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Diagnostic Ability (diagnostic + ability)

Distribution by Scientific Domains

Medical Sciences	94%

Distribution within Medical Sciences

Cardiovascular Disease	11%

Selected Abstracts

Diagnostic ability of GDx VCC to discriminate between healthy eyes, ocular hypertensive subjects and glaucoma patients

ACTA OPHTHALMOLOGICA, Issue 2007
E BORQUE
Purpose: To evaluate the diagnostic ability of laser polarimeter GDx VCC to discriminate between healthy eyes, ocular hypertensive subjects and glaucoma patients. Methods: 417 eyes of 417 subjects were included. They were divided into 60 healthy controls, 289 ocular hypertensive subjects and 71 glaucoma patients. The GDx VCC parameters were compared among the study groups using analysis of variance. The receiver operating characteristic (ROC) curves were plotted for TSNIT average, superior average, inferior average, TSNIT standard deviation and nerve fiber indicator (NFI) between control and glaucoma eyes. Results: All evaluated parameters of the GDx VCC showed significant differences between control and glaucomatous eyes and between ocular hypertensive eyes and glaucoma patients. NFI had the greatest area under the ROC curve (AUC=0.881). The AUCs for the inferior average, TSNIT standard deviation and TSNIT average were 0,834, 0.824 and 0.819, respectively. NFI presented a larger AUC than the other GDx VCC parameters. Conclusions: The GDx VCC exhibited a good diagnostic ability to discriminate between healthy and glaucomatous eyes with damage in SAP. The best parameter was NFI. [source]

Virtual microscopy: An educator's tool for the enhancement of cytotechnology students' locator skills

DIAGNOSTIC CYTOPATHOLOGY, Issue 6 2008
Jimmie Stewart III M.D.
Abstract Virtual microscopy (VM) is being utilized as an educational tool in many areas of pathology. The aim of this study is to analyze the locator and diagnostic skills of cytotechnology students by using the Aperio T3 ScanScope®, and examine VM's viability as an educational tool in cytotechnology. Ten validated cytology slides were digitized and reviewed by three senior cytotechnologist instructors. Each technologist made annotations indicating diagnostic areas on the virtual slide. A subset of the slides was used for locator skill evaluation. Cytotechnology students examined a pristine copy of the virtual slide and made annotations for comparison to those made by experienced instructors. Annotations of the subset were then scored based on the degree of correlation between students and cytotechnologists. A cytopathologist performed a final review of the students' marks; points were then added or subtracted based on this interpretation. Students were graded based on their correlation to senior cytotechnologists. A statistical analysis using modified interrater calculations ranked the students as to locator ability, producing illuminating results. This study shows that VM has promise as a cytotechnology educational tool by allowing the instructor to evaluate students' locator and diagnostic abilities. We have attempted to implement a simple scoring system for evaluation of locator skills where students are compared versus expert cytotechnologists. We anticipate further technological improvements as the products mature. Diagn. Cytopathol. 2008;36:363,368. © 2008 Wiley-Liss, Inc. [source]

Clinical application of transcranial colour-coded duplex sonography , a review

EUROPEAN JOURNAL OF NEUROLOGY, Issue 1 2002
Stephan G. Zipper
Transcranial colour-coded duplex sonography (TCCS) is a new and non-invasive ultrasound application that combines both imaging of intracranial vessels and parenchymal structures at a high spatial resolution. This manuscript reviews the clinical applications of TCCS with focus on its diagnostic abilities in acute stroke patients. Furthermore, new experimental imaging techniques are discussed. [source]

Sensitivity and specificity of immunohistochemical antibodies used to distinguish between benign and malignant pleural disease: a systematic review of published reports

HISTOPATHOLOGY, Issue 6 2006
J King
Aims:, A systematic review of published reports that have evaluated the ability of immunohistochemistry and argyrophil nucleolar organizing region (AgNOR) staining to distinguish between benign and malignant pleural disease. Methods:, Nineteen relevant papers published during the period 1979,2005 were identified. Individual results of immunohistochemistry for five diagnostic antibodies were extracted to calculate diagnostic sensitivity and specificity. Results from five of these studies that had evaluated proliferation markers or AgNOR staining techniques were also summarized. Results:, Most antibodies demonstrated poor to moderate diagnostic ability. Desmin and epithelial membrane antigen (EMA) were the most useful, with sensitivity and specificity both above 74%. The combination of EMA and AgNOR was reported as having 95% diagnostic sensitivity. A high MCM2 labelling index also differentiated between benign and malignant pleural disease. Conclusions:, Immunohistochemistry is of limited value, but newer diagnostic methods may be useful additions in this area of pathology. The diagnostic importance of histological features seen on plain tissue sections is emphasized as vital for correctly differentiating between benign pleural disease and malignant pleural mesothelioma. [source]

The diagnostic utility of FLAIR imaging in clinically verified amyotrophic lateral sclerosis

JOURNAL OF MAGNETIC RESONANCE IMAGING, Issue 5 2003
Lijuan Zhang MD
Abstract Purpose To explore the overall diagnostic ability of magnetic resonance (MR) fluid-attenuated inversion recovery (FLAIR) imaging for clinically verified amyotrophic lateral sclerosis (ALS). Materials and Methods Abnormal signal intensity in FLAIR images of 18 patients with ALS and 18 age-matched normal controls were scored and compared. Six patients had serial MR imaging scans within 97 days. Mann Whitney U statistics and ANOVA were used for statistical analysis. Results Hyperintensity in the subcortical white matter (SWM) and the dark line along the posterior rim of the precentral gyri were found more frequently in patients with ALS. The scores for these two signs were significantly different from those of normal controls. Hyperintensity in the corticospinal tract (CST) was found in both ALS and normal controls, but the difference was not statistically significant. ANOVA on the serial FLAIR studies revealed no significant difference in the scores among the series. The hyperintensity in SWM had a sensitivity of 56% and specificity of 94%, while the dark line in the motor cortex had a 74% sensitivity and 67% specificity. Conclusion Hyperintensity in SWM and the dark line along the posterior rim of the precentral gyri appeared more frequently in the patients with ALS. SWM hyperintensity has a better specificity in association with clinically verified ALS, while the motor dark line has a better sensitivity. No correlation was found between the FLAIR findings and progression of the disease. J. Magn. Reson. Imaging 2003;17:521,527. © 2003 Wiley-Liss, Inc. [source]

Measurement of lesion area and volume by three-dimensional spoiled gradient-echo MR imaging in osteonecrosis of the femoral head

JOURNAL OF ORTHOPAEDIC RESEARCH, Issue 5 2003
Yuki Kishida
Abstract The purpose of this investigation is to evaluate the diagnostic ability of three-dimensional spoiled gradient-echo (3D SPGR) magnetic resonance (MR) imaging in cases of osteonecrosis of the femoral head (ONFH), and to determine the accuracy of 3D SPGR imaging in area and volume measurement of ONFH. T1-weighted spin-echo (SE) and 3D SPGR imaging were performed on 20 femoral heads obtained from patients with ONFH. After MR imaging, the femoral heads were cut parallel to the imaging plane and were evaluated histologically. Areas and volumes of necrotic lesions were measured with a computer program and the deviation between MR images and anatomical measurements was evaluated. A low signal intensity band on 3D SPGR MR images was observed in all femoral heads and corresponded histologically to repaired marrow with viable fibrous mesenchymal tissue. The area proximate to the low band area coincided with the necrotic region. Both area and volume measurements by T1-weighted SE and 3D SPGR images showed a strong correlation to histological measurements. The discrepancies between histological and imaging results were minimal in 3D SPGR imaging, especially at the anterior and posterior portions of the femoral head. Three-dimensional SPGR imaging provides more accurate measurements of the area and volume of a necrotic lesion than T1-weighted SE imaging. © 2003 Orthopaedic Research Society. Published by Elsevier Science Ltd. All rights reserved. [source]

An appraisal of medical students' reflection-in-learning

MEDICAL EDUCATION, Issue 3 2000
Sobral
Introduction How do students reflect as they strive for some control of learning early in their clinical activities? The purpose of this study was to examine the reflection-in-learning profile of medical students as they started their clinical apprenticeship. Methods A measure of reflection-in-learning was used to appraise the level and direction of change of reflection in relation to a course experience. The study involved 103 medical students of both sexes who were beginning clinical activities. Assessments of self-regulation of learning, of the meaningfulness of the learning experience, and of diagnostic thinking were also obtained. Results The results showed that 81% of the students had an increase in scores for reflection-in-learning between the beginning and the end of a course. At the end of the course, the level of reflection-in-learning was significantly associated with self-perceived competence for self-regulated learning and with the meaningfulness of the learning experience. In the following term, students who had high reflection-in-learning scores at the end of the course had higher grade-point averages and greater self-reported diagnostic ability in comparison with those with low scores. Conclusions There was some evidence of an improved quality of reflection as the students strive for some control of learning. Overall, the findings support the idea that a greater effort at reflection is associated with a more positive learning experience. They also suggest that reflection-in-learning is related to readiness for self-regulation of learning and may be conducive to enhanced diagnostic ability. In conclusion, measuring reflection-in-learning may be a useful tool in the appraisal of medical students' learning profiles. [source]

FDA report: Ferumoxytol for intravenous iron therapy in adult patients with chronic kidney disease,,§

AMERICAN JOURNAL OF HEMATOLOGY, Issue 5 2010
Min Lu
On June 30, 2009, the United States Food and Drug Administration (FDA) approved ferumoxytol (FerahemeÔ injection, AMAG Pharmaceuticals), an iron-containing product for intravenous (IV) administration, for the treatment of iron deficiency anemia in adult patients with chronic kidney disease (CKD). The safety and efficacy of ferumoxytol were assessed in three randomized, open-label, controlled clinical trials. Two trials evaluated patients with nondialysis dependent CKD and a third trial assessed patients undergoing hemodialysis. Randomization was either to ferumoxytol or oral iron. Ferumoxytol was administered as two 510 mg IV injections, separated by 3,8 days. Oral iron, Ferro-Sequels®, was administered at a dose of 100 mg twice daily for 21 days. In all three clinical trials, ferumoxytol administration increased the mean blood hemoglobin (Hgb) concentrations by ,1.0 g/dL over the 35 day period, a mean increase that was greater than what was observed in patients receiving oral iron. Patients receiving ferumoxytol also had increases in blood transferrin saturation (TSAT) and ferritin values. For the proposed ferumoxytol dosing regimen, 4.9% of patients had serum ferritin ,800 ng/mL and TSAT ,50% post-treatment. The most important ferumoxytol safety concerns were hypersensitivity reactions and/or hypotension. Anaphylaxis or anaphylactoid reactions were reported in 0.2% of subjects, and other adverse reactions potentially associated with hypersensitivity (e.g., pruritus, rash, urticaria, or wheezing) were reported in 3.7%. Hypotension was observed in 1.9%, including three patients with serious hypotensive reactions. Ferumoxytol administration may transiently affect the diagnostic ability of magnetic resonance imaging and the drug label provides further information regarding this effect. Am. J. Hematol. 2010. Published 2010 Wiley-Liss, Inc. [source]

Onset and Offset Phonation Threshold Flow in Excised Canine Larynges,

THE LARYNGOSCOPE, Issue 7 2008
Michael F. Regner
Abstract Objectives/Hypothesis: In this study, we examined the hypothesis that the minimum flow required for phonation onset, the onset phonation threshold flow (PTF), is greater than the minimum flow to sustain phonation, the offset PTF. We also explored the hypothesis that the ratio of these two (PTF offset divided by PTF onset) falls within [0.707, 1.0]. Study Design: This was a methodology study to measure onset and offset PTFs in 10 excised canine larynges; their ratio (PTF offset divided by PTF onset) was predicted to fall in a specific domain. Methods: The onset and offset PTF and phonation threshold pressure (PTP) values were observed using 10 excised canine larynges mounted on a bench apparatus. The subglottal flow was increased until phonation was observed, and then decreased until phonation ceased; airflow and pressure measurements at critical conditions of phonation were observed as the PTF and PTP. Larynges with elongated vocal folds were then tested to observe PTF and determine if the hypothesis was observed in pathologic-like larynges. Results: The offset PTF was always less than the onset PTF (P , .0001) and 80.0% of the observed onset-offset PTF ratios were bound by [0.707, 1.0]. Conclusions: PTF onset or offset could be a useful diagnostic parameter of the voice, particularly when used in conjunction with PTP to describe laryngeal resistance and aerodynamic power. Further exploration of the relationship between onset and offset PTF values could augment clinical diagnostic ability and advance current theories on the physics of phonation. [source]

Skin sympathetic adrenergic innervation: An immunofluorescence confocal study

ANNALS OF NEUROLOGY, Issue 2 2006
Vincenzo Donadio MD
Objective The aim of this study was to characterize sympathetic adrenergic innervation of the skin in healthy subjects using dopamine , hydroxylase (D,H) as a specific marker for noradrenergic fibers. Methods Sympathetic adrenergic innervation of human skin was studied in 10 healthy subjects by indirect immunofluorescence and confocal microscopy applied to punch skin biopsies. Noradrenergic fibers were identified both in glabrous and hairy skin using D,H antibody. Results D,H immunoreactive fibers were mainly localized in arteriovenous anastomoses, arrector pilorum muscles, and arterioles, whereas few adrenergic fibers were found around sweat glands. Interpretation Our description of sympathetic adrenergic innervation of human skin aims to improve the diagnostic ability of skin biopsy to detect selective autonomic nervous system disorders. Ann Neurol 2006;59;376,381 [source]

Electrocardiographic Body Surface Mapping: Potential Tool for the Detection of Transient Myocardial Ischemia in the 21st Century?

ANNALS OF NONINVASIVE ELECTROCARDIOLOGY, Issue 2 2009
Monique R. Robinson D.Phil
Coronary artery disease (CAD) is one of the leading causes of cardiovascular mortality and morbidity worldwide. CAD presents as a wide spectrum of clinical disease from stable angina to ST segment elevation myocardial infarction. The 12-lead electrocardiogram (ECG) has been the main tool for the diagnosis of these events for almost a century but is limited in its diagnostic ability. For patients with suspected angina, the exercise tolerance test is often used to provoke and detect stress-induced ischemia but does not provide a definitive answer in a substantial proportion of patients. Body surface mapping (BSM) is a technique that samples multiple points around the thorax to provide a more comprehensive electrocardiographic data set than the conventional 12-lead ECG. Moreover, recent preliminary data demonstrate that BSM can detect and display transient regional myocardial ischemia in an intuitive fashion, employing subtraction color mapping, making it potentially valuable for diagnosing CAD causing transient regional ischemia. Research is ongoing to determine the full extent of its utility. [source]

Surgical treatment of adrenal metastasis from renal cell carcinoma: a single-centre experience of 45 patients

BJU INTERNATIONAL, Issue 3 2006
ALESSANDRO ANTONELLI
OBJECTIVE To report, in a retrospective study, the diagnostic problems and oncological results of surgery in patients with either synchronous or metachronous adrenal metastasis, which are uncommon in renal cancer, at 2,10% of patients. PATIENTS AND METHODS Of 1179 patients treated for renal cancer between 1987 and 2003, 914 had renal surgery with concomitant ipsilateral adrenalectomy (routinely in 875 and for abnormal findings on computed tomography, CT, in 39) and 15 contralateral adrenalectomy (all after suspicious findings on CT). During the follow-up after renal surgery, another 14 patients had adrenalectomy for CT evidence of an abnormal adrenal gland, contralateral to the previous renal tumour in 12 and bilaterally in two. RESULTS Of 914 ipsilateral adrenal glands removed during renal surgery, 854 (93.5%) were normal on pathological examination, 28 (3%) had a benign pathology, six (0.8%) were directly infiltrated by the tumour and 26 (2.7%) were metastatic. For both benign and metastatic ipsilateral adrenal pathology, CT had sensitivity, specificity and positive/negative predictive values of 47%, 99%, 73% and 96%, respectively. Of 29 contralateral glands removed because of suspicious CT findings (15 at diagnosis of renal cancer, 14 during the follow-up) there was no abnormality in one (3.4%), a benign pathology in seven (24%) and a metastasis in 21 (72%). Thus there were 32 synchronous (incidence 2.7%; ipsilateral to the renal tumour in 24, contralateral in six and bilateral in two), and 13 metachronous adrenal metastases (incidence 1.0%; contralateral in 11 and bilateral in two). The metachronous metastases were diagnosed at a mean (range) interval of 30.6 (8,73) months after renal surgery. No ipsilateral adrenal metastases were discovered at diagnosis or during the follow-up in the 382 patients with an organ-confined renal tumour of <4 cm in diameter. Twenty-seven patients with an isolated adrenal metastasis (synchronous in 14, metachronous in 13) had statistically significantly (P < 0.001) better survival than the 18 (all synchronous) with multiple sites of metastatic disease. In particular, there was long-term survival (mean 83 months) in 10 patients with an isolated adrenal metastasis. CONCLUSION Sparing the ipsilateral adrenal is advisable only for organ-confined renal tumours of <4 cm in diameter; clinical local staging of renal cancer is the best predictor of the risk of adrenal metastasis. Conversely, CT had good diagnostic ability for the contralateral adrenal gland, especially during the follow-up. Some patients with isolated adrenal metastasis could be treated by metastasectomy, with long-term survival free of disease and confirming that, even if in a few and unselectable patients, removing all the neoplastic bulk can be curative. Nevertheless, the high rate of relapse underlines the need for an effective systemic therapy, and more so for widespread metastatic disease that currently cannot be cured. [source]

Diagnostic ability of GDx VCC to discriminate between healthy eyes, ocular hypertensive subjects and glaucoma patients

Utility of Base Deficit for Identifying Major Injury in Elder Trauma Patients

ACADEMIC EMERGENCY MEDICINE, Issue 9 2007
Shahriar Zehtabchi MD
Background: Early identification of serious injuries is especially important in elders. Base deficit (BD) is an indicator of serious injury in trauma patients. There are limited data to support the utility of BD in elders who have sustained trauma. Objectives: To assess the diagnostic performance of BD in identifying major injury in elders. Methods: This was a prospective, observational, preliminary study. Elder (age 65 years and older) patients with significant injury mechanisms had BD analyzed during initial emergency department resuscitation. Major injury was defined by an Injury Severity Score ,15, a decrease in hematocrit of more than ten points, or blood transfusion. Patients were stratified into two groups of minor and major injuries. Data were reported as means (±SD). Receiver operating characteristic (ROC) curves tested the diagnostic ability of BD to identify major injury. Results: Seventy-four patients were enrolled; the mean (±SD) age was 75 (±7) years, and 57% were male. Twenty-four patients (32%) had major injury. The mean (±SD) for BD in the major injury group (,2.9 [±6] mmol/L) was significantly different from that in the minor injury group (0.8 [±3] mmol/L), with a mean difference of 3.7 (95% confidence interval = 1.4 to 5.9). ROC curves revealed that BD was able to identify major injury in elder patients (area under the ROC curve, 0.72; 95% confidence interval = 0.60 to 0.85; p = 0.0003). Conclusions: The preliminary data from this study indicate that in trauma patients aged 65 years and older, increased BD at emergency department arrival can predict life-threatening injury. [source]

Comparison of echocardiography and electron beam tomography in differentiating the etiology of heart failure

CLINICAL CARDIOLOGY, Issue 6 2000
Thuy Le M.D.
Abstract Background: The clinical manifestations in patients with ischemic cardiomyopathy are often indistinguishable from those in patients with primary dilated cardiomyopathy (DCM). Clinicians often base work-up of patients with heart failure on echocardiographic wall motion abnormalities; however misclassification can lead to unnecessary coronary angiography. Hypothesis: The study was undertaken to evaluate the diagnostic ability of echocardiography and electron beam tomography (EBT) to differentiate between ischemic and nonischemic cardiomyopathy. Methods: The accuracy of EBT and echocardiography was compared in 111 patients undergoing coronary angiography for the evaluation of heart failure. The presence of coronary calcification (CC) by EBT or segmental wall motion abnormalities by echocardiography was used as evidence of coronary-induced cardiomyopathy. Results: Of 63 patients, 61 (97%) with obstructive coronary artery disease had CC by EBT. This sensitivity was significantly higher compared with 43 of 63 patients (68%) with segmental wall motion abnormalities by echocardiography (p < 0.001). Of 48 patients without obstructive coronary artery disease by angiography, 39 (81%) had no CC by EBT and 35 (73%) had no segmental wall motion (global hypokinesis) by echocardiography (p = 0.33). The overall accuracy of EBT to differentiate ischemic from nonischemic cardiomyopathy was 90%, significantly higher than echocardiography (70%, p < 0.001). Conclusion: This double-blind study demonstrates that the presence of CC by EBT is superior to that of segmental wall motion abnormalities by echocardiography to distinguish ischemic from nonischemic cardiomyopathy. This modality may prove to be an important diagnostic tool when the etiology of the cardiomyopathy is not clinically evident. [source]