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diagnostic test interpretation

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https://www.readbyqxmd.com/read/28215415/diagnostic-and-prognostic-value-of-lead-avr-during-exercise-testing-in-patients-suspected-of-having-myocardial-ischemia
#1
Max Wagener, Roger Abächerli, Ursina Honegger, Nicolas Schaerli, Gil Prêtre, Raphael Twerenbold, Christian Puelacher, Germaine Sunier, Philipp Reddiess, Maria Rubini Gimenez, Karin Wildi, Jasper Boeddinghaus, Thomas Nestelberger, Patrick Badertscher, Zaid Sabti, Ramun Schmid, Remo Leber, Dayana Flores Widmer, Samyut Shrestha, Ivo Strebel, Damian Wild, Stefan Osswald, Michael Zellweger, Christian Mueller, Tobias Reichlin
We aimed to assess the diagnostic and prognostic value of ST-segment deviation in aVR, a lead often ignored in clinical practice, during exercise testing and to compare it to the most widely used criterion of ST-segment depression in V5. We enrolled 1,596 patients with suspected myocardial ischemia referred for nuclear perfusion imaging undergoing bicycle stress testing. ST-segment amplitudes in leads aVR and V5 were automatically measured. The presence of inducible myocardial ischemia was the diagnostic end point and adjudicated based on nuclear perfusion imaging and coronary angiography...
January 5, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28211806/digital-breast-tomosynthesis-plus-mammography-magnetic-resonance-imaging-plus-mammography-and-mammography-alone-a-comparison-of-diagnostic-performance-in-symptomatic-women
#2
Wei Tang, Fei-Xiang Hu, Hui Zhu, Qi-Feng Wang, Ya-Jia Gu, Wei-Jun Peng
PURPOSE: To compare the diagnostic efficiency of digital breast tomosynthesis (DBT) plus digital mammography (DM) and magnetic resonance imaging (MRI) plus DM in symptomatic women. MATERIALS AND METHODS: The protocol used in our study was accepted by the ethics committee at our hospital, and informed consent was obtained from all patients. Between June and December 2014, 197 patients with 238 histologically proven lesions all underwent DM, DBT and MRI. Two radiologists were responsible for interpreting all images according to the Breast Imaging Reporting and Data System (BI-RADS)...
February 17, 2017: Clinical Hemorheology and Microcirculation
https://www.readbyqxmd.com/read/28210531/the-daniel-k-inouye-college-of-pharmacy-scripts-updates-on-clostridium-difficile-infection-advances-in-laboratory-testing-to-aid-diagnosis-and-treatment
#3
Louis Lteif
Clostridium difficile remains a major source of nosocomial infections and associated diarrhea. More recently, community-acquired cases are on the rise creating a concern for a serious public health threat. Appropriate infection control precautions as well as prevention and optimal management may help to avoid detrimental outbreaks. A key step is utilizing laboratory testing for quick and accurate diagnosis of potential cases. This overview article describes Clostridium difficile infection control and prevention methods and updates the most recent management strategies including a focus on the utilization and interpretation of laboratory diagnostic testing and appropriate treatment...
February 2017: Hawai'i Journal of Medicine & Public Health: a Journal of Asia Pacific Medicine & Public Health
https://www.readbyqxmd.com/read/28206672/assessment-of-a-novel-point-of-care-ultrasound-curriculum-s-effect-on-competency-measures-in-family-medicine-graduate-medical-education
#4
Paul Bornemann
OBJECTIVES: Point-of-care ultrasound has been shown to decrease the use of expensive diagnostic studies and improve quality outcome measures. Currently, there is a large desire for training in family medicine residencies, but very few programs have established curricula. We sought to develop a family medicine residency curriculum and evaluate it with tools we developed. We wanted our curriculum to be easy to adopt by other residency programs, even if they did not have many well-trained ultrasound faculty...
February 16, 2017: Journal of Ultrasound in Medicine: Official Journal of the American Institute of Ultrasound in Medicine
https://www.readbyqxmd.com/read/28203372/diagnostic-challenges-and-management-of-a-patient-with-acromegaly-due-to-ectopic-growth-hormone-releasing-hormone-secretion-from-a-bronchial-carcinoid-tumour
#5
Nikolaos Kyriakakis, Jacqueline Trouillas, Mary N Dang, Julie Lynch, Paul Belchetz, Márta Korbonits, Robert D Murray
: A male patient presented at the age of 30 with classic clinical features of acromegaly and was found to have elevated growth hormone levels, not suppressing during an oral glucose tolerance test. His acromegaly was originally considered to be of pituitary origin, based on a CT scan, which was interpreted as showing a pituitary macroadenoma. Despite two trans-sphenoidal surgeries, cranial radiotherapy and periods of treatment with bromocriptine and octreotide, his acromegaly remained active clinically and biochemically...
2017: Endocrinology, Diabetes & Metabolism Case Reports
https://www.readbyqxmd.com/read/28199179/experienced-probabilities-increase-understanding-of-diagnostic-test-results-in-younger-and-older-adults
#6
Bonnie Armstrong, Julia Spaniol
BACKGROUND: With advancing age, the frequency of medical screening increases. Interpreting the results of medical tests involves estimation of posterior probabilities such as positive predictive values (PPVs) and negative predictive values (NPVs). Both laypeople and experts are typically poor at estimating posterior probabilities when the relevant statistics are communicated descriptively. The current study examined whether an experience format would improve posterior probability judgments in younger and older adults, relative to a description format...
February 1, 2017: Medical Decision Making: An International Journal of the Society for Medical Decision Making
https://www.readbyqxmd.com/read/28198726/community-acquired-pneumonia-requiring-hospitalization-rational-decision-making-and-interpretation-of-guidelines
#7
Douwe F Postma, Cornelis H van Werkhoven, Jan Jelrik Oosterheert
PURPOSE OF REVIEW: This review focuses on the evidence base for guideline recommendations on the diagnosis, the optimal choice, timing and duration of empirical antibiotic therapy, and the use of microbiological tests for patients hospitalized with community-acquired pneumonia (CAP): issues for which guidelines are frequently used as a quick reference. Furthermore, we will discuss possibilities for future research in these topics. RECENT FINDINGS: Many national and international guideline recommendations, even on critical elements of CAP management, are based on low-to-moderate quality evidence...
February 13, 2017: Current Opinion in Pulmonary Medicine
https://www.readbyqxmd.com/read/28196544/diagnostic-error-in-the-emergency-department-follow-up-of-patients-with-minor-trauma-in-the-outpatient-clinic
#8
Pieter-Jan Moonen, Luc Mercelina, Willem Boer, Tom Fret
BACKGROUND: The Emergency Department (ED) is prone to diagnostic error. Most frequent diagnostic errors involved "minor" trauma. Our goal was to determine how frequently a missed diagnosis was detected during follow up and to determine the frequency and causes of primary missed diagnosis and diagnostic error. METHODS: A retrospective single centre study review, during 6 months including all patients presenting to the outpatient clinic after ED admission with a minor trauma...
February 14, 2017: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/28195109/metastatic-nasopharyngeal-carcinoma-presenting-as-an-isolated-breast-mass-a-diagnostic-pitfall-and-a-review-of-literature
#9
Trupti Pai, Nita Nair, Gauri Pantvaidya, Kedar Deodhar, Tanuja Shet
Metastases to breast are much rarer than primary breast tumors. We now present a case of 45-year-old female, who presented with an isolated breast mass. A positron emission tomography-computed tomography (PET-CT) done revealed hypermetabolic right breast nodules, soft tissue deposits, and multiple nodal involvement. The biopsy from the breast and axillary lymph node showed dense lymphoid infiltrate and was interpreted initially as granulomatous inflammation. However, the lumps were hard and suspicious for primary breast cancer, so an immunohistochemistry for cytokeratin was performed which highlighted the epithelial cell clusters masked within the inflammatory infiltrate and the diagnosis of undifferentiated carcinoma, lymphoepithelioma-like was made...
January 2017: Indian Journal of Pathology & Microbiology
https://www.readbyqxmd.com/read/28194697/the-diagnostic-evaluation-of-patients-with-a-suspected-hereditary-periodic-fever-syndrome-experience%C3%A2-from%C3%A2-a-referral-center-in-italy
#10
Antonio Vitale, Donato Rigante, Orso Maria Lucherini, Anna De Palma, Ida Orlando, Stefano Gentileschi, Jurgen Sota, Antonella Simpatico, Claudia Fabiani, Mauro Galeazzi, Bruno Frediani, Luca Cantarini
The study aims are to describe the activity of our Unit on the diagnostics of monogenic autoinflammatory diseases (AIDs), and to apply the clinical classification criteria for periodic fevers from the Eurofever Registry to our cohort of patients, thus evaluating their usefulness in the real life. We retrospectively analyzed data from patients referring to our Center for recurrent fever attacks, and undergoing genetic analysis between April 2014 and July 2016, and we applied the classification criteria to both genetically positive and -negative patients...
February 13, 2017: Internal and Emergency Medicine
https://www.readbyqxmd.com/read/28194667/three-dimensional-anorectal-manometry-enhances-diagnostic-gain-by-detecting-sphincter-defects-and-puborectalis-pressure
#11
Shreya Raja, Francis C Okeke, Ellen M Stein, Sameer Dhalla, Monica Nandwani, Kristle L Lynch, C Prakash Gyawali, John O Clarke
BACKGROUND: Constipation and fecal incontinence (FI) are common and are often evaluated with anorectal manometry. Three-dimensional high-resolution anorectal manometry (HRAM) is a promising technology; however, implementation has been limited by lack of metrics and unclear clinical utility. AIM: To investigate the diagnostic utility of 3D HRAM compared to 2D HRAM. METHODS: Three-dimensional HRAM studies performed from April 2012 to October 2013 were identified and re-interpreted by two blinded investigators examining 3D function...
February 13, 2017: Digestive Diseases and Sciences
https://www.readbyqxmd.com/read/28193250/a-novel-modified-indirect-elisa-based-on-spherical-body-protein-4-for-detecting-antibody-during-acute-and-long-term-infections-with-diverse-babesia-bovis-strains
#12
Chungwon J Chung, Carlos E Suarez, Carey L Bandaranayaka-Mudiyanselage, Chandima-Bandara Bandaranayaka-Mudiyanselage, Joanna Rzepka, T J Heiniger, Grace Chung, Stephen S Lee, Ethan Adams, Grace Yun, Susan J Waldron
BACKGROUND: Cattle persistently infected with Babesia bovis are reservoirs for intra- and inter-herd transmission. Since B. bovis is considered a persistent infection, developing a reliable, high-throughput assay that detects antibody during all stages of the infection could be pivotal for establishing better control protocols. METHODS: A modified indirect enzyme-linked immunosorbent assay (MI-ELISA) was developed using the spherical body protein-4 (SBP4) of B. bovis to detect antibody against diverse strains through all infection stages in cattle...
February 13, 2017: Parasites & Vectors
https://www.readbyqxmd.com/read/28188700/how-suspicious-is-that-nodule-review-of-suspicious-afirma-gene-expression-classifier-in-high-risk-thyroid-nodules
#13
Sudarshana Roychoudhury, Melissa Klein, Fabiola Souza, Cecilia Gimenez, Alice Laser, Rubina Shaheen Cocker, Karen Chau, Kasturi Das
BACKGROUND: The Afirma gene expression classifier (GEC) is being increasingly utilized to confirm the benign nature of indeterminate FNA cytology results thus avoiding unnecessary surgical procedures. However the "suspicious" result of the Afirma GEC does not classify these indeterminate nodules further in determining appropriate management. This study investigated the outcome of the thyroid nodules deemed to be "suspicious" by the Afirma GEC in a high risk population. METHODS: The pathology database was searched for all thyroid nodules with Afirma test results over a three year period, 2013-2015...
February 11, 2017: Diagnostic Cytopathology
https://www.readbyqxmd.com/read/28187881/a-clinical-decision-making-mechanism-for-context-aware-and-patient-specific-remote-monitoring-systems-using-the-correlations-of-multiple-vital-signs
#14
Abdur Rahim Mohammad Forkan, Ibrahim Khalil
BACKGROUND AND OBJECTIVES: In home-based context-aware monitoring patient's real-time data of multiple vital signs (e.g. heart rate, blood pressure) are continuously generated from wearable sensors. The changes in such vital parameters are highly correlated. They are also patient-centric and can be either recurrent or can fluctuate. The objective of this study is to develop an intelligent method for personalized monitoring and clinical decision support through early estimation of patient-specific vital sign values, and prediction of anomalies using the interrelation among multiple vital signs...
February 2017: Computer Methods and Programs in Biomedicine
https://www.readbyqxmd.com/read/28185442/the-role-of-ancillary-tests-in-the-evaluation-and-management-of-patients-with-negative-and-non-diagnostic-pancreatic-cyst-aspirates
#15
Suzanne M Selvaggi
BACKGROUND: Fine needle aspiration of pancreatic cystic lesions has its limitations as the cytology is often paucicellular to acellular. This study reports on the value of ancillary tests, amylase and carcinoembryonic, in the evaluation and management of patients with negative and non-diagnostic pancreatic cysts. METHODS: From January 1, 2010 through December 31, 2015, the Cytopathology Laboratory processed 119 pancreatic cyst aspirates of which 51(43%) were negative and 52(44%) were non-diagnostic and form the basis of this study...
February 10, 2017: Diagnostic Cytopathology
https://www.readbyqxmd.com/read/28184253/concordance-between-the-tirads-ultrasound-criteria-and-the-bethesda-cytology-criteria-on-the-nontoxic-thyroid-nodule
#16
Hernando Vargas-Uricoechea, Ivonne Meza-Cabrera, Jorge Herrera-Chaparro
BACKGROUND: Thyroid nodule is a common disorder of the thyroid. Despite their benign nature, they can be associated with multiple pathologic conditions, including thyroid cancer. METHODS: This cross-sectional study determined the concordance of Ultrasound (TIRADS criteria) and Fine Needle Aspiration Biopsy (FNA-BETHESDA system) in the assessment of the nontoxic thyroid nodule. A total of 180 subjects 18 years old or older underwent the two diagnostic tests and their results were compared using kappa index...
2017: Thyroid Research
https://www.readbyqxmd.com/read/28182079/immunocytoexpression-profile-of-proexc-in-smears-interpreted-as-asc-us-asc-h-and-cervical-intraepithelial-lesion
#17
Zeynep Tosuner, İlknur Türkmen, Sema Arici, Cavide Sönmez, Seval Turna, Öykü Onaran
AIMS: We aimed to investigate the immunocytoexpression profiles of a novel assay ProEx C for topoisomerase II alpha (TOP2A) and minichromosome maintenance protein 2 (MCM2) in abnormal interpreted smears. SETTINGS AND DESIGN: Screening programs with Papanicolaou smear and high risk group human papilloma virus testing have yielded a dramatic reduction of cervical cancer incidence. However, both of these tests have limited specificity for the detection of clinically significant cervical high grade lesions...
January 2017: Journal of Cytology
https://www.readbyqxmd.com/read/28182069/role-of-morphometry-in-the-cytological-differentiation-of-benign-and-malignant-thyroid-lesions
#18
Pallavi Khatri, Monisha Choudhury, Manjula Jain, Shaji Thomas
CONTEXT: Thyroid nodules represent a common problem, with an estimated prevalence of 4-7%. Although fine needle aspiration cytology (FNAC) has been accepted as a first line diagnostic test, the rate of false negative reports of malignancy is still high. Nuclear morphometry is the measurement of nuclear parameters by image analysis. Image analysis can merge the advantages of morphologic interpretation with those of quantitative data. AIMS: To evaluate the nuclear morphometric parameters in fine needle aspirates of thyroid lesions and to study its role in differentiating benign from malignant thyroid lesions...
January 2017: Journal of Cytology
https://www.readbyqxmd.com/read/28181118/brain-uptake-and-safety-of-flutemetamol-f-18-injection-in-japanese-subjects-with-probable-alzheimer-s-disease-subjects-with-amnestic-mild-cognitive-impairment-and-healthy-volunteers
#19
Takami Miki, Hiroyuki Shimada, Jae-Seung Kim, Yasuji Yamamoto, Masakazu Sugino, Hisatomo Kowa, Kerstin Heurling, Michelle Zanette, Paul F Sherwin, Michio Senda
OBJECTIVE: This Phase 2 study assessed the performance of positron emission tomography (PET) brain images made with Flutemetamol F 18 Injection in detecting β-amyloid neuritic plaques in Japanese subjects. METHODS: Seventy subjects (25 with probable Alzheimer's disease (pAD), 20 with amnestic mild cognitive impairment (aMCI), and 25 cognitively normal healthy volunteers[HVs]) underwent PET brain imaging after intravenous Flutemetamol F 18 Injection (185 MBq). Images were interpreted as normal or abnormal for neuritic plaque density by each of five non-Japanese and five Japanese readers who were blinded to clinical data...
February 8, 2017: Annals of Nuclear Medicine
https://www.readbyqxmd.com/read/28181040/long-term-outcomes-of-youth-treated-for-an-anxiety-disorder-a-critical-review
#20
REVIEW
Brittany A Gibby, Elizabeth P Casline, Golda S Ginsburg
Pediatric anxiety disorders are common, disabling, and chronic conditions. Efforts over the past two decades have focused on developing and testing effective treatments. Short-term efficacy of both Cognitive Behavioral Therapy (CBT) and selective serotonin reuptake inhibitors has been established. Data are emerging on the long-term (i.e., 2 years or longer) effectiveness of these treatments, but this literature has yet to be adequately synthesized. This study presents a systematic and critical qualitative review of published long-term follow-up (LTFU) studies of youth treated for an anxiety disorder...
February 8, 2017: Clinical Child and Family Psychology Review
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