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At least 1,531 records · Page 85Linked to original sources
PubMed1986

AIDS and AIDS-related conditions: screening for populations at risk.

Since its onset, the acquired immunodeficiency syndrome (AIDS) epidemic has been associated with certain subgroups in the U.S. population. These include gay and bisexual men, intravenous drug users, hemophiliacs and blood product transfusion recipients. Members of these groups feeling either well or unwell may present themselves at clinics with a high level of anxiety regarding AIDS. Their needs for clinical evaluation of symptoms, education and reassurance, or further referral may be acute. The experience of the AIDS screening clinic at the AIDS/oncology clinic at San Francisco General Hospital has led to the development of protocols for nurse practitioners to use in screening members of AIDS risk groups, both the "worried well" and those who are symptomatic. This is a presentation of the clinic's screening history and physical examination criteria, including the markers of suspicion and algorithms of diagnostic studies that have been useful tools in the clinic.

Acquired Immunodeficiency Syndrome↗
PubMed1985

The inadvertent CT demonstration of intussusception.

We report a patient with idiopathic ceco-colic intussusception diagnosed by computed tomography (CT). Due to an unusual set of circumstances, the accepted algorithm of diagnostic investigations was not followed. This led to the inadvertent CT demonstration of an intussusception in an adult as a thick-walled mass containing a multiplicity of barium and gas-filled loops.

Adult↗
PubMed1979

[Various problems of diagnosis of the pre-infarct state].

The clinical course of preinfarction states was studied in 246 in-patients. The informativeness of 128 signs of preinfarction state was checked and the most informative ones were used to compile a diagnostic-tactical algorithm for the recognition of preinfarction states and a prognostic algorithm for prognosticating the development of myocardial infarction.

Adult↗
PubMed1981

[Roentgenologically wasted time in bronchial carcinoma -a review (author's transl)].

The importance of roentgenologically wasted time, its frequency, causes and relation to specific characteristics of bronchial carcinoma are discussed in details along the literature. A short casuistic will show the actuality of the problem. There may be gained some important conclusions from the literature, but the differences in methods and the missing security in some definitions don't allow reliable answers to some detailproblems. The following conclusion could be derived from literature: 1. The roentgenologically protracted rate amounts to more than 30% on average. It decreases with increasing in experience of the readers of fluorographies. But even among them in the part of protracted cases amounts up to 10%. 2. Late protracted roentgenologic roentgenologic diagnosis is caused by -overlooking minimal lesions, -false algorithm in diagnostic procedure, -false diagnosis, -inadequate techniques, -the misinterpretation of developing malign lesion on the basis of existing alterations aetiologically known, -the delay on the patient's part. 3. The most important cause of all protracted x-ray findings is misinterpreted obstructive pneumonitis; it is followed by parenchymal cloudy densities, by striped atelectasis, old tuberculous processes, peripheral coin lesions and hilus alterations. 4. The time roentgenologically wasted is differing in wide range up to some years. 5. With increasing wasted time the portion of central tumors is also rising. 6. Even in patients considered as radically resected there exists still a negative correlation between the roentgenologically wasted time and prognosis. 7. The average of wasted time in x-ray lesions is running parallel to the screening intervals. 8. There seem to exist some differences between the different histological types in view of the roentgenologically wasted time. 9. There are no correlations between the age of the patients and the roentgenologically wasted time.

Adenocarcinoma↗
PubMed1996

[Vascular assessment of the receptor before kidney transplantation].

OBJECTIVES: To analyze the prevalence of vascular risk factors in patients with end-stage renal failure who are candidates to kidney transplantation, determine the efficacy of Doppler ultrasound and to develop a diagnostic vascular algorithm. METHODS: The iliac, femoral, popliteal and posterior tibial arteries of 200 potential kidney graft recipients were evaluated by Doppler US. Patients were assessed for the following risk factors: hypertension, smoking, cholesterol and triglyceride levels, and obesity. Seventy of theses patients subsequently received a kidney allograft. A biopsy of the iliac artery was performed at the level of the arteriotomy. RESULTS: Hypertension (72%), smoking (47%), obesity, hypercholesterolemia and hyperlipidemia (7%) were the most prevalent risk factors. Atherosclerosis was histologically demonstrated in 19.2%: 80% were fibrous plaques. The atherosclerotic arteries showed peak systolic and diastolic flows significantly lower than those of normal arteries (p < 0.05). The resistance index was higher in the atherosclerotic arteries (p < 0.01). The number of cigarettes (R = -0.78) and cholesterol levels (R = -0.43) correlated inversely with the peak flows in the posterior tibial artery. CONCLUSIONS: Vascular evaluation of kidney graft recipients is fundamental. Claudication, hypertension, age > 60 years, asymmetrical pulses and femorobrachial index < 0.7 are indications for performing ultrasound evaluation prior to kidney transplantation.

Adolescent↗
PubMed1997

[The choice of the treatment procedure in complicated forms of gallstones].

The article is devoted to an assessment of results of treatment of patients with complicated forms of cholelithiasis. Results of the treatment with active surgical measures and use of the endoscopic surgery methods are compared. Advantages of using endoscopy in algorithm of diagnostic and medical measures are shown. Recommendations are given concerning the terms and consequence of using the endoscopic methods of treatment.

Acute Disease↗
PubMed1998

[Management of female stress urinary incontinence in a specialized unit].

Urinary exertional incontinence is a very common condition which requires a broad range of therapeutic options being available. Besides, the creation of specialised units in urology is now evident, one of the areas involved being Urogynaecology. To focus the issue of female urinary incontinence, the following should be considered: to begin with, treatment is not imperative, patients must be evaluated on a case-by-case basis, the least invasive principle must prevail, diagnosis must be early, and it should be taken into account that primary and secondary prevention is both possible and necessary. A working pattern was designed accordingly, to sustain therapeutic decisions, which consisted in a detailed anamnesis, complete examination and application of an established diagnostic-therapeutic algorithm. Even so, a therapeutic, medical or surgical decision will be chosen and patients will be monitored at one, four and sixteen months after completion of treatment. To achieve good results in the management of female urinary exertional incontinence it is essential to include a large number of patients. In fact, the key is to establish a close collaboration with the gynaecologists.

Clinical Protocols↗
PubMed1998

[Integration of multimodal medical images].

Multimodality analysis is becoming a required tool in medical practice due to the development of different image techniques and new imaging processing tools. This paper is a review of the basis of medical image integration, image fusion techniques, and their clinical applications, especially addressing our experience with brain tomographic studies in nuclear medicine and radiology.

Algorithms↗
PubMedDate not supplied

[Ultrasonically-guided percutaneous needle biopsy in the diagnosis of malignant abdominal diseases].

In 3-year period 340 percutaneous ultrasonographically guided needle biopsies of abdominal organs and tissues were performed in suspected neoprocesses. Positive cytologic results were obtained in 77.6% and histological in 74.8% of patients. These results were obtained thanks to good choice of a bioptic needle and the technique of performing percutaneous needle biopsy under ultrasonographic control and sometimes in combination with radioscopy, too. Experience of both a biopsy performer and a cytologist or histologist with this kind of material is of great importance. Thanks to early histologic diagnosis, made in this way, percutaneous biopsy is classified as a high sensitive method and as such it forces on to be one of the first methods in algorithm of diagnostic procedures. Even the aim of this paper is to point out not only the authors ultrasonographic experience but also reliability, simplicity and safety of percutaneous guided needle biopsies, what excludes the necessity for more difficult and more expensive diagnostic procedures significantly reducing the examination.

Abdominal Neoplasms↗
PubMed1999

Imaging of soft tissue sarcomas.

Imaging of soft tissue sarcomas is critically important in the management of these patients. Whether CT scanning or MR imaging is the best test remains controversial; studies to support either modality exist and are reviewed. An integrated approach using clinical algorithms and radiologic studies to preoperatively stage and follow these patients seems to provide optimal care.

Abdominal Neoplasms↗
PubMed1998

Locating blood vessels in retinal images by piece-wise threshold probing of a matched filter response.

We describe an automated method to locate and outline blood vessels in images of the ocular fundus. Such a tool should prove useful to eyecare specialists for purposes of patient screening, treatment evaluation, and clinical study. Our method differs from previously known methods in that it uses local and global vessel features cooperatively to segment the vessel network. A comparison of our method against hand-labeled ground truth segmentations of five images yielded 65% sensitivity and 81% specificity. A previously known technique yielded 69% sensitivity and 63% specificity. For a baseline, we also compared the ground truth against a second hand labeling, yielding 80% sensitivity and 90% specificity. These numbers indicate our method improves upon the previously known technique, but that further improvement is still possible.

Algorithms↗
PubMed1999

Discovering diagnostic rules from a neurotologic database with genetic algorithms.

Data on patients with Meniere's disease, vestibular schwannoma, traumatic vertigo, sudden deafness, benign paroxysmal positional vertigo, or vestibular neuritis were retrieved from the database of otoneurologic expert system ONE for the development and testing of a genetic algorithm (GA). The accuracy of the diagnostic rules in solving the test cases was 81%, 91%, 92%, 95%, 96%, and 98% for the respective diseases. The best rules retrieved from the GA were described by a set of questions with the most likely answers. The most important questions concerned the duration of hearing loss and the occurrence of head injury. The validity and structure of the rules created with a GA can be analyzed in detail. For rare diseases, some other reasoning process can be used, for example, case-based reasoning.

Algorithms↗
PubMed2005

Emergency ultrasound-based algorithms for diagnosing blunt abdominal trauma.

BACKGROUND: Ultrasonography is regarded as the tool of choice for early diagnostic investigations in patients with suspected blunt abdominal trauma. Although its sensitivity is too low for definite exclusion of abdominal organ injury, proponents of ultrasound argue that ultrasound-based clinical pathways enhance the speed of primary trauma assessment, reduce the number of computed tomography scans and cut costs. OBJECTIVES: To assess the efficiency and effectiveness of trauma algorithms that include ultrasound examinations in patients with suspected blunt abdominal trauma. SEARCH STRATEGY: We searched MEDLINE, EMBASE, CENTRAL, CCMED, publishers' databases, controlled trials registers and the Internet. Bibliographies of identified articles and congress abstracts were handsearched. Trials were obtained from the Cochrane Injuries Group's trials register. Authors were contacted for further information and individual patient data. SELECTION CRITERIA PARTICIPANTS: patients with blunt torso, abdominal or multiple trauma undergoing diagnostic investigations for abdominal organ injury. INTERVENTIONS: diagnostic algorithms comprising emergency ultrasonography (US). CONTROLS: diagnostic algorithms without US ultrasound examinations (e.g. primary computed tomography [CT] or diagnostic peritoneal lavage [DPL]). OUTCOME MEASURES: mortality, use of CT and DPL, cost-effectiveness, laparotomy and negative laparotomy rates, delayed diagnoses, and quality of life. STUDIES: randomised controlled trials (RCTs) and quasi-randomised trials (qRCTs). DATA COLLECTION AND ANALYSIS: Two reviewers independently selected trials for inclusion, assessed methodological quality and extracted data. Where possible, data were pooled and relative risks (RRs), risk differences (RDs) and weighted mean differences, each with 95% confidence intervals (CIs), were calculated by fixed- or random-effects modelling, as appropriate. MAIN RESULTS: We identified two RCTs with US in the experimental arm and another with US in the control group. We also considered two qRCTs. Overall, trials were of moderate methodological quality. Few authors responded to our written inquiries seeking to resolve controversial issues and to obtain individual patient data. We were able to pool data from two trials comprising 1037 patients for primary endpoint analysis (i.e. mortality). The relative risk in favour of the no-US arm was 1.4 (95% CI 0.94 to 2.08). Because of a lack of details, the meaning of this observation remains unclear. There was a marginal benefit with US-based pathways in reducing CT scans (random-effects RD -0.46; 95% CI -1.00 to 0.13), offset by trials of higher methodological rigour. No differences were observed in DPL and laparotomy rates. AUTHORS' CONCLUSIONS: There is insufficient evidence from RCTs to justify promotion of ultrasound-based clinical pathways in diagnosing patients with suspected blunt abdominal trauma.

Abdominal Injuries↗