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The differential diagnosis of wide QRS complex tachycardia

The differential diagnosis of wide QRS complex tachycardia

The differential diagnosis of the WCT includes VT and SVT-AC. Earlier literature suggests that VT is the most common diagnosis in the WCT patient [4]. While this is likely true in certain clinical settings, such as the coronary care unit, catheterization laboratory, and electrophysiolo- gy laboratory, the opposite is found in other clinical settings, such as the medical intensive care unit and emergency department (Fig. 1) [2,4,5,6]. VT includes both monomorphic and polymorphic ventricular tachycar- dia. The diagnostic possibilities within the SVT-AC category are numer- ous, including supraventricular dysrhythmias with BBB (sinus tachycardia [ST], atrial fi brillation [AF] or fl utter, atrioventricular nodal re-entrant tachycardia [AVNRT]), with ventricular pre-excitation (Wolff-Parkinson-White syndrome [WPW]-related atrial fi brillation and antidromic atrioventricular re-entrant tachycardia [AVRT]), and with dysfunctional intraventricular conduction system (toxic, metabol- ic, etc.).
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5 Lee mas

Differential diagnosis of malignant epithelial tumours in the liver: an immunohistochemical study on liver biopsy material

Differential diagnosis of malignant epithelial tumours in the liver: an immunohistochemical study on liver biopsy material

Introduction. A variety of primary and secondary malignant tumours may present in the liver. In clinical practice the most commonly encountered hepatic tumours are primary hepatocellular carcinoma, metas- tatic carcinoma and primary cholangiocarcinoma, each with its separate prognostic and management impli- cations. When these tumours are poorly differentiated and the biopsy size is limited to a needle core, the distinction can be extremely difficult. Material and methods. All liver tumours reported between 1994 and 2004 were examined. Slides from each case were tested separately with each of nine antibodies (HepPar1, CD10, MOC31, Villin, pCEA, mCEA, CK7, CK19, and CK20). Results. Liver biopsy tissue from 53 patients was examined in this retrospective study. The 53 liver biopsies were classified thus: hepatocellular carcinoma (n = 23); metastatic adenocarcinoma (n = 15); cholangiocarcinoma (n = 5); metastatic small cell carci- noma (n = 7); liver cell dysplasia (n = 1); carcinoid (n = 1); and unclassified (n = 1). Sensitivity and specificity values for different antibodies in relation to their positive staining of specific tumours was as follows: HepPar1 for HCC-81.8% and 100%; MOC31 for MA-73.3% and 92.1%; MOC31 for MA and CC as a combined group-65% and 100%; pCEA (canalicular) for HCC-82.6% and 83.3%; mCEA for MA-93.3% and 75.6%; CK7 for CC-100% and 68%; CK19 for MA and CC as a combined group-90% and 86.3%. Conclusions. An antibody panel consisting of HepPar1, pCEA, CK19 and CK7 together with either MOC31 or mCEA is recommended for use in the differential diagnosis of HCC, MA and CC.
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8 Lee mas

Differential diagnosis of acute liver failure in India

Differential diagnosis of acute liver failure in India

present in 1, haemophagocytosis in 1, ricketsial infec- tion in 4 (scrub typhus = 2, endemic typhus = 2), amoe- bic liver abscess in 4, leptospirosis in 5, dengue fever in 5 and falciparum malaria in 8 patients. In ALF-AVH, hepatitis E and B co-infection was responsible in 1, hepatitis A and E co-infection in 1 and hepatitis E, B and C co-infection in 1, hepatitis E in 18, hepatitis A in 2 and hepatitis B in 5 patients. Differentiation of vari- ous forms of ALF-ID from ALF-AVH depends on var- ious clinical, haematological and biochemical parame- ters, in addition to specific diagnostic tests. Patients with ALF-AVH had mortality rate of 50% (14/28) and ALF-ID had mortality rate of 25% (7/28). Conclu- sions: In developing countries, ALF-mimicking infec- tions should be looked for in differential diagnosis of ALF. Early identification and treatment of these infec- tions is important in reducing mortality.
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7 Lee mas

Evaluation of tumor markers for the differential diagnosis of benign and malignant ascites

Evaluation of tumor markers for the differential diagnosis of benign and malignant ascites

Introduction. The diagnosis of malignant ascites is a challenging problem in clinical practice, non-invasive techniques should be developed to improve diagnostic accuracy. The diagnostic performances of tumor markers in malignant ascites remained unsettled. Our aim was to evaluate diagnostic performance of tumor markers in differential diagnosis of benign and malignant ascites. Material and methods. A total of 437 patients were enrolled, and the relevant parameters of the patients were analyzed for the diffe- rentiation of benign ascites from malignant ascites. Results. At the predetermined cutoff values of tumor makers, tumor markers in ascitic fluid showed better diagnostic performance than those in serum. Combined use of tumor markers and the cytology increased the diagnostic yield of the latter by 37%. In cytologically negative malignant ascites, tumor markers provided assistance in differentiating malignant ascites from benign ascites, and the combination of ascitic tumor markers yielded 86% sensitivity, 97% specificity. Conclusion. Use of a panel of tumor markers exhibited excellent diagnostic performance in diagnosing malignant ascites, which indicated the detection of tumor markers may represent a beneficial adjunct to cytology, thus guiding the selection of patients who might benefit from further invasive procedures.
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7 Lee mas

Test with Calcitriol in the Differential Diagnosis of Hyperparathyroidism

Test with Calcitriol in the Differential Diagnosis of Hyperparathyroidism

of serum calcium in group A but not in B, in which serum calcium remained stable. Basal PTH levels were similar in both groups, so they cannot reliable distinguish between both types of hyperparathyroidism. After the calcitriol load, PTH dropped 44 % ± 18 in group B versus 15 % ± 27 in group A, suggesting some degree of resistance to the hormone action in PHP. ROC curves shows that a reduction of less than 30 % in PTH levels can diagnose PHP with 85% sensibility and 88% specificity. Only two patients in group B behaved as PHP at 17 and 37 months follow up, what gives the test 90 % sensibility and 100 % specificity for the diagnosis of PHP. So, this well-tolerated and easily performed test could be used for the diagnosis of PHP in patients suspected for the disease despite the normality of some basal biological markers. Rev Argent Endocrinol Metab 52:185-193, 2015
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9 Lee mas

Hepatic manifestations of Epstein Barr viral infection

Hepatic manifestations of Epstein Barr viral infection

In conclusion, EBV infection must be considered in the differential diagnosis of patients who present with hy- pertransaminasemia or cholestasis suggestive of this dis- ease or with diverse hepatic manifestations together with increased aminotransferase levels or transitory cholestasis and high levels of alkaline phosphatase (with a character- istic peak in the second week after the onset of symp- toms), with a favorable outcome. It is important to high- light the major role that MARS plays in the medical treat- ment of some patients who develop severe cholestasis or acute liver failure.
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6 Lee mas

Deterioro cognoscitivo incipiente: un estudio con SPECT de activacin y neuropsicologa

Deterioro cognoscitivo incipiente: un estudio con SPECT de activacin y neuropsicologa

Neuropsychological assessment is relevant to make a differential diagnosis between normal and pathological aging, to distinguish between different types of dementia, to define the patterns of strength and weakness and to suggest the likely pattern of underlying cerebral pathology. The Single Photon Emission Computerized Tomography (SPECT) is one of the recent neuroimaging techniques that contribute with information about the regional blood flow. Several studies of regional blood flow in AD patients demonstrate relative temporal and parietal hipoperfusion in AD. SPECT imaging conducted while the patient is engaged in a cognitive task or under sensory stimulation are referred to as activation studies. Activation studies afford unique opportunities to explore brain metabolic changes related to specific cognitive operations and to establish hypothesis of the neural networks supporting very discrete cognitive functions. Recent functional neuroimaging studies used during cognitive tasks have added to our understanding of the neural anatomy of cognition in both normal and pathological states; therefore the application of this technique to the study of patients with mild cognitive impairment could provide additional information for the early
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10 Lee mas

Diagnosis of liver nodules within and outside screening programs

Diagnosis of liver nodules within and outside screening programs

Evaluation of a liver nodule detected with ultrasound includes the recovery of a detailed medical history, a physical exam, appropriate contrast imaging examinations and, in selected cases, histopathology. In this setting, identification of liver disease accompanying a liver nodule helps distinction between benign nod- ules and metastatic malignant nodules from primary liver cancer, as recommended by scientific liver socie- ties. Diagnostic algorithms for a liver nodule in patients with liver disease involve contrast CT scan, magnetic resonance imaging or contrast enhanced ultrasounds to show the typical neoplastic pattern of early arterial hyperenhancement wash-in followed by hypoenhancement in the late portal phase wash out. The flow charts developed by western societies utilize the discriminant criterion of tumor size i.e. the ra- diological diagnosis being endorsed in a nodule equal or greater than 1 cm whereas eastern societies rely on the recognition of a typical vascular pattern of the node, independently of size. Differential diagnosis should be obtained to differentiate liver related nodules like regenerative macronodules (more than 20% of the cases) and the less frequent intrahepatic cholangiocarcinoma (~2% of the cases) from liver disease un- related nodules like hemangioma (~4%), neuroendocrine metastatic nodules (~1%) and focal nodular hyper- plasia. In patients without liver disease, the most common liver nodules in the liver are hemangioma (~1.5%), focal nodular hyperplasia (0.03%) and hepatocellular adenoma (up to 0.004% in long term users of oral contraceptives). Optimization of management of patients with a liver nodule requires establishment of a multidisciplinary clinic.
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6 Lee mas

The Histopathological Features and CT/MRI Imaging Performances in Hepatic Angiomyolipoma Patients

The Histopathological Features and CT/MRI Imaging Performances in Hepatic Angiomyolipoma Patients

Aim. To evaluate the diagnostic value of dynamic contrast-enhanced computed tomography (CT) and magnetic resonance imaging (MRI) in the differential diagnosis of hepatic angiomyolipoma (HAML) and hepatocellular carcinoma (HCC) and to clarify the relation- ship between histopathological features and CT or MRI imaging performances in HAML. Material and methods. Material and methods. Material and methods. Material and methods. Material and methods. Six HAML and 33 non-cirrhotic HCC patients confirmed by histopathology were retrospectively analyzed. The serum biomarkers, CT and MRI ex- aminations were conventionally performed before the confirmatory histological diagnosis. The clinical data from their medical records was also analyzed. Results. Results. Results. Results. Results. Six HAML patients were annotated as two types according to CT and MRI imaging characteristics, in- cluding hypovascular type (n = 1) and hypervascular type (n = 5). The imaging performances of the 33 HCC patients were hypervas- cular type. Moreover, all the 5 hypervascular type HAML patients were misdiagnosed as HCC by CT or MRI. We also found that the hypervascular type of HAML patients contained more vessels and less fatty tissues in histopathology than hypovascular type of HAML patients. However, the clinical features included HCC high risk factors (hepatitis B or C), non-specific symptoms, male and increased serum alpha fetoprotein (AFP) were more common in HCC patients than HAML patients (P < 0.05, respectively). Con- Con- Con- Con- Con- clusions.
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6 Lee mas

Individual differential privacy: A utility preserving formulation of differential privacy guarantees

Individual differential privacy: A utility preserving formulation of differential privacy guarantees

This work formalizes and discusses individual differen- tial privacy, an alternative to the standard formulation of DP that reduces the noise to be added to the query results and, thus, better preserves their accuracy/utility. While, at first sight, individual differential privacy may look like another relaxation of DP, it exactly maintains the intuitive disclosure limitation guarantee of DP: the presence or absence of one individual in the data set must be unnoticeable from the query result. Improving the accuracy of the results is possible because individual differential privacy exploits the fact that the actual data set is known by the trusted data controller at the time of answering queries. By focusing only on indistinguishability between the actual data set and its neighbor data sets, the sensitivity of the query and, and hence, the magnitude of noise to be added significantly decrease.
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12 Lee mas

Gevrey multiscale expansions of singular solutions of PDEs with cubic nonlinearity

Gevrey multiscale expansions of singular solutions of PDEs with cubic nonlinearity

This work falls into the recent trend of research on singular solutions of nonlinear partial differential equations. In the framework of linear PDEs, the case of so- called Fuchsian or regular singularity in one complex variable is a well understood subject until the fundamental works of Baouendi and Goulaouic [4], Tahara [25] and Mandai [23] who extended the classical Frobenius method working for ODEs in order to provide the structure of all analytic, singular with polynomial growth and logarithmic solutions near the isolated singularity. In the nonlinear context, the results are however more partial. Nevertheless, we can quote some deep and recent results regarding this topic. Namely, we can refer to the work by Kobayashi [16] (inspired by the seminal contribution by Weiss, Tabor and Carnevale on the celebrated Painlev´ e property for PDEs, [30]) who constructed solutions having the form of a convergent Puiseux expansions t σ P
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A Differential Fluctuation Theorem †

A Differential Fluctuation Theorem †

energy difference between two thermodynamic states to the joint probability distributions of the forward and reverse nonequi- librium work and of the generalized coordinates corresponding to the states of interest. Order parameters, whose values are associated with different conformations, are examples of such generalized coordinates. The differential fluctuation theorem allows us to use only the nonequilibrium work values that accompany transitions between subsets of the complete equi- librium ensemble to recover the relative partition functions of these subsets.

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Contributions to the development of the CRO SL algorithm: Engineering applications problems

Contributions to the development of the CRO SL algorithm: Engineering applications problems

In the last years, engineers and scientist around the world have dedicated their efforts to tackle optimization problems through meta-heuristic algorithms. This is due to the good quality of the solutions these approaches produce, and the light run-times they employ. Furthermore, they show a great performance when solving problems with special restrictions, of high dimen- sions, or objective functions with non-linear or discrete search spaces. Classical approaches do not provide, in general, good solutions in these cases or they are just unable to be applied to them. In this context, modern optimization heuristics and meta-heuristics have been lately the core of research, aimed at solving the aforementioned lack of efficient methods. A good number of such algorithms are bio-inspired techniques such as Evolutionary Algorithms (EA), which includes a whole family of techniques such as Genetic Algorithms [Eiben2003], Evolution- ary Strategies [Beyer2002], Evolutionary Programming [Yao1999], and Differential Evolution [Storn1997] among others. All of them are based on darwinian concepts as survival of the fittest and natural evolution. Likewise, some of the most famous algorithms between the bio- inspired ones are, Ant Colony Optimization [Dorigo1996], which is based on social behaviour of ants, Cuckoo Optimization Algorithm [Rajabioun2011], which is inspired by the egg laying and breeding of this bird family and Particle Swarm Optimization [Kennedy1995] that imitates bird flocking and fish schooling as a swarm, how they move, change their positions, and trajectories to find their destination. There are many other bio-inspired meta-heuristics, with approaches such as Immune Systems Algorithm [Kephart1994] focus on imitating the behavior of the im- mune system in animals, Artificial Bee Colony [Karaboga2008] which is based on the intelligent foraging behaviour of honey bee swarm in the hive, as well as Invasive Weed Optimization [Mehrabian2006] based on weed growth and their invasive properties and Hunting Search Algo- rithm [Oftadeh2010] inspired by group hunting of animals such as lions, wolves, and dolphins, etc.
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143 Lee mas

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