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PubMed1989

Laboratory diagnosis of primary hyperparathyroidism.

Although considerable effort has gone into the development and modernization of indirect parathyroid function tests, recent experience indicates that they do not possess adequate diagnostic specificity or sensitivity to provide a definitive diagnosis of HPT when they are most needed, that is, in mild or intermittent hypercalcemia. Conversely, in most research and some commercial laboratories, the combination of hypercalcemia and an elevated mid-molecule or intact PTH level will be diagnostic in more than 90% of patients.

Cyclic AMP↗

PubMed1989

Hereditary long Q-T syndrome presenting as epilepsy: electroencephalography laboratory diagnosis.

Patients with hereditary Q-T interval prolongation can present with seizures, syncope, and sudden death. In 2 siblings with autosomal dominant familial long Q-T syndrome, electroencephalographic examinations performed 6 and 2 years before diagnosis included electrocardiographic tracings documenting the cardiac abnormality. A timely diagnosis of this condition may have prevented the death of 1 of these patients. Measurement of the corrected Q-T interval on electrocardiographic tracings obtained in the electroencephalography laboratory should be considered in selected patients.

Adolescent↗

PubMed1992

Comparison of a direct fecal Shiga-like toxin assay and sorbitol-MacConkey agar culture for laboratory diagnosis of enterohemorrhagic Escherichia coli infection.

A direct fecal Shiga-like toxin assay (DSLTA) was used to prospectively screen 9,449 unselected stool samples, received at the British Columbia Provincial Health Laboratories and the Metropolitan Laboratories of Vancouver, for Shiga-like toxin I and Shiga-like toxin II. The results were compared with results of routine stool culture on sorbitol-MacConkey agar (SMAC) for Escherichia coli O157:H7. Of 80 specimens positive by either method, 59 (74%) and 74 (93%) were positive by SMAC and DSLTA, respectively; 53 (66%) were positive by both methods, 21 (26%) were positive by DSLTA only, and 6 (7%) were positive by SMAC only. On further screening, Shiga-like toxin-producing E. coli were detected in 8 (38%) of the 21 stools positive by DSLTA only, including serotypes O157:H7 (1 stool), O26:K60 (5 stools), O128:K67 (1 stool), and O103:H2 (1 stool). For the remaining 13 stools in which no SLTEC was found but DSLTA was positive, clinical information revealed that 11 of 12 patients had diarrheal illnesses, and 4 of these 11 had bloody diarrhea or hemolytic-uremic syndrome. Stools positive only by SMAC were collected earlier in the illness than stools positive by DSLTA, suggesting that free fecal toxin levels may be too low to detect at this time. Overall we found that DSLTA detected 19% more positive specimens than SMAC and that Shiga-like toxin-producing E. coli serotypes other than E. coli O157:H7 are causing disease in the province of British Columbia, Canada.

Bacterial Toxins↗

PubMed1985

[Laboratory diagnosis in suspected infections of the urinary tract].

Rules for diagnostic procedure in patients with urinary tract infections are presented: the different indications for the investigation, the optimal specimen and the different laboratory methods. At this point the value of the determination of infection markers is investigated. Relating to our own experience we propose a stepwise diagnostic procedure. Different constellations of results for infection markers, quantitative bacteriological findings and the detection of antibacterial activity are discussed. Antibiotic therapy for uncomplicated urinary tract infections and for complicated cases are presented briefly.

Bacterial Infections↗

PubMed1984

[Significance of the laboratory diagnosis of hypercoagulability].

Alterations characteristic of the hypercoagulation syndrome such as changes in fibrinogen content, in FDP concentration and platelet counts as well as the presence of fibrinogen complexes were demonstrated by laboratory findings in 175 patients with severe diseases and disturbances of haemostasis. Twenty per cent of the patients showed no clinical signs of disturbances of haemostasis, in 32.5 per cent pronounced venous thrombosis occurred, bleeding complications arised in 28 per cent and microthrombosis developed in 20 per cent. The different findings in the individual groups are assumed to be due not only to haemostatic factors but also to other ones.

Blood Coagulation Tests↗

PubMed1963