[Acute abdomen; elements of radiologic and laboratory diagnosis].
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Abdomen↗
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Results for “DIAGNOSIS, LABORATORY”
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[Laboratory diagnosis of renal diseases. XIV. Role of renal vessels studies in the diagnosis of renal diseases].
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Arteries↗
The laboratory diagnosis of malaria. The Malaria Working Party of The General Haematology Task Force of the British Committee for Standards in Haematology.
Audits of malaria diagnosis in the UK have revealed shortcomings. The use of recommended procedures should improve the standard of malaria diagnosis. Both thick and thin films should be examined. Thick films should be stained unfixed with a Giemsa or modified Field's stain. Thin films should be fixed and stained with a Giemsa or a Leishman stain. All films should be examined for an adequate period of time by two observers. In the case of P. falciparum infection parasites should be quantified. Microscopy may be supplemented by an immunological or fluorescence-based method. Slides from all cases in which a diagnosis of malaria is made should be sent to a reference centre for verification. Laboratories should participate in a relevant NEQAS scheme and should take steps to ensure that all those carrying out malaria diagnosis maintain their skills.
Clinical Laboratory Techniques↗
Laboratory diagnosis of tuberculosis.
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Clinical Laboratory Techniques↗
Laboratory diagnosis of iron-deficiency anemia: an overview.
BACKGROUND AND METHODS: To determine the diagnostic values of laboratory tests used in the diagnosis of iron-deficiency anemia, the authors conducted a systematic overview of the relevant literature. Computerized searches of the MEDLINE database yielded 1,179 potentially relevant citations. Fifty-five studies included the results of laboratory tests and histologic examination of the bone marrow for at least 50% of an identifiable patient group. In these 55 studies, quality was assessed and descriptive information concerning the study populations, the tests conducted, and the results was extracted, all in duplicate. RESULTS: Serum ferritin radioimmunoassay was by far the most powerful test, with an area under the receiver operating characteristic curve of 0.95. Test properties differed for populations of patients with inflammatory, liver, or neoplastic disease and patients without these conditions. Likelihood ratio lines, which allow precise interpretation of results across the entire range of ferritin concentration values, were constructed for the individual populations. CONCLUSION: Serum ferritin radioimmunoassay is an extremely powerful test for the diagnosis of iron-deficiency anemia and, appropriately interpreted, can be applied to the complete range of patients.
Anemia, Hypochromic↗
Effect of a common reference plasma on the inter-laboratory variation of the measurement of total and free protein S: a collaborative study of the Dutch Working Group on Haemostasis Laboratory Diagnosis.
The comparability of test results for protein S between laboratories is hampered by a high inter-laboratory variability. The effect of the use and type of common reference plasma on the inter-laboratory variability of the total and free protein S measurement was evaluated. The results of 10 plasma samples measured against a centrally distributed frozen plasma and a centrally distributed lyophilized plasma were compared with those of various local reference plasmas regularly used by the 11 participating laboratories. The mean intra-assay coefficient of variation for total protein S in each laboratory varied from 3.8 to 12.8% (mean intra-assay CV of all laboratories: 7.4+/-2.3%); for free protein S this range was 3.1 to 13.3% (mean intra-assay CV of all laboratories: 6.6+/-2.7%). We confirmed the high inter-laboratory coefficient of variation (mean+/-SD) with the several local reference plasmas for both total protein S (13.4+/-5.6%; n = 10) and free protein S (17.1+/-7.5%: n = 11). For total protein S, the inter-laboratory CV was reduced to 11.5+/-4.8%, (p=0.05) by using a common frozen reference plasma, while it was increased to 16.8+/-3.4%, (p=0.022) using a common lyophilized reference plasma. For free protein S, these values decreased only statistically significantly for the common lyophilized reference plasma, to 15.1+/-6.0%, (p = 0.008). For free protein S, the dilution factor used was identified as a factor influencing the inter-laboratory variability. This study shows that, for both types of protein S measurements, using one frozen reference plasma shows a slight decrease in inter-laboratory variability, while a common lyophilized plasma shows inconsistent results. It is concluded that further investigation is necessary to examine other sources of variability to increase the comparability of laboratory results for both total and free protein S.
Adult↗
Potential errors in the laboratory diagnosis of paroxysmal nocturnal hemoglobinuria.
In a retrospective study of laboratory tests for paroxysmal nocturnal hemoglobinuria (PNH), the red blood cells of several patients gave conflicting results when different testing procedures were used. To resolve these discrepancies, an examination of the various procedures was undertaken, using sulfhydryl reagent-treated red blood cells as model PNH cells. Rabbit antiserum to human red blood cells was used to sensitize erythrocytes for specific antibody-dependent complement lysis sensitivity tests. Acidified serum and inulin were used in fluid-phase complement activation tests. For the general laboratory, a modification of the sucrose lysis test is described, which can give the relative complement sensitivity and size of an abnormal subpopulation of red blood cells. Considering the results of our patients and the reports in the literature of the association of PNH with a variety of lymphoproliferative and myeloproliferative disorders, it is stressed that testing procedures for PNH be controlled more carefully for a better understanding of the nature of the membrane defect.
Complement System Proteins↗
The laboratory diagnosis of lupus anticoagulant in patients on oral anticoagulation.
Laboratory-specific cut-off lupus ratios (LR), above which a plasma is judged positive for lupus anticoagulant (LA), were established for both activated partial thromboplastin time-based and dilute Russell viper venom time-based methods. The validity of using these cut-off values to determine the presence of LA in patients on oral anticoagulation (OAC) was assessed. A cohort of 40 patients (23 male and 17 female), aged 22-84 years (mean 52 years) were tested for LA at the time of a thrombotic event. Repeated testing was performed after the same patients were treated with OAC (international normalized ratio 2.0-3.5). For 36 patients (90%), LA status was unchanged pre- and on-OAC. Thirteen of the 40 patients (32.5%) were positive for LA both pre- and on-OAC. Of the 27 patients negative for LA pre-OAC, 23 remained negative on-OAC. The four discordant results were interesting in that LA positivity was demonstrated only after the patient was stable on-OAC. In our cohort of 40 patients, there was a trend for LRs to decrease on-OAC, but this did not reach statistical significance. The subset (4) went against this trend and became positive after the thrombotic event.
Administration, Oral↗
Laboratory diagnosis of rotavirus infection in diarrhoeal patients by immunoenzymatic and latex-agglutination assays.
One hundred stool samples from children with acute diarrhoea were examined by six commercial latex and immunoenzymatic assays for the diagnosis of rotavirus infection in four different laboratories. Samples were also analyzed by solid-phase immune electron microscopy using a rabbit anti-group A rotavirus antiserum. With electron microscopy as a basis for comparison, sensitivity and specificity for the latex and ELISA assays varied from 91.1 to 92.9% and from 94.2 to 99.4%, respectively. Statistically significant differences were revealed in the confirmation rate of electron microscopy-negative samples between different commercial assays. Significant variability was also found between results obtained by the laboratories taking part in the study.
Antigens, Viral↗
[Experience with the use of an immunoglobulin erythrocyte preparation for the early laboratory diagnosis of pseudotuberculosis].
An immunoglobulin erythrocytic preparation for the rapid detection of Yersinia pseudotuberculosis was developed. The preparation was shown to be specific and sufficiently sensitive (8 x 10(5) microbial cells/ml). The preparation was used for the examination of 102 patients; in 62 of these patients the diagnosis was confirmed by means of common laboratory and clinical methods. Y. pseudotuberculosis antigen was detected in the blood of 39 patients (63%), and in 12 patients (29.4%) the results of traditional laboratory tests were negative. In 19 out of 23 patients the coincidence of the results of bacteriological and seroindication study was registered. During the study of the remaining 40 patients the antigen was detected only in 6 patients, including 3 patients with enteric yersiniosis.
Antigens, Bacterial↗
[Practical questions concerning the laboratory diagnosis of monoclonal immunoglobulin A (IgA)].
Authors discuss about the laboratory determination and differential diagnostic problems of the homogenous and heterogenous immunoglobulin increases--in respect to the monoclonal IgA--in the serum and urine. Their investigating system is convenient for the early detection of the small M-components and to discover the other rare protein anomalies too.
Antibodies, Monoclonal↗
Laboratory diagnosis of viral infections.
When a suspected viral agent requires laboratory confirmation, specimens must be properly collected and stored, and appropriately transported to a virology laboratory. Viruses can be isolated from a variety of specimens in tissue cultures, and characteristic cell changes may be seen in Papanicolaou smears and scrapings of vesicles. Serologic, immunofluorescent and immunoradiologic techniques are useful in identifying both antigens and antibodies.
Antigen-Antibody Reactions↗
[Developments in the laboratory diagnosis of diseases of the exocrine pancreas (author's transl)].
Laboratory tests are the object of continuous interest in acute as well as chronic pancreatic disease. Enzymic assays play an important role, particularly in screening for pancreatic disease. The diagnostic contribution of amylase, isoamylases, immunoreactive trypsin and lactoferrin, ribonuclease and galactosyltransferase, as well as the problem of chronic nonpancreatic hyperamylasemia is reviewed. Functional methods detect a normal or abnormal function and in this sense the results should be interpreted. Present evaluation of the pancreozymin-secretin test, the Lundh test, fecal chymotrypsin, determination of stimulated chymotrypsin secretion by peroral synthetic substrates marked with 4-aminobenzoic acid, duodenal excretion of 75Se-methionine and plasma pancreatic polypeptide is given. Up to now, immunologic methods have not fulfilled the expectations in spite of considerable attention paid to them in recent years.
Humans↗
Laboratory diagnosis of tuberculosis: past, present, and future.
Resurgence of tuberculosis justifies extraordinary efforts to expedite TB diagnosis and susceptibility testing. This demands that laboratory support expand to a "second generation" of methods and procedures, including rapid availability of fluorochrome smears of concentrated specimens, faster techniques for detection (e.g., the BACTEC radiometric broth system and microcolony detection), quicker identification (e.g., high-pressure liquid chromatography, nonisotopic genetic probes), more rapid susceptibility testing methods (e.g., BACTEC), and reporting of these results as critical values. Guidelines have been established for turnaround time for results of smears, TB organism identification, and susceptibility testing to usual first-line drugs. A "third generation" of laboratory techniques soon will make testing not only more effective but also more efficient. These methods include direct testing of respiratory specimens through nonisotopic genetic probes as well as nucleic acid amplification techniques utilizing polymerase chain reaction (PCR) and other molecular procedures. These new procedures and protocols place heavy demands on laboratory test volume, technologist time and costs. For the healthcare system or clinical laboratory without the resources to deal with these new demands, referral of TB specimens represents a reasonable alternative, as long as transport is adequate to meet current CDC and other guidelines for turnaround time.
Bacteriological Techniques↗
Laboratory diagnosis of genetic disorders.
Many genetic disorders affect vision or result in ophthalmic findings. Laboratory testing plays an important role in the diagnosis of genetic disorders and in carrier testing. Recent advances in cytogenetics, biochemical genetics, and molecular genetics have increased the understanding of many diseases and have allowed some to be defined at the molecular level. Concomitantly, new laboratory tests have been developed for several important hereditary eye diseases, including some forms of retinitis pigmentosa. These developments not only herald marked advances in the understanding of disease, they also introduce new legal and ethical issues that will affect the primary care clinician when using laboratory testing for genetic disease.
Clinical Laboratory Techniques↗
[Molecular biology and laboratory diagnosis of hypothalamic-pituitary-thyroid axis].
Recent developments in molecular biology have brought dramatic changes in laboratory medicine. Applications of molecular biology techniques have made it possible to make etiological diagnosis and produce recombinant proteins for reagents. Laboratory investigations of molecular biology in the hypothalamic-pituitary-thyroid axis include TRH gene, TRH effect, TSH gene, TSH receptor and its autoantibodies, thyroid peroxidase and thyroglobulin and their autoantibodies, thyroxine (T4) binding protein genes, deiodination of T4, thyroid hormone receptor, oncogenes of thyroid etc. The following developments are reviewed. 1) Human TSH (hTSH) beta gene and its abnormality: Two types of mutations of hTSH beta gene have been found in patients with hereditary isolated TSH deficiency. DNA diagnosis and genetic counseling are now being performed. 2) Structure and function of TSH receptor: The primary structure of hTSH receptor was identified from its gene. Relationships between its structure and function have been investigated using site specific mutagenesis and synthetic short peptides. 3) Thyroid hormone receptor gene and its abnormality: The thyroid hormone receptor gene has been successfully cloned. Several mutations of the gene have been demonstrated in patients with thyroid hormone resistance. 4) Application of recombinant hTSH (r-hTSH):r-hTSH has been produced in CHO cells. Immunological and biological properties of r-hTSH are similar to those of authentic pituitary hTSH. Clinical application of r-hTSH is now in progress.
Amino Acid Sequence↗
Laboratory diagnosis and biosafety issues of biological warfare agents.
Bioterrorism events have been rare until recently. Many clinical laboratories may not be familiar with handling specimens from a possible bioterrorism attack. Therefore, they should be aware of their own responsibilities and limitations in the handling and treatment of such specimens, and what to do if they are requested to process clinical samples. The Centers for Disease Control and Prevention has developed the Laboratory Response Network to provide an organized response system for the detection and diagnosis of biological warfare agents based on laboratory testing abilities and facilities. There are potentially many biological warfare agents, but probably a limited number of agents would be encountered in case of an attack, and their identification and laboratory safety will be discussed.
Biological Warfare↗
A problem-oriented approach to laboratory diagnosis.
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Animals↗