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Results for “diagnostic algorithm”

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At least 1,243 records · Page 69Linked to original sources
PubMedDate not supplied

[X-ray computerized tomography in the differential diagnosis of gastric ulceration].

The results of more than 3000 gastric examinations were used to study the potentialities of X-ray computerized tomography in the differential diagnosis of benign and malignant gastric ulcerations. CT evidence for benign and malignant gastric ulcerations is outlined. The place and role of CT in the diagnostic algorithm for gastric ulcerations are defined. In the authors' opinion, CT is a supplementary study and should be used purposefully after preliminary X-ray, endoscopic, and morphological examinations in difficult clinical situations associated with the differential diagnosis of gastric ulcerations.

Aged↗
PubMed1997

[Modern diagnostic methods for thyroid gland diseases].

The paper overviews the role of diagnostic procedures in evaluating patient with thyroid gland disease. It focuses on the diagnostics of functional disturbances and on the modern approach to the nodular goitre. The role of supersensitive, immunoenzymatic assay of TSH (sTSH) in the diagnostics of functional disturbances in underlined, particularly in subclinical course of thyroid gland diseases, or in diagnostically difficult cases. The complimentary role of tests' triangle-ultrasound, scintigraphy and fine needle biopsy in the evaluation of focal changes of the thyroid (nodular goitre) is discussed and the diagnostic algorithm of patient's qualification to surgery is proposed.

Algorithms↗
PubMed1997

[Problems in the diagnosis and treatment of splenic injuries in children].

The diagnosis and treatment of the injured spleen in children changed markedly during the last 20 years. However even when contemporary diagnostic algorithms and therapeutic procedures are used, there are still problems for which we lack an unequivocal answer. Based on their own experience and data in the literature the authors try to contribute to the solution of this important traumatological problem.

Adolescent↗
PubMed1997

[Treatment of paroxysmal ventricular tachycardia].

The authors present a retrospective evaluation of the risk stratification and therapy of 53 patients with ventricular tachycardia. They present the diagnostical algorithm used for the detection of risk of sudden death. The most frequently used drug in the set of patients was amiodarone in monotherapy or in combination with other drugs. Sotalol was used for both, its antiarrhythmic nature, and for its ability to reduce the defibrillation threshold in patients with an implanted automatic implantable cardiovertor-defibrillator (AICD). Antiarrhythmic drugs of class I in monotherapy were used in patients with non-coronary causes of ventricular tachycardia and with normal left ventricular function. The authors, on the basis of sudden death of three patients with low ejection fraction of the left ventricle which were recorded even despite Holter apparatus and electophysiologically confirmed supression of ventricular tachycardia, recommend to consider in this group of patients the primary AICD implantation. (Tab. 4, Fig. 2, Ref. 13.)

Anti-Arrhythmia Agents↗
PubMed1998

[Retroperitoneal germinal tumor: extragonadal or burned out phenomenon of testicular primary? Presentation of a clinical case].

Clinical record case of a retroperitoneal seminoma with "burned-out" phenomenon in the testicular primary, in a 38 year old male with no background of interest who consults for a picture of left nephritic colic. The ipsilateral testis study detects a fibrotic area with hyalinosis and hemosiderin deposits, although there are no tumoral debris, compatible with the "burned-out" phenomenon. Management is through surgery plus a chemotherapy protocol. Discussion of the diagnostic algorithm of retroperitoneal tumours and the literature on extragonadal germinal tumours.

Adult↗
PubMed1997

[The role of D-dimer determination in clinical evaluation with pulmonary perfusion scintigraphy].

The diagnosis of pulmonary embolism is even in contemporary clinical practice problematical. Pulmonary angiography is used in our departments very little due to its invasive character. The method of choice for diagnosis remains therefore perfusion scintigraphy of the lungs, in this country frequently without ventilation scintigraphy as it is not available in the majority of our departments of nuclear medicine. In recent years in the diagnostic algorithms also assessment of D-dimers was started, i.e. assessment of products of fibrinolysis assessed by monoclonal antibodies. The authors tried to find out how many patients admitted to the medical department for diagnosis of pulmonary embolization may have a false positive diagnosis on the basis of pulmonary scintigraphy. During the period III/96 to V/96 a total of 18 patients from the medical clinic with suspected pulmonary embolism were examined where the value of D-dimers(latex test) was assessed and at the same time perfusion scintigraphy was performed. With regard to the highly negative predictive value of D-dimer assessment the authors focused their attention on patients with a suspect or positive lung scan (i.e. treated on account of pulmonary embolism) while D-dimers were negative. Of 13 patients with suspect or possible pulmonary embolism, as assessed by scintigraphy, four had negative dimers(30%). With regard to the 90% reported negative predictive value, based on the literature, thus three of these patients were unnecessarily admitted to hospital and treated. The authors assume that assessment of D-dimers should be part of the examination protocol due to its non-pretentious character and low price as compared with costs of hospitalization.

Biomarkers↗
PubMedDate not supplied

[The characteristics of the clinico-diagnostic and therapeutic treatment procedures for workers in the marine transport shore services who are ill with circulatory encephalopathy].

A distinguishing feature of the course of discirculatory encephalopathy (DE) in workers of seaborne transport (shore services) is a high degree of vegetative and emotional (during the early stages) and affective, psycho-organic (stage II-III) disturbances secondary to adverse effects of varying kinds of social and biologic factors. We undertook to develop a diagnostic algorithm and treatment options to deal with DE aggravation and complications. Combined use of physical factors, vegeto- and vasotropic drug preparations, antihomotoxic and metabolic alternatives make for regression of the process, its stabilization, with beneficial effect being exerted on the brain vascular formations reactivity and vegetative maintenance of functions in the sick.

Adult↗
PubMed1998

[Role of ultrasonic investigations in diagnosis of pancreatic diffuse pathology in flying personnel].

The article presents data of a complex clinical/radiation examination of flying personnel with diagnosed diffuse pathologies of pancreas. Consistent patterns of the fibrotic process in pancreatic parenchyma were related to professional specifics. Preponderance of ultrasonic investigations, mathematical analyses, and X-ray computer tomography for the enhanced diagnostic algorithm for the medical certification of flying personnel were demonstrated.

Aerospace Medicine↗
PubMedDate not supplied

[Computed tomography in refined diagnosis of abdominal aortic aneurysm: comparison of radiation therapies versus surgical outcomes and morphological studies of resected abdominal aortic fragments].

The results of computed tomography (CT) was compared with ultrasonographic and angiographic findings in 168 patients. All data of radiation diagnosis of abdominal aortic aneurysms (AAA) were compared with those of operations and morphological studies of the resected fragments of the aortic parts changed due to aneurysms. These comparisons provided a detailed characterization of the potentialities of CT performed on a third-generation unit in the presurgical diagnosis of this abnormality. At the same time, detailed XCT findings (semeiotics of AAA and their complications, such infiltration, dissection, and rupture) are given. The study shows benefits of the refined AAA by applying routine CT. The paper gives a diagnostic algorithm of using radiation studies (ultrasonography, CT, angiography) in the diagnosis of AAA. Third-generation CT units widely used in clinical practice are shown to provide necessary and complete information on the magnitude of AAA. This makes it possible to extend the capacities of timely detection of this abnormality and to make a successful surgical intervention.

Aged↗
PubMed1998

[Differential diagnosis of pleural effusion].

The results of following up 598 patients diagnosed as having pleural exudate were used to analyze the potentialities of complex radiation and clinical differential diagnoses of this abnormality. The authors identified 4 most common nosological entities (tuberculosis, pleuropneumonia, cancer, mesothelioma) among patients of diagnostic hospitals. The diagnostic algorithm should be derived by taking into account the current techniques applicable to each disease form. With this, valid diagnosis may be made in 98.5% of cases.

Adolescent↗
PubMed1998

[The laboratory diagnosis of spring-summer infections in Yekaterinburg in the epidemic season for tick-borne encephalitis].

The authors propose a comprehensive approach to laboratory diagnosis of seasonal transmissible infections, based on modern methods permitting etiological deciphering of disease. A universal diagnostic algorithm notably accelerated the laboratory diagnosis due to cutting the period between collection of material from a patient and consecutive screening for antibodies to agents of tick-borne encephalitis, Lyme disease, and California encephalitis.

Algorithms↗
PubMed1998

The role of mammography in the diagnostic approach of breast hamartomas.

PURPOSE: Hamartomas are rare benign breast tumors which surfaced with the entrance of mammography in the diagnostic algorithm of breast lesions. In the present study the mammography findings of breast hamartomas were analyzed in relation to the histologic confirmation of the diagnosis. PATIENTS AND METHODS: During the seven-year period between January 1990 and January 1997 we studied 45 patients, aged from 32 to 66 years, with a clinical and/or mammographic finding of a breast lump, highly suspicious of hamartoma. In 29 (64.4%) the tumor was found in the left breast and in the remaining 16 (35.6%) in the right breast. RESULTS: The preoperative mammography of 41 patients revealed a nodular opaque mass of a nonhomogeneous composition and only four had the typical hamartoma picture. The tumor diameter ranged between 0.7-6.5 cm. All tumors were excised and the histological reports confirmed the diagnosis of hamartoma. CONCLUSION: Mammography helps in the diagnosis of hamartomas. Nevertheless, the final diagnosis must be based on the histological analysis of the tumor.

Adult↗
PubMed1998

[Does a universal strategy of acute pulmonary embolism diagnosis exist today?].

In this review, we demonstrate that there is no universal diagnostic strategy for non-severe acute pulmonary embolism. The first part of the article is devoted to the concept of thromboembolic disease: its frequency, severity and diagnostic difficulties. The second part analyzes the tools used for diagnosis of pulmonary angiography, noninvasive venous studies, and helical CT angiography. The last part discusses current diagnostic algorithms for pulmonary embolism and the changes that may be introduced by the use of helical CT in clinical practice. The potential for MR imaging id discussed.

Acute Disease↗
PubMed1998

Nutritional management of patients with AIDS-related anorexia.

Anorexia is a common problem in HIV infection and occurs via several mechanisms, including local pathology in the oral cavity or esophagus, central nervous system disease affecting eating mechanics or the perception of hunger, or secondary anorexia due to systemic infections, malabsorption, or medications, or to nonmedical factors, such as psychosocial problems, poverty, and isolation. The etiologic diagnosis of disorders of food intake is facilitated by using a diagnostic algorithm. The consideration of nutritional management centers around the body's nutritional reserves in addition to caloric intake. The specific management of a patient with poor food intake is based on the precise cause of the problem, and may include food-based and oral supplement therapies, appetite stimulants, or nonvolitional feeding via the enteral or parenteral route. Anabolic agents, cytokine inhibitors, and other therapies, such as resistance exercise, are adjunctive therapies, and do not replace adequate caloric intake.

AIDS-Related Opportunistic Infections↗
PubMed1998

Detection of antinuclear antibodies: comparative evaluation of enzyme immunoassay and indirect immunofluorescence methods.

OBJECTIVE: To evaluate a commercial microtiter enzyme immunoassay for antinuclear antibodies (ANA) by comparing the results of tests performed with this assay to an established indirect immunofluorescence method performed on human epitheliod cell substrate slides. DESIGN: Both analytical methods were used to test for the presence and levels of ANA in stored sera from 313 patients previously shown to have detectable ANA and from 102 healthy control subjects. Follow-up tests for specific autoantibodies (anti-dsDNA antibodies and antibodies to extractable nuclear antigens [ENA]) were performed on all sera from patients. The medical histories of all patients were reviewed to determine the presence of systemic rheumatic diseases (SRDs). Different cut-off levels of positivity were examined to determine the sensitivity and predictive values of positive results on the enzyme immunoassay for detecting patients with SRDs or sera with positive tests for specific autoantibodies. RESULTS: Among patients with clinically diagnosed SRDs (n = 197), the enzyme immunoassay was positive for ANA (> or =1 U) in 100% and the indirect immunofluorescence method was positive (titer > or =40) in 95.4% of cases. Among ANA-positive patients with no SRDs (n = 116), testing by enzyme immunoassay and indirect immunofluorescence yielded positive results in 97.6% and 75.6% of cases, respectively. Among healthy control subjects, each of the two methods was positive in 15% of cases. As expected, most patients with SRDs had higher levels of ANA than did ANA-positive patients with other clinical diagnoses. A cut-off level of > or =3 U on the enzyme immunoassay correctly classified 77% of patients with a SRD as "positive" and 88% of patients with other clinical diagnoses as "negative." The probability of detecting a positive result for specific autoantibodies on second-order testing increased directly with the level of ANA. A cut-off level of > or =3 U had a sensitivity of 92% for identifying sera with positive specific autoantibodies, and results > or =3 U had a predictive value of 52% for a positive second-order test result. CONCLUSION: Enzyme immunoassay is substantially equivalent to indirect immunofluorescence for detecting clinically important ANA. Cut-off levels for positive results on the enzyme immunoassay can be established that optimize the usefulness of this method in diagnostic algorithms for specific autoantibodies.

Antibodies, Antinuclear↗
PubMed1998

[The traps of pulmonary embolism].

The clinical diagnosis of pulmonary embolism (PE), even massive, remains difficult and perplexing. In our hospital, the percentage of exact clinical diagnoses has not significantly changed over recent years, with a false-negative rate of 78%, and a false-positive rate of 2%. In approximately 20% of cases, autopsy showed several emboli and pulmonary infarctions of various ages, indicating recurrent embolic episodes. The diseases most frequently associated were cardiac diseases (51%) and tumours (24%). Pneumonia considerably decreases the probability of an exact diagnosis of PE; hospitalisation in the Cardiology department or Intensive Care Unit increased the probability of this diagnosis. While the numerous diagnostic algorithms recently proposed have a limited value, the process integrating clinical and instrumental data in order to establish a prospective clinical probability, should facilitate identification of acute PE in live patients.

Acute Disease↗
PubMed1998

[Over a half century at the 1st Medical School of Charles University: development of interdisciplinary cooperation].

A vast interdisciplinary and methodological cooperation became a leading feature of pathology. It brought critical evaluation and synthesis of data from several points of view without prevalence of a pure structural empirism. Nevertheless, detailed structural analysis remains an unmatched and effective introductory way of diagnostic algorithms. A wide methodology is not always useful in its capacity but should be open to each of teachers. For the time being we rely more on outstanding personalities. Call for them as well as their reasonable uniting may restore the original sense to the School Scientific Council.

Czech Republic↗
PubMed2001

Diagnosis of pulmonary embolism.

Pulmonary embolism (PE) is a common, lethal yet treatable disease. The clinical diagnosis of PE remains to be a problem due to the nonspecific presenting signs, symptoms, electrocardiographic findings, arterial blood gas abnormalities and chest X-ray changes. Despite these nonspecific clinical findings, clinicians are adept at assigning pretest probability using overall clinical assessment. Clinical models have been developed to improve the accuracy of pretest probability assessment. D-dimers are becoming a widely available clinical tool useful in the diagnostic management of suspected PE. The limitations of the imaging modalities for PE [ventilation-perfusion (V/Q) scanning, spiral computerised tomography, pulmonary angiography and venous leg imaging] necessitate the use of these tests in series and in combination with clinical pretest probability assessment and D-dimer in diagnostic management algorithms. These algorithms permit safe diagnostic management of patients with suspected PE while limiting invasiveness, inaccessibility and expense.

Algorithms↗