Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “diagnostic optimization”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 685 records · Page 38Linked to original sources
PubMed1985

Magnifiers in dermatology: a personal survey.

Most dermatologists find some type of magnifying system useful in their practice. Over a period of 15 years, I evaluated magnifiers ranging from simple low-power, single-lens systems to a Zeiss operating microscope. This report reviews the various types of magnifiers available for examining the skin's surface and describes their optical characteristics. For the dermatologist a binocular loupe with magnification of 3X to 4X appears to be the most useful diagnostic magnifying device. Higher magnifications failed to yield additional clinically useful detail. Lower-power binocular magnifiers of 2X to 2.5X, although useful as a surgical aid, provided less-than-optimal magnification for diagnostic purposes. The ideal magnifier for each practitioner will depend on subjective needs, as well as optical characteristics. Currently available magnifiers are described and evaluated.

Dermatology↗
PubMed1986

Diagnosis of Pneumocystis carinii pneumonia. Roentgenographic-pathologic correlates based on fiberoptic bronchoscopy specimens from patients with the acquired immunodeficiency syndrome.

We analyzed the diagnosis of Pneumocystis carinii pneumonia by fiberoptic bronchoscopy in a large series of patients with the acquired immunodeficiency syndrome (AIDS). Transbronchial biopsy fragments, as opposed to endobronchial specimens, were found to have high diagnostic value. Their optimal number for diagnosis was determined by a simple statistical principle. It varied from a minimum of two in cases of severe pneumonia to a maximum of four when roentgenographic manifestations were altogether absent. The diagnostic yield of the transbronchial biopsy alone was 97 percent and that of "touch" preparations of the biopsies 88 percent; when both techniques were combined, the accuracy rose to 98 percent. By comparison, bronchial "washings" and "brushings" had a much lower yield, 59 percent and 57 percent, respectively. Because their diagnostic contribution was negligible, we conclude that the latter two procedures represent an unnecessary expense and waste of technical and professional effort.

Acquired Immunodeficiency Syndrome↗
PubMed1992

[Ultrasonic diagnosis of a hereditary multiple malformation syndrome: Meckel-Gruber syndrome or Carpenter-Hunter syndrome].

Concerned by 2 cases of a recurring multiple fetal malformation syndrome in a consanguineous couple, the authors present the ultrasonic, clinical and paraclinical data that, when introduced into a computerised prenatal diagnostic programme, suggest a Meckel-Gruber or Carpenter-Hunter syndrome. The discovery of single or multiple fetal malformations requires not only complete echographic assessment, but also detailed post-abortum examination to allow optimal use of diagnostic aid programmes.

Abnormalities, Multiple↗
PubMed2003

A computer-aided diagnostic system to characterize CT focal liver lesions: design and optimization of a neural network classifier.

In this paper, a computer-aided diagnostic (CAD) system for the classification of hepatic lesions from computed tomography (CT) images is presented. Regions of interest (ROIs) taken from nonenhanced CT images of normal liver, hepatic cysts, hemangiomas, and hepatocellular carcinomas have been used as input to the system. The proposed system consists of two modules: the feature extraction and the classification modules. The feature extraction module calculates the average gray level and 48 texture characteristics, which are derived from the spatial gray-level co-occurrence matrices, obtained from the ROIs. The classifier module consists of three sequentially placed feed-forward neural networks (NNs). The first NN classifies into normal or pathological liver regions. The pathological liver regions are characterized by the second NN as cyst or "other disease." The third NN classifies "other disease" into hemangioma or hepatocellular carcinoma. Three feature selection techniques have been applied to each individual NN: the sequential forward selection, the sequential floating forward selection, and a genetic algorithm for feature selection. The comparative study of the above dimensionality reduction methods shows that genetic algorithms result in lower dimension feature vectors and improved classification performance.

Algorithms↗
PubMed1979

Fasting and two-hour post-load glucose levels for the diagnosis of diabetes. The relationship between glucose levels and complications of diabetes in the Pima Indians.

The frequency distributions of both the fasting and two-hour post-load plasma glucose levels were bimodal in the Pima Indian population aged 25 years and over. The hyperglycaemic component of this distribution represents those with diabetes mellitus, as some 30 percent of this group had evidence of the specific vascular complications of the disease, whereas these abnormalities were virtually absent in those with lower glucose levels. The bimodal characteristics of the frequency distributions were utilized to define optimal criteria to separate those with and without diabetes. The sensitivity and specificity of these criteria for fasting and two-hour glucose levels were compared and were found to be similar. The fasting glucose determination, however, was more reproducible and stable, as well as being easier to obtain, indicating that it is the better measurement for diagnostic purposes. The optimal level for diagnosis of 7.5 mmol/l (136 mg/dl) for the fasting glucose and the equivalent two-hour value of 14 mmol/l (250 mg/dl), were higher than many previously recommended diagnostic levels. Nevertheless, there was no evidence that subjects with lower levels were at appreciable risk of developing the specific complications of diabetes. Subjects with impaired glucose tolerance (IGT), but without fasting hyperglycaemia, should not be diagnosed as having diabetes mellitus.

Adolescent↗
PubMedDate not supplied

[Prevalence of undiagnosed celiac disease in patients with irritated bowel syndrome].

In the article insufficiency of existing patterns of investigation of patients with irritated bowel syndrome (IBS) during differential diagnostics with celiac disease is underlined, that leads to wrong diagnostics and inefficient treatment of patients. Also own data on prevalence of celiac disease in patients with IBS are shown. Determination of the level of specific markers of celiac disease (in our research--antigliadin Ig) is considered to be the optimal method of diagnostic celiac disease in this group of patients.

Adolescent↗
PubMed2001

Community-acquired pneumonia. Diagnostic and therapeutic approach.

Optimal empiric therapy of CAP is with appropriate monotherapy (e.g., doxycycline, levofloxacin). Combination therapy is problematic because of potential side effects and high cost. Empiric coverage should have a high degree of activity against both typical and atypical pathogens. The antibiotic selected should have an excellent side-effect profile and be relatively inexpensive. Clinicians should be selective in their choice of antibiotic for CAP and choose an antimicrobial that has little or no resistance potential, is relatively inexpensive, and permits i.v.-to-PO switch monotherapy.

Anti-Bacterial Agents↗
PubMed2000

[Diagnostic evaluation of the breast using PET: optimization of data acquisition and postprocessing].

PURPOSE: Development and evaluation of an optimized protocol for PET examinations of the female breast with 2-F-18-fluoro-2-deoxyglucose (F-18-FDG). METHODS: All PET measurements were performed with a whole-body PET system (ECAT EXACT HR+). In order to examine the women with the breasts freely pendant, a special extension for the patient table made of carbon layer composite was designed. After data acquisition in the 3D modus, emission data were sorted into 2D sinograms using the Fourier rebinning algorithm and reconstructed by means of an ultra-fast iterative 2D algorithm (HOSP). The reconstructed emission scans were superimposed onto the corresponding transmission images. The protocol presented was evaluated in examinations on 6 women with breast lesions after the administration of 150-220 MBq F-18-FDG. From two adjacent bed positions, emission and transmission data were acquired over periods of 20 min and 10 min, respectively. For comparison, dynamic magnetic resonance (MR) image series were acquired with a whole-body MR system (MAGNETOM SP 4000) using a double-breast coil. RESULTS AND CONCLUSION: Using the designed extension of the patient table, it was possible to examine corpulent women despite the limited patient port of the PET system in the prone position with the breasts freely pendant. Alongside a reduction in motion artifacts, this positioning also offers the possibility of making a direct comparison between PET and MR images. Despite the fact that the amount of F-18-FDG applied to the patient was markedly reduced, the combination of 3D data acquisition and iterative image reconstruction resulted in excellent quality of the emission scans. By super-positioning of iteratively reconstructed emission and transmission scans, anatomical localization of breast lesions visualized on the emission scans could be improved. The postprocessing of the PET data described was completed in 60 min, this meaning that the presented concept can readily be employed in clinical practice.

Algorithms↗
PubMedDate not supplied

[Differential diagnosis of hepatocellular carcinoma using laser DNA-cytofluorometry].

Because of insufficient amount of material obtained in many cases of puncture biopsy, Differential diagnosis of hepatocellular carcinoma (HCC) with benign tumors and focal cirrhotic lesions of the liver is difficult. The study was aimed at development of additional criteria for HCC differential diagnosis of the basis of a comparison of morphological data (histological and cytological) with DNA content in the cells of focal lesion of the liver and is based on the research of biopsy material from 111 patients with focal liver lesions. Laser DNA flow cytometry (DNA-FCM) was carried out in 59 samples using laser flowing cytometer FACScan (Becton Dickinson, USA). The complex of three HCC histological criteria was established (trabecular histoarchitecture, increased nuclear-cytoplasmatic rate and nuclear crowding) for comparison with puncture biopsy of the liver (diagnostic efficiency 93.7%). Optimal quantitative parameters for HCC diagnosis were the following: reduction of the number of cells in a GO/1 phase of the cell cycle (< 77.5%), appearance of aneuploid clone of cell DNA index > 1.0 and decreased percent of binucleated cells (< 10%). Very high diagnostic specificity of the research was found (98.3%). Usage of quantitative parameters in the complex with histological criteria of HCC increased efficiency of the diagnosis up to 98%.

Aneuploidy↗
PubMed2002

Urinary tract infections in adult general practice patients.

Urinary tract infections (UTIs) are symptomatic infections of the urinary tract, mainly caused by the bacterium Escherichia coli. One in two women suffers from a UTI at least once in her life. The young and sexually active are particulaly affected, but it is also seen in elderly, postmenopausal women. The likelihood of recurrence is high. Diagnosis is made with regard to typical complaints and the presence of leucocytes and nitrites in the urine. A culture is unnecessary in most cases. Uncomplicated UTI should be distinguished from complicated UTI, which has a risk of severe illness. The treatment of choice--short-term therapy with trimethoprim or nitrofurantoin--is successful in over 80% of the cases. Co-trimoxazol fluoroquinolones or cephalsporins are not considered first-choice drugs. There are indications that general practitioners' (GPs') management of UTI is not always optimal, specifically concerning diagnostic tests, the application of second-choice antibiotics, and the length of prescribed treatment courses. Many points relevant to GPs requirefurther research, such as epidemiology and resistance of urinary pathogens in the community and natural history of UTI, as well as optimal management in elderly or complicated patients and men.

Adult↗
PubMed1992

[Diabetes and pregnancy--optimal management].

Current classification, diagnostic and therapeutic guidelines of diabetes in pregnancy are briefly reviewed in this paper. Obstetricians mainly are confronted with the insulin-dependent diabetic (IDDM) prior to conception and during pregnancy. Intensive interdisciplinary co-operation is considered a prerequisite for treatment of the diabetic patient planning or carrying a pregnancy. The following subspecialties should work together in diabetic pregnant care: Reproductive Medicine incl. high-level endocrinological diagnostics, Diabetology with a teaching facility, and--within a perinatal center--an obstetric and neonatal department experienced in diabetic care. Preconceptional metabolic adjustment as well as surveillance of fetal and maternal condition during the first trimester of pregnancy are considered the mainstay in diabetic patient's care. Possible complications of diabetic pregnancy are described. Only in rare cases, pregnancy is contraindicated because of retino- or nephropathy. The screening program for gestational diabetes is based upon the patient's history, fasting-blood-glucose-levels, 50-g-oral-glucose-tolerance-test (OGTT) and a 24-h-blood-glucose-profile. Measurement of insulin levels in amniotic fluid are recommended for cases that remain yet undiagnosed.

Diabetes Mellitus, Type 1↗
PubMed2006

Optimized contrast-enhanced CT protocols for diagnostic whole-body 18F-FDG PET/CT: technical aspects of single-phase versus multiphase CT imaging.

UNLABELLED: The purpose of this study was to compare various PET/CT examination protocols that use contrast-enhanced single-phase or contrast-enhanced multiphase CT scans under different breathing conditions. METHODS: Sixty patients with different malignant tumors were randomized into 4 different PET/CT protocols. Single-phase protocols included an intravenous contrast-enhanced (Ultravist 370; iodine at 370 mg/mL) single-phase whole-body CT scan (90 mL at 1.8 mL/min; delay, 90 s) during shallow breathing (protocol A) or during normal expiration (NormExp; protocol B). Multiphase protocols included 2 separate CT scans in the arterial contrast enhancement phase (90 mL at 2.5-2.8 mL/min; bolus tracking; scan range, base of the skull to the kidneys) and the portal-venous contrast enhancement phase (delay, 90 s; scan range, base of the lungs to the proximal thighs) during shallow breathing (protocol C) or during NormExp (protocol D) followed by a low-dose CT scan during shallow breathing for attenuation correction and whole-body PET. Feasibility was assessed by comparing the misalignment of the upper abdominal organs quantitatively by means of the craniocaudal, lateral, and anterior-posterior differences on coregistered PET/CT images. For image quality, the occurrence of CT artifacts and mismatching of rigid body points were evaluated qualitatively. RESULTS: Misalignment was significantly lower for protocol B in almost all organs and represented the best coregistration quality. Surprisingly, protocol A showed significantly better alignment than the multiphase CT scans during NormExp. Misalignment values between the multiphase protocols were not significantly different, with a trend toward lower values for protocol D. The best CT image quality, with a significantly lower occurrence of artifacts, was found for protocols B and D (NormExp). The levels of mismatching of rigid body points because of patient movement in between the transmission and emission scans were similar for all protocols. CONCLUSION: Multiphase CT protocols presented a technical disadvantage represented by suboptimal image coregistration compared with single-phase protocols. Nevertheless, multiphase protocols are technically feasible and should be considered for patients who will benefit from a contrast-enhanced multiphase CT examination for diagnosis.

Artifacts↗
PubMed1991

[The value of current imagery techniques in dentistry and stomatology].

Computed tomography, ultrasonography and magnetic resonance imaging are currently used in stomatology and dentistry. These recent imaging modalities have suppressed or reduced classic examinations (by example: conventional tomography and sialography). Efficient, exact and fast, they improve the diagnostic capacities and optimize the choice of the treatments. After some technical considerations, their applications in various stomatology and dentistry problems are evoked.

Diagnostic Imaging↗