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Sample records for pathologic gerd diagnosed

  1. GERD

    MedlinePlus

    ... carries food from your mouth to your stomach. Gastroesophageal reflux disease (GERD) happens when a muscle at the end of ... more than twice a week, you may have GERD. You can also have GERD without having heartburn. ...

  2. Diagnostic work-up of GERD.

    PubMed

    Vela, Marcelo F

    2014-10-01

    Gastroesophageal reflux disease (GERD) is frequently diagnosed by symptoms and good response to acid suppression with proton pump inhibitors. Further work up is required when the diagnosis of GERD is uncertain, for alarm symptoms, PPI-refractoriness, and often for extraesophageal presentations. Useful tools include endoscopy for mucosal assessment and reflux monitoring (pH or impedance-pH) to quantify reflux burden. Objective documentation of pathological reflux is mandatory prior to anti-reflux surgery. In some patients, symptoms that can be attributed to GERD may have other causes; in these patients, testing that excludes GERD helps direct the diagnostic and treatment efforts to other causes. PMID:25216910

  3. Defining GERD.

    PubMed Central

    Sontag, S. J.

    1999-01-01

    "It is not the death of GERD that I seek, but that it turns from its evil ways and follows the path of righteousness." The reflux world is fully aware of what GERD is and what GERD does. What the world does not know, however, is the answer to the most important yet least asked question surrounding GERD's raison-d'etre: Why is GERD here and why do we have it? What GERD is: abnormal gastric reflux into the esophagus that causes any type of mischief. What GERD does: causes discomfort and/or pain with or without destroying the mucosa; causes stricture or stenosis, preventing food from being swallowed; sets the stage for the development of esophageal adenocarcinoma; invades the surrounding lands to harass the peaceful oropharyngeal, laryngeal and broncho-pulmonary territories; reminds us that we are not only human, but that we are dust and ashes. Why GERD is here: We propose three separate and distinct etiologies of GERD, and we offer the following three hypotheses to explain why, after 1.5 million years of standing erect, we have evolved into a species (specifically Homosapiens sapiens) that is destined to live with the scourge of GERD. Hypothesis 1: congenital. The antireflux barrier, comprising the smooth-muscled lower esophageal sphincter, the skeletal-muscled right crural diaphragm and the phreno-esophageal ligament does not completely develop due to a developmental anomaly or incomplete gestation. Hypothesis 2: acute trauma: The antireflux barrier in adults suffering acute traumatic injury to the abdomen or chest is permanently disrupted by unexpected forces, such as motor vehicle accidents (with steering wheel crush impact), blows to the abdomen (from activities such as boxing, etc.), heavy lifting or moving (e.g., pianos, refrigerators) or stress positions (e.g., hand stands on parallel gym bars). The trauma creates a hiatal hernia that renders the antireflux mechanism useless and incapable of preventing GERD. Hypothesis 3: chronic trauma: The antireflux barrier

  4. Barrett’s esophagus: Prevalence and risk factors in patients with chronic GERD in Upper Egypt

    PubMed Central

    Fouad, Yasser M; Makhlouf, Madiha M; Tawfik, Heba M; Amin, Hussein El; Ghany, Wael Abdel; El-khayat, Hisham R

    2009-01-01

    AIM: To determine the prevalence and possible risk factors of Barrett’s esophagus (BE) in patients with chronic gastroesophageal reflux disease (GERD) in El Minya and Assuit, Upper Egypt. METHODS: One thousand consecutive patients with chronic GERD symptoms were included in the study over 2 years. They were subjected to history taking including a questionnaire for GERD symptoms, clinical examination and upper digestive tract endoscopy. Endoscopic signs suggestive of columnar-lined esophagus (CLE) were defined as mucosal tongues or an upward shift of the squamocolumnar junction. BE was diagnosed by pathological examination when specialized intestinal metaplasia was detected histologically in suspected CLE. pH was monitored in 40 patients. RESULTS: BE was present in 7.3% of patients with chronic GERD symptoms, with a mean age of 48.3 ± 8.2 years, which was significantly higher than patients with GERD without BE (37.4 ± 13.6 years). Adenocarcinoma was detected in eight cases (0.8%), six of them in BE patients. There was no significant difference between patients with BE and GERD regarding sex, smoking, alcohol consumption or symptoms of GERD. Patients with BE had significantly longer esophageal acid exposure time in the supine position, measured by pH monitoring. CONCLUSION: The prevalence of BE in patients with GERD who were referred for endoscopy was 7.3%. BE seems to be associated with older age and more in patients with nocturnal gastroesophageal reflux. PMID:19630106

  5. Diagnosing and treating common oral pathologies.

    PubMed

    Dilley, D C; Siegel, M A; Budnick, S

    1991-10-01

    When the physician is confronted with an oral pathologic condition in a child, the adage "common things happen commonly" should be applied. Congenital lesions such as palatal and alveolar cysts occur in almost 50% of newborns. Developmental conditions such as Fordyce granules and retrocuspid papillae are found in most children. Localized soft-tissue enlargements commonly seen in young children include the parulis, mucocele, papilloma, and inflammatory gingival tumors. In addition, soft-tissue pathologies and discomfort associated with herpesvirus infections or recurrent aphthous ulcerations often present as a chief complaint. The physician's knowledge and treatment recommendations for common oral pathologies should be an integral component to the overall medical management of infants, children, and adolescents. PMID:1886744

  6. Spinocerebellar degeneration: Discrepancies between clinical and pathological diagnoses.

    PubMed

    Yamada, Mitsunori; Toyoshima, Yasuko; Makifuchi, Takao; Kakita, Akiyoshi; Takahashi, Hitoshi

    2016-08-01

    To improve the diagnostic accuracy of sporadic spinocerebellar degeneration (SCD), we assessed the clinical and pathological data of 1494 consecutive autopsy cases. The number of patients who received a diagnosis of sporadic SCD (including multiple system atrophy) either clinically or pathologically was 19 (1.3%). We identified six cases with clinical misdiagnoses of SCD that were confirmed pathologically as progressive supranuclear palsy (PSP, four cases), basilar artery thrombosis (one case) and unclassified tauopathy (one case). The total number of patients who received a clinical diagnosis of sporadic SCD was 93 and the positive predictive value was 93.5%. We also identified 13 autopsy cases that were pathologically confirmed as SCD, but had been clinically misdiagnosed as having other disorders. Their clinical diagnoses comprised progressive supranuclear palsy (five cases) and Parkinson's disease (PD, four cases), as well as parkinsonism with dementia, amyotrophic lateral sclerosis, paraneoplastic syndrome and multiple cerebral infarction (one case each). The results indicate that it is often difficult to distinguish PSP and PD from SCD, because of the atypical combination of symptoms or atypical timing of the appearance of symptoms, such as severe autonomic failure, cognitive impairment, poor L-dopa responsiveness, early cerebellar signs and obvious vertical gaze palsy. PMID:26556659

  7. Management of paediatric GERD.

    PubMed

    Vandenplas, Yvan

    2014-03-01

    Paediatric GERD is complicated to manage, as symptoms are diverse and often difficult to interpret. In infants, regurgitation is a common physiological condition. Nevertheless, when it occurs frequently (>4 times per day) and causes the infant distress, parents often seek medical help. In children 2-10 years of age, GERD is often considered to cause extra-oesophageal symptoms, despite the absence of hard evidence. Diagnostic investigations often lack solid validation and the signs and symptoms of GERD overlap with those of cow's milk protein allergy and eosinophillic oesophagitis. Reassurance, dietary treatment and positional adaptations are recommended for troublesome infant reflux. Anti-acid medication, mainly PPIs, is over-used in infants even though, in many children, reflux is not an acid-related condition. Moreover, evidence is increasing that PPIs cause adverse events such as gastroenteritis and respiratory tract infections. Management in children older than 10 years is similar to that in adults. Using prokinetics to treat nonerosive reflux disease remains only a promising theoretical concept, as no such molecule is currently available. Today, the adverse effects of each prokinetic molecule largely outweigh its potential benefit. Laparoscopic surgery is indicated in children who have life-threatening symptoms or in cases of drug dependence. PMID:24126561

  8. Integrated pathology reporting, indexing, and retrieval system using natural language diagnoses.

    PubMed

    Moore, G W; Boitnott, J K; Miller, R E; Eggleston, J C; Hutchins, G M

    1988-01-01

    Pathology computer systems are making increasing use of natural language diagnoses. The Johns Hopkins Medical Institutions integrated pathology reporting system, a commercial product with extensive, locally added enhancements, covers all information management functions within autopsy and surgical pathology divisions and has on-line linkages to clinical laboratory reports and the medical library's Mini-MEDLINE system. All diagnoses are written in natural language, using a word processor and spelling checker. A security system with personal passwords and different levels of access for different staff members allows reports to be signed out with an electronic signature. The system produces financial reports, overdue case reports, and Boolean searches of the database. Our experience with 128,790 consecutively entered pathology reports suggests that the greater precision of natural language diagnoses makes them the most suitable vehicle for follow-up, retrieval, and systems development functions in pathology. PMID:3070549

  9. Pediatric Acid Reflux and GERD in Teens

    MedlinePlus

    ... Print Share Reflux and GERD : Teen GERD Pediatric Acid Reflux and GERD in Teens If you’re ... And here’s the better news: Most kids with acid reflux are able to lead normal, active, healthy ...

  10. Have You Heard of GERD?

    MedlinePlus

    ... can be helpful for some people who have GERD. These work by lowering the amount of acid in the ... the stomach empty more quickly. If nothing else works, a person may need surgery to treat GERD, but this isn't done very often. How ...

  11. The potential of optical coherence tomography for diagnosing meniscal pathology

    NASA Astrophysics Data System (ADS)

    Hang-Yin Ling, Carrie; Pozzi, Antonio; Thieman, Kelley M.; Tonks, Catherine A.; Guo, Shuguang; Xie, Huikai; Horodyski, MaryBeth

    2010-04-01

    Meniscal tears are often associated with anterior cruciate ligament (ACL) injury and may lead to pain and discomfort in humans. Maximal preservation of meniscal tissue is highly desirable to mitigate the progression of osteoarthritis. Guidelines of which meniscal tears are amenable to repair and what part of damaged tissues should be removed are elusive and lacking consensus. Images of microstructural changes in meniscus would potentially guide the surgeons to manage the meniscal tears better, but the resolution of current diagnostic techniques is limited for this application. In this study, we demonstrated the feasibility of using optical coherence tomography (OCT) for the diagnosis of meniscal pathology. Torn medial menisci were collected from dogs with ACL insufficiency. The torn meniscus was divided into three tissue samples and scanned by OCT and scanning electron microscopy (SEM). OCT and SEM images of torn menisci were compared. Each sample was evaluated for gross and microstructural abnormalities and reduction or loss of birefringence from the OCT images. The abnormalities detected with OCT were described for each type of tear. OCT holds promise in non-destructive and fast assessment of microstructural changes and tissue birefringence of meniscal tears. Future development of intraoperative OCT may help surgeons in the decision making of meniscal treatment.

  12. Sixty-five thousand shades of gray: importance of color in surgical pathology diagnoses.

    PubMed

    Campbell, W Scott; Talmon, Geoffrey A; Foster, Kirk W; Lele, Subodh M; Kozel, Jessica A; West, William W

    2015-12-01

    Digital whole slide imaging (WSI) is a diagnostic modality that has gained acceptance as a tool for use in some areas of surgical pathology such as remote consultations. Accurate control of color representation of digitally rendered images of histologic sections is considered an important parameter of WSI. Currently, professional societies, physicians, and other stakeholders are in the process of establishing clinical guidelines outlining the use of these devices, which include color integrity and color calibration of scanners and viewing devices. Although color is a component of surgical pathology diagnoses, it was posited that pathologists could accurately diagnose surgical specimens without color. To test this hypothesis, 5 pathologists were presented breast biopsy specimens from 20 patients consisting of 22 separate tissue specimens and WSI of 158 hematoxylin and eosin-stained slides imaged at ×20. No special stains were included. The pathologists reviewed each case using a 16-bit grayscale monitor and rendered a diagnosis for each case. Diagnoses were compared to the original light microscopy diagnoses and scored for concordance. A 92.7% concordance was observed. Discordant diagnoses represented well-known areas of diagnostic disagreement in breast pathology as well as known limitations of WSI. The research demonstrated that surgical pathologists did not rely primarily on color to render accurate diagnoses of breast biopsy cases but rather used architectural features of tissue and cellular morphology to reach a diagnostic conclusion. This research did not suggest that color is an unimportant factor in pathology diagnosis, but its importance may be overstated. PMID:26482606

  13. Incidence of gastroesophageal reflux disease (GERD), active component, U.S. Armed Forces, 2005-2014.

    PubMed

    Daniele, Denise O; Oh, Gi-Taik; O'Donnell, Francis L; Clark, Leslie L

    2015-07-01

    Gastroesophageal reflux disease (GERD) is a common condition among adults that can cause symptoms such as frequent heartburn, substernal chest pain, and regurgitation of food. During 2005-2014, a total of 137,081 active component service members had an incident (first-ever) diagnosis of GERD (incidence rate: 101.3 per 10,000 person-years). Incidence rates were higher than their respective counterparts among females, black and white non-Hispanics, service members in the Coast Guard and Air Force, officers, and those in healthcare occupations. Rates increased monotonically with increasing age groups. Most GERD cases (79.2%) were uncomplicated GERD; however, 20.8% were identified as having a symptom or complication linked to their GERD diagnosis. Lifestyle changes, medication, and prevention of serious complications should be emphasized among individuals diagnosed with GERD, particularly those at risk for severe disease. PMID:26207411

  14. Emerging therapeutic options in GERD.

    PubMed

    Woodland, Philip; Amarasinghe, Gehanjali; Sifrim, Daniel

    2013-06-01

    Gastroesophageal reflux disease (GERD) is a prevalent problem resulting in a high level of healthcare consultation and expenditure in the Western World. Although standard medical therapy (in the form of proton pump inhibitor drugs) is effective in the majority of cases, there remains a significant proportion who are refractory to treatment. In addition, surgical therapy (in the form of laparoscopic fundoplication) is not always effective, and in some can be associated with significant side-effects, particularly gas-bloat, flatulence and dysphagia. As such there remains an unmet need in GERD to develop new therapies for refractory cases, and to develop alternatives to fundoplication with fewer side-effects. This article discusses the current state of pharmacological and non-pharmacological emerging therapies for GERD. PMID:23998982

  15. Neuropsychiatric symptom profile differs based on pathology in patients with clinically diagnosed behavioral variant frontotemporal dementia

    PubMed Central

    Léger, Gabriel C; Banks, Sarah J

    2014-01-01

    Background/Aims Behavioral variant frontotemporal dementia (bvFTD) is pathologically heterogeneous. With emerging therapeutics, determining underlying pathology during life is increasingly important. Neuropsychiatric symptoms are prevalent and diagnostic in bvFTD. Methods We assessed the neuropsychiatric profile in patients with clinically diagnosed bvFTD as a function of pathology at autopsy. Patients with a clinical diagnosis of bvFTD at initial visit were selected from the National Alzheimer's Coordinating Center database. Neuropsychiatric symptoms endorsed on the Neuropsychiatric Inventory Questionnaire were analyzed. Results Of 149 patients with clinically diagnosed bvFTD, pathology was primarily Alzheimer's disease in 20.5%. These patients differed from those with underlying frontotemporal lobar degeneration: patients with AD pathology (plaques and tangles) were more likely to have hallucinations, delusions, or agitation. Patients were further differentiated into tau positive (30 % of cases, including Pick's disease, frontotemporal dementia and parkinsonism with tau-positive, and other tauopathies) or tau-negative (70% of cases including bvFTD tau-negative ubiquitin-positive inclusions). These patients also differed in some of the neuropsychiatric symptoms seen. Tau-negative cases were more likely to demonstrate depression, delusions, and changes in appetite and eating. Conclusions These preliminary findings contribute to our increasing ability to predict, using simple clinical tools the neuropathological underpinnings of bvFTD during life. PMID:24135712

  16. The Use of Visual Arts as a Window to Diagnosing Medical Pathologies.

    PubMed

    Bramstedt, Katrina A

    2016-01-01

    Observation is a key step preceding diagnosis, prognostication, and treatment. Careful patient observation is a skill that is learned but rarely explicitly taught. Furthermore, proper clinical observation requires more than a glance; it requires attention to detail. In medical school, the art of learning to look can be taught using the medical humanities and especially visual arts such as paintings and film. Research shows that such training improves not only observation skills but also teamwork, listening skills, and reflective and analytical thinking. Overall, the use of visual arts in medical school curricula can build visual literacy: the capacity to identify and analyze facial features, emotions, and general bodily presentations, including contextual features such as clothing, hair, and body art. With the ability to formulate and convey a detailed "picture" of the patient, clinicians can integrate aesthetic and clinical knowledge, helping facilitate the diagnosing of medical pathologies. PMID:27550570

  17. Management of refractory typical GERD symptoms.

    PubMed

    Scarpellini, Emidio; Ang, Daphne; Pauwels, Ans; De Santis, Adriano; Vanuytsel, Tim; Tack, Jan

    2016-05-01

    The management of patients with refractory GERD (rGERD) is a major clinical challenge for gastroenterologists. In up to 30% of patients with typical GERD symptoms (heartburn and/or regurgitation), acid-suppressive therapy does not provide clinical benefit. In this Review, we discuss the current management algorithm for GERD and the features and management of patients who do not respond to treatment (such as those individuals with an incorrect diagnosis of GERD, inadequate PPI intake, persisting acid reflux and persisting weakly acidic reflux). Symptom response to existing surgical techniques, novel antireflux procedures, and the value of add-on medical therapies (including prokinetics and reflux inhibitors) for rGERD symptoms are discussed. Pharmaceutical agents targeting oesophageal sensitivity, a condition that can contribute to symptom generation in rGERD, are also discussed. Finally, on the basis of available published data and our expert opinion, we present an outline of a current, usable algorithm for management of patients with rGERD that considers the timing and diagnostic use of pH-impedance monitoring on or off PPI, additional diagnostic tests, the clinical use of baclofen and the use of add-on neuromodulators (tricyclic agents and selective serotonin reuptake inhibitors). PMID:27075264

  18. Secondary malignancies diagnosed using kidney needle core biopsies: a clinical and pathological study of 75 cases.

    PubMed

    Huang, He; Tamboli, Pheroze; Karam, Jose A; Vikram, Raghu; Zhang, Miao

    2016-06-01

    Involvement of the kidney by secondary malignancies is uncommon. Differentiating secondary malignancies from primary kidney/urothelial tumors can be challenging, especially on limited biopsy material. A retrospective search of our institutional archive from January 2002 to May 2015 identified 1572 cases of imaging-guided needle core biopsies of the kidney. Of these, 75 (5%) cases revealed a secondary malignancy; 48 (64%) patients had undergone the biopsy with a primary kidney tumor favored clinically. There were 39 male and 36 female patients with a mean age of 59.4 years (range, 21-83 years). The majority of the cases (n = 55, 73%) were metastases from solid tumors, with lung being the most common primary site (n = 22, 29%). Diffuse large B-cell lymphoma was the most common hematological malignancy (n = 6) secondarily involving the kidney. Radiographically, 58 (77%) cases presented as a solitary kidney mass. The primary malignancy was known prior to the kidney biopsy in 66 (88%) cases. The mean interval between diagnoses of the primary tumor and secondary involvement of the kidney was 4.5 years. Immunohistochemical stains were performed in 65 (87%) cases. Follow-up information was available for 73 patients; mean survival was 19.4 months, with 43 patients dead of their disease (mean, 12 months) and 30 patients alive at last follow-up (21 with and 9 without disease; mean, 30 months). Secondary malignancy in the kidney may clinically and pathologically mimic primary kidney tumors. Accurate diagnosis can be rendered by correlating pathological features with clinical and radiographic findings and judicious use of ancillary studies. PMID:26980018

  19. GERD (Gastroesophageal Reflux) and LPR (Laryngopharyngeal Reflux)

    MedlinePlus

    ... throat, it causes a reaction similar to squirting lemon juice in your eye. This is why GERD ... of the stomach. Lifestyle factors include diet (chocolate, citrus, fatty foods, spices), destructive habits (overeating, alcohol and ...

  20. Laparoscopic Anti-Reflux (GERD) Surgery

    MedlinePlus

    ... Opportunities Sponsorship Opportunities Login Laparoscopic Anti-Reflux (GERD) Surgery Patient Information from SAGES Print PDF Find a SAGES Surgeon Surgery for “Heartburn” If you suffer from moderate to ...

  1. Critical diagnoses in surgical pathology: a retrospective single-institution study to monitor guidelines for communication of urgent results.

    PubMed

    Huang, Eric C; Kuo, Frank C; Fletcher, Christopher D M; Nosé, Vânia

    2009-07-01

    Recent attention has shifted toward defining critical values in surgical pathology, as used in clinical pathology for urgent laboratory results, which require immediate physician notification. The Association of Directors of Anatomic and Surgical Pathology recently proposed a schema for critical values in surgical pathology, better defined as critical diagnoses (CDs). To this end, our department established guidelines defining the timely communication and documentation of urgent findings. To monitor policy effectiveness and to refine a customized list of CDs, we analyzed reports over two identical 6-month periods in 2006 and 2007 for the proper documentation and communication of urgent results. Of all the general surgical pathology cases examined, slightly more than 3% were communicated urgently to the requesting physicians. Approximately 20% of those cases fell into one of the recently proposed CD categories, whereas the remaining cases had conditions that were not specified by the Association of Directors of Anatomic and Surgical Pathology, but nonetheless justified immediate notification based on local practice, such as graft-versus-host disease, acute tubulo-interstitial nephritis, and unsuspected amyloidosis. Consecutive cases from a 4-day period reviewed in 2006 showed that 23.5% notified cases were not properly documented in the final report. However, the compliance rate improved to 100% for a similar period in 2007. Our study demonstrates the need for any CD list to be customized at a given institution to address all the potential diagnoses necessary for patient care and management. It further shows that continuous monitoring and education with regard to CDs and timely communication and documentation of unexpected surgical pathology findings are important measures for optimizing patient safety. PMID:19390422

  2. GERD is becoming a challenge for the medical profession: is there any remedy?

    PubMed

    Yasawy, Mohammad Ismail; Randhawa, Mohammad Akram

    2014-09-01

    Gastroesophageal reflux disease is becoming a common and serious problem. Proton pump inhibitors are considered as drugs of choice however, long term use leads to complications. Transient lower esophageal sphincter relaxation inhibitors, i.e., gamma-aminobutyric acid B receptor agonists, baclofen, and metabotropic glutamate receptor 5 antagonists, ADX10059, were tried in resistant cases, but caused central nervous and hepatic side effects, respectively. Irregular dietary habits possess the strongest association with GERD, because intake of food in between meals aggravates gastric distention in upper stomach and generates TLESRs, triggering reflux. During fasting, migrating myoelectrical complex clears stomach of food. Considering relationship between irregular dietary habits and GERD pathophysiology, it is suggested that two regular meals a day with only fluids in between will reduce reflux and lead to healing of inflammation caused by repeated refluxes. Initially, the suggested regimen eliminated symptoms of GERD in 4 cases in 10 days. Later, in a pilot study on 20 patients of endoscopically diagnosed GERD, it benefitted 15 cases; 100% of Los Angles grade ‘a’, 66% of grade ‘b’ and 33% of grade ‘c’. Long term studies are proposed to confirm usefulness of this dietary regimen for management of GERD, alone and in combination with drugs. PMID:25436353

  3. A case of advanced systemic sclerosis with severe GERD successfully treated with acotiamide.

    PubMed

    Kato, Ryo; Nakajima, Kiyokazu; Takahashi, Tsuyoshi; Miyazaki, Yasuhiro; Makino, Tomoki; Kurokawa, Yukinori; Yamasaki, Makoto; Takiguchi, Shuji; Mori, Masaki; Doki, Yuichiro

    2016-12-01

    The majority of systemic sclerosis (SSc) patients have gastrointestinal tract involvement, but therapies of prokinetic agents are usually unsatisfactory. Patients are often compromised by the use of steroid; therefore, a surgical indication including fundoplication has been controversial. There is no report that advanced SSc with severe gastroesophageal reflux disease (GERD) is successfully treated with acotiamide, which is the acetylcholinesterase (AChE) inhibitor designed for functional dyspepsia (FD). We report a 44-year-old woman of SSc with severe GERD successfully treated with acotiamide. She had received medical treatment in our hospital since 2003. She had been aware of the significant gastroesophageal reflux symptoms (e.g., heartburn, chest pain, and dysphagia) due to the development of esophageal hardening associated with SSc since 2014. As a result of upper gastrointestinal series, upper gastrointestinal endoscopy, and 24-h pH monitoring and frequency scale for the symptoms of the GERD (FSSG) scoring, she has been diagnosed with GERD associated with SSc. First of all, she started to take prokinetic agents Rikkunshito and mosapride and proton pump inhibitor; there was no change in reflux symptoms. So, we started to prescribe her the acotiamide.After oral administration started, reflux symptoms have been improved. Five months after oral administration, FSSG score, a questionnaire for evaluation of the symptoms of GERD, was improved. Since its introduction of acotiamide, the patient has kept free from symptoms for 6 months. PMID:27072944

  4. GERD, Barrett's Esophagus and the Risk for Esophageal Cancer

    MedlinePlus

    ... Facts About Common Colon Cancer Screening Tests PATIENTS GERD, Barrett's Esophagus and the Risk for Esophageal Cancer ... commonly in Caucasians as well as people with gastroesophageal reflux disease (GERD). This cancer is increasing in frequency. ...

  5. Method for detecting and diagnosing disease caused by pathological protein aggregation

    DOEpatents

    Stevens, Fred J.; Myatt, Elizabeth A.; Solomon, Alan

    2000-01-01

    A method is provided for detecting pathological macromolecules in a patient, comprising obtaining body fluid from the patient, pretreating the body fluid, subjecting the pretreated body fluid to size-exclusion chromatography to create an excluded fluid, and analyzing the excluded fluid to detect macromolecules having a predetermined molecular weight. The method also allows for comparing elution spectra with reference spectra of suspect pathologic proteins.

  6. Method for detecting and diagnosing disease caused by pathological protein aggregation

    SciTech Connect

    Stevens, F.J.

    1994-12-31

    A method is provided for detecting pathological macromolecules in a patient, comprising obtaining body fluid from the patient, pretreating the body fluid, subjecting the pretreated body fluid to size-exclusion chromatography to create an excluded fluid, and analyzing the excluded fluid to detect macromolecules having a predetermined molecular weight. The method also allows for comparing elution spectra with reference spectra of suspect pathologic proteins.

  7. Pharmacological management of GERD: where does it stand now?

    PubMed

    Hershcovici, Tiberiu; Fass, Ronnie

    2011-04-01

    Gastroesophageal reflux disease (GERD) is very common and advances in drug development over recent years have markedly improved GERD management. A wide range of medications are currently used in GERD treatment, including antacids, Gaviscon, sucralfate, histamine-2 receptor antagonists and prokinetics. However, proton pump inhibitors (PPIs) remain the mainstay of treatment for GERD owing to their profound and consistent inhibitory effect on acid secretion. Despite the presence of a wide armamentarium of therapeutic modalities for GERD, many areas of unmet needs remain. Drug development has focused primarily on improving PPI efficacy, reducing the transient lower esophageal sphincter relaxation rate, attenuating esophageal sensitivity and developing esophageal mucosal protectants. PMID:21429600

  8. Capabilities of OCT in diagnosing pathological processes, functional states, and treatment adequacy in gynecology

    NASA Astrophysics Data System (ADS)

    Shakhova, Natalia M.; Kachalina, Tatiana S.; Kuznetzova, Irina N.; Chumakov, Yuri; Feldchtein, Felix I.; Gelikonov, Valentin M.; Gelikonov, Grigory V.; Gladkova, Natalia D.; Kamensky, Vladislav A.; Kuranov, Roman V.; Sergeev, Alexander M.

    1999-01-01

    We report on the results of using the optical coherence tomography (OCT) as one of the diagnostic methods at the Department of Gynecology of the Nizhny Novgorod Regional Hospital. An endoscopic OCT device adjusted for gynecological examinations with colposcopy, hysteroscopy and laparoscopy has been developed at the Institute of Applied Physics. It provides clinicians with sharp (up to 15 - 20 micron resolution) images of 1.5 mm thick superficial mucosa layers in the female genital tract, that are recorded at the 0.83 micron wavelength with approximately 1 frame/second rate for a 200 X 200 pixel image. Data obtained during examination of more than 100 patients demonstrate the capability of OCT in estimation of structural alterations in organs, connected with different types of pathologies and functional states of the female genital system. We present first results of OCT application to assess the adequacy of cervical pathologies treatment (electro-, laser surgery and cryotherapy) and to control the healing process.

  9. Newly Diagnosed?

    MedlinePlus

    ... Suggestions Examine Your Skin Newly Diagnosed? Understanding Your Pathology Biopsy: The First Step Sentinel Node Biopsy Melanoma ... start this journey: Get a copy of your pathology report. We can help you understand the report ...

  10. [The experience of usage of alginate contain medication in complex therapy at children with GERD disease].

    PubMed

    Shcherbakov, P L; Lobanov, Iu F; Fugol, D S; Shilova, A V

    2009-01-01

    GERD Therapy at children is complicated task because of Physiological features of a children's body, which reflects on the processes of acid production, motility in upper gastro-intestinal tract and on the metabolism of pharmaceutical products. Some of these medications have age usage limitations due to lack of investigation of side effects in treatment of children. Usage of alginate contain medication in complex therapy of such pathological condition brings to not only fast and effective relief of such symptoms as heartburn, eructation and in positive endoscopy dynamics. PMID:20201310

  11. Distinguishing GERD from eosinophilic oesophagitis: concepts and controversies

    PubMed Central

    2016-01-01

    Over the past three decades, the detection of oesophageal mucosal eosinophils has transitioned from a biomarker of GERD to a diagnostic criterion for eosinophilic oesophagitis (EoE). In GERD, oesophageal eosinophils are considered part of the chronic inflammatory response to acid reflux, whereas the marked eosinophilia in EoE is viewed as a central feature of the immune response to ingested food and/or environmental antigen stimulation. Descriptions of a considerable subset of patients with symptomatic, endoscopic and histological findings of EoE that resolve with PPI therapy has led to confusion and controversy regarding the distinction of EoE from GERD. Study findings indicate that PPI-responsive oesophageal eosinophilia (PPI-REE) more closely resembles EoE than GERD, both from a clinical and immunological aspect. Although responsiveness to PPI therapy should not be utilized to exclude EoE, PPI therapy is effective at reducing oesophageal eosinophilia in ~40% of patients, and PPI therapy is both a safe and practical initial step in the management of patients with oesophageal eosinophilia. Ongoing studies elucidating the mechanism behind PPI-REE will improve our understanding and management of EoE. In this Review, the mechanisms and evidence that underlie the controversy in the distinction between GERD and EoE are evaluated. PMID:25986303

  12. Diagnostic testing in extraesophageal GERD: another case of "furor medicus"?

    PubMed

    Spiegel, Brennan

    2013-06-01

    Proton pump inhibitors (PPIs) work for most patients with gastroesophageal reflux disease (GERD). But when PPIs fail to work, or when there are atypical extra-esophageal symptoms, diagnostic and management decisions become much more difficult. Although atypical GERD is common, there are limited data about how best to approach these patients. The temptation is often to perform extensive diagnostic testing, sometimes to little avail. In this issue of The Journal, Francis et al. present a new study to help close the research gap in understanding the costs and benefits of testing in atypical GERD. The authors conclude that diagnostic testing is very expensive and real-life benefits are modest. This editorial reviews the findings, places them into clinical perspective, and concludes that diagnostic testing in atypical GERD may be another example of "furor medicus" - an old but descriptive term referring to the instinct of doctors to implore "don't just stand there, do something!" The data from Francis et al. suggest we might do the opposite in atypical GERD: "Don't just do something, stand there." PMID:23735914

  13. [Medical data in pathology--evaluation of a large collection. (530,000 diagnoses coded in SNOMED II)].

    PubMed

    Baumann, R P

    1999-10-01

    The paper is describing the design and the performance of the computerized system, from its introduction in 1982 until the present day. The first device, using the MUMPS language on a mini-computer, followed by a VAX computer with terminals have been replaced in 1996 by an application program, using ORACLE, based on the client-server concept. The content and the particularities of the different data groups are discussed, concerning the functional components of the data bank: 'PATIENTS', 'SPECIMEN', 'SENDERS', 'REPORT' and 'DIAGNOSES'. By means of examples, we demonstrate the chronological evolution of the registration of persons, the distribution of the diagnoses according to the organ systems, the possibilities to combine various lesions and an algorithm to assure that a given lesion is registered only once per patient. In first place, the efficiency and the reliability of manual coding by a pathologist using the Systematized Nomenclature of Medicine (SNOMED; 2nd edition [1979/1982]) is discussed. The data bank currently contains 530,000 diagnoses, distributed among on SNOMED's five main modules, obtained from 1500 autopsies, 140,000 surgical and 180,000 cytological specimens. Concluding the article, an analysis is made of desirable developments in the future with the aim of a better integration of the acquired information in routine work and an enhanced use of the medical content for epidemiological research or statistical analysis. PMID:10582493

  14. The spectrum of changes in adults with multifocal pulmonary neuroendocrine proliferations: what is the minimum set of pathologic criteria to diagnose DIPNECH?

    PubMed

    Marchevsky, Alberto M; Wirtschafter, Eric; Walts, Ann E

    2015-02-01

    Diffuse idiopathic neuroendocrine cell hyperplasia (DIPNECH) can be difficult to diagnose in resections for lung tumors and other conditions, as variable diagnostic criteria and definitions of "diffuse" and/or "idiopathic" have been used in the literature. We reviewed 70 consecutive lung wedge biopsies and resection specimens with multifocal neuroendocrine cell proliferations (NEP) including neuroendocrine cell hyperplasia (NECH) and/or carcinoid tumorlets to identify pathologic findings significantly associated with neuroendocrine neoplasms. The presence of pathologic changes other than NEP (eg, interstitial fibrosis, bronchiectasis, others) and the number of tumorlets were recorded to identify "idiopathic NEP." Cases were classified into 4 groups: A: NECH only, B: >1 tumorlet without NECH, C: NECH + 2 tumorlets, and D: NECH + >2 tumorlets. Proportions of neuroendocrine neoplasms and presence/absence of pathologic changes other than NEP were compared by group with χ(2) statistics. Carcinoids were seen in 8 (22.8%) of 35 and in 21 (72.4%) of 29 groups B and D cases, respectively. Of the 21 group D carcinoids, 18 (85.7%) lacked other associated pathologic changes, and the incidence of these tumors in this group was significantly higher (P < .001) than in group B. Three high-grade neuroendocrine carcinomas were seen, 1 each in groups A to C. Because group D cases had a significantly higher proportion of carcinoid tumors and a significant lack of association with conditions that could result in secondary NECH, the presence of multifocal NECH combined with 3 or more carcinoid tumorlets is proposed as minimum pathologic criteria for the diagnosis of DIPNECH. PMID:25532694

  15. A 5-Year Retrospective Review of Avian Diseases Diagnosed at the Department of Pathology, University of Georgia.

    PubMed

    Nemeth, N M; Gonzalez-Astudillo, V; Oesterle, P T; Howerth, E W

    2016-01-01

    Avian samples (n = 827) submitted to the University of Georgia from 2006 to 2011 were reviewed to determine common disease entities and taxa-specific patterns. The study included 153 species, with 64.5% Psittaciformes, 11.3% Passeriformes, 7.9% Galliformes, 3.8% Columbiformes and 3.5% Anseriformes. Infectious agents were identified in 226 birds (27.3%); bacterial infections (n = 119; 14.4%) were most commonly gram-negative bacilli and Chlamydia psittaci and less commonly Mycoplasma and Mycobacterium spp. Mycotic infections (e.g. Aspergillus spp., Candida spp.) were identified in 66 birds (7.9%), followed by viruses in 30 birds (3.6%), most commonly polyomavirus and poxviruses. Eighteen birds had macroparasite infections, which were most common in Galliformes and most often involved gastrointestinal Capillaria spp. Neoplasia was diagnosed in 76 birds (9.2%) of 25 species, with 79% of the tumours deemed to be malignant. The most common neoplasm was lymphoma (n = 17; 22.4%), which was diagnosed in Psittaciformes, Galliformes and Passeriformes. Adenocarcinoma (n = 9) was found most frequently in the reproductive and gastrointestinal tracts. Haematopoietic neoplasms included myelocytoma and erythroid leucosis. Atherosclerosis was most common in psittacines (23/32; 71.8%) and in raptors and aquatic birds. Seventeen birds, mostly psittacines and aquatic birds, had amyloidosis, most often in the liver, kidney and spleen. Twenty-two birds had gout, most commonly the visceral form. Overall, bacterial infection was the most frequently diagnosed cause of death in captive birds, most commonly in Psittaciformes, followed by Passeriformes and Galliformes. Neoplasia was most common in Psittaciformes, which generally are longer lived than other taxa studied. Some disease entities (e.g. atherosclerosis and aspergillosis) may be associated with captive conditions, and some may involve a genetic predisposition (e.g. atherosclerosis, amyloidosis and haemosiderosis). PMID

  16. In GERD patients, mucosal repair associated genes are upregulated in non-inflamed oesophageal epithelium

    PubMed Central

    De Vries, D R; Ter Linde, J J M; Van Herwaarden, M A; Schwartz, M P; Shephard, P; Geng, M M; Smout, A J P M; Samsom, M

    2009-01-01

    Abstract Previous studies addressing the effects of acid reflux and PPI therapy on gene expression in oesophageal epithelium concentrated on inflamed tissue. We aimed to determine changes in gene expression in non-inflamed oesophageal epithelium of GERD patients. Therefore, we included 20 GERD patients with pathological total 24-hr acid exposure of 6–12% and SAP ≥ 95%. Ten patients discontinued PPI treatment (PPI-), 10 took pantoprazole 40 mg bid (PPI+). Ten age/sex-matched healthy controls were recruited. Biopsies were taken from non-inflamed mucosa 6 cm and 16 cm proximal to the squamocolumnar junction (SCJ). Gene expression profiling of biopsies from 6 cm was performed on Human Genome U133 Plus 2.0 arrays (Affymetrix). Genes exhibiting a fold change >1.4 (t-test P-value < 1E– 4) were considered differentially expressed. Results were confirmed by real-time RT-PCR. In PPI- patients, 92 microarray probesets were deregulated. The majority of the corresponding genes were associated with cell–cell contacts, cytoskeletal reorganization and cellular motility, suggesting facilitation of a migratory phenotype. Genes encoding proteins with anti-apoptotic or anti-proliferative functions or stress-protective functions were also deregulated. No probesets were deregulated in PPI+ patients. QPCR analysis of 20 selected genes confirmed most of the deregulations in PPI- patients, and showed several deregulated genes in PPI+ patients as well. In the biopsies taken at 16 cm QPCR revealed no deregulations of the selected genes. We conclude that upon acid exposure, oesophageal epithelial cells activate a process globally known as epithelial restitution: up-regulation of anti-apoptotic, anti-oxidant and migration associated genes. Possibly this process helps maintaining barrier function. PMID:19413890

  17. [Analysis of a series of 44 cases of peritoneal tuberculosis diagnosed in the pathology laboratory of the Tokoin teaching hospital of Lomé (1993-2014)].

    PubMed

    Darré, T; Tchaou, M; Sonhaye, L; Patassi, A A; Kanassoua, K; Tchangai, B; Amegbor, K; Napo-Koura, G

    2015-12-01

    It is a descriptive and cross-sectional study on all issues relating to peritoneal tuberculosis histological diagnosed in the pathology department (LAP) of the Lomé Tokoin CHU from January 1993 to December 2014 (20 years). A total of 44 cases of peritoneal tuberculosis were included. They were 18 women and 26 men, with a mean age of 37.6±0.2 years. The circumstances of discovery were dominated by ascites (84.1%), fever (75%), weight loss (63.6%) and abdominal pain (59.1%). The peritoneal involvement was isolated in 31.8% of cases, and associated with pleuropulmonary tuberculosis in 54.5% of cases. Co-infection with HIV was present in 63.9% of cases. Twenty-five patients (69.4%) with information about their social conditions had low socioeconomic level: unemployed (10 cases; 40%), workers (10 cases; 40%) and retired (5 cases; 20%). An increase in cell count was observed in 94.6% of cases. Histology revealed the epithelial giant cell granuloma associated with caseous necrosis in 38 cases (86.4%) and cheesy isolated in 6 patients. Peritoneal tuberculosis is not exceptional in our country. The diagnosis should be considered in febrile ascites, and will be confirmed by laparoscopy with histological samples for a histological diagnosis. PMID:26608272

  18. Analysis of C9orf72 repeat expansions in a large series of clinically and pathologically diagnosed cases with atypical parkinsonism.

    PubMed

    Schottlaender, Lucia V; Polke, James M; Ling, Helen; MacDoanld, Nicola D; Tucci, Arianna; Nanji, Tina; Pittman, Alan; de Silva, Rohan; Holton, Janice L; Revesz, Tamas; Sweeney, Mary G; Singleton, Andy B; Lees, Andrew J; Bhatia, Kailash P; Houlden, Henry

    2015-02-01

    A GGGGCC repeat expansion in the C9orf72 gene was recently identified as a major cause of familial and sporadic amyotrophic lateral sclerosis and frontotemporal dementia. There is suggestion that these expansions may be a rare cause of parkinsonian disorders such as progressive supranuclear palsy (PSP), multiple system atrophy (MSA), and corticobasal degeneration (CBD). Screening the C9orf72 gene in 37 patients with features of corticobasal syndrome (CBS) detected an expansion in 3 patients, confirmed by Southern blotting. In a series of 22 patients with clinically diagnosed PSP, we found 1 patient with an intermediate repeat length. We also screened for the C9orf72 expansion in a large series of neuropathologically confirmed samples with MSA (n = 96), PSP (n = 177), and CBD (n = 18). Patients were found with no more than 22 GGGGCC repeats. Although these results still need to be confirmed in a larger cohort of CBS and/or CBD patients, these data suggest that in the presence of a family history and/or motor neuron disease features, patients with CBS or clinical PSP should be screened for the C9orf72 repeat expansion. In addition, we confirm that the C9orf72 expansions are not associated with pathologically confirmed MSA, PSP, or CBD in a large series of cases. PMID:25308964

  19. The analysis of C9orf72 repeat expansions in a large series of clinically and pathologically diagnosed cases with atypical parkinsonism☆

    PubMed Central

    Schottlaender, Lucia V.; Polke, James M.; Ling, Helen; MacDoanld, Nicola D.; Tucci, Arianna; Nanji, Tina; Pittman, Alan; de Silva, Rohan; Holton, Janice L.; Revesz, Tamas; Sweeney, Mary G.; Singleton, Andy B.; Lees, Andrew J.; Bhatia, Kailash P.; Houlden, Henry

    2015-01-01

    A GGGGCC repeat expansion in the C9orf72 gene was recently identified as a major cause of familial and sporadic amyotrophic lateral sclerosis and frontotemporal dementia. There is suggestion that these expansions may be a rare cause of parkinsonian disorders such as progressive supranuclear palsy (PSP), multiple system atrophy (MSA), and corticobasal degeneration (CBD). Screening the C9orf72 gene in 37 patients with features of corticobasal syndrome (CBS) detected an expansion in 3 patients, confirmed by Southern blotting. In a series of 22 patients with clinically diagnosed PSP, we found 1 patient with an intermediate repeat length. We also screened for the C9orf72 expansion in a large series of neuropathologically confirmed samples with MSA (n = 96), PSP (n = 177), and CBD (n = 18). Patients were found with no more than 22 GGGGCC repeats. Although these results still need to be confirmed in a larger cohort of CBS and/or CBD patients, these data suggest that in the presence of a family history and/or motor neuron disease features, patients with CBS or clinical PSP should be screened for the C9orf72 repeat expansion. In addition, we confirm that the C9orf72 expansions are not associated with pathologically confirmed MSA, PSP, or CBD in a large series of cases. PMID:25308964

  20. Treatment Challenges in the Management of Gastroparesis-Related GERD

    PubMed Central

    Fass, Ronnie; McCallum, Richard W.; Parkman, Henry P.

    2009-01-01

    The relationship between gastroparesis and GERD is multi-factorial. The delay in gastric emptying associated with gastroparesis can lead to prolonged gastric retention of food that may have a propensity to reflux. Because gastroparesis allows material to remain in the stomach, there is an increase in the gastroesophageal pressure gradient, gastric volume, and the volume of potential refluxate. Additionally, the prolonged exposure of material in the stomach can increase gastric acid secretion. The onset of gastroparesis has been attributed to several causes, including comorbidities (mainly diabetes), surgical complications, and the use of specific medications (including anticholinergics, narcotics, tricyclic antidepressants, and calcium channel blockers). The etiology of some cases of gastroparesis remain unclear, a condition termed idiopathic gastroparesis. Symptoms commonly associated with gastroparesis or GERD, including nausea, vomiting, and regurgitation, may delay drug absorption. This has the potential to greatly impact systemic absorption and concentration of drugs. Several patient populations may benefit from the use of medication formulations that offer an alternative to swallowing a traditional tablet. In addition, prokinetic drugs, such as metoclopramide, are used in the first-line treatment of gastroparesis to improve the contractility of the gut muscles, as well as the movement of contents through the gastrointestinal system and regulate drug metabolism and absorption.

  1. Treatment Options for GERD or Acid Reflux Disease: A Review of the Research for Adults

    MedlinePlus

    ... surgery might help you. How does surgery for GERD work? In a fundoplication, the top part of your ... how well endoscopic treatments (EndoCinch™, Stretta®, and EsophyX™) work to control the symptoms of GERD. What are the side effects of endoscopic treatments? ...

  2. A prospective longitudinal cohort study: evolution of GERD symptoms during the course of pregnancy

    PubMed Central

    2012-01-01

    Background Symptoms of gastro-esophageal reflux disease (GERD) in pregnancy are reported with a prevalence of 30–80%. The aim of this study was to assess the prevalence and severity of GERD symptoms during the course of pregnancy. Furthermore current practice in medical care for GERD during pregnancy was assessed. Methods We performed a prospective longitudinal cohort study on 510 pregnant women (mean age 28.12, SD 5.3). Investigations for reflux symptoms where based on the use of validated reflux-disease questionnaire (RDQ). Additional information was collected about the therapy. A group of non-pregnant women (mean age 24.56, SD 5.7) was included as controls. Frequency and severity of reflux symptoms were recorded in each trimester of pregnancy. Results The prevalence of GERD symptoms in pregnant women increased from the first trimester with 26.1 to 36.1% in the second trimester and to 51.2% in the third trimester of pregnancy. The prevalence of GERD symptoms in the control group was 9.3%. Pregnant women received medication for their GERD symptoms in 12.8% during the first, 9.1% during the second and 15.7% during the third trimester. Medications used >90% antacids, 0% PPI. Conclusion GERD symptoms occur more often in pregnant women than in non-pregnant and the frequency rises in the course of pregnancy. Medical therapy is used in a minority of cases and often with no adequate symptom relief. PMID:23006768

  3. Structural and functional analysis of the GerD spore germination protein of Bacillus species.

    PubMed

    Li, Yunfeng; Jin, Kai; Ghosh, Sonali; Devarakonda, Parvathimadhavi; Carlson, Kristina; Davis, Andrew; Stewart, Kerry-Ann V; Cammett, Elizabeth; Pelczar Rossi, Patricia; Setlow, Barbara; Lu, Min; Setlow, Peter; Hao, Bing

    2014-05-01

    Spore germination in Bacillus species represents an excellent model system with which to study the molecular mechanisms underlying the nutritional control of growth and development. Binding of specific chemical nutrients to their cognate receptors located in the spore inner membrane triggers the germination process that leads to a resumption of metabolism in spore outgrowth. Recent studies suggest that the inner membrane GerD lipoprotein plays a critical role in the receptor-mediated activation of downstream germination events. The 121-residue core polypeptide of GerD (GerD⁶⁰⁻¹⁸⁰) from Geobacillus stearothermophilus forms a stable α-helical trimer in aqueous solution. The 2.3-Å-resolution crystal structure of the trimer reveals a neatly twisted superhelical rope, with unusual supercoiling induced by parallel triple-helix interactions. The overall geometry comprises three interleaved hydrophobic screws of interacting helices linked by short turns that have not been seen before. Using complementation analysis in a series of Bacillus subtilis gerD mutants, we demonstrated that alterations in the GerD trimer structure have profound effects on nutrient germination. This important structure-function relationship of trimeric GerD is supported by our identification of a dominant negative gerD mutation in B. subtilis. These results and those of others lead us to propose that GerD mediates clustering of germination proteins in the inner membrane of dormant spores and thus promotes the rapid and cooperative germination response to nutrients. PMID:24530795

  4. Achalasia Previously Diagnosed as Gastroesophageal Reflux Disease by Relying on Esophageal Impedance-pH Monitoring: Use of High-Resolution Esophageal Manometry in Children.

    PubMed

    Pyun, Jung Eun; Choi, Da Min; Lee, Jung Hwa; Yoo, Kee Hwan; Shim, Jung Ok

    2015-03-01

    Gastroesophageal reflux disorder (GERD) is the most common esophageal disorder in children. Achalasia occurs less commonly but has similar symptoms to GERD. A nine-year old boy presented with vomiting, heartburn, and nocturnal cough. The esophageal impedance-pH monitor revealed nonacidic GERD (all-refluxate clearance percent time of 20.9%). His symptoms persisted despite medical treatment for GERD, and he was lost to follow up. Four years later, he presented with heartburn, solid-food dysphagia, daily post-prandial vomiting, and failure to thrive. Endoscopy showed a severely dilated esophagus with candidiasis. High-resolution manometry was performed, and he was diagnosed with classic achalasia (also known as type I). His symptoms resolved after two pneumatic dilatation procedures, and his weight and height began to catch up to his peers. Clinicians might consider using high-resolution manometry in children with atypical GERD even after evaluation with an impedance-pH monitor. PMID:25866734

  5. Diagnosis and Anti-Reflux Therapy for GERD with Respiratory Symptoms: A Study Using Multichannel Intraluminal Impedance-pH Monitoring

    PubMed Central

    Zhang, Chao; Wu, Jimin; Hu, Zhiwei; Yan, Chao; Gao, Xiang; Liang, Weitao; Liu, Diangang; Li, Fei; Wang, Zhonggao

    2016-01-01

    Stretta procedure (0 vs. 19.4%, p = 0.006). Conclusions MII-pH monitoring effectively detected respiratory-related predictive parameters, including total/proximal reflux episodes and symptom correlations. We found that GERD patients with respiratory symptoms exhibited more proximal and total reflux episodes but not more acid-related episodes, as determined by MII-pH monitoring. Thus, such monitoring could be useful for diagnosing atypical GERD patients with respiratory symptoms. Furthermore, LTF exhibited a more significant effect on controlling typical symptoms in all GERD patients and reducing the recurrence rate than the Stretta procedure in patients with respiratory symptoms. PMID:27532103

  6. Hepatic angiomyolipoma: a series of six cases with emphasis on pathological-radiological correlations and unusual variants diagnosed by core needle biopsy

    PubMed Central

    Agaimy, Abbas; Vassos, Nikolaos; Croner, Roland S; Strobel, Deike; Lell, Michael

    2012-01-01

    Hepatic angiomyolipoma is rare and may pose differential diagnostic difficulty, particularly if encountered in core needle biopsy. We studied 6 cases from 5 males and one female (median age, 48.6 yrs). All presented with non-specific symptoms or an incidentally discovered tumor mass. Two patients had a remote history of chemotherapy for hematological neoplasms (acute lymphoblastic leukemia and Hodgkin lymphoma respectively) and another had clear cell renal cell carcinoma and anaplastic pancreatic carcinoma diagnosed at autopsy without definable syndrome. None of the patients had evidence of the tuberous sclerosis complex or renal or other extra-renal angiomyolipoma. Three tumors were resected completely and three have been only biopsied and followed up. None of the resected cases recurred at a mean follow-up of 35 months. Histologically, tumors were classified as classical triphasic (1), lipomatous (2), epithelioid/oncocytoid (1), epithelioid trabecular (1) and myelolipoma-like (1). The adjacent liver parenchyma was normal in 3 cases, showed pigment cirrhosis in one case and mild fatty change in another case. One case had clinically diagnosed but histologically unverified cirrhosis. The initial diagnostic impression/frozen section was misleading in 5 of the cases and included vascular lesion, focal fatty change, myelolipoma, hepatocellular tumor and oncocytic neoplasm. All tumors expressed HMB45 and variably desmin. One epithelioid lesion expressed HMB45 and TFE3, but lacked desmin expression. In conclusion, hepatic angiomyolipomas are increasingly recognized as incidental findings during surveillance for cirrhosis or investigations for unrelated conditions. Awareness of their diverse morphological spectrum in liver biopsy is necessary to avoid misdiagnosis as hepatocellular carcinoma, metastatic melanoma or other malignant neoplasms. PMID:22949933

  7. Getting Diagnosed

    MedlinePlus

    ... also for those with related disorders. How is Marfan syndrome diagnosed? getting_diagnosed.jpg A Marfan diagnosis ... spinal column). Is there a genetic test for Marfan syndrome? Genetic testing can provide helpful information in ...

  8. Proton pump inhibitor step-down therapy for GERD: A multi-center study in Japan

    PubMed Central

    Tsuzuki, Takao; Okada, Hiroyuki; Kawahara, Yoshiro; Takenaka, Ryuta; Nasu, Junichiro; Ishioka, Hidehiko; Fujiwara, Akiko; Yoshinaga, Fumiya; Yamamoto, Kazuhide

    2011-01-01

    AIM: To investigate the predictors of success in step-down of proton pump inhibitor and to assess the quality of life (QOL). METHODS: Patients who had heartburn twice a week or more were treated with 20 mg omeprazole (OPZ) once daily for 8 wk as an initial therapy (study 1). Patients whose heartburn decreased to once a week or less at the end of the initial therapy were enrolled in study 2 and treated with 10 mg OPZ as maintenance therapy for an additional 6 mo (study 2). QOL was investigated using the gastrointestinal symptom rating scale (GSRS) before initial therapy, after both 4 and 8 wk of initial therapy, and at 1, 2, 3, and 6 mo after starting maintenance therapy. RESULTS: In study 1, 108 patients were analyzed. Their characteristics were as follows; median age: 63 (range: 20-88) years, sex: 46 women and 62 men. The success rate of the initial therapy was 76%. In the patients with successful initial therapy, abdominal pain, indigestion and reflux GSRS scores were improved. In study 2, 83 patients were analyzed. Seventy of 83 patients completed the study 2 protocol. In the per-protocol analysis, 80% of 70 patients were successful for step-down. On multivariate analysis of baseline demographic data and clinical information, no previous treatment for gastroesophageal reflux disease (GERD) [odds ratio (OR) 0.255, 95% CI: 0.06-0.98] and a lower indigestion score in GSRS at the beginning of step-down therapy (OR 0.214, 95% CI: 0.06-0.73) were found to be the predictors of successful step-down therapy. The improved GSRS scores by initial therapy were maintained through the step-down therapy. CONCLUSION: OPZ was effective for most GERD patients. However, those who have had previous treatment for GERD and experience dyspepsia before step-down require particular monitoring for relapse. PMID:21472108

  9. Is the advanced age a contraindication to GERD laparoscopic surgery? Results of a long term follow-up

    PubMed Central

    2013-01-01

    Background In this prospective non randomized observational cohort study we have evaluated the influence of age on outcome of laparoscopic total fundoplication for GERD. Methods Six hundred and twenty consecutive patients underwent total laparoscopic fundoplication for GERD. Five hundred and twenty-four patients were younger than 65 years (YG), and 96 patients were 65 years or older (EG). The following parameters were considered in the preoperative and postoperative evaluation: presence, duration, and severity of GERD symptoms, presence of a hiatal hernia, manometric and 24 hour pH-monitoring data, duration of operation, incidence of complications and length of hospital stay. Results Elderly patients more often had atypical symptoms of GERD and at manometric evaluation had a higher rate of impaired esophageal peristalsis in comparison with younger patients. The duration of the operation was similar between the two groups. The incidence of intraoperative and postoperative complications was low and the difference was not statistically significant between the two groups. An excellent outcome was observed in 93.0% of young patients and in 88.9% of elderly patients (p = NS). Conclusions Laparoscopic antireflux surgery is a safe and effective treatment for GERD even in elderly patients, warranting low morbidity and mortality rates and a significant improvement of symptoms comparable to younger patients. PMID:24267613

  10. Understanding GERD

    MedlinePlus

    ... heartburn: chocolate, coffee, peppermint, greasy or spicy foods, tomato products and alcoholic beverages. * Stop smoking. Tobacco inhibits saliva, which is the body’s major buffer. Tobacco may also stimulate stomach acid production and relax the muscle between the esophagus ...

  11. Adult and paediatric GERD: diagnosis, phenotypes and avoidance of excess treatments.

    PubMed

    Nikaki, Kornilia; Woodland, Philip; Sifrim, Daniel

    2016-09-01

    Detailed investigations and objective measurements in patients with symptoms of gastro-oesophageal reflux should be performed with the intent of making the correct diagnosis, thus enabling choice of appropriate therapy. Establishing the most effective therapy is particularly important in adults who do not respond to standard treatment and in children. The use of PPIs for suspected GERD has increased substantially over the past decade, providing great relief in patients with acid-related symptoms, but also leading to adverse effects and a considerable economic burden. Adults with functional heartburn do not benefit from PPIs, while prolonged PPI use in patients with extraoesophageal symptoms remains a controversial area. Moreover, PPIs are not indicated in infants with GERD unless symptoms are proven to be acid-related. With regard to antireflux surgery, patients must be carefully selected to avoid the need for ongoing PPI treatment postoperatively. Correct diagnosis and phenotyping of patients with symptoms attributed to gastro-oesophageal reflux through detailed investigations is therefore imperative, leading to improved patient outcomes and rationalized use of available treatment options. In this Review, we outline currently available diagnostic tests and discuss approaches to limit any unnecessary medical or surgical interventions. PMID:27485786

  12. Diagnosing Flu

    MedlinePlus

    ... your symptoms and their clinical judgment. Will my health care provider test me for flu if I have flu-like ... flu symptoms do not require testing because the test results usually do not change how you are treated. Your health care provider may diagnose you with flu based on ...

  13. 314 GERD Screening by the Use of F-Scale and Allergy Screening for Diagnosis and Treatment of Chronic Cough

    PubMed Central

    Nishihira, Ryuichi; Komatsu, Shigeru; Shinohara, Takeshi; Tagawa, Akihiro; Ogura, Takashi; Takahashi, Hiroshi

    2012-01-01

    Background Allergy and gastro-esophageal reflux (GERD) are main causes of chronic cough, and simple, easy and rapid screening is desired for diagnosis of these symptoms. We used F-scale (Frequency Scale for Symptoms of GERD: FSSG) for GERD screening, developed by Japanese gastro-enterologist, did general allergy screenings, and investigated clinical outcome after treatment retrospectively. Methods GERD was screened by F-scale questionnaire, composed in twelve questions concerned with reflux symptoms, and scored 5 grades in each symptom. General allergy screening was defined as asking history of allergy, serum immnogloblin E (IgE) test (total, fourteen kinds of specific allergens) and measuring fraction of exhaled nitric oxide (FeNO),its positive range was greater than or equal to 20 ppb. Allergy positive was defined as at least one positive finding of allergy screening test. GERD was treated with proton pump inhibitor (PPI), and allergy was treated with inhaled corticosteroid or histamine H1 receptor blocker or leukotriene receptor antagonist. Results Fifty-four consecutive chronic cough patients were screened in GERD and general allergy screening. Thirty-seven patients (69%) were F-scale positive and 43 patients (80%) were positive in general allergy screening. Thirty patients (56%) were positive in both F-scale and general allergy screening. All patients were treated with allergy medicine or PPI, or both medicines. In all patients screened and treated with both GERD and allergy concurrently, cough improved within 2 weeks, and in patients whose positive finding was either GERD or allergy, cough improved by treatment with PPI or allergy drugs similarly. Delayed screening or treatment of either GERD or allergy was related to delayed improvement of cough. Cough finally improved in all patients in visit within 3 times. Conclusions In examination of chronic cough, adding GERD screening by use of F-scale to general allergy screening is beneficial to proper diagnosis

  14. Computational Pathology

    PubMed Central

    Louis, David N.; Feldman, Michael; Carter, Alexis B.; Dighe, Anand S.; Pfeifer, John D.; Bry, Lynn; Almeida, Jonas S.; Saltz, Joel; Braun, Jonathan; Tomaszewski, John E.; Gilbertson, John R.; Sinard, John H.; Gerber, Georg K.; Galli, Stephen J.; Golden, Jeffrey A.; Becich, Michael J.

    2016-01-01

    Context We define the scope and needs within the new discipline of computational pathology, a discipline critical to the future of both the practice of pathology and, more broadly, medical practice in general. Objective To define the scope and needs of computational pathology. Data Sources A meeting was convened in Boston, Massachusetts, in July 2014 prior to the annual Association of Pathology Chairs meeting, and it was attended by a variety of pathologists, including individuals highly invested in pathology informatics as well as chairs of pathology departments. Conclusions The meeting made recommendations to promote computational pathology, including clearly defining the field and articulating its value propositions; asserting that the value propositions for health care systems must include means to incorporate robust computational approaches to implement data-driven methods that aid in guiding individual and population health care; leveraging computational pathology as a center for data interpretation in modern health care systems; stating that realizing the value proposition will require working with institutional administrations, other departments, and pathology colleagues; declaring that a robust pipeline should be fostered that trains and develops future computational pathologists, for those with both pathology and non-pathology backgrounds; and deciding that computational pathology should serve as a hub for data-related research in health care systems. The dissemination of these recommendations to pathology and bioinformatics departments should help facilitate the development of computational pathology. PMID:26098131

  15. Evaluation of anti-GERD activity of gastro retentive drug delivery system of itopride hydrochloride.

    PubMed

    Satapathy, Trilochan; Panda, Prasana K; Goyal, Amit K; Rath, Goutam

    2010-08-01

    The present work describes the formulation and evaluation of the gastroretentive system of Itopride hydrochloride. In this research, we have formulated floating hydrogel-based microspheres employing calcium carbonate (CaCO(3)) as a gas forming agent dispersed in alginate matrix. In vitro characterizations such as drug content, particle size, and drug release were carried out. GI motility was determined by administration of charcoal meal to rats. Results demonstrated that prepared microspheres were spherical in shape with smooth surface, good loading efficiency, and excellent buoyancy. The gastro retentive dosage form of itiopride demonstrated significant antacid, anti-ulcer, and anti-GERD activity after 12 hours in comparison with the conventional dosage form. PMID:20515421

  16. Musculoskeletal Pathology.

    PubMed

    Peat, Frances J; Kawcak, Christopher E

    2015-08-01

    The current understanding of pathology as it relates to common diseases of the equine musculoskeletal system is reviewed. Conditions are organized under the fundamental categories of developmental, exercise-induced, infectious, and miscellaneous pathology. The overview of developmental pathology incorporates the new classification system of juvenile osteochondral conditions. Discussion of exercise-induced pathology emphasizes increased understanding of the contribution of cumulative microdamage caused by repetitive cyclic loading. Miscellaneous musculoskeletal pathology focuses on laminitis, which current knowledge indicates should be regarded as a clinical syndrome with a variety of possible distinct mechanisms of structural failure that are outlined in this overview. PMID:26037607

  17. Diagnosing hypertension

    PubMed Central

    Gelfer, Mark; Dawes, Martin; Kaczorowski, Janusz; Padwal, Raj; Cloutier, Lyne

    2015-01-01

    Abstract Objective To highlight the 2015 Canadian Hypertension Education Program (CHEP) recommendations for the diagnosis and assessment of hypertension. Quality of evidence A systematic search was performed current to August 2014 by a Cochrane Collaboration librarian using the MEDLINE and PubMed databases. The search results were critically appraised by the CHEP subcommittee on blood pressure (BP) measurement and diagnosis, and evidence-based recommendations were presented to the CHEP Central Review Committee for independent review and grading. Finally, the findings and recommendations were presented to the Recommendations Task Force for discussion, debate, approval, and voting. The main recommendations are based on level II evidence. Main message Based on the most recent evidence, CHEP has made 4 recommendations in 2 broad categories for 2015 to improve BP measurement and the way hypertension is diagnosed. A strong recommendation is made to use electronic BP measurement in the office setting to replace auscultatory BP measurement. For patients with elevated office readings, CHEP is recommending early use of out-of-office BP measurement, preferably ambulatory BP measurement, in order to identify early in the process those patients with white-coat hypertension. Conclusion Improvements in diagnostic accuracy are critical to optimizing hypertension management in Canada. The annual updates provided by CHEP ensure that practitioners have up-to-date evidence-based information to inform practice. PMID:26564654

  18. Recommendations for pathology peer review.

    PubMed

    Morton, Daniel; Sellers, Rani S; Barale-Thomas, Erio; Bolon, Brad; George, Catherine; Hardisty, Jerry F; Irizarry, Armando; McKay, Jennifer S; Odin, Marielle; Teranishi, Munehiro

    2010-12-01

    Pathology peer review verifies and improves the accuracy and quality of pathology diagnoses and interpretations. Pathology peer review is recommended when important risk assessment or business decisions are based on nonclinical studies. For pathology peer review conducted before study completion, the peer-review pathologist reviews sufficient slides and pathology data to assist the study pathologist in refining pathology diagnoses and interpretations. Materials to be reviewed are selected by the peer-review pathologist. Consultations with additional experts or a formal (documented) pathology working group may be used to resolve discrepancies. The study pathologist is solely responsible for the content of the final pathology data and report, makes changes resulting from peer-review discussions, initiates the audit trail for microscopic observations after all changes resulting from peer-review have been made, and signs the final pathologist's report. The peer-review pathologist creates a signed peer-review memo describing the peer-review process and confirming that the study pathologist's report accurately and appropriately reflects the pathology data. The study pathologist also may sign a statement of consensus. It is not necessary to archive working notes created during the peer-review process. PMID:20924082

  19. Surgical treatment of GERD. Comperative study of WTP vs. Toupet fundoplication – results of 151 consecutive cases

    PubMed Central

    Wróblewski, Tadeusz; Nowosad, Małgorzata; Krawczyk, Marek

    2016-01-01

    Introduction Gastroesophageal reflux disease (GERD) is recognized as one of the most common disorders of the upper gastrointestinal tract (GIT). The best choice of management for advanced GERD is laparoscopic surgery. Aim To compare and evaluate the results of surgical treatment of GERD patients operated on using two different techniques. Material and methods Between 2001 and 2012, 353 patients (211 female and 142 male), aged 17–76 years (mean 44), underwent laparoscopic antireflux surgery. The study included patients who underwent a Toupet fundoplication or Wroblewski Tadeusz procedure (WTP). Results The mean age of the group was 47.77 years (17–80 years). Forty-nine (32.45%) patients had severe symptoms, 93 (61.58%) had mild symptoms and 9 (5.96%) had a single mild but intolerable sign of GERD. Eighty-six (56.95%) patients had a Toupet fundoplication and 65 (43.04%) had a WTP. The follow-up period was 18–144 months. The average operating time for Toupet fundoplication and the WTP procedure was 164 min (90–300 min) and 147 min (90–210 min), respectively. The perioperative mortality rate was 0.66%. The average post-operative hospitalization period was 5.4 days (2–16 post-operative days (POD) = Toupet) vs. 4.7 days (2–9 POD = WTP). No reoperations were performed. No major surgical complications were identified. Conclusions Wroblewski Tadeusz procedure due to a low percentage of post-operative complications, good quality of life of patients and a zero recurrence rate of hiatal hernia should be a method of choice. PMID:27458484

  20. Potential mechanism of corpus-predominant gastritis after PPI therapy in Helicobacter pylori-positive patients with GERD

    PubMed Central

    Mukaisho, Ken-ichi; Hagiwara, Tadashi; Nakayama, Takahisa; Hattori, Takanori; Sugihara, Hiroyuki

    2014-01-01

    The long-term use of proton pump inhibitors (PPIs) exacerbates corpus atrophic gastritis in patients with Helicobacter pylori (H. pylori) infection. To identify a potential mechanism for this change, we discuss interactions between pH, bile acids, and H. pylori. Duodenogastric reflux, which includes bile, occurs in healthy individuals, and bile reflux is increased in patients with gastroesophageal reflux disease (GERD). Diluted human plasma and bile acids have been found to be significant chemoattractants and chemorepellents, respectively, for the bacillus H. pylori. Although only taurine conjugates, with a pKa of 1.8-1.9, are soluble in an acidic environment, glycine conjugates, with a pKa of 4.3-5.2, as well as taurine-conjugated bile acids are soluble in the presence of PPI therapy. Thus, the soluble bile acid concentrations in the gastric contents of patients with GERD after continuous PPI therapy are considerably higher than that in those with intact acid production. In the distal stomach, the high concentration of soluble bile acids is likely to act as a bactericide or chemorepellent for H. pylori. In contrast, the mucous layer in the proximal stomach has an optimal bile concentration that forms chemotactic gradients with plasma components required to direct H. pylori to the epithelial surface. H. pylori may then colonize in the stomach body rather than in the pyloric antrum, which may explain the occurrence of corpus-predominant gastritis after PPI therapy in H. pylori-positive patients with GERD. PMID:25232231

  1. Partial versus Complete Fundoplication for the Correction of Pediatric GERD: A Systematic Review and Meta-Analysis

    PubMed Central

    Glen, Peter; Chassé, Michaël; Doyle, Mary-Anne; Nasr, Ahmed; Fergusson, Dean A.

    2014-01-01

    Background There is no consensus as to what extent of “wrap” is required in a fundoplication for correction of gastroesophageal reflux disease (GERD). Objective To evaluate if a complete (360 degree) or partial fundoplication gives better control of GERD. Methods A systematic search of MEDLINE and Scopus identified interventional and observational studies of fundoplication in children. Screening identified those comparing techniques. The primary outcome was recurrence of GERD following surgery. Dysphagia and complications were secondary outcomes of interest. Meta-analysis was performed when appropriate. Study quality was assessed using the Cochrane Risk of Bias Tool. Results 2289 abstracts were screened, yielding 2 randomized controlled trials (RCTs) and 12 retrospective cohort studies. The RCTs were pooled. There was no difference in surgical success between partial and complete fundoplication, OR 1.33 [0.67,2.66]. In the 12 cohort studies, 3 (25%) used an objective assessment of the surgery, one of which showed improved outcomes with complete fundoplication. Twenty-five different complications were reported; common were dysphagia and gas-bloat syndrome. Overall study quality was poor. Conclusions The comparison of partial fundoplication with complete fundoplication warrants further study. The evidence does not demonstrate superiority of one technique. The lack of high quality RCTs and the methodological heterogeneity of observational studies limits a powerful meta-analysis. PMID:25386679

  2. Autopsy pathology storage and coding by microcomputer.

    PubMed

    Talamo, T S; Losos, F J; Kessler, G F

    1982-02-01

    Storage and coding of anatomic pathology data usually is accomplished by expensive main frame systems. The authors of this article have developed a microcomputer based program package for autopsy pathology which stores patient demographic data, provisional or final anatomic diagnoses, and coded diagnoses obtained from an on-line Systematized Nomenclature of Pathology (SNOP) code lexicon. The system includes limited text editor functions as well as rapid data retrieval with the generation of final reports. Data files containing SNOP codes and diagnoses are searched easily by a variety of parameters, making data retrieval of autopsy material simple and efficient. PMID:10254292

  3. Clinical and pathological correlations in endometrial pathology

    PubMed Central

    Bohîlțea, RE; Sajin, M; Furtunescu, F; Bohîlțea, LC; Mihart, A; Baros, A; Anca, AF

    2015-01-01

    The incidence and mortality rate of endometrial cancer has been registering an increasing trend both in Romania and in the whole world. The paper’s aim is to analyze the diagnostic approach of endometrial pathology in the University Emergency Hospital Bucharest, on a four years period. The medium age of the patients was of 50.51 ± 10.924 years, and the median age was of 48 years. The youngest patient suffering from endometrial cancer was of 30 years. Dilation and uterine curettage represent the main method used in the performance of endometrial biopsy, based on which the certitude etiologic histopathologic diagnosis was established in 68.4% of the patients with endometrial pathology. Hyperplasias represented half of the pathology (54.9%), most of them being without atypias. Endometrial carcinoma was identified in 19% of the patients. The diagnosis of the disease in IA stage represents 5.5% of the total endometrial cases and the diagnosis of the disease in the stage of its limitation to the uterus (stage IA, IB and IC) was of 64.2%. The endometrioid adenocarcinoma represents the most encountered histopathological form and the degree of tumor differentiation established for 68,15% of the cases was predominantly 1 and 2 (88%). The main symptom, which determines the patients’ decision to go to the physician, is the abnormal uterine bleeding. 66% of the cases of endometrial cancer in the stage of the disease limited to the uterus are diagnosed in Romania based on the abnormal uterine bleeding. However, 34% of the cases are diagnosed in advanced stages, presenting a significantly low life expectancy. PMID:26664489

  4. Gaucher's disease diagnosed by splenectomy

    PubMed Central

    Adas, Mine; Adas, Gokhan; Karatepe, Oguzhan; Altiok, Merih; Ozcan, Deniz

    2009-01-01

    Context: Splenectomy continues to find common therapeutic indications for hematologic disorders. In addition, recently it is also performed in surgical clinics to assist diagnose of some illnesses. Gaucher's disease, especially Type I, is the most frequently encountered lysosomal storage disorder in man. Manifestations of it are highly variable. The most frequently found symptoms include splenomegaly with anaemia and thrombocytopenia, mostly due to hypersplenism, hepatomegaly and bone disease. Cases: Four patients were reported in the present study. Three of them were easily diagnosed with Gaucher's disease via bone marrow cytology, and one with Gaucher's disease was detected by pathological examination following the splenectomy. Conclusions: For the pouse of diagnosis of the Gaucher's disease, performing surgery is generally not necessary. However, for the cases of difficult to diagnose by classical methods, the corect diagnosis of Gaucher's disease can only be made by a special operation. PMID:22666685

  5. Time esophageal pH < 4 overestimates the prevalence of pathologic esophageal reflux in subjects with gastroesophageal reflux disease treated with proton pump inhibitors

    PubMed Central

    Gerson, Lauren B; Triadafilopoulos, George; Sahbaie, Peyman; Young, Winston; Sloan, Sheldon; Robinson, Malcolm; Miner, Philip B; Gardner, Jerry D

    2008-01-01

    Background A Stanford University study reported that in asymptomatic GERD patients who were being treated with a proton pump inhibitor (PPI), 50% had pathologic esophageal acid exposure. Aim We considered the possibility that the high prevalence of pathologic esophageal reflux might simply have resulted from calculating acidity as time pH < 4. Methods We calculated integrated acidity and time pH < 4 from the 49 recordings of 24-hour gastric and esophageal pH from the Stanford study as well as from another study of 57 GERD subjects, 26 of whom were treated for 8 days with 20 mg omeprazole or 20 mg rabeprazole in a 2-way crossover fashion. Results The prevalence of pathologic 24-hour esophageal reflux in both studies was significantly higher when measured as time pH < 4 than when measured as integrated acidity. This difference was entirely attributable to a difference between the two measures during the nocturnal period. Nocturnal gastric acid breakthrough was not a useful predictor of pathologic nocturnal esophageal reflux. Conclusion In GERD subjects treated with a PPI, measuring time esophageal pH < 4 will significantly overestimate the prevalence of pathologic esophageal acid exposure over 24 hours and during the nocturnal period. PMID:18498663

  6. Surgical pathology of urologic diseases

    SciTech Connect

    Javadpour, N.; Barsky, S.H.

    1987-01-01

    This text details recent advances in methods for detecting, diagnosing, and managing genitourinary diseases. Included are chapters on imaging techniques (including magnetic resonance imaging, computed tomography, and ultrasound; tumor markers (such as alphafetoprotein, human chorionic gonadotropin, prostatic specific antigen, and T-antigens); immunocytochemistry; pediatric urologic pathology; and other key topics.

  7. Detection of peripheral nerve pathology

    PubMed Central

    Seelig, Michael J.; Baker, Jonathan C.; Mackinnon, Susan E.; Pestronk, Alan

    2013-01-01

    Objective: To compare accuracy of ultrasound and MRI for detecting focal peripheral nerve pathology, excluding idiopathic carpal or cubital tunnel syndromes. Methods: We performed a retrospective review of patients referred for neuromuscular ultrasound to identify patients who had ultrasound and MRI of the same limb for suspected brachial plexopathy or mononeuropathies, excluding carpal/cubital tunnel syndromes. Ultrasound and MRI results were compared to diagnoses determined by surgical or, if not performed, clinical/electrodiagnostic evaluation. Results: We identified 53 patients who had both ultrasound and MRI of whom 46 (87%) had nerve pathology diagnosed by surgical (n = 39) or clinical/electrodiagnostic (n = 14) evaluation. Ultrasound detected the diagnosed nerve pathology (true positive) more often than MRI (43/46 vs 31/46, p < 0.001). Nerve pathology was correctly excluded (true negative) with equal frequency by MRI and ultrasound (both 6/7). In 25% (13/53), ultrasound was accurate (true positive or true negative) when MRI was not. These pathologies were typically (10/13) long (>2 cm) and only occasionally (2/13) outside the MRI field of view. MRI missed multifocal pathology identified with ultrasound in 6 of 7 patients, often (5/7) because pathology was outside the MRI field of view. Conclusions: Imaging frequently detects peripheral nerve pathology and contributes to the differential diagnosis in patients with mononeuropathies and brachial plexopathies. Ultrasound is more sensitive than MRI (93% vs 67%), has equivalent specificity (86%), and better identifies multifocal lesions than MRI. In sonographically accessible regions ultrasound is the preferred initial imaging modality for anatomic evaluation of suspected peripheral nervous system lesions. PMID:23553474

  8. How Is Pneumonia Diagnosed?

    MedlinePlus

    ... page from the NHLBI on Twitter. How Is Pneumonia Diagnosed? Pneumonia can be hard to diagnose because it may ... than these other conditions. Your doctor will diagnose pneumonia based on your medical history, a physical exam, ...

  9. Prevalence of gallstones in 1,229 patients submitted to surgical laparoscopic treatment of GERD and esophageal achalasia: associated cholecystectomy was a safe procedure

    PubMed Central

    SALLUM, Rubens Antonio Aissar; PADRÃO, Eduardo Messias Hirano; SZACHNOWICZ, Sergio; SEGURO, Francisco C. B. C.; BIANCHI, Edno Tales; CECCONELLO, Ivan

    2015-01-01

    Background Association between esophageal achalasia/ gastroesophageal reflux disease (GERD) and cholelithiasis is not clear. Epidemiological data are controversial due to different methodologies applied, the regional differences and the number of patients involved. Results of concomitant cholecistectomy associated to surgical treatment of both diseases regarding safety is poorly understood. Aim To analyze the prevalence of cholelithiasis in patients with esophageal achalasia and gastroesophageal reflux submitted to cardiomyotomy or fundoplication. Also, to evaluate the safety of concomitant cholecistectomy. Methods Retrospective analysis of 1410 patients operated from 2000 to 2013. They were divided into two groups: patients with GERD submitted to laparocopic hiatoplasty plus Nissen fundoplication and patients with esophageal achalasia to laparoscopic cardiomyotomy plus partial fundoplication. It was collected epidemiological data, specific diagnosis and subgroups, the presence or absence of gallstones, surgical procedure, operative and clinical complications and mortality. All groups/subgroups were compared. Results From 1,229 patients with GERD or esophageal achalasia, submitted to laparoscopic cardiomyotomy or fundoplication, 138 (11.43%) had cholelitiasis, occurring more in females (2.38:1) with mean age of 50,27 years old. In 604 patients with GERD, 79 (13,08%) had cholelitiasis. Lower prevalence occurred in Barrett's esophagus patients 7/105 (6.67%) (p=0.037). In 625 with esophageal achalasia, 59 (9.44%) had cholelitiasis, with no difference between chagasic and idiopathic forms (p=0.677). Complications of patients with or without cholecystectomy were similar in fundoplication and cardiomyotomy (p=0.78 and p=1.00).There was no mortality or complications related to cholecystectomy in this series. Conclusions Prevalence of cholelithiasis was higher in patients submitted to fundoplication (GERD). Patients with chagasic or idiopatic forms of achalasia had the

  10. [Evaluation of action, efficacy, and onset dynamics of a single dose of alginates in patients with heartburn and GERD].

    PubMed

    Bordin, D S; Masharova, A A; Firsova, L D; Kozhurina, T S; Safonova, O V

    2009-01-01

    We conducted a crossover study, in which the efficacy and the onset of action of a single dose of Gaviscon (suspension) and Gaviscon forte (suspension) in 52 patients with heartburn of moderate intensity and gastroesophageal reflux disease (GERD) have been investigated. The average age of the patients was 44.0 +/- 17.3-years-old. The patients have undergone clinical evaluation of intensity of GERD symptoms and psychological assessment (questionnaires SF-36, SMOL, LOBI). Alginates' effects and qualities were evaluated using stopwatch technique, clinical examination, and organoleptic assessment. Primary sensation of a cooling (soothing) effect after use of a single dose of Gaviscon has been reported in 65.7 seconds (on average), and Gaviscon forte--in 66.1 seconds. Fourty three (82.7%) patients with heartburn have described the effects of both medications as "instant" cooling effects. Heartburn was relieved in 3.3 minutes in all patients after a single dose of Gaviscon, and in 3.6 minutes in 51 (98.1%) patients who have received a single dose of Gaviscon forte. Organoleptic qualities averaged at 3.6 points (on a scale of 1-5) for Gaviscon, and at 3.5 points for Gaviscon forte. Assessment of mental status of the patients suggested that a "delayed" effect of the medications in relieving heartburn in some patients may have occurred due to possible physical disadaptation. PMID:19960998

  11. Outcome of nonerosive gastro-esophageal reflux disease patients with pathological acid exposure

    PubMed Central

    Pace, Fabio; Pallotta, Stefano; Manes, Gianpiero; de Leone, Annalisa; Zentilin, Patrizia; Russo, Luigi; Savarino, Vincenzo; Neri, Matteo; Grossi, Enzo; Cuomo, Rosario

    2009-01-01

    AIM: To assess the management and outcome of nonerosive gastro-esophageal reflux disease (NERD) patients who were identified retrospectively, after a 5-year follow-up. METHODS: We included patients with gastro-esophageal reflux disease (GERD) symptoms who had a negative endoscopy result and pathological 24-h esophageal pH-monitoring while off therapy. We interviewed them after an average period of 5 years (range 3.5-7 years) by means of a structured questionnaire to assess presence of GERD symptoms, related therapy, updated endoscopic data and other features. We assessed predictors of esophagitis development by means of univariate and multivariate statistical analysis. RESULTS: 260 patients (137 women) were included. Predominant GERD symptoms were heartburn and regurgitation in 103/260 (40%). 70% received a maintenance treatment, which was proton pump inhibitor (PPI) in 55% of cases. An average number of 1.5 symptomatic relapses per patient/year of follow-up were observed. A progression to erosive gastro-esophageal reflux disease (ERD) was found in 58/193 (30.0%) of patients undergoing repeat endoscopy; 72% of these were Los Angeles grade A-B. CONCLUSION: This study shows that progression to ERD occurs in about 5% of NERD cases per year, despite therapy. Only two factors consistently and independently influence progression: smoking and absence of PPI therapy. PMID:19960567

  12. How Is Sarcoidosis Diagnosed?

    MedlinePlus

    ... page from the NHLBI on Twitter. How Is Sarcoidosis Diagnosed? Your doctor will diagnose sarcoidosis based on ... Content: NEXT >> Featured Video Living With and Managing Sarcoidosis 05/18/2011 This video—presented by the ...

  13. Diagnosing Tic Disorders

    MedlinePlus

    ... Other Websites Information For... Media Policy Makers Diagnosing Tic Disorders Language: English Español (Spanish) Recommend on Facebook ... or postviral encephalitis). Persistent (Chronic) Motor or Vocal Tic Disorder For a person to be diagnosed with ...

  14. Practice Pattern of Gastroenterologists for the Management of GERD Under the Minimal Influence of the Insurance Reimbursement Guideline: A Multicenter Prospective Observational Study

    PubMed Central

    Lee, Kwang Jae; Kim, Jin Il; Park, Ju Sang; Moon, Byung Sik; Kim, Sang-Gyun; Chun, Jae Hee; Jung, Hoon-Yong; Choi, Chang Hwan; Chun, Seong Woo; Song, Geun Am; Choi, Myung Gyu

    2011-01-01

    The objective of the study was to document practice pattern of gastroenterologists for the management of gastroesophageal reflux disease (GERD) under the minimal influence of the insurance reimbursement guideline. Data on management for 1,197 consecutive patients with typical GERD symptoms were prospectively collected during 16 weeks. In order to minimize the influence of reimbursement guideline on the use of proton pump inhibitors (PPIs), rabeprazole was used for the PPI treatment. A total of 861 patients (72%) underwent endoscopy before the start of treatment. PPIs were most commonly prescribed (87%). At the start of treatment, rabeprazole 20 mg daily was prescribed to 94% of the patients who received PPI treatment and 10 mg daily to the remaining 6%. At the third visits, rabeprazole 20 mg daily was prescribed to 70% of those who were followed and 10 mg daily for the remaining 30%. Continuous PPI treatment during the 16-week period was performed in 63% of the study patients. In conclusion, a full-dose PPI is preferred for the initial and maintenance treatment of GERD under the minimal influence of the insurance reimbursement guideline, which may reflect a high proportion of GERD patients requiring a long-term treatment of a full-dose PPI. PMID:22147999

  15. Germination of Individual Bacillus subtilis Spores with Alterations in the GerD and SpoVA Proteins, Which Are Important in Spore Germination▿

    PubMed Central

    Wang, Guiwen; Yi, Xuan; Li, Yong-qing; Setlow, Peter

    2011-01-01

    Release of Ca2+ with dipicolinic acid (CaDPA) was monitored by Raman spectroscopy and differential interference contrast microscopy during germination of individual spores of Bacillus subtilis strains with alterations in GerD and SpoVA proteins. Notable conclusions about germination after the addition of nutrient were as follows. (i) Following l-alanine addition, wild-type and gerD spores and spores with elevated SpoVA protein levels (↑SpoVA spores) slowly released ∼10% of their CaDPA during a variable (6- to 55-min) period ending at Tlag, the time when faster CaDPA release began. (ii) Tlag times were lower for ↑SpoVA spores than for wild-type spores and were higher for gerD spores. (iii) The long Tlag times of gerD spores were partially due to slow commitment to germinate. (iv) The intervals between the commitment to germinate and CaDPA release were similar for wild-type and ↑SpoVA spores but longer for gerD spores. (v) The times for rapid CaDPA release, ΔTrelease = Trelease − Tlag (with Trelease being the time at which CaDPA release was complete), were similar for wild-type, gerD, and ↑SpoVA spores. (vi) Spores with either one of two point mutations in the spoVA operon (spoVA1 and spoVA2 spores) exhibited a more rapid rate of CaDPA release beginning immediately after l-alanine addition leading to ∼65% CaDPA release prior to Tlag. (vii) Tlag times for spoVA1 and spoVA2 spores were longer than for wild-type spores. (viii) The intervals between spoVA1 and spoVA2 spores' commitment and CaDPA release were similar to those for wild-type spores, but commitment occurred later. In contrast to germination after the addition of nutrient, Tlag and ΔTrelease times were relatively similar during dodecylamine germination of spores of the five strains. These findings suggest the following. (i) GerD plays no role in CaDPA release during spore germination. (ii) SpoVA proteins are involved in CaDPA release during germination with nutrients, and probably with

  16. Transoral Incisionless Fundoplication Effective in Eliminating GERD Symptoms in Partial Responders to Proton Pump Inhibitor Therapy at 6 Months

    PubMed Central

    Barnes, William E.; Simoni, Gilbert; Shughoury, Ahmad B.; Mavrelis, Peter G.; Raza, Mamoon; Heise, Jeffrey A.; Turgeon, Daniel G.; Fox, Mark A.

    2015-01-01

    Background. Incomplete control of troublesome regurgitation and extraesophageal manifestations of chronic gastroesophageal reflux disease (GERD) is a known limitation of proton pump inhibitor (PPI) therapy. This multicenter randomized study compared the efficacy of transoral incisionless fundoplication (TIF) against PPIs in controlling these symptoms in patients with small hiatal hernias. Methods. Between June and August 2012, 63 patients were randomized at 7 US community hospitals. Patients in the PPI group were placed on maximum standard dose (MSD). Patients in the TIF group underwent esophagogastric fundoplication using the EsophyX2 device. Primary outcome was elimination of daily troublesome regurgitation or extraesophageal symptoms. Secondary outcomes were normalization of esophageal acid exposure (EAE), PPI usage and healing of esophagitis. Results. Of 63 randomized patients (40 TIF and 23 PPI), 3 were lost to follow-up leaving 39 TIF and 21 PPI patients for analysis. At 6-month follow-up, troublesome regurgitation was eliminated in 97% of TIF patients versus 50% of PPI patients, relative risk (RR) = 1.9, 95% confidence interval (CI) = 1.2-3.11 (P = .006). Globally, 62% of TIF patients experienced elimination of regurgitation and extraesophageal symptoms versus 5% of PPI patients, RR = 12.9, 95% CI = 1.9-88.9 (P = .009). EAE was normalized in 54% of TIF patients (off PPIs) versus 52% of PPI patients (on MSD), RR = 1.0, 95% CI = 0.6-1.7 (P = .914). Ninety percent of TIF patients were off PPIs. Conclusion. At 6-month follow-up, TIF was more effective than MSD PPI therapy in eliminating troublesome regurgitation and extraesophageal symptoms of GERD. PMID:24756976

  17. Quality Of Life in Reflux and Dyspepsia (QOLRAD) Questionnaire in Iranian Patients with GERD: A Validation Study

    PubMed Central

    Tofangchiha, S; Razjouyan, H; Nasseri-Moghaddam, S

    2010-01-01

    BACKGROUND Symptoms of gastro-esophageal reflux disease (GERD) affect health-related quality of life (HRQOL). When a questionnaire is translated into a new language, linguistic validation is necessary, yet insufficient, unless the psychometric characteristics have been verified. The aim of this study is to document the translation and psychometric validation of the Persian translation of the Quality of Life in Reflux and Dyspepsia (QOLRAD) questionnaire. METHODS After translation and cultural adaptation of QOLRAD to Persian, fifty patients with clinical GERD from the Prospective Acid Reflux Study of Iran (PARSI) database who had at least one of the symptoms of acid regurgitation, heartburn, non-cardiac chest pain, or dysphagia for at least four weeks over the past three months completed the QOLRAD and Short Form Health Survey-36 (SF-36). After two weeks, QOLRAD was again completed by the patients. Cronbach alpha and Intra-class Correlation Coefficient (ICC) were used to test reliability and Pearson correlation was used to compare the dimensions of SF-36 and QOLRAD. RESULTS The translation was approved by MAPI Research Institute. Fifty patients completed the SF-36 and QOLRAD questionnaires at the first visit. Mean (SD) age of the participants was 38.4 (14.6) years and 68% were females. The internal consistency and reliability of QOLRAD ranged from 0.78–0.92. The test-retest reliability of QOLRAD was from 0.87–0.93. Relevant QOLRAD domains significantly correlated with the majority of SF-36 domains, with the exception of sleep disturbance. CONCLUSION The psychometric characteristics of the Persian translation of QOLRAD were found to be good, with satisfactory reliability and validity. PMID:25197518

  18. Pathological gambling.

    PubMed

    Hollander, E; Buchalter, A J; DeCaria, C M

    2000-09-01

    With increasing access to gambling facilities through casinos, the Internet, and other venues, PG is a rapidly emerging mental health concern. This impulse-control disorder tends to be comorbid with a wide range of other disorders and is reportedly associated with a high rate of suicide. For most gamblers, gambling is a form of entertainment, but for many individuals, the activity leads to far-reaching disruption of family and work. The personal and societal financial ramifications are severe, and many individuals with PG end up in the criminal justice system. An understanding of the neurobiology of PG is beginning to surface. 5-HT is linked to behavioral initiation and disinhibition, which are important in the onset of the gambling cycle and the difficulty in ceasing the behavior. Norepinephrine is associated with the arousal and risk taking in patients with PG. Dopamine is linked to positive and negative reward, the addictive component of this disorder. Effective treatment strategies for pathological gamblers are emerging. Potentially useful pharmacologic agents include SRIs (clomipramine and fluvoxamine), mood stabilizers for pathological gamblers with comorbid bipolar disorders (lithium), and naltrexone. Cognitive-behavioral psychotherapies offer promising results in the treatment of patients with this disorder. To devise prevention and early-intervention programs, research is needed to identify specific features of the individuals at risk for gambling problems. Education targeting vulnerable youth that show early signs of gambling behavior may be worthwhile and should be investigated further. Funding is necessary to support these endeavors, so perhaps a portion of tax revenues generated from the gambling industry should go toward specialized treatment facilities, educational efforts, and research into the neurobiology and treatment of PG. PMID:10986732

  19. Imaging of Common Arthroscopic Pathology of the Ankle.

    PubMed

    Grambart, Sean T

    2016-10-01

    Arthroscopy of the ankle is used in the treatment and diagnosis of a spectrum of intra-articular pathology including soft tissue and osseous impingement, osteochondral lesions, arthrofibrosis, and synovitis. To help identify the correct pathology, imaging techniques are often used to aid the surgeon in diagnosing pathology and determining best treatment options. This article discusses the use of imaging in various ankle pathologies. PMID:27599435

  20. An alginate-antacid formulation (Gaviscon Double Action Liquid®) can eliminate the postprandial “acid pocket” in symptomatic GERD patients

    PubMed Central

    Kwiatek, Monika A.; Roman, Sabine; Fareeduddin, Anita; Pandolfino, John E.; Kahrilas, Peter J.

    2013-01-01

    SUMMARY BACKGROUND Recently, an “acid pocket” has been described in the proximal stomach, particularly evident postprandially in GERD patients, when heartburn is common. By creating a low density gel “raft” that floats on top of gastric contents, alginate-antacid formulations may neutralize the “acid pocket”. AIM We hypothesized that the postprandial “acid pocket” can be displaced distal to the esophagogastric junction (EGJ) by an alginate-antacid formulation. METHODS The “acid pocket” was studied in ten symptomatic GERD patients. Measurements were made using concurrent stepwise pH pull-throughs, high resolution manometry, and fluoroscopy in a semi-recumbent posture. Each subject was studied in three conditions: fasted, 20 min after consuming a high-fat meal and 20 min later after a 20 ml oral dose of an alginate-antacid formulation (Gaviscon Double Action Liquid®). The relative position of pH transition points (pH > 4) to the EGJ high-pressure zone was analyzed. RESULTS Most patients (8/10) exhibited an acidified segment extending from the proximal stomach into the EGJ when fasted that persisted postprandially. Gaviscon neutralized the acidified segment in 6 of the 8 subjects shifting the pH transition point significantly away from the EGJ. The length and pressure of the EGJ high-pressure zone were minimally affected. CONCLUSIONS Gaviscon can eliminate the “acid pocket” in GERD patients. Considering that EGJ length was unchanged throughout, this effect was likely attributable to the alginate “raft” displacing gastric contents away from the EGJ. These findings suggest the alginate-antacid formulation to be a well-targeted postprandial GERD therapy. PMID:21535446

  1. Curriculum Guidelines for Pathology and Oral Pathology.

    ERIC Educational Resources Information Center

    Journal of Dental Education, 1985

    1985-01-01

    Guidelines for dental school pathology courses describe the interrelationships of general, systemic, and oral pathology; primary educational goals; prerequisites; a core curriculum outline and behavioral objectives for each type of pathology. Notes on sequencing, faculty, facilities, and occupational hazards are included. (MSE)

  2. How Is Lymphocytopenia Diagnosed?

    MedlinePlus

    ... of lymphocytes—T cells, B cells, and natural killer cells. The test can help diagnose the underlying ... cause low levels of B cells or natural killer cells. Tests for Underlying Conditions Many diseases and ...

  3. How Is Endocarditis Diagnosed?

    MedlinePlus

    ... can get detailed pictures of the heart's structures. EKG An EKG is a simple, painless test that detects your ... signals as they pass through your heart. An EKG typically isn't used to diagnose IE. However, ...

  4. How Is Hemophilia Diagnosed?

    MedlinePlus

    ... page from the NHLBI on Twitter. How Is Hemophilia Diagnosed? If you or your child appears to ... have bleeding problems. However, some people who have hemophilia have no recent family history of the disease. ...

  5. Pathology neoplastic and non-neoplastic.

    PubMed

    Graeme-Cook, F

    1996-07-01

    Polyps of the gastrointestinal tract are common and often hard to diagnose by endoscopic or gross examination. Biopsy or polypectomy enables diagnosis and prognostication. This article is by no means encyclopedic, but attempts to discuss the pathology of the more common intestinal polyps. PMID:8829315

  6. Value of the Gastroesophageal Reflux Disease Questionnaire (GerdQ) in predicting the proton pump inhibitor response in coronary artery disease patients with gastroesophageal reflux-related chest pain.

    PubMed

    He, S; Liu, Y; Chen, Y; Tang, Y; Xu, J; Tang, C

    2016-05-01

    Chest pain experienced by patients with coronary artery disease can be partly due to gastroesophageal reflux-induced chest pain (GERP). Empirical proton pump inhibitor (PPI) therapy has been recommended as an initial clinical approach for treating GERP. However, PPI use may lead to some health problems. The Gastroesophageal Reflux Disease Questionnaire (GerdQ) may represent a noninvasive and cost-effective approach for avoiding PPI misuse and for identifying the appropriate patients for the PPI trial test. The aim of this pilot study was to prospectively evaluate the association between GerdQ scores and PPI response in patients with coronary artery disease (CAD) and GERP to determine whether the GerdQ predicts the PPI response in patients with CAD and GERP and to further validate the clinical application value of the GerdQ. A total of 154 consecutive patients with potential GERP were recruited to complete a GerdQ with subsequent PPI therapy. Based on the PPI trial result, patients were divided into a PPI-positive response group and a PPI-negative response group. The difference in the GerdQ scores between the two groups was assessed. The receiver operating characteristic (ROC) curve of GerdQ score was drawn according to the PPI response as the gold standard. The ability of GerdQ to predict the PPI response was assessed. A total of 96 patients completed the entire study; 62 patients (64.6%) were assigned to the PPI-positive response group, and 34 patients (35.4%) to the PPI-negative response group. The GerdQ score of the PPI-positive response group (8.11 ± 3.315) was significantly higher than that of the PPI-negative response group (4.41 ± 2.743), and the difference was statistically significant (t = 5.863, P = 0.000). The ROC curve was drawn according to a PPI response assessment result with a score above 2 as the gold standard. The area under curve was 0.806. When the critical value of GerdQ score was 7.5, Youden index was up to 0.514, the diagnostic sensitivity

  7. How Are Genetic Conditions Diagnosed?

    MedlinePlus

    ... Consultation How are genetic conditions diagnosed? How are genetic conditions diagnosed? A doctor may suspect a diagnosis ... and advocacy resources. For more information about diagnosing genetic conditions: Genetics Home Reference provides information about genetic ...

  8. Understanding Prostate Cancer: Newly Diagnosed

    MedlinePlus

    ... Wellness PCF Spotlight Glossary African American Men Understanding Prostate Cancer Newly Diagnosed Newly Diagnosed Staging the Disease Issues ... you care about has recently been diagnosed with prostate cancer, this section will help guide you through the ...

  9. Psychological Factors that Promote and Inhibit Pathological Gambling

    ERIC Educational Resources Information Center

    Morasco, Benjamin J.; Weinstock, Jeremiah; Ledgerwood, David M.; Petry, Nancy M.

    2007-01-01

    This paper describes qualitative data regarding psychological factors that may affect gambling behavior among treatment-seeking pathological gamblers. Participants (n = 84) diagnosed with pathological gambling were treated in a clinical trial examining the efficacy of cognitive behavioral therapy (CBT). Qualitative data were collected from…

  10. Diagnosing gestational diabetes.

    PubMed

    Ryan, E A

    2011-03-01

    The newly proposed criteria for diagnosing gestational diabetes will result in a gestational diabetes prevalence of 17.8%, doubling the numbers of pregnant women currently diagnosed. These new diagnostic criteria are based primarily on the levels of glucose associated with a 1.75-fold increased risk of giving birth to large-for-gestational age infants (LGA) in the Hyperglycemia Adverse Pregnancy Outcome (HAPO) study; they use a single OGTT. Thus, of 23,316 pregnancies, gestational diabetes would be diagnosed in 4,150 women rather than in 2,448 women if a twofold increased risk of LGA were used. It should be recognised that the majority of women with LGA have normal glucose levels during pregnancy by these proposed criteria and that maternal obesity is a stronger predictor of LGA. The expected benefit of a diagnosis of gestational diabetes in these 1,702 additional women would be the prevention of 140 cases of LGA, 21 cases of shoulder dystocia and 16 cases of birth injury. The reproducibility of an OGTT for diagnosing mild hyperglycaemia is poor. Given that (1) glucose is a weak predictor of LGA, (2) treating these extra numbers has a modest outcome benefit and (3) the diagnosis may be based on a single raised OGTT value, further debate should occur before resources are allocated to implementing this change. PMID:21203743

  11. Diagnosing ADHD in Adolescence

    ERIC Educational Resources Information Center

    Sibley, Margaret H.; Pelham, William E., Jr.; Molina, Brooke S. G.; Gnagy, Elizabeth M.; Waschbusch, Daniel A.; Garefino, Allison C.; Kuriyan, Aparajita B.; Babinski, Dara E.; Karch, Kathryn M.

    2012-01-01

    Objective: This study examines adolescent-specific practical problems associated with current practice parameters for diagnosing attention-deficit/hyperactivity disorder (ADHD) to inform recommendations for the diagnosis of ADHD in adolescents. Specifically, issues surrounding the use of self- versus informant ratings, diagnostic threshold, and…

  12. Diagnosing Abiotic Degradation

    EPA Science Inventory

    The abiotic degradation of chlorinated solvents in ground water can be difficult to diagnose. Under current practice, most of the “evidence” is negative; specifically the apparent disappearance of chlorinated solvents with an accumulation of vinyl chloride, ethane, ethylene, or ...

  13. Medical discourse in pathological anatomy.

    PubMed

    Moskalenko, R; Tatsenko, N; Romanyuk, A; Perelomova, O; Moskalenko, Yu

    2012-05-01

    The paper is devoted to the peculiarities of medical discourse in pathological anatomy as coherent speech and as a linguistic correlate of medical practice taking into account the analysis of its strategies and tactics. The purpose of the paper is to provide a multifaceted analysis of the speech strategies and tactics of pathological anatomy discourse and ways of their implementation. The main strategies of medical discourse in pathological anatomy are an anticipating strategy, a diagnosing strategy and an explaining one. The supporting strategies are pragmatic, conversational and a rhetorical one. The pragmatic strategy is implemented through contact establishing tactics, the conversational one - with the help of control tactics, the rhetorical one - with the help of attention correction tactics. The above mentioned tactics and strategies are used in the distinguishing of major, closely interrelated strategies: "the contact strategy" (to establish contact with a patient's relatives - phatic replicas of greeting and addressing) and "the strategy of explanation" (used in the practice of a pathologist for a detailed explanation of the reasons of a patient's death). The ethic aspect of speech conduct of a doctor-pathologist is analyzed. PMID:22870841

  14. Optical coherence tomography in diagnosing cervical cancer

    NASA Astrophysics Data System (ADS)

    Kuznetzova, Irina A.; Shakhova, Natalia M.; Kachalina, Tatiana S.; Gladkova, Natalia D.; Myakov, Alexey V.; Iksanov, Rashid R.; Feldchtein, Felix I.

    2000-05-01

    Cervical cancer remains one of the most significant problem in oncogynecology. It tends towards treatment approaches that provide termination of pathological processes along with preservation of the patient's life quality. There is a need in earlier and more accurate diagnosis of pathological states, objective assessment of physiological processes, and adequate monitoring of the course of treatment. In our previous publications we have reported unique capabilities of the Optical Coherence Tomography (OCT) to image in vivo the mucosa structure of the cervix and to monitor various physiological and pathological alterations. In this report, we present results of OCT application to diagnose different stages of cervical cancer and to control its treatment at early stages. We have performed OCT-colposcopy in 11 female patients with cervical cancer to derive OCT criteria of this disease, to provide exact demarcation of a pathological area, and to determine a real size of a tumor. We have found that, in general, borders of a tumor, defined visually and detected with OCT by violation of the basement membrane in exocervix, do not coincide. The mismatch depends on a stage of cancer and can be as much as several millimeters. This information is especially important for evaluation of linear dimension of tumors with 3 - 5 mm invasion and also for differential diagnosis between the T1 and T2 stages with cancer extension onto vagina.

  15. Gastroesophageal Reflux Disease (GERD)

    MedlinePlus

    ... foods garlic and onions mint flavorings spicy foods tomato-based foods, like spaghetti sauce, chili, and pizza ... Regurgitation is when food and liquid containing stomach acid comes back up into the throat or mouth.) ...

  16. Primary hyperparathyroidism presenting with pathological fracture.

    PubMed

    Deshmukh, R G; Alsagoff, S A; Krishnan, S; Dhillon, K S; Khir, A S

    1998-12-01

    Primary hyperparathyroidism (PHPT) is an intriguing condition. Routine automated biochemical screening has made the diagnosis commonplace in developed countries and the disease is diagnosed early in its course when it is often asymptomatic. In developing countries or in recent immigrants from these countries, PHPT is often seen in an advanced stage with bone involvement. Associated dietary deficiencies may alter the biochemical profile and cause a diagnostic dilemma. It is important to include it in the differential diagnosis of pathological fractures. We report three cases of PHPT presenting with pathological fractures and discuss their diagnosis and management. PMID:9990797

  17. Association Between Gastroesophageal Reflux Disease After Pneumatic Balloon Dilatation and Clinical Course in Patients With Achalasia

    PubMed Central

    Min, Yang Won; Lee, Jin Hee; Min, Byung-Hoon; Lee, Jun Haeng; Kim, Jae J; Rhee, Poong-Lyul

    2014-01-01

    Background/Aims The occurrence of gastroesophageal reflux disease (GERD) is known to be associated with lower post-treatment lower esophageal sphincter pressure in patients with achalasia. This study aimed to elucidate whether GERD after pneumatic balloon dilatation (PD) has a prognostic role and to investigate how the clinical course of GERD is. Methods A total of 79 consecutive patients who were first diagnosed with primary achalasia and underwent PD as an initial treatment were included in this retrospective study. Single PD was performed using a 3.0 cm balloon. The patients were divided into two groups: 1) who developed GERD after PD (GERD group) and 2) who did not develop GERD after PD (non-GERD group). GERD was defined as pathological acid exposure, reflux esophagitis or typical reflux symptoms. Results Twenty one patients (26.6%) developed GERD after PD during follow-up. There were no significant differences between the two groups in demographic or clinical factors including pre- and post-treatment manometric results. All patients in GERD group were well responsive to maintenance proton pump inhibitor therapy including on demand therapy or did not require maintenance. During a median follow-up of 17.8 months (interquartile range, 7.1–42.7 months), achalasia recurred in 15 patients (19.0%). However, the incidence of recurrence did not differ according to the occurrence of GERD after PD. Conclusions GERD often occurs after even a single PD for achalasia. However, GERD after PD is well responsive to PPI therapy. Our data suggest that GERD after PD during follow-up does not appear to have a prognostic role. PMID:24840373

  18. How Is Cystic Fibrosis Diagnosed?

    MedlinePlus

    ... from the NHLBI on Twitter. How Is Cystic Fibrosis Diagnosed? Doctors diagnose cystic fibrosis (CF) based on ... to see whether the baby has CF. Cystic Fibrosis Carrier Testing People who have one normal CFTR ...

  19. How Is Pulmonary Hypertension Diagnosed?

    MedlinePlus

    ... from the NHLBI on Twitter. How Is Pulmonary Hypertension Diagnosed? Your doctor will diagnose pulmonary hypertension (PH) ... To Look for the Underlying Cause of Pulmonary Hypertension PH has many causes, so many tests may ...

  20. How Is Muscular Dystrophy Diagnosed?

    MedlinePlus

    ... Information Clinical Trials Resources and Publications How is muscular dystrophy diagnosed? Skip sharing on social media links Share this: Page Content The first step in diagnosing muscular dystrophy (MD) is a visit with a health care ...

  1. How Is Kawasaki Disease Diagnosed?

    MedlinePlus

    ... page from the NHLBI on Twitter. How Is Kawasaki Disease Diagnosed? Kawasaki disease is diagnosed based on your child's signs ... are the first to suspect a child has Kawasaki disease. Pediatricians are doctors who specialize in treating ...

  2. Handheld computing in pathology

    PubMed Central

    Park, Seung; Parwani, Anil; Satyanarayanan, Mahadev; Pantanowitz, Liron

    2012-01-01

    Handheld computing has had many applications in medicine, but relatively few in pathology. Most reported uses of handhelds in pathology have been limited to experimental endeavors in telemedicine or education. With recent advances in handheld hardware and software, along with concurrent advances in whole-slide imaging (WSI), new opportunities and challenges have presented themselves. This review addresses the current state of handheld hardware and software, provides a history of handheld devices in medicine focusing on pathology, and presents future use cases for such handhelds in pathology. PMID:22616027

  3. Diagnosing a PDS microdensitometer

    NASA Technical Reports Server (NTRS)

    Vanaltena, W.; Lee, J. F.; Wandersee, A.

    1984-01-01

    A number of diagnostic tests are developed for the Photometric Data System PDS 2020G microdensitometer to monitor its performance and to isolate various electromechanical problems. A number of tests which help to diagnose problems with the photometer, positional accuracy and data collection are described. The tests include: (1) scanning a razor blade edge to study the response of the photometer and zero point losses in the coordinate system, (2) scanning a long straight line to evaluate the drunkness of the stage motions, (3) scanning photometric step wedge calibrations to study the response of the photometer, and (4) measurement of a series of high signal to noise plates of the same region of the sky to evaluate the overall performance of the microdensitometer. A variety of electronic tests to isolate electromechanical problems are also performed.

  4. Diagnosable structured logic array

    NASA Technical Reports Server (NTRS)

    Whitaker, Sterling (Inventor); Miles, Lowell (Inventor); Gambles, Jody (Inventor); Maki, Gary K. (Inventor)

    2009-01-01

    A diagnosable structured logic array and associated process is provided. A base cell structure is provided comprising a logic unit comprising a plurality of input nodes, a plurality of selection nodes, and an output node, a plurality of switches coupled to the selection nodes, where the switches comprises a plurality of input lines, a selection line and an output line, a memory cell coupled to the output node, and a test address bus and a program control bus coupled to the plurality of input lines and the selection line of the plurality of switches. A state on each of the plurality of input nodes is verifiably loaded and read from the memory cell. A trusted memory block is provided. The associated process is provided for testing and verifying a plurality of truth table inputs of the logic unit.

  5. [Quality Management System in Pathological Laboratory].

    PubMed

    Koyatsu, Junichi; Ueda, Yoshihiko

    2015-07-01

    Even compared to other clinical laboratories, the pathological laboratory conducts troublesome work, and many of the work processes are also manual. Therefore, the introduction of the systematic management of administration is necessary. It will be a shortcut to use existing standards such as ISO 15189 for this purpose. There is no standard specialized for the pathological laboratory, but it is considered to be important to a pathological laboratory in particular. 1. Safety nianagement of the personnel and environmental conditions. Comply with laws and regulations concerning the handling of hazardous materials. 2. Pre-examination processes. The laboratory shall have documented procedures for the proper collection and handling of primary samples. Developed and documented criteria for acceptance or rejection of samples are applied. 3. Examination processes. Selection, verification, and validation of the examination procedures. Devise a system that can constantly monitor the traceability of the sample. 4. Post-examination processes. Storage, retention, and disposal of clinical samples. 5. Release of results. When examination results fall within established alert or critical intervals, immediately notify the physicians. The important point is to recognize the needs of the client and be aware that pathological diagnoses are always "the final diagnoses". PMID:26591432

  6. Multicenter, randomized, double-blind study comparing 20 and 40 mg of pantoprazole for symptom relief in adolescents (12 to 16 years of age) with gastroesophageal reflux disease (GERD)

    Technology Transfer Automated Retrieval System (TEKTRAN)

    An age-appropriate questionnaire (GASP-Q) was used to assess the frequency and severity of the gastroesophageal reflux disease (GERD) symptoms: abdominal/belly pain, chest pain/heartburn, pain after eating, nausea, burping/belching, vomiting/regurgitation, choking when eating, and difficulty swallow...

  7. Radiographic pathology for technologists

    SciTech Connect

    Mace, J.D.; Kowalczyk, N.

    1988-01-01

    This book explains the fundamentals of disease mechanisms and relates this to the practice of radiologic science. Each chapter begins with a discussion of normal anatomy and physiology, then covers pathology and demonstrates how the pathology appears on film. Imaging modalities such as computed tomography, MRI, and ultrasound are also discussed. Clinical case studies are included.

  8. Opportunities in Speech Pathology.

    ERIC Educational Resources Information Center

    Newman, Parley W.

    The importance of speech is discussed and speech pathology is described. Types of communication disorders considered are articulation disorders, aphasia, facial deformity, hearing loss, stuttering, delayed speech, voice disorders, and cerebral palsy; examples of five disorders are given. Speech pathology is investigated from these aspects: the…

  9. Gaviscon Double Action Liquid (antacid & alginate) is more effective than antacid in controlling postprandial esophageal acid exposure in GERD patients; a double-blind crossover study

    PubMed Central

    De Ruigh, Annemijn; Roman, Sabine; Chen, Joan; Pandolfino, John E.; Kahrilas, Peter J.

    2015-01-01

    Background Recent studies have shown that Gaviscon Double Action Liquid (a combination alginate-antacid) administered postprandially co-localizes with the acid pocket, the ‘reservoir’ for postprandial acid reflux. Aim This study compared the effectiveness of Gaviscon Double Action Liquid to an equivalent strength antacid without alginate in controlling postprandial acid reflux in GERD patients. Methods 14 GERD patients undertook two 3.5-hour high-resolution manometry/pH-impedance studies during which they ate a standardized meal. In a double-blinded randomized crossover design they then took Gaviscon or CVS brand antacid, each with ~18 mmol/l acid neutralizing capacity. The primary outcome was distal esophageal acid exposure; secondary outcomes were number of reflux events, proximal extent of reflux, nadir pH of the refluxate, mechanism of reflux, and reflux symptoms scored with a validated instrument. Results 10 patients completed the study. Gaviscon studies had significantly less distal esophageal acid exposure and greater nadir refluxate pH in the 30–150 minute postprandial period than antacid studies. There were no differences in the number of reflux events (acid or weakly acidic) or the number of proximal reflux events (15–17 cm above the LES) with either study medication. Conclusions Gaviscon Double Action Liquid was more effective than an antacid without alginate in controlling postprandial esophageal acid exposure. However, the number and spatial distribution of reflux events within the esophagus were similar. This suggests that Gaviscon main effectiveness related to its co-localization with and displacement/neutralization of the post-prandial acid pocket, rather than preventing reflux. PMID:25041141

  10. Clinical governance and pathology

    PubMed Central

    Crook, M

    2002-01-01

    This article looks at clinical governance and pathology. Clinical governance should be an important tool in seeking quality improvement within the Natinal Health Service. But how as pathologists should we go about it? PMID:11896066

  11. Colorectal carcinoma: Pathologic aspects

    PubMed Central

    Fleming, Matthew; Ravula, Sreelakshmi; Tatishchev, Sergei F.

    2012-01-01

    Colorectal carcinoma is one of the most common cancers and one of the leading causes of cancer-related death in the United States. Pathologic examination of biopsy, polypectomy and resection specimens is crucial to appropriate patient managemnt, prognosis assessment and family counseling. Molecular testing plays an increasingly important role in the era of personalized medicine. This review article focuses on the histopathology and molecular pathology of colorectal carcinoma and its precursor lesions, with an emphasis on their clinical relevance. PMID:22943008

  12. A case of thoracogastropagus diagnosed before delivery.

    PubMed

    Hayashi, M; Tomobe, K; Yaoi, Y

    1998-01-01

    The subject was a 29-year-old pregnant woman whose fetuses were a conjoined twin. We diagnosed the fetuses as a conjoined twin by ultrasonography at the 12th week of gestation. The patient and her family wanted living infants and hoped that they were separated surgically. We consulted with the doctors of pediatric surgery and cardiovascular surgery departments. At the 18th week of gestation, the fetuses died in utero and they were delivered transvaginally by labor induction. Both infants were female with 430 g in total body weight and both of them were 21 cm in length. Pathological findings were thoracogastro-pagus with a single heart, a single pair of liver and a single small intestine. PMID:9704294

  13. How Is Aplastic Anemia Diagnosed?

    MedlinePlus

    ... from the NHLBI on Twitter. How Is Aplastic Anemia Diagnosed? Your doctor will diagnose aplastic anemia based on your medical and family histories, a ... your primary care doctor thinks you have aplastic anemia, he or she may refer you to a ...

  14. Diagnosing breast cancer by using Raman spectroscopy

    NASA Astrophysics Data System (ADS)

    Haka, Abigail S.; Shafer-Peltier, Karen E.; Fitzmaurice, Maryann; Crowe, Joseph; Dasari, Ramachandra R.; Feld, Michael S.

    2005-08-01

    We employ Raman spectroscopy to diagnose benign and malignant lesions in human breast tissue based on chemical composition. In this study, 130 Raman spectra are acquired from ex vivo samples of human breast tissue (normal, fibrocystic change, fibroadenoma, and infiltrating carcinoma) from 58 patients. Data are fit by using a linear combination model in which nine basis spectra represent the morphologic and chemical features of breast tissue. The resulting fit coefficients provide insight into the chemical/morphological makeup of the tissue and are used to develop diagnostic algorithms. The fit coefficients for fat and collagen are the key parameters in the resulting diagnostic algorithm, which classifies samples according to their specific pathological diagnoses, attaining 94% sensitivity and 96% specificity for distinguishing cancerous tissues from normal and benign tissues. The excellent results demonstrate that Raman spectroscopy has the potential to be applied in vivo to accurately classify breast lesions, thereby reducing the number of excisional breast biopsies that are performed. Author contributions: M.F., J.C., R.R.D., and M.S.F. designed research; A.S.H. and K.E.S.-P. performed research; A.S.H. and M.F. analyzed data; and A.S.H. wrote the paper.This paper was submitted directly (Track II) to the PNAS office.Abbreviations: DEH, ductal epithelial hyperplasia; ROC, receiver operating characteristic; N/C, nuclear-to-cytoplasm.

  15. Incidence and associated pre-morbid diagnoses of patients with chronic rhinosinusitis

    PubMed Central

    Tan, Bruce K.; Chandra, Rakesh K.; Pollak, Jonathan; Kato, Atsushi; Conley, David B.; Peters, Anju T.; Grammer, Leslie C.; Avila, Pedro C.; Kern, Robert C.; Stewart, Walter F.; Schleimer, Robert P.; Schwartz, Brian S.

    2013-01-01

    Background Chronic rhinosinusitis (CRS) is a prevalent condition with underexplored risk factors. Objectives To determine CRS incidence and evaluate associations with a range of pre-morbid medical conditions for CRS without nasal polyps (CRSsNP) and CRS with nasal polyps (CRSwNP) using real-world clinical practice data. Methods Electronic health record (EHR) data from 446,480 Geisinger Clinic primary care patients was used for a retrospective longitudinal cohort study for data from 2001–2010. Using logistic regression, newly diagnosed CRS cases between 2007-2009 were compared to frequency-matched controls on pre-morbid factors in the immediate (0-6 months), intermediate (7-24 months) and entire observed timeframes prior to diagnosis. Results : The average incidence of CRS was 83 (±13) CRSwNP cases per 100,000 person-years and 1048 (±78) CRSsNP cases per 100,000 person-years. Between 2007-2009, 595 patients with incident CRSwNP and 7523 patients with incident CRSsNP were identified and compared to 8118 controls. Compared to controls and CRSsNP, CRSwNP patients were older and more likely to be male. Prior to diagnosis, CRS patients had a higher prevalence of acute rhinosinusitis, allergic rhinitis, chronic rhinitis, asthma, gastroesophageal reflux disease (GERD), adenotonsillitis, sleep apnea, anxiety and headaches (all p < 0.001). CRSsNP had a higher pre-morbid prevalence of infections of the upper and lower airway, skin/soft tissue and urinary tract (all p < 0.001). In the immediate and intermediate timeframes analyzed, patients who developed CRS had more outpatient encounters and antibiotic prescriptions (p < 0.001) but guideline-recommended diagnostic testing was performed in a minority of cases. Conclusions Patients who are diagnosed with CRS have a higher pre-morbid prevalence of anxiety, headaches, GERD, sleep apnea and infections of the respiratory system and some non-respiratory sites that results in higher antibiotic, corticosteroid and health care

  16. Detection of environmental effects through anatomic pathology.

    PubMed

    Miller, R W

    1985-01-01

    Anatomic pathology has produced considerable knowledge about environmental teratogens and carcinogens. A special disease registry established by a pathologist provided details of the association between oral contraceptives and hepatic neoplams. Pathologists were also involved in establishing in the link between diethylstilbestrol use and clear-cell adenocarcinomas of the vagina. An area of particular interest has been gender and ethnic differences in the incidence of certain diseases. Pathologists further make use of animal studies to investigate the pathogenesis of human tumors. Finally, stored serum or tissue is often used by pathologists to help diagnose diseases retrospectively. Human skin fibroblasts grown in culture and stored have been especially valuable for laboratory research. This chapter briefly highlights some of the milestones in the detection of enviromental effects through anatomic pathology. PMID:2997598

  17. Diagnose human tumors by THz near-field imaging

    NASA Astrophysics Data System (ADS)

    Chen, Hua; Wang, Xiaozhou; Zhao, Tian; Yang, Jinwen

    2014-09-01

    Based on a THz pipe-based near-field imaging system, we demonstrated the capability of THz imaging to diagnose human breast and liver cancers. Through THz near-field mapping of the absorption constants of cancer tissues, the acquired images can not only clearly distinguish cancer from normal tissues fast, automatically, and correctly without pathological H&E staining, but also identify the distribution region of cancer, which matches well with the identification with pathological examination. Due to its capability to perform quantitative analysis, our study indicates the potential of the THz pipe-based near-field imaging for future automation on human tumor pathological examinations and for quick definition of the tumor margins during the surgical procedure such as breast-conserving surgery. With the help of THz imaging, we can expect to economize the use of hospital and human resources.

  18. Pathologic aspects of skull base tumors.

    PubMed

    Marszałek, Andrzej; Szylberg, Łukasz; Wiśniewski, Sławomir

    2016-01-01

    Skull base tumors form a highly heterogeneous group. As there are several structures in this anatomical site, a large number of different primary malignancies might develop, as well as a variety of secondary (metastatic) tumors. In this article, the most common malignancies are presented, along with a short histopathologic description. For some entities, an immunohistochemical profile is also given that should be helpful in proper diagnosis. As many pathologic diagnoses nowadays also include genetic studies, the most common genetic abnormalities in skull base tumors are presented. PMID:27330415

  19. Complexity and forensic pathology.

    PubMed

    Jones, Richard Martin

    2015-12-01

    It has become increasingly apparent that nonlinearity and complexity are the norm in human physiological systems, the relevance of which is informing an enhanced understanding of basic pathological processes such as inflammation, the host response to severe trauma, and critical illness. This article will explore how an understanding of nonlinear systems and complexity might inform the study of the pathophysiology of deaths of medicolegal interest, and how 'complexity thinking' might usefully be incorporated into modern forensic medicine and forensic pathology research, education and practice. PMID:26372537

  20. Complications of Pathologic Myopia.

    PubMed

    Cho, Bum-Joo; Shin, Joo Young; Yu, Hyeong Gon

    2016-01-01

    Pathologic myopia (PM) is one of the leading causes of visual impairment worldwide. The pathophysiology of PM is not fully understood, but the axial elongation of the eye followed by chorioretinal thinning is suggested as a key mechanism. Pathologic myopia may lead to many complications such as chorioretinal atrophy, foveoschisis, choroidal neovascularization, rhegmatogenous retinal detachment, cataract, and glaucoma. Some complications affect visual acuity significantly, showing poor visual prognosis. This article aims to review the types, pathophysiology, treatment, and visual outcome of the complications of PM. PMID:26649982

  1. Molecular Pathology Informatics.

    PubMed

    Roy, Somak

    2015-06-01

    Molecular informatics (MI) is an evolving discipline that will support the dynamic landscape of molecular pathology and personalized medicine. MI provides a fertile ground for development of clinical solutions to bridge the gap between clinical informatics and bioinformatics. Rapid adoption of next generation sequencing (NGS) in the clinical arena has triggered major endeavors in MI that are expected to bring a paradigm shift in the practice of pathology. This brief review presents a broad overview of various aspects of MI, particularly in the context of NGS based testing. PMID:26065793

  2. Development of an electronic breast pathology database in a community health system

    PubMed Central

    Nelson, Heidi D.; Weerasinghe, Roshanthi; Martel, Maritza; Bifulco, Carlo; Assur, Ted; Elmore, Joann G.; Weaver, Donald L.

    2014-01-01

    Background: Health care systems rely on electronic patient data, yet access to breast tissue pathology results continues to depend on interpreting dictated free-text reports. Objective: The objective was to develop a method to electronically search and categorize pathologic diagnoses of patients’ breast tissue specimens from dictated free-text pathology reports in a large health system for multiple users including clinicians. Design: A database integrating existing patient-level administrative and clinical information for breast cancer screening and diagnostic services and a web-based application for comprehensive searching of pathology reports were developed by a health system team led by pathologists. The Breast Pathology Assessment Tool and Hierarchy for Diagnosis (BPATH-Dx) provided search terms and guided electronic transcription of diagnoses from text fields on breast pathology clinical reports to standardized categories. Approach: Breast pathology encounters in the pathology database were matched with administrative data for 7332 women with breast tissue specimens obtained from an initial procedure in the health system from January 1, 2008 to December 31, 2011. Sequential queries of the pathology text based on BPATH-Dx categorized biopsies according to their worst pathological diagnosis, as is standard practice. Diagnoses ranged from invasive breast cancer (23.3%), carcinoma in situ (7.8%), atypical lesions (6.39%), proliferative lesions without atypia (27.9%), and nonproliferative lesions (34.7%), and were further classified into subcategories. A random sample of 5% of reports that were manually reviewed indicated 97.5% agreement. Conclusions: Sequential queries of free-text pathology reports guided by a standardized assessment tool in conjunction with a web-based search application provide an efficient and reproducible approach to accessing nonmalignant breast pathology diagnoses. This method advances the use of pathology data and electronic health

  3. How Is Lactose Intolerance Diagnosed?

    MedlinePlus

    ... following tests also can help diagnose lactose intolerance: Hydrogen breath test. For this test, a person drinks ... beverage that has lactose in it. Then, the hydrogen level in the breath is measured at set ...

  4. How Is Atrial Fibrillation Diagnosed?

    MedlinePlus

    ... too much thyroid hormone). Diagnostic Tests and Procedures EKG An EKG is a simple, painless test that records the ... the most useful test for diagnosing AF. An EKG shows how fast your heart is beating and ...

  5. How Are Uterine Fibroids Diagnosed?

    MedlinePlus

    ... Clinical Trials Resources and Publications How are uterine fibroids diagnosed? Skip sharing on social media links Share ... probably won’t know that you have uterine fibroids. Sometimes, health care providers find fibroids during a ...

  6. Ankle Fractures Often Not Diagnosed

    MedlinePlus

    ... News, Videos & Podcasts » Articles » Text Size Print Bookmark Ankle Fractures Often Not Diagnosed Long-term Complications Result from Poor Recovery Mistaking an ankle fracture for an ankle sprain has serious consequences ...

  7. How Is Bone Cancer Diagnosed?

    MedlinePlus

    ... Topic How is bone cancer staged? How is bone cancer diagnosed? A patient’s symptoms, physical exam, and results ... and other imaging tests. Imaging tests to detect bone cancer X-rays Most bone cancers show up on ...

  8. How Is Penile Cancer Diagnosed?

    MedlinePlus

    ... These might include a biopsy and imaging tests. Biopsy A biopsy is needed to diagnose penile cancer. ... depends on the nature of the abnormality. Incisional biopsy For an incisional biopsy only a part of ...

  9. Pathological Gambling: Psychiatric Models

    ERIC Educational Resources Information Center

    Westphal, James R.

    2008-01-01

    Three psychiatric conceptual models: addictive, obsessive-compulsive spectrum and mood spectrum disorder have been proposed for pathological gambling. The objectives of this paper are to (1) evaluate the evidence base from the most recent reviews of each model, (2) update the evidence through 2007 and (3) summarize the status of the evidence for…

  10. Pathological fractures in children

    PubMed Central

    De Mattos, C. B. R.; Binitie, O.; Dormans, J. P.

    2012-01-01

    Pathological fractures in children can occur as a result of a variety of conditions, ranging from metabolic diseases and infection to tumours. Fractures through benign and malignant bone tumours should be recognised and managed appropriately by the treating orthopaedic surgeon. The most common benign bone tumours that cause pathological fractures in children are unicameral bone cysts, aneurysmal bone cysts, non-ossifying fibromas and fibrous dysplasia. Although pathological fractures through a primary bone malignancy are rare, these should be recognised quickly in order to achieve better outcomes. A thorough history, physical examination and review of plain radiographs are crucial to determine the cause and guide treatment. In most benign cases the fracture will heal and the lesion can be addressed at the time of the fracture, or after the fracture is healed. A step-wise and multidisciplinary approach is necessary in caring for paediatric patients with malignancies. Pathological fractures do not have to be treated by amputation; these fractures can heal and limb salvage can be performed when indicated. PMID:23610658

  11. Is Psychometrics Pathological Science?

    ERIC Educational Resources Information Center

    Michell, Joel

    2008-01-01

    Pathology of science occurs when the normal processes of scientific investigation break down and a hypothesis is accepted as true within the mainstream of a discipline without a serious attempt being made to test it and without any recognition that this is happening. It is argued that this has happened in psychometrics: The hypothesis upon which…

  12. Pathology of Extranodal Lymphoma.

    PubMed

    Heckendorn, Emily; Auerbach, Aaron

    2016-07-01

    An overview of the pathology of extranodal lymphoma is presented. The emphasis of this presentation is on the classification system of extranodal lymphomas, including both B-cell and T-cell lymphomas, based on their morphology, phenotype, and molecular alterations. PMID:27265600

  13. Pathological Gambling Subtypes

    ERIC Educational Resources Information Center

    Vachon, David D.; Bagby, R. Michael

    2009-01-01

    Although pathological gambling (PG) is regarded in the 4th edition of the "Diagnostic and Statistical Manual of Mental Disorders" (American Psychiatric Association, 1994) as a unitary diagnostic construct, it is likely composed of distinct subtypes. In the current report, the authors used cluster analyses of personality traits with a…

  14. Guidelines for resident training in veterinary clinical pathology. III: cytopathology and surgical pathology.

    PubMed

    Kidney, Beverly A; Dial, Sharon M; Christopher, Mary M

    2009-09-01

    The Education Committee of the American Society for Veterinary Clinical Pathology has identified a need for improved structure and guidance of training residents in clinical pathology. This article is the third in a series of articles that address this need. The goals of this article are to describe learning objectives and competencies in knowledge, abilities, and skills in cytopathology and surgical pathology (CSP); provide options and ideas for training activities; and identify resources in veterinary CSP for faculty, training program coordinators, and residents. Guidelines were developed in consultation with Education Committee members and peer experts and with evaluation of the literature. The primary objectives of training in CSP are: (1) to develop a thorough, extensive, and relevant knowledge base of biomedical and clinical sciences applicable to the practice of CSP in domestic animals, laboratory animals, and other nondomestic animal species; (2) to be able to reason, think critically, investigate, use scientific evidence, and communicate effectively when making diagnoses and consulting and to improve and advance the practice of pathology; and (3) to acquire selected technical skills used in CSP and pathology laboratory management. These guidelines define expected competencies that will help ensure proficiency, leadership, and the advancement of knowledge in veterinary CSP and will provide a useful framework for didactic and clinical activities in resident-training programs. PMID:19619150

  15. Pathology informatics fellowship training: Focus on molecular pathology

    PubMed Central

    Mandelker, Diana; Lee, Roy E.; Platt, Mia Y.; Riedlinger, Gregory; Quinn, Andrew; Rao, Luigi K. F.; Klepeis, Veronica E.; Mahowald, Michael; Lane, William J.; Beckwith, Bruce A.; Baron, Jason M.; McClintock, David S.; Kuo, Frank C.; Lebo, Matthew S.; Gilbertson, John R.

    2014-01-01

    Background: Pathology informatics is both emerging as a distinct subspecialty and simultaneously becoming deeply integrated within the breadth of pathology practice. As specialists, pathology informaticians need a broad skill set, including aptitude with information fundamentals, information systems, workflow and process, and governance and management. Currently, many of those seeking training in pathology informatics additionally choose training in a second subspecialty. Combining pathology informatics training with molecular pathology is a natural extension, as molecular pathology is a subspecialty with high potential for application of modern biomedical informatics techniques. Methods and Results: Pathology informatics and molecular pathology fellows and faculty evaluated the current fellowship program's core curriculum topics and subtopics for relevance to molecular pathology. By focusing on the overlap between the two disciplines, a structured curriculum consisting of didactics, operational rotations, and research projects was developed for those fellows interested in both pathology informatics and molecular pathology. Conclusions: The scope of molecular diagnostics is expanding dramatically as technology advances and our understanding of disease extends to the genetic level. Here, we highlight many of the informatics challenges facing molecular pathology today, and outline specific informatics principles necessary for the training of future molecular pathologists. PMID:24843823

  16. [Pathology of lung cancer].

    PubMed

    Theegarten, D; Hager, T

    2016-09-01

    Lung cancer is the leading cause of cancer death in men and the second most frequent cause in women. The pathology of lung tumors is of special relevance concerning therapy and prognosis and current classification systems have to be taken into consideration. The results of molecular tissue subtyping allow further classification and therapeutic options. The histological entities are mainly associated with typical X‑ray morphological features. PMID:27495784

  17. Diagnosing and Treating Hantavirus Pulmonary Syndrome (HPS)

    MedlinePlus

    ... CDC.gov . Hantavirus Share Compartir Diagnosing and Treating Hantavirus Pulmonary Syndrome (HPS) Diagnosing HPS Diagnosing HPS in ... of patients that develop HPS from New World Hantaviruses recover completely. No chronic infection has been detected ...

  18. Masochism and pathological gambling.

    PubMed

    Rosenthal, Richard J

    2015-03-01

    That all pathological gamblers have an "unconscious wish to lose," an idea first expressed by Freud and Bergler, is neither true nor useful; wrong as well, however, are the reasons for neglecting masochism in relation to gambling. There is a small but clinically significant subgroup of pathological gamblers who are masochistic. I present clinical vignettes and a more extended treatment account to illustrate its importance. Masochism has been a confusing concept. As used here it refers to the deliberate seeking of pain, loss, suffering, or humiliation. There may be pleasure in pain, or an obligatory combining of pleasure and pain. A sense of power and control may be achieved through suffering. The case material illustrates clinically useful types (sexual masochism, masochistic personality disorder, moral masochism, relational masochism) as well as some common masochistic dynamics encountered in the treatment of pathological gamblers. These masochistic patterns are often identifiable during the initial evaluation. Distinguishing features may include a reversal of normal attitudes about winning and losing, the absence of an early winning phase, sometimes a memorable early loss. Gamblers may sabotage opportunities for success or create unnecessary obstacles for themselves. Losing may be more comfortable than winning or may be overtly sexualized. PMID:25734872

  19. Harlequin testicle and other uncommon pathologies masquerading at routine scrotal ultrasound.

    PubMed

    Medverd, Jonathan R; Peguero, Larissa; Patel, Dhairyasheel P

    2015-06-01

    Many scrotal conditions manifest similarly as pain, swelling, a palpable abnormality, or a combination of these symptoms. Most common scrotal pathologies have characteristic accompanying sonographic findings. Less common pathologies can have similar clinical presentations, and imaging with scrotal ultrasound is required to aid in proper diagnosis. This article focuses on several of these less commonly encountered scrotal pathologies--including testicular segmental infarction, scrotal filariasis, scrotal mesothelioma, seminiferous tubule fibrosis, and scrotal leiomyosarcoma--and compares and contrasts them to more routine diagnoses. Familiarity with both typical and atypical scrotal conditions is necessary to make accurate diagnoses at ultrasound to guide appropriate treatment and avoid unnecessary surgery. PMID:25938549

  20. Immunological methods for diagnosing neurocysticercosis

    SciTech Connect

    Kuhn, R.E.; Estrada, J.J.; Grogl, M.

    1989-01-31

    A method is described for diagnosing active human neurocysticercosis by detecting the presence of at least one Taenia solium larval antigen in cerebrospinal fluid, which comprises: contacting cerebrospinal fluid from a human to be diagnosed with a solid support, wherein the support binds with a Taenia solium larval antigen if present, contacting the support with a first antibody, wherein the first antibody binds with a larval Taenia solium antigen if present in the cerebrospinal fluid, contacting the solid support with a detectable second antibody which will bind with the first antibody, and detecting the second antibody bound to the support.

  1. Oncologic Care and Pathology Resources in Africa: Survey and Recommendations.

    PubMed

    Nelson, Ann M; Milner, Danny A; Rebbeck, Timothy R; Iliyasu, Yawale

    2016-01-01

    The connection of a clinician who identifies a patient with signs and symptoms of malignancy to an oncologist who has the tools to treat a patient's cancer requires a diagnostic pathology laboratory to receive, process, and diagnose the tumor. Without an accurate classification, nothing is known of diagnosis, prognosis, or treatment by the clinical team, and most important, the patient is left scared, confused, and without hope. The vast majority of deaths from malignancies occur in sub-Saharan Africa primarily as a result of lack of public awareness of cancer and how it is diagnosed and treated in the setting of a severe lack of resources (physical and personnel) to actually diagnose tumors. To correct this massive health disparity, a plan of action is required across the continent of Africa to bring diagnostic medicine into the modern era and connect patients with the care they desperately need. We performed a survey of resources in Africa for tissue diagnosis of cancer and asked quantitative questions about tools, personnel, and utilization. We identified a strong correlation between pathology staffing and capacity to provide pathology services. On the basis of this survey and through a congress of concerned pathologists, we propose strategies that will catapult the continent into an era of high-quality pathology services with resultant improvement in cancer outcomes. PMID:26578619

  2. American Society for Clinical Pathology

    MedlinePlus

    ... With the National Cancer Institute for Inaugural Global Pathology Conference March 2016 OneLab Memo ASCP Action Alert - ... 2016 Copyright © 2016 by American Society for Clinical Pathology. All Rights Reserved. Terms of Use About ASCP ...

  3. American Society for Clinical Pathology

    MedlinePlus

    ... Science Letter to Council of Deans: State of Pathology Training in Medical School Help Chart the Future ... Need Copyright © 2016 by American Society for Clinical Pathology. All Rights Reserved. Terms of Use About ASCP ...

  4. How Is Fanconi Anemia Diagnosed?

    MedlinePlus

    ... from the NHLBI on Twitter. How Is Fanconi Anemia Diagnosed? People who have Fanconi anemia (FA) are born with the disorder. They may ... questions about: Any personal or family history of anemia Any surgeries you’ve had related to the ...

  5. How Is an Aneurysm Diagnosed?

    MedlinePlus

    ... from the NHLBI on Twitter. How Is an Aneurysm Diagnosed? If you have an aortic aneurysm but no symptoms, your doctor may find it ... a routine physical exam. More often, doctors find aneurysms during tests done for other reasons, such as ...

  6. Associations among Major Psychiatric Diagnoses.

    ERIC Educational Resources Information Center

    Wolf, Abraham W.; And Others

    1988-01-01

    Examined the frequency and associations of multiple diagnoses in 205 psychiatric inpatients, assessing past and current episodes of illness. Over one-half of the sample received more than one diagnosis. Alcoholism, antisocial personality, and drug dependence formed one group; primary depression, primary mania, and secondary affective disorder,…

  7. Pathology Gross Photography: The Beginning of Digital Pathology.

    PubMed

    Rampy, B Alan; Glassy, Eric F

    2016-03-01

    The underutilized practice of photographing anatomic pathology specimens from surgical pathology and autopsies is an invaluable benefit to patients, clinicians, pathologists, and students. Photographic documentation of clinical specimens is essential for the effective practice of pathology. When considering what specimens to photograph, all grossly evident pathology, absent yet expected pathologic features, and gross-only specimens should be thoroughly documented. Specimen preparation prior to photography includes proper lighting and background, wiping surfaces of blood, removing material such as tubes or bandages, orienting the specimen in a logical fashion, framing the specimen to fill the screen, positioning of probes, and using the right-sized scale. PMID:26851666

  8. Pathology Gross Photography: The Beginning of Digital Pathology.

    PubMed

    Rampy, B Alan; Glassy, Eric F

    2015-06-01

    The underutilized practice of photographing anatomic pathology specimens from surgical pathology and autopsies is an invaluable benefit to patients, clinicians, pathologists, and students. Photographic documentation of clinical specimens is essential for the effective practice of pathology. When considering what specimens to photograph, all grossly evident pathology, absent yet expected pathologic features, and gross-only specimens should be thoroughly documented. Specimen preparation prior to photography includes proper lighting and background, wiping surfaces of blood, removing material such as tubes or bandages, orienting the specimen in a logical fashion, framing the specimen to fill the screen, positioning of probes, and using the right-sized scale. PMID:26065794

  9. Pathologic and physiologic phimosis

    PubMed Central

    McGregor, Thomas B.; Pike, John G.; Leonard, Michael P.

    2007-01-01

    OBJECTIVE To review the differences between physiologic and pathologic phimosis, review proper foreskin care, and discuss when it is appropriate to seek consultation regarding a phimotic foreskin. SOURCES OF INFORMATION This paper is based on selected findings from a MEDLINE search for literature on phimosis and circumcision referrals and on our experience at the Children’s Hospital of Eastern Ontario Urology Clinic. MeSH headings used in our MEDLINE search included “phimosis,” “referral and consultation,” and “circumcision.” Most of the available articles about phimosis and foreskin referrals were retrospective reviews and cohort studies (levels II and III evidence). MAIN MESSAGE Phimosis is defined as the inability to retract the foreskin. Differentiating between physiologic and pathologic phimosis is important, as the former is managed conservatively and the latter requires surgical intervention. Great anxiety exists among patients and parentsregarding non-retractile foreskins. Most phimosis referrals seen in pediatric urology clinics are normal physiologically phimotic foreskins. Referrals of patients with physiologic phimosis to urology clinics can create anxiety about the need for surgery among patients and parents, while unnecessarily expanding the waiting list for specialty assessment. Uncircumcised penises require no special care. With normal washing, using soap and water, and gentle retraction during urination and bathing, most foreskins will become retractile over time. CONCLUSION Physiologic phimosis is often seen by family physicians. These patients and their parents require reassurance of normalcy and reinforcement of proper preputial hygiene. Consultation should be sought when evidence of pathologic phimosis is present, as this requires surgical management. PMID:17872680

  10. The College of American Pathologists guidelines for whole slide imaging validation are feasible for pediatric pathology: a pediatric pathology practice experience.

    PubMed

    Arnold, Michael A; Chenever, Emily; Baker, Peter B; Boué, Daniel R; Fung, Bonita; Hammond, Sue; Hendrickson, Brett W; Kahwash, Samir B; Pierson, Christopher R; Prasad, Vinay; Nicol, Kathleen K; Barr, Thomas

    2015-01-01

    Whole slide imaging (WSI) is rapidly transforming educational and diagnostic pathology services. Recently, the College of American Pathologists Pathology and Laboratory Quality Center (CAP-PLQC) published recommended guidelines for validating diagnostic WSI. We prospectively evaluated the guidelines to determine their utility in validating pediatric surgical pathology and cytopathology specimens. Our validation included varied pediatric specimen types, including complex or less common diagnoses, in accordance with the guidelines. We completed WSI review of 60 surgical pathology cases and attempted WSI review of 21 cytopathology cases. For surgical pathology cases, WSI diagnoses were highly concordant with glass slide diagnoses; a discordant diagnosis was observed in 1 of 60 cases (98.3% concordance). We found that nucleated red blood cells and eosinophilic granular bodies represented specific challenges to WSI review of pediatric specimens. Cytology specimens were more frequently discordant or failed for technical reasons, with overall concordance of 66.7%. Review of pediatric cytopathology specimens will likely require image capture in multiple focal planes. This study is the first to specifically evaluate WSI review for pediatric specimens and demonstrates that specimens representing the spectrum of pediatric surgical pathology practice can be reviewed using WSI. Our application of the proposed CAP-PLQC guidelines to pediatric surgical pathology specimens is, to our knowledge, the first prospective implementation of the CAP-PLQC guidelines. PMID:25387255

  11. Pathology of melanoma.

    PubMed

    Elder, David E

    2015-04-01

    The pathology of melanoma is discussed in relation to surgical diagnosis and management. Pitfalls that may result in problems of clinicopathologic communication are emphasized. A compelling vision for the future is that all tumors will be characterized by their driving oncogenes, suppressor genes, and other genomic factors. The success of targeted therapy directed against individual oncogenes, despite its limitations, suggests that a repertoire of targeted agents will be developed that can be used against a variety of different tumors, depending on the results of genetic testing. Nevertheless, histopathologic diagnosis and surgical therapy will remain mainstays of management for melanoma. PMID:25769708

  12. Marketing the pathology practice.

    PubMed

    Berkowitz, E N

    1995-07-01

    Effective marketing of the pathology practice is essential in the face of an increasingly competitive market. Successful marketing begins with a market-driven planning process. As opposed to the traditional planning process used in health care organizations, a market-driven approach is externally driven. Implementing a market-driven plan also requires recognition of the definition of the service. Each market to which pathologists direct their service defines the service differently. Recognition of these different service definitions and creation of a product to meet these needs could lead to competitive advantages in the marketplace. PMID:7625911

  13. Pathological and Clinical Spectrum of Progressive Supranuclear Palsy: With Special Reference to Astrocytic Tau Pathology.

    PubMed

    Yokoyama, Yuichi; Toyoshima, Yasuko; Shiga, Atsushi; Tada, Mari; Kitamura, Hideaki; Hasegawa, Kazuko; Onodera, Osamu; Ikeuchi, Takeshi; Someya, Toshiyuki; Nishizawa, Masatoyo; Kakita, Akiyoshi; Takahashi, Hitoshi

    2016-03-01

    Progressive supranuclear palsy (PSP) is a four-repeat tauopathy with tau-positive, argyrophilic tuft-shaped astrocytes (TAs). We performed a pathological and clinical investigation in 40 consecutive autopsied Japanese patients with pathological diagnoses of PSP or PSP-like disease. Unequivocal TAs were present in 22 cases, all of which were confirmed to be PSP. Such TAs were hardly detected in the other 18 cases, which instead exhibited tau-positive, argyrophilic astrocytes, appearing as comparatively small clusters with central nuclei of irregularly shaped, coarse structures (equivocal TAs). Cluster analysis of the distribution pattern of tau-related pathology for these 18 cases identified two subgroups, pallido-nigro-luysian atrophy (PNLA) Type 1 (n = 9) and Type 2 (n = 9), the former being distinguished from the latter by the presence of tau-related lesions in the motor cortex, pontine nucleus and cerebellar dentate nucleus in addition to the severely affected PNL system. The duration from symptom onset until becoming wheelchair-bound was significantly longer in PNLA Type 1. Immunoblotting of samples from the three disease conditions revealed band patterns of low-molecular-mass tau fragments at ∼35 kDa. These findings shed further light on the wide pathological and clinical spectrum of four-repeat tauopathy, representing PSP in the broad sense rather than classical PSP. PMID:25974705

  14. Diagnostics of gastric pathology by means of laser fluorescence

    NASA Astrophysics Data System (ADS)

    Moysyuk, T. G.

    2012-10-01

    This article presents the principles of laser fluorescence diagnostic method used to diagnose pathological conditions of the stomach. In it, the new criteria are proposed - the total area and integrated fluorescence intensity as the differentiation of pathological conditions. The results of investigating the interrelation between the values of intensity and area of laser fluorescence are presented. They characterize the coordinate distributions of reradiation in the points of polarizationally filtered laser images of stomach histological sections. The criteria of laser polarization fluorescent diagnostics of stomach cancer nascency and its severity degree differentiation are determined.

  15. Diagnoses of corticobasal syndrome and corticobasal degeneration.

    PubMed

    Shimohata, Takayoshi; Aiba, Ikuko; Nishizawa, Masatoyo

    2016-03-30

    Experts use the term corticobasal syndrome (CBS) for patients with a clinical diagnosis of corticobasal degeneration (CBD), and reserve CBD for those whose conditions have been diagnosed on the basis of neuropathological analyses. Several studies demonstrated that patients with CBD may also present with progressive supranuclear syndrome (PSPS), aphasia, Alzheimer disease-like dementia or behavioral change, suggesting that CBS is merely one of the presenting phenotypes of CBD. Although previous CBD diagnostic criteria reflected only CBS, the international consortium proposed new diagnostic criteria for CBD in 2013 (Armstrong's criteria). The new criteria include 4 CBD subtypes; CBS, frontal behavioral-spatial syndrome (FBS), nonfluent/agrammatic variant of primary progressive aphasia (naPPA),and PSPS. These subtypes were combined to create 2 sets of criteria: more specific clinical research criteria for probable CBD (cr-CBD) and broader criteria for possible CBD that are more inclusive but have a higher chance to detect other tau-based pathologies (p-CBD). Two studies have already revealed that the sensitivity and specificity of the criteria were not high. Because therapeutic interventions that target abnormally-phosphorylated tau have started, further refinement of the criteria is needed via biomarker researches with prospective study designs. PMID:26876110

  16. Nanotechnology: Toxicologic Pathology

    PubMed Central

    Hubbs, Ann F.; Sargent, Linda M.; Porter, Dale W.; Sager, Tina M.; Chen, Bean T.; Frazer, David G.; Castranova, Vincent; Sriram, Krishnan; Nurkiewicz, Timothy R.; Reynolds, Steven H.; Battelli, Lori A.; Schwegler-Berry, Diane; McKinney, Walter; Fluharty, Kara L.; Mercer, Robert R.

    2015-01-01

    Nanotechnology involves technology, science, and engineering in dimensions less than 100 nm. A virtually infinite number of potential nanoscale products can be produced from many different molecules and their combinations. The exponentially increasing number of nanoscale products will solve critical needs in engineering, science, and medicine. However, the virtually infinite number of potential nanotechnology products is a challenge for toxicologic pathologists. Because of their size, nanoparticulates can have therapeutic and toxic effects distinct from micron-sized particulates of the same composition. In the nanoscale, distinct intercellular and intracellular translocation pathways may provide a different distribution than that obtained by micron-sized particulates. Nanoparticulates interact with subcellular structures including microtubules, actin filaments, centrosomes, and chromatin; interactions that may be facilitated in the nanoscale. Features that distinguish nanoparticulates from fine particulates include increased surface area per unit mass and quantum effects. In addition, some nanotechnology products, including the fullerenes, have a novel and reactive surface. Augmented microscopic procedures including enhanced dark-field imaging, immunofluorescence, field-emission scanning electron microscopy, transmission electron microscopy, and confocal microscopy are useful when evaluating nanoparticulate toxicologic pathology. Thus, the pathology assessment is facilitated by understanding the unique features at the nanoscale and the tools that can assist in evaluating nanotoxicology studies. PMID:23389777

  17. Exosomes in liver pathology.

    PubMed

    Sato, Keisaku; Meng, Fanyin; Glaser, Shannon; Alpini, Gianfranco

    2016-07-01

    Exosomes are small (∼100nm) membrane-bound extracellular vesicles released by various types of cells into biological fluids. They contain proteins, mRNAs and miRNAs as cargo. Different cell types can take up exosomes by endocytosis and the cargo contained within them can be transferred horizontally to these recipient cells. Exosomal proteins and miRNAs can be functional and regulate physiological cell events modifying the microenvironment in target cells, a key event of liver pathology. Exosome-mediated cell-cell communication can alter tumor growth, cell migration, antiviral infection and hepatocyte regeneration, indicating that exosomes have great potential for development as diagnostic or therapeutic tools. Analyses of circulating total or exosomal miRNAs have identified a large number of candidate miRNAs that are regulated in liver diseases, and the diagnostic testing using single or multiple miRNAs shows good sensitivity and specificity. Some candidate miRNAs have been identified to play an important role in various liver disorders. This review summarizes recent findings on the role of extracellular vesicles in liver diseases and their diagnostic and therapeutic potential, mainly focusing on exosomes but also includes microvesicles in liver pathology. PMID:26988731

  18. Tracking in anatomic pathology.

    PubMed

    Pantanowitz, Liron; Mackinnon, Alexander C; Sinard, John H

    2013-12-01

    Bar code-based tracking solutions, long present in clinical pathology laboratories, have recently made an appearance in anatomic pathology (AP) laboratories. Tracking of AP "assets" (specimens, blocks, slides) can enhance laboratory efficiency, promote patient safety, and improve patient care. Routing of excess clinical material into research laboratories and biorepositories are other avenues that can benefit from tracking of AP assets. Implementing tracking is not as simple as installing software and turning it on. Not all tracking solutions are alike. Careful analysis of laboratory workflow is needed before implementing tracking to assure that this solution will meet the needs of the laboratory. Such analysis will likely uncover practices that may need to be modified before a tracking system can be deployed. Costs that go beyond simply that of purchasing software will be incurred and need to be considered in the budgeting process. Finally, people, not technology, are the key to assuring quality. Tracking will require significant changes in workflow and an overall change in the culture of the laboratory. Preparation, training, buy-in, and accountability of the people involved are crucial to the success of this process. This article reviews the benefits, available technology, underlying principles, and implementation of tracking solutions for the AP and research laboratory. PMID:23634908

  19. A Case of Aerophagia Diagnosed by Multichannel Intraluminal Impedance Monitoring.

    PubMed

    Sohn, Ki Chang; Jeong, Young Hoon; Jo, Dong Ho; Heo, Won Gak; Yeom, Dong Han; Choi, Suck Chei; Ryu, Han Seung

    2015-11-01

    Aerophagia is a disorder caused by abnormal accumulation of air in the gastrointestinal tract as a result of repetitive and frequent inflow of air through the mouth. For the diagnosis of this condition, it is difficult to objectively measure the air swallowing. However, multichannel intraluminal impedance monitoring facilitates the differential diagnosis between normal air swallowing and pathologic aerophagia, and can aid in the determination of the frequency and amount of air swallowed. In this report, in addition to a literature review, we describe a case of 36-year-old man with abdominal distension who was diagnosed with aerophagia using esophageal impedance monitoring and was treated with clonazepam. PMID:26586352

  20. [Cystic renal pathology].

    PubMed

    Rosi, P; Cesaroni, M; Bracarda, S; Rociola, W; Virgili, G

    1993-08-01

    Ultrasonography has a great interest in diagnosis of cystic kidney disorders for typical eco-pattern of this pathology. In this work we show the eco-pattern of the most common cystic kidney disorders. Particularly we examine simple cysts (typical, atypical, complicated), multicystic kidney dysplasia, autosomal recessive polycystic kidney disease (infantile) autosomal dominant polycystic kidney disease (adult age). The so-called neoplastic cysts (multiloculated cysts, multiloculated cysts nephroma, cystic nephroblastoma), medullar cysts (medullary sponge kidney, medullary cystic disease), parapyelic cysts, acquired cystic kidney disease in renal failure patients, parasitic cysts, epidermoid cysts. About this disorders we present the more typical and expressive ultrasonographic appearance and we define the role and the opportunity of diagnostic setting by echography, moreover ultrasonography allows us to make a differential diagnosis between cystic kidney disorders and other kidney disease. PMID:8353538

  1. The otolaryngologic manifestations of gastroesophageal reflux disease (GERD): a clinical investigation of 225 patients using ambulatory 24-hour pH monitoring and an experimental investigation of the role of acid and pepsin in the development of laryngeal injury.

    PubMed

    Koufman, J A

    1991-04-01

    Occult (silent) gastroesophageal reflux disease (GER, GERD) is believed to be an important etiologic factor in the development of many inflammatory and neoplastic disorders of the upper aerodigestive tract. In order ot test this hypothesis, a human study and an animal study were performed. The human study consisted primarily of applying a new diagnostic technique (double-probe pH monitoring) to a population of otolaryngology patients with GERD to determine the incidence of overt and occult GERD. The animal study consisted of experiments to evaluate the potential damaging effects of intermittent GER on the larynx. Two hundred twenty-five consecutive patients with otolaryngologic disorders having suspected GERD evaluated from 1985 through 1988 are reported. Ambulatory 24-hour intraesophageal pH monitoring was performed in 197; of those, 81% underwent double-probe pH monitoring, with the second pH probe being placed in the hypopharynx at the laryngeal inlet. Seventy percent of the patients also underwent barium esophagography with videofluoroscopy. The patient population was divided into seven diagnostic subgroups: carcinoma of the larynx (n = 31), laryngeal and tracheal stenosis (n = 33), reflux laryngitis (n = 61), globus pharyngeus (n = 27), dysphagia (n = 25), chronic cough (n = 30), and a group with miscellaneous disorders (n = 18). The most common symptoms were hoarseness (71%), cough (51%), globus (47%), and throat clearing (42%). Only 43% of the patients had gastrointestinal symptoms (heartburn or acid regurgitation). Thus, by traditional symptomatology, GER was occult or silent in the majority of the study population. Twenty-eight patients (12%) refused or could not tolerate pH monitoring. Of the patients undergoing diagnostic pH monitoring, 62% had abnormal esophageal pH studies, and 30% demonstrated reflux into the pharynx. The results of diagnostic pH monitoring for each of the subgroups were as follows (percentage with abnormal studies): carcinoma (71

  2. [Physiological adolescence, pathological adolescence].

    PubMed

    Olié, Jean-Pierre; Gourion, David; Canceil, Olivier; Lôo, Henri

    2006-11-01

    The uncertainties of looming adulthood, nostalgia for childhood, and a general malaise explain the crisis of adolescence. Rebellion, conflict, occasional failure at school or in society, and at-risk behaviors are not always signs of future psychiatric illness. In contrast, the physician must be in a position to identify tell-tale signs such as dysmorphophobia, existential anxiety, a feeling of emptiness, and school or social breakdown. Most psychiatric disorders that begin in adolescence are only diagnosed several years after onset. Yet early diagnosis is of utmost importance, as treatment becomes less effective and the long-term prognosis worsens with time. Suicide is the second cause of death during adolescence. All signs of suicidal behavior require hospitalization and evaluation in a psychiatric unit. Antidepressants may be necessary in adolescence. The recent controversy concerning a possible increase in the suicidal risk during antidepressant treatment should not mask the fact that the real public health issue is depression, and not antidepressants. Eating disorders are especially frequent among adolescent girls; it is important to identify psychiatric comorbidities such as schizophrenia, depression and obsessive-compulsive disorders, and to assess the vital risk. Illicit drug and alcohol consumption are frequent during adolescence; for example, close to half of all French adolescents have tried cannabis at least once. Once again, it is important to detect psychiatric comorbidities in substance-abusing adolescents. Phobia is an underdiagnosed anxiety disorder among adolescents; it may become chronic if proper treatment is not implemented, leading to suffering and disability. Finally, two major psychiatric disorders--schizophrenia and bipolar disorder--generally begin in adolescence. Treatment efficacy and the long-term prognosis both depend on early diagnosis. Treatment must be tailored to the individual patient. "Borderline" states are over-diagnosed

  3. The chorionic bump: Etiologic insights from two pathologic pregnancies.

    PubMed

    Wax, Joseph R; Blaszyk, Hagen; Jones, Michael; Cartin, Angelina; Pinette, Michael G

    2016-09-01

    The clinical significance and etiology of the chorionic bump remain unclear. We describe two pregnancies characterized by chorionic bumps, which subsequently were diagnosed with a complete mole and trisomy 18, respectively. We hypothesize that placental pathology, including edema and hydropic villi, may contribute to or cause the sonographic finding of some chorionic bumps. An association between chorionic bumps and aneuploidy awaits future study. © 2016 Wiley Periodicals, Inc. J Clin Ultrasound 44:452-454, 2016. PMID:27220064

  4. [Urination disorders in the man: differential diagnoses and therapy of benign prostate syndrome].

    PubMed

    Meyer, Daniel; Schmid, Hans-Peter

    2013-10-01

    Lower urinary tract symptoms in men are highly associated with benign prostate syndrome. Nevertheless, a correct diagnosis is required to exclude other pathologies. In addition to neurogenic causes other urological differential diagnoses can be clarified and treated. If diagnosis of benign prostatic syndrome is confirmed, various medical and surgical treatment options are available. PMID:24088234

  5. Reducing turnaround time of surgical pathology reports in pathology and laboratory medicine departments

    PubMed Central

    Alshieban, Saeed; Al-Surimi, Khaled

    2015-01-01

    Turnaround time is an important quality indicator in surgical pathology. Retrospective analysis of three data points in September 2014, January 2015, and February 2015 showed that on average, about a quarter (24%) of routine surgical pathology cases (26%, 19%, and 27% respectively) are not reported on time and do not meet the accepted level of the College of American Pathologists' (CAP) standard turnaround time, which states at least 90% of routine surgical pathology cases should be reported and verified within two days. Our daily observation supported by a root cause analysis exercise revealed that subprocesses including slide allocation and delivery to pathologists, slide review by pathologists, report editing by transcriptionists, and report verification by pathologists are where most delays occur. Thus, to tackle these process issues we developed a quality improvement project using the model of improvement methods to streamline the sample flow process and avoid unjustified reporting delay. The improvement ideas included developing a time log sheet to be attached with all pathology requests, and sending a daily reminder email followed by a phonecall to all pathologists to verify completed reports on the same day. These intervention elements were tested using multiple PDSA cycles resulting in a very noticeable improvement, with more than 94% of all routine cases reported in less than two days, meeting and exceeding the CAP standards. Such noticeable improvement in turnaround of surgical pathology reports will eventually lead to improving the quality and safety of patient care outcome, including diagnosing patients on time, developing the appropriate treatment plan, and avoiding unjustified complications resulting in morbidity and mortality due to delayed reports. PMID:26734438

  6. Pathology and pathogenesis of Buerger's disease.

    PubMed

    Tanaka, K

    1998-10-01

    Since Buerger's disease, which is also called 'thromboangiitis obliterans', was proposed in 1908 (Buerger, Am J Med Soc 1908;136:567), more cases have been reported from the United States, Europe, and especially from the Orient. However the pathogenesis of this disease remains unclarified, and its acceptance as a specific disease entity has been disputed (Gore and Burrows, Am J Clin Pathol 1958;29:319; Wessler et al., N Engl J Med 1960;262:1149). We histologically examined the surgically resected arterial specimens from 113 cases, 109 males and four females, clinically diagnosed as Buerger's disease in 1975-1976 and reported the results in 1978 (Kurozumi and Tanaka, Vasc Surg 1978;12:63) and proposed that the term 'Buerger's disease' should be replaced by 'Buerger's syndrome'. We reexamined the above-mentioned cases and will report the pathology and propose the possible pathogenesis of Buerger's disease. PMID:9951825

  7. Thermal Injuries in Veterinary Forensic Pathology.

    PubMed

    Wohlsein, P; Peters, M; Schulze, C; Baumgärtner, W

    2016-09-01

    Localized thermal injuries in animals may be caused by exposure to fire and radiant heat, contact with hot items including hot liquids or steam, inhalation of hot air, and exposure to cold temperatures. In addition, animal fire victims may have intoxications caused by smoke gas. This article reviews the causes, pathogenetic aspects, morphological findings, additional investigations, differential diagnoses, and causes of death in various forms of thermal injuries. Since these cases do not occur frequently in diagnostic pathology, they represent a challenging task in general but also with respect to forensic or criminal aspects, such as whether a lesion represents an accidental or nonaccidental effect. Besides detailed information about the circumstances at the location, thermal injuries in animals require a thorough morphological evaluation, including additional investigations in conjunction with a profound knowledge about the possible lesion spectrum and suitable additional investigations. PMID:27106739

  8. New Trends of Emerging Technologies in Digital Pathology.

    PubMed

    Bueno, Gloria; Fernández-Carrobles, M Milagro; Deniz, Oscar; García-Rojo, Marcial

    2016-01-01

    The future paradigm of pathology will be digital. Instead of conventional microscopy, a pathologist will perform a diagnosis through interacting with images on computer screens and performing quantitative analysis. The fourth generation of virtual slide telepathology systems, so-called virtual microscopy and whole-slide imaging (WSI), has allowed for the storage and fast dissemination of image data in pathology and other biomedical areas. These novel digital imaging modalities encompass high-resolution scanning of tissue slides and derived technologies, including automatic digitization and computational processing of whole microscopic slides. Moreover, automated image analysis with WSI can extract specific diagnostic features of diseases and quantify individual components of these features to support diagnoses and provide informative clinical measures of disease. Therefore, the challenge is to apply information technology and image analysis methods to exploit the new and emerging digital pathology technologies effectively in order to process and model all the data and information contained in WSI. The final objective is to support the complex workflow from specimen receipt to anatomic pathology report transmission, that is, to improve diagnosis both in terms of pathologists' efficiency and with new information. This article reviews the main concerns about and novel methods of digital pathology discussed at the latest workshop in the field carried out within the European project AIDPATH (Academia and Industry Collaboration for Digital Pathology). PMID:27100343

  9. Do Emergency Department Patients Receive a Pathological Diagnosis? A Nationally-Representative Sample

    PubMed Central

    Wen, Leana S.; Espinola, Janice A.; Mosowsky, Joshua M.; Camargo, Carlos A.

    2015-01-01

    Introduction Understanding the cause of patients’ symptoms often requires identifying a pathological diagnosis. A single-center study found that many patients discharged from the emergency department (ED) do not receive a pathological diagnosis. We analyzed 17 years of data from the National Hospital Ambulatory Medical Care Survey (NHAMCS) to identify the proportion of patients who received a pathological diagnosis at ED discharge. We hypothesized that many patients do not receive a pathological diagnosis, and that the proportion of pathological diagnoses increased between 1993 and 2009. Methods Using the NHAMCS data from 1993–2009, we analyzed visits of patients age ≥18 years, discharged from the ED, who had presented with the three most common chief complaints: chest pain, abdominal pain, and headache. Discharge diagnoses were coded as symptomatic versus pathological based on a pre-defined coding system. We compared weighted annual proportions of pathological discharge diagnoses with 95% CIs and used logistic regression to test for trend. Results Among 299,919 sampled visits, 44,742 met inclusion criteria, allowing us to estimate that there were 164 million adult ED visits presenting with the three chief complaints and then discharged home. Among these visits, the proportions with pathological discharge diagnosis were 55%, 71%, and 70% for chest pain, abdominal pain, and headache, respectively. The total proportion of those with a pathological discharge diagnosis decreased between 1993 and 2009, from 72% (95% CI, 69–75%) to 63% (95% CI, 59–66%). In the multivariable logistic regression model, those more likely to receive pathological diagnoses were females, African-American as compared to Caucasian, and self-pay patients. Those more likely to receive a symptomatic diagnosis were patients aged 30–79 years, with visits to EDs in the South or West regions, and seen by a physician in the ED. Conclusion In this analysis of a nationally

  10. [Diagnostic significance of pathologic synkinesis for detection of pyramidal pathology].

    PubMed

    Baliasnyĭ, M M

    1991-01-01

    Five types of pathological synkinesis (++blepharo-ocular, ++blepharo-facial, ++bucco-manual, ++digito-digital on the hands, ++pedo-digital) are described. They are of definite importance for revealing pyramidal pathology including its early stages as well as for objective evaluation and observation of the time-course of changes in the illness. PMID:1654715

  11. Digital Pathology: Data-Intensive Frontier in Medical Imaging

    PubMed Central

    Cooper, Lee A. D.; Carter, Alexis B.; Farris, Alton B.; Wang, Fusheng; Kong, Jun; Gutman, David A.; Widener, Patrick; Pan, Tony C.; Cholleti, Sharath R.; Sharma, Ashish; Kurc, Tahsin M.; Brat, Daniel J.; Saltz, Joel H.

    2013-01-01

    Pathology is a medical subspecialty that practices the diagnosis of disease. Microscopic examination of tissue reveals information enabling the pathologist to render accurate diagnoses and to guide therapy. The basic process by which anatomic pathologists render diagnoses has remained relatively unchanged over the last century, yet advances in information technology now offer significant opportunities in image-based diagnostic and research applications. Pathology has lagged behind other healthcare practices such as radiology where digital adoption is widespread. As devices that generate whole slide images become more practical and affordable, practices will increasingly adopt this technology and eventually produce an explosion of data that will quickly eclipse the already vast quantities of radiology imaging data. These advances are accompanied by significant challenges for data management and storage, but they also introduce new opportunities to improve patient care by streamlining and standardizing diagnostic approaches and uncovering disease mechanisms. Computer-based image analysis is already available in commercial diagnostic systems, but further advances in image analysis algorithms are warranted in order to fully realize the benefits of digital pathology in medical discovery and patient care. In coming decades, pathology image analysis will extend beyond the streamlining of diagnostic workflows and minimizing interobserver variability and will begin to provide diagnostic assistance, identify therapeutic targets, and predict patient outcomes and therapeutic responses. PMID:25328166

  12. Macrophage polarization in pathology.

    PubMed

    Sica, Antonio; Erreni, Marco; Allavena, Paola; Porta, Chiara

    2015-11-01

    Macrophages are cells of the innate immunity constituting the mononuclear phagocyte system and endowed with remarkable different roles essential for defense mechanisms, development of tissues, and homeostasis. They derive from hematopoietic precursors and since the early steps of fetal life populate peripheral tissues, a process continuing throughout adult life. Although present essentially in every organ/tissue, macrophages are more abundant in the gastro-intestinal tract, liver, spleen, upper airways, and brain. They have phagocytic and bactericidal activity and produce inflammatory cytokines that are important to drive adaptive immune responses. Macrophage functions are settled in response to microenvironmental signals, which drive the acquisition of polarized programs, whose extremes are simplified in the M1 and M2 dichotomy. Functional skewing of monocyte/macrophage polarization occurs in physiological conditions (e.g., ontogenesis and pregnancy), as well as in pathology (allergic and chronic inflammation, tissue repair, infection, and cancer) and is now considered a key determinant of disease development and/or regression. Here, we will review evidence supporting a dynamic skewing of macrophage functions in disease, which may provide a basis for macrophage-centered therapeutic strategies. PMID:26210152

  13. Forest pathology in Hawaii

    USGS Publications Warehouse

    Gardner, D.E.

    2003-01-01

    Native Hawaiian forests are characterised by a high degree of endemism, including pathogens as well as their hosts. With the exceptions of koa (Acacia koa Gray), possibly maile (Alyxia oliviformis Gaud.), and, in the past, sandalwood (Santalum spp.), forest species are of little commercial value. On the other hand, these forests are immensely important from a cultural, ecological, and evolutionary standpoint. Forest disease research was lacking during the mid-twentieth century, but increased markedly with the recognition of ohia (Metrosideros polymorpha Gaud.) decline in the 1970s. Because many pathogens are themselves endemic, or are assumed to be, having evolved with their hosts, research emphasis in natural areas is on understanding host-parasite interactions and evolutionary influences, rather than disease control. Aside from management of native forests, attempts at establishing a commercial forest industry have included importation of several species of pine, Araucaria, and Eucalyptus as timber crops, and of numerous ornamentals. Diseases of these species have been introduced with their hosts. The attacking of native species by introduced pathogens is problematic - for example, Armillaria mellea (Vahl ex Fr.) Que??l. on koa and mamane (Sophora chrysophylla (Salisb.) Seem.). Much work remains to be done in both native and commercial aspects of Hawaiian forest pathology.

  14. How do surgical pathologists evaluate critical diagnoses (critical values)?

    PubMed Central

    Mireskandari, Masoud

    2008-01-01

    Background After introduction of the concept of critical value (CV) in laboratory medicine, some efforts were performed to define possible critical values in surgical pathology. Critical diagnosis (critical value) is a concept recently established in surgical pathology and is a challenging issue among pathologists and clinical specialists. The concept may be the subject of variation according to the geographical or work setting differences. The current study was performed to bring the contribution of the Iranian pathologists to the evolving concept of critical diagnoses (critical values) in surgical pathology. Materials and methods During annual meeting of Iranian Pathologist Society, November 2006, Tehran, Iran, anonymous questionnaires were distributed among participants. They were requested to openly name conditions in which a pathologist should communicate the results immediately with clinicians. Results 147 pathologists completed the questionnaire. They were varied in their level of experience and setting of workplace. Each participant referred to 1–7 (mean 3) conditions as CV. About 90 different conditions which were considered as CV by participants were extracted from the questionnaires. Discussion The list of conditions obtained through this survey as CVs in surgical pathology covered most items previously described in literature. Major differences are low number (or lack) of refers to some relatively routine and potentially important conditions and considering many unimportant conditions as CV by participants of present survey. Almost all conducted surveys have been performed on this issue so far (including the present survey) suffer from lack of supportive scientific evidences and based mainly on experience and common sense of participants in survey. Potential problems with application of CV concept in daily routine work flow of pathology, particularly in developing countries like Iran, were discussed. PMID:18620590

  15. Virtual slides: application in pulmonary pathology consultations.

    PubMed

    Słodkowska, Janina; Chyczewski, Lech; Wojciechowski, Michał

    2008-01-01

    The Virtual Slide (VS) is an interactive microscope emulator that presents a complete digitized tissue section via the Internet. A successful implementation of VS has been observed for educational, research venues and quality control. VS acquisition for consultative pathology is not so common. The purpose of this study was to explore the efficacy and usability of VS in the consultative pulmonary telepathology. 20 lung tumors entered the study. The performance was programmed for 2 medical centers specialized in pulmonary pathology (beginner and advancer in telepathology). A high-quality VSs were prepared by Coolscope (Nikon, Eclipsnet VSL, Japan), and were evaluated via the Internet. The cases were reviewed for the second time with conventional light microscope. VS diagnostic accuracy and the interobserver variability were evaluated. Also the time taken by examiners to render the diagnoses and time needed to scan the microscopic slide were analyzed. Percentage concordance between original glass-slides diagnosis and diagnosis for VSs was very high. Pathologists found the download speed of VSs adequate; experience in telepathology reduced the time of VS diagnosis. VS implementation suggests advantages for teleconsulation and education but also indicate some technical limitations. This is the first Polish trial of VS implementation in telepathology consultative service. PMID:18296275

  16. Ovarian masses revisited: radiologic and pathologic correlation.

    PubMed

    Sutton, C L; McKinney, C D; Jones, J E; Gay, S B

    1992-09-01

    Diagnosis of ovarian masses can be difficult because many pathologic conditions can affect the ovary and have similar clinical and radiologic manifestations. Knowledge of pathologic, age-specific characteristics can help refine the differential diagnosis. Ovarian masses are nonneoplastic (ovarian functional cysts, polycystic ovary disease, and ovarian torsion) or neoplastic (surface epithelial, sex cord-stromal, germ cell, and metastatic tumors). Functional cysts, if complicated by hemorrhage, can have a confusing ultrasonographic (US) appearance. Polycystic disease and torsion are easily diagnosed with US. Benign and malignant forms of serous and mucinous surface epithelial tumors can usually be differentiated with US. Imaging features of surface epithelial tumors of low malignant potential are nonspecific, resembling those of benign serous and mucinous tumors. Mature (benign) teratomas are usually cystic, with components of fat, soft tissue, and calcium, and are sonographically distinct from immature (malignant) teratomas, which are mostly solid. Sex cord-stromal tumors occur more often in menopausal or postmenopausal women and are typically solid. Metastatic disease is less common than other ovarian tumors; however, its radiologic appearance may resemble those of other masses. PMID:1529129

  17. Toxicologic pathology in the 21st century.

    PubMed

    Ettlin, Robert A

    2013-07-01

    Toxicology is and will be heavily influenced by advances in many scientific disciplines. For toxicologic pathology, particularly relevant are the increasing array of molecular methods providing deeper insights into toxicity pathways, in vivo imaging techniques visualizing toxicodynamics and more powerful computers anticipated to allow (partly) automated morphological diagnoses. It appears unlikely that, in a foreseeable future, animal studies can be replaced by in silico and in vitro studies or longer term in vivo studies by investigations of biomarkers including toxicogenomics of shorter term studies, though the importance of such approaches will continue to increase. In addition to changes based on scientific progress, the work of toxicopathologists is and will be affected by social and financial factors, among them stagnating budgets, globalization, and outsourcing. The number of toxicopathologists in North America, Europe, and the Far East is not expected to grow. Many toxicopathologists will likely spend less time at the microscope but will be more heavily involved in early research activities, imaging, and as generalists with a broad biological understanding in evaluation and management of toxicity. Toxicologic pathology will remain important and is indispensable for validation of new methods, quality assurance of established methods, and for areas without good alternative methods. PMID:23143188

  18. Is pathological gambling moderated by age?

    PubMed

    Granero, Roser; Penelo, Eva; Stinchfield, Randy; Fernandez-Aranda, Fernando; Savvidou, Lamprini G; Fröberg, Frida; Aymamí, Neus; Gómez-Peña, Mónica; Pérez-Serrano, Miriam; del Pino-Gutiérrez, Amparo; Menchón, José M; Jiménez-Murcia, Susana

    2014-06-01

    The age of a patient is a strong moderator of both the course and the evolution of disorders/diseases. However, the effects of current age in pathological gambling (PG) have rarely been examined. The aim of this study is to explore the moderating effects of the patients' current age in relation to personality traits and clinical outcomes of PG. A total sample of 2,309 treatment-seeking patients for PG, diagnosed according to DSM-IV criteria, participated in this study and were assessed with the Diagnostic Questionnaire for Pathological Gambling according to DSM-IV criteria, the South Oaks Gambling Screen, the Symptom Checklist, the Temperament and Character Inventory-R, and other clinical and psychopathological measures. Orthogonal polynomial contrasts showed linear trends in the relationship between age and PG: the older the patient, the more comorbid health problems were visible. The presence of additional quadratic trends also suggests that age plays a significant role in moderating the possibility of existing PG problems and general psychopathology. No interaction term was found between age and sex, but it was present for age and some personality traits: self-transcendence and reward dependence (these two traits were only relevant to the level of impairment due to PG at specific ages). This study suggests that the patients' age influences psychopathological and clinical aspects associated to PG. Intervention in the earliest manifestations of this complex problem is essential in order to better address the need of successful treatment planning. PMID:23494243

  19. Pathological gambling: understanding relapses and dropouts.

    PubMed

    Aragay, Núria; Jiménez-Murcia, Susana; Granero, Roser; Fernández-Aranda, Fernando; Ramos-Grille, Irene; Cardona, Sara; Garrido, Gemma; Anisul Islam, Mohammed; Menchón, José M; Vallès, Vicenç

    2015-02-01

    There is little available information on the factors that influence relapses and dropouts during therapy for pathological gambling (PG). The aim of this study was to determine socio-demographic, clinical, personality, and psychopathological predictors of relapse and dropout in a sample of pathological gamblers seeking treatment. A total of 566 consecutive outpatients diagnosed with PG according to DSM-IV-TR criteria were included. All patients underwent an individualized cognitive-behavioral treatment program. We analyzed predictors of relapse during 6months of treatment and during the subsequent 6months of follow-up, and predictors of dropout over the entire therapeutic program. Eighty patients (14.1%) experienced at least one relapse during the entire follow-up of the study: 50 (8.8%) within the treatment period and 12 (2.1%) during the subsequent 6-month follow-up period. The main predictors of relapse were single marital status, spending less than 100euros/week on gambling, active gambling behavior at treatment inclusion, and high scores on the TCI-R Harm Avoidance personality dimension. One hundred fifty-seven patients (27.8%) missed 3 or more therapeutic sessions over the entire therapeutic program. The main predictors of dropout were single marital status, younger age, and high scores on the TCI-R Novelty Seeking personality dimension. The presence of these factors at inclusion should be taken into account by physicians dealing with PG patients. PMID:25434846

  20. Children Diagnosed with Cancer: Returning to School

    MedlinePlus

    ... Spanish) Children Diagnosed With Cancer: Financial and Insurance Issues Children Diagnosed With Cancer: Late Effects of Cancer Treatment Cancer Information on the Internet Coping and emotions What Happened to You, Happened ...

  1. [Munchausen disease diagnosed ten years after debut].

    PubMed

    Mrgan, Monija; Taasti, Lena Merete

    2013-09-01

    Munchausen disease is difficult to diagnose especially because it is often an exclusion diagnosis. We present a case of skin ulcers in a young woman, who was eventually diagnosed with Munchausen disease. PMID:23992908

  2. How Is Thrombotic Thrombocytopenic Purpura Diagnosed?

    MedlinePlus

    ... Diagnosed? Your doctor will diagnosis thrombotic thrombocytopenic purpura (TTP) based on your medical history, a physical exam, and test results. If TTP is suspected or diagnosed, a hematologist will be ...

  3. How Is Long QT Syndrome Diagnosed?

    MedlinePlus

    ... page from the NHLBI on Twitter. How Is Long QT Syndrome Diagnosed? Cardiologists diagnose and treat long ... or blood levels of potassium. Types of Inherited Long QT Syndrome If you have inherited LQTS, it ...

  4. Diagnosing Femoroacetabular Impingement From Plain Radiographs

    PubMed Central

    Ayeni, Olufemi R.; Chan, Kevin; Whelan, Daniel B.; Gandhi, Rajiv; Williams, Dale; Harish, Srinivasan; Choudur, Hema; Chiavaras, Mary M.; Karlsson, Jon; Bhandari, Mohit

    2014-01-01

    Background: A diagnosis of femoroacetabular impingement (FAI) requires careful history and physical examination, as well as an accurate and reliable radiologic evaluation using plain radiographs as a screening modality. Radiographic markers in the diagnosis of FAI are numerous and not fully validated. In particular, reliability in their assessment across health care providers is unclear. Purpose: To determine inter- and intraobserver reliability between orthopaedic surgeons and musculoskeletal radiologists. Study Design: Cohort study (diagnosis); Level of evidence, 3. Methods: Six physicians (3 orthopaedic surgeons, 3 musculoskeletal radiologists) independently evaluated a broad spectrum of FAI pathologies across 51 hip radiographs on 2 occasions separated by at least 4 weeks. Reviewers used 8 common criteria to diagnose FAI, including (1) pistol-grip deformity, (2) size of alpha angle, (3) femoral head-neck offset, (4) posterior wall sign abnormality, (5) ischial spine sign abnormality, (6) coxa profunda abnormality, (7) crossover sign abnormality, and (8) acetabular protrusion. Agreement was calculated using the intraclass correlation coefficient (ICC). Results: When establishing an FAI diagnosis, there was poor interobserver reliability between the surgeons and radiologists (ICC batch 1 = 0.33; ICC batch 2 = 0.15). In contrast, there was higher interobserver reliability within each specialty, ranging from fair to good (surgeons: ICC batch 1 = 0.72; ICC batch 2 = 0.70 vs radiologists: ICC batch 1 = 0.59; ICC batch 2 = 0.74). Orthopaedic surgeons had the highest interobserver reliability when identifying pistol-grip deformities (ICC = 0.81) or abnormal alpha angles (ICC = 0.81). Similarly, radiologists had the highest agreement for detecting pistol-grip deformities (ICC = 0.75). Conclusion: These results suggest that surgeons and radiologists agree among themselves, but there is a need to improve the reliability of radiographic interpretations for FAI between the

  5. Uncommon Manifestations of Intervertebral Disk Pathologic Conditions.

    PubMed

    Diehn, Felix E; Maus, Timothy P; Morris, Jonathan M; Carr, Carrie M; Kotsenas, Amy L; Luetmer, Patrick H; Lehman, Vance T; Thielen, Kent R; Nassr, Ahmad; Wald, John T

    2016-01-01

    Beyond the familiar disk herniations with typical clinical features, intervertebral disk pathologic conditions can have a wide spectrum of imaging and clinical manifestations. The goal of this review is to illustrate and discuss unusual manifestations of intervertebral disk pathologic conditions that radiologists may encounter, including disk herniations in unusual locations, those with atypical imaging features, and those with uncommon pathophysiologic findings. Examples of atypical disk herniations presented include dorsal epidural, intradural, symptomatic thoracic (including giant calcified), extreme lateral (retroperitoneal), fluorine 18 fluorodeoxyglucose-avid, acute intravertebral (Schmorl node), and massive lumbar disk herniations. Examples of atypical pathophysiologic conditions covered are discal cysts, fibrocartilaginous emboli to the spinal cord, tiny calcified disks or disk-level spiculated osteophytes causing spinal cerebrospinal fluid (CSF) leak and intracranial hypotension, and pediatric acute calcific discitis. This broad gamut of disease includes a variety of sizes of disk pathologic conditions, from the tiny (eg, the minuscule calcified disks causing high-flow CSF leaks) to the extremely large (eg, giant calcified thoracic intradural disk herniations causing myelopathy). A spectrum of clinical acuity is represented, from hyperacute fibrocartilaginous emboli causing spinal cord infarct, to acute Schmorl nodes, to chronic intradural herniations. The entities included are characterized by a range of clinical courses, from the typically devastating cord infarct caused by fibrocartilaginous emboli, to the usually spontaneously resolving pediatric acute calcific discitis. Several conditions have important differential diagnostic considerations, and others have relatively diagnostic imaging findings. The pathophysiologic findings are well understood for some of these entities and poorly defined for others. Radiologists' knowledge of this broad scope of

  6. Speech Pathology Assistant. Trainee Manual.

    ERIC Educational Resources Information Center

    National Association for Hearing and Speech Action, Silver Spring, MD.

    Part of an instructional set which includes an instructor's guide, this trainee manual is designed to provide speech pathology students with some basic and essential knowledge about the communication process. The manual contains nine modules: (1) speech pathology assistant, (2) the bases of speech (structure and function of the speech mechanism,…

  7. Pathologies in Living Kidney Donors Diagnosed in the Long-Term Care System.

    PubMed

    Kwapisz, M; Kieszek, R; Jędrzejko, K; Domagała, P; Bieniasz, M; Gozdowska, J; Zygier, D; Drozdowski, J; Zatorski, M; Nowaczyk, M; Palczewski, P; Pączek, L; Durlik, M; Chmura, A; Kwiatkowski, A

    2016-06-01

    Kidney donation should not lead to deterioration of the donor's health condition, both during the perisurgical period and in the long term. Safety of a living kidney donor becomes a prerequisite for his/her qualification. Detailed diagnostic procedures are performed to exclude any abnormalities of his/her health condition. Additionally, a long-term post-donation follow-up system for kidney donors has been set up in Poland besides the restrictive qualification system. Transplantation centers are obligated to provide a diagnostic procedures for living organ donors as a part of the monitoring of their health condition and to ensure them a medical follow-up for 10 years after the donation. A total of 141 cases of unilateral nephroureterectomy performed in 2003-2014 to obtain a kidney for transplantation were considered. Medical files of post-donation diagnostic or therapeutic methods and their outcomes were retrospectively analyzed. The aim of the study was to assess the efficacy of monitoring of donors' health condition within the framework of the long-term follow-up system for kidney donors in the aspect of detection of the donation-independent abnormalities. PMID:27496424

  8. Pathology accessioning and retrieval system with encoding by computer (PARSEC). A microcomputer-based system for anatomic pathology featuring automated SNOP coding and multiple administrative functions.

    PubMed

    Foulis, P R; Norbut, A M; Mendelow, H; Kessler, G F

    1980-06-01

    A pathology accessioning and retrieval system with encoding by computer (PARSEC) has been developed, employing a relatively inexpensive microcomputer. PARSEC performs a variety of administrative functions for anatomic pathology, including accessioning of surgical specimens, storage of patient demographic information, editing, retrieval, and archiving of patient data, as well as CAP (college of American Pathologists) workload units, billing, and inventory functions for histopathology. In addition, appropriate gross and microscopic descriptions and pathologic diagnoses can be entered into the system by a text editor. Automatic assignment of SNOP (Systematized Nomenclature of Pathology) codes, is accomplished via an online SNOP lexicon, allowing the ultimate generation of completed surgical pathology reports. The data base management system employed makes optimum use of disk storage space, while permitting rapid data retrieval. Data file maintenance is automatically accomplished by the system, requiring no user intervention. PMID:7395803

  9. Methods of diagnosing alagille syndrome

    DOEpatents

    Li, Linheng; Hood, Leroy; Krantz, Ian D.; Spinner, Nancy B.

    2004-03-09

    The present invention provides an isolated polypeptide exhibiting substantially the same amino acid sequence as JAGGED, or an active fragment thereof, provided that the polypeptide does not have the amino acid sequence of SEQ ID NO:5 or SEQ ID NO:6. The invention further provides an isolated nucleic acid molecule containing a nucleotide sequence encoding substantially the same amino acid sequence as JAGGED, or an active fragment thereof, provided that the nucleotide sequence does not encode the amino acid sequence of SEQ ID NO:5 or SEQ ID NO:6. Also provided herein is a method of inhibiting differentiation of hematopoietic progenitor cells by contacting the progenitor cells with an isolated JAGGED polypeptide, or active fragment thereof. The invention additionally provides a method of diagnosing Alagille Syndrome in an individual. The method consists of detecting an Alagille Syndrome disease-associated mutation linked to a JAGGED locus.

  10. Computed tomography of the anterior mediastinum in myasthemia gravis: a radiologic-pathologic correlative study

    SciTech Connect

    Fon, G.T.; Bein, M.E.; Mancuso, A.A.; Keesey, J.C.; Lupetin, A.R.; Wong, W.S.

    1982-01-01

    Chest radiographs and computed tomographic (CT) scans of the mediastinum were correlated with pathologic findings of the thymus following thymectomy in 57 patients with myasthenia gravis. Based on the patient's age and the overall morphology of the anterior mediastinum, CT scans were assigned one of four grades in an attempt to predict thymus pathologic findings. Using this grading, 14 of 16 cases of thymoma were suspected or definitely diagnosed. One of the two cases not diagnosed on CT was a microscopic tumor. There were no false-positive diagnoses in 11 cases graded as definitely thymoma. We conclude that thymoma can be sensitively diagnosed in patients older than 40 years of age. However, thymoma cannot be predicted with a high level of confidence in patients younger than 40 because of the difficulty in differentiating normal thymus or hyperplasia from thymoma. Recommendations for the use of CT in the preoperative evaluation of myasthenic patients are presented.

  11. CBT for eating disorders: The impact of early changes in eating pathology on later changes in personality pathology, anxiety and depression.

    PubMed

    Turner, Hannah; Marshall, Emily; Wood, Francesca; Stopa, Lusia; Waller, Glenn

    2016-02-01

    Whilst studies have consistently identified early symptom reduction as an important predictor of treatment outcome, the impact of early change on common comorbid features has not been investigated. This study of CBT for eating disorders explored patterns of early change in eating pathology and longer-term change in personality pathology, anxiety and depression. It also explored the impact of early change in eating pathology on overall change in personality pathology, anxiety and depression. Participants were 179 adults diagnosed with eating disorders who were offered a course of CBT in an out-patient community eating disorders service in the UK. Patients completed a measure of eating disorder psychopathology at the start of treatment and following the 6th session. They also completed measures of personality disorder cognitions, anxiety and depression at the start and end of treatment. There were significant changes in eating pathology over the first six sessions of treatment. Significant improvements were also seen in personality disorder pathology, anxiety and depression by the end of therapy. Effect sizes were medium to large for both completer and intention to treat analyses. Early changes in eating pathology were associated with later changes in common comorbid features, with early reduction in restraint being a key predictor. These findings demonstrate that early symptom change can be achieved in CBT for eating disorders when delivered in routine clinical practice. Such change has long-term benefits that go beyond the domain of eating pathology, enhancing change in personality pathology, anxiety and depression. PMID:26690743

  12. Prevalence of otorhinolaryngologic diagnoses in the pediatric emergency room

    PubMed Central

    Signorelli, Luiz Gabriel; Mendes, Elaine de Abreu

    2013-01-01

    Summary Introduction: Fever and pain, which are very common in ear, nose, and throat pathologies, are among the most frequent complaints recorded during emergency room pediatric patient treatment. Most of time, the pediatricians are called on to evaluate otorhinolaryngology disorders that requires specialist assessment. Aim: To determine the prevalence of otorhinolaryngologic diagnoses in a pediatric population in a reference hospital in the city of Itatiba, São Paulo. Methods: We evaluated 2,054 pediatric patients (age range, 0–12 years, 11 months) in this descriptive, transversal observational (survey) study. Data collection was performed by a single observer during 103 night shifts (07:00 p.m. to 07:00 a.m.) between January and December 2011, and included documentation of the main diagnosis, and patient age and sex. The ethics committee and research institution approved study. Patients were divided into 2 groups based on diagnosis: Group A otorhinolaryngology disease and Group B included diagnoses not contained in Group A. Results: Of the total enrolled patients, 52.2% corresponded to Group A and 47.8% to Group B; 51.9% were male and 48.1% were female. The average age was 4.5 years (Group A, 3.93 years; Group B, 5.03 years). We compared the prevalence of the diagnostic hypotheses of the 2 groups. Conclusion: A large number of patients sought treatment at pediatric emergency rooms for otorhinolaryngologic diagnoses. PMID:25991987

  13. Histogram and gray level co-occurrence matrix on gray-scale ultrasound images for diagnosing lymphocytic thyroiditis.

    PubMed

    Shin, Young Gyung; Yoo, Jaeheung; Kwon, Hyeong Ju; Hong, Jung Hwa; Lee, Hye Sun; Yoon, Jung Hyun; Kim, Eun-Kyung; Moon, Hee Jung; Han, Kyunghwa; Kwak, Jin Young

    2016-08-01

    The objective of the study was to evaluate whether texture analysis using histogram and gray level co-occurrence matrix (GLCM) parameters can help clinicians diagnose lymphocytic thyroiditis (LT) and differentiate LT according to pathologic grade. The background thyroid pathology of 441 patients was classified into no evidence of LT, chronic LT (CLT), and Hashimoto's thyroiditis (HT). Histogram and GLCM parameters were extracted from the regions of interest on ultrasound. The diagnostic performances of the parameters for diagnosing and differentiating LT were calculated. Of the histogram and GLCM parameters, the mean on histogram had the highest Az (0.63) and VUS (0.303). As the degrees of LT increased, the mean decreased and the standard deviation and entropy increased. The mean on histogram from gray-scale ultrasound showed the best diagnostic performance as a single parameter in differentiating LT according to pathologic grade as well as in diagnosing LT. PMID:27336835

  14. Digital pathology and anatomic pathology laboratory information system integration to support digital pathology sign-out

    PubMed Central

    Guo, Huazhang; Birsa, Joe; Farahani, Navid; Hartman, Douglas J.; Piccoli, Anthony; O’Leary, Matthew; McHugh, Jeffrey; Nyman, Mark; Stratman, Curtis; Kvarnstrom, Vanja; Yousem, Samuel; Pantanowitz, Liron

    2016-01-01

    Background: The adoption of digital pathology offers benefits over labor-intensive, time-consuming, and error-prone manual processes. However, because most workflow and laboratory transactions are centered around the anatomical pathology laboratory information system (APLIS), adoption of digital pathology ideally requires integration with the APLIS. A digital pathology system (DPS) integrated with the APLIS was recently implemented at our institution for diagnostic use. We demonstrate how such integration supports digital workflow to sign-out anatomical pathology cases. Methods: Workflow begins when pathology cases get accessioned into the APLIS (CoPathPlus). Glass slides from these cases are then digitized (Omnyx VL120 scanner) and automatically uploaded into the DPS (Omnyx® Integrated Digital Pathology (IDP) software v.1.3). The APLIS transmits case data to the DPS via a publishing web service. The DPS associates scanned images with the correct case using barcode labels on slides and information received from the APLIS. When pathologists remotely open a case in the DPS, additional information (e.g. gross pathology details, prior cases) gets retrieved from the APLIS through a query web service. Results: Following validation of this integration, pathologists at our institution have signed out more than 1000 surgical pathology cases in a production environment. Integration between the APLIS and DPS enabled pathologists to review digital slides while simultaneously having access to pertinent case metadata. The introduction of a digital workflow eliminated costly manual tasks involving matching of glass slides and avoided delays waiting for glass slides to be delivered. Conclusion: Integrating the DPS and APLIS were instrumental for successfully implementing a digital solution at our institution for pathology sign-out. The integration streamlined our digital sign-out workflow, diminished the potential for human error related to matching slides, and improved the sign

  15. Investigating facets of personality in adult pathological gamblers with ADHD

    PubMed Central

    Davtian, Margarit; Reid, Rory C; Fong, Timothy W

    2012-01-01

    SUMMARY The present study explored facets of personality in a sample of pathological gamblers with ADHD (n = 52) and without ADHD (n = 43). Participants were assessed for psychopathology and gambling disorders using the Mini International Neuropsychiatric Interview, the National Opinion Research Center DSM Screen for Gambling Problems, and the Adult ADHD Self-Report Scale. Facets of personality were assessed using the NEO Personality Inventory–Revised. Group differences emerged across several facets of personality when analyzed using multivariate statistics. Although both groups experienced difficulties in several areas compared with norming data (e.g., greater depression, higher impulsivity, lower self-esteem and lower self-discipline), these facets of personality were more pronounced in pathological gamblers with ADHD. Most notable among these differences are tendencies for gamblers with ADHD to experience greater levels of emotional instability, interpersonal sensitivity and stress proneness. Pathological gamblers with ADHD also appear to experience lower self-esteem, greater difficulty being assertive and lower levels of self-discipline. Surprisingly, both groups were comparable on facets of impulsivity. These findings suggest that pathological gamblers diagnosed with adult ADHD may experience additional challenges compared with pathological gamblers without ADHD. PMID:22815658

  16. Image Analysis in Surgical Pathology.

    PubMed

    Lloyd, Mark C; Monaco, James P; Bui, Marilyn M

    2016-06-01

    Digitization of glass slides of surgical pathology samples facilitates a number of value-added capabilities beyond what a pathologist could previously do with a microscope. Image analysis is one of the most fundamental opportunities to leverage the advantages that digital pathology provides. The ability to quantify aspects of a digital image is an extraordinary opportunity to collect data with exquisite accuracy and reliability. In this review, we describe the history of image analysis in pathology and the present state of technology processes as well as examples of research and clinical use. PMID:27241112

  17. Cue reactivity in active pathological, abstinent pathological, and regular gamblers.

    PubMed

    Sodano, Ruthlyn; Wulfert, Edelgard

    2010-03-01

    Twenty-one treatment-seeking pathological gamblers, 21 pathological gamblers in recovery, and 21 recreational gamblers watched two video-taped exciting gambling scenarios and an exciting roller-coaster control scenario while their arousal (heart rate and subjective excitement) and urge to gamble were being measured. The gamblers did not differ significantly in cue-elicited heart rate elevations or excitement. However, the active pathological gamblers reported significantly greater urges to gamble across all cues compared to the abstinent pathological gamblers and, with marginal significance (p = 0.06), also compared to the social gamblers. Further exploration of these findings revealed that active pathological gamblers experience urges to gamble in response to exciting situations, whether or not they are gambling related, whereas abstinent and social gamblers only report urges to an exciting gambling-related cue. This suggests that for pathological gamblers excitement itself, irrespective of its source, may become a conditioned stimulus capable of triggering gambling behavior. Implications for treatment and future research are discussed. PMID:19662519

  18. Expertise in clinical pathology: combining the visual and cognitive perspective.

    PubMed

    Jaarsma, Thomas; Jarodzka, Halszka; Nap, Marius; van Merriënboer, Jeroen J G; Boshuizen, Henny P A

    2015-10-01

    Expertise studies in the medical domain often focus on either visual or cognitive aspects of expertise. As a result, characteristics of expert behaviour are often described as either cognitive or visual abilities. This study focuses on both aspects of expertise and analyses them along three overarching constructs: (1) encapsulations, (2) efficiency, and (3) hypothesis testing. This study was carried out among clinical pathologists performing an authentic task: diagnosing microscopic slides. Participants were 13 clinical pathologists (experts), 12 residents in pathology (intermediates), and 13 medical students (novices). They all diagnosed seven cases in a virtual microscope and gave post hoc explanations for their diagnoses. The collected data included eye movements, microscope navigation, and verbal protocols. Results showed that experts used lower magnifications and verbalized their findings as diagnoses. Also, their diagnostic paths were more efficient, including fewer microscope movements and shorter reasoning chains. Experts entered relevant areas later in their diagnostic process, and visited fewer of them. Intermediates used relatively high magnifications and based their diagnoses on specific abnormalities. Also, they took longer to reach their diagnosis and checked more relevant areas. Novices searched in detail, described findings by their appearances, and uttered long reasoning chains. These results indicate that overarching constructs can justly be identified: encapsulations and efficiency are apparent in both visual and cognitive aspects of expertise. PMID:25677013

  19. A Knowledge Discovery Approach to Diagnosing Intracranial Hematomas on Brain CT: Recognition, Measurement and Classification

    NASA Astrophysics Data System (ADS)

    Liao, Chun-Chih; Xiao, Furen; Wong, Jau-Min; Chiang, I.-Jen

    Computed tomography (CT) of the brain is preferred study on neurological emergencies. Physicians use CT to diagnose various types of intracranial hematomas, including epidural, subdural and intracerebral hematomas according to their locations and shapes. We propose a novel method that can automatically diagnose intracranial hematomas by combining machine vision and knowledge discovery techniques. The skull on the CT slice is located and the depth of each intracranial pixel is labeled. After normalization of the pixel intensities by their depth, the hyperdense area of intracranial hematoma is segmented with multi-resolution thresholding and region-growing. We then apply C4.5 algorithm to construct a decision tree using the features of the segmented hematoma and the diagnoses made by physicians. The algorithm was evaluated on 48 pathological images treated in a single institute. The two discovered rules closely resemble those used by human experts, and are able to make correct diagnoses in all cases.

  20. [Diagnosing and therapy of gout].

    PubMed

    Pavelka, Karel

    2015-06-01

    Gout is an inflammatory, metabolically conditioned crystal-induced disease. Prevalence of gout is on the increase. In clinical practice it is frequently wrongly diagnosed and the therapy of acute attacks in particular is not adequate. The first part of the publication discusses diagnostic possibilities of gouty arthritis. First of all the advantage of the analysis of synovial exudate and of direct evidence of crystals in the polarization microscope is emphasized. If the material for crystallographic analysis is not available, it is necessary to use a combination of clinical criteria as specified e.g. in the recommendations of the European League Against Rheumatism (EULAR). The second part focuses on the therapy of gout which is divided into the periods of asymptomatic hyperuricemia, acute gouty attack, intercritical and chronic tophaceous gout. Asymptomatic hyperuricemia is only treated when uricemia greater than 540 µmol/l occur repeatedly, or when other risk factors and comorbidities are present. In the treatment of acute gouty attack its early start is more important than the choice of a preparation. Alternatives are NSA, colchicine or glucocorticoids. A newly regist-ered medicine for the treatment of refractory acute inflammation is the IL-1 inhibitor canakinumab. The treatment of hyperuricemia involves regimen and diet measures, abstinence and hypouricemic therapy. Available are the xanthine oxidase inhibitors, allopurinol and febuxostat; the latter is better suited for patients with moderate renal insufficiency. A new medicine for the treatment of severe refractory tophaceous gout is pegloticase.Key words: gouty arthritis - colchicine - nonsteroidal antirheumatic drugs. PMID:26258966

  1. Diagnosing Common Benign Skin Tumors.

    PubMed

    Higgins, James C; Maher, Michael H; Douglas, Mark S

    2015-10-01

    Patients will experience a wide range of skin growths and changes over their lifetime. Family physicians should be able to distinguish potentially malignant from benign skin tumors. Most lesions can be diagnosed on the basis of history and clinical examination. Lesions that are suspicious for malignancy, those with changing characteristics, symptomatic lesions, and those that cause cosmetic problems may warrant medical therapy, a simple office procedure (e.g., excision, cryosurgery, laser ablation), or referral. Acrochordons are extremely common, small, and typically pedunculated benign neoplasms. Simple scissor or shave excision, electrodesiccation, or cryosurgery can be used for treatment. Sebaceous hyperplasia presents as asymptomatic, discrete, soft, pale yellow, shiny bumps on the forehead or cheeks, or near hair follicles. Except for cosmesis, they have no clinical significance. Lipomas are soft, flesh-colored nodules that are easily moveable under the overlying skin. Keratoacanthomas are rapidly growing, squamoproliferative benign tumors that resemble squamous cell carcinomas. Early simple excision is recommended. Pyogenic granuloma is a rapidly growing nodule that bleeds easily. Treatment includes laser ablation or shave excision with electrodesiccation of the base. Dermatofibromas are an idiopathic benign proliferation of fibroblasts. No treatment is required unless there is a change in size or color, bleeding, or irritation from trauma. Epidermal inclusion cysts can be treated by simple excision with removal of the cyst and cyst wall. Seborrheic keratoses and cherry angiomas generally do not require treatment. PMID:26447443

  2. Soft Tissue Masses of Hand: A Radio-Pathological Correlation

    PubMed Central

    Agarwal, Aditi; Prakash, Mahesh; Gupta, Pankaj; Tripathy, Satyaswarup; Kakkar, Nandita; Srinivasan, Radhika; Khandelwal, Niranjan

    2015-01-01

    Aim. To evaluate soft tissue masses of the hand with magnetic resonance imaging (MRI) and ultrasonography (USG) and to correlate imaging findings with pathological findings. Material and Methods. Thirty-five patients with soft tissue masses of the hand were evaluated with high resolution USG and contrast enhanced MRI of the hand, prospectively over a period of 2.5 years. The radiological diagnosis was then compared with cytology/histopathology. Results. There were a total of 19 (55%) females. The mean age was 27.45 ± 14.7 years. Majority (45%) of cases were heteroechoic. Four cases were predominantly hyperechoic. These were later diagnosed as lipomas. Four cases were anechoic (diagnosed as ganglions). Only four lesions showed hyperintense signal on T1-weighted images. Out of these, 3 were lipomas and one was cavernous haemangioma. Three lesions were hypointense on T2-weighted images. All these lesions were diagnosed as giant cell tumor of the tendon sheath. A correct diagnosis was possible on MRI in 80% of cases (n = 28). Conclusion. MRI provides specific findings for diagnosis of certain soft tissue lesions of the hand. Ultrasonography allows accurate diagnosis of hemangioma/vascular malformations. However, in most conditions, imaging findings are nonspecific and diagnosis rests on pathologic evaluation. PMID:26421187

  3. [One of the variants of larvate cyclothymic disorder simulating pathology of the locomotor system].

    PubMed

    Lisina, M A

    1990-01-01

    Based on the reported data and the authors' findings 40 cases of larvate cyclothymia are described. The pivotal symptomatology of the disease involved masked hypochondriac subdepressions that imitated pathology of the bones and joints. In view of this fact the mental disease could not be recognized by the physicians and was diagnosed erroneously as a pathology of the bones and joints. The author provides a 3-component structure of the given hypochondriac depressions and differential diagnostic criteria for their separation from genuine pathology of the bones and joints. PMID:2163178

  4. Novel approaches in diagnosing tuberculosis

    NASA Astrophysics Data System (ADS)

    Kolk, Arend H. J.; Dang, Ngoc A.; Kuijper, Sjoukje; Gibson, Tim; Anthony, Richard; Claassens, Mareli M.; Kaal, Erwin; Janssen, Hans-Gerd

    2011-06-01

    The WHO declared tuberculosis (TB) a global emergency. An estimated 8-9 million new cases occur each year with 2-3 million deaths. Currently, TB is diagnosed mostly by chest-X ray and staining of the mycobacteria in sputum with a detection limit of 1x104 bacteria /ml. There is an urgent need for better diagnostic tools for TB especially for developing countries. We have validated the electronic nose from TD Technology for the detection of Mycobacterium tuberculosis by headspace analysis of 284 sputum samples from TB patients. We used linear discriminant function analysis resulting in a sensitivity of 75% a specificity of 67% and an accuracy of 69%. Further research is still required to improve the results by choosing more selective sensors and sampling techniques. We used a fast gas chromatography- mass spectrometry method (GC-MS). The automated procedure is based on the injection of sputum samples which are methylated inside the GC injector using thermally assisted hydrolysis and methylation (THM-GC-MS). Hexacosanoic acid in combination with tuberculostearic acid was found to be specific for the presence of M. tuberculosis. The detection limit was similar to microscopy. We found no false positives, all microscopy and culture positive samples were also found positive with the THM-GC-MS method. The detection of ribosomal RNA from the infecting organism offers great potential since rRNA molecules outnumber chromosomal DNA by a factor 1000. It thus may possible to detect the organism without amplification of the nucleic acids (NA). We used a capture and a tagged detector probe for the direct detection of M. tuberculosis in sputum. So far the detection limit is 1x106 bacteria / ml. Currently we are testing a Lab-On-A-Chip Interferometer detection system.

  5. Newly Diagnosed Acute Promyelocytic Leukemia

    PubMed Central

    Avvisati, Giuseppe

    2011-01-01

    Acute promyelocytic leukemia (APL) represents a medical emergency with a high rate of early mortality. As a consequence, as soon as the diagnosis is suspected based upon cytologic criteria, it is necessary to start all- trans retinoic acid (ATRA) treatment without delay. For patients with newly diagnosed APL, induction therapy with ATRA plus anthracycline based chemotherapy is recommended. At present the combination of arsenic trioxide plus ATRA should be considered for patients who are not candidates for anthracycline-based therapy. For pediatric and adult patients with APL aged < 60 years who achieve a CR with induction, I recommend 3 intensive courses of consolidation chemotherapy associated to ATRA, targeted on the basis of the risk group at diagnosis. In patients treated with a very intensive consolidation chemotherapy maintenance treatment can be omitted. However If a maintenance treatment has to be adopted I suggest the use of intermittent ATRA for 15 days every 3 months for a period of 2 years, rather than ATRA associated to chemotherapy. Moreover, taking into account the medical literature, a reduced dosage of ATRA ( 25 mg/m2) in pediatric patients and a consolidation chemotherapy of reduced intensity in elderly patients is recommended. Furthermore, in order to maximize survival, careful attention should be reserved to the coagulopathy and to the appearance of the differentiation syndrome. Finally, PCR for the PML/RARA fusion gene on a bone marrow specimen every three months for two years, and then every six months for additional three years are needed during the follow-up. PMID:22220261

  6. A case of giant mediastinal cyst initially detected and diagnosed by echocardiography.

    PubMed

    Li, XiaoDong; Wang, XiaoCong; Duan, XiuMei; Xu, Hui

    2015-07-01

    Mediastinal cysts are a group of benign mediastinal lesions, and their diagnoses are primarily depended on x-ray and computed tomography. The development of ultrasound instruments and inspection techniques in recent years has led to the ability to use transthoracic echocardiography to clearly display structures surrounding the heart according to the dark fluid space (blood) of the atrium, ventricles, and large vessels as an acoustic window. This technique offers improved detection rates of mediastinal lesions. We report a case of a mediastinal cyst that was first detected and diagnosed on thoracic echocardiography examination and then confirmed by thoracoscopic surgery and pathological analysis. PMID:25640147

  7. Pathologic Diagnosis of Pancreatic Adenocarcinoma in the United States: Its Status and Prognostic Value

    PubMed Central

    Qiu, Miaozhen; Qiu, Huijuan; Jin, Ying; Wei, Xiaoli; Zhou, Yixin; Wang, Zixian; Wang, Deshen; Ren, Chao; Luo, Huiyan; Wang, Feng; Zhang, Dongsheng; Wang, Fenghua; Li, Yuhong; Yang, Dajun; Xu, Ruihua

    2016-01-01

    Purpose: Even with the development of new biopsy methods, diagnosis of pancreatic cancer is sometimes without histological evidence. The aim of our study is to find out the status of pancreatic cancer patients who are diagnosed without pathologic confirm and the prognostic value of pathologic diagnosis. Methods: We identified 52,759 pancreatic adenocarcinoma patients from the Surveillance, Epidemiology, and End Results (SEER) database. Logistic regression model was used to identify factors relating to no pathologic diagnosis. Multivariable Cox regression model identified potential prognostic factors. All statistical tests were two-sided. Results: There were 6206 (11.76%) patients without pathologic diagnosis. Older age, reported from nursing/convalescent home/hospice or physician's office/private medical practitioner, early year of diagnosis, larger tumor size, pancreatic head cancer, unmarried patients, uninsured and stage I disease all contributed to no pathologic diagnosis. Median cause specific-survival for patients with and without pathologic diagnosis were 7.72 and 3.52 months, respectively. The HR for pathologic diagnosis was 0.92 (95% CI: 0.89-0.95), P<0.001. Conclusions: Pathologic diagnosis was an independent prognostic factor for pancreatic adenocarcinoma patients. New diagnostic methods are needed to get the pathologic diagnosis. PMID:27076851

  8. Comprehensive capture of cutaneous melanoma by the Ontario Cancer Registry: validation study using community pathology reports.

    PubMed

    Tran, Jennifer M; Schwartz, Rodrigo; Fung, Kinwah; Rochon, Paula; Chan, An-Wen

    2016-01-01

    Melanoma is often managed outside hospital settings, creating the potential for underreporting to cancer registries. To our knowledge, completeness of melanoma capture in cancer registries has not been assessed using external data sources since the 1980s. We evaluated the melanoma capture rate from 1993 to 2009 in a provincial cancer registry. We identified all melanoma diagnoses in pathology reports from a major community laboratory in Ontario, Canada. Pathologically confirmed diagnoses were linked to Ontario Cancer Registry (OCR) records using health insurance numbers. We calculated capture rates as the proportion of patients with melanoma confirmed by a pathology report, with a corresponding melanoma diagnosis in OCR. OCR captured 3,798 of 4,275 (88.8, 95 % confidence interval: 87.9, 89.8 %) invasive melanoma diagnoses over the 17-year period. Annual capture rates of 94 % or higher were found for over half the study period. Among all 29,133 melanoma diagnoses in OCR, 27.6 % were registered based on a pathology report alone, compared with 3.4 % for non-cutaneous malignancies. This suggests that comprehensive capture of melanoma cases by a provincial cancer registry is achievable using source data from community laboratories. There is a need for ongoing validation to ensure data remain accurate and complete to reliably inform clinical care, research, and policy. PMID:26537120

  9. A Proposed Model for Diagnosing Information Needs.

    ERIC Educational Resources Information Center

    Grover, Robert

    1993-01-01

    Explains the concept of diagnosing information needs as part of the role of the school library media specialist. Topics discussed include the diagnostic process, i.e., the reference interview; information psychology; theories of information transfer; a model for diagnosing information needs; and implications for practitioners and for research. (19…

  10. [Diagnosing and expertizing asbestos-induced occupational diseases].

    PubMed

    Baur, X; Schneider, J; Woitowitz, H-J

    2011-11-01

    Due to latency periods that can last for decades, asbestos-related diseases show 18 years after the enforcement of the prohibition of asbestos application in Germany their highest numbers. In the centre of attention are asbestos-induced pleural fibroses, mesotheliomas, asbestoses, lung and laryngeal cancer. Diagnosing and expertizing these diseases causes difficulties, is hitherto non-uniform and does frequently not correspond to the current medico-scientific expertise. This induced the German Respiratory Society as well as the German Society of Occupational and Environmental Medicine in cooperation with the German Society of Pathology, the German Radiology Society and the German Society of Otorhinolaryngology, Head and Cervical Surgery, to develop the above mentioned guideline during seven meetings moderated by AWMF. The required thorough diagnosis is based on the detailed recording of a qualified occupational history. Since the sole radiological and pathological-anatomical findings cannot sufficiently contribute to the causal relationship the occupational history recorded by a general physician and a specialist is of decisive importance. These physicians have to report suspected occupational diseases and to advise patients on social and medical questions. Frequently, problems occur if the recognition of an occupational disease is neglected due to a supposedly too low exposure or too few ferruginous bodies or low fibre concentrations in lung tissue. The new S2k directive summarizing the current medico-scientific knowledge is for this reason, for diagnoses and expert opinions as well as for the determination of a reduced capacity for work a very important source of information. PMID:22048939

  11. [Postural imbalance in patients with vascular brain pathology].

    PubMed

    Kononova, E L; Balunov, O A; Anan'eva, N I; Sitnik, L I

    2004-01-01

    Using MRI survey, 163 patients with various brain pathology of vascular genesis were studied. Vascular dementia according to NINDS-AIREN classification was diagnosed in 15% of patients. Cognitive disturbances in other patients did not reach a level of dementia. A control group comprised 61 subjects without rough structural changes on MRI and cognitive dysfunction. Motor disorders were estimated according to classification of J. Nutt et al. (1993), quantitative static changes were registered using computer stabilography. The results of the study showed that postural instability occurs in 100% of patients with vascular brain pathology. A degree of its expression elevated in direct proportion to the expression of cognitive disturbances, reaching a maximum in patients with dementia. PMID:15581031

  12. [Pathology of the vitreomacular interface].

    PubMed

    Pop, Monica; Gheorghe, Alina

    2014-01-01

    Vitreous role in the pathophysiology of retinal diseases has increased importantly over the recent years. This was possible using Optical Coherence Tomography which reviewed the way the vitreoretinal interface should be looked at and defined and classified new pathologies such as Vitreoretinal Traction Syndrome. Vitreous is not an empty space but an important anatomical structure with role in ocular physiology. With age biochemical changes occur so that vitreous starts to liquefy. Once the vitreous is liquefied (sinchisis) it collapses and passes in the retrohialoid space (sineresis). In complete PVD besides sinchisis there is a weakness of the adherence between the posterior cortex and ILM with total detachment of posterior cortex. Abnormal adhesions are associated with incomplete PVD. The definition and understanting of vitreoretinal pathology is an active and continuous process, PVD being the trigger of a lot of retinal pathologies: epiretinal membrane, macular hole, tractional macular oedema, VMTS, myopic traction maculopathy, exacerbations of exudative ARMD. PMID:25300121

  13. Paediatric brainstem: A comprehensive review of pathologies on MR imaging.

    PubMed

    Kakkar, Chandan; Kakkar, Shruti; Saggar, Kavita; Goraya, Jatinder S; Ahluwalia, Archana; Arora, Ankur

    2016-08-01

    The brainstem is a midline structure formed by the midbrain, pons and medulla and is a home for various vital neurological centres of the human body. A diverse spectrum of disease entities can involve the brainstem, which includes infections, metabolic disorders, demyelination, vascular conditions, neurodegenerative disorders and tumours. Brainstem involvement can be primary or secondary, i.e., as part of systemic disorders. Due to the overlapping clinical presentation and symptomatology, imaging plays a decisive role in the detection, localisation and characterisation of brainstem pathologies. Magnetic resonance imaging (MRI) is the modality of choice and the use of advanced MR techniques such as diffusion-weighted imaging and spectroscopy can be especially helpful in providing a tenable diagnoses. This article is a compilation of the MR imaging manifestations of a spectrum of common and uncommon brainstem pathologies that can be encountered in the paediatric age group. Teaching Points • The paediatric brainstem can be afflicted by many pathologies that may overlap clinico-radiologically. • MRI is the best modality for the localisation and diagnosis of brainstem pathologies. • Diffusion-weighted imaging is useful in the diagnosis of vascular and metabolic disorders. • Occasionally, demyelination and neoplasms can be indistinguishable on imaging. PMID:27216793

  14. [What place and what future for the pathology of infectious and tropical diseases in France?].

    PubMed

    Hofman, Paul

    2014-06-01

    The management of tissues and cellular samples by the pathologists in the infectious and tropical diseases pathology field in 2014 needs a strong knowledge of both morphological and molecular domains which includes the good control: (i) of the taxonomy of infectious and tropical diseases pathology leading to the pathogens identification and (ii) of the ancillary methods which can be used in fixed samples in order to detect or better identify these pathogens. There is a recent paradox in France concerning the frequency of infectious diseases to be diagnosed in pathology laboratories and the progressive loss of pathologist's expertise in this domain. Different reasons could explain this statement including the omnipresence of the tumour lesions to be managed in a pathology laboratory as well as the recent constraints associated with the different biomarkers that are mandatory to be detected by immunohistochemistry and/or by molecular biology. Even if the microbiologists play a pivotal role for identifying the different pathogens as well as for the assessment of their sensitivity to the anti-microbial drugs, a large number of infectious diseases can be diagnosed only on fixed tissue and/or cells by the pathologists. The purpose of this review is to describe the current and future issues of infectious and tropical diseases diagnoses in pathology laboratories, in particular in France. PMID:24950861

  15. Confocal Raman microscopy of pathologic cells in cerebrospinal fluid

    NASA Astrophysics Data System (ADS)

    Gonchukov, S. A.; Lonkina, T. V.; Minaeva, S. A.; Sundukov, A. V.; Migmanov, T. E.; Lademann, J.; Darvin, M. E.; Bagratashvili, V. N.

    2014-01-01

    In this work, the spatial localization of leucocytes, bacteria, and erythrocytes in the crystal pattern of a dried droplet of cerebrospinal fluid (CSF) is established. Characteristic lines are detected and identified in the Raman spectrum of the CSF that point to the presence of pathologic cells therein and can be used in a timely way to diagnose meningitis, the spectroscopic sample preparation procedure being simple enough. A dry CSF sample retains its characteristic spectral features for no less than three days, which is important for its safe keeping and transportation, and also for the computer processing of its spectra.

  16. Whole slide images for primary diagnostics of urinary system pathology: a feasibility study

    PubMed Central

    Al-Janabi, Shaimaa; Huisman, André; Jonges, Geertruida N.; ten Kate, Fiebo J.W.; Goldschmeding, Roel; van Diest, Paul J.

    2014-01-01

    Introduction: During the last decade, whole slide images (WSI) have been used in many areas of pathology such as teaching, research, digital archiving, teleconsultation and quality assurance testing. However, WSI have as yet not much been used for upfront diagnostics because of the lack of validation studies. Objectives: The aim of this study was to test the feasibility of WSI for primary diagnosis of urinary tract pathology. Materials and Methods: 100 consecutive urinary tract biopsies and resections which had been diagnosed conventionally between the years 2008-2009 were scanned at 20× magnification, and rediagnosed by two pathologists on WSI, having the original clinical information available, but blinded to the original diagnoses. Original and WSI diagnoses were compared and classified as concordant, slightly discordant (without clinical consequences) and discordant. Results: Original and WSI based rediagnosis were concordant in 87% of the cases. Original and WSI diagnosis were slightly discordant in 8% of cases. Major discrepancies with clinical or prognostic implications were founded in only 5 cases. However, for 6 out of the 13 discrepancies, WSI based diagnoses were considered to be better than the original diagnoses. Conclusion: Primary diagnostics of urinary tract specimens can be reliably done on WSI. Further improvements of image resolution may help to increase diagnostic accuracy and WSI acceptance in routine pathology. PMID:25610886

  17. Optimal breast cancer pathology manifesto.

    PubMed

    Tot, T; Viale, G; Rutgers, E; Bergsten-Nordström, E; Costa, A

    2015-11-01

    This manifesto was prepared by a European Breast Cancer (EBC) Council working group and launched at the European Breast Cancer Conference in Glasgow on 20 March 2014. It sets out optimal technical and organisational requirements for a breast cancer pathology service, in the light of concerns about variability and lack of patient-centred focus. It is not a guideline about how pathology services should be performed. It is a call for all in the cancer community--pathologists, oncologists, patient advocates, health administrators and policymakers--to check that services are available that serve the needs of patients in a high quality, timely way. PMID:26283037

  18. 27 CFR 22.107 - Pathological laboratories.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 27 Alcohol, Tobacco Products and Firearms 1 2012-04-01 2012-04-01 false Pathological laboratories... Pathological laboratories. (a) Pathological laboratories, not operated by a hospital or sanitarium, may... sanitariums. If a pathological laboratory does not exclusively conduct analyses or tests for hospitals...

  19. 27 CFR 22.107 - Pathological laboratories.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 27 Alcohol, Tobacco Products and Firearms 1 2014-04-01 2014-04-01 false Pathological laboratories... Pathological laboratories. (a) Pathological laboratories, not operated by a hospital or sanitarium, may... sanitariums. If a pathological laboratory does not exclusively conduct analyses or tests for hospitals...

  20. 27 CFR 22.107 - Pathological laboratories.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 27 Alcohol, Tobacco Products and Firearms 1 2011-04-01 2011-04-01 false Pathological laboratories... Pathological laboratories. (a) Pathological laboratories, not operated by a hospital or sanitarium, may... sanitariums. If a pathological laboratory does not exclusively conduct analyses or tests for hospitals...

  1. 27 CFR 22.107 - Pathological laboratories.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 27 Alcohol, Tobacco Products and Firearms 1 2013-04-01 2013-04-01 false Pathological laboratories... Pathological laboratories. (a) Pathological laboratories, not operated by a hospital or sanitarium, may... sanitariums. If a pathological laboratory does not exclusively conduct analyses or tests for hospitals...

  2. 27 CFR 22.107 - Pathological laboratories.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 27 Alcohol, Tobacco Products and Firearms 1 2010-04-01 2010-04-01 false Pathological laboratories... Pathological laboratories. (a) Pathological laboratories, not operated by a hospital or sanitarium, may... sanitariums. If a pathological laboratory does not exclusively conduct analyses or tests for hospitals...

  3. Primary hydatid cyst of the gallbladder: an unusual localization diagnosed by Magnetic Resonance Imaging (MRI)

    PubMed Central

    Noomene, Rabii; Maamer, Anis Ben; Bouhafa, Ahmed; Haoues, Noomen; Oueslati, Abdelaziz; Cherif, Abderraouf

    2013-01-01

    Hydatid disease is endemic in Tunisia and has been considered as one of the most common surgical pathology. Several localizations have been described, but hydatidosis of the liver is the most frequent clinical entity. Primary hydatid cyst of the gallbladder is very rare. We report in this observation a new case of primary hydatid cyst of the gallbladder diagnosed by Magnetic Resonance Imaging (MRI). PMID:23504393

  4. Molecular genetics of sarcomas: applications to diagnoses and therapy.

    PubMed

    Toguchida, Junya; Nakayama, Tomitaka

    2009-09-01

    Sarcomas are mesenchymal cancers consisting of tumors with various clinical and pathological features. Some of them compel affected individuals to lose important musculoskeletal functions, and some of them are highly malignant and life-threatening. A great amount of genetic information for sarcomas has accumulated during the past two decades, contributing diagnoses and treatments. From the standpoint of molecular genetics, sarcomas are classified into two groups: those with defined genetic alterations and those with various genetic alterations. The genetic alterations in the first group include reciprocal translocations resulting in fusion oncoproteins and oncogenic mutations of defined genes such as those of the c-kit gene in gastrointestinal stromal tumors. The function of fusion proteins includes transcription regulator, signal transducer, chromatic remodeling factor, and growth factor, some of which are suitable targets for the molecular therapy. In tumors belonging to the second group, the number of which is far larger than those of the first group, considerable genetic heterogeneity was found even among tumors with same pathological diagnosis. The disruption of the RB and p53 pathways was frequently found, resulting in the dysregulation of cell cycle and the genomic instability. The application of molecular target therapy for tumors in this group requires novel strategies to overcome cross talk between different signal pathways. Recent evidence from in vitro and in vivo experiments has indicated that the cells of origin of sarcomas are tissue stem cells such as mesenchymal stem cells, and the application of stem cell biology holds the promise of novel treatment options. PMID:19555393

  5. Voice Pathologies and the 'Hippocratic Triangle'.

    PubMed

    Webster, Colin

    2016-01-01

    Hippocratic authors frequently utilise silence, babbling, lisping and otherverbal signs to diagnose a variety of physical illnesses and predict theircourse. This chapter examines these 'voice pathologies' and evaluatestheir impact on the dialogue between patients and Hippocratic physicians. In short, Hippocratic authors treat patients' voices in two dissonant ways. On the one hand, physicians promote some form of discourse,implicitly relying on patients to report internal sensations resulting fromillnesses. On the other hand, they develop extensive techniques to diminish and downplay this reliance. As a result, Hippocratic authors treatpatients' mouths not so much as the loci of potential subjective expression, but as orifices secreting verbal discharges. They weaken the distinction between the (sonic) effluvia of the mouth and those of other bodilyoutlets, thus bringing verbal output into close conceptual proximity withother types of discharge. Words come to be scrutinised for their quantity,quality and consistency as though they were quasi-excreta of the mouth. (see text). Announce what has happened, discern what is happening and foretellwhat will happen; attend to these things. Practice two things concerningdiseases: help or do no harm. The art consists of three parts: the disease,the diseased and the physician; the physician is the servant of the art; thediseased fights against the disease with the physician (Hipp., Epid.1.5L. 2.634.6-636.4 = Kiülewein 189,24-190, 6). PMID:26946677

  6. Pancreatic adenocarcinoma pathology: changing “landscape”

    PubMed Central

    Brosens, Lodewijk A. A.; Hackeng, Wenzel M.; Offerhaus, G. Johan; Hruban, Ralph H.

    2015-01-01

    Pancreatic cancer is a devastating disease. At time of diagnosis the disease is usually advanced and only a minority of patients are eligible for surgical resection. The overall 5-year survival is 6%. However, survival of patients with early stage pancreatic cancer is significantly better. To improve the prognosis of patients with pancreatic cancer, it is essential to diagnose and treat pancreatic cancer in the earliest stage. Prevention of pancreatic cancer by treating noninvasive precursor lesions just before they invade tissues can potentially lead to even better outcomes. Pancreatic carcinogenesis results from a stepwise progression in which accumulating genetic alterations drive neoplastic progression in well-defined precursor lesions, ultimately giving rise to an invasive adenocarcinoma. A thorough understanding of the genetic changes that drive pancreatic carcinogenesis can lead to identification of biomarkers for early detection and targets for therapy. Recent next-generation sequencing (NGS) studies have shed new light on our understanding of the natural history of pancreatic cancer and the precursor lesions that give rise to these cancers. Importantly, there is a significant window of opportunity for early detection and treatment between the first genetic alteration in a cell in the pancreas and development of full-blown pancreatic cancer. The current views on the pathology and genetics of pancreatic carcinogenesis that evolved from studies of pancreatic cancer and its precursor lesions are discussed in this review. PMID:26261723

  7. The practice of pathology in Africa.

    PubMed

    Kaschula, Ronald Otto Christian

    2013-06-01

    In attempting to advance the health of women and children in Africa, practitioners should be cognizant of the history of health care delivery in the continent and the nature of the existing systems. Although autopsies began in Africa several millennia ago, traditional healers have held sway for many centuries and continue to do so for most of Africa's people. The role of laboratory medicine in advancing modern health care has been impeded by its ever-increasing high cost, lack of confidence in the system, lack of adequately trained personnel, and inadequate provision of facilities and training opportunities. This is partly caused by the continent having the highest proportion of young children in the world, an exceptionally heavy disease burden, and a low proportion of tax payers. For laboratory medicine to have its intended effect in making accurate diagnoses, national, minimal standards for certification and practice should be formulated. There should be periodic inspections, rewards for excellence, and opportunities for professional development. It is recommended that laboratory medicine be practiced in a 4-tier system, with the highest in teaching hospitals, and the lowest in primary health care clinics. For the practice of anatomic pathology to advance, an effective referral system and an equitable minimal and maximal workload for each pathologist are needed. The changing dynamics of urbanization, with massive unemployment rates, unhealthy life styles, and the continued role of traditional healers calls for gifted leaders to come to the fore and facilitate internal and external cooperation with diverse health care agencies. PMID:23721269

  8. Parenting styles and eating disorder pathology.

    PubMed

    Enten, Roni S; Golan, Moria

    2009-06-01

    Our objective was to investigate the association between parenting style and eating disorder symptoms in patients treated in an intensive outpatient center for eating disorders. The study design is a cross-sectional survey set in a community-based facility for eating disorders. Participants included 53 families, including 32 with a child meeting the DSM-IV criteria for anorexia nervosa, 18 for bulimia nervosa, and 3 diagnosed ED-NOS. Data was collected using the Parental Authority Questionnaire (PAQ), the Eating Disorders Inventory-2 (EDI-2) and the Eating Attitudes Test (EAT-26). Significant, negative correlations were found between drive for thinness scores and body dissatisfaction scores and the patient's perception of the father as authoritative. Total patient EDI score was significantly and positively correlated with patient's perception of the father as authoritarian and inversely correlated with her perception of him as authoritative. These results emphasize the importance of fathers' role in the eating disorder pathology, a relatively untapped area of research. PMID:19501782

  9. Sonography of pathological changes in the hand

    PubMed Central

    Czyrny, Zbigniew; Nowicki, Paweł

    2014-01-01

    Everyday medical practice shows that most common problems within the hand result from overload, injuries and degeneration. Dorsal side pathologies such as de Quervain's and Wartenberg's disease, intersection syndrome or degenerative lesions of carpometa-carpal joint of the thumb discussed in the paper can be accurately diagnosed and differentiated by means of ultrasound examination. Ultrasound is similarly powerful in detection and grading of traumatic lesions involving extensor tendons and their sagittal bands or the flexor tendons and their pulleys. In the case of carpal tunnel syndrome one can not only visualize the median nerve but also other structures of the tunnel that may cause compression. Similarly ulnar nerve compression within the Guyon's canal can be well evaluated. In cases of nerve trauma one can precisely define the level, and in cases of nerve discontinuity, the distance between stumps can be measured which is important in surgery planning. Often nerve trauma is a sequelae of tendon reconstruction. In such cases scars and nerve entrapment can be depicted. Tumors within a hand are usually benign, of which the most common are ganglia. On ultrasound examination a connection between a ganglion and its source (usually a joint or sheath) can frequently be defined. The relationship of tumors to nerves, tendon sheaths or vessels may suggest their nature. Ultrasound with dynamic tissue assessment is a very valuable adjunct to clinical examination. PMID:26675521

  10. Sonography of pathological changes in the hand.

    PubMed

    Dębek, Anna; Czyrny, Zbigniew; Nowicki, Paweł

    2014-03-01

    Everyday medical practice shows that most common problems within the hand result from overload, injuries and degeneration. Dorsal side pathologies such as de Quervain's and Wartenberg's disease, intersection syndrome or degenerative lesions of carpometa-carpal joint of the thumb discussed in the paper can be accurately diagnosed and differentiated by means of ultrasound examination. Ultrasound is similarly powerful in detection and grading of traumatic lesions involving extensor tendons and their sagittal bands or the flexor tendons and their pulleys. In the case of carpal tunnel syndrome one can not only visualize the median nerve but also other structures of the tunnel that may cause compression. Similarly ulnar nerve compression within the Guyon's canal can be well evaluated. In cases of nerve trauma one can precisely define the level, and in cases of nerve discontinuity, the distance between stumps can be measured which is important in surgery planning. Often nerve trauma is a sequelae of tendon reconstruction. In such cases scars and nerve entrapment can be depicted. Tumors within a hand are usually benign, of which the most common are ganglia. On ultrasound examination a connection between a ganglion and its source (usually a joint or sheath) can frequently be defined. The relationship of tumors to nerves, tendon sheaths or vessels may suggest their nature. Ultrasound with dynamic tissue assessment is a very valuable adjunct to clinical examination. PMID:26675521

  11. Learning Biology with Plant Pathology.

    ERIC Educational Resources Information Center

    Carroll, Juliet E.

    This monograph contains 10 plant pathology experiments that were written to correspond to portions of a biology curriculum. Each experiment is suitable to a biology topic and designed to encourage exploration of those biological concepts being taught. Experiments include: (1) The Symptoms and Signs of Disease; (2) Koch's Postulates; (3)…

  12. THE PATHOLOGY OF MENTAL RETARDATION.

    ERIC Educational Resources Information Center

    CROME, L.; STERN, J.

    DATA FROM RECENT COMPREHENSIVE STUDIES OF THE PATHOLOGY OF MENTAL RETARDATION ARE ASSEMBLED, INCLUDING MATERIAL ON ETIOLOGY, MORPHOLOGY, BIOCHEMISTRY, AND LABORATORY DIAGNOSIS. AREAS COVERED ARE (1) GENETIC CAUSES OF MENTAL RETARDATION, (2) DISORDERS OF GESTATION, (3) BIRTH INJURY, (4) GENERAL CONSIDERATIONS OF POSTNATAL CAUSES OF MENTAL…

  13. Physiological and pathological cardiac hypertrophy.

    PubMed

    Shimizu, Ippei; Minamino, Tohru

    2016-08-01

    The heart must continuously pump blood to supply the body with oxygen and nutrients. To maintain the high energy consumption required by this role, the heart is equipped with multiple complex biological systems that allow adaptation to changes of systemic demand. The processes of growth (hypertrophy), angiogenesis, and metabolic plasticity are critically involved in maintenance of cardiac homeostasis. Cardiac hypertrophy is classified as physiological when it is associated with normal cardiac function or as pathological when associated with cardiac dysfunction. Physiological hypertrophy of the heart occurs in response to normal growth of children or during pregnancy, as well as in athletes. In contrast, pathological hypertrophy is induced by factors such as prolonged and abnormal hemodynamic stress, due to hypertension, myocardial infarction etc. Pathological hypertrophy is associated with fibrosis, capillary rarefaction, increased production of pro-inflammatory cytokines, and cellular dysfunction (impairment of signaling, suppression of autophagy, and abnormal cardiomyocyte/non-cardiomyocyte interactions), as well as undesirable epigenetic changes, with these complex responses leading to maladaptive cardiac remodeling and heart failure. This review describes the key molecules and cellular responses involved in physiological/pathological cardiac hypertrophy. PMID:27262674

  14. [An elderly man presenting polyarthritis diagnosed as chronic tophaceous gout].

    PubMed

    Sugiura, Misa; Aoki, Akiko

    2015-01-01

    An 85-year-old man was admitted to our hospital for swollen and painful bilateral lower legs and a high fever. He was initially diagnosed with acute cellulitis and treated with antibiotics. Several days after the improvement of his swollen legs, he complained of both shoulder and arm pain. The laboratory data at this time were as follow: C-reactive protein 10.7 mg/dL, uric acid 8.7 mg/dL, and creatinine 1.07 mg/dL. Both rheumatoid factor and anti-CCP antibody were negative. Whole-body gallium scintigraphy showed a high pathological accumulation in both the shoulders and left wrist. As polymyalgia rheumatica was suspected, oral prednisolone (PSL) of 10 mg/day was started. The patient's shoulder pain improved and he was discharged. However, he was hospitalized twice in the next month because of left shoulder, left knee, right arm, and right wrist pain. During the third hospitalization, we found a subcutaneous nodule on right toe. Aspiration material from the nodule was a white paste, showing acicular crystals under the microscope. According to these findings, the nodule was diagnosed as a tophaceous nodule, and recurrent episodes of polyarthritis were diagnosed as chronic tophaceous gout. Low-dose PSL was continued and febuxostat was added. This patient had multiple risk factors for chronic tophaceous gout: obesity, a habit of drinking, diabetes mellitus, hyperlipidemia, congestive heart failure, and interruption of allopurinol treatment. We herein discuss the clinical course of the patient, the interruption of allopurinol treatment and polypharmacy in elderly patients. PMID:26700782

  15. Histological examination has a major impact on macroscopic necropsy diagnoses

    PubMed Central

    Bernardi, F D C; Saldiva, P H N; Mauad, T

    2005-01-01

    Background: Necropsy is the gold standard for clinicopathological discrepancy studies and epidemiological surveys. Inadequate sampling or lack of tissue may hamper the final interpretation and quality of the necropsy. Aim: To compare the histological and gross necropsy diagnoses of different organs. Methods: A retrospective comparison of the provisional reports (gross findings only) and the final reports (after histological examination) of the necropsies performed at the department of pathology of the Hospital das Clínicas, Sao Paulo University, Brazil, a large tertiary care complex, in 2001. The total number of diagnoses listed for the lungs, heart, liver, pancreas, kidneys, and spleen were calculated. Findings were categorised into concordant/refined diagnosis, discordant/additional diagnosis, histology needed, and inconclusive. Results: Three hundred and seventy one postmortem reports were analysed. There were 214 men and 157 women, with a mean age of 50.3 years, ranging from 1 to 92. The lung received the highest number (954) and the pancreas the lowest number (390) of diagnoses. The highest frequencies of discrepancies between the gross and microscopic findings were found in the lung and the liver: 38.7% and 35.1%, respectively. The brain had the lowest frequency of discrepancies. In a small number of cases, the final diagnosis could only be achieved through microscopic analysis, with the highest frequency being found in the kidneys (8.5%). Conclusions: Histological analysis has a major impact on previously performed gross diagnosis at necropsy, especially in the lungs, liver, and kidneys. Adequate sampling and histological analysis are important for necropsy quality. PMID:16311344

  16. Time Devours Things: How Impulsivity and Time Affect Temporal Decisions in Pathological Gamblers

    PubMed Central

    Grecucci, Alessandro; Giorgetta, Cinzia; Rattin, Andrea; Guerreschi, Cesare; Sanfey, Alan G.; Bonini, Nicolao

    2014-01-01

    Impulsivity is associated with several psychiatric disorders in which the loss of control of a specific behavior determines the syndrome itself. One particularly interesting population characterized by reported high impulsivity and problematic decision-making are those diagnosed with pathological gambling. However the association between impulsivity and decision making in pathological gambling has been only partially confirmed until now. We tested 23 normal controls and 23 diagnosed pathological gamblers in an intertemporal choice task, as well as other personality trait measurements. Results showed that gamblers scored higher on impulsivity questionnaires, and selected a higher percentage of impatient choices (higher percentage of smaller, sooner rewards), when compared to normal controls. Moreover, gamblers were faster in terms of reaction times at selecting the smaller, sooner options and discounted rewards more rapidly over time. Importantly, regression analyses clarified that self-reported measures of impulsivity played a significant role in biasing decisions towards small but more rapidly available rewards. In the present study we found evidence for impulsivity in personality traits and decisions in pathological gamblers relative to controls. We conclude by speculating on the need to incorporate impulsivity and decision biases in the conceptualization of pathological gambling for a better understanding and treatment of this pathology. PMID:25296184

  17. Macroscopic Anomalies and Pathological Findings in and Around the Achilles Tendon

    PubMed Central

    Johansson, Kristian; Lempainen, Lasse; Sarimo, Janne; Laitala-Leinonen, Tiina; Orava, Sakari

    2014-01-01

    Background: Nonsurgical treatments for chronic Achilles tendinopathy (AT) results in unpredictable success rates. Surgical treatment may be chosen as reports show mostly encouraging but variable success rates depending on the pathology. The distribution of surgically confirmed pathologies in AT is largely unknown. Purpose: To ascertain the distributions of macroscopically observed anomalies in participants undergoing surgical treatment for chronic AT. Study Design: Case series; Level of evidence, 4. Methods: The main macroscopic pathologies of 1661 chronic Achilles tendon overuse injuries, which were diagnosed and surgically treated by a single surgeon, were reviewed. The surgeries were performed on professional and recreational athletes during the years 1976-1980, 1986-1990, 1996-2000, and 2006-2010. Surgical diagnoses, along with age- and sport-specific characteristics, were collected retrospectively from patient records. Results: The relative proportion of tendinosis increased during the study period from 4.2% to 21%, and paratenonitis decreased from 50% to 26%. Retrocalcaneal pathologies were the most common surgically confirmed lesions at 30%, while the mean age at surgery increased by 11 years over the entire study period. Conclusion: Surgically confirmed pathologies in and around the Achilles tendon showed coherent changes, chronic paratenonitis, and retrocalcaneal problems as the most prevalent findings. The classification of midportion and insertional tendinopathy and retrocalcaneal bursitis in AT should strictly be used as a clinical diagnosis. During surgical evaluations, the diagnosis is further clarified as more specific pathologies may be identified. PMID:26535293

  18. How Are Lung Carcinoid Tumors Diagnosed?

    MedlinePlus

    ... Research Get Involved Find Local ACS Learn About Cancer » Lung Carcinoid Tumor » Detailed Guide » How are lung carcinoid tumors diagnosed? Share this Page Close Push escape to close share window. Print ...

  19. How Can Dyslexia Be Objectively Diagnosed?

    ERIC Educational Resources Information Center

    Pavlidis, George Th.

    1979-01-01

    Describes experiments showing that the eye movement patterns of dyslexic children differed from those of normal and backward readers during both a reading and a nonreading task. Discusses possible causes of dyslexia and ways of diagnosing it. (GT)

  20. How Do Health Care Providers Diagnose Endometriosis?

    MedlinePlus

    ... Information Clinical Trials Resources and Publications How do health care providers diagnose endometriosis? Skip sharing on social media ... under a microscope, to confirm the diagnosis. 1 Health care providers may also use imaging methods to produce ...

  1. How Do Health Care Providers Diagnose Pheochromocytoma?

    MedlinePlus

    ... Information Clinical Trials Resources and Publications How do health care providers diagnose pheochromocytoma? Skip sharing on social media links Share this: Page Content A health care provider uses blood and urine tests that measure ...

  2. How Do Health Care Providers Diagnose Hypoparathyroidism?

    MedlinePlus

    ... Information Clinical Trials Resources and Publications How do health care providers diagnose hypoparathyroidism? Skip sharing on social media links Share this: Page Content A health care provider will order a blood test to determine ...

  3. How Is von Willebrand Disease Diagnosed?

    MedlinePlus

    ... of your von Willebrand factor. The test helps your doctor diagnose what type of VWD you have. Platelet function test. This test measures how well your platelets are working. You may have these tests ...

  4. How Is Mitral Valve Prolapse Diagnosed?

    MedlinePlus

    ... page from the NHLBI on Twitter. How Is Mitral Valve Prolapse Diagnosed? Mitral valve prolapse (MVP) most often is detected during a ... a clicking sound as they shut. If the mitral valve is leaking blood back into the left atrium, ...

  5. Children Diagnosed with Cancer: Returning to School

    MedlinePlus

    ... for the child and the whole family. Good communication starts early. After your child is diagnosed and ... or comments. Every child has their own coping style. Helping them figure out what feels best for ...

  6. Diagnosing Asthma in Very Young Children

    MedlinePlus

    ... Listen Español Text Size Email Print Share Diagnosing Asthma in Babies & Toddlers Page Content Article Body One ... family with recurrent bronchitis or sinus problems. When Asthma is Not the Cause Your pediatrician will listen ...

  7. Diagnosing Diabetes and Learning about Prediabetes

    MedlinePlus

    ... Size: A A A Listen En Español Diagnosing Diabetes and Learning About Prediabetes There are several ways ... mg/dl – 199 mg/dl Preventing Type 2 Diabetes You will not develop type 2 diabetes automatically ...

  8. Tips to diagnose uncommon nail disorders.

    PubMed

    Schneider, Samantha L; Tosti, Antonella

    2015-04-01

    This article reviews 6 nail disorders that, although easy to diagnose, are misdiagnosed frequently by dermatologists and general practitioners. Diagnostic clues are emphasized to familiarize readers with features that indicate the correct diagnosis. We focus on two common tumors (onychomatricoma and onychopapilloma), two rare genetic conditions that can be diagnosed owing to nail changes (Darier disease and nail patella syndrome), and two uncommon acquired disorders (the yellow nail syndrome and lichen striatus). PMID:25828712

  9. The mouse pathology ontology, MPATH; structure and applications

    PubMed Central

    2013-01-01

    Background The capture and use of disease-related anatomic pathology data for both model organism phenotyping and human clinical practice requires a relatively simple nomenclature and coding system that can be integrated into data collection platforms (such as computerized medical record-keeping systems) to enable the pathologist to rapidly screen and accurately record observations. The MPATH ontology was originally constructed in 2,000 by a committee of pathologists for the annotation of rodent histopathology images, but is now widely used for coding and analysis of disease and phenotype data for rodents, humans and zebrafish. Construction and content MPATH is divided into two main branches describing pathological processes and structures based on traditional histopathological principles. It does not aim to include definitive diagnoses, which would generally be regarded as disease concepts. It contains 888 core pathology terms in an almost exclusively is_a hierarchy nine layers deep. Currently, 86% of the terms have textual definitions and contain relationships as well as logical axioms to other ontologies such the Gene Ontology. Application and utility MPATH was originally devised for the annotation of histopathological images from mice but is now being used much more widely in the recording of diagnostic and phenotypic data from both mice and humans, and in the construction of logical definitions for phenotype and disease ontologies. We discuss the use of MPATH to generate cross-products with qualifiers derived from a subset of the Phenotype and Trait Ontology (PATO) and its application to large-scale high-throughput phenotyping studies. MPATH provides a largely species-agnostic ontology for the descriptions of anatomic pathology, which can be applied to most amniotes and is now finding extensive use in species other than mice. It enables investigators to interrogate large datasets at a variety of depths, use semantic analysis to identify the relations between

  10. Pathology of traumatic brain injury.

    PubMed

    Finnie, John W

    2014-12-01

    Although traumatic brain injury (TBI) is frequently encountered in veterinary practice in companion animals, livestock and horses, inflicted head injury is a common method of euthanasia in domestic livestock, and malicious head trauma can lead to forensic investigation, the pathology of TBI has generally received little attention in the veterinary literature. This review highlights the pathology and pathogenesis of cerebral lesions produced by blunt, non-missile and penetrating, missile head injuries as an aid to the more accurate diagnosis of neurotrauma cases. If more cases of TBI in animals that result in fatality or euthanasia are subjected to rigorous neuropathological examination, this will lead to a better understanding of the nature and development of brain lesions in these species, rather than extrapolating data from human studies. PMID:25178417