Sat, 26 Jul 2008 04:35:24 BST CiteULike: Tag diagnosis http://www.citeulike.org/tag/diagnosis CiteULike.org en-gb Copyright © 2004-2008 citeulike.org http://www.citeulike.org/user/zuccite/article/313675 <i>Indian Pediatr, Vol. 42, No. 7. (7 July 2005), pp. 691-696.</i><br /><br />This prospective study was done to assess the frequency of acute pyelonephritis (APN) in febrile children with positive urine culture as documented by Tc99m DMSA scintigraphy (DMSA) and the frequency of vesicoureteric reflux (VUR) in these children. Secondly, to determine the frequency of APN, in febrile children with supportive evidence for UTI but with negative urine culture, as documented by DMSA and frequency of VUR in them. Thirdly to stress the utility of DMSA to diagnose APN in urine culture negative febrile children and to suggest DMSA as a clinical tool in evaluation of fever of unknown origin (FUO). This study included 42 children with positive urine culture and 26 children with negative urine culture who had supportive evidence of UTI as determined by the predetermined criteria and diagnosed to have APN by DMSA. All of them had ultrasonogram (USG), DMSA and voiding cystourethrogram (VCU). They were followed up for a minimum period of 6 months. Out of the 42 children with positive urine culture 92.9percent had features of APN in the DMSA of whom 82.1% had vesicoureteric relux (VUR). The DMSA was abnormal in 26 children with negative urine culture, of whom 65.4percent had VUR. Ultrasound suggestive of parenchymal change was observed in 47.6percent in the culture positive group and 65.4percent in the culture negative group. In conclusion, it is suggested, that DMSA is a useful investigation for the diagnosis of APN in febrile UTI. DMSA is indicated in febrile children with negative urine culture but with supportive evidence of UTI and in FUO. An abnormal DMSA is a strong indication for work up for VUR. Evaluation of the use of DMSA in Culture Positive UTI and Culture Negative Acute Pyelonephritis. B Nammalwar M Vijayakumar Janani Sankar B Ramnath N Prahlad Indian Pediatr, Vol. 42, No. 7. (7 July 2005), pp. 691-696. 2005-09-08T07:45:36-00:00 2005 Indian Pediatr 0019-6061 42 7 691 696 diagnosis dmsa pediatrics pyelonephritis http://www.citeulike.org/user/zkyken/article/1506077 <i>J Urol, Vol. 137, No. 6. (June 1987), pp. 1196-1201.</i><br /><br />Cystourethrography with synchronous urodynamic monitoring was done in 90 men who were diagnosed radiologically as having normal function or bladder outlet obstruction. The separation was based on the caliber of the bladder outlet measured on spot roentgenograms at peak voiding: less than 4 mm. for obstructed and more than 6 mm for normal voiding. The radiological observations are discussed together with the measurements of bladder capacity, residual urine, intravesical pressures and voiding flow rate. The separation between normal men and those with obstruction according to radiologically determined calibers had a strong impact on the distribution of the maximum flow rates. Observations on the onset of micturition suggest that in normal voiding the contracting detrusor meets a simultaneously relaxing bladder neck without interposition of an isometric phase. The patients with subvesical obstruction presented with 2 forms of isometric overload, either as uninhibited contractions or as a variable isometric time lag between the onset of detrusor contraction and opening of the bladder neck. The pre-voiding isometric pressure increase is believed to be an abnormal finding that distinguishes the normal state from obstruction and other disorders. A characteristic decrease in subtracted intravesical pressure at the opening of the bladder neck in patients with uninhibited contractions conceivably indicates that bladder instability is caused by an abnormal reflex originating in the tightened bladder neck. Voiding cystourethrography was an accurate means of diagnosis of subvesical obstruction, especially owing to its ability to quantitate the caliber of a narrowed zone. Voiding cystourethrography with synchronous measurements of pressures and flow in the diagnosis of subvesical obstruction in men: a radiological view. RA Manoliu J Urol, Vol. 137, No. 6. (June 1987), pp. 1196-1201. 2007-07-27T03:47:19-00:00 1987 J Urol 0022-5347 137 6 1196 1201 diagnosis subvesical_obstruction http://www.citeulike.org/user/zkyken/article/1506073 <i>Urologe A, Vol. 24, No. 1. (January 1985), pp. 23-30.</i><br /><br />Acute urinary retention without subvesical obstruction is associated with neurogenic or nonneurogenic disorders of bladder function. Urodynamic investigations differentiates sensoric and/or motoric disturbances of the micturation. Neurologic and laboratory examinations are necessary to clear the etiology. Symptomatic urological treatment and specific etiological therapy should be used to manage this entity. [Urinary retention without subvesical obstruction. Differential diagnostic considerations] W Thon E Senn K Bandhauer Urologe A, Vol. 24, No. 1. (January 1985), pp. 23-30. 2007-07-27T03:44:00-00:00 1985 Urologe A 0340-2592 24 1 23 30 diagnosis review urinary_retention http://www.citeulike.org/user/zkyken/article/1506048 <i>Curr Opin Pediatr, Vol. 18, No. 2. (April 2006), pp. 139-147.</i><br /><br />PURPOSE OF REVIEW: This review will focus on the diagnosis and management of voiding dysfunction in neurologically and anatomically normal children. The discussion will highlight recent developments and research in the clinical approach as well as the etiology and classification of these disorders. RECENT FINDINGS: Voiding dysfunction in children encompasses a wide spectrum of clinical entities, recently classified collectively as dysfunctional elimination syndromes. Voiding dysfunction typically presents after toilet training and may originate from behavioral issues that arise around this time in childhood development. The spectrum of disorders includes urge syndrome, dysfunctional voiding with an uncoordination between the detrusor and urinary sphincter, and enuresis. Clinical symptoms may vary from mild incontinence to severe disorders with endpoints of irreversible bladder dysfunction with vesicoureteral reflux, urinary tract infection and resulting nephropathy. Diagnosis relies heavily on a good history and physical examination, but also includes radiologic and urodynamic evaluation. Treatment generally consists of medical therapy, primarily with anticholinergics as well as behavioral therapy to modify learned voiding patterns that contribute to the voiding dysfunction. SUMMARY: This overview of voiding dysfunction in children outlines the established approaches to its diagnosis and treatment and highlights the most recent developments in the field. Diagnosis and management of dysfunctional voiding. AS Feldman SB Bauer doi:10.1097/01.mop.0000193289.64151.49 Curr Opin Pediatr, Vol. 18, No. 2. (April 2006), pp. 139-147. 2007-07-27T03:29:55-00:00 2006 Curr Opin Pediatr 1040-8703 18 2 139 147 diagnosis dysfunctional_voiding management review http://www.citeulike.org/user/zkyken/article/1512918 <i>Minerva Urol Nefrol, Vol. 56, No. 2. (June 2004), pp. 109-122.</i><br /><br />Benign prostatic hyperplasia (BPH) is an important cause of lower urinary tract symptoms (LUTS). However, many other causes, including smooth muscle dysfunction and neurological factors may contribute to these symptoms, and accurate diagnosis is imperative before invasive treatments are chosen. Careful recording of symptoms, giving emphasis on how they interfere with the patient's quality of life, as well as the use of properly selected tests, constitutes the mainstay of making a correct diagnosis. Men with mild or moderate symptoms not experiencing complications are ideal candidates for medical treatment. For the rest with persistent symptoms or complications such as infection, bleeding, chronic retention or renal impairment further investigation and more invasive forms of treatment need to be considered. We review the patho-physiology of the disease, and current approaches and management of this common problem. Lower urinary tract symptoms and benign prostatic hyperplasia. A Skolarikos AC Thorpe DE Neal Minerva Urol Nefrol, Vol. 56, No. 2. (June 2004), pp. 109-122. 2007-07-30T14:08:36-00:00 2004 Minerva Urol Nefrol 0393-2249 56 2 109 122 bph diagnosis fulltext luts review http://www.citeulike.org/user/zkyken/article/1512879 <i>J Urol, Vol. 176, No. 1. (July 2006), pp. 29-35.</i><br /><br />PURPOSE: Many methods have been suggested to diagnose bladder outlet obstruction, as defined by the gold standard of pressure flow studies. Difficulty arises when comparing completely different methods of diagnosing bladder outlet obstruction. A comprehensive review of the literature on the different methods used to diagnose bladder outlet obstruction by noninvasive means was performed with a view to allow such a comparison. MATERIALS AND METHODS: A MEDLINE search was done of the published literature covering until the end of 2004 on noninvasive methods, including single measure and combinations of measures, to diagnose bladder outlet obstruction. A direct comparison of all of the different methods was made using the sensitivity, specificity, likelihood ratio, and pretest and posttest probability of diagnosing bladder outlet obstruction for each test. For many techniques these values were calculated from the data presented in the article. RESULTS: A multitude of methods has been applied to diagnose bladder outlet obstruction. Broadly the methods were divided into nonurodynamic and noninvasive urodynamic methods. Nonurodynamic methods were considered in part 1 of the review. Part 2 considered noninvasive urodynamic techniques, such as uroflowmetry, the penile cuff, the condom method and Doppler urodynamics. A combination of single measures was also considered and the relative merits of these approaches were discussed. CONCLUSIONS: A combination of noninvasive urodynamics and ultrasound derived measures provide promising methods of diagnosing bladder outlet obstruction. However, pressure flow studies still remain the gold standard for assessing bladder outlet obstruction. Noninvasive methods of diagnosing bladder outlet obstruction in men. Part 2: Noninvasive urodynamics and combination of measures. M Belal P Abrams doi:10.1016/S0022-5347(06)00570-2 J Urol, Vol. 176, No. 1. (July 2006), pp. 29-35. 2007-07-30T13:45:08-00:00 2006 J Urol 0022-5347 176 1 29 35 bladder_neck_obstruction diagnosis review urodynamics http://www.citeulike.org/user/zkyken/article/1512860 <i>J Urol, Vol. 176, No. 1. (July 2006), pp. 22-28.</i><br /><br />PURPOSE: Many methods have been suggested for diagnosing bladder outlet obstruction, as defined by the gold standard of pressure flow studies. Difficulty arises when comparing completely different methods of diagnosing bladder outlet obstruction. A comprehensive review of the literature of the different methods used to diagnose bladder outlet obstruction by noninvasive means was performed with a view to allow such a comparison. MATERIALS AND METHODS: A MEDLINE search was done of the published literature covering until the end of 2004 on noninvasive methods used to diagnose bladder outlet obstruction. A direct comparison of all different methods was made using the sensitivity and specificity, positive predictive value and likelihood ratio of each test. For many of the techniques these values were calculated from the data presented in the article. RESULTS: A multitude of methods has been applied to diagnose bladder outlet obstruction. Broadly the methods were divided into nonurodynamic and noninvasive urodynamic methods. Nonurodynamic methods include symptoms, biochemical tests such as prostate specific antigen, ultrasound derived measurements such as post-void residual urine, bladder weight, prostate configuration and size, intravesical prostatic protrusion and the Doppler resistive index. Part 1 of the review explores and discusses the relative merits of the nonurodynamic based methods. CONCLUSIONS: Ultrasound derived measures such as bladder wall thickness and bladder weight offer a promising possibility of diagnosing bladder outlet obstruction noninvasively. However, further reproducibility and large accuracy studies with better methodological standards are required before they can replace pressure flow studies. Noninvasive methods of diagnosing bladder outlet obstruction in men. Part 1: Nonurodynamic approach. M Belal P Abrams doi:10.1016/S0022-5347(06)00569-6 J Urol, Vol. 176, No. 1. (July 2006), pp. 22-28. 2007-07-30T13:35:05-00:00 2006 J Urol 0022-5347 176 1 22 28 bladder_neck_obstruction diagnosis review http://www.citeulike.org/user/zkyken/article/1523312 <i>European Urology, Vol. In Press, Corrected Proof</i><br /><br />Objectives The aim of this prospective study was to compare the diagnostic accuracy of detrusor wall thickness (DWT), free uroflowmetry, postvoid residual urine, and prostate volume (index tests) with pressure-flow studies (reference standard) to detect bladder outlet obstruction (BOO) in men.Methods During a 2-yr period, men older than 40 yr with lower urinary tract symptoms and/or prostatic enlargement had the following tests: ultrasound measurements of DWT, free uroflowmetry (Qmax, Qave), postvoid residual urine, and prostate volume. Pressure-flow studies were used to divide obstructed from nonobstructed bladders.Results One hundred sixty men between 40-89 yr of age (median: 62 yr) were included in the study; 75 patients (46.9%) had BOO according to pressure-flow studies. The results of all investigated index tests differed significantly between obstructed and nonobstructed men. DWT was the most accurate test to determine BOO: the positive predictive value was 94%, specificity 95%, and the area under the curve of ROC analysis 0.93. There was an agreement of 89% between the results of DWT measurement and pressure-flow studies.Conclusions Measurements of DWT can detect BOO better than free uroflowmetry, postvoid residual urine, or prostate volume. In clinical routine, DWT measurements can be used to judge BOO noninvasively. Diagnostic Accuracy of Noninvasive Tests to Evaluate Bladder Outlet Obstruction in Men: Detrusor Wall Thickness, Uroflowmetry, Postvoid Residual Urine, and Prostate Volume Matthias Oelke Klaus Hofner Udo Jonas de La Dirk Ubbink Hessel Wijkstra doi:10.1016/j.eururo.2006.12.023 European Urology, Vol. In Press, Corrected Proof 2007-07-31T01:05:33-00:00 European Urology In Press, Corrected Proof bladder_neck_obstruction diagnosis fulltext review http://www.citeulike.org/user/xtizon/article/2212171 <i>Journal of Magnetic Resonance Imaging, Vol. 27, No. 1. (2008), pp. 132-139.</i><br /><br />To elucidate the performance of apparent diffusion coefficient (ADC) map in localizing prostate carcinoma (PC) using stepwise histopathology as a reference.Preoperative MR images of 37 patients with PC who had undergone radical prostatectomy were retrospectively evaluated. First, T2-weighted images (T2WI) alone were interpreted (T2WI reading), and then T2WI along with ADC map were interpreted (T2WI/ADC map reading). Sextant-based sensitivity and specificity, and the ratio of the detected volume to the whole tumor volume (% tumor volume) were compared between the two interpretations, and results were also correlated to Gleason's scores (GS). ADC values were correlated to histological grades.Sensitivity was significantly higher in T2WI/ADC map reading than in T2WI reading (71% vs. 51%), but specificity was similar (61% vs. 60%). By adding ADC map to T2WI, % tumor volume detected increased significantly in transitional zone (TZ) lesions, but not in peripheral zone (PZ) lesions. % tumor volume detected with T2WI/ADC map reading showed a positive correlation with GS of the specimens. Less differentiated PC were associated with lower ADC values and higher detectability.T2WI/ADC map reading was better than T2WI reading in PC detection and localization. This approach may be particularly useful for detecting TZ lesions and biologically aggressive lesions. J. Magn. Reson. Imaging 2007. © 2007 Wiley-Liss, Inc. Usefulness of apparent diffusion coefficient map in diagnosing prostate carcinoma: Correlation with stepwise histopathology Kengo Yoshimitsu Keijiro Kiyoshima Hiroyuki Irie Tsuyoshi Tajima Yoshiki Asayama Masakazu Hirakawa Kousei Ishigami Seiji Naito Hiroshi Honda doi:10.1002/jmri.21181 Journal of Magnetic Resonance Imaging, Vol. 27, No. 1. (2008), pp. 132-139. 2008-01-09T20:55:15-00:00 2008 Journal of Magnetic Resonance Imaging 27 1 132 139 apparent-diffusion-coefficient diagnosis dw-mri histology prostate http://www.citeulike.org/user/xtizon/article/419746 <i>J Digit Imaging, Vol. 15, No. 2. (June 2002), pp. 59-68.</i><br /><br />Computer-aided diagnosis has been under development for more than 3 decades. The rate of progress appears exponential, with either recent approval or pending approval for devices focusing on mammography, chest radiographs, and chest CT. Related technologies improve diagnosis for many other types of medical images including virtual colonography, vascular imaging, as well as automated quantitation of image-derived metrics. A variety of techniques are currently employed with success, likely reflecting the variety of imagery used, as well as the variety of tasks. Most areas of medical imaging have had efforts at computer assistance, and some have even received FDA approval and can be reimbursed. We anticipate that the rapid advance of these technologies will continue, and that application will broaden to cover much of medical imaging. Acceptance of, and integration of computer-aided diagnosis technology with the electronic radiology practice is a current challenge. These challenges will be overcome, and we expect that computer-aided diagnosis will be routinely applied to medical images. Computer-aided detection and diagnosis at the start of the third millennium. BJ Erickson B Bartholmai doi:10.1007/s10278-002-0011-x J Digit Imaging, Vol. 15, No. 2. (June 2002), pp. 59-68. 2005-12-02T15:25:09-00:00 2002 J Digit Imaging 0897-1889 15 2 59 68 diagnosis medical-imaging perspective review http://www.citeulike.org/user/xtizon/article/2365398 <i>International Journal of Radiation Oncology*Biology*Physics, Vol. 70, No. 2. (1 February 2008), pp. 425-430.</i><br /><br />Purpose To compare the performance of T2-weighted (T2w) imaging and dynamic contrast-enhanced (DCE) magnetic resonance imaging (MRI) of the prostate gland in the localization of recurrent prostate cancer in patients with biochemical failure after external beam radiotherapy (EBRT).Methods and Materials T2-weighted imaging and DCE MRI were performed in 33 patients with suspected relapse after EBRT. Dynamic contrast-enhanced MRI was performed with a temporal resolution of 95 s. Voxels enhancing at 46 s after injection to a greater degree than the mean signal intensity of the prostate at 618 s were considered malignant. Results from MRI were correlated with biopsies from six regions in the peripheral zone (PZ) (base, mid, and apex). The percentage of biopsy core positive for malignancy from each region was correlated with the maximum diameter of the tumor on DCE MRI with a linear regression model.Results On a sextant basis, DCE MRI had significantly better sensitivity (72% [21of 29] vs. 38% [11 of 29]), positive predictive value (46% [21 of 46] vs. 24% [11 of 45]) and negative predictive value (95% [144 of 152] vs. 88% [135 of 153] than T2w imaging. Specificities were high for both DCE MRI and T2w imaging (85% [144 of 169] vs. 80% [135 of 169]). There was a linear relationship between tumor diameters on DCE MRI and the percentage of cancer tissue in the corresponding biopsy core (r = 0.9, p < 0.001), with a slope of 1.2.Conclusions Dynamic contrast-enhanced MRI performs better than T2w imaging in the detection and localization of prostate cancer in the peripheral zone after EBRT. This may be helpful in the planning of salvage therapy. Dynamic Contrast-Enhanced Magnetic Resonance Imaging for Localization of Recurrent Prostate Cancer After External Beam Radiotherapy Masoom Haider Peter Chung Joan Sweet Ants Toi Kartik Jhaveri Cynthia Menard Padraig Warde John Trachtenberg Gina Lockwood Michael Milosevic doi:10.1016/j.ijrobp.2007.06.029 International Journal of Radiation Oncology*Biology*Physics, Vol. 70, No. 2. (1 February 2008), pp. 425-430. 2008-02-12T09:32:59-00:00 2008 International Journal of Radiation Oncology*Biology*Physics 70 2 425 430 dce-mri diagnosis prostate radiotherapy http://www.citeulike.org/user/xtizon/article/2348532 <i>Radiology (25 January 2008), 2463070432.</i><br /><br />Purpose: To retrospectively compare diffusion-weighted (DW) magnetic resonance (MR) imaging with standard breath-hold T2-weighted MR imaging for focal liver lesion (FLL) detection and characterization, by using consensus evaluation and other findings as the reference standard. Materials and Methods: Approval for this retrospective HIPAA-compliant study was obtained from the institutional review board; informed consent was waived. Fifty-three consecutive patients (30 men, 23 women; mean age, 60.7 years) with at least one FLL of 1 cm or greater in diameter were evaluated. Two independent observers reviewed DW (b values of 0, 50, and 500 sec/mm2) and T2-weighted images for FLL detection and characterization. Reference standard for diagnosis was obtained from consensus review by the two observers of DW, T2-weighted, and dynamic contrast materialenhanced images, pathologic data, and follow-up imaging results. Apparent diffusion coefficient (ADC) was measured for FLLs identified at consensus review. DW and T2-weighted images were compared for FLL detection and characterization by using a binary logistic regression model. Receiver operating characteristic curve analyses were conducted to evaluate the utility of ADC for diagnosis of malignancy. Results: Two hundred eleven FLLs (136 malignant, 75 benign) were detected at consensus review. Overall detection rate (averaged for two observers) was significantly higher for DW (87.7%) versus T2-weighted (70.1%) imaging (P < .001). FLL characterization was not significantly different between DW (89.1%) and T2-weighted (86.8%) imaging (P = .51). ADCs of malignant FLLs were significantly lower than those of benign FLLs (P < .001). The area under the curve for diagnosis of malignancy was 0.839, with sensitivity of 74.2%, specificity of 77.3%, positive predictive value of 85.5%, negative predictive value of 62.3%, and accuracy of 75.3%, by using a threshold ADC of less than 1.60 x 103 mm2/sec. Conclusion: DW MR imaging was better than standard breath-hold T2-weighted imaging for FLL detection and was equal to breath-hold T2-weighted imaging for FLL characterization. Supplemental material: http://radiology.rsnajnls.org/cgi/content/full/2463070432/DC1 (C) RSNA, 2008 10.1148/radiol.2463070432 Focal Liver Lesion Detection and Characterization with Diffusion-weighted MR Imaging: Comparison with Standard Breath-hold T2-weighted Imaging Tejas Parikh Stephen Drew Vivian Lee Samson Wong Elizabeth Hecht James Babb Bachir Taouli doi:10.1148/radiol.2463070432 Radiology (25 January 2008), 2463070432. 2008-02-07T10:00:36-00:00 2008 Radiology 2463070432 diagnosis dw-mri liver mri t2 http://www.citeulike.org/user/uhbnji98/article/274456 <i>N Engl J Med, Vol. 353, No. 5. (4 August 2005), pp. 498-507.</i> Diagnosis from the blood smear. BJ Bain doi:10.1056/NEJMra043442 N Engl J Med, Vol. 353, No. 5. (4 August 2005), pp. 498-507. 2005-08-05T09:18:06-00:00 2005 N Engl J Med 1533-4406 353 5 498 507 blood diagnosis smear http://www.citeulike.org/user/timsenior/article/2338286 <i>Am J Respir Crit Care Med, Vol. 174, No. 10. (15 November 2006), pp. 1077-1087.</i><br /><br />OBJECTIVE: To determine whether peak flow monitoring has value above and beyond symptom monitoring when used as part of an asthma management plan. METHODS: From a large managed-care organization, 296 adults, aged 50-92 yr, were recruited and randomly assigned in equal numbers to either use of symptoms or peak flow rate (twice daily or "as needed") for asthma monitoring, and monitored every 6 mo for 2 yr. Interventions were delivered in four 90-min small-group classes and included a personalized action plan and coaching in proper use of asthma inhalers. RESULTS: We found no significant differences between peak flow rate and symptom monitoring, or between twice-daily and as-needed peak flow monitoring in the primary or secondary study outcomes: health care utilization (acute, nonacute, or total asthma visits), Asthma Quality-of-Life Questionnaire (AQLQ) scores, and lung function. AQLQ scores and prebronchodilator FEV1 increased significantly for both groups between baseline and 6 mo (AQLQ: mean, 0.4 units; 95% confidence interval, 0.3, 0.5; p < 0.0001; FEV1% predicted: mean, 4%). Inhaler technique improved substantially in both groups. CONCLUSIONS: Peak flow monitoring has no advantage over symptom monitoring as an asthma management strategy for older adults with moderate-severe asthma when used in a comprehensive asthma management program. Improved outcomes in both groups suggest that understanding proper medication use, regular monitoring of asthma status, and understanding how to respond to changes are of primary importance. A randomized clinical trial of peak flow versus symptom monitoring in older adults with asthma. AS Buist WM Vollmer SR Wilson EA Frazier AD Hayward doi:10.1164/rccm.200510-1606OC Am J Respir Crit Care Med, Vol. 174, No. 10. (15 November 2006), pp. 1077-1087. 2008-02-06T02:36:51-00:00 2006 Am J Respir Crit Care Med 1073-449X 174 10 1077 1087 asthma diagnosis history http://www.citeulike.org/user/timsenior/article/634929 <i>Arch Dis Child, Vol. 62, No. 8. (August 1987), pp. 851-852.</i><br /><br />Clinical features cannot differentiate rotavirus gastroenteritis from other types of diarrhoea. Sixty eight stool specimens were examined by nurses on an infant gastroenteritis ward. Of these, 69% were correctly classified by smell alone. The results are significant (p = 0.009) and support the suggestion that rotavirus stools have a characteristic smell. Diagnosis of rotavirus gastroenteritis by smell. J Poulton MJ Tarlow Arch Dis Child, Vol. 62, No. 8. (August 1987), pp. 851-852. 2006-05-15T03:05:41-00:00 1987 Arch Dis Child 1468-2044 62 8 851 852 clinical diagnosis examination rotavirus http://www.citeulike.org/user/Thyroiditis/article/571274 <i>Pediatr Endocrinol Rev, Vol. 1 Suppl 2 (December 2003)</i><br /><br />Hashimoto's Thyroiditis (HT) is the most common cause of thyroid diseases in children and adolescents and it is also the most common cause of acquired hypothyroidism with or without goiter. The linkage between HT and some HLA genes has been reported and a genetic predisposition to thyroid autoimmunity is suggested by observations in twins. There is no direct evidence that infections cause HT in humans, while iodine and iodine containing drugs can precipitate HT in susceptible populations. There is an infiltration of lymphocytes and plasma cells between the follicles followed by their atrophy. The clinical course is variable and spontaneous remission may occur in adolescence. Goiter, menstrual disorders, short stature, constipation, nervousness and exophthalmos have been reported as the most recurrent clinical features of HT. Nevertheless we studied 33 patients with HT, 22 girls and 11 boys aged 4.9-19 years and most of them were euthyroid clinically. Hashimoto thyroiditis is often associated with type 1 diabetes and other autoimmune disorders such as coeliac disease, type 2 and type 3 polyglandular autoimmune disorders. Girls with Turner syndrome may develop HT. Patients with HT have positive antibodies to thyroglobulin and/or to thyroperoxidase in blood. Thyroid function could be normal or abnormal (overt hypothyroidism, subclinical hypothyroidism and hyperthyroidism). Abnormal ultrasound patterns may be present in patients with HT disease as diffuse hypoechogenicity and pseudonodules. L-thyroxine therapy is indicated in HT with hypothyroidism, but periodic re-evaluations are required because HT could be a self-limited disorder in some cases. Hashimoto's Thyroiditis. R Lorini R Gastaldi C Traggiai PP Perucchin Pediatr Endocrinol Rev, Vol. 1 Suppl 2 (December 2003) 2006-03-31T03:20:14-00:00 2003 Pediatr Endocrinol Rev 1565-4753 1 Suppl 2 adolescence autoimmune diagnosis etiology hashimotos iodine menstrual_disorders pediatric remission http://www.citeulike.org/user/tbakernp/article/2964742 <i>BMJ, Vol. 334, No. 7606. (16 June 2007), pp. 1229-1230.</i><br /><br />10.1136/bmj.39244.344664.80 Diagnosis of peripheral arterial disease of the lower limb Andrew Bradbury Donald Adam doi:10.1136/bmj.39244.344664.80 BMJ, Vol. 334, No. 7606. (16 June 2007), pp. 1229-1230. 2008-07-04T17:56:58-00:00 2007 BMJ 334 7606 1229 1230 diagnosis of pvd http://www.citeulike.org/user/suribe/article/2235200 <i>European Journal of Oral Sciences, Vol. 114, No. 4. (2006), pp. 263-277.</i><br /><br />Baelum V, Heidmann J, Nyvad B. Dental caries paradigms in diagnosis and diagnostic research. Eur J Oral Sci 2006; 114: 263-277. c 2006 The Authors. Journal compilationc 2006 Eur J Oral Sci In this article, the fundamentals of caries diagnosis are reviewed from the three component perspectives, namely the strategy, the logics, and the tactics. Strategy concerns the objectives of the diagnostic process (i.e. why we diagnose caries). The logics describe how we assemble and evaluate the information collected and how this leads to an assessment of diagnostic value. Finally, tactics are about how we collect the information necessary to arrive at a correct diagnosis. We argue that the hitherto-dominant essentialistic caries paradigm should be replaced by a nominalistic caries concept. This allows us to circumvent the problem of a lack of a caries gold standard and to proceed in caries-diagnostic research to find the diagnostic methods that result in the best health outcomes for our patients. We also demonstrate the limitations of the medical model when attempting to understand caries diagnosis, and adhere to the Bader& Shugars caries script model. It is concluded that the current caries profile, characterized by lower prevalence and extent, and slower progression, has increased the need for an academic strengthening of the dental curriculum with respect to diagnostic reasoning and clinical decision-making processes. Dental caries paradigms in diagnosis and diagnostic research Vibeke Baelum Jens Heidmann Bente Nyvad doi:10.1111/j.1600-0722.2006.00383.x European Journal of Oral Sciences, Vol. 114, No. 4. (2006), pp. 263-277. 2008-01-15T14:52:03-00:00 2006 European Journal of Oral Sciences 114 4 263 277 caries diagnosis http://www.citeulike.org/user/suribe/article/1333867 <i>Community Dentistry and Oral Epidemiology, Vol. 35, No. 3. (June 2007), pp. 170-178.</i> The International Caries Detection and Assessment System (ICDAS): an integrated system for measuring dental caries Ismail Sohn Tellez Amaya Sen Hasson Pitts doi:10.1111/j.1600-0528.2007.00347.x Community Dentistry and Oral Epidemiology, Vol. 35, No. 3. (June 2007), pp. 170-178. 2007-05-25T20:51:27-00:00 2007 Community Dentistry and Oral Epidemiology 0301-5661 35 3 170 178 Blackwell Publishing caries diagnosis icdas http://www.citeulike.org/user/stavros/article/493701 <i>Artificial Intelligence, Vol. 32, No. 1. (April 1987), pp. 57-95.</i> A theory of diagnosis from first principles Raymond Reiter doi:10.1016/0004-3702(87)90062-2 Artificial Intelligence, Vol. 32, No. 1. (April 1987), pp. 57-95. 2006-02-04T02:25:26-00:00 1987 Artificial Intelligence 0004-3702 32 1 57 95 Elsevier Science Publishers Ltd. diagnosis logic http://www.citeulike.org/user/stavros/article/493700 <i>Artificial Intelligence, Vol. 56, No. 2-3. (August 1992), pp. 197-222.</i><br /><br />Most approaches to model-based diagnosis describe a diagnosis for a system as a set of failing components that explains the symptoms. In order to characterize the typically very large number of diagnoses, usually only the minimal such sets of failing components are represented. This method of characterizing all diagnoses is inadequate in general, in part because not every superset of the faulty components of a diagnosis necessarily provides a diagnosis. In this paper we analyze the concept of diagnosis in depth exploiting the notions of implicate/implicant and prime implicate/implicant. We use these notions to consider two alternative approaches for addressing the inadequacy of the concept of minimal diagnosis. First, we propose a new concept, that of kernel diagnosis, which is free of this problem with minimal diagnosis. This concept is useful to both the consistency and abductive views of diagnosis. Second, we consider restricting the axioms used to describe the system to ensure that the concept of minimal diagnosis is adequate. Characterizing diagnoses and systems Johan de Kleer Alan Mackworth Raymond Reiter doi:10.1016/0004-3702(92)90027-U Artificial Intelligence, Vol. 56, No. 2-3. (August 1992), pp. 197-222. 2006-02-04T02:22:18-00:00 1992 Artificial Intelligence 56 2-3 197 222 diagnosis logic http://www.citeulike.org/user/sjakov/article/1641763 <i>J Am Vet Med Assoc, Vol. 188, No. 4. (15 February 1986), pp. 387-392.</i><br /><br />Clinical differences were determined between granulomatous meningoencephalomyelitis, distemper, and suppurative meningoencephalitis in the dog. Dogs with granulomatous meningoencephalomyelitis had "head" signs on examination, which progressed to profound caudal fossa abnormalities, changes in mental status, and tetraparesis. Dogs with distemper had a gradual onset of posterior paresis; tetraparesis and occasional vestibular signs developed later in the course of disease. Dogs with suppurative meningoencephalitis had lethargy and anorexia at the time of examination, which progressed to nuchal rigidity, mental depression, tetraparesis, and profound alterations in consciousness. Analysis of cerebral spinal fluid was useful in distinguishing suppurative meningoencephalitis from the other 2 diseases. Twenty-seven cases of inflammatory disease of the CNS in dogs were reviewed. Comparisons of history, results of physical and neurologic examinations, ancillary data, and response to treatment were made. It appeared that certain clinical and neurologic features contributed to the diagnosis of these diseases. Differential diagnosis of granulomatous meningoencephalomyelitis, distemper, and suppurative meningoencephalitis in the dog. D Sarfaty JM Carrillo PG Greenlee J Am Vet Med Assoc, Vol. 188, No. 4. (15 February 1986), pp. 387-392. 2007-09-10T13:29:01-00:00 1986 J Am Vet Med Assoc 0003-1488 188 4 387 392 diagnosis distemper dog gme meningoencephalitis http://www.citeulike.org/user/sjakov/article/2634914 <i>Veterinary Surgery, Vol. 37, No. 3. (2008), pp. 294-299.</i><br /><br />Objective- To compare the diagnostic yield of conventional radiographs and computed tomography (CT) images of the skulls of dogs and cats with maxillofacial trauma (MFT). Study Design- Prospective study. Animals- Dogs (n=9) and 15 cats with MFT. Methods- CT-scans and skull radiographs (4 standard projections) for each animal were evaluated using a semi-quantitative scoring system for the ability to identify 26 predefined, clinically relevant anatomic features (Part 1), and 27 predetermined potential traumatic injuries (Part 2). For Part 1, mean scores for each anatomic feature were recorded for every view and imaging modality. For Part 2, studies were evaluated for the frequency of cases where each predetermined traumatic injury was identified. Results- Part 1: On radiographs it was easy to identify 17 of 26 anatomic features whereas 6 features were very difficult or impossible to identify on any view. All structures were considered easy or very easy to identify on CT. Scores for CT were lower than radiographs for evaluating dental occlusion and the integrity of the mandibular body. Part 2: CT scans demonstrated 1.6 times more maxillofacial injuries for dogs and 2.0 times more for cats than conventional radiographs. The average number of MFT injuries per animal by radiographs and CT-scan was 4.8 and 7.6 in dogs, and 3.8 and 7.7 in cats, respectively. Conclusion- CT is superior to conventional skull radiography for identification of anatomic structures and traumatic injuries in dogs and cats. Skull radiography is useful for visualizing the mandibular body and dental occlusion. Clinical Relevance- CT allows for accurate assessment, diagnosis and treatment planning of MFT in dogs and cats. The Diagnostic Yield of Conventional Radiographs and Computed Tomography in Dogs and Cats with Maxillofacial Trauma Yoav Am Rachel Pollard Philip Kass Frank Verstraete doi:10.1111/j.1532-950X.2008.00380.x Veterinary Surgery, Vol. 37, No. 3. (2008), pp. 294-299. 2008-04-06T15:19:25-00:00 2008 Veterinary Surgery 37 3 294 299 cat ct diagnosis dogs maxillofacial radiography trauma http://www.citeulike.org/user/sjakov/article/2460523 <i>Vet Radiol Ultrasound, Vol. 49, No. 1. (b 2008), pp. 47-50.</i> Imaging diagnosis--Feline idiopathic pulmonary fibrosis. SA Secrest MQ Bailey KJ Williams SD Smarick Vet Radiol Ultrasound, Vol. 49, No. 1. (b 2008), pp. 47-50. 2008-03-03T10:19:59-00:00 2008 Vet Radiol Ultrasound 1058-8183 49 1 47 50 cat diagnosis feline fibrosis idiopathic imaging pulmonary radiography http://www.citeulike.org/user/sjakov/article/2245461 <i>J Vet Intern Med, Vol. 21, No. 6. (c 2007), pp. 1280-1289.</i><br /><br />BACKGROUND: Diagnosis of pulmonary arterial hypertension (PAH) relies on Doppler measurement of pulmonic and tricuspid regurgitation (TR). However, these are not always detectable. HYPOTHESIS: Tissue Doppler imaging (TDI), a novel noninvasive ultrasound technique, provides indirect but sensitive and specific assessment of elevated systolic pulmonary artery pressure (SPAP) in dogs. ANIMALS: One hundred and five dogs with TR. METHODS: Prospective observational study. Dogs were categorized as presenting normal (group 1, n = 45), mildly increased (group 2, n = 19), or moderately to severely increased (group 3, n = 41) SPAP, based on TR peak velocities (< 2.5, 2.5-3.0, and > 3.0 m/s, respectively). Ten quantitative echo-Doppler- and TDI-derived variables were assessed, including the main pulmonary arterial diameter to aortic diameter ratio, pulmonary flow acceleration time, and acceleration-to-ejection time ratio, the Tei index of right ventricular function, and 6 longitudinal basal right ventricular TDI variables. RESULTS: A significant correlation was observed between SPAP and each of the 10 tested variables (P < .05). Conventional echo-Doppler variables were less discriminating than the TDI for predicting increased SPAP. The combined systolic and diastolic right TDI index had the highest sensitivity and specificity (89% and 93% respectively, for a cutoff of 11.8 cm/s) and could discriminate between dogs in group 1 from dogs in group 2. CONCLUSIONS AND CLINICAL IMPORTANCE: TDI provided effective predictors of systolic PAH and demonstrated that both alterations in right-sided systolic and diastolic myocardial function can occur with mild increases in SPAP. Diagnostic value of echo-Doppler and tissue Doppler imaging in dogs with pulmonary arterial hypertension. F Serres V Chetboul V Gouni R Tissier CC Sampedrano JL Pouchelon J Vet Intern Med, Vol. 21, No. 6. (c 2007), pp. 1280-1289. 2008-01-17T14:25:35-00:00 2007 J Vet Intern Med 0891-6640 21 6 1280 1289 arterial diagnosis dog echo-doppler hypertension pulmonary tissue-doppler-imaging ultrasound http://www.citeulike.org/user/sjakov/article/2456063 <i>Vet Radiol Ultrasound, Vol. 49, No. 1. (b 2008), pp. 51-55.</i><br /><br />An unusual form of congenital intrahepatic portosystemic shunt was identified in a 3 1/2-month-old female Labrador Retriever with neurologic signs. Ultrasonography and contrast-enhanced computed tomography were used to characterize the shunt morphology. An unusual, looping right-divisional shunt connected back to the portal vein that formed an ampula in the right-central portion of the liver. An irregularly shaped window-like opening connected the combined right-divisional loop and aneurysmal portal vein, and the caudal vena cava, while this vascular pool gradually fused more cranially. Imaging features of this complex vascular anomaly, which has not been previously reported, are presented. Imaging diagnosis--Complex intrahepatic portosystemic shunt in a dog. MA D'Anjou L Huneault Vet Radiol Ultrasound, Vol. 49, No. 1. (b 2008), pp. 51-55. 2008-03-02T00:30:53-00:00 2008 Vet Radiol Ultrasound 1058-8183 49 1 51 55 diagnosis dog intrahepatic pss ultrasound http://www.citeulike.org/user/sjakov/article/2456059 <i>Vet Radiol Ultrasound, Vol. 49, No. 1. (b 2008), pp. 56-64.</i><br /><br />Intestinal wall thickness is neither a specific nor sensitive ultrasound parameter for detecting intestinal inflammation. We hypothesize that mucosal echogenicity, lymphadenomegaly, and secondary findings of the gastrointestinal tract would be more sensitive and specific markers for detecting and differentiating causes of chronic inflammatory bowel disease in dogs. Fifty-six client-owned dogs with chronic diarrhea and 10 control dogs were examined with two-dimensional, gray-scale ultrasound (time 0, 4, and 10 weeks post therapy) and small intestinal mucosal biopsies were performed at the 0- and 4-week time points. The clinical activity was assessed at each time point using the canine inflammatory bowel disease activity index (CIBDAI). Fifty-one dogs had inflammatory infiltration of the duodenal mucosa and were divided into three groups, food-responsive disease, idiopathic inflammatory bowel disease, and protein-losing enteropathy, based on their response to the different treatments and histology. Two different patterns of increased echogenicity of the mucosa were detected: hyperechoic speckles and hyperechoic striations. A normal, hypoechoic bowel mucosa in dogs with chronic diarrhea had a sensitivity of 80% and a specificity of 81% for the diagnosis of food-responsive disease. Hyperechoic striations had a sensitivity of 75% and a specificity of 96% for dogs with protein-losing enteropathy. Hyperechoic speckles were non-specific for diagnosing inflammatory bowel disease. There was a significant relationship between ultrasound score and CIBDAI at t0, but not following therapy. Mucosal echogenicity may be a better parameter for detecting inflammatory bowel disease than bowel wall thickness in dogs with chronic diarrhea. Comparison of ultrasonographic findings with clinical activity index (CIBDAI) and diagnosis in dogs with chronic enteropathies. L Gaschen P Kircher A Stüssi K Allenspach F Gaschen M Doherr A Gröne Vet Radiol Ultrasound, Vol. 49, No. 1. (b 2008), pp. 56-64. 2008-03-02T00:27:26-00:00 2008 Vet Radiol Ultrasound 1058-8183 49 1 56 64 clinical-activity-index comparison diagnosis dog enteropathies ultrasound http://www.citeulike.org/user/sjakov/article/2515453 <i>Can Vet J, Vol. 49, No. 1. (January 2008), pp. 77-81.</i><br /><br />Ultrasound-guided fine needle aspiration was used in establishing the diagnosis in 4 cases of malignant peripheral nerve sheath tumor. Sonographic and cytologic characteristics are discussed. Because of its availability and ease of use, axillary ultrasonography with fine needle aspiration can be an initial diagnostic step for suspected brachial plexus tumors. Ultrasound-guided fine needle aspiration in the diagnosis of peripheral nerve sheath tumors in 4 dogs. RC da Costa JM Parent H Dobson K Ruotsalo D Holmberg MC Duque R Poma Can Vet J, Vol. 49, No. 1. (January 2008), pp. 77-81. 2008-03-11T15:54:47-00:00 2008 Can Vet J 0008-5286 49 1 77 81 diagnosis dog fna nerve peripheral sheath tumors ultrasound http://www.citeulike.org/user/sjakov/article/2531320 <i>Vet Radiol Ultrasound, Vol. 49, No. 1. (b 2008), pp. 65-67.</i><br /><br />Solitary renal cysts are benign and in the majority of instances asymptomatic and do not require treatment. Nevertheless, treatment may be required if abdominal discomfort or pain, hypertension, infection or renal outflow obstruction occur. Under these circumstances, percutaneous management of the cyst is the easiest and fastest procedure, and no major complications are generally encountered. In this report we describe a patient with a solitary renal cyst treated successfully by a single injection of ethanol into the cyst. The sonographic appearance of the cyst changed from a well-defined hypoechoic structure to an ill-defined hyperechoic region. Canine renal cysts may be successfully managed in some instances by a single ethanol injection. Imaging diagnosis--Ultrasound-guided ethanol sclerotherapy for a simple renal cyst. A Agut M Soler FG Laredo FJ Pallares JI Seva Vet Radiol Ultrasound, Vol. 49, No. 1. (b 2008), pp. 65-67. 2008-03-14T09:50:28-00:00 2008 Vet Radiol Ultrasound 1058-8183 49 1 65 67 cyst diagnosis ethanol imaging renal sclerotherapy ultrasound http://www.citeulike.org/user/sjakov/article/2447793 <i>J Am Vet Med Assoc, Vol. 212, No. 1. (1 January 1998), pp. 77-80.</i><br /><br />A strain injury to the infraspinatus muscle was a potential cause of forelimb lameness in a dog. Ultrasonography was used for evaluation of infraspinatus muscle injury. The ultrasonographic appearance of a typical infraspinatus muscle, contracture of an infraspinatus muscle, acute strain of an infraspinatus muscle, and progression of healing of the infraspinatus muscle are described. Use of two-dimensional real-time ultrasonography for diagnosing contracture and strain of the infraspinatus muscle in a dog. JJ Siems GJ Breur WE Blevins KK Cornell J Am Vet Med Assoc, Vol. 212, No. 1. (1 January 1998), pp. 77-80. 2008-02-29T14:23:29-00:00 1998 J Am Vet Med Assoc 0003-1488 212 1 77 80 contracture diagnosis dog infraspinatus muscle strain ultrasonography http://www.citeulike.org/user/sjakov/article/1567654 <i>Am J Vet Res, Vol. 68, No. 8. (August 2007), pp. 858-871.</i><br /><br />Objective-To test the effects of computed tomography (CT) image plane and window settings on diagnostic certainty for CT characteristics associated with dysplastic elbow joints (elbow joint dysplasia) in dogs and to provide optimal display guidelines for these CT characteristics. Sample Population-CT images of 50 dysplastic elbow joints from 49 lame dogs and 10 elbow joints from 5 sound dogs. Procedures-CT image data were obtained in transverse, sagittal, and dorsal planes. Each plane was examined by use of 3 Hounsfield unit (HU) window settings. Two veterinary radiologists independently evaluated sets of CT images for evidence of 7 CT characteristics. Effect of elbow joint status, image plane, and window settings on diagnostic certainty for these CT characteristics was tested by use of a visual analogue scale. Results-Diagnostic certainty for abnormalities of the medial coronoid process (MCP) and radial incisure was highest in the transverse plane, subchondral defects or sclerosis of the trochlea humeri was highest in the dorsal plane, and joint incongruity was highest in the sagittal plane. Certainty for hypoattenuating subchondral defects or fissures was highest at 2,500 or 3,500 HUs, whereas certainty for subchondral sclerosis was highest at 1,500 HUs and lowest at 3,500 HUs. Conclusions and Clinical Relevance-Diagnostic certainty for CT characteristics of elbow joint dysplasia in dogs was affected by image display variables. Diagnostic certainty for altered subchondral bone density was primarily influenced by window settings, whereas structural MCP abnormalities and joint incongruity were influenced most by image plane. Effect of computed tomography display window and image plane on diagnostic certainty for characteristics of dysplastic elbow joints in dogs. TC Tromblee JC Jones AM Bahr PK Shires S Aref doi:10.2460/ajvr.68.8.858 Am J Vet Res, Vol. 68, No. 8. (August 2007), pp. 858-871. 2007-08-15T20:21:03-00:00 2007 Am J Vet Res 0002-9645 68 8 858 871 ct diagnosis dog elbow-dysplasia joints http://www.citeulike.org/user/sjakov/article/1572669 <i>J Am Vet Med Assoc, Vol. 231, No. 3. (1 August 2007)</i><br /><br />Objective-To test the effects of computed tomography (CT) image plane and window settings on diagnostic certainty for CT characteristics associated with dysplastic elbow joints (elbow joint dysplasia) in dogs and to provide optimal display guidelines for these CT characteristics. Sample Population-CT images of 50 dysplastic elbow joints from 49 lame dogs and 10 elbow joints from 5 sound dogs. Procedures-CT image data were obtained in transverse, sagittal, and dorsal planes. Each plane was examined by use of 3 Hounsfield unit (HU) window settings. Two veterinary radiologists independently evaluated sets of CT images for evidence of 7 CT characteristics. Effect of elbow joint status, image plane, and window settings on diagnostic certainty for these CT characteristics was tested by use of a visual analogue scale. Results-Diagnostic certainty for abnormalities of the medial coronoid process (MCP) and radial incisure was highest in the transverse plane, subchondral defects or sclerosis of the trochlea humeri was highest in the dorsal plane, and joint incongruity was highest in the sagittal plane. Certainty for hypoattenuating subchondral defects or fissures was highest at 2,500 or 3,500 HUs, whereas certainty for subchondral sclerosis was highest at 1,500 HUs and lowest at 3,500 HUs. Conclusions and Clinical Relevance-Diagnostic certainty for CT characteristics of elbow joint dysplasia in dogs was affected by image display variables. Diagnostic certainty for altered subchondral bone density was primarily influenced by window settings, whereas structural MCP abnormalities and joint incongruity were influenced most by image plane. (Am J Vet Res 2007;68:858-871). Effect of computed tomography display window and image plane on diagnostic certainty for characteristics of dysplastic elbow joints in dogs. TC Tromblee JC Jones AM Bahr PK Shires S Aref doi:10.2460/javma.231.3.406 J Am Vet Med Assoc, Vol. 231, No. 3. (1 August 2007) 2007-08-17T16:10:29-00:00 2007 J Am Vet Med Assoc 0003-1488 231 3 ct diagnosis dog elbow-dysplasia joints http://www.citeulike.org/user/sjakov/article/2362253 <i>Clinical Radiology, Vol. In Press, Corrected Proof</i><br /><br />Aim To compare the diagnostic accuracy of computed tomography (CT) and magnetic resonance imaging (MRI) in the diagnosis of lymph node metastases in prostate cancer.Methods After a comprehensive literature search, studies were included that allowed construction of contingency tables for detection of lymph node metastases using CT or MRI. In addition, a summary receiver-operating characteristic (ROC) analysis was performed.Results A total of 24 studies were included. For CT, pooled sensitivity was 0.42 (0.26-0.56 95% CI) and pooled specificity was 0.82 (0.8-0.83 95% CI). For MRI, the pooled sensitivity was 0.39 (0.22-0.56 95% CI) and pooled specificity was 0.82 (0.79-0.83 95% CI). The differences in performance of CT and MRI were not statistically significant.Conclusion CT and MRI demonstrate an equally poor performance in the detection of lymph node metastases from prostate cancer. Reliance on either CT or MRI will misrepresent the patient's true status regarding nodal metastases, and thus misdirect the therapeutic strategies offered to the patient. The diagnostic accuracy of CT and MRI in the staging of pelvic lymph nodes in patients with prostate cancer: a meta-analysis AM Hovels RAM Heesakkers EM Adang GJ Jager S Strum YL Hoogeveen JL Severens JO Barentsz doi:10.1016/j.crad.2007.05.022 Clinical Radiology, Vol. In Press, Corrected Proof 2008-02-11T10:51:40-00:00 Clinical Radiology In Press, Corrected Proof accuracy cancer ct diagnosis human lymph_node meta-analysis mri pelvis prostate http://www.citeulike.org/user/shupsy/article/2294083 <i>Comprehensive Psychiatry, Vol. 31, No. 5. ( 1990), pp. 416-425.</i><br /><br />It is becoming increasingly recognized that one third to one half of children diagnosed as having attention deficit/hyperactivity disorder (ADHD) continue to exhibit symptoms of the disorder into adulthood. The nature of the clinical picture is not well understood by a substantial number of clinicians. The purpose of this study is to report on the demographic and clinical profile of 56 adults, age 19 to 65 years (48 men, eight women) who present with adult ADHD and meet DSM-III-R criteria for the disorder. Patients underwent a diagnostic work-up consisting of medical and psychiatric evaluation, a structured interview Schedule for Affective Disorders and Schizophrenia-Lifetime Version [SADS-L]), the Symptoms Checklist Revised (SCL-90R), Conners Attention Deficit Disorder With Hyperactivity (ADDH) scale, structured interview of ADDH, the Global Assessment of Functioning Scale (GAF), and, when available, information from parents was obtained. Ninety-one percent of our sample met the Utah Criteria for adult ADHD. The majority of the sample had additional DSM-III-R diagnoses and only seven had ADHD diagnosis alone. Fifty-three percent of the sample met the criteria for generalized anxiety disorder, 34% alcohol abuse or dependence, 30% drug abuse, 25% dysthymic disorder, and 25% cyclothymic disorder. These findings were similar to those reported in the literature. A clinical and demographic profile of a sample of adults with attention deficit hyperactivity disorder, residual state WO Shekim RF Asarnow E Hess K Zaucha N Wheeler doi:10.1016/0010-440X(90)90026-O Comprehensive Psychiatry, Vol. 31, No. 5. ( 1990), pp. 416-425. 2008-01-27T00:01:19-00:00 1990 Comprehensive Psychiatry 31 5 416 425 adhd adult clinical diagnosis http://www.citeulike.org/user/shupsy/article/1611122 <i>Am J Psychiatry, Vol. 150, No. 6. (1 June 1993), pp. 885-890.</i> The Wender Utah Rating Scale: an aid in the retrospective diagnosis of childhood attention deficit hyperactivity disorder [published erratum appears in Am J Psychiatry 1993 Aug;150(8):1280] Mf Ward Ph Wender Fw Reimherr Am J Psychiatry, Vol. 150, No. 6. (1 June 1993), pp. 885-890. 2007-08-31T19:52:52-00:00 1993 Am J Psychiatry 150 6 885 890 adhd adult assessment diagnosis wurs http://www.citeulike.org/user/shupsy/article/2124717 <i>J Clin Psychiatry, Vol. 68, No. 11. (November 2007), pp. 1776-1784.</i><br /><br />OBJECTIVE: Adult attention-deficit/hyperactivity disorder (ADHD) is increasingly recognized and reported to frequently coexist with bipolar disorder. Concurrent diagnosis of adult ADHD and bipolar disorder remains controversial. In this study, we conducted a systematic review to examine the rates and diagnostic validity of the concept of comorbid adult ADHD and bipolar disorder. DATA SOURCES: MEDLINE, Embase, PsycInfo, and Cochrane databases were searched for articles published before March 30, 2007, using the keywords manic, bipolar, attention deficit hyperactivity, and adult. The computer search was supplemented with bibliographic cross-referencing. STUDY SELECTION: Exclusion criteria were studies with only pediatric subjects, childhood ADHD only but not adult ADHD, and either bipolar disorder or ADHD only, but not both; review articles, case reports; letters to the editor; and book chapters. Of the 262 citations found, 12 studies met our inclusion criteria. DATA EXTRACTION: Specific diagnostic validating criteria examined were phenomenology, course of illness, heredity, biological markers, and treatment response. There were 6 studies on comorbid rates, 4 on phenomenology, 3 on course of illness, 2 on heredity, none on biological markers, and 1 on treatment response. DATA SYNTHESIS: The proposed comorbid syndrome is fairly common (present in up to 47% of adult ADHD and 21% of bipolar disorder populations), with a more severe course of illness compared with that of bipolar disorder alone, and high rates of comorbidity with other psychiatric disorders. Its treatment appears to require initial mood stabilization. CONCLUSIONS: Comorbid adult ADHD and bipolar disorder has been insufficiently studied, with more emphasis on comorbidity rates and few data on course, neurobiology, heredity, and treatment. The diagnostic validity of adult ADHD/ bipolar disorder as a true comorbidity is not well-established on the basis of this equivocal and insufficient literature. More studies are greatly needed to further clarify its diagnostic validity and treatment approach. A systematic review of rates and diagnostic validity of comorbid adult attention-deficit/hyperactivity disorder and bipolar disorder. AP Wingo SN Ghaemi J Clin Psychiatry, Vol. 68, No. 11. (November 2007), pp. 1776-1784. 2007-12-15T18:20:46-00:00 2007 J Clin Psychiatry 1555-2101 68 11 1776 1784 adhd adult bipolar-disorder comorbidity diagnosis http://www.citeulike.org/user/shupsy/article/1895608 <i>American Journal of Psychiatry, Vol. 163, No. 10. (1 October 2006), pp. 1720-1729.</i><br /><br />OBJECTIVE: Diagnosing attention deficit hyperactivity disorder (ADHD) in adults is difficult when diagnosticians cannot establish an onset before the DSM-IV criterion of age 7 or if the number of symptoms recalled does not achieve DSM's diagnosis threshold. METHOD: The authors addressed the validity of DSM-IV's age-at-onset and symptom threshold criteria by comparing four groups of adults: 127 subjects with full ADHD who met all DSM-IV criteria for childhood-onset ADHD, 79 subjects with late-onset ADHD who met all criteria except the age-at-onset criterion, 41 subjects with subthreshold ADHD who did not meet full symptom criteria for ADHD, and 123 subjects without ADHD who did not meet any criteria. The authors hypothesized that subjects with late-onset and subthreshold ADHD would show patterns of psychiatric comorbidity, functional impairment, and familial transmission similar to those seen in subjects with full ADHD. RESULTS: Subjects with late-onset and full ADHD had similar patterns of psychiatric comorbidity, functional impairment, and familial transmission. Most children with late onset of ADHD (83%) were younger than 12. Subthreshold ADHD was milder and showed a different pattern of familial transmission than the other forms of ADHD. CONCLUSIONS: The data about the clinical features of probands and the pattern of transmission of ADHD among relatives found little evidence for the validity of subthreshold ADHD among such subjects, who reported a lifetime history of some symptoms that never met DSM-IV's threshold for diagnosis. In contrast, the results suggested that late-onset adult ADHD is valid and that DSM-IV's age-at-onset criterion is too stringent. Diagnosing Adult Attention Deficit Hyperactivity Disorder: Are Late Onset and Subthreshold Diagnoses Valid? SV Faraone J Biederman T Spencer E Mick K Murray C Petty JJ Adamson MC Monuteaux doi:10.1176/appi.ajp.163.10.1720 American Journal of Psychiatry, Vol. 163, No. 10. (1 October 2006), pp. 1720-1729. 2007-11-10T19:13:46-00:00 2006 American Journal of Psychiatry 163 10 1720 1729 adhd adult diagnosis threshold http://www.citeulike.org/user/shupsy/article/1895580 <i>J Atten Disord, Vol. 10, No. 3. (1 February 2007), pp. 276-287.</i><br /><br />Objective: Recent evidence suggests that ADHD persists into adulthood, but the best means of diagnosis and the concordance of measures used to diagnose adult ADHD are unknown. Method: The current study explores the relationships of these measures in a sample of 69 mothers of children with ADHD. Results: This study determines the concordance of (a) self- and collateral reports on diagnostic interviews and (b) diagnostic interviews and self-report paper-and-pencil ADHD symptom measures. Conclusion: Results suggest that self- and collateral reports of inattentive and hyperactive/impulsive symptoms are highly correlated, as are self-report measures and diagnostic interviews. Additionally, it was found that probands report more inattentive symptoms than collaterals in both childhood and currently. Potential implications for the assessment of adult ADHD are presented. 10.1177/1087054706289941 Assessing the Concordance of Measures Used to Diagnose Adult ADHD Katherine Belendiuk Tana Clarke Andrea Chronis Veronica Raggi doi:10.1177/1087054706289941 J Atten Disord, Vol. 10, No. 3. (1 February 2007), pp. 276-287. 2007-11-10T19:10:35-00:00 2007 J Atten Disord 10 3 276 287 adhd adult assessment diagnosis http://www.citeulike.org/user/shupsy/article/1895521 <i>Am J Psychiatry, Vol. 161, No. 11. (1 November 2004), pp. 1948-1956.</i><br /><br />OBJECTIVE: While it is increasingly recognized that attention deficit hyperactivity disorder (ADHD) persists into adulthood, there is no consensus on diagnostic criteria for adult ADHD. In this article the authors describe and contrast competing approaches for diagnosis of adult ADHD used in clinical and research practice. METHOD: The authors review the Wender Utah criteria, DSM criteria, and laboratory assessment strategies for adult ADHD. Advantages and disadvantages of each approach are described, and recommendations are made as a basis for clinical assessment and future research. RESULTS: Both the Wender Utah criteria and DSM-based approaches identify significantly impaired ADHD adults with neurocognitive, biological, and treatment response patterns similar to pediatric ADHD patients. The Wender Utah criteria established the need for retrospective childhood diagnosis and recognize developmental differences in adult symptom expression. The Wender Utah criteria fail to identify patients with predominately inattentive symptoms, exclude some patients with significant comorbid psychopathology, and diverge significantly from the DSM conception of ADHD. The DSM criteria have never been validated in adults, do not include developmentally appropriate symptoms and thresholds for adults, and fail to identify some significantly impaired adults who are likely to benefit from treatment. There are insufficient scientific data to justify use of laboratory assessment measures, including neuropsychological tests and brain imaging, in diagnosing adult ADHD. CONCLUSIONS: Adult ADHD remains a clinical diagnosis. Clinicians should be flexible in application of the current ADHD criteria to adults. Additional research is required to validate adult diagnostic criteria. 10.1176/appi.ajp.161.11.1948 Diagnostic Controversies in Adult Attention Deficit Hyperactivity Disorder James Mcgough Russell Barkley doi:10.1176/appi.ajp.161.11.1948 Am J Psychiatry, Vol. 161, No. 11. (1 November 2004), pp. 1948-1956. 2007-11-10T19:05:23-00:00 2004 Am J Psychiatry 161 11 1948 1956 adhd adult diagnosis http://www.citeulike.org/user/shupsy/article/1895347 <i>Am J Psychiatry, Vol. 151, No. 5. (1 May 1994), pp. 633-638.</i> Attention deficit hyperactivity disorder in adults D Shaffer Am J Psychiatry, Vol. 151, No. 5. (1 May 1994), pp. 633-638. 2007-11-10T18:55:32-00:00 1994 Am J Psychiatry 151 5 633 638 adhd adult diagnosis http://www.citeulike.org/user/shupsy/article/1895339 <i>Br J Psychiatry, Vol. 170 (June 1997), pp. 489-491.</i> Attention deficit hyperactivity disorder or hyperkinetic disorder in adults. BK Toone GJ van der Linden Br J Psychiatry, Vol. 170 (June 1997), pp. 489-491. 2007-11-10T18:52:39-00:00 1997 Br J Psychiatry 0007-1250 170 489 491 adhd adult diagnosis http://www.citeulike.org/user/shupsy/article/1891186 <i>J Atten Disord, Vol. 3, No. 3. (1 October 1999), pp. 153-158.</i><br /><br />Background: The Conners' Adult ADHD Rating Scale (CAARS) was designed to assess the manifestations of ADHD in adults. Prior factor analyses suggested a 4-factor structure for the CAARS, includingdimensions related to Inattention/Cognitive Problems, Hyperactivity/Restlessness, Impulsivity/Emotional Liability, and Problems with Self-Concept. Method: The internal consistency, test-retest reliability, concurrent validity, criterion validity, and diagnostic utility for the CAARS were examined. Results: Coefficient alphas ranged from .86 to .92. Median test-retest reliability for the four factors was .89. Al/ four CAARS factors correlated significantly with scores from an established measure used in the evaluation of ADHD in adults. Criterion validity was assessed on the basis of comparisons of matched samples with and without ADHD. Sensitivity and specificity were high, with an overall diagnostic efficiency rate of 85%. Conclusion: The CAARS provides researchers and clinicians with a carefully constructed and psychometrically sound scale for the evaluation of current ADHD symptomatology in adults. 10.1177/108705479900300304 Self-ratings of ADHD symptomas in auts II: Reliability, validity, and diagnostic sensitivity D Erhardt JN Epstein CK Conners Parker G Sitarenios doi:10.1177/108705479900300304 J Atten Disord, Vol. 3, No. 3. (1 October 1999), pp. 153-158. 2007-11-09T20:46:03-00:00 1999 J Atten Disord 3 3 153 158 adhd adult caars diagnosis rating-scale http://www.citeulike.org/user/shupsy/article/1891181 <i>J Atten Disord, Vol. 3, No. 3. (1 October 1999), pp. 141-151.</i><br /><br />Background: Although well-standardized behavior rating scales are routinely utilized in children for evaluations of Attention Deficit Hyperactivity Disorder (ADHD), comparable measures for adults with ADHD symptomatology have been sparse. Based on current literature and clinical experience, nine aspects of adult ADHD functioning provided initial hypotheses regarding factor structure and scale items for a new scale for self-rating of symptoms by adults suspected of having ADHD. Method: A normative sample of 839 subjects and a clinical sample of 167 subjects completed ratings of an initial pool of 93 items. Results: Exploratory and confirmatory factor analyses suggested a four-factor structure involving 42 items. These factors include Inattention/Cognitive Problems, Hyperactivity/Restlessness, Impulsivity/Emotional Lability, and Problems with Self-Concept. Conclusion: The scale appears to cover the core features of ADHD as seen in children and adolescents, while adding content unique to adult expression of the ADHD syndrome. The new scale (Conners' Adult ADHD Rating Scale, or CAARS) may provide a useful dimensional measurement system for research and clinical applications. 10.1177/108705479900300303 Self-ratings of ADHD symptoms in adults I: Factor structure and normative data CK Conners D Erhardt JN Epstein Parker G Sitarenios E Sparrow doi:10.1177/108705479900300303 J Atten Disord, Vol. 3, No. 3. (1 October 1999), pp. 141-151. 2007-11-09T20:44:30-00:00 1999 J Atten Disord 3 3 141 151 adhd adult caars diagnosis rating-scale http://www.citeulike.org/user/shupsy/article/1891102 <i>Adv Psychiatr Treat, Vol. 10, No. 5. (1 September 2004), pp. 338-340.</i><br /><br />10.1192/apt.10.5.338 Understudied and underrecognised: INVITED COMMENTARY ON... ATTENTION-DEFICIT HYPERACTIVITY DISORDER IN ADULTS Dave Coghill doi:10.1192/apt.10.5.338 Adv Psychiatr Treat, Vol. 10, No. 5. (1 September 2004), pp. 338-340. 2007-11-09T20:17:25-00:00 2004 Adv Psychiatr Treat 10 5 338 340 adhd adult diagnosis http://www.citeulike.org/user/shupsy/article/1891092 <i>American Journal of Psychiatry, Vol. 157, No. 5. (1 May 2000), pp. 816-818.</i><br /><br />OBJECTIVE: Symptom decline in attention deficit hyperactivity disorder (ADHD) was examined with different definitions of remission.METHOD: Symptoms in 128 boys were measured five times over 4 years. The prevalences of syndromatic (less than full syndrome), symptomatic (less than subthreshold diagnosis), and functional (full recovery) remission were estimated as a function of age with multivariate logistic regression.RESULTS: Age was significantly associated with decline in total ADHD symptoms and symptoms of hyperactivity, impulsivity, and inattention. Symptoms of inattention remitted for fewer subjects than did symptoms of hyperactivity or impulsivity. The proportion of subjects experiencing remission varied considerably with the definition used (highest for syndromatic remission, lowest for functional remission).CONCLUSIONS: These results indicate that differences in reported remission rates reflect the definition used rather than the disorder's course. They provide systematic support for the clinical observation that hyperactivity and impulsivity symptoms tend to decline at a higher rate than inattention symptoms. 10.1176/appi.ajp.157.5.816 Age-dependent decline of symptoms of Attention Deficit Hyperactivity Disorder: impact of remission definition and symptom type J Biederman E Mick SV Faraone doi:10.1176/appi.ajp.157.5.816 American Journal of Psychiatry, Vol. 157, No. 5. (1 May 2000), pp. 816-818. 2007-11-09T20:15:36-00:00 2000 American Journal of Psychiatry 157 5 816 818 adhd adult diagnosis remission symptomatology http://www.citeulike.org/user/shupsy/article/1891073 <i>Adv Psychiatr Treat, Vol. 10, No. 4. (1 July 2004), pp. 248-256.</i><br /><br />Attention-deficit hyperactivity disorder (ADHD) is a commonly diagnosed childhood psychiatric disorder. Debate over its diagnostic validity, aetiology, presentation and treatment has extended from the clinical to the public domain. As children with ADHD diagnoses reach adulthood there is increasing interest in adult ADHD'. Cohorts followed up show poorer outcomes as adults than do controls. Self-referred adults, sometimes relatives of children with ADHD, are also of interest regarding adult ADHD. Innovative work is being done examining issues of aetiology, treatment, outcomes and comorbidity in these groups, but heterogeneity among those diagnosed with ADHD and changes in classification systems and diagnostic criteria over time complicate comparison of research findings. The diagnostic validity of adult ADHD remains uncertain and needs further study. 10.1192/apt.10.4.248 Attention-deficit hyperactivity disorder in adults: validity unknown Morris Zwi Ann York doi:10.1192/apt.10.4.248 Adv Psychiatr Treat, Vol. 10, No. 4. (1 July 2004), pp. 248-256. 2007-11-09T20:10:53-00:00 2004 Adv Psychiatr Treat 10 4 248 256 adhd adult diagnosis http://www.citeulike.org/user/shupsy/article/1891059 <i>Journal of Attention Disorders, Vol. 2, No. 3. (1 October 1997), pp. 159-166.</i><br /><br />Objective: Despite the increasing recognition of persistent ADHD into adulthood, there is a paucity of information available on its clinical presentation in adults. To this end, we evaluated ADHD symptoms in a large group of outpatient adults with ADHD attending to issues of psychiatric comorbidity, gender, and age. Methods: We assessed 149 clinically referred outpatient ADHD adults (mean age [+/-SD] of 37 +/-11 years) using structured diagnostic interviews for psychopathology including current and childhood ADHD symptoms. Using DSM III-R symptoms, we determined DSM-IV subtypes by proxy. Results: Inattentive symptoms were most frequently endorsed in over 90% of ADHD adults. An assessment of current ADHD symptoms showed that 56% of adults had the combined ADHD subtype, 37% the inattentive only subtype, and 2% the hyperactive/impulsive subtype. Psychiatric comorbidity with ADHD was more prominent in adults with hyperactivity-impulsivity as part of their clinical picture. Whereas females had fewer childhood hyperactive-impulsive symptoms than males, there were no gender differences in their current ADHD presentation. Conclusion: Findings from the current study suggest that the vast majority of adults with ADHD present with prominent symptoms of inattention. Given that ADHD adults are presenting from multiple domains, clinicians should carefully query for the inattentive aspects of ADHD when evaluating these individuals. 10.1177/108705479700200302 Presenting ADHD symptoms and subtypes in clinically referred adults with ADHD RB Millstein TE Wilens J Biederman TJ Spencer doi:10.1177/108705479700200302 Journal of Attention Disorders, Vol. 2, No. 3. (1 October 1997), pp. 159-166. 2007-11-09T20:08:09-00:00 1997 Journal of Attention Disorders 2 3 159 166 adhd adult diagnosis symptomatology http://www.citeulike.org/user/shupsy/article/2008304 <i>J Atten Disord, Vol. 9, No. 3. (1 February 2006), pp. 494-503.</i><br /><br />In a study of ADHD symptoms in the relatives of probands diagnosed with ADHD, the validity of self-reported and informant-reported symptoms in childhood and adulthood was investigated with a semistructured diagnostic interview, the Schedule for Affective Disorders and Schizophrenia for School-Age Children (K-SADS) adapted for adults, as a criterion. The participating relatives were 80 women and 46 men aged 17 to 77. Rating scales based on the Diagnostic and Statistical Manual of Mental Disorders (4th ed.) were completed by participants and informants. Internal consistency of the scales and interrater reliabilities of the diagnostic interview were satisfactory. Correlations between ratings across sources of information supported convergent and divergent validity. Self-report scales and informant scales predicted interview-based diagnoses in childhood and adulthood with adequate sensitivities and specificities. It was concluded that the rating scales have good psychometric properties, at least in at-risk populations. 10.1177/1087054705283650 Validity of Self-Report and Informant Rating Scales of Adult ADHD Symptoms in Comparison With a Semistructured Diagnostic Interview P Magnusson J Smari D Sigurthardottir G Baldursson J Sigmundsson K Kristjansson S Sigurthardottir S Hreitharsson S Sigurbjornsdottir OO Guthmundsson doi:10.1177/1087054705283650 J Atten Disord, Vol. 9, No. 3. (1 February 2006), pp. 494-503. 2007-11-28T23:24:58-00:00 2006 J Atten Disord 9 3 494 503 adhd adult diagnosis rating-scale http://www.citeulike.org/user/shupsy/article/2008111 <i>Addictive Behaviors, Vol. 31, No. 7. (July 2006), pp. 1277-1282.</i><br /><br />Adult substance users are known to have above average rates of Attention Deficit-Hyperactivity Disorder (ADHD), but the psychometric properties of self-report measures of ADHD symptoms for adult substance users are unknown. Subjects (206 adults with a DSM-IV substance abuse disorder) were administered the Conners Adult ADHD Rating Scales (CAARS) upon enrolling in outpatient treatment. A factor structure similar to that reported for other populations was obtained and internal consistency reliabilities for the subscales and the overall index were high. Compared with CAARS norms, substance users scored significantly above average on all subscales as well as on the overall index. The CAARS may prove useful for measuring ADHD symptomatology among substance users, but additional reliability and validity evidence is needed. The CAARS should not be used by itself to diagnose individuals for ADHD. Factor structure of the Conners Adult ADHD Rating Scale (CAARS) for substance users C Cleland S Magura J Foote A Rosenblum N Kosanke doi:10.1016/j.addbeh.2005.08.014 Addictive Behaviors, Vol. 31, No. 7. (July 2006), pp. 1277-1282. 2007-11-28T22:52:25-00:00 2006 Addictive Behaviors 31 7 1277 1282 adhd adult caars diagnosis sud http://www.citeulike.org/user/shupsy/article/2730753 <i>Journal of Clinical Psychology, Vol. 61, No. 5. (May 2005), pp. 535-547.</i><br /><br />Attention deficit hyperactivity disorder (ADHD) is a common childhood neuropsychiatric syndrome once thought to disappear with maturation. Current data indicate that ADHD remains "hidden" in many of the grown-ups who had it as children. Adult prevalence rates range from 1% to 6% of the population. Research suggests the core childhood symptoms of hyperactivity, inattention, and impulsivity shift with development, perhaps transforming into more overt difficulties in executive functions and affect regulation. ADHD is also usually nestled with other comorbid psychiatric conditions, especially in adolescents and adults, further complicating diagnosis and treatment. This article discusses how to recognize and diagnose ADHD in older patients. Key points include core symptoms present during childhood, appropriate family history in this strongly genetic condition, management of comorbidity, and the evolving role of diagnostic testing. Other medical causes for similar symptoms are considered. Diagnostic issues for adolescents and adults with ADHD J Wasserstein doi:10.1002/jclp.20118 Journal of Clinical Psychology, Vol. 61, No. 5. (May 2005), pp. 535-547. 2008-04-28T18:45:07-00:00 2005 Journal of Clinical Psychology 0021-9762 61 5 535 547 adhd adolescent adult diagnosis