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Useful Diagnostic Tool (useful + diagnostic_tool)
Selected AbstractsIntestinal Neoplasia in HorsesJOURNAL OF VETERINARY INTERNAL MEDICINE, Issue 6 2006S.D. Taylor Background:Intestinal neoplasia of horses is inadequately described. Hypothesis:Intestinal neoplasia of horses has characteristic clinicopathologic features. Animals:Thirty-four horses with intestinal neoplasia. Methods:Retrospective study. Results:Anamnesis, clinical signs, clinicopathologic and pathologic findings in 34 adult horses diagnosed histologically with intestinal neoplasia were reviewed. The horses ranged in age from 2 to 30 years (mean 16.6 years at presentation). The Arabian breed was most represented and there was no sex predisposition. The most common presenting complaints were weight loss, colic, anorexia, and fever. The most consistent clinical signs were poor body condition, tachycardia, tachypnea, fever, and diarrhea. Useful diagnostic tools included rectal examination, routine blood analyses, abdominocentesis, ultrasonographic examination, rectal biopsy, and exploratory laparotomy. Alimentary lymphoma was the most common intestinal neoplasia identified, followed by adenocarcinoma and smooth muscle tumors. The small intestine was the most common segment of intestine affected for all neoplasms. Intestinal neoplasia was diagnosed antemortem in 13 of 34 (38%) horses. The median time from onset of clinical signs to death or euthanasia was 1.9 months. The discharge rate was 15%. Although the longest survival was observed in horses with jejunal adenocarcinoma, all horses were eventually euthanized because of intestinal neoplasia. Conclusions: Arabian horses were 4.5 times more likely to have intestinal neoplasia diagnosed than were other breeds. [source] Tetrazepam drug sensitivity , usefulness of the patch testCONTACT DERMATITIS, Issue 3 2002C. Pirker The muscle relaxant tetrazepam may cause severe cutaneous adverse effects. We report 4 cases of varying intensity: Stevens,Johnson syndrome, erythema,multiforme-like exanthema, maculopapular and maculo-urticarial exanthema. Patch testing with tetrazepam (10% in petrolatum) was strongly positive in the 2 patients with severe skin eruptions and weakly positive in the other 2. Oral rechallenge with tetrazepam was positive in 3 patients (1 not done). Diazepam, with a similar chemical structure to tetrazepam, was negative on patch testing and on oral challenge testing in 2 patients. Although the optimal patch test concentration of tetrazepam has still to be determined, it is a useful diagnostic tool to confirm sensitization, particularly in patients with severe bullous eruptions. [source] "My Two-week-old Daughter Is Throwing up Blood"ACADEMIC EMERGENCY MEDICINE, Issue 8 2005M.H. Moustafa MD Abstract Swallowed maternal blood at the time of delivery or from cracked nipples during breastfeeding is the most common cause of suspected gastrointestinal bleeding in the neonate. In this case, the Apt,Downey test is a useful diagnostic tool. The Apt,Downey test can effectively differentiate neonatal from maternal hemoglobin based on the conversion of oxyhemoglobin to alkaline globin hematin when mixed with alkali. [source] A Detailed Analysis of Symptomatic Posterior Cortex Seizure Semiology in Children Younger Than Seven YearsEPILEPSIA, Issue 1 2003András Fogarasi Summary: ,Purpose: To analyze the semiology of seizure onset and evolution in young children with posterior cortex epilepsy (PCE), compare this with adult reports, and assess age-related differences. Methods: We videotaped and analyzed 110 seizures from 18 patients with PCE, aged 3,81 months. All had a good prognosis after posterior epileptogenic zone removal. Ictal events were categorized by behavioral, consciousness, autonomic, and sensory features, as well as motor patterns, which included myoclonic, tonic, clonic, unclassified motor seizures, and epileptic spasm. A time-scaled data sheet was developed to record each epileptic event as onset, very early, early, or late manifestation. Results: Patients had a high seizure frequency with ,100 attacks/day; one third of them showed a cluster tendency. The mean duration of seizures was 67 s. The most common seizure components were motor manifestations (with myoclonic and tonic seizures), but psychomotor (automotor), hypomotor attacks, and isolated auras also were frequently observed. Clinical seizure spread was frequent; auras and visual sensory signs were difficult to record in this age. Typical phenomena during seizures included behavioral changes, ictal vocalization, smile, flush, head nod, oculomotor features, and late-appearing oral automatisms, whereas hypermotor and secondarily generalized tonic,clonic seizures were not seen. Conclusions: Our results suggest that PCE in infants and young children is very heterogeneous but shows important age-related features. Compared with adults, children with PCE have shorter but more frequent seizures; they rarely report aura or visual sensory signs, only sporadically develop hypermotor and secondarily generalized tonic,clonic seizures, whereas ictal smile, flush, head nod, and behavioral change are typical features at this age. Because of frequent subtle ictal phenomena, long-term video-EEG monitoring is a useful diagnostic tool with infants and young children with PCE. [source] Magnetic resonance imaging features of an extranodal T cell rich B cell lymphoma in the pharyngeal mucosa in a horseEQUINE VETERINARY EDUCATION, Issue 6 2008V. Jakesova Summary An 11-year-old Warmblood gelding was presented for inspiratory stridor and dysphagia. Based on history and clinical examination, a solitary mass localised in the oropharynx was suspected. Due to its inaccessibility and defensive behaviour of the horse, it was difficult to visualise this mass either by upper airway endoscopy or by oral examination and the conventional imaging methods (radiology and ultrasound) provided only limited information. Fine needle aspiration cytology was suggestive of lymphoma, but the exact localisation and the extent of tissue infiltration of the tumour could only be defined by magnetic resonance imaging (MRI). MRI has proved to be a very useful diagnostic tool in equine lameness investigation and, as this case illustrates, it has considerable diagnostic potential for soft tissue examination of the equine head. [source] Antibodies Against Hepatitis C Virus,Like Particles and Viral Clearance in Acute and Chronic Hepatitis CHEPATOLOGY, Issue 3 2000Thomas F. Baumert M.D. We recently described the efficient assembly of hepatitis C virus (HCV) structural proteins into HCV-like particles (HCV-LPs) in insect cells. These noninfectious HCV-LPs have similar morphologic and biophysical properties as putative virions isolated from HCV-infected humans and can induce a broadly directed immune response in animal models. The HCV envelope proteins of HCV-LPs are presumably presented in a native, virion-like conformation and may therefore interact with antienvelope antibodies directed against conformational epitopes. In this study, HCV-LPs were used as capture antigens in an enzyme-linked immunosorbent assay (ELISA) to detect and quantify antibodies against HCV structural proteins in patients with acute and chronic hepatitis C. High titers of anti,HCV-LP antibodies were detected in patients chronically infected with HCV genotypes 1 to 6. In contrast to individuals with chronic hepatitis C, patients with acute self-limited hepatitis C displayed only a transient and weak seroreactivity against HCV-LPs. Patients with chronic HCV infection successfully treated with interferon demonstrated a gradual decline of anti,HCV-LP titers during or subsequent to viral clearance. Sustained interferon responders were characterized by significantly higher pretreatment levels of anti,HCV-LP antibodies as compared with nonresponders (P = .0001). In conclusion, HCV infection is associated with limited humoral immunity against the envelope proteins present on the HCV-LPs. An HCV-LP,based ELISA may be a useful diagnostic tool to distinguish acute hepatitis C from chronic HCV infection with exacerbation, and to predict viral clearance in response to interferon. [source] Do indicators of financial crises work?INTERNATIONAL JOURNAL OF FINANCE & ECONOMICS, Issue 1 2003An evaluation of an early warning system Abstract The object of this paper is to develop an operational early warning system (EWS) that can detect financial crises. To achieve this goal the paper analyses and extends the early warning system developed by Kaminsky, Lizondo and Reinhart (1998) and Kaminsky and Reinhart (1999) that is based on the ,signal' approach. This system monitors several indicators that tend to exhibit an unusual behaviour in the periods preceding a crisis. When an indicator exceeds (or falls below) a threshold, then it is said to issue a ,signal' that a currency crisis may occur within a given period. The model does a fairly good job of anticipating some of the crises in 1997/1998, but several weaknesses to the approach are identified. The paper also evaluates how this system can be applied to an individual country. On balance, the results in this paper are mixed, but the results suggest that an early warning system should be thought of as a useful diagnostic tool. Copyright © 2002 John Wiley & Sons, Ltd. [source] Magnetic resonance imaging and pathological findings in a case of canine idiopathic eosinophilic meningoencephalitisJOURNAL OF SMALL ANIMAL PRACTICE, Issue 8 2007C Salvadori A case of idiopathic eosinophilic meningoencephalitis in a six-month-old male Maremma shepherd dog is reported. The dog was referred with a four month history of progressive weakness and depression with loss of trained habits. Tendency to recumbency, disorientation, visual impairment, bilaterally decreased menace response and hindlimb conscious proprioception deficits were detected. Magnetic resonance imaging showed a diffuse hypointense signal involving the cerebral grey matter with enlargement of the cerebral sulci on T1-weighted and fast fluid-attenuated inversion recovery (FLAIR) sequences consistent with a diffuse necrosis or atrophy of the cortical grey matter. Histological examination revealed severe inflammatory infiltration mainly composed of eosinophils and macrophages in the subarachnoid space and in the superficial layer of the cerebral cortex where parenchymal rarefaction and necrosis of neurones were also evident. No parasites, cysts or fungi were detected, and an immunologically mediated disorder was suspected. Magnetic resonance imaging may represent a useful diagnostic tool to differentiate idiopathic eosinophilic meningoencephalitis from other inflammatory brain diseases of young dogs. [source] Systematic review and meta-analysis of methods of diagnostic assessment for urinary incontinence,,NEUROUROLOGY AND URODYNAMICS, Issue 7 2006J.L. Martin Abstract Aims To evaluate the performance of all tests proposed for the diagnosis of urinary incontinence. Methods A systematic review and meta-analyses of the published literature of methods for diagnostic assessment of urinary incontinence. Results One hundred twenty-one papers were included in the full review [Martin et al., 2006]. The quality of reporting in the primary studies was poor which reduced the number of studies that could be included in the data analysis. The literature suggests that women with urodynamic stress incontinence (USI) can be correctly identified in primary care from clinical history alone with a sensitivity of 0.92 (95% C.I.: 0.91,0.93) and specificity of 0.56 (0.53,0.60). A clinical history for the diagnosis of detrusor overactivity (DO) was found to be 0.61 (0.57,0.65) sensitive and 0.87 (0.85,0.89) specific. Within secondary care imaging of leakage by ultrasound was found to be effective in the diagnosis of USI in women with a sensitivity of 0.89 (0.84,0.93) and specificity of 0.82 (0.73,0.89). Conclusions Clinical interpretation of the results of the review is difficult because few studies could be synthesized and conclusions made. The published evidence suggests that a large proportion of women with USI can be correctly identified in primary care from history alone. Ultrasound offers a useful diagnostic tool which could be used prior to, and possibly instead of, multi-channel urodynamics in some circumstances. If a patient is to undergo urodynamic testing, multi-channel urodynamics is likely to give the most accurate result. Further primary studies adhering to STARD guidelines are required on commonly used tests. Neurourol. Urodynam. 25:674,683, 2006. © 2006 Wiley-Liss, Inc. [source] The Effectiveness of Transtelephonic Monitoring of Pacemaker Function in Pediatric PatientsPACING AND CLINICAL ELECTROPHYSIOLOGY, Issue 6 2007SCOTT A. FOX M.B.B.S. Background:To determine the sensitivity and specificity, rate of compliance, and predictors of failure of telephone transmission of pacemaker function in a pediatric population. Methods:A total of 2,638 pacemaker transmission records were reviewed retrospectively. Standard calculations of sensitivity, specificity, and positive and negative predictive values were performed. Longitudinal data analysis was used to detect factors influencing the effectiveness of transtelephonic monitoring. The proportion of missed transmissions was calculated, thus enabling assessment of compliance. Logistic regression was performed to determine predictors of poor compliance. Results:Telephone transmission of pacemaker function, as a diagnostic tool, had a sensitivity of 94.8%, specificity of 99.2%, positive predictive value of 82.1%, and negative predictive value of 99.9%. Longitudinal analysis failed to show any significant predictors of transmission failure. Compliance with a prescribed transmission reached 84.5% in our patient population. Logistic regression analysis failed to identify any predictors of noncompliance. Conclusion:Values for sensitivity and specificity indicate that telephone transmission is a useful diagnostic tool for assessing pacemaker function at a distance. Negative predictive value is 99.9%, indicating that normal telephone transmissions are very reassuring of normal pacemaker function. Telephone transmission is equally successful in all age groups, genders, distances from a tertiary referral center, underlying diagnoses, pacing modes, and pacemaker models. Compliance with telephone transmission follow-up was higher in our population than in previous studies. [source] Cross-linked envelopes in nail plate in lamellar ichthyosisBRITISH JOURNAL OF DERMATOLOGY, Issue 5 2003R.H. Rice Summary Background Corneocytes of the nail plate, like those of the stratum corneum, generate cornified envelopes (CEs) of cross-linked protein that can be visualized readily after removal of non-cross-linked protein by detergent extraction. Defective CE formation occurs in epidermal scale and hair in transglutaminase 1 (TGM1)-negative lamellar ichthyosis (LI) and has been proposed as a diagnostic aid for this syndrome. Objectives (i) To ascertain whether TGM1 is important for CE formation in nail; (ii) to characterize CE abnormalities occurring in LI that may be distinguished from other types of inherited ichthyosis when nail samples are subjected to detergent extraction; and (iii) to evaluate the utility of nails as a diagnostic aid for LI. Methods Nail samples were provided by nine patients previously classified as having TGM1-negative LI, four with other types of ichthyotic conditions and six normal controls. Samples were extracted extensively in sodium dodecyl sulphate under reducing conditions and examined by light and electron microscopy. Results After extraction, defective CE cross-linking was visualized in epidermal corneocytes from seven of nine patients exhibiting TGM1-negative LI, whereas nail samples from patients with the other syndromes were normal. The defects in CE structure resembled those recently reported for LI scale, although in some cases residual CE and CE-associated structures were present. Conclusions Despite the paucity of clinical nail symptoms in LI, TGM1 activity is important for generation of normal CE in nail plate, consistent with its importance in protein cross-linking in interfollicular epidermis and hair. Lack of this activity leads to a strikingly aberrant appearance of CE in LI nail after detergent extraction that is evident ultrastructurally in a large majority of cases. Nail envelopes therefore could provide a useful diagnostic tool in distinguishing LI from other ichthyoses with overlapping clinical features. [source] Value of preoperative diagnostic modalities in patients with recurrent thyroid carcinomaBRITISH JOURNAL OF SURGERY (NOW INCLUDES EUROPEAN JOURNAL OF SURGERY), Issue 9 2000A. Frilling Background The prognosis of differentiated thyroid carcinoma is usually excellent, but the majority of patients who develop a recurrence have a higher risk of death from the disease. Beside clinical examination, several diagnostic tools, such as ultrasonography, 131I scanning, [18F]fluorodeoxyglucose positron emission tomography (FDG-PET) and thyroglobulin (TG) measurement under raised thyroid-stimulating hormone in serum can detect tumour recurrences. This prospective study compared the value of different diagnostic modalities in the detection of recurrent differentiated thyroid cancer. Methods From April 1992 to October 1999, 181 patients with thyroid carcinoma, of whom 150 had a well differentiated tumour, subjected to surgical treatment were identified prospectively. Some 107 patients (71 per cent) presented with primary tumour and 43 patients (29 per cent) with recurrent disease. The patients with tumour recurrence were evaluated regarding the mode of detection of recurrent disease, including clinical examination, ultrasonography, fine-needle biopsy (FNB), TG measurement and FDG-PET, the surgical treatment and outcome. Results Some 63 per cent of patients presented with regional lymph node metastases and 37 per cent with local recurrence. None of the patients with local recurrence was operated on for primary tumour in this department. In 87 per cent the recurrence was detected by clinical examination. Ultrasonography and 131I scan revealed suspicious findings in 97 and 69 per cent respectively. FNB disclosed abnormal cytological findings in 95 per cent. There were pathological TG levels in 86 per cent of patients. Among patients with a raised level of TG and negative scan results, 13 underwent FDG-PET, with pathological findings in 82 per cent. Conclusion In patients with well differentiated thyroid carcinoma, ultrasonography and FNB are the most sensitive methods for the detection of local recurrence or regional lymph node metastases. FDG-PET is a useful diagnostic tool in patients with a negative 131I scan and a raised level of TG. © 2000 British Journal of Surgery Society Ltd [source] Case Series: Intraocular lymphoma diagnosed by fine-needle aspiration biopsyACTA OPHTHALMOLOGICA, Issue 6 2010Shaden Sarafzadeh Acta Ophthalmol. 2010: 88: 705,710 Abstract. Purpose:, To describe clinical experience in the diagnosis of intraocular lymphoma by fine-needle aspiration biopsy (FNAB) in patients with one or more discrete intraocular infiltrative lesions and limited or absent intravitreal tumour cells. Methods:, Retrospective descriptive analysis of patients who underwent intraocular FNAB of a solid retinal, subretinal pigment epithelial or uveal tumour that proved to be a malignant lymphoma. Results:, After exclusions, our study group consisted of seven patients, each of whom had one or more discrete intraocular infiltrative lesions and limited or absent intravitreal tumour cells and underwent a diagnostic intraocular FNAB that confirmed malignant intraocular lymphoma cytopathologically. These included three patients with one or more geographic yellow subretinal pigment epithelial infiltrates and one patient each with a prominent nodular white subretinal pigment epithelial tumour, a rapidly developing solid placoid choroidal mass, a haemorrhagic retinal infiltrative lesion and an infiltrative iris tumour, respectively. A prominent feature of virtually all aspirates was a large proportion of degenerated lymphoid cells in the background. Cytologically intact tumour cells ranged from relatively homogeneous small round cells with large nucleus to cytoplasm ratio to pleomorphic large cells with irregular knob-like nuclear protrusions. Immunocytochemical stains for lymphoid markers were helpful in confirming the pathological diagnosis of lymphoma in the five patients in whom this testing was performed. Conclusion:, FNAB was a useful diagnostic tool in the described subgroup of patients with suspected intraocular lymphoma. FNAB should be considered as a diagnostic option in selected patients with suspected intraocular lymphoma, especially if there are few or no vitreous cells. [source] Continuous-time models, realized volatilities, and testable distributional implications for daily stock returnsJOURNAL OF APPLIED ECONOMETRICS, Issue 2 2010Torben G. Andersen We provide an empirical framework for assessing the distributional properties of daily speculative returns within the context of the continuous-time jump diffusion models traditionally used in asset pricing finance. Our approach builds directly on recently developed realized variation measures and non-parametric jump detection statistics constructed from high-frequency intra-day data. A sequence of simple-to-implement moment-based tests involving various transformations of the daily returns speak directly to the importance of different distributional features, and may serve as useful diagnostic tools in the specification of empirically more realistic continuous-time asset pricing models. On applying the tests to the 30 individual stocks in the Dow Jones Industrial Average index, we find that it is important to allow for both time-varying diffusive volatility, jumps, and leverage effects to satisfactorily describe the daily stock price dynamics. Copyright © 2009 John Wiley & Sons, Ltd. [source] Current diagnosis and management of primary sclerosing cholangitisLIVER TRANSPLANTATION, Issue 6 2008Jens J. W. Tischendorf Primary sclerosing cholangitis (PSC) is an important liver disease with major morbidity and mortality. The diagnosis of PSC is confirmed by magnetic resonance cholangiopancreaticography, and endoscopic retrograde cholangiopancreaticography is performed in patients needing therapeutic endoscopy. As a result of the unknown cause of the disease, current medical therapies are unsatisfactory. Nevertheless, high-dose ursodeoxycholic acid should be recommended for treatment of PSC patients because there is a trend toward increased survival. Dominant bile duct stenoses should be treated endoscopically. However, liver transplantation continues to be the only therapeutic option for patients with advanced disease. Estimation of prognosis and timing of liver transplantation should be determined individually for each PSC patient on the basis of all results. The diagnosis and treatment of cholangiocarcinoma (CC) still remain a challenge in PSC patients. Early diagnosis of CC certainly is a prerequisite for successful treatment with surgical resection or innovative strategies such as neoadjuvant radiochemotherapy with subsequent orthotopic liver transplantation. Therefore, endoscopic techniques such as cholangioscopy and/or intraductal ultrasound may be useful diagnostic tools in patients with stenoses suspicious for malignancy. Liver Transpl 14:735,746, 2008. © 2008. [source] Clinical outcomes of persistent radioiodine uptake in the neck shown by diagnostic whole body scan in patients with differentiated thyroid carcinoma after initial surgery and remnant ablationCLINICAL ENDOCRINOLOGY, Issue 2 2010Eui Young Kim Summary Objectives, To evaluate the clinical outcomes of persistent radioiodine uptake (RAIU) in the neck by diagnostic whole body scan (DxWBS) after initial therapy and the efficacy of the second ablation in patients with differentiated thyroid carcinoma (DTC). Design, Patients with DTC who underwent bilateral surgery and high-dose remnant ablation between 2000 and 2004 were included. Patients with elevated serum stimulated thyroglobulin (sTg) or extensive lateral neck lymph node involvement at initial surgery underwent a second ablation, and patients with undetectable sTg or in very low-risk groups were observed. Results, Among 572 patients, 25 had persistent RAIU in the neck at first DxWBS. After a median 65·7 months of follow-up, five of these patients (20%) had persistent disease, whereas another 20 patients had no abnormal findings by ultrasonography (US) or other imaging modalities. Seven of 20 patients underwent second ablation and 13 were observed. RAIU disappeared spontaneously in about half of the patients in the observation group. There were no significant between-group differences in change of RAIU at follow-up DxWBS (P = 0·62). Serum sTg decreased and eventually disappeared over a few years in both groups. Ablation failure was not an independent risk factor for recurrence (P = 0·169). Conclusions, Neck US and serum sTg, but not DxWBS, were useful diagnostic tools during follow-up of patients with persistent uptake in the neck at DxWBS. A second ablation was not necessary when neck US showed no evidence of disease, especially in patients with very low sTg concentration. [source] | |||||||||||||