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Useful Test (useful + test)
Selected AbstractsElevated tryptase levels selectively cluster in myeloid neoplasms: a novel diagnostic approach and screen marker in clinical haematologyEUROPEAN JOURNAL OF CLINICAL INVESTIGATION, Issue 10 2009W. R. Sperr Abstract Background, Recent data suggest that tryptase, a mast cell enzyme, is expressed in neoplastic cells in myeloid leukaemias. In several of these patients, increased serum tryptase levels are detectable. Materials and methods, We have determined serum tryptase levels in 914 patients with haematological malignancies, including myeloproliferative disorders (n = 156), myelodysplastic syndromes (MDS, n = 241), acute myeloid leukaemia (AML, n = 317), systemic mastocytosis (SM, n = 81), non-Hodgkin,s lymphoma (n = 59) and acute lymphoblastic leukaemia (n = 26). Moreover, tryptase was measured in 136 patients with non-neoplastic haematological disorders, 102 with non-haematological disorders and 164 healthy subjects. Results, In healthy subjects, the median serum tryptase was 5·2 ng mL,1. Elevated serum tryptase levels were found to cluster in myeloid neoplasm, whereas almost all patients with lymphoid neoplasms exhibited normal tryptase. Among myeloid neoplasms, elevated tryptase levels (> 15 ng mL,1) were recorded in > 90% of patients with SM, 38% with AML, 34% with CML and 25% with MDS. The highest tryptase levels, often > 1000 ng mL,1, were found in advanced SM and core-binding-factor leukaemias. In most patients with non-neoplastic haematological disorders and non-haematological disorders analysed in our study, tryptase levels were normal, the exception being a few patients with end-stage kidney disease and helminth infections, in whom a slightly elevated tryptase was found. Conclusions, In summary, tryptase is a new diagnostic marker of myeloid neoplasms and a useful test in clinical haematology. [source] Validation of the Severe Impairment Battery for patients with Alzheimer's disease in KoreaINTERNATIONAL JOURNAL OF GERIATRIC PSYCHIATRY, Issue 7 2006Guk-Hee Suh Abstract Objective To examine the reliability and the validity of the Korean version of the SIB (SIB-K); and to determine its usefulness in patients with severe dementia. Methods Sixty-five patients (56 women, nine men) who lived in a nursing home and met the criteria of the Diagnostic and Statistical Manual of Mental Disorders, 4th edn, for the dementia of the Alzheimer's type were selected. Following clinical examination and evaluation using the Korean version of the Severe Impairment Battery (SIB-K), the Korean versions of the Mini-Mental State Examination (MMSE-K) and the cognitive subscale of the Alzheimer's Disease Assessment Scale (ADAS-K-cog) were applied as comparators. Results The mean scores on the SIB-K were 63.9 (SD,=,29.1), with a possible maximum of 100 points. Patients with MMSE scores from 0 to 4 points showed wide range of the SIB score from 4 to 62. The internal consistency of the SIB-K obtained by the Cronbach's alpha was 0.98. The inter-rater and test,retest reliabilities of the SIB-K obtained by the Spearman's rho were 0.99 and 0.97, respectively. Correlation between the SIB-K and the MMSE-K was 0.87, while correlation between the SIB-K and the ADAS-K-cog was ,0.76. Conclusions This study indicates that the Korean version of the SIB is a reliable, valid and useful test for measuring cognition of severely demented patients at a point where other conventional tests lose their sensitivity and show a floor effect. Copyright © 2006 John Wiley & Sons, Ltd. [source] Characterization of the bone marrow immunofluorescence test in childhood autoimmune neutropeniaINTERNATIONAL JOURNAL OF LABORATORY HEMATOLOGY, Issue 5 2009S. W. LANE Summary The bone marrow immunofluorescenece test (BMIFT) demonstrates autoantibodies to granulocytes and their precursors on fresh-frozen bone marrow slides. It may be used to differentiate childhood autoimmune neutropenia (AIN) from other causes of childhood neutropenia, even when circulating neutrophil counts are low. We sought to characterize the diagnostic utility of the BMIFT in childhood AIN. All BMIFT requests for investigation of children with neutropenia between January 1998 and May 2007 were reviewed. Patients were classified as AIN or nonautoimmune causes. Baseline demographic data, results of BMIFT, granulocyte immunofluorescence testing and bone marrow findings were collected from clinical records and the institutional laboratory database. Seventy-six children had BMIFT performed for investigation of neutropenia. There were 45 patients diagnosed with AIN, 28 with nonimmune neutropenia and three failed tests. The median age of children with AIN was 1.2 years (range 0.3,15.3), compared with 3.6 years (range 0.1,15.7) in the nonautoimmune group. The median neutrophil count in AIN was 0.3 × 109/l (0.9 × 109/l in nonautoimmune). BMIFT was positive in 24 of 45 patients with AIN and 0 of 28 with nonautoimmune neutropenia (sensitivity 53%, specificity 100%, positive predictive value (PPV) 100%, negative predictive value 57%). Ten patients had other autoimmune diatheses at diagnosis. The BMIFT is a simple, highly specific test with excellent PPV and thus is a clinically useful test to confirm AIN in children. [source] NBT-PABA test to assess efficiency and kinetics of substituted proteolytic enzyme action in pancreatic duct ligated minipigs,JOURNAL OF ANIMAL PHYSIOLOGY AND NUTRITION, Issue 3 2008A. Mößeler Summary The NBT-PABA test is an established method for diagnosis of pancreatic exocrine insufficiency. In the present study the NBT-PABA test was used to test and compare the efficacy of two multienzyme preparations (product A and B) differing in galenic preparation in minipigs in which pancreatic exocrine insufficiency (PEI) was induced by pancreatic duct ligation. Without enzyme substitution no distinct increase in PABA was found in blood after oral administration of NBT-PABA. Administration of both enzyme preparations led to a clear dose dependent rise in PABA-concentrations in blood. Interestingly, the two preparations showed different time curves of serum PABA concentration, indicating differences in the kinetic of proteolytic enzyme action. It is concluded that the NBT-PABA test can be a very useful test for indirectly evaluating proteolytic enzyme efficacy in vivo, and also gives information about the kinetics of enzyme action, not only the end-result of enzyme action (like digestibility trials which were used traditionally). A single test is performed in a few hours and there is no need for fistulated animals. [source] CA-125 levels in ruptured and unruptured tubal ectopic pregnanciesJOURNAL OF OBSTETRICS AND GYNAECOLOGY RESEARCH (ELECTRONIC), Issue 4 2006Erdal Malatyalioglu Abstract Aim:, This prospective, single-blind and controlled clinical study aimed to research if CA-125 levels could be a useful test in the differential diagnosis of intact and ruptured tubal ectopic pregnancy. Methods:, Sixty-five women with tubal ectopic pregnancy of 5,10 weeks' duration (27 women with ruptured tubal ectopic pregnancy [REP] and 38 women with unruptured tubal ectopic pregnancy [UREP]) and 65 women with normal intrauterine pregnancy (NIUP) of the same gestational age were studied prospectively. Serum CA-125 levels were measured in all women and these levels were compared among the REP, UREP, and NIUP groups. Results:, The mean CA-125 levels didn't show any significant difference between the REP and NIUP groups (P > 0.05). The mean CA-125 levels of these two groups were higher than that in the UREP group (P < 0.01, P < 0.001, respectively). The dispersion ratios of the CA-125 levels had a statistically significant difference between the REP and UREP groups (,2: 42.44, P < 0.0001). CA-125 levels weren't correlated with gestational weeks in the REP and UREP groups (r: 0.005, P > 0.05; r: 0.008, P > 0.05, respectively). Conclusion:, In intact tubal ectopic pregnancies, expectant or managed with medical treatment, the increase of CA-125 levels in the serial measurements could be a supplementary test for an early diagnosis of tubal rupture. [source] Usefulness of AgNOR counts in diagnosing epithelial dysplasiaJOURNAL OF ORAL PATHOLOGY & MEDICINE, Issue 2 2003Jay G. Ray Abstract Background:, Diagnosis of epithelial dysplasia has traditionally been subjective, and there is a need for a quantifiable and useful test. Methods:, In a double blind study, clinical leukoplakias from 52 people were diagnosed for presence (DLK) or absence (NDLK) of epithelial dysplasia using hematoxylin and eosin (H&E) stain as a gold standard criterion, and results were compared against their mean silver stainable nucleolar organizer region (AgNOR) counts. We used mean AgNOR count cut-point of 2.37 from our prior report as the diagnostic threshold (mean , 2.37 being DLK and mean < 2.37 being NDLK). Results:, The two methods (H&E and AgNOR) disagreed in 37% of the diagnoses. Both NDLK and DLK had high AgNOR counts. P-AgNOR was non-contributory for diagnosing epithelial dysplasia. Conclusions:, Mean AgNOR count can be a useful tool in definitive diagnosis of epithelial dysplasia. [source] Teaching and Learning Guide for: Locutionary, Illocutionary, PerlocutionaryLINGUISTICS & LANGUAGE COMPASS (ELECTRONIC), Issue 9 2010Mikhail Kissine This guide accompanies the following article: Mikhail Kissine, ,Locutionary, Illocutionary, Perlocutionary', Language and Linguistics Compass 2/6 (2008) pp. 1189,1202. DOI: 10.1111/j.1749-818x.2008.00093.x. The terms locutionary act, illocutionary act and perlocutionary act originate from Austin's classical How to do with words. The corresponding notions, however, prove difficult to define. Yet, lack of careful delineating of each level can lead to important theoretical confusions. This Teaching and Learning Guide explains why proper understanding of Austin's trichotomy is crucial for semantics and pragmatics. Author's Introduction Most contemporary discussions in semantics and pragmatics employ , implicitly or explicitly , some or all of the concepts of locutionary,illocutionary or perlocutionary acts. These notions originate from Austin's posthumous and notoriously intricate book, How to do things with words. The point of interest for the linguist, however, is not so much the exegesis of Austin's ideas, as the precise delimitation of these levels of meaning. First, it is important to characterise the locutionary level , which falls short of any illocutionary force , to avoid contaminating analyses of utterance meanings with matters relative to the illocutionary level, viz. to the speech act performed. Second, the precise definition of illocutionary acts is an extremely difficult matter. However, the first, imperative step must be a clear demarcation between perlocutionary acts , relative to causal effects of the utterances , and the utterance's illocutionary force. Third, to assess theories of illocutionary forces, one must take into account the requirements for psychological and empirical plausibility. For instance, classical Gricean theories of illocutionary force attribution link it with the cognitive capacity to perform complex multi-layered mental state attributions, which is incompatible with the data available on the pragmatic and cognitive functioning of young children. In sum, gaining better understanding of the tripartite distinction between the locutionary, illocutionary and perlocutionary levels is not a taxonomical exercise, but a prerequisite for anyone willing to tackle semantic and/or pragmatic issues with the right tools. Suggested Reading Austin, J.L. (1975) How to do things with words, Second edition, Oxford, Oxford University Press. Lecture VIII. Difficult reading, but essential to understand Austin's intuitions and the origin of the debate. Strawson, P.F. (1964) "Intention and convention in speech acts", Philosophical Review, 73, 439,60. Classical criticism of Austin's claim abut the conventionality of illocutionary acts and first formulation of a Gricean theory of speech acts. Strawson, P.F. (1973) "Austin and ,Locutionary meaning'", in I. Berlin et al. (eds.) Essays on J.L. Austin, Oxford, Clarendon Press, 46,68. This equally classical paper sheds light onto the difficult notions of rhetic and locutionary acts; it paves the way for using these concepts interchangeably. Recanati, F. (1987) Meaning and Force. The pragmatics of performative utterances, Cambridge, Cambridge University Press. Chapter 9. This is a lucid discussion and elaboration of Strawson's conception of the locuitonary act as a potential for the illocutionary level. Wilson, D. and Sperber, D. (1988) "Mood and the analysis of non-declarative sentences", in J. Dancy et al. (eds.) Human Agency, Language, Duty and Value. Philosophical essayes in honour of J.O. Urmson, Stanford, Stanford University Press, 77,101. This paper gives important reasons for not confusing the analysis of mood , of the locutionary level , with the analysis of speech acts. Kissine, M. (2009) "Illocutionary forces and what is said", Mind and Language, 24, 122,38. Provides a definition of locutionary acts as linguistic representations of mental states, and lays grounds for a theory of speech acts as reasons to believe or to act. Bach, K. (1994) "Conversational impliciture", Mind and Language, 9, 124,62. An important defence of the distinction between illocutionary and locutionary acts. However, the reader should be warned that Bach conceives of locutionary acts as context-independent propositional radicals, which is not a self-evident position. Alston (2000) Illocutionary Acts and Sentence Meaning, Ithaca, Cornell University Press, Chapter 2. Contains a clear and lucid criticism of theories that confuse illocutionary and perlocutionary levels. Dominicy, M. (2008) "Epideictic rhetoric and the representation of human decision and choice", in K. Korta and J. Garmendia (eds.) Meaning, Intentions, and Argumentation, Stanford, CSLI, 179,207. This paper contains a useful test for distinguishing verbs that describe illocutionary acts form those that describe perlocutionary acts. It is also the first proposal to formulate the illocutionary/perlocutionary divide in Davidsonian terms. Focus Questions 1,What kind of philosophy of action is called for by the distinction between locutions, perlocutions and illocutions? 2,Should the locutionary level be always fully propositional? 3,Can illocutionary acts be characterised in terms of prototypical perlocutional effects? 4,Should illocutionary acts be divided in conventional (institutional) and non-conventional (non-insitutional) ones? 5,Are there good reasons for singling out a locutionary level? 6,,Does the attribution of illocutionary forces presuppose a complex mindreading process? Connexion with to Related Material in Lectures or Discussions 1,The distinction between the locutionary and illocutionary levels is crucial for any discussion about the semantics/pragmatics interface. Many scholars hastily characterise semantics as related to sentence-meaning and pragmatics as concerning the speech act performed. However, one should not take for granted that any level where the meaning is context-dependant is necessarily that of the illocutionary act performed. 2,This distinction can also be relevant for the discussions about the meaning of moods. For instance, the imperative mood is often analysed in terms of the directive illocutionary force. However, there are cases where utterances of imperative sentences do not correspond to a directive speech act. 3,The distinction between perlocutionary and illocutionary acts remains central for any attempt to classify or to define illocutionary forces. 4,Different conceptions of illocutionary acts are important for discussions about the ontogeny and phylogeny of the pragmatic dimension(s) of linguistic competence. [source] Emergency Thoracic Ultrasound in the Differentiation of the Etiology of Shortness of Breath (ETUDES): Sonographic B-lines and N-terminal Pro-brain-type Natriuretic Peptide in Diagnosing Congestive Heart FailureACADEMIC EMERGENCY MEDICINE, Issue 3 2009Andrew S. Liteplo MD Abstract Objectives:, Sonographic thoracic B-lines and N-terminal pro-brain-type natriuretic peptide (NT-ProBNP) have been shown to help differentiate between congestive heart failure (CHF) and chronic obstructive pulmonary disease (COPD). The authors hypothesized that ultrasound (US) could be used to predict CHF and that it would provide additional predictive information when combined with NT-ProBNP. They also sought to determine optimal two- and eight-zone scanning protocols when different thresholds for a positive scan were used. Methods:, This was a prospective, observational study of a convenience sample of adult patients presenting to the emergency department (ED) with shortness of breath. Each patient had an eight-zone thoracic US performed by one of five sonographers, and serum NT-ProBNP levels were measured. Chart review by two physicians blinded to the US results served as the criterion standard. The operating characteristics of two- and eight-zone thoracic US alone, compared to, and combined with NT-ProBNP test results for predicting CHF were calculated using both dichotomous and interval likelihood ratios (LRs). Results:, One-hundred patients were enrolled. Six were excluded because of incomplete data. Results of 94 patients were analyzed. A positive eight-zone US, defined as at least two positive zones on each side, had a positive likelihood ratio (LR+) of 3.88 (99% confidence interval [CI] = 1.55 to 9.73) and a negative likelihood ratio (LR,) of 0.5 (95% CI = 0.30 to 0.82), while the NT-ProBNP demonstrated a LR+ of 2.3 (95% CI = 1.41 to 3.76) and LR, of 0.24 (95% CI = 0.09 to 0.66). Using interval LRs for the eight-zone US test alone, the LR for a totally positive test (all eight zones positive) was infinite and for a totally negative test (no zones positive) was 0.22 (95% CI = 0.06 to 0.80). For two-zone US, interval LRs were 4.73 (95% CI = 2.10 to 10.63) when inferior lateral zones were positive bilaterally and 0.3 (95% CI = 0.13 to 0.71) when these were negative. These changed to 8.04 (95% CI = 1.76 to 37.33) and 0.11 (95% CI = 0.02 to 0.69), respectively, when congruent with NT-ProBNP. Conclusions:, Bedside thoracic US for B-lines can be a useful test for diagnosing CHF. Predictive accuracy is greatly improved when studies are totally positive or totally negative. A two-zone protocol performs similarly to an eight-zone protocol. Thoracic US can be used alone or can provide additional predictive power to NT-ProBNP in the immediate evaluation of dyspneic patients presenting to the ED. [source] Fluorodeoxyglucose positron emission tomography studies in the diagnosis and staging of clinically advanced prostate cancerBJU INTERNATIONAL, Issue 1 2003J. Sung OBJECTIVE To determine the value of 18F-fluoro-2-deoxyglucose (FDG) positron-emission tomography (PET) studies in evaluating patients with advanced prostate cancer. PATIENTS AND METHODS FDG-PET scans were taken in 30 patients with advanced prostate cancer 1 h after an injection with 555 MBq of FDG. Patients were scanned from the base of the skull to the inguinal region (including the pelvis). They were also assessed by computed tomography (CT) of the abdomen and pelvis, and bone scintigraphy, to evaluate them for metastases. RESULTS Thirteen patients had locally extensive prostate cancer and 17 had metastatic disease. Twenty of the 30 patients were positive for radioisotope uptake in the prostate or extraprostatically. The patients with PET-detected prostate cancer were untreated (seven), treated hormonally while they had rising PSA levels (eight), or treated hormonally with a detectable but stable PSA (five). The remaining 10 patients were negative for FDG uptake in the prostate or any metastatic sites; these 10 patients were receiving hormone therapy, with undetectable PSA levels. CONCLUSION FDG-PET imaging is not a useful test in evaluating advanced prostate cancer in patients being treated and who have an undetectable PSA level. Staging of advanced prostate cancer may be enhanced by FDG-PET imaging in patients who are untreated, who have had an incomplete response to therapy, or who have a rising PSA level despite treatment. [source] Systematic review of methods to diagnose infection in foot ulcers in diabetesDIABETIC MEDICINE, Issue 4 2006S. O'Meara Abstract Aim, To undertake a systematic review of the diagnostic performance of clinical examination, sample acquisition and sample analysis in infected foot ulcers in diabetes. Methods, Nineteen electronic databases plus other sources were searched. To be included, studies had to fulfil the following criteria: (i) compare a method of clinical assessment, sample collection or sample analysis with a reference standard; (ii) recruit diabetic individuals with foot ulcers; (ii) present 2 × 2 diagnostic data. Studies were critically appraised using a 12-item checklist. Results Three eligible studies were identified, one each on clinical examination, sample collection and sample analysis. For all three, study groups were heterogeneous with respect to wound type and a small proportion of participants had foot ulcers due to diabetes. No studies identified an optimum reference standard. Other methodological problems included non-blind interpretation of tests and the time lag between index and reference tests. Individual signs or symptoms of infection did not prove to be useful tests when assessed against punch biopsy as the reference standard. The wound swab did not perform well when assessed against tissue biopsy. Semiquantitative analysis of wound swab might be a useful alternative to quantitative analysis. The limitations of these findings and their impact on recommendations from relevant clinical guidelines are discussed. Conclusion, Given the importance of this topic, it is surprising that only three eligible studies were identified. It was not possible to describe the optimal methods of diagnosing infection in diabetic patients with foot ulceration from the evidence identified in this systematic review. Diabet. Med. 23, 341,347 (2006) [source] Unproven diagnostic procedures in IgE-mediated allergic diseasesALLERGY, Issue 8 2004B. Niggemann A considerable body of literature on therapeutic aspects of complementary and alternative medicine has been published in recent years, but little is known on diagnostic procedures. This short review lists complementary and alternative diagnostic procedures for the diagnosis of allergic diseases and presents an assessment of their usefulness for the daily practice. The review of the literature revealed that neither the determination of specific immunoglobulin G-antibodies in serum, the hair-analysis, the cytotoxic test, kinesiology, iridology, or electrodermal testing represent useful tests for the daily practice. To date, no complementary or alternative diagnostic procedure can be recommended as a meaningful element in the diagnostic work-up of allergic diseases. This is especially true for food allergy: properly performed oral food challenges still represent the gold standard for implementing specific diets in food allergic individuals. Ineffective diagnostic approaches may be costly for the consumer and delay appropriate therapy. [source] The role of complement testing in dermatologyCLINICAL & EXPERIMENTAL DERMATOLOGY, Issue 4 2005S. Jamal Summary An up-to-date knowledge of the molecular events involved in the activation and control of the complement cascade is essential to understand the pathogenesis of a number of conditions presenting to dermatologists. This knowledge underpins the pathogenesis of these conditions but allows the clinician to request the most useful tests in terms of diagnosis and monitoring. In this review we aim to discuss complement biology, the diseases in which complement testing is of particular relevance, the types of laboratory tests available, their utility and interpretation. Additionally it is of critical importance for clinicians not only to choose the most appropriate tests but also to choose to send these to an appropriately accredited laboratory. [source] | ||||||||||