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At least 1,045 records · Page 58Linked to original sources
PubMed1999

[Radiation diagnosis of spleen changes in flying personnel of fighter and helicopter aviation].

Some specific alterations of the spleen in flying personnel of fighter and helicopter aircraft have been elucidated. Regular patterns of splenomegaly appear to be linked with the adverse effects of air flight. The ultrasonic investigation was proved to be one of the most significant elements of the diagnostic algorithm used to determine the size and structure of the glandular parenchyma. The X-ray computer tomography and methods of computational analysis are no more than ancillary tools to get better insight into syntopy of the organ and surrounding tissues. The radionuclide investigation provides tentative data concerning the functional state of the organ.

Adult↗
PubMed1998

[The enterochromaffin-serotonin system and Helicobacter infection in the mechanisms of the staged development of peptic ulcer].

Submitted in this article are scientific propositions and problems concerning the way ulcer disease (UD) of the gastroduodenal system (GDS) develops through its particular stages, and pathosanogenous role which the enterochromaffin-serotonin system (ECSS), a part of the diffusive neuroendocrine APUD-system of the organism, has in it, along with etiopathogenetic role Helicobacter infection plays in the gastroduodenal mucosa (M). Experience gained by the authors with prospective comprehensive evaluation and treatment of 310 patients with chronic gastroduodenitis (CGD), 198 UD GDS patients and 350 of those surgical patients who had undergone resection of the stomach for complicated UD GDS, indicates that all above pathological states share common etiopathogenetic, clinical, histomorphological and microbiological (Helicobacter infection) features, which facts suggest a common pathomorphogenesis of CGD, erosive GD, UD GDS and postgastroresectional UD, and a staged character of erosive-ulcerous transformation in the GDS M, with the hypercoagulative sings being present at the level of hemomicrocirculation. Progressing structural and functional changes in ECSS parallel to stages of development and severity of the UD GDS course suggest their interrelationship to pathosanogenesis during all stages of erosive-ulcerous transformation. At the molecular level, this may reflect directly the course of staged ulceration and a point of activation of processes of physiological defence, this being of diagnostic as well as prognostic value. The enterochromaffin-serotonin conception of pathosanogenesis of staged erosive-ulcerous transformation in GDS M supplements, rather than contradicts to a current infectious Helicobacter hypothesis of ulcerogenesis. Thus, evaluation of ECSS structural and functional status in UD GDS is to be part of a diagnostic algorithm testing severity of the course as well as of a monitoring of treatment and prognostication.

Adult↗
PubMed1999

[Value of MRI in diagnosis of post-traumatic wrist complaints].

The diagnostic value of MRI in acute and chronic posttraumatic wrist pain will be demonstrated in several clinical cases. The integration of MRI in a diagnostic algorithm is discussed. The indication of MRI is given for suspected complex ligamentous lesions, occult fractures and soft tissue pathologies, in particular with disconcordant clinical and radiological signs. Pathology orientated study protocols are presented. Preoperatively, MRI will be helpful in planning definitive surgical treatment.

Fractures, Bone↗
PubMed1999

The role of imaging techniques in evaluating possible graft infections.

Imaging plays a central role in the management of graft infections. Most graft infections are clinically apparent, and imaging techniques are used primarily for diagnostic confirmation and operative planning. The accurate diagnosis of less overt graft infections requires a thorough understanding of the available imaging options. Late aortic graft infections (more than 3 months postoperative) are best evaluated initially by computed tomography (CT) or magnetic resonance (MR) scanning. CT findings consistent with a graft infection include ectopic gas, perigraft fluid, perigraft inflammatory changes, anastomotic pseudoaneurysm, and thickening of adjacent bowel. MRI offers the additional advantage of T2-weighted images to identify perigraft inflammation and minute quantities of perigraft fluid. Radionuclide scanning techniques such as 111indium-labeled WBC scans are highly sensitive but suffer from a relative lack of specificity. Duplex ultrasonography is best applied to the diagnosis of late infections of superficial grafts. Sonographic findings of a graft infection include perigraft fluid and pseudoaneurysms. The imaging of early postoperative grafts (less than 3 months) for infection is problematic because perigraft fluid and inflammatory changes persist for up to 3 months postoperatively. Suspected early graft infections often require operative exploration for diagnosis. A thorough understanding of the utility and limitations of imaging techniques will enable the clinician to develop a reasonable diagnostic algorithm that is appropriate for each case.

Blood Vessel Prosthesis↗
PubMed2000

[Ultrasonic investigations in diagnostics of prostate diseases in flying personnel].

Ultrasonic semiotics of the most common prostate problems was studied. Benefits from transabdominal and transrectal scanning to evaluation of the gland and surrounding tissues were highlighted. Prostate distresses were consistent with some unfavorable factors of air flight. The significance of incorporation of USI in the diagnostic algorithms of medical certification of flying personnel afflicted with prostate problems was stated.

Adult↗
PubMed2000

An incremental cost-effectiveness analysis of the first, second and third sputum examination in the diagnosis of pulmonary tuberculosis.

SETTING: St. Francis Hospital in Katete District, Eastern Province, Zambia. OBJECTIVE: To compare the incremental cost-effectiveness of examining serial sputum smears for screening suspects for pulmonary tuberculosis at a rural district hospital in Zambia. DESIGN: An incremental cost-effectiveness analysis of serial sputum smear examinations for diagnosing pulmonary tuberculosis based on laboratory results collected during 1997 and 1998 in a rural district hospital in Zambia. The cost analysis took a health service provider perspective, and used the ingredients approach. The cost-effectiveness is expressed in terms of the incremental cost per tuberculosis case diagnosed. Relevant information was obtained from various sources, including administrative records, interviews and direct observation. RESULTS: Of a total of 166 acid-fast bacilli positive suspects who had three sputum smears examined sequentially, 128 (77.1%) were found on the first smear, a further 25 (15%) on the second smear and 13 (7.9%) additional cases were identified on the third smear. The economic analysis shows that the incremental cost of performing a third test, having already done two, increases rapidly with only a small gain in terms of additional cases of tuberculosis identified. CONCLUSION: A policy of examining two samples should be considered in resource-poor settings, if the remaining steps of the national diagnostic algorithm can be adhered to with respect to smear-negative suspects.

Cost of Illness↗
PubMed2000

[Hematuria and proteinuria--old names, new horizons].

Gradually advanced diagnostic standards for the analysis of urine specimens during the last years led to improved clinical arguments providing important clues. Unnecessary diagnostic procedures like IVP or cytoscopy in suspected glomerular hematuria may for instance be prevented, the patients comfort enhanced and costs reduced. A possible diagnostic algorithm in a case with suspected urologic pathology is shown.

Algorithms↗
PubMed2000

Diagnostic strategies in young patients with ischemic stroke in Canada.

BACKGROUND: A preliminary national survey of ischemic stroke in the young (15-45 years) undertaken by the Canadian Stroke Consortium indicated that in 44% of 356 patients, no cause was found. OBJECTIVE: To determine the reason for this high incidence of diagnostic uncertainty in young patients with ischemic stroke. METHODS: Neurologists in the ten Canadian stroke centers completed a detailed questionnaire for patients aged 15-45 years admitted to hospital between January 1993 and December 1997. Using a stepwise diagnostic algorithm incorporating clinical, neuroimaging, neurovascular and laboratory data, we divided patients into three groups: (1) those with established cause for the ischemic stroke, (2) those who remained unexplained despite adequate investigation, (3) those who remained unexplained but were, in our opinion, under-investigated. RESULTS: In 197 patients (56%), an identified cause was established including cardioembolic sources (14%), extracranial arterial dissection (13%), lacunar infarcts (8%) atherosclerosis (6%). A miscellaneous group of 15%, included cerebral venous thrombosis, coagulopathies, vasculitis and others. In 159 patients (44%) with no apparent cause for their stroke, we considered only 81 (23%) adequately investigated, and 78 (21%) inadequately investigated. CONCLUSION: About one in five young patients was inadequately investigated by a stroke-oriented group of neurologists. The major problem appears to be restriction of investigations to neuroimaging alone (usually computerized cerebral tomography), without further tests such as cerebral angiography and cardiac imaging.

Adolescent↗
PubMed2000

[The diagnosis of autonomic disorders in premature newborns].

A diagnostic algorithm has been worked out for identification of sympathicotonia and parasympathicotonia in newborn infants. The algorithm is calculated on the basis of results of observations carried out in 286 premature infants who had been examined three times during the first fourteen days of their lives. Included in the algorithm are 11 indices of informative value. Score total +13 suggest to us sympathicotonia while -13 indicates parasympathicotonia, with probability threshold being 95%. The above method permits the determination of direction of autonomic disorders in newborn infants, in which case there is no necessity whatever to conduct elaborate and expensive investigations (spectral analysis of the heart's rhythm, measurement of hormones and mediators.

Algorithms↗
PubMed1994

Lung Cancer: Diagnostic Techniques.

The diagnosis of lung cancer may be suspected on the basis of history, physical examination, or radiographic imaging studies. With rare exceptions, suspicions thus raised must be confirmed prior to the initiation of therapy. Advances in radiographic imaging provide an improved "roadmap" for designing diagnostic efforts. Advances in diagnostic procedures allow an easier, better tolerated, and more complete picture of the presence and extent of disease. A diagnostic algorithm using these advances provides the information necessary to design therapy while minimizing the cost, discomfort, and risk to the patient.

Journal Article↗
PubMed2000

[Surgical treatment of extraperitoneal rectal and perineal injuries].

The aim of this study was to analyse the results of the treatment of extraperitoneal rectal and perineal injuries for 153 patients. All the patients were examined according to the scheme. Therapeutic-diagnostic algorithm was developed for perineal, anal, rectal injuries. Wide opening and drainage of the wound was used. The method allows to avoid colostomy and its subsequent operative closing in extraperitoneal injury of the rectum. The method of surgical treatment is recommended in extraperitoneal rectal and perineal injuries.

Abdominal Injuries↗
PubMed1999

[Diagnostic strategies for pulmonary embolism and decision analysis].

Decision analysis has greatly benefited to the field of pulmonary embolism diagnosis, by allowing the theoretical assessment of potential novel strategies, which could in turn be validated in clinical trials. The adjunction of clinical probability assessment, plasma D-dimer measurement, and lower limb venous compression ultrasonography, to pulmonary scintigraphy and angiography in the diagnostic workup, results in a considerable reduction in the requirement for angiography. Moreover, these strategies are highly cost-effective, yielding cost savings without increasing morbidity or mortality. Such diagnostic algorithms are safe, as demonstrated by clinical outcome studies. Finally, spiral CTscan combined with D-dimer and ultrasonography could also prove highly cost-effective, and replace either pulmonary angiography, or even both lung scan and angiography, if ongoing studies confirm the promising preliminary results obtained with CTscan. However, such a conclusion awaits the validation of algorithms including CTscan by clinical outcome trials, in which the therapeutic decision would rest on the result of the spiral CTscan.

Angiography↗
PubMed2000

[Diagnostic accuracy of exercise testing for diagnosis of coronary artery disease: the need for a critical review].

In this review the meaning of exercise electrocardiographic changes and interpretative pitfalls in particular clinical conditions are critically reassessed. Existing studies have been carried out on different populations and with different gold standards, nevertheless exercise testing if correctly analyzed and interpreted, can provide invaluable information for diagnosis of coronary artery disease. Given its feasibility, diffusion and low risk, it remains indeed the first choice test in the diagnostic algorithm of ischemic heart disease. The use of more sophisticated and expensive tests have to be limited to selected groups of patients in whom exercise testing, correctly interpreted, remains really doubtful or prematurely interrupted.

Coronary Disease↗
PubMedDate not supplied

The lumbar spine: imaging in rheumatic disease.

Seronegative inflammatory spondyloarthropathies include ankylosing spondylitis, psoriatic arthritis, Reiter syndrome, juvenile chronic arthritis and colitic arthritis. These diseases share some characteristics among which the most important is the presence of the histocompatibility antigen HLA B27; moreover the frequent overlapping of the various inflammation patterns have accounted for their classification in a single group. Diagnostic imaging can differentiate among the different forms only if the diagnostic algorithm, based on clinical history and laboratory findings is followed, considering the advantages and limitations of each method. In this respect, it should be kept in mind that the findings relative to the spine and sacroiliac joints allow to establish a definitive diagnosis.

Arthritis↗
PubMedDate not supplied

Combined imaging in spondylodiscitis.

At present, in spite of the advancement in antibiotic therapy no significant decrease in the incidence of spinal infections is observed: most likely, this is correlated to the increased immigration flows, high risk behaviors (drug addiction, alcoholism), immunosuppressive diseases (AIDS, leukemia, lymphoma), interventional procedures (iatrogenic causes). Early diagnosis, at times difficult and often misunderstood, is facilitated by the use of a correct diagnostic algorithm, supported by blood culture, needle aspiration and biopsy. Aim of this report was to evaluate the role of the different imaging procedures, CT and MRI in particular, for prompt correct therapeutic management.

Diagnosis, Differential↗
PubMed2000

[The comprehensive surgical treatment of patients with degenerative lesions of the lumbosacral spine].

On the basis of a complex analysis of surgical treatment of 52 patients with degenerative diseases of the lumbosacral part of the spine complicated by the formation of compressive reticulopathies main states were established responsible for the worse quality of life of this category of patients. Different forms of vertebrogenic radiculopathies were determined according to the morphological substrate of compression. The methods of diagnosing the spinal diseases at the lumbosacral level were estimated and the diagnostic algorithms for different variants of degenerative lesions were developed. Rational schemes of surgical correction are proposed according to the established groups of vertebrogenic lumbosacral radiculopathies. Special attention is given to prophylactics of recurrences of the pain syndrome and postoperative instability of the spine.

Humans↗
PubMed2000

[Diagnostic tactics in localized fibroadenomatosis of the breast].

Results of the examination and treatment of 203 patients with localized fibroadenomatosis of the mammary gland are described. The authors give an estimation of diagnostic algorithms used when detecting the physical signs of the disease. It was shown that the examination of patients with the palpation signs of nodular mastopathy should necessarily include mammography which can eliminate unwarranted risk of hypodiagnosing carcinoma of the mammary gland and determine the group of patients in whom the emergency operation is not necessary.

Adult↗
PubMed2000

The autism diagnostic observation schedule-generic: a standard measure of social and communication deficits associated with the spectrum of autism.

The Autism Diagnostic Observation Schedule-Generic (ADOS-G) is a semistructured, standardized assessment of social interaction, communication, play, and imaginative use of materials for individuals suspected of having autism spectrum disorders. The observational schedule consists of four 30-minute modules, each designed to be administered to different individuals according to their level of expressive language. Psychometric data are presented for 223 children and adults with Autistic Disorder (autism), Pervasive Developmental Disorder Not Otherwise Specified (PDDNOS) or nonspectrum diagnoses. Within each module, diagnostic groups were equivalent on expressive language level. Results indicate substantial interrater and test-retest reliability for individual items, excellent interrater reliability within domains and excellent internal consistency. Comparisons of means indicated consistent differentiation of autism and PDDNOS from nonspectrum individuals, with some, but less consistent, differentiation of autism from PDDNOS. A priori operationalization of DSM-IV/ICD-10 criteria, factor analyses, and ROC curves were used to generate diagnostic algorithms with thresholds set for autism and broader autism spectrum/PDD. Algorithm sensitivities and specificities for autism and PDDNOS relative to nonspectrum disorders were excellent, with moderate differentiation of autism from PDDNOS.

Autistic Disorder↗