Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “diagnostic algorithm”

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 1,783 records · Page 99Linked to original sources
PubMed1995

The Agency for Health Care Policy and Research. Clinical guidelines for the diagnosis and treatment of benign prostatic hyperplasia.

The BPH guidelines provide a rational diagnostic and treatment algorithm for practitioners consulting with patients presenting with symptoms of prostatism. The guidelines also serve several very important purposes: They represent the first attempt at a comprehensive review of the English-language literature regarding the evaluation and treatment of men presenting with symptoms of BPH. They are presented in a comprehensible and transparent fashion to the reader, inasmuch as each piece of supporting evidence is explicitly listed. A decision diagram is presented, allowing health care providers to evaluate and treat patients with BPH in a rational fashion. A balance sheet of treatment outcomes should help patients and health care providers in their shared decision-making regarding treatment alternatives. They uncovered significant knowledge gaps and areas for future basic and clinical research. As more and more treatment alternatives become available, the guidelines will have to be updated to reflect both the changing health care environment and the ever-expanding armamentarium of treatment choices.

Humans↗
PubMed1993

Valvular disease in the elderly.

As patients survive to advanced age, they commonly develop degenerative valvular heart disease as well as degenerative diseases of other organ systems. In addition, a reservoir of patients with other forms of valvular heart disease develop progressive symptomatology with advancing age. These patients often present a challenge to the cardiologist in both diagnosis and management. Inasmuch as these patients tolerate cardiovascular surgery less well than their younger counterparts, criteria for surgical intervention may often need modification. Chronologic age must be recognized as but one of many factors affecting physiologic function. Knowledge of aging-related alterations in function must be employed in both diagnostic and therapeutic algorithms. At times, input from other health-care providers who specialize in the care of the elderly may assist in the assessment of these patients. Surgery should be reserved for higher-risk patients who are severely symptomatic or for those in whom severe symptoms are likely to soon develop based on the natural history of the disease process involved. Those less symptomatic elderly patients with otherwise preserved physiologic functions also may be offered valvular surgery. The availability of nonsurgical, albeit at times palliative, techniques to relieve aortic or mitral stenosis provides an alternative therapeutic option to cardiothoracic surgery. Advances in understanding the pathophysiology and medical therapy of heart failure will continue to contribute to an improved quality of life for those for whom only medical options exist.

Aged↗
PubMed1996

Cervical intraepithelial neoplasia in pregnancy.

There is no evidence that cervical intraepithelial neoplasia (CIN) progresses more rapidly because of pregnancy. Management of CIN in pregnancy, therefore, is conservative. Screening for invasive cancer is done at the first prenatal visit. Colposcopically directed biopsy can then be used to rule out invasive cancer. Postpartum cytology and colposcopy are important follow-up procedures for these women. Cryosurgery for CIN is usually contraindicated in pregnancy. This report includes examples of two pregnant patients with high-grade lesions. A diagnostic and treatment algorithm based on the current "expert opinion"is presented.

Adult↗
PubMed1995

[G-CSF (Neupogen Roche) in the treatment of patients with chronic aplastic anemia with severe neutropenia].

Aplastic anaemia (AA) of the chronic type with severe cytopenia is very frequently a difficult therapeutic problem. Patients with granulocyte values below 0.5 G/l are threatened by infections, incl. sepsis possibly with a fatal outcome. If the pool of stem cells for granulocytes is not completely exhausted and can respond to growth factors, these patients can be treated either chronically and/or in risk situations (e.g. injury, surgery) with preparations of the type of a recombinant, granulocyte colony stimulating factor (rhG-CSF), or granulocyte and monocyte colony stimulating factor (rhGM-CSF). The authors present a review of diagnostic and therapeutic algorithms in patients with the AA syndrome and summarize their own experience with the preparation Neupogen Roche (rhG-CSF).

Anemia, Aplastic↗
PubMed1996

Cholesterol granuloma cyst of the petrous apex.

Cholesterol granuloma cyst of the petrous apex is an uncommon lesion and often presents a diagnostic and management dilemma to the otolaryngologist. Patients usually demonstrate signs and symptoms referable to a mass lesion of the cerebellopontine angle or brainstem. We present two cases of cholesterol granuloma cyst that were treated at our institution and discuss our diagnostic and management algorithms. Also included is a thorough review of the literature.

Adult↗
PubMed1996

[Usefulness of headache classification in the planning of radiological studies].

Neurologists can only classify headaches, not patients. Doing that, they are well aware that this is partially arbitrary. But classification is essential, especially for primary headaches (migraine, tension type headache, cluster headache) to achieve epidemiological and physiopathological studies. The criteria of definition for each type of headache must be established with pertinence. Neurologists, general practitioners as well as radiologists can then use these criteria to imagine an algorithm for the diagnostic procedure of headache patients. The aim of this publication is to describe the IHS classification as well as some common clinical situations (migraine, subarachnoidal haemorrhage, brain tumor, mild head injury.

Brain Neoplasms↗
PubMed1996

An evaluation of clinical indicators for severe paediatric illness.

To help reduce paediatric morbidity and mortality in the developing world, WHO has developed a diagnostic and treatment algorithm that targets the principal causes of death in children, which include acute respiratory infection, malaria, measles, diarrhoeal disease, and malnutrition. With this algorithm, known as the Sick Child Charts, severely ill children are rapidly identified, through the presence of any one of 13 signs indicative of severe illness, and referred for more intensive health care. These signs are the inability to drink, abnormal mental status (abnormally sleepy), convulsions, wasting, oedema, chest wall retraction, stridor, abnormal skin turgor, repeated vomiting, stiff neck, tender swelling behind the ear, pallor of the conjunctiva, and corneal ulceration. The usefulness of these signs, both in current clinical practice and within the optimized context of the Sick Child Chart algorithm in a rural district of western Kenya, was evaluated. We found that 27% of children seen in outpatient clinics had one or more of these signs and that pallor and chest wall retraction were the signs most likely to be associated with hospital admission (odds ratio (OR) = 8.6 and 5.3, respectively). Presentation with any of these signs led to a 3.2 times increased likelihood of admission, although 54% of hospitalized children had no such signs and 21% of children sent home from the outpatient clinic had at least one sign. Among inpatients, 58% of all children and 89% of children who died had been admitted with a sign. Abnormal mental status was the sign most highly associated with death (OR = 59.6), followed by poor skin turgor (OR = 5.6), pallor (OR = 4.3), repeated vomiting (OR = 3.6), chest wall retraction (OR = 2.7), and oedema (OR = 2.4). Overall, the mortality risk associated with having at least one sign was 6.5 times higher than that for children without any sign. While these signs are useful in identifying a subset of children at high risk of death, their validation in other settings is needed. The training and supervision of health workers to identify severely ill children should continue to be given high priority because of the benefits, such as reduction of childhood mortality.

Cause of Death↗
PubMed1997

Primary central nervous system lymphoma in patients with AIDS.

Primary central nervous system lymphoma (PCNSL), once considered a rare brain neoplasm, has been steadily increasing in incidence mainly due to an enlarging population of immunosuppressed patients. PCNSL has become the second most common brain space occupying lesion in patients with the acquired immunodeficiency syndrome. A rapid diagnosis of this entity may represent weeks to months of survival to immunosuppressed HIV-positive patients. The radiologist now plays an important role in the noninvasive diagnosis and management of this condition through the accurate interpretation of imaging findings provided by CT, MR, and brain SPECT studies. This article focuses on the pathogenesis, clinical manifestations, neuropathology, and imaging characteristics of this brain neoplasm. New accurate imaging algorithms combining the diagnostic information provided by CT, MR, and T1-201 brain SPECT are discussed.

Brain↗
PubMed1997

Autoimmune thrombocytopenia in adults: clinical experience.

Diagnostic and treatment algorithms in autoimmune thrombocytopenia (AITP) are still somewhat controversial. We present our experience in the diagnosis and treatment of 39 AITP patients, hospitalized at our department between 1990 and 1995, and discuss alternative approaches. There were 10 male and 29 female patients, median age 47 (range 18-75) years. All patients had isolated thrombocytopenia and normal or increased number of megakaryocytes in bone marrow. Platelet count lower than 15 x 10(9)/L was found in 25 (64.1%) patients. Eighteen (54.5%) patients responded well to standard and two (6.1%) to high doses of steroids, whereas 18.2% of the patients responded well to other immunosuppressive therapy. Antiplatelet antibodies were found only in 4 (10.2%) patients. Our conclusion was that a half of adult AITP patients achieve satisfactory recovery on standard doses of steroids.

Adolescent↗
PubMed1997

The classification of benign and malignant human prostate tissue by multivariate analysis of 1H magnetic resonance spectra.

1H magnetic resonance spectroscopy studies (360 MHz) were performed on specimens of benign (n = 66) and malignant (n = 21) human prostate tissue from 50 patients, and the spectral data were subjected to multivariate analysis, specifically linear-discriminant analysis. On the basis of histopathological assessments, an overall classification accuracy of 96.6% was achieved, with a sensitivity of 100% and a specificity of 95.5% in classifying benign prostatic hyperplasia from prostatic cancer. Resonances due to citrate, glutamate, and taurine were among the six spectral subregions identified by our algorithm as having diagnostic potential. Significantly higher levels of citrate were observed in glandular than in stromal benign prostatic hyperplasia (P < 0.05). This method shows excellent promise for the possibility of in vivo assessment of prostate tissue by magnetic resonance.

Discriminant Analysis↗
PubMed1997

Laboratory diagnosis of Cyclospora infections.

The laboratory diagnosis of newly recognized infectious agents, such as Cyclospora cayetanensis, is frequently problematic because appropriate diagnostic techniques and algorithms are not available. The methods currently available for diagnosis of Cyclospora are described and compared, including concentration procedures, examination of wet preparations, various staining techniques, and the use of molecular-based assays. Because of the autofluorescent properties of the oocysts, particular attention is drawn to the role of fluorescent microscopy in providing a rapid, inexpensive, and sensitive technique for diagnosis of Cyclospora infections in stool samples. In addition to text descriptions, photomicrographs are provided to illustrate Cyclospora oocysts in wet and stained preparations and compare them with Cryptosporidium and Isospora oocysts, the other two most common coccidian infections in man.

Animals↗
PubMedDate not supplied

The road to developing standards for the diagnosis and treatment of venous leg ulcers.

In early 1996 the Venous Leg Ulcer Guideline was developed for the diagnosis and treatment of venous leg ulcers. In order to discuss the development of standards in general, and the Venous Leg Ulcer Guideline in particular, we first need to understand the difference between the following terms: Critical pathway, consensus statement, guideline, and standard. There are advantages and disadvantages to the use of guidelines. In the development of a guideline, endorsement by a respected colleague is important. Development of the Venous Leg Ulcer Guideline began with a consensus statement and then underwent review by a national advisory panel and national peer review through publication. A revised guideline has now been developed which will be tested in a pilot study for clinical efficacy, effect on cost, and impact on quality of life. Validation will require implementation in a prospective clinical trial. Diagnostic and Treatment Algorithm forms for the diagnosis and treatment of venous leg ulcers were developed as part of the preliminary testing of the guideline. Although guidelines do not substitute for good clinical judgement, they can encourage clinical judgement and help reduce fragmented care and the costs associated with inappropriate treatments.

Critical Pathways↗
PubMed1997

[Surgical wound consultation].

Treatment of patients with chronic wounds is characterized by high costs and low efficiency. Epidemiologic data are mainly based on retrospective studies. In 1992, we founded a wound care center and developed a diagnostic and therapeutic algorithm. Prospective data on 293 patients revealed an overall healing rate of 68% (diabetic foot syndrome) and 74% (venous stasis ulcer); mean treatment time was 4.5 months. Relevant prognostic factors were localization of ulcer (0.004), ischemia (0.002), age (0.02) and compliance (0.003), whereas the ulcer grading had no effect on healing.

Algorithms↗
PubMed1998

[Management of priapism induced by PGE1].

OBJECTIVE: To review the literature on priapism following intracavernous injection of PGE1, its management and the physiopathological mechanisms involved. METHODS/RESULTS: The literature on PGE1-induced priapism available on Medline is reviewed and two cases treated at our hospital are described. The diagnostic and therapeutic algorithms are presented. The relationship between drug use and priapism is difficult to establish since patients with the same history who received the same dose of Alprostatil did not develop priapism. CONCLUSIONS: Although infrequent, treatment must be instituted urgently since there is generally low flow.

Alprostadil↗
PubMed1998

Screening for anxiety disorders. Sensitivity and specificity of the Anxiety Screening Questionnaire (ASQ-15).

BACKGROUND: The paper describes the rationale, sensitivity and specificity of the Anxiety Screening Questionnaire (ASQ), a disorder-specific screening instrument for use in primary care. METHOD: Two hundred and fifty subjects sampled from psychiatric, primary care settings and the community, participated in a test-retest reliability as well as a procedural validity study, using the M-CIDI with DSM-IV algorithms as a diagnostic yardstick. RESULTS: The ASQ was found to be easy to administer and acceptable and efficient in terms of sensitivity and specificity for generalised anxiety syndromes. The test-retest item reliability was good to excellent with kappa values of 0.6 or above. As compared with the validity standard, the DSM-IV/CIDI diagnoses caseness sensitivity was generally high (above 82%) for all diagnostic domains covered, whereas the specificity was only high for DSM-IV threshold and subthreshold generalised anxiety disorder. CONCLUSIONS: These preliminary findings demonstrate the usefulness of this anxiety screening questionnaire, constructed closely following the guidelines of specific diagnostic criteria.

Adolescent↗
PubMed1998

[Surgical rectal obstruction--change in treatment over the last 10 years].

The authors retrospectively analyzed 523 patients with large bowel obstruction (LBO): 126 (24.09%) right-sided (RSLBO) and 397 (75.91%) left-sided (LSLBO), treated at the Emergency Medicine Institute "N. I. Pirogov" in Sofia. For the period 1988-1997, a trend toward more radical and aggressive surgery is shown: compared to a previous period (1964-1983) the one-time operations (partial, subtotal and total colectomy with primary anastomoses) are becoming standard operations in RSLBO as well as in LSLBO. A classification based on objective clinical, X-ray and intraoperative findings is considered in the diagnostic and therapeutic algorithm of the LSLBO.

Adult↗
PubMed2004

Comparative investigation of subjective image quality of digital intraoral radiographs processed with 3 image-processing algorithms.

OBJECTIVE: To evaluate the subjective diagnostic image quality of clinical digital intraoral radiographs processed with 3 different image-processing algorithms. STUDY DESIGN: One hundred digital intraoral radiographs were collected and subsequently processed in 3 sets. In the first set the radiographs were processed for correction for attenuation and visual response. In the second set the radiographs were processed with the same algorithms but with an additional shift in gray levels so that the average brightness of a region of interest was displayed with the mean brightness of the computer monitor. In the third, the radiographs were processed with the default gamma-correction in the Dimaxis program (Planmeca Oy, Helsinki, Finland). The 3 radiographs that were differently processed from the same original were displayed simultaneously on the computer monitor. Ten observers evaluated subjectively all the radiographs according to the portrayal of normal structures under the same viewing conditions. Five of them performed repeated evaluations of 20 of the 100 radiographs 2 months later. RESULTS: The best subjective diagnostic quality was found for the radiographs processed with the new algorithms plus an additional shift in gray levels. Radiographs processed with the new algorithms were preferred when compared with those processed with the default gamma-correction. The differences between the 3 types of radiographs were significant (P <.0001). No significant intraobserver differences were found (P=.5487). CONCLUSION: Radiographs processed for correction for attenuation and visual response might be beneficial in clinical work. Clinical radiographs processed with the new algorithms plus an additional shift in gray levels further improve the subjective impression of normal structures.

Adolescent↗
PubMed1989

[Standardization of diagnostic studies in thyroid diseases].

Standardized diagnosis of thyroid diseases includes 3 levels of diagnostic investigation proper based on the syndromic approach and distributed by 3 levels of providing medical care to population. At the 1st level of primary health care the use of "active" detectability ensures timely detection of symptomless thyroid cancer at early stages and early detection of the syndrome of its disturbance and makes it possible to start the prevention of functional and organic changes. At the second level of providing specialized medical care the role of adjuvant diagnostic methods acquires more importance (ultrasound investigations, radioimmunoassay, diagnostic puncture, thyroid lymphography) which are characterized by minimum dose formation, sufficient simplicity, reliability, low cost, a possibility to be widely employed in clinical practice, and safety. The 3rd level (scanning, endoscopy, angiography, CT, NMR) depends on the availability of expensive equipment employed in specialized clinical and diagnostic centers. The proposed algorithms of investigation can be changed in case of the appearance of new more informative and efficient diagnostic methods.

Algorithms↗