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PubMed1992

DSM-III-R as a taxonomy. A cluster analysis of diagnoses and symptoms.

While there have been many applications of cluster analysis in psychiatric classification research, there are no studies in which cluster analysis is used to discover the taxonomic structure implicit in the DSM-III itself. In order to do so, the symptom index in the DSM-III-R manual was summarized in a two-way matrix of disorders by symptoms and then analyzed using a hierarchical classes model and companion algorithm (HICLAS) that permits overlap among classes. A novel feature of this model is that superordinate-subordinate relationships among diagnostic and symptom classes are explicitly represented. The HICLAS analysis revealed that there are several discrete symptom classes in DSM-III-R and that many psychiatric disorders can be modeled as combinations of one or more of these classes. The disorders associated with these symptom classes tend to fit the hierarchical classes model relatively well, particularly the mood disorders and the psychotic disorders. However, disorders such as adjustment, personality, and sexual disorder fit the model poorly or not at all. The results are in line with the conjecture that the taxonomic model implicit in DSM-III-R is a hybrid of discrete symptom classes and some other structure, perhaps a dimensional one.

Algorithms↗

PubMed1986

[Legal aspects of pain].

Since years legal demands towards patients information are extensive and highly refined. Recently, however, pain--a permanent companion of human life since ever--was included by two sentences as an additional item. Following legal categories, the physician before diagnostic interventions is obliged to evaluate the ability of the severely suffering patient fully to understand and judge the given information. Additionally patients have to be informed on possibly appearing engraved pains. Concerning therapeutical interventions normally the same legal rules have to be considered. Furthermore doctors are obliged to inform the patient on the foreseen development of pain either with or without medical intervention.

Humans↗

PubMed1999

[The ferret. 1. General and zoologic technical information].

This series of articles on the ferret provide a practical handout for companion animal practitioners. Aspects concerning the housing, nutrition, and reproduction of ferrets are briefly described, followed by a more detailed description of diagnostic procedures such as blood collection, anaesthesia, small surgical procedures, preventive veterinary care, and hospitalization. Frequently seen clinical problems with their differential diagnosis are discussed, and the cause, clinical symptoms, diagnosis, therapy and, if applicable, prevention and control of these disorders are briefly described.

Animal Nutritional Physiological Phenomena↗

PubMed1999

[The ferret. Part 2. Veterinary medical information].

Anesthesia↗

PubMed1990

Neural networks in radiologic diagnosis. I. Introduction and illustration.

Artificial neural networks (NNs) process information in a manner similar to the way the human brain is thought to process information. Neural networks have potential application in radiology as an artificial intelligence technique that can provide computer-aided diagnostic assistance for the practicing radiologist. The basic characteristics of NNs and the manner in which information propagates through an NN are discussed in nontechnical language, to assist the diagnostic radiologist in understanding the basic principles of neurocomputing. Computer-aided diagnosis selection in pediatric chest radiography using NNs is discussed in a companion article.

Artificial Intelligence↗

PubMed2004

Diagnosing agoraphobia in the context of panic disorder: examining the effect of DSM-IV criteria on diagnostic decision-making.

A diagnostic and statistical manual (DSM)-IV diagnosis of agoraphobia in the context of panic disorder (PD) is based on three nosologically sufficient criteria: (1) avoidance, (2) use of companions, and (3) endurance of situations despite distress. Therefore, an agoraphobia diagnosis can be made across an extremely broad range of cases including when there are no avoidance behaviors (e.g., the patient endures the situation). It was hypothesized that clinicians do not weight these criteria equally and that the DSMs individual, sufficient criteria lead to poor inter-rater reliability. Clinicians (N=48) rated hypothetical patients with symptom profiles emphasizing each of these three criteria. Consistent with expectation, clinicians differentially weighted these criteria. Avoidance was relatively more apt to produce a diagnosis when only one criterion was emphasized in clinical vignettes. Inter-rater reliability was poor in instances when only one sufficient criterion was highlighted. Knowledge concerning DSM criteria resulted in a greater rate of agoraphobia endorsement, but knowledge did not account for the overall pattern of findings.

Agoraphobia↗

PubMed1992

Analysis of glycoprotein I (gI) negative and aberrant pseudorabies viral diagnostic isolates.

Glycoprotein I (gI) phenotypes and genotypes of 4 pseudorabies viral diagnostic isolates were evaluated by use of in vitro DNA amplification, monoclonal antibody binding, gI-specific serodiagnostic responses, and in vivo virulence approaches. Three viruses were avirulent and did not elicit gI-specific serologic responses, react with gI-specific monoclonal antibodies, or contain gI epitope-encoding DNA sequences. The fourth virus was virulent and did elicit a gI-specific serodiagnostic response. Compared with reference virulent pseudorabies viruses, however, the fourth isolate had reduced reactivity with a group of gI monoclonal antibodies and had a single nucleotide sequence substitution with a corresponding putative amino acid change in the epitopically dominant portion of the gI molecule. Presumably, the first 3 isolates represented diagnostic recoveries of viruses derived from gI-deleted modified-live pseudorabies viral vaccines, whereas the fourth isolate was a virulent but gI-aberrant wild-type virus. Thoroughly assessing the gI status of pseudorabies viral diagnostic isolates was considered to be essential in evaluating the epidemiologic importance of these viruses and in monitoring the validity of gI-based vaccine companion tests now used worldwide in pseudorabies control and eradication programs.

Amino Acid Sequence↗

PubMed1992

A comparative cytopathologic and histologic study of atypia, dysplasia, and adenocarcinoma in Barrett's esophagus.

As a potentially premalignant condition, Barrett's esophagus has stimulated controversy over the need for surveillance of glandular dysplasia and early carcinoma. This prompted the authors to review their experience with endoscopic cytologic brushings and biopsies from patients with Barrett's esophagus. The authors reviewed 65 consecutive specimens from 42 patients with Barrett's esophagus in which both the concurrently obtained esophageal cytologic brushings and companion biopsy specimens were available. In addition, esophagogastrectomy specimens from 9 nine these patients were reviewed. Cytologic and histologic specimens were assigned to one of four diagnostic categories, based on specifically defined criteria: simple Barrett's esophagus with or without inflammatory atypia; dysplasia; adenocarcinoma; or suspicious for dysplasia or carcinoma. Simple Barrett's esophagus was diagnosed in 38 cytologic brushings and 44 biopsy specimens, dysplasia in 4 brushings and 7 biopsy specimens, and carcinoma in 14 brushings and 10 biopsy specimens. Nine brushings and three biopsy specimens were suspicious. In 13 cases, brushings revealed a higher grade lesion than did histology; in 5 cases, biopsy specimens showed a higher grade lesion. Agreement between the two occurred in 72% (47/65) of all specimens. Accuracy was confirmed in the histologic examinations of the resection specimens. The authors conclude that specific criteria, when consistently applied, allow accurate cytologic diagnoses of epithelial changes in Barrett's esophagus. The use of esophageal brush cytology and biopsy specimens provides two complementary techniques, which detect a greater number of serious lesions than either technique alone.

Adenocarcinoma↗

PubMed1995

Encoded reaction cassette for the highly sensitive detection of the making and breaking of chemical bonds.

A reaction cassette has been designed for the highly sensitive detection of the making and breaking of chemical bonds. The system is envisioned as a companion device to be used in the search for antibody and other novel catalysts. The cassette also may have important clinical applications in the design of diagnostic reagents. In its fully encoded format, this methodology is capable of both detecting and decoding chemical events.

Antibodies↗

PubMed2006

Q fever.

An outbreak of Q fever occurred in Scotland during this summer and was reported in news headlines. Despite these newsworthy headlines, Q fever remains poorly understood. The causative organism, Coxiella burnetii, has a worldwide distribution, with the notable exception of New Zealand. Even with its ubiquitous nature, Q fever is rarely reported. We explore some of the underlying reasons for this apparent under diagnosis together with some of the diagnostic challenges posed by this obligate intracellular pathogen. The host range for this microbe spans arthropods, through to birds and a diverse range of mammals including livestock, companion animals and man. In most, infection remains sub-clinical, however, in some, infection can cause severe and life-threatening complications. Furthermore, possible long-term persistence within those infected, may result in long-term sequelae disassociated from initial risk factors or acute clinical presentation. We review current thinking on C. burnetii, and identify some of our current knowledge gaps.

Adult↗

PubMed2003

Avian cardiology.

The field of avian cardiology is continually expanding. Although a great deal of the current knowledge base has been derived from poultry data, research and clinical reports involving companion avian species have been published. This article will present avian cardiovascular anatomy and physiology, history and physical examination considerations in the avian cardiac disease patient, specific diagnostic tools, cardiovascular disease processes, and current therapeutic modalities.

Animals↗

PubMed2005

Mortality in over 350,000 insured Swedish dogs from 1995-2000: II. Breed-specific age and survival patterns and relative risk for causes of death.

This study continues analysis from a companion paper on over 350,000 insured Swedish dogs up to 10 years of age contributing to more than one million dog-years at risk during 1995-2000. The age patterns for total and diagnostic mortality and for general causes of death (trauma, tumour, locomotor, heart and neurological) are presented for numerous breeds. Survival estimates at five, eight and 10 years of age are calculated. Survival to 10 years of age was 75% or more in Labrador and golden retrievers, miniature and toy poodles and miniature dachshunds and lowest in Irish wolfhounds (91% dead by 10 years). Multivariable analysis was used to estimate the relative risk for general and more specific causes of death between breeds accounting for gender and age effects, including two-way interactions. Older females had tumour as a designated cause of death more often than males in most breeds, but not in the Bernese mountain dog. Information presented in this and the companion paper inform our understanding of the population level burden of disease, and support decision-making at the population and individual level about health promotion efforts and treatment and prognosis of disease events.

Age Factors↗

PubMed2006

A Trichinella murrelli infection in a domestic dog in the United States.

Trichinella murrelli infection was diagnosed in a naturally infected Beagle bitch from VA, USA, where encapsulated larvae were found in histological sections of several skeletal muscles. A laboratory reared dog fed infected muscles resulted in viable muscle larvae that were subsequently infective to Swiss-Webster mice. Multiplex PCR using larvae from the experimentally infected dog demonstrated two distinct bands migrating at 127 bp and 316 bp which together are diagnostic for T. murrelli; the isolate was assigned the ISS code: ISS1608 by the International Trichinella Reference Centre. This is the first report of T. murrelli infection in a companion animal.

Animals↗

PubMed2003

Gastrointestinal motility disorders and gastrointestinal prokinetic therapy.

Gastrointestinal motility disorders represent a diagnostic and therapeutic challenge. Disorders of gastrointestinal motility may result in accelerated transit, delayed transit, impaired relaxation, or inappropriate relaxation. The delayed transit disorders are the most important motility disorders of companion animals and may involve the esophagus (hypomotility and megaesophagus), stomach (delayed gastric emptying), small intestine (postoperative ileus and intestinal pseudo-obstruction), or colon (constipation and megacolon).

Animals↗

PubMed2002

Molecular diagnosis of inherited neuromuscular disease.

Prevention of inherited disease in companion animals is largely dependent on prebreeding identification of carriers of autosomal recessive disease traits. Molecular diagnosis is emerging as a convenient and reliable method of carrier detection, but few molecular diagnostic tests of inherited neuromuscular disease are readily available. New test development depends on investigations to determine disease genes and the disease causing mutations. A general approach to molecular diagnosis of inherited disorders is discussed.

Animals↗

PubMed2002

Companion animal parasitology: a clinical perspective.

In recent years there have been many changes to the ways that clinical veterinary science is conducted and nowhere is this more evident than in companion animal practice. Veterinarians working with pet dogs and cats are facing new challenges associated with the emergence and re-emergence of parasitic diseases. Some, such as Neospora caninum, have been recently recognised; others like Giardia and Cryptosporidium have been reported with increasing frequency, in part as a result of laboratory tests with improved sensitivity and specificity. In many regions, the emergence of parasitic diseases has been a consequence of pet travel and exotic diseases pose a unique diagnostic challenge for the veterinarian, as the index of suspicion for these conditions may be absent. The ranges of certain vector-borne diseases such as babesiosis, hepatozoonosis, ehrlichiosis, leishmaniasis and dirofilariasis are extending due to ecological and climatic changes and enhanced by animals with subclinical infection returning home from endemic areas. In companion animal practice, veterinarians have the additional responsibility of providing accurate information about the zoonotic transmission of parasite infections from pets, especially to those most vulnerable such as children, the elderly and the immunocompromised. Effective education is vital to allay public concerns and promote responsible pet ownership.

Animals↗

PubMed2000

The basic pathology of human breast cancer.

This article illustrates the most common benign and malignant lesions in the breast, and is intended for the biologist working in the area of breast cancer and breast biology, not for the practicing pathologist. The atlas covers benign proliferative lesions, atypical lesions, variants of in situ cancer, the main types of invasive cancers, spindle cell lesions, and examples of vascular and lymphatic spread. Some entities are included to illustrate a point of particular relevance to the biology and histogenesis of the lesions. Some controversial diagnostic areas are considered, along with the relative risk of developing breast cancer associated with some of the proliferative lesions. The content of this atlas should be read in conjunction with the companion article by Howard and Gusterson in this issue. Their article covers the cellular origin of epithelial and stromal tumors and presents a description of some of the common benign proliferative lesions that are considered to be components of the normal spectrum of changes seen at postmortem or in biopsies.

Breast↗

PubMed1997

The National Cancer Data Base report on non-Hodgkin's lymphoma.

BACKGROUND: The National Cancer Data Base (NCDB) has reported on many malignancies occurring in men and women in the U. S. from >1400 contributing hospitals. The current report on non-Hodgkin's lymphoma (NHL) is a companion to an upcoming Patient Care Evaluation study of this relatively common and serious cancer. METHODS: This report is comprised of all NHL cases submitted to the NCDB divided into two diagnostic-year groups: 1985-1988 and 1990-1993. Variables routinely collected by hospital cancer registries have been analyzed to report on patterns of diagnosis and treatment. RESULTS: High grade NHL cases were more likely to be Stage IV (40.8%) than were low or intermediate grade cases (34.8% and 32.5%, respectively). Patients with NHL arising from lymph node sites tended to present with more advanced disease (55.8% with Stages III and IV disease), whereas patients with NHL arising from extranodal sites and non-lymph node nodal sites presented at an earlier stage (64.7% and 74.0%, respectively, with Stage I or Stage II disease). Approximately 67% of all patients underwent chemotherapy, whereas only 25% underwent surgery or radiation. By histology, 5-year survival was 68.8% for low grade disease, 51.9% for intermediate grade disease, and 45.8% for high grade disease; by stage, survival rates ranged from 73.5% for Stage I to 42.9% for Stage IV disease. CONCLUSIONS: To the authors' knowledge, the 91,306 cases in this study represent the largest contemporary sample of NHL patients. The material reported here may serve as a reference with which to compare local patterns with national data. The Working Formulation's ability to stratify patients' survival rates confirms its utility for NHL. Stage according to the American Joint Committee on Cancer also was accurate in predicting survival.

Adolescent↗