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Sample records for chinese medical diagnostic

  1. Solid cancer incidence among Chinese medical diagnostic x-ray workers, 1950-1995: Estimation of radiation-related risks.

    PubMed

    Sun, Zhijuan; Inskip, Peter D; Wang, Jixian; Kwon, Deukwoo; Zhao, Yongcheng; Zhang, Liangan; Wang, Qin; Fan, Saijun

    2016-06-15

    The objective of this study was to estimate solid cancer risk attributable to long-term, fractionated occupational exposure to low doses of ionizing radiation. Based on cancer incidence for the period 1950-1995 in a cohort of 27,011 Chinese medical diagnostic X-ray workers and a comparison cohort of 25,782 Chinese physicians who did not use X-ray equipment in their work, we used Poisson regression to fit excess relative risk (ERR) and excess absolute risk (EAR) dose-response models for incidence of all solid cancers combined. Radiation dose reconstruction was based on a previously published method that relied on simulating measurements for multiple X-ray machines, workplaces and working conditions, information about protective measures, including use of lead aprons, and work histories. The resulting model was used to estimate calendar year-specific badge dose calibrated as personal dose equivalent (Sv). To obtain calendar year-specific colon doses (Gy), we applied a standard organ conversion factor. A total of 1,643 cases of solid cancer were identified in 1.45 million person-years of follow-up. In both ERR and EAR models, a statistically significant radiation dose-response relationship was observed for solid cancers as a group. Averaged over both sexes, and using colon dose as the dose metric, the estimated ERR/Gy was 0.87 (95% CI: 0.48, 1.45), and the EAR was 22 per 10(4)PY-Gy (95% CI: 14, 32) at age 50. We obtained estimates of the ERR and EAR of solid cancers per unit dose that are compatible with those derived from other populations chronically exposed to low dose-rate occupational or environmental radiation. PMID:26860236

  2. Optoelectronic tweezers for medical diagnostics

    NASA Astrophysics Data System (ADS)

    Kremer, Clemens; Neale, Steven; Menachery, Anoop; Barrett, Mike; Cooper, Jonathan M.

    2012-01-01

    Optoelectronic tweezers (OET) allows the spatial patterning of electric fields through selected illumination of a photoconductive surface. This enables the manipulation of micro particles and cells by creating non-uniform electrical fields that then produce dielectrophoretic (DEP) forces. The DEP responses of cells differ and can produce negative or positive (repelled or attracted to areas of high electric field) forces. Therefore OET can be used to manipulate individual cells and separate different cell types from each other. Thus OET has many applications for medical diagnostics, demonstrated here with work towards diagnosing Human African Trypanosomiasis, also known as sleeping sickness.

  3. Use of smart materials in medical diagnostics

    NASA Astrophysics Data System (ADS)

    Winzer, Stephen R.; Bridger, Keith; Caldwell, Paul J.; Sewell, James S.

    1996-05-01

    Medical diagnostic capabilities have seen explosive growth over the past decade, as new techniques, such as MRI, have been taken from the laboratory setting into the clinical environment, with considerable benefit to the population at large. In this paper, we address another area of medical diagnostics which, we believe, stands on the verge of explosive growth, driven more by the emerging requirements for cost-effective diagnostic tools, and by the evolving needs of the defense medical community, with spinoff of those into the strongly related emergency care area of the civilian market. One of the factors that will drive this area of medical diagnostics is the development of smart materials and the sensors and sensor systems developed from them. In this paper we discuss some of the developments in the field of smart materials as they apply to development of new, low cost acoustic sensors for patient monitoring and medical imaging.

  4. 75 FR 35439 - Medical Diagnostic Equipment Accessibility Standards

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-06-22

    ... TRANSPORTATION BARRIERS COMPLIANCE BOARD Medical Diagnostic Equipment Accessibility Standards AGENCY... consultation with the Food and Drug Administration, to issue accessibility standards for medical diagnostic... accessibility needs of individuals with disabilities with respect to medical diagnostic equipment and...

  5. Noninvasive Medical Diagnostics & Treatment Using Ultrasonics

    NASA Technical Reports Server (NTRS)

    Bar-Cohen, Y.; Siegel, R.; Grandia, W.

    1998-01-01

    In parallel to the industrial application of NDE to flaw detection and material property determination, the medical community has succesfully adapted such methods to the noninvasaive diagnostics and treatment of many conditions and disorders of the human body.

  6. Diagnostic Medical Sonographers: Seeing with Sound.

    ERIC Educational Resources Information Center

    Lacey, Alan

    2001-01-01

    Explains how diagnostic medical sonographers use special equipment to direct high frequency sound waves into areas of a patient's body. Describes specialties within the occupation, working conditions, employment and outlook, earnings, and necessary training and qualifications. (JOW)

  7. The Current State of Medical Education in Chinese Medical Schools

    ERIC Educational Resources Information Center

    Kosik, Russell Oliver; Huang, Lei; Cai, Qiaoling; Xu, Guo-Tong; Zhao, Xudong; Guo, Li; Tang, Wen; Chen, Qi; Fan, Angela Pei-Chen

    2014-01-01

    Today's doctor is as much a humanist as a scientist. Medical schools have responded to this change by introducing a variety of courses, most notably those concerning the humanities and ethics. Thus far, no one has examined the extent of use of these subjects in Chinese medical schools. The goal of this study is to determine how many and in…

  8. Munchausen Syndrome by Proxy: Medical Diagnostic Criteria.

    ERIC Educational Resources Information Center

    Rosenberg, Donna Andrea

    2003-01-01

    Medical diagnostic criteria for Munchausen Syndrome by Proxy (a persistent fabrication by one individual of illness in another) are presented. Since the strength of the known facts may vary from case to case, diagnostic criteria are given for a definitive diagnosis, a possible diagnosis, an inconclusive determination, and the definitely excluded…

  9. Medical technology transfer in major Chinese medical schools.

    PubMed

    Hu, T W; Meng, Y Y

    1991-01-01

    This paper examines how the decision-making process and its consequences affect medical technology transfer in major Chinese medical schools. Data are from a 1987 survey of 13 key medical universities, directly supervised by the Ministry of Public Health in the People's Republic of China. This paper limits itself to four types of laboratory equipment--electron microscopes, UV/VIS spectrophotometers, high-performance liquid chromatographs, and polygraphs. Decisions on the transfer of medical technology have been more decentralized in China since the economic reform in 1978. The major reason for schools to import these four types of equipment is their dissatisfaction with the quality of domestic products. Chinese medical schools depend heavily on the information provided at medical equipment exhibits and their neighboring schools. Their decisions to acquire the equipment are based more on the quality and service available than on the prices. Chinese medical schools face serious infrastructure problems in acquiring and maintaining these pieces of equipment. A number of suggestions are made for improving the efficiency of medical technology transfer in China. PMID:1778700

  10. Chinese medical ward: an American's observations.

    PubMed

    Leonard, Ryan A

    2012-01-01

    Physicians base their practices on scientific knowledge that varies little from one country to another, but their experience and their careers are shaped by the culture in which they live and work. This essay casts light on medical practice in mainland China, based on three months of field work with an elite group of physicians at a tertiary academic medical center in summer 2009. It is a story of a diverse group of Chinese professionals navigating a demanding profession, and of the foreign college student on whom they left an indelible impact. Many of the normative features of the Chinese medical profession-its chain of command, commitment to medical ethics, and scientific orientation-are highly comparable to the working lives of American physicians. PMID:22643766

  11. A recommender system for medical imaging diagnostic.

    PubMed

    Monteiro, Eriksson; Valente, Frederico; Costa, Carlos; Oliveira, José Luís

    2015-01-01

    The large volume of data captured daily in healthcare institutions is opening new and great perspectives about the best ways to use it towards improving clinical practice. In this paper we present a context-based recommender system to support medical imaging diagnostic. The system relies on data mining and context-based retrieval techniques to automatically lookup for relevant information that may help physicians in the diagnostic decision. PMID:25991188

  12. Intelligent medical diagnostics via molecular logic

    PubMed Central

    Konry, Tania; Walt, David R.

    2009-01-01

    In this communication, we describe the integration of microarray sensor technology with logic capability for screening combinations of proteins and DNA in a biological sample. In this system, we have demonstrated the use of a single platform amenable to both protein detection and protein-DNA detection using molecular logic gates. The pattern of protein and DNA inputs results in fluorescence outputs according to a truth table for AND and INHIBIT gates, thereby demonstrating the feasibility of performing medical diagnostics using a logic gate design. One possible application of this technique would be for the direct screening of various medical conditions that are dependent on combinations of diagnostic markers. PMID:19715272

  13. Photoacoustic sensor for medical diagnostics

    NASA Astrophysics Data System (ADS)

    Wolff, Marcus; Groninga, Hinrich G.; Harde, Hermann

    2004-03-01

    The development of new optical sensor technologies has a major impact on the progress of diagnostic methods. Of the permanently increasing number of non-invasive breath tests, the 13C-Urea Breath Test (UBT) for the detection of Helicobacter pylori is the most prominent. However, many recent developments, like the detection of cancer by breath test, go beyond gastroenterological applications. We present a new detection scheme for breath analysis that employs an especially compact and simple set-up. Photoacoustic Spectroscopy (PAS) represents an offset-free technique that allows for short absorption paths and small sample cells. Using a single-frequency diode laser and taking advantage of acoustical resonances of the sample cell, we performed extremely sensitive and selective measurements. The smart data processing method contributes to the extraordinary sensitivity and selectivity as well. Also, the reasonable acquisition cost and low operational cost make this detection scheme attractive for many biomedical applications. The experimental set-up and data processing method, together with exemplary isotope-selective measurements on carbon dioxide, are presented.

  14. Boosting medical diagnostics by pooling independent judgments

    PubMed Central

    Kurvers, Ralf H. J. M.; Herzog, Stefan M.; Hertwig, Ralph; Krause, Jens; Carney, Patricia A.; Bogart, Andy; Argenziano, Giuseppe; Zalaudek, Iris; Wolf, Max

    2016-01-01

    Collective intelligence refers to the ability of groups to outperform individual decision makers when solving complex cognitive problems. Despite its potential to revolutionize decision making in a wide range of domains, including medical, economic, and political decision making, at present, little is known about the conditions underlying collective intelligence in real-world contexts. We here focus on two key areas of medical diagnostics, breast and skin cancer detection. Using a simulation study that draws on large real-world datasets, involving more than 140 doctors making more than 20,000 diagnoses, we investigate when combining the independent judgments of multiple doctors outperforms the best doctor in a group. We find that similarity in diagnostic accuracy is a key condition for collective intelligence: Aggregating the independent judgments of doctors outperforms the best doctor in a group whenever the diagnostic accuracy of doctors is relatively similar, but not when doctors’ diagnostic accuracy differs too much. This intriguingly simple result is highly robust and holds across different group sizes, performance levels of the best doctor, and collective intelligence rules. The enabling role of similarity, in turn, is explained by its systematic effects on the number of correct and incorrect decisions of the best doctor that are overruled by the collective. By identifying a key factor underlying collective intelligence in two important real-world contexts, our findings pave the way for innovative and more effective approaches to complex real-world decision making, and to the scientific analyses of those approaches. PMID:27432950

  15. Boosting medical diagnostics by pooling independent judgments.

    PubMed

    Kurvers, Ralf H J M; Herzog, Stefan M; Hertwig, Ralph; Krause, Jens; Carney, Patricia A; Bogart, Andy; Argenziano, Giuseppe; Zalaudek, Iris; Wolf, Max

    2016-08-01

    Collective intelligence refers to the ability of groups to outperform individual decision makers when solving complex cognitive problems. Despite its potential to revolutionize decision making in a wide range of domains, including medical, economic, and political decision making, at present, little is known about the conditions underlying collective intelligence in real-world contexts. We here focus on two key areas of medical diagnostics, breast and skin cancer detection. Using a simulation study that draws on large real-world datasets, involving more than 140 doctors making more than 20,000 diagnoses, we investigate when combining the independent judgments of multiple doctors outperforms the best doctor in a group. We find that similarity in diagnostic accuracy is a key condition for collective intelligence: Aggregating the independent judgments of doctors outperforms the best doctor in a group whenever the diagnostic accuracy of doctors is relatively similar, but not when doctors' diagnostic accuracy differs too much. This intriguingly simple result is highly robust and holds across different group sizes, performance levels of the best doctor, and collective intelligence rules. The enabling role of similarity, in turn, is explained by its systematic effects on the number of correct and incorrect decisions of the best doctor that are overruled by the collective. By identifying a key factor underlying collective intelligence in two important real-world contexts, our findings pave the way for innovative and more effective approaches to complex real-world decision making, and to the scientific analyses of those approaches. PMID:27432950

  16. 78 FR 1166 - Medical Diagnostic Equipment Accessibility Standards Advisory Committee

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-01-08

    ... Medical Diagnostic Equipment Accessibility Standards. See 77 FR 6916 (February 9, 2012). The NPRM and... TRANSPORTATION BARRIERS COMPLIANCE BOARD 36 CFR Part 1195 RIN 3014-AA40 Medical Diagnostic Equipment.... ACTION: Notice of advisory committee meeting. SUMMARY: The Medical Diagnostic Equipment...

  17. Microhistory and Chinese Medical History: A Review.

    PubMed

    Yu, Xinzhong; Wang, Yumeng

    2015-08-01

    reinforce the narrative style and to grasp the social context of the individual or the event (the link between micro and macro levels). Nevertheless, these studies anyway indicate the invisible influence of microhistory and have paved a way for the future microhistorical investigations on medicine. We believe that microhistory is an undercurrent about to emerge in the field of Chinese medical history. It is the right time to advocate and promote the self-conscious microhistorical investigation, promptly and strongly, while updating the ideas and methods of it to make it a dominant trend rather than an undercurrent in the studies of Chinese medical history. Its rise would not only display the value and significance of microhistory in a better way, but also would help medical history to realize its core idea of history of life, therefore to propel our inquiry into Chinese medical history. PMID:26394991

  18. Diagnostic Reasoning across the Medical Education Continuum

    PubMed Central

    Smith, C. Scott; Hill, William; Francovich, Chris; Morris, Magdalena; Robbins, Bruce; Robins, Lynne; Turner, Andrew

    2014-01-01

    We aimed to study linguistic and non-linguistic elements of diagnostic reasoning across the continuum of medical education. We performed semi-structured interviews of premedical students, first year medical students, third year medical students, second year internal medicine residents, and experienced faculty (ten each) as they diagnosed three common causes of dyspnea. A second observer recorded emotional tone. All interviews were digitally recorded and blinded transcripts were created. Propositional analysis and concept mapping were performed. Grounded theory was used to identify salient categories and transcripts were scored with these categories. Transcripts were then unblinded. Systematic differences in propositional structure, number of concept connections, distribution of grounded theory categories, episodic and semantic memories, and emotional tone were identified. Summary concept maps were created and grounded theory concepts were explored for each learning level. We identified three major findings: (1) The “apprentice effect” in novices (high stress and low narrative competence); (2) logistic concept growth in intermediates; and (3) a cognitive state transition (between analytical and intuitive approaches) in experts. These findings warrant further study and comparison.

  19. Laser optoacoustic tomography for medical diagnostics: principles

    NASA Astrophysics Data System (ADS)

    Oraevsky, Alexander A.; Esenaliev, Rinat O.; Jacques, Steven L.; Tittel, Frank K.

    1996-04-01

    This paper is to describe principles of laser optoacoustic tomography for medical diagnostics. Two types of imaging modes are presented. The first is the tomography in transmission mode, which utilizes detection of stress transients transmitted from the laser-excited volume toward the depth through thick layers of tissue. The second is the tomography in reflection mode which utilizes detection of stress transients generated in superficial tissue layer and reflected back toward tissue surface. To distinguish the two modes, we have abbreviated them as (1) laser optoacoustic tomography in transmission mode, LOATT, and (2) time-resolved stress detection tomography of light absorption, TRSDTLA, in reflection mode where emphasis is made on high spatial resolution of images. The basis for laser optoacoustic tomography is the time-resolved detection of laser-induced transient stress waves, selectively generated in absorbing tissues of diagnostic interest. Such a technique allows one to visualize absorbed light distribution in turbid biological tissues irradiated by short laser pulses. Laser optoacoustic tomography can be used for detection of tissue pathological changes that result in either increased concentration of various tissue chromophores such as hemoglobin or in development of enhanced microcirculation in diseased tissue. Potential areas of applications are diagnosis of cancer, brain hemorrhages, arterial atherosclerotic plaques, and other diseased tissues. In addition, it can provide feedback information during medical treatments. Both LOATT and TRSDTLA utilize laser excitation of biological tissues and sensitive detection of laser-induced stress waves. Optical selectivity is based upon differences in optical properties of pathologically different tissues. Sensitivity comes from stress generation under irradiation conditions of temporal stress confinement. The use of sensitive wide-band lithium niobate acoustic transducers expands limits of laser optoacoustic

  20. 77 FR 14706 - Medical Diagnostic Equipment Accessibility Standards

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-03-13

    ... the Federal Register, 77 FR 6916, on accessibility standards for medical diagnostic equipment and... published an NPRM in the February 9, 2012 edition of the Federal Register, 77 FR 6916, proposing the... TRANSPORTATION BARRIERS COMPLIANCE BOARD 36 CFR Part 1195 RIN 3014-AA40 Medical Diagnostic...

  1. VCSEL technology for medical diagnostics and therapeutics

    NASA Astrophysics Data System (ADS)

    Hibbs-Brenner, M. K.; Johnson, K. L.; Bendett, M.

    2009-02-01

    In the 1990's a new laser technology, Vertical Cavity Surface Emitting Lasers, or VCSELs, emerged and transformed the data communication industry. The combination of performance characteristics, reliability and performance/cost ratio allowed high data rate communication to occur over short distances at a commercially viable price. VCSELs have not been widely used outside of this application space, but with the development of new attributes, such as a wider range of available wavelengths, the demonstration of arrays of VCSELs on a single chip, and a variety of package form factors, VCSELs can have a significant impact on medical diagnostic and therapeutic applications. One area of potential application is neurostimulation. Researchers have previously demonstrated the feasibility of using 1850nm light for nerve stimulation. The ability to create an array of VCSELs emitting at this wavelength would allow significantly improved spatial resolution, and multiple parallel channels of stimulation. For instance, 2D arrays of 100 lasers or more can be integrated on a single chip less than 2mm on a side. A second area of interest is non-invasive sensing. Performance attributes such as the narrow spectral width, low power consumption, and packaging flexibility open up new possibilities in non-invasive and/or continuous sensing. This paper will suggest ways in which VCSELs can be implemented within these application areas, and the advantages provided by the unique performance characteristics of the VCSEL. The status of VCSEL technology as a function of available wavelength and array size and form factors will be summarized.

  2. Ontology-oriented diagnostic system for traditional Chinese medicine based on relation refinement.

    PubMed

    Gu, Peiqin; Chen, Huajun; Yu, Tong

    2013-01-01

    Although Chinese medicine treatments have become popular recently, the complicated Chinese medical knowledge has made it difficult to be applied in computer-aided diagnostics. The ability to model and use the knowledge becomes an important issue. In this paper, we define the diagnosis in Traditional Chinese Medicine (TCM) as discovering the fuzzy relations between symptoms and syndromes. An Ontology-oriented Diagnosis System (ODS) is created to address the knowledge-based diagnosis based on a well-defined ontology of syndromes. The ontology transforms the implicit relationships among syndromes into a machine-interpretable model. The clinical data used for feature selection is collected from a national TCM research institute in China, which serves as a training source for syndrome differentiation. The ODS analyzes the clinical cases to obtain a statistical mapping relation between each syndrome and associated symptom set, before rechecking the completeness of related symptoms via ontology refinement. Our diagnostic system provides an online web interface to interact with users, so that users can perform self-diagnosis. We tested 12 common clinical cases on the diagnosis system, and it turned out that, given the agree metric, the system achieved better diagnostic accuracy compared to nonontology method-92% of the results fit perfectly with the experts' expectations. PMID:23533534

  3. 77 FR 62479 - Medical Diagnostic Equipment Accessibility Standards Advisory Committee

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-10-15

    ... Medical Diagnostic Equipment Accessibility Standards. See 77 FR 6916 (February 9, 2012). The NPRM and... refrain from using perfume, cologne, and other fragrances for the comfort of other participants (see...

  4. 78 FR 10582 - Medical Diagnostic Equipment Accessibility Standards Advisory Committee

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-02-14

    ... Medical Diagnostic Equipment Accessibility Standards. See 77 FR 6916 (February 9, 2012). The NPRM and... the meetings are requested to refrain from using perfume, cologne, and other fragrances for...

  5. 77 FR 53163 - Medical Diagnostic Equipment Accessibility Standards Advisory Committee

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-08-31

    ...) on Medical Diagnostic Equipment Accessibility Standards. See 77 FR 6916 (February 9, 2012). The NPRM... provided. Persons attending the meetings are requested to refrain from using perfume, cologne, and...

  6. 78 FR 16448 - Medical Diagnostic Equipment Accessibility Standards Advisory Committee

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-03-15

    ... previously published NPRM on Medical Diagnostic Equipment Accessibility Standards. See 77 FR 6916 (February 9... provided. Persons attending the meetings are requested to refrain from using perfume, cologne, and...

  7. Handheld Diagnostic Device Delivers Quick Medical Readings

    NASA Technical Reports Server (NTRS)

    2014-01-01

    To monitor astronauts' health remotely, Glenn Research Center awarded SBIR funding to Cambridge, Massachusetts-based DNA Medical Institute, which developed a device capable of analyzing blood cell counts and a variety of medical biomarkers. The technology will prove especially useful in rural areas without easy access to labs.

  8. Sherlock Holmes' methods of deductive reasoning applied to medical diagnostics.

    PubMed

    Miller, L

    1985-03-01

    Having patterned the character of Sherlock Holmes after one of his professors, Sir Arthur Conan Doyle, himself a physician, incorporated many of the didactic qualities of the 19th century medical diagnostician into the character of Holmes. In this paper I explore Holmes's techniques of deductive reasoning and their basis in 19th and 20th century medical diagnostics. PMID:3887762

  9. Sherlock Holmes's Methods of Deductive Reasoning Applied to Medical Diagnostics

    PubMed Central

    Miller, Larry

    1985-01-01

    Having patterned the character of Sherlock Holmes after one of his professors, Sir Arthur Conan Doyle, himself a physician, incorporated many of the didactic qualities of the 19th century medical diagnostician into the character of Holmes. In this paper I explore Holmes's techniques of deductive reasoning and their basis in 19th and 20th century medical diagnostics. PMID:3887762

  10. A survey of medical diagnostic imaging technologies

    SciTech Connect

    Heese, V.; Gmuer, N.; Thomlinson, W.

    1991-10-01

    The fields of medical imaging and medical imaging instrumentation are increasingly important. The state-of-the-art continues to advance at a very rapid pace. In fact, various medical imaging modalities are under development at the National Synchrotron Light Source (such as MECT and Transvenous Angiography.) It is important to understand how these techniques compare with today's more conventional imaging modalities. The purpose of this report is to provide some basic information about the various medical imaging technologies currently in use and their potential developments as a basis for this comparison. This report is by no means an in-depth study of the physics and instrumentation of the various imaging modalities; instead, it is an attempt to provide an explanation of the physical bases of these techniques and their principal clinical and research capabilities.

  11. A survey of medical diagnostic imaging technologies

    SciTech Connect

    Heese, V.; Gmuer, N.; Thomlinson, W.

    1991-10-01

    The fields of medical imaging and medical imaging instrumentation are increasingly important. The state-of-the-art continues to advance at a very rapid pace. In fact, various medical imaging modalities are under development at the National Synchrotron Light Source (such as MECT and Transvenous Angiography.) It is important to understand how these techniques compare with today`s more conventional imaging modalities. The purpose of this report is to provide some basic information about the various medical imaging technologies currently in use and their potential developments as a basis for this comparison. This report is by no means an in-depth study of the physics and instrumentation of the various imaging modalities; instead, it is an attempt to provide an explanation of the physical bases of these techniques and their principal clinical and research capabilities.

  12. [Fifty year's career of Chinese Journal of Medical History].

    PubMed

    Lu, Z

    1996-01-01

    The Journal of Medical History, the antecedent of the now Chinese Journal of Medical History, was inaugurated in March 1947. This paper divides the whole course of publication and compilation of this Journal into 3 stages, namely, Stage of Initiation and Growth (1947-1948), Stage of Tortuous Progressing (1951-1959), Stage of Flourishing and developing (1980-). Altogether 25 volumes, 95 issues have been published in 953 millon Chinese characters and 1684 original articles. Being a highly effective major journal of medical history, this Journal satisfies nearly 40% of the information in this subject and has been indexed by major medical cataloging tool books, both domestic and foreign. Experience and prospects are also mentioned here. PMID:11618794

  13. Managing waiting times in diagnostic medical imaging

    PubMed Central

    Nuti, Sabina; Vainieri, Milena

    2012-01-01

    Objective This paper aims to analyse the variation in the delivery of diagnostic imaging services in order to suggest possible solutions for the reduction of waiting times, increase the quality of services and reduce financial costs. Design This study provides a logic model to manage waiting times in a regional context. Waiting times measured per day were compared on the basis of the variability in the use rates of CT and MRI examinations in Tuscany for the population, as well as on the basis of the capacity offered with respect to the number of radiologists available. The analysis was performed at the local health authority level to support the decision-making process of local managers. Setting Diagnostic imaging services, in particular the CT and MRI examinations. The study involved all the 12 local health authorities that provide services for 3.7 million inhabitants of the Italian Tuscany Region. Primary and secondary outcome measures Participants: the study uses regional administrative data on outpatients and survey data on inpatient diagnostic examinations in order to measure productivity. Primary and secondary outcome measures The study uses the volumes per 1000 inhabitants, the days of waiting times and the number of examinations per radiologist. Variability was measured using the traditional SD measures. Results A significant variation in areas considered homogeneous in terms of age, gender or mortality may indicate that the use of radiological services is not optimal and underuse or overuse occurs and that there is room for improvement in the service organisation. Conclusions Considering that there is a high level of variability among district use rates and waiting times, this study provides managers with a specific tool to find the cause of the problem, identify a possible solution, assess the financial impact and initiate the eventual reduction of waste. PMID:23242480

  14. Plasmonic nanoprobes: from chemical sensing to medical diagnostics and therapy

    NASA Astrophysics Data System (ADS)

    Vo-Dinh, Tuan; Fales, Andrew M.; Griffin, Guy D.; Khoury, Christopher G.; Liu, Yang; Ngo, Hoan; Norton, Stephen J.; Register, Janna K.; Wang, Hsin-Neng; Yuan, Hsiangkuo

    2013-10-01

    This article provides an overview of the development and applications of plasmonics-active nanoprobes in our laboratory for chemical sensing, medical diagnostics and therapy. Molecular Sentinel nanoprobes provide a unique tool for DNA/RNA biomarker detection both in a homogeneous solution or on a chip platform for medical diagnostics. The possibility of combining spectral selectivity and high sensitivity of the surface-enhanced Raman scattering (SERS) process with the inherent molecular specificity of nanoprobes provides an important multiplex diagnostic modality. Gold nanostars can provide an excellent multi-modality platform, combining two-photon luminescence with photothermal therapy as well as Raman imaging with photodynamic therapy. Several examples of optical detection using SERS and photonics-based treatments are presented to illustrate the usefulness and potential of the plasmonic nanoprobes for theranostics, which seamlessly combines diagnostics and therapy.

  15. Data-Driven Information Extraction from Chinese Electronic Medical Records

    PubMed Central

    Zhao, Tianwan; Ge, Chen; Gao, Weiguo; Wei, Jia; Zhu, Kenny Q.

    2015-01-01

    Objective This study aims to propose a data-driven framework that takes unstructured free text narratives in Chinese Electronic Medical Records (EMRs) as input and converts them into structured time-event-description triples, where the description is either an elaboration or an outcome of the medical event. Materials and Methods Our framework uses a hybrid approach. It consists of constructing cross-domain core medical lexica, an unsupervised, iterative algorithm to accrue more accurate terms into the lexica, rules to address Chinese writing conventions and temporal descriptors, and a Support Vector Machine (SVM) algorithm that innovatively utilizes Normalized Google Distance (NGD) to estimate the correlation between medical events and their descriptions. Results The effectiveness of the framework was demonstrated with a dataset of 24,817 de-identified Chinese EMRs. The cross-domain medical lexica were capable of recognizing terms with an F1-score of 0.896. 98.5% of recorded medical events were linked to temporal descriptors. The NGD SVM description-event matching achieved an F1-score of 0.874. The end-to-end time-event-description extraction of our framework achieved an F1-score of 0.846. Discussion In terms of named entity recognition, the proposed framework outperforms state-of-the-art supervised learning algorithms (F1-score: 0.896 vs. 0.886). In event-description association, the NGD SVM is superior to SVM using only local context and semantic features (F1-score: 0.874 vs. 0.838). Conclusions The framework is data-driven, weakly supervised, and robust against the variations and noises that tend to occur in a large corpus. It addresses Chinese medical writing conventions and variations in writing styles through patterns used for discovering new terms and rules for updating the lexica. PMID:26295801

  16. Porphyria or Catatonia: Diagnostic Dilemma on the Medical Wards.

    PubMed

    Kurkjian, Natalie; Tucker, Phebe

    2016-01-01

    A 24-year-old Caucasian female, DD, was admitted to the medical service at an academic hospital with symptoms of weakness in bilateral lower extremities, falls, headaches, and altered mental status. Psychiatry was consulted to evaluate for psychiatric causes of her symptoms. This case presented a diagnostic challenge as the patient's identified symptoms changed almost daily, depending on what practitioner or medical service she encountered. In this study, we discuss the differential diagnoses, tests and treatments the patient received, with a review of literature helping differentiate between diagnostic parameters. PMID:27027143

  17. Acoustic Waves in Medical Imaging and Diagnostics

    PubMed Central

    Sarvazyan, Armen P.; Urban, Matthew W.; Greenleaf, James F.

    2013-01-01

    Up until about two decades ago acoustic imaging and ultrasound imaging were synonymous. The term “ultrasonography,” or its abbreviated version “sonography” meant an imaging modality based on the use of ultrasonic compressional bulk waves. Since the 1990s numerous acoustic imaging modalities started to emerge based on the use of a different mode of acoustic wave: shear waves. It was demonstrated that imaging with these waves can provide very useful and very different information about the biological tissue being examined. We will discuss physical basis for the differences between these two basic modes of acoustic waves used in medical imaging and analyze the advantages associated with shear acoustic imaging. A comprehensive analysis of the range of acoustic wavelengths, velocities, and frequencies that have been used in different imaging applications will be presented. We will discuss the potential for future shear wave imaging applications. PMID:23643056

  18. [Nuclear medical diagnostics for liver tumors].

    PubMed

    Buck, A K; Stollfuss, J C; Stahl, A; Beer, A J; Meisetschläger, G; Schwaiger, M

    2007-01-01

    Standard nuclear medical procedures, such as functional, blood-pool and colloid scintigraphy, play a minor role in the routine workup of liver tumors. However, these techniques are capable of assessing specific organ functions and frequently allow the diagnosis of unclear liver lesions. The sensitivity of scintigraphic procedures can be increased using tomographic imaging (SPECT), the specificity with the introduction of hybrid scanners such as SPECT/CT. Whole body positron emission tomography with 18F-fluoro-deoxy-glucose (FDG) in combination with CT scanning (PET/CT) represents one of the most sensitive imaging modalities for the detection of hepatic metastases and extrahepatic tumor manifestations. For the staging and follow-up of colorectal cancer, FDG-PET/CT represents a standard imaging modality. Metastases from neuroendocrine tumors can be detected using PET and specific tracers such as [68Ga]DOTATOC and [18F]DOPA. Molecular imaging with PET allows the quantification of metabolic processes which can be used for the assessment of an early response to treatment. PMID:17195061

  19. 77 FR 39656 - Medical Diagnostic Equipment Accessibility Standards Advisory Committee

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-07-05

    ... Proposed Rulemaking (NPRM) on Medical Diagnostic Equipment Accessibility Standards. See 77 FR 14706 (March.... In February 2012, the Access Board published an NPRM proposing the accessibility standards. See 77 FR..., Washington, DC 20004. FOR FURTHER INFORMATION CONTACT: Rex Pace, Office of Technical and Information...

  20. 78 FR 32612 - Medical Diagnostic Equipment Accessibility Standards Advisory Committee

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-05-31

    ... Accessibility Standards. See 77 FR 6916 (February 9, 2012). The NPRM and information related to the proposed... translation (CART) web streaming link will be posted on the Access Board's Medical Diagnostic Equipment Web..., 1331 F Street NW., suite 1000, Washington, DC 20004- 1111. Telephone number (202) 272-0023...

  1. An Interview with Medical Diagnostics Scientist Bernhard Weigl

    ERIC Educational Resources Information Center

    Sullivan, Megan

    2010-01-01

    Medical diagnostics help us evaluate a range of disorders, such as cancer and infectious diseases. In the United States and other developed countries, doctors have access to advanced equipment and laboratories that provide reliable diagnoses. As a result, when we are sick, we feel confident that we will get the treatment we need. Unfortunately,…

  2. A specialized framework for Medical Diagnostic Knowledge Based Systems.

    PubMed Central

    Lanzola, G.; Stefanelli, M.

    1991-01-01

    To have a knowledge based system (KBS) exhibiting an intelligent behavior, it must be endowed even with knowledge able to represent the expert's strategies, other than with domain knowledge. The elicitation task is inherently difficult for strategic knowledge, because strategy is often tacit, and, even when it has been made explicit, it is not an easy task to describe it in a form that may be directly translated and implemented into a program. This paper describes a Specialized Framework for Medical Diagnostic Knowledge Based Systems able to help an expert in the process of building KBSs in a medical domain. The framework is based on an epistemological model of diagnostic reasoning which has proved to be helpful in describing the diagnostic process in terms of the tasks by which it is composed of. PMID:1807566

  3. Chinese Confucian culture and the medical ethical tradition.

    PubMed Central

    Guo, Z

    1995-01-01

    The Confucian culture, rich in its contents and great in its significance, exerted on the thinking, culture and political life of ancient China immense influences, unparalleled by any other school of thought or culture. Confucian theories on morality and ethics, with 'goodness' as the core and 'rites' as the norm, served as the 'key notes' of the traditional medical ethics of China. The viewpoints of Confucianism on benevolence and material interests, on good and evil, on kindheartedness, and on character cultivation were all inherited by the medical workers and thus became prominent in Chinese traditional medical ethics. Hence, it is clear that the medical profession and Confucianism have long shared common goals in terms of ethics. Influenced by the excellent Confucian thinking and culture, a rather highly-developed system of Chinese traditional medical ethics emerged with a well-defined basic content, and the system has been followed and amended by medical professionals of all generations throughout Chinese history. This system, just to mention briefly, contains concepts such as the need: to attach great importance to the value of life; to do one's best to rescue the dying and to heal the wounded; to show concern to those who suffer from diseases; to practise medicine with honesty; to study medical skills painstakingly; to oppose a careless style of work; to comfort oneself in a dignified manner; to respect local customs and to be polite; to treat patients, noble or humble, equally, and to respect the academic achievements of others, etc. Of course, at the same time, Confucian culture has its own historical and class limitations, which exerted negative influences on traditional medical ethics. Now, if we are to keep up with the development of modern medicine, a serious topic must be addressed. That is how to retain the essence of our traditional medical ethics so as to maintain historic continuity and yet, at the same time, add on the new contents of medical

  4. Diagnostic computing: an elective for fourth-year medical students.

    PubMed

    Bartold, S; Hannigan, G G

    1995-01-01

    The complex problems that patients pose require familiarity with the use and limitations of diagnostic computer systems. Independent of practice specialty, physicians may expect to encounter computer applications and digital image systems to provide information for diagnosis and management. This poster describes an elective for fourth-year medical students that introduces students to diagnostic computing through the use of decision-assist software and imaging processing systems. The poster includes photographs, examples of course exercises and readings, and a summary of course evaluation information. PMID:8591394

  5. Computational Diagnostic: A Novel Approach to View Medical Data.

    SciTech Connect

    Mane, K. K.; Börner, K.

    2007-01-01

    A transition from traditional paper-based medical records to electronic health record is largely underway. The use of electronic records offers tremendous potential to personalize patient diagnosis and treatment. In this paper, we discuss a computational diagnostic tool that uses digital medical records to help doctors gain better insight about a patient's medical condition. The paper details different interactive features of the tool which offer potential to practice evidence-based medicine and advance patient diagnosis practices. The healthcare industry is a constantly evolving domain. Research from this domain is often translated into better understanding of different medical conditions. This new knowledge often contributes towards improved diagnosis and treatment solutions for patients. But the healthcare industry lags behind to seek immediate benefits of the new knowledge as it still adheres to the traditional paper-based approach to keep track of medical records. However recently we notice a drive that promotes a transition towards electronic health record (EHR). An EHR stores patient medical records in digital format and offers potential to replace the paper health records. Earlier attempts of an EHR replicated the paper layout on the screen, representation of medical history of a patient in a graphical time-series format, interactive visualization with 2D/3D generated images from an imaging device. But an EHR can be much more than just an 'electronic view' of the paper record or a collection of images from an imaging device. In this paper, we present an EHR called 'Computational Diagnostic Tool', that provides a novel computational approach to look at patient medical data. The developed EHR system is knowledge driven and acts as clinical decision support tool. The EHR tool provides two visual views of the medical data. Dynamic interaction with data is supported to help doctors practice evidence-based decisions and make judicious choices about patient

  6. [Pediatric patient sedation and analgesia for diagnostic medical procedures].

    PubMed

    Kadosaki, Mamoru

    2014-08-01

    There is an increasing demand for anesthesiologists to work outside the operating room in order to provide general anesthesia or monitored sedation for a variety of medical investigations or procedures in infants and children. The concept that treatment should be a pain- and stress-free experience is now well accepted, and this has placed additional responsibilities on anesthesiologists. We describe pediatric anesthesia and monitored sedation for diagnostic medical procedures. Children requiring a painful procedure and prolonged examination should be provided with optimal sedation and analgesia. The child should be monitored with standard ASA monitors. In the case of medical procedures such as gastrointestinal endoscopy, transesophageal echocardiography, and cardiac catheterization, general endotracheal anesthesia with neuromuscular block is recommended. Several short-acting anesthetic drugs, including sevoflurane, propofol, remifentanil, and rocuronium, have become available in Japan, and the safety and efficacy of pediatric general anesthesia for diagnostic medical procedures have improved. Infants who require a noninvasive and short examination may not be provided with anesthetics. The feed and wrap method is recommended. Satisfactory immobilization of the child during noninvasive medical procedures, including magnetic resonance imaging, may be achieved by intravenous sedation or general anesthesia. Monitored intravenous sedation using propofol is the most widely used for healthy children; general anesthesia with a laryngeal mask airway or endotracheal intubation and controlled ventilation is required for a critically ill child. PMID:25669029

  7. Diagnostic value of multiple café-au-lait macules for neurofibromatosis 1 in Chinese children.

    PubMed

    Yao, Ruen; Wang, Lili; Yu, Yongguo; Wang, Jian; Shen, Yiping

    2016-05-01

    Neurofibromatosis 1 (NF1) is a common autosomal dominant condition caused by mutations in the NF1 gene. The appearance of multiple café-au-lait macules is an early sign of the condition, which often alert physicians to follow up and further examine the patient for the possibility of NF1. In order to determine the predictive value of multiple café-au-lait macules at early age for NF1 in Chinese patients, we recruited 19 children who shared the common sign of multiple café-au-lait macules from a general pediatric clinic in Shanghai. All the patients were clinically evaluated following the National Institutes of Health criteria for NF1 and molecular tested for sequence variants and copy number changes. Nine children met the clinical diagnostic criteria of NF1, and molecular tests confirmed all nine patients with pathogenic variants including two genomic deletions, two novel frame-shift variants, four novel nonsense and a splicing variants. In addition, four children who did not meet the diagnostic criteria were also found to carry pathogenic NF1 variants. Overall, 68.4% (13/19) of children with café-au-lait macules and various other clinical presentations were molecularly confirmed with NF1. This study demonstrated that the majority of Chinese children with multiple café-au-lait macules who came to seek for medical attention had NF1. Molecular testing is necessary to be used as an adjunct and sometimes as the main tool for confirming and diagnosing children of NF1 at early age. PMID:26458495

  8. Translingual Alteration of Conceptual Information in Medical Translation: A Crosslanguage Analysis between English and Chinese.

    ERIC Educational Resources Information Center

    He, Shaoyi

    2000-01-01

    This study conducted a crosslanguage analysis of conceptual alteration in medical translation between English and Chinese, focusing on the original and translated concepts in article titles from two English medical journals and two Chinese medical journals. Findings provide insights into future studies on crosslanguage information retrieval via…

  9. A computerized data base system for medical diagnostic studies (Diastu).

    PubMed

    Rosen, I I; Hall, T C; Mettler, F; Wicks, J; Kelsey, C A; Gustafson, D E

    1980-12-01

    A computerized database system (DIASTU) has been developed for the storage and selective retrieval of the results of medical diagnostic studies. The system is being used to analyze the disease process and the efficacy and yield of selected diagnostic studies. The system runs on a DEC PDP-11/60 computer. It consists of three FORTRAN IV programs linked to a general-purpose assembly language database handler. One program, DSENT, interactively modifies the information in the database. The second, DSLIST, prints all or portions of the database. The third program, DSTAT, interactively assembles the parameters for selective searches of the database and executes them. A query language is used that allows the use of time and size specifications and Boolean operators in nested loops. PMID:7249603

  10. Hazard analysis of a computer based medical diagnostic system.

    PubMed

    Chudleigh, M F

    1994-07-01

    Medical screening of sectors of the population is now a routine and vital part of health care: an example is cervical smear testing. There is currently significant interest in the possible introduction of semi-automated microscopy systems for cervical cytology and one such experimental system is now undergoing laboratory trials. A collaborative project has been set up to demonstrate the benefits and constraints that arise from applying safety-critical methods developed in other domains to such a diagnostic system. We have carried out a system hazard analysis, successfully using the HAZOP technique adapted from the petrochemical industry. PMID:7988111

  11. Imaging Systems for Medical Diagnosis: Fundamentals and Technical Solutions - X-Ray Diagnostics- Computed Tomography - Nuclear Medical Diagnostics - Magnetic Resonance Imaging - Ultrasound Technology

    NASA Astrophysics Data System (ADS)

    Krestel, Erich

    1990-10-01

    Erick Krestel, Editor Imaging Systems for Medical Diagnostics This book provides physicians and clinical physicists with detailed information on todya's imaging modalities and assists them in selecting the optimal system for each clinical application. Physicists, engineers and computer specialists engaged in research and development and sales departments will also find this book to be of considerable use. It may also be employed at universities, training centers and in technical seminars. The physiological and physical fundamentals are explained in part 1. The technical solutions contained in part 2 illustrate the numerous possibilities available in x-ray diagnostics, computed tomography, nuclear medical diagnostics, magnetic resonance imaging, sonography and biomagnetic diagnostics. Overview of Contents Physiology of vision Image quality X-ray and gamma radiation X-ray diagnostics Computed tomography Nuclear medical diagnostics Magnetic resonance imaging Sonography Biomagnetic diagnostics

  12. How 3D immersive visualization is changing medical diagnostics

    NASA Astrophysics Data System (ADS)

    Koning, Anton H. J.

    2011-03-01

    Originally the only way to look inside the human body without opening it up was by means of two dimensional (2D) images obtained using X-ray equipment. The fact that human anatomy is inherently three dimensional leads to ambiguities in interpretation and problems of occlusion. Three dimensional (3D) imaging modalities such as CT, MRI and 3D ultrasound remove these drawbacks and are now part of routine medical care. While most hospitals 'have gone digital', meaning that the images are no longer printed on film, they are still being viewed on 2D screens. However, this way valuable depth information is lost, and some interactions become unnecessarily complex or even unfeasible. Using a virtual reality (VR) system to present volumetric data means that depth information is presented to the viewer and 3D interaction is made possible. At the Erasmus MC we have developed V-Scope, an immersive volume visualization system for visualizing a variety of (bio-)medical volumetric datasets, ranging from 3D ultrasound, via CT and MRI, to confocal microscopy, OPT and 3D electron-microscopy data. In this talk we will address the advantages of such a system for both medical diagnostics as well as for (bio)medical research.

  13. Synergistic advances in diagnostic and therapeutic medical ultrasound

    NASA Astrophysics Data System (ADS)

    Lizzi, Frederic L.

    2003-04-01

    Significant advances are more fully exploiting ultrasound's potential for noninvasive diagnosis and treatment. Therapeutic systems employ intense focused beams to thermally kill cancer cells in, e.g., prostate; to stop bleeding; and to treat specific diseases (e.g., glaucoma). Diagnostic ultrasound techniques can quantitatively image an increasingly broad spectrum of physical tissue attributes. An exciting aspect of this progress is the emerging synergy between these modalities. Advanced diagnostic techniques may contribute at several stages in therapy. For example, treatment planning for small ocular tumors uses 50-MHz, 3-D ultrasonic images with 0.05-mm resolution. Thermal simulations employ these images to evaluate desired and undesired effects using exposure stategies with specially designed treatment beams. Therapy beam positioning can use diagnostic elastography to sense tissue motion induced by radiation pressure from high-intensity treatment beams. Therapy monitoring can sense lesion formation using elastography motion sensing (to detect the increased stiffness in lesions); harmonic imaging (to sense altered nonlinear properties); and spectrum analysis images (depicting changes in the sizes, concentration, and configuration of sub-resolution structures.) Experience from these applications will greatly expand the knowledge of acoustic phenomena in living tissues and should lead to further advances in medical ultrasound.

  14. [Ancient Indian and Chinese medical oaths and the comparison of their medical rules].

    PubMed

    Aksoy, S

    2001-01-01

    The art of medicine has existed on earth since the existence of mankind. Although the traditions and practices may vary, the mere intention has been to help people remain healthy and restore their health when they get sick. Since health is man's most important fortune, the medical profession has always been open to abuse or misuse. To prevent this, it came to be a tradition to bound health care professionals with oaths and codes. This article examines medical oaths and codes in two different Eastern traditions, namely China and India. Two different medical oaths from two major ancient Indian medical books, Charaka Samhita and Susuruta will be addressed and elaborated. They will be compared and contrasted with each other and their commons and differences from the other medical oaths will be examined. Chinese medical codes, one from the 7th and the other from the 17th century are reviewed in the article. It has appeared from the discussion that although there are some 'unchangeables' in the codes and oaths, like the reference to some sacred or transcendental being or commitment to show respect to the teachers, there are differences due to the time and place. It is also interesting to note how medical practice and its values are influenced by the respective society. PMID:14570011

  15. Future Perspectives of Chinese Medical Formulae: Chinmedomics as an Effector

    PubMed Central

    Zhang, Aihua; Sun, Hui

    2012-01-01

    Abstract Traditional Chinese medicine (TCM) has been used for thousands of years to treat or prevent disease. The health care paradigm has shifted from a focus on disease to TCM therapy with a holistic approach. However, the actual value of TCM has not been fully recognized worldwide due to a lack of scientific approaches to its study. Today omics has become practically available, and resembles TCM in many aspects, and can serve as a key driving force for the translation of the traditional Chinese medical formulae (chinmediformulae) into practice, and will develop and advance the concept of the metabolomics of chinmediformulae (chinmedomics). Chinmedomics seeks to elucidate the therapeutic and synergistic properties and metabolism of chinmediformulae and the involved metabolic pathways using modern analytical techniques. It is an integral part of top-down systems biology, which aims to improve understanding of chinmediformulae. This approach of combining chinmedomics with chinmediformulae with modern health care systems may lead to a revolution in TCM therapy. Although the scientific study of chinmedomics is at an early stage and requires further scrutiny and validation, the approach has major implications to improve the efficacy of chinmediformulae. This article introduces and reviews the concept of chinmedomics, and highlights recent examples of the approach, which are presented for description and discussion. PMID:22734809

  16. Traditional Chinese medical comprehensive therapy for cancer-related fatigue.

    PubMed

    Yang, Lu; Li, Tian-Tian; Chu, Yu-Ting; Chen, Ke; Tian, Shao-Dan; Chen, Xin-Yi; Yang, Guo-Wang

    2016-01-01

    Cancer-related fatigue (CRF) is a common and one of the most severe symptom in the period of onset, diagnosis, treatment and rehabilitation process of cancer. But there are no confirmed measures to relieve this problem at present. Traditional Chinese medical comprehensive therapy has its advantages in dealing with this condition. Based on the research status of CRF, the following problems have been analyzed and solved: the term of CRF has been defined and recommended, and the definition has been made clear; the disease mechanism is proposed, i.e. healthy qi has been impaired in the long-term disease duration, in the process of surgery, chemotherapy, radiotherapy and biology disturbing; it is clear that the clinical manifestations are related to six Chinese medicine patterns: decreased functioning of the Pi (Spleen) and Wei (Stomach), deficiency of the Pi with dampness retention, deficiency of the Xin (Heart) and Pi, disharmony between the Gan (Liver) and Pi, deficiency of the Pi and Shen (Kidney), and deficiency of the Fei (Lung) and Shen. Based on its severity, the mild patients are advised to have non-drug psychological intervention and sleep treatment in cooperation with appropriate exercise; diet therapy are recommended to moderate patients together with sleep treatment and acupuncture, severe patients are recommended to have herbal treatment based on pattern differentiation together with physiological sleep therapy. PMID:26108523

  17. Empathy in Chinese medical students: psychometric characteristics and differences by gender and year of medical education

    PubMed Central

    2013-01-01

    Background In recent years in China, the tense physician-patient relationship has been an outstanding problem. Empathy is one of the fundamental factors enhancing the therapeutic effects of physician-patient relationships and is significantly associated with clinical and academic performance among students. Methods This cross-sectional study used the JSPE-S (The Student Version of the Jefferson Scale of Physician Empathy) to assess 902 medical students from 1st year to 4th year at China Medical University. The reliability of the questionnaire was assessed by Cronbach’s alpha coefficient. We performed an exploratory factor analysis to evaluate the construct validity of the JSPE-S. Group comparisons of empathy scores were conducted via the t-test and one-way ANOVA. Statistic analysis was performed by SPSS 13.0. Results The Cronbach’s alpha coefficient was 0.83. The three factors emerging in the factor analysis of the JSPE-S are “perspective taking”, “compassionate care” and “ability to stand in patients’ shoes”, which accounted for 48.00%. The mean empathy score was 109.60. The empathy score of medical students had significant differences between different genders (p < 0.05) and academic year level (p < 0.05). Conclusions This study provided support for the validity and reliability of the Chinese translated version of the JSPE-S for medical students. Early exposure to clinical training and a curriculum for professional competencies help to enhance the empathy of medical students. We suggest that the curriculum within Chinese medical schools include more teaching on empathy and communicational skills. PMID:24053330

  18. The physician charter on medical professionalism from the Chinese perspective: a comparative analysis.

    PubMed

    Jin, Pingyue

    2015-07-01

    The charter of medical professionalism in the new millennium (Charter) has been endorsed worldwide, including by the Chinese Medical Doctor Association from 2005. Six years later, the association drafted a Chinese version of medical professionalism based on the Charter, the Chinese Medical Doctor Declaration (Declaration). This Declaration encompasses six tenets, which have large areas of overlap with the Charter. Meanwhile, certain differences also exist between the universal professionalism that the Charter aims to disseminate and the ideal Chinese professionalism that the Declaration endeavours to bolster. In this paper, we explore the unique aspects of the Declaration in contrast with the Charter to gain a deeper understanding of professionalism in the particular context of China. The Declaration may omit some valuable commitments found in the Charter, but it includes longstanding Confucian and cultural traditions of China, as well as consideration of current social circumstances. The Declaration thus re-establishes the ideal of universal professionalism in light of the Chinese context. PMID:25341734

  19. The future of novel diagnostics in medical mycology.

    PubMed

    Teles, Fernando; Seixas, Jorge

    2015-04-01

    Several fungal diseases have become serious threats to human health and life, especially upon the advent of human immunodeficiency virus/AIDS epidemics and of other typical immunosuppressive conditions of modern life. Accordingly, the burden posed by these diseases and, concurrently, by intensive therapeutic regimens against these diseases has increased worldwide. Existing and available rapid tests for point-of-care diagnosis of important fungal diseases could enable the limitations of current laboratory methods for detection and identification of medically important fungi to be surpassed, both in low-income countries and for first-line diagnosis (screening) in richer countries. As with conventional diagnostic methods and devices, former immunodiagnostics have been challenged by molecular biology-based platforms, as a way to enhance the sensitivity and shorten the assay time, thus enabling early and more accurate diagnosis. Most of these tests have been developed in-house, without adequate validation and standardization. Another challenge has been the DNA extraction step, which is especially critical when dealing with fungi. In this paper, we have identified three major research trends in this field: (1) the application of newer biorecognition techniques, often applied in analytical chemistry; (2) the development of new materials with improved physico-chemical properties; and (3) novel bioanalytical platforms, allowing fully automated testing. Keeping up to date with the fast technological advances registered in this field, primarily at the proof-of-concept level, is essential for wise assessment of those that are likely to be more cost effective and, as already observed for bacterial and viral pathogens, may provide leverage to the current tepid developmental status of novel and improved diagnostics for medical mycology. PMID:25418735

  20. Novel x-ray optics for medical diagnostic techniques

    NASA Astrophysics Data System (ADS)

    Kuyumchyan, A.; Arvanian, V.; Kuyumchyan, D.; Aristov, V.; Shulakov, E.

    2009-08-01

    A new hard X - ray hologram with using crystal Fresnel zone plates (ZP) has been described. An image of Fourier hologram for hard X- ray is presented. X-ray phase contrast methods for medical diagnostics techniques are presented. We have developed an X-ray microscope, based on micro focus source which is capable of high resolution phasecontrast imaging and holograms. We propose a new imaging technique with the x-ray energy 8 keV. The method is expected to have wide applications in imaging of low absorbing samples such as biological and medical tissue. We used FIB to reproduction three dimension structures of damaged spinal cord of rat before and after combined treatment with NT3 and NR2D. PUBLISHER'S NOTE 12/16/09: This SPIE Proceedings paper has been updated with an erratum correcting several issues throughout the paper. The corrected paper was published in place of the earlier version on 9/1/2009. If you purchased the original version of the paper and no longer have access, please contact SPIE Digital Library Customer Service at CustomerService@SPIEDigitalLibrary.org for assistance.

  1. PBL and Critical Thinking Disposition in Chinese Medical Students--A Randomized Cross-Sectional Study

    ERIC Educational Resources Information Center

    Du, XiangYun; Emmersen, Jeppe; Toft, Egon; Sun, Baozhi

    2013-01-01

    The purpose of this study was to explore the relationship of problem-based learning (PBL) and the development of critical thinking disposition (CT) and academic achievement in Chinese medical students using a cross-sectional randomized design. Medical students from China Medical University (CMU) were randomized to PBL or non-PBL teaching at the…

  2. Development of polymer 'chips' used in medical diagnostics

    SciTech Connect

    Brush, Zachary G; Schultz, Laura M; Vanness, Justin W; Farinholt, Kevin M; Sarles, Stephen; Leo, Donald

    2011-01-26

    In recent years, there has been growing interest in creating bio-inspired devices that feature artificial bilayer lipid membranes (BLM), or lipid bilayers. These membranes can be tailored to mimic the structure and transport properties of cellular walls and can be used to selectively transport ions and other species between aqueous volumes. One application of this research is the formation of a standardized BLM contained within a portable and disposable housing for use in medical diagnostics. This concept utilizes a flexible polymer 'chip' that has internal compartments for housing both an organic solvent and an aqueous solution, which contains phospholipid molecules, proteins, and specific analyte molecules. The formation of a BLM within the chip enables integration of the chip into an electronic reader to perform diagnostic measurements of the sample. A key element of the bilayer formation process requires a single aqueous volume to first be separated into multiple volumes such that it can then be reattached to form a bilayer at the interface. This process, called the regulated attachment method, relies on the geometry of the deformable 'chip' to separate and reattach the aqueous contents held inside by opening and closing an aperture that divides adjacent compartments through the application of mechanical force. The purpose of this research is to develop an optimized chip that provides a controllable method for initially separating the aqueous phase via dynamic excitation. This study focuses on two specific aspects: designing an efficient excitation method for separating the aqueous volume, and optimizing the geometry of the chip to decrease the required input energy and better target the location and duration of the separation. Finite Element (FE) models are used to optimize the chip geometry and to identify suitable excitation signals. A series of experimental studies are also presented to validate the FE models.

  3. Development of polymer 'chips' used in medical diagnostics

    SciTech Connect

    Brush, Zachary G; Schultz, Laura M; Vanness, Justin W; Farinholt, Kevin M; Sarles, Stephen; Leo, Donald

    2010-11-03

    In recent years, there has been growing interest in creating bio-inspired devices that feature artificial bilayer lipid membranes (BLM), or lipid bilayers. These membranes can be tailored to mimic the structure and transport properties of cellular walls and can be used to selectively transport ions and other species between aqueous volumes. One application of this research is the formation of a standardized BLM contained within a portable and disposable housing for use in medical diagnostics. This concept utilizes a flexible polymer 'chip' that has internal compartments for housing both an organic solvent and an aqueous solution, which contains phospholipid molecules, proteins, and specific analyte molecules. The formation of a BLM within the chip enables integration of the chip into an electronic reader to perform diagnostic measurements of the sample. A key element of the bilayer formation process requires a single aqueous volume to first be separated into multiple volumes such that it can then be reattached to form a bilayer at the interface. This process, called the regulated attachment method, relies on the geometry of the deformable 'chip' to separate and reattach the aqueous contents held inside by opening and closing an aperture that divides adjacent compartments through the application of mechanical force. The purpose of this research is to develop an optimized chip that provides a controllable method for initially separating the aqueous phase via dynamic excitation. This study focuses on two specific aspects: designing an efficient excitation method for separating the aqueous volume, and optimizing the geometry of the chip to decrease the required input energy and better target the location and duration of the separation. Finite Element (FE) models are used to optimize the chip geometry and to identify suitable excitation signals. A series of experimental studies are also presented to validate the FE models.

  4. Acute Renal Failure Induced by Chinese Herbal Medication in Nigeria.

    PubMed

    Akpan, Effiong Ekong; Ekrikpo, Udeme E

    2015-01-01

    Traditional herbal medicine is a global phenomenon especially in the resource poor economy where only the very rich can access orthodox care. These herbal products are associated with complications such as acute renal failure and liver damage with a high incidence of mortalities and morbidities. Acute renal failure from the use of herbal remedies is said to account for about 30-35% of all cases of acute renal failure in Africa. Most of the herbal medications are not usually identified, but some common preparation often used in Nigeria includes "holy water" green water leaves, bark of Mangifera indica (mango), shoot of Anacardium occidentale (cashew), Carica papaya (paw-paw) leaves, lime water, Solanum erianthum (Potato tree), and Azadirachta indica (Neem) trees. We report a rare case of a young man who developed acute renal failure two days after ingestion of Chinese herb for "body cleansing" and general wellbeing. He had 4 sessions of haemodialysis and recovered kidney function fully after 18 days of admission. PMID:26199625

  5. Enhancement of MML medical data exchange standard for a localized Chinese version.

    PubMed

    Guo, Jinqiu; Takada, Akira; Niu, Tie; He, Miao; Tanaka, Koji; Sato, Junzo; Suzuki, Muneou; Suzuki, Toshiaki; Nakashima, Yusei; Araki, Kenji; Yoshihara, Hiroyuki

    2005-10-01

    Medical Markup Language (MML) is a standard for the exchange of medical data among different medical institutions. It was developed in Japan in 1995. Since version 2.21, MML has used eXtensible Markup Language (XML) as a meta-language. The latest version, 3.0, conforms to HL7 Clinical Document Architecture (CDA) and contains 14 modules and 36 data definition tables. In China, a standard which structures entire medical records in XML does not yet exist. Taking advantage of MML's flexibility, we created a localized Chinese version based on MML 3.0. Parts of the original specifications have been enhanced; these include a newly developed health insurance information module and 12 additional or redefined data definition tables. The Chinese version takes local needs into account and now makes it possible to exchange medical data among Chinese medical institutions. PMID:16180490

  6. NCI and the Chinese Academy of Medical Sciences Sign Statement of Intent

    Cancer.gov

    Today the National Cancer Institute (NCI) and the Cancer Institute/Hospital of the Chinese Academy of Medical Sciences (CICAMS) signed a statement of intent to share an interest in fostering collaborative biomedical research in oncology and a common goal

  7. Medical radiation exposures for diagnostic radiology in Malaysia.

    PubMed

    Ng, K H; Abdullah, B J; Sivalingam, S

    1999-07-01

    The medical radiation usage for diagnostic radiology in Malaysia (a Level II country) for 1990-1994 is reported, enabling a comparison to be made for the first time with the United Nations Scientific Committee on the Effects of Atomic Radiation Report. In 1994, the number of physicians, radiologists, x-ray units, and x-ray examinations per 1,000 population was 0.45, 0.005, 0.065, and 183, respectively. (Level I countries had averages of 2.6, 0.072, 0.35, and 860, respectively). In 1994, a total of 3.6 million x-ray examinations were performed; the annual effective dose per capita to the population was 0.05 mSv, and the collective effective dose was 1,000 person-Sv. Chest examinations contributed 63% of the total. Almost all examinations experienced increasing frequency from 1990 to 1994 except for barium studies, cholecystography, and intravenous urography (-23%, -36%, -51%). These decreases are related to the increasing use of ultrasound and greater availability of fiberoptic endoscopy. Notable increases during the same period were observed in computed tomography (161%), cardiac procedures (190%), and mammography (240%). In order to progress from Level II to Level I status Malaysia needs to expand and upgrade radiological service in tandem with the health care development of the country. PMID:10376539

  8. Medical diagnostics with mobile devices: Comparison of intrinsic and extrinsic sensing.

    PubMed

    Kwon, L; Long, K D; Wan, Y; Yu, H; Cunningham, B T

    2016-01-01

    We review the recent development of mobile detection instruments used for medical diagnostics, and consider the relative advantages of approaches that utilize the internal sensing capabilities of commercially available mobile communication devices (such as smartphones and tablet computers) compared to those that utilize a custom external sensor module. In this review, we focus specifically upon mobile medical diagnostic platforms that are being developed to serve the need in global health, personalized medicine, and point-of-care diagnostics. PMID:26952640

  9. Corrupt practices in chinese medical care: the root in public policies and a call for Confucian-market approach.

    PubMed

    Fan, Ruiping

    2007-06-01

    This paper argues that three salient corrupt practices that mark contemporary Chinese health care, namely the over-prescription of indicated drugs, the prescription of more expensive forms of medication and more expensive diagnostic work-ups than needed, and illegal cash payments to physicians-i.e., red packages-result not from the introduction of the market to China, but from two clusters of circumstances. First, there has been a loss of the Confucian appreciation of the proper role of financial reward for good health care. Second, misguided governmental policies have distorted the behavior of physicians and hospitals. The distorting policies include (1) setting very low salaries for physicians, (2) providing bonuses to physicians and profits to hospitals from the excessive prescription of drugs and the use of more expensive drugs and unnecessary expensive diagnostic procedures, and (3) prohibiting payments by patients to physicians for higher quality care. The latter problem is complicated by policies that do not allow the use of governmental insurance and funds from medical savings accounts in private hospitals as well as other policies that fail to create a level playing field for both private and government hospitals. The corrupt practices currently characterizing Chinese health care will require not only abolishing the distorting governmental policies but also drawing on Confucian moral resources to establish a rightly directed appreciation of the proper place of financial reward in the practice of medicine. PMID:18018995

  10. Cancer among medical diagnostic x-ray workers in China

    SciTech Connect

    Wang, J.X.; Boice, J.D. Jr.; Li, B.X.; Zhang, J.Y.; Fraumeni, J.F. Jr.

    1988-05-04

    Cancer incidence among 27,011 diagnostic x-ray workers was compared to that of 25,782 other medical specialists employed between 1950 and 1980 in China. X-ray workers had a 50% higher risk of developing cancer than the other specialists (relative risk (RR) = 1.5; 95% CI = 1.3-1.7). Leukemia was strongly linked to radiation work (RR = 3.5, n = 30). Cancers of the breast (RR = 1.4, n = 11), thyroid (RR = 2.1, n = 7), and skin (RR = 1.5, n = 6) were increased among x-ray workers employed for 10 or more years. High risks of cancers of the esophagus (RR = 3.5, n = 15) and liver (RR = 2.4, n = 48) were not consistent with a radiation effect since risk did not vary by duration of employment. This finding suggested that some differences might exist between groups of hospital workers in social class, alcohol intake, dietary habits, and other risk factors. No excess lung cancer (RR = 0.9, n = 22) or multiple myeloma (n = 0) was observed. Significant excesses of leukemia and cancers of the breast and thyroid occurred among x-ray workers first employed prior to 1960 when radiation exposures in China were high. In fact, it was not uncommon for employees to be given time off from x-ray work because their wbc count was severely depressed. These data indicated that repeated exposure to x-rays over many years can increase the risk of leukemia and several other tumors but apparently not that of lung cancer.

  11. Validity of Chinese Version of the Composite International Diagnostic Interview-3.0 in Psychiatric Settings

    PubMed Central

    Lu, Jin; Huang, Yue-Qin; Liu, Zhao-Rui; Cao, Xiao-Lan

    2015-01-01

    Background: The Composite International Diagnostic Interview-3.0 (CIDI-3.0) is a fully structured lay-administered diagnostic interview for the assessment of mental disorders according to ICD-10 and Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) criteria. The aim of the study was to investigate the concurrent validity of the Chinese CIDI in diagnosing mental disorders in psychiatric settings. Methods: We recruited 208 participants, of whom 148 were patients from two psychiatric hospitals and 60 healthy people from communities. These participants were administered with CIDI by six trained lay interviewers and the Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-I, gold standard) by two psychiatrists. Agreement between CIDI and SCID-I was assessed with sensitivity, specificity, positive predictive value and negative predictive value. Individual-level CIDI-SCID diagnostic concordance was evaluated using the area under the receiver operator characteristic curve and Cohen's K. Results: Substantial to excellent CIDI to SCID concordance was found for any substance use disorder (area under the receiver operator characteristic curve [AUC] = 0.926), any anxiety disorder (AUC = 0.807) and any mood disorder (AUC = 0.806). The concordance between the CIDI and the SCID for psychotic and eating disorders is moderate. However, for individual mental disorders, the CIDI-SCID concordance for bipolar disorders (AUC = 0.55) and anorexia nervosa (AUC = 0.50) was insufficient. Conclusions: Overall, the Chinese version of CIDI-3.0 has acceptable validity in diagnosing the substance use disorder, anxiety disorder and mood disorder among Chinese adult population. However, we should be cautious when using it for bipolar disorders and anorexia nervosa. PMID:26365963

  12. Medical physics: some recollections in diagnostic X-ray imaging and therapeutic radiology.

    PubMed

    Gray, J E; Orton, C G

    2000-12-01

    Medical physics has changed dramatically since 1895. There was a period of slow evolutionary change during the first 70 years after Roentgen's discovery of x rays. With the advent of the computer, however, both diagnostic and therapeutic radiology have undergone rapid growth and changes. Technologic advances such as computed tomography and magnetic resonance imaging in diagnostic imaging and three-dimensional treatment planning systems, stereotactic radiosurgery, and intensity modulated radiation therapy in radiation oncology have resulted in substantial changes in medical physics. These advances have improved diagnostic imaging and radiation therapy while expanding the need for better educated and experienced medical physics staff. PMID:11110920

  13. [Present situation and development strategies of Chinese medicine preparation in medical institutions].

    PubMed

    Wang, Jie; Qiao, Xi-Yao; Lin, Fei

    2015-11-01

    As the actual clinical reflecting of transform Chinese medicine special curative effect, Chinese medicine preparation not only satisfies the need of hospital clinic, scientific research and teaching, but also plays an important role in deepening medical and health system reform, improving people's health level and contributing to the economic growth. However, some problems about administration and approval (tending to western medicine), contraction of the scale, lack of synchronization for clinic and scientific research, and the imbalance of regional development make Chinese medicine preparation move forwards slowly in contradiction. It has not only reduced the effectiveness of the Chinese medicine preparation in hospital clinic, but also brought bad effect on modernized development of Chinese medicine preparation. Research shows that main influencing factors of status quo of Chinese medicine preparation in medical institution include imperfect laws and regulations, high cost than income, and shortage of talents in preparation research. The analysis indicated that the necessary measures to break the contradiction, improve clinical effect of Chinese medicine, and promote the modernization development of Chinese drugs preparation were as follows: government and related departments should strengthen the supporting force in policy by adjusting the examination and approval policy, speeding up dispensing use, reforming pricing system, including into medicare reimbursement, integrating advantage resources and so on; medical institution should actively carry out research and development of traditional Chinese Medicine through drawing the traditional and modern essence, reserving professional talents, and developing characteristic preparation; companies cooperate with hospitals for complementary advantages, which can rapidly transform Chinese medicine preparation into clinical practice. PMID:27071242

  14. A sequential decision-theoretic model for medical diagnostic system.

    PubMed

    Li, Aiping; Jin, Songchang; Zhang, Lumin; Jia, Yan

    2015-01-01

    Although diagnostic expert systems using a knowledge base which models decision-making of traditional experts can provide important information to non-experts, they tend to duplicate the errors made by experts. Decision-Theoretic Model (DTM) is therefore very useful in expert system since they prevent experts from incorrect reasoning under uncertainty. For the diagnostic expert system, corresponding DTM and arithmetic are studied and a sequential diagnostic decision-theoretic model based on Bayesian Network is given. In the model, the alternative features are categorized into two classes (including diseases features and test features), then an arithmetic for prior of test is provided. The different features affect other features weights are also discussed. Bayesian Network is adopted to solve uncertainty presentation and propagation. The model can help knowledge engineers model the knowledge involved in sequential diagnosis and decide evidence alternative priority. A practical example of the models is also presented: at any time of the diagnostic process the expert is provided with a dynamically updated list of suggested tests in order to support him in the decision-making problem about which test to execute next. The results show it is better than the traditional diagnostic model which is based on experience. PMID:26410326

  15. Diagnostic reference levels for medical exposure of patients: ICRP guidance and related ICRU quantities.

    PubMed

    Rosenstein, Marvin

    2008-11-01

    In Publication 60 of the International Commission on Radiological Protection reference levels were described as values of measured quantities at which some specified action or decision should be taken. One particular form of reference level, the diagnostic reference level, applies specifically to medical exposure of patients. The objective of a diagnostic reference level is to help avoid radiation dose to the patient that does not contribute to the clinical purpose of a medical imaging task. This is accomplished by comparison between the numerical value of the diagnostic reference level and the mean or other appropriate value observed in practice for a suitable reference group of patients or a suitable reference phantom. A diagnostic reference level is not applied to individual patients. Diagnostic reference levels have no direct linkage to the numerical values for dose limits or dose constraints, and it is inappropriate to use them for regulatory or commercial purposes. Diagnostic reference levels should be selected by professional medical bodies (often in conjunction with health and radiation protection authorities) and their values may be specific to a country or region. A diagnostic reference level can be used: (1) to improve a regional, national or local distribution of observed results for a general medical imaging task, by reducing the frequency of unjustified high or low values; (2) to promote attainment of a narrower range of values that represent good practice for a more specific medical imaging task; or (3) to promote attainment of an optimum range of values for a specified medical imaging protocol. Authorized bodies are encouraged to set diagnostic reference levels that best meet their specific needs and that are consistent for the regional, national or local area to which they apply. Report 74 of the International Commission on Radiation Units and Measurements includes a commentary regarding quantities useful in establishing diagnostic reference levels

  16. Building Large Collections of Chinese and English Medical Terms from Semi-Structured and Encyclopedia Websites

    PubMed Central

    Xu, Yan; Wang, Yining; Sun, Jian-Tao; Zhang, Jianwen; Tsujii, Junichi; Chang, Eric

    2013-01-01

    To build large collections of medical terms from semi-structured information sources (e.g. tables, lists, etc.) and encyclopedia sites on the web. The terms are classified into the three semantic categories, Medical Problems, Medications, and Medical Tests, which were used in i2b2 challenge tasks. We developed two systems, one for Chinese and another for English terms. The two systems share the same methodology and use the same software with minimum language dependent parts. We produced large collections of terms by exploiting billions of semi-structured information sources and encyclopedia sites on the Web. The standard performance metric of recall (R) is extended to three different types of Recall to take the surface variability of terms into consideration. They are Surface Recall (), Object Recall (), and Surface Head recall (). We use two test sets for Chinese. For English, we use a collection of terms in the 2010 i2b2 text. Two collections of terms, one for English and the other for Chinese, have been created. The terms in these collections are classified as either of Medical Problems, Medications, or Medical Tests in the i2b2 challenge tasks. The English collection contains 49,249 (Problems), 89,591 (Medications) and 25,107 (Tests) terms, while the Chinese one contains 66,780 (Problems), 101,025 (Medications), and 15,032 (Tests) terms. The proposed method of constructing a large collection of medical terms is both efficient and effective, and, most of all, independent of language. The collections will be made publicly available. PMID:23874426

  17. Building large collections of Chinese and English medical terms from semi-structured and encyclopedia websites.

    PubMed

    Xu, Yan; Wang, Yining; Sun, Jian-Tao; Zhang, Jianwen; Tsujii, Junichi; Chang, Eric

    2013-01-01

    To build large collections of medical terms from semi-structured information sources (e.g. tables, lists, etc.) and encyclopedia sites on the web. The terms are classified into the three semantic categories, Medical Problems, Medications, and Medical Tests, which were used in i2b2 challenge tasks. We developed two systems, one for Chinese and another for English terms. The two systems share the same methodology and use the same software with minimum language dependent parts. We produced large collections of terms by exploiting billions of semi-structured information sources and encyclopedia sites on the Web. The standard performance metric of recall (R) is extended to three different types of Recall to take the surface variability of terms into consideration. They are Surface Recall (R(S)), Object Recall (R(O)), and Surface Head recall (R(H)). We use two test sets for Chinese. For English, we use a collection of terms in the 2010 i2b2 text. Two collections of terms, one for English and the other for Chinese, have been created. The terms in these collections are classified as either of Medical Problems, Medications, or Medical Tests in the i2b2 challenge tasks. The English collection contains 49,249 (Problems), 89,591 (Medications) and 25,107 (Tests) terms, while the Chinese one contains 66,780 (Problems), 101,025 (Medications), and 15,032 (Tests) terms. The proposed method of constructing a large collection of medical terms is both efficient and effective, and, most of all, independent of language. The collections will be made publicly available. PMID:23874426

  18. Examining Shifts in Medical Students' Microanalytic Motivation Beliefs and Regulatory Processes during a Diagnostic Reasoning Task

    ERIC Educational Resources Information Center

    Cleary, Timothy J.; Dong, Ting; Artino, Anthony R., Jr.

    2015-01-01

    This study examined within-group shifts in the motivation beliefs and regulatory processes of second-year medical students as they engaged in a diagnostic reasoning activity. Using a contextualized assessment methodology called self-regulated learning microanalysis, the authors found that the 71 medical student participants showed statistically…

  19. Diagnostic Yield of Medical Thoracoscopy in Undiagnosed Pleural Effusion

    PubMed Central

    Kiani, Arda; Karimi, Mahmoud; Samadi, Katayoun; Sheikhy, Kambiz; Farzanegan, Behrooz; Pour Abdollah, Mihan; Jamaati, Hamidreza; Jabardarjani, Hamid Reza; Masjedi, Mohammad Reza

    2015-01-01

    Background: One of the most common indications for pleuroscopy is undiagnosed pleural effusion, which comprises about 25% of all cases of pleural effusions, which remain undiagnosed despite primary tests. Pleuroscopy was performed for the first time in Iran in Masih Daneshvari hospital located in Tehran. The aim of this study was to assess the diagnostic yield of pleuroscopy performed in this center in Iran. Materials and Methods: Three-hundred patients with undiagnosed pleural effusions were enrolled in this study. For all patients, primary tests including pleural effusion analysis, cytology and closed pleural biopsy (if needed) were conducted and all of them were inconclusive. The semirigid thoracoscopy (pleuroscopy) was performed for all patients for diagnostic purposes. Results: Eighty-seven percent of the peluroscopies were diagnostic and 67% of them were diagnosed as malignancy while the rest were diagnosed as tuberculosis. Only 11 patients developed minor complications. Conclusion: In conclusion, pleuroscopy is a safe procedure when performed by a skilled and experienced practitioner; it has a high diagnostic yield and results in only minor complications. PMID:27114723

  20. [A Research on the origin and development of standardization of Chinese medical case records].

    PubMed

    Zhang, Lei

    2014-11-01

    The origin of Chinese medical case history is rather early. Chunyu Yi's medical cases (zhen ji) of the Western Han Dynasty were the earliest actual extant medical case with the practical contents. In the Ming Dynasty, Han Mao put forward firstly the principles of "six aspects must be recorded" for writing the pulse record, as the beginning of the standardization of medical case record. Later, Wu Kun, Yu Yan, Li Yanzhen, He Lianchen et al. supplemented, adjusted and changed the format of medical case record. After 1949, the format of medical case record was revised several times to form the national standard. In fact, the clinical medical case record is different from the case history. The modern medical case record could not reflect fully the thinking process of traditional Chinese medicine (TCM) and the essence of the treatment based on syndrome differentiation. Exploring the origin and development of the standardization of medical case record will benefit for the improvement of modern format of medical case record. PMID:25620355

  1. Diagnostic sub-types, psychological distress and psychosocial dysfunction in southern Chinese people with temporomandibular disorders.

    PubMed

    Lee, L T K; Yeung, R W K; Wong, M C M; McMillan, A S

    2008-03-01

    The study aimed to assess the distribution of temporomandibular disorders (TMD) sub-types, psychological distress and psychosocial dysfunction in southern Chinese people seeking treatment for TMD using Research Diagnostic Criteria for TMD (RDC/TMD) and investigate potential cross-cultural differences in sub-type prevalence and psychosocial impact. Eighty-seven consecutive patients (77 females; 10 males) with a mean age of 39.3 years (s.d. 12.8) newly referred to the specialist TMD clinic at the Prince Philip Dental Hospital, Hong Kong over a 20-month period took part in the study. RDC/TMD history questionnaire and clinical assessment data were used to derive Axis I and II findings. Group I muscle disorders were the most common and found in 57.5% of patients. Group II (disc displacement) disorders were found in 42.5% and 47.1% of the right and left temporomandibular joints (TMJ) respectively. Group III disorders (arthralgia/arthrosis/arthritis) were revealed in 19.5% and 23.0% of right and left TMJ's respectively. In the Axis II assessment, 42.5% of patients had moderate/severe depression scores, 59.7% had moderate/severe somatization scores and based on graded chronic pain scores 15.0% had psychosocial dysfunction (grade III and IV). While acknowledging the small sample size, the distribution of RDC/TMD Axis I and II diagnoses was fairly similar in Chinese TMD patients compared with Western and other Asian patient groups. However, in Chinese patients, myofascial pain with limited jaw opening and TMJ disc displacement with reduction were more common and a significant number experienced psychological distress and psychosocial dysfunction. The findings have implications for the management of TMD in Chinese people. PMID:18254795

  2. The Future of Medical Diagnostics: Large Digitized Databases

    PubMed Central

    Kerr, Wesley T.; Lau, Edward P.; Owens, Gwen E.; Trefler, Aaron

    2012-01-01

    The electronic health record mandate within the American Recovery and Reinvestment Act of 2009 will have a far-reaching affect on medicine. In this article, we provide an in-depth analysis of how this mandate is expected to stimulate the production of large-scale, digitized databases of patient information. There is evidence to suggest that millions of patients and the National Institutes of Health will fully support the mining of such databases to better understand the process of diagnosing patients. This data mining likely will reaffirm and quantify known risk factors for many diagnoses. This quantification may be leveraged to further develop computer-aided diagnostic tools that weigh risk factors and provide decision support for health care providers. We expect that creation of these databases will stimulate the development of computer-aided diagnostic support tools that will become an integral part of modern medicine. PMID:23012584

  3. Fluorocarbon compounds in MRI diagnostics and medical therapy

    NASA Astrophysics Data System (ADS)

    Pirogov, Yu

    2016-02-01

    The lecture describes the application of fluorocarbon compounds as blood substitutes and contrasting preparations in MRI diagnostics. A blood substitute product fluorocarbon Perfluorane® has shown effectiveness in oxygen delivery to the tissues of living organisms, and cardioprotective effect which does not depend on the patient's blood group. Inclusion of paramagnetic atoms (gadolinium, iron, etc.) to the Perfluorane® chemical formula creates a new compound with high MRI contrast efficiencies at Larmor frequencies of protons so and fluorine-19 nuclei.

  4. The Prevalence of Medical Conditions Among U.S. Chinese Community-Dwelling Older Adults

    PubMed Central

    Chen, Ruijia; Simon, Melissa A.

    2014-01-01

    Background. The burden of medical conditions is increasing among U.S. older adults, yet we have very limited knowledge about medical conditions among Chinese older adults in the United States. This study aimed to examine the prevalence of medical conditions and its sociodemographic and health-related correlates within the context of a population-based cohort study of U.S. Chinese older adults. Method. Using a community-based participatory research approach, community-dwelling Chinese older adults aged 60 years and older in the Greater Chicago area were interviewed between 2011 and 2013. Results. Of the 3,159 participants interviewed, 58.9% were female and the mean age was 72.8 years. In total, 84.3% of older adults had one or more medical condition, 24.6% reported two conditions, 19.5% had three conditions, and 17.0% reported four or more conditions. A sizeable percentage of older adults had never been screened for dyslipidemia (24.4%) or had never been screened for diabetes mellitus (35.7%).For those who reported high cholesterol, 73.0% were taking medications when compared with 76.1% of those who reported having diabetes and 88.3% of those who reported having high blood pressure. Various sociodemographic and health-related characteristics were correlated with medical conditions. Conclusion. Medical conditions were common among U.S. Chinese older adults, yet screening and treatment rates were fairly low. Future longitudinal studies should be conducted to better understand the risk and protective factors associated with medical conditions. PMID:25378445

  5. Medical diagnostic decision support systems--past, present, and future: a threaded bibliography and brief commentary.

    PubMed Central

    Miller, R A

    1994-01-01

    Articles about medical diagnostic decision support (MDDS) systems often begin with a disclaimer such as, "despite many years of research and millions of dollars of expenditures on medical diagnostic systems, none is in widespread use at the present time." While this statement remains true in the sense that no single diagnostic system is in widespread use, it is misleading with regard to the state of the art of these systems. Diagnostic systems, many simple and some complex, are now ubiquitous, and research on MDDS systems is growing. The nature of MDDS systems has diversified over time. The prospects for adoption of large-scale diagnostic systems are better now than ever before, due to enthusiasm for implementation of the electronic medical record in academic, commercial, and primary care settings. Diagnostic decision support systems have become an established component of medical technology. This paper provides a review and a threaded bibliography for some of the important work on MDDS systems over the years from 1954 to 1993. PMID:7719792

  6. An Overview of the Roles and Responsibilities of Chinese Medical Colleges in Body Donation Programs

    ERIC Educational Resources Information Center

    Zhang, Luqing; Xiao, Ming; Gu, Mufeng; Zhang, Yongjie; Jin, Jianliang; Ding, Jiong

    2014-01-01

    The use of human tissue is critical for gross anatomy education in the health professions. Chinese medical colleges have faced a shortage of anatomical specimens over the past decade. While body donation plays an important role in overcoming this gap, this practice has only recently been introduced in China, and the donation rate is relatively low…

  7. Traditional Chinese medical herbs staged therapy in infertile women with endometriosis: a clinical study

    PubMed Central

    Ding, Zhaorong; Lian, Fang

    2015-01-01

    Background: Endometriosis is a common gynecological disease defined as the presence of endometrioid tissue (glands and stroma) outside the uterus. About 30 to 40% patients with endometriosis are infertile. In traditional Chinese medical system, endometriosis associated infertility is mostly caused by kidney deficiency and blood stasis. The herb of reinforcing kidney and removing blood stasis is designed to treat the disease. Material and methods: All the 80 up-to-standard patients were divided into two different groups exactly according to the random principle. They were treated with hormone and traditional Chinese medical herb separately. After half year’s therapy, all the patients received one year’s follow-up. Their transvaginal ultrasonographic changes, serum hormone levels and pregnancy rate were recorded to analysis the effect. Results: No significant difference happened in two groups’ demographic and clinical characteristics (P > 0.05). After the treatment, the effect on serum hormone levels and specific markers are significant (P < 0.05). The transvaginal ultrasonographic changes were positive, too. The text on hepatic and renal function confirmed to the safety of the herb. Compared to hormone therapy, the traditional Chinese medical herb is safe and effective for endometriosis patients with infertility. Conclusion: Compared with hormone therapy, traditional Chinese medical herb’s two-staged therapy is effective and safe for endometriosis patients with infertility. PMID:26550373

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

    ERIC Educational Resources Information Center

    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)

  9. The Relationship between Diagnostic Accuracy and Confidence in Medical Students.

    ERIC Educational Resources Information Center

    Mann, Doug

    Studies in psychology and clinical decision making have shown that research subjects and physicians are often overconfident in the accuracy of their judgments. In these studies, groups of 20 first-year and 27 third-year osteopathic medical students at the Ohio University College of Osteopathic Medicine (Athens) were slightly underconfident in…

  10. 77 FR 6915 - Medical Diagnostic Equipment Accessibility Standards

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-02-09

    ... accommodations are accessible to individuals with disabilities.\\7\\ See 75 FR 43452 (July 26, 2010). Among other... Rehabilitation Engineering Research Center on Accessible Medical Instrumentation conducted a national survey in.... Consultation With Food and Drug Administration G. ANSI/AAMI HE 75 H. Barriers Affecting Accessibility...

  11. Registration and identification of pulse signal for medical diagnostics

    NASA Astrophysics Data System (ADS)

    Buldakova, Tatyana I.; Suyatinov, Sergey I.

    2002-07-01

    Registration and identification of pulse signal requires the development and the use of special diagnostic equipment and modern methods of processing of the registered data. There are recognized that photoelectric and piezoelectric gauges are the most perspective converters for measurement of pulse signal. In this paper the approach to registration of pulse curves on the basis of the optical gauge is developed. The problem of identification of pulse signal is considered as the problem of recognition of images. The system of identification of pulse waves is offered. It is functioning as a visual system of recognition of images of the man and is based on artificial neural networks.

  12. 21 CFR 1000.50 - Recommendation for the use of specific area gonad shielding on patients during medical diagnostic...

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... shielding on patients during medical diagnostic x-ray procedures. 1000.50 Section 1000.50 Food and Drugs... shielding on patients during medical diagnostic x-ray procedures. Specific area gonad shielding covers an... that may cause genetic mutations during many medical x-ray procedures in which the gonads lie within...

  13. 21 CFR 1000.50 - Recommendation for the use of specific area gonad shielding on patients during medical diagnostic...

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... shielding on patients during medical diagnostic x-ray procedures. 1000.50 Section 1000.50 Food and Drugs... shielding on patients during medical diagnostic x-ray procedures. Specific area gonad shielding covers an... that may cause genetic mutations during many medical x-ray procedures in which the gonads lie within...

  14. 21 CFR 1000.50 - Recommendation for the use of specific area gonad shielding on patients during medical diagnostic...

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... shielding on patients during medical diagnostic x-ray procedures. 1000.50 Section 1000.50 Food and Drugs... shielding on patients during medical diagnostic x-ray procedures. Specific area gonad shielding covers an... that may cause genetic mutations during many medical x-ray procedures in which the gonads lie within...

  15. 21 CFR 1000.50 - Recommendation for the use of specific area gonad shielding on patients during medical diagnostic...

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... shielding on patients during medical diagnostic x-ray procedures. 1000.50 Section 1000.50 Food and Drugs... shielding on patients during medical diagnostic x-ray procedures. Specific area gonad shielding covers an... that may cause genetic mutations during many medical x-ray procedures in which the gonads lie within...

  16. 21 CFR 1000.50 - Recommendation for the use of specific area gonad shielding on patients during medical diagnostic...

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... shielding on patients during medical diagnostic x-ray procedures. 1000.50 Section 1000.50 Food and Drugs... shielding on patients during medical diagnostic x-ray procedures. Specific area gonad shielding covers an... that may cause genetic mutations during many medical x-ray procedures in which the gonads lie within...

  17. Reliability and Validity of a Chinese version of the Diagnostic Interview for Borderlines-Revised (DIB-R)

    PubMed Central

    Wang, Lanlan; Yuan, Chenmei; Qiu, Jianying; Gunderson, John; Zhang, Min; Jiang, Kaida; Leung, Freedom; Zhong, Jie; Xiao, Zeping

    2014-01-01

    Background Borderline personality disorder (BPD) is the most studied of the Axis II disorders. One of the most widely used diagnostic instruments is the Diagnostic Interview for Borderline Patients - Revised (DIB-R). The aim of this study was to test the reliability and validity of DIB-R for use in the Chinese culture. Methods The reliability and validity of the DIB-R Chinese version were assessed in a sample of 236 outpatients with a probable BPD diagnosis. The Structured Clinical Interview for DSM-IV Personality Disorders (SCID-II) was used as a standard. Test/re-test reliability was tested at 6 months later with 20 patients and inter-rater reliability was tested on 32 patients. Results The Chinese version of the DIB-R showed good internal global consistency (Cronbach’s alpha of 0.916), good test-retest reliability (Pearson correlation of 0.704), good inter-raters reliability (ICC of 0.892 and Kappa of 0.861). When compared to the DSM-IV diagnosis as measured by the SCID-II, the DIB-R showed relatively good sensitivity (0.768) and specificity (0.891) at the cutoff of 7; moderate diagnostic convergence (Kappa of 0.631), as well as good discriminating validity. Conclusion The Chinese version of the DIB-R has good psychometric properties, which renders it a valuable method for examining the presence, the severity and component phenotypes of BPD in Chinese samples. PMID:24302703

  18. General Principles of Radiation Protection in Fields of Diagnostic Medical Exposure

    PubMed Central

    2016-01-01

    After the rapid development of medical equipment including CT or PET-CT, radiation doses from medical exposure are now the largest source of man-made radiation exposure. General principles of radiation protection from the hazard of ionizing radiation are summarized as three key words; justification, optimization, and dose limit. Because medical exposure of radiation has unique considerations, diagnostic reference level is generally used as a reference value, instead of dose limits. In Korea, medical radiation exposure has increased rapidly. For medical radiation exposure control, Korea has two separate control systems. Regulation is essential to control medical radiation exposure. Physicians and radiologists must be aware of the radiation risks and benefits associated with medical exposure, and understand and implement the principles of radiation protection for patients. The education of the referring physicians and radiologists is also important. PMID:26908991

  19. Advanced synchronous luminescence imaging for chemical and medical diagnostics

    DOEpatents

    Vo-Dinh, Tuan

    2006-09-05

    A diagnostic method and associated system includes the steps of exposing at least one sample location with excitation radiation through a single optical waveguide or a single optical waveguide bundle, wherein the sample emits emission radiation in response to the excitation radiation. The same single optical waveguide or the single optical waveguide bundle receives at least a portion of the emission radiation from the sample, thus providing co-registration of the excitation radiation and the emission radiation. The wavelength of the excitation radiation and emission radiation is synchronously scanned to produce a spectrum upon which an image can be formed. An increased emission signal is generated by the enhanced overlap of the excitation and emission focal volumes provided by co-registration of the excitation and emission signals thus increasing the sensitivity as well as decreasing the exposure time necessary to obtain an image.

  20. Isotope-selective sensor for medical diagnostics based on PAS

    NASA Astrophysics Data System (ADS)

    Wolff, M.; Groninga, H. G.; Harde, H.

    2005-06-01

    Development of new optical sensor technologies has a major impact on the progression of diagnostic methods. Of the permanently increasing number of non-invasive 13C-breath tests, the Urea Breath Test for detection of Helicobacter pylori is the most prominent. However, many recent developments go beyond gastroenterological applications. We present a new detection scheme for breath analysis that employs an especially compact and simple set-up based on Photoacoustic Spectroscopy. Using a wavelength-modulated DFB-diode laser and taking advantage of acoustical resonances of the sample cell, we performed very sensitive isotope-selective measurements on CO2. Detection limits for 13CO2 of a few ppm and for the variation of the 13CO2 concentration of approximately 1% were achieved.

  1. Towards real-time medical diagnostics using hyperspectral imaging technology

    NASA Astrophysics Data System (ADS)

    Bjorgan, Asgeir; Randeberg, Lise L.

    2015-07-01

    Hyperspectral imaging provides non-contact, high resolution spectral images which has a substantial diagnostic potential. This can be used for e.g. diagnosis and early detection of arthritis in finger joints. Processing speed is currently a limitation for clinical use of the technique. A real-time system for analysis and visualization using GPU processing and threaded CPU processing is presented. Images showing blood oxygenation, blood volume fraction and vessel enhanced images are among the data calculated in real-time. This study shows the potential of real-time processing in this context. A combination of the processing modules will be used in detection of arthritic finger joints from hyperspectral reflectance and transmittance data.

  2. On-line integration of computer controlled diagnostic devices and medical information systems in undergraduate medical physics education for physicians.

    PubMed

    Hanus, Josef; Nosek, Tomas; Zahora, Jiri; Bezrouk, Ales; Masin, Vladimir

    2013-01-01

    We designed and evaluated an innovative computer-aided-learning environment based on the on-line integration of computer controlled medical diagnostic devices and a medical information system for use in the preclinical medical physics education of medical students. Our learning system simulates the actual clinical environment in a hospital or primary care unit. It uses a commercial medical information system for on-line storage and processing of clinical type data acquired during physics laboratory classes. Every student adopts two roles, the role of 'patient' and the role of 'physician'. As a 'physician' the student operates the medical devices to clinically assess 'patient' colleagues and records all results in an electronic 'patient' record. We also introduced an innovative approach to the use of supportive education materials, based on the methods of adaptive e-learning. A survey of student feedback is included and statistically evaluated. The results from the student feedback confirm the positive response of the latter to this novel implementation of medical physics and informatics in preclinical education. This approach not only significantly improves learning of medical physics and informatics skills but has the added advantage that it facilitates students' transition from preclinical to clinical subjects. PMID:22200603

  3. Low Temperature Atmospheric Argon Plasma: Diagnostics and Medical Applications

    NASA Astrophysics Data System (ADS)

    Ermolaeva, Svetlana; Petrov, Oleg; Zigangirova, Nailya; Vasiliev, Mikhail; Sysolyatina, Elena; Antipov, Sergei; Alyapyshev, Maxim; Kolkova, Natalia; Mukhachev, Andrei; Naroditsky, Boris; Shimizu, Tetsuji; Grigoriev, Anatoly; Morfill, Gregor; Fortov, Vladimir; Gintsburg, Alexander

    This study was devoted to diagnostic of low temperature plasma produced by microwave generator and investigation of its bactericidal effect against bacteria in biofilms and within eukaryotic cells. The profile of gas temperature near the torch outlet was measured. The spectrum in a wide range of wavelengths was derived by the method of optical emission spec-troscopy. Probe measurements of the floating potential of plasma were car-ried out. The estimation and adaptation of parameters of plasma flow (tem-perature, velocity, ion number density) according to medico-technical requirements were produced. The model of immersed surface-associated biofilms formed by Gram-negative bacteria, Pseudomonas aeruginosa and Burkholderia cenocepacia, and Gram-positive bacteria, Staphylococcus aureus, was used to assess bactericidal effects of plasma treatment. Reduction in the concentration of live bacteria in biofilms treated with plasma for 5 min was demonstrated by measuring Live/Dead fluorescent labeling and using direct plating. The intracellular infection model with the pathogenic bacterium, Chlamydia trachomatis, was used to study the efficacy of microwave argon plasma against intracellular parasites. A 2 min plasma treatment of mouse cells infected with C. trachomatis reduced infectious bacteria by a factor of 2×106. Plasma treatment diminished the number of viable host cells by about 20%. When the samples were covered with MgF2 glass to obstruct active particles and UV alone was applied, the bactericidal effect was re-duced by 5×104 fold compared to the whole plasma.

  4. Polymeric rapid prototyping for inexpensive and portable medical diagnostics

    NASA Astrophysics Data System (ADS)

    Ma, Tianchi; Northrup, Victoria; Fung, Andrew O.; Glerum, D. Moira; Backhouse, Christopher J.

    2012-10-01

    The advent of inexpensive CO2 laser systems has led to a wide range of demonstrations of microfabricated lab on chip systems built of acrylic. However, there has been little application of these systems to building microfluidics for DNA analysis. In this work we explore the use of CO2 laser systems for building microfluidics for DNA analysis and relate the artifacts of the fabrication technology to the performance of the system. We show that surface roughness that leads to significant constrictions in the separation channel provides an upper limit of the size of DNA that can be analysed. Below that upper limit, the resolution of the chip is strongly affected by the degree to which the separation channel is exposed to redeposited by-products of the ablation process. We show that by controlling these effects we are reliably able to discern two types of PCR product as a test representative of a real application. By being able to do this is in microfluidic devices the size of a postage stamp we have shown that we can now use CO2 laser systems for the development of extremely inexpensive diagnostic systems using a rapid prototyping approach.

  5. Multiplexed label-free optical biosensor for medical diagnostics.

    PubMed

    Bottazzi, Barbara; Fornasari, Lucia; Frangolho, Ana; Giudicatti, Silvia; Mantovani, Alberto; Marabelli, Franco; Marchesini, Gerardo; Pellacani, Paola; Therisod, Rita; Valsesia, Andrea

    2014-01-01

    This paper describes a new multiplexed label-free biosensor. The detection technology is based on nanostructured gold-polymer surfaces. These surfaces support surface plasmon resonance modes that can be probed by a miniaturized optical setup. The optical characterization of the sensing chip shows the sensitivity and the limit-of-detection to refractive index changes. Moreover, by studying the progressive adhesion of molecular monolayers of polyelectrolytes, the decay of the plasmonic mode electric field above the surface has been reconstructed. A multiplexed label-free biosensing device is then described and characterized in terms of sensitivity, lateral resolution, and sensitivity to a model biological assay. The sensitivity in imaging mode of the device is of the order of 10-6 refractive index units, while the measured lateral resolution is 6.25 μm within a field of view of several tenths of mm2, making the instrument unique in terms of multiplexing capability. Finally, the proof-of-concept application of the technology as a point-of-care diagnostic tool for an inflammatory marker is demonstrated. PMID:24474511

  6. Diagnostic Imaging in the Medical Support of the Future Missions to the Moon

    NASA Technical Reports Server (NTRS)

    Sargsyan, Ashot E.; Jones, Jeffrey A.; Hamilton, Douglas R.; Dulchavsky, Scott A.; Duncan, J. Michael

    2007-01-01

    This viewgraph presentation is a course that reviews the diagnostic imaging techniques available for medical support on the future moon missions. The educational objectives of the course are to: 1) Update the audience on the curreultrasound imaging in space flight; 2) Discuss the unique aspects of conducting ultrasound imaging on ISS, interplanetary transit, ultrasound imaging on ISS, interplanetary transit, and lunar surface operations; and 3) Review preliminary data obtained in simulations of medical imaging in lunar surface operations.

  7. The diagnostic challenges presented by patients with medically unexplained symptoms in general practice

    PubMed Central

    Aiarzaguena, José M.; Grandes, Gonzalo; Salazar, Agustín; Gaminde, Idoia; Sánchez, Álvaro

    2008-01-01

    Objective To describe the complexity of somatizing patients’ symptomatology and the difficulties involved in the diagnostic process. Design Cross-sectional study of patients with medically unexplained symptoms. Setting Basque Health Service primary care centres in Bizkaia, Spain. Subjects The study comprised 156 patients selected at random from a list of 468 patients who had presented, over the course of their lives, six or more medically unexplained somatic symptoms for females and four or more for males, identified retrospectively by their practitioners. Main outcome measures Physicians interviewed these patients using the somatoform symptoms section of the Composite International Diagnostic Interview (CIDI), and the Primary Care Evaluation of Mental Disorders (PRIME-MD). The Medical Outcomes Survey Short Form 36 (SF-36) was filled in at home. Organic diseases whose diagnosis was established during the previous year were included in the study by consulting patients’ medical records. Results Patients were found to have a median of three medically explained and 12 medically unexplained symptoms. Mental disorders were found in 83% of cases, associated with other morbidity categories in 78%. The predictive value of symptoms was lower than 26% for diagnosing broad disease categories. Conclusions These results depict an extremely difficult scenario for dichotomous diagnostic strategies aimed at classifying patients’ symptoms as either organic or functional. Rather than struggling to choose one of these hypotheses, it is suggested that both of them should always be addressed concurrently. PMID:18570008

  8. Peri-Abortion Contraceptive Choices of Migrant Chinese Women: A Retrospective Review of Medical Records

    PubMed Central

    Rose, Sally B.; Wei, Zhang; Cooper, Annette J.; Lawton, Beverley A.

    2012-01-01

    Background Migrant Asian women reportedly have low levels of contraceptive use and high rates of abortion in New Zealand. Chinese make up the largest proportion of migrant Asian in New Zealand. This study aimed to describe the contraceptive choices of Chinese women seeking abortion; to examine method choice in relation to demographic characteristics (including length of stay) and to determine whether Chinese women were over-represented among abortion clinic attendees. Methods Retrospective review of medical records at a public hospital abortion clinic involving 305 Chinese women. Previously collected data for European (n = 277) and Maori women (n = 128) were used for comparative analyses. Regression analyses explored correlates of contraceptive method choice. Population census data were used to calculate rates of clinic attendance across ethnic groups. Results Chinese women were not over-represented among clinic attendees, and had similar rates of contraceptive non-use pre-abortion as women in comparison groups. Use of the oral contraceptive pill by Chinese was lower pre-abortion than for other ethnic groups, but choice of this method post-abortion was similar for Chinese (46.9%, 95% CI 41–52.7) and European women (43.7%, 95% CI 37.8–49.7). Post-abortion choice of an intrauterine device did not differ significantly between Chinese (28.9%, 95% CI 23.8–34.3) and Maori women (37%, 95% CI 28.4–45.7), but was higher than uptake of this method by European women (21.7%, 95% CI 17–27.0). Age, parity and previous abortion were significant predictors of post-abortion method choice by Chinese women (p<0.05). Conclusions Following contraceptive counseling at the clinic, Chinese women chose more effective contraceptive methods for use post-abortion than they had used previously. As the population of migrant Chinese in New Zealand continues to increase, strategies are urgently needed to provide new arrivals with appropriate information and advice about

  9. Medical Diagnostic Breath Analysis by Cavity Ring Down Spectroscopy

    NASA Astrophysics Data System (ADS)

    Guss, Joseph S.; Metsälä, Markus; Halonen, Lauri

    2009-06-01

    Certain medical conditions give rise to the presence of chemicals in the bloodstream. These chemicals - known as biomarkers - may also be present in low concentrations in human breath. Cavity ring down spectroscopy possesses the requisite selectivity and sensitivity to detect such biomarkers in the congested spectrum of a breath sample. The ulcer-causing bacterium, Helicobacter pylori, is a prolific producer of the enzyme urease, which catalyses the breakdown of urea ((NH_2)_2CO) in the stomach as follows: (NH_2)_2CO + H_2O ⟶ CO_2 + 2NH_3 Currently, breath tests seeking altered carbon-isotope ratios in exhaled CO_2 after the ingestion of ^{13}C- or ^{14}C-labeled urea are used to diagnose H. pylori infection. We present recent results from an ongoing collaboration with Tampere Area University Hospital. The study involves 100 patients (both infected and uninfected) and concerns the possible correlation between the bacterial infection and breath ammonia. D. Y. Graham, P. D. Klein, D. J. Evans, Jr, D. G. Evans, L. C. Alpert, A. R. Opekun, T. W. Boutton, Lancet 1(8543), 1174-7 March 1987.

  10. Predictive Modeling of Student Performances for Retention and Academic Support in a Diagnostic Medical Sonography Program

    ERIC Educational Resources Information Center

    Borghese, Peter; Lacey, Sandi

    2014-01-01

    As part of a retention and academic support program, data was collected to develop a predictive model of student performances in core classes in a Diagnostic Medical Sonography (DMS) program. The research goal was to identify students likely to have difficulty with coursework and provide supplemental tutorial support. The focus was on the…

  11. Crossing the Great Divide: Adoption of New Technologies, Therapeutics and Diagnostics at Academic Medical Centers

    ERIC Educational Resources Information Center

    DeMonaco, Harold J.; Koski, Greg

    2007-01-01

    The role of new technology in healthcare continues to expand from both the clinical and financial perspectives. Despite the importance of innovation, most academic medical centers do not have a clearly defined process for technology assessment. Recognizing the importance of new drugs, diagnostics and procedures in the care of patients and in the…

  12. Principles for new optical techniques in medical diagnostics for mHealth applications

    NASA Astrophysics Data System (ADS)

    Balsam, Joshua Michael

    Medical diagnostics is a critical element of effective medical treatment. However, many modern and emerging diagnostic technologies are not affordable or compatible with the needs and conditions found in low-income and middle-income countries and regions. Resource-poor areas require low-cost, robust, easy-to-use, and portable diagnostics devices compatible with telemedicine (i.e. mHealth) that can be adapted to meet diverse medical needs. Many suitable devices will need to be based on optical technologies, which are used for many types of biological analyses. This dissertation describes the fabrication and detection principles for several low-cost optical technologies for mHealth applications including: (1) a webcam based multi-wavelength fluorescence plate reader, (2) a lens-free optical detector used for the detection of Botulinum A neurotoxin activity, (3) a low cost micro-array reader that allows the performance of typical fluorescence based assays demonstrated for the detection of the toxin staphylococcal enterotoxin (SEB), and (4) a wide-field flow cytometer for high throughput detection of fluorescently labeled rare cells. This dissertation discusses how these technologies can be harnessed using readily available consumer electronics components such as webcams, cell phones, CCD cameras, LEDs, and laser diodes. There are challenges in developing devices with sufficient sensitivity and specificity, and approaches are presented to overcoming these challenges to create optical detectors that can serve as low cost medical diagnostics in resource-poor settings for mHealth.

  13. Source Book of Educational Materials for Diagnostic Medical Ultrasound. Radiological Health Series.

    ERIC Educational Resources Information Center

    Pijar, Mary Lou, Comp; And Others

    This report is a compilation of educational materials that are available in the field of diagnostic medical ultrasound. Materials, which include publications, audiovisual aids, and teaching aids, are listed under the following categories: abdominal imaging; anatomy and physiology; anatomy and embryology; bioeffects; cardiology and vasculature;…

  14. Motion tracking in infrared imaging for quantitative medical diagnostic applications

    NASA Astrophysics Data System (ADS)

    Cheng, Tze-Yuan; Herman, Cila

    2014-01-01

    In medical applications, infrared (IR) thermography is used to detect and examine the thermal signature of skin abnormalities by quantitatively analyzing skin temperature in steady state conditions or its evolution over time, captured in an image sequence. However, during the image acquisition period, the involuntary movements of the patient are unavoidable, and such movements will undermine the accuracy of temperature measurement for any particular location on the skin. In this study, a tracking approach using a template-based algorithm is proposed, to follow the involuntary motion of the subject in the IR image sequence. The motion tacking will allow to associate a temperature evolution to each spatial location on the body while the body moves relative to the image frame. The affine transformation model is adopted to estimate the motion parameters of the template image. The Lucas-Kanade algorithm is applied to search for the optimized parameters of the affine transformation. A weighting mask is incorporated into the algorithm to ensure its tracking robustness. To evaluate the feasibility of the tracking approach, two sets of IR image sequences with random in-plane motion were tested in our experiments. A steady-state (no heating or cooling) IR image sequence in which the skin temperature is in equilibrium with the environment was considered first. The thermal recovery IR image sequence, acquired when the skin is recovering from 60-s cooling, was the second case analyzed. By proper selection of the template image along with template update, satisfactory tracking results were obtained for both IR image sequences. The achieved tracking accuracies are promising in terms of satisfying the demands imposed by clinical applications of IR thermography.

  15. Motion tracking in infrared imaging for quantitative medical diagnostic applications

    PubMed Central

    Cheng, Tze-Yuan; Herman, Cila

    2014-01-01

    In medical applications, infrared (IR) thermography is used to detect and examine the thermal signature of skin abnormalities by quantitatively analyzing skin temperature in steady state conditions or its evolution over time, captured in an image sequence. However, during the image acquisition period, the involuntary movements of the patient are unavoidable, and such movements will undermine the accuracy of temperature measurement for any particular location on the skin. In this study, a tracking approach using a template-based algorithm is proposed, to follow the involuntary motion of the subject in the IR image sequence. The motion tacking will allow to associate a temperature evolution to each spatial location on the body while the body moves relative to the image frame. The affine transformation model is adopted to estimate the motion parameters of the template image. The Lucas–Kanade algorithm is applied to search for the optimized parameters of the affine transformation. A weighting mask is incorporated into the algorithm to ensure its tracking robustness. To evaluate the feasibility of the tracking approach, two sets of IR image sequences with random in-plane motion were tested in our experiments. A steady-state (no heating or cooling) IR image sequence in which the skin temperature is in equilibrium with the environment was considered first. The thermal recovery IR image sequence, acquired when the skin is recovering from 60-s cooling, was the second case analyzed. By proper selection of the template image along with template update, satisfactory tracking results were obtained for both IR image sequences. The achieved tracking accuracies are promising in terms of satisfying the demands imposed by clinical applications of IR thermography. PMID:24587692

  16. SMS-Based Medical Diagnostic Telemetry Data Transmission Protocol for Medical Sensors

    PubMed Central

    Townsend, Ben; Abawajy, Jemal; Kim, Tai-Hoon

    2011-01-01

    People with special medical monitoring needs can, these days, be sent home and remotely monitored through the use of data logging medical sensors and a transmission base-station. While this can improve quality of life by allowing the patient to spend most of their time at home, most current technologies rely on hardwired landline technology or expensive mobile data transmissions to transmit data to a medical facility. The aim of this paper is to investigate and develop an approach to increase the freedom of a monitored patient and decrease costs by utilising mobile technologies and SMS messaging to transmit data from patient to medico. To this end, we evaluated the capabilities of SMS and propose a generic communications protocol which can work within the constraints of the SMS format, but provide the necessary redundancy and robustness to be used for the transmission of non-critical medical telemetry from data logging medical sensors. PMID:22163845

  17. Formal Art Observation Training Improves Medical Students’ Visual Diagnostic Skills

    PubMed Central

    Naghshineh, Sheila; Hafler, Janet P.; Miller, Alexa R.; Blanco, Maria A.; Lipsitz, Stuart R.; Dubroff, Rachel P.; Khoshbin, Shahram

    2008-01-01

    Background Despite evidence of inadequate physical examination skills among medical students, teaching these skills has declined. One method of enhancing inspection skills is teaching “visual literacy,” the ability to reason physiology and pathophysiology from careful and unbiased observation. Objective To improve students’ visual acumen through structured observation of artworks, understanding of fine arts concepts and applying these skills to patient care. Design Prospective, partially randomized pre- vs. post-course evaluation using mixed-methods data analysis. Participants Twenty-four pre-clinical student participants were compared to 34 classmates at a similar stage of training. Intervention Training the Eye: Improving the Art of Physical Diagnosis consists of eight paired sessions of art observation exercises with didactics that integrate fine arts concepts with physical diagnosis topics and an elective life drawing session. Measurements The frequency of accurate observations on a 1-h visual skills examination was used to evaluate pre- vs. post-course descriptions of patient photographs and art imagery. Content analysis was used to identify thematic categories. All assessments were blinded to study group and pre- vs. post-course evaluation. Results Following the course, class participants increased their total mean number of observations compared to controls (5.41 ± 0.63 vs. 0.36 ± 0.53, p < 0.0001) and had increased sophistication in their descriptions of artistic and clinical imagery. A ‘dose-response’ was found for those who attended eight or more sessions, compared to participants who attended seven or fewer sessions (6.31 + 0.81 and 2.76 + 1.2, respectively, p = 0.03). Conclusions This interdisciplinary course improved participants’ capacity to make accurate observations of art and physical findings. Electronic supplementary material The online version of this article (doi:10.1007/s11606-008-0667-0) contains

  18. Association between patients’ beliefs and oral antidiabetic medication adherence in a Chinese type 2 diabetic population

    PubMed Central

    Wu, Ping; Liu, Naifeng

    2016-01-01

    Purpose The objective of this study was to identify, using the theory of planned behavior (TPB), patients’ beliefs about taking oral antidiabetic drugs (OADs) as prescribed, and to measure the correlations between beliefs and medication adherence. Patients and methods We performed a cross-sectional study of type 2 diabetic patients using structured questionnaires in a Chinese tertiary hospital. A total of 130 patients were enrolled to be interviewed about TPB variables (behavioral, normative, and control beliefs) relevant to medication adherence. Medication adherence was assessed using the eight-item Morisky Medication Adherence Scale (MMAS-8). Spearman’s rank correlation was used to assess the association between TPB and MMAS-8. Logistic regression analysis was performed to examine the relationship between different variables and MMAS-8, with statistical significance determined at P<0.05. Results From 130 eligible Chinese patients with an average age of 60.6 years and a male proportion of 50.8%, a nonsignificant relationship between behavioral, normative, and the most facilitating control beliefs and OAD adherence was found in our study. Having the OADs on hand (P=0.037) was the only facilitating control belief associated with adherence behavior. Being away from home or eating out (P=0.000), not accepting the disease (P=0.000), ignorance of life-long drug adherence (P=0.038), being busy (P=0.001), or poor memory (P=0.008) were control belief barriers found to be correlated with poor adherence. TPB is the only important determinant influencing OAD adherence among all the factors (P=0.011). Conclusion The results indicate that the TPB model could be used to examine adherence to OADs. One facilitating control belief, and most of the barrier control beliefs of TPB were related to medication adherence among Chinese type 2 diabetes inpatients. It will be helpful to understand patients’ self-medication and provide methods to develop instruments for identifying

  19. [Influences of Confucianism, Taoism and Buddhism on Chinese Medical Formulas in Jin-Tang Dynasties].

    PubMed

    Wu, Xiao-xiang

    2006-04-01

    In the Jin-Tang Dynasties, when Confucianism, Taoism and Buddhism contended, conflicted and well blent, forming a state of mingled thoughts of the three sects. It exerted profound influences on Chinese Medical Formulas and promoted the academic fashion of compiling books about medical formulas characterized by collecting various formulas especially the simple and proved recipes. This plays a role in the formation of the formulas used in the Jin-Tang Dynasties, featuring simplicity, convenience, cheapness, and effectiveness, different from those of other periods. PMID:17096988

  20. Pre-diagnostic cruciferous vegetables intake and lung cancer survival among Chinese women

    PubMed Central

    Wu, Qi-Jun; Yang, Gong; Zheng, Wei; Li, Hong-Lan; Gao, Jing; Wang, Jing; Gao, Yu-Tang; Shu, Xiao-Ou; Xiang, Yong-Bing

    2015-01-01

    No study to date has prospectively evaluated the association between pre-diagnostic cruciferous vegetables intake and lung cancer survival among women. This analysis included 547 incident lung cancer cases identified from the Shanghai Women’s Health Study (SWHS) during the follow-up period of 1997-2011. Dietary intake was assessed for all SWHS participants at enrollment and reassessed 2-3 years later. Cox proportional hazards models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) with adjustment for potential confounders. Of the 547 lung cancer patients, 412 patients died during the follow-up. A total of 393 (95.4%) deaths from lung cancer were documented with median survival time of 10.3 months (interquartile range, 3.6-21.1 months). High cruciferous vegetables intake was significantly associated with improved lung cancer-specific survival after adjusting for all nonclinical prognostic factors (n = 547, HR = 0.69; 95%CI = 0.49-0.95; P trend = 0.02) for the highest versus lowest quartile. A slightly stronger association of cruciferous vegetables intake with lung cancer-specific survival was observed in analyses restricted to patients with known clinical prognostic factors (n = 331, HR = 0.63; 95%CI = 0.41-0.97; P trend = 0.03) or never smokers (n = 308, HR = 0.58; 95%CI = 0.37-0.91; P trend = 0.02). In conclusion, pre-diagnostic cruciferous vegetables intake is associated with better survival of lung cancer in Chinese women. PMID:25988580

  1. Children’s Exposure to Diagnostic Medical Radiation and Cancer Risk: Epidemiologic and Dosimetric Considerations

    PubMed Central

    Linet, Martha S.; Kim, Kwang pyo; Rajaraman, Preetha

    2009-01-01

    While the etiology of most childhood cancers is largely unknown, epidemiologic studies have consistently found an association between exposure to medical radiation during pregnancy and risk of childhood cancer in offspring. The relation between early life diagnostic radiation exposure and occurrence of pediatric cancer risks is less clear. This review summarizes current and historical estimated doses for common diagnostic radiologic procedures as well as the epidemiologic literature on the role of maternal prenatal, children’s postnatal and parental preconception diagnostic radiologic procedures on subsequent risk of childhood malignancies Risk estimates are presented according to factors such as the year of birth of the child, trimester and medical indication for the procedure, and the number of films taken. The paper also discusses limitations of the methods employed in epidemiologic studies to assess pediatric cancer risks, the effects on clinical practice of the results reported from the epidemiologic studies, and clinical and public health policy implications of the findings. Gaps in understanding and additional research needs are identified. Important research priorities include nationwide surveys to estimate fetal and childhood radiation doses from common diagnostic procedures, and epidemiologic studies to quantify pediatric and lifetime cancer risks from prenatal and early childhood exposures to diagnostic radiography, computed tomography, and fluoroscopically-guided procedures. PMID:19083224

  2. Medication Literacy in a Cohort of Chinese Patients Discharged with Acute Coronary Syndrome

    PubMed Central

    Zhong, Zhuqing; Zheng, Feng; Guo, Yuna; Luo, Aijing

    2016-01-01

    This study aims at investigating medication literacy of discharged patients with acute coronary syndrome (ACS) in China, and the important determinants of medication literacy among them. For this purpose, we conducted a prospective cohort study. Patient’s demographic and clinical data were retrieved from hospital charts and medication literacy was measured by instructed interview using the Chinese version of Medication Literacy Questionnaire on Discharged Patient between 7 and 30 days after the patient was discharged from the hospital. The results show that medication literacy for the surveyed patients was insufficient: >20% did not have adequate knowledge on the types of drugs and the frequency that they need to take the drugs, >30% did not know the name of and the dosage of the drugs they are taking, and >70% did not have adequate knowledge on the effects and side effects of the drugs they are taking. Our research indicated that medication literacy scores decreased with age but increased with education. The number of medicines the discharged patient took with them and days between discharge and interview were not associated with medication literacy levels. PMID:27428990

  3. Medication Literacy in a Cohort of Chinese Patients Discharged with Acute Coronary Syndrome.

    PubMed

    Zhong, Zhuqing; Zheng, Feng; Guo, Yuna; Luo, Aijing

    2016-01-01

    This study aims at investigating medication literacy of discharged patients with acute coronary syndrome (ACS) in China, and the important determinants of medication literacy among them. For this purpose, we conducted a prospective cohort study. Patient's demographic and clinical data were retrieved from hospital charts and medication literacy was measured by instructed interview using the Chinese version of Medication Literacy Questionnaire on Discharged Patient between 7 and 30 days after the patient was discharged from the hospital. The results show that medication literacy for the surveyed patients was insufficient: >20% did not have adequate knowledge on the types of drugs and the frequency that they need to take the drugs, >30% did not know the name of and the dosage of the drugs they are taking, and >70% did not have adequate knowledge on the effects and side effects of the drugs they are taking. Our research indicated that medication literacy scores decreased with age but increased with education. The number of medicines the discharged patient took with them and days between discharge and interview were not associated with medication literacy levels. PMID:27428990

  4. [Development of integrated traditional Chinese and western medicine and change of medical policy in China].

    PubMed

    Shin, S S

    1999-01-01

    "Sect of Integration of Chinese and Western Medicine" came into the world four hundred years ago when Traditional Chinese Medicine (TCM) contacted Western Medicine (WM) at the beginning of the 17th century. It collected historical experiences showing that the cooperation of TCM and WM is more efficient for the cure and prevention of disease than each of them separately. Now the recognition that the cooperation of eastern and western medicine is more efficient to cure disease is spreading widely. This study will help Korean eastern and western medicine to find their directions. First, the concept of "sect of Integration of Chinese and Western Medicine" which was established between the beginning of the 17th century and the middle of the 20th century, and Integration of Traditional Chinese and Western Medicine (ITCWM) which was formed after the middle of the 20th century will be discussed. The relationship of "sect of Integration of Chinese and Western Medicine" and ITCWM and political consideration for the establishment of ITCWM will also be discussed. Finally, the current status of ITCWM in China will be discussed. New trends of thought appeared in Chinese medicine, owing to the cultural background of modern China, the development of WM, and the academic background of the intellectual class. "Sect of Integration of Chinese and Western Medicine" and ITCWM are different in historical and social background. However, purpose, foundation of thoughts and logical idea are fundamentally the same. It can be said that "sect of Integration of Chinese and Western Medicine" provided academic mood to open the way for ITCWM and ITCWM is a succession of "sect of Integration of Chinese and Western Medicine". The concept of ITCWM has many ways of explanation. However, it can be said to build up the foundation of new medical area including Chinese special way of medical treatment and new methods of modern medicine, succeeding a legacy of TCM. ITCWM began before the establishment of

  5. Examining shifts in medical students' microanalytic motivation beliefs and regulatory processes during a diagnostic reasoning task.

    PubMed

    Cleary, Timothy J; Dong, Ting; Artino, Anthony R

    2015-08-01

    This study examined within-group shifts in the motivation beliefs and regulatory processes of second-year medical students as they engaged in a diagnostic reasoning activity. Using a contextualized assessment methodology called self-regulated learning microanalysis, the authors found that the 71 medical student participants showed statistically significant and relatively robust declines in their self-efficacy beliefs and strategic regulatory processes following negative feedback about their performance on the diagnostic reasoning task. Descriptive statistics revealed that changes in strategic thinking following negative corrective feedback were most characterized by shifts away from task-specific processes (e.g., integration, differentiating diagnoses) to non-task related factors. Implications and areas for future research are presented and discussed. PMID:25209963

  6. Principles and applications of polymerase chain reaction in medical diagnostic fields: a review

    PubMed Central

    Valones, Marcela Agne Alves; Guimarães, Rafael Lima; Brandão, Lucas André Cavalcanti; de Souza, Paulo Roberto Eleutério; de Albuquerque Tavares Carvalho, Alessandra; Crovela, Sergio

    2009-01-01

    Recent developments in molecular methods have revolutionized the detection and characterization of microorganisms in a broad range of medical diagnostic fields, including virology, mycology, parasitology, microbiology and dentistry. Among these methods, Polymerase Chain Reaction (PCR) has generated great benefits and allowed scientific advancements. PCR is an excellent technique for the rapid detection of pathogens, including those difficult to culture. Along with conventional PCR techniques, Real-Time PCR has emerged as a technological innovation and is playing an ever-increasing role in clinical diagnostics and research laboratories. Due to its capacity to generate both qualitative and quantitative results, Real-Time PCR is considered a fast and accurate platform. The aim of the present literature review is to explore the clinical usefulness and potential of both conventional PCR and Real-Time PCR assays in diverse medical fields, addressing its main uses and advances. PMID:24031310

  7. [Use of FTIR and pattern recognition to determine geographical origins of Chinese medical herbs].

    PubMed

    Liu, Shu-hua; Zhang, Xue-gong; Zhou, Qun; Sun, Su-qin

    2005-06-01

    Geographical origin of medical herbs is an important factor of the quality of many traditional Chinese herbal medicines. The objective of this study is to investigate whether FTIR spectroscopy coupled with pattern recognition techniques could effectively discriminate geographical origins of medical herbs. Nearest neighbor method (NNM) and a SVM-based multiclass classifier were employed to discriminate 269 angelicae dahuricae radix (ADR) samples from 4 provinces in China and 380 salviae miltiorrhizae radix (SMR) samples from 6 provinces. A leave-one-out cross-validation accuracy of 99% was achieved by the multiclass classifier. The study shows this classification scheme can be a highly accurate approach for the discrimination of medical herbs of different origins. PMID:16201362

  8. Qualitative differences in knowledge structure are associated with diagnostic performance in medical students.

    PubMed

    Coderre, Sylvain; Jenkins, Deirdre; McLaughlin, Kevin

    2009-12-01

    Diagnosing is a knowledge-based skill: to diagnose one must retrieve knowledge from long-term memory and then apply this to a new clinical problem. Prior research on expertise found differences in knowledge structure between experts and novices, and it is assumed that the superior diagnostic performance of experts is somehow related to their superior knowledge structure. Here our objective was to study knowledge structure in final year medical students and to examine the association between knowledge structure and diagnostic performance. Ninety-one students participated. We used concept sorting to assess knowledge structures for four clinical problems. We performed qualitative analysis of knowledge structures, categorizing these as either problem-specific, where knowledge was predominantly structured around concepts specific to that clinical problem, or generic, where knowledge was structured around general concepts that could apply to all clinical problems. We evaluated diagnostic performance using problem-solving questions. Knowledge structure varied between different problems, but for each problem most students had problem-specific knowledge structure. These students had better diagnostic performance than those with generic structure (68.5 vs. 55.3%, d = 0.45, P = 0.004). This difference persisted after adjusting for overall medical knowledge (performance on the Medical Council of Canada Part 1 examination) and clinical problem. We found that most students organize their knowledge around problem-specific concepts, and that this type of knowledge was associated with better diagnostic performance. This may be due to easier knowledge retrieval if there is congruence between how knowledge is stored and how it is applied when diagnosing. PMID:19107567

  9. Evaluation of medical staff and patient satisfaction of Chinese hospitals and measures for improvement.

    PubMed

    Li, Min; Huang, Chengyu; Lu, Xiangchan; Chen, Siyuan; Zhao, Pan; Lu, Hongzhou

    2015-06-01

    Our goal is to establish criteria for evaluating satisfaction of medical staff and patients of Chinese hospitals and propose measures for improvement. A survey was conducted among medical staff and patients of infectious disease hospitals in three locations, i.e., Shanghai, Chongqing, and Nanning. The analyses included item analysis, factor analysis, reliability analysis, Pearson correlation and one-way analysis of variance. For the patient group, Kaiser-Meyer-Olkin (KMO) = 0.973, Cronbach's α = 0.962 and the Pearson correlation coefficients among the five dimensions of satisfaction ranged from 0.583 to 0.795. For the medical staff group, KMO = 0.972, Cronbach's α = 0.970, and the Pearson correlation coefficients among the five dimensions of satisfaction ranged from 0.603 to 0.854. The means on the five dimensions of satisfaction for the patient group were 0.74 to 1.34, 0.81 to 1.17, 0.78 to 1.07, 0.89 to 1.34, and 0.71 to 1.10. The means on the five dimensions of satisfaction for the medical staff group were 0.17 to 1.03, ‒ 0.16 to 0.60, ‒ 0.18 to 0.74, 0.23 to 0.72, and ‒ 0.39 to 0.37. The clinicians were less satisfied with the hospitals than the patients. Medical staff and patients in Shanghai were relatively more satisfied. Improving the evaluation criteria and survey methods with respect to medical staff and patient satisfaction with Chinese hospitals may increase clinician and patient satisfaction and improve the health care environment in China. PMID:26166371

  10. Design of a Global Medical Database which is Searchable by Human Diagnostic Patterns

    PubMed Central

    Orthuber, Wolfgang; Fiedler, Gunar; Kattan, Michael; Sommer, Thorsten; Fischer-Brandies, Helge

    2008-01-01

    We describe a global medical database which is designed for efficient evaluation. It allows language independent search for human diagnostic parameters. Core of the database is a fully automated electronic archive and distribution server for medical histories of real but anonymous patients which contain patterns of diagnosis, chosen treatment, and outcome. Every pattern is represented by a feature vector which is usually a sequence of numbers, and labeled by an unambiguous "pattern name" which identifies its meaning. Similarity search is always done only over patterns with the same pattern name, because these are directly comparable. Similarities of patterns are mapped to spatial similarities (small distances) of their feature vectors using an appropriate metric. This makes them searchable. Pattern names can be "owned" like today domain names. This facilitates unbureaucratic definition of patterns e.g. by manufacturers of diagnostic devices. Application: If there is a new patient with certain diagnostic patterns, it is possible to combine a part or all of them and to search in the database for completed histories of patients with similar patterns to find the best treatment. Confinement of the result by conventional language based search terms is possible, and immediate individual statistics or regression analyses can quantify probabilities of success in case of different treatment choices. Conclusions: Efficient searching with diagnostic patterns is technically feasible. Labeled feature vectors induce a systematic and expandable approach. The database also allows immediate calculation of individual up to date prediction models. PMID:19415132

  11. Ancient Chinese medical ethics and the four principles of biomedical ethics.

    PubMed Central

    Tsai, D F

    1999-01-01

    The four principles approach to biomedical ethics (4PBE) has, since the 1970s, been increasingly developed as a universal bioethics method. Despite its wide acceptance and popularity, the 4PBE has received many challenges to its cross-cultural plausibility. This paper first specifies the principles and characteristics of ancient Chinese medical ethics (ACME), then makes a comparison between ACME and the 4PBE with a view to testing out the 4PBE's cross-cultural plausibility when applied to one particular but very extensive and prominent cultural context. The result shows that the concepts of respect for autonomy, non-maleficence, beneficence and justice are clearly identifiable in ACME. Yet, being influenced by certain socio-cultural factors, those applying the 4PBE in Chinese society may tend to adopt a "beneficence-oriented", rather than an "autonomy-oriented" approach, which, in general, is dissimilar to the practice of contemporary Western bioethics, where "autonomy often triumphs". PMID:10461594

  12. Ultrasound Metrology in Mexico: a round robin test for medical diagnostics

    NASA Astrophysics Data System (ADS)

    Amezola Luna, R.; López Sánchez, A. L.; Elías Juárez, A. A.

    2011-02-01

    This paper presents preliminary statistical results from an on-going imaging medical ultrasound study, of particular relevance for gynecology and obstetrics areas. Its scope is twofold, firstly to compile the medical ultrasound infrastructure available in cities of Queretaro-Mexico, and second to promote the use of traceable measurement standards as a key aspect to assure quality of ultrasound examinations performed by medical specialists. The experimental methodology is based on a round robin test using an ultrasound phantom for medical imaging. The physician, using its own ultrasound machine, couplant and facilities, measures the size and depth of a set of pre-defined reflecting and absorbing targets of the reference phantom, which simulate human illnesses. Measurements performed give the medical specialist an objective feedback regarding some performance characteristics of their ultrasound examination systems, such as measurement system accuracy, dead zone, axial resolution, depth of penetration and anechoic targets detection. By the end of March 2010, 66 entities with medical ultrasound facilities, from both public and private institutions, have performed measurements. A network of medical ultrasound calibration laboratories in Mexico, with traceability to The International System of Units via national measurement standards, may indeed contribute to reduce measurement deviations and thus attain better diagnostics.

  13. Relation of perceptions of educational environment with mindfulness among Chinese medical students: a longitudinal study

    PubMed Central

    Xu, Xin; Wu, Daxing; Zhao, Xiaohua; Chen, Junxiang; Xia, Jie; Li, Mulei; Nie, Xueqing; Zhong, Xue

    2016-01-01

    Background Perceived educational environment influences academic outcomes, such as academic achievement, students’ behaviors, well-being, socio-emotional adjustment and explicit self-esteem. Mindfulness is a set of skills that are beneficial to physical and mental health. Recently, it has been increasingly discussed about its usefulness in education, but little research has explored whether mindfulness can predict perceptions of educational environment. The aim of this study was to explore Chinese medical students’ perceptions of learning environment and their relationship with mindfulness. Methods Medical students at the Second Xiangya Hospital of Central South University (N=431) completed the Chinese version of Dundee Ready Educational Environment Measure (DREEM-C) and the Kentucky Inventory of Mindfulness Skills (KIMS-C). One year later, a subgroup of the cohort (N=231) completed the DREEM-C again. Independent-samples t-test, variance analysis, correlation analysis, and hierarchical multiple regression (HMR) were conducted. Results DREEM-C total and subscales scores were net positive, but with room for improvement. Perceptions differed in relation to gender, academic year, and age. KIMS-C scores correlated with DREEM-C scores. The predictive effect persisted 1 year later. Conclusions Medical students had net-positive perceptions about their learning environment. Higher mindfulness scores were associated with greater satisfaction with the environment and this association showed persistence. PMID:27118582

  14. Prevalence and predictors of medication non-adherence among Chinese patients with first-episode psychosis.

    PubMed

    Lai-Ming Hui, Christy; Wing-Yan Poon, Venessa; Shuk-Kuen Kwok, Vivian; Chang, Wing-Chung; Kit-Wa Chan, Sherry; Ho-Ming Lee, Edwin; Yu-Hai Chen, Eric

    2015-08-30

    Medication non-adherence is one of the major obstacles to recovery in first-episode psychosis (FEP). This study aimed to identify the predictors and rates of medication non-adherence in the first and second year after the start of treatment (baseline) in urban Chinese FEP patients. Relevant information on medication non-adherence and potential baseline predictors, including demographic variables, clinical measures, violence/suicide attempts, stressful life experiences, intervention received, and follow-up attendance, were collected from case records of 1400 FEP patients in Hong Kong. The non-adherence rate was 16.2% in year 1 and 15.4% in year 2. Regression analyses revealed the predictors for non-adherence in year 1 were no hospitalization at baseline, non-schizophrenia diagnosis, and more years of education. Predictors of non-adherence in year 2 included acute/subacute onset and older age of onset. Predictors common in both years were defaulting from psychiatric follow-up during baseline, standard psychiatric care (no early intervention), and lower positive symptoms severity at baseline. In assessing non-adherence risk and for planning phase-specific early interventions for FEP, particularly in a Chinese context, healthcare professionals should consider the common and specific predictors for non-adherence identified in the first and second years of treatment and should not overlook patients with less clinically severe symptoms. PMID:26099660

  15. Psychometric properties of a Chinese version of the medical outcomes study family and marital functioning measures in Hong Kong Chinese childbearing families.

    PubMed

    Ngai, Fei-Wan; Ngu, Siew-Fei

    2012-10-01

    The aim of the study was to evaluate the psychometric properties of the Chinese version of Medical Outcomes Study Family and Marital Functioning Measures (C-MOS-FMFM) in Hong Kong Chinese childbearing families. A cross-sectional survey was conducted using a convenience sample of 128 childbearing couples recruited from antenatal clinics. The C-MOS-FMFM demonstrated good internal consistency (Cronbach's alpha = 0.79) and test-retest reliability (intraclass correlation coefficient = 0.74). Significant correlations with Medical Outcomes Study-Social Support Survey (r = 0.38, P < 0.01) and Trait Anxiety Inventory (r = -0.48, P < 0.01) supported construct validity. Factor analysis identified one factor corresponding to family functioning and two factors corresponding to marital functioning. The C-MOS-FMFM has satisfactory psychometric properties. It has the potential to be used as a clinical and research instrument for measuring family and marital functioning in the Chinese population. PMID:22006069

  16. Visualizing and measuring the temperature field produced by medical diagnostic ultrasound using thermography

    NASA Astrophysics Data System (ADS)

    Vachutka, J.; Grec, P.; Mornstein, V.; Caruana, C. J.

    2008-11-01

    The heating of tissues by diagnostic ultrasound can pose a significant hazard particularly in the imaging of the unborn child. The demonstration of the temperature field in tissue is therefore an important objective in the teaching of biomedical physics to healthcare professionals. The temperature field in a soft tissue model was made visible and measured using thermography. Temperature data from the images were used to investigate the dependence of temperature increase within the model on ultrasound exposure time and distance from the transducer. The experiment will be used within a multi-professional biomedical physics teaching laboratory for enhancing learning regarding the principles of thermography and the thermal effects of ultrasound to medical and healthcare students and also for demonstrating the quantitative use of thermographic imaging to students of biophysics, medical physics and medical technology.

  17. Diagnostic agreement when comparing still and video imaging for the medical evaluation of child sexual abuse.

    PubMed

    Killough, Emily; Spector, Lisa; Moffatt, Mary; Wiebe, Jan; Nielsen-Parker, Monica; Anderst, Jim

    2016-02-01

    Still photo imaging is often used in medical evaluations of child sexual abuse (CSA) but video imaging may be superior. We aimed to compare still images to videos with respect to diagnostic agreement regarding hymenal deep notches and transections in post-pubertal females. Additionally, we evaluated the role of experience and expertise on agreement. We hypothesized that videos would result in improved diagnostic agreement of multiple evaluators as compared to still photos. This was a prospective quasi-experimental study using imaging modality as the quasi-independent variable. The dependent variable was diagnostic agreement of participants regarding presence/absence of findings indicating penetrative trauma on non-acute post-pubertal genital exams. Participants were medical personnel who regularly perform CSA exams. Diagnostic agreement was evaluated utilizing a retrospective selection of videos and still photos obtained directly from the videos. Videos and still photos were embedded into an on-line survey as sixteen cases. One-hundred sixteen participants completed the study. Participant diagnosis was more likely to agree with study center diagnosis when using video (p<0.01). Use of video resulted in statistically significant changes in diagnosis in four of eight cases. In two cases, the diagnosis of the majority of participants changed from no hymenal transection to transection present. No difference in agreement was found based on experience or expertise. Use of video vs. still images resulted in increased agreement with original examiner and changes in diagnostic impressions in review of CSA exams. Further study is warranted, as video imaging may have significant impacts on diagnosis. PMID:26746111

  18. [Exploration of research approaches of Chinese medicine's pharmacology based on "imprinting templates" (medical element) of supramolecules].

    PubMed

    He, Fu-yuan; He, Hong; Deng, Kai-wen; Zhou, Yi-qun; Shi, Ji-lian; Liu, Wen-long; Yang, Yan-tao; Tang, Yu

    2015-11-01

    The paper, based on the previous publication as special impact of Chinese medicine theories on supramolcular chemistry, aims to analyze the natural origination for the Chinese medicine and to explain the special impact of "Qi chromatography" reaction on "imprinting templates" in supramolcular host of human being with Chinese medicine, in order to reveal the CM's properties of "medical element" with "imprinting templates" autonomisation generally took place in natural supramolecules, and also to discover that the CM's pharmacology are satisfied with its own approaches different form western pharmacology. It was decided, for CM's pharmacology guided by CM's theories, to "Qi chromatography" relations between the CM's ingredient groups and the meridian zang-fu viscera. The supramolcular chemistry played an all-through role in procession of making macro-regularities and special presentation on behavior of "Qi chromatography" impulse owning to the matching action of all kinds of ingredients on the meridian zang-fu viscera with similar "imprinting templates". The CM's pharmacology were guided by CM's theories, owing to its interpretation of supramolecular chemistry. The pharmacology was achieved to construct up completely on base of classical chemical single molecular bonds whereas the CM's pharmacology be configured to big building by way of "imprinting templates" as multi-weak bonds among "supramolecular society". CM's pharmacology was supramolcular pharmacology dealt with "molecular society" on the base of western pharmacology, and employed to double research approaches both math-physical quantitative representation on macroscope and qualitative analyses in microscope. PMID:27071277

  19. Therapeutic use of traditional Chinese herbal medications for chronic kidney diseases

    PubMed Central

    Zhong, Yifei; Deng, Yueyi; Chen, Yiping; Chuang, Peter Y; He, John Cijiang

    2013-01-01

    Traditional Chinese herbal medications (TCHM) are frequently used in conjunction with western pharmacotherapy for treatment of chronic kidney diseases (CKD) in China and many other Asian countries. The practice of traditional Chinese medicine is guided by cumulative empiric experience. Recent in vitro and animal studies have confirmed the biological activity and therapeutic effects of several TCHM in CKD. However, the level of evidence supporting TCHM is limited to small, non-randomized trials. Due to variations in the prescription pattern of TCHM and the need for frequent dosage adjustment, which are inherent to the practice of traditional Chinese medicine, it has been challenging to design and implement large randomized clinical trials of TCHM. Several TCHM are associated with significant adverse effects, including nephrotoxicity. However, reporting of adverse effects associated with TCHM has been inadequate. To fully realize the therapeutic use of TCHM in CKD we need molecular studies to identify active ingredients of TCHM and their mechanism of action, rigorous pharmacologic studies to determine the safety and meet regulatory standards required for clinical therapeutic agents, and well-designed clinical trials to provide evidence-based support of their safety and efficacy. PMID:23868014

  20. Capillary waveguide optrodes: an approach to optical sensing in medical diagnostics

    NASA Astrophysics Data System (ADS)

    Lippitsch, Max E.; Draxler, Sonja; Kieslinger, Dietmar; Lehmann, Hartmut; Weigl, Bernhard H.

    1996-07-01

    Glass capillaries with a chemically sensitive coating on the inner surface are used as optical sensors for medical diagnostics. A capillary simultaneously serves as a sample compartment, a sensor element, and an inhomogeneous optical waveguide. Various detection schemes based on absorption, fluorescence intensity, or fluorescence lifetime are described. In absorption-based capillary waveguide optrodes the absorption in the sensor layer is analyte dependent; hence light transmission along the inhomogeneous waveguiding structure formed by the capillary wall and the sensing layer is a function of the analyte concentration. Similarly, in fluorescence-based capillary optrodes the fluorescence intensity or the fluorescence lifetime of an indicator dye fixed in the sensing layer is analyte dependent; thus the specific property of fluorescent light excited in the sensing layer and thereafter guided along the inhomogeneous waveguiding structure is a function of the analyte concentration. Both schemes are experimentally demonstrated, one with carbon dioxide as the analyte and the other one with oxygen. The device combines optical sensors with the standard glass capillaries usually applied to gather blood drops from fingertips, to yield a versatile diagnostic instrument, integrating the sample compartment, the optical sensor, and the light-collecting optics into a single piece. This ensures enhanced sensor performance as well as improved handling compared with other sensors. waveguide, blood gases, medical diagnostics.

  1. The Changing Landscape of Molecular Diagnostic Testing: Implications for Academic Medical Centers

    PubMed Central

    Rehm, Heidi L.; Hynes, Elizabeth; Funke, Birgit H.

    2016-01-01

    Over the last decade, the field of molecular diagnostics has undergone tremendous transformation, catalyzed by the clinical implementation of next generation sequencing (NGS). As technical capabilities are enhanced and current limitations are addressed, NGS is increasingly capable of detecting most variant types and will therefore continue to consolidate and simplify diagnostic testing. It is likely that genome sequencing will eventually serve as a universal first line test for disorders with a suspected genetic origin. Academic Medical Centers (AMCs), which have been at the forefront of this paradigm shift are now presented with challenges to keep up with increasing technical, bioinformatic and interpretive complexity of NGS-based tests in a highly competitive market. Additional complexity may arise from altered regulatory oversight, also triggered by the unprecedented scope of NGS-based testing, which requires new approaches. However, these challenges are balanced by unique opportunities, particularly at the interface between clinical and research operations, where AMCs can capitalize on access to cutting edge research environments and establish collaborations to facilitate rapid diagnostic innovation. This article reviews present and future challenges and opportunities for AMC associated molecular diagnostic laboratories from the perspective of the Partners HealthCare Laboratory for Molecular Medicine (LMM). PMID:26828522

  2. Medical thoracoscopy: Analysis on diagnostic yield through 30 years of experience

    PubMed Central

    Valsecchi, Alberto; Arondi, Sabrina; Marchetti, Giampietro

    2016-01-01

    BACKGROUND: Medical thoracoscopy (MT) or pleuroscopy is a procedure performed to diagnose and treat malignant and benign pleural diseases. Totally 2752 pleuroscopies executed in 1984–2013 in our center were considered in this study. METHODS: A retrospective observational study was performed. Observational time was divided into six series of 5 years. We calculated MT diagnostic yield and analyzed trends of main diseases diagnosed along the time. RESULTS: Along the 30 years population became progressively older. Number of pleuroscopies firstly increased, then stabilized and decreased in the last 5 years. The overall diagnostic yield of MT was 71%, increasing from 57% to 79%. The diagnostic yield was significantly higher in the presence of monolateral pleural effusion. Cancer represented more than half of diagnosis; tuberculosis was the most common nonneoplastic disease. The frequency of all cancers, mesothelioma, and lung cancer increased through the time; tuberculosis first decreased and then increased. All specimens resulted appropriate during the last 25 years. CONCLUSION: MT has a great diagnostic yield that can be improved by practice, permitting to achieve a specific histological diagnosis in about 80% of patients. Our experience demonstrates that the accurate selection of the patients undergoing to MT is very important to reach these results. PMID:27512506

  3. Selection of diagnostic tests for clinical decision making and translation to a problem oriented medical record.

    PubMed

    Realdi, Giuseppe; Previato, Lorenzo; Vitturi, Nicola

    2008-07-01

    The leading function of the physician is the clinical reasoning, which involves appropriate investigation of the problems of the patient, formulation of a diagnostic suspect based on the patient's symptoms and signs, gathering of additional relevant information, to select necessary tests and administration of the most suitable therapy. The problems of the patient are expressed by symptoms or signs or abnormal test results, requested for a variety of reasons. The entire scientific, as well as diagnostic approach, is based on three steps: to stumble in a problem; to try a solution through a hypothesis; to disprove or to prove the hypothesis by a process of criticism. Clinicians use the information obtained from the history and physical examination to estimate initial (or pre-test) probability and then use the results from tests and other diagnostic procedures to modify this probability until the post-test probability is such that the suspected diagnosis is either confirmed or ruled out. When the pre-test probability of disease is high, tests characterized by high specificity will be preferred, in order to confirm the diagnostic suspect. When the pre-test probability of disease is low, a test with high sensitivity is advisable to exclude the hypothetical disease. The above mentioned process of decision making has been transferred to a problem oriented medical record that is currently employed in our Clinic. PMID:18420030

  4. Chinese military medical teams in the Ebola outbreak of Sierra Leone.

    PubMed

    Lu, Yinying; Rong, G; Yu, S P; Sun, Z; Duan, X; Dong, Z; Xia, H; Zhan, N; Jin, C; Ji, J; Duan, H

    2016-06-01

    The 2014-2015 Ebola virus disease (EVD) epidemic in West Africa was the largest in history. The three most affected countries, Guinea, Liberia and Sierra Leone, have faced enormous challenges in controlling transmission and providing clinical care for patients with EVD. The Chinese government, in response to the requests of the WHO and the governments of the affected countries, responded rapidly by deploying Chinese military medical teams (CMMTs) to the areas struck by the deadly epidemic. A total of three CMMTs, comprising 115 military medical professionals, were rotationally deployed to Freetown, Sierra Leone to assist with infection prevention and control, clinical care and health promotion and training. Between 1 October 2014 and 22 March 2015, the CMMTs in Sierra Leone admitted and treated a total of 773 suspected and 285 confirmed EVD cases. Among the 285 confirmed cases, 146 (51.2%) patients survived after treatment. In addition, the CMMTs maintained the record of zero infections among healthcare workers and zero cross-infections between quarantined patients. In this manuscript, we aim to give an overview of the mission, and share our best practices experience on predeployment preparedness, EVD holding and treatment centre building and EVD case management. PMID:26744190

  5. [Material base on Chinese medical theory of 'Fei and Dachang being interior-exteriorly correlated'].

    PubMed

    Li, Jie; Cheng, Xin; Jia, Yu-Hua

    2011-02-01

    By reviewing pertinent literatures, we found that there existed some defects in studying material base on Chinese medical theory of "Fei and Dachang being interior-exteriorly related", such as the low efficacy of research methods; the neglect of intestinal and respiratory microhabitat and Chinese medical functional condition; and the unconformity of research design with evidence-based medicinal requirements. Thereby, the authors offered that the researches method of initiating merely from sole material or line linkage path should be rejected. The new research strategy should be established based on the feature of the lung and large intestine network connective structure, cutting-in from correlative changes in the two terminals (respiratory system and intestinal tissue), and the intermedial key knot of connection (blood serum), screen out in high throughput the relevant materials adopting microecological, proteomic and metabonomic techniques, and catch hold of the knots of network as much as possible. Based on these to perfect the researches on coordinating mechanism of the network, and to establish a new strategy for future researching. PMID:21425586

  6. Chinese military medical teams in the Ebola outbreak of Sierra Leone

    PubMed Central

    Lu, Yinying; Rong, G; Yu, S P; Sun, Z; Duan, X; Dong, Z; Xia, H; Zhan, N; Jin, C; Ji, J; Duan, H

    2016-01-01

    The 2014–2015 Ebola virus disease (EVD) epidemic in West Africa was the largest in history. The three most affected countries, Guinea, Liberia and Sierra Leone, have faced enormous challenges in controlling transmission and providing clinical care for patients with EVD. The Chinese government, in response to the requests of the WHO and the governments of the affected countries, responded rapidly by deploying Chinese military medical teams (CMMTs) to the areas struck by the deadly epidemic. A total of three CMMTs, comprising 115 military medical professionals, were rotationally deployed to Freetown, Sierra Leone to assist with infection prevention and control, clinical care and health promotion and training. Between 1 October 2014 and 22 March 2015, the CMMTs in Sierra Leone admitted and treated a total of 773 suspected and 285 confirmed EVD cases. Among the 285 confirmed cases, 146 (51.2%) patients survived after treatment. In addition, the CMMTs maintained the record of zero infections among healthcare workers and zero cross-infections between quarantined patients. In this manuscript, we aim to give an overview of the mission, and share our best practices experience on predeployment preparedness, EVD holding and treatment centre building and EVD case management. PMID:26744190

  7. [The provision of quality and security of medical care on the basis of standardization of medical nurse activities in counseling diagnostic center].

    PubMed

    Chikineva, A V

    2010-01-01

    The enhancement of curative diagnostic process and the increase of its quality depend not only on the management, but on the reasonable implementation of high-tech new technologies. Nowadays, the evidence-based medical nursing practice represents an actively developing direction of medical nurse business. The State Novosibirsk oblast diagnostic center has developed the standards of nurse activities targeted to decrease the duplication in work, the provision of personnel and patient security. The audit of implementation of standards and the monitoring of nursing process permit to timely input the adjustments to the provision of quality of medical nurse care. PMID:20967968

  8. A cloud system for mobile medical services of traditional Chinese medicine.

    PubMed

    Hu, Nian-Ze; Lee, Chia-Ying; Hou, Mark C; Chen, Ying-Ling

    2013-12-01

    Many medical centers in Taiwan have started to provide Traditional Chinese Medicine (TCM) services for hospitalized patients. Due to the complexity of TCM modality and the increasing need for providing TCM services for patients in different wards at distantly separate locations within the hospital, it is getting difficult to manage the situation in the traditional way. A computerized system with mobile ability can therefore provide a practical solution to the challenge presented. The study tries to develop a cloud system equipped with mobile devices to integrate electronic medical records, facilitate communication between medical workers, and improve the quality of TCM services for the hospitalized patients in a medical center. The system developed in the study includes mobile devices carrying Android operation system and a PC as a cloud server. All the devices use the same TCM management system developed by the study. A website of database is set up for information sharing. The cloud system allows users to access and update patients' medical information, which is of great help to medical workers for verifying patients' identification and giving proper treatments to patients. The information then can be wirelessly transmitted between medical personnel through the cloud system. Several quantitative and qualitative evaluation indexes are developed to measure the effectiveness of the cloud system on the quality of the TCM service. The cloud system is tested and verified based on a sample of hospitalized patients receiving the acupuncture treatment at the Lukang Branch of Changhua Christian Hospital (CCH) in Taiwan. The result shows a great improvement in operating efficiency of the TCM service in that a significant saving in labor time can be attributable to the cloud system. In addition, the cloud system makes it easy to confirm patients' identity through taking a picture of the patient upon receiving any medical treatment. The result also shows that the cloud system

  9. Non-invasive medical diagnostics by nanoparticle-based solid-state gas sensors

    NASA Astrophysics Data System (ADS)

    Tricoli, Antonio

    2013-08-01

    Chemical sensors made of tailored nanoparticles offer excellent miniaturization capability and are able to rapidly and continuously detect trace amounts of important analytes down to trace concentrations. Application of these sensing materials to non-invasive medical diagnostics by breath analysis has the potential to drastically reduce diagnostics costs while offering better service quality to the patients and enabling very early-stage detection of severe illnesses such as lung cancer. Here, we present a flexible approach to synthesize advanced solid-state gas sensor materials that have demonstrated reliable detection of important breath markers. In particular, the feasibility of capturing highly performing, meta-stable sensing nanoparticles by flame-synthesis of multi component metal-oxides is critically discussed.

  10. [Forensic medical diagnostics of intra-vitality of the strangulation mark by morphological methods].

    PubMed

    Bogomolov, D V; Zbrueva, Yu V; Putintsev, V A; Denisova, O P

    2016-01-01

    The objective of the present study WaS to overview the current domestic and foreign literature concerning the up-to-date methods employed for the expert evaluation of intra-vitality of the strangulation mark. The secondary objective was to propose the new approaches for addressing this problem. The methods of expert diagnostics with a view to determining the time of infliction of injuries as exemplified by mechanical asphyxia are discussed. It is concluded that immunohistochemical and morphometric studies provide the most promising tools for the evaluation of intra-vitality of the strangulation mark for the purpose of forensic medical expertise. PMID:27358932

  11. [The metrology of medical devices for the diagnostic in vitro: the European approach].

    PubMed

    Antonov, V S

    2011-12-01

    In the European Union, the measurement devices are regulated by the Directive 2004/22/EU establishing the mandatory requirements, rules of admittance and control/surveillance on the market. The medical laboratory analyzers don't come under the force of this Directive and are regulated by the Directive 98/72/EU in the same way as all medical devices for diagnostics in vitro. The new Russian Federal Law No102 "On the provision of the unification of measurements" came into force in 2009 is significantly harmonized with the similar international legislation and enable to eliminate the contradictions which for many years impeded the development of metrological support of clinical laboratory examinations. PMID:22416434

  12. Molecular Characterization and Antimicrobial Susceptibility of Nasal Staphylococcus aureus Isolates from a Chinese Medical College Campus

    PubMed Central

    Du, Jimei; Chen, Chun; Ding, Baixing; Tu, Jinjing; Qin, Zhiqiang; Parsons, Chris; Salgado, Cassandra; Cai, Qiangjun; Song, Yulong; Bao, Qiyu; Zhang, Liming; Pan, Jingye; Wang, Liangxing; Yu, Fangyou

    2011-01-01

    Staphylococcus aureus colonization and infection occur more commonly among persons living or working in crowded conditions, but characterization of S. aureus colonization within medical communities in China is lacking. A total of 144 (15.4%, 144/935) S. aureus isolates, including 28 (3.0%, 28/935) MRSA isolates, were recovered from the nares of 935 healthy human volunteers residing on a Chinese medical college campus. All S. aureus isolates were susceptible to vancomycin, quinupristin/dalfopristin and linezolid but the majority were resistant to penicillin (96.5%), ampicillin/sulbactam (83.3%) and trimethoprim/sulfamethoxazole (93.1%). 82%, (23/28) of the MRSA isolates and 66% (77/116) of the MSSA isolates were resistant to multiple antibiotics, and 3 MRSA isolates were resistant to mupirocin—an agent commonly used for nasal decolonization. 16 different sequence types (STs), as well as SCCmec genes II, III, IVd, and V, were represented among MRSA isolates. We also identified, for the first time, two novel STs (ST1778 and ST1779) and 5 novel spa types for MRSA. MRSA isolates were distributed in different sporadic clones, and ST59-MRSA-VId- t437 was found within 3 MRSA isolates. Moreover, one isolate with multidrug resistance belonging to ST398-MRSA-V- t571 associated with animal infections was identified, and 3 isolates distributed in three different clones harbored PVL genes. Collectively, these data indicate a high prevalence of nasal MRSA carriage and molecular heterogeneity of S. aureus isolates among persons residing on a Chinese medical college campus. Identification of epidemic MRSA clones associated with community infection supports the need for more effective infection control measures to reduce nasal carriage and prevent dissemination of MRSA to hospitalized patients and health care workers in this community. PMID:22114670

  13. Molecular characterization and antimicrobial susceptibility of nasal Staphylococcus aureus isolates from a Chinese medical college campus.

    PubMed

    Du, Jimei; Chen, Chun; Ding, Baixing; Tu, Jinjing; Qin, Zhiqiang; Parsons, Chris; Salgado, Cassandra; Cai, Qiangjun; Song, Yulong; Bao, Qiyu; Zhang, Liming; Pan, Jingye; Wang, Liangxing; Yu, Fangyou

    2011-01-01

    Staphylococcus aureus colonization and infection occur more commonly among persons living or working in crowded conditions, but characterization of S. aureus colonization within medical communities in China is lacking. A total of 144 (15.4%, 144/935) S. aureus isolates, including 28 (3.0%, 28/935) MRSA isolates, were recovered from the nares of 935 healthy human volunteers residing on a Chinese medical college campus. All S. aureus isolates were susceptible to vancomycin, quinupristin/dalfopristin and linezolid but the majority were resistant to penicillin (96.5%), ampicillin/sulbactam (83.3%) and trimethoprim/sulfamethoxazole (93.1%). 82%, (23/28) of the MRSA isolates and 66% (77/116) of the MSSA isolates were resistant to multiple antibiotics, and 3 MRSA isolates were resistant to mupirocin--an agent commonly used for nasal decolonization. 16 different sequence types (STs), as well as SCCmec genes II, III, IVd, and V, were represented among MRSA isolates. We also identified, for the first time, two novel STs (ST1778 and ST1779) and 5 novel spa types for MRSA. MRSA isolates were distributed in different sporadic clones, and ST59-MRSA-VId- t437 was found within 3 MRSA isolates. Moreover, one isolate with multidrug resistance belonging to ST398-MRSA-V- t571 associated with animal infections was identified, and 3 isolates distributed in three different clones harbored PVL genes. Collectively, these data indicate a high prevalence of nasal MRSA carriage and molecular heterogeneity of S. aureus isolates among persons residing on a Chinese medical college campus. Identification of epidemic MRSA clones associated with community infection supports the need for more effective infection control measures to reduce nasal carriage and prevent dissemination of MRSA to hospitalized patients and health care workers in this community. PMID:22114670

  14. Investigation of radiation protection of medical staff performing medical diagnostic examinations by using PET/CT technique.

    PubMed

    Wrzesień, Małgorzata; Napolska, Katarzyna

    2015-03-01

    Positron emission tomography (PET) is now one of the most important methods in the diagnosis of cancer diseases. Due to the rapid growth of PET/CT centres in Poland in less than a decade, radiation protection and, consequently, the assessment of worker exposure to ionising radiation, emitted mainly by the isotope (18)F, have become essential issues. The main aim of the study was to analyse the doses received by workers employed in the Medical Diagnostic Centre. The analysis comprises a physicist, three nurses, three physicians, three technicians, as well as two administrative staff employees. High-sensitivity thermoluminescent detectors (TLDs) were used to measure the doses for medical staff. The personnel was classified into categories, among them employees having direct contact with the 'source of radiation'-(18)FDG. The TLDs were placed on the fingertips of both hands and they were also attached at the level of eye lenses, thyroid and gonads depending on the assigned category. The highest dose of radiation was observed during the administration of the (18)FDG to the patients. In the case of the physicist, the highest dose was recorded during preparation of the radiopharmaceutical-(18)FDG. The body parts most exposed to ionizing radiation are the fingertips of the thumb, index and middle finger. PMID:25647828

  15. Quantization and diagnosis of Shanghuo (Heatiness) in Chinese medicine using a diagnostic scoring scheme and salivary biochemical parameters

    PubMed Central

    2014-01-01

    Background This study aims to establish a diagnostic scoring scheme for Shanghuo (Heatiness) and to evaluate whether Shanghuo is associated with biochemical parameters of salivary lysozyme (LYZ), salivary secreted immunoglobulin (S-IgA), salivary amylase (AMS), and saliva flow rate (SFR). Methods We collected 121 Shanghuo patients at the Affiliated Hospitals of Guangzhou University of Traditional Chinese Medicine in Guangdong Province, 60 cases as a Shanghuo recovered group, and 60 healthy cases as a healthy control group. The diagnostic scoring scheme was established by probability theory and maximum likelihood discriminatory analysis on the basis of epidemiology with the design of self-controlled clinical trial. Subsequently, we used the same methods to collect 120 Shanghuo patients, 60 Shanghuo recovered cases, and 60 healthy cases in both Hunan Province and Henan Province. The levels of LYZ, S-IgA, AMS, and SFR were tested when the patients suffered from Shanghuo or recovered, respectively. Results The diagnostic score table for Shanghuo syndrome was established first. In the retrospective tests, the sensitivity, specificity, accuracy, and positive likelihood ratio of the diagnostic score table were 98.9%, 93.5%, 97.5%, and 14.34%, respectively. In the prospective tests, the corresponding values were 94.9%, 85.7%, 91.7%, and 6.64%, respectively. Shanghuo was classified into three degrees based on the diagnostic scores, common Shanghuo: 63–120; serious Shanghuo: 121–150; very serious Shanghuo: >150. A negative correlation was found between Shanghuo and S-IgA (R = -0.428; P = 0.000). The level of S-IgA was also affected by seasonal and regional factors. No significant correlations were found between Shanghuo and the levels of LYZ, AMS, and SFR. Conclusions In this study, Shanghuo could be diagnosed by the combination of the diagnostic score table and S-lgA level. PMID:24386887

  16. Update of diagnostic medical and dental x-ray exposures in Romania.

    PubMed

    Sorop, Ioana; Mossang, Daniela; Iacob, Mihai Radu; Dadulescu, Elena; Iacob, Olga

    2008-12-01

    This national study, the third in the last 15 years, updates the magnitude of medical radiation exposure from conventional x-ray examinations, in order to optimise the radiological protection to the population in a cost-effective manner. Effective doses from diagnostic radiology were estimated for adult and paediatric patients undergoing the 20 most important types of x-ray examination. Data were collected from 179 x-ray departments, selected by their annual workload, throughout the country. Estimates were made using two dosimetric quantities: entrance surface dose, derived from the absorbed dose in air measured by simulation of radiographic examinations, and dose-area product, measured during fluoroscopic examinations performed on adult and paediatric patients. Conversion coefficients to effective dose of the UK National Radiological Protection Board (NRPB) have been used in all calculations. The effective dose per patient from all medical x-ray examinations was 0.74 mSv and the resulting annual collective effective dose was 6930 man Sv, with annual effective dose per caput of 0.33 mSv. The current size of population exposure from diagnostic radiology is lower than the previous one by 40%, but could be about 30% higher by taking into account the estimated contribution from computed tomography (CT) procedures. PMID:19029586

  17. Improving medical diagnostic accuracy of ultrasound Doppler signals by combining neural network models.

    PubMed

    Ubeyli, Elif Derya; Güler, Inan

    2005-07-01

    There are a number of different quantitative models that can be used in a medical diagnostic decision support system including parametric methods (linear discriminant analysis or logistic regression), nonparametric models (k nearest neighbor or kernel density) and several neural network models. The complexity of the diagnostic task is thought to be one of the prime determinants of model selection. Unfortunately, there is no theory available to guide model selection. This paper illustrates the use of combined neural network models to guide model selection for diagnosis of ophthalmic and internal carotid arterial disorders. The ophthalmic and internal carotid arterial Doppler signals were decomposed into time-frequency representations using discrete wavelet transform and statistical features were calculated to depict their distribution. The first-level networks were implemented for the diagnosis of ophthalmic and internal carotid arterial disorders using the statistical features as inputs. To improve diagnostic accuracy, the second-level networks were trained using the outputs of the first-level networks as input data. The combined neural network models achieved accuracy rates which were higher than that of the stand-alone neural network models. PMID:15780863

  18. Model selection for a medical diagnostic decision support system: a breast cancer detection case.

    PubMed

    West, D; West, V

    2000-11-01

    There are a number of different quantitative models that can be used in a medical diagnostic decision support system (MDSS) including parametric methods (linear discriminant analysis or logistic regression), non-parametric models (K nearest neighbor, or kernel density) and several neural network models. The complexity of the diagnostic task is thought to be one of the prime determinants of model selection. Unfortunately, there is no theory available to guide model selection. Practitioners are left to either choose a favorite model or to test a small subset using cross validation methods. This paper illustrates the use of a self-organizing map (SOM) to guide model selection for a breast cancer MDSS. The topological ordering properties of the SOM are used to define targets for an ideal accuracy level similar to a Bayes optimal level. These targets can then be used in model selection, variable reduction, parameter determination, and to assess the adequacy of the clinical measurement system. These ideas are applied to a successful model selection for a real-world breast cancer database. Diagnostic accuracy results are reported for individual models, for ensembles of neural networks, and for stacked predictors. PMID:10998586

  19. A prospective study of medical diagnostic radiography and risk of thyroid cancer.

    PubMed

    Neta, Gila; Rajaraman, Preetha; Berrington de Gonzalez, Amy; Doody, Michele M; Alexander, Bruce H; Preston, Dale; Simon, Steven L; Melo, Dunstana; Miller, Jeremy; Freedman, D Michal; Linet, Martha S; Sigurdson, Alice J

    2013-04-15

    Although diagnostic x-ray procedures provide important medical benefits, cancer risks associated with their exposure are also possible, but not well characterized. The US Radiologic Technologists Study (1983-2006) is a nationwide, prospective cohort study with extensive questionnaire data on history of personal diagnostic imaging procedures collected prior to cancer diagnosis. We used Cox proportional hazard regressions to estimate thyroid cancer risks related to the number and type of selected procedures. We assessed potential modifying effects of age and calendar year of the first x-ray procedure in each category of procedures. Incident thyroid cancers (n = 251) were diagnosed among 75,494 technologists (1.3 million person-years; mean follow-up = 17 years). Overall, there was no clear evidence of thyroid cancer risk associated with diagnostic x-rays except for dental x-rays. We observed a 13% increase in thyroid cancer risk for every 10 reported dental radiographs (hazard ratio = 1.13, 95% confidence interval: 1.01, 1.26), which was driven by dental x-rays first received before 1970, but we found no evidence that the relationship between dental x-rays and thyroid cancer was associated with childhood or adolescent exposures as would have been anticipated. The lack of association of thyroid cancer with x-ray procedures that expose the thyroid to higher radiation doses than do dental x-rays underscores the need to conduct a detailed radiation exposure assessment to enable quantitative evaluation of risk. PMID:23529772

  20. A hybrid body technique: does the pulse diagnostic cun guan chi method have Chinese-Tibetan origins?

    PubMed

    Hsu, Elisabeth

    2008-01-01

    This article investigates the medieval origins of the main pulse diagnostic method in contemporary Chinese medicine, sometimes known as san bu (three sectors) method, which requires physicians to examine the mai (vessels, vessel movements or pulse) on the wrist at the three locations cun guan chi (inch, gate, foot). The article provides evidence to suggest that this body technique grew out of an earlier Chinese one, the cun chi (inch-foot) method, which appears to have aimed at investigating the qualities of yin and yang in order to determine the condition of a patient by means of exploring fairly large areas of the patient's body surface with the palms. The article furthermore posits that the cun chi method was decisively transformed in medieval times, presumably due to the impact of early Tibetan pulse diagnostic practices: it became framed in a numerology of three and started advocating the use of the fingertips for sensing the pulse beats. The article, which draws on detailed textual analyses of medieval manuscripts, on visual evidence and also on psychophysical research, furthermore highlights how misunderstandings can constructively contribute to cultural communication. PMID:18828567

  1. [On medical risk control in Chinese missionary hospitals in China during 1820-1860].

    PubMed

    He, L P; Hu, X Y

    2016-01-28

    In the missionary hospitals founded in the nineteenth century by the missionaries in China, the sprout of consciousness of medical risk control emerged. They did their best to avoid medical accidents which might lead to anti-missionary struggle by the Chinese people, and were especially cautious to control the happening of medical accidents. First of all, the hospitals made careful screening on patients by giving priority to those patients pursuing treatment of eye diseases, and barely forced to accept patients with intractable and critical diseases. Second, before the operation, the missionary doctors usually let the patient sign an agreement of consent for surgical operation, with the patient him/herself responsible for all the consequences of operation. Generally, the patient(s) won't be hospitalized, even though the work of their nursing was generally done by the patient's relatives. All these three initiatives promoted the spread of western medicine in China and expanded a positive influence of western medicine, though it seemed to be contradictory to the principles of equality and universal love of Christianity. PMID:27049741

  2. Radiological safety status and quality assurance audit of medical X-ray diagnostic installations in India.

    PubMed

    Sonawane, A U; Singh, Meghraj; Sunil Kumar, J V K; Kulkarni, Arti; Shirva, V K; Pradhan, A S

    2010-10-01

    We conducted a radiological safety and quality assurance (QA) audit of 118 medical X-ray diagnostic machines installed in 45 major hospitals in India. The main objective of the audit was to verify compliance with the regulatory requirements stipulated by the national regulatory body. The audit mainly covered accuracy check of accelerating potential (kVp), linearity of tube current (mA station) and timer, congruence of radiation and optical field, and total filtration; in addition, we also reviewed medical X-ray diagnostic installations with reference to room layout of X-ray machines and conduct of radiological protection survey. A QA kit consisting of a kVp Test-O-Meter (ToM) (Model RAD/FLU-9001), dose Test-O-Meter (ToM) (Model 6001), ionization chamber-based radiation survey meter model Gun Monitor and other standard accessories were used for the required measurements. The important areas where there was noncompliance with the national safety code were: inaccuracy of kVp calibration (23%), lack of congruence of radiation and optical field (23%), nonlinearity of mA station (16%) and timer (9%), improper collimator/diaphragm (19.6%), faulty adjustor knob for alignment of field size (4%), nonavailability of warning light (red light) at the entrance of the X-ray room (29%), and use of mobile protective barriers without lead glass viewing window (14%). The present study on the radiological safety status of diagnostic X-ray installations may be a reasonably good representation of the situation in the country as a whole. The study contributes significantly to the improvement of radiological safety by the way of the steps already taken and by providing a vital feed back to the national regulatory body. PMID:21170188

  3. Dual Processing Model for Medical Decision-Making: An Extension to Diagnostic Testing.

    PubMed

    Tsalatsanis, Athanasios; Hozo, Iztok; Kumar, Ambuj; Djulbegovic, Benjamin

    2015-01-01

    Dual Processing Theories (DPT) assume that human cognition is governed by two distinct types of processes typically referred to as type 1 (intuitive) and type 2 (deliberative). Based on DPT we have derived a Dual Processing Model (DPM) to describe and explain therapeutic medical decision-making. The DPM model indicates that doctors decide to treat when treatment benefits outweigh its harms, which occurs when the probability of the disease is greater than the so called "threshold probability" at which treatment benefits are equal to treatment harms. Here we extend our work to include a wider class of decision problems that involve diagnostic testing. We illustrate applicability of the proposed model in a typical clinical scenario considering the management of a patient with prostate cancer. To that end, we calculate and compare two types of decision-thresholds: one that adheres to expected utility theory (EUT) and the second according to DPM. Our results showed that the decisions to administer a diagnostic test could be better explained using the DPM threshold. This is because such decisions depend on objective evidence of test/treatment benefits and harms as well as type 1 cognition of benefits and harms, which are not considered under EUT. Given that type 1 processes are unique to each decision-maker, this means that the DPM threshold will vary among different individuals. We also showed that when type 1 processes exclusively dominate decisions, ordering a diagnostic test does not affect a decision; the decision is based on the assessment of benefits and harms of treatment. These findings could explain variations in the treatment and diagnostic patterns documented in today's clinical practice. PMID:26244571

  4. Dual Processing Model for Medical Decision-Making: An Extension to Diagnostic Testing

    PubMed Central

    Tsalatsanis, Athanasios; Hozo, Iztok; Kumar, Ambuj; Djulbegovic, Benjamin

    2015-01-01

    Dual Processing Theories (DPT) assume that human cognition is governed by two distinct types of processes typically referred to as type 1 (intuitive) and type 2 (deliberative). Based on DPT we have derived a Dual Processing Model (DPM) to describe and explain therapeutic medical decision-making. The DPM model indicates that doctors decide to treat when treatment benefits outweigh its harms, which occurs when the probability of the disease is greater than the so called “threshold probability” at which treatment benefits are equal to treatment harms. Here we extend our work to include a wider class of decision problems that involve diagnostic testing. We illustrate applicability of the proposed model in a typical clinical scenario considering the management of a patient with prostate cancer. To that end, we calculate and compare two types of decision-thresholds: one that adheres to expected utility theory (EUT) and the second according to DPM. Our results showed that the decisions to administer a diagnostic test could be better explained using the DPM threshold. This is because such decisions depend on objective evidence of test/treatment benefits and harms as well as type 1 cognition of benefits and harms, which are not considered under EUT. Given that type 1 processes are unique to each decision-maker, this means that the DPM threshold will vary among different individuals. We also showed that when type 1 processes exclusively dominate decisions, ordering a diagnostic test does not affect a decision; the decision is based on the assessment of benefits and harms of treatment. These findings could explain variations in the treatment and diagnostic patterns documented in today’s clinical practice. PMID:26244571

  5. The Chinese Life-Steps Program: A Cultural Adaptation of a Cognitive-Behavioral Intervention to Enhance HIV Medication Adherence

    ERIC Educational Resources Information Center

    Shiu, Cheng-Shi; Chen, Wei-Ti; Simoni, Jane; Fredriksen-Goldsen, Karen; Zhang, Fujie; Zhou, Hongxin

    2013-01-01

    China is considered to be the new frontier of the global AIDS pandemic. Although effective treatment for HIV is becoming widely available in China, adherence to treatment remains a challenge. This study aimed to adapt an intervention promoting HIV-medication adherence--favorably evaluated in the West--for Chinese HIV-positive patients. The…

  6. [Textual research on relationship between traditional Chinese medicine and medical prescriptions in the Sanskrit formulary Bower Manuscript excavated in Xinjiang].

    PubMed

    Wang, Xingyi

    2015-05-01

    This paper introduces the Bower Manuscript in Sanskrit written on birch bark excavated in Xinjiang, which was bought in Kuqa by a British India army lieutenant Bower, hence its title. Then, it was researched, annotated, and published in 7 volumes by a German British lieutenant and orientalist Honer. The first three volumes are devoted to medical prescriptions. It is first verified that its "Dazi Xiangye San" is the "Dujuan Dachen San" in Tibetan medicine. By comparing it with other traditional medical systems, such as Chinese, Tibetan, Mongolian, and Uyghur medical systems, we found that Bower Manuscript is closer to Tibetan medicine and Mongolian medicine, while it has less relation with Chinese medicine and Uyghur medicine. However, it also exerts some influence on TCM. PMID:26420529

  7. Effectiveness, Medication Patterns, and Adverse Events of Traditional Chinese Herbal Patches for Osteoarthritis: A Systematic Review

    PubMed Central

    Wang, Xuezong; Liu, Ting; Gao, Ningyang; Ding, Daofang; Duan, Tieli; Cao, Yuelong; Zheng, Yuxin

    2014-01-01

    Objective. The aim of this study is to systematically evaluate the evidence whether traditional Chinese herbal patches (TCHPs) for osteoarthritis (OA) are effective and safe and analyze their medication patterns. Methods. A systematic literature search was performed using all the possible Medical Subject Headings (MeSH) and keywords from January 1979 to July 2013. Both randomized controlled trials (RCTs) and observational studies were included. Estimated effects were analyzed using mean difference (MD) or relative risk (RR) with 95% confidence intervals (CI) and meta-analysis. Results. 86 kinds of TCHPs were identified. RCTs and controlled clinical trials (CCTs) which were mostly of low quality favored TCHPs for local pain and dysfunction relief. TCHPs, compared with diclofenac ointment, had significant effects on global effectiveness rate (RR = 0.50; 95% CI (0.29, 0.87)). Components of formulae were mainly based on the compounds “Xiao Huo Luo Dan” (Minor collateral-freeing pill) and “Du Huo Ji Sheng Tang” (Angelicae Pubescentis and Loranthi decoction). Ten kinds of adverse events (AEs), mainly consisting of itching and/or local skin rashes, were identified after 3-4 weeks of follow-up. Conclusions. TCHPs have certain evidence in improving global effectiveness rate for OA; however, more rigorous studies are warranted to support their use. PMID:24527043

  8. Problems and the potential direction of reforms for the current individual medical savings accounts in the Chinese health care system.

    PubMed

    Kong, Xiangjin; Yang, Yang; Gong, Fuqing; Zhao, Mingjie

    2012-12-01

    Individual health savings accounts are an important part of the current basic medical insurance system for urban workers in China. Since 1998 when the system of personal medical insurance accounts was first implemented, there has been considerable controversy over its function and significance within different social communities. This paper analyzes the main problems in the practical implementation of individual medical insurance accounts and discusses the social and cultural foundations for the establishment of family health savings accounts from the perspective of Chinese Confucian familism. Accordingly, it addresses the direction of the reform and the development of the current system of individual health insurance accounts in China. PMID:23192456

  9. ASIC design of a digital fuzzy system on chip for medical diagnostic applications.

    PubMed

    Roy Chowdhury, Shubhajit; Roy, Aniruddha; Saha, Hiranmay

    2011-04-01

    The paper presents the ASIC design of a digital fuzzy logic circuit for medical diagnostic applications. The system on chip under consideration uses fuzzifier, memory and defuzzifier for fuzzifying the patient data, storing the membership function values and defuzzifying the membership function values to get the output decision. The proposed circuit uses triangular trapezoidal membership functions for fuzzification patients' data. For minimizing the transistor count, the proposed circuit uses 3T XOR gates and 8T adders for its design. The entire work has been carried out using TSMC 0.35 µm CMOS process. Post layout TSPICE simulation of the whole circuit indicates a delay of 31.27 ns and the average power dissipation of the system on chip is 123.49 mW which indicates a less delay and less power dissipation than the comparable embedded systems reported earlier. PMID:20703567

  10. Iliad and Medical HouseCall: evaluating the impact of common sense knowledge on the diagnostic accuracy of a medical expert system.

    PubMed Central

    Bouhaddou, O.; Lambert, J. G.; Morgan, G. E.

    1995-01-01

    Diagnostic expert systems are gaining acceptance among physicians. Recently, a comparative study of the performance of four major commercial diagnostic programs demonstrated that the information they produce contains a certain amount of irrelevancy that the trained physician ignores. Medical HouseCall is a consumer health information expert system based on a medical expert system for physicians, Iliad. To enhance the usefulness of Medical HouseCall to health care consumers, we are interested in significantly reducing the amount of irrelevancy contained in the diagnostic differential list. Testing with over 470 'textbook' cases revealed that a large part of the irrelevancy can be eliminated by adding universal and medical 'common sense' knowledge. Using four performance measures, we compared, on a subset of cases, the differential lists from two versions of the program: the refined knowledge base (1995) and an older version (1994) 'pre-common sense'. The results suggest that the performance of a diagnostic expert system can be significantly improved with the addition of common sense knowledge. PMID:8563388

  11. Factors associated with patient, and diagnostic delays in Chinese TB patients: a systematic review and meta-analysis

    PubMed Central

    2013-01-01

    Background Delay in seeking care is a major impediment to effective management of tuberculosis (TB) in China. To elucidate factors that underpin patient and diagnostic delays in TB management, we conducted a systematic review and meta-analysis of factors that are associated with delays in TB care-seeking and diagnosis in the country. Methods This review was prepared following standard procedures of the Cochrane Collaboration and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement and checklist. Relevant studies published up to November 2012 were identified from three major international and Chinese literature databases: Medline/PubMed, EMBASE and CNKI (China National Knowledge Infrastructure). Results We included 29 studies involving 38,947 patients from 17 provinces in China. Qualitative analysis showed that key individual level determinants of delays included socio-demographic and economic factors, mostly poverty, rural residence, lack of health insurance, lower educational attainment, stigma and poor knowledge of TB. Health facility determinants included limited availability of resources to perform prompt diagnosis, lack of qualified health workers and geographical barriers. Quantitative meta-analysis indicated that living in rural areas was a risk factor for patient delays (pooled odds ratio (OR) (95% confidence interval (CI)): 1.79 (1.62, 1.98)) and diagnostic delays (pooled OR (95% CI): 1.40 (1.23, 1.59)). Female patients had higher risk of patient delay (pooled OR (95% CI): 1.94 (1.13, 3.33)). Low educational attainment (primary school and below) was also a risk factor for patient delay (pooled OR (95% CI): 2.14 (1.03, 4.47)). The practice of seeking care first from Traditional Chinese Medicine (TMC) providers was also identified as a risk factor for diagnostic delay (pooled OR (95% CI): 5.75 (3.03, 10.94)). Conclusion Patient and diagnostic delays in TB care are mediated by individual and health facility factors. Population

  12. Surface tension in human pathophysiology and its application as a medical diagnostic tool

    PubMed Central

    Fathi-Azarbayjani, Anahita; Jouyban, Abolghasem

    2015-01-01

    Introduction: Pathological features of disease appear to be quite different. Despite this diversity, the common feature of various disorders underlies physicochemical and biochemical factors such as surface tension. Human biological fluids comprise various proteins and phospholipids which are capable of adsorption at fluid interfaces and play a vital role in the physiological function of human organs. Surface tension of body fluids correlates directly to the development of pathological states. Methods: In this review, the variety of human diseases mediated by the surface tension changes of biological phenomena and the failure of biological fluids to remain in their native state are discussed. Results: Dynamic surface tension measurements of human biological fluids depend on various parameters such as sex, age and changes during pregnancy or certain disease. It is expected that studies of surface tension behavior of human biological fluids will provide additional information and might become useful in medical practice. Theoretical background on surface tension measurement and surface tension values of reference fluids obtained from healthy and sick patients are depicted. Conclusion: It is well accepted that no single biomarker will be effective in clinical diagnosis. The surface tension measurement combined with routine lab tests may be a novel non-invasive method which can not only facilitate the discovery of diagnostic models for various diseases and its severity, but also be a useful tool for monitoring treatment efficacy. We therefore expect that studies of surface tension behavior of human biological fluids will provide additional useful information in medical practice. PMID:25901295

  13. Design of an affordable fluorescence confocal laser scanning microscope for medical diagnostics

    NASA Astrophysics Data System (ADS)

    Bechtel, Christin; Knobbe, Jens; Grüger, Heinrich; Lakner, Hubert

    2012-12-01

    Confocal fluorescence microscopes are a promising imaging tool in medical diagnostics due to their capability to selectively survey cross-sections of individual layers from `thick' samples. Non-invasive depth resolved investigation of neoplastic skin disorders is one example among other applications. However these microscopes are at present uncommon in medical practice. This is due to their main application area in research. The instruments dealt with here are generally complex, stationary units and are accordingly cost-intensive. It is for this reason, that we have designed a robust and portable MEMS based confocal fluorescence microscope with a field of view of 0.6mm x 0.6mm. This has been made possible by the integration of a 2D micro scanner mirror developed at Fraunhofer IPMS. A variable acquisition depth of cross-sectional images of the fluorescence specimen is enabled by an integrated z-shifter. With the use of commercially available optics an optical demonstrator set up has been realized. To characterize and to demonstrate the ability of this system test measurements were performed. The resolution of the microscope is better than 228 lp/mm determined by 1951 USAF resolution test target. Images of various biological samples are presented and optical sectioning capabilities are shown. A comparison of the measured with the predicted system performance will be given.

  14. SU-E-P-01: An Informative Review On the Role of Diagnostic Medical Physicist in the Academic and Private Medical Centers

    SciTech Connect

    Weir, V; Zhang, J

    2014-06-01

    Purpose: The role of physicist in the academic and private hospital environment continues to evolve and expand. This becomes more obvious with the newly revised requirements of the Joint Commission (JC) on imaging modalities and the continued updated requirements of ACR accreditation for medical physics (i.e., starting in June 2014, a physicists test will be needed before US accreditation). We provide an informative review on the role of diagnostic medical physicist and hope that our experience will expedite junior physicists in understanding their role in medical centers, and be ready to more opportunities. Methods: Based on our experience, diagnostic medical physicists in both academic and private medical centers perform several clinical functions. These include providing clinical service and physics support, ensuring that all ionizing radiation devices are tested and operated in compliance with the State and Federal laws, regulations and guidelines. We also discuss the training and education required to ensure that the radiation exposure to patients and staff is as low as reasonably achievable. We review the overlapping roles of medical and health physicist in some institutions. Results: A detailed scheme on the new requirements (effective 7/1/2014) of the JC is provided. In 2015, new standards for fluoroscopy, cone beam CT and the qualifications of staff will be phased in. A summary of new ACR requirements for different modalities is presented. Medical physicist have other duties such as sitting on CT and fluoroscopy committees for protocols design, training of non-radiologists to meet the new fluoroscopy rules, as well as helping with special therapies such as Yittrium 90 cases. Conclusion: Medical physicists in both academic and private hospitals are positioned to be more involved and prominent. Diagnostic physicists need to be more proactive to involve themselves in the day to day activities of the radiology department.

  15. Protection of patients in diagnostic and interventional medical imaging: collaboration is the key.

    PubMed

    Applegate, Kimberly E

    2015-02-01

    The radiology community (medical physicists, radiologic technologists, radiologists, and interventional proceduralists) has led the educational and awareness efforts in the medical arena to reduce radiation dose to patients through effective collaborations that bridge traditional medical specialty silos to reach health worker stakeholders. These successful collaborations have also included both vendors and regulators, with the overarching goal of radiation protection of patients (justification, optimization, and use of dose reference levels). This focus on patients often raises overall safety awareness and lowers occupational radiation doses as well. It is critical that the entire radiology community continue to act as leaders in these radiation safety efforts for both employees and patients. In order to be successful, it is important to understand safety culture and the growing, worldwide, multimedia resources that are available. There is little time or budget to recreate or duplicate training materials or risk communication information that may already exist. Together with the increasingly fast-paced and demanding healthcare environment and sharp focus on quality, it has never been more important to understand how to achieve better quality care for radiology departments. It is also important to measure and report quality for many customers, including patients, referring providers, and many other stakeholders. This short report will briefly define safety culture and describe methods for using collective learning tools that document radiation protection of patients in diagnostic and interventional imaging. These tools include the use of imaging modality registries, such as the Computed Tomography Does Index Registry, peer review of imaging reports, the use of clinical decision support, and guidelines. Finally, the Image Gently and Image Wisely campaigns provide examples of cross-disciplinary collaboration to improve radiation protection of patients. PMID:25551505

  16. Task Descriptions in Diagnostic Radiology. Research Report No. 7. Volume 1, Medical Tasks: What the Radiologist Does.

    ERIC Educational Resources Information Center

    Gilpatrick, Eleanor

    The first of four volumes in Research Report No. 7 of the Health Services Mobility Study (HSMS), this book contains 143 task descriptions covering most of the medical activities carried out by diagnostic radiologists. (The work carried out by radiologic technologists, and administrative, machine-related, and nursing-type functions are found in…

  17. Design of a Web-tool for diagnostic clinical trials handling medical imaging research.

    PubMed

    Baltasar Sánchez, Alicia; González-Sistal, Angel

    2011-04-01

    New clinical studies in medicine are based on patients and controls using different imaging diagnostic modalities. Medical information systems are not designed for clinical trials employing clinical imaging. Although commercial software and communication systems focus on storage of image data, they are not suitable for storage and mining of new types of quantitative data. We sought to design a Web-tool to support diagnostic clinical trials involving different experts and hospitals or research centres. The image analysis of this project is based on skeletal X-ray imaging. It involves a computerised image method using quantitative analysis of regions of interest in healthy bone and skeletal metastases. The database is implemented with ASP.NET 3.5 and C# technologies for our Web-based application. For data storage, we chose MySQL v.5.0, one of the most popular open source databases. User logins were necessary, and access to patient data was logged for auditing. For security, all data transmissions were carried over encrypted connections. This Web-tool is available to users scattered at different locations; it allows an efficient organisation and storage of data (case report form) and images and allows each user to know precisely what his task is. The advantages of our Web-tool are as follows: (1) sustainability is guaranteed; (2) network locations for collection of data are secured; (3) all clinical information is stored together with the original images and the results derived from processed images and statistical analysis that enable us to perform retrospective studies; (4) changes are easily incorporated because of the modular architecture; and (5) assessment of trial data collected at different sites is centralised to reduce statistical variance. PMID:20517632

  18. Traditional Chinese patent medicines for cancer treatment in China: a nationwide medical insurance data analysis

    PubMed Central

    Wu, Min; Lu, Peng; Shi, Luwen; Li, Shao

    2015-01-01

    Based on the nationwide survey into inpatients' utilization of the health service covered by China's urban basic medical insurance from 2008 to 2010, we analyzed the use rate, cancer profile and combined use of anticancer Chinese patent medicines (CPMs) on 51,382 insured cancer patients by using statistical, bi-clustering and network methods. We found that 42.4% of 51,382 cancer patients used 33 anticancer CPMs, and 51.7% used 71 anticancer Western medicines (WMs). The CPMs were most often used in lung (52%) and nasopharynx (52%) cancer patients, and least in bladder cancer (21%) and leukemia of unspecified cell type (21%) patients. The cost per patient for all 33 anticancer CPMs was 2069RMB, lower than that of the WMs (3458RMB). The cancer profile of commonly used CPMs and WMs for the top 17 cancers (>500 sampled patients) were provided, indicating anticancer CPMs had a broad spectrum of cancers and lacked selectivity in cancer treatment (CPM mean CV = 49%; WM mean CV = 152%). Moreover, 24.8% of the cancer patients used both CPMs and WMs, and CPM-WM combined use networks were constructed for four major cancers. This first nationwide analysis revealed the use characteristics and herb-drug combined use patterns of insurance covered anticancer CPMs in China. The study offers valuable information to guide future studies of the precision, safety and standard use of CPMs. PMID:26513017

  19. The Value of In Vitro Diagnostic Testing in Medical Practice: A Status Report

    PubMed Central

    Dieterle, Thomas; Giusti, Francesco; Messina, Carlo Guiseppe Mario; Toerien, Eduard; Moch, Holger; Schäfer, Hans Hendrik

    2016-01-01

    Background In vitro diagnostic (IVD) investigations are indispensable for routine patient management. Appropriate testing allows early-stage interventions, reducing late-stage healthcare expenditure (HCE). Aim To investigate HCE on IVDs in two developed markets and to assess the perceived value of IVDs on clinical decision-making. Physician-perceived HCE on IVD was evaluated, as well as desired features of new diagnostic markers. Methods Past and current HCE on IVD was calculated for the US and Germany. A total of 79 US/German oncologists and cardiologists were interviewed to assess the number of cases where: physicians ask for IVDs; IVDs are used for initial diagnosis, treatment monitoring, or post-treatment; and decision-making is based on an IVD test result. A sample of 201 US and German oncologists and cardiologists was questioned regarding the proportion of HCE they believed to be attributable to IVD testing. After disclosing the actual IVD HCE, the physician’s perception of the appropriateness of the amount was captured. Finally, the association between physician-rated impact of IVD on decision-making and perceived contribution of IVD expenditure on overall HCE was assessed. Results IVD costs account for 2.3% and 1.4% of total HCE in the US and Germany. Most physicians (81%) believed that the actual HCE on IVDs was >5%; 19% rated the spending correctly (0–4%, p<0.001). When informed of the actual amount, 64% of physicians rated this as appropriate (p<0.0001); 66% of decision-making was based on IVD. Significantly, more physicians asked for either additional clinical or combined clinical/health economic data than for the product (test/platform) alone (p<0.0001). Conclusions Our results indicate a poor awareness of actual HCE on IVD, but a high attributable value of diagnostic procedures for patient management. New markers should deliver actionable and medically relevant information, to guide decision-making and foster improved patient outcomes. PMID

  20. Using diffuse near-infrared light to characterize tissue optical and physiologic properties for medical diagnostics

    NASA Astrophysics Data System (ADS)

    Pham, Tuan Hoai

    2001-05-01

    Methods based on near-infrared (NIR) diffuse reflectance offer novel and functional approaches to medical diagnostics. NIR diffuse reflectance techniques are well suited for non-invasive, quantitative characterization of tissue optical properties, namely macroscopic absorption (μa) and reduced scattering (μs') coefficient. Tissue optical properties, in turn, provide unique and clinically relevant functional and structural information about tissues. Needless to say, understanding light- tissue interactions and light transport in multiply scattering (turbid) media is essential in order to fully capitalize on the useful features of NIR diffuse reflectance spectroscopy. This thesis addresses the practical and, to a limited extent, the theoretical issues of NIR diffuse light spectroscopy. The goals of the thesis are two folds: (1)to investigate, from an instrumental and analytical perspectives, the accuracy and limitation of the various diffuse reflectance techniques in quantifying the optical properties of homogenous and layered turbid media, and (2)to evaluate the feasibility and applicability of using NIR diffuse reflectance spectroscopy to quantify in vivo tissue optical and physiologic properties during pathophysiologic processes. With respect to the first objective, we conducted validation studies to assess the accuracy of the frequency-domain and spatially-resolved techniques in quantifying μa and μs' of homogenous turbid media. Similarly, frequency-domain and time-domain approaches were used to characterize the optical properties and thickness of two-layered turbid media. For the second objective, frequency-domain system was used to quantify the changes in the in vivo optical and physiologic properties secondary to cancerous transformation, cardiovascular dysfunction, and photodynamic therapy of tumors. In summary, studies results clearly indicate that NIR diffuse reflectance techniques accurately quantify the in vivo tissue optical and physiologic

  1. Evaluation of the medical diagnostic imaging support system based on 2 years of clinical experience.

    PubMed

    Smith, D V; Smith, S; Bender, G N; Carter, J R; Kim, Y; Cawthon, M A; Leckie, R G; Weiser, J C; Romlein, J; Goeringer, F

    1995-05-01

    The Medical Diagnostic Imaging Support (MDIS) system at Madigan Army Medical Center (MAMC) has been operational in a phased approach since March 1992. Since then, nearly all image acquisition has been digital with progressively increasing primary softcopy diagnosis used. More than 375,000 computed radiography (CR) images as well as other modality images have been archived. Considerable experience in installation and implementation phasing has been gained. The location and ergonomic aspects of equipment placement were refined with time. The original clinical scenario was insufficiently detailed and additions were made to facilitate smoother and more complete transition toward a filmless environment. The MDIS system effectiveness and performance have been good in terms of operational workload throughout, background operations, and reliability. The important areas regarding reliability are image acquisition, output, display, database operations, storage, and the local area network. Fail-safe strategies have been continually improved to maintain continuous clinical image availability during the times when the MDIS system or components malfunction. Many invaluable lessons have been learned for effective quality assurance in a hospital-wide picture archiving and communication system. These issues include training, operational quality control, practical aspects of CR image quality, and increased timeliness in the generation and distribution of radiographic reports. Clinical acceptability has been a continuous process as each phase has been implemented. Clinical physicians quickly used the workstations soon after the start of MDIS at MAMC. The major advantage for clinicians has been the amount of time saved when retrieving multimodality images for review. On the other hand, the radiologists have been slower in their acceptance of the workstation for routine use.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:7612705

  2. Seroprevalence of Antibodies against Noroviruses among Students in a Chinese Military Medical University

    PubMed Central

    Dai, Ying-chun; Nie, Jun; Zhang, Xu-fu; Li, Zhi-feng; Bai, Yang; Zeng, Zhi-rong; Yu, Shou-yi; Farkas, Tibor; Jiang, Xi

    2004-01-01

    Noroviruses (NVs) are important causes of nonbacterial gastroenteritis in humans, but the role of NVs as a cause of diseases in the Chinese people, particularly in Chinese military personnel, remains unclear. This study investigated antibody prevalence and factors that associate with the prevalence of antibody to NVs among students attending a military medical university. Serum specimens were tested by an enzyme-linked immunosorbent assay for immunoglobulin G antibody to recombinant capsid antigens of three NVs (rNorwalk, rMxV, and rVA387). Of 588 serum samples tested, the antibody prevalence was 88.9, 54.1, or 90.0% for the three antigens, respectively. There were significant differences in the prevalence of antibody to rMxV between blood types (P < 0.05); the prevalence for type O was the highest (62.5%), and the prevalence for type B was the lowest (49.1%). The average optical density values for antibody to rNorwalk and rMxV were lowest among students with type B. The number of students who did not have antibody to any of the three antigens was the highest for blood type B (6.9%) compared to other blood types (0.8 to 3.4% [P < 0.006]). The antibody prevalence also varied with the hometown residencies of the students before joining the military, with the highest rates for students from rural areas, lower rates for students from small towns or villages, and the lowest rates for students from large cities. The numbers of students who did not have antibody to any of the three antigens were highest for students from the large cities, lower for students from small towns or villages, and lowest for students from rural areas. The distribution of ABO blood types did not differ among the three groups. These data suggest that NVs are prevalent in China and that both genetic and environmental factors play a role in NV infection. PMID:15472318

  3. Justification of diagnostic medical exposures: some practical issues. Report of an International Atomic Energy Agency Consultation

    PubMed Central

    Malone, J; Guleria, R; Craven, C; Horton, P; Järvinen, H; Mayo, J; O’reilly, G; Picano, E; Remedios, D; Le Heron, J; Rehani, M; Holmberg, O; Czarwinski, R

    2012-01-01

    Objectives The Radiation Protection of Patients Unit of the International Atomic Energy Agency (IAEA) is concerned about the effectiveness of justification of diagnostic medical exposures. Recent published work and the report of an initial IAEA consultation in the area gave grounds for such concerns. There is a significant level of inappropriate usage, and, in some cases, a poor level of awareness of dose and risk among some key groups involved. This article aims to address this. Methods The IAEA convened a second group of experts in November 2008 to review practical and achievable actions that might lead to more effective justification. Results This report summarises the matters that this group considered and the outcome of their deliberations. There is a need for improved communication, both within professions and between professionals on one hand, and between professionals and the patients/public on the other. Coupled with this, the issue of consent to imaging procedures was revisited. The need for good evidence-based referral guidelines or criteria of acceptability was emphasised, as was the need for their global adaptation and dissemination. Conclusion Clinical audit was regarded as a key tool in ensuring that justification becomes an effective, transparent and accountable part of normal radiological practice. In summary, justification would be facilitated by the “3 As”: awareness, appropriateness and audit. PMID:21343316

  4. Development and use of analytical quality specifications in the in vitro diagnostics medical device industry.

    PubMed

    Powers, D M; Greenberg, N

    1999-11-01

    Manufacturers of in vitro diagnostic (IVD) medical devices have become integral partners with their customers in determining the quality of laboratory results. Design controls imposed by ISO 9001 quality system standards and various regulations require manufacturers to implement a formal design process, which begins and ends with customer requirements. For IVD systems, this means that manufacturers must establish analytical quality specifications as part of their design input. This provides greater assurance that commercial products will satisfy customer requirements. In the case of quantitative IVD measurement systems, analytical quality specifications include total allowable uncertainty (bias, imprecision, non-specificity). The primary source of customer requirements is the laboratory-customer, who should have established analytical quality specifications based on the needs of its physician-clients. The total allowable uncertainty budget is allocated in the design process to the individual components of the system, such as reagents, instrumentation, calibrators and accessories, and to other factors such as operator, specimen and environmental interactions. Their performance must collectively meet the total allowable uncertainty specification when they are finally integrated into a measurement system. The design control model requires objective evidence that design specifications have been met (verification) and, finally, that the system will satisfy the needs of its intended users (validation). Compliance with the quality system standards is monitored through independent audits, government inspections and post-market surveillance. PMID:10667695

  5. Authentication and recovery of medical diagnostic image using dual reversible digital watermarking.

    PubMed

    Deng, Xiaohong; Chen, Zhigang; Zeng, Feng; Zhang, Yaoping; Mao, Yimin

    2013-03-01

    This paper proposes a new region-based tampering detection and recovering method that utilizes both reversible digital watermarking and quad-tree decomposition for medical diagnostic image's authentication. Firstly, the quad-tree decomposition is used to divide the original image into blocks with high homogeneity, and then we computer pixels' linear interpolation as each block's recovery feature. Secondly, these recovery features as the first layer watermarking information is embedded by using simple invertible integer transformation. In order to enhance the proposed method's security, the logistic chaotic map is exploited to choose each block's reference pixel. The second layer watermark comprises by the quad-tree information and essential parameters for extraction are embedded by LSB replacement. In the authentication phase, the embedded watermark is extracted and the source image is recovered, and the similar linear interpolation technique is utilized to get each block's feature. Therefore, the tampering detection and localization can be achieved through comparing the extracted feature with the recomputed one, and the extracted feature can be used to recover those tampered regions with high similarity to their original state. Experimental results show that, compared with previous similar existing scheme, the proposed method not only achieves high embedding capacity and good visual quality of marked and restored image, but also has more accuracy for tampering detection. PMID:23755652

  6. Evaluation of Diagnostic Efficiency of Ultrasound Features on Malignant Thyroid Nodules in Chinese Patients

    PubMed Central

    Li, Ru-Qiang; Yuan, Ge-Heng; Chen, Ming; Shao, Yi-Min; Zhu, Sai-Nan; Zhang, Jun-Qing; Guo, Xiao-Hui

    2016-01-01

    Background: The aim of this study was to evaluate the efficacy of ultrasonic features in predicting the malignancy of thyroid nodules in a group of Chinese patients. Methods: In all, 762 patients with thyroid nodules (424 malignant and 338 benign) underwent ultrasound (US) check and surgery between March 2011 and July 2014 at Peking University First Hospital were identified. Univariate and receiver operating characteristic (ROC) analyses were performed to calculate the sensitivity, specificity, negative and positive predictive values of each US feature, and the accuracy of their combinations for prediction of malignancy. Results: Patients with malignant nodules were younger and without obvious risk history than those in the benign group (P < 0.001, P = 0.93). No individual US sign was fully predictive of a malignant lesion. The Youden indexes of irregular margins and hypoechogenicity were the first and second highest in all US features, which were 51.9% and 45.2%, respectively. The sensitivity of solid components (89.7%) and hypoechogenicity (89.2%) and the specificity of taller-than-wide shape (98.5%) and microcalcifications (90.6%) were the first and second highest in all US features. Intranodular flow on a color Doppler examination was a weak predictor of malignancy. Under ROC analysis excepting intranodular flow, the 95% confidence interval (CI) of areas under the curves of hypoechogenicity and irregular margins with any one of the US features were overlapped that of five-feature combinations (95% CI: 0.850–0.901). Conclusions: We should be alert with taller-than-wide shape and microcalcifications. Intranodular flow was a weak predictor of malignancy. According to Youden indexes and ROC analysis, irregular margins and hypoechogenicity combined with solid component or taller-than-wide shapes or microcalcifications have a high predicative value for malignant thyroid nodules in Chinese patients. PMID:27453225

  7. Beliefs about antidepressant medication and associated adherence among older Chinese patients with major depression: A cross-sectional survey.

    PubMed

    Lu, Yang; Arthur, David; Hu, Lili; Cheng, Gen; An, Fengrong; Li, Zheng

    2016-02-01

    Antidepressant non-adherence among people with depressive disorder is a major, ongoing public health issue, yet few studies have focused on older adults and their medication adherence. Although treatment adherence is determined by multiple factors, one of the important and modifiable predictors are patients' attitudes and beliefs about medication. We explored a sample of 135 older Chinese people with major depression, and the relationship between beliefs about antidepressants and medication adherence. Sociodemographic and illness variables were also examined. In all, high antidepressant adherence was reported in 37.8%, moderate adherence in 39.2%, and low adherence in 23%. Ordinal regression analysis showed perceived necessity (P < 0.01) and concern (P < 0.01) about antidepressants were significant influencing factors. Other variables with a positive association with higher adherence were lower average income (P < 0.05), fewer number of prior episodes of depression (P < 0.01), and comorbid anxiety (P < 0.05). The present study highlights low adherence in a sample of older depressed Chinese people, and highlights how beliefs about medication affect adherence. Therefore, more attention should be focused on non-adherence in older patients, and there is a need to establish accessible and systematic education programmes to correct misconceptions to improve their adherence. PMID:26692425

  8. TOPICAL REVIEW: Synthesis and applications of magnetic nanoparticles for biorecognition and point of care medical diagnostics

    NASA Astrophysics Data System (ADS)

    Sandhu, Adarsh; Handa, Hiroshi; Abe, Masanori

    2010-11-01

    Functionalized magnetic nanoparticles are important components in biorecognition and medical diagnostics. Here, we present a review of our contribution to this interdisciplinary research field. We start by describing a simple one-step process for the synthesis of highly uniform ferrite nanoparticles (d = 20-200 nm) and their functionalization with amino acids via carboxyl groups. For real-world applications, we used admicellar polymerization to produce 200 nm diameter 'FG beads', consisting of several 40 nm diameter ferrite nanoparticles encapsulated in a co-polymer of styrene and glycidyl methacrylate for high throughput molecular screening. The highly dispersive FG beads were functionalized with an ethylene glycol diglycidyl ether spacer and used for affinity purification of methotrexate—an anti-cancer agent. We synthesized sub-100 nm diameter magnetic nanocapsules by exploiting the self-assembly of viral capsid protein pentamers, where single 8, 20, and 27 nm nanoparticles were encapsulated with VP1 pentamers for applications including MRI contrast agents. The FG beads are now commercially available for use in fully automated bio-screening systems. We also incorporated europium complexes inside a polymer matrix to produce 140 nm diameter fluorescent-ferrite beads (FF beads), which emit at 618 nm. These FF beads were used for immunofluorescent staining for diagnosis of cancer metastases to lymph nodes during cancer resection surgery by labeling tumor cell epidermal growth factor receptor (EGFRs), and for the detection of brain natriuretic peptide (BNP)—a hormone secreted in excess amounts by the heart when stressed—to a level of 2.0 pg ml - 1. We also describe our work on Hall biosensors made using InSb and GaAs/InGaAs/AlGaAs 2DEG heterostructures integrated with gold current strips to reduce measurement times. Our approach for the detection of sub-200 nm magnetic bead is also described: we exploit the magnetically induced capture of micrometer sized 'probe

  9. Reductions in Pain Medication Use Associated with Traditional Chinese Medicine for Chronic Pain

    PubMed Central

    Elder, Charles; Ritenbaugh, Cheryl; Aickin, Mikel; Hammerschlag, Richard; Dworkin, Samuel; Mist, Scott; Harris, Richard E

    2012-01-01

    Context: Participants in a randomized trial of traditional Chinese medicine (TCM) for temporomandibular joint dysfunction (TMD) had a linear decline in pain over 16 TCM visits. Objective: To investigate whether reductions in pain among participants receiving TCM can be explained by increased use of pain medications, or whether use of pain medications also declined in this group. Design: One hundred sixty-eight participants with TMD were treated with TCM or enhanced self-care according to a stepped-care design. Those for whom self-care failed were sequentially randomized to further self-care or TCM. This report includes 111 participants during their first 16 TCM visits. The initial 8 visits occurred more than once a week; participants and practitioners determined the frequency of subsequent visits. Outcome measures: Average pain (visual analog scale, range 0–10) and morphine and aspirin dose equivalents. Results: The sample was 87% women and the average age was 44 ± 13 years. Average pain of narcotics users (n = 21) improved by 2.73 units over 16 visits (p < 0.001). Overall narcotics use trended downward until visit 11 (−3.27 doses/week, p = 0.156), and then trended upward until week 16 (+4.29 doses/week, p = 0.264). Among those using narcotics, use of nonsteroidal anti-inflammatory drugs (NSAIDs) declined linearly over visits 1–16 (−1.94 doses/week, p = 0.002). Among the top quartile of NSAID-only users (n = 22), average pain decreased linearly over 16 visits (−1.52 units, p = 0.036). Overall NSAID doses/week declined between visits 1 and 7 (−9.95 doses/week, p < 0.001) and then remained stable through 16 visits. NSAID use also declined among the third quartile (n = 23) and remained low and stable among the lower half (sorted by total intake) of NSAID users. Conclusions: Among the heaviest NSAID users, we observed a short-term reduction in NSAID use that was sustained as TCM visits became less frequent. There was no indication that pain reduction

  10. Parental refusal of life-saving treatments for adolescents: Chinese familism in medical decision-making re-visited.

    PubMed

    Hui, Edwin

    2008-06-01

    This paper reports two cases in Hong Kong involving two native Chinese adolescent cancer patients (APs) who were denied their rights to consent to necessary treatments refused by their parents, resulting in serious harm. We argue that the dynamics of the 'AP-physician-family-relationship' and the dominant role Chinese families play in medical decision-making (MDM) are best understood in terms of the tendency to hierarchy and parental authoritarianism in traditional Confucianism. This ethic has been confirmed and endorsed by various Chinese writers from Mainland China and Hong Kong. Rather than giving an unqualified endorsement to this ethic, based more on cultural sentimentalism than rational moral reasoning, we warn that a strong familism in MDM, which deprives 'weak' family members of rights, represents the less desirable elements of this tradition, against which healthcare professionals working in this cultural milieu need to safeguard. Specifically for APs, we suggest that parental authority and family integrity should be re-interpreted in terms of parental responsibility and the enhancement of children's interests respectively, as done in the West. This implies that when parents refuse to consent to necessary treatment and deny their adolescent children's right to consent, doctors, as the only remaining advocates of the APs' interest, have the duty to inform the state, which can override parental refusal to enable the doctors to fulfill their professional and moral obligations. In so doing the state exercises its 'parens patriae' power to defend the defenseless in society and the integrity of the medical profession. PMID:18447864

  11. Validation of the Compassion Fatigue Short Scale among Chinese medical workers and firefighters: a cross-sectional study

    PubMed Central

    Sun, Binghai; Hu, Mengna; Yu, Shitian; Jiang, Yiru; Lou, Baona

    2016-01-01

    Objectives To examine the psychometric properties of the Chinese version of the C-Compassion Fatigue (CF)-Short Scale among 4 independent samples of Chinese emergency workers (medical workers and firefighters). Design Cross-sectional. Setting 6 hospitals in Zhejiang Province and 12 fire stations in Shanghai. Participants Emergency workers (medical and firefighters) were consecutively recruited and divided into 4 groups: the MW1 group (medical workers, n=167), the FF1 group (firefighters, n=157), the MW2 group (medical workers, n=265) and the FF2 group (firefighters, n=231). Interventions All patients completed the C-CF-Short Scale to identify factors associated with compassion fatigue. The MW1 and FF1 groups were used for the exploratory analyses. The MW2 and FF2 groups were used for the confirmatory factor analyses. Primary and secondary outcome measures Factor loading, correlations with previously validated questionnaires (the Ego-Resiliency Scale, the Social Support Questionnaire and the Job Pressure Scale) and Cronbach's α coefficient were tested for each factor. Results The C-CF-Short Scale demonstrated excellent construct validity and good internal consistency. Specifically, the results of exploratory factor analyses in the MW1 and FF1 groups showed that secondary trauma and job burnout were associated with compassion fatigue in these emergency workers. The confirmatory factor analyses in the MW2 and FF2 groups indicated that all the fit indices of the 2-factor model were satisfactory. Finally, the Cronbach's α coefficient of each factor was excellent. Conclusions The findings suggest that the C-CF-Short Scale has good psychometric properties and can be applied to study Chinese emergency workers. PMID:27363817

  12. Parameterized algorithms for quantitative differentials in spectrally equivalent medical diagnostic x-ray beams.

    PubMed

    Okunade, Akintunde Akangbe

    2005-06-01

    Qualitative and quantitative equivalence of spectra transmitted by two different elemental filters require a good match in terms of shape and size over the entire energy range of 0-150 keV used in medical diagnostic radiology. However, the photoelectric absorptions and Compton scattering involved in the interaction of x rays with matter at these relatively low photon energies differ in a nonuniform manner with energy and atomic number. By careful choice of thicknesses for filter materials with an atomic number between 12 and 39, when compared with aluminum, it is possible to obtain transmitted beams of the same shape (quality) but not of the same size (quantity). In this paper, calculations have been carried out for the matching of the shapes and sizes of beams transmitted through specified thicknesses of aluminium filter and spectrally equivalent thicknesses of other filter materials (different from aluminium) using FORTRAN source codes traceable to the American Association of Physics in Medicine (AAPM), College Park, MD, USA. Parametrized algorithms for the evaluation of quantitative differentials (deficit or surplus) in radiation output (namely, photon fluence, exposure, kerma, energy imparted, absorbed dose, and effective dose) from these transmitted spectrally equivalent beams were developed. These differentials range between 1%, and 4% at 1 mm Al filtration and between 8%, and 25% for filtration of 6 mm Al for different filter materials in comparison with aluminum. Also developed were models for factors for converting measures of photon fluence, exposure-area product, (EAP), and kerma-area product (KAP) to risk related quantities such as energy imparted, absorbed dose, and effective dose from the spectrally equivalent beams. The thicknesses of other filter materials that are spectrally equivalent to given thicknesses of aluminum filter were characterized using polynomial functions. The fact that the use of equivalent spectra in radiological practice can

  13. Organ Doses From Diagnostic Medical Radiography-Trends Over Eight Decades (1930 to 2010).

    PubMed

    Melo, Dunstana R; Miller, Donald L; Chang, Lienard; Moroz, Brian; Linet, Martha S; Simon, Steven L

    2016-09-01

    This study provides a retrospective assessment of doses to 13 organs for the most common radiographic examinations conducted between the 1930s and 2010, taking into account typical technical parameters used for radiography during those years. This study is intended to be a resource on changes in medical diagnostic radiation exposure over time with a specific purpose of supporting retrospective epidemiological studies of radiation health risks. The authors derived organ doses to the brain, esophagus, thyroid, red bone marrow, lungs, breast, heart, stomach, liver, colon, urinary bladder, ovaries, and testes based on 14 common radiographic procedures and compared, when possible, with doses reported in the literature. These dose estimates were based on radiographic exposure parameters described in textbooks widely used by radiologic technologists in training from 1939 to 2010. The derived estimated doses presented here are believed to be representative of typical organs for an average-size adult who might be considered to be similar to the reference person. There were large variations in organ doses noted among the different types of radiographic examinations. Doses were highest in organs within the area imaged and next highest in organs in close proximity to the area imaged. Estimated organ doses have declined substantially [overall 22-fold (±38)] over time as a consequence of changes in technology, imaging protocols and protective measures. For some examinations, only slight differences were observed in doses for the decades of the 1960s, 1970s, and 1980s due to minor changes in technical parameters. Substantial dose reductions were observed in the 1990s and 2000s. PMID:27472750

  14. Parameterized algorithms for quantitative differentials in spectrally equivalent medical diagnostic x-ray beams

    SciTech Connect

    Okunade, Akintunde Akangbe

    2005-06-15

    Qualitative and quantitative equivalence of spectra transmitted by two different elemental filters require a good match in terms of shape and size over the entire energy range of 0-150 keV used in medical diagnostic radiology. However, the photoelectric absorptions and Compton scattering involved in the interaction of x rays with matter at these relatively low photon energies differ in a nonuniform manner with energy and atomic number. By careful choice of thicknesses for filter materials with an atomic number between 12 and 39, when compared with aluminum, it is possible to obtain transmitted beams of the same shape (quality) but not of the same size (quantity). In this paper, calculations have been carried out for the matching of the shapes and sizes of beams transmitted through specified thicknesses of aluminium filter and spectrally equivalent thicknesses of other filter materials (different from aluminium) using FORTRAN source codes traceable to the American Association of Physics in Medicine (AAPM), College Park, MD, USA. Parametrized algorithms for the evaluation of quantitative differentials (deficit or surplus) in radiation output (namely, photon fluence, exposure, kerma, energy imparted, absorbed dose, and effective dose) from these transmitted spectrally equivalent beams were developed. These differentials range between 1%, and 4% at 1 mm Al filtration and between 8%, and 25% for filtration of 6 mm Al for different filter materials in comparison with aluminum. Also developed were models for factors for converting measures of photon fluence, exposure-area product, (EAP), and kerma-area product (KAP) to risk related quantities such as energy imparted, absorbed dose, and effective dose from the spectrally equivalent beams. The thicknesses of other filter materials that are spectrally equivalent to given thicknesses of aluminum filter were characterized using polynomial functions. The fact that the use of equivalent spectra in radiological practice can

  15. Radiative-SPR platform for the detection of apolipoprotein E for use in medical diagnostics

    NASA Astrophysics Data System (ADS)

    Sciacca, Beniamino; Francois, Alexandre; Penno, Megan A. S.; Brazzatti, Julie A.; Klingler-Hoffmann, Manuela; Hoffmann, Peter; Monro, Tanya M.

    2012-03-01

    Surface Plasmon Resonance (SPR) based sensors enable the rapid, label-free and highly sensitive detection of a large range of biomolecules. We have previously shown that, using silver coated optical fibres with an high surface roughness, a re-scattering of the surface plasmons is possible, turning SPR into a radiative process. This approach overcomes limitations associated with current SPR technologies such as the tight tolerance on the metallic coating thickness, and results in a more compact, versatile, robust and cost-effective approach. However, the specific detection of small molecules is a challenge in SPR systems, regardless of the SPR architecture that is used. This new sensing platform, which has proved effective for the detection of large molecules such as viruses, is now demonstrated to be able to detect small proteins thanks to an improved surface functionalization procedure, a key point for reliable and robust immunosensors. Avidin, a tetrameric biotin-binding protein, was used to link biotinylated antibodies to the biotinylated surface, with a given orientation, to enable efficient sensing of the analyte. This approach may offer significant advantages compared to protein A surface functionalization strategies such as a limited cross reactivity with free IgG antibodies in clinical samples. We demonstrate that by bringing together this novel emission-based fibre SPR platform, with an improved surface functionalization process, is possible to rapidly and specifically detect human apolipoprotein E, a low molecular weight protein (~39kDa) known to be involved in cardiovascular diseases, in Alzheimer's disease and in gastric cancer. The results obtained clearly show that this new sensing platform has the potential to serve as a tool for point-of-decision medical diagnostics.

  16. In vitro diagnostic company recalls and medical laboratory practices: an Italian case

    PubMed Central

    Lippi, Giuseppe; Salvagno, Gian Luca; Brocco, Giorgio; Guidi, Gian Cesare

    2015-01-01

    Introduction In vitro human diagnostic (IVD) company recalls are a common practice aimed to either minimize a potential error or eliminate an existing failure. In this case report, we aim to provide a critical analysis of a recent IVD recall and to provide a practical framework about what to do when an IVD company recalls product(s) based on the International Organization for Standardization - ISO 15189:2012 standard. Case report In 2014, Abbott Laboratories® (Green Oaks, IL) published an urgent field safety notice regarding a product recall (Architect Intact parathyroid hormone (PTH) Assay List Number 8K25) with immediate action required. The IVD company explained the reasons for the recall as follows: i) Abbott has confirmed that a performance shift in the Architect Intact PTH assay has the potential to generate falsely elevated results on patient samples; ii) results generated with impacted lots may demonstrate a positive shift relative to those generated with previous reagent and/or calibrator lots. This issue may also impact established Architect Intact PTH reference ranges; iii) the magnitude of shift averages approximately 13% to 45%; iv) Abbott Architect Intact PTH controls do not detect the shift; and v) all current reagent, calibrator, and control inventory are impacted. The recall could have resulted in ~40,000 inaccurate laboratory tests reported by 18 laboratories from Italy (Lombardy region). Conclusion IVD company recalls have a serious impact on the patient safety and require a thorough investigation and responsible approach to minimize the possible damage. Medical laboratories accredited according to the ISO 15189 standard have procedures in place to manage such situations and ensure that patient safety is maintained when such recalls are issued. PMID:26110040

  17. Clinically Unjustified Diagnostic Imaging – a Worrisome Tendency in Today’s Medical Practice

    PubMed Central

    Sobiecka, Aleksandra; Bekiesińska-Figatowska, Monika; Rutkowska, Milena; Latos, Tomasz; Walecki, Jerzy

    2016-01-01

    Summary Background The purpose of the study was to evaluate the percentage of unjustified examinations among all the CT and MRI studies performed by two radiology departments and to determine the types of examinations which are most commonly carried out unnecessarily. Material/Methods Three radiologists assessed the justification of CT and MRI examinations performed during a period of 14 days based on the referrals. The radiologists assessed 799 referrals for CT scans (847 examinations of a particular part of the body) and 269 MRI referrals (269 examinations). The criteria for justification were: medical expertise and the guidelines. During the first stage radiologists divided the examinations into 3 groups: justified, unjustified and the examinations of questionable justification. The second step was to determine the reasons why the studies were considered as unjustified or of questionable justification. Results 73 of 1116 examinations (6.54%) were considered to be unjustified or of a questionable justification. There were 59 CT scans (59/847=6.97%) and 14 MRI studies (14/269=5.20%). The most common reasons to consider them as unjustified or of questionable justification were: inadequate method of diagnostic imaging chosen as a first-line tool and lacking or insufficient clinical details. Conclusions In our investigation 6.54% of both CT and MRI examinations were considered as unjustified or of questionable justification, which is lower than described in other studies (from 7% to 26%). The assessment was based only on referrals, therefore a total share of these examinations is likely to be higher. PMID:27471577

  18. Retrospective Evaluation of New Chinese Diagnostic Scoring System for Disseminated Intravascular Coagulation

    PubMed Central

    Deng, Jun; Wang, Huafang; Guo, Tao; Mei, Heng; Hu, Yu

    2015-01-01

    Objectives To retrospectively validate the new Chinese DIC scoring system (CDSS). Methods This study retrospectively collected the information of 619 patients (371 cases with non-hematologic malignancies, 248 cases with hematologic malignancies) who suspected of DIC in Wuhan Union Hospital during 2013-4 to 2014-6. We validated CDSS by comparing it with three leading scoring systems, from International Society on Thrombosis and Haemostasis (ISTH), Japanese Association for Acute Medicine (JAAM) and Japanese Ministry of Health and Welfare (JMHW), and evaluated its prognostic value by 28 days mortality, APACHE II and SOFA score. Results In non-hematologic malignancies, CDSS was more specific than JAAM (72.55% vs. 50.49%, p<0.05) and more sensitive than ISTH (77.07% vs. 62.03%, p<0.05). In hematologic malignancies, the area under the ROC curve of CDSS was larger than ISTH and JMHW (0.933 vs. 0.889, p<0.01 with ISTH, 0.944 vs. 0.845, p<0.01 with JMHW). In addition, the 28-day mortality rate, SOFA scores, APACHE II scores of DIC patients diagnosed by CDSS were significantly greater than non-DIC (P <0.05). Conclusions We are the first group to propose CDSS. It emphasized the values of the clinical manifestations, the rapidly declining platelet count, APTT in the diagnosis of DIC and used D-dimer as the fibrin-related maker. DIC with hematological malignancies was treated as a special part. In this study we can see that CDSS displayed an acceptable property for the diagnosis of DIC with appropriate sensitivity and specificity, and also had a good prognostic value for DIC patients. PMID:26076032

  19. [One third of Danish doctors specializing in diagnostic radiology do not feel sufficiently equipped in terms of medical expertise].

    PubMed

    Lange, Benedicte; Carlsen, Charlotte Green; Jurik, Anne Grethe

    2014-02-01

    An internet-based survey among Danish doctors specializing in diagnostic radiology revealed differences with respect to the length of internships at regional and university hospitals as well as the educational environment. The university hospitals were generally evaluated to have the best educational facilities except within practical skills. Therefore, it seems necessary to optimize the educational environment at regional hospitals, especially within medical expertise and scientific skills which are key elements regarding continuous development and quality assurance within radiology. PMID:25347440

  20. Two-layer Lab-on-a-chip (LOC) with passive capillary valves for mHealth medical diagnostics.

    PubMed

    Balsam, Joshua; Bruck, Hugh Alan; Rasooly, Avraham

    2015-01-01

    There is a new potential to address needs for medical diagnostics in Point-of-Care (PoC) applications using mHealth (Mobile computing, medical sensors, and communications technologies for health care), a mHealth based lab test will require a LOC to perform clinical analysis. In this work, we describe the design of a simple Lab-on-a-chip (LOC) platform for mHealth medical diagnostics. The LOC utilizes a passive capillary valve with no moving parts for fluid control using channels with very low aspect ratios cross sections (i.e., channel width ≫ height) achieved through transitions in the channel geometry via that arrest capillary flow. Using a CO2 laser in raster engraving mode, we have designed and fabricated an eight-channel LOC for fluorescence signal detection fabricated by engraving and combining just two polymer layers. Each of the LOC channels is capable of mixing two reagents (e.g., enzyme and substrate) for various assays. For mHealth detection, we used a mobile CCD detector equipped with LED multispectral illumination in the red, green, blue, and white range. This technology enables the development of low-cost LOC platforms for mHealth whose fabrication is compatible with standard industrial plastic fabrication processes to enable mass production of mHealth diagnostic devices, which may broaden the use of LOCs in PoC applications, especially in global health settings. PMID:25626544

  1. Research on the Present Status of the Five-Year Medical Training Program in Chinese Medical Colleges

    ERIC Educational Resources Information Center

    Xu, Yan; Dong, Zhe; Miao, Le; Ke, Yang

    2014-01-01

    The five-year program is the main path for undergraduate medical training in China. Studies have shown that during the past eleven years, the scale of medical student enrollment increased annually with a relatively simple entrance exam. The ideas, teaching contents and methods, assessment and evaluation should be updated and improved. In general,…

  2. Evidence of Second-Order Factor Structure in a Diagnostic Problem Space: Implications for Medical Education.

    ERIC Educational Resources Information Center

    Papa, Frank J.; And Others

    1997-01-01

    Chest pain was identified as a specific medical problem space, and disease classes were modeled to define it. Results from a test taken by 628 medical residents indicate a second-order factor structure that suggests that chest pain is a multidimensional problem space. Implications for medical education are discussed. (SLD)

  3. Potentialities for Learning in Medical Students' Ways of Approaching a Diagnostic Task

    ERIC Educational Resources Information Center

    Bonnevier, Anna; Josephson, Anna; Scheja, Max

    2012-01-01

    The study investigates medical students' ways of approaching a medical task. Fourteen medical students in their clinical years responded to a written patient case on chest pain. Variations in the students' responses to the task were analysed from a contextual and linguistic perspective. Students approached the task in two distinctly different…

  4. Histological Knowledge as a Predictor of Medical Students' Performance in Diagnostic Pathology

    ERIC Educational Resources Information Center

    Nivala, Markus; Lehtinen, Erno; Helle, Laura; Kronqvist, Pauliina; Paranko, Jorma; Säljö, Roger

    2013-01-01

    Over the years, the role and extent of the basic sciences in medical curricula have been challenged by research on clinical expertise, clinical teachers, and medical students, as well as by the development and diversification of the medical curricula themselves. The aim of this study was to examine how prior knowledge of basic histology and…

  5. The sensitivity of medical diagnostic decision-support knowledge bases in delineating appropriate terms to document in the medical record.

    PubMed Central

    Feldman, M. J.; Barnett, G. O.; Morgan, M. M.

    1991-01-01

    A pertinent, legible and complete medical record facilitates good patient care. The recording of the symptoms, signs and lab findings which are relevant to a patient's condition contributes importantly to the medical record. The consideration and documentation of other disease states known to be related to the patient's primary illness provide further enhancement. We propose that developing sets of disease-specific core elements which a physician may want to document in the medical record can have many benefits. We hypothesize that for a given disease, terms with high importance (TI) and frequency (TF) in the DX-plain, QMR and Iliad knowledge bases (KBs) are terms which are used commonly in the medical record, and may be, in fact, terms which physicians would find useful to document. A study was undertaken to validate ten such sets of disease-specific core elements. For each of ten prevalent diseases, high TI and TF terms from the three KBs mentioned were pooled to derive the set of core elements. For each disease, all patient records (range 385 to 16,972) from a computerized ambulatory medical record database were searched to document the actual use by physicians of each of these core elements. A significant percentage (range 50 to 86%) of each set of core elements was confirmed as being used by the physicians. In addition, all medical concepts from a selection of full text records were identified, and an average of 65% of the concepts were found to be core elements.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:1807600

  6. [Consensuses on lung cancer treatment by Chinese medicine experts from Beijing and Guangzhou and medication features in the North and South China].

    PubMed

    Wang, Shu-mei; Lin, Li-zhu; Nie, Hui

    2011-07-01

    To study the consensuses on lung cancer treatment by Chinese medicine experts from North China and South China, and to analyze their medication features from viewpoints such as the medication frequency, combination laws, medication classification by collecting 800 recipes on the treatment of lung cancer patients prescribed by 8 Chinese oncologists from Guanganmen Hospital of China Academy of Chinese Medical Sciences, the Affiliated Hospital of Guangzhou University of Traditional Chinese Medicine, and Guangdong Provincial Hospital of Traditional Chinese Medicine. Results showed that coix seed, poria, pinelliae tuber were the three herbs most commonly used in treatment of lung cancer by all experts. They generally accepted Pi invigorating and phlegm removing method as the basic treatment method for treating lung cancer. Secondly, they usually used white peony root, heterophylla falsestarwort root, and ophiopogonis tuber, etc. (with higher medication frequency) to nourish yin and moisten Fei. Thirdly, consistency was also shown in clearing heat, detoxication, and anticancer. Smilacis glabra, Rhizoma Smilacis Glabrae, Herba Hedyotis diffusae, Herba Scutellariae Barbatae were herbs used by all experts. However, there were differences between oncologists in North China and South China. Oncologists in South China paid more attention to heat toxin and blood stasis, while those in North China paid more attention to supplementing both qi and yin. PMID:21866673

  7. Tuina-Focused Integrative Chinese Medical Therapies for Inpatients with Low Back Pain: A Systematic Review and Meta-Analysis

    PubMed Central

    Kong, Ling Jun; Fang, Min; Zhan, Hong Sheng; Yuan, Wei An; Pu, Jiang Hui; Cheng, Ying Wu; Chen, Bo

    2012-01-01

    Objective. To evaluate the effectiveness of Tuina-focused integrative Chinese medical therapies (TICMT) on inpatients with low back pain (LBP). Methods. 6 English and Chinese databases were searched for randomized controlled trials (RCTs) of TICMT for in-patients with LBP. The methodological quality of the included RCTs was assessed based on PEDro scale. And the meta-analyses of TICMT for LBP on pain and functional status were conducted. Results. 20 RCTs were included. The methodological quality of the included RCTs was poor. The meta-analyses' results showed that TICMT had statistically significant effects on pain and functional status, especially Tuina plus Chinese herbal medicine (standardised mean difference, SMD: 1.17; 95% CI 0.75 to 1.60 on pain; SMD: 1.31; 95% CI 0.49 to 2.14 on functional status) and Tuina plus acupuncture (SMD: 0.94; 95% CI 0.38 to 1.50 on pain; SMD: 0.53; 95% CI 0.21 to 0.85 on functional status). But Tuina plus moxibustion or hot pack did not show significant improvements on pain. And the long-term evidence of TICMT was far from sufficient. Conclusions. The preliminary evidence from current studies suggests that TICMT might be effective complementary and alternative treatments for in-patients with LBP. However, the poor methodological quality of the included RCTs means that high-quality RCTs with long follow-up are warranted. PMID:23346207

  8. Effects of Rural Mutual Health Care on outpatient service utilization in Chinese village medical institutions: evidence from panel data.

    PubMed

    Zhou, Zhongliang; Gao, Jianmin; Xue, Qinxiang; Yang, Xiaowei; Yan, Ju'e

    2009-07-01

    To solve the problem of 'Kan bing nan, kan bing gui' (medical treatment is difficult to access and expensive), a Harvard-led research team implemented a community-based health insurance scheme known as Rural Mutual Health Care (RMHC) in Chinese rural areas from 2004 to 2006. Two major policies adopted by RMHC included insurance coverage of outpatient services (demand-side policy) and drug policy (supply-side policy). This paper focuses on the effects of these two policies on outpatient service utilization in Chinese village clinics. The data used in this study are from 3-year household follow-up surveys. A generalized negative binomial regression model and a Heckman selection model were constructed using panel data from 2005 to 2007. The results indicate that the price elasticities of demand for outpatient visits and per-visit outpatient expenses were -1.5 and -0.553, respectively. After implementing the supply-side policy, outpatient visits and per-visit outpatient expenses decreased by 94.7 and 55.9%, respectively, controlling for insurance coverage. These findings can be used to make recommendations to the Chinese government on improving the health care system. PMID:19548324

  9. Psychometric properties of the Chinese version of the Self-Efficacy for Appropriate Medication Use Scale in patients with stroke

    PubMed Central

    Dong, Xiao-fang; Liu, Yan-jin; Wang, Ai-xia; Lv, Pei-hua

    2016-01-01

    Background It has been reported that stroke has a higher incidence and mortality rate in the People’s Republic of China compared to the global average. These conditions can be managed by proper medication use, but ensuring medication adherence is challenging. Objective To translate the Self-Efficacy for Appropriate Medication Use Scale into Chinese and test its validity and reliability in patients with stroke. Methods Instrument performances were measured from January 15, 2015 to April 28, 2015 on a convenience sample of 400 patients with stroke recruited at four neurology departments of the First Affiliated Hospital of Zhengzhou University. Questionnaires included the Chinese versions of the Self-Efficacy for Appropriate Medication Use Scale (C-SEAMS) and the General Self-Efficacy Scale (C-GSE). Construct validity, convergent validity, internal consistency, and test–retest reliability were measured. Results Item analysis showed that item-to-total correlations were in the range of 0.362–0.672. Exploratory factor analysis revealed two factors (which accounted for 60.862% of total variance), with factor loading ranging from 0.534 to 0.756. Confirmatory factor analysis was performed to support the results, with an acceptable fit (χ2=73.716; df=64; P<0.01; goodness-of-fit index =0.902; adjusted goodness-of-fit index =0.897; comparative fit index =0.865; root-mean-square error of approximation =0.058). The convergent validity of the C-SEAMS correlated well with the validated measure of the C-GSE in measuring self-efficacy (r=0.531, P<0.01). Good internal consistency (Cronbach’s alpha ranged from 0.826 to 0.915) and test–retest reliability (Pearson’s correlation coefficient r=0.642, P<0.01) were found. Conclusion The C-SEAMS is a brief and psychometrically sound measure for evaluating self-efficacy for medication adherence in the Chinese population with stroke. PMID:27042023

  10. Learning tumor diagnostics and medical image processing via the WWW--the case-based radiological textbook ODITEB.

    PubMed

    Horsch, A; Balbach, T; Melnitzki, S; Knauth, J

    2000-09-01

    New Internet technologies offer excellent chances to build high-quality on-line learning media for the education in medicine. Especially, the teaching of diagnostics with medical imaging as well as medical image processing can be supported by the excellent visualization and interaction capabilities. In cooperation with three radiological departments at German universities in Munich, Erlangen and Würzburg, the case-based open distributed Internet text book (ODITEB) for tumor diagnosis of the GI-tract, liver, pancreas and thorax has been developed at the Institut für Medizinische Statistik und Epidemiologie (IMSE) of the Technische Universität München. It offers a big collection of clinical tumor cases located on servers at the provider sites Munich, Erlangen and Würzburg, visualization and interaction similar to a real CT or MRI console, original DICOM data, X-rays and endoscopic and endosonographic videos, and expert-guided tours through the cases. In a first evaluation in summer 1998, 32 medical students graded the application with 1.9 ('good') on a scale from 1 ('very good') to 5 ('very bad'). The textbook supports German language, an English version is in preparation. In a second part, it contains lessons in medical image processing for students of medical informatics. An ODITEB release 2 with several improvements will be finished until February 2000. The use of the textbook is free of cost. PMID:10978908

  11. Validation of the Developmental, Dimensional and Diagnostic Interview (3Di) Among Chinese Children in a Child Psychiatry Clinic in Hong Kong.

    PubMed

    Lai, Kelly Y C; Leung, Patrick W L; Mo, Flora Y M; Lee, Marshall M C; Shea, Caroline K S; Chan, Grace F C; Che, Kiti K I; Luk, Ernest S L; Mak, Arthur D P; Warrington, Richard; Skuse, David

    2015-05-01

    Autism spectrum disorder (ASD) is a disorder with high levels of co-morbidities. The Developmental, Dimensional and Diagnostic Interview (3 Di) is a relatively new instrument designed to provide dimensional as well as categorical assessment of autistic behaviours among children with normal intelligence. Its sound psychometric properties and relatively short administration time make it a versatile instrument. The 3 Di was translated into Chinese (Cantonese) and its applicability among 194 clinic children was examined. Results found excellent reliability and validity, and achieved a sensitivity of 95% and specificity of 77%. It was able to capture the diagnosis of ASD among children presenting with attention deficit hyperactivity disorder. However, although the disorder of ASD is considered universal, the use of a western instrument in a Chinese context should also take note of cultural influences that may impact on the manifestation of its symptoms. PMID:25326822

  12. Integrating Nursing Diagnostic Concepts into the Medical Entities Dictionary Using the ISO Reference Terminology Model for Nursing Diagnosis

    PubMed Central

    Hwang, Jee-In; Cimino, James J.; Bakken, Suzanne

    2003-01-01

    Objective: The purposes of the study were (1) to evaluate the usefulness of the International Standards Organization (ISO) Reference Terminology Model for Nursing Diagnoses as a terminology model for defining nursing diagnostic concepts in the Medical Entities Dictionary (MED) and (2) to create the additional hierarchical structures required for integration of nursing diagnostic concepts into the MED. Design and Measurements: The authors dissected nursing diagnostic terms from two source terminologies (Home Health Care Classification and the Omaha System) into the semantic categories of the ISO model. Consistent with the ISO model, they selected Focus and Judgment as required semantic categories for creating intensional definitions of nursing diagnostic concepts in the MED. Because the MED does not include Focus and Judgment hierarchies, the authors developed them to define the nursing diagnostic concepts. Results: The ISO model was sufficient for dissecting the source terminologies into atomic terms. The authors identified 162 unique focus concepts from the 266 nursing diagnosis terms for inclusion in the Focus hierarchy. For the Judgment hierarchy, the authors precoordinated Judgment and Potentiality instead of using Potentiality as a qualifier of Judgment as in the ISO model. Impairment and Alteration were the most frequently occurring judgments. Conclusions: Nursing care represents a large proportion of health care activities; thus, it is vital that terms used by nurses are integrated into concept-oriented terminologies that provide broad coverage for the domain of health care. This study supports the utility of the ISO Reference Terminology Model for Nursing Diagnoses as a facilitator for the integration process. PMID:12668692

  13. Clinical simulation training improves the clinical performance of Chinese medical students

    PubMed Central

    Zhang, Ming-ya; Cheng, Xin; Xu, An-ding; Luo, Liang-ping; Yang, Xuesong

    2015-01-01

    Background Modern medical education promotes medical students’ clinical operating capacity rather than the mastery of theoretical knowledge. To accomplish this objective, clinical skill training using various simulations was introduced into medical education to cultivate creativity and develop the practical ability of students. However, quantitative analysis of the efficiency of clinical skill training with simulations is lacking. Methods In the present study, we compared the mean scores of medical students (Jinan University) who graduated in 2013 and 2014 on 16 stations between traditional training (control) and simulative training groups. In addition, in a clinical skill competition, the objective structured clinical examination (OSCE) scores of participating medical students trained using traditional and simulative training were compared. The data were statistically analyzed and qualitatively described. Results The results revealed that simulative training could significantly enhance the graduate score of medical students compared with the control. The OSCE scores of participating medical students in the clinical skill competition, trained using simulations, were dramatically higher than those of students trained through traditional methods, and we also observed that the OSCE marks were significantly increased for the same participant after simulative training for the clinical skill competition. Conclusions Taken together, these data indicate that clinical skill training with a variety of simulations could substantially promote the clinical performance of medical students and optimize the resources used for medical education, although a precise analysis of each specialization is needed in the future. PMID:26478142

  14. Visualizing and Measuring the Temperature Field Produced by Medical Diagnostic Ultrasound Using Thermography

    ERIC Educational Resources Information Center

    Vachutka, J.; Grec, P.; Mornstein, V.; Caruana, C. J.

    2008-01-01

    The heating of tissues by diagnostic ultrasound can pose a significant hazard particularly in the imaging of the unborn child. The demonstration of the temperature field in tissue is therefore an important objective in the teaching of biomedical physics to healthcare professionals. The temperature field in a soft tissue model was made visible and…

  15. Novel medical bathing with traditional Chinese herb formula alleviates paraplegia spasticity.

    PubMed

    Liu, Xin; Meng, Qingxi; Yu, Dapeng; Zhao, Xiwu; Zhao, Tingbao

    2014-06-01

    Paraplegia spasm is a kind of chronic disease which lacks effective treatment; the patients have to endure long-term pain, which is a tough problem for nursing practice. Lots of potential candidate medicines are under investigation, and a new Chinese herb formula is introduced in the current study. In the present study, we chose six different well-known Chinese herbs to form a formula, and boiled them into the water with an optimized ratio to make bath water; 80 paraplegic patients received this medicinal bath, and 80 patients received perfume water bath as placebo group. Compared with placebo control patients, the herb-treated patients have significant reduction in paraplegia spasm, visual analogue scale score, clinician global impression and sleep disorder. This novel six-combined formula traditional medicine could be beneficial for alleviating paraplegia spasm, but the underlying action mechanism deserves further study. PMID:24621269

  16. Exploring medical diagnostic performance using interactive, multi-parameter sourced receiver operating characteristic scatter plots.

    PubMed

    Moore, Hyatt E; Andlauer, Olivier; Simon, Noah; Mignot, Emmanuel

    2014-04-01

    Determining diagnostic criteria for specific disorders is often a tedious task that involves determining optimal diagnostic thresholds for symptoms and biomarkers using receiver-operating characteristic (ROC) statistics. To help this endeavor, we developed softROC, a user-friendly graphic-based tool that lets users visually explore possible ROC tradeoffs. The software requires MATLAB installation and an Excel file containing threshold symptoms/biological measures, with corresponding gold standard diagnoses for a set of patients. The software scans the input file for diagnostic and symptom/biomarkers columns, and populates the graphical-user-interface (GUI). Users select symptoms/biomarkers of interest using Boolean algebra as potential inputs to create diagnostic criteria outputs. The software evaluates subtests across the user-established range of cut-points and compares them to a gold standard in order to generate ROC and quality ROC scatter plots. These plots can be examined interactively to find optimal cut-points of interest for a given application (e.g. sensitivity versus specificity needs). Split-set validation can also be used to set up criteria and validate these in independent samples. Bootstrapping is used to produce confidence intervals. Additional statistics and measures are provided, such as the area under the ROC curve (AUC). As a testing set, softROC is used to investigate nocturnal polysomnogram measures as diagnostic features for narcolepsy. All measures can be outputted to a text file for offline analysis. The softROC toolbox, with clinical training data and tutorial instruction manual, is provided as supplementary material and can be obtained online at http://www.stanford.edu/~hyatt4/software/softroc or from the open source repository at http://www.github.com/informaton/softroc. PMID:24561350

  17. Indo-Chinese Refugee Physician ECFMG Review Course. Hahnemann Medical College & Hospital. Project Report.

    ERIC Educational Resources Information Center

    Hahnemann Medical Coll. and Hospital, Philadelphia, PA.

    A report is presented on a special review seminar for Vietnamese physicians preparing for the July 1976 Educational Council for Foreign Medical Graduates (ECFMG) examination. The 4-month review course was offered to 73 physicians at Hahnemann Medical College & Hospital. Participants were assigned to 10 small sections for English classes, and…

  18. Continuing violence against medical personnel in China: A flagrant violation of Chinese law.

    PubMed

    Peng, Wei; Ding, Gan; Tang, Qi; Xu, Lingzhong

    2016-07-19

    Over the past few years, China has witnessed a surge in violence against medical personnel, including widely reported incidents of violent abuse, riots, attacks, and protests in hospitals, where doctors suffer from heavy workloads and little protection. China has engaged in serious efforts, such as investing large amounts into the healthcare system and implementing several decades of healthcare reform, to make medical care more accessible to and affordable for the public. However, incidents of violence against medical personnel have increased in intensity, reflecting deteriorating relations between medical staff and their patients in China over the past few decades. Hence, the effectiveness of healthcare legislation needs to be examined and medical reform and development of the healthcare system need to be reevaluated. Only by enhancing oversight, promoting healthcare reform, and improving the healthcare system can we repair the doctor-patient relationship and decrease violence against doctors in China. PMID:27245351

  19. The Adult Patient with Eisenmenger Syndrome: A Medical Update After Dana Point Part I: Epidemiology, Clinical Aspects and Diagnostic Options

    PubMed Central

    Kaemmerer, Harald; Mebus, Siegrun; Schulze-Neick, Ingram; Eicken, Andreas; Trindade, Pedro T; Hager, Alfred; Oechslin, Erwin; Niwa, Koichiro; Lang, Irene; Hess, John

    2010-01-01

    Eisenmenger syndrome is the most severe form of pulmonary arterial hypertension and arises on the basis of congenital heart disease with a systemic-to-pulmonary shunt. Due to the chronic slow progressive hypoxemia with central cyanosis, adult patients with the Eisenmenger syndrome suffer from a complex and multisystemic disorder including coagulation disorders (bleeding complications and paradoxical embolisms), renal dysfunction, hypertrophic osteoarthropathy, heart failure, reduced quality of life and premature death. For a long time, therapy has been limited to symptomatic options or lung or combined heart-lung transplantation. As new selective pulmonary vasodilators have become available and proven to be beneficial in various forms of pulmonary arterial hypertension, this targeted medical treatment has been expected to show promising effects with a delay of deterioration also in Eisenmenger patients. Unfortunately, data in Eisenmenger patients suffer from small patient numbers and a lack of randomized controlled studies. To optimize the quality of life and the outcome, referral of Eisenmenger patients to spezialized centers is required. In such centers, specific interdisciplinary management strategies of physicians specialized on congenital heart diseases and PAH should be warranted. This medical update emphasizes the current diagnostic and therapeutic options for Eisenmenger patients with particularly focussing on epidemiology, clinical aspects and specific diagnostic options. PMID:22043211

  20. [Delayed appendectomy because of diagnostic malpractice: Experiences of the Arbitration Board of the North German Medical Associations].

    PubMed

    Vinz, Heinrich; von Bülow, Markward; Neu, Johann

    2015-01-01

    From 2000 to 2012, 447 panel proceedings concerning acute appendicitis were evaluated. 271 cases (57 %) were related to alleged diagnostic malpractice. This was confirmed in 176 cases (67 %). The following medical specialities were involved (m = quote of malpractice): general surgery 33 %, m = 51 %; paediatric surgery 3 %, m = 44 %; general practitioner and prehospital emergency services 24 %, m = 62 %; internal medicine 19 %, m = 70 %; paediatrics 13 %, m = 57 %; gynaecology 3 %, m = 91 %; urology 2 %, m = 17 %. The most frequent misdiagnosis was gastroenteritis (43 % in adults, 69 % in children), obviously based on the concomitant symptom of diarrhoea. Surgery revealed all stages of advanced appendicitis up to peritoneal sepsis, organic failure and death (n = 5). The evaluation of the files and the experts' reports of the 176 cases of diagnostic malpractice allowed to define the following basic failures, which led to unjustified delay of operation: careless history-taking, no or incomplete physical examination, no follow-up investigations, incorrect interpretation of the patient's complaints and clinical findings, no or incomplete documentation. Conducting a thorough investigation is essential to avoiding diagnostic malpractice. Internal analysis of failures or near failures may contribute to reducing the number of future cases of malpractice. PMID:26699259

  1. Raman spectroscopy for medical diagnostics--From in-vitro biofluid assays to in-vivo cancer detection.

    PubMed

    Kong, Kenny; Kendall, Catherine; Stone, Nicholas; Notingher, Ioan

    2015-07-15

    Raman spectroscopy is an optical technique based on inelastic scattering of light by vibrating molecules and can provide chemical fingerprints of cells, tissues or biofluids. The high chemical specificity, minimal or lack of sample preparation and the ability to use advanced optical technologies in the visible or near-infrared spectral range (lasers, microscopes, fibre-optics) have recently led to an increase in medical diagnostic applications of Raman spectroscopy. The key hypothesis underpinning this field is that molecular changes in cells, tissues or biofluids, that are either the cause or the effect of diseases, can be detected and quantified by Raman spectroscopy. Furthermore, multivariate calibration and classification models based on Raman spectra can be developed on large "training" datasets and used subsequently on samples from new patients to obtain quantitative and objective diagnosis. Historically, spontaneous Raman spectroscopy has been known as a low signal technique requiring relatively long acquisition times. Nevertheless, new strategies have been developed recently to overcome these issues: non-linear optical effects and metallic nanoparticles can be used to enhance the Raman signals, optimised fibre-optic Raman probes can be used for real-time in-vivo single-point measurements, while multimodal integration with other optical techniques can guide the Raman measurements to increase the acquisition speed and spatial accuracy of diagnosis. These recent efforts have advanced Raman spectroscopy to the point where the diagnostic accuracy and speed are compatible with clinical use. This paper reviews the main Raman spectroscopy techniques used in medical diagnostics and provides an overview of various applications. PMID:25809988

  2. Are natural products and medical diagnostic tests still eligible for patents in the USA?

    PubMed

    Cockbain, Julian; Sterckx, Sigrid

    2012-09-01

    In 2010, the biotechnology and molecular diagnostics industries were shocked by the decision from a US District Court to the effect that isolated endogenous DNA and diagnostic tests based on newly discovered DNA sequences were not eligible for US patents. The case related to the BRCA1/2 genes for breast and ovarian cancer. On appeal, the decision was almost entirely overturned. However, in March 2012, the US Supreme Court vacated the appeal court decision and instructed the appeals court to rehear the case in the light of its very recent decision, which suggested that products of nature and their obvious uses should not be patentable. This commentary explores the points at issue. PMID:24236874

  3. Design of decision support system when undertaking medical-diagnostic action

    NASA Astrophysics Data System (ADS)

    Povoroznyuk, Anatoliy I.; Filatova, Anna E.; Surtel, Wojciech; Burlibay, Aron; Zhassandykyzy, Maral

    2015-12-01

    In the work the formalization of the problem of diagnostic and treatment activities (DTA) steps complex estimation for increasing of their efficiency and minimization of the risk of doctor's mistakes was completed. The decision support system during conducting of DTA based on formalizations of steps of DTA performing with theirs complex estimation was developed that allows to minimize the risks of doctor's mistakes, raise validity of decisions.

  4. Integration of a bioMEMS device into a disposable microfluidic cartridge for medical diagnostics

    NASA Astrophysics Data System (ADS)

    Ortiz, Pedro; Keegan, Neil; Spoors, Julia; Hedley, John; Harris, Alun; Burdess, Jim; Burnett, Richard; Velten, Thomas; Biehl, Margit; Knoll, Thorsten; Haberer, Werner; Solomon, Matthew; Campitelli, Andrew; McNeil, Calum

    2009-02-01

    A microfluidic system for cancer diagnostics based around a core MEMS biosensor technology is presented in this paper. The principle of the MEMS biosensor is introduced and the functionalisation strategy for cancer marker recognition is described. In addition, the successful packaging and integration of functional MEMS biosensor devices are reported herein. This ongoing work represents one of the first hybrid systems to integrate a PCB packaged silicon MEMS device into a disposable microfluidic cartridge.

  5. Benefit packages for chronic disease outpatients in the New Rural Cooperative Medical Scheme in 32 Chinese counties

    PubMed Central

    Gericke, Christian A

    2013-01-01

    Introduction: Chronic disease has become a major problem affecting the health of the Chinese population. In response to this situation, the New Rural Cooperative Medical Scheme (NRCMS) has begun to provide health cover for outpatients with chronic disease expenses, made possible by the increased risk pool of previous years. We compare the differences between Benefit Packages for Chronic Diseases Outpatients (BPCDO) in order to produce a reference for policy makers. Methods: Information on the various BPCDO was located by searching the official NRCMS website in Chinese, using certain criteria to select the ideal BPCDO. Population coverage, service coverage and cost of coverage were chosen to form the analytical framework for this paper. The diseases were classified according to the World Health Organisation's (WHO) International Classification of Diseases (ICD-10). Results: To avoid “moral hazard”, complex processes have been created. This has resulted in chronic disease patients finding it very difficult to become beneficiaries. Forty-one types of chronic diseases were listed in 32 different BPCDO. We found that different counties have different co-payment rates, deductible lines, ceilings, coverage of drugs and tests, appointed hospitals and reimbursement frequencies. Conclusion: High mortality diseases and diseases with a heavier cost burden should be the priority on the list of reimbursement. The BPCDO scheme should be introduced urgently at the national level. It should include twenty-one types of disease and eight essential factors. PMID:24358897

  6. The Chinese Life-Steps Program: A Cultural Adaptation of a Cognitive-Behavioral Intervention to Enhance HIV Medication Adherence

    PubMed Central

    Shiu, Cheng-Shi; Chen, Wei-Ti; Simoni, Jane; Fredriksen-Goldsen, Karen; Zhang, Fujie; Zhou, Hongxin

    2013-01-01

    China is considered to be the new frontier of the global AIDS pandemic. Although effective treatment for HIV is becoming widely available in China, adherence to treatment remains a challenge. This study aimed to adapt an intervention promoting HIV-medication adherence—favorably evaluated in the West—for Chinese HIV-positive patients. The adaptation process was theory-driven and covered several key issues of cultural adaptation. We considered the importance of interpersonal relationships and family in China and cultural notions of health. Using an evidence-based treatment protocol originally designed for Western HIV-positive patients, we developed an 11-step Chinese Life-Steps program with an additional culture-specific intervention option. We describe in detail how the cultural elements were incorporated into the intervention and put into practice at each stage. Clinical considerations are also outlined and followed by two case examples that are provided to illustrate our application of the intervention. Finally, we discuss practical and research issues and limitations emerging from our field experiments in a HIV clinic in Beijing. The intervention was tailored to address both universal and culturally specific barriers to adherence and is readily applicable to generalized clinical settings. This evidence-based intervention provides a case example of the process of adapting behavioral interventions to culturally diverse communities with limited resources. PMID:23667305

  7. The Chinese community patient’s life satisfaction, assessment of community medical service, and trust in community health delivery system

    PubMed Central

    2013-01-01

    Background Although the Chinese government put a lot of effort into promoting the community patient’s life satisfaction, there still lacked the holistic and systematic approaches to promote the community patient’s life satisfaction in various regions of China. On the basis of the literature, it was found that both the community patient’s assessment of community medical service and trust in community health delivery system were important considerations when the community patient comprehensively evaluated community medical service to generate life satisfaction. So this study was set up to test whether and to what extent the community patient’s assessments of various major aspects of community medical service/various major aspects of the community patient’s trust in community health delivery system influenced life satisfaction in whole China/in various regions of China. Methods In order to explore the situation of China’s community health delivery system before 2009 and provide a reference for China’s community health delivery system reform, the data that could comprehensively and accurately reflect the community patient’s life satisfaction, assessment of community medical service, and trust in community health delivery system in various regions of China was needed, so this study collaborated with the National Bureau of Statistics of China to carry out a large-scale 2008 national community resident household survey (N = 3,306) for the first time in China. And the specified ordered probit models were established to analyze the dataset from this household survey. Results Among major aspects of community medical service, the medical cost (particularly in developed regions), the doctor-patient communication (particularly in developed regions), the medical facility and hospital environment (particularly in developed regions), and the medical treatment process (particularly in underdeveloped regions) were all key considerations (p<0.05 for t statistics) in

  8. Traditional Chinese medication for rheumatoid arthritis: more than what meets the eye.

    PubMed

    Santosa, Amelia; Ng, P S L; Teng, G G

    2015-02-01

    There is an increasing interest in the role of traditional Chinese medicine (TCM) in rheumatoid arthritis (RA), as evidenced by recent trials comparing their efficacy against established disease-modifying antirheumatic drugs. While the TCM in these trials seem to support a favorable cost-benefit ratio, many products are marketed under the guise of TCM, potentially exposing the user to unpredicted adverse events. We present the case of a patient with RA, who developed side effects from treatment with adulterated TCM. While TCM may be of value in the treatment of rheumatic diseases, their application in routine care continues to warrant careful consideration of safety and reliability. PMID:25037898

  9. Medical Diagnostic Consultation concerning Mental Retardation: An Analogue Study of School Psychologists' Attitudes

    ERIC Educational Resources Information Center

    Wodrich, David L.; Tarbox, Jennifer; Balles, John; Gorin, Joanna

    2010-01-01

    Recent research of relevance to school psychologists suggests that the cause, or etiology, of mental retardation can be established by medical diagnosticians in approximately one-half of cases. In the current study, 109 practicing school psychologists considered a hypothetical case of an elementary student with mental retardation and indicated…

  10. Protective effects of medical ozone combined with traditional Chinese medicine against chemically-induced hepatic injury in dogs

    PubMed Central

    Li, Li-Jie; Yang, Yun-Gao; Zhang, Zhi-Ling; Nie, Sui-Feng; Li, Ze; Li, Feng; Hua, He-Yu; Hu, Yan-Jun; Zhang, Hong-Shuan; Guo, Ya-Bing

    2007-01-01

    AIM: To investigate the protective effect of medical ozone (O3) combined with Traditional Chinese Medicine (TCM) Yigan Fuzheng Paidu Capsules (YC) against carbon tetrachloride (CCl4)-induced hepatic injury in dogs. METHODS: Thirty healthy dogs were divided randomly into five groups (n = 6 in each group), namely control, oleanolic acid tablet (OAT), O3, YC and O3 + YC, given either no particular pre-treatment, oral OAT, medical ozone rectal insulfflation every other day, oral YC, or oral YC plus medical ozone rectal insulfflation every other day, respectively, for 30 consecutive days. After pre-treatment, acute hepatic injury was induced in all dogs with a single-dose intraperitoneal injection of CCl4. General condition and survival time were recorded. The biochemical and hematological indexes of alanine aminotransferase (ALT), aspartate aminotransferase/alanine aminotransferase (AST/ALT), serum total bilirubin (TBIL), prothrombin time (PT), blood ammonia (AMMO), and blood urea nitrogen (BUN) were measured after CCl4 injection. Hepatic pathological changes were also observed. RESULTS: Compared to the other four groups, the changes of group O3 + YC dogs’ general conditions (motoricity, mental state, eating, urination and defecation) could be better controlled. In group O3 + YC the survival rates were higher (P < 0.05 vs group control). AST/ALT values were kept within a normal level in group O3 + YC. Hepatic histopathology showed that hepatic injury in group O3 + YC was less serious than those in the other four groups. CONCLUSION: Medical ozone combined with TCM YC could exert a protective effect on acute liver injury induced by CCl4. PMID:18023088

  11. The Ambulatory Diagnostic and Treatment Center: A Unique Model for Educating Medical Trainees and Providing Expedited Care.

    PubMed

    Serrao, Richard A; Orlander, Jay D

    2016-05-01

    In this article, the authors reexamine the Ambulatory Diagnostic and Treatment Center (ADTC) model, which uniquely combines the education of trainees with the care of referred patients at one Veterans Affairs medical center. As an ambulatory clinic with an inpatient mind-set, the ADTC uses a series of closely spaced outpatient appointments that are longer than typical ambulatory visits, offering a VIP-level of evaluation with the patient-centered goal of expedited diagnosis and treatment. Faculty triage patients by weighing factors such as urgency, educational value, complexity, and instability of diseases in conjunction with the resources, availability, and appropriateness of other services within the medical center.The ADTC's unique focus on the education of trainees in comparison with other clinical rotations is evident in the ratio of learning to patient care. This intensive training environment expects postgraduate year 2 and 3 internal medicine residents and fourth-year medical students to read, reflect, and review literature daily. This mix of education and care delivery is ripe for reexploration in light of recent calls for curriculum reform amidst headlines exposing delays in veterans' access to care.A low-volume, high-intensity clinic like the ADTC can augment the clinical services provided by a busy primary care and subspecialty workforce without losing its emphasis on education. Other academic health centers can learn from this model and adapt its structure in settings where accountable care organizations and education meet. PMID:26839944

  12. Towards a Confucian virtue bioethics: reframing Chinese medical ethics in a market economy.

    PubMed

    Fan, Ruiping

    2006-01-01

    This essay addresses a moral and cultural challenge facing health care in the People's Republic of China: the need to create an understanding of medical professionalism that recognizes the new economic realities of China and that can maintain the integrity of the medical profession. It examines the rich Confucian resources for bioethics and health care policy by focusing on the Confucian tradition's account of how virtue and human flourishing are compatible with the pursuit of profit. It offers the Confucian account of the division of labor and the financial inequalities this produces with special attention to China's socialist project of creating the profession of barefoot doctors as egalitarian peasant physicians and why this project failed. It then further develops the Confucian acknowledgement of the unequal value of different services and products and how this conflicts with the current system of payment to physicians which has led to the corruption of medical professionalism through illegal supplementary payments. It further gives an account the oblique intentionality of Confucian moral psychology that shows how virtuous persons can pursue benevolent actions while both foreseeing profit and avoiding defining their character by greed. This account of Confucian virtue offers the basis for a medical professionalism that can function morally within a robustly profit-oriented market economy. The paper concludes with a summary of the characteristics of Confucian medical professionalism and of how it places the profit motive within its account of virtue ethics. PMID:17136438

  13. Diagnostic Potential of Zymogen Granule Glycoprotein 2 Antibodies as Serologic Biomarkers in Chinese Patients With Crohn Disease

    PubMed Central

    Zhang, Shulan; Wu, Ziyan; Luo, Jing; Ding, Xuefeng; Hu, Chaojun; Li, Ping; Deng, Chuiwen; Zhang, Fengchun; Qian, Jiaming; Li, Yongzhe

    2015-01-01

    Abstract The need for reliable biomarkers for distinguishing Crohn disease (CD) from ulcerative colitis (UC) is increasing. This study aimed at evaluating the diagnostic potential of anti-GP2 antibodies as a biomarker in Chinese patients with CD. In addition, a variety of autoantibodies, including anti-saccharomyces cerevisiae antibodies (ASCA), perinuclear anti-neutrophil cytoplasmic antibodies (PANCA), anti-intestinal goblet cell autoantibodies (GAB), and anti-pancreatic autoantibodies (PAB), were evaluated. A total of 91 subjects were prospectively enrolled in this study, including 35 patients with CD, 35 patients with UC, 13 patients with non-IBD gastrointestinal diseases as disease controls (non-IBD DC), and 8 healthy controls (HC). The diagnosis of IBD was determined based on the Lennard-Jones criteria, and the clinical phenotypes of the IBD patients were determined based on the Montreal Classification. Anti-GP2 IgG antibodies were significantly elevated in patients with CD, compared with patients with UC (P = 0.0038), HC (P = 0.0055), and non-IBD DC (P = 0.0063). The prevalence of anti-GP2 IgG, anti-GP2 IgA and anti-GP2 IgA, or IgG antibodies in patients with CD was 40.0%, 37.1%, and 54.3%, respectively, which were higher than those in non-IBD DC (anti-GP2 IgG, 15.4%; anti-GP2 IgA, 7.7%; and anti-GP2 IgA or IgG, 23.1%) and those in patients with UC (anti-GP2 IgG, 11.4%; anti-GP2 IgA, 2.9%; and anti-GP2 IgA or IgG, 14.3%). For distinguishing CD from UC, the sensitivity, specificity, positive predictive value (PPV) and positive likelihood ratios (LR+) were 40%, 88.6%, 77.8%, and 3.51 for anti-GP2 IgG, 37.1%, 97.1%, 92.9%, and 13.0 for anti-GP2 IgA, and 54.3%, 85.3%, 79.2%, and 3.69 for anti-GP2 IgA or IgG. For CD diagnosis, the combination of anti-GP2 antibodies with ASCA IgA increased the sensitivity to 68.6% with moderate loss of specificity to 74.3%. Spearman's rank of order revealed a significantly positive correlation of anti-GP2 IgG with

  14. The benomyl test as a fundamental diagnostic method for medical mycology.

    PubMed Central

    Summerbell, R C

    1993-01-01

    The fungicide benomyl has long been known to differentially affect major taxonomic groups of fungi. In the present study 163 species or aggregates of closely similar species of medically important fungi and actinomycetes, as well as species commonly isolated as clinical contaminants, were tested to determine their reactions to three concentrations of benomyl. Fungi of basidiomycetous, endomycetous, and microascaceous affinities were highly resistant, including all common yeasts and Geotrichum, Pseudallescheria, Scedosporium, and Scopulariopsis species. Also resistant were fungi of pleosporalean affinities with poroconidial anamorphs, such as Alternaria, Bipolaris, Curvularia, and Exserohilum species. Most other fungi of ascomycetous affinity were moderately to strongly susceptible. Such fungi included dermatophytes; Coccidioides, Blastomyces, and Histoplasma species; Sporothrix schenckii; medically important aspergilli; and "black yeasts." Benomyl testing aided in the provisional identification of nonsporulating mycelia, including common basidiomycetous isolates obtained as contaminants as well as nonsporulating Aspergillus fumigatus from pulmonary sources. PMID:8458952

  15. A Diagnostic Analysis of Erroneous Language in Iranian Medical Specialists’ Research Papers

    PubMed Central

    Gholami, Javad; Zeinolabedini, Maryam

    2015-01-01

    Abstract Background: As English has increasingly become the lingua franca in science and international journals require native-like academic writing standards from nonnative researchers, there is more pressure on nonnative scholars to write their research articles more accurately and appropriately in English. This study was conducted to determine the most-occurring language-related errors which Iranian medical authors/researchers commit while trying to have their research published in international English journals. Also, this article seeks to provide useful guidelines to reduce such linguistic mistakes. Methods: The present study investigated the most common language-related errors in Iranian medical specialists’ research articles. To this end, the first drafts of 60 published research articles in medical sciences were cross-checked against their peer-reviewed published versions in order to identify the most frequent non-target language forms which received discoursal, lexical, grammatical, and mechanical revisions by peer editors. Results: The findings revealed that the editors had surprisingly dealt with discoursal errors more than any other linguistic aspects of these research articles. This was followed by lexical replacements. In third place were grammatical improvements, where erroneous structures mostly related to tenses, usage of articles and prepositions, and agreement between verbs and nouns were treated. The least common revisions were on the mechanics of academic writing, consisting of hyphenating, spelling, case lettering, spacing, and spacing with commas. Conclusion: Although most of the Iranian medical authors/researchers enjoyed a good level of proficiency in English, their manuscripts required discoursal, lexical, grammatical, and mechanical revisions before publication in credited international journals. PMID:26157466

  16. Cost-effectiveness of raloxifene in the treatment of osteoporosis in Chinese postmenopausal women: impact of medication persistence and adherence

    PubMed Central

    Chen, Mingsheng; Si, Lei; Winzenberg, Tania M; Gu, Jieruo; Jiang, Qicheng; Palmer, Andrew J

    2016-01-01

    Aims Raloxifene treatment of osteoporotic fractures is clinically effective, but economic evidence in support of raloxifene reimbursement is lacking in the People’s Republic of China. We aimed at evaluating the cost-effectiveness of raloxifene in the treatment of osteoporotic fractures using an osteoporosis health economic model. We also assessed the impact of medication persistence and adherence on clinical outcomes and cost-effectiveness of raloxifene. Methods We used a previously developed and validated osteoporosis state-transition microsimulation model to compare treatment with raloxifene with current practices of osteoporotic fracture treatment (conventional treatment) from the health care payer’s perspective. A Monte Carlo probabilistic sensitivity analysis with microsimulations was conducted. The impact of medication persistence and adherence on clinical outcomes and the cost-effectiveness of raloxifene was addressed in sensitivity analyses. The simulated patients used in the model’s initial state were 65-year-old postmenopausal Chinese women with osteoporosis (but without previous fractures), simulated using a 1-year cycle length until all patients had died. Costs were presented in 2015 US dollars (USD), and costs and effectiveness were discounted at 3% annually. The willingness-to-pay threshold was set at USD 20,000 per quality-adjusted life year (QALY) gained. Results Treatment with raloxifene improved clinical effectiveness by 0.006 QALY, with additional costs of USD 221 compared with conventional treatment. The incremental cost-effectiveness ratio was USD 36,891 per QALY gained. The cost-effectiveness decision did not change in most of the one-way sensitivity analyses. With full raloxifene persistence and adherence, average effectiveness improved compared with the real-world scenario, and the incremental cost-effectiveness ratio was USD 40,948 per QALY gained compared with conventional treatment. Conclusion Given the willingness-to-pay threshold

  17. Advanced diagnostic approaches and current medical management of insulinomas and adrenocortical disease in ferrets (Mustela putorius furo).

    PubMed

    Chen, Sue

    2010-09-01

    Endocrine neoplasia is the most common tumor type in domestic ferrets, especially in middle-aged to older ferrets. Islet cell tumors and adrenocortical tumors constitute the major types of endocrine neoplasms. Insulinoma is a tumor that produces and releases excessive amounts of insulin. Evaluation of fasted blood glucose levels provides a quick diagnostic assessment for the detection of insulinomas. Use of glucocorticoids, diazoxide, and diet modification are some of the medical treatment options for insulinomas. Adrenocortical neoplasia in ferrets usually overproduces one or more sex hormones. Sex hormones which can result in progressive alopecia, vulvar swelling in females, and prostagomegaly in males. Abdominal ultrasonography and sex hormone assays can be used to diagnose adrenocortical neoplasms. Drugs such as leuprolide acetate, deslorelin acetate, and the hormone melatonin can be used to treat adrenocortical neoplasms in ferrets when surgery is not an option. PMID:20682429

  18. Microfluidic blood plasma separation for medical diagnostics: is it worth it?

    PubMed

    Mielczarek, W S; Obaje, E A; Bachmann, T T; Kersaudy-Kerhoas, M

    2016-09-21

    Circulating biomarkers are on the verge of becoming powerful diagnostic tools for various human diseases. However, the complex sample composition makes it difficult to detect biomarkers directly from blood at the bench or at the point-of-care. Blood cells are often a source of variability of the biomarker signal. While the interference of hemoglobin is a long known source of variability, the release of nucleic acids and other cellular components from hemocytes is a new concern for measurement and detection of circulating extracellular markers. Research into miniaturised blood plasma separation has been thriving in the last 10 years (2006-2016). Most point-of-care systems need microscale blood plasma separation, but developed solutions differ in complexity and sample volume range. But could blood plasma separation be avoided completely? This focused review weights the advantages and limits of miniaturised blood plasma separation and highlights the most interesting advances in direct capture as well as smart blood plasma separation. PMID:27502438

  19. Managing Awkward, Sensitive, or Delicate Topics in (Chinese) Radio Medical Consultations

    ERIC Educational Resources Information Center

    Yu, Guodong; Wu, Yaxin

    2015-01-01

    This study, using conversation analysis as the research methodology, probes into the use of "nage" (literally "that") as a practice of managing awkward, sensitive, or delicate issues in radio phone-in medical consultations about sex-related problems. Through sequential manipulation and turn manipulation, the caller uses…

  20. Performance of Physical Examination Skills in Medical Students during Diagnostic Medicine Course in a University Hospital of Northwest China

    PubMed Central

    Li, Yan; Li, Na; Han, Qunying; He, Shuixiang; Bae, Ricard S.; Liu, Zhengwen; Lv, Yi; Shi, Bingyin

    2014-01-01

    This study was conducted to evaluate the performance of physical examination (PE) skills during our diagnostic medicine course and analyze the characteristics of the data collected to provide information for practical guidance to improve the quality of teaching. Seventy-two fourth-year medical students were enrolled in the study. All received an assessment of PE skills after receiving a 17-week formal training course and systematic teaching. Their performance was evaluated and recorded in detail using a checklist, which included 5 aspects of PE skills: examination techniques, communication and care skills, content items, appropriateness of examination sequence, and time taken. Error frequency and type were designated as the assessment parameters in the survey. The results showed that the distribution and the percentage in examination errors between male and female students and among the different body parts examined were significantly different (p<0.001). The average error frequency per student in females (0.875) was lower than in males (1.375) although the difference was not statistically significant (p = 0.167). The average error frequency per student in cardiac (1.267) and pulmonary (1.389) examinations was higher than in abdominal (0.867) and head, neck and nervous system examinations (0.917). Female students had a lower average error frequency than males in cardiac examinations (p = 0.041). Additionally, error in examination techniques was the highest type of error among the 5 aspects of PE skills irrespective of participant gender and assessment content (p<0.001). These data suggest that PE skills in cardiac and pulmonary examinations and examination techniques may be included in the main focus of improving the teaching of diagnostics in these medical students. PMID:25329685

  1. The Mediating Role of Resilience in the Relationship between Big Five Personality and Anxiety among Chinese Medical Students: A Cross-Sectional Study

    PubMed Central

    Shi, Meng; Liu, Li; Wang, Zi Yue; Wang, Lie

    2015-01-01

    Backgrounds The psychological distress of medical students is a major concern of public health worldwide. However, few studies have been conducted to evaluate anxiety symptoms of medical students in China. The purpose of this study was to investigate the anxiety symptoms among Chinese medical students, to examine the relationships between big five personality traits and anxiety symptoms among medical students, and to explore the mediating role of resilience in these relationships. Methods This multicenter cross-sectional study was conducted in June 2014. Self-reported questionnaires consisting of the Zung Self-Rating Anxiety Scale (SAS), Big Five Inventory (BFI), Wagnild and Young Resilience Scale (RS-14) and demographic section were distributed to the subjects. A stratified random cluster sampling method was used to select 2925 medical students (effective response rate: 83.57%) at four medical colleges and universities in Liaoning province, China. Asymptotic and resampling strategies were used to explore the mediating role of resilience. Results The prevalence of anxiety symptoms was 47.3% (SAS index score≥50) among Chinese medical students. After adjusting for the demographic factors, the traits of agreeableness, conscientiousness and openness were all negatively associated with anxiety whereas neuroticism was positively associated with it. Resilience functioned as a mediator in the relationships between agreeableness/conscientiousness/openness and anxiety symptoms. Conclusions Among Chinese medical students, the prevalence of anxiety symptoms was high and resilience mediated the relationships between big five personality traits and anxiety symptoms. Identifying at-risk individuals and undertaking appropriate intervention strategies that focus on both personality traits and resilience might be more effective to prevent and reduce anxiety symptoms. PMID:25794003

  2. Delay, change and bifurcation of the immunofluorescence distribution attractors in health statuses diagnostics and in medical treatment

    NASA Astrophysics Data System (ADS)

    Galich, Nikolay E.; Filatov, Michael V.

    2008-07-01

    Communication contains the description of the immunology experiments and the experimental data treatment. New nonlinear methods of immunofluorescence statistical analysis of peripheral blood neutrophils have been developed. We used technology of respiratory burst reaction of DNA fluorescence in the neutrophils cells nuclei due to oxidative activity. The histograms of photon count statistics the radiant neutrophils populations' in flow cytometry experiments are considered. Distributions of the fluorescence flashes frequency as functions of the fluorescence intensity are analyzed. Statistic peculiarities of histograms set for healthy and unhealthy donors allow dividing all histograms on the three classes. The classification is based on three different types of smoothing and long-range scale averaged immunofluorescence distributions and their bifurcation. Heterogeneity peculiarities of long-range scale immunofluorescence distributions allow dividing all histograms on three groups. First histograms group belongs to healthy donors. Two other groups belong to donors with autoimmune and inflammatory diseases. Some of the illnesses are not diagnosed by standards biochemical methods. Medical standards and statistical data of the immunofluorescence histograms for identifications of health and illnesses are interconnected. Possibilities and alterations of immunofluorescence statistics in registration, diagnostics and monitoring of different diseases in various medical treatments have been demonstrated. Health or illness criteria are connected with statistics features of immunofluorescence histograms. Neutrophils populations' fluorescence presents the sensitive clear indicator of health status.

  3. Verification of in vitro medical diagnostics (IVD) metrological traceability: responsibilities and strategies.

    PubMed

    Braga, Federica; Panteghini, Mauro

    2014-05-15

    To be accurate and equivalent, laboratory results should be traceable to higher-order references. Furthermore, their analytical performance should fulfill acceptable measurement uncertainty criteria defined to fit the intended clinical use. With this aim, In Vitro Diagnostics (IVD) manufacturers should define a calibration hierarchy to assign traceable values to their system calibrators and to fulfill during this process uncertainty limits for calibrators, which should represent a proportion of the uncertainty budget allowed for laboratory results. It is important that end-users may know and verify how manufacturers have implemented the traceability of their calibrators and estimated the corresponding uncertainty. However, full information about traceability and combined uncertainty of calibrators is currently not available. Important tools for IVD traceability surveillance are the verification by laboratories of the consistency of declared performance during daily operations performed in accordance with the manufacturer's instructions and the organization of appropriately structured External Quality Assessment (EQA) programs. The former activity should be accomplished by analyzing system control materials and confirming that current measurements are in the manufacturer's established control range. With regard to EQA, it is mandatory that target values for materials are assigned with reference procedures by accredited laboratories, that materials are commutable and that a clinically allowable inaccuracy for participant's results is defined. PMID:24291059

  4. Building a diagnostic algorithm on localized neuropathic pain (LNP) and targeted topical treatment: focus on 5% lidocaine-medicated plaster

    PubMed Central

    Casale, Roberto; Mattia, Consalvo

    2014-01-01

    Within the broad definition of neuropathic pain, the refinement of clinical diagnostic procedures has led to the introduction of the concept of localized neuropathic pain (LNP). It is characterized by consistent and circumscribed area(s) of maximum pain, which are associated with negative or positive sensory signs and/or spontaneous symptoms typical of neuropathic pain. This description outlines the clinical features (currently lacking in guidelines and treatment recommendations) in patients for whom topical targeted treatment with 5% lidocaine-medicated plaster is suggested as first-line therapy. Few epidemiologic data are present in the literature but it is generally estimated that about 60% of neuropathic pain conditions are localized, and therefore identifiable as LNP. A mandatory clinical criterion for the diagnosis of LNP is that signs and symptoms must be present in a clearly identified and defined area(s). Cartographic recordings can help to define each area and to assess variations. The diagnosis of LNP relies on careful neurological examination more than on pain questionnaires, but it is recognized that they can be extremely useful for recording the symptom profiles and establishing a more targeted treatment. The most widely studied frequent/relevant clinical presentations of LNP are postherpetic neuralgia, diabetic neuropathy, and neuropathic postoperative pain. They successfully respond to treatment with 5% lidocaine-medicated plaster with equal if not better pain control but with fewer side effects versus conventional systemic treatments. Generally, the more localized the pain (ie, the area of an A4 sheet of paper) the better the results of topical treatment. This paper proposes an easy-to-understand algorithm to identify patients with LNP and to guide targeted topical treatments with 5% lidocaine medicated plaster. PMID:24790451

  5. [Forensic medical diagnostics of intoxication with certain poisonous mushrooms in the case of the lethal outcome in a hospital].

    PubMed

    Zaraf'aynts, G N

    2016-01-01

    The present study was undertaken with a view to improving forensic medical diagnostics of intoxication with poisonous mushrooms in the cases of patients' death in a hospital. A total of 15 protocols of forensic medical examination of the corpses of the people who had died from acute poisoning were available for the analysis. The deathly toxins were amanitin and muscarine contained in various combinations in the death cap (Amanita phalloides) and the early false morels (Gyromitra esculenta and G. gigas). The main poisoning season in the former case was May and in the latter case August and September (93.4%). The mortality rate in the case of group intoxication (such cases accounted for 40% of the total) amounted to 28.6%. 40% of the deceased subjects consumed mushrooms together with alcohol. The poisoning caused the development of either phalloidin- or gyromitrin-intoxication syndromes (after consumption of Amanita phalloides and Gyromitra esculenta respectively). It is emphasized that the forensic medical experts must substantiate the diagnosis of poisoning with mushroom toxins based on the results of the chemical-toxicological and/or forensic chemical investigations. The relevant materials taken from the victim or the corpse should be dispatched for analysis not only within the first day but also on days 2-4 after intoxication. The mycological and genetic analysis must include the detection and identification of mushroom microparticles and spores in the smears from the oral cavity, vomiting matter, wash water, gastric and intestinal contents. In addition, the macro- and microscopic morphological signs, clinical data (major syndromes, results of laboratory studies, methods of treatment) should be taken into consideration as well as the time (season) of mushroom gathering, simultaneous poisoning in a group of people, and other pertinent information. PMID:27030094

  6. Individualized medicine, health medicine, and constitutional theory in Chinese medicine.

    PubMed

    Wang, Qi

    2012-03-01

    The patterns of modern science and changes in the medical model can result in the transformation of the current state of individualized and health medicines into being the primary trend in medical development. Chinese and Western medical systems are dissimilar in terms of value orientations, thinking style, and research directions because of their different historical and cultural backgrounds. Individualized treatment in modern medicine is mainly established based on individual genome information and the differences in mononucleotide polymorphisms. However, such treatment method is expensive, creates an uncertain genetic marker, and leads to different result interpretations, among other problems. The Chinese constitutional theory developed in the 1970s expresses the principle behind Chinese health medicine and individual treatment and provides the corresponding methods. The Chinese constitutional theory divides the constitution of the Chinese population into nine categories based on established classification criteria. It promotes the study of the relationship of each constitution to diseases and Chinese medicine preparation toward adjusting the constitution and preventing diseases. The theory also provides methods and tools for individualized treatment. Constitution identification shows the direction and provides the core technology for the evaluation of the health status. By combining the developments in modern biotechnology, new diagnostic techniques and treatment models of constitution-differentiation, disease-differentiation, and syndrome-differentiation can be established for the development of individualized Chinese medicine treatment and health medicine for the international medical community. PMID:22460443

  7. Referral to and attitude towards traditional Chinese medicine amongst western medical doctors in postcolonial Hong Kong.

    PubMed

    Chung, Vincent C H; Hillier, Sheila; Lau, Chun Hong; Wong, Samuel Y S; Yeoh, Eng Kiong; Griffiths, Sian M

    2011-01-01

    Recognizing the international trend for patients to choose both allopathic western medicine (WM) and traditional, complementary and alternative medicine (TCAM), the World Health Organization has called for stronger collaboration between WM doctors (WMD) and TCAM practitioners. This resonates with the situation in Hong Kong where the dominant modality of patient care is primarily based on WM practice while traditional Chinese medicine (TCM) is often used as a complement. The roots of this utilization pattern lie in colonial history when TCM was marginalised during the British administration. However since 1997 when China regained sovereignty, policies to regulate and professionalize TCM practices have been formally introduced. Despite both its popularity and this policy shift, progress on implementing collaboration between WM and TCM clinicians has been slow. This study, the first since 1997, explores current attitudes and referral behaviours of WMD towards use of TCM. We hypothesised that WMD would have positive attitudes towards TCM, due to regulation and cultural affinity, but that few actual TCM referrals would be made given the lack of a formal collaboration policy between elements within the healthcare system. Our results support these hypotheses, and this pattern possibly rooted from structural inhibitions originating from the historical dominance of WM and failure of services to respond to espoused policy. These have shaped Hong Kong's TCAM policy process to be closer with situations in the West, and have clearly differentiated it from integration experiences in other East Asian health systems where recent colonial history is absent. In addition, our results revealed that self use and formal education of TCM, rather than use of evidence in decision making, played a stronger role in determining referral. This implies that effective TCAM policies within WM dominated health systems like Hong Kong would require structural and educational solutions that foster

  8. Automatic segmentation of medical images using image registration: diagnostic and simulation applications.

    PubMed

    Barber, D C; Hose, D R

    2005-01-01

    Automatic identification of the boundaries of significant structure (segmentation) within a medical image is an are of ongoing research. Various approaches have been proposed but only two methods have achieved widespread use: manual delineation of boundaries and segmentation using intensity values. In this paper we describe an approach based on image registration. A reference image is prepared and segmented, by hand or otherwise. A patient image is registered to the reference image and the mapping then applied to ther reference segmentation to map it back to the patient image. In general a high-resolution nonlinear mapping is required to achieve accurate segmentation. This paper describes an algorithm that can efficiently generate such mappings, and outlines the uses of this tool in two relevant applications. An important feature of the approach described in this paper is that the algorithm is independent of the segmentation problem being addresses. All knowledge about the problem at hand is contained in files of reference data. A secondary benefit is that the continuous three-dimensional mapping generated is well suited to the generation of patient-specific numerical models (e.g. finite element meshes) from the library models. Smoothness constraints in the morphing algorithm tend to maintain the geometric quality of the reference mesh. PMID:15804853

  9. Suicides and Medically Serious Attempters Are of the Same Population in Chinese Rural Young Adults1

    PubMed Central

    Zhang, Jie; Sun, Long; Conwell, Yeates; Qin, Ping; Jia, Cun-Xian; Xiao, Shuiyuan; Tu, Xin-Ming

    2015-01-01

    Background Suicide rates in China are among the highest in the world, although there has been a decreasing trend in the past few years. One practical approach to study the characteristics and risk factors of suicide is to interview the suicide attempters. Aims It was to compare completed suicides with serious attempters that may shed lights on suicide prevention strategies. Method This is a combination of two case control studies for suicide completers and suicide attempters respectively. After a sample of suicides (n=392) and community living controls (n=416) were obtained and studied in rural China, we collected in the same rural areas data of suicide attempt and studied 507 medically serious attempters and 503 community counterparts. Results Characteristics and previously observed risk factors were compared between the suicides and the attempters, and we found that the demographic characteristics and risk factors for the suicides were also for the medically serious attempters but at some lesser degrees for the attempters than for the suicides. It was especially true of suicide intent, deficient coping, negative life events, and impulsivity. While most of the demographic characteristics were not significantly different between the suicides and the attempters, most of the clinical variables could distinguish the two groups. Conclusions The suicide victims and the serious attempters could be of the same group of people who were at the edge of fatal self-injury, and the same clinical risk factors but of different degrees have divided them into the life and death groups. PMID:25723561

  10. Diagnostic Imaging

    MedlinePlus

    Diagnostic imaging lets doctors look inside your body for clues about a medical condition. A variety of machines and ... and activities inside your body. The type of imaging your doctor uses depends on your symptoms and ...