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Diagnostic methods for detecting forms and strains of Helicobacter pylori and evaluation of its eradication.

Diagnostic methods for detecting forms and strains of Helicobacter pylori isolated from biopsy specimens of gastric mucosa in 28 patients with duodenal ulcers and evaluation of its eradication were compared. Biopsy specimens from all patients were tested for the presence of H. pylori by the urease test, histological method, and PCR with species-specific primers before and after treatment. H. pylori infection was detected in all patients before treatment, the mean titer of serum IgG being 36.7+/-16.6 U/ml. Biopsy specimens positive for H. pylori in PCR were subjected to restriction analysis of specific PCR-amplified genes or their fragments. The fingerprint analysis gave electrophoregrams of restriction products amplified fragment of flaA gene of H. pylori in 7 patients. Differences in restriction maps indicate the presence of 5 H. pylori strains in the studied samples.

Adolescent↗

[Choice of x-ray diagnostic methods in chronic odontogenic sinusitis].

On the basis of our experiences the selection of diagnostic methods for chronic odontogenic sinusitis is discussed. The selection is based on the primary sign, the reduced transparency of the sinus, detected with conventional radiography. Its purpose is the determination of the extent and nature of the opacity. Conventional methods, contrast investigations, conventional and computed tomography are used.

Humans↗

Cheyletiella infestation in the dog: observations on diagnostic methods and clinical signs.

The aims of this study were to evaluate the ability of diagnostic methods to detect naturally occurring Cheyletiella infestation in dogs, and to quantify and relate the number of mites and eggs present to clinical signs. Privately owned dogs with skin problems were eligible for inclusion in the study. Four diagnostic tests were performed on each dog in the following order: tape impression, hair plucking, skin scraping and vacuum cleaning. Dogs with positive test results for Cheyletiella infestation in at least one of the tests under evaluation were included in the study (n=27). The severity of pruritus and scaling was graded on a four-point fixed scale. The diagnostic findings in vacuum cleaning samples provided a semiquantitative measure of the grade of infestation. The vacuum cleaning test gave a positive test result in all dogs and was significantly more efficient than the other tests evaluated (P<0.01). The number of diagnostic findings varied considerably among the different vacuum samples. No significant relationship between the number of diagnostic findings and severity of clinical signs was detected.

Animals↗

Evaluation of diagnostic methods for the detection of cytomegalovirus in recipients of allogeneic stem cell transplants.

BACKGROUND: Although several diagnostic methods are available for the surveillance of patients at risk of human cytomegalovirus (CMV) infection and disease, little data is available on their comparative performances in the diagnostic setting. OBJECTIVES: To compare different assays for CMV detection, especially assays based on (quantitative) DNA and mRNA detection. STUDY DESIGN: Eight allogeneic bone marrow and stem cell transplant recipients at high risk for developing CMV disease (donor CMV-negative, recipient positive) were regularly tested for 7-20 weeks post-transplant by spin-amplification rapid culture from urine (viruria), antigenemia (pp65 assay), pp67 mRNA in whole blood (NASBA), and CMV DNA both qualitatively (in-house PCR, whole blood) and quantitatively (in-house PCR, plasma; Cobas Amplicor CMV Monitor Test, plasma and whole blood; Hybrid Capture, whole blood). RESULTS: Four patients (50%) suffered CMV reactivation during follow-up. Out of 104 sample dates, 41 (39.4%) yielded a positive CMV result in at least one assay. Out of the 28 samples tested by all assays, the highest percentage of positive results was obtained with the in-house quantitative PCR (60.7%), followed by the Hybrid Capture system (39.3%), the Cobas Amplicor CMV Monitor Test, plasma version (35.7%), the Cobas Amplicor CMV Monitor Test, whole blood version (32.1%), in-house qualitative PCR (28.6%), and the mRNA assay (21.4%). Viruria was positive in one sample and pp65 antigenemia was found in two samples. CONCLUSIONS: Despite a considerable incidence of CMV reactivations, pre-emptive anti-CMV chemotherapy prevented the development of CMV disease with the exception of one case. The molecular assays had superior sensitivity to conventional ones. The antigenemia assay proved unsuitable for the surveillance of hematological transplant patients. However, none of the tests recognized all timepoints with CMV reactivation. Further comparative studies are needed to determine their respective diagnostic values.

Adolescent↗

Psycholinguistic diagnostic methods for focal cerebellar lesions.

In contemporary neurological diagnostics, psycholinguistic methods are mainly used for the differentiation of speech disturbances of hemispheric origin. However, the possibilities for their use is significantly wider. The mental faculties of man, most of all for speech, are provided for not only by the cerebral hemispheres, but also by the older structures of the brain stem and cerebellum. Therefore psycholinguistic methods broaden the possibilities of localizing diagnostics.

Adult↗

Candidal balano-posthitis: a study of diagnostic methods.

OBJECTIVES: To compare microscopy with culture for diagnosing candidal balanoposthitis and to document which diagnostic methods are used in genitourinary medicine clinics in Great Britain. DESIGN: (a) Penile material for microscopy and fungal culture were obtained from men with balano-posthitis. A "plain-slide" method of collecting material for microscopy was compared with a novel "adhesive-tape" method of sampling. (b) Questionnaires were sent to all genitourinary medicine clinics in Great Britain. SETTING: The Department of Genitourinary Medicine, Addenbrooke's Hospital, Cambridge, England. MAIN OUTCOME MEASURES: The sensitivity and specificity of microscopy using culture as the "gold standard" for diagnosis. RESULTS: Candida was isolated from 35% of 450 men with balano-posthitis attending the clinic over a three year period. The sensitivity of microscopy compared with culture was 12% ("plain-slide" method of material collection) and 65% ("adhesive-tape" method) (p < 0.0001). The respective specificities were 95% and 81%. The positive predictive values for the two methods of material collection were 50% ("plain-slide" method) and 75% ("adhesive-tape" method). The respective negative predictive values were 71% and 72%. 60% of 250 genitourinary medicine clinics returned questionnaires. 13% routinely diagnosed candidal balanoposthitis by appearance only and 34% sometimes relied only on clinical appearance. Culture was used by 78% and microscopy by 69% of clinics. Material for microscopy was most commonly collected by using a cotton-wool tipped swab and the Gram stain was the favoured method for microscopy. CONCLUSION: Candida is a common cause of balano-posthitis. Diagnosis by microscopy has a low sensitivity and varies with the method used for collecting material. Although up to one third of genitourinary medicine clinics may rely solely on clinical appearance for diagnosis most continue to use microscopy and culture.

Balanitis↗

Radiohistology as a new diagnostic method for barium granuloma.

Barium granulomas are rare complications of the barium enema. They pose diagnostic problems to the gastroenterologist, who may suspect a carcinoma, and to the pathologist, who may have difficulty in determining the precise nature of the foreign body. From four cases we suggest a simple and quick diagnostic method: paraffin-block roentgenography.

Adult↗

Dynamics of and diagnostic methods for detecting small carious lesions.

This paper reviews and discusses the dynamics of carious lesions and diagnostic methods for their detection. Summary data are presented on progression rates of differing lesion types with differing initial severity. Among the non-invasive techniques, fibre-optic transillumination, used appropriately, gives the most accurate estimate of posterior approximal dentinal caries. Electrical resistance methods are likely to provide a significant contribution to the diagnosis of occlusal caries in the future. Radiographs remain an important component of the diagnostic armamentarium and may be enhanced by the introduction of direct digital imaging. Problems in appropriate validation must be addressed to ensure that new techniques are correctly evaluated.

Dental Caries↗

[The value of diagnostic methods used to assess the response to treatment in patients with limited small cell lung carcinoma].

Tumor response is used as a main criterion whether or not the treatment yields an anticancer activity. The tumor response criteria are defined by WHO recommendation but little is known about the tests must be used. The aim of this paper was to compare the degree of response to the treatment of 268 patients with limited small cell lung cancer, using independently 3 methods: radiological, bronchoscopic and cytological of bronchial material. Particular categories of response (CR, PR NR and presence or absence of carcinomatous cells) were related to survival time of patients independently to method of assessment. Multivarinte Cox analysis selected 3 parameters related to 3 different methods as independent survival risk factors. We conclude that each of diagnostic method (chest x-ray, bronchoscopy, cytological examination of bronchial material yield independent information correlated with survival risk of particular patient.

Bronchi↗

Determination of independent risk factors and comparative analysis of diagnostic methods for immediate type latex allergy in spina bifida patients.

BACKGROUND: Development of allergy to natural rubber latex in spina bifida patients is determined by several risk factors, such as age, number of interventions and atopic disease that are, however, interdependent. Furthermore, several diagnostic procedures have been analysed, but a comprehensive analysis of their diagnostic significance is lacking. OBJECTIVE: To determine the independent major risk factor(s) for development of natural rubber latex allergy and the most valuable diagnostic procedure. METHODS: In aselectively collected spina bifida patients, we correlated existing natural rubber latex allergy with age, sex, atopy and the number of hospitalizations and of surgical interventions in appropriately matched subgroups. Allergy to natural rubber latex was established by application of a latex glove fragment on the skin. Skin-prick tests with glove eluate, a natural latex extract and a commercial latex extract were carried out as were specific IgE measurements by radioimmuno assay (RAST-CAP). The results of the latex application test are compared with the other diagnostic methods. RESULTS: Out of 74 fully evaluated patients, 17 had a positive application test. The number of surgical interventions correlates strongly with the presence of natural rubber latex allergy (P<0.0002), independent of age, sex and presence of atopy. Skin-prick tests with unstandardized allergens made from known high allergenic latex gloves represent the most sensitive diagnostic method, with the highest negative predictive value and a specificity of 0.95. RAST-CAP was the next best method with a specificity of 0.93, a sensitivity of 0.89 and a negative predictive value of 0.97. CONCLUSION: The number of surgical interventions is the major independent determining factor for allergy to natural rubber latex in spina bifida patients. Unstandardized skin-prick tests are the most sensitive and specific diagnostic tool, but RAST-CAP is almost equally performant and therefore a valid alternative.

Adolescent↗

[Comparison of four diagnostic methods using clinical blood by measuring (1-->3)-beta-D-glucan].

Using Amebocyte lysate of horseshoe crab to measure (1-->3)-beta-D-glucan specifically, a component of the cell wall, several kinds of diagnostic methods for deep mycosis are in practical use in Japan. However, the most important problem is that the judgment of positive or negative is method dependent. To elucidate the cause of the problem, each measurement value of the identical sample by four methods, beta-Glucan Test Maruha (MARUHA), beta-Glucan Test Wako (WAKO). FUNGITEC G Test (FUNGITEC-G) and FUNGITEC G Test MK (FUNGITEC-MK) was compared with the clinical data using 119 cases and 289 tests. Each case was divided into three groups; proven fungal infection, probable fungal infection and non-fungal infection. The negative cases for all the methods tested in the groups of proven fungal infection and probable fungal infection were allergic bronchopulmonary aspergillosis and cryptococcosis, and that for all the methods tested except FUNGITEC-MK method in the group was pulmonary aspergilloma. It seems that these cases cannot be detected correctly by only measuring (1-->3)-beta-D-glucan. On the other hand, the ratio of false positive, positive for non-fungal infection group was high in the case of FUNGITEC-MK. About 23% against the total case was positive for FUNGITEC-MK method, but negative for MARUHA, WAKO, and FUNGITEC-G methods. Although the difference of the sensitivity among four methods was not observed, the specificity, the diagnostic efficiency, and the positive predictive value of FUNGITEC-MK method were remarkably lower than those of the other methods due to false positive measurement. In conclusion, MARUHA, WAKO and FUNGITEC-G except FUNGITEC-MK is not method dependent. It is suggested that FUNGITEC-MK detects non-specific reaction resulted in false positive.

Glucans↗

A diagnostic method to detect alcelaphine herpesvirus-1 of malignant catarrhal fever using the polymerase chain reaction.

A sensitive diagnostic method specific for alcelaphine herpesvirus-1, causative agent of malignant catarrhal fever, has been developed. Based on the nucleotide sequence of the alcelaphine herpesvirus-1 genomic DNA, a pair of 30 nucleotide primers was selected and synthesized for detecting the virus genome using the polymerase chain reaction (PCR). The virus genome was detected in crude cell lysate using the amplification reaction.

Animals↗

Transcranial Doppler sonography as diagnostic method.

Having in mind the fact that cerebrovascular disease (CVB) takes today in medicine, in spite of diagnostic and therapeutic modernisation, the third place of mortality causes in the world (behind cordial and malignant diseases, but in front of depressions), and the second place of invalidity cause (right after trauma) as well as the second place of dementia cause (after Alzheimer disease), it urges primary prophylaxis. Developing countries, but before all countries of East and Middle Europe, where is our country, are highly risked areas where CV disease has trend of incidence and total frequency increase. In the neighbouring Croatia today CV disease is at the first place of mortality causes. In the world today 5 million people annually suffer CV disease, in Europe about 700.000, but frequency of suffering on Balkan is about 5 prom. Age of CV disease effecting unfortunately moved towards young age, and today 49% of effected by CV disease are of 46 to 59 years of age. Early detection and treatment of risk factors (before hypertension, smoking, diabetes mellitus, hyperlipidaemia, stress and physical non-activities) are the first aspect of CV disease prophylaxis. Together with this aspect of primary prophylaxis is early detection of complications of mentioned risk factors on the walls of blood vessels, before all changing in sense of arteriosclerosis, with consequence of disorder of cerebral haemodynamics. With that objective - verification of circulator and total haemodynamic disorders, there is obvious disclose of non-invasive diagnostic methods, and one of them is Transcranial Doppler Sonography (TCD). TCD is method comfortable for patient, reliable and rather precise, dynamic, and can be repeated several times, without side effects and in comparison with others rather cheap.

Journal Article↗

[The use of computer morphodensitometry in modern molecular diagnostic methods].

Technologies based on the use of polymerase chain reaction, in particular IS PCR are widely used now. However, wide introduction in clinico-laboratory practice of these methods requires: increase of reliability of the accepted decisions, improvement of the image for revealing more fine distinctions of objects, increase of quality of the obtained information, automated registration of results of the analysis. The application of original digital image analysis, adapted to specificity of biomedical objects--morphodensitometry--allows to solve successfully the following tasks: to optimisze conditions of IS PCR realisation on the basis of use of quantitative opticogeometrical parameters, quantitatively and subpopulistically to characterize a degree of infected cells with viral infection, and also nucleuses of cells, that is especially actual for introduction of molecular-genetic methods in clinico diagnostic practice and, automatically to register results of the analysis. Thus, employment of morphodensitometry can be very important in genediagnostic and also gene therapy.

Animals↗

[Viral respiratory infections in children: new diagnostic methods for early detection. Initial results of a pilot project in Switzerland].

The new methods of rapid viral diagnosis make it possible to specify a number of the most prevalent agents of respiratory tract infections within 24 hours. The techniques are based on the immunological detection of antigens of respiratory syncytial (RSV), adeno, parainfluenza type 1, 2 and 3, as well as of influenza A and B viruses in nasopharyngeal secretions. During a one-year period we have used these methods to evaluate diagnostically 1541 outpatients presenting with upper and lower respiratory tract infections. The patients included babies, infants and children under 16. In about 50% of all sick babies below the age of three months a definite viral infection could be established, and in approximately 30% of infants and children aged up to 4 years. RSV was most frequently observed, accounting for 53.6% of all infections (80% of all babies below the age of 3 months, in whom specified agents could be identified, had RSV infection). The next most frequent pathogens were parainfluenza type 3 (18,8%), influenza A (11,3%) and, finally, adenoviruses (10.2%). The epidemiological and clinical characteristics of these infections are summarized. In addition, the results of these antigen detecting assays have been compared with those of concomitantly conducted virus isolation techniques in cell cultures. This comparative analysis most impressively revealed the time saved by attempting an etiological diagnosis using the antigen detecting system: in only 6% was a specific diagnosis established on the basis of virus isolation, whereas the delay was equal or more than 8 days in 36% of all patients enroled.(ABSTRACT TRUNCATED AT 250 WORDS)

Adenoviridae↗

A prospective, randomized comparison of computed tomography with conventional diagnostic methods in the evaluation of penetrating injuries to the back and flank.

We prospectively compared computed tomography with conventional diagnostic methods in the evaluation of penetrating injuries to the back and flank in 85 patients. Immediate laparotomy was performed in 24 patients because of physical findings, and these patients were not randomized. Nine unnecessary operations were performed in this group, and these nine patients had significantly higher hospital costs than patients in either randomized group. In the randomized patients, there were only three true-positive and three false-positive findings. Both computed tomographic evaluation (31 patients) and conventional evaluation (30 patients) were highly accurate and specific for injuries that required operation. Evaluation with computed tomography required a longer time to make a hospital disposition but required fewer diagnostic tests. Computed tomography can be useful in the assessment of penetrating injuries to the back and flank.

Abdominal Injuries↗

Development and application of a rapid diagnostic method for invasive Candidiasis by the detection of D-/L-arabinitol using gas chromatography/mass spectrometry.

A rapid non-culture-based diagnostic method utilizing d-/l-arabinitol (DA/LA) ratios as a chemical marker of invasive candidiasis was developed and explored. The enantiomers-ratios detection was made possible by the use of gas chromatography coupled with mass spectrometry (GC/MS). The mean DA/LA ratios +/- standard deviation (range) in urine (n = 40) and serum (n = 20) were 2.08 +/- 0.78 (0.57 to 3.55) and 1.79 +/- 0.75 (0.74 to 3.54), respectively, from patients without evidence of fungal infection or colonization; in patients (n = 7) with culture-proven invasive candida infections, the figures were 9.91 +/- 3.04 (7.24 to 16.27) and 13.58 +/- 7.31 (5.57 to 25.88) in urine and serum, respectively. The differences in DA/LA ratios between the candidemic patients and the non-candidemic patients were statistically significant (p < 0.01) in both serum and urine samples. The DA/LA ratios were not significantly affected in patients with oral or vaginal candidiasis and candiduria.

Adult↗

Diagnostic methods in pulmonary embolism.

Diagnosing pulmonary embolism (PE) is challenging since clinical signs and symptoms are non-specific. The diagnostic tests available for demonstrating PE all have their drawbacks and are often costly and consume considerable amounts of resources. Simple tools that have become available in the last several years include clinical prediction rules and D-dimer testing. Assessment of the clinical probability, combined with a D-dimer test, can limit the need for additional diagnostic tests by 30%. For outpatients with a normal, sensitive ELISA D-dimer test and a low-to-moderate clinical probability, PE can safely be ruled out. Pulmonary angiography, though still the gold standard, is rarely used nowadays because of its invasiveness, its high costs and limited availability, and the declining experience of radiologists with the technique. Two imaging techniques--lung scintigraphy and helical CT--are the diagnostic methods of choice. A normal perfusion lung scan can safely exclude PE. However, 55-65% of patients have indeterminate lung scan results, making additional imaging tests necessary. Helical CT is increasingly being used as the first-line test because it can directly visualize a thromboembolus, it can suggest an alternative diagnosis, and there is excellent inter-observer agreement. A normal helical CT, followed by compression ultrasonography of the leg veins, can safely rule out PE. Finally, the safety of withholding anticoagulant treatment from patients with a normal multi-row detector helical CT as the sole test has not yet been demonstrated.

Journal Article↗