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Sample records for aid early diagnosis

  1. Eye examination for early diagnosis of disseminated tuberculosis in patients with AIDS.

    PubMed

    Heiden, David; Saranchuk, Peter; Keenan, Jeremy D; Ford, Nathan; Lowinger, Alan; Yen, Michael; McCune, Joseph; Rao, Narsing A

    2016-04-01

    Choroidal tuberculosis is present in 5-20% of patients with disseminated tuberculosis, and point-of-care dilated binocular indirect ophthalmoscopy eye examination can provide immediate diagnosis. In geographical areas of high tuberculosis prevalence and in susceptible patients (CD4 counts less than 200 cells per μL) detection of choroidal granulomas should be accepted as evidence of disseminated tuberculosis. With training and proper support, eye screening can be done by HIV/AIDS clinicians, allowing early tuberculosis treatment. In regions with a high burden of tuberculosis, we recommend that eye screening be a standard part of the initial assessment of susceptible patients, including at a minimum all patients with HIV/AIDS with CD4 less than 100 cells per μL with or without eye symptoms, and with or without suspicion of disseminated tuberculosis.

  2. Eye examination for early diagnosis of disseminated tuberculosis in patients with AIDS.

    PubMed

    Heiden, David; Saranchuk, Peter; Keenan, Jeremy D; Ford, Nathan; Lowinger, Alan; Yen, Michael; McCune, Joseph; Rao, Narsing A

    2016-04-01

    Choroidal tuberculosis is present in 5-20% of patients with disseminated tuberculosis, and point-of-care dilated binocular indirect ophthalmoscopy eye examination can provide immediate diagnosis. In geographical areas of high tuberculosis prevalence and in susceptible patients (CD4 counts less than 200 cells per μL) detection of choroidal granulomas should be accepted as evidence of disseminated tuberculosis. With training and proper support, eye screening can be done by HIV/AIDS clinicians, allowing early tuberculosis treatment. In regions with a high burden of tuberculosis, we recommend that eye screening be a standard part of the initial assessment of susceptible patients, including at a minimum all patients with HIV/AIDS with CD4 less than 100 cells per μL with or without eye symptoms, and with or without suspicion of disseminated tuberculosis. PMID:26907735

  3. 2014 CODEPEH recommendations: Early detection of late onset deafness, audiological diagnosis, hearing aid fitting and early intervention.

    PubMed

    Núñez-Batalla, Faustino; Jáudenes-Casaubón, Carmen; Sequí-Canet, Jose Miguel; Vivanco-Allende, Ana; Zubicaray-Ugarteche, Jose

    2016-01-01

    The latest scientific literature considers early diagnosis of deafness as the key element to define the educational and inclusive prognosis of the deaf child, because it allows taking advantage of the critical period of development (0-4 years). Highly significant differences exist between deaf people who have been stimulated early and those who have received late or improper intervention. Early identification of late-onset disorders requires special attention and knowledge on the part of every childcare professional. Programs and additional actions beyond neonatal screening should be designed and planed to ensure that every child with a significant hearing loss is detected early. For this purpose, the CODEPEH would like to highlight the need for continuous monitoring of children's auditory health. Consequently, CODEPEH has drafted the recommendations included in the present document.

  4. Immunophenotypic characterization of myelopoiesis in early and late myelodysplastic syndromes: use of CD44 as an aid in early diagnosis.

    PubMed

    Karmon, Yuval; Manaster, J; Chezar, J

    2002-08-15

    We investigated the possibility that myeloid cells from the bone marrow (BM) of myelodysplastic patients differ in their expression of CD44 antigen compared with expression of the antigen in normal controls. In addition, two triple-surface marker assays incorporating, respectively, CD44/CD33/CD66 and CD33/CD34/HLA-DR were used to evaluate the degree of myeloid maturation and assess the number of blasts in BM by flow cytometry. Patients with early-stage myelodysplastic syndrome (MDS; RA [FAB classification]) have significantly decreased expression of CD44 on gated myeloid cells. In contrast, patients with late-stage MDS (RAEB and RAEB-T [FAB classification]) showed an elevated expression of CD44 and an increased number of CD34 blasts compared with early-stage MDS patients and normal controls. Late-stage MDS patients also had an increase in the immature myeloid compartment (CD66 weak expression) compared with early-stage MDS patients and normal controls. We have already included this assay as part of our MDS evaluation protocol alongside BM morphology and cytogenetics.

  5. Exogenous ochronosis in a Chinese patient: use of dermoscopy aids early diagnosis and selection of biopsy site

    PubMed Central

    Liu, Wen Chun; Tey, Hong Liang; Lee, Joyce Siong See; Goh, Boon Kee

    2014-01-01

    The diagnosis of exogenous ochronosis is often challenging and requires a high index of suspicion. Herein, we report a case of exogenous ochronosis in a Chinese patient. The condition was caused by the use of bleaching agents, including creams containing hydroquinone. We demonstrate the use of dermoscopy as an invaluable tool for the early recognition of the condition, as well as in the selection of an appropriate site for a skin biopsy. PMID:24452981

  6. 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, ...

  7. Computer-aided diagnosis (CAD) for colonoscopy

    NASA Astrophysics Data System (ADS)

    Gu, Jia; Poirson, Allen

    2007-03-01

    Colorectal cancer is the second leading cause of cancer deaths, and ranks third for new cancer cases and cancer mortality for both men and women. However, its death rate can be dramatically reduced by appropriate treatment when early detection is available. The purpose of colonoscopy is to identify and assess the severity of lesions, which may be flat or protruding. Due to the subjective nature of the examination, colonoscopic proficiency is highly variable and dependent upon the colonoscopist's knowledge and experience. An automated image processing system providing an objective, rapid, and inexpensive analysis of video from a standard colonoscope could provide a valuable tool for screening and diagnosis. In this paper, we present the design, functionality and preliminary results of its Computer-Aided-Diagnosis (CAD) system for colonoscopy - ColonoCAD TM. ColonoCAD is a complex multi-sensor, multi-data and multi-algorithm image processing system, incorporating data management and visualization, video quality assessment and enhancement, calibration, multiple view based reconstruction, feature extraction and classification. As this is a new field in medical image processing, our hope is that this paper will provide the framework to encourage and facilitate collaboration and discussion between industry, academia, and medical practitioners.

  8. 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.

  9. 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

  10. [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

  11. 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.

  12. Computer aided diagnosis of diabetic peripheral neuropathy

    NASA Astrophysics Data System (ADS)

    Chekh, Viktor; Soliz, Peter; McGrew, Elizabeth; Barriga, Simon; Burge, Mark; Luan, Shuang

    2014-03-01

    Diabetic peripheral neuropathy (DPN) refers to the nerve damage that can occur in diabetes patients. It most often affects the extremities, such as the feet, and can lead to peripheral vascular disease, deformity, infection, ulceration, and even amputation. The key to managing diabetic foot is prevention and early detection. Unfortunately, current existing diagnostic techniques are mostly based on patient sensations and exhibit significant inter- and intra-observer differences. We have developed a computer aided diagnostic (CAD) system for diabetic peripheral neuropathy. The thermal response of the feet of diabetic patients following cold stimulus is captured using an infrared camera. The plantar foot in the images from a thermal video are segmented and registered for tracking points or specific regions. The temperature recovery of each point on the plantar foot is extracted using our bio-thermal model and analyzed. The regions that exhibit abnormal ability to recover are automatically identified to aid the physicians to recognize problematic areas. The key to our CAD system is the segmentation of infrared video. The main challenges for segmenting infrared video compared to normal digital video are (1) as the foot warms up, it also warms up the surrounding, creating an ever changing contrast; and (2) there may be significant motion during imaging. To overcome this, a hybrid segmentation algorithm was developed based on a number of techniques such as continuous max-flow, model based segmentation, shape preservation, convex hull, and temperature normalization. Verifications of the automatic segmentation and registration using manual segmentation and markers show good agreement.

  13. Lyme disease diagnosis and treatment: lessons from the AIDS epidemic.

    PubMed

    Stricker, R B; Johnson, L

    2010-12-01

    Lyme disease is a controversial tick-borne illness that is estimated to be four times more common than AIDS in the United States. This paper outlines the challenges overcome in the healthcare response to human immunodeficiency virus (HIV) infection, the development of sensitive laboratory tests for the AIDS virus, and the promotion of long-term combination antimicrobial regimens to effectively treat HIV disease. We suggest that similar challenges need to be overcome before the chronic form of Lyme disease can be successfully treated. Currently, diagnosis and treatment of Lyme disease is hindered by the lack of a uniform case definition that adequately reflects the clinical presentation of the disease, poor laboratory test sensitivity, and high treatment failure rates using short-term monotherapy. Consequently the optimal treatment for patients with persistent symptoms of Lyme disease remains undefined. Although antibiotic monotherapy has been successful in treating early Lyme disease, the use of combination antibiotic therapy modelled on HIV treatment appears to be more effective for patients with persistent symptoms of tick-borne infection. Resolution of the controversy surrounding Lyme disease should lead to improved diagnosis and treatment modelled on the approach to HIV disease.

  14. HIV/AIDS and Early Childhood.

    ERIC Educational Resources Information Center

    Hanssen, Elizabeth, Ed.; Zimanyi, Louise, Ed.

    2002-01-01

    The Consultative Group on Early Childhood Care and Development is increasingly concerned with the lack of attention to children affected by the HIV/AIDS pandemic. This theme issue of "Coordinators' Notebook" examines issues related to ensuring that orphans and vulnerable children under 5 years receive attention in the international, national, and…

  15. 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

  16. 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

  17. Semiautomatic segmentation for the computer aided diagnosis of clustered microcalcifications

    NASA Astrophysics Data System (ADS)

    Elter, Matthias; Held, Christian

    2008-03-01

    Screening mammography is recognized as the most effective tool for early breast cancer detection. However, its application in clinical practice shows some of its weaknesses. While clustered microcalcifications are often an early sign of breast cancer, the discrimination of benign from malignant clusters based on their appearance in mammograms is a very difficult task. Hence, it is not surprising that typically only 15% to 30% of breast biopsies performed on calcifications will be positive for malignancy. As this low positive predictive value of mammography regarding the diagnosis of calcification clusters results in many unnecessary biopsies performed on benign calcifications, we propose a novel computer aided diagnosis (CADx) approach with the goal to improve the reliability of microcalcification classification. As effective automatic classification of microcalcification clusters relies on good segmentations of the individual calcification particles, many approaches to the automatic segmentation of individual particles have been proposed in the past. Because none of the fully automatic approaches seem to result in optimal segmentations, we propose a novel semiautomatic approach that has automatic components but also allows some interaction of the radiologist. Based on the resulting segmentations we extract a broad range of features that characterize the morphology and distribution of calcification particles. Using regions of interest containing either benign or malignant clusters extracted from the digital database for screening mammography we evaluate the performance of our approach using a support vector machine and ROC analysis. The resulting ROC performance is very promising and we show that the performance of our semiautomatic segmentation is significantly higher than that of a comparable fully automatic approach.

  18. A survey on computer aided diagnosis for ocular diseases

    PubMed Central

    2014-01-01

    Background Computer Aided Diagnosis (CAD), which can automate the detection process for ocular diseases, has attracted extensive attention from clinicians and researchers alike. It not only alleviates the burden on the clinicians by providing objective opinion with valuable insights, but also offers early detection and easy access for patients. Method We review ocular CAD methodologies for various data types. For each data type, we investigate the databases and the algorithms to detect different ocular diseases. Their advantages and shortcomings are analyzed and discussed. Result We have studied three types of data (i.e., clinical, genetic and imaging) that have been commonly used in existing methods for CAD. The recent developments in methods used in CAD of ocular diseases (such as Diabetic Retinopathy, Glaucoma, Age-related Macular Degeneration and Pathological Myopia) are investigated and summarized comprehensively. Conclusion While CAD for ocular diseases has shown considerable progress over the past years, the clinical importance of fully automatic CAD systems which are able to embed clinical knowledge and integrate heterogeneous data sources still show great potential for future breakthrough. PMID:25175552

  19. Life Quality Changes after HIV/AIDS Diagnosis: Positive Directions.

    ERIC Educational Resources Information Center

    Soule, Christine J.; Appleton, Valerie

    Diagnosis of HIV/AIDS promotes a fear of the unknown, of death, or annihilation of self, of being, and of identity. Individuals face this threat in unique and holistic ways. This experience of crisis reflects stages of shock, disorganization, reorganization and resolution. Crisis can become a turning point and result in a passage toward successful…

  20. Early diagnosis of oesophageal cancer

    PubMed Central

    Bird-Lieberman, E L; Fitzgerald, R C

    2009-01-01

    Squamous cell carcinoma and adenocarcinoma of the oesophagus are cancers that develop from distinct epithelial sub-types; however, they are both related to chronic inflammation of differing aetiologies. Inflammation leads to somatically inherited genetic mutations altering control of the cell cycle, DNA replication and apoptosis, which together result in autonomous and uncontrolled proliferation. These cancers have often metastasised to lymph nodes and distant organs before symptomatic presentation and therefore carry a poor prognosis. It is therefore vital to diagnose oesophageal cancer at an early stage, before the development of symptoms, when treatment can dramatically improve prognosis. Understanding the pathogenesis of these cancers is vital to guide early diagnostic strategies. PMID:19513070

  1. GPS-Aided Tsunami Early Detection System

    NASA Astrophysics Data System (ADS)

    Song, Y. T.; Bar-Sever, Y. E.; Liu, Z.; Khachikyan, R.

    2015-12-01

    Most tsunami fatalities occur in near-field communities of earthquakes at offshore faults. Tsunami early warning is key for reducing the number of fatalities. Unfortunately, an earthquake's magnitude often does not gauge the resulting tsunami power. Here we show that real-time GPS stations along coastlines are able to detect seafloor motions due to big earthquakes, and that the detected seafloor displacements are able to determine tsunami energy and scales instantaneously for early warnings. Our method focuses on estimating tsunami energy directly from seafloor motions because a tsunami's potential or scale, no matter how it is defined, has to be proportional to the tsunami energy. Since seafloor motions are the only source of a tsunami, their estimation directly relates to the mechanism that generates tsunamis; therefore, it is a proper way of identifying earthquakes that are capable of triggering tsunamis, while being able to discriminate those particular earthquakes from false alarms. Examples of detecting the tsunami energy scales for the 2004 Sumatra M9.1 earthquake, the 2005 Nias M8.7 earthquake, the 2010 M8.8 Chilean earthquake, and the 2011 M9.0 Tohoku-Oki earthquake will be presented. The development of the Indo-Pacific GPS-Aided Tsunami Early Detection (GATED) system will be reported.

  2. [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

  3. [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

  4. PACS-Based Computer-Aided Detection and Diagnosis

    NASA Astrophysics Data System (ADS)

    Huang, H. K. (Bernie); Liu, Brent J.; Le, Anh HongTu; Documet, Jorge

    The ultimate goal of Picture Archiving and Communication System (PACS)-based Computer-Aided Detection and Diagnosis (CAD) is to integrate CAD results into daily clinical practice so that it becomes a second reader to aid the radiologist's diagnosis. Integration of CAD and Hospital Information System (HIS), Radiology Information System (RIS) or PACS requires certain basic ingredients from Health Level 7 (HL7) standard for textual data, Digital Imaging and Communications in Medicine (DICOM) standard for images, and Integrating the Healthcare Enterprise (IHE) workflow profiles in order to comply with the Health Insurance Portability and Accountability Act (HIPAA) requirements to be a healthcare information system. Among the DICOM standards and IHE workflow profiles, DICOM Structured Reporting (DICOM-SR); and IHE Key Image Note (KIN), Simple Image and Numeric Report (SINR) and Post-processing Work Flow (PWF) are utilized in CAD-HIS/RIS/PACS integration. These topics with examples are presented in this chapter.

  5. Computer-aided diagnosis of Alzheimer's disease using support vector machines and classification trees

    NASA Astrophysics Data System (ADS)

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

    2010-05-01

    This paper presents a computer-aided diagnosis technique for improving the accuracy of early diagnosis of Alzheimer-type dementia. The proposed methodology is based on the selection of voxels which present Welch's t-test between both classes, normal and Alzheimer images, greater than a given threshold. The mean and standard deviation of intensity values are calculated for selected voxels. They are chosen as feature vectors for two different classifiers: support vector machines with linear kernel and classification trees. The proposed methodology reaches greater than 95% accuracy in the classification task.

  6. 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.

  7. 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.

  8. 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.

  9. Radiology as an aid to diagnosis in lung disease.

    PubMed

    Ellis, Stephen; Aziz, Zelena

    2016-10-01

    A great deal has changed in the imaging of chest diseases over the last 90 years. The plain chest radiograph has gone through numerous improvements and continues to be the front-line investigative technique with the mainstream adoption of digital imaging opening the doors to more advances in imaging efficacy and computer-aided diagnostics. The main change is in the advent and dramatic advances in CT, in some instances superseding the chest X-ray (CXR) as the first-line imaging investigation, not entirely to the authors' liking, and providing in vivo morphological data to aid a more specific diagnosis. However, in our view, there is a danger that the improvement in diagnostic imaging is starting to undermine clinical diagnostic acumen and that there is an increasing reliance on imaging that in the long run may not be advantageous to patient management. PMID:27535941

  10. A decision aid for diagnosis of liver lesions on MRI.

    PubMed Central

    Tombropoulos, R.; Shiffman, S.; Davidson, C.

    1993-01-01

    Abdominal magnetic resonance imaging (MRI) plays an important role in the evaluation of liver abnormalities. The interpretation of MR images requires expert training in a rapidly changing field. DAFODILL (Decision Aid for Diagnosing Liver Lesions) is a decision-support tool designed to aid radiologists in the diagnosis of hepatic lesions seen on MRI. DAFODILL uses a knowledge base of MRI findings and a belief-network inference engine to generate probabilistic differential diagnoses of the most commonly encountered hepatic lesions. DAFODILL performs limited image processing to identify clinically relevant features, which are presented to the user for confirmation before they are used by the network. Preliminary evaluation of an initial version of the system suggests that DAFODILL may be a useful tool for radiology residents and nonexpert radiologists in interpreting MR images of the liver. PMID:8130512

  11. Early Childhood Teachers' Behavior Intention to Apply Teaching Aids

    ERIC Educational Resources Information Center

    Kuo, Chuen-Tzay

    2010-01-01

    This research aimed to investigate the behavior intention of early childhood teachers to apply teaching aids. The survey method was used to collect data from 281 early childhood teachers currently working at early childhood education institutes. The data was analyzed by t-test, Chi-square analysis, and Pearson coefficient to examine the…

  12. Early Diagnosis and Early Intervention in Cerebral Palsy

    PubMed Central

    Hadders-Algra, Mijna

    2014-01-01

    This paper reviews the opportunities and challenges for early diagnosis and early intervention in cerebral palsy (CP). CP describes a group of disorders of the development of movement and posture, causing activity limitation that is attributed to disturbances that occurred in the fetal or infant brain. Therefore, the paper starts with a summary of relevant information from developmental neuroscience. Most lesions underlying CP occur in the second half of gestation, when developmental activity in the brain reaches its summit. Variations in timing of the damage not only result in different lesions but also in different neuroplastic reactions and different associated neuropathologies. This turns CP into a heterogeneous entity. This may mean that the best early diagnostics and the best intervention methods may differ for various subgroups of children with CP. Next, the paper addresses possibilities for early diagnosis. It discusses the predictive value of neuromotor and neurological exams, neuroimaging techniques, and neurophysiological assessments. Prediction is best when complementary techniques are used in longitudinal series. Possibilities for early prediction of CP differ for infants admitted to neonatal intensive care and other infants. In the former group, best prediction is achieved with the combination of neuroimaging and the assessment of general movements, in the latter group, best prediction is based on carefully documented milestones and neurological assessment. The last part reviews early intervention in infants developing CP. Most knowledge on early intervention is based on studies in high-risk infants without CP. In these infants, early intervention programs promote cognitive development until preschool age; motor development profits less. The few studies on early intervention in infants developing CP suggest that programs that stimulate all aspects of infant development by means of family coaching are most promising. More research is urgently needed

  13. Computer-aided diagnosis of lumbar stenosis conditions

    NASA Astrophysics Data System (ADS)

    Koompairojn, Soontharee; Hua, Kathleen; Hua, Kien A.; Srisomboon, Jintavaree

    2010-03-01

    Computer-aided diagnosis (CAD) systems are indispensable tools for patients' healthcare in modern medicine. Nevertheless, the only fully automatic CAD system available for lumbar stenosis today is for X-ray images. Its performance is limited due to the limitations intrinsic to X-ray images. In this paper, we present a system for magnetic resonance images. It employs a machine learning classification technique to automatically recognize lumbar spine components. Features can then be extracted from these spinal components. Finally, diagnosis is done by applying a Multilayer Perceptron. This classification framework can learn the features of different spinal conditions from the training images. The trained Perceptron can then be applied to diagnose new cases for various spinal conditions. Our experimental studies based on 62 subjects indicate that the proposed system is reliable and significantly better than our older system for X-ray images.

  14. Computer-aided diagnosis in lung nodule assessment.

    PubMed

    Goldin, Jonathan G; Brown, Matthew S; Petkovska, Iva

    2008-05-01

    Computed tomography (CT) imaging is playing an increasingly important role in cancer detection, diagnosis, and lesion characterization, and it is the most sensitive test for lung nodule detection. Interpretation of lung nodules involves characterization and integration of clinical and other imaging information. Advances in lung nodule management using CT require optimization of CT data acquisition, postprocessing tools, and computer-aided diagnosis (CAD). The goal of CAD systems being developed is to both assist radiologists in the more sensitive detection of nodules and noninvasively differentiate benign from malignant lesions; the latter is important given that malignant lesions account for between 1% and 11% of pulmonary nodules. The aim of this review is to summarize the current state of the art regarding CAD techniques for the detection and characterization of solitary pulmonary nodules and their potential applications in the clinical workup of these lesions.

  15. [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

  16. 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

  17. DELM image processing for skin-melanoma early diagnosis

    NASA Astrophysics Data System (ADS)

    Fiorini, Rodolfo A.; Crivellini, M.; Codagnone, G.; Dacquino, G. F.; Libertini, M.; Morresi, A.

    1997-10-01

    Among the various skin diseases skin tumors are the most serious ones and skin Melanoma is particularly dangerous. Its malignant evolution lasts about 5 or 6 years and ends with the death of the patient. Early diagnosis is a powerful means of preventing this evolution allowing sudden intervention, which increases probability or recover and survival. Aim of the paper is to present the result of an active support system for early diagnosis of melanoma and related skin diseases. The system is based upon a digital acquisition camera with a dedicated illumination system digitally controlled in order to achieve best performance in color and feature discrimination reaching best signal to noise ratio especially in blue band. A polarization framework allows for reflected ray rejection maximization. A new classification approach is presented. It allows for a quantification of morphological patterns and standard parameters in order to implement a computer aided dermatological system. The image information extraction is based on minimal descriptor set of parameters in order to classify chromatic texture and morphological features. The results obtained allow for determination of standard reference grids for pathological cases and reliable and objective classification procedure. We adopt, as reference, the approach used by Stanganelli and Kenet. Through a bioengineering analysis we can organize reference grids that offer the possibility to extract the maximum information content from dermatological data. The classification takes into account the spread and intrinsic descriptors and correspond to the best operative description. Therefore these grids are the more suitable tools for applications which requires active support system for diagnosis. In fact it is possible to obtain quantitative evaluations too. We propose a method based on geometrical synthetical descriptors. All that permits a reliable early diagnosis of melanotic disease and to follow its evolution in time. The

  18. [Predementia Alzheimer's disease. Benefits of early diagnosis].

    PubMed

    Viloria, Aurora

    2011-10-01

    Given population aging and the rise in the number of persons with Alzheimer's disease, measures that aim not only to delay but also to prevent the development of this disease are increasingly required. Advances in the diagnosis of Alzheimer's disease support the need for a review of current clinical standards for mild cognitive impairment and provide new goals in the early treatment of this disease. The current diagnostic process should be refocussed toward the pathological substrate of this disease rather than symptoms in order to initiate therapeutic measures as soon as possible without waiting for clinical manifestations to appear. Such an approach is essential in patients with greater cognitive reserve, in whom the lesions are usually more severe at diagnosis and treatment is less effective. To identify disease-modifying therapies to delay the onset of the clinical symptoms of Alzheimer's disease in cognitively intact persons at high risk, biomarkers for this disease must be validated. A single biomarker is unlikely to provide the required diagnostic accuracy and therefore a multimodal approach, incorporating biochemical, neuropathological and anatomical and metabolic neuroimaging methods, should be employed. To optimize the results of drugs under investigation, a combination of biomarkers should be used to select appropriate participants in the earliest phases of the disease, and disease progression should be followed-up. Early diagnosis might clarify essential questions in the care of patients with Alzheimer's disease, such as the possibility of distinguishing among various subtypes, thus encouraging the development of optimal treatments for each. The ultimate goal is to develop disease-modifying treatments that could be initiated early, while patients are asymptomatic or only minimally symptomatic, to maintain their quality of life.

  19. Early diagnosis of Usher syndrome in children.

    PubMed Central

    Mets, M B; Young, N M; Pass, A; Lasky, J B

    2000-01-01

    PURPOSE: To screen severe to profound, preverbal hearing-impaired children for Usher syndrome by ophthalmologic examinations, including electroretinographic testing. These patients are especially good candidates for early cochlear implants, which will improve listening and spoken language skills. METHODS: Consecutive patients over 2 years of age, given a diagnosis of severe to profound, preverbal hearing loss, were screened for Usher syndrome by a complete ophthalmologic examination including an electroretinogram. RESULTS: Five of 48 patients screened (10.4%) were diagnosed with Usher syndrome and received cochlear implants. CONCLUSION: All children with severe to profound, preverbal sensorineural hearing loss should be screened for Usher syndrome by ophthalmologic examination including electroretinogram. PMID:11190026

  20. A handheld computer-aided diagnosis system and simulated analysis

    NASA Astrophysics Data System (ADS)

    Su, Mingjian; Zhang, Xuejun; Liu, Brent; Su, Kening; Louie, Ryan

    2016-03-01

    This paper describes a Computer Aided Diagnosis (CAD) system based on cellphone and distributed cluster. One of the bottlenecks in building a CAD system for clinical practice is the storage and process of mass pathology samples freely among different devices, and normal pattern matching algorithm on large scale image set is very time consuming. Distributed computation on cluster has demonstrated the ability to relieve this bottleneck. We develop a system enabling the user to compare the mass image to a dataset with feature table by sending datasets to Generic Data Handler Module in Hadoop, where the pattern recognition is undertaken for the detection of skin diseases. A single and combination retrieval algorithm to data pipeline base on Map Reduce framework is used in our system in order to make optimal choice between recognition accuracy and system cost. The profile of lesion area is drawn by doctors manually on the screen, and then uploads this pattern to the server. In our evaluation experiment, an accuracy of 75% diagnosis hit rate is obtained by testing 100 patients with skin illness. Our system has the potential help in building a novel medical image dataset by collecting large amounts of gold standard during medical diagnosis. Once the project is online, the participants are free to join and eventually an abundant sample dataset will soon be gathered enough for learning. These results demonstrate our technology is very promising and expected to be used in clinical practice.

  1. Computer aided lung cancer diagnosis with deep learning algorithms

    NASA Astrophysics Data System (ADS)

    Sun, Wenqing; Zheng, Bin; Qian, Wei

    2016-03-01

    Deep learning is considered as a popular and powerful method in pattern recognition and classification. However, there are not many deep structured applications used in medical imaging diagnosis area, because large dataset is not always available for medical images. In this study we tested the feasibility of using deep learning algorithms for lung cancer diagnosis with the cases from Lung Image Database Consortium (LIDC) database. The nodules on each computed tomography (CT) slice were segmented according to marks provided by the radiologists. After down sampling and rotating we acquired 174412 samples with 52 by 52 pixel each and the corresponding truth files. Three deep learning algorithms were designed and implemented, including Convolutional Neural Network (CNN), Deep Belief Networks (DBNs), Stacked Denoising Autoencoder (SDAE). To compare the performance of deep learning algorithms with traditional computer aided diagnosis (CADx) system, we designed a scheme with 28 image features and support vector machine. The accuracies of CNN, DBNs, and SDAE are 0.7976, 0.8119, and 0.7929, respectively; the accuracy of our designed traditional CADx is 0.7940, which is slightly lower than CNN and DBNs. We also noticed that the mislabeled nodules using DBNs are 4% larger than using traditional CADx, this might be resulting from down sampling process lost some size information of the nodules.

  2. Rapid diagnosis of cytomegalovirus in Thai pediatric AIDS patients.

    PubMed

    Tantivanich, Surang; Sawatmongkonkun, Wandee; Balachandra, Kruavan; Chotpitayasunondh, Tawee; Amarapal, Pomsawan

    2002-06-01

    Blood samples were collected from 100 pediatric AIDS patients for the detection of CMV in pp65-bearing leukocytes (PBLs) by immunoperoxidase staining (IP) and PCR. IgM antibody assay was performed to determine the correlation of antigen and antibody. IP and PCR can be used as methods for the early detection of CMV (prior to the presence of IgM antibody). The sensitivity and specificity of IP were 73% and 97% respectively. IP is superior to PCR in several ways: it is very easy to perform, less time consuming, less expensive, and does not require expensive instruments.

  3. [The importance of early diagnosis in acromegaly].

    PubMed

    Valkusz, Zsuzsanna; Tóth, Miklós; Boda, Judit; Nagy, Endre; Julesz, János

    2011-05-01

    The authors review the historical and epidemiological aspects, clinical features and complications of acromegaly while emphasizing the importance of the early diagnosis and treatment. Acromegaly is a rare and mostly sporadic disorder due to excessive production of growth hormone. It is characterized by progressive somatic disfigurement (mainly involving the face and extremities) and systemic manifestations. The prevalence is estimated between 40 and 125 cases/million. Generally, it is diagnosed in middle-aged adults (mean age 40 years, men and women equally affected). Due to its insidious onset and slow progression, acromegaly is often diagnosed 7 to more than 10 years after its onset. The disease has cardiovascular, rheumatological, respiratory and metabolic consequences which highly determine its prognosis. Acromegaly is associated with a number of complications resulting in a two- or four-fold increase of mortality and a decrease of life expectancy by about 10 years. The major causes of death include cardiovascular and cerebrovascular events, respiratory diseases and malignancies. The duration of the disease before the introduction of effective therapy may be a major predictor of increased mortality mainly due to complications . The early diagnosis is important for timely commencement of treatment and for prevention of serious complications of the disease. PMID:21498157

  4. [The importance of early diagnosis in acromegaly].

    PubMed

    Valkusz, Zsuzsanna; Tóth, Miklós; Boda, Judit; Nagy, Endre; Julesz, János

    2011-05-01

    The authors review the historical and epidemiological aspects, clinical features and complications of acromegaly while emphasizing the importance of the early diagnosis and treatment. Acromegaly is a rare and mostly sporadic disorder due to excessive production of growth hormone. It is characterized by progressive somatic disfigurement (mainly involving the face and extremities) and systemic manifestations. The prevalence is estimated between 40 and 125 cases/million. Generally, it is diagnosed in middle-aged adults (mean age 40 years, men and women equally affected). Due to its insidious onset and slow progression, acromegaly is often diagnosed 7 to more than 10 years after its onset. The disease has cardiovascular, rheumatological, respiratory and metabolic consequences which highly determine its prognosis. Acromegaly is associated with a number of complications resulting in a two- or four-fold increase of mortality and a decrease of life expectancy by about 10 years. The major causes of death include cardiovascular and cerebrovascular events, respiratory diseases and malignancies. The duration of the disease before the introduction of effective therapy may be a major predictor of increased mortality mainly due to complications . The early diagnosis is important for timely commencement of treatment and for prevention of serious complications of the disease.

  5. Computer-aided diagnosis of alcoholism-related EEG signals.

    PubMed

    Acharya, U Rajendra; S, Vidya; Bhat, Shreya; Adeli, Hojjat; Adeli, Amir

    2014-12-01

    Alcoholism is a severe disorder that affects the functionality of neurons in the central nervous system (CNS) and alters the behavior of the affected person. Electroencephalogram (EEG) signals can be used as a diagnostic tool in the evaluation of subjects with alcoholism. The neurophysiological interpretation of EEG signals in persons with alcoholism (PWA) is based on observation and interpretation of the frequency and power in their EEGs compared to EEG signals from persons without alcoholism. This paper presents a review of the known features of EEGs obtained from PWA and proposes that the impact of alcoholism on the brain can be determined by computer-aided analysis of EEGs through extracting the minute variations in the EEG signals that can differentiate the EEGs of PWA from those of nonaffected persons. The authors advance the idea of automated computer-aided diagnosis (CAD) of alcoholism by employing the EEG signals. This is achieved through judicious combination of signal processing techniques such as wavelet, nonlinear dynamics, and chaos theory and pattern recognition and classification techniques. A CAD system is cost-effective and efficient and can be used as a decision support system by physicians in the diagnosis and treatment of alcoholism especially those who do not specialize in alcoholism or neurophysiology. It can also be of great value to rehabilitation centers to assess PWA over time and to monitor the impact of treatment aimed at minimizing or reversing the effects of the disease on the brain. A CAD system can be used to determine the extent of alcoholism-related changes in EEG signals (low, medium, high) and the effectiveness of therapeutic plans.

  6. Early diagnosis of post-varicella necrotising fasciitis: A medical and surgical emergency

    PubMed Central

    Xavier, Rose; Abraham, Bobby; Cherian, Vinod Jacob; Joseph, Jobin I.

    2016-01-01

    Necrotising fasciitis (NF) is an extremely rare complication of a rather common paediatric viral exanthem varicella. Delayed diagnosis and treatment can lead to significant morbidity and mortality. Laboratory risk indicator of NF score aids in early clinical diagnosis in suspected cases of post-varicella NF thus enabling timely intervention. Surgery delayed for more than 24 hours, is an independent risk factor for death. Surgical debridement with good antibiotic coverage is the definitive treatment for NF. PMID:27251524

  7. Prolonged fear of AIDS as an early symptom of schizophrenia.

    PubMed

    Spivak, B; Mester, R; Babur, I; Mark, M; Bleich, A; Weizman, A

    1990-01-01

    A modern complaint--fear of AIDS--is making its way into the world of psychopathology and is becoming a symptom of a wide range of psychiatric disorders, including severe ones. We present a case of a young man who developed a pathological bizarre preoccupation of having AIDS and underwent various unnecessary medical procedures, until finally he was diagnosed as suffering from a paranoid schizophrenic disorder. With the high media profile that AIDS has achieved in recent years, it is expected that AIDS has become the object of psychopathological processes. However, the length of time elapsed between the onset of symptoms and the appropriate psychiatric diagnosis, despite being examined by other medical professionals, is surprising. The discussion focuses on the diagnostic questions and on issues related to primary and secondary psychiatric prevention. PMID:2277826

  8. Predictable Locations Aid Early Object Name Learning

    ERIC Educational Resources Information Center

    Benitez, Viridiana L.; Smith, Linda B.

    2012-01-01

    Expectancy-based localized attention has been shown to promote the formation and retrieval of multisensory memories in adults. Three experiments show that these processes also characterize attention and learning in 16- to 18-month old infants and, moreover, that these processes may play a critical role in supporting early object name learning. The…

  9. Computer-aided diagnosis workstation and network system for chest diagnosis based on multislice CT images

    NASA Astrophysics Data System (ADS)

    Satoh, Hitoshi; Niki, Noboru; Eguchi, Kenji; Moriyama, Noriyuki; Ohmatsu, Hironobu; Masuda, Hideo; Machida, Suguru

    2008-03-01

    Mass screening based on multi-helical CT images requires a considerable number of images to be read. It is this time-consuming step that makes the use of helical CT for mass screening impractical at present. To overcome this problem, we have provided diagnostic assistance methods to medical screening specialists by developing a lung cancer screening algorithm that automatically detects suspected lung cancers in helical CT images, a coronary artery calcification screening algorithm that automatically detects suspected coronary artery calcification and a vertebra body analysis algorithm for quantitative evaluation of osteoporosis likelihood by using helical CT scanner for the lung cancer mass screening. The function to observe suspicious shadow in detail are provided in computer-aided diagnosis workstation with these screening algorithms. We also have developed the telemedicine network by using Web medical image conference system with the security improvement of images transmission, Biometric fingerprint authentication system and Biometric face authentication system. Biometric face authentication used on site of telemedicine makes "Encryption of file" and Success in login" effective. As a result, patients' private information is protected. Based on these diagnostic assistance methods, we have developed a new computer-aided workstation and a new telemedicine network that can display suspected lesions three-dimensionally in a short time. The results of this study indicate that our radiological information system without film by using computer-aided diagnosis workstation and our telemedicine network system can increase diagnostic speed, diagnostic accuracy and security improvement of medical information.

  10. [A method for early diagnosis of cholelithiasis].

    PubMed

    Danylenko, M V; Chugunov, A M; Brasiuk, D L

    1993-01-01

    A method for early diagnosis of cholelithiasis on a basis of the hemagglutination inhibition reaction has been suggested. A method is realized in interaction of a specific agglutinogen obtained from lithogenic bile with the human blood serum and erythrocytes of white mongrel rats. It was established that agglutinogen is a protein with a low molecular mass of 55,000-75,000. A specificity of the method is 74-100%. The method is simple in technical performance, needs no special equipment and training of personnel. High productivity (150-200 analyses can be performed by one investigator per one shift) as compared to ultrasound investigation makes it capable to compete in mass screenings. PMID:8046861

  11. Cavernous sinus syndrome: need for early diagnosis.

    PubMed

    Toro, Jaime; Burbano, Lisseth Estefania; Reyes, Saúl; Barreras, Paula

    2015-01-01

    Cavernous sinus syndrome (CSS) is a rare condition characterised by ophthalmoplegia, proptosis, ocular and conjunctival congestion, trigeminal sensory loss and Horner's syndrome. These signs and symptoms result from the involvement of the cranial nerves passing through the cavernous sinus. We report the case of a 53-year-old man with a history of daily stabbing headache associated with dizziness, progressive blurred vision, right ocular pain, ptosis and ophthalmoplegia. After working up the patient, a meningioma was identified as the cause of the CSS. Despite advances in neuroimaging techniques, in some cases, the aetiology of CSS remains difficult to determine. We highlight the clinical and radiological features of a meningioma, one of the causes of CSS. Early diagnosis and treatment of CSS play a key role in a better prognosis. PMID:25819816

  12. Early diagnosis to enable early treatment of pre-osteoarthritis

    PubMed Central

    2012-01-01

    Osteoarthritis is a prevalent and disabling disease affecting an increasingly large swathe of the world population. While clinical osteoarthritis is a late-stage condition for which disease-modifying opportunities are limited, osteoarthritis typically develops over decades, offering a long window of time to potentially alter its course. The etiology of osteoarthritis is multifactorial, showing strong associations with highly modifiable risk factors of mechanical overload, obesity and joint injury. As such, characterization of pre-osteoarthritic disease states will be critical to support a paradigm shift from palliation of late disease towards prevention, through early diagnosis and early treatment of joint injury and degeneration to reduce osteoarthritis risk. Joint trauma accelerates development of osteoarthritis from a known point in time. Human joint injury cohorts therefore provide a unique opportunity for evaluation of pre-osteoarthritic conditions and potential interventions from the earliest stages of degeneration. This review focuses on recent advances in imaging and biochemical biomarkers suitable for characterization of the pre-osteoarthritic joint as well as implications for development of effective early treatment strategies. PMID:22682469

  13. The endoscopic diagnosis of early gastric cancer

    PubMed Central

    Yao, Kenshi

    2013-01-01

    The aim of this article is to demonstrate the basic principles for the endoscopic diagnosis of early gastric cancer. The diagnostic process can be divided into two steps, detection and characterization. Detection requires good endoscopic technique, and thorough knowledge. With regard to technique, we should administer the optimum preparation to patients, including an antiperistaltic agent. Furthermore, in order to map the entire stomach we need to follow a standardized protocol, and we propose a systematic screening protocol for the stomach. With regard to knowledge, we should be able to identify high-risk background mucosa, and we should be aware of the indicators of a suspicious lesion. Chromoendoscopy and magnifying endoscopy are promising image-enhanced endoscopic techniques for characterization. The proposed criteria for a cancerous lesion are as follows: conventional endoscopic findings of 1) a well-demarcated lesion and 2) irregularity in color/surface pattern; vessel plus surface classification using magnifying endoscopy with narrow-band imaging findings of 1) irregular microvascular pattern with a demarcation line or 2) irregular microsurface pattern with a demarcation line. Conventional endoscopy and subsequent image-enhanced endoscopy can both contribute to the detection of early gastric cancer. PMID:24714327

  14. Application of infrared thermography in computer aided diagnosis

    NASA Astrophysics Data System (ADS)

    Faust, Oliver; Rajendra Acharya, U.; Ng, E. Y. K.; Hong, Tan Jen; Yu, Wenwei

    2014-09-01

    The invention of thermography, in the 1950s, posed a formidable problem to the research community: What is the relationship between disease and heat radiation captured with Infrared (IR) cameras? The research community responded with a continuous effort to find this crucial relationship. This effort was aided by advances in processing techniques, improved sensitivity and spatial resolution of thermal sensors. However, despite this progress fundamental issues with this imaging modality still remain. The main problem is that the link between disease and heat radiation is complex and in many cases even non-linear. Furthermore, the change in heat radiation as well as the change in radiation pattern, which indicate disease, is minute. On a technical level, this poses high requirements on image capturing and processing. On a more abstract level, these problems lead to inter-observer variability and on an even more abstract level they lead to a lack of trust in this imaging modality. In this review, we adopt the position that these problems can only be solved through a strict application of scientific principles and objective performance assessment. Computing machinery is inherently objective; this helps us to apply scientific principles in a transparent way and to assess the performance results. As a consequence, we aim to promote thermography based Computer-Aided Diagnosis (CAD) systems. Another benefit of CAD systems comes from the fact that the diagnostic accuracy is linked to the capability of the computing machinery and, in general, computers become ever more potent. We predict that a pervasive application of computers and networking technology in medicine will help us to overcome the shortcomings of any single imaging modality and this will pave the way for integrated health care systems which maximize the quality of patient care.

  15. Computer aided diagnosis of osteoporosis using multi-slice CT images

    NASA Astrophysics Data System (ADS)

    Takahashi, Eiji; Saita, Shinsuke; Kawata, Yoshiki; Niki, Noboru; Ito, Masako; Nishitani, Hiromu; Moriyama, Noriyuki

    2010-03-01

    The patients of osteoporosis comprised about 11 million people in Japan and it is one of the problems the aging society has. In order to prevent the osteoporosis, it is necessary to do early detection and treatment. The development of Multislice CT technology made it possible to perform the three dimensional (3-D) image analysis with higher body axis resolution and shorter scan time. The 3-D image analysis using multi-slice CT images of thoracic vertebra can be used as a support to diagnose osteoporosis and at the same time can be used for lung cancer screening which may lead to its early detection. We develop an automatic extraction algorithm of vertebra, and the analysis algorithm of the vertebral body using shape analysis and a bone density measurement for the computer aided diagnosis of osteoporosis.

  16. Improved mammographic interpretation of masses using computer-aided diagnosis.

    PubMed

    Leichter, I; Fields, S; Nirel, R; Bamberger, P; Novak, B; Lederman, R; Buchbinder, S

    2000-01-01

    The aim of this study was to evaluate the effectiveness of computerized image enhancement, to investigate criteria for discriminating benign from malignant mammographic findings by computer-aided diagnosis (CAD), and to test the role of quantitative analysis in improving the accuracy of interpretation of mass lesions. Forty sequential mammographically detected mass lesions referred for biopsy were digitized at high resolution for computerized evaluation. A prototype CAD system which included image enhancement algorithms was used for a better visualization of the lesions. Quantitative features which characterize the spiculation were automatically extracted by the CAD system for a user-defined region of interest (ROI). Reference ranges for malignant and benign cases were acquired from data generated by 214 known retrospective cases. The extracted parameters together with the reference ranges were presented to the radiologist for the analysis of 40 prospective cases. A pattern recognition scheme based on discriminant analysis was trained on the 214 retrospective cases, and applied to the prospective cases. Accuracy of interpretation with and without the CAD system, as well as the performance of the pattern recognition scheme, were analyzed using receiver operating characteristics (ROC) curves. A significant difference (p < 0.005) was found between features extracted by the CAD system for benign and malignant cases. Specificity of the CAD-assisted diagnosis improved significantly (p < 0.02) from 14 % for the conventional assessment to 50 %, and the positive predictive value increased from 0.47 to 0.62 (p < 0.04). The area under the ROC curve (A(z)) increased significantly (p < 0. 001) from 0.66 for the conventional assessment to 0.81 for the CAD-assisted analysis. The A(z) for the results of the pattern recognition scheme was higher (0.95). The results indicate that there is an improved accuracy of diagnosis with the use of the mammographic CAD system above that of the

  17. Development and assessment of a clinically viable system for breast ultrasound computer-aided diagnosis

    NASA Astrophysics Data System (ADS)

    Gruszauskas, Nicholas Peter

    The chances of surviving a breast cancer diagnosis as well as the effectiveness of any potential treatments increase significantly with early detection of the disease. As such, a considerable amount of research is being conducted to augment the breast cancer detection and diagnosis process. One such area of research involves the investigation and application of sophisticated computer algorithms to assist clinicians in detecting and diagnosing breast cancer on medical images (termed generally as "computer-aided diagnosis" or CAD). This study investigated a previously-developed breast ultrasound CAD system with the intent of translating it into a clinically-viable system. While past studies have demonstrated that breast ultrasound CAD may be a beneficial aid during the diagnosis of breast cancer on ultrasound, there are no investigations concerning its potential clinical translation and there are currently no commercially-available implementations of such systems. This study "bridges the gap" between the laboratory-developed system and the steps necessary for clinical implementation. A novel observer study was conducted that mimicked the clinical use of the breast ultrasound CAD system in order to assess the impact it had on the diagnostic performance of the user. Several robustness studies were also performed: the sonographic features used by the system were evaluated and the databases used for calibration and testing were characterized, the effect of the user's input was assessed by evaluating the performance of the system with variations in lesion identification and image selection, and the performance of the system on different patient populations was investigated by evaluating its performance on a database consisting solely of patients with Asian ethnicity. The analyses performed here indicate that the breast ultrasound CAD system under investigation is robust and demonstrates only minor variability when subjected to "real-world" use. All of these results are

  18. Computer-aided diagnosis system for lung cancer based on retrospective helical CT image

    NASA Astrophysics Data System (ADS)

    Ukai, Yuji; Niki, Noboru; Satoh, Hitoshi; Eguchi, Kenji; Mori, Kiyoshi; Ohmatsu, Hironobu; Kakinuma, Ryutaro; Kaneko, Masahiro; Moriyama, Noriyuki

    2000-06-01

    In this paper, we present a computer-aided diagnosis (CAD) system for lung cancer to detect nodule candidates at an early stage from the present and the early helical CT screening of the thorax. We developed an algorithm that can compare automatically the slice images of present and early CT scans for the assistance of comparative reading in retrospect. The algorithm consists of the ROI detection and shape analysis based on comparison of each slice image in the present and the early CT scans. The slice images of present and early CT scans are both displayed in parallel and analyzed quantitatively in order to detect the changes in size and intensity affection. We validated the efficiency of this algorithm by application to image data for mass screening of 50 subjects (total: 150 CT scans). The algorithm could compare the slice images correctly in most combinations with respect to physician's point of view. We validated the efficiency of the algorithm which automatically detect lung nodule candidates using CAD system. The system was applied to the helical CT images of 450 subjects. Currently, we are carrying out the clinical field test program using the CAD system. The results of our CAD system have indicated good performance when compared with physician's diagnosis. The experimental results of the algorithm indicate that our CAD system is useful to increase the efficiency of the mass screening process. CT screening of thorax will be performed by using the CAD system as a counterpart to the double reading technique actually used in herical CT screening program, not by using the film display.

  19. Computer-aided diagnosis system for lung cancer based on retrospective helical CT images

    NASA Astrophysics Data System (ADS)

    Satoh, Hitoshi; Ukai, Yuji; Niki, Noboru; Eguchi, Kenji; Mori, Kiyoshi; Ohmatsu, Hironobu; Kakinuma, Ryutaro; Kaneko, Masahiro; Moriyama, Noriyuki

    1999-05-01

    In this paper, we present a computer-aided diagnosis (CAD) system for lung cancer to detect nodule candidates at an early stage from the present and the early helical CT screening of the thorax. We developed an algorithm that can compare automatically the slice images of present and early CT scans for the assistance of comparative reading in retrospect. The algorithm consists of the ROI detection and shape analysis based on comparison of each slice image in the present and the early CT scans. The slice images of present and early CT scans are both displayed in parallel and analyzed quantitatively in order to detect the changes in size and intensity affection. We validated the efficiency of this algorithm by application to image data for mass screening of 50 subjects (total: 150 CT scans). The algorithm could compare the slice images correctly in most combinations with respect to physician's point of view. We validated the efficiency of the algorithm which automatically detect lung nodule candidates using CAD system. The system was applied to the helical CT images of 450 subjects. Currently, we are carrying out the clinical field test program using the CAD system. The results of our CAD system have indicated good performance when compared with physician's diagnosis. The experimental results of the algorithm indicate that our CAD system is useful to increase the efficiency of the mass screening process. CT screening of thorax will be performed by using the CAD system as a counterpart to the double reading technique actually used in herical CT screening program, not by using the film display.

  20. Potential of surface acoustic wave biosensors for early sepsis diagnosis.

    PubMed

    Csete, Marie; Hunt, William D

    2013-08-01

    Early diagnosis of sepsis is a difficult problem for intensivists and new biomarkers for early diagnosis have been difficult to come by. Here we discuss the potential of adapting a technology from the electronics industry, surface acoustic wave (SAW) sensors, for diagnosis of multiple markers of sepsis in real time, using non-invasive assays of exhaled breath condensate. The principles and advantages of the SAW technology are reviewed as well as a proposed plan for adapting this flexible technology to early sepsis detection. PMID:23471596

  1. Computer Aided Instruction and Problem Solving in the Teaching of Oral Diagnosis.

    ERIC Educational Resources Information Center

    Spencer, Judson; Gobetti, John P.

    A computer-assisted instructional (CAI) program is being used at the University of Michigan School of Dentistry to aid in the teaching of oral diagnosis to dental students. The program is designed to simulate a real life situation--i.e., the diagnosis of patient illness-which would not be otherwise available to the student and to demonstrate to…

  2. Computer aided diagnosis based on medical image processing and artificial intelligence methods

    NASA Astrophysics Data System (ADS)

    Stoitsis, John; Valavanis, Ioannis; Mougiakakou, Stavroula G.; Golemati, Spyretta; Nikita, Alexandra; Nikita, Konstantina S.

    2006-12-01

    Advances in imaging technology and computer science have greatly enhanced interpretation of medical images, and contributed to early diagnosis. The typical architecture of a Computer Aided Diagnosis (CAD) system includes image pre-processing, definition of region(s) of interest, features extraction and selection, and classification. In this paper, the principles of CAD systems design and development are demonstrated by means of two examples. The first one focuses on the differentiation between symptomatic and asymptomatic carotid atheromatous plaques. For each plaque, a vector of texture and motion features was estimated, which was then reduced to the most robust ones by means of ANalysis of VAriance (ANOVA). Using fuzzy c-means, the features were then clustered into two classes. Clustering performances of 74%, 79%, and 84% were achieved for texture only, motion only, and combinations of texture and motion features, respectively. The second CAD system presented in this paper supports the diagnosis of focal liver lesions and is able to characterize liver tissue from Computed Tomography (CT) images as normal, hepatic cyst, hemangioma, and hepatocellular carcinoma. Five texture feature sets were extracted for each lesion, while a genetic algorithm based feature selection method was applied to identify the most robust features. The selected feature set was fed into an ensemble of neural network classifiers. The achieved classification performance was 100%, 93.75% and 90.63% in the training, validation and testing set, respectively. It is concluded that computerized analysis of medical images in combination with artificial intelligence can be used in clinical practice and may contribute to more efficient diagnosis.

  3. Computer-aided diagnosis of pneumonia in patients with chronic obstructive pulmonary disease

    PubMed Central

    Sánchez Morillo, Daniel; León Jiménez, Antonio; Moreno, Sonia Astorga

    2013-01-01

    Background Early diagnosis of pneumonia and discrimination between this disease and chronic obstructive pulmonary disease (COPD) exacerbations in patients with COPD are crucial for optimal clinical management and treatment. Objectives To examine the use of computerized analysis of respiratory sounds, a hybrid system based on principal component analysis (PCA) and probabilistic neural networks (PNNs), to aid the detection of coexisting pneumonia in patients with COPD. Methods and materials A convenience sample of 58 patients with COPD (25 patients hospitalized for community-acquired pneumonia and 33 owing to acute exacerbation of COPD) was studied. Auscultations were performed by the patients themselves on their suprasternal notch. Short-time Fourier transform analysis was used to extract features from the recorded respiratory sounds, PCA was selected for dimensionality reduction and a PNN was trained as classifier. 10-Fold cross-validation and receiver operating characteristic curve analysis were used to estimate the system performance. Results Based on the cross-validation results, a sensitivity and a specificity of 72% and 81.8%, respectively, were achieved in validation data. The operating point was selected to maximize the specificity and sensitivity pair in the training set. Discussion The results strongly suggest that electronic self-auscultation at a single location (suprasternal notch) can support diagnosis of pneumonia in patients with COPD. Conclusions A simple, cost-effective method has been proposed to aid decision-making in areas with no radiological facilities available and in resource-constrained settings, and could have a great diagnostic impact on telemedicine applications. PMID:23396513

  4. Biomarkers for the early diagnosis of hepatocellular carcinoma

    PubMed Central

    Tsuchiya, Nobuhiro; Sawada, Yu; Endo, Itaru; Saito, Keigo; Uemura, Yasushi; Nakatsura, Tetsuya

    2015-01-01

    Hepatocellular carcinoma (HCC) is the fifth most common cancer and the second leading cause of cancer-related deaths worldwide. Although the prognosis of patients with HCC is generally poor, the 5-year survival rate is > 70% if patients are diagnosed at an early stage. However, early diagnosis of HCC is complicated by the coexistence of inflammation and cirrhosis. Thus, novel biomarkers for the early diagnosis of HCC are required. Currently, the diagnosis of HCC without pathological correlation is achieved by analyzing serum α-fetoprotein levels combined with imaging techniques. Advances in genomics and proteomics platforms and biomarker assay techniques over the last decade have resulted in the identification of numerous novel biomarkers and have improved the diagnosis of HCC. The most promising biomarkers, such as glypican-3, osteopontin, Golgi protein-73 and nucleic acids including microRNAs, are most likely to become clinically validated in the near future. These biomarkers are not only useful for early diagnosis of HCC, but also provide insight into the mechanisms driving oncogenesis. In addition, such molecular insight creates the basis for the development of potentially more effective treatment strategies. In this article, we provide an overview of the biomarkers that are currently used for the early diagnosis of HCC. PMID:26457017

  5. Biomarkers for the early diagnosis of hepatocellular carcinoma.

    PubMed

    Tsuchiya, Nobuhiro; Sawada, Yu; Endo, Itaru; Saito, Keigo; Uemura, Yasushi; Nakatsura, Tetsuya

    2015-10-01

    Hepatocellular carcinoma (HCC) is the fifth most common cancer and the second leading cause of cancer-related deaths worldwide. Although the prognosis of patients with HCC is generally poor, the 5-year survival rate is > 70% if patients are diagnosed at an early stage. However, early diagnosis of HCC is complicated by the coexistence of inflammation and cirrhosis. Thus, novel biomarkers for the early diagnosis of HCC are required. Currently, the diagnosis of HCC without pathological correlation is achieved by analyzing serum α-fetoprotein levels combined with imaging techniques. Advances in genomics and proteomics platforms and biomarker assay techniques over the last decade have resulted in the identification of numerous novel biomarkers and have improved the diagnosis of HCC. The most promising biomarkers, such as glypican-3, osteopontin, Golgi protein-73 and nucleic acids including microRNAs, are most likely to become clinically validated in the near future. These biomarkers are not only useful for early diagnosis of HCC, but also provide insight into the mechanisms driving oncogenesis. In addition, such molecular insight creates the basis for the development of potentially more effective treatment strategies. In this article, we provide an overview of the biomarkers that are currently used for the early diagnosis of HCC. PMID:26457017

  6. Computer aided diagnosis and treatment planning for developmental dysplasia of the hip

    NASA Astrophysics Data System (ADS)

    Li, Bin; Lu, Hongbing; Cai, Wenli; Li, Xiang; Meng, Jie; Liang, Zhengrong

    2005-04-01

    The developmental dysplasia of the hip (DDH) is a congenital malformation affecting the proximal femurs and acetabulum that are subluxatable, dislocatable, and dislocated. Early diagnosis and treatment is important because failure to diagnose and improper treatment can result in significant morbidity. In this paper, we designed and implemented a computer aided system for the diagnosis and treatment planning of this disease. With the design, the patient received CT (computed tomography) or MRI (magnetic resonance imaging) scan first. A mixture-based PV partial-volume algorithm was applied to perform bone segmentation on CT image, followed by three-dimensional (3D) reconstruction and display of the segmented image, demonstrating the special relationship between the acetabulum and femurs for visual judgment. Several standard procedures, such as Salter procedure, Pemberton procedure and Femoral Shortening osteotomy, were simulated on the screen to rehearse a virtual treatment plan. Quantitative measurement of Acetabular Index (AI) and Femoral Neck Anteversion (FNA) were performed on the 3D image for evaluation of DDH and treatment plans. PC graphics-card GPU architecture was exploited to accelerate the 3D rendering and geometric manipulation. The prototype system was implemented on PC/Windows environment and is currently under clinical trial on patient datasets.

  7. 75 FR 3746 - Ryan White HIV/AIDS Part C Early Intervention Services (EIS) Program

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-01-22

    ... HUMAN SERVICES Health Resources and Services Administration Ryan White HIV/AIDS Part C Early..., Florida, that will ensure continuity of Part C, Early Intervention Services (EIS), HIV/AIDS care and...: Critical funding for HIV/AIDS care and treatment to the target populations in Orange County,...

  8. 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…

  9. Spinal epidural abscess: the importance of early diagnosis and treatment

    PubMed Central

    Mackenzie, A; Laing, R; Smith, C; Kaar, G; Smith, F

    1998-01-01

    OBJECTIVES—To remind clinicians of the dangers of delayed diagnosis and the importance of early treatment of spinal epidural abscess.
METHODS—A review of the literature on spinal epidural abscess and a comparison of the published literature with local experience.
RESULTS—Imaging with MRI or CT enables early diagnosis of spinal epidural abcess and optimal therapy is surgical evacuation combined with 6-12 weeks (median 8 weeks) of antimicrobial chemotherapy. Clinical features are fever, pain, and focal neurological signs and may be associated with preceding and pre-existing bone or joint disease. The commonest aetiological organism is S aureus.
CONCLUSION—Early diagnosis and appropriate early antimicrobial chemotherapy with surgery is associated with an excellent prognosis.

 PMID:9703173

  10. Early neuroimaging diagnosis of Alzheimer's disease

    NASA Astrophysics Data System (ADS)

    Jiao, Jianling; Liu, Timon C.; Li, Yan; Liu, Songhao

    2002-04-01

    Neuroimaging has played an important role in evaluating the Alzheimer's disease (AD) patients, and its uses are growing. Magnetic resonance imaging (MRI) may show the presence of cerebral infarcts and white matter disease. Single photon emission computed tomography (SPECT) and positron emission tomography (PET), which visualize such cerebral functions as glucose metabolism and blood flow, may provide positive evidence to support the diagnosis of AD. Electrical impedance tomography (EIT) is a recently developed technique which enables the internal impedance of an object to be imaged noninvasively.

  11. Acute leukemia diagnosis aid using multicriteria fuzzy assignment methodology.

    PubMed

    Belacel, N; Vincke, P; Scheiff, J M; Boulassel, M R

    2001-02-01

    We recently developed a new multicriteria classification method called PROAFTN to help medical diagnosis. The aim of this paper is to present the application of the proposed method for the diagnosis of acute leukemia (AL). The implementation of PROAFTN was carried out on cytological data of 108 cases of AL, using the classification rules of French, American and British hematologists, and was then applied on an independent test set of 83 cases of AL. Forty-seven features, obtained by examining patients' bone-marrow smears with light microscope, defined each case. In order to determine the percentage of correct classifications for each subtype of AL, we compared our results with the clinical diagnosis given previously by the hematologist. 96.4% of the cases were correctly classified by the program, suggesting that the method yields good results in terms of discrimination between AL subtypes.

  12. Dynamic MRI-based computer aided diagnostic systems for early detection of kidney transplant rejection: A survey

    NASA Astrophysics Data System (ADS)

    Mostapha, Mahmoud; Khalifa, Fahmi; Alansary, Amir; Soliman, Ahmed; Gimel'farb, Georgy; El-Baz, Ayman

    2013-10-01

    Early detection of renal transplant rejection is important to implement appropriate medical and immune therapy in patients with transplanted kidneys. In literature, a large number of computer-aided diagnostic (CAD) systems using different image modalities, such as ultrasound (US), magnetic resonance imaging (MRI), computed tomography (CT), and radionuclide imaging, have been proposed for early detection of kidney diseases. A typical CAD system for kidney diagnosis consists of a set of processing steps including: motion correction, segmentation of the kidney and/or its internal structures (e.g., cortex, medulla), construction of agent kinetic curves, functional parameter estimation, diagnosis, and assessment of the kidney status. In this paper, we survey the current state-of-the-art CAD systems that have been developed for kidney disease diagnosis using dynamic MRI. In addition, the paper addresses several challenges that researchers face in developing efficient, fast and reliable CAD systems for the early detection of kidney diseases.

  13. Advances in biomarkers for the early diagnosis of prostate cancer.

    PubMed

    Cao, Da-Long; Yao, Xu-Dong

    2010-02-01

    More and more studies have revealed that the level of serum prostate specific antigen(PSA) has little value for early diagnosis of prostate cancer (PCa). For example, negative prostate biopsies are as high as 70%-80% for patients with serum PSA ranging between 4 ng/mL and 10 ng/mL. However, the negative results cannot exclude the existence of cancer. In the studies of the early diagnosis of PCa, investigators focused on seeking biomarkers that have higher sensitivity and specificity. Recently, PSA derivatives, HPC1, PCA3, TMPRSS2: ETS, GSTP1, AMACR, GOLPH2, EPCA, sarcosine, and the combination of multiple biomarkers are widely discussed. In this article, we have reviewed their recent development and the prospective value of the combination of multiple biomarkers, which may be helpful for the early diagnosis and the prognostic monitoring of patients with PCa.

  14. Computer aided differential diagnosis in emergency situations (CADDIES) system

    SciTech Connect

    NOEL,WILLIAM P.

    2000-03-01

    This report presents an idea for a portable computerized differential diagnosis tool that could be utilized by a health care provider during an emergency situation. This radio frequency, networked, menu driven system would analyze various patient assessment parameters and make recommendations regarding possible diagnoses/treatment options outside the scope of suspicion of the health care provider. This system would serve as a repository for initial epidemiological data and assist the health care provider with spotting emerging trends.

  15. Early diagnosis improves outcomes in hepatitis C.

    PubMed

    Miller, Michael H; Dillon, John F

    2015-11-01

    Chronic hepatitis C (HCV) infection affects 0.8-1.0% of the UK population, with up to 70% having ongoing chronic infection. HCV is curable but if left untreated can progress to end stage liver disease and potentially hepatocellular carcinoma. HCV management options have changed dramatically over the past five years, with improvement in cure rates and tolerability; cure rates of more than 90% can now be achieved. The main risk factors for acquiring HCV infection in the UK are injecting drug use and sharing drug using equipment. Other risk factors include receipt of blood products in the UK before 1991; tattooing or acupuncture with non-sterile equipment; medical procedures; needlestick injuries and contact with blood from an infected person. Acute hepatitis C infection has mild symptoms only and is likely to go undiagnosed. The estimated diagnosis rate in England is 35%, suggesting that 65% of the total HCV-positive population remains undiagnosed. The most common method of detecting HCV is case finding in high- risk groups. Those who test positive for HCV antibodies should be tested for persisting viral presence through HCV PCR testing - a positive result confirms active infection. GPs can play a major role in identifying those at risk of the disease, which includes patients with known risk factors and those with unexplained abnormal liver function tests, providing information and arranging testing. Patients with confirmed active HCV infection should be referred to the local specialist hepatology or infectious disease service in accordance with locally agreed pathways. PMID:26753270

  16. Gastric cancer: Prevention, screening and early diagnosis

    PubMed Central

    Pasechnikov, Victor; Chukov, Sergej; Fedorov, Evgeny; Kikuste, Ilze; Leja, Marcis

    2014-01-01

    Gastric cancer continues to be an important healthcare problem from a global perspective. Most of the cases in the Western world are diagnosed at late stages when the treatment is largely ineffective. Helicobacter pylori (H. pylori) infection is a well-established carcinogen for gastric cancer. While lifestyle factors are important, the efficacy of interventions in their modification, as in the use of antioxidant supplements, is unconvincing. No organized screening programs can be found outside Asia (Japan and South Korea). Although several screening approaches have been proposed, including indirect atrophy detection by measuring pepsinogen in the circulation, none of them have so far been implemented, and more study data is required to justify any implementation. Mass eradication of H. pylori in high-risk areas tends to be cost-effective, but its adverse effects and resistance remain a concern. Searches for new screening biomarkers, including microRNA and cancer-autoantibody panels, as well as detection of volatile organic compounds in the breath, are in progress. Endoscopy with a proper biopsy follow-up remains the standard for early detection of cancer and related premalignant lesions. At the same time, new advanced high-resolution endoscopic technologies are showing promising results with respect to diagnosing mucosal lesions visually and targeting each biopsy. New histological risk stratifications (classifications), including OLGA and OLGIM, have recently been developed. This review addresses the current means for gastric cancer primary and secondary prevention, the available and emerging methods for screening, and new developments in endoscopic detection of early lesions of the stomach. PMID:25320521

  17. Cell-free DNA testing: an aid to prenatal sonographic diagnosis.

    PubMed

    Chitty, Lyn S

    2014-04-01

    Sonographic diagnosis of fetal abnormalities is based on the recognition of sonographic patterns associated with structural abnormalities. Although diagnosis in some situations, such as neural tube defects, gastroschisis, and omphalocoele, can be straightforward, in many situations, the constellation of fetal abnormalities suggest an underlying chromosomal or genetic cause. In these situations, invasive testing is needed to provide the information required to make a definitive diagnosis, and thus accurately counsel parents. Since the identification of cell-free fetal DNA in maternal plasma, the potential for non-invasive prenatal diagnosis is increasingly becoming possible. In this chapter, the current role and future potential of non-invasive prenatal diagnosis, combined with new molecular techniques as an aid to sonographic diagnosis, will be discussed.

  18. Echocardiography in congenital heart disease. An aid to surgical diagnosis.

    PubMed

    Meyer, R A

    1977-05-01

    Echocardiography is an important noninvasive method for accurately diagnosing many congenital cardiac defects. This method provides significant information so that cardiac surgery, when necessary, can be planned with greater facility. The value of the sonar method rests not only on its ability to diagnose specific cardiac defects but also to exclude heart disease, especially in infants with shock or cyanosis from noncardiac causes. Development of two-dimensional real-time scanning systems should provide greater understanding of anatomic spatial relationships and ease of diagnosis.

  19. Computer-aided diagnosis system: a Bayesian hybrid classification method.

    PubMed

    Calle-Alonso, F; Pérez, C J; Arias-Nicolás, J P; Martín, J

    2013-10-01

    A novel method to classify multi-class biomedical objects is presented. The method is based on a hybrid approach which combines pairwise comparison, Bayesian regression and the k-nearest neighbor technique. It can be applied in a fully automatic way or in a relevance feedback framework. In the latter case, the information obtained from both an expert and the automatic classification is iteratively used to improve the results until a certain accuracy level is achieved, then, the learning process is finished and new classifications can be automatically performed. The method has been applied in two biomedical contexts by following the same cross-validation schemes as in the original studies. The first one refers to cancer diagnosis, leading to an accuracy of 77.35% versus 66.37%, originally obtained. The second one considers the diagnosis of pathologies of the vertebral column. The original method achieves accuracies ranging from 76.5% to 96.7%, and from 82.3% to 97.1% in two different cross-validation schemes. Even with no supervision, the proposed method reaches 96.71% and 97.32% in these two cases. By using a supervised framework the achieved accuracy is 97.74%. Furthermore, all abnormal cases were correctly classified.

  20. Computer-aided diagnosis of pulmonary diseases using x-ray darkfield radiography

    NASA Astrophysics Data System (ADS)

    Einarsdóttir, Hildur; Yaroshenko, Andre; Velroyen, Astrid; Bech, Martin; Hellbach, Katharina; Auweter, Sigrid; Yildirim, Önder; Meinel, Felix G.; Eickelberg, Oliver; Reiser, Maximilian; Larsen, Rasmus; Kjær Ersbøll, Bjarne; Pfeiffer, Franz

    2015-12-01

    In this work we develop a computer-aided diagnosis (CAD) scheme for classification of pulmonary disease for grating-based x-ray radiography. In addition to conventional transmission radiography, the grating-based technique provides a dark-field imaging modality, which utilizes the scattering properties of the x-rays. This modality has shown great potential for diagnosing early stage emphysema and fibrosis in mouse lungs in vivo. The CAD scheme is developed to assist radiologists and other medical experts to develop new diagnostic methods when evaluating grating-based images. The scheme consists of three stages: (i) automatic lung segmentation; (ii) feature extraction from lung shape and dark-field image intensities; (iii) classification between healthy, emphysema and fibrosis lungs. A study of 102 mice was conducted with 34 healthy, 52 emphysema and 16 fibrosis subjects. Each image was manually annotated to build an experimental dataset. System performance was assessed by: (i) determining the quality of the segmentations; (ii) validating emphysema and fibrosis recognition by a linear support vector machine using leave-one-out cross-validation. In terms of segmentation quality, we obtained an overlap percentage (Ω) 92.63  ±  3.65%, Dice Similarity Coefficient (DSC) 89.74  ±  8.84% and Jaccard Similarity Coefficient 82.39  ±  12.62%. For classification, the accuracy, sensitivity and specificity of diseased lung recognition was 100%. Classification between emphysema and fibrosis resulted in an accuracy of 93%, whilst the sensitivity was 94% and specificity 88%. In addition to the automatic classification of lungs, deviation maps created by the CAD scheme provide a visual aid for medical experts to further assess the severity of pulmonary disease in the lung, and highlights regions affected.

  1. Morbidity in early Parkinson's disease and prior to diagnosis

    PubMed Central

    Frandsen, Rune; Kjellberg, Jakob; Ibsen, Rikke; Jennum, Poul

    2014-01-01

    Background Nonmotor symptoms are probably present prior to, early on, and following, a diagnosis of Parkinson's disease. Nonmotor symptoms may hold important information about the progression of Parkinson's disease. Objective To evaluated the total early and prediagnostic morbidities in the 3 years before a hospital contact leading to a diagnosis of Parkinson's disease. Methods Retrospective morbidity data from Danish National Patient Registry records (1997–2007) of 10,490 adult patients with a secondary care diagnosis of Parkinson's disease were compared with 42,505 control cases. Results Parkinson's disease was associated with significantly higher morbidity rates associated with conditions in the following categories: mental and psychiatric, nervous system, gastrointestinal, musculoskeletal system and connective tissue, genitourinary, abnormal clinical and laboratory findings, injury, poisoning and certain other external causes, and other factors influencing health status and contact with health services. It was negatively associated with neoplasm, cardiovascular, and respiratory diseases. Conclusions Patients with a diagnosis of Parkinson's disease present significant differences in morbidities early on, following, and prior to, their diagnosis, compared with healthy controls. PMID:24944873

  2. Virus morphology as an aid for rapid diagnosis.

    PubMed Central

    Doane, F. W.

    1980-01-01

    Standard methods of virus diagnosis may take many days to complete. As antiviral drugs are being used with more effectiveness, it becomes more important to develop rapid diagnostic methods. It takes only a few minutes to prepare and examine a specimen for electron microscopy (EM), using the negative staining technique. Viruses in the specimen can readily be identified by their morphology. In order to be detected by EM there must be at least 10(7) virus particles per milliliter of sample. This concentration is frequently found in certain types of specimens. The sensitivity of EM is increased 100-fold if homologous antibody is used to aggregate the virus. Visualization of virus-antibody aggregates forms the basis for serotyping by immunoelectron microscopy (IEM). Images PLATE 1 PLATE 2 PLATE 3 PMID:6155006

  3. Breast cancer early diagnosis based on hybrid strategy.

    PubMed

    Li, Peng; Bi, Tingting; Huang, Jiuling; Li, Siben

    2014-01-01

    The frequent occurrence of breast cancer and its serious consequences have attracted worldwide attention in recent years. Problems such as low rate of accuracy and poor self-adaptability still exist in traditional diagnosis. In order to solve these problems, an AdaBoost-SVM classification algorithm, combined with the cluster boundary sampling preprocessing techniques (CBS-AdaBoost-SVM), is proposed in this paper for the early diagnosis of breast cancer. The algorithm uses machine learning method to diagnose the unknown image data. Moreover, not all of the characteristics play positive roles for classification. To address this issue the paper delete redundant features by using Rough set attribute reduction algorithm based on the genetic algorithm (GA). The effectiveness of the proposed methods are examined on DDSM by calculating its accuracy, confusion matrix, and receiver operating characteristic curves, which give important clues to the physicians for early diagnosis of breast cancer. PMID:25227050

  4. Orthodontics: computer-aided diagnosis and treatment planning

    NASA Astrophysics Data System (ADS)

    Yi, Yaxing; Li, Zhongke; Wei, Suyuan; Deng, Fanglin; Yao, Sen

    2000-10-01

    The purpose of this article is to introduce the outline of our newly developed computer-aided 3D dental cast analyzing system with laser scanning, and its preliminary clinical applications. The system is composed of a scanning device and a personal computer as a scanning controller and post processor. The scanning device is composed of a laser beam emitter, two sets of linear CCD cameras and a table which is rotatable by two-degree-of-freedom. The rotating is controlled precisely by a personal computer. The dental cast is projected and scanned with a laser beam. Triangulation is applied to determine the location of each point. Generation of 3D graphics of the dental cast takes approximately 40 minutes. About 170,000 sets of X,Y,Z coordinates are store for one dental cast. Besides the conventional linear and angular measurements of the dental cast, we are also able to demonstrate the size of the top surface area of each molar. The advantage of this system is that it facilitates the otherwise complicated and time- consuming mock surgery necessary for treatment planning in orthognathic surgery.

  5. Effective screening for early diagnosis of pancreatic cancer.

    PubMed

    Hanada, Keiji; Okazaki, Akihito; Hirano, Naomichi; Izumi, Yoshihiro; Minami, Tomoyuki; Ikemoto, Juri; Kanemitsu, Kozue; Hino, Fumiaki

    2015-12-01

    Diagnosis of pancreatic cancer (PC) at an early stage with curative surgery should improve long-term patient outcome. At present, improving survival should lie in identifying those cases with high-risk factors or precursor lesions through an effective screening including ultrasonography, some biological markers, or national familial pancreatic cancer registration. Recently, cases with PC < 10 mm with a favorable prognosis have been reported. For the diagnoses of cases with PC < 10 mm, the rate of tumor detection was higher on endoscopic ultrasonography (EUS) than on CT or other modalities, and EUS-guided fine needle aspiration was helpful in confirming the histologic diagnosis. Additionally, for the diagnosis of cases with PC in situ, EUS and magnetic resonance cholangiopancreatography (MRCP) may play important roles in detecting the local irregular stenosis of the pancreatic duct. Cytodiagnosis of pancreatic juice using endoscopic nasopancreatic drainage multiple times may be useful in the final diagnosis. PMID:26651254

  6. Early Gastric Cancer: Current Advances of Endoscopic Diagnosis and Treatment.

    PubMed

    Zhu, Linlin; Qin, Jinyu; Wang, Jin; Guo, Tianjiao; Wang, Zijing; Yang, Jinlin

    2016-01-01

    Endoscopy is a major method for early gastric cancer screening because of its high detection rate, but its diagnostic accuracy depends heavily on the availability of endoscopic instruments. Many novel endoscopic techniques have been shown to increase the diagnostic yield of early gastric cancer. With the improved detection rate of EGC, the endoscopic treatment has become widespread due to advances in the instruments available and endoscopist's experience. The aim of this review is to summarize frequently-used endoscopic diagnosis and treatment in early gastric cancer (EGC). PMID:26884753

  7. HIV/AIDS in Early Childhood Centers: The Ethical Dilemma of Confidentiality versus Disclosure.

    ERIC Educational Resources Information Center

    Black, Sandra M.

    1999-01-01

    Discusses the privacy dilemma encountered by early childhood practitioners when they find out that a child in their program or one of the child's family members has HIV/AIDS. Provides general and specific guidelines regarding HIV/AIDS, describes universal precautions in child care settings, and delineates myths and facts about HIV/AIDS. (KB)

  8. [The new concept of osteoporosis. Early diagnosis, prevention and therapy are possible today].

    PubMed

    Hesch, R D; Harms, H; Rittinghaus, E F; Brabant, G

    1990-04-15

    A paradigma of osteoporosis pathology is discussed, at the center of which is the hormone-related disturbance of the osteoblast/osteoclast functional unit. A liberal replacement of estrogen-gestagen in post-menopausal women is advocated. Early diagnosis with the aid of quantitative computed tomography makes it possible to establish the indication for timely hormonal treatment in the future, which can result in a measureable increase in bone mass. Late therapy, that is, treatment initiated after the occurrence of fractures, has proven largely ineffective. PMID:2358288

  9. [The new concept of osteoporosis. Early diagnosis, prevention and therapy are possible today].

    PubMed

    Hesch, R D; Harms, H; Rittinghaus, E F; Brabant, G

    1990-04-15

    A paradigma of osteoporosis pathology is discussed, at the center of which is the hormone-related disturbance of the osteoblast/osteoclast functional unit. A liberal replacement of estrogen-gestagen in post-menopausal women is advocated. Early diagnosis with the aid of quantitative computed tomography makes it possible to establish the indication for timely hormonal treatment in the future, which can result in a measureable increase in bone mass. Late therapy, that is, treatment initiated after the occurrence of fractures, has proven largely ineffective.

  10. Does the Conners' Continuous Performance Test aid in ADHD diagnosis?

    PubMed

    McGee, R A; Clark, S E; Symons, D K

    2000-10-01

    The performance of clinic-referred children aged 6-11 (N = 100) was examined using the Conners' Continuous Performance Test (CPT) and measures of auditory attention (Auditory Continuous Performance Test; ACPT), phonological awareness, visual processing speed, and visual-motor competence. The Conners' CPT overall index was unrelated to measures of visual processing speed or visual-motor competence. Although the Conners' CPT converged with the ACPT, the latter demonstrated age and order effects. Significant variance in Conners' CPT parameters was predicted by phonological awareness measures, suggesting that Reading Disordered (RD) children could be "false positives" on the Conners' CPT. The Conners' CPT overall index, phonological awareness, and visual-motor measures were submitted to a 2 x 2 MANCOVA (ADHD vs. RD, covarying for age and socioeconomic status): a main effect for RD status was found. Children with ADHD did not have higher Conners' CPT scores than did clinical controls; however, children with Reading Disorders did. Phonological measures distinguished RD children from ADHD children and other clinical controls. ADHD children who failed the Conners' CPT were rated by teachers as more hyperactive. Despite the strengths of the Conners' CPT, its utility for differential diagnosis of ADHD is questioned.

  11. Magnetic resonance imaging for diagnosis of early Alzheimer's disease.

    PubMed

    Colliot, O; Hamelin, L; Sarazin, M

    2013-10-01

    A major challenge for neuroimaging is to contribute to the early diagnosis of Alzheimer's disease (AD). In particular, magnetic resonance imaging (MRI) allows detecting different types of structural and functional abnormalities at an early stage of the disease. Anatomical MRI is the most widely used technique and provides local and global measures of atrophy. The recent diagnostic criteria of "mild cognitive impairment due to AD" include hippocampal atrophy, which is considered a marker of neuronal injury. Advanced image analysis techniques generate automatic and reproducible measures both in the hippocampus and throughout the whole brain. Recent modalities such as diffusion-tensor imaging and resting-state functional MRI provide additional measures that could contribute to the early diagnosis but require further validation.

  12. AIDS: What Early Childhood Educators Need To Know.

    ERIC Educational Resources Information Center

    Spar, Ruth

    Noting that Acquired Immune Deficiency Syndrome (AIDS) is expected to become the fifth leading cause of death for children ages 1 to 4, this paper provides relevant information on AIDS and the Human Immunodeficiency Virus (HIV) to help educators understand that they can work with children and adults who are HIV positive or who have AIDS. The…

  13. On the convergence of nanotechnology and Big Data analysis for computer-aided diagnosis.

    PubMed

    Rodrigues, Jose F; Paulovich, Fernando V; de Oliveira, Maria Cf; de Oliveira, Osvaldo N

    2016-04-01

    An overview is provided of the challenges involved in building computer-aided diagnosis systems capable of precise medical diagnostics based on integration and interpretation of data from different sources and formats. The availability of massive amounts of data and computational methods associated with the Big Data paradigm has brought hope that such systems may soon be available in routine clinical practices, which is not the case today. We focus on visual and machine learning analysis of medical data acquired with varied nanotech-based techniques and on methods for Big Data infrastructure. Because diagnosis is essentially a classification task, we address the machine learning techniques with supervised and unsupervised classification, making a critical assessment of the progress already made in the medical field and the prospects for the near future. We also advocate that successful computer-aided diagnosis requires a merge of methods and concepts from nanotechnology and Big Data analysis.

  14. Diagnosis of muscle diseases presenting with early respiratory failure.

    PubMed

    Pfeffer, Gerald; Povitz, Marcus; Gibson, G John; Chinnery, Patrick F

    2015-05-01

    Here we describe a clinical approach and differential diagnosis for chronic muscle diseases which include early respiratory failure as a prominent feature in their presentation (i.e. respiratory failure whilst still ambulant). These patients typically present to neurology or respiratory medicine out-patient clinics and a distinct differential diagnosis of neuromuscular aetiologies should be considered. Amyotrophic lateral sclerosis and myasthenia gravis are the important non-muscle diseases to consider, but once these have been excluded there remains a challenging differential diagnosis of muscle conditions, which will be the focus of this review. The key points in the diagnosis of these disorders are being aware of relevant symptoms, which are initially caused by nocturnal hypoventilation or diaphragmatic weakness; and identifying other features which direct further investigation. Important muscle diseases to identify, because their diagnosis has disease-specific management implications, include adult-onset Pompe disease, inflammatory myopathy, and sporadic adult-onset nemaline myopathy. Cases which are due to metabolic myopathy or muscular dystrophy are important to diagnose because of their implications for genetic counselling. Myopathy from sarcoidosis and colchicine each has a single reported case with this presentation, but should be considered because they are treatable. Disorders which have recently had their genetic aetiologies identified include hereditary myopathy with early respiratory failure (due to TTN mutations), the FHL1-related syndromes, and myofibrillar myopathy due to BAG3 mutation. Recently described syndromes include oculopharyngodistal muscular dystrophy that awaits genetic characterisation. PMID:25377282

  15. Molecular pathological diagnosis for early esophageal cancer in Kazakh patients

    PubMed Central

    AWUT, IDIRIS; NIYAZ, MADINIYET; BIEKEMITOUFU, HADETI; ZHANG, ZHU; SHEYHEDIN, ILYAR; HAO, WEN

    2011-01-01

    Chromosome abnormalities in cancer cells occur early in carcinogenesis. We employed DNA probes for the detection of cancer cells in surgical specimens in Kazakh patients with suspected esophageal carcinoma, to analyze the application of this technique during the early diagnosis of esophageal cancer. Comparative analysis was used to compare the results of pathological diagnosis with the results of FISH. We performed esophagofiberscopic biopsy examinations in 50 Kazakh patients with suspected esophageal carcinoma, including 40 males and 10 females, with an average age of 56.8 years. The final diagnosis was esophageal squamous cell carcinoma in 47 patients, and adenocarcinoma, mucinous carcinoma and small cell carcinoma in one patient each. The pathological findings of the biopsy were positive in 45 cases, and false-negative in 5. The sensitivity and specificity of pathological diagnosis were 87.2 and 100%, respectively. Using FISH to examine the same tissues, we found that 48 cases showed aberrant copy numbers in either chromosome 3 or 17, and 2 cases were false-negative, with a sensitivity and specificity of 94.8 and 100%, respectively. The copy numbers of centromeres in chromosome 3 were significantly higher than the copy numbers of centromeres in chromosome 17 (P=0.0001). Compared with biopsy pathology, the FISH test was more sensitive. Being an objective and qualitative method, the technology of molecular pathological diagnosis may effectively increase the early diagnostic rate of esophageal cancer. In addition, the centromere probe in chromosome 3 may be the most sensitive probe for the diagnosis of esophageal cancer in Kazakh patients. PMID:22740949

  16. Early diagnosis of autism spectrum disorder: Stability and change in clinical diagnosis and symptom presentation

    PubMed Central

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

    2012-01-01

    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 findings come from high-risk samples, but reports on children screened in community settings are also needed. Methods Stability of diagnosis and Autism Diagnostic Observation Schedule–Toddler Module (ADOS-T) classifications and scores was examined across two time points in a sample of 82 children identified through the FIRST WORDSR Project. Children received two comprehensive diagnostic evaluations at average ages of 19.39 (SD=2.12) and 36.89 (SD=3.85) months. Results Stability was 100% when confirming and ruling out a diagnosis of ASD based on a comprehensive diagnostic evaluation that included clinic and home observations, although diagnosis was initially deferred for 17% of the sample. Receiver Operating Characteristic curves revealed excellent sensitivity and acceptable specificity for the ADOS-T compared to concurrent diagnosis. Logistic regressions indicated good predictive value of initial ADOS-T scores for follow-up diagnosis. Finally, both ASD and Non-ASD children demonstrated a decrease in Social Affect scores (i.e., improvement), while children with ASD demonstrated an increase in Restricted and Repetitive Behavior scores (i.e., worsening), changes that were accounted for by nonverbal developmental level in mixed model analyses. Conclusions Short-term stability was documented for children diagnosed at 19 months on average, although a minority of children initially showed unclear diagnostic presentations. Findings highlight utility of the ADOS-T in making early diagnoses and predicting follow-up diagnoses. Children with ASD demonstrated improvement in social communication behaviors and unfolding of repetitive

  17. Computational Intelligence Method for Early Diagnosis Dengue Haemorrhagic Fever Using Fuzzy on Mobile Device

    NASA Astrophysics Data System (ADS)

    Salman, Afan; Lina, Yen; Simon, Christian

    2014-03-01

    Mortality from Dengue Haemorrhagic Fever (DHF) is still increasing in Indonesia particularly in Jakarta. Diagnosis of the dengue shall be made as early as possible so that first aid can be given in expectation of decreasing death risk. The Study will be conducted by developing expert system based on Computational Intelligence Method. On the first year, study will use the Fuzzy Inference System (FIS) Method to diagnose Dengue Haemorrhagic Fever particularly in Mobile Device consist of smart phone. Expert system application which particularly using fuzzy system can be applied in mobile device and it is useful to make early diagnosis of Dengue Haemorrhagic Fever that produce outcome faster than laboratory test. The evaluation of this application is conducted by performing accuracy test before and after validation using data of patient who has the Dengue Haemorrhagic Fever. This expert system application is easy, convenient, and practical to use, also capable of making the early diagnosis of Dengue Haemorraghic to avoid mortality in the first stage.

  18. Practical Aspects Regarding the Histopathological Diagnosis of Early Mycosis Fungoides.

    PubMed

    Tebeică, T; Andrei, R; Zurac, Sabina; Stăniceanu, Florica

    2016-01-01

    Mycosis fungoides is the most common primary T-cell lymphoma of skin. The disease has a protean clinical and histological presentation in its early patch and plaque stages, when distinction from mimicking inflammatory dermatoses is difficult. Since no single criterion is specific enough, a reliable diagnosis in early stages requires integration of clinical, histopathological and molecular findings. In skin biopsies, the most helpful histologic features are the detection of atypical lymphocytes in the epidermis with minimal epidermal changes, basal alignment of lymphocytes along dermal-epidermal junction and formation of Pautrier microabscesses. An aberrant immunophenotype of T cells and molecular detection of a clonal T-cell population are factors that could allow a more specific diagnosis. This work recapitulates and discusses these features from a practical perspective. PMID:27141565

  19. Early diagnosis of renal disease and renal failure.

    PubMed

    Lees, George E

    2004-07-01

    The main goal of early diagnosis of renal disease and renal failure in dogs and cats is to enable timely application of therapeutic interventions that may slow or halt disease progression. Strategies for early diagnosis of renal disease use urine tests that detect proteinuria that is a manifestation of altered glomerular permselectivity or impaired urine-concentrating ability as well blood tests to evaluate plasma creatinine concentration. Animals with progressive renal disease should be carefully investigated and treated appropriately. Animals with mild, possibly nonprogressive, renal disease should be monitored adequately to detect any worsening trends,which should lead to further investigation and treatment even if the increments of change are small. PMID:15223206

  20. Practical Aspects Regarding the Histopathological Diagnosis of Early Mycosis Fungoides.

    PubMed

    Tebeică, T; Andrei, R; Zurac, Sabina; Stăniceanu, Florica

    2016-01-01

    Mycosis fungoides is the most common primary T-cell lymphoma of skin. The disease has a protean clinical and histological presentation in its early patch and plaque stages, when distinction from mimicking inflammatory dermatoses is difficult. Since no single criterion is specific enough, a reliable diagnosis in early stages requires integration of clinical, histopathological and molecular findings. In skin biopsies, the most helpful histologic features are the detection of atypical lymphocytes in the epidermis with minimal epidermal changes, basal alignment of lymphocytes along dermal-epidermal junction and formation of Pautrier microabscesses. An aberrant immunophenotype of T cells and molecular detection of a clonal T-cell population are factors that could allow a more specific diagnosis. This work recapitulates and discusses these features from a practical perspective.

  1. Oral Manifestations of Tuberculosis: Step towards Early Diagnosis

    PubMed Central

    Jain, Isha

    2014-01-01

    Tuberculosis, as known universally, is a chronic infectious disease that can affect any part of the body including mouth. It usually affects the lungs, TB bacilli can spread hematogenously to other parts of the body and this also includes mandible or maxilla. It can occur in the mouth involving the tongue with very unusual features and forms. So oral lesions, although rare, are very important for early diagnosis and interception of primary tuberculosis. PMID:25654056

  2. Guide to early diagnosis of biliary obstruction in infancy. Review of 143 cases

    SciTech Connect

    Ferry, G.D.; Selby, M.L.; Udall, J.; Finegold, M.; Nichols, B.

    1985-06-01

    Presenting characteristics, long-term outcome, and techniques used in the diagnosis of 143 infants with suspected biliary obstruction are reviewed. Sixty-nine patients had surgically confirmed extrahepatic disease and 74 had intrahepatic disorders. A disproportionate number of infants with intrahepatic disease were boys, low birthweight, or had siblings with liver disease. An initial total bilirubin of 20 mg/dl or greater was rare except in the intrahepatic disease category of neonatal hepatitis of known cause. The initial percutaneous liver biopsy correctly predicted the ultimate diagnosis in 94 percent of all 143 patients. A methodological outline to diagnosis is presented, emphasizing early recognition of symptoms and careful follow-up with hepatobiliary imaging, liver biopsy, and surgical exploration, if required, until definitive diagnosis is made. This approach has aided us in reducing the age of diagnosis of biliary atresia from 12.8 weeks during the period 1971 through 1979 to 6.8 weeks from 1980 to 1982. Eighteen-month survival has improved from 25 to 60 percent.

  3. Computer-aided diagnosis of interstitial lung disease: a texture feature extraction and classification approach

    NASA Astrophysics Data System (ADS)

    Vargas-Voracek, Rene; McAdams, H. Page; Floyd, Carey E., Jr.

    1998-06-01

    An approach for the classification of normal or abnormal lung parenchyma from selected regions of interest (ROIs) of chest radiographs is presented for computer aided diagnosis of interstitial lung disease (ILD). The proposed approach uses a feed-forward neural network to classify each ROI based on a set of isotropic texture measures obtained from the joint grey level distribution of pairs of pixels separated by a specific distance. Two hundred ROIs, each 64 X 64 pixels in size (11 X 11 mm), were extracted from digitized chest radiographs for testing. Diagnosis performance was evaluated with the leave-one-out method. Classification of independent ROIs achieved a sensitivity of 90% and a specificity of 84% with an area under the receiver operating characteristic curve of 0.85. The diagnosis for each patient was correct for all cases when a `majority vote' criterion for the classification of the corresponding ROIs was applied to issue a normal or ILD patient classification. The proposed approach is a simple, fast, and consistent method for computer aided diagnosis of ILD with a very good performance. Further research will include additional cases, including differential diagnosis among ILD manifestations.

  4. Sinus barotrauma--late diagnosis and treatment with computer-aided endoscopic surgery.

    PubMed

    Larsen, Anders Schermacher; Buchwald, Christian; Vesterhauge, Søren

    2003-02-01

    Sinus barotrauma is usually easy to diagnose, and treatment achieves good results. We present two severe cases where delayed diagnosis caused significant morbidity. The signs and symptoms were atypical and neither the patients themselves, nor the initial examiners recognized that the onset of symptoms coincided with descent in a commercial airliner. CT and MRI scans of the brain were normal, but in both cases showed opafication of the sphenoid sinuses, which lead to the correct diagnosis. Subsequent surgical intervention consisting of endoscopic computer-aided surgery showed blood and petechia in the affected sinuses. This procedure provided immediate relief.

  5. Teacher Aide Handbook for Early Childhood Education for the Handicapped.

    ERIC Educational Resources Information Center

    Mansfield State Coll., PA. Dept. of Special Education.

    The handbook, prepared by teachers in a summer workshop, is to be used by teacher aides at the nursery through grade 3 levels as well as by administrators and teachers. Teacher aides are said to be the candy stripers of education who help teachers in ways such as supervising art and music activities and making home visits. Notes from the…

  6. Otolaryngologic markers for the early diagnosis of Turner syndrome

    PubMed Central

    Makishima, Tomoko; King, Kelly; Brewer, Carmen C; Zalewski, Christopher K; Butman, John; Bakalov, Vladimir K; Bondy, Carolyn; Griffith, Andrew J

    2009-01-01

    Objective To identify and characterize otolaryngologic markers for the early diagnosis of Turner Syndrome (TS). Study Design Prospective cohort survey. Methods Setting Clinical Center of the National Institutes of Health (NIH). Patients Ninety-one females, 7 - 61 years old (average = 28.7 y), enrolled in a multidisciplinary study of karyotype-phenotype correlations in TS. Main Outcome Measures Age at diagnosis, X chromosome karyotype, history of chronic or recurrent otitis media (OM), sensorineural hearing loss (SNHL), palate dysmorphism, pinna deformity, pterygium colli, low posterior hairline, low-set ears, and micrognathia. Results Sixty-nine (76%) patients had a history of chronic or recurrent OM, 62 (68%) had a dysmorphic palate, 57 (63%) had SNHL, and 90 (99%) had one or more of these findings. 83 (91%; average age at diagnosis = 9.4 y) had one or more external craniofacial signs: pinna abnormalities, pterygium colli, low-set ears, micrognathia or a low posterior hairline. Eight patients (average age at diagnosis = 13.2 y) had no external craniofacial signs, although seven (88%) of these eight patients had a history of chronic or recurrent OM, dysmorphic palate or SNHL. The age at diagnosis was not significantly different between groups with or without external craniofacial signs (P = 0.126). Conclusions Patients with mild or incompletely penetrant TS phenotypes often present with otitis media, hearing loss, or both before the diagnosis of TS is established. Palatal dysmorphism, including ogival morphology, is another otolaryngologic marker for TS. Prompt recognition of these manifestations of TS could hasten its diagnosis and appropriate medical care. PMID:19732968

  7. Recognition of Immune Response for the Early Diagnosis and Treatment of Osteoarthritis.

    PubMed

    Kandahari, Adrese M; Yang, Xinlin; Dighe, Abhijit S; Pan, Dongfeng; Cui, Quanjun

    2015-01-01

    Osteoarthritis is a common and debilitating joint disease that affects up to 30 million Americans, leading to significant disability, reduction in quality of life, and costing the United States tens of billions of dollars annually. Classically, osteoarthritis has been characterized as a degenerative, wear-and-tear disease, but recent research has identified it as an immunopathological disease on a spectrum between healthy condition and rheumatoid arthritis. A systematic literature review demonstrates that the disease pathogenesis is driven by an early innate immune response which progressively catalyzes degenerative changes that ultimately lead to an altered joint microenvironment. It is feasible to detect this infiltration of cells in the early, and presumably asymptomatic, phase of the disease through noninvasive imaging techniques. This screening can serve to aid clinicians in potentially identifying high-risk patients, hopefully leading to early effective management, vast improvements in quality of life, and significant reductions in disability, morbidity, and cost related to osteoarthritis. Although the diagnosis and treatment of osteoarthritis routinely utilize both invasive and non-invasive strategies, imaging techniques specific to inflammatory cells are not commonly employed for these purposes. This review discusses this paradigm and aims to shift the focus of future osteoarthritis-related research towards early diagnosis of the disease process.

  8. Computer-aided diagnosis workstation and telemedicine network system for chest diagnosis based on multislice CT images

    NASA Astrophysics Data System (ADS)

    Satoh, Hitoshi; Niki, Noboru; Eguchi, Kenji; Ohmatsu, Hironobu; Kakinuma, Ryutaru; Moriyama, Noriyuki

    2009-02-01

    Mass screening based on multi-helical CT images requires a considerable number of images to be read. It is this time-consuming step that makes the use of helical CT for mass screening impractical at present. Moreover, the doctor who diagnoses a medical image is insufficient in Japan. To overcome these problems, we have provided diagnostic assistance methods to medical screening specialists by developing a lung cancer screening algorithm that automatically detects suspected lung cancers in helical CT images, a coronary artery calcification screening algorithm that automatically detects suspected coronary artery calcification and a vertebra body analysis algorithm for quantitative evaluation of osteoporosis likelihood by using helical CT scanner for the lung cancer mass screening. The functions to observe suspicious shadow in detail are provided in computer-aided diagnosis workstation with these screening algorithms. We also have developed the telemedicine network by using Web medical image conference system with the security improvement of images transmission, Biometric fingerprint authentication system and Biometric face authentication system. Biometric face authentication used on site of telemedicine makes "Encryption of file" and "Success in login" effective. As a result, patients' private information is protected. We can share the screen of Web medical image conference system from two or more web conference terminals at the same time. An opinion can be exchanged mutually by using a camera and a microphone that are connected with workstation. Based on these diagnostic assistance methods, we have developed a new computer-aided workstation and a new telemedicine network that can display suspected lesions three-dimensionally in a short time. The results of this study indicate that our radiological information system without film by using computer-aided diagnosis workstation and our telemedicine network system can increase diagnostic speed, diagnostic accuracy and

  9. Computer-aided diagnosis of dysplasia in Barrett"s esophagus using endoscopic optical coherence tomography

    NASA Astrophysics Data System (ADS)

    Qi, Xin; Sivak, Michael V., Jr.; Wilson, David L.; Rollins, Andrew M.

    2004-07-01

    Barrett's esophagus (BE) has become a major health care burden because of its association with adenocarcinoma of the esophagus. We have shown that endoscopic optical coherence tomography (EOCT) has a 70% accuracy in the diagnosis of dysplasia (Gastrointest Endosc 2003; 57:AB77). To demonstrate the feasiblity of computer aided diagnosis (CAD) of dysplasia in BE using EOCT digital images, to quantitate/standardize the diagnosis of dysplasia, and to develop algorithms suitable for EOCT surveillance of large areas of Barrett"s mucosa, 106 EOCT images were selected (13 patients from 28 cases) from the clinical study including 68 of non-dysplastic and 38 of dysplastic mucosa. From the digital image stream, the 3 frames immediately preceding impact of the forceps on the tissue were selected to insure close correlation between histology/EOCT image pairs. Computer aided diagnosis by center symmetric autocorrelation (CENS) and principal component analysis (PCA) were used for feature parameter extraction and analysis based on the segmented ROI. Leave-one-out cross-validation was used for classification and finally receiver operating characteristic (ROC) curve was used to evaluate the performance of CAD and the sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and accuracy were calculated. The result shows that CAD is able to achieve a higher accuracy than humans for identification of dysplasia in EOCT images. CAD may be of assistance in the EOCT surveillance of large surface areas of Barrett"s mucosa for dysplasia.

  10. Diagnosis and early detection of COPD using spirometry

    PubMed Central

    Johns, David P.

    2014-01-01

    The standard respiratory function test for case detection of chronic obstructive pulmonary disease (COPD) is spirometry. The criterion for diagnosis defined in guidelines is based on the FEV1/FVC ratio forced expiratory ratio (FER) and its severity is based on forced expiratory volume in one second (FEV1) from measurements obtained during maximal forced expiratory manoeuvres. Spirometry is a safe and practical procedure, and when conducted by a trained operator using a spirometer that provides quality feedback, the majority of patients can be coached to provide acceptable and repeatable results. This allows potentially wide application of testing to improve recognition and diagnosis of COPD, such as for case finding in primary care. However, COPD remains substantially under diagnosed in primary care and a major reason for this is underuse of spirometry. The presence of symptoms is not a reliable indicator of disease and diagnosis is often delayed until more severe airflow obstruction is present. Early diagnosis is worthwhile, as it allows risk factors for COPD such as smoking to be addressed promptly and treatment optimised. Paradoxically, investigation of the patho-physiology in COPD has shown that extensive small airway disease exists before it is detectable with conventional spirometric indices, and methods to detect airway disease earlier using the flow-volume curve are discussed. PMID:25478197

  11. Improving diagnosis of appendicitis. Early autologous leukocyte scanning.

    PubMed

    DeLaney, A R; Raviola, C A; Weber, P N; McDonald, P T; Navarro, D A; Jasko, I

    1989-10-01

    A prospective nonrandomized study investigating the accuracy and utility of autologous leukocyte scanning in the diagnosis of apendicitis was performed. One hundred patients in whom the clinical diagnosis of appendicitis was uncertain underwent indium 111 oxyquinoline labelling of autologous leukocytes and underwent scanning 2 hours following reinjection. Of 32 patients with proved appendicitis, three scans revealed normal results (false-negative rate, 0.09). Of 68 patients without appendicitis, three scans had positive results (false-positive rate, 0.03; sensitivity, 0.91; specificity, 0.97; predictive value of positive scan, 0.94; predictive value of negative scan, 0.96; and overall accuracy, 0.95). Scan results altered clinical decisions in 19 patients. In 13 cases, the scan produced images consistent with diagnoses other than appendicitis, expediting appropriate management. Early-imaging111 In oxyquinoline autologous leukocyte scanning is a practical and highly accurate adjunct for diagnosing appendicitis.

  12. Improving diagnosis of appendicitis. Early autologous leukocyte scanning

    SciTech Connect

    DeLaney, A.R.; Raviola, C.A.; Weber, P.N.; McDonald, P.T.; Navarro, D.A.; Jasko, I. )

    1989-10-01

    A prospective nonrandomized study investigating the accuracy and utility of autologous leukocyte scanning in the diagnosis of appendicitis was performed. One hundred patients in whom the clinical diagnosis of appendicitis was uncertain underwent indium 111 oxyquinoline labelling of autologous leukocytes and underwent scanning 2 hours following reinjection. Of 32 patients with proved appendicitis, three scans revealed normal results (false-negative rate, 0.09). Of 68 patients without appendicitis, three scans had positive results (false-positive rate, 0.03; sensitivity, 0.91; specificity, 0.97; predictive value of positive scan, 0.94; predictive value of negative scan, 0.96; and overall accuracy, 0.95). Scan results altered clinical decisions in 19 patients. In 13 cases, the scan produced images consistent with diagnoses other than appendicitis, expediting appropriate management. Early-imaging In 111 oxyquinoline autologous leukocyte scanning is a practical and highly accurate adjunct for diagnosing appendicitis.

  13. Fourier-based shape feature extraction technique for computer-aided B-Mode ultrasound diagnosis of breast tumor.

    PubMed

    Lee, Jong-Ha; Seong, Yeong Kyeong; Chang, Chu-Ho; Park, Jinman; Park, Moonho; Woo, Kyoung-Gu; Ko, Eun Young

    2012-01-01

    Early detection of breast tumor is critical in determining the best possible treatment approach. Due to its superiority compared with mammography in its possibility to detect lesions in dense breast tissue, ultrasound imaging has become an important modality in breast tumor detection and classification. This paper discusses the novel Fourier-based shape feature extraction techniques that provide enhanced classification accuracy for breast tumor in the computer-aided B-mode ultrasound diagnosis system. To demonstrate the effectiveness of the proposed method, experiments were performed using 4,107 ultrasound images with 2,508 malignancy cases. Experimental results show that the breast tumor classification accuracy of the proposed technique was 15.8%, 5.43%, 17.32%, and 13.86% higher than the previous shape features such as number of protuberances, number of depressions, lobulation index, and dissimilarity, respectively. PMID:23367430

  14. Fourier-based shape feature extraction technique for computer-aided B-Mode ultrasound diagnosis of breast tumor.

    PubMed

    Lee, Jong-Ha; Seong, Yeong Kyeong; Chang, Chu-Ho; Park, Jinman; Park, Moonho; Woo, Kyoung-Gu; Ko, Eun Young

    2012-01-01

    Early detection of breast tumor is critical in determining the best possible treatment approach. Due to its superiority compared with mammography in its possibility to detect lesions in dense breast tissue, ultrasound imaging has become an important modality in breast tumor detection and classification. This paper discusses the novel Fourier-based shape feature extraction techniques that provide enhanced classification accuracy for breast tumor in the computer-aided B-mode ultrasound diagnosis system. To demonstrate the effectiveness of the proposed method, experiments were performed using 4,107 ultrasound images with 2,508 malignancy cases. Experimental results show that the breast tumor classification accuracy of the proposed technique was 15.8%, 5.43%, 17.32%, and 13.86% higher than the previous shape features such as number of protuberances, number of depressions, lobulation index, and dissimilarity, respectively.

  15. Allergic contact dermatitis: early recognition and diagnosis of important allergens.

    PubMed

    Jacob, Sharon E; Steele, Tace

    2006-10-01

    Allergic contact dermatitis (ACD) is an important disease with high quality of life and economic impact. Patch testing is the procedure by which identification of the cause of ACD can be elicited. Proper performance of the test, from taking an appropriate patient history to placing the correct allergens to evaluating and educating the patient, is of utmost importance. The purpose of this article is to highlight common allergens encountered in our environment, to increase awareness for this important disease, and to underscore the importance of this testing modality. An early index of suspicion can lead to appropriate testing, diagnosis, avoidance, and cure.

  16. Psychological aspects of therapeutic abortion after early prenatal diagnosis.

    PubMed

    Di Giusto, M; Lazzari, R; Giorgetti, T; Paesano, R; Pachi, A

    1991-01-01

    The early discovery of a fetal pathology creates a "crisis" situation fraught with psychic problems for the couple who must live through it. The Authors observed a group of patients in the second trimester of pregnancy. They had all requested therapeutic abortion since serious malformation of the fetus had been confirmed. By means of a questionnaire constructed for the purpose, certain characteristics of fetal malformation and of pregnancy were evidenced, as well as the way these were experienced by the patients. The immediate and delayed reactions to the diagnosis of malformation were also studied, as was the experience lived when faced with the choice of abortion. PMID:1752049

  17. A feasibility trial of computer-aided diagnosis for enteric lesions in capsule endoscopy

    PubMed Central

    Gan, Tao; Wu, Jun-Chao; Rao, Ni-Ni; Chen, Tao; Liu, Bing

    2008-01-01

    AIM: To investigate and evaluate the feasibility of the computer-aided screening diagnosis for enteric lesions in the capsule endoscopy (CE). METHODS: After developing a series of algorithms for the screening diagnosis of the enteric lesions in CE based on their characteristic colors and contours, the normal and abnormal images obtained from 289 patients were respectively scanned and diagnosed by the CE readers and by the computer-aided screening for the enteric lesions with the image-processed software (IPS). The enteric lesions shown by the images included esoenteritis, mucosal ulcer and erosion, bleeding, space-occupying lesions, angioectasia, diverticula, parasites, etc. The images for the lesions or the suspected lesions confirmed by the CE readers and the computers were collected, and the effectiveness rate of the screening and the number of the scanned images were evaluated, respectively. RESULTS: Compared with the diagnostic results obtained by the CE readers, the total effectiveness rate (sensitivity) in the screening of the commonly-encountered enteric lesions by IPS varied from 42.9% to 91.2%, with a median of 74.2%, though the specificity and the accuracy rates were still low, and the images for the rarely-encountered lesions were difficult to differentiate from the normal images. However, the number of the images screened by IPS was 5000 on average, and only 10%-15% of the original images were left behind. As a result, a large number of normal images were excluded, and the reading time decreased from 5 h to 1 h on average. CONCLUSION: Though the total accuracy and specificity rates by the computer-aided screening for the enteric lesions with IPS are much lower than those by the CE readers, the computer-aided screening diagnosis can exclude a large number of the normal images and confine the enteric lesions to 5000 images on average, which can reduce the workload of the readers in the scanning of the images. This computer-aided screening technique can

  18. Kidney diseases in children - early diagnosis and prevention.

    PubMed

    Polenakovic, Momir; Gucev, Zoran; Tasic, Velibor

    2016-01-01

    Pediatric kidney diseases were in the focus of the World Kidney Day 2016. Macedonian pediatric nephrologists gave their contribution with public appearance in kindergartens, primary and secondary schools, with interactive lectures and discussion with the youngest about the kidney function, healthy life style and simple measures to prevent kidney and urinary tract diseases. Besides promotive appearance in the media, series of lectures were presented in front of the health professionals. The aim was to attract the attention of the professionals for early diagnosis and prevention of kidney disease. The action starts in utero, followed by early postnatal imaging and assessment, conservative treatment and in selected cases surgical treatment. The emphasis is on the multidisciplinary and comprehensive approach to children and adolescents with kidney diseases. PMID:27442411

  19. Kidney diseases in children - early diagnosis and prevention.

    PubMed

    Polenakovic, Momir; Gucev, Zoran; Tasic, Velibor

    2016-01-01

    Pediatric kidney diseases were in the focus of the World Kidney Day 2016. Macedonian pediatric nephrologists gave their contribution with public appearance in kindergartens, primary and secondary schools, with interactive lectures and discussion with the youngest about the kidney function, healthy life style and simple measures to prevent kidney and urinary tract diseases. Besides promotive appearance in the media, series of lectures were presented in front of the health professionals. The aim was to attract the attention of the professionals for early diagnosis and prevention of kidney disease. The action starts in utero, followed by early postnatal imaging and assessment, conservative treatment and in selected cases surgical treatment. The emphasis is on the multidisciplinary and comprehensive approach to children and adolescents with kidney diseases.

  20. Computer aided diagnosis for osteoporosis based on vertebral column structure analysis

    NASA Astrophysics Data System (ADS)

    Takahashi, Eiji; Kawata, Yoshiki; Niki, Noboru; Nakano, Yasutaka; Harada, Masafumi; Moriyama, Noriyuki

    2012-03-01

    Patients of osteoporosis are comprised of about 11 million people in Japan and it is one of the problems that have gained society. For preventing the osteoporosis, obtaining early detection and treatment are necessary. Multi-slice CT technology has been improving for three dimensional (3D) image analysis, higher body axis resolution and shorter scan time. 3D image analysis using multi-slice CT images of thoracic vertebra can be used for supporting diagnosis of osteoporosis. Simultaneously, this analysis can be used for lung cancer diagnosis which may lead to early detection. We develop automatic extraction and partitioning algorithm for spinal column by analyzing vertebral body structure, and the analysis algorithm of the vertebral body using shape analysis and a bone density measurement for the diagnosis of osteoporosis. An effective result was provided for the case including an insufficient complicated vertebral body bone fracture by the conventional method.

  1. Computer-aided diagnosis for osteoporosis using chest 3D CT images

    NASA Astrophysics Data System (ADS)

    Yoneda, K.; Matsuhiro, M.; Suzuki, H.; Kawata, Y.; Niki, N.; Nakano, Y.; Ohmatsu, H.; Kusumoto, M.; Tsuchida, T.; Eguchi, K.; Kaneko, M.

    2016-03-01

    The patients of osteoporosis comprised of about 13 million people in Japan and it is one of the problems the aging society has. In order to prevent the osteoporosis, it is necessary to do early detection and treatment. Multi-slice CT technology has been improving the three dimensional (3-D) image analysis with higher body axis resolution and shorter scan time. The 3-D image analysis using multi-slice CT images of thoracic vertebra can be used as a support to diagnose osteoporosis and at the same time can be used for lung cancer diagnosis which may lead to early detection. We develop automatic extraction and partitioning algorithm for spinal column by analyzing vertebral body structure, and the analysis algorithm of the vertebral body using shape analysis and a bone density measurement for the diagnosis of osteoporosis. Osteoporosis diagnosis support system obtained high extraction rate of the thoracic vertebral in both normal and low doses.

  2. Computer-aided diagnosis of breast cancer using cytological images: A systematic review.

    PubMed

    Saha, Monjoy; Mukherjee, Rashmi; Chakraborty, Chandan

    2016-10-01

    Cytological evaluation by microscopic image-based characterization [imprint cytology (IC) and fine needle aspiration cytology (FNAC)] plays an integral role in primary screening/detection of breast cancer. The sensitivity of IC and FNAC as a screening tool is dependent on the image quality and the pathologist's level of expertise. Computer-aided diagnosis (CAD) is used to assists the pathologists by developing various machine learning and image processing algorithms. This study reviews the various manual and computer-aided techniques used so far in breast cytology. Diagnostic applications were studied to estimate the role of CAD in breast cancer diagnosis. This paper presents an overview of image processing and pattern recognition techniques that have been used to address several issues in breast cytology-based CAD including slide preparation, staining, microscopic imaging, pre-processing, segmentation, feature extraction and diagnostic classification. This review provides better insights to readers regarding the state of the art the knowledge on CAD-based breast cancer diagnosis to date. PMID:27528421

  3. Computer-aided diagnosis of breast cancer using cytological images: A systematic review.

    PubMed

    Saha, Monjoy; Mukherjee, Rashmi; Chakraborty, Chandan

    2016-10-01

    Cytological evaluation by microscopic image-based characterization [imprint cytology (IC) and fine needle aspiration cytology (FNAC)] plays an integral role in primary screening/detection of breast cancer. The sensitivity of IC and FNAC as a screening tool is dependent on the image quality and the pathologist's level of expertise. Computer-aided diagnosis (CAD) is used to assists the pathologists by developing various machine learning and image processing algorithms. This study reviews the various manual and computer-aided techniques used so far in breast cytology. Diagnostic applications were studied to estimate the role of CAD in breast cancer diagnosis. This paper presents an overview of image processing and pattern recognition techniques that have been used to address several issues in breast cytology-based CAD including slide preparation, staining, microscopic imaging, pre-processing, segmentation, feature extraction and diagnostic classification. This review provides better insights to readers regarding the state of the art the knowledge on CAD-based breast cancer diagnosis to date.

  4. Early Commitment Financial Aid Programs: Promises, Practices, and Policies

    ERIC Educational Resources Information Center

    Blanco, Cheryl D.

    2005-01-01

    Student financial assistance has long been a means to promote access to postsecondary education and attainment of college degrees. Numerous types of financial aid programs have proliferated over the years, including a relatively new concept that specifically targets high-risk, low-income students, focusing not just on getting them to go to college…

  5. Preimplantation genetic diagnosis for early-onset torsion dystonia.

    PubMed

    Rechitsky, S; Verlinsky, O; Kuliev, A; Ozen, S; Laziuk, K; Beck, R; Gleicher, N; Verlinsky, Y

    2004-02-01

    Early-onset primary torsion dystonia (DYT1) is the most severe and common form of hereditary movement disorders, characterized by sustained twisting contractures that begin in childhood, which is caused in majority of cases by a 3-bp deletion of the DYT1 gene on chromosome 9q34 at the heterozygote state. As there is no effective treatment of this disease, preimplantation genetic diagnosis (PGD) may be a useful option for at-risk couples to establish an DYT1 mutation-free pregnancy. PGD was performed for two obligate carriers of the DYT1 3-bp deletion, using blastomere testing to preselect the mutation-free embryos, based on mutation analysis with simultaneous testing of the three closely linked markers, D9S62, D9S63 and ASS. Of 19 tested blastomeres in three cycles, 17 had conclusive information about the mutation and linked markers, of which eight were predicted to be free of 3-bp deletion. Six of these embryos were transferred back to patients, two in each cycle, yielding singleton DYT1 3-bp deletion-free clinical pregnancies in two. One of these pregnancies was terminated due to severe anencephaly and the other resulted in birth of a mutation-free child. This is the first PGD for primary torsion dystonia, providing an alternative for those at-risk couples who cannot accept prenatal diagnosis and termination of pregnancy as an option for avoiding early onset torsion dystonia.

  6. The diagnosis of early pregnancy failure by sonar.

    PubMed

    Robinson, H P

    1975-11-01

    In a series of 425 consecutive patients examined by sonar in the first half of pregnancy 176 ultimately aborted. On analysis of the sonar and post-abortion findings it was found that the aborted pregnancies fell into five clearly defined groups; blighted ova or anembryonic pregnancies, missed abortions, hydatidiform moles and early and late live abortions. The blighted ova and the missed abortions comprised by far the largest and the early live abortions the smallest groups. Strict diagnostic sonar criteria of abnormality, independent of menstrual or clinical histories, were established for the first three of the groups, and an absolute diagnosis could be made at the time of the first examination in all cases of missed abortion and hydatidiform mole and in just over half of the cases of blighted ovum, the remainder requiring a second and occasionally a third examination. In the first half of the study the majority of the patients were allowed to abort spontaneously but with increasing confidence in the techniques patients were offered termination whenever the diagnosis of an abortive pregnancy was made. Anticipation of fetal death in utero or impending abortion of a live fetus proved to be a much more difficult problem, and in only those patients who aborted a live fetus before the tenth week of pregnancy did the sonar examination reveal any significant abnormality. Possible aetiological backgrounds to these groups of abortions are discussed in the light of the sonar findings.

  7. Computer Aided Diagnosis for Confocal Laser Endomicroscopy in Advanced Colorectal Adenocarcinoma

    PubMed Central

    Ştefănescu, Daniela; Streba, Costin; Cârţână, Elena Tatiana; Săftoiu, Adrian; Gruionu, Gabriel; Gruionu, Lucian Gheorghe

    2016-01-01

    Introduction Confocal laser endomicroscopy (CLE) is becoming a popular method for optical biopsy of digestive mucosa for both diagnostic and therapeutic procedures. Computer aided diagnosis of CLE images, using image processing and fractal analysis can be used to quantify the histological structures in the CLE generated images. The aim of this study is to develop an automatic diagnosis algorithm of colorectal cancer (CRC), based on fractal analysis and neural network modeling of the CLE-generated colon mucosa images. Materials and Methods We retrospectively analyzed a series of 1035 artifact-free endomicroscopy images, obtained during CLE examinations from normal mucosa (356 images) and tumor regions (679 images). The images were processed using a computer aided diagnosis (CAD) medical imaging system in order to obtain an automatic diagnosis. The CAD application includes image reading and processing functions, a module for fractal analysis, grey-level co-occurrence matrix (GLCM) computation module, and a feature identification module based on the Marching Squares and linear interpolation methods. A two-layer neural network was trained to automatically interpret the imaging data and diagnose the pathological samples based on the fractal dimension and the characteristic features of the biological tissues. Results Normal colon mucosa is characterized by regular polyhedral crypt structures whereas malignant colon mucosa is characterized by irregular and interrupted crypts, which can be diagnosed by CAD. For this purpose, seven geometric parameters were defined for each image: fractal dimension, lacunarity, contrast correlation, energy, homogeneity, and feature number. Of the seven parameters only contrast, homogeneity and feature number were significantly different between normal and cancer samples. Next, a two-layer feed forward neural network was used to train and automatically diagnose the malignant samples, based on the seven parameters tested. The neural network

  8. Cone beam computed tomography aided diagnosis and treatment of endodontic cases: Critical analysis.

    PubMed

    Yılmaz, Funda; Kamburoglu, Kıvanç; Yeta, Naz Yakar; Öztan, Meltem Dartar

    2016-07-28

    Although intraoral radiographs still remain the imaging method of choice for the evaluation of endodontic patients, in recent years, the utilization of cone beam computed tomography (CBCT) in endodontics showed a significant jump. This case series presentation shows the importance of CBCT aided diagnosis and treatment of complex endodontic cases such as; root resorption, missed extra canal, fusion, oblique root fracture, non-diagnosed periapical pathology and horizontal root fracture. CBCT may be a useful diagnostic method in several endodontic cases where intraoral radiography and clinical examination alone are unable to provide sufficient information. PMID:27551342

  9. Cone beam computed tomography aided diagnosis and treatment of endodontic cases: Critical analysis

    PubMed Central

    Yılmaz, Funda; Kamburoglu, Kıvanç; Yeta, Naz Yakar; Öztan, Meltem Dartar

    2016-01-01

    Although intraoral radiographs still remain the imaging method of choice for the evaluation of endodontic patients, in recent years, the utilization of cone beam computed tomography (CBCT) in endodontics showed a significant jump. This case series presentation shows the importance of CBCT aided diagnosis and treatment of complex endodontic cases such as; root resorption, missed extra canal, fusion, oblique root fracture, non-diagnosed periapical pathology and horizontal root fracture. CBCT may be a useful diagnostic method in several endodontic cases where intraoral radiography and clinical examination alone are unable to provide sufficient information. PMID:27551342

  10. Computer-aided diagnosis of digital mammography images using unsupervised clustering and biclustering techniques

    NASA Astrophysics Data System (ADS)

    Al-Olfe, Mohamed A.; Al-Akwaa, Fadhl M.; Mohamed, Wael A.; Kadah, Yasser M.

    2010-03-01

    A new methodology for computer aided diagnosis in digital mammography using unsupervised classification and classdependent feature selection is presented. This technique considers unlabeled data and provides unsupervised classes that give a better insight into classes and their interrelationships, thus improving the overall effectiveness of the diagnosis. This technique is also extended to utilize biclustering methods, which allow for definition of unsupervised clusters of both pathologies and features. This has potential to provide more flexibility, and hence better diagnostic accuracy, than the commonly used feature selection strategies. The developed methods are applied to diagnose digital mammographic images from the Mammographic Image Analysis Society (MIAS) database and the results confirm the potential for improving the current diagnostic rates.

  11. Computer aided diagnosis for severity assessment of pneumoconiosis using CT images

    NASA Astrophysics Data System (ADS)

    Suzuki, Hidenobu; Matsuhiro, Mikio; Kawata, Yoshiki; Niki, Noboru; Kato, Katsuya; Kishimoto, Takumi; Ashizawa, Kazuto

    2016-03-01

    240,000 participants have a screening for diagnosis of pneumoconiosis every year in Japan. Radiograph is used for staging of severity in pneumoconiosis worldwide. This paper presents a method for quantitative assessment of severity in pneumoconiosis using both size and frequency of lung nodules that detected by thin-section CT images. This method consists of three steps. First, thoracic organs (body, ribs, spine, trachea, bronchi, lungs, heart, and pulmonary blood vessels) are segmented. Second, lung nodules that have radius over 1.5mm are detected. These steps used functions of our developed computer aided detection system of chest CT images. Third, severity in pneumoconiosis is quantified using size and frequency of lung nodules. This method was applied to nine pneumoconiosis patients. The initial results showed that proposed method can assess severity in pneumoconiosis quantitatively. This paper demonstrates effectiveness of our method in diagnosis and prognosis of pneumoconiosis in CT screening.

  12. Computer-Aided Diagnosis and Quantification of Cirrhotic Livers Based on Morphological Analysis and Machine Learning

    PubMed Central

    Chen, Yen-Wei; Luo, Jie; Dong, Chunhua; Han, Xianhua; Tateyama, Tomoko; Furukawa, Akira; Kanasaki, Shuzo

    2013-01-01

    It is widely known that morphological changes of the liver and the spleen occur during the clinical course of chronic liver diseases. In this paper, we proposed a morphological analysis method based on statistical shape models (SSMs) of the liver and spleen for computer-aided diagnosis and quantification of the chronic liver. We constructed not only the liver SSM but also the spleen SSM and a joint SSM of the liver and the spleen for a morphologic analysis of the cirrhotic liver in CT images. The effective modes are selected based on both its accumulation contribution rate and its correlation with doctor's opinions (stage labels). We then learn a mapping function between the selected mode and the stage of chronic liver. The mapping function was used for diagnosis and staging of chronic liver diseases. PMID:24187579

  13. The Recent Progress in Quantitative Medical Image Analysis for Computer Aided Diagnosis Systems

    PubMed Central

    Kim, Tae-Yun; Son, Jaebum

    2011-01-01

    Computer-aided diagnosis (CAD) has become one of the major research subjects in medical imaging and diagnostic radiology. Many different CAD schemes are being developed for use in the detection and/or characterization of various lesions found through various types of medical imaging. These imaging technologies employ conventional projection radiography, computed tomography, magnetic resonance imaging, ultrasonography, etc. In order to achieve a high performance level for a computerized diagnosis, it is important to employ effective image analysis techniques in the major steps of a CAD scheme. The main objective of this review is to attempt to introduce the diverse methods used for quantitative image analysis, and to provide a guide for clinicians. PMID:22084808

  14. Design-based approach to ethics in computer-aided diagnosis

    NASA Astrophysics Data System (ADS)

    Collmann, Jeff R.; Lin, Jyh-Shyan; Freedman, Matthew T.; Wu, Chris Y.; Hayes, Wendelin S.; Mun, Seong K.

    1996-04-01

    A design-based approach to ethical analysis examines how computer scientists, physicians and patients make and justify choices in designing, using and reacting to computer-aided diagnosis (CADx) systems. The basic hypothesis of this research is that values are embedded in CADx systems during all phases of their development, not just retrospectively imposed on them. This paper concentrates on the work of computer scientists and physicians as they attempt to resolve central technical questions in designing clinically functional CADx systems for lung cancer and breast cancer diagnosis. The work of Lo, Chan, Freedman, Lin, Wu and their colleagues provides the initial data on which this study is based. As these researchers seek to increase the rate of true positive classifications of detected abnormalities in chest radiographs and mammograms, they explore dimensions of the fundamental ethical principal of beneficence. The training of CADx systems demonstrates the key ethical dilemmas inherent in their current design.

  15. Combining multifractal analyses of digital mammograms and infrared thermograms to assist in early breast cancer diagnosis

    NASA Astrophysics Data System (ADS)

    Gerasimova-Chechkina, E.; Toner, B.; Marin, Z.; Audit, B.; Roux, S. G.; Argoul, F.; Khalil, A.; Gileva, O.; Naimark, O.; Arneodo, A.

    2016-08-01

    We used a 1D wavelet transform modulus maxima (WTMM) method to analyze the temporal fluctuations of breast skin temperature recorded with an infrared (IR) camera from a panel of patients with breast cancer. This study shows that the multifractal complexity of temperature fluctuations observed in healthy breasts, is lost in the region of the malignant tumor in cancerous breasts. Then, we applied the 2D WTMM method to analyze the spatial fluctuations of breast density in the X-ray mammograms of the same patients. Compared to the correlated roughness fluctuations observed in the healthy areas, some clear loss of correlations is detected in malignant tumor foci. These physiological and architectural changes in the environment of malignant tumors detected in both thermograms and mammograms open new perspectives in computer-aided multifractal methods to assist in early breast cancer diagnosis.

  16. Detection of longitudinal ulcer using roughness value for computer aided diagnosis of Crohn's disease

    NASA Astrophysics Data System (ADS)

    Oda, Masahiro; Kitasaka, Takayuki; Furukawa, Kazuhiro; Watanabe, Osamu; Ando, Takafumi; Goto, Hidemi; Mori, Kensaku

    2011-03-01

    The purpose of this paper is to present a new method to detect ulcers, which is one of the symptoms of Crohn's disease, from CT images. Crohn's disease is an inflammatory disease of the digestive tract. Crohn's disease commonly affects the small intestine. An optical or a capsule endoscope is used for small intestine examinations. However, these endoscopes cannot pass through intestinal stenosis parts in some cases. A CT image based diagnosis allows a physician to observe whole intestine even if intestinal stenosis exists. However, because of the complicated shape of the small and large intestines, understanding of shapes of the intestines and lesion positions are difficult in the CT image based diagnosis. Computer-aided diagnosis system for Crohn's disease having automated lesion detection is required for efficient diagnosis. We propose an automated method to detect ulcers from CT images. Longitudinal ulcers make rough surface of the small and large intestinal wall. The rough surface consists of combination of convex and concave parts on the intestinal wall. We detect convex and concave parts on the intestinal wall by a blob and an inverse-blob structure enhancement filters. A lot of convex and concave parts concentrate on roughed parts. We introduce a roughness value to differentiate convex and concave parts concentrated on the roughed parts from the other on the intestinal wall. The roughness value effectively reduces false positives of ulcer detection. Experimental results showed that the proposed method can detect convex and concave parts on the ulcers.

  17. Survey on computer aided decision support for diagnosis of celiac disease

    PubMed Central

    Hegenbart, Sebastian; Uhl, Andreas; Vécsei, Andreas

    2015-01-01

    Celiac disease (CD) is a complex autoimmune disorder in genetically predisposed individuals of all age groups triggered by the ingestion of food containing gluten. A reliable diagnosis is of high interest in view of embarking on a strict gluten-free diet, which is the CD treatment modality of first choice. The gold standard for diagnosis of CD is currently based on a histological confirmation of serology, using biopsies performed during upper endoscopy. Computer aided decision support is an emerging option in medicine and endoscopy in particular. Such systems could potentially save costs and manpower while simultaneously increasing the safety of the procedure. Research focused on computer-assisted systems in the context of automated diagnosis of CD has started in 2008. Since then, over 40 publications on the topic have appeared. In this context, data from classical flexible endoscopy as well as wireless capsule endoscopy (WCE) and confocal laser endomicrosopy (CLE) has been used. In this survey paper, we try to give a comprehensive overview of the research focused on computer-assisted diagnosis of CD. PMID:25770906

  18. The association between combination antiretroviral adherence and AIDS-defining conditions at HIV diagnosis.

    PubMed

    Abara, Winston E; Xu, Junjun; Adekeye, Oluwatoyosi A; Rust, George

    2016-08-01

    Combination antiretroviral therapy (cART) has changed the clinical course of HIV. AIDS-defining conditions (ADC) are suggestive of severe or advanced disease and are a leading cause of HIV-related hospitalizations and death among people living with HIV/AIDS (PLWHA) in the USA. Optimal adherence to cART can mitigate the impact of ADC and disease severity on the health and survivability of PLWHA. The objective of this study was to evaluate the association between ADC at HIV diagnosis and optimal adherence among PLWHA. Using data from the 2008 and 2009 Medicaid data from 29 states, we identified individuals, between 18 and 49 years, recently infected with HIV and with a cART prescription. Frequencies and descriptive statistics were conducted to characterize sample. Univariate and multivariable Poisson regression analyses were employed to evaluate the association optimal cART adherence (defined as ≥ 95% study days covered by cART) and ADC at HIV diagnosis (≥1 ADC) were assessed. Approximately 17% of respondents with ADC at HIV diagnosis reported optimal cART adherence. After adjusting for covariates, respondents with an ADC at HIV diagnosis were less likely to report optimal cART adherence (adjusted prevalence ratio (APR) = 0.64, 95% confidence intervals (CI), 0.54-0.75). Among the covariates, males (APR=1.10, 95% CI, 1.02-1.19) compared to females were significantly more likely to report optimal adherence while younger respondents, 18-29 years (APR=0.67, 95% CI, 0.57-0.77), 30-39 years (APR=0.86, 95% CI, 0.79-0.95) compared to older respondents were significantly less likely to report optimal adherence. PLWHA with ADC at HIV diagnosis are at risk of suboptimal cART adherence. Multiple adherence strategies that include healthcare providers, case managers, and peer navigators should be utilized to improve cART adherence and optimize health outcomes among PLWHA with ADC at HIV diagnosis. Targeted adherence programs and services are required to address

  19. Retinal vessel detection and measurement for computer-aided medical diagnosis.

    PubMed

    Li, Xiaokun; Wee, William G

    2014-02-01

    Since blood vessel detection and characteristic measurement for ocular retinal images is a fundamental problem in computer-aided medical diagnosis, automated algorithms/systems for vessel detection and measurement are always demanded. To support computer-aided diagnosis, an integrated approach/solution for vessel detection and diameter measurement is presented and validated. In the proposed approach, a Dempster-Shafer (D-S)-based edge detector is developed to obtain initial vessel edge information and an accurate vascular map for a retinal image. Then, the appropriate path and the centerline of a vessel of interest are identified automatically through graph search. Once the vessel path has been identified, the diameter of the vessel will be measured accordingly by the algorithm in real time. To achieve more accurate edge detection and diameter measurement, mixed Gaussian-matched filters are designed to refine the initial detection and measures. Other important medical indices of retinal vessels can also be calculated accordingly based on detection and measurement results. The efficiency of the proposed algorithm was validated by the retinal images obtained from different public databases. Experimental results show that the vessel detection rate of the algorithm is 100 % for large vessels and 89.9 % for small vessels, and the error rate on vessel diameter measurement is less than 5 %, which are all well within the acceptable range of deviation among the human graders.

  20. PSA Isoforms' Velocities for Early Diagnosis of Prostate Cancer.

    PubMed

    Heidegger, Isabel; Klocker, Helmut; Pichler, Renate; Horninger, Wolfgang; Bektic, Jasmin

    2015-06-01

    Free prostate-specific antigen (fPSA) and its molecular isoforms are suggested for enhancement of PSA testing in prostate cancer (PCa). In the present study we evaluated whether PSA isoforms' velocities might serve as a tool to improve early PCa diagnosis. Our study population included 381 men who had undergone at least one ultrasound-guided prostate biopsy whose pathologic examination yielded PCa or showed no evidence of prostatic malignancy. Serial PSA, fPSA, and proPSA measurements were performed on serum samples covering 7 years prior to biopsy using Beckmann Coulter Access immunoassays. Afterwards, velocities of PSA (PSAV), fPSA% (fPSA%V), proPSA% (proPSA%V) and the ratio proPSA/PSA/V were calculated and their ability to discriminate cancer from benign disease was evaluated. Among 381 men included in the study, 202 (53%) were diagnosed with PCa and underwent radical prostatectomy at our Department. PSAV, fPSA%V, proPSA%V as well as proPSA/PSA/V were able to differentiate significantly between PCa and non-cancerous prostate. The highest discriminatory power between cancer and benign disease has been observed two and one year prior to diagnosis with all measured parameters. Among all measured parameters, fPSA%V showed the best cancer specificity of 45.3% with 90% of sensitivity. In summary, our results highlight the value of PSA isoforms' velocity for early detection of PCa. Especially fPSA%V should be used in the clinical setting to increase cancer detection specificity.

  1. Cystatin C Falsely Underestimated GFR in a Critically Ill Patient with a New Diagnosis of AIDS

    PubMed Central

    Brown, Caitlin S.; Kashani, Kianoush B.; Clain, Jeremy M.

    2016-01-01

    Cystatin C has been suggested to be a more accurate glomerular filtration rate (GFR) surrogate than creatinine in patients with acquired immunodeficiency syndrome (AIDS) because it is unaffected by skeletal muscle mass and dietary influences. However, little is known about the utility of this marker for monitoring medications in the critically ill. We describe the case of a 64-year-old female with opportunistic infections associated with a new diagnosis of AIDS. During her course, she experienced neurologic, cardiac, and respiratory failure; yet her renal function remained preserved as indicated by an eGFR ≥ 120 mL/min and a urine output > 1 mL/kg/hr without diuresis. The patient was treated with nephrotoxic agents; therefore cystatin C was assessed to determine if cachexia was resulting in a falsely low serum creatinine. Cystatin C measured 1.50 mg/L which corresponded to an eGFR of 36 mL/min. Given the >60 mL/min discrepancy, serial 8-hour urine samples were collected and a GFR > 120 mL/min was confirmed. It is unclear why cystatin C was falsely elevated, but we hypothesize that it relates to the proinflammatory state with AIDS, opportunistic infections, and corticosteroids. More research is needed before routine use of cystatin C in this setting can be recommended. PMID:27293926

  2. [Progress in nuclear magnetic resonance spectroscopy for early cancer diagnosis].

    PubMed

    Gao, Xiu-xiang; Xu, Yi-zhuang; Zhao, Mei-xian; Qi, Jian; Li, Hui-zhen; Wu, Jin-guang

    2008-08-01

    Based on more than 100 references, the present paper reviews the progress in the application of nuclear magnetic resonance (NMR) spectroscopy, an effective method to study the variation in chemical composition and molecular structure in biological samples for early diagnosis of cancer at molecular level. In the past several decades, numerous works have demonstrated that NMR spectroscopy may be developed into a sensitive diagnosis method to detect cancer in early stage. Because of the rapid development of NMR spectroscopic techniques, it becomes possible to record NMR spectra of biological samples in both in-vitro and in-vivo manner. Systematic spectral differences between biological samples from cancer patients and normal controls can be observed from both liquid-state and solid-state 1H, 31P NMR spectra and used to reflect the changes in metabolic behavior of malignant tissues. This paper has summarized NMR spectroscopic investigation on biological fluid, cultured cancerous cells, resected tissues, as well as in-vivo malignant tissues by using various advanced NMR techniques including recently developedhigh-resolution magic angle spinning (HR-MAS)and magnetic resonance spectroscopy and imaging (MRSI) methods. First, characteristic peaks, which are related to choline, phosphocholine (PC) and glycerophosphocholine, can be observed in both 1H and 31P NMR spectra of biological fluid samples from cancer patients. These results indicate that alternation in the metabolic pattern occurs with the progression of cancer. The research on cultured cells by using NMR spectroscopy showed that the signal of various phospholipids and their metabolites such as PME increased significantly in cultured cancer cells. For resected tissues, two methods can be utilized. The first one is to investigate the tissues directly by using HR-MAS spectroscopy. The second method is to extract various metabolites with various solvents such as CHCl3/methonal mixtures, HClO4 solutions, etc. and then

  3. Technology-Aided Assessment of Sensorimotor Function in Early Infancy

    PubMed Central

    Allievi, Alessandro G.; Arichi, Tomoki; Gordon, Anne L.; Burdet, Etienne

    2014-01-01

    There is a pressing need for new techniques capable of providing accurate information about sensorimotor function during the first 2 years of childhood. Here, we review current clinical methods and challenges for assessing motor function in early infancy, and discuss the potential benefits of applying technology-assisted methods. We also describe how the use of these tools with neuroimaging, and in particular functional magnetic resonance imaging (fMRI), can shed new light on the intra-cerebral processes underlying neurodevelopmental impairment. This knowledge is of particular relevance in the early infant brain, which has an increased capacity for compensatory neural plasticity. Such tools could bring a wealth of knowledge about the underlying pathophysiological processes of diseases such as cerebral palsy; act as biomarkers to monitor the effects of possible therapeutic interventions; and provide clinicians with much needed early diagnostic information. PMID:25324827

  4. Autofluorescence spectroscopy for early diagnosis of cancer eye

    NASA Astrophysics Data System (ADS)

    Majumder, Shovan K.; Ghosh, Nirmalya; Rathod, Sopan M.; Gupta, Pradeep K.

    2007-02-01

    We report an in-vitro autofluorescence spectroscopic study of cow eye tissue to explore the applicability of the approach in discriminating early stage "cancer eye" from normal squamous eye tissues. Significant differences were observed in the autofluorescence signatures between the "cancer eye" and normal eye tissues. The spectral differences were quantified by employing a probability-based diagnostic algorithm developed based on recently formulated theory of Relevance Vector Machine (RVM), a Bayesian machine-learning framework of statistical pattern recognition. The algorithm provided sensitivity and specificity values of 97 +/- 2% towards cancer for the training set data based on leave-one-out cross validation and a sensitivity of 97 +/- 2% and a specificity of 99 +/- 1% towards cancer for the independent validation set data. These results suggest that autofluorescence spectroscopy might prove to be a quantitative in-vivo diagnostic modality for early and accurate diagnosis of "cancer eye" in veterinary clinical setting, which would help improve ranch management from both economic and animal care standpoint.

  5. Spectrum of complicated migraine in children: A common profile in aid to clinical diagnosis

    PubMed Central

    Gupta, Surya N; Gupta, Vikash S; Fields, Dawn M

    2015-01-01

    Complicated migraine encompasses several individual clinical syndromes of migraine. Such a syndrome in children frequently presents with various neurological symptoms in the Emergency Department. An acute presentation in the absence of headache presents a diagnostic challenge. A delay in diagnosis and treatment may have medicolegal implication. To date, there are no reports of a common clinical profile proposed in making a clinical diagnosis for the complicated migraine. In this clinical review, we propose and describe: (1) A common clinical profile in aid to clinical diagnosis for spectrum of complicated migraine; (2) How it can be used in differentiating complicated migraine from migraine without aura, migraine with aura, and seizure; (3) We discuss the status of complicated migraine in the International Headache Society classification 2013; and (4) In addition, a common treatment strategy for the spectrum of migraine has been described. To diagnose complicated migraine clinically, it is imperative to adhere with the proposed profile. This will optimize the use of investigation and will also avoid a legal implication of delay in their management. The proposed common clinical profile is incongruent with the International Headache Society 2013. Future classification should minimize the dissociation from clinically encountered syndromes and coin a single word to address collectively this subtype of migraine with an acute presentation of a common clinical profile. PMID:25664241

  6. Towards a computer-aided diagnosis system for colon motility dysfunctions

    NASA Astrophysics Data System (ADS)

    Glocker, Ben; Buhmann, Sonja; Kirchhoff, Chlodwig; Mussack, Thomas; Reiser, Maximilian; Navab, Nassir

    2007-03-01

    Colon motility disorders are a very common problem. A precise diagnosis with current methods is almost unachievable. This makes it extremely difficult for the clinical experts to decide for the right intervention such as colon resection. The use of cine MRI for visualizing the colon motility is a very promising technique. In addition, if image segmentation and qualitative motion analysis provide the necessary tools, it could provide the appropriate diagnostic solution. In this work we defined necessary steps in the image processing workflow to gain valuable measurements for a computer aided diagnosis of colon motility disorders. For each step, we developed methods to deal with the dynamic image data. There is need for compensating the breathing motion since no respiratory gating could be used. We segment the colon using a graph cuts approach in 2D and 3D for further analysis and visualization. The analysis of the large bowel motility is done by tracking the extension of the colon during a propagating peristaltic wave. The main objective of this work is to extract a motion model to define a clinical index that can be used in diagnosis of large bowel motility dysfunction. We aim at the classification and localization of such pathologies.

  7. Computer-aided diagnosis of breast cancer based on fine needle biopsy microscopic images.

    PubMed

    Kowal, Marek; Filipczuk, Paweł; Obuchowicz, Andrzej; Korbicz, Józef; Monczak, Roman

    2013-10-01

    Prompt and widely available diagnostics of breast cancer is crucial for the prognosis of patients. One of the diagnostic methods is the analysis of cytological material from the breast. This examination requires extensive knowledge and experience of the cytologist. Computer-aided diagnosis can speed up the diagnostic process and allow for large-scale screening. One of the largest challenges in the automatic analysis of cytological images is the segmentation of nuclei. In this study, four different clustering algorithms are tested and compared in the task of fast nuclei segmentation. K-means, fuzzy C-means, competitive learning neural networks and Gaussian mixture models were incorporated for clustering in the color space along with adaptive thresholding in grayscale. These methods were applied in a medical decision support system for breast cancer diagnosis, where the cases were classified as either benign or malignant. In the segmented nuclei, 42 morphological, topological and texture features were extracted. Then, these features were used in a classification procedure with three different classifiers. The system was tested for classification accuracy by means of microscopic images of fine needle breast biopsies. In cooperation with the Regional Hospital in Zielona Góra, 500 real case medical images from 50 patients were collected. The acquired classification accuracy was approximately 96-100%, which is very promising and shows that the presented method ensures accurate and objective data acquisition that could be used to facilitate breast cancer diagnosis. PMID:24034748

  8. Early Diagnosis of Colonic Anastomotic Leak With Peritoneal Endoscopy

    PubMed Central

    Gaarden, Morten; Mortensen, Frank Viborg

    2015-01-01

    Background and Objectives: At present, we do not have a reliable method for the early diagnosis of colorectal anastomotic leakage (AL). We tested peritoneal flexible endoscopy through a port placed in the abdominal wall in the early postoperative course, as a new diagnostic method for detection of this complication and evaluated the suggested method for safety, feasibility, and accuracy. Methods: Ten swine were randomized into 2 groups: group A, colorectal anastomosis without leakage; and group B, colorectal anastomosis with leakage. A button gastrostomy feeding tube was inserted percutaneously into the peritoneal cavity. Colorectal anastomosis (with or without defect) was created 48 hours after the first operation. The swine were examined by peritoneal flexible endoscopy 8 and 24 hours after the colonic operation, by a consultant surgeon who was blinded to both the presence and the allocated location of the of the anastomotic defect. Results: None of the animals showed signs of illness 48 hours after the intraperitoneal gastrostomy tube placement. More than half of the anastomosis circumference was identified in 60 and 10% of the animals at endoscopy 8 and 24 hours, respectively, after the anastomosis was created. Excessive adhesion formation was observed in all animals, irrespective of AL. The sensitivity and specificity of endoscopy in detecting peritonitis 24 hours after AL were both 60%. Conclusions: Peritoneal endoscopy is a safe and simple procedure. Visualization of the peritoneal cavity in the early postoperative course was limited due to adhesion formation. Further studies are needed to clarify the accuracy of the procedure and to address additional methodological concerns. PMID:26273185

  9. Computer-Aided Diagnosis of Micro-Malignant Melanoma Lesions Applying Support Vector Machines.

    PubMed

    Jaworek-Korjakowska, Joanna

    2016-01-01

    Background. One of the fatal disorders causing death is malignant melanoma, the deadliest form of skin cancer. The aim of the modern dermatology is the early detection of skin cancer, which usually results in reducing the mortality rate and less extensive treatment. This paper presents a study on classification of melanoma in the early stage of development using SVMs as a useful technique for data classification. Method. In this paper an automatic algorithm for the classification of melanomas in their early stage, with a diameter under 5 mm, has been presented. The system contains the following steps: image enhancement, lesion segmentation, feature calculation and selection, and classification stage using SVMs. Results. The algorithm has been tested on 200 images including 70 melanomas and 130 benign lesions. The SVM classifier achieved sensitivity of 90% and specificity of 96%. The results indicate that the proposed approach captured most of the malignant cases and could provide reliable information for effective skin mole examination. Conclusions. Micro-melanomas due to the small size and low advancement of development create enormous difficulties during the diagnosis even for experts. The use of advanced equipment and sophisticated computer systems can help in the early diagnosis of skin lesions. PMID:27382567

  10. Computer-Aided Diagnosis of Micro-Malignant Melanoma Lesions Applying Support Vector Machines

    PubMed Central

    2016-01-01

    Background. One of the fatal disorders causing death is malignant melanoma, the deadliest form of skin cancer. The aim of the modern dermatology is the early detection of skin cancer, which usually results in reducing the mortality rate and less extensive treatment. This paper presents a study on classification of melanoma in the early stage of development using SVMs as a useful technique for data classification. Method. In this paper an automatic algorithm for the classification of melanomas in their early stage, with a diameter under 5 mm, has been presented. The system contains the following steps: image enhancement, lesion segmentation, feature calculation and selection, and classification stage using SVMs. Results. The algorithm has been tested on 200 images including 70 melanomas and 130 benign lesions. The SVM classifier achieved sensitivity of 90% and specificity of 96%. The results indicate that the proposed approach captured most of the malignant cases and could provide reliable information for effective skin mole examination. Conclusions. Micro-melanomas due to the small size and low advancement of development create enormous difficulties during the diagnosis even for experts. The use of advanced equipment and sophisticated computer systems can help in the early diagnosis of skin lesions. PMID:27382567

  11. Role of Gist and PHOG Features in Computer-Aided Diagnosis of Tuberculosis without Segmentation

    PubMed Central

    Chauhan, Arun; Chauhan, Devesh; Rout, Chittaranjan

    2014-01-01

    Purpose Effective diagnosis of tuberculosis (TB) relies on accurate interpretation of radiological patterns found in a chest radiograph (CXR). Lack of skilled radiologists and other resources, especially in developing countries, hinders its efficient diagnosis. Computer-aided diagnosis (CAD) methods provide second opinion to the radiologists for their findings and thereby assist in better diagnosis of cancer and other diseases including TB. However, existing CAD methods for TB are based on the extraction of textural features from manually or semi-automatically segmented CXRs. These methods are prone to errors and cannot be implemented in X-ray machines for automated classification. Methods Gabor, Gist, histogram of oriented gradients (HOG), and pyramid histogram of oriented gradients (PHOG) features extracted from the whole image can be implemented into existing X-ray machines to discriminate between TB and non-TB CXRs in an automated manner. Localized features were extracted for the above methods using various parameters, such as frequency range, blocks and region of interest. The performance of these features was evaluated against textural features. Two digital CXR image datasets (8-bit DA and 14-bit DB) were used for evaluating the performance of these features. Results Gist (accuracy 94.2% for DA, 86.0% for DB) and PHOG (accuracy 92.3% for DA, 92.0% for DB) features provided better results for both the datasets. These features were implemented to develop a MATLAB toolbox, TB-Xpredict, which is freely available for academic use at http://sourceforge.net/projects/tbxpredict/. This toolbox provides both automated training and prediction modules and does not require expertise in image processing for operation. Conclusion Since the features used in TB-Xpredict do not require segmentation, the toolbox can easily be implemented in X-ray machines. This toolbox can effectively be used for the mass screening of TB in high-burden areas with improved efficiency. PMID

  12. Computer-aided diagnosis of peripheral soft tissue masses based on ultrasound imaging.

    PubMed

    Chiou, Hong-Jen; Chen, Chih-Yen; Liu, Tzu-Chiang; Chiou, See-Ying; Wang, Hsin-Kai; Chou, Yi-Hong; Chiang, Huihua Kenny

    2009-07-01

    Medical ultrasound (US) has been widely used for distinguishing benign from malignant peripheral soft tissue tumors. However, diagnosis by US is subjective and depends on the experience of the radiologists. The rarity of peripheral soft tissue tumors can make them easily neglected and this frequently leads to delayed diagnosis, which results in a much higher death rate than with other tumors. In this paper, we developed a computer-aided diagnosis (CAD) system to diagnose peripheral soft tissue masses on US images. We retrospectively evaluated 49 cases of pathologically proven peripheral soft tissue masses (32 benign, 17 malignant). The proposed CAD system includes three main procedures: image pre-processing and region-of-interest (ROI) segmentation, feature extraction and statistics-based discriminant analysis (DA). We developed a depth-normalization factor (DNF) to compensate for the influence of the depth setting on the apparent size of the ROI. After image pre-processing and normalization, five features, namely area (A), boundary transition ratio (T), circularity (C), high intensity spots (H) and uniformity (U), were extracted from the US images. A DA function was then employed to analyze these features. A CAD algorithm was then devised for differentiating benign from malignant masses. The CAD system achieved an accuracy of 87.8%, a sensitivity of 88.2%, a specificity of 87.5%, a positive predictive value (PPV) 78.9% and a negative predictive value (NPV) 93.3%. These results indicate that the CAD system is valuable as a means of providing a second diagnostic opinion when radiologists carry out peripheral soft tissue mass diagnosis.

  13. Mean Platelet Volume in Early Diagnosis of Adnexal Torsion

    PubMed Central

    Köleli, Işıl

    2015-01-01

    Background: Adnexal torsion (AT) is among the gynecological emergencies; more common in reproductive age, if diagnosed late, this can cause ovarian failure and infertility, but rarely thrombophlebitis and peritonitis. Despite these severe complications, preoperative diagnostic tests are not enough for early diagnosis. There are certain pieces of literature on the subject that reveal changes in mean platelet volume (MPV) values occur in inflammatory and ischemic diseases and that these changes have diagnostic and prognostic significance. However, there are no studies investigating this relationship with adnexal torsion. Aims: The aim of the study is to investigate the diagnostic and prognostic significance of the mean platelet volume value in the early diagnosis of patients with adnexal torsion. Study Design: Case-control study. Methods: Pre-operative demographic data, MPV, leukocyte count and neutrophils to lymphocytes (N/L) ratio in the blood samples of 51 patients, who were operated on preliminary adnexal torsion and diagnosed as adnexal torsion with a benign ovarian cyst (AT group) were retrospectively compared with those of 50 patients who were operated upon because of benign ovarian cysts and without torsion (control group) at this hospital between 2006 and 2014. Results: The mean MPV level was found to be 8.1 (7.1–10.7) fL in the AT group and 7.9 (6.6–10.2) fL in the control group; no statistically significant difference was found between the groups (p>0.05). Leukocyte count and N/L ratio in the AT group were, on average, 12×103/mm3 and 82% respectively and in control group; they were, on average, 7.2×103/mm3 and 59%, respectively. A statistically significant increase was found in the leukocyte count and N/L ratio of the AT group compared to the control group (p<0.001). The platelet count in the AT group was, on average, 253×103/mm3 and in the control group it was, on average, 280×103/mm3; no statistically significant difference was detected between

  14. Time to HAART Initiation after Diagnosis and Treatment of Opportunistic Infections in Patients with AIDS in Latin America

    PubMed Central

    Crabtree-Ramírez, Brenda; Caro-Vega, Yanink; Shepherd, Bryan E.; Grinsztejn, Beatriz; Wolff, Marcelo; Cortes, Claudia P.; Padgett, Denis; Carriquiry, Gabriela; Fink, Valeria; Jayathilake, Karu; Person, Anna K.; McGowan, Catherine; Sierra-Madero, Juan

    2016-01-01

    Background Since 2009, earlier initiation of highly active antiretroviral therapy (HAART) after an opportunistic infection (OI) has been recommended based on lower risks of death and AIDS-related progression found in clinical trials. Delay in HAART initiation after OIs may be an important barrier for successful outcomes in patients with advanced disease. Timing of HAART initiation after an OI in “real life” settings in Latin America has not been evaluated. Methods Patients in the Caribbean, Central and South America network for HIV Epidemiology (CCASAnet) ≥18 years of age at enrolment, from 2001–2012 who had an OI before HAART initiation were included. Patients were divided in an early HAART (EH) group (those initiating within 4 weeks of an OI) and a delayed HAART (DH) group (those initiating more than 4 weeks after an OI). All patients with an AIDS-defining OI were included. In patients with more than one OI the first event reported was considered. Calendar trends in the proportion of patients in the EH group (before and after 2009) were estimated by site and for the whole cohort. Factors associated with EH were estimated using multivariable logistic regression models. Results A total of 1457 patients had an OI before HAART initiation and were included in the analysis: 213 from Argentina, 686 from Brazil, 283 from Chile, 119 from Honduras and 156 from Mexico. Most prevalent OI were Tuberculosis (31%), followed by Pneumocystis pneumonia (24%), Invasive Candidiasis (16%) and Toxoplasmosis (9%). Median time from OI to HAART initiation decreased significantly from 5.7 (interquartile range [IQR] 2.8–12.1) weeks before 2009 to 4.3 (IQR 2.0–7.1) after 2009 (p<0.01). Factors associated with starting HAART within 4 weeks of OI diagnosis were lower CD4 count at enrolment (p-<0.001), having a non-tuberculosis OI (p<0.001), study site (p<0.001), and more recent years of OI diagnosis (p<0.001). Discussion The time from diagnosis of an OI to HAART initiation has

  15. Computer aided diagnosis of schizophrenia on resting state fMRI data by ensembles of ELM.

    PubMed

    Chyzhyk, Darya; Savio, Alexandre; Graña, Manuel

    2015-08-01

    Resting state functional Magnetic Resonance Imaging (rs-fMRI) is increasingly used for the identification of image biomarkers of brain diseases or psychiatric conditions such as schizophrenia. This paper deals with the application of ensembles of Extreme Learning Machines (ELM) to build Computer Aided Diagnosis systems on the basis of features extracted from the activity measures computed over rs-fMRI data. The power of ELM to provide quick but near optimal solutions to the training of Single Layer Feedforward Networks (SLFN) allows extensive exploration of discriminative power of feature spaces in affordable time with off-the-shelf computational resources. Exploration is performed in this paper by an evolutionary search approach that has found functional activity map features allowing to achieve quite successful classification experiments, providing biologically plausible voxel-site localizations.

  16. Evaluation of Computer-aided Diagnosis on a Large Clinical Full-Field Digital Mammographic Dataset

    PubMed Central

    Li, Hui; Giger, Maryellen L.; Yuan, Yading; Chen, Weijie; Horsch, Karla; Lan, Li; Jamieson, Andrew R.; Sennett, Charlene A.; Jansen, Sanaz A.

    2008-01-01

    Rationale and Objectives: To convert and optimize our previously developed computerized analysis methods for use with images from full-field digital mammography (FFDM) for breast mass classification in order to aid in the diagnosis of breast cancer. Materials and Methods: An institutional review board approved protocol was obtained, with waiver of consent for retrospective use of mammograms and pathology data. Seven hundreds and thirty-nine full-field digital mammographic images, which contained 287 biopsy-proven breast mass lesions, of which 148 lesions were malignant and 139 lesions were benign, were retrospectively collected. Lesion margins were delineated by an expert breast radiologist and were used as the truth for lesion-segmentation evaluation. Our computerized image analysis method consisted of several steps: 1) identified lesions were automatically extracted from the parenchymal background using computerized segmentation methods; 2) a set of image characteristics (mathematical descriptors) were automatically extracted from image data of the lesions and surrounding tissues; and 3) selected features were merged into an estimate of the probability of malignancy using a Bayesian artificial neural network classifier. Performance of the analyses was evaluated at various stages of the conversion using receiver operating characteristic (ROC) analysis. Results: An AUC value of 0.81 was obtained in the task of distinguishing between malignant and benign mass lesions in a round-robin by case evaluation on the entire FFDM dataset. We failed to show a statistically significant difference (P value=0.83) as compared with results from our previous study in which the computerized classification was performed on digitized screen-film mammograms (SFMD). Conclusion: Our computerized analysis methods developed on digitized screen-film mammography can be converted for use with FFDM. Results show that the computerized analysis methods for the diagnosis of breast mass lesions on

  17. Frontiers for the Early Diagnosis of AD by Means of MRI Brain Imaging and Support Vector Machines.

    PubMed

    Salvatore, Christian; Battista, Petronilla; Castiglioni, Isabella

    2016-01-01

    The emergence of Alzheimer's Disease (AD) as a consequence of increasing aging population makes urgent the availability of methods for the early and accurate diagnosis. Magnetic Resonance Imaging (MRI) could be used as in vivo, non invasive tool to identify sensitive and specific markers of very early AD progression. In recent years, multivariate pattern analysis (MVPA) and machine- learning algorithms have attracted strong interest within the neuroimaging community, as they allow automatic classification of imaging data with higher performance than univariate statistical analysis. An exhaustive search of PubMed, Web of Science and Medline records was performed in this work, in order to retrieve studies focused on the potential role of MRI in aiding the clinician in early diagnosis of AD by using Support Vector Machines (SVMs) as MVPA automated classification method. A total of 30 studies emerged, published from 2008 to date. This review aims to give a state-of-the-art overview about SVM for the early and differential diagnosis of AD-related pathologies by means of MRI data, starting from preliminary steps such as image pre-processing, feature extraction and feature selection, and ending with classification, validation strategies and extraction of MRI-related biomarkers. The main advantages and drawbacks of the different techniques were explored. Results obtained by the reviewed studies were reported in terms of classification performance and biomarker outcomes, in order to shed light on the parameters that accompany normal and pathological aging. Unresolved issues and possible future directions were finally pointed out. PMID:26567735

  18. CD4 quantification based on magneto ELISA for AIDS diagnosis in low resource settings.

    PubMed

    Carinelli, S; Xufré, C; Alegret, S; Martí, M; Pividori, M I

    2016-11-01

    The Acquired Immune Deficiency Syndrome (AIDS) affects the life of millions of people around the world. Although rapid and low cost screening tests are widely available for the diagnosis of HIV infection, the count of CD4+ T lymphocytes remains a drawback in the areas mostly affected by the HIV, being this control imperative for assessing the deterioration of the immunological system and the progression towards AIDS, when the counting of cells falls down 200cellsμL(-1). This paper describes a high-throughput, simple and rapid method for CD4+ T lymphocytes quantification, directly in whole blood, based on a magneto ELISA. The CD4 cells are separated and preconcentrated from whole blood in magnetic particles, and labeled with an enzyme for the optical readout performed with a standard microplate reader. The magneto ELISA is able to reach the whole CD4 counting range of medical interest, being the limit of detection as low as 50 CD4+ cells per μL of whole blood, without any pretreatment. This method is a highly suitable alternative diagnostic tool for the expensive flow cytometry at the community and primary care level, providing a sensitive method but by using instrumentation widely available in low-resource settings laboratories and requiring low-maintenance, as is the case of a microplate reader operated by filters.

  19. Electrochemical magneto-actuated biosensor for CD4 count in AIDS diagnosis and monitoring.

    PubMed

    Carinelli, S; Xufré Ballesteros, C; Martí, M; Alegret, S; Pividori, M I

    2015-12-15

    The counting of CD4(+) T lymphocytes is a clinical parameter used for AIDS diagnosis and follow-up. As this disease is particularly prevalent in developing countries, simple and affordable CD4 cell counting methods are urgently needed in resource-limited settings. This paper describes an electrochemical magneto-actuated biosensor for CD4 count in whole blood. The CD4(+) T lymphocytes were isolated, preconcentrated and labeled from 100 μL of whole blood by immunomagnetic separation with magnetic particles modified with antiCD3 antibodies. The captured cells were labeled with a biotinylated antiCD4 antibody, followed by the reaction with the electrochemical reporter streptavidin-peroxidase conjugate. The limit of detection for the CD4 counting magneto-actuated biosensor in whole blood was as low as 44 cells μL(-1) while the logistic range was found to be from 89 to 912 cells μL(-1), which spans the whole medical interest range for CD4 counts in AIDS patients. The electrochemical detection together with the immunomagnetic separation confers high sensitivity, resulting in a rapid, inexpensive, robust, user-friendly method for CD4 counting. This approach is a promising alternative for the costly standard flow cytometry and suitable as diagnostic tool at decentralized practitioner sites in low resource settings, especially in less developed countries.

  20. CD4 quantification based on magneto ELISA for AIDS diagnosis in low resource settings.

    PubMed

    Carinelli, S; Xufré, C; Alegret, S; Martí, M; Pividori, M I

    2016-11-01

    The Acquired Immune Deficiency Syndrome (AIDS) affects the life of millions of people around the world. Although rapid and low cost screening tests are widely available for the diagnosis of HIV infection, the count of CD4+ T lymphocytes remains a drawback in the areas mostly affected by the HIV, being this control imperative for assessing the deterioration of the immunological system and the progression towards AIDS, when the counting of cells falls down 200cellsμL(-1). This paper describes a high-throughput, simple and rapid method for CD4+ T lymphocytes quantification, directly in whole blood, based on a magneto ELISA. The CD4 cells are separated and preconcentrated from whole blood in magnetic particles, and labeled with an enzyme for the optical readout performed with a standard microplate reader. The magneto ELISA is able to reach the whole CD4 counting range of medical interest, being the limit of detection as low as 50 CD4+ cells per μL of whole blood, without any pretreatment. This method is a highly suitable alternative diagnostic tool for the expensive flow cytometry at the community and primary care level, providing a sensitive method but by using instrumentation widely available in low-resource settings laboratories and requiring low-maintenance, as is the case of a microplate reader operated by filters. PMID:27591585

  1. Can computer-aided diagnosis (CAD) help radiologists find mammographically missed screening cancers?

    NASA Astrophysics Data System (ADS)

    Nishikawa, Robert M.; Giger, Maryellen L.; Schmidt, Robert A.; Papaioannou, John

    2001-06-01

    We present data from a pilot observer study whose goal is design a study to test the hypothesis that computer-aided diagnosis (CAD) can improve radiologists' performance in reading screening mammograms. In a prospective evaluation of our computer detection schemes, we have analyzed over 12,000 clinical exams. Retrospective review of the negative screening mammograms for all cancer cases found an indication of the cancer in 23 of these negative cases. The computer found 54% of these in our prospective testing. We added to these cases normal exams to create a dataset of 75 cases. Four radiologists experienced in mammography read the cases and gave their BI-RADS assessment and their confidence that the patient should be called back for diagnostic mammography. They did so once reading the films only and a second time reading with the computer aid. Three radiologists had no change in area under the ROC curve (mean Az of 0.73) and one improved from 0.73 to 0.78, but this difference failed to reach statistical significance (p equals 0.23). These data are being used to plan a larger more powerful study.

  2. Electrochemical magneto-actuated biosensor for CD4 count in AIDS diagnosis and monitoring.

    PubMed

    Carinelli, S; Xufré Ballesteros, C; Martí, M; Alegret, S; Pividori, M I

    2015-12-15

    The counting of CD4(+) T lymphocytes is a clinical parameter used for AIDS diagnosis and follow-up. As this disease is particularly prevalent in developing countries, simple and affordable CD4 cell counting methods are urgently needed in resource-limited settings. This paper describes an electrochemical magneto-actuated biosensor for CD4 count in whole blood. The CD4(+) T lymphocytes were isolated, preconcentrated and labeled from 100 μL of whole blood by immunomagnetic separation with magnetic particles modified with antiCD3 antibodies. The captured cells were labeled with a biotinylated antiCD4 antibody, followed by the reaction with the electrochemical reporter streptavidin-peroxidase conjugate. The limit of detection for the CD4 counting magneto-actuated biosensor in whole blood was as low as 44 cells μL(-1) while the logistic range was found to be from 89 to 912 cells μL(-1), which spans the whole medical interest range for CD4 counts in AIDS patients. The electrochemical detection together with the immunomagnetic separation confers high sensitivity, resulting in a rapid, inexpensive, robust, user-friendly method for CD4 counting. This approach is a promising alternative for the costly standard flow cytometry and suitable as diagnostic tool at decentralized practitioner sites in low resource settings, especially in less developed countries. PMID:26264263

  3. Computer-aided diagnosis of leukoencephalopathy in children treated for acute lymphoblastic leukemia

    NASA Astrophysics Data System (ADS)

    Glass, John O.; Li, Chin-Shang; Helton, Kathleen J.; Reddick, Wilburn E.

    2005-04-01

    The purpose of this study was to use objective quantitative MR imaging methods to develop a computer-aided diagnosis tool to differentiate white matter (WM) hyperintensities as either leukoencephalopathy (LE) or normal maturational processes in children treated for acute lymphoblastic leukemia with intravenous high dose methotrexate. A combined imaging set consisting of T1, T2, PD, and FLAIR MR images and WM, gray matter, and cerebrospinal fluid a priori maps from a spatially normalized atlas were analyzed with a neural network segmentation based on a Kohonen Self-Organizing Map. Segmented regions were manually classified to identify the most hyperintense WM region and the normal appearing genu region. Signal intensity differences normalized to the genu within each examination were generated for two time points in 203 children. An unsupervised hierarchical clustering algorithm with the agglomeration method of McQuitty was used to divide data from the first examination into normal appearing or LE groups. A C-support vector machine (C-SVM) was then trained on the first examination data and used to classify the data from the second examination. The overall accuracy of the computer-aided detection tool was 83.5% (299/358) with sensitivity to normal WM of 86.9% (199/229) and specificity to LE of 77.5% (100/129) when compared to the readings of two expert observers. These results suggest that subtle therapy-induced leukoencephalopathy can be objectively and reproducibly detected in children treated for cancer using this computer-aided detection approach based on relative differences in quantitative signal intensity measures normalized within each examination.

  4. Sonographic markers for early diagnosis of fetal malformations

    PubMed Central

    Renna, Maria Daniela; Pisani, Paola; Conversano, Francesco; Perrone, Emanuele; Casciaro, Ernesto; Renzo, Gian Carlo Di; Paola, Marco Di; Perrone, Antonio; Casciaro, Sergio

    2013-01-01

    Fetal malformations are very frequent in industrialized countries. Although advanced maternal age may affect pregnancy outcome adversely, 80%-90% of fetal malformations occur in the absence of a specific risk factor for parents. The only effective approach for prenatal screening is currently represented by an ultrasound scan. However, ultrasound methods present two important limitations: the substantial absence of quantitative parameters and the dependence on the sonographer experience. In recent years, together with the improvement in transducer technology, quantitative and objective sonographic markers highly predictive of fetal malformations have been developed. These markers can be detected at early gestation (11-14 wk) and generally are not pathological in themselves but have an increased incidence in abnormal fetuses. Thus, prenatal ultrasonography during the second trimester of gestation provides a “genetic sonogram”, including, for instance, nuchal translucency, short humeral length, echogenic bowel, echogenic intracardiac focus and choroid plexus cyst, that is used to identify morphological features of fetal Down’s syndrome with a potential sensitivity of more than 90%. Other specific and sensitive markers can be seen in the case of cardiac defects and skeletal anomalies. In the future, sonographic markers could limit even more the use of invasive and dangerous techniques of prenatal diagnosis (amniocentesis, etc.). PMID:24179631

  5. Early Oscillation Detection for DC/DC Converter Fault Diagnosis

    NASA Technical Reports Server (NTRS)

    Wang, Bright L.

    2011-01-01

    The electrical power system of a spacecraft plays a very critical role for space mission success. Such a modern power system may contain numerous hybrid DC/DC converters both inside the power system electronics (PSE) units and onboard most of the flight electronics modules. One of the faulty conditions for DC/DC converter that poses serious threats to mission safety is the random occurrence of oscillation related to inherent instability characteristics of the DC/DC converters and design deficiency of the power systems. To ensure the highest reliability of the power system, oscillations in any form shall be promptly detected during part level testing, system integration tests, flight health monitoring, and on-board fault diagnosis. The popular gain/phase margin analysis method is capable of predicting stability levels of DC/DC converters, but it is limited only to verification of designs and to part-level testing on some of the models. This method has to inject noise signals into the control loop circuitry as required, thus, interrupts the DC/DC converter's normal operation and increases risks of degrading and damaging the flight unit. A novel technique to detect oscillations at early stage for flight hybrid DC/DC converters was developed.

  6. Milk fat progesterone concentrations in goats and early pregnancy diagnosis.

    PubMed

    de Montigny, G; Millerioux, P; Jeanguyot, N; Humblot, P; Thibier, M

    1982-04-01

    Blood and milk samples from foremilk during afternoon milking, were simultaneously collected from 285 dairy goats. In experiment 1, fiva cyclic goats were sampled daily for 21 days. In experiment 2, 280 females from 9 flocks were submitted to sampling 21 days after insemination. In addition, some milk samples were divided in two parts, after which one was frozen and the other kept at +4 degrees C until assay. Progesterone concentrations were measured in blood, whole milk and milk fat by radioimmunoassay. No difference in whole milk or fat progesterone levels was found between frozen and refrigerated milk samples. Milk butterfat progesterone concentrations paralleled those in plasma or whole milk throughout the estrous cycle and ranged from about 20 ng/ml at estrus to about 400 ng/ml in mid-luteal phase. The ratio of mid-luteal phase progesterone levels to those seen in the estrous period was over 20 in fat and in blood. This ratio was very much lower in whole milk. Consequently the determination of pregnant and non-pregnant goats from the samples collected 21 days after service was very much easier and accuracy was better when the progesterone content was assayed from milk fat than from whole milk. It was concluded that early pregnancy diagnosis in goats can be done routinely by determination of progesterone levels in milk fat. PMID:16725705

  7. [Early diagnosis and prevention of severe forms of epilepsy].

    PubMed

    Boldyriew, A I

    1976-01-01

    Early diagnosis and treatment are the basis of prevention of severe forms of epilepsy. In order to determine the beginning of the process the author studied 400 cases in which the duration of epilepsy ranged from several weeks to 3 years. The investigations demonstrated that epilepsy develops in subjects presenting certain premorbid symptoms and signs. The "epileptic process" develops frequently as a result of past infections and craniocerebral injuries followed by residual neurological signs and cerebrasthenia. Seizure attacks, if no additional releasing factors are present, are preceded by various clinically weakly expressed seizure phenomena. They include peculiar,very vivid dreams, sudden awakenings with partly obnubilated consciouness and a feeling of fear, abortive psychomotor and other seizure. The "microseizures" include also myoclonic twitches preceding sleep and during sleep, auras, brief viscerovegatative attacks, opercular symptoms, symptoms of dream-like states, twitches of isolated muscles without consciousness disturbances. In 44% of cases asthenic symptoms were present in connection with microseizures. They served as background for development long-standing irritative foci manifesting themselves clinically with sluggishness of thinking and affect and compulsive features. Presence of these microseizures may suggest epilepsy long before appearance of typical seizures and may be an indication to beginning of treatment which may prevent the development of severe epilepsy. The syndrome of seizure-like microsymptoms makes it possible to recognize the prodromal stage of epilepsy and to change our views on its sudden onset. PMID:1264328

  8. Histoplasma capsulatum var. duboisii infection in a patient with AIDS: rapid diagnosis using polymerase chain reaction-sequencing.

    PubMed

    Pellaton, Cyril; Cavassini, Matthias; Jaton-Ogay, Katia; Carron, Pierre-Nicolas; Christen-Zaech, Stéphanie; Calandra, Thierry; Bille, Jacques; Hauser, Philippe M

    2009-05-01

    We describe an original case of disseminated infection with Histoplasma capsulatum (Hc) var. duboisii in an African patient with AIDS who migrated to Switzerland. The diagnosis of histoplasmosis was suggested using direct examination of tissues and confirmed in 24 h with a panfungal polymerase chain reaction assay. The variety duboisii of Hc was established using DNA sequencing of the polymorphic genomic region OLE. Molecular tools allow diagnosis of histoplasmosis in 24 h, which is drastically shorter than culture procedures. PMID:19304436

  9. Multimodal Imaging Assisting the Early Diagnosis of Cat-Scratch Neuroretinitis.

    PubMed

    Freitas-Neto, Clovis Arcoverde; Oréfice, Fernando; Costa, Rogerio A; Oréfice, Juliana L; Dhanireddy, Swetha; Maghsoudlou, Armin; Foster, C Stephen

    2016-01-01

    To describe how a multifocal fundus imaging system assisted the early diagnosis of cat scratch neuroretinitis in a case of a 27-year-old male with unilateral visual loss, neuroretinitis, and a peripapillary angiomatous lesion. Multimodal fundus imaging analysis was an essential contributor to the clinical diagnosis of cat scratch neuroretinitis during the early stage of the disease.

  10. Substance abuse treatment in persons with HIV/AIDS: challenges in managing triple diagnosis.

    PubMed

    Durvasula, Ramani; Miller, Theodore R

    2014-01-01

    Clinical management of HIV must account for the "triple diagnosis" of HIV, psychiatric diagnosis, and substance use disorders and requires integrated treatment services that focus beyond just mitigation of substance use and psychiatric and medical symptoms but also address other health behaviors. Because clinical management of HIV/AIDS has shifted significantly with the advent of highly active antiretroviral therapies (HAART) in the mid 1990s, a literature review focusing on literature published since 2000, and using relevant key words was conducted using a wide range of literature search databases. This literature review was complemented by studies to expand on specific treatment modalities for which there was a dearth of literature addressing HIV infected cohorts and to provide discussion of issues around substance abuse treatment as an HIV prevention tool. Existing models of substance abuse treatment including cognitive behavioral therapy and motivational interviewing have proven to be useful for enhancing adherence and reducing substance use in outpatient populations, while methadone maintenance and directly observed treatment have been useful with specific subgroups of users. Contextualization of services heightens the likelihood of successful outcomes and relapse prevention.

  11. Reducing annotation cost and uncertainty in computer-aided diagnosis through selective iterative classification

    NASA Astrophysics Data System (ADS)

    Riely, Amelia; Sablan, Kyle; Xiaotao, Thomas; Furst, Jacob; Raicu, Daniela

    2015-03-01

    Medical imaging technology has always provided radiologists with the opportunity to view and keep records of anatomy of the patient. With the development of machine learning and intelligent computing, these images can be used to create Computer-Aided Diagnosis (CAD) systems, which can assist radiologists in analyzing image data in various ways to provide better health care to patients. This paper looks at increasing accuracy and reducing cost in creating CAD systems, specifically in predicting the malignancy of lung nodules in the Lung Image Database Consortium (LIDC). Much of the cost in creating an accurate CAD system stems from the need for multiple radiologist diagnoses or annotations of each image, since there is rarely a ground truth diagnosis and even different radiologists' diagnoses of the same nodule often disagree. To resolve this issue, this paper outlines an method of selective iterative classification that predicts lung nodule malignancy by using multiple radiologist diagnoses only for cases that can benefit from them. Our method achieved 81% accuracy while costing only 46% of the method that indiscriminately used all annotations, which achieved a lower accuracy of 70%, while costing more.

  12. Enhanced characterization of solid solitary pulmonary nodules with Bayesian analysis-based computer-aided diagnosis

    PubMed Central

    Perandini, Simone; Soardi, Gian Alberto; Motton, Massimiliano; Augelli, Raffaele; Dallaserra, Chiara; Puntel, Gino; Rossi, Arianna; Sala, Giuseppe; Signorini, Manuel; Spezia, Laura; Zamboni, Federico; Montemezzi, Stefania

    2016-01-01

    The aim of this study was to prospectively assess the accuracy gain of Bayesian analysis-based computer-aided diagnosis (CAD) vs human judgment alone in characterizing solitary pulmonary nodules (SPNs) at computed tomography (CT). The study included 100 randomly selected SPNs with a definitive diagnosis. Nodule features at first and follow-up CT scans as well as clinical data were evaluated individually on a 1 to 5 points risk chart by 7 radiologists, firstly blinded then aware of Bayesian Inference Malignancy Calculator (BIMC) model predictions. Raters’ predictions were evaluated by means of receiver operating characteristic (ROC) curve analysis and decision analysis. Overall ROC area under the curve was 0.758 before and 0.803 after the disclosure of CAD predictions (P = 0.003). A net gain in diagnostic accuracy was found in 6 out of 7 readers. Mean risk class of benign nodules dropped from 2.48 to 2.29, while mean risk class of malignancies rose from 3.66 to 3.92. Awareness of CAD predictions also determined a significant drop on mean indeterminate SPNs (15 vs 23.86 SPNs) and raised the mean number of correct and confident diagnoses (mean 39.57 vs 25.71 SPNs). This study provides evidence supporting the integration of the Bayesian analysis-based BIMC model in SPN characterization.

  13. Computer-aided diagnosis and lipidomics analysis to detect and treat breast cancer

    NASA Astrophysics Data System (ADS)

    Meyer-Bäse, Anke; Retter, Felix; Steinbrücker, Frank; Görke, Robert; Burgeth, Bernhard; Schlossbauer, Thomas

    2010-04-01

    Multi-modality diagnosis techniques are more and more replacing traditional medical imaging for breast cancer detection. Newly emerging advances in both intelligent cancer detection systems and lipidomics technologies offer an excellent opportunity to detect tumors and to understand regulation at the molecular level in many diseases such as cancer. In this paper, we present a detailed computer-aided diagnosis (CAD) systems combining motion artefact reduction and automated feature extraction and classification, and a novel data mining approach for visualization of gene therapy leading to apoptosis in U87 MG glioblastoma cells, a secondary tumor of breast cancer. The achieved results show that the CAD system represents a robust and integrative tool for reliable small contrast enhancing lesions. Graph-clustering methods are introduced as powerful correlation networks which enable a simultaneous exploration and visualization of co-regulation in glioblastoma data. These new paradigms are providing unique "fingerprints" by revealing how the intricate interactions at the lipidome level can be employed to induce apoptosis (cell death) and are thus opening a new window to biomedical frontiers.

  14. Enhanced characterization of solid solitary pulmonary nodules with Bayesian analysis-based computer-aided diagnosis

    PubMed Central

    Perandini, Simone; Soardi, Gian Alberto; Motton, Massimiliano; Augelli, Raffaele; Dallaserra, Chiara; Puntel, Gino; Rossi, Arianna; Sala, Giuseppe; Signorini, Manuel; Spezia, Laura; Zamboni, Federico; Montemezzi, Stefania

    2016-01-01

    The aim of this study was to prospectively assess the accuracy gain of Bayesian analysis-based computer-aided diagnosis (CAD) vs human judgment alone in characterizing solitary pulmonary nodules (SPNs) at computed tomography (CT). The study included 100 randomly selected SPNs with a definitive diagnosis. Nodule features at first and follow-up CT scans as well as clinical data were evaluated individually on a 1 to 5 points risk chart by 7 radiologists, firstly blinded then aware of Bayesian Inference Malignancy Calculator (BIMC) model predictions. Raters’ predictions were evaluated by means of receiver operating characteristic (ROC) curve analysis and decision analysis. Overall ROC area under the curve was 0.758 before and 0.803 after the disclosure of CAD predictions (P = 0.003). A net gain in diagnostic accuracy was found in 6 out of 7 readers. Mean risk class of benign nodules dropped from 2.48 to 2.29, while mean risk class of malignancies rose from 3.66 to 3.92. Awareness of CAD predictions also determined a significant drop on mean indeterminate SPNs (15 vs 23.86 SPNs) and raised the mean number of correct and confident diagnoses (mean 39.57 vs 25.71 SPNs). This study provides evidence supporting the integration of the Bayesian analysis-based BIMC model in SPN characterization. PMID:27648166

  15. Computer-aided diagnosis of mammographic masses using scalable image retrieval.

    PubMed

    Jiang, Menglin; Zhang, Shaoting; Li, Hongsheng; Metaxas, Dimitris N

    2015-02-01

    Computer-aided diagnosis of masses in mammograms is important to the prevention of breast cancer. Many approaches tackle this problem through content-based image retrieval techniques. However, most of them fall short of scalability in the retrieval stage, and their diagnostic accuracy is, therefore, restricted. To overcome this drawback, we propose a scalable method for retrieval and diagnosis of mammographic masses. Specifically, for a query mammographic region of interest (ROI), scale-invariant feature transform (SIFT) features are extracted and searched in a vocabulary tree, which stores all the quantized features of previously diagnosed mammographic ROIs. In addition, to fully exert the discriminative power of SIFT features, contextual information in the vocabulary tree is employed to refine the weights of tree nodes. The retrieved ROIs are then used to determine whether the query ROI contains a mass. The presented method has excellent scalability due to the low spatial-temporal cost of vocabulary tree. Extensive experiments are conducted on a large dataset of 11 553 ROIs extracted from the digital database for screening mammography, which demonstrate the accuracy and scalability of our approach. PMID:25361497

  16. Enhanced characterization of solid solitary pulmonary nodules with Bayesian analysis-based computer-aided diagnosis.

    PubMed

    Perandini, Simone; Soardi, Gian Alberto; Motton, Massimiliano; Augelli, Raffaele; Dallaserra, Chiara; Puntel, Gino; Rossi, Arianna; Sala, Giuseppe; Signorini, Manuel; Spezia, Laura; Zamboni, Federico; Montemezzi, Stefania

    2016-08-28

    The aim of this study was to prospectively assess the accuracy gain of Bayesian analysis-based computer-aided diagnosis (CAD) vs human judgment alone in characterizing solitary pulmonary nodules (SPNs) at computed tomography (CT). The study included 100 randomly selected SPNs with a definitive diagnosis. Nodule features at first and follow-up CT scans as well as clinical data were evaluated individually on a 1 to 5 points risk chart by 7 radiologists, firstly blinded then aware of Bayesian Inference Malignancy Calculator (BIMC) model predictions. Raters' predictions were evaluated by means of receiver operating characteristic (ROC) curve analysis and decision analysis. Overall ROC area under the curve was 0.758 before and 0.803 after the disclosure of CAD predictions (P = 0.003). A net gain in diagnostic accuracy was found in 6 out of 7 readers. Mean risk class of benign nodules dropped from 2.48 to 2.29, while mean risk class of malignancies rose from 3.66 to 3.92. Awareness of CAD predictions also determined a significant drop on mean indeterminate SPNs (15 vs 23.86 SPNs) and raised the mean number of correct and confident diagnoses (mean 39.57 vs 25.71 SPNs). This study provides evidence supporting the integration of the Bayesian analysis-based BIMC model in SPN characterization. PMID:27648166

  17. Enhanced characterization of solid solitary pulmonary nodules with Bayesian analysis-based computer-aided diagnosis.

    PubMed

    Perandini, Simone; Soardi, Gian Alberto; Motton, Massimiliano; Augelli, Raffaele; Dallaserra, Chiara; Puntel, Gino; Rossi, Arianna; Sala, Giuseppe; Signorini, Manuel; Spezia, Laura; Zamboni, Federico; Montemezzi, Stefania

    2016-08-28

    The aim of this study was to prospectively assess the accuracy gain of Bayesian analysis-based computer-aided diagnosis (CAD) vs human judgment alone in characterizing solitary pulmonary nodules (SPNs) at computed tomography (CT). The study included 100 randomly selected SPNs with a definitive diagnosis. Nodule features at first and follow-up CT scans as well as clinical data were evaluated individually on a 1 to 5 points risk chart by 7 radiologists, firstly blinded then aware of Bayesian Inference Malignancy Calculator (BIMC) model predictions. Raters' predictions were evaluated by means of receiver operating characteristic (ROC) curve analysis and decision analysis. Overall ROC area under the curve was 0.758 before and 0.803 after the disclosure of CAD predictions (P = 0.003). A net gain in diagnostic accuracy was found in 6 out of 7 readers. Mean risk class of benign nodules dropped from 2.48 to 2.29, while mean risk class of malignancies rose from 3.66 to 3.92. Awareness of CAD predictions also determined a significant drop on mean indeterminate SPNs (15 vs 23.86 SPNs) and raised the mean number of correct and confident diagnoses (mean 39.57 vs 25.71 SPNs). This study provides evidence supporting the integration of the Bayesian analysis-based BIMC model in SPN characterization.

  18. Computer-aided diagnosis in radiological imaging: current status and future challenges

    NASA Astrophysics Data System (ADS)

    Doi, Kunio

    2009-10-01

    Computer-aided diagnosis (CAD) has become one of the major research subjects in medical imaging and diagnostic radiology. Many different types of CAD schemes are being developed for detection and/or characterization of various lesions in medical imaging, including conventional projection radiography, CT, MRI, and ultrasound imaging. Commercial systems for detection of breast lesions on mammograms have been developed and have received FDA approval for clinical use. CAD may be defined as a diagnosis made by a physician who takes into account the computer output as a "second opinion". The purpose of CAD is to improve the quality and productivity of physicians in their interpretation of radiologic images. The quality of their work can be improved in terms of the accuracy and consistency of their radiologic diagnoses. In addition, the productivity of radiologists is expected to be improved by a reduction in the time required for their image readings. The computer output is derived from quantitative analysis of radiologic images by use of various methods and techniques in computer vision, artificial intelligence, and artificial neural networks (ANNs). The computer output may indicate a number of important parameters, for example, the locations of potential lesions such as lung cancer and breast cancer, the likelihood of malignancy of detected lesions, and the likelihood of various diseases based on differential diagnosis in a given image and clinical parameters. In this review article, the basic concept of CAD is first defined, and the current status of CAD research is then described. In addition, the potential of CAD in the future is discussed and predicted.

  19. Computer-aided diagnosis of breast microcalcifications based on dual-tree complex wavelet transform

    PubMed Central

    2012-01-01

    Background Digital mammography is the most reliable imaging modality for breast carcinoma diagnosis and breast micro-calcifications is regarded as one of the most important signs on imaging diagnosis. In this paper, a computer-aided diagnosis (CAD) system is presented for breast micro-calcifications based on dual-tree complex wavelet transform (DT-CWT) to facilitate radiologists like double reading. Methods Firstly, 25 abnormal ROIs were extracted according to the center and diameter of the lesions manually and 25 normal ROIs were selected randomly. Then micro-calcifications were segmented by combining space and frequency domain techniques. We extracted three texture features based on wavelet (Haar, DB4, DT-CWT) transform. Totally 14 descriptors were introduced to define the characteristics of the suspicious micro-calcifications. Principal Component Analysis (PCA) was used to transform these descriptors to a compact and efficient vector expression. Support Vector Machine (SVM) classifier was used to classify potential micro-calcifications. Finally, we used the receiver operating characteristic (ROC) curve and free-response operating characteristic (FROC) curve to evaluate the performance of the CAD system. Results The results of SVM classifications based on different wavelets shows DT-CWT has a better performance. Compared with other results, DT-CWT method achieved an accuracy of 96% and 100% for the classification of normal and abnormal ROIs, and the classification of benign and malignant micro-calcifications respectively. In FROC analysis, our CAD system for clinical dataset detection achieved a sensitivity of 83.5% at a false positive per image of 1.85. Conclusions Compared with general wavelets, DT-CWT could describe the features more effectively, and our CAD system had a competitive performance. PMID:23253202

  20. Survival Outcomes and Effect of Early vs. Deferred cART Among HIV-Infected Patients Diagnosed at the Time of an AIDS-Defining Event: A Cohort Analysis

    PubMed Central

    Mussini, Cristina; Johnson, Margaret; d'Arminio Monforte, Antonella; Antinori, Andrea; Gill, M. John; Sighinolfi, Laura; Uberti-Foppa, Caterina; Borghi, Vanni; Sabin, Caroline

    2011-01-01

    Objectives We analyzed clinical progression among persons diagnosed with HIV at the time of an AIDS-defining event, and assessed the impact on outcome of timing of combined antiretroviral treatment (cART). Methods Retrospective, European and Canadian multicohort study.. Patients were diagnosed with HIV from 1997–2004 and had clinical AIDS from 30 days before to 14 days after diagnosis. Clinical progression (new AIDS event, death) was described using Kaplan-Meier analysis stratifying by type of AIDS event. Factors associated with progression were identified with multivariable Cox regression. Progression rates were compared between those starting early (<30 days after AIDS event) or deferred (30–270 days after AIDS event) cART. Results The median (interquartile range) CD4 count and viral load (VL) at diagnosis of the 584 patients were 42 (16, 119) cells/µL and 5.2 (4.5, 5.7) log10 copies/mL. Clinical progression was observed in 165 (28.3%) patients. Older age, a higher VL at diagnosis, and a diagnosis of non-Hodgkin lymphoma (NHL) (vs. other AIDS events) were independently associated with disease progression. Of 366 patients with an opportunistic infection, 178 (48.6%) received early cART. There was no significant difference in clinical progression between those initiating cART early and those deferring treatment (adjusted hazard ratio 1.32 [95% confidence interval 0.87, 2.00], p = 0.20). Conclusions Older patients and patients with high VL or NHL at diagnosis had a worse outcome. Our data suggest that earlier initiation of cART may be beneficial among HIV-infected patients diagnosed with clinical AIDS in our setting. PMID:22043301

  1. Diagnosis of dengue infection using various diagnostic tests in the early stage of illness.

    PubMed

    Lolekha, Rangsima; Chokephaibulkit, Kulkanya; Yoksan, Sutee; Vanprapar, Nirun; Phongsamart, Wanatpreeya; Chearskul, Sanay

    2004-06-01

    In order to elucidate the usefulness of various tests in the early course of dengue infection, in terms of diagnosis and correlation with clinical severity, blood specimens were collected every 48 hours on 3 occasions from patients with clinical suspicion of dengue infection with fever for less than 4 days. Viral isolation was attempted by mosquito inoculation (MI), tissue culture inoculation (TC), and reverse transcriptase polymerase chain reaction (RT-PCR). Antibodies were detected by hemagglutination inhibition test (HI), an in-house-ELISA (IH-ELISA), and an ELISA by MRL diagnostics Clinical data were collected from the time of enrollment to complete recovery. Of the 40 patients enrolled, 31 were diagnosed as dengue infection and confirmed by either serology or viral isolation. Of these, 12 had primary infection and 19 had secondary infection. Dengue fever occurred in 9 cases. Dengue viruses were isolated from 28 out of 31 patients, and dengue hemorrhagic fever was diagnosed in 22 patients. Viral serotypes identified by viral isolation, and RT-PCR were concordant: DEN1 was isolated in 8, DEN2 in 13, DEN3 in 5, and DEN4 in 2 patients. Viral isolation yielded positive results on blood collected before the 5th day of fever. MI was more sensitive than TC. RT-PCR was less sensitive than viral isolation during the early days of fever, but became more sensitive after the 5th day of fever. RT-PCR was able to detect virus up to day 7-8 of fever, even after defervescence, and in the presence of antibody. During the febrile stage, serological diagnosis on blood samples taken 48 hours apart was carried out by HI, IH-ELISA, and MRL-ELISA, facilitating diagnosis in 3 (10%), 21 (67%), and 27 (87%) of patients, respectively. All of the patients with secondary infection were diagnosed by MRL-ELISA before defervescence. By the 8th day of fever, a serological diagnosis aided to diagnose in 9 (29%), 29 (93%), and 31 (100%) of patients by HI, IH-ELISA, and MRL-ELISA, respectively

  2. [Vojta's method as the early neurodevelopmental diagnosis and therapy concept].

    PubMed

    Banaszek, Grazyna

    2010-01-01

    Vaclav Vojta (1917-2000) developed an early diagnostic method of the neurodevelopmental disorder of infants and came up with therapeutic concept consisting in releasing of global motor complexes by means of the stimulation of proper areas on patients body. In the diagnostics apart from very careful observation of the spontaneous movement of the infant and examination of the reflexes that are characteristic for the first weeks of human's life, Vojta applied the examination of the 7 postural reactions. Presence of the trouble in patterns and dynamics of the postural reactions Vojta called Central Nervous Coordination Disorder--CNCD and regarded as work diagnosis or alarm signal indicating necessity of application of the therapy, especially when asymmetry of the muscle tone and primitive reflexes beyond their physiological appearance period are observed or the number of the abnormal reactions exceeds 5. Global motor complexes as reflex locomotion--crawling and rotation--consist of all the partial motion patterns, which are gradually used by healthy infant in the process of postural and motor ontogenesis. Providing the central nervous system with proper external stimulation allows to, using neuronal plasticity, recreate an access to the human's postural development program and gradually replace pathological motor patterns by those more regular. Exercises repeated several times a day rebuilt support, erectile and vertical mechanisms, improve automatic postural control and phase lower limb movement. Affecting especially on autochtonic muscles of the spine exercises balance synergic cooperation of muscle groups in the trunk and those surrounding key body joints. This way they correct body's posture and peripheral motion and pathology of the outlasted primitive reflexes gradually withdraws.

  3. Utility and effectiveness of computer-aided diagnosis of dental caries.

    PubMed

    Tracy, Kyle D; Dykstra, Bradley A; Gakenheimer, David C; Scheetz, James P; Lacina, Stephani; Scarfe, William C; Farman, Allan G

    2011-01-01

    Digital radiography has created a growing opportunity for computer-aided diagnostic (CAD) tools. The Logicon Caries Detector (LCD), with upgraded CAD software based on user feedback, was re-evaluated for its effectiveness via a retrospective clinical study. Using the upgraded LCD software, 12 dentists (evaluators) blindly assessed 17 radiographs taken by another (attending) dentist, who restored 28 proximal surfaces. The attending dentist confirmed the presence of early dentinal caries, as well as identifying 48 surfaces as caries-free or with enamel caries only subject to noninvasive treatment. The radiographs, imported into the software using a digital imaging and communications in medicine (DICOM) reader, were visually assessed under typical operatory lighting conditions, then with the aid of the software's density analysis tool. The effectiveness of the evaluators was gauged by calculating two measures of performance, sensitivity and specificity, for the detection and classification of dentinal caries. Sensitivity among all evaluator dentists was 30% with the initial image; 34% with the brightness and contrast adjusted image; 39% when the image was sharpened; and 69% when the density analysis tool was utilized. Specificity was found to be 97% with the initial image; 95% with the brightness and contrast adjusted image; 93% with the sharpened image; and 94% when the density analysis tool was used. Compared to the unaided eye, the LCD can significantly improve dentists' ability to detect and classify caries. Dentists may be able to find twice as much early dentinal caries requiring restoration (or at least aggressive noninvasive treatment) than previously, while not unnecessarily restoring additional healthy teeth. The LCD enables dentists to obtain more information from dental digital radiography than is possible with the unaided eye, leading to improved patient care.

  4. Improvement in early diagnosis of Japanese spotted fever by using a novel Rick PCR system.

    PubMed

    Kondo, Makoto; Akachi, Shigehiro; Kawano, Mitsuo; Yamanaka, Keiichi; Yamagiwa, Akisa; Gabazza, Esteban C; Ando, Katsuhiko; Mizutani, Hitoshi

    2015-11-01

    Rickettsia diseases, including Japanese spotted fever (JSF), are serious infections. Delayed diagnosis occasionally results in life-threatening liver disorders and disseminated intravascular coagulation (DIC). Because of the shortness of the latent period, serological diagnosis is not preferable for early diagnosis of JSF. Until now, a polymerase chain reaction (PCR)-based diagnosis method has been used for early diagnosis, and the sensitivity reaches as high as 90% using skin biopsy samples as we previously reported. On the other hand, the sensitivity of the same PCR method using blood samples is limited at less than 50%. In the present study, using peripheral blood samples, we developed a novel diagnostic method for JSF using a Rick PCR system with original PCR primers, showing improved sensitivity compared with the conventional nested PCR. It may constitute a preferable diagnostic tool for early and sensitive diagnosis of Rickettsia infection.

  5. Computer-aided diagnosis based on quantitative elastographic features with supersonic shear wave imaging.

    PubMed

    Xiao, Yang; Zeng, Jie; Niu, Lili; Zeng, Qingjing; Wu, Tao; Wang, Congzhi; Zheng, Rongqin; Zheng, Hairong

    2014-02-01

    Supersonic shear wave imaging (SSI) has recently been explored as a technique to evaluate tissue elasticity modulus and has become a valuable tool for tumor characterization. The purpose of this study was to develop a novel computer-aided diagnosis (CAD) system that can acquire quantitative elastographic information from color SSI elastography images automatically and objectively for the purpose of classifying benign and malignant breast tumors. Conventional ultrasonography (US) and SSI elastography images of 125 breast tumors (81 benign, 44 malignant), in 93 consecutive patients (mean age: 40 y, age range: 16-75 y), were obtained. After reconstruction of tissue elasticity data and automatic segmentation of each breast tumor, 10 quantitative elastographic features of the tumor and peri-tumoral areas, respectively (elasticity modulus mean, maximum and standard deviation, hardness degree and elasticity ratio), were computed and evaluated. A support vector machine (SVM) classifier was used for optimum classification via combination of these features. The B-mode Breast Imaging Reporting and Data System (BI-RADS) was used to compare gray-scale US and SSI elastography with respect to diagnostic performance. Histopathologic examination was used as the reference standard. Student's t-test, the Mann-Whitney U-test, the point biserial correlation coefficient and receiver operating characteristic curve analysis were performed for statistical analysis. As a result, the accuracy, sensitivity, specificity, positive predictive value and negative predictive value of benign/malignant classification were 95.2% (119/125), 90.9% (40/44), 97.5% (79/81), 95.2% (40/42) and 95.2% (79/83) for the CAD scheme, respectively, and 79.2% (99/125), 90.9% (40/44), 72.8% (59/81), 64.5% (40/62) and 93.7% (59/63) for BI-RADS assessment, respectively. The area under the receiver operating characteristic curve (Az value) for the proposed CAD system using the combination of elastographic features was

  6. Computer-Aided Diagnosis of Skin Lesions Using Conventional Digital Photography: A Reliability and Feasibility Study

    PubMed Central

    Chang, Wen-Yu; Huang, Adam; Yang, Chung-Yi; Lee, Chien-Hung; Chen, Yin-Chun; Wu, Tian-Yau; Chen, Gwo-Shing

    2013-01-01

    Background Computer-aided diagnosis (CADx) software that provides a second opinion has been widely used to assist physicians with various tasks. In dermatology, however, CADx has been mostly limited to melanoma or melanocytic skin cancer diagnosis. The frequency of non-melanocytic skin cancers and the accessibility of regular digital macrographs have raised interest in developing CADx for broader applications. Objectives To investigate the feasibility of using CADx to diagnose both melanocytic and non-melanocytic skin lesions based on conventional digital photographic images. Methods This study was approved by an institutional review board, and the requirement to obtain informed consent was waived. In total, 769 conventional photographs of melanocytic and non-melanocytic skin lesions were retrospectively reviewed and used to develop a CADx system. Conventional and new color-related image features were developed to classify the lesions as benign or malignant using support vector machines (SVMs). The performance of CADx was compared with that of dermatologists. Results The clinicians' overall sensitivity, specificity, and accuracy were 83.33%, 85.88%, and 85.31%, respectively. New color correlation and principal component analysis (PCA) features improved the classification ability of the baseline CADx (p = 0.001). The estimated area under the receiver operating characteristic (ROC) curve (Az) of the proposed CADx system was 0.949, with a sensitivity and specificity of 85.63% and 87.65%, respectively, and a maximum accuracy of 90.64%. Conclusions We have developed an effective CADx system to classify both melanocytic and non-melanocytic skin lesions using conventional digital macrographs. The system's performance was similar to that of dermatologists at our institute. Through improved feature extraction and SVM analysis, we found that conventional digital macrographs were feasible for providing useful information for CADx applications. The new color

  7. Use of genetic algorithms for computer-aided diagnosis of breast cancers from image features

    NASA Astrophysics Data System (ADS)

    Floyd, Carey E., Jr.; Tourassi, Georgia D.; Baker, Jay A.

    1996-04-01

    In this investigation we explore genetic algorithms as a technique to train the weights in a feed forward neural network designed to predict breast cancer based on mammographic findings and patient history. Mammograms were obtained from 206 patients who obtained breast biopsies. Mammographic findings were recorded by radiologists for each patient. In addition, the outcome of the biopsy was recorded. Of the 206 cases, 73 were malignant while 133 were benign at the time of biopsy. A genetic algorithm (GA) was developed to adjust the weights of an artificial neural network (ANN) so that the ANN would output the outcome of the biopsy when the mammographic findings were given as inputs. The GA is a technique for function optimization that reflects biological genetic evolution. The ANN was a fully connected feed- forward network using a sigmoid activation with 11 inputs, one hidden layer with 10 nodes, and one output node (benign/malignant). The GA approach allows much flexibility in selecting the function to be optimized. In this work both mean-squared error (MSE) and receiver operating characteristic (ROC) curve area (Az) were explored as optimization criteria. The system was trained using a bootstrap sampling. Optimizing for the two criteria result in different solutions. The 'best' solution was obtained by minimizing a linear combination of MSE and (1-Az). ROC areas were 0.82 plus or minus 0.07, somewhat less than those obtained using backpropagation for ANN training: 0.90 plus or minus 0.05. This is the first description of a genetic algorithm for breast cancer diagnosis. The novel advantage of this technique is the ability to optimize the system for maximizing ROC area rather than minimizing mean squared error. A new technique for computer-aided diagnosis of breast cancer has been explored. The flexibility of the GA approach allows optimization of cost functions that have relevance to breast cancer prediction.

  8. A tool for computer-aided diagnosis of retinopathy of prematurity

    NASA Astrophysics Data System (ADS)

    Zhao, Zheen; Wallace, David K.; Freedman, Sharon F.; Aylward, Stephen R.

    2008-03-01

    In this paper we present improvements to a software application, named ROPtool, that aids in the timely and accurate detection and diagnosis of retinopathy of prematurity (ROP). ROP occurs in 68% of infants less than 1251 grams at birth, and it is a leading cause of blindness for prematurely born infants. The standard of care for its diagnosis is the subjective assessment of retinal vessel dilation and tortuosity. There is significant inter-observer variation in those assessments. ROPtool analyzes retinal images, extracts user-selected blood vessels from those images, and quantifies the tortuosity of those vessels. The presence of ROP is then gauged by comparing the tortuosity of an infant's retinal vessels with measures made from a clinical-standard image of severely tortuous retinal vessels. The presence of such tortuous retinal vessels is referred to as 'plus disease'. In this paper, a novel metric of tortuosity is proposed. From the ophthalmologist's point of view, the new metric is an improvement from our previously published algorithm, since it uses smooth curves instead of straight lines to simulate 'normal vessels'. Another advantage of the new ROPtool is that minimal user interactions are required. ROPtool utilizes a ridge traversal algorithm to extract retinal vessels. The algorithm reconstructs connectivity along a vessel automatically. This paper supports its claims by reporting ROC curves from a pilot study involving 20 retinal images. The areas under two ROC curves, from two experts in ROP, using the new metric to diagnose 'tortuosity sufficient for plus disease', varied from 0.86 to 0.91.

  9. Age-based computer-aided diagnosis approach for pancreatic cancer on endoscopic ultrasound images

    PubMed Central

    Ozkan, Murat; Cakiroglu, Murat; Kocaman, Orhan; Kurt, Mevlut; Yilmaz, Bulent; Can, Guray; Korkmaz, Ugur; Dandil, Emre; Eksi, Ziya

    2016-01-01

    Aim: The aim was to develop a high-performance computer-aided diagnosis (CAD) system with image processing and pattern recognition in diagnosing pancreatic cancer by using endosonography images. Materials and Methods: On the images, regions of interest (ROI) of three groups of patients (<40, 40-60 and >60) were extracted by experts; features were obtained from images using three different techniques and were trained separately for each age group with an Artificial Neural Network (ANN) to diagnose cancer. The study was conducted on endosonography images of 202 patients with pancreatic cancer and 130 noncancer patients. Results: 122 features were identified from the 332 endosonography images obtained in the study, and the 20 most appropriate features were selected by using the relief method. Images classified under three age groups (in years; <40, 40-60 and >60) were tested via 200 random tests and the following ratios were obtained in the classification: accuracy: 92%, 88.5%, and 91.7%, respectively; sensitivity: 87.5%, 85.7%, and 93.3%, respectively; and specificity: 94.1%, 91.7%, and 88.9%, respectively. When all the age groups were assessed together, the following values were obtained: accuracy: 87.5%, sensitivity: 83.3%, and specificity: 93.3%. Conclusions: It was observed that the CAD system developed in the study performed better in diagnosing pancreatic cancer images based on classification by patient age compared to diagnosis without classification. Therefore, it is imperative to take patient age into consideration to ensure higher performance. PMID:27080608

  10. Computer-aided diagnosis scheme for histological classification of clustered microcalcifications on magnification mammograms.

    PubMed

    Nakayama, Ryohei; Uchiyama, Yoshikazu; Watanabe, Ryoji; Katsuragawa, Shigehiko; Namba, Kiyoshi; Doi, Kunio

    2004-04-01

    The histological classification of clustered microcalcifications on mammograms can be difficult, and thus often require biopsy or follow-up. Our purpose in this study was to develop a computer-aided diagnosis scheme for identifying the histological classification of clustered microcalcifications on magnification mammograms in order to assist the radiologists' interpretation as a "second opinion." Our database consisted of 58 magnification mammograms, which included 35 malignant clustered microcalcifications (9 invasive carcinomas, 12 noninvasive carcinomas of the comedo type, and 14 noninvasive carcinomas of the noncomedo type) and 23 benign clustered microcalcifications (17 mastopathies and 6 fibroadenomas). The histological classifications of all clustered microcalcifications were proved by pathologic diagnosis. The clustered microcalcifications were first segmented by use of a novel filter bank and a thresholding technique. Five objective features on clustered microcalcifications were determined by taking into account subjective features that experienced the radiologists commonly use to identify possible histological classifications. The Bayes decision rule with five objective features was employed for distinguishing between five histological classifications. The classification accuracies for distinguishing between three malignant histological classifications were 77.8% (7/9) for invasive carcinoma, 75.0% (9/12) for noninvasive carcinoma of the comedo type, and 92.9% (13/14) for noninvasive carcinoma of the noncomedo type. The classification accuracies for distinguishing between two benign histological classifications were 94.1% (16/17) for mastopathy, and 100.0% (6/6) for fibroadenoma. This computerized method would be useful in assisting radiologists in their assessments of clustered microcalcifications. PMID:15124996

  11. A novel approach to computer-aided diagnosis of mammographic images

    SciTech Connect

    Sari-Sarraf, H.; Gleason, S.S.; Hudson, K.T.; Hubner, K.F.

    1996-08-01

    This is a work-in-progress report of a research endeavor that deals with the design and development of a novel approach to computer-aided diagnosis (CAD) of mammographic images. With the initial emphasis being on the analysis of microcalcifications, the proposed approach defines a synergistic paradigm that utilizes new methodologies together with previously developed techniques. The new paradigm is intended to promote a higher degree of accuracy in CAD of mammograms with an increased overall throughput. The process of accomplishing these goals is initiated by the fractal encoding of the input image, which gives rise to the generation of focus-of-attention regions (FARs), that is, regions that contain anomalies. The primary thrust of this work is to demonstrate that by considering FARs, rather than the entire input image, the performances of the ensuing processes (i.e., segmentation, feature extraction, and classification) are enhanced in terms of accuracy and speed. After presenting the proposed approach to CAD of mammographic images, the paper describes the generation of FARs. Furthermore, an experimental study is included that demonstrates the impact of this front-end procedure on the process of microcalcification segmentation. Specifically, the experimentation reveals a dramatic decrease (increase) in the amount of input data (throughput), as well as a reduction in the number of false detections.

  12. Front-End Data Reduction in Computer-Aided Diagnosis of Mammograms: A Pilot Study

    SciTech Connect

    Gleason, S.S.; Nishikawa, R.M.; Sari-Sarraf, H.

    1999-02-20

    This paper presents the results of a pilot study whose primary objective was to further substantiate the efficacy of front-end data reduction in computer-aided diagnosis (CAD) of mammograms. This concept is realized by a preprocessing module that can be utilized at the front-end of most mammographic CAD systems. Based on fractal encoding, this module takes a mammo-graphic image as its input and generates, as its output, a collection of subregions called focus-of-attention regions (FARs). These FARs contain all structures in the input image that appear to be different from the normal background tissue. Subsequently, the CAD systems need only to process the presented FARs, rather than the entire input image. This accomplishes two objectives simultaneously: (1) an increase in throughput via a reduction in the input data, and (2) a reduction in false detections by limiting the scope of the detection algorithms to FARs only. The pilot study consisted of using the preprocessing module to analyze 80 mammographic images. The results were an average data reduction of 83% over all 80 images and an average false detection reduction of 86%. Furthermore, out of a total of 507 marked microcalcifications, 467 fell within FW, representing a coverage rate of 92%.

  13. A ROC-based feature selection method for computer-aided detection and diagnosis

    NASA Astrophysics Data System (ADS)

    Wang, Songyuan; Zhang, Guopeng; Liao, Qimei; Zhang, Junying; Jiao, Chun; Lu, Hongbing

    2014-03-01

    Image-based computer-aided detection and diagnosis (CAD) has been a very active research topic aiming to assist physicians to detect lesions and distinguish them from benign to malignant. However, the datasets fed into a classifier usually suffer from small number of samples, as well as significantly less samples available in one class (have a disease) than the other, resulting in the classifier's suboptimal performance. How to identifying the most characterizing features of the observed data for lesion detection is critical to improve the sensitivity and minimize false positives of a CAD system. In this study, we propose a novel feature selection method mR-FAST that combines the minimal-redundancymaximal relevance (mRMR) framework with a selection metric FAST (feature assessment by sliding thresholds) based on the area under a ROC curve (AUC) generated on optimal simple linear discriminants. With three feature datasets extracted from CAD systems for colon polyps and bladder cancer, we show that the space of candidate features selected by mR-FAST is more characterizing for lesion detection with higher AUC, enabling to find a compact subset of superior features at low cost.

  14. Quantitative evaluation of photic driving response for computer-aided diagnosis

    NASA Astrophysics Data System (ADS)

    Fukami, Tadanori; Ishikawa, Fumito; Ishikawa, Bunnoshin; Saito, Yoichi

    2008-12-01

    The aim of our research is the quantification of the photic driving response, a routine electroencephalogram (EEG) examination, for computer-aided diagnosis. It is well known that the EEG responds not only to the fundamental frequency but also to all sub and higher harmonics of a stimulus. In this study, we propose a method for detecting and evaluating responses in screening data for individuals. This method consists of two comparisons based on statistical tests. One is an intraindividual comparison between the EEG at rest and the photic stimulation (PS) response reflecting enhancement and suppression by PS, and the other is a comparison between data from an individual and a distribution of normals reflecting the position of the individual's data in the distribution of normals in the normal database. These tests were evaluated using the Z-value based on the Mann-Whitney U-test. We measured EEGs from 130 normal subjects and 30 patients with any of schizophrenia, dementia and epilepsy. Normal data were divided into two groups, the first consisting of 100 data for database construction and the second of 30 data for test data. Using our method, a prominent statistical peak of the Z-value was recognized even if the harmonics and alpha band overlapped. Moreover, we found a statistical difference between patients and the normal database at diagnostically helpful frequencies such as subharmonics, the fundamental wave, higher harmonics and the alpha frequency band.

  15. Analysis of the impact of digital watermarking on computer-aided diagnosis in medical imaging.

    PubMed

    Garcia-Hernandez, Jose Juan; Gomez-Flores, Wilfrido; Rubio-Loyola, Javier

    2016-01-01

    Medical images (MI) are relevant sources of information for detecting and diagnosing a large number of illnesses and abnormalities. Due to their importance, this study is focused on breast ultrasound (BUS), which is the main adjunct for mammography to detect common breast lesions among women worldwide. On the other hand, aiming to enhance data security, image fidelity, authenticity, and content verification in e-health environments, MI watermarking has been widely used, whose main goal is to embed patient meta-data into MI so that the resulting image keeps its original quality. In this sense, this paper deals with the comparison of two watermarking approaches, namely spread spectrum based on the discrete cosine transform (SS-DCT) and the high-capacity data-hiding (HCDH) algorithm, so that the watermarked BUS images are guaranteed to be adequate for a computer-aided diagnosis (CADx) system, whose two principal outcomes are lesion segmentation and classification. Experimental results show that HCDH algorithm is highly recommended for watermarking medical images, maintaining the image quality and without introducing distortion into the output of CADx.

  16. Three-class classification in computer-aided diagnosis of breast cancer by support vector machine

    NASA Astrophysics Data System (ADS)

    Sun, Xuejun; Qian, Wei; Song, Dansheng

    2004-05-01

    Design of classifier in computer-aided diagnosis (CAD) scheme of breast cancer plays important role to its overall performance in sensitivity and specificity. Classification of a detected object as malignant lesion, benign lesion, or normal tissue on mammogram is a typical three-class pattern recognition problem. This paper presents a three-class classification approach by using two-stage classifier combined with support vector machine (SVM) learning algorithm for classification of breast cancer on mammograms. The first classification stage is used to detect abnormal areas and normal breast tissues, and the second stage is for classification of malignant or benign in detected abnormal objects. A series of spatial, morphology and texture features have been extracted on detected objects areas. By using genetic algorithm (GA), different feature groups for different stage classification have been investigated. Computerized free-response receiver operating characteristic (FROC) and receiver operating characteristic (ROC) analyses have been employed in different classification stages. Results have shown that obvious performance improvement in both sensitivity and specificity was observed through proposed classification approach compared with conventional two-class classification approaches, indicating its effectiveness in classification of breast cancer on mammograms.

  17. Computer-aided diagnosis: detection and localization of prostate cancer within the peripheral zone.

    PubMed

    Rampun, Andrik; Chen, Zhili; Malcolm, Paul; Tiddeman, Bernie; Zwiggelaar, Reyer

    2016-05-01

    We propose a methodology for prostate cancer detection and localization within the peripheral zone based on combining multiple segmentation techniques. We extract four image features using Gaussian and median filters. Subsequently, we use each image feature separately to generate binary segmentations. Finally, we take the intersection of all four binary segmentations, incorporating a model of the peripheral zone, and perform erosion to remove small false-positive regions. The initial evaluation of this method is based on 275 MRI images from 37 patients, and 86% of the slices were classified correctly with 87% and 86% sensitivity and specificity achieved, respectively. This paper makes two contributions: firstly, a novel computer-aided diagnosis approach, which is based on combining multiple segmentation techniques using only a small number of simple image features, and secondly, the development of the proposed method and its application in prostate cancer detection and localization using a single MRI modality with the results comparable with the state-of-the-art multimodality and advanced computer vision methods in the literature. Copyright © 2015 John Wiley & Sons, Ltd.

  18. A public image database to support research in computer aided diagnosis.

    PubMed

    Reeves, A P; Biancardi, A M; Yankelevitz, D; Fotin, S; Keller, B M; Jirapatnakul, A; Lee, J

    2009-01-01

    The Public Lung Database to address drug response (PLD) has been developed to support research in computer aided diagnosis (CAD). Originally established for applications involving the characterization of pulmonary nodules, the PLD has been augmented to provide initial datasets for CAD research of other diseases. In general, the best performance for a CAD system is achieved when it is trained with a large amount of well documented data. Such training databases are very expensive to create and their lack of general availability limits the targets that can be considered for CAD applications and hampers development of the CAD field. The approach taken with the PLD has been to make available small datasets together with both manual and automated documentation. Furthermore, datasets with special properties are provided either to span the range of task complexity or to provide small change repeat images for direct calibration and evaluation of CAD systems. This resource offers a starting point for other research groups wishing to pursue CAD research in new directions. It also provides an on-line reference for better defining the issues relating to specific CAD tasks.

  19. Computer-Aided Diagnosis of Different Rotator Cuff Lesions Using Shoulder Musculoskeletal Ultrasound.

    PubMed

    Chang, Ruey-Feng; Lee, Chung-Chien; Lo, Chung-Ming

    2016-09-01

    The lifetime prevalence of shoulder pain approaches 70%, which is mostly attributable to rotator cuff lesions such as inflammation, calcific tendinitis and tears. On clinical examination, shoulder ultrasound is recommended for the detection of lesions. However, there exists inter-operator variability in diagnostic accuracy because of differences in the experience and expertise of operators. In this study, a computer-aided diagnosis (CAD) system was developed to assist ultrasound operators in diagnosing rotator cuff lesions and to improve the practicality of ultrasound examination. The collected cases included 43 cases of inflammation, 30 cases of calcific tendinitis and 26 tears. For each case, the lesion area and texture features were extracted from the entire lesions and combined in a multinomial logistic regression classifier for lesion classification. The proposed CAD achieved an accuracy of 87.9%. The individual accuracy of this CAD system was 88.4% for inflammation, 83.3% for calcific tendinitis and 92.3% for tears. Cohen's k was 0.798. On the basis of its diagnostic performance, clinical use of this CAD technique has promise.

  20. Impact of lesion segmentation metrics on computer-aided diagnosis/detection in breast computed tomography

    PubMed Central

    Kuo, Hsien-Chi; Giger, Maryellen L.; Reiser, Ingrid; Drukker, Karen; Boone, John M.; Lindfors, Karen K.; Yang, Kai; Edwards, Alexandra

    2014-01-01

    Abstract. Evaluation of segmentation algorithms usually involves comparisons of segmentations to gold-standard delineations without regard to the ultimate medical decision-making task. We compare two segmentation evaluations methods—a Dice similarity coefficient (DSC) evaluation and a diagnostic classification task–based evaluation method using lesions from breast computed tomography. In our investigation, we use results from two previously developed lesion-segmentation algorithms [a global active contour model (GAC) and a global with local aspects active contour model]. Although similar DSC values were obtained (0.80 versus 0.77), we show that the global + local active contour (GLAC) model, as compared with the GAC model, is able to yield significantly improved classification performance in terms of area under the receivers operating characteristic (ROC) curve in the task of distinguishing malignant from benign lesions. [Area under the ROC curve (AUC)=0.78 compared to 0.63, p≪0.001]. This is mainly because the GLAC model yields better detailed information required in the calculation of morphological features. Based on our findings, we conclude that the DSC metric alone is not sufficient for evaluating segmentation lesions in computer-aided diagnosis tasks. PMID:26158052

  1. Comparison between computer-aided diagnosis and radiologists: assessment of pulmonary blood flow on chest radiographs.

    PubMed

    Kido, S; Arisawa, J; Kuriyama, K; Kuroda, C; Nakamura, H

    2000-01-01

    To evaluate the performance of a computer-aided diagnosis (CAD) scheme for estimating increased pulmonary blood flow on chest radiographs, we compared computerized assessment with findings by radiologists. Our CAD scheme extracts selectively linear opacities corresponding to vessels in regions of interest (ROIs) in the right upper and lower lung zones on digitized chest radiographs, and then calculates a radiographic index as a physical measure that reflects the area of the extracted opacities in selected ROIs. As a measure of increased pulmonary blood flow, the upper/lower radiographic index ratio was calculated for each patient. Seven radiologists estimated the degree of increased pulmonary blood flow for the same images of ROI sets presented on a cathode-ray tube monitor in a randomized order. Between the normal-pulmonary capillary wedge pressure (PCWP) group and increased-PCWP groups, there was no significant difference in performance between CAD and radiologists (p = 0.105). However, when the normal and mild PCWP groups were compared, the performance of CAD was superior to that of radiologists (p = 0.001). This study indicates that our CAD scheme is promising for quantitative estimation of increased pulmonary blood flow, especially in mild cases.

  2. Computer-aided diagnosis of rheumatoid arthritis with optical tomography, Part 1: feature extraction

    PubMed Central

    Jia, Jingfei; Kim, Hyun K.; Netz, Uwe J.; Blaschke, Sabine; Müller, Gerhard A.

    2013-01-01

    Abstract. This is the first part of a two-part paper on the application of computer-aided diagnosis to diffuse optical tomography (DOT). An approach for extracting heuristic features from DOT images and a method for using these features to diagnose rheumatoid arthritis (RA) are presented. Feature extraction is the focus of Part 1, while the utility of five classification algorithms is evaluated in Part 2. The framework is validated on a set of 219 DOT images of proximal interphalangeal (PIP) joints. Overall, 594 features are extracted from the absorption and scattering images of each joint. Three major findings are deduced. First, DOT images of subjects with RA are statistically different (p<0.05) from images of subjects without RA for over 90% of the features investigated. Second, DOT images of subjects with RA that do not have detectable effusion, erosion, or synovitis (as determined by MRI and ultrasound) are statistically indistinguishable from DOT images of subjects with RA that do exhibit effusion, erosion, or synovitis. Thus, this subset of subjects may be diagnosed with RA from DOT images while they would go undetected by reviews of MRI or ultrasound images. Third, scattering coefficient images yield better one-dimensional classifiers. A total of three features yield a Youden index greater than 0.8. These findings suggest that DOT may be capable of distinguishing between PIP joints that are healthy and those affected by RA with or without effusion, erosion, or synovitis. PMID:23856915

  3. New genomic technologies: an aid for diagnosis of disorders of sex development.

    PubMed

    Barseghyan, H; Délot, E; Vilain, E

    2015-05-01

    The Chicago Consensus Conference of 2005 defined Disorders of Sex Development (DSD) as "congenital conditions in which the development of chromosomal, gonadal or anatomic sex is atypical." DSD diagnoses are difficult to establish. A lack of standardization of anatomical and endocrine phenotyping and the limited number of known DSD genes and genotype/correlation has long hampered the field, leaving many patients without a definitive diagnosis. The resulting uncertainty may intrinsically pose a great amount of discomfort to affected individuals and their families. DSD-causative genes have historically been identified thanks to positional cloning of disease-associated variants segregating in families or chromosomal rearrangements. Recent advances of chromosomal microarray and exome sequencing technologies are allowing for higher rates of diagnostic success for DSD patients and are changing clinical practice. In this review, we discuss the application of these technologies and their findings as an upcoming model for clinical diagnosis of DSD. We show that exome sequencing is a valuable tool and we propose that it should be used as a first-stage diagnostic technique because it allows for early identification of a genetic cause that may be critical for patient management.

  4. Enhancement of early cervical cancer diagnosis with epithelial layer analysis of fluorescence lifetime images.

    PubMed

    Gu, Jun; Fu, Chit Yaw; Ng, Beng Koon; Liu, Lin Bo; Lim-Tan, Soo Kim; Lee, Caroline Guat Lay

    2015-01-01

    This work reports the use of layer analysis to aid the fluorescence lifetime diagnosis of cervical intraepithelial neoplasia (CIN) from H&E stained cervical tissue sections. The mean and standard deviation of lifetimes in single region of interest (ROI) of cervical epithelium were previously shown to correlate to the gold standard histopathological classification of early cervical cancer. These previously defined single ROIs were evenly divided into layers for analysis. A 10-layer model revealed a steady increase in fluorescence lifetime from the inner to the outer epithelial layers of healthy tissue sections, suggesting a close association with cellular maturity. The shorter lifetime and minimal lifetime increase towards the epithelial surface of CIN-affected regions are in good agreement with the absence of cellular maturation in CIN. Mean layer lifetimes in the top-half cervical epithelium were used as feature vectors for extreme learning machine (ELM) classifier discriminations. It was found that the proposed layer analysis technique greatly improves the sensitivity and specificity to 94.6% and 84.3%, respectively, which can better supplement the traditional gold standard cervical histopathological examinations. PMID:25966026

  5. Ensembles of Deep Learning Architectures for the Early Diagnosis of the Alzheimer's Disease.

    PubMed

    Ortiz, Andrés; Munilla, Jorge; Górriz, Juan M; Ramírez, Javier

    2016-11-01

    Computer Aided Diagnosis (CAD) constitutes an important tool for the early diagnosis of Alzheimer's Disease (AD), which, in turn, allows the application of treatments that can be simpler and more likely to be effective. This paper explores the construction of classification methods based on deep learning architectures applied on brain regions defined by the Automated Anatomical Labeling (AAL). Gray Matter (GM) images from each brain area have been split into 3D patches according to the regions defined by the AAL atlas and these patches are used to train different deep belief networks. An ensemble of deep belief networks is then composed where the final prediction is determined by a voting scheme. Two deep learning based structures and four different voting schemes are implemented and compared, giving as a result a potent classification architecture where discriminative features are computed in an unsupervised fashion. The resulting method has been evaluated using a large dataset from the Alzheimer's disease Neuroimaging Initiative (ADNI). Classification results assessed by cross-validation prove that the proposed method is not only valid for differentiate between controls (NC) and AD images, but it also provides good performances when tested for the more challenging case of classifying Mild Cognitive Impairment (MCI) Subjects. In particular, the classification architecture provides accuracy values up to 0.90 and AUC of 0.95 for NC/AD classification, 0.84 and AUC of 0.91 for stable MCI/AD classification and 0.83 and AUC of 0.95 for NC/MCI converters classification. PMID:27478060

  6. Ensembles of Deep Learning Architectures for the Early Diagnosis of the Alzheimer's Disease.

    PubMed

    Ortiz, Andrés; Munilla, Jorge; Górriz, Juan M; Ramírez, Javier

    2016-11-01

    Computer Aided Diagnosis (CAD) constitutes an important tool for the early diagnosis of Alzheimer's Disease (AD), which, in turn, allows the application of treatments that can be simpler and more likely to be effective. This paper explores the construction of classification methods based on deep learning architectures applied on brain regions defined by the Automated Anatomical Labeling (AAL). Gray Matter (GM) images from each brain area have been split into 3D patches according to the regions defined by the AAL atlas and these patches are used to train different deep belief networks. An ensemble of deep belief networks is then composed where the final prediction is determined by a voting scheme. Two deep learning based structures and four different voting schemes are implemented and compared, giving as a result a potent classification architecture where discriminative features are computed in an unsupervised fashion. The resulting method has been evaluated using a large dataset from the Alzheimer's disease Neuroimaging Initiative (ADNI). Classification results assessed by cross-validation prove that the proposed method is not only valid for differentiate between controls (NC) and AD images, but it also provides good performances when tested for the more challenging case of classifying Mild Cognitive Impairment (MCI) Subjects. In particular, the classification architecture provides accuracy values up to 0.90 and AUC of 0.95 for NC/AD classification, 0.84 and AUC of 0.91 for stable MCI/AD classification and 0.83 and AUC of 0.95 for NC/MCI converters classification.

  7. Prenatal Diagnosis: Current Procedures and Implications for Early Interventionists Working with Families.

    ERIC Educational Resources Information Center

    Blasco, Patricia M.; And Others

    1994-01-01

    This article provides an overview of procedures commonly used in prenatal screening and diagnosis including ultrasound, amniocentesis, chorionic villus biopsy, maternal serum alpha-fetoprotein, and deoxyribonucleic acid (DNA) analysis. Emphasis is on the role of the early interventionist in supporting families during prenatal diagnosis. (Author/DB)

  8. Amyloid imaging with PET in early Alzheimer disease diagnosis.

    PubMed

    Rowe, Christopher C; Villemagne, Victor L

    2013-05-01

    In vivo imaging of amyloid-β (Aβ) with positron emission tomography has moved from the research arena into clinical practice. Clinicians working with cognitive decline and dementia must become familiar with its benefits and limitations. Amyloid imaging allows earlier diagnosis of Alzheimer disease and better differential diagnosis of dementia and provides prognostic information for mild cognitive impairment. It also has an increasingly important role in therapeutic trial recruitment and for evaluation of anti-Aβ treatments. Longitudinal observations are required to elucidate the role of Aβ deposition in the course of Alzheimer disease and provide information needed to fully use the prognostic power of this investigation.

  9. Computer-aided texture analysis combined with experts' knowledge: Improving endoscopic celiac disease diagnosis

    PubMed Central

    Gadermayr, Michael; Kogler, Hubert; Karla, Maximilian; Merhof, Dorit; Uhl, Andreas; Vécsei, Andreas

    2016-01-01

    AIM To further improve the endoscopic detection of intestinal mucosa alterations due to celiac disease (CD). METHODS We assessed a hybrid approach based on the integration of expert knowledge into the computer-based classification pipeline. A total of 2835 endoscopic images from the duodenum were recorded in 290 children using the modified immersion technique (MIT). These children underwent routine upper endoscopy for suspected CD or non-celiac upper abdominal symptoms between August 2008 and December 2014. Blinded to the clinical data and biopsy results, three medical experts visually classified each image as normal mucosa (Marsh-0) or villous atrophy (Marsh-3). The experts’ decisions were further integrated into state-of-the-art texture recognition systems. Using the biopsy results as the reference standard, the classification accuracies of this hybrid approach were compared to the experts’ diagnoses in 27 different settings. RESULTS Compared to the experts’ diagnoses, in 24 of 27 classification settings (consisting of three imaging modalities, three endoscopists and three classification approaches), the best overall classification accuracies were obtained with the new hybrid approach. In 17 of 24 classification settings, the improvements achieved with the hybrid approach were statistically significant (P < 0.05). Using the hybrid approach classification accuracies between 94% and 100% were obtained. Whereas the improvements are only moderate in the case of the most experienced expert, the results of the less experienced expert could be improved significantly in 17 out of 18 classification settings. Furthermore, the lowest classification accuracy, based on the combination of one database and one specific expert, could be improved from 80% to 95% (P < 0.001). CONCLUSION The overall classification performance of medical experts, especially less experienced experts, can be boosted significantly by integrating expert knowledge into computer-aided diagnosis

  10. Ultrasound based computer-aided-diagnosis of kidneys for pediatric hydronephrosis

    NASA Astrophysics Data System (ADS)

    Cerrolaza, Juan J.; Peters, Craig A.; Martin, Aaron D.; Myers, Emmarie; Safdar, Nabile; Linguraru, Marius G.

    2014-03-01

    Ultrasound is the mainstay of imaging for pediatric hydronephrosis, though its potential as diagnostic tool is limited by its subjective assessment, and lack of correlation with renal function. Therefore, all cases showing signs of hydronephrosis undergo further invasive studies, like diuretic renogram, in order to assess the actual renal function. Under the hypothesis that renal morphology is correlated with renal function, a new ultrasound based computer-aided diagnosis (CAD) tool for pediatric hydronephrosis is presented. From 2D ultrasound, a novel set of morphological features of the renal collecting systems and the parenchyma, is automatically extracted using image analysis techniques. From the original set of features, including size, geometric and curvature descriptors, a subset of ten features are selected as predictive variables, combining a feature selection technique and area under the curve filtering. Using the washout half time (T1/2) as indicative of renal obstruction, two groups are defined. Those cases whose T1/2 is above 30 minutes are considered to be severe, while the rest would be in the safety zone, where diuretic renography could be avoided. Two different classification techniques are evaluated (logistic regression, and support vector machines). Adjusting the probability decision thresholds to operate at the point of maximum sensitivity, i.e., preventing any severe case be misclassified, specificities of 53%, and 75% are achieved, for the logistic regression and the support vector machine classifier, respectively. The proposed CAD system allows to establish a link between non-invasive non-ionizing imaging techniques and renal function, limiting the need for invasive and ionizing diuretic renography.

  11. [Esophageal pathology in patients with the AIDS virus. Etiology and diagnosis].

    PubMed

    Varsky, C G; Yahni, V D; Freire, M C; Patrizio, E; Balbo, V; Benetucci, J; Boffi, A; Mattoni, R A; Luis; Alicia, M

    1991-01-01

    From 180 patients infected with human immunodeficiency virus (HIV) and followed-up for one year, 17 cases (9.44%) were referred to detect oesophageal pathology. They were prospectively analyzed through fibroscopy, radiology, biopsies for histopathology, virology and mycology and brush cytology. Most frequent symptoms were dysphagia. Odynophagia and retrosternal pain, usually associated, and not providing an accurate diagnostic clue. The most common causes of symptoms were oesophageal candidiasis (47.70%), and herpetic ulcers (23.52%) caused by herpes simplex virus (HSV) type 2. Reflux pathology was also found (11.76%). Cytomegalovirus, other opportunistic infections and tumors were not detected. Seven (64%) of the eleven patients with oesophageal candidiasis also had oral involvement. Four (66%) of six oesophageal ulcers were herpetic; two of them (50%) showed oral ulcers too, and one (25%) had perioral herpetic blisters. Almost in every case endoscopic features allowed diagnosis. Endoscopy in candidiasis showed isolated or confluent white plaques of variable grade. Herpetic ulcers, alone or multiple, were deep with slightly elevated borders. Radiology yielded a poor diagnostic profit (50%), specially in case of multiple lesions. Cytology was highly specific and sensitive (both 90.9%) and suggested viral etiology in 100% of HSV patients. Histopathology was less sensitive than endoscopy and cytology (73% in candida and one HSV non-ulcer case). Both, cytology and histopathology showed koilocytosis in herpetic virus infected patients. The studies performed allowed to change the HIV disease stage in ten patients (62.5%) and to diagnose AIDS in seven (43.75%). In every case medical behavior was oriented or changed by these studies.

  12. Stepwise linear discriminant analysis in computer-aided diagnosis: the effect of finite sample size

    NASA Astrophysics Data System (ADS)

    Sahiner, Berkman; Chan, Heang-Ping; Petrick, Nicholas; Wagner, Robert F.; Hadjiiski, Lubomir M.

    1999-05-01

    In computer-aided diagnosis, a frequently-used approach is to first extract several potentially useful features from a data set. Effective features are then selected from this feature space, and a classifier is designed using the selected features. In this study, we investigated the effect of finite sample size on classifier accuracy when classifier design involves feature selection. The feature selection and classifier coefficient estimation stages of classifier design were implemented using stepwise feature selection and Fisher's linear discriminant analysis, respectively. The two classes used in our simulation study were assumed to have multidimensional Gaussian distributions, with a large number of features available for feature selection. We investigated the effect of different covariance matrices and means for the two classes on feature selection performance, and compared two strategies for sample space partitioning for classifier design and testing. Our results indicated that the resubstitution estimate was always optimistically biased, except in cases where too few features were selected by the stepwise procedure. When feature selection was performed using only the design samples, the hold-out estimate was always pessimistically biased. When feature selection was performed using the entire finite sample space, and the data was subsequently partitioned into design and test groups, the hold-out estimates could be pessimistically or optimistically biased, depending on the number of features available for selection, number of available samples, and their statistical distribution. All hold-out estimates exhibited a pessimistic bias when the parameters of the simulation were obtained from texture features extracted from mammograms in a previous study.

  13. Computer-aided texture analysis combined with experts' knowledge: Improving endoscopic celiac disease diagnosis

    PubMed Central

    Gadermayr, Michael; Kogler, Hubert; Karla, Maximilian; Merhof, Dorit; Uhl, Andreas; Vécsei, Andreas

    2016-01-01

    AIM To further improve the endoscopic detection of intestinal mucosa alterations due to celiac disease (CD). METHODS We assessed a hybrid approach based on the integration of expert knowledge into the computer-based classification pipeline. A total of 2835 endoscopic images from the duodenum were recorded in 290 children using the modified immersion technique (MIT). These children underwent routine upper endoscopy for suspected CD or non-celiac upper abdominal symptoms between August 2008 and December 2014. Blinded to the clinical data and biopsy results, three medical experts visually classified each image as normal mucosa (Marsh-0) or villous atrophy (Marsh-3). The experts’ decisions were further integrated into state-of-the-art texture recognition systems. Using the biopsy results as the reference standard, the classification accuracies of this hybrid approach were compared to the experts’ diagnoses in 27 different settings. RESULTS Compared to the experts’ diagnoses, in 24 of 27 classification settings (consisting of three imaging modalities, three endoscopists and three classification approaches), the best overall classification accuracies were obtained with the new hybrid approach. In 17 of 24 classification settings, the improvements achieved with the hybrid approach were statistically significant (P < 0.05). Using the hybrid approach classification accuracies between 94% and 100% were obtained. Whereas the improvements are only moderate in the case of the most experienced expert, the results of the less experienced expert could be improved significantly in 17 out of 18 classification settings. Furthermore, the lowest classification accuracy, based on the combination of one database and one specific expert, could be improved from 80% to 95% (P < 0.001). CONCLUSION The overall classification performance of medical experts, especially less experienced experts, can be boosted significantly by integrating expert knowledge into computer-aided diagnosis

  14. Study on computer-aided diagnosis of hepatic MR imaging and mammography

    SciTech Connect

    Zhang Xuejun

    2005-04-01

    It is well known that the liver is an organ easily attacked by diseases. The purpose of this study is to develop a computer-aided diagnosis (CAD) scheme for helping radiologists to differentiate hepatic diseases more efficiently. Our software named LIVERANN integrated the magnetic resonance (MR) imaging findings with different pulse sequences to classify the five categories of hepatic diseases by using the artificial neural network (ANN) method. The intensity and homogeneity within the region of interest (ROI) delineated by a radiologist were automatically calculated to obtain numerical data by the program for input signals to the ANN. Outputs were the five pathological categories of hepatic diseases (hepatic cyst, hepatocellular carcinoma, dysplasia in cirrhosis, cavernous hemangioma, and metastasis). The experiment demonstrated a testing accuracy of 93% from 80 patients. In order to differentiate the cirrhosis from normal liver, the volume ratio of left to whole (LTW) was proposed to quantify the degree of cirrhosis by three-dimensional (3D) volume analysis. The liver region was firstly extracted from computed tomography (CT) or MR slices based on edge detection algorithms, and then separated into left lobe and right lobe by the hepatic umbilical fissure. The volume ratio of these two parts showed that the LTW ratio in the liver was significantly improved in the differentiation performance, with (25.6%{+-}4.3%) in cirrhosis versus the normal liver (16.4%{+-}5.4%). In addition, the application of the ANN method for detecting clustered microcalcifications in masses on mammograms was described here as well. A new structural ANN, so-called a shift-invariant artificial neural network (SIANN), was integrated with our triple-ring filter (TRF) method in our CAD system. As the result, the sensitivity of detecting clusters was improved from 90% by our previous TRF method to 95% by using both SIANN and TRF.

  15. Assessment of the relationship between lesion segmentation accuracy and computer-aided diagnosis scheme performance

    NASA Astrophysics Data System (ADS)

    Zheng, Bin; Pu, Jiantao; Park, Sang Cheol; Zuley, Margarita; Gur, David

    2008-03-01

    In this study we randomly select 250 malignant and 250 benign mass regions as a training dataset. The boundary contours of these regions were manually identified and marked. Twelve image features were computed for each region. An artificial neural network (ANN) was trained as a classifier. To select a specific testing dataset, we applied a topographic multi-layer region growth algorithm to detect boundary contours of 1,903 mass regions in an initial pool of testing regions. All processed regions are sorted based on a size difference ratio between manual and automated segmentation. We selected a testing dataset involving 250 malignant and 250 benign mass regions with larger size difference ratios. Using the area under ROC curve (A Z value) as performance index we investigated the relationship between the accuracy of mass segmentation and the performance of a computer-aided diagnosis (CAD) scheme. CAD performance degrades as the size difference ratio increases. Then, we developed and tested a hybrid region growth algorithm that combined the topographic region growth with an active contour approach. In this hybrid algorithm, the boundary contour detected by the topographic region growth is used as the initial contour of the active contour algorithm. The algorithm iteratively searches for the optimal region boundaries. A CAD likelihood score of the growth region being a true-positive mass is computed in each iteration. The region growth is automatically terminated once the first maximum CAD score is reached. This hybrid region growth algorithm reduces the size difference ratios between two areas segmented automatically and manually to less than +/-15% for all testing regions and the testing A Z value increases to from 0.63 to 0.90. The results indicate that CAD performance heavily depends on the accuracy of mass segmentation. In order to achieve robust CAD performance, reducing lesion segmentation error is important.

  16. Distance weighted 'inside disc' classifier for computer-aided diagnosis of colonic polyps

    NASA Astrophysics Data System (ADS)

    Hu, Yifan; Song, Bowen; Pickhardt, Perry J.; Liang, Zhengrong

    2015-03-01

    Feature classification plays an important role in computer-aided diagnosis (CADx) of suspicious lesions or polyps in this concerned study. As one of the simplest machine learning algorithms, the k-nearest neighbor (k-NN) classifier has been widely used in many classification problems. However, the k-NN classifier has a drawback that the majority classes will dominate the prediction of a new sample. To mitigate this drawback, efforts have been devoted to set weight on each neighbor to avoid the influence of the "majority" classes. As a result, various weighted or wk-NN strategies have been explored. In this paper, we explored an alternative strategy, called "distance weighted inside disc" (DWID) classifier, which is different from the k-NN and wk-NN by such a way that it classifies the test point by assigning a corresponding label (instead a weight) with consideration of only those points inside the disc whose center is the test point instead of the k-nearest points. We evaluated this new DWID classifier with comparison to the k-NN, wk-NN, support vector machine (SVM) and random forest (RF) classifiers by experiments on a database of 153 polyps, including 116 neoplastic (malignance) polyps and 37 hyperplastic (benign) polyps, in terms of CADx or differentiation of benign from malignancy. The evaluation outcomes were documented quantitatively by the Receiver Operating Characteristics (ROC) analysis and the merit of area under the ROC curve (AUC), which is a well-established evaluation criterion to various classifiers. The results showed noticeable gain on the polyp differentiation by this new classifier according to the AUC values, as compared to the k-NN and wk-NN, as well as the SVM and RF. In the meantime, this new classifier also showed a noticeable reduction of computing time.

  17. 78 FR 10183 - Ryan White HIV/AIDS Program, Part C Early Intervention Services Grant Under the Ryan White HIV...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-02-13

    ... INFORMATION: The amount of the award to ensure ongoing HIV medical services is $543,037. Authority: Section... HUMAN SERVICES Health Resources and Services Administration Ryan White HIV/AIDS Program, Part C Early Intervention Services Grant Under the Ryan White HIV/AIDS Program AGENCY: Health Resources and...

  18. 78 FR 10183 - Ryan White HIV/AIDS Program, Part C Early Intervention Services Grant Under the Ryan White HIV...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-02-13

    ... health service areas. DFHS will continue to provide critical HIV medical care and treatment services... HUMAN SERVICES Health Resources and Services Administration Ryan White HIV/AIDS Program, Part C Early Intervention Services Grant Under the Ryan White HIV/AIDS Program AGENCY: Health Resources and...

  19. A new indicator in early drought diagnosis of cucumber with chlorophyll fluorescence imaging

    NASA Astrophysics Data System (ADS)

    Wang, Heng; Li, Haifeng; Xu, Liang; Liu, Xu

    2015-05-01

    Crop population growth information can more fully reflect the state of crop growth, eliminate individual differences, and reduce error in judgment. We have built a suitable plant population growth information online monitoring system with the plant chlorophyll fluorescence and spectral scanning imaging to get the crop growth status. On the basis of the fluorescence image detection, we have studied the early drought diagnosis of cucumber. The typical chlorophyll fluorescence parameters can not reflect the drought degree significantly. We define a new indication parameter (DI). With the drought deepening, DI declines. DI can enlarge the early manifestation of cucumber drought (3-5 days), indicate more significantly in the early drought diagnosis of cucumber.

  20. Extenuating Circumstances in Perceptions of Suicide: Disease Diagnosis (AIDS, Cancer), Pain Level, and Life Expectancy.

    ERIC Educational Resources Information Center

    Martin, Stephen K.; Range, Lillian M.

    1991-01-01

    Examined whether illness type, pain level, and life expectancy affected reactions of undergraduates (n=160) toward a terminal illness suicide with Acquired Immune Deficiency Syndrome (AIDS) or cancer. AIDS patients were more stigmatized than cancer patients; suicide was more tolerated if victim was suffering greater pain. (Author/ABL)

  1. Early Diagnosis and Treatment of Traumatic Vestibulopathy and Postconcussive Dizziness.

    PubMed

    Hoffer, Michael E; Schubert, Michael C; Balaban, Carey D

    2015-08-01

    Mild traumatic brain injury (mTBI) is a common health condition in amateur and professional sports and in military operations but can occur in everyday life. Dizziness is the most common disorder seen after mTBI followed closely by headache. This article examines the diagnosis and treatment of vestibular disorders after mTBI. Data are included from the literature, and conclusions are drawn from the literature review and the experience of the authors. Much of what is known about this disorder comes from recent military experience, but the link to more common civilian injuries is detailed in this article. PMID:26231278

  2. [Early diagnosis of a newborn with a mediastinal mass].

    PubMed

    Flores-Hernández, Salomón Sergio; Ahumada Mendoza, Héctor; Santana-Montero, Blanca Lilia; González Flores, María de Lourdes

    2005-01-01

    Neuroblastoma is an embryonal tumour that evolves from the neural crest cell. This neoplasm may arise at any site in the sympathetic nervous system, including the brain, the cervical region, the posterior mediastinum, the para-aortic sympathetic ganglia, the pelvis, and the adrenal medulla. The clinical presentation in neonatal age is rare and the differential diagnosis includes congenital lung malformations, pneumoniae, atelectasia, etc. The case of a newborn with a mediastinal neuroblastoma is presented. This case illustrates how a patient with an X-ray image compatible with a thoracic tumor should be studied. PMID:16381510

  3. [EPCA-2 in the early diagnosis of prostate cancer].

    PubMed

    Yu, De-Shui; Xu, Zhuo-Qun

    2010-06-01

    More and more clinical evidence has confirmed the limitations of the use of serum PSA in the screening, detection and treatment of prostate cancer, and scientists are continuously seeking for new biomarkers of the disease. The discovery of early prostate cancer antigen 2 (EPCA-2) has provided a new base for the screening, detection, treatment and follow-up of prostate cancer.

  4. Early diagnosis and Early Start Denver Model intervention in autism spectrum disorders delivered in an Italian Public Health System service

    PubMed Central

    Devescovi, Raffaella; Monasta, Lorenzo; Mancini, Alice; Bin, Maura; Vellante, Valerio; Carrozzi, Marco; Colombi, Costanza

    2016-01-01

    Background Early diagnosis combined with an early intervention program, such as the Early Start Denver Model (ESDM), can positively influence the early natural history of autism spectrum disorders. This study evaluated the effectiveness of an early ESDM-inspired intervention, in a small group of toddlers, delivered at low intensity by the Italian Public Health System. Methods Twenty-one toddlers at risk for autism spectrum disorders, aged 20–36 months, received 3 hours/wk of one-to-one ESDM-inspired intervention by trained therapists, combined with parents’ and teachers’ active engagement in ecological implementation of treatment. The mean duration of treatment was 15 months. Cognitive and communication skills, as well as severity of autism symptoms, were assessed by using standardized measures at pre-intervention (Time 0 [T0]; mean age =27 months) and post-intervention (Time 1 [T1]; mean age =42 months). Results Children made statistically significant improvements in the language and cognitive domains, as demonstrated by a series of nonparametric Wilcoxon tests for paired data. Regarding severity of autism symptoms, younger age at diagnosis was positively associated with greater improvement at post-assessment. Conclusion Our results are consistent with the literature that underlines the importance of early diagnosis and early intervention, since prompt diagnosis can reduce the severity of autism symptoms and improve cognitive and language skills in younger children. Particularly in toddlers, it seems that an intervention model based on the ESDM principles, involving the active engagement of parents and nursery school teachers, may be effective even when the individual treatment is delivered at low intensity. Furthermore, our study supports the adaptation and the positive impact of the ESDM entirely sustained by the Italian Public Health System. PMID:27366069

  5. Retrieval boosted computer-aided diagnosis of clustered microcalcifications for breast cancer

    PubMed Central

    Jing, Hao; Yang, Yongyi; Nishikawa, Robert M.

    2012-01-01

    Purpose: The authors propose an image-retrieval based approach for case-adaptive classifier design in computer-aided diagnosis (CADx). The conventional approach in CADx is to first train a pattern-classifier based on a set of existing training samples and then apply this classifier to subsequent new cases. The purpose of this work is to improve the classification accuracy of a CADx classifier by making use of a set of known cases retrieved from a reference library that are similar to the case under consideration. Methods: In the proposed approach, the authors will first apply image-retrieval to obtain a set of lesion images from a library of known cases that have similar image features to a case being diagnosed (i.e., query). These retrieved cases are then used to optimize a pattern-classifier toward boosting its classification accuracy on the query case. The basic idea is to put more emphasis on those cases that are similar to the query. The proposed approach is demonstrated first using a linear classifier and then extended to a nonlinear classifier induced by kernel principal component analysis. Results: The proposed retrieval-driven approach was tested on a library of mammogram images from 1006 cases (646 benign and 360 malignant) obtained from multiple institutions and was demonstrated to yield significant improvement in classification performance. Measured by the area under the receiver operating characteristic curve (AUC), the case-adaptive approach could boost the classification performance of a linear classifier from AUC = 0.7415 to AUC = 0.7807; similar improvement was also obtained for a nonlinear classifier, with AUC boosted from 0.7527 to 0.7838. Conclusions: Use of additional cases from a reference library that have similar image features can improve the classification accuracy of a CADx classifier on a query case. It can even outperform retraining the classifier with all the cases from the entire reference library. This implies that cases with

  6. Early lipoedema diagnosis and the RCGP e-learning course.

    PubMed

    Fetzer, Amy; Fetzer, Sharie

    2015-04-01

    Frequently misdiagnosed as obesity, lipoedema is chronic condition involving an abnormal build-up of fat cells in the legs, thighs and buttocks that cannot be shifted by exercise or dieting. Estimated to affect up to 11% of the female population, the condition is widely unknown by health professionals. This means women typically wait for many years before diagnosis. This allows the condition to progress unchecked, resulting in unnecessary deterioration and the development of associated comorbidities, as well as significant pain and mental anguish. A free, 30-minute Royal College of General Practitioners (RCGP) e-learning course created in partnership with Lipoedema UK aims to rectify this situation by educating nurses, GPs and other health professionals on how to diagnose and manage lipoedema in primary care. This article aims to describe the condition of lipoedema, how to recognise/diagnose it, current treatment options and the findings of a 240-patient survey carried out by Lipoedema UK in 2013 that included documenting the difficulties for patients in obtaining a diagnosis as well as the mental and physical effects of the condition.

  7. Histological diagnosis of early and suspicious leprosy by in situ PCR.

    PubMed

    Natrajan, M; Katoch, K; Katoch, V M; Das, Ram; Sharma, V D

    2012-01-01

    Leprosy is a chronic mycobacterial disease whose diagnosis is primarily based on clinico-pathological examination and supported by slit skin smears for the presence of acid fast bacilli (AFB). However, definitive diagnosis of early leprosy and those suspected to have the disease but not histologically confirmed pose major public health problems. The present study reports the utility of the in situ Polymerase Chain Reaction amplification (PCR) directed at a 530bp fragment of DNA encoding the 36kd antigen of the causative Mycobacterium leprae for the diagnosis of such patients using skin biopsies of lesions. Twenty five adult patients (aged 15-50yrs) each from the clinical categories of Early and clinically Suspect leprosy were selected for the study after obtaining permission. They had solitary lesions, which were negative for AFB on slit skin smear examination. Routine histopathology confirmed the diagnosis of leprosy in 8/25 (32%) cases in the category of Early leprosy with AFB being seen in 2 biopsies, and in 5/25(20%) cases of Suspect leprosy with AFB being seen in a solitary case. The Direct in situ PCR procedure which was performed in the histologically unconfirmed cases improved the diagnosis with positive results observed in 12/17 (70.6%) cases of Early (p=0.001) and in 12/20 (60%) cases of Suspect Leprosy (p=0.005 indicating the usefulness of the Direct in situ PCR to establish the diagnosis of leprosy in histologically doubtful cases.

  8. Early diagnosis of diabetic retinopathy in primary care

    PubMed Central

    Jimenez-Baez, Maria Valeria; Barcenas-Contreras, Rodolfo; Morales Montoya, Carlos; Espinosa-Garcia, Laura Fatima

    2015-01-01

    Objective: To evaluate the impact of a strategy for early detection of diabetic retinopathy in patients with type 2 diabetes mellitus (DMT2) in Quintana Roo, México. Methods: Study transversal, observational, prospective, analytical, eight primary care units from Mexican Social Security Institute in the northern delegation of the State of Quintana Roo, Mexico were included. A program for early detection of diabetic retinopathy (DR) in adult 376,169 was designed. Were diagnosed 683 cases of type 2 diabetes, in 105 patients randomized was conducted to direct ophthalmoscopy were subjected to a secondary hospital were assigned. Will determine the degree of diabetic retinopathy and macular edema was performed. Results: In population were 55.2% female, mean age 48+11.1 years, 23.8 % had some degree of DR, 28.0% with mild non- proliferative diabetic retinopathy 48.0 % moderate 16.0% and severe and 8.0% showed proliferative diabetic retinopathy. Those over age 30 are 2.8 times more risk of developing DR, OR= 2.8; 95%CI: 0.42-18.0, and OR= 1.7; 95%CI: 1.02-2.95 women. Conclusions: The implementation of programs aimed at the early detection of debilitating conditions such as diabetic retinopathy health impact beneficiaries, effective links between primary care systems and provide second level positive health outcomes for patient diseases. PMID:26019380

  9. Early chronic kidney disease: diagnosis, management and models of care.

    PubMed

    Wouters, Olivier J; O'Donoghue, Donal J; Ritchie, James; Kanavos, Panos G; Narva, Andrew S

    2015-08-01

    Chronic kidney disease (CKD) is prevalent in many countries, and the costs associated with the care of patients with end-stage renal disease (ESRD) are estimated to exceed US$1 trillion globally. The clinical and economic rationale for the design of timely and appropriate health system responses to limit the progression of CKD to ESRD is clear. Clinical care might improve if early-stage CKD with risk of progression to ESRD is differentiated from early-stage CKD that is unlikely to advance. The diagnostic tests that are currently used for CKD exhibit key limitations; therefore, additional research is required to increase awareness of the risk factors for CKD progression. Systems modelling can be used to evaluate the impact of different care models on CKD outcomes and costs. The US Indian Health Service has demonstrated that an integrated, system-wide approach can produce notable benefits on cardiovascular and renal health outcomes. Economic and clinical improvements might, therefore, be possible if CKD is reconceptualized as a part of primary care. This Review discusses which early CKD interventions are appropriate, the optimum time to provide clinical care, and the most suitable model of care to adopt.

  10. Posterior reversible encephalopathy syndrome: the importance of early diagnosis.

    PubMed

    Teotónio, Rute; Marmoto, Dina; Januário, Cristina; Bento, Conceição

    2012-09-17

    A 14-year-old boy was submitted to cardiac transplant due to a dilated cardiomyopathy. On the fourth day of immunosuppression (corticosteroids, mycophenolate mofetil and tacrolimus), he developed right focal seizures and drowsiness. Blood pressure was in the normal range and laboratory findings in cerebral spinal fluid and blood were unremarkable, with drugs in non-toxic levels. The EEG showed a slow background rhythm more pronounced on the right and a seizure onset in the right occipital region. MRI revealed a diffuse hyperintense subcortical white-matter lesion on fluid attenuated inversion recovery, with lesser involvement of left temporal-occipital region. There was no enhancement with gadolinium and MRI diffusion-weighted imaging was consistent with vasogenic oedema. Tacrolimus was stopped with regression of MRI abnormalities and clinical recovery. Posterior reversible encephalopathy associated with tacrolimus is a rare but potentially serious complication of solid organ transplants. A prompt diagnosis and correct treatment is essential to avoid irreversible brain damage.

  11. Early diagnosis of teeth erosion using polarized laser speckle imaging.

    PubMed

    Abou Nader, Christelle; Pellen, Fabrice; Loutfi, Hadi; Mansour, Rassoul; Le Jeune, Bernard; Le Brun, Guy; Abboud, Marie

    2016-07-01

    Dental erosion starts with a chemical attack on dental tissue causing tooth demineralization, altering the tooth structure and making it more sensitive to mechanical erosion. Medical diagnosis of dental erosion is commonly achieved through a visual inspection by the dentist during dental checkups and is therefore highly dependent on the operator's experience. The detection of this disease at preliminary stages is important since, once the damage is done, cares become more complicated. We investigate the difference in light-scattering properties between healthy and eroded teeth. A change in light-scattering properties is observed and a transition from volume to surface backscattering is detected by means of polarized laser speckle imaging as teeth undergo acid etching, suggesting an increase in enamel surface roughness. PMID:26720050

  12. Early diagnosis of teeth erosion using polarized laser speckle imaging

    NASA Astrophysics Data System (ADS)

    Nader, Christelle Abou; Pellen, Fabrice; Loutfi, Hadi; Mansour, Rassoul; Jeune, Bernard Le; Brun, Guy Le; Abboud, Marie

    2016-07-01

    Dental erosion starts with a chemical attack on dental tissue causing tooth demineralization, altering the tooth structure and making it more sensitive to mechanical erosion. Medical diagnosis of dental erosion is commonly achieved through a visual inspection by the dentist during dental checkups and is therefore highly dependent on the operator's experience. The detection of this disease at preliminary stages is important since, once the damage is done, cares become more complicated. We investigate the difference in light-scattering properties between healthy and eroded teeth. A change in light-scattering properties is observed and a transition from volume to surface backscattering is detected by means of polarized laser speckle imaging as teeth undergo acid etching, suggesting an increase in enamel surface roughness.

  13. Diagnosis of neuronal ceroid lipofuscinosis type 2 (CLN2 disease): Expert recommendations for early detection and laboratory diagnosis.

    PubMed

    Fietz, Michael; AlSayed, Moeenaldeen; Burke, Derek; Cohen-Pfeffer, Jessica; Cooper, Jonathan D; Dvořáková, Lenka; Giugliani, Roberto; Izzo, Emanuela; Jahnová, Helena; Lukacs, Zoltan; Mole, Sara E; Noher de Halac, Ines; Pearce, David A; Poupetova, Helena; Schulz, Angela; Specchio, Nicola; Xin, Winnie; Miller, Nicole

    2016-09-01

    Neuronal ceroid lipofuscinoses (NCLs) are a heterogeneous group of lysosomal storage disorders. NCLs include the rare autosomal recessive neurodegenerative disorder neuronal ceroid lipofuscinosis type 2 (CLN2) disease, caused by mutations in the tripeptidyl peptidase 1 (TPP1)/CLN2 gene and the resulting TPP1 enzyme deficiency. CLN2 disease most commonly presents with seizures and/or ataxia in the late-infantile period (ages 2-4), often in combination with a history of language delay, followed by progressive childhood dementia, motor and visual deterioration, and early death. Atypical phenotypes are characterized by later onset and, in some instances, longer life expectancies. Early diagnosis is important to optimize clinical care and improve outcomes; however, currently, delays in diagnosis are common due to low disease awareness, nonspecific clinical presentation, and limited access to diagnostic testing in some regions. In May 2015, international experts met to recommend best laboratory practices for early diagnosis of CLN2 disease. When clinical signs suggest an NCL, TPP1 enzyme activity should be among the first tests performed (together with the palmitoyl-protein thioesterase enzyme activity assay to rule out CLN1 disease). However, reaching an initial suspicion of an NCL or CLN2 disease can be challenging; thus, use of an epilepsy gene panel for investigation of unexplained seizures in the late-infantile/childhood ages is encouraged. To confirm clinical suspicion of CLN2 disease, the recommended gold standard for laboratory diagnosis is demonstration of deficient TPP1 enzyme activity (in leukocytes, fibroblasts, or dried blood spots) and the identification of causative mutations in each allele of the TPP1/CLN2 gene. When it is not possible to perform both analyses, either demonstration of a) deficient TPP1 enzyme activity in leukocytes or fibroblasts, or b) detection of two pathogenic mutations in trans is diagnostic for CLN2 disease. PMID:27553878

  14. Computed tomography--a possible aid in the diagnosis of smoke inhalation injury?

    PubMed

    Reske, A; Bak, Z; Samuelsson, A; Morales, O; Seiwerts, M; Sjöberg, F

    2005-02-01

    Inhalation injury is an important contributor to morbidity and mortality in burn victims and can trigger acute lung injury and acute respiratory distress syndrome (ARDS) (1-3). Early diagnosis and treatment of inhalation injury are important, but a major problem in planning treatment and evaluating the prognosis has been the lack of consensus about diagnostic criteria (4). Chest radiographs on admission are often non-specific (5, 6), but indicators include indoor fires, facial burns, bronchoscopic findings of soot in the airways, and detection of carbon monoxide or cyanide in the blood (7). Changes in the lungs may be detected by bronchoscopy with biopsy, xenon imaging, or measurement of pulmonary extracellular fluid (4, 5, 8). These methods have, however, been associated with low sensitivity and specificity, as exemplified by the 50% predictive value in the study of Masanes et al. (8). Computed tomographs (CTs) are better than normal chest radiographs in the detection of other pulmonary lesions such as pulmonary contusion (9, 10). The importance of CT scans in patients with ARDS has been reviewed recently (9), but unfortunately there has been no experience of CT in patients with smoke inhalation injury. To our knowledge, there are only two animal studies reporting that smoke inhalation injury can be detected by CT (4, 11); specific changes in human CT scans have not yet been described. Therefore, confronted with a patient with severe respiratory failure after a burn who from the history and physical examination showed the classic risk factors for inhalation injury, we decided to request a CT. PMID:15715631

  15. Biomarkers for hepatocellular carcinoma: progression in early diagnosis, prognosis, and personalized therapy

    PubMed Central

    2013-01-01

    Hepatocellular carcinoma (HCC) is one of the most common malignant tumors in the world. Currently, surgical resection, liver transplantation, and local ablation are considered curative therapeutic practices for HCC. The diagnosis of HCC without pathologic confirmation is achieved by analyzing serum alpha-fetoprotein (AFP) levels combined with imaging techniques, including ultrasonography, magnetic resonance imaging, and computerized tomography. Although progress has been made in the diagnosis and management of HCC, its prognosis remains dismal. Various new technologies have identified numerous novel biomarkers with potential diagnostic as well as prognostic value, including Dickkopf-1 and Golgi protein 73. These biomarkers not only help in the early diagnosis and prediction of prognosis, but also assist in identifying potential targets for therapeutic interventions. In this article, we provide an up-to-date review of the biomarkers that are used for early diagnosis, prognosis prediction, and personalized treatment of HCC. PMID:24252133

  16. Improving the Accuracy of CT Colonography Interpretation: Computer-Aided Diagnosis

    PubMed Central

    Summers, Ronald M.

    2010-01-01

    Synopsis Computer-aided polyp detection aims to improve the accuracy of the colonography interpretation. The computer searches the colonic wall to look for polyp-like protrusions and presents a list of suspicious areas to a physician for further analysis. Computer-aided polyp detection has developed rapidly over the past decade and in the laboratory setting and has sensitivities comparable to those of experts. Computer-aided polyp detection tends to help inexperienced readers more than experienced ones and may also lead to small reductions in specificity. In its currently proposed use as an adjunct to standard image interpretation, computer-aided polyp detection serves as a spellchecker rather than an efficiency enhancer. PMID:20451814

  17. Ultrasonography applications in diagnosis and management of early rheumatoid arthritis.

    PubMed

    Thiele, Ralf G

    2012-05-01

    Ultrasonography is an elegant tool for the detection of tenosynovitis, synovitis, and erosions very early in rheumatoid arthritis, and the presence of a power Doppler signal is one of the best predictors of joint damage. Although clinical scores remain the mainstay of disease activity assessment, ultrasonography has proved to be a remarkably robust tool for reliable assessment of changes in rheumatoid arthritis. There is no evidence to suggest that problems with operator dependence would be greater than with other imaging modalities or physical examination, if performed by trained providers.

  18. Development of an assisting detection system for early infarct diagnosis

    SciTech Connect

    Sim, K. S.; Nia, M. E.; Ee, C. S.

    2015-04-24

    In this paper, a detection assisting system for early infarct detection is developed. This new developed method is used to assist the medical practitioners to diagnose infarct from computed tomography images of brain. Using this assisting system, the infarct could be diagnosed at earlier stages. The non-contrast computed tomography (NCCT) brain images are the data set used for this system. Detection module extracts the pixel data from NCCT brain images, and produces the colourized version of images. The proposed method showed great potential in detecting infarct, and helps medical practitioners to make earlier and better diagnoses.

  19. Mondini dysplasia as a cause for recurrent bacterial meningitis: an early diagnosis.

    PubMed

    Anandi, Shobi; Tullu, Milind S; Bhatia, Sonal; Agrawal, Mukesh

    2012-08-01

    Mondini dysplasia is a rare but an important cause for recurrent pyogenic meningitis in children and requires a high index of clinical suspicion for early diagnosis. We present the case of a 7-year-old boy, who presented with 2 episodes of pyogenic meningitis within a span of 1 month. There was no obvious history of hearing abnormalities, but pure tone audiometry suggested profound mixed hearing loss in the left ear. High-resolution computed tomographic scan and magnetic resonance imaging of temporal bones confirmed the diagnosis of Mondini dysplasia in the left ear. Computed tomographic cisternography failed to demonstrate any obvious cerebrospinal fluid leak. The child was managed conservatively and has been asymptomatic since then. Thus, in our patient, Mondini dysplasia as a cause for recurrent pyogenic meningitis was diagnosed (early) during the second episode of meningitis. The need for an early diagnosis of Mondini dysplasia has been stressed in this report. PMID:22290862

  20. Photo diagnosis of early pre cancer (LSIL) in genital tissue

    NASA Astrophysics Data System (ADS)

    Vaitkuviene, A.; Andersen-Engels, S.; Auksorius, E.; Bendsoe, N.; Gavriushin, V.; Gustafsson, U.; Oyama, J.; Palsson, S.; Soto Thompson, M.; Stenram, U.; Svanberg, K.; Viliunas, V.; De Weert, M. J.

    2005-11-01

    Permanent infections recognized as oncogenic factor. STD is common concomitant diseases in early precancerous genital tract lesions. Simple optical detection of early regressive pre cancer in cervix is the aim of this study. Hereditary immunosupression most likely is risk factor for cervical cancer development. Light induced fluorescence point monitoring fitted to live cervical tissue diagnostics in 42 patients. Human papilloma virus DNR in cervix tested by means of Hybrid Capture II method. Ultraviolet (337 nm) laser excited fluorescence spectra in the live cervical tissue analyzed by Principal Component (PrC) regression method and spectra decomposition method. PCr method best discriminated pathology group "CIN I and inflammation"(AUC=75%) related to fluorescence emission in short wave region. Spectra decomposition method suggested a few possible fluorophores in a long wave region. Ultraviolet (398 nm) light excitation of live cervix proved sharp selective spectra intensity enhancement in region above 600nm for High-grade cervical lesion. Conclusion: PC analysis of UV (337 nm) light excitation fluorescence spectra gives opportunity to obtain local immunity and Low-grade cervical lesion related information. Addition of shorter and longer wavelengths is promising for multi wave LIF point monitoring method progress in cervical pre-cancer diagnostics and utility for cancer prevention especially in developing countries.

  1. Early Diagnosis of Orthopedic Implant Failure Using Macromolecular Imaging Agents

    PubMed Central

    Ren, Ke; Dusad, Anand; Zhang, Yijia; Purdue, P. Edward; Fehringer, Edward V.; Garvin, Kevin L.; Goldring, Steven R.; Wang, Dong

    2014-01-01

    Purpose To develop and evaluate diagnostic tools for early detection of wear particle-induced orthopaedic implant loosening. Methods N-(2-hydroxypropyl)methacrylamide (HPMA) copolymer was tagged with an near infrared dye and used to detect the inflammation induced by polymethylmethacrylate (PMMA) particles in a murine peri-implant osteolysis model. It was established by inserting implant into distal femur and with routine PMMA particles challenging. The osteolysis was evaluated by micro-CT and histological analysis at different time points. Results Significant peri-implant osteolysis was found three-month post PMMA particle challenge by micro-CT and histological analysis. At one-month time point, when there was no significant peri-implant bone loss, HPMA copolymer-near infrared dye conjugate was found to specifically target to the femur with PMMA particles deposition, but not the contralateral control femur with PBS infusion. Conclusion The results from this study demonstrated the feasibility of utilizing the macromolecular diagnostic agent to report particle-induced peri-implant inflammation prior to the development of detectable osteolysis. Recognition of this early pathological event would provide the window of opportunity for prevention of peri-implant osteolysis and subsequent orthopaedic implant failure. PMID:24590878

  2. A diagnosis of chronic kidney disease: despite fears patients want to know early

    PubMed Central

    Wright Nunes, Julie; Roney, Meghan; Kerr, Eve; Ojo, Akinlolu; Fagerlin, Angela

    2016-01-01

    Aims: We elicited input from patients on their experience getting a chronic kidney disease (CKD) diagnosis to use for optimizing current CKD education interventions. Methods: We performed structured one-on-one patient interviews. Interviews were recorded, transcribed, and coded using modified grounded theory. Participants had CKD, were not on dialysis, and were recruited from general nephrology practices. Results: 49 patients enrolled from January to October 2014. Interviews revealed four major themes: 1. Reaction to diagnosis – patients described emotional reactions and subsequent behavior changes (152 statements); 2. Timing of diagnosis – patients described how they were told about their diagnosis and expectations of when a person should be told (149 statements); 3. Mediators in diagnosis delivery – patients discussed things that helped or hindered understanding and acceptance of their diagnosis (64 statements), and 4. Perceptions of diagnosis terminology – patients discussed perceptions about diagnostic terms (e.g., “chronic kidney disease”) (91 statements). Cross-sectional study design and setting limit interpretation of causality and generalizability. Conclusions: Patients experience fear but prefer early diagnosis communication. More work is needed to define evidence-based guidelines for diagnosis messaging across the spectrum of care. PMID:27345185

  3. Thallium poisoning: emphasis on early diagnosis and response to haemodialysis.

    PubMed

    Misra, U K; Kalita, J; Yadav, R K; Ranjan, P

    2003-02-01

    Thallium poisoning is known for its diverse manifestations and these can delay the diagnosis if a clear history of poisoning is not forthcoming. A 42 year old man presented on the third day of illness with flaccid quadriparesis and paresthesia, which were confused with Guillain-Barré syndrome. Because of associated loose motions, skin lesions, and liver and kidney dysfunction arsenic poisoning was considered. In the second week he developed ophthalmoplegia, nystagmus, and neck tremor and later developed alopecia, and thallium poisoning was suspected. His serum thallium level on the 18th day of illness was 40 980 micro g/ml. He was subjected to haemodialysis, potassium supplementation, laxatives, and B complex supplementation. He showed significant improvement after haemodialysis and at three months he was able to walk with support. At six months of follow up he was independent for activities of daily living. Severe paresthesia, ophthalmoplegia, cerebellar and extrapyramidal signs, and alopecia are highly suggestive of thallium poisoning. Haemodialysis may be effective even in the third week of poisoning.

  4. Screening for prevention and early diagnosis of cancer.

    PubMed

    Wardle, Jane; Robb, Kathryn; Vernon, Sally; Waller, Jo

    2015-01-01

    The poor outcomes for cancers diagnosed at an advanced stage have been the driver behind research into techniques to detect disease before symptoms are manifest. For cervical and colorectal cancer, detection and treatment of "precancers" can prevent the development of cancer, a form of primary prevention. For other cancers-breast, prostate, lung, and ovarian-screening is a form of secondary prevention, aiming to improve outcomes through earlier diagnosis. International and national expert organizations regularly assess the balance of benefits and harms of screening technologies, issuing clinical guidelines for population-wide implementation. Psychological research has made important contributions to this process, assessing the psychological costs and benefits of possible screening outcomes (e.g., the impact of false positive results) and public tolerance of overdiagnosis. Cervical, colorectal, and breast screening are currently recommended, and prostate, lung, and ovarian screening are under active review. Once technologies and guidelines are in place, delivery of screening is implemented according to the health care system of the country, with invitation systems and provider recommendations playing a key role. Behavioral scientists can then investigate how individuals make screening decisions, assessing the impact of knowledge, perceived cancer risk, worry, and normative beliefs about screening, and this information can be used to develop strategies to promote screening uptake. This article describes current cancer screening options, discusses behavioral research designed to reduce underscreening and minimize inequalities, and considers the issues that are being raised by informed decision making and the development of risk-stratified approaches to screening. PMID:25730719

  5. Role of the dental surgeon in the early detection of adults with underlying HIV infection / AIDS

    PubMed Central

    Cano, Jorge; del Romero, Jorge; Hernando, Victoria; del Amo, Julia; Moreno, Santiago

    2012-01-01

    A review is made of the late diagnosis of human immunodeficiency virus (HIV) infection, a subject of growing interest in public health. It has been estimated that in Europe 30% of all HIV-infected people are unaware of their seropositive condition, and this in turn is associated with a poorer long-term disease prognosis and an increased risk of transmission to other individuals. The role of the dental surgeon in this context could be of great importance, since there are many oral lesions that can suggest the existence of underlying infection. The study also addresses the controversial subject of rapid HIV testing, and whether these tests should be performed on a routine basis in the dental clinic, or whether it is preferable to refer the patient to a specialized center. Key words:HIV in Spain, HIV screening, early diagnosis. PMID:22143719

  6. [Quantitative perimetry for early diagnosis of open-angle glaucoma].

    PubMed

    Wu, L

    1993-09-01

    105 eyes were examined with the OCTUPUS 2000R automated perimeter. Of 19 glaucomatous eyes with abnormal visual fields by arc perimeter and campimeter, all showed field abnormalities by the quantitative perimetry, the defects being mostly of the mixed type (13/19), in the medium stage (10/19). Among 48 eyes of glaucoma or suspected glaucoma with normal visual fields by arc perimeter and campimeter, 33 showed field abnormalities by the quantitative perimetry, the defects being mostly of the mixed and diffuse type (29/33), in the early minor stage (23/33). The characteristic field defects were mostly sectorial and arcuate scotomata and some in the form of nasal steps. Among 38 normal eyes, minor local or diffuse field defects were found in 6 eyes.

  7. Novel endoscopic imaging system for early cancer diagnosis

    NASA Astrophysics Data System (ADS)

    Igarashi, Makoto; Gono, Kazuhiro

    2007-02-01

    We have developed the novel video endoscope imaging techniques; Narrow band imaging (NBI), Auto-Fluorescence Imaging (AFI), Infra-Red Imaging (IRI) and Endo-Cytoscopy System (ECS). The purpose of these imaging techniques is to emphasize the important tissue features associated with early stage of lesions. We have already launched the new medical endoscope system including NBI, AFI and IRI (EVIS LUCERA SPECTRUM, OLYMPUS MEDICAL SYSTEMS Co., Ltd., Fig.1). Moreover ECS, which has enough magnification to observe cell nuclei on a superficial mucosa under methylene blue dye staining, is the endoscopic instrument with ultra-high optical zoom. In this paper we demonstrate the concepts and the medical efficacy of each technology.

  8. Early Diagnosis and Monitoring of Neurodegenerative Langerhans Cell Histiocytosis

    PubMed Central

    Mortilla, Marzia; Savelli, Sara; Grisotto, Laura; Di Giacomo, Gianpiero; Romano, Katiuscia; Fonda, Claudio; Biggeri, Annibale; Guerrini, Renzo; Aricò, Maurizio

    2015-01-01

    Background Neurodegenerative Langerhans Cell Histiocytosis (ND-LCH) is a rare, unpredictable consequence that may devastate the quality of life of patients cured from LCH. We prospectively applied a multidisciplinary diagnostic work-up to early identify and follow-up patients with ND-LCH, with the ultimate goal of better determining the appropriate time for starting therapy. Methods We studied 27 children and young adults with either ND-LCH verified by structural magnetic resonance imaging (MRI) (group 1) or specific risk factors for (diabetes insipidus, craniofacial bone lesions), but no evidence of, neurodegenerative MRI changes (group 2). All patients underwent clinical, neurophysiological and MRI studies. Results Seventeen patients had MRI alterations typical for ND-LCH. Nine showed neurological impairment but only three were symptomatic; 11 had abnormal somatosensory evoked potentials (SEPs), and five had abnormal brainstem auditory evoked potentials (BAEPs). MR spectroscopy (MRS) showed reduced cerebellar NAA/Cr ratio in nine patients. SEPs showed sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) for predicting ND-LCH of 70.6% (95%CI, 44.0%-89.7%), 100% (69.2%-100%), 100% (73.5%-100%), and 66.7% (38.4%-88.2%), respectively. Repeated investigations in group 1 revealed increasingly abnormal EP parameters, or neurological examination, or both, in nine of fifteen patients while MRI remained unchanged in all but one patient. Conclusion A targeted MRI study should be performed in all patients with risk factors for ND-LCH for early identification of demyelination. The combined use of SEPs and careful neurological evaluation may represent a valuable, low-cost, well-tolerated and easily available methodology to monitor patients from pre-symptomatic to symptomatic stages. We suggest a multidisciplinary protocol including clinical, MRS, and neurophysiological investigations to identify a population target for future

  9. Potential of optical coherence tomography for early diagnosis of oral malignancies

    PubMed Central

    DeCoro, Michael; Wilder-Smith, Petra

    2014-01-01

    With nearly 1,500,000 new patients diagnosed every year in the USA, cancer poses a considerable challenge to healthcare today. Oral cancer is responsible for a sizeable portion of deaths due to cancer, primarily because it is diagnosed at a late stage when the prognosis is poor. Current methods for diagnosing oral cancer need to be augmented by better early detection, monitoring and screening modalities. A new approach is needed that provides real-time, accurate, noninvasive diagnosis. The results of early clinical trials using in vivo optical coherence tomography for the diagnosis of oral dysplasia and malignancy are encouraging. PMID:20214513

  10. Medical versus surgical methods of early abortion: protocol for a systematic review and environmental scan of patient decision aids

    PubMed Central

    Donnelly, Kyla Z; Thompson, Rachel

    2015-01-01

    Introduction Currently, we lack understanding of the content, quality and impact of patient decision aids to support decision-making between medical and surgical methods of early abortion. We plan to undertake a systematic review of peer-reviewed literature to identify, appraise and describe the impact of early abortion method decision aids evaluated quantitatively (Part I), and an environmental scan to identify and appraise other early abortion method decision aids developed in the US (Part II). Methods and analysis For the systematic review, we will search PubMed, Cochrane Library, CINAHL, EMBASE and PsycINFO databases for articles describing experimental and observational studies evaluating the impact of an early abortion method decision aid on women's decision-making processes and outcomes. For the environmental scan, we will identify decision aids by supplementing the systematic review search with Internet-based searches and key informant consultation. The primary reviewer will assess all studies and decision aids for eligibility, and a second reviewer will also assess a subset of these. Both reviewers will independently assess risk of bias in the studies and abstract data using a piloted form. Finally, both reviewers will assess decision aid quality using the International Patient Decision Aid Standards criteria, ease of readability using Flesch/Flesch-Kincaid tests, and informational content using directed content analysis. Ethics and dissemination As this study does not involve human subjects, ethical approval will not be sought. We aim to disseminate the findings in a scientific journal, via academic and/or professional conferences and among the broader community to contribute knowledge about current early abortion method decision-making support. Trial registration number This protocol is registered in the International Prospective Register of Systematic Reviews (CRD42015016717). PMID:26173718

  11. Techniques for early diagnosis of oral squamous cell carcinoma: Systematic review

    PubMed Central

    Carreras-Torras, Clàudia

    2015-01-01

    Background and objectives The diagnosis of early oral potentially malignant disorders (OPMD) and oral squamous cell carcinoma (OSCC) is of paramount clinical importance given the mortality rate of late stage disease. The aim of this study is to review the literature to assess the current situation and progress in this area. Material and Methods A search in Cochrane and PubMed (January 2006 to December 2013) has been used with the key words “squamous cell carcinoma”, “early diagnosis” “oral cavity”, “Potentially Malignant Disorders” y “premalignant lesions”. The inclusion criteria were the use of techniques for early diagnosis of OSCC and OPMD, 7 years aged articles and publications written in English, French or Spanish. The exclusion criteria were case reports and studies in other languages. Results Out of the 89 studies obtained initially from the search 60 articles were selected to be included in the systematic review: 1 metaanalysis, 17 systematic reviews, 35 prospective studies, 5 retrospective studies, 1 consensus and 1 semi-structured interviews. Conclusions The best diagnostic technique is that which we have sufficient experience and training. Definitely tissue biopsy and histopathological examination should remain the gold standard for oral cancer diagnose. In this systematic review it has not been found sufficient scientific evidence on the majority of proposed techniques for early diagnosis of OSCC, therefore more extensive and exhaustive studies are needed. Key words: Squamous cell carcinoma, early diagnosis, oral cavity, potentially malignant disorders, premalignant lesions. PMID:25662554

  12. [Lipids composition diet in phenylketonuric children with early diagnosis].

    PubMed

    Cornejo, Verónica; Concha, Miluska; Cabello, Juan Francisco; Raimann, Erna

    2005-12-01

    Phenylketonuria (PKU) is a genetic disorder caused by a partial or complete mutation of the enzyme phenylalanine hydroxylase (PHA), fact that produces high levels of phenylalanine in blood resulting in mental retardation if not diagnosed during the neonatal period. Treatment consists of a phenylalanine (Phe) restricted diet. Several studies have shown that due to restriction of animal protein, this diet is deficient in fatty acids such as alfalinolenic acid (ALA) and provides high levels of linoleic acid (LA). The objective of this study was to determine the lipid composition of the diet consumed by children with early-diagnosed PKU. Lipid composition of the Phenylalanine restricted diet consumed by 29 children with PKU and in follow-up at INTA, University of Chile, were analyzed. Children were paired by sex and age with a control group. A twenty-four hour dietary recall was performed for 3 consecutive days and total fatty acid intake, including saturated, monounsaturated, polyunsaturated, LA and ALA, were calculated. In the restricted diet of children with PKU, 31.8% of total calories are from fat, 13% of which are LA and 0.2% ALA, showing significant differences as compared to the control group. The ratio of saturated:monounsaturated:polyunsaturated fatty acids was 1:1.7:3.9 and the ratio of LA:ALA was ten-fold higher than the recommended ratio of 115:1. It is concluded that the Phenyalanine restricted diet of Chilean children with PKU is high in LA and low in ALA.

  13. Epidemiology and early diagnosis of primary liver cancer in China

    SciTech Connect

    Yen, F.S.; Shen, K.N.

    1986-01-01

    Epidemiological studies in different areas in China have revealed several outstanding risk factors of PLC, i.e., HBV infection, pollution of drinking water, contamination of food by AFB1 and/or nitrosamines, and family predisposition. Accordingly, a program of HBV vaccination, improved supply of drinking water, better preservation and storage of food, and possibly chemoprevention for high-risk populations should be effective preventive measures. Studies have shown that frequent AFP screening in high-risk populations is highly recommended to detect early cases of PLC. According to research in Qidong, careful follow-up of the dynamic changes of AFP in individuals with persistent low levels of positive AFP is important for distinguishing other conditions from true PLC. Newer means for the localization of small-size PLC (under 5 cm), such as type B ultrasonography, nuclide scanning, computerized tomography, and hepatoangiography, represent remarkable progress in improving markedly the success of surgery and hence the survival rate of PLC patients. The advances in knowledge of PLC have been encouraging. Although much work remains to be done on the etiological agents and the mechanism of oncogenesis, it is time that larger scale control measures be put into effect in high-incidence areas to discover if one of the most common cancers in the world can be controlled. 62 references.

  14. Computer-aided detection of early cancer in the esophagus using HD endoscopy images

    NASA Astrophysics Data System (ADS)

    van der Sommen, Fons; Zinger, Svitlana; Schoon, Erik J.; de With, Peter H. N.

    2013-02-01

    Esophageal cancer is the fastest rising type of cancer in the Western world. The recent development of High-Definition (HD) endoscopy has enabled the specialist physician to identify cancer at an early stage. Nevertheless, it still requires considerable effort and training to be able to recognize these irregularities associated with early cancer. As a first step towards a Computer-Aided Detection (CAD) system that supports the physician in finding these early stages of cancer, we propose an algorithm that is able to identify irregularities in the esophagus automatically, based on HD endoscopic images. The concept employs tile-based processing, so our system is not only able to identify that an endoscopic image contains early cancer, but it can also locate it. The identification is based on the following steps: (1) preprocessing, (2) feature extraction with dimensionality reduction, (3) classification. We evaluate the detection performance in RGB, HSI and YCbCr color space using the Color Histogram (CH) and Gabor features and we compare with other well-known features to describe texture. For classification, we employ a Support Vector Machine (SVM) and evaluate its performance using different parameters and kernel functions. In experiments, our system achieves a classification accuracy of 95.9% on 50×50 pixel tiles of tumorous and normal tissue and reaches an Area Under the Curve (AUC) of 0.990. In 22 clinical examples our algorithm was able to identify all (pre-)cancerous regions and annotate those regions reasonably well. The experimental and clinical validation are considered promising for a CAD system that supports the physician in finding early stage cancer.

  15. A hybrid fuzzy-neural system for computer-aided diagnosis of ultrasound kidney images using prominent features.

    PubMed

    Bommanna Raja, K; Madheswaran, M; Thyagarajah, K

    2008-02-01

    The objective of this work is to develop and implement a computer-aided decision support system for an automated diagnosis and classification of ultrasound kidney images. The proposed method distinguishes three kidney categories namely normal, medical renal diseases and cortical cyst. For the each pre-processed ultrasound kidney image, 36 features are extracted. Two types of decision support systems, optimized multi-layer back propagation network and hybrid fuzzy-neural system have been developed with these features for classifying the kidney categories. The performance of the hybrid fuzzy-neural system is compared with the optimized multi-layer back propagation network in terms of classification efficiency, training and testing time. The results obtained show that fuzzy-neural system provides higher classification efficiency with minimum training and testing time. It has also been found that instead of using all 36 features, ranking the features enhance classification efficiency. The outputs of the decision support systems are validated with medical expert to measure the actual efficiency. The overall discriminating capability of the systems is accessed with performance evaluation measure, f-score. It has been observed that the performance of fuzzy-neural system is superior compared to optimized multi-layer back propagation network. Such hybrid fuzzy-neural system with feature extraction algorithms and pre-processing scheme helps in developing computer-aided diagnosis system for ultrasound kidney images and can be used as a secondary observer in clinical decision making.

  16. Correlative morphologic and functional imaging for diagnosis, staging and follow up in AIDS: an overview.

    PubMed

    Brunetti, A; Soricelli, A; Rotondo, A; Alfano, B; Raman, R; Celentano, L; Di Chiro, G; Salvatore, M

    1995-09-01

    The immunocompromised patient can be affected by different opportunistic infections and tumors, that can involve all organ systems, and particularly, the central nervous system, the respiratory system, the gastrointestinal tract. The extreme variability of AIDS presentations requires a specific preparation and cooperation between the different diagnostic imaging specialists and a close collaboration with the clinicians. With AIDS, different morphologic and functional imaging techniques can be used for detection of disease sites, assessment of the extent of the disease and monitoring of disease changes over time and response to treatment. The complexity of AIDS presentations is such that full integration of the complementary information obtained with different techniques could be most useful. Image registration (coregistration, fusion) indicates approaches where precise spatial cross-references are obtained, in order to combine the information acquired with different imaging modalities, in particular by blending morphologic CT/MRI data with functional SPET/PET data. In this paper, an overview of the developments in the field of "image fusion" follows some comments on the results of morphologic and functional assessment of brain, chest and abdominal diseases in the course of AIDS, as illustrative examples of the potential benefits of multimodality image correlation.

  17. Prehospital diagnosis of massive ethylene glycol poisoning and use of an early antidote.

    PubMed

    Amathieu, Roland; Merouani, Medhi; Borron, Stephen W; Lapostolle, Frédéric; Smail, Nadia; Adnet, Frédéric

    2006-08-01

    We report the case of a patient suspected of voluntary massive poisoning by ethylene glycol. Prehospital diagnosis was established by portable blood analyser and an early antidote with 4 MP treatment initiated in out-of-hospital setting. Use of portable blood analyser in prehospital care should be considered in case of suspected massive poisoning by ethylene glycol. PMID:16808995

  18. Marketing EPSDT to Clients: A Self-Instructional Module for Early Periodic Screening Diagnosis Treatment.

    ERIC Educational Resources Information Center

    Simon, John L.; McArdle, Patricia

    Early and Periodic Screening, Diagnosis and Treatment (EPSDT) is a program of preventive health services available to individuals under 21 years of age who are eligible for Medicaid benefits. As of July 1, 1973, all states operating a Medicaid program were required to provide EPSDT services to all those eligible. The purpose of this module is to…

  19. [Potential of abdominal computed tomography and ultrasonography for the complex diagnosis of early gastric cancer].

    PubMed

    Gorshkov, A N

    2003-01-01

    The potential of computed tomography and ultrasonography in making complex diagnosis of "small forms" of early gastric cancer was demonstrated by evaluation of the data on examination of 116 patients and the pivotal role of the extent of intramural invasion was established. The semiotics of computed tomography and ultrasonography for intramural invasion and the sequence of X-ray and endoscopic procedures were developed.

  20. Chinese consensus on early diagnosis of primary lung cancer (2014 version).

    PubMed

    Hu, Jie; Qian, Gui-Sheng; Bai, Chun-Xue

    2015-09-01

    The incidence and mortality of lung cancer in China have rapidly increased. Lung cancer is the leading cause of cancer death in China, possibly because of the inadequate early diagnosis of lung cancer. Reaching a consensus on early diagnostic strategies for lung cancer in China is an unmet needed. Recently, much progress has been made in lung cancer diagnosis, such as screening in high-risk populations, the application of novel imaging technologies, and the use of minimally invasive techniques for diagnosis. However, systemic reviews of disease history, risk assessment, and patients' willingness to undergo invasive diagnostic procedures also need to be considered. A diagnostic strategy for lung cancer should be proposed and developed by a multidisciplinary group. A comprehensive evaluation of patient factors and clinical findings should be completed before treatment.

  1. Could a new sensory pen assist in the early diagnosis of Parkinson's?

    PubMed

    Walker, Richard W; Zietsma, Rutger; Gray, William K

    2014-05-01

    Neurodegeneration in Parkinson's disease (PD) affects both the fine motor control of the fingers and gross movement of the upper limb. Handwriting examinations are commonly performed in the analysis of tremor in PD and there is validity in subjective assessment in the clinic. However, there is clinical need for a more objective assessment instrument to assist in diagnosis. The Manus platform is a novel sensor system with automated mathematical methods, integrated with a digital pen, for differential diagnosis of PD that allows an objective assessment of handwriting. Our team are starting a clinical trial to assess the clinical usefulness of the system for differential diagnosis. The ability of the system to diagnose PD will be validated against the current best practice diagnosis of clinical opinion (or dopamine transporter imaging scan (DaTSCAN) imaging when an unequivocal diagnosis cannot be made). If the study proves clinically successful, the system may find application in clinics to aid in differentiating between impairments and be a low-cost alternative to DaTSCAN that can be operated with minimal training and is acceptable to patients.

  2. On-line early fault detection and diagnosis of municipal solid waste incinerators.

    PubMed

    Zhao, Jinsong; Huang, Jianchao; Sun, Wei

    2008-11-01

    A fault detection and diagnosis framework is proposed in this paper for early fault detection and diagnosis (FDD) of municipal solid waste incinerators (MSWIs) in order to improve the safety and continuity of production. In this framework, principal component analysis (PCA), one of the multivariate statistical technologies, is used for detecting abnormal events, while rule-based reasoning performs the fault diagnosis and consequence prediction, and also generates recommendations for fault mitigation once an abnormal event is detected. A software package, SWIFT, is developed based on the proposed framework, and has been applied in an actual industrial MSWI. The application shows that automated real-time abnormal situation management (ASM) of the MSWI can be achieved by using SWIFT, resulting in an industrially acceptable low rate of wrong diagnosis, which has resulted in improved process continuity and environmental performance of the MSWI. PMID:18255276

  3. Iterative method for automatic detection of masses in digital mammograms for computer-aided diagnosis

    NASA Astrophysics Data System (ADS)

    Martinez, Victor G.; Gamo, Daniel M.; Rios, Juan; Vilarrasa, Amparo

    1999-05-01

    An iterative algorithm has been developed for automatic detection of breast masses from digitalized mammograms. The procedure has been divided in two stages. The first one based on the histogram analysis of the input image. The second one employs a topological analysis from the results obtained in the first stage. The final output is a set of interest regions that are defined as suspicious areas by the system. These suspicious regions should be harder studied in order to present a final diagnosis. The developed system may be used together with any other suspicious area diagnosis algorithms. In this way a computer assisted diagnosis (CAD) program to assist radiologists in his mammography interpretation task could be easy developed.

  4. Fungal Malignant Otitis Externa with Facial Nerve Palsy: Tissue Biopsy Aids Diagnosis

    PubMed Central

    Walton, Jenny

    2014-01-01

    Fungal malignant otitis externa (FMOE) is a serious and potentially life-threatening condition that is challenging to manage. Diagnosis is often delayed due to the low sensitivity of aural swabs and many antifungal drugs have significant side effects. We present a case of FMOE, where formal tissue sampling revealed the diagnosis and the patient was successfully treated with voriconazole, in addition to an up to date review of the current literature. We would recommend tissue biopsy of the external auditory canal in all patients with suspected FMOE in addition to routine microbiology swabs. PMID:24649388

  5. The Potential of Gait Analysis to Contribute to Differential Diagnosis of Early Stage Dementia: Current Research and Future Directions

    ERIC Educational Resources Information Center

    Morgan, Debra; Funk, Melanie; Crossley, Margaret; Basran, Jenny; Kirk, Andrew; Bello-Haas, Vanina Dal

    2007-01-01

    Early differential diagnosis of dementia is becoming increasingly important as new pharmacologic therapies are developed, as these treatments are not equally effective for all types of dementia. Early detection and differential diagnosis also facilitates informed family decision making and timely access to appropriate services. Information about…

  6. [Mycosis fungoides or inflammatory dermatitis: differential diagnosis between early lymphoma and inflammation in skin biopsies].

    PubMed

    Oschlies, I; Klapper, W

    2013-05-01

    Mycosis fungoides is a cutaneous T-cell lymphoma with protracted clinical course and progression in different stages with increasing aggressiveness. The clinical picture as well as the histopathology of mycosis fungoides within the early patch and plaque phase is difficult to delineate from some inflammatory skin diseases. Thus, the diagnosis of these early stages of the lymphoma is only possible when clinical, histopathological, and molecular features are integrated into the diagnosis, especially as none of the individual disease criteria is specific. Important clues towards the diagnosis of mycosis fungoides are cytologically abnormal epidermotropic CD4-positive T-cells causing only minor epidermal alterations, the formation of Pautrier-abscesses and basal alignment of the epidermotropic T-cells. The findings of an aberrant T-cell immunophenotype of the intraepidermal lymphoid component as well as the molecular proof of T-cell clonality are important further features. In the differential diagnosis between early stage mycosis fungoides and parapsoriasis, there remains nevertheless a diagnostic and maybe also a true biological grey zone. PMID:23549914

  7. Computer-aided detection of early interstitial lung diseases using low-dose CT images

    NASA Astrophysics Data System (ADS)

    Park, Sang Cheol; Tan, Jun; Wang, Xingwei; Lederman, Dror; Leader, Joseph K.; Kim, Soo Hyung; Zheng, Bin

    2011-02-01

    This study aims to develop a new computer-aided detection (CAD) scheme to detect early interstitial lung disease (ILD) using low-dose computed tomography (CT) examinations. The CAD scheme classifies each pixel depicted on the segmented lung areas into positive or negative groups for ILD using a mesh-grid-based region growth method and a multi-feature-based artificial neural network (ANN). A genetic algorithm was applied to select optimal image features and the ANN structure. In testing each CT examination, only pixels selected by the mesh-grid region growth method were analyzed and classified by the ANN to improve computational efficiency. All unselected pixels were classified as negative for ILD. After classifying all pixels into the positive and negative groups, CAD computed a detection score based on the ratio of the number of positive pixels to all pixels in the segmented lung areas, which indicates the likelihood of the test case being positive for ILD. When applying to an independent testing dataset of 15 positive and 15 negative cases, the CAD scheme yielded the area under receiver operating characteristic curve (AUC = 0.884 ± 0.064) and 80.0% sensitivity at 85.7% specificity. The results demonstrated the feasibility of applying the CAD scheme to automatically detect early ILD using low-dose CT examinations.

  8. Consistency of Hearing Aid Use in Infants with Early-Identified Hearing Loss

    PubMed Central

    Moeller, Mary Pat; Hoover, Brenda; Peterson, Barbara; Stelmachowicz, Pat

    2008-01-01

    Purpose This study was designed to examine the consistency of hearing aid use by infants. A goal was to identify maternal, child and situational factors that affected consistency of device use. Method Maternal interviews were conducted using a non-validated structured interview (Amplification in Daily Life Questionnaire), which included five-point Likert scale items and open-ended questions. Participants were mothers of seven infants with mild to moderately-severe hearing loss, who were enrolled in a longitudinal study. Data were collected at four intervals (10.5–12, 16.5, 22.5 and 28.5 months of age). Results Consistency of amplification use was variable at early ages, but improved with age. By 28.5 months of age, toddlers used amplification regularly in most settings. Selected daily situations (e.g., car, outdoors) were more challenging for maintaining device use than contexts where the child was closely monitored. Only two families established early, consistent full time use across all contexts examined. Qualitative results were used to identify familial, developmental and situational variables that influenced the consistency of infant/toddler device use. Conclusion Families may benefit from audiological counseling that acknowledges the multi-faceted challenges that arise. Audiologists can work in partnership with families to promote consistent device use across a variety of daily situations. PMID:19029531

  9. Early diagnosis of conjoined twins using two-dimensional color Doppler and three-dimensional ultrasound.

    PubMed Central

    Bonilla-Musoles, F.; Raga, F.; Bonilla, F.; Blanes, J.; Osborne, N. G.

    1998-01-01

    Transvaginal three-dimensional (3-D) and color Doppler ultrasound were used to establish a first-trimester definitive diagnosis and classification of thoracoomphalopagus conjoined twins following two-dimensional (2-D) transabdominal and transvaginal scans that indicated twin gestation of uncertain classification. Color Doppler in combination with 3-D ultrasound can be a useful complement to 2-D ultrasound to confirm early diagnosis and determine the extent of organ sharing and definitive classification of conjoined twins. Images Figure 1 Figure 2 Figure 3 Figure 4 Figure 5 PMID:9770956

  10. Advanced tests for early and accurate diagnosis of Creutzfeldt-Jakob disease.

    PubMed

    Zanusso, Gianluigi; Monaco, Salvatore; Pocchiari, Maurizio; Caughey, Byron

    2016-06-01

    Early and accurate diagnosis of Creutzfeldt-Jakob disease (CJD) is a necessary to distinguish this untreatable disease from treatable rapidly progressive dementias, and to prevent iatrogenic transmission. Currently, definitive diagnosis of CJD requires detection of the abnormally folded, CJD-specific form of protease-resistant prion protein (PrP(CJD)) in brain tissue obtained postmortem or via biopsy; therefore, diagnosis of sporadic CJD in clinical practice is often challenging. Supporting investigations, including MRI, EEG and conventional analyses of cerebrospinal fluid (CSF) biomarkers, are helpful in the diagnostic work-up, but do not allow definitive diagnosis. Recently, novel ultrasensitive seeding assays, based on the amplified detection of PrP(CJD), have improved the diagnostic process; for example, real-time quaking-induced conversion (RT-QuIC) is a sensitive method to detect prion-seeding activity in brain homogenate from humans with any subtype of sporadic CJD. RT-QuIC can also be used for in vivo diagnosis of CJD: its diagnostic sensitivity in detecting PrP(CJD) in CSF samples is 96%, and its specificity is 100%. Recently, we provided evidence that RT-QuIC of olfactory mucosa brushings is a 97% sensitive and 100% specific for sporadic CJD. These assays provide a basis for definitive antemortem diagnosis of prion diseases and, in doing so, improve prospects for reducing the risk of prion transmission. Moreover, they can be used to evaluate outcome measures in therapeutic trials for these as yet untreatable infections. PMID:27174240

  11. Utility of Functional Hemodynamics and Echocardiography to Aid Diagnosis and Management of Shock.

    PubMed

    McGee, William T; Raghunathan, Karthik; Adler, Adam C

    2015-12-01

    The utility of functional hemodynamics and bedside ultrasonography is increasingly recognized as advantageous for both improved diagnosis and management of shock states. In contrast to conventional "static" measures, "dynamic" hemodynamic measures and bedside imaging modalities enhance pathophysiology-based comprehensive understanding of shock states and the response to therapy. The current editions of major textbooks in the primary specialties--in which clinicians routinely encounter patients in shock--including surgery, anesthesia, emergency medicine, and internal medicine continue to incorporate traditional (conventional) descriptions of shock that use well-described (but potentially misleading) intravascular pressures to classify shock states. Reliance on such intravascular pressure measurements is not as helpful as newer "dynamic" functional measures including ultrasonography to both better assess volume responsiveness and biventricular cardiac function. This review thus emphasizes the application of current functional hemodynamics and ultrasonography to the diagnosis and management of shock as a contrast to conventional "static" pressure-based measures.

  12. SeDeLo: using semantics and description logics to support aided clinical diagnosis.

    PubMed

    Rodríguez-González, Alejandro; Labra-Gayo, Jose Emilio; Colomo-Palacios, Ricardo; Mayer, Miguel A; Gómez-Berbís, Juan Miguel; García-Crespo, Angel

    2012-08-01

    Automated medical diagnosis systems based on knowledge-oriented descriptions have gained momentum with the emergence of semantic descriptions. The objective of this paper is to propose a normalized design that solves some of the problems which have been detected by authors in previous tools. The authors bring together two different technologies to develop a new clinical decision support system: description logics aimed at developing inference systems to improve decision support for the prevention, treatment and management of illness and semantic technologies. Because of its new design, the system is capable of obtaining improved diagnostics compared with previous efforts. However, this evaluation is more focused in the computational performance, giving as result that description logics is a good solution with small data sets. In this paper, we provide a well-structured ontology for automated diagnosis in the medical field and a three-fold formalization based on Description Logics with the use of Semantic Web technologies.

  13. Laser Doppler flowmetry: an aid in differential diagnosis of apical radiolucencies.

    PubMed

    Chandler, N P; Love, R M; Sundqvist, G

    1999-05-01

    The case of a patient having 2 teeth with associated apical radiolucencies that responded to conventional pulp tests is presented. A decision was made to reexamine the patient at intervals rather than perform root canal treatment. During a recall visit, use of an available laser Doppler flowmeter allowed detection of blood flow within the affected teeth. A diagnosis of periapical cemental dysplasia (cementoma) was made. PMID:10348523

  14. [A case of early recognized Wegener's granulomatosis with renal involvement. Insights for early diagnosis].

    PubMed

    Matuszewska, Agnieszka; Misterska-Skóra, Maria; Wiland, Piotr

    2010-01-01

    Systemic necrotic and granulomatous vasculitis presents with vascular involvement in almost every organ, manifesting with stenosis, ischemia, infarction, or hemorrhage. The clinical picture depends on the kind and size of the involved vessels and on the activity of the inflammatory process. Wegener's granulomatosis is a necrotic, granulomatous inflammation of small vessels of the upper and lower airways and kidneys. We present the case of a 25-year-old male in whom the definitive diagnosis of Wegener's granulomatosis was achieved within five weeks from onset. Among the first symptoms were microinfarcts localized in the fingertips and the nail matrix; their nature was investigated with capillaroscopy. PMID:21427813

  15. Infantile granular parakeratosis: cytologic examination of superficial scrapings as an aid to diagnosis.

    PubMed

    Akkaya, A Deniz; Oram, Yasemin; Aydın, Özlem

    2015-01-01

    Granular parakeratosis (GP) is a benign disorder of keratinization presenting with unilateral or bilateral red to brown hyperkeratotic plaques and papules at the intertriginous areas. The first pediatric case of GP was reported in 2002, and only a few cases have been reported since. Although the exact etiology of GP is unknown, it is thought that certain environmental factors compromise the epidermal barrier and lead to proliferation and altered maturation of the epidermis in predisposed individuals. The histopathology is diagnostic and reveals parakeratosis together with retention of keratohyalin granules within a disproportionately thickened stratum corneum and usually the preservation of stratum granulosum. Herein we report seven cases of infantile GP, six of which also had atopic dermatitis. Cytologic examination confirmed our clinical diagnosis by demonstrating the retention of keratohyalin granules and preservation of the nuclei from the superficial scrapings of the lesions, which we propose as a novel diagnostic technique. In all seven cases the lesions developed after the overuse of topical products and resolved with avoidance of their excessive use. We propose that atopic skin may be more prone to develop GP because the epidermal barrier is disrupted, resulting in the enhanced transepidermal penetration of topical products. In conclusion, GP should be included in the differential diagnosis of diaper area eruptions, especially in atopic children. Cytologic examination of superficial scrapings of the lesions can easily confirm the diagnosis of GP. PMID:25660113

  16. Computer-aided differential diagnosis in movement disorders using MRI morphometry

    NASA Astrophysics Data System (ADS)

    Duchesne, S.; Roland, Y.; Verin, M.; Barillot, C.

    2007-03-01

    Background: Reported error rates for initial clinical diagnosis in parkinsonian disorders can reach up to 35%. Reducing this initial error rate is an important research goal. The objective of this work is to evaluate the ability of an automated MR-based classification technique in the differential diagnosis of Parkinson's disease (PD), multiple systems atrophy (MSA) and progressive supranuclear palsy (PSP). Methods: A total of 172 subjects were included in this study: 152 healthy subjects, 10 probable PD patients and 10 age-matched patients with diagnostic of either probable MSA or PSP. T1-weighted (T1w) MR images were acquired and subsequently corrected, scaled, resampled and aligned within a common referential space. Tissue transformation and deformation features were then automatically extracted. Classification of patients was performed using forward, stepwise linear discriminant analysis within a multidimensional transformation/deformation feature space built from healthy subjects data. Leave-one-out classification was used to avoid over-determination. Findings: There were no age difference between groups. Highest accuracy (agreement with long-term clinical follow-up) of 85% was achieved using a single MR-based deformation feature. Interpretation: These preliminary results demonstrate that a classification approach based on quantitative parameters of 3D brainstem morphology extracted automatically from T1w MRI has the potential to perform differential diagnosis of PD versus MSA/PSP with high accuracy.

  17. A systematic review of decision aids for patients making a decision about treatment for early breast cancer.

    PubMed

    Nicholas Zdenkowski; Butow, Phyllis; Tesson, Stephanie; Boyle, Frances

    2016-04-01

    Several complex treatment decisions may be offered to women with early stage breast cancer, about a range of treatments from different modalities including surgery, radiotherapy, and endocrine and chemotherapy. Decision aids can facilitate shared decision-making and improve decision-related outcomes. We aimed to systematically identify, describe and appraise the literature on treatment decision aids for women with early breast cancer, synthesise the data and identify breast cancer decisions that lack a decision aid. A prospectively developed search strategy was applied to MEDLINE, the Cochrane databases, EMBASE, PsycINFO, Web of Science and abstract databases from major conferences. Data were extracted into a pre-piloted form. Quality and risk of bias were measured using Qualsyst criteria. Results were synthesised into narrative format. Thirty-three eligible articles were identified, evaluating 23 individual treatment decision aids, comprising 13 randomised controlled trial reports, seven non-randomised comparative studies, eight single-arm pre-post studies and five cross-sectional studies. The decisions addressed by these decision aids were: breast conserving surgery versus mastectomy (+/- reconstruction); use of chemotherapy and/or endocrine therapy; radiotherapy; and fertility preservation. Outcome measures were heterogeneous, precluding meta-analysis. Decisional conflict decreased, and knowledge and satisfaction increased, without any change in anxiety or depression, in most studies. No studies were identified that evaluated decision aids for neoadjuvant systemic therapy, or contralateral prophylactic mastectomy. Decision aids are available and improved decision-related outcomes for many breast cancer treatment decisions including surgery, radiotherapy, and endocrine and chemotherapy. Decision aids for neoadjuvant systemic therapy and contralateral prophylactic mastectomy could not be found, and may be warranted.

  18. Study of Aided Diagnosis of Hepatic Carcinoma Based on Artificial Neural Network Combined with Tumor Marker Group

    NASA Astrophysics Data System (ADS)

    Tan, Shanjuan; Feng, Feifei; Wu, Yongjun; Wu, Yiming

    To develop a computer-aided diagnostic scheme by using an artificial neural network (ANN) combined with tumor markers for diagnosis of hepatic carcinoma (HCC) as a clinical assistant method. 140 serum samples (50 malignant, 40 benign and 50 normal) were analyzed for α-fetoprotein (AFP), carbohydrate antigen 125 (CA125), carcinoembryonic antigen (CEA), sialic acid (SA) and calcium (Ca). The five tumor marker values were then used as ANN inputs data. The result of ANN was compared with that of discriminant analysis by receiver operating characteristic (ROC) curve (AUC) analysis. The diagnostic accuracy of ANN and discriminant analysis among all samples of the test group was 95.5% and 79.3%, respectively. Analysis of multiple tumor markers based on ANN may be a better choice than the traditional statistical methods for differentiating HCC from benign or normal.

  19. Do Diagnosis Delays Impact Receipt of Test Results? Evidence from the HIV Early Infant Diagnosis Program in Uganda

    PubMed Central

    Mugambi, Melissa Latigo; Deo, Sarang; Kekitiinwa, Adeodata; Kiyaga, Charles; Singer, Mendel E.

    2013-01-01

    Background There is scant evidence on the association between diagnosis delays and the receipt of test results in HIV Early Infant Diagnosis (EID) programs. We determine the association between diagnosis delays and other health care system and patient factors on result receipt. Methods We reviewed 703 infant HIV test records for tests performed between January 2008 and February 2009 at a regional referral hospital and level four health center in Uganda. The main outcome was caregiver receipt of the test result. The primary study variable was turnaround time (time between sample collection and result availability at the health facility). Additional variables included clinic entry point, infant age at sample collection, reported HIV status and receipt of antiretroviral prophylaxis for prevention of mother-to-child transmission. We conducted a pooled analysis in addition to separate analyses for each facility. We estimated the relative risk of result receipt using modified Poisson regression with robust standard errors. Results Overall, the median result turnaround time, was 38 days. 59% of caregivers received infant test results. Caregivers were less likely to receive results at turnaround times greater than 49 days compared to 28 days or fewer (ARR = 0.83; 95% CI = 0.70–0.98). Caregivers were more likely to receive results at the PMTCT clinic (ARR = 1.81; 95% CI = 1.40–2.33) and less likely at the pediatric ward (ARR = 0.54; 95% CI = 0.37–0.81) compared to the immunization clinic. At the level four health center, result receipt was half as likely among infants older than 9 months compared to 3 months and younger (ARR= 0.47; 95% CI = 0.25–0.93). Conclusion In this study setting, we find evidence that longer turnaround times, clinic entry point and age at sample collection may be associated with receipt of infant HIV test results. PMID:24282502

  20. Proximal femoral focal deficiency of the fetus - early 3D/4D prenatal ultrasound diagnosis.

    PubMed

    Kudla, Marek J; Beczkowska-Kielek, Aleksandra; Kutta, Katarzyna; Partyka-Lasota, Justyna

    2016-09-01

    Proximal Femoral Focal Deficiency (PFFD) is a rare congenital syndrome of unknown etiology. Additional disorders can be present up to 70% of PFFD cases. Management (including termination) depends on the severity of the malformation. We present a case of a 32-year-old woman referred for routine ultrasound examination in the 12th week of pregnancy. Detailed 3D/4D evaluation revealed asymmetry of lower limbs and diagnosis of isolated PFFD was established. Parents were fully informed and decided to continue the pregnancy. We stress here the importance of early 3D/4D ultrasound diagnosis. Our paper presents the earliest case where the diagnosis of PFFD was established with 3D/4D ultrasound. PMID:27622419

  1. Endoluminal Diagnosis of Early Gastric Cancer and Its Precursors: Bridging the Gap Between Endoscopy and Pathology.

    PubMed

    Uedo, Noriya; Yao, Kenshi

    2016-01-01

    Although dye-based and image-enhanced endoscopic techniques have revolutionized endoscopic diagnosis, conventional white light endoscopy still plays an important role in the diagnosis of early gastric cancer (EGC) during routine endoscopy. Chromoendoscopy reveals morphological characteristics of the mucosal lesions by enhancing mucosal contrast, while narrow-band imaging (NBI) facilitates detailed evaluation of the vascular architecture and surface features. Positive diagnostic findings of EGC on white light imaging and indigo carmine chromoendoscopy are a sharply demarcated lesion and irregularity in surface morphology or color. Magnifying NBI further improves diagnostic accuracy of white light imaging and chromoendoscopy. We review our approach to the endoscopic diagnosis of (pre-)malignant lesions in the stomach and discuss in detail novel endoscopic microvascular architectural patterns which further leverage diagnostic biopsy yield. We expect that further improvement of endoscopic techniques and correlative studies will close the gap between endoscopy and pathology. PMID:27573777

  2. Pattern classification of time plane features of ECG wave from cell-phone photography for machine aided cardiac disease diagnosis.

    PubMed

    Mitra, Rupendra Nath; Pramanik, Sayak; Mitra, Sucharita; Chaudhuri, Bidyut B

    2014-01-01

    This article reports a robust technique for extracting time plane features of Electrocardiogram (ECG) from digital images of ECG paper strips. We concluded this article reporting performance evaluation of the system developed for machine aided cardiac disease detection. Mostly paper based ECG recordings are used in developing countries and digital photographs of different leads could easily be taken and sent with a mediocre cellular phone set. Apart from extracting the features, the proposed system detects cardiac axis deviation and diagnose if Left or Right Bundle Branch Blockage (LBBB or RBBB) is present while fed with the digital photographs of different leads of ECG strips. Preprocessing of the low-resolution images involves background grid line noise removal, adaptive image binarization by Sauvola's method and Bresenham's line joining algorithm to link the ECG signature, if broken. Pattern extraction mainly delineate the time plane features like P wave, QRS complex and T wave using water reservoir based pattern recognition techniques and Discrete Wavelet Transform (DWT). Cardiac axis deviation detection is done by checking the overall voltage levels of QRS complexes of lead I, II and III. Having the knowledge of cardiac axis completes the requirements to comment on the cardiac blockage like Left or Right Bundle Branch Blockage (LBBB or RBBB). Thus, the proposed algorithm is primarily developed for machine aided diagnosis of LBBB or RBBB from the digital photographs of ECG paper strips. PMID:25571067

  3. A hybrid feature-based segmentation and classification system for the computer aided self-diagnosis of otitis media.

    PubMed

    Shie, Chuen-Kai; Chang, Hao-Ting; Fan, Fu-Cheng; Chen, Chung-Jung; Fang, Te-Yung; Wang, Pa-Chun

    2014-01-01

    We propose a novel hybrid otitis media (OM) computer aided detection (CAD) system, designed to aid in the self-diagnosis of various forms of OM. OM is a prevalent disease in both children and adults. Our system is able to differentiate normal ear from acute otitis media (AOM), otitis media with effusion (OME) and the multi-categories of chronic otitis media including perforation, retraction, cholesteatoma, etc. We propose a modified double active contour segmentation method designed for use with otoscope images, and enabled to handle user acquired data. To describe the visual symptoms (e.g., red, bulging, effusion, perforation, retraction, etc.) of otitis media accurately, we extract color, geometric and texture features by grid color moment, Gabor filter, local binary pattern and histogram of oriented gradients. A powerful classification structure based on Adaboost is used to select the most useful features and build a strong classifier. Our system achieves classification accuracy as high as 88.06% and is suitable for real use. In addition, some interesting observations about OM otoscope images are also discussed.

  4. Label-free nanoplasmonic sensing of tumor-associate autoantibodies for early diagnosis of colorectal cancer.

    PubMed

    Soler, Maria; Estevez, M-Carmen; Villar-Vazquez, Roi; Casal, J Ignacio; Lechuga, Laura M

    2016-08-01

    Colorectal cancer is treatable and curable when detected at early stages. However there is a lack of less invasive and more specific screening and diagnosis methods which would facilitate its prompt identification. Blood circulating autoantibodies which are immediately produced by the immune system at tumor appearance have become valuable biomarkers for preclinical diagnosis of cancer. In this work, we present the rapid and label-free detection of colorectal cancer autoantibodies directly in blood serum or plasma using a recently developed nanoplasmonic biosensor. Our nanoplasmonic device offers sensitive and real-time quantification of autoantibodies with excellent selectivity and reproducibility, achieving limits of detection around 1 nM (150-160 ng mL(-1)). A preliminary evaluation of clinical samples of colorectal cancer patients has shown good correlation with ELISA. These results demonstrate the reliability of the nanobiosensor strategy and pave the way towards the achievement of a sensitive diagnostic tool for early detection of colorectal cancer.

  5. Very Early In-Utero Diagnosis of Walker-Warburg Phenotype: The Cutting Edge of Technology

    PubMed Central

    Achiron, R.; Katorza, E.; Reznik-Wolf, H.; Pras, E.; Kidron, D.; Berkenstadtt, M.

    2016-01-01

    Background: Walker-Warburg phenotype is a severe and lethal autosomal recessive disorder, belonging to a group of congenital malformations defined as abnormal pial basement membrane formation. So far, prenatal diagnosis was considered possible only during late pregnancy. Methods: First trimester assessment of a pregnancy suspected to be affected by Walker-Warburg phenotype, using a high-resolution transvaginal ultrasound probe (6–12 MHz), T2 MR imaging (1.5T), molecular genetics and histopathology. Results: Very early diagnosis of the Walker-Warburg phenotype at 11 weeks of gestation proved possible by depicting the classic signs of this entity, confirmed by molecular genetics, post-abortion MR imaging and histopathology. Conclusion: Advancements in ultrasound equipment and technology, molecular genetics and histopathology have made very early detection of this syndrome possible, thus shedding new light on the natural history of this malformation.

  6. [Bioethical reflections on ill-considered care due to an early diagnosis of Alzheimer disease].

    PubMed

    Buxó, M Jesús; Casado, María

    2014-01-01

    Early diagnosis of Alzheimer disease raises important bioethical issues. In the interval between early disease detection and symptom onset, there is a time in which the patient's autonomy, privacy, and dignity may be undermined by certain healthcare measures or by family care and support. These measures may eventually turn patients into an object of care, preventing them from accepting the disease, developing an identity, and rearranging their living spaces. Every effort should be made to ensure that care does not become compassionate harassment or an invasive act, annulling the patient's autonomy, identity, and self-determination.

  7. The early diagnosis and monitoring of squamous cell carcinoma via saliva metabolomics

    PubMed Central

    Wang, Qihui; Gao, Pan; Wang, Xiaoyi; Duan, Yixiang

    2014-01-01

    Early diagnosis of oral squamous cell carcinoma (OSCC) is an attractive strategy to increase survival rate of patient. An integrated separation approach of reversed phase liquid chromatography and hydrophilic interaction chromatography combining with time of flight mass spectrometer has been firstly developed for performing global saliva metabonomics analysis for early diagnosis of OSCC. This approach was designed to overcome the limitations of a single chromatographic method due to different polarity of endogenous metabolites. As a result, 14 potential salivary metabolites were identified. Eight biomarkers up-regulated in OSCC patients are compared with control and six down-regulated groups. Receiver operating characteristic analysis was exploited to evaluate the diagnostic power of the candidate biomarkers, and related metabolic pathways have also been studied. Five salivary biomarkers (propionylcholine, N-Acetyl-L-phenylalanine, sphinganine, phytosphingosine, and S-carboxymethyl-L-cysteine) in combination yielded satisfactory accuracy (AUC = 0.997), sensitivity (100%), and specificity (96.7%) in distinguishing early stage of OSCC from the control. In this study, a comprehensive saliva metabonomics analysis for identifying potential biomarkers to early diagnose OSCC is successfully demonstrated, which has the advantages of non-invasive, simple, reliable, and low-cost. These novel metabolic biomarkers have obvious clinical utility that will help to diagnose OSCC at its early stage. PMID:25354816

  8. Computer-aided diagnosis workstation and teleradiology network system for chest diagnosis using the web medical image conference system with a new information security solution

    NASA Astrophysics Data System (ADS)

    Satoh, Hitoshi; Niki, Noboru; Eguchi, Kenji; Ohmatsu, Hironobu; Kaneko, Masahiro; Kakinuma, Ryutaro; Moriyama, Noriyuki

    2010-03-01

    Diagnostic MDCT imaging requires a considerable number of images to be read. Moreover, the doctor who diagnoses a medical image is insufficient in Japan. Because of such a background, we have provided diagnostic assistance methods to medical screening specialists by developing a lung cancer screening algorithm that automatically detects suspected lung cancers in helical CT images, a coronary artery calcification screening algorithm that automatically detects suspected coronary artery calcification and a vertebra body analysis algorithm for quantitative evaluation of osteoporosis. We also have developed the teleradiology network system by using web medical image conference system. In the teleradiology network system, the security of information network is very important subjects. Our teleradiology network system can perform Web medical image conference in the medical institutions of a remote place using the web medical image conference system. We completed the basic proof experiment of the web medical image conference system with information security solution. We can share the screen of web medical image conference system from two or more web conference terminals at the same time. An opinion can be exchanged mutually by using a camera and a microphone that are connected with the workstation that builds in some diagnostic assistance methods. Biometric face authentication used on site of teleradiology makes "Encryption of file" and "Success in login" effective. Our Privacy and information security technology of information security solution ensures compliance with Japanese regulations. As a result, patients' private information is protected. Based on these diagnostic assistance methods, we have developed a new computer-aided workstation and a new teleradiology network that can display suspected lesions three-dimensionally in a short time. The results of this study indicate that our radiological information system without film by using computer-aided diagnosis

  9. Computer aided diagnosis of degenerative intervertebral disc diseases from lumbar MR images.

    PubMed

    Oktay, Ayse Betul; Albayrak, Nur Banu; Akgul, Yusuf Sinan

    2014-10-01

    This paper presents a novel method for the automated diagnosis of the degenerative intervertebral disc disease in midsagittal MR images. The approach is based on combining distinct disc features under a machine learning framework. The discs in the lumbar MR images are first localized and segmented. Then, intensity, shape, context, and texture features of the discs are extracted with various techniques. A Support Vector Machine classifier is applied to classify the discs as normal or degenerated. The method is tested and validated on a clinical lumbar spine dataset containing 102 subjects and the results are comparable to the state of the art.

  10. Computer aided diagnosis system for retinal analysis: automatic assessment of the vascular tortuosity.

    PubMed

    Sánchez, L; Barreira, N; Penedo, M G; Coll De Tuero, G

    2014-01-01

    The tortuosity of a vessel, that is, how many times a vessel curves, and how these turns are, is an important value for the diagnosis of certain diseases. Clinicians analyze fundus images manually in order to estimate it, but there is many drawbacks as it is a tedious, time-consuming and subjective work. Thus, automatic image processing methods become a necessity, as they make possible the efficient computation of objective parameters. In this paper we will discuss Sirius (System for the Integration of Retinal Images Understanding Service), a web-based application that enables the storage and treatment of various types of diagnostic tests and, more specifically, its tortuosity calculation module.

  11. Barriers to successful early infant diagnosis of HIV infection at primary care level in Malawi.

    PubMed

    Cromwell, Elizabeth A; Dow, Anna E; Low, Daniel; Chirambo, Chawanangwa; Heyderman, Robert S; Dube, Queen; Van Rie, Annelies

    2015-03-01

    HIV-infected women seeking early infant HIV diagnosis (EID) services in Malawi were asked about factors potentially associated with returning for EID results. Many (33.3%) infants failed to complete the EID process because of time and costs required for multiple visits. Infants of mothers receiving antiretroviral treatment were less likely to drop out (adjusted risk ratio 0.51), suggesting that EID completion may improve in programs providing antiretroviral treatment to all pregnant women. PMID:25742076

  12. Early diagnosis of complex diseases by molecular biomarkers, network biomarkers, and dynamical network biomarkers.

    PubMed

    Liu, Rui; Wang, Xiangdong; Aihara, Kazuyuki; Chen, Luonan

    2014-05-01

    Many studies have been carried out for early diagnosis of complex diseases by finding accurate and robust biomarkers specific to respective diseases. In particular, recent rapid advance of high-throughput technologies provides unprecedented rich information to characterize various disease genotypes and phenotypes in a global and also dynamical manner, which significantly accelerates the study of biomarkers from both theoretical and clinical perspectives. Traditionally, molecular biomarkers that distinguish disease samples from normal samples are widely adopted in clinical practices due to their ease of data measurement. However, many of them suffer from low coverage and high false-positive rates or high false-negative rates, which seriously limit their further clinical applications. To overcome those difficulties, network biomarkers (or module biomarkers) attract much attention and also achieve better performance because a network (or subnetwork) is considered to be a more robust form to characterize diseases than individual molecules. But, both molecular biomarkers and network biomarkers mainly distinguish disease samples from normal samples, and they generally cannot ensure to identify predisease samples due to their static nature, thereby lacking ability to early diagnosis. Based on nonlinear dynamical theory and complex network theory, a new concept of dynamical network biomarkers (DNBs, or a dynamical network of biomarkers) has been developed, which is different from traditional static approaches, and the DNB is able to distinguish a predisease state from normal and disease states by even a small number of samples, and therefore has great potential to achieve "real" early diagnosis of complex diseases. In this paper, we comprehensively review the recent advances and developments on molecular biomarkers, network biomarkers, and DNBs in particular, focusing on the biomarkers for early diagnosis of complex diseases considering a small number of samples and high

  13. Improving outcomes in patients with melanoma: strategies to ensure an early diagnosis

    PubMed Central

    Voss, Rachel K; Woods, Tessa N; Cromwell, Kate D; Nelson, Kelly C; Cormier, Janice N

    2015-01-01

    Patients with thin, low-risk melanomas have an excellent long-term prognosis and higher quality of life than those who are diagnosed at later stages. From an economic standpoint, treatment of early stage melanoma consumes a fraction of the health care resources needed to treat advanced disease. Consequently, early diagnosis of melanoma is in the best interest of patients, payers, and health care systems. This review describes strategies to ensure that patients receive an early diagnosis through interventions ranging from better utilization of primary care clinics, to in vivo diagnostic technologies, to new “apps” available in the market. Strategies for screening those at high risk due to age, male sex, skin type, nevi, genetic mutations, or family history are discussed. Despite progress in identifying those at high risk for melanoma, there remains a lack of general consensus worldwide for best screening practices. Strategies to ensure early diagnosis of recurrent disease in those with a prior melanoma diagnosis are also reviewed. Variations in recurrence surveillance practices by type of provider and country are featured, with evidence demonstrating that various imaging studies, including ultrasound, computed tomography, positron emission tomography, and magnetic resonance imaging, provide only minimal gains in life expectancy, even for those with more advanced (stage III) disease. Because the majority of melanomas are attributable to ultraviolet radiation in the form of sunlight, primary prevention strategies, including sunscreen use and behavioral interventions, are reviewed. Recent international government regulation of tanning beds is described, as well as issues surrounding the continued use artificial ultraviolet sources among youth. Health care stakeholder strategies to minimize UV exposure are summarized. The recommendations encompass both specific behaviors and broad intervention targets (eg, individuals, social spheres, organizations, celebrities

  14. Cell sizing in chronic lymphoproliferative disorders: an aid to differential diagnosis.

    PubMed Central

    Alexander, H D; Markey, G M; Nolan, R L; Morris, T C

    1992-01-01

    AIMS: To determine if leucocyte volume distribution analysis (LVDA), obtained using a Coulter Counter Model S Plus IV, can be used to aid differentiation of chronic lymphoproliferative disorder (CLPD) subtypes. METHODS: Mean lymphocyte volume and lymphocyte distribution width were measured on each patient (n = 90) using a hard copy of an amplified LVDA histogram. The mean lymphocyte volume was taken as the mean of the values on either side of the peak at half maximum height. The lymphocyte distribution width was taken as the range of cell values between the two values used to calibrate the mean lymphocyte volume. A template showing typical histograms from commonly occurring CLPD was also produced on an acetate sheet. This was used to examine the histogram from each new patient to evaluate its usefulness as an alternative to the calculation of mean lymphocyte volume and lymphocyte distribution width. RESULTS: Mean lymphocyte volume and lymphocyte distribution width were significantly higher in B cell lymphocytic leukaemia of mixed cell type (B CLL/PL), B cell non-Hodgkin's lymphoma with peripheral blood spill, hairy cell leukaemia and T cell prolymphocytic leukaemia than in B cell chronic lymphocytic leukaemia (B CLL). The mean lymphocyte volume, but not the lymphocyte distribution width, was also significantly higher in T cell chronic lymphocytic leukaemia than in B CLL. The template gave an immediate preliminary indication of possible subtype(s) of disorder and could be used as an alternative to measurement of mean lymphocyte volume and lymphocyte distribution width. CONCLUSIONS: Electronic haematology analysers producing an LVDA provide a useful, cost effective cell sizing analysis which can aid the differentiation of subtypes of CLPD. Images PMID:1430257

  15. [Neutrophil CD64 Expression as A Biomarker in the Early Diagnosis of Sepsis in Malignant Hematologic Disease--Review].

    PubMed

    Shang, Yu-Xi; Wang, Li-Ru

    2016-02-01

    Malignant hematologic disease with sepsis has been characterized by high mortality and difficulty in diagnosis at early stage. A good biomarker may help to improve the accuracy of diagnosis and to reduce the mortality rate. In the early diagnosis of sepsis, neutrophil CD64 expression is a better candidate for biomarker rather than C-reactive proteins. Moreover, neutrophil CD64 expression is also helpful for assessing the severity of infection and prognosis of disease. Unfortunately, there are few studies of neutrophil CD64 expression on the early diagnosis of malignant hematologic diseases. This review focuses on the advantages, limitations, feasibilities and progresses of neutrophil CD64 expression in the early diagnosis of infection in malignant hematologic diseases in this paper.

  16. Low Dopamine Function in Attention Deficit/Hyperactivity Disorder: Should Genotyping Signify Early Diagnosis in Children?

    PubMed Central

    Gold, Mark S.; Blum, Kenneth; Oscar-Berman, Marlene; Braverman, Eric R.

    2014-01-01

    Attention deficit/hyperactivity disorder (ADHD) is present in 8% to 12% of children, and 4% of adults worldwide. Children with ADHD can have learning impairments, poor self-esteem, social dysfunction, and an increased risk of substance abuse, including cigarette smoking. Overall, the rate of treatment with medication for patients with ADHD has been increasing since 2008, with > 2 million children now being treated with stimulants. The rise of adolescent prescription ADHD medication abuse has occurred along with a concomitant increase of stimulant medication availability. Of adults presenting with a substance use disorder (SUD), 20% to 30% have concurrent ADHD, and 20% to 40% of adults with ADHD have a history of SUD. Following a brief review of the etiology of ADHD, its diagnosis and treatment, we focus on the benefits of early and appropriate testing for a predisposition to ADHD. We suggest that by genotyping patients for a number of known, associated dopaminergic polymorphisms, especially at an early age, misdiagnoses and/or over-diagnosis can be reduced. Ethical and legal issues of early genotyping are considered. As many as 30% of individuals with ADHD are estimated to either have secondary side-effects or are not responsive to stimulant medication. We also consider the benefits of non-stimulant medication and alternative treatment modalities, which include diet, herbal medications, iron supplementation, and neurofeedback. With the goals of improving treatment of patients with ADHD and SUD prevention, we encourage further work in both genetic diagnosis and novel treatment approaches. PMID:24393762

  17. New developments in the assessment of COPD: early diagnosis is key.

    PubMed

    Csikesz, Nicholas G; Gartman, Eric J

    2014-01-01

    Chronic obstructive pulmonary disease (COPD) is the most common chronic lung disease in the world, and its associated health burdens and costs are mounting. Until recently, it was generally accepted that targeting the diagnosis of COPD early in its course was a relatively fruitless effort, since treatments other than already ubiquitous smoking-cessation efforts were unlikely to alter its course. However, there is strong evidence to suggest that the majority of patients with objective COPD are not aware of their condition, and this leads to a significant delay in diagnosis, more aggressive smoking-cessation intervention, and potential treatment. Novel methods of diagnostic testing, community health programs, and primary-care provider recommendations hold promise to expand the recognition of COPD in its incipient stages - where recent evidence suggests a rapid decline in lung function occurs and may be prevented if acted upon. This review explores the evidence to support the efforts to justify programs aimed at early diagnosis, alternative diagnostic strategies that may augment traditional spirometry, therapeutic modalities that could potentially be used in the future to alter early lung-function decline, and emphasizes the necessary cooperative role that physicians, patients, communities, and governments need to play to realize the significant health impact that stands to be gained. PMID:24600220

  18. New developments in the assessment of COPD: early diagnosis is key

    PubMed Central

    Csikesz, Nicholas G; Gartman, Eric J

    2014-01-01

    Chronic obstructive pulmonary disease (COPD) is the most common chronic lung disease in the world, and its associated health burdens and costs are mounting. Until recently, it was generally accepted that targeting the diagnosis of COPD early in its course was a relatively fruitless effort, since treatments other than already ubiquitous smoking-cessation efforts were unlikely to alter its course. However, there is strong evidence to suggest that the majority of patients with objective COPD are not aware of their condition, and this leads to a significant delay in diagnosis, more aggressive smoking-cessation intervention, and potential treatment. Novel methods of diagnostic testing, community health programs, and primary-care provider recommendations hold promise to expand the recognition of COPD in its incipient stages – where recent evidence suggests a rapid decline in lung function occurs and may be prevented if acted upon. This review explores the evidence to support the efforts to justify programs aimed at early diagnosis, alternative diagnostic strategies that may augment traditional spirometry, therapeutic modalities that could potentially be used in the future to alter early lung-function decline, and emphasizes the necessary cooperative role that physicians, patients, communities, and governments need to play to realize the significant health impact that stands to be gained. PMID:24600220

  19. Early diagnosis of radiodermatitis using lactate dehydrogenase isozymes in hairless mice (SKH1-hr)

    PubMed Central

    Kim, Won-Dong

    2012-01-01

    In this study, we evaluate a method for the early diagnosis of radiodermatitis for use in the prevention and therapy of this condition. Hairless mice (SKH1-hr) were used to study the early diagnosis of radiodermatitis. Lactate dehydrogenase (LDH, EC 1.1.1.27) isozymes were analyzed using native-polyacrylamide gel electrophoresis and western blotting of blood serum and tissues collected from SKH1-hr mice. Radiodermatitis developed 24 days after the first X-irradiation. Reduced spleen weight was observed after the last X-irradiation (P<0.05). Thereafter the weight increased until 24 days after the first irradiation, finally reaching levels comparable to those in the sham-irradiated control group. LDH activity was the highest in skeletal muscle and lowest in blood serum. LDH C4, A4, A3B, A2B2, AB3, and B4 isozymes were detected, in the mentioned order, from the cathode. This result was similar in other mouse strains. In the irradiated group, LDH A4 isozyme levels were reduced in the serum until inflammation occurred, whereas those of B4 isozyme were elevated. The subunits A and B followed a similar trend to that of LDH A4 and B4 isozyme, respectively. Importantly, antibodies against LDH B4 isozyme could prove useful in the early diagnosis of radiodermatitis. PMID:23326284

  20. Fuzzy Computer-Aided Alzheimer's Disease Diagnosis Based on MRI Data.

    PubMed

    Krashenyi, Igor; Ramírez, Javier; Popov, Anton; Górriz, Juan Manuel; The Alzheimer's Disease Neuroimaging Initiative

    2016-01-01

    Alzheimer's disease (AD) is a chronic neurodegenerative disease of the central nervous system that has no cure and leads to death. One of the most prevalent tools for AD diagnosis is magnetic resonance imaging (MRI), because of its capability to visualize brain anatomical structures. There is a variety of classification methods for automatic diagnosis of AD, such as support vector machines, genetic algorithms, Bayes classifiers, neural networks, random forests, etc., but none of them provides robust information about the stage of the AD, they can just reveal the presence of disease. In this paper, a new approach for classification of MRI images using a fuzzy inference system is proposed. Two statistical moments (mean and standard deviation) of 116 anatomical regions of interests (ROIs) are used as input features for the classification system. A t-test feature selection method is used to identify the most discriminative ROIs. In order to evaluate the proposed system, MRI images from a database consisting of 818 subjects (229 normal, 401 mild cognitive impairment and 188 AD subjects) collected from the Alzheimer's disease neuroimaging initiative (ADNI) is analyzed. The receiver operating characteristics (ROC) curve and the area under the curve (AUC) of the proposed fuzzy inference system fed by statistical input features are employed as the evaluation criteria with k-fold cross validation. The proposed system yields promising results in normal vs. AD classification with AUC of 0.99 on the training set and 0.8622±0.0033 on the testing set. PMID:26971942

  1. Computer-aided design of peptide near infrared fluorescent probe for tumor diagnosis

    NASA Astrophysics Data System (ADS)

    Zhang, Congying; Gu, Yueqing

    2014-09-01

    Integrin αvβ3 receptors are expressed on activated endothelial cells during neovascularization to maintain tumor growth, so they become hot research tagets in cancer diagnosis. Peptides possess several attractive features when compared to protein and small molecule, such as small size and high structural compatibility with target proteins. Efficient design of high-affinity peptide ligands to Integrin αvβ3 receptors has been an important problem. Designed peptides in silico provide a valuable and high-selectivity peptide, meanwhile decrease the time of drug screening. In this study, we design peptide which can bind with integrin αvβ3 via computer, and then synthesis near infrared fluorescent probe. The characterization of this near infrared fluorescent probe was detected by UV. To investigate the tumor cell targeting of this probe, it was labeled with visible fluorescent dye Rhodamine B (RhB) for microscopy. To evaluate the targeting capability of this near infrared fluorescent probe, mice bearing integrin αvβ3 positive tumor xenografts were used. In vitro cellular experiments indicated that this probe have a clear binding affinity to αvβ3-positive tumor cells. In vivo experiments confirmed the receptor binding specificity of this probe. The peptide of computational design can bind with integrin αvβ3. Combined peptide near-infrared fluorescent probe with imaging technology use for clinical and tumor diagnosis have a greater development in future.

  2. The AIMAR recommendations for early diagnosis of chronic obstructive respiratory disease based on the WHO/GARD model*

    PubMed Central

    2014-01-01

    the Italian context; the document of the Agency for Regional Healthcare Services (AGE.NA.S) is a more suited compendium for consultation, and the recent joint statement on integrated COPD management of the three major Italian scientific Associations in the respiratory area together with the contribution of a Society of General Medicine deals prevalently with some critical issues (appropriateness of diagnosis, pharmacological treatment, rehabilitation, continuing care); also the document “Care Continuity: Chronic Obstructive Pulmonary Disease (COPD)” of the Global Alliance against chronic Respiratory Diseases (GARD)-Italy does not treat in depth the issue of early diagnosis. The present document – produced by the AIMAR (Interdisciplinary Association for Research in Lung Disease) Task Force for early diagnosis of chronic respiratory disease based on the WHO/GARD model and on available evidence and expertise –after a general examination of the main epidemiologic aspects, proposes to integrate the above-mentioned existing documents. In particular: a) it formally indicates on the basis of the available evidence the modalities and the instruments necessary for carrying out secondary prevention at the primary care level (a pro-active,‘case-finding’approach; assessment of the individual’s level of risk of COPD; use of short questionnaires for an initial screening based on symptoms; use of simple spirometry for the second level of screening); b) it identifies possible ways of including these activities within primary care practice; c) it places early diagnosis within the “systemic”, consequential management of chronic respiratory diseases, which will be briefly described with the aid of schemes taken from the Italian and international reference documents. PMID:25473523

  3. AID, p53 and MLH1 expression in early gastric neoplasms and the correlation with the background mucosa

    PubMed Central

    KAWATA, SOICHIRO; YASHIMA, KAZUO; YAMAMOTO, SOHEI; SASAKI, SHUJI; TAKEDA, YOHEI; HAYASHI, AKIHIRO; MATSUMOTO, KAZUYA; KAWAGUCHI, KOICHIRO; HARADA, KENICHI; MURAWAKI, YOSHIKAZU

    2015-01-01

    A number of tumor-associated genes have been associated with gastric cancer development. The present study evaluated differences in tumor-associated protein expression and phenotype among early gastric neoplasms, and correlated these data with those of the background mucosa. The expression of activation-induced cytidine deaminase (AID), p53 and MLH1 in 151 early gastric neoplasms [22 gastric adenomas, 92 intramucosal carcinomas (MCs), and 37 submucosal carcinomas (SMCs)] was examined immunohistochemically and compared with that of the corresponding background mucosal condition. The cellular phenotypes of the neoplasms and the corresponding background intestinal metaplasia were also determined. Aberrant AID, p53 and MLH1 expression was detected in 36.4, 0 and 0% of the adenomas, in 35.9, 32.6 and 16.3% of the MCs, and in 56.8, 62.2 and 21.6% of the SMCs, respectively. The frequency of aberrant AID and p53 expression in the SMCs was significantly increased compared with that in the MCs (AID, P<0.05; p53, P<0.01). Aberrant AID expression was significantly associated with p53 overexpression in the SMCs (P<0.01), but not in the adenomas or MCs. In addition, AID expression was associated with the severity of mononuclear cell activity in the non-cancerous mucosa adjacent to the tumor (P<0.05), particularly in the SMC cases. The percentage of MCs (34.8%) and SMCs (24.3%) that were of the gastric phenotype was higher compared with the percentage of adenomas (18.2%). These results indicated that p53 and MLH1 expression and a gastric phenotype may be important for carcinogenesis, and that chronic inflammation and AID and p53 expression are associated with submucosal progression. PMID:26622562

  4. Standardized evaluation of algorithms for computer-aided diagnosis of dementia based on structural MRI: the CADDementia challenge.

    PubMed

    Bron, Esther E; Smits, Marion; van der Flier, Wiesje M; Vrenken, Hugo; Barkhof, Frederik; Scheltens, Philip; Papma, Janne M; Steketee, Rebecca M E; Méndez Orellana, Carolina; Meijboom, Rozanna; Pinto, Madalena; Meireles, Joana R; Garrett, Carolina; Bastos-Leite, António J; Abdulkadir, Ahmed; Ronneberger, Olaf; Amoroso, Nicola; Bellotti, Roberto; Cárdenas-Peña, David; Álvarez-Meza, Andrés M; Dolph, Chester V; Iftekharuddin, Khan M; Eskildsen, Simon F; Coupé, Pierrick; Fonov, Vladimir S; Franke, Katja; Gaser, Christian; Ledig, Christian; Guerrero, Ricardo; Tong, Tong; Gray, Katherine R; Moradi, Elaheh; Tohka, Jussi; Routier, Alexandre; Durrleman, Stanley; Sarica, Alessia; Di Fatta, Giuseppe; Sensi, Francesco; Chincarini, Andrea; Smith, Garry M; Stoyanov, Zhivko V; Sørensen, Lauge; Nielsen, Mads; Tangaro, Sabina; Inglese, Paolo; Wachinger, Christian; Reuter, Martin; van Swieten, John C; Niessen, Wiro J; Klein, Stefan

    2015-05-01

    Algorithms for computer-aided diagnosis of dementia based on structural MRI have demonstrated high performance in the literature, but are difficult to compare as different data sets and methodology were used for evaluation. In addition, it is unclear how the algorithms would perform on previously unseen data, and thus, how they would perform in clinical practice when there is no real opportunity to adapt the algorithm to the data at hand. To address these comparability, generalizability and clinical applicability issues, we organized a grand challenge that aimed to objectively compare algorithms based on a clinically representative multi-center data set. Using clinical practice as the starting point, the goal was to reproduce the clinical diagnosis. Therefore, we evaluated algorithms for multi-class classification of three diagnostic groups: patients with probable Alzheimer's disease, patients with mild cognitive impairment and healthy controls. The diagnosis based on clinical criteria was used as reference standard, as it was the best available reference despite its known limitations. For evaluation, a previously unseen test set was used consisting of 354 T1-weighted MRI scans with the diagnoses blinded. Fifteen research teams participated with a total of 29 algorithms. The algorithms were trained on a small training set (n=30) and optionally on data from other sources (e.g., the Alzheimer's Disease Neuroimaging Initiative, the Australian Imaging Biomarkers and Lifestyle flagship study of aging). The best performing algorithm yielded an accuracy of 63.0% and an area under the receiver-operating-characteristic curve (AUC) of 78.8%. In general, the best performances were achieved using feature extraction based on voxel-based morphometry or a combination of features that included volume, cortical thickness, shape and intensity. The challenge is open for new submissions via the web-based framework: http://caddementia.grand-challenge.org.

  5. A novel supervised approach for segmentation of lung parenchyma from chest CT for computer-aided diagnosis.

    PubMed

    Darmanayagam, Shiloah Elizabeth; Harichandran, Khanna Nehemiah; Cyril, Sunil Retmin Raj; Arputharaj, Kannan

    2013-06-01

    Segmentation of lung parenchyma from the chest computed tomography is an important task in analysis of chest computed tomography for diagnosis of lung disorders. It is a challenging task especially in the presence of peripherally placed pathology bearing regions. In this work, we propose a segmentation approach to segment lung parenchyma from chest. The first step is to segment the lungs using iterative thresholding followed by morphological operations. If the two lungs are not separated, the lung junction and its neighborhood are identified and local thresholding is applied. The second step is to extract shape features of the two lungs. The third step is to use a multilayer feed forward neural network to determine if the segmented lung parenchyma is complete, based on the extracted features. The final step is to reconstruct the two lungs in case of incomplete segmentation, by exploiting the fact that in majority of the cases, at least one of the two lungs would have been segmented correctly by the first step. Hence, the complete lung is determined based on the shape and region properties and the incomplete lung is reconstructed by applying graphical methods, namely, reflection and translation. The proposed approach has been tested in a computer-aided diagnosis system for diagnosis of lung disorders, namely, bronchiectasis, tuberculosis, and pneumonia. An accuracy of 97.37 % has been achieved by the proposed approach whereas the conventional thresholding approach was unable to detect peripheral pathology-bearing regions. The results obtained prove to be better than that achieved using conventional thresholding and morphological operations. PMID:23076539

  6. Blood Transfusions in the Early Years of AIDS in Sub-Saharan Africa

    PubMed Central

    Schneider, William H.; Drucker, Ernest

    2006-01-01

    Blood transfusions transmit HIV more effectively than other means, yet there has been little examination of their role in the origins and early course of AIDS in sub-Saharan Africa. We review historical data in archives, government reports, and medical literature from African and European sources documenting the introduction, establishment, use, and growth of blood transfusions in sub-Saharan Africa. These data allow estimation of the geographic diffusion and growth of blood transfusions between 1940 and 1990. By 1955, 19 African colonies and countries reported transfusion programs—with national rates of 718 to 1372 per 100 000 by 1964, and urban rates similar to those in developed countries. We estimated 1 million transfusions per year in sub-Saharan Africa by 1970 and 2 million per year by the 1980s, indicating that transfusions were widely used throughout sub-Saharan Africa during the crucial period of 1950–1970, when all epidemic strains of HIV first emerged in this region. PMID:16670233

  7. Impact of diagnosis and early treatment on the course of multiple sclerosis.

    PubMed

    Noyes, Katia; Weinstock-Guttman, Bianca

    2013-11-01

    Multiple sclerosis (MS) is a progressive inflammatory disease of the central nervous system that results in neurological dysfunction and disability. The initiation of disease-modifying therapy (DMT) early in the course of MS may improve the prognosis for patients with MS and reduce the occurrence of neurological damage. In patients with relapsing-remitting MS (RRMS), DMT reduces the rate of relapses, reduces the appearance of magnetic resonance imaging markers of disease activity, and slows the course of disability progression. DMT has been shown to be more effective when initiated early in the course of MS. In patients who have not yet developed clinically definite MS (CDMS), but have had 1 attack of neurological symptoms consistent with MS (ie, clinically isolated syndrome [CIS]), the initiation of DMT (specifically, interferon beta, glatiramer acetate, and teriflunomide) following this attack has been shown to delay the conversion to CDMS. Current guidelines have recognized the benefits of early treatment of MS with DMTs. However, there are a number of barriers to implementing early MS treatment. Early diagnosis and treatment of MS can be hindered because patients may delay consulting a physician about their neurological symptoms or may be reluctant to start DMT. Further, even after initiating DMT, continued adherence to treatment is often poor. These delays in treatment and a lack of adherence to treatment are associated with poor patient outcomes. The objectives of this review are to highlight the importance of early diagnosis and treatment of CIS or RRMS and discuss the favorable outcomes associated with early initiation of DMT. PMID:24494633

  8. Visualizing request-flow comparison to aid performance diagnosis in distributed systems.

    PubMed

    Sambasivan, Raja R; Shafer, Ilari; Mazurek, Michelle L; Ganger, Gregory R

    2013-12-01

    Distributed systems are complex to develop and administer, and performance problem diagnosis is particularly challenging. When performance degrades, the problem might be in any of the system's many components or could be a result of poor interactions among them. Recent research efforts have created tools that automatically localize the problem to a small number of potential culprits, but research is needed to understand what visualization techniques work best for helping distributed systems developers understand and explore their results. This paper compares the relative merits of three well-known visualization approaches (side-by-side, diff, and animation) in the context of presenting the results of one proven automated localization technique called request-flow comparison. Via a 26-person user study, which included real distributed systems developers, we identify the unique benefits that each approach provides for different problem types and usage modes. PMID:24051813

  9. Computer-aided differential diagnosis of pulmonary nodules based on a hybrid classification approach

    NASA Astrophysics Data System (ADS)

    Kawata, Yoshiki; Niki, Noboru; Omatsu, Hironobu; Kusumoto, Masahiko; Kakinuma, Ryutaro; Mori, Kiyoshi; Nishiyama, Hiroyuki; Eguchi, Kenji; Kaneko, Masahiro; Moriyama, Noriyuki

    2001-07-01

    We are developing computerized feature extraction and classification methods to analyze malignant and benign pulmonary nodules in 3D thoracic CT images. Internal structure features were derived form CT density and 3D curvatures to characterize the inhomogeneous of CT density distribution inside the nodule. In the classification step, we combined an unsupervised k-means clustering (KMC) procedure and a supervised linear discriminate (LD) classifier. The KMC procedure classified the sample nodules into two classes by using the mean CT density values for two different regions such as a core region and a complement of the core region in 3D nodule image. The LD classifier was designed for each class by using internal structure features. The forward stepwise procedure was used to select the best feature subset from multi-dimensional feature spaces. The discriminant scores output form the classifier were analyzed by receiver operating characteristic (ROC) method and the classification accuracy was quantified by the area, Ax, under the ROC curve. We analyzed a data set of 248 pulmonary nodules in this study. The hybrid classifier was more effective than the LD classifier alone in distinguishing malignant and benign nodules. The improvement was statistically significant in comparison to classification in the LD classifier alone. The results of this study indicate the potential of combining the KMC procedure and the LD classifier for computer-aided classification of pulmonary nodules.

  10. Trypanosoma cruzi necrotizing meningoencephalitis in a Venezuelan HIV⁺-AIDS patient: pathological diagnosis confirmed by PCR using formalin-fixed- and paraffin-embedded-tissues.

    PubMed

    Rossi Spadafora, Marcello Salvatore; Céspedes, Ghislaine; Romero, Sandra; Fuentes, Isabel; Boada-Sucre, Alpidio A; Cañavate, Carmen; Flores-Chávez, María

    2014-01-01

    Coinfections with human immunodeficiency virus (HIV) and infectious agents have been recognized since the early 90s. In the central nervous system (CNS) of HIV(+) patients, parasitic protozoans like Toxoplasma gondii have been described as responsible for the space occupying lesions (SOL) developed. However, the involvement of Trypanosoma cruzi is also described but appears to be less frequent in acquired immunodeficiency syndrome (AIDS) and transplant recipients, associated with necrotizing myocarditis and neurological symptoms related to the occurrence of necrotizing pseudotumoral encephalitis (NPE) and meningoencephalitis (NME). The present work aims to present a Venezuelan case of NME associated with the coinfection of HIV and a T. cruzi-like trypanosomatid as well as its evolution and diagnosis by histopathological techniques, electron microscopy, and PCR methods using formalin-fixed- (FF-) and paraffin-embedded- (PE-) tissues. Postmortem cytological studies of leptomeninges imprints reveal the presence of trypomastigotes of Trypanosoma sp. Histopathological and electron microscopy studies allowed us to identify an amastigote stage and to reject the involvement of other opportunistic microorganisms as the etiological agent of the SOL. The definitive confirmation of T. cruzi as the etiological agent was achieved by PCR suggesting that the NME by T. cruzi was due to a reactivation of Chagas' disease.

  11. Trypanosoma cruzi Necrotizing Meningoencephalitis in a Venezuelan HIV+-AIDS Patient: Pathological Diagnosis Confirmed by PCR Using Formalin-Fixed- and Paraffin-Embedded-Tissues

    PubMed Central

    Rossi Spadafora, Marcello Salvatore; Céspedes, Ghislaine; Romero, Sandra; Fuentes, Isabel; Boada-Sucre, Alpidio A.; Cañavate, Carmen; Flores-Chávez, María

    2014-01-01

    Coinfections with human immunodeficiency virus (HIV) and infectious agents have been recognized since the early 90s. In the central nervous system (CNS) of HIV+ patients, parasitic protozoans like Toxoplasma gondii have been described as responsible for the space occupying lesions (SOL) developed. However, the involvement of Trypanosoma cruzi is also described but appears to be less frequent in acquired immunodeficiency syndrome (AIDS) and transplant recipients, associated with necrotizing myocarditis and neurological symptoms related to the occurrence of necrotizing pseudotumoral encephalitis (NPE) and meningoencephalitis (NME). The present work aims to present a Venezuelan case of NME associated with the coinfection of HIV and a T. cruzi-like trypanosomatid as well as its evolution and diagnosis by histopathological techniques, electron microscopy, and PCR methods using formalin-fixed- (FF-) and paraffin-embedded- (PE-) tissues. Postmortem cytological studies of leptomeninges imprints reveal the presence of trypomastigotes of Trypanosoma sp. Histopathological and electron microscopy studies allowed us to identify an amastigote stage and to reject the involvement of other opportunistic microorganisms as the etiological agent of the SOL. The definitive confirmation of T. cruzi as the etiological agent was achieved by PCR suggesting that the NME by T. cruzi was due to a reactivation of Chagas' disease. PMID:25763312

  12. Assessment methodologies and statistical issues for computer-aided diagnosis of lung nodules in computed tomography: contemporary research topics relevant to the lung image database consortium.

    PubMed

    Dodd, Lori E; Wagner, Robert F; Armato, Samuel G; McNitt-Gray, Michael F; Beiden, Sergey; Chan, Heang-Ping; Gur, David; McLennan, Geoffrey; Metz, Charles E; Petrick, Nicholas; Sahiner, Berkman; Sayre, Jim

    2004-04-01

    Cancer of the lung and bronchus is the leading fatal malignancy in the United States. Five-year survival is low, but treatment of early stage disease considerably improves chances of survival. Advances in multidetector-row computed tomography technology provide detection of smaller lung nodules and offer a potentially effective screening tool. The large number of images per exam, however, requires considerable radiologist time for interpretation and is an impediment to clinical throughput. Thus, computer-aided diagnosis (CAD) methods are needed to assist radiologists with their decision making. To promote the development of CAD methods, the National Cancer Institute formed the Lung Image Database Consortium (LIDC). The LIDC is charged with developing the consensus and standards necessary to create an image database of multidetector-row computed tomography lung images as a resource for CAD researchers. To develop such a prospective database, its potential uses must be anticipated. The ultimate applications will influence the information that must be included along with the images, the relevant measures of algorithm performance, and the number of required images. In this article we outline assessment methodologies and statistical issues as they relate to several potential uses of the LIDC database. We review methods for performance assessment and discuss issues of defining "truth" as well as the complications that arise when truth information is not available. We also discuss issues about sizing and populating a database.

  13. A systematic review of barriers to early presentation and diagnosis with breast cancer among black women

    PubMed Central

    Jones, Claire EL; Maben, Jill; Jack, Ruth H; Davies, Elizabeth A; Forbes, Lindsay JL; Lucas, Grace; Ream, Emma

    2014-01-01

    Objective To explore barriers to early presentation and diagnosis with breast cancer among black women. Design Systematic review. Methods We searched multiple bibliographic databases (January 1991–February 2013) for primary research, published in English, conducted in developed countries and investigating barriers to early presentation and diagnosis with symptomatic breast cancer among black women (≥18 years). Studies were excluded if they did not report separate findings by ethnic group or gender, only reported differences in time to presentation/diagnosis, or reported on interventions and barriers to cancer screening. We followed Cochrane and PRISMA guidance to identify relevant research. Findings were integrated through thematic synthesis. Designs of quantitative studies made meta-analysis impossible. Results We identified 18 studies (6183 participants). Delay was multifactorial, individual and complex. Factors contributing to delay included: poor symptom and risk factor knowledge; fear of detecting breast abnormality; fear of cancer treatments; fear of partner abandonment; embarrassment disclosing symptoms to healthcare professionals; taboo and stigmatism. Presentation appears quicker following disclosure. Influence of fatalism and religiosity on delay is unclear from evidence in these studies. We compared older studies (≥10 years) with newer ones (<10 years) to determine changes over time. In older studies, delaying factors included: inaccessibility of healthcare services; competing priorities and concerns about partner abandonment. Partner abandonment was studied in older studies but not in newer ones. Comparisons of healthy women and cancer populations revealed differences between how people perceive they would behave, and actually behave, on finding breast abnormality. Conclusions Strategies to improve early presentation and diagnosis with breast cancer among black women need to address symptom recognition and interpretation of risk, as well as

  14. Towards the routine use of brain imaging to aid the clinical diagnosis of disorders of consciousness.

    PubMed

    Coleman, M R; Davis, M H; Rodd, J M; Robson, T; Ali, A; Owen, A M; Pickard, J D

    2009-09-01

    Clinical audits have highlighted the many challenges and dilemmas faced by clinicians assessing persons with disorders of consciousness (vegetative state and minimally conscious state). The diagnostic decision-making process is highly subjective, dependent upon the skills of the examiner and invariably dictated by the patients' ability to move or speak. Whilst a considerable amount has been learnt since Jennett and Plum coined the term 'vegetative state', the assessment process remains largely unchanged; conducted at the bedside, using behavioural assessment tools, which are susceptible to environmental and physiological factors. This has created a situation where the rate of misdiagnosis is unacceptably high (up to 43%). In order to address these problems, various functional brain imaging paradigms, which do not rely upon the patient's ability to move or speak, have been proposed as a source of additional information to inform the diagnostic decision making process. Although accumulated evidence from brain imaging, particularly functional magnetic resonance imaging (fMRI), has been encouraging, the empirical evidence is still based on relatively small numbers of patients. It remains unclear whether brain imaging is capable of informing the diagnosis beyond the behavioural assessment and whether brain imaging has any prognostic utility. In this study, we describe the functional brain imaging findings from a group of 41 patients with disorders of consciousness, who undertook a hierarchical speech processing task. We found, contrary to the clinical impression of a specialist team using behavioural assessment tools, that two patients referred to the study with a diagnosis of vegetative state did in fact demonstrate neural correlates of speech comprehension when assessed using functional brain imaging. These fMRI findings were found to have no association with the patient's behavioural presentation at the time of investigation and thus provided additional diagnostic

  15. A computer-aided diagnosis system to detect pathologies in temporal subtraction images of chest radiographs

    NASA Astrophysics Data System (ADS)

    Looper, Jared; Harrison, Melanie; Armato, Samuel G.

    2016-03-01

    Radiologists often compare sequential radiographs to identify areas of pathologic change; however, this process is prone to error, as human anatomy can obscure the regions of change, causing the radiologists to overlook pathology. Temporal subtraction (TS) images can provide enhanced visualization of regions of change in sequential radiographs and allow radiologists to better detect areas of change in radiographs. Not all areas of change shown in TS images, however, are actual pathology. The purpose of this study was to create a computer-aided diagnostic (CAD) system that identifies which regions of change are caused by pathology and which are caused by misregistration of the radiographs used to create the TS image. The dataset used in this study contained 120 images with 74 pathologic regions on 54 images outlined by an experienced radiologist. High and low ("light" and "dark") gray-level candidate regions were extracted from the images using gray-level thresholding. Then, sampling techniques were used to address the class imbalance problem between "true" and "false" candidate regions. Next, the datasets of light candidate regions, dark candidate regions, and the combined set of light and dark candidate regions were used as training and testing data for classifiers by using five-fold cross validation. Of the classifiers tested (support vector machines, discriminant analyses, logistic regression, and k-nearest neighbors), the support vector machine on the combined candidates using synthetic minority oversampling technique (SMOTE) performed best with an area under the receiver operating characteristic curve value of 0.85, a sensitivity of 85%, and a specificity of 84%.

  16. Predictive role of polymerase chain reaction in the early diagnosis of congenital Trypanosoma cruzi infection.

    PubMed

    Velázquez, Elsa B; Rivero, Rocío; De Rissio, Ana María; Malagrino, Nora; Esteva, Mónica I; Riarte, Adelina Rosa; Ruiz, Andrés Mariano

    2014-09-01

    The efficacy of specific chemotherapy in congenital Chagas disease before the first year of life ranges between 90 and 100%. Between this age and 15 years of age, the efficacy decreases to around 60%. Therefore, early infection detection is a priority in vertical transmission. The aim of this work was to assess whether polymerase chain reaction (PCR) plays a predictive role in the diagnosis of congenital Chagas disease as compared to conventional parasitological and serological methods. To this end, we studied a total of 468 children born to Trypanosoma cruzi seroreactive mothers came from Argentina, Bolivia and Paraguay, who lived in the city of Buenos Aires and suburban areas (Argentina), a non-endemic area of this country. These children were assessed by PCR from 2004 to 2009 with the specific primers Tcz1 and Tcz2, and 121 and 122. PCR allowed detecting 49 T. cruzi-positive children. Eight of these 49 children were excluded from the analysis: six because they did not complete follow-up and two because the first control was performed after 12 months of age. Parasitological methods allowed detecting 25 positive children, 7 of whom had been earlier diagnosed by PCR (1.53±2.00 vs. 6.71±1.46 months; p=0.0002). Serological methods allowed detecting 16 positive children, 12 of whom had been earlier diagnosed by PCR (1.46±1.48 vs. 11.77±4.40 months; p<0.0001). None of the children negative by PCR was positive by serological or parasitological methods. This study shows that PCR allows early diagnosis in congenital Chagas disease. At present, an early positive PCR is not indicative for treatment. However, a positive PCR would alert the health system to search only those infected infants diagnosed by early PCR and thus generate greater efficiency in the diagnosis and treatment of congenital T. cruzi infection.

  17. Image-based retrieval system and computer-aided diagnosis system for renal cortical scintigraphy images

    NASA Astrophysics Data System (ADS)

    Mumcuoğlu, Erkan; Nar, Fatih; Uğur, Omer; Bozkurt, M. Fani; Aslan, Mehmet

    2008-03-01

    Cortical renal (kidney) scintigraphy images are 2D images (256x256) acquired in three projection angles (posterior, right-posterior-oblique and left-posterior-oblique). These images are used by nuclear medicine specialists to examine the functional morphology of kidney parenchyma. The main visual features examined in reading the images are: size, location, shape and activity distribution (pixel intensity distribution within the boundary of each kidney). Among the above features, activity distribution (in finding scars if any) was found to have the least interobserver reproducibility. Therefore, in this study, we developed an image-based retrieval (IBR) and a computer-based diagnosis (CAD) system, focused on this feature in particular. The developed IBR and CAD algorithms start with automatic segmentation, boundary and landmark detection. Then, shape and activity distribution features are computed. Activity distribution feature is obtained using the acquired image and image set statistics of the normal patients. Active Shape Model (ASM) technique is used for more accurate kidney segmentation. In the training step of ASM, normal patient images are used. Retrieval performance is evaluated by calculating precision and recall. CAD performance is evaluated by specificity and sensitivity. To our knowledge, this paper is the first IBR or CAD system reported in the literature on renal cortical scintigraphy images.

  18. Early diagnosis of Balo's concentric sclerosis by diffusion tensor tractography: a case report and literature review.

    PubMed

    Nader Kawachi, Juan Alberto; Andrade Magdaleno, María de la Luz; Peñaherrera, Carlos Andrés; Fernández De Lara, Yeni; Lavenant Borja, María Isabel

    2016-03-14

    Balo concentric sclerosis is an infrequent variant of a demyelinating disease related to multiple sclerosis, initially thought to have an acute presentation and a fatal outcome. Recent studies have reported non-fatal forms of Balo concentric sclerosis, focusing on the importance of early diagnosis using magnetic resonance imaging (MRI), along with spectroscopy and diffusion/perfusion sequences. Recently, we have been able to draw a three-dimensional image of a specific bundle of fibers by means of a diffusion tensor technique of the magnetic resonance imaging tractography (t-MRI). We report the case of a young woman presenting with acute and progressive focal neurological symptoms, including right body paresis, whose diagnosis was suggested by MRI and confirmed by pathology to be Balo concentric sclerosis. She was treated with boluses of methylprednisolone, achieving full neurological remission one year after admission. This is, to our knowledge, the first report describing the use of t-MRI for diagnosing BCS. We consider that t-MRI will allow, in a near future, early diagnosis of the disease, its prompt treatment, and establishing new classification criteria. This case confirms the existence of benign forms of Balo concentric sclerosis with a good response to steroid therapy, where functional recovery is possible.

  19. Inferior Alveolar Nerve Injuries Following Implant Placement - Importance of Early Diagnosis and Treatment: a Systematic Review

    PubMed Central

    Juodzbalys, Gintaras

    2014-01-01

    ABSTRACT Objectives The purpose of this article is to systematically review diagnostic procedures and risk factors associated with inferior alveolar nerve injury following implant placement, to identify the time interval between inferior alveolar nerve injury and its diagnosis after surgical dental implant placement and compare between outcomes of early and delayed diagnosis and treatment given based on case series recorded throughout a period of 10 years. Material and Methods We performed literature investigation through MEDLINE (PubMed) electronic database and manual search through dental journals to find articles concerning inferior alveolar nerve injury following implant placement. The search was restricted to English language articles published during the last 10 years, from December 2004 to March 2014. Results In total, we found 33 articles related to the topic, of which 27 were excluded due to incompatibility with established inclusion criteria. Six articles were eventually chosen to be suitable. The studies presented diagnostic methods of inferior alveolar nerve sensory deficit, and we carried out an assessment of the proportion of patients diagnosed within different time intervals from the time the injury occurred. Conclusions Various diagnostic methods have been developed throughout the years for dealing with 1 quite frequent complication in the implantology field - inferior alveolar nerve injury. Concurrently, the importance of early diagnosis and treatment was proved repeatedly. According to the results of the data analysis, a relatively high percentage of the practitioners successfully accomplished this target and achieved good treatment outcomes. PMID:25635209

  20. Giant-cell tumor: analysis on the importance of early diagnosis and the epidemiological profile☆

    PubMed Central

    de Carvalho Diniz Ferraz, Diego Firmino; Torres dos Santos, César Augusto; Farias Costa, Victor Hugo; Gonçalves Souza, Antônio Marcelo; Gomes Lima, Paulo Rogerio

    2016-01-01

    Objective This study aimed to ascertain the relationship between early diagnosis of giant-cell tumors (GCT) and their prognosis, by correlating the time of symptom onset with the staging of the injury (through the Campanacci classification at the time of diagnosis), and with the type of treatment. The secondary objective of the study was to outline the epidemiological profile of patients with GCT in the region where the data were gathered, and to compare them with data in the literature. Methods The authors present an evaluation on 61 patients diagnosed with bone GCT, with regard to the site of involvement, age, initial symptoms, time of symptom onset, classification and type of treatment, among patients attended between May 1994 and August 2009. Results The threshold indicated as the limit for Campanacci stage I tumors to be the commonest diagnosis, with a 98.2% chance that the treatment would be non-aggressive, was 2 months after symptom onset. This finding was statistically significant (p = 0.017). Every additional month increased the chance that a patient would be diagnosed with an advanced-stage tumor by 10.94%, in relation to the chances of having the other two stages of the tumor. Conclusion The study result not only suggests that the alternative hypothesis that the earlier the diagnosis of GCT is, the less severe the lesion will be, has been confirmed; but also especially predicts the relationship between the time of symptom appearance and the severity of the tumor. PMID:26962501

  1. Computer-aided clinical laboratory diagnosis in conjunction with the electronic medical textbook.

    PubMed

    Kawamata, F; Kondoh, M; Mori, C; Endoh, J; Takahashi, T

    1995-01-01

    1. INTRODUCTION. Medical knowledge has been increasing and diversifying on a worldwide scale, while the specialization of physicians has been extended vigorously. Under this environment, it may be natural that mistakes are made in a comprehensive diagnosis, as the physician cannot master all of this dramatically increasing volume of knowledge. The knowledge has extended beyond the memory of human beings, thereby causing the deterioration of service; this is called the "Knowledge crisis." To tackle this problem, the Electronic Medical Textbook (EMT) has been conceived and set up as a medical knowledge base for physicians to optimize both their specialties and activities in clinical practice. Meanwhile, laboratory information systems were widely introduced. However, there are few systems which allow interpretation of the findings obtained. With this in mind, we have improved the utility of the EMT by enhancing its function with laboratory information follow-up, thesaurus back-up, Japanese language support, and online access. 2. SYSTEM DESCRIPTION. The knowledge database for medical decision-making consists of three categories: 1) Medical domain knowledge (including approximately 3500 diseases) from the AMA's "The Current Medical Information & Terminology (CMIT)"; 2) Knowledge on relationship between laboratory testing results and diseases from "The Effects of Disease on Clinical Laboratory," compiled by the AACC; and 3) Clinical testing knowledge from Otsuka's laboratory test handbook "Kensa-Kojien." These categories are connected by links in the process of cross-reference. In actual use, the first is to select the supporting system bringing up clinical signs and findings on CRT from which users can then choose any representations corresponding to the patient's clinical state. Once the relevant objects have been selected, the system presents the correlated investigative tests to be performed, along with a scope of laboratory tests ordering for its initial

  2. Computer-aided diagnosis for prostate cancer detection in the peripheral zone via multisequence MRI

    NASA Astrophysics Data System (ADS)

    Niaf, Emilie; Rouvière, Olivier; Lartizien, Carole

    2011-03-01

    We propose a Computer Assisted Diagnosis Interview (CADi) scheme for determining a likelihood measure of prostate cancer presence in the peripheral zone (PZ) based on multisequence magnetic resonance imaging, including T2-weighted (T2w), diffusion-weighted (DWI) and dynamic contrast-enhanced (DCE) MRI at 1.5 Tesla (T). Based on a feature set derived from the gray level images, including first order statistics, Haralick's features, gradient features, semi-quantitative and quantitative (pharmacokinetic modeling) dynamic parameters, we trained and compared four kinds of classifiers: Support Vector Machine (SVM), Linear Discriminant Analysis (LDA), k-Nearest Neighbours (KNN) and Naïve Bayes (NB). The aim is twofold: we try to discriminate between the relevant features as well as creating an efficient classifier using these features. The database consists of 23 radical prostatectomy patients. Using histologic sections as the gold standard, both cancers and non-malignant tissues (suspicious and clearly benign) were annotated in consensus on all MR images by two radiologists, a histopathologist and a researcher. Diagnostic performances were evaluated based on a ROC curves analysis. From the outputs of all evaluated feature selection methods on the test bench, we discriminated a restrictive set of about 20 highly informative features. Quantitative evaluation of the diagnostic performance yielded to a maximal Area Under the ROC Curve (AUC) of 0.89. Moreover, the optimal CADi scheme outperformed, in terms of specificity, our human experts in differentiating malignant from suspicious tissues, thus demonstrating its potential for assisting cancer identification in the PZ.

  3. A magnetic-field enriched surface-enhanced resonance Raman spectroscopy strategy towards the early diagnosis of malaria

    NASA Astrophysics Data System (ADS)

    Yuen, Clement; Liu, Quan

    2012-03-01

    Early malaria diagnosis is important because malaria disease can develop into fatal illness within hours upon the appearance of the first symptom. The low concentration of the diagnosis biomarker, hemozoin, at the early stage of malaria disease makes early diagnosis difficult. In this paper, we present a magnetic field-enriched surface-enhanced resonance Raman spectroscopy (SERRS) strategy for the sensitive detection of β - hematin crystals, which is equivalent to hemozoin in the characteristics of Raman spectrum, by using magnetic nanoparticles. We observe several orders of magnitude enhancement in the SERRS signal of enriched β - hematin in comparison to the Raman signal of β - hematin in the cases of SERRS alone or magnetic enrichment alone, showing the great potential of this method towards early malaria diagnosis.

  4. A magnetic-field enriched surface-enhanced resonance Raman spectroscopy strategy towards the early diagnosis of malaria

    NASA Astrophysics Data System (ADS)

    Clement, Yuen; Liu, Quan

    2012-02-01

    Early malaria diagnosis is important because malaria disease can develop into fatal illness within hours upon the appearance of the first symptom. The low concentration of the diagnosis biomarker, hemozoin, at the early stage of malaria disease makes early diagnosis difficult. In this paper, we present a magnetic field-enriched surface-enhanced resonance Raman spectroscopy (SERRS) strategy for the sensitive detection of β - hematin crystals, which is equivalent to hemozoin in the characteristics of Raman spectrum, by using magnetic nanoparticles. We observe several orders of magnitude enhancement in the SERRS signal of enriched β - hematin in comparison to the Raman signal of β - hematin in the cases of SERRS alone or magnetic enrichment alone, showing the great potential of this method towards early malaria diagnosis.

  5. The Price of Innocence: Teachers, Gender, Childhood Sexuality, HIV and AIDS in Early Schooling

    ERIC Educational Resources Information Center

    Bhana, Deevia

    2007-01-01

    Drawing from data collected during interviews with grade 2 teachers who work in a black working-class township school, this paper explores the meanings that teachers attach to HIV and AIDS education. It is argued that the relationship of many teachers to the subject of HIV and AIDS is inscribed within regulatory forces based on the notion of…

  6. Early diagnosis and treatment of trauma in knee joints accompanied with popliteal vascular injury

    PubMed Central

    Xu, Yun-Qin; Li, Qiang; Shen, Tu-Gang; Su, Pei-Hua; Zhu, Ya-Zhong

    2015-01-01

    Objective: The objective of the present study was to investigate the early diagnosis and treatment of trauma in the knee joints accompanied with popliteal vascular injury. Methods: Fifteen cases of patients with trauma in knee joints accompanied with popliteal vascular injury. These patients included 8 males and 6 females between the ages of 27 and 62, the average age being 39.2. Data of clinical symptoms and signs; blood oxygen saturation, color Doppler examination; vascular intervention by DSA angiography; and surgical operations were analyzed to clearly identify their role in early diagnosis and treatment. Results: In the patient group for this study there were: 1 death case; 4 stage I amputation cases; 4 stage II amputation cases due to failure to salvage limbs; and 6 cases with patients who had successful limb salvage. The six cases of limb survival patients were followed up for 12 to 60 months, with an average follow up time of 28.3 months. The excellent rate of joint function of these patients with successful limb salvage was 83.3%. Conclusions: For patients with injured limbs, unclear dorsalis pedis artery palpation, decreased skin temperature, and decreased oxygen saturation of the toes, clinical manifestations combined with proper auxiliary inspection (such as color Doppler and blood vessel angiography of interventional DSA) enabled early diagnose of peripheral trauma in the knee joint accompanied with popliteal vascular injury. PMID:26309604

  7. Magnetic field enriched surface enhanced resonance Raman spectroscopy for early malaria diagnosis.

    PubMed

    Yuen, Clement; Liu, Quan

    2012-01-01

    Hemozoin is a by-product of malaria infection in erythrocytes, which has been explored as a biomarker for early malaria diagnosis. We report magnetic field-enriched surface-enhanced resonance Raman spectroscopy (SERRS) of β-hematin crystals, which are the equivalent of hemozoin biocrystals in spectroscopic features, by using magnetic nanoparticles with iron oxide core and silver shell (Fe(3)O(4)@Ag). The external magnetic field enriches β-hematin crystals and enhances the binding between β-hematin crystals and magnetic nanoparticles, which provides further improvement in SERRS signals. The magnetic field-enriched SERRS signal of β-hematin crystals shows approximately five orders of magnitude enhancement in the resonance Raman signal, in comparison to about three orders of magnitude improvement in the SERRS signal without the influence of magnetic field. The improvement has led to a β-hematin detection limit at a concentration of 5 nM (roughly equivalent to 30 parasites/μl at the early stages of malaria infection), which demonstrates the potential of magnetic field-enriched SERRS technique in early malaria diagnosis.

  8. The Role of Pancreatic Stone Protein in Diagnosis of Early Onset Neonatal Sepsis

    PubMed Central

    Rass, Anwar A.; Arafa, Mohamed A.; El-Saadany, Hosam F.; Amin, Ezzat K.; Abdelsalam, Mohamed Mohamed; Mansour, Mona A.; Khalifa, Naglaa A.; Kamel, Lamiaa Mahmoud

    2016-01-01

    Introduction. Early diagnosis and treatment of neonatal sepsis may help decrease neonatal mortality. Aim of the Study. To evaluate the role of pancreatic stone protein as a marker for early onset neonatal sepsis. Methods. A hospital-based prospective study was conducted on 104 (52 uninfected and 52 infected neonates) admitted to the Neonatal Intensive Care Unit (NICU) of Zagazig University hospitals during the period from April 2014 to April 2015. All newborns were subjected to full history taking, careful neonatal assessment, blood, C-reactive protein (CRP), and serum pancreatic stone protein. Results. Serum PSP levels were significantly higher in the infected group than in the uninfected group. At a cutoff level of PSP 12.96 ng/mL, the sensitivity was 96.2%, the specificity was 88.5%, positive predictive value was 95.8%, negative predictive value was 89.3%, and area under the curve was 0.87. A significant positive correlation between CRP and PSP was found in infected group. Conclusion. The high negative predictive value of PSP (89.3%) indicates that the serum PSP level is a good marker for diagnosis of early onset neonatal sepsis and can be used to limit hospital stay and antibiotic use in neonates treated for suspected sepsis. PMID:27689072

  9. The Role of Pancreatic Stone Protein in Diagnosis of Early Onset Neonatal Sepsis

    PubMed Central

    Rass, Anwar A.; Arafa, Mohamed A.; El-Saadany, Hosam F.; Amin, Ezzat K.; Abdelsalam, Mohamed Mohamed; Mansour, Mona A.; Khalifa, Naglaa A.; Kamel, Lamiaa Mahmoud

    2016-01-01

    Introduction. Early diagnosis and treatment of neonatal sepsis may help decrease neonatal mortality. Aim of the Study. To evaluate the role of pancreatic stone protein as a marker for early onset neonatal sepsis. Methods. A hospital-based prospective study was conducted on 104 (52 uninfected and 52 infected neonates) admitted to the Neonatal Intensive Care Unit (NICU) of Zagazig University hospitals during the period from April 2014 to April 2015. All newborns were subjected to full history taking, careful neonatal assessment, blood, C-reactive protein (CRP), and serum pancreatic stone protein. Results. Serum PSP levels were significantly higher in the infected group than in the uninfected group. At a cutoff level of PSP 12.96 ng/mL, the sensitivity was 96.2%, the specificity was 88.5%, positive predictive value was 95.8%, negative predictive value was 89.3%, and area under the curve was 0.87. A significant positive correlation between CRP and PSP was found in infected group. Conclusion. The high negative predictive value of PSP (89.3%) indicates that the serum PSP level is a good marker for diagnosis of early onset neonatal sepsis and can be used to limit hospital stay and antibiotic use in neonates treated for suspected sepsis.

  10. Rheumatoid arthritis in Latin America: the importance of an early diagnosis.

    PubMed

    da Mota, Licia Maria Henrique; Brenol, Claiton Viegas; Palominos, Penelope; Pinheiro, Geraldo da Rocha Castelar

    2015-03-01

    The generalization of the early rheumatoid arthritis (ERA) concept and the existence of a window of therapeutic opportunity-a time span in which the institution of a proper therapeutic method for the disease would determine clinical improvement-have set the notion that early diagnosis and treatment may modify the course of the disease. Although in several regions of the world, especially in North America and Europe, since the year 2000, a significant reduction in diagnostic delay was observed in cohorts of patients with rheumatoid arthritis (RA), probably reflecting a stronger awareness of the importance of early diagnosis, this is not a reality in Latin America (LA). LA is a region of great economic inequality, with disparities in access to the public healthcare system and limited access to private medicine, being widely difficult to obtain a specialized medical evaluation in both scenarios. This paper aims to briefly review the main difficulties in the management of ERA in LA, based on the review of the literature, on the evaluation of a survey conducted among 214 rheumatologists of LA, members of Pan-American League of Associations for Rheumatology (PANLAR) and the experience of the authors. The paper also aims to propose solutions to the difficulties in managing ERA in LA.

  11. Magnetic field enriched surface enhanced resonance Raman spectroscopy for early malaria diagnosis

    NASA Astrophysics Data System (ADS)

    Yuen, Clement; Liu, Quan

    2012-01-01

    Hemozoin is a by-product of malaria infection in erythrocytes, which has been explored as a biomarker for early malaria diagnosis. We report magnetic field-enriched surface-enhanced resonance Raman spectroscopy (SERRS) of β--hematin crystals, which are the equivalent of hemozoin biocrystals in spectroscopic features, by using magnetic nanoparticles with iron oxide core and silver shell (Fe3O4@Ag). The external magnetic field enriches β--hematin crystals and enhances the binding between β--hematin crystals and magnetic nanoparticles, which provides further improvement in SERRS signals. The magnetic field-enriched SERRS signal of β--hematin crystals shows approximately five orders of magnitude enhancement in the resonance Raman signal, in comparison to about three orders of magnitude improvement in the SERRS signal without the influence of magnetic field. The improvement has led to a β--hematin detection limit at a concentration of 5 nM (roughly equivalent to 30 parasites/μl at the early stages of malaria infection), which demonstrates the potential of magnetic field-enriched SERRS technique in early malaria diagnosis.

  12. Biomarkers for gastric cancer: Progression in early diagnosis and prognosis (Review)

    PubMed Central

    JIN, ZILIANG; JIANG, WEIHUA; WANG, LIWEI

    2015-01-01

    Gastric cancer is one of leading causes of cancer-related mortality worldwide and is a notable disease due to its heterogeneity. Recently, numerous studies have investigated the molecular basis of gastric cancer, involving the alteration of pathogenesis, and invasion and metastasis. With the development of modern technologies, various novel biomarkers had been identified that appear to possess diagnostic and prognostic value; therefore, the present review describes our current knowledge of biomarkers for the early diagnosis and prognosis of gastric cancer. Classic biomarkers for gastric cancer diagnosis include carcinoembryonic antigen and cancer antigen 19-9, while microRNA and DNA hypomethylation are proposed as novel biomarkers. Excluding classical biomarkers, biomarkers for determining the progression and prognosis of gastric cancer focus on targeting microRNAs, epigenetic alterations and genetic polymorphisms. PMID:25788990

  13. Toxic scarlet fever complicating cellulitis: early clinical diagnosis is crucial to prevent a fatal outcome.

    PubMed

    Lau, S K; Woo, P C; Yuen, K Y

    2004-04-01

    We describe a case of toxic scarlet fever in a healthy adult with streptococcal cellulitis of the right elbow as a result of skin abrasion. The clinical picture mimicked that of drug eruption after treatment of cellulitis with antibiotics. Among the five cases of scarlet fever complicating cellulitis, including the present one, reported in the English literature, four had severe systemic complications and two died. As a result of re-emergence of invasive streptococcal infections, clinicians should be aware of the differential diagnosis of scarlet fever in patients presenting with cellulitis and skin rash. Early clinical diagnosis is crucial to exclude drug eruptions, prompt initiation of antibiotic treatment, and prevention of the potentially fatal outcome.

  14. Application of Efficient Nanoparticles for Early Diagnosis and Treatment of Cancer.

    PubMed

    Alexiou, Athanasios; Vairaktarakis, Charalampos; Tsiamis, Vasilis; Ashraf, Ghulam Md

    2015-01-01

    Cancer is considered as a prevalent cause of human deaths and undoubtedly, is the most complex disease with multiple cellular physiological systems involved. During the last decade, the application of nanotechnological products for cancer treatment has received considerable attention. These sophisticated tools and materials treat cancer though the early diagnosis, the prediction, the prevention and the personalized therapy. This technology enabled the development of nanoscale particles that can be conjugated with one or multiple functional molecules simultaneously. Nanoparticles have the capability to be delivered directly through blood vessels to the tumor site and interact with targeted tumor-specific proteins located inside or on the surface of cancer cells, since their size is a hundred to thousand times smaller than cancer cells. In this review, comprehensive outline of all the latest scientific and technological applications such as quantum dots and gold nanoparticles alongside with their applications in cancer diagnosis and treatment have been presented.

  15. A Guide to Screening for the Early and Periodic Screening, Diagnosis and Treatment Program (EPSDT) Under Medicaid.

    ERIC Educational Resources Information Center

    Frankenburg, William K.; North, A. Frederick, Jr.

    The manual was designed to help public officials, physicians, nurses, and others to plan and implement an Early and Periodic Screening, Diagnosis and Treatment (EPSDT) program under Medicaid. Procedures for carrying out components of an EPSDT program are recommended. Part 1 discusses organization and administration of screening, diagnosis, and…

  16. Advances in Bio-Optical Imaging for the Diagnosis of Early Oral Cancer

    PubMed Central

    Olivo, Malini; Bhuvaneswari, Ramaswamy; Keogh, Ivan

    2011-01-01

    Oral cancer is among the most common malignancies worldwide, therefore early detection and treatment is imperative. The 5-year survival rate has remained at a dismal 50% for the past several decades. The main reason for the poor survival rate is the fact that most of the oral cancers, despite the general accessibility of the oral cavity, are not diagnosed until the advanced stage. Early detection of the oral tumors and its precursor lesions may be the most effective means to improve clinical outcome and cure most patients. One of the emerging technologies is the use of non-invasive in vivo tissue imaging to capture the molecular changes at high-resolution to improve the detection capability of early stage disease. This review will discuss the use of optical probes and highlight the role of optical imaging such as autofluorescence, fluorescence diagnosis (FD), laser confocal endomicroscopy (LCE), surface enhanced Raman spectroscopy (SERS), optical coherence tomography (OCT) and confocal reflectance microscopy (CRM) in early oral cancer detection. FD is a promising method to differentiate cancerous lesions from benign, thus helping in the determination of adequate resolution of surgical resection margin. LCE offers in vivo cellular imaging of tissue structures from surface to subsurface layers and has demonstrated the potential to be used as a minimally invasive optical biopsy technique for early diagnosis of oral cancer lesions. SERS was able to differentiate between normal and oral cancer patients based on the spectra acquired from saliva of patients. OCT has been used to visualize the detailed histological features of the oral lesions with an imaging depth down to 2–3 mm. CRM is an optical tool to noninvasively image tissue with near histological resolution. These comprehensive diagnostic modalities can also be used to define surgical margin and to provide a direct assessment of the therapeutic effectiveness. PMID:24310585

  17. [Guidelines for the early diagnosis of lung cancer for primary care physicians].

    PubMed

    2016-01-01

    Lung cancer is a serious/medical and social problem. It belongs to the most common cancers. In the past decades, lung cancer has steadily held a leading place in the structure of cancer morbidity and mortality in our country and in the majority of European countries. Cigarette smoking remains to be the major if not only risk factor for lung cancer. Many attempts were previously made to set up systems for the early (timely) lung cancerdetection in risk groups through cytological and radiological examinations. Prophylactic fluorography and X-ray study have long been an important screening procedure in Russia and foreign countries. Recently this procedure has transformed into digital lung radiography. However, there have been no conclusive proofs for its efficiency in the early detection of lung cancer for a few decades. In the past decade, large-scale prospective randomized trials of low-dose computed tomography (CT) have been performed to screen lung cancer. These have shown that this technology can potentially reduce mortality from this disease. This encouraging result has caused a substantial change in the tactics of examining people at high risk for lung cancer. CT has fully replaced linear tomography and all others special X-ray procedures in the verified diagnosis of lung cancer. The indications for pre-examination CT have been considerably expanded in patients with X-ray detected pathology. The tactics for estimating the small lung tissue foci found at CT has been changed. Availability of CT, clear clinical indications for the study, and observance of the standard procedure have become important elements of the entire system for the early identification of lung cancer. These clinical recommendations largely deal just with organizational and methodological issues. The authors hope that the recommendations will serve as a guide for primary care physicians (therapists, pulmonologists,and radiologists) in the early diagnosis of lung cancer and in the optimization

  18. Advances in bio-optical imaging for the diagnosis of early oral cancer.

    PubMed

    Olivo, Malini; Bhuvaneswari, Ramaswamy; Keogh, Ivan

    2011-01-01

    Oral cancer is among the most common malignancies worldwide, therefore early detection and treatment is imperative. The 5-year survival rate has remained at a dismal 50% for the past several decades. The main reason for the poor survival rate is the fact that most of the oral cancers, despite the general accessibility of the oral cavity, are not diagnosed until the advanced stage. Early detection of the oral tumors and its precursor lesions may be the most effective means to improve clinical outcome and cure most patients. One of the emerging technologies is the use of non-invasive in vivo tissue imaging to capture the molecular changes at high-resolution to improve the detection capability of early stage disease. This review will discuss the use of optical probes and highlight the role of optical imaging such as autofluorescence, fluorescence diagnosis (FD), laser confocal endomicroscopy (LCE), surface enhanced Raman spectroscopy (SERS), optical coherence tomography (OCT) and confocal reflectance microscopy (CRM) in early oral cancer detection. FD is a promising method to differentiate cancerous lesions from benign, thus helping in the determination of adequate resolution of surgical resection margin. LCE offers in vivo cellular imaging of tissue structures from surface to subsurface layers and has demonstrated the potential to be used as a minimally invasive optical biopsy technique for early diagnosis of oral cancer lesions. SERS was able to differentiate between normal and oral cancer patients based on the spectra acquired from saliva of patients. OCT has been used to visualize the detailed histological features of the oral lesions with an imaging depth down to 2-3 mm. CRM is an optical tool to noninvasively image tissue with near histological resolution. These comprehensive diagnostic modalities can also be used to define surgical margin and to provide a direct assessment of the therapeutic effectiveness. PMID:24310585

  19. Computer-Aided Diagnosis Scheme for Distinguishing Between Benign and Malignant Masses in Breast DCE-MRI.

    PubMed

    Honda, Emi; Nakayama, Ryohei; Koyama, Hitoshi; Yamashita, Akiyoshi

    2016-06-01

    Our purpose in this study was to develop a computer-aided diagnosis (CAD) scheme for distinguishing between benign and malignant breast masses in dynamic contrast material-enhanced magnetic resonance imaging (DCE-MRI). Our database consisted 90 DCE-MRI examinations, each of which contained four sequential phase images; this database included 28 benign masses and 62 malignant masses. In our CAD scheme, we first determined 11 objective features of masses by taking into account the image features and the dynamic changes in signal intensity that experienced radiologists commonly use for describing masses in DCE-MRI. Quadratic discriminant analysis (QDA) was employed to distinguish between benign and malignant masses. As the input of the QDA, a combination of four objective features was determined among the 11 objective features according to a stepwise method. These objective features were as follows: (i) the change in signal intensity from 2 to 5 min; (ii) the change in signal intensity from 0 to 2 min; (iii) the irregularity of the shape; and (iv) the smoothness of the margin. Using this approach, the classification accuracy, sensitivity, and specificity were shown to be 85.6 % (77 of 90), 87.1 % (54 of 62), and 82.1 % (23 of 28), respectively. Furthermore, the positive and negative predictive values were 91.5 % (54 of 59) and 74.2 % (23 of 31), respectively. Our CAD scheme therefore exhibits high classification accuracy and is useful in the differential diagnosis of masses in DCE-MRI images.

  20. Computer-aided diagnosis of prostate cancer in the peripheral zone using multiparametric MRI

    NASA Astrophysics Data System (ADS)

    Niaf, Emilie; Rouvière, Olivier; Mège-Lechevallier, Florence; Bratan, Flavie; Lartizien, Carole

    2012-06-01

    This study evaluated a computer-assisted diagnosis (CADx) system for determining a likelihood measure of prostate cancer presence in the peripheral zone (PZ) based on multiparametric magnetic resonance (MR) imaging, including T2-weighted, diffusion-weighted and dynamic contrast-enhanced MRI at 1.5 T. Based on a feature set derived from grey-level images, including first-order statistics, Haralick features, gradient features, semi-quantitative and quantitative (pharmacokinetic modelling) dynamic parameters, four kinds of classifiers were trained and compared : nonlinear support vector machine (SVM), linear discriminant analysis, k-nearest neighbours and naïve Bayes classifiers. A set of feature selection methods based on t-test, mutual information and minimum-redundancy-maximum-relevancy criteria were also compared. The aim was to discriminate between the relevant features as well as to create an efficient classifier using these features. The diagnostic performances of these different CADx schemes were evaluated based on a receiver operating characteristic (ROC) curve analysis. The evaluation database consisted of 30 sets of multiparametric MR images acquired from radical prostatectomy patients. Using histologic sections as the gold standard, both cancer and nonmalignant (but suspicious) tissues were annotated in consensus on all MR images by two radiologists, a histopathologist and a researcher. Benign tissue regions of interest (ROIs) were also delineated in the remaining prostate PZ. This resulted in a series of 42 cancer ROIs, 49 benign but suspicious ROIs and 124 nonsuspicious benign ROIs. From the outputs of all evaluated feature selection methods on the test bench, a restrictive set of about 15 highly informative features coming from all MR sequences was discriminated, thus confirming the validity of the multiparametric approach. Quantitative evaluation of the diagnostic performance yielded a maximal area under the ROC curve (AUC) of 0.89 (0.81-0.94) for the

  1. Early Diagnosis of Cerebral X-linked Adrenoleukodystrophy in Boys with Addison’s Disease Improves Survival and Neurological Outcomes

    PubMed Central

    Polgreen, LE; Chahla, S; Miller, W; Rothman, S.; Tolar, J; Kivisto, T; Nascene, D.; Orchard, PJ; Petryk, A

    2011-01-01

    Approximately one-third of boys with X-linked adrenoleukodystophy (X-ALD) develop an acute, progressive inflammatory process of the central nervous system, resulting in rapid neurologic deterioration and death. Hematopoietic cell transplantation (HCT) can halt the progression of neurologic disease if performed early in the course of the cerebral form of X-ALD. We describe a retrospective cohort study of 90 boys with X-ALD evaluated at our institution between 2000 and 2009, to determine if early diagnosis of X-ALD following the diagnosis of unexplained adrenal insufficiency (AI) improves outcomes. We describe 7 cases with a delay in the diagnosis of X-ALD, and compare their outcomes to 10 controls with the diagnosis of ALD made within 12 months following diagnosis of AI. At the time of evaluation for HCT, boys with a delay in the diagnosis of X-ALD had more extensive cerebral involvement and more limited functioning. These boys also were 3.9 times more likely to die, and had significant advancement of cerebral disease after HCT, compared to boys with a timely diagnosis of X-ALD. Conclusion Early diagnosis of cerebral X-ALD following the diagnosis of unexplained AI, and subsequent treatment with HCT, improves both neurological outcomes and survival in boys with cerebral X-ALD. PMID:21279382

  2. Myocardial strain estimation from CT: towards computer-aided diagnosis on infarction identification

    NASA Astrophysics Data System (ADS)

    Wong, Ken C. L.; Tee, Michael; Chen, Marcus; Bluemke, David A.; Summers, Ronald M.; Yao, Jianhua

    2015-03-01

    Regional myocardial strains have the potential for early quantification and detection of cardiac dysfunctions. Although image modalities such as tagged and strain-encoded MRI can provide motion information of the myocardium, they are uncommon in clinical routine. In contrary, cardiac CT images are usually available, but they only provide motion information at salient features such as the cardiac boundaries. To estimate myocardial strains from a CT image sequence, we adopted a cardiac biomechanical model with hyperelastic material properties to relate the motion on the cardiac boundaries to the myocardial deformation. The frame-to-frame displacements of the cardiac boundaries are obtained using B-spline deformable image registration based on mutual information, which are enforced as boundary conditions to the biomechanical model. The system equation is solved by the finite element method to provide the dense displacement field of the myocardium, and the regional values of the three principal strains and the six strains in cylindrical coordinates are computed in terms of the American Heart Association nomenclature. To study the potential of the estimated regional strains on identifying myocardial infarction, experiments were performed on cardiac CT image sequences of ten canines with artificially induced myocardial infarctions. The leave-one-subject-out cross validations show that, by using the optimal strain magnitude thresholds computed from ROC curves, the radial strain and the first principal strain have the best performance.

  3. Immunochemical measurement of early pregnancy isoforms of HCG: potential applications to fertility research, prenatal diagnosis, and cancer.

    PubMed

    Birken, S; Kovalevskaya, G; O'Connor, J

    2001-01-01

    Human chorionic gonadotropin, the glycoprotein hormone of pregnancy, is found naturally in blood and urine in a variety of isoforms. These variants are related to both peptide bond cleavages (such as the nicked forms of hCG) and the beta core fragment urinary metabolite, as well as the larger variety of species resulting from carbohydrate heterogeneity. We have recently developed immunoassay systems that can measure nicked forms of hCG (antibody B151) as well as particular high carbohydrate variants (hyperglycosylated forms) of hCG (B152), which are associated with cancers producing hCG. Using the assay system for nicked hCG, we found that nicked hCG does not appear to be present as a significant hCG isoform during normal pregnancies if the urine specimens are well preserved. Applying the assay for hyperglycosylated hCG isoforms, we discovered that these forms are prevalent during very early pregnancy and decline rapidly to low concentration after the first 6 weeks of pregnancy. Persistence of these early pregnancy forms does not bode well for the pregnancy. Other investigators report that measurement of such hCG isoforms may aid in diagnosis of Down syndrome pregnancies. In summary, measurement of the hyperglycosylated hCG isoforms are useful for evaluation of healthy progress of normal pregnancy, as an additional detection marker for Down syndrome pregnancies, and as a potential new marker of trophoblastic malignancy. New reference preparations will soon be available for the calibration of assay systems for measurement of many of these hCG variants and metabolites. PMID:11750741

  4. Mortality of the elderly is still exceedingly high at diagnosis of AIDS despite favourable outcomes after highly active antiretroviral therapy in Recife, Brazil.

    PubMed

    Lacerda, H R; Kitner, D

    2008-07-01

    This study aimed to compare the outcome of an elderly group of AIDS patients with that of a younger group and their features at the time of the diagnosis of AIDS. We evaluated 58 patients aged >60 years and 114 aged 20-39 years, followed for 35.3 months. There was an obvious delay in diagnosing the elderly as they had more AIDS-defining diseases at diagnosis and their most frequent opportunistic infection was pulmonary tuberculosis. Mortality at the time of the diagnosis of AIDS was four times higher in the elderly (24.1% versus 6.1%, P < 0.001). However, when comparing only those submitted to highly active antiretroviral therapy, there was a similar frequency of favourable outcomes; 76.9% in the elderly against 83.1% in the young (P = 0.455). Mean CD4 lymphocyte was 438 cells/mm(3) at the end of follow up in the young when compared with 442 cells/mm(3) in the elderly (P = 0.945). The types of antiretroviral schema and the number of antivirals per patient were similar in both groups.

  5. Computerized nipple identification for multiple image analysis in computer-aided diagnosis

    SciTech Connect

    Zhou Chuan; Chan Heangping; Paramagul, Chintana; Roubidoux, Marilyn A.; Sahiner, Berkman; Hadjiiski, Labomir M.; Petrick, Nicholas

    2004-10-01

    Correlation of information from multiple-view mammograms (e.g., MLO and CC views, bilateral views, or current and prior mammograms) can improve the performance of breast cancer diagnosis by radiologists or by computer. The nipple is a reliable and stable landmark on mammograms for the registration of multiple mammograms. However, accurate identification of nipple location on mammograms is challenging because of the variations in image quality and in the nipple projections, resulting in some nipples being nearly invisible on the mammograms. In this study, we developed a computerized method to automatically identify the nipple location on digitized mammograms. First, the breast boundary was obtained using a gradient-based boundary tracking algorithm, and then the gray level profiles along the inside and outside of the boundary were identified. A geometric convergence analysis was used to limit the nipple search to a region of the breast boundary. A two-stage nipple detection method was developed to identify the nipple location using the gray level information around the nipple, the geometric characteristics of nipple shapes, and the texture features of glandular tissue or ducts which converge toward the nipple. At the first stage, a rule-based method was designed to identify the nipple location by detecting significant changes of intensity along the gray level profiles inside and outside the breast boundary and the changes in the boundary direction. At the second stage, a texture orientation-field analysis was developed to estimate the nipple location based on the convergence of the texture pattern of glandular tissue or ducts towards the nipple. The nipple location was finally determined from the detected nipple candidates by a rule-based confidence analysis. In this study, 377 and 367 randomly selected digitized mammograms were used for training and testing the nipple detection algorithm, respectively. Two experienced radiologists identified the nipple locations

  6. Sjögren-Larsson syndrome: importance of early diagnosis and aggressive physiotherapy.

    PubMed

    Kathuria, Sushruta; Arora, Shikha; Ramesh, V

    2012-09-15

    Sjögren-Larsson syndrome (SLS) is a congenital ichthyotic disorder with spasticity. We describe a case of a 5-year-old boy with SLS diagnosed clinically based on congenital ichythosis, quadriplegia, and mental retardation. The child responded well to emollients and antihistamines. His quadriplegia was managed by aggressive physiotherapy and mental retardation by stimulation techniques. After a 3-year follow up, significant improvement was seen in his motor and mental disability. This case highlights the importance of clinical diagnosis and early intervention for such a disabling disorder.

  7. Magnetic resonance imaging applications in early rheumatoid arthritis diagnosis and management.

    PubMed

    Troum, Orrin M; Pimienta, Olga; Olech, Ewa

    2012-05-01

    Early diagnosis and treatment have been recognized as essential for improving clinical outcomes in patients with rheumatoid arthritis (RA). Magnetic resonance imaging (MRI) is a sensitive modality that can assess both inflammatory and structural lesions. MRI can assist in following the disease course in patients treated with traditional disease-modifying antirheumatic drugs and biological therapies both in the clinic and in research trials. Therefore, it is anticipated that MRI becomes the diagnostic imaging modality of choice in RA clinical trials while remaining a useful tool for clinicians evaluating patients with RA.

  8. Gitelman syndrome disclosed by calcium pyrophosphate deposition disease: early diagnosis by ultrasonographic study.

    PubMed

    Zabotti, A; Della Siega, P; Picco, L; Quartuccio, L; Bassetti, M; De Vita, S

    2016-01-01

    Gitelman's syndrome is a rare autosomal-recessive tubular disorder characterized by hypomagnesemia and hypocalciuria associated to hypokalemia. The clinical spectrum is wide and usually characterized by chronic fatigue, cramps, muscle weakness and paresthesiae. We describe a case of a 43 year-old male patient with early onset of knee arthritis and no other symptoms. Ultrasound revealed diffuse and confluent hyperechoic deposits in cartilage, fibrocartilage of the menisci and synovium and calcium pyrophosphate crystals were observed in the synovial fluid of the knee. The concomitant presence of hypomagnesemia, hypocalciuria and hypokalemia made clear the diagnosis of Gitelman's syndrome associated with chondrocalcinosis. PMID:27339375

  9. An integrated classifier for computer-aided diagnosis of colorectal polyps based on random forest and location index strategies

    NASA Astrophysics Data System (ADS)

    Hu, Yifan; Han, Hao; Zhu, Wei; Li, Lihong; Pickhardt, Perry J.; Liang, Zhengrong

    2016-03-01

    Feature classification plays an important role in differentiation or computer-aided diagnosis (CADx) of suspicious lesions. As a widely used ensemble learning algorithm for classification, random forest (RF) has a distinguished performance for CADx. Our recent study has shown that the location index (LI), which is derived from the well-known kNN (k nearest neighbor) and wkNN (weighted k nearest neighbor) classifier [1], has also a distinguished role in the classification for CADx. Therefore, in this paper, based on the property that the LI will achieve a very high accuracy, we design an algorithm to integrate the LI into RF for improved or higher value of AUC (area under the curve of receiver operating characteristics -- ROC). Experiments were performed by the use of a database of 153 lesions (polyps), including 116 neoplastic lesions and 37 hyperplastic lesions, with comparison to the existing classifiers of RF and wkNN, respectively. A noticeable gain by the proposed integrated classifier was quantified by the AUC measure.

  10. Computer-Aided Diagnosis for Breast Ultrasound Using Computerized BI-RADS Features and Machine Learning Methods.

    PubMed

    Shan, Juan; Alam, S Kaisar; Garra, Brian; Zhang, Yingtao; Ahmed, Tahira

    2016-04-01

    This work identifies effective computable features from the Breast Imaging Reporting and Data System (BI-RADS), to develop a computer-aided diagnosis (CAD) system for breast ultrasound. Computerized features corresponding to ultrasound BI-RADs categories were designed and tested using a database of 283 pathology-proven benign and malignant lesions. Features were selected based on classification performance using a "bottom-up" approach for different machine learning methods, including decision tree, artificial neural network, random forest and support vector machine. Using 10-fold cross-validation on the database of 283 cases, the highest area under the receiver operating characteristic (ROC) curve (AUC) was 0.84 from a support vector machine with 77.7% overall accuracy; the highest overall accuracy, 78.5%, was from a random forest with the AUC 0.83. Lesion margin and orientation were optimum features common to all of the different machine learning methods. These features can be used in CAD systems to help distinguish benign from worrisome lesions.

  11. A 3D computer-aided design system applied to diagnosis and treatment planning in orthodontics and orthognathic surgery.

    PubMed

    Motohashi, N; Kuroda, T

    1999-06-01

    The purpose of this article is to describe a newly developed 3D computer-aided design (CAD) system for the diagnostic set-up of casts in orthodontic diagnosis and treatment planning, and its preliminary clinical applications. The system comprises a measuring unit which obtains 3D information from the dental model using laser scanning, and a personal computer to generate the 3D graphics. When measuring the 3D shape of the model, to minimize blind sectors, the model is scanned from two different directions with the slit-ray laser beam by rotating the mounting angle of the model on the measuring device. For computed simulation of tooth movement, the representative planes, defined by the anatomical reference points, are formed for each individual tooth and are arranged along a guideline descriptive of the individual arch form. Subsequently, the 3D shape is imparted to each of the teeth arranged on the representative plane to form an arrangement of the 3D profile. When necessary, orthognathic surgery can be simulated by moving the mandibular dental arch three-dimensionally to establish the optimum occlusal relationship. Compared with hand-made set-up models, the computed diagnostic cast has advantages such as high-speed processing and quantitative evaluation on the amount of 3D movement of the individual tooth relative to the craniofacial plane. Trial clinical applications demonstrated that the use of this system facilitated the otherwise complicated and time-consuming mock surgery for treatment planning in orthognathic surgery.

  12. Computer-aided diagnosis of carotid atherosclerosis based on ultrasound image statistics, laws' texture and neural networks.

    PubMed

    Mougiakakou, Stavroula G R; Golemati, Spyretta; Gousias, Ioannis; Nicolaides, Andrew N; Nikita, Konstantina S

    2007-01-01

    Quantitative characterisation of carotid atherosclerosis and classification into symptomatic or asymptomatic is crucial in planning optimal treatment of atheromatous plaque. The computer-aided diagnosis (CAD) system described in this paper can analyse ultrasound (US) images of carotid artery and classify them into symptomatic or asymptomatic based on their echogenicity characteristics. The CAD system consists of three modules: a) the feature extraction module, where first-order statistical (FOS) features and Laws' texture energy can be estimated, b) the dimensionality reduction module, where the number of features can be reduced using analysis of variance (ANOVA), and c) the classifier module consisting of a neural network (NN) trained by a novel hybrid method based on genetic algorithms (GAs) along with the back propagation algorithm. The hybrid method is able to select the most robust features, to adjust automatically the NN architecture and to optimise the classification performance. The performance is measured by the accuracy, sensitivity, specificity and the area under the receiver-operating characteristic (ROC) curve. The CAD design and development is based on images from 54 symptomatic and 54 asymptomatic plaques. This study demonstrates the ability of a CAD system based on US image analysis and a hybrid trained NN to identify atheromatous plaques at high risk of stroke.

  13. Computer-aided diagnosis system for classifying benign and malignant thyroid nodules in multi-stained FNAB cytological images.

    PubMed

    Gopinath, Balasubramanian; Shanthi, Natesan

    2013-06-01

    An automated computer-aided diagnosis system is developed to classify benign and malignant thyroid nodules using multi-stained fine needle aspiration biopsy (FNAB) cytological images. In the first phase, the image segmentation is performed to remove the background staining information and retain the appropriate foreground cell objects in cytological images using mathematical morphology and watershed transform segmentation methods. Subsequently, statistical features are extracted using two-level discrete wavelet transform (DWT) decomposition, gray level co-occurrence matrix (GLCM) and Gabor filter based methods. The classifiers k-nearest neighbor (k-NN), Elman neural network (ENN) and support vector machine (SVM) are tested for classifying benign and malignant thyroid nodules. The combination of watershed segmentation, GLCM features and k-NN classifier results a lowest diagnostic accuracy of 60 %. The highest diagnostic accuracy of 93.33 % is achieved by ENN classifier trained with the statistical features extracted by Gabor filter bank from the images segmented by morphology and watershed transform segmentation methods. It is also observed that SVM classifier results its highest diagnostic accuracy of 90 % for DWT and Gabor filter based features along with morphology and watershed transform segmentation methods. The experimental results suggest that the developed system with multi-stained thyroid FNAB images would be useful for identifying thyroid cancer irrespective of staining protocol used.

  14. Computer-aided diagnosis of plus disease via measurement of vessel thickness in retinal fundus images of preterm infants.

    PubMed

    Oloumi, Faraz; Rangayyan, Rangaraj M; Casti, Paola; Ells, Anna L

    2015-11-01

    Changes in the characteristics of retinal vessels such as width and tortuosity can be signs of the presence of several diseases such retinopathy of prematurity (ROP) and diabetic retinopathy. Plus disease is an indicator of ROP which requires treatment and is signified by an increase in posterior venular width. In this work, we present image processing techniques for the detection, segmentation, tracking, and measurement of the width of the major temporal arcade (MTA), which is the thickest venular branch in the retina. Several image processing techniques have been employed, including the use of Gabor filters to detect the MTA, morphological image processing to obtain its skeleton, Canny's method to detect and select MTA vessel-edge candidates, least-squares fitting to interpolate the MTA edges, and geometrical procedures to measure the width of the MTA. The results, obtained using 110 retinal fundus images of preterm infants, indicate a statistically highly significant difference in MTA width of normal cases as compared to cases with plus disease (p<0.01). The results provide good accuracy in computer-aided diagnosis (CAD) of plus disease with an area under the receiver operating characteristic curve of 0.76. The proposed methods may be used in CAD of plus disease and timely treatment of ROP in a clinical or teleophthalmological setting.

  15. Incorporating texture features in a computer-aided breast lesion diagnosis system for automated three-dimensional breast ultrasound

    PubMed Central

    Liu, Haixia; Tan, Tao; van Zelst, Jan; Mann, Ritse; Karssemeijer, Nico; Platel, Bram

    2014-01-01

    Abstract. We investigated the benefits of incorporating texture features into an existing computer-aided diagnosis (CAD) system for classifying benign and malignant lesions in automated three-dimensional breast ultrasound images. The existing system takes into account 11 different features, describing different lesion properties; however, it does not include texture features. In this work, we expand the system by including texture features based on local binary patterns, gray level co-occurrence matrices, and Gabor filters computed from each lesion to be diagnosed. To deal with the resulting large number of features, we proposed a combination of feature-oriented classifiers combining each group of texture features into a single likelihood, resulting in three additional features used for the final classification. The classification was performed using support vector machine classifiers, and the evaluation was done with 10-fold cross validation on a dataset containing 424 lesions (239 benign and 185 malignant lesions). We compared the classification performance of the CAD system with and without texture features. The area under the receiver operating characteristic curve increased from 0.90 to 0.91 after adding texture features (p<0.001). PMID:26158036

  16. The Usefulness of Biological and Neuroimaging Markers for the Diagnosis of Early-Onset Alzheimer's Disease

    PubMed Central

    Padovani, Alessandro; Gilberti, Nicola; Borroni, Barbara

    2011-01-01

    The recent proposed criteria for Alzheimer's Disease (AD) have strongly claimed the usefulness of biological and neuroimaging markers for early identification AD. Cerebrospinal fluid (CSF) Tau/Abeta ratio, hippocampal atrophy, posterior cingulate, and neocortical associative area hypometabolism, or amyloid burden evaluated by PiB compound, held the premises to increase diagnostic accuracy in the preclinical disease stages. Despite many efforts to identify subjects at risk of developing AD, less attention has been paid to presenile AD diagnosis. A few data are already available in early onset AD, mainly obtained in cases of monogenic disorder. In this paper, we discuss the current literature on the role of biological and neuroimaging markers in presenile AD. PMID:21559247

  17. The usefulness of biological and neuroimaging markers for the diagnosis of early-onset Alzheimer's disease.

    PubMed

    Padovani, Alessandro; Gilberti, Nicola; Borroni, Barbara

    2011-02-21

    The recent proposed criteria for Alzheimer's Disease (AD) have strongly claimed the usefulness of biological and neuroimaging markers for early identification AD. Cerebrospinal fluid (CSF) Tau/Abeta ratio, hippocampal atrophy, posterior cingulate, and neocortical associative area hypometabolism, or amyloid burden evaluated by PiB compound, held the premises to increase diagnostic accuracy in the preclinical disease stages. Despite many efforts to identify subjects at risk of developing AD, less attention has been paid to presenile AD diagnosis. A few data are already available in early onset AD, mainly obtained in cases of monogenic disorder. In this paper, we discuss the current literature on the role of biological and neuroimaging markers in presenile AD.

  18. [Bovine milk progesterone concentration as a method of early diagnosis of pregnancy (author's transl)].

    PubMed

    Guissi, G; Laborde, N P; Rosner, J M

    1976-01-01

    With the purpose of obtaining an early indicator of pregnancy in bovines, excretion levels of milk progesterone were determined by a simple radioimmunological method. In the pregnant group, progesterone concentration was significantly (p less than 0,001) greater than in non-pregnant ones. In some cases (20-25%) there was no difference in values, resulting a method efficiency of 75-80%. Milk must be processed a few hours after collection since a decrease in progesterone values is observed within a few days. Easy obtention of this biological matherial, without special technical requirements as well as the simple dosification method make this test a practical index for establishing early diagnosis of pregnancy in bovines.

  19. Early diagnosis and surgical treatment of the lower labial frenum in infancy: a case report.

    PubMed

    Mello-Moura, Anna Carolina Volpi; Cadioli, Isabela Capparelli; Corrêa, Maria Salete Narras Pires; Rodrigues, Célia Regina Martins Delgado; De Nardi Fonoff, Ricardo

    2008-01-01

    The lower labial frenum attached to the free gingival margin can promote local tension, resulting in tissue ischemia, promoting the development of gingival recession, as well as complicating oral hygiene, resulting in a local biofilm accumulation and chronic inflammation. In such cases, periodontal surgery is recommended and the local anatomic characteristics will be improved as early as school age. In this case report, a 7 years old patient had the lower labial frenum repositioned. After this procedure, the suture of the mucosa to the periosteum was performed around the surgical wound to provide local healing by secondary intention. This case report suggests that early diagnosis and surgical treatment of the lower labial frenum in school age children is fundamental in eliminating etiological factors, reestablishing normal anatomic characteristics and preventing periodontal diseases.

  20. [The importance of early diagnosis and intervention in children diagnosed with reading disorder. Case studies].

    PubMed

    Törö, Krisztina; Balázs, Judit

    2015-06-01

    Reading Disorder (RD) belongs to Specific Learning Disorders within the chapter of Neurodevelopmental Disorders in the Diagnostic and Statistic Manual of Mental Disorders 5th edition. Previous research shows that the time of the diagnosis of RD - early (before starting school) or late - has a great impact on the prognosis. In the current paper we present the cases of two children diagnosed with RD. Our cases demonstrate that if RD is diagnosed in early childhood, the child's and his/her family's quality of life can be influenced in a positive direction, while late recognition of RD might influence the child's and the family's quality of life negatively. For these reasons it is important that experts recognize RD in time, start appropriate treatment and give proper support to children diagnosed with RD and their families.

  1. Guidelines for Screening, Early Diagnosis and Management of Severe Combined Immunodeficiency (SCID) in India.

    PubMed

    Madkaikar, Manisha; Aluri, Jahnavi; Gupta, Sudhir

    2016-05-01

    Severe combined immunodeficiency (SCID) is one of the most severe and fatal forms of inherited primary immunodeficiency. Early diagnosis of SCID improves the outcome of life before and after hematopoietic stem cell transplant (HSCT). SCID fulfills the internationally-established criteria for a condition to be screened for at birth. T cell receptor excision circle (TREC) assay is commonly used in western countries as part of newborn blood spot screening (NBS) program as the assay has high sensitivity and specificity to identify SCID infants, allowing early intervention and curative bone marrow (BM) transplantation. In India, the blood spot based screening programs are yet to mature into a full-fledged national program. Moreover, TREC assay, a PCR based test, is not widely available and may cost USD 5-7 per test; thus limiting its applicability for screening newborns in Indian scenario. Most of the SCID patients have lymphopenia at birth and routine evaluation for absolute lymphocyte count (ALC) on cord blood samples can help in pre-symptomatic detection and early intervention for neonates with SCID. Although ALC count lacks the sensitivity and specificity of TREC assay; its lower cost and widespread availability makes it an attractive option for identifying newborns with lymphopenia during the post-partum hospital stay. BCG vaccine and other live attenuated vaccines (e.g., oral polio vaccine) should be withheld in lymphopenic infants until SCID is excluded by clinical and/or immunological work-up. A diagnosis of SCID warrants immediate care to prevent and treat infections and wherever feasible, early stem cell transplantation for disease free survival.

  2. Regular Sputum Check-Up for Early Diagnosis of Tuberculosis after Exposure in Healthcare Facilities

    PubMed Central

    Chao, Wen-Cheng; Wu, Chieh-Liang; Liu, Po-Yu; Shieh, Chi-Chang

    2016-01-01

    Background The early diagnosis of patients with TB disease is critical after an outbreak of tuberculosis (TB) infection in healthcare facilities. In this study, we report a catastrophic TB outbreak in a psychiatric healthcare facility and analyze the role of regular sputum check-ups and other diagnostic tools to facilitate an early diagnosis. Methods Every exposed participant received regular sputum check-ups and chest X-rays (CXR) as part of the outbreak management protocol. We retrospectively analyzed data from the contact participants to identify risk factors for eventual TB development and investigated the diagnostic efficacy of regular sputum check-ups. Results Among 133 contact participants, 16 (12.0%) developed TB during the 4-year follow-up period. Low body-mass-index (BMI) (<21) (adjusted hazard ratio (aHR) 3.16, 95% confidence interval (CI) 1.11–8.98) and long duration of contact (>3 months) (aHR 8.70, 95% CI, 1.14–63.34) independently predicted the development of TB. Even though regular sputum check-ups required significant resources, they did facilitate the early identification of new TB cases among the contact participants. Regular sputum check-ups for high-risk patients based on BMI, contact duration and CXR findings may be a practical approach when compared with universal sputum follow-up, with a slightly decreased sensitivity but high positive likelihood ratio (88%, [95% CI, 62–98%] and 5.12, [95%CI, 3.30–7.95], respectively). Conclusion While regular sputum check-ups for all contact participants facilitated the early identification of cases after the outbreak of TB in the healthcare facility, regular sputum check-ups for high-risk patients might be an effective alternative in resource-limited settings. PMID:27258370

  3. Guidelines for Screening, Early Diagnosis and Management of Severe Combined Immunodeficiency (SCID) in India.

    PubMed

    Madkaikar, Manisha; Aluri, Jahnavi; Gupta, Sudhir

    2016-05-01

    Severe combined immunodeficiency (SCID) is one of the most severe and fatal forms of inherited primary immunodeficiency. Early diagnosis of SCID improves the outcome of life before and after hematopoietic stem cell transplant (HSCT). SCID fulfills the internationally-established criteria for a condition to be screened for at birth. T cell receptor excision circle (TREC) assay is commonly used in western countries as part of newborn blood spot screening (NBS) program as the assay has high sensitivity and specificity to identify SCID infants, allowing early intervention and curative bone marrow (BM) transplantation. In India, the blood spot based screening programs are yet to mature into a full-fledged national program. Moreover, TREC assay, a PCR based test, is not widely available and may cost USD 5-7 per test; thus limiting its applicability for screening newborns in Indian scenario. Most of the SCID patients have lymphopenia at birth and routine evaluation for absolute lymphocyte count (ALC) on cord blood samples can help in pre-symptomatic detection and early intervention for neonates with SCID. Although ALC count lacks the sensitivity and specificity of TREC assay; its lower cost and widespread availability makes it an attractive option for identifying newborns with lymphopenia during the post-partum hospital stay. BCG vaccine and other live attenuated vaccines (e.g., oral polio vaccine) should be withheld in lymphopenic infants until SCID is excluded by clinical and/or immunological work-up. A diagnosis of SCID warrants immediate care to prevent and treat infections and wherever feasible, early stem cell transplantation for disease free survival. PMID:26920398

  4. Malignant gliomas: current perspectives in diagnosis, treatment, and early response assessment using advanced quantitative imaging methods.

    PubMed

    Ahmed, Rafay; Oborski, Matthew J; Hwang, Misun; Lieberman, Frank S; Mountz, James M

    2014-01-01

    Malignant gliomas consist of glioblastomas, anaplastic astrocytomas, anaplastic oligodendrogliomas and anaplastic oligoastrocytomas, and some less common tumors such as anaplastic ependymomas and anaplastic gangliogliomas. Malignant gliomas have high morbidity and mortality. Even with optimal treatment, median survival is only 12-15 months for glioblastomas and 2-5 years for anaplastic gliomas. However, recent advances in imaging and quantitative analysis of image data have led to earlier diagnosis of tumors and tumor response to therapy, providing oncologists with a greater time window for therapy management. In addition, improved understanding of tumor biology, genetics, and resistance mechanisms has enhanced surgical techniques, chemotherapy methods, and radiotherapy administration. After proper diagnosis and institution of appropriate therapy, there is now a vital need for quantitative methods that can sensitively detect malignant glioma response to therapy at early follow-up times, when changes in management of nonresponders can have its greatest effect. Currently, response is largely evaluated by measuring magnetic resonance contrast and size change, but this approach does not take into account the key biologic steps that precede tumor size reduction. Molecular imaging is ideally suited to measuring early response by quantifying cellular metabolism, proliferation, and apoptosis, activities altered early in treatment. We expect that successful integration of quantitative imaging biomarker assessment into the early phase of clinical trials could provide a novel approach for testing new therapies, and importantly, for facilitating patient management, sparing patients from weeks or months of toxicity and ineffective treatment. This review will present an overview of epidemiology, molecular pathogenesis and current advances in diagnoses, and management of malignant gliomas.

  5. Limiting Cumulative HIV Viremia Copy-Years by Early Treatment Reduces Risk of AIDS and Death

    PubMed Central

    Walker, A. Sarah; Suthar, Amitabh B.; Sabin, Caroline; Bucher, Heiner C.; Jarrin, Inma; Moreno, Santiago; Perez-Hoyos, Santiago; Porter, Kholoud; Ford, Deborah

    2016-01-01

    Background: Viremia copy-years (VCY), a time-updated measure of cumulative HIV exposure, predicts AIDS/death; although its utility in deciding when to start combination antiretroviral therapy (cART) remains unclear. We aimed to assess the impact of initiating versus deferring cART on risk of AIDS/death by levels of VCY both independent of and within CD4 cell count strata ≥500 cells per cubic millimeter. Methods: Using Concerted Action on Seroconversion to AIDS and Death in Europe (CASCADE) data, we created a series of nested “trials” corresponding to consecutive months for individuals ≥16 years at seroconversion after 1995 who were cART-naive and AIDS-free. Pooling across all trials, time to AIDS/death by CD4, and VCY strata was compared in those initiating vs. deferring cART using Cox models adjusted for: country, sex, risk group, seroconversion year, age, time since last HIV-RNA, and current CD4, VCY, HIV-RNA, and mean number of previous CD4/HIV-RNA measurements/year. Results: Of 9353 individuals, 5312 (57%) initiated cART and 486 (5%) acquired AIDS/died. Pooling CD4 strata, risk of AIDS/death associated with initiating vs. deferring cART reduced as VCY increased. In patients with high CD4 cell counts, ≥500 cells per cubic millimeter, there was a trend for a greater reduction for those initiating vs. deferring with increasing VCY (P = 0.09), with the largest benefit in the VCY ≥100,000 copy-years/mL group [hazard ratio (95% CI) = 0.41 (0.19 to 0.87)]. Conclusions: For individuals with CD4 ≥500 cells per cubic millimeter, limiting the cumulative HIV burden to <100,000 copy-years/mL through cART may reduce the risk of AIDS/death. PMID:27116045

  6. Load of challenge Marek's disease virus DNA in blood as a criterion for early diagnosis of Marek's disease tumors.

    PubMed

    Gimeno, Isabel M; Cortes, Aneg L; Silva, R F

    2008-06-01

    Outbreaks of Marek's disease (MD) in vaccinated flocks still occur sporadically and lead to economic losses. Unfortunately, adequate methods to predict MD outbreaks are lacking. In the present study, we have evaluated whether high load of challenge MD virus (MDV) DNA in peripheral blood could aid in the early diagnosis of MD and in monitoring efficacy of vaccines against MD. One experiment was conducted to simulate field conditions by combining various vaccines (turkey herpesvirus [HVT] and HVT + MDV serotype 2 [SB1]) and challenge viruses (GA, Md5, and 648A). Vaccine efficacy among our experimental groups ranged from 13.3% to 94.2%. Each chicken was sampled three times during the length of the experiment (3, 5, and 15 wk postchallenge [wpc]), and gross lesions were evaluated in chickens that died and at termination of the experiment. DNA was extracted from whole blood and buffy coats from each sample, and the load of challenge MDV DNA and HVT DNA were quantified by real-time polymerase chain reaction. Chickens that developed MD by the end of the experiment had higher load of challenge MDV DNA (threshold cycle [Ct] glyceraldehyde-3-phosphate dehydrogenase [GAPDH]/Ct glycoprotein B [gB] ratios of 1.0, 1.04, and 1.05 at 3, 5, and 15 wpc, respectively) than those that did not develop MD (Ct GAPDH/Ct gB ratios of 0.7, 0.69, and 0.46 at 3, 5, and 15 wpc, respectively). However, load of HVT DNA in blood was not correlated with the development of tumors (Ct GAPDH/Ct HVT ratios from 0.04 to 0.10 in both groups). Vaccinated groups with >75% protection had statistically significant less challenge DNA virus (Ct GAPDH/Ct gB ratios of 0.76, 0.70, and 0.45 at 3, 5, and 15 wpc, respectively) than less protected groups (Ct GAPDH/Ct gB ratios of 0.92, 0.97, and 0.85 at 3, 5, and 15 wpc, respectively). No differences in the load of HVT DNA could be found between protected and nonprotected groups at any time point of the study (Ct GAPDH/Ct HVT from 0.05 to 0.09 in both groups). Our

  7. Diagnosis of HIV-Associated Oral Lesions in Relation to Early versus Delayed Antiretroviral Therapy: Results from the CIPRA HT001 Trial.

    PubMed

    Batavia, Ashita S; Secours, Rode; Espinosa, Patrice; Jean Juste, Marc Antoine; Severe, Patrice; Pape, Jean William; Fitzgerald, Daniel W

    2016-01-01

    Oral mucosal lesions that are associated with HIV infection can play an important role in guiding the decision to initiate antiretroviral therapy (ART). The incidence of these lesions relative to the timing of ART initiation has not been well characterized. A randomized controlled clinical trial was conducted at the GHESKIO Center in Port-au-Prince, Haiti between 2004 and 2009. 816 HIV-infected ART-naïve participants with CD4 T cell counts between 200 and 350 cells/mm3 were randomized to either immediate ART initiation (early group; N = 408), or initiation when CD4 T cell count was less than or equal 200 cells/mm3 or with the development of an AIDS-defining condition (delayed group; N = 408). Every 3 months, all participants underwent an oral examination. The incidence of oral lesions was 4.10 in the early group and 17.85 in the delayed group (p-value <0.01). In comparison to the early group, there was a significantly higher incidence of candidiasis, hairy leukoplakia, herpes labialis, and recurrent herpes simplex in the delayed group. The incidence of oral warts in delayed group was 0.97 before therapy and 4.27 post-ART initiation (p-value <0.01). In the delayed group the incidence of oral warts post-ART initiation was significantly higher than that seen in the early group (4.27 versus 1.09; p-value <0.01). The incidence of oral warts increased after ART was initiated, and relative to the early group there was a four-fold increase in oral warts if ART was initiated following an AIDS diagnosis. Based upon our findings, candidiasis, hairy leukoplakia, herpes labialis, and recurrent herpes simplex indicate immune suppression and the need to start ART. In contrast, oral warts are a sign of immune reconstitution following ART initiation.

  8. Diagnosis of HIV-Associated Oral Lesions in Relation to Early versus Delayed Antiretroviral Therapy: Results from the CIPRA HT001 Trial

    PubMed Central

    Batavia, Ashita S.; Secours, Rode; Espinosa, Patrice; Jean Juste, Marc Antoine; Severe, Patrice; Pape, Jean William; Fitzgerald, Daniel W.

    2016-01-01

    Oral mucosal lesions that are associated with HIV infection can play an important role in guiding the decision to initiate antiretroviral therapy (ART). The incidence of these lesions relative to the timing of ART initiation has not been well characterized. A randomized controlled clinical trial was conducted at the GHESKIO Center in Port-au-Prince, Haiti between 2004 and 2009. 816 HIV-infected ART-naïve participants with CD4 T cell counts between 200 and 350 cells/mm3 were randomized to either immediate ART initiation (early group; N = 408), or initiation when CD4 T cell count was less than or equal 200 cells/mm3 or with the development of an AIDS-defining condition (delayed group; N = 408). Every 3 months, all participants underwent an oral examination. The incidence of oral lesions was 4.10 in the early group and 17.85 in the delayed group (p-value <0.01). In comparison to the early group, there was a significantly higher incidence of candidiasis, hairy leukoplakia, herpes labialis, and recurrent herpes simplex in the delayed group. The incidence of oral warts in delayed group was 0.97 before therapy and 4.27 post-ART initiation (p-value <0.01). In the delayed group the incidence of oral warts post-ART initiation was significantly higher than that seen in the early group (4.27 versus 1.09; p-value <0.01). The incidence of oral warts increased after ART was initiated, and relative to the early group there was a four-fold increase in oral warts if ART was initiated following an AIDS diagnosis. Based upon our findings, candidiasis, hairy leukoplakia, herpes labialis, and recurrent herpes simplex indicate immune suppression and the need to start ART. In contrast, oral warts are a sign of immune reconstitution following ART initiation. PMID:26930571

  9. Diagnosis of HIV-Associated Oral Lesions in Relation to Early versus Delayed Antiretroviral Therapy: Results from the CIPRA HT001 Trial.

    PubMed

    Batavia, Ashita S; Secours, Rode; Espinosa, Patrice; Jean Juste, Marc Antoine; Severe, Patrice; Pape, Jean William; Fitzgerald, Daniel W

    2016-01-01

    Oral mucosal lesions that are associated with HIV infection can play an important role in guiding the decision to initiate antiretroviral therapy (ART). The incidence of these lesions relative to the timing of ART initiation has not been well characterized. A randomized controlled clinical trial was conducted at the GHESKIO Center in Port-au-Prince, Haiti between 2004 and 2009. 816 HIV-infected ART-naïve participants with CD4 T cell counts between 200 and 350 cells/mm3 were randomized to either immediate ART initiation (early group; N = 408), or initiation when CD4 T cell count was less than or equal 200 cells/mm3 or with the development of an AIDS-defining condition (delayed group; N = 408). Every 3 months, all participants underwent an oral examination. The incidence of oral lesions was 4.10 in the early group and 17.85 in the delayed group (p-value <0.01). In comparison to the early group, there was a significantly higher incidence of candidiasis, hairy leukoplakia, herpes labialis, and recurrent herpes simplex in the delayed group. The incidence of oral warts in delayed group was 0.97 before therapy and 4.27 post-ART initiation (p-value <0.01). In the delayed group the incidence of oral warts post-ART initiation was significantly higher than that seen in the early group (4.27 versus 1.09; p-value <0.01). The incidence of oral warts increased after ART was initiated, and relative to the early group there was a four-fold increase in oral warts if ART was initiated following an AIDS diagnosis. Based upon our findings, candidiasis, hairy leukoplakia, herpes labialis, and recurrent herpes simplex indicate immune suppression and the need to start ART. In contrast, oral warts are a sign of immune reconstitution following ART initiation. PMID:26930571

  10. Age of Diagnosis of Squamous Cell Cervical Carcinoma and Early Sexual Experience

    PubMed Central

    Edelstein, Zoe R.; Madeleine, Margaret M.; Hughes, James P.; Johnson, Lisa G.; Schwartz, Stephen M.; Galloway, Denise A.; Carter, Joseph J.; Koutsky, Laura A.

    2009-01-01

    Background Given the established links between young age at first intercourse (AFI), number of sex partners, high-risk human papillomavirus infection, and squamous cell cervical cancer (SCC), we hypothesized that women diagnosed with SCC at younger ages would be more likely to report young AFI than women diagnosed later in life. Methods We performed a population-based investigation among invasive SCC cases who were diagnosed between 1986 and 2004, were 22 to 53 years old, and lived in the metropolitan Seattle-Puget Sound region (n=333). Using multivariate linear regression, we estimated coefficients and 95% confidence intervals (CI) to assess the association between age at SCC diagnosis and AFI (<15, 15–18, ≥19) and number of sex partners before age 20 (0, 1, 2–4, 5–14, 15+), accounting for birth year and other factors. Interactions were assessed using the likelihood ratio test. Results The interval between AFI and SCC diagnosis ranged from 4 to 35 years. In a multivariate model, compared to SCC cases reporting AFI≥19, the mean age of diagnosis was 3.1 years younger for SCC cases reporting AFI<15 (CI: −5.8, −0.5) and 2.6 years younger for SCC cases reporting AFI 15–18 years (CI: −4.6, −0.6). Although number of sex partners before age 20 was associated with age at SCC diagnosis in a crude analysis, the association was not independent of AFI. However, in the AFI≥19 and AFI<15 groups, differences in effect were seen by number of sex partners before age 20 (p for interaction=0.08), with the association remaining strong and significant only in the AFI<15 group that had 2 or more partners before age 20 (coefficient: −4.2, CI: −6.3, −2.1). Conclusion Among younger and middle-aged women with SCC, early age of diagnosis was associated with early AFI, though the effect appeared to be modified by number of sex partners before age 20. PMID:19318437

  11. Project for the National Program of Early Diagnosis of Endometrial Cancer Part I

    PubMed Central

    Bohîlțea, RE; Ancăr, V; Cirstoiu, MM; Rădoi, V; Bohîlțea, LC; Furtunescu, F

    2015-01-01

    Rationale: Endometrial cancer recorded a peak incidence in ages 60-64 years in Romania, reaching in 2013 the average value of 8.06/ 100,000 women, and 15.97/ 100,000 women within the highest risk age range, having in recent years an increasing trend, being higher in urban than in rural population. Annually, approximately 800 new cases are registered in our country. The estimated lifetime risk of a woman to develop endometrial cancer is of about 1,03%. Based on an abnormal uterine bleeding, 35% of the endometrial cancers are diagnosed in an advanced stage of the disease, with significantly diminished lifetime expectancy. Objective: Drafting a national program for the early diagnosis of endometrial cancer. Methods and Results: We proposed a standardization of the diagnostic steps and focused on 4 key elements for the early diagnosis of endometrial cancer: investigation of abnormal uterine bleeding occurring in pre/ post-menopausal women, investigating features/ anomalies of cervical cytology examination, diagnosis, treatment and proper monitoring of precursor endometrial lesions or cancer associated endometrial lesions and screening high risk populations (Lynch syndrome, Cowden syndrome). Discussion: Improving medical practice based on diagnostic algorithms addresses the four risk groups, by improving information system reporting and record keeping. Improving addressability cases by increasing the health education of the population will increase the rate of diagnosis of endometrial cancer in the early stages of the disease. Abbreviations: ACOG = American Society of Obstetricians and Gynecologists, ASCCP = American Society for Colposcopy and Cervical Pathology, PATT = Partial Activated Thromboplastin Time, BRCA = Breast Cancer Gene, CT = Computerized Tomography, IFGO = International Federation of Gynecology and Obstetrics, HLG = Hemoleucogram, HNPCC = Hereditary Nonpolyposis Colorectal Cancer (Lynch syndrome), IHC = Immunohistochemistry, BMI = Body Mass Index, INR

  12. Early and Correct Diagnosis of Celiac Disease in the Prevention of Growth Disorders and Child Development

    PubMed Central

    Brigic, Esad; Hadzic, Devleta; Mladina, Nada

    2012-01-01

    Coeliac, in ordinary people known as “flour allergy” and in medicine world known as gluten enteropathy which means enteric damage caused by gluten. Data about incidence of gluten enteropathy is different in different countries around the World and depend on is it or is it not the right diagnosis for enteric disorder. Sometimes, this disease is unrecognized because of unspecific clinical signs. This disease is happening in every moment of a lifetime, most common during the childhood when the children try to eat any food which contains gluten. Anyway, if children had no symptoms it doesn’t¢t mean that disease not exists, and that¢is because we have to do diagnostic tests to confirm gluten enteropathy. Gluten intolerance is chronic disease and demand use of the specific non gluten food during the lifetime. Early diagnosis is right way to prevent unregularly growth. Aim of this study was to show the influence of early diagnostic about growth. For each patient we had a permission of parents and we showed our original results for three month we investigated. PMID:23678328

  13. [Telethermography in the early diagnosis and clinico-therapeutic monitoring of Sudeck's disease].

    PubMed

    Giordano, N; Battisti, E; Franci, A; Cecconami, L; Magarò, L; Marcucci, P

    1991-07-31

    In order to evaluate the potential value of telethermography in the early diagnosis of Sudeck's disease, the authors examined 10 patients presenting with this condition. Mean disease duration was 3.2 months and algodystrophic lesions in all patients were localized in one of the lower extremities. Ten healthy subjects, with mean age and sex distribution similar to those of the patients with Sudeck, were chosen as controls. Clinical examination, laboratory tests and telethermography were performed every two weeks for three months; X-rays of the affected limbs were also performed at the beginning and at the end of the study. All patients with algodystrophy were treated with salmon calcitonin (100 U.I./die/i.m. during the first 2 months and 100 U.I. on alternate days during the last month). Clinical-therapeutic thermographic monitoring showed that the localized hyperthermic pattern, initially shown in all patients (temperature levels at least three centigrades above normal values), later underwent a progressive time-related reduction leading to normalization. These results enable the authors to confirm the potential value of telethermography in the early diagnosis of Sudeck's disease and in its clinical monitoring, particularly in relation to therapy. PMID:1718654

  14. Genetics of primary bilateral macronodular adrenal hyperplasia: a model for early diagnosis of Cushing's syndrome?

    PubMed

    Drougat, Ludivine; Espiard, Stéphanie; Bertherat, Jerôme

    2015-10-01

    Long-term consequences of cortisol excess are frequent despite appropriate treatment after cure of Cushing's syndrome. This might be due to diagnostic delay, often difficult to reduce in rare diseases. The identification of a genetic predisposing factor might help to improve early diagnosis by familial screening. Primary bilateral macronodular adrenal hyperplasia (PBMAH) is a rare cause of Cushing's syndrome. Hypercortisolism in PBMAH is most often diagnosed between the fifth and sixth decades of life. The bilateral nature of the adrenocortical tumors and the occurrence of rare clear familial forms suggest a genetic origin. Indeed, a limited subset of PBMAH can be observed as part of multiple tumors syndromes due to alterations of the APC, Menin or Fumarate Hydratase genes. Rare variants of the phosphodiesterases PDE11A have been associated with PBMAH. The recent identification of ARMC5 germline alterations in 25-50% of PBMAH patients without obvious familial history or associated tumors opens new perspectives. ARMC5 alterations follow the model of a tumor suppressor gene: a first germline inactivating mutation of this 16p located gene is followed by a somatic secondary hit on the other allele (inactivating mutation or allelic loss). Functional studies demonstrate that ARMC5 controls apoptosis and steroid synthesis. The phenotype of index cases patients with the mutation seems more severe than the one of WT index cases. However, phenotype variability within a family is often observed. This review summarizes the genetics of PBMAH, focusing on ARMC5, which offer new perspectives for early diagnosis of Cushing's syndrome.

  15. [Research on Early Diagnosis of Gastric Cancer by the Surface Enhanced Raman Spectroscopy of Human Hemoglobin].

    PubMed

    Wang, Wei; Pan, Zhi-feng; Tang, Wei-yue; Li, Yun-tao; Fan, Chun-zhen

    2015-12-01

    Early diagnosis have great positive effect on the treatment of gastric cancer patients. Raman spectroscopy can provide a useful monitor for hemoglobin dynamics. Besides, Raman spectroscopy has notable advantages in the fields of abnormal hemoglobin diagnosis, hemoglobin oxygen saturation deter mination and blood methemoglobin analysis. In this paper, novel silver colloid was synthesized by microwave heated method. The surface enhanced Raman spectrums of hemoglobin from 11 normal persons and 20 gastric cancer patients are measured and analyzed in order to obtain spectrums which are high repeatability and characteristic peaks protruding. By analyzing the assignations of the SERS bands, it found that the content of asparagine, tyrosine and phenylalanine in the hemoglobin are significantly lower than healthy people. Discussing the structure of hemoglobin, when hemoglobin combines with oxygen, Fe²⁺ is in a low spin state, ionic radius shrinks and moves 0. 075 nm and fall into the pore in the middle of the heme porphyrin ring plane. This spatial variation affects F8His connected with the iron, will narrow the gap between the globin in the two strands of the helix, as a result, HC2 tyrosine pushed out of the void. Using this mechanism, the absorption peak of 1 560 cm⁻¹ confirmed that the tyrosine content in patients with gastric cancer was lower than that of normal people. Principal component analysis(PCA) is employed to get a three-dimensional scatter plot of PC scores for the health and cancer groups, and it can be learned that they are distributed in separate areas. By using the method of discriminate analysis, it is found that the diagnostic algorithm separates the two groups with sensitivity of 90.0% and diagnostic specificity of 90.9%, the overall diagnostic accuracy was 90.3%. The results from this exploratory study demonstrate that, SERS detection of oxyhemoglobin combined with multivariate analysis would be an effective method for early diagnosis of gastric

  16. [Research on Early Diagnosis of Gastric Cancer by the Surface Enhanced Raman Spectroscopy of Human Hemoglobin].

    PubMed

    Wang, Wei; Pan, Zhi-feng; Tang, Wei-yue; Li, Yun-tao; Fan, Chun-zhen

    2015-12-01

    Early diagnosis have great positive effect on the treatment of gastric cancer patients. Raman spectroscopy can provide a useful monitor for hemoglobin dynamics. Besides, Raman spectroscopy has notable advantages in the fields of abnormal hemoglobin diagnosis, hemoglobin oxygen saturation deter mination and blood methemoglobin analysis. In this paper, novel silver colloid was synthesized by microwave heated method. The surface enhanced Raman spectrums of hemoglobin from 11 normal persons and 20 gastric cancer patients are measured and analyzed in order to obtain spectrums which are high repeatability and characteristic peaks protruding. By analyzing the assignations of the SERS bands, it found that the content of asparagine, tyrosine and phenylalanine in the hemoglobin are significantly lower than healthy people. Discussing the structure of hemoglobin, when hemoglobin combines with oxygen, Fe²⁺ is in a low spin state, ionic radius shrinks and moves 0. 075 nm and fall into the pore in the middle of the heme porphyrin ring plane. This spatial variation affects F8His connected with the iron, will narrow the gap between the globin in the two strands of the helix, as a result, HC2 tyrosine pushed out of the void. Using this mechanism, the absorption peak of 1 560 cm⁻¹ confirmed that the tyrosine content in patients with gastric cancer was lower than that of normal people. Principal component analysis(PCA) is employed to get a three-dimensional scatter plot of PC scores for the health and cancer groups, and it can be learned that they are distributed in separate areas. By using the method of discriminate analysis, it is found that the diagnostic algorithm separates the two groups with sensitivity of 90.0% and diagnostic specificity of 90.9%, the overall diagnostic accuracy was 90.3%. The results from this exploratory study demonstrate that, SERS detection of oxyhemoglobin combined with multivariate analysis would be an effective method for early diagnosis of gastric

  17. Gram staining of protected pulmonary specimens in the early diagnosis of ventilator-associated pneumonia.

    PubMed

    Mimoz, O; Karim, A; Mazoit, J X; Edouard, A; Leprince, S; Nordmann, P

    2000-11-01

    We evaluated prospectively the use of Gram staining of protected pulmonary specimens to allow the early diagnosis of ventilator-associated pneumonia (VAP), compared with the use of 60 bronchoscopic protected specimen brushes (PSB) and 126 blinded plugged telescopic catheters (PTC) obtained from 134 patients. Gram stains were from Cytospin slides; they were studied for the presence of microorganisms in 10 and 50 fields by two independent observers and classified according to their Gram stain morphology. Quantitative cultures were performed after serial dilution and plating on appropriate culture medium. A final diagnosis of VAP, based on a culture of > or = 10(3) c.f.u. ml-1, was established after 81 (44%) samplings. When 10 fields were analysed, a strong relationship was found between the presence of bacteria on Gram staining and the final diagnosis of VAP (for PSB and PTC respectively: sensitivity 74 and 81%, specificity 94 and 100%, positive predictive value 91 and 100%, negative predictive value 82 and 88%). The correlation was less when we compared the morphology of microorganisms observed on Gram staining with those of bacteria obtained from quantitative cultures (for PSB and PTC respectively: sensitivity 54 and 69%, specificity 86 and 89%, positive predictive value 72 and 78%, negative predictive value 74 and 84%). Increasing the number of fields read to 50 was associated with a slight decrease in specificity and positive predictive value of Gram staining, but with a small increase in its sensitivity and negative predictive value. The results obtained by the two observers were similar to each other for both numbers of fields analysed. Gram staining of protected pulmonary specimens performed on 10 fields predicted the presence of VAP and partially identified (using Gram stain morphology) the microorganisms growing at significant concentrations, and could help in the early choice of the treatment of VAP. Increasing the number of fields read or having the Gram

  18. Early diagnosis of incipient caries based on non-invasive lasers

    NASA Astrophysics Data System (ADS)

    Velescu, A.; Todea, C.; Vitez, B.

    2016-03-01

    AIM: The aim of this study is to detect incipient caries and enamel demineralization using laser fluorescence.This serves only as an auxilary aid to identify and to monitor the development of these lesions. MATERIALS AND METHODS: 6 patients were involved in this study, three females and three male. Each patient underwent a professional cleaning, visual examination of the oral cavity, and then direct inspection using DiagnoCam and DIAGNOdent. After data recording each patient was submitted to retro-alveolar X-ray on teeth that were detected with enamel lesions. All data was collected and analyzed statistically. RESULTS: Of 36 areas considered in clinically healthy, 24 carious surfaces were found using laser fluorescence, a totally non-invasive method for detecting incipient carious lesions compared with the radiographic examination. CONCLUSIONS: This method has good applicability for patients because it improves treatment plan by early detection of caries and involves less fear for anxious patients and children.

  19. A structural-functional MRI-based disease atlas: application to computer-aided-diagnosis of prostate cancer

    NASA Astrophysics Data System (ADS)

    Xiao, G.; Bloch, B.; Chappelow, J.; Genega, E.; Rofsky, N.; Lenkinski, R.; Madabhushi, A.

    2010-03-01

    Different imaging modalities or protocols of a single patient may convey different types of information regarding a disease for the same anatomical organ/tissue. On the other hand, multi-modal/multi-protocol medical images from several different patients can also provide spatial statistics of the disease occurrence, which in turn can greatly aid in disease diagnosis and aid in improved, accurate biopsy and targeted treatment. It is therefore important to not only integrate medical images from multiple patients into a common coordinate frame (in the form of a population-based atlas), but also find the correlation between these multi-modal/multi-protocol data features and the disease spatial distribution in order to identify different quantitative structural and functional disease signatures. Most previous work on construction of anatomical atlases has focused on deriving a population-based atlas for the purpose of deriving the spatial statistics. Moreover, these models are typically derived from normal or healthy subjects, either explicitly or implicitly, where it is assumed that the inter-patient pathological variation is not large. These methods are not suitable for constructing a disease atlas, where significant differences between patients on account of disease related variations can be expected. In this paper, we present a novel framework for the construction of a multi-parametric MRI-based data-driven disease atlas consisting of multi-modal and multi-protocol data from across multiple patient studies. Our disease atlas contains 3 Tesla structural (T2) and functional (dynamic contrast enhanced (DCE)) prostate in vivo MRI with corresponding whole mount histology specimens obtained via radical prostatectomy. Our atlas construction framework comprises 3 distinct modules: (a) determination of disease spatial extent on the multi-protocol MR imagery for each patient, (b) construction of a multi-protocol MR imaging spatial atlas which captures the geographical

  20. The primary care physician in the early diagnosis of systemic sclerosis: the cornerstone of recognition and hope.

    PubMed

    Saketkoo, Lesley Ann; Magnus, Jeanette H; Doyle, Mittie K

    2014-01-01

    Systemic sclerosis (SSc) is a disease of unknown causative factor that manifests as a heterogenous group of multiorgan system manifestations and is characterized by vasculopathy and fibrosis of the skin and internal organs, with mortality related to pulmonary, cardiac, renal or gastrointestinal involvement. The prevalence of SSc may be underestimated in the general population. Cases are often undiagnosed or misdiagnosed, particularly cases with mild or no skin manifestations. Because of late referrals to rheumatologic care, many moderate-to-severe cases progress to irreversible end-organ damage that might have been prevented by early diagnosis. Early diagnosis of SSc with initiation of appropriate treatment is essential, with great impact on morbidity and mortality. This review examines presenting features, ensuing complications and treatment providing a focus on SSc as a treatable disease. Primary care providers play a pivotal role in recognizing initial symptoms associated with SSc and securing early diagnosis through early referral to specialists.

  1. The Primary Care Physician in the Early Diagnosis of Systemic Sclerosis: the Cornerstone of Recognition and Hope

    PubMed Central

    Saketkoo, Lesley Ann; Magnus, Jeanette H.; Doyle, Mittie K.

    2013-01-01

    Systemic sclerosis (SSc) is a disease of unknown etiology that manifests as a heterogeneous group of multi-organ system manifestations and is characterized by vasculopathy and fibrosis of the skin and internal organs, with mortality related to pulmonary, cardiac, renal or gastrointestinal involvement. The prevalence of SSc may be underestimated in the general population. Cases are often undiagnosed or misdiagnosed, particularly cases with mild or no skin manifestations. Due to late referrals to rheumatologic care, many moderate-to-severe cases progress to irreversible end-organ damage that might have been prevented by early diagnosis. Early diagnosis of SSc with initiation of appropriate treatment is essential, with great impact on morbidity and mortality. This review examines presenting features, ensuing complications and treatment providing a focus on SSc as a treatable disease. Primary care providers play a pivotal role in recognizing initial symptoms associated with SSc and securing early diagnosis through early referral to specialists. PMID:24366221

  2. Predictors of Late HIV Diagnosis among Adult People Living with HIV/AIDS Who Undertake an Initial CD4 T Cell Evaluation, Northern Ethiopia: A Case-Control Study

    PubMed Central

    Beyene, Melkamu Bedimo; Beyene, Habtamu Bedimo

    2015-01-01

    Introduction Early HIV testing and timely initiation of ART is critical for the improved quality of life of PLWHIV. Having identified a higher rates of Late HIV diagnosis, this study was aimed to determine Determinants of late diagnosis of HIV among adult HIV patients in Bahir Dar, Northern Ethiopia. Methods A case control study was conducted between January 2010 to December 2011 at Bahir Dar Felege Hiwot Referral Hospital. The study subjects consisted of 267 cases and 267 controls. Cases were adult people living with HIV/AIDS whose initial CD4 T cell count was < 200/μl of blood. Controls were those with a CD4 T cell count of greater than 200/ μl. Trained staff nurses were involved in data collection using a semi-structured questionnaire. Data was entered and analyzed using SPSS version 20. Descriptive statistics and Binary logistic regression were performed. Results Subjects who hold a certificate and above (AOR = 0.26; 95% CI = 0.13. 0.54), being initiated by friends, families and other socials to undertake HIV testing (AOR = 0.65; 95% CI = 0.29, 1.48), who reported a medium and high knowledge score about HIV/AIDS and who undertake HIV testing while visiting a clinic for ANC (AOR = 0.40; 95% CI = 0.19, 0.83) were less likely to be diagnosed late. Subjects who undertake HIV testing due to providers’ initiation (AOR = 1.70; 95%CI = 1.08, 2.68), who reported a medium internalized stigma (AOR = 4.94; 95% CI = 3.13, 7.80) and who reported a high internalized stigma score towards HIV/AIDS (AOR = 16.64; 95% CI = 8.29, 33.4) had a high odds of being diagnosed late compared to their counterparts. Conclusion Internalized stigma, low knowledge level about HIV/AIDS, not to have attended formal education and failure to undertake HIV testing by own initiation were significant determinant factors associated with Late HIV diagnosis. Education about HIV/AIDS, promotion of general education, and encouraging people to motivate their social mates to undertake HIV testing are

  3. Novel approaches to improve prostate cancer diagnosis and management in early-stage disease.

    PubMed

    Marberger, Michael; Barentsz, Jelle; Emberton, Mark; Hugosson, Jonas; Loeb, Stacy; Klotz, Laurence; Koch, Michael; Shariat, Shahrokh F; Vickers, Andrew

    2012-03-01

    The reported incidence of prostate cancer has risen since the implementation of screening. It is felt that the introduction of widespread prostate-specific antigen testing is responsible for most patients with prostate cancer now being diagnosed with asymptomatic, clinically localised disease. Diagnosis at this stage is associated with significantly improved treatment outcomes and longer life expectancy. Although there is evidence that screening has reduced prostate cancer mortality, there is a risk of over-diagnosis and over-treatment of early state prostate cancers, including clinically insignificant and indolent cancers. Active surveillance and focal therapy have been advocated as potential management options for some patients. However, these approaches face several challenges. Biopsy sampling errors together with less than optimal imaging of tumours can lead to difficulties in selecting suitable low-risk patients for these options.  To overcome these challenges, novel approaches to the staging and monitoring of patients with early prostate cancer are being developed. These include new imaging techniques, such as multi-parametric magnetic resonance imaging, and the development of new biomarkers and biopsy-based methods. These techniques aim to assess the potential of a specific tumour to be aggressive, and to improve patient outcomes. The aim of the present paper is to summarise presentations and debates at the third annual Interactive Genitourinary Cancer Conference concerning the use of population-based screening methods and the roles of active surveillance and focal therapy as prostate cancer treatments. The application of novel imaging biopsy-based methods and biomarkers in early-stage prostate cancer will also be explored.

  4. Project for the National Program of Early Diagnosis of Endometrial Cancer Part II

    PubMed Central

    Bohîlțea, RE; Ancăr, V; Rădoi, V; Furtunescu, F; Bohîlțea, LC

    2015-01-01

    Rationale: Endometrial cancer recorded a peak incidence in ages 60-64 years in Romania. Since 2013, an increased trend of endometrial cancer occurrence has been registered in urban areas as compared with rural ones. Unfortunately, most of the cancer cases are diagnosed too late, in an advanced stage of the disease, resulting into diminished lifetime expectancy. The first part of the article concentrated on issues such as: the description of the study, results, and discussions regarding the study, definitions and terms, risk factors specific for endometrial carcinomas, presentation of the activities of the Program, etc. Objective: Drafting a national program that will serve as an early diagnosis method of endometrial cancer. This second part of the study continues with the presentation of the activities of the Program, analyzes the human resources and materials needed to implement the Program, presents the strategies and the indicators specific for the implementation of the project. Methods and Results: A standardization of the diagnostic steps was proposed and the focus was on 4 key elements for the early diagnosis of endometrial cancer: The first steps were approached in the first part of the study and the second part of the study investigated the proper monitoring of precursor endometrial lesions or cancer associated endometrial lesions and screening high risk populations (Lynch syndrome, Cowden syndrome). Discussion: Improving medical practice based on diagnostic algorithms and programs improves and increases the lifetime expectancy, due to the fact that endometrial cancer is early diagnosed and treated before it causes serious health problems or even death. Abbreviations: ASCCP = American Society for Colposcopy and Cervical Pathology, CT = Computerized Tomography, HNPCC = Hereditary Nonpolyposis Colorectal Cancer (Lynch syndrome), IHC = Immunohistochemistry, MSI = Microsatellites instability, MSI-H/ MSI-L = high (positive test)/ low (negative test

  5. A Novel Electrochemical Microfluidic Chip Combined with Multiple Biomarkers for Early Diagnosis of Gastric Cancer

    NASA Astrophysics Data System (ADS)

    Xie, Yao; Zhi, Xiao; Su, Haichuan; Wang, Kan; Yan, Zhen; He, Nongyue; Zhang, Jingpu; Chen, Di; Cui, Daxiang

    2015-12-01

    Early diagnosis is very important to improve the survival rate of patients with gastric cancer and to understand the biology of cancer. In order to meet the clinical demands for early diagnosis of gastric cancer, we developed a disposable easy-to-use electrochemical microfluidic chip combined with multiple antibodies against six kinds of biomarkers (carcinoembryonic antigen (CEA), carbohydrate antigen 19-9 (CA19-9), Helicobacter pylori CagA protein (H.P.), P53oncoprotein (P53), pepsinogen I (PG I), and PG-II). The six kinds of biomarkers related to gastric cancer can be detected sensitively and synchronously in a short time. The specially designed three electrodes system enables cross-contamination to be avoided effectively. The linear ranges of detection of the electrochemical microfluidic chip were as follows: 0.37-90 ng mL-1 for CEA, 10.75-172 U mL-1 for CA19-9, 10-160 U L-1 for H.P., 35-560 ng mL-1 for P53, 37.5-600 ng mL-1 for PG I, and 2.5-80 ng mL-1for PG II. This method owns better sensitivity compared with enzyme-linked immunosorbent assay (ELISA) results of 394 specimens of gastric cancer sera. Furthermore, we established a multi-index prediction model based on the six kinds of biomarkers for predicting risk of gastric cancer. In conclusion, the electrochemical microfluidic chip for detecting multiple biomarkers has great potential in applications such as early screening of gastric cancer patients, and therapeutic evaluation, and real-time dynamic monitoring the progress of gastric cancer in near future.

  6. Clinical experience with a computer-aided diagnosis system for automatic detection of pulmonary nodules at spiral CT of the chest

    NASA Astrophysics Data System (ADS)

    Wormanns, Dag; Fiebich, Martin; Saidi, Mustafa; Diederich, Stefan; Heindel, Walter

    2001-05-01

    The purpose of the study was to evaluate a computer aided diagnosis (CAD) workstation with automatic detection of pulmonary nodules at low-dose spiral CT in a clinical setting for early detection of lung cancer. Two radiologists in consensus reported 88 consecutive spiral CT examinations. All examinations were reviewed using a UNIX-based CAD workstation with a self-developed algorithm for automatic detection of pulmonary nodules. The algorithm was designed to detect nodules with at least 5 mm diameter. The results of automatic nodule detection were compared to the consensus reporting of two radiologists as gold standard. Additional CAD findings were regarded as nodules initially missed by the radiologists or as false positive results. A total of 153 nodules were detected with all modalities (diameter: 85 nodules <5mm, 63 nodules 5-9 mm, 5 nodules >= 10 mm). Reasons for failure of automatic nodule detection were assessed. Sensitivity of radiologists for nodules >=5 mm was 85%, sensitivity of CAD was 38%. For nodules >=5 mm without pleural contact sensitivity was 84% for radiologists at 45% for CAD. CAD detected 15 (10%) nodules not mentioned in the radiologist's report but representing real nodules, among them 10 (15%) nodules with a diameter $GREW5 mm. Reasons for nodules missed by CAD include: exclusion because of morphological features during region analysis (33%), nodule density below the detection threshold (26%), pleural contact (33%), segmentation errors (5%) and other reasons (2%). CAD improves detection of pulmonary nodules at spiral CT significantly and is a valuable second opinion in a clinical setting for lung cancer screening. Optimization of region analysis and an appropriate density threshold have a potential for further improvement of automatic nodule detection.

  7. New results in computer-aided diagnosis (CAD) of breast cancer using a recently developed SVM/GRNN Oracle hybrid

    NASA Astrophysics Data System (ADS)

    Land, Walker H., Jr.; Wong, Lut; McKee, Daniel W.; Masters, Timothy; Anderson, Frances R.; Raturi, Anurag; Lo, Joseph Y.

    2004-05-01

    Breast cancer is second only to lung cancer as a tumor-related cause of death in women. Currently, the method of choice for the early detection of breast cancer is mammography. While sensitive to the detection of non palpable breast lesions, its positive predictive value (PPV) is low, resulting in biopsies that are only 15%-34% likely to reveal malignancy. This paper explores the use of a recently designed Support Vector Machine (SVM)/Generalized Regression Neural Network (GRNN) Oracle hybrid to classify breast lesions and evaluate the software's performance as an interpretive aid to radiologists. The main objective of the research was to perform an independent analysis, using a new, integrated film screen mammogram data base of approximately 2500 cases from five separate institutions, to verify results obtained previously[14]. This study demonstrated the following: (1) The DE crossover constant has little, if any, effect on measures of performance (MOP). (2) A specificity of approximately 5.6% is achieved at 100% sensitivity, which increases to approximately 36% at 95% sensitivity. (3) PPV increases from 51% to 56% as sensitivity is decreased from 100 to 95%, respectively.

  8. Evaluation of a computer-aided skin cancer diagnosis system for conventional digital photography with manual segmentation

    NASA Astrophysics Data System (ADS)

    Huang, Adam; Chang, Wen-Yu; Hsieh, Cheng-Han; Liu, Hsin-Yi; Chen, Gwo-Shing

    2014-03-01

    We evaluate a computer-aided diagnosis (CADx) system developed for both melanocytic and non-melanocytic skin lesions by using conventional digital photographs with lesion boundaries manually marked by a dermatologist. Clinical images of skin lesions taken by conventional digital cameras can capture useful information such as shape, color, and texture for diagnosing skin cancer. However, shape/border features are difficult to analyze automatically because skin surface reflections may change skin color and make segmentation a challenging task. In this study, two non-medical users manually mark the boundaries of a dataset of 769 (174 malignant, 595 benign) conventional photographs of melanocytic and non-melanocytic skin lesions. A state-of-the-art software system for segmenting color images, JSEG, is also tested on the same dataset. Their results are compared to a dermatologist's markings, which are used as the gold standard in this study. The human users' markings are relatively close to the gold standard and achieve an overlapping rate of 70.4% (+/- 15.3%, std) and 74.5% (+/- 14.7%, std). Compared to human users, JSEG only succeeds in segmenting 636 (82.7%) out of 769 lesions and achieves an overlapping rate of 72.4% (+/-20.4%) for these 636 lesions. The estimated area under the receiver operating characteristic curve (AUC) of the CADx by using lesion boundary markings of users 1, 2, and JSEG are 0.915, 0.940, and 0.857 respectively. Our preliminary results indicate that manual segmentation can be repeated relatively consistent compared to automatic segmentation.

  9. [Guidelines for the early diagnosis of lung cancer for primary care physicians].

    PubMed

    2016-01-01

    Lung cancer is a serious/medical and social problem. It belongs to the most common cancers. In the past decades, lung cancer has steadily held a leading place in the structure of cancer morbidity and mortality in our country and in the majority of European countries. Cigarette smoking remains to be the major if not only risk factor for lung cancer. Many attempts were previously made to set up systems for the early (timely) lung cancerdetection in risk groups through cytological and radiological examinations. Prophylactic fluorography and X-ray study have long been an important screening procedure in Russia and foreign countries. Recently this procedure has transformed into digital lung radiography. However, there have been no conclusive proofs for its efficiency in the early detection of lung cancer for a few decades. In the past decade, large-scale prospective randomized trials of low-dose computed tomography (CT) have been performed to screen lung cancer. These have shown that this technology can potentially reduce mortality from this disease. This encouraging result has caused a substantial change in the tactics of examining people at high risk for lung cancer. CT has fully replaced linear tomography and all others special X-ray procedures in the verified diagnosis of lung cancer. The indications for pre-examination CT have been considerably expanded in patients with X-ray detected pathology. The tactics for estimating the small lung tissue foci found at CT has been changed. Availability of CT, clear clinical indications for the study, and observance of the standard procedure have become important elements of the entire system for the early identification of lung cancer. These clinical recommendations largely deal just with organizational and methodological issues. The authors hope that the recommendations will serve as a guide for primary care physicians (therapists, pulmonologists,and radiologists) in the early diagnosis of lung cancer and in the optimization

  10. Current state of HIV/AIDS in Taiwan and reappraisal of early diagnostic value of serial and comparative analyses of western blot patterns of HIV infection.

    PubMed

    Chen, Mao-Yuan; Chuang, Che-Yen

    2002-02-01

    Since Taiwan is not a member of the World Health Organization (WHO), the problems of human immunodeficiency virus (HIV) and acquired immunodeficiency syndrome (AIDS) in Taiwan are not well known to the world. In this report we summarize the trend and current status of HIV/AIDS in Taiwan and also analyze Western blot (WB) patterns. The application of serial and comparative WB analyses is important in establishing an early diagnosis of neonatal HIV infection. These analyses will be useful as well in evaluating the clinical status of adults infected with HIV in developing countries. When there are "indeterminate" WBs in adults with recent HIV infection, it is imperative to perform a WB weekly to attain the earliest possible diagnosis and treatment. Usually anti-gag antibodies, most frequently the anti-p24, are followed by anti-env and anti-pol antibodies. When the set point is attained, WB studies may also be repeated if the clinical status changes or if the patients are receiving highly active antiretroviral therapy (HAART). In the advanced stages of HIV infection, usually the anti-gag antibodies will fade first and then disappear, this occurs next in the anti-pol and in the anti-env antibodies. During HAART, viral replication is usually controlled and there will thus be a partial restoration of the immunological function that will induce changes in the antigen-antibody ratio and, in the end, this will result in changes in the WB patterns. In the mid 1980s all the hepatitis B immunoglobulin (HBIG) used in Taiwan was anti-HIV positive. However, follow-up ELISA and WB studies of the HBIG injected newborns proved that HBIG was anti-HIV positive but that there was no replicable HIV in HBIG. Monthly WB tests of newborns and anti-HIV positive mothers were used to differentiate HIV infection from the passive placental transference by comparing their WB patterns. Comparative WB analyses was also done between blood donors and recipients, and also between husbands and wives

  11. 'MRI-tis' in the early diagnosis of axial SpA: issues and limitations.

    PubMed

    De Rycke, Leen; Maas, Mario; Tak, Paul P; Baeten, Dominique

    2010-11-01

    Sacroiliitis on conventional radiography, a key diagnostic feature of axial spondyloarthritis (SpA), often appears only late in the disease course. With the introduction of potent biologic agents that may also be effective in early disease, diagnostic techniques that can identify SpA early in the disease course would be highly beneficial to patients. MRI has been proposed as a novel diagnostic tool for early axial SpA based on the visualization of active inflammatory lesions in established axial SpA, as well as in pre-radiographic axial SpA. Accordingly, MRI is already widely used in clinical practice and has been included in new classification criteria. However, the specificity and predictive value of MRI lesions for the development of axial SpA remain to be fully defined and validated. Most data come from cross-sectional analyses and have not been validated in prospective studies, and the few available prospective studies were performed in highly selected patient populations and have assessed the value of MRI for the prediction of sacroiliitis rather than axial SpA. Also, some studies have indicated considerable diversity in the pattern and extent of MRI lesions, and suggest that many lesions are not specific for SpA. Prospective, longitudinal studies are needed to validate the utility of this new imaging modality for the diagnosis of axial SpA.

  12. [The ERG contribution in early diagnosis of chloroquine and hydroxychloroquine maculopathy].

    PubMed

    Karkanová, Michala; Matusková, V; Vlková, E; Dosková, H; Uhmannová, R

    2010-04-01

    Derivates of chloroquine (Plaquenil, Delagil), used for long-term treatment of rheumatic diseases, may cause clinically proven irreversible maculopathy, which may progress even after the discontinuation of their application. The optimal early diagnosis of ocular toxicity of chloroquine or hydroxychloroquine drug remains controversial up to now. The aim of this review paper was to evaluate how appropriate is the indication of the electroretinographic (ERG) examination due to the early diagnosis of cumulative drug-related maculopathy. Photopic, pattern, and multifocal ERG (Retiscan, according to the ISCEV methodology) were examined in 10 patients (20 eyes) treated by means of antimalarics, 9 due to the rheumatoid arthritis (RA) and 1 due to the systemic lupus erythremathodes (SLE). The average age of the patients was 60 +/- 15 years, the treatment period was 10 +/- 11 years; the median of the treatment period was 5 years. The control group consisted of 12 healthy, age matched patients (20 eyes) without any obvious ocular pathology. In all of them, the complete ophthalmologic examination was performed: the best corrected visual acuity (BCVA) for far using the Snellen charts, intraocular pressure (IOP) measured by means of the non contact tonometer NIDEK NT-2000, the Amsler grid test, examination of the anterior segment and the posterior segment with the slit lamp. The entry criteria in both groups were BCVA 5/7,5 (0.67) and better, the IOP in the normal range, negative Amsler grid test, anterior segment without significant decrease of the transparency, and physiological posterior segment or with subtle granular pigment dysgrupancies in the macula only. The significant difference between the group treated with chloroquine or hydrochloroquine and the control group at the 1% level of significance was found in following parameters: in the photopic ERG the value of the b wave latency [ms], in pattern ERG, the values of the waves N35 - P50 [microV] and P50 - N95 [micro

  13. AIDS/HIV Infection Policies for Early Childhood and School Settings.

    ERIC Educational Resources Information Center

    Massachusetts State Dept. of Public Health, Boston.

    This volume of policies related to children with Acquired Immune Deficiency Syndrome (AIDS) or Human Immunodeficiency Virus (HIV) describes appropriate ways to guarantee students' rights while maintaining public health, and answers questions for parents, educators, and caregivers. Section 1 presents policy guidelines for infants, toddlers, and…

  14. Wavelet-based multifractal analysis of dynamic infrared thermograms to assist in early breast cancer diagnosis

    PubMed Central

    Gerasimova, Evgeniya; Audit, Benjamin; Roux, Stephane G.; Khalil, André; Gileva, Olga; Argoul, Françoise; Naimark, Oleg; Arneodo, Alain

    2014-01-01

    Breast cancer is the most common type of cancer among women and despite recent advances in the medical field, there are still some inherent limitations in the currently used screening techniques. The radiological interpretation of screening X-ray mammograms often leads to over-diagnosis and, as a consequence, to unnecessary traumatic and painful biopsies. Here we propose a computer-aided multifractal analysis of dynamic infrared (IR) imaging as an efficient method for identifying women with risk of breast cancer. Using a wavelet-based multi-scale method to analyze the temporal fluctuations of breast skin temperature collected from a panel of patients with diagnosed breast cancer and some female volunteers with healthy breasts, we show that the multifractal complexity of temperature fluctuations observed in healthy breasts is lost in mammary glands with malignant tumor. Besides potential clinical impact, these results open new perspectives in the investigation of physiological changes that may precede anatomical alterations in breast cancer development. PMID:24860510

  15. Improving human activity recognition and its application in early stroke diagnosis.

    PubMed

    Villar, José R; González, Silvia; Sedano, Javier; Chira, Camelia; Trejo-Gabriel-Galan, Jose M

    2015-06-01

    The development of efficient stroke-detection methods is of significant importance in today's society due to the effects and impact of stroke on health and economy worldwide. This study focuses on Human Activity Recognition (HAR), which is a key component in developing an early stroke-diagnosis tool. An overview of the proposed global approach able to discriminate normal resting from stroke-related paralysis is detailed. The main contributions include an extension of the Genetic Fuzzy Finite State Machine (GFFSM) method and a new hybrid feature selection (FS) algorithm involving Principal Component Analysis (PCA) and a voting scheme putting the cross-validation results together. Experimental results show that the proposed approach is a well-performing HAR tool that can be successfully embedded in devices.

  16. Diagnosis and management of early gastric band slip after laparoscopic adjustable gastric banding.

    PubMed

    Sertkaya, Mehmet; Emre, Arif; Yazar, Fatih Mehmet; Bülbüloğlu, Ertan

    2016-01-01

    Laparoscopic adjustable gastric banding (LAGB) used to be a very popular bariatric procedure at a certain time for the treatment of obesity as it has many advantages and is associated with low morbidity and mortality rates. Complications are often late and are rarely seen by general surgeons due to the limited number of patients, and physicians should be aware of the symptoms. We present a case of a 40-year-old female patient who underwent LAGB and was admitted for a huge gastric pouch dilatation on postoperative day 5. She had a history of food consumption on the fourth day after surgery. She was diagnosed with early gastric band slippage (EGBS). The band was repositioned and gastrogastric sutures were placed to prevent reprolapse of the band. The EGBS is an immediate postoperative complication. Diagnosis of EGBS can be made with oral contrast X-ray studies, and surgical intervention is necessary. PMID:27458494

  17. Cardiovascular oscillations at the bedside: early diagnosis of neonatal sepsis using heart rate characteristics monitoring

    PubMed Central

    Moorman, J. Randall; Delos, John B.; Flower, Abigail A.; Cao, Hanqing; Kovatchev, Boris P.; Richman, Joshua S.; Lake, Douglas E.

    2014-01-01

    We have applied principles of statistical signal processing and non-linear dynamics to analyze heart rate time series from premature newborn infants in order to assist in the early diagnosis of sepsis, a common and potentially deadly bacterial infection of the bloodstream. We began with the observation of reduced variability and transient decelerations in heart rate interval time series for hours up to days prior to clinical signs of illness. We find that measurements of standard deviation, sample asymmetry and sample entropy are highly related to imminent clinical illness. We developed multivariable statistical predictive models, and an interface to display the real-time results to clinicians. Using this approach, we have observed numerous cases in which incipient neonatal sepsis was diagnosed and treated without any clinical illness at all. This review focuses on the mathematical and statistical time series approaches used to detect these abnormal heart rate characteristics and present predictive monitoring information to the clinician. PMID:22026974

  18. [Serum iron and serum copper balance in the early diagnosis of metastases of breast cancer].

    PubMed

    Wöllgens, P; Kuhne-Velte, H J; Franke-Lompa, C

    1980-02-01

    In a study made in the follow-up clinic on 684 patients with mammary carcinoma it was found that there were 64 cases of local recurrence and 244 cases of distant metastases. In both groups the serum iron and the serum copper balance in blood tests, in relation to the clinical proof of local recurrence and/or distant metastases, was investigated. It was found that there were 43.7% pathological serum iron and serum copper findings with local recurrences and 62.7% with distant metastases. The drift apart tendency of the blood serum values in patients with distant metastases could be proved in 78.7% of the cases and in 77.5% of the cases before any clinical proof. Thus, these observations allow the statement that the blood serum iron and serum copper imbalance in blood tests is of very real value in the early diagnosis of distant metastases.

  19. Signs and senses: diagnosis and prognosis in early medieval pulse and urine texts.

    PubMed

    Wallis, F

    2000-08-01

    The character of early medieval medical manuscripts makes it difficult to generalize about the nature of medical knowledge in this period. In order to reconstitute one field of medical science, namely diagnosis and prognosis, while avoiding the pitfalls of unjustified generalization, this essay limits itself to reconstructing the understanding of pulse and urine inspection available in a particular place and time: the Italian monastery of Monte Cassino at the end of the first millennium. The available texts reveal little about the rationale behind these bedside techniques; indeed, pulse and urine seem to be signs without any semiotics, any underlying theory. The clue to this paradox is the fact that these texts see pulse and urine as primarily prognostic rather than diagnostic. Prognosis was understood to be analogous to forms of intuition, judgement, revelation, and prophecy that operated outside the logic of causality. Hence a fully rationalized semiotics was not regarded as necessary for effective medical practice.

  20. Genetic analysis of Tunisian families with Usher syndrome type 1: toward improving early molecular diagnosis

    PubMed Central

    Ben-Rebeh, Imen; Bonnet, Crystel; Bouassida, Walid; Hadjamor, Imen; Ayadi, Hammadi; Ghorbel, Abdelmonem; Petit, Christine; Masmoudi, Saber

    2016-01-01

    Purpose Usher syndrome accounts for about 50% of all hereditary deaf-blindness cases. The most severe form of this syndrome, Usher syndrome type I (USH1), is characterized by profound congenital sensorineural deafness, vestibular dysfunction, and retinitis pigmentosa. Six USH1 genes have been identified, MYO7A, CDH23, PCDH15, USH1C, SANS, and CIB2, encoding myosin VIIA, cadherin-23, protocadherin-15, harmonin, scaffold protein containing ankyrin repeats and a sterile alpha motif (SAM) domain, and calcium- and integrin-binding member 2, respectively. Methods In the present study, we recruited four Tunisian families with a diagnosis of USH1, together with healthy unrelated controls. Affected members underwent detailed audiologic and ocular examinations. We used the North African Deafness (NADf) chip to search for known North African mutations associated with USH. Then, we selected microsatellite markers covering USH1 known loci to genotype the DNA samples. Finally, we performed DNA sequencing of three known USH1 genes: MYO7A, PCDH15, and USH1C. Results Four biallelic mutations, all single base changes, were found in the MYO7A, USH1C, and PCDH15 genes. These mutations consist of a previously reported splicing defect c.470+1G>A in MYO7A, three novel variants, including two nonsense (p.Arg3X and p.Arg134X) in USH1C and PCDH15, respectively, and one frameshift (p.Lys615Asnfs*6) in MYO7A. Conclusions We found a remarkable genetic heterogeneity in the studied families with USH1 with a variety of mutations, among which three were novel. These novel mutations will be included in the NADf mutation screening chip that will allow a higher diagnosis efficiency of this extremely genetically heterogeneous disease. Ultimately, efficient molecular diagnosis of USH in a patient’s early childhood is of utmost importance, allowing better educational and therapeutic management. PMID:27440999

  1. Single-Step Nanoplasmonic VEGF165 Aptasensor for Early Cancer Diagnosis

    PubMed Central

    Cho, Hansang; Yeh, Erh-Chia; Sinha, Raghu; Laurence, Ted A.; Bearinger, Jane P.; Lee, Luke P.

    2012-01-01

    Early cancer diagnosis is very important for prevention or mitigation of metastasis. However, we must improve the diagnosis and assessment of cancer by an effective and efficient method. Here, we report a single-step detection method using nanoplasmonic aptamer sensor (aptasensor), targeting a vascular endothelial growth factor-165 (VEGF165), a predominant biomarker of cancer angiogenesis. Our single-step detection is accomplished by: (1) specific target recognition by an aptamer-target molecule interaction; (2) direct readouts of the target recognition. The readout is achieved by inactivation of surface plasmon enhancement of fluorescent probes preattached to the aptamers. Our aptasensor provides the appropriate sensitivity for clinical diagnostics with a wide range of linear detection from 25 pg/mL to 25 µg/mL (= from 1.25 pM to1.25 µM), high specificity for VEGF165 against PDGF-BB, osteopontin (OPN), VEGF121, and NaCl, and temporal/thermal/biological stability. In experiments with 100 % serum and saliva from clinical samples, readouts of the aptasensor and an ELISA for VEGF165 show good agreement within the limit of the ELISA kit. We envision that our developed aptasensor holds utility for point-of-care cancer prognostics by incorporating simplicity in detection, low-cost for test, and required small sample volume. PMID:22880609

  2. Importance of an Early Diagnosis in Primary Adenocarcinoma of the Seminal Vesicle

    PubMed Central

    Dell’Atti, Lucio

    2016-01-01

    The prognosis of seminal vesicle (SV) adenocarcinoma is often poor due to delayed diagnosis. About 95% of the patients die in less than 3 years. Diagnosis is difficult due to the absence of early clinical signs as hematuria, hematospermia and/or dysuria. We present the case of a 61-year-old Caucasian man with a left SV mass detected by transrectal ultrasound. SV ultrasound-guided biopsy showed an adenocarcinoma. The tumor was uniformly strongly immunoreactive for cytokeratin-7 and carcinoembryonic antigen. There was no immunoreactivity for prostate-specific acid phosphatase (PSAP) and CK-20. These tumors have been reported to be also positive for CA-125. Therefore a combination of positive staining for CK-7, CEA and CA-125; with negative staining for CK-20, PSA and PSAP is the pattern of immunohistochemical findings noted for this rare tumor. The computed tomography of the abdomen-pelvis and chest X-ray was negative for metastases. The patient underwent a radical prostatectomy and lymphadenectomy. The prostate, rectum, bladder and lymph nodes were free from tumor involvement. The patient did not receive any adjuvant chemotherapy or radiation; and remains free of disease 3 years post-surgery. PMID:27134716

  3. The Impact of Ventilation and Early Diagnosis on Tuberculosis Transmission in Brazilian Prisons

    PubMed Central

    Urrego, Juliana; Ko, Albert I.; da Silva Santos Carbone, Andrea; Paião, Dayse Sanchez Guimarães; Sgarbi, Renata Viebrantz Enne; Yeckel, Catherine W.; Andrews, Jason R.; Croda, Julio

    2015-01-01

    Prisoners have among the highest incidence of tuberculosis (TB) globally. However, the contribution of the prison environment on transmission is not well understood and structural characteristics have received little attention as effective epidemiological interventions in TB control. We evaluated architectural characteristics and estimated ventilation rates in 141 cells in three prisons in central west Brazil using steady-state exhaled carbon dioxide (CO2) levels. We used a modified Wells–Riley equation to estimate the probability of infection for inmates sharing a cell with an infectious case and projected the impact of interventions, including early diagnosis and improved ventilation. Overall, prison cells were densely populated (mean 2.1 m2 per occupant) and poorly ventilated, with only three cells meeting World Health Organization (WHO) standards for per-person ventilation (60 L/s) applied in infection control settings. In the absence of interventions, projected mean risk of infection was 78.0% during a 6-month period. Decreasing time-to-diagnosis by 25% reduced transmission risk by 8.3%. Improving ventilation to WHO standards decreased transmission by 38.2%, whereas optimizing cross-ventilation reduced transmission by 64.4%. Prison environments promote high infection risk over short-time intervals. In this context, enhanced diagnostics have a limited impact on reducing transmission. Improving natural ventilation may be required to effectively control TB in prisons. PMID:26195459

  4. Spinal computed tomography and computed tomographic metrizamide myelography in the early diagnosis of metastatic disease

    SciTech Connect

    O'Rourke, T.; George, C.B.; Redmond, J. 3d.; Davidson, H.; Cornett, P.; Fill, W.L.; Spring, D.B.; Sobel, D.; Dabe, I.B.; Karl, R.D. Jr.

    1986-04-01

    New lesions were shown by Tc99m bone scans to have developed in sixty patients with known metastatic cancer or high-risk primary cancer and normal neurologic examinations; they were further evaluated with plain radiographs, spinal computed tomography (CT), and CT myelography (CT-M) according to an algorithm. Three groups were identified based on plain radiographs: group 1 (normal radiograph), group 2 (compression fracture as indicated by radiograph), group 3 (evidence of metastasis as indicated by radiograph). In group 1 (n = 18), spinal CT revealed that 33% of the patients had benign disease and 67%, metastases; epidural compression was seen in 25% of the patients with metastasis as indicated by CT-M. In group 2 (n = 26), CT-M disclosed that 38% had a benign compression fracture and 62% had metastases and that 63% of the patients with metastases had an epidural compression. In group 3 (n = 16), spinal CT revealed that 15 patients had metastases (one patient had benign disease). Epidural cord compression was seen in 47% of the patients with metastatic disease. In all groups, the presence of cortical bone discontinuity around the neural canal (seen in 31 patients) was highly associated with epidural compression (seen in 20 patients). Our approach allowed the early and accurate diagnosis of spinal metastasis and epidural tumor as well as the diagnosis of benign disease and was useful in planning optimal local therapy.

  5. The Impact of Ventilation and Early Diagnosis on Tuberculosis Transmission in Brazilian Prisons.

    PubMed

    Urrego, Juliana; Ko, Albert I; da Silva Santos Carbone, Andrea; Paião, Dayse Sanchez Guimarães; Sgarbi, Renata Viebrantz Enne; Yeckel, Catherine W; Andrews, Jason R; Croda, Julio

    2015-10-01

    Prisoners have among the highest incidence of tuberculosis (TB) globally. However, the contribution of the prison environment on transmission is not well understood and structural characteristics have received little attention as effective epidemiological interventions in TB control. We evaluated architectural characteristics and estimated ventilation rates in 141 cells in three prisons in central west Brazil using steady-state exhaled carbon dioxide (CO2) levels. We used a modified Wells-Riley equation to estimate the probability of infection for inmates sharing a cell with an infectious case and projected the impact of interventions, including early diagnosis and improved ventilation. Overall, prison cells were densely populated (mean 2.1 m(2) per occupant) and poorly ventilated, with only three cells meeting World Health Organization (WHO) standards for per-person ventilation (60 L/s) applied in infection control settings. In the absence of interventions, projected mean risk of infection was 78.0% during a 6-month period. Decreasing time-to-diagnosis by 25% reduced transmission risk by 8.3%. Improving ventilation to WHO standards decreased transmission by 38.2%, whereas optimizing cross-ventilation reduced transmission by 64.4%. Prison environments promote high infection risk over short-time intervals. In this context, enhanced diagnostics have a limited impact on reducing transmission. Improving natural ventilation may be required to effectively control TB in prisons. PMID:26195459

  6. Single-step nanoplasmonic VEGF165 aptasensor for early cancer diagnosis.

    PubMed

    Cho, Hansang; Yeh, Erh-Chia; Sinha, Raghu; Laurence, Ted A; Bearinger, Jane P; Lee, Luke P

    2012-09-25

    Early cancer diagnosis is very important for the prevention or mitigation of metastasis. However, effective and efficient methods are needed to improve the diagnosis and assessment of cancer. Here, we report a single-step detection method using a nanoplasmonic aptamer sensor (aptasensor), targeting a vascular endothelial growth factor-165 (VEGF(165)), a predominant biomarker of cancer angiogenesis. Our single-step detection is accomplished by (1) specific target recognition by an aptamer-target molecule interaction and (2) direct readouts of the target recognition. The readout is achieved by inactivation of surface plasmon enhancement of fluorescent probes preattached to the aptamers. Our aptasensor provides the appropriate sensitivity for clinical diagnostics with a wide range of linear detection from 25 pg/mL to 25 μg/mL (=from 1.25 pM to 1.25 μM), high specificity for VEGF(165) against PDGF-BB, osteopontin (OPN), VEGF(121), NaCl, and temporal/thermal/biological stability. In experiments with 100% serum and saliva from clinical samples, readouts of the aptasensor and an ELISA for VEGF(165) show good agreement within the limit of the ELISA kit. We envision that our developed aptasensor holds utilities for point-of-care cancer prognostics by incorporating simplicity in detection, low-cost for test, and required small sample volumes. PMID:22880609

  7. Coefficient of Energy Balance: Effective Tool for Early Differential Diagnosis of CNS Diseases

    PubMed Central

    Sobek, Ondřej; Hajduková, Lenka; Lánská, Věra; Nekola, Petr

    2013-01-01

    Urgent examination of cerebrospinal fluid (CSF) provides immediate important information about the character of central nervous system (CNS) impairment. Although this examination includes energy parameters such as glucose and lactate concentrations, it does not commonly use Coefficient of Energy Balance (CEB). In this study, we focused on CEB because it enables more exact assessment of actual energy state in the CSF compartment than glucose and lactate alone. CEB informs about the actual functioning condition of present cells, and it does not require any other analysis or costs. Using Kruskal-Wallis ANOVA, we examined a large CSF sample (n = 8183) and we compared CEB values among groups with different cytological syndromes. We found a statistically significant difference of CEB between the group with granulocyte pleocytosis and the control group. These results indicate a high degree of anaerobic metabolism caused by the oxidative burst of neutrophils. Similarly, we found a statistically significant difference of CEB between the control group and groups with tumorous oligocytosis plus pleocytosis and monocyte pleocytosis. This difference can be attributed to the oxidative burst of macrophages. Our findings suggest that CEB combined with CSF cytology has a great importance for diagnosis, differential diagnosis, and early therapy of CNS diseases. PMID:23865063

  8. Early diagnosis and successful treatment of disseminated toxoplasmosis after cord blood transplantation.

    PubMed

    Kurihara, Taro; Sumi, Masahiko; Kaiume, Hiroko; Takeda, Wataru; Kirihara, Takehiko; Sato, Keijiro; Ueki, Toshimitsu; Hiroshima, Yuki; Ueno, Mayumi; Ichikawa, Naoaki; Kaneko, Yumi; Hikosaka, Kenji; Norose, Kazumi; Kobayashi, Hikaru

    2016-06-01

    A 66-year-old woman with refractory angioimmunoblastic T-cell lymphoma underwent cord blood transplantation. Prior to transplantation, a serological test for Toxoplasma gondii-specific IgG antibodies was positive. On day 96, she exhibited fever and dry cough. Chest CT showed diffuse centrilobular ground glass opacities in both lungs. The reactivation of T. gondii was identified by the presence of parasite DNA in peripheral blood and bronchoalveolar lavage fluid. Moreover, brain MRI revealed a space occupying lesion in the right occipital lobe. Therefore, disseminated toxoplasmosis was diagnosed. She received pyrimethamine and sulfadiazine from day 99. The lung and brain lesions both showed improvement but the PCR assay for T. gondii DNA in peripheral blood was positive on day 133. On day 146, she developed blurred vision and reduced visual acuity, and a tentative diagnosis of toxoplasmic retinochoroiditis was made based on ophthalmic examination results. As agranulocytosis developed on day 158, we decided to discontinue pyrimethamine and sulfadiazine and the treatment was thus switched to atovaquone. Moreover, we added spiramycin to atovaquone therapy from day 174, and her ocular condition gradually improved. In general, the prognosis of disseminated toxoplasmosis after hematopoietic stem cell transplantation (HSCT) is extremely poor. However, early diagnosis and treatment may contribute to improvement of the fundamentally dismal prognosis of disseminated toxoplasmosis after HSCT. PMID:27384853

  9. Analysis of Autofluorescence in Polymorphonuclear Neutrophils: A New Tool for Early Infection Diagnosis

    PubMed Central

    Monsel, Antoine; Lécart, Sandrine; Roquilly, Antoine; Broquet, Alexis; Jacqueline, Cédric; Mirault, Tristan; Troude, Thibaut; Fontaine-Aupart, Marie-Pierre; Asehnoune, Karim

    2014-01-01

    Diagnosing bacterial infection (BI) remains a challenge for the attending physician. An ex vivo infection model based on human fixed polymorphonuclear neutrophils (PMNs) gives an autofluorescence signal that differs significantly between stimulated and unstimulated cells. We took advantage of this property for use in an in vivo pneumonia mouse model and in patients hospitalized with bacterial pneumonia. A 2-fold decrease was observed in autofluorescence intensity for cytospined PMNs from broncho-alveolar lavage (BAL) in the pneumonia mouse model and a 2.7-fold decrease was observed in patients with pneumonia when compared with control mice or patients without pneumonia, respectively. This optical method provided an autofluorescence mean intensity cut-off, allowing for easy diagnosis of BI. Originally set up on a confocal microscope, the assay was also effective using a standard epifluorescence microscope. Assessing the autofluorescence of PMNs provides a fast, simple, cheap and reliable method optimizing the efficiency and the time needed for early diagnosis of severe infections. Rationalized therapeutic decisions supported by the results from this method can improve the outcome of patients suspected of having an infection. PMID:24658436

  10. Feasibility of CT-Guided Percutaneous Needle Biopsy in Early Diagnosis of BOOP

    SciTech Connect

    Poulou, Loukia S. Tsangaridou, Iris; Filippoussis, Petros; Sidiropoulou, Nektaria; Apostolopoulou, Sofia; Thanos, Loukas

    2008-09-15

    Bronchiolitis obliterans organizing pneumonia (BOOP) is a nonneoplastic, noninfectious lung disease with a diverse spectrum of imaging abnormalities and nonspecific symptoms diagnosed by open lung biopsy, transbroncial biopsy, and/or video-assisted thoracoscopy. The objective of this study was to retrospectively assess the role of percutaneous computed tomography (CT)-guided biopsy in early diagnosis of the disorder. Fourteen BOOP cases diagnosed by CT-guided biopsy were analyzed in terms of imaging abnormalities and complication rate. All had previously undergone a nondiagnostic procedure (bronchoscopy, transbronchial biopsy, bronchoalveolar lavage) to exclude infection or lung cancer. The most common imaging abnormalities in descending order were bilateral consolidations (5/14), unilateral tumor-like lesions (5/14), unilateral consolidations (3/14), and diffuse reticular pattern (1/14). Coexistent abnormalities (pleural effusions, nodules, ground-glass opacities) were observed in five patients. The complication rate was 4 of 14 (28.6%), including 2 cases of subclinical pneumothorax and 1 case of minor hemoptysis and local lung injury. None required intervention. We conclude that transthoracic CT-guided biopsy may be used in the diagnosis of BOOP in selected patients with mild complications. For the focal consolidation nodule/mass imaging pattern, CT-guided biopsy may prove to be a reasonable alternative to more invasive procedures.

  11. The Impact of Ventilation and Early Diagnosis on Tuberculosis Transmission in Brazilian Prisons.

    PubMed

    Urrego, Juliana; Ko, Albert I; da Silva Santos Carbone, Andrea; Paião, Dayse Sanchez Guimarães; Sgarbi, Renata Viebrantz Enne; Yeckel, Catherine W; Andrews, Jason R; Croda, Julio

    2015-10-01

    Prisoners have among the highest incidence of tuberculosis (TB) globally. However, the contribution of the prison environment on transmission is not well understood and structural characteristics have received little attention as effective epidemiological interventions in TB control. We evaluated architectural characteristics and estimated ventilation rates in 141 cells in three prisons in central west Brazil using steady-state exhaled carbon dioxide (CO2) levels. We used a modified Wells-Riley equation to estimate the probability of infection for inmates sharing a cell with an infectious case and projected the impact of interventions, including early diagnosis and improved ventilation. Overall, prison cells were densely populated (mean 2.1 m(2) per occupant) and poorly ventilated, with only three cells meeting World Health Organization (WHO) standards for per-person ventilation (60 L/s) applied in infection control settings. In the absence of interventions, projected mean risk of infection was 78.0% during a 6-month period. Decreasing time-to-diagnosis by 25% reduced transmission risk by 8.3%. Improving ventilation to WHO standards decreased transmission by 38.2%, whereas optimizing cross-ventilation reduced transmission by 64.4%. Prison environments promote high infection risk over short-time intervals. In this context, enhanced diagnostics have a limited impact on reducing transmission. Improving natural ventilation may be required to effectively control TB in prisons.

  12. Conceptualization of Autism in the Latino Community and its Relationship with Early Diagnosis

    PubMed Central

    Zuckerman, Katharine E.; Sinche, Brianna; Cobian, Martiza; Cervantes, Marlene; Mejia, Angie; Becker, Thomas; Nicolaidis, Christina

    2014-01-01

    Objective Early identification of autism spectrum disorders (ASD) has been linked to improved long-term developmental outcomes. However, Latino children are diagnosed later than white non-Latino children. We aimed to qualitatively assess the understanding and conceptualization of ASD in the Latino community in order to understand potential community barriers to early diagnosis. Method We conducted 5 focus groups and 4 qualitative interviews with 30 parents of typically-developing Latino children in Oregon. Participants were asked structured questions concerning video vignettes that follow a Latina mother from the time she begins to worry about her 3-year-old son's behaviors to the time he receives an ASD diagnosis. Focus groups and interviews were audio-recorded, transcribed and independently coded. Coded data were analyzed using thematic analysis. Results Many Latino families in the study had not heard of ASD or had little information about it. Families sometimes assumed ASD red flags were normal or could be attributed to family dysfunction. Families also had concerns about provider communication and access to language services. Having a child with a developmental delay was associated with embarrassment, rejection, and family burden, making it difficult for parents to raise developmental concerns with providers. Conclusion Pediatric providers should not assume that Latino parents have heard of ASD or know its symptoms. Providers should be aware that parents may be reluctant to mention concerns due to cultural factors. The health care system needs to improve resources for Latino parents with limited English proficiency. Policies should encourage the use of developmental screening in primary care. PMID:25186120

  13. A hybrid feature selection approach for the early diagnosis of Alzheimer’s disease

    NASA Astrophysics Data System (ADS)

    Gallego-Jutglà, Esteve; Solé-Casals, Jordi; Vialatte, François-Benoît; Elgendi, Mohamed; Cichocki, Andrzej; Dauwels, Justin

    2015-02-01

    Objective. Recently, significant advances have been made in the early diagnosis of Alzheimer’s disease (AD) from electroencephalography (EEG). However, choosing suitable measures is a challenging task. Among other measures, frequency relative power (RP) and loss of complexity have been used with promising results. In the present study we investigate the early diagnosis of AD using synchrony measures and frequency RP on EEG signals, examining the changes found in different frequency ranges. Approach. We first explore the use of a single feature for computing the classification rate (CR), looking for the best frequency range. Then, we present a multiple feature classification system that outperforms all previous results using a feature selection strategy. These two approaches are tested in two different databases, one containing mild cognitive impairment (MCI) and healthy subjects (patients age: 71.9 ± 10.2, healthy subjects age: 71.7 ± 8.3), and the other containing Mild AD and healthy subjects (patients age: 77.6 ± 10.0 healthy subjects age: 69.4 ± 11.5). Main results. Using a single feature to compute CRs we achieve a performance of 78.33% for the MCI data set and of 97.56% for Mild AD. Results are clearly improved using the multiple feature classification, where a CR of 95% is found for the MCI data set using 11 features, and 100% for the Mild AD data set using four features. Significance. The new features selection method described in this work may be a reliable tool that could help to design a realistic system that does not require prior knowledge of a patient's status. With that aim, we explore the standardization of features for MCI and Mild AD data sets with promising results.

  14. A novel intravital multi-harmonic generation microscope for early diagnosis of oral cancer

    NASA Astrophysics Data System (ADS)

    Cheng, Yu-Hsiang; Lin, Chih-Feng; Shih, Ting-Fang; Sun, Chi-Kuang

    2013-03-01

    Oral cancer is one of the most frequently diagnosed human cancers and leading causes of cancer death all over the world, but the prognosis and overall survival rate are still poor because of delay in diagnosis and lack of early intervention. The failure of early diagnosis is due to insufficiency of proper diagnostic and screening tools and most patients are reluctant to undergo biopsy. Optical virtual biopsy techniques, for imaging cells and tissues at microscopic details capable of differentiating benign from malignant lesions non-invasively, are thus highly desirable. A novel multi-harmonic generation microscope, excited by a 1260 nm Cr:forsterite laser, with second and third harmonic signals demonstrating collagen fiber distribution and cell morphology in a sub-micron resolution, was developed for clinical use. To achieve invivo observation inside the human oral cavity, a small objective probe with a suction capability was carefully designed for patients' comfort and stability. By remotely changing its focus point, the same objective can image the mucosa surface with a low magnification, illuminated by side light-emitting diodes, with a charge-coupled device (CCD) for site location selection before the harmonic generation biopsy was applied. Furthermore, the slow galvanometer mirror and the fast resonant mirror provide a 30 fps frame rate for high-speed real-time observation and the z-motor of this system is triggered at the same rate to provide fast 3D scanning, again ensuring patients' comfort. Focusing on the special cytological and morphological changes of the oral epithelial cells, our preliminary result disclosed excellent consistency with traditional histopathology studies.

  15. Laser Raman detection of platelet as a non-invasive approach for early and differential diagnosis of Alzheimer's disease

    NASA Astrophysics Data System (ADS)

    Chen, P.; Tian, Q.; Baek, S. J.; Shang, X. L.; Park, A.; Liu, Z. C.; Yao, X. Q.; Wang, J. Z.; Wang, X. H.; Cheng, Y.; Peng, J.; Shen, A. G.; Hu, J. M.

    2011-07-01

    Early and differential diagnosis of Alzheimer's disease (AD) is a problem that puzzled many doctors. Reliable markers in easy-assembling samples are of considerable clinical diagnostic value. In this work, laser Raman spectroscopy (LRS) was developed a new method that potentially allows early and differential diagnosis of AD from the platelet sample. Raman spectra of platelets isolated from different ages of AD transgenic mice and non-transgenic controls were collected and analyzed. Multilayer perceptron networks (MLP) classification method was used to classify spectra and establish the diagnostic models. For differential diagnosis, spectra of platelets isolated from AD, Parkinson's disease (PD) and vascular dementia (VD) mice were also discriminated. Two notable spectral differences at 740 and 1654 cm-1 were revealed in the mean spectrum of platelets isolated from AD transgenic mice and the controls. MLP displayed a powerful ability in the classifying of early, advanced AD and the control group, and in differential diagnosis of PD and advanced AD, as well as VD and advanced AD. The results suggest that platelet detecting by LRS coupled with MLP analysis appears to be an easy and accurate method for early and differential diagnosis of AD. This technique could be rapidly promoted from laboratory to the hospital.

  16. Improving the Accuracy of Early Diagnosis of Thyroid Nodule Type Based on the SCAD Method.

    PubMed

    Shahraki, Hadi Raeisi; Pourahmad, Saeedeh; Paydar, Shahram; Azad, Mohsen

    2016-01-01

    Although early diagnosis of thyroid nodule type is very important, the diagnostic accuracy of standard tests is a challenging issue. We here aimed to find an optimal combination of factors to improve diagnostic accuracy for distinguishing malignant from benign thyroid nodules before surgery. In a prospective study from 2008 to 2012, 345 patients referred for thyroidectomy were enrolled. The sample size was split into a training set and testing set as a ratio of 7:3. The former was used for estimation and variable selection and obtaining a linear combination of factors. We utilized smoothly clipped absolute deviation (SCAD) logistic regression to achieve the sparse optimal combination of factors. To evaluate the performance of the estimated model in the testing set, a receiver operating characteristic (ROC) curve was utilized. The mean age of the examined patients (66 male and 279 female) was 40.9 ± 13.4 years (range 15- 90 years). Some 54.8% of the patients (24.3% male and 75.7% female) had benign and 45.2% (14% male and 86% female) malignant thyroid nodules. In addition to maximum diameters of nodules and lobes, their volumes were considered as related factors for malignancy prediction (a total of 16 factors). However, the SCAD method estimated the coefficients of 8 factors to be zero and eliminated them from the model. Hence a sparse model which combined the effects of 8 factors to distinguish malignant from benign thyroid nodules was generated. An optimal cut off point of the ROC curve for our estimated model was obtained (p=0.44) and the area under the curve (AUC) was equal to 77% (95% CI: 68%-85%). Sensitivity, specificity, positive predictive value and negative predictive values for this model were 70%, 72%, 71% and 76%, respectively. An increase of 10 percent and a greater accuracy rate in early diagnosis of thyroid nodule type by statistical methods (SCAD and ANN methods) compared with the results of FNA testing revealed that the statistical modeling

  17. Assessment of progesterone concentration using enzymeimmunoassay, for early pregnancy diagnosis in sheep and goats.

    PubMed

    Boscos, C M; Samartzi, F C; Lymberopoulos, A G; Stefanakis, A; Belibasaki, S

    2003-06-01

    The objective of this study was to determine a value of serum progesterone (P4) concentration, assessed using an enzymeimmunoassay (EIA), for the early distinction between pregnant and non-pregnant ewes and goats. Adult, non-lactating ewes of Chios (n=53), Berrichon (n=30) and Sfakia (n=45) breeds were synchronized during the breeding season with progestagens and gonadotrophins and mated to fertile rams (Experiment I). Adult, lactating goats of Swiss breeds (Alpine and Saanen, n=104) and indigenous Greek breed (n=45) were synchronized during the transitional season with progestagens, PGF2alpha and gonadotrophins. Cervical artificial insemination (AI) with fresh semen was applied once, 42-44 h after sponge removal (Experiment II). Jugular blood samples were collected on day 19 after sponge removal (ewes) or on day 21 after AI (goats) and serum P4 concentration was determined by EIA. Progesterone concentrations >/=1.0, >/=1.5, >/=2.5 and >/=4.0 ng/ml were tested as indicative of pregnancy. Pregnancy diagnosis was verified on birth. In the case of sheep, using a discriminatory level of 2.5 ng/ml, overall accuracy of pregnancy diagnosis was 91.4% and predictive value of negative and positive diagnoses were 98.3 and 85.3%, respectively. In the case of goats, predictive value of negative diagnosis was 95.8 and 94.0% and predictive value of positive diagnosis 71.3 and 71.7%, for 1.5 and 2.5 ng/ml, respectively; overall accuracy was 79.2% using either level. The other discriminatory levels tested did not improve these results. A significant positive correlation was observed between P4 concentration and the number of lambs or kids born, and further analysis indicated that this relationship is not a simple linear function. Based on the results of this study, P4 concentrations of 2.5 ng/ml in the case of ewes and 1.5-2.5 ng/ml in the case of goats, determined with EIA, are proposed as discriminatory levels between pregnant and non-pregnant animals, at an interval of one

  18. Early diagnosis of typhoid fever by an enzyme immunoassay using Salmonella typhi outer membrane protein preparations.

    PubMed

    Verdugo-Rodríguez, A; López-Vidal, Y; Puente, J L; Ruíz-Placios, G M; Calva, E

    1993-04-01

    An enzyme immunoassay (EIA) for detection of serum antibodies in patients with typhoid fever was developed using Salmonella typhi outer membrane protein (OMP) preparations as antigen. Acute phase (first week) sera from adult typhoid fever patients were tested as well as sera from the following control groups: adult travellers with diarrhea caused by enterotoxigenic Escherichia coli, children infected with Campylobacter jejuni, healthy Mexican adult blood donors, and adults with septicemia caused by other organisms. At a 1:3,125 serum dilution, the mean absorbance values were 1.41 in the typhoid fever patients, and 0.57, 0.55, 0.51 and 0.52 in the respective control groups. Inhibition EIA studies using OMP preparations or lipopolysaccharide (LPS) as free antigen indicated that proteins can play an important role in the detection of antibodies in early typhoid fever. This EIA may be useful for the diagnosis of typhoid fever since results were obtained within about five hours and in an endemic area antibodies against Salmonella typhi OMP preparations appear early in the course of the disease.

  19. Current status of nanoparticle-based imaging agents for early diagnosis of cancer and atherosclerosis.

    PubMed

    Saravanakumar, Gurusamy; Kim, Kwangmeyung; Park, Jae Hyung; Rhee, Kyehan; Kwon, Ick Chan

    2009-02-01

    Endothelium plays a vital role in various vascular functions, and its dysfunction is a key underlying process closely related to diverse array of diseases such as atherosclerosis and tumor. Therefore, early detection of endothelial dysfunction at the functional or molecular level is of high importance for effective therapy. Recent advances in nanotechnology and our understanding in cellular and molecular biology have provided various biomedical imaging modalities and nanosized multimodal imaging agents. Multimodal nanoparticles that encompass the targeting ligands and magnetic/optical imaging labels enable us to visualize the pathophysiological process of various diseases using multiple imaging techniques. To visualize the specific pathogenic process at the molecular level, the imaging probe needs to be surface-functionalized with specific affinity ligands such as monoclonal antibodies (mAb). Combining the functional imaging agents along with therapeutic drugs has great potential for effective early detection, accurate diagnosis, and treatment of disease. The current review will highlight the application of various nanoparticle-based imaging agents and their recent developments in diagnosing endothelium dysfunction with a special emphasis on atherosclerosis and cancer.

  20. Enzymatic antioxidants in erythrocytes following heavy metal exposure: Possible role in early diagnosis of poisoning

    SciTech Connect

    Gupta, A.; Shukla, G.S.

    1997-02-01

    Occupational and environmental exposure to heavy metals such as cadmium, mercury, nickel, and lead is known to cause health hazards due to their toxic action on the biological system. Metals have the potential to cause oxidative damage to various tissues, including erythrocytes. Since erythrocytes are likely to be the primary target site for metal-induced damage, they may be useful as an early diagnostic tool. Erythrocytes are equipped with a variety of biochemical mechanisms operating against cellular damage. One such line of defense is provided by the enzymatic and non-enzymatic antioxidant system which helps to detoxify highly reactive species such as superoxide anion radicals, hydrogen peroxide, and hydroxyl radicals that are being generated during oxidative stress. Therefore, in the present study cadmium (Cd), chromium (Cr), nickel (Ni), mercury (Hg), lead (Pb), manganese (Mn), and zinc (Zn) were chosen to make a comparative evaluation of the metal-induced alterations in antioxidative enzymes of RBC`s. Specifically, superoxide dismutase, catalase, and glutathione reductase activity in RBC was assessed following exposure to metals at 5, 15, and 30 ppm in drinking water for 30 days. The authors also determined if these RBC parameters are exclusively sensitive for any metal so that they can be used for early diagnosis and toxicity evaluation purposes. 16 refs., 3 figs.

  1. Early diagnosis of tongue malignancy using laser induced fluorescence spectroscopy technique

    NASA Astrophysics Data System (ADS)

    Patil, Ajeetkumar; Unnikrishnan V., K.; Ongole, Ravikiran; Pai, Keerthilatha M.; Kartha, V. B.; Chidangil, Santhosh

    2015-07-01

    Oral cancer together with pharyngeal cancer is the sixth most common malignancy reported worldwide and one with high mortality ratio among all malignancies [1]. Worldwide 450,000 new cases are estimated in 2014[2]. About 90% are a type of cancer called squamous cell carcinoma (SCC). SCC of the tongue is the most common oral malignancy accounting for approximately 40% of all oral carcinomas. One of the important factors for successful therapy of any malignancy is early diagnosis. Although considerable progress has been made in understanding the cellular and molecular mechanisms of tumorigenesis, lack of reliable diagnostic methods for early detection leading to delay in therapy is an important factor responsible for the increase in the mortality rate in various types of cancers. Spectroscopy techniques are extremely sensitive for the analysis of biochemical changes in cellular systems. These techniques can provide a valuable information on alterations that occur during the development of cancer. This is especially important in oral cancer, where "tumor detection is complicated by a tendency towards field cancerization, leading to multi-centric lesions" and "current techniques detect malignant change too late" [3], and "biopsies are not representative of the whole premalignant lesion". [4

  2. [Role of line immunoassay in the diagnosis of early HIV infection: a diagnostic case].

    PubMed

    Soylar, Muhammed; Altuğlu, Imre; Sertöz, Rüçhan; Gökengin, Deniz

    2013-07-01

    Combined p24 antigen-HIV antibody fourth-generation assays that identify most of the early HIV infections have been used extensively worldwide for several years. This poses challenges for the traditional algorithm of line immunoassay (LIA) confirmation. LIA tests are useful methods with their high specificity and their ability to differentiate HIV-1 from HIV-2, but they are reactive days after the fourth generation enzyme immunoassays. With acute HIV infection, high levels of infectious virus are detectable in serum and genital secretions. The rate of transmission during acute HIV infection is higher than the established HIV infection, for this reason, new HIV testing strategies need to focus on sensitivity, especially for this highly contagious phase immediately after infection. Serum sample of a patient sent to Ege University Hospital Clinical Virology Laboratory was repeatedly reactive with low signal/cutoff ratios with two different commercial fourth generation enzyme immunoassays (Architect HIV Ag/Ab Combo Reagent Kit, Abbott, Germany and Vidas HIV Duo Quick, Biomerieux, France). The sample was non-reactive with the LIA (INNO-LIA HIV I/II Score, Innogenetics, Belgium) and HIV RNA (RealTime HIV-I Amplification Reagent Kit, Abbott, USA) result was positive (4.1 x 10(5) copies/ml). With the presentation of this case, the role of LIA in the diagnosis of early HIV infection and its place in test algorithms were questioned. PMID:23971936

  3. Clinical study of quantitative diagnosis of early cervical cancer based on the classification of acetowhitening kinetics

    NASA Astrophysics Data System (ADS)

    Wu, Tao; Cheung, Tak-Hong; Yim, So-Fan; Qu, Jianan Y.

    2010-03-01

    A quantitative colposcopic imaging system for the diagnosis of early cervical cancer is evaluated in a clinical study. This imaging technology based on 3-D active stereo vision and motion tracking extracts diagnostic information from the kinetics of acetowhitening process measured from the cervix of human subjects in vivo. Acetowhitening kinetics measured from 137 cervical sites of 57 subjects are analyzed and classified using multivariate statistical algorithms. Cross-validation methods are used to evaluate the performance of the diagnostic algorithms. The results show that an algorithm for screening precancer produced 95% sensitivity (SE) and 96% specificity (SP) for discriminating normal and human papillomavirus (HPV)-infected tissues from cervical intraepithelial neoplasia (CIN) lesions. For a diagnostic algorithm, 91% SE and 90% SP are achieved for discriminating normal tissue, HPV infected tissue, and low-grade CIN lesions from high-grade CIN lesions. The results demonstrate that the quantitative colposcopic imaging system could provide objective screening and diagnostic information for early detection of cervical cancer.

  4. Measurement of myocardial perfusion and infarction size using computer-aided diagnosis system for myocardial contrast echocardiography.

    PubMed

    Du, Guo-Qing; Xue, Jing-Yi; Guo, Yanhui; Chen, Shuang; Du, Pei; Wu, Yan; Wang, Yu-Hang; Zong, Li-Qiu; Tian, Jia-Wei

    2015-09-01

    Proper evaluation of myocardial microvascular perfusion and assessment of infarct size is critical for clinicians. We have developed a novel computer-aided diagnosis (CAD) approach for myocardial contrast echocardiography (MCE) to measure myocardial perfusion and infarct size. Rabbits underwent 15 min of coronary occlusion followed by reperfusion (group I, n = 15) or 60 min of coronary occlusion followed by reperfusion (group II, n = 15). Myocardial contrast echocardiography was performed before and 7 d after ischemia/reperfusion, and images were analyzed with the CAD system on the basis of eliminating particle swarm optimization clustering analysis. The myocardium was quickly and accurately detected using contrast-enhanced images, myocardial perfusion was quantitatively calibrated and a color-coded map calibrated by contrast intensity and automatically produced by the CAD system was used to outline the infarction region. Calibrated contrast intensity was significantly lower in infarct regions than in non-infarct regions, allowing differentiation of abnormal and normal myocardial perfusion. Receiver operating characteristic curve analysis documented that -54-pixel contrast intensity was an optimal cutoff point for the identification of infarcted myocardium with a sensitivity of 95.45% and specificity of 87.50%. Infarct sizes obtained using myocardial perfusion defect analysis of original contrast images and the contrast intensity-based color-coded map in computerized images were compared with infarct sizes measured using triphenyltetrazolium chloride staining. Use of the proposed CAD approach provided observers with more information. The infarct sizes obtained with myocardial perfusion defect analysis, the contrast intensity-based color-coded map and triphenyltetrazolium chloride staining were 23.72 ± 8.41%, 21.77 ± 7.8% and 18.21 ± 4.40% (% left ventricle) respectively (p > 0.05), indicating that computerized myocardial contrast echocardiography can

  5. Design of a high-sensitivity classifier based on a genetic algorithm: application to computer-aided diagnosis

    NASA Astrophysics Data System (ADS)

    Sahiner, Berkman; Chan, Heang-Ping; Petrick, Nicholas; Helvie, Mark A.; Goodsitt, Mitchell M.

    1998-10-01

    -9155/43/10/014/img3.gif" ALIGN="MIDDLE"/>, although the latter provided a higher total area under the ROC curve. By setting an appropriate decision threshold, the high-sensitivity classifier and correctly identified 61% and 34% of the benign masses respectively without missing any malignant masses. Our results show that the choice of the feature selection technique is important in computer-aided diagnosis, and that the GA may be a useful tool for designing classifiers for lesion characterization.

  6. Measurement of myocardial perfusion and infarction size using computer-aided diagnosis system for myocardial contrast echocardiography.

    PubMed

    Du, Guo-Qing; Xue, Jing-Yi; Guo, Yanhui; Chen, Shuang; Du, Pei; Wu, Yan; Wang, Yu-Hang; Zong, Li-Qiu; Tian, Jia-Wei

    2015-09-01

    Proper evaluation of myocardial microvascular perfusion and assessment of infarct size is critical for clinicians. We have developed a novel computer-aided diagnosis (CAD) approach for myocardial contrast echocardiography (MCE) to measure myocardial perfusion and infarct size. Rabbits underwent 15 min of coronary occlusion followed by reperfusion (group I, n = 15) or 60 min of coronary occlusion followed by reperfusion (group II, n = 15). Myocardial contrast echocardiography was performed before and 7 d after ischemia/reperfusion, and images were analyzed with the CAD system on the basis of eliminating particle swarm optimization clustering analysis. The myocardium was quickly and accurately detected using contrast-enhanced images, myocardial perfusion was quantitatively calibrated and a color-coded map calibrated by contrast intensity and automatically produced by the CAD system was used to outline the infarction region. Calibrated contrast intensity was significantly lower in infarct regions than in non-infarct regions, allowing differentiation of abnormal and normal myocardial perfusion. Receiver operating characteristic curve analysis documented that -54-pixel contrast intensity was an optimal cutoff point for the identification of infarcted myocardium with a sensitivity of 95.45% and specificity of 87.50%. Infarct sizes obtained using myocardial perfusion defect analysis of original contrast images and the contrast intensity-based color-coded map in computerized images were compared with infarct sizes measured using triphenyltetrazolium chloride staining. Use of the proposed CAD approach provided observers with more information. The infarct sizes obtained with myocardial perfusion defect analysis, the contrast intensity-based color-coded map and triphenyltetrazolium chloride staining were 23.72 ± 8.41%, 21.77 ± 7.8% and 18.21 ± 4.40% (% left ventricle) respectively (p > 0.05), indicating that computerized myocardial contrast echocardiography can

  7. Computer-aided diagnosis of pulmonary nodules on CT scans: Segmentation and classification using 3D active contours

    PubMed Central

    Way, Ted W.; Hadjiiski, Lubomir M.; Sahiner, Berkman; Chan, Heang-Ping; Cascade, Philip N.; Kazerooni, Ella A.; Bogot, Naama; Zhou, Chuan

    2009-01-01

    We are developing a computer-aided diagnosis (CAD) system to classify malignant and benign lung nodules found on CT scans. A fully automated system was designed to segment the nodule from its surrounding structured background in a local volume of interest (VOI) and to extract image features for classification. Image segmentation was performed with a three-dimensional (3D) active contour (AC) method. A data set of 96 lung nodules (44 malignant, 52 benign) from 58 patients was used in this study. The 3D AC model is based on two-dimensional AC with the addition of three new energy components to take advantage of 3D information: (1) 3D gradient, which guides the active contour to seek the object surface, (2) 3D curvature, which imposes a smoothness constraint in the z direction, and (3) mask energy, which penalizes contours that grow beyond the pleura or thoracic wall. The search for the best energy weights in the 3D AC model was guided by a simplex optimization method. Morphological and gray-level features were extracted from the segmented nodule. The rubber band straightening transform (RBST) was applied to the shell of voxels surrounding the nodule. Texture features based on run-length statistics were extracted from the RBST image. A linear discriminant analysis classifier with stepwise feature selection was designed using a second simplex optimization to select the most effective features. Leave-one-case-out resampling was used to train and test the CAD system. The system achieved a test area under the receiver operating characteristic curve (Az) of 0.83±0.04. Our preliminary results indicate that use of the 3D AC model and the 3D texture features surrounding the nodule is a promising approach to the segmentation and classification of lung nodules with CAD. The segmentation performance of the 3D AC model trained with our data set was evaluated with 23 nodules available in the Lung Image Database Consortium (LIDC). The lung nodule volumes segmented by the 3D AC

  8. A blood-based, 7-metabolite signature for the early diagnosis of Alzheimer's disease.

    PubMed

    Olazarán, Javier; Gil-de-Gómez, Luis; Rodríguez-Martín, Andrés; Valentí-Soler, Meritxell; Frades-Payo, Belén; Marín-Muñoz, Juan; Antúnez, Carmen; Frank-García, Ana; Acedo-Jiménez, Carmen; Morlán-Gracia, Lorenzo; Petidier-Torregrossa, Roberto; Guisasola, María Concepción; Bermejo-Pareja, Félix; Sánchez-Ferro, Álvaro; Pérez-Martínez, David A; Manzano-Palomo, Sagrario; Farquhar, Ruth; Rábano, Alberto; Calero, Miguel

    2015-01-01

    Accurate blood-based biomarkers of Alzheimer's disease (AD) could constitute simple, inexpensive, and non-invasive tools for the early diagnosis and treatment of this devastating neurodegenerative disease. We sought to develop a robust AD biomarker panel by identifying alterations in plasma metabolites that persist throughout the continuum of AD pathophysiology. Using a multicenter, cross-sectional study design, we based our analysis on metabolites whose levels were altered both in AD patients and in patients with amnestic mild cognitive impairment (aMCI), the earliest identifiable stage of AD. UPLC coupled to mass spectrometry was used to independently compare the levels of 495 plasma metabolites in aMCI (n = 58) and AD (n = 100) patients with those of normal cognition controls (NC, n = 93). Metabolite alterations common to both aMCI and AD patients were used to generate a logistic regression model that accurately distinguished AD from NC patients. The final panel consisted of seven metabolites: three amino acids (glutamic acid, alanine, and aspartic acid), one non-esterified fatty acid (22:6n-3, DHA), one bile acid (deoxycholic acid), one phosphatidylethanolamine [PE(36:4)], and one sphingomyelin [SM(39:1)]. Detailed analysis ruled out the influence of potential confounding variables, including comorbidities and treatments, on each of the seven biomarkers. The final model accurately distinguished AD from NC patients (AUC, 0.918). Importantly, the model also distinguished aMCI from NC patients (AUC, 0.826), indicating its potential diagnostic utility in early disease stages. These findings describe a sensitive biomarker panel that may facilitate the specific detection of early-stage AD through the analysis of plasma samples. PMID:25649659

  9. Promising Antibody Testing Strategies for Early Infant HIV Infection Diagnosis in China

    PubMed Central

    Su, Xueli; Yao, Jun; Jiang, Yan; Li, Jie; Han, Jianfeng; Sun, Weidong

    2014-01-01

    Background In China, 1.1% of people living with HIV were transmitted vertically, causing a heavy burden on families and society. Early infant diagnosis (EID) is critical for improving neonatal survival. The purpose of this study is to suggest improvement in antibody testing strategies with dried blood spots (DBSs) for EID in China through analysis of anti-HIV seroreversion of infants. Methods A total of 280 infants born to HIV infected mothers in four diverse provinces of China where multiple subtypes coexist were enrolled. The status of the infants' infection was determined by HIV antibody enzyme immunoassay and Western blot analysis at ≥18 months of age or by convincing clinical and epidemiologic data for deceased infants. A total of 1028 DBSs were collected during follow-up, which were tested to obtain anti-HIV signal to cut-off ratio (S/CO) data. Results For uninfected infants, anti-HIV S/CO decreased with age. Seropositivity percentage declined most rapidly at 6 months to 9 months of age and 98.7% children seroreverted by 12 months of age. For most infected infants, minimum S/CO values were obtained at ≤6 months of age. Antibody negative predictive value was 100% at ≥6 months of age. An S/CO increase ≥1.86 after three months follow-up can determine HIV infection. S/CO threshold of 3.17 can differentiate infected from uninfected infants for exposed kids at 9 months or older with sensitivity as 100% and specificity ≥94.2%. Significance Suggestions obtained through studying seroreversion data of Chinese HIV-exposed infants help improve antibody strategies for HIV EID in China. The infection can be determined as early as 3 months of age and excluded as early as 6 months of age. PMID:24971594

  10. Predictors of Infant Age at Enrollment in Early Infant Diagnosis Services in Kenya.

    PubMed

    Goggin, Kathy; Wexler, Catherine; Nazir, Niaman; Staggs, Vincent S; Gautney, Brad; Okoth, Vincent; Khamadi, Samoel A; Ruff, Andrea; Sweat, Michael; Cheng, An-Lin; Finocchario-Kessler, Sarah

    2016-09-01

    Despite the importance of early detection to signal lifesaving treatment initiation for HIV+ infants, early infant diagnosis (EID) services have received considerably less attention than other aspects of prevention of mother to child transmission care. This study draws on baseline data from an on-going cluster randomized study of an intervention to improve EID services at six government hospitals across Kenya. Two logistic regressions examined potential predictors of "on time" (infant ≤6 weeks of age) vs. "late" (≥7 weeks) and "on time" versus "very late" (≥12 weeks) EID engagement among 756 mother-infant pairs. A quarter of the infants failed to get "on time" testing. Predictors of "on time" testing included being informed about EID by providers when pregnant, perceiving less HIV stigma, and mother's level of education. Predictors of "very late" testing (≥12 weeks of age) included not being informed about EID by providers when pregnant and living farther from services. Findings highlight the importance of ensuring that health care providers actively and repeatedly inform HIV+ mothers of the availability of EID services, reduce stigma by frequently communicating judgment free support, and assisting mothers in early planning for accessing EID services. Extra care should be focused on engaging mothers with less formal education who are at increased risk for seeking "late" EID testing. This study offers clear targets for improving services so that all HIV-exposed infants can be properly engaged in EID services, thus increasing the potential for the best possible outcomes for this vulnerable population. PMID:27108002

  11. Lipid raft disarrangement as a result of neuropathological progresses: a novel strategy for early diagnosis?

    PubMed

    Marin, R; Rojo, J A; Fabelo, N; Fernandez, C E; Diaz, M

    2013-08-15

    Lipid rafts are the preferential site of numerous membrane signaling proteins which are involved in neuronal functioning and survival. These proteins are organized in multiprotein complexes, or signalosomes, in close contact with lipid classes particularly represented in lipid rafts (i.e. cholesterol, sphingolipids and saturated fatty acids), which may contribute to physiological responses leading to neuroprotection. Increasing evidence indicates that alteration of lipid composition in raft structures as a consequence of neuropathologies, such as Alzheimer's disease (AD) and Parkinson's disease (PD), causes a dramatic increase in lipid raft order. These phenomena may correlate with perturbation of signalosome activities, likely contributing to neurodegenerative progression. Interestingly, significant disruption of stable raft microenvironments has been already observed in the first stages of either AD or PD, suggesting that these alterations may represent early events in the neuropathological development. In this regard, the search for biochemical markers, such as specific metabolic products altered in the brain at the first steps of the disease, presently represents an important challenge for early diagnostic strategies. Alterations of these biomarkers may be reflected in either plasma or cerebrospinal fluid, thus representing a potential strategy to predict an accurate diagnosis. We propose that pathologically-linked lipid raft markers may be interesting candidates to be explored at this level, although it has not been studied so far to what extent alteration of different signalosome components may be reflected in peripheral fluids. In this mini-review, we will discuss on relevant aspects of lipid rafts that contribute to the modulation of neuropathological events related to AD and PD. An interesting hypothesis is that anomalies on raft biomarkers measured at peripheral fluids might mirror the lipid raft pathology observed in early stages of AD and PD.

  12. LCK: a new biomarker candidate for the early diagnosis of acute myocardial infarction.

    PubMed

    Xu, Fei; Teng, Xiao; Yuan, Xin; Sun, Jiakang; Wu, Hengchao; Zheng, Zhe; Tang, Yue; Hu, Shengshou

    2014-12-01

    Acute myocardial infarction (AMI) is one of the most common cardiovascular emergencies, of which the molecular pathogenesis is still not fully understood. This study aimed to explore the differentially expressed genes (DEGs) and then identify the critical genes in AMI thus screening out potential biomarkers for the early diagnosis of this serious heart disease. The gene expression data of AMI patients (GSE19339) were downloaded from gene expression omnibus database. After preprocessing with affy package, the DEGs were screened out by significance analysis of microarray (SAM) algorithm within samr package. Then function and pathway enrichment analyses of the DEGs were carried out using DAVID (database for annotation visualization and integrated discovery software) online tools. Further, the relevant genes of AMI were screened out with GENETIC_ASSOCIATION_DB_DISEASE analysis and blastp alignment. Finally, the novel genes were subjected to transcription factor and protein-protein interaction network analyses. A total of 633 DEGs, including 378 up-regulated and 255 down-regulated, were screened out between AMI patients and normal control samples. Among those genes, several important ones such as PPAR, CCL2, HMOX1 and NPR1 were demonstrated to be related to AMI. Most importantly, a novel gene LCK (lymphocyte-specific protein tyrosine kinase) was significantly differentially expressed in AMI. Further analyses showed that LCK was involved in the expression regulation of CXCL12 (chemokine (C-X-C motif) ligand 12) and the expression of LCK can be regulated by different transcription factors. In this study, we provided a new insight into the mechanism of AMI and raised LCK as an attractive marker candidate in the diagnosis of this serious heart disease. PMID:25209966

  13. [Retinoblastoma: inventory in Mali and program to develop early diagnosis, treatments and rehabilitation].

    PubMed

    Traore, Fousseyni; Togo, Boubacar; Sylla, Fatoumata; Cheick, Traoré B; Diakité, Abdoul-Aziz; Dicko-Traore, Fatoumata; Sylla, Mariam; Sidibé, Toumani; Doz, François; Harif, M'hamed; Bey, Pierre; Desjardins, Laurence

    2013-02-01

    Retinoblastoma (RB) is a rare embryonic tumour that represents 1/16,000 births in France. In Mali, a study showed the characteristics of a hospital series of cases seen in Bamako in the Pediatric Oncology Unit of Gabriel Touré Teaching Hospital and in the Tropical Ophthalmology Institute of Africa (IOTA) between January 2005 and June 2007. Median age was 4 years versus 2 years in France for unilateral disease. Near two third of children with RB had extra-ocular extension at diagnosis, which is now exceptional in France. Only 11% were bilateral versus 35% in France. Cure rate was around 50%, but it is estimated only on the cases arriving in Bamako and with at least 20% lost of follow-up. Cure rate is over 95% in France within an exhaustive register. RB appears as an exemplary tumor and rapid improvements could be obtained in low-income countries with relatively limited means. This is why, the Alliance mondiale contre le cancer (AMCC), the Institut Curie in Paris, which is the reference center in France for RB, and teams in Bamako were proposing a program to help the development of early diagnosis, treatments, including eye preservation, and rehabilitation of children with RB in sub-Saharan Africa in collaboration with the Groupe franco-africain d'oncologie pédiatrique (GFAOP). The official launching of this program was held in Bamako November 4, 2011 for Mali and the surrounding regions. After this first experience, this program is now implemented in other countries.

  14. Early diagnosis of bladder cancer through the detection of urinary tyrosine-phosphorylated proteins

    PubMed Central

    Khadjavi, A; Mannu, F; Destefanis, P; Sacerdote, C; Battaglia, A; Allasia, M; Fontana, D; Frea, B; Polidoro, S; Fiorito, G; Matullo, G; Pantaleo, A; Notarpietro, A; Prato, M; Castagno, F; Vineis, P; Gontero, P; Giribaldi, G; Turrini, F

    2015-01-01

    Background: A noninvasive, highly sensitive and specific urine test is needed for bladder cancer (BC) diagnosis and surveillance in addition to the invasive cystoscopy. We previously described the diagnostic effectiveness of urinary tyrosine-phosphorylated proteins (UPY) and a new assay (UPY-A) for their measurement in a pilot study. The aim of this work was to evaluate the performances of the UPY-A using an independent cohort of 262 subjects. Methods: Urinary tyrosine-phosphorylated proteins were measured by UPY-A test. The area under ROC curve, cutoff, sensitivity, specificity and predictive values of UPY-A were determined. The association of UPY levels with tumour staging, grading, recurrence and progression risk was analysed by Kruskal–Wallis and Wilcoxon's test. To test the probability to be a case if positive at the UPY-A, a logistic test adjusted for possible confounding factor was used. Results: Results showed a significant difference of UPY levels between patients with BC vs healthy controls. For the best cutoff value, 261.26 Standard Units (SU), the sensitivity of the assay was 80.43% and the specificity was 78.82%. A statistically significant difference was found in the levels of UPY at different BC stages and grades between Ta and T1 and with different risk of recurrence and progression. A statistically significant increased risk for BC at UPY-A ⩾261.26 SU was observed. Conclusions: The present study supplies important information on the diagnostic characteristics of UPY-A revealing remarkable performances for early stages and allowing its potential use for different applications encompassing the screening of high-risk subjects, primary diagnosis and posttreatment surveillance. PMID:26125446

  15. A Guide to Dental Care for the Early and Periodic Screening, Diagnosis, and Treatment Program (EPSDT) Under Medicaid.

    ERIC Educational Resources Information Center

    Lindahl, Roy L.; Young, Wesley O.

    This guide has been developed to assist administrators, providers of dental care, and others involved in carrying out the dental care provisions of the EPSDT program (Early and Periodic Screening, Diagnosis, and Treatment Program). It is intended to assist in the development of programs concerned with the unique characteristics of dental diseases…

  16. EPSDT: Child Health. Child Health Information for Workers in the Medicaid Early and Periodic Screening Diagnosis and Treatment Program.

    ERIC Educational Resources Information Center

    Manela, Roger; And Others

    One of six information booklets with accompanying training materials for the Medicaid Early and Periodic Screening Diagnosis and Treatment (EPSDT) program, this booklet describes the stages of child growth and development and some of the health problems which EPSDT clients might have. Section I describes tests commonly included in an EPSDT…

  17. Improvements Needed to Speed Implementation of Medicaid's Early and Periodic Screening, Diagnosis, and Treatment Program...Report to the Congress.

    ERIC Educational Resources Information Center

    Comptroller General of the U.S., Washington, DC.

    Congressman Ralph H. Metcalfe asked the General Accounting Office (GAO) to review implementation of the Medicaid Early and Periodic Screening, Diagnosis, and Treatment (EPSDT) program administered by the Department of Health, Education, and Welfare's (HEW's) Social and Rehabilitation Service (SRS). An estimated 10 million children under age 21 are…

  18. Optimizing the Detection of Circulating Markers to Aid in Early Lung Cancer Detection

    PubMed Central

    Murlidhar, Vasudha; Ramnath, Nithya; Nagrath, Sunitha; Reddy, Rishindra M.

    2016-01-01

    Improving early detection of lung cancer is critical to improving lung cancer survival. Studies have shown that computerized tomography (CT) screening can reduce mortality from lung cancer, but this involves risks of radiation exposure and can identify non-cancer lung nodules that lead to unnecessary interventions for some. There is a critical need to develop alternative, less invasive methods to identify patients who have early-stage lung cancer. The detection of circulating tumor cells (CTCs) are a promising area of research, but current technology is limited by a low yield of CTCs. Alternate studies are investigating circulating nucleic acids and proteins as possible tumor markers. It is critical to develop innovative methods for early lung cancer detection that may include CTCs or other markers that are low-risk and low-cost, yet specific and sensitive, to facilitate improved survival by diagnosing the disease when it is surgically curable. PMID:27367729

  19. Panel of Genetic Variations as a Potential Non-invasive Biomarker for Early Diagnosis of Alzheimer's Disease

    PubMed Central

    Lam, Linda Chiu Wa

    2011-01-01

    Alzheimer's disease (AD) is the most prevalent form of dementia. Biomarkers such as levels of amyloid beta (Aβ) in cerebrospinal fluid and ApoE genotyping were suggested for the diagnosis of AD, however, the result is either non-conclusive or with invasive procedure. Genome-wide association studies (GWASs) for AD suggested single nucleotide polymorphisms (SNPs) in many genes are associated with the risk of AD, but each only contributed with small effect to the disease. By incorporating a panel of established genetic susceptibility factors, the risk of an individual in getting AD could be better estimated. Further research will be required to reveal if adding to the current well-developed clinical diagnosis protocol, the accuracy and specificity of diagnosis of AD would be greatly improved and if this might also be beneficial in identifying pre-symptomatic AD patients for early diagnosis and intervention of the disease. PMID:23429712

  20. Diagnosis and treatment of early bioprosthetic malfunction in the mitral valve position due to thrombus formation.

    PubMed

    Butnaru, Adi; Shaheen, Joseph; Tzivoni, Dan; Tauber, Rachel; Bitran, Daniel; Silberman, Shuli

    2013-11-01

    Bioprosthetic valve thrombosis is uncommon and the diagnosis is often elusive and may be confused with valve degeneration. We report our experience with mitral bioprosthetic valve thrombosis and suggest a therapeutic approach. From 2002 to 2011, 149 consecutive patients who underwent mitral valve replacement with a bioprosthesis at a single center were retrospectively screened for clinical or echocardiographic evidence of valve malfunction. Nine were found to have valve thrombus. All 9 patients had their native valve preserved, representing 24% of those with preserved native valves. Five patients (group 1) presented with symptoms of congestive heart failure at 16.4 ± 12.4 months after surgery. Echocardiogram revealed homogenous echo-dense film on the ventricular surface of the bioprosthesis with elevated transvalvular gradient, resembling early degeneration. The first 2 patients underwent reoperation: valve thrombus was found and confirmed by histologic examination. Based on these, the subsequent 3 patients received anticoagulation treatment with complete thrombus resolution: mean mitral gradient decreased from 23 ± 4 to 6 ± 1 mm Hg and tricuspid regurgitation gradient decreased from 83 ± 20 to 49 ± 5 mm Hg. Four patients (group 2) were asymptomatic, but routine echocardiogram showed a discrete mass on the ventricular aspect of the valve: 1 underwent reoperation to replace the valve and 3 received anticoagulation with complete resolution of the echocardiographic findings. In conclusion, bioprosthetic mitral thrombosis occurs in about 6% of cases. In our experience, onset is early, before anticipated valve degeneration. Clinical awareness followed by an initial trial with anticoagulation is warranted. Surgery should be reserved for those who are not responsive or patients in whom the hemodynamic status does not allow delay. Nonresection of the native valve at the initial operation may play a role in the origin of this entity.

  1. Utility of Immunoblotting for Early Diagnosis of Toxoplasmosis Seroconversion in Pregnant Women▿

    PubMed Central

    Jost, C.; Touafek, F.; Fekkar, A.; Courtin, R.; Ribeiro, M.; Mazier, D.; Paris, L.

    2011-01-01

    Congenital transmission of Toxoplasma gondii occurs mainly when a mother acquires the infection for the first time during pregnancy. It was recently shown that although early treatment of the primary infection during pregnancy has little or no impact on the fetomaternal transmission rate, it does reduce the incidence of sequelae in infected infants. Seroconversion is defined by the appearance of IgG. Commercial reagents continue to vary considerably in detecting low concentrations of antibodies, as during early seroconversion. We compared two routinely used immunoassays (IA) (Platelia and Elecsys Toxo IgG) and an indirect immunofluorescence assay (IIF) with a qualitative test based on immunoblot analysis (Toxo II IgG) (IB) to assess their abilities to diagnose seroconversion at its earliest stages. This prospective study was carried out between January and November 2010. It included 39 pregnant women with monthly follow-up who seroconverted during pregnancy. On first sera that were IgM positive but IgG negative (or equivocal) as detected by IA, IB diagnosed seroconversion twice as often as IIF (26/39 [66.7%] versus 13/39 [33.3%]; P < 0.001; χ2 test). Serum samples were retaken 2 to 5 weeks later for the other 13 cases (IgG negative by IB on first serum). Seroconversion was demonstrated as follows: IB for 5 cases where IA remained negative or equivocal, IB and IIF for 5 cases where IA remained negative or equivocal, IA for 2 cases, and no method for 1 case (a third sample was necessary). In summary, IB permitted toxoplasmosis seroconversion diagnosis before other means in 92.3% of cases (36/39) and thus earlier therapeutic intervention. PMID:21880851

  2. Computer-aided diagnosis of diagnostically challenging lesions in breast MRI: a comparison between a radiomics and a feature-selective approach

    NASA Astrophysics Data System (ADS)

    Hoffmann, Sebastian; Lobbes, Marc; Houben, Ivo; Pinker-Domenig, Katja; Wengert, Georg; Burgeth, Bernhard; Meyer-Bäse, Uwe; Lemaitre, Guillaume; Meyer-Baese, Anke

    2016-05-01

    Diagnostically challenging lesions pose a challenge both for the radiological reading and also for current CAD systems. They are not well-defined in both morphology (geometric shape) and kinetics (temporal enhancement) and pose a problem to lesion detection and classification. Their strong phenotypic differences can be visualized by MRI. Radiomics represents a novel approach to achieve a detailed quantification of the tumour phenotypes by analyzing a large number of image descriptors. In this paper, we apply a quantitative radiomics approach based on shape, texture and kinetics tumor features and evaluate it in comparison to a reduced-order feature approach in a computer-aided diagnosis system applied to diagnostically challenging lesions.

  3. A Financial Aid Need Analysis Methodology for Early Care and Education. Technical Report.

    ERIC Educational Resources Information Center

    Vast, Teresa; Baum, Sandy

    Based on the view that early care and education programs must have substantial non-tuition revenue from the public and private sectors to reduce the proportion of costs for high quality programs passed on to families as tuition costs, this report presents a methodology for identifying an "expected family contribution," a representation of what a…

  4. Non-invasive screening for early Alzheimer’s disease diagnosis by a sensitively immunomagnetic biosensor

    PubMed Central

    Li, Shan-Shan; Lin, Chih-Wen; Wei, Kuo-Chen; Huang, Chiung-Yin; Hsu, Po-Hung; Liu, Hao-Li; Lu, Yu-Jen; Lin, Sheng-Chi; Yang, Hung-Wei; Ma, Chen-Chi M.

    2016-01-01

    Amyloid-beta peptide 1–42 (Aβ42) is considered as a reliable biomarker for the early diagnosis of Alzheimer’s disease (AD). Thus, it is urgent to develop a simple and efficient method for the detection of Aβ42. In this work, a reusable biosensor based on magnetic nitrogen-doped graphene (MNG) modified Au electrode for the detection of Aβ42 has been developed. The antibodies of Aβ 1–28 (Aβab) are used as the specific biorecognition element for Aβ42 that were conjugated on the surface of MNG. In the presence of magnetic nanoparticles on MNG, the electrode coating material, the biosensor can be quickly constructed, without requiring an electrode drying process, which reduce the analysis time and is convenient for proceeding to detection. The reusable biosensor with good reproducibility and stability was linear within the range from 5 pg mL−1 to 800 pg mL−1, covering the cut-off level of Aβ42 and a detection limit of 5 pg mL−1 had been achieved. Furthermore, the fabricated biosensor for Aβ42 detection not only improves the detection performance but also reduces the cost and shortens the response time, demonstrating its potential in diagnosing applications. PMID:27112198

  5. Out-of-plane Stokes imaging polarimeter for early skin cancer diagnosis.

    PubMed

    Ghassemi, Pejhman; Lemaillet, Paul; Germer, Thomas A; Shupp, Jeffrey W; Venna, Suraj S; Boisvert, Marc E; Flanagan, Katherine E; Jordan, Marion H; Ramella-Roman, Jessica C

    2012-07-01

    Optimal treatment of skin cancer before it metastasizes critically depends on early diagnosis and treatment. Imaging spectroscopy and polarized remittance have been utilized in the past for diagnostic purposes, but valuable information can be also obtained from the analysis of skin roughness. For this purpose, we have developed an out-of-plane hemispherical Stokes imaging polarimeter designed to monitor potential skin neoplasia based on a roughness assessment of the epidermis. The system was utilized to study the rough surface scattering for wax samples and human skin. The scattering by rough skin-simulating phantoms showed behavior that is reasonably described by a facet scattering model. Clinical tests were conducted on patients grouped as follows: benign nevi, melanocytic nevus, melanoma, and normal skin. Images were captured and analyzed, and polarization properties are presented in terms of the principal angle of the polarization ellipse and the degree of polarization. In the former case, there is separation between different groups of patients for some incidence azimuth angles. In the latter, separation between different skin samples for various incidence azimuth angles is observed. PMID:22894497

  6. Challenges to the early diagnosis and treatment of breast cancer in developing countries

    PubMed Central

    Unger-Saldaña, Karla

    2014-01-01

    This critical review of the literature assembles and compares available data on breast cancer clinical stage, time intervals to care, and access barriers in different countries. It provides evidence that while more than 70% of breast cancer patients in most high-income countries are diagnosed in stages I and II, only 20%-50% patients in the majority of low- and middle-income countries are diagnosed in these earlier stages. Most studies in the developed world show an association between an advanced clinical stage of breast cancer and delays greater than three months between symptom discovery and treatment start. The evidence assembled in this review shows that the median of this interval is 30-48 d in high-income countries but 3-8 mo in low- and middle-income countries. The longest delays occur between the first medical consultation and the beginning of treatment, known as the provider interval. The little available evidence suggests that access barriers and quality deficiencies in cancer care are determinants of provider delay in low- and middle-income countries. Research on specific access barriers and deficiencies in quality of care for the early diagnosis and treatment of breast cancer is practically non-existent in these countries, where it is the most needed for the design of cost-effective public policies that strengthen health systems to tackle this expensive and deadly disease. PMID:25114860

  7. Detection of retinal nerve fiber layer defects on retinal fundus images for early diagnosis of glaucoma

    NASA Astrophysics Data System (ADS)

    Muramatsu, Chisako; Hayashi, Yoshinori; Sawada, Akira; Hatanaka, Yuji; Hara, Takeshi; Yamamoto, Tetsuya; Fujita, Hiroshi

    2010-01-01

    Retinal nerve fiber layer defect (NFLD) is a major sign of glaucoma, which is the second leading cause of blindness in the world. Early detection of NFLDs is critical for improved prognosis of this progressive, blinding disease. We have investigated a computerized scheme for detection of NFLDs on retinal fundus images. In this study, 162 images, including 81 images with 99 NFLDs, were used. After major blood vessels were removed, the images were transformed so that the curved paths of retinal nerves become approximately straight on the basis of ellipses, and the Gabor filters were applied for enhancement of NFLDs. Bandlike regions darker than the surrounding pixels were detected as candidates of NFLDs. For each candidate, image features were determined and the likelihood of a true NFLD was determined by using the linear discriminant analysis and an artificial neural network (ANN). The sensitivity for detecting the NFLDs was 91% at 1.0 false positive per image by using the ANN. The proposed computerized system for the detection of NFLDs can be useful to physicians in the diagnosis of glaucoma in a mass screening.

  8. Challenges to the early diagnosis and treatment of breast cancer in developing countries.

    PubMed

    Unger-Saldaña, Karla

    2014-08-10

    This critical review of the literature assembles and compares available data on breast cancer clinical stage, time intervals to care, and access barriers in different countries. It provides evidence that while more than 70% of breast cancer patients in most high-income countries are diagnosed in stages I and II, only 20%-50% patients in the majority of low- and middle-income countries are diagnosed in these earlier stages. Most studies in the developed world show an association between an advanced clinical stage of breast cancer and delays greater than three months between symptom discovery and treatment start. The evidence assembled in this review shows that the median of this interval is 30-48 d in high-income countries but 3-8 mo in low- and middle-income countries. The longest delays occur between the first medical consultation and the beginning of treatment, known as the provider interval. The little available evidence suggests that access barriers and quality deficiencies in cancer care are determinants of provider delay in low- and middle-income countries. Research on specific access barriers and deficiencies in quality of care for the early diagnosis and treatment of breast cancer is practically non-existent in these countries, where it is the most needed for the design of cost-effective public policies that strengthen health systems to tackle this expensive and deadly disease.

  9. The role of primary care physicians in early diagnosis and treatment of chronic gastrointestinal diseases

    PubMed Central

    Gikas, Aristofanis; Triantafillidis, John K

    2014-01-01

    Chronic gastrointestinal disorders are a source of substantial morbidity, mortality, and cost. They are common in general practice, and the primary care physician (PCP) has a central role in the early detection and management of these problems. The need to make cost-effective diagnostic and treatment decisions, avoid unnecessary investigation and referral, provide long-term effective control of symptoms, and minimize the risk of complications constitute the main challenges that PCPs face. The literature review shows that, although best practice standards are available, a considerable number of PCPs do not routinely follow them. Low rates of colorectal cancer screening, suboptimal testing and treatment of Helicobacter pylori infection, inappropriate use of proton pump inhibitors, and the fact that most PCPs are still approaching the irritable bowel disease as a diagnosis of exclusion represent the main gaps between evidence-based guidelines and clinical practice. This manuscript points out that updating of knowledge and skills of PCPs via continuing medical education is the only way for better adherence with standards and improving quality of care for patients with gastrointestinal diseases. PMID:24648750

  10. Out-of-plane Stokes imaging polarimeter for early skin cancer diagnosis

    NASA Astrophysics Data System (ADS)

    Ghassemi, Pejhman; Lemaillet, Paul; Germer, Thomas A.; Shupp, Jeffrey W.; Venna, Suraj S.; Boisvert, Marc E.; Flanagan, Katherine E.; Jordan, Marion H.; Ramella-Roman, Jessica C.

    2012-07-01

    Optimal treatment of skin cancer before it metastasizes critically depends on early diagnosis and treatment. Imaging spectroscopy and polarized remittance have been utilized in the past for diagnostic purposes, but valuable information can be also obtained from the analysis of skin roughness. For this purpose, we have developed an out-of-plane hemispherical Stokes imaging polarimeter designed to monitor potential skin neoplasia based on a roughness assessment of the epidermis. The system was utilized to study the rough surface scattering for wax samples and human skin. The scattering by rough skin--simulating phantoms showed behavior that is reasonably described by a facet scattering model. Clinical tests were conducted on patients grouped as follows: benign nevi, melanocytic nevus, melanoma, and normal skin. Images were captured and analyzed, and polarization properties are presented in terms of the principal angle of the polarization ellipse and the degree of polarization. In the former case, there is separation between different groups of patients for some incidence azimuth angles. In the latter, separation between different skin samples for various incidence azimuth angles is observed.

  11. Early diagnosis of primary Sjögren's syndrome: EULAR-SS task force clinical recommendations.

    PubMed

    Brito-Zerón, Pilar; Theander, Elke; Baldini, Chiara; Seror, Raphaèle; Retamozo, Soledad; Quartuccio, Luca; Bootsma, Hendrika; Bowman, Simon J; Dörner, Thomas; Gottenberg, Jacques-Eric; Mariette, Xavier; Bombardieri, Stefano; de Vita, Salvatore; Mandl, Thomas; Ng, Wan-Fai; Kruize, Aike A; Tzioufas, Athanasios; Vitali, Claudio; Buyon, Jill; Izmirly, Peter; Fox, Robert; Ramos-Casals, Manuel

    2016-01-01

    Sjögren's syndrome (SjS) is a systemic autoimmune disease that mainly affects the exocrine glands, leading to generalized mucosal dryness. However, primary SjS may initially present with non-sicca (systemic) manifestations. When these features appear before the onset of an overt sicca syndrome, we may talk of an underlying 'occult' SjS. The European League Against Rheumatism (EULAR) has promoted and supported an international collaborative study group (EULAR-SS Task Force) aimed at developing consensual recommendations to provide a homogeneous approach to the patient with primary SjS presenting with systemic involvement. This review summarizes the key factors that should be taken into account in the diagnostic approach in a patient with suspected SjS according to the main clinical patterns of presentation, and is especially focused on organ-specific systemic disease presentations, including a consensus set of recommendations in order to reach an early diagnosis. Close collaboration with the different specialties involved through a comprehensive multidisciplinary approach is essential in SjS patients presenting with systemic involvements.

  12. Rapid detection of HIV-1 proviral DNA for early infant diagnosis using recombinase polymerase amplification.

    PubMed

    Boyle, David S; Lehman, Dara A; Lillis, Lorraine; Peterson, Dylan; Singhal, Mitra; Armes, Niall; Parker, Mathew; Piepenburg, Olaf; Overbaugh, Julie

    2013-04-02

    Early diagnosis and treatment of human immunodeficiency virus type 1 (HIV-1) infection in infants can greatly reduce mortality rates. However, current infant HIV-1 diagnostics cannot reliably be performed at the point of care, often delaying treatment and compromising its efficacy. Recombinase polymerase amplification (RPA) is a novel technology that is ideal for an HIV-1 diagnostic, as it amplifies target DNA in <20 min at a constant temperature, without the need for complex thermocycling equipment. Here we tested 63 HIV-1-specific primer and probe combinations and identified two RPA assays that target distinct regions of the HIV-1 genome (long terminal repeat [LTR] and pol) and can reliably detect 3 copies of proviral DNA by the use of fluorescence detection and lateral-flow strip detection. These pol and LTR primers amplified 98.6% and 93%, respectively, of the diverse HIV-1 variants tested. This is the first example of an isothermal assay that consistently detects all of the major HIV-1 global subtypes.

  13. Non-invasive screening for early Alzheimer’s disease diagnosis by a sensitively immunomagnetic biosensor

    NASA Astrophysics Data System (ADS)

    Li, Shan-Shan; Lin, Chih-Wen; Wei, Kuo-Chen; Huang, Chiung-Yin; Hsu, Po-Hung; Liu, Hao-Li; Lu, Yu-Jen; Lin, Sheng-Chi; Yang, Hung-Wei; Ma, Chen-Chi M.

    2016-04-01

    Amyloid-beta peptide 1–42 (Aβ42) is considered as a reliable biomarker for the early diagnosis of Alzheimer’s disease (AD). Thus, it is urgent to develop a simple and efficient method for the detection of Aβ42. In this work, a reusable biosensor based on magnetic nitrogen-doped graphene (MNG) modified Au electrode for the detection of Aβ42 has been developed. The antibodies of Aβ 1–28 (Aβab) are used as the specific biorecognition element for Aβ42 that were conjugated on the surface of MNG. In the presence of magnetic nanoparticles on MNG, the electrode coating material, the biosensor can be quickly constructed, without requiring an electrode drying process, which reduce the analysis time and is convenient for proceeding to detection. The reusable biosensor with good reproducibility and stability was linear within the range from 5 pg mL‑1 to 800 pg mL‑1, covering the cut-off level of Aβ42 and a detection limit of 5 pg mL‑1 had been achieved. Furthermore, the fabricated biosensor for Aβ42 detection not only improves the detection performance but also reduces the cost and shortens the response time, demonstrating its potential in diagnosing applications.

  14. Docosahexaenoic acid conjugated near infrared flourescence probe for in vivo early tumor diagnosis

    NASA Astrophysics Data System (ADS)

    Li, Siwen; Cao, Jie; Qin, Jingyi; Zhang, Xin; Achilefu, Samuel; Qian, Zhiyu; Gu, Yueqing

    2013-02-01

    Docosahexaenoic acid(DHA) is an omega-3 C22 natural fatty acid with six cis double bonds and as a constituent of membranes used as a precursor for metabolic and biochemical path ways. In this manuscript,we describe the synthesis of near-infrared(NIR) flourescence ICG-Der-01 labeled DHA for in vitro and vivo tumor targeting.The structure of the probe was intensively characterized by UV and MS. The in vitro and vivo tumor targeting abilities of the DHA-based NIR probes were investigeted in MCF-7 cells and MCF-7 xenograft mice model differently by confocal microscopy and CCD camera. The cell cytotoxicity were tested in tumor cells MCF-7 .The results shows that the DHA-based NIR probes have high affinity with the tumor both in vitro and vivo.In addition ,we also found that the DHA-based NIR probes have the apparent cytotoxicity on MCF-7 cells .which demonstrated that DHA was conjugated with other antitumor drug could increase the abilities of antirumor efficacy .So DHA-ICG-Der-01 is a promising optical agent for diagnosis of tumors especially in their early stage.

  15. Scaling up early infant diagnosis of HIV in Rwanda, 2008-2010.

    PubMed

    Binagwaho, Agnes; Mugwaneza, Placidie; Irakoze, Ange Anitha; Nsanzimana, Sabin; Agbonyitor, Mawuena; Nutt, Cameron T; Wagner, Claire M; Rukundo, Alphonse; Ahayo, Anita; Drobac, Peter; Karema, Corine; Hinda, Ruton; Leung, Lucinda; Bandara, Sachini; Chopyak, Elena; Fawzi, Mary C Smith

    2013-01-01

    More than 390,000 children are newly infected with HIV each year, only 28 per cent of whom benefit from early infant diagnosis (EID). Rwanda's Ministry of Health identified several major challenges hindering EID scale-up in care of HIV-positive infants. It found poor counseling and follow-up by caregivers of HIV-exposed infants, lack of coordination with maternal and child health-care programs, and long delays between the collection of samples and return of results to the health facility and caregiver. By increasing geographic access, integrating EID with vaccination programs, and investing in a robust mobile phone reporting system, Rwanda increased population coverage of EID from approximately 28 to 72.4 per cent (and to 90.3 per cent within the prevention of mother to child transmission program) between 2008 and 2011. Turnaround time from sample collection to receipt of results at the originating health facility was reduced from 144 to 20 days. Rwanda rapidly scaled up and improved its EID program, but challenges persist for linking infected infants to care. PMID:23191941

  16. Radiographic Follow-Up during Orthodontic Treatment for Early Diagnosis of Sequential Supernumerary Teeth

    PubMed Central

    Suga, Uhana Seifert Guimarães; Terada, Raquel Sano Suga

    2016-01-01

    Most supernumerary teeth are impacted and asymptomatic. Objective. The aim of this paper is to describe two cases of sequential development of supernumerary teeth in the mandibular premolar region, identified during orthodontic treatment. Reports. The first case describes the radiographic follow-up of a female patient that presented a supernumerary tooth at the age of 9 years and 10 months in the right mandibular premolar region, followed by a further supernumerary tooth in the left mandibular premolar region identified at the age of 11 years and 3 months. In the second case, the radiographic follow-up of a male patient demonstrated 3 supernumerary teeth in the premolar region at the age of 16 years. During orthognathic surgery planning at the age of 20 years and 5 months, a supplemental supernumerary tooth was found in the left mandibular region. Conclusion. Considering the late developing of supernumerary premolars, appropriate follow-up with panoramic radiographs of patients with previous experience of supernumerary teeth is essential for early diagnosis of supplemental premolars to prevent possible complications. PMID:27313911

  17. Tattoo-Associated Skin Reaction: The Importance of an Early Diagnosis and Proper Treatment

    PubMed Central

    Bassi, Andrea; Campolmi, Piero; Cannarozzo, Giovanni; Conti, Rossana; Bruscino, Nicola; Gola, Massimo; Ermini, Stefano; Massi, Daniela; Moretti, Silvia

    2014-01-01

    Tattoo is going to be a very common practice especially among young people and we are witnessing a gradual increase of numerous potential complications to tattoo placement which are often seen by physicians, but generally unknown to the public. The most common skin reactions to tattoo include a transient acute inflammatory reaction due to trauma of the skin with needles and medical complications such as superficial and deep local infections, systemic infections, allergic contact dermatitis, photodermatitis, granulomatous and lichenoid reactions, and skin diseases localized on tattooed area (eczema, psoriasis, lichen, and morphea). Next to these inflammatory skin reactions we have to consider also the possibility of the development of cutaneous conditions such as pseudolymphomatous reactions and pseudoepitheliomatous hyperplasia. The aim of this study is to underline the importance of an early diagnosis by performing a histological examination especially when we are in front of suspected papulonodular lesions arising from a tattoo, followed by a proper treatment, since cutaneous neoplastic evolution is known to be a rare but possible complication. PMID:25147796

  18. After Early Autism Diagnosis: Changes in Intervention and Parent-Child Interaction

    ERIC Educational Resources Information Center

    Suma, Katharine; Adamson, Lauren B.; Bakeman, Roger; Robins, Diana L.; Abrams, Danielle N.

    2016-01-01

    This study documents the relation between an autism spectrum disorder (ASD) diagnosis, increases in intervention, and changes in parent-child interaction quality. Information about intervention and observations of interaction were collected before diagnosis and a half year after diagnosis for 79 low-risk toddlers who had screened positive for ASD…

  19. Early Diagnosis of Respiratory Abnormalities in Asbestos-Exposed Workers by the Forced Oscillation Technique

    PubMed Central

    2016-01-01

    Background The current reference test for the detection of respiratory abnormalities in asbestos-exposed workers is spirometry. However, spirometry has several shortcomings that greatly affect the efficacy of current asbestos control programs. The forced oscillation technique (FOT) represents the current state-of-the-art technique in the assessment of lung function. This method provides a detailed analysis of respiratory resistance and reactance at different oscillatory frequencies during tidal breathing. Here, we evaluate the FOT as an alternative method to standard spirometry for the early detection and quantification of respiratory abnormalities in asbestos-exposed workers. Methodology/Principal findings Seventy-two subjects were analyzed. The control group was composed of 33 subjects with a normal spirometric exam who had no history of smoking or pulmonary disease. Thirty-nine subjects exposed to asbestos were also studied, including 32 volunteers in radiological category 0/0 and 7 volunteers with radiological categories of 0/1 or 1/1. FOT data were interpreted using classical parameters as well as integer (InOr) and fractional-order (FrOr) modeling. The diagnostic accuracy was evaluated by investigating the area under the receiver operating characteristic curve (AUC). Exposed workers presented increased obstruction (resistance p<0.001) and a reduced compliance (p<0.001), with a predominance of obstructive changes. The FOT parameter changes were correlated with the standard pulmonary function analysis methods (R = -0.52, p<0.001). Early respiratory abnormalities were identified with a high diagnostic accuracy (AUC = 0.987) using parameters obtained from the FrOr modeling. This accuracy was significantly better than those obtained with classical (p<0.001) and InOr (p<0.001) model parameters. Conclusions The FOT improved our knowledge about the biomechanical abnormalities in workers exposed to asbestos. Additionally, a high diagnostic accuracy in the diagnosis of

  20. VitalQPlus: a potential screening tool for early diagnosis of COPD

    PubMed Central

    Sui, Chee Fai; Ming, Long Chiau; Neoh, Chin Fen; Ibrahim, Baharudin

    2015-01-01

    early diagnosis of COPD, which is crucial in improving the clinical management of the disease. PMID:26316735

  1. On the sensitivity of thermophotonic lock-in imaging and polarized Raman spectroscopy to early dental caries diagnosis.

    PubMed

    Tabatabaei, Nima; Mandelis, Andreas; Dehghany, Mehdi; Michaelian, Kirk H; Amaechi, Bennet T

    2012-02-01

    Dental caries is the leading cause of tooth loss, which can promptly be prevented if detected in early stages of progression. Unfortunately, conventional diagnostic modalities currently used in dentistry lack the sensitivity to detect early caries. The authors' intention is to compare the ability of polarized Raman spectroscopy and thermophotonic imaging to make early caries diagnosis. Extracted human teeth with no visible stain or defects were artificially demineralized in accordance to a well-known protocol in dentistry for simulated early caries development at several demineralization stages. Samples were then inspected using polarized Raman spectroscopy and thermophotonic imaging. The sensitivities of these two diagnostic modalities are compared, and the results are verified using transverse micro-radiography. It was found that compared to polarized Raman spectroscopy, thermophotonic imaging exhibits superior sensitivity to very early stages of demineralization.

  2. On the sensitivity of thermophotonic lock-in imaging and polarized Raman spectroscopy to early dental caries diagnosis

    NASA Astrophysics Data System (ADS)

    Tabatabaei, Nima; Mandelis, Andreas; Dehghany, Mehdi; Michaelian, Kirk H.; Amaechi, Bennet T.

    2012-02-01

    Dental caries is the leading cause of tooth loss, which can promptly be prevented if detected in early stages of progression. Unfortunately, conventional diagnostic modalities currently used in dentistry lack the sensitivity to detect early caries. The authors' intention is to compare the ability of polarized Raman spectroscopy and thermophotonic imaging to make early caries diagnosis. Extracted human teeth with no visible stain or defects were artificially demineralized in accordance to a well-known protocol in dentistry for simulated early caries development at several demineralization stages. Samples were then inspected using polarized Raman spectroscopy and thermophotonic imaging. The sensitivities of these two diagnostic modalities are compared, and the results are verified using transverse micro-radiography. It was found that compared to polarized Raman spectroscopy, thermophotonic imaging exhibits superior sensitivity to very early stages of demineralization.

  3. Applications of a single-molecule detection in early disease diagnosis and enzymatic reaction study

    SciTech Connect

    Li, Jiangwei

    2008-01-01

    Various single-molecule techniques were utilized for ultra-sensitive early diagnosis of viral DNA and antigen and basic mechanism study of enzymatic reactions. DNA of human papilloma virus (HPV) served as the screening target in a flow system. Alexa Fluor 532 (AF532) labeled single-stranded DNA probes were hybridized to the target HPV-16 DNA in solution. The individual hybridized molecules were imaged with an intensified charge-coupled device (ICCD) in two ways. In the single-color mode, target molecules were detected via fluorescence from hybridized probes only. This system could detect HPV-16 DNA in the presence of human genomic DNA down to 0.7 copy/cell and had a linear dynamic range of over 6 orders of magnitude. In the dual-color mode, fluorescence resonance energy transfer (FRET) was employed to achieve zero false-positive count. We also showed that DNA extracts from Pap test specimens did not interfere with the system. A surface-based method was used to improve the throughput of the flow system. HPV-16 DNA was hybridized to probes on a glass surface and detected with a total internal reflection fluorescence (TIRF) microscope. In the single-probe mode, the whole genome and target DNA were fluorescently labeled before hybridization, and the detection limit is similar to the flow system. In the dual-probe mode, a second probe was introduced. The linear dynamic range covers 1.44-7000 copies/cell, which is typical of early infection to near-cancer stages. The dual-probe method was tested with a crudely prepared sample. Even with reduced hybridization efficiency caused by the interference of cellular materials, we were still able to differentiate infected cells from healthy cells. Detection and quantification of viral antigen with a novel single-molecule immunosorbent assay (SMISA) was achieved. Antigen from human immunodeficiency virus type 1(HIV-1) was chosen to be the target in this study. The target was sandwiched between a monoclonal capture antibody and a

  4. Prenatal and Early Postnatal Diagnosis of Congenital Toxoplasmosis in a Setting With No Systematic Screening in Pregnancy.

    PubMed

    Stajner, Tijana; Bobic, Branko; Klun, Ivana; Nikolic, Aleksandra; Srbljanovic, Jelena; Uzelac, Aleksandra; Rajnpreht, Irena; Djurkovic-Djakovic, Olgica

    2016-03-01

    To determine the risk of congenital toxoplasmosis (CT) and provide early (pre- or postnatal) identification of cases of CT in the absence of systematic screening in pregnancy.I n the presented cross-sectional study, serological criteria were used to date Toxoplasma gondii infection versus conception in 80 pregnant women with fetal abnormalities or referred to as suspected of acute infection, and in 16 women after delivery of symptomatic neonates. A combination of serological, molecular (qPCR), and biological (bioassay) methods was used for prenatal and/or postnatal diagnosis of CT. Most (77.5%) pregnant women were examined in advanced pregnancy. Of all the examined seropositive women (n = 90), infection could not be ruled out to have occurred during pregnancy in 93.3%, of which the majority (69%) was dated to the periconceptual period. CT was diagnosed in 25 cases, of which 17 prenatally and 8 postnatally. Molecular diagnosis proved superior, but the diagnosis of CT based on bioassay in 7 instances and by Western blot in 2 neonates shows that other methods remain indispensable. In the absence of systematic screening in pregnancy, maternal infection is often diagnosed late, or even only when fetal/neonatal infection is suspected. In such situations, use of a complex algorithm involving a combination of serological, biological, and molecular methods allows for prenatal and/or early postnatal diagnosis of CT, but lacks the preventive capacity provided by early maternal treatment.

  5. Prenatal and Early Postnatal Diagnosis of Congenital Toxoplasmosis in a Setting With No Systematic Screening in Pregnancy

    PubMed Central

    Stajner, Tijana; Bobic, Branko; Klun, Ivana; Nikolic, Aleksandra; Srbljanovic, Jelena; Uzelac, Aleksandra; Rajnpreht, Irena; Djurkovic-Djakovic, Olgica

    2016-01-01

    Abstract To determine the risk of congenital toxoplasmosis (CT) and provide early (pre- or postnatal) identification of cases of CT in the absence of systematic screening in pregnancy. In the presented cross-sectional study, serological criteria were used to date Toxoplasma gondii infection versus conception in 80 pregnant women with fetal abnormalities or referred to as suspected of acute infection, and in 16 women after delivery of symptomatic neonates. A combination of serological, molecular (qPCR), and biological (bioassay) methods was used for prenatal and/or postnatal diagnosis of CT. Most (77.5%) pregnant women were examined in advanced pregnancy. Of all the examined seropositive women (n = 90), infection could not be ruled out to have occurred during pregnancy in 93.3%, of which the majority (69%) was dated to the periconceptual period. CT was diagnosed in 25 cases, of which 17 prenatally and 8 postnatally. Molecular diagnosis proved superior, but the diagnosis of CT based on bioassay in 7 instances and by Western blot in 2 neonates shows that other methods remain indispensable. In the absence of systematic screening in pregnancy, maternal infection is often diagnosed late, or even only when fetal/neonatal infection is suspected. In such situations, use of a complex algorithm involving a combination of serological, biological, and molecular methods allows for prenatal and/or early postnatal diagnosis of CT, but lacks the preventive capacity provided by early maternal treatment. PMID:26945416

  6. After Early Autism Diagnosis: Changes in Intervention and Parent-Child Interaction.

    PubMed

    Suma, Katharine; Adamson, Lauren B; Bakeman, Roger; Robins, Diana L; Abrams, Danielle N

    2016-08-01

    This study documents the relation between an autism spectrum disorder (ASD) diagnosis, increases in intervention, and changes in parent-child interaction quality. Information about intervention and observations of interaction were collected before diagnosis and a half year after diagnosis for 79 low-risk toddlers who had screened positive for ASD risk during a well-baby checkup. Children diagnosed with ASD (n = 44) were 2.69 times more likely to increase intervention hours. After ASD diagnosis, the relation between intervention and interaction quality was complex: although increases in intervention and interaction quality were only modestly related, the overall amount of intervention after diagnosis was associated with higher quality interactions. Moreover, lower quality interactions before diagnosis significantly increased the likelihood that intervention would increase post-diagnosis.

  7. Detection, modeling and matching of pleural thickenings from CT data towards an early diagnosis of malignant pleural mesothelioma

    NASA Astrophysics Data System (ADS)

    Chaisaowong, Kraisorn; Kraus, Thomas

    2014-03-01

    Pleural thickenings can be caused by asbestos exposure and may evolve into malignant pleural mesothelioma. While an early diagnosis plays the key role to an early treatment, and therefore helping to reduce morbidity, the growth rate of a pleural thickening can be in turn essential evidence to an early diagnosis of the pleural mesothelioma. The detection of pleural thickenings is today done by a visual inspection of CT data, which is time-consuming and underlies the physician's subjective judgment. Computer-assisted diagnosis systems to automatically assess pleural mesothelioma have been reported worldwide. But in this paper, an image analysis pipeline to automatically detect pleural thickenings and measure their volume is described. We first delineate automatically the pleural contour in the CT images. An adaptive surface-base smoothing technique is then applied to the pleural contours to identify all potential thickenings. A following tissue-specific topology-oriented detection based on a probabilistic Hounsfield Unit model of pleural plaques specify then the genuine pleural thickenings among them. The assessment of the detected pleural thickenings is based on the volumetry of the 3D model, created by mesh construction algorithm followed by Laplace-Beltrami eigenfunction expansion surface smoothing technique. Finally, the spatiotemporal matching of pleural thickenings from consecutive CT data is carried out based on the semi-automatic lung registration towards the assessment of its growth rate. With these methods, a new computer-assisted diagnosis system is presented in order to assure a precise and reproducible assessment of pleural thickenings towards the diagnosis of the pleural mesothelioma in its early stage.

  8. [Can age-dependent cognitive functions be measured? P300 potentials--concept of brain aging--early diagnosis of dementia processes].

    PubMed

    Kügler, C

    1996-10-10

    Event related P300 potentials as the electrophysiological substrate of cognitive functions, such as the stimulus processing time (P300 latencies) and visual attention capacity (P300 amplitudes) are suitable for the analysis of age-related changes in cognitive human brain functions. P300 investigations carried out in a total of 330 test subjects aged between 18 and 98 years, showed an overall slight prolongation of the P300 latencies by 10 ms for each decade, as well as a discrete reduction in the P300 amplitudes of 1 microV. To describe the relationship between the P300 parameters and chronological age, polynomial regression models are more suitable than linear functions. This means that in middle-age, P300 potentials change only slightly while, from about the age of 60 upwards, a noticeable acceleration in the P300 changes takes place. An interesting observation was the fact that the acceleration in the P300 latency increase occurred some 10 years earlier in women than in men, beginning in the early postmenopausal period. The polynomial course of the regression function for the age-dependence of P300 potentials might reflect the positive influence of socio-cultural factors on the aging of cognitive functions. The true extent of the age-related changes in cognitive functions, however, can be determined only with the aid of intra-individual longitudinal studies. This is of considerable importance for the early diagnosis of both metabolic and primarily degenerative encephalopathies.

  9. A case for critical ethnography: rethinking the early years of the AIDS epidemic in South Africa.

    PubMed

    Fassin, Didier

    2013-12-01

    The epidemic of AIDS in South Africa has been characterized not only by its rapid progression but also its impassioned controversies. Retrospectively examining a long-term anthropological project and discussing some reactions it elicited, the paper proposes a defense and illustration of a critical ethnography at three moments of the research. Ethnography is first discussed as fieldworks, proposing an alternative to the horizontal multi-sited approach via a vertical multi-layered method using various scales and locations, and thus connecting the disease endured by patients in townships and former homelands with the heated debates in scientific and political forums: this procedure substitutes a political economy of the disease for its cultural and behavioral interpretations. Ethnography is then discussed as writing, suggesting acknowledgment of the social intelligence of the agents as well as the need for a scientific distance: this principle allows the articulation of the objective historical condition of the individuals and their subjective experience of history, both revealed in the development of the epidemic. Ultimately ethnography is considered from the perspective of its afterlife, that is, the continuous process of its translation by readers and commentators, on the one hand, by the author trying to reach beyond the boundaries of the academic realm, on the other, the work of anthropology appearing as a living object open to public conversation and consequently a resource for knowledge and action. PMID:23973002

  10. A case for critical ethnography: rethinking the early years of the AIDS epidemic in South Africa.

    PubMed

    Fassin, Didier

    2013-12-01

    The epidemic of AIDS in South Africa has been characterized not only by its rapid progression but also its impassioned controversies. Retrospectively examining a long-term anthropological project and discussing some reactions it elicited, the paper proposes a defense and illustration of a critical ethnography at three moments of the research. Ethnography is first discussed as fieldworks, proposing an alternative to the horizontal multi-sited approach via a vertical multi-layered method using various scales and locations, and thus connecting the disease endured by patients in townships and former homelands with the heated debates in scientific and political forums: this procedure substitutes a political economy of the disease for its cultural and behavioral interpretations. Ethnography is then discussed as writing, suggesting acknowledgment of the social intelligence of the agents as well as the need for a scientific distance: this principle allows the articulation of the objective historical condition of the individuals and their subjective experience of history, both revealed in the development of the epidemic. Ultimately ethnography is considered from the perspective of its afterlife, that is, the continuous process of its translation by readers and commentators, on the one hand, by the author trying to reach beyond the boundaries of the academic realm, on the other, the work of anthropology appearing as a living object open to public conversation and consequently a resource for knowledge and action.

  11. [Campomelic syndrome. Difficulties in early differential diagnosis from other syndromes involving deformation of the long bones using echography].

    PubMed

    Kervran, T; Cigarme, A; Ferrier, M H; le Roux, J L; Rebour, P; Chabaud, J J; Martin, J

    1990-11-01

    One case of "campomélique" dysplasia discovered by echography at 17 weeks is reported. The details of the syndrome are recalled. In this particular case, only the histology enabled the exact diagnosis to be made. The distinction between "syndrome campomélique" and other syndromes involving deformation of long bones (imperfect osteogenesis of the foetal type and isolated curvature of the tibia) is not easy during early pregnancy using echography alone. At a later stage, the signs and symptoms become more distinct and an exact diagnosis is probably easier. PMID:2281259

  12. 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

  13. Early diagnosis of adenovirus infection and treatment with cidofovir after bone marrow transplantation in children.

    PubMed

    Legrand, F; Berrebi, D; Houhou, N; Freymuth, F; Faye, A; Duval, M; Mougenot, J F; Peuchmaur, M; Vilmer, E

    2001-03-01

    Adenovirus infection remains an important cause of mortality after bone marrow transplantation (BMT). Currently no efficient antiviral treatment is known. Thus, testing new modalities of early diagnosis and treatment is a crucial objective. Adenovirus infection is defined by the combination of symptoms and the isolation of virus from the source of clinical symptoms. The involvement of two or more organs and the presence of virus in blood cultures define disseminated disease. Seven children with a median age of 7 years received bone marrow transplantation for leukemia. All received an unrelated graft without T cell depletion. Adenovirus was sought in blood, urine and biopsy specimens using PCR and culture. Analysis of biopsy specimens included systematic immunohistochemistry. Cidofovir treatment was initiated as soon as biopsy revealed the histopathological signs of adenovirus. Cidofovir was given at 5 mg/kg once weekly for 3 weeks then every 2 weeks. Six patients had diarrhoea and one patient had cystitis. Adenovirus infection and disseminated disease were diagnosed in four cases and three cases, respectively. In six cases, serotype A31 was isolated from gastrointestinal biopsy and in two cases serotypes B2 and C6 were detected in blood and urine. Cidofovir treatment was associated with clinical improvement of diarrhoea, cystitis and fever in five patients, in whom the virus became undetectable in cultures and PCR analyses despite the persistence of immunodeficiency. The median follow-up was 360 days after BMT (240-570). One child died of invasive aspergillosis and another of disseminated adenovirus after interruption of cidofovir therapy. Further studies in immunocompromised patients will be needed to extend these promising results concerning the role of cidofovir in adenovirus infection.

  14. HPV and oral lesions: preventive possibilities, vaccines and early diagnosis of malignant lesions.

    PubMed

    Testi, D; Nardone, M; Melone, P; Cardelli, P; Ottria, L; Arcuri, C

    2015-01-01

    The importance of HPV in world healthy is high, in fact high-risk HPV types contribute significantly to viral associated neoplasms. In this article we will analyze vary expression of HPV in oral cavity both benign and malignant, their prevalence and the importance in early diagnosis and prevention. The classical oral lesions associated with human papillomavirus are squamous cell papilloma, condyloma acuminatum, verruca vulgaris and focal epithelial hyperplasia. Overall, HPV types 2, 4, 6, 11, 13 and 32 have been associated with benign oral lesions while HPV types 16 and 18 have been associated with malignant lesions, especially in cancers of the tonsils and elsewhere in the oropharynx. Transmission of the virus can occur with direct contact, genital contact, anal and oral sex; latest studies suggest a salivary transmission and from mother to child during delivery. The number of lifetime sexual partners is an important risk factor for the development of HPV-positive head-neck cancer. Oral/oropharyngeal cancer etiologically associated with HPV having an increased survival and a better prognostic (85%-90% to five years). There is no cure for the virus. There are two commercially available prophylactic vaccines against HPV today: the bivalent (16 and 18) Cervarix® and the tetravalent (6, 11, 16 and 18) Gardasil® and new vaccine Gardasil 9 (6, 11, 16, 18, 31, 33, 45, 52, 58) was approved in the United States. To be effective, such vaccination should start before "sexual puberty". The vaccine could be an important preventive strategy, in fact the scientific community is in agreement on hypothesis that blocking the contagion it may also limit the distance complications as the oropharyngeal cancer.

  15. Biomarkers: evaluation of clinical utility in surveillance and early diagnosis for hepatocellular carcinoma.

    PubMed

    Song, Peipei; Tang, Qi; Feng, Xiaobin; Tang, Wei

    2016-01-01

    Hepatocellular carcinoma (HCC) is the fifth most common cancer and the second most common cause of death from cancer worldwide. Strategies to surveil and diagnose HCC in an earlier stage are urgently needed since this is when curable interventions can be offered to achieve long-term disease-free survival. Over the past few decades, research has suggested measuring alpha-fetoprotein (AFP) concentration and performing abdominal ultrasound (US) as part of routine surveillance of HCC every 6 months for high-risk patients, and many HCC guidelines worldwide have also recommended these examinations. Over the past 5 years, however, the role of serum biomarkers in HCC surveillance and diagnosis has diminished due to advances in imaging modalities. AFP was excluded from the surveillance and/or diagnostic criteria in the HCC guidelines published by some Western countries. In Asian countries, serum biomarkers such as AFP, the Lens culinaris agglutinin-reactive fraction of AFP (AFP-L3), and des-γ-carboxyprothrombin (DCP) are still recommended for HCC surveillance and are being used as an adjunctive diagnostic tool in accordance with HCC guidelines. Moreover, novel biomarkers including Dickkopf-1 (DKK1), midkine (MDK), and microRNA (miRNA) are being studied in this regard. China accounts for 50% of HCC cases worldwide, so identifying biomarkers of HCC is paramount. Recent studies have indicated the clinical utility of simultaneous measurement of AFP and DCP for the early detection of HCC in China. They are predominantly used for cases caused by HBV infection. Additional large-scale prospective studies should be conducted to establish the utility of these biomarkers. PMID:27438343

  16. Magnetic sifters and biochips for early diagnosis and therapy monitoring of cancer

    NASA Astrophysics Data System (ADS)

    Earhart, Chris

    2008-03-01

    Magnetic nanoparticles conjugated with biomolecules or recognition moieties are finding wide applications in medicine. In this context, we are developing a micromachined magnetic sifter and magnetic nanoparticles aimed for sample preparation applications in early diagnosis of cancer. The microfabricated sifter consisting of arrays of micron sized slits etched through a silicon wafer. A magnetic film is deposited on the wafer, producing high magnetic field gradients, comparable in magnitude to gradients in planar flow devices. As the solution flows through the die, magnetic particles are captured by the magnetic material surrounding the slits. The large number of slits allows for processing of large volumes of liquid, much greater than that of planar microfluidic devices. The sifters can be simply attached to a syringe or tube, resulting in a portable and user-friendly tool for molecular biology. Separation efficiencies of ˜ 50% for one pass through the sifter have been achieved. We have also designed and fabricated several types of magnetic biochips consisting of arrays of giant magnetoresistive (GMR) spin valve detectors with appropriate dimensions, surface chemistry, and microfluidics. An advanced electronic test station has been set up as a demonstration vehicle for the integrated evaluation of our magnetic biochips with commercial and custom magnetic nanoparticle labels for DNA or protein biomarkers. The magnetic biochip is capable of detecting down to 1-30 nanotags. Real-time detection of DNA signatures and protein targets in buffer and serum samples has been successfully performed in our laboratories, suggesting that magnetic biochips hold great promises for molecular diagnostics of cancer and other diseases. In collaboration with Chris M. Earhart, Wei Hu, Robert J. Wilson, Sebastian J. Osterfeld, Robert L. White, Nader Pourmand, and Shan X. Wang @ Stanford University. This work was supported by grants from NIH (1U54CA119367-01) and DARPA/Navy (N00014-02-1-0807).

  17. HPV and oral lesions: preventive possibilities, vaccines and early diagnosis of malignant lesions.

    PubMed

    Testi, D; Nardone, M; Melone, P; Cardelli, P; Ottria, L; Arcuri, C

    2015-01-01

    The importance of HPV in world healthy is high, in fact high-risk HPV types contribute significantly to viral associated neoplasms. In this article we will analyze vary expression of HPV in oral cavity both benign and malignant, their prevalence and the importance in early diagnosis and prevention. The classical oral lesions associated with human papillomavirus are squamous cell papilloma, condyloma acuminatum, verruca vulgaris and focal epithelial hyperplasia. Overall, HPV types 2, 4, 6, 11, 13 and 32 have been associated with benign oral lesions while HPV types 16 and 18 have been associated with malignant lesions, especially in cancers of the tonsils and elsewhere in the oropharynx. Transmission of the virus can occur with direct contact, genital contact, anal and oral sex; latest studies suggest a salivary transmission and from mother to child during delivery. The number of lifetime sexual partners is an important risk factor for the development of HPV-positive head-neck cancer. Oral/oropharyngeal cancer etiologically associated with HPV having an increased survival and a better prognostic (85%-90% to five years). There is no cure for the virus. There are two commercially available prophylactic vaccines against HPV today: the bivalent (16 and 18) Cervarix® and the tetravalent (6, 11, 16 and 18) Gardasil® and new vaccine Gardasil 9 (6, 11, 16, 18, 31, 33, 45, 52, 58) was approved in the United States. To be effective, such vaccination should start before "sexual puberty". The vaccine could be an important preventive strategy, in fact the scientific community is in agreement on hypothesis that blocking the contagion it may also limit the distance complications as the oropharyngeal cancer. PMID:27555904

  18. HPV and oral lesions: preventive possibilities, vaccines and early diagnosis of malignant lesions

    PubMed Central

    TESTI, D.; NARDONE, M.; MELONE, P.; CARDELLI, P.; OTTRIA, L.; ARCURI, C.

    2015-01-01

    SUMMARY The importance of HPV in world healthy is high, in fact high-risk HPV types contribute significantly to viral associated neoplasms. In this article we will analyze vary expression of HPV in oral cavity both benign and malignant, their prevalence and the importance in early diagnosis and prevention. The classical oral lesions associated with human papillomavirus are squamous cell papilloma, condyloma acuminatum, verruca vulgaris and focal epithelial hyperplasia. Overall, HPV types 2, 4, 6, 11, 13 and 32 have been associated with benign oral lesions while HPV types 16 and 18 have been associated with malignant lesions, especially in cancers of the tonsils and elsewhere in the oropharynx. Transmission of the virus can occur with direct contact, genital contact, anal and oral sex; latest studies suggest a salivary transmission and from mother to child during delivery. The number of lifetime sexual partners is an important risk factor for the development of HPV-positive head-neck cancer. Oral/oropharyngeal cancer etiologically associated with HPV having an increased survival and a better prognostic (85%–90% to five years). There is no cure for the virus. There are two commercially available prophylactic vaccines against HPV today: the bivalent (16 and 18) Cervarix® and the tetravalent (6, 11, 16 and 18) Gardasil® and new vaccine Gardasil 9 (6, 11, 16, 18, 31, 33, 45, 52, 58) was approved in the United States. To be effective, such vaccination should start before “sexual puberty”. The vaccine could be an important preventive strategy, in fact the scientific community is in agreement on hypothesis that blocking the contagion it may also limit the distance complications as the oropharyngeal cancer. PMID:27555904

  19. Fiber optic probe enabled by surface-enhanced Raman scattering for early diagnosis of potential acute rejection of kidney transplant

    NASA Astrophysics Data System (ADS)

    Chi, Jingmao; Chen, Hui; Tolias, Peter; Du, Henry

    2014-06-01

    We have explored the use of a fiber-optic probe with surface-enhanced Raman scattering (SERS) sensing modality for early, noninvasive and, rapid diagnosis of potential renal acute rejection (AR) and other renal graft dysfunction of kidney transplant patients. Multimode silica optical fiber immobilized with colloidal Ag nanoparticles at the distal end was used for SERS measurements of as-collected urine samples at 632.8 nm excitation wavelength. All patients with abnormal renal graft function (3 AR episodes and 2 graft failure episodes) who were clinically diagnosed independently show common unique SERS spectral features in the urines collected just one day after transplant. SERS-based fiber-optic probe has excellent potential to be a bedside tool for early diagnosis of kidney transplant patients for timely medical intervention of patients at high risk of transplant dysfunction.

  20. Computer-aided diagnosis of Parkinson’s disease based on [123I]FP-CIT SPECT binding potential images, using the voxels-as-features approach and support vector machines

    NASA Astrophysics Data System (ADS)

    Oliveira, Francisco P. M.; Castelo-Branco, Miguel

    2015-04-01

    Objective. The aim of the present study was to develop a fully-automated computational solution for computer-aided diagnosis in Parkinson syndrome based on [123I]FP-CIT single photon emission computed tomography (SPECT) images. Approach. A dataset of 654 [123I]FP-CIT SPECT brain images from the Parkinson’s Progression Markers Initiative were used. Of these, 445 images were of patients with Parkinson’s disease at an early stage and the remainder formed a control group. The images were pre-processed using automated template-based registration followed by the computation of the binding potential at a voxel level. Then, the binding potential images were used for classification, based on the voxel-as-feature approach and using the support vector machines paradigm. Main results. The obtained estimated classification accuracy was 97.86%, the sensitivity was 97.75% and the specificity 98.09%. Significance. The achieved classification accuracy was very high and, in fact, higher than accuracies found in previous studies reported in the literature. In addition, results were obtained on a large dataset of early Parkinson’s disease subjects. In summation, the information provided by the developed computational solution potentially supports clinical decision-making in nuclear medicine, using important additional information beyond the commonly used uptake ratios and respective statistical comparisons. (ClinicalTrials.gov Identifier: NCT01141023)

  1. Quantitative Analysis Of Lung Texture For Computer-Aided Diagnosis Of Interstitial Disease In Digital Chest Radiographs

    NASA Astrophysics Data System (ADS)

    Katsuragawa, Shigehiko; Doi, Kunio; MacMahon, Heber

    1988-06-01

    We have employed physical measures of lung texture in an automated method of detecting and characterizing interstitial lung disease in digital chest radiographs. In addition, by using an analysis of these measures relative to an accumulated data base, we have devised an automated classification method for distinguishing between normal lungs and abnormal lungs with interstitial disease. Our results suggest that this computerized method can be a valuable aid to radiologists in their assessment of interstitial lung infiltrates.

  2. [Preparation of monoclonal antibodies to gp51 antigen and their use for early diagnosis of bovine leukemia].

    PubMed

    Mikalauskene, G I; Vaĭchiunene, V V; Peshkus, Iu K; Tamoshiunas, V I

    1996-01-01

    A strain BLV-gp51-V7 of hybrid cells has been obtained that is characterised by high specificity as to antigen (glycoprotein gp51). Ascitic tumour appear in syngenic mice inoculated with hybrid cells of strain BLV-gp51-V7. Monoclonal antibodies were isolated from the ascitic fluid of mice. These antibodies were used with the purpose of early diagnosis of cattle leucosis. PMID:9273735

  3. [Diabetes mellitus and chronic kidney disease: Possibilities of prediction, early diagnosis, and nephroprotection in the 21st century].

    PubMed

    Shestakova, M V

    2016-01-01

    The. review gives data on the prognostic value of genetic markers when analyzing the risk of chronic kidney disease in diabetes mellitus, those on new possibilities of early diagnosis of diabetic nephropathy using urinary biomarkers (nephrinuria, podocinuria) and proteomic urinalysis at the stage of normoalbuminuria. The interpretation of the index mrcroalbuminuria in type 2 diabetesis critically analyzed. The nephroprotective properties of novel classes of glucose-lowering drugs, such as incretins and gliflozins, are considered. PMID:27489899

  4. Improvement of MS (multiple sclerosis) CAD (computer aided diagnosis) performance using C/C++ and computing engine in the graphical processing unit (GPU)

    NASA Astrophysics Data System (ADS)

    Suh, Joohyung; Ma, Kevin; Le, Anh

    2011-03-01

    Multiple Sclerosis (MS) is a disease which is caused by damaged myelin around axons of the brain and spinal cord. Currently, MR Imaging is used for diagnosis, but it is very highly variable and time-consuming since the lesion detection and estimation of lesion volume are performed manually. For this reason, we developed a CAD (Computer Aided Diagnosis) system which would assist segmentation of MS to facilitate physician's diagnosis. The MS CAD system utilizes K-NN (k-nearest neighbor) algorithm to detect and segment the lesion volume in an area based on the voxel. The prototype MS CAD system was developed under the MATLAB environment. Currently, the MS CAD system consumes a huge amount of time to process data. In this paper we will present the development of a second version of MS CAD system which has been converted into C/C++ in order to take advantage of the GPU (Graphical Processing Unit) which will provide parallel computation. With the realization of C/C++ and utilizing the GPU, we expect to cut running time drastically. The paper investigates the conversion from MATLAB to C/C++ and the utilization of a high-end GPU for parallel computing of data to improve algorithm performance of MS CAD.

  5. Genetic Testing Confirmed the Early Diagnosis of X-Linked Hypophosphatemic Rickets in a 7-Month-Old Infant

    PubMed Central

    Poon, Kok Siong; Sng, Andrew Anjian; Ho, Cindy Weili; Koay, Evelyn Siew-Chuan

    2015-01-01

    Loss-of-function mutations in the phosphate regulating gene with homologies to endopeptidases on the X-chromosome (PHEX) have been causally associated with X-linked hypophosphatemic rickets (XLHR). The early diagnosis of XLHR in infants is challenging when it is based solely on clinical features and biochemical findings. We report a 7-month-old boy with a family history of hypophosphatemic rickets., who demonstrated early clinical evidence of rickets, although serial biochemical findings could not definitively confirm rickets. A sequencing assay targeting the PHEX gene was first performed on the mother’s DNA to screen for mutations in the 5′UTR, 22 coding exons, and the exon-intron junctions. Targeted mutation analysis and mRNA studies were subsequently performed on the boys’ DNA to investigate the pathogenicity of the identified mutation. Genetic screening of the PHEX gene revealed a novel mutation, c.1080-2A>C, at the splice acceptor site in intron 9. The detection of an aberrant mRNA transcript with skipped (loss of) exon 10 establishes its pathogenicity and confirms the diagnosis of XLHR in this infant. Genetic testing of the PHEX gene resulted in early diagnosis of XLHR, thus enabling initiation of therapy and prevention of progressive rachitic changes in the infant. PMID:26904698

  6. Risk factors of delayed diagnosis of acute appendicitis in children: for early detection of acute appendicitis

    PubMed Central

    Choi, Jea Yeon; Jo, Jeong Hyun; Hann, Tchah; Kim, Seong Min

    2016-01-01

    Purpose This study examined the risk factors of a delayed diagnosis of acute appendicitis in children undergoing an appendectomy. Methods This retrospective study involved children aged below 18 years, who underwent an appendectomy. After dividing them into a delayed diagnosis group and nondelayed diagnosis group according to the time interval between the initial hospital visit and final diagnosis, the risk factors of delayed diagnosis were identified using logistic regression analysis. Results Among 712 patients, 105 patients (14.7%) were classified in the delayed diagnosis group; 92 patients (12.9%) were diagnosed using ultrasonography (US), and both US and computed tomography were performed in 38 patients (5.3%). More patients in the delayed diagnosis group underwent US (P=0.03). Spring season and prior local clinic visit were significantly associated with a delayed diagnosis. Fever and diarrhea were more common in the delayed diagnosis group (fever: odds ratio [OR], 1.37; 95% confidence interval [CI], 1.05–1.81; diarrhea: OR, 1.94; 95% CI, 1.08–3.46; P<0.05). These patients showed symptoms for a longer duration (OR, 2.59; 95% CI, 1.78–3.78; P<0.05), and the admission course (OR, 1.26; 95% CI, 1.11–1.44; P<0.05) and C-reactive protein (CRP) levels (OR, 1.47; 95% CI, 1.19–1.82; P<0.05) were associated with the delayed diagnosis. Conclusion To decrease the rate of delayed diagnoses of acute appendicitis, symptoms such as fever and diarrhea, seasonal variations, admission course, and CRP levels should be considered and children with a longer duration of symptoms should be closely monitored. PMID:27721841

  7. 75 FR 28263 - Part C Early Intervention Services Grant Under the Ryan White HIV/AIDS Program

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-05-20

    ... Under the Ryan White HIV/AIDS Program AGENCY: Health Resources and Services Administration (HRSA), HHS... with HIV/AIDS, including primary medical care, laboratory testing, oral health care, outpatient mental... providing services after March 31, 2010. HRSA's HIV/AIDS Bureau identified the Rural Health Group as...

  8. Evaluation of 20 years experience of fibrodysplasia ossificans progressiva in Iran: lessons for early diagnosis and prevention.

    PubMed

    Raees-Karami, Seyed Reza; Jafarieh, Hanieh; Ziyayi, Vahid; Shekarriz Foumani, Reza; Aghighi, Yahya

    2012-07-01

    Fibrodysplasia ossificans progressiva (FOP) is a rare genetic inflammatory disorder characterized by progressive heterotopic ossification presenting as recurrent soft tissue masses and swelling which may cause disabling, restricted joint mobility. Congenital malformations of the hallux are characteristic features of classic FOP, predating the appearance of disabling features. As no definite treatment is available, the early diagnosis and prevention of exacerbating factors may lead to significant benefits in terms of the life quality of patients. A retrospective study of 12 consecutive FOP patients referred to and admitted in the rheumatology unit at an urban tertiary care academic center between 1991 and 2011. Data, such as age, gender, and past medical history, were collected from the medical history, physical examination, and skeletal survey in order to characterize the clinical presentations. All 12 children (six boys and six girls; ages 2.0-13.5 years) had congenital malformations of the great toes (microdactyly and hallux valgus deformity), in addition to heterotopic ossification presenting as multiple soft tissue tumor-like swellings. Spinal involvement, most notably in the cervical region, suggestive of an early FOP, was present in 83.3 %. Eleven patients (91.6 %) had a prior history of direct physical trauma, while 7 of 11 (63.6 %) had undergone invasive diagnostic procedures, both correlating with the exacerbations of their condition. Clinical awareness of fibrodysplasia ossificans progressiva and its early diagnostic features, particularly congenital malformations of the hallux, during a thorough neonatal examination may lead to an early diagnosis preventing the development of disabling, practically irreversible lesions of heterotopic ossification. Genetic and molecular studies can play a considerable role in the diagnosis of FOP in suspected cases. Early institution of prophylactic and precautionary measures, such as categorical avoidance of trauma and

  9. Homocysteine as a predictive biomarker in early diagnosis of renal failure susceptibility and prognostic diagnosis for end stages renal disease.

    PubMed

    Amin, Hatem K; El-Sayed, Mohamed-I Kotb; Leheta, Ola F

    2016-09-01

    Glomerular filtration rate and/or creatinine are not accurate methods for renal failure prediction. This study tested homocysteine (Hcy) as a predictive and prognostic marker for end stage renal disease (ESRD). In total, 176 subjects were recruited and divided into: healthy normal group (108 subjects); mild-to-moderate impaired renal function group (21 patients); severe impaired renal function group (7 patients); and chronic renal failure group (40 patients) who were on regular hemodialysis. Blood samples were collected, and serum was separated for analysis of total Hcy, creatinine, high sensitive C-reactive protein (CRP), serum albumin, and calcium. Data showed that Hcy level was significantly increased from normal-to-mild impairment then significantly decreases from mild impairment until the patient reaches severe impairment while showing significant elevation in the last stage of chronic renal disease. Creatinine level was increased in all stages of kidney impairment in comparison with control. CRP level was showing significant elevation in the last stage. A significant decrease in both albumin and calcium was occurred in all stages of renal impairment. We conclude Hcy in combination with CRP, creatinine, albumin, and calcium can be used as a prognostic marker for ESRD and an early diagnostic marker for the risk of renal failure.

  10. Clinical undernutrition in 2014; pathogenesis, early diagnosis and consequences; undernutrition and trophopathy.

    PubMed

    de Ulíbarri Pérez, José Ignacio

    2014-01-13

    amount of risks which could derive from an imbalanced nutritional status. The use of automated systems to predict and control the risk factors during the clinical phase makes it possible to have a more thorough control of the illness from its origins, allowing an early diagnosis and treatment of it.

  11. The Significance of MRI Evaluation of the Uterine Junctional Zone in the Early Diagnosis of Adenomyosis

    PubMed Central

    Sofic, Amela; Husic-Selimovic, Azra; Carovac, Aladin; Jahic, Elma; Smailbegovic, Velda; Kupusovic, Jana

    2016-01-01

    diagnostic marker in the diagnosis of adenomyosis. It is important to recognize this condition as early as possible and distinguish it from other pathologies in order for timely and appropriate treatment. PMID:27147800

  12. Can heat shock protein 32 be used for the early diagnosis of acute mesenteric ischemia?

    PubMed Central

    Berhuni, Sait; Öztürk, Ersin; Oral, Arzu Yılmaztepe; Sarkut, Pınar; Kahveci, Nevzat; Yılmazlar, Tuncay; Özlük, Kasım; Yerci, Ömer

    2016-01-01

    Objective: Acute mesenteric ischemia is a challenging and fatal disease. The aim of this study was to detect the heat shock protein 32 (HSP32) response in intestinal tissue and systemic blood to intestinal ischemia and ischemia/reperfusion to define a tool for the early diagnosis of acute mesenteric ischemia. Material and Methods: Thirty female Wistar albino rats were equally divided into 3 groups. Group 1 rats underwent simple laparotomy and closure (control). In Group 2 rats, 1-hour intestinal ischemia followed by 5-hour reperfusion was performed, and Group 3 rats were subjected to 6-hour intestinal ischemia. The experiment was repeated with a 24-hour waiting period. At the end of the waiting period, blood was withdrawn from the tail veins of the rats and the rats were sacrificed via cardiac puncture. Re-laparotomy was subsequently performed and intestinal tissue and luminal samples were obtained for biochemical and pathological investigations. The HSP32 levels of intestinal tissues, luminal contents and blood levels were compared among the groups. Results: At the end of the 24-hour waiting period, the median tissue HSP32 levels were 0.43 (0–6.6) ng/mL for Group 1, 9.51 (2.5–49.9) ng/mL for Group 2 and 43.13 (6.3–121.3) ng/mL for Group 3 (p=0.001). The median blood HSP32 levels were 0.11 (0.1–1.4) ng/mL for Group 1, 0.42 (0.1–0.7) ng/mL for Group 2, and 0.25 (0.1–1.2) ng/mL for Group 3 (p=0.047). The HSP levels in the luminal contents were undetectable. Conclusion: Both ischemia and ischemia/reperfusion significantly raised intestinal tissue HSP32 levels in comparison with the control group. However, this change was not reflected in the circulating blood or luminal contents. PMID:26985164

  13. Young Children, HIV/AIDS and Gender: A Summary Review. Working Papers in Early Childhood Development. Young Children and HIV/AIDS Sub-Series, No. 39

    ERIC Educational Resources Information Center

    Bhana, Deevia; Brixen, Farhana Farook

    2006-01-01

    Studies point to the existence of a global HIV/AIDS emergency among young people. An estimated 6,000 youths a day become infected, an average of one new infection every 14 seconds. The most socially and economically disadvantaged young people appear to be especially at risk of infection, and young women in developing contexts are at the greatest…

  14. HIV/AIDS: What about Very Young Children? Working Papers in Early Childhood Development. Young Children and HIV/AIDS Sub-Series, No. 35

    ERIC Educational Resources Information Center

    Dunn, Alison

    2005-01-01

    The research reviewed and the current responses identified in this paper show that at local, national and international levels there are gaps in programming and policy to engage ideas and mobilise resources to address the needs and experiences of very young children infected/affected by HIV and AIDS. Chapter one identifies some key areas where the…

  15. Clinical whole-genome sequencing in severe early-onset epilepsy reveals new genes and improves molecular diagnosis

    PubMed Central

    Martin, Hilary C.; Kim, Grace E.; Pagnamenta, Alistair T.; Murakami, Yoshiko; Carvill, Gemma L.; Meyer, Esther; Copley, Richard R.; Rimmer, Andrew; Barcia, Giulia; Fleming, Matthew R.; Kronengold, Jack; Brown, Maile R.; Hudspith, Karl A.; Broxholme, John; Kanapin, Alexander; Cazier, Jean-Baptiste; Kinoshita, Taroh; Nabbout, Rima; Bentley, David; McVean, Gil; Heavin, Sinéad; Zaiwalla, Zenobia; McShane, Tony; Mefford, Heather C.; Shears, Deborah; Stewart, Helen; Kurian, Manju A.; Scheffer, Ingrid E.; Blair, Edward; Donnelly, Peter; Kaczmarek, Leonard K.; Taylor, Jenny C.

    2014-01-01

    In severe early-onset epilepsy, precise clinical and molecular genetic diagnosis is complex, as many metabolic and electro-physiological processes have been implicated in disease causation. The clinical phenotypes share many features such as complex seizure types and developmental delay. Molecular diagnosis has historically been confined to sequential testing of candidate genes known to be associated with specific sub-phenotypes, but the diagnostic yield of this approach can be low. We conducted whole-genome sequencing (WGS) on six patients with severe early-onset epilepsy who had previously been refractory to molecular diagnosis, and their parents. Four of these patients had a clinical diagnosis of Ohtahara Syndrome (OS) and two patients had severe non-syndromic early-onset epilepsy (NSEOE). In two OS cases, we found de novo non-synonymous mutations in the genes KCNQ2 and SCN2A. In a third OS case, WGS revealed paternal isodisomy for chromosome 9, leading to identification of the causal homozygous missense variant in KCNT1, which produced a substantial increase in potassium channel current. The fourth OS patient had a recessive mutation in PIGQ that led to exon skipping and defective glycophosphatidyl inositol biosynthesis. The two patients with NSEOE had likely pathogenic de novo mutations in CBL and CSNK1G1, respectively. Mutations in these genes were not found among 500 additional individuals with epilepsy. This work reveals two novel genes for OS, KCNT1 and PIGQ. It also uncovers unexpected genetic mechanisms and emphasizes the power of WGS as a clinical tool for making molecular diagnoses, particularly for highly heterogeneous disorders. PMID:24463883

  16. Early prenatal diagnosis of an infratentorial arachnoid cyst: association with an unbalanced translocation.

    PubMed

    Hogge, W A; Schnatterly, P; Ferguson, J E

    1995-02-01

    Arachnoid cysts are an uncommon central nervous system malformation, representing only 1 per cent of all intracranial masses. We report the second-trimester prenatal diagnosis of a posterior fossa arachnoid cyst, associated with an unbalanced X;9 translocation.

  17. A Computer-Aided Diagnosis System for Dynamic Contrast-Enhanced MR Images Based on Level Set Segmentation and ReliefF Feature Selection

    PubMed Central

    Zhu, Dongmei; Li, Li

    2015-01-01

    This study established a fully automated computer-aided diagnosis (CAD) system for the classification of malignant and benign masses via breast magnetic resonance imaging (BMRI). A breast segmentation method consisting of a preprocessing step to identify the air-breast interfacing boundary and curve fitting for chest wall line (CWL) segmentation was included in the proposed CAD system. The Chan-Vese (CV) model level set (LS) segmentation method was adopted to segment breast mass and demonstrated sufficiently good segmentation performance. The support vector machine (SVM) classifier with ReliefF feature selection was used to merge the extracted morphological and texture features into a classification score. The accuracy, sensitivity, and specificity measurements for the leave-half-case-out resampling method were 92.3%, 98.2%, and 76.2%, respectively. For the leave-one-case-out resampling method, the measurements were 90.0%, 98.7%, and 73.8%, respectively. PMID:25628755

  18. A vector machine formulation with application to the computer-aided diagnosis of breast cancer from DCE-MRI screening examinations.

    PubMed

    Levman, Jacob E D; Warner, Ellen; Causer, Petrina; Martel, Anne L

    2014-02-01

    This study investigates the use of a proposed vector machine formulation with application to dynamic contrast-enhanced magnetic resonance imaging examinations in the context of the computer-aided diagnosis of breast cancer. This paper describes a method for generating feature measurements that characterize a lesion's vascular heterogeneity as well as a supervised learning formulation that represents an improvement over the conventional support vector machine in this application. Spatially varying signal-intensity measures were extracted from the examinations using principal components analysis and the machine learning technique known as the support vector machine (SVM) was used to classify the results. An alternative vector machine formulation was found to improve on the results produced by the established SVM in randomized bootstrap validation trials, yielding a receiver-operating characteristic curve area of 0.82 which represents a statistically significant improvement over the SVM technique in this application.

  19. Molecular Biomarkers of Pancreatic Intraepithelial Neoplasia and Their Implications in Early