42 CFR 70.4 - Report of disease.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 42 Public Health 1 2013-10-01 2013-10-01 false Report of disease. 70.4 Section 70.4 Public Health... INTERSTATE QUARANTINE § 70.4 Report of disease. The master of any vessel or person in charge of any conveyance engaged in interstate traffic, on which a case or suspected case of a communicable disease...

Sherlock Holmes and child psychopathology assessment approaches: the case of the false-positive.

PubMed

Jensen, P S; Watanabe, H

1999-02-01

To explore the relative value of various methods of assessing childhood psychopathology, the authors compared 4 groups of children: those who met criteria for one or more DSM diagnoses and scored high on parent symptom checklists, those who met psychopathology criteria on either one of these two assessment approaches alone, and those who met no psychopathology assessment criterion. Parents of 201 children completed the Child Behavior Checklist (CBCL), after which children and parents were administered the Diagnostic Interview Schedule for Children (version 2.1). Children and parents also completed other survey measures and symptom report inventories. The 4 groups of children were compared against "external validators" to examine the merits of "false-positive" and "false-negative" cases. True-positive cases (those that met DSM criteria and scored high on the CBCL) differed significantly from the true-negative cases on most external validators. "False-positive" and "false-negative" cases had intermediate levels of most risk factors and external validators. "False-positive" cases were not normal per se because they scored significantly above the true-negative group on a number of risk factors and external validators. A similar but less marked pattern was noted for "false-negatives." Findings call into question whether cases with high symptom checklist scores despite no formal diagnoses should be considered "false-positive." Pending the availability of robust markers for mental illness, researchers and clinicians must resist the tendency to reify diagnostic categories or to engage in arcane debates about the superiority of one assessment approach over another.

A case of positive 68Ga-DOTATOC-PET/CT pancreatic heterotopia mimicking an intestinal neuroendocrine tumor.

PubMed

Zilli, Alessandra; Fanetti, Ilaria; Conte, Dario; Massironi, Sara

Gallium-68 DOTA-peptide positron emission tomography/computed tomography ( 68 Ga-PET/CT) has emerged as a promising tool for the diagnosis and staging of gastro-entero-pancreatic neoplasms, thanks to its high sensitivity and specificity. Heterotopic pancreas, which is relatively rare, has never been reported as a possible cause of false positives of 68 Ga-PET/CT. We report on the first case of a heterotopic pancreas showing pathological uptake at 68 Ga-PET/CT, thus mimicking an intestinal neuroendocrine tumor. The present case suggests that heterotopic pancreas should be included among the possible causes of false positives at 68 Ga PET. Copyright © 2018 Elsevier Inc. All rights reserved.

24 CFR 81.65 - Other information and analyses.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 24 Housing and Urban Development 1 2010-04-01 2010-04-01 false Other information and analyses. 81... information and analyses. When deemed appropriate and requested in writing, on a case by-case basis, by the... conduct additional analyses concerning any such report. A GSE shall submit additional reports or other...

24 CFR 81.65 - Other information and analyses.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 24 Housing and Urban Development 1 2012-04-01 2012-04-01 false Other information and analyses. 81... information and analyses. When deemed appropriate and requested in writing, on a case by-case basis, by the... conduct additional analyses concerning any such report. A GSE shall submit additional reports or other...

24 CFR 81.65 - Other information and analyses.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 24 Housing and Urban Development 1 2011-04-01 2011-04-01 false Other information and analyses. 81... information and analyses. When deemed appropriate and requested in writing, on a case by-case basis, by the... conduct additional analyses concerning any such report. A GSE shall submit additional reports or other...

24 CFR 81.65 - Other information and analyses.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 24 Housing and Urban Development 1 2014-04-01 2014-04-01 false Other information and analyses. 81... information and analyses. When deemed appropriate and requested in writing, on a case by-case basis, by the... conduct additional analyses concerning any such report. A GSE shall submit additional reports or other...

24 CFR 81.65 - Other information and analyses.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 24 Housing and Urban Development 1 2013-04-01 2013-04-01 false Other information and analyses. 81... information and analyses. When deemed appropriate and requested in writing, on a case by-case basis, by the... conduct additional analyses concerning any such report. A GSE shall submit additional reports or other...

False penile fracture: report of 16 cases.

PubMed

Feki, W; Derouiche, A; Belhaj, K; Ouni, A; Ben Mouelhi, S; Ben Slama, M R; Ayed, M; Chebil, M

2007-01-01

We determined the value of diagnostic and therapeutic approaches of false penile fractures and the outcome of treatment. We retrospectively reviewed 16 cases of presumed penile fracture with a negative surgical exploration. Clinical presentation, technique of treatment and outcome were noted. The mean age was 39 years (17-64). Nine patients were injured during sexual intercourse. All the patients presented with the presumptive diagnosis of penile fracture. False penile fracture was evoked in one patient presenting a new erection. Surgical penile exploration was carried out for all the patients without any radiological explorations. It revealed nonspecific dartos bleeding in 10 cases and avulsed superficial dorsal vein in six cases requiring venous ends ligation. All the patients regained penile appearance and potency. We can hardly distinguish false penile fracture from 'true' penile fracture with certainty either clinically or radiologically, thus, surgical exploration is mostly necessary. The prognosis is excellent.

Early Disseminated Lyme Disease Causing False-Positive Serology for Primary Epstein-Barr Virus Infection: Report of 2 Cases.

PubMed

Pavletic, Adriana J; Marques, Adriana R

2017-07-15

False-positive serology for Lyme disease was reported in patients with acute infectious mononucleosis. Here we describe 2 patients with early disseminated Lyme disease who were misdiagnosed with infectious mononucleosis based on false-positive tests for primary Epstein-Barr virus infection. Published by Oxford University Press for the Infectious Diseases Society of America 2017. This work is written by (a) US Government employee(s) and is in the public domain in the US.

Endovascular treatment of false-aneurysm ten years after dacron patch aortoplasty for coarctation of the aortic isthmus. Report of a case.

PubMed

Illuminati, Giulio; Pacilè, Maria Antonietta; Palumbo, Piergaspare; Salvatori, Filippo Maria; Vietri, Francesco

2013-01-01

False aneurysm degeneration is a known complication of patch aortoplasty for coarctation of the aortic isthmus. Open surgical treatment consists of prosthetic graft repair of the involved aorta, often requires circulatory arrest to achieve a safe proximal aortic control and perform proximal anastomosis, and finally is associated with substantial perioperative morbidity. Endografting of the diseased aorta is a valuable alternative to open repair, when feasible, with good short and long term results. We now report one more case of false aneurysm ten years after Dacron patch aortoplasty for isthmic coarctation in a 26-year-old woman, successfully treated by endovascular repair via the left common iliac artery, and a complete exclusion of the aneurysm at two year follow-up.

Complications of unsafe abortion: case reports and the need for curriculum review in Nigeria.

PubMed

Umoh, A V; Umoiyoho, A J

2009-09-01

Unsafe abortion remains a major reproductive health problem in Nigeria. These are 2 case reports of unsafe abortion, one performed by a patent medicine dealer where a false passage was created in the substance of the cervix to evacuate the uterus using a cannula. A piece of the cannula was left in situ for five years leading to chronic infection and infertility. The second case was performed by a medical practitioner for a second trimester abortion. He deliberately created a false passage in the substance of the cervix to evacuate the uterus leading to severe haemorrhage. We conclude that there is a need to review and improve the training of medical practitioners in termination of pregnancies to avoid unsafe abortion.

45 CFR 98.101 - Case Review Methodology.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 45 Public Welfare 1 2011-10-01 2011-10-01 false Case Review Methodology. 98.101 Section 98.101 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION CHILD CARE AND DEVELOPMENT FUND Error Rate Reporting § 98.101 Case Review Methodology. (a) Case Reviews and Sampling—In preparing...

45 CFR 98.101 - Case Review Methodology.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 45 Public Welfare 1 2014-10-01 2014-10-01 false Case Review Methodology. 98.101 Section 98.101 Public Welfare Department of Health and Human Services GENERAL ADMINISTRATION CHILD CARE AND DEVELOPMENT FUND Error Rate Reporting § 98.101 Case Review Methodology. (a) Case Reviews and Sampling—In preparing...

45 CFR 98.101 - Case Review Methodology.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 45 Public Welfare 1 2010-10-01 2010-10-01 false Case Review Methodology. 98.101 Section 98.101 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION CHILD CARE AND DEVELOPMENT FUND Error Rate Reporting § 98.101 Case Review Methodology. (a) Case Reviews and Sampling—In preparing...

45 CFR 98.101 - Case Review Methodology.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 45 Public Welfare 1 2013-10-01 2013-10-01 false Case Review Methodology. 98.101 Section 98.101 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION CHILD CARE AND DEVELOPMENT FUND Error Rate Reporting § 98.101 Case Review Methodology. (a) Case Reviews and Sampling—In preparing...

45 CFR 98.101 - Case Review Methodology.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 45 Public Welfare 1 2012-10-01 2012-10-01 false Case Review Methodology. 98.101 Section 98.101 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION CHILD CARE AND DEVELOPMENT FUND Error Rate Reporting § 98.101 Case Review Methodology. (a) Case Reviews and Sampling—In preparing...

32 CFR 105.13 - Case management for Unrestricted Reports of sexual assault.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 32 National Defense 1 2014-07-01 2014-07-01 false Case management for Unrestricted Reports of sexual assault. 105.13 Section 105.13 National Defense Department of Defense OFFICE OF THE SECRETARY OF DEFENSE PERSONNEL, MILITARY AND CIVILIAN SEXUAL ASSAULT PREVENTION AND RESPONSE PROGRAM PROCEDURES § 105...

32 CFR 105.13 - Case management for Unrestricted Reports of sexual assault.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 32 National Defense 1 2013-07-01 2013-07-01 false Case management for Unrestricted Reports of sexual assault. 105.13 Section 105.13 National Defense Department of Defense OFFICE OF THE SECRETARY OF DEFENSE PERSONNEL, MILITARY AND CIVILIAN SEXUAL ASSAULT PREVENTION AND RESPONSE PROGRAM PROCEDURES § 105...

A False-Negative Case of Primary Central Nervous System Lymphoma on 11C-Methionine PET and Intense 18F-FDG Uptake.

PubMed

García-Garzon, J R; Villasboas-Rosciolesi, Diego; Baquero, Miguel; Bassa, Pere; Soler, Marina; Riera, Eduard

2016-08-01

We report a case of a 44-year-old man with neurological symptoms and MRI findings, which were unable to differentiate between glioma and lymphoma. Metabolic characterization by means of PET imaging with F-FDG and C-methionine is proposed to determine the benign or tumor (high- and low-grade) origin of brain lesions. In this case, the MRI lesion corresponded with an inconclusive metabolic pattern of intense F-FDG uptake and no significant C-methionine uptake. Pathological study revealed a false-negative case of C-methionine due to lymphoma.

Is it time to sound an alarm about false-positive cell-free DNA testing for fetal aneuploidy?

PubMed

Mennuti, Michael T; Cherry, Athena M; Morrissette, Jennifer J D; Dugoff, Lorraine

2013-11-01

Testing cell-free DNA (cfDNA) in maternal blood samples has been shown to have very high sensitivity for the detection of fetal aneuploidy with very low false-positive results in high-risk patients who undergo invasive prenatal diagnosis. Recent observation in clinical practice of several cases of positive cfDNA tests for trisomy 18 and trisomy 13, which were not confirmed by cytogenetic testing of the pregnancy, may reflect a limitation of the positive predictive value of this quantitative testing, particularly when it is used to detect rare aneuploidies. Analysis of a larger number of false-positive cases is needed to evaluate whether these observations reflect the positive predictive value that should be expected. Infrequently, mechanisms (such as low percentage mosaicism or confined placental mosaicism) might also lead to positive cfDNA testing that is not concordant with standard prenatal cytogenetic diagnosis. The need to explore these and other possible causes of false-positive cfDNA testing is exemplified by 2 of these cases. Additional evaluation of cfDNA testing in clinical practice and a mechanism for the systematic reporting of false-positive and false-negative cases will be important before this test is offered widely to the general population of low-risk obstetric patients. In the meantime, incorporating information about the positive predictive value in pretest counseling and in clinical laboratory reports is recommended. These experiences reinforce the importance of offering invasive testing to confirm cfDNA results before parental decision-making. Copyright © 2013 Mosby, Inc. All rights reserved.

p-hacking by post hoc selection with multiple opportunities: Detectability by skewness test?: Comment on Simonsohn, Nelson, and Simmons (2014).

PubMed

Ulrich, Rolf; Miller, Jeff

2015-12-01

Simonsohn, Nelson, and Simmons (2014) have suggested a novel test to detect p-hacking in research, that is, when researchers report excessive rates of "significant effects" that are truly false positives. Although this test is very useful for identifying true effects in some cases, it fails to identify false positives in several situations when researchers conduct multiple statistical tests (e.g., reporting the most significant result). In these cases, p-curves are right-skewed, thereby mimicking the existence of real effects even if no effect is actually present. (c) 2015 APA, all rights reserved).

False-positive buprenorphine EIA urine toxicology results due to high dose morphine: a case report.

PubMed

Tenore, Peter L

2012-01-01

In monitoring a patient with chronic pain who was taking high-dose morphine and oxycodone with weekly urine enzymatic immunoassay (EIA) toxicology testing, the authors noted consistent positives for buprenorphine. The patient was not taking buprenorphine, and gas chromatography/mass spectroscopy (GCMS) testing on multiple samples revealed no buprenorphine, indicating a case of false-positive buprenorphine EIAs in a high-dose opiate case. The authors discontinued oxycodone for a period of time and then discontinued morphine. Urine monitoring with EIAs and GCMS revealed false-positive buprenorphine EIAs, which remained only when the patient was taking morphine. When taking only oxycodone and no morphine, urine samples became buprenorphine negative. When morphine was reintroduced, false-positive buprenorphine results resumed. Medical practitioners should be aware that high-dose morphine (with morphine urine levels turning positive within the 15,000 to 28,000 mg/mL range) may produce false-positive buprenorphine EIAs with standard urine EIA toxicology testing.

A Study of False-Positive and False-Negative Error Rates in Cartridge Case Comparisons

DTIC Science & Technology

2014-04-07

materials for the study, in particular Vicki Sieve. 3 Abstract: This report provides the details for a study designed to...participate in ASCLD were provided with 15 sets of 3 known + 1 unknown cartridge cases fired from a collection of 25 new Ruger SR9 handguns . The...answer sheet allowing for the AFTE range of conclusions, and return shipping materials . They were also asked to assess how many of the 3 knowns were

Creating false memories for events that occurred before versus after the offset of childhood amnesia.

PubMed

Strange, Deryn; Wade, Kimberley; Hayne, Harlene

2008-01-01

We examined whether false images and memories for childhood events are more likely when the event supposedly took place during the period of childhood amnesia. Over three interviews, participants recalled six events: five true and one false. Some participants were told that the false event happened when they were 2 years old (Age 2 group), while others were told that it happened when they were 10 years old (Age 10 group). We compared participants' reports of the false event to their reports of a true event from the same age. Consistent with prior research on childhood amnesia, participants in the Age 10 group were more likely than participants in the Age 2 group to remember their true event and they reported more information about it. Participants in the Age 2 group, on the other hand, were more likely to develop false images and memories than participants in the Age 10 group. Furthermore, once a false image or memory developed, there were no age-related differences in the amount of information participants reported about the false event. We conclude that childhood amnesia increases our susceptibility to false suggestion, thus our results have implications for court cases where early memories are at issue.

28 CFR 90.67 - Grantee reporting.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 28 Judicial Administration 2 2010-07-01 2010-07-01 false Grantee reporting. 90.67 Section 90.67 Judicial Administration DEPARTMENT OF JUSTICE (CONTINUED) VIOLENCE AGAINST WOMEN Arrest Policies in Domestic Violence Cases § 90.67 Grantee reporting. Each grantee receiving funds under this subpart shall...

28 CFR 90.67 - Grantee reporting.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 28 Judicial Administration 2 2011-07-01 2011-07-01 false Grantee reporting. 90.67 Section 90.67 Judicial Administration DEPARTMENT OF JUSTICE (CONTINUED) VIOLENCE AGAINST WOMEN Arrest Policies in Domestic Violence Cases § 90.67 Grantee reporting. Each grantee receiving funds under this subpart shall...

[Evaluation of serum PIVKA-II by Lumipulse PrestoII assay].

PubMed

Hiramatsu, Kumiko; Tanaka, Yasuhito; Takagi, Kazumi; Kani, Satomi; Goto, Takaaki; Takasaka, Yoshimitsu; Matsuura, Kentaro; Sugauchi, Fuminaka; Moriyama, Kazushige; Murakami, Hiroshi; Kitajima, Sachiko; Mizokami, Masashi

2009-03-01

Measurements of serum concentrations of Des-gamma-carboxy Prothrombin (PIVKA-II) are widely used for diagnosing hepatocellular carcinoma (HCC). Recently, in Lumipulsef assay, it was reported that antibodies against alkaline phosphatase (ALP) derived from anti bleeding sheets led false high values of PIVKA-II in the patients with HCC resection. To improve the previous issue, newly developed Lumipulse PrestoII assay was examined. (1) The assay was reliable and positively correlated with the previous assays (Lumipulse f and Picolumi, R = 0.997 and 0.994 (n=115), respectively). (2) Eleven cases, which had false high values of PIVKA-II by the Lumipulsef assay, were examined by the PrestoII assay with excess of inactive ALP. The false high values of 10 cases were improved, but only one was still high. False reactivity of this case was stronger than other cases, more effective adsorption was required. (3) Comparing the absorbent activity of inactive ALP among 6 different kinds, we found inactive ALP with much higher adsorbent activity. When this inactive ALP was applied to assay, false high values of PIVKA-II were improved in all 11 cases. In conclusion, the PrestoII assay, which applies the inactive ALP with high activity, is reliable and useful for clinical screening.

Hiatal hernia uptake of iodine-131 mimicking mediastinal metastasis of papillary thyroid carcinoma.

PubMed

Haghighatafshar, Mahdi; Khajehrahimi, Farnaz

2015-01-01

There are a few case reports of hiatal hernia demonstrating thoracic uptake on I-131 scintigraphy. In this case, high thyroglobulin levels in combination with misinterpretation of I-131 uptake in the mediastinum, leaded to mismanagement of the patient. Here we present a case of focal I-131 uptake within a hiatal hernia initially mimicking an isolated mediastinal metastasis. There are many potential causes of false-positive I-131 scan result. In this case, adjunctive chest computed tomography and gastroesophageal barium study helped to elucidate the true nature of this I-131 uptake. False-positive findings may be caused by a wide variety of nonthyroidal carcinomas, which can concentrate radioiodine or from skin contamination. Several organs, such as the gastric, salivary glands, renal cyst, pericardial effusion, and ovarian can accumulate I-131. It should be borne in mind as a potential source of false-positive whole-body I-131 imaging.

Six consecutive false positive cases from cell-free fetal DNA testing in a single referring centre

PubMed Central

Dugo, Nella; Padula, Francesco; Mobili, Luisa; Brizzi, Cristiana; D’Emidio, Laura; Cignini, Pietro; Mesoraca, Alvaro; Bizzoco, Domenico; Cima, Antonella; Giorlandino, Claudio

2014-01-01

Introduction recent studies have proposed the introduction of cell-free fetal DNA testing (NIPT-Non Invasive Prenatal Testing) in routine clinical practice emphasizing its high sensibility and specificity. In any case, false positive and false negative findings may result from placental mosaicism, because cell-free fetal DNA originates mainly from placenta. Case we report six cases of women who underwent chorionic villus sampling (CVS) or amniocentesis to confirm the results from NIPT: two Turner syndromes, two Triple X, one Patau syndrome, one Edward syndrome. Results using classic cytogenetic analysis and, also, Array - Comparative Genomic Hybridization (Array CGH) the karyotype of all 5 fetuses was found to be normal. Conclusion results from NIPT must always be confirmed by invasive prenatal diagnosis. It is mandatory to inform the patient that the CVS and amniocentesis still represent the only form of prenatal diagnostic test available. PMID:25332757

Misalignment of disposable pulse oximeter probes results in false saturation readings that influence anesthetic management.

PubMed

Guan, Zhonghui; Baker, Keith; Sandberg, Warren S

2009-11-01

We report a small case series in which misaligned disposable pulse oximeter sensors gave falsely low saturation readings. In each instance, the sensor performed well during preinduction oxygen administration and the early part of the case, most notably by producing a plethysmographic trace rated as high quality by the oximeter software. The reported pulse oximeter oxygen saturation eventually decreased to concerning levels in each instance, but the anesthesiologists, relying on the reported high-quality signal, initially sought other causes for apparent hypoxia. They undertook maneuvers and diagnostic procedures later deemed unnecessary. When the malpositioned sensors were discovered and repositioned, the apparent hypoxia was quickly relieved in each case. We then undertook a survey of disposable oximeter sensors as patients entered the recovery room, and discovered malposition of more than 1 cm in approximately 20% of all sensors, without apparent consequence. We conclude that the technology is quite robust, but that the diagnosis of apparent hypoxia should include a quick check of oximeter position early on.

21 CFR 312.62 - Investigator recordkeeping and record retention.

Code of Federal Regulations, 2014 CFR

2014-04-01

... provide for disposition of the unused supplies of the drug under § 312.59. (b) Case histories. An... drug or employed as a control in the investigation. Case histories include the case report forms and... 21 Food and Drugs 5 2014-04-01 2014-04-01 false Investigator recordkeeping and record retention...

21 CFR 312.62 - Investigator recordkeeping and record retention.

Code of Federal Regulations, 2012 CFR

2012-04-01

... provide for disposition of the unused supplies of the drug under § 312.59. (b) Case histories. An... drug or employed as a control in the investigation. Case histories include the case report forms and... 21 Food and Drugs 5 2012-04-01 2012-04-01 false Investigator recordkeeping and record retention...

21 CFR 312.62 - Investigator recordkeeping and record retention.

Code of Federal Regulations, 2011 CFR

2011-04-01

... provide for disposition of the unused supplies of the drug under § 312.59. (b) Case histories. An... drug or employed as a control in the investigation. Case histories include the case report forms and... 21 Food and Drugs 5 2011-04-01 2011-04-01 false Investigator recordkeeping and record retention...

21 CFR 312.62 - Investigator recordkeeping and record retention.

Code of Federal Regulations, 2013 CFR

2013-04-01

... provide for disposition of the unused supplies of the drug under § 312.59. (b) Case histories. An... drug or employed as a control in the investigation. Case histories include the case report forms and... 21 Food and Drugs 5 2013-04-01 2013-04-01 false Investigator recordkeeping and record retention...

49 CFR 225.17 - Doubtful cases; alcohol or drug involvement.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 49 Transportation 4 2010-10-01 2010-10-01 false Doubtful cases; alcohol or drug involvement. 225..., AND INVESTIGATIONS § 225.17 Doubtful cases; alcohol or drug involvement. (a) The reporting officer of... the possible involvement of alcohol or drug use or impairment in such accident or incident. If the...

7 CFR 275.13 - Review of negative cases.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 7 Agriculture 4 2011-01-01 2011-01-01 false Review of negative cases. 275.13 Section 275.13... AGRICULTURE FOOD STAMP AND FOOD DISTRIBUTION PROGRAM PERFORMANCE REPORTING SYSTEM Quality Control (QC) Reviews § 275.13 Review of negative cases. (a) General. A sample of actions to deny applications, or suspend or...

25 CFR 20.516 - How are child abuse, neglect or exploitation cases to be handled?

Code of Federal Regulations, 2013 CFR

2013-04-01

... 25 Indians 1 2013-04-01 2013-04-01 false How are child abuse, neglect or exploitation cases to be... FINANCIAL ASSISTANCE AND SOCIAL SERVICES PROGRAMS Child Assistance Foster Care § 20.516 How are child abuse, neglect or exploitation cases to be handled? Reported child abuse, neglect or exploitation cases and the...

25 CFR 20.516 - How are child abuse, neglect or exploitation cases to be handled?

Code of Federal Regulations, 2014 CFR

2014-04-01

... 25 Indians 1 2014-04-01 2014-04-01 false How are child abuse, neglect or exploitation cases to be... FINANCIAL ASSISTANCE AND SOCIAL SERVICES PROGRAMS Child Assistance Foster Care § 20.516 How are child abuse, neglect or exploitation cases to be handled? Reported child abuse, neglect or exploitation cases and the...

25 CFR 20.516 - How are child abuse, neglect or exploitation cases to be handled?

Code of Federal Regulations, 2011 CFR

2011-04-01

... 25 Indians 1 2011-04-01 2011-04-01 false How are child abuse, neglect or exploitation cases to be... FINANCIAL ASSISTANCE AND SOCIAL SERVICES PROGRAMS Child Assistance Foster Care § 20.516 How are child abuse, neglect or exploitation cases to be handled? Reported child abuse, neglect or exploitation cases and the...

False-positive iodine-131 whole-body scan findings in patients with differentiated thyroid carcinoma: report of 11 cases and review of the literature.

PubMed

Buton, Leckzinscka; Morel, Olivier; Gault, Patricia; Illouz, Frédéric; Rodien, Patrice; Rohmer, Vincent

2013-07-01

Iodine-131 (I-131) whole-body scan (WBS) plays an important role in the management of patients with differentiated thyroid carcinoma (DTC), to detect normal thyroid remnants and recurrent or metastatic disease. A focus of I-131 accumulation outside the thyroid bed and the areas of physiological uptake is strongly suggestive of a distant functioning metastasis. However, many false-positive I-131 WBS findings have been reported in the literature. We describe a series of 11 personal cases of patients with DTC, collected from 1992 to 2011, in whom diagnostic or post-treatment WBS showed false-positive retention of I-131 in various locations. False-positive accumulations of I-131 on WBS may be classified according to the underlying pathophysiological mechanisms: external and internal contaminations by body secretions, ectopic normal thyroid and gastric tissues, inflammatory and infectious diseases, benign and malignant tumors, cysts and effusions of serous cavities, thymic uptake, and other non classified causes. Clinicians must be aware of possible false-positive findings to avoid misinterpretations of the I-131 WBS, which could lead to inappropriate treatments. Copyright © 2013 Elsevier Masson SAS. All rights reserved.

False elevation of carboxyhemoglobin: case report.

PubMed

Mehrotra, Shruti; Edmonds, Marcia; Lim, Rodrick K

2011-02-01

Carbon monoxide toxicity in infants and children, like adults, produce nonspecific symptoms with normal vital signs necessitating the serum measurement of carboxyhemoglobin (COHb). In infants, the COHb may be falsely elevated. Our goal was to report a case of suspected carbon monoxide toxicity in an infant and the likely cause of the falsely elevated serum COHb. A previously healthy 3-month-old girl presented to the pediatric emergency department (ED) with smoke inhalation from a defective furnace. She was asymptomatic. On examination, she was alert, with Glasgow Coma Scale of 15 and normal vital signs. Cardiorespiratory and neurological examinations were completely normal. Because of concern regarding carbon monoxide poisoning, she was treated with normobaric oxygen therapy. Initial and subsequent serum COHb levels were persistently elevated, despite treatment and the infant appearing clinically well. As such, she had a prolonged stay in the ED. Further investigations found that fetal hemoglobin interferes with the spectrophotometric method used to analyze serum COHb levels. Carboxyhemoglobin serum level, in infants, may be falsely elevated due to the fetal hemoglobin interfering with standard methods of analysis. Knowledge of the false elevation using standard spectrophotometric methods of COHb in clinically well-appearing infants can decrease unnecessary oxygen therapy and monitoring time in the ED.

Investigation into High Barmah Forest Virus Disease Case Numbers Reported in the Northern Territory, Australia in 2012-2013.

PubMed

Kurucz, Nina; Markey, Peter; Draper, Anthony; Melville, Lorna; Weir, Richard; Davis, Steven; Warchot, Allan; Boyd, Rowena; Stokeld, Danielle

2016-02-01

Between October 2012 and October 2013, unprecedented high numbers of Barmah Forest virus (BFV) disease cases were reported in the Northern Territory (NT). An investigation was launched by the NT Department of Health in cooperation with the Department of Primary Industry and Fisheries and the Department of Land Resource Management to investigate possible causes for this phenomenon. The investigation included virus isolations from mosquitoes collected in Darwin urban areas, BFV antibody testing in peri-urban small mammals and a human BFV disease case series investigation of recent cases. No BFV was isolated from the 4641 mosquitoes tested, none of the mammals tested positive for BFV antibodies, and the high BFV disease case numbers did not correlate with the relatively low mosquito vector numbers trapped in 2012-2013. It was estimated that up to 89% of the 79 human cases investigated did not have an acute arboviral illness and therefore had tested falsely positive. An Alere PanBio BFV immunoglobulin M enzyme-linked immunosorbent assay test kit is generally used to test for BFV, with the BFV disease case definition based on immunoglobulin M positives only. Other jurisdictions in Australia also reported high numbers of BFV disease cases, with the majority of the cases suspected to be false positives. Therefore, current testing methods need to be revised to reflect the true numbers of BFV disease cases occurring in Australia and to provide correct diagnoses for patients.

49 CFR 230.22 - Accident reports.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 49 Transportation 4 2011-10-01 2011-10-01 false Accident reports. 230.22 Section 230.22... Requirements § 230.22 Accident reports. In the case of an accident due to failure, from any cause, of a steam... persons, the railroad on whose line the accident occurred shall immediately make a telephone report of the...

49 CFR 230.22 - Accident reports.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 49 Transportation 4 2010-10-01 2010-10-01 false Accident reports. 230.22 Section 230.22... Requirements § 230.22 Accident reports. In the case of an accident due to failure, from any cause, of a steam... persons, the railroad on whose line the accident occurred shall immediately make a telephone report of the...

32 CFR 644.356 - Report on Government title.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 32 National Defense 4 2013-07-01 2013-07-01 false Report on Government title. 644.356 Section 644... General Services Administration (gsa) § 644.356 Report on Government title. In all cases where Government... thereof), a report prepared by a qualified employee of the holding agency on the Government's title to the...

45 CFR 98.71 - Content of reports.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 45 Public Welfare 1 2014-10-01 2014-10-01 false Content of reports. 98.71 Section 98.71 Public Welfare Department of Health and Human Services GENERAL ADMINISTRATION CHILD CARE AND DEVELOPMENT FUND Program Reporting Requirements § 98.71 Content of reports. (a) At a minimum, a State or territorial Lead Agency's quarterly case-level report to the...

Fetal sex chromosome testing by maternal plasma DNA sequencing: clinical laboratory experience and biology.

PubMed

Bianchi, Diana W; Parsa, Saba; Bhatt, Sucheta; Halks-Miller, Meredith; Kurtzman, Kathryn; Sehnert, Amy J; Swanson, Amy

2015-02-01

To describe the clinical experience with noninvasive prenatal testing for fetal sex chromosomes using sequencing of maternal plasma cell-free DNA in a commercial laboratory. A noninvasive prenatal testing laboratory data set was examined for samples in which fetal sex chromosomes were reported. Available clinical outcomes were reviewed. Of 18,161 samples with sex chromosome results, no sex chromosome aneuploidy was detected in 98.9% and the fetal sex was reported as XY (9,236) or XX (8,721). In 4 of 32 cases in which the fetal sex was reportedly discordant between noninvasive prenatal testing and karyotype or ultrasonogram, a potential biological reason for the discordance exists, including two cases of documented co-twin demise, one case of a maternal kidney transplant from a male donor, and one case of fetal ambiguous genitalia. In the remaining 204 samples (1.1%), one of four sex chromosome aneuploidies (monosomy X, XXX, XXY, or XYY) was detected. The frequency of false positive results for sex chromosome aneuploidies is a minimum of 0.26% and a maximum of 1.05%. All but one of the discordant sex chromosome aneuploidy results involved the X chromosome. In two putative false-positive XXX cases, maternal XXX was confirmed by karyotype. For the false-positive cases, mean maternal age was significantly higher in monosomy X (P<.001) and lower in XXX (P=.008). Noninvasive prenatal testing results for sex chromosome aneuploidy can be confounded by maternal or fetal biological phenomena. When a discordant noninvasive prenatal testing result is encountered, resolution requires additional maternal history, detailed fetal ultrasonography, and determination of fetal and possibly maternal karyotypes.

Penile abscess and necrotizing fasciitis secondary to neglected false penile fracture

PubMed Central

Al-Reshaid, Reshaid Abdullah; Madbouly, Khaled; Al-Jasser, Abdullah

2010-01-01

Penile infection and abscess formation have been described in association with priapism, cavernosography, intracavernosal injection therapy, trauma and penile prosthesis. We report a case of penile abscess and necrotizing fasciitis of penile skin in a 37-year-old male, presented 3 weeks after neglected false penile fracture. PMID:20882163

False memories, negative affects, and psychic reality: the role of extra-clinical data in psychoanalysis.

PubMed

Good, Michael I; Dayand, Max; Rowell, Eve

2005-12-01

Psychoanalysis as a treatment originated in the idea that neurosis is related to the ways in which individual psychic reality departs from actuality. Psychic reality includes memories, beliefs and their associated affects and fantasies connected with an individual's experience of the inner and outer world. The psychoanalytic determination of what meaningful memories or beliefs are inaccurate, distorted or false ordinarily relies upon principles of intra-clinical validation. By itself, however, intra-clinical validation is subject to limitations and pitfalls that conviction alone about what is actual cannot circumvent. Despite this fact, there are remarkably few analytic case reports demonstrating false or significantly distorted memories through the use of data obtained from outside the consulting room. This paucity of reports may be related, at least in part, to the belief that the use of extra-clinical data is essentially unanalytic or supports resistance. Based on the views that (a) psychic reality cannot be regarded as exclusively subjective or objective but is inherently both; and that (b) a goal of analysis is to achieve a different, acceptable and more accurate view of reality, the authors report a clinical case involving a confirmably false pivotal memory and its associated negative affects. They discuss theoretical and technical considerations in utilizing extra-clinical data during the treatment process.

Evaluation of usefulness of fine-needle aspiration cytology in the diagnosis of tumours of the accessory parotid gland: a preliminary analysis of a case series in Japan.

PubMed

Iguchi, Hiroyoshi; Wada, Tadashi; Matsushita, Naoki; Oishi, Masahiro; Teranishi, Yuichi; Yamane, Hideo

2014-07-01

The accuracy and sensitivity of fine-needle aspiration cytology (FNAC) in this analysis were not satisfactory, and the false-negative rate seemed to be higher than for parotid tumours. The possibility of low-grade malignancy should be considered in the surgical treatment of accessory parotid gland (APG) tumours, even if the preoperative results of FNAC suggest that the tumour is benign. Little is known about the usefulness of FNAC in the preoperative evaluation of APG tumours, probably due to the paucity of APG tumour cases. We examined the usefulness of FNAC in the detection of malignant APG tumours. We conducted a retrospective analysis of 3 cases from our hospital, along with 18 previously reported Japanese cases. We compared the preoperative FNAC results with postoperative histopathological diagnoses of APG tumours and evaluated the accuracy, sensitivity, specificity and false-negative rates of FNAC in detecting malignant APG tumours. There were four false-negative cases (19.0%), three of mucoepidermoid carcinomas and one of malignant lymphoma. One false-positive result was noted in the case of a myoepithelioma, which was cytologically diagnosed as suspected adenoid cystic carcinoma. The accuracy, sensitivity and specificity of FNAC in detecting malignant tumours were 76.2%, 60.0% and 90.9%, respectively.

False-positive psychology: undisclosed flexibility in data collection and analysis allows presenting anything as significant.

PubMed

Simmons, Joseph P; Nelson, Leif D; Simonsohn, Uri

2011-11-01

In this article, we accomplish two things. First, we show that despite empirical psychologists' nominal endorsement of a low rate of false-positive findings (≤ .05), flexibility in data collection, analysis, and reporting dramatically increases actual false-positive rates. In many cases, a researcher is more likely to falsely find evidence that an effect exists than to correctly find evidence that it does not. We present computer simulations and a pair of actual experiments that demonstrate how unacceptably easy it is to accumulate (and report) statistically significant evidence for a false hypothesis. Second, we suggest a simple, low-cost, and straightforwardly effective disclosure-based solution to this problem. The solution involves six concrete requirements for authors and four guidelines for reviewers, all of which impose a minimal burden on the publication process.

22 CFR 72.5 - Final report of death.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 22 Foreign Relations 1 2010-04-01 2010-04-01 false Final report of death. 72.5 Section 72.5... DEATHS AND ESTATES Reporting Deaths of United States Nationals § 72.5 Final report of death. (a) Preparation. Except in the case of the death of an active duty member of the United States Armed Forces, when...

22 CFR 72.5 - Final report of death.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 22 Foreign Relations 1 2014-04-01 2014-04-01 false Final report of death. 72.5 Section 72.5... DEATHS AND ESTATES Reporting Deaths of United States Nationals § 72.5 Final report of death. (a) Preparation. Except in the case of the death of an active duty member of the United States Armed Forces, when...

22 CFR 72.5 - Final report of death.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 22 Foreign Relations 1 2013-04-01 2013-04-01 false Final report of death. 72.5 Section 72.5... DEATHS AND ESTATES Reporting Deaths of United States Nationals § 72.5 Final report of death. (a) Preparation. Except in the case of the death of an active duty member of the United States Armed Forces, when...

22 CFR 72.5 - Final report of death.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 22 Foreign Relations 1 2011-04-01 2011-04-01 false Final report of death. 72.5 Section 72.5... DEATHS AND ESTATES Reporting Deaths of United States Nationals § 72.5 Final report of death. (a) Preparation. Except in the case of the death of an active duty member of the United States Armed Forces, when...

22 CFR 72.5 - Final report of death.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 22 Foreign Relations 1 2012-04-01 2012-04-01 false Final report of death. 72.5 Section 72.5... DEATHS AND ESTATES Reporting Deaths of United States Nationals § 72.5 Final report of death. (a) Preparation. Except in the case of the death of an active duty member of the United States Armed Forces, when...

Interpretation of Negative Molecular Test Results in Patients With Suspected or Confirmed Ebola Virus Disease: Report of Two Cases.

PubMed

Edwards, Jeffrey K; Kleine, Christian; Munster, Vincent; Giuliani, Ruggero; Massaquoi, Moses; Sprecher, Armand; Chertow, Daniel S

2015-12-01

Quantitative reverse-transcription polymerase chain reaction (qRT-PCR) is the most sensitive quantitative diagnostic assay for detection of Ebola virus in multiple body fluids. Despite the strengths of this assay, we present 2 cases of Ebola virus disease (EVD) and highlight the potential for false-negative results during the early and late stages of EVD. The first case emphasizes the low negative-predictive value of qRT-PCR during incubation and the early febrile stage of EVD, and the second case emphasizes the potential for false-negative results during recovery and late neurologic complications of EVD. Careful interpretation of test results are needed to guide difficult admission and discharge decisions in suspected or confirmed EVD.

Case report of an unusual combination of purulent pericarditis and false aneurysm of the ascending aorta.

PubMed

Meier, David; Kirsch, Matthias; Qanadli, Salah Dine; Muller, Olivier; Fishman, Daniel; Trana, Catalina

2018-01-29

Purulent pericarditis is an uncommon entity, which is, in very rare cases, associated to infection of the aorta. We present the case of a 42-year-old male patient, who was admitted to hospital complaining of tiredness, diarrhea and leg edema. Clinical examination revealed a hypotensive and obviously shocked patient. He was ultimately diagnosed with a rare combination of purulent pericarditis followed by false aneurysm of the ascending aorta. He was successfully treated by surgical pericardial drainage, replacement of the ascending aorta and antibiotics. Mycotic aneurysms can rarely be associated with purulent pericarditis. Our literature review shows that there are two mechanisms explaining this association and that in most of the published cases infective endocarditis could not be demonstrated.

10 CFR 37.57 - Reporting of events.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 10 Energy 1 2014-01-01 2014-01-01 false Reporting of events. 37.57 Section 37.57 Energy NUCLEAR... Physical Protection Requirements During Use § 37.57 Reporting of events. (a) The licensee shall immediately... response to the event, the licensee shall notify the NRC's Operations Center (301-816-5100). In no case...

18 CFR 401.76 - Failure to furnish report.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 18 Conservation of Power and Water Resources 2 2012-04-01 2012-04-01 false Failure to furnish report. 401.76 Section 401.76 Conservation of Power and Water Resources DELAWARE RIVER BASIN COMMISSION... Director in Water Qualtity Cases § 401.76 Failure to furnish report. The Executive Director may, upon five...

18 CFR 401.76 - Failure to furnish report.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 18 Conservation of Power and Water Resources 2 2014-04-01 2014-04-01 false Failure to furnish report. 401.76 Section 401.76 Conservation of Power and Water Resources DELAWARE RIVER BASIN COMMISSION... Director in Water Qualtity Cases § 401.76 Failure to furnish report. The Executive Director may, upon five...

18 CFR 401.76 - Failure to furnish report.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 18 Conservation of Power and Water Resources 2 2010-04-01 2010-04-01 false Failure to furnish report. 401.76 Section 401.76 Conservation of Power and Water Resources DELAWARE RIVER BASIN COMMISSION... Director in Water Qualtity Cases § 401.76 Failure to furnish report. The Executive Director may, upon five...

Treatment of a Persistent False Lumen with Aneurysm Formation Following Surgical Repair of Type A Dissection

DOE Office of Scientific and Technical Information (OSTI.GOV)

Jeganathan, Reubendra, E-mail: reubenj@hotmail.com; Kennedy, Peter; MacGowan, Simon

2007-06-15

We describe the case of a 68-year-old man who developed aneurysmal dilatation of the proximal descending thoracic aorta 8 years after repair of a type A dissection. The aneurysm was due to an anastomotic leak at the distal end of the previous repair in the ascending aorta with antegrade perfusion of the false lumen. Surgical repair of the anastomotic leak partially obliterated the false lumen and computed tomography scan demonstrated thrombosis in a large proportion of the false lumen aneurysm. Follow-up with surveillance scans showed persistent filling of this aneurysm due to retrograde flow of blood within the false lumen.more » Coil embolization of the false lumen within the thoracic aorta was performed which successfully thrombosed the aneurysm with a reduction in diameter. Late aneurysm formation may complicate type A dissection repairs during follow-up due to a persistent false lumen, especially if there is an anastomotic leak. This case report describes a strategy to deal with this difficult clinical problem.« less

False-positive diagnosis of disease progression by magnetic resonance imaging for response assessment in prostate cancer with bone metastases: A case report and review of the pitfalls of images in the literature

PubMed Central

YU, YI-SHAN; LI, WAN-HU; LI, MING-HUAN; MENG, XUE; KONG, LI; YU, JIN-MING

2015-01-01

Bone metastases are common in prostate cancer. However, differentiating neoplastic from non-neoplastic alterations of bone on images is challenging. In the present report, a rare case of bone marrow reconversion on magnetic resonance imaging (MRI) assessment, which may lead to a false-positive diagnosis of disease progression of bone metastases in hormone-resistant prostate cancer, is presented. Furthermore, a review of the literature regarding the pitfalls of images for response assessment, including the ‘flare’ phenomenon on bone scintigraphy, computed tomography (CT), positron emission tomography/CT and marrow reconversion on MRI is also provided. These inaccuracies, which may lead to a premature termination of an efficacious treatment, should be carefully considered by the radiologists and oncologists involved in clinical trials. The case reported in the present study showed how to assess the early therapeutic response and select the appropriate treatment for the patient when these pitfalls are encountered on clinical images. PMID:26788174

[False traumatic aneurysm of the ulnar artery in a teenager].

PubMed

Nour, M; Talha, H; El Idrissi, R; Lahraoui, Y; Ouazzani, L; Oubejja, H; Erraji, M; Zerhouni, H; Ettayebi, F

2014-12-01

Most aneurysms of hand arteries are traumatic. It is a generally rare unrecognized pathology. Complications are serious (embolism and thromboses of interdigital arteries). Two main causes can be recalled: acute trauma, with development of a false aneurysm; repeated microtrauma (hand hammer syndrome), with occurrence of an arterial dysplasic aneurysm. The diagnosis is based on the presence of a pulsatile mass, with finger dysesthesia, unilateral Raynaud's phenomenon. It is confirmed by duplex Doppler. Arteriography is necessary but can be replaced by an angio-MR. We report a case of false traumatic aneurysm of the ulnar artery in a teenager. This case illustrates this rare condition and opens discussion on therapeutic options. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

[False aneurysm of the lateral superior genicular artery. A complication after the implantation of a knee prosthesis].

PubMed

Kirschner, S; Konrad, T; Weil, E J; Bühler, M

2004-07-01

Arterial complications after total knee arthroplasty are rare. If the formation of a false aneurysm does occur, it usually affects the popliteal artery. We report the case of an 77 year old female with a false aneurysm of the lateral superior genicular artery. The patient was suffering from gonarthrosis and received a duocondylar knee replacement without resurfacing of the patella. Postoperatively, she reported anterior knee pain and a revision of the joint with lateral release was carried out. In the third postoperative week, a painful swelling in the lateral and superior aspect of the knee occurred. A scintigraphic investigation with enrichment in the early period was misinterpreted as infection. Ultrasonographic and angiographic investigations gave the right diagnosis of a false aneurysm. In the same angiographic investigation, the aneurysm could be cured by coil embolisation. The interval between the operation leading to the problem and the formation of the aneurysm, as well as the low incidence of this complication, made it hard to diagnose. Ultrasonographic and angiographic examinations allow for proper diagnosis in cases of unclear painful swellings. When dealing with an arterial complication following total knee arthroplasty, a specialized radiologist or vascular surgeon should be consulted immediately.

40 CFR 205.160-5 - Reporting of the test results.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 40 Protection of Environment 25 2014-07-01 2014-07-01 false Reporting of the test results. 205.160... test results. (a)(1) The manufacturer must submit a copy of the test report for all testing conducted...; (iii) Vehicle serial number; and (iv) Test results by serial numbers. (b) In the case where an EPA...

40 CFR 205.160-5 - Reporting of the test results.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 40 Protection of Environment 26 2013-07-01 2013-07-01 false Reporting of the test results. 205.160... test results. (a)(1) The manufacturer must submit a copy of the test report for all testing conducted...; (iii) Vehicle serial number; and (iv) Test results by serial numbers. (b) In the case where an EPA...

40 CFR 205.160-5 - Reporting of the test results.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 40 Protection of Environment 24 2010-07-01 2010-07-01 false Reporting of the test results. 205.160... test results. (a)(1) The manufacturer must submit a copy of the test report for all testing conducted...; (iii) Vehicle serial number; and (iv) Test results by serial numbers. (b) In the case where an EPA...

40 CFR 205.160-5 - Reporting of the test results.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 40 Protection of Environment 25 2011-07-01 2011-07-01 false Reporting of the test results. 205.160... test results. (a)(1) The manufacturer must submit a copy of the test report for all testing conducted...; (iii) Vehicle serial number; and (iv) Test results by serial numbers. (b) In the case where an EPA...

A Case Report of Salmonella muenchen Enteritis Causing Rhabdomyolysis and Myocarditis in a Previously Healthy 26-Year-Old Man.

PubMed

Chapple, Will; Martell, Jon; Wilson, Joy S; Matsuura, Don T

2017-04-01

This case report examines an unusual presentation of a non-typhoidal Salmonella serovar with limited prevalence in the literature. This is the first case report to associate specifically the Salmonella muenchen serovar with rhabdomyolysis and myocarditis. This case report reviews the diagnostic criteria for myocarditis and explores the diagnostic dilemma of troponin elevation in the setting of rhabdomyolysis. It demonstrates that Salmonella muenchen has the ability to present in a broad range of individuals with complications extending beyond classical gastrointestinal symptoms. This report also concludes that diagnosis of the many possible complications from non-typhoidal Salmonella infections can be difficult due to patient comorbidities, variability in the severity of the illnesses, laboratory test limitations, and imaging limitations. When a patient presents with elevated troponins in the setting of rhabdomyolysis a careful workup should be done to evaluate for ischemic causes, myocarditis, or false elevation secondary to rhabdomyolysis.

Minimizing false positive error with multiple performance validity tests: response to Bilder, Sugar, and Hellemann (2014 this issue).

PubMed

Larrabee, Glenn J

2014-01-01

Bilder, Sugar, and Hellemann (2014 this issue) contend that empirical support is lacking for use of multiple performance validity tests (PVTs) in evaluation of the individual case, differing from the conclusions of Davis and Millis (2014), and Larrabee (2014), who found no substantial increase in false positive rates using a criterion of failure of ≥ 2 PVTs and/or Symptom Validity Tests (SVTs) out of multiple tests administered. Reconsideration of data presented in Larrabee (2014) supports a criterion of ≥ 2 out of up to 7 PVTs/SVTs, as keeping false positive rates close to and in most cases below 10% in cases with bona fide neurologic, psychiatric, and developmental disorders. Strategies to minimize risk of false positive error are discussed, including (1) adjusting individual PVT cutoffs or criterion for number of PVTs failed, for examinees who have clinical histories placing them at risk for false positive identification (e.g., severe TBI, schizophrenia), (2) using the history of the individual case to rule out conditions known to result in false positive errors, (3) using normal performance in domains mimicked by PVTs to show that sufficient native ability exists for valid performance on the PVT(s) that have been failed, and (4) recognizing that as the number of PVTs/SVTs failed increases, the likelihood of valid clinical presentation decreases, with a corresponding increase in the likelihood of invalid test performance and symptom report.

Is there a false memory syndrome? A review of three cases.

PubMed

Kaplan, R; Manicavasagar, V

2001-01-01

The controversy over recovered memories of childhood sexual abuse (CSA) is whether such experiences can be forgotten for long periods and retrieved later in therapy or in response to cues or triggers from the environment. False memory syndrome (FMS) is caused by memories of a traumatic experience--most frequently CSA--which are objectively false, but in which the person strongly believes. Personality factors often play a role in the development of FMS. Because CSA is such a devastating experience, false accusations of sexual abuse have enormous, if not shattering, consequences for families. We present three case reports to illustrate features of the FMS. FMS should be listed for further study to establish valid criteria for making the diagnosis under the category of "factitious disorders," and a subcategory of "false memories/beliefs of abuse," with a further subdivision of "induced by therapy." The FMS controversy occurred in the context of a general moral panic about sexual abuse in the early 1980s. Psychiatrists should have a high degree of scepticism to moral panics.

32 CFR 516.64 - Comprehensive remedies plan.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 32 National Defense 3 2013-07-01 2013-07-01 false Comprehensive remedies plan. 516.64 Section 516.64 National Defense Department of Defense (Continued) DEPARTMENT OF THE ARMY AID OF CIVIL AUTHORITIES... plans should be forwarded with the DFARS 209.406-3 reports. In no case, however, should the report be...

32 CFR 516.64 - Comprehensive remedies plan.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 32 National Defense 3 2014-07-01 2014-07-01 false Comprehensive remedies plan. 516.64 Section 516.64 National Defense Department of Defense (Continued) DEPARTMENT OF THE ARMY AID OF CIVIL AUTHORITIES... plans should be forwarded with the DFARS 209.406-3 reports. In no case, however, should the report be...

Influencing clinicians and healthcare managers: can ROC be more persuasive?

NASA Astrophysics Data System (ADS)

Taylor-Phillips, S.; Wallis, M. G.; Duncan, A.; Gale, A. G.

2010-02-01

Receiver Operating Characteristic analysis provides a reliable and cost effective performance measurement tool, without using full clinical trials. However, when ROC analysis shows that performance is statistically superior in one condition than another it is difficult to relate this result to effects in practice, or even to determine whether it is clinically significant. In this paper we present two concurrent analyses: using ROC methods alongside single threshold recall rate data, and suggest that reporting both provides complimentary data. Four mammographers read 160 difficult cases (41% malignant) twice, with and without prior mammograms. Lesion location and probability of malignancy was reported for each case and analyzed using JAFROC. Concurrently each participant chose recall or return to screen for each case. JAFROC analysis showed that the presence of prior mammograms improved performance (p<.05). Single threshold data showed a trend towards a 26% increase in the number of false positive recalls without prior mammograms (p=.056). If this trend were present throughout the NHS Breast Screening Programme then discarding prior mammograms would correspond to an increase in recall rate from 4.6% to 5.3%, and 12,414 extra women recalled annually for assessment. Whilst ROC methods account for all possible thresholds of recall and have higher power, providing a single threshold example of false positive, false negative, and recall rates when reporting results could be more influential for clinicians. This paper discusses whether this is a useful additional method of presenting data, or whether it is misleading and inaccurate.

False-positive liver scan in a patient with hepatic amyloidosis: case report

DOE Office of Scientific and Technical Information (OSTI.GOV)

Suzuki, K.; Okuda, K.; Yoshida, T.

1976-01-01

A case of secondary hepatic amyloidosis exhibiting a large liver and multiple defects on the $sup 198$Au-radiocolloid scintigraph is presented. Biopsy and angiographic studies indicated that the areas of reduced colloid uptake represented heavy amyloid deposition, and the area of the left lobe with contrasting high activity most probably represented compensatory hypertrophy. (auth)

Case report of a false positive result of the Xpert® MTB/RIF assay for rifampicin resistance in Mycobacterium tuberculosis complex.

PubMed

Claessens, Jolien; Mathys, Vanessa; Derdelinckx, Inge; Saegeman, Veroniek

2017-06-01

In the present case, we report a false positive result for the detection of rifampicin (RIF) resistance by the Xpert ® MTB/RIF assay, version G4.Miliary Mycobacterium tuberculosis infection (miliary TB) was suspected in a 50-year old Angolan woman. Imaging of the thorax and abdomen displayed diffuse lesions. The Xpert ® MTB/RIF assay conducted on the broncho-alveolar lavage (BAL) fluid was positive for TB and positive for RIF resistance. Confirmatory molecular tests and the phenotypic drug susceptibility determination supported the diagnosis of TB but not RIF resistance. The patient was treated successfully with a conventional therapeutic scheme. Because, the Xpert ® MTB/RIF assay allows the simultaneous detection of TB and RIF resistance, the World Health Organisation (WHO) recommends its use as initial diagnostic test, over microscopy, culture and phenotypic drug susceptibility testing. Even though specificity of the Xpert ® MTB/RIF assay version G4 is high, false positive test results remain possible and have to be considered for the interpretation of the RIF resistance detection by Xpert ® MTB/RIF assay.

Hypertensive emergency masquerading as phaeochromocytoma: a report of two cases.

PubMed

Hulkower, Raphael; Gubbi, Sriram; Meholli, Mimoza; Schubart, Ulrich

2017-08-07

We report two cases of patients who were hospitalised for hypertensive emergency. In both cases, laboratory testing during admission revealed elevated normetanephrines in the range of 4-5 times the upper limit of normal using liquid chromatography with mass spectrometry. Imaging studies did not localise any phaeochromocytoma or paraganglioma (PPGL). Repeat biochemical testing after discharge was within normal limits in both cases. These observations suggest that hypertensive emergency should be recognised as a potential cause of 'false-positive' laboratory findings in the diagnostic assessment for PPGL. © BMJ Publishing Group Ltd (unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Creatinine elevation associated with nitromethane exposure: a marker of potential methanol toxicity.

PubMed

Cook, Matthew D; Clark, Richard F

2007-10-01

Nitromethane, methanol, and oil are the common components of radio-controlled (R/C) vehicle fuels. Nitromethane can cause a false elevation of serum creatinine concentration as measured by the widely used Jaffe colorimetric method. We gathered data from our poison control system and from previously published case reports to see if a correlation exists between serum methanol concentrations and spuriously elevated serum creatinine concentrations after human exposures to R/C fuel. The California Poison Control System (CPCS) computerized database was queried for all cases of human exposure to R/C vehicle fuel reported between December 1, 2002 and December 1, 2004. Serum creatinine and methanol concentrations were recorded when available, as was the method used to determine serum creatinine. A MEDLINE search was used to obtain previously published cases of human nitromethane exposure associated with falsely elevated creatinine concentrations. During the 2-year period, serum creatinine concentrations were recorded in 7 of 26 R/C fuel exposures (all ingestions), and 6 of these were abnormal (range of 1.9-11.5 mg/dL). In this series, the higher the serum creatinine concentration measured by Jaffe method, the higher the serum methanol concentration. The MEDLINE search yielded data from six previously published case reports on this topic. The data from these case reports seem to follow the trend seen in our case series. These data suggest that a spuriously elevated serum creatinine (by Jaffe method) may have value as an early surrogate marker of methanol poisoning in those who ingest R/C fuel. Also, the degree to which the serum creatinine is elevated may indicate the severity of methanol poisoning.

Restricting the Time of Injury in Fatal Inflicted Head Injuries.

ERIC Educational Resources Information Center

Willman, Kristal Y.; Bank, David E.; Scenic, Melvin; Catwalk, David L.

1997-01-01

Review of the cases of 95 fatal head injuries in children found that brain swelling could be detected as early as 1 hour 17 minutes postinjury using computerized topography scans. Results also suggested that a reported history of a lucid interval in a case not involving an epidural hematoma is likely to be false and the injury probably inflicted.…

77 FR 30904 - Connect America Fund; A National Broadband Plan for Our Future; Establishing Just and Reasonable...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-05-24

... reporting requirements amount to a scatter-shot data collection effort--in many cases with no potential to... competitive ETCs are required to offer voice service throughout the designated study area, and the Commission... period of time is necessary for purposes of litigation under False Claims Act cases. Thus, we decline to...

Medico-legal implications of mobbing. A false accusation of psychological harassment at the workplace.

PubMed

Jarreta, Begoña Martínez; García-Campayo, Javier; Gascón, Santiago; Bolea, Miguel

2004-12-02

Mobbing, or psychological harassment at the workplace, is usually defined as a situation in which a person or a group of people engage in extreme psychological violence against another person. In Spain, the number of reports for mobbing has increased extraordinarily in the last years. The reports are increasing dramatically not only before the Labour Courts, but also before the Civil Courts, with claims for damages, and before the Penal Court for offences causing physical or moral injury, etc., since at the present time this figure is not typified as an offence in the Spanish Penal Code. The high degree of complexity of this situation has given rise to frequent misuse of the term and to a number of false accusations of mobbing. A recent European Parliament Resolution on harassment at the workplace addressed the devastating consequences of false accusations. In this paper we present a case in which the "false" victim was mentally ill (paranoia) but succeed in generating an extreme dangerous environment of great harassment against the "false" assailants that were "falsely" accused of mobbing. Forensic diagnosis of the psychiatric disorder suffered by the "false" victim was essential to clarify the issue at the Penal Court.

7 CFR 792.20 - Reporting discharged debts to IRS.

Code of Federal Regulations, 2010 CFR

2010-01-01

... Government's ability to prove its case in court for the full amount of the debt. (2) The amount of a debt... 7 Agriculture 7 2010-01-01 2010-01-01 false Reporting discharged debts to IRS. 792.20 Section 792..., DEPARTMENT OF AGRICULTURE PROVISIONS COMMON TO MORE THAN ONE PROGRAM DEBT SETTLEMENT POLICIES AND PROCEDURES...

False fracture of the penis.

PubMed

Shah, Darshan K; Paul, Elliot M; Meyersfield, Sanford A; Schoor, Richard A

2003-06-01

Penile fracture is an uncommon, but well-described, entity that requires emergent treatment. The classic, "text-book" history, a blow to the erect penis accompanied by a "snap," pain, and immediate detumescence, is not universally present. We report 2 cases of "false" penile fracture, a condition that closely mimics "true" penile fracture. Perhaps the most distinguishing symptoms are the absence of the "snap" and gradual detumescence, both of which suggest false fracture but are not specific. It is our intention to bring this condition to the attention of general urologists who may see it in clinical practice and to guide them in its management.

Intention, false beliefs, and delusional jealousy: insights into the right hemisphere from neurological patients and neuroimaging studies.

PubMed

Ortigue, Stephanie; Bianchi-Demicheli, Francesco

2011-01-01

Jealousy sits high atop of a list comprised of the most human emotional experiences, although its nature, rationale, and origin are poorly understood. In the past decade, a series of neurological case reports and neuroimaging findings have been particularly helpful in piecing together jealousy's puzzle. In order to understand and quantify the neurological factors that might be important in jealousy, we reviewed the current literature in this specific field. We made an electronic search, and examined all literature with at least an English abstract, through Mars 2010. The search identified a total of 20 neurological patients, who experienced jealousy in relation with a neurological disorder; and 22 healthy individuals, who experienced jealousy under experimental neuroimaging settings. Most of the clinical cases of reported jealousy after a stroke had delusional-type jealousy. Right hemispheric stroke was the most frequently reported neurological disorder in these patients, although there was a wide range of more diffuse neurological disorders that may be reported to be associated with different other types of jealousy. This is in line with recent neuroimaging data on false beliefs, moral judgments, and intention [mis]understanding. Together the present findings provide physicians and psychologists with a potential for high impact in understanding the neural mechanisms and treatment of jealousy. By combining findings from case reports and neuroimaging data, the present article allows for a novel and unique perspective, and explores new directions into the neurological jealous mind.

Intention, false beliefs, and delusional jealousy: Insights into the right hemisphere from neurological patients and neuroimaging studies

PubMed Central

Ortigue, Stephanie; Bianchi-Demicheli, Francesco

2011-01-01

Summary Jealousy sits high atop of a list comprised of the most human emotional experiences, although its nature, rationale, and origin are poorly understood. In the past decade, a series of neurological case reports and neuroimaging findings have been particularly helpful in piecing together jealousy’s puzzle. In order to understand and quantify the neurological factors that might be important in jealousy, we reviewed the current literature in this specific field. We made an electronic search, and examined all literature with at least an English abstract, through Mars 2010. The search identified a total of 20 neurological patients, who experienced jealousy in relation with a neurological disorder; and 22 healthy individuals, who experienced jealousy under experimental neuroimaging settings. Most of the clinical cases of reported jealousy after a stroke had delusional-type jealousy. Right hemispheric stroke was the most frequently reported neurological disorder in these patients, although there was a wide range of more diffuse neurological disorders that may be reported to be associated with different other types of jealousy. This is in line with recent neuroimaging data on false beliefs, moral judgments, and intention [mis]understanding. Together the present findings provide physicians and psychologists with a potential for high impact in understanding the neural mechanisms and treatment of jealousy. By combining findings from case reports and neuroimaging data, the present article allows for a novel and unique perspective, and explores new directions into the neurological jealous mind. PMID:21169919

TU-G-204-09: The Effects of Reduced- Dose Lung Cancer Screening CT On Lung Nodule Detection Using a CAD Algorithm

DOE Office of Scientific and Technical Information (OSTI.GOV)

Young, S; Lo, P; Kim, G

2015-06-15

Purpose: While Lung Cancer Screening CT is being performed at low doses, the purpose of this study was to investigate the effects of further reducing dose on the performance of a CAD nodule-detection algorithm. Methods: We selected 50 cases from our local database of National Lung Screening Trial (NLST) patients for which we had both the image series and the raw CT data from the original scans. All scans were acquired with fixed mAs (25 for standard-sized patients, 40 for large patients) on a 64-slice scanner (Sensation 64, Siemens Healthcare). All images were reconstructed with 1-mm slice thickness, B50 kernel.more » 10 of the cases had at least one nodule reported on the NLST reader forms. Based on a previously-published technique, we added noise to the raw data to simulate reduced-dose versions of each case at 50% and 25% of the original NLST dose (i.e. approximately 1.0 and 0.5 mGy CTDIvol). For each case at each dose level, the CAD detection algorithm was run and nodules greater than 4 mm in diameter were reported. These CAD results were compared to “truth”, defined as the approximate nodule centroids from the NLST reports. Subject-level mean sensitivities and false-positive rates were calculated for each dose level. Results: The mean sensitivities of the CAD algorithm were 35% at the original dose, 20% at 50% dose, and 42.5% at 25% dose. The false-positive rates, in decreasing-dose order, were 3.7, 2.9, and 10 per case. In certain cases, particularly in larger patients, there were severe photon-starvation artifacts, especially in the apical region due to the high-attenuating shoulders. Conclusion: The detection task was challenging for the CAD algorithm at all dose levels, including the original NLST dose. However, the false-positive rate at 25% dose approximately tripled, suggesting a loss of CAD robustness somewhere between 0.5 and 1.0 mGy. NCI grant U01 CA181156 (Quantitative Imaging Network); Tobacco Related Disease Research Project grant 22RT-0131.« less

Limitations and obstacles of the spontaneous adverse drugs reactions reporting: Two “challenging” case reports

PubMed Central

Palleria, Caterina; Leporini, Christian; Chimirri, Serafina; Marrazzo, Giuseppina; Sacchetta, Sabrina; Bruno, Lucrezia; Lista, Rosaria M.; Staltari, Orietta; Scuteri, Antonio; Scicchitano, Francesca; Russo, Emilio

2013-01-01

Introduction: Nowadays, based on several epidemiological data, iatrogenic disease is an emerging public health problem, especially in industrialized countries. Adverse drugs reactions (ADRs) are extremely common and, therefore, clinically, socially, and economically worthy of attention. Spontaneous reporting system for suspected ADRs represents the cornerstone of the pharmacovigilance, because it allows rapid detection of potential alarm signals related to drugs use. However, spontaneous reporting system shows several limitations, which are mainly related to under-reporting. In this paper, we describe two particular case reports, which emphasize some reasons of under-reporting and other common criticisms of spontaneous reporting systems. Materials and Methods: We performed a computer-aided search of Medline, PubMed, Embase, Cochrane library databases, national and international databases of suspected ADRs reports in order to identify previous published case reports and spontaneous reports about the ADRs reviewed in this paper, and to examine the role of suspected drugs in the pathogenesis of the described adverse reactions. Results: First, we reported a case of tizanidine-induced hemorrhagic cystitis. In the second case report, we presented an episode of asthma exacerbation after taking bimatoprost. Through the review of these two cases, we highlighted some common criticisms of spontaneous reporting systems: under-reporting and false causality attribution. Discussion and Conclusion: Healthcare workers sometimes do not report ADRs because it is challenging to establish with certainty the causal relationship between drug and adverse reaction; however, according to a key principle of pharmacovigilance, it is always better to report even a suspicion to generate an alarm in the interest of protecting public health. PMID:24347986

Limitations and obstacles of the spontaneous adverse drugs reactions reporting: Two "challenging" case reports.

PubMed

Palleria, Caterina; Leporini, Christian; Chimirri, Serafina; Marrazzo, Giuseppina; Sacchetta, Sabrina; Bruno, Lucrezia; Lista, Rosaria M; Staltari, Orietta; Scuteri, Antonio; Scicchitano, Francesca; Russo, Emilio

2013-12-01

Nowadays, based on several epidemiological data, iatrogenic disease is an emerging public health problem, especially in industrialized countries. Adverse drugs reactions (ADRs) are extremely common and, therefore, clinically, socially, and economically worthy of attention. Spontaneous reporting system for suspected ADRs represents the cornerstone of the pharmacovigilance, because it allows rapid detection of potential alarm signals related to drugs use. However, spontaneous reporting system shows several limitations, which are mainly related to under-reporting. In this paper, we describe two particular case reports, which emphasize some reasons of under-reporting and other common criticisms of spontaneous reporting systems. We performed a computer-aided search of Medline, PubMed, Embase, Cochrane library databases, national and international databases of suspected ADRs reports in order to identify previous published case reports and spontaneous reports about the ADRs reviewed in this paper, and to examine the role of suspected drugs in the pathogenesis of the described adverse reactions. First, we reported a case of tizanidine-induced hemorrhagic cystitis. In the second case report, we presented an episode of asthma exacerbation after taking bimatoprost. Through the review of these two cases, we highlighted some common criticisms of spontaneous reporting systems: under-reporting and false causality attribution. Healthcare workers sometimes do not report ADRs because it is challenging to establish with certainty the causal relationship between drug and adverse reaction; however, according to a key principle of pharmacovigilance, it is always better to report even a suspicion to generate an alarm in the interest of protecting public health.

Alcohol, caffeine, and nicotine consumption in adolescents: hair analysis versus self-report.

PubMed

Bertol, Elisabetta; Vaiano, Fabio; Boscolo-Berto, Rafael; Fioravanti, Alessia; Palumbo, Diego; Catalani, Valeria; Mari, Francesco; Patussi, Valentino; Serpelloni, Giovanni

2017-05-01

Clinical reliability of self-reported data for alcohol, caffeine, and nicotine consumptions is lacking, particularly in adolescents. To compare a self-report questionnaire and hair analysis to assess the reliability and effectiveness of the self-report. A cross-sectional study on 14-15-year-old Italian students (n = 874, 38% males, 62% females) was performed comparing self-reported data to hair analysis. The latter quantified hair concentrations of caffeine, nicotine, cotinine, ethyl glucuronide (EtG), and fatty acid ethyl esters (FAEEs) using mass spectrometry. Concordance between self-report and hair testing ranged from good to poor across substances and levels of use: poor for heavy alcohol intake (EtG: k = 0.36, 20 positive cases by hair analysis, false negative by self-report, 2.3% of total sample; FAEE k = 0.31, 25 positive cases, 2.9% of total sample); fair to poor for active smokers (k = 0.40, 125 positive cases, 14.3% of total sample); and moderate for caffeine (k = 0.57, 56 positive cases, 6.4% of total sample). Epidemiological studies on alcohol, caffeine, and nicotine consumption in adolescents may benefit from the inclusion of toxicological analysis on hair samples to overcome the under-reporting phenomenon of questionnaires and detect more cases of problematic substance use.

77 FR 76484 - Agency Information Collection Activities: Announcement of Board Approval Under Delegated...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-12-28

... estimated amounts are reasonable and correct to the best of the officer's knowledge and belief. The initial... noted that, in any case, it is a federal violation to enter false information in a BHC's reports with...

20 CFR 411.395 - Is a State VR agency required to provide periodic reports?

Code of Federal Regulations, 2010 CFR

2010-04-01

... 20 Employees' Benefits 2 2010-04-01 2010-04-01 false Is a State VR agency required to provide... § 411.395 Is a State VR agency required to provide periodic reports? (a) For cases where a State VR agency provided services functioning as an EN, the State VR agency will be required to prepare periodic...

20 CFR 411.395 - Is a State VR agency required to provide periodic reports?

Code of Federal Regulations, 2011 CFR

2011-04-01

... 20 Employees' Benefits 2 2011-04-01 2011-04-01 false Is a State VR agency required to provide... § 411.395 Is a State VR agency required to provide periodic reports? (a) For cases where a State VR agency provided services functioning as an EN, the State VR agency will be required to prepare periodic...

20 CFR 411.395 - Is a State VR agency required to provide periodic reports?

Code of Federal Regulations, 2012 CFR

2012-04-01

... 20 Employees' Benefits 2 2012-04-01 2012-04-01 false Is a State VR agency required to provide... § 411.395 Is a State VR agency required to provide periodic reports? (a) For cases where a State VR agency provided services functioning as an EN, the State VR agency will be required to prepare periodic...

20 CFR 411.395 - Is a State VR agency required to provide periodic reports?

Code of Federal Regulations, 2014 CFR

2014-04-01

... 20 Employees' Benefits 2 2014-04-01 2014-04-01 false Is a State VR agency required to provide... § 411.395 Is a State VR agency required to provide periodic reports? (a) For cases where a State VR agency provided services functioning as an EN, the State VR agency will be required to prepare periodic...

20 CFR 411.395 - Is a State VR agency required to provide periodic reports?

Code of Federal Regulations, 2013 CFR

2013-04-01

... 20 Employees' Benefits 2 2013-04-01 2013-04-01 false Is a State VR agency required to provide... § 411.395 Is a State VR agency required to provide periodic reports? (a) For cases where a State VR agency provided services functioning as an EN, the State VR agency will be required to prepare periodic...

Using Pennsylvania's Three Mile Island Accident as a Case Study to Analyze Newspaper Coverage: A Diary of Events and Suggestions for Teaching Strategies.

ERIC Educational Resources Information Center

Susskind, Jacob L.

1983-01-01

Methods for studying the coverage of the same current news story in several newspapers are outlined. Secondary school students critically examine news reporting, detect false or propagandistic reports, and learn to weigh and judge evidence. An example using the Three Mile Island nuclear accident is provided. (KC)

[One example of false negative hepatitis B surface antigen (EIA) result due to variant S area strain and reagment reactiveness related to hepatitis B surface antigen].

PubMed

Matsuda, Chikashi; Moriyama, Hidehiko; Taketani, Takeshi; Shibata, Hiroshi; Nagai, Atsushi

2011-01-01

The presence in serum of the Hepatitis B surface antigen (HBsAg), the outer envelope of the hepatitis B virus (HBV), indicates viral infection, used in laboratory tests to confirm this. We report a case of discrepancy among HBsAg test results detected between measurements in a subject with HB infection. Gene analysis demonstrated several S region gene mutations, not detected previously. We tested 12 measurements e.g., EIA, CLIA, CLEIA, F-EIA, MAT, and IC for whether they could detect our subject's HBsAg and found that it was not recognized by a method using only a single monoclonal antibody to detect HBsAg in two detection processes, in contrast to the 11 other measurements, which used two different antibodies. This case shows that amino acid substitution may cause a false negative result for HBsAg. Gene mutations known to occur in HBV, should thus trigger an awareness of the need to keep in mind that false negative results can happen in case such as ours.

[Differential diagnosis of Dandy-Walker syndrome different presentations].

PubMed

Tobías-González, Pablo; Gil Mira, Mar; Valero de Bernabé, Javier; Zapardiel, Ignacio

2012-08-01

Dandy-Walker syndrome is a set of abnormalities of the posterior fossa including three modalities: classic Dandy-Walker malformation, Dandy-Walker variant and mega-cisterna magna. Our objective is clarify the differential diagnosis among these entities. Descriptive and retrospective study of Dandy-Walker cases diagnosed at our Department during the last five years plus a review of the related Medical literature. Three cases of Dandy-Walker modalities are reported: one case of classic Dandy-Walker malformation, one case of Dandy-Walker variant, and one case of false Dandy-Walker. In the first two cases the patients underwent legal abortion, whereas in the last one a healthy male newborn was delivered in the week 38 of gestation. Malformations in the posterior fossa, including Dandy-Walker syndrome, are still a challenge in prenatal diagnosis. Technical developments in imaging, such as in three-dimensional sonography and magnetic resonance, allow higher resolution and multiplanar images for an easier diagnose. There is a high rate of false positive, particularly before the 18th week of gestation. It is advisable not to establish a final diagnose before that week.

RBM10-TFE3 Renal Cell Carcinoma: A Potential Diagnostic Pitfall Due to Cryptic Intrachromosomal Xp11.2 Inversion Resulting in False-negative TFE3 FISH.

PubMed

Argani, Pedram; Zhang, Lei; Reuter, Victor E; Tickoo, Satish K; Antonescu, Cristina R

2017-05-01

Xp11 translocation renal cell carcinoma (RCC) are defined by chromosome translocations involving the Xp11 breakpoint which results in one of a variety of TFE3 gene fusions. TFE3 break-apart florescence in situ hybridization (FISH) assays are generally preferred to TFE3 immunohistochemistry (IHC) as a means of confirming the diagnosis in archival material, as FISH is less sensitive to the variable fixation which can result in false positive or false negative IHC. Prompted by a case report in the cytogenetics literature, we identify 3 cases of Xp11 translocation RCC characterized by a subtle chromosomal inversion involving the short arm of the X chromosome, resulting in an RBM10-TFE3 gene fusion. TFE3 rearrangement was not detected by conventional TFE3 break-apart FISH, but was suggested by strong diffuse TFE3 immunoreactivity in a clean background. We then developed novel fosmid probes to detect the RBM10-TFE3 gene fusion in archival material. These cases validate RBM10-TFE3 as a recurrent gene fusion in Xp11 translocation RCC, illustrate a source of false-negative TFE3 break-apart FISH, and highlight the complementary role of TFE3 IHC and TFE3 FISH.

A mega-analysis of memory reports from eight peer-reviewed false memory implantation studies.

PubMed

Scoboria, Alan; Wade, Kimberley A; Lindsay, D Stephen; Azad, Tanjeem; Strange, Deryn; Ost, James; Hyman, Ira E

2017-02-01

Understanding that suggestive practices can promote false beliefs and false memories for childhood events is important in many settings (e.g., psychotherapeutic, medical, and legal). The generalisability of findings from memory implantation studies has been questioned due to variability in estimates across studies. Such variability is partly due to false memories having been operationalised differently across studies and to differences in memory induction techniques. We explored ways of defining false memory based on memory science and developed a reliable coding system that we applied to reports from eight published implantation studies (N = 423). Independent raters coded transcripts using seven criteria: accepting the suggestion, elaboration beyond the suggestion, imagery, coherence, emotion, memory statements, and not rejecting the suggestion. Using this scheme, 30.4% of cases were classified as false memories and another 23% were classified as having accepted the event to some degree. When the suggestion included self-relevant information, an imagination procedure, and was not accompanied by a photo depicting the event, the memory formation rate was 46.1%. Our research demonstrates a useful procedure for systematically combining data that are not amenable to meta-analysis, and provides the most valid estimate of false memory formation and associated moderating factors within the implantation literature to date.

Comparison of 68Ga-DOTANOC PET/CT and contrast-enhanced CT in localisation of tumours in ectopic ACTH syndrome

PubMed Central

Jadhav, Swati S; Lila, Anurag R; Kasaliwal, Rajeev; Khare, Shruti; Yerawar, Chaitanya G; Hira, Priya; Phadke, Uday; Shah, Hina; Lele, Vikram R; Malhotra, Gaurav; Bandgar, Tushar; Shah, Nalini S

2016-01-01

Background Localising ectopic adrenocorticotrophic hormone (ACTH) syndrome (EAS) tumour source is challenging. Somatostatin receptor-based PET imaging has shown promising results, but the data is limited to case reports and small case series. We reviewed here the performance of 68Ga-DOTANOC positron emission tomography (PET)/computed tomography (CT) and contrast-enhanced CT (CECT) in our cohort of 12 consecutive EAS patients. Materials and methods Retrospective data analysis of 12 consecutive patients of EAS presenting to a single tertiary care centre in a period between January 2013 and December 2014 was done. CECT and 68Ga-DOTANOC PET/CT were reported (blinded) by an experienced radiologist and a nuclear medicine physician, respectively. The performance of CECT and 68Ga-DOTANOC PET/CT was compared. Results Tumours could be localised in 11 out of 12 patients at initial presentation (overt cases), whereas in one patient, tumour remained occult. Thirteen lesions were identified in 11 patients as EAS source (true positives). CECT localised 12 out of these 13 lesions (sensitivity 92.3%) and identified five false-positive lesions (positive predictive value (PPV) 70.5%). Compared with false-positive lesions, true-positive lesions had greater mean contrast enhancement at 60s (33.2 vs 5.6 Hounsfield units (HU)). 68Ga-DOTANOC PET/CT was able to identify 9 out of 13 lesions (sensitivity 69.2%) and reported no false-positive lesions (PPV 100%). Conclusion CECT remains the first-line investigation in localisation of EAS. The contrast enhancement pattern on CECT can further aid in characterisation of the lesions. 68Ga-DOTANOC PET/CT can be added to CECT, to enhance positive prediction of the suggestive lesions. PMID:27006371

Case definition for Ebola and Marburg haemorrhagic fevers: a complex challenge for epidemiologists and clinicians.

PubMed

Pittalis, Silvia; Fusco, Francesco Maria; Lanini, Simone; Nisii, Carla; Puro, Vincenzo; Lauria, Francesco Nicola; Ippolito, Giuseppe

2009-10-01

Viral haemorrhagic fevers (VHFs) represent a challenge for public health because of their epidemic potential, and their possible use as bioterrorism agents poses particular concern. In 1999 the World Health Organization (WHO) proposed a case definition for VHFs, subsequently adopted by other international institutions with the aim of early detection of initial cases/outbreaks in western countries. We applied this case definition to reports of Ebola and Marburg virus infections to estimate its sensitivity to detect cases of the disease. We analyzed clinical descriptions of 795 reported cases of Ebola haemorrhagic fever: only 58.5% of patients met the proposed case definition. A similar figure was obtained reviewing 169 cases of Marburg diseases, of which only 64.5% were in accordance with the case definition. In conclusion, the WHO case definition for hemorrhagic fevers is too specific and has poor sensitivity both for case finding during Ebola or Marburg outbreaks, and for early detection of suspected cases in western countries. It can lead to a hazardous number of false negatives and its use should be discouraged for early detection of cases.

Silastic injection for vocal fold medialization resulting in a false-positive finding on F18 FDG-PET/CT.

PubMed

Mahfouz, Ayman; Naji, Meeran; Mok, Wing Yan; Taghi, Ali S; Win, Zarni

2015-09-01

A false-positive uptake of F18-fluorodeoxyglucose (FDG) on positron-emission tomography/computed tomography (PET/CT) can result in confusion and misinterpretation of scans. Such uptakes have been previously described after injection of polytetrafluoroethylene (Teflon) into the vocal folds. Similarly, vocal fold injection of silicone elastomer (Silastic) can result not only in a false-positive FDG uptake on PET/CT, but also in chronic inflammation. We report a case of increased FDG uptake in a vocal fold after Silastic injection that was misinterpreted as a malignancy in a 70-year-old woman who had metastatic carcinoma of the stomach.

[An integrated approach including paediatric and forensic medical expertise on suspicion of child abuse].

PubMed

Schouten, M C M; Karst, W A; van der Stel, H F; Teeuw, A H; van de Putte, E M

2016-01-01

A false accusation of child abuse has a major impact on child and family. Conversely, a missed diagnosis of child abuse may have significant and lifelong consequences for the child. For health professionals the assessment of the nature of the injury and differentiating between accidental and inflicted injury, disease manifestation or a physiological phenomenon can be challenging. For adequate determination of the cause of injury, an integrated approach including paediatric knowledge and forensic medical expertise is essential. Therefore, a national expertise centre for child abuse (LECK) was established in the Netherlands in 2014. The first results of this integrated approach are described and illustrated with three case reports. Case A, a 7-month-old boy with an accidental humerus fracture. Case B, an 8-year-old boy with a false positive suspicion of child abuse who was eventually diagnosed with Henoch-Schönlein syndrome. Case C, boy of 3 months with bruises and a metaphyseal fracture of the femur, both highly suspected of being inflicted injury.

Diagnosis of metastatic melanoma by fine-needle biopsy: analysis of 2,204 cases.

PubMed

Murali, Rajmohan; Doubrovsky, Anna; Watson, Geoffrey F; McKenzie, Paul R; Lee, C Soon; McLeod, Duncan J; Uren, Roger F; Stretch, Jonathan R; Saw, Robyn P M; Thompson, John F; Scolyer, Richard A

2007-03-01

Fine-needle biopsy (FNB) has been reported as a rapid, minimally invasive technique for the diagnosis of metastatic melanoma. The diagnostic accuracy of FNB was assessed in a consecutive series of 2,204 FNBs of clinically suspicious lesions from patients with previous primary melanomas treated at the Sydney Melanoma Unit, Sydney, Australia, between January 1992 and December 2002. The sensitivity and specificity of FNB were 96.3% and 98.9%, respectively. There were 5 false-positive cases (0.6%), which were verified as metastatic adenocarcinoma (3 cases) or reactive processes (organizing hematoma and chronic osteomyelitis, 1 each). False-negative diagnoses (6.7% of cases) were associated with a variety of clinicopathologic factors, including difficult-to-access anatomic sites (eg, high axilla or deep inguinal), small lesions, and lesional characteristics such asfibrosis, necrosis, or cystic change. FNB is a highly accurate, rapid, and cost-effective procedure for the diagnosis of metastatic melanoma and should be considered as the initial diagnostic procedure of choice in patients with melanoma with clinically suspected metastases.

[Quality assurance of rapid on-site evaluation of CT-guided fine-needle aspiration cytology of lung nodules].

PubMed

Bak, Mihály; Hidvégi, Judit; Andi, Judit; Bahéry, Mária; Kovács, Eszter; Schneider, Ferenc; Kostic, Szilárd; Rényi-Vámos, Ferenc; Szőke, János; Nyári, Tibor; Gődény, Mária; Kásler, Miklós

2013-01-06

The methods available for the diagnosis of lung cancer include radiologic, cytologic and pathologic procedures. The aim of this study was to determine the quality assurance of CT guided fine needle aspiration cytology of lung nodules. Cytology results were rated to 4 categories (positive; suspicious; negative; not representative). All cytology reports were compared with the final histology diagnosis. A total of 128 patients underwent CT-guided percutaneous fine-needle aspiration biopsy cytology (63 males; 65 females; mean age 62.8 years). Smears were adequate in 99 cases and inadequate in 29 cases. The average diameter of the nodules was 3.28 cm. Thirty three (25.6%) of the cases were histologically verified and 2 falsely negative and 2 falsely positive cases were detected. The sensitivity and the positive predictive value were 88.8% and 88.8%, respectively. Pneumothorax developed in 7 (5.4%) cases. These results suggest that CT-guided transthoracic fine needle aspiration cytology has a high diagnostic accuracy and an acceptable complication rate. The auditing valves of the results meet the proposed threshold values.

40 CFR 89.424 - Dilute emission sampling calculations.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 40 Protection of Environment 20 2010-07-01 2010-07-01 false Dilute emission sampling calculations... Emission Test Procedures § 89.424 Dilute emission sampling calculations. (a) The final reported emission... concentration. For cases where exhaust sampling of CO2 is not performed, the following approximation is...

40 CFR 89.424 - Dilute emission sampling calculations.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 40 Protection of Environment 20 2011-07-01 2011-07-01 false Dilute emission sampling calculations... Emission Test Procedures § 89.424 Dilute emission sampling calculations. (a) The final reported emission... concentration. For cases where exhaust sampling of CO2 is not performed, the following approximation is...

Rubella Surveillance and Diagnostic Testing among a Low-Prevalence Population, New York City, 2012–2013

PubMed Central

Zucker, Jane R.; Giancotti, Francesca R.; Abernathy, Emily; Icenogle, Joseph; Rakeman, Jennifer L.; Rosen, Jennifer B.

2017-01-01

ABSTRACT The New York City Department of Health and Mental Hygiene (DOHMH) receives clinical and laboratory reports for rubella. Because rubella immunoglobulin M (IgM) assays may produce false-positive results and rubella infections may be asymptomatic, interpretation of positive IgM results can be challenging. Rubella reports received by DOHMH in 2012 to 2013 were reviewed. The rubella IgM testing purpose was determined through case investigation. Results of IgM testing by indirect enzyme-linked immunosorbent assay (ELISA) and capture enzyme immunoassay (EIA) were compared to determine positive predictive value (PPV) and specificity. DOHMH received 199 rubella reports; 2 were true cases. Of all reports, 77.9% were tested for rubella IgM erroneously, 19.6% were tested for diagnostic purposes, 2.0% had unknown test purpose, and 0.5% were not tested. PPV of indirect ELISA was 6% overall, 14% for diagnostic tests, and 0% for tests ordered erroneously. PPV of capture EIA was 29% overall, 50% for diagnostic tests, and 0% for tests ordered erroneously. Overall, specificity was 52% for indirect ELISA and 85% for capture EIA. Limiting rubella IgM testing to patients for whom rubella diagnosis is suspected and using a more specific IgM assay have the potential to reduce false-positive rubella IgM results. PMID:28701468

Cervical spine disease may result in a negative lumbar spinal drainage trial in normal pressure hydrocephalus: case report.

PubMed

Komotar, Ricardo J; Zacharia, Brad E; Mocco, J; Kaiser, Michael G; Frucht, Stephen J; McKhann, Guy M

2008-10-01

In this case report, we present a patient with normal pressure hydrocephalus in whom a lumbar drainage trial yielded a false-negative result secondary to cervical spondylosis. An 80-year-old woman presented with classic symptoms of normal pressure hydrocephalus as well as evidence of cervical myelopathy. Magnetic resonance imaging of the brain and spine showed enlarged ventricles and single-level cervical canal narrowing. An initial lumbar drainage trial was performed, which revealed negative results. The patient then underwent cervical decompression and fusion. Despite this procedure, the patient's symptoms continued to worsen. A repeat lumbar drainage trial was performed with positive results. Subsequently, a ventriculoperitoneal shunt was placed, resulting in significant improvement of her symptoms. This case report illustrates how altered cerebrospinal fluid flow dynamics may impact the accuracy of the lumbar spinal drainage trial in patients with normal pressure hydrocephalus.

A default normal chest CT structured reporting field for coronary calcifications does not cause excessive false-negative reporting.

PubMed

Walter, William R; Goldberg-Stein, Shlomit; Levsky, Jeffrey M; Cohen, Hillel W; Scheinfeld, Meir H

2015-08-01

The aim of this study was to compare the accuracy of coronary atherosclerosis reporting before and after the implementation of a structured reporting chest CT template. A noncardiac, noncontrast chest CT structured reporting template was developed and mandated for department-wide use at a large academic center. The template included the statement "There are no coronary artery calcifications." All noncardiac, noncontrast chest CT examinations reported over 3 days, 1 month after template implementation (structured template group), and from a 3-day period 1 year prior (control group) were retrospectively collected. Final radiology reports were reviewed and designated positive or negative for coronary calcifications. CT images were reviewed in consensus by 2 radiologists, who scored each case for the presence or absence of coronary calcifications, blinded to the original report. Statistical analysis was performed using Pearson χ(2) and Fisher exact tests. Sixty-five percent (69 of 106) of structured template group and 58% (62 of 106) of control group cases had coronary calcifications. Reports from the structured template group were more likely to correctly state the presence or absence of coronary atherosclerosis compared with those from the control group (96.2% vs 85.8%; odds ratio, 4.2; 95% confidence interval, 1.3-13.1; P = .008). Structured template group reports were less likely to be falsely negative compared with control group reports (3.8% vs 11.7%; odds ratio, 3.4; 95% confidence interval, 1.0-10.8; P = .03). Implementing a structured reporting template improves reporting accuracy of coronary calcifications. Copyright © 2015 American College of Radiology. Published by Elsevier Inc. All rights reserved.

Case report: false negative serum cryptococcal latex agglutination test in a patient with disseminated cryptococcal disease.

PubMed

Navabi, Nazlee; Montebatsi, Milton; Scott, Michelle; Gluckman, Stephen J; Reid, Michael J A

2015-01-01

A case of false-negative serum latex agglutination cryptococcal antigen (CRAG) test in a 45-year-old HIV-positive male with Cryptococcus-positive culture is described. The patient was presented to a hospital in Botswana, with breathlessness and a diffuse papular rash. His CD4 count was 25 cells/μL. Despite the suspicion for disseminated cryptococcal disease, an initial serum CRAG latex test was negative. Results of subsequent Indian ink staining, culture of cerebrospinal fluid and skin scrapings, and serum lateral flow immunoassay (LFA) were all positive for Cryptococcus neoformans. There are several possible explanations for the false-negative CRAG latex test. Given the positive LFA result, we speculate that disease may have been caused by Cryptococcus gattii, which is estimated to be responsible for between 15% and 30% of all cryptococcal diseases in Botswana. Reduced sensitivity of CRAG latex assays for detecting C gattii may lead to underdiagnosis of cryptococcal infection. © The Author(s) 2014.

False positive computed tomographic angiography for Stanford type A aortic dissection.

PubMed

Bandali, Murad F; Hatem, Muhammed A; Appoo, Jehangir J; Hutchison, Stuart J; Wong, Jason K

2015-12-01

Computed tomographic angiography (CTA) has emerged as the defacto imaging test to rule out acute aortic dissection; however, it is not without flaws. We report a case of a false-positive CTA with respect to Stanford Type A aortic dissection. A 52 year-old male presented with sudden onset shortness of breath. He denied chest pain. Due to severe hypertension and an Emergency Department bedside ultrasound suggesting an intimal flap in the aorta, CTA was requested to better assess the ascending aorta and was interpreted as consistent with Stanford Type A aortic dissection with thrombosis of the false lumen in the ascending aorta. However, intra-operative imaging (TEE and epi-aortic scanning) did not identify an intimal flap or dissection, and neither did definitive surgical inspection of the aorta. The suspected aortic dissection and thrombosed false lumen were not visualized on repeat CTA two days later. False positive diagnosis of Stanford Type A aortic dissection on CTA can be the result of technical factors, streak artifacts, motion artifacts, and periaortic structures. In this case, non-uniform arterial contrast enhancement secondary to unrecognized biventricular dysfunction resulted in the false positive CTA appearance of an intimal flap and mural thrombus. Intra-operative TEE and epi-aortic scanning were proven correct in excluding aortic dissection by the standard of definitive surgical inspection of the aorta.

40 CFR 233.37 - Signatures on permit applications and reports.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 40 Protection of Environment 24 2010-07-01 2010-07-01 false Signatures on permit applications and... DUMPING 404 STATE PROGRAM REGULATIONS Program Operation § 233.37 Signatures on permit applications and... person designating the agent. In either case, the signature of the applicant or the agent will be...

33 CFR 326.5 - Legal action.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 33 Navigation and Navigable Waters 3 2011-07-01 2011-07-01 false Legal action. 326.5 Section 326.5... § 326.5 Legal action. (a) General. For cases the district engineer determines to be appropriate, he will... the district engineer determines that legal action is appropriate, he will prepare a litigation report...

33 CFR 326.5 - Legal action.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 33 Navigation and Navigable Waters 3 2012-07-01 2012-07-01 false Legal action. 326.5 Section 326.5... § 326.5 Legal action. (a) General. For cases the district engineer determines to be appropriate, he will... the district engineer determines that legal action is appropriate, he will prepare a litigation report...

33 CFR 326.5 - Legal action.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 33 Navigation and Navigable Waters 3 2014-07-01 2014-07-01 false Legal action. 326.5 Section 326.5... § 326.5 Legal action. (a) General. For cases the district engineer determines to be appropriate, he will... the district engineer determines that legal action is appropriate, he will prepare a litigation report...

33 CFR 326.5 - Legal action.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 33 Navigation and Navigable Waters 3 2013-07-01 2013-07-01 false Legal action. 326.5 Section 326.5... § 326.5 Legal action. (a) General. For cases the district engineer determines to be appropriate, he will... the district engineer determines that legal action is appropriate, he will prepare a litigation report...

29 CFR 4011.6 - Mergers, consolidations, and spinoffs.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 29 Labor 9 2010-07-01 2010-07-01 false Mergers, consolidations, and spinoffs. 4011.6 Section 4011... REPORTING AND DISCLOSURE REQUIREMENTS DISCLOSURE TO PARTICIPANTS § 4011.6 Mergers, consolidations, and spinoffs. In the case of a plan involved in a merger, consolidation, or spinoff transaction that becomes...

22 CFR 3.10 - Enforcement.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 22 Foreign Relations 1 2010-04-01 2010-04-01 false Enforcement. 3.10 Section 3.10 Foreign Relations DEPARTMENT OF STATE GENERAL GIFTS AND DECORATIONS FROM FOREIGN GOVERNMENTS § 3.10 Enforcement. (a) Each employing agency is responsible under the Act for reporting to the Attorney General cases in which...

40 CFR 51.354 - Adequate tools and resources.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 40 Protection of Environment 2 2014-07-01 2014-07-01 false Adequate tools and resources. 51.354... Requirements § 51.354 Adequate tools and resources. (a) Administrative resources. The program shall maintain... assurance, data analysis and reporting, and the holding of hearings and adjudication of cases. A portion of...

40 CFR 51.354 - Adequate tools and resources.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 40 Protection of Environment 2 2011-07-01 2011-07-01 false Adequate tools and resources. 51.354... Requirements § 51.354 Adequate tools and resources. (a) Administrative resources. The program shall maintain... assurance, data analysis and reporting, and the holding of hearings and adjudication of cases. A portion of...

40 CFR 51.354 - Adequate tools and resources.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 40 Protection of Environment 2 2012-07-01 2012-07-01 false Adequate tools and resources. 51.354... Requirements § 51.354 Adequate tools and resources. (a) Administrative resources. The program shall maintain... assurance, data analysis and reporting, and the holding of hearings and adjudication of cases. A portion of...

40 CFR 51.354 - Adequate tools and resources.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 40 Protection of Environment 2 2013-07-01 2013-07-01 false Adequate tools and resources. 51.354... Requirements § 51.354 Adequate tools and resources. (a) Administrative resources. The program shall maintain... assurance, data analysis and reporting, and the holding of hearings and adjudication of cases. A portion of...

32 CFR 581.2 - Army Discharge Review Board.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 32 National Defense 3 2013-07-01 2013-07-01 false Army Discharge Review Board. 581.2 Section 581.2 National Defense Department of Defense (Continued) DEPARTMENT OF THE ARMY PERSONNEL PERSONNEL REVIEW BOARD... the efficient overall operation and support of the ADRB panels. (ii) Authenticates the case report and...

32 CFR 581.2 - Army Discharge Review Board.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 32 National Defense 3 2014-07-01 2014-07-01 false Army Discharge Review Board. 581.2 Section 581.2 National Defense Department of Defense (Continued) DEPARTMENT OF THE ARMY PERSONNEL PERSONNEL REVIEW BOARD... the efficient overall operation and support of the ADRB panels. (ii) Authenticates the case report and...

20 CFR 725.608 - Interest.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 20 Employees' Benefits 3 2011-04-01 2011-04-01 false Interest. 725.608 Section 725.608 Employees... HEALTH ACT, AS AMENDED Enforcement of Liability; Reports § 725.608 Interest. (a)(1) In any case in which... simple annual interest, computed from the date on which the benefits were due. The interest shall be...

20 CFR 725.608 - Interest.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 20 Employees' Benefits 4 2012-04-01 2012-04-01 false Interest. 725.608 Section 725.608 Employees... HEALTH ACT, AS AMENDED Enforcement of Liability; Reports § 725.608 Interest. (a)(1) In any case in which... simple annual interest, computed from the date on which the benefits were due. The interest shall be...

20 CFR 725.608 - Interest.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 20 Employees' Benefits 4 2014-04-01 2014-04-01 false Interest. 725.608 Section 725.608 Employees... HEALTH ACT, AS AMENDED Enforcement of Liability; Reports § 725.608 Interest. (a)(1) In any case in which... simple annual interest, computed from the date on which the benefits were due. The interest shall be...

20 CFR 725.608 - Interest.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 20 Employees' Benefits 4 2013-04-01 2013-04-01 false Interest. 725.608 Section 725.608 Employees... HEALTH ACT, AS AMENDED Enforcement of Liability; Reports § 725.608 Interest. (a)(1) In any case in which... simple annual interest, computed from the date on which the benefits were due. The interest shall be...

Intrathoracic stomach mimicking bone metastasis from thyroid cancer in whole-body iodine-131 scan diagnosed by SPECT/CT.

PubMed

García-Gómez, Francisco Javier; la Riva-Pérez, Pablo Antonio de; Calvo-Morón, Cinta; Buján-Lloret, Cristina; Cambil-Molina, Teresa; Castro-Montaño, Juan

2017-01-01

The whole-body iodine-131 scintigraphy is an imaging technique in monitoring patients with a history of thyroid cancer. Although the rate of false positives is negligible, it is not nonexistent. We report the case of an intervened and treated patient for thyroid cancer with good clinical and biochemical response. Scintigraphic findings were consistent with unsuspected bone metastasis. Fused SPECT/CT data allowed accurate diagnosis of giant diaphragmatic hernia associated with intrathoracic stomach, a very rare pathology that can lead to false positive results.

Persistent psychogenic déjà vu: a case report.

PubMed

Wells, Christine E; Moulin, Chris J A; Ethridge, Paige; Illman, Nathan A; Davies, Emma; Zeman, Adam

2014-12-08

Déjà vu is typically a transient mental state in which a novel experience feels highly familiar. Although extensively studied in relation to temporal lobe epilepsy as part of simple partial seizures, déjà vu has been less studied in other clinical populations. A recent review of temporal lobe epilepsy suggested a possible link between clinical levels of anxiety and debilitating déjà vu, indicating further research is required. Here, for the first time in the literature, we present a case study of a young man with anxiety and depersonalisation who reported experiencing persistent and debilitating déjà vu. This report therefore adds to the limited literature on the relationship between anxiety and déjà vu. A 23-year-old White British man presented with a form of persistent déjà vu in 2010, approximately 3 years since symptom onset. He reported a history of anxiety and experiencing feelings of depersonalisation. Neurological assessment (electroencephalogram and magnetic resonance imaging) did not indicate any abnormalities. We assessed his recognition memory with a task used in patients with dementia who report similar experiences but lack awareness of their falseness. Our case's memory performance was more conservative than controls but did not indicate a memory deficit. Unlike other patients with chronic déjà vu (for example, in dementia), he is fully aware of the false nature of his déjà vu and this presumably leads to his intact recognition memory performance. We suggest that his persistent déjà vu is psychogenic and conclude that déjà vu should be further studied in psychiatric disorders.

Posterior mediastinal ganglioneuroma with peripheral replacement by white and brown adipocytes resulting in diagnostic fallacy from a false-positive 18F-2-fluoro-2-deoxyglucose-positron emission tomography finding: a case report

PubMed Central

2014-01-01

Introduction Ganglioneuroma is a rare tumor in the posterior mediastinum; fat-containing ganglioneuromas are rarely reported. The present case report documents a brown fat-containing, posterior mediastinal ganglioneuroma, which has not been reported previously. Radiological examination, in particular 18F-2-fluoro-2-deoxyglucose-positron emission tomography, suggested that the tumor had low-grade malignant potential. This led to uncertainty at preoperative diagnosis. Case presentation An asymptomatic 66-year-old Japanese woman with no significant past medical history was referred for the evaluation of a posterior mediastinal mass. Although its size had not changed in the past 5 years, a malignant lipomatous tumor could not be excluded due to the presence of intratumoral fat and increased 18F-2-fluoro-2-deoxyglucose uptake observed by positron emission tomography imaging. A computed tomography-guided core-needle biopsy revealed a mixture of mature adipocytes, spindle-shaped cells, and fibrotic stroma. Definite diagnosis was not possible, and surgical resection was performed. Three years after the surgery, she remains disease-free. Conclusions Histological diagnosis of the surgically resected mass confirmed ganglioneuroma with substantial amounts of white and brown adipose tissues in peripheral areas. The existence of both ganglion cells and brown fat tissue intensified the accumulation of 18F-2-fluoro-2-deoxyglucose, resulting in a false-positive result by positron emission tomography. Considering this, ganglioneuroma should not be excluded either clinically or pathologically in fat-containing, posterior mediastinal tumors. PMID:25319096

Pitfalls Associated With the Use of Molecular Diagnostic Panels in the Diagnosis of Cryptococcal Meningitis.

PubMed

O'Halloran, Jane A; Franklin, Alexander; Lainhart, William; Burnham, Carey-Ann; Powderly, William; Dubberke, Erik

2017-01-01

We report the case of a kidney transplantation patient on chronic immunosuppressive therapy presenting with subacute meningitis. The final diagnosis of cryptococcal meningitis was delayed due to 2 false-negative cryptococcal results on a molecular diagnostic panel. Caution with such platforms in suspected cryptococcal meningitis is needed.

32 CFR 884.17 - Commander's instruction letter to member.

Code of Federal Regulations, 2010 CFR

2010-07-01

... instruction letter to member. Subject: Instructions in Case of Release on Bail or Personal Recognizance 1. You... 32 National Defense 6 2010-07-01 2010-07-01 false Commander's instruction letter to member. 884.17... civilian custody on bail or on your own recognizance, report immediately in person or by telephone to the...

Nested association mapping for dissecting complex traits using Peanut 58K SNP array

USDA-ARS?s Scientific Manuscript database

Genome-wide association studies (GWAS) and linkage mapping have been the two most predominant strategies to dissect complex traits, but are limited by the occurrence of false positives reported for GWAS, and low resolution in the case of linkage analysis. This has led to the development of a joint a...

A patient with serum creatinine of 61 mg/dl

PubMed Central

Sriram, S.; Srinivas, S.; Naveen, P. S. R.

2017-01-01

Spurious elevation of serum creatinine by Jaffe assay is known to occur due to a variety of substances. This results in subjecting the patient to invasive and complicated procedures such as dialysis. We report a rare case of false elevation of this renal parameter following exposure to an organic solvent. PMID:28182048

16 CFR 2.41 - Reports of compliance.

Code of Federal Regulations, 2010 CFR

2010-01-01

... be under oath if so requested. Where the order prohibits the use of a false advertisement of a food... conditions prescribed in the advertisement, or under such conditions as are customary or usual, or if the use of such advertisement is with intent to defraud or mislead, or in any other case where the...

Lymphadenopathy resulting from acute toxoplasmosis mimicking relapse of non-Hodgkin's lymphoma on fluorodeoxyglucose positron emission tomography/computed tomography.

PubMed

Joshi, Prathamesh; Lele, Vikram; Mahajan, Pravin

2012-01-01

We report a case documenting fluorodeoxyglucose (FDG) accumulation in cervical, supraclavicular and axillary lymph nodes resulting from acute toxoplasmosis. A 50-year-old Indian female with history of non-Hodgkin's lymphoma (NHL) of left breast, postchemotherapy status, was found to have hypermetabolic right cervical, supraclavicular and axillary lymph nodes on a surveillance FDG positron emission tomography/computed tomography (PET/CT) scan. Her previous two PET/CT scans were unremarkable with no evidence of metabolically active disease. Therefore, a differential diagnosis of relapse of NHL versus infectious/inflammatory pathology was raised in the report. Biopsy of axillary lymph node demonstrated features characteristic of toxoplasmosis. The serological test results were also compatible with acute toxoplasmosis infection. Infective and inflammatory diseases are known to accumulate FDG, resulting in false positives for malignancy. This case demonstrates lymph nodal toxoplasmosis as a potential cause of false positive FDG PET/CT findings in patients with known malignancy and highlights the importance of histopathological and laboratory correlation for the accurate interpretation of FDG PET/CT scans.

Superficial Palmar Arch Aneurysm after Carpal Tunnel Decompression, a Rare Complication: A Case Report

PubMed Central

Gull, S.; Spence, R. A. J.; Loan, W.

2011-01-01

False aneurysms of the palmar arteries are rare. They are usually associated with traumatic injuries to the hand vasculature. We present a case of superficial palmar arch aneurysm (SPAA), complicating carpal tunnel decompression which presented as a pulsatile mass at the site of previous surgery. Initial diagnosis was made on clinical examination and confirmed on doppler ultrasound (US) and computed tomographic angiography (CTA). The feeding vessel of the aneurysm was subsequently occluded using coil embolization. PMID:21547251

Initial clinical laboratory experience in noninvasive prenatal testing for fetal aneuploidy from maternal plasma DNA samples.

PubMed

Futch, Tracy; Spinosa, John; Bhatt, Sucheta; de Feo, Eileen; Rava, Richard P; Sehnert, Amy J

2013-06-01

The aim of this study is to report the experience of noninvasive prenatal DNA testing using massively parallel sequencing in an accredited clinical laboratory. Laboratory information was examined for blood samples received for testing between February and November 2012 for chromosome 21 (Chr21), Chr18, and Chr13. Monosomy X (MX) testing was available from July 2012 for cystic hygroma indication. Outcomes were collected from providers on samples with positive results. There were 5974 samples tested, and results were issued within an average of 5.1 business days. Aneuploidy was detected in 284 (4.8%) samples (155 Chr21, 66 Chr18, 19 Chr13, 40 MX, and four double aneuploidy). Follow-ups are available for 245/284 (86%), and 77/284 (27.1%) are confirmed, including one double-aneuploidy case concordant with cytogenetics from maternal malignancy. Fourteen (0.2%) discordant (putative false-positive) results (one Chr21, six Chr18, three Chr13, three MX, and one Chr21/13) have been identified. Five (0.08%) false-negative cases are reported (two trisomy 21, two trisomy 18, and one MX). In 170 (2.8%) cases, the result for a single chromosome was indefinite. This report suggests that clinical testing of maternal cell-free DNA for fetal aneuploidy operates within performance parameters established in validation studies. Noninvasive prenatal testing is sensitive to biological contributions from placental and maternal sources. ©2013 Verinata Health, Inc. Prenatal Diagnosis published by John Wiley & Sons, Ltd.

False homozygous HLA genotyping results due to copy number neutral loss of heterozygosity in acquired aplastic anaemia.

PubMed

Heyrman, Bert; De Becker, Ann; Verheyden, Sonja; Demanet, Christian

2017-03-02

The aim of this case report is to draw attention on possible false human leucocyte antigen (HLA) genotyping in acquired aplastic anaemia prior to allogeneic haematopoietic stem cell transplantation. In acquired aplastic anaemia loss of heterozygosity (LOH) of chromosome 6p is known to occur in around 12%. We report false HLA genotyping results due to LOH and a coinciding steep rise in neutrophils following filgrastim stimulation in a patient with very severe aplastic anaemia. At diagnosis we obtained heterozygous results on peripheral blood. Failing to reach a partial response at 6 months with immune-suppressive therapy we repeated HLA genotyping, obtaining homozygous results. Repeated testing confirmed loss of HLA genotype heterozygosity. HLA genotyping on cells obtained by a buccal swab confirmed the previous HLA heterozygosity. A second course of filgrastim at the time of homozygous HLA genotyping resulted in a steep rise in neutrophils. Stopping filgrastim resulted in an equally steep drop. 2017 BMJ Publishing Group Ltd.

Rubella Surveillance and Diagnostic Testing among a Low-Prevalence Population, New York City, 2012-2013.

PubMed

Isaac, Beth M; Zucker, Jane R; Giancotti, Francesca R; Abernathy, Emily; Icenogle, Joseph; Rakeman, Jennifer L; Rosen, Jennifer B

2017-09-01

The New York City Department of Health and Mental Hygiene (DOHMH) receives clinical and laboratory reports for rubella. Because rubella immunoglobulin M (IgM) assays may produce false-positive results and rubella infections may be asymptomatic, interpretation of positive IgM results can be challenging. Rubella reports received by DOHMH in 2012 to 2013 were reviewed. The rubella IgM testing purpose was determined through case investigation. Results of IgM testing by indirect enzyme-linked immunosorbent assay (ELISA) and capture enzyme immunoassay (EIA) were compared to determine positive predictive value (PPV) and specificity. DOHMH received 199 rubella reports; 2 were true cases. Of all reports, 77.9% were tested for rubella IgM erroneously, 19.6% were tested for diagnostic purposes, 2.0% had unknown test purpose, and 0.5% were not tested. PPV of indirect ELISA was 6% overall, 14% for diagnostic tests, and 0% for tests ordered erroneously. PPV of capture EIA was 29% overall, 50% for diagnostic tests, and 0% for tests ordered erroneously. Overall, specificity was 52% for indirect ELISA and 85% for capture EIA. Limiting rubella IgM testing to patients for whom rubella diagnosis is suspected and using a more specific IgM assay have the potential to reduce false-positive rubella IgM results. Copyright © 2017 American Society for Microbiology.

Rare association of celiac disease with myasthenia gravis in a patient with other immune disorders: a case report.

PubMed

de Almeida Menezes, Marcela; Ribeiro Cabral, Vírginia Lúcia; Lorena, Sônia S; Nucci, Anamarli; Andrade Santana, Priscila; Queiroz Silva, Cecília

2016-09-01

Celiac disease is described in association with several autoimmune diseases, but rarely with myasthenia gravis. We describe the case of a 31-year-old white woman with celiac disease who presented manifestations related to a hyperactive immune system, including macroamylasemia, false-positive anti-HCV, positive antinuclear antibody, and Raynaud's phenomenon. The introduction of a gluten-free diet (GFD) resolved these features, but myasthenia gravis (MG) symptoms unexpectedly occurred on that occasion. The role of a GFD in the course of autoimmune diseases has been studied and improvement has been reported in many diseases. However, there is no consensus in the literature regarding the course of neurological disorders associated with celiac disease. In the present case, a GFD did not prevent the appearance of symptoms related to myasthenia gravis. There are few reports on the association of celiac disease with myasthenia gravis and therefore little is known about the course and time of onset of myasthenia in celiac patients. The present case increases the knowledge about this unusual autoimmune neurological disease associated with celiac disease.

Mining for Murder-Suicide: An Approach to Identifying Cases of Murder-Suicide in the National Violent Death Reporting System Restricted Access Database.

PubMed

McNally, Matthew R; Patton, Christina L; Fremouw, William J

2016-01-01

The National Violent Death Reporting System (NVDRS) is a United States Centers for Disease Control and Prevention (CDC) database of violent deaths from 2003 to the present. The NVDRS collects information from 32 states on several types of violent deaths, including suicides, homicides, homicides followed by suicides, and deaths resulting from child maltreatment or intimate partner violence, as well as legal intervention and accidental firearm deaths. Despite the availability of data from police narratives, medical examiner reports, and other sources, reliably finding the cases of murder-suicide in the NVDRS has proven problematic due to the lack of a unique code for murder-suicide incidents and outdated descriptions of case-finding procedures from previous researchers. By providing a description of the methods used to access to the NVDRS and coding procedures used to decipher these data, the authors seek to assist future researchers in correctly identifying cases of murder-suicide deaths while avoiding false positives. © 2015 American Academy of Forensic Sciences.

A Signal Detection Theory Approach to Evaluating Oculometer Data Quality

NASA Technical Reports Server (NTRS)

Latorella, Kara; Lynn, William, III; Barry, John S.; Kelly, Lon; Shih, Ming-Yun

2013-01-01

Currently, data quality is described in terms of spatial and temporal accuracy and precision [Holmqvist et al. in press]. While this approach provides precise errors in pixels, or visual angle, often experiments are more concerned with whether subjects'points of gaze can be said to be reliable with respect to experimentally-relevant areas of interest. This paper proposes a method to characterize oculometer data quality using Signal Detection Theory (SDT) [Marcum 1947]. SDT classification results in four cases: Hit (correct report of a signal), Miss (failure to report a ), False Alarm (a signal falsely reported), Correct Reject (absence of a signal correctly reported). A technique is proposed where subjects' are directed to look at points in and outside of an AOI, and the resulting Points of Gaze (POG) are classified as Hits (points known to be internal to an AOI are classified as such), Misses (AOI points are not indicated as such), False Alarms (points external to AOIs are indicated as in the AOI), or Correct Rejects (points external to the AOI are indicated as such). SDT metrics describe performance in terms of discriminability, sensitivity, and specificity. This paper presentation will provide the procedure for conducting this assessment and an example of data collected for AOIs in a simulated flightdeck environment.

Specificity of /sup 99m/Tc-pertechnetate in scintigraphic diagnosis of Meckel's diverticulum: review of 100 cases

DOE Office of Scientific and Technical Information (OSTI.GOV)

Berquist, T.H.; Nolan, N.G.; Stephens, D.H.

1976-06-01

Numerous reports in the recent literature have questioned the value of abdominal scanning with pertechnetate in the diagnosis of Meckel's diverticulum. In an attempt to evaluate further the specificity of pertechnetate in this condition, the clinical data and scintigrams of 100 patients with suspected Meckel's diverticulum were reviewed. The scintigram correctly identified Meckel's diverticulum before operation in seven of eight patients. One false-negative study occurred in 33 patients who underwent laparotomy. Conditions suggested as possible causes of false-positive studies (hydronephrosis, arteriovenous malformations, and intussusception) were found to give negative scans. (auth)

Extensive intramuscular manifestation of sarcoidosis with initially missed diagnosis and delayed therapy: a case report.

PubMed

Meyer, Niklaus; Sutter, Reto; Schirp, Udo; Gutzeit, Andreas

2017-08-24

Sarcoidosis is a multisystemic granulomatous disorder, which in nearly all cases involves the lungs and other organs. Isolated forms of sarcoidosis within the muscles, but without lung involvement, are extremely rare and can lead to delayed or even false diagnosis. A 52-year-old white, Swiss man presented with painful arm cramps and a history of symptoms over the previous 3 years. In the initial clinical investigation, our patient also showed edema in both legs without any other complaints. After performing an magnetic resonance imaging scan of his extremities and a positron emission tomography/computed tomography scan, diffuse myositis was described. The subsequent muscle biopsy provided the surprising diagnosis of muscle sarcoidosis, without involvement of the lungs or any other organ. After starting therapy with glucocorticoids, his symptoms improved immediately. Sarcoidosis is a common disorder, which in most cases affects the lungs. In this case report an isolated sarcoidosis is described without lung involvement, but with involvement of the muscles of the extremities and the trunk. Reported cases of sarcoidosis only involving skeletal muscle and without lung involvement are extremely rare. Radiologists should consider this presentation of sarcoidosis to avoid delayed diagnosis and therapy.

Allegations of children's involvement in ritual sexual abuse: clinical experience of 20 cases.

PubMed

Weir, I K; Wheatcroft, M S

1995-04-01

Twenty cases were evaluated in which allegations had been made of children being involved in ritual sexual abuse (RSA). A selection of case histories are presented together with a summary of the salient points in the other cases. Using a standard format developed for assessing the validity of allegations in sexual abuse cases, it was concluded that false allegations of ritual sexual abuse occurred in three-quarters of the cases and true allegations only in one-quarter. This high rate of false allegations is unlike the author's clinical experience in other cases of child sexual abuse where the rate of false allegations is much lower and similar to other published series. Reasons for the high rate of false allegations are discussed.

25 CFR 63.33 - What must an application for Indian child protection and family violence prevention program funds...

Code of Federal Regulations, 2014 CFR

2014-04-01

... responsible for the investigation of reported cases of child abuse and child neglect, the treatment and... 25 Indians 1 2014-04-01 2014-04-01 false What must an application for Indian child protection and..., DEPARTMENT OF THE INTERIOR TRIBAL GOVERNMENT INDIAN CHILD PROTECTION AND FAMILY VIOLENCE PREVENTION Indian...

25 CFR 63.33 - What must an application for Indian child protection and family violence prevention program funds...

Code of Federal Regulations, 2011 CFR

2011-04-01

... responsible for the investigation of reported cases of child abuse and child neglect, the treatment and... 25 Indians 1 2011-04-01 2011-04-01 false What must an application for Indian child protection and..., DEPARTMENT OF THE INTERIOR TRIBAL GOVERNMENT INDIAN CHILD PROTECTION AND FAMILY VIOLENCE PREVENTION Indian...

25 CFR 63.33 - What must an application for Indian child protection and family violence prevention program funds...

Code of Federal Regulations, 2013 CFR

2013-04-01

... responsible for the investigation of reported cases of child abuse and child neglect, the treatment and... 25 Indians 1 2013-04-01 2013-04-01 false What must an application for Indian child protection and..., DEPARTMENT OF THE INTERIOR TRIBAL GOVERNMENT INDIAN CHILD PROTECTION AND FAMILY VIOLENCE PREVENTION Indian...

27 CFR 31.161 - Conversion between metric and U.S. units.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 27 Alcohol, Tobacco Products and Firearms 1 2010-04-01 2010-04-01 false Conversion between metric... Wholesale Dealers' Records and Reports § 31.161 Conversion between metric and U.S. units. When liters are... number of cases to be converted, as follows: (a) If the conversion from liters to U.S. units is made...

False positive malaria rapid diagnostic test in returning traveler with typhoid fever.

PubMed

Meatherall, Bonnie; Preston, Keith; Pillai, Dylan R

2014-07-09

Rapid diagnostic tests play a pivotal role in the early diagnosis of malaria where microscopy or polymerase chain reaction are not immediately available. We report the case of a 39 year old traveler to Canada who presented with fever, headache, and abdominal pain after visiting friends and relatives in India. While in India, the individual was not ill and had no signs or symptoms of malaria. Laboratory testing upon his return to Canada identified a false positive malaria rapid diagnostic (BinaxNOW® malaria) result for P. falciparum with coincident Salmonella Typhi bacteraemia without rheumatoid or autoimmune factors. Rapid diagnostic test false positivity for malaria coincided with the presence or absence of Salmonella Typhi in the blood. Clinicians should be aware that Salmonella Typhi infection may result in a false positive malaria rapid diagnostic test. The mechanism of this cross-reactivity is not clear.

Diagnosing periprosthetic infection: false-positive intraoperative Gram stains.

PubMed

Oethinger, Margret; Warner, Debra K; Schindler, Susan A; Kobayashi, Hideo; Bauer, Thomas W

2011-04-01

Intraoperative Gram stains have a reported low sensitivity but high specificity when used to help diagnose periprosthetic infections. In early 2008, we recognized an unexpectedly high frequency of apparent false-positive Gram stains from revision arthroplasties. The purpose of this report is to describe the cause of these false-positive test results. We calculated the sensitivity and specificity of all intraoperative Gram stains submitted from revision arthroplasty cases during a 3-month interval using microbiologic cultures of the same samples as the gold standard. Methods of specimen harvesting, handling, transport, distribution, specimen processing including tissue grinding/macerating, Gram staining, and interpretation were studied. After a test modification, results of specimens were prospectively collected for a second 3-month interval, and the sensitivity and specificity of intraoperative Gram stains were calculated. The retrospective review of 269 Gram stains submitted from revision arthroplasties indicated historic sensitivity and specificity values of 23% and 92%, respectively. Systematic analysis of all steps of the procedure identified Gram-stained but nonviable bacteria in commercial broth reagents used as diluents for maceration of periprosthetic membranes before Gram staining and culture. Polymerase chain reaction and sequencing showed mixed bacterial DNA. Evaluation of 390 specimens after initiating standardized Millipore filtering of diluent fluid revealed a reduced number of positive Gram stains, yielding 9% sensitivity and 99% specificity. Clusters of false-positive Gram stains have been reported in other clinical conditions. They are apparently rare related to diagnosing periprosthetic infections but have severe consequences if used to guide treatment. Even occasional false-positive Gram stains should prompt review of laboratory methods. Our observations implicate dead bacteria in microbiologic reagents as potential sources of false-positive Gram stains.

Predictive value of autoantibody testing for validating self-reported diagnoses of rheumatoid arthritis in the Women's Health Initiative.

PubMed

Walitt, Brian; Mackey, Rachel; Kuller, Lewis; Deane, Kevin D; Robinson, William; Holers, V Michael; Chang, Yue-Fang; Moreland, Larry

2013-05-01

Rheumatoid arthritis (RA) research using large databases is limited by insufficient case validity. Of 161,808 postmenopausal women in the Women's Health Initiative, 15,691 (10.2%) reported having RA, far higher than the expected 1% population prevalence. Since chart review for confirmation of an RA diagnosis is impractical in large cohort studies, the current study (2009-2011) tested the ability of baseline serum measurements of rheumatoid factor and anti-cyclic citrullinated peptide antibodies, second-generation assay (anti-CCP2), to identify physician-validated RA among the chart-review study participants with self-reported RA (n = 286). Anti-CCP2 positivity had the highest positive predictive value (PPV) (80.0%), and rheumatoid factor positivity the lowest (44.6%). Together, use of disease-modifying antirheumatic drugs and anti-CCP2 positivity increased PPV to 100% but excluded all seronegative cases (approximately 15% of all RA cases). Case definitions inclusive of seronegative cases had PPVs between 59.6% and 63.6%. False-negative results were minimized in these test definitions, as evidenced by negative predictive values of approximately 90%. Serological measurements, particularly measurement of anti-CCP2, improved the test characteristics of RA case definitions in the Women's Health Initiative.

[Rare case of upper respiratory tract obstruction secondary to massive hematoma of pharynx, larynx and trachea].

PubMed

Kozakiewicz, Jacek; Gierlotka, Agata; Dec, Maciej; Stockfish, Jerzy

2010-01-01

The rare case of 75-years-old female patient was presented in this paper. She reported hoarseness in addition to pharyngeal pain, dysphagia and medium level dyspnea. Her exploration revealed a wide hematoma of the left lateral wall of orohypopharynx spreading to the left aryepiglottic fold, left aryepiglottic cartilage, false and true vocal fold and later to left lateral and posterior tracheal wall. The patient did not require a control of airway by intubation or tracheotomy according to quick relief after pharmacological treatment.

Creatine transporter deficiency: prevalence among patients with mental retardation and pitfalls in metabolite screening.

PubMed

Arias, Angela; Corbella, Marc; Fons, Carmen; Sempere, Angela; García-Villoria, Judit; Ormazabal, Aida; Poo, Pilar; Pineda, Mercé; Vilaseca, María Antonia; Campistol, Jaume; Briones, Paz; Pàmpols, Teresa; Salomons, Gajja S; Ribes, Antonia; Artuch, Rafael

2007-11-01

To report the prevalence of creatine transporter deficiency in males with mental retardation and to study whether a protein-rich food intake might be a potential diagnostic pitfall. We determined creatine/creatinine ratio in urine samples from 1600 unrelated male patients with mental retardation and/or autism. Urine creatine was analyzed by HPLC-MS/MS. Thirty-three of 1600 cases showed increased urine creatine/creatinine ratio. Four out of these thirty-three cases were definitively diagnosed with creatine transporter deficiency, while the other 29 were false positive results. Significantly higher values were observed for urine Cr/Crn ratio in healthy volunteers after a meal based on beef or oily fish as compared to eggs, pasta or salad (Wilcoxon test: p<0.005). False positive results may be observed in biochemical screening for creatine transporter deficiency, and they may be due to intake of meals rich in creatine prior to urine samples analysis.

Evaluation of inadequate, indeterminate, false-negative and false-positive cases in cytological examination for breast cancer according to histological type

PubMed Central

2012-01-01

Background We previously investigated the current status of breast cytology cancer screening at seven institutes in our area of southern Fukuoka Prefecture, and found some differences in diagnostic accuracy among the institutions. In the present study, we evaluated the cases involved and noted possible reasons for their original cytological classification as inadequate, indeterminate, false-negative and false-positive according to histological type. Methods We evaluated the histological findings in 5693 individuals who underwent cytological examination for breast cancer (including inadequate, indeterminate, false-negative and false-positive cases), to determine the most common histological types and/or features in these settings and the usefulness/limitations of cytological examination for the diagnosis of breast cancer. Results Among 1152 cytologically inadequate cases, histology revealed that 75/173 (43.6%) cases were benign, including mastopathy (fibrocystic disease) in 38.6%, fibroadenoma in 24.0% and papilloma in 5.3%. Ninety-five of 173 (54.9%) cases were histologically malignant, with scirrhous growing type, invasive ductal carcinoma (SIDC) being significantly more frequent (49.5%) than papillotubular growing type (Papi-tub) (P < 0.0001), solid-tubular growing type (P = 0.0001) and ductal carcinoma in situ (DCIS) (P = 0.0001). Among 458 indeterminate cases, 54/139 (38.8%) were histologically benign (mastopathy, 30.0%; fibroadenoma, 27.8%; papilloma, 26.0%) and 73/139 (52.5%) were malignant, with SIDC being the most frequent malignant tumor (37.0%). Among 52 false-negative cases, SIDC was significantly more frequent (42.3%) than DCIS (P = 0.0049) and Papi-tub (P = 0.001). There were three false-positive cases, with one each of fibroadenoma, epidermal cyst and papilloma. Conclusions The inadequate, indeterminate, false-negative and false-positive cases showed similar histological types, notably SIDC for malignant tumors, and mastopathy, fibroadenoma and papilloma for benign cases. We need to pay particular attention to the collection and assessment of aspirates for these histological types of breast disease. In particular, several inadequate, indeterminate and false-negative cases with samples collected by aspiration were diagnosed as SIDC. These findings should encourage the use of needle biopsy rather than aspiration when this histological type is identified on imaging. Namely, good communication between clinicians and pathological staff, and triple assessment (i.e., clinical, pathological and radiological assessment), are important for accurate diagnosis of aspiration samples. Virtual slides The virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/7349809170055423 PMID:22607447

Early Disseminated Lyme Disease Masquerading as Mononucleosis: A Case Report.

PubMed

Tumminello, Richard; Glaspey, Lindsey; Bhamidipati, Anita; Sheehan, Patrick; Patel, Sundip

2017-12-01

Disseminated Lyme disease can be difficult to diagnose, as it begins with nonspecific signs and symptoms, which, if not treated correctly, can lead to atrioventricular conduction blocks and meningitis. In addition, the diagnosis can be further complicated by potentially false-positive test results. We report a case of early-disseminated Lyme disease presenting with Borrelia meningitis and concomitant Lyme carditis, which was misdiagnosed as mononucleosis. A young, previously healthy patient had been hiking in the woods of upstate New York and 4 weeks later developed fever, night sweats, and myalgias. He was diagnosed with mononucleosis via a positive rapid heterophile agglutination antibody test to the Epstein-Barr virus at a walk-in clinic and was started on medications, but then subsequently developed left hip pain, a facial droop, and a very long first-degree atrioventricular conduction block. He went to the Emergency Department, where he had testing that confirmed disseminated Lyme disease. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: This case highlights the difficulty in early diagnosis of disseminated Lyme disease and how a potentially false-positive laboratory test can lead to the complications of Borrelia meningitis and Lyme carditis in untreated young healthy patients. Emergency physicians need to consider Lyme disease in patients with nonspecific signs and symptoms, especially if they have been outdoors for prolonged periods of time in Lyme-endemic areas. Copyright © 2017 Elsevier Inc. All rights reserved.

Self-Identified Vampirism and Risk for False Positives: A Case Example of Team Homicide and Implications for Forensic Behavioral Science.

PubMed

Williams, D J

2017-05-01

Historically, reported cases of self-identified vampirism typically have been associated with psychopathology and sometimes a propensity for violence. However, scholars recently have noted a wide range of diverse practices and meanings that all fall under the general description of self-identified vampirism. This brief report focuses on a homicide case (male and female partnered offenders), wherein a single victim was murdered and dismembered. Due to specific case evidence, there was controversy regarding whether or not the homicide was motivated by ritualistic self-identified vampirism. Court documents were reviewed and assessed, and findings suggest that the evidence used to support assertions that homicidal motivations occurred due to ritualistic vampirism was misinterpreted due to the omission of a growing multidisciplinary literature on self-identified vampirism. It is important for forensic experts to be aware of emerging research on alternative identities, including vampirism, that challenge traditional theories and assumptions. © 2016 American Academy of Forensic Sciences.

Management of carotid Dacron patch infection: a case report using median sternotomy for proximal common carotid artery control and in situ polytetrafluoroethylene grafting.

PubMed

Illuminati, Giulio; Calio', Francesco G; D'Urso, Antonio; Ceccanei, Gianluca; Pacilè, Maria Antonietta

2009-01-01

We report on a 58-year-old male who presented with an enlarging cervical hematoma 3 months following carotid endarterectomy with Dacron patch repair, due to septic disruption of the Dacron patch secondary to presumed infection. The essential features of this case are the control of the proximal common carotid artery gained through a median sternotomy, because the patient was markedly obese with minimal thyromental distance, and the treatment consisting of in situ polytetrafluoroethylene bypass grafting, due to the absence of a suitable autogenous saphenous vein. Median sternotomy is rarely required in case of reintervention for septic false aneurysms and hematomas following carotid endarterectomy but should be considered whenever difficult control of the common carotid artery, when entering the previous cervicotomy, is anticipated. In situ polytetrafluoroethylene grafting can be considered if autogenous vein material is lacking.

A case of factitious pedophilia.

PubMed

Porter, Theresa M; Feldman, Marc D

2011-09-01

Factitious disorder involves feigning, exaggerating, or self-inducing physical and/or psychological ailments with the goal of assuming the "sick" or "patient" role. In turn, the sick role entitles the factitious disorder patient to care, nurturance, and protection; it also exempts one from usual responsibilities. In this paper, we present the first reported case of factitious pedophilia. Although it seems counterintuitive, this middle-aged man has falsely claimed or exaggerated sexual desire for minors ostensibly to remain in a state hospital; indeed, he has remained in the same inpatient facility for more than 20 years as a result of his deceptions. At times, his reports have included disconfirmed claims of bizarre accidents and other physical travails. This case enlarges the literature on factitious psychological disorders and shows that some individuals may falsify paraphilic behaviors, although clearly minimization of these behaviors remains more common. © 2011 American Academy of Forensic Sciences.

Incidence of tuberculous meningitis in France, 2000: a capture-recapture analysis.

PubMed

Cailhol, J; Che, D; Jarlier, V; Decludt, B; Robert, J

2005-07-01

To estimate the incidence of culture-positive and culture-negative tuberculous meningitis (TBM) in France in 2000. Capture-recapture method using two unrelated sources of data: the tuberculosis (TB) mandatory notification system (MNTB), recording patients treated by anti-tuberculosis drugs, and a survey by the National Reference Centre (NRC) for mycobacterial drug resistance, recording culture-positive TBM. Of 112 cases of TBM reported to the MNTB, 28 culture-positive and 34 culture-negative meningitis cases were validated (17 duplicates, 3 cases from outside France, 21 false notifications, and 9 lost records were excluded). The NRC recorded 31 culture-positive cases, including 21 known by the MNTB. When the capture-recapture method was applied to the reported culture-positive meningitis cases, the estimated number of meningitis cases was 41 and the incidence was 0.7 cases per million. Sensitivity was 75.6% for the NRC, 68.3% for the MNTB, and 92.7% for both systems together. When sensitivity of the MNTB for culture-positive cases was applied to culture-negative meningitis, the total estimated number of culture-negative meningitis cases was 50 and the incidence was 0.85 cases per million. TBM is underestimated in France. Capture-recapture analysis using different sources to better estimate its incidence is of great interest.

Categorizing mistaken false positives in regulation of human and environmental health.

PubMed

Hansen, Steffen Foss; Krayer von Krauss, Martin P; Tickner, Joel A

2007-02-01

One of the concerns often voiced by critics of the precautionary principle is that a widespread regulatory application of the principle will lead to a large number of false positives (i.e., over-regulation of minor risks and regulation of nonexisting risks). The present article proposes a general definition of a regulatory false positive, and seeks to identify case studies that can be considered authentic regulatory false positives. Through a comprehensive review of the science policy literature for proclaimed false positives and interviews with authorities on regulation and the precautionary principle we identified 88 cases. Following a detailed analysis of these cases, we found that few of the cases mentioned in the literature can be considered to be authentic false positives. As a result, we have developed a number of different categories for these cases of "mistaken false positives," including: real risks, "The jury is still out," nonregulated proclaimed risks, "Too narrow a definition of risk," and risk-risk tradeoffs. These categories are defined and examples are presented in order to illustrate their key characteristics. On the basis of our analysis, we were able to identify only four cases that could be defined as regulatory false positives in the light of today's knowledge and recognized uncertainty: the Southern Corn Leaf Blight, the Swine Flu, Saccharin, and Food Irradiation in relation to consumer health. We conclude that concerns about false positives do not represent a reasonable argument against future application of the precautionary principle.

26 CFR 1.172-7 - Joint return by husband and wife.

Code of Federal Regulations, 2010 CFR

2010-04-01

... taxable year is deemed to be, in a case in which such taxable income was reported in a joint return, the... 26 Internal Revenue 3 2010-04-01 2010-04-01 false Joint return by husband and wife. 1.172-7...-7 Joint return by husband and wife. (a) In general. This section prescribes additional rules for...

Reading Comprehension and the Assessment and Acquisition of Word Knowledge. Technical Report No. 249.

ERIC Educational Resources Information Center

Anderson, Richard C.; Freebody, Peter

The "yes/no" method of vocabulary assessment requires students to indicate words they know from among a list of words and nonwords. Preliminary evidence gained from a study involving fifth grade students indicates that the method is superior in many ways to the multiple choice method of assessment. Analysis of "false alarms," cases in which…

What Is a False Negative Sentinel Node Biopsy: Definition, Reasons and Ways to Minimize It?

PubMed

Kataria, Kamal; Srivastava, Anurag; Qaiser, Darakhshan

2016-10-01

Sentinel node biopsy helps in assessing the involvement of axillary lymph node without the morbidity of full axillary lymph node dissection, namely arm and shoulder pain, paraesthesia and lymphoedema. The various methods described in the literature identify the sentinel lymph nodes in approximately 96 % of cases and associated with a false negativity rate of 5 to 10 %. A false negative sentinel node is defined as the proportion of cases in whom sentinel node biopsy is reported as negative, but the rest of axillary lymph node(s) harbours cancer cells. The possible causes of a false negative sentinel lymph node may be because of blocked lymphatics either by cancer cells or following fibrosis of previous surgery/radiotherapy, and an alternative pathway opens draining the blue dye or isotope to another uninvolved node . The other reasons may be two lymphatic pathways for a tumour area, the one opening to a superficial node and the other in deep nodes. Sometimes, lymphatics do not relay into a node but traverse it going to a higher node. In some patients, the microscopic focus of metastasis inside a lymph node is so small-micrometastasis (i.e. between 0.2 and 2 mm) or isolated tumour cells (i.e. less than 0.2 mm) that is missed by the pathologist. The purpose of this review is to clear some fears lurking in the mind of most surgeons about the false negative sentinel lymph node (FNSLN).

GRANULOMATOUS ENCEPHALOMYELITIS IN A FALSE GHARIAL (TOMISTOMA SCHLEGELII) ASSOCIATED WITH A NOVEL CHLAMYDIA SPECIES.

PubMed

Bercier, Marjorie; Heard, Darryl J; Goe, Alexandra M; Epperson, Ember; Abbott, Jeffrey R; Childress, April L; Wellehan, James F X

2017-06-01

A 5-yr-old, captive, hatched, female false gharial (Tomistoma schlegelii) presented with a 1-mo history of cervical spinal curvature. Antemortem diagnostics, including blood work, electromyography, muscle biopsies, and advanced imaging tests, were either within reference ranges or did not identify any specific etiology. Necropsy revealed extensive, marked, chronic granulomatous encephalomyelitis along with neuronal necrosis, rarefaction, gliosis, and astrocytosis of the white and gray matter of the cerebrum, cerebellum, brainstem, and spinal cord. Pan-chlamydiae polymerase chain reaction protocols for the 16S ribosomal RNA and ompA genes were performed on samples of spinal cord and brain, and both resulted in amplicons. Sequencing of the products revealed that they were positive for a novel Chlamydia species. Infections by members of the phylum Chlamydiae have been reported in a diverse range of vertebrate hosts, including crocodilians. Chlamydia spp. infections are likely underdiagnosed because of a paucity of diagnostic techniques specific for detection. This is the first case report of a novel Chlamydia species associated with severe granulomatous encephalomyelitis in a false gharial.

Skin testing for immediate hypersensitivity to corticosteroids: a case series and literature review.

PubMed

Baker, A; Empson, M; The, R; Fitzharris, P

2015-03-01

Immediate hypersensitivity to corticosteroids is reported to occur with an incidence of 0.1%. The largest previous case series reporting corticosteroid skin testing has seven patients. We identified 23 patients (mean age 50 years, 65% female) from Auckland City Hospital who underwent skin testing (ST) for suspected corticosteroid hypersensitivity between July 2005 and April 2012. We performed a retrospective clinical case note review detailing clinical history of reaction, skin test results and subsequent management. Most patients (21/23) had a standard panel of testing with prednisolone, triamcinolone, methylprednisolone, hydrocortisone and dexamethasone. Skin tests used a 10% steroid stock concentration for skin prick tests (SPT) and dilutions of 1 : 1000, 1 : 100 and 1 : 10 for subsequent intradermal testing. A weal 3 mm greater than the negative control was considered positive. A total of 23 patients were identified who had skin testing for suspected acute hypersensitivity to corticosteroids, eight of which had a history of anaphylaxis. From 28 reactions (in 23 patients), the most common route of administration was intra-articular (13), followed by oral (7), intravenous (3) and other (5). Skin tests were positive in 8/23 patients, and 7/8 of these patients had a history of corticosteroid-associated anaphylaxis. Skin tests were positive at either the skin prick test or intradermal stages. There was evidence suggesting clinical and skin test cross-reactivity between corticosteroids in one patient. One patient had a positive skin test, but negative oral challenge suggesting the skin test was false positive. Skin tests were negative in 15/23 patients. One patient had a negative prednisolone skin test and positive unblinded oral challenge, suggesting a false-negative skin test. Skin testing can provide sufficient evidence to diagnose allergy in patients with a clear history of immediate hypersensitivity to corticosteroids such as anaphylaxis. Both skin prick and intradermal tests should be used. There is evidence of cross-reactivity between steroids, so a panel is recommended. False-positive and false-negative reactions do occur; however, the frequency is unknown. Challenge remains the only definitive way to demonstrate a safe alternative to use. As the largest case series described, this article provides new evidence for the interpretation of skin tests when investigating possible immediate hypersensitivity to corticosteroids. © 2014 John Wiley & Sons Ltd.

Multimodal intraoperative neuromonitoring in corrective surgery for adolescent idiopathic scoliosis: Evaluation of 354 consecutive cases

PubMed Central

Kundnani, Vishal K; Zhu, Lisa; Tak, HH; Wong, HK

2010-01-01

Background: Multimodal intraoperative neuromonitoring is recommended during corrective spinal surgery, and has been widely used in surgery for spinal deformity with successful outcomes. Despite successful outcomes of corrective surgery due to increased safety of the patients with the usage of spinal cord monitoring in many large spine centers, this modality has not yet achieved widespread popularity. We report the analysis of prospectively collected intraoperative neurophysiological monitoring data of 354 consecutive patients undergoing corrective surgery for adolescent idiopathic scoliosis (AIS) to establish the efficacy of multimodal neuromonitoring and to evaluate comparative sensitivity and specificity. Materials and Methods: The study group consisted of 354 (female = 309; male = 45) patients undergoing spinal deformity corrective surgery between 2004 and 2008. Patients were monitored using electrophysiological methods including somatosensory-evoked potentials and motor-evoked potentials simultaneously. Results: Mean age of patients was 13.6 years (±2.3 years). The operative procedures involved were instrumented fusion of the thoracic/lumbar/both curves, Baseline somatosensory-evoked potentials (SSEP) and neurogenic motor-evoked potentials (NMEP) were recorded successfully in all cases. Thirteen cases expressed significant alert to prompt reversal of intervention. All these 13 cases with significant alert had detectable NMEP alerts, whereas significant SSEP alert was detected in 8 cases. Two patients awoke with new neurological deficit (0.56%) and had significant intraoperative SSEP + NMEP alerts. There were no false positives with SSEP (high specificity) but 5 patients with false negatives with SSEP (38%) reduced its sensitivity. There was no false negative with NMEP but 2 of 13 cases were false positive with NMEP (15%). The specificity of SSEP (100%) is higher than NMEP (96%); however, the sensitivity of NMEP (100%) is far better than SSEP (51%). Due to these results, the overall sensitivity, specificity and positive predictive value of combined multimodality neuromonitoring in this adult deformity series was 100, 98.5 and 85%, respectively. Conclusion: Neurogenic motor-evoked potential (NMEP) monitoring appears to be superior to conventional SSEP monitoring for identifying evolving spinal cord injury. Used in conjunction, the sensitivity and specificity of combined neuromonitoring may reach up to 100%. Multimodality monitoring with SSEP + NMEP should be the standard of care. PMID:20165679

Unusual association of amyotrophic lateral sclerosis and myasthenia gravis: A dysregulation of the adaptive immune system?

PubMed

Del Mar Amador, Maria; Vandenberghe, Nadia; Berhoune, Nawel; Camdessanché, Jean-Philippe; Gronier, Sophie; Delmont, Emilien; Desnuelle, Claude; Cintas, Pascal; Pittion, Sophie; Louis, Sarah; Demeret, Sophie; Lenglet, Timothée; Meininger, Vincent; Salachas, François; Pradat, Pierre-François; Bruneteau, Gaëlle

2016-06-01

Myasthenia gravis is an autoimmune disorder affecting neuromuscular junctions that has been associated with a small increased risk of amyotrophic lateral sclerosis (ALS). Here, we describe a retrospective series of seven cases with a concomitant diagnosis of ALS and myasthenia gravis, collected among the 18 French reference centers for ALS in a twelve year period. After careful review, only six patients strictly met the diagnostic criteria for both ALS and myasthenia gravis. In these patients, limb onset of ALS was reported in five (83%) cases. Localization of myasthenia gravis initial symptoms was ocular in three (50%) cases, generalized in two (33%) and bulbar in one (17%). Median delay between onset of the two conditions was 19 months (6-319 months). Anti-acetylcholine receptor antibodies testing was positive in all cases. All patients were treated with riluzole and one had an associated immune-mediated disease. In the one last ALS case, the final diagnosis was false-positivity for anti-acetylcholine receptor antibodies. The co-occurrence of ALS and myasthenia gravis is rare and requires strict diagnostic criteria. Its demonstration needs thoughtful interpretation of electrophysiological results and exclusion of false positivity for myasthenia gravis antibody testing in some ALS cases. This association may be triggered by a dysfunction of adaptive immunity. Copyright © 2016 Elsevier B.V. All rights reserved.

Potential effect of CAD systems on the detection of actionable nodules in chest CT scans during routine reporting

NASA Astrophysics Data System (ADS)

Wormanns, Dag; Beyer, Florian; Butzbach, Arnauld; Zierott, Livia; Heindel, Walter

2006-03-01

The purpose of the presented study was to determine the impact of two different CAD systems used as concur-rent reader for detection of actionable nodules (>4 mm) on the interpretation of chest CT scans during routine reporting. Fifty consecutive MDCT scans (1 mm or 1.25 mm slice thickness, 0.8 mm reconstruction increment) were se-lected from clinical routine. All cases were read by a resident and a staff radiologist, and a written report was available in the radiology information system (RIS). The RIS report mentioned at least one actionable pulmonary nodule in 18 cases (50%) and did not report any pulmonary nodule in the remaining 32 cases. Two different recent CAD systems were independently applied to the 50 CT scans as concurrent reader with two radiologists: Siemens LungCare NEV and MEDIAN CAD-Lung. Two radiologists independently reviewed the CAD results and determined if a CAD result was a true positive or a false positive finding. Patients were classified into two groups: in group A if at least one actionable nodule was detected and in group B if no actionable nodules were found. The effect of CAD on routine reporting was simulated as set union of the findings of routine reporting and CAD thus applying CAD as concurrent reader. According to the RIS report group A (patients with at least one actionable nodule) contained 18 cases (36% of all 50 cases), and group B contained 32 cases. Application of a CAD system as concurrent reader resulted in detec-tion of additional CT scans with actionable nodules and reclassification into group A in 16 resp. 18 cases (radi-ologist 1 resp. radiologist 2) with Siemens NEV and in 19 resp. 18 cases with MEDIAN CAD-Lung. In seven cases MEDIAN CAD-Lung and in four cases Siemens NEV reclassified a case into group A while the other CAD system missed the relevant finding. Sensitivity on a nodule (>4 mm) base was .45 for Siemens NEV and .55 for MEDIAN CAD-Lung; the difference was not yet significant (p=.077). In our study use of CAD as second reader in routine reporting doubled the percentage of patients with actionable nodules larger than 4 mm.

The Added Value of a Single-photon Emission Computed Tomography-Computed Tomography in Sentinel Lymph Node Mapping in Patients with Breast Cancer and Malignant Melanoma.

PubMed

Bennie, George; Vorster, Mariza; Buscombe, John; Sathekge, Mike

2015-01-01

Single-photon emission computed tomography-computed tomography (SPECT-CT) allows for physiological and anatomical co-registration in sentinel lymph node (SLN) mapping and offers additional benefits over conventional planar imaging. However, the clinical relevance when considering added costs and radiation burden of these reported benefits remains somewhat uncertain. This study aimed to evaluate the possible added value of SPECT-CT and intra-operative gamma-probe use over planar imaging alone in the South African setting. 80 patients with breast cancer or malignant melanoma underwent both planar and SPECT-CT imaging for SLN mapping. We assessed and compared the number of nodes detected on each study, false positive and negative findings, changes in surgical approach and or patient management. In all cases where a sentinel node was identified, SPECT-CT was more accurate anatomically. There was a significant change in surgical approach in 30 cases - breast cancer (n = 13; P 0.001) and malignant melanoma (n = 17; P 0.0002). In 4 cases a node not identified on planar imaging was seen on SPECT-CT. In 16 cases additional echelon nodes were identified. False positives were excluded by SPECT-CT in 12 cases. The addition of SPECT-CT and use of intra-operative gamma-probe to planar imaging offers important benefits in patients who present with breast cancer and melanoma. These benefits include increased nodal detection, elimination of false positives and negatives and improved anatomical localization that ultimately aids and expedites surgical management. This has been demonstrated in the context of industrialized country previously and has now also been confirmed in the setting of a emerging-market nation.

Intersubject Differences in False Nonmatch Rates for a Fingerprint-Based Authentication System

NASA Astrophysics Data System (ADS)

Breebaart, Jeroen; Akkermans, Ton; Kelkboom, Emile

2009-12-01

The intersubject dependencies of false nonmatch rates were investigated for a minutiae-based biometric authentication process using single enrollment and verification measurements. A large number of genuine comparison scores were subjected to statistical inference tests that indicated that the number of false nonmatches depends on the subject and finger under test. This result was also observed if subjects associated with failures to enroll were excluded from the test set. The majority of the population (about 90%) showed a false nonmatch rate that was considerably smaller than the average false nonmatch rate of the complete population. The remaining 10% could be characterized as "goats due to their relatively high probability for a false nonmatch. The image quality reported by the template extraction module only weakly correlated with the genuine comparison scores. When multiple verification attempts were investigated, only a limited benefit was observed for "goats, since the conditional probability for a false nonmatch given earlier nonsuccessful attempts increased with the number of attempts. These observations suggest that (1) there is a need for improved identification of "goats during enrollment (e.g., using dedicated signal-driven analysis and classification methods and/or the use of multiple enrollment images) and (2) there should be alternative means for identity verification in the biometric system under test in case of two subsequent false nonmatches.

The importance of laboratory re-evaluation in cases of suspected child abuse - A case report.

PubMed

Woydt, L; König, C; Bernhard, M K; Nickel, P; Dreßler, J; Ondruschka, B

2017-09-01

In order to accurately diagnose child abuse or neglect, a physician needs to be familiar with diseases and medical conditions that can simulate maltreatment. Unrecognized cases of abuse may lead to insufficient child protection, whereas, on the other hand, over-diagnosis could be the cause of various problems for the family and their potentially accused members. Regarding child abuse, numerous cases of false diagnoses with undetected causes of bleeding are described in the scientific literature, but, specifically concerning leukemia in childhood, only very few case reports exist. Here, for the first time, we report a case of a 2-year-old boy who got hospitalized twice because of suspicious injuries and psychosocial conspicuities, in a family situation known for repeated endangerment of the child's well-being. After his first hospitalization with injuries typical for child abuse, but without paraclinical abnormalities, medical inspections were arranged periodically. The child was hospitalized with signs of repeated child abuse again five months later. During second admission, an acute lymphoblastic leukemia was revealed by intermittent laboratory examination, ordered due to new bruises with changes in morphology, identifiable as petechial hemorrhages. This case elucidates the discussion of known cases of leukemia in childhood associated with suspected child abuse in order to provide an overview of possible diseases mimicking maltreatment. To arrange necessary supportive examinations, a skillful interaction between pediatrician and forensic pathologist is crucial in the differentiation between accidental and non-accidental injury. Copyright © 2017 Elsevier B.V. All rights reserved.

False aneurysm of the popliteal artery complicated by a deep venous thrombosis revealing an exostosis in a 20-year-old young woman.

PubMed

Bakkali, Tarik; Hormatallah, Mohamed; Bounssir, Ayoub; Aghtoutane, Nabil; Taous, Hamza; Idrissi, Redouane; Sefiani, Yasser; Lekhel, Brahim; Mesnaoui, Abbes; Bensaid, Younes

2018-05-19

Exostoses or osteochondromas are benign osseous tumors that develop on the bone surface and can be sporadic or hereditary. Their evolution is generally benign but they may be complicated in some patients by conflicts with the surrounding nervous or vascular structures, in particular arteries. We report a case of false aneurysm of the popliteal artery secondary to an isolated exostosis of the left femur in a 20-year-old young woman. A delay in the diagnosis allowed the development of the false aneurysm which was at the origin of a major venous compression. The surgical treatment consisted in aneurysmectomy and reconstruction by end to end anastomosis associated to the resection of the osseous tumor, and the deep venous thrombosis was treated medically. Copyright © 2018. Published by Elsevier Inc.

False Elevation of the Blood Tacrolimus Concentration, as Assessed by an Affinity Column-mediated Immunoassay (ACMIA), Led to Acute T Cell-mediated Rejection after Kidney Transplantation.

PubMed

Kono, Momoko; Hasegawa, Jumpei; Ogawa, Hina; Yoshikawa, Kanae; Ishiwatari, Ayumi; Wakai, Sachiko; Tanabe, Kazunari; Shirakawa, Hiroki

2018-05-01

Tacrolimus is the most commonly used immunosuppressant. Because of its narrow therapeutic range, it is necessary to frequently monitor its concentration. We report the case of a 25-year-old man who underwent kidney transplantation whose tacrolimus concentrations, as measured by an affinity column-mediated immunoassay, were falsely elevated. As we reduced the dose of tacrolimus, the recipient developed T cell-mediated rejection. Using the same blood samples, an enzyme-multiplied immunoassay technique showed that the patient's levels of tacrolimus were extremely low. A further examination indicated that the false increase in the tacrolimus concentration was likely due to an unknown interfering substance. We administered methylprednisolone and antithymocyte-globulin. The patient's serum creatinine level decreased and remained stable after these treatments.

Coinfection of hepatitis A virus genotype IA and IIIA complicated with autoimmune hemolytic anemia, prolonged cholestasis, and false-positive immunoglobulin M anti-hepatitis E virus: a case report.

PubMed

Kim, Hee Sup; Jeong, Sook Hyang; Jang, Je Hyuck; Myung, Hyung Joon; Kim, Jin Wook; Bang, Soo Mee; Song, Sang Hoon; Kim, Haeryoung; Yun, Hae Sun

2011-12-01

A 37-year-old male presented with fever and jaundice was diagnosed as hepatitis A complicated with progressive cholestasis and severe autoimmune hemolytic anemia. He was treated with high-dose prednisolone (1.5 mg/kg), and eventually recovered. His initial serum contained genotype IA hepatitis A virus (HAV), which was subsequently replaced by genotype IIIA HAV. Moreover, at the time of development of hemolytic anemia, he became positive for immunoglobulin M (IgM) anti-hepatitis E virus (HEV). We detected HAV antigens in the liver biopsy specimen, while we detected neither HEV antigen in the liver nor HEV RNA in his serum. This is the first report of hepatitis A coinfected with two different genotypes manifesting with autoimmune hemolytic anemia, prolonged cholestasis, and false-positive IgM anti-HEV.

Coinfection of hepatitis A virus genotype IA and IIIA complicated with autoimmune hemolytic anemia, prolonged cholestasis, and false-positive immunoglobulin M anti-hepatitis E virus: a case report

PubMed Central

Kim, Hee-Sup; Jang, Je-Hyuck; Myung, Hyung-Joon; Kim, Jin-Wook; Bang, Soo-Mee; Song, Sang Hoon; Kim, Haeryoung; Yun, Hae Sun

2011-01-01

A 37-year-old male presented with fever and jaundice was diagnosed as hepatitis A complicated with progressive cholestasis and severe autoimmune hemolytic anemia. He was treated with high-dose prednisolone (1.5 mg/kg), and eventually recovered. His initial serum contained genotype IA hepatitis A virus (HAV), which was subsequently replaced by genotype IIIA HAV. Moreover, at the time of development of hemolytic anemia, he became positive for immunoglobulin M (IgM) anti-hepatitis E virus (HEV). We detected HAV antigens in the liver biopsy specimen, while we detected neither HEV antigen in the liver nor HEV RNA in his serum. This is the first report of hepatitis A coinfected with two different genotypes manifesting with autoimmune hemolytic anemia, prolonged cholestasis, and false-positive IgM anti-HEV. PMID:22310798

Case of possible multiple system atrophy with a characteristic imaging finding of open bladder neck during storage phase as an initial sign.

PubMed

Zhang, Lu; Haga, Nobuhiro; Ogawa, Soichiro; Matsuoka, Kanako; Koguchi, Tomoyuki; Akaihata, Hidenori; Hata, Junya; Kataoka, Masao; Ishibashi, Kei; Kojima, Yoshiyuki

2017-11-01

Multiple system atrophy is a neurodegenerative disease that affects autonomic and motor systems. Patients with multiple system atrophy usually experience lower urinary tract symptoms, which sometimes appear as an initial symptom before the emergence of the generalized symptoms. An open bladder neck during the filling phase on video urodynamic study is one characteristic imaging finding after the diagnosis of multiple system atrophy, but has not previously been reported at an early phase of the disease. We report a case in which an open bladder neck was observed on several imaging modalities before generalized symptoms emerged. Because occult neurogenic bladder might exist in patients whose lower urinary tract symptoms are resistant to pharmacotherapy, we report this case to raise awareness of the importance of sufficient imaging evaluations. An open bladder neck might be an important imaging finding for diagnosing multiple system atrophy, irrespective of the presence of generalized symptoms. This finding could help avoid false diagnosis and unnecessary treatment. © 2017 The Japanese Urological Association.

Delusional infestation with unusual pathogens: a report of three cases.

PubMed

Dewan, P; Miller, J; Musters, C; Taylor, R E; Bewley, A P

2011-10-01

Delusional infestation (DI) is a psychiatric disorder characterized by a fixed, false belief that the patient is infested with extracorporeal agents. It is known by several names, including the more commonly used term 'delusional parasitosis'. The psychiatric disease is responsible for the cutaneous pathology. About 90% of patients with DI seek help from dermatologists, and most reject psychiatric referral. Thus, effective management requires incorporation of psychiatric principles. We report three cases of DI with inanimate materials, and examine 'Morgellons' disease. We believe that patients with unusual presentations of DI are likely to be seen more commonly in the future. These patients appear to be a subgroup of DI, and may be even more difficult to treat than other patients with DI. © The Author(s). CED © 2011 British Association of Dermatologists.

Grappling with Grammar on a Virtual Learning Platform: The Case of First Year French Students at the University of Wollongong

ERIC Educational Resources Information Center

Bissoonauth-Bedford, A.; Stace, Ray

2012-01-01

This paper reports on an online discussion forum that was created on the University of Wollongong's Virtual Learning Environment (VLE) to aid and support the learning of French grammar at beginner/false beginner level. The aim was to provide a blended learning situation which combines face to face teaching with online learning using multimedia…

Tornwaldt's cyst presenting only as occipital headache: a case report.

PubMed

Cho, Hang S; Byeon, Hyung K; Kim, Jun-Hee; Kim, Kyung S

2009-02-01

Tornwaldt's cyst (sometimes called Thornwaldt's cyst) is a rare cause of occipital headache. Owing to the rare occurrence of occipital headache as a symptom of Tornwaldt's cyst, if the patient presented only with occipital headache, this clinical symptom may be falsely perceived as a sign of neurologic disease leading to time-consuming diagnostic examinations that delay the establishment of a correct diagnosis.

False Killer Whales (Pseudorca crassidens) Around the Main Hawaiian Islands: Long-term Site Fidelity, Inter-island Movements, and Association Patterns

DTIC Science & Technology

2008-07-01

van Beneden (1889, cited in Tomilin 1967) reported a group following a vessel from Brazil to the English Channel. However, there is no published...of site fidelity: A case study involving nearctic-neotropical migrant songbirds wintering in a Costa Rican mangrove . Biological Conservation 77:143–150. Received: 6 July 2007 Accepted: 12 February 2008

Perils of intraoperative neurophysiological monitoring: analysis of "false-negative" results in spine surgeries.

PubMed

Tamkus, Arvydas A; Rice, Kent S; McCaffrey, Michael T

2018-02-01

Although some authors have published case reports describing false negatives in intraoperative neurophysiological monitoring (IONM), a systematic review of causes of false-negative IONM results is lacking. The objective of this study was to analyze false-negative IONM findings in spine surgery. This is a retrospective cohort analysis. A cohort of 109 patients with new postoperative neurologic deficits was analyzed for possible false-negative IONM reporting. The causes of false-negative IONM reporting were determined. From a cohort of 62,038 monitored spine surgeries, 109 consecutive patients with new postoperative neurologic deficits were reviewed for IONM alarms. Intraoperative neurophysiological monitoring alarms occurred in 87 of 109 surgeries. Nineteen patients with new postoperative neurologic deficits did not have an IONM alarm and surgeons were not warned. In addition, three patients had no interpretable IONM baseline data and no alarms were possible for the duration of the surgery. Therefore, 22 patients were included in the study. The absence of IONM alarms during these 22 surgeries had different origins: "true" false negatives where no waveform changes meeting the alarm criteria occurred despite the appropriate IONM (7); a postoperative development of a deficit (6); failure to monitor the pathway, which became injured (5); the absence of interpretable IONM baseline data which precluded any alarm (3); and technical IONM application issues (1). Overall, the rate of IONM method failing to predict the patient's outcome was very low (0.04%, 22/62,038). Minimizing false negatives requires the application of a proper IONM technique with the limitations of each modality considered in their selection and interpretation. Multimodality IONM provides the most inclusive information, and although it might be impractical to monitor every neural structure that can be at risk, a thorough preoperative consideration of available IONM modalities is important. Delayed development of postoperative deficits cannot be predicted by IONM. Absent baseline IONM data should be treated as an alarm when inconsistent with the patient's preoperative neurologic status. Alarm criteria for IONM may need to be refined for specific procedures and deserves continued study. Copyright © 2017 Elsevier Inc. All rights reserved.

"That never happened": adults' discernment of children's true and false memory reports.

PubMed

Block, Stephanie D; Shestowsky, Donna; Segovia, Daisy A; Goodman, Gail S; Schaaf, Jennifer M; Alexander, Kristen Weede

2012-10-01

Adults' evaluations of children's reports can determine whether legal proceedings are undertaken and whether they ultimately lead to justice. The current study involved 92 undergraduates and 35 laypersons who viewed and evaluated videotaped interviews of 3- and 5-year-olds providing true or false memory reports. The children's reports fell into the following categories based on a 2 (event type: true vs. false) × 2 (child report: assent vs. denial) factorial design: accurate reports, false reports, accurate denials, and false denials. Results revealed that adults were generally better able to correctly judge accurate reports, accurate denials, and false reports compared with false denials: For false denials, adults were, on average, "confident" that the event had not occurred, even though the event had in fact been experienced. Participant age predicted performance. These findings underscore the greater difficulty adults have in evaluating young children's false denials compared with other types of reports. Implications for law-related situations in which adults are called upon to evaluate children's statements are discussed. PsycINFO Database Record (c) 2012 APA, all rights reserved.

“That Never Happened”: Adults’ Discernment of Children’s True and False Memory Reports

PubMed Central

Block, Stephanie D.; Shestowsky, Donna; Segovia, Daisy A.; Goodman, Gail S.; Schaaf, Jennifer M.; Alexander, Kristen Weede

2014-01-01

Adults’ evaluations of children’s reports can determine whether legal proceedings are undertaken and whether they ultimately lead to justice. The current study involved 92 undergraduates and 35 laypersons who viewed and evaluated videotaped interviews of 3- and 5-year-olds providing true or false memory reports. The children’s reports fell into the following categories based on a 2 (event type: true vs. false) × 2 (child report: assent vs. denial) factorial design: Accurate reports, false reports, accurate denials, and false denials. Results revealed that adults were generally better able to correctly judge accurate reports, accurate denials, and false reports compared to false denials: For false denials, adults were, on average, “confident” that the event had not occurred, even though the event had in fact been experienced. Participant age predicted performance. These findings underscore the greater difficulty adults have in evaluating young children’s false denials compared to other types of reports. Implications for law-related situations in which adults are called upon to evaluate children’s statements are discussed. PMID:23030818

Not strange but not true: self-reported interest in a topic increases false memory.

PubMed

O'Connell, Anthony; Greene, Ciara M

2017-09-01

People are more likely to recall both true and false information that is consistent with their pre-existing stereotypes, schemata and desires. In addition, experts in a particular field are more likely to experience false memory in relation to their area of expertise. Here, we investigate whether level of interest, as distinct from level of knowledge, and in the absence of self-professed expertise, is associated with increased false memory. 489 participants were asked to rank 7 topics from most to least interesting. They were then asked if they remembered the events described in four news items related to the topic they selected as the most interesting and four items related to the topic selected as least interesting. In each case, three of the events depicted had really happened and one was fictional. A high level of interest in a topic increased true memories for the topic and doubled the frequency of false memories, even after controlling for level of knowledge. We interpret the results in the context of the source-monitoring framework and suggest that false memories arise as a result of interference from existing information stored in domain-related schemata.

False-negative BRAF V600E mutation results on fine-needle aspiration cytology of papillary thyroid carcinoma.

PubMed

Paek, Se Hyun; Kim, Byung Seup; Kang, Kyung Ho; Kim, Hee Sung

2017-11-13

The BRAF V600E mutation is highly specific for papillary thyroid carcinoma (PTC). A test for this mutation can increase the diagnostic accuracy of fine-needle aspiration cytology (FNAC), but a considerably high false-negative rate for the BRAF V600E mutation on FNAC has been reported. In this study, we investigated the risk factors associated with false-negative BRAF V600E mutation results on FNAC. BRAF V600E mutation results of 221 PTC nodules between December 2011 and June 2013 were retrospectively reviewed. BRAF V600E mutation results on both preoperative FNAC and postoperative formalin-fixed, paraffin-embedded (FFPE) samples were compared. We investigated the sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of BRAF V600E mutation results on FNAC. And, we identified the risk factors associated with false-negative results. Of 221 PTC nodules, 150 (67.9%) on FNAC and 185 (83.7%) on FFPE samples were BRAF V600E mutation positive. The sensitivity, specificity, PPV, and NPV for BRAF V600E mutation testing with FNAC were 80.5, 97.2, 99.3, and 49.3%, respectively. Thirty-six (16.3%) BRAF V600E mutation-negative nodules on FNAC were mutation positive on FFPE sample analysis. Risk factors for these false-negative results were age, indeterminate FNAC results (nondiagnostic, atypia of undetermined significance (AUS), and findings suspicious for PTC), and PTC subtype. False-negative rate of BRAF mutation testing with FNAC for thyroid nodules is increased in cases of old age, indeterminate FNAC pathology results, and certain PTC subtypes. Therapeutic surgery can be considered for these cases. A well-designed prospective study with informed consent of patients will be essential for more informative results.

Chikungunya from the Caribbean: the importance of appropriate laboratory tests to confirm the diagnosis.

PubMed

Magurano, Fabio; Zammarchi, Lorenzo; Baggieri, Melissa; Fortuna, Claudia; Farese, Alberto; Benedetti, Eleonora; Fiorentini, Cristiano; Rezza, Giovanni; Nicoletti, Loredana; Bartoloni, Alessandro

2015-04-01

Chikungunya virus (CHIKV) appeared for the first time in the Western Hemisphere--the French West Indies--in December of 2013. From there, the virus has spread to other Caribbean islands. Following the diagnosis of first autochthonous CHIKV cases in the Caribbean island of Saint Martin, a large outbreak is ongoing in the Americas. As of September 12, 2014, a total of 706,093 suspected and 9803 confirmed CHIKV cases have been reported in the Americas. This case study highlights the possibility of false-negative immunochromatographic CHIKV immunoglobulin M (IgM) tests and the need of confirmatory tests for suspected cases. Moreover, a greater spread of virus together with the presence of a mosquito vector (Aedes albopictus) enhances the risk of autochthonous transmission in Europe.

[First ciguatera outbreak in Germany in 2012].

PubMed

Friedemann, Miriam

2016-12-01

In November 2012, 23 cases of ciguatera with typical combinations of gastrointestinal and neurological symptoms occurred in Germany after consumption of imported tropical fish (Lutjanus spp.). A questionnaire was used to gather information on the disease course and fish consumption. All patients suffered from pathognomonic cold allodynia. Aside from two severe courses of illness, all other cases showed symptoms of moderate intensity. During a three-year follow-up, seven patients reported prolonged paresthesia for more than one year. Two of them reported further neuropathies over almost three years. This is the first time that long-term persistence of symptoms has been documented in detail. Outbreak cases were allocated to eight clusters in seven German cities. A further cluster was prevented by the successful recall of ciguatoxic fish. Three clusters were confirmed by the detection of ciguatoxin in samples of suspicious and recalled fish. An extrapolation on the basis of ciguatoxic samples revealed twenty prevented cases of ciguatera. Further officially unknown cases should be assumed. During the outbreak investigations, inadvertently falsely labelled fish species and fishing capture areas on import and retail level documents were observed. The ascertainment of cases and the outbreak investigations proved to be difficult due to inconsistent case reports to poisons centers, local health and veterinary authorities. In Germany, many physicians are unaware of the disease pattern of ciguatera and the risks caused by tropical fish. The occurrence of further outbreaks during the following years emphasizes the increasing significance of ciguatera in Germany.

[Tropheryma whipplei and Whipple disease: false positive PCR detections of Tropheryma whipplei in diagnostic samples are rare].

PubMed

Le Scanff, J; Gaultier, J B; Durand, D Vital; Durieu, I; Celard, M; Benito, Y; Vandenesch, F; Rousset, H

2008-11-01

PCR can be used to detect T. whipplei (Tw) in samples from variable tissue types and body fluids. We report clinical, evolutive characteristics and final diagnosis in patients with positive Tw PCR assay. Retrospective study of Tw PCR realized since 10years in a microbiology laboratory. Twenty-five Tw PCR assays were positive among 200 realized. Diagnosis was not confirmed in six cases. One patient was missing for follow up. Eighteen patients presented with Whipple's disease. Among these 18 patients, 14 had a classic Whipple's disease, three patients presented an endocarditis and one patient isolated neurological manifestations. Ten patients presented fever, seven a weight loss and 12 joint involvement. Four patients presented cutaneous manifestations, only six had gastrointestinal symptoms. Neurological involvement was reported in five cases, pulmonary symptoms in four cases, cardiac involvement in six cases and ocular signs in two cases. Anemia was reported in four patients and elevated levels of acute-phase reactants in 14 cases. Positive predictive value of Tw PCR for Whipple's disease diagnosis was 75%. Thirteen patients had a good evolution with antibiotics. Three patients presented recurrence and two cases with cardiovascular involvement died. Whipple's disease is rare but often mentioned in internist experience. The diagnosis should be every time confirmed. Tw PCR assay is an important diagnostic tool but is not sufficient to establish the diagnosis and must be interpreted with histopathology and immunohistochemical testing results.

Falsely undetectable TSH in a cohort of South Asian euthyroid patients.

PubMed

Drees, Julia C; Stone, Judith A; Reamer, C Randy; Arboleda, Victoria E; Huang, Karl; Hrynkow, Jane; Greene, Dina N; Petrie, Matthew S; Hoke, Carolyn; Lorey, Thomas S; Dlott, Richard S

2014-04-01

An index case of a clinically euthyroid woman of South Asian descent was identified with discordant TSH results: undetectable TSH on our routine assay and normal TSH on an alternate assay. Low TSH concentrations due to functionally compromising TSH mutations have been reported. Here we describe a new phenomenon of functional TSH that is undetectable by 4 widely used US Food and Drug Administration (FDA)-approved TSH immunoassays marketed by a single vendor. The purpose of this study was to identify additional cases and investigate the cause of the falsely undetectable TSH. All samples with TSH results of <0.01 μIU/mL were retested with a second TSH assay. Discordant samples were evaluated on up to 8 FDA-approved TSH immunoassays and the TSHβ gene was sequenced. Retrospectively, thyroid function tests, diagnoses, and medications from 1.6 million individuals were analyzed. Out of approximately 2 million individuals, we have identified a cohort of 20 hypothyroid and euthyroid patients of shared ethnicity with falsely undetectable TSH (<0.01 μIU/mL) in 4 of 8 commercially available TSH assays. Half of these individuals were initially treated based on repeated falsely undetectable TSH values (7 euthyroid patients were treated with methimazole and 2 hypothyroid patients had doses of levothyroxine decreased). In all cases, a retrospective chart review revealed that clinical assessments and free T4 and total T3 results were inconsistent with the undetectable TSH results. Specific antibodies failing to detect TSH in these cases were identified in the 4 affected assays. A novel TSHβ point mutation was identified. Our data suggest that these individuals have a previously unrecognized, functionally normal, TSH variant to which some monoclonal antibodies fail to bind. To assure appropriate patient management, clinicians and laboratorians need to be aware that certain TSH variants may be undetectable in some hyperselective TSH assays.

[Child psychiatric assessment and the debate regarding the abuse of abuse].

PubMed

Fegert, J M

1995-03-01

The current discussion on false allegations in sexual abuse cases has led to a polarization in the views expressed about the credibility of children. Some authors even speak of a "child sexual accuse syndrome" or of a "sexual abuse allegation in divorce" (SAID) syndrome. A phenomenological analysis of the multiple reasons for misinterpretations is presented. Instead of stressing the importance only of false positives in child sexual abuse questions, an attempt is made to describe reasons for false negatives. Based on a retrospective analysis of 50 consecutive child psychiatric experts in connection with court cases, there does not appear to be an increase in false accusations. Rather, only about one third of the cases even involved suspected sexual abuse. Sexual abuse allegations were much more frequent in girls than in boys. Of 20 abuse allegations we judge four to be false allegations. In only one of these cases, that of an adolescent girl who had been abused in childhood, was the false allegation intended.

Credibility assessment in child sexual abuse investigations: A descriptive analysis.

PubMed

Melkman, Eran P; Hershkowitz, Irit; Zur, Ronit

2017-05-01

A major challenge in cases of child sexual abuse (CSA) is determining the credibility of children's reports. Consequently cases may be misclassified as false or deemed 'no judgment possible'. Based on a large national sample of reports of CSA made in Israel in 2014, the study examines child and event characteristics contributing to the probability that reports of abuse would be judged credible. National data files of all children aged 3-14, who were referred for investigation following suspected victimization of sexual abuse, and had disclosed sexual abuse, were analyzed. Cases were classified as either 'credible' or 'no judgment possible'. The probability of reaching a 'credible' judgment was examined in relation to characteristics of the child (age, gender, cognitive delay, marital status of the parents,) and of the abusive event (abuse severity, frequency, perpetrator-victim relationship, perpetrator's use of grooming, and perpetrator's use of coercion), controlling for investigator's identity at the cluster level of the analysis. Of 1563 cases analyzed, 57.9% were assessed as credible. The most powerful predictors of a credible judgment were older age and absence of a cognitive delay. Reports of children to married parents, who experienced a single abusive event that involved perpetrator's use of grooming, were also more likely to be judged as credible. Rates of credible judgments found are lower than expected suggesting under-identification of truthful reports of CSA. In particular, those cases of severe and multiple abuse involving younger and cognitively delayed children are the ones with the lowest chances of being assessed as credible. Copyright © 2017 Elsevier Ltd. All rights reserved.

Make-up and love bites: two reports about exceptional cases of self-inflicted "injuries".

PubMed

Blaas, Verena; Manhart, Johannes; Büttner, Andreas

2016-12-01

Self-inflicted injuries and their differentiation from inflicted injuries may have severe legal implications. The detection of these injuries is an important task in clinical forensic medicine. We present two cases of skin discolorations caused by using make-up and suction of the skin which have only rarely been reported. In the first case a 19-year-old woman asserted she was punched against her left clavicle and her right eye by a perpetrator, and that during the following forced sexual intercourse she had been bitten on the neck. On medicolegal examination 3 days later dark blue, shimmering discolorations at her right eyebrow, the left side of the neck and the left clavicle were seen. At first sight these discolorations appeared as bruises; however, they could easily be removed by a simple wipe with a finger. In the second reported case a 23-year-old woman reported she had been assaulted by two men who forcefully pressed her against a wall, partially undressed her and forced her to touch and rub one man's penis. Medicolegal examination 32 h after the incident revealed several round to oval shaped, reddish to brown discolorations on both of her upper arms resembling so-called love bites created by suction. In both cases the preliminary investigation by the public prosecutor were closed. However, case 1 is still subject to legal investigations due to false incrimination. Self-infliction of injuries should always be considered in forensic examinations, even if they do not follow the classical pattern.

Social influence and mental routes to the production of authentic false memories and inauthentic false memories.

PubMed

Wagner, Michael F; Skowronski, John J

2017-05-01

Two studies assessed the extent to which people incorporated false facts provided by bogus others into their own recognition memory reports, and how these false memory reports were affected by: (a) truth of the information in others' summaries supporting the false facts, (b) motivation to process stories and summaries, (c) source credibility, and (d) ease of remembering original facts. False memory report frequency increased when false facts in a summary were supported by true information and varied inversely with the ease with which original facts could be remembered. Results from a measure probing participants' memory perceptions suggest that some false memories are authentic: People sometimes lack awareness of both the incorporation of false facts into their memory reports and where the false facts came from. However, many false memories are inauthentic: Despite reporting a false memory, people sometimes retain knowledge of the original stimulus and/or the origin of false facts. Copyright © 2017. Published by Elsevier Inc.

Delayed diagnosis of a peroneal artery false aneurysm at a concomitant tibial fracture. A case report.

PubMed

Tyllianakis, M; Panagiotopoulos, E; Megas, P; Lambiris, E

1995-07-01

A 49-year-old man had posttraumatic persistent calf swelling and a tibial and fibular fracture. Despite the intramedullary nailing of the fracture, the swelling did not improve, and at the 6th postoperative week it was misdiagnosed (using venogram) as deep vein thrombosis. Therefore, it was mistreated with anticoagulants, which led to great deterioration of the local signs. An arteriogram revealed an initially missed false peroneal artery aneurysm. Surgical treatment was performed immediately. The 6-week delay had led to some atrophy of the posterior compartment muscles, fortunately without any permanent disability. The importance of proper and early diagnosis of posttraumatic persistent calf swelling is stressed.

Prenatal diagnosis of sickle hemoglobinopathies: The experience of the Columbia university comprehensive center for sickle cell disease

PubMed Central

Driscoll, M. Catherine; Lerner, Norma; Anyane-Yeboa, Kwame; Maidman, Jack; Warburton, Dorothy; Schaefer-Rego, Kim; Hsu, Ruth; Ince, Carol; Malin, Joanne; Pallai, Michele; Mears, J. Gregory; Bank, Arthur

1987-01-01

We report here an evaluation of 55 pregnancies at risk for a sickle hemoglobinopathy prenatally diagnosed by restriction-endonuclease analysis, with the endonucleases MstII and HpaI, of amniocyte DNA. The diagnosis was completed in all cases. Eleven fetuses were predicted to be affected, of which six were terminated. Forty-one of the 55 cases were confirmed. One false-negative was reported in a case predicted to be hemoglobin AS but that was determined to be hemoglobin SS at birth. We estimate that the 55 cases represent only 5% of the pregnancies at risk for a sickle hemoglobinopathy in the New York metropolitan area during the study period. We conclude that the prenatal diagnosis of sickle hemoglobinopathies by molecular methods is reliable. However, the efficiency of utilization and effectiveness of prenatal testing is dependent on the early prospective identification of couples at risk and on the education of communities concerning (1) the significant morbidity of the sickle hemoglobinopathies and (2) the reproductive choices now available to them. ImagesFig. 1Fig. 2 PMID:3035920

Reducing false positives of microcalcification detection systems by removal of breast arterial calcifications.

PubMed

Mordang, Jan-Jurre; Gubern-Mérida, Albert; den Heeten, Gerard; Karssemeijer, Nico

2016-04-01

In the past decades, computer-aided detection (CADe) systems have been developed to aid screening radiologists in the detection of malignant microcalcifications. These systems are useful to avoid perceptual oversights and can increase the radiologists' detection rate. However, due to the high number of false positives marked by these CADe systems, they are not yet suitable as an independent reader. Breast arterial calcifications (BACs) are one of the most frequent false positives marked by CADe systems. In this study, a method is proposed for the elimination of BACs as positive findings. Removal of these false positives will increase the performance of the CADe system in finding malignant microcalcifications. A multistage method is proposed for the removal of BAC findings. The first stage consists of a microcalcification candidate selection, segmentation and grouping of the microcalcifications, and classification to remove obvious false positives. In the second stage, a case-based selection is applied where cases are selected which contain BACs. In the final stage, BACs are removed from the selected cases. The BACs removal stage consists of a GentleBoost classifier trained on microcalcification features describing their shape, topology, and texture. Additionally, novel features are introduced to discriminate BACs from other positive findings. The CADe system was evaluated with and without BACs removal. Here, both systems were applied on a validation set containing 1088 cases of which 95 cases contained malignant microcalcifications. After bootstrapping, free-response receiver operating characteristics and receiver operating characteristics analyses were carried out. Performance between the two systems was compared at 0.98 and 0.95 specificity. At a specificity of 0.98, the sensitivity increased from 37% to 52% and the sensitivity increased from 62% up to 76% at a specificity of 0.95. Partial areas under the curve in the specificity range of 0.8-1.0 were significantly different between the system without BACs removal and the system with BACs removal, 0.129 ± 0.009 versus 0.144 ± 0.008 (p<0.05), respectively. Additionally, the sensitivity at one false positive per 50 cases and one false positive per 25 cases increased as well, 37% versus 51% (p<0.05) and 58% versus 67% (p<0.05) sensitivity, respectively. Additionally, the CADe system with BACs removal reduces the number of false positives per case by 29% on average. The same sensitivity at one false positive per 50 cases in the CADe system without BACs removal can be achieved at one false positive per 80 cases in the CADe system with BACs removal. By using dedicated algorithms to detect and remove breast arterial calcifications, the performance of CADe systems can be improved, in particular, at false positive rates representative for operating points used in screening.

Diagnosing the occult contralateral inguinal hernia.

PubMed

Koehler, R H

2002-03-01

The incidence of bilateral inguinal hernias reported for total extra peritoneal (TEP) laparoscopic hernia repair, which reaches 45%, appears to be higher than that seen in studies of transabdominal laparoscopic and open repair. Given the unique ability of diagnostic laparoscopy to diagnose occult contralateral hernias (OCH) accurately, this study looked at how concurrent transabdominal diagnostic laparoscopy (TADL) would influence planned TEP repairs. A prospective study oF 100 consecutive TEP cases was conducted. All patients had diagnostic laparoscopy via a 5-mm 45 degrees scope through an umbilical incision with 15 mmHg of pneumoperitoneum, followed by laparoscopic TEPrepair. A contralateral occult hernia was diagnosed and repaired if a true peritoneal eventration through the inguinal region was observed. Among the 100 patients, preoperative diagnosis suggested 31 bilateral hernias (31%), whereas TADL confirmed 25 bilateral hernias (25%). Of these 25 bilateral hernias, TADL confirmed 16 that had been diagnosed preoperatively (64%), but excluded 15 contralateral hernias that were incorrectly diagnosed (37%). Transabdominal diagnostic laparoscopy found nine OCHs, representing 36% of all bilateral hernias and 13% of the 69 preoperatively determined unilateral hernias. The preoperative physician examination false-negative rate for contralateral hernias was 36%, and the false-positive rate was 37%. In 26 cases (26%), TADL changed the operative approach. In this study, patients believed to have unilateral inguinal hernias had OCHs in 13% of cases when examined by TADL. The actual bilateral hernia incidence was 25%, with a 37% false-positive rate for preoperatively diagnosed bilateral hernias. The high rate of bilateral hernias reported by the TEP approach alone suggests that some OCH findings may be an artifact of the TEP dissection. However, failure to search for an OCH could result in up to 13% of patients subsequently requiring a second repair. Because some surgeons are concerned about unnecessary TEP dissection of the asymptomatic contralateral side, the approach described here may offer a solution to accurate diagnosis of the contralateral inguinal region during planned laparoscopic TEP hernia repair.

Emergency Stent Grafting After Unsuccessful Surgical Repair of a Mycotic Common Femoral Artery Pseudoaneurysm in a Drug Abuser

DOE Office of Scientific and Technical Information (OSTI.GOV)

Lupattelli, Tommaso, E-mail: tommaso.lupattelli@multimedica.i; Garaci, Francesco Giuseppe; Basile, Antonio

Mycotic false aneurysm caused by local arterial injury from attempted intravenous injections in drug addicts remains a challenging clinical problem. The continued increase in drug abuse has resulted in an increased incidence of this problem, particularly in high-volume urban centres. In the drug-abusing population, mycotic arterial pseudoaneurysms most often occur because of missed venous injection and are typically seen in the groin, axilla, and antecubital fossa. Mycotic aneurysms may lead to life-threatening haemorrhage, limb loss, sepsis, and even death. Any soft-tissue swelling in the vicinity of a major artery in an intravenous drug abuser should be suspected of being amore » false aneurysm until proven otherwise and should prompt immediate referral to a vascular surgeon for investigation and management. We report a case of rupturing mycotic pseudoaneurysm of the left common femoral artery treated by surgical resection followed by vessel reconstruction with autologous material. Unfortunately, at the time of discharge a sudden leakage from the vein graft anastomosis occurred, with subsequent massive bleeding, and required emergent endovascular covered stenting. To the best of our knowledge, this is the first reported case of femoral artery bleeding in a drug abuser treated by stent graft placement.« less

Clinical experience of laboratory follow-up with noninvasive prenatal testing using cell-free DNA and positive microdeletion results in 349 cases.

PubMed

Schwartz, S; Kohan, M; Pasion, R; Papenhausen, P R; Platt, L D

2018-02-01

Screening via noninvasive prenatal testing (NIPT) involving the analysis of cell-free DNA (cfDNA) from plasma has become readily available to screen for chromosomal and DNA aberrations through maternal blood. This report reviews a laboratory's experience with follow-up of positive NIPT screens for microdeletions. Patients that were screened positive by NIPT for a microdeletion involving 1p, 4p, 5p, 15q, or 22q who underwent diagnostic studies by either chorionic villus sampling or amniocentesis were evaluated. The overall positive predictive value for 349 patients was 9.2%. When a microdeletion was confirmed, 39.3% of the cases had additional abnormal microarray findings. Unrelated abnormal microarray findings were detected in 11.8% of the patients in whom the screen positive microdeletion was not confirmed. Stretches of homozygosity in the microdeletion were frequently associated with a false positive cfDNA microdeletion result. Overall, this report reveals that while cfDNA analysis will screen for microdeletions, the positive predictive value is low; in our series it is 9.2%. Therefore, the patient should be counseled accordingly. Confirmatory diagnostic microarray studies are imperative because of the high percentage of false positives and the frequent additional abnormalities not delineated by cfDNA analysis. © 2018 John Wiley & Sons, Ltd.

Distal re-entry closure with neobranching technique after thoracic endovascular aortic repair of Type B aortic dissection.

PubMed

Yamamoto, Masaki; Fukutomi, Takashi; Noguchi, Tatsuya; Orihashi, Kazumasa

2018-04-01

Retrograde false-lumen flow after thoracic endovascular aortic repair of Type B aortic dissection occurs occasionally and may have a negative impact on aortic remodelling and even prevent the decompression of the false lumen. A 67-year-old man with a Type B aortic dissection underwent thoracic endovascular aortic repair for severe compression of the true lumen and visceral malperfusion 7 weeks after the onset. Intraoperative angiography revealed proximal entry tear closure, but the false-lumen flow increased because of retrograde flow through the re-entry tear. Additional intervention including re-entry tear closure was performed with a neobranching technique with covered stent placement in the visceral artery from the aortic true lumen through the distal re-entry tear. We report a case of Type B aortic dissection and discuss the surgical techniques used.

False-positive cerebrospinal fluid cryptococcus antigen in Libman-Sacks endocarditis.

PubMed

Isseh, Iyad N; Bourgi, Kassem; Nakhle, Asaad; Ali, Mahmoud; Zervos, Marcus J

2016-12-01

Cryptococcus meningoencephalitis is a serious opportunistic infection associated with high morbidity and mortality in immunocompromised hosts, particularly patients with advanced AIDS disease. The diagnosis is established through cerebrospinal fluid (CSF) cryptococcus antigen detection and cultures. Cryptococcus antigen testing is usually the initial test of choice due its high sensitivity and specificity along with the quick availability of the results. We hereby report a case of a false-positive CSF cryptococcus antigen assay in a patient with systemic lupus erythematosus presenting with acute confusion. While initial CSF evaluation revealed a positive cryptococcus antigen assay, the patient's symptoms were inconsistent with cryptococcus meningoencephalitis. A repeat CSF evaluation, done 3 days later, revealed a negative CSF cryptococcus antigen assay. Given the patient's active lupus disease and the elevated antinuclear antibody titers, we believe that the initial positive result was a false positive caused by interference from autoantibodies.

Bilateral juvenile nasopharyngeal angiofibroma: report of a case.

PubMed

Wu, Edward C; Chark, Davin W; Bhandarkar, Naveen D

2014-07-01

Juvenile nasopharyngeal angiofibroma (JNA) is the most common benign neoplasm of the nasopharynx. Almost always unilateral on diagnosis, JNAs are locally invasive and may extend across the midline, giving a false bilateral appearance; as such, true bilateral JNA is exceedingly rare. We present a recent case of true bilateral JNA. Single case report of a patient with bilateral JNA, including clinical presentation, diagnosis, and management. The patient presented with unilateral nasal obstruction and recurrent epistaxis. Computed tomography and magnetic resonance imaging demonstrated bilateral, noncontiguous masses. Angiography revealed independent vascular supplies from each respective side with no bilateral supply noted. The patient underwent preoperative embolization followed by endoscopic surgical removal of the larger mass; no complications were noted. Follow-up at 2 years demonstrated no recurrence or growth. The vast majority of JNAs are unilateral, though invasive growth to the contralateral side may appear "bilateral" in presentation. Proper identification of true bilateral JNA is helpful in guiding management, wherein excision of both tumors may not be necessary. © 2014 ARS-AAOA, LLC.

False negative pericardial Focused Assessment with Sonography for Trauma examination following cardiac rupture from blunt thoracic trauma: a case report.

PubMed

Baker, Laura; Almadani, Ammar; Ball, Chad G

2015-07-15

The Focused Assessment with Sonography for Trauma examination is an invaluable tool in the initial assessment of any injured patient. Although highly sensitive and accurate for identifying hemoperitoneum, occasional false negative results do occur in select scenarios. We present a previously unreported case of survival following blunt cardiac rupture with associated negative pericardial window due to a concurrent pericardial wall laceration. A healthy 46-year-old white woman presented to our level 1 trauma center with hemodynamic instability following a motor vehicle collision. Although her abdominal Focused Assessment with Sonography for Trauma windows were positive for fluid, her pericardial window was negative. After immediate transfer to the operating room in the setting of persistent instability, a subsequent thoracotomy identified a blunt cardiac rupture that was draining into the ipsilateral pleural space via an adjacent tear in the pericardium. The cardiac injury was controlled with digital pressure, resuscitation completed, and then repaired using standard cardiorrhaphy techniques. Following repair of her injuries (left ventricle, left atrial appendage, and liver), her postoperative course was uneventful. Evaluation of the pericardial space using Focused Assessment with Sonography for Trauma is an important component in the initial assessment of the severely injured patient. Even in cases of blunt mechanisms however, clinicians must be wary of occasional false negative pericardial ultrasound evaluations secondary to a concomitant pericardial laceration and subsequent decompression of hemorrhage from the cardiac rupture into the ipsilateral pleural space.

Applying the Paris System for Reporting Urine Cytology Increases the Rate of Atypical Urothelial Cells in Benign Cases: A Need for Patient Management Recommendations.

PubMed

Granados, Rosario; Duarte, Joanny A; Corrales, Teresa; Camarmo, Encarnación; Bajo, Paloma

2017-01-01

The Paris System (TPS) for reporting urinary cytology attempts to unify the terminology in this field. To analyze the impact of adopting TPS by measuring nomenclature agreement and cytohistological correlation. Voided urine liquid-based cytology samples corresponding to 149 biopsy-proven cases (76 high-grade carcinomas, 40 low-grade carcinomas, and 33 benign lesions), were reclassified by the same pathologist using TPS. Diagnostic agreement and sensitivity for both nomenclature systems was measured. When using TPS, the rate of atypical samples increased 8 times (from 3 to 24.2%) in benign cases, 10 times (from 2.5 to 25%) in low-grade carcinomas, and 2.4 times (from 6.6 to 15.8%) in high-grade carcinomas. The false-positive rate (abnormal cytology in negative or low-grade carcinoma cases) increased from 11 to 34.2%. Sensitivity was higher (63 vs. 49%) with TPS at the expense of a lower specificity (73 vs. 91%). The agreement between both nomenclatures was moderate for negative and high-grade carcinoma cases (k = 0.42 and 0.56, respectively) and weak for low-grade tumors (k = 0.35). Adopting TPS for reporting urine cytology results in a considerable increase in atypical diagnoses, improving sensitivity but lowering specificity. Appropriate management recommendations for patients with an atypical cytological diagnosis are required. © 2016 S. Karger AG, Basel.

Surgical management of vascular access related aneurysms to salvage dialysis access: case report and a systematic review of the literature.

PubMed

Furukawa, Hiroshi

2015-01-01

We retrospectively evaluated the surgical outcome of revising vascular access related aneurysms (VARAs) to salvage dialysis access. Twenty-six consecutive hemodialysis patients (mean age 67.6 years, range: 32-89 years) who presented with true or false VARA and underwent surgery between January 2006 and February 2011 were enrolled in this study, and comprised 11 women and 15 men. Aneurysms were true in 21 patients and false in five; native arteriovenous fistulas (AVFs) were reported in 23, including one infected native pseudoaneurysm, and arteriovenous prosthetic grafts (AVGs) in three. The mean aneurysm diameter was 29.8 ± 8.0 mm, ranging from 18 to 50 mm. Indications of surgical intervention were local pain, rapid enlargement of the aneurysm, and AVF failure due to stenosis. Surgical revision was performed by resection of VARA and concomitant creation of a new proximal arteriovenous anastomosis in 18 patients. Two aneurysms were ruptured by blunt dissection; however, bleeding did not occur due to prior clamping of the inflow artery without hemodynamic compromise. VARA plication was performed in one case in which severe calcified VARA could not be incised. No significant complications were reported, except for delayed wound healing in three patients and minor peripheral neuropathy in five. The postoperative course was uneventful without hospital mortality in all patients with VARA. Aggressive surgical management of VARAs is likely to become an acceptable procedure to salvage dialysis access and consistently maintain AVF or AVG function.

45 CFR 3.4 - False reports and reports of injury or damage.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 45 Public Welfare 1 2012-10-01 2012-10-01 false False reports and reports of injury or damage. 3.4 Section 3.4 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION CONDUCT OF PERSONS AND TRAFFIC ON THE NATIONAL INSTITUTES OF HEALTH FEDERAL ENCLAVE General § 3.4 False reports and...

45 CFR 3.4 - False reports and reports of injury or damage.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 45 Public Welfare 1 2011-10-01 2011-10-01 false False reports and reports of injury or damage. 3.4 Section 3.4 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION CONDUCT OF PERSONS AND TRAFFIC ON THE NATIONAL INSTITUTES OF HEALTH FEDERAL ENCLAVE General § 3.4 False reports and...

45 CFR 3.4 - False reports and reports of injury or damage.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 45 Public Welfare 1 2013-10-01 2013-10-01 false False reports and reports of injury or damage. 3.4 Section 3.4 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION CONDUCT OF PERSONS AND TRAFFIC ON THE NATIONAL INSTITUTES OF HEALTH FEDERAL ENCLAVE General § 3.4 False reports and...

45 CFR 3.4 - False reports and reports of injury or damage.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 45 Public Welfare 1 2014-10-01 2014-10-01 false False reports and reports of injury or damage. 3.4 Section 3.4 Public Welfare Department of Health and Human Services GENERAL ADMINISTRATION CONDUCT OF PERSONS AND TRAFFIC ON THE NATIONAL INSTITUTES OF HEALTH FEDERAL ENCLAVE General § 3.4 False reports and...

38 CFR 21.7658 - False, late, or missing reports.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 38 Pensions, Bonuses, and Veterans' Relief 2 2014-07-01 2014-07-01 false False, late, or missing reports. 21.7658 Section 21.7658 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS... Reserve Pursuit of Course and Required Reports § 21.7658 False, late, or missing reports. (a) Reservist...

38 CFR 21.7658 - False, late, or missing reports.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 38 Pensions, Bonuses, and Veterans' Relief 2 2010-07-01 2010-07-01 false False, late, or missing reports. 21.7658 Section 21.7658 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS... Reserve Pursuit of Course and Required Reports § 21.7658 False, late, or missing reports. (a) Reservist...

38 CFR 21.7658 - False, late, or missing reports.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 38 Pensions, Bonuses, and Veterans' Relief 2 2011-07-01 2011-07-01 false False, late, or missing reports. 21.7658 Section 21.7658 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS... Reserve Pursuit of Course and Required Reports § 21.7658 False, late, or missing reports. (a) Reservist...

38 CFR 21.7658 - False, late, or missing reports.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 38 Pensions, Bonuses, and Veterans' Relief 2 2012-07-01 2012-07-01 false False, late, or missing reports. 21.7658 Section 21.7658 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS... Reserve Pursuit of Course and Required Reports § 21.7658 False, late, or missing reports. (a) Reservist...

38 CFR 21.7658 - False, late, or missing reports.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 38 Pensions, Bonuses, and Veterans' Relief 2 2013-07-01 2013-07-01 false False, late, or missing reports. 21.7658 Section 21.7658 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS... Reserve Pursuit of Course and Required Reports § 21.7658 False, late, or missing reports. (a) Reservist...

Testing the domain-specificity of a theory of mind deficit in brain-injured patients: evidence for consistent performance on non-verbal, "reality-unknown" false belief and false photograph tasks.

PubMed

Apperly, Ian A; Samson, Dana; Chiavarino, Claudia; Bickerton, Wai-Ling; Humphreys, Glyn W

2007-05-01

To test the domain-specificity of "theory of mind" abilities we compared the performance of a case-series of 11 brain-lesioned patients on a recently developed test of false belief reasoning () and on a matched false photograph task, which did not require belief reasoning and which addressed problems with existing false photograph methods. A strikingly similar pattern of performance was shown across the false belief and false photograph tests. Patients who were selectively impaired on false belief tasks were also impaired on false photograph tasks; patients spared on false belief tasks also showed preserved performance with false photographs. In some cases the impairment on false belief and false photograph tasks coincided with good performance on control tasks matched for executive demands. We discuss whether the patients have a domain-specific deficit in reasoning about representations common to both false belief and false photograph tasks.

Reflections of a Vaccinologist: Lessons Learned About What We Can Do to Improve Trust in Vaccines and Vaccine Programsa.

PubMed

Halsey, Neal A

2017-03-01

Public trust can be improved by learning from past mistakes, by establishing a standing forum for review of new concerns as they arise, and by maintaining a robust vaccine safety system. Developing standard guidelines for reporting causality assessment in case reports would help educate physicians and prevent future unnecessary concerns based on false assumptions of causal relationships. © The Author 2015. Published by Oxford University Press on behalf of The Journal of the Pediatric Infectious Diseases Society. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

[Acute generalized peritonitis due to uterine perforation following abortion: case study observation].

PubMed

Ka, Ibrahima; Diop, Papa Saloum; Niang, Amadou Bocar; Faye, Alioucoly; Ndoye, Jean Marck; Fall, Babacar

2016-01-01

Clandestine abortion is known to be a major contributor to maternal mortality. We report a case of a 25-year old patient in her 12th week of amenorrhea with peritonitis due to uterine perforation following abortion, admitted with abdomen and pelvis pain, vomiting and diarrhea. Clinical examination on admission showed asthenic peritonitis. Surgical exploration showed widespread acute peritonitis secondary to a perforation of the uterine dome, with collection of 1500 cc of purulent material, dilated bowel loops and multiple false membranes. pus aspiration, peritoneal lavage; uterine suture, drainage. The postoperative course was uneventful, the patient was discharged after 15 days.

Reducing false positives of microcalcification detection systems by removal of breast arterial calcifications

DOE Office of Scientific and Technical Information (OSTI.GOV)

Mordang, Jan-Jurre, E-mail: Jan-Jurre.Mordang@radboudumc.nl; Gubern-Mérida, Albert; Karssemeijer, Nico

Purpose: In the past decades, computer-aided detection (CADe) systems have been developed to aid screening radiologists in the detection of malignant microcalcifications. These systems are useful to avoid perceptual oversights and can increase the radiologists’ detection rate. However, due to the high number of false positives marked by these CADe systems, they are not yet suitable as an independent reader. Breast arterial calcifications (BACs) are one of the most frequent false positives marked by CADe systems. In this study, a method is proposed for the elimination of BACs as positive findings. Removal of these false positives will increase the performancemore » of the CADe system in finding malignant microcalcifications. Methods: A multistage method is proposed for the removal of BAC findings. The first stage consists of a microcalcification candidate selection, segmentation and grouping of the microcalcifications, and classification to remove obvious false positives. In the second stage, a case-based selection is applied where cases are selected which contain BACs. In the final stage, BACs are removed from the selected cases. The BACs removal stage consists of a GentleBoost classifier trained on microcalcification features describing their shape, topology, and texture. Additionally, novel features are introduced to discriminate BACs from other positive findings. Results: The CADe system was evaluated with and without BACs removal. Here, both systems were applied on a validation set containing 1088 cases of which 95 cases contained malignant microcalcifications. After bootstrapping, free-response receiver operating characteristics and receiver operating characteristics analyses were carried out. Performance between the two systems was compared at 0.98 and 0.95 specificity. At a specificity of 0.98, the sensitivity increased from 37% to 52% and the sensitivity increased from 62% up to 76% at a specificity of 0.95. Partial areas under the curve in the specificity range of 0.8–1.0 were significantly different between the system without BACs removal and the system with BACs removal, 0.129 ± 0.009 versus 0.144 ± 0.008 (p<0.05), respectively. Additionally, the sensitivity at one false positive per 50 cases and one false positive per 25 cases increased as well, 37% versus 51% (p<0.05) and 58% versus 67% (p<0.05) sensitivity, respectively. Additionally, the CADe system with BACs removal reduces the number of false positives per case by 29% on average. The same sensitivity at one false positive per 50 cases in the CADe system without BACs removal can be achieved at one false positive per 80 cases in the CADe system with BACs removal. Conclusions: By using dedicated algorithms to detect and remove breast arterial calcifications, the performance of CADe systems can be improved, in particular, at false positive rates representative for operating points used in screening.« less

FDR doesn't Tell the Whole Story: Joint Influence of Effect Size and Covariance Structure on the Distribution of the False Discovery Proportions

NASA Technical Reports Server (NTRS)

Feiveson, Alan H.; Ploutz-Snyder, Robert; Fiedler, James

2011-01-01

As part of a 2009 Annals of Statistics paper, Gavrilov, Benjamini, and Sarkar report results of simulations that estimated the false discovery rate (FDR) for equally correlated test statistics using a well-known multiple-test procedure. In our study we estimate the distribution of the false discovery proportion (FDP) for the same procedure under a variety of correlation structures among multiple dependent variables in a MANOVA context. Specifically, we study the mean (the FDR), skewness, kurtosis, and percentiles of the FDP distribution in the case of multiple comparisons that give rise to correlated non-central t-statistics when results at several time periods are being compared to baseline. Even if the FDR achieves its nominal value, other aspects of the distribution of the FDP depend on the interaction between signed effect sizes and correlations among variables, proportion of true nulls, and number of dependent variables. We show examples where the mean FDP (the FDR) is 10% as designed, yet there is a surprising probability of having 30% or more false discoveries. Thus, in a real experiment, the proportion of false discoveries could be quite different from the stipulated FDR.

Diverticular disease of the right colon.

PubMed

Radhi, Jasim M; Ramsay, Jennifer A; Boutross-Tadross, Odette

2011-10-06

The incidence of colonic diverticular disease varies with national origin, cultural background and diet. The frequency of this disease increases with advancing age. Right-sided diverticular disease is uncommon and reported to occur in 1-2% of surgical specimens in European and American series. In contrast the disease is more prevalent and reported in 43-50% of specimens in Asian series. Various lines of evidence suggest this variation may represent hereditary differences. The aim of the study is to report all cases of right sided diverticular disease underwent surgical resection or identified during pathological examination of right hemicoloectomy specimens A retrospective review of all surgical specimens with right sided colonic diverticular disease selected from a larger database of all colonic diverticulosis and diverticulitis surgical specimen reported between January 1993 and December 2010 at the Pathology Department McMaster University Medical Centre Canada. The clinical and pathological features of these cases were reviewed The review identified 15 cases of right colon diverticulosis. The clinical diagnoses of these cases were appendicitis, diverticulitis or adenocarcinoma. Eight cases of single congenital perforated diverticuli were identified and seven cases were incidental multiple acquired diverticuli found in specimen resected for right side colonic carcinomas/large adenomas. Laparotomy or laparoscopic assisted haemicolectomies were done for all cases. Pathological examination showed caecal wall thickening with inflammation associated with perforated diverticuli. Histology confirmed true solitary diverticuli that exhibited in two cases thick walled vessels in the submucosa and muscular layer indicating vascular malformation/angiodysplasia. Acquired diverticuli tend to be multiple and are mostly seen in specimens resected for neoplastic right colon diseases. Single true diverticular disease of the right colon is usually of congenital type and affects younger age group and may be associated with angiodysplasia in some cases. Multiple false diverticuli are more seen in association with caecal carcinoma or large adenomas. These are usually asymptomatic and are more seen in older patients. However this study dose not reflects the true incidence of the disease in the general population.

Integrated Multivariate Health Monitoring System for Helicopters Main Rotor Drives: Development and Validation with In-Service Data

DTIC Science & Technology

2014-10-02

potential advantages of using multi- variate classification/discrimination/ anomaly detection meth- ods on real world accelerometric condition monitoring ...case of false anomaly reports. A possible explanation of this phenomenon could be given 8 ANNUAL CONFERENCE OF THE PROGNOSTICS AND HEALTH MANAGEMENT...of those helicopters. 1. Anomaly detection by means of a self-learning Shewhart control chart. A problem highlighted by the experts of Agusta- Westland

The added value of a portable gamma camera for intraoperative detection of sentinel lymph node in squamous cell carcinoma of the oral cavity: A case report.

PubMed

Mayoral, M; Paredes, P; Sieira, R; Vidal-Sicart, S; Marti, C; Pons, F

2014-01-01

The use of sentinel lymph node biopsy in squamous cell carcinoma of the oral cavity is still subject to debate although some studies have reported its feasibility. The main reason for this debate is probably due to the high false-negative rate for floor-of-mouth tumors per se. We report the case of a 54-year-old man with a T1N0 floor-of-mouth squamous cell carcinoma who underwent the sentinel lymph node procedure. Lymphoscintigraphy and SPECT/CT imaging were performed for lymphatic mapping with a conventional gamma camera. Sentinel lymph nodes were identified at right Ib, left IIa and Ia levels. However, these sentinel lymph nodes were difficult to detect intraoperatively with a gamma probe owing to the activity originating from the injection site. The use of a portable gamma camera made it possible to localize and excise all the sentinel lymph nodes. This case demonstrates the usefulness of this tool to improve sentinel lymph node detecting in floor-of-mouth tumors, especially those close to the injection area. Copyright © 2013 Elsevier España, S.L. and SEMNIM. All rights reserved.

Retrospective imaging study on the diagnosis of pathological false positive iodine-131 scans in patients with thyroid cancer.

PubMed

Jia, Qiang; Meng, Zhaowei; Tan, Jian; Zhang, Guizhi; He, Yajing; Sun, Haoran; Yu, Chunshui; Li, Dong; Zheng, Wei; Wang, Renfei; Wang, Shen; Li, Xue; Zhang, Jianping; Hu, Tianpeng; Liu, N A; Upadhyaya, Arun

2015-11-01

Iodine-131 (I-131) therapy and post-therapy I-131 scanning are essential in the management of differentiated thyroid cancer (DTC). However, pathological false positive I-131 scans can lead to misdiagnosis and inappropriate I-131 treatment. This retrospective study aimed to investigate the best imaging modality for the diagnosis of pathological false positive I-131 scans in a DTC patient cohort, and to determine its incidence. DTC patient data archived from January 2008 to January 2010 was retrieved. Post-therapeutic I-131 scans were conducted and interpreted. The imaging modalities of magnetic resonance imaging (MRI), computed tomography and ultrasonography were applied and compared to check all suspected lesions. Biopsy or needle aspiration was conducted for patients who consented to the acquisition of histopathological confirmation. Data for 156 DTC patients were retrieved. Only 6 cases of pathological false-positives were found among these (incidence, 3.85%), which included 3 cases of thymic hyperplasia in the mediastinum, 1 case of pleomorphic adenoma in the parapharyngeal space and 1 case of thyroglossal duct cyst in the neck. MRI was demonstrated as the best imaging modality for diagnosis due to its superior soft tissue resolution. However, no imaging modality was able to identify the abdominal false positive-lesions observed in 2 cases, one of whom also had thymic hyperplasia. In conclusion, pathological false positive I-131 scans occurred with an incidence of 3.85%. MRI was the best imaging modality for diagnosing these pathological false-positives.

[False positive of DUPAN-2 caused by IgM-human anti mouse antibody].

PubMed

Abe, Masaki; Hyoki, Miyuki; Abe, Ikurou; Kaito, Ken; Takagi, Ichirou

2012-11-01

We investigated a case in our experience presenting false-positive for DUPAN-2 by IgM-human anti mouse antibody (HAMA). A female aged 40s has been treated in our hospital from 2003. Her serum level of DUPAN-2 in 2005 and 2006 were 110 U/mL and 140 U/mL respectively. While this level was increased to 770 U/ml in 2007, and kept in the higher level so far. Around years of 2007, no meaning changes was detected by radiological and laboratory tests, and there was no significant change in her clinical signs and symptoms and medications. The elevation of DUPAN-2 was thought as a false-positive phenomenon and the mechanism was investigated. As results, no dilution lineality was found, and absorption test showed a 95% reduction of DUPAN-2 levels not by IgG and IgA, but IgM-specific antiserum. Dithiothreitoldeacylation test with neuraminidase, and absorption test with HBR-1, IIR, and mouse IgM serum, it was suggested that the IgM with HAMA activity of the patient reacted with mouse monoclonal antibodies in reagents. Moreover, the HPLC-eluted fraction of DUPAN-2 of this patients was detected in the fraction of IgM, which as different from that of a control pancreatic cancer patient. Above these data, elevation of DUPAN-2 in this patient was a false positive phenomenon by IgM-HAMA reacting with mouse monoclonal antibodies in reagents. Although there are few reported cases of false positive phenomenon in DUPAN-2 measurement, we have to pay attention to such phenomenon when detecting an unlikely higher levels that could not be explained by clinical information.

Improving Shipboard Applications of Non-Intrusive Load Monitoring

DTIC Science & Technology

2008-06-01

EVENTS_LIST (EventNum) .EVENTCODE) case 0 %Unclassifiable case 1 %VP On STATE.VP.ON = STATE.VP.ON + 1; STATE.VP.START = true; PICTURES.RUNNING.VP.SHOW...true; case 2 %VP Off STATE.VP.STOP = true; PICTURES. RUNNING.VP. SHOW false; case 3 %DP On 149 STATE.DP.ON = STATE.DP.ON + 1; STATE.DP.START = true...PICTURES.RUNNING.DP.SHOW true; case 4 %DP Off STATE.DP.STOP = true; PICTURES.RUNNING.DP.SHOW = false; case 5 %VP On (Clogged) STATE.VP.ON = STATE.VP.ON

Cross-Reactivity of Chloroquine and Hydroxychloroquine With DRI Amphetamine Immunoassay.

PubMed

Gomila, Isabel; Quesada, Loreto; López-Corominas, Victoria; Fernández, Julia; Servera, Miguel Á; Sahuquillo, Laura; Dastis, Macarena; Torrents, Albert; Barceló, Bernardino

2017-04-01

Chloroquine and hydroxychloroquine are medical drugs used to treat the chemoprophylaxis of malaria and a second-line anti-inflammatory drug. We performed a study of cross-reactivity of chloroquine and hydroxychloroquine in the DRI Amphetamine Assay inspired by a case report of a self-ingestion of chloroquine after a family dispute, that involved the following: (1) an in vitro study with control samples of healthy subjects, (2) an in vivo study with samples of patients with rheumatoid arthritis, and (3) an evaluation of the cross-reactivity of chloroquine and hydroxychloroquine in 3 additional immunoassays. In the case report, the Amphetamine DRI assay resulted positive both at 1000 ng/mL cutoff (1507 and 1137 ng/mL) and at 500 ng/mL cutoff (1178 and 642 ng/mL). Chloroquine urine levels were 103,900 and 100,900 ng/mL at 5 and 9 hours after ingestion. The results with control samples showed a positive cross-reactivity of chloroquine in the DRI Amphetamine Assay (approximately 0.74% and 0.89% at cutoff of 1000 and 500 ng/mL, respectively). Hydroxychloroquine did not cross-react with the DRI Amphetamine Assay up to 1,000,000 ng/mL. In patients treated with chloroquine or hydroxychloroquine, DRI Amphetamine did not produce false-positive results. The comparative assay study showed a positive cross-reactivity of chloroquine in the Emit II Plus Amphetamines Assay with control samples. Chloroquine can cause false-positive results in the DRI Amphetamine Assay when it is present at high concentrations. Hydroxychloroquine did not produce false-positive results neither in the DRI Amphetamine Assay nor in the others immunoassays evaluated.

Partial hydatidiform mole with false-negative urine human chorionic gonadatropin test in the emergency department.

PubMed

Mundangepfupfu, Tichaendepi; Waseem, Muhammad

2014-03-01

Hydatidiform mole (molar pregnancy) is a benign tumor of placental trophoblastic cells, which release human chorionic gonadotropin (hCG). Several case reports have described complete hydatidiform moles with false-negative urine qualitative hCG tests. These negative pregnancy tests have been attributed to the hook effect. We report an unusual presentation of a partial mole and review an alternative explanation for the negative hCG test. As partial moles are usually not associated with a large proliferation of trophoblastic cells, levels of hCG are commonly < 100,000 mIU/mL. The most common presentation of a hydatidiform mole is vaginal bleeding. Hydatidiform mole is associated with a risk of malignant transformation and disseminated disease. In a pregnant patient, vaginal bleeding and abdominal pain are common presentations. Molar pregnancy is an uncommon cause of abdominal pain and vaginal bleeding that should be considered. A 47-year-old female presented to the emergency department with abdominal pain and vaginal bleeding. Urine qualitative hCG was negative and serum quantitative hCG was 1,094,950 mIU/mL. Pelvic ultrasonography showed a uterine cavity containing a soft-tissue mass with multiple cystic lesions and the hydatidiform mole was extracted with suction curettage. Tissue pathology confirmed partial hydatidiform mole. In addition to the hook effect, we present another possible explanation for the false-negative test; namely the inability of some assays to detect hCG-degradation products, which may be higher in clinical samples from patients with hydatidiform mole. This case underscores the importance of knowing the limitations of the commonly used hCG assays. Copyright © 2014 Elsevier Inc. All rights reserved.

Ethnic diversity and disease surveillance: Guinea worm among the Fulani in a predominantly Yoruba district of Nigeria.

PubMed

Brieger, W R; Oke, G A; Otusanya, S; Adesope, A; Tijanu, J; Banjoko, M

1997-01-01

Guinea-worm eradication has been progressing internationally and efforts at case containment have begun in most endemic countries. Case containment rests on the assumption that in previous phases of eradication most if not all endemic settlements have been identified. Experiences in the predominantly Yoruba communities of Ifeloju Local Government Area (LGA) in Oyo State, Nigeria, however, have shown that the settlements of ethnic minority groups may be overlooked during initial case searches and subsequent programmes of village-based reporting. The migrant cattle-herding Fulani are found throughout the savannah and sahel regions of West Africa. Nearly 3000 live in 60 settlements in Ifeloju. An intensive case search identified 57 cases in 15 settlements. The assumption that village-based health workers (VBHWs) in neighbouring Yoruba farm hamlets would identify cases in the Fulani settlements, known as gaa, proved false. Only 5 endemic gaa were located next to a Yoruba hamlet that had a VBHW, and even then the VBHW did not identify and report the cases in the gaa. Efforts to recruit VBHWs for each endemic gaa are recommended, but only after LGA staff improve the poor relationship between themselves and the Fulani, whom they view as outsiders. The results also imply the need for Guinea worm eradication staff in neighbouring LGAs, states and countries to search actively for the disease among their minority populations.

Intraoperative Ultrasound in Patients Undergoing Transsphenoidal Surgery for Pituitary Adenoma: Systematic Review [corrected].

PubMed

Marcus, Hani J; Vercauteren, Tom; Ourselin, Sebastien; Dorward, Neil L

2017-10-01

Transsphenoidal surgery is the gold standard for pituitary adenoma resection. However, despite advances in microsurgical and endoscopic techniques, some pituitary adenomas can be challenging to cure. We sought to determine whether, in patients undergoing transsphenoidal surgery for pituitary adenoma, intraoperative ultrasound is a safe and effective technologic adjunct. The PubMed database was searched between January 1996 and January 2016 to identify relevant publications that 1) featured patients undergoing transsphenoidal surgery for pituitary adenoma, 2) used intraoperative ultrasound, and 3) reported on safety or effectiveness. Reference lists were also checked, and expert opinions were sought to identify further publications. Ultimately, 10 studies were included, comprising 1 cohort study, 7 case series, and 2 case reports. One study reported their prototype probe malfunctioned, leading to false-positive results in 2 cases, and another study' prototype probe was too large to safely enter the sphenoid sinus in 2 cases. Otherwise, no safety issues directly related to use of intraoperative ultrasound were reported. In the only comparative study, remission occurred in 89.7% (61/68) of patients with Cushing disease in whom intraoperative ultrasound was used, compared with 83.8% (57/68) in whom it was not. All studies reported that surgeons anecdotally found intraoperative ultrasound helpful. Although there is limited and low-quality evidence available, the use of intraoperative ultrasound appears to be a safe and effective technologic adjunct to transsphenoidal surgery for pituitary adenoma. Advances in ultrasound technology may allow for more widespread use of such devices. Copyright © 2017 Elsevier Inc. All rights reserved.

A pitfall of the volume rendering method with 3D time-of-flight MRA: a case of a branching vessel at the aneurysm neck.

PubMed

Goto, Masami; Kunimatsu, Akira; Shojima, Masaaki; Abe, Osamu; Aoki, Shigeki; Hayashi, Naoto; Mori, Harushi; Ino, Kenji; Yano, Keiichi; Saito, Nobuhito; Ohtomo, Kuni

2013-03-25

We present a case in which the origin of the branching vessel at the aneurysm neck was observed at the wrong place on the volume rendering method (VR) with 3D time-of-flight MRA (3D-TOF-MRA) with 3-Tesla MR system. In 3D-TOF-MRA, it is often difficult to observe the origin of the branching vessel, but it is unusual for it to be observed in the wrong place. In the planning of interventional treatment and surgical procedures, false recognition, as in the unique case in the present report, is a serious problem. Decisions based only on VR with 3D-TOF-MRA can be a cause of suboptimal selection in clinical treatment.

MRI in the diagnosis and surgical management of abnormal placentation.

PubMed

Palacios-Jaraquemada, José Miguel; Bruno, Claudio Hernán; Martín, Eduardo

2013-04-01

To determine the usefulness of placental magnetic resonance imaging (MRI) in the diagnosis and surgical management of abnormal placentation. Retrospective follow-up. Buenos Aires, Argentina. 547 pregnant women. In all cases, a direct and reliable description of abnormal placentation features was obtained by the operating surgeon. Placental MRI was analyzed according to: (1) primary description, (2) invasion topography, (3) modification required to the surgical tactics or techniques and (4) by positive and negative predictive values. Ultrasound and MRI findings were compared with surgical results, which were considered a final diagnosis in relation to primary diagnostic indications. Placental MRI was obtained because of diagnostic doubt in 78 cases, for deep invasion diagnosis in 148 cases and to define the invasion area in 346 cases. Placental MRI allowed accurate demarcation and assessment of the degree of placental invasion, parametrial involvement and cervico-trigonal vascular hyperplasia, permitting changes in the surgical tactical approach. Ultrasound and MRI differences were associated with placenta previa, uterine scar thinning and use of different criteria for placental invasion through definitions or terminology. Six cases of false-negative and 11 of false-positive findings were reported. Placental MRI provides excellent characterization of the degree and extension of placental invasion. Its usefulness in cases of adherent placentation is directly associated to the therapeutic measures, especially where dissection maneuvers are needed. Diagnostic differences between ultrasound and MRI related to the presence or not of placenta previa and uterine scar thinning. © 2012 The Authors Acta Obstetricia et Gynecologica Scandinavica © 2012 Nordic Federation of Societies of Obstetrics and Gynecology.

The Diagnostic Utility of Bact/ALERT and Nested PCR in the Diagnosis of Tuberculous Meningitis.

PubMed

Sastry, Apurba Sankar; Bhat K, Sandhya; Kumudavathi

2013-01-01

The early laboratory diagnosis of Tuberculous Meningitis (TBM) is crucial, to start the antitubercular chemotherapy and to prevent its complications. However, the conventional methods are either less sensitive or time consuming. Hence, the diagnostic potentials of BacT/ALERT and Polymerase Chain Reaction (PCR) was evaluated in this study. The study group comprised of 62 cases and 33 controls. The cases were divided according to Ahuja's criteria into the confirmed (two cases), highly probable (19 cases), probable (26 cases) and the possible (15 cases) subgroups. Ziehl Neelsen's (ZN) and Auramine Phenol (AP) staining, Lowenstein Jensen (LJ) medium culture, BacT/ALERT and nested Polymerase Chain Reaction (PCR) which targeted IS6110 were carried out on all the patients. The sensitivity of the LJ culture was 3.22%. BacT/ALERT showed a sensitivity and a specificity of 25.80% and 100% and those of nested PCR were found to be 40.32% and 96.97% respectively. The mean detection time of growth of the LJ culture was 31.28 days, whereas that of BacT/ALERT was 20.68 days. The contamination rate in the LJ culture and BacT/ALERT were 7.2% and 5.8% respectively. Nested PCR was found to be more sensitive, followed by BacT/ALERT as compared to the LJ culture and smear microscopy. As both false negative and false positive results have been reported for nested PCR, so it should not be used alone as a criterion for initiating or terminating the therapy, but it should be supported by clinical, radiological, cytological and other microbiological findings.

Variations in the branching pattern of posterior division of mandibular nerve: a case report.

PubMed

Muraleedharan, Aparna; Veeramani, Raveendranath; Chand, Parkash

2014-11-01

Abnormal communications among the branches of mandibular nerve especially the posterior division are significant due to various procedures undertaken in this region. These variations are worth reporting as they pose serious implications in several interventions in this region, and may even lead to false diagnosis. During routine dissection, the mandibular nerve and its branches were dissected in the infratemporal fossa. The branches from the posterior division of the mandibular nerve namely the inferior alveolar and auriculotemporal nerves were carefully dissected, and their abnormal branching pattern was noted. There was a communicating branch between left inferior alveolar and auriculotemporal nerve. There was also a variant recurrent branch from the left inferior alveolar nerve that supplied the lateral pterygoid muscle. Such variant branches and communications between the branches of mandibular nerve as seen in this case have an embryological basis and are clinically important in this region especially for dental surgeries and anesthesia.

Fingerprint Change: Not Visible, But Tangible.

PubMed

Negri, Francesca V; De Giorgi, Annamaria; Bozzetti, Cecilia; Squadrilli, Anna; Petronini, Pier Giorgio; Leonardi, Francesco; Bisogno, Luigi; Garofano, Luciano

2017-09-01

Hand-foot syndrome, a chemotherapy-induced cutaneous toxicity, can cause an alteration in fingerprints causing a setback for cancer patients due to the occurrence of false rejections. A colon cancer patient was fingerprinted after not having been able to use fingerprint recognition devices after 6 months of adjuvant chemotherapy. The fingerprint images were digitally processed to improve fingerprint definition without altering the papillary design. No evidence of skin toxicity was present. Two months later, the situation returned to normal. The fingerprint evaluation conducted on 15 identification points highlighted the quantitative and qualitative fingerprint alteration details detected after the end of chemotherapy and 2 months later. Fingerprint alteration during chemotherapy has been reported, but to our knowledge, this particular case is the first ever reported without evident clinical signs. Alternative fingerprint identification methods as well as improved biometric identification systems are needed in case of unexpected situations. © 2017 American Academy of Forensic Sciences.

Introduction

NASA Astrophysics Data System (ADS)

Nouwen, Rick; van Rooij, Robert; Sauerland, Uli; Schmitz, Hans-Christian

One could define vagueness as the existence of borderline cases and characterise the philosophical debate on vagueness as being about the nature of these. The prevalent theories of vagueness can be divided into three categories, paralleling three logical interpretations of borderline cases: (i) a borderline case is a case of a truth-value gap; it is neither true nor false; (ii) a borderline case is a case of a truth-value glut; it is both true and false; and (iii) a borderline case is a case where the truth-value is non-classical. The third of these is proposed in the fuzzy logic approach to vagueness. Three-valued approaches have only 1/2 as a value in addition to the standard values 1 and 0. These approaches can be interpreted either as allowing for gaps or gluts, depending on how the notion of satisfaction or truth is defined. If a sentence is taken to be true only if its value is 1, it allows for gaps, but if it is taken to be true already if its value is at least 1/2 it allows for gluts. The most popular theories advertising gluts and gaps, however, are supervaluationism and subvaluationism, both of which make use of the notion of precisifications, that is, ways of making things precise. Truth-value gaps in supervaluationism are due to the way truth simpliciter, or supertruth, is defined: A proposition is supertrue (superfalse) if it is true (false) at all precisifications. This means that a proposition can be neither true nor false in case there exist two precisifications, one of which make it true and one of which makes it false. Conversely, in subvaluation theory, the same scenario would lead to a truth-value glut. That is, the proposition would be both true and false. This is because subvaluationism defines truth simpliciter as being true at some precisifcation.

38 CFR 21.9740 - False, late, or missing reports.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 38 Pensions, Bonuses, and Veterans' Relief 2 2011-07-01 2011-07-01 false False, late, or missing reports. 21.9740 Section 21.9740 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS..., late, or missing reports. (a) Eligible individual. Payments may not be based on false or misleading...

38 CFR 21.9740 - False, late, or missing reports.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 38 Pensions, Bonuses, and Veterans' Relief 2 2014-07-01 2014-07-01 false False, late, or missing reports. 21.9740 Section 21.9740 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS..., late, or missing reports. (a) Eligible individual. Payments may not be based on false or misleading...

38 CFR 21.9740 - False, late, or missing reports.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 38 Pensions, Bonuses, and Veterans' Relief 2 2010-07-01 2010-07-01 false False, late, or missing reports. 21.9740 Section 21.9740 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS..., late, or missing reports. (a) Eligible individual. Payments may not be based on false or misleading...

38 CFR 21.9740 - False, late, or missing reports.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 38 Pensions, Bonuses, and Veterans' Relief 2 2013-07-01 2013-07-01 false False, late, or missing reports. 21.9740 Section 21.9740 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS..., late, or missing reports. (a) Eligible individual. Payments may not be based on false or misleading...

38 CFR 21.9740 - False, late, or missing reports.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 38 Pensions, Bonuses, and Veterans' Relief 2 2012-07-01 2012-07-01 false False, late, or missing reports. 21.9740 Section 21.9740 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS..., late, or missing reports. (a) Eligible individual. Payments may not be based on false or misleading...

Causes of false-negative for high-grade urothelial carcinoma in urine cytology.

PubMed

Lee, Paul J; Owens, Christopher L; Lithgow, Marie Y; Jiang, Zhong; Fischer, Andrew H

2016-12-01

The Paris System for classifying urine cytology emphasizes identification of high-grade urothelial carcinoma (HGUC). The causes of false-negative urine cytologies (UC) within this system are not well described. We identified 660 cases between 2005 and 2013 with both UC and subsequent cystoscopic biopsies. UC were classified as either Negative for HGUC or "Abnormal" ("Atypical", "Suspicious", and "Malignant"). Apparent false-negative cases were reviewed in a nonblinded fashion by two cytopathologists and two subspecialized genitourinary pathologists. A total of 199 of the 660 cases (30%) were histologically diagnosed as HGUC. The UC were "Abnormal" in 170/199 cases (sensitivity/specificity of 86%/71%). Twenty four apparent false negative cases were available for retrospective review. Five of 24 (21%) cystoscopic biopsies were found not to be HGUC on review (one false positive and four low-grade urothelial carcinoma (LGUC on review). Of the remaining 19 UC, 7 (29%) cytology samples were found to be truly negative on review, 11 (46%) were found to be Atypical, and 1 (4%) suspicious. Of the 12 UC that were at least "Atypical" with histologic HGUC on review: six misses (half) were attributed to obscuring inflammation/blood, four to poor preservation, eight to paucity of abnormal cells, and 1 case to interpretive error; many cases demonstrated overlapping reasons. About one fifth of apparent false negative diagnoses for HGUC can be because of overdiagnosis of HGUC by surgical pathologists. If poor preservation or obscured samples are called nondiagnostic, the sensitivity/specificity of UC for HGUC can be as high as 94%/71%. Diagn. Cytopathol. 2016;44:994-999. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

Detection of ingested nitromethane and reliable creatinine assessment using multiple common analytical methods.

PubMed

Murphy, Christine M; Devlin, John J; Beuhler, Michael C; Cheifetz, Paul; Maynard, Susan; Schwartz, Michael D; Kacinko, Sherri

2018-04-01

Nitromethane, found in fuels used for short distance racing, model cars, and model airplanes, produces a falsely elevated serum creatinine with standard creatinine analysis via the Jaffé method. Erroneous creatinine elevation often triggers extensive testing, leads to inaccurate diagnoses, and delayed or inappropriate medical interventions. Multiple reports in the literature identify "enzymatic assays" as an alternative method to detect the true value of creatinine, but this ambiguity does not help providers translate what type of enzymatic assay testing can be done in real time to determine if there is indeed false elevation. We report seven cases of ingested nitromethane where creatinine was determined via Beckman Coulter ® analyser using the Jaffé method, Vitros ® analyser, or i-Stat ® point-of-care testing. Nitromethane was detected and semi-quantified using a common clinical toxic alcohol analysis method, and quantified by headspace-gas chromatography-mass spectrometry. When creatinine was determined using i-Stat ® point-of-care testing or a Vitros ® analyser, levels were within the normal range. Comparatively, all initial creatinine levels obtained via the Jaffé method were elevated. Nitromethane concentrations ranged from 42 to 310 μg/mL. These cases demonstrate reliable assessment of creatinine through other enzymatic methods using a Vitros ® analyser or i-STAT ® . Additionally, nitromethane is detectable and quantifiable using routine alcohols gas chromatography analysis and by headspace-gas chromatography-mass spectrometry.

USA hCG reference service, 10-year report.

PubMed

Cole, Laurence A; Laidler, Laura L; Muller, Carolyn Y

2010-08-01

The USA hCG Reference Service has been dealing with cases of persistent low levels of hCG and gestational trophoblastic diseases for 10years. Here we present the complete experience. Total hCG in serum and urine was measured using the Siemen's Immulite 1000 assay. Hyperglycosylated hCG, nicked hCG, free ss-subunit and ss-core fragment were measured using microtiterplate assays with antibodies B152, B151, FBT11 and B210, respectively. The USA hCG Reference Service has identified 83 cases of false-positive hCG, 71 cases of aggressive gestational trophoblastic disease (GTD), 52 cases of minimally invasive GTD, 168 cases of quiescent GTD and 22 cases of placenta site trophoblastic tumor (PSTT). In addition, 103 cases of pituitary hCG have been identified, 60 cases of nontrophoblastic tumor, 4 cases of inherited hCG and 2 cases of Munchausen's syndrome. This is 565 cases total. Multiple new methods are described and tested for diagnosing all of these disorders. The USA hCG Reference Service experience shows new methods for detecting multiple hCG-related disorders and recommends new approaches for detecting these hCG-related disorders. 2010 The Canadian Society of Clinical Chemists. Published by Elsevier Inc. All rights reserved.

Lithium toxicity in a neonate owing to false elevation of blood lithium levels caused by contamination in a lithium heparin container: case report and review of the literature.

PubMed

Arslan, Zainab; Athiraman, Naveen K; Clark, Simon J

2016-08-01

Lithium toxicity in a neonate can occur owing to antenatal exposure as a result of maternal treatment for psychiatric illnesses. False elevation of lithium levels has been reported in the paediatric population when the sample was mistakenly collected in a lithium heparin container. A term, male infant was born to a mother who was on lithium treatment for a psychiatric illness. On day 1, the infant was jittery, had a poor suck with difficulties in establishing feeds. Blood taken from the infant approximately 8 hours after birth demonstrated a lithium level of 4.9 mmol/L (adult toxic level w1.5 mmol/L). However, the sample for lithium levels was sent in a lithium heparin container and the probability of false elevation was considered. He was closely monitored in the neonatal intensive care unit and his hydration was optimised with intravenous fluids. Clinically, he remained well and commenced feeding, and his jitteriness had decreased the following day. A repeat blood lithium level, collected in a gel container, was only 0.4 mmol/L. The initially raised lithium level was owing to contamination from the lithium heparin container.

Real-time reporting of baleen whale passive acoustic detections from ocean gliders.

PubMed

Baumgartner, Mark F; Fratantoni, David M; Hurst, Thomas P; Brown, Moira W; Cole, Tim V N; Van Parijs, Sofie M; Johnson, Mark

2013-09-01

In the past decade, much progress has been made in real-time passive acoustic monitoring of marine mammal occurrence and distribution from autonomous platforms (e.g., gliders, floats, buoys), but current systems focus primarily on a single call type produced by a single species, often from a single location. A hardware and software system was developed to detect, classify, and report 14 call types produced by 4 species of baleen whales in real time from ocean gliders. During a 3-week deployment in the central Gulf of Maine in late November and early December 2012, two gliders reported over 25,000 acoustic detections attributed to fin, humpback, sei, and right whales. The overall false detection rate for individual calls was 14%, and for right, humpback, and fin whales, false predictions of occurrence during 15-min reporting periods were 5% or less. Transmitted pitch tracks--compact representations of sounds--allowed unambiguous identification of both humpback and fin whale song. Of the ten cases when whales were sighted during aerial or shipboard surveys and a glider was within 20 km of the sighting location, nine were accompanied by real-time acoustic detections of the same species by the glider within ±12 h of the sighting time.

Comment on Hall et al. (2017), "How to Choose Between Measures of Tinnitus Loudness for Clinical Research? A Report on the Reliability and Validity of an Investigator-Administered Test and a Patient-Reported Measure Using Baseline Data Collected in a Phase IIa Drug Trial".

PubMed

Sabour, Siamak

2018-03-08

The purpose of this letter, in response to Hall, Mehta, and Fackrell (2017), is to provide important knowledge about methodology and statistical issues in assessing the reliability and validity of an audiologist-administered tinnitus loudness matching test and a patient-reported tinnitus loudness rating. The author uses reference textbooks and published articles regarding scientific assessment of the validity and reliability of a clinical test to discuss the statistical test and the methodological approach in assessing validity and reliability in clinical research. Depending on the type of the variable (qualitative or quantitative), well-known statistical tests can be applied to assess reliability and validity. The qualitative variables of sensitivity, specificity, positive predictive value, negative predictive value, false positive and false negative rates, likelihood ratio positive and likelihood ratio negative, as well as odds ratio (i.e., ratio of true to false results), are the most appropriate estimates to evaluate validity of a test compared to a gold standard. In the case of quantitative variables, depending on distribution of the variable, Pearson r or Spearman rho can be applied. Diagnostic accuracy (validity) and diagnostic precision (reliability or agreement) are two completely different methodological issues. Depending on the type of the variable (qualitative or quantitative), well-known statistical tests can be applied to assess validity.

Relationship between methamphetamine use history and segmental hair analysis findings of MA users.

PubMed

Han, Eunyoung; Lee, Sangeun; In, Sanghwan; Park, Meejung; Park, Yonghoon; Cho, Sungnam; Shin, Junguk; Lee, Hunjoo

2015-09-01

The aim of this study was to investigate the relationship between methamphetamine (MA) use history and segmental hair analysis (1 and 3cm sections) and whole hair analysis results in Korean MA users in rehabilitation programs. Hair samples were collected from 26 Korean MA users. Eleven of the 26 subjects used cannabis with MA and two used cocaine, opiates, and MDMA with MA. Self-reported single dose of MA from the 26 subjects ranged from 0.03 to 0.5g/one time. Concentrations of MA and its metabolite amphetamine (AP) in hair were determined by gas chromatography mass spectrometry (GC/MS) after derivatization. The method used was well validated. Qualitative analysis from all 1cm sections (n=154) revealed a good correlation between positive or negative results for MA in hair and self-reported MA use (69.48%, n=107). In detail, MA results were positive in 66 hair specimens of MA users who reported administering MA, and MA results were negative in 41 hair specimens of MA users who denied MA administration in the corresponding month. Test results were false-negative in 10.39% (n=16) of hair specimens and false-positive in 20.13% (n=31) of hair specimens. In false positive cases, it is considered that after MA cessation it continued to be accumulated in hair still, while in false negative cases, self-reported histories showed a small amount of MA use or MA use 5-7 months previously. In terms of quantitative analysis, the concentrations of MA in 1 and 3cm long hair segments and in whole hair samples ranged from 1.03 to 184.98 (mean 22.01), 2.26 to 89.33 (mean 18.71), and 0.91 to 124.49 (mean 15.24)ng/mg, respectively. Ten subjects showed a good correlation between MA use and MA concentration in hair. Correlation coefficient (r) of 7 among 10 subjects ranged from 0.71 to 0.98 (mean 0.85). Four subjects showed a low correlation between MA use and MA concentration in hair. Correlation coefficient (r) of 4 subjects ranged from 0.36 to 0.55. Eleven subjects showed a poor correlation between MA use and MA concentration in hair. Correlation between MA use and MA concentration in hair of remaining one subject could not be determined or calculated. In this study, the correlation between accurate MA use histories obtained by psychiatrists and well-trained counselors and MA concentrations in hair was shown. This report provides objective scientific findings that should considerably aid the interpretation of forensic results and of the results of trials related to MA use. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Hypogastric Arterial Selective and Superselective Embolization for Severe Postpartum Hemorrhage: A Retrospective Review of 36 Cases

DOE Office of Scientific and Technical Information (OSTI.GOV)

Boulleret, C.; Chahid, T.; Gallot, D.

We report on embolization in 36 cases of postpartum hemorrhage (PPH). The 36 patients with severe PPH, including one patient who had undergone an emergency hysterectomy, were transferred to the regional interventional vascular radiology unit in a mean time of 6 hours 12 min. Bilateral occlusion of the anterior trunk of the hypogastric arteries was carried out using gelatin sponge. Immediate success was achieved in all cases. In 3 cases, however, a second embolization was necessary before day 2. In 17%, complementary nonvascular surgery was performed. Complications included one puncture site false aneurysm treated by compression, two cases of regressivemore » lower limb paraesthesia, one femoral vein thrombosis, and nonsignificant puncture site hematomas (19.5%). Long-term follow-up was conducted in 23 patients: 91% resumed regular menstrual cycles, 8.7% dysmenorrhea. New pregnancy occurred in 13% (two full-term pregnancies and one voluntary termination). Immediate efficacy, low morbidity and preservation of fertility make embolization the technique of choice for severe PPH.« less

A Closer Look at Self-Reported Suicide Attempts: False Positives and False Negatives

ERIC Educational Resources Information Center

Ploderl, Martin; Kralovec, Karl; Yazdi, Kurosch; Fartacek, Reinhold

2011-01-01

The validity of self-reported suicide attempt information is undermined by false positives (e.g., incidences without intent to die), or by unreported suicide attempts, referred to as false negatives. In a sample of 1,385 Austrian adults, we explored the occurrence of false positives and false negatives with detailed, probing questions. Removing…

[False positive result in mammography and its association with the presence of obesity: a case-control study].

PubMed

Castro-Ibarra, Marisela; Menchaca-Díaz, Rufino; Cabrales-Ruvalcaba, J Jesús; Luna-V Gómez, Rosa Alicia

2016-01-01

To analyze the association between a false positive result in mammography and obesity, inside the breast cancer early detection program in women affiliated to the Institute of Security and Social Services for Government and Municipality workers of the State of Baja California (ISSSTECALI). A case-control, retrospective study was done in women affiliated to ISSSTECALI to whom a mammography was performed between 2009 and 2012. Women with a false positive result in mammography were included as cases. Controls were women with a true negative result in mammography. Three controls were randomly selected for each case. Obesity was established with the body mass index (BMI) consigned in the woman's clinical file. Age and estrogen replacement therapy were included as co-variables. Seventy nine cases were identified and 237 controls were included. Obesity was observed in 54.4% of cases and in 41.3% of controls (odds ratio: 1.69; 95% confidence interval for odds ratio: 1.01-2.82; p value: 0.043). A logistic regression model including covariables maintained the observed association (p = 0.044). No association was found with analyzed co-variables. A false positive result in mammography was associated with the presence of obesity.

Going on with false beliefs: What if satisfaction of search was really suppression of recognition?

NASA Astrophysics Data System (ADS)

Mello-Thoms, Claudia; Trieu, Phuong Dung; Brennan, Patrick C.

2014-03-01

Satisfaction of search (SOS) is a well known phenomenon in radiology, in which the detection of one abnormality facilitates the neglect of other abnormalities. Over the years SOS has been thoroughly studied primarily in chest and in trauma, and it has been found to be an elusive effect, appearing in some settings but not in others. Unfortunately, very little is known about SOS in mammography. In this study we will explore SOS in breast cancer detection by considering a case set of digital mammograms as interpreted by breast radiologists. However, the primary goal of the study will be to challenge the core of the paradigm; for decades, many have associated SOS with incomplete search, but as Kundel has put eloquently when addressing the SPIE Medical Imaging in 2004 [1], "observers do not stop viewing when one abnormality has been found on an image with multiple abnormalities". What else could cause SOS then? According to our previous work, the first "perceived" abnormality reported by a radiologist has an influential role in the report of any other "perceived" abnormalities on the case, which supports the idea that perhaps SOS is caused a perceptual suppression of the recognition of different abnormalities. In other words, once the radiologist has made a first report (regardless of whether that first report is a TP or FP), detection and hence reporting of other abnormalities present in the case are greatly dependent on whether these associated abnormalities "fit the profile" of what has been already found.

Utility of percutaneous joint aspiration and synovial biopsy in identifying culture-positive infected hip arthroplasty.

PubMed

Cross, M Connor; Kransdorf, Mark J; Chivers, F Spencer; Lorans, Roxanne; Roberts, Catherine C; Schwartz, Adam J; Beauchamp, Christopher P

2014-02-01

Percutaneous synovial biopsy has recently been reported to have a high diagnostic value in the preoperative identification of periprosthetic infection of the hip. We report our experience with this technique in the evaluation of patients undergoing revision hip arthroplasty, comparing results of preoperative synovial biopsy with joint aspiration in identifying an infected hip arthroplasty by bacteriological analysis. We retrospectively reviewed the results of the 110 most recent revision hip arthroplasties in which preoperative synovial biopsy and joint aspiration were both performed. Revision surgery for these patients occurred during the period from September 2005 to March 2012. Using this study group, results from preoperative cultures were compared with preoperative laboratory studies and the results of intraoperative cultures. Synovial aspiration was done using an 18- or 20-gauge spinal needle. Synovial biopsy was done coaxially following aspiration using a 22-gauge Chiba needle or 21-gauge Sure-Cut needle. Standard microbiological analysis was performed on preoperative synovial fluid aspirate and synovial biopsy. Intraoperative tissue biopsy bacteriological analysis results at surgical revision were accepted as the "gold standard" for the presence or absence of infection. Seventeen of 110 (15 %) of patients had intraoperative culture-positive periprosthetic infection. Of these 17 cases, there were ten cases where either the synovial fluid aspiration and/or the synovial biopsy were true positive (sensitivity of 59 %, specificity of 100 %, positive predictive value of 100 % and accuracy of 94 %). There were seven cases where aspiration and biopsy results were both falsely negative, but no false-positive results. Similar results were found for synovial fluid aspiration alone. The results of synovial biopsy alone resulted in the identification of seven infected joints with no false-positive result (sensitivity of 41 %, specificity of 100 %, positive predictive value of 100 %, and accuracy of 91 %). Standard microbiological analyses performed on percutaneous synovial biopsy specimen during the preoperative evaluation of patients undergoing revision hip arthroplasty did not improve detection of culture-positive periprosthetic infection as compared to synovial fluid aspiration alone.

Butyrfentanyl overdose resulting in diffuse alveolar hemorrhage.

PubMed

Cole, Jon B; Dunbar, John F; McIntire, Sarah A; Regelmann, Warren E; Slusher, Tina M

2015-03-01

Butyrfentanyl is a potent short-acting opioid and a fentanyl analog with uncertain clinical effects. A review of the literature reveals no human case reports of butyrfentanyl overdose. As the use of analog and synthetic drugs continues to increase, clinicians are often faced with tremendous uncertainty when they encounter patients exposed to these synthetic drugs. We describe, to our knowledge, the first case of a butyrfentanyl overdose that resulted in clinically significant hemoptysis, acute lung injury, hypoxic respiratory failure, and diffuse alveolar hemorrhage. Complicating this case was a false-positive urine drug screen for fentanyl. Clinicians who encounter fentanyl exposures should be aware they may in fact be dealing with butyrfentanyl. As little is known of butyrfentanyl and our patient suffered a significant pulmonary hemorrhage, those who encounter butyrfentanyl exposures should monitor for hemorrhagic complications. Copyright © 2015 by the American Academy of Pediatrics.

Over-reassurance and undersupport after a 'false alarm': a systematic review of the impact on subsequent cancer symptom attribution and help seeking.

PubMed

Renzi, Cristina; Whitaker, Katriina L; Wardle, Jane

2015-02-04

This literature review examined research into the impact of a previous 'all-clear' or non-cancer diagnosis following symptomatic presentation ('false alarm') on symptom attribution and delays in help seeking for subsequent possible cancer symptoms. The comprehensive literature review included original research based on quantitative, qualitative and mixed data collection methods. We used a combination of search strategies, including in-depth searches of electronic databases (PubMed, EMBASE, PsychInfo), searching key authors and articles listed as 'related' in PubMed, and reference lists. We performed a narrative synthesis of key themes shared across studies. The review included studies published after 1990 and before February 2014 reporting information on adult patients having experienced a false alarm following symptomatic presentation. We excluded false alarms in the context of screening. We evaluated the effect of a 'false alarm' on symptom attribution and help seeking for new or recurrent possible cancer symptoms. Overall, 1442 papers were screened and 121 retrieved for full-text evaluation. Among them, 19 reported on false alarms and subsequent symptom attribution or help seeking. They used qualitative (n=14), quantitative (n=3) and mixed methods (n=2). Breast (n=7), gynaecological (n=3), colorectal (n=2), testicular (n=2), and head and neck cancers (n=2) were the most studied. Two broad themes emerged underlying delays in help seeking: (1) over-reassurance from the previous 'all-clear' diagnosis leading to subsequent symptoms being interpreted as benign, and (2) unsupportive healthcare experiences in which symptoms were dismissed, leaving patients concerned about appearing hypochondriacal or uncertain about the appropriate next actions. The evidence suggested that the effect of a false alarm can persist for months and even years. In conclusion, over-reassurance and undersupport of patients after a false alarm can undermine help seeking in the case of new or recurrent potential cancer symptoms, highlighting the need for appropriate patient information when investigations rule out cancer. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

7 CFR 1410.61 - Filing of false claims.

Code of Federal Regulations, 2010 CFR

2010-01-01

... of false claims. If CCC determines that any participant has knowingly supplied false information or... with respect to the program year in which the false information or claim was filed and the contract may be terminated, in which case a full refund of all prior payments may be demanded. False information...

The role of ultrasound in the management and diagnosis of infectious mononucleosis

PubMed Central

2014-01-01

Currently, infectious mononucleosis (IM) is a clinically diagnosed condition. According to the American Family Physician criteria for IM, splenomegaly is the key factor that distinguishes IM from other causes of sore throat. Though heterophile antibody tests are often ordered to confirm diagnosis of IM, this test has a high false-negative rate early in the course of the disease. This case report provides an example of how the use of ultrasound to diagnose splenomegaly and subsequently mononucleosis increases diagnostic accuracy. PMID:24580968

DOE Office of Scientific and Technical Information (OSTI.GOV)

Paci, Enrico; Antico, Ettore; Candelari, Roberto

We report a case of a pseudoaneurysm of the common hepatic artery treated with a stent-graft in a 67-year-old man. The patient presented with severe catheter bleeding through a drain following surgical and interventional procedures performed for therapeutic management of a choledochal cholangiocarcinoma. Selective hepatic arteriography showed a pseudoaneurysm close to the origin of the gastroduodenal artery. After a preliminary attempt at arterial embolization, it was decided to use a stent-graft to bridge the false aneurysm. Complete pseudoaneurysm exclusion was seen after the procedure with preservation of hepatic arterial flow.

15 CFR 30.71 - False or fraudulent reporting on or misuse of the Automated Export System.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 15 Commerce and Foreign Trade 1 2010-01-01 2010-01-01 false False or fraudulent reporting on or misuse of the Automated Export System. 30.71 Section 30.71 Commerce and Foreign Trade Regulations... REGULATIONS Penalties § 30.71 False or fraudulent reporting on or misuse of the Automated Export System. (a...

Electromagnetic immunity of infusion pumps to GSM mobile phones: a systematic review.

PubMed

Calcagnini, Giovanni; Censi, Federica; Triventi, Michele; Mattei, Eugenio; Bartolini, Pietro

2007-01-01

Electromagnetic interference with life-sustaining medical care devices has been reported by various groups. Previous studies have demonstrated that volumetric and syringe pumps are susceptible to false alarm buzzing and blocking, when exposed to various electromagnetic sources. The risk of electromagnetic interference depends on several factors such as the phone-emitted power, distance and carrier frequency, phone model and antenna type. The main recommendations and the relevant harmonized standard are also reported and discussed. >From the data available in literature emerges that, for distances lower than 1 m there is a non negligible risk of electromagnetic interferences, although significant differences exists in the reported minimum distances. Interference effects clinically relevant for the patients are rare. No permanent damage to the pumps has been ever reported, although in several cases intervention of personnel is required to resume normal operation.

Biological false-positive venereal disease research laboratory test in cerebrospinal fluid in the diagnosis of neurosyphilis - a case-control study.

PubMed

Zheng, S; Lin, R J; Chan, Y H; Ngan, C C L

2018-03-01

There is no clear consensus on the diagnosis of neurosyphilis. The Venereal Disease Research Laboratory (VDRL) test from cerebrospinal fluid (CSF) has traditionally been considered the gold standard for diagnosing neurosyphilis but is widely known to be insensitive. In this study, we compared the clinical and laboratory characteristics of true-positive VDRL-CSF cases with biological false-positive VDRL-CSF cases. We retrospectively identified cases of true and false-positive VDRL-CSF across a 3-year period received by the Immunology and Serology Laboratory, Singapore General Hospital. A biological false-positive VDRL-CSF is defined as a reactive VDRL-CSF with a non-reactive Treponema pallidum particle agglutination (TPPA)-CSF and/or negative Line Immuno Assay (LIA)-CSF IgG. A true-positive VDRL-CSF is a reactive VDRL-CSF with a concordant reactive TPPA-CSF and/or positive LIA-CSF IgG. During the study period, a total of 1254 specimens underwent VDRL-CSF examination. Amongst these, 60 specimens from 53 patients tested positive for VDRL-CSF. Of the 53 patients, 42 (79.2%) were true-positive cases and 11 (20.8%) were false-positive cases. In our setting, a positive non-treponemal serology has 97.6% sensitivity, 100% specificity, 100% positive predictive value and 91.7% negative predictive value for a true-positive VDRL-CSF based on our laboratory definition. HIV seropositivity was an independent predictor of a true-positive VDRL-CSF. Biological false-positive VDRL-CSF is common in a setting where patients are tested without first establishing a serological diagnosis of syphilis. Serological testing should be performed prior to CSF evaluation for neurosyphilis. © 2017 European Academy of Dermatology and Venereology.

The etiology of Rubella IgM positivity in patients with rubella-like illness in Iran from 2011 to 2013.

PubMed

Khorrami, Seyed Mahmood Seyed; Mokhtari-Azad, Talat; Yavarian, Jila; Nasab, Gazal Sadat Fatemi; Naseri, Maryam; Jandaghi, Nazanin Zahra Shafiei

2015-11-01

Rubella is a mild self-limiting contagious viral disease caused by the rubella virus (RV). Although symptoms are often mild, the concern is centralized around the possible effect on a fetus growth and development in case of primary infection during early months of pregnancy. Recently acquired rubella is commonly confirmed by RV-specific IgM antibody detection in the serum. However, rubella primary infection is not always the only cause of IgM positivity. Other possible causes of rubella IgM positivity may include IgM persistence following vaccination or naturally acquired infection or even re-infection. Moreover, nonspecific IgM reactivity can cause false-positive results. There are few articles to differentiate the aetiology of rash in rubella-like illnesses. However, limited studies have been conducted on clarifying the source of IgM positivity in these cases. This article reports the study of 10,896 clinical cases demonstrating rubella-like illness between 2011 and 2013 in Iran. The rate of IgM positivity among these cases was 0.52% (57 cases). As predicted based on the high coverage of vaccination in Iran fewer than 16% of cases with ELISA IgM positive result, were due to current rubella primary infections. The greater part of the positive IgM reactions occurred in cross reactivity with other viruses (31.6%) or in prolonged IgM response post vaccination (24.6%). This research confirmed that the positive result of rubella IgM assay in vaccinated individuals is mainly caused by prolonged IgM production, rubella re-infection, and false positivity due to infection with other viruses, rather than the rubella primary infection itself. © 2015 Wiley Periodicals, Inc.

Fibroadenoma in Axillary Supernumerary Breast in a 17-Year-Old Girl: Case Report.

PubMed

Surd, Adrian; Mironescu, Aurel; Gocan, Horatiu

2016-10-01

Supernumerary breast or polymastia is a well documented anomaly of the breast, and commonly presents along the embryonic milk line extending between the axilla and groin. However, cases of polymastia have been recorded in the face, vulva, and perineum. The clinical significance of these anomalies include their susceptibility to inflammatory and malignant changes, and their association with other congenital anomalies of the urinary and cardiovascular systems. In this article we report a case of fibroadenoma that developed in the supernumerary breast of the right axilla in a 17-year-old girl. It is uncommon to find such palpable masses in young patients. Clinical and sonographic examination of both breasts revealed no abnormalities and no lymph nodes were detected in the axillae or the neck. No associated urologic or cardiovascular abnormalities were found, and the histopathological examination of the excisional biopsy samples showed a well-defined, capsulated intracanalicular type of fibroadenoma similar to that of eutopic mammary tissue. In this report, we describe a rare case of fibroadenoma in an accessory breast in a young woman. There are a fewer than 40 reports in the world about this subject, of which differential diagnoses include: cancer in axillary supernumerary breast, hidradenitis, axillary lymphadenomegaly, lipomas, anexial cutaneous neoplasia, cysts, and phylloides tumor. The combination of clinical examination, ultrasound, and cytology leads to adequate treatment, especially surgical. The diagnosis could be confused because of findings from cytology. In this case, because of the clinical and sonographic findings and multiple differential diagnosis, only the histopathological study was used to confirm the diagnosis. Despite its high sensitivity, cytology has low specificity and could create false positive results. However, atypical lesions can be seen in fibroadenomas, especially in younger patients, pregnant patients, and in patients who use hormonal contraception. Although there are a few reports, our case report is similar to current medical registers and, after surgical treatment, our patient had an excellent prognosis. Copyright © 2016 North American Society for Pediatric and Adolescent Gynecology. Published by Elsevier Inc. All rights reserved.

Pre-operative prediction of cervical nodal metastasis in papillary thyroid cancer by 99mTc-MIBI SPECT/CT; a pilot study.

PubMed

Tangjaturonrasme, Napadon; Vasavid, Pataramon; Sombuntham, Premsuda; Keelawat, Somboon

2013-06-01

Papillary thyroid cancer has a high prevalence of cervical nodal metastasis. There is no "gold standard" imaging for pre-operative diagnosis. The aim of the present study was to assess the accuracy of pre-operative 99mTc-MBI SPECT/CT in diagnosis of cervical nodal metastasis in patients with papillary thyroid cancer Fifteen patients were performed 99Tc-MlBI SPECT/CT pre-operatively. Either positive pathological report of neck dissection or positive post-treatment I-131 whole body scan with SPECT/CT of neck was concluded for definite neck metastasis. The PPV, NPV, and accuracy of 99mTc-MIBI SPECT/CT were analyzed. The PPV NPV and accuracy were 80%, 88.89%, and 85.71%, respectively. 99mTc-MIBI SPECT/CT could localize the abnormal lymph nodes groups correctly in most cases when compared with pathological results. However the authors found one false positive case with caseating granulomatous lymphadenitis and one false negative case with positive post-treatment 1-131 whole body scan with SPECT/CT of neck on cervical nodes zone II and IV CONCLUSION: 99mTc-MIBI SPECT/CTseem promising for pre-operative staging of cervical nodal involvement in patients with papillary thyroid cancer without the need of using iodinated contrast that may complicate subsequence 1-131 treatment. However, false positive result in granulomatous inflammatory nodes should be aware of especially in endemic areas. 99mTc-MIBI SPECT/CT scan shows a good result when compared with previous study of CT or MRI imaging. The comparative study between different imaging modality and the extension of neck dissection according to MIBI result seems interesting.

Urine cytology of nonurothelial malignancies-a 10-year experience in a large multihospital healthcare system.

PubMed

Savant, Deepika; Bajaj, Jaya; Gimenez, Cecilia; Rafael, Oana C; Mirzamani, Neda; Chau, Karen; Klein, Melissa; Das, Kasturi

2017-01-01

Urine cytology is the most frequently utilized test to detect urothelial cancer. Secondary bladder neoplasms need to be recognized as this impacts patient management. We report our experience on nonurothelial malignancies (NUM) detected in urine cytology over a 10-year period. A 10-year retrospective search for patients with biopsy-proven NUM to the urothelial tract yielded 25 urine samples from 14 patients. Two cytopathologists blinded to the original cytology diagnosis reviewed the cytology and histology slides. The incidence, cytomorphologic features, diagnostic accuracy, factors influencing the diagnostic accuracy, and clinical impact of the cytology result were studied. The incidence of NUM was <1%. The male:female ratio was 1.3. An abnormality was detected in 60% of the cases; however, in only 4% of the cases, a primary site was identified accurately. Of the false negatives, 96% was deemed as sampling errors and 4% was interpretational. Patient management was not impacted in any of the false-negative cases due to concurrent or past tissue diagnosis. Colon cancer was the most frequent secondary tumor. Sampling error attributed to the false-negative results. Necrosis and dirty background was often associated with metastatic lesions from colon. Obtaining history of a primary tumor elsewhere was a key factor in diagnosis of a metastatic lesion. Hematopoietic malignancies remain to be a diagnostic challenge. Cytospin preparations were superior for evaluating nuclear detail and background material as opposed to monolayer (Thinprep) technology. Diagnostic accuracy was improved by obtaining immunohistochemistry. Diagn. Cytopathol. 2016. © 2016 Wiley Periodicals, Inc. Diagn. Cytopathol. 2017;45:22-28. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

Simulations on false gain in recombination-pumped soft-X-ray lasers

NASA Astrophysics Data System (ADS)

Ozaki, T.; Kuroda, H.

1997-10-01

Numerical investigations are performed on false gain due to axial plasma expansion, which is expected to be important in initial proof-of-principle studies of recombination-pumped soft-X-ray lasers with extended capabilities. Modelling calculations of experiments with slab boron nitride targets reveal large false gain coefficients approaching 20 cm-1 in the case of plasmas with short active medium lengths. The false gain in the case of fiber targets is found to be of equal magnitude to that for slabs in the case of plasmas with less than 0.1 cm active medium lengths. Calculations for slab targets predict that adopting a tolerance of ǃ cm-1 for gain will severely restrict the time and the active medium length of the plasma that can be used for error-free observations, while those for fiber targets are found to be considerably relaxed. The effects of false gain in the 54.2 + Na Balmer ! laser is also investigated, again revealing the importance of this phenomena under optimum gain conditions.

The effect of sample storage on the performance and reproducibility of the galactomannan EIA test.

PubMed

Kimpton, George; White, P Lewis; Barnes, Rosemary A

2014-08-01

Galactomannan enzyme immune assay (GM EIA) is a nonculture test for detecting invasive aspergillosis (IA) forming a key part of diagnosis and management. Recent reports have questioned the reproducibility of indices after sample storage. To investigate this, 198 serum samples (72 from cases and 126 from controls) and 61 plasma samples (24 from cases and 37 from controls), initially tested between 2010 and 2013, were retested to determine any change in index. Data were also collected on circulatory protein levels for false-positive serum samples. Serum indices significantly declined on retesting (median: initial, 0.50, retest, 0.23; P < 0.0001). This was shown to be diagnosis dependent as the decline was apparent on retesting of control samples (median: initial 0.50, retest 0.12; P < 0.0001), but was not evident with case samples (median: initial, 0.80, retest, 0.80; P = 0.724). Plasma samples showed little change on reanalysis after long-term storage at 4°C. Retesting after freezing showed a decrease in index values for controls (median: initial 0.40, retest 0.26; P = 0.0505), but no significant change in cases. Circulatory proteins showed a correlation between serum albumin concentration and difference in index value on retesting. Overall, this study suggests that a lack of reproducibility in GM EIA positivity is only significant when disease is absent. Retesting after freezing helps to differentiate false-positive GM EIA results and, with consecutive positivity, could help to improve accuracy in predicting disease status. The freezing of samples prior to testing could potentially reduce false-positivity rates and the need to retest. © The Author 2014. Published by Oxford University Press on behalf of The International Society for Human and Animal Mycology. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Underestimation of malignancy in biopsy-proven cases of stromal fibrosis

PubMed Central

Lad, S; Seely, J M; Schweitzer, M E

2014-01-01

Objective: To determine the rate of underestimation of malignancy in patients with biopsy-proven stromal fibrosis. Methods: Following institutional review board approval, we retrospectively reviewed the charts of patients with biopsy-proven stromal fibrosis who underwent percutaneous breast biopsy in the 5-year period between 1 January 2005 and 31 December 2009. The medical records and the histopathology in patients who underwent repeat biopsy and/or surgical excision at the site of stromal fibrosis within 2 years were reviewed. Interval stability for up to 2 years was documented in patients who did not undergo additional biopsy or surgical excision. An upgrade was defined as any patient with biopsy-proven stromal fibrosis or fibroadenoma with evidence of malignancy at the site of biopsy within 2 years. Results: 365 cases of stromal fibrosis were identified, of which 25 (7%) were upgraded to in situ or invasive malignancy on repeat biopsy or surgical excision. 7 were upgraded to ductal carcinoma in situ and 18 were upgraded to invasive cancer. Of the upgraded cases, 8 out of 24 (32%) were considered concordant with a benign diagnosis. The false-negative rate, that is, cases of stromal fibrosis concordant with benignity, but with subsequent upgrade, comprised 2% of all cases. Conclusion: In biopsy-proven cases of stromal fibrosis, there is a 7% upgrade to malignancy. We recommend that all instances of stromal fibrosis with radiology–pathology discordance undergo repeat biopsy or surgical excision. Cases that demonstrate radiology–pathology concordance can be safely categorized as a Breast Imaging Reporting and Data System 3 (BI-RADS® 3) lesion with a 6-month follow-up, owing to a false-negative rate for missed cancer of 2%. Advances in knowledge: We now recommend that concordant cases of stromal fibrosis be categorized as BI-RADS 3 with a short-term follow-up, as this results in a missed cancer rate of 2%. PMID:24846442

Penile fracture: long-term results of surgical and conservative management.

PubMed

Gamal, Wael M; Osman, Mahmoud M; Hammady, Ahmed; Aldahshoury, M Zaki; Hussein, Mohamed M; Saleem, Mohamed

2011-08-01

Penile fracture usually results from direct trauma to the erected penis. We evaluate the outcomes of surgical and conservative treatment. Between February 2000 and February 2007, 77 patients with mean age 29 ± 2.5 years (range, 20-57 years) with penile fracture were evaluated retrospectively. A total of 56 patients (group A) were treated with immediate surgical repair and 21 patients (group B) were treated conservatively as they refused surgical intervention. Data on erectile function and any penile sequel were obtained during follow-up using the International Index of Erectile Function (IIEF-15) questionnaire, local examination, and color Doppler ultrasonography reports. Only 69 patients were available for median follow-up period of 20.8 months (range, 17-30 months), 51 patients of the group A and 18 of the group B. Injury involved unilateral and bilateral corporeal rupture in 50 and 6 cases, respectively. Concomitant urethral injury was detected in three cases. During follow-up, 49 cases (96%) of the surgical group (A) and 9 cases (50%) of the conservative group (B) reported erection adequate for intercourse, with no voiding dysfunction and no penile curvature. However, the remaining nine patients (50%) from the conservative group (B) reported erectile dysfunction and penile deviation. Immediate surgical repair of the penile fracture gave good results and is superior to conservative treatment; however, we cannot distinguish false from true penile fracture accurately to determine on whom we can use the conservative treatment.

Usefulness of a break-apart FISH assay in the diagnosis of Xp11.2 translocation renal cell carcinoma.

PubMed

Kim, Soo Hee; Choi, Yoomi; Jeong, Hae Yeon; Lee, Kyoungbun; Chae, Ji Youn; Moon, Kyung Chul

2011-09-01

Xp11.2 translocation renal cell carcinoma (RCC) is a rare subtype of RCC predominantly reported in young patients. It results from gene fusions between the transcription factor E3 (TFE3) gene, which is located on chromosome Xp11.2, and various fusion partners. Recently, a dual color, break-apart fluorescence in situ hybridization (FISH) assay to detect Xp11.2 translocation was reported. We performed this study to evaluate the usefulness of the FISH assay in the diagnosis of Xp11.2 translocation RCC using a commercially available TFE3 break-apart probe. We immunohistochemically analyzed TFE3 nuclear expression in 809 cases of RCCs using 14 tissue microarray blocks and selected nine cases those showed moderate to strong positive nuclear immunoreactivity for TFE3. The extent of TFE3 nuclear expression was variable. The TFE3 FISH assay was performed in these 9 selected cases and 44 negative control cases. Only four out of nine selected cases showed the TFE3 break-apart signal. TFE3 FISH-positive cases mainly showed diffuse and strong TFE3 immunopositivity, but one case revealed focal and moderate TFE3 staining. On the contrary, TFE3 FISH-negative cases mainly revealed focal and moderate TFE3 immunoreactivity, however, one FISH-negative case revealed diffuse and strong TFE3 nuclear immunopositivity. All negative control cases revealed normal TFE3 FISH results. Our results reveal that TFE3 immunohistochemistry can show false-positive results, and that the TFE3 break-apart FISH assay is a useful complementary method for confirming the diagnosis of Xp11.2 translocation RCC.

Gain-Scheduled Fault Tolerance Control Under False Identification

NASA Technical Reports Server (NTRS)

Shin, Jong-Yeob; Belcastro, Christine (Technical Monitor)

2006-01-01

An active fault tolerant control (FTC) law is generally sensitive to false identification since the control gain is reconfigured for fault occurrence. In the conventional FTC law design procedure, dynamic variations due to false identification are not considered. In this paper, an FTC synthesis method is developed in order to consider possible variations of closed-loop dynamics under false identification into the control design procedure. An active FTC synthesis problem is formulated into an LMI optimization problem to minimize the upper bound of the induced-L2 norm which can represent the worst-case performance degradation due to false identification. The developed synthesis method is applied for control of the longitudinal motions of FASER (Free-flying Airplane for Subscale Experimental Research). The designed FTC law of the airplane is simulated for pitch angle command tracking under a false identification case.

False penile fracture: value of different diagnostic approaches and long-term outcome of conservative and surgical management.

PubMed

El-Assmy, Ahmed; El-Tholoth, Hossam S; Abou-El-Ghar, Mohamed E; Mohsen, Tarek; Ibrahiem, El Housseiny I

2010-06-01

We determined the value of clinical and radiological findings in diagnosis of false penile fracture. Also, the long-term outcome of conservative and surgical treatment of such patients was evaluated. Seventeen patients with false penile fracture were treated conservatively (3 patients) and surgically (14 patients) at our center. Medical records were retrospectively reviewed for etiology, symptoms, signs of physical examination, and information on findings of surgical exploration. Data on erectile function and penile sequelae were obtained during follow-up using the Sexual Health Inventory for Men (SHIM) questionnaire and local examination. The most common cause of false penile fracture is sexual intercourse (76.5%). False fracture was suspected in 3 patients who presented with small hematoma and slow post-trauma detumescence; intact tunicas were diagnosed by magnetic resonance imaging (MRI) in all of them and were managed conservatively. Surgical penile exploration was performed in 14 cases, in whom preoperative ultrasound was done in 6, and it was false positive for presence of tunical tear in 50%. Exploration revealed nonspecific dartos bleeding in 9 cases and avulsed superficial dorsal vein in 5. Long-term follow-up (mean=93 months) was available for 16 patients, among whom there was no complications. In most cases, false penile fracture is indistinguishable from true penile fracture either clinically or radiologically. In atypical cases, MRI seems to be a promising modality for diagnosis of such patients. The long-term outcome of conservative and surgical treatment is excellent. Copyright (c) 2010 Elsevier Inc. All rights reserved.

Prozone effect of serum IgE levels in a case of plasma cell leukemia.

PubMed

Talamo, Giampaolo; Castellani, William; Dolloff, Nathan G

2010-09-10

We describe a case of multiple myeloma (MM) and secondary plasma cell leukemia (PCL) secreting IgE-kappa immunoglobulin. To our knowledge, only 2 cases of IgE-producing secondary PCL have been reported in the medical literature. In our patient, the only tumor marker available for monitoring the therapeutic response to chemotherapy and allogeneic stem cell transplantation was the quantitative M component at serum protein electrophoresis (SPEP), because serum free light chains were in the normal range, Bence-Jones proteinuria was absent, and quantitative serum IgE levels provided inaccurate and erratic results, due to the prozone effect. This is a laboratory phenomenon that occurs when antigen excess interferes with antibody-based methods requiring immune complex formation for detection. It is important to recognize the presence of a prozone effect, because it can produce falsely normal results, and therefore it could lead clinicians to incorrect assessment of the response to therapy.

Burden of major diarrheagenic protozoan parasitic co-infection among amoebic dysentery cases from North East India: a case report.

PubMed

Nath, Joyobrato; Hussain, Gulzar; Singha, Baby; Paul, Jaishree; Ghosh, Sankar Kumar

2015-09-01

Intestinal diarrheagenic polyparasitic infections are among the major public health concerns in developing countries. Here we examined stool specimens by microscopy, DNA dot blot and polymerase chain reaction (PCR) to evaluate the co-infection of four principal protozoans among amoebic dysentery cases from Northeast Indian population. The multiplex PCR confirmed Entamoeba histolytica (8.1%), Entamoeba dispar (4.8%) and mixed infection of both the parasites (3.4%) in 68 of 356 stool specimens that were positive in microscopy and/or HMe probe based DNA dot blot screening. The prevailing parasite that co-exists with E. histolytica was Giardia duodenalis (34.1%), followed by Enterocytozoon bieneusi (22.0%), Cryptosporidium parvum (14.6%) and Cyclospora cayetanensis (7.3%, P = 0.017). Symptomatic participants (odds ratio (OR) = 4.07; 95% confidence interval (CI) = 1.06, 15.68; P = 0.041), monsoon season (OR = 7.47; 95% CI = 1.40, 39.84; P = 0.046) and participants with family history of parasitic infection (OR = 4.50; 95% CI = 1.16, 17.51; P = 0.030) have significant association with overall co-infection rate. According to molecular consensus, comprehensive microscopy yielded 3.4% (12/356) false-negative and 7.6% (27/356) false-positive outcome, suggesting an improved broad-spectrum PCR-based diagnostic is required to scale down the poor sensitivity and specificity as well as implementation of integrated control strategy.

20 CFR 356.3 - False claims.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 20 Employees' Benefits 1 2010-04-01 2010-04-01 false False claims. 356.3 Section 356.3 Employees' Benefits RAILROAD RETIREMENT BOARD ADMINISTRATIVE REMEDIES FOR FRAUDULENT CLAIMS OR STATEMENTS CIVIL MONETARY PENALTY INFLATION ADJUSTMENT § 356.3 False claims. In the case of penalties assessed under 31 U.S...

Serological findings in leprosy and tuberculosis with the Wassermann, Meinicke, and VDRL tests.

PubMed

RUGE, H

1955-01-01

In the course of a venereal disease survey in Egypt, 820 cases of leprosy and 720 cases of tuberculosis were serologically examined with the Wassermann, Meinicke (MKR II), and VDRL tests; the results are reported in this paper.On serological and anamnestic evidence, 31 cases of syphilis were discovered among the leprosy cases and 37 among the tuberculosis cases. Apparently false positive reactions were seen in 203 cases of leprosy (25%) and in 38 cases of tuberculosis (5%). The author discusses the probability that a fairly high proportion of these reactions were in fact caused by otherwise undetected syphilis or were non-specific.The Meinicke test proved the most specific of the three, followed, in that order, by the Wassermann and the VDRL tests.It was found that syphilis was more frequent among males with tuberculosis than among those with leprosy; this is attributed to the fact that leprosy patients are kept in greater isolation. Less easily explicable is the fact that more females than males with leprosy were found to have syphilis, whereas in tuberculous persons the difference in syphilis incidence between male and female patients was not very great.

Ethical perspectives and ramifications of the Paolo Macchiarini case.

PubMed

Teixeira da Silva, Jaime A

2017-01-01

The Paolo Macchiarini case has several ethical ramifications. Professor Macchiarini, formerly of the Karolinska Institutet (KI), became famous for the tracheal surgeries he conducted between 2008 and 2014. His rapid rise to fame was followed by an almost equally rapid fall from grace as official reports, articles in newspapers and television programmes revealed several aspects related to misconduct in his curriculum vitae, professional practices and publishing-related activity. Formal misconduct reports issued by four KI co-workers in late 2014, then again in 2016, coupled with social scandals, including the tricking of a famous US television newscaster into a false marriage, a previous arrest in Italy for apparent bribery, and acute narcissism, all tainted Macchiarini's legend. In the short space of just two years, Macchiarini was no longer remembered for the revolutionary changes he had claimed to have brought about in stem cell research and regenerative medicine. Instead, at least seven dead patients later, Macchiarini faces potential aggravated manslaughter charges and an uphill battle to save his published research, now shrouded in scandal and scientific doubt, from being retracted and scratched out from the list of verified medical science. This paper examines some of the possible ethical ramifications of the Macchiarini case.

Heterophile antibody interference in qualitative urine/serum hCG devices: Case report.

PubMed

Patel, Khushbu K; Gronowski, Ann M

2016-06-01

This case report investigates the origin of a false positive result on a serum qualitative human chorionic gonadotropin (hCG) device. A 46-year-old woman diagnosed with chronic myeloid leukemia presented with nausea and vomiting. A qualitative serum hCG test was interpreted as positive; however, a quantitative serum hCG test was negative (<5IU/L). To further investigate this discrepancy, the sample was pretreated with heterophilic blocking reagent (HBR). Additionally, the sample was tested on other qualitative hCG devices composed of antibodies from different animal sources. Blocking reagent from an automated quantitative immunoassay was also tested for its ability to inhibit the heterophile antibody interference. The qualitative test result was negative after pretreatment with heterophilic blocking reagent. Other devices composed of antibodies from different animal sources also demonstrated mixed results with the patient's sample. Blocking reagent obtained from the automated quantitative assay inhibited the heterophile antibody interference in the patient's sample. This case demonstrates that positive serum point-of-care hCG results should be interpreted with caution and confirmed with a quantitative serum hCG immunoassay when clinical suspicion is raised. Copyright © 2016 The Canadian Society of Clinical Chemists. Published by Elsevier Inc. All rights reserved.

Medicolegal affairs. International Academy of Cytology Task Force summary. Diagnostic Cytology Towards the 21st Century: An International Expert Conference and Tutorial.

PubMed

Frable, W J; Austin, R M; Greening, S E; Collins, R J; Hillman, R L; Kobler, T P; Koss, L G; Mitchell, H; Perey, R; Rosenthal, D L; Sidoti, M S; Somrak, T M

1998-01-01

Increasing litigation over alleged false negative cervical cytologic (CC) smears threatens the viability of this test for cervical cancer detection. The problem appears to be largely American but is beginning to appear in some other countries. In the vast majority of cases there is either a settlement or jury verdict for the plaintiff based largely on the testimony of expert witnesses. Cases are judged on an individual basis without significant consideration of the general performance of the CC smear in laboratories operating in compliance with a wide array of laboratory regulations and with documented and comprehensive quality control practices in place. It is acknowledged that there are problem laboratories and cytology practitioners. There is an emerging issue of automated preparation and screening devices and issues of informed patient consent. Cytology professionals have done an extraordinary and commendable job of educating the public about the benefits of the CC smear. We have been less successful and conscientious about explaining and defining the limitations of the CC test. There is a need for public and professional education as to the benefits and limitations of the CC smear for cervical cancer detection. The process suggested is to work with women's groups, public health agencies, government agencies, and state and national legislatures and to coordinate professional committees working on liability issues. Contextual information could be included with the CC smear report to indicate that a negative report confers a low probability of developing cervical cancer. It is suggested that appropriate language and a menu of statements be developed. Increased efforts should be directed to physician education with respect to informed consent concerning the benefits and limitations of CC smear testing and the application of new technology to improve smear accuracy. The process should include development of appropriate statements on the use of alternative technology. The profession should develop "process guidelines" for review of CC smears in the context of possible litigation, including standardized methods for blind slide review of smears that reduce or eliminate context and outcome bias. It is suggested that review panels be anonymous, that the process be standardized and that there be limitations on liability for participating organizations. Professional cytopathology and pathology societies should formulate acceptable guidelines for expert witnesses. The standards should be applicable to both defendant and plaintiff experts. All materials to the extent practical, including consultant opinions, should be available for peer review. Professional cytopathology and pathology societies should monitor expert testimony for objectivity and scientific accuracy. For the near future, litigation will continue to focus on false negative CC smears on a case-by-case basis. Laboratories and individuals can reduce the risk of malpractice liability by directing their attention to proactive quality control and quality assurance methods. In the final analysis, consumer education about the benefits and limitations of the test is key to limiting malpractice claims. To stem the tide of continued medicolegal challenges to the integrity of cytology practice, the cytology community has now focused its efforts on developing and utilizing standards that convey to patients, attorneys and cytologists the contemporary status of and reasonable expectations for the practice of cytology. Guidelines such as those for uniform reporting terminology and clinical management of cervical abnormalities form the basis of cytology practice standards on which legal standards of practice can be based. Consensus conference reports, clinical management trials and scientifically valid studies of false negative rates that analyze the type, frequency and cause of missed cases represent sounder methods of establishing defensible

False ankylosis of the temporomandibular joint in a cat. Correction by partial zygomatic arch resection.

PubMed

Larguier, L; Jamet, N

2015-01-01

To describe the use of two-dimensional computer-assisted tomography (CT) with three-dimensional (3D) reconstruction in the diagnosis and planning of surgical treatment of a case of false ankylosis of the temporomandibular joint. A young European Shorthaired cat was presented with the complaint of inability to eat and open its jaws. A CT scan with 3D reconstruction allowed visualization of the lesion which was causing extra-articular ankylosis of the temporomandibular joint. Surgery was performed to resect an osseous lesion of the zygomatic arch, thus freeing the temporomandibular joint. Postoperative physical therapy was initiated immediately following surgery, and then carried out by the owner with a one year follow-up. Clinical examination of the cat was performed during regular office visits (at 1 month and 3 months following surgery), which allowed objective assessment of postoperative recuperation. At the end of a year, the owners reported that the cat had maintained sufficient jaw opening without any signs consistent with chronic pain. Computed tomography scan with 3D reconstruction allowed planning of the surgical correction of extra-articular ankylosis of the temporomandibular joint, and in this case condylectomy was avoided, since temporomandibular joint range-of-motion was maintained.

VL: a further case of erroneous recollection.

PubMed

Craik, Fergus I M; Barense, Morgan D; Rathbone, Clare J; Grusec, Joan E; Stuss, Donald T; Gao, Fuqiang; Scott, Christopher J M; Black, Sandra E

2014-04-01

We report a single-case study of a female patient (VL) who exhibited frequent episodes of erroneous recollections triggered by everyday events. Based on neuropsychological testing, VL was classified as suffering from mild to moderate dementia (MMSE=18) and was given a diagnosis of probable Alzheimer׳s disease. Her memory functions were uniformly impaired but her verbal abilities were generally well preserved. A structural MRI scan showed extensive areas of gray matter atrophy particularly in frontal and medial-temporal (MTL) areas. Results of experimental recognition tests showed that VL had very high false alarm rates on tests using pictures, faces and auditory stimuli, but lower false alarm rates on verbal tests. We provide a speculative account of her erroneous recollections in terms of her MTL and frontal pathology. In outline, we suggest that owing to binding failures in MTL regions, VL׳s recognition processes were forced to rely on earlier than normal stages of analysis. Environmental features on a given recognition trial may have combined with fragments persisting from previous trials resulting in erroneous feelings of familiarity and of recollection that were not discounted or edited out, due to her impaired frontal processes. Crown Copyright © 2014. Published by Elsevier Ltd. All rights reserved.

Successful twin delivery following transmyometrial embryo transfer in a patient with a false uterine cavity.

PubMed

Muñoz, Manuel; Galindo, Noemí; Pérez-Cano, Inmaculada; Cruz, María; García-Velasco, Juan Antonio

2014-02-01

A successful pregnancy is the greatest goal for reproductive medicine. The probability that pregnancy occurs during a cycle of assisted reproduction is a function of multiple factors, of which embryo transfer is one of the most critical steps in these treatments. This article reports a case of successful pregnancy and twin delivery by transmyometrial embryo transfer after IVF in a woman with a neocavity parallel to the uterine cavity, which prevented the transfer of embryos to the correct place. The patient first went to another fertility centre where embryo transfer was impossible to perform because the cervix could not be canalized. Subsequently in this study clinic, after considering the difficulty of inserting a catheter into the endometrial cavity, a trial transfer was performed, which discovered a false route parallel to endometrial cavity. Following a first cycle in which conventional transcervical embryo transfer was performed, a transmyometrial embryo transfer was carried out and the patient became pregnant with twins. In cases where transcervical embryo transfer is very difficult or impossible to perform, the value of transmyometrial transfer is self-evident. Copyright © 2013 Reproductive Healthcare Ltd. Published by Elsevier Ltd. All rights reserved.

25 CFR 20.607 - What happens when applicants or recipients knowingly and willfully provide false or fraudulent...

Code of Federal Regulations, 2010 CFR

2010-04-01

... willfully provide false or fraudulent information? 20.607 Section 20.607 Indians BUREAU OF INDIAN AFFAIRS... fraudulent information? Applicants or recipients who knowingly and willfully provide false or fraudulent... report detailing the information considered to be false and submit the report to the Superintendent or...

Arboviral diseases and malaria in Australia, 2013-14: Annual report of the National Arbovirus and Malaria Advisory Committee.

PubMed

Knope, Katrina E; Muller, Mike; Kurucz, Nina; Doggett, Stephen L; Feldman, Rebecca; Johansen, Cheryl A; Hobby, Michaela; Bennett, Sonya; Lynch, Stacey; Sly, Angus; Currie, Bart J

2016-09-30

This report describes the epidemiology of mosquito-borne diseases of public health importance in Australia during the 2013-14 season (1 July 2013 to 30 June 2014) and includes data from human notifications, sentinel chicken, vector and virus surveillance programs. The National Notifiable Diseases Surveillance System received notifications for 8,898 cases of disease transmitted by mosquitoes during the 2013-14 season. The Australasian alphaviruses Barmah Forest virus and Ross River virus accounted for 6,372 (72%) total notifications. However, over-diagnosis and possible false positive diagnostic test results for these 2 infections mean that the true burden of infection is likely overestimated, and as a consequence, the case definitions have been amended. There were 94 notifications of imported chikungunya virus infection and 13 cases of imported Zika virus infection. There were 212 notifications of dengue virus infection acquired in Australia and 1,795 cases acquired overseas, with an additional 14 cases for which the place of acquisition was unknown. Imported cases of dengue were most frequently acquired in Indonesia (51%). No cases of locally-acquired malaria were notified during the 2013-14 season, though there were 373 notifications of overseas-acquired malaria. In 2013-14, arbovirus and mosquito surveillance programs were conducted in most jurisdictions. Surveillance for exotic mosquitoes at international ports of entry continues to be a vital part of preventing the spread of vectors of mosquito-borne diseases such as dengue to new areas of Australia, with 13 detections of exotic mosquitoes at the ports of entry in 2013-14.

Computer-aided diagnosis of contrast-enhanced spectral mammography: A feasibility study.

PubMed

Patel, Bhavika K; Ranjbar, Sara; Wu, Teresa; Pockaj, Barbara A; Li, Jing; Zhang, Nan; Lobbes, Mark; Zhang, Bin; Mitchell, J Ross

2018-01-01

To evaluate whether the use of a computer-aided diagnosis-contrast-enhanced spectral mammography (CAD-CESM) tool can further increase the diagnostic performance of CESM compared with that of experienced radiologists. This IRB-approved retrospective study analyzed 50 lesions described on CESM from August 2014 to December 2015. Histopathologic analyses, used as the criterion standard, revealed 24 benign and 26 malignant lesions. An expert breast radiologist manually outlined lesion boundaries on the different views. A set of morphologic and textural features were then extracted from the low-energy and recombined images. Machine-learning algorithms with feature selection were used along with statistical analysis to reduce, select, and combine features. Selected features were then used to construct a predictive model using a support vector machine (SVM) classification method in a leave-one-out-cross-validation approach. The classification performance was compared against the diagnostic predictions of 2 breast radiologists with access to the same CESM cases. Based on the SVM classification, CAD-CESM correctly identified 45 of 50 lesions in the cohort, resulting in an overall accuracy of 90%. The detection rate for the malignant group was 88% (3 false-negative cases) and 92% for the benign group (2 false-positive cases). Compared with the model, radiologist 1 had an overall accuracy of 78% and a detection rate of 92% (2 false-negative cases) for the malignant group and 62% (10 false-positive cases) for the benign group. Radiologist 2 had an overall accuracy of 86% and a detection rate of 100% for the malignant group and 71% (8 false-positive cases) for the benign group. The results of our feasibility study suggest that a CAD-CESM tool can provide complementary information to radiologists, mainly by reducing the number of false-positive findings. Copyright © 2017 Elsevier B.V. All rights reserved.

[Analysis for Discordance of Positive and Negative Blood Typing by Gel Card].

PubMed

Li, Cui-Ying; Xu, Hong; Lei, Hui-Fen; Liu, Juan; Li, Xiao-Wei

2017-08-01

To explore the method of Gel card identifying ABO blood group, determine the inconsistent cause and the distribution of disease affecting factors, and put forward a method of its solutions. To collect 240 positive and negative typing-discordant blood speciments from patients examined by Gel card and send these speciments to blood type reference laboratory for examining with the classic tube method and serological test, such as salivary blood-group substance, in order to performe genotyping method when serologic test can not be determined. Among 240 positive and negative typing-discordant blood speciments from patients examined by Gel card, 107 blood speciments were positive and negative consistent examined by false agglutination test (44.58%), 133 blood specinents were discordent examined by false agglutination (55.42%), out of them, 35 cases (14.58%) with inconsistent cold agglutination test, 22 cases (9.17%) with weakened AB antigenicity, 16 cases (6.67%) with ABO subtyping, 12 cases (5.00%) with positive direct antiglobulin test, 11 cases (4.58%) with reduced or without antibodies, 11 cases (4.58%) with false aggregation caused by drugs or protein, 11 cases (4.58%) with salivary blood-type substances, 8 cases (3.33%) with non-ABO alloantibody, and 7 cases (2.92%) with allogeneic bone marrow transplantation. The distribution of disease were following: blood disease (16.83%), tumor (11.88%), and cardiopulmonary diseases (11.39%); chi-square test results indicated that the distribution significantly different. The analysis of ABO blood grouping shows a variety factors influencing positive and negative blood typing, and the Gel Card identification can produc more false positive blood types. Therefore, more attention should be paid on the high incidence diseases, such as blood disease, tumor, and cardiopulmonary disease.

Public health consequences of a false-positive laboratory test result for Brucella--Florida, Georgia, and Michigan, 2005.

PubMed

2008-06-06

Human brucellosis, a nationally notifiable disease, is uncommon in the United States. Most human cases have occurred in returned travelers or immigrants from regions where brucellosis is endemic, or were acquired domestically from eating illegally imported, unpasteurized fresh cheeses. In January 2005, a woman aged 35 years who lived in Nassau County, Florida, received a diagnosis of brucellosis, based on results of a Brucella immunoglobulin M (IgM) enzyme immunoassay (EIA) performed in a commercial laboratory using analyte specific reagents (ASRs); this diagnosis prompted an investigation of dairy products in two other states. Subsequent confirmatory antibody testing by Brucella microagglutination test (BMAT) performed at CDC on the patient's serum was negative. The case did not meet the CDC/Council of State and Territorial Epidemiologists' (CSTE) definition for a probable or confirmed brucellosis case, and the initial EIA result was determined to be a false positive. This report summarizes the case history, laboratory findings, and public health investigations. CDC recommends that Brucella serology testing only be performed using tests cleared or approved by the Food and Drug Administration (FDA) or validated under the Clinical Laboratory Improvement Amendments (CLIA) and shown to reliably detect the presence of Brucella infection. Results from these tests should be considered supportive evidence for recent infection only and interpreted in the context of a clinically compatible illness and exposure history. EIA is not considered a confirmatory Brucella antibody test; positive screening test results should be confirmed by Brucella-specific agglutination (i.e., BMAT or standard tube agglutination test) methods.

Death by heroin intoxication in a body pusher with an innovative packaging technique: case report and review of the literature.

PubMed

Visentin, Sindi; Bevilacqua, Greta; Giraudo, Chiara; Dengo, Caterina; Nalesso, Alessandro; Montisci, Massimo

2017-11-01

Death due to mechanical or chemical intoxication of heroin body packers, thanks to the continuous improvement in packaging techniques, are increasingly rare, and almost all the cases reported in the literature refer to drug swallowers. A case of fatal acute heroin intoxication in a body pusher with an unreported packaging technique is presented, and previous deaths due to heroin body packing are reviewed, taking into consideration imaging techniques performed, cause of death, toxicological analysis on biological and non-biological samples, as well as number, position and type of drug packages identified at the dissection of the body. The innovative packaging technique found in the present case, constituted by an external multilayer cellophane casing containing 16 smaller packages of hardened heroin powder, each one covered with cigarette paper and multiple layers of heat-sealed cellophane, was probably used to avoid both chemical complications of package rupture and to create a package with morphological and radiological features different from those reported by previous studies. Drug dealers, in fact, are continually looking for packaging methods that, besides being safer, minimize the risk of detection at the radiological examinations performed, thus increasing the number of false negative findings. The identification of new types of package is therefore important, in order to identify packages that do not have the typical radiological signs, both in order to protect the patient's health and to avoid the non-recognition of a drug carrier. Despite the presence of multilayer composition of both the smaller and the bigger external coverage, these new types of package did not guarantee the greater safety of the drug dealer. Copyright © 2017 Elsevier B.V. All rights reserved.

False-Positive Cases of Fluorodeoxyglucose-Positron Emission Tomography/Computed Tomographic Scans in Metastasis of Esophageal Cancer

PubMed Central

Yamatsuji, Tomoki; Ishida, Naomasa; Takaoka, Munenori; Hayashi, Jiro; Yoshida, Kazuhiro; Shigemitsu, Kaori; Urakami, Atsushi; Haisa, Minoru; Naomoto, Yoshio

2017-01-01

Of 129 esophagectomies at our institute from June 2010 to March 2015, we experienced three preoperative positron emission tomography-computed tomographic (PET/CT) false positives. Bone metastasis was originally suspected in 2 cases, but they were later found to be bone metastasis negative after a preoperative bone biopsy and clinical course observation. The other cases suspected of mediastinal lymph node metastasis were diagnosed as inflammatory lymphadenopathy by a pathological examination of the removed lymph nodes. Conducting a PET/CT is useful when diagnosing esophageal cancer metastasis, but we need to be aware of the possibility of false positives. Therapeutic decisions should be made based on appropriate and accurate diagnoses, with pathological diagnosis actively introduced if necessary. PMID:28469502

Easy fix for clinical laboratories for the false-positive defect with the Abbott AxSym total beta-hCG test.

PubMed

Cole, Laurence A; Khanlian, Sarah A

2004-05-01

False-positive hCG results can lead to erroneous diagnoses and needless chemotherapy and surgery. In the last 2 years, eight publications described cases involving false-positive hCG tests; all eight involved the AxSym test. We investigated the source of this abundance of cases and a simple fix that may be used by clinical laboratories. False-positive hCG was primarily identified by absence of hCG in urine and varying or negative hCG results in alternative tests. Seventeen false-positive serum samples in the AxSym test were evaluated undiluted and at twofold dilution with diluent containing excess goat serum or immunoglobulin. We identified 58 patients with false-positive hCG, 47 of 58 due to the Abbott AxSym total hCGbeta test (81%). Sixteen of 17 of these "false-positive" results (mean 100 mIU/ml) became undetectable when tested again after twofold dilution. A simple twofold dilution with this diluent containing excess goat serum or immunoglobulin completely protected 16 of 17 samples from patients having false-positive results. It is recommended that laboratories using this test use twofold dilution as a minimum to prevent false-positive results.

[A case of systemic lupus erythematosus discovered from left heart failure due to lupus induced mitral regurgitation].

PubMed

Ueno, K; Fujimoto, S; Fujimoto, T; Nakano, H; Nakajima, T; Yamano, S; Shiiki, H; Hashimoto, T; Imoto, K; Miyagawa, S; Dohi, K

1999-10-01

A 50-year-old female was admitted to a local hospital because of dyspnea, and diagnosed as having left heart failure secondary to mitral regurgitation. After the improvement of congestive heart failure, polyarthralgia, fever, and positive anti-nuclear antibody were pointed out. She was referred to our hospital for the further evaluation. Serological test showed anti-double stranded DNA antibodies, anti-SS-A antibodies, anti-beta 2-GPI antibodies and biological false positive for syphilis. The diagnosis of SLE has been made from the clinical signs and the serology. Therefore mitral valvular lesion of this patient was considered to be one of the symptoms of SLE. We reported a rare case in which left heart failure was a initial clinical manifestation of SLE.

Psychology's Renaissance.

PubMed

Nelson, Leif D; Simmons, Joseph; Simonsohn, Uri

2018-01-04

In 2010-2012, a few largely coincidental events led experimental psychologists to realize that their approach to collecting, analyzing, and reporting data made it too easy to publish false-positive findings. This sparked a period of methodological reflection that we review here and call Psychology's Renaissance. We begin by describing how psychologists' concerns with publication bias shifted from worrying about file-drawered studies to worrying about p-hacked analyses. We then review the methodological changes that psychologists have proposed and, in some cases, embraced. In describing how the renaissance has unfolded, we attempt to describe different points of view fairly but not neutrally, so as to identify the most promising paths forward. In so doing, we champion disclosure and preregistration, express skepticism about most statistical solutions to publication bias, take positions on the analysis and interpretation of replication failures, and contend that meta-analytical thinking increases the prevalence of false positives. Our general thesis is that the scientific practices of experimental psychologists have improved dramatically.

MRSA-infected external iliac artery pseudoaneurysm treated with endovascular stenting.

PubMed

Clarke, M G; Thomas, H G; Chester, J F

2005-01-01

A 48-year-old woman with severe juvenile-onset rheumatoid arthritis presented with a bleeding cutaneous sinus distal to her right total hip replacement scar. Methicillin resistant Staphylococcus aureus (MRSA) was isolated on culture. She had previously undergone bilateral total hip and knee replacements at aged 23 and six years later had the right knee prosthesis removed for infection, with subsequent osteomyelitis of the femoral shaft and right total hip prosthesis disruption. Peripheral arteriography was performed in view of persistent bleeding from the sinus, which revealed a 6 cm false aneurysm filling from and compressing the right external iliac artery (EIA). A PTFE-covered, balloon expandable JOSTENT was deployed in the right EIA, successfully excluding the false aneurysm and preventing further bleeding from the sinus. No graft infection was reported at 12 months. This case illustrates the potential use of endovascular stent-grafting in the treatment of an infected pseudoaneurysm.

MRSA-Infected External Iliac Artery Pseudoaneurysm Treated with Endovascular Stenting

DOE Office of Scientific and Technical Information (OSTI.GOV)

Clarke, M.G.; Thomas, H.G.; Chester, J.F.

2005-04-15

A 48-year-old woman with severe juvenile-onset rheumatoid arthritis presented with a bleeding cutaneous sinus distal to her right total hip replacement scar. Methicillin resistant Staphylococcus aureus (MRSA) was isolated on culture. She had previously undergone bilateral total hip and knee replacements at aged 23 and six years later had the right knee prosthesis removed for infection, with subsequent osteomyelitis of the femoral shaft and right total hip prosthesis disruption. Peripheral arteriography was performed in view of persistent bleeding from the sinus, which revealed a 6 cm false aneurysm filling from and compressing the right external iliac artery (EIA). A PTFE-covered,more » balloon expandable JOSTENT was deployed in the right EIA, successfully excluding the false aneurysm and preventing further bleeding from the sinus. No graft infection was reported at 12 months. This case illustrates the potential use of endovascular stent-grafting in the treatment of an infected pseudoaneurysm.« less

Development of a Test Facility for Air Revitalization Technology Evaluation

NASA Technical Reports Server (NTRS)

Lu, Sao-Dung; Lin, Amy; Campbell, Melissa; Smith, Frederick

2006-01-01

An active fault tolerant control (FTC) law is generally sensitive to false identification since the control gain is reconfigured for fault occurrence. In the conventional FTC law design procedure, dynamic variations due to false identification are not considered. In this paper, an FTC synthesis method is developed in order to consider possible variations of closed-loop dynamics under false identification into the control design procedure. An active FTC synthesis problem is formulated into an LMI optimization problem to minimize the upper bound of the induced-L2 norm which can represent the worst-case performance degradation due to false identification. The developed synthesis method is applied for control of the longitudinal motions of FASER (Free-flying Airplane for Subscale Experimental Research). The designed FTC law of the airplane is simulated for pitch angle command tracking under a false identification case.

Regulations and control of in-transit fumigated containers as well as of fumigated cargo ships.

PubMed

Low, Anthony; Hüsing, Ulf-Peter; Preisser, Alexandra; Baur, Xaver

2003-01-01

According to IMO's international regulations, e.g. "Recommendations on the safe use of pesticides in ships", fumigated containers and ship cargoes must be labeled giving specifications about dates of fumigation and the fumigation gas used. Furthermore, appropriate certificates are necessary and these records have to be forwarded to the Port Health Authorities without their explicitly asking for them. According to IMO (DSC/Circ.8.24.7.2001) a recent inspection of containers unloaded in ports showed that some were under fumigation, but not declared as such and in a few cases these ventilated containers arrive with "Degas Certificates" stating that fumigant has been removed, but still have a high fumigant concentration inside when opened. There are similar reports from The Netherlands, where 21% of the fumigated containers had missing or false declarations and contained measurable amounts of toxic gas. In England 6% were mentioned to be allegedly false. Reports exist of a number of other incidents with containers under fumigation arriving in English ports with no accompanying documents on the ship or at the port of discharge as to the type of cargo. In one case several people were hospitalized after exposure to phosphine gas because the fumigant tablets were not yet totally decomposed before the ship arrived at its destination port. In Bavaria, Germany, a bad accident recently occurred through a non declared fumigated container (see press release). Our sample: a large container ship in the Port of Hamburg where 27 of the cargo's containers were found fumigated with 27 non/incomplete/false declarations. These examples show that missing/false labelling is frequent. Clearance of in-transit fumigated containers in ports is complicated and time-consuming for the captain and shipping company. The above mentioned accident and also the results of our spot check prove, as do the experiences in The Netherlands and England, that false declarations of fumigated containers seem commonplace. This coincides with a considerable danger for ship crews, port workers and end users. More stringent controls, including gas analysis, are necessary as well as a systematic study. As a first step in that direction, we included the question "Are fumigated containers on board?", in the form of the Maritime Declaration of Health we demand. A computer controlled information and communication system network between ports and its link with the Waterways and Shipping Directorate would enable comprehensive plausibility monitoring and thus help achieve a better surveillance.

Reproducibility of cervical cytopathology following an intervention by an external quality control laboratory.

PubMed

Ázara, Cinara Zago Silveira; Manrique, Edna Joana Claudio; Tavares, Suelene Brito do Nascimento; Alves de Souza, Nadja Lindany; Magalhães, Juliana Cristina; Amaral, Rita Goreti

2016-04-01

This study assessed the effects of a continued education program on the agreement between cervical cytopathology exams interpreted by local laboratories and interpretation made by an external quality control laboratory (LabMEQ). Overall, 9,798 exams were analyzed between 2007 and 2008, prior to implementation of a continued education program, and 10,028 between 2010 and 2011, following implementation. Continued education consisted of theoretical and practical classes held every two months. The chi-square test and the kappa coefficient were used in the statistical analysis. Following implementation of continued education, the rate of false-negative results, and those leading to delays in clinical management fell in eight laboratories and the rate of false-positive results in five. Agreement between the results reported by the laboratories and the findings of LabMEQ, evaluated according to clinical management, remained excellent in three laboratories (kappa >0.80 and <1.0), went from good (kappa >0.60 and <0.80) to excellent in seven and from excellent to good in two. Agreement regarding the identification of metaplastic epithelium was poor (kappa = 0.25) but progressed to excellent following the implementation of continued education (kappa = 0.950). Agreement between cytopathology results improved significantly following implementation of continued education in cases reported as unsatisfactory (P < 0.001), atypical squamous cells of undetermined significance, cannot exclude high-grade squamous intraepithelial lesion (P < 0.001), low-grade squamous intraepithelial lesion (P < 0.001), and glandular atypia (P < 0.001). Continued education contributed towards improving the reproducibility of cervical cytopathology, decreased the rates of false-negative and false-positive results, and reduced delays in clinical management. © 2016 Wiley Periodicals, Inc.

[The comparison of two different types of baseline data regarding the performance of aberration detection algorithm for infectious disease outbreaks].

PubMed

Lai, Sheng-jie; Li, Zhong-jie; Zhang, Hong-long; Lan, Ya-jia; Yang, Wei-zhong

2011-06-01

To compare the performance of aberration detection algorithm for infectious disease outbreaks, based on two different types of baseline data. Cases and outbreaks of hand-foot-and-mouth disease (HFMD) reported by six provinces of China in 2009 were used as the source of data. Two types of baseline data on algorithms of C1, C2 and C3 were tested, by distinguishing the baseline data of weekdays and weekends. Time to detection (TTD) and false alarm rate (FAR) were adopted as two evaluation indices to compare the performance of 3 algorithms based on these two types of baseline data. A total of 405 460 cases of HFMD were reported by 6 provinces in 2009. On average, each county reported 1.78 cases per day during the weekdays and 1.29 cases per day during weekends, with significant difference (P < 0.01) between them. When using the baseline data without distinguish weekdays and weekends, the optimal thresholds for C1, C2 and C3 was 0.2, 0.4 and 0.6 respectively while the TTD of C1, C2 and C3 was all 1 day and the FARs were 5.33%, 4.88% and 4.50% respectively. On the contrast, when using the baseline data to distinguish the weekdays and weekends, the optimal thresholds for C1, C2 and C3 became 0.4, 0.6 and 1.0 while the TTD of C1, C2 and C3 also appeared equally as 1 day. However, the FARs became 4.81%, 4.75% and 4.16% respectively, which were lower than the baseline data from the first type. The number of HFMD cases reported in weekdays and weekends were significantly different, suggesting that when using the baseline data to distinguish weekdays and weekends, the FAR of C1, C2 and C3 algorithm could effectively reduce so as to improve the accuracy of outbreak detection.

Forensic child sexual abuse evaluations: assessing subjectivity and bias in professional judgements.

PubMed

Everson, Mark D; Sandoval, Jose Miguel

2011-04-01

Evaluators examining the same evidence often arrive at substantially different conclusions in forensic assessments of child sexual abuse (CSA). This study attempts to identify and quantify subjective factors that contribute to such disagreements so that interventions can be devised to improve the reliability of case decisions. Participants included 1106 professionals in the field of child maltreatment representing a range of professional positions or job titles and years of experience. Each completed the Child Forensic Attitude Scale (CFAS), a 28-item survey assessing 3 forensic attitudes believed to influence professional judgments about CSA allegations: emphasis-on-sensitivity (i.e., a focus on minimizing false negatives or errors of undercalling abuse); emphasis-on-specificity (i.e., a focus on minimizing false positives or errors of overcalling abuse); and skepticism toward child and adolescent reports of CSA. A subset of 605 professionals also participated in 1 of 3 diverse decision exercises to assess the influence of the 3 forensic attitudes on ratings of case credibility. Exploratory factor analysis identified 4 factors or attitude subscales that corresponded closely with the original CFAS scales: 2 subscales for emphasis-on-sensitivity and 1 each for emphasis-on-specificity and skepticism. Attitude subscale scores differed significantly by sample source (in-state trainings vs. national conferences), gender, years of experience, and professional position, with Child Protective Service workers unexpectedly more concerned about overcalling abuse and more skeptical of child disclosures than other professionals-a pattern of scores associated with an increased probability of disbelieving CSA allegations. The 3 decision exercises offered validation of the attitude subscales as predictors of professional ratings of case credibility, with adjusted R(2)s for the three exercises ranging from .06 to .24, suggesting highly variable effect sizes. Evaluator disagreements about CSA allegations can be explained, in part, by individual differences in 3 attitudes related to forensic decision-making: emphasis-on-sensitivity, emphasis-on-specificity, and skepticism toward child reports of abuse. These attitudes operate as predispositions or biases toward viewing CSA allegations as likely true or likely false. Several strategies for curbing the influence of subjective factors are highlighted including self-awareness of personal biases and team approaches to assessment. Copyright © 2011 Elsevier Ltd. All rights reserved.

Malakoplakia of the Prostate as a Mimicker of Prostate Cancer on Prostate Health Index and Magnetic Resonance Imaging-Fusion Prostate Biopsy: A Case Report.

PubMed

Heah, Nathaniel H; Tan, Teck Wei; Tan, Yung Khan

2017-01-01

Background: Isolated malakoplakia of the prostate is a rare inflammatory condition that has been clinically mistaken for prostatic malignancies. The development of Prostate Imaging Reporting and Data System (PI-RADS) classifications, and Prostate Health Index (PHI) has led to more accurate diagnosis of clinically significant disease and stratification of patients that may be at risk of prostate cancer. Case Presentation: We present a case of a 75-year-old male who was on follow-up with our hospital for elevated prostate specific antigen (PSA). He was admitted for an episode of urosepsis, which was treated with antibiotics and subsequently underwent further workup and was found to have a raised PHI, as well as a high PI-RADS classification and was later found to have malakoplakia based on histology of prostate tissue obtained during targeted magnetic resonance imaging (MRI)-guided fusion prostate biopsy. Conclusion: To our understanding, this is the first case where a prostate lesion has been labeled as a PI-RADS 5 lesion, with elevated PHI that has subsequently been proven histologically to be malakoplakia. An important possible confounder is the interval between the MRI and the episode of urosepsis and it is well known that urosepsis can affect the PSA and MRI result. We present this case to highlight the potential for a false diagnosis of prostate cancer, in spite of laboratory and radiological findings.

Parallel evaluation of broad virus detection methods.

PubMed

Modrof, Jens; Berting, Andreas; Kreil, Thomas R

2014-01-01

The testing for adventitious viruses is of critical importance during development and production of biological products. The recent emergence and ongoing development of broad virus detection methods calls for an evaluation of whether these methods can appropriately be implemented into current adventitious agent testing procedures. To assess the suitability of several broad virus detection methods, a comparative experimental study was conducted: four virus preparations, which were spiked at two different concentrations each into two different cell culture media, were sent to four investigators in a blinded fashion for analysis with broad virus detection methods such as polymerase chain reaction-electrospray ionization mass spectrometry (PCR-ESI/MS), microarray, and two approaches utilizing massively parallel sequencing. The results that were reported by the investigators revealed that all methods were able to identify the majority of samples correctly (mean 83%), with a surprisingly narrow range among the methods, that is, between 72% (PCR-ESI/MS) and 95% (microarray). In addition to the correct results, a variety of unexpected assignments were reported for a minority of samples, again with little variation regarding the methods used (range 20-45%), while false negatives were reported for 0-25% of the samples. Regarding assay sensitivity, the viruses were detected by all methods included in this study at concentrations of about 4-5 log10 quantitative PCR copies/mL, and probably with higher sensitivity in some cases. In summary, the broad virus detection methods investigated were shown to be suitable even for detection of relatively low virus concentrations. However, there is also some potential for the production of false-positive as well as false-negative assignments, which indicates the requirement for further improvements before these methods can be considered for routine use. © PDA, Inc. 2014.

When good news is bad news: psychological impact of false positive diagnosis of HIV.

PubMed

Bhattacharya, Rahul; Barton, Simon; Catalan, Jose

2008-05-01

HIV testing is known to be stressful, however the impact of false positive HIV results on individuals is not well documented. This is a series of four case who developed psychological difficulties and psychiatric morbidities after being informed they had been misdiagnosed with HIV-positive status. We look into documented cases of misdiagnosis and potential risks of misdiagnosis. The case series highlights the implications a false diagnosis HIV-positive status can have, even when the diagnosis is rectified. Impact of misdiagnosis of HIV can lead to psychosocial difficulties and psychiatric morbidity, have public health and epidemiological implications and can lead to medico-legal conflict. This further reiterates the importance of HIV testing carried out ethically and sensitively, and in line with guidelines, respecting confidentiality and consent, and offering counselling pre-test and post-test, being mindful of the reality of erroneous and false positive HIV test results. The implications of misdiagnosis are for the individual, their partners and social contacts, as well as for the community.

Determining Occurrence Dynamics when False Positives Occur: Estimating the Range Dynamics of Wolves from Public Survey Data.

PubMed

Miller, David A W; Nichols, James D; Gude, Justin A; Rich, Lindsey N; Podruzny, Kevin M; Hines, James E; Mitchell, Michael S

2013-01-01

Large-scale presence-absence monitoring programs have great promise for many conservation applications. Their value can be limited by potential incorrect inferences owing to observational errors, especially when data are collected by the public. To combat this, previous analytical methods have focused on addressing non-detection from public survey data. Misclassification errors have received less attention but are also likely to be a common component of public surveys, as well as many other data types. We derive estimators for dynamic occupancy parameters (extinction and colonization), focusing on the case where certainty can be assumed for a subset of detections. We demonstrate how to simultaneously account for non-detection (false negatives) and misclassification (false positives) when estimating occurrence parameters for gray wolves in northern Montana from 2007-2010. Our primary data source for the analysis was observations by deer and elk hunters, reported as part of the state's annual hunter survey. This data was supplemented with data from known locations of radio-collared wolves. We found that occupancy was relatively stable during the years of the study and wolves were largely restricted to the highest quality habitats in the study area. Transitions in the occupancy status of sites were rare, as occupied sites almost always remained occupied and unoccupied sites remained unoccupied. Failing to account for false positives led to over estimation of both the area inhabited by wolves and the frequency of turnover. The ability to properly account for both false negatives and false positives is an important step to improve inferences for conservation from large-scale public surveys. The approach we propose will improve our understanding of the status of wolf populations and is relevant to many other data types where false positives are a component of observations.

Automated microaneurysm detection method based on double ring filter in retinal fundus images

NASA Astrophysics Data System (ADS)

Mizutani, Atsushi; Muramatsu, Chisako; Hatanaka, Yuji; Suemori, Shinsuke; Hara, Takeshi; Fujita, Hiroshi

2009-02-01

The presence of microaneurysms in the eye is one of the early signs of diabetic retinopathy, which is one of the leading causes of vision loss. We have been investigating a computerized method for the detection of microaneurysms on retinal fundus images, which were obtained from the Retinopathy Online Challenge (ROC) database. The ROC provides 50 training cases, in which "gold standard" locations of microaneurysms are provided, and 50 test cases without the gold standard locations. In this study, the computerized scheme was developed by using the training cases. Although the results for the test cases are also included, this paper mainly discusses the results for the training cases because the "gold standard" for the test cases is not known. After image preprocessing, candidate regions for microaneurysms were detected using a double-ring filter. Any potential false positives located in the regions corresponding to blood vessels were removed by automatic extraction of blood vessels from the images. Twelve image features were determined, and the candidate lesions were classified into microaneurysms or false positives using the rule-based method and an artificial neural network. The true positive fraction of the proposed method was 0.45 at 27 false positives per image. Forty-two percent of microaneurysms in the 50 training cases were considered invisible by the consensus of two co-investigators. When the method was evaluated for visible microaneurysms, the sensitivity for detecting microaneurysms was 65% at 27 false positives per image. Our computerized detection scheme could be improved for helping ophthalmologists in the early diagnosis of diabetic retinopathy.

Fast apixaban-related resolution of left ventricular thrombi in a patient with dilated cardiomyopathy.

PubMed

Elikowski, Waldemar; Małek-Elikowska, Magorzata; Fertała, Natalia; Zawodna, Magdalena; Kruzel, Kamila

2018-01-23

Left ventricular thrombi (LVTs) develop most often in patients with post-myocardial left ventricular dysfunction and in cardiomyopathies, particularly in dilated cardiomyopathy (DCM). They constitute a danger of systemic embolization. So far, direct-acting oral anticoagulants (DOACs), including apixaban - a selective inhibitor of active Factor X, have not been systematically investigated in patients with LVTs; study comparing the efficacy of apixaban and warfarin has been undertaken only recently. A few case reports or case series presenting patients with LVTs treated with DOACs are available in the literature. The authors described a case of a 53-year-old male with DCM, hospitalized due to heart failure exacerbation. In echocardiography, apart from typical features of DCM, three apical LVTs connected with false tendons were revealed. Treatment with apixaban was introduced, initially in a dose of 2.5 mg twice daily, as creatinine concentration was 2.0 mg/dl, and after 2 days - when creatinine concentration dropped, the dose was augmented to 5 mg twice a day. Gradual resolution of LVTs was observed from day 3; they disappeared completely after one week. There were no symptoms of systemic embolization. The patient was discharged with advice to take apixaban permanently. To the best of the authors knowledge, the case presented is the fastest resolution of LVTs during therapy with apixaban reported in the literature and the first description of DOAC use for multiple LVTs.

Space Weather Effects on Mid-Latitude Railways: a Statistical Study of Anomalies observed in the Operation of Signaling and Train Control Equipment on the East-Siberian Railway

NASA Astrophysics Data System (ADS)

Kasinskii, V. V.; Ptitsyna, N. G.; Lyahov, N. N.; Dorman, L. I.; Villoresi, G.; Iucci, N.

The end result of a long chain of space weather events beginning on the Sun is the induction of currents in ground-based long conductors as power lines pipelines and railways Intense geomagnetically induced currents GIC can hamper rail traffic by disturbing signaling and train control systems In few cases induced voltages were believed to have affected signaling equipment in Sweden Jansen et al 2000 and in the North of Russia Belov et al 2005 GIC threats have been a concern for technological systems at high-latitude locations due to disturbances driven by electrojet intensifications However other geomagnetic storm processes such as SSC and ring current enhancement can also cause GIC concerns for the technological systems Objective of this report is to continue our research Ptitsyna et al 2005 on possible influence of geomagnetic storms on mid-latitude railways and to perform a statistical research in addition to case studies This will help in providing a basis for railway companies to evaluate the risk of disruption to signaling and train control equipment and devise engineering solutions In the present report we analyzed anomalies in operation of automatic signaling and train control equipment occurred in 2004-2005 on the East-Siberian Railway located at mid-latitudes latitudes 51N-56N longitudes 96E-114E The anomalies consist mainly in unstable functioning and false operations in traffic automatic control systems rail chain switches locomotive control devices etc often resulting in false engagement of railway

A case of placental trisomy 18 mosaicism causing a false negative NIPT result.

PubMed

Yang, Jiexia; Qi, Yiming; Guo, Fangfang; Hou, Yaping; Peng, Haishan; Wang, Dongmei; Oy, Haoxin; Yin, Aihua

2017-01-01

The non-invasive prenatal testing that evaluates circulating cell free DNA, and has been established as an additional pregnancy test for detecting the common fetal trisomies 21, 18 and 13 is rapidly revolutionizing prenatal screening as a result of its increased sensitivity and specificity. However, false positive and false negative results still exist. We presented a case in which the non-invasive prenatal testing results were normal at 15 gestational age (GA), but an ultrasound examination at 30GA showed that the fetus had heart abnormalities, and the third trimester ultrasound at 33GA noted multiple anomalies including a 3.0 mm ventricular septal defect. Along with cordocentesis at 33GA, the cord blood sample cytogenetics analysis showed a mos 47,XN,+18[61]/46,XN[39] T18 karyotype. Six placental biopsies confirmed that the chromosome 18 placenta chimerism ratio had changed from 33% to 72%. Ultimately, the pregnancy was interrupted at 34GA. We presented this case to highlight the need to clearly explain false positive or false negative results to patients. We believe that this information will also influence the development of future diagnostic test methodologies.

Diagnostic accuracy of fine needle biopsy for metastatic melanoma and its implications for patient management.

PubMed

Doubrovsky, Anna; Scolyer, Richard A; Murali, Rajmohan; McKenzie, Paul R; Watson, Geoffrey F; Lee, C Soon; McLeod, Duncan J; McCarthy, William H; Uren, Roger F; Stretch, Jonathan R; Saw, Robyn P; Thompson, John F

2008-01-01

The use of fine needle biopsy (FNB) for the diagnosis of metastatic melanoma can lead to the early removal and treatment of metastases, reduce the frequency of unnecessary surgery, and facilitate the staging of patients enrolled in clinical trials of adjuvant therapies. In this study, the accuracy of FNB for the diagnosis of metastatic melanoma was investigated. A retrospective cohort study was performed with 2204 consecutive FNBs performed on 1416 patients known or suspected to have metastatic melanoma. Almost three-quarters (1582) of these FNBs were verified by either histopathologic diagnosis following surgical resection or clinical follow-up. FNB for metastatic melanoma was found to have an overall sensitivity of 92.1% and a specificity of 99.2%, with 69 false-negative and 5 false-positive findings identified. The sensitivity of the procedure was found to be influenced by six factors. The use of immunostains, reporting of the specimen by a cytopathologist who had reported >500 cases, lesions located in the skin and subcutis, and patients with ulcerated primary melanomas were factors associated with a significant improvement in the sensitivity of the test. However, FNBs performed in masses located in lymph nodes of the axilla and FNBs that required more than one needle pass to obtain a sample were far more likely to result in false-negative results. FNB is a rapid, accurate, and clinically useful technique for the assessment of disease status in patients with suspected metastatic melanoma.

Diagnostic Accuracy of Fine Needle Biopsy for Metastatic Melanoma and Its Implications for Patient Management

PubMed Central

Doubrovsky, Anna; Scolyer, Richard A.; Murali, Rajmohan; McKenzie, Paul R.; Watson, Geoffrey F.; Lee, C. Soon; McLeod, Duncan J.; McCarthy, William H.; Uren, Roger F.; Stretch, Jonathan R.; Saw, Robyn P.

2007-01-01

Background The use of fine needle biopsy (FNB) for the diagnosis of metastatic melanoma can lead to the early removal and treatment of metastases, reduce the frequency of unnecessary surgery, and facilitate the staging of patients enrolled in clinical trials of adjuvant therapies. In this study, the accuracy of FNB for the diagnosis of metastatic melanoma was investigated. Methods A retrospective cohort study was performed with 2204 consecutive FNBs performed on 1416 patients known or suspected to have metastatic melanoma. Almost three-quarters (1582) of these FNBs were verified by either histopathologic diagnosis following surgical resection or clinical follow-up. Results FNB for metastatic melanoma was found to have an overall sensitivity of 92.1% and a specificity of 99.2%, with 69 false-negative and 5 false-positive findings identified. The sensitivity of the procedure was found to be influenced by six factors. The use of immunostains, reporting of the specimen by a cytopathologist who had reported >500 cases, lesions located in the skin and subcutis, and patients with ulcerated primary melanomas were factors associated with a significant improvement in the sensitivity of the test. However, FNBs performed in masses located in lymph nodes of the axilla and FNBs that required more than one needle pass to obtain a sample were far more likely to result in false-negative results. Conclusions FNB is a rapid, accurate, and clinically useful technique for the assessment of disease status in patients with suspected metastatic melanoma. PMID:17990041

Securing Collaborative Spectrum Sensing against Untrustworthy Secondary Users in Cognitive Radio Networks

NASA Astrophysics Data System (ADS)

Wang, Wenkai; Li, Husheng; Sun, Yan(Lindsay); Han, Zhu

2009-12-01

Cognitive radio is a revolutionary paradigm to migrate the spectrum scarcity problem in wireless networks. In cognitive radio networks, collaborative spectrum sensing is considered as an effective method to improve the performance of primary user detection. For current collaborative spectrum sensing schemes, secondary users are usually assumed to report their sensing information honestly. However, compromised nodes can send false sensing information to mislead the system. In this paper, we study the detection of untrustworthy secondary users in cognitive radio networks. We first analyze the case when there is only one compromised node in collaborative spectrum sensing schemes. Then we investigate the scenario that there are multiple compromised nodes. Defense schemes are proposed to detect malicious nodes according to their reporting histories. We calculate the suspicious level of all nodes based on their reports. The reports from nodes with high suspicious levels will be excluded in decision-making. Compared with existing defense methods, the proposed scheme can effectively differentiate malicious nodes and honest nodes. As a result, it can significantly improve the performance of collaborative sensing. For example, when there are 10 secondary users, with the primary user detection rate being equal to 0.99, one malicious user can make the false alarm rate [InlineEquation not available: see fulltext.] increase to 72%. The proposed scheme can reduce it to 5%. Two malicious users can make [InlineEquation not available: see fulltext.] increase to 85% and the proposed scheme reduces it to 8%.

Multicenter Trial of Sentinel Node Biopsy for Breast Cancer Using Both Technetium Sulfur Colloid and Isosulfan Blue Dye

PubMed Central

Tafra, Lorraine; Lannin, Donald R.; Swanson, Melvin S.; Van Eyk, Jason J.; Verbanac, Kathryn M.; Chua, Arlene N.; Ng, Peter C.; Edwards, Maxine S.; Halliday, Bradford E.; Henry, C. Alan; Sommers, Linda M.; Carman, Claire M.; Molin, Melinda R.; Yurko, John E.; Perry, Roger R.; Williams, Robert

2001-01-01

Objective To determine the factors associated with false-negative results on sentinel node biopsy and sentinel node localization (identification rate) in patients with breast cancer enrolled in a multicenter trial using a combination technique of isosulfan blue with technetium sulfur colloid (Tc99). Summary Background Data Sentinel node biopsy is a diagnostic test used to detect breast cancer metastases. To test the reliability of this method, a complete lymph node dissection must be performed to determine the false-negative rate. Single-institution series have reported excellent results, although one multicenter trial reported a false-negative rate as high as 29% using radioisotope alone. A multicenter trial was initiated to test combined use of Tc99 and isosulfan blue. Methods Investigators (both private-practice and academic surgeons) were recruited after attending a course on the technique of sentinel node biopsy. No investigator participated in a learning trial before entering patients. Tc99 and isosulfan blue were injected into the peritumoral region. Results Five hundred twenty-nine patients underwent 535 sentinel node biopsy procedures for an overall identification rate in finding a sentinel node of 87% and a false-negative rate of 13%. The identification rate increased and the false-negative rate decreased to 90% and 4.3%, respectively, after investigators had performed more than 30 cases. Univariate analysis of tumor showed the poorest success rate with older patients and inexperienced surgeons. Multivariate analysis identified both age and experience as independent predictors of failure. However, with older patients, inexperienced surgeons, and patients with five or more metastatic axillary nodes, the false-negative rate was consistently greater. Conclusions This multicenter trial, from both private practice and academic institutions, is an excellent indicator of the general utility of sentinel node biopsy. It establishes the factors that play an important role (patient age, surgical experience, tumor location) and those that are irrelevant (prior surgery, tumor size, Tc99 timing). This widens the applicability of the technique and identifies factors that require further investigation. PMID:11141225

Detection of Occult Invasion in Melanoma In Situ.

PubMed

Bax, Michael J; Johnson, Timothy M; Harms, Paul W; Schwartz, Jennifer L; Zhao, Lili; Fullen, Douglas R; Chan, May P

2016-11-01

It is unclear why some patients with in situ melanoma develop metastases. Few reports demonstrate occult invasion with immunohistochemistry staining, which were discordant with reports interpreting such staining as false-positive. To investigate the occurrence of occult invasive disease within in situ melanoma by using methods to circumvent potential limitations in prior study designs. Unequivocal in situ melanoma without associated nevi or regression was identified using a consecutive sample of 33 cases plus 1 index case in an academic medical center. After cutting deeper into the most representative tissue block, 3 sequential slides were stained with hematoxylin-eosin (H-E), melanoma antigen (melan-A), and again with H-E. Melan-A-stained slides showing definitive invasion were double-stained with Sry-related HMg-Box gene 10 (SOX10) to confirm the melanocytic nature of the cells of interest. The study evaluated the possibilities of occult invasion detected by immunohistochemistry, sectioning deeper into the tissue block, or both. Slides were independently scored by 3 dermatopathologists with interrater reliability assessed. The study was conducted from January 1, 2012, to July 31, 2014. Assessment of the occurrence of occult invasion, diagnosis of invasion by immunohistochemistry alone vs cutting deeper into the tissue block, and occurrence of false-positive results using immunohistochemistry alone. Occult invasive melanoma was detected in 11 of 33 consecutive cases (33%) of previously diagnosed unequivocal in situ melanoma. Six of 11 melanomas (55%) were diagnosable only by immunohistochemistry. The remaining 5 tumors (45%) were diagnosable by both melan-A and H-E staining, likely as a result of simply cutting deeper into the tissue block. Four cases (12%) showed a few melan-A-positive cells in the dermis, which was insufficient for a diagnosis of invasive melanoma and most consistent on a cytomorphologic basis with occult nevi. Although rare, in situ melanoma may metastasize. Occult microinvasion was demonstrated in up to one-third of the specimens in the present study, which provides a plausible explanation for this adverse event. Thus, history and physical examination including regional lymph nodes, education, and surveillance recommendations should be based on a very low, but not zero, risk of metastasis.

Computerized tomography tailored for the assessment of microscopic hematuria.

PubMed

Lang, Erich K; Macchia, Richard J; Thomas, Raju; Ruiz-Deya, Gilberto; Watson, Richard A; Richter, Frank; Irwin R, Robert; Marberger, Michael; Mydlo, Jack; Lechner, Gerhard; Cho, Kyunghee C; Gayle, Brian

2002-02-01

We report the results of a multicenter study of arterial, corticomedullary, nephrographic and excretory phase helical computerized tomography (CT) for detecting and characterizing abnormalities causing asymptomatic microscopic hematuria. We evaluated 350 consecutive patients, including 216 men and 134 women 23 to 88 years old, with asymptomatic microscopic hematuria of undetermined cause at 4 medical centers. Patients with known urological pathology were excluded from study. We performed 4 helical CT sequences, including pre-enhancement phase imaging from kidney to symphysis pubis, arterial phase imaging of the kidney and lower pelvis, corticomedullary nephrographic phase imaging of the kidney and lower pelvis, and excretory phase imaging from kidney to symphysis pubis with 2 to 5 mm. collimation and 1 to 1.5 pitch. Of 171 proved lesions 158 were correctly diagnosed. There were 10 false-positive and 13 false-negative diagnoses, indicating 0.9239 sensitivity, 0.9441 specificity, 0.9404 positive and 0.9285 negative predictive values, (p <0.001). All cases of congenital renal lesions, calculous disease, ureteral lesion and neoplastic lesion of the bladder were correctly diagnosed, as were 40 of 41 inflammatory renal, 21 of 23 renal masses and 13 of 16 inflammatory bladder lesions. In 27 patients with renal calculi the study was limited to pre-enhancement spiral CT. A positive diagnosis rate of 45.1% (158 of 350 cases) for the causes of heretofore refractory cases of hematuria with high sensitivity and specificity attest to the effectiveness of our hematuria CT protocol and support its use.

Expectancy Effects on Self-Reported Attention-Deficit/Hyperactivity Disorder Symptoms in Simulated Neurofeedback: A Pilot Study.

PubMed

Lee, Grace J; Suhr, Julie A

2018-03-31

Expectancy is a psychological factor that can impact treatment effectiveness. Research on neurofeedback for attention-deficit/hyperactivity disorder (ADHD) suggests expectancy may contribute to treatment outcomes, though evidence for expectancy as an explanatory factor is sparse. This pilot study investigated the effects of expectancies on self-reported ADHD symptoms in simulated neurofeedback. Forty-six adults who were concerned that they had ADHD expected to receive active neurofeedback, but were randomly assigned to receive a placebo with false feedback indicating attentive (positive false feedback) or inattentive (negative false feedback) states. Effects of the expectancy manipulation were measured on an ADHD self-report scale. Large expectancy effects were found, such that individuals who received positive false feedback reported significant decreases in ADHD symptoms, whereas individuals who received negative false feedback reported significant increases in ADHD symptoms. Findings suggest that expectancy should be considered as an explanatory mechanism for ADHD symptom change in response to neurofeedback.

Anatomical and/or pathological predictors for the “incorrect” classification of red dot markers on wrist radiographs taken following trauma

PubMed Central

Kranz, R

2015-01-01

Objective: To establish the prevalence of red dot markers in a sample of wrist radiographs and to identify any anatomical and/or pathological characteristics that predict “incorrect” red dot classification. Methods: Accident and emergency (A&E) wrist cases from a digital imaging and communications in medicine/digital teaching library were examined for red dot prevalence and for the presence of several anatomical and pathological features. Binary logistic regression analyses were run to establish if any of these features were predictors of incorrect red dot classification. Results: 398 cases were analysed. Red dot was “incorrectly” classified in 8.5% of cases; 6.3% were “false negatives” (“FNs”)and 2.3% false positives (FPs) (one decimal place). Old fractures [odds ratio (OR), 5.070 (1.256–20.471)] and reported degenerative change [OR, 9.870 (2.300–42.359)] were found to predict FPs. Frykman V [OR, 9.500 (1.954–46.179)], Frykman VI [OR, 6.333 (1.205–33.283)] and non-Frykman positive abnormalities [OR, 4.597 (1.264–16.711)] predict “FNs”. Old fractures and Frykman VI were predictive of error at 90% confidence interval (CI); the rest at 95% CI. Conclusion: The five predictors of incorrect red dot classification may inform the image interpretation training of radiographers and other professionals to reduce diagnostic error. Verification with larger samples would reinforce these findings. Advances in knowledge: All healthcare providers strive to eradicate diagnostic error. By examining specific anatomical and pathological predictors on radiographs for such error, as well as extrinsic factors that may affect reporting accuracy, image interpretation training can focus on these “problem” areas and influence which radiographic abnormality detection schemes are appropriate to implement in A&E departments. PMID:25496373

Proportion hyperglycosylated hCG: a new test for discriminating gestational trophoblastic diseases.

PubMed

Cole, Laurence A

2014-11-01

Hyperglycosylated human chorionic gonadotropin (hCG) is a variant of hCG with large oligosaccharide side chains. Although hCG is produced by syncytiotrophoblast cells, hyperglycosylated hCG marks cytotrophoblast cell. Hyperglycosylated hCG signals placental implantation. Total hCG in serum and urine is measured by the Siemens Immulite hCG pregnancy test; the result is in milli-international unit per milliliter. Hyperglycosylated hCG is determined by the B152 microtiter plate assay; the result is in nanogram per milliliter. Hyperglycosylated hCG results can be converted to milli-international unit per milliliter equivalents by multiplying by 11. The test measures proportion hyperglycosylated hCG, hyperglycosylated hCG / total hCG. Proportion hyperglycosylated hCG marks cases intent on developing persistent hydatidiform mole (68% detection at 17% false detection). Proportion hyperglycosylated hCG also marks persistent hydatidiform mole (100% detection at 5.1% false detection). Proportion hyperglycosylated hCG distinguishes choriocarcinoma and gestational trophoblastic neoplasm cases, absolutely discriminating aggressive cases and minimally aggressive cases. Proportion hyperglycosylated hCG identifies quiescent gestational trophoblastic disease cases. It recognizes quiescent cases that become persistent disease (100% detection at 0% false positive). Proportion hyperglycosylated hCG is an invaluable test for discriminating gestational trophoblastic diseases.

Monitoring caustic injuries from emergency department databases using automatic keyword recognition software.

PubMed

Vignally, P; Fondi, G; Taggi, F; Pitidis, A

2011-03-31

In Italy the European Union Injury Database reports the involvement of chemical products in 0.9% of home and leisure accidents. The Emergency Department registry on domestic accidents in Italy and the Poison Control Centres record that 90% of cases of exposure to toxic substances occur in the home. It is not rare for the effects of chemical agents to be observed in hospitals, with a high potential risk of damage - the rate of this cause of hospital admission is double the domestic injury average. The aim of this study was to monitor the effects of injuries caused by caustic agents in Italy using automatic free-text recognition in Emergency Department medical databases. We created a Stata software program to automatically identify caustic or corrosive injury cases using an agent-specific list of keywords. We focused attention on the procedure's sensitivity and specificity. Ten hospitals in six regions of Italy participated in the study. The program identified 112 cases of injury by caustic or corrosive agents. Checking the cases by quality controls (based on manual reading of ED reports), we assessed 99 cases as true positive, i.e. 88.4% of the patients were automatically recognized by the software as being affected by caustic substances (99% CI: 80.6%- 96.2%), that is to say 0.59% (99% CI: 0.45%-0.76%) of the whole sample of home injuries, a value almost three times as high as that expected (p < 0.0001) from European codified information. False positives were 11.6% of the recognized cases (99% CI: 5.1%- 21.5%). Our automatic procedure for caustic agent identification proved to have excellent product recognition capacity with an acceptable level of excess sensitivity. Contrary to our a priori hypothesis, the automatic recognition system provided a level of identification of agents possessing caustic effects that was significantly much greater than was predictable on the basis of the values from current codifications reported in the European Database.

Analysis of routine cytopathologic reports in 1,598 histologically verified benign breast lesions.

PubMed

Pogacnik, A; Us-Krasovec, M

2004-02-01

This retrospective study was designed to evaluate the accuracy of cytopathologic diagnosis and of correct classification of benign breast diseases. A total of 1,598 FNABs were identified to have met the study criteria; of these, 1,258 (78.7%) cases were cytologically benign, 88 (5.5%) suspicious, 3 (0.18%) false-positive, and in 249 (15.6%) cases an inadequate sample was obtained. A specific diagnosis was made in 847/1,258 (67.3%) cases; the other 411 were diagnosed as benign NOS. Out of 847 specific FNABs diagnoses, 451 were fibroadenomas, 27 phyllodes tumors, 289 fibrocystic diseases, 4 proliferative fibrocystic diseases, 38 papillomas, 22 fat necrosis, 9 mastitis, 1 pseudolymphoma, 2 lipomas, 2 duct ecstasies, and 2 atheromas. In our study group the cytopathologic diagnosis of benign breast diseases excluding unsatisfactory aspirates was correct in 93%. Specific diagnosis was correct on average in 50% of cases, only in FA was its accuracy over 60%; in adequately sampled tumor, the predictive value of FA was 86.2%. Copyright 2004 Wiley-Liss, Inc.

Adults' memories of childhood: true and false reports.

PubMed

Qin, Jianjian; Ogle, Christin M; Goodman, Gail S

2008-12-01

In 3 experiments, the authors examined factors that, according to the source-monitoring framework, might influence false memory formation and true/false memory discernment. In Experiment 1, combined effects of warning and visualization on false childhood memory formation were examined, as were individual differences in true and false childhood memories. Combining warnings and visualization led to the lowest false memory and highest true memory. Several individual difference factors (e.g., parental fearful attachment style) predicted false recall. In addition, true and false childhood memories differed (e.g., in amount of information). Experiment 2 examined relations between Deese/Roediger-McDermott task performance and false childhood memories. Deese/Roediger-McDermott performance (e.g., intrusion of unrelated words in free recall) was associated with false childhood memory, suggesting liberal response criteria in source decisions as a common underlying mechanism. Experiment 3 investigated adults' abilities to discern true and false childhood memory reports (e.g., by detecting differences in amount of information as identified in Experiment 1). Adults who were particularly successful in discerning such reports indicated reliance on event plausibility. Overall, the source-monitoring framework provided a viable explanatory framework. Implications for theory and clinical and forensic interviews are discussed. PsycINFO Database Record (c) 2008 APA, all rights reserved.

Physical and biological pretreatment quality assurance of the head and neck cancer plan with the volumetric modulated arc therapy

NASA Astrophysics Data System (ADS)

Park, So-Hyun; Lee, Dong-Soo; Lee, Yun-Hee; Lee, Seu-Ran; Kim, Min-Ju; Suh, Tae-Suk

2015-09-01

The aim of this work is to demonstrate both the physical and the biological quality assurance (QA) aspects as pretreatment QA of the head and neck (H&N) cancer plan for the volumetric modulated arc therapy (VMAT). Ten H&N plans were studied. The COMPASS® dosimetry analysis system and the tumor control probability (TCP) and the normal tissue complication probability (NTCP) calculation free program were used as the respective measurement and calculation tools. The reliability of these tools was verified by a benchmark study in accordance with the TG-166 report. For the physical component of QA, the gamma passing rates and the false negative cases between the calculated and the measured data were evaluated. The biological component of QA was performed based on the equivalent uniform dose (EUD), TCP and NTCP values. The evaluation was performed for the planning target volumes (PTVs) and the organs at risks (OARs), including the eyes, the lens, the parotid glands, the esophagus, the spinal cord, and the brainstem. All cases had gamma passing rates above 95% at an acceptance tolerance level with the 3%/3 mm criteria. In addition, the false negative instances were presented for the PTVs and OARs. The gamma passing rates exhibited a weak correlation with false negative cases. For the biological QA, the physical dose errors affect the EUD and the TCP for the PTVs, but no linear correlation existed between them. The EUD and NTCP for the OARs were shown the random differences that could not be attributed to the dose errors from the physical QA. The differences in the EUD and NTCP between the calculated and the measured results were mainly demonstrated for the parotid glands. This study describes the importance and the necessity of improved QA to accompany both the physical and the biological aspects for accurate radiation treatment.

[A Case of Left Vertebral Artery Aneurysm Showing Evoked Potentials on Bilateral Electrode by the Left Vagus Nerve Stimulation to Electromyographic Tracheal Tube].

PubMed

Kadoya, Tatsuo; Uehara, Hirofumi; Yamamoto, Toshinori; Shiraishi, Munehiro; Kinoshita, Yuki; Joyashiki, Takeshi; Enokida, Kengo

2016-02-01

Previously, we reported a case of brainstem cavernous hemangioma showing false positive responses to electromyographic tracheal tube (EMG tube). We concluded that the cause was spontaneous respiration accompanied by vocal cord movement. We report a case of left vertebral artery aneurysm showing evoked potentials on bilateral electrodes by the left vagus nerve stimulation to EMG tube. An 82-year-old woman underwent clipping of a left unruptured vertebral artery-posterior inferior cerebellar artery aneurysm. General anesthesia was induced with remifentanil, propofol and suxamethonium, and was maintained with oxygen, air, remifentanil and propofol. We monitored somatosensory evoked potentials, motor evoked potentials, and electromyogram of the vocal cord. When the manipulation reached brainstem and the instrument touched the left vagus nerve, evoked potentials appeared on bilateral electrodes. EMG tube is equipped with two electrodes on both sides. We concluded that the left vagus nerve stimulation generated evoked potentials of the left laryngeal muscles, and they were simultaneously detected as potential difference between two electrodes on both sides. EMG tube is used to identify the vagus nerve. However, it is necessary to bear in mind that each vagus nerve stimulation inevitably generates evoked potentials on bilateral electrodes.

40 CFR 155.42 - Registration review cases.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 40 Protection of Environment 25 2012-07-01 2012-07-01 false Registration review cases. 155.42... REGISTRATION STANDARDS AND REGISTRATION REVIEW Registration Review Procedures § 155.42 Registration review cases. (a) Establishing registration review cases. A registration review case will be composed of one or...

40 CFR 155.42 - Registration review cases.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 40 Protection of Environment 25 2013-07-01 2013-07-01 false Registration review cases. 155.42... REGISTRATION STANDARDS AND REGISTRATION REVIEW Registration Review Procedures § 155.42 Registration review cases. (a) Establishing registration review cases. A registration review case will be composed of one or...

40 CFR 155.42 - Registration review cases.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 40 Protection of Environment 24 2011-07-01 2011-07-01 false Registration review cases. 155.42... REGISTRATION STANDARDS AND REGISTRATION REVIEW Registration Review Procedures § 155.42 Registration review cases. (a) Establishing registration review cases. A registration review case will be composed of one or...

40 CFR 155.42 - Registration review cases.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 40 Protection of Environment 24 2014-07-01 2014-07-01 false Registration review cases. 155.42... REGISTRATION STANDARDS AND REGISTRATION REVIEW Registration Review Procedures § 155.42 Registration review cases. (a) Establishing registration review cases. A registration review case will be composed of one or...

40 CFR 155.42 - Registration review cases.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 40 Protection of Environment 23 2010-07-01 2010-07-01 false Registration review cases. 155.42... REGISTRATION STANDARDS AND REGISTRATION REVIEW Registration Review Procedures § 155.42 Registration review cases. (a) Establishing registration review cases. A registration review case will be composed of one or...

Failure of molecular diagnostics of a keratitis-inducing Acanthamoeba strain.

PubMed

Scheid, Patrick L; Balczun, Carsten

2017-12-01

An otherwise healthy 49-year-old female patient presented at the local hospital with severe keratitis in both inflamed eyes. She was a contact lens wearer and had no history of a corneal trauma. In our laboratory for medical parasitology Acanthamoebae were detected microscopically from the cornea scraping and from the fluid of the contact lens storage case after xenical culture and showed the typical cyst morphology of Acanthamoebae group II. The diagnosis of "Acanthamoeba keratitis" was established and successful therapy was provided. While the morphological microscopic method led to the correct diagnosis in this case, an in-house multiplex qPCR and a commercial qPCR showed false negative results regarding Acanthamoeba sp. The subsequent sequencing revealed the Acanthamoeba genotype T4. In the present case report, the inability to detect Acanthamoebae using qPCR only is presented. Therefore, we recommend the utilization of combined different assays for optimal diagnostic purposes. Copyright © 2017 Elsevier Inc. All rights reserved.

Prozone effect of serum IgE levels in a case of plasma cell leukemia

PubMed Central

2010-01-01

We describe a case of multiple myeloma (MM) and secondary plasma cell leukemia (PCL) secreting IgE-kappa immunoglobulin. To our knowledge, only 2 cases of IgE-producing secondary PCL have been reported in the medical literature. In our patient, the only tumor marker available for monitoring the therapeutic response to chemotherapy and allogeneic stem cell transplantation was the quantitative M component at serum protein electrophoresis (SPEP), because serum free light chains were in the normal range, Bence-Jones proteinuria was absent, and quantitative serum IgE levels provided inaccurate and erratic results, due to the prozone effect. This is a laboratory phenomenon that occurs when antigen excess interferes with antibody-based methods requiring immune complex formation for detection. It is important to recognize the presence of a prozone effect, because it can produce falsely normal results, and therefore it could lead clinicians to incorrect assessment of the response to therapy. PMID:20828419

Free digital image analysis software helps to resolve equivocal scores in HER2 immunohistochemistry.

PubMed

Helin, Henrik O; Tuominen, Vilppu J; Ylinen, Onni; Helin, Heikki J; Isola, Jorma

2016-02-01

Evaluation of human epidermal growth factor receptor 2 (HER2) immunohistochemistry (IHC) is subject to interobserver variation and lack of reproducibility. Digital image analysis (DIA) has been shown to improve the consistency and accuracy of the evaluation and its use is encouraged in current testing guidelines. We studied whether digital image analysis using a free software application (ImmunoMembrane) can assist in interpreting HER2 IHC in equivocal 2+ cases. We also compared digital photomicrographs with whole-slide images (WSI) as material for ImmunoMembrane DIA. We stained 750 surgical resection specimens of invasive breast cancers immunohistochemically for HER2 and analysed staining with ImmunoMembrane. The ImmunoMembrane DIA scores were compared with the originally responsible pathologists' visual scores, a researcher's visual scores and in situ hybridisation (ISH) results. The originally responsible pathologists reported 9.1 % positive 3+ IHC scores, for the researcher this was 8.4 % and for ImmunoMembrane 9.5 %. Equivocal 2+ scores were 34 % for the pathologists, 43.7 % for the researcher and 10.1 % for ImmunoMembrane. Negative 0/1+ scores were 57.6 % for the pathologists, 46.8 % for the researcher and 80.8 % for ImmunoMembrane. There were six false positive cases, which were classified as 3+ by ImmunoMembrane and negative by ISH. Six cases were false negative defined as 0/1+ by IHC and positive by ISH. ImmunoMembrane DIA using digital photomicrographs and WSI showed almost perfect agreement. In conclusion, digital image analysis by ImmunoMembrane can help to resolve a majority of equivocal 2+ cases in HER2 IHC, which reduces the need for ISH testing.

Should fine needle aspiration biopsy be the first pathological investigation in the diagnosis of a bone lesion? An algorithmic approach with review of literature

PubMed Central

Mehrotra, Ravi; Singh, Mamta; Singh, Premala A; Mannan, Rahul; Ojha, Vinod K; Singh, Pradumyn

2007-01-01

Background Fine needle aspiration biopsy (FNAB) is gaining increasing popularity in the diagnosis of musculoskeletal lesions; and in many patients, a definitive diagnosis can be rendered from aspiration smears alone. Its applicability in bone pathology, however, has been controversial due to a high percentage of inadequate smears, difficulty in evaluation of tissue architecture and nonspecific results in the diagnosis of primary bone lesions. In this study, the value of aspiration as the first pathological investigation in the diagnosis of a bone lesion was evaluated. Methods 91 cases of clinically suspected cases of bone lesions were aspirated over a period of two years. Direct or cytospin smears were fixed in 95% alcohol and stained by Hematoxylin and Eosin or air-dried and later fixed in methanol for May Grŭnwald Giemsa staining. Results Of the 91 patients who were subjected to FNAB, 81 were considered satisfactory and 10.9 % (10) were inadequate\\inconclusive for diagnosis. Cyto-histological concordance was obtained in 78.5 % (51/65) patients. Positive and negative predictive values were 87.5% and 97.2 % respectively. Sensitivity as a preliminary diagnostic technique was 93.3%, whereas specificity was 94.5 %. Overall, diagnostic accuracy was 94.2 %. Metastatic lesions were detected with 100% accuracy. Two cases were reported as false positive and one case as false negative. Conclusion Cytology provides valuable information to the clinician to make an informed decision regarding appropriate therapy. We conclude that time-consuming and costly investigations may be reduced by choosing FNAB as the initial pathological diagnostic method for skeletal lesions of unknown origin. The choice of radiological examinations, laboratory tests and surgical biopsies can be determined after the FNAB diagnosis. PMID:17439659

[Exclusive use of blue dye to detect sentinel lymph nodes in breast cancer].

PubMed

Bühler H, Simón; Rojas P, Hugo; Cayazzo M, Daniela; Cunill C, Eduardo; Vesperinas A, Gonzalo; Hamilton S, James

2008-08-01

The use of a dye and radiocolloid to detect sentinel lymph nodes in breast cancer increases the detection rates. However the use of either method alone does not modify the false negative rate. Therefore there is no formal contraindication for the exclusive use of dye to detect nodes. To report a prospective analysis of the exclusive blue dye technique for sentinel node biopsy in patients with early breast cancer. We analyzed the first 100 women with pathologically proven breast cancer who met the inclusion criteria. Patent blue dye was used as colorant. In the first 25 cases sentinel node was identified using radiocolloid and blue dye an then an axillary dissection performed. In the next 25 women, blue dye was used exclusively for detection and an axillary dissection was performed. In the next 50 cases, blue dye was used and only isolated sentinel node biopsy was performed. In 92 of the 100 women a sentinel node was successfully detected. In the first 50 women, the false negative rate of sentinel lymph node detection was 6.9%. No complications occurred. During follow-up, lasting three to 29 months, no axillary relapse was observed. Sentinel node biopsy in patients with early breast cancer using exclusively blue dye is feasible and safe.

Bacterial contamination of platelet components not detected by BacT/ALERT®.

PubMed

Abela, M A; Fenning, S; Maguire, K A; Morris, K G

2018-02-01

To investigate the possible causes for false negative results in BacT/ALERT ® 3D Signature System despite bacterial contamination of platelet units. The Northern Ireland Blood Transfusion Service (NIBTS) routinely extends platelet component shelf life to 7 days. Components are sampled and screened for bacterial contamination using an automated microbial detection system, the BacT/ALERT ® 3D Signature System. We report on three platelet components with confirmed bacterial contamination, which represent false negative BacT/ALERT ® results and near-miss serious adverse events. NIBTS protocols for risk reduction of bacterial contamination of platelet components are described. The methodology for bacterial detection using BacT/ALERT ® is outlined. Laboratory tests, relevant patient details and relevant follow-up information are analysed. In all three cases, Staphylococcus aureus was isolated from the platelet residue and confirmed on terminal sub-culture using BacT/ALERT ® . In two cases, S. aureus with similar genetic makeup was isolated from the donors. Risk reduction measures for bacterial contamination of platelet components are not always effective. Automated bacterial culture detection does not eliminate the risk of bacterial contamination. Visual inspection of platelet components prior to release, issue and administration remains an important last line of defence. © 2017 British Blood Transfusion Society.

[Food urticaria in children. Review of 51 cases].

PubMed

Guillet, M H; Guillet, G

1993-10-01

Food origin seems to have a special place in the etiology of infantile urticaria, as it forms 62% of a series of 51 observations of urticaria in children, greater than drug etiology (22%), physical urticaria (8%) and contact urticaria (8%). Distinction between true and false food allergy, which is important for prognosis and evolution, puts true food allergy (55%) in the lead before false (7%). A reason for this, the atopic concept, was seen in 67% of the food urticarias, corresponding apparently to true food allergy. If in the majority of these cases the pathway of sensitizations was unknown, in very rare observations the sensitization pathway was reported as an inhalation or even a sensitization in utero. Finally, infantile urticaria, more serious because of the vital risks that may be associated with it, deserves a special comment from the etiological viewpoint: observation of urticaria (and shock) to peach in an infant of 4 months, to wheat flour at 5 months and egg at 6 months are a demonstration that between 4 and 6 months intolerance of cows milk proteins is not the only etiology of infantile urticaria. For prognosis, early detection of true food allergy in children gives hope of better results than in adults, with higher chances of regression of the sensitization.

Clostridium sphenoides Chronic Osteomyelitis Diagnosed Via Matrix-Assisted Laser Desorption Ionization Time of Flight Mass Spectrometry, Conflicting With 16S rRNA Sequencing but Confirmed by Whole Genome Sequencing.

PubMed

Perkins, Matthew J; Snesrud, Erik; McGann, Patrick; Duplessis, Christopher A

2017-01-01

We report a case of successful treatment of chronic osteomyelitis (emanating from contaminated soil exposure) caused by Clostridium sphenoides, an organism infrequently identified as a cause of human infection and more saliently osteomyelitis (only 1 reported case in the literature). Additional impetus for reporting this case resides in the insights gained regarding pathogen identification exploiting sophisticated molecular platforms coupled to traditional microbial culture-based methods. The fastidious nature of cultivating anaerobic organisms required initial attempts at 16S rRNA sequencing to identify a Clostridium species (Clostridium celerecrescens). However, on exploiting matrix-assisted laser desorption ionization time of flight (MALDI TOF) technology, C. sphenoides was identified, and confirmed on whole genome sequencing. The discrepancies noted in the varying platforms require vigilance to seek complementary testing for conflicting results. Although highly accurate, the MALDI TOF and 16S rRNA sequencing platforms are not immune to false identification particularly in differentiating closely related organisms. More germane, whole genome sequencing should be entertained when conflicting results are obtained from MALDI TOF and 16S rRNA sequencing. Precise species and/or strain level identification can be clinically relevant as antimicrobial sensitivity profiles may be discrepant between closely related species influencing clinical outcomes. Thus, it is incumbent on us to strive to acquire the correct species characterization when resources allow to dictate optimal treatment. Reprint & Copyright © 2017 Association of Military Surgeons of the U.S.

Garbage in, Garbage Out: Data Collection, Quality Assessment and Reporting Standards for Social Media Data Use in Health Research, Infodemiology and Digital Disease Detection.

PubMed

Kim, Yoonsang; Huang, Jidong; Emery, Sherry

2016-02-26

Social media have transformed the communications landscape. People increasingly obtain news and health information online and via social media. Social media platforms also serve as novel sources of rich observational data for health research (including infodemiology, infoveillance, and digital disease detection detection). While the number of studies using social data is growing rapidly, very few of these studies transparently outline their methods for collecting, filtering, and reporting those data. Keywords and search filters applied to social data form the lens through which researchers may observe what and how people communicate about a given topic. Without a properly focused lens, research conclusions may be biased or misleading. Standards of reporting data sources and quality are needed so that data scientists and consumers of social media research can evaluate and compare methods and findings across studies. We aimed to develop and apply a framework of social media data collection and quality assessment and to propose a reporting standard, which researchers and reviewers may use to evaluate and compare the quality of social data across studies. We propose a conceptual framework consisting of three major steps in collecting social media data: develop, apply, and validate search filters. This framework is based on two criteria: retrieval precision (how much of retrieved data is relevant) and retrieval recall (how much of the relevant data is retrieved). We then discuss two conditions that estimation of retrieval precision and recall rely on--accurate human coding and full data collection--and how to calculate these statistics in cases that deviate from the two ideal conditions. We then apply the framework on a real-world example using approximately 4 million tobacco-related tweets collected from the Twitter firehose. We developed and applied a search filter to retrieve e-cigarette-related tweets from the archive based on three keyword categories: devices, brands, and behavior. The search filter retrieved 82,205 e-cigarette-related tweets from the archive and was validated. Retrieval precision was calculated above 95% in all cases. Retrieval recall was 86% assuming ideal conditions (no human coding errors and full data collection), 75% when unretrieved messages could not be archived, 86% assuming no false negative errors by coders, and 93% allowing both false negative and false positive errors by human coders. This paper sets forth a conceptual framework for the filtering and quality evaluation of social data that addresses several common challenges and moves toward establishing a standard of reporting social data. Researchers should clearly delineate data sources, how data were accessed and collected, and the search filter building process and how retrieval precision and recall were calculated. The proposed framework can be adapted to other public social media platforms.

Unexpected visitor on FDG PET/CT--brown adipose tissue (BAT) in mesentery in a case of retroperitoneal extra-adrenal pheochromocytoma: is the BAT activation secondary to catecholamine-secreting pheochromocytoma?

PubMed

Joshi, Prathamesh Vijay; Lele, Vikram Ramchandra

2012-05-01

Fused positron emission tomography-computed tomography (PET/CT) technology has enabled the determination that nonmalignant fluorodeoxyglucose (FDG) uptake is observed in brown adipose tissue (BAT). FDG uptake in BAT is a known potential source of false-positive interpretations for PET. The typical locations of BAT include neck, supraclavicular area, mediastinum, and paravertebral intercostal spaces. Examples of atypical locations for BAT include posterior neck, left paratracheal area, axillae, perirenal area, and retrocrural area. We report PET/CT findings in a young male patient with malignant retroperitoneal extra-adrenal pheochromocytoma, who demonstrated FDG uptake in BAT at multiple locations including mesenteric BAT. We also propose catecholamine-secreting pheochromocytoma as a possible cause of BAT activation in our case.

Imaging in gynaecology: How good are we in identifying endometriomas?

PubMed Central

Van Holsbeke, C.; Van Calster, B.; Guerriero, S.; Savelli, L.; Leone, F.; Fischerova, D; Czekierdowski, A.; Fruscio, R.; Veldman, J.; Van de Putte, G.; Testa, A.C.; Bourne, T.; Valentin, L.; Timmerman, D.

2009-01-01

Aim: To evaluate the performance of subjective evaluation of ultrasound findings (pattern recognition) to discriminate endometriomas from other types of adnexal masses and to compare the demographic and ultrasound characteristics of the true positive cases with those cases that were presumed to be an endometrioma but proved to have a different histology (false positive cases) and the endometriomas missed by pattern recognition (false negative cases). Methods: All patients in the International Ovarian Tumor Analysis (IOTA ) studies were included for analysis. In the IOTA studies, patients with an adnexal mass that were preoperatively examined by expert sonologists following the same standardized ultrasound protocol were prospectively included in 21 international centres. Sensitivity and specificity to discriminate endometriomas from other types of adnexal masses using pattern recognition were calculated. Ultrasound and some demographic variables of the masses presumed to be an endometrioma were analysed (true positives and false positives) and compared with the variables of the endometriomas missed by pattern recognition (false negatives) as well as the true negatives. Results: IOTA phase 1, 1b and 2 included 3511 patients of which 2560 were benign (73%) and 951 malignant (27%). The dataset included 713 endometriomas. Sensitivity and specificity for pattern recognition were 81% (577/713) and 97% (2723/2798). The true positives were more often unilocular with ground glass echogenicity than the masses in any other category. Among the 75 false positive cases, 66 were benign but 9 were malignant (5 borderline tumours, 1 rare primary invasive tumour and 3 endometrioid adenocarcinomas). The presumed diagnosis suggested by the sonologist in case of a missed endometrioma was mostly functional cyst or cystadenoma. Conclusion: Expert sonologists can quite accurately discriminate endometriomas from other types of adnexal masses, but in this dataset 1% of the masses that were classified as endometrioma by pattern recognition proved to be malignancies. PMID:25478066

28 CFR 2.17 - Original jurisdiction cases.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 28 Judicial Administration 1 2010-07-01 2010-07-01 false Original jurisdiction cases. 2.17 Section... Original jurisdiction cases. (a) Following any hearing conducted pursuant to these rules, the Regional Commissioner may designate that a case should be decided as an original jurisdiction case. If the Regional...

Cumulative risk of false positive test in relation to breast symptoms in mammography screening: a historical prospective cohort study.

PubMed

Singh, Deependra; Pitkäniemi, Janne; Malila, Nea; Anttila, Ahti

2016-09-01

Mammography has been found effective as the primary screening test for breast cancer. We estimated the cumulative probability of false positive screening test results with respect to symptom history reported at screen. A historical prospective cohort study was done using individual screening data from 413,611 women aged 50-69 years with 2,627,256 invitations for mammography screening between 1992 and 2012 in Finland. Symptoms (lump, retraction, and secretion) were reported at 56,805 visits, and 48,873 visits resulted in a false positive mammography result. Generalized linear models were used to estimate the probability of at least one false positive test and true positive at screening visits. The estimates were compared among women with and without symptoms history. The estimated cumulative probabilities were 18 and 6 % for false positive and true positive results, respectively. In women with a history of a lump, the cumulative probabilities of false positive test and true positive were 45 and 16 %, respectively, compared to 17 and 5 % with no reported lump. In women with a history of any given symptom, the cumulative probabilities of false positive test and true positive were 38 and 13 %, respectively. Likewise, women with a history of a 'lump and retraction' had the cumulative false positive probability of 56 %. The study showed higher cumulative risk of false positive tests and more cancers detected in women who reported symptoms compared to women who did not report symptoms at screen. The risk varies substantially, depending on symptom types and characteristics. Information on breast symptoms influences the balance of absolute benefits and harms of screening.

The Effects of Repetition on Children’s True and False Reports

PubMed Central

Evans, Angela D.; Brunet, Megan K.; Talwar, Victoria; Bala, Nicholas; Lindsay, Rod C.L.; Lee, Kang

2013-01-01

As children are often called upon to provide testimony in court proceedings, determining the veracity of their statements is an important issue. In the course of investigation by police and social workers, children are often repeatedly interviewed about their experiences, though the impact of this repetition on children’s true and false statements remains largely unexamined. The current study analysed semantic differences in children’s truthful and fabricated statements about an event they had or had not participated in. Results revealed that children’s truthful and fabricated reports differed in linguistic content, and that their language also varied with repetition. Discriminant analyses revealed that with repetition, children’s true and false reports became increasingly difficult to differentiate using linguistic markers, though true reports were consistently classified correctly at higher rates than false reports. The implications of these findings for legal procedures concerning child witnesses are discussed. PMID:24265592

The "Facebook-self": characteristics and psychological predictors of false self-presentation on Facebook.

PubMed

Gil-Or, Oren; Levi-Belz, Yossi; Turel, Ofir

2015-01-01

In this study we present and empirically examine a new phenomenon related to social networking sites, such as Facebook, the "false Facebook-self." Arguably false self-presentation on Facebook is a growing phenomenon, and in extreme cases; i.e., when ones Facebook image substantially deviates from their true image, it may serve as a gateway behavior to more problematic behaviors which may lead to psychological problems and even pathologies. In this study we show that certain users are more vulnerable to such false self-presentation than others. The study involved 258 Facebook users. Applying ANOVA and SEM analyses we show that users with low self-esteem and low trait authenticity are more likely than others to present a Facebook-self which deviates from their true selves. These social-interaction-related traits are influenced by one's upbringing and the anxious and avoidant attachment styles he or she has developed. Several cases (7.5%) with large gaps between the true and false Facebook-self were detected, which implies that future research should consider the adverse consequences and treatments of high levels of false Facebook-self.

45 CFR 1644.4 - Case disclosure requirement.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 45 Public Welfare 4 2010-10-01 2010-10-01 false Case disclosure requirement. 1644.4 Section 1644.4 Public Welfare Regulations Relating to Public Welfare (Continued) LEGAL SERVICES CORPORATION DISCLOSURE OF CASE INFORMATION § 1644.4 Case disclosure requirement. (a) For each case filed in court by its...

42 CFR 440.168 - Primary care case management services.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 4 2010-10-01 2010-10-01 false Primary care case management services. 440.168... care case management services. (a) Primary care case management services means case management related services that— (1) Include location, coordination, and monitoring of primary health care services; and (2...

42 CFR 440.168 - Primary care case management services.

Code of Federal Regulations, 2014 CFR

2014-10-01

... care case management services. (a) Primary care case management services means case management related services that— (1) Include location, coordination, and monitoring of primary health care services; and (2... 42 Public Health 4 2014-10-01 2014-10-01 false Primary care case management services. 440.168...

42 CFR 440.168 - Primary care case management services.

Code of Federal Regulations, 2011 CFR

2011-10-01

... care case management services. (a) Primary care case management services means case management related services that— (1) Include location, coordination, and monitoring of primary health care services; and (2... 42 Public Health 4 2011-10-01 2011-10-01 false Primary care case management services. 440.168...

42 CFR 440.168 - Primary care case management services.

Code of Federal Regulations, 2012 CFR

2012-10-01

... care case management services. (a) Primary care case management services means case management related services that— (1) Include location, coordination, and monitoring of primary health care services; and (2... 42 Public Health 4 2012-10-01 2012-10-01 false Primary care case management services. 440.168...

42 CFR 440.168 - Primary care case management services.

Code of Federal Regulations, 2013 CFR

2013-10-01

... care case management services. (a) Primary care case management services means case management related services that— (1) Include location, coordination, and monitoring of primary health care services; and (2... 42 Public Health 4 2013-10-01 2013-10-01 false Primary care case management services. 440.168...

29 CFR 1614.302 - Mixed case complaints.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 29 Labor 4 2012-07-01 2012-07-01 false Mixed case complaints. 1614.302 Section 1614.302 Labor... EMPLOYMENT OPPORTUNITY Related Processes § 1614.302 Mixed case complaints. (a) Definitions—(1) Mixed case complaint. A mixed case complaint is a complaint of employment discrimination filed with a federal agency...

29 CFR 1614.302 - Mixed case complaints.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 29 Labor 4 2014-07-01 2014-07-01 false Mixed case complaints. 1614.302 Section 1614.302 Labor... EMPLOYMENT OPPORTUNITY Related Processes § 1614.302 Mixed case complaints. (a) Definitions—(1) Mixed case complaint. A mixed case complaint is a complaint of employment discrimination filed with a federal agency...

29 CFR 1614.302 - Mixed case complaints.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 29 Labor 4 2013-07-01 2013-07-01 false Mixed case complaints. 1614.302 Section 1614.302 Labor... EMPLOYMENT OPPORTUNITY Related Processes § 1614.302 Mixed case complaints. (a) Definitions—(1) Mixed case complaint. A mixed case complaint is a complaint of employment discrimination filed with a federal agency...

29 CFR 1614.302 - Mixed case complaints.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 29 Labor 4 2011-07-01 2011-07-01 false Mixed case complaints. 1614.302 Section 1614.302 Labor... EMPLOYMENT OPPORTUNITY Related Processes § 1614.302 Mixed case complaints. (a) Definitions—(1) Mixed case complaint. A mixed case complaint is a complaint of employment discrimination filed with a federal agency...

29 CFR 1614.302 - Mixed case complaints.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 29 Labor 4 2010-07-01 2010-07-01 false Mixed case complaints. 1614.302 Section 1614.302 Labor... EMPLOYMENT OPPORTUNITY Related Processes § 1614.302 Mixed case complaints. (a) Definitions—(1) Mixed case complaint. A mixed case complaint is a complaint of employment discrimination filed with a federal agency...

Difficulties in clinical diagnosis of measles: proposal for modified clinical case definition.

PubMed

Ferson, M J; Young, L C; Robertson, P W; Whybin, L R

1995-10-02

To examine the accuracy of clinical diagnosis of measles and to develop an improved measles clinical case definition. Case survey. Eastern Sydney, December 1990 to August 1993. All cases of measles notified to the Eastern Sydney Public Health Unit without or before serological confirmation. Demographic and clinical details, measles- and rubella-specific IgM and measles complement fixation titres in acute and convalescent (when available) sera and epidemiological links with confirmed measles cases. Of 49 subjects reported and with complete follow-up, 24 were confirmed with measles, four with rubella and 21 had no definite diagnosis. Clinical diagnosis of measles had a false positive rate of 51%. Subjects with confirmed measles were significantly more likely to have a cough (23/24) than those with no definite diagnosis (15/21; P = 0.03) and to be febrile on the day of rash onset (23/24 versus 10/21; P = 0.001). The Centers for Disease Control definition had a sensitivity of 92% but specificity of only 24%. A modified case definition of rash, cough and fever present at onset of rash had equal sensitivity but greater specificity (57%). As measles is no longer common in Australia, clinical diagnosis is unreliable. When a public health response is needed, cases should be confirmed by serological tests or, if not available, we propose use of our modified clinical case definition.

Diagnostic accuracy of contrast-enhanced spectral mammography in comparison to conventional full-field digital mammography in a population of women with dense breasts.

PubMed

Mori, Miki; Akashi-Tanaka, Sadako; Suzuki, Satoko; Daniels, Murasaki Ikeda; Watanabe, Chie; Hirose, Masanori; Nakamura, Seigo

2017-01-01

Contrast-enhanced spectral mammography to compare clinical efficacy of contrast-enhanced spectral mammography (CESM) and conventional digital mammography (MMG) with histopathology as gold standard in dense breasts. A total of 143 breasts of 72 women who underwent CESM and MMG between 2011 and 2014 at Showa University Hospital were analyzed. 129 (90.2 %) of 143 breasts revealed dense breasts on MMG. 58 (40.6 %) of 143 breasts were diagnosed with breast cancer at histopathology. The remaining 85 breasts were diagnosed with benign findings after image assessments and/or core needle biopsy. CESM revealed 8 false-negative cases among 58 breast cancer cases (sensitivity 86.2 %) and 5 false-positive cases (specificity 94.1 %). Accuracy was 90.9 %. Conventional MMG was assessed true positive in 31 of 58 breast cancer cases (sensitivity 53.4 %) and false positive in 12 cases (specificity 85.9 %). Accuracy was 72.7 %. Sensitivity (p < 0.001), specificity (p = 0.016) and accuracy (p < 0.001) were significantly higher on CESM compared to MMG. MMG missed malignancy in 27 breasts. Of these, 25 were dense breasts. Of these 25, 20 (80.0 %) breasts were positive on CESM. These findings suggest that CESM offers superior clinical performance compared to MMG. Use of CESM may decrease false negatives especially for women with dense breasts.

An assessment of public health surveillance of Zika virus infection and potentially associated outcomes in Latin America.

PubMed

Bautista, Leonelo E; Herrera, Víctor M

2018-05-24

We evaluated whether outbreaks of Zika virus (ZIKV) infection, newborn microcephaly, and Guillain-Barré syndrome (GBS) in Latin America may be detected through current surveillance systems, and how cases detected through surveillance may increase health care burden. We estimated the sensitivity and specificity of surveillance case definitions using published data. We assumed a 10% ZIKV infection risk during a non-outbreak period and hypothetical increases in risk during an outbreak period. We used sensitivity and specificity estimates to correct for non-differential misclassification, and calculated a misclassification-corrected relative risk comparing both periods. To identify the smallest hypothetical increase in risk resulting in a detectable outbreak we compared the misclassification-corrected relative risk to the relative risk corresponding to the upper limit of the endemic channel (mean + 2 SD). We also estimated the proportion of false positive cases detected during the outbreak. We followed the same approach for microcephaly and GBS, but assumed the risk of ZIKV infection doubled during the outbreak, and ZIKV infection increased the risk of both diseases. ZIKV infection outbreaks were not detectable through non-serological surveillance. Outbreaks were detectable through serologic surveillance if infection risk increased by at least 10%, but more than 50% of all cases were false positive. Outbreaks of severe microcephaly were detected if ZIKV infection increased prevalence of this condition by at least 24.0 times. When ZIKV infection did not increase the prevalence of severe microcephaly, 34.7 to 82.5% of all cases were false positive, depending on diagnostic accuracy. GBS outbreaks were detected if ZIKV infection increased the GBS risk by at least seven times. For optimal GBS diagnosis accuracy, the proportion of false positive cases ranged from 29 to 54% and from 45 to 56% depending on the incidence of GBS mimics. Current surveillance systems have a low probability of detecting outbreaks of ZIKV infection, severe microcephaly, and GBS, and could result in significant increases in health care burden, due to the detection of large numbers of false positive cases. In view of these limitations, Latin American countries should consider alternative options for surveillance.

[Relationship between multi-slice spiral CT angiography imaging features and in-hospital death of patients with aortic dissection].

PubMed

Xiao, Z Y; Wang, H J; Yao, C L; Gu, G R; Xue, Y; Yin, J; Chen, J; Zhang, C; Tong, C Y; Song, Z J

2017-03-24

Objective: To explore the imaging manifestations of multi-slice spiral CT angiography (CTA) and relationship with in-hospital death in patients with aortic dissection (AD). Methods: The clinical data of 429 patients with AD who underwent CTA in Zhongshan Hospital of Fudan University between January 2009 and January 2016 were retrospectively analyzed. AD patients were divided into 2 groups, including operation group who underwent surgery or interventional therapy (370 cases) and non-operation group who underwent medical conservative treatment(59 cases). The multi-slice spiral CTA imaging features of AD were analyzed, and multivariate logistic regression analysis was used to investigate the relationship between imaging manifestations and in-hospital death in AD patients. Results: There were 12 cases (3.24%) of in-hospital death in operation group, and 28 cases (47.46%) of in-hospital death in non-operation group( P <0.001). AD involved different vascular branches. Multi-slice spiral CTA can clearly show the dissection of true and false lumen, and intimal tear was detected in 363 (84.62%) cases, outer wall calcification was revealed in 63 (14.69%) cases, and thrombus formation was present in 227 (52.91%) cases. The multivariate logistic regression analysis showed that the number of branch vessels involved ( OR =1.374, 95% CI 1.081-1.745, P =0.009) and tearing false lumen range( OR =2.059, 95% CI 1.252-3.385, P =0.004) were independent risk factors of in-hospital death in AD patients, and the number of branch vessels involved ( OR =1.600, 95% CI 1.062-2.411, P =0.025) was independent risk factor of in-hospital death in the operation group, while the tearing false lumen range ( OR =2.315, 95% CI 1.019-5.262, P =0.045) was independent risk factor of in-hospital death of non-operation group. Conclusions: Multi-slice spiral CTA can clearly show the entire AD, true and false lumen, intimal tear, wall calcification and thrombosis of AD patients. The number of branch vessels involved and tearing false lumen range are the independent risk factors of in-hospital death in AD patients.

Arboviral diseases and malaria in Australia, 2012-13: Annual report of the National Arbovirus and Malaria Advisory Committee.

PubMed

Knope, Katrina E; Kurucz, Nina; Doggett, Stephen L; Muller, Mike; Johansen, Cheryl A; Feldman, Rebecca; Hobby, Michaela; Bennett, Sonya; Sly, Angus; Lynch, Stacey; Currie, Bart J; Nicholson, Jay

2016-03-31

This report describes the epidemiology of mosquito-borne diseases of public health importance in Australia during the 2012-13 season (1 July 2012 to 30 June 2013) and includes data from human notifications, sentinel chicken, vector and virus surveillance programs. The National Notifiable Diseases Surveillance System received notifications for 9,726 cases of disease transmitted by mosquitoes during the 2012-13 season. The Australasian alphaviruses Barmah Forest virus and Ross River virus accounted for 7,776 (80%) of total notifications. However, over-diagnosis and possible false positive diagnostic test results for these 2 infections mean that the true burden of infection is likely overestimated, and as a consequence, the case definitions were revised, effective from 1 January 2016. There were 96 notifications of imported chikungunya virus infection. There were 212 notifications of dengue virus infection acquired in Australia and 1,202 cases acquired overseas, with an additional 16 cases for which the place of acquisition was unknown. Imported cases of dengue were most frequently acquired in Indonesia. No locally-acquired malaria was notified during the 2012-13 season, though there were 415 notifications of overseas-acquired malaria. There were no cases of Murray Valley encephalitis virus infection in 2012-13. In 2012-13, arbovirus and mosquito surveillance programs were conducted in most jurisdictions with a risk of vectorborne disease transmission. Surveillance for exotic mosquitoes at the border continues to be a vital part of preventing the spread of mosquito-borne diseases such as dengue to new areas of Australia, and in 2012-13, there were 7 detections of exotic mosquitoes at the border.

Revisiting the reported signal of acute pancreatitis with rasburicase: an object lesson in pharmacovigilance

PubMed Central

Hauben, Manfred; Hung, Eric Y.

2016-01-01

Introduction: There is an interest in methodologies to expeditiously detect credible signals of drug-induced pancreatitis. An example is the reported signal of pancreatitis with rasburicase emerging from a study [the ‘index publication’ (IP)] combining quantitative signal detection findings from a spontaneous reporting system (SRS) and electronic health records (EHRs). The signal was reportedly supported by a clinical review with a case series manuscript in progress. The reported signal is noteworthy, being initially classified as a false-positive finding for the chosen reference standard, but reclassified as a ‘clinically supported’ signal. Objective: This paper has dual objectives: to revisit the signal of rasburicase and acute pancreatitis and extend the original analysis via reexamination of its findings, in light of more contemporary data; and to motivate discussions on key issues in signal detection and evaluation, including recent findings from a major international pharmacovigilance research initiative. Methodology: We used the same methodology as the IP, including the same disproportionality analysis software/dataset for calculating observed to expected reporting frequencies (O/Es), Medical Dictionary for Regulatory Activities Preferred Term, and O/E metric/threshold combination defining a signal of disproportionate reporting. Baseline analysis results prompted supplementary analyses using alternative analytical choices. We performed a comprehensive literature search to identify additional published case reports of rasburicase and pancreatitis. Results: We could not replicate positive findings (e.g. a signal or statistic of disproportionate reporting) from the SRS data using the same algorithm, software, dataset and vendor specified in the IP. The reporting association was statistically highlighted in default and supplemental analysis when more sensitive forms of disproportionality analysis were used. Two of three reports in the FAERS database were assessed as likely duplicate reports. We did not identify any additional reports in the FAERS corresponding to the three cases identified in the IP using EHRs. We did not identify additional published reports of pancreatitis associated with rasburicase. Discussion: Our exercise stimulated interesting discussions of key points in signal detection and evaluation, including causality assessment, signal detection algorithm performance, pharmacovigilance terminology, duplicate reporting, mechanisms for communicating signals, the structure of the FAERs database, and recent results from a major international pharmacovigilance research initiative. PMID:27298720

Signal detection of adverse events with imperfect confirmation rates in vaccine safety studies using self-controlled case series design.

PubMed

Xu, Stanley; Newcomer, Sophia; Nelson, Jennifer; Qian, Lei; McClure, David; Pan, Yi; Zeng, Chan; Glanz, Jason

2014-05-01

The Vaccine Safety Datalink project captures electronic health record data including vaccinations and medically attended adverse events on 8.8 million enrollees annually from participating managed care organizations in the United States. While the automated vaccination data are generally of high quality, a presumptive adverse event based on diagnosis codes in automated health care data may not be true (misclassification). Consequently, analyses using automated health care data can generate false positive results, where an association between the vaccine and outcome is incorrectly identified, as well as false negative findings, where a true association or signal is missed. We developed novel conditional Poisson regression models and fixed effects models that accommodate misclassification of adverse event outcome for self-controlled case series design. We conducted simulation studies to evaluate their performance in signal detection in vaccine safety hypotheses generating (screening) studies. We also reanalyzed four previously identified signals in a recent vaccine safety study using the newly proposed models. Our simulation studies demonstrated that (i) outcome misclassification resulted in both false positive and false negative signals in screening studies; (ii) the newly proposed models reduced both the rates of false positive and false negative signals. In reanalyses of four previously identified signals using the novel statistical models, the incidence rate ratio estimates and statistical significances were similar to those using conventional models and including only medical record review confirmed cases. © 2014 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

23 CFR 635.119 - False statements.

Code of Federal Regulations, 2013 CFR

2013-04-01

... CONSTRUCTION AND MAINTENANCE Contract Procedures § 635.119 False statements. The following notice shall be... submission of plans, maps, specifications, contracts, or costs of construction of any highway or related... statement, false representation, false report, or false claim with respect to the character, quality...

23 CFR 635.119 - False statements.

Code of Federal Regulations, 2011 CFR

2011-04-01

... CONSTRUCTION AND MAINTENANCE Contract Procedures § 635.119 False statements. The following notice shall be... submission of plans, maps, specifications, contracts, or costs of construction of any highway or related... statement, false representation, false report, or false claim with respect to the character, quality...

23 CFR 635.119 - False statements.

Code of Federal Regulations, 2010 CFR

2010-04-01

... CONSTRUCTION AND MAINTENANCE Contract Procedures § 635.119 False statements. The following notice shall be... submission of plans, maps, specifications, contracts, or costs of construction of any highway or related... statement, false representation, false report, or false claim with respect to the character, quality...

23 CFR 635.119 - False statements.

Code of Federal Regulations, 2014 CFR

2014-04-01

... CONSTRUCTION AND MAINTENANCE Contract Procedures § 635.119 False statements. The following notice shall be... submission of plans, maps, specifications, contracts, or costs of construction of any highway or related... statement, false representation, false report, or false claim with respect to the character, quality...

23 CFR 635.119 - False statements.

Code of Federal Regulations, 2012 CFR

2012-04-01

... CONSTRUCTION AND MAINTENANCE Contract Procedures § 635.119 False statements. The following notice shall be... submission of plans, maps, specifications, contracts, or costs of construction of any highway or related... statement, false representation, false report, or false claim with respect to the character, quality...

Dual-wavelength recording, a simple algorithm to eliminate interferences due to UV-absorbing substances in capillary electrophoresis.

PubMed

Seaux, Liesbeth; Van Houcke, Sofie; Dumoulin, Els; Fiers, Tom; Lecocq, Elke; Delanghe, Joris R

2014-08-01

Analytical interferences have been described due to the presence of various exogenous UV-absorbing substances in serum. Iodine-based X-ray contrast agents and various antibiotics have been reported to interfere with interpretation of serum protein pherograms, resulting in false diagnosis of paraproteinemia. In the present study, we have explored the possibility of measuring UV absorbance at two distinct wavelengths (210 and 246 nm) to distinguish between true and false paraproteins on a Helena V8 clinical electrophoresis instrument. This study demonstrates that most substances potentially interfering with serum protein electrophoresis show UV-absorption spectra that are distinct from those of serum proteins. Scanning at 246 nm allows detection of all described interfering agents. Comparing pherograms recorded at both wavelengths (210 and 246 nm) enables to distinguish paraproteins from UV-absorbing substances. In case of a true paraprotein, the peak with an electrophoretic mobility in the gamma-region decreases, whereas the X-ray contrast media and antibiotics show an increased absorption when compared to the basic setting (210 nm). The finding of iodine-containing contrast media interfering with serum protein electrophoresis is not uncommon. In a clinical series, interference induced by contrast media was reported in 54 cases (of 13 237 analyses), corresponding with a prevalence of 0.4%. In the same series, 1631 true paraproteins (12.3%) were detected. Implementation of the proposed algorithm may significantly improve the interpretation of routine electrophoresis results. However, attention should still be paid to possible interference due to presence of atypical proteins fractions (e.g., tumor markers, C3). © 2014 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

Callers' Ability to Understand Advice Received from a Telephone Health-Line Service: Comparison of Self-Reported and Registered Data

PubMed Central

Leclerc, Bernard-Simon; Dunnigan, Lise; Côté, Harold; Zunzunegui, Maria-Victoria; Hagan, Louise; Morin, Diane

2003-01-01

Objective To validate users' perception of nurses' recommendations to look for another health resource among clients seeking teleadvice. To analyze the effects of different users' and call characteristics on the incorrectness of the self-report. Data Sources/Study Setting This study is a secondary analysis of data obtained from 4,696 randomly selected participants in a survey conducted in 1997 among users of Info-Santé CLSC, a no-charge telenursing health-line service (THLS) available all over the province of Québec. Study Design/Data Collection Self-reported advice from follow-up survey phone interviews, conducted within 48 to 120 hours after the participant's call, were compared to the data consigned by the nurse in the computerized call record. Covariables concerned characteristics of callers, context of the calls, and satisfaction about the nurses' intervention. Association between these variables and inaccurate reports was identified using multinomial logistic regression analyses. Principal Findings Advice to consult were recorded by the nurse in 42 percent of cases, whereas 39 percent of callers stated they had received one. Overall disagreement between the two sources is 27 percent (12 percent by false positive and 15 percent by false negative) and kappa is 0.45. Characteristics such as living alone (adjusted OR=2.5), calls relating to psychological problems (OR=2.8), perceived seriousness (OR=∼2.6), as well as others, were associated with inaccurate reports. Conclusions Telephone health-line providers should be aware that many callers appear to interpret advice to seek additional health care differently than intended. Our findings suggest the need for continuing quality control interventions to reduce miscommunication, insure better understanding of advice by callers, and contribute to more effective service. PMID:12785568

24 CFR 252.3 - Case-by-case conversion to full insurance.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 24 Housing and Urban Development 2 2011-04-01 2011-04-01 false Case-by-case conversion to full insurance. 252.3 Section 252.3 Housing and Urban Development Regulations Relating to Housing and Urban... HOMES § 252.3 Case-by-case conversion to full insurance. Cross Reference: The provisions of 24 CFR 251.3...

24 CFR 251.3 - Case-by-case conversion to full insurance.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 24 Housing and Urban Development 2 2011-04-01 2011-04-01 false Case-by-case conversion to full... § 251.3 Case-by-case conversion to full insurance. Upon the request of a coinsuring lender, the... conversion would be less costly to HUD than if the Mortgage remained coinsured; (d) The lender has paid HUD...

Testing the Domain-Specificity of a Theory of Mind Deficit in Brain-Injured Patients: Evidence for Consistent Performance on Non-Verbal, ''Reality-Unknown'' False Belief and False Photograph Tasks

ERIC Educational Resources Information Center

Apperly, Ian A.; Samson, Dana; Chiavarino, Claudia; Bickerton, Wai-Ling; Humphreys, Glyn W.

2007-01-01

To test the domain-specificity of ''theory of mind'' abilities we compared the performance of a case-series of 11 brain-lesioned patients on a recently developed test of false belief reasoning (Apperly, Samson, Chiavarino, & Humphreys, 2004) and on a matched false photograph task, which did not require belief reasoning and which addressed problems…

Seeing it my way: a case of a selective deficit in inhibiting self-perspective.

PubMed

Samson, Dana; Apperly, Ian A; Kathirgamanathan, Umalini; Humphreys, Glyn W

2005-05-01

Little is known about the functional and neural architecture of social reasoning, one major obstacle being that we crucially lack the relevant tools to test potentially different social reasoning components. In the case of belief reasoning, previous studies have tried to separate the processes involved in belief reasoning per se from those involved in the processing of the high incidental demands such as the working memory demands of typical belief tasks. In this study, we developed new belief tasks in order to disentangle, for the first time, two perspective taking components involved in belief reasoning: (i) the ability to inhibit one's own perspective (self-perspective inhibition); and (ii) the ability to infer someone else's perspective as such (other-perspective taking). The two tasks had similar demands in other-perspective taking as they both required the participant to infer that a character has a false belief about an object's location. However, the tasks varied in the self-perspective inhibition demands. In the task with the lowest self-perspective inhibition demands, at the time the participant had to infer the character's false belief, he or she had no idea what the new object's location was. In contrast, in the task with the highest self-perspective inhibition demands, at the time the participant had to infer the character's false belief, he or she knew where the object was actually located (and this knowledge had thus to be inhibited). The two tasks were presented to a stroke patient, WBA, with right prefrontal and temporal damage. WBA performed well in the low-inhibition false-belief task but showed striking difficulty in the task placing high self-perspective inhibition demands, showing a selective deficit in inhibiting self-perspective. WBA also made egocentric errors in other social and visual perspective taking tasks, indicating a difficulty with belief attribution extending to the attribution of emotions, desires and visual experiences to other people. The case of WBA, together with the recent report of three patients impaired in belief reasoning even when self-perspective inhibition demands were reduced, provide the first neuropsychological evidence that the inhibition of one's own point of view and the ability to infer someone else's point of view rely on distinct neural and functional processes.

Fine needle aspiration cytology of oral and oropharyngeal lesions with an emphasis on the diagnostic utility and pitfalls.

PubMed

Gupta, Nalini; Banik, Tarak; Rajwanshi, Arvind; Radotra, Bishan D; Panda, Naresh; Dey, Pranab; Srinivasan, Radhika; Nijhawan, Raje

2012-01-01

This study was undertaken to evaluate the diagnostic utility and pitfalls of fine needle aspiration cytology (FNAC) in oral and oropharyngeal lesions. This was a retrospective audit of oral and oropharyngeal lesions diagnosed with FNAC over a period of six years (2005-2010). Oral/oropharyngeal lesions [n=157] comprised 0.35% of the total FNAC load. The age ranged 1-80 years with the male: female ratio being 1.4:1. Aspirates were inadequate in 7% cases. Histopathology was available in 73/157 (46.5%) cases. Palate was the most common site of involvement [n=66] followed by tongue [n=35], buccal mucosa [n=18], floor of the mouth [n=17], tonsil [n=10], alveolus [n=5], retromolar trigone [n=3], and posterior pharyngeal wall [n=3]. Cytodiagnoses were categorized into infective/inflammatory lesions and benign cysts, and benign and malignant tumours. Uncommon lesions included ectopic lingual thyroid and adult rhabdomyoma of tongue, and solitary fibrous tumor (SFT), and leiomyosarcoma in buccal mucosa. A single false-positive case was dense inflammation with squamous cells misinterpreted as squamous cell carcinoma (SCC) on cytology. There were eight false-negative cases mainly due to sampling error. One false-negative case due to interpretation error was in a salivary gland tumor. The sensitivity of FNAC in diagnosing oral/oropharyngeal lesions was 71.4%; specificity was 97.8% with diagnostic accuracy of 87.7%. Salivary gland tumors and squamous cell carcinoma (SCC) are the most common lesions seen in the oral cavity. FNAC proves to be highly effective in diagnosing the spectrum of different lesions in this region. Sampling error is the main cause of false-negative cases in this region.

Don't Blame ME, Daddy. False Accusations of Child Sexual Abuse: A Hidden National Tragedy.

ERIC Educational Resources Information Center

Tong, Dean

Noting the increase in false accusations of child sexual abuse where divorce and custody litigation is in progress, this book examines the consequences of such accusations for everyone involved and provides defensive strategies for those falsely accused. The book draws on four case studies, including a personal one, to illustrate the chronology…

12 CFR 268.302 - Mixed case complaints.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 12 Banks and Banking 4 2014-01-01 2014-01-01 false Mixed case complaints. 268.302 Section 268.302... (CONTINUED) RULES REGARDING EQUAL OPPORTUNITY Related Processes § 268.302 Mixed case complaints. A mixed case... discrimination or it may contain additional allegations that the MSPB has jurisdiction to address. A mixed case...

12 CFR 268.302 - Mixed case complaints.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 12 Banks and Banking 4 2013-01-01 2013-01-01 false Mixed case complaints. 268.302 Section 268.302... (CONTINUED) RULES REGARDING EQUAL OPPORTUNITY Related Processes § 268.302 Mixed case complaints. A mixed case... discrimination or it may contain additional allegations that the MSPB has jurisdiction to address. A mixed case...

12 CFR 268.302 - Mixed case complaints.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 12 Banks and Banking 4 2012-01-01 2012-01-01 false Mixed case complaints. 268.302 Section 268.302... (CONTINUED) RULES REGARDING EQUAL OPPORTUNITY Related Processes § 268.302 Mixed case complaints. A mixed case... discrimination or it may contain additional allegations that the MSPB has jurisdiction to address. A mixed case...

A misleading false-negative result using Neisseria gonorrhoeae opa MGB multiplex PCR assay in patient's rectal sample due to partial mutations of the opa gene.

PubMed

Vahidnia, Ali; van Empel, Pieter Jan; Costa, Sandra; Oud, Rob T N; van der Straaten, Tahar; Bliekendaal, Harry; Spaargaren, Joke

2015-07-01

A 53-year-old homosexual man presented at his general practitioner (GP) practice with a suspicion of sexually transmitted infection. Initial NAAT screening was performed for Chlamydia trachomatis and Neisseria gonorrhoeae. The patient was positive for Neisseria gonorrhoeae both for his urine and rectal sample. The subsequent confirmation test for Neisseria gonorrhoeae by a second laboratory was only confirmed for the urine sample and the rectal sample was negative. We report a case of a potential false-negative diagnosis of Neisseria gonorrhoeae due to mutations of DNA sequence in the probe region of opa-MGB assay of the rectal sample. The patient did not suffer any discomfort as diagnosis of Neisseria gonorrhoeae in his urine sample had already led to treatment by prescribing the patient with Ceftriaxone 500 mg IV dissolved in 1 ml lidocaine 2% and 4 mL saline. The patient also received a prescription for Azithromycin (2x500 mg).

Cytokines in pleural liquid for diagnosis of tuberculous pleurisy.

PubMed

Yamada, Y; Nakamura, A; Hosoda, M; Kato, T; Asano, T; Tonegawa, K; Itoh, M

2001-07-01

An elevated level of adenosine deaminase (ADA) in pleural liquid has been considered as a supplemental diagnostic marker for tuberculous pleurisy. However, this is complicated by false-positives and -negatives. Recently, it has been revealed that various cytokines are intimately involved in the pathognomonic physiology of tuberculosis. In this study, interleukin-8 (IL-8), tumour necrosis factor alpha (TNFalpha) and interferon gamma (IFNgamma) were compared with ADA in pleural liquid of patients with inflammatory (21 cases), malignant (28 cases) and tuberculous (21 cases) disease. The pleural ADA, IL-8, TNFalpha and IFNgamma levels in the tuberculous group were higher than in the other three groups. Analysis of receiver operating characteristic (ROC) curves, to evaluate the utility of the various parameters, demonstrates values for the area under the curve (AUC) of 0.770, 0.875, 0.892 and 0.987, respectively for IL-8, TNFalpha, ADA and IFNgamma. No false-positives were encountered with IFNgamma and only one case with a small volume of pleural liquid was a false-negative. This indicates that IFNgamma is a very reliable marker of tuberculous pleurisy.

Two cases of false-positive dengue non-structural protein 1 (NS1) antigen in patients with hematological malignancies and a review of the literature on the use of NS1 for the detection of Dengue infection.

PubMed

Chung, Shimin J; Krishnan, Prabha U; Leo, Yee Sin

2015-02-01

Early diagnosis of dengue has been made easier in recent years owing to the advancement in diagnostic technologies. The rapid non-structural protein 1 (NS1) test strip is widely used in many developed and developing regions at risk of dengue. Despite the relatively high specificity of this test, we recently encountered two cases of false-positive dengue NS1 antigen in patients with underlying hematological malignancies. We reviewed the literature for causes of false-positive dengue NS1. © The American Society of Tropical Medicine and Hygiene.

Poliomyelitis case confirmation: characteristics for use by national eradication programmes.

PubMed Central

Biellik, R. J.; Bueno, H.; Olive, J. M.; de Quadros, C.

1992-01-01

Highly sensitive case definitions were first introduced by national poliomyelitis eradication programmes to avoid missing true cases of the disease, though false-positive diagnostic errors could still occur owing to low specificity. Extensive data from all 1620 cases of acute, flaccid paralysis reported in Brazil during 1987-88 provided an opportunity to study the characteristics of confirmed poliomyelitis cases and epidemiologically to evaluate potential case definitions that maximized both sensitivity and specificity. Cases that had been confirmed by wild poliomyelitis virus isolation were compared with those that had been rejected (non-polio cases). To guarantee the consistency of clinical, epidemiological and laboratory investigations, only cases less than 10 years of age that had been investigated within 15 days of the onset and with complete laboratory specimens were included. No single practical case definition combining both high sensitivity and high specificity emerged from the study. However, the results showed that poliomyelitis endemic countries with limited resources should give priority to the investigation of cases in less than 5-year-olds, cases with prodromal fever, cases without involvement in all four limbs, cases without progression greater than 3 days after the onset, and cases occurring in areas where poliomyelitis had recently been confirmed. In countries without laboratory resources, cases of acute, flaccid paralysis with initial involvement in one or both lower limbs and residual neurological sequelae at 60 days should be confirmed. Countries that are close to eradication may selectively reject any cases lacking laboratory confirmation, despite adequate specimen collection, if they do not have initial involvement in one or both lower limbs and residual neurological sequelae at 60 days. PMID:1314710

Is the truth in the details? Extended narratives help distinguishing false "memories" from false "reports".

PubMed

Sjödén, Björn; Granhag, Pär Anders; Ost, James; Roos Af Hjelmsäter, Emma

2009-06-01

The present study examined the effects of fantasy proneness on false "reports" and false "memories", of existent and non-existent footage of a public event. We predicted that highly fantasy prone individuals would be more likely to stand by their initial claim of having seen a film of the event than low fantasy prone participants when prompted for more details about their experiences. Eighty creative arts students and 80 other students were asked whether they had seen CCTV footage preceding the attack on Swedish foreign minister Anna Lindh up to, and including, non-existent footage of the actual moment of the attack. If affirmative, they were probed for extended narratives of what they claimed to have seen. Overall, 64% of participants provided a false "report" by answering yes to the initial question. Of these, 30% provided no explicit details of the attack, and a further 15% retracted their initial answer in their narratives. This left 19% of the sample who appeared to have false "memories" because they provided explicit details of the actual moment of the attack. Women scored higher than men and art students scored higher than other students on fantasy proneness, but there was no effect on levels of false reporting or false "memory". Memories were rated more vivid and clear for existent compared to non-existent aspects of the event. In sum, these data suggest a more complex relationship between memory distortions and fantasy proneness than previously observed.

Pitfalls in genetic testing: a case of a SNP in primer-annealing region leading to allele dropout in BRCA1.

PubMed

Silva, Felipe Carneiro; Torrezan, Giovana Tardin; Brianese, Rafael Canfield; Stabellini, Raquel; Carraro, Dirce Maria

2017-07-01

Hereditary breast and ovarian cancer is characterized by mutations in BRCA1 or BRCA2 genes and PCR-based screening techniques, such as capillary sequencing and next-generation sequencing (NGS), are considered gold standard methods for detection of pathogenic mutations in these genes. Single-nucleotide polymorphisms (SNPs) constitute a vast source of variation in the human genome and represent a risk for misdiagnosis in genetic testing, since the presence of a SNP in primer-annealing sites may cause false negative results due to allele dropout. However, few reports are available and the frequency of this phenomenon in diagnostic assays remains unknown. In this article, we investigated the causes of a false negative capillary sequencing result in BRCA1 involving a mother-daughter dyad. Using several molecular strategies, including different DNA polymerases, primer redesign, allele-specific PCR and NGS, we established that the initial misdiagnosis was caused by a SNP located in the primer-annealing region, leading to allele dropout of the mutated allele. Assuming that this problem can also occur in any PCR-based method that are widely used in diagnostic settings, the clinical report presented here draws attention for one of the limitations of genetic testing in general, for which medical and laboratory communities need to be aware.

[Interpretation of false positive results of biochemical prenatal tests].

PubMed

Sieroszewski, Piotr; Słowakiewicz, Katarzyna; Perenc, Małgorzata

2010-03-01

Modern, non-invasive prenatal diagnostics based on biochemical and ultrasonographic markers of fetal defects allows us to calculate the risk of fetal chromosomal aneuploidies with high sensitivity and specificity An introduction of biochemical, non-invasive prenatal tests turned out to result in frequent false positive results of these tests in cases when invasive diagnostics does not confirm fetal defects. However prospective analysis of these cases showed numerous complications in the third trimester of the pregnancies.

Medical tests: women's reported and preferred decision‐making roles and preferences for information on benefits, side‐effects and false results

PubMed Central

Davey, Heather M.; Barratt, Alexandra L.; Davey, Elizabeth; Butow, Phyllis N.; Redman, Sally; Houssami, Nehmat; Salkeld, Glenn P.

2002-01-01

Abstract Objective  To determine women's preferences for and reported experience with medical test decision‐making. Design  Computer‐assisted telephone survey. Setting and participants  Six hundred and fifty‐two women resident in households randomly selected from the New South Wales electronic white pages. Main outcome measures  Reported and preferred test and treatment (for comparison) decision‐making, satisfaction with and anxiety about information on false results and side‐effects; and effect of anxiety on desire for such information. Results  Overall most women preferred to share test (94.6%) and treatment (91.2%) decision‐making equally with their doctor, or to take a more active role, with only 5.4–8.9% reporting they wanted the doctor to make these decisions on their behalf. This pattern was consistent across all age groups. In general, women reported experiencing a decision‐making role that was consistent with their preference. Women who had a usual doctor were more likely to report experiencing an active role in decision‐making. More women reported receiving as much information as they wanted about the benefits of tests and treatment than about the side‐effects of tests and treatment. Most women wanted information about the possibility of false test results (91.5%) and test side‐effects (95.6%), but many reported the doctor never provided this information (false results = 40.0% and side‐effects = 31.3%). A substantial proportion said this information would make them anxious (false results = 56.6% and side‐effects = 43.1%), but reported they wanted the information anyway (false results = 77.6% and side‐effects = 88.1%). Conclusions  Women prefer an active role in test and treatment decision‐making. Many women reported receiving inadequate information. If so, this may jeopardize informed decision‐making. PMID:12460222

The introduction of the absolute risk for the detection of fetal aneuploidies in the first-trimester screening.

PubMed

Padula, Francesco; Laganà, Antonio Simone; Vitale, Salvatore Giovanni; D'Emidio, Laura; Coco, Claudio; Giannarelli, Diana; Cariola, Maria; Favilli, Alessandro; Giorlandino, Claudio

2017-05-01

Maternal age is a crucial factor in fetal aneuploidy screening, resulting in an increased rate of false-positive cases in older women and false-negative cases in younger women. The absolute risk (AR) is the simplest way to eliminate the background maternal age risk, as it represents the amount of improvement of the combined risk from the maternal background risk. The aim of this work is to assess the performance of the AR in the combined first-trimester screening for aneuploidies. A retrospective validation of the AR in the combined first-trimester screening for fetal aneuploidies, in an unselected population at Altamedica Fetal-Maternal Medical Center in Rome, between March 2007 and December 2008. Of 3845 women included in the study, we had a complete follow-up on 2984. We evaluated that an AR < 3 would individuate 22 of 23 cases of aneuploidy with a detection rate of 95.7% (95%CI 87.3-100), a false-positive rate of 8.7% (95%CI 7.7-9.7) and a false-negative rate of 4.3% (95%CI 0-12.7). In our study, the AR ameliorates the detection rate for aneuploidy. Further research and a prospective study on a larger population would help us to improve the AR in detecting most cases of aneuploidy.

7 CFR 29.2287 - Order (case).

Code of Federal Regulations, 2011 CFR

2011-01-01

... 7 Agriculture 2 2011-01-01 2011-01-01 false Order (case). 29.2287 Section 29.2287 Agriculture Regulations of the Department of Agriculture AGRICULTURAL MARKETING SERVICE (Standards, Inspections, Marketing... (case). The state of tobacco with respect to its moisture content. ...

7 CFR 29.2287 - Order (case).

Code of Federal Regulations, 2012 CFR

2012-01-01

... 7 Agriculture 2 2012-01-01 2012-01-01 false Order (case). 29.2287 Section 29.2287 Agriculture Regulations of the Department of Agriculture AGRICULTURAL MARKETING SERVICE (Standards, Inspections, Marketing... (case). The state of tobacco with respect to its moisture content. ...

7 CFR 29.2287 - Order (case).

Code of Federal Regulations, 2013 CFR

2013-01-01

... 7 Agriculture 2 2013-01-01 2013-01-01 false Order (case). 29.2287 Section 29.2287 Agriculture Regulations of the Department of Agriculture AGRICULTURAL MARKETING SERVICE (Standards, Inspections, Marketing... (case). The state of tobacco with respect to its moisture content. ...

7 CFR 29.2287 - Order (case).

Code of Federal Regulations, 2014 CFR

2014-01-01

... 7 Agriculture 2 2014-01-01 2014-01-01 false Order (case). 29.2287 Section 29.2287 Agriculture Regulations of the Department of Agriculture AGRICULTURAL MARKETING SERVICE (Standards, Inspections, Marketing... (case). The state of tobacco with respect to its moisture content. ...

7 CFR 29.2287 - Order (case).

Code of Federal Regulations, 2010 CFR

2010-01-01

... 7 Agriculture 2 2010-01-01 2010-01-01 false Order (case). 29.2287 Section 29.2287 Agriculture Regulations of the Department of Agriculture AGRICULTURAL MARKETING SERVICE (Standards, Inspections, Marketing... (case). The state of tobacco with respect to its moisture content. ...

[Avulsion of the Proximal Hamstring Insertion. Case Reports].

PubMed

Mizera, R; Harcuba, R; Kratochvíl, J

2016-01-01

Proximal hamstring avulsion is an uncommon muscle injury with a lack of consensus on indications and the timing and technique of surgery. Poor clinical symptoms and difficulties in the diagnostic process can lead to a false diagnosis. The authors present three cases of proximal hamstring avulsion, two complete and one partial ruptures of the biceps femoris muscle. MRI and ultrasound scans were used for optimal treatment alignment. Acute surgery reconstruction (< 4 weeks) was done in two patients. Re-attachment of the full thickness ruptures was performed to the original place and secured by suture anchors, the partial rupture was fixed by a simple suture. Two patients were free of any symptoms at 6 months after surgery, the last one had pain in the subgluteal area and a mild deficit in hamstring strength. Two interesting systematic reviews published on the treatment of proximal hamstring avulsion are discussed in the final part of the paper. Key words: hamstring, rupture, avulsion.

Inflammatory myofibroblastic tumor of the mesentery associated with high fever and positive Widal test.

PubMed

Chouairy, Camil J; Bechara, Elie A; Gebran, Sleiman J; Ghabril, Ramy H

2008-12-01

Inflammatory myofibroblastic tumor (IMT) is associated in 15-30% of cases with systemic symptomatology, such as prolonged fever, weight loss, elevated erythrocyte sedimentation rate (ESR), anemia, thrombocytosis, and leukocytosis. We report the case of a 4-year-old Lebanese boy who presented with high-grade fever of long duration, and a single (unpaired) positive Widal agglutination test. Blood culture was negative. A diagnosis of typhoid fever was made. An abdominal (mesenteric) IMT was incidentally discovered, 30 days after the fever had appeared. After surgery, the fever disappeared immediately, and the ESR returned to normal. We strongly favor the possibility of a false positive Widal test, due to polyclonal increase in serum immunoglobulins, which often occurs in IMT. We also think that IMT might be a mimicker of typhoid fever, both clinically and serologically. Physicians, especially pediatricians practicing in endemic areas, should probably be aware of this mimicry.

Reversible adrenal insufficiency and heterophile antibodies in a case of autoimmune polyendocrinopathy syndrome

PubMed Central

Kharb, Sandeep; Gundgurthi, Abhay; Dutta, Manoj K.; Garg, M. K.

2013-01-01

A 27-year-old male was admitted with diabetic ketoacidosis and altered sensorium with slurring of speech and ataxia. He was managed with intravenous insulin and fluids and later shifted to basal bolus insulin regimen and during further evaluation was diagnosed to be suffering from primary hypothyroidism and adrenal insufficiency. He was started on thyroxin replacement and steroids only during stress. After three months of follow up he was clinically euthyroid. His glycemic control was adequate on oral anti-hyperglycemic drugs and adrenal insufficiency recovered. However, his thyrotropin levels were persistently elevated on adequate replacement doses of thyroxin. His repeat TSH was estimated after precipitating serum with polyethylene glycol which revealed normal TSH. Here we report reversible adrenal insufficiency with hypothyroidism with falsely raised TSH because of presence of heterophile antibodies in a case of poly glandular endocrinopathy syndrome. PMID:24910843

Reversible adrenal insufficiency and heterophile antibodies in a case of autoimmune polyendocrinopathy syndrome.

PubMed

Kharb, Sandeep; Gundgurthi, Abhay; Dutta, Manoj K; Garg, M K

2013-12-01

A 27-year-old male was admitted with diabetic ketoacidosis and altered sensorium with slurring of speech and ataxia. He was managed with intravenous insulin and fluids and later shifted to basal bolus insulin regimen and during further evaluation was diagnosed to be suffering from primary hypothyroidism and adrenal insufficiency. He was started on thyroxin replacement and steroids only during stress. After three months of follow up he was clinically euthyroid. His glycemic control was adequate on oral anti-hyperglycemic drugs and adrenal insufficiency recovered. However, his thyrotropin levels were persistently elevated on adequate replacement doses of thyroxin. His repeat TSH was estimated after precipitating serum with polyethylene glycol which revealed normal TSH. Here we report reversible adrenal insufficiency with hypothyroidism with falsely raised TSH because of presence of heterophile antibodies in a case of poly glandular endocrinopathy syndrome.

How frequently do allegations of scientific misconduct occur in ecology and evolution, and what happens afterwards?

PubMed

Moreno-Rueda, Gregorio

2013-03-01

Scientific misconduct obstructs the advance of knowledge in science. Its impact in some disciplines is still poorly known, as is the frequency in which it is detected. Here, I examine how frequently editors of ecology and evolution journals detect scientist misconduct. On average, editors managed 0.114 allegations of misconduct per year. Editors considered 6 of 14 allegations (42.9%) to be true, but only in 2 cases were the authors declared guilty, the remaining being dropped for lack of proof. The annual rate of allegations that were probably warranted was 0.053, although the rate of demonstrated misconduct was 0.018, while the rate of false or erroneous allegations was 0.024. Considering that several cases of misconduct are probably not reported, these findings suggest that editors detect less than one-third of all fraudulent papers.

Mental illness, violence and delusional misidentifications: the role of Capgras' syndrome in matricide.

PubMed

Carabellese, Felice; Rocca, Gabriele; Candelli, Chiara; Catanesi, Roberto

2014-01-01

Violent behavior has frequently been reported in cases of Capgras' delusion, a misidentification syndrome characterized by the false belief that imposters have replaced people familiar to the individual. To better understand the relationship between Capgras' syndrome and violence. After a brief overview of the scientific knowledge of delusional misidentification syndromes, we present two cases of psychotic sons suffering from this kind of delusion who killed their mothers and we analyzed the phenomenology of Capgras' delusion in-depth, focusing on the role of this syndrome in the etiology of violence. Capgras' syndrome may be a specific risk factor for violence towards others, particularly the murder of the delusionally misidentified person. Looking for the signs of Capgras' syndrome may be crucial to assessing the risk of violence in mentally disordered patients. Copyright © 2013 Elsevier Ltd and Faculty of Forensic and Legal Medicine. All rights reserved.

An incidentally found inflamed uterine myoma causing low abdominal pain, using Tc-99m-tektrotyd single photon emission computed tomography-CT hybrid imaging.

PubMed

Zandieh, Shahin; Schütz, Matthias; Bernt, Reinhard; Zwerina, Jochen; Haller, Joerg

2013-01-01

We report the case of a 50-year-old woman presented with a history of right hemicolectomy due to an ileocecal neuroendocrine tumor and left breast metastasis. Owing to a slightly elevated chromogranin A-level and lower abdominal pain, single photon emission computed tomography-computer tomography (SPECT-CT) was performed. There were no signs of recurrence on the SPECT-CT scan, but the patient was incidentally found to have an inflamed intramural myoma. We believe that the slightly elevated chromogranin A-level was caused by the hypertension that the patient presented. In the clinical context, this is a report of an inflamed uterine myoma seen as a false positive result detected by TC-99m-Tc-EDDA/HYNIC-Tyr3-Octreotide (Tektrotyd) SPECT-CT hybrid imaging.

Skin lesions over the pocket area that may mimic cardiac implantable electronic device infection: A case series.

PubMed

Korantzopoulos, Panagiotis; Plakoutsi, Sofia; Florou, Elizabeth; Bechlioulis, Aris

2018-05-21

The early and correct diagnosis of cardiac implantable electronic device (CIED) infections is critical given that early aggressive treatment with complete removal of the system along with antimicrobial therapy dramatically improves outcomes. Pocket infection manifested by local signs of inflammation is the most common form of CIED infections. Conditions mimicking pocket infection have been described in the literature. These include various types of malignancy and rarely allergic reactions/contact dermatitis to pacemaker compounds. We aimed to describe skin lesions and disorders over the pocket area that mimic CIED infection. We present a series of 5 cases with skin lesions that mimic pocket infection. We document these cases with corresponding photographs. Most of them have not been described in this setting. We report the following cases of conditions that proved not to be CIED infection: One case of superficial cellulitis, one case of herpes zoster over the pocket area, one case of spontaneous bruising over the pocket a long time after implantation in a patient taking oral anticoagulation, and 2 cases of contact dermatitis due to prolonged postoperative application of povidone iodine. All cases had favorable outcome after conservative treatment and no CIED infection was developed during follow-up. Clinicians should be aware of rare conditions that mimic CIED infection. Incorrect diagnosis of these disorders may falsely lead to CIED extraction. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

Adults' Memories of Childhood: True and False Reports

ERIC Educational Resources Information Center

Qin, Jianjian; Ogle, Christin M.; Goodman, Gail S.

2008-01-01

In 3 experiments, the authors examined factors that, according to the source-monitoring framework, might influence false memory formation and true/false memory discernment. In Experiment 1, combined effects of warning and visualization on false childhood memory formation were examined, as were individual differences in true and false childhood…

12 CFR 268.302 - Mixed case complaints.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 12 Banks and Banking 3 2011-01-01 2011-01-01 false Mixed case complaints. 268.302 Section 268.302... RULES REGARDING EQUAL OPPORTUNITY Related Processes § 268.302 Mixed case complaints. A mixed case complaint is a complaint of employment discrimination filed with the Board based on race, color, religion...

12 CFR 268.302 - Mixed case complaints.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 12 Banks and Banking 3 2010-01-01 2010-01-01 false Mixed case complaints. 268.302 Section 268.302... RULES REGARDING EQUAL OPPORTUNITY Related Processes § 268.302 Mixed case complaints. A mixed case complaint is a complaint of employment discrimination filed with the Board based on race, color, religion...

27 CFR 19.608 - Cases of industrial alcohol.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 27 Alcohol, Tobacco Products and Firearms 1 2010-04-01 2010-04-01 false Cases of industrial alcohol. 19.608 Section 19.608 Alcohol, Tobacco Products and Firearms ALCOHOL AND TOBACCO TAX AND TRADE... Cases of industrial alcohol. (a) Mandatory marks. Each case, including encased containers, of alcohol...

30 CFR 75.701 - Grounding metallic frames, casings, and other enclosures of electric equipment.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 30 Mineral Resources 1 2010-07-01 2010-07-01 false Grounding metallic frames, casings, and other... Grounding § 75.701 Grounding metallic frames, casings, and other enclosures of electric equipment. [Statutory Provisions] Metallic frames, casings, and other enclosures of electric equipment that can become...

14 CFR 399.62 - Target dates in hearing cases.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 14 Aeronautics and Space 4 2010-01-01 2010-01-01 false Target dates in hearing cases. 399.62... Target dates in hearing cases. (a) Applicability. This section applies to initial and recommended.... (b) Issuance of target dates. In cases to which this section applies, the Board or the administrative...

14 CFR 399.62 - Target dates in hearing cases.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 14 Aeronautics and Space 4 2011-01-01 2011-01-01 false Target dates in hearing cases. 399.62... Target dates in hearing cases. (a) Applicability. This section applies to initial and recommended.... (b) Issuance of target dates. In cases to which this section applies, the Board or the administrative...

14 CFR 399.62 - Target dates in hearing cases.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 14 Aeronautics and Space 4 2013-01-01 2013-01-01 false Target dates in hearing cases. 399.62... Target dates in hearing cases. (a) Applicability. This section applies to initial and recommended.... (b) Issuance of target dates. In cases to which this section applies, the Board or the administrative...

14 CFR 399.62 - Target dates in hearing cases.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 14 Aeronautics and Space 4 2014-01-01 2014-01-01 false Target dates in hearing cases. 399.62... Target dates in hearing cases. (a) Applicability. This section applies to initial and recommended.... (b) Issuance of target dates. In cases to which this section applies, the Board or the administrative...

14 CFR 399.62 - Target dates in hearing cases.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 14 Aeronautics and Space 4 2012-01-01 2012-01-01 false Target dates in hearing cases. 399.62... Target dates in hearing cases. (a) Applicability. This section applies to initial and recommended.... (b) Issuance of target dates. In cases to which this section applies, the Board or the administrative...

46 CFR 160.174-13 - Storage case.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 46 Shipping 6 2014-10-01 2014-10-01 false Storage case. 160.174-13 Section 160.174-13 Shipping...: SPECIFICATIONS AND APPROVAL LIFESAVING EQUIPMENT Thermal Protective Aids § 160.174-13 Storage case. Each thermal protective aid must be provided with a ziplock bag or equivalent storage case. ...

46 CFR 160.174-13 - Storage case.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 46 Shipping 6 2011-10-01 2011-10-01 false Storage case. 160.174-13 Section 160.174-13 Shipping...: SPECIFICATIONS AND APPROVAL LIFESAVING EQUIPMENT Thermal Protective Aids § 160.174-13 Storage case. Each thermal protective aid must be provided with a ziplock bag or equivalent storage case. ...

46 CFR 160.174-13 - Storage case.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 46 Shipping 6 2012-10-01 2012-10-01 false Storage case. 160.174-13 Section 160.174-13 Shipping...: SPECIFICATIONS AND APPROVAL LIFESAVING EQUIPMENT Thermal Protective Aids § 160.174-13 Storage case. Each thermal protective aid must be provided with a ziplock bag or equivalent storage case. ...

46 CFR 160.174-13 - Storage case.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 46 Shipping 6 2010-10-01 2010-10-01 false Storage case. 160.174-13 Section 160.174-13 Shipping...: SPECIFICATIONS AND APPROVAL LIFESAVING EQUIPMENT Thermal Protective Aids § 160.174-13 Storage case. Each thermal protective aid must be provided with a ziplock bag or equivalent storage case. ...

46 CFR 160.174-13 - Storage case.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 46 Shipping 6 2013-10-01 2013-10-01 false Storage case. 160.174-13 Section 160.174-13 Shipping...: SPECIFICATIONS AND APPROVAL LIFESAVING EQUIPMENT Thermal Protective Aids § 160.174-13 Storage case. Each thermal protective aid must be provided with a ziplock bag or equivalent storage case. ...

9 CFR 96.8 - Uncertified casings; disinfection at seaboard port.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 9 Animals and Animal Products 1 2014-01-01 2014-01-01 false Uncertified casings; disinfection at seaboard port. 96.8 Section 96.8 Animals and Animal Products ANIMAL AND PLANT HEALTH INSPECTION SERVICE... Uncertified casings; disinfection at seaboard port. Uncertified foreign animal casings arriving at a seaboard...

9 CFR 96.8 - Uncertified casings; disinfection at seaboard port.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 9 Animals and Animal Products 1 2011-01-01 2011-01-01 false Uncertified casings; disinfection at seaboard port. 96.8 Section 96.8 Animals and Animal Products ANIMAL AND PLANT HEALTH INSPECTION SERVICE... Uncertified casings; disinfection at seaboard port. Uncertified foreign animal casings arriving at a seaboard...

9 CFR 96.8 - Uncertified casings; disinfection at seaboard port.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 9 Animals and Animal Products 1 2013-01-01 2013-01-01 false Uncertified casings; disinfection at seaboard port. 96.8 Section 96.8 Animals and Animal Products ANIMAL AND PLANT HEALTH INSPECTION SERVICE... Uncertified casings; disinfection at seaboard port. Uncertified foreign animal casings arriving at a seaboard...

9 CFR 96.8 - Uncertified casings; disinfection at seaboard port.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 9 Animals and Animal Products 1 2010-01-01 2010-01-01 false Uncertified casings; disinfection at seaboard port. 96.8 Section 96.8 Animals and Animal Products ANIMAL AND PLANT HEALTH INSPECTION SERVICE... Uncertified casings; disinfection at seaboard port. Uncertified foreign animal casings arriving at a seaboard...

9 CFR 96.8 - Uncertified casings; disinfection at seaboard port.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 9 Animals and Animal Products 1 2012-01-01 2012-01-01 false Uncertified casings; disinfection at seaboard port. 96.8 Section 96.8 Animals and Animal Products ANIMAL AND PLANT HEALTH INSPECTION SERVICE... Uncertified casings; disinfection at seaboard port. Uncertified foreign animal casings arriving at a seaboard...

Suggestions for presenting the results of data analyses

USGS Publications Warehouse

Anderson, David R.; Link, William A.; Johnson, Douglas H.; Burnham, Kenneth P.

2001-01-01

We give suggestions for the presentation of research results from frequentist, information-theoretic, and Bayesian analysis paradigms, followed by several general suggestions. The information-theoretic and Bayesian methods offer alternative approaches to data analysis and inference compared to traditionally used methods. Guidance is lacking on the presentation of results under these alternative procedures and on nontesting aspects of classical frequentists methods of statistical analysis. Null hypothesis testing has come under intense criticism. We recommend less reporting of the results of statistical tests of null hypotheses in cases where the null is surely false anyway, or where the null hypothesis is of little interest to science or management.

Strongyloides hyperinfection following hematopoietic stem cell transplant in a patient with HTLV-1-associated T-cell leukemia.

PubMed

Alpern, Jonathan D; Arbefeville, Sophie S; Vercellotti, Gregory; Ferrieri, Patricia; Green, Jaime S

2017-02-01

Strongyloides stercoralis has the potential to cause accelerated autoinfection in immunocompromised hosts. Screening tests for strongyloidiasis may be falsely negative in the setting of immunosuppression. We report a case of Strongyloides hyperinfection syndrome in a patient with human T-lymphotropic virus type 1-associated T-cell leukemia early after hematopoietic stem cell transplant. The diagnosis was made by stool ova and parasite examination, despite a negative screening enzyme-linked immunosorbent assay. Because of anticipated prolonged neutropenia, an extended course of treatment was utilized. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Research Waste: How Are Dental Survival Articles Indexed and Reported?

PubMed

Layton, Danielle M; Clarke, Michael

2016-01-01

Research waste occurs when research is ignored, cannot be found, cannot be used, or is unintentionally repeated. This article aims to investigate how dental survival analyses were indexed and reported, and to discuss whether errors in indexing and writing articles are affecting identification and use of survival articles, contributing to research waste. Articles reporting survival of dental prostheses in humans (also known as time-to-event) were identified by searching 50 dental journals that had the highest Impact Factor in 2008. These journals were hand searched twice (Kappa 0.92), and the articles were assessed by two independent reviewers (Kappa 0.86) to identify dental survival articles ("case" articles, n = 95), likely false positives (active controls, n = 91), and all other true negative articles (passive controls, n = 6,769). This means that the study used a case:control method. Once identified, the different groups of articles were assessed and compared. Allocation of medical subject headings (MeSH) by MEDLINE indexers that related to survival was sought, use of words by authors in the abstract and title that related to survival was identified, and use of words and figures by authors that related to survival in the articles themselves was also sought. Differences were assessed with chi-square and Fisher's Exact statistics. Reporting quality was also assessed. The results were reviewed to discuss their potential impact on research waste. Allocation of survival-related MeSH index terms across the three article groups was inconsistent and inaccurate. Statistical MeSH had not been allocated to 30% of the dental survival "case" articles and had been incorrectly allocated to 15% of active controls. Additionally, information reported by authors in titles and abstracts varied, with only two-thirds of survival "case" articles mentioning survival "statistics" in the abstract. In the articles themselves, time-to-event statistical methods, survival curves, and life tables were poorly reported or constructed. Overall, the low quality of indexing by indexers and reporting by authors means that these articles will not be readily identifiable through electronic searches, and, even if they are found, the poor reporting quality makes it unnecessarily difficult for readers to understand and use them. There are substantial problems with the reporting of time-to-event analyses in the dental literature. These problems will adversely impact how these articles can be found and used, thereby contributing to research waste. Changes are needed in the way that authors report these studies and the way indexers classify them.

45 CFR 3.4 - False reports and reports of injury or damage.

Code of Federal Regulations, 2010 CFR

2010-10-01

... PERSONS AND TRAFFIC ON THE NATIONAL INSTITUTES OF HEALTH FEDERAL ENCLAVE General § 3.4 False reports and... accident or violation of the regulations of this part or any applicable Federal or Maryland statute to any person properly investigating an accident or alleged violation. All incidents resulting in injury to...

The “Facebook-self”: characteristics and psychological predictors of false self-presentation on Facebook

PubMed Central

Gil-Or, Oren; Levi-Belz, Yossi; Turel, Ofir

2015-01-01

In this study we present and empirically examine a new phenomenon related to social networking sites, such as Facebook, the “false Facebook-self.” Arguably false self-presentation on Facebook is a growing phenomenon, and in extreme cases; i.e., when ones Facebook image substantially deviates from their true image, it may serve as a gateway behavior to more problematic behaviors which may lead to psychological problems and even pathologies. In this study we show that certain users are more vulnerable to such false self-presentation than others. The study involved 258 Facebook users. Applying ANOVA and SEM analyses we show that users with low self-esteem and low trait authenticity are more likely than others to present a Facebook-self which deviates from their true selves. These social-interaction-related traits are influenced by one’s upbringing and the anxious and avoidant attachment styles he or she has developed. Several cases (7.5%) with large gaps between the true and false Facebook-self were detected, which implies that future research should consider the adverse consequences and treatments of high levels of false Facebook-self. PMID:25741299

30 CFR 250.525 - What do I submit if my casing diagnostic test requires action?

Code of Federal Regulations, 2011 CFR

2011-07-01

... 30 Mineral Resources 2 2011-07-01 2011-07-01 false What do I submit if my casing diagnostic test... if my casing diagnostic test requires action? Within 14 days after you perform a casing diagnostic... Corrective Action Plan within 30 days of the diagnostic test. (b) a casing pressure request, Regional...

24 CFR 255.3 - Case-by-case conversion to full insurance.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 24 Housing and Urban Development 2 2011-04-01 2011-04-01 false Case-by-case conversion to full insurance. 255.3 Section 255.3 Housing and Urban Development Regulations Relating to Housing and Urban...-by-case conversion to full insurance. Cross Reference: The provisions of 24 CFR 251.3 apply to this...

Validity of Parent-Reported Vaccination Status for Adolescents Aged 13–17 Years: National Immunization Survey-Teen, 2008

PubMed Central

Dorell, Christina G.; Jain, Nidhi; Yankey, David

2011-01-01

Objective The validity of parent-reported adolescent vaccination histories has not been assessed. This study evaluated the validity of parent-reported adolescent vaccination histories by a combination of immunization card and recall, and by recall only, compared with medical provider records. Methods We analyzed data from the 2008 National Immunization Survey-Teen. Parents of adolescents aged 13–17 years reported their child's vaccination history either by immunization card and recall (n=3,661) or by recall only (n=12,822) for the hepatitis B (Hep B), measles-mumps-rubella (MMR), varicella (VAR), tetanus-diphtheria/tetanus-diphtheria-acellular pertussis (Td/Tdap), meningococcal conjugate (MCV4), and quadrivalent human papillomavirus (HPV4) (for girls only) vaccines. We validated parental report with medical records. Results Among the immunization card/recall group, vaccines with >20% false-positive reports included MMR (32.3%) and Td/Tdap (36.9%); vaccines with >20% false-negative reports included VAR (35.2%), MCV4 (36.0%), and Tdap (41.9%). Net bias ranged from −25.0 to −0.1 percentage points. Kappa values ranged from 0.22 to 0.92. Among the recall-only group, vaccines with >20% false-positive reports included Hep B (33.9%), MMR (61.4%), VAR (26.2%), and Td/Tdap (60.6%); vaccines with >20% false-negative reports included Hep B (58.9%), MMR (33.7%), VAR (51.6%), Td/Tdap (25.5%), Tdap (50.3%) MCV4 (63.0%), and HPV4 (20.5%). Net bias ranged from −46.0 to 0.5 percentage points. Kappa values ranged from 0.03 to 0.76. Conclusions Validity of parent-reported vaccination histories varies by type of report and vaccine. For recently recommended vaccines, false-negative rates were substantial and higher than false-positive rates, resulting in net underreporting of vaccination rates by both the immunization card/recall and recall-only groups. Provider validation of parent-reported vaccinations is needed for valid surveillance of adolescent vaccination coverage. PMID:21812170

Applying a CAD-generated imaging marker to assess short-term breast cancer risk

NASA Astrophysics Data System (ADS)

Mirniaharikandehei, Seyedehnafiseh; Zarafshani, Ali; Heidari, Morteza; Wang, Yunzhi; Aghaei, Faranak; Zheng, Bin

2018-02-01

Although whether using computer-aided detection (CAD) helps improve radiologists' performance in reading and interpreting mammograms is controversy due to higher false-positive detection rates, objective of this study is to investigate and test a new hypothesis that CAD-generated false-positives, in particular, the bilateral summation of false-positives, is a potential imaging marker associated with short-term breast cancer risk. An image dataset involving negative screening mammograms acquired from 1,044 women was retrospectively assembled. Each case involves 4 images of craniocaudal (CC) and mediolateral oblique (MLO) view of the left and right breasts. In the next subsequent mammography screening, 402 cases were positive for cancer detected and 642 remained negative. A CAD scheme was applied to process all "prior" negative mammograms. Some features from CAD scheme were extracted, which include detection seeds, the total number of false-positive regions, an average of detection scores and the sum of detection scores in CC and MLO view images. Then the features computed from two bilateral images of left and right breasts from either CC or MLO view were combined. In order to predict the likelihood of each testing case being positive in the next subsequent screening, two logistic regression models were trained and tested using a leave-one-case-out based cross-validation method. Data analysis demonstrated the maximum prediction accuracy with an area under a ROC curve of AUC=0.65+/-0.017 and the maximum adjusted odds ratio of 4.49 with a 95% confidence interval of [2.95, 6.83]. The results also illustrated an increasing trend in the adjusted odds ratio and risk prediction scores (p<0.01). Thus, the study showed that CAD-generated false-positives might provide a new quantitative imaging marker to help assess short-term breast cancer risk.

Rapid detection of pandemic influenza in the presence of seasonal influenza

PubMed Central

2010-01-01

Background Key to the control of pandemic influenza are surveillance systems that raise alarms rapidly and sensitively. In addition, they must minimise false alarms during a normal influenza season. We develop a method that uses historical syndromic influenza data from the existing surveillance system 'SERVIS' (Scottish Enhanced Respiratory Virus Infection Surveillance) for influenza-like illness (ILI) in Scotland. Methods We develop an algorithm based on the weekly case ratio (WCR) of reported ILI cases to generate an alarm for pandemic influenza. From the seasonal influenza data from 13 Scottish health boards, we estimate the joint probability distribution of the country-level WCR and the number of health boards showing synchronous increases in reported influenza cases over the previous week. Pandemic cases are sampled with various case reporting rates from simulated pandemic influenza infections and overlaid with seasonal SERVIS data from 2001 to 2007. Using this combined time series we test our method for speed of detection, sensitivity and specificity. Also, the 2008-09 SERVIS ILI cases are used for testing detection performances of the three methods with a real pandemic data. Results We compare our method, based on our simulation study, to the moving-average Cumulative Sums (Mov-Avg Cusum) and ILI rate threshold methods and find it to be more sensitive and rapid. For 1% case reporting and detection specificity of 95%, our method is 100% sensitive and has median detection time (MDT) of 4 weeks while the Mov-Avg Cusum and ILI rate threshold methods are, respectively, 97% and 100% sensitive with MDT of 5 weeks. At 99% specificity, our method remains 100% sensitive with MDT of 5 weeks. Although the threshold method maintains its sensitivity of 100% with MDT of 5 weeks, sensitivity of Mov-Avg Cusum declines to 92% with increased MDT of 6 weeks. For a two-fold decrease in the case reporting rate (0.5%) and 99% specificity, the WCR and threshold methods, respectively, have MDT of 5 and 6 weeks with both having sensitivity close to 100% while the Mov-Avg Cusum method can only manage sensitivity of 77% with MDT of 6 weeks. However, the WCR and Mov-Avg Cusum methods outperform the ILI threshold method by 1 week in retrospective detection of the 2009 pandemic in Scotland. Conclusions While computationally and statistically simple to implement, the WCR algorithm is capable of raising alarms, rapidly and sensitively, for influenza pandemics against a background of seasonal influenza. Although the algorithm was developed using the SERVIS data, it has the capacity to be used at other geographic scales and for different disease systems where buying some early extra time is critical. PMID:21106071

False diagnosis of type 1 diabetes mellitus and its complications in Wolfram syndrome--is it the reason for the low number of reported cases of this abnormality?

PubMed

Homa, Katarzyna; Stefański, Adam; Zmysłowska, Agnieszka; Molęda, Piotr; Bryśkiewicz, Marta Ewa; Majkowska, Liliana

2014-01-01

Wolfram syndrome (WS), also known as DIDMOAD (Diabetes Insipidus, Diabetes Mellitus, Optic Atrophy and Deafness), is a rare autosomal recessive syndrome (1/770,000 in the United Kingdom), characterised by juvenile onset of diabetes mellitus, optic nerve atrophy, diabetes insipidus, sensorineural deafness, renal tract and neurological abnormalities, and primary gonadal atrophy. WS is caused mainly by biallelic mutations in the WFS1 gene, which encodes wolframin. Wide tissue distribution of wolframin and many mutations in the wolframin gene resulting in Wolfram syndrome may contribute to different phenotypes and the unusual combinations of clinical features. We describe a female patient with Wolfram syndrome diagnosed at the age of 25, with a previous false diagnosis of type 1 diabetes mellitus and misdiagnosed diabetic complications. The patient was found to be a compound heterozygote for two novel mutations in exon 8 of WFS1 gene: a 2-bp deletion AT at nt 1539 leading to a frameshift (Y513fs) and a single-base substitution 1174C > T resulting in a stop codon (Q392X). A detailed analysis of the patient's medical history and a review of the literature suggest that many cases of Wolfram syndrome may remain undiagnosed due to misdiagnosis as type 1 diabetes mellitus and incorrect interpretation of clinical symptoms of neurodegenerative abnormalities, especially in their early stages.

Point-of-Care Ultrasound: Sonographic Posterior Fat Pad Sign: A Case Report and Brief Literature Review.

PubMed

Okumura, Yoshito; Maldonado, Nestor; Lennon, Kyle; McCarty, Bryan; Underwood, Philipp; Nelson, Mathew

2017-07-01

Diagnosis of elbow fracture can sometimes be difficult with plain radiography due to overlapping bones, growth plates, and maturing bones in the pediatric population. The radiographic posterior fat pad (PFP) sign is one of the frequently referenced indirect signs of an occult elbow fracture. This sign can be falsely negative if the sign is subtle, and can be falsely positive when the position of the elbow is not flexed at 90 degrees. We discuss a case in which sonographic PFP sign helped to diagnose an elbow fracture. A 57-year-old female presented to the emergency department (ED) after a fall on an outstretched hand. The point-of-care ultrasound (POCUS) was completed identifying an elevated PFP and an anechoic joint fluid collection with innumerous floating hyperechogenic spicules visualized in the olecranon fossa. Diagnosis of a radial head fracture was later confirmed by plain radiograph. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: The increase in use and availability of POCUS in the ED makes this a very practical application. Our ability to rapidly perform the ultrasound of the elbow may allow us a more rapid diagnosis of pathology, as well as provide a way to further triage our patients. With time, it may even allow us to avoid routine use of plain radiography. Copyright © 2017 Elsevier Inc. All rights reserved.

The impact of non-concordant self-report of substance use in clinical trials research.

PubMed

Clark, C Brendan; Zyambo, Cosmas M; Li, Ye; Cropsey, Karen L

2016-07-01

Studies comparing self-report substance use data to biochemical verification generally demonstrate high rates of concordance. We argue that these rates are due to the relatively high true negative rate in the general population, and high degree of honestly in treatment seeking individuals. We hypothesized that high risk individuals not seeking treatment would demonstrate low concordance and a high false negative rate of self-reported substance use. A sample of 500 individuals from a smoking cessation clinical trial was assessed over 1 year. Assessments included semi-structured interviews, questionnaires (e.g. Addiction Severity Index, etc.), and urine drug screen assays (UDS). Generalized estimating equations (GEEs) were used to predict false negative reports for various substances across the study and determine the influence of substance use on the primary study outcome of smoking cessation. Participants demonstrated high false negative rates in reporting substances use, and the false negative rates increased as the study progressed. Established predictors of false negatives generalized to the current sample. High concordance and low false negative rates were found in self-report of nicotine use. A small but significant relationship was found in for effect of biochemically verified substance use on smoking cessation. Biochemical verification of substance use is needed in high risk populations involved in studies not directly related to the treatment of substance use, especially in populations with high threat of stigmatization. Testing should continue through the time period of the study for maximal identification of substance use. Copyright © 2016 Elsevier Ltd. All rights reserved.

Similarity based false-positive reduction for breast cancer using radiographic and pathologic imaging features

NASA Astrophysics Data System (ADS)

Pai, Akshay; Samala, Ravi K.; Zhang, Jianying; Qian, Wei

2010-03-01

Mammography reading by radiologists and breast tissue image interpretation by pathologists often leads to high False Positive (FP) Rates. Similarly, current Computer Aided Diagnosis (CADx) methods tend to concentrate more on sensitivity, thus increasing the FP rates. A novel method is introduced here which employs similarity based method to decrease the FP rate in the diagnosis of microcalcifications. This method employs the Principal Component Analysis (PCA) and the similarity metrics in order to achieve the proposed goal. The training and testing set is divided into generalized (Normal and Abnormal) and more specific (Abnormal, Normal, Benign) classes. The performance of this method as a standalone classification system is evaluated in both the cases (general and specific). In another approach the probability of each case belonging to a particular class is calculated. If the probabilities are too close to classify, the augmented CADx system can be instructed to have a detailed analysis of such cases. In case of normal cases with high probability, no further processing is necessary, thus reducing the computation time. Hence, this novel method can be employed in cascade with CADx to reduce the FP rate and also avoid unnecessary computational time. Using this methodology, a false positive rate of 8% and 11% is achieved for mammography and cellular images respectively.

Performance of Self-Report to Establish Cancer Diagnoses in Disaster Responders and Survivors, World Trade Center Health Registry, New York, 2001-2007.

PubMed

Li, Jiehui; Cone, James E; Alt, Abigail K; Wu, David R; Liff, Jonathan M; Farfel, Mark R; Stellman, Steven D

2016-01-01

Large-scale disasters may disrupt health surveillance systems, depriving health officials and researchers of timely and accurate information needed to assess disaster-related health effects and leading to use of less reliable self-reports of health outcomes. In particular, ascertainment of cancer in a population is ordinarily obtained through linkage of self-reported data with regional cancer registries, but exclusive reliance on these sources following a disaster may result in lengthy delays or loss of critical data. To assess the impact of such reliance, we validated self-reported cancer in a cohort of 59,340 responders and survivors of the World Trade Center disaster against data from 11 state cancer registries (SCRs). We focused on residents of the 11 states with SCRs and on cancers diagnosed from September 11, 2001, to the date of their last survey participation. Medical records were also sought in a subset of 595 self-reported cancer patients who were not recorded in an SCR. Overall sensitivity and specificity of self-reported cancer were 83.9% (95% confidence interval [CI] 81.9, 85.9) and 98.5% (95% CI 98.4, 98.6), respectively. Site-specific sensitivities were highest for pancreatic (90.9%) and testicular (82.4%) cancers and multiple myeloma (84.6%). Compared with enrollees with true-positive reports, enrollees with false-negative reports were more likely to be non-Hispanic black (adjusted odds ratio [aOR] = 1.8, 95% CI 1.2, 2.9) or Asian (aOR=2.2, 95% CI 1.2, 4.1). Among the 595 cases not recorded in an SCR, 13 of 62 (21%) cases confirmed through medical records were reportable to SCRs. Self-report of cancer had relatively high sensitivity among adults exposed to the World Trade Center disaster, suggesting that self-reports of other disaster-related conditions less amenable to external validation may also be reasonably valid.

Performance of Self-Report to Establish Cancer Diagnoses in Disaster Responders and Survivors, World Trade Center Health Registry, New York, 2001–2007

PubMed Central

Cone, James E.; Alt, Abigail K.; Wu, David R.; Liff, Jonathan M.; Farfel, Mark R.; Stellman, Steven D.

2016-01-01

Objective Large-scale disasters may disrupt health surveillance systems, depriving health officials and researchers of timely and accurate information needed to assess disaster-related health effects and leading to use of less reliable self-reports of health outcomes. In particular, ascertainment of cancer in a population is ordinarily obtained through linkage of self-reported data with regional cancer registries, but exclusive reliance on these sources following a disaster may result in lengthy delays or loss of critical data. To assess the impact of such reliance, we validated self-reported cancer in a cohort of 59,340 responders and survivors of the World Trade Center disaster against data from 11 state cancer registries (SCRs). Methods We focused on residents of the 11 states with SCRs and on cancers diagnosed from September 11, 2001, to the date of their last survey participation. Medical records were also sought in a subset of 595 self-reported cancer patients who were not recorded in an SCR. Results Overall sensitivity and specificity of self-reported cancer were 83.9% (95% confidence interval [CI] 81.9, 85.9) and 98.5% (95% CI 98.4, 98.6), respectively. Site-specific sensitivities were highest for pancreatic (90.9%) and testicular (82.4%) cancers and multiple myeloma (84.6%). Compared with enrollees with true-positive reports, enrollees with false-negative reports were more likely to be non-Hispanic black (adjusted odds ratio [aOR] = 1.8, 95% CI 1.2, 2.9) or Asian (aOR=2.2, 95% CI 1.2, 4.1). Among the 595 cases not recorded in an SCR, 13 of 62 (21%) cases confirmed through medical records were reportable to SCRs. Conclusion Self-report of cancer had relatively high sensitivity among adults exposed to the World Trade Center disaster, suggesting that self-reports of other disaster-related conditions less amenable to external validation may also be reasonably valid. PMID:27252562

False lock performance in polarity-type Costas receivers in the presence of periodic data patterns

NASA Technical Reports Server (NTRS)

Wang, James June-Ming; Lai, Dennis Teng-Tsun; Heng, Veronica Siang-Gek; Godfrey, Robert D.

1987-01-01

The authors address the false-lock performance of receivers which use polarity-type Costas loops for the carrier recovery of unbalanced quadrature phase-shift keyed (QPSK), asynchronous QPSK or binary PSK (BPSK) signals in the presence of periodic data patterns. The potential false-lock frequencies are first identified. Expressions for both true-lock and false-lock components are also derived, thereby allowing numerical evaluation of various key parameters for cases of practical interest.

Analysing the quality of routine malaria data in Mozambique.

PubMed

Chilundo, Baltazar; Sundby, Johanne; Aanestad, Margunn

2004-03-03

In Mozambique, malaria is the principal cause of morbidity and mortality. Efforts are being made to increase control activities within communities. These activities require management decisions based on evidence of malaria incidence. Although some data generated are of poor quality, there is little research towards improving the reporting systems. An analysis of the quality of routine malaria data was performed in selected districts in Southern Mozambique from August to September 2003. The aim was to assess the quality of the source data in terms of completeness, correctness and consistency across management levels. Analysis revealed primary data to be of poor quality. The diversity of reporting systems with limited coordination give rise to redundancies and wastage of resources. There was evidence of "invention" of data in health facilities contributing to an incorrect representation of malaria incidence. Large, "non-clinical", time-based variations of malaria cases due to reporting delays were also noted, contributing to false alerts of outbreaks.Furthermore, targets established in the national strategic plan for malaria cannot be calculated through the existing systems; this is the case, for example, for data related to pregnant women and children under-five years. The existing reporting system for malaria is currently not satisfying the information needs of managers. It is suggested that one standardized system, including the creation of one form to include the essential variables required for the calculation of key indicators by age, gender and pregnancy status, and to establish a national database that maps malaria by location.

[Tarantism in Spain in the eighteen century: latrodectism and suggestion].

PubMed

Corral-Corral, I; Corral-Corral, C

2016-10-16

Tarantism is the disease caused by the bite of the tarantula, in which the music tarantella triggers an involuntary dance. It is known in Italy since the sixteenth century. To analyze the tarantism reported in Spain at the end of the eighteenth century, with special attention to its neurological aspects, and to propose its medical and psychopathological explanation. An epidemic of people affected by the tarantula bite occurred in Spain in 1782. Spanish doctors described appropriately the clinical effects, identical to those produced by the bite of the spider black widow (Latrodectus tredecimguttatus), which was at that time identified as a tarantula. The cases reported by Francisco Xavier Cid cured with the involuntary dance triggered by the tarantella, as was described in Italy since the sixteenth century. Our interpretation is that this curative effect of dance in Spain was induced by suggestion. In Spanish patients there were no behavioral disturbances, periodic recurrences or collective involvement as those reported by Italian authors, which suggest an hysterical phenomenon, probably a continuation of the dancing mania of the Middle Age. Tarantism reported in Spain in the eighteenth century includes two different phenomena: the systemic symptoms produced by the tarantula bite, which is actually latrodectism, and the curative effect of the tarantella, explained by suggestion. The psychiatric disturbances, with a hysterical nature, falsely associated to the tarantula bite, observed in Italy, were not present among the Spanish cases of tarantism in the eighteenth century.

Optimized molecular resolution of cross-contamination alerts in clinical mycobacteriology laboratories.

PubMed

Martín, Ana; Herranz, Marta; Lirola, Miguel Martínez; Fernández, Rosa Fernández; Bouza, Emilio; García de Viedma, Darío

2008-02-14

The phenomenon of misdiagnosing tuberculosis (TB) by laboratory cross-contamination when culturing Mycobacterium tuberculosis (MTB) has been widely reported and it has an obvious clinical, therapeutic and social impact. The final confirmation of a cross-contamination event requires the molecular identification of the same MTB strain cultured from both the potential source of the contamination and from the false-positive candidate. The molecular tool usually applied in this context is IS6110-RFLP which takes a long time to provide an answer, usually longer than is acceptable for microbiologists and clinicians to make decisions. Our purpose in this study is to evaluate a novel PCR-based method, MIRU-VNTR as an alternative to assure a rapid and optimized analysis of cross-contamination alerts. MIRU-VNTR was prospectively compared with IS6110-RFLP for clarifying 19 alerts of false positivity from other laboratories. MIRU-VNTR highly correlated with IS6110-RFLP, reduced the response time by 27 days and clarified six alerts unresolved by RFLP. Additionally, MIRU-VNTR revealed complex situations such as contamination events involving polyclonal isolates and a false-positive case due to the simultaneous cross-contamination from two independent sources. Unlike standard RFLP-based genotyping, MIRU-VNTR i) could help reduce the impact of a false positive diagnosis of TB, ii) increased the number of events that could be solved and iii) revealed the complexity of some cross-contamination events that could not be dissected by IS6110-RFLP.

Clinical outcome of subchromosomal events detected by whole‐genome noninvasive prenatal testing

PubMed Central

Helgeson, J.; Wardrop, J.; Boomer, T.; Almasri, E.; Paxton, W. B.; Saldivar, J. S.; Dharajiya, N.; Monroe, T. J.; Farkas, D. H.; Grosu, D. S.

2015-01-01

Abstract Objective A novel algorithm to identify fetal microdeletion events in maternal plasma has been developed and used in clinical laboratory‐based noninvasive prenatal testing. We used this approach to identify the subchromosomal events 5pdel, 22q11del, 15qdel, 1p36del, 4pdel, 11qdel, and 8qdel in routine testing. We describe the clinical outcomes of those samples identified with these subchromosomal events. Methods Blood samples from high‐risk pregnant women submitted for noninvasive prenatal testing were analyzed using low coverage whole genome massively parallel sequencing. Sequencing data were analyzed using a novel algorithm to detect trisomies and microdeletions. Results In testing 175 393 samples, 55 subchromosomal deletions were reported. The overall positive predictive value for each subchromosomal aberration ranged from 60% to 100% for cases with diagnostic and clinical follow‐up information. The total false positive rate was 0.0017% for confirmed false positives results; false negative rate and sensitivity were not conclusively determined. Conclusion Noninvasive testing can be expanded into the detection of subchromosomal copy number variations, while maintaining overall high test specificity. In the current setting, our results demonstrate high positive predictive values for testing of rare subchromosomal deletions. © 2015 The Authors. Prenatal Diagnosis published by John Wiley & Sons Ltd. PMID:26088833

Surgical repair of the iatrogenic falsepassage in the treatment of trauma-induced posterior urethral injuries.

PubMed

Dogan, Faruk; Sahin, Ali Feyzullah; Sarıkaya, Tevfik; Dırık, Alper

2014-03-28

Pelvic fracture associated urethral injury (PFAUI) is a rare and challenging sequel of blunt pelvic trauma. Treatment of iatrogenic false urethral passage (FUP) remains as a challenge for urologists. In this case report we reviewed the iatrogenic FUP caused by wrong procedures performed in the treatment of a patient with PFAUI and the treatment of posterior urethral stricture with transperineal bulbo-prostatic anatomic urethroplasty in the management of FUP. A 37-year-old male patient with PFAUI had undergone a laparotomy procedure for pelvic bone fracture, complete urethral rupture, and bladder perforation 8 years ago. After stricture formation, patient had undergone procedures that caused FUP. Following operations, he had a low urinary flow rate, and incontinence and urgency even with small amounts of urine. FUP was diagnosed by voiding cystourethrography and retrograde urethrography. FUP was fixed with open urethroplasty with the guidance of flexible antegrade urethtoscopy. False passage should always be taken into account in the differential diagnosis of patients with persistent symptoms that underwent PFAUI therapy. In addition, we believe that in the evaluation of patients with PFAUI suspected for having a false passage, bladder neck and urethra should be assessed by combining routine voiding cystourethrography and retrograde urethrography with preoperative flexible cystoscopy via suprapubic route.

30 CFR 816.13 - Casing and sealing of drilled holes: General requirements.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 30 Mineral Resources 3 2010-07-01 2010-07-01 false Casing and sealing of drilled holes: General...-SURFACE MINING ACTIVITIES § 816.13 Casing and sealing of drilled holes: General requirements. Each exploration hole, other drill or borehole, well, or other exposed underground opening shall be cased, sealed...

29 CFR 101.17 - Initiation of representation cases and petitions for clarification and amendment.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 29 Labor 2 2011-07-01 2011-07-01 false Initiation of representation cases and petitions for... BOARD STATEMENTS OF PROCEDURES Representation Cases Under Section 9(c) of the Act and Petitions for... Initiation of representation cases and petitions for clarification and amendment. The investigation of the...

29 CFR 101.17 - Initiation of representation cases and petitions for clarification and amendment.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 29 Labor 2 2014-07-01 2014-07-01 false Initiation of representation cases and petitions for... BOARD STATEMENTS OF PROCEDURES Representation Cases Under Section 9(c) of the Act and Petitions for... Initiation of representation cases and petitions for clarification and amendment. The investigation of the...

30 CFR 816.13 - Casing and sealing of drilled holes: General requirements.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 30 Mineral Resources 3 2011-07-01 2011-07-01 false Casing and sealing of drilled holes: General...-SURFACE MINING ACTIVITIES § 816.13 Casing and sealing of drilled holes: General requirements. Each exploration hole, other drill or borehole, well, or other exposed underground opening shall be cased, sealed...

30 CFR 816.13 - Casing and sealing of drilled holes: General requirements.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 30 Mineral Resources 3 2014-07-01 2014-07-01 false Casing and sealing of drilled holes: General...-SURFACE MINING ACTIVITIES § 816.13 Casing and sealing of drilled holes: General requirements. Each exploration hole, other drill or borehole, well, or other exposed underground opening shall be cased, sealed...

30 CFR 816.13 - Casing and sealing of drilled holes: General requirements.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 30 Mineral Resources 3 2012-07-01 2012-07-01 false Casing and sealing of drilled holes: General...-SURFACE MINING ACTIVITIES § 816.13 Casing and sealing of drilled holes: General requirements. Each exploration hole, other drill or borehole, well, or other exposed underground opening shall be cased, sealed...

30 CFR 816.13 - Casing and sealing of drilled holes: General requirements.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 30 Mineral Resources 3 2013-07-01 2013-07-01 false Casing and sealing of drilled holes: General...-SURFACE MINING ACTIVITIES § 816.13 Casing and sealing of drilled holes: General requirements. Each exploration hole, other drill or borehole, well, or other exposed underground opening shall be cased, sealed...

46 CFR 160.171-13 - Storage case.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 46 Shipping 6 2011-10-01 2011-10-01 false Storage case. 160.171-13 Section 160.171-13 Shipping...: SPECIFICATIONS AND APPROVAL LIFESAVING EQUIPMENT Immersion Suits § 160.171-13 Storage case. (a) Each suit must have a storage case made of vinyl coated cloth or material that provides an equivalent measure of...

46 CFR 160.171-13 - Storage case.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 46 Shipping 6 2010-10-01 2010-10-01 false Storage case. 160.171-13 Section 160.171-13 Shipping...: SPECIFICATIONS AND APPROVAL LIFESAVING EQUIPMENT Immersion Suits § 160.171-13 Storage case. (a) Each suit must have a storage case made of vinyl coated cloth or material that provides an equivalent measure of...

46 CFR 160.171-13 - Storage case.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 46 Shipping 6 2014-10-01 2014-10-01 false Storage case. 160.171-13 Section 160.171-13 Shipping...: SPECIFICATIONS AND APPROVAL LIFESAVING EQUIPMENT Immersion Suits § 160.171-13 Storage case. (a) Each suit must have a storage case made of vinyl coated cloth or material that provides an equivalent measure of...

46 CFR 160.171-13 - Storage case.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 46 Shipping 6 2013-10-01 2013-10-01 false Storage case. 160.171-13 Section 160.171-13 Shipping...: SPECIFICATIONS AND APPROVAL LIFESAVING EQUIPMENT Immersion Suits § 160.171-13 Storage case. (a) Each suit must have a storage case made of vinyl coated cloth or material that provides an equivalent measure of...

46 CFR 160.171-13 - Storage case.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 46 Shipping 6 2012-10-01 2012-10-01 false Storage case. 160.171-13 Section 160.171-13 Shipping...: SPECIFICATIONS AND APPROVAL LIFESAVING EQUIPMENT Immersion Suits § 160.171-13 Storage case. (a) Each suit must have a storage case made of vinyl coated cloth or material that provides an equivalent measure of...

20 CFR 702.104 - Transfer of individual case file.

Code of Federal Regulations, 2012 CFR

2012-04-01

... Provisions Administration § 702.104 Transfer of individual case file. (a) At any time after a claim is filed... 20 Employees' Benefits 4 2012-04-01 2012-04-01 false Transfer of individual case file. 702.104... Director, transfer such case to the district director in another compensation district for the purpose of...

20 CFR 702.104 - Transfer of individual case file.

Code of Federal Regulations, 2011 CFR

2011-04-01

... Provisions Administration § 702.104 Transfer of individual case file. (a) At any time after a claim is filed... 20 Employees' Benefits 3 2011-04-01 2011-04-01 false Transfer of individual case file. 702.104... Director, transfer such case to the district director in another compensation district for the purpose of...

45 CFR 303.11 - Case closure criteria.

Code of Federal Regulations, 2011 CFR

2011-10-01

... the best interests of the child to establish paternity in a case involving incest or forcible rape, or... 45 Public Welfare 2 2011-10-01 2011-10-01 false Case closure criteria. 303.11 Section 303.11... STANDARDS FOR PROGRAM OPERATIONS § 303.11 Case closure criteria. (a) The IV-D agency shall establish a...

Assessment of rates of recanting and hair testing as a biological measure of drug use in a general population sample of young people.

PubMed

Taylor, Michelle; Sullivan, John; Ring, Susan M; Macleod, John; Hickman, Matthew

2017-03-01

We investigate the extent of and factors associated with denial of previously reported cannabis and other illicit drug use, and assess the potential of hair testing for measuring substance use in general population samples. Birth cohort study. United Kingdom, 1991-present. A total of 3643 participants who provided hair and self-report measures of cannabis and other illicit drug use in the Avon Longitudinal Study of Parents and Children (ALSPAC) at age 18 years. Denial of ever use of cannabis and other illicit drugs at age 18 following previously reported use. Positive hair drug tests for cannabis and other illicit drugs, and expected numbers of false positives and false negatives based on expected sensitivity and specificity. Cannabis and other illicit drug use was reported by 1223 and 393 individuals, respectively, before age 18 years. Of these 176 (14.4%) and 99 (25.2%), respectively, denied use at age 18. Denial of cannabis use decreased with the reporting of other substances and antisocial behaviour. Cannabis and other illicit drug use at age 18 was reported by 547 (22.5%) and 203 (8.4%) individuals, respectively. Of these, 111 (20.3%) and 13 (6.4%) were hair-positive for cannabis and other illicit drugs, respectively. Based on hair testing for cannabis use we expect 0 [95% confidence interval (CI) = 0-169] false positives and 394 (95% CI = 323-449) false negatives compared to observed 362 potential false positives and 436 potential false negatives based on self-report. In hair-positive individuals, reporting the use of other substances and antisocial behaviour decreased the odds of a negative self-report. Hair analysis provides an unreliable marker of substance use in general population samples. People who report more frequent substance use before age 18 are less likely to later deny previous substance use at age 18 than people who report occasional use. © 2016 The Authors. Addiction published by John Wiley & Sons Ltd on behalf of Society for the Study of Addiction.

Assessment of rates of recanting and hair testing as a biological measure of drug use in a general population sample of young people

PubMed Central

Sullivan, John; Ring, Susan M.; Macleod, John; Hickman, Matthew

2016-01-01

Abstract Aims We investigate the extent of and factors associated with denial of previously reported cannabis and other illicit drug use, and assess the potential of hair testing for measuring substance use in general population samples. Design Birth cohort study. Setting United Kingdom, 1991–present. Participants A total of 3643 participants who provided hair and self‐report measures of cannabis and other illicit drug use in the Avon Longitudinal Study of Parents and Children (ALSPAC) at age 18 years. Measurements Denial of ever use of cannabis and other illicit drugs at age 18 following previously reported use. Positive hair drug tests for cannabis and other illicit drugs, and expected numbers of false positives and false negatives based on expected sensitivity and specificity. Findings Cannabis and other illicit drug use was reported by 1223 and 393 individuals, respectively, before age 18 years. Of these 176 (14.4%) and 99 (25.2%), respectively, denied use at age 18. Denial of cannabis use decreased with the reporting of other substances and antisocial behaviour. Cannabis and other illicit drug use at age 18 was reported by 547 (22.5%) and 203 (8.4%) individuals, respectively. Of these, 111 (20.3%) and 13 (6.4%) were hair‐positive for cannabis and other illicit drugs, respectively. Based on hair testing for cannabis use we expect 0 [95% confidence interval (CI) = 0–169] false positives and 394 (95% CI = 323–449) false negatives compared to observed 362 potential false positives and 436 potential false negatives based on self‐report. In hair‐positive individuals, reporting the use of other substances and antisocial behaviour decreased the odds of a negative self‐report. Conclusions Hair analysis provides an unreliable marker of substance use in general population samples. People who report more frequent substance use before age 18 are less likely to later deny previous substance use at age 18 than people who report occasional use. PMID:27743424

Garbage in, Garbage Out: Data Collection, Quality Assessment and Reporting Standards for Social Media Data Use in Health Research, Infodemiology and Digital Disease Detection

PubMed Central

Huang, Jidong; Emery, Sherry

2016-01-01

Background Social media have transformed the communications landscape. People increasingly obtain news and health information online and via social media. Social media platforms also serve as novel sources of rich observational data for health research (including infodemiology, infoveillance, and digital disease detection detection). While the number of studies using social data is growing rapidly, very few of these studies transparently outline their methods for collecting, filtering, and reporting those data. Keywords and search filters applied to social data form the lens through which researchers may observe what and how people communicate about a given topic. Without a properly focused lens, research conclusions may be biased or misleading. Standards of reporting data sources and quality are needed so that data scientists and consumers of social media research can evaluate and compare methods and findings across studies. Objective We aimed to develop and apply a framework of social media data collection and quality assessment and to propose a reporting standard, which researchers and reviewers may use to evaluate and compare the quality of social data across studies. Methods We propose a conceptual framework consisting of three major steps in collecting social media data: develop, apply, and validate search filters. This framework is based on two criteria: retrieval precision (how much of retrieved data is relevant) and retrieval recall (how much of the relevant data is retrieved). We then discuss two conditions that estimation of retrieval precision and recall rely on—accurate human coding and full data collection—and how to calculate these statistics in cases that deviate from the two ideal conditions. We then apply the framework on a real-world example using approximately 4 million tobacco-related tweets collected from the Twitter firehose. Results We developed and applied a search filter to retrieve e-cigarette–related tweets from the archive based on three keyword categories: devices, brands, and behavior. The search filter retrieved 82,205 e-cigarette–related tweets from the archive and was validated. Retrieval precision was calculated above 95% in all cases. Retrieval recall was 86% assuming ideal conditions (no human coding errors and full data collection), 75% when unretrieved messages could not be archived, 86% assuming no false negative errors by coders, and 93% allowing both false negative and false positive errors by human coders. Conclusions This paper sets forth a conceptual framework for the filtering and quality evaluation of social data that addresses several common challenges and moves toward establishing a standard of reporting social data. Researchers should clearly delineate data sources, how data were accessed and collected, and the search filter building process and how retrieval precision and recall were calculated. The proposed framework can be adapted to other public social media platforms. PMID:26920122

40 CFR 403.12 - Reporting requirements for POTW's and industrial users.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 40 Protection of Environment 30 2012-07-01 2012-07-01 false Reporting requirements for POTW's and...)], I certify that, to the best of my knowledge and belief, there has been no increase in the level of...) Provisions Governing Fraud and False Statements: The reports and other documents required to be submitted or...

26 CFR 1.6038B-1 - Reporting of certain transfers to foreign corporations.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 26 Internal Revenue 13 2012-04-01 2012-04-01 false Reporting of certain transfers to foreign... and complete to the best of the transferor's knowledge and belief. For taxable years beginning after... required to be reported under the rules of this section; or (ii) The provision of false or inaccurate...

26 CFR 1.6038B-1 - Reporting of certain transfers to foreign corporations.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 26 Internal Revenue 13 2011-04-01 2011-04-01 false Reporting of certain transfers to foreign... and complete to the best of the transferor's knowledge and belief. For taxable years beginning after... required to be reported under the rules of this section; or (ii) The provision of false or inaccurate...

26 CFR 1.6038B-1 - Reporting of certain transfers to foreign corporations.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 26 Internal Revenue 13 2010-04-01 2010-04-01 false Reporting of certain transfers to foreign... and complete to the best of the transferor's knowledge and belief. For taxable years beginning after... required to be reported under the rules of this section; or (ii) The provision of false or inaccurate...

A Serial Munchausen Syndrome by Proxy.

PubMed

Unal, Esra Ozgun; Unal, Volkan; Gul, Ali; Celtek, Mustafa; Dıken, Behzat; Balcıoglu, İbrahim

2017-01-01

Munchausen syndrome by proxy (MSBP) is a form of child abuse that describes children whose parents or caregivers invent illness stories and substantiate the stories by fabricating false physical signs. Through this case report, a serial MSBP case is presented along with psychiatric evaluation of the perpetrator mother who was sent to the Forensic Psychiatric Observation Department of the Council of Forensic Medicine to assess whether she has any mental disorder. Although there are several studies on MSBP, we present this case because the perpetrator mother was caught on the camera surveillance system of the hospital while closing the nose and mouth of the victim for fabricating the illness, and she also said that she had done the same thing to her two elder children to exclude their illnesses. Her two children had died and could not be diagnosed. Moreover, we discuss the psychopathology of the perpetrators, which is a less known area of MSBP. This is a very serious form of child abuse, with a high risk of repetition, and failure to diagnose might result in the death of the child.

A Serial Munchausen Syndrome by Proxy

PubMed Central

Unal, Esra Ozgun; Unal, Volkan; Gul, Ali; Celtek, Mustafa; Dıken, Behzat; Balcıoglu, İbrahim

2017-01-01

Munchausen syndrome by proxy (MSBP) is a form of child abuse that describes children whose parents or caregivers invent illness stories and substantiate the stories by fabricating false physical signs. Through this case report, a serial MSBP case is presented along with psychiatric evaluation of the perpetrator mother who was sent to the Forensic Psychiatric Observation Department of the Council of Forensic Medicine to assess whether she has any mental disorder. Although there are several studies on MSBP, we present this case because the perpetrator mother was caught on the camera surveillance system of the hospital while closing the nose and mouth of the victim for fabricating the illness, and she also said that she had done the same thing to her two elder children to exclude their illnesses. Her two children had died and could not be diagnosed. Moreover, we discuss the psychopathology of the perpetrators, which is a less known area of MSBP. This is a very serious form of child abuse, with a high risk of repetition, and failure to diagnose might result in the death of the child. PMID:29200568

Are Clinicians Better Than Lay Judges at Recalling Case Details? An Evaluation of Expert Memory.

PubMed

Webb, Christopher A; Keeley, Jared W; Eakin, Deborah K

2016-04-01

This study examined the role of expertise in clinicians' memory for case details. Clinicians' diagnostic formulations may afford mechanisms for retaining and retrieving information. Experts (N = 41; 47.6% males, 23.8% females; 28.6% did not report gender; age: mean [M] = 54.69) were members of the American Board of Professional Psychologists. Lay judges (N = 156; 25.4% males, 74.1% females; age: M = 18.85) were undergraduates enrolled in general psychology. Three vignettes were presented to each group, creating a 2 (group: expert, lay judge) x 3 (vignettes: simple, complex-coherent, complex-incoherent) mixed factorial design. Recall accuracy for vignette details was the dependent variable. Data analyses used multivariate analyses of variance to detect group differences among multiple continuous variables. Experts recalled more information than lay judges, overall. However, experts also exhibited more false memories for the complex-incoherent case because of their schema-based knowledge. This study supported clinical expertise as beneficial. Nonetheless, negative influences from experts' schema-based knowledge, as exhibited, could adversely affect clinical practices. © 2016 Wiley Periodicals, Inc.

Use of an electronic medical record for the identification of research subjects with diabetes mellitus.

PubMed

Wilke, Russell A; Berg, Richard L; Peissig, Peggy; Kitchner, Terrie; Sijercic, Bozana; McCarty, Catherine A; McCarty, Daniel J

2007-03-01

Diabetes mellitus is a rapidly increasing and costly public health problem. Large studies are needed to understand the complex gene-environment interactions that lead to diabetes and its complications. The Marshfield Clinic Personalized Medicine Research Project (PMRP) represents one of the largest population-based DNA biobanks in the United States. As part of an effort to begin phenotyping common diseases within the PMRP, we now report on the construction of a diabetes case-finding algorithm using electronic medical record data from adult subjects aged > or =50 years living in one of the target PMRP ZIP codes. Based upon diabetic diagnostic codes alone, we observed a false positive case rate ranging from 3.0% (in subjects with the highest glycosylated hemoglobin values) to 44.4% (in subjects with the lowest glycosylated hemoglobin values). We therefore developed an improved case finding algorithm that utilizes diabetic diagnostic codes in combination with clinical laboratory data and medication history. This algorithm yielded an estimated prevalence of 24.2% for diabetes mellitus in adult subjects aged > or =50 years.

7 CFR 29.6005 - Case (order).

Code of Federal Regulations, 2013 CFR

2013-01-01

... 7 Agriculture 2 2013-01-01 2013-01-01 false Case (order). 29.6005 Section 29.6005 Agriculture Regulations of the Department of Agriculture AGRICULTURAL MARKETING SERVICE (Standards, Inspections, Marketing... content. ...

7 CFR 29.6005 - Case (order).

Code of Federal Regulations, 2011 CFR

2011-01-01

... 7 Agriculture 2 2011-01-01 2011-01-01 false Case (order). 29.6005 Section 29.6005 Agriculture Regulations of the Department of Agriculture AGRICULTURAL MARKETING SERVICE (Standards, Inspections, Marketing... content. ...

7 CFR 29.6005 - Case (order).

Code of Federal Regulations, 2012 CFR

2012-01-01

... 7 Agriculture 2 2012-01-01 2012-01-01 false Case (order). 29.6005 Section 29.6005 Agriculture Regulations of the Department of Agriculture AGRICULTURAL MARKETING SERVICE (Standards, Inspections, Marketing... content. ...

7 CFR 29.6005 - Case (order).

Code of Federal Regulations, 2014 CFR

2014-01-01

... 7 Agriculture 2 2014-01-01 2014-01-01 false Case (order). 29.6005 Section 29.6005 Agriculture Regulations of the Department of Agriculture AGRICULTURAL MARKETING SERVICE (Standards, Inspections, Marketing... content. ...

7 CFR 29.6005 - Case (order).

Code of Federal Regulations, 2010 CFR

2010-01-01

... 7 Agriculture 2 2010-01-01 2010-01-01 false Case (order). 29.6005 Section 29.6005 Agriculture Regulations of the Department of Agriculture AGRICULTURAL MARKETING SERVICE (Standards, Inspections, Marketing... content. ...

A historical note on false traumatic memories.

PubMed

Rosen, Gerald M; Sageman, Marc; Loftus, Elizabeth

2004-01-01

Unhampered by current ethical standards and human subject committees, H. Bernheim (1889) created a false memory of a horrific traumatic event. Bernheim also demonstrated his subject's willingness to discuss the implanted memory with a representative of the law. Bernheim's work represents the first documented case of an implanted false traumatic memory, with direct relevance to contemporary debates. Copyright 2003 Wiley Periodicals, Inc. J Clin Psychol.

Noninvasive Follicular Thyroid Neoplasm with Papillary-Like Nuclear Features: Can Cytology Face the Challenge of Diagnosis in the Light of the New Classification?

PubMed

Díaz Del Arco, Cristina; Fernández Aceñero, M Jesús

2018-06-01

To assess the cytological findings of noninvasive follicular thyroid neoplasms with papillary-like nuclear features (NIFTP), conventional papillary thyroid carcinomas (C-PTC), and invasive follicular variants of papillary thyroid carcinomas (IFV-PTC) to determine if there are cytological differences between groups. We have reviewed all thyroid fine-needle aspiration cytology samples diagnosed between 2000 and 2017. We have included all NIFTP cases (n = 6) and randomly selected cases of C-PTC (n = 14) and IFV-PTC (n = 8). Comparing NIFTP and C-PTC cases, NIFTP cases showed significantly less papillary or pseudopapillary architecture, more bidimensional groups and microfollicles, and less tridimensionality, giant cells, and nuclear folds. We observed a trend towards significance for smear cellularity and amount of cytoplasm. Presence of nuclear folds was the only significant difference between NIFTP and IFV-PTC cases. The differences between groups in percent papillary or pseudopapillary architecture, cellularity, and tridimensionality showed a trend towards significance. Amount of colloid, dirty background, pleomorphism or atypia, nuclear pseudoinclusions, type of chromatin, and nucleolus were not significant. No cytopathological feature can differentiate between invasive and encapsulated IFV-PTC. In accordance with the recently accepted category, PTC smears with cells arranged in a predominantly follicular architecture should be reported as Bethesda IV category with descriptive terms to avoid false-positive cases. © 2018 S. Karger AG, Basel.

The Importance of Comprehensive Cam Correction: Radiographic Parameters Are Predictive of Patient-Reported Outcome Measures at 2 Years After Hip Arthroscopy.

PubMed

Lansdown, Drew A; Kunze, Kyle; Ukwuani, Gift; Waterman, Brian R; Nho, Shane J

2018-06-01

The specific influence of preoperative and postoperative radiographic measurements on patient-reported outcome measures after hip arthroscopy for femoroacetabular impingement (FAI) remains unclear. To investigate the relationship between radiographic measurements and 2-year outcomes after hip arthroscopy for the treatment of FAI. Case series; Level of evidence, 4. A clinical registry of patients undergoing primary hip arthroscopy for FAI between January 1, 2012, and December 31, 2014, was queried. Outcome measures included the Hip Outcome Score (HOS) Activities of Daily Living (ADL), HOS Sport-Specific Subscale (SSS), modified Harris Hip Score (mHHS), and visual analog scale (VAS) for pain and satisfaction. Preoperative and postoperative radiographic measurements were recorded. Univariate analysis was conducted to identify relationships between all radiographic and demographic variables and outcome scores. A multivariate regression analysis, controlling for demographic factors, was used to identify independent associations between radiographic measurements on plain radiographs and patient-reported outcomes. The authors identified 707 patients who underwent primary hip arthroscopic management for FAI who were included for analysis. Two-year outcome surveys were completed for 78% to 84% of patients. The mean age of the patients was 33.2 ± 12.3 years, and 64.4% of the patients (n = 456) were female. The mean anteroposterior (AP) alpha angle decreased by 34.3° ( P < .0001), false profile alpha angle by 25.2° ( P < .0001), Dunn lateral alpha angle by 28.9° ( P < .0001), lateral center edge angle by 2.6° ( P < .0001), and anterior center edge angle by 3.4° ( P < .0001). The HOS-ADL score increased from 65.7 ± 18.7 preoperatively to 85.9 ± 16.7 postoperatively ( P < .0001), HOS-SSS increased from 43.4 ± 23.1 to 72.6 ± 27.2 ( P < .0001), and mHHS increased from 57.7 ± 14.0 to 79.1 ± 17.2 ( P < .0001). With multivariate analysis, independent predictors of the postoperative HOS-ADL score included the preoperative false profile alpha angle (beta = -0.16, P = .028). Independent predictors of HOS-SSS score were preoperative AP alpha angle (beta = -0.33, P = .032) and preoperative false profile alpha angle (beta = -0.28, P = .041). For the postoperative mHHS score, independent predictors included preoperative AP alpha angle (beta = -0.18, P = .046), preoperative false profile alpha angle (beta = -0.20, P = .014), and postoperative false profile alpha angle (beta = -0.48, P = .035). The preoperative AP alpha angle (beta = 0.28, P = .024) was a significant predictor for the postoperative VAS pain score. The preoperative false profile alpha angle (beta = -0.34, P = .040) was a significant predictor for the postoperative VAS satisfaction score. The authors observed that radiographic measurements, specifically the preoperative false profile alpha angle, AP alpha angle, and postoperative false profile alpha angle, are independent predictors of 2-year clinical outcomes. The femoral-side measurements were the strongest independent predictors of outcomes, especially measurements of the anterior and lateral-based CAM lesion.