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At least 271 records · Page 15Linked to original sources

[Transbronchial lung biopsy as a diagnostic method of peripheral lesions].

The aim of the study was to assess the diagnostic yield of transbronchial lung biopsy (TBLB) without fluoroscopic guidance in peripheral lesions of diameter 2,5-6 cm. TBLB was performed in 65 consecutive patients without abnormalities in bronchial tree in standard bronchofiberoscopy and preceded by computed tomography (CT). The CT guidance helped to select the segment of lung to be biopsied. In 39 patients (60%) TBLB enabled to diagnose 36 cases of lung cancer, 2 cases of carcinoid and 1 case of malignant lymphoma. There were 26 cases (including 21 cases of lung cancer) undiagnosed by means of TBLB. In 24 patients the diagnosis was established by means of other methods like transbronchial needle aspiration (TBNA)--5 cases, thin needle biopsy (TNB)--12 cases, open lung biopsy (OLB)--7 cases and in the remaining 2 patients a regression of clinical and radiological features was observed. Transbronchial lung biopsy was found to be efficient diagnostic method in peripheral lesions higher than 2,5cm. However, in 40% of cases this technique doesn't allow to establish a diagnosis. This, in turn implicates the necessity for further diagnostic procedures including TBNA, TNB or even OLB.

Adult↗

[Transbronchial needle aspiration as a diagnostic method of mediastinal adenopathy].

The aim of the study was to assess the diagnostic yield of transbronchial needle aspiration (TBNA) in mediastinal or hilar adenopathy in: sarcoidosis, tuberculosis and malignancy. Transbronchial needle aspiration was performed in 53 patients, preeceded by computed tomography (CT). In 22 patients (41,5%) TBNA enabled to diagnose 10 cases of sarcoidosis, 12 cases of neoplastic infiltrates of the lung. There were 31 cases undiagnosed by means of TBNA. In 24 patients the diagnosis was established by means of other methods like bronchoscopy with mucose biopsy (8 cases of sarcoidosis), transbronchial lung biopsy (4 cases of squamous cell carcinoma and adenocarcinoma, 2 cases of sarcoidosis), mediastinoscopy (3 cases of sarcoidosis and 2 cases of Hodgkin's disease), and videothoracoscopy (2 cases of sarcoidosis), transthoracic needle biopsy (1 case of squamous cell carcinoma) and lymph node biopsy (1 case of adenocarcinoma and 1 case of sarcoidosis). In the remaining 7 patients who were followed-up for a period of one year the diagnosis of sarcoidosis was confirmed by clinical, radiological and cytological (BAL) examinations. Transbronchial needle aspiration was shown to be efficient diagnostic method in mediastinal or hilar adenopathy in sarcoidosis and malignancy except lymphoma. Moreover in approximately 60% of cases this technique doesn't allow to establish a diagnosis and in turn implicates the necessity for further diagnostic procedures like mediastinoscopy, or transbronchial or thoracoscopic lung biopsy.

Biopsy, Fine-Needle↗

Modification of left ventricular isovolumic relaxation time during dobutamine echocardiography as a diagnostic method for ischemic heart disease.

BACKGROUND: The diagnostic ability of dobutamine stress two-dimensional echocardiography is limited by the clarity of the echocardiographic image. In this study, left ventricular isovolumic relaxation time (IVRT) was modified and the effect of this modification on the diagnostic accuracy of dobutamine echocardiography (DE) in detecting ischemia was assessed. METHODS: DE was performed in 59 subjects (34 and 25 in the control and patient group, respectively). The results were compared with coronary angiography and stress scintigraphy. We focused on the changes of the IVRT, the corrected IVRT which was the IVRT corrected for heart rate, and the modified IVRT which is the corrected IVRT modified by a new-designed equation. RESULTS: These isovolumic relaxation variables shortened with the increment of dobutamine dosage and were markedly prolonged when ischemia developed. The sensitivity and specificity of DE were 84% and 74%. However, using the prolongation of corrected IVRT and modified IVRT as indicators of ischemia, the specificity increased (from 74% to 91% and to 94%, respectively), without a significant reduction in sensitivity (from 84% to 76% and to 84%, respectively). Patients with positive results for these variables, as compared with negative results, had a significant result of more ischemic segments and a tendency of more diseased vessels. CONCLUSION: The prolongation of these isovolumic relaxation variables during myocardial ischemia improves the diagnostic accuracy of DE and is also well correlated with the severity of ischemia.

Adult↗

[Simple method of differential diagnosis of peripheral and central vertigo--development of diagnostic method and studies of 178 cases].

In patients who complain of vertigo or who have equilibrium disorders, it is often difficult to determine the etiology of the disorder, that is to determine whether it is dependent on a peripheral or central vestibular disorder. To attempt to determine the etiology in these cases, we divised a new method, the caloric eye tracking pattern test (CETP-Test). Seventeen normal subjects and 161 patients were tested. The latter group included 33 with peripheral disorders such as Meniere's disease, benign paroxysmal positional nystagmus, and others, and 128 with central disorders such as vertebral basilar artery insufficiency, cervical vertigo, and others, were tested. The cases of central disorders were limited to those patients whose eye tracking pattern before the caloric stimulation was normal. In normal subjects and in patients with peripheral disorders, it is well known that caloric nystagmus has little influence on the eye tracking pattern. In contrast, in patients with central vestibular disorders, caloric nystagmus evokes abnormalities on the eye tracking pattern, either superimposed or saccades, despite the fact that the eye tracking pattern before the caloric stimulation is normal. First we administer the eye tracking stimulation test using a target which moves horizontally at 0.3 cycle per second. Next, we perform the caloric test on the right ear, using 20 c.c. of ice water for 10 seconds. During the evoked caloric nystagmus we administer the eye tracking test once again. The eye tracking pattern is recorded for 20 seconds beginning 50 seconds after the start of the ice water injection. The procedure repeated on the left ear. The results on each case are presented as three patterns of ENG-recording. We may stat that in normal subjects and in patients with peripheral vestibular disorders, visual suppression of caloric nystagmus remains functional. Caloric induced nystagmus does not affect the CETP. In patients with central vestibular disorders, visual suppression of caloric nystagmus does not function properly because of defects in the visual suppression mechanism. Therefore, caloric nystagmus greatly influences the CETP. Consequently, the CETP may not be smooth when CETP test is administered to patients with central vestibular disorders. We may say also that the visual suppression to the vestibular nystagmus is evoked more strongly by pursuing a moving visual stimulus than by gazing a stational target. These results allow for a differential diagnosis between peripheral and central disorders.

Adult↗

[Transbronchial lung biopsy as a diagnostic method of diffuse pulmonary diseases].

The aim of the study was to assess the diagnostic yield of transbronchial lung biopsy (TBLB) in some of diffuse pulmonary diseases, like: sarcoidosis, organizing pneumonia--(OP), tuberculosis and neoplasmatic infiltrates of the lung. Transbronchial lung biopsy was performed in 123 patients, preceded by high resolution computed tomography (HRCT). The HRCT guidance helped to select the area of lung to be biopsied. In 80 patients (65%) TBLB enabled to diagnose 40 cases of sarcoidosis, 15 cases of OP, 13 cases of neoplasmatic infiltrates of the lung and 5 cases of tuberculosis. There were 43 cases undiagnosed by means of TBLB. In 19 patients the diagnosis was established by means of other methods like videothoracoscopy (8 cases), bronchoscopy with bronchial mucose biopsy (7 cases of sarcoidosis), mediastinoscopy (2 cases of Hodgkin's disease), transthoracic needle biopsy (2 cases of adenocarcinoma). Moreover sarcoidosis was diagnosed in 15 cases by means of clinical, radiological examination and BAL. 9 patients didn't agree for further invasive diagnostics. Transbronchial lung biopsy was shown to be efficient diagnostic method especially in sarcoidosis, OP and neoplasmatic infiltrates of the lung. However, in approximately 35% of cases of diffuse pulmonary diseases this technique doesn't allow to establish a diagnosis. This in turn implicates the necessity for further diagnostic procedures including videothoracoscopic or open lung biopsy.

Adult↗

[Rotator cuff rupture in the shoulder impingement syndrome. Echography and arthrography: 2 diagnostic methods compared].

After briefly reviewing the shoulder impingement syndrome, the authors investigate the role of two diagnostic imaging methods, i.e., ultrasonography (US) and arthrography, in demonstrating the typical features of this condition. Over a 15 months' period, 190 patients suffering from shoulder pain were examined with arthrography; 50 of them subsequently underwent acromion plastic surgery and rotator cuff stitching. This study was aimed at comparing US and arthrographic results, applying classifiable criteria to make the most accurate diagnosis of rotator cuff tears. The lack of visibility of the rotator cuff at US was the major and clearest sign of tear (100% of cases). The association between cuff thinning and hypo/hyperechoic damaged focal areas was another major sign (in 76.19% of complete tears and in 14.28% of incomplete tears). Hyperechoic focal areas alone proved to be a false-positive finding in 5 cases, while in 11 of 19 cases normal US patterns were a false-negative finding; in 3 cases other conditions were diagnosed. To conclude, the value of US is emphasized in the screening of the painful shoulder and the use of arthrography is suggested when both clinical tests and US fail to yield enough information for a diagnosis to be made.

Aged↗

Comparison of case-deletion diagnostic methods for Cox regression.

Case-deletion diagnostics are a routine component of regression analysis since they identify unusual observations that substantially affect parameter estimates. The exact approach is to compute the change in each regression parameter by dropping that individual and refitting the model. Repeating a Cox regression for the removal of each individual is very time consuming and therefore not done in practice. The two methods commonly used to approximate the exact case-deletion change for Cox regression are the empirical influence function approach and the covariate-vector augmentation approach. This paper reports the results of a simulation study on how well these methods estimate the exact change in a parameter estimate when deleting a known outlier or a known non-outlier. Additionally, we investigate how well these methods correctly identify outliers and non-outliers. The covariate augmentation approach clearly outperformed the influence function approach in these simulations.

Adenocarcinoma↗

[Evaluation of diagnostic methods].

AIM: Describe the statistical tools for the evaluation of a diagnostic test. MATERIAL AND METHODS: Description of the methods and practical examples based on published data. RESULTS: The following methods are described: 1) reproducibility of a measurement, both for a qualitative and a quantitative result, 2) comparison of a new diagnostic test to a reference test, 3) comparison of two diagnostic tests, 4) sample size computation. CONCLUSION: The tools required to evaluate diagnostic tests rigorously are available and simple. They should be used more often.

Data Interpretation, Statistical↗

Systematic review: sphincter of Oddi dysfunction--non-invasive diagnostic methods and long-term outcome after endoscopic sphincterotomy.

BACKGROUND: Sphincter of Oddi dysfunction is a benign, functional gastrointestinal disorder for which invasive endoscopic therapy with potential complications is often recommended. AIMS: To review the available evidence regarding the diagnostic accuracy of non-invasive methods that have been used to establish the diagnosis and to estimate the long-term outcome after endoscopic sphincterotomy. METHODS: A systematic review of English language articles and abstracts containing relevant terms was performed. RESULTS: Non-invasive diagnostic methods are limited by their low sensitivity and specificity, especially in patients with Type III sphincter of Oddi dysfunction. Secretin-stimulated magnetic resonance cholangiopancreatography appears to be useful in excluding other potential causes of symptoms, and morphine-provocated hepatobiliary scintigraphy also warrants further study. Approximately 85%, 69% and 37%, of patients with biliary Types I, II and III sphincter of Oddi dysfunction, respectively, experience sustained benefit after endoscopic sphincterotomy. In pancreatic sphincter of Oddi dysfunction, approximately 75% of patients report symptomatic improvement after pancreatic sphincterotomy, but the studies have been non-controlled and heterogeneous. CONCLUSIONS: Patients with suspected sphincter of Oddi dysfunction, particularly those with biliary Type III, should be carefully evaluated before considering sphincter of Oddi manometry and endoscopic sphincterotomy. Further controlled trials are needed to justify the invasive management of patients with biliary Type III and pancreatic sphincter of Oddi dysfunction.

Common Bile Duct Diseases↗

[Development of diagnostic methods in upper gastrointestinal tract bleeding].

Since the first description of upper gastrointestinal bleeding, presented as ground coffee vomiting and melena by Galen Claudius in 200 A.D., we have been observing dynamic progress in the diagnostics of this disease. This article presents modern methods and diagnostic examinations used to detect and localise the bleeding source.

Angiography↗

Diagnostic methods for detection of Classical swine fever virus--status quo and new developments.

Classical swine fever (CSF) is a highly contagious disease causing major losses in pig populations almost worldwide. The disease occurs in many regions of Asia, Central and South America and parts of Europe and Africa. Some countries have eradicated the disease (Australia, USA, Canada, within the EU), yet it keeps recurring sporadically (South Africa, Germany, Netherlands, England). The causative virus is a member of the genus Pestivirus, family Flaviviridae. The first diagnosis of CSF is based on the recognition of clinical signs by the veterinarian in the field and by post mortem findings. Many signs are not exclusively associated with CSF and they may vary with the strain of virus, age and health status of the pigs. Since clinical signs may be confused with other pig diseases, laboratory diagnosis of CSF is indispensable. Both the Office International des Epizooties (OIE) and the European Union, have approved diagnostic manuals establishing sampling methods and diagnostic procedures for the confirmation of the disease. In this review, experiences with current tests will be analyzed and complemented with new developments, with emphasis on the polymerase chain reaction after reverse transcription of the RNA genome (RT-PCR).

Animals↗

The establishment of a venereal disease clinic: II. An appraisal of current diagnostic methods in uncomplicated urogenital and rectal gonorrhea.

Some of the diagnostic procedures for uncomplicated urogenital and rectal gonorrhea were studied in a university-based venereal disease clinic. On the basic of our results, recommendations are made concerning the types of media to be used, sites to be sampled, methods of obtaining specimens, and other diagnostic considerations. We conclude that ongoing quality control including a review of diagnostic procedures should be carried on in all venereal disease clinics.

Bacteriological Techniques↗

Diagnostic methods for insect sting allergy.

PURPOSE OF REVIEW: This review overviews advances from mid-2002 to the present in the validation and performance methods used in the diagnosis of Hymenoptera venom-induced immediate-type hypersensitivity. RECENT FINDINGS: The general diagnostic algorithm for insect sting allergy is initially discussed with an examination of the AAAAI's 2003 revised practice parameter guidelines. Changes as a result of a greater recognition of skin test negative systemic reactors include repeat analysis of all testing and acceptance of serology as a complementary diagnostic test to the skin test. Original data examining concordance of venom-specific IgE results produced by the second-generation Pharmacia CAP System with the Johns Hopkins University radioallergosorbent test are presented. Diagnostic performance of honeybee venom-specific IgE assays used in clinical laboratories in North America is discussed using data from the Diagnostic Allergy Proficiency Survey conducted by the College of American Pathologists. Validity of venom-specific IgE antibody in postmortem blood specimens is demonstrated. The utility of alternative in-vivo (provocation) and in-vitro (basophil-based) diagnostic testing methods is critiqued. SUMMARY: This overview supports the following conclusions. Improved practice parameter guidelines include serology and skin test as complementary in supporting a positive clinical history during the diagnostic process. Data are provided which support the analytical performance of commercially available venom-specific IgE antibody serology-based assays. Intentional sting challenge in-vivo provocation, in-vitro basophil flow cytometry (CD63, CD203c) based assays, and in-vitro basophil histamine and sulfidoleukotriene release assays have their utility in the study of difficult diagnostic cases, but their use will remain as supplementary, secondary diagnostic tests.

Animals↗

A prospective comparison of 3 diagnostic methods to evaluate ejaculatory duct obstruction.

PURPOSE: Various diagnostic tests are available to evaluate patients with ejaculatory duct obstruction (EDO). However, the most accurate diagnostic technique, defined as the one that best predicts a successful outcome after ejaculatory duct resection, is unclear. We prospectively performed transrectal ultrasound (TRUS) and 3 other tests in men with EDO and determined their relative value in this diagnosis. MATERIALS AND METHODS: Patients with suspected EDO on clinical evaluation that included TRUS proceeded to further intraoperative evaluation with duct chromotubation, seminal vesicle aspiration and seminal vesiculography. A comparative analysis of findings from each technique was performed and the success of subsequent transurethral resection procedures was assessed. RESULTS: All 25 patients had evidence of EDO on diagnostic TRUS, a finding that merited further evaluation with other modalities. However, TRUS findings correlated poorly with those of the other diagnostic tests. Obstruction on TRUS was confirmed in only 52%, 48% and 36% of vesiculography, seminal vesicle aspiration and duct chromotubation studies, respectively. A better correlation was observed between the dynamic tests of duct chromotubation and seminal vesiculography. Based on all diagnostic tests only 12 patients (48%) proceeded to duct resection, of whom 10 (83%) showed significant improvement in semen analysis parameters or clinical symptoms after the procedure. CONCLUSIONS: A comparative analysis of 4 diagnostic techniques suggests that TRUS alone has poor specificity for EDO evaluation. Incorporating dynamic tests into the algorithm of EDO diagnosis may decrease unnecessary duct resection procedures and improve the success of the resection procedures that are indicated.

Adolescent↗

Development of a foot-and-mouth disease NSP ELISA and its comparison with differential diagnostic methods.

The gene encoding the nonstructural protein (NSP) of O/SKR/2000 foot-and-mouth disease virus (FMDV) was constructed to express under the polyhedron promoter of baculovirus. The expression of NSP was confirmed by indirect immunofluorescence assay (IFA) and Western blotting. The expressed NSP was applied as a diagnostic antigen for indirect-trapping ELISA (I-ELISA). An I-ELISA using monoclonal antibody (Mab) against 3A as trapping antibody was developed to differentiate infected from vaccinated cattle. The diagnostic efficiency of Mab linked I-ELISA was compared and evaluated with baculovirus expressed 3ABC I-ELISA from USDA and Mab (3A) linked E. coli expressed 3ABC I-ELISA from IZSLE through retrospective sero-surveillance. Compared with the two different I-ELISA methods, Mab (3A) linked I-ELISA using baculovirus expressed NSP showed the same level of sensitivity and specificity, indicating that this method is suitable for a differential diagnostic method in cattle.

Animals↗

Cavernous sinus meningioma presenting as orbital apex syndrome. Diagnostic methods of dynamic MRI, spoiled GRASS (SPGR) image.

Orbital apex syndrome is a symptomatologic complex. In this paper, the usefulness of several clinical diagnostic MR methods in preparing for surgery is discussed. These include dynamic MRI and the spoiled GRASS (SPGR) image for a cavernous sinus meningioma presenting with orbital apex syndrome. A 53 year old man, who had right cavernous sinus tumor presenting with orbital apex syndrome, was examined by several new MRI techniques. The tumor was partially removed and fibroblastic meningioma was confirmed pathologically.

Humans↗