Diagnostic tests in child poisoning

1968 ◽  
Vol 6 (26) ◽  
pp. 103-104
Keyword(s):  
Clinical Response ◽  
Diagnostic Tests ◽  
Toxic Substance ◽  
Diagnostic Value ◽  
England And Wales ◽  
Unexplained Symptoms ◽  
Seriously Ill ◽  
Symptoms And Signs

Each year about 200 children under the age of fifteen die in England and Wales from poisoning.1 2 Poisoning must always be considered when a child shows unexplained symptoms and signs, is in coma or is seriously ill. The nature of the toxic substance is frequently not known, and sometimes an antidote giving a rapid clinical response is of diagnostic value. This article discusses only the diagnostic help that certain drugs can give; it does not summarise treatment.

scholarly journals Does the patient with chest pain have a coronary heart disease? Diagnostic value of single symptoms and signs – a meta-analysis

2012 ◽  
Vol 53 (5) ◽  
pp. 432-441 ◽  
Author(s):  
Jörg Haasenritter ◽  
Damaris Stanze ◽  
Grit Widera ◽  
Christian Wilimzig ◽  
Maren Abu Hani ◽  
...  
Keyword(s):  
Coronary Heart Disease ◽  
Heart Disease ◽  
Chest Pain ◽  
Meta Analysis ◽  
Diagnostic Value ◽  
Symptoms And Signs

Lymphopaenia as a predictor of sarcoidosis in patients with a first episode of uveitis

2018 ◽  
Vol 103 (9) ◽  
pp. 1296-1300 ◽  
Author(s):  
Fahriye Groen-Hakan ◽  
Laura Eurelings ◽  
Aniki Rothova ◽  
Jan van Laar
Keyword(s):  
Diagnostic Tests ◽  
Medical Center ◽  
Age At Onset ◽  
Diagnostic Value ◽  
Youden Index ◽  
First Episode ◽  
Operating Characteristics ◽  
Non Invasive ◽  
Erasmus Medical ◽  
Uveitis Attack

Background/aimsThe diagnostic properties of conventional diagnostic tests (ACE and chest radiography) for sarcoidosis-associated uveitis are not ideal. The diagnostic value of lymphopaenia for sarcoidosis-associated uveitis is investigated.MethodsA retrospective study of 191 consecutive patients with a first uveitis episode visiting the ophthalmology department (Erasmus Medical Center, Rotterdam, The Netherlands). Receiver operating characteristics (ROC) analysis was performed and compared with known ROC values from literature of conventional diagnostic tests for sarcoidosis-associated uveitis. An ideal cut-off was determined for lymphopaenia by calculation of the highest Youden index.ResultsOut of all patients with first uveitis attack, 32/191 or 17% were subsequently diagnosed with biopsy-proven or radiological diagnosis of sarcoidosis. Lymphopaenia (<1.5×109/L) was significantly more often observed in patients with sarcoidosis-associated uveitis compared with patients with non-sarcoidosis-associated uveitis (p<0.05). The sensitivity and specificity of lymphopaenia was 75 % and 77 %, respectively. The optimal cut-off for lymphopaenia for diagnosing sarcoidosis-associated uveitis was 1.47 ×109/L. Lymphopaenia resulted in a 12.0 (95% CI 4.7 to 30.5 fold risk for having sarcoidosis, corrected for sex, race and age at onset of uveitis in patients with a first uveitis attack.ConclusionLymphopaenia is a non-invasive and useful marker for diagnosing sarcoidosis-associated uveitis.

scholarly journals Diagnostic Biomarkers: Are We Moving from Discovery to Clinical Application?

2018 ◽  
Vol 64 (11) ◽  
pp. 1657-1667 ◽  
Author(s):  
Lucy A Parker ◽  
Elisa Chilet-Rosell ◽  
Ildefonso Hernández-Aguado ◽  
María Pastor-Valero ◽  
Sonia Gea ◽  
...  
Keyword(s):  
Clinical Application ◽  
Diagnostic Tests ◽  
Biomarker Discovery ◽  
Diagnostic Value ◽  
Original Research ◽  
Technical Improvement ◽  
Diagnostic Biomarkers ◽  
Diagnostic Studies ◽  
Research Investment ◽  
Biomedical Journals

Abstract BACKGROUND Despite considerable research investment, moving from biomarker discovery to clinical application has presented unique challenges. We aimed to evaluate progress toward clinical application of a sample of molecular- and “omics”-based diagnostic tests over a 10-year period. METHODS We used Scopus to locate studies, published before the December 31, 2016, citing 107 original-research articles published in 2006 that assessed the diagnostic value of a molecular- or “omics”-based test. We identified diagnostic studies of the same test and disease and determined whether the article represented progress in the validation of the molecular test. We classified the types of progress: (a) clinical validation (measuring diagnostic accuracy in a series of patients similar to the population in which the test will be used in practice), (b) technical improvement, (c) extended diagnostic application (modification of the diagnostic question attended initially by the test), (d) economic evaluation, or (e) clinical use or implementation. RESULTS In the 10-year period analyzed, 4257 articles cited the 107 diagnostic studies; 118 (2.8%) were diagnostic studies of the same test, and of these papers, 25 (21.2%) did not constitute progress toward validation of the test for use in clinical practice (potential research waste). Of the 107 molecular- or “omics”-based tests described in 2006, only 28 (26.2%) appeared to have made progress toward clinical application. Only 4 (9.1%) of 44 proteomics-based tests had made progress toward clinical application. CONCLUSIONS Articles evaluating molecular- or “omics”-based diagnostic tests are numerous in biomedical journals. Few tests have made progress toward clinical application in the 10 years following their discovery.

Bladder outlet obstruction

2013 ◽  
pp. 71-126
Author(s):  
John Reynard ◽  
Simon Brewster ◽  
Suzanne Biers
Keyword(s):  
Benign Prostatic Hyperplasia ◽  
Diagnostic Tests ◽  
Growth And Development ◽  
Bladder Outlet Obstruction ◽  
Outlet Obstruction ◽  
Prostatic Hyperplasia ◽  
Benign Prostatic Obstruction ◽  
Prostate Growth ◽  
Symptoms And Signs

Regulation of prostate growth and development of benign prostatic hyperplasia (BPH) 72 Pathophysiology and causes of bladder outlet obstruction (BOO) and BPH 73 Benign prostatic obstruction (BPO): symptoms and signs 74 Diagnostic tests in men with LUTS thought to be due to BPH 76 The management of LUTS in men: NICE 2010 Guidelines ...

scholarly journals Monoclonal gammopathies of clinical significance

Hematology ◽  
2020 ◽  
Vol 2020 (1) ◽  
pp. 380-388
Author(s):  
Angela Dispenzieri
Keyword(s):  
Differential Diagnosis ◽  
Clinical Significance ◽  
Monoclonal Gammopathy ◽  
Monoclonal Gammopathies ◽  
Skin Biopsies ◽  
Unexplained Symptoms ◽  
Symptoms And Signs ◽  
Important Disease ◽  
Iv Immunoglobulin ◽  
Undetermined Significance

Abstract “Monoclonal gammopathy of clinical significance” (MGCS) is the term used to describe nonmalignant monoclonal gammopathies causing important disease. MGCS is the differential diagnosis for any patient presenting with what appears to be a monoclonal gammopathy of undetermined significance but is also experiencing other unexplained symptoms. Broadly, these conditions can be separated into symptoms and signs referable to the nerves, the kidneys, and the skin. The first step in making these diagnoses is to consider them. With a particular condition in mind, the next step is to order those tests that can help confirm or dismiss a particular diagnosis. Nearly all of the renal and dermatologic conditions are diagnosed by renal and skin biopsies, respectively. The importance of a highly competent renal pathologist and dermatopathologist cannot be underestimated. Biopsy is less specific for the neuropathic conditions. Because several of the MGCSs are syndromes, recognizing other manifestations is also key. Treatment recommendations for many of these conditions are anecdotal because of their rarity, but for several of the conditions, IV immunoglobulin, rituximab, and plasma cell–directed therapy are the best options.

scholarly journals Overinterpretation of Clinical Applicability in Molecular Diagnostic Research

2009 ◽  
Vol 55 (4) ◽  
pp. 786-794 ◽  
Author(s):  
Blanca Lumbreras ◽  
Lucy A Parker ◽  
Miquel Porta ◽  
Marina Pollán ◽  
John P A Ioannidis ◽  
...  
Keyword(s):  
Diagnostic Tests ◽  
Odds Ratio ◽  
Adjusted Odds Ratio ◽  
Diagnostic Value ◽  
Molecular Techniques ◽  
Impact Factors ◽  
Molecular Diagnostic ◽  
Original Research ◽  
Clinical Applicability ◽  
Diagnostic Research

Abstract Background: We evaluated whether articles on molecular diagnostic tests interpret appropriately the clinical applicability of their results. Methods: We selected original-research articles published in 2006 that addressed the diagnostic value of a molecular test. We defined overinterpretation of clinical applicability by means of prespecified rules that evaluated study design, conclusions regarding applicability, presence of statements suggesting the need for further clinical evaluation of the test, and diagnostic accuracy. Two reviewers independently evaluated the articles; consensus was reached after discussion and arbitration by a third reviewer. Results: Of 108 articles included in the study, 82 (76%) used a design that used healthy controls or alternative-diagnosis controls, only 15 (11%) addressed a clinically relevant population similar to that in which the test might be applied in practice, 104 articles (96%) made definitely favorable or promising statements regarding clinical applicability, and 61 (56%) of the articles apparently overinterpreted the clinical applicability of their findings. Articles published in journals with higher impact factors were more likely to overinterpret their results than those with lower impact factors (adjusted odds ratio, 1.71 per impact factor quartile; 95% CI, 1.09–2.69; P = 0.020). Overinterpretation was more common when authors were based in laboratories than in clinical settings (adjusted odds ratio, 18.7; 95% CI, 1.41–249; P = 0.036). Conclusions: Although expectations are high for new diagnostic tests based on molecular techniques, the majority of published research has involved preclinical phases of research. Overinterpretation of the clinical applicability of findings for new molecular diagnostic tests is common.

scholarly journals Diagnostic accuracy of two commercial SARS-CoV-2 Antigen-detecting rapid tests at the point of care in community-based testing centers

2020 ◽  
Author(s):  
Alice Berger ◽  
Marie Therese Ngo Nsoga ◽  
Francisco Javier Perez-Rodriguez ◽  
Yasmine Abi Aad ◽  
Pascale Sattonnet-Roche ◽  
...  
Keyword(s):  
Diagnostic Tests ◽  
Point Of Care ◽  
Rapid Test ◽  
Diagnostic Value ◽  
Rapid Diagnostic Tests ◽  
Ease Of Use ◽  
Rt Pcr ◽  
Test Device ◽  
Community Based ◽  
Rapid Tests

AbstractBackgroundAntigen-detecting rapid diagnostic tests for SARS-CoV-2 offer new opportunities for the quick and laboratory-independent identification of infected individuals for control of the SARS-CoV-2 pandemic.MethodsWe performed a prospective, single-center, point of care validation of two antigen-detecting rapid diagnostic tests (Ag-RDT) in comparison to RT-PCR on nasopharyngeal swabs.FindingsBetween October 9th and 23rd, 2020, 1064 participants were enrolled. The Panbio™Covid-19 Ag Rapid Test device (Abbott) was validated in 535 participants, with 106 positive Ag-RDT results out of 124 positive RT-PCR individuals, yielding a sensitivity of 85.5% (95% CI: 78.0–91.2). Specificity was 100.0% (95% CI: 99.1–100) in 411 RT-PCR negative individuals. The Standard Q Ag-RDT (SD Biosensor, Roche) was validated in 529 participants, with 170 positive Ag-RDT results out of 191 positive RT-PCR individuals, yielding a sensitivity of 89.0% (95%CI: 83.7–93.1). One false positive result was obtained in 338 RT-PCR negative individuals, yielding a specificity of 99.7% (95%CI: 98.4–100). For individuals presenting with fever 1-5 days post symptom onset, combined Ag-RDT sensitivity was above 95%.InterpretationWe provide an independent validation of two widely available commercial Ag-RDTs, both meeting WHO criteria of ≥80% sensitivity and ≥97% specificity. Although less sensitive than RT-PCR, these assays could be beneficial due to their rapid results, ease of use, and independence from existing laboratory structures. Testing criteria focusing on patients with typical symptoms in their early symptomatic period onset could further increase diagnostic value.FundingFoundation of Innovative Diagnostics (FIND), Fondation privée des HUG, Pictet Charitable Foundation.

Intracranial bruit: Charles Warlow’s challenge revisited

2021 ◽  
pp. practneurol-2021-003226
Author(s):  
Andrew J Larner
Keyword(s):  
Arteriovenous Malformation ◽  
Diagnostic Tests ◽  
Contingency Table ◽  
Diagnostic Value ◽  
Historical Case ◽  
Intracranial Arteriovenous Malformation ◽  
Founding Editor

Over 20 years ago, Charles Warlow, the founding editor of Practical Neurology, offered a copy of his stroke textbook to anyone diagnosing an intracranial arteriovenous malformation by auscultation of the skull alone. This article examines the possible diagnostic value of intracranial bruit in terms of the 2×2 contingency table for diagnostic tests and recounts an historical case.

Arachnoid Cysts of the Posterior Fossa

1981 ◽  
Vol 89 (2) ◽  
pp. 328-332 ◽  
Author(s):  
Dennis G. Pappas ◽  
Derald E. Brackmann
Keyword(s):  
Thin Section ◽  
Posterior Fossa ◽  
Acoustic Neuroma ◽  
Diagnostic Tests ◽  
Clinical Symptoms ◽  
Internal Auditory Canal ◽  
Arachnoid Cysts ◽  
Surgical Approaches ◽  
Symptoms And Signs

The clinical symptoms and signs of four patients with arachnoid cysts in the posterior fossa are discussed. In three patients, the cyst was in the internal auditory canal; one patient had an acoustic neuroma and two large cysts in the cerebellum. Whereas the conventional diagnostic tests for acoustic neuroma cannot differentiate between neuromas and arachnoid cysts, the newer thin section body scanners can show a lesion with no enhancement in the case of the cyst. Surgical approaches for removal of this lesion must take into consideration the preservation of hearing in the involved ear.

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