[New routine diagnostic test for syphilis (Treponema pallidum-IHA test)].
Explore the source record for details and available documents.
Evaluation Studies as Topic↗
SEARCH · PubMed Health
Results for “Diagnostic Tests, Routine”
Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.
Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.
Completion of hemagglutination inhibition test by solid-phase radioimmunoassay test in routine diagnostic rubella serology.
A solid-phase radioimmunoassay (RIA) test for rubella virus IgG and IgM class antibodies was used for completing the hemagglutination inhibition (HI) test in routine diagnostic serology. During a six-month period 80 serum specimens from 47 patients were tested by RIA because the HI test result was either unreliable or gave insufficient information. This was approximately 5% of the total number of serum specimens tested for rubella antibodies in our laboratory during the study period. The main indications for using the RIA test were improper timing in the taking of serum specimens, which accounted for IgM determination, and nonspecific agglutinins or nonspecific serum hemaglutination inhibitors, which disturbed the HI test. In all cases an unambiguous result was obtained by the RIA test, and five recent rubella infections, not diagnosably by the HI test, were detected. Based on these findings we consider the RIA test to be a good alternative among the methods proposed for diagnostic rubella serology.
Hemagglutination Inhibition Tests↗
Rapid pan-microbial metagenomics for pathogen detection and personalised therapy in the intensive care unit: a single-centre prospective observational study.
BACKGROUND: Most clinical metagenomic studies do not provide rapid results, detect pathogens from all microbial kingdoms, or measure clinical impacts. We aimed to evaluate the feasibility, performance, and clinical impacts of a rapid pan-microbial respiratory metagenomic service for patients admitted to intensive care units (ICUs). METHODS: This was a single-centre observational study of a rapid metagenomics service that tests respiratory samples from ICU patients at Guy's and St Thomas' hospitals, London, UK, between Dec 5, 2023, and April 12, 2024. Testing used a previously published pan-microbial metagenomics workflow, which simultaneously detects bacteria, fungi, and DNA and RNA viruses; provides same-day preliminary results after 2 h; and provides final results after 24 h. Patients were included if they were aged 18 years or older, admitted to the ICU, had confirmed respiratory failure requiring supplemental oxygen or advanced airway support, and had at least one of the following: (1) clinical suspicion of lower respiratory tract infection based on clinical, biochemical, or radiological findings, (2) sepsis of unknown origin, and (3) concern from an intensive care physician regarding inflammatory pathology. Patients with a suspected or confirmed containment level three organism were excluded. The outcome was performance characteristics of the metagenomic test compared with routine diagnostic testing, detection of additional pathogens by metagenomics, change in antimicrobial prescribing within 24 h of testing, and initiation of immunomodulation. FINDINGS: We processed 114 samples (1-5 per day) from 74 patients (39 [53%] female and 35 [47%] male). 107 (94%) of 114 samples passed quality control, of which 101 (94%) provided same-day preliminary results. Bacteria were detected in 45 (43%) of 104 tested specimens, fungal organisms in 17 (16%) of 104 tested specimens, and viruses in 28 (34%) of 83 tested specimens. Sensitivity in lower respiratory tract samples after 24 h was 97% (95% CI 87-100) for bacteria, 89% (65-99) for fungi, and 89% (71-98) for viruses, with only one false positive for bacteria. Metagenomics identified 42 pathogens not detected by other tests in 32 (30%) of 107 samples. Antimicrobial therapy was changed after metagenomic results from 30 (28%) of 107 samples: 22 (21%) were de-escalated and eight (7%) were escalated. Metagenomics contributed to the initiation of immunomodulation in 15 (20%) of 74 patients for a range of inflammatory conditions. Pathogens with clinical significance to local infection control or national public health were found in ten (14%) of 74 patients, including three invasive Group A streptococci, two parvovirus B19, and one each of HIV-1, measles virus, Mycobacterium tuberculosis, Neisseria meningitidis, and Mycoplasma pneumoniae. INTERPRETATION: Respiratory metagenomics for ICU patients showed good performance and turnaround time, and diverse clinical and public health benefits. This ability to inform both personalised patient therapy and infectious disease surveillance needs evaluation in multicentre studies. FUNDING: None.
Humans↗
The interpretation and significance of certain "routine" laboratory diagnostic tests.
Explore the source record for details and available documents.
Blood Chemical Analysis↗
Evaluation of conventional diagnostic tests for detection of recurrent carcinoma of the cervix.
The use of routine diagnostic tests to evaluate patients periodically after treatment for carcinoma of the cervix has been reviewed. Of 169 patients treated at Brooke Army Medical Center for carcinoma of the cervix, 73 were evaluated after their treatment by a group of six diagnostic tests referred to collectively as an oncologic survey. The survey consisted of an intravenous pyelogram (IVP), chest roentgenogram, barium enema, cystoscopy, proctoscopy, and bone scan. Although 16 patients developed recurrent tumor, the oncologic survey detected only three recurrences that had not already been suspected by physical examination. Only the IVP and chest roentgenogram were of sufficient benefit to suggest their routine use for the detection of recurrent cancer. The other tests included in the oncologic survey were not beneficial when used routinely and should be reserved to evaluate patients otherwise suspected of recurrent cancer.
Barium Sulfate↗
One hundred digitalis blood levels. A utilization review.
One hundred consecutive digitalis serum level determination requests and results were analyzed to evaluate the rational of ordering the test and utilizing the results at his hospital. Sixty-six percent of the reasons given for ordering the test were categorized as "acceptable". As many as 25% of physicians requesting the test considered digitalis levels as "routine" diagnostic tests in a patient taking these drugs. There were 12 levels within the potentially toxic range, 19 below the usual therapeutic range. The physicians modified their therapeutic management in 38 patients as a result of their knowledge of the digitalis level in blood. It is concluded that digitalis level determinations at this hospital are reasonably well utilized and that knowledge of the digitalis levels improve the accuracy of digitalis utilization in at least one third of the patients in whom this test is done.
Adult↗
[Studies on the antibacterial activity of the combination sulfamoxole/trimethoprim (CN 3123) (author's transl)].
After giving a survey on the situation of antibiotic resistance in the region of Northern Bavaria during 1973/74 and comparing the activity of a sulfamethoxazole (SMZ) trimethoprim (TMP) combination to other commonly used antibiotics and chemotherapeutic agents, the results of tests with the new combination of N1-(4,5-dimethyl-2-oxazolyl)-sulfanilamide) (sulfamoxole) and 2,4-diamino-5-(3,4,5-trimethoxy-benzyl)-pyrimidine (trimethoprim) at a ratio of 5:1 (CN 3123; Nevin, Supristol) are compared to those of tests with TMP/SMZ. This was done by correlating the inhibition zone diameters and, on the other hand, by referring to a great number of sensitivity evaluations in routine diagnostic tests. According to the size of the inhibition zone, CN 3123 showed a somewhat greater activity on Enterococcus (fecal streptococci), Escherichia coli, and Klebsiella aerogenes, whereas the TPM/SMZ combination had apparently a stronger antibacterial effect in vitro against Proteus mirabilis, Staphylococcus aureus, and the Achromobacter-group. Analysis of sensitivity readings from routine diagnosis demonstrated accordance of CN 3123 with TMP/SMZ in 92.6% (first series) and 94.2% (second series), respectively. These results should be considered critically in view of the manifold factors which influence sensitivity tests in the agar diffusion method.
Anti-Bacterial Agents↗
Vaccination against bovine brucellosis with a low dose of strain 19 administered by the conjunctival route. III. -- Serological response and immunity in the pregnant cow.
Seventy-four heifers, 7 to 12 months old, were randomized in four groups: group A, 8 heifers as controls; group B, 19 heifers vaccinated subcutaneously with 9 X 10(10) Brucella abortus strain B 19; group C, 19 heifers vaccinated as in group B, then revaccinated by the conjunctival route 6 to 8 months later with 5 X 10(9) bacteria; group D, 28 heifers vaccinated twice by the conjunctival route with the same dose and time intervals as in group C. Serological responses in agglutination, complement fixation and Rose Bengal tests were typical of those following standard vaccination with Strain B 19 in group B. Iu group C after the booster vaccination, there was a transient rise in titers which lasted about 3 months. Iu group D, titers were infrequent, low, and lasted no more than 8 weeks, after both primary and secondary vaccination. Fifty of the heifers, when 4 1/2 to 6 1/2 months pregnant, were challenged by the conjunctival route, with 16 X 10(6) B. abortus strain 544. Calves were born at full term (greater than or equal to 264 days) to 1/7 heifers in group A, 6/12 in group B, 8/II in group C and 14/19 in group D. Serological tests every two weeks after challenge; bacteriological examination of vaginal mucus, colostrum, foetuses and dead calves; bacterial enumeration of ten mixed samples of lymph nodes and organs taken at slaughter about 6 weeks after parturition, were made to determine the infection status of the heifers. Brucella was isolated at some time from 7/7 heifers in group A, II/I2 in group B, 6/I2 in group C and I4/I9 in group D. Five heifers (2 in B, I in C, 2 in D) cleared themselves of infection between parturition and slaughter, The average degree of infection per group at slaughter, expressed as a logarithmic index of the number of Brucella isolated from the ten samples, was significantly lower in the three vaccinated groups than in the controls, and in groups C and D than in groups B, and it was not significantly different in group C and D. For field vaccination, a booster vaccination by the conjunctival route, as in group C, would provide more protection than the standard vaccination without serious interference in routine diagnostic tests. Two vaccinations by the conjunctival route, as in group D, would be simpler, more economical and at least as effective as the standard system of vaccination, and would have the advantage that vaccination could be done at nay age without risk of serological response.
Agglutination Tests↗
[Gonadotropin secretion after stimulation with a highly effective analog of the gonadotropin-releasing-hormone (GnRH) in normal adult human males (author's transl)].
Potent long acting anologs of GnRH are of great interest especially in view of treatment of hypothalamic hypogonadotropic hypogonadism and of cryptorchidism. To find necessary parenteral doses of such a substance immunoreactive serum LH and FSH were measured in 4 normal adult human males after s.c. injection of various doses of D-Leu6-des-Gly10-GnRH-EA. 5 microgram of the GnRH anlog were necessary to obtain increased serum gonadotropins over a period of at least 8 h. Comparable maximal levels were seen after i.v. bolus injection of 25 microgram natural GnRH a dose as used in diagnostic routine tests in 3 probands. Comparing the areas under the curves of LH secretion an over 15 times greater effectiveness of the analog was calculated.
Adult↗
Intestinal disruption due to blunt abdominal trauma.
Twenty-three patients with thirty-one disruptions of the intestines due to blunt abdominal trauma are reviewed. The bowel disruptions occurred in the stomach (2 perforations), duodenum (9), proximal jejunum (18), and sigmoid colon (2). The causes of injury, diagnostic difficulties, delays in treatment, associated trauma, surgical correction, and results are analyzed. Deaths (4) and complications (6) are presented in detail. Intestinal disruptions can be due to a variety of types of blunt trauma, with the automobile being the most common etiologic agent. The bowel can perforate anywhere in its course. Intestinal perforations are often associated with severe injuries which will probably be the determining factors in survival. Persistence, particularly repeated physical examination, is required for the diagnosis of bowel injury. Routine diagnostic tests for duodenal injury are not reliable. Retroperitoneal hematomas around the duodenum must be explored. The injuries themselves are easy to repair, and repair is secure when performed at the primary operation. Prophylactic antibiotics are recommended.
Abdominal Injuries↗
Total calcium content of skeletal muscle isolated from humans and pigs susceptible to malignant hyperthermia.
Total calcium content of both human and porcine MHS skeletal muscle is significantly less than normal. This data is consistent with the concept that some organelle (probably the sarcoplasmic reticulum, the mitochondrion or even the sarcolemma) within the MHS muscle stores less than normal amounts of calcium. The large variability between muscle specimens rules out measurement of total calcium content of skeletal muscle as a routine diagnostic test for malignant hyperthermia susceptibility.
Animals↗
Malaria rapid diagnostic tests: performance, pitfalls, and progress.
PURPOSE OF REVIEW: Malaria rapid diagnostic tests (RDTs) have revolutionized malaria diagnosis in endemic settings. RDTs are simple to use and accurate for clinical cases, although sensitivity is reduced at parasite densities below 200 parasites/μl. However, increasing prevalence of hrp2/3 gene deletions in certain areas threaten utility of histidine-rich protein 2 (HRP2)-based RDTs, and lingering HRP2 antigenemia can generate false-positive results after parasite clearance. This review summarizes current performance of malaria RDTs, threats to their validity, and recent innovations to improve their performance and continued role in malaria diagnosis. RECENT FINDINGS: Most World Health Organization (WHO) prequalified RDTs perform well for clinical diagnosis, with only occasional exceptions, including a recently reported issue affecting several countries. RDT sensitivity is generally related to malaria transmission intensity, with higher proportions of false-negative results in lower-transmission areas. Newly prequalified lactate dehydrogenase (pLDH)-based RDTs perform well for both Plasmodium falciparum in areas with >5% hrp2/3 gene deletions and for Plasmodium vivax diagnosis. Several point-of-care alternatives to RDTs, including micro-fluidic devices, hemozoin-detecting devices, and automated hematology analyzers, have shown promising results in small studies, but require larger-scale trials before widespread use. SUMMARY: RDTs remain a critical tool in clinical diagnosis of malaria, and newer pLDH-based tests perform well in areas where hrp2/3 gene deletions threaten validity of HRP2-based RDTs.
Humans↗
Simplified chromatographic separation of immunoglobulin M from G and its application to toxoplasma indirect immunofluorescence.
The indirect immunofluorescent (IIF) antibody technique for the detection of Toxoplasma gondii immunoglobulin M (IgM) often gives false negative results, probably due to the competition between IgG and IgM. We therefore adapted a gel filtration procedure for the separation of IgG and IgM to a routine diagnostic test capable handling at least 10 sera per day and requiring only 50 microliters of serum. The results from 108 sera having positive complement fixation titers for Toxoplasma showed that 17 were IgM positive when the whole serum was tested by IIF compared with 55 positive when the IgM fraction was used. Sera with antideoxyribonucleic acid titers do not give false positive results after fractionation, and the removal of IgG eliminates false positive results due to rheumatoid factor. A prospective study showed that Toxoplasma IgM may persist up to 9 months.
Antibodies↗
[Toxins and enzymes of several species of Bacillus, especially of the B. cereus-thuringiensis group (author's transl)].
In the examined strains the production of following toxins or enzymes was determined by bioassay or by semiquantitative and routine diagnostical tests: delta-endotoxin, alpha-exotoxin, beta-exotoxin hemolysin, phospholipase C, proteinase. The production of delta-endotoxin (= a parasporal crystal toxic for several insects) is the only character in that B. thuringiensis differs from B. cereus. Other biochemical features as production of so-called alpha-exotoxin (= soluble toxic protein), hemolysin, phospholipase or proteinase are common in both species. Strains of B. megaterium may produce proteinase, but no phospholipase, hemolysin or alpha-exotoxin. The identity of the alpha-exotoxin of the B. cereus-thuringiensis group with any of the exoenzymes studied here could not be confirmed. At present, this toxin is only demonstrable by bioassay. Formation of beta-exotoxin (= soluble toxic nucleotide) is restricted to special strains of the B. cereus-thuringiensis group. -- All strains of B. megaterium tested do not produce any of the toxins quoted; they have found to be apathogenic under the experimental conditions. As the so-called "egg yolk clearing factor" is produced by all strains of B. megaterium (in contrast to strains of the B. cereus-thuringiensis group) it does not represent a factor of pathogenicity and therefore the term "gamma-exotoxin" is unfounded. -- Not too much attention should be paid in connection with taxonomic studies to the ability or non-ability of strains of bacteria to produce a special toxin.
Animals↗
Diagnostic value of routine liver tests.
In 131 patients on a medical service and 97 patients on a surgical service, in whom a diagnosis of hepatobiliary disease was verified in the hospital, the diagnostic value of routine liver tests performed soon after admission was evaluated by stepwise discriminant analysis. By measurements of alanine aminotransferase, alkaline phosphatases, gamma globulin, prothrombin time, bilirubin, and albumin, half of the medical patients were correctly classified into one of seven diagnostic categories. Aminotransferase contributed most to the classification, being twice as effective as random allocation. Decreasing the number of diagnostic categories to three (hepatitis, fatty liver, and chronic liver disease) increased the frequency of correct allocation to 80%. The allocation of all the patients to seven medical and four surgical diagnostic categories by means of four tests (aminotransferase, alkaline phosphatases, prothrombin time, and bilirubin) was significantly improved by each step with a misclassification rate of 55% when all tests were used. A reduction of the diagnostic groups to five (hepatitis, fatty liver, chronic liver disease, duct obstruction and tumor) increased the frequency of correct allocation to 63%. The analysis demonstrates the limited diagnostic effectiveness of routine liver tests when used alone. The absolute discrimination values depend on the a priori frequencies of the diagnostic groups investigated, and therefore may vary from time to time and from place to place.
Alanine Transaminase↗
Diagnostic value of routine exercise testing in hospital patients with angina pectoris.
A group of patients with angina pectoris were investigated prospectively using a simple and well-recognised exercise test protocol, and S-T segment displacements during exercise were correlated with the results of coronary arteriography. Definitive exercise results in 100 patients correlated well with findings on coronary angiograms: 69 out of 70 patients with positive exercise test results had significant coronary disease on angiography, while 23 out of 30 with negative exercise test results had no significant coronary disease. In six patients a period of physical training changed indeterminate initial tests to definitive ones after the training. These results show that the use of a widely available exercise test and a light physical training programme, with rigid adherence to the protocol, can reduce the overall demand on coronary arteriography.
Adult↗
Determining the necessity for routine preoperative laboratory tests and x-rays: a cooperative PSRO/hospital study.
Explore the source record for details and available documents.
Blood Cell Count↗
Purification of adenovirus 4 type-specific hemagglutinins for use in diagnostic counterelectrophoresis tests.
Three type-specific hemagglutinins of adenovirus (AV) 4 were purified, tested for various activities, and used as immunogens in rabbits. The components were purified by anion exchange and exclusion chromatographies to purification factors of 33, 20, and 37, respectively, and were identified as fiber (polypeptide, mol wt 70,000; incomplete hemagglutinin), penton (mol wt greater than 400,000; incomplete hemagglutinin; possession of cytotoxic activity), and dodecon (mol wt greater than 400,000; complete hemagglutinin; appearance by electron microscopy). Rabbit antisera to these hemagglutinating components possessed type-specific hemagglutination-inhibition and serum neutralization antibodies and were thoroughly evaluated for potency and specificty in immunodiffusion (ID), immunoelectrophoresis, and counterelectrophoresis (CE) tests. The anti-fiber and anti-dodecon sera were highly type-specific in ID and CE tests with a battery of commonly isolated AV serotypes; the anti-penton serum was similarly specific after it was absorbed with AV 2 hexons. These sera were thus proved to be suitable reagents for use in both the routine diagnostic ID test and the more rapid CE test.
Adenoviruses, Human↗