Differential diagnosis of bipolar disorder in children and adolescents

Issues complicating the differential diagnosis of bipolar disorder in young people are discussed. They include: a) the subtype of bipolar disorder being considered; b) the person’s age and stage of development; c) whether one views bipolar disorder more conservatively, requiring clear episodes that mark a distinct change from premorbid levels of function, or more liberally, focusing for instance on severe irritability/explosive outbursts as the mood change; d) who is reporting manic symptoms, and whether symptoms are past and must be recalled or current and more likely to be observed; e) impact of family history. The diagnosis of mania/bipolar I disorder may not become clear for a number of years. This is an impairing disorder, but so are the conditions from which it must be distinguished. Family history may increase the odds that certain symptoms/behaviors are manifestations of bipolar disorder but it does not make the diagnosis. Until there are biomarkers that can confirm the diagnosis, and treatments unique to the condition, it is wise to make a diagnosis of bipolar disorder in children and adolescents provisionally and keep an open mind to the likelihood that revisions may be necessary.     

Frèvre typhoïde: du diagnostic biologique à la prise en charge thérapeutique

A Typhoid fever is an infection widely affecting developing countries. Its diagnosis remains difficult. Malaria is within the differential diagnosis to be taken into account before considering Typhoid fever. The Widal test remains the most affordable test but it is poorly contributive to its diagnosis. The antibodies appear too late (2^nd week), it is highly non-specific and produces a considerable number of false negative results. Definitive diagnosis of typhoid fever generally requires isolation of the organism mainly from blood but also from other samples (stools...). This current review highlights the importance, contribution and limitations of the main laboratory tests used in routine practice.     

A simple mathematical method revealing the early stage of acute leukemia in patients with cytopenias

On the basis of findings in examinations made in 50 patients (25 with hypoplastic anaemia and 15 in the hypoplastic stage of acute leukemia) a simple mathematical method was developed for the differential diagnosis of these two diseases. The following laboratory findings were used for calculating a formula: cellularity of the bone-marrow, percentage of blast cells in the myelogram, percentage of blast cells in leukocyte concentrate, morphology of erythrocytes, presence of normoblastosis, percentage of monocytes and absolute number of neutrophils in the peripheral blood. This method allows the correct diagnosis to be made in 91% of cases with hypoplastic anaemia and in 100% of cases with acute leukemia. By using 7 laboratory findings to be obtained easily this method will enable a correct diagnosis to be made even in those situations where hitherto it was very difficult to make a differential diagnosis or where it was impossible at all.     

前列腺粘液腺癌的研究进展

前列腺粘液腺癌(MC)是一种比较少见的前列腺癌,发病多见于老年人,病因目前尚不明确。其临床症状与前列腺增生及前列腺腺泡癌相似,常易被误诊,故确诊有赖于病理诊断,分泌大量粘液为其病理学特点。治疗手段以外科手术及内分泌治疗为主。对于该病的报道较少,本文就其发病概况、病因、病理、诊断及治疗等最新进展作一综述。     

Improved Methods in the Diagnosis of Ureteral Duplication and Ectopia

Ureteral duplication with ectopia is of clinical importance because it is attended by a high incidence of persistent urinary disease. Its diagnosis is frequently made difficult by the obscure position of the extravesical ureteral orifice, and often by its obstruction, which may block the passage of radiopaque medium. But it is in precisely such cases that early diagnosis and treatment are most essential to the preservation of renal function. The chances of diagnosis have been increased within recent years by the development of new or modified radiographic and nonradiographic techniques.     

Cancer Mortality in People Treated with Antidepressants before Cancer Diagnosis: A Population Based Cohort Study

BackgroundDepression is common after a cancer diagnosis and is associated with an increased mortality, but it is unclear whether depression occurring before the cancer diagnosis affects cancer mortality. We aimed to study cancer mortality of people treated with antidepressants before cancer diagnosis.ConclusionsInitiation of antidepressive treatment prior to cancer diagnosis is common and is associated with an increased mortality.     

人附睾蛋白4在卵巢癌中的研究进展

卵巢癌是严重威胁女性健康的恶性疾病之一。糖类抗原125（carbohydrate antigen125,CA125）是目前临床上广泛用于诊断卵巢上皮性癌的肿瘤标记物,然而其缺乏敏感性和特异性,因此,迫切需要寻找一种新的标志物来提高卵巢癌的诊断。人附睾蛋白4（human epididymis protein4,HE4）是近年发现的肿瘤标志物,其在良性肿瘤和正常组织中含量极低,但在卵巢癌中高表达。本文就HE4在卵巢癌中的诊断,动态监测等方面的进展做一综述。     

Dysfunctional uterine bleeding; the relationship of microscopic observations to treatment

Dysfunctional bleeding is not an entity, it is a symptom. With proper history, physical examination and laboratory aids a definitive diagnosis can be made. With this diagnosis rational and direct treatment may be instituted. Both diagnosis and treatment are outlined and discussed. When hormonal treatment is indicated, the type, amount and timing must be fitted to the patient's needs.     

Acute pulmonary histoplasmosis in a Spanish traveller to Nicaragua: an imported disease case

Pulmonary histoplasmosis is a rare disease in Spain. Moreover, it is difficult to diagnose due to unspecific clinical and radiological symptoms. The isolation of the fungus is essential for a proper diagnosis. Nevertheless, it is very difficult to identify the fungus itself in respiratory stains and we usually need invasive techniques. For all these reasons and taking into account the increase in journeys and immigration, we believe that it is probably underdiagnosed in our country. We report a case of acute pulmonary histoplasmosis in a Spanish traveller and emphasize the importance of the anamnesis and the value of the microbiologist's experience to obtain the diagnosis.     

猪繁殖与呼吸综合征检测技术研究进展

猪繁殖与呼吸综合征是导致猪繁殖障碍疾病的一种重要猪病。其致病机制和自身复制规律至今尚不完全明确,因此无法从根本上清除该病的存在,这就使得对该病的检测显得尤为重要。现从直观的临床诊断、精确的实验室诊断及鉴别诊断等方面对猪繁殖与呼吸综合征检测技术进行了综述,其中对可以最终确诊的实验室检测技术进行了重点介绍,并对猪繁殖与呼吸综合征生物学检测技术进行了总结。     

DYSFUNCTIONAL UTERINE BLEEDING—The Relationship of Microscopic Observations to Treatment

Dysfunctional bleeding is not an entity, it is a symptom. With proper history, physical examination and laboratory aids a definitive diagnosis can be made. With this diagnosis rational and direct treatment may be instituted. Both diagnosis and treatment are outlined and discussed. When hormonal treatment is indicated, the type, amount and timing must be fitted to the patient''s needs.     

Spinal ultrasound study in pediatrics: its role in the diagnosis of spinal cord malformations and postoperative conditions

The advent of new technologies in neurosurgery has made it necessary to create a current algorithm of the radiation diagnosis of congenital spinal cord diseases in children in the pre- and postoperative period. Due to the efficiency and low cost of a study, ultrasound diagnosis becomes an important element of this algorithm.     

Molecular diagnostic cytopathology: definitions, scope and clinical utility

Molecular diagnosis is the application of molecular biology techniques and knowledge of the molecular mechanisms of disease to diagnosis, prognostication and treatment of diseases. Although it is not widely used in routine molecular cytological practice, some examples are presented here of the application of molecular techniques to the routine cytopathological diagnosis of solid tumours and lymphoreticular malignancies. The term 'molecular diagnostic cytopathology' is proposed to define the application of molecular diagnosis to cytopathology, and the challenges of the introduction of molecular diagnosis into routine diagnostic histopathology and cytopathology are discussed. Finally, the importance of a combined morphological, immunophenotypic and molecular approach to maintain the diagnostic pathologist at the heart of the clinical decision-making process is emphasized.     

核酸适配体在三阴性乳腺癌诊疗中的研究进展*

乳腺癌是女性高发恶性肿瘤,三阴性乳腺癌(triple-negative breast cancer, TNBC)恶性程度极高,且发病机制复杂,是乳腺癌分型中预后最差的类型,但目前其早期筛查和诊断的敏感度仍处在较低水平。因此,亟须通过应用具有高度特异性的肿瘤标志物分子探针,实现其早期诊断和治疗。核酸适配体是在人工合成的随机单链核酸序列文库中,通过指数富集的配体系统进化技术(systematic evolution of ligands by exponential enrichment, SELEX)筛选获得的寡核苷酸序列。高效的分子识别能力使其成为最具潜力的生物靶向分子,在肿瘤诊断及治疗中具有广阔的应用前景。目前,通过筛选已获得了多种靶向TNBC细胞的核酸适配体。重点综述基于SELEX及其衍生技术筛选TNBC相关核酸适配体的新进展,以及核酸适配体在TNBC诊断和治疗中的应用,为相关研究提供参考。     

Reappearance of catatonia. A case report

We describe a patient who was ill for more than 15 years. She was treated predominantly as a neurological case because of multiple motor signs. The diagnosis of catatonia was considered at the time when she was hospitalized in a psychiatric hospital after a suicidal attempt. The "therapeutic blindness", which was obviously present during 15 years of her illness, is discussed: the ICD--10 is perhaps misleading regarding this diagnosis while it associates it too tightly only to schizophrenia.     

Kind-Making, objectivity, and political neutrality; the case of Solastalgia

Politics and science, it is customarily and broadly assumed, should not mix. I investigate a purported "new mental illness" arising from psychological stress associated with environmental damage. Previous assessments have concluded that the diagnosis of "solastalgia", which is clearly intended to advance a political agenda, may thereby lack scientific validity. Building on work by Ian Hacking and Nelson Goodman, and drawing comparisons with the history of "political medicine"--in particular, the scientific study of Child Abuse and Sudden Infant Death Syndrome--I argue that the political consequences of such a diagnosis may plausibly help to justify it as a distinct objective scientific kind, by demarcating it from alternative classifications. That science should be objective, then, does not require that it be politically neutral.     

The Bioethics of Diagnosis: A Biocultural Critique of Certainty

This article argues that traditional models of diagnosis are incomplete in their reliance on a models of certainty that are no longer tenable in a postmodern world. Further, it argues that the current form of diagnosis, as applied to psychiatric and affective disorders, reduces patient agency and reinscribes the effects of biopower.     

Children with septo-optic dysplasia - how to improve and sharpen the diagnosis

The data in this article are based on investigations performed in 25 children with suspected septo-optic dysplasia (SOD). There are many signs and methods that help in the diagnosis of SOD. In particular, the ocular fundus, abnormalities of the hypothalamo-pituitary axis and other midline brain structures should be described. In order to achieve a more holistic and functional diagnosis, the degree of neurological, neuropsychiatric and psychological involvement should also be stated. It has been suggested that SOD is associated with autosomal recessive inheritance, and it can be speculated that it is the result of genetic and environmental influences early in gestation. An early diagnosis can favourably influence the outcome of the affected child.     

The evaluation of the vibriocidal antibody test in establishing a diagnosis of cholera or Vibrio carriage]

On the basis of the serological survey of cholera patients, vibrio carriers and persons having had contacts with the source or reservoir of Vibrio cholerae the conclusion has been made that the test for the presence of vibriocidal antibodies, together with the bacteriological study of the patient, is of diagnostic importance in the diagnosis of cholera or vibrio carriership. The detection of vibriocidal antibodies, especially in the study of paired sera, permits the detection of cholera cases which have not been bacteriologically confirmed due to various reasons; besides, it makes it possible to exclude the diagnosis of cholera made only on the basis of clinical data. Like bacteriological study, the determination of vibriocidal antibodies must be obligatory for persons hospitalized in a provisory hospital or an isolation ward; it will undoubtedly improve the quality of cholera diagnosis and permit taking timely antiepidemic measures in the focus of infection.     

基于QRS波群的心律失常辅助诊断模型研究

基于对QRS波群的特征变量提取。利用减法聚类和自适应模糊神经网络构建心律失常辅助诊断模型,分析不同训练数据集对模型测试结果的影响。实验结果表明。该模型能准确识别不同类型的QRS波群,使用不同训练数据集对诊断结果存在影响,为进一步实现更复杂的心律失常辅助诊断模型提供方法。