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At least 1,189 records · Page 66Linked to original sources
PubMed1987

Role of qualitative choriogonadotropin assays in diagnosis of ectopic pregnancy.

We compared the clinical sensitivity and cost-effectiveness of a qualitative assay for choriogonadotropin in human urine ("Icon" hCG) with a quantitative assay of serum from 142 women with pathologically-diagnosed ectopic pregnancy. Results show that although the qualitative assay had a clinical sensitivity for pregnancy of 98.6%, as compared to 100% for the quantitative assay, it was more economical to use, and had a significantly shorter turnaround time. We conclude that qualitative hCG assay of either urine or serum is a good screening method for detecting pregnancy, and can replace the stat quantitative assay in women with suspected ectopic pregnancy. We present a diagnostic algorithm to illustrate the role of qualitative and quantitative hCG assays in conjunction with ultrasonography, culdocentesis, and laparoscopy for diagnosis of ectopic pregnancy.

Algorithms↗
PubMed1986

The role of digital subtraction angiography in neuroradiology. An evaluation of intravenous and intra-arterial digital subtraction angiography.

A few years after the introduction of intravenous digital subtraction angiography (DSA) in clinical practice it became clear that, although the method had been developed as an alternative to arterial angiography, especially for the analysis of cerebral ischemia, its application was not as successful as the earlier reports had indicated. Based on the results of a study comparing intravenous DSA, intra-arterial DSA, and the Doppler examination, in 168 consecutive patients, a diagnostic algorithm for the management of these patients is proposed. A second and more important application of digital subtraction is its use with arterial angiography, especially with a high resolution system configuration.

Angiography, Digital Subtraction↗
PubMed1988

Microscopic hematuria.

Microscopic hematuria is a common problem that may affect up to 13 per cent of the population. The number of RBCs identified in the urine sediment is dependent, in part, upon the technique used in performing the urinalysis. The exact number of RBCs normally excreted into the urine has been difficult to establish. However, three to eight RBCs per HPF would be accepted by most investigators as an acceptable dividing point between normal and abnormal hematuria. Although the prevalence of microscopic hematuria in the general population is high, the number of patients who have serious urologic disease is low. Many diagnostic algorithms are available for evaluating these patients, but at the present time there is still uncertainty regarding how extensive the evaluation should be for patients with asymptomatic microscopic hematuria.

Algorithms↗
PubMed1988

[Fine-needle biopsy in the early diagnosis of thyroid neoplasms].

Among the patients directed to the Department of Endocrinology of the Institute of Internal Medicine for diagnostic examinations of the thyroid, 726 (647 women and 79 men, of age between 16 and 79 years) were qualified to surgery after scintigraphic detection of cold nodules. From this group, 474 patients had thin-needle biopsy specimens taken for cytologic examination. The results of the latter examinations have been compared with those of histologic examination performed on the tissue removed during surgery. The occurrence of a malignant tumor (in 99.1%--thyroid cancer) was found in 108 patients (22.8%) from the group having thin-needle biopsy performed. Comparison of the results of cytologic examination with those of postoperative histologic examination demonstrated low sensitivity of biopsy examination (50.0%), as opposed to high specificity (96.2%) and high accuracy (85, 3%). Analysis of the false-negative results (54/108) revealed that the main causes of errors are difficulties in differentiation of adenoma from follicular carcinoma. Widening of the indications to surgery by a group of patients with adenoma will increase sensitivity to 84.8% and will require including into the operated group of about 50% of patients with scintigraphically diagnosed cold nodules: The introduction of the new term: "urgent strumectomy", has been proposed; also a diagnostic algorithm, useful for early diagnosis of malignant tumors of the thyroid, has been discussed.

Adolescent↗
PubMed1986

Diagnosis, screening, and 'demoralization': epidemiologic implications.

The Dohrenwends have associated psychiatric screening instruments with Frank's concept of 'demoralization' through negative evidence of the criterion validity of the instruments for identifying 'diagnosable mental disorders'. New evidence from the Stirling County Study is given to suggest that absence of validity stems from symptom-enumerative scoring procedures and that concordance with clinical judgment is improved by employing diagnostic algorithms. The concepts of diagnosis and 'demoralization' are discussed, and the history of screening instruments is reviewed. It is suggested that, while 'demoralization' may be a useful concept for clinicians, it poses serious drawbacks for epidemiological research because of the assumptions it involves about etiology and outcome.

Affective Symptoms↗
PubMed1987

Peripheral arterial missile embolization: a case report and 22-year literature review.

The present case report is that of an air pistol missile injury with perforation of a common femoral artery and subsequent arterioarterial embolization to the anterior tibial artery. Included in this report is a review and analysis of a 22-year experience in the vascular trauma literature with missile injuries resulting in cardioarterial or arterioarterial embolization. In-depth analysis of this collective literature review revealed small weapon caliber (79%), usually .22. Soft tissue tamponade at the injury site in the form of mediastinal hematoma, retroperitoneal hematoma, or hemopericardium preventing exsanguination occurred in 37% of cases. Cardiac and thoracic aortic entry sites represented 70% of the series with distinct patterns of peripheral vascular embolization found resulting from anatomic relationships and laminar flow. Diagnostic evaluation by means of remote x-ray screening documented 86% of the emboli and was supplemented with arteriographic studies in 36%. Direct transverse arteriotomy overlying the projectile was favored; most of the delayed embolectomies stemmed from a failure to recognize those patients with peripheral embolization and a compensated asymptomatic limb. An appropriate management plan and diagnostic algorithm for this rare vascular phenomenon have been generated by this study.

Adolescent↗
PubMed1987

Evaluation of the usefulness of routine microscopy in canine urinalysis.

The initial physical signs, clinical problems, and results of 1,000 consecutive urinalyses of canine patients at the Colorado State University Veterinary Teaching Hospital were reviewed and summarized to compare microscopic and physicochemical examinations of urine. Physicochemical examination alone would have resulted in an 11.4% (64/562) false-negative rate for detection of abnormal urine specimens without consideration of patient risk for genitourinary disease. The effects of a discriminative diagnostic algorithm on macroscopic examination sensitivity were determined. Fifty-one macronegative/micropositive and 85 macro- and micronegative specimens were obtained from higher-risk patients with history, physical signs, clinical problems, or serum biochemical analysis results indicative of predisposition to genitourinary disease, which would have warranted complete urinalyses regardless of physicochemical findings. Exclusion of these patients from evaluation of physicochemical examination sensitivity in order to consider such methodology's impact as a screening procedure only for those patients whose genitourinary disease was not already suspect resulted in a significantly (P less than 0.001) lower false-negative rate of 3.05% (13/426).

Animals↗
PubMed1987

Prevalence of otitis media in a Venda village.

During mid-winter in 1985, 263 children and 217 adults from a remote rural community in Venda, were examined for the presence of middle ear lesions by: pneumatic otoscopic examination; tympanometry; and contralateral acoustic reflex. A diagnostic algorithm was applied to assess the findings. The prevalence of otitis media (OM) in children (less than or equal to 15 years) was 8.4% and in adults (greater than 15 years) 2.3%, with the highest figure in the 0-23 months age group. OM with effusion was found in 3.6% of the children. Our data suggest the existence of considerable differences in the prevalence of OM between comparable black rural communities.

Adolescent↗
PubMed1986

[Value of plain x-ray procedures in the diagnosis of ocular muscle paralysis].

Out of 444 patients with paralysis of the eye muscles 187 were examined by plain X-ray films, 144 of were reviewed in order to address the question, whether the X-ray examination was able to elucidate etiology and pathogenesis of the paralysis. Of 444 patients we found positive results in only 14 per cent. Among traumatic, tumorous or inflammatory lesions we found positive results in 47 to 84 per cent of the patients, so that there was reasonable influence on the following diagnostic procedure. Plain films were rarely able to establish a definite diagnosis suitable for therapy. By comparison, computed tomography delivers additional information, so that special procedures could be omitted. In spite of that plain films of the skull should be the first step of the diagnostic algorithm, because they give the right direction to the subsequent expensive procedures.

Humans↗
PubMedDate not supplied

The computer as a tool in the diagnosis and treatment of peripheral vascular disease.

The application of a mini computer to a routine diagnostic vascular laboratory has been assessed in over 4,500 patients over a period of 5 years. The laboratory functions to provide diagnosis of peripheral vascular disease. The computer functions are: scientific, in which it is used for modelling the arterial system and for applying diagnostic algorithms using haemodynamic signals re-input data, data base management, in which it is used to store clinical histories, the results of haemodynamic tests, and data for reconstructive surgery, and administrative, in which it is used for laboratory booking, report generation and management and workload statistics.

Blood Flow Velocity↗
PubMed1986

[Means for optimizing the diagnosis of diabetic angiopathies].

Diagnostic algorithms for the recognition of diabetic angiopathies have been developed: an algorithm for the recognition of the most important syndromes of vascular involvement in patients with diabetes mellitus; an algorithm for the recognition of stages of diabetic retinopathy, and an algorithm for the recognition of stages of nephropathy. The algorithms are intended for a wide clinical use and mainly based on simple methods of research. More sophisticated methods extend the probability of the recognition of angiopathies. The use of the algorithms raise the efficacy of the recognition of angiopathies in demonstration experiments for teaching purposes.

Diabetic Angiopathies↗
PubMed1985

[Pituitary hemangiopericytoma].

Information on the first observation of the hypophyseal hemangiopericytoma having the clinical symptoms of hypophyseal adenoma is presented. It is noted that such tumours can be mistakingly diagnosed as adenomas. Therefore on the basis of light microscopical, histochemical and electronmicroscopical data a tactical diagnostical algorithm is worked out and proposed that facilitates the distinguishing of hemangiopericytoma among other tumours of the hypophysis anterior lobe.

Hemangiopericytoma↗
PubMed1984

The outcome of hyponatremia in a general hospital population.

To determine the prognosis of hyponatremia in an unselected population, we collected clinical and laboratory data and determined the outcome of hospitalization for all hyponatremic patients in a general hospital over a three month period. Of the 78 patients studied, 36 (46%) had CNS symptoms while 42 (54%) were asymptomatic. Using a diagnostic algorithm we classified the patients with CNS symptoms into two groups: those with CNS symptoms due to hyponatremia (11 patients) and those with CNS symptoms caused by other factors (25 patients). Twenty-one patients (27%) died during the study. The highest mortality (64%) was in patients with CNS symptoms related to factors other than hyponatremia. Patients with CNS symptoms due to hyponatremia had a mortality rate (9%) similar to that of patients without CNS symptoms (10%). These findings suggest that the relationship between hyponatremia and outcome is probably not causal. Rather, hyponatremia appears to be a marker for severe underlying disease that carries a poor prognosis.

Adult↗
PubMed1980

The evaluation of peripheral lymphadenopathy.

Lymph node enlargement occurs in a large variety of diseases, which may be considered in groups defined by their characteristic presentations. A meticulous history and physical examination will generally define the disorder, which may then be confirmed by appropriate laboratory procedures. Biopsy of the node is generally the last step in the diagnostic algorithm and is definitive in 40 to 60 per cent of cases. For the hard, nontender, unilateral cervical node, a meticulous search for the primary lesion should precede the biopsy. Continued observation and occasionally reevaluation are important aspects of the care of all patients.

Adult↗
PubMed1981

[Current role of angiography in the diagnosis of hepatic cavernous hemangioma].

46 cases of cavernous hemangioma of the liver, studied by angiography, are reported. Part of them were studied with echotomography and CT too, and 28 with angiotomography. In author's opinion based on experience, angiographic diagnosis of the lesion is, in presence of typical angiographic patterns, always confirmed, while echotomography and CT are not specific, especially in differential diagnosis with neoplastic malignant, primitive or secondary, hepatic lesions. Diagnostic algorithm needs, in their opinion, an initial echotomographical phase and, in presence of positive pictures for expansive hepatic mass with clinical suspicion for haemangioma, angiography and angiotomography for complete and specific diagnosis.

Adult↗
PubMed1994

Prostate cancer detection in BPH patients.

The first problem to be solved in the evaluation of BPH patients is surely the differential diagnosis with prostate carcinoma. We evaluated the impact of a combined approach for prostate cancer detection using DRE, PSA, TRUS and ultrasound-guided biopsy, determining the sensitivity and specificity of different tools, in order to obtain a diagnostic algorithm to be used for pretreatment differential diagnosis between prostate cancer and BPH.

Aged↗
PubMed1995

[Our technique in orthotopic neobladder].

The strive in the field of orthotopic neobladders derives from the need to improve their morphofunctional aspects and to simplify the surgical procedures. The Authors propose their experience on a new method of orthotopic neobladder in 8 patients submitted to radical cystectomy for advanced bladder neoplasia from march 91 until june 93. The surgical technique was to prepare a reservoir with a simile Camey 2 type procedure modified by them using 50 cm of ileus, 30 of which detubularized and reconfigured into a simile spheric shape with Polygia 75 staplers. The remaining length was left intact for the ureteral anastomosis performing the Wallace 1 type procedure. The advantages of this technique are that: the neobladder is prepared rapidly using staplers, thus reducing operating time the presence of an isoperistaltic segment of ileus for ureteral anastomosis permits an reduced ureteral mobilization with a low probability of reflux a simple reconversion in ileal conduit in case of reservoir failure or neoplastic urethral recurrence is possible. The criteria for selecting the patients are reported and the diagnostic algorithm regarding the follow-up presented. The latter is done with biochemical, echographic, radiological and pressure studies, every 4-6 or 12 months. Particular attention has been focused on the quality of life in relation to the diurnal/nocturnal continence and micturation interval. They conclude that this technique is surgically simple and rapid with satisfactory clinical and urodynamic results.

Adult↗
PubMed1994

[A combination of a duodenal diverticulum and the postcholecystectomy syndrome].

The surgical treatment results of 68 patients with duodenal diverticulum were analyzed, 21 of whom the various interventions on biliary tracts for cholelithic disease and her complications earlier were conducted. Postcholecystectomy syndrome origin was connected with non-diagnosed and non-eliminated duodenal peripapillary diverticulum. The clinical peculiarities, diagnostic algorithm and the complex of preoperative preparation, surgical treatment and complications prophylaxis are adduced. The necessity of associated terminal common bile duct portion correction plus diverticulectomy or intestine exclusion according to A. G. Zemlianoĭ was suggested.

Adult↗