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PubMed2005

New molecular diagnostic methods in head and neck cancer.

Initial cancer evaluation includes assessment of histologic appearance, tumor grading, assessment of lymph node status, and presence of metastasis. However, traditional diagnostic methods such as histopathology and radiology are not sensitive enough to detect small numbers of cancer cells and are limited in their ability to predict response to treatment. Recently, there has been considerable progress in molecular diagnostics in these areas. Using molecular-based technologies, it is now possible to detect cancer early in asymptomatic individuals, identify minimal residual disease at histopathologic normal surgical margins, more precisely assess tumor burden in cancer patients, and more accurately assess the prognosis of the patients. Examples of these applications in the evaluation of head and neck cancer are reviewed here. However, despite the great promise of these new molecular approaches for cancer detection, much of the current technology limits their implementation into routine clinical use.

Biomarkers, Tumor↗

PubMedDate not supplied

Isolation of the Rift Valley fever virus by inoculation into Aedes pseudoscutellaris cells: comparison with other diagnostic methods.

The Rift Valley fever epidemic, which arose in the south of Mauritania beginning on October 15, 1987, enabled a comparative study of different diagnostic methods among humans. During the first two weeks of the epidemic, four parallel methods were used: inoculation into Aedes pseudoscutellaris cells, inoculation intracerebrally into suckling mice, tests by immunocapture of the circulating antigen and detection of type IgM gammaglobulins. Of 370 examined sera, 181 showed at least one marker of recent infection. Inoculation into A. pseudoscutellaris cells was by far the most sensitive and easiest method to use. Detection of the antigen by immunocapture was also a useful technique, since it allowed quick aetiological diagnosis or examination of sera conserved under poor conditions. However, its sensitivity was weak, as it could only detect 26% of positive cases. Vero cells used on a limited scale, in this particular case seemed less sensitive than A. pseudoscutellaris cells. Of a total of 991 sera, 221 diagnoses were reported by discovery of the virus and 271 by detection of specific IgM. In every case, A. pseudoscutellaris cells seemed most appropriate as the system of reference.

Aedes↗

PubMed1999

[Esophageal carcinoma: accurate staging thanks to modern diagnostic methods open up new therapeutic strategies].

INTRODUCTION: Since the tumour stage has significant prognostic and therapeutic implications, accurate preoperative staging is decisive. ALGORITHM FOR DIAGNOSTIC STUDIES: Flexible endoscopy of the oesophagus with biopsies is the first diagnostic step in patients with signs of oesophageal cancer and allows assessment of (1) tumour localisation, (2) tumour size, (3) grade of stricture, (4) type of histology, and (5) cellular grading. Thereafter, CT scan of the chest and upper abdomen is performed to assess the provisional TNM stage. The local TN stage is verified in operable patients by endosonography and additionally by bronchoscopy if the tumour is located in the upper half of the oesophagus. The M stage can be preoperatively verified by laparoscopy. CONCLUSION: Modern diagnostic methods yield accurate staging, which makes it possible to optimise selection of the most appropriate therapeutic strategy.

Algorithms↗

PubMed1982

A prospective study of diagnostic methods in adenoma follow-up.

Three hundred and thirty patients having had previous colonoscopic polypectomy of adenomas were recalled for follow-up and submitted to all available diagnostic methods: occult blood testing, digital examination, rigid proctosigmoidoscopy, fibre-optic sigmoidoscopy, total colonoscopy and double contrast barium enema. Polyps up to 7 mm diameter were electro-coagulated during diagnostic endoscopy but larger polyps were left in situ for barium enema before polypectomy at a later date. Disparities between endoscopy and X-ray were rechecked by one or both procedures. Occult blood testing, digital examination and rigid proctosigmoidoscopy were found to be inaccurate or ineffective in diagnosis of the 37% of patients with further adenomas or carcinomas. Double contrast barium enema demonstrated 71% of larger lesions compared to the 92% shown by colonoscopy. The commonest sites of X-ray inaccuracy were in the sigmoid colon and caecum. Colonoscopy permits immediate electrocoagulation or snare polypectomy of any lesions seen, as well as being the more accurate investigation and is, therefore, the procedure of choice in post polypectomy follow-up. The mean time taken for diagnostic total colonoscopy in this series was 15.3 minutes, comparable to the time taken for barium enema. Postal questionnaire showed both procedures to be equally well tolerated by the patients. Thirty per cent of colonoscopies were, however, considered technically difficult by the endoscopist, and for these patients it is suggested that follow-up should be by the combination of fibre-sigmoidoscopy using carbon dioxide insufflation and immediate double contrast barium enema. Should this combination indicate a need for total colonoscopy, then almost all adenomas and cancers would be detected. Total examination of the colon by one or other means is essential, over half the patients with adenomas and three of the five patients with carcinoma showing no pathology in the territory of fibresigmoidoscopy or limited colonoscopy.

Adenoma↗

PubMed2006

Random urine protein to creatinine ratio as a diagnostic method of significant proteinuria in pre-eclampsia.

BACKGROUND: Because of the importance of pre-eclampsia and proteinuria in pregnancy, a faster and simpler diagnostic method is needed. AIM: To compare random urine protein to creatinine ratio (p:c ratio) with 24-h urine protein excretion rate in pregnant women with a suspicion of pre-eclampsia. METHODS: The study was conducted on 100 pregnant women with gestational ages of >or=20 weeks; 50 patients were suspected of having pre-eclampsia and 50 were healthy pregnant women. A random urine sample for p:c ratio determination and a 24-h urine sample for protein measurement were obtained. RESULTS: All women suspected of having pre-eclampsia had significant proteinuria. The single-voided p:c ratio demonstrated a sensitivity of 94% with a specificity of 96% at the cut-off>or=0.2 mg/mg. There was strong correlation between the two methods in this group (r=0.70, P<0.001, R2=49%). Using the same cut-off in the pregnant women who were not thought to have pre-eclampsia, the sensitivity of the test (p:c ratio) was 29% and the specificity was 87%. Pearson's correlation coefficient was 26 (P<0.06). Negative predictive value and positive predictive value were 34 and 83%, respectively. CONCLUSION: There is a strong correlation between 24-h urine protein excretion and single-voided urine p:c ratio in women suspected of having pre-eclampsia. A single-voided p:c ratio of >or=0.2 mg/mg is highly predictive for significant proteinuria. However, this test was not found to be a reasonable alternative to 24-h urine collection; and it must be followed by 24-h urine collection in a clinically suspect patient with a p:c ratio of <0.2 mg/mg.

Adolescent↗

PubMed1993

[Diagnostic methods for finding causes of infertility, results of HSG examination and laparoscopy in infertile women examined at the gynecologic ward of the city hospital].

The paper presents diagnostic methods employed at the Gynaecological Ward of the City Hospital in Pruszków and the results of HSG and laparoscopy examination, with special attention being drawn to the usefulness of these methods in finding out the causes of infertility. 51 patients with primary and second infertility were examined. HSG and laparoscopy make it possible to diagnose correctly the cause of infertility. They also enable adequate and early classification of patients for further diagnosis and treatment at highly specialized centres dealing with the problems of infertility.

Female↗

PubMed2006

Clinical reevaluation of the QuantiFERON TB-2G test as a diagnostic method for differentiating active tuberculosis from nontuberculous mycobacteriosis.

INTRODUCTION: We reevaluated the usefulness of a whole-blood interferon-gamma enzyme-linked immunosorbent assay (QuantiFERON TB-2G [QFT-TB]; Cellestis) in obtaining a differential diagnosis between active tuberculosis (TB) and nontuberculous mycobacteriosis (NTM). METHODS: The subjects were 50 healthy volunteers, 50 patients with active TB, and 100 patients with NTM who satisfied the diagnostic guidelines of the American Thoracic Society from April 2005 through June 2006. The tuberculin skin test (TST) and the QFT-TB test were performed for all subjects. The QFT-TB test was performed every 2 months. RESULTS: Of the healthy volunteers, 64% had a negative TST result and 94% had a negative QFT-TB test result. Of the patients with active TB, 64% had a positive TST result and 4% had a negative QFT-TB test result. Of the patients with pulmonary Mycobacterium avium complex disease, 60% had a positive TST result and 7% had a positive QFT-TB test result. The QFT-TB test had a mean sensitivity of 86% and a mean specificity of 94%. The QFT-TB test results for patients with active TB transiently decreased during treatment involving antituberculous drugs. The rate of positive QFT-TB test results was 86% at the initiation of treatment, 48% 6 months later, and 33% 12 months later. CONCLUSIONS: We confirmed that the QFT-TB test is a useful diagnostic method for differentiating active pulmonary TB from NTM, compared with the TST. However, because it is possible that the effect of the QFT-TB test may be long lasting after treatment and may not be resolved over time, even with treatment, as in this study, it may not provide any level of certainty regarding cure of infection.

Adult↗

PubMed1995

[Helicobacter pylori--comparison of selected diagnostic methods].

Among 108 persons sick from chronic gastritis, 61 with ulcus ventriculi and 91 with ulcus doudeni, diagnostic of Helicobacter pylori with simultaneous utilization of the following methods: direct preparation of homogenous tissue (gastrobiopsy), histological preparation (coloring by Giemza method), culture and serologic test (ELISA and IFP) was carried out. It was proved that among sick persons under examination depending on the diagnostic methods used, frequency of the infection was as follows 20%--direct preparation, 63.8%--histological preparation, 68.1%--culture, 81.5%--serologic test. Differences in prevalence of H. pylori in respective sickness depending on diagnostic methods were noted. It was also determined on the ground of discrimination analysis that in order to obtain the best diagnostic value the most advisable is to couple serologic test and histological examination.

Adult↗

PubMed2000

[Use of platelet function analyzer PFA-100 and whole blood aggregometry to monitor blood platelet sensitivity to acetylsalicylic acid (aspirin). Is it possible to reliably monitor antiplatelet treatment using routine laboratory diagnostic methods?].

Introduction of the antiplatelet agents of new generations and the occurrence of the phenomenon of "aspirin-resistance" triggered the search for better, simpler and more reliable routine diagnostic methods to monitor platelet reactivity. Our objective was to evaluate the usefulness and reliability of two simple methods: platelet function analyzer (PFA-100) and whole blood platelet aggregometry for monitoring of platelet function in 18 healthy blood donors and 35 patients with ischaemic heart disease (IHD) subjected to small doses/75 mg and 150 mg a day) of acetylsalicylic acid (aspirin). In 50% of healthy blood donors the intake of 75 mg ASA a day resulted in the prolongation of PFA-100 collagen/epinephrine closure time (CEPI = (relevant to reduced platelet reactivity) of over 150 s, whereas 75% donors responded to 150 mg ASA-. Otherwise, the daily dose of 150 mg ASA resulted in a prolonged CEPI merely in 23% of in IHD patients. At both doses ASA completely inhibited the arachidonic acid-induced whole blood platelet aggregation in all healthy donors and in all but 3 IHD patients. Collagen-induced platelet aggregation was only negligibly affected by either dose of ASA. Our results point that the simultaneous monitoring of the PFA-100 collagen/epinephrine closure time and whole blood platelet aggregometry (Chrono-Log) enables to reliably evaluate the inhibition of platelet function by ASA and discriminate the partial or complete platelet insensitivity to aspirin. The phenomenon of more frequent platelet aspirin-resistance in IHD patients requires to be verified in randomised clinical prospective studies.

Adult↗

PubMed1980

Diagnostic methods for herpes simplex infection: a review.

An antiviral treatment modalities appear in ever-increasing numbers, the need for precise viral diagnosis becomes essential. A review of the current diagnostic methods, including virus isolation, serology, biopsy, and cytology, is presented. The newer, more sensitive immunoperoxidase stain and ELISA are discussed. The needs, methods, and benefits of an accurate viral diagnosis are stressed.

Biopsy↗

PubMed1995

[Diagnostic methods in angina pectoris. The Angina Pectoris Study Group of the Ischemic Cardiopathy Section and Coronary Units of the Spanish Society of Cardiology].

Diagnosis and risk stratification in angina pectoris is supported on clinical evaluation, rest electrocardiogram, exercise stress test and coronary angiography. Use and timing application of that diagnostic methods depend on coronary artery disease prevalence and on clinical situation. This review describe diagnostic and prognostic value of the tests in angina pectoris.

Angina Pectoris↗

PubMed2005

Perineal noise recording as a non-invasive diagnostic method of urinary bladder outlet obstruction: a study in polyvinyl alcohol and silicone model urethras.

AIMS: At present, an invasive pressure flow study is recommended to diagnose urinary bladder outlet obstruction. This method induces the risk of urinary tract infection and urethral trauma. We studied perineal noise recording as an alternative, non-invasive diagnostic method in three flexible/extensible model urethras and two silicone tubes. METHODS: The flexible/extensible model urethras were made of a 10% aqueous solution of polyvinyl alcohol (PVA) and differed in wall- stiffness, the silicone tubes differed in diameter and wall-thickness. Three degrees of obstruction were applied by inflating a cuff placed around the PVA-urethras and by compressing the silicone tubes with an adjustable clamp. Noise, produced during flow, was recorded at three positions distal to the obstruction using a piëzoceramic contact microphone. RESULTS: The average amplitude of the noise and the essential frequency of the power spectrum of each noise recording depended significantly on the degree of obstruction, the position of the microphone and the wall-stiffness in PVA-urethras and the diameter in silicone tubes. CONCLUSIONS: Based on the results of this study perineal noise recording shows good potential as an alternative method for diagnosing bladder outlet obstruction.

Data Interpretation, Statistical↗

PubMed1998

Dementia as a predictor of adverse outcomes following stroke: an evaluation of diagnostic methods.

BACKGROUND AND PURPOSE: Although it is understood that dementia is a risk factor for adverse outcomes, little is known about the predictive validity of the numerous methods that have been proposed for its diagnosis. Thus, we performed the present study to assess the utility of a variety of diagnostic methods in the prediction of adverse outcomes following stroke. METHODS: We administered neuropsychological, neurological, and functional examinations to 244 patients (age, 71.7+/-8.5 years) 3 months after ischemic stroke. We diagnosed dementia using each of the following methods: (1) neuropsychological testing, requiring deficits in increasing numbers of cognitive domains, both with and without memory impairment, as well as functional impairment; (2) Mini-Mental State Examination (MMSE) score of <24; and (3) neurologists' clinical judgment. We then used survival analyses to investigate the ability of diagnoses based on those methods to predict death and recurrent stroke during long-term follow-up. RESULTS: Log-rank tests and Cox proportional hazards analyses, with recurrent stroke entered as a time dependent covariate, determined that all of the paradigms were significant predictors of mortality, but the performance of paradigms based on neuropsychological testing was superior to the use of the MMSE and clinical judgment, particularly when memory impairment was required. Log-rank tests determined that paradigms based on neuropsychological testing were the only significant predictors of recurrent stroke and performed best when memory impairment was required. CONCLUSIONS: Our results suggest that dementia diagnosis based on neuropsychological assessment and an operationalized paradigm requiring deficits in memory and other cognitive domains is superior to other conventional methods in its ability to identify patients at elevated risk of adverse outcomes following stroke.

Activities of Daily Living↗

PubMed1989

Diagnostic methods and epidemiologic surveillance of Taenia solium infection.

Taeniasis and cysticercosis caused by Taenia solium, the pork tapeworm, are widespread infections of Latin America, Africa, and Asia. The disease in humans (neurocysticercosis), caused by the cystic larval stages which develop in the central nervous system, is often disabling and sometimes fatal. T. solium infections are endemic in rural and urban areas in some countries that have limited resources to introduce and sustain control programs. To give T. solium control high national priority, the effect of the diseases on health and social care budgets must be accurately measured. Surveys are needed to establish prevalence and geographical distribution of the diseases, to obtain basic epidemiologic data, to learn about transmission, to provide baseline data for the establishment of control measures, and to monitor control measures. Continuing surveys can provide information on changes in prevalence brought about by specific control measures or by changes in the standard of living, education, animal husbandry, and meat processing. Data are not yet available for any endemic-cysticercosis area, and this has hindered efforts to control the disease. There are technical limitations of currently-available methods for diagnosing both taeniasis and cysticercosis in humans in and lower animal hosts. This paper reviews the status and limitations of diagnostic methods and emphasizes the need for further research.

Animals↗

PubMed2006

Molecular diagnostic methods in the diagnosis and follow-up of well-differentiated thyroid carcinoma.

Thyroid cancers are the most common endocrine malignancies and are being diagnosed with increased frequency in modern clinical practice. Among other diagnostic modalities, fine-needle aspiration (FNA) biopsy of clinically suspicious thyroid nodules is becoming increasingly popular. Preliminary investigations have suggested that molecular diagnostic assays using tumor-specific markers may improve the sensitivity and accuracy of FNA and so may be expected to reduce the frequency of open surgical procedures by identifying those patients with demonstrably benign lesions who do not require definitive surgical excision of their lesions for diagnosis. At the same time, thyroid-specific mRNA assays (especially thyroglobulin mRNA testing) have been used by investigators in the postoperative follow-up of patients with thyroid cancer as a potential means of detecting tumor recurrence in the peripheral blood. Although these studies have not all reported unqualified successes--indeed, some problems based on both technical and biologic limitations have been identified-these assays still hold out the possibility that potentially important new advances in the management of patients with well-differentiated thyroid cancer may be offered by these and other molecular diagnostic methods.

Biomarkers, Tumor↗

PubMedDate not supplied

[Diagnostic methods and therapeutic options in vasculogenic impotence].

Until a few years ago, the main cause of men's genital impotence was reputed to be psychogenic. On the other hand, the development of diagnostic techniques has been in aid in isolating the most frequent cause of impotence among the organic forms, and in particular those of vascular origin. The authors herein examine the diagnostic methods of vasculogenic impotence and evaluate the therapeutic options in relation to the various causes identified.

Humans↗

PubMed2002

Diagnostic methods current best practices and guidelines for isolation of bacteria and fungi in infective endocarditis.

This article addresses the clinical need for accurate detection of bacteria and fungi that may cause infective endocarditis (IE). The pathophysiology of bacteremia during endocarditis is reviewed to provide an understanding of how current diagnostic methods may be used to determine the etiologic diagnosis. The critical contribution of microbiologic findings to the current clinical diagnostic criteria is emphasized. Finally, "best practices" recommendations are presented to optimize the likelihood of reaching a correct etiologic diagnosis while minimizing the number of "culture-negative" cases.

Bacteria↗

PubMedDate not supplied

[Cardiac myxoma, diagnostic methods and curative surgery. Report of 5 cases].

We report five patients with Myxomas of the left atrium studied by catheterization and/or Echocardiography between november 1976 and october 1978. Four patients were operated immediately with extracorporeal circulation which confirmed the diagnosis. The last patient died before surgical intervention due to a severe hepatorenal syndrome and extensive pulmonary infection. Another patient died postoperatively on the second day due to irreversible pulmonary hypertensión. The remaining three patients are asymptomatic (average 28 months after surgery). Reviewing the diagnostic methods, particularly the Echocardiogram, we found that it is a good diagnostic tool, making catheterization with the risks of myxomatous embolization unnecessary. Furthermore, the Echo facilitates simple and economic observation for the detection of relapses. Finally, broad and careful surgical management most be emphasized in order to avoid transoperative emboli, tumoral dissemination, and latent relapses, mediated by the greater use of filters and a broad resection of the implantation pedicule.

Adult↗