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Diagnostic Implications (diagnostic + implication)
Selected AbstractsDiagnostic Implications of Uric Acid in Electroanalytical MeasurementsELECTROANALYSIS, Issue 14 2005Abstract Urate has a long history in clinical analysis and has served as an important diagnostic in a number of contexts. The increasing interest in metabolic syndrome has led to urate being used in combination with a number of other biomarkers in the assessment of cardiovascular risk. The traditional view of urate as principally an interferent in electrochemical measurement is now gradually being replaced with the realization that its measurement could serve as an invaluable secondary (if not primary) marker when monitoring conditions such as diabetes and heart disease. Rather than attempting to wholly exclude urate electrochemistry, many strategies are being developed that can integrate the urate signal within the device architecture such that a range of biomarkers can be sequentially assessed. The present review has sought to rationalize the clinical importance that urate measurements could hold in future diagnostic applications , particularly within near patient testing contexts. The technologies harnessed for its detection and also those previously employed for its removal are reviewed with the aim of highlighting how the seemingly contrasting approaches are evolving to aid the development of new sensing devices for clinical analysis. [source] THE MOLECULAR FUTURE IN CYTOLOGYCYTOPATHOLOGY, Issue 2006M. Salto-Tellez Molecular diagnosis is the application of molecular biology techniques and knowledge of the molecular mechanisms of disease to diagnosis, prognostication and treatment of diseases. Molecular Diagnosis is, arguably, the fastest growing area of diagnostic medicine. The US market for molecular testing generated $1.3 billion in 2000, which was predicted to increase to about $4.2 billion by 2007.1 We proposed the term Diagnostic Molecular Cytopathology to define the application of molecular diagnosis to cytopathology2. Diagnostic Molecular Cytopathology is essential for the following reasons: (i) Molecular testing is sometimes indispensable to establish an unequivocal diagnosis on cell preparations; (ii) Molecular testing provides extra information on the prognosis or therapy of diseases diagnosed by conventional cytology; (iii) Molecular testing provides genetic information on the inherited nature of diseases that can be directly investigated in cytology samples, by either exfoliation or by fine needle aspiration; (iv) Sometimes the cytopathology sample is the most convenient (or the only available) source of material for molecular testing; (v). Direct molecular interrogation of cells allows for a diagnostic correlation that would otherwise not be possible. Parallel to this direct diagnostic implication, cytopathology is increasing important in the validation of biomarkers for specific diseases, and in therefore of significant importance in the overall translational research strategies. We illustrate its application in some of the main areas of oncology molecular testing, such as molecular fingerprinting of neoplasms,3 lymphoreticular diseases,2 sarcomas4 and lung cancer,5 as well as translational research using diagnostic cytopathology techniques. The next years will see the consolidation of Diagnostic Molecular Cytopathology, a process that will lead to a change of many paradigms. In general, diagnostic pathology departments will have to reorganize molecular testing to pursue a cost-efficient operation. Sample preparation will have to take into account optimal preservation of nuclear acids. The training of technical staff and the level of laboratory quality control and quality assurance would have to follow strict clinical (not research) laboratory parameters. And, most importantly, those pathologists undertaking molecular diagnosis as a discipline would have to develop their professional expertise within the same framework of fellowships and professional credentials that is offered in other sub-specialties. The price to pay if this effort is not undertaken is too important for the future of diagnostic pathology in general. The increasing characterization of molecular biomarkers with diagnostic, prognostic or therapeutic value is making the analysis of tissue and cell samples prior to treatment a more complex exercise. If cytopathologists and histopathologists allow others to take charge of molecular diagnosis, our overall contribution to the diagnostic process will be diminished. We may not become less important, but we may become less relevant. However, those within the discipline of diagnostic pathology who can combine the clinical background of diseases with the morphological, immunocytochemical and molecular diagnostic interpretation will represent bona fide diagnostic specialists. Such ,molecular cytopathologists' would place themselves at the centre of clinical decision-making. Reference:, 1. Liz Fletcher. Roche leads molecular diagnostics charge. Nature Biotechnol 20, 6,7; 2002 2. Salto-Tellez M and Koay ESC. Molecular Diagnostic Cytopathology - Definitions, Scope and Clinical Utility. Cytopathology 2004; 15:252,255 3. Salto-Tellez M, Zhang D, Chiu LL, Wang SC, Nilsson B, and Koay ESC. Immunocytochemistry Versus Molecular Fingerprinting of Metastases. Cytopathology, 2003 Aug; 14(4):186,90. 4. Chiu LL, Koay SCE, Chan NL and Salto-Tellez M. Molecular Cytopathology: Sequencing of the EWS-WT1 Gene Fusion Transcript in the Peritoneal Effusion of a Patient with Desmoplastic Small Round Cell Tumour. Diagnostic Cytopathology, 2003 Dec; 29(6): 341,3. 5. TM Chin, D Anuar, R Soo, M Salto-Tellez, WQ Li, B Ahmad, SC Lee, BC Goh, K Kawakami, A Segal, B Iacopetta, R Soong. Sensitive and Cost-Effective deptection of epidermal growth factor Receptor Mutations in Small Biopsies by denaturing High Performance Liquid Chromatography. (In press). [source] Langerhans cell microgranulomas (pseudo-pautrier abscesses): morphologic diversity, diagnostic implications and pathogenetic mechanismsJOURNAL OF CUTANEOUS PATHOLOGY, Issue 9 2002Kelly L. Burkert The term ,Langerhans cell microgranuloma' (LCM) was introduced a decade ago to draw attention to focal collections of these cells within the epidermal layer that develops during certain immune reactions. In spite of a growing awareness of this phenomenon during the past decade, few reports have focused on the development and phenotype of LCM. In this commentary, we review the historical development of the concept of LCM, demonstrate the salient immunomorphologic characteristics of LCM, and advance a hypothesis to explain their sequential evolution and formation. [source] Exercise-Induced Nonsustained Ventricular Tachycardia: A Significant Marker of Coronary Artery Disease?JOURNAL OF INTERVENTIONAL CARDIOLOGY, Issue 3 2002MARTIN FEJKA M.D. Diagnostic exercise stress testing is commonly performed in patients with known or suspected cardiovascular disease. The significance of an ischemic response, manifested as significant ST-segment depression, angina pectoris, transient myocardial perfusion abnormalities, or combinations thereof, is well established. However, the diagnostic implications of exercise-induced nonsustained VT are uncertain, especially as an isolated finding. The patient had threatening ventricular arrhythmias at peak exercise without an ischemic response. Subsequent cardiac catheterization revealed significant CAD requiring percutaneous coronary intervention. [source] Pityriasis rosea in pregnancy , specific diagnostic implications and management considerationsAUSTRALIAN AND NEW ZEALAND JOURNAL OF OBSTETRICS AND GYNAECOLOGY, Issue 3 2005Antonio A. T. CHUH No abstract is available for this article. [source] Native and transformed ,2 -macroglobulin in plasma from patients with multiple sclerosisACTA NEUROLOGICA SCANDINAVICA, Issue 1 2003M. Gunnarsson Multiple sclerosis (MS) is an inflammatory demyelinating disease with unknown etiology. Various proteinases have been observed in increased levels in the central nervous system of patients with MS, which may contribute to the release of immunogenic myelin components. ,2 -Macroglobulin (,2M) inhibits a broad spectrum of proteinases sterically, undergoing major conformational changes induced by the proteinases themselves. Moreover, ,2M acts as a carrier of several cytokines in the systemic circulation. By use of radial immunodiffusion, we determined the total ,2M levels in plasma from 28 MS patients and 15 control subjects [14 patients with other neurologic diseases (OND) and one healthy individual]. No significant differences in total ,2M concentration were observed between the MS patients and the control subjects. A comparison of the degree of ,2M transformation in MS patients with different disease courses and controls was performed, using monoclonal antibodies (mAbs) specific for binding to native and transformed ,2M, respectively. The fractions of transformed ,2M were significantly increased in patients with secondary or primary progressive disease course compared with the controls. No significant differences were obtained using a native-specific mAb. At least a major proportion of ,2M from the MS patients was able to change conformation from its native to its transformed state, as demonstrated by a shift in mAb reactivity, following methylamine treatment of the plasma samples. In conclusion, the results indicate that plasma ,2M may be inactivated at a higher degree in patients with chronic progressive MS compared with patients with OND. This may influence the levels of proteinases and cytokines in the systemic circulation and may furthermore have diagnostic implications. [source] Parameters for Successful Implant Integration Revisited Part I: Immediate Loading Considered in Light of the Original Prerequisites for OsseointegrationCLINICAL IMPLANT DENTISTRY AND RELATED RESEARCH, Issue 2010FACD, Oded Bahat BDS ABSTRACT Purpose: With the increasing popularity and publication of loading implants at the time of placement, including at time of dental extraction and simultaneous with reconstructive procedures, the objective was to evaluate known variables identified for a traditional unloaded healing period and determine the applicability of these variables to immediate loading. Materials: A total of 124 published reports available as of January 2008 that contained information about loading from the time of surgery up to 3 months postsurgically were examined in light of published variables affecting osseointegration based on a 2 stage surgical approach. Methods: The articles were examined to differentiate between immediate loading (within the initial 48 hours) and early/delayed loading of implants. Success or survival criteria were noted, and where reasons for failure were available, categorized according to six variables considered as determinants for maintaining a long-term bone-to-implant contact. Results: Approximately 60 of the 124 reports described immediately loading implants within 48 with single-tooth, partial, and full-arch restorations, as well as implant overdentures. The implant success or survival rates ranged from 70.8% to 100%. Most studies considered implant survival to be the only criterion for success. Conclusions: Of six parameters identified in 1981 as influencing osseointegration, two parameters (the status of the bone/implant site and implant loading conditions) appear to have diagnostic implications, whereas three (implant design, surgical technique, and implant finish) may affect immediate loading positively or adversely. [source] Parameters for Successful Implant Integration Revisited Part II: Algorithm for Immediate Loading Diagnostic FactorsCLINICAL IMPLANT DENTISTRY AND RELATED RESEARCH, Issue 2010FACD, Oded Bahat BDS ABSTRACT Immediate loading of dental implants has become a widely reported practice with success rates ranging from 70.8% to 100%. Although most studies have considered implant survival to be the only measure of success, a better definition includes the long-term stability of the hard and soft tissues around the implant(s) and other adjacent structures, as well as the long-term stability of all the restorative components. The parameters identified in 1981 by Albrektsson and colleagues as influencing the establishment and maintenance of osseointegration have been reconsidered in relation to immediate loading to improve the chances of achieving such success. Two of the six parameters (status of the bone/implant site and implant loading conditions) have preoperative diagnostic implications, whereas three (implant design, surgical technique, and implant finish) may compensate for less-than-ideal site and loading conditions. Factors affecting the outcome of immediate loading are reviewed to assist clinicians attempting to assess its risks and benefits. [source] | ||||||||||