scholarly journals Optimization of Early Diagnostics of Prostate Cancer

2020 ◽  
Vol 6 (5) ◽  
pp. 97-104
Author(s):  
N. Stepanov ◽  
Z. Duvayarov ◽  
I, Bystrova ◽  
T. Chepaikina ◽  
V. Kostrova
Keyword(s):  
Prostate Cancer ◽  
Differential Diagnosis ◽  
Early Diagnosis ◽  
Clinical Symptoms ◽  
Clinical Signs ◽  
Diagnostic Errors ◽  
Decay Products ◽  
Examination Methods ◽  
Special Examination ◽  
Diagnostic Capabilities

The prevalence and incidence of prostate cancer is gradually increasing both in our country and in countries near and far abroad. The difficulties in the differential diagnosis of prostate cancer are convincingly evidenced by the fact that the level of diagnostic errors reaches 40%. It should be noted that in assessing the differential diagnostic capabilities of the indicators of the clinical and special examination methods for patients with lower urinary tract symptoms, disagreements were found in 46–77% of the analyzed clinical signs, the changes of which mainly reflect the negative nature of the effect of tumor decay products on the patient’s body. The aim of the study was to improve the early diagnosis of prostate cancer by using the mathematical method of differential diagnosis of prostate pathology, as well as the rationale for the proposed method for early diagnosis of prostate cancer in patients with clinical symptoms. Using our proposed method for early diagnosis of prostate cancer makes the diagnosis not only reliable and accurate, but also independent of the level of qualification of the urologist and his personal experience, allows you to unify, optimize and personify the differential diagnosis of prostatic hypertrophy and prostate cancer.

scholarly journals What about the others: differential diagnosis of COVID-19 in a German emergency department

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
David Fistera ◽  
Annalena Härtl ◽  
Dirk Pabst ◽  
Randi Manegold ◽  
Carola Holzner ◽  
...  
Keyword(s):  
Emergency Department ◽  
Differential Diagnosis ◽  
Clinical Symptoms ◽  
Respiratory Infections ◽  
Health Care Systems ◽  
Clinical Signs ◽  
Vital Signs ◽  
Main Diagnosis ◽  
Clinical Trial Registry ◽  
Airway Infections

Abstract Background The ongoing COVID-19 pandemic remains a major challenge for worldwide health care systems and in particular emergency medicine. An early and safe triage in the emergency department (ED) is especially crucial for proper therapy. Clinical symptoms of COVID-19 comprise those of many common diseases; thus, differential diagnosis remains challenging. Method We performed a retrospective study of 314 ED patients presenting with conceivable COVID-19 symptoms during the first wave in Germany. All were tested for COVID-19 with SARS-Cov-2-nasopharyngeal swabs. Forty-seven patients were positive. We analyzed the 267 COVID-19 negative patients for their main diagnosis and compared COVID-19 patients with COVID-19 negative respiratory infections for differences in laboratory parameters, symptoms, and vital signs. Results Among the 267 COVID-19 negative patients, 42.7% had respiratory, 14.2% had other infectious, and 11.2% had cardiovascular diseases. Further, 9.0% and 6.7% had oncological and gastroenterological diagnoses, respectively. Compared to COVID-19 negative airway infections, COVID-19 patients showed less dyspnea (OR 0.440; p = 0.024) but more dysgeusia (OR 7.631; p = 0.005). Their hospital stay was significantly longer (9.0 vs. 5.6 days; p = 0.014), and their mortality significantly higher (OR 3.979; p = 0.014). Conclusion For many common ED diagnoses, COVID-19 should be considered a differential diagnosis. COVID-19 cannot be distinguished from COVID-19 negative respiratory infections by clinical signs, symptoms, or laboratory results. When hospitalization is necessary, the clinical course of COVID-19 airway infections seems to be more severe compared to other respiratory infections. Trial registration: German Clinical Trial Registry DRKS, DRKS-ID of the study: DRKS00021675 date of registration: May 8th, 2020, retrospectively registered.

scholarly journals Arthroscopical treatment of elbow joint disease

2012 ◽  
Vol 64 (1) ◽  
pp. 9-14 ◽  
Author(s):  
C.M.F. Rezende ◽  
E.G. Melo ◽  
C. Malm ◽  
V.A. Gheller
Keyword(s):  
Early Diagnosis ◽  
Osteochondritis Dissecans ◽  
Elbow Joint ◽  
Clinical Symptoms ◽  
Clinical Signs ◽  
Arthroscopic Treatment ◽  
Joint Disease ◽  
Elbow Arthroscopy ◽  
Medial Condyle ◽  
Clinical Recovery

Elbow arthroscopy was performed in 30 dogs of different breeds. The procedure was performed bilaterally in 20 of these dogs, yielding a total of 50 joints. Different lesions were found, varying from cartilage fissures (8) to fragmentation (42) of medial coronoid process (FCP) of the ulna. Osteochondritis dissecans (OCD) of the humerus medial condyle was associated in four of them. All of these cases displayed varying degrees of synovitis. Osteoarthrosis (OA) in varying intensity was observed in 44 joints. The majority of cases were treated two to four months after the manifestation of clinical signs. Good clinical recovery occurred in dogs with minimal joint lesions, where these were diagnosed and treated within four weeks of the onset of clinical symptoms. Early diagnosis and arthroscopic treatment prevent osteoarthrosis and preserve locomotor function.

scholarly journals Clinical manifestations, laboratory markers, and renal ultrasonographic examinations in 1-month to 12-year-old Iranian children with pyelonephritis: a six-year cross-sectional retrospective study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Daryoosh Fahimi ◽  
Leila Khedmat ◽  
Azadeh Afshin ◽  
Zahra Noparast ◽  
Maryam Jafaripor ◽  
...  
Keyword(s):  
Urinary Tract ◽  
Early Diagnosis ◽  
Clinical Symptoms ◽  
Clinical Signs ◽  
Clinical Manifestations ◽  
Ureteral Stones ◽  
Cross Sectional ◽  
Laboratory Markers ◽  
Febrile Uti ◽  
Iranian Children

Abstract Background Upper urinary tract infection (UTI) or pyelonephritis may increase the pathogenesis rate and risk of severe complications in children due to kidney atrophy. Objective A set of clinical symptoms, laboratory markers, and ultrasound findings were assessed to achieve the early diagnosis and prognosis of pyelonephritis in hospitalized pediatrics. Methods A cross-sectional study with 104 Iranian children (95 girls and 9 boys) aged 1 month to 12 years with acute pyelonephritis during 2012–2018 was conducted. The ultrasound examination of kidneys and urinary tract during hospitalization, the incidence of clinical symptoms, and laboratory markers in blood and urine were monitored to identify the best predictive factors of early diagnosis of this bacterial infection. Results Three-fourth of the patients had one of the four clinical symptoms of abdominal pain, constipation, dysuria, and vomiting, while others were asymptomatic. A much frequency of pyuria (88.46%), Escherichia coli in urine (92.31%), leukocytosis (81.73%), and high ESR (> 10 mm/h, 92.30%) and CRP (> 10 mg/L, 82.82%) was observed. The kidney and urinary tract ultrasonography only in 32.7% of children revealed findings in favor of pyelonephritis (cystitis, ureteral stones, and hydronephrosis). Conclusion There was a high frequency of clinical signs and laboratory markers associated with pyelonephritis. Ultrasound alone was not an efficient tool to track febrile UTI as most patients presented normal sonography.

Molecular monitoring of adenovirus in peripheral blood after allogeneic bone marrow transplantation permits early diagnosis of disseminated disease

Blood ◽  
2003 ◽  
Vol 102 (3) ◽  
pp. 1114-1120 ◽  
Author(s):  
Thomas Lion ◽  
Rosi Baumgartinger ◽  
Franz Watzinger ◽  
Susanne Matthes-Martin ◽  
Magdalena Suda ◽  
...  
Keyword(s):  
Early Diagnosis ◽  
Real Time ◽  
Peripheral Blood ◽  
Clinical Symptoms ◽  
Virus Disease ◽  
Antiviral Treatment ◽  
Allogeneic Bone Marrow Transplantation ◽  
Clinical Signs ◽  
Allogeneic Bone ◽  
Disseminated Disease

AbstractAdenovirus (AdV) infection in the course of allogeneic stem cell transplantation (SCT) is associated with high transplant-related morbidity and mortality. Disseminated AdV disease is lethal in most instances. Early detection of AdV infection and identification of patients carrying a high risk of disseminated disease therefore remain a major challenge. In view of the large number of existing AdV types, we have established real-time polymerase chain reaction (PCR) assays permitting sensitive detection and quantification of all 51 currently known human AdV serotypes. In a series of 132 consecutive pediatric patients undergoing SCT, more than 5000 samples derived from peripheral blood (PB), stool, urine, and throat were screened for adenovirus infection by PCR during the posttransplantation period. Thirty-six patients (27%) tested positive by PCR, revealing AdV types of the subgenera A, B, C, D, and F. Except for enteritis in some patients with AdV positivity in stool, detection of the virus at sites other than PB was not associated with clinical signs of virus disease, and transplant-related mortality was not significantly different from AdV-negative patients. By contrast, 82% of patients who had detectable AdV in PB died from infectious complications (P < .001). Monitoring of PB specimens by real-time PCR permitted early diagnosis of invasive AdV infection in all instances. In patients who developed disseminated AdV disease, detection of the virus in PB preceded onset of clinical symptoms by a median of more than 3 weeks. The observation of AdV in peripheral blood may therefore serve as a basis for early initiation of preemptive antiviral treatment.

scholarly journals Advances in Hemophagocytic Lymphohistiocytosis: Pathogenesis, Early Diagnosis/Differential Diagnosis, and Treatment

2011 ◽  
Vol 11 ◽  
pp. 697-708 ◽  
Author(s):  
Yong-Min Tang ◽  
Xiao-Jun Xu
Keyword(s):  
Immune Response ◽  
Differential Diagnosis ◽  
Early Diagnosis ◽  
Hemophagocytic Lymphohistiocytosis ◽  
Clinical Symptoms ◽  
Molecular Genetic ◽  
Hematopoietic Stem ◽  
Curative Therapy ◽  
New Finding ◽  
Life Threatening

Hemophagocytic lymphohistiocytosis (HLH) is a histiocytic disorder characterized by a highly stimulated, but ineffective, immune response to antigens, which results in life-threatening cytokine storm and inflammatory reaction. Considerable progress has been made during the past 2 decades. Detection of molecular genetic abnormalities in genes involved in immune response pathways, such as PRF1, STX11, UNC13D, STXBP2, RAB27A, LYST, AP3B1, SH2D1A, and BIRC4, is confirmatory for the diagnosis. Clinical diagnosis is largely made according to HLH-2004 criteria. However, a new finding of the Th1/Th2 cytokine pattern (significant increase of IFN-γ and IL-10 with slightly increased or normal level of IL-6) is a useful biomarker for the early diagnosis, differential diagnosis, and the monitoring of the disease. Intensive immunosuppressive therapy is generally accepted as treatment for the relief of clinical symptoms/signs, while allogeneic hematopoietic stem cell transplantation is currently the only potentially curative therapy option for severe familial forms of HLH.

scholarly journals Problems of early diagnosis of systemic lupus erythematosus during the COVID-19 pandemic

2021 ◽  
Vol 59 (2) ◽  
pp. 119-128
Author(s):  
E. L. Nasonov ◽  
T. V. Popkova ◽  
T. A. Panafidina
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Early Diagnosis ◽  
Lupus Erythematosus ◽  
Clinical Symptoms ◽  
Clinical Signs ◽  
Immunological Tolerance ◽  
Unknown Etiology ◽  
Systemic Lupus ◽  
Stress Effects ◽  
Autoimmune Rheumatic Disease

Systemic lupus erythematosus (SLE) is an autoimmune rheumatic disease of unknown etiology, characterized by overproduction of organ-nonspecific autoantibodies to various components of the cell nucleus and cytoplasm and the development of immune-inflammatory damage to internal organs. The debut of SLE is preceded by an asymptomatic period, characterized by impaired immunological tolerance to its own autoantigens, determined by the multifaceted interaction of external, genetic and epigenetic factors, hormonal disorders, microbiome pathology, stress effects, etc. Development of a certain spectrum of clinical symptoms characteristic of SLE along with the detection of a reflects the progression of the immunopathological process in SLE, however, there is no generally accepted term that defines the patient’s condition, which has individual serological and clinical signs characteristic of this disease. In rheumatology, the concept of «incomplete» SLE is currently most often used. The problems of early diagnosis of SLE, clinical and laboratory predictors of the transformation of “incomplete” SLE into “reliable” SLE, difficulties in diagnosing SLE during the COVID-19 pandemic are considered. Particular attention is paid to the comparative characteristics of the immunopathological mechanisms of SLE and COVID-19.

scholarly journals Differential diagnosis of rosacea

2020 ◽  
Vol 23 (1) ◽  
pp. 50-56
Author(s):  
Vsevolod G. Akimov ◽  
L. S. Kruglova
Keyword(s):  
Differential Diagnosis ◽  
Clinical Picture ◽  
Clinical Signs ◽  
Diagnostic Errors ◽  
Skin Lesions ◽  
Facial Skin ◽  
Skin Erythema

The clinical picture of rosacea, including facial skin erythema, telangiectasia, and popular, and pustular elements, is similar to other dermatoses, thereby causing difficulties in the differential diagnosis. Original photos and descriptions of the clinical signs that distinguish these diseases from rosacea are provided. Therefore, the possibility of rare skin lesions that are sometimes mistaken for a more frequent pathology should be considered to avoid diagnostic errors.

Clinic and CNS pathology of natural Visna cases

2007 ◽  
Vol 35 (03) ◽  
pp. 219-224
Author(s):  
P. Henze ◽  
P. Wohlsein ◽  
M. Ganter
Keyword(s):  
Cerebrospinal Fluid ◽  
Differential Diagnosis ◽  
Mononuclear Cells ◽  
Clinical Symptoms ◽  
Clinical Signs ◽  
Lymphocytic Infiltration ◽  
Serological Screening ◽  
Laboratory Findings ◽  
Cytologic Examination ◽  
Important Differential Diagnosis

Summary Objective: This study summarizes the clinical, serological, pathomorphological and laboratory findings in 19 sheep with spontaneous Visna in Germany. The cases occurred over a period of 13 years in 13 flocks. In all affected sheep cytologic examination of cerebrospinal fluid (CSF) was performed. In addition in six flocks from which 12 of the Visna cases came the whole flock was tested for Maedi/Visna virus (MVV) antibodies. Material and methods: The diagnosis of spontaneous Visna with typical clinical signs was proven by serological and histopathological investigations. Serological screening for MVV antibodies was performed with the agargel-immuno- precipitation-test (AGIDT). Additionally, cerebrospinal fluid (CSF) was obtained by lumbosacral puncture and examined cytologically. Results: Nine of the 19 cases were Texels and six East Frisian Milk sheep. Six out of nine Texels came from the same flock with a MVV-antibody intra-flock prevalence of 0.94. The mean age of the sheep was 3.9 ± 2.3 years (0.5–10 years). Time between onset of clinical symptoms until euthanasia due to recumbency was 35 ± 23 days (6–102 days). In most cases clinical signs started with ataxia, staggering and circling, followed by increasing paresis of the hind legs. In the late stages of the disease 14 sheep suffered from tetraparesis. Trembling of lips or eye lids, blindness and scratching were rare signs. In all cases pleocytosis (11–876 M/l, mean = 167 M/l) with mononuclear cells, predominantly macrophages, was found. This finding provides an additional diagnostic aid to support the clinical differentiation from other infectious diseases with neurological manifestation in sheep. Histopathology of the CNS revealed in most cases a severe leukoencephalitis and demyelinisation with perivascular lymphocytic infiltration. Conclusion and clinical relevance: Visna is an important differential diagnosis in CNS disorders of sheep. It also occurs in animals younger than one year. Visna occurs especially in highly infected flocks of susceptible sheep breeds. CSF cytology can help to differentiate Visna from other CNS diseases. Clinically, Visna may be an important differential diagnosis to Scrapie.

scholarly journals Clinical Manifestations, Laboratory Markers, and Renal Ultrasonographic Examinationsin 1-month to12-year-old Iranian Children with Pyelonephritis: A Six-year Cross-sectional Retrospectivestudy

2020 ◽  
Author(s):  
Daryoosh Fahimi ◽  
Leila Khedmat ◽  
Azadeh Afshin ◽  
Zahra Noparast ◽  
Maryam Jafaripor ◽  
...  
Keyword(s):  
Urinary Tract ◽  
Early Diagnosis ◽  
Clinical Symptoms ◽  
Clinical Signs ◽  
Clinical Manifestations ◽  
Ureteral Stones ◽  
Cross Sectional ◽  
Laboratory Markers ◽  
Hospitalization Period ◽  
Iranian Children

Abstract Background: Upper urinary tract infection (UTI) or pyelonephritismay increase the pathogenesis rate and risk of severe complications in children due to the atrophy of the kidneys.Objective: A set of clinical symptoms, laboratory markers, and ultrasound findings were assessed to reach early diagnosis and prognosis of pyelonephritis in hospitalized pediatrics.Methods: A cross-sectional study was conducted on 104 Iranian children (95 girls and 9 boys) aged 1 month to 12 years with acute pyelonephritis during 2012-2018. The ultrasound examination of kidneys and urinary tract during the hospitalization period, the incidence of clinical symptoms, and the monitoring of laboratory markersin blood and urine were studied to identify the best predictive factors of early diagnosis of this bacterial infection.Results: Three-fourth of the patients had one of the four clinical symptoms of abdominal pain, constipation, dysuria, andvomiting, whileotherswere asymptomatic. A considerable frequency of pyuria(88.4%), Escherichia coli in urine (92%), leukocytosis (81.7%), and high ESR (> mm/h, 80%) and CRP (> 10mg/L, 82.8%) was observed. The kidney and urinary tract ultrasonography onlyin 32.7% of children showed in favor of pyelonephritis (cystitis, ureteral stones, and hydronephrosis).Conclusion: In the majority of patients, there was a high prevalence of clinical signs and laboratory markers associated with pyelonephritis. Since most patients have normal sonography, ultrasound alonecould notbe an efficient tool fortracingfebrile UTI.

scholarly journals „What about the others – differential diagnosis of COVID-19 in a German emergency department“

2020 ◽  
Author(s):  
David Fistera ◽  
Annalena Haertl ◽  
Dirk Pabst ◽  
Randi Manegold ◽  
Carola Holzner ◽  
...  
Keyword(s):  
Emergency Department ◽  
Differential Diagnosis ◽  
Clinical Symptoms ◽  
Respiratory Infections ◽  
Health Care Systems ◽  
Clinical Signs ◽  
Vital Signs ◽  
Nasopharyngeal Swab ◽  
Main Diagnosis ◽  
Airway Infections

Abstract Background: The ongoing COVID-19 pandemia is a major challenge for worldwide health care systems. Especially an early and safe triage in the emergency department (ED) is crucial for proper therapy. Clinical symptoms of COVID-19 comprise those of many common diseases thus differential diagnosis remains challenging.Method: We performed a retrospective study of 314 ED patients presenting with possible symptoms of COVID-19. All were tested for COVID-19 with SARS-Cov2-nasopharyngeal swab. 47 patients were positive for COVID-19. We analyzed the 267 COVID-19 negative patients for their main diagnosis and compared COVID-19 patients with COVID-19 negative respiratory infections for differences in laboratory parameters, symptoms and vital signs. Results: Among the 267 COVID-19 negative patients 42.7% had respiratory, 14.2% other infectious and 11.2% cardiovascular diseases, followed by 9.0% oncological and 6.7% gastroenterological diagnosis. Compared to COVID-19 negative airway infections, COVID-19 patients showed less dyspnea but more dysgeusia. Their hospital stay was significantly longer and their mortality significantly higher. Conclusion: For many common ED diagnoses COVID-19 should be considered as a differential diagnosis. COVID-19 cannot be distinguished from COVID-19 negative respiratory infections by clinical signs, symptoms or laboratory results. When hospitalization is necessary, the clinical course of COVID-19 airway infections seems to be more severe compared to other respiratory infections.

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