooled pressure-tube-type reactor. Next, simulation for 100 seconds was executed to determine how plant parameters respond to an occurrence of a transient induced by the cause. Third, the simulation data was analysed utilizing an autoregressive model. From this analysis, a total of 36 coherency functions up to 0.5 Hz in each transient were computed among nine important and detectable plant parameters, that is neutron flux, flow rate of coolant, steam and feed water, water level in the steam drum, pressure and opening area of control valve in a steam pipe, feed water temperature and electrical power. Last, the inverse problem of the fuzzy relational equation was solved. Relation matrices were adjusted from 0.00 to 1.00, after nine membership functions following the Gussian distribution for the symptom vector were estimated from correlation values of the coherency functions

  1. Plague Diagnosis and Treatment

    Science.gov (United States)

    ... Healthcare Professionals Clinicians Public Health Officials Veterinarians Prevention History of Plague Resources FAQ Diagnosis and Treatment Recommend on Facebook Tweet Share Compartir Detailed Diagnosis and Treatment Recommendations ...

  2. [Diagnosis and treatment of interstitial cystitis].

    Science.gov (United States)

    Meyer, D; Gregorin, J; Schmid, H-P

    2011-02-16

    Interstitial Cystitis, first described in 1887 as an inflammatory disease of the bladder wall, is now regarded as a very common disease with an estimated number of unreported cases. Reasons for underdiagnosis is the widespread use of strict exclusion criteria. The disease can already be suspected by a careful medical history and physical examination in an early stage and then be treated with promising multimodal therapeutic approaches. In addition to a symptomatic oral therapy, local instillations with constituents of the protective glycosaminoglycan-layer are the most common therapeutic approach, because its defective integrity plays a key role in the pathogenesis of interstitial cystitis.

  3. Proposal for best practice in the use of video-EEG when psychogenic non-epileptic seizures are a possible diagnosis

    Directory of Open Access Journals (Sweden)

    Kimberley Whitehead

    Full Text Available The gold-standard for the diagnosis of psychogenic non-epileptic seizures (PNES is capturing an attack with typical semiology and lack of epileptic ictal discharges on video-EEG. Despite the importance of this diagnostic test, lack of standardisation has resulted in a wide variety of protocols and reporting practices. The goal of this review is to provide an overview of research findings on the diagnostic video-EEG procedure, in both the adult and paediatric literature. We discuss how uncertainties about the ethical use of suggestion can be resolved, and consider what constitutes best clinical practice. We stress the importance of ictal observation and assessment and consider how diagnostically useful information is best obtained. We also discuss the optimal format of video-EEG reports; and of highlighting features with high sensitivity and specificity to reduce the risk of miscommunication. We suggest that over-interpretation of the interictal EEG, and the failure to recognise differences between typical epileptic and nonepileptic seizure manifestations are the greatest pitfalls in neurophysiological assessment of patients with PNES. Meanwhile, under-recognition of semiological pointers towards frontal lobe seizures and of the absence of epileptiform ictal EEG patterns during some epileptic seizure types (especially some seizures not associated with loss of awareness, may lead to erroneous PNES diagnoses. We propose that a standardised approach to the video-EEG examination and the subsequent written report will facilitate a clear communication of its import, improving diagnostic certainty and thereby promoting appropriate patient management. Keywords: Psychogenic nonepileptic seizures, Nonepileptic attack disorder, Suggestion, EEG

  4. Enzyme-linked immunoassay for plasma-free metanephrines in the biochemical diagnosis of phaeochromocytoma in adults is not ideal.

    LENUS (Irish Health Repository)

    2012-02-01

    Abstract Background: The aim of the study was to define the analytical and diagnostic performance of the Labor Diagnostica Nord (LDN) 2-Met plasma ELISA assay for fractionated plasma metanephrines in the biochemical diagnosis of phaeochromocytoma. Methods: The stated manufacturer\\'s performance characteristics were assessed. Clinical utility was evaluated against liquid chromatography tandem mass spectrometry (LC-MS\\/MS) using bias, sensitivity and specificity outcomes. Samples (n=73) were collected from patients in whom phaeochromocytoma had been excluded (n=60) based on low probability of disease, repeat negative testing for urinary fractionated catecholamines and metanephrines, lack of radiological and histological evidence of a tumour and from a group (n=13) in whom the tumour had been histologically confirmed. Blood collected into k(2)EDTA tubes was processed within 30 min. Separated plasma was aliquoted (x2) and frozen at -40 degrees C prior to analyses. One aliquot was analysed for plasma metanephrines using the LDN 2-Met ELISA and the other by LC-MS\\/MS. Results: The mean bias of -32% for normetanephrine (ELISA) when compared to the reference method (LC-MS\\/MS) makes under-diagnosis of phaeochromocytoma likely. The sensitivity of the assay (100%) was equal to the reference method, but specificity (88.3%) lower than the reference method (95%), making it less than optimum for the biochemical diagnosis of phaeochromocytoma. Conclusions: Plasma-free metanephrines as measured by Labor Diagnostica Nord (LDN) 2-Met ELISA do not display test characteristics that would support their introduction or continuation as part of a screening protocol for the biochemical detection of phaeochromocytoma unless the calibration problem identified is corrected and other more accurate and analytically specific methods remain unavailable.

  5. Dual Diagnosis - Multiple Languages

    Science.gov (United States)

    ... Are Here: Home → Multiple Languages → All Health Topics → Dual Diagnosis URL of this page: https://medlineplus.gov/ ... V W XYZ List of All Topics All Dual Diagnosis - Multiple Languages To use the sharing features ...

  6. About Vulvodynia: Diagnosis

    Science.gov (United States)

    ... and Vaginal Pain in the Media Need an Interview? Make a Difference Volunteer with NVA Educate Others Donate Navigation What is Vulvodynia? Vulvar Anatomy What Causes Vulvodynia? Diagnosis Vulvodynia Treatments Home Diagnosis After taking a thorough ...

  7. Using Schemata for Diagnosis*

    OpenAIRE

    Turner, Roy M.

    1988-01-01

    Medical diagnosis is a planning task in which the operators are actions such as asking for information and drawing an inference. Diagnosis involves interleaving planning and plan execution, since information gathered by the diagnostician may change the future course of diagnosis. In this paper we present an approach to computer-based medical diagnosis called schema-based reasoning. This approach represents the reasoner's planning knowledge as packets of procedural information called schemata;...

  8. Underdiagnosis of Obstructive Sleep Apnoea in Peripheral Arterial Disease.

    Science.gov (United States)

    Pizarro, Carmen; Schaefer, Christian; Kimeu, Irene; Pingel, Simon; Horlbeck, Fritz; Tuleta, Izabela; Nickenig, Georg; Skowasch, Dirk

    2015-02-21

    Background: Obstructive sleep apnoea (OSA) has interdependently been related to the onset and progression of a large portion of atherosclerotic cardiovascular disorders. In due consideration of OSA-mediated endothelial dysfunction, its impact on peripheral artery disease is conceivable, but undefined. Objectives: The aim of this study was to identify the prevalence of OSA in a lower extremity artery disease (LEAD) study population. Methods: A total of 91 patients receiving in- and outpatient treatment for LEAD were included in this prospectively conducted trial. In addition to an angiological examination, all patients underwent nocturnal screening for sleep-disordered breathing by use of SOMNOcheck micro® (SC micro) and - depending on the results obtained - polysomnography. Results: Patients were principally late middle-aged (69.3 ± 10.8 years), male (71.4%) and slightly overweight (BMI 26.8 ± 3.9). Overnight screening determined a sleep apnoea prevalence of 78.0%, of which 90.1% exhibited a predominantly obstructive genesis. The mean apnoea-hypopnoea index (AHI; events/h) and oxygen desaturation index (events/h) averaged 11.8 ± 13.4 and 8.9 ± 14.2, respectively. The individual AHI categories of non-pathological (<5), mild (5 to <15), moderate (15 to <30) and severe sleep apnoea (≥30) accounted for 22.0, 59.3, 13.2 and 5.5%, respectively. A distributive examination of AHI within LEAD severity groups evinced a significant association (p = 0.047). In cases of at least moderate sleep apnoea (AHI ≥15) polysomnography was performed (n = 17, 18.7% of the whole collective). Correlative analysis revealed a significant correlation between values obtained by SC micro recording and polysomnography, establishing the diagnostic accuracy of the screening results. Conclusions: OSA exhibits an important prevalence of 70.3% in LEAD patients with prior undiagnosed sleep-disordered breathing, indicating major OSA unawareness in this cardiovascular cohort. However, the impact of OSA treatment on LEAD propagation remains to be determined. © 2015 S. Karger AG, Basel.

  9. Diagnostic challenges leading to underdiagnosis of dissociative disorders

    Directory of Open Access Journals (Sweden)

    Aadil M

    2017-02-01

    Full Text Available Muhammad Aadil,1 Maria Shoaib2 1Department of Psychiatry, Rush University Medical Center, Chicago, IL, USA; 2Department of medicine, Dow Medical College, Karachi, PakistanWe read the article “Is the Dissociative Experiences Scale able to identify detachment and compartmentalization symptoms? Factor structure of the Dissociative Experiences Scale in a large sample of psychiatric and nonpsychiatric subjects” by Mazzotti et al with great interest and would like to add our views in its support.1View the original paper by Mazzotti and colleagues.

  10. Prevalence of chronic obstructive pulmonary disease according to BTS, ERS, GOLD and ATS criteria in relation to doctor's diagnosis, symptoms, age, gender, and smoking habits.

    Science.gov (United States)

    Lindberg, Anne; Jonsson, Ann-Christin; Rönmark, Eva; Lundgren, Rune; Larsson, Lars-Gunnar; Lundbäck, Bo

    2005-01-01

    Guidelines and standards for diagnosis and management of chronic obstructive pulmonary disease (COPD) have been presented by different national and international societies, but the spirometric criteria for COPD differ between guidelines. To estimate prevalence of COPD using the guidelines of the British Thoracic Society (BTS), the European Respiratory Society (ERS), the Global Initiative for Chronic Obstructive Lung Disease (GOLD), and the American Thoracic Society (ATS). Further, to evaluate reported airway symptoms, contacts with health care providers, and physician diagnosis of COPD in relation to the respective criteria, and gender differences. In 1992 a postal questionnaire was sent to a random sample of adults aged 20-69 years, 4,851 (85%) out of 5,681 subjects responded. In 1994-1995 a random sample of the responders, 970 subjects, were invited to a structured interview and a lung function test; 666 (69%) participated. The prevalence of COPD was 7.6, 14.0, 14.1, 12.2 and 34.1% according to BTS, ERS, GOLD, clinical ATS (with symptoms or physician diagnosis), and spirometric ATS criteria, respectively. Prevalent COPD was related to age, smoking habits and family history of obstructive airway disease but not to gender. Physician diagnosis of chronic bronchitis or emphysema was only reported by 16.3, 12.2, 11.0, 23.4 and 8.2% of subjects fulfilling the respective criteria, though a majority reported airway symptoms. The main determinants for prevalent COPD were age, smoking habits and spirometric criteria of COPD. Though a majority reported airway symptoms and contact with health care providers due to respiratory complaints, only a minority was diagnosed as having COPD, indicating a large underdiagnosis. Copyright (c) 2005 S. Karger AG, Basel.

  11. Amblyopia: Lazy Eye Diagnosis

    Science.gov (United States)

    ... Stories Español Eye Health / Eye Health A-Z Amblyopia Sections Amblyopia: What Is Lazy Eye? Amblyopia: What ... Amblyopia: Lazy Eye Diagnosis Amblyopia: Lazy Eye Treatment Amblyopia: Lazy Eye Diagnosis Leer en Español: Ambliopía: Diagnóstico ...

  12. Symptoms, Diagnosis & Treatment

    Science.gov (United States)

    ... gums Sweating, especially at night Bone or joint pain Diagnosis Your doctor will perform blood tests to see ... Weakness and tiredness that don't go away Pain, swelling, or a feeling of fullness in the abdomen Diagnosis A lymph node biopsy is used to diagnose ...

  13. Diagnosis of bovine neosporosis.

    Science.gov (United States)

    Dubey, J P; Schares, G

    2006-08-31

    The protozoan parasite Neospora caninum is a major cause of abortion in cattle. The diagnosis of neosporosis-associated mortality and abortion in cattle is difficult. In the present paper we review histologic, serologic, immunohistochemical, and molecular methods for dignosis of bovine neosporosis. Although not a routine method of diagnosis, methods to isolate viable N. caninum from bovine tissues are also reviewed.

  14. Neurofibromatoses: part 1 ? diagnosis and differential diagnosis

    Directory of Open Access Journals (Sweden)

    Luiz Oswaldo Carneiro Rodrigues

    2014-03-01

    Full Text Available Neurofibromatoses (NF are a group of genetic multiple tumor growing predisposition diseases: neurofibromatosis type 1 (NF1, neurofibromatosis type 2 (NF2 and schwannomatosis (SCH, which have in common the neural origin of tumors and cutaneous signs. They affect nearly 80 thousand of Brazilians. In recent years, the increased scientific knowledge on NF has allowed better clinical management and reduced complication morbidity, resulting in higher quality of life for NF patients. In most cases, neurology, psychiatry, dermatology, clinical geneticists, oncology and internal medicine specialists are able to make the differential diagnosis between NF and other diseases and to identify major NF complications. Nevertheless, due to its great variability in phenotype expression, progressive course, multiple organs involvement and unpredictable natural evolution, NF often requires the support of neurofibromatoses specialists for proper treatment and genetic counseling. This Part 1 offers step-by-step guidelines for NF differential diagnosis. Part 2 will present the NF clinical management.

  15. [Diagnosis and differential diagnosis of Cushing's syndrome].

    Science.gov (United States)

    Santos, Silvia; Santos, Estefanía; Gaztambide, Sonia; Salvador, Javier

    2009-02-01

    Because of the variability in the clinical expression of Cushing's syndrome, different biochemical tests and imaging techniques must be used for effective diagnosis and treatment. The clinical history is important to assess the general impact of hypercortisolism on organs and systems, as well as to guide suspicion toward more aggressive entities such as overt ectopic ACTH syndrome or to detect an iatrogenic etiology of Cushing's syndrome. The screening phase relies on tests that are sensitive but not specific, such as urinary free cortisol, nocturnal salivary cortisol and 1 mg dexamethasone suppression, which still require established assessment criteria. Confirmation can be obtained by repeating urinary cortisol, 2 mg/day dexamethasone suppression, both alone and combined with corticotropin releasing hormone (CRH), to exclude pseudoCushing states. ACTH dependency can be easily explored by ACTH measurements, but the differential diagnosis between pituitary and ectopic Cushing's disease is difficult and may require invasive procedures such as inferior petrosal sinus sampling. Sophisticated imaging and isotopic techniques play a significant role in locating the source of ACTH in ectopic syndromes but are not always effective. In general, biochemical and imaging tests should be combined in order to assess different mechanisms and perspectives of the syndrome. Rigorous methodology is essential to obtain accurate results, allowing a correct diagnosis and improving therapeutic performance in this devastating disease.

  16. 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.)

  17. MAT FOR LEPTOSPIROSIS DIAGNOSIS

    Directory of Open Access Journals (Sweden)

    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.

  18. Sonographic diagnosis of pneumothorax

    OpenAIRE

    Husain, Lubna F; Hagopian, Laura; Wayman, Derek; Baker, William E; Carmody, Kristin A

    2012-01-01

    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 pneumoth...

  19. 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

  20. 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 inputs are disturbance inputs, reference inputs and auxilary inputs. The diagnosis of the system is derived by an evaluation of the signature from the inputs in the residual outputs. The changes of the signatures form the external inputs are used for detection and isolation of the parametric faults....

  1. Peritoneal tuberculosis: radiographic diagnosis

    Directory of Open Access Journals (Sweden)

    Carolina Ospina-Moreno

    2014-12-01

    Full Text Available Peritoneal tuberculosis (TB is an extrapulmonary form of presentation of tuberculosis. HIV infection is a primary risk factor for this condition. Diagnosis requires microbiological or histopathological confirmation in addition to supporting radiological imaging studies. Abdominal ultrasonography and CT are useful to obtain a radiographic diagnosis, with typical findings including diffuse peritoneal thickening, presence of ascites in varying volumes, adenopathies, and caseating nodes. We report 2 cases of patients with ascites and nodular peritoneal thickening on diagnostic images, as well as high CA-125 levels in laboratory tests. In both patients, a diagnosis of peritoneal tuberculosis was reached following a US-guided peritoneal biopsy.

  2. Diagnosis of acute leptospirosis.

    Science.gov (United States)

    Toyokawa, Takao; Ohnishi, Makoto; Koizumi, Nobuo

    2011-01-01

    Leptospirosis is a globally important zoonotic disease and an important public health problem in developing countries. Early diagnosis is essential because antibiotic treatment is most effective when initiated early in the course of the disease. Culture and the microscopic agglutination test are gold standard methods for leptospirosis diagnosis; however, they are not useful for early diagnosis. Current whole cell-based rapid serological tests have low sensitivity for early phase leptospirosis and may have low specificity in highly endemic areas. PCR is demonstrably useful for early diagnosis, but it is unavailable in most developing countries. Thus, diagnostic methods that not only have higher sensitivity and accuracy for early phase leptospirosis but are also widely applicable in developing countries remain to be developed. The availability of genome sequences and genetic tools of Leptospira spp. will accelerate our understanding of Leptospira pathogenesis and provide insights into the development of more efficient and accurate diagnostic tests for acute-phase leptospirosis.

  3. DSS FOR ORGANIZATIONAL DIAGNOSIS

    NARCIS (Netherlands)

    FROWEIN, JC; POSTMA, TJBM

    1992-01-01

    Information technology in relation to organizational diagnosis and organizational change is the subject of extensive and increasing discussion. A condition for change is insight into organizational problems. This paper discusses the relation between the concepts ''problem'', ''decision making'' and

  4. Body Lice Diagnosis

    Science.gov (United States)

    ... Frequently Asked Questions (FAQs) Epidemiology & Risk Factors Disease Biology Diagnosis Treatment Prevention & Control Resources for Health Professionals Publications Get Email Updates To receive email updates about this page, enter ...

  5. Pubic "Crab" Lice Diagnosis

    Science.gov (United States)

    ... Frequently Asked Questions (FAQs) Epidemiology & Risk Factors Disease Biology Diagnosis Treatment Prevention & Control Resources for Health Professionals Publications Get Email Updates To receive email updates about this page, enter ...

  6. Atrial Fibrillation: Diagnosis

    Science.gov (United States)

    ... of this page please turn JavaScript on. Feature: Atrial Fibrillation Atrial Fibrillation: Diagnosis Past Issues / Winter 2015 Table of Contents ... of your body's cells and organs. Read More "Atrial Fibrillation" Articles Atrial Fibrillation / Who Is at Risk for ...

  7. Preimplantation genetic diagnosis

    DEFF Research Database (Denmark)

    Bay, Bjorn; Ingerslev, Hans Jakob; Lemmen, Josephine Gabriela

    2016-01-01

    OBJECTIVE: To study whether women conceiving after preimplantation genetic diagnosis (PGD) and their children have greater risks of adverse pregnancy and birth outcomes compared with children conceived spontaneously or after IVF with or without intracytoplasmic sperm injection (ICSI). DESIGN...

  8. Salmonella Diagnosis and Treatment

    Science.gov (United States)

    ... FDA) USDA Food Safety and Inspection Service Follow Salmonella RSS Diagnosis and Treatment Recommend on Facebook Tweet Share Compartir How Can Salmonella Infections Be Diagnosed? Diagnosing salmonellosis requires testing a ...

  9. Symptoms and Diagnosis

    Science.gov (United States)

    ... Special Events Faces of Dystonia Donate Donate Online Membership Find an Event Donor Bill of Rights About Dystonia Symptoms & Diagnosis Forms of Dystonia Genetics Glossary Treatment Find a Doctor Oral Medications Botulinum Neurotoxin Neurosurgery ...

  10. Dementia: Diagnosis and Tests

    Science.gov (United States)

    ... our e-newsletter! Aging & Health A to Z Dementia Diagnosis & Tests If you or someone you care ... To determine whether an older adult might have dementia, a healthcare professional will: Ask about the person’s ...

  11. Preimplantation genetic diagnosis.

    Science.gov (United States)

    Black, S H

    1994-12-01

    Preimplantation genetic diagnosis now represents an alternative reproductive option for parents at high risk of having offspring affected with certain genetic diseases. Progress in the past year has included increasing reliability in embryo sexing by both polymerase chain reaction and fluorescent in situ hybridization techniques; delivery of babies free of specific diseases such as cystic fibrosis, Lesch-Nyhan syndrome, and Tay-Sachs disease; and successful development of molecular techniques for detecting common diseases such as fragile-X syndrome. In addition, sperm separation in combination with preimplantation genetic diagnosis appears to be an exciting advance in yielding more in vitro fertilization female embryos for transfer and subsequent pregnancy in families at risk for X-linked diseases. Accumulated world experience can now be reviewed to provide couples considering preimplantation genetic diagnosis with observed pregnancy rates and accuracy of diagnosis.

  12. Personality disorder diagnosis

    OpenAIRE

    WIDIGER, THOMAS A

    2003-01-01

    Every person has a characteristic manner of thinking, feeling, and relating to others. Some of these personality traits can be so dysfunctional as to warrant a diagnosis of personality disorder. The World Health Organization's International Classification of Diseases (ICD- 10) includes ten personality disorder diagnoses. Three issues of particular importance for the diagnosis of personality disorders are their differentiation from other mental disorders, from general persona...

  13. [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.

  14. Somnambulism: Diagnosis and treatment

    Science.gov (United States)

    Bharadwaj, Rahul; Kumar, Suresh

    2007-01-01

    Somnambulism is an arousal disorder that is usually benign, self-limited and only infrequently requires treatment. Chronic sleepwalking in children has been shown to be associated with behavioral problems and poor emotional regulation. Most cases can be diagnosed with careful noting of case history and epilepsy is an important differential diagnosis. Management with pharmacological and behavioural measures is usually safe and effective. We present two cases of somnambulism that highlight the importance of the diagnosis and treatment of this condition. PMID:20711396

  15. Radiological diagnosis and differential diagnosis of headache

    International Nuclear Information System (INIS)

    Langner, S.; Kirsch, M.

    2015-01-01

    Headache is very common and affects almost everyone at some point. It is one of the most common disorders that leads patients to see their physician. All different forms have the nociception via trigeminal nerve fibers in common. Beside the clinical course headaches are classified as either primary or secondary, with the latter having an identifiable structural or biochemical cause. Imaging has a low diagnostic yield in primary headache but play an important role in the differential diagnosis of secondary forms. An overview of different forms of secondary headache is given, outlining diagnostic procedures and the morphologic imaging features of each syndrome.

  16. 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.

  17. Carcinoma involving the gallbladder: a retrospective review of 23 cases - pitfalls in diagnosis of gallbladder carcinoma

    Directory of Open Access Journals (Sweden)

    Giang Tran H

    2012-01-01

    Full Text Available Abstract Background Carcinoma of the gallbladder (GBC clinically mimics benign gallbladder diseases and often escapes detection until advanced stage. Despite the frequency of cholecystectomy, diagnosis of GBC remains problematic in many situations. We sought to identify pathologic features that contribute to the difficulty in recognition of GBC. Methods We identified 23 patients (ranged from 45 to 86 years, male to female ratio 1:4.5 with carcinoma involving the gallbladder referred to an academic medical center over a period of 10 years for study. This includes 10 cases of primary GBC, 6 cases of metastatic tumor to gallbladder, 6 cases of directly invasive adenocarcinoma arising elsewhere in the biliary tree, and one case of unidentified origin adenocarcinoma. Primary tumors include adenocarcinoma not otherwise specified (NOS in 6 cases, papillary adenocarcinoma in 2 cases, and single cases of undifferentiated carcinoma and combined adenocarcinoma and neuroendocrine carcinoma (NEC. Metastatic tumors to gallbladder were from a wide range of primary sites, predominantly the gastrointestinal tract. Results These cases illustrate seven potential pitfalls which can be encountered. These include: 1 mistakenly making a diagnosis of adenocarcinoma of gallbladder when only benign lesions such as deeply penetrating Rokitansky-Aschoff sinuses are present (overdiagnosis, 2 misdiagnosing well-differentiated invasive carcinoma with minimal disease as benign disease (underdiagnosis, 3 differentiating between primary NEC of gallbladder and metastasis, 4 confusing primary mucinous adenocarcinoma of gallbladder with pseudomyxoma peritonei from a low grade appendiceal neoplasm disseminated to gallbladder, 5 confusing gangrenous necrosis related to cholecystitis with geographic tumoral necrosis, 6 undersampling early, grossly occult disease, and 7 misinterpreting extracellular mucin pools. Conclusions Clinical history and a high index of suspicion are

  18. 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

  19. 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

  20. Remote diagnosis server

    Science.gov (United States)

    Deb, Somnath (Inventor); Ghoshal, Sudipto (Inventor); Malepati, Venkata N. (Inventor); Kleinman, David L. (Inventor); Cavanaugh, Kevin F. (Inventor)

    2004-01-01

    A network-based diagnosis server for monitoring and diagnosing a system, the server being remote from the system it is observing, comprises a sensor for generating signals indicative of a characteristic of a component of the system, a network-interfaced sensor agent coupled to the sensor for receiving signals therefrom, a broker module coupled to the network for sending signals to and receiving signals from the sensor agent, a handler application connected to the broker module for transmitting signals to and receiving signals therefrom, a reasoner application in communication with the handler application for processing, and responding to signals received from the handler application, wherein the sensor agent, broker module, handler application, and reasoner applications operate simultaneously relative to each other, such that the present invention diagnosis server performs continuous monitoring and diagnosing of said components of the system in real time. The diagnosis server is readily adaptable to various different systems.

  1. [Diagnosis of vaginal discharge].

    Science.gov (United States)

    Böcher, Sidsel; Helmig, Rikke Bek; Arpi, Magnus; Bjerrum, Lars

    2018-01-15

    Changes in vaginal discharge are often caused by imbalance in the vaginal microflora, and laboratory testing is usually of little use, as most microbes detected are commensals. In-office diagnosis in general practice using wet mount microscopy and Amsel criteria is helpful and often sufficient to ensure correct diagnosis and treatment. Laboratory testing of vaginal discharge should only be performed, if sexually transmitted disease is suspected, if there is treatment failure or inconclusive wet mount prior to gynaecological surgery, and in pregnant women with recurrent miscarriage or preterm birth.

  2. Imaging diagnosis in jaundice

    International Nuclear Information System (INIS)

    Schulman, A.

    1985-01-01

    For a patient presenting with jaundice, ultrasonography is the most rapid and sure way of ascertaining whether the jaundice is due to biliary obstruction of a macroscopic surgical nature rather than of an intrahepatic microscopic nature. Diagnosis could be done by percutaneous transhepatic cholangiography, endoscopic retrograde cholangiopancreatography or computed tomography. These methods as well as radionuclide scintigraphy are discussed

  3. Hints for Diagnosis

    DEFF Research Database (Denmark)

    Poulsen, Lars K

    2015-01-01

    The diagnosis of food allergy requires responses to two important questions: Does the patient have a food allergy? If so, which foods will elicit allergic symptoms? The first question will most often have to be answered following a physical examination and an interview with the patient and/or car...

  4. 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.

  5. Frontotemporal Dementias: Diagnosis

    Science.gov (United States)

    ... Behavioral Variant FTD (bvFTD) Corticobasal Syndrome FTD with Motor Neuron Disease (FTD/MND) Pick’s Disease Nonfluent / Agrammatic variant Primary ... This test is important in the diagnosis of motor neuron diseases such as ALS (Lou Gehrig’s disease). Lumbar puncture ( ...

  6. [Diagnosis of laryngeal cancer].

    Science.gov (United States)

    Szmeja, Z; Kruk-Zagajewska, A

    1995-01-01

    The basic methods of larynx cancer diagnosis were presented. It included subjective and objective examination, and laboratory examination. The importance of detailed history of cases determined by the tumor localization was underlined. Indirect and direct laryngoscopy have not lost it importance despite the development of modern methods of larynx cancer diagnosis. Microlaryngoscopy provides the most valuable information about the localization and advancement of neoplasmatic change. Its also allows for precise taking of specimen for histopathological examination. Radiological method in larynx cancer diagnosis were also taken into consideration particularly laryngotomography which allows for evaluation of subglottic region, ventrical and recesus piriformis. The histological examination remains a decisive factor in the surgery of larynx cancer. Great diagnostic possibilities of neck lymphatic system and larynx are being provided by the ultrasonographic examinations, computer tomography and magnetic tomography of nuclear resonance which allow for detailed evaluation of neoplasm extend and appearance of recurrence and metastases. The greatest responsibility in diagnosis of larynx cancer is put on a doctor who first advised the patient.

  7. Body imaging: Diagnosis

    African Journals Online (AJOL)

    peritoneal breach, a tangential caudocranial trajectory of the biopsy needle was employed. Three passes were made ... endometrial seeding. The final diagnosis was abdominal wall endometriosis with surrounding fibrosis. Discussion. Endometriosis is a fairly common entity in women of child- bearing age, occurring in 10% ...

  8. [Computer assisted orthodontic diagnosis].

    Science.gov (United States)

    Romeo García, A; González Blanco, A

    1991-03-01

    Quick Ceph is a program to help in orthodontic diagnosis, which is not limited to lateral cephalometric analysis but also allows, thanks to the Macintosh graphic interface the simulation of all orthodontic and surgical movements and so this to establish a treatment plan.

  9. 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...

  10. [Urticaria: diagnosis and treatment].

    Science.gov (United States)

    Soria, A; Francès, C

    2014-09-01

    Urticaria is a common inflammatory skin disease. It is clinically defined as the occurrence of transient papular skin and/or mucosal lesions or subcutaneous lesions called angioedema. Chronic urticaria is defined as a clinical course over more than 6weeks. Different clinical forms of urticaria can coexist in the same patient. Urticaria results of mast cell activation. The diagnosis of urticaria is based on clinical examination. An allergic etiology for acute urticaria, although rare, is always to find and remove. Chronic urticaria is not allergic. Diagnosis is based on questioning and a careful clinical examination to rule out differential diagnoses. Few diagnostic tests are necessary for diagnosis and management, and are especially useful in case of doubtful diagnosis. The treatment of urticaria is symptomatic and based on anti-H1 second generation antihistamines as first-line therapy. In some chronic urticarial, antihistamines up dosing may be necessary. In the majority of patients, this treatment is sufficient to control chronic urticaria. In case of antihistamines failure, other treatment particularly immunomodulatory treatments can be offered in specialized departments. Copyright © 2014 Société nationale française de médecine interne (SNFMI). Published by Elsevier SAS. All rights reserved.

  11. 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.

  12. 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

  13. Diagnosis of cystic fibrosis

    NARCIS (Netherlands)

    H.J. Veeze

    1995-01-01

    textabstractApplying the sweat-test as the first choice of test when a diagnosis of cystic fibrosis is suspected is still common practice and advisable. Since the cloning of the CFTR gene more than 400 different cystic fibrosis (CF) mutations have already been identified. The use of CF mutation

  14. Performance based fault diagnosis

    DEFF Research Database (Denmark)

    Niemann, Hans Henrik

    2002-01-01

    Different aspects of fault detection and fault isolation in closed-loop systems are considered. It is shown that using the standard setup known from feedback control, it is possible to formulate fault diagnosis problems based on a performance index in this general standard setup. It is also shown...

  15. 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

  16. Classification, disease, and diagnosis.

    Science.gov (United States)

    Jutel, Annemarie

    2011-01-01

    Classification shapes medicine and guides its practice. Understanding classification must be part of the quest to better understand the social context and implications of diagnosis. Classifications are part of the human work that provides a foundation for the recognition and study of illness: deciding how the vast expanse of nature can be partitioned into meaningful chunks, stabilizing and structuring what is otherwise disordered. This article explores the aims of classification, their embodiment in medical diagnosis, and the historical traditions of medical classification. It provides a brief overview of the aims and principles of classification and their relevance to contemporary medicine. It also demonstrates how classifications operate as social framing devices that enable and disable communication, assert and refute authority, and are important items for sociological study.

  17. Diagnosis of adrenal tumors

    Energy Technology Data Exchange (ETDEWEB)

    Richter, E.I.; Loesch, H.

    1987-09-01

    Of 155 patients with adrenal disorders, 120 (77%) were correctly diagnosed as negative. There were no correlations between the results of computer tomography and phlebography or between computer tomography and laboratory tests. In 31 patients (20%) a correct diagnosis was obtained and these patients were sent to surgery. Four cases (3%) were shown to be false positive. In these cases (with one exception), both the computer tomography and phlebography results had been overinterpreted. Computer tomography was shown to be a method of high sensitivity and almost as great specificity. Tumors cannot be distinguished by phlebography; only pheochromocytoma shows a characteristic alteration of vessels in arteriograms. In general, an accurate diagnosis requires positive angiography (arterio- or phlebography) results and clear evidence of elevated hormone levels. Only then is surgery indicated.

  18. Diagnosis of adrenal tumors

    International Nuclear Information System (INIS)

    Richter, E.I.; Loesch, H.

    1987-01-01

    Of 155 patients with adrenal disorders, 120 (77%) were correctly diagnosed as negative. There were no correlations between the results of computer tomography and phlebography or between computer tomography and laboratory tests. In 31 patients (20%) a correct diagnosis was obtained and these patients were sent to surgery. Four cases (3%) were shown to be false positive. In these cases (with one exception), both the computer tomography and phlebography results had been overinterpreted. Computer tomography was shown to be a method of high sensitivity and almost as great specificity. Tumors cannot be distinguished by phlebography; only pheochromocytoma shows a characteristic alteration of vessels in arteriograms. In general, an accurate diagnosis requires positive angiography (arterio- or phlebography) results and clear evidence of elevated hormone levels. Only then is surgery indicated. (orig.) [de

  19. Achieving diagnosis by consensus

    LENUS (Irish Health Repository)

    Kane, Bridget

    2009-08-01

    This paper provides an analysis of the collaborative work conducted at a multidisciplinary medical team meeting, where a patient’s definitive diagnosis is agreed, by consensus. The features that distinguish this process of diagnostic work by consensus are examined in depth. The current use of technology to support this collaborative activity is described, and experienced deficiencies are identified. Emphasis is placed on the visual and perceptual difficulty for individual specialities in making interpretations, and on how, through collaboration in discussion, definitive diagnosis is actually achieved. The challenge for providing adequate support for the multidisciplinary team at their meeting is outlined, given the multifaceted nature of the setting, i.e. patient management, educational, organizational and social functions, that need to be satisfied.

  20. Ion beam diagnosis

    International Nuclear Information System (INIS)

    Strehl, P.

    1994-04-01

    This report is an introduction to ion beam diagnosis. After a short description of the most important ion beam parameters measurements of the beam current by means of Faraday cups, calorimetry, and beam current transformers and measurements of the beam profile by means of viewing screens, profile grids and scanning devices, and residual gas ionization monitors are described. Finally measurements in the transverse and longitudinal phase space are considered. (HSI)

  1. Vaginitis: Diagnosis and Treatment.

    Science.gov (United States)

    Paladine, Heather L; Desai, Urmi A

    2018-03-01

    Vaginitis is defined as any condition with symptoms of abnormal vaginal discharge, odor, irritation, itching, or burning. The most common causes of vaginitis are bacterial vaginosis, vulvovaginal candidiasis, and trichomoniasis. Bacterial vaginosis is implicated in 40% to 50% of cases when a cause is identified, with vulvovaginal candidiasis accounting for 20% to 25% and trichomoniasis for 15% to 20% of cases. Noninfectious causes, including atrophic, irritant, allergic, and inflammatory vaginitis, are less common and account for 5% to 10% of vaginitis cases. Diagnosis is made using a combination of symptoms, physical examination findings, and office-based or laboratory testing. Bacterial vaginosis is traditionally diagnosed with Amsel criteria, although Gram stain is the diagnostic standard. Newer laboratory tests that detect Gardnerella vaginalis DNA or vaginal fluid sialidase activity have similar sensitivity and specificity to Gram stain. Bacterial vaginosis is treated with oral metronidazole, intravaginal metronidazole, or intravaginal clindamycin. The diagnosis of vulvovaginal candidiasis is made using a combination of clinical signs and symptoms with potassium hydroxide microscopy; DNA probe testing is also available. Culture can be helpful for the diagnosis of complicated vulvovaginal candidiasis by identifying nonalbicans strains of Candida. Treatment of vulvovaginal candidiasis involves oral fluconazole or topical azoles, although only topical azoles are recommended during pregnancy. The Centers for Disease Control and Prevention recommends nucleic acid amplification testing for the diagnosis of trichomoniasis in symptomatic or high-risk women. Trichomoniasis is treated with oral metronidazole or tinidazole, and patients' sex partners should be treated as well. Treatment of noninfectious vaginitis should be directed at the underlying cause. Atrophic vaginitis is treated with hormonal and nonhormonal therapies. Inflammatory vaginitis may improve with

  2. 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.

  3. Pneumonia. Treatment and diagnosis.

    Science.gov (United States)

    Mattila, Joshua T; Fine, Michael J; Limper, Andrew H; Murray, Patrick R; Chen, Bill B; Lin, Philana Ling

    2014-08-01

    Pneumonia remains a leading cause of morbidity and mortality despite advances in treatment and therapy. The "Pneumonia: Treatment and Diagnosis" session of the Pittsburgh International Lung Conference examined topics related to improving care of patients with pneumonia. These topics included the process and quality of care for community-acquired pneumonia (CAP), diagnosis and treatment of emerging fungal pathogens, an overview of the strengths and weaknesses of different diagnostic modalities, and an example of how basic science is exploring immunomodulatory strategies for pneumonia treatment. Systematic health care provider and institutional improvements can decrease mortality rates in CAP, particularly in patients with increasingly complex comorbidities. Aspects of current guidelines for the diagnosis and treatment of fungal pneumonia were reviewed through a series of case presentations. Proper treatment of pneumonia hinges on correct pathogen identification but is complicated by the variety of diagnostic assays with variable specificity, sensitivity, and interpretation. In addressing this topic, Dr. Patrick Murray, Ph.D., discussed a range of diagnostic tests for a variety of pathogens and guidelines for their use. In addition to the current state of CAP treatment, Bill (Beibei) Chen, M.D., Ph.D., presented a new potential therapeutic agent called forsythin, an immunomodulatory compound derived from a plant used in traditional Chinese medicine. These topics, ranging from institution-sized policy to interactions at the molecular scale, paint a broad perspective of the efforts against pneumonia.

  4. Imaging diagnosis of hepatoma

    International Nuclear Information System (INIS)

    Ashizawa, Tatsuto

    1984-01-01

    Nuclear medicine (NM), ultrasonography (US), and computed tomography (CT) were evaluated as screening methods for hepatoma, and the characteristics of each modality were compared. Qualitative diagnosis of hepatoma by measuring the quantitative time-lapse changes in 67 Ga-citrate accumulation was also investigated. A prospective analysis using the above modalities was conducted for 70 patients with hepatoma, with the following results: sensitivities of NM, US and CT were 91.1% ; 91.8% ; and 96.9% respectively. In comparing the characteristics of the three modalities, however, it was concluded that the combined use of NM and US was recommended for screening, and that CT should be used for more detailed examination of a tumor indicated by NM and/or US. In the diagnosis of hepatoma by 67 Ga-citrate, a sensitivity rate of 73.7% and a specificity rate of 92.5% were obtained, indicating 67 Ga-citrate's considerable significance for qualitative diagnosis of hepatoma. A decision tree was also made for those patients with chronic liver disease in whom positive hepatitis B virus (HBV) infection was detected or in whom serum alpha-fetoprotein (AFP) showed an increasing tendency. (author)

  5. BRAIN DEATH DIAGNOSIS

    Directory of Open Access Journals (Sweden)

    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.

  6. Vaginitis: diagnosis and management.

    Science.gov (United States)

    Quan, Martin

    2010-11-01

    Vaginitis is one of the most common ambulatory problems to occur in women. It is a disorder responsible for > 10% of visits made to providers of women's health care. Although vaginal infections are the most common cause, other considerations include cervicitis, a normal vaginal discharge, foreign-body vaginitis, contact vaginitis, atrophic vaginitis, and desquamative inflammatory vaginitis. The medical history and examination are an important source of clues to the underlying diagnosis. However, making a definitive diagnosis requires skillful performance of office laboratory procedures, including the vaginal pool wet mount examination, determination of the vaginal pH, and the whiff test. Vaginal and cervical cultures, nucleic acid tests, and point-of-care tests are available and may be required in selected patients. Once a specific diagnosis is made, effective therapy can be prescribed. Candida vaginitis is generally treated with either the vaginal administration of an imidazole or triazole antifungal agent or the prescription of oral fluconazole. Oral nitroimidazole agents, metronidazole or tinidazole, are the only effective treatments for trichomoniasis in the United States. Bacterial vaginosis, which has been linked to important gynecologic and pregnancy complications, can be treated with an available oral or topical agent containing either a nitroimidazole or clindamycin.

  7. Reprogenetics: preimplantational genetics diagnosis

    Directory of Open Access Journals (Sweden)

    Roberto Coco

    2014-01-01

    Full Text Available Preimplantational Genetics Diagnosis (PGD is requested by geneticists and reproductive specialists. Usually geneticists ask for PGD because one or both members of the couple have an increased genetic risk for having an affected offspring. On the other hand, reproductive specialists ask for embryo aneuploidy screening (PGS to assures an euploid embryo transfer, with the purpose to achieve an ongoing pregnancy, although the couple have normal karyotypes. As embryonic aneuploidies are responsible for pre and post implantation abortions, it is logical to considerer that the screening of the embryonic aneuploidies prior to embryo transfer could improve the efficiency of the in vitro fertilization procedures. Nevertheless, it is still premature to affirm this until well-designed clinical trials were done, especially in women of advanced age where the rate of embryos with aneuploidies is much greater. Although the indications of PGD are similar to conventional prenatal diagnosis (PND, PGD has less ethical objections than the PND. As with the PGD/PGS results only unaffected embryos are transferred, both methods can avoid the decision to interrupt the pregnancy due to a genetic problem; this makes an important difference when compared to conventional prenatal diagnosis.

  8. Culture and psychiatric diagnosis.

    Science.gov (United States)

    Lewis-Fernández, Roberto; Aggarwal, Neil Krishan

    2013-01-01

    Since the publication of DSM-IV in 1994, neurobiologists and anthropologists have criticized the rigidity of its diagnostic criteria that appear to exclude whole classes of alternate illness presentations, as well as the lack of attention in contemporary psychiatric nosology to the role of contextual factors in the emergence and characteristics of psychopathology. Experts in culture and mental health have responded to these criticisms by revising the very process of diagnosis for DSM-5. Specifically, the DSM-5 Cultural Issues Subgroup has recommended that concepts of culture be included more prominently in several areas: an introductory chapter on Cultural Aspects of Psychiatric Diagnosis - composed of a conceptual introduction, a revised Outline for Cultural Formulation, a Cultural Formulation Interview that operationalizes this Outline, and a glossary on cultural concepts of distress - as well as material directly related to culture that is incorporated into the description of each disorder. This chapter surveys these recommendations to demonstrate how culture and context interact with psychiatric diagnosis at multiple levels. A greater appreciation of the interplay between culture, context, and biology can help clinicians improve diagnostic and treatment planning. Copyright © 2013 APA*

  9. 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

  10. Seasonal Allergies: Diagnosis, Treatment & Research

    Science.gov (United States)

    ... 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 ...

  11. Sonographic diagnosis of

    Directory of Open Access Journals (Sweden)

    Stroever, Brigitte

    2005-11-01

    Full Text Available Introduction: The acute abdomen is the main term for an at first unclear emergency situation of the abdominal cavity. The acute abdomen belongs to the three most important reasons for the admission of patients into the emergency room. Further, this illness ranks 40% of all consultations in the ambulant care sector. The acute abdomen requires an early and direct diagnosis because of its potential of having a life threatening differential diagnosis. This HTA report aimed to assess the ultrasound diagnosis of the acute abdomen considering children and adults. This will be done from a medical and economic perspective. The differential diagnosis respectively the cause of the acute abdomen binds high direct treatment costs, especially in the stationary sector. Ultrasound diagnosis is a procedure that plays a big part in the differential diagnosis process and it is widely used in practise. Other research methods of diagnosing acute abdominal illness are: clinical examinations with inspection and palpation, surgical exploration and laparocopy as well as computer tomography and x-ray examination. Objectives: The main objective of this HTA report is to assess what significance sonography should have within the examination strategy of the acute abdomen from the medical and economical view. Second, this HTA report will evaluate under which circumstances the ultrasonographic diagnosis of the acute abdomen, considering medical and economical quality classifications, is the alternative of choice to comparable diagnostic measures. Methods: The target population this HTA report is aimed at are children and adults with acute abdomen or embedded differential diagnosis. A systematic literature search was conducted covering all relevant medical and HTA-databases. Furthermore, handsearch was conducted inside of the known data bases of HTA-institutions as well as from medical and economical journals. The following databases were searched in cooperation with DIMDI to

  12. [Diagnosis, clinical course, and differential diagnosis of schizophrenia].

    Science.gov (United States)

    Hori, Hikaru; Nakamura, Jun

    2013-04-01

    Schizophrenia is a disease whose symptoms are shown to a little less than 1% at adolescence. Since the morbidity elucidation is not yet made many of psychiatry diseases including schizophrenia, a useful biological marker or image inspection, and a physiological inspection are not in diagnosis. About diagnosis of a psychiatric disorder, the symptoms study diagnostic method never must be used. Then, diagnosis needs to be made appropriately and carefully and differential diagnosis must also perform it exactly. It is because medical treatment may differ depending on diagnosis. If this is not made appropriately, it may lead to medication of an unnecessary and aimless antipsychotic. In this paper, diagnosis and differential diagnosis of schizophrenia, and clinical course were summarized.

  13. Molecular Diagnosis of Phytoplasmas

    Directory of Open Access Journals (Sweden)

    C. Marzachì

    2004-08-01

    Full Text Available Phytoplasmas are wall-less prokaryotes associated with diseases in numerous plant species worldwide. In nature they are transmitted by phloem-sucking insects. Yellowing, decline, witches’ broom, leaf curl, floral virescence and phyllody are the most conspicuous symptoms associated with phytoplasmas, although infections are sometimes asymptomatic. Since phytoplasmas cannot be cultured in vitro, molecular techniques are needed for their diagnosis and characterization. The titer of phytoplasma cells in the phloem of infected plants may vary according to the season and the plant species, and it is often very low in woody hosts. Different DNA extraction procedures have therefore been tried out to obtain phytoplasma DNA at a concentration and purity high enough for effective diagnosis. DNA/DNA hybridization methods were reported in the nineties to be appropriate for the detection of phytoplasmas, but at present PCR is considered the most suitable. Universal and group-specific primers have been designed on the rRNA operon of the phytoplasma genome and on plasmid sequences. RFLP analysis of the obtained amplicons has classified these pathogens into major 16Sr RNA groups. Group-specific primers have also been designed on other genomic sequences. PCR is a very sensitive technique, but due to the low titre of phytoplasmas a further increase in sensitivity may be required for accurate diagnosis. This is routinely obtained with a second round of PCR (nested PCR. The drawback of nested PCR is that there is a greater chance of obtaining false positives due to contamination. Many authors have therefore developed protocols based on hybridization (PCR/dot blot or serological approaches (PCR/ELISA to increase the sensitivity and specificity of the direct PCR, reducing the risks due to nested PCR. Real time PCR protocols may also improve the sensitivity and specificity of the direct PCR assay.

  14. Burnout: a fashionable diagnosis.

    Science.gov (United States)

    Kaschka, Wolfgang P; Korczak, Dieter; Broich, Karl

    2011-11-01

    "Burnout syndrome" is now a common reason for medical excuses from work, and thus an important topic in health-related economics. Much research is still needed, however, to establish the scientific basis for this entity, the criteria by which it might be diagnosed and classified, and how it should be treated. A systematic review of this topic, previously published as an HTA report, is presented here together with a selective overview of pertinent literature. There currently exists neither an officially accepted definition nor a valid instrument for the differential diagnosis of burnout syndrome. Its manifestations are generally considered to lie along three dimensions: emotional exhaustion, depersonalization, and reduced performance ability and/or motivation. Most of the available studies on its epidemiology and differential diagnosis provide no more than a low level of evidence for their conclusions. There have been no controlled trials of treatments for burnout. High-quality controlled studies on burnout syndrome are lacking. A standardized and internationally accepted diagnostic instrument with a validated rating scale should be developed. There is also a need for epidemiological and health-economic studies on the prevalence, incidence, and cost of burnout. The etiology and pathogenesis of burnout should be studied with special regard to the possible role of neurobiological factors. Treatments for it should be studied systematically so that their effects can be judged at a high level of evidence. In view of the current lack of knowledge about what is called "burnout," the term should not be used as a medical diagnosis or as a basis for decisions regarding disability or other socioeconomic matters.

  15. Tarsaltunnel syndrome - MRI diagnosis

    International Nuclear Information System (INIS)

    Trattnig, S.; Helbich, T.; Imhof, H.

    1995-01-01

    Clinical findings and symptoms of tarsal tunnel are commonly vague and diffuse and electrodiagnostic studies do not provide definitive diagnosis. MR imaging with its excellent soft tissue contrast can demonstrate clearly the anatomy of the tarsal tunnel and its contents. MRI is able to demonstrate a space-occypyinglesion and its relationship to the posterior tibial nerve and its branches. This information aids in surgical planning by determining the extent of the decompression required. MR imaging may also be used to follow up non-surgical causes of tarsal tunnel syndrome such as tenosynovitis. (orig.) [de

  16. Elementwise Business Diagnosis of Enterprise Activity

    OpenAIRE

    Skrynkovskyy Ruslan M.

    2016-01-01

    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 ins...

  17. Laboratory diagnosis of leptospirosis

    Directory of Open Access Journals (Sweden)

    Ahmad S

    2005-01-01

    Full Text Available Leptospirosis is a worldwide zoonosis caused by pathogenic Leptospira species, for which humans are accidental hosts. It is endemic in the tropical urban areas including our country, where seasonal epidemics are becoming increasingly common. Laboratory tests are necessary to confirm the diagnosis of clinically suspected leptospirosis due to its varied symptomatology. Moreover, leptospirosis must always be considered during the differential diagnosis of other tropical febrile illnesses .Laboratory analysis depends on the samples available and temporal stage of the illness. A confusing array of laboratory tests is described for the detection of this spirochete and antibodies. The conventional tests include direct microscopy, culture and the most widely used reference standard method -the microscopic agglutination test. In addition a variety of newer serological tests and those based on molecular techniques have been described.This review has attempted to describe the basis of these techniques and discussed the relative advantages and drawbacks of these assays with special emphasis on the selection of the most appropriate specimen and test, and the correct interpretation of the test result

  18. [Diagnosis of bacterial vaginosis].

    Science.gov (United States)

    Djukić, Slobodanka; Ćirković, Ivana; Arsić, Biljana; Garalejić, Eliana

    2013-01-01

    Bacterial vaginosis is a common, complex clinical syndrome characterized by alterations in the normal vaginal flora. When symptomatic, it is associated with a malodorous vaginal discharge and on occasion vaginal burning or itching. Under normal conditions, lactobacilli constitute 95% of the bacteria in the vagina. Bacterial vaginosis is associated with severe reduction or absence of the normal H2O2-producing lactobacilli and overgrowth of anaerobic bacteria and Gardnerella vaginalis, Atopobium vaginae, Mycoplasma hominis and Mobiluncus species. Most types of infectious disease are diagnosed by culture, by isolating an antigen or RNA/DNA from the microbe, or by serodiagnosis to determine the presence of antibodies to the microbe. Therefore, demonstration of the presence of an infectious agent is often a necessary criterion for the diagnosis of the disease. This is not the case for bacterial vaginosis, since the ultimate cause of the disease is not yet known. There are a variety of methods for the diagnosis of bacterial vaginosis but no method can at present be regarded as the best. Diagnosing bacterial vaginosis has long been based on the clinical criteria of Amsel, whereby three of four defined criteria must be satisfied. Nugent's scoring system has been further developed and includes validation of the categories of observable bacteria structures. Up-to-date molecular tests are introduced, and better understanding of vaginal microbiome, a clear definition for bacterial vaginosis, and short-term and long-term fluctuations in vaginal microflora will help to better define molecular tests within the broader clinical context.

  19. Early diagnosis of leptospirosis

    Directory of Open Access Journals (Sweden)

    Andrea Babic-Erceg

    2014-06-01

    Full Text Available A 25-years old man from Zagreb, Croatia, was admitted to the University Hospital for Infectious Diseases four days after the onset of symptoms such as fever, intense pain in the calves and anuria. The patient owned a rabbit and, before the onset of the disease, repaired some rubber pipes damaged by rodents. At admission, he had a severe clinical picture with fever, hypotension, jaundice, immobility, and pain in leg muscles. Treatment with ceftriaxone was initiated in combination with volume restitution. Renal failure soon ensued. Consequently continuous venovenous hemodiaphiltration therapy was performed. Due to acute respiratory distress syndrome, the patient was mechanically ventilated. The patient’s condition gradually improved and he recovered fully from multi-organ failure. Diagnosis was confirmed by a microscopic agglutination test (MAT covering 15 leptospira serovars and real-time polymerase-chain reaction (PCR. The first serum sample taken on day 6 tested negative for leptospira, while PCR showed positive results for leptospiral DNA. The second serum sample taken on day 13 tested positive for serovar Canicola serogroup Canicola, serovar Patoc, serovar Grippotyphosa serogroup Grippotyphosa and serovar Tarassovi serogroup Tarassovi (titre 4000, 4000, 1000 and 2000, respectively, while PCR was negative. This report highlights the benefits of combining MAT and PCR methods in early diagnosis of leptospirosis.

  20. Differential diagnosis of hyponatraemia.

    LENUS (Irish Health Repository)

    Thompson, Chris

    2012-03-01

    The appropriate management of hyponatraemia is reliant on the accurate identification of the underlying cause of the hyponatraemia. In the light of evidence which has shown that the use of a clinical algorithm appears to improve accuracy in the differential diagnosis of hyponatraemia, the European Hyponatraemia Network considered the use of two algorithms. One was developed from a nephrologist\\'s view of hyponatraemia, while the other reflected the approach of an endocrinologist. Both of these algorithms concurred on the importance of assessing effective blood volume status and the measurement of urine sodium concentration in the diagnostic process. To demonstrate the importance of accurate diagnosis to the correct treatment of hyponatraemia, special consideration was given to hyponatraemia in neurosurgical patients. The differentiation between the syndrome of inappropriate antidiuretic hormone secretion (SIADH), acute adrenocorticotropic hormone (ACTH) deficiency, fluid overload and cerebral salt-wasting syndrome was discussed. In patients with SIADH, fluid restriction has been the mainstay of treatment despite the absence of an evidence base for its use. An approach to using fluid restriction to raise serum tonicity in patients with SIADH and to identify patients who are likely to be recalcitrant to fluid restriction was also suggested.

  1. Diagnosis of Cytomegalovirus Infections

    Science.gov (United States)

    Ross, S.A.; Novak, Z.; Pati, S.; Boppana, S.B.

    2013-01-01

    Cytomegalovirus (CMV) is recognized as the most common congenital viral infection in humans and an important cause of morbidity and mortality in immunocompromised hosts. This recognition of the clinical importance of invasive CMV disease in the setting of immunodeficiency and in children with congenital CMV infection has led to the development of new diagnostic procedures for the rapid identification of immunocompromised individuals with CMV disease, as well as fetuses and infants with congenital infection. Diagnosis of acute maternal CMV infection by the presence of IgM and low IgG avidity requires confirmation of fetal infection which is typically performed by CMV PCR of the amniotic fluid. Viral culture of the urine and saliva obtained within the first two weeks of life continue to be the gold standard for diagnosis of congenitally infected infants. PCR assays of dried blood spots from infants have not been shown to have sufficient sensitivity for the identification of most infants with congenital CMV infection. However, saliva PCR assays are currently being assessed as a useful screening method for congenital CMV infection. In the immunocompromised host, newer rapid diagnostic assays such as pp65 antigenemia and real-time CMV PCR of blood or plasma have allowed for preemptive treatment reducing morbidity and mortality. However, lack of standardized real-time PCR protocols hinders the comparison of the data across different centers and the development of uniform guidelines for the management of invasive CMV infections in immunocompromised individuals. PMID:21827433

  2. Image diagnosis of hyperparathyroidism

    International Nuclear Information System (INIS)

    Morikawa, Mitsuru; Saga, Yuuji; Watabe, Yoshihiko; Fujisawa, Makoto; Kaneko, Shigeo; Tokunaka, Sohei; Yachiku, Sunao

    1989-01-01

    Between January, 1983 and January 1988, the diagnosis of hyperparathyroidism was made on 14 patients (8 primary and 6 secondary), and was identified operatively in all. The procedures for image diagnosis were computed tomography (CT), ultrasonography and scintigraphy. Scintigraphy was performed using Tc-99m and T1-201 by a subtraction technique. For primary hyperparathyroidism, the accuracy of localization was 100% by CT, 87.5% by ultrasonography, 100% by scintigraphy, and 100% by the combination of these three methods. For secondary hyperparathyroidism, it was 68% by CT, 68% by ultrasonography, 36% by scintigraphy and 84% by the combination of these three methods. Ultrasonography and CT were quite useful for imaging of small abnormal parathyroid glands. The accuracy of scintigraphy in secondary hyperparathyroidism was low. Because the swellings of glands do not occur equally in most secondary hyperparathyroidism cases, we consider that large glands absorb the majority of injected radionuclides. Some discussion on merits and demerits of each image procedure was done. (author)

  3. JUVENILE DERMATOMIYOSITIS: PENEGAKAN DIAGNOSIS

    Directory of Open Access Journals (Sweden)

    Flora Ramona Sigit Prakoeswa

    2015-06-01

    Full Text Available Juvenile dermatomiyositis (JDM merupakan suatu penyakit autoimun infl amatif yang jarang dijumpai dan secara khas ditandai oleh adanya lesi-lesi kulit tipikal serta kelemahan otot proksimal yang simetris. Etiologi penyakit tersebut belum diketahui dengan pasti, namun demikian patogenesisnya diketahui bersifat multifaktorial meliputi faktor genetik, paparan sinar ultra violet (UV serta infeksi oleh berbagai mikroba seperti virus Coxsackie atau Borrelia burgdorferi. Penegakan diagnosis JDM adalah berdasarkan kriteria Bohan-Peter meliputi: 1 kelemahan otot proksimal simetris, 2 peningkatan enzim otot, 3 infl amasi miopati pada hasil biopsi otot 4 gambaran miyopati pada hasil pemeriksaan EMG, dan 5 lesi kulit tipikal. Ditemukannya papul-papul Gottron dan heliotrope rash di kulit, serta adanya kelemahan otot proksimal yang simetris, merupakan manifestasi klinis yang khas untuk JDM. Terapi lini pertama penatalaksanaan JDM adalah kortikosteroid sistemik. Dilaporkan satu kasus JDM pada seorang anak perempuan berusia 6 tahun. Diagnosis ditegakkan berdasarkan adanya lesi kulit tipikal, kelemahan otot proksimal simetris dan peningkatan kadar enzim penanda infl amasi jaringan muskuloskeletal. Pasien berespon baik terhadap pemberian kortikosteroid adekuat serta tabir surya. Kata Kunci: Juvenile dermatomiyositis, systemic corticosteroid

  4. CT Diagnosis of Appendicitis

    Directory of Open Access Journals (Sweden)

    Christopher Libby

    2017-01-01

    Full Text Available History of present illness: A 19-year-old male with no previous medical history presented with 7/10 non-radiating, constant, sharp, periumbilical pain associated with nausea, and four episodes of vomiting. He was seen at urgent care where his labs showed a WBC of 16,000/mcL. He was subsequently sent to the emergency department (ED for concern of appendicitis. Of note, his pain worsened with bumps during the drive to the ED. After arriving to the ED the pain migrated to the right lower quadrant. Computed tomography (CT revealed acute appendicitis and the patient was admitted to the surgery service and taken to the operating room (OR for an appendectomy. Significant findings: The CT abdomen/pelvis with IV contrast shows a dilated appendix (see red outline with thickened, hyperenhancing wall (see blue outline best visualized in the axial and coronal planes. Discussion: Appendicitis is a common diagnosis in the emergency department in patients presenting with abdominal pain, occurring most frequently in young adults with a peak incidence in those aged 10-19.1 Failure to quickly diagnose acute appendicitis can result in perforation rates as high as 80 percent.2 While the diagnosis of appendicitis can be made clinically, CT is a non-invasive modality that improves the detection of appendicitis with sensitivities of 88–100%, specificities of 91–99%, positive predictive values of 92–98%, negative predictive values of 95–100%, and accuracies of 94–98%.3-8 The major advantage of CT over both clinical exam and ultrasound is the ability of the radiologist to exclude acute appendicitis if the appendix appears normal. However, CT carries the risks associated with ionizing radiation. While previously there was some debate on the best choice for type of CT scan and use of IV and oral contrast, recent studies have shown that CT abdomen/pelvis with IV contrast alone is sufficient for diagnosis of appendicitis.9, 10

  5. [Clinical diagnosis of dyslexia].

    Science.gov (United States)

    Martínez Hermosillo, A; Balderas Gil, A

    1980-01-01

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

  6. Cancer diagnosis program

    International Nuclear Information System (INIS)

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

    1981-01-01

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

  7. Diagnosis of fatty liver

    International Nuclear Information System (INIS)

    Saitoh, Shuichi; Nagamine, Takeaki; Takagi, Hitoshi

    1988-01-01

    Diagnostic values of various ultrasonographic findings were evaluated from fatty infiltration ratio calculated by liver specimens in 42 patients. The ratio of the CT number of liver to those of spleen were also compared with fatty infiltration ratio in 11 patients. Fatty bandless sign one plus (perirenal bright echo between the liver and the right kidney is masked partially) or more and the fatty score 3 (it is calculated by several ultrasonographic findings) and the less than 0.90 of the ratio of CT number of liver to those of spleen were useful for diagnosis of fatty liver, the sensitivity was 100%, 87.5%, 85.7% and the accuracy was 78.1%, 81.8%, 81.8% respectively. It was considered that these criteria were suitable in screening study of fatty liver. (author)

  8. Radiological diagnosis in traumatology

    International Nuclear Information System (INIS)

    Frahm, R.

    2001-01-01

    This loose-leaf publication covers all radiological problems that may possibly occur in accident surgery. The focus is on conventional radiological diagnosis. The physical and technical fundamentals of diagnostic examination methods are discussed, followed by practical hints on radiation protection, technical equipment and quality assurance, as well as accurate information on the procedure of taking and interpreting standard X-ray pictures. The indications for standard X-raying, tomography, CT and MRT are presented in consideration of the radiation exposure incurred by the patient. The reader is also informed on the dynamics and varying morphology of bone fracture healing, potential disturbances of callus formation and reconstruction, as well as on possible complications. The main section of the book discusses injuries of the skull, spinal cord, pectoral girdle, upper arm, elbow and lower arm, wrist and hands, pelvis, hip joint, knee and upper and lower leg, ankle joint and foot, thorax and abdomen. (orig.)

  9. [Headache: classification and diagnosis].

    Science.gov (United States)

    Carbaat, P A T; Couturier, E G M

    2016-11-01

    There are many types of headache and, moreover, many people have different types of headache at the same time. Adequate treatment is possible only on the basis of the correct diagnosis. Technically and in terms of content the current diagnostics process for headache is based on the 'International Classification of Headache Disorders' (ICHD-3-beta) that was produced under the auspices of the International Headache Society. This classification is based on a distinction between primary and secondary headaches. The most common primary headache types are the tension type headache, migraine and the cluster headache. Application of uniform diagnostic concepts is essential to come to the most appropriate treatment of the various types of headache.

  10. Radiological diagnosis of neurotuberculosis

    International Nuclear Information System (INIS)

    Backmund, H.

    1983-01-01

    An important role is attributed to computer tomography in the neuroradiological diagnosis of central tuberculosis today. Tuberculomas are impressive as areas of pathological tissue with pronounced storage of contrast medium. Additional angiography may be necessary for the delimination of original brain tumors and metastases. In tuberculous meningitis an internal hydrocephalus is the most frequent finding. Depending on the duration and acuity of the disease process a contrast storage in the region of the basal subarachnoid spaces may appear as a characteristic sign. Among our own patients we found in 3 with confirmed tuberculous meningitis, circulation-dependent necroses in the region of the knee of the internal capsule, sometimes with extension into the anterior nuclear area of the thalamus. (orig.) [de

  11. Radiological diagnosis of neurotuberculosis

    Energy Technology Data Exchange (ETDEWEB)

    Backmund, H.

    1983-02-18

    An important role is attributed to computer tomography in the neuroradiological diagnosis of central tuberculosis today. Tuberculomas are impressive as areas of pathological tissue with pronounced storage of contrast medium. Additional angiography may be necessary for the delimination of original brain tumors and metastases. In tuberculous meningitis an internal hydrocephalus is the most frequent finding. Depending on the duration and acuity of the disease process a contrast storage in the region of the basal subarachnoid spaces may appear as a characteristic sign. Among our own patients we found in 3 with confirmed tuberculous meningitis, circulation-dependent necroses in the region of the knee of the internal capsule, sometimes with extension into the anterior nuclear area of the thalamus.

  12. 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 

  13. Diagnosis of PRRS

    DEFF Research Database (Denmark)

    Bøtner, Anette

    1997-01-01

    This paper reviews various diagnostic methods for the detection of porcine reproductive and respiratory syndrome (PRRS) virus or antibodies to PRRS virus reported during the period from 1991 to 1995. In addition, experience from a European Community Concerted Action and especially Danish experien......This paper reviews various diagnostic methods for the detection of porcine reproductive and respiratory syndrome (PRRS) virus or antibodies to PRRS virus reported during the period from 1991 to 1995. In addition, experience from a European Community Concerted Action and especially Danish...... experiences concerning serological tests are presented. It is concluded that, in general, serological diagnosis with a high specificity and sensitivity is easy to perform on a herd level. However, no serological test has proven to be suitable for individual animal certification....

  14. [Communication disorders: differential diagnosis].

    Science.gov (United States)

    Campos-Castelló, J; Briceño-Cuadros, S

    To evaluate components of clinical semiology in the differential diagnosis of communication disorders (TC) and their possible biological markers. We consider two groups, according to the communication disorders themselves and their effects on social interaction. In the first case both aspects are affected in parallel and in the second it is predominantly social interaction which is affected. In the first groups we studied dyslalias, dyrhrythmias, acquired aphasias, TC relation to epilepsy, types of seizures and EEG discharges. The dysphasia of development and epilepsy may be associated by chance, as a result of the same cause or the epilepsy be responsible for the TC, either because of seizures or continuously (acquired epileptic aphasia, SLK). Based on personal data and the literature we studied the semiology, possible biological markers and differential diagnosis. We consider disorders of neurone migration and metabolic alterations of initial neuropsychological semiology and cerebellar anomalies involved in cognitive functions. In the second group we assessed autism, generalized disorders of development and particular syndromes with semantic pragmatic TC. The development of language cannot be separated from other aspects of neurological maturation. One cannot affirm that there is a direct relationship between epilepsy and TC, although this does occur in some cases. We accept the hypothesis that SLK, POCSL and atypical EPB are clinical forms of the same syndrome of epilepsy. Recognition of the cognitive affective cerebellar syndrome by its involvement in social executive function, language and personality characterizes certain conditions (Williams, Asperger, fragile X, autism). A progressive rational battery of complementary studies on clinical data is essential to determine biological markers in syndromes which still lack them.

  15. Diagnosis of bacterial vaginosis

    Directory of Open Access Journals (Sweden)

    Đukić Slobodanka

    2013-01-01

    Full Text Available Bacterial vaginosis is a common, complex clinical syndrome characterized by alterations in the normal vaginal flora. When symptomatic, it is associated with a malodorous vaginal discharge and on occasion vaginal burning or itching. Under normal conditions, lactobacilli constitute 95% of the bacteria in the vagina. Bacterial vaginosis is associated with severe reduction or absence of the normal H2O2­producing lactobacilli and overgrowth of anaerobic bacteria and Gardnerella vaginalis, Atopobium vaginae, Mycoplasma hominis and Mobiluncus species. Most types of infectious disease are diagnosed by culture, by isolating an antigen or RNA/DNA from the microbe, or by serodiagnosis to determine the presence of antibodies to the microbe. Therefore, demonstration of the presence of an infectious agent is often a necessary criterion for the diagnosis of the disease. This is not the case for bacterial vaginosis, since the ultimate cause of the disease is not yet known. There are a variety of methods for the diagnosis of bacterial vaginosis but no method can at present be regarded as the best. Diagnosing bacterial vaginosis has long been based on the clinical criteria of Amsel, whereby three of four defined criteria must be satisfied. Nugent’s scoring system has been further developed and includes validation of the categories of observable bacteria structures. Up­to­date molecular tests are introduced, and better understanding of vaginal microbiome, a clear definition for bacterial vaginosis, and short­term and long­term fluctuations in vaginal microflora will help to better define molecular tests within the broader clinical context.

  16. 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

  17. 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.

  18. CRD lifetime diagnosis device

    International Nuclear Information System (INIS)

    Konno, Takahiro.

    1990-01-01

    Reliability analysis has been conducted by retrieving information concerning disadvantages and failures in the past of instruments and parts, and average life time, rate of failure and state of failures have been analized. Further remaining life time has been estimated for each of them independently by the trend control and reliability analysis for the instruments and parts. However, there were neither actual cases that disadvantages and failures occurred in the past for the CRD (control rod drives) nor such cases of conducting the remaining life diagnosis method, e.g., trend control and reliability analysis in comparison for one instrument collectively. Then, in the present invention, information analyzing data base obtained by an acceleration test for CRD and trend analyzing data base comprising the trend information are used to constitute a means for obtaining the remaining life for reliability and that for the trend, and a means for estimating the remaining life of CRD by comparing both of the remaining lives, thereby enabling to obtain a desired value at a high accuracy. (N.H.)

  19. Diagnosis of brain death

    Directory of Open Access Journals (Sweden)

    Calixto Machado

    2010-06-01

    Full Text Available Brain death (BD should be understood as the ultimate clinical expression of a brain catastrophe characterized by a complete and irreversible neurological stoppage, recognized by irreversible coma, absent brainstem reflexes, and apnea. The most common pattern is manifested by an elevation of intracranial pressure to a point beyond the mean arterial pressure, and hence cerebral perfusion pressure falls and, as a result, no net cerebral blood flow is present, in due course leading to permanent cytotoxic injury of the intracranial neuronal tissue. A second mechanism is an intrinsic injury affecting the nervous tissue at a cellular level which, if extensive and unremitting, can also lead to BD. We review here the methodology of diagnosing death, based on finding any of the signs of death. The irreversible loss of cardio-circulatory and respiratory functions can cause death only when ischemia and anoxia are prolonged enough to produce an irreversible destruction of the brain. The sign of such loss of brain functions, that is to say BD diagnosis, is fully reviewed.

  20. Syncope: Approach to diagnosis

    Directory of Open Access Journals (Sweden)

    Om Murti Anil

    2016-01-01

    Full Text Available Syncope is a transient loss of consciousness (LOC due to transient global cerebral hypoperfusion characterized by rapid onset, short duration, and spontaneous complete recovery. Here, the term "transient LOC" encompasses all disorders characterized by self-limited LOC irrespective of the mechanism. Central point in pathophysiology of the development of syncope is fall in systemic blood pressure (BP with a decrease in global cerebral blood flow. The evaluation and treatment of syncope are very challenging because syncope is not the only cause of transient LOC. Moreover, symptoms of syncope are fleeting, patient is usually asymptomatic at the time of evaluation, and most of the events are often unwitnessed. The guiding principle of assessment is to differentiate syncope from other causes of transient LOC and the more benign causes of syncope from the potentially serious ones. Initial assessment of syncope consists of a detailed history and examination complemented by 12-lead electrocardiography and supine and standing BP. If the cause is suspected, then further investigations may be needed to confirm the particular disorder. A deliberate approach based on initial risk stratification is more likely to give a correct diagnosis. Despite the difficulties, a thorough evaluation of the cause of syncope is warranted in all patients, not just in those deemed to be at high mortality risk. The goal in every case should be to determine the cause with sufficient confidence to provide a reliable assessment of prognosis and treatment options.

  1. Analysis of CTG repeat length variation in the DMPK gene in the general population and the molecular diagnosis of myotonic dystrophy type 1 in Malaysia.

    Science.gov (United States)

    Ambrose, Kathlin K; Ishak, Taufik; Lian, Lay-Hoong; Goh, Khean-Jin; Wong, Kum-Thong; Ahmad-Annuar, Azlina; Thong, Meow-Keong

    2017-03-31

    The lack of epidemiological data and molecular diagnostic services in Malaysia has hampered the setting-up of a comprehensive management plan for patients with myotonic dystrophy type 1 (DM1), leading to delayed diagnosis, treatment and support for patients and families. The aim of this study was to estimate the prevalence of DM1 in the 3 major ethnic groups in Malaysia and evaluate the feasibility of a single tube triplet-primed PCR (TP-PCR) method for diagnosis of DM1 in Malaysia. We used PCR to determine the size of CTG repeats in 377 individuals not known to be affected by DM and 11 DM1 suspected patients, recruited from a tertiary hospital in Kuala Lumpur. TP-PCR was performed on selected samples, followed by Southern blot hybridisation of PCR amplified fragments to confirm and estimate the size of CTG expansion. The number of individuals not known to be affected by DM with (CTG) >18 was determined according to ethnic group and as a whole population. The χ 2 test was performed to compare the distribution of (CTG) >18 with 12 other populations. Additionally, the accuracy of TP-PCR in detecting CTG expansion in 11 patients with DM1 was determined by comparing the results with that from Southern blot hybridisation. Of the 754 chromosomes studied, (CTG) >18 frequency of 3.60%, 1.57% and 4.00% in the Malay, Chinese and Indian subpopulations, respectively, was detected, showing similarities to data from Thai, Taiwanese and Kuwaiti populations. We also successfully detected CTG expansions in 9 patients using the TP-PCR method followed by the estimation of CTG expansion size via Southern blot hybridisation. The results show a low DM1 prevalence in Malaysia with the possibility of underdiagnosis and demonstrates the feasibility of using a clinical and TP-PCR-based approach for rapid and cost-effective DM1 diagnosis in developing countries. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  2. Onychomycosis: Diagnosis and management

    Directory of Open Access Journals (Sweden)

    Archana Singal

    2011-01-01

    Full Text Available Onychomycosis is a common nail ailment associated with significant physical and psychological morbidity. Increased prevalence in the recent years is attributed to enhanced longevity, comorbid conditions such as diabetes, avid sports participation, and emergence of HIV. Dermatophytes are the most commonly implicated etiologic agents, particularly Trichophyton rubrum and Trichophyton mentagrophytes var. interdigitale, followed by Candida species and non dermatophytic molds (NDMs. Several clinical variants have been recognized. Candida onychomycosis affects fingernails more often and is accompanied by paronychia. NDM molds should be suspected in patients with history of trauma and associated periungual inflammation. Diagnosis is primarily based upon KOH examination, culture and histopathological examinations of nail clippings and nail biopsy. Adequate and appropriate sample collection is vital to pinpoint the exact etiological fungus. Various improvisations have been adopted to improve the fungal isolation. Culture is the gold standard, while histopathology is often performed to diagnose and differentiate onychomycosis from other nail disorders such as psoriasis and lichen planus. Though rarely used, DNA-based methods are effective for identifying mixed infections and quantification of fungal load. Various treatment modalities including topical, systemic and surgical have been used.Topically, drugs (ciclopirox and amorolfine nail lacquers are delivered through specialized transungual drug delivery systems ensuring high concentration and prolonged contact. Commonly used oral therapeutic agents include terbinafine, fluconazole, and itraconazole. Terbinafine and itraconazole are given as continuous as well as intermittent regimes. Continuous terbinafine appears to be the most effective regime for dermatophyte onychomycosis. Despite good therapeutic response to newer modalities, long-term outcome is unsatisfactory due to therapeutic failure, relapse

  3. Primary care physician perceptions on the diagnosis and management of chronic obstructive pulmonary disease in diverse regions of the world

    Directory of Open Access Journals (Sweden)

    Aisanov Z

    2012-04-01

    information on the management of COPD patients in primary care. A web-based pilot survey was conducted to evaluate the primary care physician's, or general practitioner's (GP's, knowledge, understanding, and management of COPD in twelve territories across the Asia-Pacific region, Africa, eastern Europe, and Latin America, using a 10-minute questionnaire comprising 20 questions and translated into the native language of each participating territory. The questionnaire was administered to a total of 600 GPs (50 from each territory involved in the management of COPD patients and all data were collated and analyzed by an independent health care research consultant. This survey demonstrated that the GPs' understanding of COPD was variable across the territories, with large numbers of GPs having very limited knowledge of COPD and its management. A consistent finding across all territories was the underutilization of spirometry (median 26%; range 10%–48% and reliance on X-rays (median 14%; range 5%–22% for COPD diagnosis, whereas overuse of blood tests (unspecified was particularly high in Russia and South Africa. Similarly, there was considerable underrecognition of the importance of exacerbation history as an important factor of COPD and its initial management in most territories (median 4%; range 0%–22%. Management of COPD was well below guideline-recommended levels in most of the regions investigated. The findings of this survey suggest there is a need for more ongoing education and information, specifically directed towards GPs outside of Europe and North America, and that global COPD guidelines appear to have limited reach and application in most of the areas studied.Keywords: COPD, questionnaire, survey, guidelines

  4. [The early diagnosis of spondyloarthritis].

    Science.gov (United States)

    Novak, Srdan

    2011-01-01

    The most frequent early symptoms of spondyloarthritides are inflammatory back pain and asymetric peripheral arthritis. Currently the mean delay between the onset of first symptoms and diagnosing ankylosing spondylitis which is the frequent type of spondyloarthritis is over 5 years. The availability of effective therapies makes an early diagnosis mandatory. The clinical symptoms of inflammatory back pain, active inflamation on MR, and positivity for HLA-B27 are the most important parameters for an early diagnosis of spondyloarthritis, especially in combination. Moreover, the combination of clinical and laboratory parameters is necessary for the early diagnosis.

  5. 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.

  6. Prenatal Diagnosis of Osteogenesis Imperfecta

    Directory of Open Access Journals (Sweden)

    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.

  7. New vistas in endodontic diagnosis

    Directory of Open Access Journals (Sweden)

    Shashi Prabha Tyagi

    2012-01-01

    Full Text Available In the recent times no other field has shown so much growth in Endodontics as much as that of diagnosis. The human element in diagnosis is enriched by newer technologies available as adjuncts to the process of endodontic diagnosis. The trend of this development has been toward increasing objectivity sensitivity and reproducibility of the pulp tests while decreasing the patient discomfort. Methods like Pulse Oximetry, Laser Doppler Flowmetry, Ultrasound Doppler, Dual Wavelength Spectroscopy, Photoplethysmography besides the thermographic imaging and calorimetric pulp tests are being developed and evolved to suit the current clinical setting for the modern endodontist. A necessity arises here to keep abreast of all the new methods in order to be able to choose the best tools for the successful diagnostician. The aim of this review therefore was to assess the usefulness of some devices and techniques used in endodontic therapy to make the correct pulpal diagnosis.

  8. 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.

  9. 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.

  10. Parkinson's Disease: Diagnosis and Treatment

    Science.gov (United States)

    ... of this page please turn JavaScript on. Feature: Parkinson's Disease Parkinson's Disease: Diagnosis and Treatment Past Issues / Winter 2014 Table of Contents Medications for Parkinson's disease can help many patients live productive lives and ...

  11. [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.

  12. 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.

  13. Image diagnosis of malignant mesothelioma

    International Nuclear Information System (INIS)

    Niimi, Akiko; Ueno, Keiko; Isobe, Yoshinori; Hirayama, Akira

    1987-01-01

    3 cases of malignant mesothelioma confirmed by pathological examination were reported. CT showed solid mass with moderate enhancement by contrast medium. CT appears to be a very useful tool to make a diagnosis of malignant mesothelioma. (author)

  14. Fault diagnosis of induction motors

    CERN Document Server

    Faiz, Jawad; Joksimović, Gojko

    2017-01-01

    This book is a comprehensive, structural approach to fault diagnosis strategy. The different fault types, signal processing techniques, and loss characterisation are addressed in the book. This is essential reading for work with induction motors for transportation and energy.

  15. [Etiological diagnosis of leg ulcers].

    Science.gov (United States)

    Debure, Clélia

    2010-09-20

    Etiological diagnosis of leg ulcers must be the first step of treatment, even if we know that veinous disease is often present. We can build a clinical decisional diagram, which helps us to understand and not forget the other causes of chronic wounds and choose some basic examination, like ultrasound and histological findings. This diagnosis helps to choose the right treatment in order to cure even the oldest venous ulcers. Educational programs should be improved to prevent recurrence.

  16. DNA Sensors for Malaria Diagnosis

    DEFF Research Database (Denmark)

    Hede, Marianne Smedegaard; Fjelstrup, Søren; Knudsen, Birgitta R.

    2015-01-01

    In the field of malaria diagnosis much effort is put into the development of faster and easier alternatives to the gold standard, blood smear microscopy. Nucleic acid amplification based techniques pose some of the most promising upcoming diagnostic tools due to their potential for high sensitivi......, robustness and user-friendliness. In the current review, we will discuss some of the different DNA-based sensor systems under development for the diagnosis of malaria....

  17. Endoscopic tissue diagnosis of cholangiocarcinoma.

    LENUS (Irish Health Repository)

    Harewood, Gavin C

    2008-09-01

    The extremely poor outcome in patients with cholangiocarcinoma, in large part, reflects the late presentation of these tumors and the challenging nature of establishing a tissue diagnosis. Establishing a diagnosis of cholangiocarcinoma requires obtaining evidence of malignancy from sampling of the epithelium of the biliary tract, which has proven to be challenging. Although endoscopic ultrasound-guided fine needle aspiration performs slightly better than endoscopic retrograde cholangiopancreatography in diagnosing cholangiocarcinoma, both endoscopic approaches demonstrate disappointing performance characteristics.

  18. 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.

  19. Ileocecal endometriosis: diagnosis and management.

    Science.gov (United States)

    López Carrasco, Ana; Hernández Gutiérrez, Alicia; Hidalgo Gutiérrez, Paula A; Rodríguez González, Roberto; Marijuán Martín, José L; Zapardiel, Ignacio; de Santiago García, Javier

    2017-04-01

    Ileocecal endometriosis is rare. Symptoms range from no symptoms, cramps, vomiting, to acute intestinal obstruction. Our objective was to review our cases, clarify, and resume its most appropriate management focusing on the factors to determine diagnosis. This is a retrospective study by revision of medical charts of all ileal endometriosis cases of our unit from 2006 to 2014. Seven cases were found; three (43%) had previous endometriosis laparoscopic diagnosis, four (57%) had partial bowel obstruction episodes, three (43%) had chronic pelvic pain, and one developed acute intestinal obstruction in postoperative ileostomy closure. In three (43%), the diagnosis was made with magnetic resonance imaging (MRI) and double contrast barium enema, in one (14%) only with MRI, and the other three (43%) during surgery. All patients underwent resection of the ileum and evolved favorably. 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. Copyright © 2017. Published by Elsevier B.V.

  20. Diagnosis of skeletal muscle channelopathies.

    Science.gov (United States)

    Spillane, Jennifer; Fialho, Doreen; Hanna, Michael G

    2013-11-01

    Skeletal muscle channelopathies are rare disorders of muscle membrane excitability. Their episodic nature may result in diagnostic difficulty and delays in diagnosis. Advances in diagnostic clinical electrophysiology combined with DNA-based diagnosis have improved diagnostic accuracy and efficiency. Ascribing pathogenic status to identified genetic variants in muscle channel genes may be complex and functional analysis, including molecular expression, may help with this. Accurate clinical and genetic diagnosis enables genetic counselling, advice regarding prognosis and aids treatment selection. An approach to accurate and efficient diagnosis is outlined. The importance of detailed clinical evaluation including careful history, examination and family history is emphasised. The role of specialised electrodiagnostics combined with DNA testing and molecular expression is considered. New potential biomarkers including muscle MRI using MRC Centre protocols are discussed. A combined diagnostic approach using careful clinical assessment, specialised neurophysiology and DNA testing will now achieve a clear diagnosis in most patients with muscle channelopathies. An accurate diagnosis enables genetic counselling and provides information regarding prognosis and treatment selection. Genetic analysis often identifies new variants of uncertain significance. In this situation, functional expression studies as part of a diagnostic service will enable determination of pathogenic status of novel genetic variants.

  1. Five misconceptions in cancer diagnosis

    Science.gov (United States)

    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

  2. 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.

  3. 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

  4. Cardiac Involvement is Underdiagnosed in Patients with Biopsy-Proven Systemic AL Amyloidosis

    Directory of Open Access Journals (Sweden)

    Haoyi Zheng

    2016-01-01

    Diagnosis of cardiac amyloidosis based on presence of heart failure symptoms led to underdiagnosis of cardiac involvement defined by the NCCN criteria. Guideline recommended assessment of cardiac involvement and cardiac response to treatment was not routinely implemented in our cohort.

  5. Misleading diagnosis of retroperitoneal actinomycosis

    Energy Technology Data Exchange (ETDEWEB)

    Berchtenbreiter, C.; Bruening, R.; Reiser, M. [Inst. of Diagnostic Radiology, University Hospital Grosshadern, Ludwig Maximilians University, Munich (Germany); Auernhammer, A. [Medical Clinic II, Univ. Hospital Grosshadern, Ludwig Maximilians University, Munich (Germany)

    1999-07-01

    A 34-year-old woman presented with a left-sided suprarenal space-occupying lesion on sonography. Culture of material obtained during sonographic-guided puncture of the retroperitoneal lesion yielded a mixed flora of Actinomyces and Peptostreptococcus. Initially, a misleading diagnosis of an adrenal pheochromocytoma was initiated by highly positive metaiodobenzylguanidine scintigraphy after chemical chemistry vanillylmandelic acid (VMA) test showed elevated values for adrenaline and its derivatives. Retroperitoneal actinomycosis with yet unproven spread into thoracic and cervical compartments is a particular unusual presentation of an infection with these organisms. Because it may mimic subacute infections or malignant masses in terms of clinical and laboratory findings, radiological diagnosis of this entity may be difficult. The diagnosis was based on results of culture and the response of the patient to long-term penicillin-derivate therapy after surgical drainage of the suprarenal abscess formation. (orig.)

  6. Incidental radiological diagnosis of rickets.

    Science.gov (United States)

    Rennie, L M; Beattie, T F; Wilkinson, A G; Crofton, P; Bath, L E

    2005-08-01

    Rickets fortunately remains rare in the United Kingdom, although its actual incidence is currently undetermined.1 Many still consider it to be a disease of poverty prevalent during the Victorian era. However, a number of recent articles have highlighted concern among British health professionals about the number of cases still being diagnosed in this country. These cases have nearly all involved non-Caucasian children who are considered to be at high risk due to skin colour, prolonged breast feeding, and low maternal vitamin D levels. Their presentations are variable ranging from failure to thrive, bone deformities, seizures, and even stridor. The diagnosis is usually made in babies and toddlers.We present a series of patients attending our accident and emergency (A&E) department, over a five month period, where the diagnosis of rickets was primarily a radiological diagnosis.

  7. Diagnosis of human visceral pentastomiasis.

    Directory of Open Access Journals (Sweden)

    Dennis Tappe

    Full Text Available Visceral pentastomiasis in humans is caused by the larval stages (nymphs of the arthropod-related tongue worms Linguatula serrata, Armillifer armillatus, A. moniliformis, A. grandis, and Porocephalus crotali. The majority of cases has been reported from Africa, Malaysia, and the Middle East, where visceral pentastomiasis may be an incidental finding in autopsies, and less often from China and Latin America. In Europe and North America, the disease is only rarely encountered in immigrants and long-term travelers, and the parasitic lesions may be confused with malignancies, leading to a delay in the correct diagnosis. Since clinical symptoms are variable and serological tests are not readily available, the diagnosis often relies on histopathological examinations. This laboratory symposium focuses on the diagnosis of this unusual parasitic disease and presents its risk factors and epidemiology.

  8. Missed Opportunities for HIV Diagnosis.

    Science.gov (United States)

    Downing, Asia; Garcia-Diaz, Julia B

    It has been previously shown that patients may present for multiple health issues in the years preceding their initial HIV diagnosis. This retrospective cohort study analyzed the data of patients with a new HIV diagnosis, at Ochsner Health System between January 1, 2011, and December 31, 2012. The primary end point was missed opportunities, the number of healthcare visits these patients made in the 2 years prior to being diagnosed with HIV. The 125 patients in the study cohort had 649 healthcare visits during which an HIV test was not performed. These missed opportunities are the key to capturing the undiagnosed and unaware HIV-positive individual. Primary care is an ideal setting to conduct HIV testing for those who have access to regular health care. However, nontraditional providers should also be encouraged to conduct HIV testing regardless of their ability to provide treatment because evidence shows that knowledge of the diagnosis may change behavior.

  9. MRI diagnosis for prostate cancer

    International Nuclear Information System (INIS)

    Tamada, Tsutomu; Nagai, Kiyohisa; Imai, Shigeki; Kajihara, Yasumasa; Jo, Yoshimasa; Tanaka, Hiroyoshi; Fukunaga, Masao; Matsuki, Takakazu

    1998-01-01

    Recently, in Japan, both the Westernization of life styles and the advent of an aged-society have led to an increase in the incidence of prostate cancer. In making a localizing diagnosis of prostate cancer, magnetic resonance imaging (MRI), which has excellent contrast resolution, and transrectal ultrasonography, are used clinically, and their usefulness is being established. MRI is employed in the diagnosis of prostate cancer to detect tumors, and to determine the stage of such tumors. For the visualization of prostate cancer by MRI, T2-weighted axial images are used exclusively. After becoming familiar with normal prostate images, it is important to evaluate the localization of a tumor, and the invasion of the capsule and seminal vesicles. Future applications of new techniques for MRI will undoubtedly be found. In this paper, the present state of MRI diagnosis of prostate cancer at Kawasaki Medical School Hospital will be reviewed. (author)

  10. [Asperger syndrome - a fashionable diagnosis?].

    Science.gov (United States)

    Haker, Helene

    2014-10-01

    The Asperger Syndrome is - in contrast to early childhood autism - a disorder at the lighter end of the autism spectrum. Although first described in 1943, it was included in the ICD-10 not before 1992. The knowledge about this lighter autistic disorder spread only slowly. The increasing prevalence rates can be explained by the increased knowledge about this disorder and the growing clinical experience. In contrast to the public that gives repeated medial attention to it, and to would-be affected who seem to see an attractive excuse for social problems in an Asperger diagnosis, many psychiatrists appear cautious to state a diagnosis with which they are not familiar and which is discredited as a fashionable diagnosis.

  11. [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.

  12. Celiac Disease Diagnosis and Management

    Science.gov (United States)

    Leffler, Daniel

    2012-01-01

    Celiac disease is one of the most prevalent autoimmune gastrointestinal disorders but as the case of Ms. J illustrates, diagnosis is often delayed or missed. Based on serology studies, the prevalence of celiac disease in many populations is estimated to be approximately 1% and has been increasing steadily over the last 50 years. Evaluation for celiac disease is generally straightforward, and uses commonly available serologic tests, however the signs and symptoms of celiac disease are nonspecific and highly heterogeneous making diagnosis difficult. While celiac disease is often considered a mild disorder treatable with simple dietary changes, in reality celiac disease imparts considerable risks including reduced bone mineral density, impaired quality of life, and increased overall mortality. In addition, the gluten free diet is highly burdensome and can profoundly affect patients and their families. For these reasons, care of individuals with celiac disease requires prompt diagnosis and ongoing multidisciplinary management. PMID:21990301

  13. Potential screening and early diagnosis method for cancer: Tongue diagnosis

    Science.gov (United States)

    HAN, SHUWEN; YANG, XI; QI, QUAN; PAN, YUEFEN; CHEN, YONGCHAO; SHEN, JUNJUN; LIAO, HAIHONG; JI, ZHAONING

    2016-01-01

    Tongue diagnosis, as a unique method of traditional Chinese medicine (TCM), was used to discriminate physiological functions and pathological conditions by observing the changes of the tongue and tongue coating. The aims of the present study were to explore a potential screening and early diagnosis method of cancer through evaluating the differences of the images of tongue and tongue coating and the microbiome on the tongue coating. The DS01-B tongue diagnostic information acquisition system was used to photograph and analyze the tongue and tongue coating. The next-generation sequencing technology was used to determine the V2-V4 hypervariable regions of 16S rDNA to investigate the microbiome on the tongue coating. Bioinformatics and statistical methods were used to analyze the microbial community structure and diversity. Comparing with the healthy people, the number of mirror-like tongue, thick tongue coating and the moisture of tongue were increased in cancers. The dominant color of the tongue in the healthy people was reddish while it was purple in the cancers. The relative abundance of Neisseria, Haemophilus, Fusobacterium and Porphyromonas in the healthy people were higher than that in the cancers. We also found 6 kinds of special microorganisms at species level in cancers. The study suggested that tongue diagnosis may provide potential screening and early diagnosis method for cancer. PMID:27035407

  14. Fetal Diagnosis of Infectious Disease: A Lagos Prenatal Diagnosis ...

    African Journals Online (AJOL)

    Prenatal diagnosis of infectious diseases has been shown to be indispensable in order to confirm or exclude in utero infections due to cytomegalovirus, rubella, toxoplasmosis, varicella and hepatitis and multidisciplinary approach is needed. Our report is on data obtained from n=65 pregnant women at risk for the above ...

  15. Optic Neuritis: Another Dickensian Diagnosis.

    Science.gov (United States)

    Petzold, Axel

    2013-01-01

    The clinical diagnosis and natural history of optic neuritis was established in the late 1880s by the ophthalmologists von Graefe and Nettleship. The earlier, accurate and insightful description of transient, bilateral visual loss of Esther, the main character in the Charles Dickens novel Bleak House (1852--1853), suggests optic neuritis as a Dickensian diagnosis. Remarkably, Dickens' observations, also preceding the earliest clinical description of multiple sclerosis by Charcot in 1868, described many clinical features such as a prodromal phase; a nadir; gradual recovery over weeks; glare disability; reduced contrast sensitivity; possibly Uhthoff's phenomenon; and visual fading. All this with an accuracy that, to quote Russell Brain, "would credit a trained physician."

  16. Antenatal diagnosis of congenital deafness.

    Science.gov (United States)

    Isaacson, G

    1988-01-01

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

  17. Radiological diagnosis of pulmonary hypertension

    International Nuclear Information System (INIS)

    Huebsch, P.; Jenny, C.; Schwaighofer, B.; Seidl, G.; Burghuber, O.C.

    1987-01-01

    In 43 patients with obstructive and restrictive lung disease a catheterisation of the right heart with measurement of pulmonary artery pressure was performed. In a retrospective study several radiological parameters of pulmonary hypertension were evaluated on the chest radiographs of these patients. Considering those parameters on the p.a. and lateral chest radiograph, the diagnosis of pulmonary hypertension in patients with elevated pulmonary artery pressure at rest can be made with great accuracy. When pulmonary artery pressure is elevated only during exercise, the accuracy of radiological diagnosis is much lower. (orig.) [de

  18. Laboratorial diagnosis of lymphocytic meningitis

    Directory of Open Access Journals (Sweden)

    Sérgio Monteiro de Almeida

    Full Text Available Meningitis is the main infectious central nervous system (CNS syndrome. Viruses or bacteria can cause acute meningitis of infectious etiology. The term "Aseptic Meningitis" denotes a clinical syndrome with a predominance of lymphocytes in the cerebrospinal fluid (CSF, with no common bacterial agents identified in the CSF. Viral meningitis is considered the main cause of lymphocyte meningitis. There are other etiologies of an infectious nature. CSF examination is essential to establish the diagnosis and to identify the etiological agent of lymphocytic meningitis. We examined CSF characteristics and the differential diagnosis of the main types of meningitis.

  19. Rhabdomyolysis: Pathogenesis, Diagnosis, and Treatment

    Science.gov (United States)

    Torres, Patrick A.; Helmstetter, John A.; Kaye, Adam M.; Kaye, Alan David

    2015-01-01

    Background Rhabdomyolysis is a complex medical condition involving the rapid dissolution of damaged or injured skeletal muscle. Methods This review focuses on the epidemiology, pathophysiology, causes, presentation, diagnosis, complications, management, and anesthetic considerations related to rhabdomyolysis. Results Any form of muscle damage––and by extension any entity that causes muscle damage––can initiate rhabdomyolysis. One of the most important treatment goals when rhabdomyolysis is suspected is avoiding acute kidney injury. Conclusion All clinicians should be aware of common causes, diagnosis, and treatment options. PMID:25829882

  20. Apophatic attending: an essential for pastoral diagnosis.

    Science.gov (United States)

    Rodgerson, Thomas E

    2012-03-01

    While mechanisms for spiritual assessment have multiplied in recent years, specific approaches to pastoral diagnosis have remained elusive. The elusive nature of pastoral diagnosis reminds caregivers of the necessity not only to pay attention to the kataphatic side of pastoral diagnosis, but also to the apophatic side of pastoral diagnosis, ultimately allowing for a kataphatic and apophatic interplay.

  1. Epidural abscess: diagnosis and management

    African Journals Online (AJOL)

    Adele

    Delayed diagnosis of an epidural abscess may cause the death of a patient. Important clinical manifestations include a high fever, back pain and leucocytosis. Due to its rare ... departments with dedicated and specialised nursing. Epidural abscess is both ... removed and sent for bacteriological examination. Neurologi-.

  2. Radioisotopes for diagnosis in urology

    International Nuclear Information System (INIS)

    Galvan, G.

    1980-01-01

    A lecture, held on the occasion of the meeting, organized by the Austrian Company for Urology and the Bavarian Union of Urologists. Kidney diagnosis with means of nuclear medicine technology, scintigraphy of skeleton and candula suprarenalis as well as radioimmunological hormone determination are characterized by a non-invasive, valuable extension of the convential nephrourological diagnosis under a relatively low rate of radioactive emission. In the field of kidney diagnosis the specification of the function of each kidney by means of renography, sequence-scintigraphy and clearance must be regarded as an important factor, especially for the measurement of the degree of kidney damages. Therefore, it is also of a great pre-operative value in context with the determination of the functional capacity of a kidney, the control of prae-, -intra - and postrenal diseases, urological emergencies and the period after kidney-transplantations. The Tc-perfusion can be used for the diagnosis of kidney arterio-stenosis. In the field of skeleton scintigraphy with Tc-marked phosphates a very sensitive method for the discovery of metastasis is available. It can be applied as a screeningstest to the determination of the stage and to the control of the progress concerning the prostata carcinoma. The candula suprarenalis scintigraphy guarantees the differentiation of hormon producing tumors of the adrenalin gland in context with the determination of ACTH, cortisol, aldosteron, estrogens and testosteron. (F.R.)

  3. Biochemical diagnosis of mitochondrial disorders

    NARCIS (Netherlands)

    Rodenburg, R.J.T.

    2011-01-01

    Establishing a diagnosis in patients with a suspected mitochondrial disorder is often a challenge. Both knowledge of the clinical spectrum of mitochondrial disorders and the number of identified disease-causing molecular genetic defects are continuously expanding. The diagnostic examination of

  4. DIAGNOSIS OF DIABETES IN 2010

    African Journals Online (AJOL)

    The number of people with diabetes is expected to increase from 171 million in 2000 to 366 million in 2030.1,2 However, although almost. 5% of the world's population is expected to have this disease, the methods used for its diagnosis are still being debated. Over the years the various blood glucose cut-points for the ...

  5. Trichotillomania: Assessment, Diagnosis, and Treatment

    Science.gov (United States)

    Kress, Victoria E. White; Kelly, Brandy L.; McCormick, Laura J.

    2004-01-01

    This article examines the assessment, diagnosis, and treatment of trichotillomania (the recurrent desire to pull out one's hair). The authors provide a brief review both of proposed etiologies of trichotillomania and of the diagnostic and assessment issues related to this disorder, and they discuss interventions and treatments that have been shown…

  6. Diagnosis and management of impetigo.

    Science.gov (United States)

    VanRavenstein, Kathy; Durham, Catherine OʼConnor; Williams, Tiffany H; Smith, Whitney

    2017-03-07

    Impetigo, a bacterial skin infection that involves the superficial layers of the skin, is one of the most common skin infections in children ages 2 to 5 but can occur in individuals across the lifespan. This article discusses the diagnosis and management of impetigo in primary care.

  7. Avian influenza surveillance and diagnosis

    Science.gov (United States)

    Rapid detection and accurate identification of low (LPAI) and high pathogenicity avian influenza (HPAI) is critical to controlling infections and disease in poultry. Test selection and algorithms for the detection and diagnosis of avian influenza virus (AIV) in poultry may vary somewhat among differ...

  8. Diagnosis of Hymenoptera venom allergy

    NARCIS (Netherlands)

    Bilo, BM; Rueff, F; Mosbech, H; Bonifazi, F; Oude Elberink, JNG

    2005-01-01

    The purpose of diagnostic procedure is to classify a sting reaction by history, identify the underlying pathogenetic mechanism, and identify the offending insect. Diagnosis of Hymenoptera venom allergy thus forms the basis for the treatment. In the central and northern Europe vespid (mainly Vespula

  9. Presymptomatic diagnosis of Fabry's disease

    DEFF Research Database (Denmark)

    Hasselbalch, Rasmus Bo; Lav Madsen, Per; Bundgaard, Henning

    2016-01-01

    differential diagnoses in patients presenting with cardiac hypertrophy. In boys, onset has been reported in early childhood with complaints initially comprising neuropathic pain, reduced sweat production, and gastrointestinal symptoms. Later the cardiac, renal, and central nervous systems may become affected...... inheritable cardiomyopathies. The specific - precise - diagnosis may be crucial for the patient as well as the relatives....

  10. Ultrasound diagnosis of ectopic pregnancy

    Science.gov (United States)

    2015-01-01

    Abstract Ectopic pregnancy (EP) remains the number one cause of first trimester maternal death. Traditionally, laparoscopy has been the gold standard for diagnosis of EP. The advent of high‐resolution transvaginal scan (TVS) means more clinically stable women with EPs are diagnosed earlier, well before surgery becomes necessary in many cases. Early diagnosis by TVS is therefore potentially life saving and can reduce surgical morbidity by allowing elective surgery or even non‐surgical conservative treatment options. Combining transabdominal and transvaginal scanning confers no benefit over transvaginal scanning alone. Reports that reads “…empty uterus, ectopic pregnancy cannot be excluded” should be a thing of the past. Diagnosis of EP should be based upon the positive identification of an adnexal mass using TVS rather than the absence of an intra‐uterine gestational sac. A systematic approach to scanning the early pregnancy pelvis will diagnose the vast majority of EPs at the initial scan. Ultrasound, and in particular TVS, is fast becoming the new gold standard for diagnosis of all types of EP. In modern management, laparoscopy should be seen as the operative tool of choice while TVS the diagnostic tool of choice. PMID:28191110

  11. Prenatal Diagnosis of WAGR Syndrome

    Directory of Open Access Journals (Sweden)

    Berrin Tezcan

    2015-01-01

    Full Text Available Wilm’s tumour, aniridia, genitourinary abnormalities, and mental retardation (WAGR syndrome is a rare genetic disorder with an estimated prevalence of 1 in 500,000 to 1 million. It is a contiguous gene syndrome due to deletion at chromosome 11p13 in a region containing WT1 and PAX6 genes. Children with WAGR syndrome mostly present in the newborn/infancy period with sporadic aniridia. The genotypic defects in WAGR syndrome have been well established. However, antenatal ultrasonographic presentation of this syndrome has never been reported. Prenatal diagnosis of this condition is possible in some cases with careful ultrasound examination of classical and nonclassical manifestations of this syndrome. The key point for this rare diagnosis was the decision to perform chromosomal microarray analysis after antenatal diagnosis of absent corpus callosum and absent cavum septum pellucidum, as this finding mandates search for potentially associated genetic disorders. We report a case of WAGR syndrome diagnosed prenatally at 29-week gestation. The diagnosis of the anomaly was based on two- and three-dimensional ultrasound as well as fetal MRI scan and microarray analysis. The ultrasonographic findings included borderline ventriculomegaly, absent corpus callosum, and absent cavum septum pellucidum. Cytogenetic results from the amniotic fluid confirmed WAGR syndrome. Parental karyotype was normal, with no evidence of copy number change, deletion, or rearrangement of this region of chromosome 11.

  12. CT diagnosis of central neurofibromatosis

    International Nuclear Information System (INIS)

    Jordanov, J.; Poptodorov, G.; Nacheva, N.; Shirov, T.

    1997-01-01

    Central neurofibromatosis (NF2) is a condition characterized by multiple tumors involving the central nervous system. The typical intracranial CT findings in five patients presenting NF2, and the natural history of the disease in three illustrative cases are described. The early diagnosis of asymptomatic lesions may prove of utmost importance for the patient

  13. 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.

  14. Classification and Diagnosis of Fibromyalgia

    OpenAIRE

    1996-01-01

    Fibromyalgia was recently classified when a sleep disorder was described with diffuse musculoskeletal pain. The standard modern definition was reached on the basis of thorough analysis of pain patterns and characteristic tender points. The principles of classification are reviewed with respect to this diagnosis.

  15. Plant equipment abnormality diagnosis device

    International Nuclear Information System (INIS)

    Okamachi, Masao.

    1995-01-01

    In addition to a condensate flow rate measuring means for measuring flowrate at each of predetermined positions in a condensate system, a condensate recycling flowrate estimating means and a diagnosing calculation means are additionally disposed. Namely, the condensate recycling flow rate in the condensate recycling system is estimated based on the measured value for the flow rate obtained by the condensate flow rate measuring means. A predetermined diagnosing calculation is performed by the diagnosing calculation means based on the estimated value of the condensate recycling flow rate and an opening/closing state of a predetermined control valve intervened in the condensate system and a control valve for condensate recycling flow rate intervened in the condensate recycling system. The result of the diagnosis obtained by the calculation is informed by an information means. In addition, guidance information for coping with the result of the diagnosis, as well as the result of the diagnosis are formed and outputted in the diagnosing calculation means, and the result of the diagnosis and the guidance information outputted from the diagnosing calculation means are displayed auditory and visually. (N.H.)

  16. Diagnosis of cracked tooth syndrome

    Directory of Open Access Journals (Sweden)

    Sebeena Mathew

    2012-01-01

    Full Text Available The incidences of cracks in teeth seem to have increased during the past decade. Dental practitioners need to be aware of cracked tooth syndrome (CTS in order to be successful at diagnosing CTS. Early diagnosis has been linked with successful restorative management and predictably good prognosis. The purpose of this article is to highlight factors that contribute to detecting cracked teeth.

  17. Diagnosis of cracked tooth syndrome.

    Science.gov (United States)

    Mathew, Sebeena; Thangavel, Boopathi; Mathew, Chalakuzhiyil Abraham; Kailasam, Sivakumar; Kumaravadivel, Karthick; Das, Arjun

    2012-08-01

    The incidences of cracks in teeth seem to have increased during the past decade. Dental practitioners need to be aware of cracked tooth syndrome (CTS) in order to be successful at diagnosing CTS. Early diagnosis has been linked with successful restorative management and predictably good prognosis. The purpose of this article is to highlight factors that contribute to detecting cracked teeth.

  18. Diagnosis of cracked tooth syndrome

    OpenAIRE

    Mathew, Sebeena; Thangavel, Boopathi; Mathew, Chalakuzhiyil Abraham; Kailasam, SivaKumar; Kumaravadivel, Karthick; Das, Arjun

    2012-01-01

    The incidences of cracks in teeth seem to have increased during the past decade. Dental practitioners need to be aware of cracked tooth syndrome (CTS) in order to be successful at diagnosing CTS. Early diagnosis has been linked with successful restorative management and predictably good prognosis. The purpose of this article is to highlight factors that contribute to detecting cracked teeth.

  19. 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…

  20. Diagnosis and management of dementia

    African Journals Online (AJOL)

    2007-09-19

    Sep 19, 2007 ... Dementia is an acquired syndrome of memory decline with at least one other cognitive deficit in language, ... the diagnosis and management of dementia, memory lapses in the elderly are still erroneously brushed off at ..... because of sedation and anticholinergic side-effects. BPSD are associated with a.

  1. Paediatric neuro-imaging: Diagnosis

    Directory of Open Access Journals (Sweden)

    S.K. Misser

    2013-06-01

    Full Text Available We congratulate Professor Savvas Andronikou of the Department of Radiology, University of Pretoria, for his spot-on diagnosis, for which he receives the award of R1 000 from the RSSA. Dr Misser elaborates below on the images and findings. Please refer to page 45 of the March 2013 issue of the SAJR for the investigative images.

  2. Classification and Diagnosis of Fibromyalgia

    Directory of Open Access Journals (Sweden)

    Harold Merskey

    1996-01-01

    Full Text Available Fibromyalgia was recently classified when a sleep disorder was described with diffuse musculoskeletal pain. The standard modern definition was reached on the basis of thorough analysis of pain patterns and characteristic tender points. The principles of classification are reviewed with respect to this diagnosis.

  3. Short Stature Diagnosis and Referral

    Directory of Open Access Journals (Sweden)

    Mohamad Maghnie

    2018-01-01

    Full Text Available The “360° GH in Europe” meeting, which examined various aspects of GH diseases, was held in Lisbon, Portugal, in June 2016. The Merck KGaA (Germany funded meeting comprised three sessions entitled “Short Stature Diagnosis and Referral,” “Optimizing Patient Management,” and “Managing Transition.” Each session had three speaker presentations, followed by a discussion period, and is reported as a manuscript, authored by the speakers. The first session examined current processes of diagnosis and referral by endocrine specialists for pediatric patients with short stature. Requirements for referral vary widely, by country and by patient characteristics such as age. A balance must be made to ensure eligible patients get referred while healthcare systems are not over-burdened by excessive referrals. Late referral and diagnosis of non-GH deficiency conditions can result in increased morbidity and mortality. The consequent delays in making a diagnosis may compromise the effectiveness of GH treatment. Algorithms for growth monitoring and evaluation of skeletal disproportions can improve identification of non-GH deficiency conditions. Performance and validation of guidelines for diagnosis of GH deficiency have not been sufficiently tested. Provocative tests for investigation of GH deficiency remain equivocal, with insufficient information on variations due to patient characteristics, and cutoff values for definition differ not only by country but also by the assay used. When referring and diagnosing causes of short stature in pediatric patients, clinicians need to rely on many factors, but the most essential is clinical experience.

  4. Diagnosis in stroke - an uptake

    International Nuclear Information System (INIS)

    Aichner, F.T.

    2003-01-01

    In practical day-to-day terms, most patients have one of the common causes of stroke: ischemic stroke caused by the complications of atherothrombosis, intracranial small vessel disease, embolism from the heart, primary intracerebral hemorrhage caused by hypertension, or subarachnoid hemorrhage as a result of a ruptured saccular aneurysm. There are three issues to be considered in assessing the reliability of the clinical diagnosis of stroke: the diagnosis of stroke itself: is it a stroke or not; whether the stroke is caused by an infarct or a hemorrhage and particular in ischemic stroke the site and size of the lesion (anterior vs. posterior circulation, lacunar vs. cortical, etc.). No clinical scoring method can differentiate with absolute reliability ischemic stroke from primary intracerebral hemorrhage. To do this brain computed tomography or magnetic resonance imaging is required. For vascular diagnosis ultrasound and magnetic resonance angiography are ideal and complementary non-invasive techniques. Both have no risks and are reasonably sensitive. Catheterangiography is only reserved for patients with subarachnoid hemorrhage with a view to surgical or endovascular treatment or in exceptional cases to establish a more firm prognosis. The diagnosis of ischemic stroke caused by embolism from the heart can only be considered at all if there is an identifiable cardioembolic source which is the case in about 30 % of ischemic stroke, a higher proportion in recent studies using transoesophageal echocardiography. It is not clear that transoesophageal echocardiography provides much more information for clinical decision-making than transthoracic echocardiography, although it certainly provides more anatomical information in selected patients. This article summarizes the diagnostic armamentarium which is used for the diagnosis of stroke and gives an overview of clinically reliable and relevant measures. Refs. 23 (author)

  5. Prototype diagnosis of psychiatric syndromes

    Science.gov (United States)

    WESTEN, DREW

    2012-01-01

    The method of diagnosing patients used since the early 1980s in psychiatry, which involves evaluating each of several hundred symptoms for their presence or absence and then applying idiosyncratic rules for combining them for each of several hundred disorders, has led to great advances in research over the last 30 years. However, its problems have become increasingly apparent, particularly for clinical practice. An alternative approach, designed to maximize clinical utility, is prototype matching. Instead of counting symptoms of a disorder and determining whether they cross an arbitrary cutoff, the task of the diagnostician is to gauge the extent to which a patient’s clinical presentation matches a paragraph-length description of the disorder using a simple 5-point scale, from 1 (“little or no match”) to 5 (“very good match”). The result is both a dimensional diagnosis that captures the extent to which the patient “has” the disorder and a categorical diagnosis, with ratings of 4 and 5 corresponding to presence of the disorder and a rating of 3 indicating “subthreshold” or “clinically significant features”. The disorders and criteria woven into the prototypes can be identified empirically, so that the prototypes are both scientifically grounded and clinically useful. Prototype diagnosis has a number of advantages: it better captures the way humans naturally classify novel and complex stimuli; is clinically helpful, reliable, and easy to use in everyday practice; facilitates both dimensional and categorical diagnosis and dramatically reduces the number of categories required for classification; allows for clinically richer, empirically derived, and culturally relevant classification; reduces the gap between research criteria and clinical knowledge, by allowing clinicians in training to learn a small set of standardized prototypes and to develop richer mental representations of the disorders over time through clinical experience; and can help

  6. 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)

  7. The diagnosis of cystic fibrosis.

    Science.gov (United States)

    De Boeck, Kris; Vermeulen, Francois; Dupont, Lieven

    2017-06-01

    Establishing the diagnosis of cystic fibrosis (CF) is straight forward in the majority of patients: they present with a clear clinical picture (most frequently chronic respiratory symptoms plus malabsorption), the sweat chloride value is>60mmol/L and two known disease causing CFTR mutations are identified. In less than 5% of subjects, mainly those with a milder or limited phenotype, the diagnostic process is more complex, because initial diagnostic test results are inconclusive: sweat chloride concentration in the intermediate range, less than 2 CF causing mutations identified or both. These patients should be referred to expert centers where bioassays of CFTR function like nasal potential difference measurement or intestinal current measurement can be done. Still, in some patients, despite symptoms compatible with CF and some indication of CFTR dysfunction (e.g. only intermediate sweat chloride value), diagnostic criteria are not met (e.g. only 1 CFTR mutation identified). For these subjects, the term CFTR related disorder (CFTR-RD) is used. Patients with disseminated bronchiectasis, congenital bilateral absence of the vas deferens and acute or recurrent pancreatitis may fall in this category. CF has a very wide disease spectrum and increasingly the diagnosis is being made during adult life, mainly in subjects with milder phenotypes. In many countries, nationwide CF newborn screening (NBS) has been introduced. In screen positive babies, the diagnosis of CF must be confirmed by a sweat test demonstrating a sweat chloride concentration above 60mmol/L. To achieve the benefit of NBS, every baby in whom the diagnosis of CF is confirmed must receive immediate follow-up and treatment in a CF reference center. CF NBS is not full proof: some diagnoses will be missed and in some babies the diagnosis cannot be confirmed nor ruled out with certainty. Screening algorithms that include gene sequencing will detect a high number of such babies that are screen positive with an

  8. Diagnosis dan Penatalaksanaan Striktur Esofagus

    Directory of Open Access Journals (Sweden)

    Fachzi Fitri

    2014-05-01

    Full Text Available AbstrakLatar belakang : Kasus striktur esofagus jarang ditemukan, namun kasus ini memerlukan penanganan yang optimal. Sebelum kita melakukan penatalaksanaan terhadap striktur esofagus, perlu dilakukan diagnosis yang akurat agar dapat memilih teknik penatalaksanaan yang tepat. Tujuan : untuk mengetahui cara mendiagnosis dan penatalaksanaan striktur esofagus. Tinjauan pustaka : Striktur esofagus merupakan penyempitan lumen esofagus yang dapat menyebabkan keluhan disfagia. Berdasarkan etiologinya, striktur esofagus dibedakan menjadi striktur esofagus benigna dan maligna. Striktur esofagus benigna disebabkan oleh GERD, zat korosif, web, radiasi, post anastomosis esofagus, sedangkan striktur esofagus maligna disebabkan oleh keganasan baik dari dalam maupun dari luar esofagus. Diagnosis suatu striktur esofagus dapat ditegakkan melalui pemeriksaan barium meal, esofagoskopi, tomografi komputer dan rontgen toraks. Penatalaksanaan kasus striktur ini dapat berupa dilatasi dengan busi atau balon, pemasangan stent dan terapi pembedahan. Pada kasus striktur esofagus maligna juga dapat dilakukan terapi laser dan teknik brakiterapi. Kesimpulan: diagnosis yang akurat perlu dilakukan sebelum memilih teknik penatalaksanaan yang tepat, sehingga dapat mengurangi keluhan disfagia pada penderita striktur esofagus.Kata kunci: Striktur esofagus, barium meal, esofagoskopi, dilatasi, stent, laser, brakiterapiAbstractBackground: Esophageal stricture is rare cases, but these cases required optimal management. Before we manage of esophageal strictures, need an accurate diagnosis in order to choose appropriate management techniques. Purpose: to know how to diagnose and management of esophageal strictures. Literature review: esophageal stricture is a narrowing of the lumen of the esophagus that cause dysphagia. Based on the etiology, esophageal strictures can be divided into benign and malignant. Benign esophageal strictures caused by GERD, corrosive substances, web, radiation

  9. Histopathologic diagnosis of multifactorial alopecia.

    Science.gov (United States)

    Wohltmann, Wendi E; Sperling, Leonard

    2016-06-01

    Establishing a definitive diagnosis for any form of alopecia can be challenging. Adding to the diagnostic complexity is the fact that many patients have more than one form of alopecia contributing to their hair loss. We conducted a review of 1360 consecutive scalp biopsy specimens submitted for the evaluation of scalp hair loss over a 16-month period, demonstrating that 12.5% of cases had a combination of diagnoses (multifactorial alopecia) accounting for their hair loss. An approach to the histopathologic diagnosis of multifactorial alopecia, particularly multiple forms of alopecia found in a single biopsy, is here presented. Published 2016. This article is a U.S. Government work and is in the public domain in the USA.

  10. Radiologic diagnosis of lung tuberculosis

    International Nuclear Information System (INIS)

    Eisenhuber, E.; Mostbeck, G.; Bankier, A.; Stadler, A.; Rumetshofer, R.

    2007-01-01

    The radiologic knowledge of tuberculosis-associated lung disease is an essential tool in the clinical diagnosis of tuberculosis. Chest radiography is the primary imaging method, but the importance of CT is still increasing, as CT is more sensitive in the detection of cavitation, of hilar and mediastinal lymphadenopathie, of endobronchial spread and of complications in the course of the disease. In addition, CT has been proven as a valuable technique in the assessment of tuberculosis activity, especially in patients where M. tuberculosis has not been detected in the sputum or in patients with multidrug-resistant tuberculosis. Depending on the immune status of the patient, the morphologic spectrum of tuberculosis is quite variable. Early diagnosis of tuberculosis is essential to prevent further spread of the disease. (orig.) [de

  11. CT diagnosis of mediastinal tumors

    International Nuclear Information System (INIS)

    Zhu Dadong

    2009-01-01

    Objective: To explore the value of CT for diagnosing the mediastinal tumors, in order to improve the accuracy of the diagnosis on mediastinal tumor. Methods: 16 cases of mediastinal tumors proved by surgery or pathology were analyzed retrospectively. Results: There were 6 cases of thymoma, 3 of intrathoracic thyroid, 2 of bronchial cyst, 2 of malignant lymphoma, 2 of neurogenic tumor, and 1 of teratoma. The accuracy rate of CT localization and CT diagnosis were 100% and 93.75% respectively. Conclusion: CT examination is one of the most effective ways in diagnosing mediastinal tumor. According to the mediastinal tumor location, imaging features with proper examining method, closely combing the clinical data and lab examination, generally, mediastinal tumors can be diagnosed accurately. (authors)

  12. Preimplantation diagnosis of genetic diseases

    Directory of Open Access Journals (Sweden)

    Adiga S

    2010-01-01

    Full Text Available One of the landmarks in clinical genetics is prenatal diagnosis of genetic disorders. The recent advances in the field have made it possible to diagnose the genetic conditions in the embryos before implantation in a setting of in vitro fertilization. Polymerase chain reaction and fluorescence in situ hybridization are the two common techniques employed on a single or two cells obtained via embryo biopsy. The couple who seek in vitro fertilization may screen their embryos for aneuploidy and the couple at risk for a monogenic disorder but averse to abortion of the affected fetuses after prenatal diagnosis, are likely to be the best candidates to undergo this procedure. This article reviews the technique, indications, benefits, and limitations of pre-implantation genetic testing in clinical practice.

  13. Radionuclide diagnosis of allograft rejection

    International Nuclear Information System (INIS)

    George, E.A.

    1982-01-01

    Interaction with one or more anatomical and physiopathological characteristics of the rejecting renal allograft is suggested by those radioagents utilized specifically for the diagnosis of allograft rejection. Rejection, the most common cause of declining allograft function, is frequently mimicked clinically or masked by other immediate or long term post transplant complications. Understanding of the anatomical pathological features and kinetics of rejection and their modification by immunosuppressive maintenance and therapy are important for the proper clinical utilization of these radioagents. Furthermore, in selecting these radionuclides, one has to consider the comparative availability, preparatory and procedural simplicity, acquisition and display techniques and the possibility of timely report. The clinical utilities of radiofibrinogen, /sup 99m/Tc sulfur colloid and 67 Ga in the diagnosis of allograft rejection have been evaluated to a variable extent in the past. The potential usefulness of the recently developed preparations of 111 In labeled autologous leukocytes and platelets are presently under investigation

  14. Otoscopic diagnosis of otitis media.

    Science.gov (United States)

    Isaacson, Glenn

    2016-12-01

    Accurate diagnosis of otitis media is important to prevent suffering and complications when infection is present, and unnecessary antibiotic use when infection is absent. The usual signs and symptoms of acute otitis media are unreliable guides in infants and young children. Similarly, middle ear effusions may present with little discomfort in older children. We therefore depend on examination of the tympanic membrane with an otoscope to make most diagnoses. This article aims to improve the accuracy of middle ear diagnosis by pneumatic otoscopy. It includes descriptions and photographs of the normal ear drum and illustrates the pathologic changes seen in acute otitis media, long-standing eustachian tube dysfunction and otitis media with effusion.

  15. Hyperprolactinemia: causes, diagnosis, and treatment

    International Nuclear Information System (INIS)

    Karasek, M.; Pawlikowski, M.; Lewinski, A.

    2006-01-01

    The basic data on hyperprolactinemia (i.e. an excess of PRL above a reference laboratory's upper limits), the most common endocrine disorder of the hypothalamic-pituitary axis are given in this review. The following issues are discussed: regulation of prolactin (Prl) secretion, definition of hyperprolactinemia, its etiology and pathogenesis as well as its symptoms, diagnosis, and treatment (including medical and surgical therapy). It should be stressed that finding of elevated PRL serum concentrations constitute the beginning of diagnostic procedure and, after exclusion of physiologic, pharmacologic, and other organic causes of increased PRL levels, should be followed by detailed diagnosis including MRI. In patients in whom hyperprolactinemia has been confirmed the treatment with dopamine agonists (with prevalence of cabergoline, followed by quinagoline) is currently considered first-choice therapy. Surgery should be performed only in the patients resistant or intolerant to these agents, or in patients who refuse long-term therapy. (author)

  16. DIAGNOSIS AND MANAGEMENT CHRONIC INSOMNIA

    Directory of Open Access Journals (Sweden)

    G.A Dian Puspitha Candra

    2013-03-01

    Full Text Available Insomnia is defined as difficulty to start sleeping, maintain it, or low quality sleeping, if the condition persist for more than one month, it is called chronic insomnia. Diagnosis is made through anamnesa and sleep wake diaries, aktigraphy, polisomnography. Pharmachologycally drugs that have been used to treat insomnia are benzodiazepin reseptor agonis, antihistamine, antidepressant. Non pharmacological ways include behavioural intervention for insomnia, give significant result in decreasing sleep latency, reducing awakness duration during the night and improving total sleeping time.

  17. Diagnosis Deafness in a Child

    OpenAIRE

    Robabeh Taghavi

    1993-01-01

    It is difficult for clinicians to make parents aware of any disease or permanent handicap of their children.It is crucial to have vivid picture of the reactions to such crisis in order to manage severe psychological effects of the mentioned situations such as depression and unhappiness. Confronting the situation parents have diverse feelings regarding the pregnancy period, birth time and handicap diagnosis and these are the factors that shape the parent’s upcoming reactions. Common feedbacks ...

  18. Radiologic diagnosis of chest disease

    International Nuclear Information System (INIS)

    Sperber, M.

    1990-01-01

    This book discusses the fundamentals of pulmonary disorders and appropriate use of new diagnostic modalities. Methodologies of choosing techniques are also discussed. The applications of the various radiographic modalities are reviewed. Radiographic manifestations and appropriate imaging techniques most useful for diagnosis are addressed. This book reviews the applications of various recently developed radiographic modalities (CT and MRI) and discusses which are appropriate for specific lung diseases

  19. Epidemiology and Diagnosis of Hypoparathyroidism.

    Science.gov (United States)

    Clarke, Bart L; Brown, Edward M; Collins, Michael T; Jüppner, Harald; Lakatos, Peter; Levine, Michael A; Mannstadt, Michael M; Bilezikian, John P; Romanischen, Anatoly F; Thakker, Rajesh V

    2016-06-01

    Hypoparathyroidism is a disorder characterized by hypocalcemia due to insufficient secretion of PTH. Pseudohypoparathyroidism is a less common disorder due to target organ resistance to PTH. This report summarizes the results of the findings and recommendations of the Working Group on Epidemiology and Diagnosis of Hypoparathyroidism. Each contributing author reviewed the recent published literature regarding epidemiology and diagnosis of hypoparathyroidism using PubMed and other medical literature search engines. The prevalence of hypoparathyroidism is an estimated 37 per 100 000 person-years in the United States and 22 per 100 000 person-years in Denmark. The incidence in Denmark is approximately 0.8 per 100 000 person-years. Estimates of prevalence and incidence of hypoparathyroidism are currently lacking in most other countries. Hypoparathyroidism increases the risk of renal insufficiency, kidney stones, posterior subcapsular cataracts, and intracerebral calcifications, but it does not appear to increase overall mortality, cardiovascular disease, fractures, or malignancy. The diagnosis depends upon accurate measurement of PTH by second- and third-generation assays. The most common etiology is postsurgical hypoparathyroidism, followed by autoimmune disorders and rarely genetic disorders. Even more rare are etiologies including parathyroid gland infiltration, external radiation treatment, and radioactive iodine therapy for thyroid disease. Differentiation between these different etiologies is aided by the clinical presentation, serum biochemistries, and in some cases, genetic testing. Hypoparathyroidism is often associated with complications and comorbidities. It is important for endocrinologists and other physicians who care for these patients to be aware of recent advances in the epidemiology, diagnosis, and genetics of this disorder.

  20. Takayasu's arteritis: a challenging diagnosis.

    LENUS (Irish Health Repository)

    Fanning, D M

    2009-03-01

    The practices of medicine and surgery are inherently and irrevocably entwined. This case report highlights the need for an integrated, multi-disciplinary approach to care of the modern patient. Our patient fulfils the traditional Ishikawa\\'s criteria and the modified Ishikawa\\'s criteria for the clinical diagnosis of Takayasu\\'s disease. Her case underpins the need for co-ordinated care and careful periodic review of the symptomatology and signs of the multiple clinic attendees.

  1. Early diagnosis of breast cancer

    International Nuclear Information System (INIS)

    Semiglazov, V.F.

    1989-01-01

    Modern data are presentd on epidemology etiopathogensis and statistics of breast cancer. Home and international clinical and histological classifications is given. Much attention is paid to the methods for early diagnosis of pretumor diseases and breast cancer: clinical roentgenomammography, thrmography and computerized tomomammography. The role of self-examination in cancer early detection has been analyzed. Special attention is paid to system of detection of minimal and unpalpable form of breast cancer, screening of these tumors. 113 refs.; 60 figs.; 6 tabs

  2. Diagnosis and treatment of haemorrhoids

    DEFF Research Database (Denmark)

    Buntzen, Steen; Christensen, Peter Quist; Khalid, Ali

    2013-01-01

    These guidelines provide a review of diagnosis, conservative and surgical treatment of haemorrhoids with primary focus on the surgical treatment. In symptomatic hemorrhoids it is recommended, that conservative treatment is used as basic treatment regardless of grading. The vast majority of grade II...... haemorrhoids are treated conservatively, but surgery may be considered in a few cases with pronounced symptoms. In these cases chirurgia minor, Doppler guided dearterilization procedures or stapled haemorrhoidopexy are recommended. In grade III and IV Doppler guided dearterilization procedures, stapled...

  3. Differential diagnosis of retinal vasculitis.

    Science.gov (United States)

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

    2009-10-01

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

  4. ADHD: Is Objective Diagnosis Possible?

    OpenAIRE

    Gualtieri, C. Thomas; Johnson, Lynda G.

    2005-01-01

    Although attention deficit/hyperactivity disorder (ADHD) is one of the most common cognitive disorders, the usual diagnostic procedures pursued by psychiatrists, neurologists, pediatricians, and family practitioners are based largely, if not exclusively, on subjective assessments of perceived behavior. The recommended approaches to ADHD diagnosis are reviewed, first from the perspective of the various expert panels, and then from the research literature upon which those recommendations are ba...

  5. DIAGNOSIS OF HYPERGLYCEMIA IN PREGNANCY

    OpenAIRE

    Đelmiš, Josip; Ivanišević, Marina; Juras, Josip; Herman, Mislav

    2010-01-01

    HAPO study (Hyperglycemia Adverse Pregnancy Outcome) was designed to establish the more accurate levels in gestational diabetics where more active intervention will be necessary.11 The goal of HAPO study was to clarify the association between various glucose intolerance stages and adverse perinatal outcomes in the people without pregestational diabetes. It was important also for the HAPO study to propose new criteria for diagnosis of gestational diabetes (GDM). The proposition of the HAPO stu...

  6. Cardiorenal Syndrome: Diagnosis and Treatment

    Directory of Open Access Journals (Sweden)

    O.O. Melnyk

    2017-02-01

    Full Text Available In the diagnosis of cardiorenal syndrome (CRS, the biological markers are widely used, they can be applied to identify the pathophysiological stages of CRS, to assess the amount of risk, prognosis and outcome, as well as to monitor the effectiveness of treatment. CRS therapy includes diuretics, vasodilators, angiotensin converting enzyme inhibitors, angiotensin II receptor antagonists, nitrates and cardiac glycosides. One of the most effective methods of CRS treatment is the use of renal replacement therapy.

  7. Diagnosis of Carpal Tunnel Syndrome

    OpenAIRE

    Keith, Michael Warren; Masear, Victoria; Chung, Kevin; Maupin, Kent; Andary, Michael; Amadio, Peter C.; Barth, Richard W.; Watters, William C.; Goldberg, Michael J.; Haralson, Robert H.; Turkelson, Charles M.; Wies, Janet L.

    2009-01-01

    This clinical practice guideline was created to improve patient care by outlining the appropriate information-gathering and decision-making processes involved in managing the diagnosis of carpal tunnel syndrome. The methods used to develop this clinical practice guideline were designed to combat bias, enhance transparency, and promote reproducibility. The guideline’s recommendations are as follows: The physician should obtain an accurate patient history. The physician should perform a physica...

  8. [Early diagnosis of periodontal disease].

    Science.gov (United States)

    Sicilia, A M; Cobo Plana, J; López Arranz, J S; Ainamo, J

    1988-12-01

    Early diagnosis is necessary if the prevalence of periodontal disease is to be brought under control. For periodontal screening in dental practice we propose to employ the C.P.I.T.N. system, combined with examination of two or four dental bite-wing radiographs. Both of these procedures can be accurately applied in general dental practice conditions. The screening is not time consuming and can yield very important diagnostic data.

  9. Lupus vulgaris: difficulties in diagnosis.

    Science.gov (United States)

    Rhodes, Julia; Caccetta, Tony Philip; Tait, Clare

    2013-05-01

    Lupus vulgaris is one of the most common forms of cutaneous tuberculosis. It presents a diagnostic challenge due to its paucibacillary nature. This is a report of a case of a delayed diagnosis of lupus vulgaris, presenting as perianal and peristomal plaques, followed by a review of the diagnostic tools for lupus vulgaris and their limitations. © 2012 The Authors. Australasian Journal of Dermatology © 2012 The Australasian College of Dermatologists.

  10. Pulmonary Hypertension: Diagnosis and Management

    OpenAIRE

    McGoon, Michael D.; Kane, Garvan C.

    2009-01-01

    Pulmonary arterial hypertension is a progressive, symptomatic, and ultimately fatal disorder for which substantial advances in treatment have been made during the past decade. Effective management requires timely recognition and accurate diagnosis of the disorder and appropriate selection among therapeutic alternatives. Despite progress in treatment, obstacles remain that impede the achievement of optimal outcomes. The current article provides an overview of the pathobiologic mechanisms of pu...

  11. Early diagnosis of the Spondyloarthropathies

    International Nuclear Information System (INIS)

    Gonzalez Naranjo, Luis Alonso; Londono, John D; Valle, Rafael Raul

    2005-01-01

    Spondyloarthropathies are a cluster of chronic inflammatory diseases that primarily include ankylosing spondylitis, reactive arthritis, psoriatic arthritis; arthritis associated with inflammatory bowel diseases and undifferentiated spondyloarthropathies. The most common subgroups of spondyloarthropathies are ankylosing spondylitis and undifferentiated spondyloarthropathy. The diagnosis of ankylosing spondylitis is mainly based on unequivocal radiographic sacroiliitis of at least grade 2 bilaterally or grade 3 unilaterally. How ever, in the early phase of disease, conventional radiographs are often too insensitive to show sacroiliitis and it usually takes several years for definite radiographic sacroiliitis to evolve. Thus, the diagnosis of ankylosing spondylitis is a commonly delayed by 8 to 11 years after the onset of symptoms. As a result, diagnosing axial spondyloarthropathy in the absence of radiographic sacroiliitis is very difficult to rheumatologists. In the early phase of disease, HLA B27 test and magnetic resonance imaging of sacroiliac joints may be helpful to the early diagnosis. In the presence of chronic low back pain the probability of axial spondyloarthropathy is about 5% and is about 14% if the back pain is inflammatory. The presence of = 3 features of spondyloarthropathy (heel pain, uveitis, dactylitis, positive family history, alternating buttock pain, psoriasis, inflammatory bowel disease, asymmetrical arthritis, positive response to anti-inflammatory drugs) increase the probability of axial spondyloarthropathy to 90%. Both, the positive HLA B27 and magnetic resonance imaging with signs of sacroiliitis increase the probability of spondyloarthropathy, particularly in patients without spondyloarthropathies features or with only 1 or 2 features. Since ankylosing spondylitis in association with psoriasis and inflammatory bowel disease is often HLA B27 negative, this test is of limited value under theses circumstances. Is important to consider that

  12. Part 1: diagnosis and monitoring

    Directory of Open Access Journals (Sweden)

    Dorota Krasowska

    2017-11-01

    Full Text Available Systemic sclerosis is an immune-mediated disease characterized by a chronic and progressive course. It often leads to multiorgan failure and patient disability, and contributes to significant reduction in the quality of life. Systemic sclerosis affects the skin, subcutaneous tissue, muscles, osteoarticular system and internal organs. The complexity and diversity of clinical presentations require an individual approach and multidisciplinary collaboration both at the stage of diagnosis and treatment. Critical factors in systemic sclerosis include early diagnosis, assessment of internal organ involvement, identification of patients at potential risk of organ complications, assessment of disease dynamics and activity, and implementation of optimal therapy. Part 1 presents current recommendations for the diagnostics and monitoring of patients with systemic sclerosis. Attention is given to classification criteria, clinical forms of systemic sclerosis, assessment of skin thickness and systemic sclerosis microangiopathy, significance of antinuclear antibodies, diagnosis of interstitial lung disease and pulmonary arterial hypertension, renal crisis and cardiac abnormalities, and evaluation of the gastrointestinal tract and osteoarticular and muscular systems.

  13. Radiological diagnosis of skeletal tuberculosis

    International Nuclear Information System (INIS)

    Numberger, J.

    1982-01-01

    The general X-ray-symptoms follow one another or appear at the same time: Swelling of soft tissues by fungus; toxic perifocal and sometimes parafocal osteoporosis; osteolysis by specific granulation tissues; destruction of adjacent discs and articulation cartilages; formation of sequesters; cold abscess and formation of fistulas because of perforation of the corticalis by liquified tuberculous tissue; bone compression and deformation; amorphous calcifications; perifocal osteosclerosis as a repairing process. The spondylitis tuberculosis is the most frequent form with about 50%; usually narrowing of the discspace is the earliest X-ray-finding. On the second and third place follow the tuberculosis of the hip- and the knee-joint, the rest shows up at other locations of red bone marrow. Very often the perifocal osteoporosis is the earliest X-ray-symptom of joint tuberculosis. All X-ray-findings, even the earliest, in reality are late symptoms, because at that time the disease exists at least some months. Radiologically only the differential diagnosis can be made, final diagnosis is established by histologic examination only. Because the course of untreated skeletal tuberculosis usually is chronic and destructive and, on the other hand early antituberculous chemotherapy as well as surgical treatment show excellent results early radiological suggestion of tuberculosis is of great importance for initiating other diagnostic procedures to establish the diagnosis. (orig./MG) [de

  14. Onychomycosis: Pathogenesis, Diagnosis, and Management

    Science.gov (United States)

    Elewski, Boni E.

    1998-01-01

    Although not life-threatening, onychomycosis (a fungal infection of the nail, usually caused by a dermatophyte) constitutes an important public health problem because of its high prevalence (about 10% of the U.S. population) and associated morbidity. The disease can have certain negative consequences for patients, such as pain, and can potentially undermine work and social lives. This review discusses the etiology, classification, diagnosis, and treatment of onychomycosis. Four types of onychomycosis are recognized based on the site and pattern of fungal invasion. Dermatophyte fungi are the predominant pathogens, but yeasts (especially Candida albicans) and nondermatophyte molds may also be implicated. Accurate diagnosis requires direct microscopy and fungal culture. The differential diagnosis includes psoriasis, lichen planus, onychogryphosis, and nail trauma. Onychomycosis is more difficult to treat than most dermatophytoses because of the inherent slow growth of the nail. Older antifungal agents (ketoconazole and griseofulvin) are unsuitable for onychomycosis because of their relatively poor efficacy and potential adverse effects. Three recently developed antimycotic agents (fluconazole, itraconazole, and terbinafine) offer high cure rates and good safety profiles. In addition, the short treatment times (<3 months) and intermittent dosing schedules are likely to enhance compliance and reduce the costs of therapy. PMID:9665975

  15. DIFFERENTIAL DIAGNOSIS OF HYPERTROPHIC CARDIOMYOPATHY

    Directory of Open Access Journals (Sweden)

    I. V. Leontyeva

    2017-01-01

    Full Text Available Hypertrophic cardiomyopathy is the most common form of cardiomyopathy, occurring in childhood, occurring when a gene is mutated that encodes proteins of sarcomeric and non-sarcomeric complexes. The diagnosis of the disease is based on the data of echocardiography, revealing structural changes in the heart muscle according to the type of hypertrophy, while the genesis of these changes remains unclear. The causes of hypertrophic cardiomyopathy in childhood are diverse. Of great importance is the early diagnosis of metabolic forms of hypertrophic cardiomyopathy, so in some cases regress of hypertrophy is possible against the background of enzyme-substitution or other drug therapy. The article presents a clinical (cardiac and extracardiac symptoms and laboratory markers of hypertrophic cardiomyopathy with mutations of genes of proteins of the sarcomeric complex, congenital metabolic disorders (glycogenoses, lysosomal pathology, fatty acid metabolism disorders, and mitochondrial diseases, genetic syndromes (Noonan, LEOPARD, Costello, cardio-fascial-cutaneous, neuromuscular diseases. The criteria for differential diagnosis of genetic forms of hypertrophic cardiomyopathy and myocardial hypertrophy in athletes are presented. 

  16. Diagnosis of asthma - new theories.

    Science.gov (United States)

    Löwhagen, Olle

    2015-01-01

    Recent studies have shown a remarkably high frequency of poorly controlled asthma. Several reasons for this treatment failure have been discussed, however, the basic question of whether the diagnosis is always correct has not been considered. Follow-up studies have shown that in many patients asthma cannot be verified despite ongoing symptoms. Mechanisms other than bronchial obstruction may therefore be responsible. The current definition of asthma may also include symptoms that are related to mechanisms other than bronchial obstruction, the clinical hallmark of asthma. Based on a review of the four cornerstones of asthma - inflammation, hyperresponsiveness, bronchial obstruction and symptoms - the aim was to present some new aspects and suggestions related to the diagnosis of adult non-allergic asthma. Recent studies have indicated that "classic" asthma may sometimes be confused with asthma-like disorders such as airway sensory hyperreactivity, small airways disease, dysfunctional breathing, non-obstructive dyspnea, hyperventilation and vocal cord dysfunction. This confusion may be one explanation for the high proportion of misdiagnosis and treatment failure. The current diagnosis, focusing on bronchial obstruction, may be too "narrow". As there may be common mechanisms a broadening to include also non-obstructive disorders, forming an asthma syndrome, is suggested. Such broadening requires additional diagnostic steps, such as qualitative studies with analysis of reported symptoms, non-effort demanding methods for determining lung function, capsaicin test for revealing airway sensory hyperreactivity, careful evaluation of the therapeutic as well as diagnostic effect of corticosteroids and testing of suggested theories.

  17. Diagnosis of Toxoplasmosis in Pregnancy

    Directory of Open Access Journals (Sweden)

    Umit Savasci

    2012-12-01

    Full Text Available Toxoplasmosis is a common worldwide parasitic infection that caused by Toxoplasma gondii. The clinical progress is generally asymptomatic in patient with normal immune system, on the other hand severe clinical presentations seen in patients with immune deficiency or pregnancy. Congenital toxoplasmosis can emerge due to contamination during pregnancy but 6-8 weeks prior to pregnancy are also at risk. Infants with toxoplasmosis have some clinical semptoms such as chorioretinitis, epilepsia, hypotonia, psychomotor disorders, mental retardation, encephalitis, microcephaly, hydrocephalus, intracranial calcifications, hepatosplenomegaly. Early diagnosis during pregnancy and subsequent treatment. may prevent malformations. Toxoplasmosis diagnosis during pregnancy is mostly based on IgM and IgG antibody screening tests. While IgM indicates the acute infection, it disappears in early period and can be detected in low consantrations through long ages. Therefore IgG avidity test takes more place in the diagnosis of toxoplasmosis during pregnancy. High avidity levels indicate acquired infection prior than 16 weeks, so that it is recommended to perform the test in the first trimester. Low IgG avidity level may indicate a newly onset infection. Amniotic fluid T.gondii PCR, anomaly screening with ultrasonography, Toxoplasma gondii cyst dying with Wright-Giemsa dye in plasental and fetal tissue are the other diagnostic tools can be performed during pregnancy. Avidity test methods during the 16 weeks of pregnancy reduce repeating serum analysis, amniotic fluid PCR reguirement, unnecessary antibiotic treatments and noncompulsory abortus. [TAF Prev Med Bull 2012; 11(6.000: 767-772

  18. Cardiac angiosarcoma: an unexpected diagnosis

    Directory of Open Access Journals (Sweden)

    Milton Roberto Furst Crenitte

    2014-09-01

    Full Text Available Cardiac angiosarcoma is a rare entity. The incidence through autopsy findings ranges between 0.001% and 0.03%. The disease usually presents with non-specific symptoms, although asymptomatic cases are frequent; therefore, diagnosis is unexpected and consequently delayed. The authors report the case of a middle-aged man with a recent onset cough and dyspnea. He sought medical care several times without receiving a definite diagnosis until a plain chest radiography was taken showing a mediastinal enlargement, which was the reason why he was hospitalized for clinical investigation. During the diagnostic workup, an echodopplercardiogram and a thoracic computed tomography were performed, showing a heterogeneous soft-tissue mass infiltrating the pericardium and the anterior atrial wall. Multiple and scattered pulmonary nodules were also present. A pulmonary nodule was biopsied, which revealed an angiosarcoma. The clinical features added to the radiological and histological findings permitted the diagnosis of right atrial angiosarcoma. The authors highlight the unexpected pattern in the presentation of cardiac tumors.

  19. [Early diagnosis of ectopic pregnancy].

    Science.gov (United States)

    Belics, Zoran; Gérecz, Balázs; Csákány, M György

    2014-07-20

    Ectopic pregnancy is a high-risk condition that occurs in 2% of reported pregnancies. This percentage is fivefold higher than that registered in the 1970s. Since 1970 there has been a two-fold increase in the ratio of ectopic pregnancies to all reported pregnancies in Hungary and in 2012 7.4 ectopic pregnancies per thousand registered pregnancies were reported. Recently, the majority (80%) of cases can be diagnosed in early stage, and the related mortality objectively decreased in the past few decades to 3.8/10,000 ectopic pregnancies. If a woman with positive pregnancy test has abdominal pain and/or vaginal bleeding the physician should perform a work-up to safely exclude the possibility of ectopic pregnancy. The basis of diagnosis is ultrasonography, especially vaginal ultrasound examination and measurement of the β-subunit of human chorionic gonadotropin. The ultrasound diagnosis is based on the visualization of an ectopic mass rather than the inability to visualize an intrauterine pregnancy. In some questionable cases the diagnostic uterine curettage or laparoscopy may be useful. The actuality of this topic is justified by practical difficulties in obtaining correct diagnosis, especially in the early gestational time.

  20. The diagnosis of multiple sclerosis

    International Nuclear Information System (INIS)

    Sanders, E.A.C.M.

    1982-01-01

    This thesis describes recently developed research methods for the diagnosis of multiple sclerosis. In Chapter X the use of the CT-scan in the detection of hemispheral or cerebellar lesions is discussed. In chapter XIII the results of the application of all methods to a group of 89 patients with definite, probable or possible multiple sclerosis and to a group of 25 purely optic neuritis patients are presented. With the aid of the CT-scan, hypo- or hyperdense areas in the white matter of the cerebral hemispheres were found in 52% of the 114 patients. Most reports ascribe these lesions to demyelinating cerebral plaques. The CT-scan showed no cerebellar or brainstem lesions. The CT-scan is independent of the duration of, and degree of incapacitation due to, the disease and can be helpful in giving a definite diagnosis in an early stage of the disease. The CT-scan will always play an important role for the differential diagnosis. (Auth.)

  1. Diagnosis of chronic myeloid leukemia

    International Nuclear Information System (INIS)

    Demitrovicova, L.; Mikuskova, E.; Copakova, L.; Leitnerova, M.

    2012-01-01

    Chronic myeloid leukemia (CML) was the first cancer associated with the specific chromosomal aberration. Philadelphia chromosome due to translocation (9, 22) is present in 95% cases, fusion gene BCR/ABL is present in 100% cases at the time of diagnosis. Disease has its own characteristics detectable by physical examination, by the examination of blood count and differential and by cytomorhologic examination of bone marrow, however the diagnosis of CML is determined by cytogenetics and molecular genetics. If the diagnosis of Ph+ BCR/ABL positive CML is confirmed, the disease is treated by tyrosine kinase inhibitors (TKI). TKI don´t affect formation of leukemic gene BCR/ABL, but they can stop the action of this gene. The target therapy of tyrosine kinase inhibitors markedly improved the survival of patients with CML by inhibition the proliferation of leukemic clone on the clinically safety level of minimal disease, although probably this treatment cannot cure the CML. Cytogenetics and molecular genetics are very important at the monitoring of residual disease with sensitivity 10 -6 . (author)

  2. Lipidomics in diagnosis of lipidoses.

    Science.gov (United States)

    Wolf, C; Quinn, P J

    2008-01-01

    A review is presented of the major clinical features of a number of glycolipidoses including Fabry, Gaucher, Tay-Sachs, metachromatic leukodystrophy as well as CeroidLipofucinosis and Sjogren-Larsson syndrome. The possibilities offered by lipidomics for diagnosis and follow-up after enzyme replacement therapy are presented from a practical perspective. The contribution of HPLC coupled with tandem mass spectrometry has considerably simplified the detection and assay of abnormal metabolites. Corresponding internal standards consisting of weighed mixtures of the stable-isotope labeled metabolites required to calibrate and quantitate lipid components of these orphan diseases standards have yet to become commercially available. A lipidomics approach has been found to compare favorably with DNA-sequence analysis for the rapid diagnosis of pre-birth syndromes resulting from these multiple gene defects. The method also seems to be suitable for screening applications in terms of a high throughput combined with a low rate of false diagnoses based on the wide differences in metabolite concentrations found in affected patients as compared with normal subjects. The practical advantages of handling samples for lipidomic diagnoses as compared to enzyme assay are presented for application to diagnosis during pregnancy.

  3. Review of epidemiology of depression and implications for ...

    African Journals Online (AJOL)

    This is attributed (amongst other reasons) to the under-recognition of the problem by the health professionals including the general practice nurses.In order to improve recognition rates it is imperative that nurses and especially those working at community settings appreciate the importance of prompt diagnosis which, ...

  4. Stage at diagnosis and ovarian cancer survival

    DEFF Research Database (Denmark)

    Maringe, Camille; Walters, Sarah; Butler, John

    2012-01-01

    We investigate what role stage at diagnosis bears in international differences in ovarian cancer survival.......We investigate what role stage at diagnosis bears in international differences in ovarian cancer survival....

  5. Glaucoma: Symptoms, Diagnosis, Treatment and Latest Research

    Science.gov (United States)

    ... of this page please turn Javascript on. Feature: Glaucoma Glaucoma: Symptoms, Diagnosis, Treatment and Latest Research Past Issues / Fall 2009 Table of Contents Symptoms and Diagnosis Glaucoma can develop in one or both eyes. Often ...

  6. Dual Diagnosis: Substance Abuse and Mental Illness

    Science.gov (United States)

    ... an effective dual diagnosis treatment plan. In particular, cognitive behavioral therapy ( CBT ) helps people with dual diagnosis learn how ... groups for people recovering from alcohol or drug addiction. Be sure to find a group that understands ...

  7. Coping with a Breast Cancer Diagnosis

    Science.gov (United States)

    FACTS FOR LIFE Coping With a Breast Cancer Diagnosis Coping with breast cancer A breast cancer diagnosis can cause a wide range of ... as normal a routine as possible. Be patient. Coping with breast cancer requires time, acceptance, a fighting ...

  8. Alzheimer's and Dementia Testing for Earlier Diagnosis

    Science.gov (United States)

    ... for Earlier Diagnosis What if we could diagnose Alzheimer's before symptoms started? The hope is, future treatments ... diagnosis is among the most active areas in Alzheimer's science, and funding from the Alzheimer's Association has ...

  9. 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

  10. Consideration Regarding Diagnosis Analyze of Corporate Management

    Directory of Open Access Journals (Sweden)

    Mihaela Ciopi OPREA

    2009-01-01

    Full Text Available Diagnosis management aims to identify critical situations and positive aspectsof corporate management. An effective diagnosis made by a team with thestatus of independence from the organization’s management is for managers auseful feedback necessary to improve performance. The work presented focuseson the methodology to achieve effective diagnosis, considering multitudecriteria and variables to be analyzed.

  11. 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

  12. 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.

  13. [Leber congenital amaurosis: diagnosis, follow-up and differential diagnosis].

    Science.gov (United States)

    Grieshaber, M C; Niemeyer, G

    1998-05-01

    Leber's congenital amaurosis (LCA) had been diagnosed on/in 42 children between 1968 and 1996 at the Deptm. of Ophthalmology, University Hospital Zurich. We reexamined critically this rare diagnosis in retrospect and with new examinations where possible. Clinical and electroretinographic (ERG) results, often obtained in general anesthesia, were re-evaluated and when possible repeated in new examinations. Thirty-three of the total 42 patients presented with an extinguished, 35 with markedly reduced, and 6 with minimal ERGs. A profound visual loss (from no light perception to 20/200), nystagmus and strabismus were the principal symptoms. The heterogeneity of retinal findings ranged from normal to salt and pepper or bone spicules pigmentation and pronounced chorioretinal atrophy. Vascular attenuation and rarification were frequent. Patients with nonocular findings such as mental retardation (n = 12), renal (n = 3) and skeletal (n = 4) abnormalities revealed no differing ERG- or retinal findings. The oculodigital sign (eye-poking) was found in 25%, and parental consanguinity was evident in 10% of the cases. In 16 patients that were reexamined, the progression of the disease was characterized by an increase in retinal pigmentary changes, attenuation of retinal vessel, and further diminuation of the visual acuity (n = 6). Upon review, the diagnosis had to be revised in 8 patients as juvenile retinitis pigmentosa and in one as infantile Refsum syndrome. Bilateral visual impairement in infants should be assessed clinically and electroretinographically within the first year. Neuropediatric and metabolic examinations meaningfully complement the diagnostic procedures.

  14. Neuroradiology of human prion diseases, diagnosis and differential diagnosis.

    Science.gov (United States)

    Gaudino, Simona; Gangemi, Emma; Colantonio, Raffaella; Botto, Annibale; Ruberto, Emanuela; Calandrelli, Rosalinda; Martucci, Matia; Vita, Maria Gabriella; Masullo, Carlo; Cerase, Alfonso; Colosimo, Cesare

    2017-05-01

    Human transmissible spongiform encephalopathies (TSEs), or prion diseases, are invariably fatal conditions associated with a range of clinical presentations. TSEs are classified as sporadic [e.g. sporadic Creutzfeldt-Jakob disease (sCJD), which is the most frequent form], genetic (e.g. Gerstmann-Straussler-Scheinker disease, fatal familial insomnia, and inherited CJD), and acquired or infectious (e.g. Kuru, iatrogenic CJD, and variant CJD). In the past, brain imaging played a supporting role in the diagnosis of TSEs, whereas nowadays magnetic resonance imaging (MRI) plays such a prominent role that MRI findings have been included in the diagnostic criteria for sCJD. Currently, MRI is required for all patients with a clinical suspicion of TSEs. Thus, MRI semeiotics of TSEs should become part of the cultural baggage of any radiologist. The purposes of this update on the neuroradiology of CJD are to (i) review the pathophysiology and clinical presentation of TSEs, (ii) describe both typical and atypical MRI findings of CJD, and (iii) illustrate diseases mimicking CJD, underlining the MRI key findings useful in the differential diagnosis.

  15. Urological diagnosis using clinical PACS

    Science.gov (United States)

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

    1995-05-01

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

  16. [Diverticular disease - diagnosis and classification].

    Science.gov (United States)

    Lembcke, B

    2014-04-01

    A reliable diagnosis is fundamental for operative, interventional and conservative treatment of the different facets of diverticular disease. Not only differential diagnoses but also overlap or coincidence with other entities sharing similar symptoms must be considered. Furthermore, an adequate surgical strategy and correct stratification of complications is mandatory. Subsequently, in the light of currently validated diagnostic techniques, the consensus conference of the German Societies of Gastroenterology (DGVS) and Visceral Surgery (DGAV) has released a new classification of diverticulitis displaying the different facets of diverticular disease. This classification also comprises symptomatic uncomplicated diverticular disease (SUDD), largely resembling irritable bowel syndrome, as well as diverticular bleeding. While detailed history, physical examination and laboratory testing are of great importance for exploring a patient with diverticular disease, they are not sufficient to diagnose (or stratify) diverticulitis without cross-sectional imaging using ultrasonography (US) or computed tomography (CT). The diagnostic value of qualified US is equipotent to qualified CT, complies with relevant legislation for radiation exposure protection and is frequently effective for diagnosis. Therefore, US is considered to be the first choice for imaging in diverticular disease. In contrast, CT has definite indications in unclear, discrepant situations or insufficient US performance. Strengths and weaknesses of both methods are discussed. Endoscopy is not required for the diagnosis of diverticulitis and should not be performed in an acute attack. Colonoscopy, however, is warranted after healing of diverticulitis, prior to elective surgery and in cases of an atypical course. Prior exclusion of perforation is considered mandatory. An unequivocal indication for colonoscopy is diverticular bleeding and the rapid performance (within 12-24 h) allows better identification of sites

  17. Chronic Diarrhea: Diagnosis and Management.

    Science.gov (United States)

    Schiller, Lawrence R; Pardi, Darrell S; Sellin, Joseph H

    2017-02-01

    Chronic diarrhea is a common problem affecting up to 5% of the population at a given time. Patients vary in their definition of diarrhea, citing loose stool consistency, increased frequency, urgency of bowel movements, or incontinence as key symptoms. Physicians have used increased frequency of defecation or increased stool weight as major criteria and distinguish acute diarrhea, often due to self-limited, acute infections, from chronic diarrhea, which has a broader differential diagnosis, by duration of symptoms; 4 weeks is a frequently used cutoff. Symptom clusters and settings can be used to assess the likelihood of particular causes of diarrhea. Irritable bowel syndrome can be distinguished from some other causes of chronic diarrhea by the presence of pain that peaks before defecation, is relieved by defecation, and is associated with changes in stool form or frequency (Rome criteria). Patients with chronic diarrhea usually need some evaluation, but history and physical examination may be sufficient to direct therapy in some. For example, diet, medications, and surgery or radiation therapy can be important causes of chronic diarrhea that can be suspected on the basis of history alone. Testing is indicated when alarm features are present, when there is no obvious cause evident, or the differential diagnosis needs further delineation. Testing of blood and stool, endoscopy, imaging studies, histology, and physiological testing all have roles to play but are not all needed in every patient. Categorizing patients after limited testing may allow more directed testing and more rapid diagnosis. Empiric antidiarrheal therapy can be used to mitigate symptoms in most patients for whom a specific treatment is not available. Copyright © 2017 AGA Institute. Published by Elsevier Inc. All rights reserved.

  18. MRI diagnosis of eyeball diseases

    International Nuclear Information System (INIS)

    Tao Xiaofeng; Shi Zengru; Xiao Xiangsheng; Yu Hong; Wei Ruili

    2003-01-01

    Objective: To review the MR imaging of eyeball mass in 75 patients with the intention to enhance the acknowledgement to eyeball diseases. Methods: Seventy-five patients, 45 males and 30 females, were examined with MRI before treatment. Most MRI studies were performed with head coil and a few with orbit surface coil. Sagittal, coronal, and axial images were attained. Enhanced MRI studies were performed in 37 cases. High magnetic field MRI studies were performed with additional fat saturation technique. Results: Retinoblastoma (20 cases) showed isointensity in 11 and low signal intensity in 9 on T 1 WI, and isointensity in 5 and slight high signal in 15 on T 2 WI. Coats' disease (5 cases) involved single eyeball in all cases without calcification or eyeball enlargement, and presented as slight high signal on T 1 WI and high signal on T 2 WI. Choroidal angioma (3 cases) showed slight high signal on T 1 WI and high signal on T 2 WI. Metastasis (20 cases) was located in the posterior wall of the eyeball. Extra-global invasion occurred in 8 cases and intra-global invasion in 20. Marked thickening of the global wall with isointensity (8 cases) or low signal intensity (12 cases) was detected on T 1 WI, and isointensity (6 cases) or slight high signal intensity (14 cases) was demonstrated on T 2 WI. Marked enhancement was revealed in all 15 cases. Melanoma (7 cases) showed high signal intensity (5) and isointensity (2) on T 1 WI, and low signal (7) on T 2 WI. Retinal detachment (19 cases) showed high signal on both T 1 and T 2 WI, etc. In the diagnosis of eyeball diseases with MRI, the total sensitivity was 100% and specificity was 86.7%. Conclusions: MRI imaging is an important examination method to eyeball diseases, and most diagnosis and differential diagnosis of eyeball diseases can be made correctly with MRI

  19. Radiological diagnosis of skeletal metastases

    International Nuclear Information System (INIS)

    Soederlund, V.

    1996-01-01

    The clinical management of patients with skeletal metastases puts new demands on imaging. The radiological imaging in screening for skeletal metastases entails detection, metastatic site description and radiologically guided biopsy for morphological typing and diagnosis. Regarding sensitivity and the ease in performing surveys of the whole skeleton, radionuclide bone scintigraphy still is the first choice in routine follow-up of asymptomatic patients with metastatic disease of the skeleton. A negative scan has to be re-evaluated with other findings, with emphasis on the possibility of a false-negative result. Screening for metastases in patients with local symptoms or pain is best accomplished by a combination of radiography and MRI. Water-weighted sequences are superior in sensitivity and in detection of metastases. Standard spin-echo sequences on the other hand are superior in metastatic site description and in detection of intraspinal metastases. MRI is helpful in differentiating between malignant disease, infection, benign vertebral collapse, insufficiency fracture after radiation therapy, degenerative vertebral disease and benign skeletal lesions. About 30% of patients with known cancer have benign causes of radiographic abnormalities. Most of these are related to degenerative diseases and are often easily diagnosed. However, due to overlap in MRI characteristics, bone biopsy sometimes is essential for differentiating between malignant and nonmalignant lesions. Performing bone biopsy and aspiration cytology by radiologist and cytologist in co-operation has proven highly accurate in diagnosing bone lesions. The procedure involves low risk to the patient and provides a morphological diagnosis. Once a suspected metastatic lesion is detected, irrespective of modality, the morphological diagnosis determines the appropriate work-up imaging with respect to the therapy alternatives. (orig./VHE)

  20. [Disclosing the diagnosis and guidance].

    Science.gov (United States)

    Bopp-Kistler, Irene

    2015-04-01

    Before the disclosure of the diagnosis, both the patients with dementia and their relatives experience a long time not only full of insecurity, uncertainty, fear and misgivings but also of conflicts. The beginning of a neurodegenerative disease is always associated with a lot of open questions. If young patients are still active in their professional life, already the stage of "Mild Cognitive Impairment" will cause mistakes, burnout, mobbing, depression and sick leaves. In the partner relationship conflicts and accusations may emerge. It is far too little recognized that those problems at the relational level are often more burdening than the typical deficiencies due to dementia. Unfortunately, it is still considered that a clarification and diagnosis are only worthwhile for diseases which are curable. However, the aim of every evidence-based medicine should be giving every patient and his relatives the best possible quality of life, including symptomatic treatment options and prevention of possible complications. A frank opening discussion of the diagnosis paves the way for the patient and his relatives to deal with the situation and to develop together a solution strategy in the challenging setting of dementia, which always affects the whole familial and social system. The patient is entitled to be informed about his/her diagnosis, including dementia. The diagnostic disclosure requires time and highest professionalism, the knowledge of the individual deficiencies and resources, the social situation, the biography and the personality of the patients but also of their relatives. The diagnostic disclosure arouses a lot of emotions, that need to be addressed and also be absorbed. Primarily, the conversation should be conducted with the patient, but preferably in the presence of the relatives. A very important point is the appreciation of the dementia patient, even with anosognosia. The relatives should not be given just general advice, there should rather be a

  1. Comprehensive diagnosis of breast fibroadenomas

    International Nuclear Information System (INIS)

    Shekhter, A.I.; Minkov, Yu.M.

    1981-01-01

    An extensive use of mass screening among women over the last years brought about an increase in the detection of breast fibroadenomas-tumors of dyshormonal origin. Taking into account their prevalence and possible malignancy the problems of clinical radiodiagnosis and management become urgent. Altogether 421 patients have been examined using the clinical, X-ray, thermographic and cytological methods for detection, diagnosis and determination of the proliferative activity in breast fibroadenoma. Two- and ten year periods of follow up of 219 women permitted studying the character of dynamic changes in fibroadenoma. Examination schemes for women with breast fibroadenoma have been developed on the basis of the data obtained

  2. [Modern methods of diagnosis dyslipidemia ].

    Science.gov (United States)

    Sukhorukov, V N; Karagodin, V P; Orekhov, A N

    2016-01-01

    Dyslipidemia is abnormalities of lipid and lipoprotein metabolism. Most dyslipidemias are hyperlipidemias; that is an abnormally high level of lipids and/or lipoproteins in the blood. Lipid and lipoprotein abnormalities are common in the general population, and are regarded as a modifiable risk factor for cardiovascular disease due to their influence on atherosclerosis. Primary dyslipidemia is usually due to genetic causes, while secondary dyslipidemia arises due to other underlying causes such as diabetes mellitus. Thus, dyslipidemia is an important factor in the development of atherosclerosis and cardiovascular diseases therefore, it is important to diagnose it in time. This review focuses on the modern methods of diagnosis of dyslipidemia.

  3. Juvenile hyaline fibromatosis. Radiological diagnosis

    International Nuclear Information System (INIS)

    Fuentes, R.; Sar, V.; Cabrera, J.J.; Diaz, L.; Hernandez, B.; Valeron, P.; Baez, O.; Rodriguez, M.

    1993-01-01

    Juvenile hyaline fibromatosis (JHF) is a rare disorder of unknown etiology, very few cases of which have been reported in the literature. It presents similarities to other fibromatosys, but has its particular radiological features which differentiate it from them. The clinical findings consist of several, slow growing, subcutaneous nodules, flexion contractures of the joints which can lead to disability, gingival hypertrophy and muscular atrophy. The suspected radiological diagnosis is confirmed by electron microscopy study of the nodules, although light microscopy can also reveal suggestive images. Author (9 refs.)

  4. SARCOPENIA: DIAGNOSIS, STAGES AND TREATMENT

    Directory of Open Access Journals (Sweden)

    Pasca Luminita Aurelia

    2015-02-01

    Full Text Available Sarcopenia is defined as the age-related loss of skeletal muscle mass and decline of function. The causes of sarcopenia are multi-factorial. The diagnosis of sarcopenia should be considered in all older patients who present with declines in physical function, because of potential consequences for the development of frailty and disability. There are numerous techniques to assess muscle mass, muscle strength and physical performance. Treatment consists of nutritional (macro- and micronutrients and physical activity (resistance exercise regimens adapted to person. There is an emerging role for testosterone and anabolic steroids in severe sarcopenia.

  5. Coeliac cavity ultrasonic diagnosis apparatus

    Energy Technology Data Exchange (ETDEWEB)

    Ando, O.; Suwaki, T.

    1983-07-05

    A coeliac cavity ultrasonic diagnosis apparatus is disclosed which includes an ultrasonic transducer or scanner portion adapted to be inserted into a coeliac cavity to effect a sector scan of an ultrasonic beam to produce an ultrasonic image of internal tissues and in which the ultrasonic oscillator on the one hand and an ultrasonic reflecting mirror and rotary disc on the other hand are relatively rotated so as to effect the sector scan of the ultrasonic beam and the rotary angle of the rotary disc is detected so as to obtain a deflecting angle of the ultrasonic beam and a display on a cathode ray tube of a precise ultrasonic picture image.

  6. DIAGNOSIS DAN PENATALAKSAAN SPONDILITIS TUBERKULOSA

    Directory of Open Access Journals (Sweden)

    I Ketut Suyasa

    2012-11-01

    Full Text Available Spondilitis tuberculosis merupakan fokus sekunder infeksi tuberculosis yang mengenai tulang belakang. Keterlibatan tulang belakang akan dapat memperberat morbiditas karena adanya potensi defsit neurologis dan deformitas yang permanent. Diagnosis ditegakkan berdasarkan klinis, laboratories, imaging, bakteriologis dan histopathologis. Sampai saat ini belum ada therapi definitif yang baku. Masih ada kontroversi antara terapi konservative dengan pembedahan. Telah dikembangkan metode total treatment yang merupakan gabungan terapi konservatif dan tindakan operatif berdasarkan identifikasi masalah yang dihadapi masing ? masing penderita.Therapi pembedahan dapat berupa radikal atau middle path, anterior atau posterior, atau kombinasi anterior posterior dengan atau tanpa instrumentasi.

  7. Diagnosis of spinal cord diseases

    International Nuclear Information System (INIS)

    Halimi, P.; Sigal, R.; Doyon, D.; David, P.

    1989-01-01

    Magnetic resonance imaging (MRI) nowadays plays a predominant role in the diagnosis and evaluation of spinal canal pathologies and has reduced the other exploratory methods, including computerized tomography (CT) and myelography, to an ancillary role. These pathologies are divided into three groups: those where MRI is the only imaging method (syringomyela, tumours in the spinal canal, phakomatoses, external pachimeningitis, spinal cord injuries, myelitis); those where MRI is the initial method and is completed by other examinations (vascular malformations, dysraphism, myelopathies due to cervical osteoarthritis) and those where MRI still play a lesser role than CT (degenerative lesions of the lumbar column) [fr

  8. Differential diagnosis of sacral lesions

    International Nuclear Information System (INIS)

    Mesgarzadeh, M.; Rodman, M.S.; Bonakdarpour, A.; Mahboubi, S.

    1987-01-01

    The authors reviewed the teaching files of Temple University Hospital and Children's Hospital of Philadelphia and selected the best representative cases of various lesions of the sacrum. They selected the following lesions: metastasis, chondrosarcoma, chrodoma, plasmacytoma, giant cell tumor, osteogenic sarcoma, Ewing sarcoma, neuroblastoma, neurofibrosarcoma, hemangiopericytoma, osteoblastoma, ossifying fibroma, eosinophilic granuloma, aneurysmal bone cyst, sacrococcygeal teratoma, anterior meningocele, endodermal sinus tumor, and stress fracture. The authors illustrate, for each lesion, the likely age range, sights of predilection, likelihood of occurrence in the sacrum, and radiographic findings helpful in limiting the differential diagnosis. They demonstrate the value of bone scintigraphy in detecting, and CT in confirming, stress fractures of the sacrum

  9. Diagnosis and Treatment of Neurocysticercosis

    Directory of Open Access Journals (Sweden)

    Christina M. Coyle

    2009-01-01

    Full Text Available Neurocysticercosis, the infection caused by the larval form of the tapeworm Taenia solium, is the most common parasitic disease of the central nervous system and the most common cause of acquired epilepsy worldwide. This has primarily been a disease that remains endemic in low-socioeconomic countries, but because of increased migration neurocysticercosis is being diagnosed more frequently in high-income countries. During the past three decades improved diagnostics, imaging, and treatment have led to more accurate diagnosis and improved prognosis for patients. This article reviews the current literature on neurocysticercosis, including newer diagnostics and treatment developments.

  10. Laboratory Diagnosis of Congenital Toxoplasmosis

    Science.gov (United States)

    Pomares, Christelle

    2016-01-01

    Recent studies have demonstrated that screening and treatment for toxoplasmosis during gestation result in a decrease of vertical transmission and clinical sequelae. Early treatment was associated with improved outcomes. Thus, laboratory methods should aim for early identification of infants with congenital toxoplasmosis (CT). Diagnostic approaches should include, at least, detection of Toxoplasma IgG, IgM, and IgA and a comprehensive review of maternal history, including the gestational age at which the mother was infected and treatment. Here, we review laboratory methods for the diagnosis of CT, with emphasis on serological tools. A diagnostic algorithm that takes into account maternal history is presented. PMID:27147724

  11. On diagnosis of congenital toxoplasmosis

    International Nuclear Information System (INIS)

    Denisova, L.B.; Vorontsova, S.V.; Shvedov, V.A.

    1999-01-01

    Chemical manifestations are considered and CT-semiotics of congenital toxoplasmosis, which can form intracranial calcinates, is described. Taking a certain case of congenital toxoplasmosis observation as an example the potentialities and significance of X-ray computerized tomography (CT) in the identification of brain pathological changes are demonstrated. It is shown that intracranial calcificates may be a sign of toxoplasmosis infection. In case of cytomegalovirus infection the calcificates on CT-scans have mostly periventricular localization. Equally with the revealing of brain status in case of chronic stage of neutrotoxoplasmosis the CT has also played a decisive role in diagnosis of pseudotumoroseus course of ischemic insult [ru

  12. 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

  13. Monodetector system for diagnosis (DETEC)

    International Nuclear Information System (INIS)

    Alonso Abad, D.; Fernandez Paz, J.L.; Lopez Torres, O.M. and others

    1997-01-01

    Several clinical searches can be done using The Single Probe Diagnosis System: Thyroid uptake, Eritroferrocinetic studies, Studies of survival of hematite's, Studies of peripheral vascular diseases , Studies of gastric emptying time. The system can be set spectrometric parameters for several radionuclides ( 131I , 125I , 99mT c, 59F e, 51C r, 57G a, 57C o) used in Nuclear Medicine by itself. It is a unit made of a mechanical structure and a detection-measured system based in a Z80 microprocessor. Data obtained are processed and can be printed or sent to a P C by RS-232 protocol

  14. Exploring the Underdiagnosis and Prevalence of Autism Spectrum Conditions in Beijing

    Science.gov (United States)

    Allison, Carrie; Matthews, Fiona E.; Zhang, Zhixiang; Auyeung, Bonnie; Baron‐Cohen, Simon; Brayne, Carol

    2015-01-01

    Previous studies reported that the prevalence of Autism Spectrum Conditions (ASC) in mainland China is much lower than estimates from developed countries (around 1%). The aim of the study is to apply current screening and standardized diagnostic instruments to a Chinese population to establish a prevalence estimate of ASC in an undiagnosed population in mainland China. We followed the design development used previously in the UK published in 2009 by Baron‐Cohen and colleagues. The Mandarin Childhood Autism Spectrum Test (CAST) was validated by screening primary school pupils (n = 737 children age 6–10 years old) in Beijing and by conducting diagnostic assessments using the Autism Diagnostic Observation Schedule and the Autism Diagnostic Interview‐Revised. The prevalence estimate was generated after adjusting and imputing for missing values using the inverse probability weighting. Response was high (97%). Using the UK cutoff (≥15), CAST performance has 84% sensitivity and 96% specificity (95% confidence interval [CI]: 46, 98, and 96, 97, respectively). Six out of 103 children, not previously diagnosed, were found to the meet diagnostic criteria (8.5 after adjustment, 95% CI: 1.6, 15.4). The preliminary prevalence in an undiagnosed primary school population in mainland China was 119 per 10,000 (95% CI: 53, 265). The utility of CAST is acceptable as a screening instrument for ASC in large epidemiological studies in China. Using a comparable method, the preliminary prevalence estimate of ASC in mainland China is similar to that of those from developed countries. Autism Res 2015, 8: 250–260. © 2015 The Authors. Autism Research published by Wiley Periodicals, Inc. on behalf of International Society for Autism Research PMID:25952676

  15. Underdiagnosis of Vertebral Collapse on Routine Multidetector Computed Tomography Scan of the Abdomen

    Energy Technology Data Exchange (ETDEWEB)

    Obaid, H.; Husamaldin, Z.; Bhatt, R. (Doncaster Royal Infirmary, Doncaster (United Kingdom))

    2008-09-15

    Background: Vertebral fractures are commonly associated with osteoporosis and have significant morbidity and mortality rates. Osteoporotic vertebral fractures are presently considered as a treatable and preventable condition, and early detection is vital for further management. The evaluation of vertebral compression on multidetector computed tomography (MDCT) scans of the abdomen has, to our knowledge, not been reported before. Purpose: To assess the prevalence of vertebral collapse on routine abdominal CT scans, and to evaluate the usefulness of the multiplanar reconstruction (MPR) capability of MDCT scans in accurately identifying vertebral abnormalities such as vertebral collapse, spondylolisthesis, and retrolisthesis. Material and Methods: A retrospective review of 307 MDCT scans of the abdomen was carried out at a university teaching hospital. Identifiable patient information was anonymized for data protection. All images were reviewed on a picture archiving and communications system (PACS) using sagittal MPR and bone window for the assessment of the vertebrae. Data were collected from the Computerized Radiology Information System (CRIS). Results: Vertebral collapse was seen in 42 (13.6%) of the 307 patients undergoing routine MDCT of the abdomen. Multilevel and single-level collapses were seen in 24 and 18 patients, respectively. Spondylolisthesis was identified in 5.5% (n=17), and retrolisthesis was seen in 0.6% (n=2). All patients with vertebral fracture were older than 50 years. Women were more commonly affected than men. Conclusion: A significant number of patients with vertebral collapse were diagnosed using MPR on MDCT routine scans of the abdomen

  16. Working with Alcoholic Families in a Child Welfare Agency: The Problem of Underdiagnosis.

    Science.gov (United States)

    Thompson, Lois

    1990-01-01

    Social Service agencies have been reluctant to focus on alcoholism as an issue in treating client and family problems, although there are 48 million alcoholics in the U.S., and 7 million of them are under age 18. Reasons for the reluctance to focus on alcoholism include lack of knowledge, poor prognosis, nihilism, denial, social workers' fears of…

  17. Underdiagnosis of posterior communicating artery aneurysm in non-invasive brain vascular studies

    Science.gov (United States)

    Elmalem, Valerie I.; Hudgins, Patricia A.; Bruce, Beau B.; Newman, Nancy J.; Biousse, Valérie

    2013-01-01

    Introduction Expert interpretation of modern noninvasive neuroimaging such as CTA or MRA should detect nearly all aneurysms responsible for an isolated third nerve palsy. Whether a catheter angiogram should still be obtained in cases with negative CTA or MRA remains debated, and mostly relies on whether the noninvasive study was correctly performed and interpreted. The aim of our study was to review the diagnostic strategies used to evaluate patients with isolated aneurysmal third nerve palsy at a large academic center. Methods Retrospective review of all cases with posterior communicating artery (PCom A) aneurysmal third nerve palsies seen at our institution since 2001. Results We identified 417 cases with third nerve palsy, aneurysm, or subarachnoid hemorrhage, among which 17 presented with an acute isolated painful third nerve palsy related to an ipsilateral PCom A aneurysm (mean age 52; range 33–83 years). Patients were classified into 3 groups based on the results of the noninvasive imaging obtained at initial presentation. Group I included 4 cases with subarachnoid hemorrhage on initial non-contrast head CT initially obtained in an emergency department for evaluation of their isolated third nerve palsy. Group II included 5 cases with isolated third nerve palsy and normal non-contrast head CT at presentation, immediately correctly diagnosed with a PCom A aneurysm at the referring institution. Group III included the 8 remaining cases who all had aneurysms that were missed on noninvasive studies at outside institutions. Review of these outside studies at our institution showed a PCom A aneurysm, confirming misinterpretation of these tests by the outside radiologists, rather than inadequate technique. Absence of specific training in neuroradiology and inaccurate clinical information provided to the interpreting radiologist were associated with test misinterpretation at the outside institutions. The average size of PCom A aneurysms causing an isolated third nerve palsy across all 3 groups was 7.3 mm, and was similar in each group. Conclusion Our study suggests that aside from an accurate history, the training and experience of the interpreting radiologist is probably the most important factor in determining the reliability of a noninvasive scan in patients with isolated third nerve palsies. PMID:21150642

  18. CT diagnosis of rectal cancer

    International Nuclear Information System (INIS)

    Kanda, Hiroshi; Hachisuka, Kitao; Yamaguchi, Akihiro

    1986-01-01

    Preoperative diagnosis of the depth of invasion and lymph node metastasis of rectal cancer were studied using the findings of computed tomography (CT). Of one hundred and four cases operated on for rectal cancer over a period of 32 months, thirty five cases were examined by CT with the use of olive oil enema and contrast enhancement using a 60 % Conray drip infusion with reference to the histological findings. For direct invasion into the wall, the diagnoses by CT were coincident with microscopic findings in 75 % of cancers of the rectosigmoid, in 75 % of the upper rectum and in 84 % of the lower rectum. Of all cases, 28 (80 %) were diagnosed correctly. As to local lymph node metastasis, 74 % of all diagnoses by CT corresponded with the histological diagnosis. Moreover, seventeen cases were evaluated for lateral lymph node metastasis, and the diagnostic accuracy by CT was 88 %. In conclusion, preoperative CT evaluation of the extension into the rectal wall and lymph node metastasis in rectal cancer was considesed useful. (author)

  19. Scabies: Advances in Noninvasive Diagnosis.

    Science.gov (United States)

    Micali, Giuseppe; Lacarrubba, Francesco; Verzì, Anna Elisa; Chosidow, Olivier; Schwartz, Robert A

    2016-06-01

    Scabies is a common, highly contagious skin parasitosis caused by Sarcoptes scabiei var. hominis. Early identification and prompt treatment of infested subjects is essential, as missed diagnosis may result in outbreaks, considerable morbidity, and significantly increased economic burden. The standard diagnostic technique consists of mites' identification by microscopic examination of scales obtained by skin scraping. This is a time-consuming and risk-associated procedure that is also not suitable to a busy practice. In recent years, some advanced and noninvasive techniques such as videodermatoscopy, dermatoscopy, reflectance confocal microscopy, and optical coherence tomography have demonstrated improved efficacy in the diagnosis of scabies. Their advantages include rapid, noninvasive mass screening and post-therapeutic follow-up, with no physical risk. A greater knowledge of these techniques among general practitioners and other specialists involved in the intake care of overcrowded populations vulnerable to scabies infestations is now viewed as urgent and important in the management of outbreaks, as well as in consideration of the recent growing inflow of migrants in Europe from North Africa.

  20. Osteogenesis imperfecta: diagnosis and treatment.

    Science.gov (United States)

    Palomo, Telma; Vilaça, Tatiane; Lazaretti-Castro, Marise

    2017-12-01

    Here we summarize the diagnosis of osteogenesis imperfecta, discuss newly discovered genes involved in osteogenesis imperfecta, and review the management of this disease in children and adults. Mutations in the two genes coding for collagen type I, COL1A1 and COL1A2, are the most common cause of osteogenesis imperfecta. In the past 10 years, defects in at least 17 other genes have been identified as responsible for osteogenesis imperfecta phenotypes, with either dominant or recessive transmission. Intravenous bisphosphonate infusions are the most widely used medical treatment. This has a marked effect on vertebra in growing children and can lead to vertebral reshaping after compression fractures. However, bisphosphonates are less effective for preventing long-bone fractures. At the moment, new therapies are under investigation. Despite advances in the diagnosis and treatment of osteogenesis imperfecta, more research is needed. Bisphosphonate treatment decreases long-bone fracture rates, but such fractures are still frequent. New antiresorptive and anabolic agents are being investigated but efficacy and safety of these drugs, especially in children, need to be better established before they can be used in clinical practice.

  1. 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.

  2. Navigation in diagnosis and therapy

    International Nuclear Information System (INIS)

    Vannier, Michael W.; Haller, John W.

    1999-01-01

    Image-guided navigation for surgery and other therapeutic interventions has grown in importance in recent years. During image-guided navigation a target is detected, localized and characterized for diagnosis and therapy. Thus, images are used to select, plan, guide and evaluate therapy, thereby reducing invasiveness and improving outcomes. A shift from traditional open surgery to less-invasive image-guided surgery will continue to impact the surgical marketplace. Increases in the speed and capacity of computers and computer networks have enabled image-guided interventions. Key elements in image navigation systems are pre-operative 3D imaging (or real-time image acquisition), a graphical display and interactive input devices, such as surgical instruments with light emitting diodes (LEDs). CT and MRI, 3D imaging devices, are commonplace today and 3D images are useful in complex interventions such as radiation oncology and surgery. For example, integrated surgical imaging workstations can be used for frameless stereotaxy during neurosurgical interventions. In addition, imaging systems are being expanded to include decision aids in diagnosis and treatment. Electronic atlases, such as Voxel Man or others derived from the Visible Human Project, combine a set of image data with non-image knowledge such as anatomic labels. Robot assistants and magnetic guidance technology are being developed for minimally invasive surgery and other therapeutic interventions. Major progress is expected at the interface between the disciplines of radiology and surgery where imaging, intervention and informatics converge

  3. Sifilis Laten: Diagnosis dan Pengobatan

    Directory of Open Access Journals (Sweden)

    Rasmia Rowawi

    2013-09-01

    Full Text Available Abstrak   Sifilis laten merupakan stadium sifilis yang diakibatkan oleh T. pallidum yang masih menetap dalam tubuh, namun tidak menunjukkan gejala dan hanya menunjukkan hasil pemeriksaan serologis yang reaktif. Sifilis laten yang tidak diterapi dapat menetap bertahun-tahun atau seumur hidup dan dapat meningkatkan risiko terinfeksi HIV. Ibu hamil dengan sifilis laten dini akan menyebabkan sekitar 40% bayi yang dilahirkankannya tertular, 20% prematur, 10% lahir mati, dan 4% meninggal pada waktu dilahirkan. Diagnosis sifilis laten dini ditegakkan bila dalam 12 bulan terakhir ditemukan satu atau lebih dari tanda-tanda berikut ini: peningkatan titer VDRL/RPR sebanyak empat kali atau lebih; pada anamnesis didapatkan gejala sifilis primer dan sekunder; riwayat kontak seksual dengan seseorang yang didiagnosis atau diduga menderita sifilis primer atau sifilis sekunder atau sifilis laten dini; serta kontak seksual dengan seseorang dengan tes VDRL atau RPR dan TPHA reaktif. Pengobatan yang direkomendasikan untuk sifilis laten dini adalah benzatin penisilin 2,4 juta UI, IM, dosis tunggal, sedangkan pada sifilis laten lanjut, benzatin penisilin 2,4 juta UI, IM, diberikan 3 kali dengan interval satu minggu. Pemeriksaan serologis sifilis non- treponemal (VDRL atau RPR dilakukan setelah pengobatan 3, 6, 12, dan 24 bulan untuk menilai keberhasilan pengobatan.   Kata kunci: Diagnosis, silifis laten, terapi

  4. MR diagnosis of diaphragmatic endometriosis

    International Nuclear Information System (INIS)

    Rousset, Pascal; Gregory, Jules; Coste, Joel; Rousset-Jablonski, Christine; Hugon-Rodin, Justine; Regnard, Jean-Francois; Chapron, Charles; Golfier, Francois; Revel, Marie-Pierre

    2016-01-01

    To evaluate magnetic resonance imaging (MRI) for diaphragmatic endometriosis diagnosis. Over a 2-year period, all diaphragmatic MRI performed in the context of diaphragmatic endometriosis were reviewed. Axial and coronal fat-suppressed T1- and T2-weighted sequences were analyzed by two independent readers for the presence of nodules, plaque lesions, micronodule clustering, or focal liver herniation. MR abnormalities were correlated to surgical findings in women surgically treated. Interobserver agreement was assessed by κ statistics. Twenty-three women with diaphragmatic endometriosis criteria comprised the population; 14 had surgical confirmation and nine had symptoms relief with hormonal treatment. MRI sensitivity was 83 % (19/23; 95 % confidence interval [CI]: 68, 98) for reader 1 and 78 % (18/23; 95 % CI: 61, 95) for reader 2. Kappa value was 0.86 (95 % CI: 0.47, 1.00). Readers 1 and 2 detected 35 and 36 lesions, respectively, all right-sided and agreed for 32 lesions on the type, location, and signal. Lesions were mostly nodules (23/32, 72 %), predominantly posterior (28/32, 87.5 %) and hyperintense on T1 (20/32, 63 %). MRI was negative for both readers in 2 surgically treated patients with small nodules or isolated diaphragmatic holes. MRI allows diaphragmatic endometriosis diagnosis with 78 to 83 % sensitivity and excellent interobserver agreement. (orig.)

  5. MR diagnosis of diaphragmatic endometriosis

    Energy Technology Data Exchange (ETDEWEB)

    Rousset, Pascal [Lyon 1 Claude Bernard University, Villeurbanne (France); Centre Hospitalier Lyon Sud, Radiology Department, Pierre Benite (France); Gregory, Jules; Coste, Joel [Paris Descartes University, Sorbonne Paris Cite, Paris (France); Groupe Hospitalier Cochin Hotel-Dieu, Biostatistics and Epidemiology department, Paris (France); Rousset-Jablonski, Christine [Centre Hospitalier Lyon Sud, Obstetric and Gynecologic Department, Pierre Benite (France); Hugon-Rodin, Justine [Paris Descartes University, Sorbonne Paris Cite, Paris (France); Groupe Hospitalier Cochin Hotel-Dieu, Gynecology Endocrinology Department, Paris (France); Regnard, Jean-Francois [Paris Descartes University, Sorbonne Paris Cite, Paris (France); Groupe Hospitalier Cochin Hotel-Dieu, Thoracic Surgery Department, Paris (France); Chapron, Charles [Paris Descartes University, Sorbonne Paris Cite, Paris (France); Groupe Hospitalier Cochin Hotel-Dieu, Obstetric and Gynecologic Department, Paris (France); Golfier, Francois [Lyon 1 Claude Bernard University, Villeurbanne (France); Centre Hospitalier Lyon Sud, Obstetric and Gynecologic Department, Pierre Benite (France); Revel, Marie-Pierre [Paris Descartes University, Sorbonne Paris Cite, Paris (France); Groupe Hospitalier Cochin Hotel-Dieu, Radiology Department, Paris (France)

    2016-11-15

    To evaluate magnetic resonance imaging (MRI) for diaphragmatic endometriosis diagnosis. Over a 2-year period, all diaphragmatic MRI performed in the context of diaphragmatic endometriosis were reviewed. Axial and coronal fat-suppressed T1- and T2-weighted sequences were analyzed by two independent readers for the presence of nodules, plaque lesions, micronodule clustering, or focal liver herniation. MR abnormalities were correlated to surgical findings in women surgically treated. Interobserver agreement was assessed by κ statistics. Twenty-three women with diaphragmatic endometriosis criteria comprised the population; 14 had surgical confirmation and nine had symptoms relief with hormonal treatment. MRI sensitivity was 83 % (19/23; 95 % confidence interval [CI]: 68, 98) for reader 1 and 78 % (18/23; 95 % CI: 61, 95) for reader 2. Kappa value was 0.86 (95 % CI: 0.47, 1.00). Readers 1 and 2 detected 35 and 36 lesions, respectively, all right-sided and agreed for 32 lesions on the type, location, and signal. Lesions were mostly nodules (23/32, 72 %), predominantly posterior (28/32, 87.5 %) and hyperintense on T1 (20/32, 63 %). MRI was negative for both readers in 2 surgically treated patients with small nodules or isolated diaphragmatic holes. MRI allows diaphragmatic endometriosis diagnosis with 78 to 83 % sensitivity and excellent interobserver agreement. (orig.)

  6. Reflex syncope: Diagnosis and treatment

    Directory of Open Access Journals (Sweden)

    Richard Sutton

    2017-12-01

    Full Text Available For the diagnosis of reflex syncope, diligent history-building with the patient and a witness is required. In the Emergency Department (ED, the assessment of syncope is a challenge which may be addressed by an ED Observation Unit or by a referral to a Syncope Unit. Hospital admission is necessary for those with life-threatening cardiac conditions although risk stratification remains an unsolved problem. Other patients may be investigated with less urgency by carotid sinus massage (>40 years, tilt testing, and electrocardiogram loop recorder insertion resulting in a clear cause for syncope. Management includes, in general terms, patient education, avoidance of circumstances in which syncope is likely, increase in fluid and salt consumption, and physical counter-pressure maneuvers. In older patients, those that will benefit from cardiac pacing are now well defined. In all patients, the benefit of drug therapy is often disappointing and there remains no ideal drug. A role for catheter ablation may emerge for the highly symptomatic reflex syncope patient. Keywords: Cardiac pacing, Catheter ablation, Diagnosis, Drugs, Management, Reflex syncope

  7. Brain abscess - diagnosis and management

    International Nuclear Information System (INIS)

    Bhand, A.K

    2004-01-01

    Objective: To evaluate the clinical presentation, diagnosis, and sources of infection, surgical management outcome and microorganisms involved in the brain abscess in our locality. Subjects and Methods: All patients who were confirmed cases of brain abscess were entered into the study. Data collected on proforma, contained categories of age, gender, clinical presentation, diagnostic laboratory findings, computed tomography scans reports, associated anomalies, surgical management, culture reports antibiotic therapy, microbiologic features and treatment out come. Results: Out of 82 patients, 58 were males and 24 females. Mean age was 18 years (range 05 months to 55 years). Headache with papilloedema was the commonest presentation (82%). Neurological deficit was present in 46%. A source of infection was present in 89%. Otogenic source was the commonest (63%). CT scan was diagnostic in all (100%) cases. Solitary abscess was found in 79% of the cases while in 21 % of the cases multiple abscesses were found. Temporal lobe he commonest site involved (55%). Cultures were found positive for microorganism in 82% of the cases. Bactericides (38%) and Streptococci (25%) were the commonest isolates. Burr hole aspiration was done in only 38% of the cases while excision of the capsule along with aspiration was carried out in 62% of the cases. Over all morality was 22% in this series; causes of death were septicemia, ventriculitis and pneumonia. Conclusion: Diagnosis with CT scan, appropriate antibiotic therapy and complete removal of abscess along with excision capsule could reduce the mortality and neurological deficits from brain abscess. (author)

  8. A radiologist's approach to diagnosis

    International Nuclear Information System (INIS)

    McNulty, J.G.

    1986-01-01

    In suspected biliary tract disease the first diagnostic procedure in all patients following the taking of the case history, physical examination and laboratory studies is ultrasonography. Obesity, intestinal gas and bone structures in the right upper abdomen make the procedure difficult or impossible in some patients. Following ultrasound examination the next procedure is either direct cholangiography or immediate surgery. Close co-operation of surgeon radiologist and endoscopist is necessary to obtain maximum benefit for the patient of the various diagnostic and interventional procedures which are available. It is important to recognise inoperable disease and to promote procedures which benefit the patient without the use of major surgery. In the study of gallbladder disease the oral cholecystogram as a diagnostic test is today only necessary in a few patients. However, because of the number of patients requiring investigation of suspected gallbladder disease and the totally inadequate number of ultrasound machines available in our hospitals compared with other countries the oral cholecystogram continues in use. Infusion cholangiography continues to decline in use although it is valuable in demonstrating retained bile duct stones in some patients when ERCP is not available. The diagnosis of choledocholithiasis by ultrasound is much less accurate than the diagnosis of cholelithiasis. Directing attention to the common bile duct rather than the intrahepatic ducts in suspected biliary obstruction and the development of endoscopic ultrasonography and operative ultrasonography may dispense with contrast studies involving radiation in the near future. (author)

  9. Diagnosis of carotid artery stegnosis

    International Nuclear Information System (INIS)

    Uwatoko, Takeshi; Okada, Yasushi

    2008-01-01

    Carotid Artery Stegnosis (CAS) is an important cause of the crisis of atherothrombotic cerebral infarction. This paper describes diagnosis and evaluation of CAS by echo and MRI/MR angiography (MRA) together with its clinical characteristics. Two hundreds Japanese patients undergone with carotid endarterectomy in authors' hospital are found to have had complications of coronary lesions in 38% and arteriosclerosis obliterans in 13%. Echo is a useful and simple method for detection of dynamic state of CAS and in cerebral infarction, diagnosis to decide whether the plaque is the culprit lesion is important as well as to decide the degree of stegnosis. The lesion is detected through the B mode method and the degree, through the color Doppler imaging; and blood flow rate and its waveform can be evaluated. MRI/MRA has advantages of its objectivity and wide imaging range. The MRI/MRA using various imaging techniques like black-blood method by spin echo or gradient echo modes and fat-suppression combination is advantageous and expectedly to be further developed for evaluation of plaque nature and status leading to therapeutic planning. Thus the degree of stegnosis and vulnerability of the plaque evaluated by echo and MRI/MRA of the cervical artery will be more important for judging the surgical applicability of circulatory reconstruction. (R.T.)

  10. Computational diagnosis of canine lymphoma

    International Nuclear Information System (INIS)

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

    2014-01-01

    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

  11. Radiological methods in liver diagnosis

    International Nuclear Information System (INIS)

    Boeck, N.M.

    1982-01-01

    In 63 localized masses in a group of 169 patients, CT was found to be the most reliable diagnostic method with an accuracy of 97%, a sensitivity of 95%, and a specificity of 97%. With an accuracy of 87%, a sensitivity of 75% and a specificity of 95%, sonography was more efficient than scintiscanning which had an accuracy of 73%, a sensitivity of 71%, and a specificity of 63%. CT and sonography were further compared in a group of 600 patients with 150 proved localized masses. With an accuracy of 82%, a sensitivity of 66% and a specificity of 87%, sonography was clearly inferior to CT which had an accuracy of 97%, a sensitivity of 92%, and a specificity of 98%. CT provided a sure differential diagnosis in 73% of all cases and sonography in 60% (referred to the number of processes detected). Diffuse processes can be detected by radiological methods only at a certain intensity. Here, scintiscanning had a sensitivity of 66%, CT of 53% and somography of 47%. Angiography is indicated for pre-operative determination of the intrahepatic vascular and collateral supply and of the patency of the portal veins. Differential diagnosis is usually reliable. (orig./MG) [de

  12. [Endosonography in diagnosis of choledocholithiasis].

    Science.gov (United States)

    Épshteĭn, A M; Duberman, B L; Dyn'kov, S M; Pozdeev, V N

    2014-01-01

    In 38-80% patients with suspicion to choledocholithiasis were no stones in common bile duct (CBD) after endoscopic retrograde cholangiopancreatography (ERCP). ERCP is not safe procedure and has a risk of complications ranging 4-15%. The aim of our study was to estimate the diagnostic value and safety of endoscopic ultrasound (EUS) in CBD stones diagnosis. In patients with medium probability of CBD stones (i.e. CBD ≤ 10 mm and/or bilirubin ≤ 2 times upper normal) was performed BUS with Pentax EG-3870UTK and Hitachi EUB-7000HV. From September 2012 till December 2013 it were done 72 investigations in patients with suspicion of CBD stones. After EUS suspicion for CBD stones were in 21 patients. Average size of hyperechoic defects was 5.6 ± 3.3 (2-12) mm. ERCP was performed in 20 of them. Stones were confirmed and removed in 18 patients, in 2 patients without stones it was found a stricture of terminal part of CBD. In 9 patients absence of stones was confirmed during laparoscopic cholecystectomy with IOC. Patients without indications to cholecystectomy were followed for six months and there were no additional investigations. It were no complications after EUS. EUS sensitivity was 100%, specificity--96.2%, PPV--90%, NPV--100%. EUS is effective tool for diagnosis of CBD stones in patients with medium probability of choledocholithiasis. It could be recommended as a first diagnostic step in these patients because the risk of complications is negligible.

  13. Diagnosis of Carpal Tunnel Syndrome

    Science.gov (United States)

    Keith, Michael Warren; Masear, Victoria; Chung, Kevin; Maupin, Kent; Andary, Michael; Amadio, Peter C.; Barth, Richard W.; Watters, William C.; Goldberg, Michael J.; Haralson, Robert H.; Turkelson, Charles M.; Wies, Janet L.

    2016-01-01

    This clinical practice guideline was created to improve patient care by outlining the appropriate information-gathering and decision-making processes involved in managing the diagnosis of carpal tunnel syndrome. The methods used to develop this clinical practice guideline were designed to combat bias, enhance transparency, and promote reproducibility. The guideline’s recommendations are as follows: The physician should obtain an accurate patient history. The physician should perform a physical examination of the patient that may include personal characteristics as well as performing a sensory examination, manual muscle testing of the upper extremity, and provocative and/or discriminatory tests for alternative diagnoses. The physician may obtain electrodiagnostic tests to differentiate among diagnoses. This may be done in the presence of thenar atrophy and/or persistent numbness. The physician should obtain electrodiagnostic tests when clinical and/or provocative tests are positive and surgical management is being considered. If the physician orders electrodiagnostic tests, the testing protocol should follow the American Academy of Neurology/American Association of Neuromuscular and Electrodiagnostic Medicine/American Academy of Physical Medicine and Rehabilitation guidelines for diagnosis of carpal tunnel syndrome. In addition, the physician should not routinely evaluate patients suspected of having carpal tunnel syndrome with new technology, such as magnetic resonance imaging, computed tomography, and pressure-specified sensorimotor devices in the wrist and hand. This decision was based on an additional nonsystematic literature review following the face-to-face meeting of the work group. PMID:19474448

  14. Radiological diagnosis of lung diseases

    International Nuclear Information System (INIS)

    Kauczor, H.U.; Heussel, C.P.; Thelen, M.

    2000-01-01

    Radiological cross-sectional imaging modalities, particularly computed tomography (CT) have become the mainstays for diagnosing lung disease in recent years. These enable morphological visualization of pathological processes with the greatest possible spatial resolution. Modern technical developments and complementary strategies have led to new applications and new functional assessments which need to be reviewed together with state-of-the-art techniques in nuclear imaging. The diagnosis of pulmonary embolism using spiral CT angiography and magnetic resonance (MR) angiography certainly belongs in this category. CT has become the an alternative modality of first choice, and it is also challenging pulmonary angiography as the gold standard. Direct visualization of patent pulmonary arteries and thromboembolic material is complemented by that of effects on the pulmonary parenchyma and right heart function; it also provides perfusion studies and MR-based flow measurement to assess hemodynamic compromise. Ventilation studies have long been a domain of nuclear imaging, and new techniques for the direct visualization of ventilation are emerging from recent developments in the field of MR imaging, for example, using hyperpolarized inert gases. New functional parameters of ventilation can be derived from these studies. For the diagnosis of metabolically active disease, such as tumor and pneumonia, CT offers very high sensitivity, for example, in screening for intrapulmonary nodules using low-dose CT and in the early detection of pulmonary infiltrates in high-risk patients. Especially for characterizing pulmonary nodules there is a need to combine nuclear medicine techniques, such as in positron-emission tomography. (orig.) [de

  15. Clinical diagnosis of breast cancer.

    Science.gov (United States)

    Leis, H P

    1975-06-01

    Breast cancer is the most common malignant neoplasm in women, and 6% will develop it during their normal life expectancy. There is a group who have a high risk of developing breast cancer. The recent improvement in cure rates seems to be jue chiefly to earlier diagnosis rather than to improved methods of therapy. The physician, by careful periodic breast examinations and by the judicious use of diagnostic aids such as mammography and thermography, especially in the high risk group, has a golden opportunity to pick up cancer in a localized stage where the prognosis for cure with appropriate therapy is excellent. A tentative diagnosis of breast cancer (Table XI) can be made with a fair degree of accuracy by taking a careful history, utilizing and combining available statistics about the frequency, median age, characteristic symptom complexes of the common breast lesions and factors related to a high mammary carcinoma risk, and by a systematic and thorough breast examination supplemented with diagnostic aids when appropriate. However, biopsy and histologic examination is mandatory in all patients with a) true, three dimentional, dominant lumps even if diagnostic aids are negative except for cysts which can be safely aspirated under controlled conditions; b) suspicious lesions found by diagnostic aids even though there are no clinical findings; c) serous, serosanguineous, bloody, or watery nipple discharge; and d) other signs of cancer, i.e. eczema of the nipple, axillary adenopathy, etc., in order to determine with absolute accuracy whether the lesion is benign or malignant.

  16. Neuropathological diagnosis of brain tumours.

    Science.gov (United States)

    Pollo, Bianca

    2011-11-01

    With recent progress in radiological, pathological, immunohistochemical, molecular and genetic diagnoses, the characterisation of brain tumours has improved. The last World Health Organization (WHO) Classification of Tumours of the Central Nervous System was done in 2007, based on morphological features, growth pattern and molecular profile of neoplastic cells, defined malignancy grade. The neuropathological diagnosis and the grading of each histotype are based on identification of histopathological criteria and immunohistochemical data. Molecular and genetic profiles may identify different tumour subtypes varying in biological and clinical behaviour, indicating prognostic and predictive factors. In order to investigate new therapeutic approaches, it is important to study the molecular pathways responsible for proliferation, invasion, angiogenesis, and anaplastic transformation. Different prognostic and predictive factors for glioma patients were identified by genetic studies, such as the loss of heterozygosis on chromosome 1p and 19q for oligodendrogliomas, proangiogenic factors such as Vascular Endothelial Growth Factor for glioblastomas and the methylation status of gene promoter of MethylGuanine-MethylTransferase. In conclusion, the prognostic evaluation and the therapeutic strategies for patients depend on the synthesis of histological diagnosis, malignancy grade, gene-molecular profile, radiological images, surgical resection and clinical findings (age, tumour location, and "performance status").

  17. Scabies: Advances in Noninvasive Diagnosis.

    Directory of Open Access Journals (Sweden)

    Giuseppe Micali

    2016-06-01

    Full Text Available Scabies is a common, highly contagious skin parasitosis caused by Sarcoptes scabiei var. hominis. Early identification and prompt treatment of infested subjects is essential, as missed diagnosis may result in outbreaks, considerable morbidity, and significantly increased economic burden. The standard diagnostic technique consists of mites' identification by microscopic examination of scales obtained by skin scraping. This is a time-consuming and risk-associated procedure that is also not suitable to a busy practice. In recent years, some advanced and noninvasive techniques such as videodermatoscopy, dermatoscopy, reflectance confocal microscopy, and optical coherence tomography have demonstrated improved efficacy in the diagnosis of scabies. Their advantages include rapid, noninvasive mass screening and post-therapeutic follow-up, with no physical risk. A greater knowledge of these techniques among general practitioners and other specialists involved in the intake care of overcrowded populations vulnerable to scabies infestations is now viewed as urgent and important in the management of outbreaks, as well as in consideration of the recent growing inflow of migrants in Europe from North Africa.

  18. 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...

  19. Ethical issues in prenatal diagnosis.

    Science.gov (United States)

    Johnson, S R; Elkins, T E

    1988-06-01

    Prenatal diagnosis raises complex ethical issues not only in terms of individual decision making, but also in the development of clinical services and the formulation of public policy regarding access and funding. The motivation behind prenatal diagnosis is generally to provide the family with information regarding the pregnancy so that the outcome can be improved or, in the case of severely affected pregnancies, a decision can be made about pregnancy termination. Although many of the ethical issues involved in prenatal diagnosis and treatment overlap those common to all types of diagnostic procedures, the former situation is complicated by controversy about the moral status of the fetus and the use of selective abortion as a form of treatment. While there is general agreement that pregnancy termination after the 2nd trimester can be justified if the fetus is afflicted with a condition that is incompatible with postnatal survival or characterized by the virtual absence of cognitive functioning, the disposition of a fetus afflicted with a non-life-threatening physical or mental disability (e.g., Down's syndrome) is more controversial. An additional concern is that women with positive screening test results may choose elective abortion rather than undergo a definitive work-up. The issue of maternal versus fetal rights is perhaps the single most controversial dilemma. Here, the basic ethical dilemma is the conflict between respecting maternal autonomy versus acting beneficently toward the fetus. As a general rule, the more invasive the medical technique and the less certain the benefit to the fetus (e.g., laparotomy), the more difficult it is to make a convincing argument for forced interventions involving the mother's body. Situations in which compelling arguments can be made for forced interventions against the will of the mother are those where an otherwise healthy infant will die without immediate intervention or failure to perform a procedure will result in the

  20. Imaging diagnosis of Baker's cysts

    International Nuclear Information System (INIS)

    Ding Xiaonan; Yuan Jianhua; Lv Jun

    2009-01-01

    Objective: To analyze the imaging features of Baker's cysts and to improve the accuracy in diagnosis. Methods: Imaging manifestation of 22 cases with Baker's cysts were analyzed retrospectively. The location and shape of cysts and feature of signal (density) and relation with the adjacent cysts were reviewed. Results: With 22 cases of Baker's cysts, 9 cases (40.9%) located between the medial head of gastrocnemius muscle and semimembranous muscle, 4 cases (18.2%) in the medial head of gastrocnemius muscle, 4 cases (18.2%) in the joint capsule, 3 cases (13.6%) in the semimembranous muscle, 1 cases located between the lateral head of gastrocnemius muscle and biceps muscle of thigh, 1 cases in the popliteal muscle. Conclusion: The location, size, shape, adjacent relationship and accompanied diseases of Baker's cysts can be better displayed on the CT, MRI, which can provide important clinical value. (authors)

  1. Diagnosis Deafness in a Child

    Directory of Open Access Journals (Sweden)

    Robabeh Taghavi

    1993-03-01

    Full Text Available It is difficult for clinicians to make parents aware of any disease or permanent handicap of their children.It is crucial to have vivid picture of the reactions to such crisis in order to manage severe psychological effects of the mentioned situations such as depression and unhappiness. Confronting the situation parents have diverse feelings regarding the pregnancy period, birth time and handicap diagnosis and these are the factors that shape the parent’s upcoming reactions. Common feedbacks to the crisis are refusing the problem, keeping their child away from society, the emotions that provoke disappointment, asking about the reasons for hearing loss, referring to religion, condemning the physician, feeling sin and changing doctor frequently. When parent accept the situation and that hearing could not recurrent and understanding the natural reasons back on their child’s handicap, they can manage the situation constructively.

  2. CT diagnosis of abdominal abscesses

    International Nuclear Information System (INIS)

    Sobota, J.

    1983-01-01

    The noninvasive nature and amount of information obtained using computed tomography have very quickly put this method of diagnosis to the forefront of the interest of the medical public. So far the authors examined 21 cases of intraabdominal abscess. The successful detection of the abscess depends on the site of the abscess, the stage of development, the size, the choice of measuring program and the experience of the examining physician. The diagnostic possibilities of CT as compared with other radiological methods are by far the best. Ultrasound and scintigraphy are also highly successful but CT also allows the physician to localize the abscess, to determine its size, shape and distance from neighbouring organs which is very important in targeted aspiration biopsy. CT also makes it possible to estimate the stage of development, to make a choice of therapy and to evaluate the state of healing or the success of drainage. (author)

  3. Molecular Diagnosis of Cystic Fibrosis.

    Science.gov (United States)

    Deignan, Joshua L; Grody, Wayne W

    2016-01-01

    This unit describes a recommended approach to identifying causal genetic variants in an individual suspected of having cystic fibrosis. An introduction to the genetics and clinical presentation of cystic fibrosis is initially presented, followed by a description of the two main strategies used in the molecular diagnosis of cystic fibrosis: (1) an initial targeted variant panel used to detect only the most common cystic fibrosis-causing variants in the CFTR gene, and (2) sequencing of the entire coding region of the CFTR gene to detect additional rare causal CFTR variants. Finally, the unit concludes with a discussion regarding the analytic and clinical validity of these approaches. Copyright © 2016 John Wiley & Sons, Inc.

  4. Postsurgical endophthalmitis: Diagnosis and management

    Directory of Open Access Journals (Sweden)

    Das Taraprasad

    1995-01-01

    Full Text Available Infectious endophthalmitis following intraocular surgery is a complication that could cause severe visual loss or loss of the eye. The categorisation of the event that led to intraocular infection will help the clinician to predict the infectious agent and begin appropriate therapy. Most of the cases of postsurgical endophthalmitis are seen following cataract surgery. It is important for all ophthalmologists, irrespective of specialisation and areas of interest,to be familiar with the management of endophthalmitis. This review briefly describes the facets of clinical and laboratory diagnosis, pathology, and management. While the different viewpoints in the management of endophthalmitis are mentioned in appropriate places, more attention is paid to present a rational approach to the management of endophthalmitis.

  5. [Differential diagnosis in potency disorders].

    Science.gov (United States)

    Kockott, G; Dittmar, F

    1976-12-02

    Disorders of sexual libido are seldom organic, in general they are of psychological origin. It is, however, difficult to obtain a differential diagnosis. One of the first diagnostic considerations must be the establishment of primary or secondary libidinal dificit, or indeed, whether there is no libido at all. In cases of libido disorders with primary libido dificit, depression, organic disease, or side effects of pharmaca may be the cause. Libido disorders in the presence of functional libido, however, must be regarded as primarily psychologically caused. An exception are libido problems in the presence of diabetes mellitus and peripheral vasculatory defeciencies. In these cases libido is either totally absent or appears only secondarily. The symptomatology of libido disorders in the presence of depression, diabetes melitus, and peripheral vasculatory disturbancies, as well as psychologically caused erectile and ejaculatory difficulties are discussed in detail. These groups are compared with respect to libido and behavior involving erection, ejaculation, anxiety and avoidance.

  6. Sonographic Diagnosis of Complicated Cholecystitis.

    Science.gov (United States)

    Shapira-Rootman, Mika; Mahamid, Ahmad; Reindorp, Nadir; Nachtigal, Alicia; Zeina, Abdel-Rauf

    2015-12-01

    Early detection of the complications of cholecystitis is important for clinical management, yet only a small percentage of patients have a correct diagnosis before surgery. The purpose of our study was to identify sonographic findings that are associated with complicated cholecystitis. Sonographic, surgical, and pathologic reports were reviewed for 70 patients who underwent early cholecystectomies from January 2010 to August 2014. Sonograms were assessed for 16 independent variables. Statistical analyses were performed to evaluate associations between various sonographic features and complicated cholecystitis. Sonographic signs associated with complicated cholecystitis (Pcholecystitis. In most cases, sonograms reflected severe inflammation, with multiple sonographic signs. Although multiple sonographic signs are associated with complicated cholecystitis, none of them is sensitive and specific enough to definitively diagnose it. Sonograms usually reflect severe inflammation, with numerous sonographic signs. Thus, in the right clinical context, sonograms of severe cholecystitis should alert radiologists to the possibility of complications. © 2015 by the American Institute of Ultrasound in Medicine.

  7. Diagnosis and treatment of impetigo.

    Science.gov (United States)

    Cole, Charles; Gazewood, John

    2007-03-15

    Impetigo is a highly contagious, superficial skin infection that most commonly affects children two to five years of age. The two types of impetigo are nonbullous impetigo (i.e., impetigo contagiosa) and bullous impetigo. The diagnosis usually is made clinically, but rarely a culture may be useful. Although impetigo usually heals spontaneously within two weeks without scarring, treatment helps relieve the discomfort, improve cosmetic appearance, and prevent the spread of an organism that may cause other illnesses (e.g., glomerulonephritis). There is no standard treatment for impetigo, and many options are available. The topical antibiotics mupirocin and fusidic acid are effective and may be superior to oral antibiotics. Oral antibiotics should be considered for patients with extensive disease. Oral penicillin V is seldom effective; otherwise there is no clear preference among antistaphylococcal penicillins, amoxicillin/clavulanate, cephalosporins, and macrolides, although resistance rates to erythromycin are rising. Topical disinfectants are not useful in the treatment of impetigo.

  8. Polyhydramnios: Causes, Diagnosis and Therapy.

    Science.gov (United States)

    Hamza, A; Herr, D; Solomayer, E F; Meyberg-Solomayer, G

    2013-12-01

    Polyhydramnios is defined as a pathological increase of amniotic fluid volume in pregnancy and is associated with increased perinatal morbidity and mortality. Common causes of polyhydramnios include gestational diabetes, fetal anomalies with disturbed fetal swallowing of amniotic fluid, fetal infections and other, rarer causes. The diagnosis is obtained by ultrasound. The prognosis of polyhydramnios depends on its cause and severity. Typical symptoms of polyhydramnios include maternal dyspnea, preterm labor, premature rupture of membranes (PPROM), abnormal fetal presentation, cord prolapse and postpartum hemorrhage. Due to its common etiology with gestational diabetes, polyhydramnios is often associated with fetal macrosomia. To prevent the above complications, there are two methods of prenatal treatment: amnioreduction and pharmacological treatment with non-steroidal anti-inflammatory drugs (NSAIDs). However, prenatal administration of NSAIDs to reduce amniotic fluid volumes has not been approved in Germany. In addition to conventional management, experimental therapies which would alter fetal diuresis are being considered.

  9. Radiologic diagnosis of pleural mesothelioma

    International Nuclear Information System (INIS)

    Fujimoto, Toshifumi; Hayashi, Kuniaki; Matsunaga, Naofumi

    1989-01-01

    Five cases of pleural mesothelioma (3 benign and 2 malignant) were evaluated with chest radiograph and CT. A case of benign localized mesothelioma growing within the major fissure, and a case of diffuse malignant mesothelioma encircling the descending thoracic aorta are included among the five cases. Pleural mesotheliomas present a variety of roentgenographic manifestations depending upon the histologic type, the site of origin, and the direction of the extension, and can easily be misdiagnosed as lung tumor, aortic aneurysm, or mediastinal tumor. It is emphasized that pleural mesothelioma should be considered as a differential diagnosis when a mass lesion is found in the mediastinum, hilar region, interlobar fissure, or near the chest wall. (author)

  10. The diagnosis of food allergy

    DEFF Research Database (Denmark)

    Soares-Weiser, K; Takwoingi, Y; Panesar, S S

    2014-01-01

    BACKGROUND: We investigated the accuracy of tests used to diagnose food allergy. METHODS: Skin prick tests (SPT), specific-IgE (sIgE), component-resolved diagnosis and the atopy patch test (APT) were compared with the reference standard of double-blind placebo-controlled food challenge. Seven...... is limited and weak and is therefore difficult to interpret. Overall, SPT and sIgE appear sensitive although not specific for diagnosing IgE-mediated food allergy....... databases were searched and international experts were contacted. Two reviewers independently identified studies, extracted data, and used QUADAS-2 to assess risk of bias. Where possible, meta-analysis was undertaken. RESULTS: Twenty-four (2831 participants) studies were included. For cows' milk allergy...

  11. 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

  12. Intracochlear Schwannoma: Diagnosis and Management

    Directory of Open Access Journals (Sweden)

    Bittencourt, Aline Gomes

    2014-01-01

    Full Text Available Introduction Schwannomas of the eighth cranial nerve are benign tumors that usually occur in the internal auditory canal or the cerebellopontine angle cistern. Rarely, these tumors may originate from the neural elements within the vestibule, cochlea, or semicircular canals and are called intralabyrinthine schwannomas. Intracochlear schwannomas (ICSs represent a small percentage of these tumors, and their diagnosis is based on high-resolution magnetic resonance imaging (MRI. Objectives To report the clinical and radiologic features and audiometric testing results of an ICS in a 48-year-old man after a 22-month follow-up period. Resumed Report A patient with an 8-year history of persistent tinnitus in his right ear, combined with ipsilateral progressive hearing loss and aural fullness. Audiometry revealed normal hearing in the left ear and a moderate to severe sensorineural hearing loss in the right ear, with decreased speech reception threshold and word recognition score, compared with the exam performed 5 years previously. MRI showed a small intracochlear nodular lesion in the modiolus, isointense on T1 with a high contrast enhancement on T1 postgadolinium images. During the follow-up period, there were no radiologic changes on imaging studies. Thus, a wait-and-scan policy was chosen as the lesion remained stable with no considerable growth and the patient still presents with residual hearing. Conclusions Once diagnosed, not all ICS patients require surgery. Treatment options for ICS include stereotactic radiotherapy and rescanning policy, depending on the tumor's size, evidence of the tumor's growth, degree of hearing loss, intractable vestibular symptoms, concern about the pathologic diagnosis, and the patient's other medical conditions.

  13. Conversion disorder: a problematic diagnosis.

    Science.gov (United States)

    Nicholson, Timothy R J; Stone, Jon; Kanaan, Richard A A

    2011-11-01

    The diagnosis of conversion disorder is problematic. Since doctors have conceptually and practically differentiated the symptoms from neurological ('organic') disease it has been presumed to be a psychological disorder, but the psychological mechanism, and how this differs from feigning (conscious simulation), has remained elusive. Although misdiagnosis of neurological disease as conversion disorder is uncommon, it remains a concern for clinicians, particularly for psychiatrists who may be unaware of the positive ways in which neurologists can exclude organic disease. The diagnosis is anomalous in psychiatry in that current diagnostic systems require that feigning is excluded and that the symptoms can be explained psychologically. In practice, feigning is very difficult to either disprove or prove, and a psychological explanation cannot always be found. Studies of childhood and adult psychological precipitants have tended to support the relevance of stressful life events prior to symptom onset at the group level but they are not found in a substantial proportion of cases. These problems highlight serious theoretical and practical issues not just for the current diagnostic systems but for the concept of the disorder itself. Psychology, physiology and functional imaging techniques have been used in attempts to elucidate the neurobiology of conversion disorder and to differentiate it from feigning, but while intriguing results are emerging they can only be considered preliminary. Such work looks to a future that could refine our understanding of the disorder. However, until that time, the formal diagnostic requirement for associated psychological stressors and the exclusion of feigning are of limited clinical value. Simplified criteria are suggested which will also encourage cooperation between neurology and psychiatry in the management of these patients.

  14. Diagnosis of shoulder impingement syndrome

    International Nuclear Information System (INIS)

    Hodler, J.

    1996-01-01

    This article reviews the pathogenesis and clinical and imaging findings in shoulder impingement syndrome. Different stages of impingement syndrome are described. Stage I relates to edema and hemorrhage of the supraspinatus tendon. Stage II is characterized by bursal inflammation and fibrosis, as well as tendinopathy. In stage III there is a tear of the rotator cuff. Clinical signs many overlap. Moreover, calcifying tendinitis, fractures and pain originating from the cervical spine may mimic shoulder impingement syndrome. Imaging is important for the exact diagnosis. Standard radiographs are the basis of imaging in shoulder impingement syndrome. They may demonstrate subchondral sclerosis of the major tuberosity, subacromial spurs, and form anomalies of the acromion. They are also important in the differential diagnosis of shoulder impingement syndrome and demonstrate calcifying tendinitis, fractures and neoplasm. Ultrasonography has found acceptance as a screening tool and even as a final diagnostic method by many authors. However, there is a high interobserver variability in the demonstration of rotator cuff tears. Its usefulness has therefore been questioned. MR imaging is probably the method of choice in the evaluation of the rotator cuff and surrounding structures. Several investigations have demonstrated that differentiation of early findings, such as tendinopathy versus partial tears, may be difficult with MR imaging. However, reproducibility for fullthickness tears appears to be higher than for sonography. Moreover, specificity appears to be superior to sonography. MR arthrography is not universally accepted. However, it allows for more exact differentiation of discrete findings and may be indicated in preoperative planning. Standard arthrography and CT have a limited role in the current assessment of the rotator cuff. (orig.) [de

  15. Diagnosis and management of bronchiolitis.

    Science.gov (United States)

    2006-10-01

    Bronchiolitis is a disorder most commonly caused in infants by viral lower respiratory tract infection. It is the most common lower respiratory infection in this age group. It is characterized by acute inflammation, edema, and necrosis of epithelial cells lining small airways, increased mucus production, and bronchospasm. The American Academy of Pediatrics convened a committee composed of primary care physicians and specialists in the fields of pulmonology, infectious disease, emergency medicine, epidemiology, and medical informatics. The committee partnered with the Agency for Healthcare Research and Quality and the RTI International-University of North Carolina Evidence-Based Practice Center to develop a comprehensive review of the evidence-based literature related to the diagnosis, management, and prevention of bronchiolitis. The resulting evidence report and other sources of data were used to formulate clinical practice guideline recommendations. This guideline addresses the diagnosis of bronchiolitis as well as various therapeutic interventions including bronchodilators, corticosteroids, antiviral and antibacterial agents, hydration, chest physiotherapy, and oxygen. Recommendations are made for prevention of respiratory syncytial virus infection with palivizumab and the control of nosocomial spread of infection. Decisions were made on the basis of a systematic grading of the quality of evidence and strength of recommendation. The clinical practice guideline underwent comprehensive peer review before it was approved by the American Academy of Pediatrics. This clinical practice guideline is not intended as a sole source of guidance in the management of children with bronchiolitis. Rather, it is intended to assist clinicians in decision-making. It is not intended to replace clinical judgment or establish a protocol for the care of all children with this condition. These recommendations may not provide the only appropriate approach to the management of children

  16. Prenatal diagnosis of perplexing cases of lipidoses.

    Science.gov (United States)

    Aboul Nasr, Ahmed L; Fateen, Ekram M

    2008-01-01

    To present and discuss the technical, ethical and counseling difficulties that were encountered in the prenatal diagnosis of some perplexing cases of lipidoses. Four pregnant women were referred to us for prenatal diagnosis with the diagnosis of lipidosis in an affected sibling. (1) It is recommended to do the enzyme assays as the first choice in all cases suspected clinically to have lipidoses in order to establish the diagnosis instead of doing invasive procedures as liver and bone marrow biopsies. (2) Activity of more than one enzyme should be assayed to confirm specific deficiency against reference values. (3) Suspected prenatal diagnosis and indefinite diagnosis should only be considered after detailed and non-directive counseling (Tab. 1, Fig. 4, Ref. 5).

  17. Content validation of the nursing diagnosis Nausea

    Directory of Open Access Journals (Sweden)

    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.

  18. Diagnosis in the Enterprise Management System

    OpenAIRE

    Skrynkovskyy Ruslan M.; Pawlowski Grzegorz

    2016-01-01

    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 eliminat...

  19. Nursing diagnosis in intenzive care units

    OpenAIRE

    Bartošová, Simona

    2013-01-01

    v AJ: This diploma thesis deals with the field of nursing diagnosis in internal intensive care units. The theoretical part describes the basics of the nursing process and mainly focuses on the nursing diagnosis. Subsequently, it informs the reader about history, development and structure of the NANDA Taxonomy II. The main part of the thesis consists of a quantitative survey which aims at general nurses' knowledge about the nursing diagnosis NANDA - International. It also comments on how nursi...

  20. Training Changes Professionals’ Attitudes Towards Dual Diagnosis

    DEFF Research Database (Denmark)

    Pinderup, Pernille

    2016-01-01

    Studies have shown that mental health professionals in many cases have counterproductive attitudes towards patients with mental illnesses and comorbid substance use disorders (dual diagnosis). This is problematic because professionals’ attitudes are important for both the therapeutic alliance...... and treatment outcome. This study tested whether providing training in dual diagnosis treatment to mental health professionals will affect their attitudes positively. Twenty-one professionals completed a questionnaire on attitudes towards working with dual diagnosis (Comorbidity Problems Perceptions...

  1. DISCUSSING NURSING DIAGNOSIS APPLIED BY NURSING STUDENTS

    OpenAIRE

    K. M. H. Cavalcante; M. L. Botelho; P. P. Cavalcanti; F. M. P. Garcia

    2016-01-01

    Aimed to identify and discuss nursing diagnosis present in 50 Case Studies developed by students of graduation nursing of Federal University of Mato Grosso - Campus of Sinop, in a unit of clinical medical. Documentary research that addressed quantitatively the nursing diagnosis proposed using the Taxonomy II of NANDA-I (2009-2011). It was documented 82 different diagnosis, and covered all the 13 domains. The involvement of all the domains and the large variability of diagnoses identified sug...

  2. COPD is frequent in conditions of comorbidity in patients treated with various diseases in a university hospital

    Directory of Open Access Journals (Sweden)

    Akira Yamasaki

    2010-09-01

    Full Text Available Akira Yamasaki, Kiyoshi Hashimoto, Yasuyuki Hasegawa, Ryota Okazaki, Miki Yamamura, Tomoya Harada, Shizuka Ito, Soichiro Ishikawa, Hiroki Takami, Masanari Watanabe, Tadashi Igishi, Yuji Kawasaki, Eiji ShimizuDivision of Medical Oncology and Molecular Respirology, Department of Multidisciplinary Internal Medicine, Faculty of Medicine, Tottori University, JapanBackground: Chronic obstructive pulmonary disease (COPD is one of the leading causes of death and loss of disability-adjusted life-years. However, many COPD patients are not diagnosed because of underrecognition or underdiagnosis of this disease among many patients and physicians. One possible reason is underrecognition of spirometry. In this study, we examined the prevalence of airflow limitation and underlying disease in patients with airflow limitation.Methodology: From April 2006 to March 2008, patients who had spirometry performed were examined. The original disease of patients, pulmonary function tests, smoking status, and respiratory symptoms were surveyed from their medical records.Results: Of all patients who had spirometry performed, 15.8% showed airflow limitation (FEV1/FVC < 0.7. A variety of diseases were observed in patients with airflow limitation. Among all diseases, cardiovascular disease was the highest and gastrointestinal malignant disease had the second highest prevalence in patients with airflow limitation.Conclusion: COPD might be frequent in conditions of comorbidity in patients treated for various diseases. Attention should be paid to the possibility of co-existence of COPD and the influence of COPD on these patients.Keywords: airflow limitation, chronic obstructive pulmonary disease, comorbidity, spirometry, prevalence

  3. Intelligent Systems for Active Program Diagnosis

    Directory of Open Access Journals (Sweden)

    Haider Ali Ramadhan

    2000-12-01

    Full Text Available Intelligent program diagnosis systems are computer programs capable of analyzing logical and design-level errors and misconceptions in programs. Upon discovering the errors, these systems provide intelligent feedback and thus guide the users in the problem-solving process. Intelligent program diagnosis systems are classified by their primary means of program analysis. The most distinct split is between those systems that are unable to analyze partial code segments as they are provided by the user and must wait until the entire solution code is completed before attempting any diagnosis, and those that are capable of analyzing partial solutions and providing proper guidance whenever an error or misconception is encountered. This paper gives an overview of the field and then critically compares work accomplished on several closely related active diagnosis systems, emphasizing such issues as the representation techniques used to capture the domain knowledge required for the diagnosis, ability to handle the diagnosis of partial code segments of the solutions, features of the user interfaces, and methodologies used in conducting the diagnosis process. Finally the paper presents a detailed discussion on issues related to active program diagnosis along with various design considerations to improve the engineering of this approach to intelligent diagnosis. The discussion presented in this paper tackles the issues referred above within the context of DISCOVER, an intelligent system for programming by discovery.

  4. Legionella (Legionnaires' Disease and Pontiac Fever): Diagnosis

    Science.gov (United States)

    ... Program Application CDC Legionella Healthy Swimming CDC Vessel Sanitation Program Unexplained Respiratory Disease Outbreaks (URDO) European Legionnaires’ Disease Surveillance Network (ELDSNet) Diagnosis, Treatment, and Complications Language: English (US) ...

  5. Improving Distributed Diagnosis Through Structural Model Decomposition

    Data.gov (United States)

    National Aeronautics and Space Administration — Complex engineering systems require efficient fault diagnosis methodologies, but centralized ap- proaches do not scale well, and this motivates the development of...

  6. Wheat allergy: diagnosis and management

    Science.gov (United States)

    Cianferoni, Antonella

    2016-01-01

    Triticum aestivum (bread wheat) is the most widely grown crop worldwide. In genetically predisposed individuals, wheat can cause specific immune responses. A food allergy to wheat is characterized by T helper type 2 activation which can result in immunoglobulin E (IgE) and non-IgE mediated reactions. IgE mediated reactions are immediate, are characterized by the presence of wheat-specific IgE antibodies, and can be life-threatening. Non-IgE mediated reactions are characterized by chronic eosinophilic and lymphocytic infiltration of the gastrointestinal tract. IgE mediated responses to wheat can be related to wheat ingestion (food allergy) or wheat inhalation (respiratory allergy). A food allergy to wheat is more common in children and can be associated with a severe reaction such as anaphylaxis and wheat-dependent, exercise-induced anaphylaxis. An inhalation induced IgE mediated wheat allergy can cause baker’s asthma or rhinitis, which are common occupational diseases in workers who have significant repetitive exposure to wheat flour, such as bakers. Non-IgE mediated food allergy reactions to wheat are mainly eosinophilic esophagitis (EoE) or eosinophilic gastritis (EG), which are both characterized by chronic eosinophilic inflammation. EG is a systemic disease, and is associated with severe inflammation that requires oral steroids to resolve. EoE is a less severe disease, which can lead to complications in feeding intolerance and fibrosis. In both EoE and EG, wheat allergy diagnosis is based on both an elimination diet preceded by a tissue biopsy obtained by esophagogastroduodenoscopy in order to show the effectiveness of the diet. Diagnosis of IgE mediated wheat allergy is based on the medical history, the detection of specific IgE to wheat, and oral food challenges. Currently, the main treatment of a wheat allergy is based on avoidance of wheat altogether. However, in the near future immunotherapy may represent a valid way to treat IgE mediated reactions to

  7. Wheat allergy: diagnosis and management

    Directory of Open Access Journals (Sweden)

    Cianferoni A

    2016-01-01

    Full Text Available Antonella Cianferoni Department of Pediatrics, Division of Allergy and Immunology, The Children’s Hospital of Philadelphia, PA, USA Abstract: Triticum aestivum (bread wheat is the most widely grown crop worldwide. In genetically predisposed individuals, wheat can cause specific immune responses. A food allergy to wheat is characterized by T helper type 2 activation which can result in immunoglobulin E (IgE and non-IgE mediated reactions. IgE mediated reactions are immediate, are characterized by the presence of wheat-specific IgE antibodies, and can be life-threatening. Non-IgE mediated reactions are characterized by chronic eosinophilic and lymphocytic infiltration of the gastrointestinal tract. IgE mediated responses to wheat can be related to wheat ingestion (food allergy or wheat inhalation (respiratory allergy. A food allergy to wheat is more common in children and can be associated with a severe reaction such as anaphylaxis and wheat-dependent, exercise-induced anaphylaxis. An inhalation induced IgE mediated wheat allergy can cause baker’s asthma or rhinitis, which are common occupational diseases in workers who have significant repetitive exposure to wheat flour, such as bakers. Non-IgE mediated food allergy reactions to wheat are mainly eosinophilic esophagitis (EoE or eosinophilic gastritis (EG, which are both characterized by chronic eosinophilic inflammation. EG is a systemic disease, and is associated with severe inflammation that requires oral steroids to resolve. EoE is a less severe disease, which can lead to complications in feeding intolerance and fibrosis. In both EoE and EG, wheat allergy diagnosis is based on both an elimination diet preceded by a tissue biopsy obtained by esophagogastroduodenoscopy in order to show the effectiveness of the diet. Diagnosis of IgE mediated wheat allergy is based on the medical history, the detection of specific IgE to wheat, and oral food challenges. Currently, the main treatment of a

  8. The diagnosis of social phobia.

    Science.gov (United States)

    Greist, J H

    1995-01-01

    Humans are social animals attuned to reactions of others; however, some are exquisitely sensitive to--and often misperceive--perceptions of those they encounter. The core feature of social phobia is marked and persistent fear of embarrassment or humiliation in social situations where the individual worries that others may judge his or her performance as too much or too little. Anticipatory anxiety and avoidance occur when the individual is under scrutiny while speaking or performing publicly, eating with others, writing in public, or using public bathrooms. Diagnosis of social phobia is based largely on history obtained from the patient. Onset is usually around puberty; its course is chronic with comorbid depression common and alcohol and other substances routinely abused in misguided attempts to minimize anxiety and depressive symptoms. At examination, patients often have a moist hand, averted gaze, blushing, and other manifest signs of anxiety. Slight shyness is familiar to most, but a substantial number suffer dysfunctional and distressing social anxiety to the point that they become phobic. A few patients satisfy criteria for avoidant personality disorder, which can be socially incapacitating.

  9. Biloma: radiologic diagnosis and treatment

    International Nuclear Information System (INIS)

    Kim, Hong; Woo, Yung Hoon; Woo, Seong Ku

    1990-01-01

    The localized intraabdominal bile collection or biloma has recently been diagnosed in increased frequently due to the wide spread use of US, CT, DISIDA scintigram, and radiologically guided percutaneous needle aspiration with or without subsequent catheter drainage. The underlying cause of biloma is trauma or iatrogenic injury which includes abdominal surgery, percutaneous drainage or PTC. We experience 20 patients with 22 biloma diagnostically confirmed by DISIDA scan, image-guided needle aspiration, percutaneous catheter drainage and / or operation. Of the 22 biloma, 7 were intrahepatic and 15 were extrahepatic. Of the 15 extrahepatic biloma, 7 were in partially hepatectomized bed, 3 were subhepatic, 3 were right subphrenic and 1 was subcapsular. We were able to determine the infectivity in 16 biloma and of these 12 biloma were found to be infected. Percutaneous drainage was performed on 20 biloma in 18 patients : by a needle aspiration with irrigation on 2 patient and by percutaneous catheter drainage on 18 bilomas. Overall success rate of the drainage was 90%. Cause of the two failures were CHD stone with choledochoduodenal fistula and recurrent hemobilia with acute cholecystitis. We describe the processes in reaching the diagnosis of biloma, propensity of biloma to purulent intrahepatic or perihepatic abscess formation, and the necessity of percutaneous radiologic catheter drainage as an optional management

  10. Diagnosis of appendicitis in pregnancy.

    Science.gov (United States)

    Freeland, Michael; King, Erin; Safcsak, Karen; Durham, Rodney

    2009-12-01

    The diagnosis of appendicitis in pregnant patients is challenging. The records of pregnant patients with suspected appendicitis were reviewed. Forty-seven patients with suspected appendicitis were identified. Twenty-four patients did not undergo surgery. Twenty-three patients had ultrasound (US), none of which visualized the appendix. Seventeen patients were followed up clinically and improved. Six patients had a negative computed tomography (CT) and none required surgery. Twenty-three patients underwent surgery for presumed appendicitis. Three patients had no imaging. Twelve patients had US only; US was positive in 5 patients and all had appendicitis. Seven patients who underwent surgery had a nondiagnostic US. One patient had appendicitis. Seven patients had a positive CT and appendicitis at surgery. One patient had a positive US and magnetic resonance imaging, and had appendicitis. A total of 43 patients had US, of which 86% were nondiagnostic. Six US were read as positive and all patients had appendicitis. Thirteen patients had CT with no false-positive or false-negative results. US, when read as positive, requires no further confirmatory test other than surgery. If US is nondiagnostic, further imaging may avoid a negative appendectomy.

  11. Achalasia: from diagnosis to management.

    Science.gov (United States)

    Vaezi, Michael F; Felix, Valter N; Penagini, Roberto; Mauro, Aurelio; de Moura, Eduardo Guimarães Hourneaux; Pu, Leonardo Zorrón Cheng Tao; Martínek, Jan; Rieder, Erwin

    2016-10-01

    Achalasia is an esophageal motility disorder associated with abnormalities in peristalsis and lower esophageal sphincter (LES) relaxation. The etiology of the disease remains elusive. It is often misdiagnosed initially as gastroesophageal reflux disease. Patients with achalasia often complain of dysphagia to solids and liquids but may focus on regurgitation as the primary symptom, leading to the early misdiagnosis. Chest pain, weight loss, and occasional vomiting may be additional symptoms encountered in those with achalasia. The disease may be suspected on the basis of clinical presentation, but diagnosis depends on classic findings using high-resolution manometry, showing either failed or simultaneous contractions with associated normal or high LES pressures with no or incomplete relaxation with swallows. There are no cures for achalasia, and, in most patients, treatments have to be repeated over time. Definitive treatment options in achalasia include pneumatic dilation, surgical myotomy, and the new technique of per-oral endoscopic myotomy. Botulinum toxin (Botox) or other medical therapies are often reserved for those who cannot have definitive therapies owing to comorbid conditions. © 2016 New York Academy of Sciences.

  12. Turco's injury: diagnosis and treatment

    Directory of Open Access Journals (Sweden)

    Ana Paula Simões da Silva

    2014-08-01

    Full Text Available The aim of this study was to alert doctors to the existence of Turco's injury and discus the existing treatments that have been described in the worldwide literature. A bibliographic survey of Lisfranc's injury and Turco's injury covering from 1985 to 2013 was conducted in the SciELO and PubMed databases. Among the 193 articles, those relating to bone-ligament injuries of the Lisfranc joint and high-energy trauma were excluded, as were the case reports. The patients selected were professional or amateur athletes who solely presented a ligament injury to the Lisfranc joint (Turco's injury, which was diagnosed from the history, physical examination, radiographs and magnetic resonance images. Non-athletic patients and those with associated bone injuries were excluded (10. According to the injury classification, the patients were treated by means of either an open or a closed procedure and then a standard rehabilitation protocol. Out of the 10 patients, five underwent conservative treatment and five underwent surgical treatment using different techniques and synthesis materials. We obtained two poor results, one satisfactory, five good and two excellent. We conclude that the correct diagnosis has a direct influence on the treatment and on the final result obtained, and that lack of knowledge of this injury is the main factor responsible for underdiagnosing Turco's injury. There is a need for randomized prospective studies comparing the types of synthesis and evolution of treated cases, in order to define the best treatment for this injury.

  13. Differential diagnosis of neuropathic pain

    Directory of Open Access Journals (Sweden)

    Yu. N. Bykov

    2015-01-01

    Full Text Available Neuropathic pain is an acute or chronic pain caused by damage to or dysfunction of the peripheral and/or central nervous system. Neuropathic pain is a direct sequel of damage to or disease of the somatosensory nervous system. The paper presents the definition, international diagnostic criteria, clinical and diagnostic features, and causes of neuropathic pain syndrome, differences between nociceptive and neuropathic pain, the classification of major neuropathic pain syndromes, and the DN4 questionnaire to identify neuropathic pain. It shows a substantial clinical and pathophysiological similarity of neuropathic pain and fibromyalgia and gives preliminary diagnostic criteria for fibromyalgia. The differential diagnosis of neuropathic, nociceptive, and psychogenic pain and the determination of the level of damage to the nervous system and a leading pathogenetic mechanism of neuropathic pain syndrome require not only meticulous clinical examination of the sensory sphere, but also neurophysiological examination including electroneuromyography, somatosensory evoked potential recording, quantitative sensory testing, and, in a number of cases, neuroimaging (magnetic resonance imaging or morphological (intraepidermal nerve fiber density examination verification of injury somatosensory afferents. 

  14. Childhood Asthma: Diagnosis and Treatment

    Directory of Open Access Journals (Sweden)

    Wim M. van Aalderen

    2012-01-01

    Full Text Available Many children suffer from recurrent coughing, wheezing and chest tightness. In preschool children one third of all children have these symptoms before the age of six, but only 40% of these wheezing preschoolers will continue to have asthma. In older school-aged children the majority of the children have asthma. Quality of life is affected by asthma control. Sleep disruption and exercised induced airflow limitation have a negative impact on participation in sports and social activities, and may influence family life. The goal of asthma therapy is to achieve asthma control, but only a limited number of patients are able to reach total control. This may be due to an incorrect diagnosis, co-morbidities or poor inhalation technique, but in the majority of cases non-adherence is the main reason for therapy failures. However, partnership with the parents and the child is important in order to set individually chosen goals of therapy and may be of help to improve control. Non-pharmacological measures aim at avoiding tobacco smoke, and when a child is sensitised, to avoid allergens. In pharmacological management international guidelines such as the GINA guideline and the British Guideline on the Management of Asthma are leading.

  15. Onychomycosis - epidemiology, diagnosis and management

    Directory of Open Access Journals (Sweden)

    Kaur R

    2008-01-01

    Full Text Available Onychomycosis is a fungal infection of nails caused by dermatophytes, yeasts or nondermatophyte molds and represents about 30% of mycotic cutaneous infections. Increasingly onychomychosis is being viewed as more than a mere cosmetic problem. In spite of improved personal hygiene and living environment, onychomycosis continues to spread and persist. The prevalence rate of onychomycosis is determined by age, predisposing factor, social class, occupation, climate, living environment and frequency of travel. Onychomycosis in immunocompromised patients can pose a more serious health problem. Dermatophytes are the most frequently implicated causative agents in onychomycosis. Previously regarded as contaminants, yeasts are now increasingly recognised as pathogens in fingernail infections, as are some moulds. Clinical diagnosis of onychomycosis is based on the patients′ history; a physical examination, microscopy and culture of nail specimens. The treatment of onychomycosis has been attempted throughout the ages, but only in the last two decades have safe, effective systemic treatments been available for this chronic superficial fungal disease. Oral Griseofulvin and Ketoconazole; once the agents of choice for the treatment of onychomycosis, have been superseded by newer systemic compounds that have a higher cure and lower relapse rates, cause fewer side effects and are suitable for short-term dosing.

  16. Necrotizing fasciitis: an urgent diagnosis

    Energy Technology Data Exchange (ETDEWEB)

    Paz Maya, Silvia; Dualde Beltran, Delfina [Hospital Clinico Universitario de Valencia, Valencia (Spain); Lemercier, Pierre; Leiva-Salinas, Carlos [Hospital Politecnico y Universitario La Fe, Valencia (Spain)

    2014-05-15

    Necrotizing fasciitis (NF) is a rare, life-threatening soft-tissue infection and a medical and surgical emergency, with increasing incidence in the last few years. It is characterized by a rapidly spreading, progressive necrosis of the deep fascia and subcutaneous tissue. Necrotizing fasciitis is often underestimated because of the lack of specific clinical findings in the initial stages of the disease. Many adjuncts such as laboratory findings, bedside tests - e.g., the ''finger test'' or biopsy - and imaging tests have been described as being helpful in the early recognition of the disease. Imaging is very useful to confirm the diagnosis, but also to assess the extent of the disorder, the potential surgical planning, and the detection of underlying etiologies. The presence of gas within the necrotized fasciae is characteristic, but may be lacking. The main finding is thickening of the deep fasciae due to fluid accumulation and reactive hyperemia, best seen on magnetic resonance imaging. (orig.)

  17. Adaptive diagnosis of coeliac disease.

    Science.gov (United States)

    Korponay-Szabó, Ilma R; Troncone, Riccardo; Discepolo, Valentina

    2015-06-01

    Coeliac disease has for a long time simply been regarded as a gluten-dependent enteropathy and a duodenal biopsy was required in all patients for the diagnosis. It is now accepted that autoimmunity against transglutaminase 2 is an earlier, more universal and more specific feature of coeliac disease than histologic lesions. Moreover, high serum levels of combined anti-transglutaminase 2 and anti-endomysium antibody positivity have excellent predictive value for the presence of enteropathy with villous atrophy. This makes the histology evaluation of the gut no longer necessary in well defined symptomatic paediatric patients with compatible HLA-DQ2 and/or DQ8 background. The biopsy-sparing diagnostic route is not yet recommended by gastroenterologists for adults, and certain clinical circumstances (immunodeficiency conditions, extraintestinal manifestations, type-1 diabetes mellitus, age less than 2 years) may require modified diagnostic approaches. Coeliac patients with preserved duodenal villous structure do exist and these need a more extended evaluation by immunologic and molecular biology tools. Copyright © 2015 Elsevier Ltd. All rights reserved.

  18. Vulvodynia. Definition, diagnosis and treatment

    DEFF Research Database (Denmark)

    Petersen, Christina Damsted; Lundvall, Lene; Kristensen, Ellids

    2008-01-01

    Vulvodynia is a chronic painful disorder with an estimated prevalence of 9-12%. A rising incidence of the condition constitutes a growing problem. This has lead to an increased focus on etiology and treatment, while the definition also requires attention. Previous assumptions stating that the pro......Vulvodynia is a chronic painful disorder with an estimated prevalence of 9-12%. A rising incidence of the condition constitutes a growing problem. This has lead to an increased focus on etiology and treatment, while the definition also requires attention. Previous assumptions stating...... that the problem is solely a psychological disorder have been abandoned, because inflammatory mechanisms and genetic factors have been found to be involved in the pathogenesis as well as psychosexual contributors. This article describes the terminology and definition of the condition, theories on patho......-physiological mechanisms underlying the disorder, methods of diagnosis and evidence and recommendations on clinical management. A critical examination of the literature regarding vulvodynia reveals numerous strategies and recommendations for treatment, many of which are not evidence-based, and a lack of effective...

  19. Infantile perforated appendicitis: A forgotten diagnosis

    Directory of Open Access Journals (Sweden)

    Katherine W. Gonzalez

    2015-04-01

    Full Text Available Acute appendicitis in the infant is a rare surgical diagnosis despite its frequency in older patients. The clinical presentation is often vague and can be misleading. We present the successful diagnosis and treatment of a 3 month old female with perforated appendicitis.

  20. Improved microscopy diagnosis of pulmonary tuberculosis using ...

    African Journals Online (AJOL)

    2007-05-02

    May 2, 2007 ... Abstract: Pulmonary tuberculosis diagnosis commonly relies on the bacteriological examination of sputum. A cross-sectional ... the spot” improve the sensitivity of tuberculosis diagnosis among patients with a history of coughing of over three weeks. However .... supervision of a trained nurse in the open air.

  1. Pai syndrome: challenging prenatal diagnosis and management

    Energy Technology Data Exchange (ETDEWEB)

    Blouet, Marie [Centre Hospitalier Universitaire de Caen, Department of Radiology, Caen (France); University of Lower Normandie, Caen (France); Belloy, Frederique [Centre Hospitalier Universitaire de Caen, Department of Radiology, Caen (France); Jeanne-Pasquier, Corinne [Centre Hospitalier Universitaire de Caen, Department of Pathology, Caen (France); Leporrier, Nathalie [University of Lower Normandie, Caen (France); Centre Hospitalier Universitaire de Caen, Department of Genetics, Caen (France); Benoist, Guillaume [University of Lower Normandie, Caen (France); Centre Hospitalier Universitaire, Pole Femmes-Enfants, Department of Obstetrics and Gynecology, Caen (France)

    2014-09-15

    Pai syndrome is a rare disorder that includes midline cleft lip, pericallosal lipoma and cutaneous polyp of the face. We report a case of prenatal diagnosis using sonography and MRI. We emphasize the importance of facial examination with prenatal association of midline cleft lip and pericallosal lipoma in making the diagnosis of Pai syndrome. (orig.)

  2. FINE NEEDLE ASPIRATION CYTOLOGY IN TUMOUR DIAGNOSIS

    African Journals Online (AJOL)

    drclement

    rapid diagnosis of tissue samples but does not preserve ... breast biopsies. This results in delay in definitive diagnosis of lesions and institution of appropriate early management, thus leading to increased morbidity and mortality rates in these .... Photomicrograph of a malignant breast smear done at the FNAC clinic in UBTH.

  3. Diagnosis of wind turbine rotor system

    DEFF Research Database (Denmark)

    Niemann, Hans Henrik; Mirzaei, Mahmood; Henriksen, Lars Christian

    2016-01-01

    This paper describes a model free method for monitoring and fault diagnosis of the elements in a rotor system for a wind turbine. The diagnosis as well as the monitoring is done without using any model of the wind turbine and the applied controller or a description of the wind profile. The method...

  4. Training for Skill in Fault Diagnosis

    Science.gov (United States)

    Turner, J. D.

    1974-01-01

    The Knitting, Lace and Net Industry Training Board has developed a training innovation called fault diagnosis training. The entire training process concentrates on teaching based on the experiences of troubleshooters or any other employees whose main tasks involve fault diagnosis and rectification. (Author/DS)

  5. Breathing Better with a COPD Diagnosis

    Science.gov (United States)

    ... out of the lungs. Normal luNg CoPD luNg breathiNg better with a CoPD DiagNosis 3 DiagNosis aND ... Using a machine called a spirometer, this noninvasive breathing test measures the amount of air a person ...

  6. Actuator Fault Detection and Diagnosis for Quadrotors

    NARCIS (Netherlands)

    Lu, P.; Van Kampen, E.J.; Yu, B.

    2014-01-01

    This paper presents a method for fault detection and diagnosis of actuator loss of effectiveness for a quadrotor helicopter. This paper not only considers the detection of the actuator loss of effectiveness faults, but also addresses the diagnosis of the faults. The detection and estimation of the

  7. [Diagnosis and therapy of systemic necrotizing vasculitis].

    Science.gov (United States)

    Aksamija-Rizvić, B

    1992-01-01

    Through the presentation of the case of Leucocytoclastic vasculitis of a young man we enlighten the problems of diagnosis, differential diagnosis, ethiology, development of disease, and therapeutic approach. We presented the new knowledge in the patogenesis of changes in the vessel wall and possible correlation with thrombotic thrombocytopenic purpura.

  8. Clinical versus molecular diagnosis of heterozygous familial ...

    African Journals Online (AJOL)

    The predominance of 10 LDLR gene mutations in the local population justifies population-directed D A diagnosis of FH in South Africa on a routine basis, particularly since expression of the defective gene measured in biochemical tests does not allow accurate diagnosis of FH in all cases. D A testing provides a definitive ...

  9. Differential Diagnosis of Narrow QRS Tachycardia

    Directory of Open Access Journals (Sweden)

    Syamkumar Menon

    2017-04-01

    Full Text Available Differential diagnosis of short RP tachycardia include atrioventricualr nodal re entrant tachycardia, atrio ventricular re entrant tachycardia and less commonly atrial tachycardia with a long PR interval. Analysis of retrograde P waves in different leads is helpful in the differential diagnosis, with certain limitations.

  10. Screening for Breast Cancer: Detection and Diagnosis

    Science.gov (United States)

    ... page please turn JavaScript on. Feature: Screening For Breast Cancer Detection and Diagnosis Past Issues / Summer 2014 Table of Contents Screening ... Breast Cancer" Articles #BeBrave: A life-saving test / Breast Cancer Basics ... and Diagnosis / Staging and Treatment / Selected National Cancer Institute Breast ...

  11. Laser desorption mass spectrometry for molecular diagnosis

    Science.gov (United States)

    Chen, C. H. Winston; Taranenko, N. I.; Zhu, Y. F.; Allman, S. L.; Tang, K.; Matteson, K. J.; Chang, L. Y.; Chung, C. N.; Martin, Steve; Haff, Lawrence

    1996-04-01

    Laser desorption mass spectrometry has been used for molecular diagnosis of cystic fibrosis. Both 3-base deletion and single-base point mutation have been successfully detected by clinical samples. This new detection method can possibly speed up the diagnosis by one order of magnitude in the future. It may become a new biotechnology technique for population screening of genetic disease.

  12. Childhood injury after a parental cancer diagnosis

    NARCIS (Netherlands)

    R. Chen (Ruoqing); A.R. Wallin (Amanda Regodón); A. Sjölander (Arvid); U. Valdimarsdóttir (Unnur); W. Ye (Weimin); H.W. Tiemeier (Henning); K. Fall (Katja); C. Almqvist (Catarina); K. Czene (Kamila); F. Fang (Fang)

    2015-01-01

    textabstractA parental cancer diagnosis is psychologically straining for the whole family. We investigated whether a parental cancer diagnosis is associated with a higher-than-expected risk of injury among children by using a Swedish nationwide register-based cohort study. Compared to children

  13. Differential diagnosis of disseminated periventricular calcifications

    International Nuclear Information System (INIS)

    Rieger, P.; Piepgras, U.

    1986-01-01

    Juvenile disseminated periventricular calcifications may occur in tuberous sclerosis, toxoplasmosis, cytomegaly, and in tuberculous meningitis. Cysticercosis, by contrast, does not result in corresponding intracerebral foci until an older age. Differential diagnosis is no problem if clinical findings are typical (tuberous sclerosis) or if serological verification is positive. However, any unclear clinical diagnosis can often be secured by CT. (orig.) [de

  14. Ultrasonic Diagnosis of Fetal Ascites and Toxoplasmosis

    DEFF Research Database (Denmark)

    Blaakær, Jan

    1986-01-01

    The ultrasonic diagnosis of fetal ascites caused by Toxoplasma Gondii is presented. When a diagnosis of fetal ascites without obvious etiological malformation is established, toxoplasmosis should be suspected. A serological test should be performed, in view of the possibility of antenatal treatment...

  15. Unraveling executive functioning in dual diagnosis

    NARCIS (Netherlands)

    Duijkers, J.C.L.M.; Vissers, C.T.W.M.; Egger, J.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

  16. Echocardiography in the diagnosis left ventricular noncompaction

    Directory of Open Access Journals (Sweden)

    Song Ze-Zhou

    2008-12-01

    Full Text Available Abstract Echocardiography is the method of choice to establish a diagnosis and determine a treatment plan for patients with noncompaction of ventricular myocardium (NVM. The 2-dimentional echocardiography, 3-dimentional echocardiography, color Doppler echocardiography and contrast-enhanced echocardiography are of critical importance for diagnosis and family screening of NVM.

  17. An analysis of multi-agent diagnosis

    NARCIS (Netherlands)

    Roos, Nico; Ten Teije, Annette; Bos, André; Witteveen, Cees; Castelfranchi, C.; Johnson, W.L.

    2002-01-01

    This paper analyzes the use of a Multi-Agent System for Model-Based Diagnosis. In a large dynamical system, it is often infeasible or even impossible to maintain a model of the whole system. Instead, several incomplete models of the system have to be used to establish a diagnosis and to detect

  18. Differential diagnosis of disseminated periventricular calcifications

    Energy Technology Data Exchange (ETDEWEB)

    Rieger, P.; Piepgras, U.

    1986-08-01

    Juvenile disseminated periventricular calcifications may occur in tuberous sclerosis, toxoplasmosis, cytomegaly, and in tuberculous meningitis. Cysticercosis, by contrast, does not result in corresponding intracerebral foci until an older age. Differential diagnosis is no problem if clinical findings are typical (tuberous sclerosis) or if serological verification is positive. However, any unclear clinical diagnosis can often be secured by CT.

  19. EDITORIAL MALARIA DIAGNOSIS Malaria remains the most ...

    African Journals Online (AJOL)

    hi-tech

    2005-03-02

    Mar 2, 2005 ... Malaria remains the most significant parasitic disease affecting man. Prompt and accurate diagnosis of malaria is the key to cost effective management (1). Since the identification of Plasmodium parasites in human blood in 1880, the diagnosis of malaria has remained a hot bed of scientific discussion.

  20. 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.

  1. Fault diagnosis in sparse multiprocessor systems

    Science.gov (United States)

    Blough, Douglas M.; Sullivan, Gregory F.; Masson, Gerald M.

    1988-01-01

    The problem of fault diagnosis in multiprocessor systems is considered under a uniformly probabilistic model in which processors are faulty with probability p. This work focuses on minimizing the number of tests that must be conducted in order to correctly diagnose the state of every processor in the system with high probability. A diagnosis algorithm that can correctly diagnose the state of every processor with probability approaching one in a class of systems performing slightly greater than a linear number of tests is presented. A nearly matching lower bound on the number of tests required to achieve correct diagnosis in arbitrary systems is also proven. The number of tests required under this probabilistic model is shown to be significantly less than under a bounded-size fault set model. Because the number of tests that must be conducted is a measure of the diagnosis overhead, these results represent a dramatic improvement in the performance of system-level diagnosis technique.

  2. Radiopeptides from diagnosis to therapy

    Directory of Open Access Journals (Sweden)

    John. R. Buscombe

    2002-09-01

    Full Text Available Radiopeptides are playing an increasing role in the diagnosis of disease. Initially based on the somatatostatin system, early research concentrated on identifying tumours of neuroendocrine origin. New techniques with artificial peptides are extending their role into other areas such as thrombus formation and heart disease. It has been shown that radiopeptides have excellent labelling new methods have looked at therapy starting with high activities of In-111 pentetreotide to the development of Y-90 based products and new and novel peptides and radio isotopes. Outside of PET there are the most exciting developments in nuclear medicine.Radiopeptídeos estão desempenhando um papel cada vez mais relevante no diagnóstico de doenças. Inicialmente dedicado ao sistema somatostatinérgico, a pesquisa nesta área concentrava-se em identificar tumores de origem neuroendócrina. Novas técnicas com peptídeos artificiais estão estendendo seu papel em outras áreas, tais como a formação de trombos em doenças cardíacas. Tem sido mostrado novos e excelentes métodos de marcação de radiopeptídeos começando por aqueles com alta atividade, tais como In-111 pentetreotídeo, ao desenvolvimento de produtos com Y-90 e recentes peptídeos e radioisótopos. Além do PET, há interessantes desenvolvimentos em Medicina Nuclear.

  3. Contemporary diagnosis of venous malformation

    Directory of Open Access Journals (Sweden)

    Lee BB

    2013-11-01

    Full Text Available BB Lee,1 I Baumgartner21Department of Surgery, George Washington University, Washington, DC, USA; 2Swiss Cardiovascular Center, University Hospital Bern, Bern, SwitzerlandAbstract: Venous malformation is a congenital vascular malformation resulting from defective development during various stages of embryogenesis and selectively affecting the venous system. Depending on the embryologic stage when the developmental arrest occurred, the clinical presentation of venous malformation is extremely variable in location, extent, severity, natural progression, and hemodynamic impact. Extratruncular lesions occur in the earlier stages of embryonic life, and retain characteristics unique to mesenchymal cells (angioblasts, growing and proliferating when stimulated internally (eg, by menarche, pregnancy, and hormones or externally (eg, by trauma or surgery. These lesions also have a significant hemodynamic impact on the venous system involved, in addition to the risk of localized intravascular coagulopathy. However, truncal lesions, as defective developments along the late stage, no longer carry the risk of proliferation and recurrence due to lack of mesenchymal characteristics. Although, they often have serious hemodynamic consequences due to direct involvement of the main vein trunk. Therefore, a thorough clinical history and careful physical examination should be followed by an appropriate combination of noninvasive and less invasive tests (eg, Doppler ultrasonography, magnetic resonance imaging, computed tomography to confirm the clinical impression as well as to define the extent and severity of the venous malformation. Invasive tests, eg, phlebography or angiography, are seldom needed for the diagnosis per se. Additional evaluation for coagulation abnormalities, eg, D-dimer and fibrinogen levels, is generally recommended, especially for the treatment of surgery and endovascular candidates with extensive lesions to assess the localized intravascular

  4. DIFFERENTIAL DIAGNOSIS OF NORMOCALCEMIC HYPERPARATHYROIDISM

    Directory of Open Access Journals (Sweden)

    N. A. Kravchun

    2015-01-01

    Full Text Available Objective: to describe a case of normocalcemic hyperparathyroidism.Materials and methods. A female patient aged 51 years sought medical advice for complaints of spinal column and bone pains, periodic dizziness, and hand numbness. The patient underwent clinical and biochemical blood tests, determination of the blood levels of calcium, phosphorus, parathyroid hormone, concentrations of total vitamin D, calciuria, electrocardiography, thyroid ultrasonography, and neck computed tomography.Results. Based on her complaints, examination evidence, evaluation of the clinical presentations of the disease, and objective and instrumental examination findings, the patient was diagnosed with left parathyroid adenoma and primary hyperparathyroidism; stage II hypertensive disease, grade I, a moderate risk; retinal angiopathy of both eyes; stage I dyscirculatory encephalopathy with liquor and venous dyscirculation and moderate vestibular ataxia; urolithiasis; kidney stones; and spondylosis mainly involving the lumbar spine. The diagnostic determinants for verifying the diagnosis were the results of neck computed tomography, namely: the signs of space-occupying lesion in the projection of the left parathyroid gland; the blood level of parathyroid hormone 118.6 pg/ml (normal value (N 9.5–75.0 pg/ml; total vitamin D 21.64 nmol/l (N 75–250 nmol/l; and calcium 2.48 mmol/l (N 2.15–2.50 mmol/l. The history of urolithiasis, repeated lithotripsy, as well as spondylosis with lumboischalgia was an absolute indication for surgical treatment.Conclusion. The practical interest in this case is due to the complexity of diagnosing normocalcemic hyperparathyroidism after vitamin D deficiency. The early stages of primary hyperparathyroidism are asymptomatic and frequently give rise to irreversible renal complications, causing renal failure and, as a consequence, disability. This clinical case demonstrates the importance of routinely determining vitamin D concentrations

  5. [Optical diagnosis of cervical dysplasia].

    Science.gov (United States)

    Charvet, Igor; Meda, Paolo; Genet, Magalie; Pelte, Marie-Françoise; Vlastos, Anne-Thérèse

    2004-01-01

    Cervix cancer is a curable disease when diagnosed at an early stage. Screening of cervical lesions by cytology and colposcopy with in situ staining has allowed for substantial progress in early diagnosis and consequently the cure of cervix cancer. Nevertheless, because of its low specificity, this approach generally implies repetitive tissue sampling and, thus a relative long time before the treatment of the lesions. Furthermore, the cost of preparation and analysis of biopsy samples is sufficiently high to represent a burden for industrialized countries and a virtual impossibility for the developing world. To overcome these problems, various biophotonic methods using optical fibers have been developed to allow for detection of cervical epithelial anomalies in a specific, fast and non-invasive way. This process, known as "optical biopsy", is based on the measurement of light-tissue interactions, which are analysed by various mathematical and data processing methods, to provide information on the metabolism and morphology of epithelial tissue. Currently investigated methods can be distinguished according to the type of signal used to probe the tissue (fluorescence, reflectance), the depth of analysed tissue (surface analysis, confocal imaging, tomography), the analysis modalities (spectral measurements or imaging), and the use of additive molecules (contrasting or photosensitizing agents, inorganic fluorophores). While most of the methods remain experimental, constant progress in the understanding of the mechanisms of light behavior in biological environments as well as advances in optical fibers technology, will make a number of these methods soon available for clinical practice to contribute efficiently to the reduction of biopsy number and cost of cervical screening. Copyright John Libbey Eurotext 2003.

  6. [Diagnosis and differential diagnosis in psychiatry and the question of situation referred prognostic diagnosis].

    Science.gov (United States)

    Meyendorf, R

    1980-01-01

    To diagnose--in its true meaning--is a search for etiology. The different sides of psychiatric diagnoses in this century do reflect the various attempts of this search. Examples are: Kraepelin's concept of etiological unity (morbus) of a disease, Bonhoeffer's attempt of separating exogenous from endogenous psychoses, K. Schneider's definition of psychiatric illness in terms of medical disease, Kretschmer's and Rümke's multidimensional diagnoses and Essen-Möller's principle of separating (postponing) etiology from psychopathological syndromes. The situationa prognostic diagnosis plays its main role in everyday diagnosing. It presupposes that one can recognize, distinguish and differentiate between different symptoms and diseases. The decision for a specific treatment reveals which etiology one thinks to be the main one. It presupposes that one has constantly to consider the kind, the severity and the course of psychiatric disease, Nosological thinking is necessary. The term etiology has a twofold meaning in Greek. 1. cause = causa and 2. accusation, guilt = culpa. In diagnosing psychiatric illnesses this double aspect plays an important role, though unconsciously and unwillingly. Though somatogenic (metabolic) as well as psychogenic (reactive) etiologies are etiologies in the sense of causa there is a fundamental difference between them. They have a common causa materialis but a different causa efficiens. In the first instance it is the non-personal side (related to pure matter), in the second instance the personal side which makes the difference. Only a person can be responsible. Where responsibility does play a role, there also accusation and guilt play a role.

  7. Ichthyosis: etiology, diagnosis, and management.

    Science.gov (United States)

    DiGiovanna, John J; Robinson-Bostom, Leslie

    2003-01-01

    The ichthyoses are a heterogeneous group of disorders with both inherited and acquired forms. Clinical presentation, pattern of inheritance, and laboratory evaluation may establish a precise diagnosis, which can assist in prognosis and genetic counseling. Congenital autosomal recessive ichthyosis (CARI) usually presents at birth, often as a collodion baby. CARI can progress into any one of a spectrum of disorders. Lamellar ichthyosis is characterized by dark, plate (armor)-like scale. This disease is often caused by mutations in the gene encoding the enzyme transglutaminase 1. Congenital ichthyosiform erythroderma is another phenotype within CARI, marked by generalized redness and fine white scale. Epidermolytic hyperkeratosis is an autosomal dominant disorder characterized by hyperkeratosis and blistering, and at least six clinical phenotypes have been described. It may be due to mutations in the gene encoding the intermediate filament proteins keratin 1 and 10. Ichthyosis vulgaris is the most common ichthyosis, and is inherited in an autosomal dominant pattern. Involvement is generally mild and may vary greatly with climate and humidity. X-linked ichthyosis, due to a defect in the enzyme steroid sulfatase, affects males with generalized scaling that usually begins soon after birth. There may be associated corneal opacities that do not affect vision. Sjögren-Larsson syndrome is an autosomal recessive ichthyosis associated with progressive spastic paralysis and mental retardation. This condition is caused by mutations in the gene for fatty aldehyde dehydrogenase. Refsum's disease, due to accumulation of phytanic acid, results in ichthyosis and progressive neurologic dysfunction. The erythrokeratodermas are characterized by hyperkeratosis and localized erythema. Erythrokeratodermia variabilis is autosomal dominant and characterized by generalized or localized hyperkeratosis and migratory red patches. Mutations in the genes encoding the gap junction proteins

  8. Advances in Diagnosis of Rabies

    Directory of Open Access Journals (Sweden)

    Shankar B.P.

    2009-04-01

    Full Text Available Rabies is a major zoonosis for which diagnostic techniques have been standardised internationally. Laboratory techniques are preferably conducted on central nervous system (CNS tissue removed from the cranium. Agent identification is preferably done using the fluorescent antibody test. A drop of purified immunoglobulin previously conjugated with fluorescein isothiocyanate is added to an acetone-fixed brain tissue smear, preferably made from several parts of the brain, including the hippocampus, cerebellum and medulla oblongata. For a large number of samples, as in an epidemiological survey, the immunoenzyme technique can provide rapid results (the rapid rabies enzyme immunodiagnosis. FAT provides a reliable diagnosis in 98-100% of cases for all genotypes if a potent conjugate is used, while RREID detects only genotype 1 virus. Infected neuronal cells have been demonstrated by histological tests and these procedures will reveal aggregates of viral material (the Negri bodies in the cytoplasm of neurones. However, the sensitivity of histological techniques is much less than that of immunological methods, especially if there has been some autolysis of the specimen. Consequently, histological techniques can no longer be recommended. As a single negative test on fresh material does not rule out the possibility of infection, inoculation tests, or other tests, should be carried out simultaneously. Newborn or 3-4-week-old mice are inoculated intracerebrally with a pool of several CNS tissues, including the brain stem, and then kept under observation for 28 days. For any mouse that dies between 5 and 28 days, the cause of death should be confirmed by FAT. Alternatively, a monolayer culture of susceptible cells is inoculated with the same material as used for mice. FAT carried out after appropriate incubation will demonstrate the presence or absence of viral antigen. Wherever possible, virus isolation in cell culture should replace mouse inoculation tests

  9. UNDESCENDED TESTIS, DIAGNOSIS AND TREATMENT

    Directory of Open Access Journals (Sweden)

    Winarta Lesmana Handrea

    2013-05-01

    Full Text Available Normal 0 false false false EN-US X-NONE X-NONE Undescended testis (UDT or cryptorchidism is one of the commonest abnormalities in male infants. In this anomaly, testes are not located normally in the scrotum. The incidence of UDT is 4-5% of term male infants, and 20-33% of premature male infants. The occurrence of abnormalities of hormones control or anatomy process that is required in the normal process of lowering the testes can cause UDT. UDT can be differentiated into palpable and nonpalpable. The diagnosis of UDT can be known through physical examination. However, if the testes are impalpable, laparoscopy can be done to determine the position of the testis. Hormonal therapy to overcome UDT is still under controversy. The action that often done is surgery, called orchidopexy. The most serious complication of orchidopexy is testicular atrophy. It occurs in a small percentage, which is about 5-10%. Infertility may occur in 1 to 3 of 4 adult males and the risk of occurrence of malignancies is increased by as much as 5-10 times higher in men with a history of UDT. /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-priority:99; mso-style-qformat:yes; mso-style-parent:""; mso-padding-alt:0in 5.4pt 0in 5.4pt; mso-para-margin-top:0in; mso-para-margin-right:0in; mso-para-margin-bottom:10.0pt; mso-para-margin-left:0in; line-height:115%; mso-pagination:widow-orphan; font-size:11.0pt; font-family:"Calibri","sans-serif"; mso-ascii-font-family:Calibri; mso-ascii-theme-font:minor-latin; mso-fareast-font-family:"Times New Roman"; mso-fareast-theme-font:minor-fareast; mso-hansi-font-family:Calibri; mso-hansi-theme-font:minor-latin; mso-bidi-font-family:"Times New Roman"; mso-bidi-theme-font:minor-bidi;}

  10. Voice Disorders: Etiology and Diagnosis.

    Science.gov (United States)

    Martins, Regina Helena Garcia; do Amaral, Henrique Abrantes; Tavares, Elaine Lara Mendes; Martins, Maira Garcia; Gonçalves, Tatiana Maria; Dias, Norimar Hernandes

    2016-11-01

    Voice disorders affect adults and children and have different causes in different age groups. The aim of the study is to present the etiology and diagnosis dysphonia in a large population of patients with this voice disorder.for dysphonia of a large population of dysphonic patients. We evaluated 2019 patients with dysphonia who attended the Voice Disease ambulatories of a university hospital. Parameters assessed were age, gender, profession, associated symptoms, smoking, and videolaryngoscopy diagnoses. Of the 2019 patients with dysphonia who were included in this study, 786 were male (38.93%) and 1233 were female (61.07). The age groups were as follows: 1-6 years (n = 100); 7-12 years (n = 187); 13-18 years (n = 92); 19-39 years (n = 494); 41-60 years (n = 811); and >60 years (n = 335). Symptoms associated with dysphonia were vocal overuse (n = 677), gastroesophageal symptoms (n = 535), and nasosinusal symptoms (n = 497). The predominant professions of the patients were domestic workers, students, and teachers. Smoking was reported by 13.6% patients. With regard to the etiology of dysphonia, in children (1-18 years old), nodules (n = 225; 59.3%), cysts (n = 39; 10.3%), and acute laryngitis (n = 26; 6.8%) prevailed. In adults (19-60 years old), functional dysphonia (n = 268; 20.5%), acid laryngitis (n = 164; 12.5%), and vocal polyps (n = 156; 12%) predominated. In patients older than 60 years, presbyphonia (n = 89; 26.5%), functional dysphonia (n = 59; 17.6%), and Reinke's edema (n = 48; 14%) predominated. In this population of 2019 patients with dysphonia, adults and women were predominant. Dysphonia had different etiologies in the age groups studied. Nodules and cysts were predominant in children, functional dysphonia and reflux in adults, and presbyphonia and Reinke's edema in the elderly. Copyright © 2016 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

  11. Establishing the diagnosis of tuberculous vertebral osteomyelitis.

    Science.gov (United States)

    Colmenero, Juan D; Ruiz-Mesa, Juan D; Sanjuan-Jimenez, Rocío; Sobrino, Beatriz; Morata, Pilar

    2013-06-01

    The aim of this article has been to analyze the clinical and radiological data suggesting tuberculous vertebral osteomielitis (TVO), and then discuss the steps to be followed to achieve an aetiological diagnosis. A thorough literature search was carried out to identify the best clinical and microbiological evidence for a fast and efficient diagnosis of TVO. The clinical and radiological diagnosis of spinal tuberculosis suffers from serious limitations, with a high percentage of cases requiring vertebral biopsy to reach a definitive diagnosis. The increasing incidence of multidrug-resistant tuberculosis has highlighted the insufficiency of the histopathological diagnosis and the need for microbiological diagnosis. Unfortunately, the maximum sensitivity of spinal tuberculosis cultures is 80 %, and traditional methods require 6 to 8 weeks for the isolation, identification and sensitivity study. New culture media and identification methods have improved sensitivity and reduced the time required for the identification. Molecular methods have now been integrated into a single test, with identification of the mycobacterium responsible and its sensitivity to rifampicin. Additionally, multiplex-PCR tests have been developed that allow a rapid differential diagnosis between granulomatous spondylodiscitis. All patients with subacute inflammatory back or neck pain showing suggestive radiological findings should be studied to rule out TVO. If there is no clear evidence of tuberculosis from another location or indication for surgery, a percutaneous vertebral biopsy should be performed. When TVO is suspected, all spinal or paravertebral tissue samples should be sent simultaneously to pathology and microbiology laboratories for appropriate processing.

  12. Necrotizing fasciitis: strategies for diagnosis and management.

    Science.gov (United States)

    Taviloglu, Korhan; Yanar, Hakan

    2007-08-07

    Necrotizing fasciitis (NF) is uncommon and difficult to diagnose, and it cause progressive morbidity until the infectious process is diagnosed and treated medically and surgically. The literature addressed NF contains confusing information, inaccurate bacteriologic data, and antiquated antibiotic therapy. A delay in diagnosis is associated with a grave prognosis and increased mortality. The main goal of the clinician must be to establish the diagnosis and initially treat the patient within the standard of care. This review is planned as a guide for the clinician in making an early diagnosis of NF and initiating effective medical and surgical therapy.

  13. Sonographic diagnosis of intestinal polyps in children.

    Science.gov (United States)

    Parra, Dimitri A; Navarro, Oscar M

    2008-06-01

    Although colonoscopy is the modality of choice for the diagnosis of intestinal polyps, sonography may be the first diagnostic modality in the evaluation of children with this pathology. Graded compression sonography of the small and large bowel may be useful in diagnosing intestinal polyps. A specific diagnosis is possible in many cases as most polyps have a characteristic appearance. Although sonography is not intended to replace endoscopy in the diagnostic work-up of intestinal polyps, it is important for radiologists to be aware of this appearance as they can be the first in making the diagnosis of intestinal polyps using sonography.

  14. Synthesis of new radiotracers for tuberculosis diagnosis

    International Nuclear Information System (INIS)

    Keskes, Badis

    2009-01-01

    Tuberculosis remains a worldwide health problem and its diagnosis presents a major challenge. The examinations currently employed are little appreciable and so far there is no reliable diagnosis test. These last years, the development of the new radiopharmaceuticals, referred to diagnosis, has revived interest in the search for new molecules with a tropism to a particular disease. Thanks to this field, which lies at the interface of organic and organometallic chemistry, nuclear medicine and biology, we have been led to synthesize a technetium radiotracer linked to isoniazid. For the identification of this radiotracer, we used its similar rhenium model. (Author)

  15. Advanced methods in diagnosis and therapy

    International Nuclear Information System (INIS)

    1987-01-01

    This important meeting covers the following topics: use and optimization of monoclonal antibobies in oncology: - Tumor markers: Clinical follow-up of patients through tumor marker serum determinations. - Cancer and medical imaging: The use of monoclonal antibodies in immunoscintigraphy. - Immunoradiotherapy: Monoclonal antibodies as therapeutic vectors. Advanced methods in diagnosis: - Contribution of monoclonal antibodies in modern immunochemistry (RIA, EIA). - Interest of monoclonal antibody in immunohistochemical pathology diagnosis. - In vitro diagnosis future prospects: with receptors and oncogenes. - Immunofluoroassay: a new sensitive immunoanalytical procedure with broad applications. Recent advances in brachitherapy: - Interest of computer processing. Blood products irradiation: - Interest in transfusion and bone marrow transplantations [fr

  16. Cystic Fibrosis Diagnosis and Newborn Screening.

    Science.gov (United States)

    Rosenfeld, Margaret; Sontag, Marci K; Ren, Clement L

    2016-08-01

    The diagnosis of cystic fibrosis (CF) has evolved over the past decade as newborn screening has become universal in the United States and elsewhere. The heterogeneity of phenotypes associated with CF transmembrane conductance regulator (CFTR) dysfunction and mutations in the CFTR gene has become clearer, ranging from classic pancreatic-insufficient CF to manifestations in only 1 organ system to indeterminate diagnoses identified by newborn screening. The tools available for diagnosis have also expanded. This article reviews the newest diagnostic criteria for CF, newborn screening, prenatal screening and diagnosis, and indeterminate diagnoses in newborn-screened infants and symptomatic adults. Copyright © 2016 Elsevier Inc. All rights reserved.

  17. Diagnosis of liver, biliary tract and gastrointestine

    International Nuclear Information System (INIS)

    Aburano, Tamio

    1981-01-01

    The role of RI imaging in the diagnosis of lesions of the liver, biliary tracts and gastrointestinal tracts are reviewed, and representative cases are shown. Liver scintigraphy was of value for the diagnosis of lesions limitted to the liver such as primary and metastatic liver cancer and inflammatory liver diseases. However, RI methods were less useful in the diagnosis of lesions of the biliary tracts and stomach. RI scintigraphy was more sensitive than angiography in the detection of Meckel's deverticulum, Ballet's esophagus, and gastrointestinal hemorrhage. (Tsunoda, M.)

  18. Necrotizing fasciitis: strategies for diagnosis and management

    Directory of Open Access Journals (Sweden)

    Yanar Hakan

    2007-08-01

    Full Text Available Abstract Necrotizing fasciitis (NF is uncommon and difficult to diagnose, and it cause progressive morbidity until the infectious process is diagnosed and treated medically and surgically. The literature addressed NF contains confusing information, inaccurate bacteriologic data, and antiquated antibiotic therapy. A delay in diagnosis is associated with a grave prognosis and increased mortality. The main goal of the clinician must be to establish the diagnosis and initially treat the patient within the standard of care. This review is planned as a guide for the clinician in making an early diagnosis of NF and initiating effective medical and surgical therapy.

  19. First International Diagnosis Competition – DXC’09

    Data.gov (United States)

    National Aeronautics and Space Administration — A framework to compare and evaluate diagnosis algorithms (DAs) has been created jointly by NASA Ames Research Center and PARC. In this paper, we present the first...

  20. HIV / AIDS: Symptoms, Diagnosis, Prevention and Treatment

    Science.gov (United States)

    Skip Navigation Bar Home Current Issue Past Issues HIV / AIDS HIV / AIDS: Symptoms , Diagnosis, Prevention and Treatment Past Issues / ... Most people who have become recently infected with HIV will not have any symptoms. They may, however, ...

  1. Orthorexia nervosa: validation of a diagnosis questionnaire.

    Science.gov (United States)

    Donini, L M; Marsili, D; Graziani, M P; Imbriale, M; Cannella, C

    2005-06-01

    To validate a questionnaire for the diagnosis of orhorexia oervosa, an eating disorder defined as "maniacal obsession for healthy food". 525 subjects were enrolled. Then they were randomized into two samples (sample of 404 subjects for the construction of the test for the diagnosis of orthorexia ORTO-15; sample of 121 subjects for the validation of the test). The ORTO-15 questionnaire, validated for the diagnosis of orthorexia, is made-up of 15 multiple-choice items. The test we proposed for the diagnosis of orthorexia (ORTO 15) showed a good predictive capability at a threshold value of 40 (efficacy 73.8%, sensitivity 55.6% and specificity 75.8%) also on verification with a control sample. However, it has a limit in identifying the obsessive disorder. For this reason we maintain that further investigation is necessary and that new questions useful for the evaluation of the obsessive-compulsive behavior should be added to the ORTO-15 questionnaire.

  2. Hepatitis C: Information on Testing and Diagnosis

    Science.gov (United States)

    HEPATITIS C Information on Testing & Diagnosis What is Hepatitis C? Hepatitis C is a serious liver disease that results from infection with the Hepatitis C virus. Hepatitis C has been called a silent ...

  3. Diagnosis and treatment of ampullary tumors

    Directory of Open Access Journals (Sweden)

    YIN Tao

    2017-02-01

    Full Text Available Ampullary tumors mainly manifest as obstructive jaundice and ampullary mass in clinical practice and are difficult to be identified in early stage due to a complex structure of the anatomical site, a deep location, and hidden symptoms. Sometimes a qualitative diagnosis cannot be made. Based on the experience in the treatment of ampullary tumors for many years in our center, this article summarizes the features of ampullary tumors from the aspects of clinical manifestations, diagnosis, treatment, and prognosis, especially the issues regarding imaging evaluation of ampullary tumors, selection of surgical procedure, and prognosis. An early diagnosis is the key to the treatment of ampullary tumors, and early identification and treatment of lesions have great impacts on patients′ prognosis. Accurate preoperative imaging evaluation, a professional diagnosis and treatment team, accurate preoperative and intraoperative pathological analysis, and implementation of reasonable therapeutic strategy are the key to patients′ recovery.

  4. Diagnosis and Treatment of Influenza in Children

    Directory of Open Access Journals (Sweden)

    M. S. Savenkova

    2016-01-01

    Full Text Available The article presents data on influenza epidemiology, pathogenesis, classification, clinical variants, diagnosis. Given the variety of antiviral drugs, highlighted the most relevant and used in pediatric patients, depending on age and mixed-flow options viral infections.

  5. Diagnosis by endoscopy and advanced imaging

    NARCIS (Netherlands)

    Swager, A.; Curvers, W. L.; Bergman, J. J.

    2015-01-01

    Evaluation of patients with Barrett's oesophagus (BO) using dye-based chromoendoscopy, optical chromoendoscopy, autofluorescence imaging, or confocal laser endomicroscopy does not significantly increase the number of patients with a diagnosis of early neoplasia compared with high-definition white

  6. Present problems in biliary lithiasis diagnosis

    International Nuclear Information System (INIS)

    Oancea, R.

    1992-01-01

    The diagnosis strategy of biliary lithiasis is continuously developing. The diagnostic methods improved in last ten years. Paraclinical investigations are used in order to confirm the biliary lithiasis diagnosis. The direct method used for intra- and extrahepatic biliary ducts are: echography, oral cholecystography, biliary scintigraphy, cholangiography and computerized tomography. These techniques are the most important for biliary lithiasis diagnosis. Biliary scintigraphy or radioisotope cholangiography are performed with radiopharmaceutical preparations such as iminodiacetic acid derivatives labelled with 99m Tc. This test is easy to carry out and the irradiation risk is minor. In normal conditions, the biliary ducts and duodenal excretion occur after 30 min from radiopharmaceutical injection. It is absorbed by liver in the first five minutes. The gall bladder is visible after 30 min from radioisotope administration. Radioisotope cholecystography is a very sensitive method for biliary lithiasis diagnosis

  7. Single cell enzyme diagnosis on the chip

    DEFF Research Database (Denmark)

    Jensen, Sissel Juul; Harmsen, Charlotte; Nielsen, Mette Juul

    2013-01-01

    Conventional diagnosis based on ensemble measurements often overlooks the variation among cells. Here, we present a droplet-microfluidics based platform to investigate single cell activities. Adopting a previously developed isothermal rolling circle amplification-based assay, we demonstrate detec...

  8. Diagnosis, Synthesis and Analysis of Probabilistic Models

    NARCIS (Netherlands)

    Han, Tingting

    2009-01-01

    This dissertation considers three important aspects of model checking Markov models: diagnosis — generating counterexamples, synthesis — providing valid parameter values and analysis — verifying linear real-time properties. The three aspects are relatively independent while all contribute to

  9. Computed tomographic diagnosis of internal hernia

    Energy Technology Data Exchange (ETDEWEB)

    Harbin, W.P.

    1982-06-01

    Computed tomography (CT) was used to study an abdominal mass in a patient who presented with acute abdominal pain. The CT demonstration of sac-like encapsulation of small bowel loops allowed a diagnosis of internal hernia.

  10. Environmental diagnosis of the washing machine motor

    DEFF Research Database (Denmark)

    Erichsen, Hanne K. Linnet

    1997-01-01

    An environmental diagnosis of the washing machine focusing on the motor is performed. The goal of the diagnosis is to designate environmental focus points in the product. The LCA of the washing machine showed impact potentials from the life cycle of the product (see: LCA of a washing machine......). The diagnosis points to which of the impact potentials are considered to be problematic, and locates where in the product the problems are situated.The diagnosis is also used for showing which effects ideas for changes in the motor have on the environment. The ideas which are looked upon are: motor efficiency...... up 2%, Manually disassembling and recycling of metals, Reuse of motor in a new washing machine, aluminium wire instead of copper wire in the motor....

  11. Advances in imaging diagnosis of liver cancer

    Directory of Open Access Journals (Sweden)

    ZHANG Chunyu

    2017-07-01

    Full Text Available Liver biopsy is the gold standard for the diagnosis of primary liver cancer, but it is an invasive examination. At present, imaging has become the preferred method for the diagnosis of liver cancer. This article summarizes new imaging methods and techniques for the diagnosis and evaluation of primary liver cancer, including contrast-enhanced ultrasound, CT perfusion imaging, diffusion-weighted imaging-intravoxel incoherent motion, IDEAL IQ sequence, dynamic contrast-enhanced MRI, and hepatocyte-specific contrast-enhanced imaging, and points out that diagnostic imaging can not only evaluate the degree of tumor differentiation, blood supply and perfusion, and invasiveness of lesions, but also predict the prognosis and evaluate liver function. Therefore, it can provide a reference for clinical diagnosis and treatment.

  12. 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.

  13. Fluorescence diagnosis in keratinocytic intraepidermal neoplasias.

    NARCIS (Netherlands)

    Smits, T.; Kleinpenning, M.M.; Blokx, W.A.M.; Kerkhof, P.C.M. van de; Erp, P.E.J. van; Gerritsen, M.J.P.

    2007-01-01

    BACKGROUND: As different tissue types have distinct capabilities to accumulate protoporphyrin-IX, fluorescence diagnosis with aminolevulinic acid-induced porphyrin (FDAP) could be used to discriminate between different tissue types. OBJECTIVE: Protoporphyrin-IX accumulation and proliferation were

  14. Prenatal diagnosis of lissencephaly: A case report

    Directory of Open Access Journals (Sweden)

    Cerovac Nataša

    2016-01-01

    Full Text Available Introduction. Lissencephaly (“smooth brain” forms a major group of brain malformations due to abnormal neuronal migration. It can cause severe intellectual and motor disability and epilepsy in children. The prenatal diagnosis of this malformation is rare. Case report. We presented a case of the prenatal diagnosis of lissencephaly. A 30-year old pregnant woman was reffered to the hospital at the week 35 of gestation for magnetic resonance imaging (MRI after an ultrasound examination demonstrated fetal cerebral ventriculomegaly. Fetal MRI of the brain showed “smooth”, agyrya cortex. The female infant was born at term with birth weight of 2,500 g and Apgar score 8, showing global developmental delay. Postnatal ultrasound and MRI confirmed classical lissencephaly. She is now 8 years old and has spastic quadriparesis, mental retardation and epilepsy. Conclusion. Confirmation of the ultrasound diagnosis with MRI is desirable for the prenatal diagnosis of lissencephaly.

  15. (PCR) in the diagnosis of bacterial infections

    African Journals Online (AJOL)

    ... bacterial infections that can be diagnosed using the technique which include among others; Tuberculosis (TB), whooping cough, brain abscesses and spinal infection, otitis media with effusion, Mycoplasmal pneumonia, endophthalmitis and bacterial meningitis. Keywords: Polymerase chain reaction, Diagnosis, Bacteria, ...

  16. Diagnosis delay in tuberculosis and its consequences

    International Nuclear Information System (INIS)

    Habibullah, S.; Sheikh, M.A.; Sadiq, A.; Anwar, T.

    2004-01-01

    Objective: To find out the average duration from onset of symptoms to the diagnosis and treatment of tuberculosis, reasons for diagnostic delay, its consequences, association of variables and formulation of recommendations. Results: In this study it was found that average time from onset of initial symptoms to diagnosis and treatment of tuberculosis was 120 days. In 64% of the patients medical practitioners were responsible for delaying the diagnosis of tuberculosis. Loss of weight in 40% and haemoptysis is 21% were the consequences of diagnostic delay of tuberculosis. Delay in the diagnosis of tuberculosis was statistically significant in those patients who consulted private practitioners, and consequences of tuberculosis were severe in those patients who consulted late. (author)

  17. Malignant mesothelioma: biology, diagnosis and therapeutic approaches

    Czech Academy of Sciences Publication Activity Database

    Tomasetti, M.; Amati, M.; Santarelli, L.; Alleva, R.; Neužil, Jiří

    2009-01-01

    Roč. 2, č. 2 (2009), s. 190-206 ISSN 1874-4672 Institutional research plan: CEZ:AV0Z50520514 Keywords : malignant mesothelioma * biology * diagnosis and therapeutic approaches Subject RIV: EB - Genetics ; Molecular Biology

  18. Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: Diagnosis

    Science.gov (United States)

    ... Continuing Education Event Resources Disability and ME-CFS Diagnosis Recommend on Facebook Tweet Share Compartir To diagnose myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS), a patient’s doctor or healthcare provider ...

  19. [Microbiological diagnosis of human immunodeficiency virus infection].

    Science.gov (United States)

    Álvarez Estévez, Marta; Reina González, Gabriel; Aguilera Guirao, Antonio; Rodríguez Martín, Carmen; García García, Federico

    2015-10-01

    This document attempts to update the main tasks and roles of the Clinical Microbiology laboratory in HIV diagnosis and monitoring. The document is divided into three parts. The first deals with HIV diagnosis and how serological testing has changed in the last few years, aiming to improve diagnosis and to minimize missed opportunities for diagnosis. Technological improvements for HIV Viral Load are shown in the second part of the document, which also includes a detailed description of the clinical significance of low-level and very low-level viremia. Finally, the third part of the document deals with resistance to antiretroviral drugs, incorporating clinical indications for integrase and tropism testing, as well as the latest knowledge on minority variants. Copyright © 2014 Elsevier España, S.L.U. y Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

  20. Aluminium Process Fault Detection and Diagnosis

    Directory of Open Access Journals (Sweden)

    Nazatul Aini Abd Majid

    2015-01-01

    Full Text Available The challenges in developing a fault detection and diagnosis system for industrial applications are not inconsiderable, particularly complex materials processing operations such as aluminium smelting. However, the organizing into groups of the various fault detection and diagnostic systems of the aluminium smelting process can assist in the identification of the key elements of an effective monitoring system. This paper reviews aluminium process fault detection and diagnosis systems and proposes a taxonomy that includes four key elements: knowledge, techniques, usage frequency, and results presentation. Each element is explained together with examples of existing systems. A fault detection and diagnosis system developed based on the proposed taxonomy is demonstrated using aluminium smelting data. A potential new strategy for improving fault diagnosis is discussed based on the ability of the new technology, augmented reality, to augment operators’ view of an industrial plant, so that it permits a situation-oriented action in real working environments.

  1. CT in the diagnosis of appendicitis

    Energy Technology Data Exchange (ETDEWEB)

    Toyama, Yoshihiro; Teraoka, Hiromichi; Matsui, Hisahiro; Itoh, Yasunori; Satoh, Gen [Ritsurin Hospital, Takamatsu, Kagawa (Japan); Ohkawa, Motoomi; Tanabe, Masatada

    1995-11-01

    In five years 13 cases of acute appendicitis were examined with CT before operation. These diagnosis were not obvious with clinical evaluation and US. CT without oral contrast material clearly depicted the abnormal appendix appendicolitis periappendiceal inflammation and abscess. Especially CT showed 4 cases of periappendiceal abscess with abnormal appendix. We think unenhanced CT without oral contrast material is useful test to diagnose appendicitis and appendiceal abscess when its diagnosis are not obvious with US. (author).

  2. Recent developments in building diagnosis techniques

    CERN Document Server

    2016-01-01

    This book presents a collection of recent research on building diagnosis techniques related to construction pathology, hygrothermal behavior and durability, and diagnostic techniques. It highlights recent advances and new developments in the field of building physics, building anomalies in materials and components, new techniques for improved energy efficiency analysis, and diagnosis techniques such as infrared thermography. This book will be of interest to a wide readership of professionals, scientists, students, practitioners, and lecturers.

  3. New guidelines for the diagnosis of fibromyalgia.

    Science.gov (United States)

    Heymann, Roberto E; Paiva, Eduardo S; Martinez, José Eduardo; Helfenstein, Milton; Rezende, Marcelo C; Provenza, Jose Roberto; Ranzolin, Aline; Assis, Marcos Renato de; Feldman, Daniel P; Ribeiro, Luiz Severiano; Souza, Eduardo J R

    2017-01-01

    To establish guidelines based on scientific evidence for the diagnosis of fibromyalgia. Evidence collection was performed based on 9 questions regarding the diagnosis of fibromyalgia, structured using the Patient, Intervention or Indicator, Comparison and Outcome (P.I.C.O.), with searches in the main, primary databases of scientific information. After defining the potential studies to support the recommendations, they were graded according to evidence and degree of recommendation. Copyright © 2017. Published by Elsevier Editora Ltda.

  4. Preimplantation genetic diagnosis of hemophilia A

    OpenAIRE

    Chen, Ming; Chang, Shun-Ping; Ma, Gwo-Chin; Lin, Wen-Hsian; Chen, Hsin-Fu; Chen, Shee-Uan; Tsai, Horng-Der; Tsai, Feng-Po; Shen, Ming-Ching

    2016-01-01

    Preimplantation genetic diagnosis (PGD) is a powerful tool to tackle the transmission of monogenic inherited disorders in families carrying the diseases from generation to generation. It currently remains a challenging task, despite PGD having been developed over 25?years ago. The major difficulty is it does not have an easy and general formula for all mutations. Different gene locus needs individualized, customized design to make the diagnosis accurate enough to be applied on PGD, in which t...

  5. Diagnosis of Cystic Fibrosis in Nonscreened Populations.

    Science.gov (United States)

    Sosnay, Patrick R; White, Terry B; Farrell, Philip M; Ren, Clement L; Derichs, Nico; Howenstine, Michelle S; Nick, Jerry A; De Boeck, Kris

    2017-02-01

    Although the majority of cases of cystic fibrosis (CF) are now diagnosed through newborn screening, there is still a need to standardize the diagnostic criteria for those diagnosed outside of the neonatal period. This is because newborn screening started relatively recently, it is not performed everywhere, and even for individuals who were screened, there is the possibility of a false negative. To limit irreversible organ pathology, a timely diagnosis of CF and institution of CF therapies can greatly benefit these patients. Experts on CF diagnosis were convened at the 2015 CF Foundation Diagnosis Consensus Conference. The participants reviewed and discussed published works and instructive cases of CF diagnosis in individuals presenting with signs, symptoms, or a family history of CF. Through a modified Delphi methodology, several consensus statements were agreed upon. These consensus statements were updates of prior CF diagnosis conferences and recommendations. CF diagnosis in individuals outside of newborn screening relies on the clinical evidence and on evidence of CF transmembrane conductance regulator (CFTR) dysfunction. Clinical evidence can include typical organ pathologies seen in CF such as bronchiectasis or pancreatic insufficiency but often represent a broad range of severity including mild cases. CFTR dysfunction can be demonstrated using sweat chloride testing, CFTR molecular genetic analysis, or CFTR physiologic tests. On the basis of the large number of patients with bona fide CF currently followed in registries with sweat chloride levels between 30 and 40 mmol/L, the threshold considered "intermediate" was lowered from 40 mmol/L in the prior diagnostic guidelines to 30 mmol/L. The CF diagnosis was also discussed in the context of CFTR-related disorders in which CFTR dysfunction may be present, but the individual does not meet criteria for CF. CF diagnosis remains a rare but important condition that can be diagnosed when characteristic clinical

  6. Canavan disease prenatal diagnosis and genetic counseling.

    Science.gov (United States)

    Matalon, Reuben; Matalon, Kimberlee Michals

    2002-06-01

    Canavan disease is a severe leukodystrophy more common among Ashkenazi Jews. The enzyme defect, apartoacylase, has been identified, and the gene cloned. Only two mutations account for over 98% of all Jewish alleles with Canavan disease. The carrier frequency among healthy Jews is 1:37-58. Carrier detection and prenatal diagnosis can be accurately carried out using molecular analysis. When mutations are unknown, analysis of amniotic fluid for NAA using stable isotope dilution technique can be used for prenatal diagnosis.

  7. Echocardiography diagnosis of myocardial infarction complications

    Directory of Open Access Journals (Sweden)

    N.D. Oryshchyn

    2016-03-01

    Full Text Available Diagnosis and management of myocardial infarction complications are discussed in this article. These complications are associated with high level of mortality and surgery is a main treatment method. High level of suspicion and early diagnosis are essential for appropriate treatment and improvement of prognosis. Echocardiography is a main diagnostic method. Analysis of literature about contemporary management of mechanical complications of myocardial infarction has been performed, case reports are presented.

  8. Epidemiologi dan Diagnosis Dengue di Indonesia

    OpenAIRE

    Zilhadia, Zilhadia

    2007-01-01

    Dengue fever/DF and dengue hemorrhagic fever/DHF is a global public health problem that occured in tropical and subtropical region. Epidemic dengue occurs every years, and it continues to be a major health problem in Indonesia. Due to its asymptomatic nature, a reliable, rapid and accurate dengue diagnosis is needed. Dengue diagnosis method based on molecular dengue virus properties and it will be developed by researcher. Dengue rapid test isnewly method. This article explaine about dengue ep...

  9. Differential diagnosis of Jakob-Creutzfeldt disease

    OpenAIRE

    Paterson, RW; Torres-Chae, CC; Kuo, AL; Ando, T; Nguyen, EA; Wong, K; DeArmond, SJ; Haman, A; Garcia, P; Johnson, DY; Miller, BL; Geschwind, MD

    2012-01-01

    Objectives: 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. Design: Retrospective medical record review. Setting: A specialty referral center of a tertiary academic medical center. Participants: One hundred sixty-three serial patients over a 5.5-y...

  10. 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.

  11. Presentation and Diagnosis of Fournier Gangrene.

    Science.gov (United States)

    Voelzke, Bryan B; Hagedorn, Judith C

    2018-04-01

    Necrotizing fasciitis is a severe type of necrotizing soft tissue infection involving the superficial fascia and subcutaneous tissues. Fournier gangrene, a type of necrotizing fasciitis, affects the genitalia or perineum. Although a rare health condition, Fournier gangrene can result in significant morbidity and unnecessary mortality following delay in diagnosis and management. We provide a review of relevant presenting features to aid diagnosis and allow timely surgical management of this serious infectious condition. Copyright © 2017 Elsevier Inc. All rights reserved.

  12. 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.

  13. Diagnosis in Prader-Willi syndrome.

    OpenAIRE

    Chu, C E; Cooke, A; Stephenson, J B; Tolmie, J L; Clarke, B; Parry-Jones, W L; Connor, J M; Donaldson, M D

    1994-01-01

    Thirty one patients with the putative diagnosis of Prader-Willi syndrome were reassessed clinically and by DNA analysis. Eleven patients were judged not to have Prader-Willi syndrome and 20 to have the condition. This was confirmed by DNA analysis in all but one case. The diagnosis of Prader-Willi syndrome, especially in early infancy, should be made with caution unless confirmed by molecular genetic studies.

  14. Diagnosis of Equipment Failures by Pattern Recognition

    DEFF Research Database (Denmark)

    Pau, L. F.

    1974-01-01

    The main problems in relation to automatic fault finding and diagnosis in equipments or production systems are discussed: 1) compression of the syndrome and observation spaces for better discrimination between failure modes; 2) simultaneous display of the failure patterns and the failure instants......, for maintenance control and review of the reliability design; 3) automatic production of a final set of diagnosis assumptions classified according to their probabilities. 4) sequencing of the inspections in accordance with the failure rates and inspection costs....

  15. Diagnosis and treatment of obturator hernia

    Energy Technology Data Exchange (ETDEWEB)

    Nakayama, Takamori; Kobayashi, Seiji; Shiraishi, Kou; Nishiumi, Takao; Mori, Syunji; Isobe, Kiyoshi; Furuta, Yoshiaki [Shizuoka Red Cross Hospital (Japan)

    2002-09-01

    Obturator hernia is a rare type of hernia, but it is a significant cause of intestinal obstruction due to the associated anatomy. Correct diagnosis and treatment of obturator hernia is important, because delay can lead to high mortality. Twelve patients with obturator hernia were managed during a 11-year period, including 11 women and 1 man with a mean age of 82 years. We compared our experience with the previously published data to establish standards for the diagnosis and treatment of this hernia. All 12 patients presented with intestinal obstruction. The median interval from admission to operation was 2 days. The Howship-Romberg sign was positive in 5 patients. A correct diagnosis was made in all 8 patients who underwent pelvic CT scanning. Surgery was performed via an abdominal approach (n=7) or an inguinal approach (n=5). The hernial orifice was closed using the uterine fundus (n=6), a patch (n=5), and direct suture (n=1). Mean follow-up time was 33 months, and no recurrence has been detected. The poor physical condition of patients might have led to a delay in diagnosis and treatment. In troubled patients with nonspecific intestinal obstruction, CT scanning is useful for the early diagnosis of obturator hernia. Correct CT diagnosis of obturator hernia allows us to select the inguinal approach combined with patch repair, which is minimally invasive surgery. (author)

  16. Molecular diagnosis of Haemorrhagic Septicaemia - A Review

    Directory of Open Access Journals (Sweden)

    Ranjan Rajeev

    2011-08-01

    Full Text Available Pasteurella multocida is associated with hemorrhagic septicaemia in cattle and buffaloes, pneumonic pasteurellosis in sheep and goats, fowl cholera in poultry, atrophic rhinitis in pigs and snuffles in rabbits. Haemorrhagic septicaemia is caused by Pasteurella multocida type B:2, B:2,5 and B:5 in Asian countries and type E:2 in African countries. Pasteurella multocida have five types of capsular serotype i.e. type A, B, D, E and F. Diagnosis of the disease is mainly based on the clinical sign and symptom, post mortem findings. Confirmatory diagnosis is done by isolation and identification of causative agent. A variety of laboratory diagnostic techniques have been developed over the years for pasteurellosis and used routinely in the laboratory. Among these techniques molecular techniques of diagnosis is most important. This technique not only gives diagnosis but it also provides information regarding capsular type of Pasteurella multocida. Techniques which are used for molecular diagnosis of haemorrhagic septicaemia are PCR based diagnosis, Restriction endonuclease analysis (REA, Ribotyping, Colony hybridization assay, Filled alternation gel electrophoresis (FAGE, Detection of Pasteurella multocida by Real Time PCR. Among these techniques real time PCR is most sensitive and specific. [Vet. World 2011; 4(4.000: 189-192

  17. Degenerative cervical radiculopathy: diagnosis and conservative treatment. A review

    NARCIS (Netherlands)

    Kuijper, B.; Tans, J. Th J.; Schimsheimer, R. J.; van der Kallen, B. F. W.; Beelen, A.; Nollet, F.; de Visser, M.

    2009-01-01

    Degenerative cervical radiculopathy: clinical diagnosis and conservative treatment. A review. To provide a state-of-the-art assessment of diagnosis and non-surgical treatment of degenerative cervical radiculopathy a literature search for studies on epidemiology, diagnosis including

  18. Unraveling Executive Functioning in Dual Diagnosis.

    Science.gov (United States)

    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.

  19. [Pitfalls in the diagnosis of hypercortisolemia].

    Science.gov (United States)

    Maciejewski, Adam; Stellmach, Angelika; Łącka, Katarzyna

    2015-10-01

    Cushing's syndrome (CS) is relatively rare disorder affecting 2-5 per million per year, although the issue of establishing the diagnosis of CS and differential diagnosis of the disease are a significant clinical problem. CS is usually the result of excessive exogenous glucocorticoids usage (iatrogenic CS), endogenous CS can be divided into ACTH-dependent and ACTH-independent. Regardless of its etiology, the most important steps in establishing the diagnosis of CS are taking careful history and examination. The symptoms with high discriminatory value are myopathy, reddish purple striae, easy bruising and plethora. Knowledge of the pathomechanisms leading to the development of CS symptoms, facilitates establishing the diagnosis and understanding the importance of early diagnosis. Although the sensitivity and specificity of laboratory test have increased and imaging techniques developed, establishing the diagnosis of CS is still a challenging problem in clinical practice. When choosing appropriate diagnostic test we should remember of both advantages and limitations of each of them. The increasing popularity of late night/midnight salivary cortisol measurement as a first line diagnostic test is observed, also urinary free cortisol measurement, 1mg dexamethasone overnight suppression test and midnight serum cortisol measurement are used in the initial testing for hypercortisolemia. Subclinical CS as well as cyclical or episodic CS may be challenging especially. Another diagnostic problem is differentiation between functional hypercortisolism (pseudo-Cushing's syndrome) and pathological hypercortisolism with organic changes (CS). Right and early diagnosis is of vital importance in patients with CS because of large extent of complications resulting from untreated hypercortisolemia. In the course of CS many different organs and systems can be affected, leading to increase in total morbidity and mortality. © 2015 MEDPRESS.

  20. 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...

  1. Prenatal diagnosis in the Netherlands. Dutch Working Party of Prenatal Diagnosis

    NARCIS (Netherlands)

    Leschot, N. J.; Kloosterman, M. D.

    1997-01-01

    Prenatal invasive diagnosis of genetic conditions in the Netherlands is well organised, based on uniform indications and has a sound financial structure. Facilities for fetal karyotyping and DNA analysis are available in the 8 academic centres. Prenatal diagnosis of metabolic diseases is mainly

  2. Women's experiences of their osteoporosis diagnosis at the time of diagnosis and 6 months later

    DEFF Research Database (Denmark)

    Hansen, Carrinna; Konradsen, Hanne; Abrahamsen, Bo

    2014-01-01

    -osteoporotic treatment. Exclusion criteria were previous diagnosis of osteoporosis or previous treatment with anti-osteoporotic medication. Data were collected through in-depth interviews shortly after diagnosis and 6 months later. The performed analyses were inspired by Paul Ricoeur's theory of interpretation of texts...

  3. Sonography in the diagnosis of acute appendicitis

    Directory of Open Access Journals (Sweden)

    Ahmad Ryazi

    2003-09-01

    Full Text Available Graded compressive sonography may be useful as an adjuvant in the diagnosis of acute appendicitis. To determine the role of sonography in the differential diagnosis of acute appendicitis, preappendectomy sonographic data of 164 consecutive cases in Fatemeh-Zahra Teaching Hospital were evaluated. Of 113 (68.9% patients who had acute appendicitis in histopathology, 64 (56.6% cases had preoperative sonographic diagnosis of acute appendicitis. Of 51 patients who had normal appendices, 40 (78.4% cases had normal appendices in sonographic evaluations. Sensitivity, specificity and accuracy of sonography for acute appendicitis were 56.7%, 78.4% and 0.63, respectively. The positive and negative predictive values were 85.3% and 44.49% respectively. As a result, sonographic evaluation is an additional diagnostic tool in acute appendicitis.

  4. Silicon nanostructures for cancer diagnosis and therapy.

    Science.gov (United States)

    Peng, Fei; Cao, Zhaohui; Ji, Xiaoyuan; Chu, Binbin; Su, Yuanyuan; He, Yao

    2015-01-01

    The emergence of nanotechnology suggests new and exciting opportunities for early diagnosis and therapy of cancer. During the recent years, silicon-based nanomaterials featuring unique properties have received great attention, showing high promise for myriad biological and biomedical applications. In this review, we will particularly summarize latest representative achievements on the development of silicon nanostructures as a powerful platform for cancer early diagnosis and therapy. First, we introduce the silicon nanomaterial-based biosensors for detecting cancer markers (e.g., proteins, tumor-suppressor genes and telomerase activity, among others) with high sensitivity and selectivity under molecular level. Then, we summarize in vitro and in vivo applications of silicon nanostructures as efficient nanoagents for cancer therapy. Finally, we discuss the future perspective of silicon nanostructures for cancer diagnosis and therapy.

  5. [Cervical lymph node tuberculosis: diagnosis and treatment].

    Science.gov (United States)

    Zaatar, R; Biet, A; Smail, A; Strunski, V; Page, C

    2009-01-01

    The purpose of this study was to evaluate the advantages of surgery for diagnosis and treatment of cervical lymph node tuberculosis. This was a retrospective study from 1st January 1998 to 31st December 2007 including 30 patients with cervical lymph node tuberculosis. The population included 60% autochthones with a mean age of 47.1 years and a female predominance (73.33%). The lymph nodes were most often supraclavicular, unilateral, firm, and a mean 3 cm at its largest span. Lymph nodes were excised for diagnosis in 22 patients, which demonstrated specific granulomatous and giant cell lesions with caseous necrosis in 21 patients out of 22. Five abscessed adenopathies required surgical drainage, and three cases required repeated lymph node cleaning after well-conducted medical treatment. Surgery retains an important place in the diagnosis and treatment of cervical lymph node tuberculosis.

  6. Fault diagnosis methods for district heating substations

    Energy Technology Data Exchange (ETDEWEB)

    Pakanen, J.; Hyvaerinen, J.; Kuismin, J.; Ahonen, M. [VTT Building Technology, Espoo (Finland). Building Physics, Building Services and Fire Technology

    1996-12-31

    A district heating substation is a demanding process for fault diagnosis. The process is nonlinear, load conditions of the district heating network change unpredictably and standard instrumentation is designed only for control and local monitoring purposes, not for automated diagnosis. Extra instrumentation means additional cost, which is usually not acceptable to consumers. That is why all conventional methods are not applicable in this environment. The paper presents five different approaches to fault diagnosis. While developing the methods, various kinds of pragmatic aspects and robustness had to be considered in order to achieve practical solutions. The presented methods are: classification of faults using performance indexing, static and physical modelling of process equipment, energy balance of the process, interactive fault tree reasoning and statistical tests. The methods are applied to a control valve, a heat excharger, a mud separating device and the whole process. The developed methods are verified in practice using simulation, simulation or field tests. (orig.) (25 refs.)

  7. [Informing of the diagnosis in dementia].

    Science.gov (United States)

    Robles, María José; Cucurella, Eulàlia; Formiga, Francesc; Fort, Isabel; Rodríguez, Daniel; Barranco, Elena; Catena, Joan; Cubí, Dolors

    2011-01-01

    Dementia is a syndrome characterized by a progressive deterioration of cognitive functions, accompanied by psychiatric symptoms and behavioral disturbances that produce a progressive and irreversible disability. The way it should communicate the diagnosis of dementia is a key discussion point on which there is no unanimous agreement so far. The communicating of the diagnosis of dementia is a complex issue that affects not only, the patient but also to caregivers and health professionals who care and must conform to the ethical principles governing medical practice (autonomy, nonmaleficence, beneficence, and justice). Therefore, from the Dementia Working Group of the Catalan Geriatric Society (Grupo de Trabajo de Demencia de la Sociedad Catalana de Geriatría) arises the need to review the issue and propose a course of action for the disclosure of diagnosis. Copyright © 2010 SEGG. Published by Elsevier Espana. All rights reserved.

  8. Maternal depressive symptoms following autism spectrum diagnosis.

    Science.gov (United States)

    Taylor, Julie Lounds; Warren, Zachary E

    2012-07-01

    The current study examined depressive symptoms, concerning the week following autism spectrum diagnosis and an average of 1.4 years later, in mothers (n = 75) of young children diagnosed with an autism spectrum disorder (ASD). Over three-quarters of mothers (78.7%) provided retrospective reports of clinically significant depressive symptoms regarding the week following their child's ASD diagnosis, with some 37.3% continuing to report clinically significant levels of depressive symptoms at follow-up. Depressive symptoms immediately following diagnosis were not related to initial global characteristics of child functioning, but were related to reported child problem behaviors and financial barriers at follow-up. Results of this study underscore the importance of attention to caregiver distress and depression within models of autism detection and intervention.

  9. The commonly missed diagnosis of intracranial hypotension

    Directory of Open Access Journals (Sweden)

    Ashlee N. Ruggeri-McKinley, BSN, RN

    2016-06-01

    Full Text Available We report a 28 year old female who presented with a subacute onset of a severe throbbing and stabbing headache after a morning spin class 9 months ago. We confirmed the diagnosis of spontaneous intracranial hypotension cause by a cerebrospinal fluid leak. The headache finally resolved after a 55 ml blood patch. Affecting an estimated 5/100,000 patients, spontaneous intracranial hypotension is considered rare in medical literature. Many patients with spontaneous intracranial hypotension are incapacitated for years and even decades. The misdiagnosis of intracranial hypotension can have serious consequences and lead to unnecessary testing and treatment. Healthcare professionals need to be aware of this diagnosis when evaluating a patient with acute head pain. Considering that physical exams are usually normal, clinicians must focus on the patient history and physical. Clues in the patient interviewing process can lead to an immediate and accurate diagnosis.

  10. Problem Diagnosis in Software Process Improvement

    DEFF Research Database (Denmark)

    Iversen, Jakob; Nielsen, Peter Axel; Nørbjerg, Jacob

    1998-01-01

    This paper addresses software process improvement. In particular it reports on action research undertaken to understand the problems with software processes of a large Danish company. It is argued that in order to understand what the specific problems are we may, on the one hand, rely on process...... to enable process improvement to effectively take place. It is argued that problem diagnosis a useful approach and that it has advantages over model-based assessment....... models like CMM or Bootstrap. On the other hand, we may also see the specific and unique features of software processes in this company through what we call problem diagnosis. Problem diagnosis deals with eliciting problems perceived by software project managers and with forming commitment structures...

  11. [Is the diagnosis 'depression' still useful?].

    Science.gov (United States)

    Terluin, Berend; Oud, Marian J T

    2012-01-01

    The DSM diagnosis of depression is based solely on the presence of symptoms, without taking into account the context in which these symptoms have occurred. For this reason, the DSM diagnosis does not distinguish between sadness as a normal reaction to a painful loss and pathologically depressive reactions that are disproportionate to personal life events and circumstances. According to a group of mental health expert general practitioners, a true depressive disorder is characterized by a depression that has acquired a life of its own and is hard to control. This depression is severe, and is recognized by the patient as alien to his or her character. Loss of the ability to experience pleasure in ordinary things (anhedonia) and thoughts about death as an alternative for the torment experienced are often present. We recommend the diagnosis of depression be reserved for clearly pathologically depressive reactions that are also recognized as such by the patient.

  12. Diagnosis of pilomatricoma using an otoscope.

    Science.gov (United States)

    Barreto-Chang, Odmara L; Gorell, Emily S; Yamaguma, Mark A; Lane, Alfred T

    2010-01-01

    Pilomatricoma is a benign tumor that presents as a 3-30-mm, firm, solitary, deep, dermal or subcutaneous tumor on the head, neck, or upper extremities. The clinical diagnosis is often made by the firm, sometimes rock-hard texture of the skin. The diagnosis can be confirmed by a skin biopsy or excision of the lesion. We have recently noted that pilomatricomas appear as a black mass in the skin when the lesion is transilluminated by placing the light of a fiberoptic otoscope adjacent to the skin lesion. To our knowledge, this is the first report demonstrating preoperative diagnosis of pilomatricoma by transilluminating the lesion with an otoscope. © 2010 Wiley Periodicals, Inc.

  13. Epidemiology and Diagnosis of Helicobacter pylori infection.

    Science.gov (United States)

    Mentis, Andreas; Lehours, Philippe; Mégraud, Francis

    2015-09-01

    During the period reviewed, prevalence studies were essentially performed in less economically advanced countries and a high prevalence was found. The traditional risk factors for Helicobacter pylori positivity were mostly found. Transmission studied by molecular typing showed a familial transmission. The eventual role of water transmission was explored in several studies with controversial results. Concerning diagnosis, most of the invasive and noninvasive methods used for the diagnosis of H. pylori infection are long standing with efficient performance. The most interesting recent improvements in H. pylori diagnosis include advances in endoscopy, developments in molecular methods, and the introduction of omics-based techniques. Interpretation of old or newer method should take into account the pretest probability and the prevalence of H. pylori in the population under investigation. © 2015 John Wiley & Sons Ltd.

  14. Early breast cancer: diagnosis, treatment and survivorship.

    LENUS (Irish Health Repository)

    Meade, Elizabeth

    2013-01-11

    Breast cancer is the most common female cancer and globally remains a major public health concern. The diagnosis and treatment of breast cancer continues to develop. Diagnosis is now more precise, surgery is less mutilating and women now have the option of breast conserving therapy with better cosmesis, and without sacrificing survival. Radiotherapy is more targeted and the selection of patients for adjuvant chemotherapy is based not only on prognostic and predictive factors, but also on newer molecular profiling that will ensure that chemotherapy is given to the patients who need and respond to it. These developments all provide a more tailored approach to the treatment of breast cancer. Management now involves a multidisciplinary team approach in order to provide the highest standard of care for patients throughout their cancer journey from diagnosis through treatment and into follow-up care.

  15. Clinical Assessment And Diagnosis Of Dementia

    Directory of Open Access Journals (Sweden)

    Srikanth S

    2005-01-01

    Full Text Available Dementia is characterized by progressive decline in an alert individual, leading to loss of independence in day-to-day functioning. It is a generic term for a condition that has various causes and hence myriad clinical presentations. It has to be distinguished from age-related cognitive decline, depression and delirium all of which are common in the elderly population. Detailed history and mental status examination are necessary to identify dementia, fit it into one of the various bedside classifications and pursue the differential diagnosis. This teaching review summarizes current information on definition, differential diagnosis and classification of dementia and presents a brief elaboration of bedside cognitive testing pertaining to dementia. A bird′s eye view of the profiles of various dementia subtypes is also provided so that after reading this article the reader will able to recognize dementia, conduct clinical examination to identify the characteristic cognitive profile and formulate the differential diagnosis with confidence.

  16. Ultrasonographic diagnosis of amebic liver abscess

    Energy Technology Data Exchange (ETDEWEB)

    Jeon, Hae Jeong; Suh, Won Hyuck; Park, Ung Chae [Korea University College of Medicine, Seoul (Korea, Republic of)

    1988-10-15

    Amebric liver abscess is the most common extraintestinal complication of amoebiasis. Radionuclide scan, computed tomography have helped ultrasound in making diagnosis of a amebic liver abscess, but sonography have made a remarkable contribution in the diagnosis and management. Sonographic features of proven amebic abscess of 17 cases in 16 patients were retrospectively analyzed. The abscess lesions were located in right lobe of the liver (14 cases), single in number (15 cases). There were 9 cases of pleural effusion. In one patient, colitis was present as a complication. Sonographic findings of amebic abscess were round inhomogeneous hypoechoic lesion; absence of definite wall echoes; posterior wall enhancement; progressive echolucent change with maturation. Ultrasound guided aspiration can make the microbiological diagnosis of amebic abscess.

  17. Prenatal diagnosis of congenital paraesophageal hiatal hernia

    Directory of Open Access Journals (Sweden)

    Min Jeng Cho

    2018-05-01

    Full Text Available Abstracts: Congenital paraesophageal hiatal hernia (CPEH is a rare condition. CPEH can cause important clinical problems such as gastric volvulus, hematemesis, vomiting, failure to thrive, and respiratory distress, it requires early diagnosis and prompt surgical treatment. In this paper, we describe a case of CPEH that was suspected in a prenatal ultrasound. Postnatal upper gastrointestinal contrast series confirmed a CPEH with intrathoracic gastric volvulus. An emergency operation was performed. The stomach was reduced, the hiatal defect was repaired by crural approximation, and a Nissen fundoplication was done. The prenatal diagnosis of CPEH is unusual, but prenatal detection is important because it allows planned neonatal surgery before the onset of complications and reduces long-term morbidity. Keywords: Congenital paraesophageal hiatal hernia, Antenatal diagnosis, Gastric volvulus

  18. Addison's disease - the difficulty of diagnosis

    Directory of Open Access Journals (Sweden)

    Clara Preto

    2018-04-01

    Full Text Available Introduction: Primary adrenal insufficiency is a rare disease, especially in pediatric age. Case report: We report the case of a teenager with astenia with four months’ evolution, causing repeated visits to the emergency department during the previous month due gastrointestinal symptoms and a ten kilograms weight loss. In admission the patient had a reasonable general condition, hydrated and without cutaneous hyperpigmentation. Laboratory results showed hyponatremia, increased levels of corticotropin with normal cortisol levels, increased levels of renin with decreased aldosterone levels and presence of antissuprarrenal antibodies, allowing the diagnosis of autoimmune primary adrenal insufficiency. The boy started treatment with hydrocortisone and fludrocortisone with favorable response. Discussion/conclusions: The diagnosis of Addison’s disease requires a high degree of suspicion due its unspecific symptomatology. This disease often presents gastrointestinal symptoms. Thus, towards a patient with hyponatremia accompanied by constitutional and gastrointestinal symptoms, we must always consider this diagnosis.

  19. Methods to isolate extracellular vesicles for diagnosis

    Science.gov (United States)

    Kang, Hyejin; Kim, Jiyoon; Park, Jaesung

    2017-12-01

    Extracellular vesicles (EVs) are small membrane-bound bodies that are released into extracellular space by diverse cells, and are found in body fluids like blood, urine and saliva. EVs contain RNA, DNA and proteins, which can be biomarkers for diagnosis. EVs can be obtained by minimally-invasive biopsy, so they are useful in disease diagnosis. High yield and purity contribute to precise diagnosis of disease, but damaged EVs and impurities can cause confu sed results. However, EV isolation methods have different yields and purities. Furthermore, the isolation method that is most suitable to maximize EV recovery efficiency depends on the experimental conditions. This review focuses on merits and demerits of several types of EV isolation methods, and provides examples of how to diagnose disease by exploiting information obtained by analysis of EVs.

  20. Ultrasonographic diagnosis of pyometra in bitches

    Directory of Open Access Journals (Sweden)

    Nereu Carlos Prestes

    1995-06-01

    Full Text Available A B-mode ultrasonography (SCANNER 450 (5MHz, Pie Medical, Netherlands was used either alone or associated with laboratorial and radiographic examinations in 33 bitches with clinical diagnosis of pyometra. The increased uterus appeared as a well defined tubular structure with diameter ranging from 0.5 up to 4.0 cm. The uterine lumen was less echoic than the wall, with evident echoic shinings. There was an accordance between the increasing in the viscosity of the vaginal secretion and the echoigenicity. The ultrasonographic diagnosis was possible in 31 bitches (94% confirmed by laparotomy and autopsy. The B-mode ultrasonography can be used in the diagnosis of bitches with pyometra.

  1. Active fault diagnosis by controller modification

    DEFF Research Database (Denmark)

    Stoustrup, Jakob; Niemann, Hans Henrik

    2010-01-01

    Two active fault diagnosis methods for additive or parametric faults are proposed. Both methods are based on controller reconfiguration rather than on requiring an exogenous excitation signal, as it is otherwise common in active fault diagnosis. For the first method, it is assumed that the system...... considered is controlled by an observer-based controller. The method is then based on a number of alternate observers, each designed to be sensitive to one or more additive faults. Periodically, the observer part of the controller is changed into the sequence of fault sensitive observers. This is done...... in a way that guarantees the continuity of transition and global stability using a recent result on observer parameterization. An illustrative example inspired by a field study of a drag racing vehicle is given. For the second method, an active fault diagnosis method for parametric faults is proposed...

  2. Diagnosis of pancreatitis in dogs and cats.

    Science.gov (United States)

    Xenoulis, P G

    2015-01-01

    Pancreatitis is the most common disorder of the exocrine pancreas in both dogs and cats. Ante-mortem diagnosis of canine and feline pancreatitis can be challenging. The clinical picture of dogs and cats with pancreatitis varies greatly (from very mild to severe or even fatal) and is characterised by non-specific findings. Complete blood count, serum biochemistry profile and urinalysis should always be performed in dogs and cats suspected of having pancreatitis, although findings are not-specific for pancreatitis. Serum amylase and lipase activities and trypsin-like immunoreactivity (TLI) concentrations have no or only limited clinical value for the diagnosis of pancreatitis in either dogs or cats. Conversely, serum pancreatic lipase immunoreactivity (PLI) concentration is currently considered to be the clinicopathological test of choice for the diagnosis of canine and feline pancreatitis. Abdominal radiography is a useful diagnostic tool for the exclusion of other diseases that may cause similar clinical signs to those of pancreatitis. Abdominal ultrasonography can be very useful for the diagnosis of pancreatitis, but this depends largely on the clinician's experience. Histopathological examination of the pancreas is considered the gold standard for the diagnosis and classification of pancreatitis, but it is not without limitations. In clinical practice, a combination of careful evaluation of the animal's history, serum PLI concentration and abdominal ultrasonography, together with pancreatic cytology or histopathology when indicated or possible, is considered to be the most practical and reliable means for an accurate diagnosis or exclusion of pancreatitis compared with other diagnostic modalities. © 2015 British Small Animal Veterinary Association.

  3. Patients' preference to hear cancer diagnosis.

    Directory of Open Access Journals (Sweden)

    Mohammad Arbabi

    2014-03-01

    Full Text Available Bad news disclosure is one of the complex communication tasks of the physicians. Bad news is defined as:" any news that adversely and seriously affects an individual's view of his or her future". Recent studies indicate that the patients' and physicians' attitudes toward disclosure of bad news have been changed since few years ago. The evidence of breaking bad news is also different across different cultures. In the present study, we aimed to evaluate the patients' prospect about breaking bad news and to provide a clinical guidance for Iranian patients and those patients in countries with a similar cultural background.A cross sectional descriptive study was conducted on a sample of 200 cancer patients at a cancer institute in Tehran. The patients' demographic characteristics and their attitudes toward the manner of disclosing the diagnosis were registered in a research based questionnaire.In this study, 165 patients (82.5% claimed to be aware of the diagnosis; however, only 121 patients (73% were aware of the actual diagnosis of their disease. Most patients tended to know the diagnosis (n = 186, 93% and accepted patient as the first person to be informed (n = 151, 75.5% by their physician (n = 174, 87%. The preference of being alone or with a family member when exposed to bad news was almost the same. Most patients (n = 169, 84.5% believed that physicians should consult the patients to make treatment decisions. Treatment options (n = 140, 70% and life expectancy (n = 121, 60.5% were the most desirable topics to be discussed. Most patients (n = 144, 72% agreed upon allowing them to express their emotional feelings.According to the patients' preferences about being fully informed about the diagnosis, it is suggested that the disclosure of cancer diagnosis be done by a physician and in the presence of a family member. It is also recommended that physicians consult the patients about treatment options.

  4. Diagnosis of Cystic Fibrosis in Screened Populations.

    Science.gov (United States)

    Farrell, Philip M; White, Terry B; Howenstine, Michelle S; Munck, Anne; Parad, Richard B; Rosenfeld, Margaret; Sommerburg, Olaf; Accurso, Frank J; Davies, Jane C; Rock, Michael J; Sanders, Don B; Wilschanski, Michael; Sermet-Gaudelus, Isabelle; Blau, Hannah; Gartner, Silvia; McColley, Susanna A

    2017-02-01

    Cystic fibrosis (CF) can be difficult to diagnose, even when newborn screening (NBS) tests yield positive results. This challenge is exacerbated by the multitude of NBS protocols, misunderstandings about screening vs diagnostic tests, and the lack of guidelines for presumptive diagnoses. There is also confusion regarding the designation of age at diagnosis. To improve diagnosis and achieve standardization in definitions worldwide, the CF Foundation convened a committee of 32 experts with a mission to develop clear and actionable consensus guidelines on diagnosis of CF with an emphasis on screened populations, especially the newborn population. A comprehensive literature review was performed with emphasis on relevant articles published during the past decade. After reviewing the common screening protocols and outcome scenarios, 14 of 27 consensus statements were drafted that apply to screened populations. These were approved by 80% or more of the participants. It is recommended that all diagnoses be established by demonstrating dysfunction of the CF transmembrane conductance regulator (CFTR) channel, initially with a sweat chloride test and, when needed, potentially with newer methods assessing membrane transport directly, such as intestinal current measurements. Even in babies with 2 CF-causing mutations detected via NBS, diagnosis must be confirmed by demonstrating CFTR dysfunction. The committee also recommends that the latest classifications identified in the Clinical and Functional Translation of CFTR project [http://www.cftr2.org/index.php] should be used to aid with CF diagnosis. Finally, to avoid delays in treatment, we provide guidelines for presumptive diagnoses and recommend how to determine the age of diagnosis. Copyright © 2016. Published by Elsevier Inc.

  5. 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.

  6. Autism in preschoolers: does individual clinician's first visit diagnosis agree with final comprehensive diagnosis?

    Science.gov (United States)

    Westman Andersson, Gunilla; Miniscalco, Carmela; Gillberg, Christopher

    2013-01-01

    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.

  7. An intelligent model for liver disease diagnosis.

    Science.gov (United States)

    Lin, Rong-Ho

    2009-09-01

    Liver disease, the most common disease in Taiwan, is not easily discovered in its initial stage; early diagnosis of this leading cause of mortality is therefore highly important. The design of an effective diagnosis model is therefore an important issue in liver disease treatment. This study accordingly employs classification and regression tree (CART) and case-based reasoning (CBR) techniques to structure an intelligent diagnosis model aiming to provide a comprehensive analytic framework to raise the accuracy of liver disease diagnosis. Based on the advice and assistance of doctors and medical specialists of liver conditions, 510 outpatient visitors using ICD-9 (International Classification of Diseases, 9th Revision) codes at a medical center in Taiwan from 2005 to 2006 were selected as the cases in the data set for liver disease diagnosis. Data on 340 patients was utilized for the development of the model and on 170 patients utilized to perform comparative analysis of the models. This paper accordingly suggests an intelligent model for the diagnosis of liver diseases which integrates CART and CBR. The major steps in applying the model include: (1) adopting CART to diagnose whether a patient suffers from liver disease; (2) for patients diagnosed with liver disease in the first step, employing CBR to diagnose the types of liver diseases. In the first phase, CART is used to extract rules from health examination data to show whether the patient suffers from liver disease. The results indicate that the CART rate of accuracy is 92.94%. In the second phase, CBR is developed to diagnose the type of liver disease, and the new case triggers the CBR system to retrieve the most similar case from the case base in order to support the treatment of liver disease. The new case is supported by a similarity ratio, and the CBR diagnostic accuracy rate is 90.00%. Actual implementation shows that the intelligent diagnosis model is capable of integrating CART and CBR techniques to

  8. Intestinal tuberculosis simulating Crohn's disease: Differential diagnosis.

    Science.gov (United States)

    García-Morales, Natalia; García-Campos, María; Cordón, Gisselle; Iborra, Marisa

    2018-03-13

    Tuberculosis is a public health's problema in the world. Its incidence is increasing in our environment due to inmigration and the use of inmunosupressors. It's a systemic disease that can affect rarely the gastrointestinal tract. We should take into account the epidemiological and clinical context of each patient, because the differential diagnosis is broad. It can mimic with other diseases, such as Crohn's disease. We report a case of intestinal tuberculosis, and underline the importance of the differential diagnosis of these patients. Copyright © 2018 Elsevier España, S.L.U. All rights reserved.

  9. Fungal Endocarditis: Update on Diagnosis and Management.

    Science.gov (United States)

    Pasha, Ahmed Khurshid; Lee, Justin Z; Low, See-Wei; Desai, Hem; Lee, Kwan S; Al Mohajer, Mayar

    2016-10-01

    Fungal endocarditis is an extremely debilitating disease associated with high morbidity and mortality. Candida spp. are the most common isolated organisms in fungal endocarditis. It is most prevalent in patients who are immunosuppressed and intravenous drug users. Most patients present with constitutional symptoms, which are indistinguishable from bacterial endocarditis, hence a high index of suspicion is required for pursuing diagnosis. Diagnosis of fungal endocarditis can be very challenging: most of the time, blood cultures are negative or take a long time to yield growth. Fungal endocarditis mandates an aggressive treatment strategy. A medical and surgical combined approach is the cornerstone of therapy. Copyright © 2016 Elsevier Inc. All rights reserved.

  10. Exploring Symmetry to Assist Alzheimer's Disease Diagnosis

    Science.gov (United States)

    Illán, I. A.; Górriz, J. M.; Ramírez, J.; Salas-Gonzalez, D.; López, M.; Padilla, P.; Chaves, R.; Segovia, F.; Puntonet, C. G.

    Alzheimer's disease (AD) is a progressive neurodegenerative disorder first affecting memory functions and then gradually affecting all cognitive functions with behavioral impairments and eventually causing death. Functional brain imaging as Single-Photon Emission Computed Tomography (SPECT) is commonly used to guide the clinician's diagnosis. The essential left-right symmetry of human brains is shown to play a key role in coding and recognition. In the present work we explore the implications of this symmetry in AD diagnosis, showing that recognition may be enhanced when considering this latent symmetry.

  11. CT diagnosis of occipital bone pacchionian depression

    International Nuclear Information System (INIS)

    Zhu Jianguo; Xu Xiaolin

    2004-01-01

    Objective: To improve the recognition of the CT findings of occipital bone pacchionian depression, in order to avoid misdiagnosis. Methods: occipital bone pacchionian depression underwent CT with plain scan and intravenous contrast enhancement in 11 cases, and then the CT findings were analyzed. Results: Occipital bone pacchionian depression situated beside the torcular herophilia in 11 cases. The depression or bone defect were found at occipital bone inner plate, they can reach diploe or outer plate and had no enhancement after contrast injection. Conclusions: CT scans play an important role in diagnosis and differential diagnosis of occipital bone pacchionian depression

  12. Clinical diagnosis and treatment of olfactory meningioma

    International Nuclear Information System (INIS)

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

    2005-01-01

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

  13. Cooperative human-machine fault diagnosis

    Science.gov (United States)

    Remington, Roger; Palmer, Everett

    1987-01-01

    Current expert system technology does not permit complete automatic fault diagnosis; significant levels of human intervention are still required. This requirement dictates a need for a division of labor that recognizes the strengths and weaknesses of both human and machine diagnostic skills. Relevant findings from the literature on human cognition are combined with the results of reviews of aircrew performance with highly automated systems to suggest how the interface of a fault diagnostic expert system can be designed to assist human operators in verifying machine diagnoses and guiding interactive fault diagnosis. It is argued that the needs of the human operator should play an important role in the design of the knowledge base.

  14. [Differential diagnosis of Graves' orbitopathy. Case report].

    Science.gov (United States)

    Erdei, Annamária; Steiber, Zita; Gazdag, Annamária; Bodor, Miklós; Berta, Eszter; Szász, Róbert; Szántó, Antónia; Ujhelyi, Bernadett; Barna, Sándor; Berényi, Ervin; Nagy, V Endre

    2016-02-21

    Graves' orbitopathy is the extrathyroidal manifestation of Graves' disease, which is the most common cause of exophthalmos. As eye symptoms usually coincide with the development of thyrotoxicosis, the diagnosis of the disease is rarely difficult. The aim of the authors was to summarize the differential diagnosis of Graves' orbitopathy based on literature review and presentation of their own four problematic cases on this topic. They conclude that symptoms similar to endocrine orbitopathy are present in other disorders. Endocrinologists need to be aware of these other conditions to avoid treatment failures.

  15. Visceral leishmaniasis: an update of laboratory diagnosis

    Directory of Open Access Journals (Sweden)

    Zineb Tlamcani

    2016-07-01

    Full Text Available Visceral leishmaniasis, is an infection due to obligate intracellular protozoa of the genus Leishmania. There exist two varieties of visceral leishmaniasis, that vary in their transmission aspects: zoonotic visceral leishmaniasis and anthroponotic visceral leishmaniasis. Their clinical features are comparable with sevral differences. Laboratory diagnosis of visceral leishmaniasis consists of microscopic observation of parasite, culture from appropriate samples, detection of antigen, serological tests, and identification of parasite DNA. In this review, we will discuss the different techniques of diagnosis and the interet of the recent methods such as rapid diagnostic test and direct agglutination test.

  16. Fusion Imaging in the Diagnosis of Cancer

    International Nuclear Information System (INIS)

    Maldonado, A.; Gonzalez Alenda, J.

    2007-01-01

    Early diagnosis is one of the most important aids in the fight against cancer. Of the tests available in Medicine, anatomic imaging techniques such as Computed Tomography (CT)and Magnetic Resonance Imaging (MRI) have been the ones used for many years. the emergence of Positron Emission Tomography (PET) more than a decade ago was a major breakthrough in the early diagnosis of malignant lesions, as it was based on tumor metabolism and not on anatomy. The merger of both techniques into one thanks to PET-CT cameras has made this technology the most important tool in the management of cancer patients. (Author)

  17. Diagnosis and management of interstitial cystitis.

    Science.gov (United States)

    Barr, Susan

    2014-09-01

    Interstitial cystitis is a diagnosis of exclusion. The definition has expanded over the years to encompass painful bladder syndrome. It is disease state that is often delayed in its diagnosis and difficult to manage. Treatment options include oral and intravesical therapies as well as both minor and major surgical options. Also, a patient can improve symptoms by following self-management recommendations that focus on both diet and stress management. Treatment options should be periodically evaluated with validated questionnaires to insure they are improving the patient's symptoms, and a multidisciplinary approach is best to manage the patient. Copyright © 2014 Elsevier Inc. All rights reserved.

  18. Diagnosis of Adult Patients with Cystic Fibrosis.

    Science.gov (United States)

    Nick, Jerry A; Nichols, David P

    2016-03-01

    The diagnosis of cystic fibrosis (CF) is being made with increasing frequency in adults. Patients with CF diagnosed in adulthood typically present with respiratory complaints, and often have recurrent or chronic airway infection. At the time of initial presentation individuals may appear to have clinical manifestation limited to a single organ, but with subclinical involvement of the respiratory tract. Adult-diagnosed patients have a good response to CF center care, and newly available cystic fibrosis transmembrane receptor-modulating therapies are promising for the treatment of residual function mutation, thus increasing the importance of the diagnosis in adults with unexplained bronchiectasis. Copyright © 2016 Elsevier Inc. All rights reserved.

  19. Labaratory capacity of differential anemia diagnosis

    Directory of Open Access Journals (Sweden)

    L. M. Meshсheryakova

    2015-06-01

    Full Text Available The paper presents the laboratory values by which modern differential diagnosis of anemias can be performed. This takes into account a widerange of laboratory tests, including: serum ferritin, erythrocyte ferritin, serum iron, total serum iron binding capacity, iron transferrin saturation,transferrin, transferrin receptor, serum vitamin B12, erythrocyte vitamin B12, serum folate, erythrocyte folate, hepsidin, HIF-1 (hypoxiainducible factor-1, immunoglobulins on erythrocytes end others. The combination of these studies helps to accurate diagnosis and appropriate therapy.

  20. The differential diagnosis of spastic diplegia.

    Science.gov (United States)

    Huntsman, Richard; Lemire, Edmond; Norton, Jonathon; Dzus, Anne; Blakley, Patricia; Hasal, Simona

    2015-05-01

    Spastic diplegia is the most common form of cerebral palsy worldwide. Many disorders mimic spastic diplegia, which can result in misdiagnosis for the child with resultant negative treatment and family counselling implications. In this paper, the authors provide a brief review of spastic diplegia and the various disorders in the differential diagnosis. We also provide a diagnostic algorithm to assist physicians in making the correct diagnosis. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

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

    Directory of Open Access Journals (Sweden)

    Nikonova L. V.

    2018-03-01

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

  2. Emphysematous and xanthogranulomatous pyelonephritis: rare diagnosis

    Directory of Open Access Journals (Sweden)

    Lya Duarte Ramos

    Full Text Available Pyelonephritis is a pyogenic infection of renal parenchyma that involves the renal pelvis. It is generally of easy diagnosis. The present case report aims to describe two different manifestations of this infection: xanthogranulomatous pyelonephritis and emphysematous pyelonephritis, which have poor prognosis and require a more effective treatment. The two cases were women in the fiftieth and sixtieth decade of life, with diabetes mellitus and history of weight loss. The diagnosis of the renal infection was established through computed tomography and the treatment was based in surgical procedure, with favorable outcome.

  3. Diagnosis and treatment of Lyme arthritis.

    Science.gov (United States)

    Arvikar, Sheila L; Steere, Allen C

    2015-06-01

    In the United States, Lyme arthritis is the most common feature of late-stage Borrelia burgdorferi infection, usually beginning months after the initial bite. In some, earlier phases are asymptomatic and arthritis is the presenting manifestation. Patients with Lyme arthritis have intermittent or persistent attacks of joint swelling and pain in 1 or a few large joints. Serologic testing is the mainstay of diagnosis. Synovial fluid polymerase chain reaction for B burgdorferi DNA is often positive before treatment, but is not a reliable marker of spirochetal eradication after therapy. This article reviews the clinical manifestations, diagnosis, and management of Lyme arthritis. Copyright © 2015 Elsevier Inc. All rights reserved.

  4. Serological diagnosis of toxoplasmosis and standardization.

    Science.gov (United States)

    Zhang, Kuo; Lin, Guigao; Han, Yanxi; Li, Jinming

    2016-10-01

    Humans can be infected by the intracellular parasite Toxoplasma gondii, which causes toxoplasmosis, a common parasitic disease. Although the infection is generally asymptomatic for most adults, severe complications may occur in some individuals, especially women in early pregnancy. Serologic diagnosis is used as a routine practice to determine the immune status for infection by T. gondii. In this review, we attempt to provide an overview of the serological diagnosis of toxoplasmosis, including diagnostic strategy, current problems in detection with specific antibodies, and the standardization of T. gondii serological detection. Copyright © 2016 Elsevier B.V. All rights reserved.

  5. Kidney stones: pathophysiology, diagnosis and management.

    Science.gov (United States)

    Cunningham, Priscilla; Noble, Helen; Al-Modhefer, Abdul-Kadhum; Walsh, Ian

    2016-11-10

    The prevalence of kidney stones is increasing, and approximately 12 000 hospital admissions every year are due to this condition. This article will use a case study to focus on a patient diagnosed with a calcium oxalate kidney stone. It will discuss the affected structures in relation to kidney stones and describe the pathology of the condition. Investigations for kidney stones, differential diagnosis and diagnosis, possible complications and prognosis, will be discussed. Finally, a detailed account of management strategies for the patient with kidney stones will be given, looking at pain management, medical procedures and dietary interventions.

  6. Glusoce-6-phosphate dehydrogenase- History and diagnosis

    Directory of Open Access Journals (Sweden)

    K Gautam

    2016-09-01

    Full Text Available Glucose-6-phosphate dehydrogenase deficiency is the most common enzymatic defect of red blood cells, which increases the vulnerability of erythrocytes to oxidative stress leading to hemolytic anemia. Since its identification more than 60 years ago, much has been done with respect to its clinical diagnosis, laboratory diagnosis and treatment. Association of G6PD is not just limited to anti malarial drugs, but a vast number of other diseases. In this article, we aimed to review the history of Glucose-6-phosphate dehydrogenase, the diagnostic methods available along with its association with other noncommunicable diseases. 

  7. [Usefulness of pancreatic scintilography in clinical diagnosis].

    Science.gov (United States)

    Graef, A; Arevila, N; Ibarrola, J L

    1977-01-01

    Our experience in pancreatic scintigraphy is presented in this paper. It was used as radioactive substance 75 semetionina. 21 patients with pancreatic pathology and 6 controls constituted the clinical material. The scintigraphy studies showed an homogenous distribution of the radioactive material in the control group. In 7 cases a defect of concentration was showed. The diagnosis of carcinoma were made with surgery in all of them. Similar findings were demonstrated in cases of pancreatic pseudocyst. Irregular distribution was noted in patients with pancreatitis. We concluded that in same instances pancreatic scintigraphy can be useful for differential diagnosis in the clinical field.

  8. Diagnosis of Electric Submersible Centrifugal Pump

    Science.gov (United States)

    Kovalchuk, M. S.; Poddubniy, D. A.

    2018-01-01

    The paper deals with the development of system operational diagnostics of electrical submersible pumps (ESP). At the initial stage of studies have explored current methods of the diagnosis of ESP, examined the existing problems of their diagnosis. Resulting identified a number of main standard ESP faults, mechanical faults such as bearing wear, protective sleeves of the shaft and the hubs of guide vanes, misalignment and imbalance of the shafts, which causes the breakdown of the stator bottom or top bases. All this leads to electromagnetic faults: rotor eccentricity, weakening the pressing of steel packs, wire breakage or a short circuit in the stator winding, etc., leading to changes in the consumption current.

  9. Edwards syndrome: prenatal diagnosis by ultrasound

    International Nuclear Information System (INIS)

    Guedea, A.; Riazuelo, G.; Mota, J.; Canon, R.; Garcia, S.

    1997-01-01

    Edwards syndrome is the second most common trisomy syndrome occurring in 0.3/1,000 births. The prenatal diagnosis of this trisomy may be suspected in the routine ultrasound exam of the pregnancy by means of the recognition of a constellation of findings: fetal structural anomalies, intrauterine growth retardation (CIR) and umbilical cord or amniotic fluid volume abnormalities. The diagnosis is then confirmed by chromosome analysis of either amniotic fluid or fetal blood or tissue. We present six cases of Edwards syndrome suspected by fetal ultrasonography exam, all of them confirmed by karyotype, describing the major sonographic findings. (Author) 15 refs

  10. Diagnosis and treatment of Alzheimer's disease

    International Nuclear Information System (INIS)

    Hampel, H.; Padberg, F.; Koetter, H.U.; Teipel, S.J.; Ehrhardt, T.; Hegerl, U.; Stuebner, S.; Moeller, H.J.

    1997-01-01

    Alzheimer's disease is often diagnosed too late. Its etiology is still largely unknown and remains one of the big challenges in neurobiological fundamental research. Optimized early and differential diagnosis can be ensured by a dynamic concept of multidisciplinary diagnosis in cooperation between practitioners specializing in brain disorders, clinical psychogeriatric deprtments, and general practitioners. This, in turn, will enable individualized planning of further living conditions and care of Alzheimer patients and their relations as well as efficient and early pharmacotherapy and psychological intervention. (orig) [de

  11. Computerized tomography in the diagnosis of hyperparathyroidism

    International Nuclear Information System (INIS)

    Sobota, J.; Girl, J.; Sotornik, I.; Kocandrle, V.

    1990-01-01

    Long-term experience in the application of computerized tomography to the diagnosis of hyperparathyroidism is summarized. Based on a large number of examinations (164) of parathyroid glands associated with the possibility of verification and comparison with the results of ultrasonography and other imaging methods, the potential of computerized tomography in the diagnosis of hyperparathyroidism and its advantages and limitations are summarized. It is concluded that owing to its high diagnostic precision, this technique can be regarded reliable in detecting enlarged parathyroid glands. (author). 11 figs., 1 tab., 19 refs

  12. Vibrational spectroscopy in diagnosis and screening

    CERN Document Server

    Severcan, F

    2012-01-01

    In recent years there has been a tremendous growth in the use of vibrational spectroscopic methods for diagnosis and screening. These applications range from diagnosis of disease states in humans, such as cancer, to rapid identification and screening of microorganisms. The growth in such types of studies has been possible thanks to advances in instrumentation and associated computational and mathematical tools for data processing and analysis. This volume of Advances in Biomedical Spectroscopy contains chapters from leading experts who discuss the latest advances in the application of Fourier

  13. Prevalence and associated factors of late HIV diagnosis in north ...

    African Journals Online (AJOL)

    Information regarding age, sex, WHO stage, type of opportunistic condition, HIV testing service and on diagnosis CD4 counts were all collected. On diagnosis CD4 counts <200cells/µl was coded as Late HIV diagnosis. The proportion of with Late HIV diagnosis was calculated and logistic regression modal was used to ...

  14. 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...

  15. Prenatal sonographic diagnosis of focal musculoskeletal anomalies

    Energy Technology Data Exchange (ETDEWEB)

    Ryu, Jung Kyu; Cho, Jeong Yeon; Lee, Young Ho; Kim, Ei Jeong; Chun, Yi Kyeong [Samsung Cheil Hospital, Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of)

    2002-09-15

    Focal musculoskeletal anomalies are various and may be an isolated finding or may be found in conjunction with numerous associations, including genetic syndromes, Karyotype abnormals, central nervous system anomalies and other general musculoskeletal disorders. Early prenatal diagnosis of these focal musculoskeletal anomalies nor only affects prenatal care and postnatal outcome but also helps in approaching other numerous associated anomalies.

  16. Antenatal diagnosis of the congenital craniopharyngioma

    International Nuclear Information System (INIS)

    Jurkiewicz, E.; Bekiesinska-Figatowska, M.; Duczkowski, M.; Grajkowska, W.; Roszkowski, M.; Czech-Kowalska, J.; Dobrzanska, A.

    2010-01-01

    Background: Craniopharyngioma is a rare fetal and neonatal tumor. Case Report: We report a case of a congenital craniopharyngioma diagnosed by prenatal magnetic resonance. This diagnosis was confirmed by postnatal MR imaging, neurosurgical treatment and histopathological examination. Conclusions: Outcome of neonatal craniopharyngioma is very poor, even if radical surgery is performed. The main problems are pituitary insufficiency, diabetes insipidus, and visual disturbance. (authors)

  17. Prenatal sonographic diagnosis of focal musculoskeletal anomalies

    International Nuclear Information System (INIS)

    Ryu, Jung Kyu; Cho, Jeong Yeon; Lee, Young Ho; Kim, Ei Jeong; Chun, Yi Kyeong

    2002-01-01

    Focal musculoskeletal anomalies are various and may be an isolated finding or may be found in conjunction with numerous associations, including genetic syndromes, Karyotype abnormals, central nervous system anomalies and other general musculoskeletal disorders. Early prenatal diagnosis of these focal musculoskeletal anomalies nor only affects prenatal care and postnatal outcome but also helps in approaching other numerous associated anomalies.

  18. Diagnosis of radiological security of installations

    International Nuclear Information System (INIS)

    Herrera V, L.

    1991-01-01

    The objective of this work is to discuss the diagnosis of the radiological safety of nuclear or radioactive facilities. It was concluded that the one diagnoses like discipline of the radiological safety is susceptible of being represented, taught and programmable in computer and useful systems as preventive tool and of inspection

  19. Diagnosis and management of testosterone deficiency

    Directory of Open Access Journals (Sweden)

    James A McBride

    2015-04-01

    Full Text Available Testosterone supplementation therapy (TST use has dramatically increased over the past decade, due to the availability of newer agents, aggressive marketing, and an increasing incidence of testosterone deficiency (TD. Despite the increase in TST, a degree of ambiguity remains as to the exact diagnostic criteria of TD, and administration and monitoring of TST. One explanation for this phenomenon is the complex role testosterone plays in multiple physiologic pathways. Numerous medical co-morbidities and medications can alter testosterone levels resulting in a wide range of nonspecific clinical signs and symptoms of TD. The diagnosis is also challenging due to the lack of a definitive serum total testosterone level that reliably correlates with symptoms. This observation is particularly true in the aging male and is exacerbated by inconsistencies between different laboratory assays. Several prominent medical societies have developed guideline statements to clarify the diagnosis, but they differ from each other and with expert opinion in several ways. Aside from diagnostic dilemmas, there are numerous subtle advantages and disadvantages of the various testosterone agents to appreciate. The available TST agents have changed significantly over the past decade similar to the trends in the diagnosis of TD. Therefore, as the usage of TST increases, clinicians will be challenged to maintain an up-to-date understanding of TD and TST. The purpose of this review is to provide a clear description of the current strategies for diagnosis and management of TD.

  20. Diagnosis and management of testosterone deficiency

    Science.gov (United States)

    McBride, James A; Carson, Culley C; Coward, Robert M

    2015-01-01

    Testosterone supplementation therapy (TST) use has dramatically increased over the past decade, due to the availability of newer agents, aggressive marketing, and an increasing incidence of testosterone deficiency (TD). Despite the increase in TST, a degree of ambiguity remains as to the exact diagnostic criteria of TD, and administration and monitoring of TST. One explanation for this phenomenon is the complex role testosterone plays in multiple physiologic pathways. Numerous medical co-morbidities and medications can alter testosterone levels resulting in a wide range of nonspecific clinical signs and symptoms of TD. The diagnosis is also challenging due to the lack of a definitive serum total testosterone level that reliably correlates with symptoms. This observation is particularly true in the aging male and is exacerbated by inconsistencies between different laboratory assays. Several prominent medical societies have developed guideline statements to clarify the diagnosis, but they differ from each other and with expert opinion in several ways. Aside from diagnostic dilemmas, there are numerous subtle advantages and disadvantages of the various testosterone agents to appreciate. The available TST agents have changed significantly over the past decade similar to the trends in the diagnosis of TD. Therefore, as the usage of TST increases, clinicians will be challenged to maintain an up-to-date understanding of TD and TST. The purpose of this review is to provide a clear description of the current strategies for diagnosis and management of TD. PMID:25532575