Set Of Diagnostic Criteria Research Articles

Polycystic Ovary Syndrome (PCOS): A Comprehensive Review

Polycystic Ovary Syndrome (PCOS) is a prevalent endocrine illness that affects people of reproductive age and is characterized by a variety of clinical, hormonal, and metabolic aspects. This review article aims to provide a comprehensive overview of the PCOS epidemiology, aetiology, clinical presentation, diagnostic standards, and therapeutic choices. Worldwide estimates of PCOS prevalence among women of reproductive age range from 5% to 20%. This syndrome is well known for being complex in nature, encompassing both genetic predisposition and environmental influences. Menstrual abnormalities, hyperandrogenism, and an ultrasound showing polycystic ovarian morphology are frequent clinical symptoms. Several sets of diagnostic criteria, such as the Rotterdam criteria and the National Institutes of Health standards, are available, but accurate diagnosis is still essential. Insulin resistance, dyslipidemia, and obesity are among the metabolic disorders that are more likely to develop in people with PCOS. Long-term health effects include an increased risk of type 2 diabetes, cardiovascular disease, and infertility. Improvements in hormonal imbalances, metabolic abnormalities, and fertility outcomes are the main goals of therapeutic interventions, which are individualized to the patient's presentation and goals and include both lifestyle changes and pharmaceutical therapies. this review collects the most recent research results and clinical insights to enhance the understanding of PCOS among healthcare professionals.

Characteristics and Outcomes of Obstetric Sepsis by Three Sets of Clinical Diagnostic Criteria: A Retrospective Study.

Pregnancy-related mortality in the United States is the highest of all developed nations with a reported rate of 17 deaths per 100,000 live births in 2014 to 2017. Sepsis-related mortality is a major component of pregnancy-related mortality. Similar to nonpregnancy-related sepsis, the criteria for pregnancy-related sepsis are evolving. The purposes of this study were to compare three criteria for sepsis (Sepsis-2, Sepsis-3, California Maternal Quality Care Collaborative [CMQCC]) with one another and to determine patient outcomes using those three sets of criteria. Using the electronic medical record, we obtained granular data on all patients at University of Michigan Medical Center from July 10, 2009 to September 4, 2019 with suspected sepsis (blood cultures and administration of antibiotics) during pregnancy until the 42nd postpartum day. Agreement between the three criteria were assessed with kappa and shown by a Venn diagram. Groups were compared using standardized differences and chi square, rank sum, or independent t-tests. Of the 228 patients having sepsis by any criteria, 191 (83%) patients met the criteria for Sepsis-2, 131 (57%) for Sepsis-3, and 62 (27%) met criteria according to CMQCC. Agreement between the three criteria ranged from kappa = 0.13 (95% confidence interval [CI]: 0.09, 0.18) to kappa = 0.31 (95% CI: 0.23, 0.39). Patients who met CMQCC criteria tended to have more comorbidities and higher APACHE II (Acute Physiology And Chronic Health Evaluation) scores. Mortality (by 90 days) among the groups was low with 10 (4%) patients dying. Patients meeting criteria for CMQCC sepsis had higher mortality than the non-CMQCC patients with sepsis (10 vs. 2%, standardized difference = 0.31, p = 0.027). The agreement among Sepsis-2, Sepsis-3, and CMQCC diagnostic criteria is weak. CMQCC criteria identifies patients with sepsis at higher risk of death. · Agreements (kappa) between the three criteria are poor.. · CMQCC sepsis patients have more comorbidities.. · Endometritis was the most common cause of sepsis.. · CMQCC mortality was 10%; non-CMQCC mortality was 2%..

Development and validation of diagnostic criteria for elderly atopic dermatitis

Objective: Elderly atopic dermatitis (AD) is a newly identified subtype of AD. Whether specific diagnostic criteria are needed for elderly AD has been debated. This study aimed to propose diagnostic criteria for elderly AD and evaluate the sensitivity. Methods: A hospital-based study was conducted. We screened the clinical features of 1312 patients with AD of different ages in one cohort and proposed a set of diagnostic criteria for elderly AD. The criteria were then validated in another cohort of 223 patients clinically diagnosed with elderly AD by dermatologists specialized in AD to examine the diagnostic sensitivity compared with other criteria by chi-square test. Results: Based on the patients’ clinical features, a set of diagnostic criteria for elderly AD were proposed. The new diagnostic criteria showed significantly higher sensitivity than the classical diagnostic criteria (P<0.001), especially for mild and moderate AD (P<0.001）. Of all 223 patients with elderly AD, 93.3% fulfilled our criteria, while only 43.5%, 65.5%, and 52.0% fulfilled the Hanifin and Rajka criteria, the Japanese Dermatology Academy criteria, and the United Kingdom Working Party criteria, respectively. Conclusion: The newly proposed criteria for elderly AD yielded high diagnostic sensitivity, particularly for mild and moderate AD.

Amyotrophic Lateral Sclerosis and Other Motor Neuron Diseases.

This article reviews the clinical spectrum of amyotrophic lateral sclerosis (ALS), its variant presentations, and the approach to diagnosis and management. This review includes a detailed discussion of current and emerging disease-modifying therapies and the management of respiratory and bulbar manifestations of disease. An updated review of ALS genetics and pathophysiology is also provided. This article also touches on several other important motor neuron diseases. A new set of simplified diagnostic criteria may help identify patients at earlier stages of the disease. A coformulation of sodium phenylbutyrate and tauroursodeoxycholic acid has been shown to have a significant benefit on disease progression and survival, leading to approval by regulatory authorities in the United States and Canada. An oral formulation of edaravone and an antisense oligonucleotide to a SOD1 gene variation (tofersen) have also recently been approved by the US Food and Drug Administration (FDA). Phase 3 trials of intrathecal mesenchymal stem cells failed to meet primary end points for efficacy. Updated American Academy of Neurology quality measures for the care of patients with ALS were published in 2023. There has been continued progress in ALS genetics, diagnosis, and disease-modifying therapies. However, we still lack a definitive biomarker or a treatment that can halt the progression or reverse the course of disease. The evolving understanding of the genetic and pathophysiologic underpinnings of disease offers promise for more effective and clinically meaningful treatments in the future.

Clinicoradiologic Criteria for the Diagnosis of Stroke-like Episodes in MELAS.

Stroke-like episodes (SLEs) in patients with mitochondrial encephalomyopathy, lactic acidosis, and stroke-like episodes (MELAS) syndrome are often misdiagnosed as acute ischemic stroke (AIS). We aimed to determine unique clinical and neuroimaging features for SLEs and formulate diagnostic criteria. We retrospectively identified patients with MELAS admitted for SLEs between January 2012 and December 2021. Clinical features and imaging findings were compared with a cohort of patients who presented with AIS and similar lesion topography. A set of criteria was formulated and then tested by a blinded rater to evaluate diagnostic performance. Eleven MELAS patients with 17 SLE and 21 AISs were included. Patients with SLEs were younger (median 45 [37-60] vs 77 [68-82] years, p < 0.01) and had a lower body mass index (18 ± 2.6 vs 29 ± 4, p < 0.01), more commonly reported hearing loss (91% vs 5%, p < 0.01), and more commonly presented with headache and/or seizures (41% vs 0%, p < 0.01). The earliest neuroimaging test performed at presentation was uniformly a noncontrast CT. Two main patterns of lesion topography with a stereotypical spatiotemporal evolution were identified-an anterior pattern (7/21, 41%) starting at the temporal operculum and spreading to the peripheral frontal cortex and a posterior pattern (10/21, 59%) starting at the cuneus/precuneus and spreading to the lateral occipital and parietal cortex. Other distinguishing features for SLEs vs AIS were cerebellar atrophy (91% vs 19%, p < 0.01), previous cortical lesions with typical SLE distribution (46% vs 9%, p = 0.03), acute lesion tissue hyperemia and venous engorgement on CT angiography (CTA) (45% vs 0%, p < 0.01), and no large vessel occlusion on CTA (0% vs 100%, p < 0.01). Based on these clinicoradiologic features, a set of diagnostic criteria were constructed for possible SLE (sensitivity 100%, specificity 81%, AUC 0.905) and probable SLE (sensitivity 88%, specificity 95%, AUC 0.917). Clinicoradiologic criteria based on simple anamnesis and a CT scan at presentation can accurately diagnose SLE and lead to early administration of appropriate therapy. This study provides Class III evidence that an algorithm using clinical and imaging features can differentiate stroke-like episodes due to MELAS from acute ischemic strokes.

How I Treat Chronic Inflammatory Demyelinating Polyneuropathy Podcast.

Chronic inflammatory demyelinating polyneuropathy (CIDP) is an acquired immune-mediated neuropathy that typically presents with progressive or relapsing, symmetric, proximal, and distal weakness of upper and lower limbs, sensory involvement of at least two limbs, and decreased or absent deep tendon reflexes. The symptoms of CIDP can be similar to those of other neuropathies, making diagnosis difficult, which can often lead to delays in correct diagnosis and treatment. The updated European Academy of Neurology/Peripheral Nerve Society (EAN/PNS) 2021 guideline outlines a set of diagnostic criteria that help to identify CIDP with high accuracy and provides recommendations for the treatment of CIDP. The aim of this podcast, featuring Dr. Urvi Desai (Professor of Neurology, Wake Forest School of Medicine and Atrium Health Neurosciences Institute Wake Forest Baptist, Charlotte), is to discuss how the new guideline impacts diagnosis and treatment decisions in her everyday clinical practice. Using a patient case study example, the updated guideline recommends assessing a patient for clinical, electrophysiological, and supportive criteria for CIDP, enabling a more straightforward diagnosis of either typical CIDP, a CIDP variant, or an autoimmune nodopathy. A second patient case study highlights how the new guideline no longer considers autoimmune nodopathies as CIDP, as patients with these disorders do not meet hallmark CIDP criteria. This leaves an unmet need in terms of guidance on how to treat this subset of patients. Although the new guideline has not necessarily changed treatment preference in clinical practice, the addition of subcutaneous immunoglobulin (SCIG) into the guideline now better reflects clinical practice. The guideline helps to define and categorize CIDP more simply and consistently, allowing quicker and more accurate diagnosis, leading to a positive impact on treatment response and prognosis. These real-world insights into the diagnosis and management of patients with CIDP could help guide best clinical practice and help facilitate optimization of patient outcomes.

Diseases from the Spectrum of Dermatitis and Eczema: Can "Omics" Sciences Help with Better Systematics and More Accurate Differential Diagnosis?

Researchers active in the field of inflammatory skin diseases from the spectrum of dermatitis and eczema are well aware of a considerable overlap in the clinical pictures and proposed sets of diagnostic criteria for these diseases, which can hardly be overcome through the clinical or epidemiological research. In effect, patients are included in studies based on vague and overlapping criteria, while heterogeneous study populations may, in turn, lead to non-representative outcomes and continued confusion. In this narrative review, a systematics of diseases from the spectrum of dermatitis and eczema is proposed based on the origins of causative factors and the pathomechanisms involved. Difficulties in differentiating between these diseases are discussed, and the extent to which advances in the "omics" sciences might help to overcome them is considered. Of all the "omics" research in this field, more than 90% of the published papers were devoted to atopic dermatitis, with a striking underrepresentation of other diseases from the spectrum of dermatitis and eczema, conditions which collectively exceed the rates of atopic dermatitis by far. A greater "omics" research effort is urgently needed to tackle other dermatitides, like allergic, irritant and protein contact dermatitis, as well as radiation, seborrheic, stasis or autoimmune dermatitis. Atopic dermatitis findings should be validated not only against healthy donors but also other dermatitides. A clinic-oriented approach is proposed for future "omics" studies in the field of dermatitis and eczema.

Cu-Ag-Au Microspherules in Igneous Rocks: Morphology, Composition, Diagnostic Criteria and Possible Origin

Igneous rocks from the Russian Far East contain Cu-Ag-Au microspherules with distinct exterior and interior structures, compositions and assemblages of Cu-rich micro-inclusions. Natural microspherules are compared in this study with technogenic Cu-Ag-Au microspherules, which are experimentally produced and extracted from gold scrap jewelry. The following set of diagnostic criteria are considered to distinguish natural from technogenic microspherules on a genetic basis as follows: (1) compacted-related features versus cellular appearance of the exterior; (2) lack of exsolution- or crystallization-related features in natural and domain-type internal structure in technogenic microspherules; (3) absence of spherical copper-oxide inclusions along with meniscus-type textural boundaries in technogenic mcirospherules; (4) pure copper-oxide composition of inclusions versus the common presence of Fe, Ni, Zn, Cu and Na in natural microspherules. The diagnostic characteristics of natural Cu-Ag-Au microspherules suggest extremely fast cooling rates during their formation, which is possible during violent explosive volcanic eruptions or injection of partially molten, pulverized metal alloys into shallow intra-crustal cavities and fault-related tectonic gashes.

Developing diagnostic criteria for tooth wear, a preliminary beta version based on expert opinion, and a narrative literature review.

Tooth wear is a multifactorial condition, leading to the irreversible loss of dental hard tissues. The availability of an unambiguous, universally applicable assessment protocol remains lacking. The goal of the authors is to develop a set of diagnostic criteria for the assessment of tooth wear (DC-TW). A two-step approach will be used to achieve this objective: (1) to develop a preliminary beta version of the DC-TW, based on the authors' clinical experience and their shared expertise and supported by a narrative review of the existing literature, and (2) to develop the final DC-TW, with input from a larger group of experts using an international Delphi process. This paper relates to the first step. The authors outlined the components that should be incorporated into the DC-TW. The literature search was performed to investigate if their concept was in line with the available literature. The search was conducted to identify eligible publications from inception to July 11, 2022. Two authors independently screened all publications, and differences in judgements were resolved through a consensus procedure. The search yielded 5362 publications, resulting in the final inclusion of 383. These publications were divided into four main topics: (1) nomenclature/taxonomies; (2) self-report tools; (3) clinical assessment tools; and (4) clinical decision-making. The information from the publications was used and fused with the clinical experience and shared expertise of the authors to contribute to the development of a preliminary beta version of the DC-TW.

Hypothermia as a Possible Symptom of Serotonin Toxicity: A Case Report.

Background There are three commonly used sets of criteria to diagnose serotonin syndrome and all three diagnostic tools have all been shown to have shortcomings that do not fully encompass the possible symptoms of serotonin toxicity. Objective To describe a case of an atypical presentation of possible drug-induced serotonin syndrome, characterized by hypothermia, night sweats, muscle tremors, and confusion. Setting A rural and medically underserved area in eastern Washington State. Practice Description This patient case was identified as a part of a project to identify and intervene with complex and high-risk patients from local rural and underserved populations. The pharmacist identified the symptoms of possible drug-induced serotonin syndrome during a comprehensive medication review with the patient. Results The pharmacist identified a possible case of drug-induced serotonin syndrome and made a recommendation to the patient's physician that led to discontinuation of both fluoxetine and trazodone. At the follow-up visit, the patient reported that his symptoms had resolved completely. Discussion The three sets of diagnostic criteria for serotonin syndrome all include fever as a symptom, but do not list hypothermia. Effects at various 5-HT receptors and receptor subtypes have been linked to symptoms often seen in serotonin syndrome, but there are gaps in the currently used diagnostic criteria. Conclusion Pharmacists' comprehensive review of medications can allow identification of symptoms, such as hypothermia to identify possible serotonin syndrome.

Variation in prognosis and treatment outcome in juvenile myoclonic epilepsy: a Biology of Juvenile Myoclonic Epilepsy Consortium proposal for a practical definition and stratified medicine classifications.

Reliable definitions, classifications and prognostic models are the cornerstones of stratified medicine, but none of the current classifications systems in epilepsy address prognostic or outcome issues. Although heterogeneity is widely acknowledged within epilepsy syndromes, the significance of variation in electroclinical features, comorbidities and treatment response, as they relate to diagnostic and prognostic purposes, has not been explored. In this paper, we aim to provide an evidence-based definition of juvenile myoclonic epilepsy showing that with a predefined and limited set of mandatory features, variation in juvenile myoclonic epilepsy phenotype can be exploited for prognostic purposes. Our study is based on clinical data collected by the Biology of Juvenile Myoclonic Epilepsy Consortium augmented by literature data. We review prognosis research on mortality and seizure remission, predictors of antiseizure medication resistance and selected adverse drug events to valproate, levetiracetam and lamotrigine. Based on our analysis, a simplified set of diagnostic criteria for juvenile myoclonic epilepsy includes the following: (i) myoclonic jerks as mandatory seizure type; (ii) a circadian timing for myoclonia not mandatory for the diagnosis of juvenile myoclonic epilepsy; (iii) age of onset ranging from 6 to 40 years; (iv) generalized EEG abnormalities; and (v) intelligence conforming to population distribution. We find sufficient evidence to propose a predictive model of antiseizure medication resistance that emphasises (i) absence seizures as the strongest stratifying factor with regard to antiseizure medication resistance or seizure freedom for both sexes and (ii) sex as a major stratifying factor, revealing elevated odds of antiseizure medication resistance that correlates to self-report of catamenial and stress-related factors including sleep deprivation. In women, there are reduced odds of antiseizure medication resistance associated with EEG-measured or self-reported photosensitivity. In conclusion, by applying a simplified set of criteria to define phenotypic variations of juvenile myoclonic epilepsy, our paper proposes an evidence-based definition and prognostic stratification of juvenile myoclonic epilepsy. Further studies in existing data sets of individual patient data would be helpful to replicate our findings, and prospective studies in inception cohorts will contribute to validate them in real-world practice for juvenile myoclonic epilepsy management.

Kindler syndrome: a rare case report from Syria.

Kindler syndrome is a rare autosomal recessive inherited disease. The authors report a case with unique presentation that has never reported before in the medical Literatur" lanugo hair". This is a case of a 13-year-old Syrian child, who presented with difuse fine face hair, and serious urinary complications. Kindler syndrome is characterized by acral skin blistering beginning at birth, diffuse cutaneous atrophy, photosensitivity, poikiloderma, and various mucosal findings. Highlighting a set of clinical diagnostic criteria; which is used only if a genetic test is not available.

Hemodiyaliz Tedavisi Almakta Olan Son Dönem Böbrek Yetmezliği Olan Hastalarda Spondiloartropati sıklığı

Objectives: Destructive spondyloarthropathy (dSpA) occurs due to inflammatory destruction of axial joints due to beta2-microglobulin (beta2-M) accumulation in patients with end-stage renal disease (ESRD) receiving renal replacement therapy (RRT). This study aimed to investigate the frequency of dSpA in ESRD patients receiving RRT, by the diagnostic criteria sets of inflammatory back pain (IBP) and inflammatory classical SpA.&#x0D; Methods: A total of 140 patients were included. The data of the demographic informations, laboratory tests, clinical findings, HLA allele subgroups were collected. Sacroiliac and lateral feet X-rays and if necessary sacroiliac tomography were taken in patients with dSpA related pain. dSpA was investigated according to the Amor and ESSG criteria sets. &#x0D; Results: Fifty two patients were women (37%). The mean age was 51 ± 15 years. IBP and sacroiliitis were detected in 22 and 28 of the patients, respectively. There was a significant difference according to sacroiliitis and IBP in terms of CRP (p=0.028, p=0.043). dSpA were detected in 21 (15%) patients. Presence of HLA-A1 and duration of HD were determined as independent risk factors for dSpA. &#x0D; Conclusions: In the diagnosis of dSpA, the character and inflammatory origin of the pain and inflammatory markers should be investigated in addition to the radiological criteria.

Renewed call to improve approaches for developing fetal alcohol spectrum disorder diagnostic criteria: Commentary on "Comparison of three systems for the diagnosis of fetal alcohol spectrum disorders in a community sample".

Renewed call to improve approaches for developing fetal alcohol spectrum disorder diagnostic criteria: Commentary on "Comparison of three systems for the diagnosis of fetal alcohol spectrum disorders in a community sample".

Author’s reply to Krishnamurthy et al. and Thiagarajan

It was encouraging to note the bolstering responses from experts in the field to the recently published editorial on second primary versus recurrent tumor.[1] The editorial discussed the inconsistencies in the currently used sets of diagnostic criteria and their practical implications, focusing mainly on head-and-neck squamous cell carcinoma (HNSCC). I thank Krishnamurthy et al.[2] and Thiagarajan[3] for their letters, which not only shed light on a few more crucial observations relevant to the topic but also incited further deliberation on possible solutions to the problem at hand. In addition to the peculiar statistical and clinical issues highlighted in the editorial arising from the lack of a standardized definition of a second primary tumor and uniform criteria to distinguish it from recurrence (locally) or metastasis (distantly), there is also the question of how to determine the pathological status of the intervening mucosa. Does this accurate diagnosis mandate invasive pathological sampling of normal-looking intervening mucosa? As raised by Thiagarajan, what would be the diagnostic stand if the intervening mucosa showed dysplasia?[3] Regarding the risk of a second primary tumor, as conjectured by Krishnamurthy et al.,[2] some of the recent studies have reported an apparent protective effect of human papillomavirus (HPV) positivity in HNSCC, that contrasts with the significant increase in the risk of second primary tumors conferred by traditional risk factors like tobacco and alcohol.[4–6] This is not surprising, given the remarkable differences in the molecular mechanisms of carcinogenesis between HPV-positive and HPV-negative tobacco-related HNSCC.[7] Interestingly, in these studies, patients with oral cavity primaries and those with comorbidities were noted to have a significantly higher rate of second primary tumors, suggesting that these factors are also important determinants of the risk of developing second primary tumors in HNSCC.[4,5] As highlighted by Thiagarajan,[3] although the works of Warren and Gates from the 1930s remain the most cited criteria for defining the second primary tumor in the literature, several articles cite Theodore Billroth’s work from the 1880s as the origin of the three-point criteria.[4,5,8] However, the inability to access the original work of Billroth, and consequently, the lack of clarity about the context and components of the criteria described by him, could be some of the reasons for it not being widely adopted or cited. Nevertheless, as highlighted in the editorial,[1] despite the presence of sets of criteria endorsed by the International Association of Cancer Registries and the Surveillance, Epidemiology, and End Results program for a few decades now, researchers still prefer using the Warren and Gates criteria to define second primary tumors, probably for their simplicity and comprehensibility.[4,5] Interestingly, as discussed in both letters,[2,3] a group of researchers from The Netherlands proposed a novel and intriguing classification scheme in 2002 intending to solve the clinical predicament of distinguishing a second primary tumor from recurrent disease with the help of molecular characterization of the tumors.[9] However, not many have explored this approach, probably owing to issues with feasibility, technical challenges, and practical applicability of such a scheme in patient care, as subsequently pointed out by the experts from the International Head and Neck Scientific Group, which also included authors of the 2002 study from The Netherlands.[10] In other words, the practical utility of molecular diagnostics is yet to be streamlined and has a long way ahead. Even if made available in most large centers, standardization and universal adherence may still be challenging.[11] Thus, although molecular profiling is the future, with several added advantages that could aid in therapeutic decision-making until a sensitive and standardized set of molecular criteria are established for separating second primary tumors from recurrent and metastatic tumors, the most feasible solution currently is to standardize the existing clinical guidelines and ensure universal adherence across cancer registries and research groups. Financial support and sponsorship Nil. Conflicts of interest There are no conflicts of interest.

Left Bundle Branch Block-Induced Cardiomyopathy.

Left bundle branch block-induced cardiomyopathy is an increasingly recognized type of dilated cardiomyopathy identified in a minority but not negligible proportion of patients with newly diagnosed heart failure. However, it has not yet been included among the possible etiologies of dilated cardiomyopathies or among the unclassified cardiomyopathies. Although a few sets of diagnostic criteria have been proposed, currently there is a lack of universal consensus regarding diagnostic criteria. Some specific clinical features and electrocardiography, echocardiography, and cardiac magnetic resonance imaging findings are recommended to help physicians in the diagnosis of left bundle branch block-induced cardiomyopathy. In this review, prevalence, pathophysiological mechanisms, diagnostic criteria, diagnostic modalities, and specific features of left bundle branch block-induced cardiomyopathy have been addressed with attention to the differential diagnosis of other dilated cardiomyopathies.

What is in a name?—Demystifying “SKINTED”—A review of literature from dermatological perspective

Surgery of the knee, injury to the infrapatellar branch of the saphenous nerve, traumatic eczematous dermatitis (SKINTED) is a regional dermatitis specific to total knee arthroplasty, occurring postsurgically. It is characterized by an eczematous eruption localized to the knee, mostly the anteroinferior aspect, presenting as pruritic, dry, erythematous, scaly, or at times papulovesicular lesions. Having been known over the past decade by various nomenclatures, the basic pathogenesis has now been agreed upon as a locoregional immune dysfunction because of damage to lymphatics occurring postsurgically. We have described three case reports of typical eczematous lesions occurring after total knee replacement surgery and reviewed the literature for similar cases described across the literature. A PubMed and Google Scholar search pertaining to the articles published with the keywords “SKINTED” and “autonomic denervation dermatitis” was conducted. A total of 10 results were obtained after exclusion of duplicated and irrelevant search results. This yielded one review article, one original article, seven case reports, and two correspondence articles. Based on the review, the authors agree with the concept of Rucco’s immunocompromised district, being the most logical explanation for the occurrence of SKINTED. SKINTED should be differentiated from implant eczema occurring because of hypersensitivity to metal implants, which presents as systematized contact dermatitis and has a predefined set of diagnostic criteria.

Stilova bolest sa adultnim početkom u infektološkoj praksi - prikaz slučaja

Adult-onset Still's disease is a rare autoimmune disorder accompanied by a triad of fever, exanthema, and arthralgia. In addition to this dominant presentation, it has a wide spectrum of clinical symptoms, with extensive involvement of multiple organs. Because of this, the diagnosis of adult-onset Still's disease remains one of exclusion and fulfilling sets of diagnostic criteria. We report on the case of a 20-year-old female who was initially treated for a suspected allergic reaction to a drug and then referred to an infectious disease specialist as fever of unknown origin accompanied with rash. This case highlights the challenges that clinicians face in differential diagnostic of Still's disease.

Development of a method for recognizing the type of defect based on the results of dissolved gas analysis using a set of diagnostic criteria

Ensuring a reliable supply of electricity to both the households and industry is the main task of the power industry. One of the factors that affects the operational reliability of electric power equipment is the ageing of equipment, which is observed in every country. The most used among non-destructive methods of diagnosing the condition of high-voltage oil-filled equipment is the dissolved gas analysis. Using the values of gas ratios, gas percentages, as well as the values of gas ratios to the gas with the maximum content, most methods of interpreting the results of dissolved gas analysis can recognize electrical and thermal type defects, and some methods allow to recognize also combined type defects. However, the reliability of defect recognition by different methods for the same data is significantly different. The use of only one of the diagnostic criteria to recognize defects of different types does not always allow to make the correct diagnosis. Thus, the issue of developing a method for recognizing the type of defect based on the results of the dissolved gas analysis with the simultaneous use of a set of diagnostic criteria is relevant and has practical significance. Since the values of diagnostic criteria in the diagnostic space differ for different types of defects, it is advisable to use deterministic recognition methods, in particular distance recognition methods. To recognize the type of defect, it is proposed to use the method of minimum distance to the set, which allows not only to recognize the type of defect, but also to identify the same type of object with the closest gas content and with known causes of the defect. For the practical implementation of the method, an algorithm has been developed based on the joint use of the key gas method and the ratios of characteristic gases. The given example of practical use of the developed method showed its high efficiency in comparison with the existing methods of interpreting the results of the dissolved gas analysis.

Using the NINDS Consensus Diagnostic Criteria for Traumatic Encephalopathy Syndrome on 4 Cohorts of Retired Contact Sport Athletes.

A 2021 National Institute for Neurological Disorders and Stroke (NINDS) consensus panel proposed a set of clinical diagnostic criteria for traumatic encephalopathy syndrome (TES) and determined provisional levels of certainty for chronic traumatic encephalopathy (CTE) pathology based on neuropathological evidence. The panel suggested the criteria needed to be validated by clinical studies of living populations exposed to repetitive head impacts (RHIs). As the consensus criteria were developed solely from neuropathologically diagnosed cases of CTE, we hypothesized that they may not be readily applicable to the clinical impressions developed from the histories and examination findings of living patients whose neuropathology was unknown. We applied the consensus criteria to 4 groups of living retired contact sports athletes collected from previously published articles in the medical literature. Level 4. Clinical evidence from 4 groups of living retired athletes (boxers and American football players) with extensive RHI exposure was available. We used the NINDS consensus criteria to determine for each athlete whether or not they met the criteria for TES. For those who met the criteria, we determined their provisional level of certainty for CTE pathology. Among all 80 subjects, the prevalence of TES was 21.3% (17 of 80), the prevalence of possible CTE was 12.5% (10 of 80), and the prevalence of probable CTE was 2.5% (2 of 80). Among the 45 retired football players, the prevalence of TES was 24.4% (11 of 45) and the prevalence of possible CTE was 17.7% (8 of 45). None of the retired football players met the criteria for probable CTE. Among the 35 total retired boxers (from all 3 groups), the prevalence of TES was 17.1% (6 of 35), the prevalence of possible CTE was 5.7% (2 of 35), and the prevalence of probable CTE was 5.7% (2 of 35). Applying the NINDS consensus criteria to this historical cohort of living retired athletes with extensive RHI exposure resulted in a relatively low prevalence of TES and possible/probable certainties of CTE pathology, which might suggest limitations on the sensitivity of the NINDS criteria. Physicians are often asked by retired contact sports athletes and their families to determine if their clinical picture is related to TES and/or CTE. Physicians may turn to the NINDS consensus criteria for guidance in making such determinations. The data presented here may assist physicians in evaluating the reliability and validity of using the consensus criteria in living subjects.