Improving early diagnosis of multiple endocrine neoplasia type 1 by assessing the gastrointestinal symptoms,hypercalcemia,and elevated serum gastrin

Despite advancements in the field,early diagnosis of multiple endocrine neoplasia type 1(MEN1)remains unachievable.This letter to the editor highlighted the importance of carefully assessing gastrointestinal symptoms,hypercalcemia,and elevated serum gastrin levels,as suggested by Yuan et al in their paper.They focused on a patient with recurrent abdominal pain and diarrhea whose diagnostic path led to establishing a MEN1 diagnosis within a year.This emphasized the need for clinicians to consider MEN1 in patients with similar presentations,particularly when gastrointestinal symptoms persist or recur after discontinuation of proton pump inhibitors,especially knowing that early recognition and intervention are crucial for improving patient outcomes.

Breast cancer-related lymphedema: Symptoms, diagnosis, risk reduction, and management

The global burden of breast cancer continues to increase largely because of the aging and growth of the world population. More than 1.38 million women worldwide were estimated to be diagnosed with breast cancer in 2008, accounting for 23% of all diagnosed cancers in women. Given that the 5-year survival rate for breast cancer is now 90%, experiencing breast cancer is ultimately about quality of life. Women treated for breast cancer are facing a life-time risk of developing lymphedema, a chronic condition that occurs in up to 40% of this population and negatively affects breast cancer survivors' quality of life. This review offers an insightful understanding of the condition by providing clinically relevant and evidence based knowledge regarding lymphedema symptoms, diagnosis, risk reduction, and management with the intent to inform health care professionals so that they might be better equipped to care for patients.

Role of symptoms in diagnosis and outcome of gastric cancer

Gastric cancer is one of the most common cancers and the second most common cause of cancer deaths worldwide. Apart from Japan, where screening programmes have resulted in early diagnosis in asymptomatic patients, in most countries the diagnosis of gastric cancers is invariably made on account on dyspeptic and alarm symptoms, which may also be of prognostic significance when reported by the patient at diagnosis. However, their use as selection criteria for endoscopy seems to be inconsistent since alarm symptoms are not sufficiently sensitive to detect malignancies. In fact, the overall prevalence of these symptoms in dyspeptic patients is high, while the prevalence of gastro-intestinal cancer is very low. Moreover, symptoms of early stage cancer may be indistinguishable from those of benign dyspepsia, while the presence of alarm symptoms may imply an advanced and often inoperable disease. The features of dyspeptic and alarm symptoms may reflect the pathology of the tumour and be of prognostic value in suggesting site, stage and aggressiveness of cancer. Alarm symptoms in gastric cancer are independently related to survival and an increased number, as well as specific alarm symptoms, are closely correlated to the risk of death.Dysphagia, weight loss and a palpable abdominal mass appear to be major independent prognostic factors in gastric cancer, while gastro-intestinal bleeding, vomiting and also duration of symptoms, do not seem to have a relevant prognostic impact on survival in gastric cancer.

An Incremental Model Transfer Method for Complex Process Fault Diagnosis

Fault diagnosis is an important measure to ensure the safety of production, and all kinds of fault diagnosis methods are of importance in actual production process. However, the complexity and uncertainty of production process often lead to the changes of data distribution and the emergence of new fault classes, and the number of the new fault classes is unpredictable. The reconstruction of the fault diagnosis model and the identification of new fault classes have become core issues under the circumstances. This paper presents a fault diagnosis method based on model transfer learning and the main contributions of the paper are as follows: 1) An incremental model transfer fault diagnosis method is proposed to reconstruct the new process diagnosis model. 2) Breaking the limit of existing method that the new process can only have one more class of faults than the old process, this method can identify M faults more in the new process with the thought of incremental learning. 3) The method offers a solution to a series of problems caused by the increase of fault classes. Experiments based on Tennessee-Eastman process and ore grinding classification process demonstrate the effectiveness and the feasibility of the method.

Differential diagnosis of obsessive-compulsive symptoms from delusions in schizophrenia: A phenomenological approach

Several studies suggest increased prevalence-rates of obsessive-compulsive symptoms(OCS) and even of obsessive-compulsive disorder(OCD) in patients with schizophrenic disorders. Moreover, it has been recently proposed the existence of a distinct diagnostic subgroup of schizo-obsessive disorder. However, the further investigation of the OCS or OCD-schizophrenia diagnostic comorbidity presupposes the accurate clinical differential diagnosis of obsessions and compulsions from delusions and repetitive delusional behaviours, respectively. In turn, this could be facilitated by a careful comparative examination of the phenomenological features of typical obsessions/compulsions and delusions/repetitive delusional behaviours, respectively. Thiswas precisely the primary aim of the present investigation. Our examination included seven features of obsessions/delusions(source of origin and sense of ownership of the thought, conviction, consistency with one's belief-system, awareness of its inaccuracy, awareness of its symptomatic nature, resistance, and emotional impact) and five features of repetitive behaviours(aim of repetitive behaviours, awareness of their inappropriateness, awareness of their symptomatic nature, and their immediate effect on underlying thought, and their emotional impact). Several of these clinical features, if properly and empathically investigated, can help discriminate obsessions and compulsive rituals from delusions and delusional repetitive behaviours, respectively, in patients with schizophrenic disorders. We comment on the results of our examination as well as on those of another recent similar investigation. Moreover, we also address several still controversial issues, such as the nature of insight, the diagnostic status of poor insight in OCD, the conceptualization and differential diagnosis of compulsions from other categories of repetitive behaviours, as well as the diagnostic weight assigned to compulsions in contemporary psychiatric diagnostic systems. We stress the importance of the feature of mental reflexivity for understanding the nature of insight and the ambiguous diagnostic status of poor insight in OCD which may be either a marker of the chronicity of obsessions, or a marker of their delusionality. Furthermore, we criticize two major shortcomings of contemporary psychiatric diagnostic systems(DSM-IV, DSM-V, ICD-10) in their criteria or guidelines for the diagnosis of OCD or OCS: first, the diagnostic parity between obsessions and compulsions and, second, the inadequate conceptualization of compulsions. We argue that these shortcomings might artificially inflate the clinical prevalence of OC symptoms in the course of schizophrenic disorders. Still, contrary to a recent proposal, we do not exclude on purely a priori grounds the possibility of a concurrence of genuine obsessions along with delusions in patients with schizophrenia.

Fault diagnosis of time-delay complex dynamical networks using output signals

This paper proposes a novel approach for fault diagnosis of a time-delay complex dynamical network. Unlike the other methods, assuming that the dynamics of the network can be described by a linear stochastic model, or using the state variables of nodes in the network to design an adaptive observer, it only uses the output variable of the nodes to design an observer and an adaptive law of topology matrix in the observer of a complex network, leading to simple design of the observer and easy realisation of topology monitoring for the complex networks in real engineering. The proposed scheme can monitor any changes of the topology structure of a time-delay complex network. The effectiveness of this method is successfully demonstrated by virtue of a complex networks with Lorenz model.

Accurate diagnosis of myalgic encephalomyelitis and chronic fatigue syndrome based upon objective test methods for characteristic symptoms

Although myalgic encephalomyelitis(ME) and chronic fatigue syndrome(CFS) are considered to be synonymous,the definitional criteria for ME and CFS define two distinct,partially overlapping,clinical entities.ME,whether defined by the original criteria or by the recently proposed criteria,is not equivalent to CFS,let alone a severe variant of incapacitating chronic fatigue.Distinctive features of ME are:muscle weaknessand easy muscle fatigability,cognitive impairment,circulatory deficits,a marked variability of the symptoms in presence and severity,but above all,post-exertional "malaise":a(delayed) prolonged aggravation of symptoms after a minor exertion.In contrast,CFS is primarily defined by(unexplained) chronic fatigue,which should be accompanied by four out of a list of 8 symptoms,e.g.,headaches.Due to the subjective nature of several symptoms of ME and CFS,researchers and clinicians have questioned the physiological origin of these symptoms and qualified ME and CFS as functional somatic syndromes.However,various characteristic symptoms,e.g.,post-exertional "malaise" and muscle weakness,can be assessed objectively using wellaccepted methods,e.g.,cardiopulmonary exercise tests and cognitive tests.The objective measures acquired by these methods should be used to accurately diagnose patients,to evaluate the severity and impact of the illness objectively and to assess the positive and negative effects of proposed therapies impartially.

A Hierarchical Modeling and Fault Diagnosis Method for Complex Electronic Devices

Due to the shortcomings of the diagnosis systems for complex electronic devices such as failure models hard to build and low fault isolation resolution, a new hierarchical modeling and diagnosis method is proposed based on multisignal model and support vector machine （SVM）. Multisignal model is used to describe the failure propagation relationship in electronic device system, and the most probable failure printed circuit boards （PCBs） can be found by Bayes inference. The exact failure modes in the PCBs can be identified by SVM. The results show the proposed modeling and diagnosis method is effective and suitable for diagnosis for complex electronic devices.

CLINICAL VALUE OF ALARM SYMPTOMS IN DIAGNOSIS OF LOWER GASTROINTESTINAL DISEASES

Objective To evaluate the clinical value of alarm symptoms in diagnosis of lower gastrointestinal diseases. Methods Data of consecutive autochthonous patients referred to the endoscopy center of Renji Hospital during the period of Oct. 2002 to Dec. 2003 were retrospectively analyzed. The prevalence of alarm symptoms in Shanghai patients with colorectal malignancies or other organic or functional lower gastrointestinal diseases was investigated. Results 83 （4. 9% ） cases of colorectal malignancies were found in 1681 patients referred to the center for colonoscopy because of lower gastrointestinal symptoms. All these malignancies were verified to be in the progressive stage. The prevalence of alarm symptoms was 81.9% （68/83）. Hematochezia （ OR 4. 1, 95% CI 3.3 -5.2, P 〈0. 001）, melena （0R6.4, 95%CI3. 7-11. 0, P 〈0. 001） and anemia （OR 9.6, 95%C13. 7 - 25. 0, P 〈 0. 001 ） were the most common and specific alarm symptoms. All the patients without alarm symptoms were above the age of 40 years. 264 （15. 7% ） cases of organic colorectal diseases other than malignancies and 1334 （ 79. 4% ） cases with no causal pathology identified were found in 1681 patients, and the prevalence of alarm symptoms in these two groups was 48. 5% （128/264） and 14. 8% （197/1334）, respectively. Conclusion Alarm symptoms including hemotochezia, melena, and anemia were useful in distinguishing organic from functional colorectal diseases in patients over 40 years old at the onset of symptoms. Furthermore, hematochezia, melena, anemia, severe weight loss, and abdominal mass were helpful in differentiating malignant from non-malignant colorectal diseases. Colonoscopy should be recommended for patients regardless of age with these alarm symptoms, and so do patients above the age of 40 years with no alarm symptoms before the diagnosis of functional diseases are made.

Routine diagnosis of intestinal tuberculosis and Crohn's disease in Southern India

AIM:To investigate whether routinely measured clinical variables could aid in differentiating intestinal tuberculosis(ITB)from Crohn’s disease(CD).METHODS:ITB and CD patients were prospectively included at four South Indian medical centres from October 2009 to July 2012.Routine investigations included case history,physical examination,blood biochemistry,ileocolonoscopy and histopathological examination of biopsies.Patients were followed-up after 2 and 6 mo of treatment.The diagnosis of ITB or CD was re-evaluated after 2 mo of antituberculous chemotherapy or immune suppressive therapy respectively,based on improvement in signs,symptoms and laboratory variables.This study was considered to be an exploratory analysis.Clinical,endoscopic and histopathological features recorded at the time of inclusion were subject to univariate analyses.Disease variables with sufficient number of recordings and P<0.05 were entered into logistic regression models,adjusted for known confounders.Finally,we calculated the odds ratios with respective confidence intervals for variables associated with either ITB or CD.RESULTS:This study included 38 ITB and 37 CD patients.Overall,ITB patients had the lowest body mass index(19.6 vs 22.7,P=0.01)and more commonly reported weight loss(73%vs 38%,P<0.01),watery diarrhoea(64%vs 33%,P=0.01)and rural domicile(58%vs 35%,P<0.05).Endoscopy typically showed mucosal nodularity(17/31 vs 2/37,P<0.01)and histopathology more frequently showed granulomas(10/30vs 2/35,P<0.01).The CD patients more frequently reported malaise(87%vs 64%,P=0.03),nausea(84%vs 56%,P=0.01),pain in the right lower abdominal quadrant on examination(90%vs 54%,P<0.01)and urban domicile(65%vs 42%,P<0.05).In CD,endoscopy typically showed involvement of multiple intestinal segments(27/37 vs 9/31,P<0.01).Using logistic regression analysis we found weight loss and nodularity of the mucosa were independently associated with ITB,with adjusted odds ratios of 8.6(95%CI:2.1-35.6)and 18.9(95%CI:3.5-102.8)respectively.Right lower abdominal quadrant pain on examination and involvement of≥3 intestinal segments were independently associated with CD with adjusted odds ratios of 10.1(95%CI:2.0-51.3)and 5.9(95%CI:1.7-20.6),respectively.CONCLUSION:Weight loss and mucosal nodularity were associated with ITB.Abdominal pain and excessive intestinal involvement were associated with CD.ITB and CD were equally common.

Considerations on the concept, definition, and diagnosis of amyotrophic lateral sclerosis

The concept, definition, and diagnosis of amyotrophic lateral sclerosis(ALS) currently present some problems. This article systematically reviews the literature on the history, current concepts, definition, and diagnosis of ALS, and discloses the present problems based on the retrieved literature and the authors' clinical experience. The current concepts and definitions of ALS have not yet been unified or standardized in clinical practice, and are sometimes vague or inaccurate, which can cause difficulties for neurologists in the clinical treatment of ALS. The concept and definition of ALS need to be further ascertained, and the current diagnostic criteria for ALS require further development. The identification of effective and objective biomarkers may be a feasible method for the early and accurate diagnosis of ALS. Therefore, future research should focus on the identification of reliable biomarkers—especially neuroimaging biomarkers—through autopsy. Standardizing the concept and definition of ALS and formulating clear diagnostic criteria will largely avoid many uncertainties in the future clinical research and treatment of ALS, which will greatly benefit patients.

External anal sphincter electromyography in multiple system atrophy:implications for diagnosis,clinical correlations,and novel insights into prognosis

Multiple system atrophy is a sporadic,progressive,adult-onset,neurodegenerative disorder characte rized by autonomic dysfunction symptoms,parkinsonian features,and cerebellar signs in va rious combinations.An early diagnosis of multiple system atrophy is of utmost impo rtance for the proper prevention and management of its potentially fatal complications leading to the poor prognosis of these patients.The current diagnostic criteria incorporate several clinical red flags and magnetic resonance imaging marke rs supporting diagnosis of multiple system atrophy.Nonetheless,especially in the early disease stage,it can be challenging to differentiate multiple system atrophy from mimic disorders,in particular Parkinson’s disease.Electromyography of the external anal sphincter represents a useful neurophysiological tool for diffe rential diagnosis since it can provide indirect evidence of Onuf’s nucleus degeneration,which is a pathological hallmark of multiple system atrophy.However,the diagnostic value of external anal sphincter electromyography has been a matter of debate for three decades due to controve rsial reports in the literature.In this review,after a brief ove rview of the electrophysiological methodology,we first aimed to critically analyze the available knowledge on the diagnostic role of external anal sphincter electromyography.We discussed the conflicting evidence on the clinical correlations of neurogenic abnormalities found at external anal sphincter electro myography.Finally,we repo rted recent prognostic findings of a novel classification of electromyography patterns of the external anal sphincter that could pave the way toward the implementation of this neurophysiological technique for survival prediction in patients with multiple system atrophy.

Clinical Intelligent Diagnosis Path Based on the Chief Complaint

Goals of traditional Chinese medicine(TCM)include precision,accuracy,and recognition by clinical practice.Establishment of a diagnosis and treatment system that closely conforms to the principle-method-recipe-medicines system and derivation of an accurate diagnosis and treatment plan should be considerations of TCM.Artificial intelligence research based on computer technology is one of the effective ways to solve this problem.In the research of intelligent diagnosis path,reflecting the characteristics of the overall view and dialectical treatment of TCM such as"Combination of four diagnostic methods""overall examination""combination of disease and syndrome"and"treatment individualized to patient,season and locality"are key for successful research of artificial intelligence in TCM diagnosis or recognition by clinical practice.

SEQUENTIAL DIAGNOSIS FOR A CENTRIFUGAL PUMP BASED ON FUZZY NEURAL NETWORK

A sequential diagnosis method is proposed based on a fuzzy neural network realized by ＂the partially-linearized neural network （PNN）＂, by which the fault types of rotating machinery can be precisely and effectively distinguished at an early stage on the basis of the possibilities of symptom parameters. The non-dimensional symptom parameters in time domain are defined for reflecting the features of time signals measured for the fault diagnosis of rotating machinery. The synthetic detection index is also proposed to evaluate the sensitivity of non-dimensional symptom parameters for detecting faults. The practical example of condition diagnosis for detecting and distinguishing fault states of a centrifugal pump system, such as cavitation, impeller eccentricity which often occur in a centrifugal pump system, are shown to verify the efficiency of the method proposed in this paper.

Fault Diagnosis of a Turbo-unit Based on Wavelet Packet Theory

In this paper we studied the fault feature of the generator set and the characteristics of wavelet packet theory for signal de noising. The vibration signal of the generator set in different states is analyzed by using the signal re construction technique of the wavelet packet theory. The time domain method is given for the generator set fault diagnosis. The experiment results show that the wavelet packet theory can be used to directly identify the state of the generator set and provide a credible new idea for complex machinery fault diagnosis.

A Novel Integrated Learning Scheme for Predictive Diagnosis of Critical Care Patient

Machine learning has proven to be one of the efficient solutions for analyzing complex data to perform identification and classification.With a large number of learning tools and techniques,the health section has significantly benefited from solving the diagnosis problems.This paper has reviewed some of the recent scientific implementations on learning-based schemes to find that existing studies of learning have mainly focused on predictive analysis with less emphasis on preprocessing and more inclination towards adopting sophisticated learning schemes that offer higher accuracy at the cost of the higher computational burden.Therefore,the proposed method addresses the concern mentioned above by a novel computational learning model that emphasizes fine-tuning complex medical data and makes it suitable for learning to balance better classification performance and computational complexity.The implementation is carried out using the MIMIC-III dataset,where the proposed system discretizes,the complete model using physician reports and furnished patient information as the first step.It also prepares the data by choosing a specific tuple and its associated field.The second step introduces a novel relatedness function where preprocessing is carried out using word quantization while adopting auto-encoders in deep learning followed by a novel learning-based diagnosis.The outcome exhibits that the proposed system offers better classification performance in reduced processing time in comparison to existing learning schemes.

A Novel Approach for Fault Diagnosis in Wireless Sensor Networks

The following article has been retracted due to special reason of the author. This paper published in Vol.5 No. 2, 2013, has been removed from this site.

Diagnosis and Prevention of Glasserella parasuis

This paper introduced the characteristics of Glasserella parasuis from the aspects of pathogen,epidemiology,clinical symptoms and anatomical symptoms,and put forward its clinical and laboratory diagnosis methods.Moreover,the disease was differentiated from similar diseases such as mycoplasmal pneumonia of swine,swine flu infectious pleuropneumonia of swine,swine streptococcosis and porcine reproductive and respiratory syndrome.Finally,the prevention and treatment measures of the disease are proposed.

Diagnosis and Prevention of Swine Foot-and-mouth Disease

This paper introduces the characteristics of swine foot-and-mouth disease from the aspects of pathogen,epidemiology,clinical symptoms,and anatomical symptoms,and puts forward clinical comprehensive diagnosis and laboratory diagnostic methods.The disease is distinguished with similar diseases,such as swine pox,porcine vesicular stomatitis,and swine vesicular disease.Finally,the prevention and control measures of the disease are proposed.

Lassa Fever Case Report: Challenges in Making Early Diagnosis

Introduction: Lassa fever is a disease of public health importance because of the associated morbidity and high case fatality rate among hospitalized patients. Even after recovery, there may be residual problems such as sensorineural hearing loss. The initial presentation of Lassa fever may be with non-specific symptoms similar to what is seen in the more common febrile illnesses such as malaria or typhoid fever. In such a setting therefore, timely diagnosis of Lassa fever may be difficult. Case Report: We report a case of Lassa fever that presented to our institution. She was a middle aged woman who had non-specific symptoms of febrile illness and who died in less than 48 hours of admission. She had a subtle bleeding on the lip just before death which was what raised the suspicion for Lassa fever. Laboratory confirmation of Lassa fever was made retrospectively. Conclusion: When the presenting symptoms are non-specific, a high index of suspicion is required for timely recognition of Lassa fever. Early diagnosis is important for prompt therapeutic intervention as well as for limiting the spread of the disease. This is the second case of Lassa fever presenting to our hospital, but the first published case of Lassa fever from our hospital.