Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Testing”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 217 records · Page 12Linked to original sources
PubMed2001

Comparing the adrenaline-Pirquet test with international PPD tuberculin tests.

Several tuberculins, strengths and setting methods are in everyday use. We wanted to compare the Norwegian reference adrenaline Pirquet test with the internationally recommended Mantoux PPD test and Rhoditest. In responders of a random sample of young adults, with randomization of test subjects, we intra-individually compared the adrenaline-Pirquet (aP) test with Norwegian-produced synthetic medium tuberculin (SMT) with either the Mantoux test with PPD 2 tuberculin units (TU) (M2), the Mantoux-PPD 5 TU (M5) or the PPD 2 TU-Rhoditest (Rh). The criteria for a positive reaction were > or = 4mm for the aP test, > or = 10 mm for the M2 test, > or = 6 mm for the M5 test and > or = 2 mm for the Rh test. Strongly positive reactions were defined as aP test > or = 10 mm and M2/M5 test > or = 15 mm. One of the tuberculin tests was positive while the comparison test was negative in 14% of the M2 test group (n = 236), 15% in the M5 test group (n = 162) and 20% in the Rh test group (n = 187). The three PPD tests had positive reactions 3-10 times as often, with a simultaneous negative aP test, than vice versa. Strongly positive reactions occurred in 7% of the aP tests (> or = 10 mm), 32% of the M2 tests (> or = 15 mm) and in 41% of the M5 tests (> or = 15 mm). Receiver operating characteristic (ROC) curves gave the best agreement, with aP test >3mm compared with the M2 and the Rh tests. Regression equations are presented for transformations of the Norwegian reference method of adrenaline-Pirquet results to internationally recommended PPD tests. The international recommendations, globalization in general and the skill of Norwegian public health nurses in performing intra-dermal BCG suggest a future shift to the PPD 2 TU Mantoux test in Norway. Due to the lack of sensitivity and specificity of all tuberculin tests they might be used in targeted tuberculin testing and not as a general screening procedure in a low-incidence tuberculosis area with BCG-vaccinated inhabitants.

Adult↗
PubMed1986

[Immunodiagnostic studies in ovarian cancer using the leukocyte adherence inhibition test (LAI test). 1. Detection of cellular sensitization of peripheral blood lymphocytes using the LAI test].

34 patients with histological assured ovarian cancer were investigated with the direct chamber LAI-assay according to Halliday and Miller. As antigens we used KCl-extracts of ovarian cancer, fetal tissue and four other tumor associated antigens, A sensitivity of lymphocytes to ovarian cancer antigens (OCA) and fetal antigens (FA) was detected in the malignant group with significant differences p less than 0.0005 to the control group. The accuracy for OCA was 86% respectively 82% for FA. The LAI-assay has additional value for diagnosing of ovarian cancer. Difficulties in interpreting the individual LAI-assays results as well as false positive tests in the control group are discussed.

Adult↗
PubMed1981

Atopic skin test re-evaluated. X. Comparison of a perfected technique of intracutaneous skin testing and the prick test performed with a modified Morrow Brown Needle.

With a modified Morrow Brown needle it proved possible to obtain duplicate skin-test values with almost the same reliability as those obtained with the intracutaneous method described in one of the preceding papers of this series. The results of the present study also showed that 50% glycerin has a distinct inhibitory effect when added to the extracts, whereas 0.0005% Tween 80 produces a distinct enhancement of the skin reaction.

Adolescent↗
PubMed1997

Eliminating access to anonymous HIV antibody testing in North Carolina: effects on HIV testing and partner notification.

Anonymous HIV testing may attract persons who might otherwise not be tested but may hinder partner notification. We evaluated the effects on North Carolina's HIV testing and partner notification programs of policy changes that eliminated and later restored anonymous testing in 82 counties. We used an interrupted time-series design to compare counties eliminating with counties retaining anonymous testing. We analyzed HIV testing and partner notification data from before, during, and after elimination of anonymous testing. After elimination of anonymous testing in 82 counties, the mean monthly level of testing (+/- SE) increased by 45%, or 548 (+/- 123) tests per month, while in 18 counties that retained anonymous testing, there was a 63% increase, or 802 (+/- 162) tests per month (p > .05). Among men of all races, testing increased by 16%, or 155 (+/- 35) tests per month, in counties that eliminated anonymous testing; and by 51%, or 305 (+/- 42) tests per month (p < .05), in counties that retained anonymous testing. After elimination of anonymous testing, both county types experienced similar increases in the rate of partners notified. However, partner notification was more successful if the index patient was tested confidentially; 2.7 times as many partners per index patient were notified and counseled. There was no effect on testing or on partner notification rates following restoration of anonymous testing. Substantial community opposition to eliminating anonymous testing was encountered. The policy change appeared to result in a slight decrease in testing among men and a slight increase in partners notified. Programs considering the elimination of anonymous testing should weigh these potential gains and losses, as well as the impact on relationships between the public health and advocacy communities

Confidentiality↗
PubMed1997

A comparison of the insulin tolerance/glucagon test with the short ACTH stimulation test in the assessment of the hypothalamo-pituitary-adrenal axis in the early post-operative period after hypophysectomy.

OBJECTIVE: The insulin tolerance test (ITT) is the established reference test for assessing the hypothalamo-pituitary-adrenal (HPA) axis. Various authorities, however, have suggested that the 250 microgram short ACTH stimulation test may be used to assess the HPA axis in place of the ITT in suspected hypopituitarism, although a number of other studies have suggested that the test may be unreliable in this setting. In this study, the ITT (or glucagon test) has been compared with the 250 microgram short ACTH stimulation test in patients with pituitary tumours pre-operatively and within 2 weeks of trans-sphenoidal hypophysectomy. DESIGN: An ITT, or a glucagon test when the ITT was contraindicated, and the 250 micrograms short ACTH stimulation test, were performed in all the patients before (an ITT in 18 and a glucagon test in three patients) and within 2 weeks after trans-sphenoidal hypophysectomy (an ITT in 16 and a glucagon test in five patients). PATIENTS: Twenty-one patients with pituitary disorders (15 with acromegaly, one with a prolactinoma and five with non-functioning tumours) were studied; four had a microadenoma, two a mesoadenoma and 15 a macroadenoma. MEASUREMENTS: Serum cortisol was measured by radioimmunoassay. A normal response was defined as a rise in serum cortisol to 580 nmol/l or above for all the tests. RESULTS: Before surgery, three of 18 patients (17%) had a discrepancy between the ITT and the 30 minute short ACTH stimulation test and one of three between the glucagon test and the 30 minute short ACTH stimulation test. Combined together, pre-operatively, four of 21 patients (19%) had discrepant results. In the early post-operative period, the discrepancy between ITT and the 30 minute short ACTH stimulation test was higher with four of 16 patients (25%) showing discordant results; one of the five patients tested had a discrepancy between the glucagon test and the 30 minute short ACTH stimulation test. On combining the tests, the post-operative discrepancy was five of 21 patients (24%). CONCLUSIONS: The 250 microgram short ACTH stimulation test produces discordant results from the ITT in a clinically significant proportion of affected patients when assessing the HPA axis, although the rate of discordance varies according to the criteria used for normality for both the tests. We suggest that the ITT should remain the preferred test for assessing ACTH secretory capacity compared with the standard 250 microgram short ACTH stimulation test, both in the preoperative and in the early post-trans-sphenoidal hypophysectomy period.

Adenoma↗
PubMed1999

A study on the equivalence of olive oil and the EU official substitute test media for migration testing at high temperatures.

As a consequence of an increasing awareness and findings about the technical and analytical difficulties related to the employment of triglycerides as fatty food simulants in migration testing, EU Directive 82/711/EEC on the basic rules of migration has been amended for the second time and adapted with the recent Commission Directive 97/48/EC. The major merit of this important amendment is to authorize alternative tests such as extraction tests and to allow substitute tests for the fat test with concrete indication of corresponding test conditions to be applied. As a novelty in food law compliance testing it authorizes a modified polyphenylene oxide (MPPO), well-known as Tenax, a thermostable and highly adsorptive porous polymer, as a 'solid' matrix to substitute fat simulant D at temperatures equal to or higher than 100 degrees C. In the study presented here, comparative migration testing--overall and specific--was carried out between fat simulants olive oil and 14C-labelled HB 307 and the substitute test media iso-octane, 95% ethanol and MPPO using polypropylene materials as examples at test temperatures of 100 degrees C to 120 degrees C and prescribed corresponding substitute test conditions. As a consequence, a number of conclusions were drawn which are relevant for overall and/or specific migration testing under the investigated test conditions. One of the major findings was that MPPO was generally more equivalent to the fat test than the other two substitute test media. The presence of volatile hydrocarbons in the test samples was found to play a crucial role with respect to the equivalence of the iso-octane-based substitute test. At high volatile concentrations in the test sample the iso-octane test underestimated the olive oil benchmark whereas low volatile concentrations led to satisfying equivalence. It is therefore recommended that the procedure is modified and GC-FID screening of the isooctane extract is carried out. As a logical consequence, the possibility of quantitative determination of the overall extract by GC-FID is recommendable and should be investigated in more depth. Concerning the overall migration test procedure in olive oil, the vacuum pre-conditioning at 60 degrees C should be given re-consideration to avoid the possibility of loss of volatile migrants whose determination should be within the scope of the overall migration test method itself. Finally, the specific migration related equivalence between olive oil, MPPO and iso-octane needs further investigations to clarify the net effect of strongly increased diffusion rates at the regular high temperature versus the substitute test solvent accelerated extraction effect at 60 degrees C. Stability aspects of migrants at the different test temperatures deserve further consideration.

Chromatography, Gas↗
PubMed1997

On-site HIV testing in resource-poor settings: is one rapid test enough?

OBJECTIVE: To determine the feasibility, accuracy and cost-effectiveness of a rapid, on-site, HIV testing strategy in a rural hospital, and to assess its impact on test turnaround time and the proportion of patients post-test counselled. DESIGN: Prospective comparison of two testing strategies [double rapid test on-site versus central enzyme-linked immunosorbent assay (ELISA)-based testing], and an economic evaluation. SETTING: Hlabisa Hospital, a rural South African district hospital. PATIENTS: A total of 454 consecutive adult inpatients requiring and consenting to HIV testing as part of their clinical management. MAIN OUTCOME MEASURES: Concordance between rapid tests, and between the rapid and ELISA strategies, test turnaround time, proportion of patients post-test counselled, and cost-effectiveness. RESULTS: HIV seroprevalence was 49.6%. Both rapid tests were concordant in all patients [one-sided 95% confidence interval (CI) of probability, 99.3-100]. The rapid strategy was 100% sensitive (95% CI, 97.9-100) and 99.6% specific (95% CI, 97.2-100) compared with the ELISA strategy. The mean interval between ordering a test and post-test counselling fell from 21 days prior to the introduction of the rapid test strategy to 4.6 days after its introduction (P < 0.00001). The proportion of patients post-test counselled increased to 96% from 17% after the introduction of the rapid test strategy (P < 0.00001). By using a double rapid test strategy the cost per patient post-test counselled was almost halved to US$ 11. Accuracy of the rapid strategy was not substantially increased by performing two tests. CONCLUSION: In high prevalence, resource-poor settings, rapid, on-site HIV testing is feasible, accurate and highly cost-effective, substantially increasing the number of patients post-test counselled. A single rapid test may be sufficient.

AIDS Serodiagnosis↗
PubMed1994

Toxicity testing of polymer materials for dialysis equipment: is there any need for in vivo testing?

In an earlier work, slightly more than 650 plastic materials, intended for use in medical devices, were tested with a battery of chemical, as well as in vitro and in vivo biological tests. An analysis showed that only a limited number of the tests used were actually necessary to obtain the same pass or fail decision as that obtained using the full test battery. This prompted us to prescreen all new materials with a small test battery consisting of the two most discriminating chemical tests and an in vitro cell growth inhibition test. The present work is a report of our findings after testing another 155 materials using this prescreen system. For each single one of the 155 tested materials the same decision on whether or not to use the material in the intended medical device would have been reached without any in vivo testing. In no single case in a total of 851 in vivo tests did an eluate that had passed the in vitro cell test give rise to a reaction in vivo. Thus, among the tests on living systems, the cell test alone seems to be sensitive enough to provide sufficient information. Nothing appears to be gained from the in vivo animal tests. However, some of the materials that passed the prescreening tests later failed in one or several of the chemical tests. Both nonspecific chemical tests and tests for specific molecules seem to detect undesirable levels of leachable substances not detected by the prescreening system. Therefore these tests should not be abandoned. Abandoning unnecessary in vivo testing, on the other hand, would save considerable costs.

Animals↗
PubMed2001

Use of ESAT-6 in the interferon-gamma test for diagnosis of bovine tuberculosis following skin testing.

The whole blood interferon-gamma (IFN-gamma) test has proven to be a practical ancillary test for re-testing cattle for bovine tuberculosis 8-28 days following tuberculin skin testing. An improvement in the specificity of the IFN-gamma test could further reduce culling of false positive animals. The primary aim of this study was to evaluate a single mycobacterial antigen, ESAT-6 in the IFN-gamma test for use in skin test-positive cattle. These skin test-positive cattle comprised 51 Mycobacterium bovis-infected animals from tuberculosis-infected herds and 85 non-infected animals from tuberculosis-free herds. The test based on ESAT-6 had a higher specificity than the test based on purified protein derivative (PPD) tuberculin, but this was offset by a small decrease in sensitivity. Use of a lower cut-off in the ESAT-6-based test improved the sensitivity, while still maintaining a very high specificity. A secondary aim in the study was to assess the ESAT-6 and PPD-based tests for detecting bovine tuberculosis in skin test-negative animals from a persistently infected herd. The PPD-based test detected the majority of the lesioned or M. bovis-culture positive animals, while the ESAT-6-based test detected a smaller proportion. The false negatives in the IFN-gamma test from both the skin test-negative and positive groups were predominantly M. bovis-culture positive animals with no visible lesions. The current study has shown that a defined specific antigen such as ESAT-6 can markedly improve the specificity of the IFN-gamma test for re-testing skin test-positive animals. An ESAT-6-based IFN-gamma test could be particularly useful to reduce the false positive rate, yet still maintain an acceptable level of sensitivity.

Animals↗
PubMed1991

Quantitative antimicrobial susceptibility testing of Haemophilus influenzae and Streptococcus pneumoniae by using the E-test.

The E-test (PDM Epsilometer; AB Biodisk, Solna, Sweden) is an antimicrobial agent gradient-coated plastic test strip which allows MIC determinations on agar media. The test is performed in a manner similar to the agar disk diffusion procedure. A collection of Haemophilus influenzae and Streptococcus pneumoniae strains possessing various resistance mechanisms was used to evaluate the E-test method. H. influenzae strains were tested with both Haemophilus test medium (HTM) and PDM ASM II chocolate agar, while the S. pneumoniae strains were tested on Mueller-Hinton sheep blood agar. E-test MICs for a total of 10 antimicrobial agents were compared with broth microdilution MICs determined according to National Committee for Clinical Laboratory Standards methods. In general, E-test MICs for both species were quickly and easily interpreted and agreed within one log2 MIC increment in 89.8% of tests with H. influenzae and in 80.4% of pneumococcal tests. The majority of disagreements between the E-test and conventional MICs occurred with trimethoprim-sulfamethoxazole because of trailing and diffuse E-test MIC endpoints with both species. Ampicillin MICs for beta-lactamase-producing H. influenzae determined by the E-test differed at times from those determined by conventional testing because of the vagaries of interpreting colonies growing within the E-test inhibition ellipses. E-test penicillin MICs for pneumococci tended to be 1 to 2 log2 dilutions lower than those determined by using Mueller-Hinton broth supplemented with lysed horse blood. Nevertheless, strains of both species with documented resistance to the study drugs were detected by E-tests, i.e., 0.7% of the tests had very major errors with H. influenzae and 0.8% had very major errors with S. pneumoniae. Thus, the E-test represents a potential alternative method for antimicrobial susceptibility testing of these two fastidious bacterial species.

Culture Media↗
PubMed1993

Comparison of the fluorescent treponemal antibody absorption (FTA-ABS) test with the FTA-ABS double staining test for detection of antitreponemal immunoglobulin M in the 19S fraction of human serum.

A widely used immunoglobulin M (IgM) detection assay for the diagnosis of neonatal congenital syphilis is the fluorescent treponemal antibody absorption test used with fractionated serum (FTA-ABS 19S IgM test). Reading the results of the FTA-ABS test is more cumbersome than reading those of the FTA-ABS double staining (FTA-ABS-DS) test, a confirmatory test for specific IgG. To verify that the FTA-ABS-DS test used with an anti-human IgM conjugate could detect specific IgM in fractionated serum samples (FTA-ABS-DS 19S IgM test), 164 fractionated (QUIK-SEP IgM Isolation System; ISOLAB, Inc., Akron, Ohio) serum specimens from infected neonates or adults or from IgG-seronegative subjects were tested by both techniques. The sensitivity limits of the two tests were assessed with reactive serum samples diluted to an endpoint titer. Samples nonreactive by the FTA-ABS 19S IgM test (n = 74) were either nonreactive (n = 65), minimally reactive (n = 5), or reactive (n = 4) by the FTA-ABS-DS 19S IgM test. Samples minimally reactive by the FTA-ABS 19S IgM test (n = 32) were minimally reactive (n = 1) or reactive (n = 31) by the double staining test. All samples reactive by the FTA-ABS 19S IgM test (n = 58) were also reactive by the FTA-ABS-DS 19S IgM test. There was a directly proportional linear relationship (r = 0.9794) between titers obtained by both tests. FTA-ABS-DS 19S IgM titers were constantly equal to or higher than FTA-ABS 19S IgM titers. Fluorescence intensity reading repeatability was 91.4% for the FTA-ABS-DS 19S IgM test and 81.7% for the FTA-ABS 19S IgM test (P = 0.015). Because the more easily read FTA-ABS-DS 19S IgM test is at least as sensitive as, if not more sensitive than, the FTA-ABS 19S IgM test, it is a good alternative to the latter test for the detection of specific IgM in human fractionated sera for those using fluorescence microscopes with incident light.

Adult↗
PubMed2000

Simplified 13C-urea breath test for the diagnosis of Helicobacter pylori infection--the availability of without fasting and without test meal.

The conventional 13C-urea breath test (13C-UBT) for detecting Helicobacter pylori infection was performed during fasting state and with a test meal to delay gastric emptying during the test. For the convenience of propagating this test, we assessed the availability of non-fast and without test meal in 13C-UBT for the diagnosis of H. pylori infection. One hundred and five consecutive patients who received endoscopic examination were studied. All of them received endoscopic biopsy for urease test, culture and histopathology to determine whether there was a presence of H. pylori infection. Each patient received four separate 13C-UBT under the following four testing conditions. Test I) fasting state with test meal (100 ml fresh milk), Test II) non-fast (taking usual food) but with test meal, Test III) fasting state without test meal, and Test IV) non-fast and without test meal. The excess delta 13CO2 values were calculated via the breathed samples that were collected at 15 minutes after ingestion of 13C-urea. There were 61 H. pylori positive and 44 negative patients in this study, with an excess delta 13CO2 values 3.0, 4.0, 3.5 and 4.0 as a cut-off value in the four tests respectively, according to the ROC curve. The results of test I, a conventional procedure, had a good correlation with the gold standard. The sensitivity and specificity were 100% and 95% respectively. The alternative procedures in other tests also have high sensitivity and specificity at 15-minute detecting time. The sensitivity of the tests II, III and IV at 15-minute detecting times were 98%, 98% and 100%, and the specificities of those were 95%, 98% and 95% respectively. We therefore suggest that fasting and test meal possibly be omitted when the cut-off value is 4.0 per mil in the simplified 13C-UBT (non-fast and without test meal, and detection at 15 minutes after ingestion of 13C-urea) which is a simple and available procedure for clinical diagnosis of H. pylori infection.

Adult↗
PubMed1993

Attitudes toward direct predictive testing for the Huntington disease gene. Relevance for other adult-onset disorders. The Canadian Collaborative Group on Predictive Testing for Huntington Disease.

OBJECTIVE: To assess attitudes toward, and projected utilization of, direct mutation testing by individuals at risk for Huntington disease (HD). DESIGN: Prior to the cloning of the gene for HD, a questionnaire concerning the use of a definitive test was constructed and mailed to 354 participants in the Canadian Collaborative Study for HD. Completed questionnaires were received from 250 participants (response rate, 71%). Persons were asked to indicate whether they would participate in a new predictive test that was either 100% accurate (the definitive test, requiring blood only from the proband) or only 99% accurate. RESULTS: Most (72%) of the persons who had previously received a result in a predictive testing program said they would request testing in either situation. Significantly more persons would request the definitive test than the 99% accurate test (72% vs 58%; P < .02). Respondents for whom testing was uninformative in the linkage test program or who had previously received an increased-risk result were more likely to indicate they would use the test than those who received a decreased-risk result or chose not to have the original test (P = .0003). Less than half (46%) of the participants who initially chose not to have the linkage test said they would return for the new direct test. The major factor that has limited acceptance of predictive testing for this group is the concern about receiving an increased-risk result in the absence of any therapy to alter progression of the disease. CONCLUSIONS: A direct mutation test for HD will most readily be accepted by persons who wanted but could not previously receive a result in the linkage test program and those who previously received an increased-risk result. In the absence of therapy, the majority of persons who previously chose not to have predictive testing are unlikely to participate in a new test despite improved accuracy. This has implications for the expected demands for testing services for other adult-onset genetic disorders.

Attitude to Health↗
PubMed2001

Reliability of the lateral pull test and tilt test to assess patellar alignment in subjects with symptomatic knees: student raters.

STUDY DESIGN: Test-retest reliability with blinded testers. OBJECTIVES: To determine the inter- and intra-rater reliability of the lateral pull test and patellar tilt test. BACKGROUND: If patellar malalignment can be detected by clinical examination, then condition-specific treatment interventions may be implemented in patients with patellofemoral pain syndrome. However, several clinical tests used to assess patellar mobility have recently been shown to have poor to fair reliability. Because the lateral pull test and the patellar tilt test are widely used clinically as diagnostic tests for patellofemoral pain syndrome but have not been previously tested for reliability, we examined these tests. METHODS AND MEASURES: Fifty-two subjects (age range, 21-48 years) provided 95 knees (19 symptomatic and 76 asymptomatic) for assessment of the lateral pull test. Two testers, blinded to the presence or absence of symptoms, independently performed the lateral pull test in random order. Fifty-five subjects (age range, 22-42 years) provided 99 knees (73 asymptomatic and 26 symptomatic) for assessment of the patellar tilt test. Three blinded testers independently performed the patellar tilt test in random order. All subjects were tested and retested within 3-5 days. A kappa (kappa) statistic was used to assess the agreement of findings within each tester and between testers. RESULTS: The kappa coefficients for intrarater reliability varied from 0.39 to 0.47 for the lateral pull test and from 0.44 to 0.50 for the patellar tilt test, while the coefficients for interrater reliability were 0.31 for the lateral pull test and varied from 0.20 to 0.35 for the tilt test. CONCLUSIONS: Repeated lateral pull tests and patellar tilt tests had fair intrarater and poor interrater reliability. Our results suggest that care must be taken in placing too much emphasis on these tests when making clinical decisions.

Adult↗
PubMedDate not supplied

[Gel agglutination test--a new test system for semiquantitative detection of feto-maternal transfusion in Rhesus incompatibility].

BACKGROUND: The postpartum administration of an adequate amount of anti-D immunoglobulin to the mother in cases of Rhesus incompatibility requires the exact quantification of the amount of Rh-positive fetal cells that may be present in the Rh-negative maternal circulation. The classical methods to detect an intrapartum fetomaternal hemorrhage are either time-intensive (such as the Kleihauer-Betke test), of low specificity (such as the indirect Coombs test), or technically cumbersome (such as flow cytometry). The goals of our study were to develop a simple screening test that may be used routinely to quantify fetomaternal hemorrhage in cases of Rhesus incompatability and to evaluate this test in clinical practice. STUDY DESIGN AND METHODS: In cases of Rhesus-negative mothers of Rhesus-positive neonates, 2.5 ml of maternal Rhesus negative blood was sampled in an EDTA tubes immediately postpartum and was incubated with anti-D antibodies. Thereafter, a semiquantitative determination was made of the amount of antibody that remained unbound in the serum via a gel agglutination test (GAT) (DiaMed., Switzerland) after mixing with test red blood cells. The amount of anti-D consumed (bound to fetal cells in the first phase) is the semi-quantitatively indicated by the degree of positivity in the second phase the weaker reaction--the more anti-D absorbed in the first phase--the more Rhesus-positive fetal cells present in the maternal sample--the larger the fetomaternal hemorrhage. Following the development of a discrimination zone using this GAT which could ascertain an Rhesus-positive erythrocyte concentration of over 0.2%, the test was applied in a clinical setting. Between September 1995 and April 1998 in unselected postpartum blood samples from 603 Rhesus negative parturients, the GAT was used to test the same blood samples as those requiring evaluation for HbF concentration using the traditional Kleihauer-Betke test. RESULTS: In 585 of the 603 cases (97%) there was no evidence of a fetomaternal transfusion following testing using both methods. Furthermore, both tests showed significant evidence for a fetomaternal transfusion in five cases. The Kleihauer-Betke test was false-positive in three cases of mothers who had a hereditary elevation of the HbF concentration. The GAT showed three false-positive reaction due to a Dweak maternal varient. In two cases, the disparity between the GAT and the Kleihauer-Betke test could be attributed to an antecedant dose of anti-D antibody. In the two cases, the Kleihauer-Betke test results were 0.3% while the GAT was only 0.2%. CONCLUSION: The GAT may be used as a screening method in routine clinical practice. This is a quick test that allows for the specific determination and semiquantitative evaluation of the Rh-positive erythrocyte concentration in clinically relevant concentrations. Thus, following a positive GAT screening test, a further specific test such as the Kleihauer-Betke test may be utilized to absolutely quantify the amount of blood transfused from fetus to mother. It is also possible to perform such a quantification test with the GAT by eventually using a diluted maternal blood sample.

Female↗
PubMed1999

Fingerstick Helicobacter pylori antibody test: better than laboratory serological testing?

OBJECTIVE: Antibody testing is the recommended method to screen for Helicobacter pylori (H. pylori) infection. Whole-blood fingerstick antibody tests are simple, in-office tests providing rapid results, but the accuracy of first-generation tests was lower than other diagnostic tests. We assessed a new whole-blood antibody test, using endoscopic biopsy tests as a "gold standard," and compared it with a laboratory quantitative serological test. METHODS: Two hundred-one patients not previously treated for H. pylori who were undergoing endoscopy had gastric biopsies for rapid urease test and histological examination; whole-blood antibody tests and quantitative serological tests were also performed. Two separate gold standards for H. pylori infection were employed: either rapid urease test or histological exam positive; and both rapid urease test and histological exam positive. RESULTS: Sensitivities for whole-blood test versus quantitative serology with gold standard 1 (either biopsy test positive) were 86% versus 92% (95% confidence interval [CI] of difference, -2-14%; p = 0.19) and specificities were 88% versus 77% (95% CI of difference, 0.4-22%; p = 0.052). Sensitivities with gold standard 2 (both biopsy tests positive) were 90% versus 94% (95% CI of difference, -4-12%; p = 0.41) and specificities were 79% versus 67% (95% CI of difference, 1-24%; p = 0.048). CONCLUSIONS: New generation in-office, whole-blood antibody tests that can achieve a sensitivity and specificity similar to or better than those of widely used quantitative laboratory serological tests may be used as the initial screening tests of choice for H. pylori.

Adult↗
PubMed1994

Stereopsis testing without polarized glasses: a comparison study on five new stereoacuity tests.

BACKGROUND: Stereopsis testing is commonly used to assess the presence and level of binocular vision. A new series of stereopsis tests requiring no polarized goggles are available in the form of the Titmus Stereo Test, the Stereo Reindeer Test, the Random Dot Butterfly, the Random Dot Figures, and the Random E, Circle, Square. These polarized-free tests employ a special prismatic printing process creating a panagraphic presentation, i.e., a separate image is presented to each eye without the need for polarization. The purpose of this study was to compare the polarized-free stereo tests with their traditional polarized counterparts. METHODS: Thirty four subjects, including several persons with strabismus, ages 10-35 years, were each tested with the polarized and polarized-free versions of the Titmus, Reindeer, Butterfly, and Figures. Twenty nine of these subjects were tested with the Random Dot E. Half the subjects were tested first with polarized-free and half were tested first with polarized tests. Tests were performed according to manufacturer instructions by the same examiner in clinical settings. RESULTS: The results (matched pair ranked correlation coefficients) indicate that the polarized-free tests were highly correlated (r = 0.997, r = 0.998, r = 0.997, r = 1.00, and r = 1.00 respectively) with the polarized comparison tests. No significant difference (Wilcoxon Ranked Sign) in the stereopsis level was obtained between the two versions of the tests. CONCLUSIONS: We conclude that these five polarized-free tests were just as valid in measuring the subjects' stereopsis as their traditional polarized version. The use of goggle-free testing has potential clinical advantages, e.g., testing of young children who will not wear the glasses or the improved observation of the ocular alignment during stereopsis testing.

Adolescent↗
PubMed1975

[Changes in responsivity to TRH test and T3-suppression test after surgical treatment of hyperthyroidism (author's transl)].

TRH test and T3 suppression test were performed on patients with Graves' disease who underwent subtotal thyroidectomy after treatment with antithyroid drugs for 2.5 approximately 5 months. On 43 or the patients, TRH test was performed before, 1 week after and 1 approximately 2 months after surgery and T3 suppression test was also performed in 1 approximately 2 months post-operative period. For other 3 groups of the patients TRH test was performed at 2 approximatley 6 months, 6 approximately 12 months, 12 approximately 24 months and 24 approximately 41 months after surgery, and T3 suppression test was also performed just after each TRH test. As to TRH test, the response was defined as positive when basal TSH value was less than 2.0 muU/ml and peak value was more than 6.2 muU/ml or the difference between basal TSH and peak TSH value was over 5 muU/ml following TRH (500 mug) injection. T3 suppression test was perfomed by measuring the 24-hr thyroidal uptake of radioiodine after daily administration of 75 mug of T3 for 8 days. The response was defined as positive when the value for 24-hr uptake after T3 administration was less than half of the control value. The results were as follows; (1) In 11 of 43 patients, response to TRH test already changed to positive 1 week after operation and in 21 of 43 patients TRH test changes to positive 1 approximately 2 months after operation. (2) In general, response to TRH test changed to positive earlier than response to T3 suppression test. (3) T3 suppression test in 1 approximately 2 months after operation was useful to evaluate prognosis. (4) A half of the positive respondents to TRH test showed exaggerated response. (5) Basal TSH value of positive respondents to TRH test was 9.27 +/- 1.81 muU/ml (mean +/- SE) which exceeded the normal range. (6) Some patients showed negative response to conventional T3 suppression test despite of their high basal TSH value. This might be due to the insufficient dose of T3 to suppress TSH. (7) Concerning patients whose serum T3-RU, T4, T3 and TSH were within normal limit after subtotal thyroidectomy, 80% of them showed correspondance in the results of TRH test and T3 suppression test.

Adolescent↗