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At least 433 records · Page 24Linked to original sources

PubMed1999

Mental stress test is an effective inducer of vasospastic angina pectoris: comparison with cold pressor, hyperventilation and master two-step exercise test.

BACKGROUND: Cold pressor, hyperventilation and exercise stress tests were usually used for inducing an angina attack in patients with vasospastic angina pectoris. We induced vasospastic angina attack using the mental calculation stress test, and compared the results with those using other stress tests. SUBJECTS AND METHODS: Subjects were 29 patients with vasospastic angina pectoris. Their ages were 60.8+/-8.4 years. Coronary vasospasm was induced by an acetylcholine infusion test during coronary angiography. The mental stress test was performed as follows; after memorizing six digits numbers, they repeated these numbers in reverse for 5 min, and performed serial subtraction of 17 from 1000 for 5 min. Blood pressure, heart rate and ECG were recorded every 1-5 min during the mental stress test. The serum concentrations of epinephrine and norepinephrine were measured before and during the mental stress test. We compared these results with those obtained using cold pressor, hyperventilation and the Master two-step exercise stress test. RESULTS: (1) Eight of the 29 patients (28%) showed ischemic ST-T change, which was caused by the mental stress test. (2) The increase in norepinephrine was greater in patients with an ST-T change than without an ST-T change (0.11+/-0.06 vs. 0.04+/-0.04 ng/ml, P<0.01). (3) The incidence of the ST-T change caused by the mental stress test (28%) was similar to the cold pressor test (27%) and greater than that caused by the hyperventilation test (13%). The incidence of ST-T change caused by the Master two-step test was 55%. CONCLUSIONS: The mental stress test is an effective inducer of vasospastic angina attack, and attack may be induced by neurohumoral vasoconstrictive reflex and/or increased left ventricular afterload.

Acetylcholine↗

PubMed1986

Comparison of the brucellin skin test with the lymphocyte transformation test in bovine brucellosis.

The brucellin skin test and the lymphocyte transformation test were compared in heifers infected with virulent Brucella abortus strain 544, heifers vaccinated against brucellosis and unexposed cattle. Results of the in vitro lymphocyte transformation test were consistently positive for all 9 Brucella-infected heifers while the skin test was consistently positive for 6 of the 9 heifers. In 7 heifers repeatedly vaccinated with B. abortus strain-19 vaccine the in vitro test classified 3 animals as positive whereas the skin test identified all the animals as infected during most of the experimental period. Four heifers injected with a single dose of B. abortus strain 19 were consistently negative to the lymphocyte transformation test while the skin test classified all the animals as infected during most of the experimental period. The skin test gave strong reactions indicative of Brucella infection in heifers vaccinated with 'Duphavac' and 'Abortox' vaccines whereas the lymphocyte transformation test was consistently negative with these vaccines. The two tests were negative in unexposed cattle. It was concluded that the in vitro test correlated better with Brucella isolation than the in vivo test did and that the lack of agreement between the results of the two tests is likely to be due to the different antigens used in the assays.

Animals↗

PubMed2001

Twenty-minute 50 mg 13C-urea breath test without test meal for the diagnosis of Helicobacter pylori infection in Chinese.

BACKGROUND: We have previously shown that the 75 mg 13C-urea breath test without citrate test meal is highly accurate for the diagnosis of Helicobacter pylori infection in Chinese subjects. A lower dose 50 mg 13C-urea breath test protocol with a sampling time at 20 min has not been validated previously. AIM: To investigate the accuracy of a 20-min 50 mg 13C-urea breath test protocol in Chinese subjects. METHODS: Consecutive dyspeptic patients referred for upper endoscopy were recruited. 13C-urea breath test was performed using (a) 75 mg and 50 mg of 13C-urea on two separate days without a test meal, and (b) 50 mg of 13C-urea with 2.4 g citrate as test meal, and compared with the gold standard [rapid urease test (CLO test) and histology]. Baseline, 20-min and 30-min breath samples were collected in all cases. RESULTS: Two hundred and six patients were tested. The accuracy of the 50 mg 13C-urea breath test (no citrate) at 20 min and 30 min was 98%, comparable to that of the 50 mg 13C-urea breath test with citrate (99.1%) and the 75 mg 13C-urea breath test without citrate (100%). CONCLUSIONS: A 20-min 50 mg 13C-urea breath test without citrate produced highly accurate results for the diagnosis of Helicobacter pylori infection and is more economical and convenient for the Chinese population.

Adult↗

PubMed2001

Biceps load test II: A clinical test for SLAP lesions of the shoulder.

PURPOSE: The purpose of this report is to describe the biceps load test II for evaluating the superior labral anterior and posterior (SLAP) lesions. TYPE OF STUDY: This is a double-blind study in consecutive data, which includes diagnostic accuracy of a test using sensitivity, specificity, and interexaminer reliability. METHODS: In the supine position, the arm is elevated to 120 degrees and externally rotated to its maximal point, with the elbow in the 90 degrees flexion and the forearm in the supinated position. The patient is asked to flex the elbow while resisting the elbow flexion by the examiner. The test is considered positive if the patient complains of pain during the resisted elbow flexion. The test is negative if pain is not elicited or if the pre-existing pain during the elevation and external rotation of the arm is unchanged or diminished by the resisted elbow flexion. A prospective study was performed in 127 patients to evaluate the diagnostic accuracy for the biceps load test II. Two independent examiners were assigned to perform the new diagnostic test. The results of the tests were confirmed during the arthroscopic examination. RESULTS: A positive test result in 38 subjects correlated with a SLAP lesion in 35 patients and an intact biceps-superior labrum in 3 patients. A negative test result in 89 patients correlated with an intact superior labrum complex in 85 patients, whereas 4 patients with a negative test result had a type II SLAP lesion. The biceps load test II had a sensitivity of 89.7%, a specificity of 96.9%, a positive-predictive value of 92.1%, a negative-predictive value of 95.5%, and a kappa coefficient of 0.815. The abduction and external rotation of the shoulder during the test changes the relative direction of the biceps fiber in a position of oblique angle to the posterosuperior labrum. The resisted contraction of the biceps increases the pain generated on the superior labrum that is already peeled off the glenoid margin in the abducted and externally rotated position. CONCLUSIONS: The biceps load test II is an effective diagnostic test for SLAP lesions.

Acromioclavicular Joint↗

PubMed2006

Uptake of BRCA1 rearrangement panel testing: in individuals previously tested for BRCA1/2 mutations.

PURPOSE: Individuals undergoing genetic testing for BRCA1/2 mutations are routinely counseled about the sensitivity and specificity of testing. In August 2002, testing for 5 large genomic rearrangements in the BRCA1 gene that would not have been detected with full gene sequence analysis became commercially available. We present our data on uptake of the BRCA1 rearrangement panel testing in our clinical cancer genetics program. METHODS: Women who participated in our clinical genetic testing program and had previously received an uninformative negative or variant of uncertain significance result from BRCA1/2 full gene sequencing were invited to consider BRCA1 rearrangement panel testing. RESULTS: Overall, 18/72 individuals underwent BRCA1 rearrangement panel testing. No significant differences were found in the levels of BRCAPRO scores (P = 0.406), age at testing (P = 0.986), number of children (P = 0.35) or number of siblings (P = 0.4) between individuals who chose to pursue additional testing with the rearrangement panel and those who declined. Fisher's Exact Test analysis showed that there is a negative association between having breast or ovarian cancer and being inclined to undergo rearrangement panel testing (P = 0.013). CONCLUSION: Individuals who undergo genetic testing will not consistently pursue additional or enhanced genetic testing. Future research is needed to clearly elucidate the factors associated with uptake of additional genetic testing.

Adult↗

PubMed1996

Cardiovascular and respiratory adjustments in normal volunteers during modified exercise tests in comparison to standard exercise tests.

Sixteen normal, non-smoking first year medical students underwent four standard exercise tests, while cardiovascular (heart rate and blood pressure) and pulmonary (respiratory rate, tidal volume and oxygen consumption) adjustments were being monitored. Maximal exercise level for all tests were defined following the Jones scale. No variation was noted in respiratory rate among the four exercise tests. The cycle ergometry (CE), hand ergometry (HE), and treadmill (TM) exercise tests produced progressive increases of the various parameters as expected, although target maximal heart rates were not reached in most cases secondary to muscle fatigue. The step test (ST) approximated the physiological parameter changes noted in these three tests during the early stages of exercise, but levelled off after 3 minutes, probably due to lack of incremental load. The ST took the longest time to reach maximal level of exercise parameters, and recorded the lowest tidal volume increase. The same subjects underwent a modified step test (MST1) by adding 1 kg sandbags every 3 min to backpacks worn by the subjects, to provide incremental load. This modification provided a slight increase in the parameters measured, but still plateaued after 3 min. Another set of 18 normal, non-smoking medical students underwent bicycle ergometry and two other modified exercise tests. The modified step test two (MST2) was similar to our initial MST1, except that the sandbags added every 3 min were not fixed at 1 kg but were also incremental (1, 2, 3 and 4 kg). The other test (Ramp test or RT) required the subjects to walk up and down a ramp, which entailed not only the addition of incremental weights of sandbags every 3 min, but also increasing the elevation of the ramp at each stage. Data analysis showed that these two tests showed almost similar changes in cardiovascular and respiratory adjustments in the subjects, compared to the standard bicycle ergometry. These pilot studies showed that low-cost modified step tests may be utilized to approximate the expensive standard treadmill and bicycle exercise tests. More studies on larger populations have to be done to validate these results.

Adaptation, Physiological↗

PubMed2002

Helicobacter pylori antigen stool test and 13C-urea breath test in patients after eradication treatments.

OBJECTIVES: Current guidelines recommend either the urea breath test (UBT) or the Helicobacter pylori antigen stool test (HpSA) for monitoring H. pylori infection. The aim of this study was to evaluate the agreement between the two tests in patients after treatment. METHODS: After eradication treatments, patients were tested with both UBT and HpSA. Cut-off values (delta value over baseline at 30') for UBT were positive (> or = 5 per thousand), indeterminate (3.01-4.99 per thousand), and negative (< or = 3 per thousand). Cut-off values (absorbance at 450 nm) for HpSA test were positive (> or = 0.160), indeterminate (0.159-0.140), and negative (< 0.140). Patients with either discordant or indeterminate tests underwent repeat endoscopy with multiple gastric biopsies for rapid urease test (RUT), culture, histology, and immunohistochemistry to detect H. pylori and to assess the ratio between coccoid and bacillary forms. RESULTS: A total of 458 patients were studied. Of these, 422 (92.2%) had concordant tests, three (0.6%) indeterminate tests (one on UBT and two on HpSA), and 33 (7.2%) discordant tests. A total of 28 patients (25 with discordant and three with indeterminate tests) underwent endoscopy. The HpSA was inaccurate in 24 cases (18 false negative, four false positive, and two indeterminate results), whereas the UBT was inaccurate in four cases (two false positive, one false negative, and one indeterminate results). Biopsy-based tests showed no bacillary or coccoid forms in all five endoscoped patients who were negative on UBT and positive on HpSA, but in one in whom the ratio between coccoid and bacillary forms was 3:1 in the antrum and corpus. CONCLUSIONS: UBT and HpSA test give discordant or indeterminate results in nearly 8% of patients after treatment. The HpSA test is less accurate than the UBT. Coccoid forms do not cause false positive HpSA results.

Adolescent↗

PubMed2004

Effect of proton pump inhibitors and antacid therapy on 13C urea breath tests and stool test for Helicobacter pylori infection.

OBJECTIVE: There is uncertainty about the best method of testing patients for Helicobacter pylori (H. pylori) infection while they are taking proton pump inhibitors. The aim of this study was to determine: (i) if the decreased sensitivity of the urea breath test during proton pump inhibitor is corrected by different techniques for breath testing and (ii) if the sensitivity of stool test is decreased with the administration of proton pump inhibitors. METHODS: Prospective randomized single-blind study was performed in a tertiary care university hospital. Out of 72 H. pylori infected patients endoscoped for upper abdominal symptoms 48 were randomized to proton pump inhibitors (omeprazole 20 mg each day or esomeprazole 40 mg each day) and 24 to antacid (aluminum hydroxide 800 mg each day) for 14 days. Several breath tests (standard 75 mg (13)C-UBT with citric acid, with orange juice, a tablet breath test with 100 and 50 mg of (13)C), and a stool test were carried out. Baseline samples were collected before and after treatment. RESULTS: The baseline sensitivity for all breath tests was 100% in both groups; for stool test it was 97.8% (95% CI: 88.7-96.6) and 90% (95% CI: 69.9-97.2) in the proton pump inhibitor and antacid group, respectively. After treatment, the sensitivity of tests was significantly low (UBTs range: 77.1%-85.4%; stool test: 83%; 95% CI: 63.9-91.1), while it was unchanged in the antacid group. CONCLUSIONS: False negative breath and stool tests are equally common in patients taking proton pump inhibitors. Antacids do not impair the sensitivity of the breath tests or the stool test.

Administration, Oral↗

PubMed2006

Visual field testing with the new Humphrey Matrix: a comparison between the FDT N-30 and Matrix N-30-F tests.

PURPOSE: To determine if the N-30-F test with the new Humphrey Matrix instrument is comparable to the traditional frequency-doubling technology (FDT) N-30 test. METHODS: A sample of 47 eyes from 47 patients (five normal subjects, 27 with ocular hypertension and 15 with glaucoma) underwent visual field (VF) testing with standard automated perimetry, and with FDT, using the FDT N-30 program, and the Matrix N-30-F program (using the same 19 tested points, full-threshold strategy, but with an enhanced algorithm to reduce testing time). The plots, mean deviation (MD), pattern standard deviation (PSD), defect locations and test time were compared. RESULTS: The agreement between the two tests was shown to be good, except for subjects with large VF defects, in which greater PSD values were observed with the FDT test, whereas the Matrix test gave a higher MD and number of abnormal test locations in the total deviation plot. A lack of agreement was also found for the number of abnormal test locations on the pattern deviation plot at any VF loss severity level. The test time for the Matrix test was significantly shorter. CONCLUSION: The FDT N-30 and Matrix N-30-F tests proved to be comparable in cases of early to moderate VF defects.

Adult↗

PubMed1999

Activity of gatifloxacin against Haemophilus influenzae and Moraxella catarrhalis, including susceptibility test development, E-test comparisons, and quality control guidelines for H. influenzae.

In vitro antimicrobial activity and susceptibility testing interpretation criteria and quality control were studied for gatifloxacin, a new 8-methoxy fluoroquinolone, tested against Haemophilus influenzae. Moraxella catarrhalis (600 strains) and H. influenzae (1,400 strains) from the SENTRY Antimicrobial Surveillance Program in North America (Canada and the United States) were also tested against gatifloxacin and 12 other antimicrobial agents. Gatifloxacin (MIC at which 90% of the isolates are inhibited [MIC90], </=0.03 microg/ml; 100.0% of strains inhibited at </=2 microg/ml) was the most active agent tested against H. influenzae and was similar to four comparison fluoroquinolones (MICs, </=0.03 to 2 microg/ml) against M. catarrhalis. A subset of 300 recent clinical isolates of H. influenzae were tested by using media (Haemophilus Test Medium agar and broth) and procedures recommended by the National Committee for Clinical Laboratory Standards (NCCLS) and with the E-test (AB BIODISK, Solna, Sweden). Gatifloxacin (MIC50, 0.008 microg/ml) was slightly more active than levofloxacin, and E-test results were generally elevated by 0.5 log2 dilution step compared to reference MICs. The gatifloxacin 5-microg disk test produced zone diameters that were routinely above 30 mm for H. influenzae strains, corresponding to gatifloxacin MICs of 0.008 or 0. 016 microg/ml. The gatifloxacin susceptibility breakpoint proposed for nonfastidious species (</=2 microg/ml; >/=18 mm) was also suggested for H. influenzae testing. No interpretive errors were observed. Quality control guidelines for H. influenzae ATCC 49247 were determined by using the NCCLS M23-T3 (1998) study design. The results from the nine-laboratory protocol suggested the following control ranges: for broth microdilution tests, 0.004 to 0.03 microg/ml; for disk diffusion testing, 33 to 41 mm. Gatifloxacin appears to be a potent anti-Haemophilus fluoroquinolone compound with in vitro testing interpretive criteria that will produce accurate results (disk diffusion, broth microdilution, and E-test).

Anti-Bacterial Agents↗

PubMed2005

A new method of oral drug provocation testing for determining safe alternatives for patients with non-steroidal anti-inflammatory drug intolerance: the triple test.

BACKGROUND: Although some of the non-steroidal anti-inflammatory drugs (NSAIDs) are reported to be safe for NSAID-intolerant patients, they should not be suggested before confirming the safety by single-blind oral drug provocation tests. Various test protocols are used in different allergy centers. The aim of this survey was to find out if testing three drugs a day could be a safe, time-saving and cost-effective method. METHODS: We have enrolled 84 patients into this survey between September 1, 2002, and July 31, 2004. RESULTS: Their mean age was 37.3+/-11.0 years; 63 (75%) patients were female. By reliable history, the NSAID most commonly causing intolerance was aspirin (46.4%), and the most common reaction to analgesic intolerance was angioedema (60.7%). Eighty-seven tests were performed with meloxicam, rofecoxib, celecoxib, benzydamine, azapropazone, codeine and paracetamol in various triple combinations. Seventeen of the triple tests were positive, and one of them was suspiciously positive. After repeating these 18 tests with the same analgesics in the same order on 54 separate days, we have determined the responsible analgesics for 14 of the triple tests. There were no reactions when four of the triple tests were repeated on separate days (two of the triple tests demonstrated urticaria and the other two angioedema). Five patients had nausea and vomiting, and 2 had abdominal pain and other dyspeptic complaints during the tests. If we had performed the tests by the classical method, 264 days would have elapsed instead of 148 days (including the extra tests that we have performed after positive triple tests and gastrointestinal symptoms). CONCLUSION: The triple oral drug provocation testing seems to be a safe, time-/manpower-saving and cost-effective method for determining safe alternatives for NSAID-intolerant patients.

Adult↗

PubMed1999

Contribution of head-up tilt testing and ATP testing in assessing the mechanisms of vasovagal syndrome: preliminary results and potential therapeutic implications.

BACKGROUND: In patients with vasovagal syndrome, head-up tilt testing may reproduce symptoms generally associated with vasodepression. Recent research suggests ATP testing identifies patients with abnormal vagal cardiac inhibition. This preliminary study examined the joint contribution of both tests in identifying underlying mechanisms in the general population with vasovagal syndrome. METHODS AND RESULTS: Both tests were performed in random order during 1 session and outside of predominant sympathetic periods in 72 patients hospitalized for syncope (n=56) or presyncope (n=16) for whom no cardiac or extracardiac cause was found. For passive and isoproterenol-provocative tilt testing by standard protocol, reproduction of symptoms defined a positive test. The ATP test consisted of injecting ATP 20 mg IV at bedside, continuously monitoring ECG and blood pressure; a vagal cardiac pause >10 seconds defined a positive test. For most patients (64%), >/=1 test was positive. Of the 41 patients (57%) with a positive tilt test (either passive or provoked by isoproterenol), 32% had cardiac disease; none had significant bradycardia (<50 bpm). Of the 8 patients (11%) with a positive ATP test, 62% had cardiac disease; the probability of a positive result increased with age (P=0.015). Both tests were positive in 3 patients and negative in 26 patients; the tilt and ATP test results were uncorrelated (P=0.28). CONCLUSIONS: Results suggest tilt and ATP tests individually and jointly determine the mechanism of vasovagal symptoms in most patients and that vagal cardiac inhibition increases with age.

Adenosine Triphosphate↗

PubMed1994

Comparison of results of immunotherapy based on skin end-point titration, prick testing, and scratch testing.

Presented is a clinical study comparing the result of immunotherapy based on allergy testing with three different test modalities: skin end-point titration, prick testing, and scratch testing. Thirty patients with allergic rhinitis were randomly assigned to one of the three test groups. Treatment vials were made on test results according to the instructions for each test. For skin end-point titration, each antigen was included at a concentration based on the patient's sensitivity, found with the fivefold dilution testing procedure. For the prick test, treatment vials were based on a two-level test response scale of stronger or lesser positive results. The scratch test yields vials used in one concentration based simply on a positive vs. negative test result. Patients in all three groups were treated at weekly intervals with immunotherapy, progressing in volume until the maximum tolerated dose was achieved. Relief of symptoms was evaluated after 6 months of treatment. Nine of the 10 patients receiving skin end-point titration based immunotherapy had complete relief of symptoms, and one had partial relief. None of the patients in the prick or scratch test groups achieved relief of symptoms after 6 months of treatment. Results dramatically demonstrate the need to base allergy immunotherapy treatment on a test that quantifies the patient's level of sensitivity to each antigen.

Desensitization, Immunologic↗

PubMed2004

A field test and comparison of acute and chronic sediment toxicity tests with the estuarine amphipod Leptocheirus plumulosus in Chesapeake Bay, USA.

A 28-d partial life-cycle test with the estuarine amphipod Leptocheirus plumulosus was developed in response to the need for an assay to mimic chronic exposure to sediment-associated contaminants. To ensure that toxicity tests have environmental relevance, it is essential to evaluate the relationship between laboratory responses and field measures of contamination. Consequently, one objective of the study was to compare the results of the chronic sediment toxicity test with L. plumulosus to gradients of sediment contamination and the in situ benthic community in its native Chesapeake Bay. Chronic tests were conducted by two laboratories, the Army Corps of Engineers Waterways Experiment Station ([WES]; Vicksburg, MS, USA) and the University of Maryland ([UM] College Park, MD, USA) using different feeding regimes, providing the opportunity to evaluate the effect of this variable on response sensitivity. A second objective was to compare the relative sensitivity of acute and chronic tests with L. plumulosus with field-collected sediments. Overall, there was good agreement between the toxicological response of acute and chronic tests with L. plumulosus and field measures of contamination. Survival in the acute test and chronic test conducted by WES was negatively correlated with concentrations of sediment-associated contaminants. Survival in acute exposures was significantly reduced in sediments from 8 of 11 stations. Indigenous L. plumulosus were found only at two of the three stations that did not exhibit acute toxicity. An unexpected finding was the difference in responsiveness of the two chronic tests. Survival in tests conducted by UM and WES was significantly reduced in sediments from 4 and 6 of 11 stations, respectively. No additional sublethal toxicity was detected in the UM chronic test, but the WES test detected reproductive effects at two additional stations. We believe the observed differences were related to the test diet used. Partly as a result of our findings, the recommended diet for the L. plumulosus chronic test was changed in the final methods document.

Acute Disease↗

PubMedDate not supplied

[The use of skin testing in the investigation of toxidermia: from pathophysiology to the results of skin testing].

Drug skin tests can be of value in investigating cutaneous adverse drug reactions (CADR). Guidelines have been recently published for drug skin tests to standardize the management of patients suffering from CADR in European dermatological departments. Three sorts of drug skin tests can be performed, each investigating specific immunological mechanisms: delayed cellular hypersensitivity with patch tests (PT), immediate hypersensitivity with prick tests and both immediate or delayed hypersensitivity with intradermal tests (IDT). The mechanisms involved in inducing CADR are not well elucidated. The results of the drug skin tests depend on the drug and the mechanisms i.e. the clinical features of the CADR. 164 patients developed a CADR that could be attributed to one drug. After a patch test and a negative prick and intradermal test, positive drug skin tests were nevertheless obtained in 72% of the cases. Some urticarias are due to an immediate IgE related hypersensitivity; in such cases prick tests and IDT performed with sequential dilutions can have immediate positive results. Vasculitis is related to circulating immune complexes and cannot be reproduced by skin tests. Delayed cellular hypersensitivity is involved in inducing maculopapular rashes, Baboon syndrome, localized or generalized eczema or acute generalized exanthematous pustulosis. In such CADR, drug PT or delayed positive reactions on IDT occur in more than 50% of the patients. Diluted drug patch tests can be positive in investigating drug rash with eosinophilia and systemic symptoms. As Stevens-Johnson and Lyell's syndromes are due to many both toxic and immunological mechanisms, drug skin tests are not of great value in investigating these severe CADR.

Drug Eruptions↗

PubMed1985

[Long-term (10 years) predictive value of the exercise test after myocardial infarct and significance of the longitudinal repetition of the test during follow-up].

Our follow-up after myocardial infarction consists of 321 patients followed for 10 years or until death. 147 patients, free of clinical features associated with high risk of subsequent events, underwent a late exercise test at cycloergometer 6 to 17 months after infarction. Ten year mortality was 48.3% and 10.3% in patients with a positive or a negative test respectively (p less than 0.0001). Incidence of nonfatal reinfarction was 4.6% and 33.3% respectively (p less than 0.001). 108 patients underwent a second test later in the follow-up (2.8 +/- .9 years): in 27 patients who were positive at first test the second test was also positive and mortality was 33.3%. Sixteen out of 81 patients with a former negative test resulted positive at a repeat test and mortality was 37.5% vs a 3% mortality rate among 65 patients who were negative at both tests. Thus long-term prognostic significance of exercise stress testing after acute myocardial infarction is confirmed and extended, despite limitation of a late test. Moreover, the second test along the follow-up allows further stratification. In conclusion, patients with a negative test and without clinical features predictive of poor prognosis constitute a very low risk group who need not undergo invasive testing, whereas patients with a positive result or who become positive at following test deserve further evaluation and may become bypass candidates in the ensuing years.

Evaluation Studies as Topic↗

PubMed1994

Comparison of oxygen uptake during a conventional treadmill test and the shuttle walking test in chronic airflow limitation.

The purpose of this study was to investigate the relationship between performance on the shuttle walking test and maximal oxygen uptake (VO2max) during a conventional treadmill test in patients with chronic airflow limitation. Two different techniques were used to measure oxygen consumption, i.e. conventional Douglas bag techniques (treadmill test) and a portable oxygen consumption meter (shuttle test). Initially, 19 patients performed a shuttle walking test (after one practice walk) and a maximal treadmill walking test, in a randomized, balanced design. Subsequently, 10 patients, (after one practice) completed an unencumbered shuttle walking test and one supporting the portable oxygen consumption meter, in random order. The results of the first experiment revealed a strong relationship between performance during the shuttle walking test and VO2max during the treadmill walking test (r = 0.88). The results of the second experiment consistently demonstrated an incremental increase in oxygen consumption and ventilation in response to the increasing intensity of the shuttle walking test. Again, a strong relationship between VO2max and performance on the shuttle test was demonstrated (r = 0.81). We concluded that the shuttle walking test is a valid field exercise test of functional capacity. Performance on the test relates strongly to VO2max, the traditional indicator of cardiorespiratory capacity.

Exercise Test↗

PubMed1978

[Allergy diagnosis in patients with bronchial asthma (bronchial provocation test, skin test and RAST) (author's transl)].

87 patients with bronchial asthma underwent skin test, RAST and measurment of airway resistance before and after inhalation of control solution as well as at least 10 times after each of one to four bronchial provocations (making up a total of 171 tests) with extracts of house dust, house dust mite, animal dander, mould spores and pollen in increasing concentrations. An actual clinical significance of the skin test reactions was found in 60% of all cases and of the RAST results in 66% of all cases. The overall agreement between skin test results and RAST results was 61%. The correlations between the different tests depended on the degree of hypersensitivity, on the tested allergen and on whether the results of skin test and RAST, respectively, were positive or negative. There existed a good correlation between the results of all three test methods and case history only for pollen allergens and animal dander. Noticeably often negative RAST results with house dust and mould spores, as well as positive skin tests with house dust mite and mould spores could not be confirmed by the provocation test. Important indications for a bronchial provocation test in asthmatics are doubtful case history, doubtful skin test or RAST results with the problem-allergens house dust, house dust mite and mould spores; the bronchial provocation test is especially commendable when drastic or cumbersome therapeutic measures (immunotherapy, change of home, change of job) are to follow or if late asthmatic reactions are expected.

Allergens↗