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Sample records for 99mtc-etambutol untuk diagnosis

  1. Fault diagnosis

    NASA Technical Reports Server (NTRS)

    Abbott, Kathy

    1990-01-01

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

  2. Melanoma Diagnosis

    NASA Astrophysics Data System (ADS)

    Horsch, Alexander

    The chapter deals with the diagnosis of the malignant melanoma of the skin. This aggressive type of cancer with steadily growing incidence in white populations can hundred percent be cured if it is detected in an early stage. Imaging techniques, in particular dermoscopy, have contributed significantly to improvement of diagnostic accuracy in clinical settings, achieving sensitivities for melanoma experts of beyond 95% at specificities of 90% and more. Automatic computer analysis of dermoscopy images has, in preliminary studies, achieved classification rates comparable to those of experts. However, the diagnosis of melanoma requires a lot of training and experience, and at the time being, average numbers of lesions excised per histology-proven melanoma are around 30, a number which clearly is too high. Further improvements in computer dermoscopy systems and their competent use in clinical settings certainly have the potential to support efforts of improving this situation. In the chapter, medical basics, current state of melanoma diagnosis, image analysis methods, commercial dermoscopy systems, evaluation of systems, and methods and future directions are presented.

  3. Pubic "Crab" Lice Diagnosis

    MedlinePlus

    ... Treatment FAQs Malathion FAQs Epidemiology & Risk Factors Disease Biology Diagnosis Treatment Prevention & Control Resources for Health Professionals ... Frequently Asked Questions (FAQs) Epidemiology & Risk Factors Disease Biology Diagnosis Treatment Prevention & Control Resources for Health Professionals ...

  4. Head Lice: Diagnosis

    MedlinePlus

    ... Treatment FAQs Malathion FAQs Epidemiology & Risk Factors Disease Biology Diagnosis Treatment Prevention & Control Resources for Health Professionals ... Frequently Asked Questions (FAQs) Epidemiology & Risk Factors Disease Biology Diagnosis Treatment Prevention & Control Resources for Health Professionals ...

  5. Body Lice Diagnosis

    MedlinePlus

    ... Treatment FAQs Malathion FAQs Epidemiology & Risk Factors Disease Biology Diagnosis Treatment Prevention & Control Resources for Health Professionals ... Frequently Asked Questions (FAQs) Epidemiology & Risk Factors Disease Biology Diagnosis Treatment Prevention & Control Resources for Health Professionals ...

  6. Prenatal diagnosis of achondrogenesis.

    PubMed

    Golbus, M S; Hall, B D; Filly, R A; Poskanzer, L B

    1977-09-01

    Severe rhizomelic and mesomelic dwarfism was demonstrated in a 20-week gestation fetus by amniography. A systematic progressive approach to prenatal diagnosis in the absence of a definitive diagnosis and the use of contrast radiography is discussed. PMID:894421

  7. Bell's Palsy Diagnosis

    MedlinePlus

    ... Stories Español Eye Health / Eye Health A-Z Bell's Palsy Sections What Is Bell's Palsy? Bell's Palsy Symptoms ... Bell's Palsy? Bell's Palsy Diagnosis Bell's Palsy Treatment Bell's Palsy Diagnosis Reviewed by: Philip R Rizzuto, MD FACS ...

  8. Postpartal nursing diagnosis.

    PubMed

    Gorrie, T M

    1986-01-01

    The responsibility of nurses for postpartal patients has changed greatly in the past few years. No longer is it adequate to assess and manage only those physical problems that occur during the hospital stay. Today, potential psychosocial problems and consequences of parental knowledge deficit are part of nursing's domain of diagnosis and management. A review of the purpose of nursing diagnosis is important. Clarifying the difference between medical diagnosis and nursing diagnosis is also essential if one is to be comfortable with the process. Careful scrutiny of the unique needs of new parents will form the basis for formulating meaningful postpartal nursing diagnosis.

  9. Celiac Disease: Diagnosis.

    PubMed

    Byrne, Greg; Feighery, Conleth F

    2015-01-01

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

  10. Diagnosis and differential diagnosis of fibromyalgia.

    PubMed

    Goldenberg, Don L

    2009-12-01

    Fibromyalgia is a chronic functional illness that presents with widespread musculoskeletal pain as well as a constellation of symptoms including fatigue, cognitive dysfunction, sleep difficulties, stiffness, anxiety, and depressed mood. The diagnosis of fibromyalgia, similar to other functional disorders, requires that organic diseases are not causing the symptoms. Systemic and rheumatic diseases can be ruled out by a patient history, physical examination, and laboratory investigations. Because there are no specific laboratory tests for fibromyalgia, the 1990 American College of Rheumatology (ACR) classification criteria have been used in clinical settings; however, they are not ideal for individual patient diagnosis. Clinicians should be aware of limitations inherent in using tender points in the diagnosis of fibromyalgia. The multiple symptoms of fibromyalgia often overlap with those of related disorders and may further complicate the diagnosis. One of the most challenging diagnostic dilemmas that clinicians face is distinguishing fibromyalgia from other central pain disorders (e.g., irritable bowel syndrome, chronic fatigue syndrome, migraine). Screening questions based on published criteria can be used as a first approach in diagnosing functional illnesses. Numerous studies report a higher prevalence of psychiatric disorders in patients with fibromyalgia. Therefore, a careful history and evaluation should be taken for the presence of primary mood disturbances. To date, there is no "gold standard" for diagnosing fibromyalgia. Until a better clinical case definition of fibromyalgia exists, all diagnostic criteria should be interpreted with caution, considered rudimentary, and subject to modification.

  11. [Cluster headache differential diagnosis].

    PubMed

    Guégan-Massardier, Evelyne; Laubier, Cécile

    2015-11-01

    Cluster headache is characterized by disabling stereotyped headache. Early diagnosis allows appropriate treatment, unfortunately diagnostic errors are frequent. The main differential diagnoses are other primary or essential headaches. Migraine, more frequent and whose diagnosis is carried by excess, trigeminal neuralgia or other trigemino-autonomic cephalgia. Vascular or tumoral underlying condition can mimic cluster headache, neck and brain imaging is recommended, ideally MRI.

  12. Case for diagnosis*

    PubMed Central

    Sano, Daniela Tiemi; de Melo, Luciana Valentini; Tebcherani, Antonio José; Sanchez, Ana Paula Galli

    2014-01-01

    Focal acral hyperkeratosis is a rare genodermatosis with an autosomal dominant pattern of inheritance. It is characterized by usually asymptomatic keratotic papules along the borders of the hands and/or feet. The main differential diagnosis is acrokeratoelastoidosis of Costa, which differs from the former only by not presenting elastorrhexis in histopathological examination, thus requiring this exam for a correct diagnosis. PMID:25184932

  13. Prenatal diagnosis of achondrogenesis.

    PubMed

    Anteby, S O; Aviad, I; Weinstein, D

    1977-01-01

    An achondrogenic fetus, in whom the diagnosis was made prior to delivery by plain abdominal X-rays, is presented. The intrauterine characteristic roentgenographic manifestations are the short dense tubular bones of the extremities. An early diagnosis in fetuses with this disease can be made on a plain abdominal X-ray in the 22nd-24th week of gestation. PMID:300166

  14. Diagnosis of secondary caries.

    PubMed

    Kidd, E A

    2001-10-01

    A systematic review of the diagnosis of dental caries was produced before the conference. It did not include the diagnosis of secondary or recurrent caries. This was a wise decision because what little literature exists on the subject potentially clouds the issue. Diagnosis is a mental resting place on the way to a treatment decision. A vital part of caries diagnosis is to decide whether a lesion is active and rapidly progressing or already arrested. This information is essential to plan logical management. However, lesion activity should be judged in the patient. Thus, research on the diagnosis of secondary caries must be carried out in vivo and this usually precludes histological validation. Even if such validation is possible, it has its own problems, particularly in distinguishing recurrent from residual caries. The diagnosis of secondary caries is very important since so many restorations are replaced because dentists think there is a new decay. It will be important to establish valid criteria for the diagnosis of active secondary caries, which will be facilitated by the suggestion that secondary caries is no different from primary caries except that it occurs next to a filling. This implies that it can be seen clinically and on a radiograph, next to a restoration.

  15. Diagnosis of secondary caries.

    PubMed

    Kidd, E A

    2001-10-01

    A systematic review of the diagnosis of dental caries was produced before the conference. It did not include the diagnosis of secondary or recurrent caries. This was a wise decision because what little literature exists on the subject potentially clouds the issue. Diagnosis is a mental resting place on the way to a treatment decision. A vital part of caries diagnosis is to decide whether a lesion is active and rapidly progressing or already arrested. This information is essential to plan logical management. However, lesion activity should be judged in the patient. Thus, research on the diagnosis of secondary caries must be carried out in vivo and this usually precludes histological validation. Even if such validation is possible, it has its own problems, particularly in distinguishing recurrent from residual caries. The diagnosis of secondary caries is very important since so many restorations are replaced because dentists think there is a new decay. It will be important to establish valid criteria for the diagnosis of active secondary caries, which will be facilitated by the suggestion that secondary caries is no different from primary caries except that it occurs next to a filling. This implies that it can be seen clinically and on a radiograph, next to a restoration. PMID:11700003

  16. Using Schemata for Diagnosis*

    PubMed Central

    Turner, Roy M.

    1988-01-01

    Medical diagnosis is a planning task in which the operators are actions such as asking for information and drawing an inference. Diagnosis involves interleaving planning and plan execution, since information gathered by the diagnostician may change the future course of diagnosis. In this paper we present an approach to computer-based medical diagnosis called schema-based reasoning. This approach represents the reasoner's planning knowledge as packets of procedural information called schemata; each schema can be applied to achieve a goal. Schemata are retrieved using the goals and other features of a consultation. To facilitate opportunism and reactive planning, several schemata can be active at once. The reasoner switches between them as needed, using information about the consultation and using strategies that are represented as strategic schemata. Our approach is implemented in the MEDIO program, a schema-based diagnostic reasoner whose domain is pulmonology.

  17. Plague Diagnosis and Treatment

    MedlinePlus

    ... Search The CDC Cancel Submit Search The CDC Plague Note: Javascript is disabled or is not supported ... message, please visit this page: About CDC.gov . Plague Home Ecology & Transmission Symptoms Diagnosis & Treatment Maps & Statistics ...

  18. [Cardiovascular syphilis: diagnosis, treatment].

    PubMed

    Carrada-Bravo, Teodoro

    2006-01-01

    Cardiovascular tertiary syphilis may lead to aortitis, aortic aneurism, coronary stenosis, aortic insufficiency and, rarely, to myocarditis. The physician must be familiar with the clinical presentations of this process, including the asymptomatic variety and must be able to have an organized plan for the diagnosis and evaluation to establish or exclude the presence of cardiovascular pathology and the differential diagnosis with other entities. Once the etiologic and topographic diagnosis is established, the patient should be treated with penicillin, doxicycline and other antibiotics, and the consequences of the disorder, both actual and potential, should be considered before deciding weather to recommend surgical intervention. Although late syphilis can be prevented by appropriate therapy of early syphilis, this is a cardiovascular disease that most likely will continue to be diagnosed lately. Understanding of the pathology and pathophysiology of the disease, is most important for its prompt recognition and subsequent management. This paper reviews the natural history, diagnosis and therapy of cardiovascular syphilis. PMID:17469346

  19. Diagnosis of Osteoporosis.

    ERIC Educational Resources Information Center

    Wahner, H. W.

    1987-01-01

    Early recognition of osteoporosis is difficult because symptoms are lacking and there are no distinct, readily accessible diagnostic features. This article reviews the standard approach, radiographic and laboratory diagnosis, bone mass measurement techniques, and interpretation of bone mineral data. (MT)

  20. Diagnosis of hepatitis B

    PubMed Central

    Song, Jeong Eun

    2016-01-01

    Hepatitis B virus (HBV) infection is a major global health problems leading to severe liver disease such as cirrhosis and hepatocellular carcinoma (HCC). HBV is a circular, partly double-stranded DNA virus with various serological markers: hepatitis B surface antigen (HBsAg) and anti-HBs, anti-HBc IgM and IgG, and hepatitis B e antigen (HBeAg) and anti-HBe. It is transmitted by sexual, parenteral and vertical route. One significant method to diminish the burden of this disease is timely diagnosis of acute, chronic and occult cases of HBV. First step of HBV diagnosis is achieved by using serological markers for detecting antigens and antibodies. In order to verify first step of diagnosis, to quantify viral load and to identify genotypes, quantitative or qualitative molecular tests are used. In this article, the serological and molecular tests for diagnosis of HBV infection will be reviewed. PMID:27761442

  1. Frontotemporal Dementias: Diagnosis

    MedlinePlus

    ... imaging), PET (positron emission tomography), and SPECT (single photon emission computed tomography). Clinical Diagnosis vs. Pathology It ... or if pre-approval is needed. SPECT (Single Photon Emission Computed Tomography) : A type of nuclear medicine ...

  2. [Diagnosis: synovial fluid analysis].

    PubMed

    Gallo Vallejo, Francisco Javier; Giner Ruiz, Vicente

    2014-01-01

    Synovial fluid analysis in rheumatological diseases allows a more accurate diagnosis in some entities, mainly infectious and microcrystalline arthritis. Examination of synovial fluid in patients with osteoarthritis is useful if a differential diagnosis will be performed with other processes and to distinguish between inflammatory and non-inflammatory forms. Joint aspiration is a diagnostic and sometimes therapeutic procedure that is available to primary care physicians.

  3. Diagnosis and Metaphor.

    PubMed

    Hanne, Michael

    2015-01-01

    Human beings rely on metaphor as a primary cognitive device for interpreting the world around them. Metaphors figure especially strongly in discourse around health, illness, and medicine. It is not just that patients use metaphors to describe their personal experience of being unwell, or that medical professionals employ metaphor to convey a diagnosis, describe a treatment, or explain the function of an organ to their patients. Metaphor, it is argued, lies at the heart of the process of diagnosis. Moreover, diagnosticians employ competing metaphors in the early stages of diagnosis to speculate on alternative ways of viewing a puzzling set of symptoms. Diagnosis is often defined as a process of ordering and classifying, while metaphor is a device for playing with classifications. The medical systems of different cultures depend on different sets of fundamental metaphors. Modern Western biomedicine is organized around a series of basic metaphors: the body as machine, the body as the site of battle, and the body as a communication system. Traditional Chinese medicine, on the other hand, uses images of flow and blockage, balance and imbalance, and works by analogy with five elements: wood, fire, earth, metal, and water. Psychologists are sometimes able to detect from a patient's own use of metaphor, or inability to use or recognize metaphor, clues to a diagnosis of psychosis or autism. With conditions such as anorexia nervosa, therapists may actually work to modify the dysfunctional metaphors by which patients depict themselves, with the purpose of establishing positive metaphors for envisaging recovery. PMID:26657680

  4. Diagnosis and Metaphor.

    PubMed

    Hanne, Michael

    2015-01-01

    Human beings rely on metaphor as a primary cognitive device for interpreting the world around them. Metaphors figure especially strongly in discourse around health, illness, and medicine. It is not just that patients use metaphors to describe their personal experience of being unwell, or that medical professionals employ metaphor to convey a diagnosis, describe a treatment, or explain the function of an organ to their patients. Metaphor, it is argued, lies at the heart of the process of diagnosis. Moreover, diagnosticians employ competing metaphors in the early stages of diagnosis to speculate on alternative ways of viewing a puzzling set of symptoms. Diagnosis is often defined as a process of ordering and classifying, while metaphor is a device for playing with classifications. The medical systems of different cultures depend on different sets of fundamental metaphors. Modern Western biomedicine is organized around a series of basic metaphors: the body as machine, the body as the site of battle, and the body as a communication system. Traditional Chinese medicine, on the other hand, uses images of flow and blockage, balance and imbalance, and works by analogy with five elements: wood, fire, earth, metal, and water. Psychologists are sometimes able to detect from a patient's own use of metaphor, or inability to use or recognize metaphor, clues to a diagnosis of psychosis or autism. With conditions such as anorexia nervosa, therapists may actually work to modify the dysfunctional metaphors by which patients depict themselves, with the purpose of establishing positive metaphors for envisaging recovery.

  5. [Biological diagnosis of Legionnaire's disease].

    PubMed

    Edelstein, P H

    1984-01-01

    Specific laboratory diagnosis of Legionnaires' disease is possible using sputum and other respiratory tract samples. Culture diagnosis, overlooked in the past, should now be the major means of laboratory diagnosis. Detection of bacterial antigen in respiratory secretions and urine by immunologic means has the advantage of speed of diagnosis (hours vs. days for culture diagnosis), but the disadvantage of the need for use of many different antibody types. Serological diagnosis, by detection of antibody changes, probably has the lowest specificity of any of the specific tests, and often takes weeks rather than days or hours to make a diagnosis of Legionnaires' disease.

  6. Diagnosis of hepatocellular carcinoma

    PubMed Central

    Di Bisceglie, Adrian M.

    2005-01-01

    Hepatocellular carcinoma (HCC) is responsible for a large proportion of cancer deaths worldwide. HCC is frequently diagnosed after the development of clinical deterioration at which time survival is measured in months. Long-term survival requires detection of small tumors, often present in asymptomatic individuals, which may be more amenable to invasive therapeutic options. Surveillance of high-risk individuals for HCC is commonly performed using the serum marker alfa-fetoprotein (AFP) often in combination with ultrasonography. Various other serologic markers are currently being tested to help improve surveillance accuracy. Diagnosis of HCC often requires more sophisticated imaging modalities such as CT scan and MRI, which have multiphasic contrast enhancement capabilities. Serum AFP used alone can be helpful if levels are markedly elevated, which occurs in fewer than half of cases at time of diagnosis. Confirmation by liver biopsy can be performed under circumstances when the diagnosis of HCC remains unclear. PMID:18333158

  7. Remote diagnosis server

    NASA Technical Reports Server (NTRS)

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

    2004-01-01

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

  8. Human prenatal diagnosis

    SciTech Connect

    Filkins, K.; Russo, R.J.

    1985-01-01

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

  9. Molecular systematics and diagnosis.

    PubMed

    Thompson, R C A; Zarlenga, D S; La Rosa, G; Pozio, E; Rosenthal, B; Bandi, C; Mortarino, M; Casiraghi, M; Genchi, C; Gasser, R B; Hu, M; Chilton, N B; Matthews, J B; Hodgkinson, J E

    2004-10-28

    This collection of articles provides an account of six presentations delivered at the 19th International Conference of the World Association for the Advancement of Veterinary Parasitology(WAAVP) (held in New Orleans, Louisiana, USA, from 10 to 14 August 2003) in a symposium session on Molecular Systematics and Diagnosis, organised and chaired by R.B. Gasser and D.S. Zarlenga. The focus was on recent advances in molecular tools for specific and genotypic identification,diagnosis, systematics and population genetics, with special emphasis on investigations of parasitic nematodes and protists.

  10. Diagnosis and differential diagnosis of breast calcifications

    SciTech Connect

    Lanyi, M.

    1987-01-01

    This book is the result of more than 10 years' intensive research into the phenomena of breast calcifications. The author, himself a decisive figure in the development of mammography, demonstrates that a careful, detailed analysis of X-rays can lead to a high degree of diagnostic certainty. Indeed, Lanyi's descriptions make one ask why mammography, which originally awakened such high hopes, is given so little attention today. Contents: historical review; critical analysis of the literature; statement of problems and goals; instruments used in the evaluation of breast microcalcifications; remarks on the pathogenesis, pathophysiology, and composition of breast calcifications; calcifications within the lobular and ductal system of the breast; calcifications in intra- and pericanalicular fibroadenomas; calcifications outside the lobular and ductal systems of the breast; differential diagnosis of microcalcifications; clinically occult, mammographically suspicious microcalcification cluster: Pre-, intra-, and postoperative measures; references, and index.

  11. [Diagnosis of congenital infection].

    PubMed

    Sampedro Martínez, Antonio; Martínez, Luis Aliaga; Teatino, Pablo Mazuelas; Rodríguez-Granger, Javier

    2011-12-01

    In general, congenital diagnosis is based on: a) maternal serologic assays; b) microbiologic study of amniotic fluid or fetal blood sampling; and c) serology in children and microorganism detection by polymerase chain reaction (PCR) or culture. Congenital infections due to cytomegalovirus, herpes simplex, varicella, B19 erythrovirus and toxoplasmosis are usually the result of primary infection in the mother. Therefore, when IgG antibodies are detected before pregnancy, these infections are ruled out. Definitive serologic diagnosis of acute infection in pregnant women requires the demonstration of seroconversion (i.e., from seronegative to seropositive). In these cases, amniotic fluid or fetal blood sampling should be performed to determine the presence of intrauterine congenital infection. Cytomegalovirus, rubella and toxoplasmosis can be diagnosed by detection of specific IgM antibodies in fetal blood. However, PCR in amniotic fluid has replaced conventional prenatal diagnostic techniques, including fetal blood sampling, in the diagnosis of these infections. In the newborn, these infections may be confirmed by measuring IgM specific antibodies. B19 erythrovirus can be detected by PCR in amniotic fluid or fetal blood. Congenital varicella-zoster infection may be diagnosed on the basis of persistence of IgG antibodies after birth. Definitive diagnosis of herpes simplex virus infection requires viral isolation. Swabs or scraping from clinical specimens can be inoculated into susceptible cell lines for isolation. PMID:22305665

  12. Multi-Disciplinary Diagnosis.

    ERIC Educational Resources Information Center

    Schiffman, Gilbert B.

    The diagnosis of severely retarded pupils as an interdisciplinary concern is discussed. Descriptions of the severe reading disability syndrome given by various disciplines are presented under the following headings: Neurological Factors--minimal brain damage, lateral dominance; Physical Factors--endocrine and metabolic disorders, optical and…

  13. Prenatal diagnosis: whose right?

    PubMed

    Heyd, D

    1995-10-01

    The question who is the subject of the right to prenatal diagnosis may be answered in four ways: the parents, the child, society, or no one. This article investigates the philosophical issues involved in each of these answers, which touch upon the conditions of personal identity, the principle of privacy, the scope of social responsibility, and the debate about impersonalism in ethics.

  14. [Cryptorchidism: diagnosis and treatment].

    PubMed

    Longui, Carlos Alberto

    2005-02-01

    Cryptorchidism corresponds to the extra-scrotal position of the testis, and can be found in 3% of the term newborns and 0.5 to 1.0% of adults. It is usually an isolated clinical feature, but in around 10% of the cases can be associated to hypothalamic-pituitary dysfunction and genetic or embryonic disorders. The presence of additional genital abnormalities, such as hypospadia or micropenis, increases the probability of the diagnosis of an intersex condition. Detailed description of the testicular anatomic position is essential to adequate diagnosis, treatment and prognostic evaluation. The diagnosis of cryptorchidism is made by clinical examination. The complementary exams, such as image analysis, add limited information on the diagnosis. Gonadotropins and testicular hormones measurement can be useful if the hypothalamic-pituitary-gonadal axis is activated, as observed during the first 6 months of life or during puberty. Clinical treatment is indicated in patients with retained testis or in severely retractile testis. In these cases, human chorionic gonadotropin is employed at a dose of 50 IU/kg/week for 6 consecutive weeks. Clinical treatment cannot be used in cases of confirmed inguinal hernia, varicocele or spermatic cord cysts. Surgical correction is indicated after failure of clinical treatment or for ectopic testes. The long-term prognosis of cryptorchidism seems to be related to the precocity of the therapy. Therefore, recognition and treatment of cryptorchid testes should be done during the first 2 years of life, potentially improving the risks of infertility and gonadal neoplasia.

  15. Diagnosis of classical galactosaemia.

    PubMed Central

    Monk, A M; Mitchell, A J; Milligan, D W; Holton, J B

    1977-01-01

    We report a child with classical galactosaemia whose diagnosis was missed until 12 weeks of age. The limitations of urine screening tests are discussed and the wider use of a qualitative enzyme assay for screening is recommended. Reference ranges for a quantitative enzyme assay using 14galacoste-1-phosphate as substrate are presented. PMID:606167

  16. What Makes Diagnosis Hard?

    ERIC Educational Resources Information Center

    Wears, Robert L.

    2009-01-01

    This essay uses a case study to explore some of the reasons why understanding failures associated with diagnosis seems to have lagged behind the attention and understanding directed at failures in other aspects of healthcare (e.g., wrong patient/procedure, medication misadministration, etc). The goal is not to pose an alternative to many of the…

  17. Assessment, Diagnosis, and Treatment.

    ERIC Educational Resources Information Center

    Mullis, Thomas

    The purpose of this paper is to provide an overview of assessment, diagnosis, and treatment planning for individuals with substance abuse problems. The intent is to provide information to professional counselors in school, rehabilitation, school psychology, social work, public mental health, and private treatment settings. Information to be…

  18. Application of Strength Diagnosis.

    ERIC Educational Resources Information Center

    Newton, Robert U.; Dugan, Eric

    2002-01-01

    Discusses the various strength qualities (maximum strength, high- and low-load speed strength, reactive strength, rate of force development, and skill performance), noting why a training program design based on strength diagnosis can lead to greater efficacy and better performance gains for the athlete. Examples of tests used to assess strength…

  19. [Toxoplasmosis: Epidemiology, Diagnosis, Treatment].

    PubMed

    Khryanin, A A; Reshetnikov, O V; Kuvshinova, I N

    2015-01-01

    The up-to-date literature and original data on the epidemiology, diagnosis and treatment of toxoplasmosis are presented. Particular attention is paid to the parasite infection during pregnancy. Spiramycin is the drug of choice for acute toxoplasmosis in pregnant women.

  20. Human prenatal diagnosis

    SciTech Connect

    Filkins, K.; Russo, J.F.

    1985-01-01

    Advances in the field of prenatal diagnosis have been rapid during the past decade. Moreover, liberal use of birth control methods and restriction of family size have placed greater emphasis on optimum outcome of each pregnancy. There are many prenatal diagnostic techniques of proven value; the risks, including false negatives and false positives, are known. With the rapid proliferation of new and experimental techniques, many disorders are potential diagnosable or even treatable; however, risk factors are unknown and issues relating to quality control have not been resolved. These problems are readily appreciated in the dramatic new techniques involving recombinant DNA, chorion villus sampling, and fetal surgery. Unfortunately, clinicians may not appreciate the difficulties that may also be encountered in the more mundane prenatal diagnostic tests such as ultrasonography or enzymatic testing. The aim of this volume is to clarify and rationalize certain aspects of diagnosis, genetic counseling, and intervention. New and experimental techniques are presented in the light of current knowledge.

  1. Hemobilia: computed tomographic diagnosis

    SciTech Connect

    Krudy, A.G.; Doppman, J.L.; Bissonette, M.B.; Girton, M.

    1983-09-01

    A case of postbiopsy hemobilia is presented in which computed tomographic (CT) scanning showed blood within the gallbladder appearing as high-density material measuring 67-91 HU. Residual clots were seen by CT and ultrasound 8 days after the acute episode. These findings were confirmed by serial CT scans in two monkeys in whom blood was experimentally injected into the gallbladder. When the cystic duct is patent, the diagnosis of hemobilia may be excluded if bile of normal density (0-20 HU) is demonstrated by CT scanning. However, when homogeneous or inhomogeneous material of high attenuation (50+ HU) is present in the gallbladder on CT scanning, the diagnosis of hemobilia is strongly suggested if other causes such as stone or contrast material have been eliminated. CT may show residual blood for days after the acute episode.

  2. Classification, disease, and diagnosis.

    PubMed

    Jutel, Annemarie

    2011-01-01

    Classification shapes medicine and guides its practice. Understanding classification must be part of the quest to better understand the social context and implications of diagnosis. Classifications are part of the human work that provides a foundation for the recognition and study of illness: deciding how the vast expanse of nature can be partitioned into meaningful chunks, stabilizing and structuring what is otherwise disordered. This article explores the aims of classification, their embodiment in medical diagnosis, and the historical traditions of medical classification. It provides a brief overview of the aims and principles of classification and their relevance to contemporary medicine. It also demonstrates how classifications operate as social framing devices that enable and disable communication, assert and refute authority, and are important items for sociological study. PMID:21532133

  3. Classification, disease, and diagnosis.

    PubMed

    Jutel, Annemarie

    2011-01-01

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

  4. Diagnosis of Hearing Loss.

    ERIC Educational Resources Information Center

    World Federation of the Deaf, Rome (Italy).

    Seven conference papers from the U.S.S.R., India, Poland, Czechoslovakia, and Yugoslavia consider the diagnosis of hearing loss. They are "Examination of Hearing of Children, Aged from 2 to 5, by Means of Playing Audiometry" by A. P. Kossacheva, "A Study of the Etiology and Pattern of Deafness in a School for the Deaf in Madras, South India" by Y.…

  5. Case for diagnosis*

    PubMed Central

    Mesquita, Ludmila de Sousa Ursino; Sherlock, Jonnia; Portugal, Fedro Menezes; Mota, Lívia de Souza; Fakhouri, Ricardo; da Silva, Samuel Freire

    2014-01-01

    Ostraceous psoriasis is a rare form of psoriasis, characterized by lesions with firmly adhered thick scales, in various colors, with surfaces resembling oysters shells. The protracted course of clinical presentation allied with peculiar lesions and histopathological examination permit the diagnosis. Lesions are usually resistant to topical medications, requiring systemic treatment. It is important that dermatologists are able to diagnose the unusual forms of psoriasis to avoid iatrogeny. We report the case of a patient with ostraceous psoriasis treated with methotrexate. PMID:25184935

  6. [Diagnosis of maternofetal infections].

    PubMed

    Vauloup-Fellous, Christelle; Bouthry, Elise

    2015-06-01

    Prevention is an essential aspect of management of infections that can be transmitted from mother to fetus during pregnancy: The prescription and interpretation of serologic markers differ according to clinical context: screening, counts, clinical signs, or ultrasound signs. Testing for rubella IgG antibodies is recommended at the beginning of pregnancy, in the absence of written results proving either immunity or previous vaccination with two doses. Monthly serologic monitoring (IgG and IgM) is recommended for woman lacking immunity to toxoplasmosis. Diagnosis of a primary infection requires the concomitant detection of IgG and IgM. Nonetheless, the presence of specific IgM is not necessarily a marker of recent infection. IgG avidity must be measured to confirm or rule out a recent primary infection when IgM is positive. The observation of stable antibody titers is often inaccurately considered to be reassuring. In fact, depending on the individuals tested and especially the technique used, antibodies may reach a plateau several days or several weeks after the onset of the infection. Clinical diagnosis of rubella is not reliable, and its rarity today means that physicians are unlikely to recognize it or consider it as a possible differential diagnosis. Nonetheless, residual circulation of the rubella virus continues in France. A chickenpox rash is diagnosed clinically. For atypical eruptions, the virus can be sought directly in the vesicular fluid. Serology is not helpful in this case. PMID:26033555

  7. Anaphylaxis: diagnosis and management.

    PubMed

    Brown, Simon G A; Mullins, Raymond J; Gold, Michael S

    2006-09-01

    Anaphylaxis is a serious, rapid-onset, allergic reaction that may cause death. Severe anaphylaxis is characterised by life-threatening upper airway obstruction, bronchospasm and/or hypotension. Anaphylaxis in children is most often caused by food. Bronchospasm is a common symptom, and there is usually a background of atopy and asthma. Venom- and drug-induced anaphylaxis are more common in adults, in whom hypotension is more likely to occur. Diagnosis can be difficult, with skin features being absent in up to 20% of people. Anaphylaxis must be considered as a differential diagnosis for any acute-onset respiratory distress, bronchospasm, hypotension or cardiac arrest. The cornerstones of initial management are putting the patient in the supine position, administering intramuscular adrenaline into the lateral thigh, resuscitation with intravenous fluid, support of the airway and ventilation, and giving supplementary oxygen. If the response to initial management is inadequate, intravenous infusion of adrenaline should be commenced. Use of vasopressors should be considered if hypotension persists. The patient should be observed for at least 4 hours after symptom resolution and referred to an allergist to assist with diagnosis, allergen avoidance measures, risk assessment, preparation of an action plan and education on the use of self-injectable adrenaline. Provision of a MedicAlert bracelet should also be arranged. PMID:16948628

  8. Culture and psychiatric diagnosis.

    PubMed

    Lewis-Fernández, Roberto; Aggarwal, Neil Krishan

    2013-01-01

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

  9. [Ultrasonic diagnosis in urology].

    PubMed

    Lutz, H; Petzoldt Ehler, R

    1977-08-11

    In recent years ultrasonography has been established as a reliable diagnostic method in various urological disorders. The first and most important indication is the differentiation between renal cysts and solid tumors. But ultrasound is suitable, too, for the diagnosis of haematomas, abscesses and hydronephrosis in the postoperative period and for the evaluation of renal transplants to detect early signs of rejection. Ultrasound allows the examination of patients with renal insufficiency and of patients with unilateral absence of contrast medium excretion in urography, because it is independent of contrast medium and renal function. In these patients as well as in traumatized patients ultrasound can be used as a bed-side method. Furthermore, it is possible to diagnose retroperitoneal tumors causing obstruction, megaureter, and tumors of the bladder. For the diagnosis of the prostate the rectal application of an ultrasonic transducer seems to be the best method. With an ultrasonic Doppler probe the diagnosis of testicular torsion is possible on ground of the absence of intratesticular arterial pulsation. Finally the possibility of ultrasonic targeted percutaneous puncture of the kidneys, tumors and cysts as a diagnostic and occasionally therapeutic approach has to be mentioned.

  10. Genetic diagnosis of human embryos.

    PubMed

    Bonnicksen, Andrea

    1992-01-01

    For all the worried talk about genetic engineering over the last two decades, it is surprising how quietly plans for the genetic diagnosis of human embryos have developed. The issues raised warrant careful examination: what needs are met through embryo diagnosis? Who bears responsibility for monitoring this technique? Under what overarching ethic should embryo diagnosis and, eventually, embryo therapy, be applied? What are the broader social implications raised by the genetic diagnosis of human embryos?

  11. Diagnosis of Sarcoidosis.

    PubMed

    Wessendorf, Thomas E; Bonella, Francesco; Costabel, Ulrich

    2015-08-01

    The diagnosis of sarcoidosis, a systemic granulomatous disease, is based on a compatible clinical-radiological picture and the histological evidence of noncaseating granulomas. Other diseases mimicking sarcoidosis, mostly infections and other granulomatoses, have to be excluded. There is no single test for sarcoidosis, and the presence of granulomas alone does not establish the diagnosis. Symptoms of sarcoidosis are not specific and can be markedly different according to organ involvement and disease course. Respiratory symptoms and fatigue are the most common symptoms at any stage of disease. Histological confirmation is not needed for Löfgren's or Heerfordt's syndrome and asymptomatic bihilar lymphadenopathy. The radiological staging system is still based on chest radiography, and computed tomography is not mandatory for routine follow-up. (18)F-fluorodeoxyglucose positron emission tomography may be of value in special cases. For assessment of lung involvement and follow-up, pulmonary function tests are necessary with vital capacity being the most important single parameter and diffusion capacity the most sensitive. Bronchoscopy with biopsy is the most common procedure for detection of granulomas, when there is no easier biopsy site like skin or peripheral lymph nodes. Endobronchial ultrasonography-guided transbronchial needle aspiration has replaced mediastinoscopy for evaluation of mediastinal and hilar lymph nodes with a high diagnostic yield. Despite numerous studies, no single biomarker can be reliably used for correct diagnosis or exclusion of sarcoidosis. Genetic testing, despite promising advances, has still not been included in routine care for sarcoidosis patients. The long-term prognosis of sarcoidosis depends on the different organ manifestations: Cardiac or central nervous involvement, together with respiratory complications, is critical. A multidisciplinary approach is necessary for comprehensive care of the sarcoidosis patient.

  12. Diagnosis of DVT

    PubMed Central

    Jaeschke, Roman; Stevens, Scott M.; Goodacre, Steven; Wells, Philip S.; Stevenson, Matthew D.; Kearon, Clive; Schunemann, Holger J.; Crowther, Mark; Pauker, Stephen G.; Makdissi, Regina; Guyatt, Gordon H.

    2012-01-01

    Background: Objective testing for DVT is crucial because clinical assessment alone is unreliable and the consequences of misdiagnosis are serious. This guideline focuses on the identification of optimal strategies for the diagnosis of DVT in ambulatory adults. Methods: The methods of this guideline follow those described in Methodology for the Development of Antithrombotic Therapy and Prevention of Thrombosis Guidelines: Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines. Results: We suggest that clinical assessment of pretest probability of DVT, rather than performing the same tests in all patients, should guide the diagnostic process for a first lower extremity DVT (Grade 2B). In patients with a low pretest probability of first lower extremity DVT, we recommend initial testing with D-dimer or ultrasound (US) of the proximal veins over no diagnostic testing (Grade 1B), venography (Grade 1B), or whole-leg US (Grade 2B). In patients with moderate pretest probability, we recommend initial testing with a highly sensitive D-dimer, proximal compression US, or whole-leg US rather than no testing (Grade 1B) or venography (Grade 1B). In patients with a high pretest probability, we recommend proximal compression or whole-leg US over no testing (Grade 1B) or venography (Grade 1B). Conclusions: Favored strategies for diagnosis of first DVT combine use of pretest probability assessment, D-dimer, and US. There is lower-quality evidence available to guide diagnosis of recurrent DVT, upper extremity DVT, and DVT during pregnancy. PMID:22315267

  13. Arsenicosis: diagnosis and treatment.

    PubMed

    Das, Nilay Kanti; Sengupta, Sujit Ranjan

    2008-01-01

    Diagnosis of arsenicosis relies on both clinical and laboratory criteria, but principally it can be diagnosed on the basis of its cutaneous manifestations. Cutaneous manifestations (melanosis, keratosis, and cutaneous cancers) are essential clues in the diagnosis, and trained dermatologists or arsenic experts are able to clinically confirm a case even without laboratory backup. Although systemic manifestations are not considered as diagnostic hallmarks, yet their presence serves as important telltale signs in arriving at the diagnosis. In countries where laboratory facilities are available, measuring the level of arsenic in drinking water (consumed in the last 6 months), urine, hair, and nails is of immense value. Newer biomarkers of arsenic exposure are being explored to provide early information about arsenic intoxication, of which urinary porphyrin level, blood metallothionein have shown promising results. Controlling the problem of arsenicosis depends on various factors, of which the most important is cessation of intake of arsenic-contaminated water. Deep wells, traditional dug wells, treatment of surface water, rainwater harvesting, and removing arsenic from the contaminated water by arsenic removal plant or arsenic treatment unit are the available options for providing arsenic-free drinking water. The role of nutrition and antioxidants in preventing the onset of symptoms of arsenicosis is also of importance. Nonspecific therapies (e.g., keratolytics for hyperkeratosis) cannot also be ignored and serve as palliative measures. The persons affected need to be followed up at regular intervals to detect the onset of cancers (if any) at the earliest. Role of counseling and education should never be underestimated since absence of public awareness can undermine all efforts of mitigation measures.

  14. Laboratory diagnosis of thalassemia.

    PubMed

    Brancaleoni, V; Di Pierro, E; Motta, I; Cappellini, M D

    2016-05-01

    The thalassemias can be defined as α- or β-thalassemias depending on the defective globin chain and on the underlying molecular defects. The recognition of carriers is possible by hematological tests. Both α- and β-thalassemia carriers (heterozygotes) present with microcytic hypochromic parameters with or without mild anemia. Red cell indices and morphology followed by separation and measurement of Hb fractions are the basis for identification of carriers. In addition, iron status should be ascertained by ferritin or zinc protoporphyrin measurements and the iron/total iron-binding capacity/saturation index. Mean corpuscular volume and mean corpuscular hemoglobin are markedly reduced (mean corpuscular volume: 60-70 fl; MCH: 19-23 pg) in β-thalassemia carriers, whereas a slight to relevant reduction is usually observed in α-carriers. HbA2 determination is the most decisive test for β-carrier detection although it can be disturbed by the presence of δ-thalassemia defects. In α-thalassemia, HbA2 can be lower than normal and it assumes significant value when iron deficiency is excluded. Several algorithms have been introduced to discriminate from thalassemia carriers and subjects with iron-deficient anemia; because the only discriminating parameter is the red cell counts, these formulas must be used consciously. Molecular analysis is not required to confirm the diagnosis of β-carrier, but it is necessary to confirm the α-thalassemia carrier status. The molecular diagnosis is essential to predict severe transfusion-dependent and intermediate-to-mild non-transfusion-dependent cases. DNA analysis on chorionic villi is the approach for prenatal diagnosis and the methods are the same used for mutations detection, according to the laboratory facilities and expertise. PMID:27183541

  15. Arsenicosis: diagnosis and treatment.

    PubMed

    Das, Nilay Kanti; Sengupta, Sujit Ranjan

    2008-01-01

    Diagnosis of arsenicosis relies on both clinical and laboratory criteria, but principally it can be diagnosed on the basis of its cutaneous manifestations. Cutaneous manifestations (melanosis, keratosis, and cutaneous cancers) are essential clues in the diagnosis, and trained dermatologists or arsenic experts are able to clinically confirm a case even without laboratory backup. Although systemic manifestations are not considered as diagnostic hallmarks, yet their presence serves as important telltale signs in arriving at the diagnosis. In countries where laboratory facilities are available, measuring the level of arsenic in drinking water (consumed in the last 6 months), urine, hair, and nails is of immense value. Newer biomarkers of arsenic exposure are being explored to provide early information about arsenic intoxication, of which urinary porphyrin level, blood metallothionein have shown promising results. Controlling the problem of arsenicosis depends on various factors, of which the most important is cessation of intake of arsenic-contaminated water. Deep wells, traditional dug wells, treatment of surface water, rainwater harvesting, and removing arsenic from the contaminated water by arsenic removal plant or arsenic treatment unit are the available options for providing arsenic-free drinking water. The role of nutrition and antioxidants in preventing the onset of symptoms of arsenicosis is also of importance. Nonspecific therapies (e.g., keratolytics for hyperkeratosis) cannot also be ignored and serve as palliative measures. The persons affected need to be followed up at regular intervals to detect the onset of cancers (if any) at the earliest. Role of counseling and education should never be underestimated since absence of public awareness can undermine all efforts of mitigation measures. PMID:19171979

  16. The diagnosis of hematuria.

    PubMed

    Abuelo, J G

    1983-05-01

    The causes of hematuria are briefly outlined and an approach to the diagnosis of this common finding is suggested. All cases require investigation, since even less than ten RBCs per high-power field may be the first sign of a malignant neoplasm or other serious disease. The most common causes are stones, malignant neoplasm, urethrotrigonitis, bacterial infection, prostatic hypertrophy, and glomerulonephritis; however, there are many other conditions to be kept in mind. A few simple laboratory tests will detect easily diagnosed problems such as bacterial infection, while more extensive and invasive studies are reserved to identify malignant neoplasms and other conditions in the remaining cases.

  17. Diagnosis and treatment planning.

    PubMed

    Fagan, D A

    1986-09-01

    It must be emphasized that any examination of a supposedly healthy patient must be thorough and careful, for the early detection of disease demands that minute and inconspicuous deviations from the normal be evaluated carefully. The detection of disease occurs during the examination procedure, and from a practical point of view, it appears that clinicians employ at least the following three types of examination, depending upon circumstances: the comprehensive examination; the screening examination; and the emergency or limited examination. Although the latter two types represent a justifiable compromise with respect to the comprehensive examination in light of limitations of time or resources, the general inaccessibility of the patient in veterinary practice suggests that one should make the most of the opportunity for examination when it presents itself. A complete, thorough examination is not, by definition, a time-consuming and expensive procedure, particularly if there is no disease present. Exam-related expense is more a function of a differential diagnostic effort once clinical abnormality is detected, and then it is certainly justified. The term "diagnosis" originates from a Greek word meaning to distinguish or to discern. For the clinician, it refers to the process of identification of a disease by investigating, in all their manifestations, the signs and symptoms presented by the patient. The word diagnosis describes not just a "disease identified," but the process by which the identification is made. The procedure for making a diagnosis includes the following four primary steps: Collection of the facts. Analysis of the data for relative importance. Correlation between synthesized data and descriptive features of suspected diseases. Selection of the disease that best explains the collected facts and apparent disturbed physiologic processes of the patient. The process of diagnosis usually results in the naming of a disease. It is well to remember that a

  18. The incidental diagnosis.

    PubMed

    Silverberg, L I

    1999-04-01

    Incidental findings transcend medical practice. Two cases are discussed in which significant conditions were discovered during clinical examination for an unrelated disorder. The first case presents a disease reported for the first time in a male. Recent literature has alluded to missed diagnoses found only at autopsies. With cost constraint as a national theme, the appropriate use of technology presents a challenge to the physician. The cases discussed raise questions about the process of diagnosis. Both situations bring to light the limitations of clinical investigation early in the pathologic process.

  19. DIAGNOSIS OF HISTOPLASMOSIS

    PubMed Central

    Guimarães, Allan Jefferson; Nosanchuk, Joshua D.; Zancopé-Oliveira, Rosely Maria

    2010-01-01

    Endemic mycoses can be challenging to diagnose and accurate interpretation of laboratory data is important to ensure the most appropriate treatment for the patients. Although the definitive diagnosis of histoplasmosis (HP), one of the most frequent endemic mycoses in the world, is achieved by direct diagnosis performed by micro and/or macroscopic observation of Histoplasma capsulatum (H. capsulatum), serologic evidence of this fungal infection is important since the isolation of the etiologic agents is time-consuming and insensitive. A variety of immunoassays have been used to detect specific antibodies to H. capsulatum. The most applied technique for antibody detection is immunodiffusion with sensitivity between 70 to 100 % and specificity of 100%, depending on the clinical form. The complement fixation (CF) test, a methodology extensively used on the past, is less specific (60 to 90%). Detecting fungal antigens by immunoassays is valuable in immunocompromised individuals where such assays achieve positive predictive values of 96–98%. Most current tests in diagnostic laboratories still utilize unpurified antigenic complexes from either whole fungal cells or their culture filtrates. Emphasis has shifted, however, to clinical immunoassays using highly purified and well-characterized antigens including recombinant antigens. In this paper, we review the current conventional diagnostic tools, such as complement fixation and immunodiffusion, outline the development of novel diagnostic reagents and methods, and discuss their relative merits and disadvantages to the immunodiagnostic of this mycosis. PMID:20445761

  20. Differential diagnosis of hyponatraemia.

    PubMed

    Thompson, Chris; Berl, Tomas; Tejedor, Alberto; Johannsson, Gudmundur

    2012-03-01

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

  1. Differential diagnosis of hyponatraemia.

    PubMed

    Thompson, Chris; Berl, Tomas; Tejedor, Alberto; Johannsson, Gudmundur

    2012-03-01

    The appropriate management of hyponatraemia is reliant on the accurate identification of the underlying cause of the hyponatraemia. In the light of evidence which has shown that the use of a clinical algorithm appears to improve accuracy in the differential diagnosis of hyponatraemia, the European Hyponatraemia Network considered the use of two algorithms. One was developed from a nephrologist's view of hyponatraemia, while the other reflected the approach of an endocrinologist. Both of these algorithms concurred on the importance of assessing effective blood volume status and the measurement of urine sodium concentration in the diagnostic process. To demonstrate the importance of accurate diagnosis to the correct treatment of hyponatraemia, special consideration was given to hyponatraemia in neurosurgical patients. The differentiation between the syndrome of inappropriate antidiuretic hormone secretion (SIADH), acute adrenocorticotropic hormone (ACTH) deficiency, fluid overload and cerebral salt-wasting syndrome was discussed. In patients with SIADH, fluid restriction has been the mainstay of treatment despite the absence of an evidence base for its use. An approach to using fluid restriction to raise serum tonicity in patients with SIADH and to identify patients who are likely to be recalcitrant to fluid restriction was also suggested. PMID:22469249

  2. Laboratory Diagnosis of Amebiasis

    PubMed Central

    Tanyuksel, Mehmet; Petri, William A.

    2003-01-01

    The detection of Entamoeba histolytica, the causative agent of amebiasis, is an important goal of the clinical microbiology laboratory. To assess the scope of E. histolytica infection, it is necessary to utilize accurate diagnostic tools. As more is discovered about the molecular and cell biology of E. histolytica, there is great potential for further understanding the pathogenesis of amebiasis. Molecular biology-based diagnosis may become the technique of choice in the future because establishment of these protozoa in culture is still not a routine clinical laboratory process. In all cases, combination of serologic tests with detection of the parasite (by antigen detection or PCR) offers the best approach to diagnosis, while PCR techniques remain impractical in many developing country settings. The detection of amebic markers in serum in patients with amebic colitis and liver abscess appears promising but is still only a research tool. On the other hand, stool antigen detection tests offer a practical, sensitive, and specific way for the clinical laboratory to detect intestinal E. histolytica. All the current tests suffer from the fact that the antigens detected are denatured by fixation of the stool specimen, limiting testing to fresh or frozen samples. PMID:14557296

  3. [Diagnosis of inherited thrombocytopenia].

    PubMed

    Baccini, V; Alessi, M C

    2016-02-01

    Inherited thrombocytopenias are rare, heterogenous and probably under-diagnosed because often classified as autoimmune thrombocytopenia. About 20 genes were described responsible for these thrombocytopenias. Precise diagnosis is necessary because the prognosis is different and some of them can evolve into hemopathies. First of all, it is important to gather a body of evidence to orientate towards an inherited cause: presence of the thrombocytopenia since childhood and of other family cases is a strong argument. Secondly, it is difficult to target the genetic investigations that settle the precise diagnosis. Genetic variants responsible for inherited thrombocytopenias affect different stage during megakaryocytopoiesis and cause thrombocytopenias with distinct characteristics. Presence of extra-hematological features, platelets' size measurement and evaluation of bone marrow megakaryocyte morphology when it is possible allow a primary orientation. We propose a diagnostic approach considering extra-hematological features, mode of inheritance, morphology, molecular and functional platelets' studies and bone marrow megakaryocyte morphology in order to better target genetic study. Nevertheless, despite this approach, some inherited thrombocytopenias remain still unexplained and could benefit from new methods of new generation sequencing in the future. PMID:26617290

  4. Laboratory diagnosis of Leishmania.

    PubMed

    Palma, G; Gutierrez, Y

    1991-12-01

    Leishmaniasis should be considered in the differential diagnosis of individuals living in or with a history of having traveled to known endemic areas and who present with signs and symptoms of visceral infection or with cutaneous or mucosal lesions. Because leishmaniae are capable of producing a wide spectrum of disease in humans, the clinical manifestations overlap with many other diseases. Definitive diagnosis of Leishmania infection in the laboratory requires demonstration of the parasite in smears, in biopsies, or by isolation of the organism in culture media or in experimental animals. Many other methods for demonstration of parasites (histochemical and immunohistochemical) or for detecting the presence of antibodies against leishmaniae (serologic) have been described. Many advances have been made in these areas, but the methodology and the technology involved in immunohistochemistry and serology remain outside the reach of the standard clinical diagnostic laboratory, which both in developed and less developed countries still relies on demonstration of the parasites in smears stained with Giemsa stain and on biopsy specimens processed and stained with hematoxylin and eosin stain. The newer serologic techniques, such as ELISA with several variations, IFAT, and others, are largely research tools with the greatest use in seroepidemiologic surveys.

  5. Diagnosis of arsenicosis.

    PubMed

    Saha, Kshitish Chandra

    2003-01-01

    Arsenicosis is chronic subclinical or clinical toxicity due to high level of arsenic in body. Diagnosis of arsenicosis was derived by chronological establishment of facts: (a) arsenic as the cause of malady, (b) drinking water (tubewell water) as the vehicle of arsenic, (c) soil as the source of arsenic, (d) mechanism of leaching of arsenic from soil, and (e) cause of prevalence in particular areas of the country. Arsenicosis has been classified by the author into 4 stages, 7 grades and 20 subgrades. Stage I is pre-clinical or grade 0. While clinical features were not found at this stage, high level of arsenic metabolites was observed in urine. As disease progressed to stable phase of grade 0, high level of arsenic was also found in nails, hair, and skin scales. Stage II or clinical stage is divided into 4 grades, (1) Melanosis, (2) Spotted keratosis in palms/soles, (3) Diffuse keratosis in palms/soles, and (4) Dorsal keratosis. Clinical complications are grouped in stage III and grade 5. Malignancy is considered in stage IV and grade 6. There is a concern of both underdiagnosis and overdiagnosis. Therefore, cases of arsenicosis should be cautiously evaluated. Melanosis was the earliest cutaneous sign of clinical arsenicosis. Mild cases of melanosis could only be revealed by a thorough comparison with normal palms. Similarly mild cases of keratosis might not be visible and could only be revealed by careful palpation of palms and soles. Combination of melanosis and keratosis in adults indicated clinical diagnosis of arsenical dermatosis (ASD) that should be confirmed by showing high arsenic concentration in body tissues e.g., nails, hair, skin scales. Isolated melanosis or keratosis in newborn or children below 2 years almost negated the diagnosis of arsenicosis. Genetic melanosis or keratosis is often present since birth. Isolated melanosis or keratosis in adults should be differentiated from non-arsenical dermatosis and proven by absence of high arsenic level in

  6. [Diagnosis of food allergy].

    PubMed

    Leśniak, Małgorzata; Juda, Maciej; Dyczek, Łukasz; Czarnobilska, Maria; Leśniak, Magdalena; Czarnobilska, Ewa

    2016-01-01

    Food allergy is most often linked to the type I allergic reaction, while IgE-dependent mechanism causes symptoms in only about 50% of patients. If symptoms are coming from other types of allergic reactions we do not have enough standardized diagnostic methods. The purpose of our review is to discuss the possibilities of diagnosis of food allergies. Regardless of the causal mechanism the interview has the most important role in the diagnosis, and the gold standard is a double blind placebo controlled food challenge. Additional tests that can be performed in suspected IgE-mediated reactions include: skin prick tests, specific IgE measurement, component-resolved diagnostics and in doubtful cases basophil activation test (BAT). Due to the fact that the spectrum of the symptoms of the type I food hypersensitivity can include potentially life-threatening reactions, diagnosis is often limited to in vitro assays. In these cases BAT may play an important role--in a recent publication, for the first time BAT reactivity reflected the allergy severity and BAT sensitivity reflected the threshold of response to allergen in an oral food challenge. Atopy patch tests are valuable diagnostic tool in suspected type IV food hypersensitivity, but due to the lack of standardization they are not used routinely. The cytotoxic test has been developed on the basis of the observations that leucopenia developing in the type II hypersensitivity reaction mechanism may be one of the symptoms of food allergy. Unfortunately its use is not justified in any method fulfill the criteria of controlled clinical trial. Food allergy can also develop in the type III hypersensitivity reaction, but there is lack of research supporting the role of IgG measurement in the detection of allergens responsible for symptoms. Each result of additional diagnostic tests before the introduction of food elimination should be confirmed in double-blind, placebo-controlled or open food challenge, because non proper diet is

  7. [Diagnosis of delayed puberty].

    PubMed

    Busiah, K; Belien, V; Dallot, N; Fila, M; Guilbert, J; Harroche, A; Leger, J

    2007-09-01

    Puberty is the phenomenon that conducts once to reproductive maturation. Delayed puberty (DP) is defined by the absence of testicular development in boys beyond 14 years old (or a testicular volume lower than 4 ml) and by the absence of breast development in girls beyond 13 years old. DP occurs in approximatively 3% of cases. Most cases are functional DP, with a large amount of constitutional delay of puberty. Others etiologies are hypogonadotrophic hypogonadism like Kallmann syndrome, or hypergonadotrophic hypogonadism. Turner syndrome is a diagnostic one should not forget by its frequency. Treatment is hormonal replacement therapy and of the etiology. During the last decade, many genes have been identified and elucidated the etiological diagnosis of some hypogonadotrophic hypogonadism syndrome. Further studies are required in collaboration with molecular biologists to better understand the mechanism of hypothalamic pituitary gonadal axis abnormalities and of the neuroendocrine physiology of the onset of puberty.

  8. [Differential diagnosis of hoarseness].

    PubMed

    Voigt-Zimmermann, S; Lampe, K; Arens, C

    2014-04-01

    Hoarseness can be the leading symptom of dysphonia. In combination with impaired vocal performance and subjective voice-related discomfort, it can represent an individually different handicap for patients and lead to limited participation in social and professional life. Since the reasons for dysphonia may be not only functional but also organic with a potentially poor prognosis, hoarseness must be clarified using differential diagnosis. In addition to the knowledge of possible diseases, pathogenesis, and treatment options for dysphonia, the differential diagnostic approach requires profound knowledge of the various diagnostic methods, and of the interpretation of the results in particular. The etiology of dysphonia is very diverse and rarely monocausal. Therefore, a team-based and interdisciplinary differential diagnostic approach is recommended.

  9. Photobacteriosis: Prevention and Diagnosis

    PubMed Central

    2014-01-01

    Photobacteriosis or fish pasteurellosis is a bacterial disease affecting wild and farm fish. Its etiological agent, the gram negative bacterium Photobacterium damselae subsp. piscicida, is responsible for important economic losses in cultured fish worldwide, in particular in Mediterranean countries and Japan. Efforts have been focused on gaining a better understanding of the biology of the pathogenic microorganism and its natural hosts with the aim of developing effective vaccination strategies and diagnostic tools to control the disease. Conventional vaccinology has thus far yielded unsatisfactory results, and recombinant technology has been applied to identify new antigen candidates for the development of subunit vaccines. Furthermore, molecular methods represent an improvement over classical microbiological techniques for the identification of P. damselae subsp. piscicida and the diagnosis of the disease. The complete sequencing, annotation, and analysis of the pathogen genome will provide insights into the pathogen laying the groundwork for the development of vaccines and diagnostic methods. PMID:24982922

  10. [Clinical diagnosis of dyslexia].

    PubMed

    Martínez Hermosillo, A; Balderas Gil, A

    1980-01-01

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

  11. Hybrid Systems Diagnosis

    NASA Technical Reports Server (NTRS)

    McIlraith, Sheila; Biswas, Gautam; Clancy, Dan; Gupta, Vineet

    2005-01-01

    This paper reports on an on-going Project to investigate techniques to diagnose complex dynamical systems that are modeled as hybrid systems. In particular, we examine continuous systems with embedded supervisory controllers that experience abrupt, partial or full failure of component devices. We cast the diagnosis problem as a model selection problem. To reduce the space of potential models under consideration, we exploit techniques from qualitative reasoning to conjecture an initial set of qualitative candidate diagnoses, which induce a smaller set of models. We refine these diagnoses using parameter estimation and model fitting techniques. As a motivating case study, we have examined the problem of diagnosing NASA's Sprint AERCam, a small spherical robotic camera unit with 12 thrusters that enable both linear and rotational motion.

  12. [Diagnosis of bacterial vaginosis].

    PubMed

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

    2013-01-01

    Bacterial vaginosis is a common, complex clinical syndrome characterized by alterations in the normal vaginal flora. When symptomatic, it is associated with a malodorous vaginal discharge and on occasion vaginal burning or itching. Under normal conditions, lactobacilli constitute 95% of the bacteria in the vagina. Bacterial vaginosis is associated with severe reduction or absence of the normal H2O2-producing lactobacilli and overgrowth of anaerobic bacteria and Gardnerella vaginalis, Atopobium vaginae, Mycoplasma hominis and Mobiluncus species. Most types of infectious disease are diagnosed by culture, by isolating an antigen or RNA/DNA from the microbe, or by serodiagnosis to determine the presence of antibodies to the microbe. Therefore, demonstration of the presence of an infectious agent is often a necessary criterion for the diagnosis of the disease. This is not the case for bacterial vaginosis, since the ultimate cause of the disease is not yet known. There are a variety of methods for the diagnosis of bacterial vaginosis but no method can at present be regarded as the best. Diagnosing bacterial vaginosis has long been based on the clinical criteria of Amsel, whereby three of four defined criteria must be satisfied. Nugent's scoring system has been further developed and includes validation of the categories of observable bacteria structures. Up-to-date molecular tests are introduced, and better understanding of vaginal microbiome, a clear definition for bacterial vaginosis, and short-term and long-term fluctuations in vaginal microflora will help to better define molecular tests within the broader clinical context. PMID:24073569

  13. [Rapid diagnosis of respiratory infection].

    PubMed

    Hashimoto, Toru

    2012-08-01

    The identification of pathogens is very important for the diagnosis and treatment of respiratory infectious disease. Bacterial culture is a basic method to identify various pathogens, but it takes several days to get the final results. Many new methods for the rapid diagnosis of respiratory infection have been developed in recent years. This has changed the treatment of respiratory infection. Broad-spectrum antibiotics were often used to treat respiratory infection previously, but rapid diagnosis has changed the choice of antibiotics from broad-spectrum to specific ones. New methods of rapid diagnosis are very useful and powerful tools in the treatment of respiratory infection.

  14. [Diagnosis of functional bowel diseases].

    PubMed

    Kruis, W

    2007-02-28

    Functional bowel disorders cause frequent doctor visits. The term comprises various disease entities. Most frequent are the irritable bowel syndrome, functional constipation and functional diarrhea. An exact history plays an outstanding role for the diagnosis of all these entities. History either confirms a positive diagnosis or initiates some complementary investigations. Redundant and dangerous technical procedures should be avoided in the diagnostic work up.

  15. [Antenatal diagnosis of placenta accreta].

    PubMed

    Malinova, M

    2014-01-01

    Placenta accreta is a potentially life-threatening obstetric condition. Diagnosis of placenta accreta before delivery allows multidisciplinary planning in an attempt to minimize potential maternal or neonatal morbidity and mortality The diagnosis is usually established by 2D, 3D Ultrasonography and Color Doppler ultrasonography and occasionally supplemented by Magnetic Resonance Imaging. PMID:25510048

  16. Radiological diagnosis of gallbladder disease

    SciTech Connect

    Berk, R.N.; Ferrucci, J.T.; Fordtran, J.S.

    1981-10-01

    Changes in the radiological diagnosis of gallbladder disease are occurring at a remarkable rate. In this symposium, several recognized authorities place the various diagnostic modalities and their interrelation in modern perspective. The present and future roles of oral cholecystography and intravenous cholangiography, the radiological diagnosis of chronic acalculous cholecystits, and the use of ultrasonography and cholescintigraphy are analyzed.

  17. Bronchoscopic diagnosis of pneumonia.

    PubMed Central

    Baselski, V S; Wunderink, R G

    1994-01-01

    Lower respiratory tract infections are characterized by significant morbidity and mortality but also by a relative inability to establish a specific etiologic agent on clinical grounds alone. With the recognized shortcomings of expectorated or aspirated secretions toward establishing an etiologic diagnosis, clinicians have increasingly used bronchoscopy to obtain diagnostic samples. A variety of specimen types may be obtained, including bronchial washes or brushes, protected specimen brushings, bronchoalveolar lavage, and transbronchial biopsies. Bronchoscopy has been applied in three primary clinical settings, including the immunocompromised host, especially human immunodeficiency virus-infected and organ transplant patients; ventilator-associated pneumonia; and severe, nonresolving community- or hospital-acquired pneumonia in nonventilated patients. In each clinical setting, and for each specimen type, specific laboratory protocols are required to provide maximal information. These protocols should provide for the use of a variety of rapid microscopic and quantitative culture techniques and the use of a variety of specific stains and selective culture to detect unusual organism groups. PMID:7834604

  18. Computer diagnosis in cardiology.

    PubMed

    Ewing, Graham Wilfred; Ewing, Elena Nikolayevna

    2009-09-01

    This article reports upon the emergence of a novel cognitive, computer-based technology which may lead to significantly improved methods of cardiological diagnosis and a rapid and inexpensive method of cardiological screening.The technology 'Virtual Scanning' illustrates how, in blood, the reaction of proteins and their reactive substrates releases light; that the colour and intensity of this bioluminescence is unique to each reaction and it's rate; and that the development of pathologies influence cognition and visual perception. This illustrates that the function of the autonomic nervous system is linked to that of the physiological systems and that the rate of biochemical reactions, and the progression of disease, can be measured by a cognitive test procedure and used as an indication of the disease(s) affecting heart function.The article discusses the limitations of the conventional biomarker technique, and the potential value of non-invasive cognitive techniques, such as Virtual Scanning, to the medical practitioner. Finally, it discusses how the ability of Virtual Scanning to diagnose disease from its presymptomatic origins may lead to improved diagnostic accuracy and significantly reduced costs.

  19. Diagnosis of autoimmune pancreatitis

    PubMed Central

    Matsubayashi, Hiroyuki; Kakushima, Naomi; Takizawa, Kohei; Tanaka, Masaki; Imai, Kenichiro; Hotta, Kinichi; Ono, Hiroyuki

    2014-01-01

    Autoimmune pancreatitis (AIP) is a distinct form of chronic pancreatitis that is increasingly being reported. The presentation and clinical image findings of AIP sometimes resemble those of several pancreatic malignancies, but the therapeutic strategy differs appreciably. Therefore, accurate diagnosis is necessary for cases of AIP. To date, AIP is classified into two distinct subtypes from the viewpoints of etiology, serum markers, histology, other organ involvements, and frequency of relapse: type 1 is related to IgG4 (lymphoplasmacytic sclerosing pancreatitis) and type 2 is related to a granulocytic epithelial lesion (idiopathic duct-centric chronic pancreatitis). Both types of AIP are characterized by focal or diffuse pancreatic enlargement accompanied with a narrowing of the main pancreatic duct, and both show dramatic responses to corticosteroid. Unlike type 2, type 1 is characteristically associated with increasing levels of serum IgG4 and positive serum autoantibodies, abundant infiltration of IgG4-positive plasmacytes, frequent extrapancreatic lesions, and relapse. These findings have led several countries to propose diagnostic criteria for AIP, which consist of essentially similar diagnostic items; however, several differences exist for each country, mainly due to differences in the definition of AIP and the modalities used to diagnose this disease. An attempt to unite the diagnostic criteria worldwide was made with the publication in 2011 of the international consensus diagnostic criteria for AIP, established at the 2010 Congress of the International Association of Pancreatology (IAP). PMID:25469024

  20. Avian toxicologic diagnosis

    USGS Publications Warehouse

    Sigurdson, C.J.; Franson, J.C.; Fudge, A.M.

    2000-01-01

    This chapter describes the sources and pathophysiology of some potential poisons that affect birds and summarizes useful laboratory tests. The diagnosis of poisoning in birds, as in mammals, requires a complete and accurate history, careful observation of clinical signs, and a thorough necropsy evaluation. Appropriate sample handling and analysis, based on consultation with the diagnostic toxicologist, are critical (Table 19--1). Veterinary toxicology laboratories are becoming increasingly specialized, with only certain laboratories capable of analyzing for drug residues or anticoagulants, for example. Although a local laboratory may not be able to fulfill a specific test request, they may recommend an alternative laboratory or may be willing to forward the sample. As a general rule in suspect poisoning cases, large tissue samples of liver, kidney, brain, and subcutaneous fat and of crop, proventriculus, and ventriculus contents should be collected at necropsy and frozen. Appropriate samples should be submitted frozen, with the remainder held in the freezer for possible later testing. A second set of tissues should be placed in 10% formalin for histopathologic examination.

  1. Diagnosis of acute rhinosinusitis.

    PubMed

    Esposito, Susanna; Marchisio, Paola; Tenconi, Rossana; Tagliaferri, Laura; Albertario, Giada; Patria, Maria Francesca; Principi, Nicola

    2012-08-01

    Rhinosinusitis is almost always a complication of a viral infection involving the upper respiratory tract. A common cold is the first symptom of rhinosinusitis, but infectious processes involving the nose inevitably affect the paranasal sinuses because of their anatomical contiguity. The symptoms remain those of a common cold as long as nasal phlogosis is moderate and the ostia between the nose and sinuses are patent. If the inflammation is intense, edema may obliterate the ostia and isolate the sinuses, thus stopping the removal of the exudates. The duration of symptoms makes it possible to distinguish acute (10-30 days) from subacute (30-90 days) and chronic rhinosinusitis (>90 days). The diagnosis of rhinosinusitis should only be based on anamnestic and clinical criteria in children with serious or persistent symptoms of upper respiratory tract infection, or which appear within a short time of an apparent recovery. Computed tomography and magnetic resonance images of the paranasal sinuses should be reserved for children reasonably considered to be candidates for surgery. Antibiotics are recommended in cases of mild acute bacterial rhinosinusitis as a means of accelerating the resolution of symptoms. The use of antibiotics is mandatory in severe acute bacterial rhinosinusitis to cure the disease and avoid the possible onset of severe complications.

  2. Costochondritis: diagnosis and treatment.

    PubMed

    Proulx, Anne M; Zryd, Teresa W

    2009-09-15

    Costochondritis, an inflammation of costochondral junctions of ribs or chondrosternal joints of the anterior chest wall, is a common condition seen in patients presenting to the physician's office and emergency department. Palpation of the affected chondrosternal joints of the chest wall elicits tenderness. Although costochondritis is usually self-limited and benign, it should be distinguished from other, more serious causes of chest pain. Coronary artery disease is present in 3 to 6 percent of adult patients with chest pain and chest wall tenderness to palpation. History and physical examination of the chest that document reproducible pain by palpation over the costal cartilages are usually all that is needed to make the diagnosis in children, adolescents, and young adults. Patients older than 35 years, those with a history or risk of coronary artery disease, and any patient with cardiopulmonary symptoms should have an electrocardiograph and possibly a chest radiograph. Consider further testing to rule out cardiac causes if clinically indicated by age or cardiac risk status. Clinical trials of treatment are lacking. Traditional practice is to treat with acetaminophen or anti-inflammatory medications where safe and appropriate, advise patients to avoid activities that produce chest muscle overuse, and provide reassurance.

  3. OSTEOPOROSIS DIAGNOSIS AND TREATMENT

    PubMed Central

    de Souza, Márcio Passini Gonçalves

    2015-01-01

    Articles that update the state of knowledge regarding osteoporosis run the risk of quickly becoming obsolete because research and studies on osteoporosis today are arousing great interest among researchers, the pharmaceutical and medical equipment industries, governments and even WHO. All orthopedists know about osteoporosis because of its most deleterious effect: osteoporotic fracture. Osteoporosis without fractures does not arouse suspicion because this is a pathological condition with a nonspecific clinical profile. Osteoporotic fractures have an economic cost (from treatment), a social cost (from its sequelae) and a medical cost (from deaths). Many fractures could be avoided through diagnosing osteoporosis prior to the first fracture and thus many temporary and permanent disabilities could be avoided and many lives saved. Awareness of the risk factors for osteoporosis raises suspicions and bone densitometry aids in diagnosis. Treatment should be based on the physiopathology of the disease. Hence, for prevention or treatment of osteoporosis, the activity of osteoclasts should be diminished or the activity of osteoblasts should be increased, or both. Treatment that reduces the incidence of fractures by improving the bone geometry and microarchitecture would be ideal. Newly formed bone tissue needs to have good cell and matrix quality, normal mineralization, a good ratio between mineralized (mechanically resistant) and non-mineralized (flexible) bone, and no accumulated damage. The ideal treatment should have a positive remodeling rate and fast and long-lasting therapeutic effects. Such effects need to be easily detectable. They need to be safe. PMID:27022545

  4. Principles of well diagnosis

    SciTech Connect

    McLeod, H.O.

    1994-12-31

    Well performance analysis provides an effective engineering resource for the analysis of well problems and the benefit possible from well workovers or well stimulation to improve well performance. Transient pressure testing and analysis has long been used to identify formation potential and to disclose wellbore restrictions; however, this methodology does not identify the source of restricted flow or a realistic potential of a well completion change. Well diagnosis not only involves pressure transient testing and analysis, but also well completion procedure analysis, well log analysis, special petrographic analysis, and flowing well system analysis (often called Nodal Analysis). Although reservoir flow and tubular flow are important in this systems analysis, well completion modeling is often the key to improvements through workover or stimulation. Several completion or wellbore models have been developed and presented in the last 20 years. Those models dealing with perforated wells and gravel packed wells will be reviewed and illustrated with case histories that demonstrate how well systems analysis leads to improved well performance. The geology of the formation is often critical in the analysis of formation damage and interpretation of well production problems, especially when flow is not sufficient to allow pressure transient testing. Well completion operation analysis is a developing art which incorporates an understanding of the latest research and a familiarity with field practice, and a strategy for this analysis will be provided.

  5. Difficult prenatal diagnosis: fetal coarctation

    PubMed Central

    Buyens, A.; Gyselaers, W.; Coumans, A.; Al Nasiry, S.; Willekes, C.; Boshoff, D.; Frijns, J.-P.; Witters, I.

    2012-01-01

    The prenatal diagnosis of fetal coarctation is still challenging. It is mainly suspected by ventricular disproportion (smaller left ventricle than right ventricle). The sensitivity of ventricular discrepancy is however moderate for the diagnosis of coarctation and there is a high false positive rate. Prenatal diagnosis of coarctation is important because the delivery can be arranged in a centre with a pediatric cardiac intensive careand this reduces postnatal complications and longterm morbidity. For many years the prenatal diagnosis of coarctation has been investigated to improve specificity and sensitivity by several of measurements. This article reviews all relevant articles from 2000 until 2011 searching pubmed and the reference list of interesting articles. An overview of specific measurements and techniques that can improve the diagnosis of coarctation has been made, such as the isthmus diameter, ductal diameter, isthmus/ductal ratio, z-scores derived from measurements of the distal aortic isthmus and arterial duct, the presence of a shelf andisthmal flow disturbance. Also 3-dimensional (3D) and 4-dimensional (4D) imaging with or without STIC has been suggested to be used as newer techniques to improve diagnosis of coarctation in fetal life. Although more methods regarding prenatal diagnosis of coarctationare being investigated, the ultrasound specialist remains challenged to correctly diagnose this cardiac anomaly in prenatal life. PMID:24753914

  6. [Psychogenic tremor: a positive diagnosis].

    PubMed

    Redondo, L; Morgado, Y; Durán, E

    2010-01-01

    Psychogenic movement disorders are a daily challenge for the neurologist. A mistake in its recognition may have important consequences for the patients. As a result, the diagnosis must be considered very carefully in clinical practice. However, psychogenic movement disorders are not unusual, are mainly tremors, and a wrong diagnosis is common. Psychogenic is an unspecific term that usually masks the real mental disorder, and should be called somatoform disorders, factitious disorders, malingering, depression, anxiety and histrionic personality disorder, although the absence of a psychiatric diagnosis does not preclude a psychogenic cause. The diagnosis may often be difficult and should be made by an expert neurologist. Organic movement disorders must be excluded after a detailed neurological history, examination, and appropriate diagnostic studies. Psychogenic tremor is not only a diagnosis of exclusion, it can be diagnosed positively by its neurological signs, mainly: variability in frequency and amplitude, bilateral and sudden onset, non-progressive with frequent remissions, absence of finger, tongue or face tremor and coactivation of antagonistic muscles. Several tests can be useful in diagnosis, such as: accelerometry, EMG and response to placebo or suggestion. The treatment requires close cooperation between the medical team and patient. The problem must never be minimised and early diagnosis and treatment must be attempted. PMID:20388461

  7. [Diagnosis. History and physical examination].

    PubMed

    Pérez Martín, Álvaro

    2014-01-01

    Family physicians play a key role in the diagnosis and management of patients with osteoarthritis. Diagnosis is mainly clinical and radiological. A complete history should be taken with meticulous physical examination of the joints. The history-taking should aim to detect risk factors and compatible clinical symptoms. Pain characteristics should be identified, distinguishing between mechanical and inflammatory pain, and an exhaustive examination of the joints should be performed, with evaluation of the presence of pain, deformity, mobility restrictions (both active and passive), crepitus, joint effusion, and inflammation. A differential diagnosis should be made with all diseases that affect the joints and/or produce joint stiffness.

  8. Delayed diagnosis of Pendred syndrome.

    PubMed

    Smith, Natalie; U-King-Im, Jean-Marie; Karalliedde, Janaka

    2016-01-01

    We describe a case of a delayed diagnosis of Pendred syndrome. The patient had a history of hearing loss from childhood and presented to the endocrine clinic when aged 32 with an enlarging goitre. The characteristic Mondini deformity was noted on auditory canal MRI scan. Genetic tests confirmed the diagnosis. Pendred syndrome is an autosomal recessive disorder, characterised by congenital sensorineural hearing loss, goitre and impaired iodide organification and can present at any age. We highlight to the general physician the classical features of this syndrome that would aid early diagnosis. PMID:27620717

  9. Diagnosis of esophagogastric tumors.

    PubMed

    Moretó, M

    2005-01-01

    ulcerations in which curative treatment is possible. 5) High-resolution endoscopy allows more precise diagnosis of early gastric cancer. The presence of irregular minute vessels and variations in vessel caliber were found to be specific of early gastric cancer. The small regular pattern of sulci and ridges was observed significantly more frequently in differentiated carcinoma than in undifferentiated carcinoma. 6) Infrared-ray electronic endoscopy combined with indocyanine green injection appears to be effective in detecting sentinel nodes that contain metastases in patients with gastric cancer. 7) Gastric adenocarcinoma was found to show specific changes in the fluorescence spectra emitted, in comparison with normal gastric mucosa. However, there was wide variation in the emitted autofluorescence spectra in gastric cancer with signet-ring cells in comparison with normal mucosa. PMID:15657854

  10. Diagnosis of High Blood Pressure

    MedlinePlus

    ... the NHLBI on Twitter. Diagnosis of High Blood Pressure For most patients, health care providers diagnose high ... 140/90 mmHg or above. Confirming High Blood Pressure A blood pressure test is easy and painless ...

  11. [Microbiological diagnosis of HIV infection].

    PubMed

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

    2007-12-01

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

  12. Diagnosis of Diabetes and Prediabetes

    MedlinePlus

    ... with type 2 diabetes. Defining Safe Blood Glucose Levels for Pregnancy Many studies have shown that gestational ... of Gestational Diabetes” for blood glucose levels. OGTT Levels for Diagnosis of Gestational Diabetes Time of Sample ...

  13. Molecular diagnosis of peanut allergy.

    PubMed

    Chan, Susan M H; Dumitru, Catalina; Turcanu, Victor

    2012-11-01

    Peanut allergy prevalence has increased in developed countries over the last few decades in the frame of the allergy epidemics, currently affecting 1-2% of children. While less frequent in developing countries, its prevalence is rising as these countries adopt a more westernized lifestyle. There is no curative treatment for peanut allergy at present so patient management relies on peanut avoidance, which requires an accurate diagnosis. Recent progress in peanut allergy diagnosis was made with the introduction of component resolved diagnosis that allows the assessment of IgE specific to individual peanut allergens. Component-resolved diagnosis needs to be interpreted in the context of clinical data but overall increases the diagnostic accuracy, as described in the typical cases that we present. Novel diagnostic tools have been proposed recently, such as the basophil activation test, mRNA expression and resonance magnetic evaluation of biomarkers. PMID:23249205

  14. Fanconi Anemia and its Diagnosis

    PubMed Central

    Auerbach, Arleen D.

    2009-01-01

    Fanconi anemia (FA) is a genetically and phenotypically heterogeneous recessive disorder characterized by diverse congenital malformations, progressive pancytopenia, and predisposition to both hematologic malignancies and solid tumors. Congenital anomalies vary from patient to patient and may affect skeletal morphogenesis as well as any of the major organ systems. Although this highly variable phenotype makes accurate diagnosis on the basis of clinical manifestations difficult in some patients, laboratory study of chromosomal breakage induced by diepoxybutane (DEB) or other crosslinking agents provides a unique cellular marker for the diagnosis of the disorder either prenatally or postnatally. Diagnosis based on abnormal response to DNA crosslinking agents can be used to identify the pre-anemia patient as well as patients with aplastic anemia or leukemia who may or may not have the physical stigmata associated with the syndrome. This overview will present our present knowledge regarding the varied phenotypic manifestations of FA and procedures for diagnosis based upon abnormal DNA damage responses. PMID:19622403

  15. Hyperaldosteronism: diagnosis, lateralization, and treatment.

    PubMed

    Harvey, Adrian M

    2014-06-01

    Primary hyperaldosteronism is an important and commonly unrecognized secondary cause of hypertension. This article provides an overview of the current literature with respect to screening, diagnosis, and lateralization. Selection and outcomes of medical and surgical treatment are discussed.

  16. [Radiation diagnosis of spleen diseases].

    PubMed

    Vlasov, P V; Kotliarov, P M

    1997-01-01

    The paper deals with the diagnosis of splenic diseases by using the currently available techniques. Based on the examination of a large group including 391 patients with various benign and malignant splenic diseases, the authors showed that despite the fact that primary diseases of the spleen are comparatively rarely encountered, nevertheless, early diagnosis of its lesions is of great importance for the diagnosis of various systemic diseases and abnormalities of primary organ processes. Based on the data available in the literature and their own findings, the authors concluded that at the earliest stages of their preclinical development, splenic tumors can be now diagnosed by a complete package of up-to-date diagnostic tools. Ultrasonic and computerized tomographies are of the highest informative value. However, diagnostic puncture is required in some cases. The paper details the semiotics of a wide range of splenic pathological processes by applying all currently available techniques of radiation diagnosis.

  17. Pruritus ani: diagnosis and treatment.

    PubMed

    Nasseri, Yosef Y; Osborne, Marc C

    2013-12-01

    Pruritus ani is a common condition with multiple causes. Primary causes are thought to be fecal soiling or food irritants. Secondary causes include malignancy, infections including sexually transmitted diseases, benign anorectal diseases, systemic diseases, and inflammatory conditions. A broad differential diagnosis must be considered. A reassessment of the diagnosis is required if symptoms or findings are not responsive to therapy. The pathophysiology of itching, an overview of primary and secondary causes, and various treatment options are reviewed.

  18. Diagnosis of metabolic bone disease

    SciTech Connect

    Grech, P.; Martin, T.J.; Barrington, N.A.; Ell, P.J.

    1986-01-01

    This book presents a reference on the radiologic evaluation, features, and differential diagnosis of metabolic diseases involving the whole skeleton, calcium deficiencies resulting from pharmacologic agents, and bone changes related to endocrine disturbances. It also stresses how radiology, nuclear medicine, and biochemistry - either alone or in concert - contribute to clinical diagnosis. It covers renal bone disease, Paget's disease, hyperphosphatasia, extraskeletal mineralization, metabolic bone disorders related to malnutrition, tumors, plus radionuclide studies including materials and methods.

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

    PubMed

    Haker, Helene

    2014-10-01

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

  20. Celiac Disease Diagnosis and Management

    PubMed Central

    Leffler, Daniel

    2012-01-01

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

  1. [Differential diagnosis of status epilepticus].

    PubMed

    Navarro, V; Fischer, C; Convers, P

    2009-04-01

    The diagnosis of status epilepticus can be retained, wrongly, in several circumstances. Nonepileptic pseudoseizures from a psychiatric origin and some movement disorders can mimic convulsive status epilepticus. Encephalopathy of various causes (post-anoxic, metabolic, toxic, Creutzfeldt-Jakob disease) can be wrongly taken for non-convulsive status epilepticus, mainly due to inadequate interpretation of the electroencephalogram (EEG). In these encephalopathies, the existence of (non-epileptic) myoclonus and the abolition of the EEG abnormalities with the use of a benzodiazepine (without correction of the clinical symptoms) are additional confounding factors, leading to false diagnosis. Nevertheless, in general, the diagnosis of status epilepticus can be confirmed or rejected base on a combined analysis of the clinical data and the EEG. PMID:19217635

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

    PubMed

    Haker, Helene

    2014-10-01

    The Asperger Syndrome is - in contrast to early childhood autism - a disorder at the lighter end of the autism spectrum. Although first described in 1943, it was included in the ICD-10 not before 1992. The knowledge about this lighter autistic disorder spread only slowly. The increasing prevalence rates can be explained by the increased knowledge about this disorder and the growing clinical experience. In contrast to the public that gives repeated medial attention to it, and to would-be affected who seem to see an attractive excuse for social problems in an Asperger diagnosis, many psychiatrists appear cautious to state a diagnosis with which they are not familiar and which is discredited as a fashionable diagnosis. PMID:25270748

  3. ADHD: Is Objective Diagnosis Possible?

    PubMed Central

    Johnson, Lynda G.

    2005-01-01

    Although attention deficit/hyperactivity disorder (ADHD) is one of the most common cognitive disorders, the usual diagnostic procedures pursued by psychiatrists, neurologists, pediatricians, and family practitioners are based largely, if not exclusively, on subjective assessments of perceived behavior. The recommended approaches to ADHD diagnosis are reviewed, first from the perspective of the various expert panels, and then from the research literature upon which those recommendations are based. The authors agree that ADHD is a clinical diagnosis, and that the assessment of subjective reports can be systematic. But they propose that objective data should also contribute to the clinical diagnosis of ADHD; and that new computerized assessment technology can generate objective cognitive data in an efficient and cost-effective way. Computerized tests can also improve the assessment of treatment response over time. PMID:21120096

  4. Diagnosis of alcoholic liver disease.

    PubMed

    Torruellas, Cara; French, Samuel W; Medici, Valentina

    2014-09-01

    Alcohol is a hepatotoxin that is commonly consumed worldwide and is associated with a spectrum of liver injury including simple steatosis or fatty liver, alcoholic hepatitis, fibrosis, and cirrhosis. Alcoholic liver disease (ALD) is a general term used to refer to this spectrum of alcohol-related liver injuries. Excessive or harmful alcohol use is ranked as one of the top five risk factors for death and disability globally and results in 2.5 million deaths and 69.4 million annual disability adjusted life years. All patients who present with clinical features of hepatitis or chronic liver disease or who have elevated serum elevated transaminase levels should be screened for an alcohol use disorder. The diagnosis of ALD can generally be made based on history, clinical and laboratory findings. However, the diagnosis of ALD can be clinically challenging as there is no single diagnostic test that confirms the diagnosis and patients may not be forthcoming about their degree of alcohol consumption. In addition, clinical findings may be absent or minimal in early ALD characterized by hepatic steatosis. Typical laboratory findings in ALD include transaminase levels with aspartate aminotransferase greater than alanine aminotransferase as well as increased mean corpuscular volume, gamma-glutamyltranspeptidase, and IgA to IgG ratio. In unclear cases, the diagnosis can be supported by imaging and liver biopsy. The histological features of ALD can ultimately define the diagnosis according to the typical presence and distribution of hepatic steatosis, inflammation, and Mallory-Denk bodies. Because of the potential reversible nature of ALD with sobriety, regular screening of the general population and early diagnosis are essential. PMID:25206273

  5. Diagnosis of alcoholic liver disease

    PubMed Central

    Torruellas, Cara; French, Samuel W; Medici, Valentina

    2014-01-01

    Alcohol is a hepatotoxin that is commonly consumed worldwide and is associated with a spectrum of liver injury including simple steatosis or fatty liver, alcoholic hepatitis, fibrosis, and cirrhosis. Alcoholic liver disease (ALD) is a general term used to refer to this spectrum of alcohol-related liver injuries. Excessive or harmful alcohol use is ranked as one of the top five risk factors for death and disability globally and results in 2.5 million deaths and 69.4 million annual disability adjusted life years. All patients who present with clinical features of hepatitis or chronic liver disease or who have elevated serum elevated transaminase levels should be screened for an alcohol use disorder. The diagnosis of ALD can generally be made based on history, clinical and laboratory findings. However, the diagnosis of ALD can be clinically challenging as there is no single diagnostic test that confirms the diagnosis and patients may not be forthcoming about their degree of alcohol consumption. In addition, clinical findings may be absent or minimal in early ALD characterized by hepatic steatosis. Typical laboratory findings in ALD include transaminase levels with aspartate aminotransferase greater than alanine aminotransferase as well as increased mean corpuscular volume, gamma-glutamyltranspeptidase, and IgA to IgG ratio. In unclear cases, the diagnosis can be supported by imaging and liver biopsy. The histological features of ALD can ultimately define the diagnosis according to the typical presence and distribution of hepatic steatosis, inflammation, and Mallory-Denk bodies. Because of the potential reversible nature of ALD with sobriety, regular screening of the general population and early diagnosis are essential. PMID:25206273

  6. Autism Diagnosis and Screening: Factors to Consider in Differential Diagnosis

    ERIC Educational Resources Information Center

    Matson, Johnny L.; Beighley, Jennifer; Turygin, Nicole

    2012-01-01

    There has been an exponential growth in assessment methods to diagnose disorders on the autism spectrum. Many reasons for this trend exist and include advancing knowledge on how to make a diagnosis, the heterogeneity of the spectrum, the realization that different methods may be needed based on age and intellectual disability. Other factors…

  7. Rhabdomyolysis: Pathogenesis, Diagnosis, and Treatment

    PubMed Central

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

    2015-01-01

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

  8. Diagnosis and prevention of thalassemia.

    PubMed

    Ip, Ho-Wan; So, Chi-Chiu

    2013-11-01

    Thalassemia is the most common monogenic inherited disease worldwide and it affects most countries to various extents. This review summarizes the current approaches to phenotypic and genotypic diagnosis of thalassemia in clinical practice. Prevention strategies that encompass carrier screening, genetic counseling and prenatal diagnosis are discussed. The importance of public education and an awareness of a changing perception regarding this group of diseases are emphasized. It also addresses the impact of the rapidly increasing knowledge in disease severity modification by hemoglobin F (Hb F).

  9. [The differential diagnosis of tenosynovitis].

    PubMed

    Brulhart, Laure; Gabay, Cem

    2011-03-16

    Etymologically a ténosynovites means inflammation of a tendon sheath. We recognize two separate presentations: exsudative and stenosing. The wide differential diagnosis includes infections, most of chronic inflammatory joint diseases, mainly connective tissue disorders, rheumatoid and psoriatic arthritis, pathology related to mechanical stress as De Quervain's tenosynovitis or trigger finger and unusually tumor. Diabetes is a risk factor for most of them and is related to poor prognosis. Musculoskeletal ultrasound is useful for diagnosis and to guide procedure as fluid aspiration or steroid injection. PMID:21510342

  10. Diagnosis of myofascial pain syndrome.

    PubMed

    Gerwin, Robert D

    2014-05-01

    Myofascial pain is one of the most common causes of pain. The diagnosis of myofascial pain syndrome (MPS) is made by muscle palpation. The source of the pain in MPS is the myofascial trigger point, a very localized region of tender, contracted muscle that is readily identified by palpation. The trigger point has well-described electrophysiologic properties and is associated with a derangement of the local biochemical milieu of the muscle. A proper diagnosis of MPS includes evaluation of muscle as a cause of pain, and assessment of associated conditions that have an impact on MPS.

  11. [Echographic diagnosis of fetal malformations].

    PubMed

    Gramellini, D; Chiavazza, F; Zampriolo, P; Salvini, P; Trentadue, R; Grignaffini, A; Cavatorta, E

    1982-01-01

    The Authors report their experience about ultrasound diagnosis of congenital anomalies, related to 15 cases from approximately 4000 gravides. They emphasize the impossibility to carry out total antenatal population screening by sonar and the usefulness to carefully select the gravidas at high risk for harboring a fetus with a birth defect. They also suggest that, in looking for physical defects, it is best to make ultrasound examination at 17a-18a weeks' gestation; at this moment, the ultrasound evaluation is particularly favorable for diagnosis and treatment.

  12. [Laboratory diagnosis of growth hormone].

    PubMed

    Macchia, V; Mariano, A

    1993-09-01

    The role of Clinical Pathology Laboratory in normal and altered growth hormone secretion is discussed. In particular, it is reported that the normal GH secretion can be studied by serum and urine GH determinations whereas the diagnosis of GH deficiency rests upon the demonstration of an inadequate rise serum GH after provocative stimuli and serum measurement of somatomedins (IGF-I) by radioimmunoassay method. As it concerns increase GH secretion the diagnosis is clinically made (acromegaly and gigantism) and the laboratory has only the role to confirm it by the assessment of basal and stimulated GH secretion. PMID:7910655

  13. Current diagnosis of temporomandibular pathologies.

    PubMed

    Learreta, Jorge A; Matos, Jane L F; Matos, Marcelo Freire; Durst, Andreas C

    2009-04-01

    The current scientific knowledge of TMJ pathologies points to the importance of etiological research and the need for differential diagnosis using the most modem technological resources. Those include MRI, computed tomography, serologic studies, genetic mapping, and bioelectronic instruments which allow clinicians to study, understand, and measure respectively, the structural changes of soft and hard tissues, infections, genetic susceptibility for autoimmune diseases, and stomatognathic function. The purpose of this article is an overview of the current knowledge and related tools for the diagnosis of TMJ pathologies.

  14. Mental Retardation: Diagnosis and Treatment.

    ERIC Educational Resources Information Center

    Poser, Charles M., Ed.

    A collection of writings by 17 authors, the text includes the following discussions: general principles of diagnosis and management of mental retardation, neurologic evaluation of the infant and child, psychological evaluation, educational information, and treatment of pseudoretardation, communicative disorders, and metabolic and endocrine causes.…

  15. Teacher Diagnosis of Educational Difficulties.

    ERIC Educational Resources Information Center

    Smith, Robert M., Ed.

    Seven contributors treat teacher diagnosis of educational difficulties. Robert Smith and John Neisworth review the fundamentals of informal educational assessment; Neisworth describes the educational irrelevance of intelligence; and Smith discusses perceptual motor skills. Also included are James Lister on personal-social-emotional skills, G.…

  16. [Microbiological diagnosis of imported malaria].

    PubMed

    Torrús, Diego; Carranza, Cristina; Manuel Ramos, José; Carlos Rodríguez, Juan; Rubio, José Miguel; Subirats, Mercedes; Ta-Tang, Thuy-Huong

    2015-07-01

    Current diagnosis of malaria is based on the combined and sequential use of rapid antigen detection tests (RDT) of Plasmodium and subsequent visualization of the parasite stained with Giemsa solution in a thin and thick blood smears. If an expert microscopist is not available, should always be a sensitive RDT to rule out infection by Plasmodium falciparum, output the result immediately and prepare thick smears (air dried) and thin extensions (fixed with methanol) for subsequent staining and review by an expert microscopist. The RDT should be used as an initial screening test, but should not replace microscopy techniques, which should be done in parallel. The diagnosis of malaria should be performed immediately after clinical suspicion. The delay in laboratory diagnosis (greater than 3 hours) should not prevent the initiation of empirical antimalarial treatment if the probability of malaria is high. If the first microscopic examination and RDT are negative, they must be repeated daily in patients with high suspicion. If suspicion remains after three negative results must be sought the opinion of an tropical diseases expert. Genomic amplification methods (PCR) are useful as confirmation of microscopic diagnosis, to characterize mixed infections undetectable by other methods, and to diagnose asymptomatic infections with submicroscopic parasitaemia.

  17. Lupus vulgaris: difficulties in diagnosis.

    PubMed

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

    2013-05-01

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

  18. [Autoimmune thrombocytopenia: diagnosis and treatment].

    PubMed

    Veneri, Dino; Franchini, Massimo

    2005-05-01

    Idiopathic thrombocytopenic purpura (ITP) is an autoimmune disease characterized by an isolated, persistent thrombocytopenia in absence of known causes. In this review, we briefly analyze the most important diagnostic criteria of this autoimmune disorder, with particular consideration to differential diagnosis (false thrombocytopenia, congenital thrombocytopenia, acquired thrombocytopenia, pregnancy-associated thrombocytopenia) and to therapeutic options.

  19. Learning Disabilities: Diagnosis and Prescription.

    ERIC Educational Resources Information Center

    Kappelman, Murray M.

    The author advocates an interdisciplinary team approach to diagnosis and prescription for the elementary school learning disabled (LD) child. Described is a 5-year project, funded under Title VI, operating within 11-18 elementary schools surrounding the University of Maryland Hospital. Biweekly services are offered to participating schools by a…

  20. Learning Disability: Experience of Diagnosis

    ERIC Educational Resources Information Center

    Kenyon, Elinor; Beail, Nigel; Jackson, Tom

    2014-01-01

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

  1. Challenging diagnosis of peripillous sheaths.

    PubMed

    Gnarra, Maria; Saraceni, Pierluigi; Rossi, Alfredo; Murabit, Amera; Caradonna, Emanuela; Fania, Luca; Feliciani, Claudio

    2014-01-01

    Peripillous sheaths, or hair casts, are asymptomatic, white, cylindrical concretions that encircle the hair without adhering to it. They are infrequently documented in the literature, are often misdiagnosed, and generate avoidable apprehension and expense for parents and caregivers. Dermoscopy is the standard for a rapid, noninvasive, cost-effective diagnosis. We describe a case of peripillous sheaths presenting in a boy. PMID:24846654

  2. Trichotillomania: Assessment, Diagnosis, and Treatment

    ERIC Educational Resources Information Center

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

    2004-01-01

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

  3. Delay in cutaneous melanoma diagnosis

    PubMed Central

    Xavier, Marcus H.S.B.; Drummond-Lage, Ana P.; Baeta, Cyntia; Rocha, Lorena; Almeida, Alessandra M.; Wainstein, Alberto J.A.

    2016-01-01

    Abstract Advanced melanoma is an incurable disease with complex and expensive treatments. The best approach to prevent melanoma at advanced stages is an early diagnosis. A knowledge of factors associated with the process of detecting cutaneous melanomas and the reasons for delays in diagnosis is essential for the improvement of the secondary prevention of the disease. Identify sociodemographic, individual, and medical aspects related to cutaneous melanoma diagnosis delay. Interviews evaluated the knowledge of melanoma, signals, symptoms, persons who were suspected, delays in seeking medical attention, physician's deferrals, and related factors of 211 patients. Melanomas were self-discovered in 41.7% of the patients; healthcare providers detected 29.9% of patients and others detected 27%. The main component in delay was patient-related. Only 31.3% of the patients knew that melanoma was a serious skin cancer, and most thought that the pigmented lesion was not important, causing a delay in seeking medical assistance. Patients (36.4%) reported a wait interval of more than 6 months from the onset of an observed change in a pigmented lesion to the first visit to a physician. The delay interval from the first physician visit to a histopathological diagnosis was shorter (<1 month) in 55.5% of patients. Improper treatments without a histopathological confirmation occurred in 14.7% of patients. A professional delay was related to both inappropriate treatments performed without histopathological confirmation (P = 0.003) and long requirements for medical referrals (P < 0.001). A deficient knowledge in the population regarding melanoma and physicians’ misdiagnoses regarding suspicious lesions contributed to delays in diagnosis. PMID:27495055

  4. Digital diagnosis of medical images

    NASA Astrophysics Data System (ADS)

    Heinonen, Tomi; Kuismin, Raimo; Jormalainen, Raimo; Dastidar, Prasun; Frey, Harry; Eskola, Hannu

    2001-08-01

    The popularity of digital imaging devices and PACS installations has increased during the last years. Still, images are analyzed and diagnosed using conventional techniques. Our research group begun to study the requirements for digital image diagnostic methods to be applied together with PACS systems. The research was focused on various image analysis procedures (e.g., segmentation, volumetry, 3D visualization, image fusion, anatomic atlas, etc.) that could be useful in medical diagnosis. We have developed Image Analysis software (www.medimag.net) to enable several image-processing applications in medical diagnosis, such as volumetry, multimodal visualization, and 3D visualizations. We have also developed a commercial scalable image archive system (ActaServer, supports DICOM) based on component technology (www.acta.fi), and several telemedicine applications. All the software and systems operate in NT environment and are in clinical use in several hospitals. The analysis software have been applied in clinical work and utilized in numerous patient cases (500 patients). This method has been used in the diagnosis, therapy and follow-up in various diseases of the central nervous system (CNS), respiratory system (RS) and human reproductive system (HRS). In many of these diseases e.g. Systemic Lupus Erythematosus (CNS), nasal airways diseases (RS) and ovarian tumors (HRS), these methods have been used for the first time in clinical work. According to our results, digital diagnosis improves diagnostic capabilities, and together with PACS installations it will become standard tool during the next decade by enabling more accurate diagnosis and patient follow-up.

  5. [Isaacs' syndrome. Diagnosis and differential diagnosis of neuromyotonia].

    PubMed

    Fischer, D; Schröder, R

    2004-06-01

    Neuromyotonia is a clinical and electrophysiological syndrome of spontaneous muscle fiber activity due to hyperexcitability of peripheral nerve origin causing generalised, visible myokymia and muscular cramps. Electromyography shows abnormal doublet and triplet discharges of high intraburst frequency as well as myokymic and neuromyotonic discharges. Fasciculations and fibrillation potentials are common. Most commonly, neuromyotonia is an acquired immune-mediated disorder (Isaacs' syndrome) showing elevated antibody levels against presynaptic, voltage-gated, potassium channels. Some of these patients have additional autonomic (hyperhidrosis) and/or CNS symptoms similar to those from limbic encephalitis (referred to then as Morvan's syndrome). We report on a patient with Isaacs' syndrome and discuss the clinical and electrophysiological features, pathophysiology, diagnosis, and differential diagnosis of diseases with peripheral nerve hyperexcitability. PMID:15257376

  6. Overview of food allergy diagnosis

    PubMed Central

    MANEA, IRENA; AILENEI, ELENA; DELEANU, DIANA

    2016-01-01

    Food allergy is a condition with significant social and economic impact and a topic of intense concern for scientists and clinicians alike. Worldwide, over 220 million people suffer from some form of food allergy, but the number reported is just the tip of the iceberg. Recent years have brought new perspectives in diagnosing food allergy. Elucidating incriminated immunological mechanisms, along with drawing the clinical phenotype of food hypersensitivity reactions ensures an accurate diagnosis of food allergy. Moreover, molecular based allergy diagnosis, which is increasingly used in routine care, is a stepping-stone to improved management of food allergy patients. The aim of this review is to summarize the topic of IgE-mediated food allergy from the perspective of current diagnostic methods. PMID:27004019

  7. Prenatal diagnosis of cloacal malformation.

    PubMed

    Peiro, Jose L; Scorletti, Federico; Sbragia, Lourenco

    2016-04-01

    Persistent cloaca malformation is the most severe type of anorectal and urogenital malformation. Decisions concerning the surgical treatment for this condition are taken during the first hours of life and may determine the quality of life of these patients. Thus, prenatal diagnosis becomes important for a prompt and efficient management of the fetus and newborn, and accurate counseling of the parents regarding its consequences and the future of the baby. Careful evaluation by ultrasonography, and further in-depth analysis with MRI, allow prenatal detection of characteristic findings, which can lead to diagnose or at least suspect this condition. We reviewed our experience and the literature in order to highlight the most important clues that can guide the physician in the differential diagnosis. PMID:26969229

  8. Lingual thyroid. Diagnosis and treatment

    SciTech Connect

    Kansal, P.; Sakati, N.; Rifai, A.; Woodhouse, N.

    1987-11-01

    We describe four patients who presented with a lingual thyroid condition (three females and one male, aged between 7 and 22 years). Only the male patient was symptomatic with mild dysphagia and hemoptysis. The diagnosis was suspected in three patients, and was confirmed by iodine 123 or 131 scanning in all patients and by a computed tomographic scan in the one patient studied. The patient with dysphagia received a 10-mCl therapeutic dose of iodine 131 before thyroxine replacement was started. The diagnosis and management of lingual thyroid is discussed. All patients need lifelong thyroxine suppression. Unenhanced computed tomographic scans have a diagnostic appearance due to the iodine content of the ectopic thyroid tissue.

  9. Ultrasound diagnosis of uterine myomas.

    PubMed

    Fascilla, Fabiana D; Cramarossa, Paola; Cannone, Rossella; Olivieri, Claudiana; Vimercati, Antonella; Exacoustos, Caterina

    2016-06-01

    Myomas represent a large part of benign gynecological pathology, widely spread in fertile female population. First step to diagnose fibroids is ultrasound (US) that can be 2-dimensional (2D), 3-dimensional (3D), Color Doppler (CD) and sonohysterography (SHG). This review develops according to MUSA's sonographic features (Morphological Uterus Sonographic Assessment). One of the main topic of interest for ultrasonographer today is endo/myometrial junctional zone (JZ), because it may be useful to discern a diagnosis of myoma and adenomyosis. Another important aspect of ultrasound is the analysis of vascularization in front of a uterine lesion. Indeed, vascular pattern can be used to make differential diagnosis between myoma-adenomyosis and leiomyosarcomas. Myomas should be described accurately according to sonographic guidelines. Sonographic features correlated with symptoms should guide an appropriate surgical or medical treatment. PMID:27014801

  10. [Differential diagnosis of acute arthritis].

    PubMed

    Eviltis, Egidijus

    2003-01-01

    Acute arthritis can first present as a symptom of dangerous and rapidly progressing disease. It is quite easy to differentiate between arthritis and periarthritis. More problematical is correct early differential diagnosis of the acute arthritis. Determining whether one, several or many joints are affected can narrow the diagnostic possibilities. Arthrocentesis and synovial fluid testing provide much information and should be done at initial evaluation if possible. The presence or absence of fever, rash, family history of joint disease and exposure to infective organisms can further direct diagnostic studies and treatment. In general, to avoid masking clues, drug therapy should be delayed for mild symptoms until diagnosis is complete. This article is designed mostly for primary care physicians, residents and includes author's original data and review of recommended reading. PMID:12794379

  11. CAD tool for burn diagnosis.

    PubMed

    Acha, Begoña; Serrano, Carmen; Acha, José I; Roa, Laura M

    2003-07-01

    In this paper a new system for burn diagnosis is proposed. The aim of the system is to separate burn wounds from healthy skin, and the different types of burns (burn depths) from each other, identifying each one. The system is based on the colour and texture information, as these are the characteristics observed by physicians in order to give a diagnosis. We use a perceptually uniform colour space (L*u*v*), since Euclidean distances calculated in this space correspond to perceptually colour differences. After the burn is segmented, some colour and texture descriptors are calculated and they are the inputs to a Fuzzy-ARTMAP neural network. The neural network classifies them into three types of bums: superficial dermal, deep dermal and full thickness. Clinical effectiveness of the method was demonstrated on 62 clinical burn wound images obtained from digital colour photographs, yielding an average classification success rate of 82% compared to expert classified images.

  12. DIAGNOSIS OF PULMONARY COCCIDIOIDAL INFECTIONS

    PubMed Central

    Smith, Charles E.

    1951-01-01

    A wide variety of pulmonary lesions may be caused by coccidioidomycosis. Suspicion of coccidioidomycosis may be substantiated by careful clinical-epidemiological histories. The first laboratory procedure should be a coccidioidin skin test. If the reaction to the test is positive, serological tests are next. Also, if there is no reaction to coccidioidin, serological tests are still indicated if dissemination is suspected. The more severe the infection, the greater the probability of establishing a diagnosis serologically. In only three-fifths of patients with coccidioidal cavities can the diagnosis be fixed serologically. In such patients if differential skin tests are not conclusive, attempt should be made to recover the fungus. However, this is accompanied by great risk of laboratory infection. Eosinophilia and accelerated erythrocyte sedimentation are only circumstantial items of evidence, as is the appearance of the pulmonary roentgenogram. ImagesFigure 1. PMID:14886741

  13. CAD tool for burn diagnosis.

    PubMed

    Acha, Begoña; Serrano, Carmen; Acha, José I; Roa, Laura M

    2003-07-01

    In this paper a new system for burn diagnosis is proposed. The aim of the system is to separate burn wounds from healthy skin, and the different types of burns (burn depths) from each other, identifying each one. The system is based on the colour and texture information, as these are the characteristics observed by physicians in order to give a diagnosis. We use a perceptually uniform colour space (L*u*v*), since Euclidean distances calculated in this space correspond to perceptually colour differences. After the burn is segmented, some colour and texture descriptors are calculated and they are the inputs to a Fuzzy-ARTMAP neural network. The neural network classifies them into three types of bums: superficial dermal, deep dermal and full thickness. Clinical effectiveness of the method was demonstrated on 62 clinical burn wound images obtained from digital colour photographs, yielding an average classification success rate of 82% compared to expert classified images. PMID:15344466

  14. Genetic counseling and prenatal diagnosis (image)

    MedlinePlus

    Genetic counseling (and prenatal diagnosis) provides parents with the knowledge to make intelligent, informed decisions regarding possible pregnancy and its outcome. If a pregnancy occurs the couple may want to evaluate the fetus by prenatal diagnosis.

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

    MedlinePlus

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

  16. Feature Hepatitis: Hepatitis Symptoms, Diagnosis, Treatment & Prevention

    MedlinePlus

    ... Navigation Bar Home Current Issue Past Issues Feature Hepatitis Hepatitis: Symptoms, Diagnosis, Treatment & Prevention Past Issues / Spring 2009 ... No appetite Fever Headaches Diagnosis To check for hepatitis viruses, your doctor will test your blood. You ...

  17. Craniosynostosis : Updates in Radiologic Diagnosis

    PubMed Central

    Kim, Hyun Jeong; Roh, Hong Gee

    2016-01-01

    The purpose of this article is to review imaging findings and to discuss the optimal imaging methods for craniosynostosis. The discussion of imaging findings are focused on ultrasonography, plain radiography, magnetic resonance imaging and computed tomography with 3-dimensional reconstruction. We suggest a strategy for imaging work-up for the diagnosis, treatment planning and follow-up to minimize or avoid ionized radiation exposure to children by reviewing the current literature. PMID:27226852

  18. Algorithms Could Automate Cancer Diagnosis

    NASA Technical Reports Server (NTRS)

    Baky, A. A.; Winkler, D. G.

    1982-01-01

    Five new algorithms are a complete statistical procedure for quantifying cell abnormalities from digitized images. Procedure could be basis for automated detection and diagnosis of cancer. Objective of procedure is to assign each cell an atypia status index (ASI), which quantifies level of abnormality. It is possible that ASI values will be accurate and economical enough to allow diagnoses to be made quickly and accurately by computer processing of laboratory specimens extracted from patients.

  19. [Diagnosis of periprosthetic hip infections].

    PubMed

    Lüdemann, C M; Schütze, N; Rudert, M

    2015-06-01

    The diagnosis of periprosthetic infection requires a clear definition itself and structured procedure concerning anamnesis, clinical examination, laboratory findings, puncture and imaging diagnostics. The clinical presentation may vary considerable due to the time of their occurrence as early, delayed, or late infection. Recognition of risk factors and knowledge of differential diagnoses facilitate and confirm the diagnosis. The synovial fluid is assessed with regard to leukocyte count, protein content, and glucose. Intraoperative tissue specimen sampling has to be performed correctly; the histopathological and microbiological studies must be assessed using specific criteria. The examination and classification of periprosthetic membranes make discrimination of the causal pathological mechanism possible, especially distinction between septic and aseptic loosening. In this manner statements with regard to etiology and prosthesis durability are possible. Different causative microorganisms appear postoperatively at specific times. Pathogens that grow as biofilms are of great significance, as they may compound diagnosis and therapy. Early infections are often caused by virulent microorganisms (S. aureus) with acute onset. Delayed (low grade) infections are usually caused by less virulent microorganisms, such as S. epidermidis or coagulase-negative staphylococci. Many diagnostic imaging methods have been used in the assessment of periprosthetic infection: plain radiographs, arthrography, ultrasonography, computed tomography, and magnetic resonance imaging. Nuclear medicine with bone scintigraphy or positron-emission tomography enhance diagnostic capabilities. Cultures of samples obtained by sonication of prostheses are more sensitive than conventional periprosthetic tissue culture. Multiplex PCR of sonication fluid is a promising test for diagnosis of periprosthetic joint infection. The promising diagnostic accuracy for interleukin-6 and procalcitonin has yet not been

  20. Porphyria: Pathophysiology, diagnosis, and treatment.

    PubMed

    Gasson, Tracy; Klein, Kathleen

    2015-08-15

    Porphyrias are inherited metabolic disorders that involve alterations in enzymes utilized in the heme biosynthetic pathway. Most of these conditions are inherited; however, some are believed to be acquired through environmental exposures. Patients with porhyrias often present with a wide range of clinical symptoms, making it difficult to diagnose. Treatments vary depending on clinical presentation. A thorough and detailed history is essential and key to discovering a porphyria diagnosis.

  1. Laboratory diagnosis of malaria -- overview.

    PubMed

    Bhatt, K M

    1994-01-01

    Features of the laboratory diagnosis of malaria are described. Microscope equipment is absolutely essential. Clinical symptoms are inadequate for the proper diagnosis of malaria. Screening for malaria involves identification of all cases where high fever is present in endemic areas. Diagnosis is complicated because many people take antimalarial drugs which reduce the chances of detecting malarial parasites. Confirmation should be made before treatment is administered. A thick blood slide can be quickly and cheaply taken without much training of health personnel. The disadvantage of thick stains is the difficulty in identifying "plasmodium" strains. When a thin smear with Giemsa and Leishmanin stain is used, a light infection may be missed. Thin smears require trained personnel and time, which in peak seasons may be impractical. Urinary tract and viral infections may be confused with malaria. Evidence of parasites can be discerned from thick stains. Modern assay techniques are also available. There are enzyme linked immunosorbent assays (ELISA) and immunofluorescent assay techniques (IFAT), which are frequently used in large scale seroepidemiological studies. DNA probes have the limitation of radioisotope handling problems. Acridine orange fluorescent microscopy with capillary centrifuged blood is a technique which improves the viability of Giemsa stain procedures. This technique is desirable because of the sensitivity and speed of diagnosis. The quantitative buddy coat (GBC) technique is superior to Giemsa stained thick blood film in identifying malaria, but it is not reliable with mixed infections. Advanced techniques are not readily available in local settings. The recommendation is to continue use of thick or thin blood film and trained health personnel. Laboratory results must be interpreted in the context of when the flood film was prepared, prior drug administration, and clinical manifestations.

  2. Rapid diagnosis of pulmonary tuberculosis

    PubMed Central

    Sarmiento, José Mauricio Hernández; Restrepo, Natalia Builes; Mejía, Gloria Isabel; Zapata, Elsa; Restrepo, Mary Alejandra; Robledo, Jaime

    2014-01-01

    Introduction World Health Organization had estimated 9.4 million tuberculosis cases on 2009, with 1.7 million of deaths as consequence of treatment and diagnosis failures. Improving diagnostic methods for the rapid and timely detection of tuberculosis patients is critical to control the disease. The aim of this study was evaluating the accuracy of the cord factor detection on the solid medium Middlebrook 7H11 thin layer agar compared to the Lowenstein Jensen medium for the rapid tuberculosis diagnosis. Methods Patients with suspected tuberculosis were enrolled and their sputum samples were processed for direct smear and culture on Lowenstein Jensen and BACTEC MGIT 960, from which positive tubes were subcultured on Middlebrook 7H11 thin layer agar. Statistical analysis was performed comparing culture results from Lowenstein Jensen and the thin layer agar, and their corresponding average times for detecting Mycobacterium tuberculosis. The performance of cord factor detection was evaluated determining its sensitivity, specificity, positive and negative predictive value. Results 111 out of 260 patients were positive for M. tuberculosis by Lowenstein Jensen medium with an average time ± standard deviation for its detection of 22.3 ± 8.5 days. 115 patients were positive by the MGIT system identifying the cord factor by the Middlebrook 7H11 thin layer agar which average time ± standard deviation was 5.5 ± 2.6 days. Conclusion The cord factor detection by Middlebrook 7H11 thin layer agar allows early and accurate tuberculosis diagnosis during an average time of 5 days, making this rapid diagnosis particularly important in patients with negative sputum smear. PMID:25419279

  3. Diagnosis of Intracranial Artery Dissection

    PubMed Central

    KANOTO, Masafumi; HOSOYA, Takaaki

    2016-01-01

    Cerebral arterial dissection is defined as a hematoma in the wall of a cervical or an intracranial artery. Cerebral arterial dissection causes arterial stenosis, occlusion, and aneurysm, resulting in acute infarction and hemorrhage. Image analysis by such methods as conventional angiography, computed tomography, magnetic resonance imaging, and so on plays an important role in diagnosing cerebral arterial dissection. In this study, we explore the methods and findings involved in the diagnosis of cerebral arterial dissection. PMID:27180630

  4. [Differential diagnosis of chronic diarrhoea].

    PubMed

    Louis, E

    2014-01-01

    Chronic diarrhoea is a frequent clinical presentation in our population. It may correspond to many gastrointestinal or systemic pathologies. Most frequent causes are irritable bowel syndrome, functional intestinal disorders or lactose intolerance, but organic diseases have also to be searched. Focused patient questioning and some specific aspects of clinical examination play a key-role in diagnosis orientation and the use of complementary explorations. The present paper proposes a structured diagnostic procedure aiming at an optimal use of complementary explorations. PMID:24640309

  5. Molecular diagnosis in lung diseases.

    PubMed

    Calabrese, Fiorella; Lunardi, Francesca; Popper, Helmut

    2015-01-01

    The development of different molecular biology techniques in the past decade has led to an explosion of new research in molecular pathology with consequent important applications to diagnosis, prognosis, and therapeutics, as well as a clearer concept of the disease pathogenesis. Many methods used in molecular pathology are now validated and used in several areas of pathological diagnosis, particularly on infectious and neoplastic diseases. The spectrum of infectious diseases, especially lung infective diseases, is now broadening and modifying, thus the pathologist is increasingly involved in the diagnosis of these pathologies. The precise tissue characterization of lung infections has an important impact on specific therapeutic treatment. Increased knowledge of significant alterations in lung cancer has led today to a better understanding of the pathogenic substrate underlying the development, progression and metastasis of neoplastic processes. Molecular tests are now routinely performed in different lung tumors allowing a more precise patient stratification in terms of prognosis and therapy. This review focuses on molecular pathology of the principal infective lung diseases and tumors.

  6. Pulmonary Hypertension: Diagnosis and Treatment.

    PubMed

    Dunlap, Beth; Weyer, George

    2016-09-15

    Pulmonary hypertension is a common, complex group of disorders that result from different pathophysiologic mechanisms but are all defined by a mean pulmonary arterial pressure of 25 mm Hg or greater. Patients often initially present to family physicians; however, because the symptoms are typically nonspecific or easily attributable to comorbid conditions, diagnosis can be challenging and requires a stepwise evaluation. There is limited evidence to support screening of asymptomatic individuals. Echocardiography is recommended as the initial step in the evaluation of patients with suspected pulmonary hypertension. A definitive diagnosis cannot be made on echocardiographic abnormalities alone, and some patients require invasive evaluation by right heart catheterization. For certain categories of pulmonary hypertension, particularly pulmonary arterial hypertension, treatment options are rapidly evolving, and early diagnosis and prompt referral to an expert center are critical to ensure the best prognosis. There are no directed therapies for many other categories of pulmonary hypertension; therefore, family physicians have a central role in managing contributing comorbidities. Other important considerations for patients with pulmonary hypertension include influenza and pneumonia immunizations, contraception counseling, preoperative assessment, and mental health. PMID:27637122

  7. [Pathological diagnosis of Hodgkin lymphoma].

    PubMed

    Tamaru, Jun-ichi

    2014-03-01

    This lymphoma was recognized by Thomas Hodgkin in 1832. In 1865, Samuel Wilks named it Hodgkin disease. Now, the term Hodgkin lymphoma (HL) is acceptable over Hodgkin disease. Since the neoplastic cells of the disease is well-recognized to be a lymphoid cell, especially B lymphocyte. In WHO classification published in 2008, HLs are divided into two entities: Classical HL and nodular lymphocyte predominat HL. The former is composed of four different subtypes: nodular sclerosis (NS), mixed cellularity (MC), lymphocyte rich (LR), and lymphocyte depletion (LD). HL is characterized by the morphological feature comprising a minority of neoplastic cells, Hodgkin/Reed-Sternberg cells and popcorn (LP) cells and a majority of non-neoplastic reactive cells. Antigen receptor gene analyses by prevailing molecular methods and flow cytometry are not appropriate method for the diagnosis of HL, because of small number of neoplastic cells. They are, however, very useful in the differential diagnosis to rule out other lymphomas. Even the present when science progressed, pathological (morphological and immunohistochemical) examination is very worth for diagnosis of HL. PMID:24724402

  8. Molecular diagnosis of intrahepatic cholangiocarcinoma

    PubMed Central

    Haga, Hiroaki; Patel, Tushar

    2015-01-01

    Intrahepatic cholangiocarcinomas (iCCA) are primary intrahepatic malignancies originating from biliary epithelia. While both hepatocellular cancer and iCCA can present as mass lesions within the liver, these cancers are distinct in their morphology, etiology, pathology, natural history and response to therapy. There is a need for accurate and sensitive molecular markers for the diagnosis of iCCA. Recent advances in elucidating molecular and genetic characteristics of iCCA offer the potential of molecular-based diagnosis of iCCA. Specific genetic mutations of IDH1/2, BAP1, p53, and KRAS, FGFR gene fusions and alterations in microRNA have all been described in iCCA. Although there are no accurate serum or biliary biomarkers currently available for diagnosis of iCCA, several potential candidates have been identified. Knowledge of specific genetic or molecular abnormalities offers potential for individualized approaches for the treatment of patients with iCCA in the future. PMID:25267595

  9. Navigating Your Child's Hearing Loss Diagnosis

    ERIC Educational Resources Information Center

    Trapp Petty, Melissa A.

    2011-01-01

    For hearing parents, receiving a hearing loss diagnosis for their child can be a shocking event. For some parents, the diagnosis is the fulfillment of a hunch; confirmation of the suspected, but still scary verdict. Recent research finds that the period directly after hearing loss diagnosis is the most stressful and burdensome for parents,…

  10. Why Is Cognitive Diagnosis Necessary? A Reaction

    ERIC Educational Resources Information Center

    Davidson, Fred

    2010-01-01

    "Language Assessment Quarterly," Volume 6, Issue 3, 2009, is a special issue titled "Cognitive Diagnosis and Q-Matrices in Language Assessment." This special issue is a textbook for cognitive diagnosis, one that language testers can study for many years to come. This article presents the author's reaction on why cognitive diagnosis is necessary.…

  11. Diagnosis and pathology of endocrine diseases

    SciTech Connect

    Shriver, B.D.

    1988-01-01

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

  12. A Multicomponent Latent Trait Model for Diagnosis

    ERIC Educational Resources Information Center

    Embretson, Susan E.; Yang, Xiangdong

    2013-01-01

    This paper presents a noncompensatory latent trait model, the multicomponent latent trait model for diagnosis (MLTM-D), for cognitive diagnosis. In MLTM-D, a hierarchical relationship between components and attributes is specified to be applicable to permit diagnosis at two levels. MLTM-D is a generalization of the multicomponent latent trait…

  13. Diagnosis, Phenomenology, Differential Diagnosis, and Comorbidity of Pediatric Bipolar Disorder.

    PubMed

    Kowatch, Robert A

    2016-01-01

    Diagnosing a pediatric patient with bipolar disorder can pose a challenge for clinicians. Children typically do not present with the full criteria for a mood episode and may have symptoms of other disorders such as attention-deficit/hyperactivity disorder, oppositional defiant disorder, anxiety disorders, and other mood disorders, which may complicate the diagnostic process. By diligently interviewing parents and children about behaviors, thoroughly reviewing family histories, and systematically ruling out other disorders, clinicians can provide an accurate diagnosis for their pediatric patients. PMID:27570927

  14. Psychiatric diagnosis: the indispensability of ambivalence

    PubMed Central

    Callard, Felicity

    2014-01-01

    The author analyses how debate over the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders has tended to privilege certain conceptions of psychiatric diagnosis over others, as well as to polarise positions regarding psychiatric diagnosis. The article aims to muddy the black and white tenor of many discussions regarding psychiatric diagnosis by moving away from the preoccupation with diagnosis as classification and refocusing attention on diagnosis as a temporally and spatially complex, as well as highly mediated process. The article draws on historical, sociological and first-person perspectives regarding psychiatric diagnosis in order to emphasise the conceptual—and potentially ethical—benefits of ambivalence vis-à-vis the achievements and problems of psychiatric diagnosis. PMID:24515564

  15. [Renal angiomyolipoma: diagnosis and treatment].

    PubMed

    Arima, K; Kise, H; Yamashita, A; Yanagawa, M; Tochigi, H; Kawamura, J; Horiuchi, E; Sugimura, Y

    1995-09-01

    In 10 years the diagnosis of renal angiomyolipoma (RAML) was made in 14 patients (male-to female ratio 1:3.7) at our institution; 1 case was associated with tuberous sclerosis (TS) and 1 case had regional lymph node involvement. A statistical study was done on data taken from 739 cases of RAML in the Japanese literature, including our cases. The male to female ratio was 1 to 3. Twenty eight percent of the cases were associated with TS. The ratio of bilateral cases to the unilateral one was 1 to 3. The main clinical signs were flank pain, abdominal mass, hematuria and fever elevation. Recently the ratio of nephrectomy has decreased to 30%. The percentage of detecting the fat component by ultrasonography (US), computed tomography (CT) and magnetic resonance imaging were 88.1%, 86.5% and 80.8% respectively. The percentages of visualizing hypervascularity, aneurysms, absence of arterio-venous shunt and onion peel appearance by selective renal angiography were 77.3%, 71.4%, 48.1% and 4.9% respectively. Small (less than 3 cm), asymptomatic, simple lesions with adipose component may be observed annually by CT and US until more experiences is gained with surveillance of these patients. Embolization was useful for emergency cases or pre-treatment of nephron sparing surgery, but insufficient by itself. As there still remain problems in the diagnosis of RAML, especially in the case of very small tumors, in the case with almost no adipose component and in the case associated with renal cell carcinoma, the diagnosis of RAML should be made synthetically including angiography. PMID:7484542

  16. Urological diagnosis using clinical PACS

    NASA Astrophysics Data System (ADS)

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

    1995-05-01

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

  17. Knowledge-based nursing diagnosis

    NASA Astrophysics Data System (ADS)

    Roy, Claudette; Hay, D. Robert

    1991-03-01

    Nursing diagnosis is an integral part of the nursing process and determines the interventions leading to outcomes for which the nurse is accountable. Diagnoses under the time constraints of modern nursing can benefit from a computer assist. A knowledge-based engineering approach was developed to address these problems. A number of problems were addressed during system design to make the system practical extended beyond capture of knowledge. The issues involved in implementing a professional knowledge base in a clinical setting are discussed. System functions, structure, interfaces, health care environment, and terminology and taxonomy are discussed. An integrated system concept from assessment through intervention and evaluation is outlined.

  18. Laboratory Diagnosis of Congenital Toxoplasmosis

    PubMed Central

    Pomares, Christelle

    2016-01-01

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

  19. [Disclosing the diagnosis and guidance].

    PubMed

    Bopp-Kistler, Irene

    2015-04-01

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

  20. [Cardiac arrhythmias: Diagnosis and management].

    PubMed

    Waldmann, V; Marijon, E

    2016-09-01

    Cardiac arrhythmias, with, on top of the list, atrial fibrillation, are frequent conditions and any physician might have to get involved at any stage of patient care (from diagnosis to treatment), without always having the opportunity to immediately refer to the cardiologist. The aim of this review is to present a summary of pathophysiology, clinical and electrocardiographic presentations, as well as diagnostic and therapeutic strategies for the main cardiac arrhythmias. Supra-ventricular tachycardias (atrial fibrillation and flutter, atrioventricular reciprocating tachycardias) and ventricular tachycardias will be consecutively presented and discussed.

  1. Prenatal diagnosis of colobomatous microphthalmos.

    PubMed

    Dar, Suhail A; Johal, Sheila C; Marino, Meghan J; Singh, Arun D

    2015-04-30

    Optic nerve coloboma and microphthalmos with colobomatous cyst are rare congenital anomalies that are difficult to detect on prenatal ultrasonography and magnetic resonance imaging. Only four cases of optic nerve coloboma and two cases of microphthalmos with colobomatous cyst have been detected on prenatal imaging. The authors report a case of a fetus initially suspected to have retinoblastoma of the right eye on prenatal ultrasonography who was later diagnosed as having microphthalmos on fetal magnetic resonance imaging. Following delivery, she was noted to have microphthalmos with colobomatous cyst of the right eye and optic nerve coloboma of the left eye. The authors also review the prenatal ocular imaging findings of the differential diagnosis.

  2. Laboratory Diagnosis of Congenital Toxoplasmosis.

    PubMed

    Pomares, Christelle; Montoya, Jose G

    2016-10-01

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

  3. Pulmonary Sarcoidosis: Diagnosis and Treatment.

    PubMed

    Carmona, Eva M; Kalra, Sanjay; Ryu, Jay H

    2016-07-01

    Sarcoidosis is a chronic granulomatous disease of unknown cause that is seen worldwide and occurs mainly in patients between the ages of 20 and 60 years. It can be difficult to diagnose because it can mimic many other diseases including lymphoproliferative disorders and granulomatous infections and because there is no specific test for diagnosis, which depends on correlation of clinicoradiologic and histopathologic features. This review will focus on recent discoveries regarding the pathogenesis of sarcoidosis, common clinical presentations, diagnostic evaluation, and indications for treatment. This review is aimed largely at general practitioners and emphasizes the importance of differentiating pulmonary sarcoidosis from its common imitators. PMID:27378039

  4. Molecular Diagnosis of Cystic Fibrosis.

    PubMed

    Deignan, Joshua L; Grody, Wayne W

    2016-01-01

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

  5. Functional Overlay: An Illegitimate Diagnosis?

    PubMed Central

    Bromberg, Walter

    1979-01-01

    Functional overlay is not a recognized psychiatric diagnosis. Evaluating functional overlay and differentiating between this concept and organic conditions is important in medicolegal areas in which financial values are placed on pain and disability. Functional overlay is not malingering: the former is based on preconscious or unconscious mechanisms, the latter is consciously induced. In considering psychologic reactions to pain and disability, a gradient of simulation, malingering, symptom exaggeration, overvaluation, functional overlay and hysteria is useful. The dynamics of overlay are a combination of anxiety from body-image distortion and depression from decreased efficiency of the body, as well as the resulting psychosocial disruption in a patient's life. PMID:516698

  6. Adrenal insufficiency: diagnosis and management.

    PubMed

    Munver, Ravi; Volfson, Ilya A

    2006-01-01

    Adrenal insufficiency is a disorder characterized by hypoactive adrenal glands resulting in insufficient production of the hormones cortisol and aldosterone by the adrenal cortex. This disorder may develop as a primary failure of the adrenal cortex or be secondary to an abnormality of the hypothalamic-pituitary axis. Patients with adrenal insufficiency often are asymptomatic or they may present with fatigue, muscle weakness, weight loss, low blood pressure, and sometimes darkening of the skin. The presentation of adrenal insufficiency varies dramatically and poses a major diagnostic dilemma. This review focuses on the diagnosis and treatment of primary and secondary adrenal insufficiency.

  7. Epilepsy emergencies: diagnosis and management.

    PubMed

    Foreman, Brandon; Hirsch, Lawrence J

    2012-02-01

    Seizures and status epilepticus are epilepsy emergencies with high morbidity and mortality. Early treatment is crucial, and the identification of an underlying etiology informs both continued treatment and prognosis. Many patients have underdiagnosed nonconvulsive seizures or nonconvulsive status epilepticus, particularly the comatose or critically ill. Timely EEG can be useful for diagnosis, management, optimizing treatment response, and determining prognosis in these patients. Refractory conditions can be quite complicated with limited evidence-based guidance, but treatment should not be restricted by nihilism even in the most prolonged cases, especially if there is not widespread irreversible brain injury. PMID:22284053

  8. Glaucoma Suspect: Diagnosis and Management.

    PubMed

    Chang, Robert T; Singh, Kuldev

    2016-01-01

    Glaucoma suspect is a diagnosis reserved for individuals who do not definitively have glaucoma at the present time but have characteristics suggesting that they are at high risk of developing the disease in the future based on a variety of factors. This review provides a practical approach to individuals classified as glaucoma suspects caused by one or more of the following risk factors or indicators of disease: ocular hypertension, optic nerve features suggestive of glaucoma, visual field abnormalities, and other characteristics placing them at greater risk than the average population. In addition to diagnostic considerations, this overview provides information on therapeutic approaches to the glaucoma suspect.

  9. Acute gangrenous cholecystitis: radionuclide diagnosis

    SciTech Connect

    Brachman, M.B.; Tanasescu, D.E.; Ramanna, L.; Waxman, A.D.

    1984-04-01

    Radionuclide hepatobiliary imaging with Tc-99m IDA is a useful procedure for the diagnosis of acute cholecystitis. Visualization of the gallbladder essentially rules out acute cholecystitis. Nonvisualization suggest acute cholecystitis but may also be associated with chronic gallbladder disease or other conditions. The authors recently observed five patients in whom a rim of increased parenchymal liver activity was seen adjacent to the gallbladder fossa. All five patients had acute gangrenous cholecystitis. The rim of increased activity appears to be a useful secondary sign of acute cholecystitis.

  10. Laboratory Diagnosis of Congenital Toxoplasmosis.

    PubMed

    Pomares, Christelle; Montoya, Jose G

    2016-10-01

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

  11. [Diagnosis of duodenal wall hematoma].

    PubMed

    Zapf, S; Düber, C; Kuhn, F P; Lauff, V

    1988-01-01

    Blunt trauma to the epigastrium is becoming an increasingly important cause of injury and may result in retroperitoneal haematoma involving the head of the pancreas as well as the descending duodenum. Ultrasound seems to be of great advantage in the diagnosis of the effects and complications of blunt abdominal trauma such as obstruction of the biliary tree, the gastric outlet and the inferior vena cava. Direct involvement of the descending duodenum seems to be relatively uncommon, intramural haematoma of the duodenum is described only rarely in the literature. Three additional cases of intramural haematoma of the duodenum are reported with particular reference to the recent literature.

  12. Diagnosis and treatment of haemorrhoids.

    PubMed

    Buntzen, Steen; Christensen, Peter; Khalid, Ali; Ljungmann, Ken; Lindholt, Jan; Lundby, Lilli; Walker, Line Rossell; Raahave, Dennis; Qvist, Niels

    2013-12-01

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

  13. Cardiac sarcoidosis: diagnosis and management.

    PubMed

    Dubrey, S W; Sharma, R; Underwood, R; Mittal, T

    2015-07-01

    Cardiac sarcoidosis is one of the most serious and unpredictable aspects of this disease state. Heart involvement frequently presents with arrhythmias or conduction disease, although myocardial infiltration resulting in congestive heart failure may also occur. The prognosis in cardiac sarcoidosis is highly variable, which relates to the heterogeneous nature of heart involvement and marked differences between racial groups. Electrocardiography and echocardiography often provide the first clue to the diagnosis, but advanced imaging studies using positron emission tomography and MRI, in combination with nuclear isotope perfusion scanning are now essential to the diagnosis and management of this condition. The identification of clinically occult cardiac sarcoidosis and the management of isolated and/or asymptomatic heart involvement remain both challenging and contentious. Corticosteroids remain the first treatment choice with the later substitution of immunosuppressive and steroid-sparing therapies. Heart transplantation is an unusual outcome, but when performed, the results are comparable or better than heart transplantation for other disease states. We review the epidemiology, developments in diagnostic techniques and the management of cardiac sarcoidosis.

  14. Computational diagnosis of canine lymphoma

    NASA Astrophysics Data System (ADS)

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

    2014-03-01

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

  15. Scabies: Advances in Noninvasive Diagnosis.

    PubMed

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

    2016-06-01

    Scabies is a common, highly contagious skin parasitosis caused by Sarcoptes scabiei var. hominis. Early identification and prompt treatment of infested subjects is essential, as missed diagnosis may result in outbreaks, considerable morbidity, and significantly increased economic burden. The standard diagnostic technique consists of mites' identification by microscopic examination of scales obtained by skin scraping. This is a time-consuming and risk-associated procedure that is also not suitable to a busy practice. In recent years, some advanced and noninvasive techniques such as videodermatoscopy, dermatoscopy, reflectance confocal microscopy, and optical coherence tomography have demonstrated improved efficacy in the diagnosis of scabies. Their advantages include rapid, noninvasive mass screening and post-therapeutic follow-up, with no physical risk. A greater knowledge of these techniques among general practitioners and other specialists involved in the intake care of overcrowded populations vulnerable to scabies infestations is now viewed as urgent and important in the management of outbreaks, as well as in consideration of the recent growing inflow of migrants in Europe from North Africa. PMID:27311065

  16. CBCT Use in Endodontic Diagnosis.

    PubMed

    Beach, David A

    2016-02-01

    Endodontic diagnosis and treatment planning has taken a giant leap forward due to introduction of CBCT in dentistry. While conventional 2-D radiographs remain the most cost-effective and routine method to evaluate a patient’s dentition, their diagnostic potential is limited. The 3-D manipulation of images that CBCT offers provides better insight into diagnostic dilemmas and complicate treatment decisions. Despite the advantages of CBCT imaging, it should be used complimentary to 2-D radiography, not as a replacement. The principle of ALARA (in which patients should be exposed to radiation “as low as reasonably achievable”), still applies to this technology. CBCT should not be used routinely in the absence of clinical signs or symptoms that necessitate a more in-depth view of a tooth and surrounding structures. In other words, if a conventional 2-D radiograph will suffice, then a CBCT pretreatment scan is not necessary. However, if more information is needed to make an accurate diagnosis, a 3-D CBCT image is justified and highly beneficial as shown through several case examples share in this article.

  17. CBCT Use in Endodontic Diagnosis.

    PubMed

    Beach, David A

    2016-02-01

    Endodontic diagnosis and treatment planning has taken a giant leap forward due to introduction of CBCT in dentistry. While conventional 2-D radiographs remain the most cost-effective and routine method to evaluate a patient’s dentition, their diagnostic potential is limited. The 3-D manipulation of images that CBCT offers provides better insight into diagnostic dilemmas and complicate treatment decisions. Despite the advantages of CBCT imaging, it should be used complimentary to 2-D radiography, not as a replacement. The principle of ALARA (in which patients should be exposed to radiation “as low as reasonably achievable”), still applies to this technology. CBCT should not be used routinely in the absence of clinical signs or symptoms that necessitate a more in-depth view of a tooth and surrounding structures. In other words, if a conventional 2-D radiograph will suffice, then a CBCT pretreatment scan is not necessary. However, if more information is needed to make an accurate diagnosis, a 3-D CBCT image is justified and highly beneficial as shown through several case examples share in this article. PMID:26995838

  18. [Early diagnosis of rheumatoid arthritis].

    PubMed

    Badot, V

    2014-09-01

    Rheumatoid arthritis is the most common chronic inflammatory rheumatic disorder, and is characterized by inflammation of the joint, which can lead to irreversible bone damage, joint deformity and disability, if not diagnosed timely or treated adequately. New classification criteria were developed in 2010 in order to identify patients at risk of developing persistent or erosive arthritis, and requiring early therapy. In order to detect early arthritis or bone erosions before their appearance on X-rays, ultrasound and magnetic resonance imaging are now routinely used by clinicians, and also seem to deliver prognostic information about the disease. Synovial biopsies are potentially interesting in case of early arthritis to identify markers of diagnosis, prognosis or therapeutic response. Genetic or environmental risk factors were described to play a role in the development or maintenance of the disease; they could also help to screen early RA. A rapid diagnosis is eventually based on the right information and a tight collaboration between the primary care physician and the rheumatology care specialist. PMID:25675622

  19. Caries diagnosis using laser fluorescence

    NASA Astrophysics Data System (ADS)

    Zanin, Fatima A. A.; Pinheiro, Antonio L. B.; Souza-Campos, Dilma H.; Brugnera, Aldo, Jr.; Pecora, Jesus D.

    2000-03-01

    Caries prevention is a goal to be achieved by dentist in order to promote health. There are several methods used to detect dental caries each one presenting advantages and disadvantages, especially regarding hidden occlusal caries. The improvement of laser technology has permitted the use of laser fluorescence for early diagnosis of hidden occlusal caries. The aim of this study was to assess the efficacy of the use of 655 nm laser light on the detection of hidden occlusal caries. Forty molar teeth from patients of both sexes which ages ranging from 10 - 18 years old were used on this study. Following manufacture's instructions regarding the use of the equipment, the teeth had their occlusal surface examined with the DIAGNOdent. Twenty six of 40 teeth had hidden occlusal caries detected by the DIAGNOdent. However only 17 of these 26 teeth showed radiographic signs of caries the other 9 teeth showed no radiological signs of the lesion. Radiographic examination was able to identify 34,61% of false negative cases. This means that many caries would be left untreated due to the lack of diagnosis using both visual and radiographic examination. The use of the DIAGNOdent was effective in successfully detecting hidden occlusal caries.

  20. Early diagnosis of lung cancer

    NASA Astrophysics Data System (ADS)

    Saccomanno, Geno; Bechtel, Joel J.

    1991-06-01

    Lung cancer remains the leading cause of death in the United States. Although the incidence of cigarette smoking is decreasing in the United States it appears to be increasing worldwide. The five-year survival rate has not improved in cases with advanced disease, but several articles have indicated that survival can be improved in cases diagnosed early by sputum cytology and chest x-ray. In cases diagnosed while the lesion is in the in-situ stage or measures less than 1 cm in diameter, surgical excision and/or radiation therapy improves survival; therefore, the early diagnosis of high-risk patients should be vigorously pursued. A recent study at a community hospital in Grand Junction, Colorado, presented 45 lung cancer cases diagnosed with positive sputum cytology and negative chest x-ray, and indicates that early diagnosis does improve survival. This study has been conducted during the past six years; 16 cases have survived three years and six cases show five-year survival.

  1. [Prenatal diagnosis of choledochal cyst].

    PubMed

    Hernández Herrera, Ricardo Jorge; Flores Santos, Roberto; Hinojosa Salinas, Adán; Ramos González, René; Ramírez González, Beatriz

    2013-02-01

    The choledocal cyst is a defect of the biliary extrahepatic route, the incidence is 1 in 100-150,000 newborns. This paper reports the case of a female newborn with choledocal cyst detected prenatally, from a 32-year-old mother, 2nd term pregnancy, who was diagnosed in the routine obstetric ultrasound as an abdominal fetal cyst. An anatomic obstetric ultrasound confirmed the diagnosis that was defined of a probable hepatic origin. Newborn was delivered at 39 weeks by caesarean section, with weight of 3,980 g and Apgar score 9-9 in conventional time. Newborn presented a maxim bilirubin level of 16 mg, controlled with phototherapy; the hepatic function was normal. Ultrasound showed a choledocal cyst which measured 50 x 49 x 48 mm, with dilatation of the hepatic common conduct, the gall bladder was normal. The abdominal scan reported a cystic mass in the middle abdominal region of 44 x 53 x 52 mm confirming a choledocal cyst. The diagnosis was confirmed after surgery. Patient had a satisfactory post-surgical evolution. PMID:23596735

  2. [Radionuclide diagnosis of acute pyelonephritis].

    PubMed

    Mil'ko, V I; Moskalenko, N I; Tikhonenko, E P

    1986-01-01

    Nephroscintigraphy using a 67Ga-citrate complex and 99mTc-pyrophosphate was performed in 88 patients with acute pyelonephritis. Nuclide hyperfixation was revealed in 97.8% of the cases. Three groups of patients were singled out on the basis of the intensity of incorporation and nature of the distribution of the radiopharmaceuticals (RP) in the kidneys. In the 1st group the RP incorporation was insignificant but higher than normal values; the RP distribution in the affected kidney was diffuse-inhomogenous. These changes were considered to be typical of acute serous pyelonephritis. In the 2nd and 3rd groups a sharp rise of the RP accumulation was noted, being typical of acute purulent pyelonephritis. One could distinguish between diffuse and focal lesions by the picture of the RP distribution in the renal parenchyma. Diuresis stimulation made it possible to differentiate an actual nuclide fixation during inflammation from nuclide mechanical retention as a result of urine outflow disorder. According to the authors, both radiopharmaceuticals could be applied for the diagnosis of acute pyelonephritis as well as for differential diagnosis of various forms of the disease. PMID:3001474

  3. [Radioimmunotargeting: diagnosis and therapeutic use].

    PubMed

    Vuillez, J P

    2000-11-01

    Monoclonal antibodies labeled with a radionuclide make feasible the in vivo radioimmunotargeting of tumor cells. This targeting could be performed for diagnosis, using gamma emitters, or for therapeutic purpose when antibodies are labeled with beta- and in the future alpha-emitters. Diagnosis applications (tumor detection and caracterization), i.e. immunoscintigraphy, have been widely investigated during 20 last years. This technic appeared quite interesting, complementary of morphological imaging, and clinically useful, but difficult on a practical point of view because of several pharmacological and immunological limitations. For these reasons, despite several consequent improvements (especially two-steps or pre-targeting methods), immunoscintigraphy is currently not widely used; furthermore, other scintigraphic methods, mainly positron emission tomography with 18F-fluorodeoxyglucose, are efficient and easier to perform. On the other hand, knowledge of the biodistribution of radiolabeled antibodies allows the development of their therapeutic use, i.e. radioimmunotherapy, which represents a new method of cancer treatment. Radioimmunotherapy has several particular radiobiological and dosimetric aspects, which remain widely under investigation. Understanding of these aspects, together with a better delineation of the indications, allow to be really optimist concerning this new way of cancer treatment, as shown by clinical results that have been obtained in non Hodgkin's lymphoma. Radiolabeled immunoconjugates appears as a growing field in nuclear medicine, which sustains numerous preclinical and clinical studies. PMID:11125290

  4. Scabies: Advances in Noninvasive Diagnosis

    PubMed Central

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

    2016-01-01

    Scabies is a common, highly contagious skin parasitosis caused by Sarcoptes scabiei var. hominis. Early identification and prompt treatment of infested subjects is essential, as missed diagnosis may result in outbreaks, considerable morbidity, and significantly increased economic burden. The standard diagnostic technique consists of mites’ identification by microscopic examination of scales obtained by skin scraping. This is a time-consuming and risk-associated procedure that is also not suitable to a busy practice. In recent years, some advanced and noninvasive techniques such as videodermatoscopy, dermatoscopy, reflectance confocal microscopy, and optical coherence tomography have demonstrated improved efficacy in the diagnosis of scabies. Their advantages include rapid, noninvasive mass screening and post-therapeutic follow-up, with no physical risk. A greater knowledge of these techniques among general practitioners and other specialists involved in the intake care of overcrowded populations vulnerable to scabies infestations is now viewed as urgent and important in the management of outbreaks, as well as in consideration of the recent growing inflow of migrants in Europe from North Africa. PMID:27311065

  5. Diagnosis of congenital fibrinogen disorders.

    PubMed

    Lebreton, Aurélien; Casini, Alessandro

    2016-08-01

    Congenital fibrinogen disorders comprise quantitative disorders defined by a complete absence (afibrinogenemia) or by a decreased level (hypofibrinogenemia) of circulating fibrinogen and qualitative disorders characterized by a discrepancy between the activity and the antigenic levels of fibrinogen (dysfibrinogenemia and hypodysfibrinogenemia). The biological diagnosis is based on a standard haemostasis assessment. All the coagulation tests that depend on the formation of fibrin as the end point are affected; although in dysfibrinogenemia the specificity and sensitivity of routine test depend on reagent and techniques. A genetic exploration permits to confirm the diagnosis and may enhance the prediction of the patient's phenotype. Homozygous or composite heterozygous null mutations are most often responsible for afibrinogenemia while hypofibrinogenemic patients are mainly heterozygous carrier of an afibrinogenemic allele. Heterozygous missense mutations are prevalent in dysfibrinogenemia, with two hot spot localized in exon 2 of the FGA and in the exon 8 of the FGG. The correlation between phenotype and genotype has been identified in some fibrinogen variants, including six mutations clustered in exons 8 and 9 of the FGG leading to hypofibrinogenemia with hepatic inclusions of abnormal fibrinogen aggregates as well as a few mutations associated with an increase risk of thrombotic events. A familial screening and additional functional assays should be carried out when possible.

  6. Velopharyngeal insufficiency: diagnosis and management

    PubMed Central

    Shprintzen, Robert J.; Marrinan, Eileen

    2009-01-01

    Purpose of Review Journal articles relevant to the diagnosis and treatment of velopharyngeal insufficiency (VPI) were reviewed. All articles ascertained by PubMed search were included. Recent Findings Articles reported on the application of magnetic resonance scanning, reliability tests of the International Working Group diagnostic protocol, the use of nasometry, and techniques designed to assess the function of the velopharyngeal mechanism. Treatment papers focused on outcomes in small samples of cases and complication rates from pharyngeal flap. One paper discussed ineffective speech therapy procedures. Summary There were relatively few papers this past year. Those that were published were hindered by small and heterogeneous sample sizes, and occasionally by inappropriate methods for assessing outcomes. None of the findings will have a major impact on the current state-of-the-art for diagnosis of VPI. The speech therapy paper has a very important message that should be taken to heart by all clinicians involved in the management of children with clefts and craniofacial disorders. PMID:19448542

  7. Laboratory diagnosis of bacterial meningitis.

    PubMed Central

    Gray, L D; Fedorko, D P

    1992-01-01

    Bacterial meningitis is relatively common, can progress rapidly, and can result in death or permanent debilitation. This infection justifiably elicits strong emotional reactions and, hopefully, immediate medical intervention. This review is a brief presentation of the pathogenesis of bacterial meningitis and a review of current knowledge, literature, and recommendations on the subject of laboratory diagnosis of bacterial meningitis. Those who work in clinical microbiology laboratories should be familiar with the tests used in detecting bacteria and bacterial antigens in cerebrospinal fluid (CSF) and should always have the utmost appreciation for the fact that results of such tests must always be reported immediately. Academic and practical aspects of the laboratory diagnosis of bacterial meningitis presented in this review include the following: anatomy of the meninges; pathogenesis; changes in the composition of CSF; etiological agents; processing CSF; microscopic examination of CSF; culturing CSF; methods of detecting bacterial antigens and bacterial components in CSF (counter-immunoelectrophoresis, coagglutination, latex agglutination, enzyme-linked immunosorbent assay, Limulus amebocyte lysate assay, and gas-liquid chromatography); use of the polymerase chain reaction; and practical considerations for testing CSF for bacterial antigens. PMID:1576585

  8. Hemimegalencephaly: prenatal diagnosis and outcome.

    PubMed

    Alvarez, Rosa María; García-Díaz, Lutgardo; Márquez, Javier; Fajardo, Manuel; Rivas, Eloy; García-Lozano, Juan Carlos; Antiñolo, Guillermo

    2011-01-01

    Hemimegalencephaly (HME) is a developmental abnormality of the central nervous system (CNS) which may present as either a syndromic or isolated case. Here, we present two cases of early prenatal diagnosis of HME. Prenatal CNS ultrasound and MRI in the first case revealed ventricular asymmetry, midline shift with displacement of the occipital lobe across the midline, large dilatation mainly at the posterior horn of the left lateral ventricle, and a head circumference in the 90th percentile without involvement of the brain stem and cerebellum, as well as abdominal lymphangioma. Right hemispherectomy was performed at 3 months of age due to intractable seizures. The pathological specimen showed findings characteristic of HME, including a disorganized cytoarchitecture with lack of neuronal lamination, focal areas of polymicrogyria, and neuronal heterotopias with dysplastic cells. In the second case, 2D and 3D neurosonography demonstrated similar findings (asymmetry of cerebral hemispheres, midline shift, and dilation of the posterior horn of the left lateral cerebral ventricle). Posterior fossa structures were unremarkable. HME was diagnosed and the pregnancy was terminated. Autopsy findings confirmed the diagnosis of HME.

  9. Meralgia Paresthetica, The Elusive Diagnosis

    PubMed Central

    Ivins, Gregory K.

    2000-01-01

    Objective To discuss the diagnosis and treatment of meralgia paresthetica as reported in the literature and as experienced by the author. Summary Background Data Meralgia paresthetica is a mononeuropathy of the lateral femoral cutaneous nerve that can lead to significant disability when the diagnosis and treatment is delayed or missed. This condition is relatively common but is frequently mistaken for other disorders. Methods Fifteen cases of meralgia paresthetica were identified in 14 patients in a private surgical practice during a 4-year period. All patients were initially treated conservatively and seven patients subsequently underwent surgical treatment. Follow-up ranged from 3 to 6 years. Results Conservative management consisting of local analgesics, steroids, nonsteroidal antiinflammatories, rest, and reduction or elimination of aggravating factors yielded long-lasting improvement in five patients with meralgia paresthetica. Nine patients with 10 cases of meralgia paresthetica did not benefit in the long term from conservative management. Seven of these patients, representing eight cases of meralgia paresthetica, ultimately opted for surgical management, and all obtained good long-term relief of symptoms. Conclusion Surgical management of meralgia paresthetica is a viable option for patients in whom medical management fails. Based on the published literature and the author’s experience, a rationale is presented for determining the appropriate surgical management of these patients. PMID:10903608

  10. Fibromyalgia syndrome: presentation, diagnosis, differential diagnosis, and vulnerability.

    PubMed

    Russell, I Jon; Raphael, Karen G

    2008-03-01

    Fibromyalgia syndrome (FMS) presents with widespread soft tissue pain. Common comorbidities include severe insomnia, body stiffness, affective symptoms, irritable bowels, and urethral syndrome. A 1990 research classification depends on a history of widespread pain and prominent tenderness to palpation at 11 or more of 18 specific tender points. It is a criteria-based diagnosis rather than one by exclusion and can accompany other medical conditions. FMS occurs worldwide, and can present any age, but is most common in adult females. Although numerous studies and reviews contend that FMS may be caused by psychological stress such as sexual abuse, critical epidemiological review fails to support that concept. Existing data suggest that some individuals with FMS may have a dysregulated physiological stress response system that predates the onset of symptoms.

  11. Rabies Diagnosis for Developing Countries

    PubMed Central

    Dürr, Salome; Naïssengar, Service; Mindekem, Rolande; Diguimbye, Colette; Niezgoda, Michael; Kuzmin, Ivan; Rupprecht, Charles E.; Zinsstag, Jakob

    2008-01-01

    Background Canine rabies is a neglected disease causing 55,000 human deaths worldwide per year, and 99% of all cases are transmitted by dog bites. In N'Djaména, the capital of Chad, rabies is endemic with an incidence of 1.71/1,000 dogs (95% C.I. 1.45–1.98). The gold standard of rabies diagnosis is the direct immunofluorescent antibody (DFA) test, requiring a fluorescent microscope. The Centers for Disease Control and Prevention (CDC, Atlanta, United States of America) developed a histochemical test using low-cost light microscopy, the direct rapid immunohistochemical test (dRIT). Methodology/Principal Findings We evaluated the dRIT in the Chadian National Veterinary Laboratory in N'Djaména by testing 35 fresh samples parallel with both the DFA and dRIT. Additional retests (n = 68 in Chad, n = 74 at CDC) by DFA and dRIT of stored samples enhanced the power of the evaluation. All samples were from dogs, cats, and in one case from a bat. The dRIT performed very well compared to DFA. We found a 100% agreement of the dRIT and DFA in fresh samples (n = 35). Results of retesting at CDC and in Chad depended on the condition of samples. When the sample was in good condition (fresh brain tissue), we found simple Cohen's kappa coefficient related to the DFA diagnostic results in fresh tissue of 0.87 (95% C.I. 0.63–1) up to 1. For poor quality samples, the kappa values were between 0.13 (95% C.I. −0.15–0.40) and 0.48 (95% C.I. 0.14–0.82). For samples stored in glycerol, dRIT results were more likely to agree with DFA testing in fresh samples than the DFA retesting. Conclusion/Significance The dRIT is as reliable a diagnostic method as the gold standard (DFA) for fresh samples. It has an advantage of requiring only light microscopy, which is 10 times less expensive than a fluorescence microscope. Reduced cost suggests high potential for making rabies diagnosis available in other cities and rural areas of Africa for large populations for which a capacity

  12. The Reliability of Psychiatric Diagnosis Revisited

    PubMed Central

    Rankin, Eric; France, Cheryl; El-Missiry, Ahmed; John, Collin

    2006-01-01

    Background: The authors reviewed the topic of reliability of psychiatric diagnosis from the turn of the 20th century to present. The objectives of this paper are to explore the reasons of unreliability of psychiatric diagnosis and propose ways to improve the reliability of psychiatric diagnosis. Method: The authors reviewed the literature on the concept of reliability of psychiatric diagnosis with emphasis on the impact of interviewing skills, use of diagnostic criteria, and structured interviews on the reliability of psychiatric diagnosis. Results: Causes of diagnostic unreliability are attributed to the patient, the clinician and psychiatric nomenclature. The reliability of psychiatric diagnosis can be enhanced by using diagnostic criteria, defining psychiatric symptoms and structuring the interviews. Conclusions: The authors propose the acronym ‘DR.SED,' which stands for diagnostic criteria, reference definitions, structuring the interview, clinical experience, and data. The authors recommend that clinicians use the DR.SED paradigm to improve the reliability of psychiatric diagnoses. PMID:21103149

  13. Model-based reconfiguration: Diagnosis and recovery

    NASA Technical Reports Server (NTRS)

    Crow, Judy; Rushby, John

    1994-01-01

    We extend Reiter's general theory of model-based diagnosis to a theory of fault detection, identification, and reconfiguration (FDIR). The generality of Reiter's theory readily supports an extension in which the problem of reconfiguration is viewed as a close analog of the problem of diagnosis. Using a reconfiguration predicate 'rcfg' analogous to the abnormality predicate 'ab,' we derive a strategy for reconfiguration by transforming the corresponding strategy for diagnosis. There are two obvious benefits of this approach: algorithms for diagnosis can be exploited as algorithms for reconfiguration and we have a theoretical framework for an integrated approach to FDIR. As a first step toward realizing these benefits we show that a class of diagnosis engines can be used for reconfiguration and we discuss algorithms for integrated FDIR. We argue that integrating recovery and diagnosis is an essential next step if this technology is to be useful for practical applications.

  14. Optical diagnosis of acute scrotum in children

    NASA Astrophysics Data System (ADS)

    Shadgan, Babak; Macnab, Andrew; Stothers, Lynn; Nigro, Mark; Afshar, Kourosh; Kajbafzadeh, A. M.

    2015-03-01

    Acute scrotum is a urologic condition defined by scrotal pain, swelling, and redness of acute onset. Prompt diagnosis and treatment are necessary to preserve testicular viability. The history and clinical symptoms reported are key to diagnosis and proper treatment, but are not always readily obtained in children, in whom common causes of acute scrotum include testicular torsion, torsion of the appendix testis, and epididymitis. These acute conditions have different causal pathology that mandate specific treatment, hence the importance of early and accurate diagnosis.

  15. Efficient Model-Based Diagnosis Engine

    NASA Technical Reports Server (NTRS)

    Fijany, Amir; Vatan, Farrokh; Barrett, Anthony; James, Mark; Mackey, Ryan; Williams, Colin

    2009-01-01

    An efficient diagnosis engine - a combination of mathematical models and algorithms - has been developed for identifying faulty components in a possibly complex engineering system. This model-based diagnosis engine embodies a twofold approach to reducing, relative to prior model-based diagnosis engines, the amount of computation needed to perform a thorough, accurate diagnosis. The first part of the approach involves a reconstruction of the general diagnostic engine to reduce the complexity of the mathematical-model calculations and of the software needed to perform them. The second part of the approach involves algorithms for computing a minimal diagnosis (the term "minimal diagnosis" is defined below). A somewhat lengthy background discussion is prerequisite to a meaningful summary of the innovative aspects of the present efficient model-based diagnosis engine. In model-based diagnosis, the function of each component and the relationships among all the components of the engineering system to be diagnosed are represented as a logical system denoted the system description (SD). Hence, the expected normal behavior of the engineering system is the set of logical consequences of the SD. Faulty components lead to inconsistencies between the observed behaviors of the system and the SD (see figure). Diagnosis - the task of finding faulty components - is reduced to finding those components, the abnormalities of which could explain all the inconsistencies. The solution of the diagnosis problem should be a minimal diagnosis, which is a minimal set of faulty components. A minimal diagnosis stands in contradistinction to the trivial solution, in which all components are deemed to be faulty, and which, therefore, always explains all inconsistencies.

  16. [Ultrasound diagnosis in patients with renal colic].

    PubMed

    Belyĭ, L E

    2009-01-01

    The paper is devoted to ultrasonography of the upper urinary tract with reference to ultrasound semiotics of its acute obstruction, detection of hydronephrotic transformation of the kidneys, and methods for optimization of ultrasound diagnosis of urodynamics. Merits and demerits of ultrasound technique for the diagnosis of renal colic are discussed. Major difficulties encountered in dopplerographic diagnosis of disturbed urine passage and renal hemodynamics are described.

  17. [Progresses in the diagnosis of allergy].

    PubMed

    Nieto, Antonio; Nieto, María; Mazón, Angel

    2014-01-01

    The traditional diagnosis of allergy by Prick tests and/or RAST offers very limited information about the real nature of allergic problems and of their clinical, therapeutic and prognostic implications. The diagnosis by allergic components (natural or recombinant) suppose a great qualitative step leading a great improving in the diagnosis and treatment of allergic patients, because its use with clinical history and other diagnostic in vivo or in vitro methods improve importantly the diagnostic accuracy.

  18. Pollen Allergens for Molecular Diagnosis.

    PubMed

    Pablos, Isabel; Wildner, Sabrina; Asam, Claudia; Wallner, Michael; Gadermaier, Gabriele

    2016-04-01

    Pollen allergens are one of the main causes of type I allergies affecting up to 30% of the population in industrialized countries. Climatic changes affect the duration and intensity of pollen seasons and may together with pollution contribute to increased incidences of respiratory allergy and asthma. Allergenic grasses, trees, and weeds often present similar habitats and flowering periods compromising clinical anamnesis. Molecule-based approaches enable distinction between genuine sensitization and clinically mostly irrelevant IgE cross-reactivity due to, e. g., panallergens or carbohydrate determinants. In addition, sensitivity as well as specificity can be improved and lead to identification of the primary sensitizing source which is particularly beneficial regarding polysensitized patients. This review gives an overview on relevant pollen allergens and their usefulness in daily practice. Appropriate allergy diagnosis is directly influencing decisions for therapeutic interventions, and thus, reliable biomarkers are pivotal when considering allergen immunotherapy in the context of precision medicine.

  19. DNA Methylation and Cancer Diagnosis

    PubMed Central

    Delpu, Yannick; Cordelier, Pierre; Cho, William C.; Torrisani, Jérôme

    2013-01-01

    DNA methylation is a major epigenetic modification that is strongly involved in the physiological control of genome expression. DNA methylation patterns are largely modified in cancer cells and can therefore be used to distinguish cancer cells from normal tissues. This review describes the main technologies available for the detection and the discovery of aberrantly methylated DNA patterns. It also presents the different sources of biological samples suitable for DNA methylation studies. We discuss the interest and perspectives on the use of DNA methylation measurements for cancer diagnosis through examples of methylated genes commonly documented in the literature. The discussion leads to our consideration for why DNA methylation is not commonly used in clinical practice through an examination of the main requirements that constitute a reliable biomarker. Finally, we describe the main DNA methylation inhibitors currently used in clinical trials and those that exhibit promising results. PMID:23873296

  20. Diagnosis and treatment of impetigo.

    PubMed

    Cole, Charles; Gazewood, John

    2007-03-15

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

  1. Artificial intelligence in medical diagnosis.

    PubMed

    Szolovits, P; Patil, R S; Schwartz, W B

    1988-01-01

    In an attempt to overcome limitations inherent in conventional computer-aided diagnosis, investigators have created programs that simulate expert human reasoning. Hopes that such a strategy would lead to clinically useful programs have not been fulfilled, but many of the problems impeding creation of effective artificial intelligence programs have been solved. Strategies have been developed to limit the number of hypotheses that a program must consider and to incorporate pathophysiologic reasoning. The latter innovation permits a program to analyze cases in which one disorder influences the presentation of another. Prototypes embodying such reasoning can explain their conclusions in medical terms that can be reviewed by the user. Despite these advances, further major research and developmental efforts will be necessary before expert performance by the computer becomes a reality.

  2. The modern diagnosis of syphilis

    PubMed Central

    Olansky, Sidney; Price, I. N. Orpwood

    1956-01-01

    After briefly outlining the natural history of syphilitic infection, the authors review in detail the diagnosis of syphilis in the various stages of the disease and discuss the relative value at each stage of the commonly used serological tests and the Treponema pallidum immobilization (TPI) test. In their conclusions, they remark that the TPI test should be used with discretion and not as a matter of routine with all sera. Owing to its complexities and to the lengthy procedure involved, it is better suited for use with “problem” sera, for instance, sera from expectant mothers suspected of being acute non-treponemal reactors, or sera from persons with latent syphilis. PMID:13329849

  3. Antenatal Diagnosis of Alobar Holoprosencephaly

    PubMed Central

    Raman, Rajesh; Mukunda Jagadesh, Geetha

    2014-01-01

    A twenty-year-old second gravida presented to the department of radiodiagnosis for routine obstetric ultrasound examination. Ultrasonography revealed a live fetus of 17 weeks with absent falx, fused thalami, monoventricle, proboscis, and cyclopia. Fetal MRI was performed and the findings were confirmed. Even though ultrasonography is diagnostic in the detection of fetal anomalies, MRI plays a vital role due to its multiplanar capability and excellent soft tissue resolution. The importance of presenting this classical case of alobar holoprosencephaly is to sensitize the clinicians and radiologists to the imaging manifestations of holoprosencephaly and to stress the importance of early diagnosis. If diagnosed in utero at an early stage of pregnancy, termination can be performed and maternal psychological trauma of bearing a deformed fetus can be avoided. PMID:25126440

  4. Prenatal diagnosis of colobomatous microphthalmos.

    PubMed

    Dar, Suhail A; Johal, Sheila C; Marino, Meghan J; Singh, Arun D

    2015-01-01

    Optic nerve coloboma and microphthalmos with colobomatous cyst are rare congenital anomalies that are difficult to detect on prenatal ultrasonography and magnetic resonance imaging. Only four cases of optic nerve coloboma and two cases of microphthalmos with colobomatous cyst have been detected on prenatal imaging. The authors report a case of a fetus initially suspected to have retinoblastoma of the right eye on prenatal ultrasonography who was later diagnosed as having microphthalmos on fetal magnetic resonance imaging. Following delivery, she was noted to have microphthalmos with colobomatous cyst of the right eye and optic nerve coloboma of the left eye. The authors also review the prenatal ocular imaging findings of the differential diagnosis. PMID:25942066

  5. [Reverse genetics and prenatal diagnosis].

    PubMed

    Plauchu, H

    1988-05-01

    "Reverse" genetics is a research process consisting in finding the gene of a disease, then in "descending" toward the final product that it codes. This reasoning is the reverse of the one normally used which "ascends from the protein to the gene" and can be applied to the discovery of the pathogenic mechanism of a disease. There are numerous spin-offs of this new type of approach for prenatal diagnosis (PND). Thus, the discovery of polymorphic tracers surrounding the gene enables an indirect PND in informative families. Reliability is great if we have many probes at our disposal. Then, discovery of the gene itself permits a direct PND with the use of intragenic probes and synthetic oligonucleotides.

  6. Diagnosis and Treatment of Hypopituitarism

    PubMed Central

    2015-01-01

    Hypopituitarism is a chronic endocrine illness that caused by varied etiologies. Clinical manifestations of hypopituitarism are variable, often insidious in onset and dependent on the degree and severity of hormone deficiency. However, it is associated with increased mortality and morbidity. Therefore, early diagnosis and prompt treatment is necessary. Hypopituitarism can be easily diagnosed by measuring basal pituitary and target hormone levels except growth hormone (GH) and adrenocorticotropic hormone (ACTH) deficiency. Dynamic stimulation tests are indicated in equivocal basal hormone levels and GH/ACTH deficiency. Knowledge of the use and limitations of these stimulation tests is mandatory for proper interpretation. It is necessary for physicians to inform their patients that they may require lifetime treatment. Hormone replacement therapy should be individualized according to the specific needs of each patient, taking into account possible interactions. Long-term endocrinological follow-up of hypopituitary patients is important to monitor hormonal replacement regimes and avoid under- or overtreatment. PMID:26790380

  7. Diagnosis of hyperandrogenism: biochemical criteria.

    PubMed

    Stanczyk, Frank Z

    2006-06-01

    Biochemical derangements in ovarian, adrenal, and peripheral androgen production and metabolism play an important role in underlying causes of hyperandrogenism. Specific diagnostic serum markers such as testosterone (total) and dehydroepiandrosterone sulfate (DHEAS), respectively, may be helpful in the diagnosis of ovarian and adrenal hyperandrogenism, respectively. Validated immunoassays or mass spectrometry assays should be used to quantify testosterone, DHEAS and other principal androgens. Free testosterone measurements, determined by equilibrium dialysis or the calculated method, are advocated for routine evaluation of more subtle forms of hyperandrogenism. The skin, with its pilosebaceous units (PSUs), is an important site of active androgen production. A key regulator in PSUs is 5alpha-reductase, which transforms testosterone or androstenedione to dihydrotestosterone (DHT). DHT in blood is not effective in indicating the presence of hyperandrogenism. However, distal metabolites of DHT have been shown to be good markers of clinical manifestations of hirsutism, acne and alopecia. Assays for these peripheral markers need improvement for routine clinical testing. PMID:16772150

  8. Systemic vasculitis: a dual diagnosis?

    PubMed

    Gil, Eliza; Lutalo, Pamela; D'Cruz, David

    2011-12-02

    The authors describe a 25-year-old male with systemic vasculitis fulfilling the American College of Rheumatology classification criteria for both granulomatosis with polyangiitis (Wegener's granulomatosis) and polyarteritis nodosa. The patient was diagnosed with granulomatosis with polyangiitis following a mediastinal biopsy which revealed necrotising granulomas of the large airways, a positive cytoplasmic antineutrophil cytoplasmic antibodies and high antiproteinase 3 antibody titre. He then developed acute right-sided abdominal and testicular pain as well as areas of hyperaesthesia and parasthesiae on both lower limbs. He was found to have focal crescentic glomerulonephritis and mononeuritis multiplex, in keeping with his diagnosis of granulomatosis with polyangiitis, as well as two areas of infarction in his right testicle and multiple aneurysms of his hepatic and right renal arteries, more typical of polyarteritis nodosa. His symptoms developed 6 weeks after hepatitis B vaccination, which may have played an aetiological role.

  9. [Rapid diagnosis of diarrhea viruses].

    PubMed

    Loginov, Raisa; Mannonen, Laura; Lappalainen, Maija

    2016-01-01

    Viral diagnosis is required mainly in the analysis of outbreaks of diarrhea, cases of gastroenteritis in infants and in the exploration of the cause of diarrhea in severely ill patients. Antigens of rotaviruses and adenoviruses can be detected in the feces of the patient, and the rapid tests applied have proven to possess sufficient sensitivity. Sensitivities of the tests intended for norovirus antigen detection have instead remained poor. In addition to antigen detection tests, a real-time PCR test based on the,detection of norovirus nucleic acids has come onto the market, being both easy to use and substantially more sensitive. In the future, multiplex PCR tests allowing simultaneous detection of several different diarrhea-causing microorganisms are expected to become more common. PMID:27188089

  10. Diagnosis of adult GH deficiency.

    PubMed

    Ghigo, E; Aimaretti, G; Corneli, G

    2008-02-01

    The current guidelines for the diagnosis of adult GHD are mainly based on the statements from the GH Research Society Consensus from Port Stevens in 1997. It is stated that diagnosis of adult GHD must be shown biochemically by provocative tests within the appropriate clinical context. The insulin tolerance test (ITT) was indicated as that of choice and severe GHD defined by a GH peak lower than 3 microg/L. The need to rely on provocative tests is based on evidence that that the measurement of IGF-I as well as of IGFBP-3 levels does not distinguish between normal and GHD subjects. Hypoglycemia may be contraindicated; thus, alternative provocative tests were considered, provided they are used with appropriate cut-off limits. Among classical provocative tests, arginine and glucagon alone were indicated as alternative tests, although less discriminatory than ITT. Testing with the combined administration of GHRH plus arginine was recommended as an alternative to ITT, mostly taking into account its marked specificity. Based on data in the literature in the last decade, the GRS Consensus Statements should be appropriately amended. Regarding the appropriate clinical context for the suspicion of adult GHD, one should evaluate patients with hypothalamic or pituitary disease or a history of cranial irradiation, as well as those with childhood-onset GHD are at obvious risk as adults for severe GHD. Brain injuries (trauma, subarachnoid hemorrage, tumours of the central nervous system) very often cause acquired hypopituitarism, including severe GHD. Given the epidemiology of brain injuries, the important role of the endocrinologist in providing major clinical benefit to brain injured patients who are still undiagnosed should be underscored. From the biochemical point of view, although normal IGF-I levels do not rule out severe GHD, very low IGF-I levels in patients highly suspected for GHD (i.e. patients with childhood-onset, severe GHD or with multiple hypopituitarism acquired

  11. Diagnosis and Treatment of Delirium

    PubMed Central

    Henry, W. Desmond; Mann, Alan M.

    1965-01-01

    Delirium is not a clinical entity but a symptom-complex of manifold etiology. Its presence signifies acute cerebral insufficiency and often represents a medical and/or psychiatric emergency. Though some forms of delirium have distinctive features, the fundamental phenomena are common to all, with clouding of consciousness the sine qua non. The condition has two major components: (1) the basic “acute brain syndrome” and (2) associated release phenomena. Clinicians must first make the vital differentiation between delirium and “functional” mental disorder, then proceed with the elucidation of the underlying diagnosis and the concurrent organization of symptomatic and etiologic treatment. Proper treatment combines management of the acute brain syndrome with general and specific procedures for control of the underlying condition. Dealing with the symptom-complex itself involves the principles and practice of sedation, hydration, and nutrition, nursing care and supportive measures. Provided the basic organic condition is treatable, the prognosis today is usually good. PMID:5844423

  12. Neuropathic itch: diagnosis and management.

    PubMed

    Stumpf, Astrid; Ständer, Sonja

    2013-01-01

    Chronic pruritus (CP) is a frequent symptom in the general population; in 8% of all patients, it has a neuropathic origin. CP is of neuropathic origin when nerve fiber damage is responsible for the symptom. The damage can be caused by compression or degeneration of the nerve fibers in the skin or extracutaneous in peripheral nerves or the central nervous system. There are significant differences in the pathogenesis and in the clinical presentation of neuropathic CP. Localized neuropathic CP such as brachioradial pruritus or notalgia paresthetica are due to a circumscribed nerve compression and are often limited on the corresponding dermatome. In contrast, generalized neuropathic CP, as in small fiber neuropathies, may be associated with a systemic or metabolic underlying disease. It is not always easy to establish the diagnosis because a variety of diseases can be responsible for this type of CP. The present study shows an overview of possible diseases, diagnostic tools, and the relevant therapy strategies. PMID:23551367

  13. Radiological diagnosis of Brodie's abscess.

    PubMed

    Kowalewski, Michał; Swiatkowski, Jan; Michałowska, Ilona; Swiecicka, Dorota

    2002-12-30

    Background. Brodie's abscess is a kind of rare subacute or chronic osteitis. It is probably caused by mistreated or non-treated osteitis, or by bacteria of low virulence.
    Material and methods. In the Orthopedic and Traumatology Clinic of our medical school 5 patients were diagnosed with Brodie's obsecess between 1999 and 2002. all the patients had conventional x-rays, while one also had CT and MRI.
    Results and conclusions. The typical x-ray image shows an osteolytic lesion with sclerotic margin in the diametophysis. Each of the 5 patients had surgery. In 4 cases the histopatological results confirmed the radiological diagnosis. In one case fibrous dysplasia was found.

  14. Intracochlear schwannoma: diagnosis and management.

    PubMed

    Bittencourt, Aline Gomes; Alves, Ricardo Dourado; Ikari, Liliane Satomi; Burke, Patrick Rademaker; Gebrim, Eloisa Maria Santiago; Bento, Ricardo Ferreira

    2014-07-01

    Introduction Schwannomas of the eighth cranial nerve are benign tumors that usually occur in the internal auditory canal or the cerebellopontine angle cistern. Rarely, these tumors may originate from the neural elements within the vestibule, cochlea, or semicircular canals and are called intralabyrinthine schwannomas. Intracochlear schwannomas (ICSs) represent a small percentage of these tumors, and their diagnosis is based on high-resolution magnetic resonance imaging (MRI). Objectives To report the clinical and radiologic features and audiometric testing results of an ICS in a 48-year-old man after a 22-month follow-up period. Resumed Report A patient with an 8-year history of persistent tinnitus in his right ear, combined with ipsilateral progressive hearing loss and aural fullness. Audiometry revealed normal hearing in the left ear and a moderate to severe sensorineural hearing loss in the right ear, with decreased speech reception threshold and word recognition score, compared with the exam performed 5 years previously. MRI showed a small intracochlear nodular lesion in the modiolus, isointense on T1 with a high contrast enhancement on T1 postgadolinium images. During the follow-up period, there were no radiologic changes on imaging studies. Thus, a wait-and-scan policy was chosen as the lesion remained stable with no considerable growth and the patient still presents with residual hearing. Conclusions Once diagnosed, not all ICS patients require surgery. Treatment options for ICS include stereotactic radiotherapy and rescanning policy, depending on the tumor's size, evidence of the tumor's growth, degree of hearing loss, intractable vestibular symptoms, concern about the pathologic diagnosis, and the patient's other medical conditions. PMID:25992114

  15. The Diagnosis of Periprosthetic Infection

    PubMed Central

    del Arco, Alfonso; Bertrand, María Luisa

    2013-01-01

    Periprosthetic infection (PJI) is the most serious joint replacement complication, occurring in 0.8-1.9% of knee arthroplasties and 0.3-1.7% of hip arthroplasties. A definition of PJI was proposed in the November 2011 issue of the journal Clinical Orthopedics and Related Research. The presence of a fistula or of local inflammatory signs is indicative of PJI, but in many cases local pain is the only symptom. In the absence of underlying inflammatory conditions, C-reactive protein measurement is the most useful preoperative blood test for detecting infection associated with a prosthetic joint. The most useful preoperative diagnostic test is the aspiration of synovial joint fluid to obtain a total and differential cell count and culture. Intraoperative frozen sections of periprosthetic tissues produce excellent accuracy in predicting a diagnosis of PJI but only moderate accuracy in ruling out the diagnosis. In this process, obtaining a quality sample is the first step, and determines the quality of microbiological results. Specimens for culture should be obtained prior to the initiation of antibiotic treatment. Sonication of a removed implant may increase the culture yield. Plain radiography has low sensitivity and low specificity for detecting infection associated with a prosthetic joint. Computed tomography and magnetic resonance imaging may be useful in the evaluation of complex cases, but metal inserts interfere with these tests, and abnormalities may be non-specific. Labelled-leucocyte imaging (e.g., leucocytes labelled with indium-111) combined with bone marrow imaging with the use of technetium-99m–labelled sulphur colloid is considered the imaging test of choice when imaging is necessary. PMID:23898349

  16. [Postmortem diagnosis of tropical malaria].

    PubMed

    Albert, S; Schröter, A; Bratzke, H; Brade, V

    1995-01-01

    Thirteen days after returning from a four week holiday in Kenya a 35-year-old man consulted his doctor complaining of feeling unwell. The doctor diagnosed influenza and gave him a sickness certificate for three days. Because the patient did not reappear at his workplace a search was made and he was found dead in his flat seven days after seeing his doctor. A medicolegal autopsy was performed two days after the estimated time of death. There was marked swelling of liver and spleen together with jaundice and "dirty grey" colouration of the viscera. Samples of heart blood and spleen puncture material were taken. Giemsa stained preparations (ordinary and thick blood smears) revealed numerous objects 1.2 to 1.5 microns in size with indistinct reddish blue staining, some of them arranged in rosettes reminiscent of schizonts. A few of them contained pigment. In material from the spleen there were masses of blackish-brown pigment. The malaria immunofluorescence test performed on serum gave a weakly positive titre of 1:40. The findings were considered enough to support a diagnosis of fulminant falciparum malaria, and this was confirmed by histological changes in various organs, notably the typical capillary blockages in the brain. Because of the popularity of long-haul tourism, cases of imported malaria are increasingly frequent and, in view of the insidiously progressive course of the disease, it should always be considered in the differential diagnosis. In cases of unexplained death, if there is any suspicion of malaria, blood should always be taken for appropriate investigations, in addition to blocks for histological examination. PMID:7821199

  17. The diagnosis of periprosthetic infection.

    PubMed

    Del Arco, Alfonso; Bertrand, María Luisa

    2013-01-01

    Periprosthetic infection (PJI) is the most serious joint replacement complication, occurring in 0.8-1.9% of knee arthroplasties and 0.3-1.7% of hip arthroplasties. A definition of PJI was proposed in the November 2011 issue of the journal Clinical Orthopedics and Related Research. The presence of a fistula or of local inflammatory signs is indicative of PJI, but in many cases local pain is the only symptom. In the absence of underlying inflammatory conditions, C-reactive protein measurement is the most useful preoperative blood test for detecting infection associated with a prosthetic joint. The most useful preoperative diagnostic test is the aspiration of synovial joint fluid to obtain a total and differential cell count and culture. Intraoperative frozen sections of periprosthetic tissues produce excellent accuracy in predicting a diagnosis of PJI but only moderate accuracy in ruling out the diagnosis. In this process, obtaining a quality sample is the first step, and determines the quality of microbiological results. Specimens for culture should be obtained prior to the initiation of antibiotic treatment. Sonication of a removed implant may increase the culture yield. Plain radiography has low sensitivity and low specificity for detecting infection associated with a prosthetic joint. Computed tomography and magnetic resonance imaging may be useful in the evaluation of complex cases, but metal inserts interfere with these tests, and abnormalities may be non-specific. Labelled-leucocyte imaging (e.g., leucocytes labelled with indium-111) combined with bone marrow imaging with the use of technetium-99m-labelled sulphur colloid is considered the imaging test of choice when imaging is necessary.

  18. The Future of Prenatal Diagnosis and Screening

    PubMed Central

    Pergament, Eugene

    2014-01-01

    The future of prenatal diagnosis and screening lies in developing clinical approaches and laboratory technologies applicable to genetic analyses and therapeutic interventions during embryonic development. PMID:26237604

  19. Theories of dual diagnosis in mental retardation.

    PubMed

    Matson, J L; Sevin, J A

    1994-02-01

    Dual diagnosis, defined in this instance as the co-occurrence of mental health disorders with mental retardation, has become a major area of clinical practice and research in the past 10 years. Whereas areas such as differential diagnosis, assessment, and prevalence have been major focuses of research, etiologies of dual diagnosis have received less attention. Current etiological theories have practical implications for the treatment and prevention of dual diagnoses and suggest important directions for future research. This article provides a historical review of theory development in the field of dual diagnosis. Current status of etiological theories and future directions are discussed with an aim toward encouraging further study.

  20. Computer vision for microscopy diagnosis of malaria.

    PubMed

    Tek, F Boray; Dempster, Andrew G; Kale, Izzet

    2009-07-13

    This paper reviews computer vision and image analysis studies aiming at automated diagnosis or screening of malaria infection in microscope images of thin blood film smears. Existing works interpret the diagnosis problem differently or propose partial solutions to the problem. A critique of these works is furnished. In addition, a general pattern recognition framework to perform diagnosis, which includes image acquisition, pre-processing, segmentation, and pattern classification components, is described. The open problems are addressed and a perspective of the future work for realization of automated microscopy diagnosis of malaria is provided.

  1. Early Lung Cancer Diagnosis by Biosensors

    PubMed Central

    Zhang, Yuqian; Yang, Dongliang; Weng, Lixing; Wang, Lianhui

    2013-01-01

    Lung cancer causes an extreme threat to human health, and the mortality rate due to lung cancer has not decreased during the last decade. Prognosis or early diagnosis could help reduce the mortality rate. If microRNA and tumor-associated antigens (TAAs), as well as the corresponding autoantibodies, can be detected prior to clinical diagnosis, such high sensitivity of biosensors makes the early diagnosis and prognosis of cancer realizable. This review provides an overview of tumor-associated biomarker identifying methods and the biosensor technology available today. Laboratorial researches utilizing biosensors for early lung cancer diagnosis will be highlighted. PMID:23892596

  2. Dilemmas, diagnosis and de-stigmatization: parental perspectives on the diagnosis of autism spectrum disorders.

    PubMed

    Russell, Ginny; Norwich, Brahm

    2012-04-01

    Many children who display autistic behaviours at clinical levels do not receive a formal diagnosis. This study used qualitative methods to examine parental influence in pursuing or avoiding a diagnosis of autism spectrum disorder (ASD). The aim was to explore the function of ASD diagnosis for parents, and examine whether a diagnosis affected how parents perceived ASD. Seventeen parents participated in in-depth semi-structured interviews, which were analyzed using thematic and grounded theory approaches. Data analysis revealed dilemmas faced by parents: whether to act to retain the 'normal' status of the child or to 'normalize' the child through diagnosis and subsequent remediation. Parents who had received an ASD diagnosis for their children became proactive in trying to reduce stigmatization of ASD more widely, and in some cases actively advocating ASD diagnosis to other parents. Thus their actions may make it more likely that others will opt for diagnosis in the future.

  3. Dilemmas, diagnosis and de-stigmatization: parental perspectives on the diagnosis of autism spectrum disorders.

    PubMed

    Russell, Ginny; Norwich, Brahm

    2012-04-01

    Many children who display autistic behaviours at clinical levels do not receive a formal diagnosis. This study used qualitative methods to examine parental influence in pursuing or avoiding a diagnosis of autism spectrum disorder (ASD). The aim was to explore the function of ASD diagnosis for parents, and examine whether a diagnosis affected how parents perceived ASD. Seventeen parents participated in in-depth semi-structured interviews, which were analyzed using thematic and grounded theory approaches. Data analysis revealed dilemmas faced by parents: whether to act to retain the 'normal' status of the child or to 'normalize' the child through diagnosis and subsequent remediation. Parents who had received an ASD diagnosis for their children became proactive in trying to reduce stigmatization of ASD more widely, and in some cases actively advocating ASD diagnosis to other parents. Thus their actions may make it more likely that others will opt for diagnosis in the future. PMID:22219019

  4. [Chronic cholecystitis and its clinical masks: diagnosis and differential diagnosis].

    PubMed

    Tsimmerman, Ia S

    2006-01-01

    The author adduces modern data on the ethiology and pathogenesis of chronic cholecystitis and the stages of the development of biliary pathology (motorotonic disturbances of the gall bladder and the sphincter apparatus of the extrahepatic biliary tract - chronic acalculous cholecystitis - chronic calculous cholecystitis). He considers in detail the methods of diagnostics of chronic cholecystitis paying special attention to clinical (non-instrumental) methods. The author offers an original classification of physical symptoms of chronic cholecystitis, distinguishing three groups of symptoms according to their pathogenesis and clinical significance: segmentary reflectory symptoms ("exacerbation symptoms"); reflectory symptoms, localized in the right half of the body outside the segments of hepatobiliary system innervation ("severity symptoms"); irritative symptoms, observed during all the periods of chronic cholecystitis. The article contains a description of various clinical "masks" of chronic cholecystitis, which make the diagnosis more difficult: cardial, duodenal (gastrointestinal), rheumatic, solaralgic, allergic, pre-menstrual tension, and other masks, as well as a description of their differential diagnostic methods. PMID:16827271

  5. Prenatal Diagnosis of Down Syndrome: Mothers' Reflections on Supports Needed from Diagnosis to Birth.

    ERIC Educational Resources Information Center

    Helm, David T.; Miranda, Sara; Chedd, Naomi Angoff

    1998-01-01

    A qualitative study of 10 mothers who received a prenatal diagnosis of Down syndrome and chose to continue their pregnancy examined how the diagnosis was presented, the decision to continue the pregnancy, and the mothers' experiences with professionals from diagnosis to delivery. Mothers' suggestions to others facing the same challenges and to…

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

    PubMed

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

    2012-11-01

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

  7. Wheat allergy: diagnosis and management

    PubMed Central

    Cianferoni, Antonella

    2016-01-01

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

  8. Training for Skill in Fault Diagnosis

    ERIC Educational Resources Information Center

    Turner, J. D.

    1974-01-01

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

  9. Update on the imaging diagnosis of otosclerosis.

    PubMed

    Gredilla Molinero, J; Mancheño Losa, M; Santamaría Guinea, N; Arévalo Galeano, N; Grande Bárez, M

    2016-01-01

    Otosclerosis is a primary osteodystrophy of the temporal bone that causes progressive conductive hearing loss. The diagnosis is generally clinical, but multidetector CT (MDCT), the imaging technique of choice, is sometimes necessary. The objective of this article is to systematically review the usefulness of imaging techniques for the diagnosis and postsurgical assessment of otosclerosis, fundamentally the role of MDCT, to decrease the surgical risk.

  10. Diagnosis of Subtraction Bugs Using Bayesian Networks

    ERIC Educational Resources Information Center

    Lee, Jihyun; Corter, James E.

    2011-01-01

    Diagnosis of misconceptions or "bugs" in procedural skills is difficult because of their unstable nature. This study addresses this problem by proposing and evaluating a probability-based approach to the diagnosis of bugs in children's multicolumn subtraction performance using Bayesian networks. This approach assumes a causal network relating…

  11. Delays to the diagnosis of cervical dystonia.

    PubMed

    Bertram, Kelly L; Williams, David R

    2016-03-01

    The diagnosis of cervical dystonia (CD) is based on physical examination and is therefore reliant on clinician experience. Due to variability of presenting symptoms it may be misdiagnosed, thus delaying the provision of effective treatment. We sought to determine the average time taken to make a diagnosis of CD in our clinical cohort and explore contributing factors to diagnostic delay. Forty-nine patients with a diagnosis of CD attending a movement disorder specialist for treatment completed a questionnaire regarding symptoms and clinical interactions at onset and diagnosis. The mean time from symptom onset to diagnosis was 6.8 years (range 0-53 years). More than 50% of patients sought physical therapies initially, prior to consulting their general practitioner. Only 40% of patients sought medical advice within the first 6 months of symptom onset and only 10% were given an initial diagnosis of CD. The first referral from the general practitioner was to a specialist other than a neurologist in 31% of patients. Patients were seen by a mean of three doctors (range one to nine) before being given the correct diagnosis of CD. Delay to diagnosis of CD may in part be due to lack of awareness of the condition amongst health care professionals. Improved diagnostic skill appears likely to have had a substantial impact on the delivery of appropriate treatment in this population.

  12. Prenatal diagnosis of inherited metabolic diseases.

    PubMed Central

    Diukman, R; Goldberg, J D

    1993-01-01

    Advances in the prenatal diagnosis of inherited metabolic disease have provided new reproductive options to at-risk couples. These advances have occurred in both sampling techniques and methods of analysis. In this review we present an overview of the currently available prenatal diagnostic approaches for the diagnosis of metabolic disease in a fetus. Images PMID:8236980

  13. Completing fault models for abductive diagnosis

    SciTech Connect

    Knill, E. ); Cox, P.T.; Pietrzykowski, T. )

    1992-11-05

    In logic-based diagnosis, the consistency-based method is used to determine the possible sets of faulty devices. If the fault models of the devices are incomplete or nondeterministic, then this method does not necessarily yield abductive explanations of system behavior. Such explanations give additional information about faulty behavior and can be used for prediction. Unfortunately, system descriptions for the consistency-based method are often not suitable for abductive diagnosis. Methods for completing the fault models for abductive diagnosis have been suggested informally by Poole and by Cox et al. Here we formalize these methods by introducing a standard form for system descriptions. The properties of these methods are determined in relation to consistency-based diagnosis and compared to other ideas for integrating consistency-based and abductive diagnosis.

  14. [Truth telling of Alzheimer's disease diagnosis].

    PubMed

    Fuentes R, Paola; Prato, Juan Andrés

    2012-06-01

    Alzheimer's disease is becoming an increasingly common problem due to population aging. Most of the research on truth telling in relation to diagnosis has been done in oncology. However, although growing, there has a lack of interest about attitudes held among physicians towards disclosing the diagnosis of Alzheimer's disease. Physicians, family caregivers and patients have different views about it. The reasons most often given for communicating the diagnosis are the right to know, relief of anxiety to know the cause of memory problems, early access to treatment and ability to plan ahead. On the contrary, the reasons for concealing the diagnosis are based on the right not to know, the anxiety associated to knowing the diagnosis and the absence of curative therapies for the disease. The aim of this paper is to report the current state of literature on diagnostic truth telling in dementia, review the ethical principles involved, and finally give a strategy to address the issue.

  15. Laparoscopic Diagnosis and Treatment in Gynecologic Emergencies

    PubMed Central

    Cantele, Héctor; Leyba, José Luis; Navarrete, Manuel; Llopla, Salvador Navarrete

    2003-01-01

    Objective: To present an analysis of our experience with 22 consecutive cases of acute abdominal gynecologic emergencies managed with a laparoscopic approach. Methods: From March 1997 to October 1998, 22 patients with a diagnosis of acute abdominal gynecologic emergencies underwent laparoscopic intervention. A transvaginal ultrasound was performed on all patients preoperatively to supplement the diagnostic workup. Surgical time, complications, and length of hospital stay were evaluated, and the laparoscopic diagnosis was compared with the preoperative diagnosis. Results: The laparoscopic diagnosis was different from the preoperative diagnosis in 31.8% of patients. Of the 22 patients, laparoscopic therapeutic procedures were performed in 18 (81.8%), all satisfactorily, and with no need for conversion to open surgery. No morbidity or mortality occurred. Conclusion: Laparoscopy is a safe and effective method for diagnosing and treating gynecologic emergencies. PMID:14558712

  16. Hepatitis Diagnosis Using Facial Color Image

    NASA Astrophysics Data System (ADS)

    Liu, Mingjia; Guo, Zhenhua

    Facial color diagnosis is an important diagnostic method in traditional Chinese medicine (TCM). However, due to its qualitative, subjective and experi-ence-based nature, traditional facial color diagnosis has a very limited application in clinical medicine. To circumvent the subjective and qualitative problems of facial color diagnosis of Traditional Chinese Medicine, in this paper, we present a novel computer aided facial color diagnosis method (CAFCDM). The method has three parts: face Image Database, Image Preprocessing Module and Diagnosis Engine. Face Image Database is carried out on a group of 116 patients affected by 2 kinds of liver diseases and 29 healthy volunteers. The quantitative color feature is extracted from facial images by using popular digital image processing techni-ques. Then, KNN classifier is employed to model the relationship between the quantitative color feature and diseases. The results show that the method can properly identify three groups: healthy, severe hepatitis with jaundice and severe hepatitis without jaundice with accuracy higher than 73%.

  17. Early diagnosis of resistant pathogens

    PubMed Central

    2013-01-01

    Infections with organisms that are resistant to various anti-microbial agents pose a serious challenge to effective management of infections. Resistance to antimicrobial agents, which may be intrinsic or acquired, has been noted in a wide variety of microorganisms causing human infections. These include resistance to antiviral agents in HIV, HBV, CMV and influenza virus, anti-parasitic agents in Plasmodium falciparum, anti-fungal agents in certain Candida species and MDR (multidrug-resistant) tuberculosis. It is however, the problem of multidrug-resistant bacterial infections (caused by MRSA, VRE, ESBL/AmpC/metallo-β lactamase producers and colistin-resistant Gram-negative bacilli) that has become a cause of major concern in clinical settings. Infections with these organisms can increase morbidity, mortality, increase the cost of therapy and increase the duration of hospitalization. The objective of this article is to review the question how early diagnosis of these infections, affects the overall management of infected or colonized patients, with regard to antimicrobial therapy. PMID:23302786

  18. Childhood Asthma: Diagnosis and Treatment

    PubMed Central

    van Aalderen, Wim M.

    2012-01-01

    Many children suffer from recurrent coughing, wheezing and chest tightness. In preschool children one third of all children have these symptoms before the age of six, but only 40% of these wheezing preschoolers will continue to have asthma. In older school-aged children the majority of the children have asthma. Quality of life is affected by asthma control. Sleep disruption and exercised induced airflow limitation have a negative impact on participation in sports and social activities, and may influence family life. The goal of asthma therapy is to achieve asthma control, but only a limited number of patients are able to reach total control. This may be due to an incorrect diagnosis, co-morbidities or poor inhalation technique, but in the majority of cases non-adherence is the main reason for therapy failures. However, partnership with the parents and the child is important in order to set individually chosen goals of therapy and may be of help to improve control. Non-pharmacological measures aim at avoiding tobacco smoke, and when a child is sensitised, to avoid allergens. In pharmacological management international guidelines such as the GINA guideline and the British Guideline on the Management of Asthma are leading. PMID:24278725

  19. [Endoscopic diagnosis of colonic tuberculosis].

    PubMed

    Wedmann, B; Wegener, M; Adamek, R J; Müller, K M

    1994-12-01

    A 67-year-old woman had developed weakness, fatigue and a 10 kg weight loss over the past year. On examination a cylindrical mass was palpated in the right middle abdominal cavity. Erythrocyte sedimentation rate was increased to 87/126 mm, there was an hypochromic anaemia (haemoglobin 9.1 mg/dl) and an hypoalbuminaemia (32 g/l) with an increase in alpha 2-globulins (9.4 g/l), Cholinesterase activity was decreased to 588 U/l. X-ray film of the abdomen revealed a calcified mesenteric lymph-node and coloscopy demonstrated polypoid tumorous changes with ulcerations, extending from the pole of the caecum to the right flexure. Histological examination showed epithelioid-cell granulomas with Langhans giant cells. Culture grew Mycobacterium tuberculosis, confirming the diagnosis of intestinal tuberculosis. She was treated with oral doses of isoniazid (300 mg daily), rifampicin (600 mg daily) and pyrazinamide (2 g daily) for 2 months, followed by isoniazid and rifampicin for a further 4 months. After this the laboratory tests were within normal limits and urine as well as stool samples contained no acid-fast bacilli. As the patient felt so well she declined another coloscopy.

  20. Laboratory Diagnosis of Bacterial Gastroenteritis

    PubMed Central

    Humphries, Romney M.

    2015-01-01

    SUMMARY Bacterial gastroenteritis is a disease that is pervasive in both the developing and developed worlds. While for the most part bacterial gastroenteritis is self-limiting, identification of an etiological agent by bacterial stool culture is required for the management of patients with severe or prolonged diarrhea, symptoms consistent with invasive disease, or a history that may predict a complicated course of disease. Importantly, characterization of bacterial enteropathogens from stool cultures in clinical laboratories is one of the primary means by which public health officials identify and track outbreaks of bacterial gastroenteritis. This article provides guidance for clinical microbiology laboratories that perform stool cultures. The general characteristics, epidemiology, and clinical manifestations of key bacterial enteropathogens are summarized. Information regarding optimal specimen collection, transport, and processing and current diagnostic tests and testing algorithms is provided. This article is an update of Cumitech 12A (P. H. Gilligan, J. M. Janda, M. A. Karmali, and J. M. Miller, Cumitech 12A, Laboratory diagnosis of bacterial diarrhea, 1992). PMID:25567220

  1. Nanoparticles for Improving Cancer Diagnosis

    PubMed Central

    Chen, Hongmin; Zhen, Zipeng; Todd, Trever; Chu, Paul K.; Xie, Jin

    2013-01-01

    Despite the progress in developing new therapeutic modalities, cancer remains one of the leading diseases causing human mortality. This is mainly attributed to the inability to diagnose tumors in their early stage. By the time the tumor is confirmed, the cancer may have already metastasized, thereby making therapies challenging or even impossible. It is therefore crucial to develop new or to improve existing diagnostic tools to enable diagnosis of cancer in its early or even pre-syndrome stage. The emergence of nanotechnology has provided such a possibility. Unique physical and physiochemical properties allow nanoparticles to be utilized as tags with excellent sensitivity. When coupled with the appropriate targeting molecules, nanoparticle-based probes can interact with a biological system and sense biological changes on the molecular level with unprecedented accuracy. In the past several years, much progress has been made in applying nanotechnology to clinical imaging and diagnostics, and interdisciplinary efforts have made an impact on clinical cancer management. This article aims to review the progress in this exciting area with emphases on the preparation and engineering techniques that have been developed to assemble “smart” nanoprobes. PMID:24068857

  2. Preimplantation genetic diagnosis and screening.

    PubMed

    Kearns, W G; Pen, R; Graham, J; Han, T; Carter, J; Moyer, M; Richter, K S; Tucker, M; Hoegerman, S F; Widra, E

    2005-11-01

    Preimplantation genetic diagnosis (PGD) identifies genetic abnormalities in preimplantation embryos prior to embryo transfer. PGD is an exciting technology that may improve the likelihood of a successful pregnancy and birth for five distinct patient groups: (1) those with infertility related to recurrent miscarriages or unsuccessful in vitro fertilization (IVF) cycles, (2) those with unexplained infertility, (3) advanced maternal age, (4) severe male factor infertility, and (5) couples at risk for transmitting a hereditary disease to their offspring. PGD is always performed following an IVF cycle where multiple oocytes are retrieved and fertilized. Sophisticated techniques such as multiprobe, multicolor fluorescence in situ hybridization are used to test single cells for structural or numerical chromosome abnormalities, whereas the polymerase chain reaction, linkage analysis, and DNA sequencing are used to analyze single cells for disease-specific DNA mutations. PGD allows one to transfer only those embryos identified as being free of genetic abnormalities, thus potentially increasing the implantation rate and decreasing the miscarriage rate. These technologies identify embryos free of specific genetic abnormalities and may increase the likelihood of achieving the patient's goal: the birth of a healthy infant.

  3. Childhood asthma: diagnosis and treatment.

    PubMed

    van Aalderen, Wim M

    2012-01-01

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

  4. Diagnosis of irritable bowel syndrome.

    PubMed

    Olden, Kevin W

    2002-05-01

    Irritable bowel syndrome (IBS) is the most common disorder seen in gastroenterology practice. It is also a large component of primary care practices. Although the classic IBS symptoms of lower abdominal pain, bloating, and alteration of bowel habits is easily recognizable to most physicians, diagnosing IBS remains a challenge. This is in part caused by the absence of anatomic or physiologic markers. For this reason, the diagnosis of IBS currently needs to be made on clinical grounds. A number of symptom-based diagnostic criteria have been proposed over the last 15 years. The most recent of these, the Rome II criteria, seem to show reasonable sensitivity and specificity in diagnosing IBS. However, the role of the Rome II criteria in clinical practice remains ill defined. A review of the literature shows that, in patients with no alarm symptoms, the Rome criteria have a positive predictive value of approximately 98%, and that additional diagnostic tests have a yield of 2% or less. Diagnostic evaluation should also include a psychosocial assessment specifically addressing any history of sexual or physical abuse because these issues significantly influence management strategies and treatment success. PMID:12016433

  5. Turco's injury: diagnosis and treatment.

    PubMed

    da Silva, Ana Paula Simões; Shimba, Leandro Girardi; Ribas, Luiz Henrique Boraschi Vieira; de Almeida, Alexandre Simmonds; Naves, Vinicius; Duarte Júnior, Aires

    2014-01-01

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

  6. Ultrasound Fracture Diagnosis in Space

    NASA Technical Reports Server (NTRS)

    Dulchavsky, Scott A.; Amponsah, David; Sargsyan, Ashot E.; Garcia, Kathleen M.; Hamilton, Douglas R.; vanHolsbeeck, Marnix

    2010-01-01

    Introduction: This ground-based investigation accumulated high-level clinical evidence on the sensitivity and specificity of point of care ultrasound performed by expert and novice users for the rapid diagnosis of musculoskeletal (MSK) injuries. We developed preliminary educational methodologies to provide just-in-time training of novice users by creating multi-media training tools and imaging procedures for non expert operators and evaluated the sensitivity and specificity of non-expert performed musculoskeletal ultrasound to diagnose acute injuries in a Level 1 Trauma Center. Methods: Patients with potential MSK injuries were identified in the emergency room. A focused MSK ultrasound was performed by expert operators and compared to standard radiographs. A repeat examination was performed by non-expert operators who received a short, just-in-time multimedia education aid. The sensitivity and specificity of the expert and novice ultrasound examinations were compared to gold standard radiography. Results: Over 800 patients were enrolled in this study. The sensitivity and specificity of expert performed ultrasound exceeded 98% for MSK injuries. Novice operators achieved 97% sensitivity and 99% specificity for targeted examinations with the greatest error in fractures involving the hand and foot. Conclusion: Point of care ultrasound is a sensitive and specific diagnostic test for MSK injury when performed by experts and just-in-time trained novice operators.

  7. [Barrett esophagus. Diagnosis and treatment].

    PubMed

    Cortesini, C; Bechi, P

    1995-01-01

    Columnar epithelial metaplasia of the distal esophagus (i.e. barrett's esophagus) is an acquired condition showing a prevalence of 4%. It is probably due to abnormal reparative processes of the esophageal squamous epithelium after gastroesophageal reflux damage. "Mixed" (both acid and biliary) reflux seems more relevant for the pathogenesis of Barrett's esophagus than acid reflux alone, as shown by recent studies with Bilitec 2000. Its diagnosis is not easy for the "cardiac", "fundic" or "indeterminate" types of columnar metaplasia and needs a close cooperation between the endoscopist and the pathologist. On the contrary, it is less difficult for the "distinctive" type of metaplasia. Barrett's esophagus surveillance represents a major challenge in the perspective of its malignant degeneration (adenocarcinoma risk 350 times greater than in the general population). Therapy of Barrett's esophagus includes drugs and surgical treatment. Among the drugs proton pump inhibitors such as Omeprazole seem, at the moment, the most effective for reflux control, as well as the Nissen-Rossetti operation seems the most widely accepted among the anti-reflux surgical procedures. The novelty concerning Barrett's esophagus therapy is represented by laser photoablation associated with proton pump inhibiting therapy. But the experience with this treatment is still at a preliminary stage. For Barrett's esophagus with severe dysplasia and/or adenocarcinoma and/or squamous cell carcinoma esophagectomy is needed with a different extent and approach, according to the extent of Barrett's esophagus and to the stage and site of the neoplastic changes.

  8. Perinatal arrhythmias -- diagnosis and treatment.

    PubMed

    Moura, Cláudia; Vieira, António; Guimarães, Hercília; Areias, José Carlos

    2002-01-01

    We did a retrospective analysis of the clinical files of 26 neonates with arrhythmia born during the period between January 1994 and February 1999. Fourteen (53.8%) of the neonates were male and 16 (61.5%) had prenatal diagnosis. Four (15.3%) had associated congenital heart disease. Twenty-one (80.7%) had abnormal rhythm and five (19.2%) had cardiac conduction disorder. Digoxin was the therapy of first choice to restore normal rhythm, used in 66.6% of the patients, followed by adenosine (16.6%) and electrical cardioversion (16.6%). An epicardial pacemaker was used in two of the three neonates with complete atrioventricular (AV) block. One neonate died due to cerebral hemorrhage. All the neonates were discharged in a clinically stable condition and 16 (88.8%) of them were medicated with digoxin. In a follow-up period that varied from 0 to 71 months (mean of 30.8 months), two patients had an episode of supraventricular tachycardia (SVT) after treatment withdrawal. Perinatal arrhythmias, although uncommon, can be life-threatening, and hence we consider our experience with these situations worth presenting.

  9. Delirium diagnosis, screening and management

    PubMed Central

    Lawlor, Peter G.; Bush, Shirley H.

    2014-01-01

    Purpose of review Our review focuses on recent developments across many settings regarding the diagnosis, screening and management of delirium, so as to inform these aspects in the context of palliative and supportive care. Recent findings Delirium diagnostic criteria have been updated in the long-awaited Diagnostic Statistical Manual of Mental Disorders, fifth edition. Studies suggest that poor recognition of delirium relates to its clinical characteristics, inadequate interprofessional communication and lack of systematic screening. Validation studies are published for cognitive and observational tools to screen for delirium. Formal guidelines for delirium screening and management have been rigorously developed for intensive care, and may serve as a model for other settings. Given that palliative sedation is often required for the management of refractory delirium at the end of life, a version of the Richmond Agitation-Sedation Scale, modified for palliative care, has undergone preliminary validation. Summary Although formal systematic delirium screening with brief but sensitive tools is strongly advocated for patients in palliative and supportive care, it requires critical evaluation in terms of clinical outcomes, including patient comfort. Randomized controlled trials are needed to inform the development of guidelines for the management of delirium in this setting. PMID:25004177

  10. Halitosis: From diagnosis to management

    PubMed Central

    Aylıkcı, Bahadır Uğur; Çolak, Hakan

    2013-01-01

    Halitosis is formed by volatile molecules which are caused because of pathological or nonpathological reasons and it originates from an oral or a non-oral source. It is very common in general population and nearly more than 50% of the general population have halitosis. Although halitosis has multifactorial origins, the source of 90% cases is oral cavity such as poor oral hygiene, periodontal disease, tongue coat, food impaction, unclean dentures, faulty restorations, oral carcinomas, and throat infections. Halitosis affects a person's daily life negatively, most of people who complain about halitosis refer to the clinic for treatment but in some of the people who can suffer from halitosis, there is no measurable halitosis. There are several methods to determine halitosis. Halitosis can be treated if its etiology can be detected rightly. The most important issue for treatment of halitosis is detection etiology or determination its source by detailed clinical examination. Management may include simple measures such as scaling and root planning, instructions for oral hygiene, tongue cleaning, and mouth rinsing. The aim of this review was to describe the etiological factors, prevalence data, diagnosis, and the therapeutic mechanical and chemical approaches related to halitosis. PMID:23633830

  11. [Cervical nodules: diagnosis and management].

    PubMed

    Grosjean, Pierre; Monnier, Philippe

    2004-06-01

    Family physicians frequently encounter patients with neck lumps. The causes are numerous but in the adult the origin is most often a lymph node, the majority of which are malignant. Inappropriate management may often lead to a very poor outcome. Relevant investigations must therefore be correctly chosen. The risk for a neck lump to be malignant depends mainly on age, male sex, and alcohol and tobacco consumption and to a lesser extent on a family history for head and neck malignancy. Careful medical history looks for symptoms such as dysphagia, pain, dysphonia, otalgia, or weight loss. On physical examination, the location, size, consistency and mobility of the mass is described. A careful inspection of the scalp, skin of the face and mucosal surface of the upper aerodigestive tract is performed followed by palpation. If no inflammatory or tumoral lesion is identified, the next step is to perform a fine needle aspiration biopsy of the neck mass which will most often lead to a definite diagnosis. When this is not the case, an otolaryngology consultation and excisional biopsy should be obtained. PMID:15293445

  12. Adaptive diagnosis of coeliac disease.

    PubMed

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

    2015-06-01

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

  13. Late diagnosis of chronic renal failure.

    PubMed

    Sesso, R; Belasco, A G; Ajzen, H

    1996-11-01

    A comparison was made between patients with a late diagnosis of chronic renal failure (1 month or less before starting dialysis, N = 96) and those with an early diagnosis (6 months or more, N = 45) in terms of the following aspects: referral characteristics during the pre-dialysis phase, demographic details and patient biochemistry prior to maintenance dialysis. Information was obtained by surveying consecutive patients with primary renal disease admitted to a university dialysis unit in São Paulo. Fifty-three percent of all patients surveyed had a late diagnosis. These patients had a lower median duration of symptoms (2 vs 6 months, P < 0.01) and were less likely to be referred for dialysis by a nephrologist (9% vs 51%, P < 0.001) than early diagnosis patients. In the early diagnosis group, 7 patients (16%) had follow-up care for less than 6 months and 11 (24%) did not receive any follow-up; 21 patients (47%) did not follow a low-protein diet. At the start of dialysis, patients with a late diagnosis had higher blood pressure and a higher rate of pulmonary infections (19% vs 4%, P = 0.03). Mean concentrations of BUN, serum creatinine and potassium were significantly higher and mean blood hematocrit was lower for the late diagnosis group. After 3 months of dialysis, the mortality rate was higher in the late than in the early diagnosis group (22.9% vs 6.7%, P = 0.02). Late diagnosis of chronic renal failure and lack of adequate follow-up care, prior to the start of dialysis, are common. Interventions to promote early diagnosis of chronic renal failure and to improve compliance with regular nephrological follow-up can be important to reduce the morbidity and the mortality of patients with chronic renal insufficiency. PMID:9196548

  14. [Molecular diagnosis of mycobacterial infections].

    PubMed

    Fend, F; Langer, R; Hann von Weyhern, C W; Schulz, S; Miethke, T

    2007-01-01

    Tuberculosis remains a leading cause of morbidity and mortality worldwide. A rapid and reliable diagnosis and discrimination from infections with nontuberculous mycobacteria (NTM) is critical. Frequently, formalin-fixed, paraffin-embedded (FFPE) tissues remain the only source for detection of micro-organisms in suspected cases of mycobacterial infection. Recently, numerous methods, including PCR assays, in situ hybridization and immunohistochemistry have been developed for detection of mycobacteria in FFPE samples. PCR-based assays are directed either against M.tbc.-specific sequences, such as IS6110, or amplify regions common to many mycobacterial species, e.g. the 65 kDa antigen, and then require sequencing or restriction fragment length polymorphism for species identification. Whereas the detection of DNA of M.tbc. in the correct setting is always of clinical relevance, the presence of various NTM species has to be interpreted with great caution due to their ubiquitous nature. However, the routine application of molecular tests has demonstrated that NTM infections are more common than previously thought, even in non-immunosuppressed hosts. The introduction of real-time PCR technology allows precise quantification of mycobacterial DNA and can be used for species identification through melting point analysis or appropriate DNA probes. Application of these assays originally developed for clinical microbiology offer a great opportunity for diagnostic improvement in molecular pathology as compared to qualitative PCR, mainly due to an increased specificity and a lower risk of contamination. Given the clinical impact of a positive molecular result for M. tbc., future efforts have to be aimed at standardization and quality control. PMID:18314607

  15. [Molecular diagnosis of mycobacterial infections].

    PubMed

    Fend, F; Langer, R; Hann von Weyhern, C W; Schulz, S; Miethke, T

    2007-01-01

    Tuberculosis remains a leading cause of morbidity and mortality worldwide. A rapid and reliable diagnosis and discrimination from infections with nontuberculous mycobacteria (NTM) is critical. Frequently, formalin-fixed, paraffin-embedded (FFPE) tissues remain the only source for detection of micro-organisms in suspected cases of mycobacterial infection. Recently, numerous methods, including PCR assays, in situ hybridization and immunohistochemistry have been developed for detection of mycobacteria in FFPE samples. PCR-based assays are directed either against M.tbc.-specific sequences, such as IS6110, or amplify regions common to many mycobacterial species, e.g. the 65 kDa antigen, and then require sequencing or restriction fragment length polymorphism for species identification. Whereas the detection of DNA of M.tbc. in the correct setting is always of clinical relevance, the presence of various NTM species has to be interpreted with great caution due to their ubiquitous nature. However, the routine application of molecular tests has demonstrated that NTM infections are more common than previously thought, even in non-immunosuppressed hosts. The introduction of real-time PCR technology allows precise quantification of mycobacterial DNA and can be used for species identification through melting point analysis or appropriate DNA probes. Application of these assays originally developed for clinical microbiology offer a great opportunity for diagnostic improvement in molecular pathology as compared to qualitative PCR, mainly due to an increased specificity and a lower risk of contamination. Given the clinical impact of a positive molecular result for M. tbc., future efforts have to be aimed at standardization and quality control.

  16. Diagnosis and Treatment of Hemoptysis.

    PubMed

    Cordovilla, Rosa; Bollo de Miguel, Elena; Nuñez Ares, Ana; Cosano Povedano, Francisco Javier; Herráez Ortega, Inmaculada; Jiménez Merchán, Rafael

    2016-07-01

    Hemoptysis is the expectoration of blood from the tracheobronchial tree. It is commonly caused by bronchiectasis, chronic bronchitis, and lung cancer. The expectorated blood usually originates from the bronchial arteries. When hemoptysis is suspected, it must be confirmed and classified according to severity, and the origin and cause of the bleeding determined. Lateral and AP chest X-ray is the first study, although a normal chest X-ray does not rule out the possibility of malignancy or other underlying pathology. Multidetector computed tomography (MDCT) must be performed in all patients with frank hemoptysis, hemoptoic sputum, suspicion of bronchiectasis or risk factors for lung cancer, and in those with signs of pathology on chest X-ray. MDCT angiography has replaced arteriography in identifying the arteries that are the source of bleeding. MDCT angiography is a non-invasive imaging technique that can pinpoint the presence, origin, number and course of the systemic thoracic (bronchial and non-bronchial) and pulmonary arterial sources of bleeding. Endovascular embolization is the safest and most effective method of managing bleeding in massive or recurrent hemoptysis. Embolization is indicated in all patients with life-threatening or recurrent hemoptysis in whom MDCT angiography shows artery disease. Flexible bronchoscopy plays a pivotal role in the diagnosis of hemoptysis in patients with hemoptoic sputum or frank hemoptysis. The procedure can be performed rapidly at the bedside (intensive care unit); it can be used for immediate control of bleeding, and is also effective in locating the source of the hemorrhage. Flexible bronchoscopy is the first-line procedure of choice in hemodynamically unstable patients with life-threatening hemoptysis, in whom control of bleeding is of vital importance. In these cases, surgery is associated with an extremely high mortality rate, and is currently only indicated when bleeding is secondary to surgery and its source can be

  17. Cystic Fibrosis Diagnosis and Newborn Screening.

    PubMed

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

    2016-08-01

    The diagnosis of cystic fibrosis (CF) has evolved over the past decade as newborn screening has become universal in the United States and elsewhere. The heterogeneity of phenotypes associated with CF transmembrane conductance regulator (CFTR) dysfunction and mutations in the CFTR gene has become clearer, ranging from classic pancreatic-insufficient CF to manifestations in only 1 organ system to indeterminate diagnoses identified by newborn screening. The tools available for diagnosis have also expanded. This article reviews the newest diagnostic criteria for CF, newborn screening, prenatal screening and diagnosis, and indeterminate diagnoses in newborn-screened infants and symptomatic adults. PMID:27469178

  18. Diagnosis of automotive fuel cell power generators

    NASA Astrophysics Data System (ADS)

    Hissel, D.; Péra, M. C.; Kauffmann, J. M.

    Most of car manufacturers around the world have launched important research programs on the integration of fuel cell (FC) power generators into cars. Despite the first achievements, fuel cell systems are still badly known, particularly when talking about fault diagnosis and predictive maintenance. This paper proposes a first step in this way by introducing a simple but also efficient diagnosis-oriented model of a proton exchange membrane fuel cell (PEMFC). The considered diagnosis model is here a fuzzy one and is tuned thanks to genetic algorithms.

  19. Vascular anomalies: differential diagnosis and mimickers.

    PubMed

    Garzon, Maria C; Weitz, Nicole; Powell, Julie

    2016-03-01

    Vascular anomalies are very common in children and encompass a wide spectrum of diseases. Many vascular anomalies can be mistaken for infantile hemangioma (IH). In addition, there is a variety of rare disorders including benign and malignant tumors that may mimic IH and other types of vascular anomalies. Understanding the clinical features, natural history, and typical clinical course of different types of vascular anomalies is essential in order to make the correct diagnosis and guide management. Radiologic imaging plays an important role in establishing the diagnosis; and when the diagnosis remains in doubt, a biopsy performed by a surgical specialist with expertise may prove to be lifesaving. PMID:27607326

  20. Antemortem laboratory diagnosis of Alzheimer's disease.

    PubMed

    Gauthier, S; Robitaille, Y; Quirion, R; Leblanc, R

    1986-01-01

    The accuracy of diagnosis for AD by conventional clinical and laboratory means is in the order of 80%. Neurophysiological techniques (EEG, evoked potentials) show abnormalities in AD that could prove to be useful for diagnosis after pharmacological challenges. CSF analysis show a reduction of the concentration of various neuropeptides, reduction shared by other types of dementias. Among the existing imaging techniques PET using 18F-fluorodeoxyglucose is the most diagnostic in AD because of the early and often asymmetrical decrease in parietotemporal metabolic activity. Cortical biopsy with histological and biochemical analysis can provide an accurate in vivo diagnosis of AD.

  1. Laboratory support in the diagnosis of uveitis

    PubMed Central

    Majumder, Parthopratim Dutta; Sudharshan, S; Biswas, Jyotirmay

    2013-01-01

    Intraocular inflammations are still a diagnostic challenge for ophthalmologists. It is often difficult to make a precise etiological diagnosis in certain situations. Recently, there have been several advances in the investigations of uveitis, which has helped the ophthalmologists a lot in the management of such clinical conditions. A tailored approach to laboratory diagnosis of uveitic cases should be directed by the history, patient's symptoms and signs, and clinical examination. This review summarizes various modalities of laboratory investigations and their role in the diagnosis of uveitis. PMID:23803478

  2. Probabilistic Performance Analysis of Fault Diagnosis Schemes

    NASA Astrophysics Data System (ADS)

    Wheeler, Timothy Josh

    The dissertation explores the problem of rigorously quantifying the performance of a fault diagnosis scheme in terms of probabilistic performance metrics. Typically, when the performance of a fault diagnosis scheme is of utmost importance, physical redundancy is used to create a highly reliable system that is easy to analyze. However, in this dissertation, we provide a general framework that applies to more complex analytically redundant or model-based fault diagnosis schemes. For each fault diagnosis problem in this framework, our performance metrics can be computed accurately in polynomial-time. First, we cast the fault diagnosis problem as a sequence of hypothesis tests. At each time, the performance of a fault diagnosis scheme is quantified by the probability that the scheme has chosen the correct hypothesis. The resulting performance metrics are joint probabilities. Using Bayes rule, we decompose these performance metrics into two parts: marginal probabilities that quantify the reliability of the system and conditional probabilities that quantify the performance of the fault diagnosis scheme. These conditional probabilities are used to draw connections between the fault diagnosis and the fields of medical diagnostic testing, signal detection, and general statistical decision theory. Second, we examine the problem of computing the performance metrics efficiently and accurately. To solve this problem, we examine each portion of the fault diagnosis problem and specify a set of sufficient assumptions that guarantee efficient computation. In particular, we provide a detailed characterization of the class of finite-state Markov chains that lead to tractable fault parameter models. To demonstrate that these assumptions enable efficient computation, we provide pseudocode algorithms and prove that their running time is indeed polynomial. Third, we consider fault diagnosis problems involving uncertain systems. The inclusion of uncertainty enlarges the class of systems

  3. Prenatal Diagnosis of Congenital Adrenal Hyperplasia.

    PubMed

    Yau, Mabel; Khattab, Ahmed; New, Maria I

    2016-06-01

    Congenital adrenal hyperplasia (CAH) owing to 21-hydroxylase deficiency is a monogenic disorder of adrenal steroidogenesis. To prevent genital ambiguity, in girls, prenatal dexamethasone treatment is administered early in the first trimester. Prenatal genetic diagnosis of CAH and fetal sex determination identify affected female fetuses at risk for genital virilization. Advancements in prenatal diagnosis are owing to improved understanding of the genetic basis of CAH and improved technology. Cloning of the CYP21A2 gene ushered in molecular genetic analysis as the current standard of care. Noninvasive prenatal diagnosis allows for targeted treatment and avoids unnecessary treatment of males and unaffected females. PMID:27241964

  4. Micropenis: etiology, diagnosis and treatment approaches.

    PubMed

    Hatipoğlu, Nihal; Kurtoğlu, Selim

    2013-01-01

    Micropenis is a medical diagnosis based on correct measurement of length. If stretched penile length is below the value corresponding to - 2.5 standard deviation of the mean in a patient with normal internal and external male genitalia, a diagnosis of micropenis is considered. Micropenis can be caused by a variety of factors including structural or hormonal defects of the hypothalamic-pituitary-gonadal axis. It can also be a component of a number of congenital syndromes. For the etiological evaluation, endocrinologic tests are important. This article reviews the etiology, diagnosis, treatment and management of micropenis.

  5. Dentin hypersensitivity: differential diagnosis, tests, and etiology.

    PubMed

    Trushkowsky, Richard D; Garcia-Godoy, Franklin

    2014-02-01

    Dentin hypersensitivity (DHS) is a painful condition that affects up to 57 percent of the adult population. It occurs as a result of exposure of dentin to the oral environment. Ensuring the correct diagnosis of this condition is based on history and examination. An oral screening for DHS should encompass such elements as patient history, clinical examination that includes radiographs, a variety of tests, identification of risk factors, and a differential diagnosis. An understanding of dentinal fluid and odontoblasts is also beneficial for diagnosis. PMID:24571559

  6. Distributed real-time model-based diagnosis

    NASA Technical Reports Server (NTRS)

    Barrett, A. C.; Chung, S. H.

    2003-01-01

    This paper presents an approach to onboard anomaly diagnosis that combines the simplicity and real-time guarantee of a rule-based diagnosis system with the specification ease and coverage guarantees of a model-based diagnosis system.

  7. Diagnosis of Hymenoptera venom allergy.

    PubMed

    Biló, B M; Rueff, F; Mosbech, H; Bonifazi, F; Oude-Elberink, J N G

    2005-11-01

    The purpose of diagnostic procedure is to classify a sting reaction by history, identify the underlying pathogenetic mechanism, and identify the offending insect. Diagnosis of Hymenoptera venom allergy thus forms the basis for the treatment. In the central and northern Europe vespid (mainly Vespula spp.) and honeybee stings are the most prevalent, whereas in the Mediterranean area stings from Polistes and Vespula are more frequent than honeybee stings; bumblebee stings are rare throughout Europe and more of an occupational hazard. Several major allergens, usually glycoproteins with a molecular weight of 10-50 kDa, have been identified in venoms of bees, vespids. and ants. The sequences and structures of the majority of venom allergens have been determined and several have been expressed in recombinant form. A particular problem in the field of cross-reactivity are specific immunoglobulin E (IgE) antibodies directed against carbohydrate epitopes, which may induce multiple positive test results (skin test, in vitro tests) of still unknown clinical significance. Venom hypersensitivity may be mediated by immunologic mechanisms (IgE-mediated or non-IgE-mediated venom allergy) but also by nonimmunologic mechanisms. Reactions to Hymenoptera stings are classified into normal local reactions, large local reactions, systemic toxic reactions, systemic anaphylactic reactions, and unusual reactions. For most venom-allergic patients an anaphylactic reaction after a sting is very traumatic event, resulting in an altered health-related quality of life. Risk factors influencing the outcome of an anaphylactic reaction include the time interval between stings, the number of stings, the severity of the preceding reaction, age, cardiovascular diseases and drug intake, insect type, elevated serum tryptase, and mastocytosis. Diagnostic tests should be carried out in all patients with a history of a systemic sting reaction to detect sensitization. They are not recommended in subjects with

  8. Cushing's Syndrome: Screening and Diagnosis.

    PubMed

    Ceccato, Filippo; Boscaro, Marco

    2016-09-01

    Endogenous Cushing's syndrome (CS) is a rare disease, and usually characterized by hypertension, diabetes, obesity, osteoporosis, facial rounding, dorsocervical fat pad, thin skin, purple striae, hirsutism, and mood disorders. Efficient diagnostic and screening strategies lead to the diagnosis of a significantly higher number of cases of CS. As a screening test for CS, the Endocrine Society's Clinical Practice Guidelines recommend a single test with a high diagnostic accuracy, among the 1-mg dexamethasone suppression test (1-mg DST), late night salivary cortisol (LNSC), and 24 h urinary free cortisol (UFC). In normal subjects, administering a higher than physiological dose of glucocorticoids prompts the suppression of cortisol secretion. The 1-mg DST explores this normal feedback reaction from the hypothalamic-pituitary-adrenal axis (HPA). It is a simple dynamic test, usually performed in outpatients. A morning serum cortisol level <50 nmol/L suffices to exclude CS, unless there is a strong clinical suspicion to suggest otherwise. The HPA axis reaches a nadir just after a person has fallen asleep, but its circadian rhythm is impaired in CS patients, who feature higher cortisol values at night, which are easy to measure in saliva (the LNSC assay). Saliva collection is also suitable for outpatients since cortisol is stable at room temperature and the collection device can be mailed to the laboratory for analysis. UFC levels reflect the integrated tissue exposure to free cortisol over 24 h, and thus provide a particular picture of endogenous hypercortisolism. In most cases, high UFC levels coincide with severe hypercortisolism. UFC is used not only to diagnose CS, but also to monitor its response to medical treatment. All screening tests have procedural snares: some drugs can interfere with the DST; false-positive or false-negative LNSC results may be due to an inadequate soaking of the device or to cyclic CS; and in the case of UFC it is important to ensure that

  9. Cushing's Syndrome: Screening and Diagnosis.

    PubMed

    Ceccato, Filippo; Boscaro, Marco

    2016-09-01

    Endogenous Cushing's syndrome (CS) is a rare disease, and usually characterized by hypertension, diabetes, obesity, osteoporosis, facial rounding, dorsocervical fat pad, thin skin, purple striae, hirsutism, and mood disorders. Efficient diagnostic and screening strategies lead to the diagnosis of a significantly higher number of cases of CS. As a screening test for CS, the Endocrine Society's Clinical Practice Guidelines recommend a single test with a high diagnostic accuracy, among the 1-mg dexamethasone suppression test (1-mg DST), late night salivary cortisol (LNSC), and 24 h urinary free cortisol (UFC). In normal subjects, administering a higher than physiological dose of glucocorticoids prompts the suppression of cortisol secretion. The 1-mg DST explores this normal feedback reaction from the hypothalamic-pituitary-adrenal axis (HPA). It is a simple dynamic test, usually performed in outpatients. A morning serum cortisol level <50 nmol/L suffices to exclude CS, unless there is a strong clinical suspicion to suggest otherwise. The HPA axis reaches a nadir just after a person has fallen asleep, but its circadian rhythm is impaired in CS patients, who feature higher cortisol values at night, which are easy to measure in saliva (the LNSC assay). Saliva collection is also suitable for outpatients since cortisol is stable at room temperature and the collection device can be mailed to the laboratory for analysis. UFC levels reflect the integrated tissue exposure to free cortisol over 24 h, and thus provide a particular picture of endogenous hypercortisolism. In most cases, high UFC levels coincide with severe hypercortisolism. UFC is used not only to diagnose CS, but also to monitor its response to medical treatment. All screening tests have procedural snares: some drugs can interfere with the DST; false-positive or false-negative LNSC results may be due to an inadequate soaking of the device or to cyclic CS; and in the case of UFC it is important to ensure that

  10. Hearing Loss Signals Need for Diagnosis

    MedlinePlus

    ... Products For Consumers Home For Consumers Consumer Updates Hearing Loss Signals Need for Diagnosis Share Tweet Linkedin Pin ... or serious ear condition and lead to further hearing loss or other complications. “The problem might be as ...

  11. Women's Memory Advantage Might Skew Alzheimer's Diagnosis

    MedlinePlus

    ... https://medlineplus.gov/news/fullstory_161328.html Women's Memory Advantage Might Skew Alzheimer's Diagnosis Women tend to hold on to better verbal memory skills as they age compared to men, study ...

  12. The diagnosis and treatment of amenorrheas.

    PubMed

    Jewelewicz, R

    1976-12-01

    Correct diagnosis and treatment of amenorrhea is a challenging problem to the clinician. A systematic approach to the differential diagnosis and treatment, based on functional activity along the hypothalamic-pituitary-ovarian axis, is presented. By obtaining a detailed history, performing a meticulous physical examination, and utilizing several simple clinical and laboratory tests, a correct diagnosis can be reached for the majority of patients. Treatment is relatively simple and geared to the patient's desires. In most instances, understanding of the basic problem helps the patient to cope with it and no treatment is needed. If lack of menses is a problem, cyclic bleeding at regular intervals can be induced. When fertility is a problem, ovulation can be induced, provided that there is no ovarian failure. By spending sufficient time with the patient, paying attention to detail, and giving some thought, a correct diagnosis can be reached and adequate treatment given to most amenorrheic patients.

  13. Heart Health - Heart Disease: Symptoms, Diagnosis, Treatment

    MedlinePlus

    ... or stomach. Diagnosis Key heart tests include: Electrocardiogram (ECG or EKG) —This records the electrical activity of the heart as it contracts and relaxes. The ECG can detect abnormal heartbeats, some areas of damage, ...

  14. Cystinosis: practical tools for diagnosis and treatment

    PubMed Central

    Wilmer, Martijn J.; Schoeber, Joost P.; van den Heuvel, Lambertus P.

    2010-01-01

    Cystinosis is the major cause of inherited Fanconi syndrome, and should be suspected in young children with failure to thrive and signs of renal proximal tubular damage. The diagnosis can be missed in infants, because not all signs of renal Fanconi syndrome are present during the first months of life. In older patients cystinosis can mimic idiopathic nephrotic syndrome due to focal and segmental glomerulosclerosis. Measuring elevated white blood cell cystine content is the corner stone for the diagnosis. The diagnosis is confirmed by molecular analysis of the cystinosin gene. Corneal cystine crystals are invariably present in all patients with cystinosis after the age of 1 year. Treatment with the cystine depleting drug cysteamine should be initiated as soon as possible and continued lifelong to prolong renal function survival and protect extra-renal organs. This educational feature provides practical tools for the diagnosis and treatment of cystinosis. PMID:20734088

  15. Diagnosis supporting rules of the Hepar system.

    PubMed

    Bobrowski, L; Wasyluk, H

    2001-01-01

    The "Hepar" system comprises a clinical database and the shell of procedures that aim at data analysis and the support of diagnosis. The database consists of hepatological patient cases. Each case is described by about 200 medical findings and histopathologically verified diagnosis. The diagnosis supporting rules of "Hepar" are based on visualizing data transformations and on the similarity based techniques. The applied linear visualizing transformations of data sets on the plane aim at separating of the groups of patients associated with different diseases. The resulting diagnostic maps by the visual inspection allow to find such cases in the database that are similar to the previously diagnosed patients. This paper examines combining of data transformations with the nearest neighbors techniques in the support of diagnosis. We report the results on the experimental comparisons of different decision rules including the feature selection procedure.

  16. Modern diagnosis and management of the porphyrias.

    PubMed

    Sassa, Shigeru

    2006-11-01

    Recent advances in the molecular understanding of the porphyrias now offer specific diagnosis and precise definition of the types of genetic mutations involved in the disease. Molecular diagnostic testing is powerful and very useful in kindred evaluation and genetic counselling when a disease-responsible mutation has been identified in the family. It is also the only way to properly screen asymptomatic gene carriers, facilitating correct treatment and appropriate genetic counselling of family members at risk. However, it should be noted that DNA-based testing is for the diagnosis of the gene carrier status, but not for the diagnosis of clinical syndrome or severity of the disease, e.g. an acute attack. For the diagnosis of clinically expressed porphyrias, a logical stepwise approach including the analysis of porphyrins and their precursors should not be underestimated, as it is still very useful, and is often the best from the cost-effective point of view.

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

    MedlinePlus

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

  18. Retinal Detachment: Torn or Detached Retina Diagnosis

    MedlinePlus

    ... Eye Health / Eye Health A-Z Detached or Torn Retina Sections Retinal Detachment: What Is a Torn ... Retina Treatment Retinal Detachment Vision Simulator Retinal Detachment: Torn or Detached Retina Diagnosis Written by: Kierstan Boyd ...

  19. Genital ulcers: their diagnosis and management.

    PubMed

    Sacks, S L

    1987-08-01

    THIS ARTICLE OFFERS SOME BACKGROUND INFORMATION ON DIAGNOSIS AND TREATMENT OF THREE MAJOR CAUSES OF GENITAL ULCERS: syphilis, herpes simplex virus (HSV), and chancroid. The author also discusses differential diagnoses and suggests an approach to treatment.

  20. Osteoporosis: Symptoms, Diagnosis, Treatment and Prevention

    MedlinePlus

    ... of this page please turn Javascript on. Feature: Osteoporosis Osteoporosis: Symptoms, Diagnosis, Treatment and Prevention Past Issues / Winter 2011 Table of Contents Osteoporosis can strike at any age, although the risk ...

  1. Diagnosis and treatment of rapidly progressive dementias

    PubMed Central

    Paterson, Ross W.; Takada, Leonel T.

    2012-01-01

    Summary Rapidly progressive dementias are conditions that typically cause dementia over weeks or months. They are a particular challenge to neurologists as the differential diagnosis often is different from the more typical, slowly progressive dementias. Early and accurate diagnosis is essential, as many of the etiologies are treatable. The information in this review is in part based on experience through our rapidly progressive dementia program at the University of California San Francisco, Memory and Aging Center. As treatment of a rapidly progressive dementia is entirely dependent on the diagnosis, we present a comprehensive, structured, but pragmatic approach to diagnosis, including key clinical, laboratory, and radiologic features. For the 2 most common causes of rapid dementia, treatment algorithms for the autoimmune encephalopathies and symptomatic management for the neurodegenerative causes are discussed. PMID:23634367

  2. Knowledge-based diagnosis for aerospace systems

    NASA Technical Reports Server (NTRS)

    Atkinson, David J.

    1988-01-01

    The need for automated diagnosis in aerospace systems and the approach of using knowledge-based systems are examined. Research issues in knowledge-based diagnosis which are important for aerospace applications are treated along with a review of recent relevant research developments in Artificial Intelligence. The design and operation of some existing knowledge-based diagnosis systems are described. The systems described and compared include the LES expert system for liquid oxygen loading at NASA Kennedy Space Center, the FAITH diagnosis system developed at the Jet Propulsion Laboratory, the PES procedural expert system developed at SRI International, the CSRL approach developed at Ohio State University, the StarPlan system developed by Ford Aerospace, the IDM integrated diagnostic model, and the DRAPhys diagnostic system developed at NASA Langley Research Center.

  3. Differential diagnosis of wide QRS tachycardias.

    PubMed

    Lobban, J H; Schmidt, S B; Rhodes, L A; Jain, A C

    1994-06-01

    This article has reviewed the differential diagnosis of wide QRS tachycardia. We have found the stepwise approach suggested by Brugada to be very useful. Of the newer criteria that he proposes, the R to S interval of > 100 ms. appears to be a particularly helpful clue favoring the diagnosis of ventricular tachycardia. Hemodynamic stability, young age, 1:1 AV association, and the absence of structural heart disease do not exclude a diagnosis of ventricular tachycardia. Most wide QRS tachycardias in adults are ventricular, and when all else fails, one will be right more often than not in favoring this as the diagnosis over supraventricular tachycardia with aberrancy. The R to S interval is measured in the precordial (V) leads from the onset of the R wave to the deepest part of the S wave. A value > 100 ms. in any V lead strongly favors ventricular tachycardia. Example is from Case 1 (upper tracing is V1). PMID:8067039

  4. Oesophageal trauma: incidence, diagnosis, and management.

    PubMed Central

    Triggiani, E; Belsey, R

    1977-01-01

    The clinical manifestations, diagnosis, and surgical treatment of 110 cases of oesophageal trauma, admitted under the care of one surgical team between 1949 and 1973, are reviewed. The importance of early diagnosis and an aggressive surgical approach in the management of a potentially lethal situation are stressed. In our opinion, spontaneous rupture of the oesophagus, instrumental perforation, open and closed traumatic lesions, and postoperative anastomotic leaks are, as far as diagnosis and management are concerned, different aspects of the same desperate surgical problem. Oesophageal trauma is accompanied by a high morbidity and mortality rate if diagnosis and treatment are delayed. Perforations of the cervical oesophagus may be treated conservatively. Intrathoracic perforations demand an aggressive surgical appraoch; only exteriorisation followed by reconstruction at a later date offers a reasonable chance to save the life of the patient and ultimately restore continuity. PMID:882938

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

    PubMed

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

    2015-10-01

    This document attempts to update the main tasks and roles of the Clinical Microbiology laboratory in HIV diagnosis and monitoring. The document is divided into three parts. The first deals with HIV diagnosis and how serological testing has changed in the last few years, aiming to improve diagnosis and to minimize missed opportunities for diagnosis. Technological improvements for HIV Viral Load are shown in the second part of the document, which also includes a detailed description of the clinical significance of low-level and very low-level viremia. Finally, the third part of the document deals with resistance to antiretroviral drugs, incorporating clinical indications for integrase and tropism testing, as well as the latest knowledge on minority variants. PMID:25444049

  6. Hepatitis C: Information on Testing and Diagnosis

    MedlinePlus

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

  7. Diagnosis and management of facial pigmented macules.

    PubMed

    Lallas, Aimilios; Argenziano, Giuseppe; Moscarella, Elvira; Longo, Caterina; Simonetti, Vito; Zalaudek, Iris

    2014-01-01

    The differential diagnosis of pigmented macules on the mottled chronic sun-damaged skin of the face is challenging and includes lentigo maligna (LM), pigmented actinic (solar) keratosis, solar lentigo, and lichen-planus-like keratosis. Although dermatoscopy improves the diagnostic accuracy of the unaided eye, the accurate diagnosis and management of pigmented facial macules remains one of the most challenging scenarios in daily practice. This is related to the fact that pigmented actinic (solar) keratosis, lichen-planus-like keratosis, and LM may reveal overlapping criteria, making their differential diagnosis clinically difficult. For this reason, practical rules have been introduced, which should help to minimize the risk for inappropriate diagnosis and management of LM.

  8. Brown's syndrome: diagnosis and management.

    PubMed Central

    Wright, K W

    1999-01-01

    PURPOSE: To better understand the various etiologies of Brown's syndrome, define specific clinical characteristics of Brown's syndrome, describe the natural history of Brown's syndrome, and evaluate the longterm outcome of a novel surgical procedure: the silicone tendon expander. Also, to utilize a computer model to simulate the pattern of strabismus seen clinically with Brown's syndrome and manipulate the model to show potential surgical outcomes of the silicone tendon expander. METHODS: Charts were reviewed on patients with the diagnosis of Brown's syndrome seen at a children's hospital ophthalmology clinic from 1982 to 1997, or seen in the author's private practice. Objective fundus torsion was assessed in up gaze, down gaze, and primary position in 7 Brown's syndrome patients and in 4 patients with primary superior oblique overaction. A fax survey was taken of members of the American Association of Ophthalmology and Strabismus (AAPOS) listed in the 1997-1998 directory regarding their results using the silicone tendon expander procedure for the treatment of Brown's syndrome. A computer model of Brown's syndrome was created using the Orbit 1.8 program by simulating a shortened superior oblique tendon or by changing stretch sensitivity to create an inelastic muscle. RESULTS: A total of 96 patients were studied: 85 with Brown's syndrome (38 with congenital and 47 with acquired disease), 6 with masquerade syndromes, 1 with Brown's syndrome operated on elsewhere, and 4 with primary superior oblique overaction in the torsion study. Three original clinical observations were made: 1. Significant limitation of elevation in abduction occurs in 70% of Brown's syndrome cases surgically verified as caused by a tight superior oblique tendon. Contralateral pseudo-inferior oblique overaction is associated with limited elevation in abduction. 2. Traumatic Brown's syndrome cases have larger hypotropias than nontraumatic cases (P < .001). There was no significant hypotropia in

  9. Update on the imaging diagnosis of otosclerosis.

    PubMed

    Gredilla Molinero, J; Mancheño Losa, M; Santamaría Guinea, N; Arévalo Galeano, N; Grande Bárez, M

    2016-01-01

    Otosclerosis is a primary osteodystrophy of the temporal bone that causes progressive conductive hearing loss. The diagnosis is generally clinical, but multidetector CT (MDCT), the imaging technique of choice, is sometimes necessary. The objective of this article is to systematically review the usefulness of imaging techniques for the diagnosis and postsurgical assessment of otosclerosis, fundamentally the role of MDCT, to decrease the surgical risk. PMID:27267384

  10. Diagnosis and management of diaper dermatitis.

    PubMed

    Shin, Helen T

    2014-04-01

    This article presents an overview of diaper dermatitis for the pediatric community. The pathogenesis, differential diagnosis, and management of this common condition in infancy are reviewed. This information will assist in making the appropriate diagnosis and managing this irritant contact dermatitis of the diaper area. With conservative management, most cases of irritant diaper dermatitis are self-limited. When the condition persists, one must consider other diagnoses.

  11. Cysticercosis of tongue: Cytohistologic approach to diagnosis

    PubMed Central

    Koteeswaran, Govindaswamy; Mangala, Goneppanavar; Kotasthane, Dhanajay Srikant; Tirou, Aroul T

    2013-01-01

    Cysticercosis is continuing to be a major health problem in developing countries. Radiological and serological techniques are routinely used for pre-operative diagnosis of cysticercosis. But fine needle aspiration cytology (FNAC) is cost effective and simple procedure, so it is important to be aware of diagnostic pitfalls in the cytomorphologic diagnosis of cysticercosis. We present a case of cysticercosis of tongue, which accounts for only 34 cases in the world literature. PMID:24574684

  12. [Diagnosis of Lepore hemoglobinopathy with DNA analysis].

    PubMed

    Lavinha, J; Sampaio, V; da Mata, E

    1992-07-01

    We illustrate the application of recombinant DNA methods (namely Southern blotting) for the genotype diagnosis of haemoglobin Lepore Boston: the use of the restriction endonucleases PstI and XbaI along with a beta globin gene specific probe make it possible to detect a deletion of approximately 7kb which typically characterizes the delta beta Boston gene. The impact of using such methods in the prenatal diagnosis of major haemoglobinopathies is discussed.

  13. Diagnosis and management of diaper dermatitis.

    PubMed

    Shin, Helen T

    2014-04-01

    This article presents an overview of diaper dermatitis for the pediatric community. The pathogenesis, differential diagnosis, and management of this common condition in infancy are reviewed. This information will assist in making the appropriate diagnosis and managing this irritant contact dermatitis of the diaper area. With conservative management, most cases of irritant diaper dermatitis are self-limited. When the condition persists, one must consider other diagnoses. PMID:24636651

  14. Genital contact allergy: A diagnosis missed

    PubMed Central

    Marfatia, Yogesh S.; Patel, Dimpal; Menon, Devi S.; Naswa, Smriti

    2016-01-01

    Genital allergy should be considered as a possible diagnosis in all patients with genital soreness or irritation for which no infection or dermatosis can be identified and in whom symptoms remain unchanged or worsen with treatment. It is an underreported and underdiagnosed condition as patients may not complain about symptoms in this area. Moreover, diagnosis and therapy may not often be conducted by a dermatologist or allergologist. Therefore, many cases of allergic diseases in the genital area remain undetected. PMID:27190404

  15. Trichodystrophies: A hair-raising differential diagnosis.

    PubMed

    Vij, Alok; Bergfeld, Wilma F

    2015-01-01

    The appearance of an individual's hair is said to be reflective of internal health. Patients with hair shaft disorders commonly present with fragile, lusterless, sparse hair in addition to psychosocial distress. Hair shaft disorders may be hereditary or acquired and may present in children or adults. Due to the varied presentations, the differential diagnosis for hair is broad and often confusing. The authors present a question-by-question guide to help clinicians arrive at the correct diagnosis.

  16. The Charcot foot: pathophysiology, diagnosis and classification.

    PubMed

    Trieb, K

    2016-09-01

    Neuropathic changes in the foot are common with a prevalence of approximately 1%. The diagnosis of neuropathic arthropathy is often delayed in diabetic patients with harmful consequences including amputation. The appropriate diagnosis and treatment can avoid an extensive programme of treatment with significant morbidity for the patient, high costs and delayed surgery. The pathogenesis of a Charcot foot involves repetitive micro-trauma in a foot with impaired sensation and neurovascular changes caused by pathological innervation of the blood vessels. In most cases, changes are due to a combination of both pathophysiological factors. The Charcot foot is triggered by a combination of mechanical, vascular and biological factors which can lead to late diagnosis and incorrect treatment and eventually to destruction of the foot. This review aims to raise awareness of the diagnosis of the Charcot foot (diabetic neuropathic osteoarthropathy and the differential diagnosis, erysipelas, peripheral arterial occlusive disease) and describe the ways in which the diagnosis may be made. The clinical diagnostic pathways based on different classifications are presented. Cite this article: Bone Joint J 2016;98-B:1155-9.

  17. Pituitary Carcinoma: Difficult Diagnosis and Treatment

    PubMed Central

    2011-01-01

    Context: Although pituitary tumors are common, pituitary carcinoma is very rare and is only diagnosed when pituitary tumor noncontiguous with the sellar region is demonstrated. Diagnosis is difficult, resulting in delays that may adversely effect outcome that is traditionally poor. Barriers to earlier diagnosis and management strategies for pituitary carcinoma are discussed. Evidence Acquisition: PubMed was employed to identify relevant studies, a review of the literature was conducted, and data were summarized and integrated from the author's perspective. Evidence Synthesis: The available data highlight the difficulties in diagnosis and management and practical challenges in conducting clinical trials in this rare condition. They suggest that earlier diagnosis with aggressive multimodal therapy may be advantageous in some cases. Conclusions: Although pituitary carcinoma remains difficult to diagnose and treat, recent developments have led to improved outcomes in selected cases. With broader use of molecular markers, efforts to modify current histopathological criteria for pituitary carcinoma diagnosis may now be possible. This would assist earlier diagnosis and, in combination with targeted therapies, potentially improve long-term survival. PMID:21956419

  18. Vehicle condition monitoring and fault diagnosis

    SciTech Connect

    Not Available

    1985-01-01

    This book contains a compilation of papers on vehicle condition monitoring and fault diagnosis. The complete contents include: Bus operators' needs for the nineties; The use of portable remote data collection devices in vehicle preventive maintenance programs; The diagnosis of cylinder power faults in diesel engines by flywheel speed measurements; Current and future developments in vehicle servicing, condition monitoring and diagnostics; Experience with condition monitoring in other industries; Contamination and viscosity monitoring of automobile and motor cycle oils using a portable contamination meter; Knock detection alternatives for production vehicles; Oil monitoring - under what conditions can it improve engine life, yet be financed by condition-based oil changes: The use of speed sensing for monitoring the condition of military vehicle engines; The development of vehicle condition monitoring and fault diagnosis equipment for commercial vehicle fleets; The development of automotive diagnostic systems for armoured fighting vehicles in the British Army; Oil analysis techniques used in the development of automotive diesel engines and their condition monitoring in service; Recent developments in the nonintrusive diagnosis of engine faults; Operating experience with a vehicle fault diagnosis system; The case for on-board diagnostics; An on-board monitoring system with its essential sensors and evaluating characteristics; Computerized diagnostics for diesel engines; Laser tools for diesel engine diagnosis.

  19. The Charcot foot: pathophysiology, diagnosis and classification.

    PubMed

    Trieb, K

    2016-09-01

    Neuropathic changes in the foot are common with a prevalence of approximately 1%. The diagnosis of neuropathic arthropathy is often delayed in diabetic patients with harmful consequences including amputation. The appropriate diagnosis and treatment can avoid an extensive programme of treatment with significant morbidity for the patient, high costs and delayed surgery. The pathogenesis of a Charcot foot involves repetitive micro-trauma in a foot with impaired sensation and neurovascular changes caused by pathological innervation of the blood vessels. In most cases, changes are due to a combination of both pathophysiological factors. The Charcot foot is triggered by a combination of mechanical, vascular and biological factors which can lead to late diagnosis and incorrect treatment and eventually to destruction of the foot. This review aims to raise awareness of the diagnosis of the Charcot foot (diabetic neuropathic osteoarthropathy and the differential diagnosis, erysipelas, peripheral arterial occlusive disease) and describe the ways in which the diagnosis may be made. The clinical diagnostic pathways based on different classifications are presented. Cite this article: Bone Joint J 2016;98-B:1155-9. PMID:27587513

  20. Unraveling Executive Functioning in Dual Diagnosis

    PubMed Central

    Duijkers, Judith C. L. M.; Vissers, Constance Th. W. M.; Egger, Jos I. M.

    2016-01-01

    In mental health, the term dual-diagnosis is used for the co-occurrence of Substance Use Disorder (SUD) with another mental disorder. These co-occurring disorders can have a shared cause, and can cause/intensify each other’s expression. Forming a threat to health and society, dual-diagnosis is associated with relapses in addiction-related behavior and a destructive lifestyle. This is due to a persistent failure to control impulses and the maintaining of inadequate self-regulatory behavior in daily life. Thus, several aspects of executive functioning like inhibitory, shifting and updating processes seem impaired in dual-diagnosis. Executive (dys-)function is currently even seen as a shared underlying key component of most mental disorders. However, the number of studies on diverse aspects of executive functioning in dual-diagnosis is limited. In the present review, a systematic overview of various aspects of executive functioning in dual-diagnosis is presented, striving for a prototypical profile of patients with dual-diagnosis. Looking at empirical results, inhibitory and shifting processes appear to be impaired for SUD combined with schizophrenia, bipolar disorder or cluster B personality disorders. Studies involving updating process tasks for dual-diagnosis were limited. More research that zooms in to the full diversity of these executive functions is needed in order to strengthen these findings. Detailed insight in the profile of strengths and weaknesses that underlies one’s behavior and is related to diagnostic classifications, can lead to tailor-made assessment and indications for treatment, pointing out which aspects need attention and/or training in one’s self-regulative abilities. PMID:27445939

  1. Fast Algorithms for Model-Based Diagnosis

    NASA Technical Reports Server (NTRS)

    Fijany, Amir; Barrett, Anthony; Vatan, Farrokh; Mackey, Ryan

    2005-01-01

    Two improved new methods for automated diagnosis of complex engineering systems involve the use of novel algorithms that are more efficient than prior algorithms used for the same purpose. Both the recently developed algorithms and the prior algorithms in question are instances of model-based diagnosis, which is based on exploring the logical inconsistency between an observation and a description of a system to be diagnosed. As engineering systems grow more complex and increasingly autonomous in their functions, the need for automated diagnosis increases concomitantly. In model-based diagnosis, the function of each component and the interconnections among all the components of the system to be diagnosed (for example, see figure) are represented as a logical system, called the system description (SD). Hence, the expected behavior of the system is the set of logical consequences of the SD. Faulty components lead to inconsistency between the observed behaviors of the system and the SD. The task of finding the faulty components (diagnosis) reduces to finding the components, the abnormalities of which could explain all the inconsistencies. Of course, the meaningful solution should be a minimal set of faulty components (called a minimal diagnosis), because the trivial solution, in which all components are assumed to be faulty, always explains all inconsistencies. Although the prior algorithms in question implement powerful methods of diagnosis, they are not practical because they essentially require exhaustive searches among all possible combinations of faulty components and therefore entail the amounts of computation that grow exponentially with the number of components of the system.

  2. Unraveling Executive Functioning in Dual Diagnosis.

    PubMed

    Duijkers, Judith C L M; Vissers, Constance Th W M; Egger, Jos I M

    2016-01-01

    In mental health, the term dual-diagnosis is used for the co-occurrence of Substance Use Disorder (SUD) with another mental disorder. These co-occurring disorders can have a shared cause, and can cause/intensify each other's expression. Forming a threat to health and society, dual-diagnosis is associated with relapses in addiction-related behavior and a destructive lifestyle. This is due to a persistent failure to control impulses and the maintaining of inadequate self-regulatory behavior in daily life. Thus, several aspects of executive functioning like inhibitory, shifting and updating processes seem impaired in dual-diagnosis. Executive (dys-)function is currently even seen as a shared underlying key component of most mental disorders. However, the number of studies on diverse aspects of executive functioning in dual-diagnosis is limited. In the present review, a systematic overview of various aspects of executive functioning in dual-diagnosis is presented, striving for a prototypical profile of patients with dual-diagnosis. Looking at empirical results, inhibitory and shifting processes appear to be impaired for SUD combined with schizophrenia, bipolar disorder or cluster B personality disorders. Studies involving updating process tasks for dual-diagnosis were limited. More research that zooms in to the full diversity of these executive functions is needed in order to strengthen these findings. Detailed insight in the profile of strengths and weaknesses that underlies one's behavior and is related to diagnostic classifications, can lead to tailor-made assessment and indications for treatment, pointing out which aspects need attention and/or training in one's self-regulative abilities.

  3. Unraveling Executive Functioning in Dual Diagnosis.

    PubMed

    Duijkers, Judith C L M; Vissers, Constance Th W M; Egger, Jos I M

    2016-01-01

    In mental health, the term dual-diagnosis is used for the co-occurrence of Substance Use Disorder (SUD) with another mental disorder. These co-occurring disorders can have a shared cause, and can cause/intensify each other's expression. Forming a threat to health and society, dual-diagnosis is associated with relapses in addiction-related behavior and a destructive lifestyle. This is due to a persistent failure to control impulses and the maintaining of inadequate self-regulatory behavior in daily life. Thus, several aspects of executive functioning like inhibitory, shifting and updating processes seem impaired in dual-diagnosis. Executive (dys-)function is currently even seen as a shared underlying key component of most mental disorders. However, the number of studies on diverse aspects of executive functioning in dual-diagnosis is limited. In the present review, a systematic overview of various aspects of executive functioning in dual-diagnosis is presented, striving for a prototypical profile of patients with dual-diagnosis. Looking at empirical results, inhibitory and shifting processes appear to be impaired for SUD combined with schizophrenia, bipolar disorder or cluster B personality disorders. Studies involving updating process tasks for dual-diagnosis were limited. More research that zooms in to the full diversity of these executive functions is needed in order to strengthen these findings. Detailed insight in the profile of strengths and weaknesses that underlies one's behavior and is related to diagnostic classifications, can lead to tailor-made assessment and indications for treatment, pointing out which aspects need attention and/or training in one's self-regulative abilities. PMID:27445939

  4. When psychiatric diagnosis becomes an overworked tool.

    PubMed

    Szmukler, George

    2014-08-01

    A psychiatric diagnosis today is asked to serve many functions-clinical, research, medicolegal, delimiting insurance coverage, service planning, defining eligibility for state benefits (eg, for unemployment or disability), as well as providing rallying points for pressure groups and charities. These contexts require different notions of diagnosis to tackle the particular problem such a designation is meant to solve. In a number of instances, a 'status' definition (ie, a diagnostic label or category) is employed to tackle what is more appropriately seen as requiring a 'functional' approach (ie, how well the person is able to meet the demands of a test of performance requiring certain capabilities, aptitudes or skills). In these instances, a diagnosis may play only a subsidiary role. Some examples are discussed: the criteria for involuntary treatment; the determination of criminal responsibility; and, assessing entitlements to state benefits. I suggest that the distinction between 'status' versus 'function' has not been given sufficient weight in discussions of diagnosis. It is in the functional domain that some of the problematic relationships between clinical psychiatry and the social institutions with which it rubs shoulders are played out. A status, signified by a diagnosis, has often been encumbered with demands for which it is poorly equipped. It is a reductive way of solving problems of management, allocation or disposal for which a functional approach should be given greater weight. PMID:24241948

  5. Molecular diagnosis of chronic granulomatous disease.

    PubMed

    Roos, D; de Boer, M

    2014-02-01

    Patients with chronic granulomatous disease (CGD) suffer from recurrent, life-threatening bacterial and fungal infections of the skin, the airways, the lymph nodes, liver, brain and bones. Frequently found pathogens are Staphylococcus aureus, Aspergillus species, Klebsiella species, Burkholderia cepacia and Salmonella species. CGD is a rare (∼1:250 000 births) disease caused by mutations in any one of the five components of the nicotinamide adenine dinucleotide phosphate (NADPH) oxidase in phagocytes. This enzyme generates superoxide and is essential for intracellular killing of pathogens by phagocytes. Molecular diagnosis of CGD involves measuring NADPH oxidase activity in phagocytes, measuring protein expression of NADPH oxidase components and mutation analysis of genes encoding these components. Residual oxidase activity is important to know for estimation of the clinical course and the chance of survival of the patient. Mutation analysis is mandatory for genetic counselling and prenatal diagnosis. This review summarizes the different assays available for the diagnosis of CGD, the precautions to be taken for correct measurements, the flow diagram to be followed, the assays for confirmation of the diagnosis and the determinations for carrier detection and prenatal diagnosis. PMID:24016250

  6. Exostoses, enchondromatosis and metachondromatosis; diagnosis and management.

    PubMed

    McFarlane, John; Knight, Tim; Sinha, Anubha; Cole, Trevor; Kiely, Nigel; Freeman, Rob

    2016-03-01

    We describe a 5 years old girl who presented to the multidisciplinary skeletal dysplasia clinic following excision of two bony lumps from her fingers. Based on clinical examination, radiolographs and histological results an initial diagnosis of hereditary multiple exostosis (HME) was made. Four years later she developed further lumps which had the radiological appearance of enchondromas. The appearance of both exostoses and enchondromas suggested a possible diagnosis of metachondromatosis. Genetic testing revealed a splice site mutation at the end of exon 11 on the PTPN11 gene, confirming the diagnosis of metachondromatosis. While both single or multiple exostoses and enchondromas occur relatively commonly on their own, the appearance of multiple exostoses and enchondromas together is rare and should raise the differential diagnosis of metachondromatosis. Making this diagnosis is important as the lesions in metachondromatosis may spontaneously resolve and therefore surgical intervention is often unnecessary. We discuss the diagnostic findings, genetic causes, treatment and prognosis of this rare condition of which less than thirty cases have previously been reported. PMID:26984661

  7. Childhood injury after a parental cancer diagnosis

    PubMed Central

    Chen, Ruoqing; Regodón Wallin, Amanda; Sjölander, Arvid; Valdimarsdóttir, Unnur; Ye, Weimin; Tiemeier, Henning; Fall, Katja; Almqvist, Catarina; Czene, Kamila; Fang, Fang

    2015-01-01

    A parental cancer diagnosis is psychologically straining for the whole family. We investigated whether a parental cancer diagnosis is associated with a higher-than-expected risk of injury among children by using a Swedish nationwide register-based cohort study. Compared to children without parental cancer, children with parental cancer had a higher rate of hospital contact for injury during the first year after parental cancer diagnosis (hazard ratio [HR] = 1.27, 95% confidence interval [CI] = 1.22-1.33), especially when the parent had a comorbid psychiatric disorder after cancer diagnosis (HR = 1.41, 95% CI = 1.08-1.85). The rate increment declined during the second and third year after parental cancer diagnosis (HR = 1.10, 95% CI = 1.07-1.14) and became null afterwards (HR = 1.01, 95% CI = 0.99-1.03). Children with parental cancer also had a higher rate of repeated injuries than the other children (HR = 1.13, 95% CI = 1.12-1.15). Given the high rate of injury among children in the general population, our findings may have important public health implications. DOI: http://dx.doi.org/10.7554/eLife.08500.001 PMID:26519735

  8. The Fuzzy Model for Diagnosis of Animal Disease

    NASA Astrophysics Data System (ADS)

    Jianhua, Xiao; Luyi, Shi; Yu, Zhang; Li, Gao; Honggang, Fan; Haikun, Ma; Hongbin, Wang

    The knowledge of animal disease diagnosis was fuzzy; the fuzzy model can imitate the character of clinical diagnosis for veterinary. The fuzzy model of disease, the methods for class the disease group of differential diagnosis and the fuzzy diagnosis model were discussed in this paper.

  9. Psychiatric Diagnosis in Persons with Intellectual Disability in India

    ERIC Educational Resources Information Center

    Kishore, M. T.; Nizamie, A.; Nizamie, S. H.; Jahan, M.

    2004-01-01

    This study examines the rate of psychiatric diagnosis as per ICD-10 and Reiss Screen for Maladaptive Behaviours (RSMB), and distribution of psychiatric diagnosis with regard to the severity of intellectual disability (ID). It also explores the degree of agreement between Reiss screen and clinical diagnosis (ICD-10) in relation to dual diagnosis. …

  10. Early Diagnosis of Autism Spectrum Disorder: Stability and Change in Clinical Diagnosis and Symptom Presentation

    ERIC Educational Resources Information Center

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

    2013-01-01

    Background: Although a diagnosis of autism spectrum disorder (ASD) appears to be stable in children as young as age three, few studies have explored stability of a diagnosis in younger children. Predictive value of diagnostic tools for toddlers and patterns of symptom change are important considerations for clinicians making early diagnoses. Most…

  11. Silicon nanostructures for cancer diagnosis and therapy.

    PubMed

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

    2015-01-01

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

  12. Cervical cancer: Biomarkers for diagnosis and treatment.

    PubMed

    Dasari, Subramanyam; Wudayagiri, Rajendra; Valluru, Lokanatha

    2015-05-20

    Cervical cancer is a major gynecological cancer which involves uncontrolled cell division and tissue invasiveness of the female uterine cervix. With the availability of new technologies researchers have increased their efforts to develop novel biomarkers for early diagnosis, and evaluation and monitoring of therapeutic treatments. This approach will help in the development of early diagnosis and in increasing treatment efficacy with decreased recurrence. The present review explains the currently available biomarkers for cervical cancer diagnosis and prognosis. Apart from the currently available biomarkers the review also explains strategies for the development of biomarkers based on cellular and molecular approaches such as DNA, protein and other metabolic markers with suitable clinical examples. The investigations of specific proteins, enzymes and metabolites will establish more useful biomarkers for accurate detection and management of gynecological cancers especially cervical cancer.

  13. Postmortem molecular diagnosis of sickle beta thalassaemia.

    PubMed

    Kutlar, F; Mirmow, D; Glendenning, M; Holley, L; Kutlar, A

    2005-05-01

    This report describes a case in which the diagnosis of sickle cell disease (SCD) was established after death. The diagnosis of sickle cell syndrome was made in a 68 year old black patient who was found to have sickled red blood cells in many organs at necropsy although the disease had not been diagnosed during her lifetime. DNA was isolated from a peripheral blood smear obtained on the day of the patient's death. The beta globin gene was polymerase chain reaction amplified and sequenced, revealing that the patient had S-beta(+) thalassaemia. This study shows that blood smears are a suitable source for retrospective DNA analysis studies. This case illustrates that relatively "mild" forms of SCD can be overlooked, despite symptomatology suggestive of a sickle syndrome, and demonstrates the feasibility of the postmortem molecular diagnosis of haemoglobinopathies in such cases.

  14. Delayed Diagnosis of Adult Indolent Systemic Mastocytosis

    PubMed Central

    Mikkelsen, Carsten Sauer; Nybo, Andrew; Arvesen, Kristian Bakke; Holk-Poulsen, Johan

    2014-01-01

    Systemic mastocytosis (SM) is a rare, heterogeneous disorder characterized by infiltration and accumulation of mast cells within multiple organs, most commonly the skin. Given the rarity of the disease and the fact that many of its symptoms are shared by more common disorders, a diagnosis may be delayed or hindered. These patients have an elevated risk of developing potentially life-threatening anaphylactoid reactions, thus underscoring the importance of keeping SM in mind as a differential diagnosis when a patient presents with chronic, itchy skin lesions and a history of multiple allergic reactions to bites, drugs, and anesthesia. We present a case illustrating that features of SM common to many disorders may hinder or delay its diagnosis. PMID:25386326

  15. Unexplained male infertility: diagnosis and management.

    PubMed

    Hamada, Alaa; Esteves, Sandro C; Nizza, Mark; Agarwal, Ashok

    2012-01-01

    Unexplained male infertility is a diagnosis reserved for men in whom routine semen analyses results are within normal values and physical as well as endocrine abnormalities were ruled out. In addition to erectile problems and coital factors, immunologic causes and sperm dysfunction may contribute to such condition. New etiologies of unexplained male infertility include low level leukocytospermia and mitochondrial DNA polymerase gene polymorphism. Contemporary andrology may reveal cellular and sub-cellular sperm dysfunctions which may explain subfertility in such cases, thus aiding the clinician to direct the further work-up, diagnosis and counseling of the infertile male. The objective of this article is to highlight the concept of unexplained male infertility and focuses on the diagnosis and treatment of this condition in the era of modern andrology and assisted reproductive techniques. Extensive literature review was performed using the search engines: Pubmed, Science-direct, Ovid and Scopus.

  16. [Informing of the diagnosis in dementia].

    PubMed

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

    2011-01-01

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

  17. Orofacial tuberculosis: Clinical manifestations, diagnosis and management

    PubMed Central

    Bansal, Ramta; Jain, Aditya; Mittal, Sunandan

    2015-01-01

    Orofacial tuberculosis (TB) is an uncommon form of extrapulmonary TB and is nonspecific in its clinical presentation. It can be misdiagnosed especially when oral lesions are present before systemic symptoms become apparent. Doctors especially attending dentist who generally is the first among clinicians to come across such pathological entity should be aware of the orofacial lesions of TB and consider them in the differential diagnosis of suspicious oral lesions to ensure early diagnosis of TB and its treatment. In this review, we have discussed in detail the clinical presentation of various forms of orofacial TB, diagnosis, and management of patients. Also, an update is provided about recent anti-TB drug development. PMID:26288770

  18. Congenital lobar emphysema: Pitfalls in diagnosis.

    PubMed

    Chinya, Abhishek; Pandey, Prince Raj; Sinha, Shandip Kumar; Sarin, Yogesh Kumar

    2016-01-01

    Congenital lobar emphysema (CLE) is a rare but life-threatening congenital anomaly leading to respiratory distress in early childhood. Diagnosis requires a strong clinical suspicion. We report a case of a 31/2-month-old infant who was initially diagnosed with pneumonia requiring multiple hospital admissions. After computed tomography of the thorax, a diagnosis on CLE was made. The child was planned for surgery in the next available routine operation theatre. However, suddenly in the evening, she developed respiratory distress and needed emergency surgical intervention. The child improved dramatically after surgery, and the postoperative period was uneventful. Early diagnosis and treatment in such cases can lead to dramatic results. PMID:27185998

  19. Improving Distributed Diagnosis Through Structural Model Decomposition

    NASA Technical Reports Server (NTRS)

    Bregon, Anibal; Daigle, Matthew John; Roychoudhury, Indranil; Biswas, Gautam; Koutsoukos, Xenofon; Pulido, Belarmino

    2011-01-01

    Complex engineering systems require efficient fault diagnosis methodologies, but centralized approaches do not scale well, and this motivates the development of distributed solutions. This work presents an event-based approach for distributed diagnosis of abrupt parametric faults in continuous systems, by using the structural model decomposition capabilities provided by Possible Conflicts. We develop a distributed diagnosis algorithm that uses residuals computed by extending Possible Conflicts to build local event-based diagnosers based on global diagnosability analysis. The proposed approach is applied to a multitank system, and results demonstrate an improvement in the design of local diagnosers. Since local diagnosers use only a subset of the residuals, and use subsystem models to compute residuals (instead of the global system model), the local diagnosers are more efficient than previously developed distributed approaches.

  20. Pulmonary Tuberculosis Diagnosis: Where We Are?

    PubMed Central

    Leylabadlo, Hamed Ebrahimzadeh; Yousefi, Mehdi; Aghazadeh, Mohammad; Asgharzadeh, Mohammad

    2016-01-01

    In recent years, in spite of medical advancement, tuberculosis (TB) remains a worldwide health problem. Although many laboratory methods have been developed to expedite the diagnosis of TB, delays in diagnosis remain a major problem in the clinical practice. Because of the slow growth rate of the causative agent Mycobacterium tuberculosis, isolation, identification, and drug susceptibility testing of this organism and other clinically important mycobacteria can take several weeks or longer. During the past several years, many methods have been developed for direct detection, species identification, and drug susceptibility testing of TB. A good understanding of the effectiveness and practical limitations of these methods is important to improve diagnosis. This review summarizes the currently-used advances in nonmolecular and molecular diagnostics. PMID:27433173

  1. Epidemiology and Diagnosis of Helicobacter pylori infection.

    PubMed

    Mentis, Andreas; Lehours, Philippe; Mégraud, Francis

    2015-09-01

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

  2. Evaluation, Diagnosis, and Staging of Cutaneous Lymphoma.

    PubMed

    Olsen, Elise A

    2015-10-01

    Primary cutaneous lymphomas (PCLs) are an extremely heterogeneous group of non-Hodgkin lymphomas that manifest in the skin. Their diagnosis is complex and based on clinical lesion type and evaluation of findings on light microscopic examination, immunohistochemistry and molecular analysis of representative skin biopsies. The evaluation, classification, and staging system is unique for mycosis fungoides (MF) and Sézary syndrome (SS), the most common subtypes of cutaneous T-cell lymphoma (CTCL) versus the other subtypes of Non-MF/Non-SS CTCL and the subtypes of cutaneous B-cell lymphoma (CBCL). Since current treatment is stage-based, it is particularly important that the correct diagnosis and stage be ascertained initially. The purpose of this article is to review the current evaluation, diagnosis, classification, staging, assessment techniques, and response criteria for the various types of both T-cell and B-cell PCLs. PMID:26433839

  3. Real-time value-driven diagnosis

    NASA Technical Reports Server (NTRS)

    Dambrosio, Bruce

    1995-01-01

    Diagnosis is often thought of as an isolated task in theoretical reasoning (reasoning with the goal of updating our beliefs about the world). We present a decision-theoretic interpretation of diagnosis as a task in practical reasoning (reasoning with the goal of acting in the world), and sketch components of our approach to this task. These components include an abstract problem description, a decision-theoretic model of the basic task, a set of inference methods suitable for evaluating the decision representation in real-time, and a control architecture to provide the needed continuing coordination between the agent and its environment. A principal contribution of this work is the representation and inference methods we have developed, which extend previously available probabilistic inference methods and narrow, somewhat, the gap between probabilistic and logical models of diagnosis.

  4. [Differential diagnosis between dissociative disorders and schizophrenia].

    PubMed

    Shibayama, Masatoshi

    2011-01-01

    The differential diagnosis of dissociative disorders includes many psychiatric disorders, such as schizophrenia, bipolar disorders (especially bipolar II disorder), depressive disorder (especially atypical depression), epilepsy, Asperger syndrome, and borderline personality disorder. The theme of this paper is the differential diagnosis between dissociative disorders and schizophrenia. Schneiderian first-rank symptoms in schizophrenia are common in dissociative disorders, especially in dissociative identity disorder (DID). Many DID patients have been misdiagnosed as schizophrenics and treated with neuroleptics. We compared and examined Schneiderian symptoms of schizophrenia and those of dissociative disorders from a structural viewpoint. In dissociative disorders, delusional perception and somatic passivity are not seen. "Lateness" and "Precedence of the Other" originated from the concept of "Pattern Reversal" (H. Yasunaga)" is characteristic of schizophrenia. It is important to check these basic structure of schizophrenia in subjective experiences in differential diagnosis between dissociative disorders and schizophrenia.

  5. [Ultrasound diagnosis of salivary gland tumors].

    PubMed

    Fernández-Martínez, A; Gutiérrez-Cabello, F; Jiménez-Alonso, J; Aranegui, P; Castro, J; Hernández-Hernández, L

    1997-03-01

    The ultrasonic diagnosis of salivary gland tumors can give a more accurate information than clinical data alone. For example, it will help differentiate intraglandular from extraglandular tumors and benign from malignant processes. We conducted a prospective study in 39 patients with parotidal or submaxillary tumors. Patients were evaluated with a physical exam and a with ultrasound. Results indicate that only 53.86% of the physical examinations were correct in their diagnosis compared to 87.18% of the those done by ultrasound. Specificity and sensibility for malignancy was 96.43% and 81.81% respectively. These results were similar to those reported by other authors. We conclude that the use of ultrasound techniques in the study of salivary gland pathology is well justified, due to its capacity to provide high resolution, improving clinical diagnosis.

  6. Brain death diagnosis in misleading conditions.

    PubMed

    de Tourtchaninoff, M; Hantson, P; Mahieu, P; Guérit, J M

    1999-07-01

    The necessity of defining brain death (BD) arose from technological development in medical science. The definition of this concept had practical consequences and opened the way to organ donation from BD patients. Nowadays, the imbalance between the number of organs available for transplantation and the size of the demand is becoming critical. In most laboratories, a BD diagnosis is made according to precise criteria and in a well-defined process. BD diagnosis should be improved, not only to assure the safety and to preserve the human dignity of the patient, but also in order to increase the rate of organ donation. By analysing some epidemiological parameters in BD diagnosis and organ donation, it appears that BD diagnoses can be made more often and more rapidly if one has a reliable, accurate, and safe confirmatory test, especially under misleading conditions (hypothermia, drugs, metabolic disturbances). In our experience, the use of multimodality evoked potentials (MEPs) to confirm a BD diagnosis has many advantages: MEPs can be rapidly performed at the patient's bedside, assess the brain stem as well as the cerebral cortex, and are innocuous for the patient. Moreover, their insensitivity to the aforementioned misleading factors is sufficient to distinguish BD from clinical and EEG states that mimic BD. They give an immediate diagnosis, and no delay is required in BD confirmation if there is sufficient cause to account for BD. MEPs are a safe, accurate, and reliable tool for confirming a BD diagnosis, and their use can improve the organ donation rate while preserving the safety of the patient. PMID:10627891

  7. Diagnosis of Bleeding Meckel's Diverticulum in Adults

    PubMed Central

    Hong, Sung Noh; Jang, Hyun Joo; Ye, Byong Duk; Jeon, Seong Ran; Im, Jong Pil; Cha, Jae Myung; Kim, Seong-Eun; Park, Soo Jung; Kim, Eun Ran; Chang, Dong Kyung

    2016-01-01

    Background and Aims Various modalities have been used to diagnose Meckel's diverticulum (MD) in practice, but with their diagnostic accuracy deemed to be unsatisfactory for clinical practice. Moreover, the usefulness of these modalities has not been evaluated for the diagnosis of bleeding MD in adults, due to the relative rarity of this condition. Therefore, the aim of our multicenter study was to determine the most accurate modality for the preoperative diagnosis of bleeding MD in adults. Methods We conducted a retrospective analysis of the diagnostic accuracy for small bowel bleeding associated with MD of different modalities in patients ≥18 years old who underwent assessment for MD, with confirmation at the time of explorative surgery. Diagnostic accuracy of the different modalities was evaluated against the diagnosis obtained using technetium-99m pertechnetate scintigraphy (also known as Meckel's scan), considered to be the gold standard for the diagnosis of bleeding MD in pediatrics. Results Thirty-five adults were identified with bleeding in MD over the study period, between 2005 and 2012. Among these patients, only 24 (68.6%) were diagnosed with MD preoperatively. The mean (95% confidence interval) diagnostic accuracy of selected modalities was as follows: Meckel’s scan, 21.4% (5.7%-51.2%); capsule endoscopy, 35.7% (14.0%-64.4%); balloon-assisted enteroscopy (BAE), 85.0% (61.1%-96.0%); angiography, 0.0% (0.0%-80.2%); computed tomography, 31.8% (14.7%-54.9%); and small-bowel follow-through, 62.5% (25.9%-90.0%). The diagnostic accuracy was significantly higher for BAE than for Meckel’s scan (P = 0.001). Conclusions Among available diagnostic modalities, BAE provides the highest accuracy for the diagnosis of bleeding MD in adults and, therefore, should be considered as the preferred modality for preoperative diagnosis. PMID:27626641

  8. Exploring Symmetry to Assist Alzheimer's Disease Diagnosis

    NASA Astrophysics Data System (ADS)

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

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

  9. Neonatal candidiasis: diagnosis, prevention, and treatment.

    PubMed

    Greenberg, Rachel G; Benjamin, Daniel K

    2014-11-01

    Infection with Candida species is associated with significant morbidity and mortality in infants. The incidence of Candida infection varies widely across centers, likely due to differences in practice related to modifiable risk factors such as exposure to empiric antibiotics and length of parenteral nutrition. Early diagnosis of Candida and prompt treatment with appropriate antifungal agents, such as fluconazole, amphotericin B deoxycholate, and micafungin, are critical for improved outcomes. This paper reviews the current literature relating to the prevention, diagnosis, and treatment of Candida infections in the neonatal intensive care unit.

  10. Computer-aided diagnosis in thoracic CT

    NASA Astrophysics Data System (ADS)

    Li, Qiang

    2009-10-01

    Computer-aided diagnosis (CAD) provides a computer output as a "second opinion" in order to assist radiologists in the diagnosis of various diseases on medical images. Currently, a hot topic in CAD is the development of computerized schemes for detection of lung abnormalities, such as lung nodule and interstitial lung disease, in computed tomography (CT) images. The author describes in this article the current status of the CAD schemes for the detection of lung nodules and interstitial lung disease in CT developed by the author and his colleagues at the University of Chicago and Duke University.

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

    PubMed

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

    2016-02-21

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

  12. Diagnosis and treatment of Lyme arthritis.

    PubMed

    Arvikar, Sheila L; Steere, Allen C

    2015-06-01

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

  13. Pulmonary hypertension in dogs: diagnosis and therapy.

    PubMed

    Kellihan, Heidi B; Stepien, Rebecca L

    2010-07-01

    Pulmonary hypertension (PH) has been recognized as a clinical syndrome for many years in veterinary medicine, but routine accurate clinical diagnosis in dogs was greatly enhanced by widespread use of echocardiography and Doppler echocardiography. Most cases of PH in veterinary medicine can be categorized as precapillary or postcapillary. These subsets of patients often differ with regard to clinical presentation, response to therapy, and prognosis. Effective medical therapy is now available to treat this often-devastating clinical complication of common chronic diseases, making accurate diagnosis even more important to patient longevity and quality of life.

  14. Serological diagnosis of toxoplasmosis and standardization.

    PubMed

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

    2016-10-01

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

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

    PubMed

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

    2016-02-21

    Graves' orbitopathy is the extrathyroidal manifestation of Graves' disease, which is the most common cause of exophthalmos. As eye symptoms usually coincide with the development of thyrotoxicosis, the diagnosis of the disease is rarely difficult. The aim of the authors was to summarize the differential diagnosis of Graves' orbitopathy based on literature review and presentation of their own four problematic cases on this topic. They conclude that symptoms similar to endocrine orbitopathy are present in other disorders. Endocrinologists need to be aware of these other conditions to avoid treatment failures. PMID:26876268

  16. Diagnosis of Adult Patients with Cystic Fibrosis.

    PubMed

    Nick, Jerry A; Nichols, David P

    2016-03-01

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

  17. Diagnosis of hantavirus infection in humans.

    PubMed

    Mattar, Salim; Guzmán, Camilo; Figueiredo, Luis Tadeu

    2015-08-01

    Rodent-borne hantaviruses (family Bunyaviridae, genus Hantavirus) cause hantavirus pulmonary syndrome in the Americas and hemorrhagic fever with renal syndrome in Europe and Asia. The viruses are transmitted to humans mainly by inhalation of virus-contaminated aerosols of rodent excreta and secreta. Classic clinical hemorrhagic fever with renal syndrome occurs in five phases: fever, hypotension, oliguria, polyuria, and convalescence. Hantavirus pulmonary syndrome is a severe acute disease that is associated with respiratory failure, pulmonary edema and cardiogenic shock. The diagnosis of hantavirus infections in humans is based on clinical and epidemiological information as well as laboratory tests. We review diagnosis for hantavirus infections based on serology, PCR, immunochemistry and virus culture.

  18. Macromelanosomes in the early diagnosis of neurofibromatosis.

    PubMed

    Slater, C; Hayes, M; Saxe, N; Temple-Camp, C; Beighton, P

    1986-08-01

    Skin biopsies of café-au-lait macules from 34 patients with a clinical diagnosis of classical neurofibromatosis were examined histologically and ultrastructurally to determine the presence or absence of macromelanosomes in the epidermal melanocytes and keratinocytes. Sixteen of the 34 patients had macromelanosomes. The presence of macromelanosomes varied with age and ethnic background; they were detected in nine of 12 Whites, six of 10 persons of mixed ancestry, and one of two Blacks. In these populations skin biopsy is useful in early diagnosis of neurofibromatosis. However, none of 10 persons of Indian stock had macromelanosomes. Their total absence in this group may be indicative of genetic heterogeneity.

  19. Diagnosis and treatment of allergic rhinitis.

    PubMed

    Smith, L J

    1995-10-01

    Allergic rhinitis is frequently seen by primary care providers. Symptoms include rhinorrhea, itching of nose and eyes, nasal congestion, and sneezing. They occur when the patient is exposed to antigens stimulating mediator release. History is essential to assist differential diagnosis and provide education. This article reviews common findings of the physical exam, diagnostic testing, and differential diagnosis. The first line of treatment is avoidance, followed by medications such as antihistamines, decongestants, and nasal steroids. If these treatments are not effective, then referral to an allergist is necessary for further workup and possible treatment with immunotherapy.

  20. Primary cutaneous lymphomas: diagnosis and treatment

    PubMed Central

    Olek-Hrab, Karolina; Ruckemann-Dziurdzińska, Katarzyna

    2015-01-01

    Primary cutaneous lymphomas (CLs) are a heterogeneous group of lymphoproliferative neoplasms, with lymphatic proliferation limited to the skin with no involvement of lymph nodes, bone marrow or viscera at the diagnosis. Cutaneous lymphomas originate from mature T-lymphocytes (65% of all cases), mature B-lymphocytes (25%) or NK cells. Histopathological evaluation including immunophenotyping of the skin biopsy specimen is the basis of the diagnosis, which must be complemented with a precise staging of the disease and identification of prognostic factors, to allow for the choice of the best treatment method as well as for the evaluation of the treatment results. PMID:26759546

  1. Malaria diagnosis: Memorandum from a WHO Meeting*

    PubMed Central

    1988-01-01

    This Memorandum reviews (1) the diagnostic requirements for malaria control within the primary health care system; (2) the current methods of malaria diagnosis used both in the clinic and in epidemiological studies; (3) the status of research on alternative methods to microscopy for the diagnosis of malaria; and (4) the application of new diagnostic methods in individual cases, in the community, and in the mosquito and their possible integration into existing epidemiological studies and control programmes. It also identifies priorities for the development and validation of new and reliable diagnostic techniques, and makes recommendations for the improvement, standardization, and utilization of current methodology. PMID:3061674

  2. Duodenal angiolipoma -- endoscopic diagnosis and therapy.

    PubMed

    Mohl, W; Fischinger, J; Moser, C; Remberger, K; Zeuzem, S; Stallmach, A

    2004-12-01

    We report on two patients with upper gastrointestinal bleeding owing to duodenal angiolipomas, and their endoscopic diagnosis and therapy. In both cases the bleeding source was a pedunculated tumour. Diagnosis and definitive therapy was made by endoscopic snare polypectomy. After stopping the bleeding from the mucosal defect by injection therapy in one patient, the further course was uneventful in both. A colonic angiolipoma in one of the patients was also treated by polypectomy. Gastrointestinal angiolipomas are exceedingly rare, however, these case reports show that duodenal angiolipomas do exist and that they, as lipomas, may lead to substantial gastrointestinal bleeding and may be treated successfully by standard polypectomy techniques.

  3. Serological diagnosis of toxoplasmosis and standardization.

    PubMed

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

    2016-10-01

    Humans can be infected by the intracellular parasite Toxoplasma gondii, which causes toxoplasmosis, a common parasitic disease. Although the infection is generally asymptomatic for most adults, severe complications may occur in some individuals, especially women in early pregnancy. Serologic diagnosis is used as a routine practice to determine the immune status for infection by T. gondii. In this review, we attempt to provide an overview of the serological diagnosis of toxoplasmosis, including diagnostic strategy, current problems in detection with specific antibodies, and the standardization of T. gondii serological detection. PMID:27470936

  4. Primary cutaneous lymphomas: diagnosis and treatment.

    PubMed

    Sokołowska-Wojdyło, Małgorzata; Olek-Hrab, Karolina; Ruckemann-Dziurdzińska, Katarzyna

    2015-10-01

    Primary cutaneous lymphomas (CLs) are a heterogeneous group of lymphoproliferative neoplasms, with lymphatic proliferation limited to the skin with no involvement of lymph nodes, bone marrow or viscera at the diagnosis. Cutaneous lymphomas originate from mature T-lymphocytes (65% of all cases), mature B-lymphocytes (25%) or NK cells. Histopathological evaluation including immunophenotyping of the skin biopsy specimen is the basis of the diagnosis, which must be complemented with a precise staging of the disease and identification of prognostic factors, to allow for the choice of the best treatment method as well as for the evaluation of the treatment results. PMID:26759546

  5. Advances in Diagnosis of Respiratory Virus Infections

    PubMed Central

    Loeffelholz, Michael; Chonmaitree, Tasnee

    2010-01-01

    The diagnosis of respiratory virus infections has evolved substantially in recent years, with the emergence of new pathogens and the development of novel detection methods. While recent advances have improved the sensitivity and turn-around time of diagnostic tests for respiratory viruses, they have also raised important issues such as cost, and the clinical significance of detecting multiple viruses in a single specimen by molecular methods. This article reviews recent advances in specimen collection and detection methods for diagnosis of respiratory virus infections, and discusses the performance characteristics and limitations of these methods. PMID:20981303

  6. Differential diagnosis of the palatal mass.

    PubMed

    Houston, G D; Brown, F H

    1993-10-01

    It is well understood that the palatal mass can pose a difficult diagnostic dilemma for the clinician. The differential diagnosis of the palatal mass includes the palatal abscess, benign and malignant salivary gland neoplasms, the benign neural tumors, and the traumatic or irritation fibroma. The lesions have many characteristics in common and may appear clinically indistinguishable. Emphasis is placed on the importance of obtaining a thorough, comprehensive health and dental history and collecting relevant laboratory information. Ultimately, a biopsy of the palatal mass may be necessary to render a definitive diagnosis and determine the optimal treatment and management of the patient.

  7. Research into a distributed fault diagnosis system and its application

    NASA Astrophysics Data System (ADS)

    Qian, Suxiang; Jiao, Weidong; Lou, Yongjian; Shen, Xiaomei

    2005-12-01

    CORBA (Common Object Request Broker Architecture) is a solution to distributed computing methods over heterogeneity systems, which establishes a communication protocol between distributed objects. It takes great emphasis on realizing the interoperation between distributed objects. However, only after developing some application approaches and some practical technology in monitoring and diagnosis, can the customers share the monitoring and diagnosis information, so that the purpose of realizing remote multi-expert cooperation diagnosis online can be achieved. This paper aims at building an open fault monitoring and diagnosis platform combining CORBA, Web and agent. Heterogeneity diagnosis object interoperate in independent thread through the CORBA (soft-bus), realizing sharing resource and multi-expert cooperation diagnosis online, solving the disadvantage such as lack of diagnosis knowledge, oneness of diagnosis technique and imperfectness of analysis function, so that more complicated and further diagnosis can be carried on. Take high-speed centrifugal air compressor set for example, we demonstrate a distributed diagnosis based on CORBA. It proves that we can find out more efficient approaches to settle the problems such as real-time monitoring and diagnosis on the net and the break-up of complicated tasks, inosculating CORBA, Web technique and agent frame model to carry on complemental research. In this system, Multi-diagnosis Intelligent Agent helps improve diagnosis efficiency. Besides, this system offers an open circumstances, which is easy for the diagnosis objects to upgrade and for new diagnosis server objects to join in.

  8. Diagnosis and treatment of septic arthritis.

    PubMed

    Morton, Alison J

    2005-12-01

    Septic arthritis (SA) is a common orthopedic condition encountered in horses that are presented to equine veterinarians. Successful out-come is dependent on prompt and thorough evaluation and treatment. This article briefly reviews the pathophysiology, outlines diagnostics, describes treatment options and prognostics, and discusses current research in diagnosis and treatment of SA.

  9. Photodynamic Diagnosis and Therapy of Cancer

    SciTech Connect

    Subiel, Anna

    2010-01-05

    This paper gives brief information about photodynamic method used in diagnosis and therapy for cancer and other human body disorders. In particular it concentrates on detection and analysis of fluorescent dye, i.e. protoporphyrin IX (PpIX) and its two-photon excitation (TPE) process, which offers photodynamic method many fascinating possibilities.

  10. DIAGNOSIS OF MALARIA BY MAGNETIC DEPOSITION MICROSCOPY

    PubMed Central

    ZIMMERMAN, PETER A.; THOMSON, JODI M.; FUJIOKA, HISASHI; COLLINS, WILLIAM E.; ZBOROWSKI, MACIEJ

    2013-01-01

    Although malaria contributes to a significant public health burden, malaria diagnosis relies heavily on either non-specific clinical symptoms or blood smear microscopy methods developed in the 1930s. These approaches severely misrepresent the number of infected individuals and the reservoir of parasites in malaria-endemic communities and undermine efforts to control disease. Limitations of conventional microscopy-based diagnosis center on time required to examine slides, time required to attain expertise sufficient to diagnose infection accurately, and attrition from the limited number of existing malaria microscopy experts. Earlier studies described magnetic properties of Plasmodium falciparum but did not refine methods to diagnosis infection by all four human malaria parasite species. Here, following specific technical procedures, we show that it is possible to concentrate all four human malaria parasite species, at least 40-fold, on microscope slides using very inexpensive magnets through an approach termed magnetic deposition microscopy. This approach delivered greater sensitivity than a thick smear preparation while maintaining the clarity of a thin smear to simplify species-specific diagnosis. Because the magnetic force necessary to concentrate parasites on the slide is focused at a precise position relative to the magnet surface, it is possible to examine a specific region of the slide for parasitized cells and avoid the time-consuming process of scanning the entire slide surface. These results provide insight regarding new strategies for performing malaria blood smear microscopy. PMID:16606985

  11. [TMJ diagnosis in oral and maxillofacial surgery].

    PubMed

    Feifel, H; Riediger, D

    1991-01-01

    Recording pathologic mandibular movements is of crucial importance to the diagnosis and treatment of functional disorders of the masticatory system. The electronic computersupported recording system presented in this paper is a diagnostic instrument of extremely high precision. The clinical and scientific applications possible with this system in oral and maxillofacial surgery are discussed.

  12. Prenatal diagnosis of amniotic band syndrome

    PubMed Central

    Padmanabhan, Laxmi Devi; Hamza, Zareena V; Thampi, Madhavan Venugopalan; Nampoothiri, Sheela

    2016-01-01

    Amniotic band can cause a broad spectrum of anomalies ranging from simple band constrictions to major craniofacial and visceral defects. It can cause significant neonatal morbidity. Accurate diagnosis will help in the management of the present pregnancy and in counseling with regard to future pregnancies. Here we report three cases of amniotic band syndrome detected in the prenatal period. PMID:27081225

  13. Fibromyalgia Syndrome: Etiology, Pathogenesis, Diagnosis, and Treatment

    PubMed Central

    Bellato, Enrico; Marini, Eleonora; Castoldi, Filippo; Barbasetti, Nicola; Mattei, Lorenzo; Bonasia, Davide Edoardo; Blonna, Davide

    2012-01-01

    Fibromyalgia syndrome is mainly characterized by pain, fatigue, and sleep disruption. The etiology of fibromyalgia is still unclear: if central sensitization is considered to be the main mechanism involved, then many other factors, genetic, immunological, and hormonal, may play an important role. The diagnosis is typically clinical (there are no laboratory abnormalities) and the physician must concentrate on pain and on its features. Additional symptoms (e.g., Raynaud's phenomenon, irritable bowel disease, and heat and cold intolerance) can be associated with this condition. A careful differential diagnosis is mandatory: fibromyalgia is not a diagnosis of exclusion. Since 1990, diagnosis has been principally based on the two major diagnostic criteria defined by the ACR. Recently, new criteria have been proposed. The main goals of the treatment are to alleviate pain, increase restorative sleep, and improve physical function. A multidisciplinary approach is optimal. While most nonsteroidal anti-inflammatory drugs and opioids have limited benefit, an important role is played by antidepressants and neuromodulating antiepileptics: currently duloxetine (NNT for a 30% pain reduction 7.2), milnacipran (NNT 19), and pregabalin (NNT 8.6) are the only drugs approved by the US Food and Drug Administration for the treatment of fibromyalgia. In addition, nonpharmacological treatments should be associated with drug therapy. PMID:23213512

  14. Laboratory diagnosis of human chlamydial infections.

    PubMed Central

    Barnes, R C

    1989-01-01

    Chlamydia trachomatis is a human pathogen that causes ocular disease (trachoma and inclusion conjunctivitis), genital disease (cervicitis, urethritis, salpingitis, and lymphogranuloma venereum), and respiratory disease (infant pneumonitis). Respiratory chlamydioses also occur with infection by avian strains of C. psittaci or infection by the newly described TWAR agent. Diagnosis of most acute C. trachomatis infections relies on detection of the infecting agent by cell culture, fluorescent antibody, immunoassay, cytopathologic, or nucleic acid hybridization methods. Individual non-culture tests for C. trachomatis are less sensitive and specific than the best chlamydial cell culture system but offer the advantages of reduced technology and simple transport of clinical specimens. Currently available nonculture tests for C. trachomatis perform adequately as screening tests in populations in which the prevalence of infection is greater than 10%. A negative culture or nonculture test for C. trachomatis does not, however, exclude infection. The predictive value of a positive nonculture test may be unsatisfactory when populations of low infection prevalence are tested. Tests that detect antibody responses to chlamydial infection have limited utility in diagnosis of acute chlamydial infection because of the high prevalence of persistent antibody in healthy adults and the cross-reactivity due to infection by the highly prevalent C. trachomatis and TWAR agents. Assays for changes in antibody titer to the chlamydial genus antigen are used for the diagnosis of respiratory chlamydioses. A single serum sample that is negative for chlamydial antibody excludes the diagnosis of lymphogranuloma venereum. PMID:2650858

  15. Dual Diagnosis of Down Syndrome & Autism

    MedlinePlus

    ... problems that are hidden—such as earache, headache, toothache, sinusitis, gastritis, ulcer, pelvic pain, glaucoma, and so on—the situation results in behaviors that may appear “autistic-like” such as ... Issues & Down Syndrome Dual Diagnosis of Down Syndrome & ...

  16. Sources of Observer Variation in Dermatologic Diagnosis.

    ERIC Educational Resources Information Center

    Norman, Geoffrey R.; And Others

    1990-01-01

    This study examined the effects of similarity to prior examples in predicting errors in dermatologic diagnosis. Two interpretations about the acquisition of expertise are independent cues and instance-based categorization. The subjects (N=16) were first-year family medicine residents from McMaster University (Ontario). (MLW)

  17. Testing Person Fit in Cognitive Diagnosis

    ERIC Educational Resources Information Center

    Liu, Ying; Douglas, Jeffrey A.; Henson, Robert A.

    2009-01-01

    In cognitive diagnosis, the test-taking behavior of some examinees may be idiosyncratic so that their test scores may not reflect their true cognitive abilities as much as that of more typical examinees. Statistical tests are developed to recognize the following: (a) nonmasters of the required attributes who correctly answer the item (spuriously…

  18. Dosimetry in Nuclear Medicine Diagnosis and Therapy

    NASA Astrophysics Data System (ADS)

    Noßke, D.; Mattsson, S.; Johansson, L.

    This document is part of Subvolume A 'Fundamentals and Data in Radiobiology, Radiation Biophysics, Dosimetry and Medical Radiological Protection' of Volume 7 'Medical Radiological Physics' of Landolt-Börnstein - Group VIII 'Advanced Materials and Technologies'. It contains the Section '4.7 Necessity of Patient-Specific Dose Planning in Radionuclide Therapy' of the Chapter '4 Dosimetry in Nuclear Medicine Diagnosis and Therapy'.

  19. [Differential diagnosis of secondary arterial hypertension].

    PubMed

    Ruilope, L M

    1990-01-01

    The adequate performance of the differential diagnosis will permit us to classify any increase in blood pressure as due to primary or secondary causes. The data obtained in the clinical history and physical examination as well as those obtained through the minimal laboratory tests to be performed are the clues to identify secondary causes of arterial hypertension.

  20. Diagnosis and treatment for chronic migraine

    PubMed Central

    Moriarty, Maureen; Mallick-Searle, Theresa

    2016-01-01

    Abstract: Migraine is a debilitating headache disorder that is underdiagnosed and undertreated worldwide, partially attributable to misdiagnosis and expectations of poor treatment outcomes. This article provides a review of chronic migraine, including pathophysiology, burden, diagnosis, and management, with special emphasis on the role of NPs. PMID:27203455

  1. [Cowden syndrome can be a challenging diagnosis].

    PubMed

    Skytte, Anne-Bine; Gerdes, Anne-Marie; Bygum, Anette

    2014-01-20

    Cowden syndrome is a rare autosomal dominant overgrowth syndrome with a predisposition to cancer. The overgrowth and cancer may occur in many different tissues, which makes it a challenge to recognize it, but due to the high risk of cancer early diagnosis is important. We present the Danish screening guidelines for patients with Cowden syndrome. PMID:24629684

  2. Laboratory Diagnosis of Human Rabies: Recent Advances

    PubMed Central

    Mani, Reeta Subramaniam; Madhusudana, Shampur Narayan

    2013-01-01

    Rabies, an acute progressive, fatal encephalomyelitis, transmitted most commonly through the bite of a rabid animal, is responsible for an estimated 61,000 human deaths worldwide. The true disease burden and public health impact due to rabies remain underestimated due to lack of sensitive laboratory diagnostic methods. Rapid diagnosis of rabies can help initiate prompt infection control and public health measures, obviate the need for unnecessary treatment/medical tests, and assist in timely administration of pre- or postexposure prophylactic vaccination to family members and medical staff. Antemortem diagnosis of human rabies provides an impetus for clinicians to attempt experimental therapeutic approaches in some patients, especially after the reported survival of a few cases of human rabies. Traditional methods for antemortem and postmortem rabies diagnosis have several limitations. Recent advances in technology have led to the improvement or development of several diagnostic assays which include methods for rabies viral antigen and antibody detection and assays for viral nucleic acid detection and identification of specific biomarkers. These assays which complement traditional methods have the potential to revolutionize rabies diagnosis in future. PMID:24348170

  3. Diagnosis and management of ventricular dysphonia.

    PubMed

    Von Hake, C P; Ganzman, I P; Mauer, T P

    1989-02-01

    Ventricular phonation may develop on a functional level, or it may occur as an alternative voice for the patient who has an organic disease of the true vocal folds. Three cases that represent iatrogenic, traumatic, and neurologic forms of the disorder are reported. Diagnosis, treatment, and guidelines for follow-up speech therapy are discussed.

  4. [Double diagnosis and forensic psychiatric opinion].

    PubMed

    Kocur, Józef; Trendak, Wiesława

    2009-01-01

    Addiction to alcohol or any other psychoactive substance can run parallel with other diseases or mental disorders. One can then observe co-occurrence and mutual interaction of dysfunctions typical of addiction and of other mental disorders that accompany addiction. That is why, clinical pictures of such states (double diagnosis) are usually less unique, have an unusual course and cause diagnostic and therapeutic difficulty. The problem of forensic psychiatric opinion and treatment of people with a double diagnosis is another aspect of these difficulties. It is caused by the fact that forensic psychiatric assessment of the mental state of such people requires taking into consideration a very complex clinical and legal situation triggered by the interference of various ethiopathogenetic and clinical disorders. It leads to the need for complex evaluation and reference to sanity or other signs of functioning within the current law should result, first of all, from the analyses directly pertaining to the influence of the diagnosed disorders on the state of patients with double diagnosis. The forensic psychiatric aspect of disorders connected with double diagnosis is particularly significant as there is a relatively high risk of behaviours posing a threat to public order in this group of patients.

  5. Prenatal diagnosis of amniotic band syndrome.

    PubMed

    Padmanabhan, Laxmi Devi; Hamza, Zareena V; Thampi, Madhavan Venugopalan; Nampoothiri, Sheela

    2016-01-01

    Amniotic band can cause a broad spectrum of anomalies ranging from simple band constrictions to major craniofacial and visceral defects. It can cause significant neonatal morbidity. Accurate diagnosis will help in the management of the present pregnancy and in counseling with regard to future pregnancies. Here we report three cases of amniotic band syndrome detected in the prenatal period.

  6. Diagnosis and management of testosterone deficiency

    PubMed Central

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

    2015-01-01

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

  7. Tractable particle filters for robot fault diagnosis

    NASA Astrophysics Data System (ADS)

    Verma, Vandi

    Experience has shown that even carefully designed and tested robots may encounter anomalous situations. It is therefore important for robots to monitor their state so that anomalous situations may be detected in a timely manner. Robot fault diagnosis typically requires tracking a very large number of possible faults in complex non-linear dynamic systems with noisy sensors. Traditional methods either ignore the uncertainly or use linear approximations of nonlinear system dynamics. Such approximations are often unrealistic, and as a result faults either go undetected or become confused with non-fault conditions. Probability theory provides a natural representation for uncertainty, but an exact Bayesian solution for the diagnosis problem is intractable. Classical Monte Carlo methods, such as particle filters, suffer from substantial computational complexity. This is particularly true with the presence of rare, yet important events, such as many system faults. The thesis presents a set of complementary algorithms that provide an approach for computationally tractable fault diagnosis. These algorithms leverage probabilistic approaches to decision theory and information theory to efficiently track a large number of faults in a general dynamic system with noisy measurements. The problem of fault diagnosis is represented as hybrid (discrete/continuous) state estimation. Taking advantage of structure in the domain it dynamically concentrates computation in the regions of state space that are currently most relevant without losing track of less likely states. Experiments with a dynamic simulation of a six-wheel rocker-bogie rover show a significant improvement in performance over the classical approach.

  8. Diagnosis and management of rheumatoid arthritis.

    PubMed

    Wasserman, Amy M

    2011-12-01

    Rheumatoid arthritis is the most commonly diagnosed systemic inflammatory arthritis. Women, smokers, and those with a family history of the disease are most often affected. Criteria for diagnosis include having at least one joint with definite swelling that is not explained by another disease. The likelihood of a rheumatoid arthritis diagnosis increases with the number of small joints involved. In a patient with inflammatory arthritis, the presence of a rheumatoid factor or anti-citrullinated protein antibody, or elevated C-reactive protein level or erythrocyte sedimentation rate suggests a diagnosis of rheumatoid arthritis. Initial laboratory evaluation should also include complete blood count with differential and assessment of renal and hepatic function. Patients taking biologic agents should be tested for hepatitis B, hepatitis C, and tuberculosis. Earlier diagnosis of rheumatoid arthritis allows for earlier treatment with disease-modifying antirheumatic agents. Combinations of medications are often used to control the disease. Methotrexate is typically the first-line drug for rheumatoid arthritis. Biologic agents, such as tumor necrosis factor inhibitors, are generally considered second-line agents or can be added for dual therapy. The goals of treatment include minimization of joint pain and swelling, prevention of radiographic damage and visible deformity, and continuation of work and personal activities. Joint replacement is indicated for patients with severe joint damage whose symptoms are poorly controlled by medical management.

  9. Fetal cardiac arrhythmias: diagnosis and management.

    PubMed

    Feit, L R

    2001-05-01

    The diagnosis and management of fetal cardiac arrhythmias requires complex skills and knowledge, and has had a great impact on the care of infants with congenital heart disease and their families. Optimal benefits will be derived from a thoughtful team approach, with skillful internal communication, and especially when parental involvement is encouraged in the decision making process. PMID:11392955

  10. Zika Virus: Diagnosis, Therapeutics, and Vaccine.

    PubMed

    Shan, Chao; Xie, Xuping; Barrett, Alan D T; Garcia-Blanco, Mariano A; Tesh, Robert B; Vasconcelos, Pedro Fernando da Costa; Vasilakis, Nikos; Weaver, Scott C; Shi, Pei-Yong

    2016-03-11

    The current explosive epidemic of Zika virus in South and Central America, as well as the Caribbean, poses a global public health emergency. Here we comment on the challenges on development of better diagnosis and potential therapeutics and vaccine for Zika virus. PMID:27623030

  11. Computerized system for clinical diagnosis of melanoma

    NASA Astrophysics Data System (ADS)

    Ferrario, Mario; Barbieri, Fabio

    1991-07-01

    A computerized system was developed to carry out the clinical diagnosis of cutaneous melanoma. The main objective of the system is to produce a real-time first level diagnosis of skin lesion images acquired by a color TV camera. The algorithms are based on research activities started in 1985 at the National Cancer Institute of Milan. Color slides of skin lesions were used as a training field for studying and tuning the image analysis procedures. A prototype system was then developed to capture and analyze skin lesion images on a real-time basis. More than 200 images were acquired and the first level diagnosis output by the system was compared with the diagnosis of expert clinicians. The obtained results were judged very encouraging by the clinicians, and research is in progress to improve and refine the system. The diagnostic procedure is based on image processing and understanding techniques, automatic lesion contour recognition, feature extraction (feature components derived from lesion shape, color and texture) and computation of a malignancy index. The malignancy index depends on the lesion feature values and a thesaurus collecting the system knowledge; the histologic results of clinically diagnosed malignant lesions are used to upgrade the system knowledge.

  12. Antenatal diagnosis of lethal skeletal dysplasias.

    PubMed

    Tretter, A E; Saunders, R C; Meyers, C M; Dungan, J S; Grumbach, K; Sun, C C; Campbell, A B; Wulfsberg, E A

    1998-02-17

    Lethal skeletal dysplasias (LSD) are a heterogeneous group of rare but important genetic disorders characterized by abnormal growth and development of bone and cartilage. We describe the diagnosis and outcome of 29 cases of lethal skeletal dysplasias evaluated between January 1989 and December 1996 at the University of Maryland Medical Center and the Ultrasound Institute of Baltimore. Two cases presented at delivery with no prenatal care while the remaining 27 cases were identified by antenatal sonography. Final diagnoses included thanatophoric dysplasia (14), osteogenesis imperfecta, type II (6), achondrogenesis (2), short rib syndromes (3), campomelic syndrome (2), atelosteogenesis (1), and no evidence of a skeletal dysplasia (1). Twenty out of 27 pregnancies were terminated with an average at detection of 21.6 weeks. The other 7 pregnancies that went on to deliver had an average age at detection of 29.2 weeks. Fetal abnormalities in the terminated pregnancies were identified at a significantly earlier gestational age (P = 0.0016) than the pregnancies that continued. While the identification of LSD by sonography was excellent (26/27), only 13/27 (48%) were given an accurate specific antenatal diagnosis. In 8/14 (57%) cases with an inaccurate or nonspecific diagnosis there was a significant or crucial change in the genetic counseling. Thus, while antenatal sonography is an excellent method for discovering LSD, clinical examination, radiographs, and autopsy are mandatory for making a specific diagnosis. PMID:9489797

  13. Zika Virus: Diagnosis, Therapeutics, and Vaccine.

    PubMed

    Shan, Chao; Xie, Xuping; Barrett, Alan D T; Garcia-Blanco, Mariano A; Tesh, Robert B; Vasconcelos, Pedro Fernando da Costa; Vasilakis, Nikos; Weaver, Scott C; Shi, Pei-Yong

    2016-03-11

    The current explosive epidemic of Zika virus in South and Central America, as well as the Caribbean, poses a global public health emergency. Here we comment on the challenges on development of better diagnosis and potential therapeutics and vaccine for Zika virus.

  14. Diagnosis and Treatment of Eating Disorders.

    ERIC Educational Resources Information Center

    Neuman, Patricia; And Others

    This paper was designed to provide professional counselors with a comprehensive but concise method of accurately evaluting, interviewing, and planning for treatment of eating disorder clients. The paper is organized in five sections. The first section, Diagnosis, compares, contrasts, and offers clear explanations of the diagnostic criteria for…

  15. Measurement selection for parametric IC fault diagnosis

    NASA Technical Reports Server (NTRS)

    Wu, A.; Meador, J.

    1991-01-01

    Experimental results obtained with the use of measurement reduction for statistical IC fault diagnosis are described. The reduction method used involves data pre-processing in a fashion consistent with a specific definition of parametric faults. The effects of this preprocessing are examined.

  16. Diagnosis and management of rheumatoid arthritis.

    PubMed

    Wasserman, Amy M

    2011-12-01

    Rheumatoid arthritis is the most commonly diagnosed systemic inflammatory arthritis. Women, smokers, and those with a family history of the disease are most often affected. Criteria for diagnosis include having at least one joint with definite swelling that is not explained by another disease. The likelihood of a rheumatoid arthritis diagnosis increases with the number of small joints involved. In a patient with inflammatory arthritis, the presence of a rheumatoid factor or anti-citrullinated protein antibody, or elevated C-reactive protein level or erythrocyte sedimentation rate suggests a diagnosis of rheumatoid arthritis. Initial laboratory evaluation should also include complete blood count with differential and assessment of renal and hepatic function. Patients taking biologic agents should be tested for hepatitis B, hepatitis C, and tuberculosis. Earlier diagnosis of rheumatoid arthritis allows for earlier treatment with disease-modifying antirheumatic agents. Combinations of medications are often used to control the disease. Methotrexate is typically the first-line drug for rheumatoid arthritis. Biologic agents, such as tumor necrosis factor inhibitors, are generally considered second-line agents or can be added for dual therapy. The goals of treatment include minimization of joint pain and swelling, prevention of radiographic damage and visible deformity, and continuation of work and personal activities. Joint replacement is indicated for patients with severe joint damage whose symptoms are poorly controlled by medical management. PMID:22150658

  17. Differential Diagnosis of Stuttering for Forensic Purposes

    ERIC Educational Resources Information Center

    Seery, Carol Hubbard

    2005-01-01

    Purpose: This case study demonstrates the application of an assessment protocol for differential diagnosis of psychogenic stuttering, neurogenic stuttering, developmental stuttering, and malingering. Method: A male in his late 30s, accused of armed robbery, was evaluated for stuttering at the request of his defense attorney. The speech assessment…

  18. Quantifying the measurement of differential diagnosis.

    PubMed

    Johnson, L A

    1995-01-01

    Differential diagnosis is central to the work and training of all health care professionals. To develop solid differential diagnosis and skills, students required practice diagnosing numerous and varied patients. In the absence of real patients, patient simulations are commonly used to provide this range of diagnostic experiences. This study examined the benefits of interactive patient simulations on the diagnostic approaches of beginning dental students (novices) and practicing dentists (experts). The study tested the hypothesis that novices tend to use trial-and-error, while experts tend to use pattern recognition during differential diagnosis. a second goal of the study explored objective and subjective measures of a differential diagnosis approach. Seventy-five subjects comprised two treatment groups: a novice group and an expert group. Each group completed ten patient simulations and a case study test measured the diagnostic approach. A three factor MANOVA (p>0.05) was followed by univariate ANOVA's. The result indicated differences between the diagnostic approaches of experts and novices and that the subjective Ratings and the objective Maximum Decisions and Average Variation variables were the best measures of a differential diagnostic approach. PMID:8591429

  19. Human herpesvirus infections: Pathogenesis, diagnosis, and treatment

    SciTech Connect

    Lopez, C.; Roizman, B.

    1986-01-01

    This book contains 24 selections. Some of the titles are: Molecular Biology of Latent HSV-1; Molecular Genetics of Antiviral Chemotherapy of Herpes Viruses; Molecular Basis of Foscarnet Action; Use of Vaccinia Virus as a Vector for Expression of Herpesvirus Genes; and Diagnosis of Herpesvirus with Monoclonal Antibodies.

  20. Hierarchical Item Response Models for Cognitive Diagnosis

    ERIC Educational Resources Information Center

    Hansen, Mark Patrick

    2013-01-01

    Cognitive diagnosis models (see, e.g., Rupp, Templin, & Henson, 2010) have received increasing attention within educational and psychological measurement. The popularity of these models may be largely due to their perceived ability to provide useful information concerning both examinees (classifying them according to their attribute profiles)…

  1. Diagnosis of the Gifted in Israel

    ERIC Educational Resources Information Center

    David, Hanna

    2014-01-01

    Many parents of gifted, talented and high-ability children seek counseling in the belief that a "diagnosis" of their child as "gifted" will solve the problems they and their child are encountering. In Israel, most children are screened for giftedness using the Szold examinations in grade 2 or 3 between the ages of 7 and 9…

  2. [Laparoscopic diagnosis of acute mesenteric lymphadenitis].

    PubMed

    Perminova, G I; Sirotinskiĭ, V V; Sokolov, A A

    1989-01-01

    In 14 patients with non-specific mesadenitis, the diagnosis was established at emergency laparoscopy, performed for suspected acute appendicitis. Laparoscopic semiotics of the disease is described. Conservative treatment with additional local administration of drugs was successful. The mean duration of the in-hospital treatment of the patients was 4.6 days.

  3. Testing Physical Diagnosis Skills with Videotape

    ERIC Educational Resources Information Center

    Stillman, Paula L.; And Others

    1977-01-01

    An inexpensive videotape testing system has been developed at the Department of Pediatrics and Department of Medical TV-Cinematography at the University of Arizona College of Medicine. The development and validation of a test using this system to assess observational skills important for accurate physical diagnosis are described. (LBH)

  4. Tumors of the salivary glands. Comparison of frozen-section diagnosis with final pathologic diagnosis.

    PubMed

    Wheelis, R F; Yarington, C T

    1984-02-01

    Of the 256 cases of salivary gland tumors subjected to frozen-section diagnosis, the error rate in diagnosis for malignant disease was one of four cases, and in benign disease, it was one of ten cases. Six of the 52 malignant tumors were erroneously labeled as benign, while four of the 204 benign tumors were diagnosed as malignant neoplasms. The occurrence of concurrent benign and malignant disease, nonneoplastic alterations of salivary gland tissue, and sampling errors militated against total reliance on frozen-section diagnosis in the management of salivary gland neoplasms.

  5. [Early diagnosis of autism: Phenotype-endophenotype].

    PubMed

    Kotsopoulos, S

    2015-01-01

    Autism Spectrum Disorders have for some time been the focus of intense interest for clinicians and researchers because of the high prevalence of the disorders among children in the community (approximately 1%), their severity and pervasiveness. Particular attention has been paid to the early diagnosis of the disorder and to the intensive therapeutic intervention. Currently the best prognosis for autism lays in the early diagnosis and intervention. Postponing the diagnosis and the intervention beyond infancy is considered loss of precious time. The diagnosis of autism, which begins early in life, was until recently considered that could be reliability made at the age of 3 years. Recent follow up studies however on children at risk for autism (children who had an older sibling with autism) have shown that the clinical signs of autism emerge at the end of the first year and become distinct by the end of the second year when the diagnosis can reliably be made. From a clinical perspective it is noted that the early clinical signs of risk for autism are related to social communication (e.g. limited or absent response when calling his/her name and to joint attention), stereotype behaviours and body movements or unusual handling of objects (e.g. intensive observation of objects and stereotype movements of hands and tapping or spinning), incongruent regulation of emotions (reduced positive and increased negative emotion). There is also delay in developmental characteristics such as the language (both receptive and expressive) and motor (particularly in postural control - characteristic is the drop of the head backwards when the infant is held in horizontal position). Studies on various aspects of the endophenotype of certain clinical signs among infants at risk for Autism Spectrum Disorders, such as avoidance of eye contact, delay in verbal communication and increase of the head circumference, may provide useful information and may assist the clinician on follow up in the

  6. [Early diagnosis of autism: Phenotype-endophenotype].

    PubMed

    Kotsopoulos, S

    2015-01-01

    Autism Spectrum Disorders have for some time been the focus of intense interest for clinicians and researchers because of the high prevalence of the disorders among children in the community (approximately 1%), their severity and pervasiveness. Particular attention has been paid to the early diagnosis of the disorder and to the intensive therapeutic intervention. Currently the best prognosis for autism lays in the early diagnosis and intervention. Postponing the diagnosis and the intervention beyond infancy is considered loss of precious time. The diagnosis of autism, which begins early in life, was until recently considered that could be reliability made at the age of 3 years. Recent follow up studies however on children at risk for autism (children who had an older sibling with autism) have shown that the clinical signs of autism emerge at the end of the first year and become distinct by the end of the second year when the diagnosis can reliably be made. From a clinical perspective it is noted that the early clinical signs of risk for autism are related to social communication (e.g. limited or absent response when calling his/her name and to joint attention), stereotype behaviours and body movements or unusual handling of objects (e.g. intensive observation of objects and stereotype movements of hands and tapping or spinning), incongruent regulation of emotions (reduced positive and increased negative emotion). There is also delay in developmental characteristics such as the language (both receptive and expressive) and motor (particularly in postural control - characteristic is the drop of the head backwards when the infant is held in horizontal position). Studies on various aspects of the endophenotype of certain clinical signs among infants at risk for Autism Spectrum Disorders, such as avoidance of eye contact, delay in verbal communication and increase of the head circumference, may provide useful information and may assist the clinician on follow up in the

  7. A dynamic integrated fault diagnosis method for power transformers.

    PubMed

    Gao, Wensheng; Bai, Cuifen; Liu, Tong

    2015-01-01

    In order to diagnose transformer fault efficiently and accurately, a dynamic integrated fault diagnosis method based on Bayesian network is proposed in this paper. First, an integrated fault diagnosis model is established based on the causal relationship among abnormal working conditions, failure modes, and failure symptoms of transformers, aimed at obtaining the most possible failure mode. And then considering the evidence input into the diagnosis model is gradually acquired and the fault diagnosis process in reality is multistep, a dynamic fault diagnosis mechanism is proposed based on the integrated fault diagnosis model. Different from the existing one-step diagnosis mechanism, it includes a multistep evidence-selection process, which gives the most effective diagnostic test to be performed in next step. Therefore, it can reduce unnecessary diagnostic tests and improve the accuracy and efficiency of diagnosis. Finally, the dynamic integrated fault diagnosis method is applied to actual cases, and the validity of this method is verified.

  8. A Dynamic Integrated Fault Diagnosis Method for Power Transformers

    PubMed Central

    Gao, Wensheng; Liu, Tong

    2015-01-01

    In order to diagnose transformer fault efficiently and accurately, a dynamic integrated fault diagnosis method based on Bayesian network is proposed in this paper. First, an integrated fault diagnosis model is established based on the causal relationship among abnormal working conditions, failure modes, and failure symptoms of transformers, aimed at obtaining the most possible failure mode. And then considering the evidence input into the diagnosis model is gradually acquired and the fault diagnosis process in reality is multistep, a dynamic fault diagnosis mechanism is proposed based on the integrated fault diagnosis model. Different from the existing one-step diagnosis mechanism, it includes a multistep evidence-selection process, which gives the most effective diagnostic test to be performed in next step. Therefore, it can reduce unnecessary diagnostic tests and improve the accuracy and efficiency of diagnosis. Finally, the dynamic integrated fault diagnosis method is applied to actual cases, and the validity of this method is verified. PMID:25685841

  9. Trends in Imaging after Thyroid Cancer Diagnosis

    PubMed Central

    Banerjee, Mousumi; Muenz, Daniel G.; Worden, Francis P.; Haymart, Megan R.

    2015-01-01

    Background The largest growth in differentiated thyroid cancer (DTC) diagnosis is in low-risk cancers. Trends in imaging after DTC diagnosis are understudied. Hypothesizing a reduction in imaging utilization due to rising low-risk disease, we evaluated post-diagnosis imaging patterns over time and patient characteristics that are associated with likelihood of imaging. Methods Using the Surveillance Epidemiology and End Results-Medicare database, we identified patients diagnosed with localized, regional or distant DTC between 1991 and 2009. We reviewed Medicare claims for neck ultrasound, I-131 scan, or PET scan within 3 years post-diagnosis. Using regression analyses we evaluated trends of imaging utilization. Multivariable logistic regression was used to estimate the likelihood of imaging based on patient characteristics. Results 23,669 patients were included. Patients diagnosed during 2001-2009, compared to 1991-2000, were more likely to have localized disease (p<0.001) and tumors less than 1cm (p<0.001). Use of neck ultrasound and I-131 scan increased in patients with localized disease (p=<0.001 and p=0.003, respectively), regional disease (p<0.001 and p<0.001), and distant metastasis (p=0.001 and p=0.015). Patients diagnosed after 2000 were more likely to undergo neck ultrasound (OR 2.15, 95% CI 2.02-2.28) and I-131 scan (OR 1.44, 95% CI 1.35-1.54). PET scan use from 2005-2009, compared to 1996-2004, increased 32.4-fold (p=<0.001) in localized patients, 13.1-fold (p<0.001) in regional disease patients, and 33.4-fold (p<0.001) in patients with distant DTC. Conclusion Despite a rise in low-risk disease, the use of post-diagnosis imaging increased in all stages of disease. The largest growth was in use of PET scan after 2004. PMID:25565063

  10. Bipolar disorder, not so rare diagnosis: subtypes of different degrees of severity, diagnosis, therapy.

    PubMed

    Amihăesei, Ioana Cristina

    2014-01-01

    Bipolar disorder is manifesting as a mood disorder, typically showing episodes of mania, alternating with depressive episodes. The subtypes are including bipolar I disorder (one or several manic episodes) and bipolar II disorder (hypomanic episodes and one or several major depressive episodes). Nevertheless, sub-threshold diagnosis criteria may include another 5.1, up to 6.4% of the population as having a bipolar spectrum disorder diagnosis. Anyone who received the diagnosis is not considered cured afterwards (just in remission). Diagnosis is considering the symptoms of mania, hypomania and depression. Therapy is based on lithium, anticonvulsants, for the manic symptoms, lamotrigine for the depressive episodes and antipsychotics. Under medication, most of the affected subjects are living a normal life; to a certain degree, medication may also prevent the relapses.

  11. Scintigraphy for the diagnosis of testicular torsion and differential diagnosis of acute intrascrotal processes.

    PubMed

    Romics, I; Wesseler, T; Bach, D

    1988-01-01

    Twenty-five patients suffering from acute painful testicular processes were subjected to scintigraphy. Testicular torsion in the early and delayed phases were diagnosed with 100% accuracy, but one out of 7 cases of epididymitis was wrongly recognized as negative. Interoperative diagnosis in two cases of hydatid torsion proved the foregoing scintigraphic finding to have been wrong. Nevertheless, scintigraphy was found to be reliable in testicular torsion diagnosis.

  12. Psychiatric diagnosis and the oppression of women.

    PubMed

    Russell, D

    1985-01-01

    The system of psychiatric diagnosis which has recently been adopted by most western countries has features, which in various ways, work against the interests of women. This is important as the diagnostic scheme is not a theoretical work which will lay gathering dust on the bookshelves in medical libraries, it is a practical tool which forms the basis for the categorization of 'the insane'. Once the label has been assigned, it is then quite likely that the person labelled will be encouraged or even forced to have certain treatments. This may cause disquiet if the initial labelling is suspect. The purpose of this article is to reveal problems lurking beneath the surface of this moderately bland-looking system of psychiatric diagnosis and to show how the Scheme may help perpetuate the oppression of women.

  13. Autonomous power system intelligent diagnosis and control

    NASA Technical Reports Server (NTRS)

    Ringer, Mark J.; Quinn, Todd M.; Merolla, Anthony

    1991-01-01

    The Autonomous Power System (APS) project at NASA Lewis Research Center is designed to demonstrate the abilities of integrated intelligent diagnosis, control, and scheduling techniques to space power distribution hardware. Knowledge-based software provides a robust method of control for highly complex space-based power systems that conventional methods do not allow. The project consists of three elements: the Autonomous Power Expert System (APEX) for fault diagnosis and control, the Autonomous Intelligent Power Scheduler (AIPS) to determine system configuration, and power hardware (Brassboard) to simulate a space based power system. The operation of the Autonomous Power System as a whole is described and the responsibilities of the three elements - APEX, AIPS, and Brassboard - are characterized. A discussion of the methodologies used in each element is provided. Future plans are discussed for the growth of the Autonomous Power System.

  14. [Immunohistochemistry in the diagnosis of sarcomas].

    PubMed

    Decouvelaere, Anne-Valérie

    2015-01-01

    Immunohistochemistry (IHC) is essential in the diagnosis of soft tissue tumor and must rely on good quality technic. Among useful antibodies, it is important to distinguish those with a poor specificity required in order to establish the broad lineage, from those with high specificity, which may lead straightforward towards the entity. Diagnostically useful antibodies such as myogenin, ALK1 and DOG1 have been recently completed by MUC4 and STAT6 which show good sensitivity and specificity in the diagnosis of low-grade fibromyxoid sarcoma and solitary fibrous tumor respectively. ERG is also an interesting antibody. However, it is not completely specific of vascular tumors. Moreover, available material is often limited because of the increase of microbiopsy specimens. Therefore, it is mandatory to optimize this precious tissue by using these new antibodies, especially because molecular technics are increasingly performed in addition to IHC.

  15. Diagnosis and management of primary ciliary dyskinesia

    PubMed Central

    Lucas, Jane S; Burgess, Andrea; Mitchison, Hannah M; Moya, Eduardo; Williamson, Michael; Hogg, Claire

    2014-01-01

    Primary ciliary dyskinesia (PCD) is an inherited autosomal-recessive disorder of motile cilia characterised by chronic lung disease, rhinosinusitis, hearing impairment and subfertility. Nasal symptoms and respiratory distress usually start soon after birth, and by adulthood bronchiectasis is invariable. Organ laterality defects, usually situs inversus, occur in ∼50% of cases. The estimated prevalence of PCD is up to ∼1 per 10 000 births, but it is more common in populations where consanguinity is common. This review examines who to refer for diagnostic testing. It describes the limitations surrounding diagnosis using currently available techniques and considers whether recent advances to genotype patients with PCD will lead to genetic testing and screening to aid diagnosis in the near future. It discusses the challenges of monitoring and treating respiratory and ENT disease in children with PCD. PMID:24771309

  16. An unusual diagnosis of splenic rupture

    PubMed Central

    Roche, Matthew; Maloku, Fatmir; Abdel-Aziz, Tarek Ezzat

    2014-01-01

    A 22-year-old woman presented with a 3-day history of worsening epigastric pain, non-productive cough and vomiting. On examination she was pale and had abdominal tenderness predominant in the right upper quadrant. Abdominal ultrasound excluded the presence of gall stones, but was unable to rule out free fluid in the abdomen. CT demonstrated extensive high-density ascites; however, no source of bleeding could be demonstrated. Clinically the patient's condition deteriorated, and an exploratory laparotomy was performed. In theatre the splenic capsule was found to have detached from the splenic body and emergency splenectomy was performed. Virology serology later demonstrated acute cytomegalovirus (CMV) infection, although tissue microscopy and CMV staining were negative. No other cause of rupture was found. The interesting aspects of this case include the poor correlation between initial presenting symptoms and subsequent diagnosis, the difficulty encountered in making a firm diagnosis and the atypical cause of rupture. PMID:25293683

  17. Cerebral Whipple's disease. Diagnosis by brain biopsy.

    PubMed

    Johnson, L; Diamond, I

    1980-10-01

    Whipple's disease, a multisystem chronic granulomatous disease treatable by antibiotics, usually presents clinically with gastrointestinal or joint symptoms. Usually, the diagnosis is substantiated by small intestinal biopsy. This shows diastase-resistant periodic-acid-Schiff-(PAS)-positive inclusions in the cytoplasm of macrophages within the lamina propria. By electron microscopy, this PAS-positive material consists of 1.5 X 0.2-mum bacilli and fine fibrillar material within macrophage phagolysosomes. Rarely, Whipple's disease presents clinically as a primary neurologic disease without gastrointestinal symptoms. Because untreated cerebral Whipple's disease usually progresses rapidly to death, it is imperative to establish the diagnosis promptly. This report describes a case of cerebral Whipple's disease without gastrointestinal symptoms that was diagnosed early by light-and electron-microscopic study of brain biopsy material. PMID:6158859

  18. [Preimplantation genetic diagnosis: technical and ethical considerations].

    PubMed

    Oliva Teles, Natália

    2011-01-01

    Following the advances in the techniques of medically assisted reproduction (ART), 1990 has seen the first born child after the development of pre-implantation genetic diagnosis. In this analysis embryos are tested for the presence of genetic anomalies at three to five days after fertilization and only unaffected embryos are transferred to the maternal uterus. The technique offers good prospects to couples at risk for conventional prenatal diagnosis. It is particularly useful where ART techniques are necessary, in which early embryo selection avoids later termination of pregnancy. In Portugal the application of laws concerning regulation of medically assisted reproduction in 2008 has clarified and formalised the medical and laboratory procedures and in some cases fundamentally changed them, particularly in the requirement to cryopreserve all high quality non-transferred embryos and in specifying conditions in which embryo experimentation may be permitted.

  19. Plantar fascia: imaging diagnosis and guided treatment.

    PubMed

    McNally, Eugene G; Shetty, Shilpa

    2010-09-01

    Plantar fasciopathy is a common cause of heel pain. This article covers the imaging anatomy of the hindfoot, the imaging findings on ultrasound and magnetic resonance imaging (MRI) of plantar fasciopathy, plantar fibromas, trauma, Achilles tendonopathy, neural compression, stress fractures of the os calcis and other heel pad lesions. Thickening of the plantar fascia insertion more than 5 mm either on ultrasound or MRI is suggestive of plantar fasciopathy. Ultrasound is superior to MRI for diagnosis of plantar fibroma as small low signal lesions on MRI are similar to the normal plantar fascia signal. Ultrasound demonstrates low echogenicity compared with the echogenic plantar fascia. Penetrating injuries can appear bizarre due to associated foreign body impaction and infection. Achilles tendonopathy can cause heel pain and should be considered as a possible diagnosis. Treatment options include physical therapy, ECSWT, corticosteroid injection, and dry needling. Percutaneous US guided treatment methods will be described.

  20. Intraventricular neurocysticercosis: Presentation, diagnosis and management.

    PubMed

    Jensen, Tomas Ostergaard; Post, Jeffrey John

    2016-08-01

    Neurocysticercosis is thought to be the most common helminthic infection of the central nervous system and its epidemiology is changing due to increasing travel and migration. Evidence to guide management of the intraventricular form is limited. We aimed to review the clinical presentation, diagnosis and treatment of intraventricular neurocysticercosis with reference to two recent cases seen at our institution. The intraventricular variant of neurocysticercosis is less common than parenchymal disease and usually presents with acutely raised intracranial pressure and untreated it progresses rapidly with high mortality. The diagnosis is based on imaging and serological tests but more invasive testing including histopathological examination of surgically acquired tissue specimens is sometimes required. Treatment is mainly surgical, using a neuroendoscopic approach if possible. Patients should also receive antihelmintic treatment with concomitant corticosteroids to reduce the incidence of shunt failure if a ventricular shunt is inserted and to treat viable lesions elsewhere. PMID:27569895

  1. Clinical manifestations and diagnosis of fibromyalgia.

    PubMed

    Bennett, Robert M

    2009-05-01

    Since the publication of the American College of Rheumatology Classification Criteria for Fibromyalgia 18 years ago, there have been an ever-increasing number of research articles and reviews. From the National Library of Medicine alone there are more than 10,000 articles related to fibromyalgia. The major clinical manifestations of fibromyalgia have not changed, but their prevalence, associations, relative importance to the patient, and scientific underpinnings are increasingly better understood. This article provides an update on fibromyalgia symptomatology and looks at issues that need to be considered in the development of updated diagnostic guidelines. There is still no gold standard for making a diagnosis of fibromyalgia, but there is an increasing consensus for the development of new guidelines for diagnosis that modifies the currently proscribed tender point evaluation.

  2. Lactose intolerance: from diagnosis to correct management.

    PubMed

    Di Rienzo, T; D'Angelo, G; D'Aversa, F; Campanale, M C; Cesario, V; Montalto, M; Gasbarrini, A; Ojetti, V

    2013-01-01

    This review discusses one of the most relevant problems in gastrointestinal clinical practice: lactose intolerance. The role of lactase-persistence alleles the diagnosis of lactose malabsorption the development of lactose intolerance symptoms and its management. Most people are born with the ability to digest lactose, the major carbohydrate in milk and the main source of nutrition until weaning. Approximately, 75% of the world's population loses this ability at some point, while others can digest lactose into adulthood. Symptoms of lactose intolerance include abdominal pain, bloating, flatulence and diarrhea with a considerable intraindividual and interindividual variability in the severity. Diagnosis is most commonly performed by the non invasive lactose hydrogen breath test. Management of lactose intolerance consists of two possible clinical choice not mutually exclusive: alimentary restriction and drug therapy.

  3. [Validity of the psychophysiological diagnosis of paraphylia].

    PubMed

    Kamenskov, M Iu

    2013-01-01

    Author presents an analysis of the results of the examination of 113 sex offenders using clinical-psychopathological, sexological and psychophysiological (polygraph testing) methods. The data analysis revealed that the results of verbal and visual psychophysiological stimulation allowed to diagnose a sexual disorder in people with paraphylia in 80% and 69.6% cases, respectively. The experimental-practical validity of the psychophysiological diagnosis was 0.63 that corresponded to the high level of validity. The study enabled to define highly probable and probable criteria of the paraclinical diagnosis of paraphylia that should be interpreted by a sexologist with the account of the results of other methods (clinical, experimental-psychological). PMID:23612409

  4. Premenstrual Syndrome: Approaches to Diagnosis and Treatment

    PubMed Central

    Simkin, Ruth J.

    1985-01-01

    There has been much confusion in the literature over the definition, diagnosis and treatment of premenstrual syndrome (PMS). This article discusses definitions of PMS, incidence, etiology and symptomatology. Diagnosis depends on the timing of symptoms rather than the type. Symptoms commonly occur during the late premenstruum; at ovulation and during the premenstruum; or at ovulation, gradually increasing in severity throughout the luteal phase. To diagnose PMS, three consecutive menstrual cycles must be charted, the symptoms must be limited to the luteal phase, and there must be a complete absence of symptoms for at least one week in the postmenstruum. Rational treatment programs for mild, moderate and severe PMS are proposed. The role of progesterone in treatment is discussed. PMID:21274209

  5. Mitochondrial disorders: Challenges in diagnosis & treatment

    PubMed Central

    Khan, Nahid Akhtar; Govindaraj, Periyasamy; Meena, Angamuthu Kannan; Thangaraj, Kumarasamy

    2015-01-01

    Mitochondrial dysfunctions are known to be responsible for a number of heterogenous clinical presentations with multi-systemic involvement. Impaired oxidative phosphorylation leading to a decrease in cellular energy (ATP) production is the most important cause underlying these disorders. Despite significant progress made in the field of mitochondrial medicine during the last two decades, the molecular mechanisms underlying these disorders are not fully understood. Since the identification of first mitochondrial DNA (mtDNA) mutation in 1988, there has been an exponential rise in the identification of mtDNA and nuclear DNA mutations that are responsible for mitochondrial dysfunction and disease. Genetic complexity together with ever widening clinical spectrum associated with mitochondrial dysfunction poses a major challenge in diagnosis and treatment. Effective therapy has remained elusive till date and is mostly efficient in relieving symptoms. In this review, we discuss the important clinical and genetic features of mitochondrials disorders with special emphasis on diagnosis and treatment. PMID:25857492

  6. New instruments for dry eye diagnosis.

    PubMed

    Yokoi, Norihiko; Komuro, Aoi; Maruyama, Kunio; Kinoshita, Shigeru

    2005-01-01

    Several non-invasive techniques for dry eye diagnosis have been developed in the past decade. These include quantitative assessment of tear volume, tear film stability, tear dynamics, and integrity of ocular surface epithelium. A combination of meniscometry and interferometry is useful for proving focal dry eye, by confirming whether or not tears at the meniscus have an effect on the ocular surface. Interferometer is also useful to evaluate tear dynamics on soft contact lenses. Fluorophotometry is useful for assessing the severity of dry eye from the view point of corneal epithelial barrier function and measuring the tear turnover rate. Both video-meibography and meibometry are useful for screening meibomian gland dysfunction. The advances in these techniques accumulate knowledge regarding pathophysiology of dry eye and allow precise diagnosis of dry eye. More targeted treatment will become feasible based on the clearer pathophysiology.

  7. Current diagnosis and management of achalasia.

    PubMed

    Moonen, An; Boeckxstaens, Guy

    2014-07-01

    Achalasia is the best characterized primary esophageal motility disorder of the esophagus and typically presents with absent peristalsis of the esophageal body and a failure of the lower esophageal sphincter to relax upon swallowing on manometry, associated with progressively severe dysphagia, regurgitation, aspiration, chest pain, and weight loss. The diagnosis is suggested by barium swallow and endoscopy, and confirmed by manometry. As there is no curative treatment for achalasia, treatment is confined to disruption of the lower esophageal sphincter to improve bolus passage. Treatment modalities available for this purpose include pneumatic dilation, laparoscopic Heller myotomy and since recently peroral endoscopic myotomy or POEM. In this review, we will discuss the current diagnosis, management, and treatment options of achalasia.

  8. Diagnosis of latent forms of labyrinthine affections

    NASA Technical Reports Server (NTRS)

    Vaslilyeva, V. P.

    1980-01-01

    Features and significance of individual vestibular symptoms for the diagnosis of latent labyrinthitis and limited forms of labyrinthine affections offering considerable difficulties are discussed. Vestibular symptoms are indistinct. In case of the negative fistular symptom the greatest significance is acquired by the study of posture nystagmus according to the results of electronystagmograms, changes of tonic reactions and statics, as well as data of experimental vestibular tests. The necessity of evaluation of all the vestibular symptoms from the point of view of their vector characteristics and in a complex of evidence obtained by otoneurological examination of the patient is emphasized. Delicate topic and differential diagnosis of vestibular disturbances is of great importance and significance in the choice of the conservative or surgical method of treatment.

  9. [Disseminated intravascular coagulation: clinical and biological diagnosis].

    PubMed

    Touaoussa, Aziz; El Youssi, Hind; El Hassani, Imane; Hanouf, Daham; El Bergui, Imane; Zoulati, Ghizlane; Amrani Hassani, Moncef

    2015-01-01

    Disseminated intravascular coagulation (DIC) is a syndrome characterized by the systemic activation of blood coagulation. Its pathophysiological mechanisms are complex and dependent on the underlying pathology, making the clinical and biological expression of quite variable DIC. Among the various biological parameters disrupted, most are not specific, and none of them allows in itself to make the diagnosis. All this does not facilitate the task of the practitioner for diagnosis of overt DIC, much less that of the non-overt DIC, early stage whose treatment would improve the prognosis. These considerations have led to develop scores, combining several parameters depending on their availability in daily practice, as well as their diagnostic relevance. Of all the scores, the ISTH (International society of thrombosis and hemostasis) remains the most used.

  10. Psychosis in Parkinson's disease: diagnosis and treatment.

    PubMed

    Doraiswamy, M; Martin, W; Metz, A; Deveaugh-Geiss, J

    1995-09-01

    1. This article reviews the prevalence, diagnosis, pathophysiology and management of psychosis in Parkinson's disease. 2. Psychosis in Parkinson's disease has been associated with all antiparkinsonian medications. The most common symptoms are vivid disturbing dreams, visual hallucinations and paranoid delusions. 3. The emergence of psychosis reduces the patient's functional capacity and increases caregiver burden. It also poses a therapeutic dilemma because effective treatment of psychotic symptoms may result in worsening of motor symptoms and vice versa. 4. Increased physician awareness is essential for proper diagnosis and management. Withdrawal of anticholinergic medications and amantadine followed by levodopa dose adjustment is effective in many patients. 5. Atypical neuroleptics, in low doses, may be successful when other measures have failed. However, these agents are not approved for treating Parkinsonian psychosis and must be considered as investigational therapies.

  11. Clinical Manifestations and Diagnosis of Acromegaly

    PubMed Central

    Lugo, Gloria; Pena, Lara; Cordido, Fernando

    2012-01-01

    Acromegaly and gigantism are due to excess GH production, usually as a result of a pituitary adenoma. The incidence of acromegaly is 5 cases per million per year and the prevalence is 60 cases per million. Clinical manifestations in each patient depend on the levels of GH and IGF-I, age, tumor size, and the delay in diagnosis. Manifestations of acromegaly are varied and include acral and soft tissue overgrowth, joint pain, diabetes mellitus, hypertension, and heart and respiratory failure. Acromegaly is a disabling disease that is associated with increased morbidity and reduced life expectancy. The diagnosis is based primarily on clinical features and confirmed by measuring GH levels after oral glucose loading and the estimation of IGF-I. It has been suggested that the rate of mortality in patients with acromegaly is correlated with the degree of control of GH. Adequately treated, the relative mortality risk can be markedly reduced towards normal. PMID:22518126

  12. Crystallographic Model Validation: from Diagnosis to Healing

    PubMed Central

    Richardson, Jane S.; Prisant, Michael G.; Richardson, David C.

    2013-01-01

    Model validation has evolved from a passive final gatekeeping step to an ongoing diagnosis and healing process that enables significant improvement of accuracy. A recent phase of active development was spurred by the worldwide Protein Data Bank requiring data deposition and establishing Validation Task Force committees, by strong growth in high-quality reference data, by new speed and ease of computations, and by an upswing of interest in large molecular machines and structural ensembles. Progress includes automated correction methods, concise and user-friendly validation reports for referees and on the PDB websites, extension of error correction to RNA and error diagnosis to ligands, carbohydrates, and membrane proteins, and a good start on better methods for low resolution and for multiple conformations. PMID:24064406

  13. Heparin induced thrombocytopenia: diagnosis and management.

    PubMed

    Alaraj, Ali; Wallace, Adam; Tesoro, Eljim; Ruland, Sean; Amin-Hanjani, Sepideh; Charbel, Fady T; Aletich, Victor

    2010-12-01

    The incidence of heparin induced thrombocytopenia (HIT) in neurological patients continues to increase with expansion of indication for neurointerventional procedures. The pathophysiology of HIT is related to a hypersensitivity reaction against complex platelet factor 4. The diagnosis is mostly clinical and is often confirmed by laboratory testing. Patients with HIT have a higher rate of thromboembolic complications, both arterial and venous, and with worse neurological outcomes at the time of discharge. Early diagnosis and heparin cessation are essential in the management of those patients. Both immediate and prolonged alternative anticoagulation are necessary. Understanding of the mechanism of action, indication and drug interaction of the alternative anticoagulants (direct thrombin inhibitors, fondaparinux and danaparoid) and warfarin is essential during management of these patients. PMID:21990651

  14. Antenatal diagnosis of extralobar pulmonar sequestration

    PubMed Central

    Houda, El Mhabrech; Ahmed, Zrig; Amine, Ksia; Amina, Ben Salem; Raja, Faleh; Chiraz, Hafsa

    2014-01-01

    Extralobar pulmonary sequestrations (ELS) are masses of non-functioning lung tissue that are supplied by an anomalous systemic artery and do not have a bronchial connection to the native tracheobronchial tree. On prenatal ultrasonography, an ELS appears as a well-defined echodense, homogeneous mass. Detection by color flow Doppler ultrasonography of a systemic artery from the aorta to the fetal lung lesion is a pathognomonic feature of fetal ELS. MR imaging may help in the diagnosis of pulmonary sequestration by demonstrating a solid, well-defined mass, and the feeding artery. In this case report, we describe the sonographic and MR diagnosis of an ELS in a fetus at 22 weeks gestation with a review of the available literature. PMID:25667716

  15. Whole genome amplification in preimplantation genetic diagnosis.

    PubMed

    Zheng, Ying-ming; Wang, Ning; Li, Lei; Jin, Fan

    2011-01-01

    Preimplantation genetic diagnosis (PGD) refers to a procedure for genetically analyzing embryos prior to implantation, improving the chance of conception for patients at high risk of transmitting specific inherited disorders. This method has been widely used for a large number of genetic disorders since the first successful application in the early 1990s. Polymerase chain reaction (PCR) and fluorescent in situ hybridization (FISH) are the two main methods in PGD, but there are some inevitable shortcomings limiting the scope of genetic diagnosis. Fortunately, different whole genome amplification (WGA) techniques have been developed to overcome these problems. Sufficient DNA can be amplified and multiple tasks which need abundant DNA can be performed. Moreover, WGA products can be analyzed as a template for multi-loci and multi-gene during the subsequent DNA analysis. In this review, we will focus on the currently available WGA techniques and their applications, as well as the new technical trends from WGA products.

  16. Cutaneous Lupus Erythematosus: Diagnosis and treatment

    PubMed Central

    Okon, Lauren G.; Werth, Victoria P.

    2013-01-01

    Cutaneous lupus erythematosus encompasses a wide range of dermatologic manifestations, which may or may not be associated with the development of systemic disease. Cutaneous lupus is divided into several subtypes, including acute cutaneous lupus erythematosus, subacute cutaneous lupus erythematosus, and chronic cutaneous lupus erythematosus. Chronic cutaneous lupus erythematosus includes discoid lupus erythematosus, lupus erythematosus profundus, chilblain cutaneous lupus, and lupus tumidus. Diagnosis of these diseases requires proper classification of the subtype, through a combination of physical exam, laboratory studies, histology, antibody serology, and occasionally direct immunofluorescence, while ensuring to exclude systemic disease. Treatment of cutaneous lupus consists of patient education on proper sun protection along with appropriate topical and systemic agents. Systemic agents are indicated in cases of widespread, scarring, or treatment-refractory disease. In this review, we discuss issues in classification and diagnosis of the various subtypes of CLE, as well as provide an update on therapeutic management. PMID:24238695

  17. The diagnosis and treatment of chronic migraine

    PubMed Central

    2015-01-01

    Migraine is the most common disabling brain disorder. Chronic migraine, a condition characterized by the experience of migrainous headache on at least 15 days per month, is highly disabling. Patients with chronic migraine present to primary care, are often referred for management to secondary care, and make up a large proportion of patients in specialist headache clinics. Many patients with chronic migraine also have medication overuse, defined as using a compound analgesic, opioid, triptan or ergot derivative on at least 10 days per month. All doctors will encounter patients with chronic headaches. A basic working knowledge of the common primary headaches, and a rational manner of approaching the patient with these conditions, allows a specific diagnosis of chronic migraine to be made quickly and safely, and by making this diagnosis one opens up a substantial number of acute and preventive treatment options. This article discusses the current state of management of chronic migraine. PMID:25954496

  18. Cryptococcal Meningitis: Diagnosis and Management Update

    PubMed Central

    Abassi, Mahsa; Boulware, David R; Rhein, Joshua

    2015-01-01

    Recent advances in the diagnosis and management of cryptococcal meningitis are promising and have been improving long-term survival. Point of care testing has made diagnosing cryptococcal meningitis rapid, practical, and affordable. Targeted screening and treatment programs for cryptococcal antigenemia are a cost effective method for reducing early mortality on antiretroviral therapy (ART). Optimal initial management with amphotericin and flucytosine improves survival against alternative therapies, although amphotericin is difficult to administer and flucytosine is not available in middle or low income countries, where cryptococcal meningitis is most prevalent. Controlling increased intracranial pressure with serial therapeutic lumbar punctures has a proven survival benefit. Delaying ART initiation for 4 weeks after the diagnosis of cryptococcal meningitis is associated with improved survival. Fortunately, new approaches have been leading the way toward improving care for cryptococcal meningitis patients. New trials utilizing different combinations of antifungal therapy are reviewed, and we summarize the efficacy of different regimens. PMID:26279970

  19. Antenatal diagnosis of extralobar pulmonar sequestration.

    PubMed

    Houda, El Mhabrech; Ahmed, Zrig; Amine, Ksia; Amina, Ben Salem; Raja, Faleh; Chiraz, Hafsa

    2014-01-01

    Extralobar pulmonary sequestrations (ELS) are masses of non-functioning lung tissue that are supplied by an anomalous systemic artery and do not have a bronchial connection to the native tracheobronchial tree. On prenatal ultrasonography, an ELS appears as a well-defined echodense, homogeneous mass. Detection by color flow Doppler ultrasonography of a systemic artery from the aorta to the fetal lung lesion is a pathognomonic feature of fetal ELS. MR imaging may help in the diagnosis of pulmonary sequestration by demonstrating a solid, well-defined mass, and the feeding artery. In this case report, we describe the sonographic and MR diagnosis of an ELS in a fetus at 22 weeks gestation with a review of the available literature. PMID:25667716

  20. Optimizing the Diagnosis of Food allergy

    PubMed Central

    Sicherer, Scott H.

    2015-01-01

    SYNOPSIS Making an accurate diagnosis when evaluating a patient with a possible food allergy is particularly important both to avoid unnecessary dietary restrictions and to prevent life threatening reactions. The testing modalities used routinely in clinical practice, including skin prick testing and food specific IgE levels, have limited accuracy, and a physician-supervised oral food challenge is often required to make a definitive diagnosis. Given the labor-intensive nature of this test and the risk of inducing an allergic reaction, researchers have investigated a number of alternative diagnostic modalities to improve the accuracy of food allergy testing. Testing for IgE antibodies to particular protein components in foods has already shown promise to improve diagnostics and has entered clinical practice. Additional modalities are under study that show potential including epitope binding, T cell studies, basophil activation and others. PMID:25459577

  1. Psoriatic arthritis: Epidemiology, diagnosis, and treatment

    PubMed Central

    Liu, Jung-Tai; Yeh, Horng-Ming; Liu, Shyun-Yeu; Chen, Kow-Tong

    2014-01-01

    Our understanding of psoriatic arthritis has evolved as new knowledge of the disease has emerged. However, the exact prevalence of psoriatic arthritis is unknown, and its pathogenesis has not been fully elucidated. Genetic, environmental, and immunologic factors have all been implicated in disease development. Early diagnosis and treatment have become primary objectives in clinical rheumatology. Psoriatic arthritis not only causes functional impairment, but also increases mortality risk of patients. The advent of new therapeutic agents capable of arresting the progression of joint damage is expected. However, early psoriatic arthritis assessment remains limited. The objectives of this article are to outline the epidemiology, diagnosis, and treatment of psoriatic arthritis and to suggest a paradigm for identifying early psoriatic arthritis patients. PMID:25232529

  2. Intramasseterin-infiltrating angiolipoma: a challenging diagnosis.

    PubMed

    Cassoni, Andrea; Romano, Andrea; Terenzi, Valentina; Bartoli, Davina; Buonaccorsi, Sara; Valentini, Valentino

    2012-07-01

    Angiolipomas are benign mesenchymal tumors infrequently affecting the head and neck region, manifesting themselves as small (<4 cm), slow-growing mass that are painful or tender to palpation. Ultrasonography, fine needle aspiration biopsy, computed tomography, and magnetic resonance imaging can be used to make a diagnosis. Surgical excision is the treatment of choice in both infiltrating and noninfiltrating forms, even if liposuction can be considered in multiple forms. We describe a case of infiltrating intramasseterin angiolipoma, in which diagnosis was suspected after magnetic resonance imaging with gadolinium; then a transoral surgical excision was performed. To the best of our knowledge, only 1 other case of intramasseterin-infiltrating angiolipoma has been previously described.

  3. Multiple sensor fault diagnosis for dynamic processes.

    PubMed

    Li, Cheng-Chih; Jeng, Jyh-Cheng

    2010-10-01

    Modern industrial plants are usually large scaled and contain a great amount of sensors. Sensor fault diagnosis is crucial and necessary to process safety and optimal operation. This paper proposes a systematic approach to detect, isolate and identify multiple sensor faults for multivariate dynamic systems. The current work first defines deviation vectors for sensor observations, and further defines and derives the basic sensor fault matrix (BSFM), consisting of the normalized basic fault vectors, by several different methods. By projecting a process deviation vector to the space spanned by BSFM, this research uses a vector with the resulted weights on each direction for multiple sensor fault diagnosis. This study also proposes a novel monitoring index and derives corresponding sensor fault detectability. The study also utilizes that vector to isolate and identify multiple sensor faults, and discusses the isolatability and identifiability. Simulation examples and comparison with two conventional PCA-based contribution plots are presented to demonstrate the effectiveness of the proposed methodology.

  4. Immunological and molecular diagnosis of cysticercosis

    PubMed Central

    Rodriguez, Silvia; Wilkins, Patricia; Dorny, Pierre

    2012-01-01

    Cysticercosis, the infection with the larval stage of Taenia solium, is a cause of neurological symptoms including seizures, affecting the quality of life of patients and their families. Diagnosis focuses on brain imaging and serological tests are mostly used as confirmatory tools. Most cases, however, occur in poor endemic areas, where both kinds of diagnostic tools are poorly available. Development of point of care diagnostic tests is one of the most important priorities for cysticercosis researches today. The ideal point of care test would require detection of viable cysticercosis and hopefully identify cases with severe or progressive forms of neurocysticercosis, leading to referral of the patient for specialized medical attention. This manuscript describes the evolution of the serological diagnosis of cysticercosis over time, and the characteristics of the most common currently available tools, their advantages and disadvantages, and their potential use in future diagnostic tests. PMID:23265553

  5. [Diagnosis and treatment of periprosthetic infections].

    PubMed

    Lenz, M; Hofmann, G O; Mückley, T

    2012-06-01

    The differentiation of periprosthetic infections into early onset and late onset infections is the determining factor fores the therapeutic strategy. The diagnosis of chronic unapparent infections is sometimes difficult. The therapeutic success, especially in early onset infections, is essentially influenced by a well-timed diagnosis and an immediate therapy. Surgical wound debridement with preservation of the prosthesis, one-stage replacement and two-stage replacement all with concomitant appropriate systemically administered double combined antibiotics are therapeutic options depending on factors, such as the duration of the infection. Prosthesis replacement is currently the only option to treat biofilm colonization of endoprosthetic surfaces. The bacterial adhesion on polyethylene can be extremely resistant. Due to the therapeutic consequences, periprosthetic infections remain one of the worst complications in endoprosthetic joint replacement.

  6. The Diagnosis of Periprosthetic Joint Infection.

    PubMed

    Springer, Bryan D

    2015-06-01

    Periprosthetic joint infection remains one of the most common failure modes following total hip and total knee arthroplasty. As such, a systematic and cost effective approach to the evaluation and work-up of a patient with a suspected periprosthetic joint infection should be undertaken in every patient with a painful total joint. Although we have many diagnostic tools, a history and physical remain the most important. Many of the current laboratory tests are indirect measure of infection, lack specificity for diagnosis of infection, but serve as sensitive and cost effective screening tools. In addition, a new definition of periprosthetic infection helps to standardize the diagnosis. Biomarkers hold the promise of improved specificity and are becoming increasingly popular as a diagnostic tool.

  7. Diagnosis and management of primary ciliary dyskinesia.

    PubMed

    Lucas, Jane S; Burgess, Andrea; Mitchison, Hannah M; Moya, Eduardo; Williamson, Michael; Hogg, Claire

    2014-09-01

    Primary ciliary dyskinesia (PCD) is an inherited autosomal-recessive disorder of motile cilia characterised by chronic lung disease, rhinosinusitis, hearing impairment and subfertility. Nasal symptoms and respiratory distress usually start soon after birth, and by adulthood bronchiectasis is invariable. Organ laterality defects, usually situs inversus, occur in ∼50% of cases. The estimated prevalence of PCD is up to ∼1 per 10,000 births, but it is more common in populations where consanguinity is common. This review examines who to refer for diagnostic testing. It describes the limitations surrounding diagnosis using currently available techniques and considers whether recent advances to genotype patients with PCD will lead to genetic testing and screening to aid diagnosis in the near future. It discusses the challenges of monitoring and treating respiratory and ENT disease in children with PCD.

  8. Diagnosis of Fanconi Anemia by Diepoxybutane Analysis

    PubMed Central

    Auerbach, Arleen D.

    2015-01-01

    Fanconi anemia (FA) is a genetically and phenotypically heterogeneous disorder characterized by congenital malformations, progressive bone marrow failure, and predisposition to cancer, particularly hematological malignancies and solid tumors of the head and neck. The main role of FA proteins is in the repair of DNA interstrand crosslinks (ICLs). FA results from pathogenic variants in at least 16 distinct genes, causing genomic instability. Although the highly variable phenotype makes accurate diagnosis on the basis of clinical manifestations difficult in some patients, diagnosis based on a profound sensitivity to DNA crosslinking agents can be used to identify the pre-anemia patient as well as patients with aplastic anemia or leukemia who may or may not have the physical stigmata associated with the syndrome. Diepoxybutane (DEB) analysis is the preferred test for FA because other agents have higher rates of false-positive and false-negative results. PMID:25827349

  9. Radioisotope labeled platelets in medical diagnosis

    SciTech Connect

    Pope, C.F.; Sostman, H.D.

    1986-08-01

    The myriad of applications of indium-111 labeled platelets (/sup 111/In-P), both in biomedical research and clinical diagnostic imaging, in recent years is an index of the potential of this technology. Because many diseases involve the vascular system, a nontoxic platelet label suitable for imaging has immense potential for diagnosis. Presently confined to research centers, this technique is currently used in three main diagnostic situations: deep vein thrombosis, cardiac thrombi, and organ (renal) transplantation rejection. Future applications will proliferate when difficulties in achieving rapid labeling are overcome, and the period between study initiation and final diagnosis is diminished. This review emphasizes current clinical applications and the potential role of this technology in diagnostic imaging. 52 references.

  10. Lactose intolerance: from diagnosis to correct management.

    PubMed

    Di Rienzo, T; D'Angelo, G; D'Aversa, F; Campanale, M C; Cesario, V; Montalto, M; Gasbarrini, A; Ojetti, V

    2013-01-01

    This review discusses one of the most relevant problems in gastrointestinal clinical practice: lactose intolerance. The role of lactase-persistence alleles the diagnosis of lactose malabsorption the development of lactose intolerance symptoms and its management. Most people are born with the ability to digest lactose, the major carbohydrate in milk and the main source of nutrition until weaning. Approximately, 75% of the world's population loses this ability at some point, while others can digest lactose into adulthood. Symptoms of lactose intolerance include abdominal pain, bloating, flatulence and diarrhea with a considerable intraindividual and interindividual variability in the severity. Diagnosis is most commonly performed by the non invasive lactose hydrogen breath test. Management of lactose intolerance consists of two possible clinical choice not mutually exclusive: alimentary restriction and drug therapy. PMID:24443063

  11. [Diagnosis and Treatment of Diaphragmatic Dysfunction].

    PubMed

    Windisch, W; Schönhofer, B; Magnet, F S; Stoelben, E; Kabitz, H-J

    2016-07-01

    There are many reasons for an impairment of the diaphragmatic function potentially affecting all components of the respiratory pump. Particularly, diagnosis and treatment of unilateral and bilateral phrenic nerve paralysis are challenging. Neuromuscular disorders, trauma, iatrogenic conditions, tumor compression, but also infectious and inflammatory conditions in addition to neuralgic amyotrophy and idiopathic phrenic nerve paralysis are reasons for phrenic nerve paralysis. Primarily, diagnostic procedures include the anamnesis, physical examination, blood gas analysis, lung function testing and the diagnosis of the underlying disease. In addition, specific respiratory muscle testing and respiratory imaging are available today. Current established treatment options include respiratory muscle training, long-term non-invasive ventilation and surgical diaphragm plication in selected patients. PMID:27411076

  12. [Radiographic diagnosis of vertical root fracture].

    PubMed

    Guangning, Zheng; Jiyao, Li

    2016-02-01

    Vertical root fracture (VRF) is different from odontoclasis caused by trauma or injury. VRF is defined as a complete or incomplete fracture of roots caused by long-term and persistent stimulus, such as excessive forces from mastication or occlusion, improper tooth anatomy, and tooth treatment accident. Early diagnosis of VRF is essential to prevent the absorption of alveolar bone, thereby improving prognosis. Radiographic examination is the most common and effective evaluation method for VRF. Cone beam computed tomography can provide three-dimensional information for fracture details, which are more precise than traditional periapical films. In this paper, we present the radiographic features, differential diagnosis, and new treatment techniques for VRF. PMID:27266189

  13. Clinical manifestations and diagnosis of acromegaly.

    PubMed

    Lugo, Gloria; Pena, Lara; Cordido, Fernando

    2012-01-01

    Acromegaly and gigantism are due to excess GH production, usually as a result of a pituitary adenoma. The incidence of acromegaly is 5 cases per million per year and the prevalence is 60 cases per million. Clinical manifestations in each patient depend on the levels of GH and IGF-I, age, tumor size, and the delay in diagnosis. Manifestations of acromegaly are varied and include acral and soft tissue overgrowth, joint pain, diabetes mellitus, hypertension, and heart and respiratory failure. Acromegaly is a disabling disease that is associated with increased morbidity and reduced life expectancy. The diagnosis is based primarily on clinical features and confirmed by measuring GH levels after oral glucose loading and the estimation of IGF-I. It has been suggested that the rate of mortality in patients with acromegaly is correlated with the degree of control of GH. Adequately treated, the relative mortality risk can be markedly reduced towards normal. PMID:22518126

  14. Etiologic Diagnosis of Lower Respiratory Tract Infections

    PubMed Central

    Hoeprich, Paul D.

    1970-01-01

    Decision as to the role of infection in lower respiratory tract disease requires examination by culture of specimens known to be derived from the infra-laryngeal respiratory tract. Methods that involve the upper respiratory tract in collection of specimens entail the hazard of contamination by microbiota resident in the upper respiratory tract. The extrapulmonary approaches of cutting-needle biopsy and needle aspiration of intrathoracic disease have not been impressively productive of etiologic diagnosis of infections. While open-chest surgical biopsy has been a highly effective means to diagnosis, this approach does have special requirements in facilities and technical skills. Percutaneous transtracheal aspiration of tracheo-broncho-pulmonary secretions-exudates has been productive of useful information. Because of inherent simplicity and safety, transtracheal aspiration should precede resort to more demanding, difficult, dangerous procedures. PMID:5470140

  15. Diagnosis of GDM: a suggested consensus.

    PubMed

    McIntyre, Harold David; Colagiuri, Stephen; Roglic, Gojka; Hod, Moshe

    2015-02-01

    Despite recent attempts at building consensus, an internationally consistent definition of gestational diabetes mellitus (GDM) remains elusive. Within and between countries, there is disagreement between obstetric, medical, and endocrine groups as to the diagnosis and management of GDM. The current article aims to discuss the background to the controversy of GDM diagnosis and to address issues related to the detection and treatment of GDM in low-, middle-, and high-resource settings. The criteria recommended by the International Association of the Diabetes and Pregnancy Study Groups (IADPSG), the American Diabetes Association (ADA), and the World Health Organization (WHO) are endorsed. We also wish to put into perspective the importance of GDM, both during and after pregnancy, in terms of its relationship to overall women's health. PMID:25242583

  16. A PC based fault diagnosis expert system

    NASA Technical Reports Server (NTRS)

    Marsh, Christopher A.

    1990-01-01

    The Integrated Status Assessment (ISA) prototype expert system performs system level fault diagnosis using rules and models created by the user. The ISA evolved from concepts to a stand-alone demonstration prototype using OPS5 on a LISP Machine. The LISP based prototype was rewritten in C and the C Language Integrated Production System (CLIPS) to run on a Personal Computer (PC) and a graphics workstation. The ISA prototype has been used to demonstrate fault diagnosis functions of Space Station Freedom's Operation Management System (OMS). This paper describes the development of the ISA prototype from early concepts to the current PC/workstation version used today and describes future areas of development for the prototype.

  17. Hepatobiliary Tumors: Update on Diagnosis and Management

    PubMed Central

    Kabbach, Ghassan; Assi, Hussein A; Bolotin, George; Schuster, Michael; Lee, Hwa Jeong; Tadros, Micheal

    2015-01-01

    Tumors of the liver and biliary tree, mainly hepatocellular carcinoma and cholangiocarcinoma, are the second leading cause of cancer related death worldwide and the sixth leading cause of cancer related death among men in developed countries. Recent developments in biomarkers and imaging modalities have enhanced early detection and accurate diagnosis of these highly fatal malignancies. These advances include serological testing, micro-ribonucleic acids, fluorescence in situ hybridization, contrast-enhanced ultrasound, and hepatobiliary-phase magnetic resonance imaging. In addition, there have been major developments in the surgical and nonsurgical management of these tumors, including expansion of the liver transplantation criteria, new locoregional treatments, and molecularly targeted therapies. In this article, we review various types of hepatobiliary tumors and discuss new developments in their diagnosis and management. PMID:26623263

  18. Diagnosis and treatment of microscopic colitis.

    PubMed

    Okamoto, Ryuichi; Negi, Mariko; Tomii, Syohei; Eishi, Yoshinobu; Watanabe, Mamoru

    2016-08-01

    Microscopic colitis (MC) designates two types of chronic diarrhea diseases, which are lymphocytic colitis and collagenous colitis. The prevalence of microscopic colitis is increasing in both Western and Eastern countries, possibly due to the high incidence of colonoscopic survey in chronic diarrhea patients. Although the overall prognosis of MC patients is mostly good, it should be noted that appropriate diagnosis and choice of treatment is required to assure a good clinical outcome for MC patients. Also, a certain population of MC patients may take a severe and refractory clinical course, and thus require advanced clinical care using medications supported by less evidence. In this review, we would like to feature the essential points regarding the diagnosis of MC, and also describe the current standard of treatments for MC patients. In addition, we would like to add some findings from the national survey and research carried out in Japan, to compare those data with the western countries. PMID:27271790

  19. Autism: cause factors, early diagnosis and therapies.

    PubMed

    Bhat, Shreya; Acharya, U Rajendra; Adeli, Hojjat; Bairy, G Muralidhar; Adeli, Amir

    2014-01-01

    Autism spectrum disorder (ASD) is a complex neurobiological disorder characterized by neuropsychological and behavioral deficits. Cognitive impairment, lack of social skills, and stereotyped behavior are the major autistic symptoms, visible after a certain age. It is one of the fastest growing disabilities. Its current prevalence rate in the U.S. estimated by the Centers for Disease Control and Prevention is 1 in 68 births. The genetic and physiological structure of the brain is studied to determine the pathology of autism, but diagnosis of autism at an early age is challenging due to the existing phenotypic and etiological heterogeneity among ASD individuals. Volumetric and neuroimaging techniques are explored to elucidate the neuroanatomy of the ASD brain. Nuroanatomical, neurochemical, and neuroimaging biomarkers can help in the early diagnosis and treatment of ASD. This paper presents a review of the types of autism, etiologies, early detection, and treatment of ASD.

  20. [Ultrasonics in the diagnosis of stomach tumors].

    PubMed

    Portnoĭ, L M; Roslov, A L; Dibirov, M P

    1991-01-01

    Proceeding from analysis of over 2000 ultrasound investigations (USI) the role of this method in the diagnosis of stomach tumors was defined (employed during routine investigation of the abdominal cavity and as a procedure with liquid filling of the stomach cavity). Ultrasound semiotics of a neoplastic process of the stomach was described. USI can be used for screening and specification. Various methodological approaches were proposed with regard to purposes to be achieved. Routine methods (x-ray and endoscopy) were shown to remain the chief methods. USI can be used in doubtful cases or for obtaining detailed information. The most valuable are its potentialities in showing details of intraparietal changes in endophytic stomach carcinomas which are difficult for diagnosis.

  1. [Ultrasonography in the diagnosis of colonic obstruction].

    PubMed

    Legostaeva, T B; Klassovskaia, N Iu

    2007-01-01

    The authors of the present paper outline the results of studying the use of routine transabdominal sonography and ultrasound irrigoscopy (UI) in the diagnosis of acute colonic obstruction (ACO) in 70 patients. The cause of ACO was tumor-induced colonic luminal obturation in 55 patients and colonic evacuatory dysfunction due to congenital anomalies and acquired constrictions of inflammatory genesis in 15 cases. UI was used to determine the presence, degree, and causes of colonic obstruction. The paper details the UI procedure developed by the authors and the ultrasound semiotics of ACO, shown by routine transabdominal sonography and UI. Analysis of the results of the studies allows the authors to state that UI is as highly informative as X-ray irrigoscopy in the diagnosis of ACO and may be included into a diagnostic algorithm in these patients.

  2. Extrapulmonary tuberculosis: importance of differential diagnosis

    PubMed Central

    Mota, Patrícia Caetano; Sá, David; Mota, Margarida; Duarte, Raquel

    2011-01-01

    Patients with tuberculosis (TB) typically present with pulmonary TB, but extrapulmonary TB is also an important clinical problem. In particular, osteoarticular TB has a great morbidity and its diagnosis gold-standard includes culture and histopathology of the infected area. The present case study describes a 53-year-old female Portuguese farmer who had initial clinical and imaging features suggestive of tuberculous osteomyelitis. However, she denied any TB contacts and the tuberculin skin-test and interferon-γ release assay result were negative. Brucella melitensis was isolated from a tissue biopsy cultural examination, and treatment for brucellosis was started, yielding a favourable outcome. In similar circumstances, a precise diagnosis, that considers the epidemiological context, is crucially important for adequate treatment and reduction of morbidity. PMID:22679255

  3. [Mucopolysaccharidosis: clinical features, diagnosis and management].

    PubMed

    Suarez-Guerrero, Jorge Luis; Gómez Higuera, Pedro José Iván; Arias Flórez, Juan Sebastian; Contreras-García, Gustavo Adolfo

    2016-01-01

    The mucopolysaccharidoses (MPS) are a group of rare (orphan) diseases, characterised by a deficiency of enzymes involved in the metabolism of glycosaminoglycans (GAGs) at lysosomal level. When there is a deficiency of a particular enzyme there is an accumulation of GAGs in the cells resulting in progressive cellular damage, which can affect multiple organ systems and lead to organ failure. Diagnosis is based on knowledge of the clinical manifestations, performing biochemical analyses to identify the type of GAG that is accumulating, and confirm the type of disorder with the corresponding enzymatic determination. Their identification is essential to initiate early treatment, taking into account that multidisciplinary management and enzyme replacement therapy is available for MPS I (Hurler syndrome), MPS II (Hunter syndrome), MPS IV (Morquio syndrome), and MPS VI (Maroteaux-Lamy syndrome. In this review, an analysis is made of each of these syndromes, as well as their diagnosis and treatment.

  4. Headaches and Migraines: Headache Symptoms, Diagnosis, and Treatment

    MedlinePlus

    ... Bar Home Current Issue Past Issues Headaches and Migraines Headache Symptoms, Diagnosis, and Treatment Past Issues / Spring ... of headache. Each has distinct symptoms and treatments. Migraine and Other Vascular Headaches—Symptoms and Diagnosis Migraine: ...

  5. How Does Your Doctor Make a PD Diagnosis?

    MedlinePlus

    ... More > Español In Your Area NPF Shop How Does Your Doctor Make a PD Diagnosis Make Text ... and possible falls, also called postural instability How does your doctor make a PD diagnosis? The bedside ...

  6. Lactose intolerance: diagnosis, genetic, and clinical factors.

    PubMed

    Mattar, Rejane; de Campos Mazo, Daniel Ferraz; Carrilho, Flair José

    2012-01-01

    Most people are born with the ability to digest lactose, the major carbohydrate in milk and the main source of nutrition until weaning. Approximately 75% of the world's population loses this ability at some point, while others can digest lactose into adulthood. This review discusses the lactase-persistence alleles that have arisen in different populations around the world, diagnosis of lactose intolerance, and its symptomatology and management. PMID:22826639

  7. Cytopathologic diagnosis of liver mass lesions.

    PubMed

    Conrad, Rachel; Castelino-Prabhu, Shobha; Cobb, Camilla; Raza, Anwar

    2013-03-01

    The liver is a common site for metastatic malignancies, particularly from the gastrointestinal tract. It also may be involved by primary neoplasms, both benign and malignant. Cytopathologic examination of mass lesions of the liver with pertinent use of ancillary studies is a useful method of establishing a correct diagnosis for patient management. The authors reviewed the literature for articles pertaining to cytologic characteristics of specific tumor types, utility of immunohistochemical markers and pertinent molecular studies, differential diagnoses and pitfalls.

  8. Rubella and pregnancy: diagnosis, management and outcomes.

    PubMed

    Bouthry, Elise; Picone, Olivier; Hamdi, Ghada; Grangeot-Keros, Liliane; Ayoubi, Jean-Marc; Vauloup-Fellous, Christelle

    2014-12-01

    Rubella is a mild viral disease that typically occurs in childhood. Rubella infection during pregnancy causes congenital rubella syndrome, including the classic triad of cataracts, cardiac abnormalities and sensorineural deafness. Highly effective vaccines have been developed since 1969, and vaccination campaigns have been established in many countries. Although there has been progress, the prevention and diagnosis of rubella remain problematic. This article reviews the implications and management of rubella during pregnancy. PMID:25066688

  9. Hyperhidrosis: an approach to diagnosis and management.

    PubMed

    Haider, Aamir; Solish, Nowell

    2004-12-01

    Hyperhidrosis is defined as focal or generalized excessive sweating with a prevalence of 2.8% of the general population. This medical condition is associated with significant psychosocial morbidity and has a dramatic impact on activities of daily living. A significant proportion of patients do not consult a physician for this condition. Early diagnosis is essential in order to implement management strategies that have excellent efficacy rates and patient satisfaction.

  10. Rubella and pregnancy: diagnosis, management and outcomes.

    PubMed

    Bouthry, Elise; Picone, Olivier; Hamdi, Ghada; Grangeot-Keros, Liliane; Ayoubi, Jean-Marc; Vauloup-Fellous, Christelle

    2014-12-01

    Rubella is a mild viral disease that typically occurs in childhood. Rubella infection during pregnancy causes congenital rubella syndrome, including the classic triad of cataracts, cardiac abnormalities and sensorineural deafness. Highly effective vaccines have been developed since 1969, and vaccination campaigns have been established in many countries. Although there has been progress, the prevention and diagnosis of rubella remain problematic. This article reviews the implications and management of rubella during pregnancy.

  11. Neonatal alloimmune thrombocytopenia: pathogenesis, diagnosis and management

    PubMed Central

    Peterson, Julie A.; McFarland, Janice G.; Curtis, Brian R.; Aster, Richard H.

    2014-01-01

    Summary Neonatal alloimmune thrombocytopenia, (NAIT) is caused by maternal antibodies raised against alloantigens carried on fetal platelets. Although many cases are mild, NAIT is a significant cause of morbidity and mortality in newborns and is the most common cause of intracranial haemorrhage in full-term infants. In this report, we review the pathogenesis, clinical presentation, laboratory diagnosis and prenatal and post-natal management of NAIT and highlight areas of controversy that deserve the attention of clinical and laboratory investigators. PMID:23384054

  12. Computer-aided-diagnosis (CAD) for colposcopy

    NASA Astrophysics Data System (ADS)

    Lange, Holger; Ferris, Daron G.

    2005-04-01

    Uterine cervical cancer is the second most common cancer among women worldwide. Colposcopy is a diagnostic method, whereby a physician (colposcopist) visually inspects the lower genital tract (cervix, vulva and vagina), with special emphasis on the subjective appearance of metaplastic epithelium comprising the transformation zone on the cervix. Cervical cancer precursor lesions and invasive cancer exhibit certain distinctly abnormal morphologic features. Lesion characteristics such as margin; color or opacity; blood vessel caliber, intercapillary spacing and distribution; and contour are considered by colposcopists to derive a clinical diagnosis. Clinicians and academia have suggested and shown proof of concept that automated image analysis of cervical imagery can be used for cervical cancer screening and diagnosis, having the potential to have a direct impact on improving women"s health care and reducing associated costs. STI Medical Systems is developing a Computer-Aided-Diagnosis (CAD) system for colposcopy -- ColpoCAD. At the heart of ColpoCAD is a complex multi-sensor, multi-data and multi-feature image analysis system. A functional description is presented of the envisioned ColpoCAD system, broken down into: Modality Data Management System, Image Enhancement, Feature Extraction, Reference Database, and Diagnosis and directed Biopsies. The system design and development process of the image analysis system is outlined. The system design provides a modular and open architecture built on feature based processing. The core feature set includes the visual features used by colposcopists. This feature set can be extended to include new features introduced by new instrument technologies, like fluorescence and impedance, and any other plausible feature that can be extracted from the cervical data. Preliminary results of our research on detecting the three most important features: blood vessel structures, acetowhite regions and lesion margins are shown. As this is a new

  13. Shoulder Conditions: Diagnosis and Treatment Guideline.

    PubMed

    Codsi, Michael; Howe, Chris R

    2015-08-01

    The following guideline covers a wide array of shoulder conditions seen in the workers' compensation, as well as the nonworkers' compensation, population. The guideline is intended to help establish work relatedness and aid in making the diagnosis of shoulder injuries and degenerative conditions. It also provides a nonoperative and operative guideline for the treatment of several shoulder conditions, not limited to rotator cuff tears, subacromial impingement syndrome, acromioclavicular arthritis and dislocations, as well as glenohumeral arthritis.

  14. [Diagnosis and therapy of chondropathia patellae].

    PubMed

    Jungmichel, D

    1980-04-01

    As a role the comprehensive compiling of the case history as well as the clinical and roentgenological examination give the correct diagnosis. But the variable conservative and/or operative treatment must be carried out without polypragmasy. Thus good up to very good results can be achieved in 80 per cent. The therapy must aim at making the patients free from symptoms, but it is not the aim to enable them to accomplish great physical performances.

  15. Semantic dementia: aspects of the early diagnosis.

    PubMed

    Belliard, S; Merck, C; Jonin, P Y; Vérin, M

    2013-10-01

    Semantic dementia is a lobar atrophy syndrome, related to a degeneration of anterior temporal regions, and characterized by a very predominant impairment of semantic memory. Whereas the diagnosis is relatively easy to establish in the typical form and if the patient is seen early, the emergence of possible additional cognitive or psycho-behavioural disorders can lead to a misdiagnosis in favour of a frontotemporal dementia syndrome or even probable Alzheimer's disease.

  16. [Oral cavity cancer: epidemiology and early diagnosis].

    PubMed

    Ghantous, Y; Yaffi, V; Abu-Elnaaj, I

    2015-07-01

    Cancer of the oral cavity (Oral cancer) is the 11th most common malignancy in the world, despite the general global trend of a slight decrease in the incidence of oral cancer, tongue cancer incidence is increasing. About 90% of tumors are subtyped to oral Squamous cell carcinoma (OSCC). The incidence and mortality of this tumor shows variability according to the geographic location in which it is diagnosed, however in the last decade an increase was seen in the percentage of young patients, especially patients with tongue cancer. The overall prognosis of this cancer is roughly 55-65%, this is probably due to late diagnosis. Early diagnosis of oral cancer is the most important factor affecting the overall survival and prognosis, thus several diagnosis methods have been developed in the past few years. Still, the prognosis did not improve as expected. Oral cancer biomarkers in saliva is as easy body fluid, for noninvasive detection. Several researches identified several possible biomarkers, but none was specific. In our review, the incidence and mortality of oral tumors pose a main health problem in many aspects all around the world, as well as differences in behavior of these tumors. We witnessed more cases of anterior tongue cancers affecting mainly the young age patient group, a two decades younger than the normal risk group of oral cancer. Several countries in Europe showed a significant increase of oral cancer prevalence, such as Germany, especially in men. Similar behavior was also reported in the United States, which showed a change in the risk groups. Studies have reported an alarming lack of awareness about oral cancer, its symptoms and early diagnosis. These gaps in knowledge need to be addressed by further public education, possibly targeted at high-risk groups. With the knowledge of possible, specific, early biomarkers, primary detection could improve the prognosis tremendously. Research on the salivary biomarkers of the disease would help to develop

  17. Delay in diagnosis of right atrial myxoma

    SciTech Connect

    Northcote, R.J.; Sethia, B.; Ballantyne, D.

    1985-02-01

    Clinical, echocardiographic, and nuclear angiographic findings in a 51-year-old woman who presented with a history of dyspnea are discussed. Initial echocardiography revealed no abnormality. However, a subsequent radionuclide angiogram revealed a filling defect on the right side of the heart. This represented a right atrial myxoma. Radionuclide angiography can provide a useful noninvasive tool in the diagnosis of intracardiac tumors when echocardiography has not been helpful.

  18. Diagnosis and management of xerostomia and hyposalivation

    PubMed Central

    Villa, Alessandro; Connell, Christopher L; Abati, Silvio

    2015-01-01

    Xerostomia, the subjective complaint of dry mouth, and hyposalivation remain a significant burden for many individuals. Diagnosis of xerostomia and salivary gland hypofunction is dependent upon a careful and detailed history and thorough oral examination. There exist many options for treatment and symptom management: salivary stimulants, topical agents, saliva substitutes, and systemic sialogogues. The aim of this review is to investigate the current state of knowledge on management and treatment of patients affected by xerostomia and/or hyposalivation. PMID:25653532

  19. The challenge of dry eye diagnosis

    PubMed Central

    Savini, Giacomo; Prabhawasat, Pinita; Kojima, Takashi; Grueterich, Martin; Espana, Edgar; Goto, Eiki

    2008-01-01

    The currently available methods for the diagnosis of dry eye are still far from being perfect for a variety of reasons. This review attempts to highlight the advantages and disadvantages of both traditional tests (such as Schirmer’s test, break-up time and ocular surface staining) and innovative noninvasive procedures, including tear meniscus height measurement, corneal topography, functional visual acuity, tear interferometry, tear evaporimetry and tear osmolarity assessment. PMID:19668387

  20. Lactose intolerance: diagnosis, genetic, and clinical factors

    PubMed Central

    Mattar, Rejane; de Campos Mazo, Daniel Ferraz; Carrilho, Flair José

    2012-01-01

    Most people are born with the ability to digest lactose, the major carbohydrate in milk and the main source of nutrition until weaning. Approximately 75% of the world’s population loses this ability at some point, while others can digest lactose into adulthood. This review discusses the lactase-persistence alleles that have arisen in different populations around the world, diagnosis of lactose intolerance, and its symptomatology and management. PMID:22826639

  1. [Gestational malaria: HELLP syndrome mistaken diagnosis].

    PubMed

    Castillo Medina, Nayra Marizol; Velázquez Fonseca, Julián; Hernández Pacheco, José Antonio; Acevedo Tacuba, José Luis

    2008-05-01

    Malaria is one of the most important parasitic infections in Mexico and Latin America. Here we report a case of a 21 year-old female with 38.4 weeks of pregnancy and previous hospitalization due to malaria. Showing a thick drop negative test she was referred to Mexico City Hospital de la Mujer with presumptive diagnosis of preeclampsia and HELLP syndrome. During her stay in ICU she developed malarial paroxysm and Plasmodium vivax was identified, conducting to specific therapy.

  2. Artificial neural network cardiopulmonary modeling and diagnosis

    DOEpatents

    Kangas, L.J.; Keller, P.E.

    1997-10-28

    The present invention is a method of diagnosing a cardiopulmonary condition in an individual by comparing data from a progressive multi-stage test for the individual to a non-linear multi-variate model, preferably a recurrent artificial neural network having sensor fusion. The present invention relies on a cardiovascular model developed from physiological measurements of an individual. Any differences between the modeled parameters and the parameters of an individual at a given time are used for diagnosis. 12 figs.

  3. Diaper Dermatitis: Differential Diagnosis and Management

    PubMed Central

    Kellen, Philippa E.

    1990-01-01

    Diaper dermatitis is one of the most common dermatoses occurring in infancy. It is an irritant dermatitis, in which a variety of factors act in concert to produce inflammation of the diapered skin. The differential diagnosis includes many common and some uncommon conditions. Successful treatment requires detailed instructions to caregivers regarding simple hygienic procedures and diapering practices. ImagesFigure 1Figure 2 PMID:21233927

  4. Immunity-based diagnosis for a motherboard.

    PubMed

    Shida, Haruki; Okamoto, Takeshi; Ishida, Yoshiteru

    2011-01-01

    We have utilized immunity-based diagnosis to detect abnormal behavior of components on a motherboard. The immunity-based diagnostic model monitors voltages of some components, CPU temperatures, and fan speeds. We simulated abnormal behaviors of some components on the motherboard, and we utilized the immunity-based diagnostic model to evaluate motherboard sensors in two experiments. These experiments showed that the immunity-based diagnostic model was an effective method for detecting abnormal behavior of components on the motherboard. PMID:22163857

  5. Artificial neural network cardiopulmonary modeling and diagnosis

    DOEpatents

    Kangas, Lars J.; Keller, Paul E.

    1997-01-01

    The present invention is a method of diagnosing a cardiopulmonary condition in an individual by comparing data from a progressive multi-stage test for the individual to a non-linear multi-variate model, preferably a recurrent artificial neural network having sensor fusion. The present invention relies on a cardiovascular model developed from physiological measurements of an individual. Any differences between the modeled parameters and the parameters of an individual at a given time are used for diagnosis.

  6. Polymylagia rheumatica: common disease, elusive diagnosis.

    PubMed

    Mager, Diana R

    2015-03-01

    Polymyalgia rheumatica (PMR) is a common inflammatory rheumatic disease with little known about its etiology or incidence. Frequently found in older adult women, this disease can be debilitating, painful, and dangerous. Diagnosing PMR can be elusive due to lack of specific laboratory tests, and treatment with use of long-term glucocorticoids can be difficult due to side effects. The following article describes the pathophysiology, diagnosis, signs and symptoms, and treatment of PMR, as well as implications for home healthcare.

  7. HVAC Fault Detection and Diagnosis Toolkit

    2004-12-31

    This toolkit supports component-level model-based fault detection methods in commercial building HVAC systems. The toolbox consists of five basic modules: a parameter estimator for model calibration, a preprocessor, an AHU model simulator, a steady-state detector, and a comparator. Each of these modules and the fuzzy logic rules for fault diagnosis are described in detail. The toolbox is written in C++ and also invokes the SPARK simulation program.

  8. [Splenic abscess: etiology, diagnosis and possible therapeutics].

    PubMed

    Burnier, C; Ribordy-Baudat, V; Lamy, O

    2007-10-31

    We report the case of a 28-year-old intravenous drug abuser under quadritherapy for stage C3 AIDS and with past history of infectious endocarditis. He was admitted with a diminished general condition, weight loss, progressive unbearable abdominal pain and vomiting, without fever. An inflammatory syndrome is noted and imaging reveals a voluminous splenic abscess. Conservative treatment is initiated with repetitive drainages and intravenous antibiotics. Aetiologies, diagnosis and possible therapeutics of splenic abscesses are discussed. PMID:18018950

  9. [Borderline leprosy as a rare differential diagnosis].

    PubMed

    Trawinski, Henning; Brüning, Jan-Hinnerk; Baum, Petra; Ziemer, Mirjana; Schubert, Stefan; Lübbert, Christoph

    2016-06-01

    History and clinical findings | A 42-year-old migrant from Brazil presented with persistent sensory disturbances, skin discolorations and local alopecia in the upper limbs. Decisive for the presentation in our Tropical Medicine Clinic were new occurrences of severe pain and redness and swelling in the area of the lesions that had already been assessed by a number of medical specialists without a clear diagnosis could be made. Investigations and diagnosis | The histological analysis of skin biopsies showed perivascular, perineural, periadnexial lymphocytic and granulomatous dermatitis. In a direct microbiological preparation individual acid fast bacilli could be detected (Ziehl-Neelsen stain). The electroneurographical examination demonstrated a sensitive peripheral-neurogenic damage with emphasis on the right median nerve and the left ulnar and radial nerves. Thermography revealed an increased heating or cooling threshold. The serological investigation by ELISA for IgM antibodies against the phenolic glycolipid (PGL-1) was positive (titer 1 : 1200). In summary, the diagnosis of borderline leprosy (infection with Mycobacterium leprae) with transition to multibacillary leprosy (according to WHO) and leprosy reaction type 1 was made. Treatment and course | We initiated an oral antimycobacterial therapy (multidrug therapy, MDT) with rifampin, clofazimine and dapsone for 12 months (WHO regimen for multibacillary leprosy). Leprosy reaction type 1 was treated with prednisolone and by increasing the dose of clofazimine. Analgesic therapy on demand was carried out with nonsteroidal anti-inflammatory drugs (ibuprofen). MDT and successful management of leprosy reaction lead to a rapid improvement of symptoms. Conclusions | Leprosy is an infectious disease occurring only rarely in Germany (average incidence of 1-2 cases per year) that is diagnosed almost exclusively among migrants. Main symptoms comprise non-itchy, reddish, touch insensitive skin lesions or nerve deficits. The

  10. Systemic AA amyloidosis: epidemiology, diagnosis, and management

    PubMed Central

    Real de Asúa, Diego; Costa, Ramón; Galván, Jose María; Filigheddu, María Teresa; Trujillo, Davinia; Cadiñanos, Julen

    2014-01-01

    The term “amyloidosis” encompasses the heterogeneous group of diseases caused by the extracellular deposition of autologous fibrillar proteins. The global incidence of amyloidosis is estimated at five to nine cases per million patient-years. While amyloid light-chain (AL) amyloidosis is more frequent in developed countries, amyloid A (AA) amyloidosis is more common in some European regions and in developing countries. The spectrum of AA amyloidosis has changed in recent decades owing to: an increase in the median age at diagnosis; a percent increase in the frequency of primary AL amyloidosis with respect to the AA type; and a substantial change in the epidemiology of the underlying diseases. Diagnosis of amyloidosis is based on clinical organ involvement and histological evidence of amyloid deposits. Among the many tinctorial characteristics of amyloid deposits, avidity for Congo red and metachromatic birefringence under unidirectional polarized light remain the gold standard. Once the initial diagnosis has been made, the amyloid subtype must be identified and systemic organ involvement evaluated. In this sense, the 123I-labeled serum amyloid P component scintigraphy is a safe and noninvasive technique that has revolutionized the diagnosis and monitoring of treatment in systemic amyloidosis. It can successfully identify anatomical patterns of amyloid deposition throughout the body and enables not only an initial estimation of prognosis, but also the monitoring of the course of the disease and the response to treatment. Given the etiologic diversity of AA amyloidosis, common therapeutic strategies are scarce. All treatment options should be based upon a greater control of the underlying disease, adequate organ support, and treatment of symptoms. Nevertheless, novel therapeutic strategies targeting the formation of amyloid fibrils and amyloid deposition may generate new expectations for patients with AA amyloidosis. PMID:25378951

  11. Cancer diagnosis by infrared spectroscopy: methodological aspects

    NASA Astrophysics Data System (ADS)

    Jackson, Michael; Kim, Keith; Tetteh, John; Mansfield, James R.; Dolenko, Brion; Somorjai, Raymond L.; Orr, F. W.; Watson, Peter H.; Mantsch, Henry H.

    1998-04-01

    IR spectroscopy is proving to be a powerful tool for the study and diagnosis of cancer. The application of IR spectroscopy to the analysis of cultured tumor cells and grading of breast cancer sections is outlined. Potential sources of error in spectral interpretation due to variations in sample histology and artifacts associated with sample storage and preparation are discussed. The application of statistical techniques to assess differences between spectra and to non-subjectively classify spectra is demonstrated.

  12. [How to announce the diagnosis for melanoma?].

    PubMed

    Charles, Cécile; Rouby, Pascal; Robert, Caroline

    2014-01-01

    Announcing a diagnosis of cutaneaous melanoma is a complex moment of medical activity and has some specificities due to the disease, but also to its management. After defining these aspects, the article deals with the principals steps and elements, including communicative ones, of this form of announcement. Its aim is above all practice: it is proposing some guidelines drawn from official recommendations and recent works on the physician-patient relationship in oncology, aiming at helping health professionals in this field.

  13. Pitfalls in the radiographic diagnosis of angiofibroma.

    PubMed

    Shaffer, K; Haughton, V; Farley, G; Friedman, J

    1978-05-01

    Radiographic findings previously thought pathognomonic for juvenile nasopharyngeal angiofibroma are anterior bowing of the posterior wall of the maxillary antrum on plain films or tomography, and a dense homogeneous blush on angiography. Two patients presented with nasopharyngeal masses which mimicked angiofibroma radiographically: one mass was a lymphoepithelioma and the other was a fibrous tumor. Constitutional symptoms and atypical physical findings should alert the physician to a diagnosis other than juvenile nasopharyngeal angiofibroma.

  14. Diagnosis of adrenal tumors with radionuclide imaging

    SciTech Connect

    Beierwaltes, W.H.; Sisson, J.C.; Shapiro, B.

    1984-01-01

    The development of radiolabeled cholesterols in 1969 as precursors of adrenocortical steroid production allowed the first noninvasive imaging of the adrenal cortices. FDA-NDA approval in 1984 should allow routine use of these agents in most hospitals. NP-59 is most commonly used in the diagnosis and management of Cushing syndrome; the second most common use is in the diagnosis of primary aldosteronism. It is also helpful in the differential diagnosis of adrenal and ovarian hyperandrogenism and hirsutism, and is the only noninvasive method of detecting unilateral adrenocortical hypofunction. The newest and most popular use is in the differential diagnosis of asymptomatic masses in the region of the adrenal gland discovered incidentally with CT scan (incidentalomas). In this situation, the NP-59 scan can define whether the tumor is in the adrenal gland and if it is functional or nonfunctional. The authors believe that, in the future, radiolabeled enzyme inhibitors might offer better diagnostic imaging of the adrenal cortex, although these agents will probably not be available for routine use for some time. The development of a radioiodinated guanethidine analog, /sup 131/I-MIBG, has allowed differentiation of normal adrenal medullary function from bilateral adrenal medullary hyperplasia before the development of hypertension or tachycardia, diagnostic increases in plasma or urinary catecholamines, or abnormal CT scans. The search for a pheochromocytoma should begin with /sup 131/I-MIBG scintigraphy. While over 90% of primary pheochromocytomas occur in the abdomen, neither a survey of the abdomen nor the finding of a single tumor should conclude the search.

  15. A distributed expert system for fault diagnosis

    SciTech Connect

    Cardozo, E.; Talukdar, S.N.

    1988-05-01

    This paper describes a hybrid approach to synthesizing solutions for diagnosis and set covering problems from the area of power system operations. The approach combines expert systems written in a rule-based language (OPS5) with algorithmic programs written in C and Lisp. An environment called DPSK has been developed to allow these programs to be run in parallel in a network of computers. Speeds sufficient for real-time applications can thereby be obtained.

  16. [Depressive pseudodementia. Differential diagnosis or meeting point?].

    PubMed

    Richly, Pablo; Abdulhamid, Pablo; Bustin, Julián

    2012-01-01

    Depressive pseudodementia is a major depressive disorder in which the cognitive deficits secondary to the affective disorder is so significant that clinicians are obliged to consider dementia as a differential diagnosis. The relationship between depression and dementia is complex and intricate. Even after depressive pseudodementia has remitted, certain cognitive deficits may persist and the risk of developing dementia increases. The concept of depressive pseudodementia continues to be useful in clinical practice in spite of its limitations.

  17. [Differential echographic diagnosis of salivary gland tumors].

    PubMed

    Bleier, R; Rochels, R

    1988-05-01

    76 patients with tumorous swellings of the salivary glands were examined by means of standardized A-scan and B-scan sonography. B-scan echography allowed a differentiation between benign and malignant tumours in all cases. Analysis of the various A-scan criteria (internal structure, reflectivity, borders, consistency and sound attenuation) provided a pathognomonic combination of these criteria for each lesion, enabling further histological diagnosis.

  18. [Pylephlebitis in the child: a challenging diagnosis].

    PubMed

    Gatibelza, M-E; Gaudin, J; Mcheik, J; Levard, G

    2010-09-01

    Pylephlebitis or septic thrombophlebitis of the portomesenteric veins is a complication of intra-abdominal infections. The disease is rare in children and the diagnosis is often delayed. The morbidity of pylephlebitis is relatively low, although there is a risk of residual thrombosis. We report on 2 cases of pylephlebitis in a 12-year-old girl and a 13-year-old boy, following undiagnosed appendicitis. In the 1st case, the young girl had been misdiagnosed with Salmonella infection and was given antibiotics; in the 2nd case, the boy had retrocecal appendicitis that was clinically subacute. An accurate diagnosis was finally made in both cases by CT scan. Both children evolved satisfactorily following appendectomy, long-term antibiotics, and anticoagulation. Clinically, the severe sepsis associated with pylephlebitis is at the forefront. Physical examination is often normal and therefore of little help; the knowledge of a preceding abdominal infection leads to further radiological investigations. Biologically, there are pronounced signs of infection. CT is the preferred exam for diagnosing pylephlebitis, as it can also show the underlying cause of the intra-abdominal sepsis or possible complications. Doppler sonography is recommended more for follow-up of the portal vein thrombosis. Treatment of pylephlebitis associated with appendicitis always includes long-term antibiotics. An appendectomy is always performed either at the time of diagnosis or later. The need for anticoagulation therapy in children is controversial. However, most pediatricians recommend its use, beginning as soon as possible, to be continued until normalization of portal vein flow.

  19. Diagnosis and Management of Iridocorneal Endothelial Syndrome.

    PubMed

    Sacchetti, Marta; Mantelli, Flavio; Marenco, Marco; Macchi, Ilaria; Ambrosio, Oriella; Rama, Paolo

    2015-01-01

    The iridocorneal endothelial (ICE) syndrome is a rare ocular disorder that includes a group of conditions characterized by structural and proliferative abnormalities of the corneal endothelium, the anterior chamber angle, and the iris. Common clinical features include corneal edema, secondary glaucoma, iris atrophy, and pupillary anomalies, ranging from distortion to polycoria. The main subtypes of this syndrome are the progressive iris atrophy, the Cogan-Reese syndrome, and the Chandler syndrome. ICE syndrome is usually diagnosed in women in the adult age. Clinical history and complete eye examination including tonometry and gonioscopy are necessary to reach a diagnosis. Imaging techniques, such as in vivo confocal microscopy and ultrasound biomicroscopy, are used to confirm the diagnosis by revealing the presence of "ICE-cells" on the corneal endothelium and the structural changes of the anterior chamber angle. An early diagnosis is helpful to better manage the most challenging complications such as secondary glaucoma and corneal edema. Treatment of ICE-related glaucoma often requires glaucoma filtering surgery with antifibrotic agents and the use of glaucoma drainage implants should be considered early in the management of these patients. Visual impairment and pain associated with corneal edema can be successfully managed with endothelial keratoplasty.

  20. Diagnosis and treatment of plantar fasciitis.

    PubMed

    Goff, James D; Crawford, Robert

    2011-09-15

    Plantar fasciitis, a self-limiting condition, is a common cause of heel pain in adults. It affects more than 1 million persons per year, and two-thirds of patients with plantar fasciitis will seek care from their family physician. Plantar fasciitis affects sedentary and athletic populations. Obesity, excessive foot pronation, excessive running, and prolonged standing are risk factors for developing plantar fasciitis. Diagnosis is primarily based on history and physical examination. Patients may present with heel pain with their first steps in the morning or after prolonged sitting, and sharp pain with palpation of the medial plantar calcaneal region. Discomfort in the proximal plantar fascia can be elicited by passive ankle/first toe dorsiflexion. Diagnostic imaging is rarely needed for the initial diagnosis of plantar fasciitis. Use of ultrasonography and magnetic resonance imaging is reserved for recalcitrant cases or to rule out other heel pathology; findings of increased plantar fascia thickness and abnormal tissue signal the diagnosis of plantar fasciitis. Conservative treatments help with the disabling pain. Initially, patient-directed treatments consisting of rest, activity modification, ice massage, oral analgesics, and stretching techniques can be tried for several weeks. If heel pain persists, then physician-prescribed treatments such as physical therapy modalities, foot orthotics, night splinting, and corticosteroid injections should be considered. Ninety percent of patients will improve with these conservative techniques. Patients with chronic recalcitrant plantar fasciitis lasting six months or longer can consider extracorporeal shock wave therapy or plantar fasciotomy.

  1. Molecular diagnosis of orbital inflammatory disease.

    PubMed

    Rosenbaum, James T; Choi, Dongseok; Wilson, David J; Grossniklaus, Hans E; Sibley, Cailin H; Harrington, Christina A; Planck, Stephen R

    2015-04-01

    Orbital inflammatory diseases include thyroid eye disease (TED), granulomatosis with polyangiitis (GPA), sarcoidosis, and nonspecific orbital inflammation (NSOI). Histopathological diagnosis usually relies on the clinical context and is not always definitive. Gene expression profiling provides diagnostic and therapeutic information in several malignancies, but its role in evaluating nonmalignant disease is relatively untested. We hypothesized that gene expression profiling could provide diagnostic information for NSOI. We collected formalin-fixed, paraffin-embedded orbital biopsies from 10 institutions and 83 subjects including 25 with thyroid eye disease, 25 nonspecific orbital inflammation, 20 healthy controls, 6 with granulomatosis with polyangiitis, and 7 with sarcoidosis. Tissues were divided into discovery and validation sets. Gene expression was quantified using Affymetrix U133 Plus 2.0 microarrays. A random forest statistical algorithm based on data from 39 probe sets identified controls, GPA, or TED with an average accuracy of 76% (p=0.02). Random forest analysis indicated that 52% of tissues from patients with nonspecific inflammation were consistent with a diagnosis of GPA. Molecular diagnosis by gene expression profiling will augment clinical data and histopathology in differentiating forms of orbital inflammatory disease.

  2. Population health diagnosis with an ecohealth approach

    PubMed Central

    Arenas-Monreal, Luz; Cortez-Lugo, Marlene; Parada-Toro, Irene; Pacheco-Magaña, Lilian E; Magaña-Valladares, Laura

    2015-01-01

    OBJECTIVE To analyze the characteristics of health diagnosis according to the ecohealth approach in rural and urban communities in Mexico. METHODS Health diagnosis were conducted in La Nopalera, from December 2007 to October 2008, and in Atlihuayan, from December 2010 to October 2011. The research was based on three principles of the ecohealth approach: transdisciplinarity, community participation, gender and equity. To collect information, a joint methodology and several techniques were used to stimulate the participation of inhabitants. The diagnostic exercise was carried out in five phases that went from collecting information to prioritization of problems. RESULTS The constitution of the transdisciplinary team, as well as the participation of the population and the principle of gender/equity were differentials between the communities. In the rural community, the active participation of inhabitants and authorities was achieved and the principles of transdisciplinarity and gender/equity were incorporated. CONCLUSIONS With all the difficulties that entails the boost in participation, the incorporation of gender/equity and transdisciplinarity in health diagnosis allowed a holistic public health approach closer to the needs of the population. PMID:26538099

  3. Immunohistochemical diagnosis of eastern equine encephalomyelitis.

    PubMed

    Patterson, J S; Maes, R K; Mullaney, T P; Benson, C L

    1996-04-01

    An immunohistochemical (IHC) assay was developed for the detection of eastern equine encephalomyelitis (EEE) virus antigen in formalin-fixed, paraffin-embedded tissues. All cases of EEE diagnosed at the Michigan State University Animal Health Diagnostic Laboratory from 1991 through 1994 were evaluated. The diagnosis was based on histopathologic examination of the brain and confirmatory virus, isolation. Sections of cerebrum from 26 equids and 5 birds were assessed by IHC. Histologically normal brain tissues from 2 horses and 1 pheasant and brain tissues from 2 cases of equine neurologic disease with diagnoses other than EEE served as negative controls. The IHC assay was based on standard streptavidin-biotin technology, using a commercially available kit and a monospecific polyclonal primary antibody preparation derived from murine ascitic fluid. Nineteen of 20 equids and all 5 birds positive by histopathology and virus isolation were positive for EEE virus antigen by IHC. Three equids with histologic lesions compatible with a diagnosis of EEE but negative by virus isolation also were negative for virus antigen by IHC. In 3 other equids, histopathology and IHC were positive for EEE, but virus isolation was not attempted because of contamination of the brain specimen. The IHC assay of formalin-fixed, paraffin-embedded brain tissues for EEE virus antigen is a rapid, effective test for confirming a histopathologic diagnosis of EEE, and assay results correlate well with virus isolation results.

  4. Pneumothorax: from definition to diagnosis and treatment

    PubMed Central

    Kioumis, Ioannis; Pitsiou, Georgia; Porpodis, Konstantinos; Lampaki, Sofia; Papaiwannou, Antonis; Katsikogiannis, Nikolaos; Zaric, Bojan; Branislav, Perin; Secen, Nevena; Dryllis, Georgios; Machairiotis, Nikolaos; Rapti, Aggeliki; Zarogoulidis, Konstantinos

    2014-01-01

    Pneumothorax is an urgent situation that has to be treated immediately upon diagnosis. Pneumothorax is divided to primary and secondary. A primary pneumothorax is considered the one that occurs without an apparent cause and in the absence of significant lung disease. On the other hand secondary pneumothorax occurs in the presence of existing lung pathology. There is the case where an amount of air in the chest increases markedly and a one-way valve is formed leading to a tension pneumothorax. Unless reversed by effective treatment, this situation can progress and cause death. Pneumothorax can be caused by physical trauma to the chest or as a complication of medical or surgical intervention (biopsy). Symptoms typically include chest pain and shortness of breath. Diagnosis of a pneumothorax requires a chest X-ray or computed tomography (CT) scan. Small spontaneous pneumothoraces typically resolve without treatment and require only monitoring. In our current special issue we will present the definition, diagnosis and treatment of pneumothorax from different experts in the field, different countries and present different methods of treatment. PMID:25337391

  5. Diagnosis and distress in Navajo healing.

    PubMed

    Csordas, Thomas J; Storck, Michael J; Strauss, Milton

    2008-08-01

    In contemporary Navajo society, traditional Navajo ceremonies, Native American Church prayer meetings, and Navajo Christian faith healing are all highly sought-after resources in the everyday pursuit of health and well-being. What is the nature of affliction among patients who turn to such forms of religious healing? Are these patients typically afflicted with psychiatric disorder? In this article we discuss 84 Navajo patients who participated in the Navajo Healing Project during a period in which they consulted one of these forms of healing. We present diagnostic results obtained from the Structured Clinical Interview for DSMIV (SCID) administered to these patients. We then present an ethnographically augmented analysis comparing the research diagnosis obtained via the SCID with a clinical diagnosis, with the diagnosis given by religious healers, and with the understanding of their own distress on the part of patients. These analyses demonstrate how a cultural approach contributes to the basic science and clinical understandings of affliction as well as to discussion of the advantages and limitations of DSM categories as descriptors of distress and disorder.

  6. [The diagnosis of hepatitis C virus infection].

    PubMed

    Gervain, Judit

    2014-06-29

    The successful therapy of hepatitis C viral infection requires that the illness is diagnosed before the development of structural changes of the liver. Testing is stepwise consisting of screening, diagnosis, and anti-viral therapy follow-up. For these steps there are different biochemical, serological, histological and molecular biological methods available. For screening, alanine aminotransferase and anti-HCV tests are used. The diagnosis of infection is confirmed using real-time polymerase chain reaction of the viral nucleic acid. Before initiation of the therapy liver biopsy is recommended to determine the level of structural changes in the liver. Alternatively, transient elastography or blood biomarkers may be also used for this purpose. Differential diagnosis should exclude the co-existence of other viral infections and chronic hepatitis due to other origin, with special attention to the presence of autoantibodies. The outcome of the antiviral therapy and the length of treatment are mainly determined by the viral genotype. In Hungary, most patients are infected with genotype 1, subtype b. The polymorphism type that occurs in the single nucleotide located next to the interleukin 28B region in chromosome 19 and the viral polymorphism type Q80K for infection with HCV 1a serve as predictive therapeutic markers. The follow-up of therapy is based on the quantitative determination of viral nucleic acid according to national and international protocols and should use the same method and laboratory throughout the treatment of an individual patient.

  7. Cell metabolism, tumour diagnosis and multispectral FLIM

    NASA Astrophysics Data System (ADS)

    Rück, A.; Hauser, C.; Lorenz, S.; Mosch, S.; Rotte, S.; Kessler, M.; Kalinina, S.

    2013-02-01

    Fluorescence guided diagnosis of tumour tissue is in many cases insufficient, because false positive results are interfering with the outcome. Discrimination between tumour and inflammation could be therefore difficult. Improvement of fluorescence diagnosis through observation of cell metabolism could be the solution, which needs a detailed understanding of the origin of autofluorescence. However, a complex combination of fluorophores give rise to the emission signal. Also in PDD (photodynamic diagnosis) different photosensitizer metabolites contribute to the fluorescence signal. Therefore, the fluorescence decay in many cases does not show a simple monoexponential profile. In those cases a considerable improvement could be achieved when time-resolved and spectral-resolved techniques are simultaneously incorporated. The discussion will focus on the detection of NADH, FAD and 5-ALA induced porphyrins. With respect to NADH and FAD the discrimination between protein bound and free coenzyme was investigated with multispectral FLIM in normal oral keratinocytes and squamous carcinoma cells from different origin. The redox ratio, which can be correlated with the fluorescence lifetimes of NADH and FAD changed depending on the state of the cells. Most of the investigations were done in monolayer cell cultures. However, in order to get information from a more realistic in vivo situation additionally the chorioallantoismembrane (CAM) of fertilized eggs was used where tumour cells or biopsies were allowed to grow. The results of theses measurements will be discussed as well.

  8. [Endocrine diagnosis in puberty--pathophysiologic bases].

    PubMed

    Girard, J

    1994-05-01

    Puberty is characterized by activation of the maturing gonads and by the thus started increased secretion of sexual steroids. Consequences are the appearance of secondary signs of puberty sensu strictori, i. e. the development of breasts in girls, the increase of testicle volume in boys, often followed by growing pubic hair, axillary hair, menarche or laryngeal growth (puberty vocal change) respectively. The most important accompanying symptom is the spurt of growth starting around 12 to 18 months after the onset of the development of the secondary pubertal signs. From the time sequence of the development and the possible delays, valuable diagnostic hints can be gained, giving rise to a more precise analysis of the hormonal phenomena of adolescence. In cases of pubertas tarda a primary malfunction must be differentiated from secondary hypogonadotropic functional defect. The syndromes should be classified correctly according to their etiology. The most frequent diagnosis is that of a simply delayed puberty. Acne, hypertrichosis, hirsutism are concomitant phenomena of puberty development which can indicate a hormonal imbalance (differential diagnosis AGS, ovarian hyperandrogeny). The swelling of breasts in boys (gynecomastia) is a common transitory phenomenon in male adolescence (DD, tumor of the gonads or Klinefelter syndrome). Interesting considerations of differential diagnosis apply also to the assessment of the enlargement of the thyroid gland in puberty, which affects more often girls than boys. PMID:8016754

  9. Oligonucleotide microarrays in constitutional genetic diagnosis.

    PubMed

    Keren, Boris; Le Caignec, Cedric

    2011-06-01

    Oligonucleotide microarrays such as comparative genomic hybridization arrays and SNP microarrays enable the identification of genomic imbalances - also termed copy-number variants - with increasing resolution. This article will focus on the most significant applications of high-throughput oligonucleotide microarrays, both in genetic diagnosis and research. In genetic diagnosis, the method is becoming a standard tool for investigating patients with unexplained developmental delay/intellectual disability, autism spectrum disorders and/or with multiple congenital anomalies. Oligonucleotide microarray have also been recently applied to the detection of genomic imbalances in prenatal diagnosis either to characterize a chromosomal rearrangement that has previously been identified by standard prenatal karyotyping or to detect a cryptic genomic imbalance in a fetus with ultrasound abnormalities and a normal standard prenatal karyotype. In research, oligonucleotide microarrays have been used for a wide range of applications, such as the identification of new genes responsible for monogenic disorders and the association of a copy-number variant as a predisposing factor to a common disease. Despite its widespread use, the interpretation of results is not always straightforward. We will discuss several unexpected results and ethical issues raised by these new methods.

  10. Batten disease: features to facilitate early diagnosis

    PubMed Central

    Collins, J; Holder, G E; Herbert, H; Adams, G G W

    2006-01-01

    Aims To ascertain the clinical and electrophysiological features in patients with juvenile neuronal ceroid lipofuscinosis (jNCL/Batten disease) and to identify those features that facilitate early diagnosis. Methods Nine patients with jNCL were identified retrospectively and their case notes reviewed. All had undergone an extensive clinical examination, including electrophysiology. Blood and molecular genetic testing confirmed the diagnosis. Results Age at onset ranged from 4–8 years. At presentation, two of nine patients had normal fundi; only two of nine patients had a bull's eye maculopathy. The electroretinogram (ERG) findings in this series included undetectable rod specific ERGs, an electronegative maximal response, reduced and delayed cone flicker ERGs, reduction in the b:a ratio in the photopic single flash ERG, and an undetectable pattern ERG. Vacuolated lymphocytes on peripheral blood film testing were present in eight of nine patients. Five of eight patients were homozygous for the 1.02 kb deletion on the CLN3 gene on molecular genetic testing; two of eight patients were heterozygous for that deletion. Conclusion jNCL should be considered in children of 10 years and under presenting with visual loss and fundal changes ranging from normal through to pigmentary/atrophic changes or a bull's eye maculopathy. Electrophysiology may suggest jNCL. Although currently untreatable, early diagnosis is important to institute appropriate counselling and support. PMID:16754648

  11. Clinical and laboratory diagnosis of influenza.

    PubMed

    Rodrigo, Carlos; Méndez, Maria

    2012-01-01

    The clinical diagnosis of influenza can be very difficult or rather easy depending on the circumstances. It's easy when the epidemiological context is appropriate; the patient is a school kid or a teenager, and the symptoms are typical. On the other hand, it is hard when it fails to match any of the above premises, the more imformation that is missing, the more difficult it becomes. The symptomatology is correlated with age; therefore, typical clinical manifestations are only referred from 3-4 y old: rhinitis, fever with or without chills, cough, headache, joint and muscle pain and malaise. The patient often says he/she "feels sick" but his/her general condition is not at all serious. A rapid influenza diagnosis has been shown to reduce unnecessary test and antibiotics in pediatric patients and allows rational use of antivirals, early discharge from emergency departments and hospital wards, appropriate infection control measures and cohorting of infected patients. Tests that yield results in a timely manner that can influence clinical management are recommended to guide patient care. Results of testing should take into account the a priori likelihood of influenza infection based on the patient's signs and symptoms, the sensitivity and specificity of the test used, and information on circulation of influenza in the community. Failing to use the option of microbiological diagnosis when appropriate is a missed opportunity that can generate anxiety without justification, avoid unnecessarily antibiotics, omit antiviral therapy when convenient, and a teaching possibility. PMID:22251993

  12. Advances in the diagnosis of tuberculous pleuritis

    PubMed Central

    2016-01-01

    Pleural tuberculosis (TB) remains difficult to diagnose. In about two-thirds of the cases the diagnosis is reliant upon clinical suspicion along with consistent fluid biochemistries (i.e., lymphocytic predominant exudates) and exclusion of other potential causes for the effusion. Microbiological methods for a confirmatory diagnosis of pleural TB, which include acid-fast smears (Ziehl-Nelseen), cultures on solid media (Lowenstein-Jensen) and polymerase chain reaction tests from either pleural fluid or sputum samples, remain suboptimal since they are positive in only a minority of patients. Liquid media, however, significantly increase sensitivity while shortening culture positivity as compared with solid cultures. A number of pleural fluid biomarkers such as adenosine deaminase (ADA), interferon-Ƴ, interferon-Ƴ-induced protein of 10 KDa (IP-10) and interleukin-27 (IL-27), have shown promise for the rapid diagnosis of TB, but only ADA combines the accuracy and simplicity required to be considered a mainstay investigative tool for clinical decisions, particularly in areas with medium to high TB prevalence. In countries where ADA is not available, pleural biopsies to evaluate for caseating granulomas are a standard diagnostic approach. They are now frequently performed under ultrasound guidance to optimize yield and patient safety. PMID:27570776

  13. Diagnosis and distress in Navajo healing.

    PubMed

    Csordas, Thomas J; Storck, Michael J; Strauss, Milton

    2008-08-01

    In contemporary Navajo society, traditional Navajo ceremonies, Native American Church prayer meetings, and Navajo Christian faith healing are all highly sought-after resources in the everyday pursuit of health and well-being. What is the nature of affliction among patients who turn to such forms of religious healing? Are these patients typically afflicted with psychiatric disorder? In this article we discuss 84 Navajo patients who participated in the Navajo Healing Project during a period in which they consulted one of these forms of healing. We present diagnostic results obtained from the Structured Clinical Interview for DSMIV (SCID) administered to these patients. We then present an ethnographically augmented analysis comparing the research diagnosis obtained via the SCID with a clinical diagnosis, with the diagnosis given by religious healers, and with the understanding of their own distress on the part of patients. These analyses demonstrate how a cultural approach contributes to the basic science and clinical understandings of affliction as well as to discussion of the advantages and limitations of DSM categories as descriptors of distress and disorder. PMID:18974670

  14. Prenatal diagnosis of 45,X/46,XX

    SciTech Connect

    Hsu, L.Y.F.

    1996-03-01

    I read with great interest the paper on {open_quotes}Prenatal Diagnosis of 45,X/46,XX mosaicism and 45,X: Implications for Postnatal Outcome{close_quotes} by Koeberl et al. They reported their experience with 12 prenatally diagnosed cases of 45,X/46,XX mosaicism and made a clinical comparison between those 12 cases and their own 41 postnatally diagnosed cases of 45,X/46,XX mosaicism. As expected, they found an overall milder phenotypic manifestation in the prenatal cases than in the postnatal ones. These authors report a lack of previous prognostic information on this type of prenatally diagnosis of mosaicism and offer their findings to fill this need. However, considerable information on this topic has been published. There have been >200 prenatally diagnosed cases of 45,X/46,XX. According to my data on 189 cases with a prenatal diagnosis of 45,X/46,XX mosaicism (Hsu 1992), there are 114 cases with available information on phenotypic outcome. Of these, 12 (10.5%) were reported to have some features of Turner syndrome, 4 had other anomalies probably not related to Turner syndrome, and 2 resulted in stillbirth. The overall rate for an abnormal phenotype in this category was thus 16/114 (14.03%). However, we must realize that, even in patients with a nonmosaic 45,X complement, the major features of Turner syndrome, such as short stature and sexual infantilism, are manifested only later in childhood or in adolescence. 3 refs.

  15. Subjectivity and intersubjectivity in psychiatric diagnosis.

    PubMed

    Fuchs, Thomas

    2010-01-01

    The establishment of criteriological diagnostic systems since the 1980s has increased the reliability of psychiatric diagnosis. On the other hand, the limits of this approach for clinicians and researchers are becoming increasingly apparent. In particular, the assessment of subjective experience is nearly excluded on the theoretical level and undervalued on the pragmatic level, with detrimental consequences for the validity of psychiatric diagnosis, empirical research and therapeutic purposes. To correct this unfavourable development, three major approaches to the assessment of mental illness should be equally taken into account: (1) the positivistic, objectifying or 3rd-person approach as endorsed by DSM-IV and ICD-10, focusing mainly on observable behavioural symptoms; (2) the phenomenological, subject-oriented or 1st-person approach, focusing on the patient's self-experience and exploring its basic structures, and (3) the hermeneutic, intersubjective or 2nd-person approach, mainly aiming at the co-construction of narratives and interpretations regarding the patient's self-concept, relationships and conflicts. These three approaches will be compared regarding their respective values for psychopathological description, diagnosis, research and therapeutic purposes.

  16. Laboratory Diagnosis of Central Nervous System Infection.

    PubMed

    He, Taojun; Kaplan, Samuel; Kamboj, Mini; Tang, Yi-Wei

    2016-11-01

    Central nervous system (CNS) infections are potentially life threatening if not diagnosed and treated early. The initial clinical presentations of many CNS infections are non-specific, making a definitive etiologic diagnosis challenging. Nucleic acid in vitro amplification-based molecular methods are increasingly being applied for routine microbial detection. These methods are a vast improvement over conventional techniques with the advantage of rapid turnaround and higher sensitivity and specificity. Additionally, molecular methods performed on cerebrospinal fluid samples are considered the new gold standard for diagnosis of CNS infection caused by pathogens, which are otherwise difficult to detect. Commercial diagnostic platforms offer various monoplex and multiplex PCR assays for convenient testing of targets that cause similar clinical illness. Pan-omic molecular platforms possess potential for use in this area. Although molecular methods are predicted to be widely used in diagnosing and monitoring CNS infections, results generated by these methods need to be carefully interpreted in combination with clinical findings. This review summarizes the currently available armamentarium of molecular assays for diagnosis of central nervous system infections, their application, and future approaches. PMID:27686677

  17. Problems with the diagnosis of endometriosis.

    PubMed

    Berker, Bulent; Seval, Murat

    2015-08-01

    Endometriosis is classically defined as the presence of endometrial glands and stroma in outside the uterine cavity. As the definition suggests that confirming the ectopic endometrial stroma and glands in ectopic location histopathologically should be necessary for the diagnosis of endometriosis. Therefore, this situation leads to the need for surgery like laparoscopy for diagnosis. However, this surgical diagnostic approach will not be reliable for all patients with suspected endometriosis. It seems to be an important problem that there is still no reliable clinically diagnostic method or pathognomonic clinical finding, which may allow accurate diagnosis of endometriosis without the need for surgery or histopathologic evaluation. While these clinical features are not pathognomonic for the endometriosis, they should be used as markers for creating high-risk population for endometriosis. Clinical features and the available diagnostic methods, their advantages and limitations for the endometriosis will be discussed in this article. The different options for clinical assessment, laboratory tests and imaging techniques will be summarized and the advantages and disadvantages of these methods will be evaluated. We will also discuss the gold standard definitive diagnostic options with their problematic aspects.

  18. [Financial impact of introducing filmless CRT diagnosis].

    PubMed

    Kusakabe, Yukihiro

    2002-09-01

    There has been a great deal of discussion as to the cost and benefit of introducing filmless CRT diagnosis for radiological exams. Although the various advantages of the filmless system tend to be highlighted, very few studies have attempted to provide a quantitative estimate of the degree of impact. We analyzed the potential financial impact on the cost of film management (film development, maintenance, and transportation) if CRT diagnosis were to be introduced in Seirei Hamamatsu Hospital. In conducting this analysis, we assumed that CRT diagnosis initially would be limited to CT and MR. The analysis demonstrated that the actual yearly cost of managing films amounts to about 240 million yen. As individual items, the cost of film materials, labor, and depreciation of assets were the three largest cost sectors, with the cost of film accounting for more than 30% of the total. The expense attributable to CT and MR exams was roughly half of the total cost. Against this level of expense, the expected savings in the first year after shifting to the filmless system would be 100 million yen, or a 36% reduction in current expenses. This savings reflects various effects of system change, including lack of need for related materials, reduction in staff workload, elimination of unnecessary equipment, etc. Under the simulation we conducted, 70% of savings occurred in the area of variable costs and 30% in the area of fixed costs.

  19. [RARE DISEASES DTC: DIAGNOSIS, TREATMENT AND CARE].

    PubMed

    Mendlovic, Joseph; Barash, Hila; Yardeni, Hadar; Banet-Levi, Yonit; Yonath, Hagith; Raas-Rothschild, Annick

    2016-04-01

    Rare diseases are chronic, progressive genetic disorders, which affect around 6-8% of the general population, mainly children. Therefore, in Israel approximately 500,000 people are probably affected by a rare disease. In this article, we review some of the issues pertaining to rare diseases, such as the need for accurate diagnosis which is necessary not only for specific care and treatment but also for informed family planning. In addition, we review the impact of the activities of patients' organizations on the awareness of rare diseases and their involvement in the creation of the Orphan Drug Act, which was the leading point on the way to drug development worldwide. During the last few years networks for reaching leading specialists' opinions on the way to proper diagnosis were created. Thereafter, the next generation genetic technologies, such as exome sequencing, have been a revolution in terms of options and hope for patients with rare undiagnosed diseases. Patients with rare diseases and their families are a challenge to the health care system, not only in terms of diagnosis and therapy, but also in terms of special needs. In addition, deciphering molecular pathways of rare diseases might be the key for understanding molecular events involved in common disorders. We emphasize the duty to ensure appropriate capacity and equal access to follow-up and clinical management of patients with rare diseases in Israel.

  20. [RARE DISEASES DTC: DIAGNOSIS, TREATMENT AND CARE].

    PubMed

    Mendlovic, Joseph; Barash, Hila; Yardeni, Hadar; Banet-Levi, Yonit; Yonath, Hagith; Raas-Rothschild, Annick

    2016-04-01

    Rare diseases are chronic, progressive genetic disorders, which affect around 6-8% of the general population, mainly children. Therefore, in Israel approximately 500,000 people are probably affected by a rare disease. In this article, we review some of the issues pertaining to rare diseases, such as the need for accurate diagnosis which is necessary not only for specific care and treatment but also for informed family planning. In addition, we review the impact of the activities of patients' organizations on the awareness of rare diseases and their involvement in the creation of the Orphan Drug Act, which was the leading point on the way to drug development worldwide. During the last few years networks for reaching leading specialists' opinions on the way to proper diagnosis were created. Thereafter, the next generation genetic technologies, such as exome sequencing, have been a revolution in terms of options and hope for patients with rare undiagnosed diseases. Patients with rare diseases and their families are a challenge to the health care system, not only in terms of diagnosis and therapy, but also in terms of special needs. In addition, deciphering molecular pathways of rare diseases might be the key for understanding molecular events involved in common disorders. We emphasize the duty to ensure appropriate capacity and equal access to follow-up and clinical management of patients with rare diseases in Israel. PMID:27323543