Intracranial bruit: Charles Warlow’s challenge revisited

2021 ◽  
pp. practneurol-2021-003226
Author(s):  
Andrew J Larner

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.

2019 ◽  
Vol 1 (1) ◽  
pp. 16-18 ◽  
Author(s):  
Norafida Bahari ◽  
Nik Azuan Nik Ismail ◽  
Jegan Thanabalan ◽  
Ahmad Sobri Muda

In this article, we evaluate the effectiveness of Cone Beam Computed Tomography, through a case study, in assessing the complication of intracranial bleeding during an endovascular treatment of brain arteriovenous malformation when compared to Multislice-Detector Computed Tomography performed immediately after the procedure. The image quality of Cone Beam Computed Tomography has enough diagnostic value in differentiating between haemorrhage, embolic materials and the arteriovenous malformation nidus to facilitate physicians to decide for further management of the patient.


Author(s):  
Norafida Bahari ◽  
NikAzuan Nik Ismail ◽  
Jegan Thanabalan ◽  
Ahmad Sobri Muda

In this article, we evaluate the effectiveness of Cone Beam Computed Tomography, through a case study, in assessing the complication of intracranial bleeding during an endovascular treatment of brain arteriovenous malformation when compared to Multislice-Detector Computed Tomography performed immediately after the procedure. The image quality of Cone Beam Computed Tomography has enough diagnostic value in differentiating between haemorrhage, embolic materials and the arteriovenous malformation nidus to facilitate physicians to decide for further management of the patient.


1968 ◽  
Vol 6 (26) ◽  
pp. 103-104

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.


2018 ◽  
Vol 103 (9) ◽  
pp. 1296-1300 ◽  
Author(s):  
Fahriye Groen-Hakan ◽  
Laura Eurelings ◽  
Aniki Rothova ◽  
Jan van Laar

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.


2018 ◽  
Vol 64 (11) ◽  
pp. 1657-1667 ◽  
Author(s):  
Lucy A Parker ◽  
Elisa Chilet-Rosell ◽  
Ildefonso Hernández-Aguado ◽  
María Pastor-Valero ◽  
Sonia Gea ◽  
...  

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.


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