Dynamic Posturography and Caloric Test Results Patients with and without Vertigo

1989 ◽  
Vol 100 (6) ◽  
pp. 553-558 ◽  
Author(s):  
Joel A. Goebel ◽  
Gary D. Paige
Keyword(s):  
Caloric Test ◽  
Test Results ◽  
Dynamic Posturography ◽  
Caloric Stimulation ◽  
History Of ◽  
Abnormal Test Result ◽  
Test Result

Patients with Dizziness Were Evaluated with Caloric Stimulation and with Dynamic Platform Posturography (Neurocom Equltest). The Ability of These Tests To Detect Abnormalities in Patients with and Without Vertigo Was Assessed. In 159 Patients, roughly a third had abnormal calorics while half experienced one or more “falls” during posturography. Calorics revealed proportionately more abnormalities in patients with vertigo, whereas posturography alone did not distinguish between patients with or without vertigo. Posturography did, however, Identify abnormalities in a third of patients with normal calorics, regardless of their history of vertigo. Overall, more patients with vertigo had at least one abnormal test result (70%) compared with patients without vertigo (47%). We conclude that caloric abnormalities correlate with a history of vertigo, whereas posturographic deficits can be Identified regardless of the presence of vertigo.

Performance of a New Global Chromogenic Assay for Protein C Pathway (HemosIL ThromboPath) in the Diagnosis of Lupus Anticoagulant and Antiphospholipid Antibodies.

Blood ◽  
2008 ◽  
Vol 112 (11) ◽  
pp. 2279-2279
Author(s):  
Pierre A. Toulon ◽  
Isabelle Martin-Toutain ◽  
Jean-Charles Piette ◽  
Marie-Claude Diemert ◽  
Annick Ankri
Keyword(s):  
Antiphospholipid Antibodies ◽  
Arterial Thrombosis ◽  
Lupus Anticoagulant ◽  
Control Group ◽  
Test Results ◽  
Chromogenic Assay ◽  
Apc Resistance ◽  
Significant Difference ◽  
History Of ◽  
Test Result

Abstract Background: The HemosIL ThromboPath assay (Instrumentation Laboratory) is a new chromogenic assay designed to globally evaluate the functionality of the PC pathway. It is based on the ability of endogenous APC generated after activation of PC by a snake venom extract (Protac) to reduce the thrombin generation induced by a reagent containing tissue factor. Briefly, optical density is measured after addition of a thrombin-specific chromogenic substrate in the presence (OD A) or absence (OD B) of Protac. It is recommended by the test manufacturer to express results as the Protac-Induced Coagulation Inhibition percentage (PICI%) which corresponds to the ratio [OD B - OD A]/OD B x 100. Previous studies demonstrated a high sensitivity (over 96%) for PC pathway abnormalities i.e. PC/PS deficiency, and FV Leiden-related APC Resistance, but also for lupus anticoagulant (LA), known to be associated with acquired APC Resistance. The aim of the present study was to evaluate the sensitivity of that assay for antiphospholipid antibodies (APL), especially in connection with the occurrence of thrombotic complications. Actually, APL is a heterogeneous family of antibodies which have a significant impact on coagulation tests (LA) or could be detected using ELISA anticardiolipin assays (ACL). Methods: We retrospectively evaluated the frozen plasma samples from 178 patients previously diagnosed as positive for LA or as having high ACL levels. There were 48 M and 130 F with a mean age=43 years (range 14 – 87). None was on vitamin K-antagonist. Screening for LA, performed according to the ISTH criteria (Thromb Haemost1995;74:1185), was positive in 126 patients (LA+ patients) and negative in 52 patients, all of the latter having high ACL levels (LA- patients). Among LA+ patients, 41 had antiphospholipid syndrome (APS) i.e. 18 with a history of venous thrombosis (VT), 10 with arterial thrombosis (AT), 7 with obstetrical complication (OB) and 6 with combined vascular complications (CVC). The same applied to 39 LA- patients with high APL levels i.e. VT (n=13), AT (n=8), OB (n=12) and CVC (n=6). The control group consisted of 29 age- and sex-matched healthy subjects without a history of vascular or auto-immune disease. The HemosIL ThromboPath assay was performed by an operator blinded of the specific biological test results and of the clinical status of the patients. Results: Test result was significantly lower in LA+ patients than in LA- patients or in healthy controls (Table). Similarly, the percentage of abnormal test results i.e. PICI% below 85.0% as the cut-off value, was significantly higher in LA+ patients than in the two other groups (p<0.0001 in both cases). That cut-off value for the PICI% was determined, according to the recommendations of the reagent manufacturer, as the mean minus 1 SD of the values measured in the plasma of 29 healthy control subjects. Despite significantly lower PICI% in LA- patients than in controls (p<0.05), the proportion of abnormal test results was not significantly different (p<0.10) in these two groups. LA+ Patients (n=126) LA-Patients (n=52) Controls (n=29) Test Result (PICI%) 74.5 ± 13.1 86.7 ± 9.4 90.3 ± 5.3 PICI%<85% (n, %) 99 (78.6%) 15 (28.8%) 3 (10.3%) Moreover, test result was not significantly different in LA+ patients with and without a history of vascular thrombosis (PICI%=74.4 ± 12.9, n=51 vs. 74.5 ± 13.5 n=75, p=0.91) and the same applied for the percentage of abnormal test results (n=41/51 (80.4%) vs. n=58/75 (77.3%); p=0.83). There was no significant difference between LA+ patients with venous, arterial thrombosis and obstetrical complications. Conclusion: The HemosIL ThromboPath assay was highly sensitive for LA (78.6%) but it did not allow to distinguish between LA+ patients those with APS. It was found to be weakly sensitive (28.8%) to high ACL levels without LA activity, despite a higher percentage of abnormal test results. The potential interest of the HemosIL ThromboPath assay as part of the screening strategy of LA deserves to be further investigated prospectively.

Stance performance under different sensorimotor conditions in patients with post-traumatic otolith disorders

2007 ◽  
Vol 17 (1) ◽  
pp. 25-31 ◽  
Author(s):  
Dietmar Basta ◽  
Andrew Clarke ◽  
Arne Ernst ◽  
Ingo Todt
Keyword(s):  
Otolith Organs ◽  
Test Results ◽  
Dynamic Posturography ◽  
System A ◽  
Test Conditions ◽  
Trunk Sway ◽  
History Of ◽  
Balance Deficits ◽  
Post Traumatic ◽  
And Gender

Dynamic posturography with the Equitest® system is helpful to screen patients for balance deficits, but diagnostic specificity, for otolith disorders is unknown until now. It was therefore the aim of our present paper to examine patients with a well-defined otolith disorder on the Equitest® at different test conditions while simultaneously recording trunk sway by means of the Sway Star® system. A total of 22 patients with different types of otolith disorders were included in this study. All test results of the patients were matched with respect to age and gender to controls without history of ENT diseases. The overall sensitivity of the Equitest® system in our series was only higher than 50% in 2 conditions. The results of the trunk sway recordings were significantly different between patients with a sacculo-utricular disorder and controls in all test conditions. The results suggest that a disorder of the otolith organs seems to affect especially the trunk sway to a large extent.

scholarly journals Developing Software to “Track and Catch” Missed Follow-up of Abnormal Test Results in a Complex Sociotechnical Environment

2013 ◽  
Vol 04 (03) ◽  
pp. 359-375 ◽  
Author(s):  
M. Smith ◽  
D. Murphy ◽  
A. Laxmisan ◽  
D. Sittig ◽  
B. Reis ◽  
...  
Keyword(s):  
Formative Evaluation ◽  
Usability Testing ◽  
Test Results ◽  
Clinical Workflow ◽  
Alert Fatigue ◽  
High Workload ◽  
Abnormal Test Result ◽  
Test Result ◽  
Software Prototype

SummaryBackground: Abnormal test results do not always receive timely follow-up, even when providers are notified through electronic health record (EHR)-based alerts. High workload, alert fatigue, and other demands on attention disrupt a provider’s prospective memory for tasks required to initiate follow-up. Thus, EHR-based tracking and reminding functionalities are needed to improve follow-up.Objectives: The purpose of this study was to develop a decision-support software prototype enabling individual and system-wide tracking of abnormal test result alerts lacking follow-up, and to conduct formative evaluations, including usability testing.Methods: We developed a working prototype software system, the Alert Watch And Response Engine (AWARE), to detect abnormal test result alerts lacking documented follow-up, and to present context-specific reminders to providers. Development and testing took place within the VA’s EHR and focused on four cancer-related abnormal test results. Design concepts emphasized mitigating the effects of high workload and alert fatigue while being minimally intrusive. We conducted a multifaceted formative evaluation of the software, addressing fit within the larger socio-technical system. Evaluations included usability testing with the prototype and interview questions about organizational and workflow factors. Participants included 23 physicians, 9 clinical information technology specialists, and 8 quality/safety managers.Results: Evaluation results indicated that our software prototype fit within the technical environment and clinical workflow, and physicians were able to use it successfully. Quality/safety managers reported that the tool would be useful in future quality assurance activities to detect patients who lack documented follow-up. Additionally, we successfully installed the software on the local facility’s “test” EHR system, thus demonstrating technical compatibility.Conclusion: To address the factors involved in missed test results, we developed a software prototype to account for technical, usability, organizational, and workflow needs. Our evaluation has shown the feasibility of the prototype as a means of facilitating better follow-up for cancer-related abnormal test results.

scholarly journals Analysis Factor Associated Tuberculin Test in Children Contact Tuberculosis History

2014 ◽  
Vol 2 (2) ◽  
pp. 151
Author(s):  
Tika Triharinni ◽  
Muhammad Atoillah Isvandiari
Keyword(s):  
Nutritional Status ◽  
Health Center ◽  
Significant Relationship ◽  
Average Duration ◽  
Tuberculin Test ◽  
Residential Density ◽  
Test Results ◽  
Tuberculosis Patients ◽  
History Of ◽  
Test Result

ABSTRACTTuberculosis in children can not be separated from the history of contact with smear-positive tuberculosis patients as a source of infection. The aims of this study was to identify and analyze the risks tuberculin test results among children who had contact with patients with smear-positive tuberculosis in health center Bangil and health center Raci Pasuruan. The design of this study was cross sectional using systematik random sampling technique. Sample were drown from children with history of contacts with smear positive tuberculosis patients during 2012. This studies was from January until Juni 2013. The independent variables included age, sex, BCG immunization status, nutritional status, the average duration of exposure per day and residential density, the dependent variable was the tuberculin test results. It was found that from the study the results that a positive tuberculin test result was 28.57%. There was a significant relationship between age, nutritional status, the average duration of exposure per day, residential density of the tuberculin test, and there was no significant relationship between sex and status of BCG immunization results and tuberculin test results. Male and a dense residential density increases the risk of a positive tuberculin test results. While a good nutritional status is a protective factor for tuberculin test result positive.Keywords: tuberculin test, children, history of contacts of smear positive

scholarly journals Analysis Factor Associated Tuberculin Test in Children Contact Tuberculosis History

2014 ◽  
Vol 2 (2) ◽  
pp. 151
Author(s):  
Tika Triharinni ◽  
Muhammad Atoillah Isvandiari
Keyword(s):  
Nutritional Status ◽  
Health Center ◽  
Significant Relationship ◽  
Average Duration ◽  
Tuberculin Test ◽  
Residential Density ◽  
Test Results ◽  
Tuberculosis Patients ◽  
History Of ◽  
Test Result

ABSTRACTTuberculosis in children can not be separated from the history of contact with smear-positive tuberculosis patients as a source of infection. The aims of this study was to identify and analyze the risks tuberculin test results among children who had contact with patients with smear-positive tuberculosis in health center Bangil and health center Raci Pasuruan. The design of this study was cross sectional using systematik random sampling technique. Sample were drown from children with history of contacts with smear positive tuberculosis patients during 2012. This studies was from January until Juni 2013. The independent variables included age, sex, BCG immunization status, nutritional status, the average duration of exposure per day and residential density, the dependent variable was the tuberculin test results. It was found that from the study the results that a positive tuberculin test result was 28.57%. There was a significant relationship between age, nutritional status, the average duration of exposure per day, residential density of the tuberculin test, and there was no significant relationship between sex and status of BCG immunization results and tuberculin test results. Male and a dense residential density increases the risk of a positive tuberculin test results. While a good nutritional status is a protective factor for tuberculin test result positive.Keywords: tuberculin test, children, history of contacts of smear positive

Experiences with the butterfly chart

1986 ◽  
Vol 100 (2) ◽  
pp. 157-164 ◽  
Author(s):  
M. V. Kirtane ◽  
S. N. Merchant ◽  
S. B. Medikeri
Keyword(s):  
Clinical Application ◽  
Vestibular Function ◽  
Caloric Test ◽  
Test Results ◽  
The Past ◽  
Caloric Stimulation ◽  
Exact Procedure ◽  
Caloric Nystagmus

AbstractThe bithermal caloric test remains, four decades after its first description, the single most valuable test of vestibular function. However, there are several variations described in the exact procedure of caloric stimulation and in the method of evaluating and representing the test results. For the past 10 years, we have followed a procedure using a constant standardized stimulus and a particular system for caloric nystagmus representation, viz., the Butterfly Chart, and have found it to be very satisfactory. This paper describes our experience with the use of the Butterfly Chart and its clinical application in over 4,500 cases.

Item Context and /s/ Phone Articulation Test Results

1972 ◽  
Vol 15 (4) ◽  
pp. 852-860 ◽  
Author(s):  
Zoe Zehel ◽  
Ralph L. Shelton ◽  
William B. Arndt ◽  
Virginia Wright ◽  
Mary Elbert
Keyword(s):  
Test Score ◽  
Sound Production ◽  
Broad Context ◽  
Test Results ◽  
Production Task ◽  
Test Result

Fourteen children who misarticulated some phones of the /s/ phoneme were tape recorded articulating several lists of items involving /s/. The lists included the Mc-Donald Deep Test for /s/, three lists similar to McDonald’s but altered in broad context, and an /s/ sound production task. Scores from lists were correlated, compared for differences in means, or both. Item sets determined by immediate context were also compared for differences between means. All lists were found to be significantly correlated. The comparison of means indicated that both broad and immediate context were related to test result. The estimated “omega square” statistic was used to evaluate the percentage of test score variance attributable to context.

scholarly journals Seroprevalence of SARS-CoV-2 Antibodies Among Health Care Personnel at a Health Care System in Pakistan

2021 ◽  
pp. 101053952110110
Author(s):  
Salma Abbas ◽  
Aun Raza ◽  
Ayesha Iftikhar ◽  
Aamir Khan ◽  
Shahzaib Khan ◽  
...  
Keyword(s):  
Health Care ◽  
Control Measures ◽  
Health Care Personnel ◽  
Test Results ◽  
Antibody Testing ◽  
Chain Reaction ◽  
Past Infection ◽  
Infection Control Measures ◽  
History Of ◽  
Polymerase Chain

Health care personnel (HCP) are at high risk for coronavirus disease-2019 acquisition. Serum antibodies against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) indicate past infection. Our institution offered SARS-CoV-2 antibody testing to HCP. We surveyed HCP with positive test results to explore past exposure to SARS-CoV-2, details of symptoms during the preceding 6 months, and a history of SARS-CoV-2 polymerase chain reaction testing. A total of 2162 HCP underwent antibody testing. Eight hundred fifty-seven (39.6%) employees tested positive and, of these, 820 (95.7%) participated in the survey. When adjusted for age, males had higher odds of testing positive for SARS-CoV-2 antibodies compared with females (OR = 1.68; 95% CI = 1.37-2.05; P = .00) and clinical staff had higher odds of SARS-CoV-2 seropositivity compared with nonclinical staff (OR = 1.273; 95% CI = 1.06-1.53; P = .01). Implementation of effective infection control measures is essential to protect HCP from coronavirus disease-2019.

scholarly journals Clinical judgement in chest pain: a case report 

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Mishita Goel ◽  
Shubhkarman Dhillon ◽  
Sarwan Kumar ◽  
Vesna Tegeltija
Keyword(s):  
Chest Pain ◽  
Coronary Artery ◽  
Tobacco Use ◽  
Stress Test ◽  
Artery Bypass ◽  
Pretest Probability ◽  
Clinical Judgement ◽  
Test Results ◽  
Cardiac Stress ◽  
History Of

Abstract Background Cardiac stress testing is a validated diagnostic tool to assess symptomatic patients with intermediate pretest probability of coronary artery disease (CAD). However, in some cases, the cardiac stress test may provide inconclusive results and the decision for further workup typically depends on the clinical judgement of the physician. These decisions can greatly affect patient outcomes. Case presentation We present an interesting case of a 54-year-old Caucasian male with history of tobacco use and gastroesophageal reflux disease (GERD) who presented with atypical chest pain. He had an asymptomatic electrocardiogram (EKG) stress test with intermediate probability of ischemia. Further workup with coronary computed tomography angiography (CCTA) and cardiac catheterization revealed multivessel CAD requiring a bypass surgery. In this case, the patient only had a history of tobacco use but no other significant comorbidities. He was clinically stable during his hospital stay and his testing was anticipated to be negative. However to complete workup, cardiology recommended anatomical testing with CCTA given the indeterminate EKG stress test results but the results of significant stenosis were surprising with the patient eventually requiring coronary artery bypass grafting (CABG). Conclusion As a result of the availability of multiple noninvasive diagnostic tests with almost similar sensitivities for CAD, physicians often face this dilemma of choosing the right test for optimal evaluation of chest pain in patients with intermediate pretest probability of CAD. Optimal test selection requires an individualized patient approach. Our experience with this case emphasizes the role of history taking, clinical judgement, and the risk/benefit ratio in deciding further workup when faced with inconclusive stress test results. Physicians should have a lower threshold for further workup of patients with inconclusive or even negative stress test results because of the diagnostic limitations of the test. Instead, utilizing a different, anatomical test may be more valuable. Specifically, the case established the usefulness of CCTA in cases such as this where other CAD diagnostic testing is indeterminate.

scholarly journals Influenza colloidal gold method and blood routine tests combination for rapid diagnosis of influenza: a decision tree-based analysis

2021 ◽  
Vol 31 (1) ◽  
Author(s):  
Xiaoguang Li ◽  
Jing Chen ◽  
Fei Lin ◽  
Wei Wang ◽  
Jie Xu ◽  
...  
Keyword(s):  
Decision Tree ◽  
Predictive Value ◽  
Colloidal Gold ◽  
Influenza A ◽  
Clinical Manifestations ◽  
Rapid Test ◽  
Test Results ◽  
Tree Model ◽  
Routine Blood ◽  
Test Result

AbstractRapid influenza diagnosis can facilitate targeted treatment and reduce antibiotic misuse. However, diagnosis efficacy remains unclear. This study examined the efficacy of a colloidal gold rapid test for rapid influenza diagnosis. Clinical characteristics of 520 patients with influenza-like illness presenting at a fever outpatient clinic during two influenza seasons (2017–2018; 2018–2019) were evaluated. The clinical manifestations and results of routine blood, colloidal gold, and nucleic acid tests were used to construct a decision tree with three layers, nine nodes, and five terminal nodes. The combined positive predictive value of a positive colloidal gold test result and monocyte level within 10.95–12.55% was 88.2%. The combined negative predictive value of a negative colloidal gold test result and white blood cell count > 9.075 × 109/L was 84.9%. The decision-tree model showed the satisfactory accuracy of an early influenza diagnosis based on colloidal gold and routine blood test results.

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