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PubMed1988

[In vitro diagnosis of food allergy. Correlations among different diagnostic methods].

Diagnosis of immediate-type food allergy (AA) needs several kinds of investigation. To make their respective values clearer, we have studied the correlations that may exist between clinical scores, prick-tests (PT), oral provocation tests (TPO), measurement of fixed IgE on the polynuclear basophils (TDBH) free, serum IgE (RAST) and lymphoblast transformation (TTB) in 105 patients aged from 5 months to 17 years 3 months, who were suspected of AA. The weakest tests were PT and TPO of which the use (or not) at first were the two possible diagnostic approaches for AA. The study of the linear correlations between the different diagnostic tests taken two by two showed that there was a statistically significant correlation - the only one that we found - between PT and RAST (p2 less than 0.001). Finally, the level of agreement between PT and TPO was 86%.

Adolescent↗

PubMed1993

Diagnostic methods and treatment modalities of dry eye conditions.

One may view dry eye conditions as a group of diseases in which the ocular surface is adversely affected. Tear film instability invariably leads to some degree of cellular surface damage over the cornea and conjunctiva. In turn, ocular epitheliopathy may adversely affect tear film stability. The clinical presentation of the disease may not yield a clue as to its etiology. In recent years considerable progress was made both in the diagnosis and the treatment of the disease and promising studies are planned or are underway. The diagnostic techniques can be divided into four groups. The first is concerned with the clinical presentation. The second is concerned with the bulk properties of the aqueous tears including dynamic characteristics, composition, and colligative properties. The third is tear-film related and includes the film break-up time, evaporation rate, and lipid abnormality. The fourth is concerned with the ocular surface and includes vital staining, impression cytology, and surface microscopy. The most promising attempts are being made in the second group by attempting to elucidate the role of enzyme and enzyme activator activity and inhibitor contents as well as the tear protein profiles and correlating them with the specific disease states. The treatment modalities belong to three major groups aside from surgical intervention; the supplementation, preservation, and the stimulation of tears. The modern version of tear supplementation is expected to include the topical use of efficacious aqueous formulations that typically contain film stabilizing polymers, nutrients, and/or--in the future--biochemically active ingredients such as enzyme activators and inhibitors.

Dry Eye Syndromes↗

PubMed2006

[Hymenoptera venom allergy--new diagnostic methods].

During the past years, the number of patients with both anaphylaxis to hymenoptera sting and negative IgE detected by conventional methods has been increasing. To obviate this problem new assays have been tried, such as Western blot and in vitro challenge tests involving basophil activation, with either the measurement of histamine and sulphidoleukotrien released (CAST--Cellular Antigen Stimulation Test) or the detection of activation markers on the cell surface with flow cytometric analysis (Flow CAST). In this paper the principles of these assays as well as their diagnostic value in hymenoptera allergy are briefly reviewed.

Algorithms↗

PubMed1991

[Value of diagnostic methods in conduction disorders for pacemaker indications and choice of a suitable stimulation mode].

Sinus node syndrome: In patients with sinus node dysfunction, additional conduction disturbances may be present in the AV-node thereby precluding the possibility for basically-desirable atrial stimulation. Systematic electrophysiologic studies have shown that, overall, conduction disturbances are uncommon, albeit more frequently than in normal subjects and most are incurred a high rate of stimulation. In practice, invasive electrophysiologic studies are not required to clarify this question. If there is no high-grade AV-block on Holter monitoring, diagnostic atrial stimulation can be carried out at the time of pacemaker implantation via the atrial electrode. A low rate should be used initially then increased gradually. On 1:1 conduction to 130 to 140 b/min permanent atrial pacing is possible since under these conditions it is very unlikely that high-grade AV-block will occur. If AV-block is observed at an atrial rate of 130 b/min, an additional ventricular electrode for two-chamber pacing should be implanted. If there is intact retrograde ventriculo-atrial (V-A) conduction, isolated ventricular stimulation should not be carried out because of the possibility of hemodynamically-unfavorable pacemaker syndrome. Possible problems with intact V-A conduction currently have only negligible importance since the development of modern programmable two-chamber systems. Carotid sinus syndrome: On manipulation of the hypersensitive carotid sinus, the invariably-present functional compromise of the AV-node is masked by the marked bradycardia but can be detected by atrial stimulation. This examination is not routinely necessary however, since in carotid sinus syndrome isolated atrial stimulation is not carried out.(ABSTRACT TRUNCATED AT 250 WORDS)

Arrhythmias, Cardiac↗

PubMed1998

Investigations of thyroid diseases--an update on diagnostic methods.

Iodine deficiency disorders (IDD) are an important public health problem in India. It requires further refinement and improvements in thyroid disease diagnosis, especially in the early diagnosis of thyroid malfunctioning and risk assessment of autonomously functioning thyroid tissue. Scintigraphy with technetium-99m pertechnetate under exogenous or endogenous thyroid stimulating hormone (TSH) suppression provides the best results. There has been significant improvement in methodology in various laboratory investigations that have resulted from the application of newer luminescent techniques and gene technology in various thyroid function tests. TSH measurement especially by using second or third generation assays has ensured diagnostic accuracy and thyrotropin releasing hormone (TRH) test now almost always unnecessary. Determination of glycosaminoglycans in urine may become a helpful tool in the follow up of endocrine ophthalmopathy. The differentiation of blocking and stimulating TSH receptor antibodies is relevant when discrepant results are obtained with respect to thyroid function. Some newer imaging agents have been used in thyroid disease scintigraphy such as octreotide or in thyroid diseases diagnosis such as fluorodeoxyglucose. Both improve the detectability of thyroid cancer metastasis especially if radioiodine scan is negative.

Goiter, Endemic↗

PubMed1988

Pertussis: the disease and new diagnostic methods.

Bordetella pertussis, the causative agent of whooping cough, produces an acute and chronic respiratory infection in infants and young children. B. pertussis is still a major health problem of young children throughout the world even though effective immunization against whooping cough is available. While predominantly a childhood disease, it has been reported also to be a cause of persistent cough in adults. This review discusses the numerous bacterial virulence factors that may play roles in the pathogenesis of pertussis and in immunity to infection. The present problems with pertussis diagnosis, recent advances, and future prospects for new and improved rapid diagnostics tests also are explored.

Bordetella pertussis↗

PubMed1997

Poor prognosis of gallbladder cancer persists regardless of improved diagnostic methods. Incidence and results of surgery during 20 years in Helsinki.

BACKGROUND AND AIMS: The ominous prognosis of primary gallbladder cancer is well-known. This study assesses whether the prognosis has improved, and whether the substantial development in the radiologic imaging techniques is reflected in the survival of these patients. MATERIAL AND METHODS: The series consisted of 122 patients operated on for primary cancer in the gallbladder in the Helsinki City area between 1970 and 1990. RESULTS: The mean age of the patients was 68.6 years and did not change during the period, but there was a significant proportional increase in male patients. Only 2% of patients had a localized disease at the time of diagnosis, and there was no improvement in the diagnostic sensitivity during the observation period. Yet, the number of unexpected postoperative cancer diagnoses increased from 4% to 15% during the two decades. The primary mortality decreased from 21% to 13%, the one-year survival increased from 7% to 13%, whereas the five-year survival remained unchanged. CONCLUSIONS: During the past two decades the frequency of surgery for primary gallbladder cancer has increased significantly among males in the Helsinki City area. Regardless of the improved immediate survival the long-term survival has remained poor. The marked development in radiologic techniques is not reflected in the prognosis of these patients. Even under conditions in which the potential for the diagnosis of a malignant gallbladder disease is available, the opportunities for radical surgery are not utilized maximally, which is a cause for concern.

Adult↗

PubMed2005

The Adult Asperger Assessment (AAA): a diagnostic method.

At the present time there are a large number of adults who have suspected Asperger syndrome (AS). In this paper we describe a new instrument, the Adult Asperger Assessment (AAA), developed in our clinic for adults with AS. The need for a new instrument relevant to the diagnosis of AS in adulthood arises because existing instruments are designed for use with children. Properties of the AAA include (1) being electronic, data-based, and computer-scorable; (2) linking with two screening instruments [the Autism Spectrum Quotient (AQ) and the Empathy Quotient (EQ)]; and (3) employing a more stringent set of diagnostic criteria than DSM-IV, in order to avoid false positives. The AAA is described, and its use with a series of n = 42 clinic-patients is reported. Thirty-seven of these (88%) met DSM-IV criteria, but only 34 of these (80%) met AAA criteria. The AAA is therefore more conservative than DSM-IV.

Adult↗

PubMed1976

Direct spectrofluorometry of diluted erythrocytes and plasma: a rapid diagnostic method in primary and secondary porphyrinemias.

Primary and secondary porphyrinemias are characterized by the presence of several porphyrin species in erythrocytes and/or plasma. Acid solvent extraction of porphyrins from natural ligands can preclude observation of significant spectral differences apparent on direct spectrofluorometric examination of porphyrin complexes in tissue. Erythrocytes and hemoglobin-free plasma obtained from 13 patients with erythropoietic, 9 with lead intoxication, 5 with porphyria cutanea tarda, 3 with iron deficiency anemia, 1 with erythropoietic porphyria, and 10 normal persons were simply diluted and analyzed spectrofluorometrically. Characteristic porphyrin-ligand spectral patterns were consistently obtained for each group of specimens, allowing diagnostic application of the data.

Anemia↗

PubMed1993

[Advances in diagnostic methods for mycobacteria].

Two systems, biphasic MB-Check and radiometric BACTEC, based on liquid media proved to be significantly better than the egg-based solid media for the isolation of mycobacteria from clinical specimens. The difference in the rates of isolation of mycobacteria between two groups of media was more remarkable with smear-negative specimens. The time to the detection of the Mycobacterium tuberculosis complex with MB-Check was shorter than that with the 3% Ogawa egg method but longer than that with BACTEC. A total of 135 sputum specimens were examined by the polymerase chain reaction (PCR) using oligonucleotides based on the repetitive sequence (IS986) of M. tuberculosis as a primer. The PCR gave an overall positivity rate of 84.2%, as compared with 71.9% by smear and 96.9% by culture in the liquid medium, MB-Check. Although the sensitivity of the PCR appeared to be similar to that of culture with the MB-Check system, the PCR should be very useful for rapid detection of M. tuberculosis infections. DNA probe technology facilitates a rapid and specific identification of microorganisms. The diagnostic specificity and sensitivity of the nonradioactive Accuprobe M. tuberculosis complex and Accuprobe M. avium complex culture confirmation tests were nearly 100%. The results of the colorimetric microdilution plate hybridization test (DDH-Mycobacteria) for identification of mycobacteria were consistent with those of biochemical identification. About 90% of clinical isolates could be identified by the DDH kit. Both of these methods may contribute to the rapid diagnosis of mycobacterial infections. Epidemiological studies with techniques which allow differentiation of strains within M. tuberculosis groups are important for limiting the dissemination of the disease.(ABSTRACT TRUNCATED AT 250 WORDS)

Humans↗

PubMed1996

An update on diagnostic methods in the investigation of diseases of the thyroid.

Iodine deficiency and iodine-deficiency disorders continue to be problems in several parts of Europe, requiring further improvements in the techniques employed in thyroid diagnosis, and particularly in the early diagnosis and risk assessment of autonomously functioning thyroid tissue. For the latter purpose, scintigraphy with technetium-99m pertechnetate under exogenous or endogenous thyroid-stimulating hormone (TSH) suppression provides the best results. Significant methodological improvements in laboratory tests have resulted from the application of new luminescent techniques and gene technology to thyroid function tests. Especially TSH measurement using second- or third-generation assays ensures diagnostic accuracy, so that the thyrotropin-releasing hormone (TRH) test is now almost always unnecessary. The differentiation of blocking and stimulating TSH receptor antibodies is relevant when discrepant results are obtained with respect to thyroid function. Determination of glycosaminoglycans in urine may become a helpful tool in the follow-up of endocrine ophthalmopathy. Some new imaging agents have recently been applied in the scintigraphy of thyroid diseases, such as octreotide, or in thyroid diagnosis, such as fluorodeoxyglucose. Both improve the detectability of metastases of thyroid cancer, especially if the radioiodine scan is negative.

Biopsy, Needle↗

PubMed2000

[Comparison of modern diagnostic methods in children with intractable focal epilepsy].

The basic aim of neuroimaging in children with intractable focal epilepsy is stablishing localization of epileptogenic zone. In this study 34 children (age 11-17 years) with intractable focal epilepsy were examined including: clinical history, physical examination, EEG, CT, MR, 99mTc-HMPAO SPECT. The hypoperfused region in interictal SPECT was concordant with clinical seizure characteristics in 22 children, with EEG in 13, with MR with 13 children. The localization of hyperperfused region in ictal SPECT was concordant with the clinical seizure characteristics in 9 from 10 examined children, with EEG in 7 and with MR in 8. The diagnostic value of estimation of the localization of epileptogenic zone in interictal SPECT (63 per cent) was comparable with the results of EEG (56 per cent) and MR (59 per cent), but ictal SPECT offers more information (100 per cent). In conclusion, performing both ictal and interictal SPECT studies may provide data about both seizure origin and its relationship with structurally abnormal regions of the brain.

Adolescent↗

PubMed1998

[New diagnostic methods and classification of diabetes. Not many changes--but why?].

Of the approximately 300,000 diabetics in Sweden, about 15 per cent have type I or juvenile diabetes, and the remainder type II or diabetes of maturity. Naturally, this is a gross oversimplification of the situation, and reflects our predilection for classification rather than our knowledge of the etiology and heterogeneity of the disease. Not only is there a broad indeterminate zone between the two main types, but during recent years a number of genetically determined forms have also been described. Accordingly, the World Health Organisation has recently proposed changes in the classification of diabetes and in the diagnostic criteria. The new proposals are reviewed in the article.

Diabetes Mellitus, Type 1↗

PubMed2002

The use of chosen serological diagnostic methods in Lyme disease in horses. Part I. Indirect immunofluorescence and enzyme-linked immunosorbent assay (ELISA).

The investigations aimed to establish the reliability of the chosen serological tests designed for the diagnosis of Lyme borreliosis in horses. The investigations were carried out in five Horse Breeding Centres (OHK). Statistical analysis methods were used to determine sample size for particular centres: Krasne (Kr)--49, Łack (Ł)--21, Walewice (W)--111, BogusŁawice (B)--17, Kozienice (K)--61. The experimental material comprised the chosen horses from which blood samples were collected in order to obtain sera. The test used for indirect immunofluorescence assay (IFA No 75941, Bio-Mérieux) is commercially designed for the investigation of human sera and thus needed a prior species adaptation and standardization; ELISA (MRL DIAGNOSTICS, No EL0400G) which was also species adapted and stardandized and ELISA commercially assigned for the examination of dog or horse sera (Die System Diagnostica GmbH Borrelia burgdorferi Veterinary ELISA No. 122.00 Genzyme Virotech GmbH). In the IFA test the highest share of positive results was obtained in respect of the sera from OHK in (K)--60.7% and then in (B)--52.9%, (Ł)--42.9%, (W)--40.5%, (Kr)--38.7%. In the standardized ELISA the highest percent of positive results, amounting to 33.3%, was obtained in respect of the sera from (Ł), and then from (W)--20.7%, (K)--11.5%, (Kr)--10.2% and (B)--5.9%. The percent of positive results obtained in the commercial ELISA also agreement on a high level: the sera originating from (W) were positive in 18.9%, from (K)--9.8%, (Ł)--9.5%. (B)--5.9% and (Kr)--4.1%. Both ELISAs showed high agreement although the standardized test was characterized by a greater tendency for suggesting the presence of B. burgdorferi infection and the agreement of these two ELISAs with the IFA was not so strong. The IFA showed the highest tendency for suggesting the presence of the B. burgdorferi infection, being characterized by the highest percent of false positive results.

Animals↗

PubMed1982

Impact of modern diagnostic methods on the management of active rectal bleeding. Ten year experience.

We analyzed 178 patients admitted with a diagnosis of lower gastrointestinal hemorrhage from 1970 to 1979. Fifty-four percent had a subsequent or previous episode of bleeding and 78 percent required transfusions. One hundred eighteen patients had rigid sigmoidoscopy, with positive findings in 10 (8.5 percent); 98 underwent angiography, with positive findings in 41 percent; and 58 underwent colonoscopy, with positive findings in 48 percent. Comparison of these tests when the patient had active bleeding revealed the rates of positive findings for angiography and colonoscopy to be 42 and 85 percent, respectively. Sixty-five patients underwent operation and 16 eventually died, for a mortality rate of 25 percent. There was a higher percentage of deaths among patients with nondirected than in those with directed operations (32 versus 22 percent). Patients with lower gastrointestinal bleeding should undergo aggressive diagnostic evaluation utilizing sigmoidoscopy, angiography, and colonoscopy to increase the number of directed operations and decrease mortality and operative morbidity.

Adolescent↗

PubMed1986

Labial minor salivary gland biopsy: a highly discriminatory diagnostic method between sarcoidosis and Sjögren's syndrome.

Sixty labial minor salivary gland biopsies (lip biopsies) from 32 patients with sarcoidosis and 28 patients with primary Sjögren's syndrome were evaluated retrospectively and blindly. Six biopsies revealed typical sarcoid granulomata. All six belonged to patients with previously diagnosed sarcoidosis. Twelve lip biopsies, all from sarcoidosis patients, were classified as presenting 1+ or less lymphoid infiltrates according to Tarpley's classification. The biopsies of the remaining 14 patients with sarcoidosis showed normal tissues. Finally, 28 biopsies were classified as having 2+ or 3+ lymphoid infiltrates and/or fibrosis. All belonged to patients with Sjögren's syndrome. Our results indicate that lip biopsy has a rather low diagnostic yield in sarcoidosis (19%) but, more importantly, it can discriminate very well between sarcoidosis and Sjögren's syndrome.

Adult↗

PubMed1986

Brain changes in dementia of Alzheimer's type relevant to new imaging diagnostic methods.

The aim of the article is to correlate grey and white matter changes and their topography to the results of modern methods for brain imaging such as CT, rCBF, PET, SPECT and NMR in Alzheimer's type of dementia. The findings are based on the study of a large material investigated thoroughly patho-anatomically. The findings are correlated with psychiatric and neurophysiologic follow-up studies. The degenerative grey matter process shows a regionally varying accent according to a pattern which is consistent and typical for the disease. This corresponds to metabolic changes on rCBF, PET and SPECT and thereby becomes of diagnostic value. This pattern is largely symmetric. Metabolic asymmetries have however been reported on PET scans. In this context individual variations of the topographic degenerative brain pattern and normal anatomical brain asymmetries are of interest. The white matter however also frequently shows changes, in particular loss of myelin and axons and a mild gliosis, slight in 1/3 of the cases and severe in an additional 1/3. These changes cause a decrease of density in the centrum semiovale correlating to lipid depletion. They may also influence the ventricular shape and size, of interest in CT or NMR studies. Also here variations in ventricular shape, normal and such due to pathological processes unrelated to the Alzheimer disease, may cause confusion, regarding degree of atrophy and even type of brain process. Such factors should be considered in the interpretation of non-invasive brain studies.

Aging↗

PubMed1982

Lymphocyte capping: a diagnostic method in progressive muscular dystrophy?

Recent observations indicate that antibody-induced redistribution ("capping") of membrane antigens of B-lymphocytes is subnormal in patients with progressive muscular dystrophy. The present study was primarily designed to verify or refute claims that such an abnormally low capping capacity can be used to diagnose this disease group. In eight dystrophy patients we found the median capping to be reduced to 40%, while it was 52% in 27 neurological control patients, and 62% in 20 healthy blood donors. However, there was considerable overlap between the capping percentages of the three groups. Thus, our data indicate that the demonstration of reduced lymphocyte capping in the individual patient is of little, if any, diagnostic value.

Female↗