Hypoglycemia. Symptoms, differential diagnosis, therapy

The article deals with epidemiologic evaluation of long-term chemical effects. The authors stress difficulties in setting the "cause-effect" relationships and define some typical mistakes in such research.     

Diagnosis and differential diagnosis of the terminal esophagus. (author's transl)

On hand of a few selected cases diagnostic and differential diagnostic problems of the cardia are discussed. Radiological and endoscopical values are presented.     

Diagnosis and differential diagnosis of sleep disorders in children

Sleep disorders in children are very common and their impact on emotional and cognitive functions is considerable. Clinical work necessitates an interdisciplinary access to the subject because the scope of sleep medicine is related to various medical disciplines (e.g. paediatric neurology, pulmology and child psychiatry). Although many sleep problems are seen in both children and adults diagnoses, symptoms and pathogenetic factors are quite different in the two groups. In childhood especially parent-child interactional factors and developmental aspects of the sleep architecture and the sleep-wake cycle have to be taken into account leading to different diagnostic and therapeutic approaches. In this article we focus on important developmental aspects of childrens' sleep problems. Their relationship to neurologic, paediatric and psychiatric diseases is demonstrated and finally clear indications to diagnostic procedures, especially polysomnography, are given.     

Migraine--diagnosis, differential diagnosis and therapy

Migraine is caused by intermittent brain dysfunction. Attacks result in severe unilateral headache with nausea, vomiting, photophobia, phonophobia and general weakness. The prevalence of migraine is 12 to 20% in women and 8 to 12% in man. Treatment of an acute attack is done by antiemetics in combination with analgesics. Severe migraine attacks are treated with ergotamine or sumatriptan. Parenteral treatment is performed most efficiently and safely with i.v. ASA. Frequent and severe attacks require prophylaxis. Drugs of first choice are metoprolol, propranolol, flunarizine and cyclandelate. Substances of second choice are valproic acid, DHE, pizotifen, methysergide and magnesium. Homeopathic remedies are not superior to placebo. Nonpharmacological treatment consists of sport therapy and muscle relaxation techniques.     

Dementias--diagnosis, differential diagnosis and therapy

The most common cause of primary (degenerative) dementia in old age is Alzheimer's disease, with vascular forms of dementia taking second place. Endocrinopathies, normal pressure hydrocephalus and space-occupying lesions are frequent causes of secondary dementia. A multitude of further, more rare clinical presentations results in a wide differential diagnostic spectrum necessitating a careful diagnostic work-up of the demential syndrome before considering treatment. This work-up must include clinical, laboratory and equipment-based investigations. The multimodal therapeutic approach to dementia covers not only the elimination of treatable underlying causal conditions and the medical treatment of cognitive symptoms and psychiatric accompanying symptoms, but also non-medicamentous aspects.     

Diagnosis of diagnosis diagnosed.

Agrees with the article by J. Meyers (see record 1989-10292-001) recommending a conceptual shift in assessment practice; however, the present author contends that a conceptualization of the relation between norm-referenced assessment procedures and the new techniques is missing. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Angle-closure glaucoma. Etiology and differential diagnosis]

The primary factors in determining beef quality grades are the amount and distribution of intramuscular fat percentage (IMFAT). Texture analysis was applied to ultrasound B-mode images from ribeye muscle of live beef cattle to predict its IMFAT. We used wavelet transform (WT) for multiresolutional texture analysis and second-order statistics using a gray-level co-occurrence matrix (GLCM) technique. Sets of WT- and GLCM-based texture features were calculated from ultrasonic images from 207 animals and linear regression methods were used for IMFAT prediction. WT-based features included energy ratios, central moments of wavelet-decomposed subimages and wavelet edge density. The regression model using WT features provided a root mean square error (RMSE) of 1.44 for prediction of IMFAT using validation images, while that of GLCM features provided an RMSE of 1.90. The prediction models using the WT features showed potential for objective quality evaluation in the live animals.     

Bacterial meningoencephalitis. Case report and differential diagnosis

Products of cleavage of beta-carotene and certain apocarotenoids (beta-apo-4', 8', 10', and 12'-carotenols and citranaxanthol) were studied, and the dynamics of their generation in the presence of an enzyme preparation isolated from rabbit intestinal mucosa was determined. The data suggest that metabolism of beta-apocarotenols involves the production of retinal and beta-apo-14'-carotenal mediated by enzymes different from beta-carotene-15,15'-dioxygenase, which converts beta-carotene to retinal. A scheme of metabolic conversion of beta-carotene is discussed.     

The agitated brain injured patient. Part 1: Definitions, differential diagnosis, and assessment

This study was designed to examine the relationship between dysfunctional families in childhood and shame experienced by adults and compare feelings of guilt and shame. The results indicated that the shame young adults feel is correlated with their perceived family environment as a child. Greater feelings of shame on the Test of Self-Conscious Affect (TOSCA) were correlated with lower Family Environment Scale scores on Cohesion, Expressiveness, Intellectual-Cultural Orientation, Moral-Religious Emphasis and Organization and higher Conflict scores. Other variables were also examined. The results support the hypothesis that people coming from dysfunctional families experience more shame as adults and that guilt and shame are differentially related to dysfunctional families.     

Thymus hyperplasia, differential diagnosis in the wheezing infant

Desmopressin (DDAVP), a synthetic analogue of vasopressin, has been shown to improve the bleeding time in patients with cirrhosis. The duration of this effect and the hemodynamic changes associated with DDAVP have not been studied so far. To evaluate these issues, 14 cirrhotics with portal hypertension were studied in basal conditions and after DDAVP (0.3 uk/kg). In 8 patients, hemostatic tests were done at basal conditions and 1, 3, 6 and 24 hs after drug administration. In the remaining 6 patients, mean arterial pressure, cardiac output, portal and femoral blood flows were evaluated. Hemodynamic parameters were measured by Doppler ultrasound. DDVP caused a marked decrease in bleeding time at 1, 3, 6 and 24 hs (14 +/- 9 vs 8 +/- 3, 7 +/- 4, 6 +/- 4 and 8 +/- 4 min, respectively); the decrease was maximal and statistically significant at 6 hs (55 +/- 15%, p < 0.02) after DDAVP infusion. Bleeding time reduction was observed in every patient studied. In the hemodynamic study, DDAVP caused a mild but significant decrease in mean arterial pressure (12 +/- 8%, p < 0.05); no significant changes were observed in the rest of hemodynamic parameters studied. These findings show that DDAVP can be used to shorten the bleeding time for a period of at least 24 hs in patients with cirrhosis, without deleterious hemodynamic effects. This beneficial effect may be of potential relevance in the medical management of patients with chronic liver diseases.     

Single-group validity, differential validity, and differential prediction.

The controversial topics of single-group and differential validity have been the subject of several recent articles. In line with the critiques of the original articles, it is argued that differential validity is too narrow a focus. Differential prediction and considerations of bias in selection procedures are more critical issues and require more than a comparison of correlation coefficients. (16 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Cues and clues to differential diagnosis in childhood autism.

There has been considerable disagreement as to the nature of autism. Since the problem has not yet been clearly defined, etiology remains nebulous, and treatment varies among therapists. An attempt is made to develop a definition of autism by drawing from a variety of reliable sources describing the disorder, and, with reference to these sources, some diagnostic procedures that seem to be effective are discussed. This suggested diagnostic assessment is based on observation, history taking, and a limited use of treatment technique. Diagnostic intervention in the form of intrusion and interaction is most instrumental in reaching diagnostic decisions. When tested in such areas as tactile, kinesthetic, and spatial intrusion, nonautistic children respond in a manner widely disparate from autistic children. No one single manifestation of an autisticlike response is a sufficient diagnostic clue; rather, there is a whole set of reactions upon which a clinical judgment rests. (16 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)