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Clinical diagnostics

Miriam da Silva Wanderley, Miriam Monteiro Álvares, Maria de Fátima Brito Vogt, Lizandra Moura Paravidine Sazaki
Objective To evaluate the accuracy of transvaginal ultrasonography, hysteroscopy and uterine curettage in the diagnosis of endometrial polyp, submucous myoma and endometrial hyperplasia, using as gold standard the histopathological analysis of biopsy samples obtained during hysteroscopy or uterine curettage. Methods Cross-sectional study performed at the Hospital Universitário de Brasília (HUB). Data were obtained from the charts of patients submitted to hysteroscopy or uterine curettage in the period from July 2007 to July 2012...
October 21, 2016: Revista Brasileira de Ginecologia e Obstetrícia
Matthew D Hale, Matthew Nankivell, Gordon G Hutchins, Sally P Stenning, Ruth E Langley, Wolfram Mueller, Nicholas P West, Alexander I Wright, Darren Treanor, Lindsay C Hewitt, William H Allum, David Cunningham, Jeremy D Hayden, Heike I Grabsch
BACKGROUND: Neoadjuvant chemotherapy followed by surgery is the standard of care for UK patients with locally advanced resectable oesophageal carcinoma (OeC). However, not all patients benefit from multimodal treatment and there is a clinical need for biomarkers which can identify chemotherapy responders. This study investigated whether the proportion of tumour cells per tumour area (PoT) measured in the pre-treatment biopsy predicts chemotherapy benefit for OeC patients. PATIENTS AND METHODS: PoT was quantified using digitized haematoxylin/eosin stained pre-treatment biopsy slides from 281 OeC patients from the UK MRC OE02 trial (141 treated by surgery alone (S); 140 treated by 5-fluorouracil/cisplatin followed by surgery (CS))...
October 18, 2016: Oncotarget
Wen Yea Hwong, Michiel L Bots, Sharmini Selvarajah, L Jaap Kappelle, Zariah Abdul Aziz, Norsima Nazifah Sidek, Ilonca Vaartjes
BACKGROUND: A shortage of computed tomographic (CT) machines in low and middle income countries often results in delayed CT imaging for patients suspected of a stroke. Yet, time constraint is one of the most important aspects for patients with an ischemic stroke to benefit from thrombolytic therapy. We set out to assess whether application of the Siriraj Stroke Score is able to assist physicians in prioritizing patients with a high probability of having an ischemic stroke for urgent CT imaging...
2016: PloS One
Ivan A Zaporozhchenko, Evgeny S Morozkin, Tatyana E Skvortsova, Anastasia A Ponomaryova, Elena Yu Rykova, Nadezhda V Cherdyntseva, Evgeny S Polovnikov, Oksana A Pashkovskaya, Evgeny A Pokushalov, Valentin V Vlassov, Pavel P Laktionov
Lung cancer is a complex disease that often manifests at the point when treatment is not effective. Introduction of blood-based complementary diagnostics using molecular markers may enhance early detection of this disease and help reduce the burden of lung cancer. Here we evaluated the diagnostic potential of seven plasma miRNA biomarkers (miR-21, -19b, -126, -25, -205, -183, -125b) by quantitative reverse transcription PCR. Influence clinical and demographical characteristics, including age, tumor stage and cancer subtype on miRNA levels was investigated...
2016: PloS One
Mauro Mondelli, Andrea Farioli, Stefano Mattioli, Alessandro Aretini, Federica Ginanneschi, Giuseppe Greco, Stefania Curti
OBJECTIVE: To study the diagnostic properties of hand/wrist and body measures according to validated clinical and electrophysiological carpal tunnel syndrome (CTS) severity scales. METHODS: We performed a prospective case-control study. For each case, two controls were enrolled. Two five-stage clinical and electrophysiological scales were used to evaluate CTS severity. Anthropometric measurements were collected and obesity indicators and hand/wrist ratios were calculated...
2016: PloS One
Jacob J Glaser, Cassandra Cardarelli, Samuel Galvagno, Thomas M Scalea, Sarah B Murthi
BACKGROUND: Point-of-care ultrasound often includes cardiac ultrasound. It is commonly used to evaluate cardiac function in critically ill patients but lacks the specific quantitative anatomic assessment afforded by standard transthoracic echocardiography (TTE). We developed the Focused Rapid Echocardiographic Examination (FREE), a hybrid between a cardiac ultrasound and TTE that places an emphasis on cardiac function rather than anatomy. We hypothesized that data obtained from FREE correlate well with TTE while providing actionable information for clinical decision making...
November 2016: Journal of Trauma and Acute Care Surgery
Hardeep Singh, Mark L Graber, Timothy P Hofer
Timely and accurate diagnosis is foundational to good clinical practice and an essential first step to achieving optimal patient outcomes. However, a recent Institute of Medicine report concluded that most of us will experience at least one diagnostic error in our lifetime. The report argues for efforts to improve the reliability of the diagnostic process through better measurement of diagnostic performance. The diagnostic process is a dynamic team-based activity that involves uncertainty, plays out over time, and requires effective communication and collaboration among multiple clinicians, diagnostic services, and the patient...
October 20, 2016: Journal of Patient Safety
Gregory Plotnikoff, Melissa Barber
INTRODUCTION: Single-disorder or single-organ-system clinical practice guidelines are often of limited usefulness in guiding effective management of patients with chronic multidimensional signs and symptoms. The presence of multiple long-standing medical problems in a given patient despite intensive medical effort suggests that addressing systemic core imbalances could complement more narrowly focused approaches. CASE PRESENTATION: A 72-year-old man experiencing longstanding depression, fatigue, irritable bowel syndrome, and chronic pain in the context of additional refractory illnesses was assessed and treated, guided by a system-oriented approach to underlying core imbalances termed functional medicine...
October 14, 2016: Permanente Journal
Christian Weisstanner, Gerlinde M Gruber, Peter C Brugger, Christan Mitter, Mariana C Diogo, Gregor Kasprian, Daniela Prayer
Foetal MR now plays an important role in the clinical work-up of pregnant women. It is performed mainly at 1.5T. However, the desire to obtain a more precise foetal depiction or the fact that some institutions have access only to a 3T scanner, has resulted in a growing interest in performing foetal MR at 3T. The aim of this article is to provide a reference for the use of 3T MRI as a prenatal diagnostic method.
October 21, 2016: British Journal of Radiology
Margaret E Hunter, Robert M Dorazio, John S S Butterfield, Gaia Meigs-Friend, Leo G Nico, Jason A Ferrante
A set of universal guidelines is needed to determine the limit of detection (LOD) in PCR-based analyses of low concentration DNA. In particular, environmental DNA (eDNA) studies require sensitive and reliable methods to detect rare and cryptic species through shed genetic material in environmental samples. Current strategies for assessing detection limits of eDNA are either too stringent or subjective, possibly resulting in biased estimates of species' presence. Here, a conservative LOD analysis grounded in analytical chemistry is proposed to correct for overestimated DNA concentrations predominantly caused by the concentration plateau, a nonlinear relationship between expected and measured DNA concentrations...
October 21, 2016: Molecular Ecology Resources
Loren E Clarke, Darl D Flake, Klaus Busam, Clay Cockerell, Klaus Helm, Jennifer McNiff, Jon Reed, Jaime Tschen, Jinah Kim, Raymond Barnhill, Rosalie Elenitsas, Victor G Prieto, Jonathan Nelson, Hillary Kimbrell, Kathryn A Kolquist, Krystal L Brown, M Bryan Warf, Benjamin B Roa, Richard J Wenstrup
BACKGROUND: Recently, a 23-gene signature was developed to produce a melanoma diagnostic score capable of differentiating malignant and benign melanocytic lesions. The primary objective of this study was to independently assess the ability of the gene signature to differentiate melanoma from benign nevi in clinically relevant lesions. METHODS: A set of 1400 melanocytic lesions was selected from samples prospectively submitted for gene expression testing at a clinical laboratory...
October 21, 2016: Cancer
Edem Tsikata, Ramon Lee, Eric Shieh, Huseyin Simavli, Christian J Que, Rong Guo, Ziad Khoueir, Johannes de Boer, Teresa C Chen
Purpose: To describe spectral-domain optical coherence tomography (OCT) methods for quantifying neuroretinal rim tissue in glaucoma and to compare these methods to the traditional retinal nerve fiber layer thickness diagnostic parameter. Methods: Neuroretinal rim parameters derived from three-dimensional (3D) volume scans were compared with the two-dimensional (2D) Spectralis retinal nerve fiber layer (RNFL) thickness scans for diagnostic capability. This study analyzed one eye per patient of 104 glaucoma patients and 58 healthy subjects...
October 1, 2016: Investigative Ophthalmology & Visual Science
Laura Coco, Craig A Champlin, Robert H Eikelboom
Purpose: Sections of the community face barriers to accessing audiology services. The aim of this study was to assess the barriers faced by people in typically underserved community settings and to provide audiology services in their natural environment. Information gathered by questionnaire was used to determine each site's candidacy as a potential tele-audiology site. Method: Sixty-three participants were recruited across 3 community sites that were identified as gathering places for individuals who experience barriers to accessing traditional clinical audiology services...
October 1, 2016: American Journal of Audiology
Dennis Chan, Laura Marie Gallaher, Kuven Moodley, Ludovico Minati, Neil Burgess, Tom Hartley
This protocol describes the administration of the 4 Mountains Test (4MT), a short test of spatial memory, in which memory for the topographical layout of four mountains within a computer-generated landscape is tested using a delayed match-to-sample paradigm. Allocentric spatial memory is assessed by altering the viewpoint, colors and textures between the initially presented and target images. Allocentric spatial memory is a key function of the hippocampus, one of the earliest brain regions to be affected in Alzheimer's disease (AD) and impairment of hippocampal function predates the onset of dementia...
October 13, 2016: Journal of Visualized Experiments: JoVE
Mieke T Bus, Daniel M De Bruin, Guido M Kamphuis, Patricia J Zondervan, Maria P Laguna Pes, Theo M De Reijke, Ton G Van Leeuwen, Jean J De LA Rosette
BACKGROUND: The applicability of urinary biomarkers and optical diagnostics in upper urinary tract carcinoma (UUTUC) are increasingly debated. To receive insight in the opinion of the urological community involved in this field, a survey was sent out to identify the most promising techniques and understand the need for new diagnostics. Primary objective of this study was to provide an overview of current diagnostics in upper urinary tract urothelial carcinoma. Secondary objectives of this study was to assess the need for additional diagnostic techniques in the current diagnostic work-up for UUT-UC and to assess knowledge of novel techniques...
October 21, 2016: Minerva Urologica e Nefrologica, the Italian Journal of Urology and Nephrology
J Rübenthaler, K Paprottka, J Marcon, E Hameister, K Hoffmann, N Joiko, M Reiser, D A Clevert
PURPOSE: To compare the sensitivity and specificity of contrast-enhanced ultrasound (CEUS) and magnetic resonance imaging (MRI) in the evaluation of unclear renal lesions to the histopathological outcome. MATERIALS AND METHODS: A total of 36 patients with a single unclear solid renal lesion with initial imaging studies between 2005 and 2015 were included. CEUS and MRI were used for determining malignancy or benignancy and initial findings were correlated with the histopathological outcome...
October 21, 2016: Clinical Hemorheology and Microcirculation
Rabeea'h W Aslam, Vickie Bates, Yenal Dundar, Juliet Hounsome, Marty Richardson, Ashma Krishan, Rumona Dickson, Angela Boland, Eleanor Kotas, Joanne Fisher, Sudip Sikdar, Louise Robinson
BACKGROUND: Cognitive impairment is a growing public health concern, and is one of the most distinctive characteristics of all dementias. The timely recognition of dementia syndromes can be beneficial, as some causes of dementia are treatable and are fully or partially reversible. Several automated cognitive assessment tools for assessing mild cognitive impairment (MCI) and early dementia are now available. Proponents of these tests cite as benefits the tests' repeatability and robustness and the saving of clinicians' time...
October 2016: Health Technology Assessment: HTA
Markus Zutt, Hagen Rudolph, Kjell Matthias Kaune, Werner Wosniok, Ulrich Gärtner, Rainer Linke
BACKGROUND: In recent years, cardiac comorbidities in psoriasis patients have increasingly moved into the focus of clinical research. The objective of the present study was to evaluate myocardial scintigraphy as a screening method in patients with psoriasis. PATIENTS AND METHODS: Assessment of various comorbidities in 50 psoriasis patients without clinical symptoms of cardiac disease. Myocardial scintigraphy was employed to detect cardiac risk/exercise-induced ischemia...
October 2016: Journal der Deutschen Dermatologischen Gesellschaft, Journal of the German Society of Dermatology: JDDG
Chiranjit Ghosh, Santanu Mandal, Gourab D Banik, Abhijit Maity, Prabuddha Mukhopadhyay, Shibendu Ghosh, Manik Pradhan
The inability to envisage the acute onset and progression of type 1 diabetes (T1D) has been a major clinical stumbling block and an important area of biomedical research over the last few decades. Therefore there is a pressing need to develop a new and an effective strategy for early detection of T1D and to precisely distinguish T1D from type 2 diabetes (T2D). Here we describe the precise role of the enzymatic activity of carbonic anhydrase (CA) in erythrocytes in the pathogenesis of T1D and T2D. We show that CA activities are markedly altered during metabolism of T1D and T2D and this facilitates to the oxygen-18 ((18)O) isotopic fractionations of breath CO2...
October 21, 2016: Scientific Reports
Sanna Lindåse, Katarina Nostell, Johan Bröjer
BACKGROUND: An oral sugar test (OST) using Karo(®) Light Corn Syrup has been developed in the USA as a field test for the assessment of insulin dysregulation in horses but the syrup is not available in Scandinavian grocery stores. The aim of the study was to compare the results of a modified OST between horses with equine metabolic syndrome (EMS) and healthy horses using a Scandinavian commercially available glucose syrup (Dansukker glykossirap). In addition, the effect of breed and the repeatability of the test were evaluated...
October 20, 2016: Acta Veterinaria Scandinavica
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