scholarly journals Revisiting the question of cutaneous vasculitis classification

2021 ◽  
Vol 97 (4) ◽  
pp. 48-59
Author(s):  
Alexey V. Samtsov ◽  
Vladislav R. Khairutdinov ◽  
Evgeny V. Sokolovskiy ◽  
Muza M. Kokhan ◽  
Irena E. Belousova ◽  
...  
Keyword(s):  
Diagnostic Criteria ◽  
Clinical Picture ◽  
Integrated Assessment ◽  
Clinical Signs ◽  
Cutaneous Vasculitis ◽  
Vascular Lesions ◽  
Instrumental Methods

Currently, there is no generally accepted terminology and classification of vasculitis and vascular cutaneous disorders. In Russia there are various approaches to the classification of cutaneous vasculitis vascular lesions are classified according to clinical signs, etiology and pathogenesis. Significant difficulties are caused by the lack of a unified terminology, clear diagnostic criteria for vasculitis and the existence of a large number of duplicate names, among which there are many eponymous terms. This issue is one of the most complex, confusing and debatable not only in dermatovenereology, but also in other disciplines. Modern principles of diagnosis of cutaneous vasculitis are based on an integrated assessment of the data of the disease history, clinical picture, laboratory and instrumental methods of examination. For standardization of definitions and diagnostic criteria, it is necessary, first of all, to adopt a unified interdisciplinary classification of vasculitis, which will be based on the etiopathogenetic principle. The applied unified classification of cutaneous vasculitis is proposed for discussion.

scholarly journals New principles of diagnosis and classification of the Ehlers-Danlos syndrome

2018 ◽  
Vol 9 (1) ◽  
pp. 118-125
Author(s):  
Vadim G. Arsentev ◽  
Tamara I. Kadurina ◽  
Larisa N. Abbakumova
Keyword(s):  
Connective Tissue ◽  
Diagnostic Criteria ◽  
Clinical Picture ◽  
Clinical Signs ◽  
Connective Tissue Disorders ◽  
Ehlers Danlos Syndrome ◽  
Dominant Type ◽  
Monogenic Diseases ◽  
Danlos Syndrome

Ehlers-Danlos syndrome (EDS) is a heterogeneous group of monogenic diseases caused by a violation of collagen metabolism, the structure and function of myomatrix and the synthesis of proteoglycans. This pathology is characteri zed by hyperelasticity of the skin, subcutaneous globules, overextension of the joints, tissue vulnerability and hemorrhagic syndrome. EDS is one of the seven hereditary connective tissue disorders for which international diagnostic criteria are met. More than 30 years ago, the so-called Berlin nosology of hereditary connective tissue disorders was first compiled and approved (1986). For a long time, doctors used the “Villefranche Nosology” classification of EDS, adopted in 1998 and divided the disease into 6 types. The new criteria were published by the International Committee of Experts in 2017. In the clinical classification of EDS, 13 types with different inheritance, clinical features and biochemical defects are described. In most cases, it is inherited by an autosomal dominant type. True prevalence is unknown due to the complexity of verification and a large number of light forms, the frequency of diagnosed cases is 1 : 5000 births, severe forms are rare (1 : 100 000). Diagnosis of this syndromeis also based on the diagnostic criteria of the international classification. The lecture presents new data on classification diagnostic criteria of EDS, polymorphism of the clinical picture, genetic heterogeneity, the main principles of treatment of the disease. The new classification criteria take into account, in the main, the features of the clinical picture, they did not simplify the diagnosis, but they increased the specificity and increased the significance of the clinical and anamnestic features. The scope of the examination is determined by the presence of leading clinical signs. The genealogical examination and molecular genetic methods of diagnostics are of great importance.

To the clinical picture of silent syphilitic aortitis

1935 ◽  
Vol 31 (10) ◽  
pp. 1201-1204
Author(s):  
I. G. Sipitiner
Keyword(s):  
Early Diagnosis ◽  
Clinical Picture ◽  
Clinical Signs ◽  
Late Diagnosis ◽  
Vascular Lesions ◽  
Aortic Lesion ◽  
Anatomical Changes ◽  
Long Time ◽  
Initial Forms ◽  
Syphilitic Aortitis

An unfavourable prediction of syphilitic aortic lesion is due to its late diagnosis. The key to the success of therapy is in early diagnosis of s. a., when there are no persistent anatomical changes and the main clinical signs have not yet developed. The initial forms of s. a. have been disguised for a long time, distinguishing them from other vascular lesions which symptoms are usually quite definite.

scholarly journals Are new diagnostic criteria and classification of diabetes necessary?

1999 ◽  
Vol 45 (3) ◽  
pp. 21-25
Author(s):  
M. I. Balabolkin ◽  
V. M. Kreminskaya
Keyword(s):  
Diagnostic Criteria ◽  
Clinical Picture ◽  
Diagnostic Algorithm ◽  
Classification Of Diseases ◽  
Diagnosis And Classification

The issues of diagnosis and classification of diseases are given priority. This is understandable, since each classification reflects the level of our knowledge and ideas about the pathogenesis of the disease for a certain period of time. The classification of diseases, therefore, is a kind of tool that helps practitioners navigate the diverse clinical picture of the same disease and correctly conduct the diagnostic algorithm. Ultimately, the classification of the disease, based on current pathogenesis data, provides practical assistance to the doctor in matters of both diagnosis and therapeutic tactics of the disease.

scholarly journals Morphological Characteristics, Classifications and Difficulties in the Use of Diagnostic Criteria for Serrated Lesions of the Large Intestine

2021 ◽  
Author(s):  
Cesar de Souza Bastos Junior ◽  
Vera Lucia Nunes Pannain ◽  
Adriana Caroli-Bottino
Keyword(s):  
Diagnostic Criteria ◽  
Morphological Characteristics ◽  
World Health ◽  
Diagnostic Tools ◽  
Serrated Adenoma ◽  
The Past ◽  
The World ◽  
Serrated Lesions ◽  
Health Organization

Abstract Introduction Colorectal carcinoma (CRC) is the most common gastrointestinal neoplasm in the world, accounting for 15% of cancer-related deaths. This condition is related to different molecular pathways, among them the recently described serrated pathway, whose characteristic entities, serrated lesions, have undergone important changes in their names and diagnostic criteria in the past thirty years. The multiplicity of denominations and criteria over the last years may be responsible for the low interobserver concordance (IOC) described in the literature. Objectives The present study aims to describe the evolution in classification of serrated lesions, based on the last three publications of the World Health Organization (WHO) and the reproducibility of these criteria by pathologists, based on the evaluation of the IOC. Methods A search was conducted in the PubMed, ResearchGate and Portal Capes databases, with the following terms: sessile serrated lesion; serrated lesions; serrated adenoma; interobserver concordance; and reproducibility. Articles published since 1990 were researched. Results and Discussion The classification of serrated lesions in the past thirty years showed different denominations and diagnostic criteria. The reproducibility and IOC of these criteria in the literature, based on the kappa coefficient, varied in most studies, from very poor to moderate. Conclusions Interobserver concordance and the reproducibility of microscopic criteria may represent a limitation for the diagnosis and appropriate management of these lesions. It is necessary to investigate diagnostic tools to improve the performance of the pathologist's evaluation, for better concordance, and, consequently, adequate diagnosis and treatment.

scholarly journals Automatic Evaluation of the Lung Condition of COVID-19 Patients Using X-ray Images and Convolutional Neural Networks

2021 ◽  
Vol 11 (1) ◽  
pp. 28
Author(s):  
Ivan Lorencin ◽  
Sandi Baressi Šegota ◽  
Nikola Anđelić ◽  
Anđela Blagojević ◽  
Tijana Šušteršić ◽  
...  
Keyword(s):  
Neural Networks ◽  
Convolutional Neural Networks ◽  
Clinical Picture ◽  
Data Augmentation ◽  
Lower Amount ◽  
Training Procedure ◽  
X Ray ◽  
Severe Clinical Picture ◽  
Lung Condition

COVID-19 represents one of the greatest challenges in modern history. Its impact is most noticeable in the health care system, mostly due to the accelerated and increased influx of patients with a more severe clinical picture. These facts are increasing the pressure on health systems. For this reason, the aim is to automate the process of diagnosis and treatment. The research presented in this article conducted an examination of the possibility of classifying the clinical picture of a patient using X-ray images and convolutional neural networks. The research was conducted on the dataset of 185 images that consists of four classes. Due to a lower amount of images, a data augmentation procedure was performed. In order to define the CNN architecture with highest classification performances, multiple CNNs were designed. Results show that the best classification performances can be achieved if ResNet152 is used. This CNN has achieved AUCmacro¯ and AUCmicro¯ up to 0.94, suggesting the possibility of applying CNN to the classification of the clinical picture of COVID-19 patients using an X-ray image of the lungs. When higher layers are frozen during the training procedure, higher AUCmacro¯ and AUCmicro¯ values are achieved. If ResNet152 is utilized, AUCmacro¯ and AUCmicro¯ values up to 0.96 are achieved if all layers except the last 12 are frozen during the training procedure.

Diagnosis of Menière’s disease according to the criteria of 2015: Characteristics and challenges in 96 patients

2021 ◽  
pp. 1-13
Author(s):  
Friedrich Ihler ◽  
Ivelina Stoycheva ◽  
Jennifer L. Spiegel ◽  
Daniel Polterauer ◽  
Joachim Müller ◽  
...  
Keyword(s):  
Diagnostic Criteria ◽  
Clinical Signs ◽  
Real Life ◽  
Meniere’S Disease ◽  
Menière’S Disease ◽  
Meniere's Disease ◽  
Ménière’S Disease ◽  
Menière's Disease ◽  
Duration Of Symptoms ◽  
Ménière's Disease

BACKGROUND: The diagnosis of Menière’s disease (MD) is made according to diagnostic criteria, the last revision of which was in 2015. For diagnosis, symptoms are weighted with audiometric findings and this can be challenging in individual patients. OBJECTIVE: To analyze patient’s characteristics and symptoms in a real-life cohort of 96 patients with diagnosed MD regarding sociodemographic parameters, clinical specifics, and audiometry. METHODS: Prospective clinical patient registry containing demographic and socioeconomic parameters, symptoms, as well as pure-tone audiometry data. RESULTS: 31 patients with definite MD, and 36 with probable MD were identified. 29 patients showed typical clinical signs of MD, but did not meet the full diagnostic criteria, and were considered separately. Mean duration of symptoms prior to presentation was 3.9±4.6 years. Significant differences between categories were found regarding aural fullness, tinnitus, and fluctuating hearing. If multiple audiograms were available, 28.6 %(6/21) documented fluctuating hearing. CONCLUSIONS: Current diagnostic criteria probably do not represent patients with monosymptomatic presentation or an early stage very well. Long-term follow-up with repeated audiometry is advisable.

scholarly journals AB0411 CHALLENGES IN THE MANAGEMENT OF MIXED CONNECTIVE TISSUE DISEASE: A RETROSPECTIVE ANALYSIS OF THE MCTD COHORT IN A TERTIARY REFERRAL CENTRE

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 1233.3-1234
Author(s):  
A. Wanzenried ◽  
A. Garaiman ◽  
S. Jordan ◽  
O. Distler ◽  
B. Maurer
Keyword(s):  
Connective Tissue ◽  
International Symposium ◽  
Diagnostic Criteria ◽  
Connective Tissue Disease ◽  
Lupus Erythematosus ◽  
Mixed Connective Tissue Disease ◽  
Activity Index ◽  
Referral Centre ◽  
Tertiary Referral Centre

Background:As a rare, complex, and heterogeneous disease, mixed connective tissue disease (MCTD) represents a challenge for clinical practice.Objectives:We aimed to unravel potential pitfalls including correct referral diagnosis, fulfilment of diagnostic criteria, distinction from other CTDs, disease course and activity, and treatment modalities.Methods:We analysed the prospectively collected MCTD cohort at our tertiary referral centre. The patients’ medical histories were investigated for fulfilment of Sharp’s (1), Kasukawa’s (2), and Alarcón-Segovia’s (3) diagnostic MCTD criteria. We defined overlap syndromes as simultaneous fulfilment of clinical as well as immunological criteria of two defined rheumatic diseases. Disease conversion was defined as emergence of new symptoms and autoantibodies consistent with another rheumatic disease. Remission was defined by simultaneous systemic lupus erythematosus disease activity index 2000 (SLEDAI-2 K) of 0 and European League Against Rheumatism scleroderma trial and research (EUSTAR) activity index <2.5. Disease phenotype and disease activity were monitored over time and all patients were evaluated for fulfilment of classification criteria of various connective tissue diseases.Results:Out of 85 patients initially referred as MCTD, only one third fulfilled the diagnostic MCTD criteria. Most of the remaining patients had undifferentiated CTD (29%) or overlap syndromes (20%). In our final cohort of 33 MCTD patients, 6 (48%) also met the classification criteria of systemic sclerosis, 13 (39%) those of systemic lupus erythematosus (SLE), 6 (18%) those of rheumatoid arthritis, and 3 (9%) those of primary myositis. Over the median observation period of 4.6 (1.6, 9.9) years, only two patients (6%) underwent disease conversion from MCTD to SLE and no patient converted towards other diseases. The number of patients in remission increased from 6 (18%) to 15 (45%) due to introduction of immune modulatory treatment. Combination therapy was favoured in most cases (17 patients, 52%), whereas monotherapy was less frequent (12 patients, 36%), and only 4 (12%) patients remained without immune modulators until the end of the follow-up period. Hydroxychloroquine, prednisone, and methotrexate were the most frequently used medications in our cohort.Conclusion:Our study showed a high risk for misdiagnosis for patients with MCTD. Phenotype conversion was a very rare event. As a multi-organ disease, MCTD required prolonged (combined) immunosuppressive therapy to achieve remission. The establishment of an international registry with longitudinal data from observational multi-centre cohorts might represent a first step to address the many unmet needs of MCTD.References:[1]Sharp GC. Diagnostic criteria for classification of MCTD. In: Kasukawa R, Sharp GC, editors. Mixed connective tissue disease and anti-nuclear antibodies: proceedings of the International Symposium on Mixed Connective Tissue Disease and Anti-nuclear Antibodies, Tokyo, 29-30 August 1986. no. 719. Amsterdam: Elsevier Science Publishers B.V. (Biomedical Division); 1987. p. 23-30.[2]Kasukawa R, Tojo T, Miyawaki S, Yoshida H, Tanimoto K, Nobunaga M, et al. Preliminary diagnostic criteria for classification of mixed connective tissue disease. In: Kasukawa R, Sharp GC, editors. Mixed connective tissue disease and anti-nuclear antibodies: proceedings of the International Symposium on Mixed Connective Tissue Disease and Anti-nuclear Antibodies, Tokyo, 29-30 August 1986. no. 719. Amsterdam: Elsevier Science Publishers B.V. (Biomedical Division); 1987. p. 41-7.[3]Alarcón-Segovia D, Villarreal M. Classification and diagnostic criteria for mixed connective tissue disease. In: Kasukawa R, Sharp GC, editors. Mixed connective tissue disease and anti-nuclear antibodies: proceedings of the International Symposium on Mixed Connective Tissue Disease and Anti-nuclear Antibodies, Tokyo, 29-30 August 1986. no. 719. Amsterdam: Elsevier Science Publishers B.V. (Biomedical Division); 1987. p. 33-40.Disclosure of Interests:Adrian Wanzenried: None declared, Alexandru Garaiman: None declared, Suzana Jordan: None declared, Oliver Distler Consultant of: O.D. had consultancy relationship and/or has received research funding from Abbvie, Actelion, Acceleron Pharma, Amgen, AnaMar, Baecon Discovery, Blade Therapeutics, Bayer, Boehringer Ingelheim, Catenion, Competitive Drug Development International Ltd, CSL Behring, ChemomAb, Curzion Pharmaceuticals, Ergonex, Ga-lapagos NV, Glenmark Pharmaceuticals, GSK, Inventiva, Italfarmaco, iQone, iQvia, Lilly, medac, Medscape, Mitsubishi Tanabe Pharma, MSD, Novartis, Pfizer, Roche, Sanofi, Target Bio Science and UCB in the area of potential treatments of scleroderma and its complications., Britta Maurer Consultant of: Boehringer-Ingelheim, Grant/research support from: AbbVie, Protagen, and Novartis Biomedical Research as well as congress support from Pfizer, Roche, Actelion, mepha, and MSD.

Muscular syndrome in patients with inflammatory and degenerative diseases of joints and vertebral column

1999 ◽  
Vol 80 (2) ◽  
pp. 113-116
Author(s):  
R. A. Khabirov
Keyword(s):  
Rheumatoid Arthritis ◽  
Rheumatic Diseases ◽  
Clinical Picture ◽  
Skeletal Muscles ◽  
Vertebral Column ◽  
Degenerative Diseases ◽  
Muscular System ◽  
Pathogenetic Mechanisms ◽  
Diagnosis Criteria

The manifestations of muscular syndrome affecting the gravity and prediction of the disease take place in the most widespread and invalidizing rheumatic diseases: osteoarthrosis, rheumatoid arthritis and ankylosing spondylarthritis. Paraclinical studies showed heterogeneity of pathogenetic mechanisms in lesion of skeletal muscles in rheumatic diseases. The differentiated methods of the treatment of patients with osteoarthrosis, rheumatoid arthritis and ankylosing spondylarthritis taking into account the clinical picture and pathogenesis of muscular syndrome, as well as the diagnosis criteria and classification of muscular system lesion are suggested.

scholarly journals Cervicogenic headache: Josey's cases revisited

1997 ◽  
Vol 55 (4) ◽  
pp. 841-848 ◽  
Author(s):  
Maurice Vincent ◽  
Renato A. Luna
Keyword(s):  
Differential Diagnosis ◽  
Diagnostic Criteria ◽  
Clinical Picture ◽  
High Frequency ◽  
Female Gender ◽  
Cervicogenic Headache ◽  
Common Disorder ◽  
Recommended Treatment ◽  
Previous Trauma

Before Sjaastad coined the term cervicogenic headache (CH) 15 years ago, neck-related headaches have been considered by different authors for many years. Even after the publication of diagnostic criteria, dispute on the clinical picture, differential diagnosis, pathophysiology and treatment of CH still persists. A paper published in 1949 by Josey reports on 6 "illustrative" cases of cervical-related headaches. Indeed, looked from a more recent perspective, those cases could eventually correspond to CH. Important topics such as the relatively high frequency, fixed unilaterality of the pain, relation to previous trauma, irradiation from the back to the forehead, normal or slightly abnormal roentgenograms, and the mechanical precipitation of attacks are some of the topics considered by Josey. The female gender was not prevalent in Josey's series. Traction and analgesics were basically the recommended treatment. CH is probably a common disorder, an idea already considered by a clinician in 1949. This syndrome was not adequately described before Sjaastad's group papers in the 80's.

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