WorldWideScience

Sample records for videotaped diagnostic evaluations

  1. Teaching diagnostic reasoning: using a classroom-as-clinic methodology with videotapes.

    Science.gov (United States)

    Neistadt, M E; Smith, R E

    1997-05-01

    The purpose of this study was to examine the effect of a "classroom-as-clinic" format, using videotaped occupational therapy evaluations, on students' diagnostic reasoning skills. In the classroom-as-clinic format, students write a problem list on the basis of preliminary client information before viewing the videotape. A post-hoc experimental design was used to compare the accuracy of treatment plan problem lists for two groups of senior occupational therapy students--one group viewed two videotapes of client-therapist interactions without a classroom-as-clinic format (n = 82), and one group viewed the same videotapes within the context of a classroom-as-clinic format (n = 45). Both groups viewed the same two videotapes. Videotape 1 was of a client with a brain stem infarct, and Videotape 2 was of a client with traumatic brain injury. Subjects experiencing a classroom-as-clinic format identified significantly more occupational therapy problems for Videotape 1 than those who did not have preevaluation information. There was no significant difference between the two subject groups in the accuracy of their problem lists for Videotape 2. Only subjects in the non-classroom-as-clinic group showed a significant improvement from Videotape 1 to Videotape 2 in occupational therapy problem identification. This study suggests that to be truly effective when used videotapes, the classroom-as-clinic methodology needs to be combined with explicit coaching in problem sensing and problem definition.

  2. Evaluation of Videotaped and Live Theatre Auditions.

    Science.gov (United States)

    Ward, William C.

    Theatre auditions by 24 semifinalists in the 1980 Scholars in the Arts program were evaluated under two conditions. Four judges ranked the live auditions, while five evaluated videotapes of the same performance of the high school seniors. The auditions were videotaped in black and white. A single camera was used, fixed at an intermediate distance…

  3. Evaluating first-year nursing students' ability to self-assess psychomotor skills using videotape.

    Science.gov (United States)

    Watts, Wilda Ellen; Rush, Kathy; Wright, Marjorie

    2009-01-01

    Developing confidence in self-assessment is an important skill in becoming a self-regulated learner. This article describes the process undertaken by a group of educators of incorporating self-assessment in combination with psychomotor skill development with freshman students. Students were videotaped performing a wound-dressing change; the videotaping was immediately followed by a self-assessment of their performance using a faculty-generated checklist. Comparison of faculty and student ratings revealed the tendency for students to overrate their performance and identified discordance between students and faculty on several steps of the procedure. These evaluation findings are discussed and future directions explored.

  4. A Videotape Series for Teaching Physicians to Evaluate Sexually Abused Children

    Science.gov (United States)

    Jones, Jerry G.; Garrett, Judy; Worthington, Toss

    2004-01-01

    A free videotape subscription series was utilized to increase the knowledge of general physicians in clinical practice about the medical evaluation of sexually abused children. Of the 65 physicians who requested the first tape, 39 (60%) completed it. Fourteen of the 39 physicians who completed the first tape (36%) completed the 5-tape series.…

  5. Scars. [Videotape].

    Science.gov (United States)

    2002

    This 40-minute videotape tackles the issue of childhood bullying and unwanted teasing and torment. This videotape features real school children handling dramatic roles, and "doing the right thing" (aka "positive modeling.") The film is divided into two distinct parts: first act themes include bullying, girl bullies, children without one or both…

  6. Evaluating diagnostic tests

    African Journals Online (AJOL)

    Adele

    Appraising the predictive abilities of diagnostic tests can be surprisingly difficult. The purpose of this article is to provide an introduction to the principles underlying the objective evaluation of diagnostic tests. Starting from basic concepts about probability,. Bayes' theorem will be introduced and an explanation given as to.

  7. A Study of Behavioral Change in 50 Severely Multi-Sensorily Handicapped Children Through Application of the Video-Tape Recorded Behavioral Evaluation Protocol. Final Report.

    Science.gov (United States)

    Curtis, W. Scott

    Examined with 49 deaf-blind children (under 9 years old) was the use of the Telediagnostic Behavior Evaluation Protocol, a video-tape recorded evaluation protocol. To further develop the Telediagnostic Protocol and delineate the characteristics of the Ss observed during the process of test development, Ss were video-taped in eight 3-minute…

  8. The Carrot Highway [Videotape].

    Science.gov (United States)

    Wyss, Ron

    "The Carrot Highway" is a 40-minute award-winning videotape that takes viewers on a whirlwind tour around the world to tell the story of the carrot. This videotape reveals the carrot in all its glory by cleverly integrating live-action, music, animation, videotape footage, and games. Viewers travel with a troupe of animated carrot characters to…

  9. Anemia: Evaluation and Diagnostic Tests.

    Science.gov (United States)

    Cascio, Michael J; DeLoughery, Thomas G

    2017-03-01

    Anemia is among the most common medical problems and clinical and laboratory evaluation need to be approached logically. The complete blood count with red cell indices offers clues to diagnosis. Many anemias have characteristic red cell morphology. The reticulocyte count serves as a useful screen for hemolysis or blood loss. Testing for specific causes of the anemia is performed. Occasionally, examination of the bone marrow is required for diagnosis. Molecular testing is increasingly being use to aid the diagnostic process. This article reviews diagnostic tests for anemia and suggests a rational approach to determining the etiology of a patient's anemia. Copyright © 2016 Elsevier Inc. All rights reserved.

  10. Evaluating the Utility of Commercial Videotapes for Teaching Hand Washing to Children with Autism

    Science.gov (United States)

    Rosenberg, Nancy E.; Schwartz, Ilene S.; Davis, Carol A.

    2010-01-01

    We evaluated the effects of using a commercially available video model to teach three preschoolers with autism to wash their hands. While one child learned 80% of the hand washing steps, 2 of the 3 children did not learn from the commercial model. All were subsequently exposed to a customized video model, which resulted in at least some…

  11. An evaluation of the effectiveness of a videotape programme on interobserver reliability in outcome assessment for osteoarthritis.

    Science.gov (United States)

    Bellamy, N; Anjema, C; Alikhan, N; Chhina, T; Dhanoa, D; Edelist, D; Esufali, Z; Ismail, F; Hill, J; Campbell, J

    1999-01-01

    A study was designed to assess the effects of a standardized instructional videotape on training senior medical students to acceptable levels of reliability in performing several commonly used observer dependent outcome measures in patients with osteoarthritis (OA). During a single day, six third-year medical students independently examined six patients with OA in predetermined order using a Latin Square design, before and after viewing a standardized videotape demonstrating 13 examination techniques. Reliability coefficients were calculated based on variance components of the analysis of variance (ANOVA) table. Preslandardization reliability coefficients were goniometry were uniformly low. Following the intervention, all but four reliability coefficients were >/= 0.93. For many measures, high levels of interobserver agreement were noted prior to viewing the instructional videotape. This may represent the success of undergraduate clinical skills training programmes, or it may be the result of having reviewed an illustrated instructional text just prior to the initial patient examinations. The notable exception was knee goniometry. Despite apparent familiarity with the technique, prestandardization reliability coefficients were very low. However, following the intervention, all coefficients improved dramatically, two-thirds achieving very high levels. These data suggest that skills development in senior medical students is not uniform and that, while reliability is high for many, the assessment of knee range of movement can be improved by viewing an instructional videotape.

  12. Statistical innovations in diagnostic device evaluation.

    Science.gov (United States)

    Yu, Tinghui; Li, Qin; Gray, Gerry; Yue, Lilly Q

    2016-01-01

    Due to rapid technological development, innovations in diagnostic devices are proceeding at an extremely fast pace. Accordingly, the needs for adopting innovative statistical methods have emerged in the evaluation of diagnostic devices. Statisticians in the Center for Devices and Radiological Health at the Food and Drug Administration have provided leadership in implementing statistical innovations. The innovations discussed in this article include: the adoption of bootstrap and Jackknife methods, the implementation of appropriate multiple reader multiple case study design, the application of robustness analyses for missing data, and the development of study designs and data analyses for companion diagnostics.

  13. Practical Diagnostics for Evaluating Residential Commissioning Metrics

    Energy Technology Data Exchange (ETDEWEB)

    Wray, Craig; Walker, Iain; Siegel, Jeff; Sherman, Max

    2002-06-11

    In this report, we identify and describe 24 practical diagnostics that are ready now to evaluate residential commissioning metrics, and that we expect to include in the commissioning guide. Our discussion in the main body of this report is limited to existing diagnostics in areas of particular concern with significant interactions: envelope and HVAC systems. These areas include insulation quality, windows, airtightness, envelope moisture, fan and duct system airflows, duct leakage, cooling equipment charge, and combustion appliance backdrafting with spillage. Appendix C describes the 83 other diagnostics that we have examined in the course of this project, but that are not ready or are inappropriate for residential commissioning. Combined with Appendix B, Table 1 in the main body of the report summarizes the advantages and disadvantages of all 107 diagnostics. We first describe what residential commissioning is, its characteristic elements, and how one might structure its process. Our intent in this discussion is to formulate and clarify these issues, but is largely preliminary because such a practice does not yet exist. Subsequent sections of the report describe metrics one can use in residential commissioning, along with the consolidated set of 24 practical diagnostics that the building industry can use now to evaluate them. Where possible, we also discuss the accuracy and usability of diagnostics, based on recent laboratory work and field studies by LBNL staff and others in more than 100 houses. These studies concentrate on evaluating diagnostics in the following four areas: the DeltaQ duct leakage test, air-handler airflow tests, supply and return grille airflow tests, and refrigerant charge tests. Appendix A describes those efforts in detail. In addition, where possible, we identify the costs to purchase diagnostic equipment and the amount of time required to conduct the diagnostics. Table 1 summarizes these data. Individual equipment costs for the 24

  14. The Development and Evaluation of a Video-Tape Protocol for the Examination of Multicapped Deaf-Blind Children.

    Science.gov (United States)

    Donlon, Edward T.; Curtis, W. Scott

    Due to the belief that written communication about a deaf blind child among professional examiners and treatment agencies can be more accurate and precise, the experimenters developed and evaluated a video tape protocol for the examination of the communication skills of 20 multiply handicapped deaf blind children, who ranged from 3 to 8 years in…

  15. Videotaped evaluation of eyedrop instillation in glaucoma patients with visual impairment or moderate to severe visual field loss.

    Science.gov (United States)

    Hennessy, Amy L; Katz, Joanne; Covert, David; Protzko, Colleen; Robin, Alan L

    2010-12-01

    Objectively evaluate the ability of visually disabled glaucoma patients to successfully administer a single drop onto their eye. Prospective, observational study. Experienced glaucoma patients with Early Treatment of Diabetic Retinopathy Study visual acuity (VA) of ≤ 6/18 (≤ 20/60) ≥ 1 eye, or moderate or severe visual field damage in ≥ 1 eye. Subjects were "low vision" (20/60 ≤ VA 6 months. Subjects used a mean of 1.9 ± 1.1 bottles of intraocular pressure-lowering medications to treat their glaucoma. Seventy-six percent (155/204) of subjects had severe visual field damage, with a mean deviation of -14.5 ± 8.0. Twenty-six percent (54/204) had acuity of ≤ 20/200 in ≥ 1 eye, and subjects had a mean logarithm of minimal angle of resolution acuity of 0.8 ± 0.9. Seventy-one percent of subjects were able to get a drop onto the eye; only 39% instilled 1 drop onto the eye without touching the ocular surface, instilling a mean 1.4 ± 1.0 drops, using 1.2 ± 0.6 attempts. Of the 142 subjects who denied touching the bottle to the ocular surface, 24% did touch the bottle to the eye. Multiple factors were tested for ability to predict successful application of an eyedrop; however, only age (visually impaired glaucoma patients, we evaluated the difficulty this population has instilling eyedrops, most important, the use of multiple drops per instillation, potential contamination of a chronically used bottle, and poor patient understanding of the situation. Ability to self-administer eyedrops and cost considerations of wasted drops must be thought out before institution of glaucoma therapy. Efforts to determine better methods of eyedrop administration need to be undertaken. Copyright © 2010 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.

  16. Diagnostic criteria in proliferative verrucous leukoplakia: Evaluation

    Science.gov (United States)

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

    2014-01-01

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

  17. Evaluating diagnostic tests: review | Coetzee | Southern African ...

    African Journals Online (AJOL)

    Anaesthesiologists are increasingly more involved in perioperative patient care wherein interpretation of special investigations is crucial to making therapeutic and prognostic decisions. Furthermore, anaesthetic journal publications increasingly rely on diagnostic tests, without paying sufficient attention to the methodology ...

  18. Videotapes

    CERN Document Server

    Chavanne, A

    1989-01-01

    1666 : impact de la creation de l'Academie des Sciences par Colbert, trente ans apres le proces de Galile, et au moment des disparitions de Pascal, Descartes et Fermat. Elle dirigee par le hollandais Huyggens jusqu'a sa fuite de France au moment de la revocation de l'Edit de Nantes. - 1750 : l'Encyclopedie (ou "Dictionnaire raisonne des Sciences, des Arts et des Metiers") de Diderot et d'Alembert, soutenus par Malherbes, Buffon, Condorcet et Rousseau. - 1789 : Revolution francaise. - 8 aout 1793 : l'Assemblee, par une declaration de Marat, dissout l'Academie des Sciences. Celle-ci continue cependant ses travaux pour les poids et mesures jusqu'en 1795. - la Terreur : la condamnation a mort, pas au nom d'une "Revolution qui n'a pas besoin de savants", de trois grands hommes de science : Lavoisier, Bailly et Condorcet. - 1793-1794 : Au printemps 93, le Comite de Salut Publique s'inquiete du demi-million de soldats etrangers de toutes les pays frontaliers qui essaient de penetrer en France pour occuper le pays. C...

  19. Camera Perspective Bias in Videotaped Confessions: Evidence that Visual Attention Is a Mediator

    Science.gov (United States)

    Ware, Lezlee J.; Lassiter, G. Daniel; Patterson, Stephen M.; Ransom, Michael R.

    2008-01-01

    Several experiments have demonstrated a "camera perspective bias" in evaluations of videotaped confessions: videotapes with the camera focused on the suspect lead to judgments of greater voluntariness than alternative presentation formats. The present research investigated potential mediators of this bias. Using eye tracking to measure visual…

  20. Evaluation of the diagnostic performance and operational ...

    African Journals Online (AJOL)

    Johns Hopkins Bloomberg School of Public Health, Baltimore, USA. 6. Université de Ouagadougou, Laboratoire de Bactériologie-Virologie. Abstract. Background and objective: Little information is available on the rapid diagnostic testing for syphilis in Burkina Faso. The objectives of the study were (i) to assess the sensitivity ...

  1. Training Parents with Videotapes: Recognizing Limitations

    Science.gov (United States)

    Foster, Brandon W.; Roberts, Mark W.

    2007-01-01

    Among the many methods of teaching skills to parents of disruptive children, videotape modeling of specific parent-child interaction sequences has been particularly effective. Given the likelihood of timeout resistance in defiant children, the authors tested the effectiveness of videotape parent training with a sample of clinic referred,…

  2. Diagnostic Evaluation of Pelvic Inflammatory Disease

    Directory of Open Access Journals (Sweden)

    Jeffrey F. Peipert

    1994-01-01

    An early and accurate diagnosis of PID is extremely important for the effective management of the acute illness and for the prevention of long-term sequelae. The diagnosis of PID is difficult, with considerable numbers of false-positive and false-negative diagnoses. An abnormal vaginal discharge or evidence of lower genital tract infection is an important and predictive finding that is often underemphasized and overlooked. This paper reviews the clinical diagnosis and supportive laboratory tests for the diagnosis of PID and outlines an appropriate diagnostic plan for the clinician and the researcher.

  3. Evaluation of laboratory diagnostic methods for cryptosporidiosis ...

    African Journals Online (AJOL)

    Background: The laboratory diagnosis of Cryptosporidium parum infection involves the demonstration of the infective oocysts in stool specimen. The conventional method of modified Ziehl-Neelsen (MZN) is very laborious, and stool debris can be mistaken for the parasite oocytes. Objective: This research was set to evaluate ...

  4. Evaluation of the diagnostic performance and operational ...

    African Journals Online (AJOL)

    ponema pallidum haemagglutination assay (TPHA) as a gold standard and (ii) to evaluate the operational characteristics of those tests among ... Treponema pallidum hemagglutination assay (TPHA) as the gold standard. Blood samples were ..... Mabey D, Peeling RW, Ballard R, Benzaken a S, Gal- bán E, Changalucha J, ...

  5. Use of the SADS Diagnostic Interview in Evaluating Legal Insanity.

    Science.gov (United States)

    Rogers, Richard; And Others

    1984-01-01

    Examined clinical usefulness of the Schedule of Affective Disorders and Schizophrenia (SADS) diagnostic interview in evaluations of criminal responsibility. Findings, based on 78 evaluations from a forensic clinic, indicated that SADS successfully differentiated between sane and insane evaluatees. Differences were primarily in severity of symptoms…

  6. From Colorado to Guam: Infant Diagnostic Audiological Evaluations by Telepractice

    Science.gov (United States)

    Hayes, Deborah; Eclavea, Elaine; Dreith, Susan; Habte, Bereket

    2012-01-01

    This manuscript describes a pilot project in which infants in Guam who refer on newborn hearing screening receive diagnostic audiological evaluation conducted by audiologists in Colorado over the Internet (telepractice). The evaluation is completed in real time using commercially-available software and personal computers to control the diagnostic…

  7. Videotape review: a valuable tool for self-assessment of teaching skills.

    Science.gov (United States)

    Kleffner, J H; Hendricson, W D; Littlefield, J H; Hudepohl, N

    1985-11-01

    This paper describes the components of an instructor improvement program known as VISIT (Videotaping Instruction for Self-Assessment of Instructional Technique). Through the use of videotape recordings of classroom, laboratory or clinical teaching and observation by trained observers, faculty can pinpoint instructional strengths and problem areas, plan refinements and evaluate the impact of these refinements. Ten years of experience with VISIT indicates that post-lecture consultation sessions between the instructor and observer are vital to the success of this activity.

  8. Uncertainty during breast diagnostic evaluation: state of the science.

    Science.gov (United States)

    Montgomery, Mariann

    2010-01-01

    To present the state of the science on uncertainty in relationship to the experiences of women undergoing diagnostic evaluation for suspected breast cancer. Published articles from Medline, CINAHL, PubMED, and PsycINFO from 1983-2008 using the following key words: breast biopsy, mammography, uncertainty, reframing, inner strength, and disruption. Fifty research studies were examined with all reporting the presence of anxiety persisting throughout the diagnostic evaluation until certitude is achieved through the establishment of a definitive diagnosis. Indirect determinants of uncertainty for women undergoing breast diagnostic evaluation include measures of anxiety, depression, social support, emotional responses, defense mechanisms, and the psychological impact of events. Understanding and influencing the uncertainty experience have been suggested to be key in relieving psychosocial distress and positively influencing future screening behaviors. Several studies examine correlational relationships among anxiety, selection of coping methods, and demographic factors that influence uncertainty. A gap exists in the literature with regard to the relationship of inner strength and uncertainty. Nurses can be invaluable in assisting women in coping with the uncertainty experience by providing positive communication and support. Nursing interventions should be designed and tested for their effects on uncertainty experienced by women undergoing a breast diagnostic evaluation.

  9. Diagnostic evaluation of dementia in the secondary health care sector

    DEFF Research Database (Denmark)

    Phung, Thien Kieu Thi; Andersen, Birgitte Bo; Kessing, Lars Vedel

    2009-01-01

    BACKGROUND: We conducted a nationwide registry-based study of the quality of diagnostic evaluation for dementia in the secondary health care sector. METHOD: Two hundred patients were randomly selected from the patient population (4,682 patients) registered for the first time with a dementia diagn...

  10. Students' Evaluation of Teaching: Concerns of Item Diagnosticity

    Science.gov (United States)

    Madden, Thomas J.; Dillon, William R.; Leak, Roland L.

    2010-01-01

    The validity and reliability of students' evaluation of teaching effectiveness has been debated since the 1970s. One concern is the extent to which the ratings are influenced by halo, and if so, how does halo affect the interpretation of the ratings? This study seeks to assess the degree to which the halo affects the diagnosticity of individual…

  11. Validity Arguments for Diagnostic Assessment Using Automated Writing Evaluation

    Science.gov (United States)

    Chapelle, Carol A.; Cotos, Elena; Lee, Jooyoung

    2015-01-01

    Two examples demonstrate an argument-based approach to validation of diagnostic assessment using automated writing evaluation (AWE). "Criterion"®, was developed by Educational Testing Service to analyze students' papers grammatically, providing sentence-level error feedback. An interpretive argument was developed for its use as part of…

  12. Evaluation of nitric oxide as a novel diagnostic marker for ...

    African Journals Online (AJOL)

    45%. Nitrite/Nitrate is a stable end product of nitric oxide increase in patients with HCC. Aim: It was to evaluate nitric oxide as a novel diagnostic marker for hepatocellular carcinoma. Methods: Eighty patients and 15 normal individuals enrolled in the study: Group (1) 15 normal individuals. Group (2) 30 patients with chronic ...

  13. Field evaluation of a malaria rapid diagnostic test (ICT Pf ...

    African Journals Online (AJOL)

    Field evaluation of a malaria rapid diagnostic test (ICT Pf) ... province to determine the accuracy of the MRDT currently used in public sector clinics and hospitals. ... The positive predictive value of the test was 98.48 (99% CI 98.41 - 100%), and the negative predictive value was 99.52% (95% CI 96.47 – 100%). Conclusions.

  14. Project BORN FREE. Career Development Training Models to Reduce Sex-Role Stereotyping in Educational Institutions. Evaluation Report on BORN FREE Videotapes, Training Packets and Selected Workshops.

    Science.gov (United States)

    Warsett, Sue

    BORN FREE is designed as a collaborative effort of university-based counseling psychologists and field-site educators to reduce career-related sex stereotyping in 14 educational institutions. This report describes the evaluation of BORN FREE products and includes field testing of the three training packets for elementary, secondary, and higher…

  15. Statistical evaluation of diagnostic performance topics in ROC analysis

    CERN Document Server

    Zou, Kelly H; Bandos, Andriy I; Ohno-Machado, Lucila; Rockette, Howard E

    2016-01-01

    Statistical evaluation of diagnostic performance in general and Receiver Operating Characteristic (ROC) analysis in particular are important for assessing the performance of medical tests and statistical classifiers, as well as for evaluating predictive models or algorithms. This book presents innovative approaches in ROC analysis, which are relevant to a wide variety of applications, including medical imaging, cancer research, epidemiology, and bioinformatics. Statistical Evaluation of Diagnostic Performance: Topics in ROC Analysis covers areas including monotone-transformation techniques in parametric ROC analysis, ROC methods for combined and pooled biomarkers, Bayesian hierarchical transformation models, sequential designs and inferences in the ROC setting, predictive modeling, multireader ROC analysis, and free-response ROC (FROC) methodology. The book is suitable for graduate-level students and researchers in statistics, biostatistics, epidemiology, public health, biomedical engineering, radiology, medi...

  16. [Situational diagnostic of an evaluation process of professional perfomance].

    Science.gov (United States)

    Gonçalves, Vera Lúcia Mira; Leite, Maria Madalena Januário

    2004-01-01

    The aim of this study was to realize a diagnostic situational about the evaluation process of the nursing team performance of USP Hospital. Based in two guiding questions, it was carried out 9 interviews with nurses of this hospital. These interviews were analyzed according Analyze of Contend. The most frequent themes were: The meaning of evaluation; the feelings; the difficulties and facilities concerning the instrument and the capacitacion. This experience brought about many feelings, as well as aspects that either favor or make the execution of the evaluation difficult, showing the principal points of vulnerability of the process and, therefore, deserving better attention and short-term intervention.

  17. A multi-diagnostic approach to cloud evaluation

    Science.gov (United States)

    Williams, Keith D.; Bodas-Salcedo, Alejandro

    2017-07-01

    Most studies evaluating cloud in general circulation models present new diagnostic techniques or observational datasets, or apply a limited set of existing diagnostics to a number of models. In this study, we use a range of diagnostic techniques and observational datasets to provide a thorough evaluation of cloud, such as might be carried out during a model development process. The methodology is illustrated by analysing two configurations of the Met Office Unified Model - the currently operational configuration at the time of undertaking the study (Global Atmosphere 6, GA6), and the configuration which will underpin the United Kingdom's Earth System Model for CMIP6 (Coupled Model Intercomparison Project 6; GA7). By undertaking a more comprehensive analysis which includes compositing techniques, comparing against a set of quite different observational instruments and evaluating the model across a range of timescales, the risks of drawing the wrong conclusions due to compensating model errors are minimized and a more accurate overall picture of model performance can be drawn. Overall the two configurations analysed perform well, especially in terms of cloud amount. GA6 has excessive thin cirrus which is removed in GA7. The primary remaining errors in both configurations are the in-cloud albedos which are too high in most Northern Hemisphere cloud types and sub-tropical stratocumulus, whilst the stratocumulus on the cold-air side of Southern Hemisphere cyclones has in-cloud albedos which are too low.

  18. Evaluation of Diagnostic Visual Findings at Laparoscopy in Endometriosis

    Directory of Open Access Journals (Sweden)

    Saghar Salehpour

    2007-01-01

    Full Text Available Background: Endometriosis has been widely implicated as one of the causes of chronic pelvic pain, dysmenorrhea and infertility. The purpose of our study was to define the presumed correlation between visual and histologic diagnostic features of endometriosis based on the peritoneal findings identified in laparoscopy as a diagnostic trial with a standardized technique. So, all the specimens including complete excised lesions suggestive of endometriosis and systematic biopsies of normal appearing pelvic peritoneum were analyzed. This study was performed in Mahdieh hospital and IRHRC1 between 2004 and 2005.Materials and Methods: A diagnostic study of 30 patients (14 to 45 years undergoing diagnostic laparoscopy for the evaluation of chronic pelvic pain, infertility, dysmenorrhea and dyspareunia was carried out (average age was 28.6±5.14.All areas suggestive of endometriosis were excised and examined pathologically. Peritoneal biopsy specimens were obtained from areas of normal appearing peritoneum to rule out microscopic endometriosis.The positive predictive value, sensitivity, negative predictive value and specificity were determined for identified endometriosis versus the histological findings.Results: The mean prevalence of abnormalities visually consistent with endometriosis was 63% while 42% confirmed histologically. The positive predictive value was 42.1%, sensitivity 88.8%, negative predictive 90.9% and specificity 47.6% for visual versus histological diagnosis of endometriosis.Conclusion: A diagnosis of endometriosis should be established only after histologic confirmation.

  19. Space Science in Action: Earth's Atmosphere [Videotape].

    Science.gov (United States)

    1999

    In this videotape recording, students learn about the layers of the atmosphere and why each is important to the survival of life on the planet. Students discover why the atmosphere is responsible for weather and see how special aircraft actually fly into hurricanes. Students build their own working barometer in a hands-on activity. Contents…

  20. Space Science in Action: Stars [Videotape].

    Science.gov (United States)

    1999

    This videotape recording shows students the many ways scientists look at the stars and how they can use what they see to answer questions such as What are stars made of?, How far away are they?, and How old are the stars? Students learn about the life span of stars and the various stages they pass through from protostar to main sequence star to…

  1. Space Science in Action: Space Exploration [Videotape].

    Science.gov (United States)

    1999

    In this videotape recording, students learn about the human quest to discover what is out in space. Students see the challenges and benefits of space exploration including the development of rocket science, a look back at the space race, and a history of manned space travel. A special section on the Saturn V rocket gives students insight into the…

  2. Videotaping the Lifespan of a Soap Bubble.

    Science.gov (United States)

    Ramme, Goran

    1995-01-01

    Describes how the use of a videotape to record the history of a soap bubble allows a study of many interesting events in considerable detail including interference fringes, convection and turbulence patterns on the surface, formation of black film, and the ultimate explosion of the bubble. (JRH)

  3. Space Science in Action: Astronomy [Videotape].

    Science.gov (United States)

    1999

    This videotape recording teaches students about constellations, star movement, and how scientists have studied celestial bodies throughout history from Ptolemy to Copernicus to the work of the Hubble Space Telescope. An interview with Kathy Thornton, one of the astronauts who repaired the Hubble while in orbit, is featured. A hands-on activity…

  4. Adding Feminist Therapy to Videotape Demonstrations.

    Science.gov (United States)

    Konrad, Jennifer L.; Yoder, Janice D.

    2000-01-01

    Provides directions for presenting a 32-minute series of four videotape segments that highlights the fundamental features of four approaches to psychotherapy, extending its reach to include a feminist perspective. Describes the approaches and included segments. Reports that students' comments demonstrate that the video sequence provided a helpful…

  5. Assessment of Waco, Texas FLIR videotape

    Science.gov (United States)

    Frankel, Donald S.

    2001-09-01

    The FLIR video recorded by the FBI on 19 April 1993, records the final assault on the Branch Davidian compound in Waco, Texas, and the fire in which some 80 members of the sect died. Attention has focused on a number of flashes recorded on the videotape. The author has examined the 1993 videotape and the recorded videotapes of the re-enactment conducted at Fort Hood, Texas on 19 March 2000. The following conclusions have been reached: 1) The flashes seen on the tape cannot be weapons muzzle flash. Their duration is far too long and their spatial extent is far too great. They are almost certainly the result of solar energy or heat energy form nearby vehicles reflected toward the FLIR by debris or puddles. 2) The FLIR video technology has a very low probability of detecting small arms muzzle flash. 3) As a consequence of 2) above, the absence of muzzle flash detection on the FLIR tape does not prove that no weapons were actually fired during the final assault. Indeed, there is ample evidence (not presented here) that the Davidians fired at the federal agents, but none of their muzzle flashes are detectable on the videotape.

  6. Copyright Handbook for Videotapes and Microcomputer Software.

    Science.gov (United States)

    Ensign, David; And Others

    Developed to help library media personnel, administrators, and educators understand and work with the copyright law as it applies to videotape and microcomputer software, this handbook provides: (1) an overview of copyright, including rights granted to copyright holders and libraries and court interpretation of the copyright law; (2) suggestions…

  7. The Evaluation of Diagnostic Tests for Sexually Transmitted Infections

    Directory of Open Access Journals (Sweden)

    Max A Chernesky

    2005-01-01

    Full Text Available Diagnostic tests should receive method- and use-effectiveness evaluations. Method-effectiveness evaluations determine sensitivity, specificity and predictive values for new tests. Use-effectiveness evaluations determine how practical or convenient a new test will be in a specific setting and may not be performed in a formal way in North American laboratories. To perform a clinical method evaluation of diagnostic tests, a good relationship between laboratory and clinical personnel is essential. Studies are usually conducted separately on populations of men and women, and should include sampling from different prevalence groups. Test performance comparisons may be made on a single specimen type or on more than one specimen from the same patient, which allows for the expansion of a reference standard and includes the ability of a particular assay, performed on a specimen type to diagnose an infected individual. The following components of the evaluation should be standardized and carefully followed: specimen identification; collection; transportation; processing; quality control; reading; proficiency testing; confirmatory testing; discordant analysis -- sensitivity, specificity and predictive value calculations; and record keeping. Methods are available to determine whether sample results are true or false positives or negatives. Use-effectiveness evaluations might determine the stability or durability of supplies and equipment; the logistics of shipping, receiving and storing supplies; the clarity and completeness of test instructions; the time and effort required to process and read results; the subjectivity factors in interpretation and reporting; and the costs. These determinations are usually more apparent for commercial assays than for homemade tests.

  8. Facial diplegia: etiology, clinical manifestations, and diagnostic evaluation.

    Science.gov (United States)

    Varol, Sefer; Ozdemir, Hasan Huseyin; Akil, Esref; Arslan, Demet; Aluclu, M Ufuk; Demir, Caner F; Yucel, Yavuz

    2015-12-01

    Facial diplegia (FD) is a rare neurological manifestation with diverse causes. This article aims to systematically evaluate the etiology, diagnostic evaluation and treatment of FD. The study was performed retrospectively and included 17 patients with a diagnosis of FD. Patients were diagnosed with Guillain-Barré syndrome (GBS) (11), Bickerstaff's brainstem encephalitis (1), neurosarcoidosis (1), non-Hodgkin's Lymphoma (1), tuberculous meningitis (1) herpes simplex reactivation (1) and idiopathic (1). In addition, two patients had developed FD during pregnancy. Facial diplegia is an ominous symptom with widely varying causes that requires careful investigation.

  9. Facial diplegia: etiology, clinical manifestations, and diagnostic evaluation

    Directory of Open Access Journals (Sweden)

    Sefer Varol

    2015-12-01

    Full Text Available ABSTRACT Objective Facial diplegia (FD is a rare neurological manifestation with diverse causes. This article aims to systematically evaluate the etiology, diagnostic evaluation and treatment of FD. Method The study was performed retrospectively and included 17 patients with a diagnosis of FD. Results Patients were diagnosed with Guillain-Barré syndrome (GBS (11, Bickerstaff’s brainstem encephalitis (1, neurosarcoidosis (1, non-Hodgkin’s Lymphoma (1, tuberculous meningitis (1 herpes simplex reactivation (1 and idiopathic (1. In addition, two patients had developed FD during pregnancy. Conclusion Facial diplegia is an ominous symptom with widely varying causes that requires careful investigation.

  10. From the Ground Up. [Videotape

    Science.gov (United States)

    Enns, Garry; And Others

    Through interviews with farmers, agricultural experts, and students, this video raises student's awareness of sustainable development issues in modern agriculture and food production. The video explores the following themes: agriculture and sustainable development, different approaches to farming, evaluation of farming practices in the context of…

  11. Diagnostic Evaluation of Nontraumatic Chest Pain in Athletes.

    Science.gov (United States)

    Moran, Byron; Bryan, Sean; Farrar, Ted; Salud, Chris; Visser, Gary; Decuba, Raymond; Renelus, Deborah; Buckley, Tyler; Dressing, Michael; Peterkin, Nicholas; Coris, Eric

    This article is a clinically relevant review of the existing medical literature relating to the assessment and diagnostic evaluation for athletes complaining of nontraumatic chest pain. The literature was searched using the following databases for the years 1975 forward: Cochrane Database of Systematic Reviews; CINAHL; PubMed (MEDLINE); and SportDiscus. The general search used the keywords chest pain and athletes. The search was revised to include subject headings and subheadings, including chest pain and prevalence and athletes. Cross-referencing published articles from the databases searched discovered additional articles. No dissertations, theses, or meeting proceedings were reviewed. The authors discuss the scope of this complex problem and the diagnostic dilemma chest pain in athletes can provide. Next, the authors delve into the vast differential and attempt to simplify this process for the sports medicine physician by dividing potential etiologies into cardiac and noncardiac conditions. Life-threatening causes of chest pain in athletes may be cardiac or noncardiac in origin, which highlights the need for the sports medicine physician to consider pathology in multiple organ systems simultaneously. This article emphasizes the importance of ruling out immediately life threatening diagnoses, while acknowledging the most common causes of noncardiac chest pain in young athletes are benign. The authors propose a practical algorithm the sports medicine physician can use as a guide for the assessment and diagnostic work-up of the athlete with chest pain designed to help the physician arrive at the correct diagnosis in a clinically efficient and cost-effective manner.

  12. Evaluation of diagnostic classifiers using artificial clinical cases

    Directory of Open Access Journals (Sweden)

    Antczak Karol

    2017-01-01

    Full Text Available Evaluation of classifiers in diagnosis support systems is a non-trivial task. It can be done in a form of controlled and blinded clinical trial, which is often difficult and costly. We propose a new method for generating artificial medical cases from a knowledge base, utilizing the concept of so-called medical diamonds. Cases generated using this method have features analogous to that of double-blinded trial and, thus, can be used for measuring sensitivity and specificity of diagnostic classifiers. This is easy and low-cost method of evaluation and comparison of classifiers in diagnosis support systems. We demonstrate that this method is able to produce valuable results when used for evaluation of similarity-based classifiers as well as shallow and deep neural networks.

  13. Usage of analytical diagnostics when evaluating functional surface material defects

    Directory of Open Access Journals (Sweden)

    R. Frischer

    2015-10-01

    Full Text Available There are occurring defects due to defects mechanisms on parts of production devices surfaces. Outer defects pronouncement is changing throw the time with unequal speed. This variability of defect’s mechanism development cause that is impossible to evaluate technical state of the device in any moment, without the necessary underlying information. Proposed model is based on analytical diagnostics basis. Stochastic model with usage of Weibull probability distribution can assign probability of function surface defect occurrence on the operational information in any moment basis. The knowledge of defect range limiting moment, then enable when and in what range will be necessary to make renewal.

  14. Quality of dementia diagnostic evaluation for ethnic minority patients: a nationwide study

    DEFF Research Database (Denmark)

    Nielsen, T Rune; Andersen, Birgitte Bo; Kastrup, Marianne

    2011-01-01

    Background/Aims: Diagnostic evaluation of dementia for ethnic minority patients may be challenging. This study aimed to evaluate the quality of diagnostic evaluation of dementia for patients from ethnic minorities in Denmark. Methods: The Danish national hospital registers were used to identify......: There are significant ethnic disparities in the quality of diagnostic evaluations and outcome of dementia in the secondary healthcare sector....... records were reviewed. An acceptable diagnostic workup was documented in only 23% of the patients. Dementia diagnosis was confirmed in 35%. Significant differences in the quality of the diagnostic evaluation were found between patients from ethnic minorities and the general population. Conclusion...

  15. Medical Student Assessment of Videotape for Teaching in Diagnostic Radiology

    Science.gov (United States)

    Moss, J. R.; McLachlan, M. S. F.

    1976-01-01

    A series of six recordings that describe some aspects of the radiology of the chest, using only radiographs, were viewed by a small group of final year medical students. Their scores for factual questions immediately afterwards were compared with their attitudes to the learning experience; higher scores correlated with positive attitudes. (LBH)

  16. Dosimetric evaluation of Plastic Water Diagnostic-Therapy.

    Science.gov (United States)

    Ramaseshan, Ramani; Kohli, Kirpal; Cao, Fred; Heaton, Robert K

    2008-04-29

    High-precision radiotherapy planning and quality assurance require accurate dosimetric and geometric phantom measurements. Phantom design requires materials with mechanical strength and resilience, and dosimetric properties close to those of water over diagnostic and therapeutic ranges. Plastic Water Diagnostic Therapy (PWDT: CIRS, Norfolk, VA) is a phantom material designed for water equivalence in photon beams from 0.04 MeV to 100 MeV; the material has also good mechanical properties. The present article reports the results of computed tomography (CT) imaging and dosimetric studies of PWDT to evaluate the suitability of the material in CT and therapy energy ranges. We characterized the water equivalence of PWDT in a series of experiments in which the basic dosimetric properties of the material were determined for photon energies of 80 kVp, 100 kVp, 250 kVp, 4 MV, 6 MV, 10 MV, and 18 MV. Measured properties included the buildup and percentage depth dose curves for several field sizes, and relative dose factors as a function of field size. In addition, the PWDT phantom underwent CT imaging at beam qualities ranging from 80 kVp to 140 kVp to determine the water equivalence of the phantom in the diagnostic energy range. The dosimetric quantities measured with PWDT agreed within 1.5% of those determined in water and Solid Water (Gammex rmi, Middleton, WI). Computed tomography imaging of the phantom was found to generate Hounsfield numbers within 0.8% of those generated using water. The results suggest that PWDT material is suitable both for regular radiotherapy quality assurance measurements and for intensity-modulated radiation therapy (IMRT) verification work. Sample IMRT verification results are presented.

  17. A philosophical perspective supports the need for patient-outcome studies in diagnostic test evaluation.

    NARCIS (Netherlands)

    Sonke, G.S.; Verbeek, A.L.M.; Kiemeney, L.A.L.M.

    2009-01-01

    OBJECTIVE: Most clinical research evaluates diagnostic tests by accuracy measures such as sensitivity and specificity. This is stimulated by the Standards for Reporting of Diagnostic Accuracy initiative, which focuses on accuracy in the widely accepted guidelines. Referring to the clinical

  18. Comparing Streaming Video and Videotapes: Can Streaming Video Convey Affective Meaning as Well as Videotape?

    Science.gov (United States)

    Cofield, Jay L.

    This study investigated whether or not low-bandwidth streaming video could be useful for affective purposes. A group of 30 students in a cinema course at a public, liberal arts university viewed a 10-minute dramatic video scene by either videotape or low-bandwidth streaming video. They also took a survey to determine their affective responses and…

  19. Waco investigation: analysis of FLIR videotapes

    Science.gov (United States)

    Klasen, Lena M.

    2001-09-01

    This paper presents some of the image processing techniques that were applied to seek an answer to the question whether agents of the Federal Bureau of Investigation (FBI) directed gunfired against the Branch Davidian complex in the tragic event that took place in Waco, Texas, U.S., 1993. The task for this investigation was to provide a scientific opinion that clarified the cause of the questioned events, or flashes, that can be seen on one of the surveillance videotapes. These flashes were by several experts, concluded to be evidence of gunfire. However, there were many reasons to question the correctness of that conclusion, such as the fact that some of the flashes appeared on a regular basis. The main hypothesis for this work was that the flashes instead were caused by specular solar reflections. The technical approach for this work was to analyze and compare the flashes appearance. By reconstructing the spatial and temporal position of the sensor, the complex and the sun, the geometrical properties was compared to the theoretical appearance of specular solar reflections. The result showed that the flashes seen on the FLIR videotape, were caused by solar or heat reflections from single or multiple objects. Consequently, they could not form evidence of gunfire. Further, the result highlights the importance of considering the characteristics of the imaging system within investigations that utilizes images as information source. This is due to the need of separating real data from other phenomena (such as solar reflections), distortions and artifacts in a correct manner.

  20. Evaluation of the field size in dental diagnostic radiology system

    Energy Technology Data Exchange (ETDEWEB)

    Andrade, P.S.; Potiens, M.P.A. [Instituto de Pesquisas Energeticas e Nucleares, Sao Paulo (Brazil)

    2006-07-01

    In this work the field size of a dental X rays machine was evaluated considering the recommendation of the Brazilian Health Ministry Regulation 453 which established basic lines of radiological protection in medical and dental diagnostic radiology. The diameter of the field should not be superior to 6 cm in the localized end point, limiting the radiated area and protecting the head-neck region. The measurements were carried out in a dental X rays machine, Dabi Atlante, model Spectro 70X Seletronic. For the field size or useful beam determination, the intra-oral films were positioned on a plain surface to be exposed in four stages and two focus-film distances (FFD), 20 cm and 27.5 cm: 1) with spacer cone; 2) without spacer cone; 3) with spacer cone and film-holding device; 4) without spacer cone and film-holding device. The results show that the diameter of the field size is satisfactory only for FFD = 20 cm. When the film-holding device is used, which is recommended by the Regulation 453, item 5.8 d(ii), the diameter of the field size exceeds the maximum recommended value of 6 cm. (authors)

  1. [Evaluation of diagnostic sensitivity of electroneurography for facial neurotmesis].

    Science.gov (United States)

    Yang, Zhao Hui; Peng, Xin; Xie, Qiu Fei

    2008-12-18

    To evaluate diagnostic sensitivity of electroneurography (ENoG) for facial neurotmesis. The data of 24 patients suffering from facial neurotmesis on one side, having non-emergency operation, and having preoperative records of ENoG were collected. Among the patients, 18 were men and 6 were women, aged from 3 to 55 years (median 28). The duration of injury before ENoG examination was from 1 to 56 days (mean 23.6 days) for them. The electroneurographic examination was carried out for facial nerves on both sides preoperatively. Percentages of evoked potential amplitude reduction on affected sides were calculated according to the value of normal side. The 90% reduction of amplitude was used as a cutting point. The facial neurotmesis was observed during operation. The sensitivity and false negative proportions of ENoG were analyzed. Among the 24 patients with facial neurotmesis, 22 had ENoG amplitude reduction over 90%, and 2 having this reduction less than 90%. The sensitivity and false negative proportions of ENoG in patients with facial neurotmesis were 91.7% and 8.3% respectively. The preoperative ENoG examination is high sensitivity for facial neurotmesis. The patients whose ENoG reduction over 90% should be advised to have a facial neurorrhaphy as soon as possible.

  2. All about Bugs. Animal Life for Children. [Videotape].

    Science.gov (United States)

    2000

    Bugs fascinate children, and each kind of bug plays a special role in the circle of life. Some bugs pollinate plants, while others help to decompose plant and animal waste. In this videotape, students learn about the similar characteristics that all bugs share and compare them to their close cousins, the arachnids. This videotape correlates to the…

  3. Critical Time: Earthquake Response Planning and Schools. [Videotape].

    Science.gov (United States)

    Federal Emergency Management Agency, Washington, DC.

    A videotape that describes what earthquakes are, and examines the disaster planning schools can develop during the first few minutes following an earthquake to assure students and staff survive. The kinds of destruction likely to happen during a damaging earthquake are highlighted. The videotape stresses the need for children and staff to know…

  4. All about Birds. Animal Life for Children. [Videotape].

    Science.gov (United States)

    2000

    Winged, feathered friends helped to inspire the airplane and have always interested human bird watchers. In this videotape, children learn about the main characteristics of birds and look at their similar needs. Students find out about the process of egg laying and hatching in some of the most common birds. This videotape correlates to the…

  5. All about Mammals. Animal Life for Children. [Videotape].

    Science.gov (United States)

    2000

    In this videotape, students learn more about the characteristics of common warm-blooded mammals and what makes them different from other animals. Children also find out how humans are more advanced in structure than other mammals, but how they still share the same basic traits. This videotape correlates to the following National Science Education…

  6. Diagnostic test evaluation for Trichinella infections in pigs: a renewed interaction between diagnostic test data and their statistical analysis

    NARCIS (Netherlands)

    Dopfer, D.D.V.; Maassen, C.B.M.; Achterberg, R.P.; Giessen, van der J.W.B.; Teunis, P.; Buist, W.G.; Molina, V.; Guarnera, E.; Gonzales, M.; Krivokapich, S.; Rodriguez, M.; Peralta, J.L.; Trabattoni, H.; Larrieu, E.; Engel, B.

    2006-01-01

    To evaluate the usefulness of serological tests applied to monitor Trichinella free herds, Bayesian methodology was used to estimate the diagnostic test parameters: sensitivity, specificity and prevalence in the absence of a Gold Standard test. In the absence of Dutch serum samples for positive

  7. The Use of Audiovisual Procedures in Evaluating Oral Diagnostic and Treatment Planning Skills of Dental Students.

    Science.gov (United States)

    Silberman, Stephen L.; And Others

    1980-01-01

    A new test developed by the University of Mississippi School of Dentistry that included videotape, visual aids, and relevant dental data as part of the exam is reported. The degree of student anxiety before, during, and after the examination was measured. A videotaped segment simulating a case history was used. (Author/MLW)

  8. Ultrasonographic diagnostics and evaluation of calcaneal fracture: case report

    National Research Council Canada - National Science Library

    Lukac, Damir; Milenović, Natasa; Drapsin, Miodrag; Kecojević, Vaso; Sekulić, Slobodan; Klasnja, Aleksandar

    2013-01-01

    Radiography is the standard tool in the diagnostics of bone fractures. This paper presents a case of calcaneal fracture diagnosed by ultrasonography that was also used in the follow-up of recovery progress...

  9. Diagnostic evaluation of dementia in general practice in Denmark. A national survey

    DEFF Research Database (Denmark)

    Waldorff, Frans Boch; Møller, S

    2001-01-01

    . SUBJECTS: All 3379 GPs in Denmark. RESULTS: The questionnaire was completed by 75.1%. According to our Diagnostic Evaluation Index, 47.2% of the GPs were classified as conducting a good basic diagnostic evaluation of dementia, and tended to have the following characteristics: they conducted regular follow......OBJECTIVE: To examine GPs' self-reported basic diagnostic evaluation of dementia according to the recommendations in multidisciplinary consensus guidelines and to analyse explanatory factors for GP performance. DESIGN: Postal questionnaire study, spring 1998. SETTING: General practice in Denmark......-up consultations with demented patients (odds ratio (OR) 2.4), they were inclined to state that all patients with possible dementia should undergo diagnostic evaluation (OR 2.0), they considered that the GP should play the major role in diagnostic evaluation (OR 1.7) and they believed their methods were adequate...

  10. Diagnostic Accuracy of Lachman Test in the Evaluation of Anterior ...

    African Journals Online (AJOL)

    Background: In most cities and towns in the developing countries there are none or very few centers with sophisticated diagnostic investigative tests. We therefore depend a lot on clinical tests for diagnosis. The Lachman test is a very important test of the integrity of the anterior cruciate ligament. In this prospective study, the ...

  11. Evaluation of tuberculosis diagnostics in children: 2. Methodological issues for conducting and reporting research evaluations of tuberculosis diagnostics for intrathoracic tuberculosis in children. Consensus from an expert panel.

    Science.gov (United States)

    Cuevas, Luis E; Browning, Renee; Bossuyt, Patrick; Casenghi, Martina; Cotton, Mark F; Cruz, Andrea T; Dodd, Lori E; Drobniewski, Francis; Gale, Marianne; Graham, Stephen M; Grzemska, Malgosia; Heinrich, Norbert; Hesseling, Anneke C; Huebner, Robin; Jean-Philippe, Patrick; Kabra, Sushil Kumar; Kampmann, Beate; Lewinsohn, Deborah; Li, Meijuan; Lienhardt, Christian; Mandalakas, Anna M; Marais, Ben J; Menzies, Heather J; Montepiedra, Grace; Mwansambo, Charles; Oberhelman, Richard; Palumbo, Paul; Russek-Cohen, Estelle; Shapiro, David E; Smith, Betsy; Soto-Castellares, Giselle; Starke, Jeffrey R; Swaminathan, Soumya; Wingfield, Claire; Worrell, Carol

    2012-05-15

    Confirming the diagnosis of childhood tuberculosis is a major challenge. However, research on childhood tuberculosis as it relates to better diagnostics is often neglected because of technical difficulties, such as the slow growth in culture, the difficulty of obtaining specimens, and the diverse and relatively nonspecific clinical presentation of tuberculosis in this age group. Researchers often use individually designed criteria for enrollment, diagnostic classifications, and reference standards, thereby hindering the interpretation and comparability of their findings. The development of standardized research approaches and definitions is therefore needed to strengthen the evaluation of new diagnostics for detection and confirmation of tuberculosis in children. In this article we present consensus statements on methodological issues for conducting research of Tuberculosis diagnostics among children, with a focus on intrathoracic tuberculosis. The statements are complementary to a clinical research case definition presented in an accompanying publication and suggest a phased approach to diagnostics evaluation; entry criteria for enrollment; methods for classification of disease certainty, including the rational use of culture within the case definition; age categories and comorbidities for reporting results; and the need to use standard operating procedures. Special consideration is given to the performance of microbiological culture in children and we also recommend for alternative methodological approaches to report findings in a standardized manner to overcome these limitations are made. This consensus statement is an important step toward ensuring greater rigor and comparability of pediatric tuberculosis diagnostic research, with the aim of realizing the full potential of better tests for children.

  12. Usefulness of Videotape Instruction in an Academic Department of Neurology.

    Science.gov (United States)

    Kaufman, David M.; Kaufman, Rita G.

    1983-01-01

    Videotape instruction produced better performance in identification in only certain areas in a neurology clerkship: neuropsychologic phenomena, disorders with subtle or unique movements, and seizures. The choice and cost of equipment and some professional assurances are discussed. (Author/MLW)

  13. Diagnosing Chronic Pancreatitis: Comparison and Evaluation of Different Diagnostic Tools.

    Science.gov (United States)

    Issa, Yama; van Santvoort, Hjalmar C; van Dieren, Susan; Besselink, Marc G; Boermeester, Marja A; Ahmed Ali, Usama

    2017-10-01

    This study aims to compare the M-ANNHEIM, Büchler, and Lüneburg diagnostic tools for chronic pancreatitis (CP). A cross-sectional analysis of the development of CP was performed in a prospectively collected multicenter cohort including 669 patients after a first episode of acute pancreatitis. We compared the individual components of the M-ANNHEIM, Büchler, and Lüneburg tools, the agreement between tools, and estimated diagnostic accuracy using Bayesian latent-class analysis. A total of 669 patients with acute pancreatitis followed-up for a median period of 57 (interquartile range, 42-70) months were included. Chronic pancreatitis was diagnosed in 50 patients (7%), 59 patients (9%), and 61 patients (9%) by the M-ANNHEIM, Lüneburg, and Büchler tools, respectively. The overall agreement between these tools was substantial (κ = 0.75). Differences between the tools regarding the following criteria led to significant changes in the total number of diagnoses of CP: abdominal pain, recurrent pancreatitis, moderate to marked ductal lesions, endocrine and exocrine insufficiency, pancreatic calcifications, and pancreatic pseudocysts. The Büchler tool had the highest sensitivity (94%), followed by the M-ANNHEIM (87%), and finally the Lüneburg tool (81%). Differences between diagnostic tools for CP are mainly attributed to presence of clinical symptoms, endocrine insufficiency, and certain morphological complications.

  14. Point-of-care diagnostic tools : Selection, evaluation and implementation in resource-constrained settings

    NARCIS (Netherlands)

    Kosack, C.S.

    2017-01-01

    In recent year’s point-of-care diagnostic tools especially for the three main killer diseases HIV/AIDS, tuberculosis and malaria have been emerging on the market. This thesis examines the selection, evaluation and implementation of point-of-care diagnostic tools for use in resource-constrained

  15. Evaluation of the appendix during diagnostic laparoscopy, the laparoscopic appendicitis score : a pilot study

    NARCIS (Netherlands)

    Hamminga, Jenneke T. H.; Hofker, H. Sijbrand; Broens, Paul M. A.; Kluin, Philip M.; Heineman, Erik; Haveman, Jan Willem

    Diagnostic laparoscopy is the ultimate diagnostic tool to evaluate the appendix. Still, according to the literature, this strategy results in a negative appendectomy rate of approximately 12-18 % and associated morbidity. Laparoscopic criteria for determining appendicitis are lacking. The goal of

  16. Colonic polyps: inheritance, susceptibility, risk evaluation, and diagnostic management

    Directory of Open Access Journals (Sweden)

    Emanuele Neri

    2010-12-01

    Full Text Available Emanuele Neri, Lorenzo Faggioni, Lorenzo Cini, Carlo BartolozziDiagnostic and Interventional Radiology, University of Pisa, Pisa, ItalyAbstract: Colorectal cancer (CRC is the third-ranked neoplasm in order of incidence and mortality, worldwide, and the second cause of cancer death in industrialized countries. One of the most important environmental risk factors for CRC is a Western-type diet, which is characterized by a low-fiber and high-fat content. Up to 25% of patients with CRC have a family history for CRC, and a fraction of these patients are affected by hereditary syndromes, such as familial adenomatous polyposis, Gardner or Turcot syndromes, or hereditary nonpolyposis colorectal cancer. The onset of CRC is triggered by a well-defined combination of genetic alterations, which form the bases of the adenoma-carcinoma sequence hypothesis and justify the set-up of CRC screening techniques. Several screening and diagnostic tests for CRC are illustrated, including rectosigmoidoscopy, optical colonoscopy (OC, double contrast barium enema (DCBE, and computed tomography colonography (CTC. The strengths and weaknesses of each technique are discussed. Particular attention is paid to CTC, which has evolved from an experimental technique to an accurate and mature diagnostic approach, and gained wide acceptance and clinical validation for CRC screening. This success of CTC is due mainly to its ability to provide cross-sectional analytical images of the entire colon and secondarily detect extracolonic findings, with minimal invasiveness and lower cost than OC, and with greater detail and diagnostic accuracy than DCBE. Moreover, especially with the advent and widespread availability of modern multidetector CT scanners, excellent quality 2D and 3D reconstructions of the large bowel can be obtained routinely with a relatively low radiation dose. Computer-aided detection systems have also been developed to assist radiologists in reading CTC examinations

  17. Fundamentals of Laparoscopic Surgery manual test: is videotaped performance assessment an option?

    Science.gov (United States)

    Rooney, Deborah M; Brissman, Inga C; Finks, Jonathan F; Gauger, Paul G

    2015-01-01

    In efforts to maintain standards required to evaluate the high-stakes assessment, Society of American Gastrointestinal and Endoscopic Surgeons Fundamentals of Laparoscopic Surgery (FLS) requires all new proctors to complete the train-the-proctor workshop. As the pool of FLS proctors expands, new methods to streamline training and quality assurance programs should be considered. We propose that videotaped performances of the FLS manual tasks may be an alternative proxy to live assessment for training of new proctors, but evaluation of proctors' measures from videotaped FLS performances is required before implementation. A 2-phased research consisted of capturing newly trained proctors' (n = 20) ratings of 3 similar FLS performances across 3 stations-live (Live), videotaped-laparoscopic only (Lap Only) view, and videotaped-dual (Dual) views, during the 2012 Society of American Gastrointestinal and Endoscopic Surgeons FLS train-the-proctor workshop. A month later, a sample of proctors (n = 9) viewed videotaped versions of live FLS performances originally observed during the workshop. Captured metrics include recognition of a predefined critical error for each task (dichotomously scored and summed) and time to complete each of the 5 tasks. Analysis of variance compared the proctors' summed ratings for similar performances across Live, Lap Only, and Dual views, whereas paired t test compared recorded times of Lap Only vs Dual views, Live vs web ratings, and proctors' recorded times across the Lap Only and Dual views. There were neither differences in ratings across Live, Lap Only, and Dual views (p = 0.49) nor in recorded times for performances viewed across Lap Only and Dual viewing options (p = 0.29 and 0.76, respectively). Mean summed performance ratings observed live (4.6) were higher than those observed via the web (4.0), although not significant (p = 0.051). There were no differences in recorded times for identical performances across Live and web observations (p

  18. Safety evaluation of routine intracoronary acetylcholine infusion in patients undergoing a first diagnostic coronary angiogram

    NARCIS (Netherlands)

    Tio, RA; Monnink, SHJ; Amoroso, G; Jessurun, GAJ; Veeger, N; Volkers, C; Hautvast, R; Tan, ES; van Gilst, WH; van Boven, AJ

    Background: Recent findings imply prognostic significance of intracoronary acetylcholine infusion for endothelial function testing. We evaluated whether routine use of this test in coronary angiography patients is safe. Methods: Patients undergoing a first diagnostic coronary angiography were

  19. Diagnostic Evaluation of Ozone Production and Horizontal Transport in a Regional Photochemical Air Quality Modeling System

    Science.gov (United States)

    A diagnostic model evaluation effort has been performed to focus on photochemical ozone formation and the horizontal transport process since they strongly impact the temporal evolution and spatial distribution of ozone (O3) within the lower troposphere. Results from th...

  20. Ultrasonographic diagnostics and evaluation of calcaneal fracture: Case report

    Directory of Open Access Journals (Sweden)

    Lukač Damir

    2013-01-01

    Full Text Available Introduction. Radiography is the standard tool in the diagnostics of bone fractures. This paper presents a case of calcaneal fracture diagnosed by ultrasonography that was also used in the follow-up of recovery progress. Case Outline. A 68-year-old male patient was diagnosed avulsion fracture of the calcaneus by ultra-sonography (US examination using a multi-frequency linear probe (7-15 MHz and confirmed by X-ray findings; US also provided insight into the dynamics of the reparatory processes. Control examinations were performed on day 14, 21, 30, 60 and 300 (10 months after the occurrence of the fracture. During this time rehabilitation process was carried out. The diameters of the wedge defect of the calcaneus were measured by US for the follow-up of the healing process of the injured bone. Postero-anterior (PA or longitudinal diameter and latero-medial or medio-lateral or transverse diameter were measured. Conclusion. Study results indicate a possible use of US in the diagnostics of fractures and monitoring of calcaneal healing.

  1. Computational evaluation of a pencil ionization chamber in a standard diagnostic radiology beam

    Energy Technology Data Exchange (ETDEWEB)

    Mendonca, Dalila Souza Costa; Neves, Lucio Pereira; Perini, Ana Paula, E-mail: anapaula.perini@ufu.br [Universidade Federal de Uberlandia (UFU), MG (Brazil). Instituto de Fisica; Santos, William S.; Caldas, Linda V.E. [Instituto de Pesquisas Energeticas e Nucleares (IPEN/CNEN-SP), Sao Paulo, SP (Brazil); Belinato, Walmir [Instituto Federal de Educacao, Ciencia e Tecnologia da Bahia (IFBA), Vitoria da Conquista, BA (Brazil)

    2016-07-01

    In this work a pencil ionization chamber was evaluated. This evaluation consisted in the determination of the influence of the ionization chamber components in its response. For this purpose, the Monte Carlo simulations and the spectrum of the standard diagnostic radiology beam (RQR5) were utilized. The results obtained, showed that the influence of the ionization chamber components presented no significant influence on the chamber response. Therefore, this ionization chamber is a good alternative for dosimetry in diagnostic radiology. (author)

  2. Preoperative accuracy of diagnostic evaluation of the urachal mass.

    Science.gov (United States)

    Meeks, Joshua J; Herr, Harry W; Bernstein, Melanie; Al-Ahmadie, Hikmat A; Dalbagni, Guido

    2013-04-01

    Urachal carcinoma is a rare urological neoplasm that arises along the urachal remnant from umbilicus to bladder dome. To our knowledge no published study has examined the diagnostic accuracy of modern preoperative testing to differentiate urachal carcinoma from a benign urachal cyst and spare the resection of potentially benign urachal tissue. We determined whether a urachal mass could be safely diagnosed preoperatively. We reviewed the records of 104 patients with a urachal mass treated between 1979 and 2011. Study exclusion criteria were unresectable metastatic disease at presentation, no surgery and management by transurethral resection alone. Of the patients who remained only 65 had preoperative diagnostic testing as well as definitive pathological results available for analysis. Mean age was 51 years. Of the patients 86% were white and 65% were male. The accuracy of diagnosis based on preoperative tests was compared to that of final pathology (cancer or benign). A total of 57 tumors (87%) were malignant and 83% of the masses were adenocarcinoma. Compared to computerized tomography, cytology and exploration under anesthesia, transurethral resection of bladder tumor had the highest sensitivity (0.93), specificity (1) and positive predictive value (1) but low negative predictive value (0.5). Study limitations included small cohort size and few benign urachal masses for comparison. No test has a high enough negative predictive value to prevent urachal mass excision. With few treatment options for localized, advanced and metastatic urachal cancer, these data suggest that early excision remains the best treatment for a suspicious urachal mass. Copyright © 2013 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

  3. Prevalence of Autism Spectrum Disorder in Children Referred for Diagnostic Autism Evaluation.

    Science.gov (United States)

    Monteiro, Sonia A; Spinks-Franklin, Adiaha; Treadwell-Deering, Diane; Berry, Leandra; Sellers-Vinson, Sherry; Smith, Eboni; Proud, Monica; Voigt, Robert G

    2015-12-01

    Increased public awareness of autism spectrum disorders (ASD) and routine screening in primary care have contributed to increased requests for diagnostic ASD evaluations. However, given the scarcity of subspecialty autism diagnostic resources, overreferral of children suspected of having ASD may be contributing to long waiting lists at tertiary care autism centers and delaying diagnosis for those children who truly have ASD. To determine whether children are being excessively referred to ASD-specific diagnostic clinics, our objective was to determine the prevalence of true ASD diagnoses in children referred for diagnostic ASD evaluation. Charts of all patients referred to a regional autism center between April 2011 and August 2012 for suspicion of a possible ASD were retrospectively reviewed and demographic and clinical diagnoses abstracted. Only 214 of 348 patients evaluated (61%) received an ASD diagnosis. Thus, concerns about autism are not confirmed by an ASD diagnosis in a significant number of children. © The Author(s) 2015.

  4. Computer-based desktop system for surgical videotape editing.

    Science.gov (United States)

    Vincent-Hamelin, E; Sarmiento, J M; de la Puente, J M; Vicente, M

    1997-05-01

    The educational role of surgical video presentations should be optimized by linking surgical images to graphic evaluation of indications, techniques, and results. We describe a PC-based video production system for personal editing of surgical tapes, according to the objectives of each presentation. The hardware requirement is a personal computer (100 MHz processor, 1-Gb hard disk, 16 Mb RAM) with a PC-to-TV/video transfer card plugged into a slot. Computer-generated numerical data, texts, and graphics are transformed into analog signals displayed on TV/video. A Genlock interface (a special interface card) synchronizes digital and analog signals, to overlay surgical images to electronic illustrations. The presentation is stored as digital information or recorded on a tape. The proliferation of multimedia tools is leading us to adapt presentations to the objectives of lectures and to integrate conceptual analyses with dynamic image-based information. We describe a system that handles both digital and analog signals, production being recorded on a tape. Movies may be managed in a digital environment, with either an "on-line" or "off-line" approach. System requirements are high, but handling a single device optimizes editing without incurring such complexity that management becomes impractical to surgeons. Our experience suggests that computerized editing allows linking surgical scientific and didactic messages on a single communication medium, either a videotape or a CD-ROM.

  5. Evaluation of microbiological diagnostics in urogenital infections in postmenopausal women

    Directory of Open Access Journals (Sweden)

    Blaženka Hunjak,

    2010-02-01

    Full Text Available Objective To establish the percentage of infections in postmenopausal women with urinary symptoms which can be confirmed by microbiological analysis, the most common causative agents and whether the urethra and vagina in patients with cystitis are concurrently colonized by pathogenic microorganisms. Methods Laboratories of the Croatian National Institute of Public Health in Zagreb, in the period of two years, analyzed 245 samples taken from patients with urinary symptoms who had been postmenopausal at least for a year. Urine samples, as well as urethral and vaginal swabs were taken from each patient and tested for causative agents of urogenital infections, genital mycoplasma and Chlamydia trachomatis.Results Cystitis was confirmed by microbiological analysis in 31.4% women, urethritis in 24.8%, and vaginitis in 15.1%. The most common causative agent of urethritis was Ureaplasma urealyticum, while Gardnerella vaginalis was the most common in vaginal infections. E. coli was concurrently isolated in urine, urethral and vaginal samples in 65.1% of patients with E. coli cystitis, while Streptococcus agalactiae was isolated in urethral and vaginal samples in each patient with Streptococcus agalactiae cystitis.Conclusion Mucosal colonization of the urethra and vagina contributes to the incidence of cystitis in postmenopausal women. Microbiological diagnostics is necessary to distinguish between the symptoms of ageing of the urogenital system and infection, with a view to preventing unnecessary antibiotic therapy.

  6. Diagnostic laparoscopy in the evaluation of female factor infertility

    OpenAIRE

    Ashok Kumar K.; Priyanka Jogi Y.; Bharathi Anjanappa

    2017-01-01

    Background: Infertility is a global problem, with more than 70 million couples suffering every year. In India 10-15% of populations are suffering from infertility. All these people need accurate diagnosis and treatment. Among the many investigations available to evaluate the female partner of the infertile couples, laparoscopy is relatively recent and considered gold standard for pelvis evaluation. The objective of the study was to study the different causes of female factor infertility with ...

  7. Quantitative Percussion Diagnostics For Evaluating Bond Integrity Between Composite Laminates

    Science.gov (United States)

    Poveromo, Scott Leonard

    Conventional nondestructive testing (NDT) techniques used to detect defects in composites are not able to determine intact bond integrity within a composite structure and are costly to use on large and complex shaped surfaces. To overcome current NDT limitations, a new technology was utilized based on quantitative percussion diagnostics (QPD) to better quantify bond quality in fiber reinforced composite materials. Experimental results indicate that this technology is capable of detecting 'kiss' bonds (very low adhesive shear strength), caused by the application of release agents on the bonding surfaces, between flat composite laminates bonded together with epoxy adhesive. Specifically, the local value of the loss coefficient determined from quantitative percussion testing was found to be significantly greater for a release coated panel compared to that for a well bonded sample. Also, the local value of the probe force or force returned to the probe after impact was observed to be lower for the release coated panels. The increase in loss coefficient and decrease in probe force are thought to be due to greater internal friction during the percussion event for poorly bonded specimens. NDT standards were also fabricated by varying the cure parameters of an epoxy film adhesive. Results from QPD for the variable cure NDT standards and lap shear strength measurements taken of mechanical test specimens were compared and analyzed. Finally, experimental results have been compared to a finite element analysis to understand the visco-elastic behavior of the laminates during percussion testing. This comparison shows how a lower quality bond leads to a reduction in the percussion force by biasing strain in the percussion tested side of the panel.

  8. Anticipated identification costs: Improving assortment evaluation by diagnostic attributes

    NARCIS (Netherlands)

    Herpen, van E.; Pieters, F.G.M.

    2007-01-01

    Abstract Consumers often make quick assessments of product assortments, to determine if these are worthwhile for further investigation. They anticipate how difficult it will be to distinguish the various options in the assortment, which will influence their assortment evaluations. We reason that

  9. Identification and diagnostic evaluation of possible dementia in general practice. A prospective study

    DEFF Research Database (Denmark)

    Waldorff, Frans Boch; Rishøj, Susanne; Waldemar, Gunhild

    2005-01-01

    , and 4 (3%) were treated for depression or referred for another condition. A total of 6 patients were lost to follow-up. In the remaining 102 undiagnosed patients the main reasons for not performing a diagnostic evaluation of dementia were patient/relative hesitation (34%), the GP thought that it would......OBJECTIVE: To investigate the rate of diagnostic evaluation of dementia for patients in whom a suspicion of dementia was raised, and to investigate reasons why a diagnostic evaluation was not always being performed. DESIGN: A prospective study among elderly patients aged 65+, and a follow-up study...... of dementia, laboratory-screening tests prescribed by the GPs and referral status after 6 months, and follow-up questionnaire. RESULTS: Of 793 patients a total of 138 patients were identified with possible dementia. Among the identified patients 26 (20%) were referred for further evaluation within 6 months...

  10. Evaluation of the Revised Algorithm of Autism Diagnostic Observation Schedule (ADOS) in the Diagnostic Investigation of High-Functioning Children and Adolescents with Autism Spectrum Disorders

    Science.gov (United States)

    Kamp-Becker, Inge; Ghahreman, Mardjan; Heinzel-Gutenbrunner, Monika; Peters, Mira; Remschmidt, Helmut; Becker, Katja

    2013-01-01

    The Autism Diagnostic Observation Schedule (ADOS) is a semi-structured, standardized assessment designed for use in diagnostic evaluation of individuals with suspected autism spectrum disorder (ASD). The ADOS has been effective in categorizing children who definitely have autism or not, but has lower specificity and sometimes sensitivity for…

  11. Diagnostic Tools for Doctors' Evaluation of Tattoo Complications

    DEFF Research Database (Denmark)

    Serup, Jørgen

    2017-01-01

    Diagnosis of tattoo complications is a multi-facetted field since many clinical entities and disease mechanisms are represented. Infections, allergies, and pigment foreign body reactions with granuloma are the major groups. The clinician needs a structured approach to diagnosis and an armamentarium...... of standard tests. Diagnosis primarily builds on patient history, objective clinical examination, and punch biopsy, supplemented with microbiology testing, ultrasound scanning, and clinical photography. Evaluation of allergic tattoo reactions and allergy to pigments by patch testing is not applicable and has...... a falsely negative outcome except for the diagnosis of allergy to metals and preservatives. Simple inspection of raw punch biopsies from chronic tattoo reactions, preferably evaluated with stereo microscopy, provides important information about the density and the local distribution of tattoo pigment...

  12. Multi-Laboratory Evaluation of a Scrub Typhus Diagnostic Kit

    Science.gov (United States)

    1990-01-01

    when tested for specific reac- TABLE 3 Reproducibility ofanti- Rickettsia tsutsugamushi immunoglobulin specific liP Test Kit results between evaluating...others, 1983. Eval- hospitalized patients. Am J Trop Med Hyg 33: uation of latex- Rickettsia rickettsii test for Rocky 311-315. file m83; (ui) 84176341...1.00), reproducibility of 0.86, and efficiency of 0.92 when compared to the reference laboratory. In a proficiency survey in which 10 laboratories

  13. MRI in diagnostic evaluation of osteomyelitis in children

    Energy Technology Data Exchange (ETDEWEB)

    Stoever, B. [Inst. fuer Roentgendiagnostik, Paediatrische Radiologie, Universitaetsklinikum Charite, Berlin (Germany); Sigmund, G. [Dept. of Radiology, Albert-Ludwigs-Univ., Freiburg (Germany); Langer, M. [Dept. of Radiology, Albert-Ludwigs-Univ., Freiburg (Germany); Brandis, M. [Dept. of Pediatrics, Albert-Ludwigs Univ., Freiburg (Germany)

    1994-08-01

    Several MRI investigations for detecting or excluding acute and non-post-traumatic chronic osteomyelitis were performed in 31 children, osteomyelitis was evident in 21 patients. The sensitivity of MRI for osteomyelitis was 90%, and specificity was 100%. In children with confirmed osteomyelitis 23 follow-up investigations were carried out in order to evaluate duration of the medullary edema. In uncomplicated cases only treated by antibiotics edema regression was evident after 4 weeks and completed after 12-16 weeks. In cases in whom extended concomitant soft-tissue infection was depicted regression of edema was prolonged independent of surgical intervention. The study reveals that at onset of acute osteomyelitis in children MRI can replace technetium 99m-labeled scintigraphy and reduce plain-film investigations. The results support the usefulness of MRI in discrimination of isolated soft-tissue infection and noninfectious diseases of bone. (orig.)

  14. Evaluating the role of the diagnostic research radiographer

    Energy Technology Data Exchange (ETDEWEB)

    Reid, Karen, E-mail: karen.reid@nnuh.nhs.uk [Radiology Directorate, Level 2 East Block, Norfolk and Norwich University Hospital, Colney Lane, Norwich, NR4 7UY (United Kingdom); Edwards, Hazel, E-mail: hazel.edwards@nnuh.nhs.uk [Norwich Radiology Academy, Norfolk and Norwich University Hospital, Colney Lane, Norwich, NR4 7UB (United Kingdom)

    2011-08-15

    The NHS has an increasingly strong focus on evidence-based medicine to underpin policy making and the development of a culture of evaluation and learning. Good quality research is the foundation for this ethos. Numbers of research projects and clinical trials involving imaging are increasing and therefore more radiographers are contributing to these studies but perhaps on some occasions they may be unaware. This paper describes the benefits of having a dedicated research radiographer within a radiology department to organise and monitor studies. We explain the procedures of the research process, the knowledge and skills that such a radiographer requires and the value of coordination and governance in developing a culture of research in a radiology department. We make suggestions to overcome perceived barriers to engaging with research and discuss the advantages and limitations of the role. Others who are considering appointing a dedicated research radiographer may find our experience helpful.

  15. Diagnostic Tools for Doctors' Evaluation of Tattoo Complications.

    Science.gov (United States)

    Serup, Jørgen

    2017-01-01

    Diagnosis of tattoo complications is a multi-facetted field since many clinical entities and disease mechanisms are represented. Infections, allergies, and pigment foreign body reactions with granuloma are the major groups. The clinician needs a structured approach to diagnosis and an armamentarium of standard tests. Diagnosis primarily builds on patient history, objective clinical examination, and punch biopsy, supplemented with microbiology testing, ultrasound scanning, and clinical photography. Evaluation of allergic tattoo reactions and allergy to pigments by patch testing is not applicable and has a falsely negative outcome except for the diagnosis of allergy to metals and preservatives. Simple inspection of raw punch biopsies from chronic tattoo reactions, preferably evaluated with stereo microscopy, provides important information about the density and the local distribution of tattoo pigment in the dermis and changes of micro- anatomical skin structures. Histology may show subtle structural changes, but traditional patterns (lichenoid reaction, pseudolymphoma, granuloma, and pseudoepitheliomatous epidermal hyperplasia) are of little or no help in the diagnosis since the patterns overlap and have no distinct clinical correlates. Histology cannot separate allergic and nonallergic reactions. However, granulomatous reaction and sarcoid granuloma are significant findings since papulonodular reaction of black tattoos and sarcoidosis are strongly associated with each other. 20-MHz ultrasound scanning is important for noninvasive imaging and characterization of inflammatory tattoo reactions and can be used preoperatively as guide to treatment. Electron microscopy can visualize pigment particles in tissues, cells, and tattoo inks. Chemicals of pigment in tissues and in tattoo inks can be analyzed by high-performance liquid chromatography, mass spectroscopy, and Raman spectroscopy. © 2017 S. Karger AG, Basel.

  16. Diagnostic leaf to evaluate the nutritional status of Jatropha

    Directory of Open Access Journals (Sweden)

    Carlos Hissao Kurihara

    2015-12-01

    Full Text Available ABSTRACT The analytical determination of nutrient levels in recently mature leaves in order to diagnose nutritional status is based on the fact that leaves are metabolically active and more sensitive to variation in nutrients of the soil. In most of cases, there is a direct well known between foliar content and the development and yield of the plant. However, for a more accurate interpretation, it is essential to establish the index leaf. There are few published studies about Jatropha with contrasting results. In order to establish the index leaf, in adult plants, the macronutrient levels were evaluated in samples collected in experimental plots, in which doses of nitrogen and phosphorus were applied, in two parts of the floral branches (in the top and in the middle thirds; and in three positions of leaves of the floral branch (between the 1st and 3rd, 6th and 8th, and 13th and 15th leaves below the inflorescence. The location of the leaf on the plant significantly affects nutrient contents. Nitrogen, phosphorus, potassium and sulfur tend to have higher concentration in young tissues. Calcium and magnesium showed higher levels in the basal leaves of floral branches. Samples collected in the top third of plants (between the 6th and 15th leaves of the floral branch are more sensitive to variations of nitrogen and phosphorus fertilization. Therefore, we indicate the 6th to 15th leaves of the top third plants as index leaves estimate nutritional status of Jatropha.

  17. Evaluation of diagnostic tests using information theory for multi-class diagnostic problems and its application for the detection of occlusal caries lesions.

    Science.gov (United States)

    Arslan, Umut; Karaağaoğlu, Ergun; Özkan, Gökhan; Kanlı, Aydan

    2014-09-01

    Several methods are available to evaluate the performance of the tests when the purpose of the diagnostic test is to discriminate between two possible disease states. However multi-class diagnostic problems frequently appear in many areas of medical science. Hence, there is a need for methods which will enable us to characterize the accuracy of diagnostic tests when there are more than two possible disease states. To show that two information theory measures, information content (IC) and proportional reduction in diagnostic uncertainty (PRDU), can be used for the evaluation of the performance of diagnostic tests for multi-class diagnostic problems that may appear in different areas of medical science. Diagnostic accuracy study. Sixty freshly extracted permanent human molar and pre-molar teeth suspected to have occlusal caries lesions were selected for the study and were assessed by two experienced examiners. Each examiner performed two evaluations. Histological examination was used as the gold standard. The scores of the histological examination were defined as sound (n=11), enamel caries (n=22) and dentin caries (n=27). Diagnostic performance of i) visual inspection, ii) radiography, iii) laser fluorescence (LF) and iv) micro-computed tomography (M-CT) caries detection methods was evaluated by calculating IC and PRDU. Micro-computed tomography examination was the best method among the diagnostic techniques for the diagnosis of occlusal caries in terms of both IC and PRDU. M-CT examination supplied the maximum diagnostic information about the diagnosis of occlusal caries in the first (IC: 1.056; p<0.05), (PRDU: 70.5%) and second evaluation (IC: 1.105; p<0.05), (PRDU: 73.8%) for the first examiner. M-CT examination was the best method among the diagnostic techniques for the second examiner in both the first (IC:1.105; p<0.05), (PRDU:73.8%) and second evaluation (IC:1.061; p<0.05), (PRDU:70.8%). IC and PRDU were lowest for visual inspection. The present study

  18. Breaststroke learning through the use of videotape feedback

    Directory of Open Access Journals (Sweden)

    Marcela de Castro Ferracioli

    2013-03-01

    Full Text Available DOI: http://dx.doi.org/10.5007/1980-0037.2013v15n2p204 People from all age groups and social backgrounds have always sought to learn swimming. However, the swimming learning process is usually considered repetitive and tiring, requiring the teacher to use methods that motivate students to join the practice without ignoring the need for improvement in their performance. This study assessed motivation during a breaststroke learning process in students who received videotape feedback, verbal feedback, and who did not receive any feedback during practice. Thirty seven swimming inexperienced students were divided into three groups: Video (n=13, which received videotape feedback; Verbal (n=15, which received verbal feedback; and Control (n=9, which did not receive any feedback during experimental phases (pre-test, acquisition (5 days, post-test and retention. Participants completed a questionnaire based on Likert scale for motivation assessment. Scores were given to their performance by a swimming teacher to assess breaststroke learning during each experimental phase. Results of motivation assessment showed that students who received feedback (videotape or verbal felt more motivated during practice than those who did not receive any feedback. Regarding the breaststroke learning, all participants improved their performance along experimental phases, but, during the retention one, Verbal group’s performance was considered superior to the Control group’s performance. This study concluded that the use of videotape and verbal feedback has motivational results on breaststroke learning, and that it is effective in the learning process.

  19. Space Science for Children: All about Stars [Videotape].

    Science.gov (United States)

    1999

    This 23-minute videotape features information, for children in grades K-4, about stars including their composition, brightness, and location. How stars are formed, why they seem to move across our sky, and how humans have used their patterns to form the constellations are discussed. A hands-on activity related to the reflecting telescope is also…

  20. All about Amphibians. Animal Life for Children. [Videotape].

    Science.gov (United States)

    2000

    This videotape teaches children about their favorite amphibious creatures, as well as amphibians' nearest cousins--toads, newts, and salamanders. Young students discover how these amazing creatures can live both in and out of water, learn about the amphibious life cycle, and compare the differences between amphibians and reptiles. This videotape…

  1. Me & Isaac Newton. [Videotape and] KIDSNET Guide for Educators.

    Science.gov (United States)

    2001

    This videotape records the stories of 7 scientists, 3 women and 4 men who range in age from 33 to 81. Beginning with their earliest scientific questions and including their most personal ponderings, the scientists reveal their histories and professional obligations to affect the world. Director Michael Apted allows the personal adventures of the…

  2. Use of Videotape Feedback with Severely Disturbed Adolescents.

    Science.gov (United States)

    Michel, Jane; Blitstein, Sheldon

    1979-01-01

    Summarizes the design and effects of a group therapy project using videotape feedback with seriously disturbed adolescents. Offers anecdotal evidence that the feedback facilitated the correction of the participants' distorted body images, low self-esteem, lack of capacity for self-observation, and poor peer relationships. (SS)

  3. All about Dinosaurs. Animal Life for Children. [Videotape].

    Science.gov (United States)

    2000

    Dinosaurs were the rulers of the land 65 million years ago. In this videotape, children learn more about the different kinds of dinosaurs by viewing vivid illustrations and fossil discoveries. Students compare the dinosaurs to their modern kin--snakes, lizards, and crocodiles. Students also listen to different theories to try to answer the big…

  4. All about Reptiles. Animal Life for Children. [Videotape].

    Science.gov (United States)

    2000

    Dinosaurs may be extinct, but reptiles are distant cousins to the beasts that once walked the earth. From snakes and lizards to iguanas and tuataras, children learn what factors make them different from other animals. In this videotape, students explore the mysterious, often misunderstood, world of reptiles and learn about their characteristics…

  5. All about Animal Behavior & Communication. Animal Life for Children. [Videotape].

    Science.gov (United States)

    2000

    Why do animals do what they do? What is the difference between instinct and learned behavior? How do animals communicate? These questions are answered as children examine animal behaviors that help them find food, protect themselves, and care for their young. This videotape correlates to the following National Science Education Standards for Life…

  6. All about Food Chains. Animal Life for Children. [Videotape].

    Science.gov (United States)

    2000

    Whether animals are herbivores, carnivores, or omnivores, each one is part of an eternal food chain that carries on from one generation to the next. In this videotape, students learn more about terms like "predator,""pre-consumer" and "producer," as well as the cycles of food chains and food webs and how they support…

  7. Evaluation of the virtual learning object "Diagnostic reasoning in nursing applied to preterm newborns".

    Science.gov (United States)

    Góes, Fernanda dos Santos Nogueira de; Fonseca, Luciana Mara Monti; Furtado, Maria Cândida de Carvalho; Leite, Adriana Moraes; Scochi, Carmen Gracinda Silvan

    2011-01-01

    The potential use of computer technology in teaching and continuous education for nursing motivated the development of this study to evaluate the virtual learning object, "Diagnostic Reasoning in Nursing Applied to Preterm Newborns" at an intermediate neonatal care unit. This descriptive study evaluates the appearance and content of the virtual object concerning aspects related to presentation, organization, usability and overall impression. Experts from the fields of computer technology (12) and nursing (31) participated in the evaluation process. Each sub-item of the instrument was assessed on a Likert scale and blank space was provided for comments/suggestions. All items were positively evaluated by over 80% of the experts, except for the 'informational density' criterion in the evaluation performed by computer technology experts. The developed product is considered adequate to be used for teaching for nursing students and in continuous education of diagnostic reasoning in the development of Nursing Diagnoses for preterm newborns, in the problem-posing pedagogical framework.

  8. Performance Evaluation of Commercial Dengue Diagnostic Tests for Early Detection of Dengue in Clinical Samples

    Directory of Open Access Journals (Sweden)

    Tuan Nur Akmalina Mat Jusoh

    2017-01-01

    Full Text Available The shattering rise in dengue virus infections globally has created a need for an accurate and validated rapid diagnostic test for this virus. Rapid diagnostic test (RDT and reverse transcription-polymerase chain reaction (RT-PCR diagnostic detection are useful tools for diagnosis of early dengue infection. We prospectively evaluated the diagnostic performance of nonstructural 1 (NS1 RDT and real-time RT-PCR diagnostic kits in 86 patient serum samples. Thirty-six samples were positive for dengue NS1 antigen while the remaining 50 were negative when tested with enzyme-linked immunosorbent assay (ELISA. Commercially available RDTs for NS1 detection, RTK ProDetect™, and SD Bioline showed high sensitivity of 94% and 89%, respectively, compared with ELISA. GenoAmp® Trioplex Real-Time RT-PCR and RealStar® Dengue RT-PCR tests presented a comparable kappa agreement with 0.722. The result obtained from GenoAmp® Real-Time RT-PCR Dengue test showed that 14 samples harbored dengue virus type 1 (DENV-1, 8 samples harbored DENV-2, 2 samples harbored DENV-3, and 1 sample harbored DENV-4. 1 sample had a double infection with DENV-1 and DENV-2. The NS1 RDTs and real-time RT-PCR tests were found to be a useful diagnostic for early and rapid diagnosis of acute dengue and an excellent surveillance tool in our battle against dengue.

  9. Producing Videotape Programs for Computer Training: An Example with AMA/NET

    OpenAIRE

    Novey, Donald W.

    1990-01-01

    To facilitate user proficiency with AMA/Net, an 80-minute training videotape has been produced. The production was designed to use videotape's advantages, where information and emotion are combined; and to accommodate its chief disadvantage, lack of resolution for fine text, with close-ups and graphics. Content of the videotape was conceived, outlined, demonstrated with simultaneous text capture, edited into script form, narration added, and scripts marked for videotaping and narrating. Video...

  10. Producing Videotape Programs for Computer Training: An Example with AMA/NET

    OpenAIRE

    Novey, Donald W.

    1990-01-01

    To facilitate user proficiency with AMA/Net, an 80-minute training videotape has been produced. The production was designed to use videotape's advantages, where information and emotion are combined; and to accommodate its chief disadvantage, lack of resolution for fine text, with close-ups and graphics. Content of the videotape was conceived, out-lined, demonstrated with simultaneous text capture, edited into script form, narration added, and scripts marked for videotaping and narrating. Vide...

  11. Evaluating Secondary Students' Scientific Reasoning in Genetics Using a Two-Tier Diagnostic Instrument

    Science.gov (United States)

    Tsui, Chi-Yan; Treagust, David

    2010-05-01

    While genetics has remained as one key topic in school science, it continues to be conceptually and linguistically difficult for students with the concomitant debates as to what should be taught in the age of biotechnology. This article documents the development and implementation of a two-tier multiple-choice instrument for diagnosing grades 10 and 12 students' understanding of genetics in terms of reasoning. The pretest and posttest forms of the diagnostic instrument were used alongside other methods in evaluating students' understanding of genetics in a case-based qualitative study on teaching and learning with multiple representations in three Western Australian secondary schools. Previous studies have shown that a two-tier diagnostic instrument is useful in probing students' understanding or misunderstanding of scientific concepts and ideas. The diagnostic instrument in this study was designed and then progressively refined, improved, and implemented to evaluate student understanding of genetics in three case schools. The final version of the instrument had Cronbach's alpha reliability of 0.75 and 0.64, respectively, for its pretest and the posttest forms when it was administered to a group of grade 12 students (n = 17). This two-tier diagnostic instrument complemented other qualitative data collection methods in this research in generating a more holistic picture of student conceptual learning of genetics in terms of scientific reasoning. Implications of the findings of this study using the diagnostic instrument are discussed.

  12. Does evaluation of the ligamentous compartment enhance diagnostic utility of sacroiliac joint MRI in axial spondyloarthritis?

    DEFF Research Database (Denmark)

    Weber, Ulrich; Maksymowych, Walter P; Chan, Stanley M

    2015-01-01

    in the ligamentous compartment and their potential diagnostic utility in axial SpA. We therefore aimed to evaluate the ligamentous compartment on sacroiliac joint MRI for lesion distribution and potential incremental value towards diagnosis of SpA over and above the traditional assessment of the cartilaginous...

  13. Does Sex Influence the Diagnostic Evaluation of Autism Spectrum Disorder in Adults?

    Science.gov (United States)

    Wilson, C. Ellie; Murphy, Clodagh M.; McAlonan, Grainne; Robertson, Dene M.; Spain, Debbie; Hayward, Hannah; Woodhouse, Emma; Deeley, P. Quinton; Gillan, Nicola; Ohlsen, J. Chris; Zinkstok, Janneke; Stoencheva, Vladimira; Faulkner, Jessica; Yildiran, Hatice; Bell, Vaughan; Hammond, Neil; Craig, Michael C.; Murphy, Declan G. M.

    2016-01-01

    It is unknown whether sex influences the diagnostic evaluation of autism spectrum disorder, or whether male and female adults within the spectrum have different symptom profiles. This study reports sex differences in clinical outcomes for 1,244 adults (935 males and 309 females) referred for autism spectrum disorder assessment. Significantly, more…

  14. A reusable simulation model to evaluate the effects of walk-in for diagnostic examinations

    NARCIS (Netherlands)

    Braaksma, Aleida; Kortbeek, Nikky; Smid, Kees; Sprengers, Marieke E.S.

    2017-01-01

    Enabling patients to walk in for their diagnostic examination without an appointment has considerable potential in terms of quality of care, patient service, and system efficiency. We present a model to evaluate the effect of implementing a combined walk-in and appointment system, offering

  15. Evaluating radiographers' diagnostic accuracy in screen-reading mammograms: what constitutes a quality study?

    Energy Technology Data Exchange (ETDEWEB)

    Debono, Josephine C, E-mail: josephine.debono@bci.org.au [Westmead Breast Cancer Institute, Westmead, New South Wales (Australia); Poulos, Ann E [Discipline of Medical Radiation Sciences, Faculty of Health Sciences, University of Sydney, Lidcombe, New South Wales (Australia); Westmead Breast Cancer Institute, Westmead, New South Wales (Australia)

    2015-03-15

    The aim of this study was to first evaluate the quality of studies investigating the diagnostic accuracy of radiographers as mammogram screen-readers and then to develop an adapted tool for determining the quality of screen-reading studies. A literature search was used to identify relevant studies and a quality evaluation tool constructed by combining the criteria for quality of Whiting, Rutjes, Dinnes et al. and Brealey and Westwood. This constructed tool was then applied to the studies and subsequently adapted specifically for use in evaluating quality in studies investigating diagnostic accuracy of screen-readers. Eleven studies were identified and the constructed tool applied to evaluate quality. This evaluation resulted in the identification of quality issues with the studies such as potential for bias, applicability of results, study conduct, reporting of the study and observer characteristics. An assessment of the applicability and relevance of the tool for this area of research resulted in adaptations to the criteria and the development of a tool specifically for evaluating diagnostic accuracy in screen-reading. This tool, with further refinement and rigorous validation can make a significant contribution to promoting well-designed studies in this important area of research and practice.

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

    Directory of Open Access Journals (Sweden)

    Linden-Phillips Luan

    2010-05-01

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

  17. Evaluation of HistoGel™-embedded specimens for use in veterinary diagnostic pathology.

    Science.gov (United States)

    Joiner, Kellye S; Spangler, Elizabeth A

    2012-07-01

    HistoGel™ is an aqueous specimen-processing gel that encapsulates and suspends histologic and cytologic specimens in a solidified medium. HistoGel-embedded specimens can then be processed and evaluated by routine histologic and immunohistochemical methods. This methodology has been used in human diagnostic pathology and is especially useful for small, friable, or viscous tissue samples that are difficult to process. In addition, special histochemical stains or immunohistochemistry can be performed on HistoGel-embedded cytologic specimens using standardized methods developed for histopathology. The current report describes several applications for HistoGel, including use with cytologic specimens, bone marrow aspirates, retention of tissue orientation for endoscopic biopsy specimens, and evaluation of friable tissues. Samples were encapsulated in HistoGel, fixed in 10% neutral buffered formalin, routinely processed, paraffin embedded, and sectioned for histochemical and immunohistochemical evaluation. The results of this study support the use of HistoGel in veterinary diagnostic pathology.

  18. Structured approach to design of diagnostic test evaluation studies for chronic progressive infections in animals

    DEFF Research Database (Denmark)

    Nielsen, Søren Saxmose; Toft, Nils; Gardner, Ian Andrew

    2011-01-01

    Diagnostic test evaluations (DTEs) for chronic infections are challenging because a protracted incubation period has to be considered in the design of the DTE, and the adverse effects of infection may be widespread and progressive over an animal's entire life. Frequently, the specific purpose......) than originally intended. The objective of this paper is to outline a structured approach to the design and conduct of a DTE for diagnostic tests used for chronic infections in animals, and intended for different purposes. We describe the process from reflections about test purpose and the underlying...... of the test is not formally considered when a test is evaluated. Therefore, the result is often a DTE where test sensitivity and specificity estimates are biased, either because of problems with establishing the true infection status or because the test detects another aspect of the infection (and analyte...

  19. Diagnostic value of radionuclide phallography with intravenous vasodilator stress in the evaluation of arteriogenic impotence

    Energy Technology Data Exchange (ETDEWEB)

    Siraj, Q.H. (Dept. of Nuclear Medicine, Royal Free Hospital, London (United Kingdom)); Hilson, A.J.W. (Dept. of Nuclear Medicine, Royal Free Hospital, London (United Kingdom))

    1994-07-01

    Arteriogenic impotence is a major cause of organic erectile dysfunction. We evaluated the diagnostic value of quantitative radionuclide phallography with intravenous pharmacological stress in screening impotent patients for penile arterial inadequacy. Using technetium-99m labelled autologous erythrocytes, dynamic scintigraphy of the penile blood pool was performed. Penile haemodynamic changes following intravenous injection of the vasodilator isoxsuprine hydrochloride were assessed by quantitation of penile blood flow and volume. Forty-seven impotent patients (11 psychogenic, 24 arteriogenic, 10 venogenic, 2 endocrine) were studied. Arteriogenic impotent patients demonstrated a lesser degree of increase in penile blood flow and volume than impotent patients with uncompromised penile arterial inflow. Quantitation of penile blood flow and volume yielded a high diagnostic accuracy (>90%). Radionuclide phallography with intravenous vasodilator stress forms a simple and accurate method for evaluating the functional integrity of penile arterial inflow. (orig.)

  20. 36 CFR 1280.50 - What will I be allowed to film, photograph, or videotape for news purposes?

    Science.gov (United States)

    2010-07-01

    ... film, photograph, or videotape for news purposes? 1280.50 Section 1280.50 Parks, Forests, and Public... film, photograph, or videotape for news purposes? (a) NARA will permit you to film, photograph, or..., photograph, or videotape if you intend to use the film, photographs, or videotape for commercial, partisan...

  1. Evaluation of graphical diagnostics for assessing goodness of fit of logistic regression models.

    Science.gov (United States)

    Pavan Kumar, Venkata V; Duffull, Stephen B

    2011-04-01

    The aim of the current work was to evaluate graphical diagnostics for assessment of the fit of logistic regression models. Assessment of goodness of fit of a model to the data set is essential to ensure the model provides an acceptable description of the binary variables seen. For logistic regression the most common diagnostic used for this purpose is binning the data and comparing the empirical probability of the occurrence of a dependent variable with the model predicted probability against the mean covariate value in the bin. Although intuitively appealing this method, which we term simple binning, may not have consistent properties for diagnosing model problems. In this report we describe and evaluate two different diagnostic procedures, random binning and simplified Bayes marginal model plots. These procedures were assessed via simulation under three different designs. Design 1: studies which were balanced on binary variables and a continuous covariate. Design 2: studies that were balanced on binary variables but unbalanced on the continuous covariate. Design 3: studies that were unbalanced on both the binary variables and the covariate. Each simulated study consisted of 500 individuals. Thirty studies were simulated. The covariate of interest was dose which could range from 0 to 20 units. The data were simulated with the dose being related to the outcome according to an E (max) model on the logit scale. A logit E (max) model (correct model) and a logit linear model (wrong model) were fitted to all data sets. The performance of the above diagnostics, in addition to simple binning, was compared. For all designs the proposed diagnostics performed at least as well and in many instances better than simple binning. In case of design 1 random binning and simple binning are identical. In the case of designs 2 and 3 random binning and simplified Bayes marginal model plots were superior in assessing the model fit when compared to simple binning. For the examples tested

  2. Data mining approach to the evaluation of diagnostic tests in Wilson disease

    Science.gov (United States)

    Plutecki, Michal M.; Dądalski, Maciej; Socha, Piotr; Mulawka, Jan J.

    2009-06-01

    The purpose of this paper is to figure out a new, better than so-far-known, evaluation method of diagnostic tests in Wilson disease. In order to find the most interesting classification models various data mining techniques were applied to real, suffering from Wilson disease, set of patients. It occurred that a combination of two classification algorithms with its implementations in Weka environment may significantly increase classification ability.

  3. Compression evaluation of surgery video recordings retaining diagnostic credibility (compression evaluation of surgery video)

    Science.gov (United States)

    Duplaga, M.; Leszczuk, M. I.; Papir, Z.; Przelaskowski, A.

    2008-12-01

    Wider dissemination of medical digital video libraries is affected by two correlated factors, resource effective content compression that directly influences its diagnostic credibility. It has been proved that it is possible to meet these contradictory requirements halfway for long-lasting and low motion surgery recordings at compression ratios close to 100 (bronchoscopic procedures were a case study investigated). As the main supporting assumption, it has been accepted that the content can be compressed as far as clinicians are not able to sense a loss of video diagnostic fidelity (a visually lossless compression). Different market codecs were inspected by means of the combined subjective and objective tests toward their usability in medical video libraries. Subjective tests involved a panel of clinicians who had to classify compressed bronchoscopic video content according to its quality under the bubble sort algorithm. For objective tests, two metrics (hybrid vector measure and hosaka Plots) were calculated frame by frame and averaged over a whole sequence.

  4. A Comprehensive Diagnostic Framework for Evaluating Business Intelligence and Analytics Effectiveness

    Directory of Open Access Journals (Sweden)

    Neil Foshay

    2015-09-01

    Full Text Available Business intelligence and analytics (BIA initiatives are costly, complex and experience high failure rates. Organizations require effective approaches to evaluate their BIA capabilities in order to develop strategies for their evolution. In this paper, we employ a design science paradigm to develop a comprehensive BIA effectiveness diagnostic (BIAED framework that can be easily operationalized. We propose that a useful BIAED framework must assess the correct factors, should be deployed in the proper process context and acquire the appropriate input from different constituencies within an organization. Drawing on the BIAED framework, we further develop an online diagnostic toolkit that includes a comprehensive survey instrument. We subsequently deploy the diagnostic mechanism within three large organizations in North America (involving over 1500 participants and use the results to inform BIA strategy formulation. Feedback from participating organizations indicates that BIA diagnostic toolkit provides insights that are essential inputs to strategy development. This work addresses a significant research gap in the area of BIA effectiveness assessment.

  5. Diagnostic Value of Contrast-Enhanced Ultrasound Evaluation of Malignant and Benign Solitary Thyroid Nodules

    Directory of Open Access Journals (Sweden)

    Priedītis Pēteris

    2016-02-01

    Full Text Available The aim of the study was to investigate the diagnostic value of contrast-enhanced ultrasound (CEUS in differentiating benign and malignant thyroid nodules. Thirty-five patients with morphologically proved thyroid nodules (17 malignant; 18 benign, underwent CEUS examination. Five enhancement patterns were evaluated: vascularisation, homogeneity, presence of peripheral rim type enhancement, wash-out rate of the contrast medium, and enhancement using microvascular imaging application. Time-intensity curves (TIC were analysed in post-processing and defined as three types: slow versus rapid and stable versus rapid biphasic wash-out. Diagnostic value of the listed CEUS parameters was calculated. The results showed medium strength correlation between morphology (benign versus malignant nodule and type of TIC curve rs = 0.38 (p = 0.021, as well as between mode of contrast enhancement rs = 0.39 (p = 0.022 and wash-out pattern rs =0.39 (p = 0.024. The overall pooled sensitivity of selected diagnostic parameters was 82%, specificity 57%, and accuracy 70%. Malignant nodules were characterised by iso- or hypovascular contrast enhancement and slow wash-out, while benign nodules showed hypervascular enhancement with rapid wash-out TIC curve and rim-like pattern. The CEUS patterns significantly differed between malignant and benign thyroid nodules with high diagnostic accuracy. Thus, CEUS has important clinical value as an additional tool to ultrasound and fine needle biopsy.

  6. Therapy Videotape Presentation for Eating Disorder Clients: Development and Evaluation

    OpenAIRE

    Quakenbush, Benita J.

    1998-01-01

    Eating disorder clients show low motivation, poor follow-through, and inordinate premature dropout rates in treatment. Earlier studies support the use of pretherapy training to help clients understand the tasks and challenges of therapy. However, a pretherapy intervention, such as showing prospective clients a video that outlines recovery issues and themes, had not yet been developed specifically for the prevalent, recalcitrant problem of eating disorders. Thus, of particular interest to clin...

  7. The pilot evaluation for the National Evaluation System in South Africa – A diagnostic review of early childhood development

    Directory of Open Access Journals (Sweden)

    Margot Davids

    2015-07-01

    Full Text Available Policymaking in many instances does not follow proper diagnosis of a problem using evidence to justify why particular decisions have been taken. This article describes findings of a diagnostic review of existing challenges facing early childhood development (ECD in South Africa. The review is part of the government’s attempt to use information to drive policy in strategic areas. It is part of the role that the Presidency is seeking to play in ensuring government programmes are evaluated to ensure that money that is spent is spent on programmes that have an impact and that there is value for money. This article summarises the key findings of the diagnostic review that was conducted of policy, services and coordination.The results reveal that a broader definition of ECD programmes is needed to cover all aspects of children’s development, growth and health, from conception to the foundation phase of schooling. Many elements of comprehensive ECD support and services are already in place and some are performing well. However, there are important gaps. Key ECD strategies for the future are identified. The diagnostic evaluation used a variety of methods, including desktop analysis, interviews and data analysis. Issues emerged around how to link the evaluation with other processes in the involved departments. A particular challenge was how to handle the transition to implementation of the findings, as responsibility shifted from the steering committee to the departments. The process worked well despite past challenges with coordination across government.

  8. The pilot evaluation for the National Evaluation System in South Africa – A diagnostic review of early childhood development

    Directory of Open Access Journals (Sweden)

    Margot Davids

    2015-10-01

    Full Text Available Policymaking in many instances does not follow proper diagnosis of a problem using evidence to justify why particular decisions have been taken. This article describes findings of a diagnostic review of existing challenges facing early childhood development (ECD in South Africa. The review is part of the government’s attempt to use information to drive policy in strategic areas. It is part of the role that the Presidency is seeking to play in ensuring government programmes are evaluated to ensure that money that is spent is spent on programmes that have an impact and that there is value for money. This article summarises the key findings of the diagnostic review that was conducted of policy, services and coordination.The results reveal that a broader definition of ECD programmes is needed to cover all aspects of children’s development, growth and health, from conception to the foundation phase of schooling. Many elements of comprehensive ECD support and services are already in place and some are performing well. However, there are important gaps. Key ECD strategies for the future are identified. The diagnostic evaluation used a variety of methods, including desktop analysis, interviews and data analysis. Issues emerged around how to link the evaluation with other processes in the involved departments. A particular challenge was how to handle the transition to implementation of the findings, as responsibility shifted from the steering committee to the departments. The process worked well despite past challenges with coordination across government.

  9. Videotaped recording as a method of participant observation in psychiatric nursing research.

    Science.gov (United States)

    Latvala, E; Vuokila-Oikkonen, P; Janhonen, S

    2000-05-01

    This paper describes videotaped recording as a data collection method when conducting participant observation in a psychiatric nursing study. The videotaped episodes were part of the daily life of psychiatric nursing in a hospital environment. The advantages and limitations of using videotaped recording in nursing research will be discussed. This paper is based on two studies. The data consisted of 21 videotaped episodes of nursing report sessions or interdisciplinary team meetings in the psychiatric clinic of a university hospital. The participants consisted of patients, their significant others, nurses, doctors, social workers and physiotherapists. All videotaped material was transcribed verbatim. An essential advantage of videotaping is that most potentially useful interaction and behaviour can be captured. The advantage in terms of the credibility of videotaping was that the investigator was able to review the same videotaped situations again and again. Videotaped material is rich and provides several possibilities for analysing the data. In these studies data and source triangulation enabled the researchers to reduce personal influence on the results. The investigator must also be aware of the limitations concerning this method. The most essential limitations are mechanical problems and the influence of videotaping on behaviour. Careful ethical considerations are important concerning personal privacy, informed consent and respect for the self-determination of psychiatric patients.

  10. ARM Data-Oriented Metrics and Diagnostics Package for Climate Model Evaluation Value-Added Product

    Energy Technology Data Exchange (ETDEWEB)

    Zhang, Chengzhu [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States); Xie, Shaocheng [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States)

    2017-10-15

    A Python-based metrics and diagnostics package is currently being developed by the U.S. Department of Energy (DOE) Atmospheric Radiation Measurement (ARM) Infrastructure Team at Lawrence Livermore National Laboratory (LLNL) to facilitate the use of long-term, high-frequency measurements from the ARM Facility in evaluating the regional climate simulation of clouds, radiation, and precipitation. This metrics and diagnostics package computes climatological means of targeted climate model simulation and generates tables and plots for comparing the model simulation with ARM observational data. The Coupled Model Intercomparison Project (CMIP) model data sets are also included in the package to enable model intercomparison as demonstrated in Zhang et al. (2017). The mean of the CMIP model can serve as a reference for individual models. Basic performance metrics are computed to measure the accuracy of mean state and variability of climate models. The evaluated physical quantities include cloud fraction, temperature, relative humidity, cloud liquid water path, total column water vapor, precipitation, sensible and latent heat fluxes, and radiative fluxes, with plan to extend to more fields, such as aerosol and microphysics properties. Process-oriented diagnostics focusing on individual cloud- and precipitation-related phenomena are also being developed for the evaluation and development of specific model physical parameterizations. The version 1.0 package is designed based on data collected at ARM’s Southern Great Plains (SGP) Research Facility, with the plan to extend to other ARM sites. The metrics and diagnostics package is currently built upon standard Python libraries and additional Python packages developed by DOE (such as CDMS and CDAT). The ARM metrics and diagnostic package is available publicly with the hope that it can serve as an easy entry point for climate modelers to compare their models with ARM data. In this report, we first present the input data, which

  11. The diagnostic work up of growth failure in secondary health care; An evaluation of consensus guidelines

    Directory of Open Access Journals (Sweden)

    Dekker Friedo W

    2008-05-01

    Full Text Available Abstract Background As abnormal growth might be the first manifestation of undetected diseases, it is important to have accurate referral criteria and a proper diagnostic work-up. In the present paper we evaluate the diagnostic work-up in secondary health care according to existing consensus guidelines and study the frequency of underlying medical disorders. Methods Data on growth and additional diagnostic procedures were collected from medical records of new patients referred for short stature to the outpatient clinics of the general paediatric departments of two hospitals (Erasmus MC – Sophia Children's Hospital, Rotterdam and Spaarne Hospital, Haarlem between January 1998 and December 2002. As the Dutch Consensus Guideline (DCG is the only guideline addressing referral criteria as well as diagnostic work-up, the analyses were based on its seven auxological referral criteria to determine the characteristics of children who are incorrectly referred and the adequacy of workup of those who are referred. Results Twenty four percent of children older than 3 years were inappropriately referred (NCR. Of the correctly referred children 74–88% were short corrected for parental height, 40–61% had a height SDS Conclusion Existing guidelines for workup of children with suspected growth failure are poorly implemented. Although poorly implemented the DCG detects at least 5% pathologic causes of growth failure in children referred for short stature. New guidelines for referral are required with a better sensitivity and specificity, wherein distance to target height should get more attention. The general diagnostic work up for short stature should include testing for celiac disease in all children and for Turner syndrome in girls.

  12. Recommendations for CSF AD biomarkers in the diagnostic evaluation of dementia

    DEFF Research Database (Denmark)

    Simonsen, Anja Hviid; Herukka, Sanna-Kaisa; Andreasen, Niels

    2017-01-01

    This article presents recommendations, based on the Grading of Recommendations, Assessment, Development, and Evaluation method, for the clinical application of cerebrospinal fluid (CSF) amyloid-β1-42, tau, and phosphorylated tau in the diagnostic evaluation of patients with dementia. The recommen......This article presents recommendations, based on the Grading of Recommendations, Assessment, Development, and Evaluation method, for the clinical application of cerebrospinal fluid (CSF) amyloid-β1-42, tau, and phosphorylated tau in the diagnostic evaluation of patients with dementia....... The recommendations were developed by a multidisciplinary working group based on the available evidence and consensus from focused discussions for (i) identification of Alzheimer's disease (AD) as the cause of dementia, (ii) prediction of rate of decline, (iii) cost-effectiveness, and (iv) interpretation of results....... The working group found sufficient evidence to support a recommendation to use CSF AD biomarkers as a supplement to clinical evaluation, particularly in uncertain and atypical cases, to identify or exclude AD as the cause of dementia. Because of insufficient evidence, it was uncertain whether CSF AD...

  13. Prospective evaluation of serum glial fibrillary acidic protein (GFAP) as a diagnostic marker for glioblastoma.

    Science.gov (United States)

    Tichy, Julia; Spechtmeyer, Sabrina; Mittelbronn, Michel; Hattingen, Elke; Rieger, Johannes; Senft, Christian; Foerch, Christian

    2016-01-01

    Glioblastoma (GBM) is the most common malignant primary brain tumor. Although clinical presentation and brain imaging might be suggestive, histopathological evaluation by means of a brain biopsy is routinely performed to establish the diagnosis. A serum marker indicative of GBM may simplify the diagnostic work-up of patients suspected to having a brain tumor. We prospectively examined 113 patients with newly diagnosed single supratentorial or infratentorial space-occupying brain lesions. Glial fibrillary acidic protein (GFAP) levels were determined from venous blood samples via a prototype ELISA assay prior to any invasive procedures. Serum levels of GFAP were correlated with histopathological findings and MRI parameters. GFAP values were significantly higher in GBM patients (n = 33) compared to all other tumors (p diagnostic accuracy. Serum GFAP levels in GBM patients were positively correlated with tumor volume and histopathological tumor characteristics.

  14. Diagnostic tests and algorithms used in the investigation of haematuria: systematic reviews and economic evaluation.

    Science.gov (United States)

    Rodgers, M; Nixon, J; Hempel, S; Aho, T; Kelly, J; Neal, D; Duffy, S; Ritchie, G; Kleijnen, J; Westwood, M

    2006-06-01

    To determine the most effective diagnostic strategy for the investigation of microscopic and macroscopic haematuria in adults. Electronic databases from inception to October 2003, updated in August 2004. A systematic review was undertaken according to published guidelines. Decision analytic modelling was undertaken, based on the findings of the review, expert opinion and additional information from the literature, to assess the relative cost-effectiveness of plausible alternative tests that are part of diagnostic algorithms for haematuria. A total of 118 studies met the inclusion criteria. No studies that evaluated the effectiveness of diagnostic algorithms for haematuria or the effectiveness of screening for haematuria or investigating its underlying cause were identified. Eighteen out of 19 identified studies evaluated dipstick tests and data from these suggested that these are moderately useful in establishing the presence of, but cannot be used to rule out, haematuria. Six studies using haematuria as a test for the presence of a disease indicated that the detection of microhaematuria cannot alone be considered a useful test either to rule in or rule out the presence of a significant underlying pathology (urinary calculi or bladder cancer). Forty-eight of 80 studies addressed methods to localise the source of bleeding (renal or lower urinary tract). The methods and thresholds described in these studies varied greatly, precluding any estimate of a 'best performance' threshold that could be applied across patient groups. However, studies of red blood cell morphology that used a cut-off value of 80% dysmorphic cells for glomerular disease reported consistently high specificities (potentially useful in ruling in a renal cause for haematuria). The reported sensitivities were generally low. Twenty-eight studies included data on the accuracy of laboratory tests (tumour markers, cytology) for the diagnosis of bladder cancer. The majority of tumour marker studies

  15. Research waste in diagnostic trials: a methods review evaluating the reporting of test-treatment interventions

    Directory of Open Access Journals (Sweden)

    Lavinia Ferrante di Ruffano

    2017-02-01

    Full Text Available Abstract Background The most rigorous method for evaluating the effectiveness of diagnostic tests is through randomised trials that compare test-treatment interventions: complex interventions comprising episodes of testing, decision-making and treatment. The multi-staged nature of these interventions, combined with the need to relay diagnostic decision-making and treatment planning, has led researchers to hypothesise that test-treatment strategies may be very challenging to document. However, no reviews have yet examined the reporting quality of interventions used in test-treatment RCTs. In this study we evaluate the completeness of intervention descriptions in a systematically identified cohort of test-treatment RCTs. Methods We ascertained all test-treatment RCTs published 2004–2007, indexed in CENTRAL. Included trials randomized patients to diagnostic tests and measured patient outcomes after treatment. Two raters examined the completeness of test-treatment intervention descriptions in four components: 1 the test, 2 diagnostic decision-making, 3 management decision-making, 4 treatments. Results One hundred and three trials compared 105 control with 119 experimental interventions, most commonly in cardiovascular medicine (35, 34%, obstetrics and gynecology (17%, gastroenterology (14% or orthopedics (10%. A broad range of tests were evaluated, including imaging (50, 42%, biochemical assays (21% and clinical assessment (12%. Only five (5% trials detailed all four components of experimental and control interventions, none of which also provided a complete care pathway diagram. Experimental arms were missing descriptions of tests, diagnostic-decision making, management planning and treatments (36%, 51%, 55% and 79% of trials respectively; control arms were missing the same details in 61%, 66%, 67% and 84% of trials. Conclusion Reporting of test-treatment interventions is very poor, inadequate for understanding the results of these trials, and

  16. Evaluation of prenatal and postnatal diagnostic criteria for twin anemia-polycythemia sequence.

    Science.gov (United States)

    Veujoz, Marine; Sananès, Nicolas; Severac, François; Meyer, Nicolas; Weingertner, Anne-Sophie; Kohler, Monique; Guerra, Fernando; Gaudineau, Adrien; Nisand, Israël; Favre, Romain

    2015-03-01

    The aim of this study is to analyze the relevance of the prenatal and postnatal diagnostic parameters of twin anemia-polycythemia sequence (TAPS). Diagnostic data of all cases of TAPS followed in our institution between 2006 and 2013 were reviewed. Statistical analyses were conducted using Bayesian methods. Twenty cases of TAPS were included. We found a relationship between the hemoglobin level and the middle cerebral artery peak systolic velocity (coefficient -0.25 [-0.34, -0.15], Pr(coef  1) = 14.8%)], the mean diameter (OR = 0.98 [0.32, 3.06], Pr(OR > 1) = 48.9%), or the total diameter (OR = 0.79 [0.36, 1.53], Pr(OR > 1) = 26.3%) of arteriovenous anastomoses and the severity of TAPS. Middle cerebral artery peak systolic velocity is a reliable tool for estimating the hemoglobin level in cases of TAPS. The correspondence between prenatal and postnatal diagnosis is imperfect. Further studies are required to evaluate opportunity of widening postnatal diagnostic criteria. © 2014 John Wiley & Sons, Ltd. © 2014 John Wiley & Sons, Ltd.

  17. Aligning the flow cytometric evaluation with the diagnostic need: an evidence-based approach.

    Science.gov (United States)

    Williams-Voorbeijpel, Dawn; Sanchez, Francisco; Roth, Christine G

    2017-09-01

    Elimination of non-value added testing without compromising high-quality clinical care is an important mandate for laboratories in a value-based reimbursement system. The goal of this study was to determine the optimal combination of flow cytometric markers for a screening approach that balances efficiency and accuracy. An audit over 9 months of flow cytometric testing was performed, including rereview of all dot plots from positive cases. Of the 807 cases in which leukaemia/lymphoma testing was performed, 23 were non-diagnostic and 189 represented bronchoalveolar lavage specimens. Of the remaining 595 cases, 137 (23%) were positive for an abnormal haematolymphoid population. Review of the positive cases identified minimum requirements for a screening tube as well as analysis strategies to overcome the diagnostic pitfalls noted. It is estimated that 38% fewer antibodies would be used in a screening approach, representing an opportunity for significant cost savings. We provide a framework for developing an evidence-based screening combination for cost-effective characterisation of haematolymphoid malignancies, promoting adoption of 'just-in-time' testing systems that tailor the evaluation to the diagnostic need. 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/.

  18. Evaluation of the diagnostic efficacy of Fasciola adult worm vomit for serodiagnosis of human fasciolosis.

    Science.gov (United States)

    Elsibaei, Mahmoud Mohamed; Ali, Nehad Mahmoud; Ibrahim, Ayman Nabil; Mohammed, Basant Osama

    2013-05-01

    The diagnostic efficacy of Fasciola gigantica adult worm vomit (AWV) preparation in diagnosis of human fasciolosis was evaluated using conventional enzyme-linked immunosorbent assay (ELISA) and Falcon assay screening test (FAST)-ELISA in comparison with F. gigantica adult total soluble extract (TSE). Sera of fasciolosis patients, patients with other parasitic diseases (hydatid disease, schistosomiasis, toxoplasmosis, and amebiasis), and sera of healthy individuals were enrolled in this study. The results showed that the sensitivity of both conventional ELISA and FAST-ELISA was improved from 95 % using TSE to 100 % when using AWV. The specificity of conventional ELISA was 93.3 % using TSE and increased to 96.7 % using AWV. The specificity of FAST-ELISA using TSE was 96.7 % and became 100 % AWV antigen. The diagnostic accuracy of conventional ELISA was 94 % using TSE and increased to 98 % using AWV. The diagnostic accuracy of FAST-ELISA was 96 % using TSE and increased to 100 % using AWV. It is concluded that both TSE and AWV antigenic preparations are efficient for use in the serodiagnosis of human fasciolosis.

  19. [Implication of inverse-probability weighting method in the evaluation of diagnostic test with verification bias].

    Science.gov (United States)

    Kang, Leni; Zhang, Shaokai; Zhao, Fanghui; Qiao, Youlin

    2014-03-01

    To evaluate and adjust the verification bias existed in the screening or diagnostic tests. Inverse-probability weighting method was used to adjust the sensitivity and specificity of the diagnostic tests, with an example of cervical cancer screening used to introduce the Compare Tests package in R software which could be implemented. Sensitivity and specificity calculated from the traditional method and maximum likelihood estimation method were compared to the results from Inverse-probability weighting method in the random-sampled example. The true sensitivity and specificity of the HPV self-sampling test were 83.53% (95%CI:74.23-89.93)and 85.86% (95%CI: 84.23-87.36). In the analysis of data with randomly missing verification by gold standard, the sensitivity and specificity calculated by traditional method were 90.48% (95%CI:80.74-95.56)and 71.96% (95%CI:68.71-75.00), respectively. The adjusted sensitivity and specificity under the use of Inverse-probability weighting method were 82.25% (95% CI:63.11-92.62) and 85.80% (95% CI: 85.09-86.47), respectively, whereas they were 80.13% (95%CI:66.81-93.46)and 85.80% (95%CI: 84.20-87.41) under the maximum likelihood estimation method. The inverse-probability weighting method could effectively adjust the sensitivity and specificity of a diagnostic test when verification bias existed, especially when complex sampling appeared.

  20. Evaluating operational specifications of point-of-care diagnostic tests: a standardized scorecard.

    Science.gov (United States)

    Lehe, Jonathan D; Sitoe, Nádia E; Tobaiwa, Ocean; Loquiha, Osvaldo; Quevedo, Jorge I; Peter, Trevor F; Jani, Ilesh V

    2012-01-01

    The expansion of HIV antiretroviral therapy into decentralized rural settings will increasingly require simple point-of-care (POC) diagnostic tests that can be used without laboratory infrastructure and technical skills. New POC test devices are becoming available but decisions around which technologies to deploy may be biased without systematic assessment of their suitability for decentralized healthcare settings. To address this, we developed a standardized, quantitative scorecard tool to objectively evaluate the operational characteristics of POC diagnostic devices. The tool scores devices on a scale of 1-5 across 30 weighted characteristics such as ease of use, quality control, electrical requirements, shelf life, portability, cost and service, and provides a cumulative score that ranks products against a set of ideal POC characteristics. The scorecard was tested on 19 devices for POC CD4 T-lymphocyte cell counting, clinical chemistry or hematology testing. Single and multi-parameter devices were assessed in each of test categories. The scores across all devices ranged from 2.78 to 4.40 out of 5. The tool effectively ranked devices within each category (p0.80; ptechnology. It is particularly relevant for countries and testing programs considering the adoption of new POC diagnostic tests.

  1. Evaluation of diagnostic ability of CCD digital radiography in the detection of incipient dental caries

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Wan; Lee, Byung Do [Wonkwang University College of Medicine, Iksan (Korea, Republic of)

    2003-03-15

    The purpose of this experiment was to evaluate the diagnostic ability of a CCD-based digital system (CDX-2000HQ) in the detection of incipient dental caries. 93 extracted human teeth with sound proximal surfaces and interproximal artificial cavities were radiographed using 4 imaging methods. Automatically processed No.2 Insight film (Eastman Kodak Co., U.S.A.) was used for conventional radiography, scanned images of conventional radiograms for indirect digital radiography were used. For the direct digital radiography, the CDX-2000HQ CCD system (Biomedisys Co. Korea) was used. The subtraction images were made from two direct digital images by Sunny program in the CDX-2000HQ system. Two radiologists and three endodontists examined the presence of lesions using a five-point confidence scale and compared the diagnostic ability by ROC (Receiver Operating Characteristic) analysis and one way ANOVA test. The mean ROC areas of conventional radiography, indirect digital radiography, direct digital radiography, and digital subtraction radiography were 0.9093, 0.9102, 0.9184, and 0.9056, respectively. The diagnostic ability of direct digital radiography was better than the other imaging modalities, but there were no statistical differences among these imaging modalities (p>0.05). These results indicate that new CCD-based digital systems (CDX-2000HQ) have the potential to serve as an alternative to conventional radiography in the detection of incipient dental caries.

  2. The efficacy of videotape feedback for enhancing the effects of exposure-based treatment for social anxiety disorder: A controlled investigation

    NARCIS (Netherlands)

    Smits, J.A.J.; Powers, M.B.; Buxkamper, R.; Telch, M.J.

    2006-01-01

    Correcting patients' faulty beliefs concerning social evaluative threats is the hallmark of cognitive-behavioral treatment of social anxiety disorder. The current study examined the efficacy of two videotape feedback procedures as adjuncts to exposure-based treatment. Participants suffering from

  3. Method for Evaluating Information to Solve Problems of Control, Monitoring and Diagnostics

    Science.gov (United States)

    Vasil'ev, V. A.; Dobrynina, N. V.

    2017-06-01

    The article describes a method for evaluating information to solve problems of control, monitoring and diagnostics. It is necessary for reducing the dimensionality of informational indicators of situations, bringing them to relative units, for calculating generalized information indicators on their basis, ranking them by characteristic levels, for calculating the efficiency criterion of a system functioning in real time. The design of information evaluation system has been developed on its basis that allows analyzing, processing and assessing information about the object. Such object can be a complex technical, economic and social system. The method and the based system thereof can find a wide application in the field of analysis, processing and evaluation of information on the functioning of the systems, regardless of their purpose, goals, tasks and complexity. For example, they can be used to assess the innovation capacities of industrial enterprises and management decisions.

  4. Prospective evaluation of three rapid diagnostic tests for diagnosis of human leptospirosis.

    Directory of Open Access Journals (Sweden)

    Marga G A Goris

    Full Text Available BACKGROUND: Diagnosis of leptospirosis by the microscopic agglutination test (MAT or by culture is confined to specialized laboratories. Although ELISA techniques are more common, they still require laboratory facilities. Rapid Diagnostic Tests (RDTs can be used for easy point-of-care diagnosis. This study aims to evaluate the diagnostic performance of the RDTs LeptoTek Dri Dot, LeptoTek Lateral Flow, and Leptocheck-WB, prospectively. METHODOLOGY: During 2001 to 2012, one or two of the RDTs at the same time have been applied prior to routine diagnostics (MAT, ELISA and culture on serum specimens from participants sent in for leptospirosis diagnosis. The case definition was based on MAT, ELISA and culture results. Participants not fulfilling the case definition were considered not to have leptospirosis. The diagnostic accuracy was determined based on the 1(st submitted sample and paired samples, either in an overall analysis or stratified according to days post onset of illness. RESULTS: The overall sensitivity and specificity for the LeptoTek Dri Dot was 75% respectively 96%, for the LeptoTek Lateral Flow 78% respectively 95%, and for the Leptocheck-WB 78% respectively 98%. Based on the 1(st submitted sample the sensitivity was low (51% for LeptoTek Dri Dot, 69% for LeptoTek Lateral Flow, and 55% for Leptocheck-WB, but substantially increased when the results of paired samples were combined, although accompanied by a lower specificity (82% respectively 91% for LeptoTek Dri Dot, 86% respectively 84% for LeptoTek Lateral Flow, and 80% respectively 93% for Leptocheck-WB. CONCLUSIONS: All three tests present antibody tests contributing to the diagnosis of leptospirosis, thus supporting clinical suspicion and contributing to awareness. Since the overall sensitivity of the tested RDTs did not exceed 80%, one should be cautious to rely only on an RDT result, and confirmation by reference tests is strongly recommended.

  5. Laboratory evaluation of immunochromatographic rapid diagnostic tests for cholera in Haiti.

    Directory of Open Access Journals (Sweden)

    Wilfredo R Matias

    Full Text Available Rapid diagnostic tests (RDT for cholera are promising tools for detecting cholera in areas with limited laboratory infrastructure. However, evidence on the characteristics of the many available RDTs is scarce, and their use has been limited by suboptimal performance. We evaluated the performance characteristics of three cholera RDTs from Span Diagnostics, Artron Laboratories, and Standard Diagnostics in a regional laboratory in Haiti.We retrospectively reviewed records from May 2014 to October 2015 of a laboratory-based surveillance program for Vibrio cholerae at Hôpital Saint-Nicolas in Saint-Marc, Haiti. We compared the results of 511 Crystal VC, 129 Artron and 451 SD Bioline RDTs to bacterial culture as the gold standard. Of 905 cultures, 477 (52.7% were positive for V. cholerae O1, of which 27.7% were serotype Inaba. No cultures grew V. cholerae O139. Sensitivity and specificity of Crystal VC were 98.6% (95%CI: 96.5%-99.6% and 71.1% (95%CI: 64.7%-76.9%, respectively. Artron demonstrated a sensitivity of 98.6% (95%CI: 92.7%-100% and specificity of 69.1% (95%CI: 55.2%-80.9%. SD Bioline demonstrated a sensitivity of 81.1% (95%CI: 75.6%-85.8% and specificity of 92.8% (95%CI: 88.4%-95.9%. Crystal VC and Artron frequently showed false positive O139 bands, whereas none were seen with SD Bioline.There is significant variation in the performance of different cholera diagnostic RDTs. Artron and Crystal VC RDTs have high sensitivity and low specificity, while SD Bioline RDT has low to moderate sensitivity and high specificity when performed by laboratory technicians in Haiti. Study limitations included its retrospective design. The suboptimal characteristics of these tests limit their use as clinical point-of-care tests; however, they may be useful in outbreak response, surveillance, and research in resource-limited settings.

  6. Evaluation of the diagnostic advantage of intraoral D and E film for detecting interproximal caries.

    Science.gov (United States)

    Ardakani, Fatemeh Ezoddini; Davari, Abdolrahim; Goodarzipour, Daryoush; Goodarzipour, Koorosh; Fallahzadeh, Hossein

    2004-11-15

    Clinicians strive to reduce the exposure of patients to X-ray radiation in an effort to decrease its harmful effects on the body. A potential strategy for achieving this goal is the use of high-speed films that require less exposure to radiation to generate a diagnostic image. There are two film types commonly used in intraoral radiography: high speed or "Ekta-speed" film (Type E) and normal speed or Ultra-speed film (Type D). Type E film requires nearly half of the exposure time that is required by Type D films to produce an acceptable diagnostic image; however, the diagnosis quality and usability of these film types are under question. The purpose of this research is to compare the diagnostic quality of Type E with Type D film when used to diagnose proximal caries. In this study 40 pairs of extracted maxillary premolar teeth were chosen and divided into four groups of 10 pairs. Cavities were made on proximal surfaces at different depths (0.5, 1, 1.5, and 2 mm) for each group. Bitewing radiographs were then taken on each pair of teeth using Type E film and then again using Type D film. Radiographs were evaluated by two oral radiologists and two operative dentistry specialists who recorded the perceived diagnostic depth of the prepared cavities. Our data showed both Type D and E films are suitable for use in diagnosing proximal caries, and despite a minor discrepancy between them no significant difference was found with regard to their value in diagnosing proximal caries.

  7. Recommendations for cerebrospinal fluid Alzheimer's disease biomarkers in the diagnostic evaluation of mild cognitive impairment

    DEFF Research Database (Denmark)

    Herukka, Sanna-Kaisa; Simonsen, Anja Hviid; Andreasen, Niels

    2017-01-01

    impairment (MCI). The recommendations were developed by a multidisciplinary working group and based on the available evidence and consensus from focused group discussions for 1) prediction of clinical progression to Alzheimer's disease (AD) dementia, 2) cost-effectiveness, 3) interpretation of results, and 4......) patient counseling. The working group recommended using CSF AD biomarkers in the diagnostic workup of MCI patients, after prebiomarker counseling, as an add-on to clinical evaluation to predict functional decline or conversion to AD dementia and to guide disease management. Because of insufficient...

  8. Evaluation of oral submucous fibrosis using ultrasonographic technique: A new diagnostic tool

    Directory of Open Access Journals (Sweden)

    K Manjunath

    2011-01-01

    Full Text Available Aim: The aim of this study is to evaluate oral submucous fibrosis (OSMF by clinical and histopathological examination, and compare the results with those from ultrasonographic technique. Materials and Methods: 30 clinically diagnosed OSMF patients were subjected to both ultrasonographic and histopathological evaluation before treatment. Later, only ultrasonographical examination was done during 4 th and 8 th week of treatment. Prognosis of the lesion for the treatment was evaluated. Peak systolic velocity (PSV of blood in the lesional area was statistically analyzed. 10 normal individuals without any mucosal lesions were considered as the control group. Results: In normal individuals, ultrasonography delineates normal mucosa with uniform fine mottled appearance with interspersed hypoechoic areas. Color Doppler and spectral Doppler depicts uniform distribution of blood vessels and normal peak systolic velocity of blood respectively. All OSMF patients were diagnosed upon clinical and histopathological examination. Clinical examination revealed 14 individuals with unilateral palpable fibrotic bands and 16 individuals with bilateral fibrotic bands whereas, ultrasonographic evaluation revealed 6 individuals with unilateral fibrotic bands and 24 individuals were with bilateral fibrotic bands, which was statistically significant. Ultrasonography demonstrated number, length and thickness of the fibrotic bands. Color Doppler and spectral Doppler showed decreased vascularity and PSV in lesional area. Prognosis evaluation revealed 25 cases of good prognosis and 5 cases were showed poor prognosis. Wilcoxon Signed Ranks Test revealed no significant difference of PSV was seen in poor prognosis patients. Conclusion: Ultrasonography is a non-invasive diagnostic tool for OSMF. It could be a better diagnostic tool compared to clinical and histopathological examination.

  9. Application of a model based on fuzzy logic for evaluating nursing diagnostic accuracy of students.

    Science.gov (United States)

    Lopes, Maria Helena Baena de Moraes; Jensen, Rodrigo; da Cruz, Diná de Almeida Lopes Monteiro; Matos, Fabiana Gonçalves de Oliveira Azevedo; Silveira, Paulo Sérgio Panse; Ortega, Neli Regina Siqueira

    2013-09-01

    To describe a model for assessing nursing diagnostic accuracy and its application to undergraduate students, comparing students' performance according to the course year. This model, based on the theory of fuzzy sets, guides a student through three steps: (a) the student must parameterize the model by establishing relationship values between defining characteristic/risk factors and nursing diagnoses; (b) presentation of a clinical case; (c) the student must define the presence of each defining characteristic/risk factors for the clinical case. Subsequently, the model computes the most plausible diagnoses by taking into account the values indicated by the student. This gives the student a performance score in comparison with parameters and diagnoses that were previously provided by nursing experts. These nursing experts collaborated with the construction of the model indicating the strength of the relationship between the concepts, meaning, they parameterized the model to compare the student's choice with the expert's choice (gold standard), thus generating performance scores for the student. The model was tested using three clinical cases presented to 38 students in their third and fourth years of the undergraduate nursing course. Third year students showed superior performance in identifying the presence of defining characteristic/risk factors, while fourth year students showed superior performance in the diagnoses by the model. The Model for Evaluation of Diagnostic Accuracy Based on Fuzzy Logic applied in this study is feasible and can be used to evaluate students' performance. In this regard, it will open a broad variety of applications for learning and nursing research. Despite the ease in filling the printed questionnaires out, the number of steps and fields to fill in may explain the considerable number of questionnaires with incorrect or missing data. This was solved in the digital version of the questionnaire. In addition, in more complex cases, it is

  10. The diagnostic utility of a genetics evaluation in children with pervasive developmental disorders.

    Science.gov (United States)

    Abdul-Rahman, Omar A; Hudgins, Louanne

    2006-01-01

    A genetics evaluation of children with pervasive developmental disorders (PDDs) identifies a diagnosis in 6% to 15% of cases. However, previous studies have not measured the incidence of genetic disorders among children with autistic-like features who do not necessarily meet the Diagnostic and Statistical Manual for Mental Disorders, Fourth Edition criteria for PDD. We identified 101 patients at our institution referred for PDD, autism, Asperger syndrome, or autistic features. Seventy-eight were males and 23 were females, giving a male-to-female ratio of 3.4:1. No diagnosis was identified on examination alone, although Rett syndrome was suspected in six females. Seventeen patients did not undergo any type of testing because of noncompliance. Of the remaining 84 patients analyzed, seven (8.3%) were found to have abnormalities on testing. Three chromosomal anomalies were found: one with 5p duplication, one with low-level mosaicism for trisomy 21, and one with an unbalanced 10;22 translocation. Three females were diagnosed with Rett syndrome after MECP2 analysis identified a disease-causing mutation. The remaining patient was found to have an elevated urine orotic acid, with a normal ammonia level, of unknown significance. On the basis of our series, the yield of a genetics evaluation in patients with features of PDD who do not necessarily meet the Diagnostic and Statistical Manual for Mental Disorders, Fourth Edition criteria is 8.3%. Approximately half of these were the result of a chromosomal abnormality. Three cases of Rett syndrome were identified for which autistic behaviors are a well-described feature. These findings suggest that a high-resolution karyotype provides the greatest diagnostic yield for patients with autistic-like features. MECP2 analysis should be considered for females who present with autistic behaviors.

  11. Maladaptive eating behavior assessment among bariatric surgery candidates: Evaluation of the Eating Disorder Diagnostic Scale.

    Science.gov (United States)

    Williams, Gail A; Hawkins, Misty A W; Duncan, Jennifer; Rummell, Christina M; Perkins, Shannon; Crowther, Janis H

    2017-07-01

    Eating pathology among bariatric surgery candidates is common and associated with adverse outcomes. However, its assessment is complicated by the inconsistent use of standardized measures. We addressed this by examining the use of the Eating Disorder Diagnostic Scale (EDDS) in a large bariatric sample (N = 343). To evaluate the EDDS among bariatric surgery candidates via examination of: (1) Diagnostic and Statistical Manual of Mental Disorders, fourth edition, text revision (DSM-IV-TR) and fifth edition (DSM-5) rates of binge eating disorder, bulimia nervosa, and maladaptive eating behaviors, and (2) the relationship between response biases and self-reported eating disorder symptoms. Participants were bariatric surgery candidates at a large public hospital in the Midwest. As part of a larger preoperative evaluation, 343 patients seeking bariatric surgery completed the EDDS and measures of problematic response bias. Approximately 16% of the sample met full threshold criteria for binge eating disorder using DSM-5 criteria. Using the DSM-IV-TR, rates were lower but still substantial at 13%. Rates for bulimia nervosa were 8% (DSM-5) and 6% (DSM-IV-TR). The majority (66.1%) of participants reported at least one binge-eating episode per week. The most commonly used compensatory behavior was fasting (20.4%), followed by excessive exercise (11.7%), laxative use (5.6%), and vomiting (1.8%). An inverse relationship between severity of the eating symptomatology and problematic response bias emerged. The EDDS shows promise as a screening tool that uses diagnostic criteria to provide rates of binge eating and eating psychopathology among surgical candidates. Our findings suggest that subsequent validation studies of this measure are needed, should address potential response bias concerns, and should employ clear definitions of binge eating to promote standardization of eating pathology assessment in the bariatric population. Copyright © 2017 American Society for Bariatric

  12. Impact of customized videotape education on quality of life in patients with chronic obstructive pulmonary disease.

    Science.gov (United States)

    Petty, Thomas L; Dempsey, Edward C; Collins, Timothy; Pluss, William; Lipkus, Isaac; Cutter, Gary R; Chalmers, Robin; Mitchell, Amy; Weil, Kenneth C

    2006-01-01

    To compare the impact of a library of pulmonary rehabilitation videotapes versus an older videotape and usual care on quality of life and ability to perform activities of daily living in persons with chronic obstructive pulmonary disease. Two hundred fourteen patients diagnosed with chronic obstructive pulmonary disease, emphysema, or chronic bronchitis were recruited and randomized to receive customized videotapes, standard videotapes, or usual care. Outcome measures included the Fatigue Impact Scale, Seattle Obstructive Lung Disease Questionnaire, and the SF-36(R) Health Survey. Differences in coping skills and emotional functioning on the Seattle Obstructive Lung Disease Questionnaire were found among the 174 subjects who completed the study. The customized videotape group improved by 8.6 and 4.8 points, respectively, whereas the score of the other groups decreased by less than 1 point for the coping skills, and the scores of the standard video and the control groups decreased by 3.0 and 2.1 points, respectively, for emotional functioning (P Impact Scale also improved for the customized videotape group, whereas the scores of the others remained unchanged. Videotape users demonstrated better conversion to and retention of exercise habits, with over 80% of customized videotape subjects who reported exercise habits at baseline continuing the habits as compared with 40% in the usual care group. Sedentary subjects at baseline were more likely to begin and maintain exercise if randomized to videotapes. These findings demonstrate increased quality of life, lower fatigue, and better compliance with a prescribed exercise regimen among subjects using the customized videotapes. There was a significant improvement in emotional functioning and coping skills among customized videotape subjects.

  13. Evaluation of a multi-guard ring (MGR) structure diode as diagnostic X-ray dosimeter

    Energy Technology Data Exchange (ETDEWEB)

    Camargo, F. [Instituto de Pesquisas Energeticas e Nucleares IPEN-CNEN/SP, Caixa Postal 11049, Sao Paulo SP 05422-970, Brasil (Brazil); Khoury, H.J.; Nascimento, C.R.; Asfora, V.K. [Universidade Federal de Pernambuco, Av. Prof. Luiz Freire 1000, Recife PE 50740-540, Brasil (Brazil); Bueno, C.C. [Instituto de Pesquisas Energeticas e Nucleares IPEN-CNEN/SP, Caixa Postal 11049, Sao Paulo SP 05422-970, Brasil (Brazil); Pontificia Universidade Catolica de Sao Paulo, Rua Marques de Paranagua 111, Sao Paulo SP 01303-050, Brasil (Brazil)], E-mail: ccbueno@ipen.br

    2007-09-21

    In this paper, we describe the results obtained for the evaluation of a multi-guard ring (MGR) structure diode as diagnostic X-ray dosimeter. This device was developed in the framework of R and D programs for the future CMS experiment at the Large Hadron Collider (LHC) with high radiation hardness to fulfill the requirements from this accelerator environment. In order to use the MGR diode as a dosimeter, it was connected in the photovoltaic mode to the input of an integrating electrometer and positioned at the center of an X-ray beam, beside a previously calibrated ionization chamber. The dependence of the diode response on the X-ray beam doses was evaluated for 35-90 kV X-ray generator bias supply, with doses in the range of 50 {mu}Gy-5 mGy. The good linearity of the dose-response curve obtained showed the MGR diode dosimeter to be a reliable alternative method for diagnostic X-ray dosimetry.

  14. Evaluation of a specific diagnostic marker for rheumatoid arthritis based on cyclic citrullinated peptide.

    Science.gov (United States)

    Park, Min; Pyun, Jae-Chul; Akter, Hafeza; Nguyen, Binh Thanh; Kang, Min-Jung

    2015-11-10

    A specific peptide marker for diagnosing rheumatoid arthritis (RA) was found based on cyclic citrullinated peptide (CCP) using the following three steps: (1) analysis of the binding epitope of autoimmune antibodies using ϵ-aminocaproic acid-modified peptides; (2) RA diagnosis using sequence-modified peptides; and (3) evaluation of the peptides' diagnostic performance for RA diagnosis. Ninety-five serum samples were analyzed by ELISA and compared using MedCalc (version 15.2.1). Microplate binding ϵ-aminocaproic acid was added to the N- or C-terminal of the CCP sequence. The N-terminal anchoring peptide assay showed 15% higher specificity compared with the C-terminal anchoring peptide assay. Based on this result, the hydrophilic C-terminal sequence of CCP was substituted with a hydrophobic amino acid. Among the sequence-modified peptides, CCP11A (in which alanine was substituted for the 11th amino acid of CCP) assay showed the highest sensitivity (87%) and specificity (100%) for RA diagnosis. Thus, CCP11A was selected as a possible specific marker peptide for RA diagnosis and further analyzed. The results of this analysis indicated that CCP11A showed better specificity than the CCP assay in both healthy individuals (11% better) and OA cohort (20% better). From these results, CCP11A was evaluated as a specific marker for diagnosing RA with higher diagnostic performance. Copyright © 2015 The Authors. Published by Elsevier B.V. All rights reserved.

  15. Gender responsiveness diagnostic of national monitoring and evaluation systems – methodological reflections

    Directory of Open Access Journals (Sweden)

    Madri S. Jansen van Rensburg

    2017-04-01

    Full Text Available Background: This article reflects on the implementation of a diagnostic study carried out to understand the gender responsiveness of the national monitoring and evaluation (M&E systems of Benin, South Africa and Uganda. Carrying out the study found that the potential for integrating the cross-cutting systems of gender and monitoring and evaluation (M&E are strong. At the same time, it highlighted a range of challenges intersecting these two areas of work. This article explores these issues, which range from logistical to conceptual.Objectives: This article aims to share reflections from the gender diagnostic study to enable more appropriate capacity building in the field of gender responsiveness in national M&E systems. Developing more sophisticated tools to measure gender responsiveness in complex contexts is critical. A better understanding of how gender and national M&E systems intersect is important to understanding firstly how we can more accurately measure the gender responsiveness of existing systems and secondly how better to engender capacity development initiatives.Method: As part of the Twende Mbele programme, Centre for Learning on Evaluation and Results (CLEAR commissioned Africa Gender and Development Evaluator’s Network (AGDEN to coordinate teams of researchers in Benin, Uganda, and South Africa to collaboratively develop the diagnostic tool, and then implement it by conducting a review of key documentation and to interview officials within the government wide monitoring and evaluation systems as well as the national gender machinery in each country.Results: The study found that the gender responsiveness of M&E systems across all three systems was unequal, but more importantly, it is important to do more work on how M&E and gender are conceptualised, to ensure this can be studied in a more meaningful way. To strengthen national monitoring and evaluation systems, gender responsiveness and equity must serve as a foundation for

  16. [Diagnostic evaluation of the developmental level in children identified at risk of delay through the Child Development Evaluation Test].

    Science.gov (United States)

    Rizzoli-Córdoba, Antonio; Campos-Maldonado, Martha Carmen; Vélez-Andrade, Víctor Hugo; Delgado-Ginebra, Ismael; Baqueiro-Hernández, César Iván; Villasís-Keever, Miguel Ángel; Reyes-Morales, Hortensia; Ojeda-Lara, Lucía; Davis-Martínez, Erika Berenice; O'Shea-Cuevas, Gabriel; Aceves-Villagrán, Daniel; Carrasco-Mendoza, Joaquín; Villagrán-Muñoz, Víctor Manuel; Halley-Castillo, Elizabeth; Sidonio-Aguayo, Beatriz; Palma-Tavera, Josuha Alexander; Muñoz-Hernández, Onofre

    The Child Development Evaluation (or CDE Test) was developed in Mexico as a screening tool for child developmental problems. It yields three possible results: normal, slow development or risk of delay. The modified version was elaborated using the information obtained during the validation study but its properties according to the base population are not known. The objective of this work was to establish diagnostic confirmation of developmental delay in children 16- to 59-months of age previously identified as having risk of delay through the CDE Test in primary care facilities. A population-based cross-sectional study was conducted in one Mexican state. CDE test was administered to 11,455 children 16- to 59-months of age from December/2013 to March/2014. The eligible population represented the 6.2% of the children (n=714) who were identified at risk of delay through the CDE Test. For inclusion in the study, a block randomization stratified by sex and age group was performed. Each participant included in the study had a diagnostic evaluation using the Battelle Development Inventory, 2 nd edition. From the 355 participants included with risk of delay, 65.9% were male and 80.2% were from rural areas; 6.5% were false positives (Total Development Quotient ˃90) and 6.8% did not have any domain with delay (Domain Developmental Quotient Infantil de México Federico Gómez. Publicado por Masson Doyma México S.A. All rights reserved.

  17. Labelling, molecular modelling and biological evaluation of vardenafil: a potential agent for diagnostic evaluation of erectile dysfunction.

    Science.gov (United States)

    El-Kawy, O A; García-Horsman, J A; Tuominen, R K

    2016-12-01

    99mTc-tricarbonyl-vardenafil was specifically radiosynthesized for diagnostic evaluation of erectile dysfunction with a radiochemical yield ~97.2%. It was stable in saline up to 15h and in serum for more than 6h. The radiocomplex was lipophilic with a partition coefficient ~1.32 and plasma protein binding 72-76%. Its structure was determined using molecular mechanics and confirmed by NMR. In-silico docking to its target PDE5 enzyme was performed. The radiocomplex inhibitory activity was assessed and its IC50 was 0.7nM. Biodistribution in normal rats and biological evaluation in rat models of erectile dysfunction were performed. The results strongly suggested that 99mTc-tricarbonyl-vardenafil is a good candidate to image erectile dysfunction in humans. Copyright © 2016 Elsevier Ltd. All rights reserved.

  18. Early Book Stages, 0-5 Years [and] Creciendo con Libros (Growing [up] with Books). [Videotape.

    Science.gov (United States)

    Holguin, Roxanna

    Using a lighthearted and simple approach, this 23-minute videotape in English and Spanish versions presents interactions between parents and children while reading books. The children in the videotape range in age from 0 to 5 years. The video is introduced by scenes of children enjoying books while narration discussing the impact of reading to…

  19. Videotape Helps Standardize and Increase Objectivity of Medical Exams Across the Country

    Science.gov (United States)

    Diefenbach, Robert C.

    1976-01-01

    A 90-minute videotape demonstrates how to stage six stations simulating medical emergency problems to be solved by emergency medical technicians (EMT's) taking the National Registry's 150-question written final examination. The videotape also details the logistics of arranging the entire one-hour examination, used in over 30 States. (AJ)

  20. Comparative Evaluation of the Diagnostic Performance of the Prototype Cepheid GeneXpert Ebola Assay

    Science.gov (United States)

    Jansen van Vuren, Petrus; Grobbelaar, Antoinette; Storm, Nadia; Conteh, Ousman; Konneh, Kelfala; Kamara, Abdul; Sanne, Ian

    2015-01-01

    The Ebola virus disease (EVD) outbreak in West Africa has highlighted an urgent need for point-of-care (POC) assays for the diagnosis of this devastating disease in resource-limited African countries. The diagnostic performance characteristics of a prototype Cepheid GeneXpert Ebola POC used to detect Ebola virus (EBOV) in stored serum and plasma samples collected from suspected EVD cases in Sierra Leone in 2014 and 2015 was evaluated. The GeneXpert Ebola POC is a self-contained single-cartridge automated system that targets the glycoprotein (GP) and nucleoprotein (NP) genes of EBOV and yields results within 90 min. Results from 281 patient samples were compared to the results of a TaqMan real-time reverse transcription-PCR (RT-PCR) targeting the polymerase gene and performed on two real-time PCR machines. Agreement between the three platforms was 100% at cycle threshold (CT) values of ≤34.99, but discordant results were noted between CT values of 35 and 45.The diagnostic sensitivity of the three platforms was 100% in 91 patient samples that were confirmed to be infectious by virus isolation. All three molecular platforms detected viral EBOV RNA in additional samples that did not contain viable EBOV. The analytical sensitivity of the GeneXpert Ebola POC for the detection of NP was higher, and comparable to that of polymerase gene detection, than that for the detection of GP when using a titrated laboratory stock of EBOV. There was no detectable cross-reactivity with other hemorrhagic fever viruses or arboviruses. The GeneXpert Ebola POC offers an easy to operate and sensitive diagnostic tool that can be used for the rapid screening of suspected EVD cases in treatment or in holding centers during EVD outbreaks. PMID:26637383

  1. Diagnostic Accuracy of Radiologic Scoring System for Evaluation of Suspicious Hirschsprung Disease in Children

    Science.gov (United States)

    Alehossein, Mehdi; Roohi, Ahad; Pourgholami, Masoud; Mollaeian, Mansour; Salamati, Payman

    2015-01-01

    Background: In 1996, Donovan and colleagues represented a scoring system for better prediction of Hirschsprung disease (HD). Objectives: Our objective was to devise another scoring system that uses a checklist of radiologic and clinical signs to determine the probability of HD in suspicious patients. Patients and Methods: In a diagnostic accuracy study, 55 children with clinical manifestations of HD that referred to a training hospital from 1998 to 2011 were assessed. A checklist was used to evaluate the items proposed by contrast enema (CE), based on six subscales, including transitional zone, rectosigmoid index (RSI), irregular contractions in aganglionic region, cobblestone appearance, filling defect due to fecaloid materials and lack of meconium defecation during the first 48 hours after birth. The patients were classified as high score and low score. Sensitivity, specificity, positive predictive value and negative predictive value of our scoring system were calculated for identifying HD, in comparison with pathologically proved or ruled out HD. Results: Of the 55 patients, 36 (65.4%) cases had HD and 19 (34.6%) cases were without HD. In the HD group, 32 patients showed high scores and four patients had low scores. The sensitivity and specificity of our diagnostic scoring system were 88.9% (95% CI: 78.6% - 99.1%) and 84.2% (95% CI: 68.7% - 100%), respectively. Moreover, positive predictive value (PPV) and negative predictive value (NPV) were 91.4% (95% CI: 82.1% - 100%) and 80% (95% CI: 62.5% - 97.5%), respectively. Conclusions: Our new scoring system of CE is a useful diagnostic method in HD. If a patient’s score is high, that patient is highly suspicious to HD and reversely, when one’s score is low, the patient presents a reduced probability to be diagnosed with HD. PMID:25901256

  2. Diagnostic Evaluation of Nmme Precipitation and Temperature Forecasts for the Continental United States

    Science.gov (United States)

    Karlovits, G. S.; Villarini, G.; Bradley, A.; Vecchi, G. A.

    2014-12-01

    Forecasts of seasonal precipitation and temperature can provide information in advance of potentially costly disruptions caused by flood and drought conditions. The consequences of these adverse hydrometeorological conditions may be mitigated through informed planning and response, given useful and skillful forecasts of these conditions. However, the potential value and applicability of these forecasts is unavoidably linked to their forecast quality. In this work we evaluate the skill of four global circulation models (GCMs) part of the North American Multi-Model Ensemble (NMME) project in forecasting seasonal precipitation and temperature over the continental United States. The GCMs we consider are the Geophysical Fluid Dynamics Laboratory (GFDL)-CM2.1, NASA Global Modeling and Assimilation Office (NASA-GMAO)-GEOS-5, The Center for Ocean-Land-Atmosphere Studies - Rosenstiel School of Marine & Atmospheric Science (COLA-RSMAS)-CCSM3, Canadian Centre for Climate Modeling and Analysis (CCCma) - CanCM4. These models are available at a resolution of 1-degree and monthly, with a minimum forecast lead time of nine months, up to one year. These model ensembles are compared against gridded monthly temperature and precipitation data created by the PRISM Climate Group, which represent the reference observation dataset in this work. Aspects of forecast quality are quantified using a diagnostic skill score decomposition that allows the evaluation of the potential skill and conditional and unconditional biases associated with these forecasts. The evaluation of the decomposed GCM forecast skill over the continental United States, by season and by lead time allows for a better understanding of the utility of these models for flood and drought predictions. Moreover, it also represents a diagnostic tool that could provide model developers feedback about strengths and weaknesses of their models.

  3. A probit latent class model with general correlation structures for evaluating accuracy of diagnostic tests.

    Science.gov (United States)

    Xu, Huiping; Craig, Bruce A

    2009-12-01

    Traditional latent class modeling has been widely applied to assess the accuracy of dichotomous diagnostic tests. These models, however, assume that the tests are independent conditional on the true disease status, which is rarely valid in practice. Alternative models using probit analysis have been proposed to incorporate dependence among tests, but these models consider restricted correlation structures. In this article, we propose a probit latent class model that allows a general correlation structure. When combined with some helpful diagnostics, this model provides a more flexible framework from which to evaluate the correlation structure and model fit. Our model encompasses several other PLC models but uses a parameter-expanded Monte Carlo EM algorithm to obtain the maximum-likelihood estimates. The parameter-expanded EM algorithm was designed to accelerate the convergence rate of the EM algorithm by expanding the complete-data model to include a larger set of parameters and it ensures a simple solution in fitting the PLC model. We demonstrate our estimation and model selection methods using a simulation study and two published medical studies.

  4. [THE DIFFERENTIAL DIAGNOSTIC POSSIBILITIES IN EVALUATION OF IRON-DEFICIENT CONDITION UNDER ANEMIAS].

    Science.gov (United States)

    Zubrikhina, G N; Blindar, V N; Matveeva, I I

    2016-03-01

    The article presents data concerning differential diagnostic possibilities of evaluation of genuine iron-deficient anemia and anemia of chronic diseases. The variety of mechanisms of development of anemia of chronic diseases is demonstrated, including effect of humoral inhibitors of erythropoiesis, disorder of iron metabolism at the expense of its redistribution into cells of macrophage system, suppression of erythropoiesis resulted in redistributed or functional iron deficiency. The data is presented concerning significance in diagnostic of anemia of chronic diseases of such factors as content of ferritin, dissolving receptors of transferrin and role of hepcidin protein in pathogenesis of anemia of chronic diseases. The analysis of scientific publications demonstrated that hepcidin is a negative regulator of iron metabolism. Under iron-deficient anemia its level in blood decreases that contribute to extensive absorption of iron in gastrointestinal tract. On the contrary, under anemia of chronic diseases its content drastically increases and results in blocking of iron transport everywhere, including internal epithelium, macrophages, placenta and other types of cells. The hyper-production of hepcidin during infection and inflammation is responsible for anemia of chronic diseases. The perspectives of development of pharmaceuticals decreasing level of hepcidin for treatment of anemia of chronic diseases is demonstrated.

  5. Dosimetric evaluation of Rhizophora spp. binderless particleboard phantom for diagnostic X-ray energy

    Science.gov (United States)

    Marashdeh, M. W.; Tajuddin, A. A.; Bauk, S.; Hashim, R.

    2017-07-01

    This research aims to evaluate the suitability of using binderless particleboard made from Rhizophora spp. mangrove wood as a dosimetric phantom for X-ray in the diagnostic energy regions. Comparative measurements of percentage depth and surface doses in Rhizophora spp. binderless particleboard phantom and similarly shaped Perspex and water phantoms were performed. Measurements were conducted in the diagnostic X-ray energy range of 50 kVp to 90 kVp. Results showed that the binderless particleboard phantom can be used for dosimetric measurements. For the X-ray beam at 90 kVp, the binderless particleboard and water phantom showed data agreement of 1.6%, 2.7%, and 4.3% at depths of 1, 2, and 4 cm, respectively, whereas the measurements in water and Perspex were 1.8%, 2.7%, and 4.4%. The surface dose differences were due to difference in the backscattering material. The doses measured at the surface were within 0.4% for binderless particleboard and water and within 0.9% for Perspex and water.

  6. Evaluation of the measurement uncertainty in screening immunoassays in blood establishments: computation of diagnostic accuracy models.

    Science.gov (United States)

    Pereira, Paulo; Westgard, James O; Encarnação, Pedro; Seghatchian, Jerard

    2015-02-01

    The European Union regulation for blood establishments does not require the evaluation of measurement uncertainty in virology screening tests, which is required by ISO 15189 guideline following GUM principles. GUM modular approaches have been discussed by medical laboratory researchers but no consensus has been achieved regarding practical application. Meanwhile, the application of empirical approaches fulfilling GUM principles has gained support. Blood establishments' screening tests accredited by ISO 15189 need to select an appropriate model even GUM models are intended uniquely for quantitative examination procedures. Alternative (to GUM) models focused on probability have been proposed in medical laboratories' diagnostic tests. This article reviews, discusses and proposes models for diagnostic accuracy in blood establishments' screening tests. The output of these models is an alternative to VIM's measurement uncertainty concept. Example applications are provided for an anti-HCV test where calculations were performed using a commercial spreadsheet. The results show that these models satisfy ISO 15189 principles and that the estimation of clinical sensitivity, clinical specificity, binary results agreement and area under the ROC curve are alternatives to the measurement uncertainty concept. Copyright © 2014. Published by Elsevier Ltd.

  7. Evaluation of five rapid diagnostic kits for influenza A/B virus.

    Science.gov (United States)

    Cho, Chi Hyun; Woo, Mi Kyung; Kim, Ju Yeon; Cheong, Seok; Lee, Chang-Kyu; An, SeongSoo A; Lim, Chae Seung; Kim, Woo Joo

    2013-01-01

    Influenza viruses cause seasonal epidemics associated with high morbidity and mortality. However, even during periods of epidemic prevalence, clinical diagnoses are problematic. Rapid diagnostic tests for the detection of pandemic influenza A/B virus are valuable for their ease of use. Many rapid influenza diagnostic kits were introduced recently in the Republic of Korea (ROK), including Directizen EZ Flu A and B (Becton Dickinson, Sparks, USA), Binax Now Influenza A/B antigen kit (Binax, Portland, USA), Genedia influenza Ag (Green Cross, Yongin, ROK), Humasis Influenza A/B antigen test (Humasis, Anyang, ROK), and SD Bioline rapid influenza kit (Standard Diagnostics, Yongin, ROK). The objective of this study was to evaluate the performance of these five rapid diagnostic kits. The results were compared with those of viral culture and reverse transcription (RT)-PCR. A total of 253 nasopharyngeal swabs were analyzed from 253 patients (influenza A, n=67; B, n=86; negative samples, n=100). The specimens were tested immediately by conventional influenza virus culture and RT-PCR, stored at -80°C, and tested using five rapid test kits. The performance of the five rapid tests kits varied with sensitivities between 71.0 and 82.1% and between 37.2 and 47.7% for detecting influenza A and B, respectively. For influenza A, the sensitivities of the Directizen EZ Flu A and B, Binax Now Influenza A/B antigen kit, Genedia influenza Ag, Humasis Influenza A/B antigen test, and SD Bioline rapid influenza kits were 82.1%, 71.0%, 76.1%, 79.1%, and 82.1%, respectively; those for influenza B were 40.7%, 37.2%, 40.7%, 41.8%, and 47.7%, respectively. The specificity of all rapid tests was 100%. Commercial influenza antigen detection assays are useful tools for the rapid diagnosis of influenza. However, confirmatory testing is always recommended. Crown Copyright © 2012. Published by Elsevier B.V. All rights reserved.

  8. Evaluating the diagnostic accuracy of Arabic SNAP test for children with hypernasality.

    Science.gov (United States)

    Abou-Elsaad, Tamer; Afsah, Omayma; Baz, Hemmat; Mansy, Alzahraa

    2016-06-01

    Nasometry is a method of measuring the acoustic correlates of resonance through a computer-based instrument called nasometer. High nasalance scores in comparison to normative data suggest hypernasality and/or other nasality disorders, while low scores suggest hyponasality. Normative values of nasalance for Egyptian Arabic speakers were established using the Arabic SNAP (Simplified Nasometric Assessment Procedures) test. to evaluate the diagnostic accuracy of Arabic SNAP test to allow for its use in the differentiation between normal and hypernasal speech in Egyptian Arabic-speaking children. Nasalance scores of normal children (n=92) on Arabic SNAP test were compared to those of 30 children with velopharyngeal insufficiency due to cleft palate. Receiver operating characteristic (ROC) curve was used to determine cutoff points with the highest sensitivity and specificity. Statistically significant differences were found between both groups for all items in nasometric evaluation (p0.05). Cutoff points were determined and certain items were selected for routine nasometric evaluation. The Arabic SNAP test is a sensitive and specific tool for evaluation of children with hypernasality and can be used for both diagnosis and follow up of these cases. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  9. Evaluation of TLD dose response compared to MCNP-5 simulation of diagnostic X ray equipment - radiation diagnostic image

    Energy Technology Data Exchange (ETDEWEB)

    Sanchez G, R.; Cavalieri, T. A.; De Paiva, F.; Dalledone S, P. de T.; Yoriyaz, H. [Instituto de Pesquisas Energeticas e Nucleares, Centro de Engenharia Nuclear / CNEN, Av. Lineu Prestes 2242, Cidade Universitaria, 05508-000 Sao Paulo (Brazil); Rodrigues F, M. A. [Universidade Estadual Paulista, Faculdade de Medicina de Botucatu, Departamento de Dermatologia e Radioterapia, Av. Prof. Montenegro s/n, Rubiao Junior, 18601-970 Botucatu (Brazil); Vivolo, V., E-mail: chancez@hotmail.com [Instituto de Pesquisas Energeticas e Nucleares, Gerencia de Metrologia das Radiacoes / CNEN, Av. Lineu Prestes 2242, Cidade Universitaria, 05508-000 Sao Paulo (Brazil)

    2014-08-15

    The thermo luminescent dosimeter (TLD) is used as a radiation dosimeter and can be used as environmental and staff personnel monitoring. The TLD measures ionizing radiation exposure by a process in which the amount of radiation collected by the dosimeter is converted in visible light when the crystal is heated. The amount of emitted light is proportional to the radiation exposure, and then the response of the TLD must be the related to the real dose. In this work it was used twenty four TLD 700 in order to obtain eight values of doses from a diagnostic X-ray equipment. The TLD-700 is a LiF TLD enriched with {sup 7}Li isotope. One way to compare and study the response of TLD is by Monte Carlo method, which has been used as a computational tool to solve problems stochastically. This method can be applied to any geometry, even those where the boundary conditions are unknown, making the method particularly useful to solve problems a priori. In this work it was modeled the X-ray tube exactly as the one used to irradiate the TLD, after the simulation and the TLD irradiation the results of dose value from both were compared. (Author)

  10. Multicenter evaluation of molecular and culture-dependent diagnostics for Shigella species and Entero-invasive Escherichia coli in the Netherlands

    NARCIS (Netherlands)

    van den Beld, Maaike J. C.; Friedrich, Alexander W.; van Zanten, Evert; Reubsaet, Frans A. G.; Kooistra-Smid, Mirjam A. M. D.; Rossen, John W. A.

    2016-01-01

    An inter-laboratory collaborative trial for the evaluation of diagnostics for detection and identification of Shigella species and Entero-invasive Escherichia coil (EIEC) was performed. Sixteen Medical Microbiological Laboratories (MMLs) participated. MMLs were interviewed about their diagnostic

  11. Development, Evaluation, and Integration of a Quantitative Reverse-Transcription Polymerase Chain Reaction Diagnostic Test for Ebola Virus on a Molecular Diagnostics Platform.

    Science.gov (United States)

    Cnops, Lieselotte; Van den Eede, Peter; Pettitt, James; Heyndrickx, Leo; De Smet, Birgit; Coppens, Sandra; Andries, Ilse; Pattery, Theresa; Van Hove, Luc; Meersseman, Geert; Van Den Herrewegen, Sari; Vergauwe, Nicolas; Thijs, Rein; Jahrling, Peter B; Nauwelaers, David; Ariën, Kevin K

    2016-10-15

     The 2013-2016 Ebola epidemic in West Africa resulted in accelerated development of rapid diagnostic tests for emergency outbreak preparedness. We describe the development and evaluation of the Idylla™ prototype Ebola virus test, a fully automated sample-to-result molecular diagnostic test for rapid detection of Zaire ebolavirus (EBOV) and Sudan ebolavirus (SUDV).  The Idylla™ prototype Ebola virus test can simultaneously detect EBOV and SUDV in 200 µL of whole blood. The sample is directly added to a disposable cartridge containing all reagents for sample preparation, RNA extraction, and amplification by reverse-transcription polymerase chain reaction analysis. The performance was evaluated with a variety of sample types, including synthetic constructs and whole blood samples from healthy volunteers spiked with viral RNA, inactivated virus, and infectious virus.  The 95% limits of detection for EBOV and SUDV were 465 plaque-forming units (PFU)/mL (1010 copies/mL) and 324 PFU/mL (8204 copies/mL), respectively. In silico and in vitro analyses demonstrated 100% correct reactivity for EBOV and SUDV and no cross-reactivity with relevant pathogens. The diagnostic sensitivity was 97.4% (for EBOV) and 91.7% (for SUDV), the specificity was 100%, and the diagnostic accuracy was 95.9%.  The Idylla™ prototype Ebola virus test is a fast, safe, easy-to-use, and near-patient test that meets the performance criteria to detect EBOV in patients with suspected Ebola. © The Author 2016. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail journals.permissions@oup.com.

  12. Evaluation of the Diagnostic Power of Thermography in Breast Cancer Using Bayesian Network Classifiers

    Science.gov (United States)

    Nicandro, Cruz-Ramírez; Efrén, Mezura-Montes; María Yaneli, Ameca-Alducin; Enrique, Martín-Del-Campo-Mena; Héctor Gabriel, Acosta-Mesa; Nancy, Pérez-Castro; Alejandro, Guerra-Hernández; Guillermo de Jesús, Hoyos-Rivera; Rocío Erandi, Barrientos-Martínez

    2013-01-01

    Breast cancer is one of the leading causes of death among women worldwide. There are a number of techniques used for diagnosing this disease: mammography, ultrasound, and biopsy, among others. Each of these has well-known advantages and disadvantages. A relatively new method, based on the temperature a tumor may produce, has recently been explored: thermography. In this paper, we will evaluate the diagnostic power of thermography in breast cancer using Bayesian network classifiers. We will show how the information provided by the thermal image can be used in order to characterize patients suspected of having cancer. Our main contribution is the proposal of a score, based on the aforementioned information, that could help distinguish sick patients from healthy ones. Our main results suggest the potential of this technique in such a goal but also show its main limitations that have to be overcome to consider it as an effective diagnosis complementary tool. PMID:23762182

  13. An economic evaluation of public programs for internationalization: the case of the Diagnostic Program in Spain.

    Science.gov (United States)

    Cansino, José M; Lopez-Melendo, Jaime; Pablo-Romero, María del P; Sánchez-Braza, Antonio

    2013-12-01

    This paper evaluates the Diagnostic Program in Spain which is a publicly funded program to promote internationalization of companies located in Andalusia (south of Spain). The methodology used is the propensity score-matching. The treatment group consists of companies which participated in the Program until 2008. The control group has companies which planned to participate in the Program but had not done so up to that date. The response variable measures the ratio of export to total sales for each company. Four covariates have been taken into account: activity, location, sales and number of employees. The analysis leads to the conclusion that the companies that participated in the Program improved their ratio of exports to total sales by about 10 percentage points. Copyright © 2013 Elsevier Ltd. All rights reserved.

  14. Diagnostic accuracy of static graf technique of ultrasound evaluation of infant hips for developmental dysplasia.

    Science.gov (United States)

    Pillai, Anand; Joseph, Jibu; McAuley, Andrew; Bramley, Diane

    2011-01-01

    Ultrasound examination of infant hips is a widely used and accepted tool for the diagnosis and monitoring of developmental dysplasia of the hip. Its use and timing is still a focus of debate and its diagnostic accuracy has not been fully investigated. We have compared the ultrasound findings by the Graf technique with radiographic appearance (acetabular index) at 6 months of age. The negative predictive value of Ultrasound for DDH was 98% and was unaffected by the timing of the examination. The specificity and accuracy of the examination increased with age and was highest at 3 months of age. Ultrasound examination of the infant hip by the static Graf technique is a safe and effective screening tool for the evaluation of DDH.

  15. Does evaluation of the ligamentous compartment enhance diagnostic utility of sacroiliac joint MRI in axial spondyloarthritis?

    DEFF Research Database (Denmark)

    Weber, Ulrich; Maksymowych, Walter P; Chan, Stanley M

    2015-01-01

    INTRODUCTION: Inflammation of the sacroiliac joints (SIJ) is a fundamental clinical feature of axial spondyloarthritis (SpA). The anatomy of the irregularly shaped SIJ is complex with an antero-inferior cartilaginous compartment containing central hyaline and peripheral fibrocartilage, and a dorso...... in the ligamentous compartment and their potential diagnostic utility in axial SpA. We therefore aimed to evaluate the ligamentous compartment on sacroiliac joint MRI for lesion distribution and potential incremental value towards diagnosis of SpA over and above the traditional assessment of the cartilaginous...... compartment alone. METHODS: Two independent cohorts of 69 and 88 consecutive back pain patients ≤50 years were referred for suspected SpA (cohort A) or acute anterior uveitis plus back pain (cohort B). Patients were classified according to rheumatologist expert opinion based on clinical, radiographic...

  16. Evaluation of diagnostic performance of whole-body simultaneous PET/MRI in pediatric lymphoma.

    Science.gov (United States)

    Ponisio, Maria Rosana; McConathy, Jonathan; Laforest, Richard; Khanna, Geetika

    2016-08-01

    Whole-body (18)F-fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) is the standard of care for lymphoma. Simultaneous PET/MRI (magnetic resonance imaging) is a promising new modality that combines the metabolic information of PET with superior soft-tissue resolution and functional imaging capabilities of MRI while decreasing radiation dose. There is limited information on the clinical performance of PET/MRI in the pediatric setting. This study evaluated the feasibility, dosimetry, and qualitative and quantitative diagnostic performance of simultaneous whole-body FDG-PET/MRI in children with lymphoma compared to PET/CT. Children with lymphoma undergoing standard of care FDG-PET/CT were prospectively recruited for PET/MRI performed immediately after the PET/CT. Images were evaluated for quality, lesion detection and anatomical localization of FDG uptake. Maximum and mean standardized uptake values (SUVmax/mean) of normal organs and SUVmax of the most FDG-avid lesions were measured for PET/MRI and PET/CT. Estimation of radiation exposure was calculated using specific age-related factors. Nine PET/MRI scans were performed in eight patients (mean age: 15.3 years). The mean time interval between PET/CT and PET/MRI was 51 ± 10 min. Both the PET/CT and PET/MRI exams had good image quality and alignment with complete (9/9) concordance in response assessment. The SUVs from PET/MRI and PET/CT were highly correlated for normal organs (SUVmean r(2): 0.88, Pcompared with PET/CT. Simultaneous whole-body PET/MRI is clinically feasible in pediatric lymphoma. PET/MRI performance is comparable to PET/CT for lesion detection and SUV measurements. Replacement of PET/CT with PET/MRI can significantly decrease radiation dose from diagnostic imaging in children.

  17. Evaluation of diagnostic tests for cytomegalovirus active infection in renal transplant recipients

    Directory of Open Access Journals (Sweden)

    Rodrigo Fontanive Franco

    Full Text Available Abstract Introduction: Cytomegalovirus (CMV infection is a main viral infection after kidney transplantation. The diagnostic methods currently employed are pp65 antigenemia and nucleic acid amplification by polymerase chain reaction (PCR and aim at detecting viral replication. Objective: The goal of this study was to evaluate and compare by both methods the incidence of CMV active infection in kidney transplant patients and to establishthe best clinical-laboratory correlation. Methods: Thirty sequential kidney transplant recipients were enrolled in a single center prospective cohort study. Peripheral blood samples were drawn from day 15 until the 6th month after transplantation and tested for CMV replication by pp65 antigenemia and quantitative PCR assays (qPCR. Results: Two hundred forty samples were analyzed and the incidence of active infection was similar by both methods. Time elapsed to the first positive test was almost identical but more samples tested positive by qPCR than by antigenemia in a behavior that was almost evenly distributed overtime. Agreement between tests was observed in 217 samples (90.4%; kappa = 0.529; p < 0.001 and in 25 patients the tests were concordant (83.3%; kappa = 0.667; p < 0.001. The evaluation of the diagnostic parameters for CMV replication revealed higher sensitivity for the qPCR test (82.1% against antigenemia (59.0%. Quantitative PCR was also slightly more accurate than antigenemia. Conclusion: Our data demonstrate that both methods are suitable and have almost equivalent accuracy for the detection of post-transplant cytomegalovirus replication. The choice for either test must take in consideration the demand, execution capability and cost-effectiveness at each institution.

  18. Evaluation of infrared thermography as a diagnostic tool to predict heat stress events in feedlot cattle.

    Science.gov (United States)

    Unruh, Ellen M; Theurer, Miles E; White, Brad J; Larson, Robert L; Drouillard, James S; Schrag, Nora

    2017-07-01

    OBJECTIVE To determine whether infrared thermographic images obtained the morning after overnight heat abatement could be used as the basis for diagnostic algorithms to predict subsequent heat stress events in feedlot cattle exposed to high ambient temperatures. ANIMALS 60 crossbred beef heifers (mean ± SD body weight, 385.8 ± 20.3 kg). PROCEDURES Calves were housed in groups of 20 in 3 pens without any shade. During the 6 am and 3 pm hours on each of 10 days during a 14-day period when the daily ambient temperature was forecasted to be > 29.4°C, an investigator walked outside each pen and obtained profile digital thermal images of and assigned panting scores to calves near the periphery of the pen. Relationships between infrared thermographic data and panting scores were evaluated with artificial learning models. RESULTS Afternoon panting score was positively associated with morning but not afternoon thermographic data (body surface temperature). Evaluation of multiple artificial learning models indicated that morning body surface temperature was not an accurate predictor of an afternoon heat stress event, and thermographic data were of little predictive benefit, compared with morning and forecasted weather conditions. CONCLUSIONS AND CLINICAL RELEVANCE Results indicated infrared thermography was an objective method to monitor beef calves for heat stress in research settings. However, thermographic data obtained in the morning did not accurately predict which calves would develop heat stress later in the day. The use of infrared thermography as a diagnostic tool for monitoring heat stress in feedlot cattle requires further investigation.

  19. Clinical application and evaluation of the Bien diagnostic criteria for Rasmussen encephalitis.

    Science.gov (United States)

    Olson, Heather E; Lechpammer, Mirna; Prabhu, Sanjay P; Ciarlini, Pedro D S C; Poduri, Annapurna; Gooty, Vasu D; Anjum, Muhammad W; Gorman, Mark P; Loddenkemper, Tobias

    2013-10-01

    The 2005 diagnostic criteria for Rasmussen encephalitis (RE) are based on seizures, clinical deficits, electroencephalography (EEG), neuroimaging, and pathology (Brain, 128, 2005, 451). We applied these criteria to patients evaluated for RE and epilepsy surgery controls to determine the sensitivity, specificity, and positive and negative predictive values (PPVs, NPVs) using pathology as the gold standard. We identified patients evaluated for RE based on medical records from 1993 to 2011. Fifty-two control patients with refractory epilepsy, unilateral magnetic resonance imaging (MRI) changes, and biopsies were selected from an epilepsy surgery database from matching years. Patients meeting all three of group A and/or two of three group B criteria were classified as meeting full criteria (positive). Patients not meeting full criteria were classified as negative. When available, pathology findings were re-reviewed with neuropathologists, and MRI imaging was re-reviewed with a neuroradiologist. RE was considered in the differential diagnosis for 82 patients, of whom 35 had biopsies. Twenty patients met full criteria (positive) without another explanation, including seven for whom biopsy was required to meet criteria and one in whom another etiology was identified. Two patients met full criteria but had another explanation. Thirty-five met partial criteria (negative), of whom 14 had another etiology identified. Twenty-five met no criteria (negative). The diagnostic criteria had a sensitivity of 81% with four false negatives (criteria-negative, biopsy-positive) when compared to pathology as a gold standard. Five false positives (criteria positive, biopsy negative) had identifiable alternate diagnoses. The 2005 Bien clinical diagnostic criteria for RE have reasonably high sensitivity and specificity and good clinical-pathologic correlation in most cases. We suggest modification of the criteria to allow inclusion of cases with well-described but less common features

  20. Common evidence gaps in point-of-care diagnostic test evaluation: a review of horizon scan reports.

    Science.gov (United States)

    Verbakel, Jan Y; Turner, Philip J; Thompson, Matthew J; Plüddemann, Annette; Price, Christopher P; Shinkins, Bethany; Van den Bruel, Ann

    2017-09-01

    Since 2008, the Oxford Diagnostic Horizon Scan Programme has been identifying and summarising evidence on new and emerging diagnostic technologies relevant to primary care. We used these reports to determine the sequence and timing of evidence for new point-of-care diagnostic tests and to identify common evidence gaps in this process. Systematic overview of diagnostic horizon scan reports. We obtained the primary studies referenced in each horizon scan report (n=40) and extracted details of the study size, clinical setting and design characteristics. In particular, we assessed whether each study evaluated test accuracy, test impact or cost-effectiveness. The evidence for each point-of-care test was mapped against the Horvath framework for diagnostic test evaluation. We extracted data from 500 primary studies. Most diagnostic technologies underwent clinical performance (ie, ability to detect a clinical condition) assessment (71.2%), with very few progressing to comparative clinical effectiveness (10.0%) and a cost-effectiveness evaluation (8.6%), even in the more established and frequently reported clinical domains, such as cardiovascular disease. The median time to complete an evaluation cycle was 9 years (IQR 5.5-12.5 years). The sequence of evidence generation was typically haphazard and some diagnostic tests appear to be implemented in routine care without completing essential evaluation stages such as clinical effectiveness. Evidence generation for new point-of-care diagnostic tests is slow and tends to focus on accuracy, and overlooks other test attributes such as impact, implementation and cost-effectiveness. Evaluation of this dynamic cycle and feeding back data from clinical effectiveness to refine analytical and clinical performance are key to improve the efficiency of point-of-care diagnostic test development and impact on clinically relevant outcomes. While the 'road map' for the steps needed to generate evidence are reasonably well delineated, we

  1. Comparative Evaluation for Assessing Oratest as a Diagnostic Tool for Evaluation of Plaque Levels & Gingivitis

    Directory of Open Access Journals (Sweden)

    Mahasweta Joshi

    2012-01-01

    Full Text Available Aims & Objectives: Periodontal disease comprises a group of inflammatory conditions of the supporting tissues of the teeth that are caused by bacteria. The present study was undertaken to evaluate whether Oratest could be used as a sensitive indicator of plaque levels and gingivitis. Material and Methods: Hundred caries free patients visiting the out-patient department of A.E.C.S. Maaruti College of Dental Sciences and Research Centre, Banglore were selected according to predetermined selection criteria. The study consisted of two clinical stages: Stage 1. Recording of Plaque Index (Loe, 1967 and Gingival Index (Loe & Silness 1963 in the subjects. Stage 2. Performance of the Oratest and recording the scores in the same subjects. The Oratest was performed by rinsing the mouth with sterilized UHT (Ultra high temperature milk. About 3 ml of expectorated milk was added to a test tube containing the 0.12 ml of 0.1% methylene blue. The time required for colour change from blue to white attained at the bottom of the tube was recorded. Plaque Index, Gingival Index and Oratest scores were compared using Student t test. Pearson correlation test was applied to assess correlation between the indices and Oratest scores. Results:The results of the study showed that as age increased plaque and Gingival Indexes also increased whereas Oratest scores decreased. No significant difference between males and females was found in mean values of Plaque Index, Gingival Index and Oratest scores. Negative correlation was seen between Plaque Index and Oratest scores (r = 0.724 and also between Gingival Index and Oratest scores (r = 0.728. Conclusions: The study showed high correlation between the plaque and gingival indices and Oratest scores. This study validates Oratest as a predictable & sensitive test to assess periodontal disease.

  2. Evaluation of spine boards for X-ray diagnostics; Evaluation von Wirbelsaeulenbrettern fuer die Roentgendiagnostik

    Energy Technology Data Exchange (ETDEWEB)

    Linsenmaier, U.; Kroetz, M.; Papst, E.; Rieger, J.; Pfeifer, K.J. [Muenchen Univ. (Germany). Inst. fuer Klinische Radiologie; Kranz, K.G.; Russ, W.; Mutscher, W. [Muenchen Univ. (Germany). Chirurgische Klinik

    2001-11-01

    Purpose: Spine boards are frequently used in preclinical emergency care. Different models were examined with regard to their feasibility for plain film radiography and computed tomography (CT). Methods: Five current spine board models were measured for their dimensions and weight. Transmission of radiation [{mu}Gyls] and dose area product [cGy x cm{sup 2}] were determined with a patient equivalent aluminium phantom. Image artifacts, image quality and resolution of anatomic details were evaluated with an anthropomorphic Alderson phantom. Results: With only 6.3 kg new models show a 28% reduction in weight, three spine boards generate lateral artifacts due to a narrow width of 41 - 42 cm. Radiation transmission of all boards was similar, however dose area products differed by up to 59%. Image quality was impaired in 4 out 5 boards because of image artifacts, CT scanning was not impaired with all boards. Conclusion: Only one board (Ferno Millenia {sup trademark}) showed sufficient properties for plain film radiography and CT. There is no suitable spine board for preclinical and clinical applications as well as for trauma radiology, further improvements of current designs are essential. (orig.) [German] Ziel: Wirbelsaeulenlagerungsbretter werden in der praeklinischen Notfallversorgung haeufig eingesetzt. Verschiedene Modelle wurden hinsichtlich ihrer Eignung fuer die konventionelle Roentgendiagnostik und Computertomographie (CT) untersucht. Methode: Fuenf gaengige Wirbelsaeulenbretter wurden vermessen und gewogen. Strahlendurchlaessigkeit [{mu}Gy/s] und Flaechendosisprodukte [cGy x cm{sup 2}] mit einem patientenaequivalenten Aluminiumphantom ermittelt. Bildartefakte, Bildqualitaet und die Erkennbarkeit anatomischer Details wurden mit einem Alderson-Phantom, die Binnenstruktur der Bretter mittels CT untersucht. Ergebnisse: Mit nur 6.3 kg besitzen einzelne Modelle ein um bis zu 28% reduziertes Gewicht; mit 41-42 cm weisen drei Bretter eine problematische Breite auf. Die

  3. 36 CFR 1280.48 - How do I apply to film, photograph, or videotape on NARA property for news purposes?

    Science.gov (United States)

    2010-07-01

    ..., photograph, or videotape on NARA property for news purposes? 1280.48 Section 1280.48 Parks, Forests, and... film, photograph, or videotape on NARA property for news purposes? (a) If you wish to film, photograph... wish to film, photograph, or videotape for news purposes at a Presidential library or at a regional...

  4. Economic evaluations of diagnostic tests, treatment and prevention for lateral ankle sprains: a systematic review.

    Science.gov (United States)

    Lin, Chung-Wei Christine; Uegaki, Kimi; Coupé, Veerle M H; Kerkhoffs, Gino M; van Tulder, Maurits W

    2013-12-01

    To assess and summarise the economic evidence regarding diagnostic tests, treatment and prevention for lateral ankle sprains. Potential studies were identified from electronic databases and trial registries and by scanning reference lists. Risk of bias and methodological quality were evaluated. Two independent reviewers screened, assessed studies and extracted data. Data were synthesised descriptively due to study heterogeneity. A total of 230 records were identified; 10 studies were included. Five studies conducted a full economic evaluation and five studies involved cost analyses. Lack of blinding was the main risk of bias. The methodological quality of the full economic evaluations was fairly good. Valuation of costs, measurement of outcomes and sensitivity analysis were points for improvement. Single studies showed that the Ottawa ankle rules (OAR) was cost effective for diagnosing lateral ankle sprains in the emergency setting compared with existing hospital protocols; acute treatment with anti-inflammatory medication and the plaster cast for severe sprains appeared cost effective; and neuromuscular training was cost effective in preventing ankle re-injury. Results of this current systematic review supplements the evidence provided by reviews of effectiveness. There is evidence to support the implementation of OAR in the emergency setting, the use of anti-inflammatory medication and the plaster cast in the acute phase, and the prescription of neuromuscular exercises to prevent re-injury. Although the evidence is limited due to the low number of studies, shortcomings in methodological quality and small sample sizes, the findings may be used to inform clinical practice and practice guidelines.

  5. [Evaluation of the toxoplasmosis seroprevalence in pregnant women and creating a diagnostic algorithm].

    Science.gov (United States)

    Mumcuoglu, Ipek; Toyran, Alparslan; Cetin, Feyza; Coskun, Feride Alaca; Baran, Irmak; Aksu, Neriman; Aksoy, Altan

    2014-04-01

    Toxoplasma gondii, an obligatory intracellular protozoon is widely distributed around the world and can infect all mammals and birds. While acquired toxoplasmosis is usually asymptomatic in healthy subjects, acute infection during pregnancy may lead to abortion, stillbirth, fetal neurological and ocular damages. For the prevention of congenital toxoplasmosis it is recommended that a screening programme and a diagnostic algorithm in pregnant women should be implemented while considering the cost effectiveness. Thus, it is necessary to determine the seroprevalence of toxoplasmosis in pregnant women and the actual risk of T.gondii transmission during pregnancy in a certain area. The aims of this study were to detect the T.gondii seropositivity in the pregnant women admitted to our hospital and to create a diagnostic algorithm in order to solve the problems arising from interpretation of the serological test results. A total of 6140 women aged 15-49 years who were admitted to our hospital between April 1st, 2010 to July 31st, 2013, were evaluated retrospectively. In the serum samples, T.gondii IgM, IgG and IgG avidity tests were performed by VIDAS automated analyzer using TOXO IgM, TOXO IgG II and TOXO IgG avidity kits (bioMerieux, France). It was noted that, both T.gondii IgM and IgG tests were requested from 4758 (77.5%) of the pregnant women, while only IgM test from 1382 (22.5%) cases. Sole IgM positivity was found as 0.2% (11/6140), IgG as 26.4% (1278/4758) and both IgM + IgG as 0.9% (44/4758). T.gondii IgG avidity tests were requested from 12 of 44 women who were found both IgM and IgG positive and eight of them revealed high avidity and four low avidity. Avidity test was ordered for the 91 (7.1%) of 1278 sole IgG positive cases and four of them were found to have low avidity. IgG avidity test was ordered for 554 (16.2%) of IgM and/or IgG negative subjects, however, the test was not performed according to rejection criteria of the laboratory. It was noticed that

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

    Science.gov (United States)

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

    2014-06-01

    The DSM-5 proposed the diagnostic criteria of Internet gaming disorder (IGD) and suggested that more evidence is necessary before it is included as a standard disorder in the DSM system. The aims of this study were to: 1) evaluate the diagnostic validity of individual criteria of IGD in the DSM-5 and the criteria of craving and irritability; 2) determine the optimal cut-off point for the IGD criteria in the DSM-5. We recruited 75 subjects with IGD, 75 without IGD, and 75 in remission from IGD based on the Diagnostic Criteria of Internet Addiction for College Students (DC-IA-C). All participants underwent a diagnostic interview based on the diagnostic criteria of IGD in the DSM-5 and completed the CIAS and QGU-B. Except for the "deceiving" and "escape" criteria, all criteria of IGD had diagnostic accuracy ranging from 77.3% to 94.7% to differentiate university students with IGD from remitted students. The criterion of craving had diagnostic accuracy of 88% and the criteria of irritability had an accuracy of 68.7%. Fulfilling 5 or more criteria of IGD in the DSM-5 was the best cut-off point to differentiate young adults with IGD from healthy or remitted users. Copyright © 2014 Elsevier Ltd. All rights reserved.

  7. Clinical Evaluation of Rapid Diagnostic Test Kit Using the Polysaccharide as a Genus-Specific Diagnostic Antigen for Leptospirosis in Korea, Bulgaria, and Argentina.

    Science.gov (United States)

    Lee, Jin-Woo; Park, Sungman; Kim, Seung Han; Christova, Iva; Jacob, Paulina; Vanasco, Norma B; Kang, Yeon-Mi; Woo, Ye-Ju; Kim, Min Soo; Kim, Young-Jin; Cho, Min-Kee; Kim, Yoon-Won

    2016-02-01

    Leptospirosis, a zoonotic disease that is caused by many serovars which are more than 200 in the world, is an emerging worldwide disease. Accurate and rapid diagnostic tests for leptospirosis are a critical step to diagnose the disease. There are some commercial kits available for diagnosis of leptospirosis, but the obscurity of a species- or genus-specific antigen of pathogenic Leptospira interrogans causes the reduced sensitivity and specificity. In this study, the polysaccharide derived from lipopolysaccharide (LPS) of nonpathogenic Leptospira biflexa serovar patoc was prepared, and the antigenicity was confirmed by immunoblot and enzyme linked immunosorbent assay (ELISA). The performance of the rapid diagnostic test (RDT) kit using the polysaccharide as a diagnostic antigen was evaluated in Korea, Bulgaria and Argentina. The sensitivity was 93.9%, 100%, and 81.0% and the specificity was 97.9%, 100%, and 95.4% in Korea (which is a rare region occurring with 2 serovars mostly), Bulgaria (epidemic region with 3 serovars chiefly) and Argentina (endemic region with 19 serovars mainly) respectively. These results indicate that this RDT is applicable for global diagnosis of leptospirosis. This rapid and effective diagnosis will be helpful for diagnosis and manage of leptospirosis to use and the polysaccharide of Leptospira may be called as genus specific antigen for diagnosis.

  8. Model-independent evaluation of tumor markers and a logistic-tree approach to diagnostic decision support.

    Science.gov (United States)

    Ni, Weizeng; Huang, Samuel H; Su, Qiang; Shi, Jinghua

    2014-01-01

    Sensitivity and specificity of using individual tumor markers hardly meet the clinical requirement. This challenge gave rise to many efforts, e.g., combing multiple tumor markers and employing machine learning algorithms. However, results from different studies are often inconsistent, which are partially attributed to the use of different evaluation criteria. Also, the wide use of model-dependent validation leads to high possibility of data overfitting when complex models are used for diagnosis. We propose two model-independent criteria, namely, area under the curve (AUC) and Relief to evaluate the diagnostic values of individual and multiple tumor markers, respectively. For diagnostic decision support, we propose the use of logistic-tree which combines decision tree and logistic regression. Application on a colorectal cancer dataset shows that the proposed evaluation criteria produce results that are consistent with current knowledge. Furthermore, the simple and highly interpretable logistic-tree has diagnostic performance that is competitive with other complex models.

  9. Model-Independent Evaluation of Tumor Markers and a Logistic-Tree Approach to Diagnostic Decision Support

    Directory of Open Access Journals (Sweden)

    Weizeng Ni

    2014-01-01

    Full Text Available Sensitivity and specificity of using individual tumor markers hardly meet the clinical requirement. This challenge gave rise to many efforts, e.g., combing multiple tumor markers and employing machine learning algorithms. However, results from different studies are often inconsistent, which are partially attributed to the use of different evaluation criteria. Also, the wide use of model-dependent validation leads to high possibility of data overfitting when complex models are used for diagnosis. We propose two model-independent criteria, namely, area under the curve (AUC and Relief to evaluate the diagnostic values of individual and multiple tumor markers, respectively. For diagnostic decision support, we propose the use of logistic-tree which combines decision tree and logistic regression. Application on a colorectal cancer dataset shows that the proposed evaluation criteria produce results that are consistent with current knowledge. Furthermore, the simple and highly interpretable logistic-tree has diagnostic performance that is competitive with other complex models.

  10. Development of a novel recombinant encapsidated RNA particle: evaluation as an internal control for diagnostic RT-PCR

    DEFF Research Database (Denmark)

    King, Donald P.; Montague, Nick; Ebert, Katja

    2007-01-01

    This report describes the generation of novel encapsidated RNA particles and their evaluation as in-tube internal controls in diagnostic real-time reverse-transcription PCR (rRT-PCR) assays for the detection of RNA viruses. A cassette containing sequences of 2 diagnostic primer sets for foot...... unguiculata). RNA contained in these particles was amplified in diagnostic rRT-PCR assays used for detection of FMDV and SVDV. Amplification of these internal controls was used to confirm that rRT-PCR inhibitors were absent from clinical samples, thereby verifying negative assay results. The recombinant CPMVs...... did not reduce the analytical sensitivity of the rRT-PCRs when amplification of the insert was performed in the same tube as the diagnostic target. This system provides an attractive solution to the production of internal controls for rRT-PCR assays since CPMV grows to high yields in plants...

  11. Prospective evaluation of an extended 21-core biopsy scheme as initial prostate cancer diagnostic strategy.

    Science.gov (United States)

    Ploussard, Guillaume; Nicolaiew, Nathalie; Marchand, Charles; Terry, Stéphane; Vacherot, Francis; Vordos, Dimitri; Allory, Yves; Abbou, Claude-Clément; Salomon, Laurent; de la Taille, Alexandre

    2014-01-01

    The debate on the optimal number of prostate biopsy core samples that should be taken as an initial strategy is open. To prospectively evaluate the diagnostic yield of a 21-core biopsy protocol as an initial strategy for prostate cancer (PCa) detection. During 10 yr, 2753 consecutive patients underwent a 21-core biopsy scheme for their first set of biopsy specimens. All patients underwent a standardized 21-core protocol with cores mapped for location. The PCa detection rate of each biopsy scheme (6, 12, or 21 cores) was compared using a McNemar test. Predictive factors of the diagnostic yield achieved by a 21-core scheme were studied using logistic regression analyses. PCa detection rates using 6 sextant biopsies, 12 cores, and 21 cores were 32.5%, 40.4%, and 43.3%, respectively. The 12-core procedure improved the cancer detection rate by 19.4% (p=0.004), and the 21-biopsy scheme improved the rate by 6.7% overall (p10% in prostates with volume >70 ml, in men with a prostate-specific antigen level<4 ng/ml, with a prostate-specific antigen density (PSAD) <0.20 ng/ml per gram. A PSAD <0.20 ng/ml per gram was the strongest independent predictive factor of the diagnostic yield offered by the 21-core scheme (p<0.001). The 21-core protocol significantly increased the rate of PCa eligible for active surveillance (62.5% vs 48.4%; p=0.036) than those detected by a 12-core scheme without statistically increasing the rate of insignificant PCa (p=0.503). A 21-core biopsy scheme improves significantly the PCa detection rate compared with a 12-core protocol. We identified a cut-off PSAD (0.20 ng/ml per gram) below which an extended 21-core scheme might be systematically proposed to significantly improve the overall detection rate without increasing the rate of detected insignificant PCa. Copyright © 2012 European Association of Urology. Published by Elsevier B.V. All rights reserved.

  12. Diagnostic Accuracy of Ultrasonography and Radiography in Initial Evaluation of Chest Trauma Patients

    Directory of Open Access Journals (Sweden)

    Ali Vafaei

    2016-01-01

    Full Text Available Introduction: Application of chest radiography for all multiple trauma patients is associated with a significant increase in total costs, exposure to radiation, and overcrowding of the emergency department. Ultrasound has been introduced as an alternative diagnostic tool in this regard. The aim of the present study is to compare the diagnostic accuracy of chest ultrasonography and radiography in detection of traumatic intrathoracic injuries. Methods: In the present prospective cross-sectional study, patients with traumatic intrathoracic injuries, who were referred to the emergency department from December 2013 to December 2014, were assessed. The patients underwent bedside ultrasound, radiographic and computed tomography (CT scan examinations based on ATLS recommendations. Screening performance characteristics of ultrasonography and radiography were compared using SPSS 21.0. Chest CT scan was considered as gold standard. Results: 152 chest trauma patients with a mean age of 31.4 ± 13.8 years (range: 4 ‒ 67, were enrolled (77.6% male. Chest CT scan showed pulmonary contusion in 48 (31.6% patients, hemothorax in 29 (19.1%, and pneumothorax in 55 (36.2% cases. Area under the ROC curve of ultrasonography in detection of pneumothorax, hemothorax, and pulmonary contusion were 0.91 (95% CI: 0.86‒0.96, 0.86 (95% CI: 0.78‒0.94, and 0.80 (95% CI: 0.736‒0.88, respectively. Area under the ROC curve of radiography was 0.80 (95% CI: 0.736‒0.87 for detection of pneumothorax, 0.77 (95% CI: 0.68‒0.86 for hemothorax, and 0.58 (95% CI: 0.5‒0.67 for pulmonary contusion. Comparison of areas under the ROC curve declared the significant superiority of ultrasonography in detection of pneumothorax (p = 0.02 and pulmonary contusion (p < 0.001. However, the diagnostic value of the two tests was equal in detection of hemothorax (p = 0.08. Conclusion: The results of the present study showed that ultrasonography is preferable to radiography in the initial

  13. Research Diagnostic Criteria for Temporomandibular Disorders: Evaluation of Psychometric Properties of the Axis II Measures

    Science.gov (United States)

    Ohrbach, Richard; Turner, Judith A.; Sherman, Jeffrey J.; Mancl, Lloyd A.; Truelove, Edmond L.; Schiffman, Eric L.; Dworkin, Samuel F.

    2011-01-01

    AIMS To evaluate the psychometric properties of the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) biobehavioral (Axis II) screening instruments. METHODS Participants with Axis I TMD diagnoses (n=626) completed the Axis II instruments (Depression, Nonspecific Physical Symptoms, Graded Chronic Pain) and other instruments assessing psychological distress, pain, and disability at three study sites. Internal consistency, temporal stability, and convergent/discriminant validity of the Axis II measures were assessed. To assess criterion validity of Depression and Nonspecific Physical Symptoms instruments as screeners, 170 participants completed a structured psychiatric diagnostic interview. RESULTS The Axis II instruments showed very good-excellent internal consistency (Cronbach’s alpha = 0.80 – 0.95). Their convergent (correlation range 0.3–0.9) and discriminant (range 0.0–0.6) validity were generally supported, although Nonspecific Physical Symptoms was more strongly associated with depressive than with somatic symptoms. Temporal stability was high for characteristic pain intensity (Lin’s correlation concordance coefficient [CCC] = 0.91), interference (CCC = 0.89), and chronic pain grade (weighted kappa = 0.87), and fair-good for Depression and Nonspecific Physical Symptoms (CCC = 0.63 – 0.78). The Depression instrument normal vs moderate-severe cut-point was good at identifying current-year DSM-IV depression and dysthymia diagnoses (sensitivity 87%, specificity 53%). Nonspecific Physical Symptoms did not have high utility for detecting psychiatric disorders (sensitivity 86%, specificity 31%). CONCLUSION The Axis-II Depression and Graded Chronic Pain instruments have clinically relevant and acceptable psychometric properties for reliability and validity and utility as instruments for identifying TMD patients with high levels of distress, pain, and disability that can interfere with treatment response and course of Axis I disorders

  14. [Evaluation of diagnostic scales for appendicitis in patients with lower abdominal pain].

    Science.gov (United States)

    Sanabria, Alvaro; Domínguez, Luis Carlos; Bermúdez, Charles; Serna, Adriana

    2007-09-01

    Diagnosis of apendicitis is difficult; however several clinical scales have been developed that attempt to improve diagnostic accuracy. The operational characteristics of Alvarado and Fenyö scales were defined in patients with abdominal pain suggestive of appendicitis and were compare with clinical and pathological diagnoses. A prospective trial assessed the diagnostic tests. Sign, symptoms, and laboratory tests were included in scales selected. Surgeon decision was maintained independent from the results of the scales. Sensitivity, specificity, positive and negative predictive value and positive and negative likelihood ratio for each scale was compared with the surgeon evaluation. The sample included 374 patients with approximately equal sexes. Of these 269 patients underwent surgery. Howeve, 16.9% of the male and 31.4% of female patients did not have appendicitis. For men, a diagnosis made by the surgeon had better sensitivity than scales (86.2% vs. 73% for Alvarado and 67.2% for Fenyö) without significant differences in specificity. For women, surgeon and Alvarado scale diagnoses were similar, and better than Fenyö scale (77.1% vs. 79.5% for Alvarado and 47% for Fenyö), but specificity was higher for Fenyö scale (92.9% vs. 71.4% for Alvarado and 75.9% for surgeon). Accuracy in diagnosis of appendicitis increases with a higher Alvarado score. For men with abdominal pain on right lower quadrant, surgeon diagnosis is more accurate than scales. For women, Fenyö scale offers a better sensitivity. Alvarado score can facilitate decision-making in patients with these abdominal symptoms.

  15. Autofluorescence guided diagnostic evaluation of suspicious oral mucosal lesions: opportunities, limitations, and pitfalls

    Science.gov (United States)

    Vigneswaran, Nadarajah

    2011-03-01

    Wide-filed autofluorescence examination is currently considered as a standard of care for screening and diagnostic evaluation of early neoplastic changes of the skin, cervix, lung, bladder, gastrointestinal tract and oral cavity. Naturally occurring fluorophores within the tissue absorb UV and visible light and can re-emit some of this light at longer wavelengths in the form of fluorescence. This non-invasive tissue autofluorescence imaging is used in optical diagnostics, especially in the early detection of cancer. Usually, malignant transformation is associated with thickening of the epithelium, enhanced cellular density due to increased nuclear cytoplasmic ratio which may attenuate the excitation leading to a decrease in collagen autofluorescence. Hence, dysplastic and cancerous tissues often exhibit decreased blue-green autofluorescence and appear darker compared to uninvolved mucosa. Currently, there are three commercially available devices to examine tissue autofluorescence in the oral cavity. In this study we used the oral cancer screening device IdentafiTM 3000 to examine the tissue reflectance and autofluorescence of PML and confounding lesions of the oral cavity. Wide-field autofluorescence imaging enables rapid inspection of large mucosal surfaces, to aid in recognition of suspicious lesions and may also help in discriminate the PML (class 1) from some of the confounding lesions (class II). However, the presence of inflammation or pigments is also associated with loss of stromal autofluorescence, and may give rise to false-positive results with widefield fluorescence imaging. Clinicians who use these autofluorescence based oral cancer screening devices should be aware about the benign oral mucosal lesions that may give false positivity so that unnecessary patient's anxiety and the need for scalpel biopsy can be eliminated.

  16. Multicenter Evaluation of Clinical Diagnostic Methods for Detection and Isolation of Campylobacter spp. from Stool.

    Science.gov (United States)

    Fitzgerald, Collette; Patrick, Mary; Gonzalez, Anthony; Akin, Joshua; Polage, Christopher R; Wymore, Kate; Gillim-Ross, Laura; Xavier, Karen; Sadlowski, Jennifer; Monahan, Jan; Hurd, Sharon; Dahlberg, Suzanne; Jerris, Robert; Watson, Renee; Santovenia, Monica; Mitchell, David; Harrison, Cassandra; Tobin-D'Angelo, Melissa; DeMartino, Mary; Pentella, Michael; Razeq, Jafar; Leonard, Celere; Jung, Carrianne; Achong-Bowe, Ria; Evans, Yaaqobah; Jain, Damini; Juni, Billie; Leano, Fe; Robinson, Trisha; Smith, Kirk; Gittelman, Rachel M; Garrigan, Charles; Nachamkin, Irving

    2016-05-01

    The use of culture-independent diagnostic tests (CIDTs), such as stool antigen tests, as standalone tests for the detection of Campylobacter in stool is increasing. We conducted a prospective, multicenter study to evaluate the performance of stool antigen CIDTs compared to culture and PCR for Campylobacter detection. Between July and October 2010, we tested 2,767 stool specimens from patients with gastrointestinal illness with the following methods: four types of Campylobacter selective media, four commercial stool antigen assays, and a commercial PCR assay. Illnesses from which specimens were positive by one or more culture media or at least one CIDT and PCR were designated "cases." A total of 95 specimens (3.4%) met the case definition. The stool antigen CIDTs ranged from 79.6% to 87.6% in sensitivity, 95.9 to 99.5% in specificity, and 41.3 to 84.3% in positive predictive value. Culture alone detected 80/89 (89.9% sensitivity) Campylobacter jejuni/Campylobacter coli-positive cases. Of the 209 noncases that were positive by at least one CIDT, only one (0.48%) was positive by all four stool antigen tests, and 73% were positive by just one stool antigen test. The questionable relevance of unconfirmed positive stool antigen CIDT results was supported by the finding that noncases were less likely than cases to have gastrointestinal symptoms. Thus, while the tests were convenient to use, the sensitivity, specificity, and positive predictive value of Campylobacter stool antigen tests were highly variable. Given the relatively low incidence of Campylobacter disease and the generally poor diagnostic test characteristics, this study calls into question the use of commercially available stool antigen CIDTs as standalone tests for direct detection of Campylobacter in stool. Copyright © 2016, American Society for Microbiology. All Rights Reserved.

  17. Diagnostic accuracy of susceptibility-weighted magnetic resonance imaging for the evaluation of pineal gland calcification

    Science.gov (United States)

    Böker, Sarah M.; Bender, Yvonne Y.; Diederichs, Gerd; Fallenberg, Eva M.; Wagner, Moritz; Hamm, Bernd; Makowski, Marcus R.

    2017-01-01

    Objectives To determine the diagnostic performance of susceptibility-weighted magnetic resonance imaging (SWMR) for the detection of pineal gland calcifications (PGC) compared to conventional magnetic resonance imaging (MRI) sequences, using computed tomography (CT) as a reference standard. Methods 384 patients who received a 1.5 Tesla MRI scan including SWMR sequences and a CT scan of the brain between January 2014 and October 2016 were retrospectively evaluated. 346 patients were included in the analysis, of which 214 showed PGC on CT scans. To assess correlation between imaging modalities, the maximum calcification diameter was used. Sensitivity and specificity and intra- and interobserver reliability were calculated for SWMR and conventional MRI sequences. Results SWMR reached a sensitivity of 95% (95% CI: 91%-97%) and a specificity of 96% (95% CI: 91%-99%) for the detection of PGC, whereas conventional MRI achieved a sensitivity of 43% (95% CI: 36%-50%) and a specificity of 96% (95% CI: 91%-99%). Detection rates for calcifications in SWMR and conventional MRI differed significantly (95% versus 43%, p<0.001). Diameter measurements between SWMR and CT showed a close correlation (R2 = 0.85, p<0.001) with a slight but not significant overestimation of size (SWMR: 6.5 mm ± 2.5; CT: 5.9 mm ± 2.4, p = 0.02). Interobserver-agreement for diameter measurements was excellent on SWMR (ICC = 0.984, p < 0.0001). Conclusions Combining SWMR magnitude and phase information enables the accurate detection of PGC and offers a better diagnostic performance than conventional MRI with CT as a reference standard. PMID:28278291

  18. Evaluating the accuracy of molecular diagnostic testing for canine visceral leishmaniasis using latent class analysis.

    Directory of Open Access Journals (Sweden)

    Manuela da Silva Solcà

    Full Text Available Host tissues affected by Leishmania infantum have differing degrees of parasitism. Previously, the use of different biological tissues to detect L. infantum DNA in dogs has provided variable results. The present study was conducted to evaluate the accuracy of molecular diagnostic testing (qPCR in dogs from an endemic area for canine visceral leishmaniasis (CVL by determining which tissue type provided the highest rate of parasite DNA detection. Fifty-one symptomatic dogs were tested for CVL using serological, parasitological and molecular methods. Latent class analysis (LCA was performed for accuracy evaluation of these methods. qPCR detected parasite DNA in 100% of these animals from at least one of the following tissues: splenic and bone marrow aspirates, lymph node and skin fragments, blood and conjunctival swabs. Using latent variable as gold standard, the qPCR achieved a sensitivity of 95.8% (CI 90.4-100 in splenic aspirate; 79.2% (CI 68-90.3 in lymph nodes; 77.3% (CI 64.5-90.1 in skin; 75% (CI 63.1-86.9 in blood; 50% (CI 30-70 in bone marrow; 37.5% (CI 24.2-50.8 in left-eye; and 29.2% (CI 16.7-41.6 in right-eye conjunctival swabs. The accuracy of qPCR using splenic aspirates was further evaluated in a random larger sample (n = 800, collected from dogs during a prevalence study. The specificity achieved by qPCR was 76.7% (CI 73.7-79.6 for splenic aspirates obtained from the greater sample. The sensitivity accomplished by this technique was 95% (CI 93.5-96.5 that was higher than those obtained for the other diagnostic tests and was similar to that observed in the smaller sampling study. This confirms that the splenic aspirate is the most effective type of tissue for detecting L. infantum infection. Additionally, we demonstrated that LCA could be used to generate a suitable gold standard for comparative CVL testing.

  19. Advanced error diagnostics of the CMAQ and Chimere modelling systems within the AQMEII3 model evaluation framework

    OpenAIRE

    E. Solazzo; C. Hogrefe; A. Colette; M. Garcia-Vivanco; M. Garcia-Vivanco; S. Galmarini

    2017-01-01

    The work here complements the overview analysis of the modelling systems participating in the third phase of the Air Quality Model Evaluation International Initiative (AQMEII3) by focusing on the performance for hourly surface ozone by two modelling systems, Chimere for Europe and CMAQ for North America. The evaluation strategy outlined in the course of the three phases of the AQMEII activity, aimed to build up a diagnostic methodology for model evaluation, is pursued her...

  20. [Application and evaluation of invasive prenatal diagnostic techniques and analysis of chromosomal karyotype].

    Science.gov (United States)

    Wang, Liqiong; Wang, Xin; Zhang, Shaoling; Zhou, Zhongmin; Zhu, Fufan; Ding, Yiling

    2013-04-01

    To evaluate the safety, effectiveness and complications of serial invasive prenatal diagnostic techniques, and to investigate the prenatal diagnosis indication as well as to analyze the abnormal chromosomal karyotype. We retrospectively studied all patients from March 2005 to May 2012 who received amniocentesis and cordocentesis in the prenatal diagnosis center of Second Xiangya Hospital. The indication of the procedure, successful rate and complications were evaluated, and 25 abnormal chromosome nuclear types were analyzed. A total of 669 patients received invasive prenatal diagnosis from March 2005 to May 2012 in Second Xiangya Hospital: 598 received amniocentesis and 71 cordocentesis carried out. Compared with the cordocentesis group, the amniocentesis group had higher achievement ratio (91.54% vs 100%, Pabnormal karyotypes (11.27% vs 2.84%, Pabnormality were the top 3 indications of amniocentesis and cordocentesis. We found 25 abnormal karyotypes, including 6 cases of trisomy 21, 4 sex chromosomal abnormalities, 7 autosomal balanced translocations, 1 marker chromosome, and 7 mosaics. As a widely used invasive prenatal diagnosis, amniocentesis is safe and effective. The complications of cordocentesis are much higher than those of amniocentesis, which is not a proper routine procedure for prenatal diagnosis of abnormal karyotype. The analysis of karyotype not only can identify fetal chromosome abnormality, but also provide the scientific basis for pregnancy continuation, thus reducing the ratio of birth defect.

  1. Main causes and diagnostic evaluation in patients with primary complaint of olfactory disturbances

    Directory of Open Access Journals (Sweden)

    Marco Aurélio Fornazieri

    2014-06-01

    Full Text Available INTRODUCTION: Establishing a diagnosis in patients with olfactory disturbances has always been challenging for physicians.One reason for this is the rarity of some of the diseases that affect this sense, such as Kallmann's syndrome and post-viral olfactory loss. OBJECTIVE: To identify the major causes of olfactory disturbances and to describe the diagnostic evaluation in outpatients attended to at an ambulatory clinic specialized in olfaction disorders. METHODS: A retrospective analysis was performed in outpatients with primary olfactory complaint attended to between June 1, 2011 and September 30, 2013 in a center specialized in olfactory disorders. Patient history, nasofibroscopy, and the University of Pennsylvania Smell Identification Test (UPSIT comprised the examination. RESULTS: Sixty-two patients were evaluated. The major causes were chronic rhinosinusitis (31%; rhinitis, primarily the allergic type (19%; post-viral olfactory loss (13%; and post-traumatic loss (8%. UPSIT scores were statistically different among different etiologies (p = 0.01. CONCLUSIONS: The major diagnoses that should be part of the physician assessment when a patient complains of olfactory disturbance are chronic rhinosinusitis with and without polyps, allergic rhinitis, post-viral olfactory loss, and post-traumatic loss.

  2. Evaluation of the diagnostic potential of urinary N-Acetyltyramine-O,β-glucuronide (NATOG) as diagnostic biomarker for Onchocerca volvulus infection.

    Science.gov (United States)

    Lagatie, Ole; Njumbe Ediage, Emmanuel; Batsa Debrah, Linda; Diels, Luc; Nolten, Christ; Vinken, Petra; Debrah, Alex; Dillen, Lieve; Silber, Steven; Stuyver, Lieven J

    2016-05-23

    Onchocerciasis, also known as river blindness is one of the neglected tropical diseases affecting millions of people, mainly in sub-Saharan Africa and is caused by the filarial nematode Onchocerca volvulus. Efforts to eliminate this disease are ongoing and are based on mass drug administration programs with the microfilaricide ivermectin. In order to monitor the efficacy of these programs, there is an unmet need for diagnostic tools capable of identifying infected patients. We have investigated the diagnostic potential of urinary N-acetyltyramine-O,β-glucuronide (NATOG), which is a promising O. volvulus specific biomarker previously identified by urine metabolome analysis. A liquid chromatography tandem mass spectrometry (LC-MS/MS) method was used to assess the stability characteristics of NATOG and to evaluate the levels of NATOG in study samples. An LC-fluorescence method was also developed. Stability characteristics of NATOG were investigated and shown to be ideally suited for use in tropical settings. Also, an easy and more accessible method based on liquid chromatography coupled to fluorescence detection was developed and shown to have the necessary sensitivity (limit of quantification 1 μM). Furthermore, we have evaluated the levels of NATOG in a population of 98 nodule-positive individuals from Ghana with no or low levels of microfilaria in the skin and compared them with the levels observed in different control groups (endemic controls (n = 50), non-endemic controls (n = 18) and lymphatic filariasis (n = 51). Only a few (5 %) of nodule-positive individuals showed an increased level (> 10 μM) of NATOG and there was no statistical difference between the nodule-positive individuals and the control groups (P > 0.05). Results of the present study indicate the limited potential of NATOG as a diagnostic biomarker for O. volvulus infection in amicrofilaridermic individuals.

  3. Early evaluation of a second generation information monitoring and diagnostic system

    Energy Technology Data Exchange (ETDEWEB)

    Piette, Mary Ann; Kinney, Satkartar; Bourassa, Norman; Xu, Peng; Haves, Philip; Kinney, Kristopher; Shockman, Christine

    2002-03-25

    Private sector commercial office buildings are challenging environments for energy efficiency projects. This challenge is related to the complexity of business environments that involve ownership, operation, and tenant relationships. Whether it is poor quality design, inefficient operations, degradation of equipment over time, or merely the increasing use of energy by tenants and inattention from landlords, commercial office building energy use continues to increase. This research project was developed to examine the environment for building operations and identify causes of inefficient use of energy related to technical and organizational issues. This report discusses a second-generation Information Monitoring and Diagnostic System (IMDS) installed at a leased office building in Sacramento, California. The report begins with a brief summary of the IMDS research at the previous building, followed by a discussion of the building selection process, the IMDS design and installation, recent use of the IMDS, costs and benefits, and fault detection and diagnostic research using the IMDS. A web site describes the IMDS in detail (see imds.lbl.gov). The underlying principle of this research project is that high quality building performance data can help show where energy is being used and how buildings systems actually perform is an important first step toward improving building energy efficiency. The project utilizes a high-quality monitoring system that has been developed during the past decade by a partnership between LBNL and private industry. This research project has been successful in demonstrating that the IMDS is tremendously valuable to the building operators at the Sacramento site. The building operators not only accept the technology, but it has become the core of their day-to-day building control concepts. The innovative property management company, Jones Lang LaSalle, is interested in installing more sites to determine if the system could provide an economic

  4. Evaluation of the diagnostic utility of the traditional and revised WHO dengue case definitions.

    Directory of Open Access Journals (Sweden)

    Gamaliel Gutiérrez

    Full Text Available Dengue, a mosquito-borne viral illness, is a major public health problem worldwide, and its incidence continues to increase. In 2009, the World Health Organization published guidelines that included a revision of the dengue case definition. Compared to the traditional definition, the revised case definition relies more on signs than on symptoms, making it more applicable to young children. We evaluated the diagnostic utility of both case definitions in two studies of pediatric dengue in Managua, Nicaragua. In a community-based cohort study, we included data from 3,407 suspected dengue cases, of which 476 were laboratory-confirmed. In the second study, we collected information from 1,160 participants recruited at the national pediatric reference hospital (723 laboratory-confirmed. In the cohort study, the traditional definition had 89.3% sensitivity and 43.1% specificity, while the revised definition yielded similar sensitivity (86.6% and higher specificity (55.2%, p<0.001. In the hospital study, the traditional case definition yielded 96.7% sensitivity and 22.0% specificity, whereas the revised case definition had higher sensitivity (99.3%, p<0.001 but lower specificity (8.5%, p<0.001. We then evaluated the performance of two diagnostic models based on the signs/symptoms included in each definition by analyzing the effect of increasing numbers of signs/symptoms on the sensitivity and specificity of case capture. Receiver operating characteristic analysis showed a slightly better performance for the revised model in both studies. Interestingly, despite containing less symptoms that cannot be readily expressed by children aged less than 4 years, the revised definition did not perform better in this age group. Overall, our results indicate that both case definitions have similar capacity to diagnose dengue. Owing to their high sensitivity and low specificity, they should be primarily used for screening purposes. However, in a primary care setting

  5. Air quality modeling for accountability research: Operational, dynamic, and diagnostic evaluation

    Science.gov (United States)

    Henneman, Lucas R. F.; Liu, Cong; Hu, Yongtao; Mulholland, James A.; Russell, Armistead G.

    2017-10-01

    Photochemical grid models play a central role in air quality regulatory frameworks, including in air pollution accountability research, which seeks to demonstrate the extent to which regulations causally impacted emissions, air quality, and public health. There is a need, however, to develop and demonstrate appropriate practices for model application and evaluation in an accountability framework. We employ a combination of traditional and novel evaluation techniques to assess four years (2001-02, 2011-12) of simulated pollutant concentrations across a decade of major emissions reductions using the Community Multiscale Air Quality (CMAQ) model. We have grouped our assessments in three categories: Operational evaluation investigates how well CMAQ captures absolute concentrations; dynamic evaluation investigates how well CMAQ captures changes in concentrations across the decade of changing emissions; diagnostic evaluation investigates how CMAQ attributes variability in concentrations and sensitivities to emissions between meteorology and emissions, and how well this attribution compares to empirical statistical models. In this application, CMAQ captures O3 and PM2.5 concentrations and change over the decade in the Eastern United States similarly to past CMAQ applications and in line with model evaluation guidance; however, some PM2.5 species-EC, OC, and sulfate in particular-exhibit high biases in various months. CMAQ-simulated PM2.5 has a high bias in winter months and low bias in the summer, mainly due to a high bias in OC during the cold months and low bias in OC and sulfate during the summer. Simulated O3 and PM2.5 changes across the decade have normalized mean bias of less than 2.5% and 17%, respectively. Detailed comparisons suggest biased EC emissions, negative wintertime SO42- sensitivities to mobile source emissions, and incomplete capture of OC chemistry in the summer and winter. Photochemical grid model-simulated O3 and PM2.5 responses to emissions and

  6. IN VITRO INDUCTION OF ENAMEL SUBSURFACE DEMINERALIZATION FOR EVALUATION OF DIAGNOSTIC IMAGING METHODS

    Science.gov (United States)

    Ferreira, Rívea Inês; Haiter-Neto, Francisco; Tabchoury, Cínthia Pereira Machado; Bóscolo, Frab Norberto

    2007-01-01

    The aim of this study was to investigate a model of inducing enamel subsurface demineralization for evaluating diagnostic imaging methods. Fifty sound teeth had their crowns coated with acid-resistant varnish, leaving a 7 mm2 circular window of exposed enamel in one of the proximal surfaces. The specimens were assigned to 5 groups (4 experimental and the control) and were kept immersed in a buffer solution at pH 4.8, 50% saturated in relation to enamel, for 60, 75, 90 and 120 days, or were not exposed to the solution. Digital radiographs were taken, prior to and after each immersion period, and interpreted by a radiologist. For validation, the enamel was submitted to microhardness profiling. In addition, the solutions were analyzed for phosphorus (Pi) and calcium (Ca) concentrations. Microhardness data were evaluated using two-way ANOVA (pradiography was assessed by ROC analysis. The microhardness values for the control group ranged from 405 to 432 KHN. Of the 4 experimental groups, the 60-day group demonstrated the highest values (179-379 KHN) and the 120-day group, the lowest values (103-277 KHN). The lowest total concentrations of Pi and Ca (1.74 mM and 2.63 mM, respectively) were found in the solutions of the 60- day group, indicating the lowest rate of mineral loss, however, there was no significant difference among the other experimental groups. The performance for detecting images consistent with caries lesions was high (Az = 0.89). Therefore, this in vitro model of inducing demineralization may be considered suitable for research intended to evaluate imaging methods for the diagnosis of proximal caries lesions. PMID:19089167

  7. Diagnostic ratios for the rapid evaluation of natural attenuation of heavy fuel oil pollution along shores.

    Science.gov (United States)

    Esquinas, Noemi; Rodríguez-Valdés, Eduardo; Márquez, Gonzalo; Gallego, José Luis R

    2017-10-01

    Marine oil spills are typically followed by complex clean-up and monitoring operations of the shorelines affected. In this regard, determination of the changes in the chemical composition of the spilled product is crucial for evaluation purposes. The "GC-MS fingerprint" approach requires the identification of several key parameters in order to differentiate between weathering processes. In this context, we performed a 900-day study (eight sampling campaigns) of natural attenuation on a rocky shore affected by a heavy fuel oil spill. The residues coating the rocks were studied by extraction, separation and evaluation of SARA fractions, followed by GC-MS analysis for saturates and aromatics. The results identified a group of diagnostic ratios with irregular capabilities to differentiate between volatilization, photodegradation, and biodegradation (using n-alkanes, isoprenoids and PAHs), while a second group of primarily stable ratios (using dibenzothiphenes, tricyclics and hopanes) was also obtained. Notably, this is the first time that some of these ratios have been used for marine spill monitoring purposes. The ratios were applied not only to evaluate weathering at the study site, but also to obtain a comparison with the degradation of floating oil slicks-a demonstration that weathering of the latter was quicker than that of oil on the shore rocks. Additionally, Pyrolysis-GC-MS analysis of the asphaltene fraction of residues coating the rocks revealed moderate changes in the composition of this initially recalcitrant fraction. These changes were consistent with those found in the proportion of resins and asphaltene fractions over time. Copyright © 2017 Elsevier Ltd. All rights reserved.

  8. In vitro induction of enamel subsurface demineralization for evaluation of diagnostic imaging methods

    Directory of Open Access Journals (Sweden)

    Rívea Inês Ferreira

    2007-10-01

    Full Text Available The aim of this study was to investigate a model of inducing enamel subsurface demineralization for evaluating diagnostic imaging methods. Fifty sound teeth had their crowns coated with acid-resistant varnish, leaving a 7 mm² circular window of exposed enamel in one of the proximal surfaces. The specimens were assigned to 5 groups (4 experimental and the control and were kept immersed in a buffer solution at pH 4.8, 50% saturated in relation to enamel, for 60, 75, 90 and 120 days, or were not exposed to the solution. Digital radiographs were taken, prior to and after each immersion period, and interpreted by a radiologist. For validation, the enamel was submitted to microhardness profiling. In addition, the solutions were analyzed for phosphorus (Pi and calcium (Ca concentrations. Microhardness data were evaluated using two-way ANOVA (p<0.05 and Tukey's test. Pi and Ca concentrations were compared using one-way ANOVA (alpha = 0.05. The performance of radiography was assessed by ROC analysis. The microhardness values for the control group ranged from 405 to 432 KHN. Of the 4 experimental groups, the 60-day group demonstrated the highest values (179-379 KHN and the 120-day group, the lowest values (103-277 KHN. The lowest total concentrations of Pi and Ca (1.74 mM and 2.63 mM, respectively were found in the solutions of the 60-day group, indicating the lowest rate of mineral loss, however, there was no significant difference among the other experimental groups. The performance for detecting images consistent with caries lesions was high (Az = 0.89. Therefore, this in vitro model of inducing demineralization may be considered suitable for research intended to evaluate imaging methods for the diagnosis of proximal caries lesions.

  9. Clinical and diagnostic methods for evaluation of sharp foreign body syndrome in buffaloes

    Directory of Open Access Journals (Sweden)

    Nasr-Eldin M. Aref

    2013-06-01

    Full Text Available Aim: The present study was designed to evaluate clinically and under laboratory condition the sharp foreign body syndrome (SFBS in buffaloes with special emphasis on the diagnostic value of radiography, ultrasonography and blood gases and acidbase balance. Materials and Methods: 196 buffaloes with a history of anorexia, reduction of milk production and no response to previous medical treatment were included in the present study. These animals were subjected to clinical and radiographical examinations. Positive cases for SFBS were further evaluated by sonography, hemato-biochemical and blood gas and acid base balance analysis.Results: Out of 196 admitted cases, 49 (25% cases were confirmed as SFBS by clinical and radiographical examination. Positive cases were subsequently divided into two main categories (complicated and non complicated according to radiographical and sonographical findings. SFBS with no complication was diagnosed in 16 cases while 33 cases showed various degrees of complication including reticular adhesion (abdominal and diaphragmatic, n= 23, diaphragmatic hernia (n = 6 and traumatic pericarditis (n = 4. Leukocytosis, hyperprotenemia and increased activity of AST and ALT were of additional values in the diagnosis of SFBS. A consistent finding of primary metabolic alkalosis was recorded in all cases except one with advanced traumatic pericarditis that showed metabolic acidosis. Conclusion: While there is no substitution for clinical examination, using of ultrasonography and radiography simultaneously are essential for proper evaluation and differentiation between various sequelae of SFBS in buffaloes. Radiography is an efficient tool for visualization of metallic foreign body while ultrasonography is an excellent device in assessing fibrinous deposits. Hemato-biochemical and blood gases and acid base balance are of additional values in discriminating between various outcomes of SFBS.

  10. Quality and Reporting of Diagnostic Accuracy Studies in TB, HIV and Malaria: Evaluation Using QUADAS and STARD Standards

    Science.gov (United States)

    Fontela, Patricia Scolari; Pant Pai, Nitika; Schiller, Ian; Dendukuri, Nandini; Ramsay, Andrew; Pai, Madhukar

    2009-01-01

    Background Poor methodological quality and reporting are known concerns with diagnostic accuracy studies. In 2003, the QUADAS tool and the STARD standards were published for evaluating the quality and improving the reporting of diagnostic studies, respectively. However, it is unclear whether these tools have been applied to diagnostic studies of infectious diseases. We performed a systematic review on the methodological and reporting quality of diagnostic studies in TB, malaria and HIV. Methods We identified diagnostic accuracy studies of commercial tests for TB, malaria and HIV through a systematic search of the literature using PubMed and EMBASE (2004–2006). Original studies that reported sensitivity and specificity data were included. Two reviewers independently extracted data on study characteristics and diagnostic accuracy, and used QUADAS and STARD to evaluate the quality of methods and reporting, respectively. Findings Ninety (38%) of 238 articles met inclusion criteria. All studies had design deficiencies. Study quality indicators that were met in less than 25% of the studies included adequate description of withdrawals (6%) and reference test execution (10%), absence of index test review bias (19%) and reference test review bias (24%), and report of uninterpretable results (22%). In terms of quality of reporting, 9 STARD indicators were reported in less than 25% of the studies: methods for calculation and estimates of reproducibility (0%), adverse effects of the diagnostic tests (1%), estimates of diagnostic accuracy between subgroups (10%), distribution of severity of disease/other diagnoses (11%), number of eligible patients who did not participate in the study (14%), blinding of the test readers (16%), and description of the team executing the test and management of indeterminate/outlier results (both 17%). The use of STARD was not explicitly mentioned in any study. Only 22% of 46 journals that published the studies included in this review required

  11. Assessing Autism in Adults: An Evaluation of the Developmental, Dimensional and Diagnostic Interview-Adult Version (3Di-Adult)

    Science.gov (United States)

    Mandy, William; Clarke, Kiri; McKenner, Michele; Strydom, Andre; Crabtree, Jason; Lai, Meng-Chuan; Allison, Carrie; Baron-Cohen, Simon; Skuse, David

    2018-01-01

    We developed a brief, informant-report interview for assessing autism spectrum conditions (ASC) in adults, called the Developmental, Dimensional and Diagnostic Interview-Adult Version (3Di-Adult); and completed a preliminary evaluation. Informant reports were collected for participants with ASC (n = 39), a non-clinical comparison group (n = 29)…

  12. Evaluation of the research diagnostic criteria for temporomandibular disorders for the recognition of an anterior disc displacement with reduction

    NARCIS (Netherlands)

    Naeije, M.; Kalaykova, S.; Visscher, C.M.; Lobbezoo, F.

    2009-01-01

    The aim of this Focus Article is to review critically the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) for the recognition of an anterior disc displacement with reduction (ADDR) in the temporomandibular joint (TMJ). This evaluation is based upon the experience gained

  13. Evaluation of selected clinical and diagnostic parameters in girls with anorexia nervosa (I).

    Science.gov (United States)

    Nogal, Paweł; Pniewska-Siark, Barbara; Lewiński, Andrzej

    2008-08-01

    Body weight loss in patients with anorexia nervosa (AN) is accompanied by a number of hormonal and metabolic disorders. The scope and intensity of these disorders may have a considerable influence on the prognosis in this disease. The goal of the study was an evaluation of selected diagnostic examinations in comparison with clinical data of female patients with AN. Retrospective studies involved eighty-seven (87) patients with AN. On therapy commencement, routine laboratory tests (full blood cell count, serum concentrations of sodium, potassium, glucose, cholesterol, triglycerides, total calcium, phosphates, total protein and the urea) and hormonal tests (TSH, TSH, FT4, FT3, E2, T, cortisol measured at 8(00), 17(00) and 24(00), LH and FSH in stimulation test with GnRH) were performed in each patient. Correlations were determined between clinical data and the measured hormone concentrations. In the studied girls, the mean values of routine laboratory tests, performed at the beginning of the therapy, were within the normal ranges (except hypernatremia). The mean concentrations of LH, FSH and FT4 were below reference values; the mean concentration of cortisol considerably exceeded the standard range. Statistically significant relations were demonstrated between BMI values and the concentrations of LH, E2 and cortisol. Body weigh loss is not significantly reflected by abnormal results of routinely performed laboratory tests. Hypogonadotropic hypogonadism and hypercortisolemia are the most characteristic hormonal symptoms in girls with AN.

  14. Diagnostic efficacy and therapeutic impact of computed tomography in the evaluation of clinically suspected otosclerosis

    Energy Technology Data Exchange (ETDEWEB)

    Dudau, Cristina [King' s College Hospital NHS Foundation Trust, Department of Neuroradiology, London (United Kingdom); Salim, Fakhruddin; Jiang, Dan [Department of Otolaryngology, Head and Neck Surgery, Auditory Implantation Centre, London (United Kingdom); Connor, Steve E.J. [Department of Radiology, Guy' s and St Thomas' NHS Foundation Trust, London (United Kingdom)

    2017-03-15

    To assess the diagnostic efficacy and therapeutic impact of CT in evaluating patients with clinically suspected otosclerosis. CT scans performed over a 5-year period for clinically suspected otosclerosis were retrospectively reviewed. CT diagnoses were correlated with subsequent surgical management. For otosclerosis positive cases, clinically significant extensions of otosclerosis were correlated with audiometry and the diagnosis was correlated with surgical findings. Of 259 CT studies, 46 % of patients were positive, 49 % negative and 5 % equivocal for otosclerosis. A relevant alternative CT diagnosis was evident in 33 % of the negative studies. One targeted surgery was performed for every four CT studies. CT outcome influenced the decision to perform stapedectomy in 41 % CT-positive versus 4 % CT-negative patients. CT-positive ears for otosclerosis could not be predicted from baseline clinical or audiometric criteria. Those with endosteal extension demonstrated lower bone conduction thresholds presurgically. The positive predictive value of CT diagnosis of otosclerosis was 100 %. CT demonstrated a high rate of clinically relevant diagnoses in both CT-positive and -negative for otosclerosis patients, and this frequently influenced surgical management. CT also added value by demonstrating relevant extensions of the otosclerotic foci, some of which were predictive of audiometric parameters. (orig.)

  15. Diagnostic Value of CT Arthrography for Evaluation of Osteochondral Lesions at the Ankle

    Directory of Open Access Journals (Sweden)

    Jan S. Kirschke

    2016-01-01

    Full Text Available Background. To retrospectively determine the diagnostic value of computed tomography arthrography (CTA of the ankle in the evaluation of (osteochondral lesions in comparison to conventional magnetic resonance imaging (MRI and intraoperative findings. Methods. A total of N=79 patients had CTAs and MRI of the ankle; in 17/79 cases surgical reports with statements on cartilage integrity were available. Cartilage lesions and bony defects at talus and tibia were scored according to defect depth and size by two radiologists. Statistical analysis included sensitivity analyses and Cohen’s kappa calculations. Results. On CTA, 41/79 and 31/79 patients had full thickness cartilage defects at the talus and at the tibia, respectively. MRI was able to detect 54% of these defects. For the detection of full thickness cartilage lesions, interobserver agreement was substantial (0.72 ± 0.05 for CTA and moderate (0.55 ± 0.07 for MRI. In surgical reports, 88–92% and 46–62% of full thickness defects detected by CTA and MRI were described. CTA findings changed the further clinical management in 15.4% of cases. Conclusions. As compared to conventional MRI, CTA improves detection and visualization of cartilage defects at the ankle and is a relevant tool for treatment decisions in unclear cases.

  16. Evaluation of a rapid diagnostic test for yaws infection in a community surveillance setting.

    Directory of Open Access Journals (Sweden)

    Michael Marks

    2014-09-01

    Full Text Available Yaws is a non-venereal treponemal infection caused by Treponema pallidum ssp. pertenue. The WHO has launched a worldwide control programme, which aims to eradicate yaws by 2020. The development of a rapid diagnostic test (RDT for serological diagnosis in the isolated communities affected by yaws is a key requirement for the successful implementation of the WHO strategy. We conducted a study to evaluate the utility of the DPP test in screening for yaws, utilizing samples collected as part of a community prevalence survey conducted in the Solomon Islands. 415 serum samples were tested using both traditional syphilis serology (TPPA and quantitative RPR and the Chembio DPP Syphilis Screen and Confirm RDT. We calculated the sensitivity and specificity of the RDT as compared to gold standard serology. The sensitivity of the RDT against TPPA was 58.5% and the specificity was 97.6%. The sensitivity of the RDT against RPR was 41.7% and the specificity was 95.2%. The sensitivity of the DPP was strongly related to the RPR titre with a sensitivity of 92.0% for an RPR titre of >1/16. Wider access to DPP testing would improve our understanding of worldwide yaws case reporting and the test may play a key role in assessing patients presenting with yaws like lesions in a post-mass drug administration (MDA setting.

  17. A Diagnostic Post-Occupancy Evaluation of the Nacadia® Therapy Garden.

    Science.gov (United States)

    Sidenius, Ulrik; Karlsson Nyed, Patrik; Linn Lygum, Victoria; K Stigsdotter, Ulrika

    2017-08-05

    The design of the Nacadia® therapy garden is based on a model for evidence-based health design in landscape architecture (EBHDL). One element of the model is a diagnostic post-occupancy evaluation (DPOE), which has not previously been fully developed. The present study develops a generic DPOE for therapy gardens, with a focus on studying the effects of the design on patients' health outcomes. This is done in order to identify successes and failures in the design. By means of a triangulation approach, the DPOE employs a mixture of methods, and data is interpreted corroborating. The aim of the present study is to apply the DPOE to the Nacadia® therapy garden. The results of the DPOE suggest that the design of the Nacadia® therapy garden fulfills its stated aims and objectives. The overall environment of the Nacadia ® therapy garden was experienced as protective and safe, and successfully incorporated the various elements of the nature-based therapy programme. The participants encountered meaningful spaces and activities which suited their current physical and mental capabilities, and the health outcome measured by EQ-VAS (self-estimated general health) indicated a significant increase. Some design failures were identified, of which visual exposure was the most noteworthy. The DPOE model presented appears to be efficient but would nonetheless profit from being validated by other cases.

  18. A Diagnostic Post-Occupancy Evaluation of the Nacadia® Therapy Garden

    Science.gov (United States)

    Sidenius, Ulrik; Karlsson Nyed, Patrik; Linn Lygum, Victoria; K. Stigsdotter, Ulrika

    2017-01-01

    The design of the Nacadia® therapy garden is based on a model for evidence-based health design in landscape architecture (EBHDL). One element of the model is a diagnostic post-occupancy evaluation (DPOE), which has not previously been fully developed. The present study develops a generic DPOE for therapy gardens, with a focus on studying the effects of the design on patients’ health outcomes. This is done in order to identify successes and failures in the design. By means of a triangulation approach, the DPOE employs a mixture of methods, and data is interpreted corroborating. The aim of the present study is to apply the DPOE to the Nacadia® therapy garden. The results of the DPOE suggest that the design of the Nacadia® therapy garden fulfills its stated aims and objectives. The overall environment of the Nacadia ® therapy garden was experienced as protective and safe, and successfully incorporated the various elements of the nature-based therapy programme. The participants encountered meaningful spaces and activities which suited their current physical and mental capabilities, and the health outcome measured by EQ-VAS (self-estimated general health) indicated a significant increase. Some design failures were identified, of which visual exposure was the most noteworthy. The DPOE model presented appears to be efficient but would nonetheless profit from being validated by other cases. PMID:28783060

  19. Diagnostic value and prognostic evaluation of dynamic video-electroencephalogram monitoring in children with epilepsy

    Science.gov (United States)

    Wu, Xiaobo; Su, Ying; Liu, Wei; Jia, Xiaoyu; Zhang, Yanling; Zhang, Xinyang; Wang, Guilan

    2017-01-01

    The diagnostic and prognostic value of dynamic video-electroencephalogram (V-EEG) monitoring in children with epilepsy were investigated. From February 2014 to February 2016, in total 200 children with epilepsy were selected during their stay in the First Hospital of Qinghuangdao and were randomly allocated to a dynamic and a conventional V-EEG monitoring group (n=100). The detection rate of epileptiform discharges in the two groups was evaluated. The V-EEG monitoring index was used to select treatment methods for patients with epilepsy. After 3 months, the patients were rechecked. Disease features and incidence of epilepsy were recorded. There were no significant differences in the course of disease, seizure frequency and age between the two groups (P>0.05). The detection rate of epileptiform discharges in the dynamic V-EEG was significantly higher than in the routine monitoring group (P<0.01). The accuracy and specificity of monitoring in the V-EEG were significantly higher than in the routine monitoring group (P<0.01). Seizure frequency and number of epilepsy attacks in patients in the V-EEG group were significantly lower than in the routine monitoring group (P<0.01). Dynamic V-EEG can improve epilepsy detection rate. The high accuracy and specificity of dynamic V-EEG suggest that it may be of great clinical value in the diagnosis and prognosis of epilepsy. PMID:28962191

  20. A Diagnostic Post-Occupancy Evaluation of the Nacadia® Therapy Garden

    Directory of Open Access Journals (Sweden)

    Ulrik Sidenius

    2017-08-01

    Full Text Available The design of the Nacadia® therapy garden is based on a model for evidence-based health design in landscape architecture (EBHDL. One element of the model is a diagnostic post-occupancy evaluation (DPOE, which has not previously been fully developed. The present study develops a generic DPOE for therapy gardens, with a focus on studying the effects of the design on patients’ health outcomes. This is done in order to identify successes and failures in the design. By means of a triangulation approach, the DPOE employs a mixture of methods, and data is interpreted corroborating. The aim of the present study is to apply the DPOE to the Nacadia® therapy garden. The results of the DPOE suggest that the design of the Nacadia® therapy garden fulfills its stated aims and objectives. The overall environment of the Nacadia ® therapy garden was experienced as protective and safe, and successfully incorporated the various elements of the nature-based therapy programme. The participants encountered meaningful spaces and activities which suited their current physical and mental capabilities, and the health outcome measured by EQ-VAS (self-estimated general health indicated a significant increase. Some design failures were identified, of which visual exposure was the most noteworthy. The DPOE model presented appears to be efficient but would nonetheless profit from being validated by other cases.

  1. Bipolar diagnosis in China: Evaluating diagnostic confidence using the Bipolarity Index.

    Science.gov (United States)

    Ma, Yantao; Gao, Huimin; Yu, Xin; Si, Tianmei; Wang, Gang; Fang, Yiru; Liu, Zhening; Sun, Jing; Yang, Haichen; Wang, Xueyi; Li, Jing; Zhang, Yonghua; Sachs, Gary

    2016-09-15

    Diagnosis of bipolar disorder is inherently difficult. The goal of this study was to examine the utility and psychometric properties of the Bipolarity Index (BPx) in a population of patients treated in China. At nine Chinese health facilities participating in CAFÉ-BD, clinicians completed a standardized affective disorder evaluation for consecutive patients (N=615) with a clinical diagnosis of MDD and BPD and scored the Bipolarity Index. The investigators constructed ROC curves to determine the optimal cut off points to discriminate subjects in three clinical diagnostic groups: bipolar disorder (BPD), major depressive disorder (MDD) and healthy (no psychiatric diagnosis) controls (HC). This study is registered with ClinicalTrials.gov, number NCT02015143. 1) The cut-off score between the MDD and BPD groups was 42.0, with a sensitivity of 0.957 and specificity of 0.881 (Z=63.064, Pbipolar spectrum disorders. Further prospective study is necessary to determine if the BPx is useful in identifying subgroups among MDD subjects at high risk for conversion to BPD. Copyright © 2016 Elsevier B.V. All rights reserved.

  2. Diagnostic value and prognostic evaluation of dynamic video-electroencephalogram monitoring in children with epilepsy.

    Science.gov (United States)

    Wu, Xiaobo; Su, Ying; Liu, Wei; Jia, Xiaoyu; Zhang, Yanling; Zhang, Xinyang; Wang, Guilan

    2017-09-01

    The diagnostic and prognostic value of dynamic video-electroencephalogram (V-EEG) monitoring in children with epilepsy were investigated. From February 2014 to February 2016, in total 200 children with epilepsy were selected during their stay in the First Hospital of Qinghuangdao and were randomly allocated to a dynamic and a conventional V-EEG monitoring group (n=100). The detection rate of epileptiform discharges in the two groups was evaluated. The V-EEG monitoring index was used to select treatment methods for patients with epilepsy. After 3 months, the patients were rechecked. Disease features and incidence of epilepsy were recorded. There were no significant differences in the course of disease, seizure frequency and age between the two groups (P>0.05). The detection rate of epileptiform discharges in the dynamic V-EEG was significantly higher than in the routine monitoring group (Pmonitoring in the V-EEG were significantly higher than in the routine monitoring group (Pmonitoring group (P<0.01). Dynamic V-EEG can improve epilepsy detection rate. The high accuracy and specificity of dynamic V-EEG suggest that it may be of great clinical value in the diagnosis and prognosis of epilepsy.

  3. Impact of an intra-cycle motion correction algorithm on overall evaluability and diagnostic accuracy of computed tomography coronary angiography

    Energy Technology Data Exchange (ETDEWEB)

    Pontone, Gianluca; Bertella, Erika; Baggiano, Andrea; Mushtaq, Saima; Loguercio, Monica; Segurini, Chiara; Conte, Edoardo; Beltrama, Virginia; Annoni, Andrea; Formenti, Alberto; Petulla, Maria; Trabattoni, Daniela; Pepi, Mauro [Centro Cardiologico Monzino, IRCCS, Milan (Italy); Andreini, Daniele; Montorsi, Piero; Bartorelli, Antonio L. [Centro Cardiologico Monzino, IRCCS, Milan (Italy); University of Milan, Department of Cardiovascular Sciences and Community Health, Milan (Italy); Guaricci, Andrea I. [University of Foggia, Department of Cardiology, Foggia (Italy)

    2016-01-15

    The aim of this study was to evaluate the impact of a novel intra-cycle motion correction algorithm (MCA) on overall evaluability and diagnostic accuracy of cardiac computed tomography coronary angiography (CCT). From a cohort of 900 consecutive patients referred for CCT for suspected coronary artery disease (CAD), we enrolled 160 (18 %) patients (mean age 65.3 ± 11.7 years, 101 male) with at least one coronary segment classified as non-evaluable for motion artefacts. The CCT data sets were evaluated using a standard reconstruction algorithm (SRA) and MCA and compared in terms of subjective image quality, evaluability and diagnostic accuracy. The mean heart rate during the examination was 68.3 ± 9.4 bpm. The MCA showed a higher Likert score (3.1 ± 0.9 vs. 2.5 ± 1.1, p < 0.001) and evaluability (94%vs.79 %, p < 0.001) than the SRA. In a 45-patient subgroup studied by clinically indicated invasive coronary angiography, specificity, positive predictive value and accuracy were higher in MCA vs. SRA in segment-based and vessel-based models, respectively (87%vs.73 %, 50%vs.34 %, 85%vs.73 %, p < 0.001 and 62%vs.28 %, 66%vs.51 % and 75%vs.57 %, p < 0.001). In a patient-based model, MCA showed higher accuracy vs. SCA (93%vs.76 %, p < 0.05). MCA can significantly improve subjective image quality, overall evaluability and diagnostic accuracy of CCT. (orig.)

  4. Evaluation of the diagnostic accuracy of CareStart G6PD deficiency Rapid Diagnostic Test (RDT) in a malaria endemic area in Ghana, Africa.

    Science.gov (United States)

    Adu-Gyasi, Dennis; Asante, Kwaku Poku; Newton, Sam; Dosoo, David; Amoako, Sabastina; Adjei, George; Amoako, Nicholas; Ankrah, Love; Tchum, Samuel Kofi; Mahama, Emmanuel; Agyemang, Veronica; Kayan, Kingsley; Owusu-Agyei, Seth

    2015-01-01

    Glucose-6-phosphate dehydrogenase (G6PD) deficiency is the most widespread enzyme defect that can result in red cell breakdown under oxidative stress when exposed to certain medicines including antimalarials. We evaluated the diagnostic accuracy of CareStart G6PD deficiency Rapid Diagnostic Test (RDT) as a point-of-care tool for screening G6PD deficiency. A cross-sectional study was conducted among 206 randomly selected and consented participants from a group with known G6PD deficiency status between February 2013 and June 2013. A maximum of 1.6ml of capillary blood samples were used for G6PD deficiency screening using CareStart G6PD RDT and Trinity qualitative with Trinity quantitative methods as the "gold standard". Samples were also screened for the presence of malaria parasites. Data entry and analysis were done using Microsoft Access 2010 and Stata Software version 12. Kintampo Health Research Centre Institutional Ethics Committee granted ethical approval. The sensitivity (SE) and specificity (SP) of CareStart G6PD deficiency RDT was 100% and 72.1% compared to Trinity quantitative method respectively and was 98.9% and 96.2% compared to Trinity qualitative method. Malaria infection status had no significant (P=0.199) change on the performance of the G6PD RDT test kit compared to the "gold standard". The outcome of this study suggests that the diagnostic performance of the CareStart G6PD deficiency RDT kit was high and it is acceptable at determining the G6PD deficiency status in a high malaria endemic area in Ghana. The RDT kit presents as an attractive tool for point-of-care G6PD deficiency for rapid testing in areas with high temperatures and less expertise. The CareStart G6PD deficiency RDT kit could be used to screen malaria patients before administration of the fixed dose primaquine with artemisinin-based combination therapy.

  5. Methods for the field evaluation of quantitative G6PD diagnostics: a review.

    Science.gov (United States)

    Ley, Benedikt; Bancone, Germana; von Seidlein, Lorenz; Thriemer, Kamala; Richards, Jack S; Domingo, Gonzalo J; Price, Ric N

    2017-09-11

    Individuals with glucose-6-phosphate dehydrogenase (G6PD) deficiency are at risk of severe haemolysis following the administration of 8-aminoquinoline compounds. Primaquine is the only widely available 8-aminoquinoline for the radical cure of Plasmodium vivax. Tafenoquine is under development with the potential to simplify treatment regimens, but point-of-care (PoC) tests will be needed to provide quantitative measurement of G6PD activity prior to its administration. There is currently a lack of appropriate G6PD PoC tests, but a number of new tests are in development and are likely to enter the market in the coming years. As these are implemented, they will need to be validated in field studies. This article outlines the technical details for the field evaluation of novel quantitative G6PD diagnostics such as sample handling, reference testing and statistical analysis. Field evaluation is based on the comparison of paired samples, including one sample tested by the new assay at point of care and one sample tested by the gold-standard reference method, UV spectrophotometry in an established laboratory. Samples can be collected as capillary or venous blood; the existing literature suggests that potential differences in capillary or venous blood are unlikely to affect results substantially. The collection and storage of samples is critical to ensure preservation of enzyme activity, it is recommended that samples are stored at 4 °C and testing occurs within 4 days of collection. Test results can be visually presented as scatter plot, Bland-Altman plot, and a histogram of the G6PD activity distribution of the study population. Calculating the adjusted male median allows categorizing results according to G6PD activity to calculate standard performance indicators and to perform receiver operating characteristic (ROC) analysis.

  6. Field evaluation of a dual rapid diagnostic test for HIV infection and syphilis in Lima, Peru.

    Science.gov (United States)

    Bristow, Claire C; Leon, Segundo R; Huang, Emily; Brown, Brandon J; Ramos, Lourdes B; Vargas, Silver K; Flores, Juan A; Caceres, Carlos F; Klausner, Jeffrey D

    2016-05-01

    Screening for HIV and syphilis in key populations is recommended by the WHO to reduce the morbidity, mortality and transmission associated with undiagnosed and untreated infections. Rapid point-of-care tests that can detect multiple infections with a single fingerprick whole blood specimen using a single device are gaining popularity. We evaluated the field performance of a rapid dual HIV and syphilis test in people at high risk of HIV and syphilis infections. Participants included men who have sex with men and transgender women recruited in Lima, Peru. Reference standard testing for detection of HIV and syphilis infections, conducted using blood samples from venipuncture, included Treponema pallidum particle agglutination and fourth-generation HIV enzyme immunoassay for which positive results had a confirmation HIV Western blot test. For the evaluation test, SD BIOLINE HIV/Syphilis Duo test (Standard Diagnostics, Korea), a fingerprick blood specimen was used. Sensitivity and specificity were calculated and the exact binomial method was used to determine 95% CIs. A total of 415 participants were recruited for the study. The dual test sensitivity for detection of T. pallidum infection was 89.2% (95% CI 83.5% to 93.5%) and specificity 98.8% (95% CI 96.5% to 99.8%). For detection of HIV infection, the sensitivity of the dual test was 99.1% (95% CI 94.8% to 100%) and specificity 99.4% (95% CI 97.7% to 99.9%). This high performing dual test should be considered for the use in clinical settings to increase uptake of simultaneous testing of HIV and syphilis and accelerate time to treatment for those who need it. 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/

  7. Diagnostic evaluation and management of chronic thromboembolic pulmonary hypertension: A clinical practice guideline

    Science.gov (United States)

    Mehta, Sanjay; Helmersen, Doug; Provencher, Steeve; Hirani, Naushad; Rubens, Fraser D; De Perrot, Marc; Blostein, Mark; Boutet, Kim; Chandy, George; Dennie, Carole; Granton, John; Hernandez, Paul; Hirsch, Andrew M; Laframboise, Karen; Levy, Robert D; Lien, Dale; Martel, Simon; Shoemaker, Gerard; Swiston, John; Weinkauf, Justin

    2010-01-01

    BACKGROUND Pulmonary embolism is a common condition. Some patients subsequently develop chronic thromboembolic pulmonary hypertension (CTEPH). Many care gaps exist in the diagnosis and management of CTEPH patients including lack of awareness, incomplete diagnostic assessment, and inconsistent use of surgical and medical therapies. METHODS A representative interdisciplinary panel of medical experts undertook a formal clinical practice guideline development process. A total of 20 key clinical issues were defined according to the patient population, intervention, comparator, outcome (PICO) approach. The panel performed an evidence-based, systematic, literature review, assessed and graded the relevant evidence, and made 26 recommendations. RESULTS Asymptomatic patients postpulmonary embolism should not be screened for CTEPH. In patients with pulmonary hypertension, the possibility of CTEPH should be routinely evaluated with initial ventilation/ perfusion lung scanning, not computed tomography angiography. Pulmonary endarterectomy surgery is the treatment of choice in patients with surgically accessible CTEPH, and may also be effective in CTEPH patients with disease in more ‘distal’ pulmonary arteries. The anatomical extent of CTEPH for surgical pulmonary endarterectomy is best assessed by contrast pulmonary angiography, although positive computed tomography angiography may be acceptable. Novel medications indicated for the treatment of pulmonary hypertension may be effective for selected CTEPH patients. CONCLUSIONS The present guideline requires formal dissemination to relevant target user groups, the development of tools for implementation into routine clinical practice and formal evaluation of the impact of the guideline on the quality of care of CTEPH patients. Moreover, the guideline will be updated periodically to reflect new evidence or clinical approaches. PMID:21165353

  8. Immunoassay screening in urine for synthetic cannabinoids - an evaluation of the diagnostic efficiency.

    Science.gov (United States)

    Franz, Florian; Angerer, Verena; Jechle, Hanna; Pegoro, Melanie; Ertl, Harald; Weinfurtner, Georg; Janele, David; Schlögl, Christian; Friedl, Matthias; Gerl, Stefan; Mielke, Reinhard; Zehnle, Ralf; Wagner, Matthias; Moosmann, Bjoern; Auwärter, Volker

    2017-08-28

    The abuse of synthetic cannabinoids (SCs) as presumed legal alternative to cannabis poses a great risk to public health. For economic reasons many laboratories use immunoassays (IAs) to screen for these substances in urine. However, the structural diversity and high potency of these designer drugs places high demands on IAs regarding cross-reactivity of the antibodies used and detection limits. Two retrospective studies were carried out in order to evaluate the capability of two homogenous enzyme IAs for the detection of currently prevalent SCs in authentic urine samples. Urine samples were analyzed utilizing a 'JWH-018' kit and a 'UR-144' kit. The IA results were confirmed by an up-to-date liquid chromatography-electrospray ionization-tandem mass spectrometry (LC-ESI-MS/MS) screening method covering metabolites of 45 SCs. The first study (n=549) showed an 8% prevalence of SCs use (LC-MS/MS analysis) among inpatients of forensic-psychiatric clinics, whereas all samples were tested negative by the IAs. In a second study (n=200) the combined application of both IAs led to a sensitivity of 2% and a diagnostic accuracy of 51% when applying the recommended IA cut-offs. Overall, 10 different currently prevalent SCs were detected in this population. The results can be explained by an insufficient cross-reactivity of the antibodies towards current SCs in combination with relatively high detection limits of the IAs. In light of the presented study data it is strongly recommended not to rely on the evaluated IA tests for SCs in clinical or forensic settings. For IA kits of other providers similar results can be expected.

  9. Added value of a serum proteomic signature in the diagnostic evaluation of lung nodules.

    Science.gov (United States)

    Pecot, Chad V; Li, Ming; Zhang, Xueqiong J; Rajanbabu, Rama; Calitri, Ciara; Bungum, Aaron; Jett, James R; Putnam, Joe B; Callaway-Lane, Carol; Deppen, Steve; Grogan, Eric L; Carbone, David P; Worrell, John A; Moons, Karel G M; Shyr, Yu; Massion, Pierre P

    2012-05-01

    Current management of lung nodules is complicated by nontherapeutic resections and missed chances for cure. We hypothesized that a serum proteomic signature may add diagnostic information beyond that provided by combined clinical and radiographic data. Cohort A included 265 and cohort B 114 patients. Using multivariable logistic regression analysis we calculated the area under the receiver operating characteristic curve (AUC) and quantified the added value of a previously described serum proteomic signature beyond clinical and radiographic risk factors for predicting lung cancer using the integration discrimination improvement (IDI) index. The average computed tomography (CT) measured nodule size in cohorts A and B was 37.83 versus 23.15 mm among patients with lung cancer and 15.82 versus 17.18 mm among those without, respectively. In cohort A, the AUC increased from 0.68 to 0.86 after adding chest CT imaging variables to the clinical results, but the proteomic signature did not provide meaningful added value. In contrast, in cohort B, the AUC improved from 0.46 with clinical data alone to 0.61 when combined with chest CT imaging data and to 0.69 after adding the proteomic signature (IDI of 20% P = 0.0003). In addition, in a subgroup of 100 nodules between 5 and 20 mm in diameter, the proteomic signature added value with an IDI of 15% (P ≤ 0.0001). The results show that this serum proteomic biomarker signature may add value to the clinical and chest CT evaluation of indeterminate lung nodules. This study suggests a possible role of a blood biomarker in the evaluation of indeterminate lung nodules.

  10. Diagnostic performance and useful findings of ultrasound re-evaluation for patients with equivocal CT features of acute appendicitis.

    Science.gov (United States)

    Kim, Mi Sung; Kwon, Heon-Ju; Kang, Kyung A; Do, In-Gu; Park, Hee-Jin; Kim, Eun Young; Hong, Hyun Pyo; Choi, Yoon Jung; Kim, Young Hwan

    2018-02-01

    To evaluate the diagnostic performance of ultrasound and to determine which ultrasound findings are useful to differentiate appendicitis from non-appendicitis in patients who underwent ultrasound re-evaluation owing to equivocal CT features of acute appendicitis. 62 patients who underwent CT examinations for suspected appendicitis followed by ultrasound re-evaluation owing to equivocal CT findings were included. Equivocal CT findings were considered based on the presence of only one or two findings among the CT criteria, and ultrasound re-evaluation was done based on a predefined structured report form. The diagnostic performance of ultrasound and independent variables to discriminate appendicitis from non-appendicitis were assessed. There were 27 patients in the appendicitis group. The overall diagnostic performance of ultrasound re-evaluation was sensitivity of 96.3%, specificity of 91.2% and accuracy of 91.9%. In terms of the performance of individual ultrasound findings, probe-induced tenderness showed the highest accuracy (86.7%) with sensitivity of 74% and specificity of 97%, followed by non-compressibility (accuracy 71.7%, sensitivity 85.2% and specificity 60.6%). The independent ultrasound findings for discriminating appendicitis were non-compressibility (p = 0.002) and increased flow on the appendiceal wall (p = 0.001). Ultrasound re-evaluation can be used to improve diagnostic accuracy in cases with equivocal CT features for diagnosing appendicitis. The presence of non-compressibility and increased vascular flow on the appendix wall are useful ultrasound findings to discriminate appendicitis from non-appendicitis. Advances in knowledge: Ultrasound re-evaluation is useful to discriminate appendicitis from non-appendicitis when CT features are inconclusive.

  11. Diagnostic accuracy of cone beam computed tomography in identification and postoperative evaluation of furcation defects

    Directory of Open Access Journals (Sweden)

    Natasha Pajnigara

    2016-01-01

    Full Text Available Background: Decision-making in periodontal therapeutics is critical and is influenced by accurate diagnosis of osseous defects, especially furcation involvement. Commonly used diagnostic methods such as clinical probing and conventional radiography have their own limitations. Hence, this study was planned to evaluate the dimensions of furcation defects clinically (pre- and post-surgery, intra-surgically, and by cone beam computed tomography (CBCT (pre- and post-surgery. Materials and Methods: The study comprised a total of 200 Grade II furcation defects in forty patients, with a mean age of 38.05 ± 4.77 years diagnosed with chronic periodontitis which were evaluated clinically (pre- and post-surgically, by CBCT (pre- and post-surgically, and intrasurgically after flap reflection (40 defects in each. After the presurgical clinical and CBCT measurements, demineralized freeze-dried bone allograft was placed in the furcation defect and the flaps were sutured back. Six months later, these defects were evaluated by recording measurements clinically, i.e., postsurgery clinical measurements and also postsurgery CBCT measurements (40 defects each. Results: Presurgery clinical measurements (vertical 6.15 ± 1.71 mm and horizontal 3.05 ± 0.84 mm and CBCT measurements (vertical 7.69 ± 1.67 mm and horizontal 4.62 ± 0.77 mm underestimated intrasurgery measurements (vertical 8.025 ± 1.67 mm and horizontal 4.82 ± 0.67 mm in both vertical and horizontal aspects, and the difference was statistically not significant (vertical P = 1.000, 95% confidence interval [CI], horizontal P = 0.867, 95% CI. Further, postsurgery clinical measurements (vertical 2.9 ± 0.74 mm and horizontal 1.52 ± 0.59 mm underestimated CBCT measurements (vertical 3.67 ± 1.17 mm and horizontal 2.45 ± 0.48 mm. There was statistically significant difference between presurgery clinical–presurgery CBCT (P < 0.0001, 95% CI versus postsurgery clinical–postsurgery CBCT (P < 0.0001, 95% CI

  12. Musculoskeletal Sonoelastography: A Focused Review of its Diagnostic Applications for Evaluating Tendons and Fascia

    National Research Council Canada - National Science Library

    Wu, Chueh-Hung; Chen, Wen-Shiang; Park, Gi-Young; Wang, Tyng-Guey; Lew, Henry L

    2012-01-01

    ...-Young Park (3), Tyng-Guey Wang (2), Henry L. Lew (4)(5) Abstract: Although its clinical utility remains under investigation, sonoelastography has demonstrated potential for use as an adjunct diagnostic tool in musculoskeletal medicine...

  13. Echocardiographic evaluation of pre-diagnostic development in young relatives genetically predisposed to hypertrophic cardiomyopathy

    DEFF Research Database (Denmark)

    Jensen, Morten K; Havndrup, Ole; Christiansen, Michael

    2015-01-01

    Identification of the first echocardiographic manifestations of hypertrophic cardiomyopathy may be important for clinical management and our understanding of the pathogenesis. We studied the development of pre-diagnostic echocardiographic changes in young relatives to HCM patients during long...

  14. Evaluation of diagnostic thresholds dependability for tribologic signals received in the environment disturbed by vibroacoustic and functional signals

    Directory of Open Access Journals (Sweden)

    Lindstedt Paweł

    2015-12-01

    Full Text Available Determination of dependable diagnostic thresholds for tribologic signals received e.g. from antifriction bearings (in particular for insufficient number of measurements, only 4÷5 is a really difficult task due to complexity of working environment where such bearings are operated. Typical working environment for such objects must take account for operation time under various working conditions and accompanying (and disturbing signals, e.g. vibroacoustic ones. The sought assessment of the relationship between diagnostic signals and environmental noise can be determined from convolution of both diagnostic and environments signals that make up the complete set of received information. The convolution of these two series of signals can be obtained from an algorithm based on the Cauchy product. Then one has to find the coherence factor and the square of amplitude gain for the set of diagnostic signals with reference to various sets of signals received from environment, which makes it possible to evaluate cohesion of the investigated series of signals, thus their suitability to determine diagnostic threshold for tribologic signals intended for the analysis.

  15. Receiver Operating Characteristic (ROC) Curve Analysis for Medical Diagnostic Test Evaluation.

    Science.gov (United States)

    Hajian-Tilaki, Karimollah

    2013-01-01

    This review provides the basic principle and rational for ROC analysis of rating and continuous diagnostic test results versus a gold standard. Derived indexes of accuracy, in particular area under the curve (AUC) has a meaningful interpretation for disease classification from healthy subjects. The methods of estimate of AUC and its testing in single diagnostic test and also comparative studies, the advantage of ROC curve to determine the optimal cut off values and the issues of bias and confounding have been discussed.

  16. Evaluation of a diagnostic therapeutic educational pathway for asthma management in youth.

    Science.gov (United States)

    Guarnaccia, Sebastiano; Quecchia, Cristina; Festa, Andrea; Magoni, Michele; Moneda, Marco; Gretter, Valeria; Scarcella, Carmelo; Pluda, Ada; Gasparotti, Cinzia; Frassine, Malica; Vitale, Luigi; D'Agata, Emanuele; Limina, Rosa Maria; Donato, Francesco

    2017-11-23

    In spite of some evidence for positive effects of patient's education to asthma self-management by randomized clinical trials, there are few studies on the impact of patient' s educational programs in the real world. We aimed to assess the impact of a diagnostic therapeutic educational pathway (DTEP) on asthma control of children and adolescents by comparing frequency of outcomes indicative of asthma control before and after attending the pathway. This is a retrospective cohort study including all patients aged 6-11 and 12-17 years who attended the DTEP in 2007-2014. The DTEP includes 3 specialist's evaluations at 8- to 12-week intervals and two follow-up visits. Patients and their parents receive an educational course concerning prevention measures, early recognition of symptoms, and appropriate use of drugs and devices. The rates of hospitalizations, outpatient services, emergency room visits, and drug prescriptions were considered as outcomes and computed as number of events divided by person-time. A total of 806 patients were enrolled. A statistically significant decrease in rates from before to after DTEP was observed for almost all outcomes, in both age groups, with relative risks ranging from 0.12 to 0.60. The rates of drug prescription showed a statistically significant decrease, from before to after DTEP, for each type of medicine for asthma, in both age groups, from percent difference of -66% to -24.3%. The positive impact of this program on the outcomes indicative of asthma control in both children and adolescents suggests that it may be valuable for asthma management. © 2017 EAACI and John Wiley and Sons A/S. Published by John Wiley and Sons Ltd.

  17. Clinical utility of a complete diagnostic protocol for the ocular evaluation of free-living raptors.

    Science.gov (United States)

    Labelle, Amber L; Whittington, Julia K; Breaux, Carrie B; Labelle, Philippe; Mitchell, Mark A; Zarfoss, Mitzi K; Schmidt, Stephanie A; Hamor, Ralph E

    2012-01-01

      To describe a protocol for the examination of free-living raptors and report the ophthalmic examination findings of seven raptor species native to central Illinois, namely the barred owl, Cooper's hawk, eastern screech owl, great horned owl, American kestrel, red-tailed hawk, and turkey vulture and to determine if the findings relative to visual prognosis affected eligibility for future release.   Seventy-nine free-living raptors.   Under manual restraint, complete ophthalmic examination including slit-lamp biomicroscopy and indirect funduscopy, applanation tonometry, rebound tonometry, ocular morphometrics, B-mode ultrasound, and electroretinography (ERG) were performed on each bird. Histopathology of enucleated globes was performed after euthanasia or death in selected cases.   The examination protocol was easily performed using manual restraint alone on all birds. Ocular lesions were detected in 48.1% of birds, with 47.3% affected unilaterally and 52.6% affected bilaterally. Ocular lesions were considered to be vision threatening in 29.0% of the unilaterally affected birds and 29.0% of the bilaterally affected birds. The most common case outcomes were discharge from hospital to rehabilitation facility (45.6%) followed by euthanasia (43.0%). The presence of an ocular lesion or a vision-threatening ocular lesion was not significantly associated with outcome. Reference ranges are reported for B-mode ultrasound, ocular morphometrics, and horizontal corneal diameter in all species.   Complete ophthalmic examination can be supplemented by the use of ocular morphometrics, ultrasound, and ERG in the manually restrained raptor. These advanced diagnostic techniques may be useful in developing more objective criteria for evaluating eligibility for release following rehabilitation of free-living birds of prey. © 2011 American College of Veterinary Ophthalmologists.

  18. Evaluation of Serum Thyroid-Stimulating Hormone Concentration as a Diagnostic Test for Hyperthyroidism in Cats.

    Science.gov (United States)

    Peterson, M E; Guterl, J N; Nichols, R; Rishniw, M

    2015-01-01

    In humans, measurement of serum thyroid-stimulating hormone (TSH) concentration is commonly used as a first-line discriminatory test of thyroid function. Recent reports indicate that canine TSH (cTSH) assays can be used to measure feline TSH and results can help diagnose or exclude hyperthyroidism. To investigate the usefulness of cTSH measurements as a diagnostic test for cats with hyperthyroidism. Nine hundred and seventeen cats with untreated hyperthyroidism, 32 euthyroid cats suspected of having hyperthyroidism, and 131 clinically normal cats. Prospective study. Cats referred to the Animal Endocrine Clinic for suspected hyperthyroidism were evaluated with serum T4, T3, free T4 (fT4), and TSH concentrations. Thyroid scintigraphy was used as the gold standard to confirm or exclude hyperthyroidism. Median serum TSH concentration in the hyperthyroid cats (hyperthyroid cats had measurable TSH concentrations (≥0.03 ng/mL), whereas 114 (69.9%) of the 163 euthyroid cats had detectable concentrations. Combining serum TSH with T4 or fT4 concentrations lowered the test sensitivity of TSH from 98.0 to 97.0%, but markedly increased overall test specificity (from 69.9 to 98.8%). Serum TSH concentrations are suppressed in 98% of hyperthyroid cats, but concentrations are measurable in a few cats with mild-to-moderate hyperthyroidism. Measurement of serum TSH represents a highly sensitive but poorly specific test for diagnosis of hyperthyroidism and is best measured in combination with T4 and fT4. Copyright © 2015 The Authors. Journal of Veterinary Internal Medicine published by Wiley Periodicals, Inc. on behalf of the American College of Veterinary Internal Medicine.

  19. EVALUATION OF DIAGNOSTIC ACCURACY OF THE COMPARATIVE TUBERCULIN SKIN TEST IN REHABILITANT BORNEAN ORANGUTANS (PONGO PYGMAEUS).

    Science.gov (United States)

    Dench, Rosalie; Sulistyo, Fransiska; Fahroni, Agus; Philippa, Joost

    2015-12-01

    The tuberculin skin test (TST) has been the mainstay of tuberculosis (TB) testing in primates for decades, but its interpretation in orangutans (Pongo spp.) is challenging, because many animals react strongly, without evidence of infection with Mycobacterium tuberculosis complex. One explanation is cross-reactivity with environmental nontuberculous mycobacteria (NTM). The use of a comparative TST (CTST), comparing reactivity to avian (representing NTM) and bovine (representing tuberculous mycobacteria) tuberculins aids in distinguishing cross-reactivity due to sensitization by NTM from shared antigens. The specificity of the TST can be increased with the use of CTST. We considered three interpretations of the TST in rehabilitant Bornean orangutans ( Pongo pygmaeus ) using avian purified protein derivative (APPD; 25,000 IU/ml) and two concentrations of bovine purified protein derivative (BPPD; 100,000 and 32,500 IU/ml). The tests were evaluated for their ability to identify accurately seven orangutans previously diagnosed with and treated for TB from a group of presumed negative individuals (n = 288 and n = 161 for the two respective BPPD concentrations). BPPD at 32,500 IU/ml had poor diagnostic capacity, whereas BPPD at 100,000 IU/ml performed better. The BPPD-only interpretation had moderate sensitivity (57%) and poor specificity (40%) and accuracy (41%). The comparative interpretation at 72 hr had similar sensitivity (57%) but improved specificity (95%) and accuracy (94%). However, best results were obtained by a comparative interpretation incorporating the 48- and 72-hr scores, which had good sensitivity (86%), specificity (95%) and accuracy (95%). These data reinforce recommendations that a CTST be used in orangutans and support the use of APPD at 25,000 IU/ml and BPPD at 100,000 IU/ml. The highest score at each site from the 48- and 72-hr checks should be considered the result for that tuberculin. If the bovine result is greater than the avian result, the

  20. Evaluation of the diagnostic accuracy of CareStart G6PD deficiency Rapid Diagnostic Test (RDT in a malaria endemic area in Ghana, Africa.

    Directory of Open Access Journals (Sweden)

    Dennis Adu-Gyasi

    Full Text Available Glucose-6-phosphate dehydrogenase (G6PD deficiency is the most widespread enzyme defect that can result in red cell breakdown under oxidative stress when exposed to certain medicines including antimalarials. We evaluated the diagnostic accuracy of CareStart G6PD deficiency Rapid Diagnostic Test (RDT as a point-of-care tool for screening G6PD deficiency.A cross-sectional study was conducted among 206 randomly selected and consented participants from a group with known G6PD deficiency status between February 2013 and June 2013. A maximum of 1.6ml of capillary blood samples were used for G6PD deficiency screening using CareStart G6PD RDT and Trinity qualitative with Trinity quantitative methods as the "gold standard". Samples were also screened for the presence of malaria parasites. Data entry and analysis were done using Microsoft Access 2010 and Stata Software version 12. Kintampo Health Research Centre Institutional Ethics Committee granted ethical approval.The sensitivity (SE and specificity (SP of CareStart G6PD deficiency RDT was 100% and 72.1% compared to Trinity quantitative method respectively and was 98.9% and 96.2% compared to Trinity qualitative method. Malaria infection status had no significant (P=0.199 change on the performance of the G6PD RDT test kit compared to the "gold standard".The outcome of this study suggests that the diagnostic performance of the CareStart G6PD deficiency RDT kit was high and it is acceptable at determining the G6PD deficiency status in a high malaria endemic area in Ghana. The RDT kit presents as an attractive tool for point-of-care G6PD deficiency for rapid testing in areas with high temperatures and less expertise. The CareStart G6PD deficiency RDT kit could be used to screen malaria patients before administration of the fixed dose primaquine with artemisinin-based combination therapy.

  1. Evaluation of observed blast loading effects on NIF x-ray diagnostic collimators.

    Science.gov (United States)

    Masters, N D; Fisher, A; Kalantar, D; Prasad, R; Stölken, J S; Wlodarczyk, C

    2014-11-01

    We present the "debris wind" models used to estimate the impulsive load to which x-ray diagnostics and other structures are subject during National Ignition Facility experiments. These models are used as part of the engineering design process. Isotropic models, based on simulations or simplified "expanding shell" models, are augmented by debris wind multipliers to account for directional anisotropy. We present improvements to these multipliers based on measurements of the permanent deflections of diagnostic components: 4× for the polar direction and 2× within the equatorial plane-the latter relaxing the previous heuristic debris wind multiplier.

  2. Evaluating next-generation sequencing for direct clinical diagnostics in diarrhoeal disease

    DEFF Research Database (Denmark)

    Joensen, Katrine Grimstrup; Engsbro, A L Ø; Lukjancenko, Oksana

    2017-01-01

    . DNA was extracted from faecal samples and sequenced on the Illumina MiSeq system. Species distribution was determined with MGmapper and NGS-based diagnostic prediction was performed based on the relative abundance of pathogenic bacteria and Giardia and detection of pathogen-specific virulence genes....... NGS-based diagnostic results were compared to conventional findings for 55 of the diarrhoeal samples; 38 conventionally positive for bacterial pathogens, two positive for Giardia, four positive for virus and 11 conventionally negative. The NGS-based approach enabled detection of the same bacterial...

  3. One size does not fit all: a diagnostic post-occupancy evaluation model for an emergency department.

    Science.gov (United States)

    Guinther, Lindsey; Carll-White, Allison; Real, Kevin

    2014-01-01

    This study presents a detailed account of processes and multiple methodologies used in conducting a diagnostic post-occupancy evaluation (POE) in an urban hospital emergency department. Healthcare design POE research findings can lead to improved work environments for healthcare providers and higher levels of staff, patient, and visitor satisfaction. This evaluation was conducted in two separate phases over 12 months, with data analysis occurring after each phase. Phase 1 involved 200 hours of observation, physical measurements, and occupancy counts. Phase 2 included surveys (n = 315) of staff, visitors, and patients. In addition, eight distinct staff focus groups (e.g., Nursing, Housekeeping, Physician, etc.) were conducted. To illustrate the process, one healthcare design-related issue, privacy and confidentiality, was assessed in light of the linear design model with a central core. Phase 1 observation results indicated that most confidential conversations were contained within the linear core. However, Phase 2 focus groups revealed that many staff members had concerns regarding the level of privacy and confidentiality due to the core's open design. The use of multiple methods provided greater information and a more comprehensive picture of the emergency department environment and design. This study presents a comprehensive framework for diagnostic post-occupancy evaluation in healthcare design. The findings indicate that a systematic, multi-methodological approach developed around a conceptual framework can lead to higher quality evaluations. Diagnostic POEs should be grounded in extant literature and customized based on the setting, the client's guiding principles, and the design team's objectives. In diagnostic POEs, one size does not fit all. Case study, design process, interdisciplinary, post-occupancy, privacy and confidentiality.

  4. Refining multi-model projections of temperature extremes by evaluation against land–atmosphere coupling diagnostics

    Directory of Open Access Journals (Sweden)

    S. Sippel

    2017-05-01

    , the differences between projected and present-day climate extremes are affected to a lesser extent by the applied constraint, i.e. projected changes are reduced locally by around 0.5 to 1 °C – but this remains a local effect in regions that are highly sensitive to land–atmosphere coupling. In summary, our approach offers a physically consistent, diagnostic-based avenue to evaluate multi-model ensembles and subsequently reduce model biases in simulated and projected extreme temperatures.

  5. Refining multi-model projections of temperature extremes by evaluation against land-atmosphere coupling diagnostics

    Science.gov (United States)

    Sippel, Sebastian; Zscheischler, Jakob; Mahecha, Miguel D.; Orth, Rene; Reichstein, Markus; Vogel, Martha; Seneviratne, Sonia I.

    2017-05-01

    and present-day climate extremes are affected to a lesser extent by the applied constraint, i.e. projected changes are reduced locally by around 0.5 to 1 °C - but this remains a local effect in regions that are highly sensitive to land-atmosphere coupling. In summary, our approach offers a physically consistent, diagnostic-based avenue to evaluate multi-model ensembles and subsequently reduce model biases in simulated and projected extreme temperatures.

  6. Producing Videotape Programs for Computer Training: An Example with AMA/NET

    Science.gov (United States)

    Novey, Donald W.

    1990-01-01

    To facilitate user proficiency with AMA/Net, an 80-minute training videotape has been produced. The production was designed to use videotape's advantages, where information and emotion are combined; and to accommodate its chief disadvantage, lack of resolution for fine text, with close-ups and graphics. Content of the videotape was conceived, outlined, demonstrated with simultaneous text capture, edited into script form, narration added, and scripts marked for videotaping and narrating. Videotaping was performed with actual keyboard sounds for realism. The recording was divided into four areas: office mock-up, keyboard close-ups, scan-conversion and screen close-ups. Once the footage was recorded, it was logged and rough-edited. Care was taken to balance the pace of the program with visual stimulation and amount of narration. The final edit was performed as a culmination of all scripts, video materials and rough edit, with graphics and steady change of visual information offsetting the static nature of the screen display. Carefully planned video programs can be a useful and economical adjunct in the training process for online services.

  7. Diagnostic Value of Urinary Steroid Profiling in the Evaluation of Adrenal Tumors

    NARCIS (Netherlands)

    Kerkhofs, T. M. A.; Kerstens, M. N.; Kema, I. P.; Willems, T. P.; Haak, H. R.

    Radiological examination may unexpectedly reveal an adrenal mass. Current algorithms for differentiating between benign and malignant lesions mainly rely on size and densitometry on unenhanced CT, which have limited specificity. We examined the diagnostic value of urinary steroid profiling by gas

  8. A Global Comparative Evaluation of Commercial Immunochromatographic Rapid Diagnostic Tests for Visceral Leishmaniasis

    NARCIS (Netherlands)

    Cunningham, Jane; Hasker, Epco; Das, Pradeep; El Safi, Sayda; Goto, Hiro; Mondal, Dinesh; Mbuchi, Margaret; Mukhtar, Maowia; Rabello, Ana; Rijal, Suman; Sundar, Shyam; Wasunna, Monique; Adams, Emily; Menten, Joris; Peeling, Rosanna; Boelaert, Marleen; Khanal, Basudha; Das, Murari; Oliveira, Edward; de Assis, Tália Machado; Costa, Dorcas Lamounier; Bhaskar, Khondaker Rifathassan; Huda, M. Mamun; Hassan, Mukidul; Abdoun, Asim Osman; Awad, Aymen; Osman, Mohamed; Prajapati, Dinesh Kumar; Gidwani, Kamlesh; Tiwary, Puja; Paniago, Anamaria Mello Miranda; Sanchez, Maria Carmen Arroyo; Celeste, Beatriz Julieta; Jacquet, Diane; Magiri, Charles; Muia, A.; Kesusu, J.; Ageed, Al Farazdag; Galal, Nuha; Osman, Osman Salih; Gupta, A. K.; Bimal, Afrad S.; Das, V. N. R.

    2012-01-01

    Background. Poor access to diagnosis stymies control of visceral leishmaniasis (VL). Antibody-detecting rapid diagnostic tests (RDTs) can be performed in peripheral health settings. However, there are many brands available and published reports of variable accuracy. Methods. Commercial VL RDTs

  9. A multi-center comparison of diagnostic methods for the biochemical evaluation of suspected mitochondrial disorders

    NARCIS (Netherlands)

    Rodenburg, R.J.T.; Schoonderwoerd, G.C.; Tiranti, V.; Taylor, R.W.; Rotig, A.; Valente, L.; Invernizzi, F.; Chretien, D.; He, L.; Backx, G.P.; Janssen, K.J.; Chinnery, P.F.; Smeets, H.J.M.; Coo, I.F. de; Heuvel, L.P. van den

    2013-01-01

    A multicenter comparison of mitochondrial respiratory chain and complex V enzyme activity tests was performed. The average reproducibility of the enzyme assays is 16% in human muscle samples. In a blinded diagnostic accuracy test in patient fibroblasts and SURF1 knock-out mouse muscle, each lab made

  10. Diagnostic Evaluation and Management of Chronic Thromboembolic Pulmonary Hypertension: A Clinical Practice Guideline

    Directory of Open Access Journals (Sweden)

    Sanjay Mehta

    2010-01-01

    Full Text Available BACKGROUND: Pulmonary embolism is a common condition. Some patients subsequently develop chronic thromboembolic pulmonary hypertension (CTEPH. Many care gaps exist in the diagnosis and management of CTEPH patients including lack of awareness, incomplete diagnostic assessment, and inconsistent use of surgical and medical therapies.

  11. Prospective evaluation of three rapid diagnostic tests for diagnosis of human leptospirosis.

    NARCIS (Netherlands)

    M.G.A. Goris (Marga); M.M.G. Leeflang (Mariska); M. Lodén (Martin); J.F.P. Wagenaar (Jiri); P.R. Klatser (Paul); R.A. Hartskeerl (Rudy); K.R. Boer (Kimberly)

    2013-01-01

    markdownabstractDiagnosis of leptospirosis by the microscopic agglutination test (MAT) or by culture is confined to specialized laboratories. Although ELISA techniques are more common, they still require laboratory facilities. Rapid Diagnostic Tests (RDTs) can be used for easy point-of-care

  12. Experimental guinea pig model of dermatophytosis: a simple and useful tool for the evaluation of new diagnostics and antifungals

    DEFF Research Database (Denmark)

    Saunte, D.M.; Hasselby, J.P.; Brillowska-Dabrowska, A.

    2008-01-01

    The aim of this study was to establish a simple guinea pig model for the purpose of evaluating diagnostic principles and treatment modalities for dermatophytic infections. The following variables were evaluated; pre-treatment of the skin by shaving versus tape stripping, Microsporum canis...... stripping. Inoculation under occlusion showed no advantage in the establishment of experimental infections. Infection severity showed some association with the inoculum concentration and subtype of T. mentagrophytes but not in studies involving M. canis. The establishment of dermatophytosis was confirmed...

  13. Childhood videotaped social and neuromotor precursors of schizophrenia: a prospective investigation

    DEFF Research Database (Denmark)

    Schiffman, Jason; Walker, Elaine; Ekstrøm, Morten

    2004-01-01

    OBJECTIVE: The authors examined videotaped behaviors of children who developed schizophrenia as adults and of comparison subjects to disclose possible social and neuromotor deficits foreshadowing later development of schizophrenia. METHOD: In 1972, a sample of 265 11-13-year-old Danish children...... disorder. In 1991, adult psychiatric outcome data were obtained for 91.3% (N=242). This study systematically analyzed the videotapes to determine whether the children who developed schizophrenia as adults evidenced greater social and/or neuromotor deficits than children who did not develop a psychiatric...... disorder and children who developed other psychiatric disorders. RESULTS: The findings from this study suggest that the brief videotaped footage of children eating lunch was able to discriminate between the individuals who later developed schizophrenia and those who did not. Specifically...

  14. Newborn Congenital Cytomegalovirus Screening Based on Clinical Manifestations and Evaluation of DNA-based Assays for In Vitro Diagnostics.

    Science.gov (United States)

    Fujii, Tomoyuki; Oka, Akira; Morioka, Ichiro; Moriuchi, Hiroyuki; Koyano, Shin; Yamada, Hideto; Saito, Shigeru; Sameshima, Hiroshi; Nagamatsu, Takeshi; Tsuchida, Shinya; Inoue, Naoki

    2017-10-01

    To establish a strategy for congenital cytomegalovirus (cCMV) screening and to establish confirmatory assays approved as in vitro diagnostics by the regulatory authorities, we evaluated the clinical risks and performance of diagnostic assays developed by commercial companies, since cCMV infection has significant clinical consequences. Newborns with clinical manifestations considered to be consequences of cCMV infection (n = 575) were screened for the presence of cytomegalovirus (CMV) DNA in urine specimens collected onto filter paper placed in their diapers using the polymerase chain reaction-based assay reported previously. Liquid urine specimens were obtained from all of 20 CMV-positive newborns and 107 of the CMV-negative newborns identified in the screening. We used these 127 specimens, as well as 12 from cCMV cases identified in a previous study and 41 from healthy newborns, to compare the performance of 2 commercial assays and 1 in-house assay. The risk-based screening allowed the identification of cCMV cases at least 10-fold more efficiently than our previous universal screening, although there appears to be a limit to the identification of asymptomatically infected newborns. Although CMV-specific IgM during pregnancy was found frequently in mothers of cCMV newborns, CMV-IgM alone is not an effective diagnostic marker. The urine-filter-based assay and the 3 diagnostic assays yielded identical results. Although risk-based and universal newborn screening strategies for cCMV infection each have their respective advantages and disadvantages, urine-filter-based assay followed by confirmatory in vitro diagnostics assays is able to identify cCMV cases efficiently.

  15. Evaluation of the Quality Control Program for Diagnostic Radiography and Fluoroscopy Devices in Syria during 2005-2013

    Directory of Open Access Journals (Sweden)

    M. H. Kharita

    2017-06-01

    Full Text Available Introduction: Extensive use of diagnostic radiology is the largest contributor to total population radiation doses. Thus, appropriate equipment and safe practice are necessary for good-quality images with optimal doses. This study aimed to perform quality control (QC audit for radiography and fluoroscopy devices owned by private sector in Syria (2005-2013 to verify compliance of performance of X-ray machines with the regulatory requirements stipulated by the national regulatory body. Materials and Methods: In this study, QC audit included 487 X-ray diagnostic machines, (363 radiography and 124 fluoroscopy devices, installed in 306 medical diagnostic radiology centers in 14 provinces in Syria. We employed an X-ray beam analyzer device (NERO model 8000, Victoreen, USA, which was tested and calibrated at the National Secondary Standard Dosimetry Laboratory traceable to the IAEA Network of Secondary Standard Dosimetry Laboratories. Standard QC tool kits were used to evaluate tube and generator of the X-ray machines, which constituted potential (kVp, timer accuracy, radiation output consistency, tube filtration, small and large focal spot sizes, X-ray beam collimation and alignment, as well as high- and low-resolution and entrance surface dose in fluoroscopy. Results: According to our results, most of the assessed operating parameters were in compliance with the standards stipulated by the National Regulatory Authority. In cases of noncompliance for the assessed parameters, maximum value (28.77% pertained to accuracy of kVp calibration for radiography units, while the lowest value (2.42% belonged to entrance surface dose in fluoroscopy systems. Conclusion: Effective QC program in diagnostic radiology leads to obtaining information regarding quality of radiology devices used for medical diagnosis and minimizing the doses received by patients and medical personnel. The findings of this QC program, as the main part of QA program, illustrated that most

  16. [Diagnostics, treatment and expert evaluation of air crew members with polypoid growth in the gallbladder].

    Science.gov (United States)

    Bagaudinov, K G; Saidov, S S; Zubkov, A D; Abdulaev, R A; Lubashev, Ia A; Ovakimian, G S; Abdulaev, I A; Gasanov, A M

    2007-01-01

    The article discusses results of diagnosing and treatment of various forms of gallbladder polypoid growth (GBPG) in air crew members in the past 10 yr. period. Growth of polyps was detected in 12.1% of pilots with gallbladder pathologies. Timely and correct diagnostics with the use of radiologic visualization may prevent unwarranted surgery of the hepatobilizry system and thus extend the flying longevity. Ultrasound Doppler investigation is particularly effective in diagnosing early GBPG. High quality of visual differentiation attainable with these techniques made it possible to diagnose the nonneoplastic nature of GBPG in 75% of cases that did not require operational treatment. In most cases the authors' diagnostic and treatment algorithm reduced the amount of surgical activity and prolonged ace careers.

  17. Evaluation of the diagnostic performance of infrared imaging of the breast: a preliminary study

    OpenAIRE

    Wu Yuh-Ming; Tsai Yuh-Show; Chien Kuo-Liong; Chen Chin-Yu; Chang King-Jen; Wang Jane; Teng Yu-Chuan; Shih Tiffany

    2010-01-01

    Abstract Background The study was conducted to investigate the diagnostic performance of infrared (IR) imaging of the breast using an interpretive model derived from a scoring system. Methods The study was approved by the Institutional Review Board of our hospital. A total of 276 women (mean age = 50.8 years, SD 11.8) with suspicious findings on mammograms or ultrasound received IR imaging of the breast before excisional biopsy. The interpreting radiologists scored the lesions using a scoring...

  18. New roentgen technologies (tomosynthesis for diagnostics and outcomes evaluation of genital tuberculosis treatment

    Directory of Open Access Journals (Sweden)

    Yu. A. Tsybulskaya

    2015-01-01

    Full Text Available This article describes the specific primary disorder of small pelvis organs in the female patient with no tuberculosis in her medical history. Use of this roentgen technique for genital tuberculosis detection and assessment of treatment efficacy enhances the effectiveness of diagnostic activities and allows early detection of this pathology thus reducing the risk of complications which is crucial for pregnancy planning given the young age of the patient.

  19. Diagnostic evaluation of the MRP-8/14 for the emergency assessment of chest pain.

    Science.gov (United States)

    Vora, Amit N; Bonaca, Marc P; Ruff, Christian T; Jarolim, Petr; Murphy, Sabina; Croce, Kevin; Sabatine, Marc S; Simon, Daniel I; Morrow, David A

    2012-08-01

    Elevated levels of myeloid-related protein (MRP)-8/14 (S100A8/A9) are associated with first cardiovascular events in healthy individuals and worse prognosis in patients with acute coronary syndrome (ACS). The diagnostic utility of MRP-8/14 in patients presenting to the emergency room with symptoms concerning for ACS is uncertain. MRP-8/14 was measured in serial serum and plasma samples in a single center prospective cohort-study of patients presenting to the emergency room with non-traumatic chest pain concerning for ACS. Final diagnosis was adjudicated by an endpoint committee. Of patients with baseline MRP-8/14 results (n = 411), the median concentration in serum was 1.57 μg/ml (25th, 75th: 0.87, 2.68) and in plasma was 0.41 μg/ml (MRP-8/14 was higher in patients presenting with MI (p MRP-8/14 was poor: sensitivity 28% (95% CI 20-38), specificity 82% (78-86), positive predictive value 36% (26-47), and negative predictive value 77% (72-81). The area under the ROC curve for diagnosis of MI with MRP-8/14 was 0.55 (95% CI 0.51-0.60) compared with 0.95 for cTnI. The diagnostic performance was not improved in early-presenters, patients with negative initial cTnI, or using later MRP-8/14 samples. Patients presenting with MI had elevated levels of serum MRP-8/14 compared to patients with non-cardiac chest pain. However, overall diagnostic performance of MRP-8/14 was poor and neither plasma nor serum MRP-8/14 offered diagnostic utility comparable to cardiac troponin.

  20. Diagnostic Accuracy of the CASI-4R Psychosis Subscale for Children Evaluated in Pediatric Outpatient Clinics.

    Science.gov (United States)

    Rizvi, Sabeen H; Salcedo, Stephanie; Youngstrom, Eric A; Freeman, Lindsey K; Gadow, Kenneth D; Fristad, Mary A; Birmaher, Boris; Kowatch, Robert A; Horwitz, Sarah M; Frazier, Thomas W; Arnold, L Eugene; Taylor, H Gerry; Findling, Robert L

    2018-01-26

    Diagnostic accuracy of the Diagnostic and Statistical Manual of Mental Disorders-oriented Child and Adolescent Symptom Inventory (CASI-4R) Psychotic Symptoms scale was tested using receiver operating characteristic analyses to identify clinically significant psychotic symptoms. Participants were new outpatients (N = 700), ages 6.0 to 12.9 years (M = 9.7, SD = 1.8) at 9 child outpatient mental health clinics, who participated in the Longitudinal Assessment of Manic Symptoms (LAMS) Study baseline assessment. Because LAMS undersampled participants with low mania scores by design, present analyses weighted low scorers to produce unbiased estimates. Psychotic symptoms, operationally defined as a score of 3 or more for hallucinations or 4 or more for delusions based on the Schedule for Affective Disorders and Schizophrenia (K-SADS) psychosis items, occurred in 7% of youth. K-SADS diagnoses for those identified with psychotic symptoms above threshold included major depressive disorder, bipolar spectrum disorder, attention deficit/hyperactivity disorder, posttraumatic stress disorder, psychotic disorders, and autism spectrum disorder. The optimal psychosis screening cut score (maximizing sensitivity and specificity) was 2.75+ (corresponding diagnostic likelihood ratio [DiLR] = 4.29) for the parent version and 3.50+ (DiLR = 5.67) for the teacher version. The Area under the Curve for parent and teacher report was .83 and .74 (both p clinically useful for identifying psychotic symptoms in children because of its brevity and accuracy.

  1. Adulticidal Susceptibility Evaluation of Aedes albopictus Using New Diagnostic Doses in Penang Island, Malaysia.

    Science.gov (United States)

    Rahim, Junaid; Ahmad, Abu H; Ahmad, Hamdan; Ishak, Intan H; Rus, Adanan Che; Maimusa, Hamisu A

    2017-09-01

    Insecticide-based vector control approaches are facing challenges due to the development of resistance in vector mosquitoes. Therefore, a proper resistance surveillance program using baseline lethal concentrations is crucial for resistance management strategies. Currently, the World Health Organization's (WHO) diagnostic doses established for Aedes aegypti and Anopheles species are being used to study the resistance status of Aedes albopictus. In this study, we established the diagnostic doses for permethrin, deltamethrin, and malathion using a known susceptible reference strain. Five field-collected populations were screened against these doses, following the WHO protocol. This study established the diagnostic dose of malathion at 2.4%, permethrin at 0.95%, and deltamethrin at 0.28%, which differ from the WHO doses for Aedes aegypti and Anopheles spp. Among the insecticides tested on the 5 wild populations, only deltamethrin showed high effectiveness. Different susceptibility and resistance patterns were observed with permethrin, malathion, and dichloro-diphenyl-trichloroethane (DDT) at 4%. This study may assist the health authorities to improve future chemical-based vector control operations in dengue-endemic areas.

  2. The diagnostic accuracy of US, CT, MRI and (1)H-MRS for the evaluation of hepatic steatosis compared with liver biopsy: a meta-analysis

    NARCIS (Netherlands)

    Bohte, A.E.; van Werven, J.R.; Bipat, S.; Stoker, J.

    2011-01-01

    OBJECTIVE: To meta-analyse the diagnostic accuracy of US, CT, MRI and (1)H-MRS for the evaluation of hepatic steatosis. METHODS: From a comprehensive literature search in MEDLINE, EMBASE, CINAHL and Cochrane (up to November 2009), articles were selected that investigated the diagnostic performance

  3. Evaluation of a new rapid diagnostic kit (FemExam) for bacterial vaginosis in patients with vaginal discharge syndrome in The Gambia

    NARCIS (Netherlands)

    West, Beryl; Morison, Linda; Schim van der Loeff, Maarten; Gooding, Euphemia; Awasana, Akum Aveika; Demba, Edward; Mayaud, Philippe

    2003-01-01

    Diagnosis of bacterial vaginosis (BV) in resource-poor primary health care settings is often overlooked; there is a need for a cheap, rapid, objective point-of-care diagnostic test. The goal was to determine the prevalence of BV and to evaluate the performance of a new commercial diagnostic test kit

  4. Diagnostic efficacy of a modified low-dose acquisition protocol for the preoperative evaluation of mini-implant sites

    Energy Technology Data Exchange (ETDEWEB)

    Tadinada, Aditya; Marczak, Alana; Yadav, Sumit [University of Connecticut School of Dental Medicine, Farmington (United States)

    2017-09-15

    The objective of this study was to compare the outcomes of surgical mini-implant placement when potential mini-implant sites were scanned using a lower-dose 180° acquisition protocol versus a conventional 360° acquisition protocol. Ten dentate human skulls were used to provide sites for potential mini-implant placement. The sites were randomly divided into 2 groups: 360° and 180° cone-beam computed tomography (CBCT) acquisition protocols. A small-volume 180° CBCT scan and a 360° CBCT scan of each site were acquired using a Morita Accuitomo-170 CBCT machine and then a mini-implant was placed. A follow-up 360° CBCT scan was done as a gold standard to evaluate the location of the mini-implant and root perforation. Two raters evaluated the scans. Ninety-eight percent of the mini-implants placed did not perforate any root structure. Two percent of the sites had an appearance suggestive of perforation. On a Likert scale, both raters agreed that their subjective evaluation of the diagnostic quality of the protocols, ability to make and read measurements of the sites, and preferences for the specified diagnostic task were comparable. The Cohen kappa showed high inter-rater and intra-rater agreement. In this ex vivo study, we found that the 180° rotational acquisition was as effective as the conventional 360° rotational acquisition for the preoperative evaluation of potential mini-implant sites.

  5. Oscillation mechanics of the respiratory system in never-smoking patients with silicosis: pathophysiological study and evaluation of diagnostic accuracy.

    Science.gov (United States)

    Sá, Paula Morisco de; Lopes, Agnaldo José; Jansen, José Manoel; Melo, Pedro Lopes de

    2013-05-01

    Silicosis is a chronic and incurable occupational disease that can progress even after the cessation of exposure. Recent studies suggest that the forced oscillation technique may help to clarify the changes in lung mechanics resulting from silicosis as well as the detection of these changes. We investigated the effects of airway obstruction in silicosis on respiratory impedance and evaluated the diagnostic efficacy of the forced oscillation technique in these patients. Spirometry was used to classify the airway obstruction, which resulted in four subject categories: controls (n=21), patients with a normal exam (n=12), patients with mild obstruction (n=22), and patients with moderate-to-severe obstruction (n=12). Resistive data were interpreted using the zero-intercept resistance (R0), the resistance at 4 Hz (Rrs4), and the mean resistance. We also analyzed the mean reactance (Xm) and the dynamic compliance. The total mechanical load was evaluated using the absolute value of the respiratory impedance (Z4Hz). The diagnostic potential was evaluated by investigating the area under the receiver operating characteristic curve. ClinicalTrials.gov: NCT01725971. We observed significant (p0.80) and highly accurately in the detection of moderate-to-severe obstruction (area under the curve>0.90). The forced oscillation technique may contribute to the study of the pathophysiology of silicosis and may improve the treatment offered to these patients, thus representing an alternative and/or complementary tool for evaluating respiratory mechanics.

  6. The Cloud Feedback Model Intercomparison Project (CFMIP) Diagnostic Codes Catalogue - metrics, diagnostics and methodologies to evaluate, understand and improve the representation of clouds and cloud feedbacks in climate models

    Science.gov (United States)

    Tsushima, Yoko; Brient, Florent; Klein, Stephen A.; Konsta, Dimitra; Nam, Christine C.; Qu, Xin; Williams, Keith D.; Sherwood, Steven C.; Suzuki, Kentaroh; Zelinka, Mark D.

    2017-11-01

    The CFMIP Diagnostic Codes Catalogue assembles cloud metrics, diagnostics and methodologies, together with programs to diagnose them from general circulation model (GCM) outputs written by various members of the CFMIP community. This aims to facilitate use of the diagnostics by the wider community studying climate and climate change. This paper describes the diagnostics and metrics which are currently in the catalogue, together with examples of their application to model evaluation studies and a summary of some of the insights these diagnostics have provided into the main shortcomings in current GCMs. Analysis of outputs from CFMIP and CMIP6 experiments will also be facilitated by the sharing of diagnostic codes via this catalogue.Any code which implements diagnostics relevant to analysing clouds - including cloud-circulation interactions and the contribution of clouds to estimates of climate sensitivity in models - and which is documented in peer-reviewed studies, can be included in the catalogue. We very much welcome additional contributions to further support community analysis of CMIP6 outputs.

  7. 36 CFR 1280.44 - May I film, photograph, or videotape on NARA property for commercial purposes?

    Science.gov (United States)

    2010-07-01

    ... 36 Parks, Forests, and Public Property 3 2010-07-01 2010-07-01 false May I film, photograph, or videotape on NARA property for commercial purposes? 1280.44 Section 1280.44 Parks, Forests, and Public... Rules for Filming, Photographing, or Videotaping on NARA Property? § 1280.44 May I film, photograph, or...

  8. Merging the Power of the Computer and VCR: Interactive Videotape with the Mandell Instant-Active Interface.

    Science.gov (United States)

    Brown, Scott W.

    1991-01-01

    Describes the Mandell Instant-Active Device, a microcomputer-based system that enables teachers to add questions and/or statement prompts to an existing videotape without affecting the videotape itself. Applications, procedures, student feedback, and hardware requirements are discussed. Ordering information is included. (MES)

  9. Evaluation of beam divergence of a negative hydrogen ion beam using Doppler shift spectroscopy diagnostics

    Science.gov (United States)

    Deka, A. J.; Bharathi, P.; Pandya, K.; Bandyopadhyay, M.; Bhuyan, M.; Yadav, R. K.; Tyagi, H.; Gahlaut, A.; Chakraborty, A.

    2018-01-01

    The Doppler Shift Spectroscopy (DSS) diagnostic is in the conceptual stage to estimate beam divergence, stripping losses, and beam uniformity of the 100 keV hydrogen Diagnostics Neutral Beam of International Thermonuclear Experimental Reactor. This DSS diagnostic is used to measure the above-mentioned parameters with an error of less than 10%. To aid the design calculations and to establish a methodology for estimation of the beam divergence, DSS measurements were carried out on the existing prototype ion source RF Operated Beam Source in India for Negative ion Research. Emissions of the fast-excited neutrals that are generated from the extracted negative ions were collected in the target tank, and the line broadening of these emissions were used for estimating beam divergence. The observed broadening is a convolution of broadenings due to beam divergence, collection optics, voltage ripple, beam focusing, and instrumental broadening. Hence, for estimating the beam divergence from the observed line broadening, a systematic line profile analysis was performed. To minimize the error in the divergence measurements, a study on error propagation in the beam divergence measurements was carried out and the error was estimated. The measurements of beam divergence were done at a constant RF power of 50 kW and a source pressure of 0.6 Pa by varying the extraction voltage from 4 kV to10 kV and the acceleration voltage from 10 kV to 15 kV. These measurements were then compared with the calorimetric divergence, and the results seemed to agree within 10%. A minimum beam divergence of ˜3° was obtained when the source was operated at an extraction voltage of ˜5 kV and at a ˜10 kV acceleration voltage, i.e., at a total applied voltage of 15 kV. This is in agreement with the values reported in experiments carried out on similar sources elsewhere.

  10. [Cost-effectiveness evaluation of predictive molecular diagnostics using the example of hereditary non-polyposis colorectal cancer (HNPCC)].

    Science.gov (United States)

    Hagen, A; Hessabi, H K; Gorenoi, V; Schönermark, M P

    2008-01-01

    a final evaluation of the use of predictive molecular diagnostics, other dimensions (such as possible psychological problems and discriminatory risks) apart from cost-effectiveness should also be included.

  11. Vibration diagnostic system for evaluation of state interconnected electrical motors mechanical parameters

    Science.gov (United States)

    Vasilevskyi, Oleksandr M.; Kulakov, Pavlo I.; Dudatiev, Igor A.; Didych, Volodymyr M.; Kotyra, Andrzej; Suleimenov, Batyrbek; Assembay, Azat; Kozbekova, Ainur

    2017-08-01

    The paper presents the structural diagram and mathematical model of a vibration diagnostic system to measure angular velocities of two interconnected electric motors. The system is based on vibration signals and the control signals of the motor mechanical parameters. The measurement procedure of the rotor rotational speed is based on vibration signals during synchronization. The procedure presented allows simultaneous measurement and synchronization frequencies of rotation to diagnose of the motors' mechanical parts. The calculated reduced error of synchronizing frequencies of rotation of the rotors, which is 0.45% of the measurement range of frequencies of rotation from 0 to 80Hz.

  12. Paranoia.Ada: A diagnostic program to evaluate Ada floating-point arithmetic

    Science.gov (United States)

    Hjermstad, Chris

    1986-01-01

    Many essential software functions in the mission critical computer resource application domain depend on floating point arithmetic. Numerically intensive functions associated with the Space Station project, such as emphemeris generation or the implementation of Kalman filters, are likely to employ the floating point facilities of Ada. Paranoia.Ada appears to be a valuabe program to insure that Ada environments and their underlying hardware exhibit the precision and correctness required to satisfy mission computational requirements. As a diagnostic tool, Paranoia.Ada reveals many essential characteristics of an Ada floating point implementation. Equipped with such knowledge, programmers need not tremble before the complex task of floating point computation.

  13. Pain evaluation in outpatients undergoing diagnostic anesthesia-free hysteroscopy in a teaching hospital: a cohort study.

    Science.gov (United States)

    de Carvalho Schettini, Juliana A; Ramos de Amorim, Melania Maria; Ribeiro Costa, Aurélio Antônio; Albuquerque Neto, Luiz Cavalcante

    2007-01-01

    To evaluate and determine the main causes for pain occurrence and intensity in outpatients undergoing anesthesia-free hysteroscopy in a medical school hospital. Cohort study (Canadian Task Force classification II-2). Diagnosis Center of the Instituto Materno-Infantil de Pernambuco. One hundred seventy-one outpatients undergoing anesthesia-free diagnostic hysteroscopy. To assess pain occurrence, intensity, and associated factors reported by patients undergoing anesthesia-free diagnostic hysteroscopy. Pain frequency and intensity were determined by visual analog scale (VAS) at the end of the procedure and at 15-, 30-, and 60-minute intervals. Data analysis of clinical, obstetric, and gynecologic history and its association with pain was performed. Association through chi2 test (Pearson), risk ratio with 95% CI, and multiple logistic regression were used for statistical analysis. Pain score was higher immediately after the procedure with a median of 6, decreasing to 3, 1, and 0 at 15-, 30-, and 60-minute intervals, respectively. Multiple logistic regression was performed, and the only parameters remaining that were significantly associated with pain were menopause, speculum placement, and the absence of previous vaginal delivery. Anesthesia-free diagnostic hysteroscopy is often associated with pain, and it has been determined that menopause, speculum placement, and absence of previous vaginal delivery are factors associated with pain occurrence and intensity.

  14. Application of the Diagnostic Evaluation for Alopecia in Traditional Veterinary Species to Laboratory Rhesus Macaques (Macaca mulatta)

    Science.gov (United States)

    Luchins, Kerith R; Baker, Kate C; Gilbert, Margaret H; Blanchard, James L; Liu, David Xianhong; Myers, Leann; Bohm, Rudolf P

    2011-01-01

    Alopecia in nonhuman primates in the biomedical research setting is often attributed to compromised psychologic wellbeing. Behavioral causes, mainly hair plucking, have become the unconfirmed and exclusive default diagnosis, and the possibility that alopecia may be secondary to a primary medical or dermatologic disease is often overlooked. Although nonbehavioral causes of alopecia in nonhuman primates are described in the literature, few prospective hypothesis-based studies have investigated medical and behavioral etiologies concurrently. We therefore undertook such a study with the aim of designing a clinical diagnostic guide for approaching cases of nonhuman primate alopecia. Because most cases of alopecia in nonhuman primates in the literature and at our facility are not associated with a definitive diagnosis, the hypothesis we tested was that the well-established diagnostic evaluation for alopecia used for traditional veterinary species is not applicable to nonhuman primates. Discounting differences in histopathology and behavioral assessment, the current study revealed few clinically relevant significant differences between nonhuman primates with and without alopecia. As a result, our hypothesis was confirmed, and we conclude that the standard dermatologic diagnostic plan typically described for alopecia diagnosis in traditional veterinary species and used as the basis for assessment of alopecia in nonhuman primates should be reassessed. PMID:22330789

  15. Undergoing Diagnostic Evaluation for Possible Cancer Affects the Health-Related Quality of Life in Patients Presenting with Non-Specific Symptoms

    DEFF Research Database (Denmark)

    Larsen, Ellen Frøsig Moseholm; Rydahl Hansen, Susan; Lindhardt, Bjarne Ørskov

    2016-01-01

    Aim Undergoing diagnostic evaluation for possible cancer can affect health-related quality of life (HRQoL). The aims of this study were to examine the HRQoL in patients undergoing a diagnostic evaluation for possible cancer due to non-specific symptoms and further to investigate the impact of socio-demographic...... and medical factors associated with HRQoL at the time of diagnosis. Methods This was a prospective, multicenter survey study that included patients who were referred for a diagnostic evaluation due to non-specific cancer symptoms. Participants completed the EORTC-QLQ-C30 quality of life scale before and after...... completing the diagnostic evaluation. The baseline and follow-up EORTC-QLQ-C30 scores were compared with reference populations. The impact of socio-demographic and medical factors on HRQoL at follow-up was explored by bootstrapped multivariate linear regression. Results A total of 838 patients participated...

  16. Evaluation of subjective image quality in relation to diagnostic task for cone beam computed tomography with different fields of view.

    Science.gov (United States)

    Lofthag-Hansen, Sara; Thilander-Klang, Anne; Gröndahl, Kerstin

    2011-11-01

    To evaluate subjective image quality for two diagnostic tasks, periapical diagnosis and implant planning, for cone beam computed tomography (CBCT) using different exposure parameters and fields of view (FOVs). Examinations were performed in posterior part of the jaws on a skull phantom with 3D Accuitomo (FOV 3 cm×4 cm) and 3D Accuitomo FPD (FOVs 4 cm×4 cm and 6 cm×6 cm). All combinations of 60, 65, 70, 75, 80 kV and 2, 4, 6, 8, 10 mA with a rotation of 180° and 360° were used. Dose-area product (DAP) value was determined for each combination. The images were presented, displaying the object in axial, cross-sectional and sagittal views, without scanning data in a random order for each FOV and jaw. Seven observers assessed image quality on a six-point rating scale. Intra-observer agreement was good (κw=0.76) and inter-observer agreement moderate (κw=0.52). Stepwise logistic regression showed kV, mA and diagnostic task to be the most important variables. Periapical diagnosis, regardless jaw, required higher exposure parameters compared to implant planning. Implant planning in the lower jaw required higher exposure parameters compared to upper jaw. Overall ranking of FOVs gave 4 cm×4 cm, 6 cm×6 cm followed by 3 cm×4 cm. This study has shown that exposure parameters should be adjusted according to diagnostic task. For this particular CBCT brand a rotation of 180° gave good subjective image quality, hence a substantial dose reduction can be achieved without loss of diagnostic information. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

  17. Diagnostic difficulties and pitfalls in rapid on-site evaluation of endobronchial ultrasound guided fine needle aspiration

    Directory of Open Access Journals (Sweden)

    Monaco Sara

    2010-01-01

    Full Text Available Background: One of the novel techniques utilizing fine needle aspiration (FNA in the diagnosis of mediastinal and lung lesions is the endobronchial ultrasound (EBUS-guided FNA. In this study, we describe five cases which had a discrepancy between on-site evaluation and final diagnosis, or a diagnostic dilemma when rendering the preliminary diagnosis, in order to illustrate some of the diagnostic difficulties and pitfalls that can occur in EBUS FNA. Methods: A total of five EBUS FNA cases from five patients were identified in our records with a discrepancy between the rapid on-site evaluation (ROSE and final diagnosis, or that addressed a diagnostic dilemma. All of the cases had histological confirmation or follow-up. The cytomorphology in the direct smears, cell block, and immunohistochemical stains were reviewed, along with the clinical history and other available information. Results: Two cases were identified with a nondefinitive diagnosis at ROSE that were later diagnosed as malignant (metastatic signet-ring cell adenocarcinoma and metastatic renal cell carcinoma (RCC on the final cytological diagnosis. Three additional cases were identified with a ROSE and final diagnosis of malignant (large cell neuroendocrine carcinoma (LCNEC and two squamous cell carcinomas, but raised important diagnostic dilemmas. These cases highlight the importance of recognizing discohesive malignant cells and bland neoplasms on EBUS FNA, which may lead to a negative or a nondefinitive preliminary diagnosis. Neuroendocrine tumors can also be difficult due to the wide range of entities in the differential diagnosis, including benign lymphocytes, lymphomas, small and nonsmall cell carcinomas, and the lack of immunohistochemical stains at the time of ROSE. Finally, the background material in EBUS FNAs may be misleading and unrelated to the cells of interest. Conclusions: This study illustrates the cytomorphology of five EBUS FNA cases that address some of the

  18. Evaluating the diagnostic accuracy of the Xpert®MTB/RIF assay on bronchoalveolar lavage fluid: a retrospective study.

    Science.gov (United States)

    Lu, Yanjun; Zhu, Yaowu; Shen, Na; Tian, Lei; Sun, Ziyong

    2018-02-08

    Limited data on the diagnostic accuracy of the Xpert ® MTB/RIF assay using bronchoalveolar lavage fluid in patients with suspected pulmonary tuberculosis (PTB) have been reported in China. Therefore, we designed a retrospective study to evaluate the diagnostic accuracy of this assay. Clinical, radiological, and microbiological characteristics of 238 PTB-suspected patients were retrospectively reviewed. The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) for the diagnosis of active PTB were calculated for the Xpert ® MTB/RIF assay using TB culture or final diagnosis based on clinical and radiological evaluation as a reference standard. The sensitivity and specificity of the Xpert ® MTB/RIF assay were 84.5% and 98.9%, and those for smear microscopy (SM) were 36.2% and 100%, respectively, when compared with those of the culture method. However, compared with the sensitivity and specificity of final diagnosis based on clinical and radiological evaluation, the sensitivity and specificity of the assay were 72.9% and 98.7%, which were significantly higher than those for SM. The Xpert ® MTB/RIF assay on bronchoalveolar lavage fluid could serve as an additional rapid diagnosis tool for PTB in a high TB-burden country and improve the time to TB treatment initiation in patients with PTB. Copyright © 2018 The Authors. Published by Elsevier Ltd.. All rights reserved.

  19. Diagnostic investigations and historical-stylistic evaluation on the oil painting: "reading man by oil lamp light"

    Directory of Open Access Journals (Sweden)

    Salvatore Lorusso

    2006-02-01

    Full Text Available This investigation intends to verify the attribution of the oil painting (70x50,5 cm portraying a reading man by oil lamp light, to Gerrit van Hontorst. The note refers not only to a stylistic and historical-artistical evaluation but also to the knowledge, through diagnostic techniques, of the application to characterize components of matter, and of the manufacture execution technique and preservation conditions. This investigation denies the attribution to the painter Gerrit van Hontorst, but it does not exclude a dating within the XVII century.

  20. Analytical-diagnostic and computing technologies for the attribution, authentication and economic evaluation of art works

    Directory of Open Access Journals (Sweden)

    Salvatore Lorusso

    2014-12-01

    Full Text Available This study, addresses the specific subject relating to the formulation of the economic value of art works in connection with their attribution and authentication. Through this process, which also includes regulatory issues, it follows that the current problem in the field of forgery and, in general inauthentic works, is precisely that of ascertaining, by means of scientific methods, whether a work of art is authentic or not.With this aim in mind, the following research project has been proposed and aims to develop the right methodological path to use to achieve this aim. It includes a cognitive phase involving aesthetic, stylistic, iconographic, and historical analysis and concludes with a technical-experimental phase in which diagnostic-analytical and computer technologies are employed.On completion of the research, combined the diagnostic and analytical results, as well as the development of software allowing the style of a particular artist to be identified, will provide a valuable contribution to the various and complex issues relating to the attribution and authentication of art works.

  1. Quantity of Candida Colonies in Saliva: 
A Diagnostic Evaluation for Oral Candidiasis.

    Science.gov (United States)

    Zhou, Pei Ru; Hua, Hong; Liu, Xiao Song

    To investigate the relationship between the quantity of Candida colonies in saliva and oral candidiasis (OC), as well as to identify the threshold for distinguishing oral candidiasis from healthy carriage. A diagnostic test was conducted in 197 patients with different oral problems. The diagnosis of OC was established based on clinical features. Whole saliva samples from the subjects were cultured for Candida species. Receiver operating characteristic (ROC) curve analysis was used in this study. OC patients had significantly more Candida colony-forming units per millilitre saliva (795 cfu/ml) than asymptomatic carriers (40 cfu/ml; P Candida colonies differed. The number of Candida colonies in pseudomembranous type was significantly higher than that in the erythematous type (P Candida albicans was the predominant species of Candida. The cut-off point with the best fit for OC diagnosis was calculated to be 266 cfu/ml. The sensitivity and specificity were 0.720 and 0.825, respectively. Analysis of the ROC curve indicated that Candida colonies had a high diagnostic value for OC, as demonstrated by the area under the curve (AUC = 0.873). Based on this study, the value of 270 cfu/ml was considered a threshold for distinguishing OC from carriage.

  2. Evaluation of Virus Inactivation by Formaldehyde to Enhance Biosafety of Diagnostic Electron Microscopy

    Directory of Open Access Journals (Sweden)

    Lars Möller

    2015-02-01

    Full Text Available Formaldehyde (FA fixation of infectious samples is a well-established protocol in diagnostic electron microscopy of viruses. However, published experimental data that demonstrate virus inactivation by these fixation procedures are lacking. Usually, fixation is performed immediately before the sample preparation for microscopy. The fixation procedure should transform viruses in a non–infectious but nonetheless structurally intact form in order to allow a proper diagnosis based on morphology. FA provides an essential advantage in comparison to other disinfectants, because it preserves the ultrastructure of biological material without interfering significantly with the preparation (i.e., the negative staining and the detection of viruses. To examine the efficiency of FA inactivation, we used Vaccinia virus, Human adenovirus and Murine norovirus as models and treated them with FA under various conditions. Critical parameters for the inactivation efficiency were the temperature, the duration of the FA treatment, and the resistance of the virus in question. Our results show that FA inactivation at low temperature (4 °C bears a high risk of incomplete inactivation. Higher temperatures (25 °C are more efficient, although they still require rather long incubation times to fully inactivate a complex and highly robust virus like Vaccinia. A protocol, which applied 2% buffered FA for 60 min and a temperature–shift from 25 to 37 °C after 30 min was efficient for the complete inactivation of all test viruses, and therefore has the potential to improve both biosafety and speed of diagnostic electron microscopy.

  3. Animal Classification. Animal Life in Action[TM]. Schlessinger Science Library. [Videotape].

    Science.gov (United States)

    2000

    This 23-minute videotape for grades 5-8, presents the myriad of animal life that exists on the planet. Students can view and perform experiments and investigations that help explain animal traits and habits. They learn what the terms "kingdom", "phylum", and "order" mean, and discover how the 3.5 million-plus organisms found on Earth fit into…

  4. Darwin's Revolution in Thought: An Illustrated Lecture. Teaching Guide and Videotape.

    Science.gov (United States)

    Gould, Stephen Jay

    "Darwin's Revolution in Thought" is Stephen Jay Gould's definitive treatise on Charles Darwin. This 50-minute classroom edition videotaped lecture is structured in the form of a paradox and three riddles about Darwin's life. Each is designed to shed light on one of the key features of the theory of natural selection, its philosophical…

  5. Marine & Other Invertebrates. Animal Life in Action[TM]. Schlessinger Science Library. [Videotape].

    Science.gov (United States)

    2000

    This 23-minute videotape for grades 5-8, presents the myriad of animal life that exists on the planet. Students can view and perform experiments and investigations that help explain animal traits and habits. Invertebrate animals include a vast array of spineless creatures. In this video, students discover marine lifeforms such as jellyfish,…

  6. Real Talk: Interviews, Radio Broadcasts and Videotaping as Context in Advanced Italian Conversation Courses.

    Science.gov (United States)

    Orban, Clara

    1997-01-01

    Discusses the problems faced by teachers of third-year (i.e. advanced) Italian language courses, particularly in developing students' speaking skills. Stresses the importance of "real talk" and discusses relevant student activities such as interviewing native speakers, preparing live radio broadcasts, and videotaping students speeches and…

  7. Amphibians. Animal Life in Action[TM]. Schlessinger Science Library. [Videotape].

    Science.gov (United States)

    2000

    This 23-minute videotape for grades 5-8, presents the myriad of animal life that exists on the planet. Students can view and perform experiments and investigations that help explain animal traits and habits. Students find out about the world of amphibians as they examine their physical characteristics, environments, and life cycles, as well as…

  8. Camera Perspective Bias in Videotaped Confessions: Experimental Evidence of Its Perceptual Basis

    Science.gov (United States)

    Ratcliff, Jennifer J.; Lassiter, G. Daniel; Schmidt, Heather C.; Snyder, Celeste J.

    2006-01-01

    The camera perspective from which a criminal confession is videotaped influences later assessments of its voluntariness and the suspect's guilt. Previous research has suggested that this camera perspective bias is rooted in perceptual rather than conceptual processes, but these data are strictly correlational. In 3 experiments, the authors…

  9. Robert Sylwester on Social Interaction and Brain Development. Windows to the Mind, Volume 1. [Videotape].

    Science.gov (United States)

    Sylwester, Robert

    This videotape explores the relationship between the child's social world and cognitive development. The first part of the video examines why the social environment is important to brain development. This section looks at the amount of time a child spends in a social environment, and the anatomy of the developing brain. The second part of the…

  10. Insects & Other Arthropods. Animal Life in Action[TM]. Schlessinger Science Library. [Videotape].

    Science.gov (United States)

    2000

    This 23-minute videotape for grades 5-8, presents the myriad of animal life that exists on the planet. Students can view and perform experiments and investigations that help explain animal traits and habits. They also learn that there are more species of insects than any other animal class in the world. Insects are incredible creatures with many…

  11. The Importance of Child Development in Education: A Conservation with James Comer and Chip Wood. [Videotape].

    Science.gov (United States)

    Comer, James; Wood, Chip

    Taped before an audience of teachers from around the country, this 65-minute videotape presents a discussion between James Comer and Chip Wood, noted experts in child development and education, in which they converse and respond to questions about critical issues confronting educators today. During the first part of the video, Comer and Wood…

  12. Dancetime! 500 Years of Social Dance. Volume I: 15th-19th Centuries. [Videotape].

    Science.gov (United States)

    Teten, Carol

    This VHS videotape recording is the first in a two-volume series that presents 500 years of social dance, music, and fashion. It focuses on the 15th-19th centuries, including Renaissance nobility, Baroque extravagance, Regency refinement, and Victorian romanticism. Each era reflects the changing relationships between men and women through the…

  13. Dancetime! 500 Years of Social Dance. Volume II: 20th Century. [Videotape].

    Science.gov (United States)

    Teten, Carol

    This 50-minute VHS videotape is the second in a 2-volume series that presents 500 years of social dance, music, and fashion. It features dance and music of the 20th century, including; 1910s: animal dances, castle walk, apache, and tango; 1920s: black bottom and charleston; 1930s: marathon, movie musicals, big apple, and jitterbug; 1940s: rumba;…

  14. Video-Taped Instruction Creates Listening and Visual Memory Integration for Higher Reading and Math Scores.

    Science.gov (United States)

    Erland, Jan

    This pre-post quasi-experimental study was conducted in a public school 5th grade class to determine the effects of video-taped instruction in teaching analysis and pattern finding skills. Methodology included guidelines from Cognitive Behavior Modification, Suggestopedia, and Guilford's Structure of Intellect Model within the Kaufman and Kaufman…

  15. Birds. Animal Life in Action[TM]. Schlessinger Science Library. [Videotape].

    Science.gov (United States)

    2000

    This 23-minute videotape for grades 5-8, presents the myriad of animal life that exists on the planet. Students can view and perform experiments and investigations that help explain animal traits and habits. There are many different types of birds, over 9,000 different species. While not all birds take to the air, they all have feathers. Students…

  16. A system for sampling changes in blood pressure from a videotape, using Finapres(TM)

    NARCIS (Netherlands)

    Näring, G.W.B.; Wittebrood, J.; Staak, C. van der; DeMey, H.; Schaap, C.

    1996-01-01

    A system is described that measures blood pressure noninvasively and continuously during a videotaped verbal interaction. The system incorporates the use of the Finapres to nonintrusively and continuously measure BP during a verbal interaction. Segments from the interaction, in which blood pressure

  17. How To Dance through Time. Volume II: Dances of the Ragtime Era, 1910-1920. [Videotape].

    Science.gov (United States)

    Teten, Carol

    This 59-minute VHS videotape is the second in a series of "How To Dance Through Time" videos. It provides 44 step combinations and how-to instructions to help viewers learn to dance the most popular dances of the early 20th century (the ragtime era), including: the wild animal dances (fox trot, horse trot, kangaroo hop, duck waddle, squirrel,…

  18. Presenting Social Issues with Videotape [and] Teaming Up to Take a Risk.

    Science.gov (United States)

    Agosta, Diana; Jackson, Dick

    1991-01-01

    Two articles discuss the use of media in schools. One describes the use of videotapes to present social issues; the second describes the use of an integrated learning system with ninth and tenth grade at-risk students to improve their rate of attendance, academic achievement, and self-esteem. (LRW)

  19. Reptiles. Animal Life in Action[TM]. Schlessinger Science Library. [Videotape].

    Science.gov (United States)

    1999

    This 23-minute videotape for grades 5-8, presents the myriad of animal life that exists on the planet. Students can view and perform experiments and investigations that help explain animal traits and habits. The ancestors of reptiles date back to the dinosaurs. After the dinosaurs died out, it was one of the best-adapted species that survived and…

  20. Food Chains. Animal Life in Action[TM]. Schlessinger Science Library. [Videotape].

    Science.gov (United States)

    2000

    This 23-minute videotape for grades 5-8, presents the myriad of animal life that exists on the planet. Students can view and perform experiments and investigations that help explain animal traits and habits. The food chain provides a clear example of how life continues year after year. Students learn how the cycle of energy starts with the sun,…

  1. Using video-taped examples of standardized patient to teach medical students taking informed consent

    Directory of Open Access Journals (Sweden)

    SHIRIN HABIBI KHORASANI

    2015-04-01

    Full Text Available Introduction: Medical student should be trained in medical ethics and one of the most essential issues in this field is taking informed consents. In this research, we compared the effect of effectiveness of teaching methods on students’ ability in taking informed consent from patients. Methods: This semi-experimental study was carried out on fifty eight subjects from the 4th-year students of Shiraz University of Medical Sciences who attended in medical ethics course before their ‘clinical clerkship’training.Method of sampling was census and students were randomly allocated into two groups of control group (n=28 was trained in traditional lecture-based class and the case groupnamed as A1 (n=22 were taught by video-taped examples of standardized patient.Then A1 group attended in traditional lecture-based classes named as A2. The groups were evaluated in terms the ability of recognition of ethical issues through the scenario based ethical examination before and after each training. Scenarios were related to the topics of informed consent. Data were analyzed by SPSS 14 software using descriptive statistics and anova test. P-value less than 0.05 was considered as significant. Results: The mean scores results of A2, A1 and B group were found to be 7.21, 5.91 and 5.73 out of 8, respectively. Comparison between the groups demonstrated that the ability of taking informed consent was significantly higher in A2 group (p<0.001, followed by A1 group (p<0.05, while was the least in the B group (p=0.875. Conclusion: According to this research, lecture-based teaching is still of great value in teaching medical ethics, but when combined with standardized patient, the outcome will be much better. It should be considered that mixed methods of teaching should be used together for better result.

  2. Diagnostic performance of magnetic resonance imaging and pre-surgical evaluation in the assessment of traumatic intra-articular knee disorders in children and adolescents: what conditions still pose diagnostic challenges?

    Energy Technology Data Exchange (ETDEWEB)

    Gans, Itai; Ganley, Theodore J. [The Children' s Hospital of Philadelphia, Division of Orthopaedics, 34th and Civic Center Boulevard, Philadelphia, PA (United States); Bedoya, Maria A.; Ho-Fung, Victor [The Children' s Hospital of Philadelphia, Department of Radiology, Philadelphia, PA (United States)

    2014-08-31

    Diagnosis of intra-articular lesions in children based on clinical examination and MRI is particularly challenging. To evaluate the diagnostic performance of MRI and pre-surgical evaluation of the knee in pediatric patients relative to arthroscopic evaluation as the gold standard. We report diagnoses frequently missed or inaccurately diagnosed pre-operatively. We conducted a retrospective review of MRI and pre-surgical evaluation in children and adolescents ages 1-17 years who were treated by knee arthroscopy during a 21/2-year period. All MRIs were reviewed by a pediatric radiologist blinded to clinical findings. Pediatric orthopedic clinic notes were reviewed for pre-surgical evaluation (based on physical exam, radiograph, MR images and radiologist's MRI report). Arthroscopic findings were used as the gold standard. We calculated the percentages of diagnoses at arthroscopy missed on both MRI and pre-surgical evaluation. Diagnostic accuracy between children and adolescents and in patients with one pathological lesion vs. those with >1 lesion was analyzed. We performed a second review of MR images of the missed or over-called MRI diagnoses with knowledge of arthroscopic findings. We included 178 children and adolescents. The most common diagnoses missed on MRI or pre-surgical evaluation but found at arthroscopy were: discoid meniscus (8/30, or 26.7% of cases); lateral meniscal tears (15/80, or 18.8% of cases); intra-articular loose bodies (5/36, or 13.9% of cases), and osteochondral injuries (9/73, or 12.3% of cases). Overall diagnostic accuracy of MRI and pre-surgical evaluation was 92.7% and 95.3%, respectively. No significant difference in diagnostic accuracy between children and adolescents was observed. When multiple intra-articular lesions were present, lateral meniscal tears were more likely to be inaccurately diagnosed (missed or over-called) on both MRI (P = 0.009) and pre-surgical evaluation (P < 0.001). Overall diagnostic accuracy of MRI and pre

  3. The effect of videotaping students' interviews with patients for interview skill education.

    Science.gov (United States)

    Lee, Woo Sung; Hwang, Ji Young; Lim, Ji Eun; Suh, Sang-Yeon; Park, Ki Heum; Sung, Nak-Jin

    2013-03-01

    The importance of communication between patients and physicians has been proven in many previous studies. The authors analyzed the effect of interview skill education through videotapes which recorded students' interviews with real patients in the outpatient department of family medicine. This study was conducted with all students who chose the elective course of family medicine and one randomly selected student every week from an 'infectious internal medicine' class at Dongguk University Ilsan Hospital during the period from December 2008 to March 2011. All students performed a preliminary examination of a new patient at the outpatient department of family medicine. All consultations were videotaped. Feedback to the student was given on the same day by viewing the videotape together. After feedback, all students performed another preliminary examination of one new patient at the department of family medicine the same week. Three family medicine residents scored all videotapes using 10-item interview skill checklists. Many parts of the checklists were modified using the Arizona Clinical Interview Rating Scales. Thirty-three students participated. Of 10 items, nine showed increased scores after feedback. There was a significant change in four items after feedback: 'type of question' (before 2.36 ± 0.60, after 2.73 ± 0.72), 'timeline' (before 2.82 ± 0.68, after 3.18 ± 0.73), 'positive verbal reinforcement' (before 2.24 ± 0.56, after 2.61 ± 0.90), and the total score (before 21.70 ± 2.62, after 23.39 ± 3.13) (P skills using videotapes of students' preliminary consultations with real patients in outpatient settings, was effective in improving the interview areas of 'type of question,' 'timeline,' 'positive verbal reinforcement,' and the total interview scores.

  4. Reflectance measurements of skin lesions: noninvasive method for diagnostic evaluation of pigmented neoplasia

    Science.gov (United States)

    Borisova, E.; Trojanova, P.; Avramov, L.

    2005-08-01

    The aims of this work are investigation and differentiation between normal skin and pigmented skin lesions by using optical reflectance spectroscopy. Optical reflectance spectra in the wavelength range 400-900 nm were obtained from malignant and benign skin lesions and characteristic differences between them were studied. The lesions were preliminarily classified dermatoscopically (MoleMax II, DERMA Instruments). All suspicious lesions were excised and the materials were investigated histologically by standard methods. An algorithm was developed for differentiation and valuation of the skin tissue condition using dimensionless ratios of the reflectance signal intensities of normal skin and pigmented lesions, which allowed the use of non-normalized reflectance spectra for lesion assessment. These ratios were found to have a definite diagnostic potential, as significant differences were observed between normal skin, benign and malignant pigmented lesions.

  5. A texture analysis approach for objective uniformity evaluation in diagnostic ultrasound imaging: A preliminary study.

    Science.gov (United States)

    Scorza, Andrea; Conforto, Silvia; Lupi, Giulia; Sciuto, Salvatore Andrea

    2015-01-01

    Ultrasound image uniformity is an important parameter for quality assurance in diagnostic ultrasounds, but it is usually assessed by a qualitative judgement of technicians so its estimation is rough and subjective. In this work a novel method is developed to give an objective measurement of the Bmode image uniformity over the whole field of view or some of its part: the Texture Distribution Analysis Method (TDAM) is based on a segmentation of the Region of Interest, depending on some texture features calculated from co-occurrence matrices. Results on a set of 10 test images with different non-uniformities (Uniformity Image Test Set or UITS) show a good sensitivity and agreement of TDAM with the mean judgment by 5 human observers (TUV): TDAM and TUV uniformity values are coherent for the whole UITS, nevertheless a high uncertainty in uniformity values has been observed (up to 28 percent). Preliminary results look encouraging and more efforts are worth to refine the method.

  6. [Evaluation of the Unicel DXC 600 (Beckman Coulter) and comparison with Integra 800 (Roche Diagnostics)].

    Science.gov (United States)

    Servonnet, A; Théfenne, H; Boukhira, A; Vest, P; Renard, C

    2007-01-01

    The Unicel DXC 600 is an automated analytical system from Beckman Coulter for measuring usual biochemistry parameters (electrolytes, substrates and enzymatic activities), therapeutic drugs, drugs of abuse and specific proteins. According to the "Société française de biologie clinique (SFBC)" validation protocol, we tested the following parameters: electrolytes (sodium, potassium, chloride, total CO2), substrates (uric acid, calcium, phosphate, glucose, creatinine, urea, cholesterol, HDL cholesterol, bilirubin, iron, triglycerides), enzymes (ALAT, ASAT, amylase, CK, GGT, LDH, lipase, ALP), total proteins and specific proteins (albumin, CRP, haptoglobin). The results confirm the excellent analytical performances regarding imprecision. The comparison study shows differences between values obtained with Unicel DXC 600 and Integra 800 (Roche diagnostics), leading to the use of correcting factors for some parameters.

  7. [Evaluation of diagnostic and therapeutic services in German university hospitals for adults with autism spectrum disorder (ASD)].

    Science.gov (United States)

    Michel, T M; Sheldrick, A J; Frentzel, T G; Herpertz-Dahlmann, B; Herpertz, S; Habel, U; Bruegmann, E; Schneider, K; Schneider, F

    2010-07-01

    Autism spectrum disorders (ASD), are pervasive developmental disorders, which are defined by qualitative impairment in reciprocal social interaction and communication as well as by stereotyped repetitive behaviour. Newer epidemiological studies report a prevalence of 1 %. However, parents and self-help organisations report a considerable lack of diagnostic services, especially in the university hospital setting. In order to receive funding for adequate treatment at an "autism therapy centre", a Consultant psychiatrist has to diagnose ASD. We assessed the diagnostic and therapeutic facilities for adults with ASD by sending out questionnaires to 33 German university hospitals. Furthermore, we evaluated the demographic data of the first 74 patients that presented at the specialist clinic for adults with ASD at the Department for Psychiatry and Psychotherapy, RWTH Aachen University. At the time of the evaluation, only 9 university hospitals in Germany offered a specialist clinic for diagnostics and/or treatment for adults with ASD. A comorbid psychiatric disorder was diagnosed in 52.9 % of the patients presenting at the specialist clinic for adult ASD. These were mostly mental retardation and affective disorders. The most common differential diagnosis for the patients presenting at the service were affective and personality disorders. There is still great need of specialist services at university hospitals in Germany for adults with ASD, although more services have been established over the past few years. Over half of the patients with ASD had other psychiatric comorbid disorders, which were mostly mental retardation and affective disorders. The most common differential diagnosis for patients presenting at the clinics were personality disorders and depression. (c) Georg Thieme Verlag KG Stuttgart-New York

  8. Critical evaluation of fine needle aspiration cytology as a diagnostic technique in bone tumors and tumor-like lesions.

    Science.gov (United States)

    Chakrabarti, Sudipta; Datta, Alok Sobhan; Hira, Michael

    2012-01-01

    Though open surgical biopsy is the procedure of choice for the diagnosis of bone tumors, many disadvantages are associated with this approach. The present study was undertaken to evaluate the role of fine needle aspiration cytology (FNAC) as a diagnostic tool in cases of bony tumors and tumor-like lesions which may be conducted in centers where facilities for surgical biopsies are inadequate. The study population consisted of 51 cases presenting with a skeletal mass. After clinical evaluation, radiological correlation was done to assess the nature and extent of each lesion. Fine needle aspiration was performed aseptically and smears were prepared. Patients subsequently underwent open surgical biopsy and tissue samples were obtained for histopathological examination. Standard statistical methods were applied for analysis of data. Adequate material was not obtained even after repeated aspiration in seven cases, six of which were benign. Among the remaining 44 cases, diagnosis of malignancy was correctly provided in 28 (93.3%) out of 30 cases and categorical diagnosis in 20 (66.67%). Interpretation of cytology was more difficult in cases of benign and tumor-like lesions, with a categorical opinion only possible in seven (50%) cases. Statistical analysis showed FNAC with malignant tumors to have high sensitivity (93.3%), specificity (92.9%) and positive predictive value of 96.6%, whereas the negative predictive value was 86.7%. FNAC should be included in the diagnostic workup of a skeletal tumor because of its simplicity and reliability. However, a definitive pathologic diagnosis heavily depends on compatible clinical and radiologic features which can only be accomplished by teamwork. The cytological technique applied in this study could detect many bone tumors and tumor-like conditions and appears particularly suitable as a diagnostic technique for rural regions of India as other developing countries.

  9. Evaluation of the diagnostic performance of infrared imaging of the breast: a preliminary study.

    Science.gov (United States)

    Wang, Jane; Chang, King-Jen; Chen, Chin-Yu; Chien, Kuo-Liong; Tsai, Yuh-Show; Wu, Yuh-Ming; Teng, Yu-Chuan; Shih, Tiffany Ting-Fang

    2010-01-07

    The study was conducted to investigate the diagnostic performance of infrared (IR) imaging of the breast using an interpretive model derived from a scoring system. The study was approved by the Institutional Review Board of our hospital. A total of 276 women (mean age = 50.8 years, SD 11.8) with suspicious findings on mammograms or ultrasound received IR imaging of the breast before excisional biopsy. The interpreting radiologists scored the lesions using a scoring system that combines five IR signs. The ROC (receiver operating characteristic) curve and AUC (area under the ROC curve) were analyzed by the univariate logistic regression model for each IR sign and an age-adjusted multivariate logistic regression model including 5 IR signs. The cut-off values and corresponding sensitivity, specificity, Youden's Index (Index = sensitivity+specificity-1), positive predictive value (PPV), negative predictive value (NPV) were estimated from the age-adjusted multivariate model. The most optimal cut-off value was determined by the one with highest Youden's Index. For the univariate model, the AUC of the ROC curve from five IR signs ranged from 0.557 to 0.701, and the AUC of the ROC from the age-adjusted multivariate model was 0.828. From the ROC derived from the multivariate model, the sensitivity of the most optimal cut-off value would be 72.4% with the corresponding specificity 76.6% (Youden's Index = 0.49), PPV 81.3% and NPV 66.4%. We established an interpretive age-adjusted multivariate model for IR imaging of the breast. The cut-off values and the corresponding sensitivity and specificity can be inferred from the model in a subpopulation for diagnostic purpose. NCT00166998.

  10. Evaluation of the diagnostic performance of infrared imaging of the breast: a preliminary study

    Directory of Open Access Journals (Sweden)

    Wu Yuh-Ming

    2010-01-01

    Full Text Available Abstract Background The study was conducted to investigate the diagnostic performance of infrared (IR imaging of the breast using an interpretive model derived from a scoring system. Methods The study was approved by the Institutional Review Board of our hospital. A total of 276 women (mean age = 50.8 years, SD 11.8 with suspicious findings on mammograms or ultrasound received IR imaging of the breast before excisional biopsy. The interpreting radiologists scored the lesions using a scoring system that combines five IR signs. The ROC (receiver operating characteristic curve and AUC (area under the ROC curve were analyzed by the univariate logistic regression model for each IR sign and an age-adjusted multivariate logistic regression model including 5 IR signs. The cut-off values and corresponding sensitivity, specificity, Youden's Index (Index = sensitivity+specificity-1, positive predictive value (PPV, negative predictive value (NPV were estimated from the age-adjusted multivariate model. The most optimal cut-off value was determined by the one with highest Youden's Index. Results For the univariate model, the AUC of the ROC curve from five IR signs ranged from 0.557 to 0.701, and the AUC of the ROC from the age-adjusted multivariate model was 0.828. From the ROC derived from the multivariate model, the sensitivity of the most optimal cut-off value would be 72.4% with the corresponding specificity 76.6% (Youden's Index = 0.49, PPV 81.3% and NPV 66.4%. Conclusions We established an interpretive age-adjusted multivariate model for IR imaging of the breast. The cut-off values and the corresponding sensitivity and specificity can be inferred from the model in a subpopulation for diagnostic purpose. Trial Registration NCT00166998.

  11. The experiences of health-related quality of life in patients with nonspecific symptoms who undergo a diagnostic evaluation for cancer

    DEFF Research Database (Denmark)

    Moseholm Larsen, Ellen Frøsig; Lindhardt, Bjarne Oerskov; Rydahl-Hansen, Susan

    2016-01-01

    The diagnostic phase of cancer can affect health-related quality of life (HRQoL). The aim of this study was to investigate how patients with nonspecific symptoms experience HRQoL while undergoing diagnostic evaluations for cancer. Twenty-one participants who had completed a fast-track evaluation...... of Cancer Quality of Life questionnaire (EORCT-QLQ-C30). Data analysis was based on qualitative content analysis by Krippendorff. The analysis generated six categories: symptoms, physical-, role-, emotional-, cognitive- and social functioning, and the diagnostic fast-track experience. From these categories...... for possible cancer at one of three hospitals in the Capital Region, Denmark were interviewed 2-4 weeks after completing diagnostic evaluations. The interviews were semi-structured and were supported by an interview guide based on the same themes as in The European Organisation for Research and Treatment...

  12. Evaluation of a density-based rapid diagnostic test for sickle cell disease in a clinical setting in Zambia.

    Directory of Open Access Journals (Sweden)

    Ashok A Kumar

    Full Text Available Although simple and low-cost interventions for sickle cell disease (SCD exist in many developing countries, child mortality associated with SCD remains high, in part, because of the lack of access to diagnostic tests for SCD. A density-based test using aqueous multiphase systems (SCD-AMPS is a candidate for a low-cost, point-of-care diagnostic for SCD. In this paper, the field evaluation of SCD-AMPS in a large (n = 505 case-control study in Zambia is described. Of the two variations of the SCD-AMPS used, the best system (SCD-AMPS-2 demonstrated a sensitivity of 86% (82-90% and a specificity of 60% (53-67%. Subsequent analysis identified potential sources of false positives that include clotting, variation between batches of SCD-AMPS, and shipping conditions. Importantly, SCD-AMPS-2 was 84% (62-94% sensitive in detecting SCD in children between 6 months and 1 year old. In addition to an evaluation of performance, an assessment of end-user operability was done with health workers in rural clinics in Zambia. These health workers rated the SCD-AMPS tests to be as simple to use as lateral flow tests for malaria and HIV.

  13. Diagnostic evaluation and risk factors for drug allergies in children: from clinical history to skin and challenge tests.

    Science.gov (United States)

    Arikoglu, Tugba; Aslan, Gulen; Batmaz, Sehra Birgul; Eskandari, Gulcin; Helvaci, Ilter; Kuyucu, Semanur

    2015-08-01

    Parent or self-reported drug allergy claims frequently overestimate the real incidence of hypersensitivity reactions. A detailed and algorithmic diagnostic evaluation of drug reactions may allow a proper diagnosis. The aim of this study was to determine the confirmation rates and risk factors for confirmed allergic drug reactions in children. Mersin University Hospital in Turkey. The study consisted of children between ages of 8 months and 18 years with the history of suspected drug allergy as reported by the clinician or the patients. Parents were interviewed by a clinician to complete questionnaires that included questions about demographic data and characteristics of index drug reaction. Immediate reactions (IRs) were assessed with immediate-reading skin prick (SPT) and intradermal tests (IDT). Nonimmediate reactions (NIRs) were assessed with SPT, both early and delayed reading of IDT and patch tests. In case of negative skin tests, drug provocation tests were performed. The possible risk factors for confirmed drug allergy in univariate analysis (p Parent or self-reported drug allergy should be evaluated with a standardized diagnostic work-up before strict prohibitions are made. In addition, family and personal histories of drug allergy were significant risk factors related to allergic drug reactions in children.

  14. Virtual microscopy: an evaluation of its validity and diagnostic performance in routine histologic diagnosis of skin tumors

    DEFF Research Database (Denmark)

    Nielsen, Patricia Switten; Lindebjerg, Jan; Rasmussen, Jan

    2010-01-01

    in routine histologic diagnosis of skin tumors. Our aim is to investigate whether conventional microscopy of skin tumors can be replaced by virtual microscopy. Ninety-six skin tumors and skin-tumor-like changes were consecutively gathered over a 1-week period. Specimens were routinely processed, and digital...... that it is feasible to make histologic diagnosis on the skin tumor types represented in this study using virtual microscopy after pathologists have completed a period of training. Larger studies should be conducted to verify whether virtual microscopy can replace conventional microscopy in routine practice.......Digitization of histologic slides is associated with many advantages, and its use in routine diagnosis holds great promise. Nevertheless, few articles evaluate virtual microscopy in routine settings. This study is an evaluation of the validity and diagnostic performance of virtual microscopy...

  15. Fool's Gold: Why Imperfect Reference Tests Are Undermining the Evaluation of Novel Diagnostics: A Reevaluation of 5 Diagnostic Tests for Leptospirosis

    Science.gov (United States)

    Limmathurotsakul, Direk; Turner, Elizabeth L.; Wuthiekanun, Vanaporn; Thaipadungpanit, Janjira; Suputtamongkol, Yupin; Chierakul, Wirongrong; Smythe, Lee D.; Day, Nicholas P. J.; Cooper, Ben; Peacock, Sharon J.

    2012-01-01

    Background. We observed that some patients with clinical leptospirosis supported by positive results of rapid tests were negative for leptospirosis on the basis of our diagnostic gold standard, which involves isolation of Leptospira species from blood culture and/or a positive result of a microscopic agglutination test (MAT). We hypothesized that our reference standard was imperfect and used statistical modeling to investigate this hypothesis. Methods. Data for 1652 patients with suspected leptospirosis recruited during three observational studies and one randomized control trial that described the application of culture, MAT, immunofluorescence assay (IFA), lateral flow (LF) and/or PCR targeting the 16S rRNA gene were reevaluated using Bayesian latent class models and random-effects meta-analysis. Results. The estimated sensitivities of culture alone, MAT alone, and culture plus MAT (for which the result was considered positive if one or both tests had a positive result) were 10.5% (95% credible interval [CrI], 2.7%–27.5%), 49.8% (95% CrI, 37.6%–60.8%), and 55.5% (95% CrI, 42.9%–67.7%), respectively. These low sensitivities were present across all 4 studies. The estimated specificity of MAT alone (and of culture plus MAT) was 98.8% (95% CrI, 92.8%–100.0%). The estimated sensitivities and specificities of PCR (52.7% [95% CrI, 45.2%–60.6%] and 97.2% [95% CrI, 92.0%–99.8%], respectively), lateral flow test (85.6% [95% CrI, 77.5%–93.2%] and 96.2% [95% CrI, 87.7%–99.8%], respectively), and immunofluorescence assay (45.5% [95% CrI, 33.3%–60.9%] and 96.8% [95% CrI, 92.8%–99.8%], respectively) were considerably different from estimates in which culture plus MAT was considered a perfect gold standard test. Conclusions. Our findings show that culture plus MAT is an imperfect gold standard against which to compare alterative tests for the diagnosis of leptospirosis. Rapid point-of-care tests for this infection would bring an important improvement

  16. Diagnostic efficacy of color Doppler ultrasound in evaluation of cervical lymphadenopathy

    Directory of Open Access Journals (Sweden)

    Deepankar Misra

    2016-01-01

    Conclusion: Within the limitations of this study, CDUS evaluation was found to be highly significant with a high sensitivity and specificity over clinical evaluation CDUS examination provides a prospect to reduce the need for biopsy/fine needle aspiration cytology in reactive nodes.

  17. Diagnostic utility of magnetic resonance imaging and magnetic resonance angiography in the radiological evaluation of pulsatile tinnitus.

    Science.gov (United States)

    Shweel, Mohamed; Hamdy, Balegh

    2013-01-01

    Our aim was to assess the diagnostic utility of magnetic resonance imaging with complimentary magnetic resonance angiography (MRI/MRA) in the radiological evaluation of patients with pulsatile tinnitus (PT). The present study was retrospectively conducted on 27 patients with pulsatile tinnitus. All patients showed normal otoscopic findings and were evaluated with magnetic resonance imaging (MRI) with complimentary magnetic resonance angiography (MRA), 9/27 (33.3%) patients were investigated by CT, and 12/27 (44.4%) were evaluated by angiography. All patients' clinical investigation was reviewed to discard systemic causes of PT. All hard copies of MRI/MRA studies were evaluated. MRI/MRA detected the underlying etiology of subjective pulsatile tinnitus (PT) in 11/27 patients (40.7%), and 16/27 patients (59.5%) showed normal MRI/MRA examination. The most common cause was dural arteriovenous malformation (AFM) in 4/27 (14.8%) patients, high jugular bulbus in 2/27 (7.4%), aneurysm of internal carotid artery in 1/27 (3.7%), aberrant internal carotid artery in 1/27 (3.7%), vertebral artery hypoplasia in 2/27 (7.4%), and glomus tumor in 1/27 (3.7%). The statistical results of the present study showed that MRI/MRA had the following: 80% sensitivity, 88% specificity, 86% accuracy, 85% PPV, 83% NPV, and 15% error percentage for diagnosis of PT. MRI/MRA was an effective radiological imaging method in detecting the underlying pathology of pulsatile tinnitus. Magnetic resonance may be considered a first line diagnostic imaging modality in the assessment of subjective pulsatile tinnitus. © 2013 Elsevier Inc. All rights reserved.

  18. Oscillation mechanics of the respiratory system in never-smoking patients with silicosis: pathophysiological study and evaluation of diagnostic accuracy

    Science.gov (United States)

    de Sá, Paula Morisco; Lopes, Agnaldo José; Jansen, José Manoel; de Melo, Pedro Lopes

    2013-01-01

    OBJECTIVES: Silicosis is a chronic and incurable occupational disease that can progress even after the cessation of exposure. Recent studies suggest that the forced oscillation technique may help to clarify the changes in lung mechanics resulting from silicosis as well as the detection of these changes. We investigated the effects of airway obstruction in silicosis on respiratory impedance and evaluated the diagnostic efficacy of the forced oscillation technique in these patients. METHODS: Spirometry was used to classify the airway obstruction, which resulted in four subject categories: controls (n = 21), patients with a normal exam (n = 12), patients with mild obstruction (n = 22), and patients with moderate-to-severe obstruction (n = 12). Resistive data were interpreted using the zero-intercept resistance (R0), the resistance at 4 Hz (Rrs4), and the mean resistance. We also analyzed the mean reactance (Xm) and the dynamic compliance. The total mechanical load was evaluated using the absolute value of the respiratory impedance (Z4Hz). The diagnostic potential was evaluated by investigating the area under the receiver operating characteristic curve. ClinicalTrials.gov: NCT01725971. RESULTS: We observed significant (p0.80) and highly accurately in the detection of moderate-to-severe obstruction (area under the curve>0.90). CONCLUSIONS: The forced oscillation technique may contribute to the study of the pathophysiology of silicosis and may improve the treatment offered to these patients, thus representing an alternative and/or complementary tool for evaluating respiratory mechanics. PMID:23778400

  19. [The scientific videotape with digital processing in surgery. The new opportunities offered surgery for videotape recording and postprocessing with the use of information and digital technologies].

    Science.gov (United States)

    Picardi, N

    1999-01-01

    The facility of the tape recording of a surgical operation, by means of simple manageable apparatuses and at low costs, especially in comparison with the former cinematography, makes it possible for all surgeons to record their own operative activity. Therefore at present the demonstration in video of surgical interventions is very common, but very often the video-tapes show surgical events only in straight chronological succession, as for facts of chronicle news. The simplification of the otherwise sophisticated digital technology of informatics elaboration of images makes more convenient and advisable to assemble the more meaningful sequences for a final product of higher scientific value. The digital technology gives at the best its contribution during the phase of post-production of the video-tape, where the surgeon himself can assemble an end product of more value because aimed to a scientific and rational communication. Thanks to such an elaboration the video-tape can aim not simply to become a good documentary, but also to achieve an educational purpose or becomes a truly scientific film. The initial video will be recorded following a specific project, the script, foreseeing and programming what has to be demonstrated of the surgical operation, establishing therefore in advance the most important steps of the intervention. The sequences recorded will then be assembled not necessarily in a chronological succession but integrating the moving images with static pictures, as drawings, schemes, tables, aside the picture-in picture technique, and besides the vocal descriptive comment. The cinema language has accustomed us to a series of passages among the different sequences as fading, cross-over, "flash-back", aiming to stimulate the psychological associative powers and encourage those critical. The video-tape can be opportunely shortened, paying attention to show only the essential phases of the operation for demonstrate only the core of the problem and utilize

  20. Convergence between DSM-IV-TR and DSM-5 diagnostic models for personality disorder: evaluation of strategies for establishing diagnostic thresholds.

    Science.gov (United States)

    Morey, Leslie C; Skodol, Andrew E

    2013-05-01

    The Personality and Personality Disorders Work Group for the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) recommended substantial revisions to the personality disorders (PDs) section of DSM-IV-TR, proposing a hybrid categorical-dimensional model that represented PDs as combinations of core personality dysfunctions and various configurations of maladaptive personality traits. Although the DSM-5 Task Force endorsed the proposal, the Board of Trustees of the American Psychiatric Association (APA) did not, placing the Work Group's model in DSM-5 Section III ("Emerging Measures and Models") with other concepts thought to be in need of additional research. This paper documents the impact of using this alternative model in a national sample of 337 patients as described by clinicians familiar with their cases. In particular, the analyses focus on alternative strategies considered by the Work Group for deriving decision rules, or diagnostic thresholds, with which to assign categorical diagnoses. Results demonstrate that diagnostic rules could be derived that yielded appreciable correspondence between DSM-IV-TR and proposed DSM-5 PD diagnoses-correspondence greater than that observed in the transition between DSM-III and DSM-III-R PDs. The approach also represents the most comprehensive attempt to date to provide conceptual and empirical justification for diagnostic thresholds utilized within the DSM PDs.

  1. Advanced error diagnostics of the CMAQ and Chimere modelling systems within the AQMEII3 model evaluation framework

    Science.gov (United States)

    Solazzo, Efisio; Hogrefe, Christian; Colette, Augustin; Garcia-Vivanco, Marta; Galmarini, Stefano

    2017-09-01

    The work here complements the overview analysis of the modelling systems participating in the third phase of the Air Quality Model Evaluation International Initiative (AQMEII3) by focusing on the performance for hourly surface ozone by two modelling systems, Chimere for Europe and CMAQ for North America. The evaluation strategy outlined in the course of the three phases of the AQMEII activity, aimed to build up a diagnostic methodology for model evaluation, is pursued here and novel diagnostic methods are proposed. In addition to evaluating the base case simulation in which all model components are configured in their standard mode, the analysis also makes use of sensitivity simulations in which the models have been applied by altering and/or zeroing lateral boundary conditions, emissions of anthropogenic precursors, and ozone dry deposition. To help understand of the causes of model deficiencies, the error components (bias, variance, and covariance) of the base case and of the sensitivity runs are analysed in conjunction with timescale considerations and error modelling using the available error fields of temperature, wind speed, and NOx concentration. The results reveal the effectiveness and diagnostic power of the methods devised (which remains the main scope of this study), allowing the detection of the timescale and the fields that the two models are most sensitive to. The representation of planetary boundary layer (PBL) dynamics is pivotal to both models. In particular, (i) the fluctuations slower than ˜ 1.5 days account for 70-85 % of the mean square error of the full (undecomposed) ozone time series; (ii) a recursive, systematic error with daily periodicity is detected, responsible for 10-20 % of the quadratic total error; (iii) errors in representing the timing of the daily transition between stability regimes in the PBL are responsible for a covariance error as large as 9 ppb (as much as the standard deviation of the network-average ozone observations in

  2. Advanced error diagnostics of the CMAQ and Chimere modelling systems within the AQMEII3 model evaluation framework

    Directory of Open Access Journals (Sweden)

    E. Solazzo

    2017-09-01

    Full Text Available The work here complements the overview analysis of the modelling systems participating in the third phase of the Air Quality Model Evaluation International Initiative (AQMEII3 by focusing on the performance for hourly surface ozone by two modelling systems, Chimere for Europe and CMAQ for North America. The evaluation strategy outlined in the course of the three phases of the AQMEII activity, aimed to build up a diagnostic methodology for model evaluation, is pursued here and novel diagnostic methods are proposed. In addition to evaluating the base case simulation in which all model components are configured in their standard mode, the analysis also makes use of sensitivity simulations in which the models have been applied by altering and/or zeroing lateral boundary conditions, emissions of anthropogenic precursors, and ozone dry deposition. To help understand of the causes of model deficiencies, the error components (bias, variance, and covariance of the base case and of the sensitivity runs are analysed in conjunction with timescale considerations and error modelling using the available error fields of temperature, wind speed, and NOx concentration. The results reveal the effectiveness and diagnostic power of the methods devised (which remains the main scope of this study, allowing the detection of the timescale and the fields that the two models are most sensitive to. The representation of planetary boundary layer (PBL dynamics is pivotal to both models. In particular, (i the fluctuations slower than ∼ 1.5 days account for 70–85 % of the mean square error of the full (undecomposed ozone time series; (ii a recursive, systematic error with daily periodicity is detected, responsible for 10–20 % of the quadratic total error; (iii errors in representing the timing of the daily transition between stability regimes in the PBL are responsible for a covariance error as large as 9 ppb (as much as the standard deviation of the network

  3. Diagnostic Evaluation of Co-Occurrence of Acanthamoeba and Fungi in Keratitis: A Preliminary Report.

    Science.gov (United States)

    Raghavan, Anita; Baidwal, Shaffie; Vijayaraghavan, Prabhu; Rajeswari, Sakthi; Rajaraman, Revathi; Venkatapathy, Narendran; Menon, Sunitha; Rammohan, Ram

    2017-11-14

    To test the hypothesis that the coexistence of Acanthamoeba with other forms of microbial keratitis, especially fungal keratitis (FK), is more prevalent than suspected. A prospective diagnostic study whereby patients presenting with stromal keratitis were additionally tested for Acanthamoeba, irrespective of the initial diagnosis. In addition to the routine workup with Gram stain, KOH mount, and cultures on blood agar and potato dextrose agar, nonnutrient agar was included. Confocal microscopy was performed where feasible. Samples for polymerase chain reaction studies were also obtained. We present the preliminary report of the first 100 culture-positive cases. The primary outcome measured was the number of coexistent Acanthamoeba and FK. The secondary outcomes were the total number of Acanthamoeba cases detected and the correlation between clinical diagnosis and microbiological observations. Of the first 100 cases, 22 were culture positive for Acanthamoeba, of which 9 were associated with concurrent FK, 5 with bacterial keratitis, and 8 in isolation. However, only 2 cases were diagnosed clinically as Acanthamoeba, whereas 5 were Acanthamoeba suspects. An additional 4 cases of fungal/Acanthamoeba coexistence in keratitis were revealed purely by confocal microscopy. Acanthamoeba can coexist with other forms of microbial keratitis. The frequency of infection coexistent or otherwise is higher than reported, and the possibility of coinfection must be considered especially in unresponsive cases. Including nonnutrient agar and confocal microscopy in all cases of keratitis would perhaps translate into better treatment strategies and outcomes.

  4. Application of molecular diagnostics to the evaluation of the surgical approach to thyroid cancer.

    Science.gov (United States)

    Miccoli, Paolo

    2014-06-01

    Recent important studies that include long-term follow-up have shown that BRAF and RAS mutations can have negative implications for disease recurrence and survival. BRAF positivity has been shown to be associated with decreased survival and is an independent predictor of poor prognosis. Reliable pre-operative identification of high-risk papillary thyroid cancer (PTC) patients may productively guide initial surgical management since reoperative neck surgery is associated with increased morbidity. However, it is probably too early to conclude that at present it is possible to tailor surgical therapy patient by patient only on the basis of their mutational status. Other important parameters, not including molecular testing, represented by some specific morphological aspects, still play an important role, probably still more significant than molecular diagnostics, such as neck ultrasonography. Pre-operative knowledge of BRAF-positive PTC could alter the initial surgical treatment for at least 20% of patients and can potentially prevent the increased morbidity associated with reoperative neck exploration. However, additional multi-institutional and randomized studies will be needed to further define the role of the pre-operative identification of BRAF positivity to guide not only the initial extent of total thyroidectomy (TT) but also the need for and extent of lymphadenectomy.

  5. Finite Element Analysis of Quantitative Percussion Diagnostics for Evaluating the Strength of Bonds Between Composite Laminates

    Science.gov (United States)

    Poveromo, Scott; Malcolm, Doug; Earthman, James

    Conventional nondestructive (NDT) techniques used to detect defects in composites are not able to determine intact bond integrity within a composite structure and are costly to use on large and complex shaped surfaces. To overcome current NDT limitations, a new technology was adopted based on quantitative percussion diagnostics (QPD) to better quantify bond quality in fiber reinforced composite materials. Results indicate that this technology is capable of detecting weak (`kiss') bonds between flat composite laminates. Specifically, the local value of the probe force determined from quantitative percussion testing was predicted to be significantly lower for a laminate that contained a `kiss' bond compared to that for a well-bonded sample, which is in agreement with experimental findings. Experimental results were compared to a finite element analysis (FEA) using MSC PATRAN/NASTRAN to understand the visco-elastic behavior of the laminates during percussion testing. The dynamic FEA models were used to directly predict changes in the probe force, as well as effective stress distributions across the bonded panels as a function of time.

  6. [Cutaneous malignant melanoma; diagnostic procedures and their evaluation in diagnosing and mapping sentinel nodes].

    Science.gov (United States)

    Valsamaki, Pipitsa; Zanglis, Antonios; Gerali, Sophia

    2009-01-01

    Cutaneous malignant melanoma represents 4% of all the malignant neoplasms. Nevertheless, 79% of the fatal malignant skin diseases are attributed to melanoma. In melanoma patients, the most important prognostic factor is the regional lymph node invasion. The present article describes the classical diagnostic, staging and therapeutic strategies in melanoma patients. In the realm of cutaneous melanoma, pre-operative lymphoscintigraphy and the intra-operative gamma-probe detection, removal and biopsy of the sentinel lymph node(s), comprise convenient, procedures, virtually lacking morbidity. The definition of sentinel includes the first lymph node or nodes, draining the lymph from the primary lesion, thereby attributed with the highest probability of harbouring migrating metastatic cells. A sentinel lymph node negative for malignancy accurately "predicts" the absence of melanoma cell invasion in all the rest regional and distant lymphatic basins. The method aims in the best discrimination of high-risk patients, as candidates for selective lymphadenectomy, with or without adjunctive treatment. Radionuclide-guided lymphatic mapping and surgery is based on the phagocytosis of colloidal-based radiopharmaceuticals by the macrophages encountered in functional tumour-infiltrated sentinel nodes. The nuclear methods successfully add to the staging and the potential surgical treatment of the disease.

  7. Recall and understanding of feedback by adult patients following diagnostic audiological evaluation.

    Science.gov (United States)

    Watermeyer, Jennifer; Kanji, Amisha; Mlambo, Nelisiwe

    2015-01-01

    Patient recall and understanding of information provided during feedback sessions may impact on adherence to treatment recommendations and may be affected by the audiologist's information giving style. This study examined patients' recall and understanding of diagnostic audiological information provided in a feedback session after an initial assessment. An exploratory, qualitative research design was used and involved: (1) observation of audiological assessments; (2) video recording of feedback sessions between audiologists and patients; (3) audio recorded semi-structured interviews with participants. Transcription-less analysis was used for the videoed interactions and content analysis for the interviews. Participants included five adult second-language English speaking patients and five audiologists at an audiology clinic. Patients correctly recalled and understood diagnoses and recommendations but struggled to recall other information provided. There appeared to be a mismatch between the information audiologists deemed important, versus what patients actually recalled and understood. Both facilitatory and inhibitory information giving strategies were used by audiologists in feedback sessions. This study suggests the need for a greater focus on communication skills training in the audiology curriculum with particular attention paid to information giving strategies and patient-centredness. Implications for teaching and practice are discussed.

  8. Performance Evaluation and Implementation of FPGA Based SGSF in Smart Diagnostic Applications.

    Science.gov (United States)

    Agarwal, Shivangi; Rani, Asha; Singh, Vijander; Mittal, A P

    2016-03-01

    The main objective of the paper is to implement Savitzky Golay Smoothing Filter (SGSF) so as to apply in pre-processing of real time smart medical diagnostic systems. As very important information of EEG and ECG waveforms lies in the peak of the signal, hence it becomes absolutely necessary to filter noise and artifacts from the signal. The implemented filter should be able to reject the noise efficiently along with the least distortion from the original signal. The shape preserving characteristics of the filter are determined by introducing different noise levels in the signal. The designed filter is tested on synthetic signals of EEG and ECG by adding different types of noise and the performance is analysed on various parameters, i.e., SNR, SSNR, SNRI, MSE, COR and signal distortion of the final output. The smoothing performance comparison of SGSF with the most commonly used Moving Average Filter (MAF) proves that SGSF is more efficient. Hence it is suggested that MAF can be replaced by SGSF. For real time issues, it is further implemented on reconfigurable architectures so as to achieve high speed, low cost, low power consumption and less area. Therefore SGSF is realized on FPGA platform to combine the advantages of both. Real time EEG and ECG signals are also considered for experimentation. The experimental results show that the proposed methodology (FPGA-SGSF) significantly reduces the processing time and preserves the actual features of the signal.

  9. Evaluation of the diagnostic ability of vector parameters characterizing the corneal astigmatism and regularity in clinical and subclinical keratoconus.

    Science.gov (United States)

    Martínez-Abad, Antonio; Piñero, David P; Ruiz-Fortes, Pedro; Artola, Alberto

    2017-04-01

    To evaluate the diagnostic ability of the vector parameters ocular residual astigmatism (ORA), topography disparity (TD) and topographic astigmatism CorT (anterior and total) for the detection of clinical and subclinical keratoconus, and to develop a detection model based on them. This study comprised a total of 61 keratoconus eyes (KC group), 19 eyes with subclinical keratoconus (SKC group) and 100 healthy eyes (control group). In all cases, a complete eye exam was performed including an analysis of the corneal structure with the Sirius system (Costruzione Strumenti Oftalmici, CSO). Likewise, the iASSORT software (ASSORT Pty) was used to calculate in all cases the vector parameters ORA, TD and CorT. Significant differences among groups were found in ORA, TD and CorT (anterior and total) (pkeratoconus was good, whereas anterior and total CorT showed a poorer diagnostic ability. ORA (cutoff 0.925 D, sensitivity/specificity 63.2%/77%) and TD (cutoff 0.710 D, sensitivity/specificity 74%/68%) showed an acceptable diagnostic ability for the detection of subclinical keratoconus, but anterior and total CorT did not. A detection model for subclinical keratoconus was obtained by logistic regression analysis involving TD, anterior corneal spherical aberration and posterior high order aberrations. The vector parameters ORA and TD are useful for the diagnosis of clinical and subclinical keratoconus. In this last condition, the combination of TD with corneal aberrometric data provides a consistent detection model. Copyright © 2016 British Contact Lens Association. Published by Elsevier Ltd. All rights reserved.

  10. A Pilot Study for the Evaluation of PCR as a Diagnostic Tool in Patients with Suspected Dermatophytoses.

    Science.gov (United States)

    Sharma, Robin; Gupta, Samiksha; Asati, Dinesh P; Karuna, T; Purwar, Shashank; Biswas, Debasis

    2017-01-01

    The conventional diagnostic tools for dermatophytoses suffer from several limitations including low sensitivity, specificity, and long turn-around-time. The present study was, therefore, performed to evaluate the performance of a polymerase chain reaction (PCR)-based method for the diagnosis of this condition. The study was conducted in the Dermatology outpatient department of a tertiary care teaching hospital in central India over a period of 3 months from July to September 2015. Forty participants, including 25 cases and 15 controls, were recruited in this observational study. Direct microscopy and fungal culture were performed from skin scrapings and nail clippings collected from the participants. PCR was also performed to amplify the chitin synthase 1 and internal transcribed spacer 2 genes from DNA samples extracted from the same clinical materials, using the method reported by Brillowska-Dabrowska et al. The diagnostic performance of fungal culture and PCR was compared using OpenEpi software. We observed a significant male predominance among patients with dermatophytoses. The sensitivity of fungal culture and dermatophyte PCR to diagnose dermatophytoses was 24% and 48%, respectively, whereas the specificity of the two assays was 100% and 93.3%, respectively. The likelihood ratio of a positive PCR assay was 7.2 and the negative likelihood ratio was 0.5. PCR assay also delivered a significant shortening of the time-to-diagnosis, with the mean turn-around-time being 8 hours and 14 days for PCR and culture, respectively. This study, thus, highlights the potential merits of the dermatophyte PCR assay in achieving a rapid diagnosis of dermatophytoses and underscores its utility as a complementary test to improve the sensitivity of the conventional diagnostic tools for this condition, as well as to reliably differentiate this condition from other similar skin conditions.

  11. Evaluation of machine learning algorithms and structural features for optimal MRI-based diagnostic prediction in psychosis.

    Directory of Open Access Journals (Sweden)

    Raymond Salvador

    Full Text Available A relatively large number of studies have investigated the power of structural magnetic resonance imaging (sMRI data to discriminate patients with schizophrenia from healthy controls. However, very few of them have also included patients with bipolar disorder, allowing the clinically relevant discrimination between both psychotic diagnostics. To assess the efficacy of sMRI data for diagnostic prediction in psychosis we objectively evaluated the discriminative power of a wide range of commonly used machine learning algorithms (ridge, lasso, elastic net and L0 norm regularized logistic regressions, a support vector classifier, regularized discriminant analysis, random forests and a Gaussian process classifier on main sMRI features including grey and white matter voxel-based morphometry (VBM, vertex-based cortical thickness and volume, region of interest volumetric measures and wavelet-based morphometry (WBM maps. All possible combinations of algorithms and data features were considered in pairwise classifications of matched samples of healthy controls (N = 127, patients with schizophrenia (N = 128 and patients with bipolar disorder (N = 128. Results show that the selection of feature type is important, with grey matter VBM (without data reduction delivering the best diagnostic prediction rates (averaging over classifiers: schizophrenia vs. healthy 75%, bipolar disorder vs. healthy 63% and schizophrenia vs. bipolar disorder 62% whereas algorithms usually yielded very similar results. Indeed, those grey matter VBM accuracy rates were not even improved by combining all feature types in a single prediction model. Further multi-class classifications considering the three groups simultaneously made evident a lack of predictive power for the bipolar group, probably due to its intermediate anatomical features, located between those observed in healthy controls and those found in patients with schizophrenia. Finally, we provide MRIPredict (https

  12. [Evaluation of malaria rapid diagnostic test Optimal-IT® pLDH along the Plasmodium falciparum distribution limit in Mauritania].

    Science.gov (United States)

    Ba, H; Ahouidi, A D; Duffy, C W; Deh, Y B; Diedhiou, C; Tandia, A; Diallo, M Y; Assefa, S; Lô, B B; Elkory, M B; Conway, D J

    2017-02-01

    Performance of the malaria Rapid Diagnostic Test (RDT) OptiMal-IT® was evaluated in Mauritania where malaria is low and dependent on a short transmission season. Slide microscopy was considered as the reference method of diagnosis. Febrile patients with suspected malaria were recruited from six health facilities, 3 urban and 3 rural, during two periods (December 2011 to February 2012, and August 2012 to March 2013). Overall, 780 patients were sampled, with RDT and thick blood film microscopy results being obtained for 759 of them. Out of 774 slides examined, of which 200 were positive, P. falciparum and P. vivax mono-infections were detected in 63.5% (127) and 29.5% (59), while P. falciparum/P. vivax coinfections were detected in 7% (14). Both species were observed in all study sites, although in significantly different proportions. The proportions of thick blood film and OptiMal-IT® RDT positive individuals was 26.3% and 30.3% respectively. Sensitivity and specificity of OptiMal-IT® RDT were 89% [95% CI, 84.7-93.3] and 91.1% [88.6-93.4]. Positives and negative predictive values were 78.1% [72.2-83.7] and 95.9% [94.1-97.5]. These diagnostic values are similar to those generally reported elsewhere, and support the use of RDTs as the main diagnostic tool for malaria in Mauritanian health facilities. In the future, choice of RDTs to be used must take account of thermostability in a hot, dry environment and their ability to detect P. falciparum and P. vivax.

  13. How to Determine the Accuracy of an Alternative Diagnostic Test when It Is Actually Better than the Reference Tests: A Re-Evaluation of Diagnostic Tests for Scrub Typhus Using Bayesian LCMs.

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    Lim, Cherry; Paris, Daniel H; Blacksell, Stuart D; Laongnualpanich, Achara; Kantipong, Pacharee; Chierakul, Wirongrong; Wuthiekanun, Vanaporn; Day, Nicholas P J; Cooper, Ben S; Limmathurotsakul, Direk

    2015-01-01

    The indirect immunofluorescence assay (IFA) is considered a reference test for scrub typhus. Recently, the Scrub Typhus Infection Criteria (STIC; a combination of culture, PCR assays and IFA IgM) were proposed as a reference standard for evaluating alternative diagnostic tests. Here, we use Bayesian latent class models (LCMs) to estimate the true accuracy of each diagnostic test, and of STIC, for diagnosing scrub typhus. Data from 161 patients with undifferentiated fever were re-evaluated using Bayesian LCMs. Every patient was evaluated for the presence of an eschar, and tested with blood culture for Orientia tsutsugamushi, three different PCR assays, IFA IgM, and the Panbio IgM immunochromatographic test (ICT). True sensitivity and specificity of culture (24.4% and 100%), 56kDa PCR assay (56.8% and 98.4%), 47kDa PCR assay (63.2% and 96.1%), groEL PCR assay (71.4% and 93.0%), IFA IgM (70.0% and 83.8%), PanBio IgM ICT (72.8% and 96.8%), presence of eschar (42.7% and 98.9%) and STIC (90.5% and 82.5%) estimated by Bayesian LCM were considerably different from those obtained when using STIC as a reference standard. The IgM ICT had comparable sensitivity and significantly higher specificity compared to IFA (p=0.34 and p<0.001, respectively). The low specificity of STIC was caused by the low specificity of IFA IgM. Neither STIC nor IFA IgM can be used as reference standards against which to evaluate alternative diagnostic tests. Further evaluation of new diagnostic tests should be done with a carefully selected set of diagnostic tests and appropriate statistical models.

  14. Diagnostic management strategies for adults and children with minor head injury: a systematic review and an economic evaluation.

    Science.gov (United States)

    Pandor, A; Goodacre, S; Harnan, S; Holmes, M; Pickering, A; Fitzgerald, P; Rees, A; Stevenson, M

    2011-08-01

    clinically normal patients with a normal CT. The CCHR is widely validated and cost-effective for adults. Decision rules for children appear cost-effective, but need further validation. Hospital admission is cost-effective for patients with abnormal, but not normal, CT. The main research priorities are to (1) validate decision rules for children; (2) determine the prognosis and treatment benefit for non-neurosurgical injuries; (3) evaluate the use of S100B alongside a validated decision rule; (4) evaluate the diagnosis and outcomes of anticoagulated patients with MHI; and (5) evaluate the implementation of guidelines, clinical decision rules and diagnostic strategies. Formal expected value of sample information analysis would be recommended to appraise the cost-effectiveness of future studies. The National Institute for Health Research Health Technology Assessment programme.

  15. A diagnostic evaluation of real-time PCR, fluorescent antibody and microscopic agglutination tests in cases of equine leptospiral abortion.

    Science.gov (United States)

    Erol, E; Jackson, C B; Steinman, M; Meares, K; Donahoe, J; Kelly, N; Locke, S; Smith, J L; Carter, C N

    2015-03-01

    A comprehensive evaluation of the real-time PCR assay for leptospirosis in comparison with other diagnostic assays on a large-scale basis is fundamental in validating the assay and determining the causes of equine abortions. To compare and evaluate the diagnostic value of real-time PCR assay for leptospirosis with traditional methods in equine leptospiral abortions. Cross-sectional observational study. A Leptospira spp. fluorescent antibody test (FAT), microscopic agglutination test (MAT) and real-time PCR (targeting the LipL32 gene) were compared and evaluated in equine fetal necropsy specimens (placenta, kidney, liver and heart blood) and maternal serum (when available) in 339 equine fetuses. From a total of 339 equine fetuses necropsied, 21 cases (6.19%) were diagnosed as leptospiral abortion. The majority of leptospiral abortions occurred in January (8 cases) and February (5 cases). Real-time PCR detected 21 of 21 cases, whereas MAT and FAT detected 19 and 18 (including 2 suspicious cases) cases, respectively. Comparing tissues, placenta yielded somewhat similar cycle of threshold values by real-time PCR compared with kidney, whereas kidney was the best specimen for the diagnosis of leptospirosis by the FAT test. In all MAT positive cases, the predominant titre in fetal heart blood was to serovar Pomona (ranging 1:100 to 1:204,800) with little or no cross-reaction to serovar Grippotyphosa. The results indicate that real-time PCR is an effective method for the diagnosis of leptospiral abortion in horses. However, MAT should continue to be used in clinical cases for serovar determination. © 2014 EVJ Ltd.

  16. [Field evaluation for diagnostic accuracy of the rapid test SD Bioline Malaria Antigen Pf/Pv® in Colombia].

    Science.gov (United States)

    Mendoza, Nohora Marcela; Cucunubá, Zulma Milena; Aponte, Samanda; González, Nohora Elizabeth; Bernal, Sindy Durley

    2013-01-01

    Rapid diagnostic tests (RDT) have been postulated as a way to ensure access to malaria diagnosis in remote areas. Despite its widespread use, there are no field studies to evaluate the accuracy of the SD Bioline Malaria Antigen Pf/Pv in Colombia RDT. To evaluate the diagnostic accuracy of the SD Bioline Malaria Antigen Pf/Pv® RDT in two departments endemic for malaria, comparing diagnosis with thick film corrected with PCR. A retrospective study was carried out to evaluate sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), concordance and sensitivity limits according to parasitemia ranges for the SD Bioline Malaria Antigen Pf/Pv ® test in Cordoba and Choco. The results were compared with microscopy corrected by PCR. A total of 383 samples processed, 121 were positive (75 for P. vivax , 42 for P. falciparum and 4 for mixed infection) and 262 negative samples. P. vivax: sensitivity 92.0% (95% CI: 83.6-96.3), specificity 98.7% ( 95% CI: 96.7-99.5), PPV 94.5% (95% CI: 86.7-97.9), NPV 98.1% (95% CI: 95.8-99.1), Cohen's kappa coefficient was 0.90 (0.80-1.00). P. falciparum: sensitivity 88.1% (95% CI: 75.0-94.8), specificity 97.9% (95% CI: 95.8-99.0), PPV 84.1% (95% CI: 70.6-92.1), NPV 98.5% (95% IC: 96.6-99.4), Cohen's kappa coefficient 0.80 (95% CI: 0.70-0.90). The test performed well, being better for P. vivax as compared to P. falciparum. There are still difficulties of RDT to detect low parasitemias. The non amplification of Pfhrp2 and Pfhrp3 genes in two samples diagnosed as mixed infection, suggest a possible deletion of these two genes together.

  17. Evaluation of a new paleosecular variation activity index as a diagnostic tool for geomagnetic field variations

    Science.gov (United States)

    Panovska, Sanja; Constable, Catherine

    2015-04-01

    Geomagnetic indices like Dst, K and A, have been used since the early twentieth century to characterize activity in the external part of the modern geomagnetic field and as a diagnostic for space weather. These indices reflect regional and global activity and serve as a proxy for associated physical processes. However, no such tools are yet available for the internal geomagnetic field driven by the geodynamo in Earth's liquid outer core. To some extent this reflects limited spatial and temporal sampling for longer timescales associated with paleomagnetic secular variation, but recent efforts in both paleomagnetic data gathering and modeling activity suggest that longer term characterization of the internal geomagnetic weather/climate and its variability would be useful. Specifically, we propose an index for activity in paleosecular variation, useful as both a local and global measure of field stability during so-called normal secular variation and as a means of identifying more extreme behavior associated with geomagnetic excursions and reversals. To date, geomagnetic excursions have been identified by virtual geomagnetic poles (VGPs) deviating more than some conventional limit from the geographic pole (often 45 degrees), and/or by periods of significant intensity drops below some critical value, for example 50% of the present-day field. We seek to establish a quantitative definition of excursions in paleomagnetic records by searching for synchronous directional deviations and lows in relative paleointensity. We combine paleointensity variations with deviations from the expected geocentric axial dipole (GAD) inclination in a single parameter, which we call the paleosecular variation (PSV) activity index. This new diagnostic can be used on any geomagnetic time series (individual data records, model predictions, spherical harmonic coefficients, etc.) to characterize the level of paleosecular variation activity, find excursions, or even study incipient reversals

  18. Evaluation of diagnostic tests for Wuchereria bancrofti infection in Brazilian schoolchildren

    Directory of Open Access Journals (Sweden)

    Paula Oliveira

    2014-06-01

    Full Text Available Introduction Since the launch of the Global Programme to Eliminate Lymphatic Filariasis, more than 70% of the endemic countries have implemented mass drug administration (MDA to interrupt disease transmission. The monitoring of filarial infection in sentinel populations, particularly schoolchildren, is recommended to assess the impact of MDA. A key issue is choosing the appropriate tools for these initial assessments (to define the best intervention and for monitoring transmission. Methods This study compared the pre-MDA performance of five diagnostic methods, namely, thick film test, Knott's technique, filtration, Og4C3-ELISA, and the AD12-ICT card test, in schoolchildren from Brazil. Venous and capillary blood samples were collected between 11 pm and 1 am. The microfilarial loads were analyzed with a negative binomial regression, and the prevalence and associated 95% confidence intervals were estimated for all methods. The accuracies of the AD12-ICT card and Og4C3-ELISA tests were assessed against the combination of parasitological test results. Results A total of 805 schoolchildren were examined. The overall and stratified prevalence by age group and gender detected by Og4C3-ELISA and AD12-ICT were markedly higher than the prevalence estimated by the parasitological methods. The sensitivity of the AD12-ICT card and Og4C3-ELISA tests was approximately 100%, and the positive likelihood ratios were above 6. The specificity of the Og4C3-ELISA was higher than that of the AD12-ICT at different prevalence levels. Conclusions The ICT card test should be the recommended tool for monitoring school-age populations living in areas with ongoing or completed MDA.

  19. Evaluation of Serum Interleukin-17 (IL-17) Levels as a Diagnostic Marker in Pancreatic Adenocarcinoma.

    Science.gov (United States)

    Karabulut, Senem; Afsar, Çiğdem Usul; Karabulut, Mehmet; Alış, Halil; Kılıc, Leyla; Çikot, Murat; Yasasever, Ceren Tilgen; Aykan, Nuri Faruk

    2016-03-01

    Inflammatory cytokines modulate immune responses in the tumor microenvironment during progression. The role of interleukin (IL-17) in cancer is currently under debate. This study was conducted to investigate the serum levels of IL-17 in patients with pancreatic adenocarcinoma (PA) and the relationship with tumor progression and known prognostic parameters. Thirty-five patients with PA were investigated. Serum samples were obtained on first admission before treatment and follow-up. Both serum IL-17 levels were determined using enzyme-linked immunosorbent assay (ELISA). Age- and sex-matched 35 healthy controls were included in the analysis. The median age at diagnosis was 61 years, range 38-84 years; 21 (60%) patients were men. The tumor was located in the head of pancreas in 24 (69%) patients. The most common metastatic site was liver in 20 patients with metastasis (n = 18, 90%). The median follow-up time was 24.0 weeks (range 1.0-191.0 weeks). At the end of the observation period, 12 (34%) patients experienced disease progression and 23 patients (66%) were dead. Forty-four percent of 18 metastatic patients who received palliative chemotherapy (CTx) were CTx-responsive. Median progression-free survival and overall survival of the whole group were 13.7 ± 2.3 weeks [95% confidence interval (CI) = 9-18 weeks] and 48.0 ± 12.8 weeks (95% CI = 23-73 weeks), respectively. The baseline serum IL-17 levels were significantly higher in patients with PA than in the control group (p = 0.001). Moreover, serum IL-17 levels were significantly higher in the patients with large pathologic tumor status and low albumin levels (p = 0.04 and p = 0.03, respectively). However, serum IL-17 assays had no prognostic roles on outcome. Although serum levels of IL-17 assays were found to be diagnostic value, no predictive and prognostic value was determined in PA patients.

  20. Evaluation of the diagnostic accuracy of hand and foot MRI for early Rheumatoid Arthritis.

    Science.gov (United States)

    Nieuwenhuis, Wouter P; van Steenbergen, Hanna W; Mangnus, Lukas; Newsum, Elize C; Bloem, Johan L; Huizinga, Tom W J; le Cessie, Saskia; Reijnierse, Monique; van der Helm-van Mil, Annette H M

    2017-08-01

    To assess the diagnostic value of MRI for early RA. In some RA patients, a classifiable diagnosis cannot be made at first presentation; these patients present with unclassified arthritis (UA). The use of MRI for early diagnosis of RA is recommended, yet the evidence for its reliability is limited. MRI of hand and foot was performed in 589 early arthritis patients included in the Leiden Early Arthritis Clinic (229 presented with RA, 159 with other arthritides and 201 with UA). Symptom-free controls provided a reference for defining an abnormal MRI. In preliminary investigations, MRI of patients who presented with RA was compared with MRI of symptom-free controls and of patients with other arthritides. Thereafter, the value of MRI in early RA diagnosis was determined in UA patients using the 1-year follow-up on fulfilling the 1987 RA criteria and start of disease-modifying drugs as outcomes. Preliminary investigations were promising. Of the UA patients, 14% developed RA and 37% started disease-modifying treatment. MRI-detected tenosynovitis was associated with RA development independent of other types of MRI-detected inflammation [odds ratio (OR) = 7.5, 95% CI: 2.4, 23] and also independent of age and other inflammatory measures (swollen joints, CRP) (OR = 4.2, 95% CI: 1.4, 12.9). Within UA patients, the negative predictive value of abnormal tenosynovitis was 95% (95% CI: 89%, 98%) and the positive predictive value 25% (95% CI: 17%, 35%). The performance was best in the subgroup of UA patients presenting with oligoarthritis (18% developed RA): the positive predictive value was 36% (95% CI: 23%, 52%), the negative predictive value was 98% (95% CI: 88%, 100%), the sensitivity was 93% (95% CI: 70%, 99%) and the specificity was 63% (95% CI: 51%, 74%). MRI contributes to the identification of UA patients who will develop RA, mostly in UA patients presenting with oligoarthritis.

  1. Evaluation of Ultrasonography as a Diagnostic Tool in Maxillofacial Space Infections

    Directory of Open Access Journals (Sweden)

    Praveen Kumar Pandey

    2011-11-01

    Full Text Available Objectives: The purpose of the study was to establish the role of ultrasonography in determining the involvement of specific fascial spaces in maxillofacial region and the stage of infection, in indicating the appropriate time for surgical intervention and to compare clinical and ultrasonographic findings.Material and Methods: Twenty five patients with fascial space infection in maxillofacial region were subjected to ultrasonographic examination following a detailed clinical and radiological examination. Ultrasonography guided needle aspiration was performed. Based on the findings, patients diagnosed with abscess were subjected to incision and drainage and those with cellulitis were subjected to medical line of treatment.Results: More than one fascial space was involved in all patients. On clinical examination 64 spaces were involved, of them 34 spaces had abscess formation and 30 spaces were in the stage of cellulitis. On ultrasonography examination, 28 spaces were reported to have abscess formation and 36 spaces were diagnosed to be in the stage of cellulitis. On comparative analysis of both clinical and ultrasonographic findings, ultrasonography was found to be sensitive in 65% of the cases and having specificity of 80%. It was registered statistically significant (P < 0.001 agreement between these two methods of assessment (kappa index = 0.814.Conclusions: Ultrasonography is a quick, widely available, relatively inexpensive, and painless procedure and can be repeated as often as necessary without risk to the patient. Thus ultrasonography is a valuable diagnostic aid to the oral and maxillofacial surgeon for early and accurate diagnosis of fascial space infection, their appropriate treatment and to limit their further spread.

  2. Diagnostic performance of the upper gastrointestinal series in the evaluation of children with clinically suspected malrotation

    Energy Technology Data Exchange (ETDEWEB)

    Sizemore, Alecia W. [Indiana University School of Medicine, Department of Radiology, Indianapolis, IN (United States); University of Virginia School of Medicine, Department of Radiology, Charlottesville, VA (United States); Rabbani, Kaneez Z. [Indiana University School of Medicine, Department of Medicine, Indianapolis, IN (United States); Ladd, Alan [Indiana University School of Medicine, Division of Pediatric Surgery, Riley Hospital, Indianapolis, IN (United States); Applegate, Kimberly E. [Indiana University School of Medicine, Section of Pediatric Radiology, Department of Radiology, Indianapolis, IN (United States); Riley Hospital for Children, Department of Radiology, Indianapolis, IN (United States)

    2008-05-15

    Malrotation is a congenital disorder of abnormal intestinal rotation and fixation that predisposes infants to potentially life-threatening midgut volvulus. Upper gastrointestinal tract (UGI) examination is sometimes equivocal and can lead to inaccurate diagnosis. To determine the diagnostic performance of UGI examinations in children who subsequently underwent a Ladd procedure for suspected malrotation or volvulus. We reviewed all children up to 21 years old who had undergone both a UGI examination and a Ladd procedure for possible malrotation across 9 years. Children were excluded if they had not undergone either a UGI examination or a Ladd procedure and if congenital abdominal wall defects were present. Of 229 patients identified, 166 (59% male, median age 67 days) were included. Excluded were 47 without a UGI series, 12 with omphalocele or gastroschisis, 1 without verifiable operative data, 1 who had not undergone a Ladd procedure, and 2 older than 21 years. Of the 166 patients, 40% were neonates and 73% were <12 months old, and 31% presented with bilious vomiting and 15% with abdominal distention. Of 163 patients with surgically verified malrotation, 156 had a positive UGI examination, a sensitivity of 96%. There were two patients with a false-positive UGI examination and seven with false-negative examination. Jejunal position was normal in six of the seven with a false-negative examination and abnormal in the two with a false-positive examination. Of 38 patients with surgically verified volvulus, 30 showed volvulus on the UGI series. Five required bowel resection and three died. Jejunal position can lead to inaccurate UGI series interpretation. Meticulous technique and periodic assessment of performance will help more accurately diagnose difficult or equivocal cases. (orig.)

  3. The iliac crest in forensic age diagnostics: evaluation of the apophyseal ossification in conventional radiography.

    Science.gov (United States)

    Wittschieber, Daniel; Vieth, Volker; Domnick, Christoph; Pfeiffer, Heidi; Schmeling, Andreas

    2013-03-01

    Due to the increasing significance of forensic age estimations in the age of globalisation, novel radiographic criteria besides clavicles and hand bones may provide additional certainty for forensic age expertises. The present study analyses the suitability of the iliac crest apophysis by means of 643 pelvic radiographs of patients between 10 and 30 years of age. Retrospective assessments were carried out according to the forensically established classification and sub-classification systems modified after Kreitner et al. (Rofo 166(6):481-486, 1997) and Kellinghaus et al. (Int J Legal Med 124(4):321-325, 2010). The basic ossification stages range from 1 to 4, and the sub-stages of stage 2 and 3 range from a to c. While stage 3c was first achieved at the age of 15 by both sexes, stage 4 was first observed in females at the age of 16 and in males at the age of 17. This indicates the possibility of a valid diagnosis of both the age of 14 and the age of 16 years which represent legally relevant age thresholds in numerous countries. Applied as targeted radiography on the iliac crest, the exposure to radiation would range between other radiographic techniques recently applied. Therefore, the iliac crest apophysis appears principally suitable as novel possible criterion for forensic age estimation in the living. However, for the establishment of the iliac crest apophysis in routine diagnostics, further studies are needed focussing on the comparison of different grading systems and different radiological techniques.

  4. Evaluation of real-time PCR for Strongyloides stercoralis and hookworm as diagnostic tool in asymptomatic schoolchildren in Cambodia.

    Science.gov (United States)

    Schär, Fabian; Odermatt, Peter; Khieu, Virak; Panning, Marcus; Duong, Socheat; Muth, Sinuon; Marti, Hanspeter; Kramme, Stefanie

    2013-05-01

    Diagnosis of soil-transmitted helminths such as Strongyloides stercoralis and hookworms (Ancylostoma duodenale and Necator americanus) is challenging due to irregular larval and egg output in infected individuals and insensitive conventional diagnostic procedures. Sensitive novel real-time PCR assays have been developed. Our study aimed to evaluate the real-time PCR assays as a diagnostic tool for detection of Strongyloides spp. and hookworms in a random stool sample of 218 asymptomatic schoolchildren in Cambodia. Overall prevalence of 17.4% (38/218) and 34.9% (76/218) were determined by real-time PCR for S. stercoralis and hookworms, respectively. Sensitivity and specificity of S. stercoralis specific real-time PCR as compared to the combination of Baermann/Koga Agar as gold standard were 88.9% and 92.7%, respectively. For hookworm specific real-time PCR a sensitivity of 78.9% and specificity of 78.9% were calculated. Co-infections were detectable by PCR in 12.8% (28/218) of individuals. S. stercoralis real-time PCR applied in asymptomatic cases showed a lower sensitivity compared to studies undertaken with symptomatic patients with the same molecular tool, yet it proved to be a valid supplement in the diagnosis of STH infection in Cambodia. Copyright © 2013. Published by Elsevier B.V.

  5. Evaluation of a pan-serotype point-of-care rapid diagnostic assay for accurate detection of acute dengue infection.

    Science.gov (United States)

    Vivek, Rosario; Ahamed, Syed Fazil; Kotabagi, Shalini; Chandele, Anmol; Khanna, Ira; Khanna, Navin; Nayak, Kaustuv; Dias, Mary; Kaja, Murali-Krishna; Shet, Anita

    2017-03-01

    The catastrophic rise in dengue infections in India and globally has created a need for an accurate, validated low-cost rapid diagnostic test (RDT) for dengue. We prospectively evaluated the diagnostic performance of NS1/IgM RDT (dengue day 1) using 211 samples from a pediatric dengue cohort representing all 4 serotypes in southern India. The dengue-positive panel consisted of 179 dengue real-time polymerase chain reaction (RT-PCR) positive samples from symptomatic children. The dengue-negative panel consisted of 32 samples from dengue-negative febrile children and asymptomatic individuals that were negative for dengue RT-PCR/NS1 enzyme-linked immunosorbent assay/IgM/IgG. NS1/IgM RDT sensitivity was 89.4% and specificity was 93.8%. The NS1/IgM RDT showed high sensitivity throughout the acute phase of illness, in primary and secondary infections, in different severity groups, and detected all 4 dengue serotypes, including coinfections. This NS1/IgM RDT is a useful point-of-care assay for rapid and reliable diagnosis of acute dengue and an excellent surveillance tool in our battle against dengue. Copyright © 2016. Published by Elsevier Inc.

  6. Radiological imaging of lymph nodes for diagnostic evaluation and follow-up; Radiologische Bildgebung von Lymphknoten in Diagnostik und Verlaufskontrolle

    Energy Technology Data Exchange (ETDEWEB)

    Mende, U. [Abt. Klinische Radiologie und Poliklinik, Radiologische Universitaetsklinik Heidelberg (Germany)

    2002-06-01

    CT, MR imaging and sonography are the radiological modalities of choice complementing the conventional methods of anamnesis, clinical examination, laboratory findings, and cellular analysis in primary diagnostics, therapy monitoring, and follow-up of pathological lymph nodes. Final selection of methods will depend on the patients' individual conditions, physical constraints, local availability, and economic boundary conditions. Diagnostic criteria such as spreading patterns, morphology, structure, vascularisation and restriction should be evaluated in the light of case history and clinical findings, so as to permit selection of the most suitable methods for a 'functional imaging' that will answer the clinical queries. In no case, however, will even the most sophisticated imaging method make redundant the pathohistological diagnosis. (orig./CB) [German] Neben Anamnese, klinischer Untersuchung, Laborparametern und feingeweblicher Sicherung bilden die radiologischen Schnittbildverfahren Computertomographie, Magnetresonanztomographie und Sonographie einen Eckpfeiler in Primaerdiagnostik, Therapie-Monitoring und Verlaufskontrolle pathologischer Lymphknoten. Erkrankung des Patienten, physikalische Grenzen, logistische Verfuegbarkeit und oekonomische Erfordernisse bestimmen die Methodenauswahl. Die Kriterienn Ausbreitungsmuster, Morphologie, Struktur, Vaskularisation und Begrenzung sind nur unter Beruecksichtigung von Vorgeschichte und Klinik zu werten. Ziel ist ein 'functional imaging', welches die therapierelevanten Fragen des Klinikers beantwortet. Dennoch ist die Bildgebung, selbst durch Kombination komplementaerer Verfahren und subtile Auswertung, nicht in der Lage, die pathohistologische Diagnose zu ersetzen. (orig.)

  7. Determining skeletal maturation stage using cervical vertebrae: evaluation of three diagnostic methods

    Directory of Open Access Journals (Sweden)

    Luci Mara Fachardo Jaqueira

    2010-12-01

    Full Text Available The aim of the present study was to compare the use of three cervical vertebral evaluation methods (Hassel-Farman, Baccetti et al., and Seedat-Forsberg for determinating skeletal maturation stage in orthodontic patients. Twenty-three radiographs were randomly selected from a private orthodontic practice. Each radiograph was analyzed on three separate occasions by four evaluators (one radiologist and three orthodontists, who determined the skeletal maturation stage using the references established by each of the three methods. Intraevaluator and interevaluator comparisons were performed, and the degree of agreement was established using the weighted Kappa coefficient (95% CI. Good agreement (Kappa between 0.61 and 0.80 was observed between the determinations of most of the evaluators. The three methods demonstrated clinical applicability. However, the method proposed by Baccetti et al. achieved the best results, followed by the Hassel-Farman and the Seedat-Forsberg methods.

  8. [Diagnostic accuracy of cone beam computed tomography and eight-slice computed tomography for evaluation of external root reabsorption].

    Science.gov (United States)

    Xie, Xiao-yan; Zhang, Zu-yan

    2012-08-18

    To evaluate the diagnostic accuracy of cone beam computed tomography (CBCT) and high resolution multi-slice computed tomography (MSCT) with eight-detector-rows in detecting the simulated external root resorption defects. External root resorption defects of different sizes and in different locations were simulated in 40 human single rooted teeth. Cavities simulating root resorption defects of 1 mm in diameter and 0.1 mm, 0.2 mm, 0.3 mm, 0.4 mm in depth were drilled in the cervical, middle and apical thirds of lingual surfaces of the teeth. The specimens were scanned with both CBCT (Accuitomo 3DX, Morita Co., Japan) and high resolution 8-slice CT (BrightSpeed Edge, GE Co., USA). The CBCT and MSCT images were read by two experienced observers. The data were analyzed with receiver operating characteristics (ROC) analysis. ROC curves were generated and the area under ROC curve (Az) was employed to express the diagnostic accuracy. The diagnostic accuracy (Az value) in detecting the simulated defects of all the locations and sizes were 0.921 for CBCT and 0.770 for MSCT. The Az values for CBCT in detecting defects located in the cervical, middle and apical thirds were 0.885, 0.991 and 0.873, while those for MSCT were 0.752, 0.844 and 0.709, respectively. The Az values for CBCT in detecting the defects of 0.1 mm, 0.2 mm, 0.3 mm and 0.4 mm in depth were 0.794, 0.934, 0.992 and 0.992, and those for MSCT were 0.592, 0.719, 0.920 and 0.990, respectively. The diagnostic ability for external root resorption of CBCT is better than that of MSCT. Smaller defects are better delineated with CBCT than with MSCT. The defects in the middle thirds of the roots are easier to be detected than those in the cervical and apical ones using both CBCT and MSCT.

  9. Routine radiography does not have a role in the diagnostic evaluation of ambulatory adult febrile neutropenic cancer patients

    NARCIS (Netherlands)

    Nijhuis, CSMO; Gietema, JA; Vellenga, E; Daenen, SMGJ; De Bont, ESJM; Kamps, WA; Groen, HJM; van der Jagt, EJ; van der Graaf, WTA

    2003-01-01

    Cancer patients treated with chemotherapy are susceptible to bacterial infections. When an adult patient presents with febrile neutropenia. standard diagnostic care includes physical examination, laboratory diagnostics, chest X-ray (CXR) and sinus radiography. However, the yield of routine

  10. Diagnostic accuracy of color doppler ultrasonography in evaluation of cervical lymph nodes in oral cancer patients

    Directory of Open Access Journals (Sweden)

    Sadaksharam Jayachandran

    2012-01-01

    Conclusion: CDUS plays a definitive role as an adjunct to clinical evaluation of differentiating metastatic from reactive cervical lymph involvement in patients with oral cancer as it aid in grading and staging of oral cancer and can determine the treatment plan prognosis and morbidity by diminishing the possibility nodal dissection.

  11. The diagnostic yield of the first episode of a periodic health evaluation: a descriptive epidemiology study

    Directory of Open Access Journals (Sweden)

    Kermott Cindy A

    2012-05-01

    Full Text Available Abstract Background The benefits of a periodic health evaluation remain debatable. The incremental value added by such evaluations beyond the delivery of age appropriate screening and preventive medicine recommendations is unclear. Methods We retrospectively collected data on a cohort of consecutive patients presenting for their first episode of a comprehensive periodic health evaluation. We abstracted data on new diagnoses that were identified during this single episode of care and that were not trivial (i.e., required additional testing or intervention. Results The cohort consisted of 491 patients. The rate of new diagnoses per this single episode of care was 0.9 diagnoses per patient. The majority of these diagnoses was not prompted by patients’ complaints (71% and would not have been identified by screening guidelines (51%. Men (odds ratio 2.67; 95% CI, 1.76, 4.03 and those with multiple complaints at presentation (odds ratio 1.12; 95% CI, 1.05, 1.19 were more likely to receive a clinically relevant diagnosis at the conclusion of the visit. Age was not a predictor of receiving a diagnosis in this cohort. Conclusion The first episode of a comprehensive periodic health evaluation may reveal numerous important diagnoses or risk factors that are not always identified through routine screening.

  12. Evaluation of a diagnostic ELISA for insect bite hypersensitivity in horses using recombinant Obsoletus complex allergens

    NARCIS (Netherlands)

    Meide, van der N.M.A.; Savelkoul, H.F.J.; Meulenbroeks, C.; Ducro, B.J.; Tijhaar, E.J.

    2014-01-01

    Culicoides spp. of the Obsoletus complex belong to the most important species of midge, involved in causing insect bite hypersensitivity (IBH) in horses in The Netherlands. The aim of the current study was to evaluate seven different Obsoletus complex-derived recombinant allergens (Cul o 1–Cul o 7)

  13. [THE VIRTUAL CYTOLOGIC SLIDES FOR EXTERNAL EVALUATION OF QUALITY OF IMPLEMENTATION OF CYTOLOGIC ANALYSES IN CLINICAL DIAGNOSTIC LABORATORIES: POSSIBILITIES AND PERSPECTIVES].

    Science.gov (United States)

    Djangirova, T V; Shabalova, I P; Pronichev, A N; Polyakov, E V

    2015-08-01

    The article considers application of technology of analysis of cytological slides in external quality control of clinical diagnostic laboratories. The advantages of virtual slides are demonstrated against other applied technologies of external evaluation of quality i.e. slide plate and digital micro-photography. The conditions of formation of virtual slides for external evaluation of quality of clinical diagnostic laboratories. The technology of their application is described. The success of practical application of considered technology in the Federal system of external evaluation of quality is emphasized.

  14. Evaluating diagnostic tests for bovine tuberculosis in the southern part of Germany: A latent class analysis

    Science.gov (United States)

    Knubben-Schweizer, Gabriela; Döpfer, Dörte; Groll, Andreas; Hafner-Marx, Angela; Hörmansdorfer, Stefan; Sauter-Louis, Carola; Straubinger, Reinhard K.; Zimmermann, Pia; Hartnack, Sonja

    2017-01-01

    Germany has been officially free of bovine tuberculosis since 1996. However, in the last years there has been an increase of bovine tuberculosis cases, particularly in the southern part of Germany, in the Allgäu region. As a consequence a one-time tuberculosis surveillance program was revisited with different premortal and postmortal tests. The aim of this paper was to estimate diagnostic sensitivities and specificities of the different tests used within this surveillance program. In the absence of a perfect test with 100% sensitivity and 100% specificity, thus in the absence of a gold standard, a Bayesian latent class approach with two different datasets was performed. The first dataset included 389 animals, tested with single intra-dermal comparative cervical tuberculin (SICCT) test, PCR and pathology; the second dataset contained 175 animals, tested with single intra-dermal cervical tuberculin (SICT) test, Bovigam® assay, pathology and culture. Two-way conditional dependencies were considered within the models. Additionally, inter-laboratory agreement (five officially approved laboratories) of the Bovigam® assay was assessed with Cohen's kappa test (21 blood samples). The results are given in posterior means and 95% credibility intervals. The specificities of the SICT test, SICCT test, PCR and pathology ranged between 75.8% [68.8–82.2%] and 99.0% [96.8–100%]. The Bovigam® assay stood out with a very low specificity (6.9% [3.6–11.1%]), though it had the highest sensitivity (95.7% [91.3–99.2%]). The sensitivities of the SICCT test, PCR, SICT test, pathology and culture varied from 57.8% [48.0–67.6%] to 88.9% [65.5–99.7%]. The prevalences were 19.8% [14.6–26.5%] (three-test dataset) and 7.7% [4.2–12.3%] (four-test dataset). Among all pairwise comparisons the highest agreement was 0.62 [0.15–1]). In conclusion, the specificity of the Bovigam® assay and the inter-laboratory agreement were lower than expected. PMID:28640908

  15. Childhood videotaped social and neuromotor precursors of schizophrenia: a prospective investigation

    DEFF Research Database (Denmark)

    Schiffman, Jason; Walker, Elaine; Ekstrøm, Morten

    2004-01-01

    were filmed under standardized conditions while they were eating lunch. The examination was part of a larger study investigating early signs of schizophrenia spectrum disorders. Many of the subjects had a parent with schizophrenia, leaving them at high risk for developing a schizophrenia spectrum...... disorder and children who developed other psychiatric disorders. RESULTS: The findings from this study suggest that the brief videotaped footage of children eating lunch was able to discriminate between the individuals who later developed schizophrenia and those who did not. Specifically...... disorder. In 1991, adult psychiatric outcome data were obtained for 91.3% (N=242). This study systematically analyzed the videotapes to determine whether the children who developed schizophrenia as adults evidenced greater social and/or neuromotor deficits than children who did not develop a psychiatric...

  16. An Evaluation of Serum Procalcitonin and C-Reactive Protein Levels as Diagnostic and Prognostic Biomarkers of Severe Sepsis

    Directory of Open Access Journals (Sweden)

    Szederjesi Janos

    2015-10-01

    Full Text Available Background: Recommendations have been made, following the multicenter Surviving Sepsis Campaign study, to standardize the definition of severe sepsis with reference to several parameters such as haemodynamic stability, acid-base balance, bilirubin, creatinine, International Normalized Ratio (INR, urine output and pulmonary functional value of the ratio between arterial oxigen partial pressure and inspiratory oxigen concentration. Procalcitonin (PCT is considered to be a gold standard biomarker for the inflammatory response, and recent studies have shown that it may help to discover whether a seriously ill person is developing sepsis. C-reactive protein (CRP is also used as a marker of inflammation in the body, as its blood levels increase if there is any inflammation in the body. The aim of this study was to evaluate serum procalcitonin and C-reactive protein levels as diagnostic and prognostic biomarkers of severe sepsis.

  17. Evaluation of the Standard Diagnostics Leptospira IgM ELISA for diagnosis of acute leptospirosis in Lao PDR

    NARCIS (Netherlands)

    Tanganuchitcharnchai, Ampai; Smythe, Lee; Dohnt, Michael; Hartskeerl, Rudy; Vongsouvath, Manivanh; Davong, Viengmone; Lattana, Olay; Newton, Paul N.; Blacksell, Stuart D.

    2012-01-01

    The diagnostic utility of the Standard Diagnostics Leptospira IgM ELISA for detection of acute leptospirosis was assessed in febrile adults admitted in Vientiane, Laos. Using the cut-off suggested by the manufacturer [optical density (OD) >= 0.75], the assay demonstrated limited diagnostic capacity

  18. Brief Report: An Exploratory Study of the Diagnostic Reliability for Autism Spectrum Disorder

    Science.gov (United States)

    Taylor, Lauren J.; Eapen, Valsamma; Maybery, Murray; Midford, Sue; Paynter, Jessica; Quarmby, Lyndsay; Smith, Timothy; Williams, Katrina; Whitehouse, Andrew J.

    2017-01-01

    Previous research shows inconsistency in clinician-assigned diagnoses of Autism Spectrum Disorder (ASD). We conducted an exploratory study that examined the concordance of diagnoses between a multidisciplinary assessment team and a range of independent clinicians throughout Australia. Nine video-taped Autism Diagnostic Observation Schedule (ADOS)…

  19. Survivors of early childhood trauma: evaluating a two-dimensional diagnostic model of the impact of trauma and neglect

    Directory of Open Access Journals (Sweden)

    Marleen Wildschut

    2014-04-01

    Full Text Available Background: A two-dimensional diagnostic model for (complex trauma-related and personality disorders has been proposed to assess the severity and prognosis of the impact of early childhood trauma and emotional neglect. An important question that awaits empirical examination is whether a distinction between trauma-related disorders and personality disorders reflects reality when focusing on survivors of early childhood trauma. And, is a continuum of trauma diagnoses a correct assumption and, if yes, what does it look like? Objective: We describe the design of a cross-sectional cohort study evaluating this two-dimensional model of the impact of trauma and neglect. To provide the rationale of our study objectives, we review the existing literature on the impact of early childhood trauma and neglect on trauma-related disorders and personality disorders. Aims of the study are to: (1 quantify the two-dimensional model and test the relation with trauma and neglect; and (2 compare the two study groups. Method: A total of 200 consecutive patients referred to two specific treatment programs (100 from a personality disorder program and 100 from a trauma-related disorder program in the north of Holland will be included. Data are collected at the start of treatment. The assessments include all DSM-5 trauma-related and personality disorders, and general psychiatric symptoms, trauma history, and perceived emotional neglect. Discussion: The results will provide an evaluation of the model and an improvement of the understanding of the relationship between trauma-related disorders and personality disorders and early childhood trauma and emotional neglect. This may improve both diagnostic as well as indication procedures. We will discuss possible strengths and limitations of the design.

  20. Survivors of early childhood trauma: evaluating a two-dimensional diagnostic model of the impact of trauma and neglect

    Science.gov (United States)

    Wildschut, Marleen; Langeland, Willemien; Smit, Jan H.; Draijer, Nel

    2014-01-01

    Background A two-dimensional diagnostic model for (complex) trauma-related and personality disorders has been proposed to assess the severity and prognosis of the impact of early childhood trauma and emotional neglect. An important question that awaits empirical examination is whether a distinction between trauma-related disorders and personality disorders reflects reality when focusing on survivors of early childhood trauma. And, is a continuum of trauma diagnoses a correct assumption and, if yes, what does it look like? Objective We describe the design of a cross-sectional cohort study evaluating this two-dimensional model of the impact of trauma and neglect. To provide the rationale of our study objectives, we review the existing literature on the impact of early childhood trauma and neglect on trauma-related disorders and personality disorders. Aims of the study are to: (1) quantify the two-dimensional model and test the relation with trauma and neglect; and (2) compare the two study groups. Method A total of 200 consecutive patients referred to two specific treatment programs (100 from a personality disorder program and 100 from a trauma-related disorder program) in the north of Holland will be included. Data are collected at the start of treatment. The assessments include all DSM-5 trauma-related and personality disorders, and general psychiatric symptoms, trauma history, and perceived emotional neglect. Discussion The results will provide an evaluation of the model and an improvement of the understanding of the relationship between trauma-related disorders and personality disorders and early childhood trauma and emotional neglect. This may improve both diagnostic as well as indication procedures. We will discuss possible strengths and limitations of the design. PMID:24711888

  1. Evaluation of serological diagnostic methods for the 2009 pandemic influenza A (H1N1) virus.

    Science.gov (United States)

    Papenburg, Jesse; Baz, Mariana; Hamelin, Marie-Ève; Rhéaume, Chantal; Carbonneau, Julie; Ouakki, Manale; Rouleau, Isabelle; De Serres, Gaston; Boivin, Guy

    2011-03-01

    Serology improves influenza diagnosis by capturing cases missed by reverse transcriptase PCR (RT-PCR). We prospectively evaluated microneutralization and hemagglutination inhibition assays for 2009 influenza A (H1N1) virus diagnosis among 24 RT-PCR-confirmed cases and 98 household contacts. Compared to hemagglutination inhibition, microneutralization demonstrated a higher level of concordance with RT-PCR (kappa = 0.69 versus kappa = 0.60) and greater sensitivity (83% versus 71%; P = 0.016).

  2. Pain, role play, and videotape. Pain management staff development in a community hospital.

    Science.gov (United States)

    Daroszewski, E B; Meehan, D A

    1997-01-01

    Videotaped role play was an effective staff development strategy used as an initial exercise in a five-part class to update the pain management skills of experienced nurses. It engaged the participants in learning and stimulated discussion and provided concrete feedback of current clinical practices for comparison with the Agency for Health Care Policy and Research pain management guidelines (Acute Pain Management Guideline Panel, 1992).

  3. Computed tomographic evaluation of mesentery: diagnostic value in acute mesenteric ischemia.

    Science.gov (United States)

    Mazzei, Maria Antonietta; Mazzei, Francesco Giuseppe; Marrelli, Daniele; Imbriaco, Giusi; Guerrini, Susanna; Vindigni, Carla; Civitelli, Serenella; Roviello, Franco; Grassi, Roberto; Volterrani, Luca

    2012-01-01

    To evaluate the computed tomographic appearances of mesentery in acute mesenteric ischemia (AMI) to recognize characteristic features and their prognostic values. Computed tomographic examinations of 34 patients with a confirmed diagnosis of AMI were retrospectively reviewed to evaluate the number of mesenteric vessels, diameter of the superior mesenteric artery and superior mesenteric vein, mesenteric fat stranding, mesenteric vessel pneumatosis and ascites. Overall, at least one of these mesenteric signs was present in all but 1 patient. In all AMI of arterial occlusive type and in 68% of nonocclusive mesenteric ischemia, the number of arterial vessels was reduced (P = 0.067). Mesenteric vessel pneumatosis and reduced number of venous vessels were significantly associated with higher mortality (P = 0.027 and P = 0.042, respectively). Reperfusion signs were associated with a reduced mortality (28.7% vs 65.5%). Considering its characteristic features and its possible prognostic value, the evaluation of mesentery will supply additional information in the interpretation of computed tomography in AMI.

  4. Diagnostic and economic evaluation of new biomarkers for Alzheimer’s disease: the research protocol of a prospective cohort study

    Directory of Open Access Journals (Sweden)

    Handels Ron LH

    2012-08-01

    Full Text Available Abstract Background New research criteria for the diagnosis of Alzheimer’s disease (AD have recently been developed to enable an early diagnosis of AD pathophysiology by relying on emerging biomarkers. To enable efficient allocation of health care resources, evidence is needed to support decision makers on the adoption of emerging biomarkers in clinical practice. The research goals are to 1 assess the diagnostic test accuracy of current clinical diagnostic work-up and emerging biomarkers in MRI, PET and CSF, 2 perform a cost-consequence analysis and 3 assess long-term cost-effectiveness by an economic model. Methods/design In a cohort design 241 consecutive patients suspected of having a primary neurodegenerative disease are approached in four academic memory clinics and followed for two years. Clinical data and data on quality of life, costs and emerging biomarkers are gathered. Diagnostic test accuracy is determined by relating the clinical practice and new research criteria diagnoses to a reference diagnosis. The clinical practice diagnosis at baseline is reflected by a consensus procedure among experts using clinical information only (no biomarkers. The diagnosis based on the new research criteria is reflected by decision rules that combine clinical and biomarker information. The reference diagnosis is determined by a consensus procedure among experts based on clinical information on the course of symptoms over a two-year time period. A decision analytic model is built combining available evidence from different resources among which (accuracy results from the study, literature and expert opinion to assess long-term cost-effectiveness of the emerging biomarkers. Discussion Several other multi-centre trials study the relative value of new biomarkers for early evaluation of AD and related disorders. The uniqueness of this study is the assessment of resource utilization and quality of life to enable an economic evaluation. The study results

  5. Diagnostic performance of quantitative shear wave elastography in the evaluation of solid breast masses: determination of the most discriminatory parameter.

    Science.gov (United States)

    Au, Frederick Wing-Fai; Ghai, Sandeep; Moshonov, Hadas; Kahn, Harriette; Brennan, Cressida; Dua, Hemi; Crystal, Pavel

    2014-09-01

    The purpose of this article is to assess the diagnostic performance of quantitative shear wave elastography in the evaluation of solid breast masses and to determine the most discriminatory parameter. B-mode ultrasound and shear wave elastography were performed before core biopsy of 123 masses in 112 women. The diagnostic performance of ultrasound and quantitative shear wave elastography parameters (mean elasticity, maximum elasticity, and elasticity ratio) were compared. The added effect of shear wave elastography on the performance of ultrasound was determined. The mean elasticity, maximum elasticity, and elasticity ratio were 24.8 kPa, 30.3 kPa, and 1.90, respectively, for 79 benign masses and 130.7 kPa, 154.9 kPa, and 11.52, respectively, for 44 malignant masses (p elasticity ratio (0.943) was the highest. By adding shear wave elastography parameters to the evaluation of BI-RADS category 4a masses, about 90% of masses could be downgraded to BI-RADS category 3. The numbers of downgraded masses were 40 of 44 (91%) for mean elasticity, 39 of 44 (89%) for maximum elasticity, and 42 of 44 (95%) for elasticity ratio. The numbers of correctly downgraded masses were 39 of 40 (98%) for mean elasticity, 38 of 39 (97%) for maximum elasticity, and 41 of 42 (98%) for elasticity ratio. There was improvement in the diagnostic performance of ultrasound of mass assessment with shear wave elastography parameters added to BI-RADS category 4a masses compared with ultrasound alone. Combined ultrasound and elasticity ratio had the highest improvement, from 35.44% to 87.34% for specificity, from 45.74% to 80.77% for positive predictive value, and from 57.72% to 90.24% for accuracy (p elasticity ratio (0.914) was the highest compared with the other combined parameters. There was a statistically significant difference in the values of the quantitative shear wave elastography parameters of benign and malignant solid breast masses. By adding shear wave elastography parameters to BI

  6. Clinical characteristics, diagnostic evaluation, and antibiotic prescribing patterns for skin infections in nursing homes

    Directory of Open Access Journals (Sweden)

    Norihiro Yogo

    2016-07-01

    Full Text Available Background: The epidemiology and management of skin infections in nursing homes has not been adequately described. We reviewed the characteristics, diagnosis and treatment of skin infections among residents of nursing homes to identify opportunities to improve antibiotic use. Methods: A retrospective study involving 12 nursing homes in the Denver metropolitan area. For residents at participating nursing homes diagnosed with a skin infection between July 1, 2013 and June 30, 2014, clinical and demographic information was collected through manual chart review.Results: Of 100 cases included in the study, the most common infections were non-purulent cellulitis (n=55, wound infection (n=27, infected ulcer (n=8, and cutaneous abscess (n=7. In 26 cases, previously published minimum clinical criteria for initiating antibiotics (Loeb criteria were not met. Most antibiotics (n=52 were initiated as a telephone order following a call from a nurse, and 41 patients were not evaluated by a provider within 48 hours after initiation of antibiotics. Nearly all patients (n=95 were treated with oral antibiotics alone. The median treatment duration was 7 days (interquartile range [IQR] 7-10; 43 patients received treatment courses of ≥ 10 days.Conclusions: Most newly diagnosed skin infections in nursing homes were non-purulent infections treated with oral antibiotics. Antibiotics were initiated by telephone in over half of cases, and lack of a clinical evaluation within 48 hours after starting antibiotics was common. Improved diagnosis through more timely clinical evaluations and decreasing length of therapy are important opportunities for antibiotic stewardship in nursing homes.

  7. Yield of diagnostic tests in evaluating syncopal episodes in older patients.

    Science.gov (United States)

    Mendu, Mallika L; McAvay, Gail; Lampert, Rachel; Stoehr, Jonathan; Tinetti, Mary E

    2009-07-27

    Syncopal episodes are common among older adults; etiologies range from benign to life threatening. We determined the frequency, yield, and costs of tests obtained to evaluate older persons with syncope. We also calculated the cost per test yield and determined whether the San Francisco syncope rule (SFSR) improved test yield. Review of 2106 consecutive patients 65 years or older admitted following a syncopal episode. Electrocardiograms (in 99% of admissions), telemetry (in 95%), cardiac enzyme tests (in 95%), and head computed tomographic (CT) scans (in 63%) were the most frequently obtained tests. Results from cardiac enzymes tests, CT scans, echocardiography, carotid ultrasonography, and electroencephalography all affected diagnosis or management in less than 5% of cases and helped determine the etiology of syncope less than 2% of the time. Postural blood pressure (BP) recording, performed in only 38% of episodes, had the highest yield with respect to affecting diagnosis (18%-26%) or management (25%-30%) and determining etiology of the syncopal episode (15%-21%). The cost per test affecting diagnosis or management was highest for electroencephalography ($32 973), CT scans ($24 881), and cardiac enzymes test ($22 397) and lowest for postural BP recording ($17-$20). The yields and costs for cardiac tests were better among patients meeting, vs those not meeting, the SFSR. For example, the cost per cardiac enzymes test affecting diagnosis or management was $10 331 in those meeting, vs $111 518 in those not meeting, the SFSR. Many unnecessary tests are obtained to evaluate syncope. Selecting tests based on history and examination and prioritizing less expensive and higher yield tests would ensure a more informed and cost-effective approach to evaluating older patients with syncope.

  8. Current and capacitance measurements as a fast diagnostic tool for evaluation of semiconductor parameters

    CERN Document Server

    Kemmer, J; Krause, N; Krieglmeyer, C; Yang Yi

    2000-01-01

    A fast qualitative method is described for evaluation of semiconductor parameters by analyzing both the capacitance/voltage (C/V) and current/voltage (I/V) characteristics of pn- or Schottky-diodes, which are fabricated on the material under investigation. The method is applied for measurement of recombination and generation lifetimes of minority charge carriers and for determination of doping profiles and distribution of active generation/recombination (G/R) centers after irradiation with Am-alpha particles and deep phosphorus implantation. Measurements on epitaxial silicon result in doping profiles and distributions of active impurities within the epi-layer.

  9. Evaluation device of diagnostic X-ray beam; Analisador de feixe de raios-X diagnostico

    Energy Technology Data Exchange (ETDEWEB)

    Pela, Carlos Alberto; Paula, Eldereis de; Bruco, Jose Luiz; Ghilardi Netto, Thomaz [Sao Paulo Univ., Ribeirao Preto, SP (Brazil). Faculdade de Filosofia, Ciencias e Letras. CIDRA

    1996-12-31

    A device developed to determine the physical parameters useful to the evaluation of both dental and medical X-ray equipment is presented. Nine detectors connected each one to a signal amplifier are used. The amplifiers output has being connected to an analog to digital interface plugged in a PC-AT microcomputer. The X-ray pass through filters before reaching the detectors. The data collected by microcomputer are used to calculate the kVp and other factors as total tube filtration, waveform, half-value layer, exposure rate and exposure time 4 tabs.

  10. The diagnostic efficiency of ultrasound guided imaging algorithm in evaluation of patients with hematuria

    Energy Technology Data Exchange (ETDEWEB)

    Unsal, Alparslan, E-mail: alparslanunsal@yahoo.com [Adnan Menderes University, Faculty of Medicine, Department of Radiology, 09100 Aydin (Turkey); Caliskan, Eda Kazak [Adnan Menderes University, Faculty of Medicine, Department of Radiology, 09100 Aydin (Turkey); Erol, Haluk [Adnan Menderes University, Faculty of Medicine, Department of Urology, 09100 Aydin (Turkey); Karaman, Can Zafer [Adnan Menderes University, Faculty of Medicine, Department of Radiology, 09100 Aydin (Turkey)

    2011-07-15

    Purpose: To assess the efficiency of the following imaging algorithm, including intravenous urography (IVU) or computed tomography urography (CTU) based on ultrasonographic (US) selection, in the radiological management of hematuria. Materials and methods: One hundred and forty-one patients with hematuria were prospectively evaluated. Group 1 included 106 cases with normal or nearly normal US result and then they were examined with IVU. Group 2 was composed of the remaining 35 cases which had any urinary tract abnormality, and they were directed to CTU. Radiological results were compared with clinical diagnosis. Results: Ultrasonography and IVU results of 97 cases were congruent in group 1. Eight simple cysts were detected with US and 1 non-obstructing ureter stone was detected with IVU in remaining 9 patients. The only discordant case in clinical comparison was found to have urinary bladder cancer on conventional cystoscopy. Ultrasonography and CTU results were congruent in 30 cases. Additional lesions were detected with CTU (3 ureter stones, 1 ureter TCC, 1 advanced RCC) in remaining 5 patients. Ultrasonography + CTU combination results were all concordant with clinical diagnosis. Except 1 case, radio-clinical agreement was achieved. Conclusion: Cross-sectional imaging modalities are preferred in evaluation of hematuria. CTU is the method of choice; however the limitations preclude using CTU as first line or screening test. Ultrasonography is now being accepted as a first line imaging modality with the increased sensitivity in mass detection compared to IVU. The US guided imaging algorithm can be used effectively in radiological approach to hematuria.

  11. Prospective, multi-centre clinic-based evaluation of four rapid diagnostic tests for syphilis.

    Science.gov (United States)

    Mabey, D; Peeling, R W; Ballard, R; Benzaken, A S; Galbán, E; Changalucha, J; Everett, D; Balira, R; Fitzgerald, D; Joseph, P; Nerette, S; Li, J; Zheng, H

    2006-12-01

    To evaluate prospectively four rapid, point-of-care serological tests for syphilis in prenatal or high risk populations in four countries. Tests were performed on consecutive clinic attenders, using whole blood in the clinic, and whole blood and serum in the laboratory. The sensitivity and specificity of each test was evaluated, using a standard treponemal test (Treponema pallidum haemagglutination assay (TPHA) or fluorescent treponemal antibody, absorbed (FTA-ABS) as gold standard. Non-treponemal tests (rapid plasma reagin (RPR) or venereal diseases research laboratory (VDRL) tests) were also performed on all subjects at three sites. The specificity of each rapid test was >95% at each site. Sensitivities varied from 64-100% and, in most cases, were lower when whole blood was used rather than serum. Rapid serological tests for syphilis are an acceptable alternative to conventional laboratory tests. Since they do not require equipment or electricity, they could increase coverage of syphilis screening, and enable treatment to be given at the first clinic visit.

  12. Prospective, multi‐centre clinic‐based evaluation of four rapid diagnostic tests for syphilis

    Science.gov (United States)

    Mabey, D; Peeling, R W; Ballard, R; Benzaken, A S; Galbán, E; Changalucha, J; Everett, D; Balira, R; Fitzgerald, D; Joseph, P; Nerette, S; Li, J; Zheng, H

    2006-01-01

    Objectives To evaluate prospectively four rapid, point‐of‐care serological tests for syphilis in prenatal or high risk populations in four countries. Methods Tests were performed on consecutive clinic attenders, using whole blood in the clinic, and whole blood and serum in the laboratory. The sensitivity and specificity of each test was evaluated, using a standard treponemal test (Treponema pallidum haemagglutination assay (TPHA) or fluorescent treponemal antibody, absorbed (FTA‐ABS) as gold standard. Non‐treponemal tests (rapid plasma reagin (RPR) or venereal diseases research laboratory (VDRL) tests) were also performed on all subjects at three sites. Results The specificity of each rapid test was >95% at each site. Sensitivities varied from 64–100% and, in most cases, were lower when whole blood was used rather than serum. Conclusions Rapid serological tests for syphilis are an acceptable alternative to conventional laboratory tests. Since they do not require equipment or electricity, they could increase coverage of syphilis screening, and enable treatment to be given at the first clinic visit. PMID:17215274

  13. [Shielding evaluation of lead-free board for diagnostic X-rays].

    Science.gov (United States)

    Katoh, Yoh; Tsukada, Masaru; Mita, Sogo; Fukushi, Masahiro; Nyui, Yoshiyuki; Abe, Shinji; Kimura, Junichi

    2010-12-20

    For physical foundation data used in the shielding calculation of structural facilities such as a radiation room, there are air kerma transmissions concerning the thickness of shielding objects, and half value layers and tenth value layers concerning a greatly attenuated wide X-ray beam. Accordingly, we evaluated the above-mentioned items with a lead-free board, which is mixed sulfuric acid calcium and barium sulfate with equiponderance for the amount of sulfuric acid calcium included in the usual plasterboard. Permeability in NCRP Report 147 is expressed by 3 parameters, α, β and γ, and shielding objects x. It showed that it corresponds to the measurement point and permeability curve with parameters, α, β and γ obtained by nonlinear regression analysis. Furthermore, we calculated the half value layer and tenth value layer concerning the greatly attenuated wide X-ray beam. The evaluated lead-free board, used in this examination, is useful as the shielding material for the diagnosis X-ray and, moreover, the partition wall materials are hard enough, with a board that is even heavier than the usual plaster board. Besides, the use of lead-free materials is friendly to the general environment.

  14. Evaluation of tumor motion effect in canine model for diagnostic and radiotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Woo, Sangkeun; Nam, Taewon; Kim, Kyeongmin [Molecular Imaging Research Center, Seoul (Korea, Republic of); Park, Seungwoo; Han, Suchul; Ji, Younghoon [Korea Institute of Radiological and Medical Sciences, Seoul (Korea, Republic of); Park, Nohwon; Eom, Kidong [Konkuk Univ., Seoul (Korea, Republic of)

    2013-05-15

    The internal organs move up to 35mm maximum and it provides information and uncertainty that has been distorted in the diagnosis and treatment. Previous most studies for the effect of respiration have been performed with external monitoring systems but it cannot represent internal organ motion such as liver, pancreas, and lung. Positron emission tomography (PET) is more influenced by motion than computed tomography (CT) and magnetic resonance imaging (MRI) since measurement time for image acquisition is longer than CT and MRI. Thus, count of tumor is to be underestimated and region of tumor is to be overestimated. The first aim of this study was developing the artificial pulmonary nodule which can be performed non-invasive transplant into thorax of dogs and second is to assess the effect of respiratory motion on PET image with evaluating the applicability of the artificial model using dogs for diagnosis and treatment. The developed artificial pulmonary nodule showed reproducibility and motion effect as respiratory cycle and it was verified in PET images. Radiation dose estimated was not changed and was reduced slightly of 10 rpm and 15 rpm, respectively, in both of glass dosimeter and ion chamber. The developed artificial pulmonary nodule will be useful tool for evaluating respiratory motion and better research performance for diagnosis and treatment will be expected with performing simulated experiment using the nodule conducted in this study.

  15. Evaluation of the scattered radiations of lead and lead-free aprons in diagnostic radiology by MCNPX.

    Science.gov (United States)

    Tayebi, Mansour; Shooli, Fatemeh Shekoohi; Saeedi-Moghadam, Mahdi

    2017-01-01

    Over the past few years, because of high attenuation and lightweight, non-toxic, lead-free aprons (LFAs) have been replaced by lead aprons (LAs). Lots of studies declared that this fact was based on the interactions of diagnostic X-ray with material such as the photoelectric effect (PE) and Compton scattering. These studies have demonstrated that in these types of aprons, due to the presence of different K-edge absorption, PE has a wide absorption in various metals with divers K-edges. The measurement geometry in most of these studies was narrow beam geometry, i.e. a collimated source and a collimated detector with a large source-detector distance. The present study intended to evaluate the attenuation of radiology scattered radiations in LAs and LFAs in both narrow and broad beam geometries, which is a more realistic situation, in order to check whether or not the higher attenuation is valid. In this study, a lead apron contains (Pb + EPV) and two non-lead compounds of (W + Sn + EPVC) with different weight percent (Wt%) were evaluated in the energy range of diagnostic radiology (100 kVp). The MCNPX code was applied to simulate broad - and narrow-beam measurement geometries. The evaluations have been performed in three situations: 1st) the same density thickness of LA and LFAs 2nd) same line thickness of LA and LFAs 3rd) considering the thickness of LFAs which has the same attenuation with LAs i.e. lead equivalent thickness for LFAs in the narrow beam. Finally, the x-ray transmission ratio (I/I_0) of LAs and LFAs was compared in 100 kVp for three mentioned conditions. Our results indicated that LFAs had more radiation attenuation rather than LA in the 1st and 2nd conditions with both geometries. However, LFAs had lower attenuation in comparison to LAs in the 3rd condition with broad beam geometry. More importantly, the transmission ratio (I/I_0) of LFAs in the broad beam condition was more significant than LA. The scattered radiations produced by LFAs are more than

  16. Analysis of Microstructure Using Thermoelectric Diagnostics for Non-Destructive Evaluation of Materials

    Science.gov (United States)

    Park, Y. D.; Kaydanov, V. I.; Mishra, B.; Olson, D. L.

    2005-04-01

    Measurements of Thermoelectric power (TEP) were used to evaluate microstructural analysis in HSLA steel weldments and retained austenite volume fraction for TRIP steel. First, the measurements of TEP for weld microstructure across weldment have shown good correlation with hardness profile. The different TEP values indicated that changes in weld microstructure can be correlated with TEP values measured. Second, it was demonstrated that retained austenite volume fraction were well correlated to TEP measurements for transformation induced plasticity (TRIP) steels. The results suggest that TEP measurements can be correlated to retained austenite volume fraction for TRIP steels, which do not have same chemical composition and thermal heat treatment processes. The retained austenite volume fraction also was measured by X-ray diffraction (XRD) method. With the introduction of these advanced TEP coefficient measurement techniques, the welding and steel industry will be using analytical tools similar to those instruments applied in the semiconductor industry.

  17. The diagnostic efficiency of ultrasound guided imaging algorithm in evaluation of patients with hematuria.

    Science.gov (United States)

    Unsal, Alparslan; Calişkan, Eda Kazak; Erol, Haluk; Karaman, Can Zafer

    2011-07-01

    To assess the efficiency of the following imaging algorithm, including intravenous urography (IVU) or computed tomography urography (CTU) based on ultrasonographic (US) selection, in the radiological management of hematuria. One hundred and forty-one patients with hematuria were prospectively evaluated. Group 1 included 106 cases with normal or nearly normal US result and then they were examined with IVU. Group 2 was composed of the remaining 35 cases which had any urinary tract abnormality, and they were directed to CTU. Radiological results were compared with clinical diagnosis. Ultrasonography and IVU results of 97 cases were congruent in group 1. Eight simple cysts were detected with US and 1 non-obstructing ureter stone was detected with IVU in remaining 9 patients. The only discordant case in clinical comparison was found to have urinary bladder cancer on conventional cystoscopy. Ultrasonography and CTU results were congruent in 30 cases. Additional lesions were detected with CTU (3 ureter stones, 1 ureter TCC, 1 advanced RCC) in remaining 5 patients. Ultrasonography+CTU combination results were all concordant with clinical diagnosis. Except 1 case, radio-clinical agreement was achieved. Cross-sectional imaging modalities are preferred in evaluation of hematuria. CTU is the method of choice; however the limitations preclude using CTU as first line or screening test. Ultrasonography is now being accepted as a first line imaging modality with the increased sensitivity in mass detection compared to IVU. The US guided imaging algorithm can be used effectively in radiological approach to hematuria. Copyright © 2009 Elsevier Ireland Ltd. All rights reserved.

  18. Evaluation of three different methods of distance learning for postgraduate diagnostic imaging education: A pilot study.

    Science.gov (United States)

    Poirier, Jean-Nicolas; Cooley, Jeffrey R; Wessely, Michelle; Guebert, Gary M; Petrocco-Napuli, Kristina

    2014-10-01

    Objective : The purpose of this study was to evaluate the perceived effectiveness and learning potential of 3 Web-based educational methods in a postgraduate radiology setting. Methods : Three chiropractic radiology faculty from diverse geographic locations led mini-courses using asynchronous discussion boards, synchronous Web conferencing, and asynchronous voice-over case presentations formatted for Web viewing. At the conclusion of each course, participants filled out a 14-question survey (using a 5-point Likert scale) designed to evaluate the effectiveness of each method in achieving specified course objectives and goals and their satisfaction when considering the learning potential of each method. The mean, standard deviation, and percentage agreements were tabulated. Results : Twenty, 15, and 10 participants completed the discussion board, Web conferencing, and case presentation surveys, respectively. All educational methods demonstrated a high level of agreement regarding the course objective (total mean rating >4.1). The case presentations had the highest overall rating for achieving the course goals; however, all but one method still had total mean ratings >4.0 and overall agreement levels of 70%-100%. The strongest potential for interactive learning was found with Web conferencing and discussion boards, while case presentations rated very low in this regard. Conclusions : The perceived effectiveness in achieving the course objective and goals was high for each method. Residency-based distance education may be a beneficial adjunct to current methods of training, allowing for international collaboration. When considering all aspects tested, there does not appear to be a clear advantage to any one method. Utilizing various methods may be most appropriate.

  19. Diagnostic evaluation of uterine artery Doppler sonography for the prediction of adverse pregnancy outcomes

    Directory of Open Access Journals (Sweden)

    Mojgan Barati

    2014-01-01

    Full Text Available Background : Increased impedance to flow in the uterine arteries assessed by value of the Doppler is associated with adverse pregnancy outcomes, especially pre-eclampsia. We investigated the predictive value of a uterine artery Doppler in the identification of adverse pregnancy outcomes such as ′pre-eclampsia′ and ′small fetus for gestational age′ (SGA. Materials and Methods: Three hundred and seventy-nine women, with singleton pregnancy, between 18 and 40 years of age, without risk factors, randomly underwent Doppler interrogation of the uterine arteries, between 16-22 weeks of gestation. Those who had a mean pulsatility index (PI of >1.45 were considered to have an abnormal result, and were evaluated and compared with those who had normal results for adverse pregnancy outcomes, including pre-eclampsia and small for gestational age. The relationship between the variables was assessed with the use of the chi-square test. Results : There were 17 cases (4.5% of abnormal uterine artery Doppler results and 15 of them (88.2% developed pre-eclampsia and four cases (23.5% had neonates small for gestational age. For predicting pre-eclampsia, the mean uterine artery PI had to be >1.45, had to have a specificity of 95.5% (95% CI, 70-92%, a sensitivity of 79% (95% CI, 43-82%, a negative predictive value (NPV of 98.9% (95% CI, 72-96%, and a positive predictive value (PPV of 88.2% (95% CI, 68-98%. In the case of ′small for gestational age′ it had to have a specificity of 96.5% (95% CI, 42-68%, a sensitivity of 57% (95% CI, 53-76%, an NPV of 99.2% (95% CI, 70-92%, and a PPV of 23.5% (95% CI, 30-72%. Conclusion : Uterine artery Doppler evaluation at 16-22 weeks of gestation might be an appropriate tool for identifying pregnancies that may be at an increased risk for development of pre-eclampsia and small fetus for gestational age.

  20. Evaluation of ADAM-12 as a diagnostic biomarker of ectopic pregnancy in women with a pregnancy of unknown location.

    Directory of Open Access Journals (Sweden)

    Andrew W Horne

    Full Text Available Ectopic pregnancy (EP remains the most life-threatening acute condition in modern gynaecology. It remains difficult to diagnose early and accurately. Women often present at emergency departments in early pregnancy with a 'pregnancy of unknown location' (PUL and diagnosis/exclusion of EP is challenging due to a lack of reliable biomarkers. Recent studies suggest that serum levels of a disintegrin and metalloprotease protein-12 (ADAM-12 can be used differentiate EP from viable intrauterine pregnancy (VIUP. Here we describe a prospective study evaluating the performance of ADAM-12 in differentiating EP from the full spectrum of alternative PUL outcomes in an independent patient cohort.Sera were collected from 120 patients at their first clinical presentation with a PUL and assayed for ADAM-12 by ELISA. Patients were categorized according to final pregnancy outcomes. Serum ADAM-12 concentrations were increased in women with histologically-confirmed EP (median 442 pg/mL; 25%-75% percentile 232-783 pg/mL compared to women with VIUP (256 pg/mL; 168-442 pg/mL or miscarriage (192 pg/mL; 133-476 pg/mL. Serum ADAM-12 did not differentiate histologically-confirmed EP from spontaneously resolving PUL (srPUL (416 pg/mL; 154-608 pg/mL. The diagnostic potential of ADAM-12 was only significant when 'ambiguous' PUL outcomes were excluded from the analysis (AROC = 0.6633; P = 0.03901.When measured in isolation, ADAM-12 levels had limited value as a diagnostic biomarker for EP in our patient cohort. The development of a reliable serum biomarker-based test for EP remains an ongoing challenge.

  1. Adaptation and Psychometric Evaluation of the Young Diagnostic Questionnaire (YDQ) for Parental Assessment of Adolescent Problematic Internet Use.

    Science.gov (United States)

    Wartberg, Lutz; Kriston, Levente; Kegel, Katharina; Thomasius, Rainer

    2016-06-01

    Background and aims The surge of problematic Internet use in adolescents is a continuously growing problem across the globe. To our knowledge, to date valid questionnaire-based measurement of problematic Internet use is possible only by self-assessment. The objective for the present study was to adapt an established instrument for a parental assessment of adolescent problematic Internet use and to evaluate the psychometric properties of this questionnaire. Methods Data were collected from a representative German sample of 1,000 parents of adolescents aged between 12 and 17 years using a standardized questionnaire. To assess problematic Internet use, we adapted the established Young Diagnostic Questionnaire by rewording the items to survey a parental rating instead of a self-report ("Parental version of the Young Diagnostic Questionnaire," PYDQ). Additionally, we assessed the Internet usage time, parental monitoring, family functioning, school performance of the adolescent, and parent-adolescent conflicts. We conducted a confirmatory factor analysis based on the 8 items of the PYDQ modeled as categorical indicators and one latent factor using a robust weighted least squares estimator. We also calculated a reliability coefficient, the acceptance of the instrument, and performed correlation analyses. Results The unidimensional model showed excellent global goodness-of-fit (χ(2)/df = 1.65, RMSEA = 0.03, CFI = 0.99, TLI = 0.99) and satisfactory factor loadings (standardized values ranged from 0.60 to 0.77). We observed a reliability coefficient of 0.70, a good acceptance of the instrument, and the correlation analyses indicated the construct validity of the PYDQ. Discussion and conclusion The proposed PYDQ is a suitable instrument for parental assessment of adolescent problematic Internet use.

  2. Adaptation and Psychometric Evaluation of the Young Diagnostic Questionnaire (YDQ) for Parental Assessment of Adolescent Problematic Internet Use

    Science.gov (United States)

    Wartberg, Lutz; Kriston, Levente; Kegel, Katharina; Thomasius, Rainer

    2016-01-01

    Background and aims The surge of problematic Internet use in adolescents is a continuously growing problem across the globe. To our knowledge, to date valid questionnaire-based measurement of problematic Internet use is possible only by self-assessment. The objective for the present study was to adapt an established instrument for a parental assessment of adolescent problematic Internet use and to evaluate the psychometric properties of this questionnaire. Methods Data were collected from a representative German sample of 1,000 parents of adolescents aged between 12 and 17 years using a standardized questionnaire. To assess problematic Internet use, we adapted the established Young Diagnostic Questionnaire by rewording the items to survey a parental rating instead of a self-report (“Parental version of the Young Diagnostic Questionnaire,” PYDQ). Additionally, we assessed the Internet usage time, parental monitoring, family functioning, school performance of the adolescent, and parent–adolescent conflicts. We conducted a confirmatory factor analysis based on the 8 items of the PYDQ modeled as categorical indicators and one latent factor using a robust weighted least squares estimator. We also calculated a reliability coefficient, the acceptance of the instrument, and performed correlation analyses. Results The unidimensional model showed excellent global goodness-of-fit (χ2/df = 1.65, RMSEA = 0.03, CFI = 0.99, TLI = 0.99) and satisfactory factor loadings (standardized values ranged from 0.60 to 0.77). We observed a reliability coefficient of 0.70, a good acceptance of the instrument, and the correlation analyses indicated the construct validity of the PYDQ. Discussion and conclusion The proposed PYDQ is a suitable instrument for parental assessment of adolescent problematic Internet use. PMID:27363465

  3. Computer-aided diagnostics in digital pathology: automated evaluation of early-phase pancreatic cancer in mice.

    Science.gov (United States)

    Langer, Leeor; Binenbaum, Yoav; Gugel, Leonid; Amit, Moran; Gil, Ziv; Dekel, Shai

    2015-07-01

    Digital pathology diagnostics are often based on subjective qualitative measures. A murine model of early-phase pancreatic ductal adenocarcinoma provides a controlled environment with a priori knowledge of the genetic mutation and stage of the disease. Use of this model enables the application of supervised learning methods to digital pathology. A computerized diagnostics system for histological detection of pancreatic adenocarcinoma was developed and tested. METHODS : Pathological H&E-stained specimens with early pancreatic lesions were identified and evaluated with a system that models cancer detection using a top-down object learning paradigm, mimicking the way a pathologist learns. First, the dominant primitives were identified and segmented in the images, i.e., the ducts, nuclei and tumor stroma. A boost-based machine learning technique was used for duct segmentation, classification and outlier pruning. Second, a set of morphological features traditionally used for cancer diagnosis which provides quantitative image features was employed to quantify subtle findings such as duct deformation and nuclei malformations. Finally, a visually interpretable predictive model was trained to distinguish between normal tissue and premalignant cancer lesions, given ground truth samples. RESULTS : A predictive success rate of 92% was achieved using tenfold cross-validation and 93% on an independent test set. Comparison was made with state-of-the-art classification algorithms that are not interpretable as visible features yielded the contribution of individual primitive features to the prediction outcome. Quantitative image analysis and classification were successful in preclinical histology diagnosis for early-stage pancreatic adenocarcinoma. The usage of annotated contours coupled with interpretable supervised learning methods and outlier pruning can be adapted to other medical imaging tasks. The usage of interpretable supervised learning techniques may improve the success

  4. Evaluation of the sensitivity and specificity of bovine tuberculosis diagnostic tests in naturally infected cattle herds using a Bayesian approach.

    Science.gov (United States)

    Alvarez, Julio; Perez, Andrés; Bezos, Javier; Marqués, Sergio; Grau, Anna; Saez, Jose Luis; Mínguez, Olga; de Juan, Lucía; Domínguez, Lucas

    2012-02-24

    Test-and-slaughter strategies have been the basis of bovine tuberculosis (BT) eradication programs worldwide; however, eradication efforts have not succeeded in certain regions, and imperfect sensitivity and specificity of applied diagnostic techniques have been deemed as one of the possible causes for such failure. Evaluation of tuberculosis diagnostic tools has been impaired by the lack of an adequate gold standard to define positive and negative individuals. Here, a Bayesian approach was formulated to estimate for the first time sensitivity (Se) and specificity (Sp) of the tests [single intradermal tuberculin (SIT) test, and interferon-gamma (IFN-γ) assay] currently used in Spain. Field data from the first implementation of IFN-γ assay (used in parallel with SIT test 2-6months after a first disclosure SIT test) in infected beef, dairy and bullfighting cattle herds from the region of Castilla and Leon were used for the analysis. Model results suggested that in the described situation: (i) Se of SIT test was highly variable (40.1-92.2% for severe interpretation, median=66-69%), and its Sp was high (>99%) regardless interpretation criteria; (ii) IFN-γ assay showed a high Se (median=89-90% and 83.5% for 0.05 and 0.1 cut-off points respectively) and an acceptable Sp (85.7% and 90.3% for 0.05 and 0.1 thresholds) and (iii) parallel application of both tests maximized the combined Se (95.6% using severe SIT and 0.05 cut-off point in the IFN-γ assay). These results support the potential use of the IFN-γ assay as an ancillary technique for routine BT diagnosis. Copyright © 2011 Elsevier B.V. All rights reserved.

  5. Development and evaluation of diagnostic tests for the serological diagnosis of brucellosis in swine

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    Tiziana Di Febo

    2012-06-01

    Full Text Available A competitive enzyme-linked immunosorbent assay (c-ELISA, an indirect ELISA (i-ELISA and a dissociation-enhanced lanthanide fluorescence immunoassay (DELFIA were developed to test for antibodies to Brucella suis in pig and wild boar sera. An anti-Brucella-LPS monoclonal antibody (MAb 4B5A (c-ELISA and DELFIA and an anti-swine IgG monoclonal antibody (MAb 10C2G5 (i-ELISA were used for the three assays. The specificity (Sp and sensitivity (Se of the assays gave the following results: Se and Sp = 100% at a cut-off value of 61.0% (B/B0% for c-ELISA; Sp = 99.1% and Se = 100% at a cut-off value of 21.7% (percentage positivity: PP% for i-ELISA; Sp = 91.0% and Se = 75% at a cut-off value of 37.0% (B/B0% for DELFIA. In addition, the performance of a commercial fluorescence polarisation assay (FPA, standardised for bovine sera, was evaluated in swine sera. The specificity and sensitivity obtained were both 100% at a cut-off value of 99.5 (millipolarisation unit values. These results suggest that the combination of c-ELISA, i-ELISA and FPA can be used to improve the serological diagnosis of swine brucellosis.

  6. Diagnostic Value of Elastosonographic Evaluation of Cervix in Idiopathic Recurrent Spontaneous Miscarriage in the First Trimester

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    Doğa Fatma Öcal

    2016-12-01

    Full Text Available Aim: To detect prognostic role of cervical elastosonography (ES among women with a history of idiopathic recurrent spontaneous miscarriage (IRSM in early pregnancy. Methods: There were 40 women enrolled in the study. Of the 40, 20 were women diagnosed with IRSM in the first trimester and 20 were healthy women who had at least one childbirth experience. All patients underwent ES evaluation of the cervix. Strain ratio values of certain cervical tissue were recorded for all women. Results: The results of elastosonographic measures showed that external part of the upper lip of the cervix was significantly softer than the internal part and lower lip in women with IRSM. However, for women who had not experienced miscarriage, the results were not different. There were no significant differences observed between cervical length and elasticity among either group. Conclusion: Although we found that Region A was softer than Region C and D in women with IRSM, we also found similar results for women who have not experienced miscarriage. Our results support that cervical elasticity may not play a central role in the detection of etiopathogenesis of IRSM. Further studies with larger groups are needed.

  7. Evaluation of reverse-transcriptase PCR as a diagnostic tool to confirm Japanese encephalitis virus infection.

    Science.gov (United States)

    Saxena, Vandana; Mishra, Virendra K; Dhole, Tapan N

    2009-04-01

    Japanese encephalitis (JE) is a serious central nervous system infection and major public health problem in several countries of Southeast Asia including India. This study evaluated the use of IgM ELISA and reverse-transcriptase (RT)-PCR in blood and cerebrospinal fluid (CSF) samples from acute encephalitis patients for the detection of Japanese encephalitis virus (JEV). Forty-four children suffering from acute encephalitis were enrolled, and 36 were selected from whom both CSF and serum samples were available. Twenty-two of the 36 CSF samples were positive for JEV by IgM ELISA and all were negative by RT-PCR. Twenty-three of the 36 serum samples were positive by IgM ELISA while 28 were positive by RT-PCR. Total positivity for JEV infection in CSF and serum samples was 66.7% (24/36) and 83.3% (30/36) respectively by one or both tests. The overall positivity for JEV infection was 86.1% (31/36). We suggest that the use of RT-PCR in serum samples during the early days of JEV infection may be helpful in confirming diagnosis in those cases which are negative for JEV-specific IgM antibodies in both serum and CSF samples.

  8. [Methods for evaluating diagnostic tests in Enfermedades Infecciosas y Microbiología Clínica].

    Science.gov (United States)

    Ramos, J M; Hernández, I

    1998-04-01

    In the field of infectious diseases and clinical microbiology, the evaluation of diagnostic tests (DT) is an important research area. The specific difficulties of this type of research has motivated that have not caught the severity methodological of others areas of clinical research. This article try to asses and characterize the methodology of articles about DT published in Enfermedades Infecciosas y Microbiología Clínica (EIMC) journal. Forty-five articles was selected in the EIMC journal during the 1990-1996 period, because of determinate the sensitivity and specificity of different DT. Methodological standards, extensively accepted was used. In all of articles, except one (98%) the gold standard was specified yours use, however in 4 studies (9%) include the DT in the gold standard (incorporation bias). The correct description of DT was reported in 75% of cases, but only in 11% cases the reproducibility of test was evaluated. The description of source of reference population, standard of inclusion and spectrum of composition was described in 58, 33 and 40% of articles, respectively. In 33% of studies presented workup bias, only 6% commented blind-analysis of results, and 11% presented indeterminate test results. Half of the studies reported test indexes for clinical subgroups, only one article (2%) provided numerical precision for test indexes, and only 7% reported receiver operating characteristics curves. The methodological quality of DT research in the EIMC journal may improve in different aspects of design and presentation of results.

  9. Assessment of alcoholic standard drinks using the Munich composite international diagnostic interview (M-CIDI): An evaluation and subsequent revision.

    Science.gov (United States)

    Kuitunen-Paul, Sören; Rehm, Jürgen; Lachenmeier, Dirk W; Kadrić, Firdeus; Kuitunen, Paula T; Wittchen, Hans-Ulrich; Manthey, Jakob

    2017-09-01

    The quantity and frequency of alcohol consumption are crucial both in risk assessment as well as epidemiological and clinical research. Using the Munich Composite International Diagnostic Interview (M-CIDI), drinking amounts have been assessed in numerous large-scale studies. However, the accuracy of this assessment has rarely been evaluated. This study evaluates the relevance of drink categories and pouring sizes, and the factors used to convert actual drinks into standard drinks. We compare the M-CIDI to alternative drink assessment instruments and empirically validate drink categories using a general population sample (n = 3165 from Germany), primary care samples (n = 322 from Italy, n = 1189 from Germany), and a non-representative set of k = 22503 alcoholic beverages sold in Germany in 2010-2016. The M-CIDI supplement sheet displays more categories than other instruments (AUDIT, TLFB, WHO-CIDI). Beer, wine, and spirits represent the most prevalent categories in the samples. The suggested standard drink conversion factors were inconsistent for different pouring sizes of the same drink and, to a smaller extent, across drink categories. For the use in Germany and Italy, we propose the limiting of drink categories and pouring sizes, and a revision of the proposed standard drinks. We further suggest corresponding examinations and revisions in other cultures. © 2017 The Authors International Journal of Methods in Psychiatric Research Published by John Wiley & Sons Ltd.

  10. Evaluation of the Diagnostic Accuracy of Serum D-Dimer Levels in Pregnant Women with Adnexal Torsion

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    Hasan Onur Topçu

    2015-01-01

    Full Text Available We aimed to evaluate the diagnostic accuracy of serum D-dimer levels in pregnant women with adnexal torsion (AT. The pregnant women with ovarian cysts who suffered from pelvic pain were divided into two groups; the first group consisted of the cases with surgically proven as AT (n = 17 and the second group consisted of the cases whose pain were resolved in the course of follow-up period without required surgery (n = 34. The clinical characteristics and serum D-dimer levels were compared between the groups. Patients with AT had a higher rate of elevated serum white blood cell (WBC count (57% vs. 16%, p = 0.04 and serum D-dimer levels (77% vs. 21%, p < 0.01 on admission in the study group than in the control group. Elevated D-dimer and cyst diameter larger than 5 cm yielded highest sensitivity (82% for each; whereas the presence of nausea and vomiting and elevated CRP had the highest specificity (85% and 88%, respectively. This is the first study that evaluates the serum D-dimer levels in humans in the diagnosis of AT, and our findings supported the use of D-dimer for the early diagnosis of AT in pregnant women.

  11. Tools for Evaluating Fault Detection and Diagnostic Methods for HVAC Secondary Systems

    Science.gov (United States)

    Pourarian, Shokouh

    Although modern buildings are using increasingly sophisticated energy management and control systems that have tremendous control and monitoring capabilities, building systems routinely fail to perform as designed. More advanced building control, operation, and automated fault detection and diagnosis (AFDD) technologies are needed to achieve the goal of net-zero energy commercial buildings. Much effort has been devoted to develop such technologies for primary heating ventilating and air conditioning (HVAC) systems, and some secondary systems. However, secondary systems, such as fan coil units and dual duct systems, although widely used in commercial, industrial, and multifamily residential buildings, have received very little attention. This research study aims at developing tools that could provide simulation capabilities to develop and evaluate advanced control, operation, and AFDD technologies for these less studied secondary systems. In this study, HVACSIM+ is selected as the simulation environment. Besides developing dynamic models for the above-mentioned secondary systems, two other issues related to the HVACSIM+ environment are also investigated. One issue is the nonlinear equation solver used in HVACSIM+ (Powell's Hybrid method in subroutine SNSQ). It has been found from several previous research projects (ASRHAE RP 825 and 1312) that SNSQ is especially unstable at the beginning of a simulation and sometimes unable to converge to a solution. Another issue is related to the zone model in the HVACSIM+ library of components. Dynamic simulation of secondary HVAC systems unavoidably requires an interacting zone model which is systematically and dynamically interacting with building surrounding. Therefore, the accuracy and reliability of the building zone model affects operational data generated by the developed dynamic tool to predict HVAC secondary systems function. The available model does not simulate the impact of direct solar radiation that enters a zone

  12. Diagnostic yield of spiral enteroscopy when performed for the evaluation of abnormal capsule endoscopy findings.

    Science.gov (United States)

    Buscaglia, Jonathan M; Richards, Robert; Wilkinson, Mark N; Judah, Joel R; Lam, Yvette; Nagula, Satish; Draganov, Peter V

    2011-04-01

    Spiral enteroscopy (SE) has emerged as a new alternative for deep intubation of the small intestine. SE is most often used to evaluate abnormal findings on capsule endoscopy (CE). Investigate the ability of SE to reproduce abnormal findings detected on preceding CE. Prospective study. Two academic tertiary care centers. Consecutive patients undergoing SE to investigate a clinically significant finding on CE. Ability of SE to identify findings on CE. Total of 56 anterograde SE procedures were performed. CE findings included arteriovenous malformations (AVMs) (n=26), masses (n=8), ulcers (n=4), polyps (n=4), abnormal mucosa (n=6), fresh blood (n=6), and stricture (n=1). Majority of the patients had CE findings located in the jejunum (41 of 56 or 73.2%). Mean depth of enteroscope insertion was 224.6±68.7 cm. SE detected relevant small bowel pathology in 32 of 56 (57.1%) patients. Findings on CE were reproduced in 30 of 56 (53.6%) cases. Reproducibility was independent of patient body mass index (P=0.38), CE indication (P=0.24), CE lesion location (P=0.29), days between CE and SE (P=0.30), and depth of insertion (P=0.81). Type of CE findings (particularly AVMs) significantly affected SE reproducibility (P=0.015). SE procedure time was inversely related to SE reproducibility (odds ratio=0.94, 95% confidence interval=0.88-0.99, P=0.02). Small sample size and potential for false-positive CE study. SE seems to be moderately effective (57.1%) in terms of its ability to locate pathology within the small intestine. The type of small bowel pathology targeted by SE may affect its clinical utility. AVMs observed on CE can be seen at the time of SE in the majority of cases (60%).

  13. Diagnostic Accuracy of Computed Tomogram in the Evaluation of a Neck Mass

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    M K Shrestha

    2011-12-01

    Full Text Available Introduction: The concept of dividing extracranial head and neck into different spaces is a notion that dates back to the 1800s. Various studies have led to detailed description of the soft tissue spaces that are contained within the fascial layers. This study was carried out to determine the accuracy of computed tomogram (CT in differentiating malignant from benign lesions in the neck, to study the spatial distribution of different types of histological groups in the neck and the prevalence of malignant versus benign diseases involving the neck. Methods: This was a hospital-based, prospective study conducted in the department of Radiodiagnosis, Kasturba Medical college, Mangalore, from 2005-2008. A hundred consecutive patients referred for CT scan examination presenting with complaints related to involvement of neck spaces or presence of palpable neck masses were enrolled in this study. The details of all the cases regarding their radiological fi ndings and histopathology were reviewed. Results: Of the 100 patients studied, 53 % had malignant lesions, out of which 43 % were squamous cell carcinoma and 4 % were metastatic lymph nodal involvement. Twenty percent of the lesions were of an infective origin while 23 % were benign and congenital cystic lesions. Conclusions: CT scan as an imaging modality has the ability to evaluate the malignant and benign tumors of the neck. Considering histopathology as the gold standard, the sensitivity of CT in detecting malignant/benign lesions was 96.5 % with a specifi city of 100 %. The positive predictive value was 100 % and the negative predictive value 95.2 %. Keywords: CT scan, neck mass, neck spaces.

  14. Evaluation of complementary diagnostic tools for bovine tuberculosis detection in dairy herds from India.

    Science.gov (United States)

    Thakur, Mukesh Kumar; Sinha, Dharmender Kumar; Singh, Bhoj Raj

    2016-08-01

    A cross-sectional study was undertaken to know the herd prevalence and evaluate the single intradermal tuberculin testing (SITT), culture isolation, and polymerase chain reaction (PCR) analysis for the diagnosis of bovine tuberculosis (TB). A total of 541 cows of three dairy farms of Bareilly and Mukteshwar were screened by SITT followed by collection of pre-scapular lymph node (PSLN) aspirates (71), milk (54), and blood (71) samples from reactor animals. These clinical samples were processed for culture isolation and direct PCR-based identification and species differentiation. Out of 541 cows screened by SITT, 71 (13.12%) animals were found positive. Mycobacteria were isolated from 3 (4.22%) PSLN aspirate but not from any cultured milk and blood samples. 28 (39.43%) PSLN aspirate and 5 (9.25%) milk samples were positive for Mycobacterium TB (MTB) complex (MTC) by PCR amplification for the IS6110 insertion sequence; however, blood samples were found negative. For species differentiation, multiplex-PCR using 12.7 kb primers was conducted. Out of 28 PSLN aspirate, Mycobacterium bovis was detected in 18 (64.28%) and MTB in 8 (28.57%), whereas 2 aspirate samples (7.14%) were positive for both the species. All the five milk positive samples were positive for M. bovis. Direct detection of bovine TB by a molecular-based method in dairy animals after preliminary screening was appeared to be more sensitive and specific compared to the conventional method (i.e., culture isolation). Its application in form of serial testing methodology for the routine diagnosis and thereafter, culling of infected stock may be suggested for the control programs in dairy herds. The PSLN aspirate was found to be the most suitable specimen for culture isolation and PCR-based detection of Mycobacterium spp. among live infected animals.

  15. Evaluation of complementary diagnostic tools for bovine tuberculosis detection in dairy herds from India

    Directory of Open Access Journals (Sweden)

    Mukesh Kumar Thakur

    2016-08-01

    Full Text Available Aim: A cross-sectional study was undertaken to know the herd prevalence and evaluate the single intradermal tuberculin testing (SITT, culture isolation, and polymerase chain reaction (PCR analysis for the diagnosis of bovine tuberculosis (TB. Materials and Methods: A total of 541 cows of three dairy farms of Bareilly and Mukteshwar were screened by SITT followed by collection of pre-scapular lymph node (PSLN aspirates (71, milk (54, and blood (71 samples from reactor animals. These clinical samples were processed for culture isolation and direct PCR-based identification and species differentiation. Results: Out of 541 cows screened by SITT, 71 (13.12% animals were found positive. Mycobacteria were isolated from 3 (4.22% PSLN aspirate but not from any cultured milk and blood samples. 28 (39.43% PSLN aspirate and 5 (9.25% milk samples were positive for Mycobacterium TB (MTB complex (MTC by PCR amplification for the IS6110 insertion sequence; however, blood samples were found negative. For species differentiation, multiplex-PCR using 12.7 kb primers was conducted. Out of 28 PSLN aspirate, Mycobacterium bovis was detected in 18 (64.28% and MTB in 8 (28.57%, whereas 2 aspirate samples (7.14% were positive for both the species. All the five milk positive samples were positive for M. bovis. Conclusion: Direct detection of bovine TB by a molecular-based method in dairy animals after preliminary screening was appeared to be more sensitive and specific compared to the conventional method (i.e., culture isolation. Its application in form of serial testing methodology for the routine diagnosis and thereafter, culling of infected stock may be suggested for the control programs in dairy herds. The PSLN aspirate was found to be the most suitable specimen for culture isolation and PCR-based detection of Mycobacterium spp. among live infected animals.

  16. Diagnostic evaluation of ischemic heart disease by X-ray computed tomography and magnetic resonance imaging

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    Masuda, Yoshiaki; Kobayashi, Shiro; Takasu, Junichiro; Sakakibara, Makoto; Imai, Hitoshi; Aoyagi, Yutaka; Morooka, Nobuhiro; Watanabe, Shigeru; Inagaki, Yoshiaki

    1987-04-01

    To assess the usefulness of X-ray computed tomography (CT) and magnetic resonance imaging (MRI) in detecting and evaluating ischemic heart disease, conventional and enhanced CT were performed for 180 patients (150 with transmural infarction, 12 with subendocardial infarction, and 18 with angina pectoris). MRI examinations were performed for 38 patients (31 with transmural infarction, three with subendocardial infarction, and four with angina pectoris). With enhanced CT, two findings in the myocardium were direct evidence of myocardial infarction: 1) filling defects on the early scans, and 2) late enhancement of the myocardium on the delayed scans. The former were observed mainly at the sites of recent anterior myocardial infarction and the latter were seen in about half of the patients with recent and remote anterior myocardial infarctions. However, these findings were inadequately imaged in patients with inferoposterior infarction and subendocardial infarction. Among 137 patients with transmural infarction, enhanced CT revealed left ventricular aneurysms in 51 (37 %) and ventricular thrombi in 26 (19 %). ECG-gated MRI apparatus having a superconducting magnetic operating at 0.25 Tesla was used, and data for this study were collected using the single-slice spin echo technique. In eight of nine patients with acute myocardial infarction, gated MRI demonstrated the infarcted myocardium as regions of high signal intensity relative to that of the adjacent normal myocardium. Such a difference in MRI signal intensity was scarcely recognized in the chronic stage of myocardial infarction, but the indirect findings of infarction, such as regional wall thinning, wall motion disturbances, left ventricular aneurysms, and ventricular thrombi were easily detected using MRI. No characteristic finding was obtained by CT or MRI in patients with angina pectoris.

  17. Evaluation of Tuberculosis Diagnostics in Children: 1. Proposed Clinical Case Definitions for Classification of Intrathoracic Tuberculosis Disease. Consensus From an Expert Panel

    Science.gov (United States)

    Graham, Stephen M.; Ahmed, Tahmeed; Amanullah, Farhana; Browning, Renee; Cardenas, Vicky; Casenghi, Martina; Cuevas, Luis E.; Gale, Marianne; Gie, Robert P.; Grzemska, Malgosia; Handelsman, Ed; Hatherill, Mark; Hesseling, Anneke C.; Jean-Philippe, Patrick; Kampmann, Beate; Kabra, Sushil Kumar; Lienhardt, Christian; Lighter-Fisher, Jennifer; Madhi, Shabir; Makhene, Mamodikoe; Marais, Ben J.; McNeeley, David F.; Menzies, Heather; Mitchell, Charles; Modi, Surbhi; Mofenson, Lynne; Musoke, Philippa; Nachman, Sharon; Powell, Clydette; Rigaud, Mona; Rouzier, Vanessa; Starke, Jeffrey R.; Swaminathan, Soumya; Wingfield, Claire

    2012-01-01

    There is a critical need for improved diagnosis of tuberculosis in children, particularly in young children with intrathoracic disease as this represents the most common type of tuberculosis in children and the greatest diagnostic challenge. There is also a need for standardized clinical case definitions for the evaluation of diagnostics in prospective clinical research studies that include children in whom tuberculosis is suspected but not confirmed by culture of Mycobacterium tuberculosis. A panel representing a wide range of expertise and child tuberculosis research experience aimed to develop standardized clinical research case definitions for intrathoracic tuberculosis in children to enable harmonized evaluation of new tuberculosis diagnostic technologies in pediatric populations. Draft definitions and statements were proposed and circulated widely for feedback. An expert panel then considered each of the proposed definitions and statements relating to clinical definitions. Formal group consensus rules were established and consensus was reached for each statement. The definitions presented in this article are intended for use in clinical research to evaluate diagnostic assays and not for individual patient diagnosis or treatment decisions. A complementary article addresses methodological issues to consider for research of diagnostics in children with suspected tuberculosis. PMID:22448023

  18. Evaluation of tuberculosis diagnostics in children: 1. Proposed clinical case definitions for classification of intrathoracic tuberculosis disease. Consensus from an expert panel.

    Science.gov (United States)

    Graham, Stephen M; Ahmed, Tahmeed; Amanullah, Farhana; Browning, Renee; Cardenas, Vicky; Casenghi, Martina; Cuevas, Luis E; Gale, Marianne; Gie, Robert P; Grzemska, Malgosia; Handelsman, Ed; Hatherill, Mark; Hesseling, Anneke C; Jean-Philippe, Patrick; Kampmann, Beate; Kabra, Sushil Kumar; Lienhardt, Christian; Lighter-Fisher, Jennifer; Madhi, Shabir; Makhene, Mamodikoe; Marais, Ben J; McNeeley, David F; Menzies, Heather; Mitchell, Charles; Modi, Surbhi; Mofenson, Lynne; Musoke, Philippa; Nachman, Sharon; Powell, Clydette; Rigaud, Mona; Rouzier, Vanessa; Starke, Jeffrey R; Swaminathan, Soumya; Wingfield, Claire

    2012-05-15

    There is a critical need for improved diagnosis of tuberculosis in children, particularly in young children with intrathoracic disease as this represents the most common type of tuberculosis in children and the greatest diagnostic challenge. There is also a need for standardized clinical case definitions for the evaluation of diagnostics in prospective clinical research studies that include children in whom tuberculosis is suspected but not confirmed by culture of Mycobacterium tuberculosis. A panel representing a wide range of expertise and child tuberculosis research experience aimed to develop standardized clinical research case definitions for intrathoracic tuberculosis in children to enable harmonized evaluation of new tuberculosis diagnostic technologies in pediatric populations. Draft definitions and statements were proposed and circulated widely for feedback. An expert panel then considered each of the proposed definitions and statements relating to clinical definitions. Formal group consensus rules were established and consensus was reached for each statement. The definitions presented in this article are intended for use in clinical research to evaluate diagnostic assays and not for individual patient diagnosis or treatment decisions. A complementary article addresses methodological issues to consider for research of diagnostics in children with suspected tuberculosis.

  19. Anthelmintic resistance in gastrointestinal nematodes in goats and evaluation of FAMACHA diagnostic marker in Uganda.

    Science.gov (United States)

    Nabukenya, Immaculate; Rubaire-Akiiki, Chris; Olila, Deogracious; Muhangi, Denis; Höglund, Johan

    2014-10-15

    Gastrointestinal nematodes (GIN) are a challenge to goat production globally causing reduced growth, morbidity and mortality. We report here results of the first nation-wide anthelmintic resistance (AR) study and validation of assessment of clinical anaemia with FAMACHA eye scores in goats in Uganda. From August to December 2012 the efficacy of albendazole (7.5mg/kg), levamisole (10.5mg/kg) and ivermectin (0.3mg/kg) against strongyle nematodes was tested on 33 goat farms in Soroti, Gulu, Mpigi, Mbarara and Ssembabule districts of Uganda. Altogether 497 goats were subjected to a total of 45 different faecal egg count reduction tests (FECRT), each involving 5-20 goats. On one farm all substances were tested. Faecal and blood samples were collected and FAMACHA eye scores evaluated on the day of treatment and 15 days later. A questionnaire survey was conducted on frequency, type and dose of anthelmintics used, farm size and grazing management system. Examination of infective third stage larvae (L3) from pooled faecal cultures demonstrated Haemonchus to be the predominant genus (>75%). Resistance to at least one anthelmintic group was detected on 61% of the 33 farms and in 49% of the 45 test groups. Prevalence of resistance to ivermectin, levamisole and albendazole was respectively 58%, 52% and 38%. Correlation between pre-treatment packed cell volume determinations and FAMACHA scores (r(498) = -0.89) was significant. Paddock grazing system (Odds ratio 4.9, 95% CI 1.4-17.3) and large farm size of >40 goats (odds ratio 4.4, 95% CI 1.2-16.1) were significant predictors of AR. In all districts, resistance to all three anthelmintics was higher on large-scale goat farms practising mostly paddock grazing. Interestingly, resistance to albendazole, the most commonly used anthelmintic in Uganda, was lower than that to ivermectin and levamisole. We recommend adaptation of FAMACHA to goats to help restrict anthelmintic treatment to heavily infected individuals. This will limit

  20. Method of evaluation of diagnostics reference levels in computerized tomography; Metodo de avaliacao de niveis de referencia de radiodiagnostico em tomografia computadorizada

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    Vega, Walter Flores

    1999-04-01

    Computerized tomography is a complex technique with several selectable exposition parameters delivering high doses to the patient. In this work it was developed a simple methodology to evaluate diagnostic reference levels in computerized tomography, using the concept of Multiple Scan Average Dose (MSAD), recently adopted by the Health Ministry. For evaluation of the MSAD, a dose distribution was obtained through a measured dose profile on the axial axis of a water phantom with thermoluminescence dosemeters, TLD-100, for different exam technique. The MSAD was evaluated hrough two distinct methods. First, it was evaluated by the integration of the dose profile of a single slice and, second, obtained by the integration on central slice of the profile of several slices. The latter is in of accordance with the ionization chamber method, suggesting to be the most practical method of dose evaluation to be applied in the diagnostic reference level assessment routine for CT, using TLDs. (author)

  1. Facet joint pain in chronic spinal pain: an evaluation of prevalence and false-positive rate of diagnostic blocks.

    Science.gov (United States)

    Manchukonda, Rajeev; Manchikanti, Kavita N; Cash, Kimberly A; Pampati, Vidyasagar; Manchikanti, Laxmaiah

    2007-10-01

    A retrospective review. Evaluation of the prevalence of facet or zygapophysial joint pain in chronic spinal pain of cervical, thoracic, and lumbar origin by using controlled, comparative local anesthetic blocks and evaluation of false-positive rates of single blocks in the diagnosis of chronic spinal pain of facet joint origin. Facet or zygapophysial joints are clinically important sources of chronic cervical, thoracic, and lumbar spine pain. The previous studies have demonstrated the value and validity of controlled, comparative local anesthetic blocks in the diagnosis of facet joint pain, with a prevalence of 15% to 67% variable in lumbar, thoracic, and cervical regions. False-positive rates of single diagnostic blocks also varied from 17% to 63%. Five hundred consecutive patients receiving controlled, comparative local anesthetic blocks of medial branches for the diagnosis of facet or zygapophysial joint pain were included. Patients were investigated with diagnostic blocks using 0.5 mL of 1% lidocaine per nerve. Patients with lidocaine-positive results were further studied using 0.5 mL of 0.25% bupivacaine per nerve on a separate occasion. Medial branch blocks were performed with intermittent fluoroscopic visualization, at 2 levels to block a single joint. A positive response was considered as one with at least 80% pain relief from a block of at least 2 hours duration when lidocaine was used, and at least 3 hours or longer than the duration of relief with lidocaine when bupivacaine was used, and also the ability to perform prior painful movements. A total of 438 patients met inclusion criteria. The prevalence of facet joint pain was 39% in the cervical spine [95% confidence interval (CI), 32%-45%]; 34% (95% CI, 22%-47%) in the thoracic pain; and 27% (95% CI, 22%-33%) in the lumbar spine. The false-positive rate with a single block in the cervical region was 45%, in the thoracic region was 42%, and in the lumbar region 45%. This retrospective review once again

  2. Virtual microscopy: an evaluation of its validity and diagnostic performance in routine histologic diagnosis of skin tumors.

    Science.gov (United States)

    Nielsen, Patricia Switten; Lindebjerg, Jan; Rasmussen, Jan; Starklint, Henrik; Waldstrøm, Marianne; Nielsen, Bjarne

    2010-12-01

    Digitization of histologic slides is associated with many advantages, and its use in routine diagnosis holds great promise. Nevertheless, few articles evaluate virtual microscopy in routine settings. This study is an evaluation of the validity and diagnostic performance of virtual microscopy in routine histologic diagnosis of skin tumors. Our aim is to investigate whether conventional microscopy of skin tumors can be replaced by virtual microscopy. Ninety-six skin tumors and skin-tumor-like changes were consecutively gathered over a 1-week period. Specimens were routinely processed, and digital slides were captured on Mirax Scan (Carl Zeiss MicroImaging, Göttingen, Germany). Four pathologists evaluated the 96 virtual slides and the associated 96 conventional slides twice with intermediate time intervals of at least 3 weeks. Virtual slides that caused difficulties were reevaluated to identify possible reasons for this. The accuracy was 89.2% for virtual microscopy and 92.7% for conventional microscopy. All κ coefficients expressed very good intra- and interobserver agreement. The sensitivities were 85.7% (78.0%-91.0%) and 92.0% (85.5%-95.7%) for virtual and conventional microscopy, respectively. The difference between the sensitivities was 6.3% (0.8%-12.6%). The subsequent reevaluation showed that virtual slides were as useful as conventional slides when rendering a diagnosis. Differences seen are presumed to be due to the pathologists' lack of experience using the virtual microscope. We conclude that it is feasible to make histologic diagnosis on the skin tumor types represented in this study using virtual microscopy after pathologists have completed a period of training. Larger studies should be conducted to verify whether virtual microscopy can replace conventional microscopy in routine practice. Copyright © 2010 Elsevier Inc. All rights reserved.

  3. Evaluation of the e-Learning material developed by EMERALD and EMIT for diagnostic imaging and radiotherapy.

    Science.gov (United States)

    Aitken, Victoria; Tabakov, Slavik

    2005-09-01

    Two Leonardo projects, EMERALD and EMIT, have developed in a partnershipof university and hospital departments (the consortia) e-Learning materials in X-ray diagnostic radiology, nuclear medicine, radiotherapy, ultrasound and magnetic resonance imaging for medical physics graduates and other healthcare professionals. These e-Learning materials are described in a separate paper in this issue. To assess the effectiveness and relevance of the e-Learning material, a series of evaluations by student users groups plus experts in medical physics education and training were undertaken. The students, with backgrounds in physics and clinical ultrasound, reviewed the e-Learning material using an evaluation form developed by the consortia. The student feedback was favourable with students commenting that their level of knowledge had increased having completed the tasks. Areas identified for development were a reduction in text volume and an increase in the time allowed for completion of some tasks. The feedback from the experts was positive with an overall appreciation of the value of the learning material as a resource for students in medical physics field across Europe and identified other disciplines in which the access to the learning material could be useful contribution to their learning. Suggestions made for improvements ranged from grading the tasks into basic and advanced topics to increasing the interactive nature of the material. These early evaluation of the e-Learning material look promising and provide a framework for further developments in the field. Insight into users and providers views is important if developers are to provide relevant and worthwhile educational learning opportunities.

  4. Diagnostic evaluation of malignant head and neck cancer by F-18-FDG PET compared to CT/MRI

    Energy Technology Data Exchange (ETDEWEB)

    Nowak, B.; Cremerius, U.; Zimny, M.; Reinartz, P.; Buell, U. [Technische Hochschule Aachen (Germany). Klinik fuer Nuklearmedizin; Di Martino, E. [Aachen Univ. (Germany). Abt. Otorhinolaryngology; Jaenicke, S. [Technische Hochschule Aachen (Germany). Lehrstuhl fuer Zahn-, Mund-, Kiefer- und Plastische Gesichtschirurgie, Abt. Zahn-, Mund-, Kiefer- und Plastische Gesichtschirurgie; Adam, G. [Technische Hochschule Aachen (Germany). Klinik fuer Radiologische Diagnostik

    1999-07-01

    Aim: Evaluation of F-18-FDG PET in comparison to CT/MRI as diagnostic tool in primary and recurrent head and neck cancer. Methods: 78 F-18-FDG PET studies were performed in 71 patients with known or suspected primary (n=48) or recurrent (n=30) head and neck cancer and compared to CT (n=75) or MRI investigations (n=3) concerning detection of the primary or recurrent tumor and detection of regional lymph node metastases in the ipsilateral and contralateral neck sides. Glucose uptake (SUV) of PET findings was correlated to tumor location, grading and dignity of the lesion. Results: Sensitivity and specificity for PET in detection of primary tumors were 87%* and 67%, respectively (CT/MRI 67%* and 44%) ({sup *}p<0.05), in detection of local recurrence 86% and 75%, respectively (CT/MRI 57% and 92%), in detection of necks affected by lymph node metastases 80% and 92%, respectively (CT/MRI 80% and 84%). Laryngeal, buccal (cheek) and salivary gland tumors had significant lower glucose uptake (SUV) when compared to tumors of the hypopharynx (p<0.05). G1-tumors (mean SUV 4.26) had significant (p<0.05) lower glucose uptake when compared to G2- and G3-tumors (mean SUV 7.73 and 8.19, respectively). Mean SUV of malignant PET findings (7.88) was significant (p<0.05) higher than mean SUV of benign PET findings (5.70). However, a SUV threshold to improve diagnostic accuracy could not be defined. Conclusion: F-18-FDG PET is significantly more accurate than CT/MRI for detection of head and neck cancer. Both methods are valuable for detection of cervical lymph node metastases. Glucose uptake shows correlation to histological grading. A quantitative SUV analysis does not improve diagnostic accuracy. (orig.) [German] Ziel: Evaluation der F-18-FDG-PET in der Primaer- und Rezidivdiagnostik von Kopf-Hals-Tumoren im Vergleich zur CT/MRT. Methoden: Es wurden 78 F-18-FDG-PET-Untersuchungen bei 71 Patienten mit gesichertem oder vermutetem primaerem (n=48) oder rezidiviertem (n=30) Kopf

  5. Scratching Where They Itch: Evaluation of Feedback on a Diagnostic English Grammar Test for Taiwanese University Students

    Science.gov (United States)

    Yin, Muchun; Sims, James; Cothran, Daniel

    2012-01-01

    Feedback to the test taker is a defining characteristic of diagnostic language testing (Alderson, 2005). This article reports on a study that investigated how much and in what ways students at a Taiwan university perceived the feedback to be useful on an online multiple-choice diagnostic English grammar test, both in general and by students of…

  6. Evaluation of the Criterion and Convergent Validity of the Diagnostic Interview for Social and Communication Disorders in Young and Low-Functioning Children

    Science.gov (United States)

    Maljaars, Jarymke; Noens, Ilse; Scholte, Evert; van Berckelaer-Onnes, Ina

    2012-01-01

    The Diagnostic Interview for Social and Communication Disorders (DISCO; Wing, 2006) is a standardized, semi-structured and interviewer-based schedule for diagnosis of autism spectrum disorder (ASD). The objective of this study was to evaluate the criterion and convergent validity of the DISCO-11 ICD-10 algorithm in young and low-functioning…

  7. The Extent of Applying the Diagnostic Evaluation by the First Grade Teachers in Teaching Copied Dictation in the Schools of Ma'an

    Science.gov (United States)

    Nafa'a, Mohammed Abd Al-kareem

    2014-01-01

    This study examined the extent of the teachers' of the first grade applying to the components of diagnostic evaluation in teaching dictation in Ma'an, and the answer two question this study, the researcher chose a sample consisting of (60) teachers (females) who teach this grade, holders of B.A degree. The researcher attended classes with these…

  8. Evaluation of the DIBELS (Sixth Edition) Diagnostic System for the Selection of Native and Proficient English Speakers at Risk of Reading Difficulties

    Science.gov (United States)

    Smolkowski, Keith; Cummings, Kelli D.

    2016-01-01

    This comprehensive evaluation of the Dynamic Indicators of Basic Early Literacy Skills Sixth Edition (DIBELS6) set of measures gives a practical illustration of signal detection methods, the methods used to determine the value of screening and diagnostic systems, and offers an updated set of cut scores (decision thresholds). Data were drawn from a…

  9. Diagnostic yield of CT urography in the evaluation of hematuria in young patients in a military population.

    Science.gov (United States)

    Mace, Laura R; Galloway, Terrel L; Ma, Andrew; Montgomery, Richard S; Rockhill, Ryan C; Reynolds, William W; Marks, Robert M

    2017-07-01

    To assess the diagnostic yield of a computed tomography urography (CTU) study in patients less than 50 years of age, who have a history of military service, and who are at increased risk of urological cancers secondary to harmful practices and work-related exposures. 137 Consecutive patients who underwent CTU between 2012 and 2013 for new onset of hematuria were included. Initial review of the clinical interpretations of the CTU studies grouped the studies into negative and positive exams for any urological findings. Review of the patients' medical records and subsequent radiology studies determined microscopic versus gross hematuria at presentation and any findings after their CTU study consistent with a urological malignancy. The positive exams were reviewed by second readers, blinded to the clinical interpretation of the initial CTU studies, who first read the unenhanced images. The readers characterized findings as visible on non-contrast CT alone or they requested contrast-enhanced images. Each urological finding was recorded for each patient. Of the 137 included patients, 84 had micro-hematuria and 53 had gross hematuria. There were a total of 99 negative examinations of the 137 included patients. Contrast was requested 14 times to confirm 11 benign cysts. No findings concerning for malignancy were found by the readers or on subsequent record reviews for each patient. An unenhanced CT may be appropriate to evaluate new onset microscopic, and possibly gross hematuria, in patients younger than 40, even in patients at increased risk of urologic cancer.

  10. EVALUATION OF HYPERBILIRUBINAEMIA AS A NEW DIAGNOSTIC MARKER FOR ACUTE APPENDICITIS AND ITS ROLE IN THE PREDICTION OF APPENDICULAR PERFORATION

    Directory of Open Access Journals (Sweden)

    Lalit Kumar Regar

    2016-07-01

    Full Text Available BACKGROUND There are various investigations recommended to diagnose acute appendicitis; however, till date there is no confirmatory laboratory marker to diagnose preoperatively acute appendicitis & appendicular perforation. The purpose of study is to evaluate hyperbilirubinaemia as a new diagnostic marker for acute appendicitis and its role in the prediction of appendicular perforation. Preoperative assessment of serum bilirubin appears to be a promising new laboratory marker for diagnosing acute appendicitis & have a predictive potential for the diagnosis of appendicular perforation. METHODS A prospective analytical study of 100 cases comprising of a non-randomised cohort. RESULTS Hyperbilirubinaemia was found in most of the patients diagnosed with acute appendicitis (68.23% or appendicular perforation (73.33%. The mean total bilirubin level in patients diagnosed with acute appendicitis was 1.34 mg% while in patients diagnosed with appendicular perforation was 2.12 mg%. CONCLUSIONS Preoperative assessment of serum bilirubin should be routinely performed in cases of acute appendicitis as it can help in diagnosis of acute appendicitis as well as also serve as an important maker of acute gangrenous appendicitis.

  11. Evaluation of Diagnostic Value in Using a Panel of Multiple Tumor-Associated Antigens for Immunodiagnosis of Cancer

    Directory of Open Access Journals (Sweden)

    Peng Wang

    2014-01-01

    Full Text Available To determine whether a panel of multiple tumor-associated antigens (TAAs would enhance antibody detection, the diagnostic value of autoantibodies to a panel of multiple TAAs in cancer has been evaluated. The TAAs used in this study was composed of eight TAAs including Imp1, p62, Koc, p53, C-myc, Cyclin B1, Survivin, and p16 full-length recombinant proteins. Enzyme-linked immunosorbent assay and immunoblotting were used to detect antibodies in 304 cancer sera and also 58 sera from normal individuals. The antibody frequency to any individual TAA in cancer was variable but rarely exceeded 20%. With the successive addition of TAAs to a final combination of total of eight antigens, there was a stepwise increase of positive antibody reactions reaching a sensitivity of 63.5% and a specificity of 86.2% in the combined cancer group. In different types of cancer, the ranges of positive and negative likelihood ratio were 4.07–4.76 and 0.39–0.51, respectively, and the ranges of positive and negative predictive values were 74.2–88.7% and 58.8–75.8%, respectively. Agreement rate and Kappa value were 67.1% and 0.51, respectively. These results further support our previous hypothesis that detection of anti-TAAs autoantibodies for diagnosis of certain type of cancer can be enhanced by using a miniarray of several TAAs.

  12. [Evaluation of a rapid diagnostic test in the diagnosis of toxoplasmosis in pregnant women in Cotonou (Bénin)].

    Science.gov (United States)

    Ogouyèmi-Hounto, A; Agbayahoun-Chokki, F; Sissinto Savi de Tove, Y; Biokou Bankole, B; Adinsi de Souza, V; Assogba, M; Kinde-Gazard, D; Massougbodji, A

    2014-05-01

    The aim of the study was to evaluate the performance of the ImmunoComb® Toxo IgG and ImmunoComb® Toxo IgMassays (rapid diagnostic test) in the laboratory diagnosis of toxoplasmosis in pregnant women in Cotonou. We interviewed 266 pregnant women, who first answered an epidemiological questionnaire, and collected blood samples for measurement of IgG and IgM anti T. gondii antibodies with the ImmunoComb toxo assays and with the ARCHITECT CIMA method. The sensitivity, specificity, positive predictive values (PPV) and negative predictive values (NPV) were calculated to determine the performance of the rapid test. The seroprevalences of IgG against T. gondii by CIMA technique and rapid test were respectively 48.9% and 48.5%. The prevalence increased with age. Performances for IgG were: sensitivity 97%, specificity 100%, PPV 100%, NPV = 97.10%. For IgM, Sensitivity: 33.3% Specificity: 100%, PPV 100%, NPV = 99.2%. Seroprevalence obtained shows that about half of the study population is not immune against T. gondii and requires regular serological monitoring until delivery. According to these results, and given the needs of toxoplasmosis diagnosis on the field characterized by an important decrease of immunized women, this test may be recommended in the laboratory diagnosis of toxoplasmosis in peripheral levels of the health pyramid.

  13. Role of FDG PET/CT in Diagnostic Evaluation of Granulocytic Sarcomas: A Series of 12 Patients.

    Science.gov (United States)

    Chandra, Piyush; Dhake, Sanket; Purandare, Nilendu; Agrawal, Archi; Shah, Sneha; Rangarajan, Venkatesh

    2017-01-01

    Granulocytic sarcoma (GS) is a rare extramedullary manifestation in patients with acute myeloid leukemia (AML), which can precede the diagnosis or occur in the posttreatment setting. Unlike its established role in other hematological malignancies like Hodgkin's on non-Hodgkin's disease, the exact role of positron emission tomography/computed tomography (PET/CT) in AML with or without GS remains to be defined. We retrospectively reviewed PET/CT scans of 12 patients with histologically proven GS. Marrow examination of these patients identified nine patients with isolated GS (without existent leukemia) and three patients with coexistent leukemia. PET/CT accurately identified all clinically evident GS in all 12 patients at initial staging and at follow-up with tumors, showing moderate to high 2-deoxy-2-fluoro-D-glucose uptake. Coexistent marrow disease was seen on PET/CT in three patients, which was confirmed on histopathology. In the same patients, PET/CT also detected additional sites of extramedullary disease in 66.6% (n = 8), which was either clinically occult or not evident on routine CT. PET/CT appears to be a highly sensitive imaging modality in diagnostic evaluation of GS. The most important indication of using PET/CT in these cases is to identify additional sites of clinically occult extramedullary disease, which can potentially impact treatment decisions and outcomes.

  14. Comparative efficacy of conventional diagnostic methods and evaluation of polymerase chain reaction for the diagnosis of bovine brucellosis

    Directory of Open Access Journals (Sweden)

    Raheela Akhtar

    2010-04-01

    Full Text Available The comparative efficacy of Rose Bengal Plate Test (RBPT and Milk Ring test (MRT was calculated in terms of sensitivity and specificity for the diagnosis of bovine brucellosis in cows (Group A and buffaloes (Group B from Lahore and Okara districts of Punjab, Pakistan. Using bacterial growth as a gold standard RBPT showed high sensitivity values of 100% in both groups. While its specificity was 96.29% (Group A and 90.62% (Group B. On the other hands MRT showed low sensitivity (80.0% in Group A; 86.6% in Group B while its specificity was 100% in all the animals of both groups. The calculated positive predictive and negative predictive values of both groups were in correspondence with their specificity and sensitivity values respectively. High sensitivity and low specificity of RBPT as compare to high specificity and low sensitivity of MRT in all groups suggested the poor efficacy of both tests used individually as compare to bacterial growth. In the continuation of this study polymerase chain reaction (PCR was evaluated for its diagnostic efficacy of quick Brucella abortus isolation from same samples. PCR conducted on serum samples gave more positive results than on milk samples. Therefore, the combination of both conventional tests alongwith serum PCR can be recommended. [Vet. World 2010; 3(2.000: 53-56

  15. First Indian study evaluating role of biochemical investigations and diagnostic tools in detection of adverse drug reactions.

    Science.gov (United States)

    Tandon, Vishal R; Khajuria, Vijay; Raina, Kapila; Mahajan, Vivek; Sharma, Aman; Gillani, Zahid

    2014-09-01

    To evaluate the role of biochemical investigations (BI) and diagnostic tools (DT) in ADR detection. An observational prospective cross-sectional study was done using suspected ADR data collection form. A total of 2381 ADR related events were recorded in two years. Total number/percentage of biochemical abnormalities (BA) related ADR detection rate was 14.57% and of DT was 1.091% in contrast to 84.33% recorded with clinical presentation. Maximum cases were inward patients (87.13%), 67.02% were recorded by active surveillance. ADR detection rate at one point & detection on follow up was 56.31% Vs 46.38%. ADR detection rate of ECG, endoscopy, X-ray were 0.57%, 0.22%, 0.22% and of CT scan, MRI, DEXA scan, USG and biopsy was 0.04% each. Maximum ADRs were severe/serious, latent and Type-A in nature. Anemia (4.6%), followed by liver dysfunction (2.8%), renal dysfunction, electrolyte imbalance, hyperglycemia (1.1% each), abnormal coagulation profile (1%), decrease platelet count (0.8%), hypoglycemia (0.7%) were the most common BAs. Anti retroviral drugs (ART), tirofiban and methotrexate accounted for anemia, ART and anti tubercular drugs for liver & renal dysfunction, insulin for hypoglycemia, tirofiban, paclitaxel, capecipabine and ifosfamide for thrombocytopenia, hematuria by enoxaparin & dyslipidemia with ART were common ADRs. BI and DT can play very important role in ADR detection.

  16. Assessing Autism in Adults: An Evaluation of the Developmental, Dimensional and Diagnostic Interview-Adult Version (3Di-Adult).

    Science.gov (United States)

    Mandy, William; Clarke, Kiri; McKenner, Michele; Strydom, Andre; Crabtree, Jason; Lai, Meng-Chuan; Allison, Carrie; Baron-Cohen, Simon; Skuse, David

    2017-11-07

    We developed a brief, informant-report interview for assessing autism spectrum conditions (ASC) in adults, called the Developmental, Dimensional and Diagnostic Interview-Adult Version (3Di-Adult); and completed a preliminary evaluation. Informant reports were collected for participants with ASC (n = 39), a non-clinical comparison group (n = 29) and a clinical comparison group (n = 20) who had non-autistic mental health conditions. Mean administration time was 38 min (50 min for ASC). Internal consistency (αs ≥ 0.93) and inter-rater agreement (ICCs ≥ 0.99) were high. When discriminating ASC from non-ASC, the 3Di-Adult showed excellent sensitivity (95%) and specificity (92%). The 3Di-Adult shows promise as a psychometrically sound and time-efficient interview for collecting standardised informant reports for DSM-5 assessments of ASC in adults, in research and clinical practice.

  17. Extensions to decision curve analysis, a novel method for evaluating diagnostic tests, prediction models and molecular markers

    Directory of Open Access Journals (Sweden)

    Gonen Mithat

    2008-11-01

    Full Text Available Abstract Background Decision curve analysis is a novel method for evaluating diagnostic tests, prediction models and molecular markers. It combines the mathematical simplicity of accuracy measures, such as sensitivity and specificity, with the clinical applicability of decision analytic approaches. Most critically, decision curve analysis can be applied directly to a data set, and does not require the sort of external data on costs, benefits and preferences typically required by traditional decision analytic techniques. Methods In this paper we present several extensions to decision curve analysis including correction for overfit, confidence intervals, application to censored data (including competing risk and calculation of decision curves directly from predicted probabilities. All of these extensions are based on straightforward methods that have previously been described in the literature for application to analogous statistical techniques. Results Simulation studies showed that repeated 10-fold crossvalidation provided the best method for correcting a decision curve for overfit. The method for applying decision curves to censored data had little bias and coverage was excellent; for competing risk, decision curves were appropriately affected by the incidence of the competing risk and the association between the competing risk and the predictor of interest. Calculation of decision curves directly from predicted probabilities led to a smoothing of the decision curve. Conclusion Decision curve analysis can be easily extended to many of the applications common to performance measures for prediction models. Software to implement decision curve analysis is provided.

  18. Positron emission tomography-computed tomography in the diagnostic evaluation of smoldering multiple myeloma: identification of patients needing therapy.

    Science.gov (United States)

    Siontis, B; Kumar, S; Dispenzieri, A; Drake, M T; Lacy, M Q; Buadi, F; Dingli, D; Kapoor, P; Gonsalves, W; Gertz, M A; Rajkumar, S V

    2015-10-23

    We studied 188 patients with a suspected smoldering multiple myeloma (MM) who had undergone a positron emission tomography-computed tomography (PET-CT) scan as part of their clinical evaluation. PET-CT was positive (clinical radiologist interpretation of increased bone uptake and/or evidence of lytic bone destruction) in 74 patients and negative in 114 patients. Of these, 25 patients with a positive PET-CT and 97 patients with a negative PET-CT were observed without therapy and formed the study cohort (n=122). The probability of progression to MM within 2 years was 75% in patients with a positive PET-CT observed without therapy compared with 30% in patients with a negative PET-CT; median time to progression was 21 months versus 60 months, respectively, P=0.0008. Of 25 patients with a positive PET-CT, the probability of progression was 87% at 2 years in those with evidence of underlying osteolysis (n=16) and 61% in patients with abnormal PET-CT uptake but no evidence of osteolysis (n=9). Patients with positive PET-CT and evidence of underlying osteolysis have a high risk of progression to MM within 2 years when observed without therapy. These observations support recent changes to imaging requirements in the International Myeloma Working Group updated diagnostic criteria for MM.

  19. A Simple Evaluation Tool (ET-CET) Indicates Increase of Diagnostic Skills From Small Bowel Capsule Endoscopy Training Courses

    Science.gov (United States)

    Albert, J.G.; Humbla, O.; McAlindon, M.E.; Davison, C.; Seitz, U.; Fraser, C.; Hagenmüller, F.; Noetzel, E.; Spada, C.; Riccioni, M.E.; Barnert, J.; Filmann, N.; Keuchel, M.

    2015-01-01

    Abstract Small bowel capsule endoscopy (SBCE) has become a first line diagnostic tool. Several training courses with a similar format have been established in Europe; however, data on learning curve and training in SBCE remain sparse. Between 2008 and 2011, different basic SBCE training courses were organized internationally in UK (n = 2), Italy (n = 2), Germany (n = 2), Finland (n = 1), and nationally in Germany (n = 10), applying similar 8-hour curricula with 50% lectures and 50% hands-on training. The Given PillCam System was used in 12 courses, the Olympus EndoCapsule system in 5, respectively. A simple evaluation tool for capsule endoscopy training (ET-CET) was developed using 10 short SBCE videos including relevant lesions and normal or irrelevant findings. For each video, delegates were required to record a diagnosis (achievable total score from 0 to 10) and the clinical relevance (achievable total score 0 to 10). ET-CET was performed at baseline before the course and repeated, with videos in altered order, after the course. Two hundred ninety-four delegates (79.3% physicians, 16.3% nurses, 4.4% others) were included for baseline analysis, 268 completed the final evaluation. Forty percent had no previous experience in SBCE, 33% had performed 10 or less procedures. Median scores for correct diagnosis improved from 4.0 (IQR 3) to 7.0 (IQR 3) during the courses (P endoscopy may be useful before attending an SBCE course. PMID:26512623

  20. Concept of computer-assisted clinical diagnostic documentation systems for the practice with the option of later scientific evaluations.

    Science.gov (United States)

    Ahlers, M O; Jaeger, D; Jakstat, H A

    2010-01-01

    Treatment data from practices and specialization centers, especially in the increasingly specialized areas which university clinics do not cover, are very important for evaluating the effectiveness and efficiency of dental examination and treatment methods. In the case of paper-based documentation, the evaluation of these data usually fails because of the cost it entails. With the use of electronic medical records, this expense can be markedly lower, provided the data acquisition and storage is structured accordingly. Since access to sensitive person-related data is simplified considerably by this method, such health data are protected, especially on the European level. Other than generally assumed, this protection is not restricted solely to the confidentiality principle, but also comprises the power of disposition over the data (data protection). The result is that from a legal point of view, the treatment data cannot be readily used for scientific studies, not even by dentists and physicians who have collected the data legally during the course of their therapeutic work. The technical separation of treatment data from the personal data offers a legally acceptable solution to this problem. It must ensure that a later assignment to individual persons will not be feasible at a realistic expense ("effective anonymization"). This article describes the legal and information technology principles and their practical implementation, as illustrated by the concept of a respective compliant IT architecture for the dentaConcept CMD fact diagnostic software. Here, a special export function automatically separates the anonymized treatment data and thus facilitates multicentric studies within an institution and among dental practices.

  1. Evaluation of the diagnostic accuracy of ultra-miniaturized pocket ultrasound device on cardiac function in critically ill patients

    Directory of Open Access Journals (Sweden)

    Li WANG

    2016-09-01

    Full Text Available Objective  To compare the diagnostic accuracy of a new ultra-miniaturized pocket ultrasound device (PUD (VscanTM, GE Healthcare, Wauwatosa, WI and conventional high-quality echocardiography system (Vivid qTM, GE Healthcare for a cardiac focused ultrasonography in critical patients. Methods  The patients admitted to our hospital and receiving transthoracic echocardiography (TTE using a PUD and a conventional echocardiography system were included in this study during the 10 months from December 2013 to October 2014. Each examination was performed independently by an intensive care unit (ICU physician and an experienced ultrasound doctor, unaware of the results found by the alternative device. The following parameters were assessed: global cardiac systolic function, identification of ventricular size, whether or not accompanying enlargement or hypertrophy, assessment for the morphology of cardiac valves and its function, pericardial effusion and estimation of the inferior vena cava (IVC diameter. The time-consuming of each device were recorded. Results  One hundred and twenty-eight patients were included in the study. Their left ventricular wall motion abnormalities, global left ventricular systolic dysfunction, pericardial effusion, IVC dilation were assessed by PUD and the assessment results were highly consistent with those by Vivid q (κ>0.84. The consistency was slightly lower in evaluating the left and right ventricular size. For evaluating the cardiac valves function, the agreement of two devices were relatively low (κ=0.69-0.84. Compared with Vivid q, PUD took less time (4.7±1.4min vs 6.3±2.6min; P<0.05. Conclusion  PUD can provide fast, reliable cardiac examination, thus being an effective method for ICU physicians to assess the cardiac f unction in critical patients. DOI: 10.11855/j.issn.0577-7402.2016.08.10

  2. Multicountry Prospective Clinical Evaluation of Two Enzyme-Linked Immunosorbent Assays and Two Rapid Diagnostic Tests for Diagnosing Dengue Fever

    Science.gov (United States)

    Dauner, Allison L.; Valks, Andrea; Forshey, Brett M.; Long, Kanya C.; Thaisomboonsuk, Butsaya; Sierra, Gloria; Picos, Victor; Talmage, Sara; Morrison, Amy C.; Halsey, Eric S.; Comach, Guillermo; Yasuda, Chadwick; Loeffelholz, Michael; Jarman, Richard G.; Fernandez, Stefan; An, Ung Sam; Kochel, Tadeusz J.; Jasper, Louis E.; Wu, Shuenn-Jue L.

    2015-01-01

    We evaluated four dengue diagnostic devices from Alere, including the SD Bioline Dengue Duo (nonstructural [NS] 1 Ag and IgG/IgM), the Panbio Dengue Duo Cassette (IgM/IgG) rapid diagnostic tests (RDTs), and the Panbio dengue IgM and IgG capture enzyme-linked immunosorbent assays (ELISAs) in a prospective, controlled, multicenter study in Peru, Venezuela, Cambodia, and the United States, using samples from 1,021 febrile individuals. Archived, well-characterized samples from an additional 135 febrile individuals from Thailand were also used. Reference testing was performed on all samples using an algorithm involving virus isolation, in-house IgM and IgG capture ELISAs, and plaque reduction neutralization tests (PRNT) to determine the infection status of the individual. The primary endpoints were the clinical sensitivities and specificities of these devices. The SD Bioline Dengue Duo had an overall sensitivity of 87.3% (95% confidence interval [CI], 84.1 to 90.2%) and specificity of 86.8% (95% CI, 83.9 to 89.3%) during the first 14 days post-symptom onset (p.s.o.). The Panbio Dengue Duo Cassette demonstrated a sensitivity of 92.1% (87.8 to 95.2%) and specificity of 62.2% (54.5 to 69.5%) during days 4 to 14 p.s.o. The Panbio IgM capture ELISA had a sensitivity of 87.6% (82.7 to 91.4%) and specificity of 88.1% (82.2 to 92.6%) during days 4 to 14 p.s.o. Finally, the Panbio IgG capture ELISA had a sensitivity of 69.6% (62.1 to 76.4%) and a specificity of 88.4% (82.6 to 92.8%) during days 4 to 14 p.s.o. for identification of secondary dengue infections. This multicountry prospective study resulted in reliable real-world performance data that will facilitate data-driven laboratory test choices for managing patient care during dengue outbreaks. PMID:25588659

  3. Multicountry prospective clinical evaluation of two enzyme-linked immunosorbent assays and two rapid diagnostic tests for diagnosing dengue fever.

    Science.gov (United States)

    Pal, Subhamoy; Dauner, Allison L; Valks, Andrea; Forshey, Brett M; Long, Kanya C; Thaisomboonsuk, Butsaya; Sierra, Gloria; Picos, Victor; Talmage, Sara; Morrison, Amy C; Halsey, Eric S; Comach, Guillermo; Yasuda, Chadwick; Loeffelholz, Michael; Jarman, Richard G; Fernandez, Stefan; An, Ung Sam; Kochel, Tadeusz J; Jasper, Louis E; Wu, Shuenn-Jue L

    2015-04-01

    We evaluated four dengue diagnostic devices from Alere, including the SD Bioline Dengue Duo (nonstructural [NS] 1 Ag and IgG/IgM), the Panbio Dengue Duo Cassette (IgM/IgG) rapid diagnostic tests (RDTs), and the Panbio dengue IgM and IgG capture enzyme-linked immunosorbent assays (ELISAs) in a prospective, controlled, multicenter study in Peru, Venezuela, Cambodia, and the United States, using samples from 1,021 febrile individuals. Archived, well-characterized samples from an additional 135 febrile individuals from Thailand were also used. Reference testing was performed on all samples using an algorithm involving virus isolation, in-house IgM and IgG capture ELISAs, and plaque reduction neutralization tests (PRNT) to determine the infection status of the individual. The primary endpoints were the clinical sensitivities and specificities of these devices. The SD Bioline Dengue Duo had an overall sensitivity of 87.3% (95% confidence interval [CI], 84.1 to 90.2%) and specificity of 86.8% (95% CI, 83.9 to 89.3%) during the first 14 days post-symptom onset (p.s.o.). The Panbio Dengue Duo Cassette demonstrated a sensitivity of 92.1% (87.8 to 95.2%) and specificity of 62.2% (54.5 to 69.5%) during days 4 to 14 p.s.o. The Panbio IgM capture ELISA had a sensitivity of 87.6% (82.7 to 91.4%) and specificity of 88.1% (82.2 to 92.6%) during days 4 to 14 p.s.o. Finally, the Panbio IgG capture ELISA had a sensitivity of 69.6% (62.1 to 76.4%) and a specificity of 88.4% (82.6 to 92.8%) during days 4 to 14 p.s.o. for identification of secondary dengue infections. This multicountry prospective study resulted in reliable real-world performance data that will facilitate data-driven laboratory test choices for managing patient care during dengue outbreaks. Copyright © 2015, American Society for Microbiology. All Rights Reserved.

  4. Thyroid diagnostics

    Energy Technology Data Exchange (ETDEWEB)

    Scriba, P.C.; Boerner, W.; Emrich, S.; Gutekunst, R.; Herrmann, J.; Horn, K.; Klett, M.; Krueskemper, H.L.; Pfannenstiel, P.; Pickardt, C.R.

    1985-03-01

    None of the in-vitro and in-vivo methods listed permits on unambiguous diagnosis when applied alone, owing to the fact that similar or even identical findings are obtained for various individual parameters in different thyroid diseases. Further, especially the in-vitro tests are also subject to extrathyroidal effects which may mask the typical findings. The limited and varying specificity and sensitivity of the tests applied, as well as the falsification of results caused by the patients' idiosyncracies and the methodology, make it necessary to interpret and evaluate the in-vivo and in-vitro findings only if the clinical situation (anamnesis and physical examination) is known. For maximum diagnostic quality of the tests, the initial probability of the assumed type of thyroid disease must be increased (formulation of the clinical problem). The concepts of exclusion diagnosis and identification must be distinguished as well as the diagnosis of functional disturbances on the one hand and of thyroid diseases on the other. Both of this requires a qualified, specific and detailed anamnesis and examination procedure, and the clinical examination remains the obligatory basis of clinical diagnostics. In case of inexplicable discrepancies between the clinical manifestations and the findings obtained with specific methods, or between the findings obtained with a specific method, the patient should be referred to an expert institution, or the expert institution should be consulted.

  5. An evaluation of the diagnostic efficacy of fine needle aspiration biopsy in patients operated for a thyroid nodular goiter

    Directory of Open Access Journals (Sweden)

    Janczak D

    2016-09-01

    FNA biopsies that are performed have been improved, especially due to the wide adoption of the Bethesda cytological evaluation system. FNA biopsy remains an obligatory and valuable diagnostic tool in thyroid nodules, but it is still insufficient as a standard procedure. A preoperative biopsy should always be related to all the available clinical data in order to provide the best treatment option for each patient individually. Keywords: thyroid cancer, fine needle aspiration biopsy, goiter, The Bethesda System for Reporting Thyroid Cytopathology (TBSRTC

  6. Knowledge-based iterative model reconstruction (IMR) algorithm in ultralow-dose CT for evaluation of urolithiasis: evaluation of radiation dose reduction, image quality, and diagnostic performance.

    Science.gov (United States)

    Park, Sung Bin; Kim, Yang Soo; Lee, Jong Beum; Park, Hyun Jeong

    2015-10-01

    To evaluate the efficacy of a knowledge-based iterative model reconstruction (IMR) algorithm for reducing image noise in ultralow-dose (ULD) CT for urolithiasis. A total of 103 patients diagnosed with urinary stones (n = 276) were enrolled. Regular dose (RD) scans (120 kV and 150 mAs, maximal tube current in dose modulation) were reconstructed using filtered back-projection (FBP, RD-FBP), and ULD scans (100 kV and 20 mAs, fixed tube current) were reconstructed with FBP (ULD-FBP), statistical iterative reconstruction (IR; ULD-iDose), and a knowledge-based IMR algorithm (ULD-IMR). Prospective interpretations of the two scans were performed with respect to radiation dose, objective image noise, and subjective assessment. The subjective assessment was also evaluated with regard to each patient's body mass index (BMI, < 25 or ≥ 25 kg/m(2)). Using RD CT (RD-FBP) as the reference standard, two reviewers assessed the diagnostic performance and inter-observer agreement for ULD-IMR. The average effective doses with RD CT and ULD CT were 8.31 and 0.68 mSv, respectively, and the average radiation dose reduction rate was 91.82% (p < 0.01). The lowest objective image noise was observed with ULD-IMR (p < 0.01). Subjective assessment in ULD-IMR was comparable to that of RD-FBP, although RD-FBP remained statistically superior. For BMI, there was a statistically significant difference in subjective image quality between the normal (4.7 ± 0.54) and overweight or obese groups (4.2 ± 0.5) (p < 0.05). The ULD-IMR showed a greater than 75% concordant rate in overall stones and 100% in ureter stones larger than 3 mm. However, for stones <3 mm, neither reviewer had a good detection rate (45.5% and 56.9% for the general and genitourinary radiologist, respectively). Inter-observer agreement was almost perfect (κ = 0.82). Despite a significant radiation dose reduction, ULD-IMR images were comparable in image quality and noise to RD-FBP images. Furthermore, the diagnostic performance of

  7. Quantification of video-taped images in microcirculation research using inexpensive imaging software (Adobe Photoshop).

    Science.gov (United States)

    Brunner, J; Krummenauer, F; Lehr, H A

    2000-04-01

    Study end-points in microcirculation research are usually video-taped images rather than numeric computer print-outs. Analysis of these video-taped images for the quantification of microcirculatory parameters usually requires computer-based image analysis systems. Most software programs for image analysis are custom-made, expensive, and limited in their applicability to selected parameters and study end-points. We demonstrate herein that an inexpensive, commercially available computer software (Adobe Photoshop), run on a Macintosh G3 computer with inbuilt graphic capture board provides versatile, easy to use tools for the quantification of digitized video images. Using images obtained by intravital fluorescence microscopy from the pre- and postischemic muscle microcirculation in the skinfold chamber model in hamsters, Photoshop allows simple and rapid quantification (i) of microvessel diameters, (ii) of the functional capillary density and (iii) of postischemic leakage of FITC-labeled high molecular weight dextran from postcapillary venules. We present evidence of the technical accuracy of the software tools and of a high degree of interobserver reliability. Inexpensive commercially available imaging programs (i.e., Adobe Photoshop) provide versatile tools for image analysis with a wide range of potential applications in microcirculation research.

  8. Evaluation of diagnostic utility of step sections in dermatopathology: A prospective study of 200 consecutive punch biopsies

    Directory of Open Access Journals (Sweden)

    Prashant Jerath

    2016-01-01

    Full Text Available Background: Obtaining deeper sections or step sections is a common practice for small skin biopsies. Much of the available literature highlights the importance of step sections in neoplastic diseases of skin. However, the routine dermatopathology practice in developing countries shows a predominant burden of nonneoplastic diseases, and the utility of step sections in this context has not been much reported. Objective: The study was aimed to evaluate the utility of prospective step sections in routine dermatopathology practice. Materials and Methods: The present study comprising 200 consecutive skin biopsies was carried out in a prospective manner. Three slides were prepared in each case: Slide 0 was prepared from the ribbon of tissue obtained from untrimmed block, step sections 1 and 2 were obtained at 50 μm and 100 μm depth, respectively. The diagnosis was rendered on slide 0 and subsequently reviewed after examining step section 1 and 2. Results: Of the 200 cases, additional findings on step sections were found in 18 cases (9% which led to change in diagnosis in 10 (5% cases. Step section 1 led to correct diagnosis in 6 cases (3%. Step section 2 led to correct diagnosis in 10 cases (5%; however, this was statistically not significant (P ≥ 0.065 when comparing to step section 1. Additional findings which led to diagnosis was most commonly found in the cases of borderline tuberculoid leprosy (5 out of 10 cases followed by bullous disorders. Conclusion: We therefore believe that step sections improve the diagnostic accuracy in skin biopsies and they are, especially useful in suspected cases of Hansen's disease. There is no statistical advantage of step section 2 versus step section 1; although, step section 2 had shown to include all the additional findings which led to a change in diagnosis.

  9. Toward noninvasive microspectrofluorometry of skin lesions for diagnostic and prognostic evaluation of cell metabolism and organelle interactions

    Science.gov (United States)

    Hirschberg, Joseph G.; Schachtschabel, Astrid; Kohen, Elli; Kohen, Cahide; Schachtschabel, Dietrich O.

    1995-02-01

    studies with the new highly sensitive cyanine nucleic acid dyes and their dimers, but caution should be exerted in the use of such compounds because of cytotoxicity (e.g., limiting it to cellular studies used in the interpretation of dermatological findings). Parallel cellular and non-invasive dermatological studies will help to define the most specific set of parameters to be used in diagnostic and prognostic evaluations of skin lesions.

  10. Nonphysician Care Providers Can Help to Increase Detection of Cognitive Impairment and Encourage Diagnostic Evaluation for Dementia in Community and Residential Care Settings.

    Science.gov (United States)

    Maslow, Katie; Fortinsky, Richard H

    2018-01-18

    In the United States, at least half of older adults living with dementia do not have a diagnosis. Their cognitive impairment may not have been detected, and some older adults whose physician recommends that they obtain a diagnostic evaluation do not follow through on the recommendation. Initiatives to increase detection of cognitive impairment and diagnosis of dementia have focused primarily on physician practices and public information programs to raise awareness about the importance of detection and diagnosis. Nonphysician care providers who work with older adults in community and residential care settings, such as aging network agencies, public health agencies, senior housing, assisted living, and nursing homes, interact frequently with older adults who have cognitive impairment but have not had a diagnostic evaluation. These care providers may be aware of signs of cognitive impairment and older adults' concerns about their cognition that have not been expressed to their physician. Within their scope of practice and training, nonphysician care providers can help to increase detection of cognitive impairment and encourage older adults with cognitive impairment to obtain a diagnostic evaluation to determine the cause of the condition. This article provides seven practice recommendations intended to increase involvement of nonphysician care providers in detecting cognitive impairment and encouraging older adults to obtain a diagnostic evaluation. The Kickstart-Assess-Evaluate-Refer (KAER) framework for physician practice in detection and diagnosis of dementia is used to identify ways to coordinate physician and nonphysician efforts and thereby increase the proportion of older adults living with dementia who have a diagnosis. © The Author(s) 2018. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  11. Differentiating between analytical and diagnostic performance evaluation with a focus on the method comparison study and identification of bias.

    Science.gov (United States)

    Flatland, Bente; Friedrichs, Kristen R; Klenner, Stefanie

    2014-12-01

    Prior to introduction of a new method to the diagnostic laboratory, analytical performance must be validated to ensure operation within the manufacturer's specifications and/or within predetermined quality requirements. In addition, the new method may require diagnostic performance assessment to ensure it differentiates between diseased and nondiseased individuals as intended. These 2 phases of assessment, while complementary, are not equivalent and require a different set of experiments, statistical analyses, and interpretation. Studies of analytical performance typically include a method comparison experiment, the purpose of which is to identify bias (inaccuracy) of the "test" (or "index") method (new method) relative to a "comparative method" (established method). Analysis of method comparison data is facilitated by commercial software programs that present the statistical significance of identified bias; however, the clinical relevance of any bias also should be considered. Studies of diagnostic performance should not be pursued until analytical performance is fully characterized and may not be required for well-established tests or for those for which results are nonspecific (ie, not referable to a specific disease or condition). Diagnostic performance assessment may include assessment of sensitivity, specificity, predictive values, odds ratios, and/or likelihood ratios. The purpose of this review is to clarify differences between the assessment of analytical and diagnostic performance, and to explore the method comparison study and bias assessment from a perspective not addressed in prior veterinary articles. © 2014 American Society for Veterinary Clinical Pathology.

  12. Magnetic resonance imaging for diagnostic evaluation of hernia of an invertebral disk. Optimisation of imaging parameters by application of various magnetic field intensities

    Energy Technology Data Exchange (ETDEWEB)

    Beyer, H.K.; Oppel, G.; Bluemm, R.; Uhlenbrock, D.

    1988-02-01

    The article reports experience gained within three years with diagnostic NMR imaging of the lumbar spine. On the basis of results obtained by almost 500 examinations, an optimisation concept with regard to measuring sequences and orientation of sectional cuts is presented. Imaging of the spine in three planes, with sectional layer thickness between 3 and 5 mm, using a 1.5 Tesla system, seems to yield the diagnostic optimum, and in our opinion is superior over invasive myelography and CT scanning. A prospective study we made indicates a hit rate of 97.2%, and of 100% for evaluation of the results obtained with the 1.5 Tesla system together with an evaluation of the paraxial sections. The magnetic field intensity of 1.5 Tesla especially improves the quality of images of paraxial cuts as compared with the 0.5 Tesla field system, due to the better contrast-to-noise ratio, and thinner sections.

  13. Patients, doctors, and videotape: a prescription for creating optimal healing environments?

    Science.gov (United States)

    Frankel, Richard M; Sung, Sue Hee; Hsu, John T

    2005-01-01

    Despite repeated calls for greater patient autonomy, shared decision making, and exploration of patient preferences, relatively little is known about how patients actually experience care as a face-to-face interactional process. A selected review of the literature in this area suggests that important asymmetries exist. Key among them is the tendency to report experiences from the point of view of only one member of the doctor-patient dyad. Thus, patients might report on their experiences of the system gone awry or professionals might attempt to understand the root cause(s) of an error by describing the conditions under which it occurred. Either way, information about the experience of care tends to be reported as a "my side" telling. Optimal healing environments are defined as health care contexts that are based upon mutual respect and build positive, resilient relationships among participants, using the qualities and resources of those relationships to enhance health. Understanding optimal healing environments also requires a knowledge of how doctors and patients share time and space together in the consultation (an etic or outsider perspective) and also a knowledge of the participants' experience of their time together (an emic or insider perspective). After reviewing its methodological roots, the IMPACT approach (Interactive Methodology for Preserving and Analyzing Clinical Transactions) using videotaped encounters along with independent commentaries by participants is described and applied in two different types of analyses: one in which the doctor-patient dyad is the unit of measure; the second in which physicians are stratified by having historically high or low satisfaction scores. In the latter approach, doctors' and patients' comments are compared across strata. At the dyadic level, and despite large gaps in income and social status, doctors and patients exhibit a strong tendency to cluster in terms of where they comment, so much so that in a pilot study

  14. Evaluation of diagnostic accuracy of conventional and digital periapical radiography, panoramic radiography, and cone-beam computed tomography in the assessment of alveolar bone loss

    OpenAIRE

    Wilton Mitsunari Takeshita; Lilian Cristina Vessoni Iwaki; Mariliani Chicarelli Da Silva; Renata Hernandes Tonin

    2014-01-01

    Background: To evaluate the diagnostic accuracy of different radiographic methods in the assessment of proximal alveolar bone loss (ABL). Materials and Methods: ABL, the distance between cement-enamel junction and alveolar bone crest, was measured in 70 mandibular human teeth - directly on the mandibles (control), using conventional periapical radiography with film holders (Rinn XCP and Han-Shin), digital periapical radiography with complementary metal-oxide semiconductor sensor, conventional...

  15. Evaluation of a research diagnostic algorithm for DSM-5 neurocognitive disorders in a population-based cohort of older adults.

    Science.gov (United States)

    Eramudugolla, Ranmalee; Mortby, Moyra E; Sachdev, Perminder; Meslin, Chantal; Kumar, Rajeev; Anstey, Kaarin J

    2017-03-04

    There is little information on the application and impact of revised criteria for diagnosing dementia and mild cognitive impairment (MCI), now termed major and mild neurocognitive disorders (NCDs) in the DSM-5. We evaluate a psychometric algorithm for diagnosing DSM-5 NCDs in a community-dwelling sample, and characterize the neuropsychological and functional profile of expert-diagnosed DSM-5 NCDs relative to DSM-IV dementia and International Working Group criteria for MCI. A population-based sample of 1644 adults aged 72-78 years was assessed. Algorithmic diagnostic criteria used detailed neuropsychological data, medical history, longitudinal cognitive performance, and informant interview. Those meeting all criteria for at least one diagnosis had data reviewed by a neurologist (expert diagnosis) who achieved consensus with a psychiatrist for complex cases. The algorithm accurately classified DSM-5 major NCD (area under the curve (AUC) = 0.95, 95% confidence interval (CI) 0.92-0.97), DSM-IV dementia (AUC = 0.91, 95% CI 0.85-0.97), DSM-5 mild NCD (AUC = 0.75, 95% CI 0.70-0.80), and MCI (AUC = 0.76, 95% CI 0.72-0.81) when compared to expert diagnosis. Expert diagnosis of dementia using DSM-5 criteria overlapped with 90% of DSM-IV dementia cases, but resulted in a 127% increase in diagnosis relative to DSM-IV. Additional cases had less severe memory, language impairment, and instrumental activities of daily living (IADL) impairments compared to cases meeting DSM-IV criteria for dementia. DSM-5 mild NCD overlapped with 83% of MCI cases and resulted in a 19% increase in diagnosis. These additional cases had a subtly different neurocognitive profile to MCI cases, including poorer social cognition. DSM-5 NCD criteria can be operationalized in a psychometric algorithm in a population setting. Expert diagnosis using DSM-5 NCD criteria captured most cases with DSM-IV dementia and MCI in our sample, but included many additional cases suggesting that DSM-5

  16. Effect of MRI on preterm infants and their families: a randomised trial with nested diagnostic and economic evaluation.

    Science.gov (United States)

    Edwards, A David; Redshaw, Maggie E; Kennea, Nigel; Rivero-Arias, Oliver; Gonzales-Cinca, Nuria; Nongena, Phumza; Ederies, Moegamad; Falconer, Shona; Chew, Andrew; Omar, Omar; Hardy, Pollyanna; Harvey, Merryl Elizabeth; Eddama, Oya; Hayward, Naomi; Wurie, Julia; Azzopardi, Denis; Rutherford, Mary A; Counsell, Serena

    2018-01-01

    We tested the hypothesis that routine MRI would improve the care and well-being of preterm infants and their families. Parallel-group randomised trial (1.1 allocation; intention-to-treat) with nested diagnostic and cost evaluations (EudraCT 2009-011602-42). Participants from 14 London hospitals, imaged at a single centre. 511 infants born before 33 weeks gestation underwent both MRI and ultrasound around term. 255 were randomly allocated (siblings together) to receive only MRI results and 255 only ultrasound from a paediatrician unaware of unallocated results; one withdrew before allocation. Maternal anxiety, measured by the State-Trait Anxiety inventory (STAI) assessed in 206/214 mothers receiving MRI and 217/220 receiving ultrasound. Secondary outcomes included: prediction of neurodevelopment, health-related costs and quality of life. After MRI, STAI fell from 36.81 (95% CI 35.18 to 38.44) to 32.77 (95% CI 31.54 to 34.01), 31.87 (95% CI 30.63 to 33.12) and 31.82 (95% CI 30.65 to 33.00) at 14 days, 12 and 20 months, respectively. STAI fell less after ultrasound: from 37.59 (95% CI 36.00 to 39.18) to 33.97 (95% CI 32.78 to 35.17), 33.43 (95% CI 32.22 to 34.63) and 33.63 (95% CI 32.49 to 34.77), p=0.02. There were no differences in health-related quality of life. MRI predicted moderate or severe functional motor impairment at 20 months slightly better than ultrasound (area under the receiver operator characteristic curve (CI) 0.74; 0.66 to 0.83 vs 0.64; 0.56 to 0.72, p=0.01) but cost £315 (CI £295-£336) more per infant. MRI increased costs and provided only modest benefits. ClinicalTrials.gov NCT01049594 https://clinicaltrials.gov/ct2/show/NCT01049594. EudraCT: EudraCT: 2009-011602-42 (https://www.clinicaltrialsregister.eu/). © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  17. Evaluation of Anthelmintic Resistance and Exhaust Air Dust PCR as a Diagnostic Tool in Mice Enzootically Infected with Aspiculuris tetraptera.

    Science.gov (United States)

    Kapoor, Pratibha; Hayes, Yumiko O; Jarrell, Leslie T; Bellinger, Dwight A; Thomas, Rhiannon D; Lawson, Gregory W; Arkema, Jaclyn D; Fletcher, Craig A; Nielsen, Judith N

    2017-05-01

    The entry of infectious agents in rodent colonies occurs despite robust sentinel monitoring programs, strict quarantine measures, and stringent biosecurity practices. In light of several outbreaks with Aspiculuris tetraptera in our facilities, we investigated the presence of anthelmintic resistance and the use of exhaust air dust (EAD) PCR for early detection of A. tetraptera infection. To determine anthelmintic resistance, C57BL/6, DBA/2, and NCr nude mice were experimentally inoculated with embryonated A. tetraptera ova harvested from enzootically infected mice, followed by treatment with 150 ppm fenbendazole in feed, 150 ppm fenbendazole plus 5 ppm piperazine in feed, or 2.1 mg/mL piperazine in water for 4 or 8 wk. Regardless of the mouse strain or treatment, no A. tetraptera were recovered at necropsy, indicating the lack of resistance in the worms to anthelmintic treatment. In addition, 10 of 12 DBA/2 positive-control mice cleared the A. tetraptera infection without treatment. To evaluate the feasibility of EAD PCR for A. tetraptera, 69 cages of breeder mice enzootically infected with A. tetraptera were housed on a Tecniplast IVC rack as a field study. On day 0, 56% to 58% of the cages on this rack tested positive for A. tetraptera by PCR and fecal centrifugation flotation (FCF). PCR from EAD swabs became positive for A. tetraptera DNA within 1 wk of placing the above cages on the rack. When these mice were treated with 150 ppm fenbendazole in feed, EAD PCR reverted to pinworm-negative after 1 mo of treatment and remained negative for an additional 8 wk. The ability of EAD PCR to detect few A. tetraptera positive mice was investigated by housing only 6 infected mice on another IVC rack as a field study. The EAD PCR from this rack was positive for A. tetraptera DNA within 1 wk of placing the positive mice on it. These findings demonstrate that fenbendazole is still an effective anthelmintic and that EAD PCR is a rapid, noninvasive assay that may be a useful

  18. Evaluating Diagnostic and Prognostic Value of Plasma miRNA133a in Acute Chest Pain Patients Undergoing Coronary Angiography.

    Science.gov (United States)

    Ke-Gang, Jia; Zhi-Wei, Li; Xin, Zhang; Jing, Wang; Ping, Shi; Xue-Jing, Han; Hong-Xia, Tang; Xin, Tang; Xiao-Cheng, Liu

    2016-04-01

    Circulating microRNA has recently emerged as a promising biomarker for cardiovascular disease. This study sought to evaluate the diagnostic and prognostic value of circulating miR-133a as a marker of acute myocardial infarction in acute chest pain patients undergoing coronary angiography.Plasma was collected from 312 patients with chest pain on admission in the emergency department and 67 healthy controls. MiR-133a was detected using real-time quantitative PCR and enhanced accu-TnI, creatinine kinase-MB mass, and myoglobin were measured by immunoassay. End-point events (serious adverse cardiovascular events which require hospitalization or cardiovascular death) were examined in the AMI (acute myocardical infarction) group within 1, 6, 12, and 24 months.The miR-133a level was higher in AMI patients than in non-AMI patients (P < 0.001). In the ROC analysis, the sensitivity of miR-133a in diagnosis of AMI is 0.61 and the specificity is 0.68. In the prognostic analysis, only 1 endpoint event was observed in the non-AMI group; the amount of cases with end-point events in the AMI group at 1,6,12, and 24 months were 8, 19, 28, and 35, respectively. The cutoff value of miR-133a was determined using the median value of the AMI group and separated the patients into a positive group and a negative group. The Kaplan-Meier survival curve showed no significant difference in survival was detected in AMI patients between the miR-133a positive group and negative group after follow-up (12-month: x2 = 1.353, P = 0.245; 24-month: x2 = 3.722, P = 0.054). After adjusting for age, gender, Killip classes, prior myocardiac infarction history, myoglobin, LVEF (left ventricular ejection fraction), diabetes, hypertension, smoking and systolic blood pressure, miR133a had a significant association with the risk of events at 12 months (HR = 2.869, P = 0.024) and 24 months (HR = 3.936, P = 0.001).In patients undergoing coronary angiography, circulating miR-133a

  19. Gathering the Dreamers: The Transformation Process to a Learner-Centered School. The Reinventing School Series. Part Two and Viewing Guide. Videotape.

    Science.gov (United States)

    Burrello, Leonard C.; DiLaura, Nancy

    This videotape and viewing guide present an emerging learner-centered paradigm of teaching and learning and answer questions of why and how a staff changes its practices. The viewing guide describes the elementary school in the videotape, noting the full inclusion of 50 students identified as disabled, the team approach in which teachers are…

  20. More Than Just Accuracy: A Novel Method to Incorporate Multiple Test Attributes in Evaluating Diagnostic Tests Including Point of Care Tests.

    Science.gov (United States)

    Thompson, Matthew; Weigl, Bernhard; Fitzpatrick, Annette; Ide, Nicole

    2016-01-01

    Current frameworks for evaluating diagnostic tests are constrained by a focus on diagnostic accuracy, and assume that all aspects of the testing process and test attributes are discrete and equally important. Determining the balance between the benefits and harms associated with new or existing tests has been overlooked. Yet, this is critically important information for stakeholders involved in developing, testing, and implementing tests. This is particularly important for point of care tests (POCTs) where tradeoffs exist between numerous aspects of the testing process and test attributes. We developed a new model that multiple stakeholders (e.g., clinicians, patients, researchers, test developers, industry, regulators, and health care funders) can use to visualize the multiple attributes of tests, the interactions that occur between these attributes, and their impacts on health outcomes. We use multiple examples to illustrate interactions between test attributes (test availability, test experience, and test results) and outcomes, including several POCTs. The model could be used to prioritize research and development efforts, and inform regulatory submissions for new diagnostics. It could potentially provide a way to incorporate the relative weights that various subgroups or clinical settings might place on different test attributes. Our model provides a novel way that multiple stakeholders can use to visualize test attributes, their interactions, and impacts on individual and population outcomes. We anticipate that this will facilitate more informed decision making around diagnostic tests.

  1. Diagnostic tests for Helicobacter pylori : A prospective evaluation of their accuracy, without selecting a single test as the gold standard

    NARCIS (Netherlands)

    Thijs, J C; van Zwet, A A; Thijs, W J; Oey, H B; Karrenbeld, A; Stellaard, F; Luijt, D S; Meyer, B C; Kleibeuker, J H

    1996-01-01

    OBJECTIVE: To assess the accuracy of six commonly used diagnostic tests for Helicobacter pylori in a prospective study without using any specific test as the gold standard (the patient was regarded as H. pylori-infected if two or more tests, whatever their nature, were positive). METHODS: In 105

  2. The Application and Evaluation of a Two-Concept Diagnostic Instrument with Students Entering College General Chemistry

    Science.gov (United States)

    Heredia, Keily; Xu, Xiaoying; Lewis, Jennifer E.

    2012-01-01

    The Particulate Nature of Matter and Chemical Bonding Diagnostic Instrument (Othman J., Treagust D. F. and Chandrasegaran A. L., (2008), "Int. J. Sci. Educ.," 30(11), 1531-1550) is used to investigate college students' understanding of two chemistry concepts: particulate nature of matter and chemical bonding. The instrument, originally…

  3. Overview and Recommendations for Medical Screening and Diagnostic Evaluation of Postdeployment Lung Disease in Returning US Warfighters

    Science.gov (United States)

    2012-06-01

    emphysema , chronic obstructive pulmonary disease , bronchiolitis, new interstitial lung disease , AEP (as is already being done at Landstuhl Regional...nonspecific, and disease is difficult to distinguish from more common obstruc- tive lung diseases such as chronic asthma and emphysema . Constric- tive...lung diseases and for a standardized diagnostic approach for all symptomatic deployed personnel. Deployment, Pulmonary disease , Health

  4. Comparison of the diagnostic value of pump and gravity cavernosometry in the evaluation of the cavernous veno-occlusive mechanism

    NARCIS (Netherlands)

    Meuleman, E. J.; Wijkstra, H.; Doesburg, W. H.; Debruyne, F. M.

    1991-01-01

    We performed cavernosometry in 96 patients with erectile dysfunction. Two different techniques were compared: pump cavernosometry using a roller pump as the inflow source and gravity cavernosometry using an infusion set as the inflow source. We conclude that the diagnostic value of both techniques

  5. Crosstown: A Fox Family Channel Afternoon Special for Cable in the Classroom. [Videotape with] Guide for Educators.

    Science.gov (United States)

    2000

    "Crosstown," the television program featured in this videotape and teaching guide, depicts a teenager who is forced, due to her father's lack of child support payments, to leave her comfortable home four years after her parents' divorce and to move across town to an apartment in an inner city neighborhood. The teenager decides not to be…

  6. Evidence synthesis to inform model-based cost-effectiveness evaluations of diagnostic tests: a methodological review of health technology assessments

    Directory of Open Access Journals (Sweden)

    Bethany Shinkins

    2017-04-01

    Full Text Available Abstract Background Evaluations of diagnostic tests are challenging because of the indirect nature of their impact on patient outcomes. Model-based health economic evaluations of tests allow different types of evidence from various sources to be incorporated and enable cost-effectiveness estimates to be made beyond the duration of available study data. To parameterize a health-economic model fully, all the ways a test impacts on patient health must be quantified, including but not limited to diagnostic test accuracy. Methods We assessed all UK NIHR HTA reports published May 2009-July 2015. Reports were included if they evaluated a diagnostic test, included a model-based health economic evaluation and included a systematic review and meta-analysis of test accuracy. From each eligible report we extracted information on the following topics: 1 what evidence aside from test accuracy was searched for and synthesised, 2 which methods were used to synthesise test accuracy evidence and how did the results inform the economic model, 3 how/whether threshold effects were explored, 4 how the potential dependency between multiple tests in a pathway was accounted for, and 5 for evaluations of tests targeted at the primary care setting, how evidence from differing healthcare settings was incorporated. Results The bivariate or HSROC model was implemented in 20/22 reports that met all inclusion criteria. Test accuracy data for health economic modelling was obtained from meta-analyses completely in four reports, partially in fourteen reports and not at all in four reports. Only 2/7 reports that used a quantitative test gave clear threshold recommendations. All 22 reports explored the effect of uncertainty in accuracy parameters but most of those that used multiple tests did not allow for dependence between test results. 7/22 tests were potentially suitable for primary care but the majority found limited evidence on test accuracy in primary care settings

  7. Use of videotape to assess mobility in a controlled randomized crossover trial of physiotherapy in chronic multiple sclerosis.

    Science.gov (United States)

    Wiles, C M; Newcombe, R G; Fuller, K J; Jones, A; Price, M

    2003-05-01

    To determine to what degree assessment of mobility based on comparison of videotape recordings before and after courses of physiotherapy in patients with chronic multiple sclerosis (MS) is reliable, correlates with 'live' assessments and indicates benefit. Prospective data collection within a randomized crossover controlled trial of physiotherapy at home, as an outpatient, or 'no therapy' in 40 patients. Hospital outpatients: outpatient and home physiotherapy. Mobility change based on a comparison of short video recordings before and after each treatment period was scored independently by two physiotherapists blinded to therapy type and other measures of outcome. Scores were compared with changes in the Rivermead Mobility Index (RMI) and other indices assessed by a physiotherapist in the patient's home. The two video observers agreed substantially on patient outcome. Changes in walking based on video correlated with RMI for home treatment (r = 0.41, p = 0.008) but not for hospital or no treatment periods (r = 0.14 and 0.15): video changes correlated with the 'live' assessor's global change score inconsistently ('no therapy' r = 0.48, p = 0.002, hospital r = 0.30, p = 0.06 and home r = 0.17, p = 0.30 treatment periods). Based on video data alone, improved mobility was evident following home therapy for only one observer but not for the other or the averaged scores of both. There was substantial agreement between two observers deciding on change in mobility based on independent blinded evaluation of short video sequences. However the correlations of these with 'live' assessments were variable. Physiotherapy had a less clear benefit on mobility based on video analysis alone compared with 'live' assessments. The study highlights the need for more objective measures of habitual mobility over longer periods.

  8. Glaucoma diagnostics.

    Science.gov (United States)

    Geimer, Sabina Andersson

    2013-02-01

    This thesis addresses several aspects of glaucoma diagnostics from both a clinical and a screening perspective. New instruments for diagnosing glaucoma have been developed over the past years, but little information is available regarding their performance as screening methods and their usefulness in ordinary clinical practice. PURPOSE OF THE RESEARCH UNDERLYING THIS THESIS:  The objectives of this research were as follows: to compare the accuracy of results of analysis of the optic nerve head (ONH) achieved by computerized imaging using the Heidelberg Retina Tomograph (HRT) and by subjective assessment performed by physicians with different degrees of experience of glaucoma (paper III); to evaluate the effect of a continuous medical education (CME) lecture on subjective assessment of the ONH for diagnosis of glaucoma (paper II); to investigate subjective assessment of perimetric test results by physicians with varying knowledge of glaucoma with a trained artificial neural network (ANN) and to compare the certainty of the classifications (paper IV); and to compare the diagnostic performance of time-domain Stratus optical coherence tomography (OCT) with that of spectral-domain Cirrus OCT (paper I), frequency doubling technology (FDT) screening perimetry and scanning laser polarimetry with the GDx variable corneal compensator (VCC) in a random population-based sample and in patients with glaucoma of varying disease severity.   In evaluation of the ONH, use of the HRT statistical tools, Moorfields regression analysis (MRA) and the Glaucoma Probability Score (GPS) was compared with subjective assessment performed by 45 physicians. Optic nerve head images and photographs from 138 healthy and 97 glaucoma subjects were included. The sensitivity of MRA was higher (87-94%) than that of the average physician (62-82%), considerably greater than that of ophthalmologists with subspecialties other than glaucoma (53-77%) and non-significantly better than that of glaucoma

  9. Evaluation of the contribution of the importance of neuroimaging for the diagnostics of dementias - comparison to the psychological diagnostics; Evaluation des Beitrages der radiologischen bildgebende Diagnostik bei demenziellen Erkrankungen - ein Vergleich mit der psychologischen Diagnostik

    Energy Technology Data Exchange (ETDEWEB)

    Hentschel, F.; Kreis, M.; Damian, M. [Univ. Heidelberg (Germany). Abt. fuer Neuroradiologie; Syren, M. [Univ. Heidelberg (Germany). Gedaechtnisambulanz; Krumm, B. [Univ. Heidelberg (Germany). Abt. fuer Biostatistik

    2003-10-01

    Objective: While psychology is accepted as a necessary component of the dementia diagnostics, the extended clinical diagnostics with neuroimaging is differently estimated. The goal of the study is the quantification of the individual contribution of the two different methods. Methods: Of 100 patient the diagnosis of entrance, the neurological, the psychological, and the final clinical diagnosis were documented. For both imaging and psychology the sensitivity, specificity, and the positive predictive value were computed. The diagnostic of each method was determined from the change of the final in relation to the initial clinical diagnosis. The neuroradiological investigation took place with MRI, the psychological examination used both usual power and special speed tests. Results: The extended clinical diagnostics led for 26% of the patients to the change of the clinical diagnosis. Imaging and psychology supplied different own but supplementing contributions. In the case of annihilation imaging contributed with 73.3%, psychology with 54.1% to the diagnosis of a neurodegenerative dementia, whereas the contributions to the diagnosis of a vascular dementia were 83.3% and 70.8%, respectively. However psychology diagnosed and quantified the dementia. The contribution of neuroimaging consisted in the differential diagnosis of the dementias organic causes of symptomatic clementias and vascular encephalopathy without dementia but with consequences for a secondary prophylaxis were additional information also. Conclusion: Psychology improves the diagnostic accuracy of dementias. Neuroimaging improves the differential diagnosis of dementias and supplies additional clinically relevant findings. In the qualified diagnostics and differential diagnostics of the dementias both methods are indispensable. (orig.) [German] Ziel: Waehrend die Bedeutung der Psychologie als notwendiger Bestandteil der Demenzdiagnostik akzeptiert ist, wird die erweiterte klinische Diagnostik mit

  10. A General Latent Class Model for Performance Evaluation of Diagnostic Tests in the Absence of a Gold Standard: An Application to Chagas Disease

    Directory of Open Access Journals (Sweden)

    Gilberto de Araujo Pereira

    2012-01-01

    Full Text Available We propose a new general Bayesian latent class model for evaluation of the performance of multiple diagnostic tests in situations in which no gold standard test exists based on a computationally intensive approach. The modeling represents an interesting and suitable alternative to models with complex structures that involve the general case of several conditionally independent diagnostic tests, covariates, and strata with different disease prevalences. The technique of stratifying the population according to different disease prevalence rates does not add further marked complexity to the modeling, but it makes the model more flexible and interpretable. To illustrate the general model proposed, we evaluate the performance of six diagnostic screening tests for Chagas disease considering some epidemiological variables. Serology at the time of donation (negative, positive, inconclusive was considered as a factor of stratification in the model. The general model with stratification of the population performed better in comparison with its concurrents without stratification. The group formed by the testing laboratory Biomanguinhos FIOCRUZ-kit (c-ELISA and rec-ELISA is the best option in the confirmation process by presenting false-negative rate of 0.0002% from the serial scheme. We are 100% sure that the donor is healthy when these two tests have negative results and he is chagasic when they have positive results.

  11. Subjective cognitive complaints included in diagnostic evaluation of dementia helps accurate diagnosis in a mixed memory clinic cohort

    DEFF Research Database (Denmark)

    Salem, L C; Vogel, Asmus Mejling; Ebstrup, J

    2015-01-01

    functions were assessed with the Mini-mental state examination (MMSE) and Addenbrooke's cognitive examination (ACE), and symptoms of depression were rated with Major Depression Inventory (MDI). All interviews and the diagnostic conclusion were blinded to the SMC score. RESULTS: We found that young patients......OBJECTIVE: Our objective was to examine the quantity and profile of subjective cognitive complaints in young patients as compared with elderly patients referred to a memory clinic. METHODS: Patients were consecutively recruited from the Copenhagen University Hospital Memory Clinic at Rigshospitalet....... In total, 307 patients and 149 age-matched healthy controls were included. Patients were classified in 4 diagnostic groups: dementia, mild cognitive impairment, affective disorders and no cognitive impairment. Subjective memory was assessed with subjective memory complaints (SMC) scale. Global cognitive...

  12. Two Consecutive Standardized Skin Surface Biopsies: An Improved Sampling Method to Evaluate Demodex Density as a Diagnostic Tool for Rosacea and Demodicosis.

    Science.gov (United States)

    Forton, Fabienne M N; De Maertelaer, Viviane

    2017-02-08

    Diagnosing papulopustular rosacea is not always straightforward; no specific diagnostic test is currently available. A high density of Demodex mites is consistently observed in this condition. This retrospective study assesses an improved method for evaluating Demodex density among 1,044 patients presenting to our dermatology practice. The skin was cleaned with ether and Demodex densities were measured in 2 consecutive standardized skin surface biopsies taken from the same site. Mean densities in patients with rosacea and demodicosis were much higher than those in healthy controls and patients with other facial dermatoses. The optimal cut-off values for the 2 biopsies were combined and the resultant criterion (presence of a first biopsy density rosacea or demodicosis with a sensitivity of 98.7% and specificity of 95.5%, making this a valuable diagnostic tool for dermatologists in routine clinical practice.

  13. Prospectively ECG-Triggered Sequential Dual-Source Coronary CT Angiography in Patients with Atrial Fibrillation: Influence of Heart Rate on Image Quality and Evaluation of Diagnostic Accuracy.

    Directory of Open Access Journals (Sweden)

    Lin Yang

    Full Text Available To evaluate the effects of mean heart rate (HR and heart rate variation (HRV on image quality and diagnostic accuracy of prospectively ECG-triggered sequential dual-source coronary CT angiography (CCTA in patients with atrial fibrillation (AF.Eighty-five patients (49 women, 36 men; mean age 62. 1 ± 9.5 years with persistent AF underwent prospectively ECG-triggered sequential second-generation dual-source CCTA. Tube current and voltage were adjusted according to body mass index (BMI and iterative reconstruction was used. Image quality of coronary segments (four-point scale and presence of significant stenosis (>50% were evaluated. Diagnostic accuracy was analyzed in 30 of the 85 patients who underwent additional invasive coronary angiography (ICA.Only 8 of 1102 (0.7% segments demonstrated poor image quality. No significant impact on image quality was found for mean HR (94.9 ± 21.8 bpm; r=0.034, p=0.758; F=0.413, p=0.663 or HRV (67.5 ± 22.8 bpm; r=0.097, p=0.377; F=0.111, p=0.895. On per-segment analysis, sensitivity, specificity, positive predictive value (PPV, and negative predictive value (NPV were 89.7% (26/29, 99.4% (355/357, 92.9% (26/28, and 99.2% (355/358, respectively, with excellent correlation (kappa=0.91 with ICA. Mean effective dose was 3.3 ± 1.0 mSv.Prospectively ECG-triggered sequential dual-source CCTA provides diagnostic image quality and good diagnostic accuracy for detection of coronary stenosis in AF patients without significant influence by HR or HRV.

  14. Evaluation of a laboratory quality assurance pilot programme for malaria diagnostics in low-transmission areas of Kenya, 2013.

    Science.gov (United States)

    Wanja, Elizabeth; Achilla, Rachel; Obare, Peter; Adeny, Rose; Moseti, Caroline; Otieno, Victor; Morang'a, Collins; Murigi, Ephantus; Nyamuni, John; Monthei, Derek R; Ogutu, Bernhards; Buff, Ann M

    2017-05-25

    One objective of the Kenya National Malaria Strategy 2009-2017 is scaling access to prompt diagnosis and effective treatment. In 2013, a quality assurance (QA) pilot was implemented to improve accuracy of malaria diagnostics at selected health facilities in low-transmission counties of Kenya. Trends in malaria diagnostic and QA indicator performance during the pilot are described. From June to December 2013, 28 QA officers provided on-the-job training and mentoring for malaria microscopy, malaria rapid diagnostic tests and laboratory QA/quality control (QC) practices over four 1-day visits at 83 health facilities. QA officers observed and recorded laboratory conditions and practices and cross-checked blood slides for malaria parasite presence, and a portion of cross-checked slides were confirmed by reference laboratories. Eighty (96%) facilities completed the pilot. Among 315 personnel at pilot initiation, 13% (n = 40) reported malaria diagnostics training within the previous 12 months. Slide positivity ranged from 3 to 7%. Compared to the reference laboratory, microscopy sensitivity ranged from 53 to 96% and positive predictive value from 39 to 53% for facility staff and from 60 to 96% and 52 to 80%, respectively, for QA officers. Compared to reference, specificity ranged from 88 to 98% and negative predictive value from 98 to 99% for health-facility personnel and from 93 to 99% and 99%, respectively, for QA officers. The kappa value ranged from 0.48-0.66 for facility staff and 0.57-0.84 for QA officers compared to reference. The only significant test performance improvement observed for facility staff was for specificity from 88% (95% CI 85-90%) to 98% (95% CI 97-99%). QA/QC practices, including use of positive-control slides, internal and external slide cross-checking and recording of QA/QC activities, all increased significantly across the pilot (p malaria QA/QC practices over the pilot. However, these advances did not translate into improved accuracy of

  15. Evaluation of Commercially Available Diagnostic Tests for the Detection of Dengue Virus NS1 Antigen and Anti-Dengue Virus IgM Antibody

    Science.gov (United States)

    Hunsperger, Elizabeth A.; Yoksan, Sutee; Buchy, Philippe; Nguyen, Vinh Chau; Sekaran, Shamala Devi; Enria, Delia A.; Vazquez, Susana; Cartozian, Elizabeth; Pelegrino, Jose L.; Artsob, Harvey; Guzman, Maria G.; Olliaro, Piero; Zwang, Julien; Guillerm, Martine; Kliks, Susie; Halstead, Scott; Peeling, Rosanna W.; Margolis, Harold S.

    2014-01-01

    Commercially available diagnostic test kits for detection of dengue virus (DENV) non-structural protein 1 (NS1) and anti-DENV IgM were evaluated for their sensitivity and specificity and other performance characteristics by a diagnostic laboratory network developed by World Health Organization (WHO), the UNICEF/UNDP/World Bank/WHO Special Programme for Research and Training in Tropical Diseases (TDR) and the Pediatric Dengue Vaccine Initiative (PDVI). Each network laboratory contributed characterized serum specimens for the panels used in the evaluation. Microplate enzyme-linked immunosorbent assay (ELISA) and rapid diagnostic test (RDT formats) were represented by the kits. Each ELISA was evaluated by 2 laboratories and RDTs were evaluated by at least 3 laboratories. The reference tests for IgM anti-DENV were laboratory developed assays produced by the Armed Forces Research Institute for Medical Science (AFRIMS) and the Centers for Disease Control and Prevention (CDC), and the NS1 reference test was reverse transcriptase polymerase chain reaction (RT-PCR). Results were analyzed to determine sensitivity, specificity, inter-laboratory and inter-reader agreement, lot-to-lot variation and ease-of-use. NS1 ELISA sensitivity was 60–75% and specificity 71–80%; NS1 RDT sensitivity was 38–71% and specificity 76–80%; the IgM anti-DENV RDTs sensitivity was 30–96%, with a specificity of 86–92%, and IgM anti-DENV ELISA sensitivity was 96–98% and specificity 78–91%. NS1 tests were generally more sensitive in specimens from the acute phase of dengue and in primary DENV infection, whereas IgM anti-DENV tests were less sensitive in secondary DENV infections. The reproducibility of the NS1 RDTs ranged from 92-99% and the IgM anti-DENV RDTs from 88–94%. PMID:25330157

  16. Evaluation of commercially available diagnostic tests for the detection of dengue virus NS1 antigen and anti-dengue virus IgM antibody.

    Directory of Open Access Journals (Sweden)

    Elizabeth A Hunsperger

    2014-10-01

    Full Text Available Commercially available diagnostic test kits for detection of dengue virus (DENV non-structural protein 1 (NS1 and anti-DENV IgM were evaluated for their sensitivity and specificity and other performance characteristics by a diagnostic laboratory network developed by World Health Organization (WHO, the UNICEF/UNDP/World Bank/WHO Special Programme for Research and Training in Tropical Diseases (TDR and the Pediatric Dengue Vaccine Initiative (PDVI. Each network laboratory contributed characterized serum specimens for the panels used in the evaluation. Microplate enzyme-linked immunosorbent assay (ELISA and rapid diagnostic test (RDT formats were represented by the kits. Each ELISA was evaluated by 2 laboratories and RDTs were evaluated by at least 3 laboratories. The reference tests for IgM anti-DENV were laboratory developed assays produced by the Armed Forces Research Institute for Medical Science (AFRIMS and the Centers for Disease Control and Prevention (CDC, and the NS1 reference test was reverse transcriptase polymerase chain reaction (RT-PCR. Results were analyzed to determine sensitivity, specificity, inter-laboratory and inter-reader agreement, lot-to-lot variation and ease-of-use. NS1 ELISA sensitivity was 60-75% and specificity 71-80%; NS1 RDT sensitivity was 38-71% and specificity 76-80%; the IgM anti-DENV RDTs sensitivity was 30-96%, with a specificity of 86-92%, and IgM anti-DENV ELISA sensitivity was 96-98% and specificity 78-91%. NS1 tests were generally more sensitive in specimens from the acute phase of dengue and in primary DENV infection, whereas IgM anti-DENV tests were less sensitive in secondary DENV infections. The reproducibility of the NS1 RDTs ranged from 92-99% and the IgM anti-DENV RDTs from 88-94%.

  17. Diagnostic Imaging for Implants

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    Sanjay M Mallya

    2004-01-01

    Full Text Available Dental implants are a popular modality for permanent tooth replacement. The key to successful implant placement, its subsequent osseointegration and the final prosthetic rehabilitation is proper preoperative assessment. Diagnostic imaging plays an important role in the pre- and post-surgical evaluation process. Imaging is used to evaluate suitability of implant sites, aid in selection of appropriate implants, and finally evaluate implant placement and osseointegration. This article reviews the role of diagnostic imaging in the various phases and the advantages and limitations of the numerous imaging modalities.

  18. Diagnostic Algorithm for Encephalitis

    Directory of Open Access Journals (Sweden)

    J Gordon Millichap

    2013-12-01

    Full Text Available Diagnostic algorithm for initial evaluation of encephalitis in children is proposed with a consensus statement from the International Encephalitis Consortium, a committee begun in 2010 to serve as a practical aid to clinicians evaluating patients with suspected encephalitis.

  19. Clinico-pathological study to evaluate oral lichen planus for the establishment of clinical and histopathological diagnostic criteria.

    Science.gov (United States)

    Hiremath, Santhosh; Kale, Alka D; Hallikerimath, Seema

    2015-01-01

    Lichen planus and lichenoid lesions affecting the oral cavity show similar clinico-pathological features creating a diagnostic dilemma. Hence, the aim of the present study was to establish a clinical and histopathological correlation in the diagnosis of oral lichen planus, based on the modified WHO diagnostic criteria of oral lichen planus and oral lichenoid lesions proposed by Van der Meij and Van der Waal in 2003. In the present study, 100 cases of oral lichen planus were clinically and histopathologically analyzed. Out of the 100 cases, 50 were prospective and 50 were retrospective cases. Prospective cases were collected based on the clinical diagnosis of oral lichen planus and oral lichenoid lesion. Retrospective cases were collected based on the histopathological diagnosis of oral lichen planus. Both the clinical and histopathological analyses were performed based on a proposal for a set of modified diagnostic criteria of oral lichen planus and oral lichenoid lesion. A final diagnosis of oral lichen planus was made only after the correlation of the clinical diagnosis with the histopathological diagnosis. The interobserver agreement among three observers for both prospective and retrospective cases in the final diagnosis of oral lichen planus was found to be "good" to "very good" indicating high reproducibility. However, the final diagnoses of true oral lichen planus after clinico-pathological correlation in prospective and retrospective study groups appeared to be 38.0% and 54.0% respectively. The results of the present study revealed mild to moderate clinico-pathological correlation in the final diagnosis of oral lichen planus for the prospective and retrospective study groups respectively.

  20. Diagnostic Accuracy of MRI Versus CT for the Evaluation of Acute Appendicitis in Children and Young Adults.

    Science.gov (United States)

    Kinner, Sonja; Pickhardt, Perry J; Riedesel, Erica L; Gill, Kara G; Robbins, Jessica B; Kitchin, Douglas R; Ziemlewicz, Timothy J; Harringa, John B; Reeder, Scott B; Repplinger, Michael D

    2017-10-01

    Appendicitis is frequently diagnosed in the emergency department, most commonly using CT. The purpose of this study was to compare the diagnostic accuracy of contrast-enhanced MRI with that of contrast-enhanced CT for the diagnosis of appendicitis in adolescents when interpreted by abdominal radiologists and pediatric radiologists. Our study included a prospectively enrolled cohort of 48 patients (12-20 years old) with nontraumatic abdominal pain who underwent CT and MRI. Fellowship-trained abdominal and pediatric radiologists reviewed all CT and MRI studies in randomized order, blinded to patient outcome. Likelihood for appendicitis was rated on a 5-point scale (1, definitely not appendicitis; 5, definitely appendicitis) for CT, the unenhanced portion of the MRI, and the entire contrast-enhanced MRI study. ROC curves were generated and AUC compared for each scan type for all six readers and then stratified by radiologist type. Image test characteristics, interrater reliability, and reading times were compared. Sensitivity and specificity were 85.9% (95% CI, 76.2-92.7%) and 93.8% (95% CI, 89.7-96.7%) for unenhanced MRI, 93.6% (95% CI, 85.6-97.9%) and 94.3% (95% CI, 90.2-97%) for contrast-enhanced MRI, and 93.6% (95% CI, 85.6-97.9%) and 94.3% (95% CI, 90.2-97%) for CT. No difference was found in the diagnostic accuracy or interpretation time when comparing abdominal radiologists to pediatric radiologists (CT, 3.0 min vs 2.8 min; contrast-enhanced MRI, 2.4 min vs 1.8 min; unenhanced MRI, 1.5 min vs 2.3 min). Substantial agreement between abdominal and pediatric radiologists was seen for all methods (κ = 0.72-0.83). The diagnostic accuracy of MRI to diagnose appendicitis was very similar to CT. No statistically significant difference in accuracy was observed between imaging modality or radiologist subspecialty.

  1. Diagnostic Criteria for Problematic Internet Use among U.S. University Students: A Mixed-Methods Evaluation.

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    Wen Li

    Full Text Available Empirical studies have identified increasing rates of problematic Internet use worldwide and a host of related negative consequences. However, researchers disagree as to whether problematic Internet use is a subtype of behavioral addiction. Thus, there are not yet widely accepted and validated diagnostic criteria for problematic Internet use. To address this gap, we used mixed-methods to examine the extent to which signs and symptoms of problematic Internet use mirror DSM-5 diagnostic criteria for substance use disorder, gambling disorder, and Internet gaming disorder. A total of 27 university students, who self-identified as intensive Internet users and who reported Internet-use-associated health and/or psychosocial problems were recruited. Students completed two measures that assess problematic Internet use (Young's Diagnostic Questionnaire and the Compulsive Internet Use Scale and participated in focus groups exploring their experiences with problematic Internet use. Results of standardized measures and focus group discussions indicated substantial overlap between students' experiences of problematic Internet use and the signs and symptoms reflected in the DSM-5 criteria for substance use disorder, gambling disorder, and Internet gaming disorder. These signs and symptoms included: a use Internet longer than intended, b preoccupation with the Internet, c withdrawal symptoms when unable to access the Internet, d unsuccessful attempts to stop or reduce Internet use, e craving, f loss of interest in hobbies or activities other than the Internet, g excessive Internet use despite the knowledge of related problems, g use of the Internet to escape or relieve a negative mood, and h lying about Internet use. Tolerance, withdrawal symptoms, and recurrent Internet use in hazardous situations were uniquely manifested in the context of problematic Internet use. Implications for research and practice are discussed.

  2. Evaluation of Bipolar Disorder in Children and Adolescents Referred to a Mood Service: Diagnostic Pathways and Manic Dimensions.

    Science.gov (United States)

    Ferreira-Maia, Ana P; Boronat, Alexandre C; Boarati, Miguel A; Fu-I, Lee; Wang, Yuan-Pang

    2016-11-01

    Few studies have examined pediatric mental health services for early-onset bipolar disorder (BD). The goal of this study was to describe diagnostic pathways and manic dimensions in BD among referred children and adolescents. Data were obtained from a review of the charts of 814 subjects, 2 to 17 years of age, with a complaint of mood disturbances who were referred between 2003 and 2012 to a university-based child and adolescent clinic that specializes in mood disorders. After screening, eligible participants (N=494) were systematically assessed and followed to determine diagnoses on the basis of criteria in the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision in accordance with the best-estimate approach. Manic symptoms were subjected to principal component analysis to investigate the dimensional bipolar profile of the sample. Among the total help-seeking sample, approximately one third of the participants dropped out at intake and, after an average follow-up of 1.7 years, one third had been determined to meet criteria for BD and one third did not fulfill operational criteria for BD. The diagnostic status was changed in 35% of patients: approximately 10% were false positive (going from any bipolar diagnosis to a nonbipolar diagnosis) and approximately 25% were false negative (going from a nonbipolar diagnosis to any bipolar diagnosis). Most patients who converted to a bipolar diagnosis were initially labeled with major depressive disorder or attention-deficit/hyperactivity disorder and had a longer follow-up period. Relevant manic dimensions were elation, grandiosity, and disruption, which explained 41.4% of total variance. Regular reappraisal and follow-up of children and adolescents with mood disturbances provides a window for detection of BD (eg, of core manic dimensions). A coordinated and hierarchical connection among pediatric mental health services with different degrees of specialization is recommended.

  3. Diagnostic Criteria for Problematic Internet Use among U.S. University Students: A Mixed-Methods Evaluation.

    Science.gov (United States)

    Li, Wen; O'Brien, Jennifer E; Snyder, Susan M; Howard, Matthew O

    2016-01-01

    Empirical studies have identified increasing rates of problematic Internet use worldwide and a host of related negative consequences. However, researchers disagree as to whether problematic Internet use is a subtype of behavioral addiction. Thus, there are not yet widely accepted and validated diagnostic criteria for problematic Internet use. To address this gap, we used mixed-methods to examine the extent to which signs and symptoms of problematic Internet use mirror DSM-5 diagnostic criteria for substance use disorder, gambling disorder, and Internet gaming disorder. A total of 27 university students, who self-identified as intensive Internet users and who reported Internet-use-associated health and/or psychosocial problems were recruited. Students completed two measures that assess problematic Internet use (Young's Diagnostic Questionnaire and the Compulsive Internet Use Scale) and participated in focus groups exploring their experiences with problematic Internet use. Results of standardized measures and focus group discussions indicated substantial overlap between students' experiences of problematic Internet use and the signs and symptoms reflected in the DSM-5 criteria for substance use disorder, gambling disorder, and Internet gaming disorder. These signs and symptoms included: a) use Internet longer than intended, b) preoccupation with the Internet, c) withdrawal symptoms when unable to access the Internet, d) unsuccessful attempts to stop or reduce Internet use, e) craving, f) loss of interest in hobbies or activities other than the Internet, g) excessive Internet use despite the knowledge of related problems, g) use of the Internet to escape or relieve a negative mood, and h) lying about Internet use. Tolerance, withdrawal symptoms, and recurrent Internet use in hazardous situations were uniquely manifested in the context of problematic Internet use. Implications for research and practice are discussed.

  4. Multicenter evaluation of molecular and culture-dependent diagnostics for Shigella species and Entero-invasive Escherichia coli in the Netherlands.

    Science.gov (United States)

    van den Beld, Maaike J C; Friedrich, Alexander W; van Zanten, Evert; Reubsaet, Frans A G; Kooistra-Smid, Mirjam A M D; Rossen, John W A

    2016-12-01

    An inter-laboratory collaborative trial for the evaluation of diagnostics for detection and identification of Shigella species and Entero-invasive Escherichia coli (EIEC) was performed. Sixteen Medical Microbiological Laboratories (MMLs) participated. MMLs were interviewed about their diagnostic methods and a sample panel, consisting of DNA-extracts and spiked stool samples with different concentrations of Shigella flexneri, was provided to each MML. The results of the trial showed an enormous variety in culture-dependent and molecular diagnostic techniques currently used among MMLs. Despite the various molecular procedures, 15 out of 16 MMLs were able to detect Shigella species or EIEC in all the samples provided, showing that the diversity of methods has no effect on the qualitative detection of Shigella flexneri. In contrast to semi quantitative analysis, the minimum and maximum values per sample differed by approximately five threshold cycles (Ct-value) between the MMLs included in the study. This indicates that defining a uniform Ct-value cut-off for notification to health authorities is not advisable. Copyright © 2016 Elsevier B.V. All rights reserved.

  5. Evaluation of the diagnostic and prognostic use of gated myocardial perfusion single-photon emission computed tomography in patients with acute chest pain: comparison with the SYNTAX score.

    Science.gov (United States)

    Karacavus, Seyhan; Tutus, Ahmet; Topsakal, Ramazan; Kula, Mustafa; Celik, Ahmet; Abdulrezzak, Ummuhan; Durukan, Polat

    2015-09-01

    The aim of this study was to evaluate the diagnostic and prognostic efficacy of gated single-photon emission computed tomography (GSPECT) in patients with acute chest pain and to compare quantitative GSPECT parameters and the coronary angiographic SYNTAX score. A total of 168 patients who presented with clinical symptoms of acute chest pain were enrolled in the study. Study participants were divided into two groups according to the risk of acute coronary syndrome (ACS): low-intermediate and high risk. All participants underwent rest or stress-GSPECT (R/S-GSPECT). Coronary angiography was performed in all high-risk patients and the SYNTAX score was determined. All patients were followed for 24 ± 3 months and monitored for the occurrence of major adverse coronary events (MACE). Among patients with low-intermediate ACS risk, R-GSPECT and S-GSPECT were associated with 100 and 86% sensitivity, 99 and 98% specificity, 100 and 98% negative predictive value, 80 and 86% positive predictive value, and 98 and 97% accuracy, respectively. At follow-up, MACE occurred in 16 patients. Among high-risk patients, GSPECT quantitative parameters were the most significant predictors of MACE in Cox regression analysis. R/S-GSPECT, a noninvasive diagnostic method, is associated with an excellent safety profile and exceptional diagnostic and prognostic accuracy in cases of ACS.

  6. Which are the most useful scales for predicting repeat self-harm? A systematic review evaluating risk scales using measures of diagnostic accuracy

    Science.gov (United States)

    Quinlivan, L; Cooper, J; Davies, L; Hawton, K; Gunnell, D; Kapur, N

    2016-01-01

    Objectives The aims of this review were to calculate the diagnostic accuracy statistics of risk scales following self-harm and consider which might be the most useful scales in clinical practice. Design Systematic review. Methods We based our search terms on those used in the systematic reviews carried out for the National Institute for Health and Care Excellence self-harm guidelines (2012) and evidence update (2013), and updated the searches through to February 2015 (CINAHL, EMBASE, MEDLINE, and PsychINFO). Methodological quality was assessed and three reviewers extracted data independently. We limited our analysis to cohort studies in adults using the outcome of repeat self-harm or attempted suicide. We calculated diagnostic accuracy statistics including measures of global accuracy. Statistical pooling was not possible due to heterogeneity. Results The eight papers included in the final analysis varied widely according to methodological quality and the content of scales employed. Overall, sensitivity of scales ranged from 6% (95% CI 5% to 6%) to 97% (CI 95% 94% to 98%). The positive predictive value (PPV) ranged from 5% (95% CI 3% to 9%) to 84% (95% CI 80% to 87%). The diagnostic OR ranged from 1.01 (95% CI 0.434 to 2.5) to 16.3 (95%CI 12.5 to 21.4). Scales with high sensitivity tended to have low PPVs. Conclusions It is difficult to be certain which, if any, are the most useful scales for self-harm risk assessment. No scales perform sufficiently well so as to be recommended for routine clinical use. Further robust prospective studies are warranted to evaluate risk scales following an episode of self-harm. Diagnostic accuracy statistics should be considered in relation to the specific service needs, and scales should only be used as an adjunct to assessment. PMID:26873046

  7. The evaluation of GM6-based ELISA and ICT as diagnostic methods on a Mongolian farm with an outbreak of non-tsetse transmitted horse trypanosomosis.

    Science.gov (United States)

    Davaasuren, Batdorj; Amgalanbaatar, Tovuu; Musinguzi, Simon Peter; Suganuma, Keisuke; Otgonsuren, Davaajav; Mossaad, Ehab; Narantsatsral, Sandagdorj; Battur, Banzragch; Battsetseg, Badgar; Xuan, Xuenan; Inoue, Noboru

    2017-09-15

    Trypanosoma equiperdum, which is the etiological agent of dourine, spreads through sexual intercourse in equines. Dourine (T. equiperdum) has been reported in Mongolia, where it is considered an economically important disease of horses. T. evansi has also been reported in Mongolian domestic animals. The objective of this study was to evaluate the potential application of recombinant T. evansi GM6 (rTeGM6-4r)-based diagnostic methods on a farm with an outbreak of non-tsetse transmitted horse trypanosomosis. Ninety-seven percent homology was found between the amino acid sequences of T. equiperdum GM6 and the GM6 of another Trypanozoon, which also shared the same cellular localization. This finding suggests the utility of rTeGM6-4r-based serodiagnostic methods for epidemiological studies and the diagnosis of both surra and dourine in Equidae. Fifty blood samples were examined from a herd of horses. The diagnostic value of an rTeGM6-4r-based ELISA and an rTeGM6-4r-based immunochromatographic test (ICT) were measured in comparison to a T. evansi crude antigen-based ELISA, which is a diagnostic method recommended by the OIE. However, this is not a perfect diagnostic method for trypanosomosis. Positive serum samples were detected in 46%, 42% and 28% of the tested horses using an rTeGM6-4r-based ELISA, crude antigen-based ELISA and rTeGM6-4r-based ICT, respectively. The sensitivity of rTeGM6-based ELISA was 81%, the specificity was 79%, and the agreement was moderate. We conclude that rTeGM6-4r-based ELISA and ICT represent alternative options for baseline epidemiological studies and the on-site diagnosis of horse trypanosomoses in the field, respectively. Copyright © 2017 Elsevier B.V. All rights reserved.

  8. Systematic review and meta-analysis of studies evaluating diagnostic test accuracy: A practical review for clinical researchers-Part I. general guidance and tips

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Kyung Won; Choi, Sang Hyun; Huh, Jimi; Park, Seong Ho [Dept. of Radiology, and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul (Korea, Republic of); Lee, June Young [Dept. of Biostatistics, Korea University College of Medicine, Seoul (Korea, Republic of)

    2015-12-15

    In the field of diagnostic test accuracy (DTA), the use of systematic review and meta-analyses is steadily increasing. By means of objective evaluation of all available primary studies, these two processes generate an evidence-based systematic summary regarding a specific research topic. The methodology for systematic review and meta-analysis in DTA studies differs from that in therapeutic/interventional studies, and its content is still evolving. Here we review the overall process from a practical standpoint, which may serve as a reference for those who implement these methods.

  9. Comparison of single incision and multi incision diagnostic laparoscopy on evaluation of diaphragmatic status after left thoracoabdominal penetrating stab wounds

    Directory of Open Access Journals (Sweden)

    Mehmet Ilhan

    2017-01-01

    Full Text Available Aim: Single incision diagnostic laparoscopy (SIDL may be an alternative procedure to multi-incision diagnostic laparoscopy (MDL for penetrating thoracoabdominal stab wounds. The purpose of this study is sharing our experience and comparing two techniques for diaphragmatic status. Materials and Methods: Medical records of 102 patients with left thoracoabdominal penetrating stab injuries who admitted to Istanbul School of Medicine, Trauma and Emergency Surgery Clinic between February 2012 and April 2016 were examined. The patients were grouped according to operation technique. Patient records were retrospectively reviewed for data including, age, sex, length of hospital stay, diaphragm injury rate, surgical procedure, operation time and operation time with wound repair, post-operative complications and accompanying injuries. Results: The most common injury location was the left anterior thoracoabdomen. SIDL was performed on 26 patients. Nine (34.6% of the 26 patients had a diaphragm injury. Seventy-six patients underwent MDL. Diaphragmatic injury was detected in 20 (26.3% of 76 patients. The average operation time and post-operative complications were similar; there was no statistically significant difference between MDL and SIDL groups. Conclusion: SIDL can be used as a safe and feasible procedure in the repair of a diaphragm wounds. SIDL may be an alternative method in the diagnosis and treatment of these patients.

  10. Evaluation of tissue-equivalent materials to be used as human brain tissue substitute in dosimetry for diagnostic radiology

    Energy Technology Data Exchange (ETDEWEB)

    Ferreira, C.C., E-mail: cassio.c.ferreira@gmail.co [Departamento de Fisica, Universidade Federal de Sergipe, Postal Code 353, Sergipe-SE 49100-000 (Brazil); Ximenes Filho, R.E.M., E-mail: raimundoximenes@hotmail.co [Departamento de Fisica, Universidade Federal de Sergipe, Postal Code 353, Sergipe-SE 49100-000 (Brazil); Vieira, J.W., E-mail: jwvieira@br.inter.ne [Centro Federal de Educacao Tecnologica de Pernambuco (CEFET-PE), Av. Professor Luiz Freire, 500 Curado, CEP 50740-540, Recife (Brazil); Escola Politecnica de Pernambuco, Universidade de Pernambuco (EPP/UPE), Rua Benfica, 455, Madalena, CEP 50720-001, Recife (Brazil); Tomal, A., E-mail: alessandratomal@pg.ffclrp.usp.b [Departamento de Fisica e Matematica, FFCLRP, Universidade de Sao Paulo, Ribeirao Preto-SP 14040-90 (Brazil); Poletti, M.E., E-mail: poletti@ffclrp.usp.b [Departamento de Fisica e Matematica, FFCLRP, Universidade de Sao Paulo, Ribeirao Preto-SP 14040-90 (Brazil); Garcia, C.A.B., E-mail: cgarcia@ufs.b [Departamento de Quimica, Universidade Federal de Sergipe, Postal Code 353, Sergipe-SE 49100-000 (Brazil); Maia, A.F., E-mail: afmaia@ufs.b [Departamento de Fisica, Universidade Federal de Sergipe, Postal Code 353, Sergipe-SE 49100-000 (Brazil)

    2010-08-15

    Tissue-equivalent materials to be used as substitutes for human brain tissue in dosimetry for diagnostic radiology have been investigated in terms of calculated total mass attenuation coefficient ({mu}/{rho}), calculated mass energy-absorption coefficient ({mu}{sub en}/{rho}) and absorbed dose. Measured linear attenuation coefficients ({mu}) have been used for benchmarking the calculated total mass attenuation coefficient ({mu}/{rho}). The materials examined were bolus, nylon (registered) , orange articulation wax, red articulation wax, PMMA (polymethylmethacrylate), bees wax, paraffin I, paraffin II, pitch and water. The results show that water is the best substitute for brain among the materials investigated. The average percentage differences between the calculated {mu}/{rho} and {mu}{sub en}/{rho} coefficients for water and those for brain were 1.0% and 2.5%, respectively. Absorbed doses determined by Monte Carlo methods confirm water as being the best brain substitute to be used in dosimetry for diagnostic radiology, showing maximum difference of 0.01%. Additionally this study showed that PMMA, a material often used for the manufacturing of head phantoms for computed tomography, cannot be considered to be a suitable substitute for human brain tissue in dosimetry.

  11. Evaluating laboratory approaches to the identification of lupus anticoagulants: a diagnostic challenge from the RCPA Haematology QAP.

    Science.gov (United States)

    Bonar, Roslyn; Favaloro, Emmanuel; Zebeljan, Diane; Rosenfeld, David; Kershaw, Geoff; Mohammed, Soma; Marsden, Katherine; Hertzberg, Mark

    2012-04-01

    Laboratory identification of lupus anticoagulants (LA), an important component of the clinical diagnosis of the autoimmune disorder antiphospholipid syndrome (APS), is challenged by the heterogeneity of tests available, the diagnostic and laboratory approach undertaken, and the heterogeneity of the autoantibodies present. : To assess the laboratory approach for investigation of LA, as well as the utility of various tests and test approaches, given a difficult clinical scenario in which LA might or might not be present. Ninety-three participants in the Royal College of Pathologists of Australasia (RCPA) Haematology Quality Assurance Program (QAP) were sent 4  mL of a complex but strongly positive LA sample blinded to the nature of the abnormality. Seventy-three (79%) participants returned results and in most cases diagnostic interpretations. The laboratory approach to LA investigation of this sample was quite varied: 34.7% of participants concluded the sample was LA negative, with 91.7% of these performing dilute Russell viper venom time (dRVVT) testing without mixing, whereas 43.5% of participants identified a strong LA, with 96.7% of these having performed mixing studies. Most laboratories reporting negative LA instead identified the false presence of specific factor inhibitors against a variety of factors, including II, V and VIII. For this difficult challenge, performance of non-mixing dRVVT was associated with a high false negative LA rate. (C) 2012 Royal College of Pathologists of Australasia.

  12. Development and evaluation of a saliva-based chair-side diagnostic for the detection of Porphyromonas gingivalis.

    Science.gov (United States)

    O'Brien-Simpson, Neil M; Burgess, Kate; Brammar, Gail C; Darby, Ivan B; Reynolds, Eric C

    2015-01-01

    Porphyromonas gingivalis is a key pathogen in the polymicrobial biofilm that is associated with the oral disease chronic periodontitis. A number of studies have shown that in humans the level of P. gingivalis in the polymicrobial biofilm is positively correlated with disease progression. The aim of this study was to develop a P. gingivalis diagnostic that has high specificity and sensitivity for P. gingivalis using a range of laboratory and clinical isolates and then compare the efficacy of the diagnostic with RTPCR using samples from chronic periodontitis patients and age- and sex-matched healthy controls. Key parameters for the kit were to use saliva as the biological fluid as this is a most convenient medium for chair-side sampling and to give a positive reading for the reported threshold for detection of 5×10(5) P. gingivalis cells/mL that indicates disease progression. We initially screened a range of monoclonal antibodies for recognition of the P. gingivalis conserved virulence factor RgpA-Kgp complex and identified two mAbs that could be used in a capture and detection ELISA system. These mAbs were used to formulate and manufacture the GC P. gingivalis saliva diagnostic kit used in the study. To validate the saliva kit, saliva (P. gingivalis free) was spiked with known concentrations of viable P. gingivalis whole cells of W50, 381, A7A1-28, and ATCC 33277; P. gingivalis clinical isolates; P. gingivalis vesicles; and the secreted form of the RgpA-Kgp complex. Laboratory findings indicated that the kit was able to detect all laboratory and clinical isolate strains of P. gingivalis at 5×10(4)/mL to 5×10(5)/mL. It was also able to detect the RgpA-Kgp complex and vesicles at 5×10(4) and 5×10(5) cell equivalent doses, respectively. Saliva and plaque were then collected from 50 subjects with moderate-severe chronic periodontitis and 50 age- and sex-matched subjects with healthy periodontium. Real-time PCR was utilised to analyse levels of P. gingivalis in both

  13. Development and evaluation of a saliva-based chair-side diagnostic for the detection of Porphyromonas gingivalis

    Directory of Open Access Journals (Sweden)

    Neil M. O'Brien-Simpson

    2015-09-01

    Full Text Available Porphyromonas gingivalis is a key pathogen in the polymicrobial biofilm that is associated with the oral disease chronic periodontitis. A number of studies have shown that in humans the level of P. gingivalis in the polymicrobial biofilm is positively correlated with disease progression. The aim of this study was to develop a P. gingivalis diagnostic that has high specificity and sensitivity for P. gingivalis using a range of laboratory and clinical isolates and then compare the efficacy of the diagnostic with RTPCR using samples from chronic periodontitis patients and age- and sex-matched healthy controls. Key parameters for the kit were to use saliva as the biological fluid as this is a most convenient medium for chair-side sampling and to give a positive reading for the reported threshold for detection of 5×105 P. gingivalis cells/mL that indicates disease progression. We initially screened a range of monoclonal antibodies for recognition of the P. gingivalis conserved virulence factor RgpA-Kgp complex and identified two mAbs that could be used in a capture and detection ELISA system. These mAbs were used to formulate and manufacture the GC P. gingivalis saliva diagnostic kit used in the study. To validate the saliva kit, saliva (P. gingivalis free was spiked with known concentrations of viable P. gingivalis whole cells of W50, 381, A7A1-28, and ATCC 33277; P. gingivalis clinical isolates; P. gingivalis vesicles; and the secreted form of the RgpA-Kgp complex. Laboratory findings indicated that the kit was able to detect all laboratory and clinical isolate strains of P. gingivalis at 5×104/mL to 5×105/mL. It was also able to detect the RgpA-Kgp complex and vesicles at 5×104 and 5×105 cell equivalent doses, respectively. Saliva and plaque were then collected from 50 subjects with moderate–severe chronic periodontitis and 50 age- and sex-matched subjects with healthy periodontium. Real-time PCR was utilised to analyse levels of P

  14. Does burnout among doctors affect their involvement in patients' mental health problems? A study of videotaped consultations

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    de Bakker Dinny H

    2009-08-01

    Full Text Available Abstract Background General practitioners' (GPs' feelings of burnout or dissatisfaction may affect their patient care negatively, but it is unknown if these negative feelings also affect their mental health care. GPs' available time, together with specific communication tools, are important conditions for providing mental health care. We investigated if GPs who feel burnt out or dissatisfied with the time available for their patients, are less inclined to encourage their patients to disclose their distress, and have shorter consultations, in order to gain time and energy. This may result in less psychological evaluations of patients' complaints. Methods We used 1890 videotaped consultations from a nationally representative sample of 126 Dutch GPs to analyse GPs' communication and the duration of their consultations. Burnout was subdivided into emotional exhaustion, depersonalisation and reduced accomplishment. Multilevel regression analyses were used to investigate which subgroups of GPs differed significantly. Results GPs with feelings of exhaustion or dissatisfaction with the available time have longer consultations compared to GPs without these feelings. Exhausted GPs, and GPs with feelings of depersonalisation, talk more about psychological or social topics in their consultations. GPs with feelings of reduced accomplishment are an exception: they communicate less affectively, are less patient-centred and have less eye contact with their patients compared to GPs without reduced accomplishment. We found no relationship between GPs' feelings of burnout or dissatisfaction with the available time and their psychological evaluations of patients' problems. Conclusion GPs' feelings of burnout or dissatisfaction with the time available for their patients do not obstruct their diagnosis and awareness of patients' psychological problems. On the contrary, GPs with high levels of exhaustion or depersonalisation, and GPs who are dissatisfied with the

  15. A videotaped intervention to enhance child control and reduce anxiety of the pain of dental injections.

    Science.gov (United States)

    Weinstein, P; Raadal, M; Naidu, S; Yoshida, T; Kvale, G; Milgrom, P

    2003-12-01

    While the psychological literature shows that perceptions of uncontrollability contribute to anxiety and other pathologies, interventions that enhance perceived control have been shown to reduce anxiety. This study attempted to assess a brief videotape to enhance child perceived control in a dental setting. 101 children aged 7-9 years completed warm-up procedures and viewed either: a) the experimental intervention, a 2 minutes video of a dentist explaining what an injection will feel like and proposing hand raising as a signal mechanism; or b) the control condition, a 2 minutes video of Disneyland. Fear of dental injections was assessed on a 10 cm visual analogue scale before and after the intervention. In the experimental group there was a significant fear reduction from pre- to post-intervention, while this was not the case in the control group. Children with higher pre-existing levels of fear benefited more from the intervention than children with lower levels of fear. The results of this pilot study suggest that intervention packages that impact child control have promise in lowering anxiety.

  16. Provider Education about Glaucoma and Glaucoma Medications during Videotaped Medical Visits

    Directory of Open Access Journals (Sweden)

    Betsy Sleath

    2014-01-01

    Full Text Available Objective. The purpose of this study was to examine how patient, physician, and situational factors are associated with the extent to which providers educate patients about glaucoma and glaucoma medications, and which patient and provider characteristics are associated with whether providers educate patients about glaucoma and glaucoma medications. Methods. Patients with glaucoma who were newly prescribed or on glaucoma medications were recruited and a cross-sectional study was conducted at six ophthalmology clinics. Patients’ visits were videotape recorded and patients were interviewed after visits. Generalized estimating equations were used to analyze the data. Results. Two hundred and seventy-nine patients participated. Providers were significantly more likely to educate patients about glaucoma and glaucoma medications if they were newly prescribed glaucoma medications. Providers were significantly less likely to educate African American patients about glaucoma. Providers were significantly less likely to educate patients of lower health literacy about glaucoma medications. Conclusion. Eye care providers did not always educate patients about glaucoma or glaucoma medications. Practice Implications. Providers should consider educating more patients about what glaucoma is and how it is treated so that glaucoma patients can better understand their disease. Even if a patient has already been educated once, it is important to reinforce what has been taught before.

  17. Farm-level risk factors for Fasciola hepatica infection in Danish dairy cattle as evaluated by two diagnostic methods

    DEFF Research Database (Denmark)

    Takeuchi-Storm, Nao; Denwood, Matthew; Hansen, Tina Vicky Alstrup

    2017-01-01

    , time span between slaughter data and BTM, and the relatively low sensitivity of liver inspection at slaughter. Control of bovine fasciolosis in Denmark should target heifers and dry cows through grazing management and appropriate anthelmintic treatment, and BTM ELISA can be a useful diagnostic tool...... on wet pastures, dry cows grazing on wet pastures, herd size, breed and concurrent beef cattle production were identified as risk factors associated with being classified as a case farm. With the categorised BTM ELISA result as the response variable, heifers grazing on wet pastures, dry cows grazing...... on wet pastures, and purchase of cows were identified as risk factors. Within the case and control groups, 74.8 and 12.7% of farms were positive for fasciolosis on BTM ELISA, respectively. The differences are likely to be related to the detection limit of the farm-level prevalence by the BTM ELISA test...

  18. Usability and eHealth Literacy Evaluation of a Mobile Health Application Prototype to Track Diagnostic Imaging Examinations.

    Science.gov (United States)

    Griffith, Janessa; Monkman, Helen

    2017-01-01

    In the absence of a pan-Canadian electronic health record, unnecessary duplicate diagnostic imaging (DI) examinations are sometimes ordered when a physician is not aware of prior DI or prior DI is not available. Research suggests that physicians may ask their patient to recall their DI history; however, patient recall of DI can be unreliable. As a potential solution, a patient-facing mobile health application (app) prototype was developed for users to record their DI. The app was designed to be usable and inclusive to users of all health literacy levels. The aim of this paper is to demonstrate how eHealth literacy and usability heuristics can be used during the design phases of app development.

  19. Evaluation of Altona Diagnostics RealStar Zika Virus Reverse Transcription-PCR Test Kit for Zika Virus PCR Testing.

    Science.gov (United States)

    L'Huillier, Arnaud G; Lombos, Ernesto; Tang, Elaine; Perusini, Stephen; Eshaghi, Alireza; Nagra, Sandeep; Frantz, Christine; Olsha, Romy; Kristjanson, Erik; Dimitrova, Kristina; Safronetz, David; Drebot, Mike; Gubbay, Jonathan B

    2017-05-01

    With the emerging Zika virus (ZIKV) epidemic, accessible real-time reverse transcription-PCR (rRT-PCR) assays are needed to streamline testing. The commercial Altona Diagnostics RealStar ZIKV rRT-PCR test kit (Altona PCR) has been approved for emergency use authorization by the U.S. FDA. Our aim was to verify the Altona PCR by comparing it to the CDC-designed dual-target ZIKV rRT-PCR reference assay (reference PCR) and describe the demographics of patients tested for ZIKV by rRT-PCR in Ontario, Canada. A large set of clinical specimens was tested for ZIKV by the Altona PCR and the reference PCR. Positive or equivocal specimens underwent PCR and Sanger sequencing targeting the ZIKV NS5 gene. A total of 671 serum specimens were tested by the reference PCR: 58 (8.6%) were positive, 193 (28.8%) were equivocal, and 420 (62.6%) were negative. Ninety percent of the reference PCR-positive patients were tested in the first 5 days after symptom onset. The Altona PCR was performed on 284/671 specimens tested by the reference PCR. The Altona PCR was positive for 53/58 (91%) reference PCR-positive specimens and 16/193 (8%) reference PCR-equivocal specimens; the ZIKV NS5 PCR was positive for all 68 Altona PCR-positive specimens and negative for all 181 Altona PCR-negative specimens that underwent the NS5 PCR. The Altona PCR has very good sensitivity (91%) and specificity (97%) compared to the reference PCR. The Altona PCR can be used for ZIKV diagnostic testing and has less extensive verification requirements than a laboratory-developed test. Copyright © 2017 American Society for Microbiology.

  20. Evaluation of the Diagnostic Performance of Onchocerca volvulus Linear Epitopes in a Peptide Enzyme-Linked Immunosorbent Assay.

    Science.gov (United States)

    Lagatie, Ole; Verheyen, Ann; Nijs, Erik; Van Dorst, Bieke; Batsa Debrah, Linda; Debrah, Alex; Supali, Taniawati; Sartono, Erliyani; Stuyver, Lieven J

    2018-01-08

    Diagnostic tools for the detection of infection with Onchocerca volvulus are presently limited to microfilaria detection in skin biopsies and serological assessment using the Ov16 immunoglobulin G4 (IgG4) rapid test, both of which have limited sensitivity. We have investigated the diagnostic performance of a peptide enzyme-linked immunosorbent assay (ELISA) based on immunodominant linear epitopes previously discovered. Peptides that were used in these assays were designated O. volvulus motif peptides (OvMP): OvMP-1 (VSV-EPVTTQET-VSV), OvMP-2 (VSV-KDGEDK-VSV), OvMP-3 (VSV-QTSNLD-VSV), and the combination of the latter two, OvMP-23 (VSV-KDGEDK-VSV-QTSNLD-VSV). Sensitivity (O. volvulus infection), specificity (non-helminth infections), and cross-reactivity (helminth infections) were determined using several panels of clinical plasma isolates. OvMP-1 was found to be very sensitive (100%) and specific (98.7%), but showed substantial cross-reactivity with other helminths. Of the other peptides, OvMP-23 was the most promising peptide with a sensitivity of 92.7%, a specificity of 100%, and a cross-reactivity of 6%. It was also demonstrated that these peptides were immunoreactive to IgG but not IgG4, and there is no correlation with the Ov16 IgG4 status, making them promising candidates to complement this already available test. Combination of the Ov16 IgG4 rapid test and OvMP-23 peptide ELISA led to a sensitivity of 97.3% for the detection of O. volvulus infection, without compromising specificity and with minimal impact on cross-reactivity. The available results open the opportunity for a "clinical utility use case" discussion for improved O. volvulus epidemiological mapping.

  1. Comparison between two diagnostic models of atmospheric flow above complex terrain : the evaluation of the wind potential of La Ventosa

    Energy Technology Data Exchange (ETDEWEB)

    Milanesi, M.; Cassola, F.; Burlando, M.; Ratto, C.F. [Genoa Univ., Genoa (Italy). Dept. of Physics

    2008-07-01

    Interest in wind energy production has increased in recent years due to improvements in wind turbine technology and the growing need for energy production by renewable sources. One of the most important issues to deal with is the choice of an adequate site. Therefore, wind energy researchers deal directly with statistical properties of wind, coming from in-situ measurements. Different methodologies have been developed to study and define the wind climate of a particular region, starting from measured data. Diagnostic wind field models can simulate wind fields and determine the best sites for wind turbine arrays. This study compared the performance of 2 diagnostic atmospheric flow models, notably the Wind Atlas Analysis and Application Program (WAsP) and the Wind-field Interpolation by Non-Divergent Schemes (WINDS) model. The models are based on two very different approaches. The Navier-Stokes equations of motion are considered in the WAsP model, but only the equation of mass conservation is taken into account in the WINDS model. The models were used to analyze the available wind data in the region of La Ventosa, Mexico where some of the world's highest wind resources are available. Both the models and the methodologies proved to be suitable for managing the wind climatology of this region. A bi-modal non-directional frequency distribution of the wind speed exists due to the presence of two distinct wind regimes during winter and summer respectively. The comparison between the mean wind speeds simulated by the models showed that the values were very similar over the least complex terrain, while the discrepancies increase in the highest and steepest areas. In general, WAsP predicted lower values over valleys and depressed areas, and higher values over ridges. This was due to the sheltering effect of the mountain ridges north-west and north-east of the anemometer station. 30 refs., 6 figs.

  2. Collection and Characterization of Samples for Establishment of a Serum Repository for Lyme Disease Diagnostic Test Development and Evaluation

    Science.gov (United States)

    Molins, Claudia R.; Sexton, Christopher; Young, John W.; Ashton, Laura V.; Pappert, Ryan; Beard, Charles B.

    2014-01-01

    Serological assays and a two-tiered test algorithm are recommended for laboratory confirmation of Lyme disease. In the United States, the sensitivity of two-tiered testing using commercially available serology-based assays is dependent on the stage of infection and ranges from 30% in the early localized disease stage to near 100% in late-stage disease. Other variables, including subjectivity in reading Western blots, compliance with two-tiered recommendations, use of different first- and second-tier test combinations, and use of different test samples, all contribute to variation in two-tiered test performance. The availability and use of sample sets from well-characterized Lyme disease patients and controls are needed to better assess the performance of existing tests and for development of improved assays. To address this need, the Centers for Disease Control and Prevention and the National Institutes of Health prospectively collected sera from patients at all stages of Lyme disease, as well as healthy donors and patients with look-alike diseases. Patients and healthy controls were recruited using strict inclusion and exclusion criteria. Samples from all included patients were retrospectively characterized by two-tiered testing. The results from two-tiered testing corroborated the need for novel and improved diagnostics, particularly for laboratory diagnosis of earlier stages of infection. Furthermore, the two-tiered results provide a baseline with samples from well-characterized patients that can be used in comparing the sensitivity and specificity of novel diagnostics. Panels of sera and accompanying clinical and laboratory testing results are now available to Lyme disease serological test users and researchers developing novel tests. PMID:25122862

  3. Using case studies and videotaped vignettes to facilitate the development of critical thinking skills in new graduate nurses.

    Science.gov (United States)

    Hooper, Barbara L

    2014-01-01

    Critical thinking skills are an essential component of nursing and crucial to nursing practice. Case studies with videotaped vignettes were used to help facilitate the development of critical thinking skills in new graduate nurses. Results revealed a statistically significant increase (p = .041) on the overall Health Sciences Reasoning Test score. It is essential for educators to be aware of educational strategies that can affect the development of critical thinking skills.

  4. The utility of ultrasound superb microvascular imaging for evaluation of breast tumour vascularity: comparison with colour and power Doppler imaging regarding diagnostic performance.

    Science.gov (United States)

    Park, A Y; Seo, B K; Woo, O H; Jung, K S; Cho, K R; Park, E K; Cha, S H; Cha, J

    2017-11-06

    To investigate the utility of superb microvascular imaging (SMI) for evaluating the vascularity of breast masses in comparison with colour or power Doppler ultrasound (US) and the effect on diagnostic performance. A total of 191 biopsy-proven masses (99 benign and 92 malignant) in 166 women with greyscale, colour Doppler, power Doppler, and SMI images were enrolled in this retrospective study. Three radiologists analysed the vascular images using a three-factor scoring system to evaluate the number, morphology, and distribution of tumour vessels. They assessed the Breast Imaging-Reporting and Data System categories for greyscale US alone and combinations of greyscale US and each type of vascular US. The Kruskal-Wallis test was performed and the area under the receiver-operating characteristic curve (AUC) measured. On SMI, vascular scores were compared between benign and malignant masses and the optimal cut-off value for the overall score was determined. SMI showed higher vascular scores than colour or power Doppler US and malignant masses had higher scores than benign masses (pDoppler US (AUC, 0.815 versus 0.774, 0.789, 0.791; pDoppler US for characterising the vascularity in breast masses and improving diagnostic performance. Copyright © 2017 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.

  5. Jeff's Reef Oculina Banks Clelia Dive 607 2001 Digital Imagery - Captured from Videotapes taken during Submersible Dives to the Oculina Banks Deep Sea Coral Reefs (NODC Accession 0047190)

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — Digitial imagery, mpegs and jpegs, captured from mini-DV magnetic videotapes collected with an underwater 3-chip CCD color video camera, deployed from the research...

  6. Eau Gallie, Oculina Banks Clelia Dive 608 2001 Digital Imagery - Captured from Videotapes taken during Submersible Dives to the Oculina Banks Deep Sea Coral Reefs (NODC Accession 0047190)

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — Digitial imagery, mpegs and jpegs, captured from mini-DV magnetic videotapes collected with an underwater 3-chip CCD color video camera, deployed from the research...

  7. Sebastian Pinnacles Oculina Banks Clelia Dive 618 2001 Digital Imagery - Captured from Videotapes taken during Submersible Dives to the Oculina Banks Deep Sea Coral Reefs (NODC Accession 0047190)

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — Digitial imagery, mpegs and jpegs, captured from mini-DV magnetic videotapes collected with an underwater 3-chip CCD color video camera, deployed from the research...

  8. Cape Canaveral Oculina Banks Clelia Dive 616 2001 Digital Imagery - Captured from Videotapes taken during Submersible Dives to the Oculina Banks Deep Sea Coral Reefs (NODC Accession 0047190)

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — Digitial imagery, mpegs and jpegs, captured from mini-DV magnetic videotapes collected with an underwater 3-chip CCD color video camera, deployed from the research...

  9. Chapman's Reef Oculina Banks Clelia Dive 620 2001 Digital Imagery - Captured from Videotapes taken during Submersible Dives to the Oculina Banks Deep Sea Coral Reefs (NODC Accession 0047190)

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — Digitial imagery, mpegs and jpegs, captured from mini-DV magnetic videotapes collected with an underwater 3-chip CCD color video camera, deployed from the research...

  10. Sebastian Pinnacles, Oculina Banks Clelia Dive 614 2001 Digital Imagery - Captured from Videotapes taken during Submersible Dives to the Oculina Banks Deep Sea Coral Reefs (NODC Accession 0047190)

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — Digitial imagery, mpegs and jpegs, captured from mini-DV magnetic videotapes collected with an underwater 3-chip CCD color video camera, deployed from the research...

  11. Sebastian Pinnacles, Oculina Banks Clelia Dive 615 2001 Digital Imagery - Captured from Videotapes taken during Submersible Dives to the Oculina Banks Deep Sea Coral Reefs (NODC Accession 0047190)

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — Digitial imagery, mpegs and jpegs, captured from mini-DV magnetic videotapes collected with an underwater 3-chip CCD color video camera, deployed from the research...

  12. Eau Galllie Oculina Banks Clelia Dive 609 2001 Digital Imagery - Captured from Videotapes tken during Submersible Dives to the Oculina Banks Deep Sea Coral Reefs (NODC Accession 0047190)

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — Digitial imagery, mpegs and jpegs, captured from mini-DV magnetic videotapes collected with an underwater 3-chip CCD color video camera, deployed from the research...

  13. Chapman's Reef Oculina Banks Clelia Dive 621 2001 Digital Imagery - Captured from Videotapes taken during Submersible Dives to the Oculina Banks Deep Sea Coral Reefs (NODC Accession 0047190)

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — Digitial imagery, mpegs and jpegs, captured from mini-DV magnetic videotapes collected with an underwater 3-chip CCD color video camera, deployed from the research...

  14. Jeff's Reef Oculina Banks Clelia Dive 606 2001 Digital Imagery - Captured from Videotapes taken during Submersible Dives to the Oculina Banks Deep Sea Coral Reefs (NODC Accession 0047190)

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — Digitial imagery, mpegs and jpegs, captured from mini-DV magnetic videotapes collected with an underwater 3-chip CCD color video camera, deployed from the research...

  15. Cocoa Beach Oculina Banks Clelia Dive 617 2001 Digital Imagery - Captured from Videotapes taken during Submersible Dives to the Oculina Banks Deep Sea Coral Reefs (NODC Accession 0047190)

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — Digitial imagery, mpegs and jpegs, captured from mini-DV magnetic videotapes collected with an underwater 3-chip CCD color video camera, deployed from the research...

  16. Sebastian Pinnacles Oculina Banks Clelia Dive 619 2001 Digital Imagery - Captured from Videotapes taken during Submersible Dives to the Oculina Banks Deep Sea Coral Reefs (NODC Accession 0047190)

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — Digitial imagery, mpegs and jpegs, captured from mini-DV magnetic videotapes collected with an underwater 3-chip CCD color video camera, deployed from the research...

  17. Comparative evaluation of bivalent malaria rapid diagnostic tests versus traditional methods in field with special reference to heat stability testing in Central India.

    Directory of Open Access Journals (Sweden)

    Neeru Singh

    Full Text Available BACKGROUND: Malaria presents a diagnostic challenge in areas where both Plasmodium falciparum and P.vivax are co-endemic. Bivalent Rapid Diagnostic tests (RDTs showed promise as diagnostic tools for P.falciparum and P.vivax. To assist national malaria control programme in the selection of RDTs, commercially available seven malaria RDTs were evaluated in terms of their performance with special reference to heat stability. METHODOLOGY/PRINCIPAL FINDINGS: This study was undertaken in four forested districts of central India (July, 2011- March, 2012. All RDTs were tested simultaneously in field along with microscopy as gold standard. These RDTs were stored in their original packing at 25°C before transport to the field or they were stored at 35°C and 45°C upto 100 days for testing the performance of RDTs at high temperature. In all 2841 patients with fever were screened for malaria of which 26% were positive for P.falciparum, and 17% for P.vivax. The highest sensitivity of any RDT for P.falciparum was 98% (95% CI; 95.9-98.8 and lowest sensitivity was 76% (95% CI; 71.7-79.6. For P.vivax highest and lowest sensitivity for any RDT was 80% (95% CI; 94.9 - 83.9 and 20% (95% CI; 15.6-24.5 respectively. Heat stability experiments showed that most RDTs for P.falciparum showed high sensitivity at 45°C upto 90 days. While for P.vivax only two RDTs maintained good sensitivity upto day 90 when compared with RDTs kept at room temperature. Agreement between observers was excellent for positive and negative readings for both P.falciparum and P.vivax (Kappa >0.6-0.9. CONCLUSION: This is first field evaluation of RDTs regarding their temperature stability. Although RDTs are useful as diagnostic tool for P.falciparum and P.vivax even at high temperature, the quality of RDTs should be regulated and monitored more closely.

  18. [Diagnostics in osteology].

    Science.gov (United States)

    Jakob, F; Genest, F; Seefried, L; Tsourdi, E; Lapa, C; Hofbauer, L C

    2016-07-01

    Clinical diagnostics in metabolic bone diseases cover a broad spectrum of conventional and state of the art methods ranging from the medical history and clinical examination to molecular imaging. Patient treatment is carried out in an interdisciplinary team due to the multiple interactions of bone with other organ systems. Diagnosis of osteoporosis is supported by high level national guidelines. A paradigm shift concerning the clinical relevance of bone mineral density measurement renders this now to be a strong risk factor rather than a diagnostic parameter, while strengthening the value of other clinical factors for risk assessment. The impact of parameters for muscle mass, structure and function is steadily increasing in all age groups. In order to identify underlying diseases that influence bone metabolism a panel of general laboratory diagnostic parameters is recommended. Markers for bone formation and resorption and specific parameters for the regulation of calcium and phosphate metabolism should be evaluated by specialists because they require diligence in preanalytics and experience in interpretation. Genetic diagnosis is well established for rare bone diseases while diagnostic panels are not yet available for routine diagnostics in polygenetic diseases such as osteoporosis. Conventional radiology is still very important to identify, e. g. fractures, osteolytic and osteoblastic lesions and extraosseous calcifications; however tomography-based methods which combine, e. g. scintigraphy or positron emission technologies with anatomical imaging are of increasing significance. Clinical diagnostics in osteology require profound knowledge and are subject to a dynamic evolution.

  19. Evaluation of the sensitivity and fading characteristics of an image plate system for x-ray diagnostics

    Science.gov (United States)

    Meadowcroft, A. L.; Bentley, C. D.; Stott, E. N.

    2008-11-01

    Image plates (IPs) are a reusable recording media capable of detecting ionizing radiation, used to diagnose x-ray emission from laser-plasma experiments. Due to their superior performance characteristics in x-ray applications [C. C. Bradford, W. W. Peppler, and J. T. Dobbins III, Med. Phys. 26, 27 (1999) and J. Digit. Imaging. 12, 54 (1999)], the Fuji Biological Analysis System (BAS) IPs are fielded on x-ray diagnostics for the HELEN laser by the Plasma Physics Department at AWE. The sensitivities of the Fuji BAS IPs have been absolutely calibrated for absolute measurements of x-ray intensity in the energy range of 0-100 keV. In addition, the Fuji BAS IP fading as a function of time was investigated. We report on the characterization of three Fuji BAS IP responses to x-rays using a radioactive source, and discrete x-ray line energies generated by the Excalibur soft x-ray facility and the Defense Radiological Standards Centre filter-fluorescer hard x-ray system at AWE.

  20. CNS imaging is a key diagnostic tool in the evaluation of patients with CFC syndrome: two cases and literature review.

    Science.gov (United States)

    Papadopoulou, Eleftheria; Sifakis, Stavros; Sol-Church, Katia; Klein-Zighelboim, Eva; Stabley, Deborah L; Raissaki, Maria; Gripp, Karen W; Kalmanti, Maria

    2011-03-01

    Cardio-facio-cutaneous (CFC) syndrome is characterized by a variable degree of cognitive impairment, and multiple congenital anomalies including characteristic facies, cardiac, and ectodermal abnormalities. CFC syndrome is caused by mutations in the genes BRAF, MEK1, or MEK2. Here we provide a follow-up report on two patients presenting distinct facial appearance and other features of the syndrome, and we present the first molecular evidence of paternal origin for a CFC-causing germline mutation. Brain imaging revealed a lipoma of the corpus callosum and periventricular leukoencephalopathy as well as a hypoplastic corpus callosum, and defects in myelinization, in each patient, respectively. A review of the literature showed that, although non-specific, ventriculomegaly, hydrocephalus, and cortical atrophy represent the most frequent imaging findings of brain anomalies in CFC syndrome. CNS abnormalities are significant diagnostic features of CFC syndrome and a brain MRI is recommended in individuals diagnosed with CFC or suspected of having CFC syndrome. Copyright © 2011 Wiley-Liss, Inc.