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PubMedDate not supplied

[Outpatient evaluation of venous diseases. Role of instrumental diagnostic methods].

Venous investigations have increasingly gained a large part in daily phlebological activity; with the currently available diagnostic tools it's now possible to achieve a "hemodynamic" evaluation in every single patient. This in mandatory for outpatients varicose veins surgery, where sites of reflux must be exactly mapped to avoid unnecessary dissections. The authors present a personal diagnostic protocol (algorithm), they carefully prepared to assess a large number of patients avoiding useless and time-consuming examinations. Results of 100 consecutive examinations are reported; only 15 highly-selected patients required the use imaging techniques studies (echoDoppler, venography). The authors believe that a standardized diagnostic protocol can effectively reduce the number of expensive examinations required and the patients waiting time.

Adolescent↗
PubMed1991

Diagnostic methods for caries: what is appropriate when?

A Workshop was held which invited a range of speakers to consider separately the different diagnostic tools presently available for the detection of caries and then the various applications to which these tools can be put. Each presentation was followed by a vigorous discussion period. It was concluded that there is no one single method suitable for all anatomical sites and degrees of caries and that the requirements for epidemiological surveys, clinical trials and individual patient care are different. The choice of appropriate diagnostic technique(s) should be made, in each situation, on the basis of published performance data which has to be regularly re-evaluated due to the pace of change.

DMF Index↗
PubMed2005

Contrast ultrasound perfusion imaging of lower extremities in peripheral arterial disease: a novel diagnostic method.

AIMS: The purpose of this study was to establish contrast-enhanced ultrasound perfusion imaging (CUPI) of the lower extremities as a novel non-invasive diagnostic tool for patients with peripheral arterial disease (PAD). METHODS AND RESULTS: Ultrasound contrast agent (SonoVue) was injected into a peripheral vein of 16 control subjects and 16 PAD patients and its appearance in the calf muscle was detected by low-energy harmonic ultrasound. Analysis of the wash-in curves revealed that PAD patients had a significantly longer time to peak intensity (TTP), i.e. duration of maximum contrast perfusion [37 s (19-79 s) in control subjects vs. 56 s (32-104 s) in PAD patients at rest, age-adjusted P=0.002]. Exercise stress test of the calf muscle resulted in a decrease of the TTP, maintaining the significant difference in TTP between the groups [19 s (8-37 s) in control subjects vs. 32 s (18-48 s) in PAD patients after exercise, age-adjusted P=0.004]. Neither ankle-brachial index and TTP nor age and TTP showed a significant correlation. CONCLUSION: CUPI reflects the regional blood circulation of the calf muscle. In this pilot study, PAD patients show a significantly longer TTP than control subjects. The clinical relevance of CUPI is topic of ongoing studies.

Adult↗
PubMed2006

Comparison of different diagnostic methods in infants with Cholestasis.

AIM: To evaluate different methods in differentiating idiopathic neonatal hepatitis from biliary atresia. METHODS: Sixty-five infants with cholestatic jaundice and final diagnosis of idiopathic neonatal hepatitis and biliary atresia were studied prospectively from September 2003 to March 2006. A thorough history and physical examination were undertaken and the liver enzymes were examined. All cases underwent abdominal ultrasonography, hepatobiliary scintigraphy, and percutaneous liver biopsy. The accuracy, sensitivity, specificity and predictive values of these various methods were compared. RESULTS: There were 34 girls and 31 boys, among them 46 subjects had idiopathic neonatal hepatitis (age, 61 +/- 17 d) and 19 had biliary atresia (age, 64 +/- 18 d). The mean age at onset of jaundice was significantly lower in cases of biliary atresia when compared to idiopathic neonatal hepatitis cases (9 +/- 13 d vs 20 +/- 21 d; P = 0.032). The diagnostic accuracy of different methods was as follows: liver biopsy, 96.9%; clinical evaluation, 70.8%; ultrasonography, 69.2%; hepatobiliary scintigraphy, 58.5%; and liver enzymes, 50.8%. CONCLUSION: Our results indicate that clinical evaluation by an experienced pediatric hepatologist and a biopsy of the liver are considered as the most reliable methods to differentiate idiopathic neonatal hepatitis and biliary atresia.

Alanine Transaminase↗
PubMed1992

[Integration of diagnostic methods in renal vascular pathology].

Modern technology allows us to study the renal vascular diseases by means of many diagnostic procedures. In the past the main diagnostic technique was Urography, whereas Angiography were performed only in few selected cases. The new Imaging Techniques totally changed the diagnostic approach to this kind of diseases. Today in fact Echo-Color-Doppler and Nuclear Medicine are the early diagnostic techniques to be performed. Actually only few selected patients undergo Angiography, not the conventional one but the Digital; this new technique, in fact, in case of renovascular Hypertension is not only of diagnostic value but is often the definitive therapy.

Angiography↗
PubMed2002

[Diagnostic methods and treatment of community-acquired pneumonia in Spain: NACE study].

BACKGROUND: Community-acquired pneumonia (CAP) is one of the most frequent infectious disease conditions. With the aim of knowing the diagnostic and therapeutic strategies of CAP in Spanish hospitals we performed a prospective, observational and multicenter study. PATIENTS AND METHOD: Observational study of 468 patients with CAP consecutively evaluated in 21 Spanish hospitals. Clinical, diagnostic, therapeutic and evolutive variables were recorded. RESULTS: We included 468 patients with a mean age of 63 (18) years; 75% of them had some comorbidity. 380 (81%) patients required hospitalization in a conventional ward while 19 (4%) were admitted in an Intensive Care Unit (ICU). 69 patients (15%) required ICU admission. During the first 24 h of admission, biochemical determinations were performed in 98% of cases, blood gas measurements in 88%, blood cultures in 265 (58%), sputum cultures in 149 (41%) and an invasive diagnostic technique was carried out in 17 cases. In 62 cases (14%), a microbiological diagnosis was achieved. Streptococcus pneumoniae (28 cases) was the most frequent isolate followed by Legionella pneumophila (6 cases). Clarithromycin was the most frequent antibiotic prescribed (38%), either as monotherapy (28) or in combination (148), followed by amoxicillin-clavulanate (124 cases). Nine percent of patients were considered non-responders to initial empirical antibiotic tretament. Overall mortality was 6% (25%) and it was significanty higher in non-responders. CONCLUSIONS: In most patients with CAP admitted in Spanish hospitals, a systematic diagnostic approach is lacking. There is an important variability in the administration of antimicrobials, the association of a betalactam plus clarithromycin being the most frequent strategy. Overall mortality is low and significantly higher in those patients with a lack of response to initial antibiotic treatment.

Adolescent↗
PubMed1997

Modern Diagnostic Methods in Ewing's Sarcoma Family: Six Patients With Histologic Soft Tissue Tumors.

Background: Soft tissue tumors often present a major diagnostic challenge for the pathologist. The correct diagnosis has important prognostic and therapeutic consequences. In recent years significant progress has been made in identifying characteristic chromosomal abnormalities associated with certain solid tumors. More than 85% of tumors in the Ewing's sarcoma (ES) family contain a specific t(11;22) (q24;q12) translocation. Methods and Results: We present six patients with a soft tissue tumor of which only four were diagnosed primarily as belonging to the ES family. All cases were further examined by the following methods: immunohistochemistry with MIC2, cytogenetics, nested reverse transcription-polymerase chain reaction of the t(11;22), using fresh-frozen or formalin-fixed, paraffin-embedded archival material. Conclusions: This method clearly allowed the diagnosis of a tumor of the ES family in all six cases.

Journal Article↗
PubMed1991

[A comparison of 2 diagnostic methods in women with long-term sterility].

The study was carried out on 40 women, admitted to the clinic for diagnostic laparoscopy. The mean age of the patients was 28.57 years. Duration of sterility was 5.7 years as 27 women suffered from primary sterility and 13 women-with secondary. Ultrasound diagnosis was made on all women before laparoscopy. The exactness of ultrasound diagnosis (USD) was 80.51% of women. Preovulatory follicles and polycystic disease of the ovaries was established by USD in 100% of women. High sensitivity of the method was achieved in women with leiomyomas and ovarian cysts. Discrepancy in the diagnosis was found in the following cases: a myoma was hyper-diagnosis, a hydrosalpinx was diagnosed as a cyst; a tubo-ovarian formation was found to be hydrosalpinx and vice versa; two hydrosalpinx women with diagnosed hydrosalpinx had tubo-ovarian formations. A hydrosalpinx was not diagnosed. USD was found to be almost non-valid in comparison of the two methods for diagnosis of endometriosis.

Adult↗
PubMedDate not supplied

Ultrasound-guided aspiration biopsy for detection of nonpalpable axillary node metastases in breast cancer patients: new diagnostic method.

This study was designed to evaluate the accuracy of ultrasonography alone and in combination with fine-needle aspiration biopsy (FNAB) for detection of axillary metastases of nonpalpable lymph nodes in breast cancer patients. Ultrasonography was carried out in 150 axillas of 148 patients (mean age 57 years, range 30-80 years); and in 93 axillas lymph nodes were detected. Nodes were described according to their dimension and echo patterns and were compared with histopathologic results. FNAB was carried out in 81 axillas (122 nodes). The sensitivity of ultrasonography was highest (87%) when size (length >5 mm) was used as criterion for malignancy, but the specificity was rather low (56%). When nodes with a malignant pattern (echo-poor or inhomogeneous) were visualized, specificity was 95%. Ultrasound-guided FNAB had a sensitivity of 80% and a specificity of 100% and detected metastases in 63% of node-positive patients. It is concluded that FNAB is an easy, reliable, inexpensive method for identifying patients with positive nodes. In the case of negative findings, other diagnostic procedures to exclude lymph node metastases, such as sentinel node mapping, could be performed.

Axilla↗
PubMedDate not supplied

Indigenous rapid diagnostic method for Escherichia coli O157:H7.

Rapid methods for detection of Escherichia coli O157: H7 diarrhoea are preferred to limit differential diagnostic evaluation including invasive procedures. Fifty stool samples from children and adult patients having diarrhoea and ten control samples from volunteers without diarrhoea were collected. Each sample was inoculated into two tubes containing peptone water and one containing MacConkey broth. They were incubated for 5 hours or longer till growth occurred. The first tube of peptone water with growth was tested for production of indole. All samples were tested for enzyme beta-glucuronidase in the pellet of the second peptone water growth. The MacConkey broth growth was tested with latex beads sensitized separately with antisera to E. coli O157 and E. coli H7. All indole positive and beta glucuronidase negative samples with positive agglutination with E. coli O157 and H7 coated latex beads were taken as E. coli O157: H7 positive samples. Three out of 50 diarrhoeic samples were found to be positive for E. coli O157:H7. Confirmation of the results of our rapid assay was done by parallel conventional culture of faecal specimens on sorbitol MacConkey agar. Our rapid assay required only 7-10 hours compared to the conventional technique where the report is available only on the third day. It can therefore be used routinely for initial screening of faecal specimens for E. coli O157: H7.

Adult↗