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At least 1,567 records · Page 87Linked to original sources
PubMed2001

[Diagnostic problems of expansive intracranial process in HIV infected patients of the Bobo-Dioulasso Central Hospital (Burkina Faso)].

In HIV infection, cerebral focal lesions are relatively frequent and raise many kinds of diagnostic problems. In tropical practice, neuroradiology is scarcely available and necropsy is still not developed. Therefore, diagnosis of intracerebral masses among patients is not easily performed. We examined a total of 72 patients who presented over a 3-year period. Patients were allocated to presumed diagnostic categories of toxoplasma encephalitis (TE), primary central nervous system lymphoma (PCNSL) or progressive multifocal leukoencephalopathy (PML), based on clinical and therapeutic criteria. In an internal medicine ward, we examined 72 suspected cases of intracerebral masses in a sample of 43 males (60%) and 29 females (40%). The average age was 38 years with extremes ranging from 21 to 72 years. Because of diagnostic problems, the presumption of a TE has been retained in 54 cases (75% of the sample) owing to the efficiency of the treatment of antitoxoplasmic proof. As for the other intracerebral masses, despite insufficient diagnostic means, the assumption of PCNSL was made for 8 cases and PML for 6 cases on the basis of evolutional criteria. In 4 cases, no diagnosis could be retained because of insufficient diagnostic means and treatment failure. Since brain tomodensitometry and brain biopsy are not available, treatment of toxoplasmosis has to be systematically set up whenever there is a presumption of intracerebral masses among patients with HIV infection. It is only in case of failure of this treatment that other hypotheses can be contemplated, especially as they are not entirely reliable.

Adult↗
PubMed2002

Protein conformation and diagnostic tests: the prion protein.

BACKGROUND: Many clinical diagnostic tests depend on the accurate detection and quantification of proteins and peptides and their functions. Alterations of protein structure, and the resulting consequences on dynamics, can affect the outcome of laboratory tests. These changes can be a result of mutations, other in vivo factors, or even the experimental conditions of the diagnostic test. APPROACH: The relationship between protein structure and dynamics and experimentally observable properties used in diagnostic assays are discussed in light of transmissible spongiform encephalopathies, or prion diseases. CONTENT: This review describes current efforts and possible future directions of prion diagnostic development. Recent advances in therapeutic development are also addressed. SUMMARY: The intent of the review is to highlight the role of protein dynamics and conformational change in protein-based diagnostics and treatments for prion disease.

Animals↗
PubMed2002

Role of ultrasonography, computed tomography and diagnostic peritoneal lavage in abdominal blunt trauma.

OBJECTIVE: To compare the diagnostic accuracy of diagnostic peritoneal lavage (DPL), ultrasonography and computed tomography in the management of blunt abdominal trauma. METHODS: A retrospective review of the charts of 233 patients with blunt abdominal trauma necessitating admission to Riyadh Medical Complex, Riyadh, Kingdom of Saudi Arabia was carried out over a 2 year period (January 2000 to December 2001). The diagnostic yields of DPL, ultrasound and computed tomography were analyzed. The results were compared with findings on subsequent laparotomy or ultimate outcome, which continued in hospital observation and conservative management. RESULTS: Mean age was 23 years and 79% patients were male. Road traffic accident remained the most common cause (70%) and 56% patients had multisystem injuries. The sensitivity for DPL, ultrasound and computed tomography scans was found to be 98%, 96% and 98% with an overall accuracy rate of 92%, 95% and 99%. Diagnostic peritoneal lavage showed false positive results with retroperitoneal injuries and missed one small bowel injury and a pancreatic injury, and resulted in one catheter related bowel injury. Computed tomography scan was able to grade, quantify and localize the injury and helped in devising a successful management plan in 76.5% cases. CONCLUSION: Diagnostic peritoneal lavage is a promising bedside investigation, but is invasive with low accuracy for retroperitoneal injuries and high probability of nontherapeutic laparotomy with false positive results. The high sensitivity and accuracy rates of computed tomography justify its use in quantifying and estimating the grade of injury in order to select the appropriate management of trauma victims. Computed tomography is recommended as the initial investigation of choice in hemodynamically stable patients with blunt abdominal trauma.

Abdominal Injuries↗
PubMed2003

Sample collection factors affect the sensitivity of the diagnostic test for Tritrichomonas foetus in bulls.

The current diagnostic test for Tritrichomonas foetus involves the culture of collected preputial or vaginal samples. In an earlier study, which evaluated sampling tools for use with bulls, it was observed that the sensitivity of the diagnostic test was higher for 2nd samples collected from the right side of the prepuce than it was for samples collected 1st from the left side. The study described in this paper was conducted to evaluate which of these factors was responsible for the effect on diagnostic sensitivity. Twenty-nine bulls infected with T. foetus were repeatedly sampled in a 2-factor cross-over design. Samples taken from the right side of the prepuce were 4 times as likely to be positive as samples taken from the left side (P = 0.03). Other factors did not have a significant effect on the outcome of the diagnostic test. Unexpected factors may affect the sensitivity of the diagnostic test for T. foetus.

Animals↗
PubMed1992

[Effect of diagnostic habits on the incidence of psychiatric diagnoses].

In this study, we analyzed the frequency of ICD-9-diagnoses in 2,868 inpatients (spanning 3 consecutive years) who had been admitted to the Psychiatric Hospital at the University of Tübingen. "Paranoid schizophrenia" (15.8%), "endogenous monopolar depression" (11.2%), "alcohol dependency" (9.9%), "neurotic depression" (6.5%) and "schizoaffective psychosis" (5.3%) turned out to be the most frequently diagnosed illnesses. The diagnosis of 6 mental illnesses described more than 50% of our patient population. In a concurrent study physicians employed at the hospital filled out a questionnaire about their diagnostic style. According to the data physicians were not aware of their narrow diagnostic style. A comparison of physicians within each ward resulted in moderate diagnostic agreement insofar as their diagnoses was based on 4-digit-ICD-categories. When using 3-digit-diagnostic main categories, diagnostic agreement appeared to be higher.

Affective Disorders, Psychotic↗
PubMed2003

[Diagnostic and therapeutic possibilities of interventional echotomography in gastroenterology].

Interventional ultrasound includes all diagnostic and therapy procedures controlled by ultra sound. In this manner, conventional ultrasound diagnostics which has a very important diagnostic role in gastroenterology increases its potential in diagnosis and gives an important contribution in the therapy of abdominal organs diseases. Diagnostic interventional ultrasonography enables sampling from solid and cystic changes for histological or cytological analyses. This procedure enables a more precise injection of contrasts in biliary or pancreatic ducts in the situations when it cannot be done by ERCP. Potential of interventional ultrasonography in the therapy is seen in the possibility to place the needle or the catheter into cystic and abscess changes in order to drain pathological collections and inject medicaments into pathological changes. The procedure is relatively simple and therefore considerably less aggressive compared to surgical treatment. Being very economic and efficient it became an important method in diagnostics and therapy of gastroentrological diseases.

Gastrointestinal Diseases↗
PubMed2003

Diagnostic accuracy of Tuned Aperture Computed Tomography (TACT).

The diagnostic accuracy of Tuned Aperture Computed Tomography (TACT) was evaluated for a variety of diagnostic tasks. Drawbacks of 2D radiography, lack of accessibility and high cost associated with advanced imaging modalities prompted these studies. Mechanically induced vertical/oblique radicular fractures (VRF) on unrestored and endodontically treated teeth were imaged using 2D radiography, unprocessed and TACT-IR images. The effect of iterative restoration on diagnostic accuracy was studied in association with detection tasks such as VRF and mandibular fractures, as also with quantification efforts associated with osseous healing studied in vivo. Iterative restoration deblurring of TACT produced consistently higher diagnostic quality than the other two image types. The effect of observer training and previous experience with viewing TACT indicated that observers with prior experience performed better. It was also noted that fractures extending beyond the middle third of the roots were more accurately detected. The effect of the number of basis images on diagnostic accuracy of TACT radiographs for mandibular fractures showed that reconstructions using 16 basis images that had been iteratively restored performed significantly better. In the in vivo study, quantitative evaluation of healing of osseous defects subjected to different types of grafts using TACT indicates that the most optimal healing occurred with osteoblast-polymer matrix combination. TACT-IR correlated most with histomorphometric data. Increases in gray values corresponding to bone formation were notable during the early period following surgery. These studies indicate that there is enough justification for TACT to find applications in many clinical situations where an ordinary dental x-ray source and a digital sensor/film are currently being used.

Alveolar Bone Loss↗
PubMed1992

[Integration of diagnostic methods in renal vascular pathology].

Modern technology allows us to study the renal vascular diseases by means of many diagnostic procedures. In the past the main diagnostic technique was Urography, whereas Angiography were performed only in few selected cases. The new Imaging Techniques totally changed the diagnostic approach to this kind of diseases. Today in fact Echo-Color-Doppler and Nuclear Medicine are the early diagnostic techniques to be performed. Actually only few selected patients undergo Angiography, not the conventional one but the Digital; this new technique, in fact, in case of renovascular Hypertension is not only of diagnostic value but is often the definitive therapy.

Angiography↗
PubMed1992

[The use of multivariate mathematical methods in medical diagnostic systems--a model for the evaluation of cytological smears].

The methods of the multivariate mathematics have been applied in several studies to increase the diagnostic reliability of medical decision support system. In the recent years some new algorithms for decision support (fuzzy logic) and for pattern recognition (neural nets), both specified by nonlinearity, were developed. This paper provides results for the application of this methods in the area of quantitative cytology and the comparison with the traditional classifiers. 21 normal, 15 dysplastic, 23 malignant, Feulgen stained gastric imprint smears were analysed on a Leitz Miamed DNA equipment. The determination of mean DNA content, the 2c deviation index (2cDI), 5c Exceeding rate (RcER), G1,S,G2 phase fraction ratios, cell nucleus area, form factor was performed. The discriminant analysis classified correctly the 95.6% of malignant cases, 86.7% of dysplasias, and 80.7% normal cases. Our diagnostic system using fuzzy logic made the diagnostic borders fine tuneable, and reliable. The back propagation neural net could classify all three diagnostic groups above 95% correctly. The application of nonlinear computational methods made the diagnostic system more reliable. The application of these algorithms are encouraged.

Algorithms↗
PubMed2000

Diagnostic accuracy of mammography and scintimammography in detection of primary breast cancer related size of the tumour.

BACKGROUND: The detection of breast cancer relies on physical examination and mammography (XMM). The sensitivity of conventional imaging is lesions-size dependent. However, mammography has good sensitivity in small tumours when microcalcification is present, but the sensitivity is relatively low in other small tumours. The use of scintimammography with Tc-99m sestaMIBI (SMM) may be helpful in this situation. The aim of this study is to compare the diagnostic accuracy of mammography and scintimammography across all groups with different sizes of lesions. METHODS: Data for 273 patients aged 26 to 84 years (mean 52; SD 12) with 298 lesions were analysed. All lesions were removed and final histology and pathological size of the tumours were retrospectively reviewed (mean size 2.9 cm, SD 2.4 cm). All patients had XMM and SMM. Each imaging study was graded using five grades of certainty. SMM images were reviewed by an independent specialist blinded to clinical presentation and XMM results. The diagnostic accuracy of each test, overall and by each lesions size subgroup, was compared using receiver operating characteristic curve (ROC) analysis. RESULTS: The sensitivity of scintimammography was consistently high across all size groups; overall 89% (82?100%) compared with 68% (51?88%) for mammography. In those tumours below 2 cm, the area under the ROC was significantly larger with SMM than XMM (p < 0.05), with 80% certainty indicative of greater diagnostic accuracy. Also in all patients the area under the ROC was significantly larger with SMM than XMM (p < 0.05), with 90% certainty indicative of greater diagnostic accuracy. In other groups of lesions size the area under ROC for SMM was larger in lesions size between 2 and 4 cm and slightly smaller in lesions over 4 cm, but it was not significant. CONCLUSION: Scintimammography using Tc-99m sestaMIBI seems to be a sensitive and consistently reliable diagnostic test for breast cancer independent of the size of the tumour.

Journal Article↗
PubMed2003

[Study on diagnostic criterion of pregnancy induced hypertension].

OBJECTIVE: To study the rationality of the current diagnostic criterion of pregnancy induced hypertension (PIH) in mainland China. METHODS: To analytically review the 916 cases of PIH in our hospital, reclassify them using both the current domestic diagnostic criteria and the William Obstetrics' criteria, then compare and analyze perinatal and maternal outcomes from the two standards. RESULTS: (1) Maternal outcomes: comparison result of the occurrences among three groups of premature birth, postpartum haemorrhage and placental abruption according to domestic classification had significant difference (P < 0.05). And it's the same result according to foreign classification (P < 0.05). But the occurrences within three groups of premature birth, postpartum haemorrhage and placental abruption between domestic and foreign classifications showed no significant difference (P > 0.05). (2) Perinatal outcomes: Comparison results of the occurrences among three groups of fetal growth restriction, asphyxia neonatorum and perinatal fetal and neonatal death incidence according to domestic classification had significant difference (P < 0.05). And it's the same result according to foreign classification (P < 0.05). But the occurrences within three groups of fetal growth restriction, asphyxia neonatorum and perinatal fetal death and neonatal incidence showed no significant difference (P > 0.05). (3) The constituent ratio of mild, moderate, severe PIH according to domestic classifications was 46.6%, 18.4%, 34.9% respectively. The constituent ratio of gestationgal hypertision, mild preeclampsia and severe preeclampsia according to foreign classifications was 47.6%, 14.3%, 38.1%. There were significant differences between domestic and foreign constituent ratio (P < 0.05). If you compare the results from these two diagnostic classifications, with mild PIH, the accordant rate was 85.0%; with severe PIH, the rate was 93.8%; but it's only 40.2% with moderate PIH. CONCLUSIONS: The diagnostic criteria for PIH being used in our mainland China is rational, but in the current stage, due to the lack of objective index for early diagnosis and overall assessment of patient's condition, it's also limited. More objective index should be adopted to improve the diagnostic standard for PIH.

Female↗
PubMed2003

[Causes and diagnostic procedure of diffuse lung disease in 28 children].

OBJECTIVE: Diffuse lung disease comprises a large, heterogeneous group of pulmonary interstitial and parenchymal disease. It is therefore difficult to some extent to make etiologic diagnosis. Little information on clinical spectrum and diagnostic evaluation of pediatric diffuse lung disease is available in our country. The purpose of this study was to explore the causes of and diagnostic approach to diffuse lung disease in children. METHODS: Twenty-eight children with diffuse lung disease aged 2 months to 14 years were studied retrospectively. Their history, physical examination, radiographic findings, final diagnosis and diagnostic processes were reviewed. RESULTS: Confirmed diagnosis was established in 25 cases and suggestive diagnosis in 3 cases. Confirmed diagnoses included: mycoplasma pneumonia in 1 case, Chlamydia trachomatis pneumonia in 2 cases, Epstein-Barr virus pneumonia in 1, CMV pneumonia in 2, hematogenous disseminated pulmonary tuberculosis in 3, pulmonary cryptococcosis in 1, invasive pulmonary aspergillosis in 2, Staphylococcus aureus sepsis in 1, diffuse bronchiectasis in 2, idiopathic pulmonary hemosiderosis in 1, idiopathic pulmonary fibrosis in 1, extrinsic allergic alveolitis in 1, HIV-related lymphocytic interstitial pneumonitis in 1, Wegner's granulomatosis in 1, Langerhan's cell histiocytosis in 2, and lymphoma in 3. Suggestive diagnoses included Nocardia pneumonia in 1, Pneumocystis carinii pneumonia in 1, and juvenile rheumatoid arthritis-associated pulmonary fibrosis in 1. The diagnostic directions of 26 patients were conducted by radiographic features. In 17 of 26 cases, the diagnostic range was confined by history. The diagnosis of 14 cases was made by noninvasive tests including antibody detection, bacterial culture, those of 8 cases by examination of biopsy material, and those of 2 cases by autopsy. CONCLUSIONS: The causes of pediatric diffuse lung disease included pulmonary infectious disease, idiopathic pulmonary disease and pulmonary lesion associated with systemic diseases. The diagnosis may be made by radiography, history, physical examination, noninvasive tests in most cases, while in some cases invasive procedures were necessary.

Adolescent↗
PubMedDate not supplied

[Prognostic significance of diagnostic delay in carcinoma of the endometrium: our experience].

Although endometrial carcinoma is characterized by a precocious symptomatology, in 28.4-22.6% of cases at the time of diagnosis it is found to be at clinical stage higher than I. In the present study the diagnostic delay is related to the stage of disease. Our data suggest that diagnostic delay can cause a higher risk of advanced-stage disease; all the cases of stage III and IV disease, in fact, were diagnosed after more than 7 months. Diagnostic delay was also directly related to depth of myometrial invasion; the mean diagnostic delay was significantly shorter in patients with stage I disease and superficial myometrial invasion (3.92 vs 8.76 months) (p < 0.001). Therefore, diagnostic delay is directly related to well-established prognostic variables as well as to clinical stage and depth of myometrial invasion.

Adenocarcinoma↗
PubMed2004

A diagnostic rule for the aetiology of lower respiratory tract infections as guidance for antimicrobial treatment.

BACKGROUND: The majority of patients with lower respiratory tract infections (LRTIs) are treated with antibiotics; some of them are unnecessary because of a viral cause. Information on prediction of the aetiology, especially in a general practice setting, is missing. AIM: To differentiate between viral and bacterial LRTI on simple clinical criteria, easily obtained at the bedside. DESIGN OF STUDY: Prospective observational study. SETTING: General practices in the Leiden region of The Netherlands. METHOD: Adult patients with LRTI were included. Standard medical history and physical examination were performed. Sputum, blood and throat swabs were collected for diagnostic tests. According to microbiological findings, patients were classified as bacterial, viral, dual infection and unknown cause. In a logistic regression model independent predictors were determined. Scoring systems were developed. The accuracies of the diagnostic rules were tested by using receiver operating characteristic (ROC) curves. RESULTS: One-hundred and forty-five patients were classified as having bacterial (n = 35), viral (n = 49), or dual infection (n = 8), or infection of unknown cause (n = 53), respectively. Independent predictors for bacterial infection were fever (odds ratio [OR] = 8.0; 95% confidence interval [CI] = 0.9 to 71.0), headache (OR = 4.3; 95% CI = 1.0 to 19.1) cervical painful lymph nodes (OR = 8.7; 95% CI = 1.1 to 68.0), diarrhoea (OR = 0.3; 95% CI = 0.1 to 1.0) and rhinitis (OR = 0.3; 95% CI = 0.1 to 0.9). As an additional independent predictor, an infiltrate on chest X-ray (OR = 5.0; 95% CI = 1.2 to 20.5) was found. The diagnostic rules developed from these variables classified the aetiology of LRTI with a ROC curve area of 0.79 (clinical score), 0.77 (simplified score) and 0.83 (extended score). CONCLUSIONS: A diagnostic rule was developed, based on information that is easy to obtain at the bedside, to predict a bacterial infection. This diagnostic rule may be a tool for general practitioners in their management of patients with LRTI.

Anti-Bacterial Agents↗
PubMed2004

[Use of 3 French catheters for diagnostic and interventional procedures in newborns and small infants].

Miniaturisation of diagnostic and interventional tools is of main interest for cardiac catheterization of newborns and small infants, due to the limited vascular access of these patients. Since January 2001 to November 2002, we performed 11 diagnostic and 5 interventional procedures in 15 infants, utilising custom-made 3 F sheaths and catheters. The median age and weight of the patients were 7 days (range 1-180) and 2.8 kg (range 2-4), respectively. Diagnostic catheterizations gave the required information in all cases. Angiography was performed following the results of in vitro pressure to volume tests. Blood sampling was possible by using gentle aspiration. Pressure measurement, although showing some dumping, allowed the evaluation of peak to peak gradient through right and left ventricular outflow tracts. It was always possible to perform an interventional procedure, when required. No procedural complications occurred. The price for a diagnostic or interventional procedure performed with 3 F sheath and catheters exceeded of 23 euros that of a procedure performed with material measuring 4 F or more. Patients underwent echographic examination of femoral vessels at a median follow-up of 6.3 months (range 2-10 months). All vessels of the examined patients were patent, without stenosis nor collateral circulation. In conclusion, preliminary results utilising 3 F sheaths and catheters are encouraging, in terms of feasibility of diagnostic and interventional procedures, absence of procedural complications and preservation of vascular access. Financial implications are not of major concern.

Cardiac Catheterization↗
PubMed2004

Comparison of diagnostic yields of clinical and radiographic caries examinations in children of different age.

AIM: This was to investigate if the pattern of distribution of caries lesions detected by clinical and radiographic examinations at different diagnostic thresholds changed over a 3-year period during the course of eruption of the permanent dentition. It has been hypothesized that the contribution of bitewing radiography to caries detection in posterior teeth may increase when approximal contacts are established during maturation of the dentition. METHODS: Clinical and radiographic caries recordings were made using the non- cavitated/enamel and cavity/dentine thresholds for caries detection among a group of 12-year-old Lithuanian children with a high caries experience. Examinations were repeated in the same children after 3 years. The bitewing radiographs from both examination sessions were coded to ensure unbiased recordings and were read by a single examiner. RESULTS: The diagnostic yields of the clinical and radiographic examination methods did not change after the permanent teeth had fully erupted. At both examination sessions the clinical examination resulted in the detection of significantly more lesions than did the radiographic method at the non-cavitated level (43- 47% lesions detected by clinical means only and 2-26% by radiographic means only). Only for approximal surfaces at the cavity/dentine diagnostic threshold did radiographs contribute to more lesions (15-16% lesions detected by clinical means only and 38-41% by radiographic means only). Establishment of approximal contacts in the permanent dentition did not increase the relative diagnostic yields of bite-wing radiography in this study group. CONCLUSION: The contribution of the two methods to caries diagnosis depends more on the diagnostic threshold selected than on the stage of maturation of the dentition.

Child↗
PubMedDate not supplied

[The specificity of organization of the consultative-and-diagnostic service for the adult population in a big city].

The volume and structure of the diagnostic services and of the medical aid appealability were analyzed for the Eastern Administrative District of Moscow by the example of a stage-2 diagnostic-and-consultative center. The analysis was made on the basis of 80233 receipts of patients for the period of January-April 2003. Three types of patients' flow were defined with respect to the purpose of visit: consultative aid (CA, 17.3%), consultative-and-diagnostic aid (CDA, 16.2%) and diagnostics (D, 66.5%). Differences are shown in the structure of appealability by the classes of diseases (nosological forms of diseases) and according to groups of patients. Consultations are mostly provided in cases of diseases of the endocrine system (20.9%), digestive system (20.2%) blood-circulation system (18.0%) and urogenital system (14.6%). Patients with urogenital disease (31.1%) and with blood-circulation lesions (13.5%) were found to be predominant in the CDA group. The structure of appealability is defined for the classes of diseases, their nosological forms and for medical specialties. It is pointed out that 52.1% of patients visited their general practitioners. Patients visited most often the doctors of the below specialties: oncology--16.1%, endocrinology and cardiology 12.3%, general practitioner--11.5% and gastroenterology--78%. The rate of visits was evaluated for the classes of diseases and medical fields; the estimated distribution of appealability was estimated with respect to the rate of visits. The structure of diagnostic examinations was analyzed by types, purpose, and classes of diseases (nosological forms).

Adult↗
PubMed2004

Computed Tomography is Diagnostic in the Cervical Imaging of Helmeted Football Players With Shoulder Pads.

OBJECTIVE: Prospective, observational case series evaluating the value of cervical spine computed tomography (CT) scans in the initial evaluation of a helmeted football player with suspected cervical spine injury. SUBJECTS: Five asymptomatic male football players, fully equipped and immobilized on a backboard. DESIGN: Multiple 3.0-mm, helically acquired, axially displayed CT images of the cervical spine were obtained from the skull base inferiorly through T1, with images filmed at soft tissue and bone windows. Sagittal and coronal reformatted images were performed. Software was used to minimize metallic artifact. MEASUREMENTS: All series were reviewed by a Board-certified neuroradiologist for image clarity and diagnostic capability. RESULTS: Lateral scout films demonstrated mild segmental degradation, depending on the location of the metallic snaps overlying the spine. Anteroposterior scout films and bone window images were of diagnostic quality. The soft tissue windows showed minimal localized artifact occurring at the same levels as in the lateral scout views. This minimal beam-hardening streak artifact did not affect the diagnostic quality of the soft tissue windows. Reconstructed images were uniformly of clinical diagnostic quality. DISCUSSION: When CT scans were reviewed as a unit, sufficient information was available to allow reliable clinical decisions about the helmeted football player. In light of recent publications demonstrating the difficulty of obtaining adequate radiographs to evaluate cervical spine injury in equipped football players, helmeted athletes may undergo CT scanning without any significant diagnostic limitations.

Journal Article↗