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At least 55 records · Page 3Linked to original sources
PubMed1998

Electropotential measurements as a new diagnostic modality for breast cancer.

BACKGROUND: Proliferative changes in breast epithelium are an intrinsic aspect in the development of breast cancer, and result in regions of epithelial electrical depolarisation within the breast parenchyma, which can extend to the skin surface. Diagnostic information might be obtained from a non-imaging and non-invasive test based on skin-surface electropotentials. METHODS: In 661 women, scheduled for open biopsy at eight European centres, we studied whether measurements of breast electrical activity with surface sensors could distinguish benign from malignant breast disease. A depolarisation index was developed. RESULTS: We found a highly significant trend of progressive electrical changes according to the proliferative characteristics of the biopsied tissue. Discriminatory information was obtained in both premenopausal and postmenopausal women, and the index was not related to age. The best test performances were for women with palpable lesions. The median index was 0.398 for non-proliferative benign lesions, 0.531 for proliferative benign lesions, and 0.644 for cancer (ductal carcinoma-in-situ and invasive). A specificity of 55% was obtained at 90% sensitivity for women with palpable lesions when a discriminant based on age and the depolarisation index was used. INTERPRETATION: This new modality may have diagnostic value, especially in reducing the number of unnecessary diagnostic tests among women with inconclusive findings on physical examination. Understanding and control of the biological variability of these electrical phenomena will be important in the improvement of this test. Studies in populations with a lower cancer prevalence are needed to assess further the diagnostic value of this approach.

Adolescent↗
PubMed1999

Study of diagnostic modalities and pathology of Helicobacter pylori infection in children.

To evaluate various diagnostic tests for Helicobacter pylori (Hp) in children, and to study the spectrum of endoscopic and histological changes in the stomach and duodenum of children with gastroduodenal disorders, associated with Hp infection Children below 12 years of age with various gastroduodenal disorders requiring upper gastrointestinal endoscopy were studied. Endoscopic biopsy specimens were collected from duodenum and antrum. Apart from histopathological examination of biopsy material, rapid urease test (RUT) of the antral biopsy specimen and blood examination to estimate specific IgG antibodies to Hp by Indirect Solid Phase Enzyme Immunoassay was performed. Forty seven children were included. Nine (19.1%) of them were positive both by serology and RUT. Seven (14.9%) were positive by histology. A significant correlation of Hp was noticed with chronic antral gastritis (p = 0.002) and chronic duodenitis (p = 0.006). Age equal to or more than 10 years was found to be significant risk factor for acquiring Hp infection. Prevalence of Hp in children with gastroduodenal complaints was found to be 19%. Both RUT and serology were found to be reliable diagnostic tests for Hp as compared with histology. Antral gastritis and chronic duodenitis had a significant correlation with Hp colonization.

Child↗
PubMed1999

Rupture of silicone gel filled testicular prosthesis: causes, diagnostic modalities and treatment of a rare event.

PURPOSE: Rupture of the envelope of silicone gel filled testicular prostheses is rare and alleged to be unlikely without intraoperative needle puncture. We observed that it may be caused by chronic intermittent trauma or a single acute increase of pressure, and report diagnostic and therapeutic modalities. MATERIALS AND METHODS: Four cases treated by us during the last 10 years are presented. One patient had testicular implants for Klinefelter's syndrome, whereas the other 3 had been treated for female-to-male transsexualism. Diagnosis was confirmed by ultrasonography and magnetic resonance imaging. The fibrous capsule surrounding the ruptured prosthesis was left intact to allow en bloc surgical extirpation. Histological evaluation of the resected specimen was performed. RESULTS: Rupture of silicone gel filled testicular implants may be caused by acute or chronic pressure without intraoperative needle puncture. CONCLUSIONS: Magnetic resonance imaging offers superior diagnostic accuracy and should be regarded the gold standard in the evaluation of implant rupture. Ultrasonography is an acceptable alternative. In cases when gross symptoms of scrotal inflammation are lacking replacement of implants is facilitated by the fibrous capsule that forms around any prosthesis. Transcapsular migration of silicone particles was observed even when the fibrous capsule was intact.

Adult↗
PubMed1999

Advances in echocardiographic diagnostic modalities for the pediatrician.

Two-dimensional Doppler echocardiography has become the primary diagnostic tool in the assessment of infants and children with congenital and acquired heart disease. Over the past 10 years, specialized echocardiographic techniques have also become critical components in the evaluation and treatment of these patients. Using fetal echocardiography enables us to image the heart early in gestation and have begun to understand those lesions that can develop and progress in utero. Transesophageal echocardiography has allowed you to image the patient with congenital heart disease during repair in the operating room and in the cardiac catheterization laboratory so that adequacy of the repair can be assess and any residual lesions addressed immediately. Both of these specialized techniques are discussed in detail, with a brief overview at the three-dimensional future of echocardiography in the pediatric patient.

Cardiac Catheterization↗
PubMedDate not supplied

Diagnostic modalities for the evaluation of anomalous left main coronary arteries.

Anomalous coronary arteries are rare and usually identified as an incidental finding during cardiac catheterization. The particular difficulty with cardiac catheterization techniques is not necessarily the presence of the anomalous coronary artery, but its anatomic course. Oftentimes, surgical intervention is necessary once these anomalies are discovered. The identification and anatomic characterization of anomalous coronary arteries has been significantly advanced with the use of current diagnostic noninvasive imaging modalities. We present 3 cases of an anomalous left main coronary artery that arises from the right sinus of Valsalva. Noninvasive imaging methods provided a clear anatomic course of the anomalous vessel.

Adult↗
PubMed2004

A review of potential new diagnostic modalities for caries lesions.

This paper aims to present a simple overview of potential new diagnostic methods for dental caries. There are several novel methods of caries detection (with potential application to diagnosis) which have been proposed in the last few years, in addition to those that are gaining some commercial exposure and clinical acceptance. For the most part, these methods have been demonstrated in laboratories and are generally many years away from routine clinical application. They include multi-photon imaging, infrared thermography and infrared fluorescence, optical coherence tomography, ultrasound, and terahertz imaging.

Dental Caries↗
PubMed1977

Diagnosis of sellar and parasellar lesions by computed tomography and other diagnostic modalities.

A review of 5,000 computed tomographic (CT) brain scans revealed 76 patients with proved pathology involving the sellar and parasellar areas. The overall diagnostic accuracy of CT scanning was 93.4%, whereas the accuracy of isotope scanning, angiography, and pneumoencephalography was 55.4, 81 and 100% respectively. The criteria used in making the diagnosis with CT scanning are listed. The results indicate that CT scanning is the initial diagnostic procedure of choice, but that other modalities, particularly angiography, are still required for more accurate evaluation in the majority of cases.

Cerebral Angiography↗
PubMed1991

Diagnostic modalities in abdominal trauma. Peritoneal lavage, ultrasonography, computed tomography scanning, and arteriography.

Numerous algorithms encompassing the diagnostic studies described above have been published in recent years. For practical purposes, diagnostic peritoneal lavage and CT scanning are the diagnostic studies most commonly used in patients without obvious indications for celiotomy after blunt or penetrating abdominal trauma. Diagnostic peritoneal lavage is invasive, rapidly performed, cheap, and accurate and has a primary role in documenting intra-abdominal bleeding or contamination in hypotensive patients with blunt trauma or selected stable patients with penetrating stab wounds. It misses small and large injuries to the diaphragm and cannot rule out injury to retroperitoneal structures. Computed tomography is noninvasive, time consuming to perform, expensive, and accurate and has a primary role in defining the location and magnitude of intra-abdominal injuries in stable patients with blunt trauma or with penetrating trauma to the flank or back. In many hospitals, it misses gastrointestinal perforations or ruptures. Both studies may be needed in the same stable patient, and both should be available and used in a complementary fashion in the modern trauma center.

Abdominal Injuries↗
PubMed2005

Evolving diagnostic modalities in inflammatory bowel disease.

Over the past several years, significant advances have been made in the diagnostic techniques used in the management of ulcerative colitis and Crohn's disease. These advances have occurred mainly in the area of gastrointestinal endoscopy and radiology. Capsule endoscopy and double-balloon endoscopy have permitted better visualization of the small bowel mucosa. Advanced imaging techniques, including chromoendoscopy, magnification endoscopy, confocal endomicroscopy, and spectroscopy, may aid in the diagnosis of colorectal neoplasia in patients with long-standing disease. Improved radiographic imaging techniques based on computed tomography and magnetic resonance imaging allow noninvasive means of evaluating the small bowel in patients with known or suspected Crohn's disease. Finally, positron emission tomography is an investigative tool for inflammatory bowel disease that may also aid in the detection of inflammation in these diseases.

Colonography, Computed Tomographic↗
PubMed1986

Infectious retinitis. Diagnostic modalities.

Advances in surgical techniques have made vitreoretinal and sclerochorio-retinal biopsies part of the available diagnostic armamentarium of the ophthalmologist. Special studies can be performed on tissue obtained in this way in order to provide a specific etiologic diagnosis of virus associated pathology. The advantages and disadvantages of immunopathologic and ultrastructural methods, tissue culture, and nucleic acid hybridization techniques for viral identification are compared and discussed.

Culture Techniques↗
PubMed2000

Spontaneous subcapsular and intrarenal hematoma demonstrated by various diagnostic modalities and monitored by ultrasonography until complete resolution.

A patient with acute right abdominal pain and nausea underwent various diagnostic imaging studies, including ultrasonography (US), computed tomography (CT), magnetic resonance imaging (MRI), technetium-99m DTPA renal study, and contrast arteriogram. The 99mTc renal study showed a linear photopenic area along the lateral cortical aspect of the right kidney and a focal cortical defect in the left kidney. These lesions corresponded to the findings of US, CT, MRI, and contrast angiography. Because of a suspected malignant mass, a CT-guided aspiration biopsy of the right kidney was performed that resulted in bloody fluid without malignant cells. The patient's condition was diagnosed as intrarenal and subcapsular renal hematoma. The patient was treated conservatively and followed up with CT and US studies. Sequential CT and US demonstrated gradual reduction of the size of the hematoma, and complete resolution was confirmed by US 1.5 years later. As long as underlying pathology can be ruled out, conservative management of spontaneous renal subcapsular hematoma is recommended.

Aged↗
PubMed2001

[Diagnostic modalities of endometrial ultrasonography in women with irregular bleeding in menopause].

UNLABELLED: The aim of the present study was to investigate the diagnostic possibilities of the endovaginal sonography for the assessment of the state of the endometrium in women with irregular bleeding in climax. MATERIALS AND METHODS: Fifty women between 40 to 60 years (mean 47.8) with irregular genital bleeding were investigate. Using transvaginal ultrasound, anterior-posterior, length and width dimensions of the uterus were measured and echostructure of the endometrium was defined. The dilatation and curettage of endometrial cavity was performed subsequently. RESULTS AND DISCUSSION: The histological examination of the curettage material shows - normal endometrium in 15 women, cystic hyperplasian in 16, atrophic endometrium in 11, atypical hyperplasia in 5 and endometrial cancer in 3 women. The correlation of these findings with the results from ultrasound investigation shows, that the degree of the endometrial thickness play a role as a criteria to establish the diagnostic protocol. CONCLUSION: The summarized data from our study shows, that in the limit of 8 mm, the diagnostic accuracy of the method - sensitivity - 75% specificity - 73.8% amd efficacy - 74% give us cause to recommend the transvaginal sonography of the endometrium in women in climax, as a screening tool in the diagnostic protocol for endometrial cancer.

Adult↗
PubMed2005

A meta-analysis of the yield of capsule endoscopy compared to other diagnostic modalities in patients with obscure gastrointestinal bleeding.

OBJECTIVES: Due to its superior ability to examine the entire small bowel mucosa, capsule endoscopy (CE) has broadened the diagnostic evaluation of patients with obscure gastrointestinal bleeding (OGIB). Published studies have revealed a numerically superior performance of CE in determining a source of OGIB compared with other modalities, but due to small sample sizes, the overall magnitude of benefit is unknown. Additionally, the types of lesions more likely to be found by CE versus alternate modalities are also unknown. The aim of this study was to evaluate the yield of small bowel findings with CE in patients with OGIB compared to other modalities using meta-analysis. METHODS: We performed a recursive literature search of prospective studies comparing the yield of CE to other modalities in patients with OGIB. Data on yield and types of lesions identified among various modalities were extracted, pooled, and analyzed. Incremental yield (IY) (yield of CE-yield of comparative modality) and 95% confidence intervals (95% CI) of CE over comparative modalities were calculated. RESULTS: A total of 14 studies (n = 396) compared the yield of CE with push enteroscopy for OGIB. The yield for CE and push enteroscopy was 63% and 28%, respectively (IY = 35%, p < 0.00001, 95% CI = 26-43%) and for clinically significant findings (n = 376) was 56% and 26%, respectively (IY = 30%, p < 0.00001, 95% CI = 21-38%). Three studies (n = 88) compared the yield of CE to small bowel barium radiography. The yield for CE and small bowel barium radiography for any finding was 67% and 8%, respectively (IY = 59%, p < 0.00001, 95% CI = 48-70%) and for clinically significant findings was 42% and 6%, respectively (IY = 36%, p < 0.00001, 95% CI = 25-48%). Number needed to test (NNT) to yield one additional clinically significant finding with CE over either modality was 3 (95% CI = 2-4). One study each compared the yield of significant findings on CE to intraoperative enteroscopy (n = 42, IY = 0%, p= 1.0, 95% CI =-16% to 16%), computed tomography enteroclysis (n = 8, IY = 38%, p= 0.08, 95% CI =-4% to 79%), mesenteric angiogram (n = 17, IY =-6%, p= 0.73, 95% CI =-39% to 28%), and small bowel magnetic resonance imaging (n = 14, IY = 36%, p= 0.007, 95% CI = 10-62%). Ten of the 14 trials comparing CE with push enteroscopy classified the types of lesions found on examination. CE had a 36% yield for vascular lesions versus 20% for push enteroscopy, with an IY of 16% (p < 0.00001, 95% CI = 9-23%). Inflammatory lesions were also found more often in CE (11%) than in push enteroscopy (2%), with an IY of 9% (p= 0.0001, 95% CI = 5-13%). There was no significant difference in the yield of tumors or "other" findings between CE and push enteroscopy. CONCLUSIONS: CE is superior to push enteroscopy and small bowel barium radiography for diagnosing clinically significant small bowel pathology in patients with OGIB. In study populations, the IY of CE over push enteroscopy and small bowel barium radiography for clinically significant findings is >or=30% with an NNT of 3, primarily due to visualization of additional vascular and inflammatory lesions by CE.

Barium Sulfate↗
PubMed2003

Intrinsic urethral sphincteric deficiency: critical analysis of various diagnostic modalities.

PURPOSE OF REVIEW: The proper diagnosis of intrinsic urethral sphincteric deficiency among women with urinary incontinence carries important implications for determining the most effective medical or surgical therapy. Numerous diagnostic tests have been described attempting to make an accurate and comprehensive assessment of urethral function, but all suffer from a lack of standardization or inconsistently quoted reference values. This paper will review the literature on the positive aspects and limitations of commonly employed procedures to diagnose intrinsic urethral sphincteric deficiency. RECENT FINDINGS: Specific urodynamic studies, including the 'active' valsalva leak-point pressure and the 'static' urethral pressure profile are commonly used to determine urethral competence. However, these tests measure specific aspects of the continence mechanism under different clinical conditions, which limits the direct comparison between them. More complex techniques such as Doppler ultrasound, video-urodynamics and both static and dynamic magnetic resonance imaging are attempting to validate the urodynamic findings for urethral function. This approach may encourage the standardization of these procedures and parameters for diagnosing intrinsic urethral sphincteric deficiency. SUMMARY: A single definitive test for the diagnosis of intrinsic urethral sphincteric deficiency does not exist. Instead, multiple tests should be employed to reach a consensus for the diagnosis. This should include a complete voiding history, simple office examinations, and advanced studies such as urethrocystoscopy, urodynamics and possibly radiological evaluations. Understanding the limitations and variabilities of their equipment and the specific studies utilized should enable practitioners to standardize the approach for determining the extent of urethral dysfunction.

Diagnostic Techniques, Urological↗
PubMed1993

[Diagnostic modalities and treatment of cancer of the pancreas. Evolution in the population in the department of Côte d'Or from 1976 to 1988].

There is no study establishing time trends for the diagnostic and therapeutic approaches to pancreatic cancer based on population data. The data of the Registry of Digestive Tumors of Côte-d'Or (France) were used to this end in 544 cancers diagnosed between 1976 and 1988. The proportion of the histologically confirmed cases increased annually by 13.4% (P < 0.001). This was mainly due to progress in percutaneous biopsy (+25.7% per year between 1983 and 1988, P < 0.001). As regards the diagnosis, ultrasonography was used more frequently (+21.9% per year, P < 0.001) as well as CT scan since its introduction in 1983 (+19.6% per year, P < 0.001). Pancreatic cancer was diagnosed by sonography in 16.7% of the cases in 1976 and 70.6% in 1988 (mean annual variation: +5.7%, P < 0.001). The proportions for CT scan were 12.8% in 1983 and 23.5% in 1988 (mean annual variation: +3.5%, NS). There was no significant change in the use of retrograde cholangiopancreatography over time. Other diagnosis criteria were less frequently used: laparoscopy was no longer used after 1983 and intraoperative diagnosis was made less frequently (-2.5% per year, P < 0.001). Endoscopy or radiographic data were rarely used as a diagnosis criterion. These changes in approaches to the diagnosis of pancreatic cancer were not accompanied by any progress in diagnosis stage, therapeutic approach or survival suggesting that when clinical symptoms become evident, pancreatic cancer is already advanced. Therapeutic advances, early diagnosis in patient at risk or identification or reasons for pancreatic cancer are the only means of progress in this problem.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1981

Osteoid osteoma: an evaluation of diagnostic modalities.

Significant delays still occur in the diagnosis of osteoid osteoma yet in two-thirds of cases the plain films show the characteristic features; unfortunately, early changes may be overlooked. A diagnostic approach is proposed for the investigation of focal bone pain in young individuals. Plain radiography is followed by isotope bone scanning with, if possible, a bone blood flow study. Tomography is sometimes helpful in atypical cases. CT scanning is valuable in foci in the axial skeleton including the pelvis. Lesions in the appendages of the vertebrae should be sought in patients with painful scoliosis or lordosis of relatively recent onset.

Adolescent↗