scholarly journals Diagnostic Evaluation of 99mTc-TRODAT-1 SPECT in Parkinsonism

2021 ◽  
Vol 9 (1) ◽  
pp. 36-36
Author(s):  
Zahra Babaei Aghdam ◽  
Safa Najmi Tabrizi ◽  
Amin Arasteh ◽  
Mohammad Khalafi ◽  
Morteza Ghojazadeh ◽  
...  
Keyword(s):  
Basal Ganglia ◽  
Healthy Subjects ◽  
Clinical Presentation ◽  
Evaluation Study ◽  
Diagnostic Value ◽  
Test Evaluation ◽  
Diagnostic Test Evaluation ◽  
Uptake Pattern ◽  
Spect Images

Background Parkinsonism as a group of movement disorders, exhibit similar clinical presentation. Therefore, clinically differentiating these diseases is difficult. We investigated the diagnostic value of 99m Tc-TRODAT-1 SPECT in this setting. Due to the fact that this modality has some limitations in imaging small organs like the sub-regions of basal ganglia, we also evaluated the use of anatomical MR imaging along with functional SPECT imaging in parkinsonism. Methods This follow-up diagnostic test evaluation study was performed with 40 patients with the clinical presentation of parkinsonism, and 10 healthy subjects as controls. After administration of the radiopharmaceutical, SPECT images were acquired, then co-registered on MRI. Uptake values were evaluated in basal ganglia semi-quantitatively. Results In this study, 99mTc-TRODAT-1 SPECT was able to differentiate essential tremor and healthy subjects from progressive supranuclear palsy (PSP) and Parkinson’s disease (PD) with a sensitivity of 76.47% and specificity of 100% at a cut-off of 0.53; however, findings were not significant in differentiation of PD from PSP (p ˃0.05), and the results were similar in SPECT and co-registered MRI/SPECT images. In evaluation of the uptake pattern in basal ganglia, the lateralization of decreased uptake was only seen in PD; and in PSP, the dysfunction was bilateral in all patients. Conclusion 99mTc-TRODAT-1 SPECT is sensitive and specific in diagnosing basal ganglia dysfunction; however, 99mTc-TRODAT-1 SPECT alone or co-registration on MRI are not adequate in differentiation of the etiologies of basal ganglia dysfunction.

scholarly journals Does the Somatosensory Temporal Discrimination Threshold Change over Time in Focal Dystonia?

2017 ◽  
Vol 2017 ◽  
pp. 1-6 ◽  
Author(s):  
Antonella Conte ◽  
Gina Ferrazzano ◽  
Daniele Belvisi ◽  
Nicoletta Manzo ◽  
Antonio Suppa ◽  
...  
Keyword(s):  
Basal Ganglia ◽  
Cervical Dystonia ◽  
Healthy Subjects ◽  
Temporal Discrimination ◽  
Discrimination Threshold ◽  
Focal Dystonia ◽  
Inhibitory Interneurons ◽  
Follow Up Study ◽  
Over Time

Background. The somatosensory temporal discrimination threshold (STDT) is defined as the shortest interval at which an individual recognizes two stimuli as asynchronous. Some evidence suggests that STDT depends on cortical inhibitory interneurons in the basal ganglia and in primary somatosensory cortex. Several studies have reported that the STDT in patients with dystonia is abnormal. No longitudinal studies have yet investigated whether STDT values in different forms of focal dystonia change during the course of the disease.Methods. We designed a follow-up study on 25 patients with dystonia (15 with blepharospasm and 10 with cervical dystonia) who were tested twice: upon enrolment and 8 years later. STDT values from dystonic patients at the baseline were also compared with those from a group of 30 age-matched healthy subjects.Results. Our findings show that the abnormally high STDT values observed in patients with focal dystonia remained unchanged at the 8-year follow-up assessment whereas disease severity worsened.Conclusions. Our observation that STDT abnormalities in dystonia remain unmodified during the course of the disease suggests that the altered activity of inhibitory interneurons—either at cortical or at subcortical level—responsible for the increased STDT does not deteriorate as the disease progresses.

Chorea in the clinical presentation of moyamoya disease: results of surgical revascularization and a proposed clinicopathological correlation

2013 ◽  
Vol 11 (3) ◽  
pp. 313-319 ◽  
Author(s):  
Edward S. Ahn ◽  
R. Michael Scott ◽  
Richard L. Robertson ◽  
Edward R. Smith
Keyword(s):  
Surgical Treatment ◽  
Basal Ganglia ◽  
Moyamoya Disease ◽  
Clinical Presentation ◽  
Disease Stage ◽  
Consecutive Series ◽  
Unilateral Disease ◽  
Collateral Vessels ◽  
Revascularization Surgery

Object Chorea is a movement disorder characterized by brief, irregular, involuntary contractions that appear to flow from 1 muscle to another. There are a limited number of reports in the literature that have linked moyamoya disease and chorea. The authors describe their experience in treating moyamoya disease in patients in whom chorea developed as part of the clinical presentation. Methods The authors conducted a retrospective review of a consecutive series of 316 children who underwent pial synangiosis revascularization for moyamoya disease at the Boston Children's Hospital. Results Of 316 surgically treated patients with moyamoya disease, 10 (3.2%; 6 boys and 4 girls) had chorea as a part of their presentation. The average age at surgical treatment was 9.9 years (range 3.8–17.9 years). All patients had evidence of hypertrophied lenticulostriate collateral vessels through the basal ganglia on preoperative angiography and/or MRI on affected sides. Two patients had cystic lesions in the basal ganglia. Nine patients underwent bilateral craniotomies for pial synangiosis, and 1 patient underwent a single craniotomy for unilateral disease. Follow-up was available in 9 patients (average 50.1 months). The mean duration of chorea was 1.36 years (range 2 days to 4 years), with resolution of symptoms in all patients. One patient developed chorea 3 years after surgical treatment, 4 patients had transient chorea that resolved prior to surgery, and 5 patients experienced resolution of the chorea after surgery (average 13 months). Conclusions The authors describe children with moyamoya disease and chorea as part of their clinical presentation. The data suggest that involvement of the basal ganglia by the hypertrophied collateral vessels contributes to the development of chorea, which can wax or wane depending on disease stage or involution of the vessels after revascularization surgery. In most patients, however, the chorea improves or disappears about 1 year after presentation.

Serum Thyroglobulin Determinations in Patients with Differentiated Thyroid Carcinoma

1983 ◽  
Vol 22 (04) ◽  
pp. 204-211 ◽  
Author(s):  
J. Němec ◽  
V. Zamrazil ◽  
S. Váňa ◽  
D. Pohunková ◽  
S. Rohling ◽  
...  
Keyword(s):  
Thyroid Carcinoma ◽  
Healthy Subjects ◽  
Distant Metastases ◽  
Diagnostic Value ◽  
Differentiated Thyroid Carcinoma ◽  
Serum Thyroglobulin ◽  
Thyroglobulin Antibody ◽  
Long Term Follow Up

Serum thyroglobulin levels were measured in 636 patients with differentiated thyroid carcinoma, in whom altogether 1240 determinations were performed in different phases of disease and treatment. A modified sensitive radioimmunoassay was employed using an own high-specific thyroglobulin antibody. The results showed that both the majority of patients with functioning metastases accumulating radioiodine and with non-functioning metastases which could not be detected by scanning had higher serum TG levels, compared with a group of healthy subjects. However, “normal” TG values in patients with metastases, especially non-functioning, were found too. Thus, these findings decrease the diagnostic value of the TG determination. The highest TG values were found in patients with distant metastases of differentiated thyroid carcinoma (in lungs and bones); on the other hand, the proportion of patients with lymph-node(s) métastasés and “normal” TG levels was relatively high. We suggest that the serum TG determination cannot generally replace scanning with l31I and cannot serve as the only test, while being a helpful indicator in the long-term follow-up of differentiated thyroid cancer patients.

The Development and Validation of DSM 5-Based AIIMS-Modified INDT ADHD Tool for Diagnosis of ADHD: A Diagnostic Test Evaluation Study

2020 ◽  
Vol 68 (2) ◽  
pp. 352
Author(s):  
Sheffali Gulati ◽  
Lokesh Saini ◽  
JayaShankar Kaushik ◽  
Biswaroop Chakrabarty ◽  
NK Arora ◽  
...  
Keyword(s):  
Diagnostic Test ◽  
Evaluation Study ◽  
Test Evaluation ◽  
Dsm 5 ◽  
Diagnostic Test Evaluation ◽  
Development And Validation

Theoretical and Methodological Problems of a 10-Year Follow-Up Program Evaluation Study

2002 ◽  
Vol 18 (3) ◽  
pp. 229-241 ◽  
Author(s):  
Kurt A. Heller ◽  
Ralph Reimann
Keyword(s):  
Program Evaluation ◽  
Evaluation Studies ◽  
Evaluation Study ◽  
Control Groups ◽  
Cross Sectional ◽  
Long Term Study ◽  
Partial Inclusion ◽  
Methodological Problems

Summary In this paper, conceptual and methodological problems of school program evaluation are discussed. The data were collected in conjunction with a 10 year cross-sectional/longitudinal investigation with partial inclusion of control groups. The experiences and conclusions resulting from this long-term study are revealing not only from the vantage point of the scientific evaluation of new scholastic models, but are also valuable for program evaluation studies in general, particularly in the field of gifted education.

Optimizing Breast Cancer Follow-up Care: Diagnostic Value and Costs of Additional Routine Breast Ultrasound

2010 ◽  
Vol 31 (S 01) ◽  
Author(s):  
S Wojcinski ◽  
A Farrokh ◽  
U Hille ◽  
E Hirschauer ◽  
W Schmidt ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Diagnostic Value ◽  
Breast Ultrasound ◽  
Follow Up Care

Follow-up of Osteomyelitis of Infants with Systemic Serum Parameters and Bone Scintigraphy

1996 ◽  
Vol 35 (04) ◽  
pp. 116-121 ◽  
Author(s):  
G. E Fueger ◽  
M. Vejda ◽  
R. M. Aigner
Keyword(s):  
Bone Scintigraphy ◽  
Antibiotic Treatment ◽  
Diagnostic Value ◽  
Clinical Findings ◽  
Laboratory Findings ◽  
Radiographic Findings ◽  
Serum Parameters ◽  
Wbc Count ◽  
Differential White Blood Cell

Summary Aim: To prevent orthopedic sequelae in acute hematogenous pyogenic osteomyelitis (AHPO) of infants early diagnosis, recognition of recurrence and effective therapy is needed. This retrospective study of 47 infants with bacteriologically confirmed AHPO concerned with an analysis of the diagnostic value of systemic serum parameters compared to bone scintigraphy (BSC). Methods: AHPO was characterized initially and during the course of disease by clinical findings, C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), total and differential white blood cell (WBC) count, BSC, and plain radiography. Results: CRP was the most effective serum parameter for follow- up of disease. The first sign of BSC to signal adequate response to antibiotic treatment was the decrease or normalization of hyperperfusion. Escape from therapy or poor prognosis, even when the serum parameters were normalized, was signaled by the recurrence of focal hyperperfusion and the persistent or increasing local uptake ratios on the 3-h-image over 6 weeks during a course of antibiotic treatment. Conclusion: Antibiotic treatment masks the clinical presentation, and the radiographic findings, causes non-characteristic laboratory findings, but do not prevent the scintigraphic visualization; BSC and serum parameters used in the right completion are the most successful and efficient modalities for follow-up of AHPO. Maintenance of antibiotic therapy should be done until BSC findings have reverted to normal.

Computer-Aided Diagnosis in Jaundice: Comparison of Knowledge-based and Probabilistic Approaches

1996 ◽  
Vol 35 (01) ◽  
pp. 41-51 ◽  
Author(s):  
F. Molino ◽  
D. Furia ◽  
F. Bar ◽  
S. Battista ◽  
N. Cappello ◽  
...  
Keyword(s):  
Clinical Presentation ◽  
Clinical Information ◽  
Diagnostic Value ◽  
Clinical Findings ◽  
Clinical Documentation ◽  
Data Set ◽  
Knowledge Based ◽  
Number Of Patients ◽  
Support Tools ◽  
Aided Diagnosis

AbstractThe study reported in this paper is aimed at evaluating the effectiveness of a knowledge-based expert system (ICTERUS) in diagnosing jaundiced patients, compared with a statistical system based on probabilistic concepts (TRIAL). The performances of both systems have been evaluated using the same set of data in the same number of patients. Both systems are spin-off products of the European project Euricterus, an EC-COMACBME Project designed to document the occurrence and diagnostic value of clinical findings in the clinical presentation of jaundice in Europe, and have been developed as decision-making tools for the identification of the cause of jaundice based only on clinical information and routine investigations. Two groups of jaundiced patients were studied, including 500 (retrospective sample) and 100 (prospective sample) subjects, respectively. All patients were independently submitted to both decision-support tools. The input of both systems was the data set agreed within the Euricterus Project. The performances of both systems were evaluated with respect to the reference diagnoses provided by experts on the basis of the full clinical documentation. Results indicate that both systems are clinically reliable, although the diagnostic prediction provided by the knowledge-based approach is slightly better.

Long-term outcomes of lumbar microdiscectomy in the pediatric population: a large single-institution case series

2019 ◽  
Vol 24 (5) ◽  
pp. 549-557
Author(s):  
Malia McAvoy ◽  
Heather J. McCrea ◽  
Vamsidhar Chavakula ◽  
Hoon Choi ◽  
Wenya Linda Bi ◽  
...  
Keyword(s):  
Conservative Management ◽  
Functional Outcomes ◽  
Pediatric Patients ◽  
Clinical Presentation ◽  
Case Series ◽  
Csf Leak ◽  
Single Institution ◽  
The Mean

OBJECTIVEFew studies describe long-term functional outcomes of pediatric patients who have undergone lumbar microdiscectomy (LMD) because of the rarity of pediatric disc herniation and the short follow-up periods. The authors analyzed risk factors, clinical presentation, complications, and functional outcomes of a single-institution series of LMD patients over a 19-year period.METHODSA retrospective case series was conducted of pediatric LMD patients at a large pediatric academic hospital from 1998 to 2017. The authors examined premorbid risk factors, clinical presentation, physical examination findings, type and duration of conservative management, indications for surgical intervention, complications, and postoperative outcomes.RESULTSOver the 19-year study period, 199 patients underwent LMD at the authors’ institution. The mean age at presentation was 16.0 years (range 12–18 years), and 55.8% were female. Of these patients, 70.9% participated in competitive sports, and among those who did not play sports, 65.0% had a body mass index greater than 25 kg/m2. Prior to surgery, conservative management had failed in 98.0% of the patients. Only 3 patients (1.5%) presented with cauda equina syndrome requiring emergent microdiscectomy. Complications included 4 cases of postoperative CSF leak (2.0%), 1 case of a noted intraoperative CSF leak, and 3 cases of wound infection (1.5%). At the first postoperative follow-up appointment, minimal or no pain was reported by 93.3% of patients. The mean time to return to sports was 9.8 weeks. During a mean follow-up duration of 8.2 years, 72.9% of patients did not present again after routine postoperative appointments. The total risk of reoperation was a rate of 7.5% (3.5% of patients underwent reoperation for the same level; 4.5% underwent adjacent-level decompression, and one patient [0.5%] ultimately underwent a fusion).CONCLUSIONSMicrodiscectomy is a safe and effective treatment for long-term relief of pain and return to daily activities among pediatric patients with symptomatic lumbar disc disease in whom conservative management has failed.

Necrosis avascular

2020 ◽  
Vol 63 (2) ◽  
pp. 18-23
Author(s):  
Alejandro Jardón Gómez ◽  
Ana Cristina King ◽  
Carlos Pacheco Díaz
Keyword(s):  
Femoral Head ◽  
Avascular Necrosis ◽  
Femoral Fracture ◽  
Open Fracture ◽  
Clinical Presentation ◽  
Femoral Fractures ◽  
Proximal Femoral Fracture ◽  
Young Population ◽  
Steroid Use

The clinical presentation of a proximal femoral fracture is completely different between young and adult patients. Unlike closed proximal femoral fractures, the incidence of exposed fractures is found in the young population between 15 and 30 years of age. Osteonecrosis of the femoral head is one the complications we can find in this type of fractures. Avascular necrosis (AVN or osteonecrosis) is defined as the interruption of blood supply to the femoral head due to trauma, infectionalcohol or steroid use, resulting in bone necrosis, joint collapse and osteoarthrosis. The treatment will depend on the clinical presentation, age of the patient and when the diagnosis is made. This is a case report of a 16-year-old patient with a gunshot wound on the hip. Surgical cleansing and closed reduction plus internal fixation with a nail in the center of the spine were performed. A 3-year clinical and radiographic follow up was made, observing the evolution of the fracture and the subsequent avascular necrosis that the patient presented. Key words: Proximal femoral fracture; hip; avascular necrosis (AVN, osteonecrosis); open fracture; osteoarthritis.

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