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At least 1,621 records · Page 90Linked to original sources
PubMed1988

[Accuracy of analysis and susceptibility to faults in ECG detection using pacemakers with diagnostic functions].

The accuracy of analysis and susceptibility to faults of additional diagnostic functions in pacemakers were tested in 16 patients (eight men, eight women, average age 61.5 +/- 10.8 years, 14 VVI, 2 AAI) with diagnostic pacemakers (Quintech DPG 921). The average observation period was 19.7 months. With 109 follow-up intervals this meant an observation period of 25.9 patient-years. A stage-by-stage test structure over several periods of time was used in order to validate the data acquired through pacemaker Holter functions by means of control ECGs and mathematical test methods. The only fault to occur in the diagnostic functions was a loss of stored data. This was observed in 10% of follow-up intervals and was, on average, 28% (16-38%) of the total events. 44% (7/16) of the pacemakers were affected by this malfunction. Our results show that the diagnostic data are certainly correctly acquired. The clinical value of the diagnostic functions is clearly reduced by this potential loss of data.

Adult↗
PubMed1986

New diagnostic methods in dermatological mycology.

In dermatological mycology, direct microscopy and culture are the main diagnostic procedures. Microscopic examination of a wet KOH preparation is usually satisfactory for the detection of the infecting organism based on the morphological characteristics of the fungal elements. However, examination of the KOH mount requires skill and experience. In order to help the unskilled personnel to recognize fungal elements by microscopic examination, a number of differential strains have been described. Great strides have been made to improve the sensitivity and specificity of direct microscopy for the detection of fungi also on chemical properties of the fungal cell wall. Thus fluorescence microscopy using fluorescent brighteners, e.g. Blancophor BA holds great promise for its wide application in dermatologic mycology. Culture media enjoy considerable application in the isolation and identification of dermatophytes and Candida species from clinical specimens. Some novel media have been formulated recently to assist in the early detection and identification of some fastidious dermatophytes e.g. Trichophyton verrucosum. In dermatological mycology the predictive diagnostic value of the diagnostic tests has to be delineated for each disease state. As an example, direct microscopy is a useful diagnostic procedure for the detection of dermatophytes and Pityrosporum-yeasts in clinical materials, but less valuable for the detection of Candida. Furthermore, considerable attention needs to be focused on the utilization of new and old diagnostic tests from a series of viewpoints including necessity, usefulness, clinical relevance and cost-benefit analysis.

Candida↗
PubMed1987

Rapid cytophotometry and its application to diagnostic pathology.

Computer processing of microscopic imagery of cervical lesions can provide novel quantitative diagnostic information. Interpretation of this information, from the level of the image itself to that of diagnostic truth, calls for the use of appropriate data structures. The resolution of the problems of diagnostic consensus and truth may be furthered by the use of these techniques in conjunction with diagnostic expert systems. The impact of our expanded ability to differentiate and to extract diagnostic and prognostic information will lead to changes in the way we practice clinical pathology. Technologic advances have now made it possible to perform quantitative measurements in a very rapid fashion as a practical part of routine clinical pathology activity.

Carcinoma↗
PubMed1979

[Early diagnostic imaging of rheumatoid arthritis (RA) (author's transl)].

The respective diagnostic value each of diagnostic radiology and nuclear medicine in the detection of early rheumatoid arthritis is being demonstrated--with close correlation to its clinical presentation and course. Diagnostic radiology is found to be specific and nuclear medicine to be highly sensitive, with the latter giving better diagnostic information at an earlier time about the activity of the disease than the former--including soft tissue technique. Nuclear medicine further--more will be helpful for appropriate timing of diagnostic radiology evaluations of this disease.

Adult↗
PubMed1985

Contribution of cavography to diagnostics of urological diseases.

In the work diagnostic value of cavography in diseases of retroperitoneum organs and anomalies of inferior vena cava and its tributaries is described with a special regard to urological diseases. In correlation with other examination procedures cavography gives valuable information on extent of renal tumours and their relation to surrounding structures, as well as on their infiltration into vascular system. It is justifiable also in diagnostics of primary tumours of retroperitoneum and in diseases of lymph nodes. It completes right diagnostic conclusion and it helps in decision of operability and in determination of therapeutic operation tactics. Its application exceeds the urological field, it brings also differentially diagnostic possibilities and it is applied also in control of therapeutic results. Cavography should not miss in arsenal of modern diagnostic methods.

Adolescent↗
PubMed1985

Penetrating neck trauma: diagnostic studies in the asymptomatic patient.

The selective management of penetrating neck trauma implies an attempt to individualize care and minimize unnecessary surgical exploration. In asymptomatic patients, diagnostic studies are performed in an attempt to exclude clinically unrecognized injuries. This review of 100 consecutive cases of penetrating neck trauma assesses the role of ancillary diagnostic studies in 53 patients selectively managed. The diagnostic yield from a combination of angiography, fluoro-esophagography, and aerodigestive tract endoscopy was 22.6% (12 of 53). However, only five patients (9.4%) actually benefitted from ancillary diagnostic studies, in that angiography documented clinically unrecognized injury. In an effort to avoid the indiscriminate use of ancillary diagnostic studies, a selective management plan based on anatomic zones of injury is provided.

Adolescent↗
PubMed1985

[Liver diagnostics].

Prerequisite of a scientific and rational liver diagnostics is the knowledge of the physician of function and structure of the liver. The laboratory demand should always be an accomplishment of the physician and should be performed only upon such a scale that it is also followed by therapeutic consequences and/or consequences concerning the expert's opinion. The biochemical blood analysis gives information about the size of the injury to the parenchyma and about the disturbance of the various partial functions of the liver. In this case is to be taken into consideration that biochemical and histological parameters are no concurrent, but supplementing diagnostic methods. A progress in liver diagnostics is the use of the isoenzymes of the aspartate aminotransferase and the lactate dehydrogenase as well as of the enzymes of the metabolism of the connective tissue. With the entering into selected parameters of the liver diagnostics possibilities to the establishment of the disturbed liver metabolism by means of markers are shown and at the same time recommendations for the praxis of the liver diagnostics are derived.

Clinical Enzyme Tests↗
PubMed1977

Comparison of diagnostic accuracy of different peripheric parameters of thyroid function.

Diagnostic value of a scope of peripheric parameters of thyroid function was assessed in an unselected group of untreated patients with suspected thyroid disorder, further in untraeted selected patients (without cardiac involvement) and in treated patients. Comparison of relative values of individual tests was performed, based on relation to plasma thyroid hormone level represented by PBI. It was found that: 1. The diagnostic value of heart rate, plasma cholesterol level, B. M. R. and Hegglin's sign (T-2s interval) is of a very limited degree. 2. The diagnostic accuracy of AJT, Q-Kd interval and PEP was found to be of considerable interest even in unselected patients. Values of IRVD and D indices found for these tests are comparable and allow the immediate estimation of thyroid function in bedside diagnosis. 3. The diagnostic value of PEP could be enhanced by exclusion of patients with suspected or proved cardiac disorder or myocardial failure; this may be useful for physiologic studies. 4. While heart rate is profoundly and inconsistently influenced by beta-blockade, AJT is influenced to a minimal degree only and Q-Kd and PEP are uniformly shifted to higher values, allowing thus diagnostic evaluation during this form of treatment also. 5. As Q-Kd is considerably age-and height-dependent, AJT and PEP are believed to be the most suitable test for immediated clinical diagnosis.

Achilles Tendon↗
PubMed1982

[Diagnostic imaging of malignant lymphoma].

Diagnostic accuracy about the relation between staging laparotomy and each diagnostic modality was reviewed. Modern diagnostic imaging revealed high diagnostic accuracy (80-90%) in detection of abdominal lymphoma except for diffuse hepatic and splenic lesions. Staging of malignant lymphoma before and after computed tomography was evaluated: in 15 cases out of 47 patients with malignant lymphoma, stage of disease was changed into the higher stage. Computed tomography can provide complementary information about extension of the disease, which are not detected by gallium scintigraphy and lymphography. Lymphography, gallium scintigraphy and computed tomography are the major diagnostic modalities for staging of malignant lymphoma.

Diagnosis, Differential↗
PubMed1980

[The diagnostic value of measuring the electric conductivity of milk].

A positive correlation of the milk specific conductance (MSC) to the number of cells (r = 0.65) and to the content of chloride ions (r = 0.93) was found on the basis of an examination of 196 udder-quarter milk samples. As indicated by the closeness of the relationship to the number of cells, MSC measurement at a determination level of 41.8% has similar diagnostic effectiveness as the determination of the content of chloride ions (determination level 43.5%) and lactose content (determination level 42.8%), and much higher diagnostic effectiveness than the determination of titration acidity (determination level 23.4%). As indicated by the closeness of the relationship to the content of chloride ions, MSC measurement at a determination level of 86.7% has higher diagnostic effectiveness than the determination of lactose content (determination level 73.9%) and titration acidity (determination level 54.6%). In both comparisons, the highest diagnostic effectiveness was found in assessing the chlorine-sugar number (determination levels of 49.8% and 94.0%). The MSC value, corresponding to the cellulization of 500 . 10(3) cells per ml of milk, was determined from regression: 0.523 S . m-1. The diagnostic congruence of MSC with the number of cells in milk was 81.25%, and with the findings of mastitis test-NK only 54.0%. The variability of the measurements of MSC renders it impossible to use this measurement to indirect multi-step screening of milk cellulization. It is only realistic to distinguish two classes of the measured MSC values: negative and positive.

Animals↗
PubMed1982

Impact of diagnostic arthroscopy on the clinical judgement of an experienced arthroscopist.

This study explores the impact of a careful analysis of 1000 consecutive cases of diagnostic arthroscopy conducted by the author. The cases are evaluated to determine whether there is a tendency to clinically misdiagnose certain lesions. The findings furthered knowledge in regards to other possible diagnoses for specific symptom complexes. Diagnostic arthroscopy has allowed surgeons to " fine tune" their preoperative diagnostic ability and can be a very useful enhancement to the armamentarium of clinical evaluations, laboratory tests, plain radiographs, and double contrast arthrograms as diagnostic tools for knee problems. An "audit" procedure is outlined that could benefit any surgeon who is concerned about increasing their diagnostic ability.

Adolescent↗
PubMed1978

[Diagnostic ultrasonography and X-ray computer tomography in space-occupying orbital lesions--a joint effort (author's transl)].

Diagnostic ultrasonography (A-and B-scans) and X-ray computer tomography are completely different in their physical bases. The yield, therefore, different informations in the examination of space-space-occupying lesions in the orbit. The informations which can be recorded from normal and pathologic tissues in the orbit are described in this paper. The value, but also the limitations, of the various diagnostic methods are demonstrated in clinical cases. The reliable diagnosis of unilateral, progressive pseudoprotrusion in high myopia by ultrasound exophthalmometry is described. Facilities and diagnostic value of ultrasonography and X-ray computer tomography in the localisation of orbital tumours and in the determination of their relationship to the orbital walls are discussed. The diagnostic management in intermittent exophthalmos, in orbital abscess and in Grave's disease is reported. The complete ophthalmic examination is followed by ultrasound exophthalmometry and--if indicated--A- and B-scan ultrasonography of orbital tissues. Computed X-ray tomography is indicated in all tumour-suspicious lesions within the orbit. The results of diagnostic ultrasonography and computed X-ray tomography may complete each other in a very helpful manner. The combined evaluation yields better results than the use of only one of these methods. In orbital varices we recommend, to supplement ultrasonography by venography and eventually arteriography. In diagnoses of orbital abscesses resulting from paranasal sinusitis it may usually suffice to combine ultrasound diagnosis with native X-ray examinations. Good interdisciplinary cooperation in diagnosis and therapy is mandatory in all patients with space-occupying orbital lesions.

Abscess↗
PubMed1982

[The clinical course as assessment for a diagnostic test].

Investigations assessing the predictive value of diagnostic tests are rarely performed. Several factors may contribute to this matter. Firstly, a diagnostic key is required, secondly a pathoanatomic examination is most often regarded as the true diagnostic key and thirdly, when this demand cannot be met clinical syndromes are created. However, a prediction of the clinical course is of major value to the physician compared to a pathoanatomic diagnosis. Together with the paraclinical data, the clinical course may comprise the diagnostic key in assessing diagnostic probabilities or "probabilities of a certain clinical course", i e the actual predictive probabilities.

Decision Making↗
PubMed1995

[Percutaneous transthoracic needle aspiration biopsy. Diagnostic yield after negative fiberoptic bronchoscopy in patients with peripheral pulmonary infiltrations].

The diagnostic potential of secondary transthoracic needle biopsy (TNB) following negative fiberoptic bronchoscopy in patients with peripheral circumscribed pulmonary lesions was evaluated in a retrospective study. The records from 224 patients who had TNB performed over a five-year period were reviewed. Of these, 103 patients met the criteria for inclusion in this series. The overall diagnostic yield of TNB in malignancy was 73.8% (54 of 73 patients). TNB allowed cytological classification of the tumour type in 72.2% (39 of 54 patients). Five of the 54 patients (9.3%) presented with small cell anaplastic bronchogenic carcinoma, diagnosed by TNB, and were treated with chemotherapy. Of the 49 patients with a negative TNB, 27 went on to diagnostic surgical procedures; 19 had malignancy, three benign tumour, two infection, and three sequelae after pulmonary infarction. The remaining 22 patients with undiagnosed lesions were followed long term, five showed progression of the pulmonary lesion suggesting malignancy. TNB appeared unsuitable in the diagnosis of benign lesions. Unspecific inflammation was not considered evidence of benignity, and therefore a definitive benign diagnosis was not made by TNB in this series. There were no serious complications to TNB. In 18.1% of the procedures a pneumothorax developed, indicating a chest tube in 8.6% of the procedures. TNB is a suitable diagnostic procedure with a high diagnostic yield in patients with peripheral, malignant pulmonary lesions.

Adult↗
PubMed1995

The SDDS-PC: a diagnostic aid for multiple mental disorders in primary care.

The Symptom Driven Diagnostic System for Primary Care (SDDS-PC) is a new computerized clinical procedure to assist primary care physicians in diagnosing mental disorders during the course of routine practice. It has three components: (1) a 5-minute patient-administered 16-item screening questionnaire, (2) six 5-minute physician-administered diagnostic interview modules based on DSM-III-R criteria, and (3) a longitudinal tracking form. The SDDS-PC covers five disorders (major depression, panic disorder, alcohol abuse or dependence, generalized anxiety disorder, and obsessive compulsive disorder) as well as suicidal ideation. Patients who screen positive for a disorder receive the corresponding diagnostic interview module. Patients who meet mental disorder criteria on the diagnostic interview module are then followed with the longitudinal tracking form. Minor or subsyndromal conditions are also addressed at the physician's discretion. This article describes the development of SDDS-PC and summarizes results from two studies which involved comparisons between the SDDS-PC and independently administered full-length structured diagnostic interviews.

Depression↗
PubMed1995

[Preliminary study of a double chamber pacemaker with diagnostic function].

Pacemakers with diagnostic functions have been implanted for several years. The main clinical indication for these devices is unexplained syncope. Some reports of the use of diagnostic pacemakers have shown that in patients with unexplained syncope, paroxysmal bradycardia was a common finding after implantation. Until recently, diagnostic functions were only available in VVI pacemakers, which explains the limitations of this type of function in determining the mechanism of the bradycardia. The aim of this study was to assess a new dual-chamber diagnostic pacemaker functioning in the VDI mode. Twenty-three patients were implanted with this type of unit and followed up for an average of 153 days. The number of episodes of bradycardia detected was 6 +/- 10 (median: 3). The interval between the installation of the algorithm and the date of the first episode of bradycardia was 67 +/- 86 days (range: 12-306 days). The mechanisms of the bradycardia were atrioventricular block (6 patients), sinus node dysfunction (6 patients) and blocked atrial bigeminy in 1 patient. These conclusions were drawn from analysis of chains of markers. Bradycardia was recorded during the day or during the day and night in 21 patients; bradycardia was exclusively nocturnal in only 2 patients. The tolerance of the algorithm was good on the whole but 3 patients reported minor symptoms related to the relative bradycardia inherent with this type of algorithm. Four other patients had a VDI pacemaker syndrome which was completely corrected by reprogramming the pacemaker to the standard DDD mode. These new devices represent a technical advance in the field of diagnostic pacemakers.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMedDate not supplied

A comparison of pelvic ultrasound and magnetic resonance imaging as diagnostic studies for müllerian tract abnormalities.

OBJECTIVE: The purpose of the present study was to compare prospectively the accuracy of pelvic US examination and MR imaging in the assessment of müllerian tract abnormalities. PATIENTS AND METHODS: Sixteen patients with congenital müllerian defects underwent US examination, MR imaging, diagnostic laparoscopy, and hysteroscopy. Abnormalities included unicornuate (n = 2), bicornuate (n = 6), and septate (n = 6) uteri, and normal uteri with septate vagina (n = 2). Patients with müllerian abnormalities were referred after hysterosalpingogram or clinical examination revealed uterine, cervical, and/or vaginal congenital abnormalities. Laparoscopic and hysteroscopic confirmation of these radiologic impressions was made in all patients. RESULTS: Pelvic US examination and MR imaging for all abnormalities had an overall sensitivity of 57% and 77%, specificity of 50% and 33%, a positive predictive value of 89% and 83%, and a negative predictive value of 14% and 25%, respectively. Pelvic US examination and MR imaging correctly diagnosed septate uterus in 2/6 cases (33%) and 3/6 cases (50%), respectively. This abnormality was most commonly misdiagnosed as a normal or bicornuate uterine cavity. For bicornuate uterus, pelvic US and MR, however, correctly diagnosed 6/6 cases (100%) and 5/6 cases (83%), respectively. Accurate diagnoses were made for bicornuate uteri using either modality owing mainly to the presence of a characteristic fundal notch. US examination was nonspecific for unicornuate uterus (0/2 cases diagnosed), defining only a single cavity, but without sufficient details of adnexal regions. MR imaging of unicornuate uteri, however, provided detailed images of both uterine cavity configuration (2/2 cases diagnosed) and adnexal anatomy. CONCLUSIONS: Our data suggest that pelvic US examination and MR imaging are not sufficiently accurate to qualify as sole diagnostic studies for septate uteri. Though less expensive and less invasive than diagnostic laparoscopy, they do not provide a sufficiently sensitive and specific method to differentiate septate from bicornuate uteri, a critical aspect for surgical planning. Though more costly, diagnostic laparoscopy appears to be the most accurate diagnostic study for the assessment of uterine anatomy and definition of müllerian abnormalities.

Female↗
PubMed1995

Diagnostic laparoscopy in women with acute abdominal pain.

Nineteen women with acute lower abdominal pain of uncertain etiology underwent diagnostic laparoscopy during a 2-year period from August 1991 to August 1993 and were retrospectively reviewed. All patients, aged 12 to 44 years, were premenopausal. Laparoscopy provided definitive diagnosis in all 19 patients. Laparoscopic findings included appendicitis (11 cases), pelvic inflammatory disease (five cases), significant ovarian cysts (two cases), and ectopic pregnancy (one case). Successful laparoscopic procedures included appendectomy (five cases), and salpingo-oophorectomy (one case). Five patients required only diagnostic laparoscopy. Eight patients required conversion to an open procedure because of anatomical considerations (six cases) or equipment failure (two cases). Median operative time was 71 min, and median postoperative hospital stay was 2 days. Most diagnostic procedures were performed on the same day as admission, resulting in a median hospital stay of 3 days. Diagnostic laparoscopy performed in premenopausal female patients with acute lower abdominal pain of unknown etiology provides diagnostic accuracy as well as therapeutic capabilities and prevents unnecessary laparotomy.

Abdomen, Acute↗