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PubMed1981

Diagnosing borderline personality. A pilot study using multiple diagnostic methods.

The research described in this paper stemmed from the hypothesis that borderline personality organization can be differentiated from neurotic and psychotic levels of personality organization by means of three structural criteria: degree of identity integration, level of defensive operations, and capacity for reality testing. In order to elicit these criteria, the "structural" interview has been developed that focuses on the "here-and-now" patient-interviewer interaction. The patient's responses to the interviewer's attempts to clarify, confront, and interpret various aspects of the patient's interview behavior provide the basis for judgments as to the patient's structural diagnosis. Specifically, the paper reports a study of the differential diagnosis of 48 hospitalized patients in which structural diagnoses of borderline or psychotic personality organization were made according to this diagnostic interview approach. These diagnoses were compared with ones obtained from Gunderson's Diagnostic Interview for Borderlines, with psychological test diagnoses, and with clinical diagnoses based on past history and current illness. Results show substantial convergent agreement among all of the diagnostic methods and support the utility of the structural interview. In most discrepant cases, other methods reflected disagreement among themselves despite the diagnoses obtained from the structural interview, suggesting that there are some cases difficult to classify by any means. Further analysis suggests that the structural interview may be eliciting a different dimension of personality functioning in arriving at borderline diagnoses than do the other methods studied. The results also indicate that borderline structural diagnoses refer to patients described clinically as having severe character pathology, and do not overlap with patients described as having schizophrenic disorders. The structural interview appears to warrant further study, and, at the same time, shows promise as a research tool in further studies of structural diagnosis and its relevance for prognosis and treatment.

Adolescent↗
PubMed1993

[The validation of a rapid diagnostic method for urinary infection in the school-age population].

Validity of visual reading of a reactive strip is measured, in comparison with automatized reading and the exam of the urinary sediment, in 562 school pupils with ages between 6 and 16 years. Using urine culture as standard reference, sensibility of the leukocyte-esterase (L-E) test, nitrites and red cells was 66.7%, 33.3% and 66.7% respectively, for the visual reading; 66.7%, 33.3% and 33.3% for automatized reading, respectively; and 66.7% for leukocyturia, and 33.3% for hematuria in the urine sediment. Specificity of tests was 84.9%, 99% and 42.7% for L-E, nitrites and red cells, in visual reading; 92.5%, 100% and 80.8% for the same tests in automatized reading, and 94.5% (leukocyturia) and 86.3% (red cells) in the urinary sediment. Validity of these diagnostic methods results different depending on the population they are applied to. Even though the multi-urine test is still the most effective test in a symptomatic population and the less expensive, it would be not recommendable its use as a screening test in a school population with hidden urinary infection.

Adolescent↗
PubMed1979

[Modern angiological diagnostic methods].

The tasks of apparative examination methods in the angiologic diagnostics are explained. Apart from the mechanical oscillography the possibilities of registration and evaluation of the peripheral pulse wave are discussed. As quantitative examination method the plethysmography is broadly used. The most important applications of the ultrasound-Doppler-technique are described.

Arterial Occlusive Diseases↗
PubMed2004

[Visualization of symmetric striopallidodentate calcinosis by using high-resolution susceptibility-weighted MR imaging. An account of the impact of different diagnostic methods of M. Fahr].

Bilateral striopallidodentate calcinosis, also known as Fahr's disease, is characterized by symmetric calcifications of the basal ganglia, thalami, dentate nuclei of the cerebellum and white matter of the cerebral hemispheres. Besides the common idiopathic etiology of bilateral intracerebral calcinosis, alterations of calcium metabolism are present in rare cases, which are especially caused by hormonal dysfunction of the parathyroids. Advanced imaging techniques, such as CT and MRI, demonstrate increasing relevance regarding diagnosis of bilateral striopallidodentate calcinosis. Intracranial calcifications are routinely observed with high sensitivity by CT. On MR images calcifications exhibit different signal intensities, which depend on the stage of the disease, differences in calcium metabolism and the compound of these calcifications. Application of a new high-resolution, susceptibility-weighted MR sequence allows detailed visualization of the intracerebral calcifications in Fahr's disease. Further diagnostic methods and important aspects regarding clinical manifestation of bilateral striopallidodentate calcinosis are also discussed.

Basal Ganglia Diseases↗
PubMedDate not supplied

Sensitivity to aspirin: a new serological diagnostic method.

Certain adverse reactions to aspirin (ASA), nonsteroidal anti-inflammatory drugs (NSAIDs) and pyrazolone derivatives resemble IgE-mediated hypersensitivity. However, convincing evidence of antigen-antibody interactions or inhibition of the cyclooxygenase pathway of arachidonic acid metabolism, stimulating the production of leukotrienes (LTs) and decreasing the production of prostaglandins (PGs), has not been presented. In this study, two types of specific IgE antibodies have been found in six serum samples from eight ASA-sensitive patients with salicyloyl and O-methylsalicyloyl disks using the Radio Allergo Sorbent Test (RAST), whereas no positive result could be found with acetylsalicyloyl disks. Further investigation on the specificity of these IgE antibodies and the chemical structure of their epitopes were performed by cross-inhibition studies. The results are in favor of an IgE-dependent mechanism involved in ASA sensitivity, and suggest that determination of specific IgE antibodies would be a safe diagnostic method for ASA sensitivity in vitro.

Adult↗
PubMedDate not supplied

[A diagnostic method in acute pyelonephritis in pregnant women].

A radiothermometer has made it possible to take deep temperature directly from the kidney. Comparison of temperatures, obtained from normal nonpregnant women, normal pregnant women and pregnant patients with acute pyelonephritis has demonstrated a significant drop in renal temperature during pregnancy. In acute pyelonephritis, renal temperature drops still further, with the temperature difference between the affected kidney and the contralateral one ranging from 0.5 degrees to 1.5 degrees. Deep temperature measurements of each kidney are taken from several sites, selected at ultrasonic scanning, which makes it possible to calculate temperature variance for the kidney. Variance increases significantly (more than two-fold) in the inflamed kidney, as compared to the intact one. Therefore, the diagnosis of acute pyelonephritis can be made where deep temperature difference is between 0.5 degrees and 1.5 degrees and temperature variance is increased twofold or more in one kidney, as compared to the other, in a pregnant patient. The side of affection is also determined in this way. The proposed diagnostic method is perfectly safe for the mother and the fetus, and can be used for the diagnosis of acute pyelonephritis during pregnancy, along with other procedures.

Acute Disease↗
PubMed1985

A comparison of two diagnostic methods. Clinical ICD diagnoses vs DSM-III and Research Diagnostic Criteria using the Diagnostic Interview Schedule (version 2).

In the context of a seven-year follow-up study, 171 former psychiatric inpatients and 158 subjects from the general population were interviewed twice, first with the German version of the Diagnostic Interview Schedule (DIS) (version 2), and second with a clinical interview using the Arbeitsgemeinschaft für Methodik und Dokumentation in der Psychiatrie (AMDP) checklist to assign a clinical International Classification of Diseases (eighth revision) (ICD-8) diagnosis, independent of the DIS. With the clinicians' ICD-8 diagnosis as a measure of the quality of the DIS, the results indicate a sufficiently high overall specificity and sensitivity of the DIS as a case-finding instrument in a general population survey, and a surprisingly high concordance of most DIS diagnostic classes with comparable ICD diagnoses. Only for panic disorders (possibly due to different symptom and time criteria) and schizophrenia (possibly due to the strict probe system, the dependence on self-reports, and time criteria) was low sensitivity found. Because there is no DIS diagnostic category comparable with ICD-8 unipolar affective psychosis, a meaningful comparison of this ICD category with Research Diagnostic Criteria and DSM-III was not possible.

Adult↗
PubMed1995

Experimental myocarditis induced by two different coxsackievirus B3 variants: aspects of pathogenesis and comparison of diagnostic methods.

The ability of two coxsackievirus B3 (CBV3) variants to induce myocarditis in BALB/c mice was studied and plaque-forming assay, polymerase chain reaction (PCR), in situ hybridization, and immunohistochemistry were compared for detecting viruses and viral components in the myocardium. The virological findings were related to histopathologic and ultrastructural changes in the myocardium. CBV3-W induced severe myocarditis characterized by massive myocyte necrosis. Widely distributed myocyte damage clearly preceded modest inflammatory infiltrates in the myocardium. In contrast, CBV3-M1 induced mild myocardial injury. Both variants caused fulminant pancreatitis with nearly complete necrosis of the exocrine pancreas. CBV3 RNA was identified by PCR in the myocardium of CBV3-W-infected mice until the end of the follow-up period of 14 days. Moreover, semiquantitative results were obtained when the PCR/hybridization results were analyzed by a phosphor imaging system. Immunohistochemistry and in situ hybridization from formaldehyde-fixed, paraffin-embedded specimens were highly similar in detecting viral components during the early stages of the myocardial injury. The results indicate that: (i) direct viral damage plays an essential role in acute murine CBV3-induced myocarditis, (ii) PCR appears a useful and sensitive diagnostic method in acute myocarditis, and (iii) immunohistochemistry as a specific and relatively rapid method might be practicable also in studying the early stages of acute myocarditis from archival clinical material.

Acute Disease↗
PubMed1994

Comparative evaluation of diagnostic methods in ovarian carcinoma with emphasis on CT and MRI.

A prospective study was performed in 64 patients suspected of having primary or recurrent ovarian epithelial cancer. Physical examination (PE), ultrasonography (US), computer tomography (CT), and magnetic resonance imaging (MRI) were performed and CA 125 serum levels (CA 125) were determined. This evaluation was followed within 3 weeks by laparotomy, which served with the pathology data as the gold standard. Both CT and MRI were, independently, evaluated by two experienced radiologists. The accuracy in diagnosing ovarian carcinoma of both CT (70 and 91%) and MRI (64 and 88%) in patients suspected of primary and recurrent cancer grouped together differed between the two radiologists, but for each radiologist no difference in overall accuracy between CT and MRI was observed. The accuracy of PE was 64%, of US, 67%, and of CA 125, 72%. At surgery, 132 separate tumor locations were present. With CT, 41 and 69% and with MRI, 44 and 56% of these lesions were recognized by the two radiologists, respectively. This was the case in 27% with PE and 34% with US. We conclude that in our setting MRI had no additional value over CT. The interobserver variability was high for both MRI and CT. MRI and CT are both useful diagnostic methods in the diagnosis of ovarian carcinoma.

Adult↗
PubMed1977

[Significance of suprapubic puncture of the bladder as a diagnostic method].

In 650 cases for the purpose of a methodical comparison was examined urine got by paracentesis of the bladder and midstream urine. The most important results were: 1. Urine got by paracentesis of the bladder was infected in 30.9%, midstream urine in 51.7%. 2. Further 39.4% of the samples of midstream urine were poor in germs; in 2.3% these findings corresponded to an infection. 3. Only 69.7% of the kinds of germs and 38.8% of the numbers of germs were identical. 4. 28.4% of the samples of midstream urine with a significant bacteriuria and 60.6% of those ones in the region of suspicion showed sterility in the corresponding urine got by paracentesis of the bladder. 5. On the other hand 30.8% of the infected urine got by paracentesis of the bladder did not reveal a significant bacteriuria in the midstream urine. These results confirm the relevance of the quickly performable and complicationless suprapubic paracentesis of the bladder as diagnostic method. It should more be taken into consideration in clinic and outpatient department.

Bacteriuria↗
PubMed2003

Paratuberculosis: eradication, control and diagnostic methods.

At the beginning of the twentieth century, the dairy industry and cattle breeding organisations initiated a programme to control infectious diseases by means of a complex system of rewards and penalties. The history of programmes to control paratuberculosis in sheep, goats, and cattle in various countries is described. The vaccination of young animals (especially goats and sheep) seems to be an effective measure in the prevention of clinical paratuberculosis, although changes in management and hygiene practices are also important. A control programme for infectious cattle diseases has a number of phases (a life cycle) and different components. Two components are essential for success, namely, open and regular communication with farmers, veterinary practitioners, and other people involved, and a good registration and identification system for cattle, herds, and veterinary practitioners. The principles and different levels of control of paratuberculosis are discussed. The Dutch paratuberculosis programme is divided in two parts: an intensive programme based on test and cull and an extensive programme based on education. The intensive programme has ten herd status levels: 5 to 10 for non?suspect herds and 1 to 4 for infected herds or herds of unknown status. The higher the status, the greater the chance that a herd is free of paratuberculosis. An outline is given of the Dutch paratuberculosis programme. Diagnostic methods are summarised. Future developments regarding vaccination and control or acceptance of paratuberculosis are discussed.

Animals↗
PubMed1995

Reactive arthritis: urogenital swab culture is the only useful diagnostic method for the detection of the arthritogenic infection in extra-articularly asymptomatic patients with undifferentiated oligoarthritis.

Reactive arthritis (ReA) is a seronegative oligoarthritis triggered by a preceding extra-articular infection. While evidence of a microbial infection is mandatory for establishing the diagnosis of ReA, the sensitivity of bacteriological and serological tests has not been determined in patients without symptoms of infection. In a retrospective study, we evaluated the usefulness of urogenital swab cultures, serology and stool culture to identify infections in 234 patients with undifferentiated oligoarthritis. One hundred and forty-four patients complaining about joint pain who had no sign or history of inflammatory arthritis served as controls. Urogenital swab cultures showed a microbial infection in 44% of the patients with oligoarthritis (15% Chlamydia, 14% Mycoplasma, 28% Ureaplasma), whereas in the control group only 26% had a positive result (4% Chlamydia, 7% Mycoplasma, 21% Ureaplasma) (P < 0.001). A Chlamydia IgG-antibody titre > or = 1:256 was found in 22% of the patients in the oligoarthritis group and in 9% of the controls (P < 0.01). However, for only half of Chlamydia IgG-positive patients could a Chlamydia infection be confirmed by urogenital swab culture. Twenty-one per cent of patients with oligoarthritis vs 23% of the controls had positive antibody titres for Salmonella (not significant), 15% vs 5% for Yersinia (P < 0.05) and 17% vs 3% for Borrelia IgG (P < 0.01). In two patients, stool cultures were positive for Campylobacter. Urogenital swab culture is a sensitive diagnostic method to identify the triggering infection in ReA. A single determination of antibodies against Chlamydia trachomatis is of limited value because of the high prevalence of positive results in the control group.

Adult↗
PubMed1997

[A novel diagnostic method for allergy "LUCICA HRT"].

We developed a novel glass microfiber-based histamine release test (HRT) which is characteristic of response of basophil leukocyte to allergens in vitro. It allows the determination of 20 allergens (10 for inhalation allergy, and the other for food allergy) at the same time using a small amount of whole blood. For 158 patients of inhalation allergy and 135 patients of food allergy, they were evaluated by HRT, CAP-RAST, skin test, and provocation test. The concordance of HRT, CAP-RAST, and skin test were 78%, 72%, and 62% in inhalation allergy, and 84%, 71%, and 81% in food allergy, respectively. The specificity of HRT, CAP-RAST, and skin test were 63%, 37%, and 19% in inhalation allergy, and 92%, 63%, and 83% in food allergy, respectively. The positive predictive value of HRT, CAP-RAST, and skin test were 79%, 71%, and 63%, respectively. The false positive ratio of HRT (14%) was lower than that of CAP-RAST (42%). The sensitivity of CAP-RAST was higher than that of HRT. In addition, we experienced a case of patient who showed significant improvement by treatment. At initial stage, not only the symptoms were erythema and scratching but also HRT, CAP-RAST, and skin test resulted in positive. Four months later, he had no allergic symptoms, HRT resulted in negative, but CAP-RAST and skin test resulted in still positive. From these results, we concluded that CAP-RAST is good for screening of etiological allergens and that HRT is a useful diagnostic method for the confirmation of a clinical allergy.

Adolescent↗
PubMed2000

[New diagnostic methods in non-Hodgkin lymphoma].

We describe five patients with non-Hodgkin's lymphoma (NHL) in which immunohistochemical investigation (IH) and polymerase chain reaction (PCR) were important for diagnosis and choice of treatment. One patient got the diagnosis follicular NHL after PCR showed t(14;18) in a fine needle biopsy from a tumour in the abdomen. Two small and partly traumatized biopsies from two patients were diagnosed as low grade NHL of B-cell type after PCR showed monoclonality for B-lymphocytes and IH showed B-cell phenotype and low proliferation rate. Biopsy from another patient showed positive immunohistochemical reaction for cyclin D1 and t(11;14) by PCR compatible with mantel cell lymphoma. One patient was diagnosed with high grade NHL of T-cell type after IH showed positive reaction for T-cell markers and high proliferation rate, and PCR showed monoclonality for T-lymphocytes. These cases demonstrate that IH and PCR can often benefit patients with NHL. The new methods contribute to enhanced diagnostic security and precision in subclassification and make possible the use of small biopsies which save the patients from major surgery for diagnostic purposes.

Aged↗
PubMed1976

[The evidence of precipitins in Aspergillus caused disorders of the lung as a diagnostic method (author's transl)].

A report is given about serologic results of 27 aspergilloses, mostly aspergillomas. The evidence of antibodies directed against aspergillus species was carried out by radial diffusion according to OUCHTERLONY and immunoelectrophoretically. Filtrate antigens ("metabolic antigens") were used troughout. The positive yield lies in about 90%. Regarding the criteria for evaluation no positive reactions were seen in a control group of 140 patients with serious tuberculosis and other lung disorders. The method is emphasized as diagnostic mean for clearing up shadows of the lung and for pathogenetic control of aspergillus--grown from lung materials.

Adult↗
PubMed1984

[Can therapeutic trials serve as a model for the evaluation of diagnostic methods?].

Many health care professionals think that diagnostic technologies must be assessed as treatments are and that controlled diagnostic trials must be organized for evaluation of diagnostic tests. There are many differences between these two types of trials relating with: unfeasibility of blind judgments, biases due to requesting of diagnostic tests in addition to technologies to be compared, number of patients required for a sufficiently powerful statistical analysis, diverging interest of the various clinical teams involved into the assessment. A different approach using simulation methods and decision trees appears more appropriate in the evaluation of diagnostic technics.

Clinical Trials as Topic↗