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  • 2020-2023
  • 2000-2004  (21)
  • 1990-1994  (32)
  • 1985-1989  (18)
  • 1860-1869
  • Diagnosis
  • 1
    Electronic Resource
    Electronic Resource
    Leucocytoclastic vasculitis as presenting feature of primary Sjögren's syndrome (1994)
    Springer
    Clinical rheumatology 13 (1994), S. 269-272 
    Details
    ISSN: 1434-9949
    Keywords: Primary Sjögren's Syndrome ; Vasculitis ; Diagnosis
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Described are two patients whose primary Sjögren's syndrome presented as leucocytoclastic vasculitis of the skin. One patient initially admitted complaints of dryness of the eyes and the mouth after direct questioning, and serologic testing revealed the presence of Ro/SS-A and La/SS-B antibodies. In the other patient the presence of antinuclear antibodies and rheumatoid factors in serum were the only suggestions of the presence of primary Sjögren's syndrome. Primary Sjögren's syndrome should be considered in patients presenting with leucocytoclastic vasculitis.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF02249025
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  • 2
    Electronic Resource
    Electronic Resource
    Microbiological confirmation of tuberculosis cases at diagnosis and at the end of treatment in Italy (2000)
    Springer
    European journal of epidemiology 16 (2000), S. 719-724 
    Details
    ISSN: 1573-7284
    Keywords: Diagnosis ; Microbiology ; Treatment monitoring ; Tuberculosis
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Microbiological findings at diagnosis and at the end of treatment are relevant for evaluating tuberculosis (TB) treatment programmes. The objectives of this study were to describe the microbiological findings at diagnosis and at the end of treatment in pulmonary and extrapulmonary TB patients treated under programme conditions in Italy. The study was a prospective monitoring activity based on the collection of standard recording and reporting forms from a representative sample of Italian TB Units. The forms with individual data were reviewed and analysed on a quarterly basis, 9 months after enrolment. The complete bacteriological profile of patients was analysed at diagnosis and at the completion of treatment. Individual data on 992 patients were analysed. At diagnosis 320 (32.2%) of cases were pulmonary sputum smear positive, 361 (36.4%) pulmonary smear negative or not done and 311 (33.4%) extrapulmonary; 424 (42.7%) of all TB cases were culture confirmed at diagnosis (368, 50.2%, of pulmonary cases); 575 (84.4%) of pulmonary cases had a culture done at diagnosis and 156 (22.9%) at the end of treatment (p〈 0.001); 572 (84%) had a sputum smear done at diagnosis and 164 (24.1%) at the end of treatment (p〈 0.001). Although the rate of bacteriologically confirmed cases is similar to that of other European countries, the bacteriological confirmation at diagnosis and, particularly, at the end of treatment, is sub-optimal. The importance of further disseminating national guidelines among physicians managing TB is emphasized, in order to achieve a higher proportion of TB cases bacteriologically confirmed at diagnosis and monitored at the end of treatment.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1023/A:1026798000966
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  • 3
    Electronic Resource
    Electronic Resource
    Diagnosis of bacterial infection in the ICU: General principles (1994)
    Springer
    Intensive care medicine 20 (1994), S. S12 
    Details
    ISSN: 1432-1238
    Keywords: Diagnosis ; Intensive care unit ; Infection
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Diagnosis and treatment of infection is a common procedure in the clinical management of patients in the ICU. Infection in the ICU is an important area for study, but requires well-defined and proven diagnostic criteria. The diagnosis of infection, like any diagnosis, is based on probability, and diagnostic criteria are therefore selected according to the physician's objectives and the acceptable margin of error. It is easier to diagnose correctly a full-blown, severe bacterial infection than one that is just beginning, and the same criteria cannot be used to identify accurately both conditions. We should diagnose an infectious complication at the time it needs treatment, but there is often a lack of clear objectives in the diagnostic process, and up to now, few reliable criteria have been available. Before considering the sensitivity and specificity of single diagnostic procedures it is important to trace the evolution of the infection. The problem may be approached in two steps, by describing or defining (i) the minimum level of severity of a probable infection which requires/justifies specific treatment as the first end-point of the diagnosis, and (ii) the ways the diagnosis may be confirmed using the best available procedure (which might not be always available or applicable in all cases in the short term).
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01713977
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  • 4
    Electronic Resource
    Electronic Resource
    Frequency of child abuse seen in a pediatric surgery unit (1992)
    Springer
    Pediatric surgery international 7 (1992), S. 454-458 
    Details
    ISSN: 1437-9813
    Keywords: Child abuse ; Diagnosis ; Pediatric surgery unit ; Incidence
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract In a 3 $${\raise0.5ex\hbox{$\scriptstyle 1$}\kern-0.1em/\kern-0.15em\lower0.25ex\hbox{$\scriptstyle 2$}}$$ -month prospective study, all inpatients seen at the department of pediatric surgery of a children's hospital were examined for child abuse and neglect. Of 815 children admitted, 749 (91.7%) were included in the study. Two different methods of case definition were applied: the first involved a theoretical model containing a decision tree. The physician recorded the child's signs and symptoms and rated the plausibility of the history given. At the end of the study period a “technical diagnosis” was made. With this approach 7 children (0.9%) were classified as abused or neglected. Cases were also defined by having the physician decide at the time of admission whether child abuse was possible or could be excluded (“clinical diagnosis”). With this procedure 10 children (1.3%) were judged to be abused or neglected; 13 children (1.7%) were found by combining both methods. The validity of these two diagnostic approaches was ascertained by comparing the results with the degree of certainty of the clinicians' assessment and by describing the type of injuries the children had. The decision tree appears to be a useful tool for identifying abused and neglected children. We recommend thorough assessment of all suspected cases.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00178828
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  • 5
    Electronic Resource
    Electronic Resource
    Predicting microscopic extrauterine spread of endometrial carcinoma with MRI to support less invasive therapy (2000)
    Springer
    International journal of clinical oncology 5 (2000), S. 158-163 
    Details
    ISSN: 1437-7772
    Keywords: Key words Endometrial carcinoma ; MRI ; Diagnosis ; Minimally invasive therapy
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Background. Magnetic resonance imaging (MRI) provides precise staging of endometrial carcinoma. However, we have sometimes experienced patients with microscopic extrauterine extension in whom MRI showed the disease as being limited to the uterus. We studied indirect MRI signs for microscopic extrauterine spread of endometrial carcinoma which outwardly seemed to be limited to within the uterus. Methods. MRI studies and the clinical records of 100 patients with surgically proven endometrial carcinoma were retrospectively reviewed. We evaluated: (1) MRI staging, (2) tumor growing at the orifices of the fallopian tube in the uterine fundus, (3) hydrosalpinx, and (4) ascites, in each MRI study. Results. Surgical specimens showed that 12 of the 100 patients had extrauterine spread, with 1 patient showing both ovarian extension and omental metastasis; there ovarian extension in 3, extension to the fallopian tubes in 3, omental metastasis in 1, and positive peritoneal cytology in 4. Tumor growing at the orifices of the fallopian tubes with deep myometrial invasion showed higher accuracy for predicting microscopic intrauterine spread (82.0%) although it was not significantly different from the accuracy of deep myometrial invasion anywhere within the uterus (75.0%). However, tumor growing at the orifices of the fallopian tubes in a patients with stage Ia disease showed a high negative predictive value (89.7%). Hydrosalpinx had the highest specificity (98.9%) and accuracy (88.0%); however, it did not seem to be practical because it was observed in only 2 patients. Ascites in postmenopausal patients showed higher specificity (93.5%), although it was not considered to be useful in the premenopausal patients. Conclusion. Tumor extension at the orifices of the fallopian tubes in patients with stage Ia disease, and ascites in postmenopausal patients on MRI seemed to be predictive factors for microscopic extrauterine spread.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/PL00012031
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  • 6
    Electronic Resource
    Electronic Resource
    Diagnosis of chronic granulomatous disease and of its mode of inheritance by dihydrorhodamine 123 and flow microcytofluorometry (1991)
    Springer
    European journal of pediatrics 150 (1991), S. 161-165 
    Details
    ISSN: 1432-1076
    Keywords: Chronic granulomatous disease ; Dihydrorhodamine 123 ; Diagnosis ; Inheritance ; Flow microcytofluorimetry
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Dihydrorhodamine 123 (DHR) attached to membranes of granulocytes (PMN) and monocytes is caused to fluoresce by reactive oxygen intermediates (ROI) indicating the ability of phagocytes to produce these microbicide metabolites in a flow microcytofluorimeter. Whole blood samples from five boys with known chronic granulomatous disease (CGD) and from their mothers (and from one father and one grandmother), were examined following erythrocyte lysis in order to test this new method. An incubation period of 10 min with phorbol-myristate-acetate, followed by another 15 min incubation period with DHR before flow microcytofluorimetric analysis of 5 or 10×103 phagocytes, was sufficient to obtain the following results. PMN and monocytes from four patients with CGD could clearly not produce any ROI whereas cells from one patient displayed decreased activity in ROI production as compared to cells from a healthy donor. The X-linked mode of inheritance was detected in six carriers by the presence of two different cell populations (one normal ROI-producing and one negative or less active population). All the phagocytes from one mother produced ROI in normal amounts suggesting an autosomal mode of inheritance. All in all, the method presented provides a fast and most simple tool to diagnose CGD, to determine a decrease or total lack of ROI production and to establish the mode of inheritance of the disease.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01963557
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  • 7
    Electronic Resource
    Electronic Resource
    Glycogen storage disease type Ia: recent experience with mutation analysis, a summary of mutations reported in the literature and a newly developed diagnostic flowchart (2000)
    Springer
    European journal of pediatrics 159 (2000), S. 322-330 
    Details
    ISSN: 1432-1076
    Keywords: Key words Glycogen storage disease type Ia ; Glucose-6-phosphatase ; Mutations ; Diagnosis ; Prenatal diagnosis
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We studied the glucose-6-phosphatase (G6Pase) gene of 30 unrelated glycogen storage disease type Ia (GSD Ia) patients using single strand conformational polymorphism (SSCP) prior to automated sequencing of exons revealing an aberrant SSCP pattern. In all patients we could identify mutations on both alleles of the G6Pase gene, indicating that this method is a reliable procedure. A total of 14 different mutations were identified. R83C (16/60), 158delC (12/60), Q347X (7/60), R170X (6/60) and ΔF327 (4/60) were found most frequently. Nine other mutations accounted for the other 15 mutant alleles. Two DNA-based prenatal diagnoses were performed successfully. At present, 56 mutations in the G6Pase gene have been reported in 300 unrelated GSD Ia patients and an overview of these mutations is presented. Evidence for a clear genotype-phenotype correlation could be established neither from our data nor from those in the literature. With increased knowledge about the genetic basis of GSD Ia and GSD Ib and the high detection rate of mutations, it is our opinion that the diagnoses GSD Ia and GSD Ib can usually be based on clinical and biochemical abnormalities combined with mutation analysis instead of enzyme assays in liver tissue obtained by biopsy. A newly developed flowchart for the diagnosis of GSD I is presented. Conclusion Increased knowledge of the genetic basis of glycogen storage disease type I provides a DNA-based diagnosis, prenatal DNA-based diagnosis in chorionic villus samples and carrier detection.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s004310051281
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  • 8
    Electronic Resource
    Electronic Resource
    Clinical diagnosis of muscle cramp and muscular cramp syndromes (1991)
    Springer
    European archives of psychiatry and clinical neuroscience 241 (1991), S. 98-101 
    Details
    ISSN: 1433-8491
    Keywords: Muscle cramp ; Syndromes ; Diagnosis
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary The diagnosis of muscle cramp is based on clinical features. Algorithms are presented for the diagnosis of muscle cramp and cramp syndromes.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF02191149
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  • 9
    Electronic Resource
    Electronic Resource
    Fascioliasis in Spain: A review of the literature and personal observations (1985)
    Springer
    European journal of epidemiology 1 (1985), S. 121-126 
    Details
    ISSN: 1573-7284
    Keywords: Fascioliasis ; Geographical distribution ; Epidemiology ; Diagnosis
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The fascioliasis induced by Fasciola hepatica is a syndrome which has still not been fully clarified in this country, though the different peninsular regions are suitable for completion of the life cycle of the worm; infested animals may found throughout these regions and in almost all of them human fascioliasis has been diagnosed, with the greatest incidence in the Basque Country, Navarra and La-Rioja. This greater appearance is probably related to the dietary habits in those areas, since the consumption of water cress is undoubtedly the principal source of contamination and is entirely responsible for the rest of the epidemiology of the diseases in humans. In the cases studied, the clinical symptoms did not differ from those habitually found in this syndrome. Serological methods have resolved the diagnosis in the acute phase of the disease and furthermore are of great use for monitoring post-treatment evolution. The cases studied by this Department were diagnosed with immunodiffusion, haemagglutination and immunoelectrophoresis techniques and the evolution of the patients was also followed by immunodiffusion and haemagglutination.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00141804
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  • 10
    Electronic Resource
    Electronic Resource
    Appendizitissonographie durch chirurgen — Erfahrungssache? Eine prospektive studie (1994)
    Springer
    Langenbeck's archives of surgery 379 (1994), S. 335-340 
    Details
    ISSN: 1435-2451
    Keywords: Appendicitis ; Ultrasound studies ; Diagnosis ; Prospective trial ; Laparotomy
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung Am Departement Chirurgie des Universitätsspitals Zürich wurden zwischen 1. Dezember 1990 und 31 Dezember 1992 302 Patienten mit klinischer Verdachtsdiagnose “akute Appendizitis” ausschließlich von 7 Chirurgen sonographisch beurteilt, wobei der “Instruktor” ein Chirurg mit mehrjdhriger Erfahrung in sonographischen Untersuchungstechniken war. Von den untersuchten Patienten/innen wurden 139 (46%) laparotomiert. 119 (39,4%) zeigten intraoperativ und histologisch eine Appendizitis, wovon klinisch 87 (28,8%), sonographisch 119 (39,4%) in der Erstbeurteilung als eindeutig positiv beurteilt wurden. Sonographisch falsch-positive und falsch-negative stellten sich bei je 10 (3,3%) Patienten heraus. Bei den 163 Patienten die nicht operiert werden mußten, konnte 60mal (19,9%) sonographisch eine andere Diagnose gestellt wurden. Bei negativen Sonographien, negativer oder fraglicher Klinik führte die klinische Beurteilung des Stationsoberarztes zur Operationsindikation. Zu “Negativlaparotomien” kam es bei kombinierter Beurteilung bei 10 (7,2%) Patienten. Für das ganze Sonographieteam betrugen Sensitivität und Spezifität 92 bzw. 95% und für die Klinik alleine 81 bzw. 80%. Die absolute Trefferquote der Sonographie betrug 92%. Die Sensitivität und Spezifität der 6 angelermen Chirurgen betrug 87 und 93%. Die Sonographie erreichte in der Hand der Chirurgen somit vergleichbare Resultate mit denen der Sonographiespezialisten und hat in unserer Klinik deshalb ihren festen Platz in der Abkldrung der akuten Appendizitis eingenommen.
    Notes: Abstract A number of studies have shown that ultrasound has an advantage over physical examination in the diagnosis of acute appendicitis. Most of these studies were conducted by experts in the field of ultrasonography. In this study the influence of experience on the results of the sonography of actue appendicitis were evaluated. All 203 patients admitted to our unit between December 1990 and December 1992 were examined physically and sonographically by a team of surgeons consisting of one experienced sonographer and six inexperienced surgical trainees. Laparotomy was performed in 136 patients (46%). Appendicitis was demonstrated histologically in 119 cases (39.4%). Initial clinical findings were positive in 87 (28.8%). Sonography was positive in 119 patients (39.4%). The 163 patients not operated on demonstrated other pathology on ultrasound in 60 cases (19.9%). The rate of negative laparotomies amounted to 7.2% in our study. Sensitivity and specificity for the sonographic diagnosis were 92% and 95%, respectively. They were only 81% and 80% for physical examination. Overall accuracy was 92% for sonography. Sensitivity and specificity for the inexperienced surgeons were 87% and 93%, respectively, while the experienced surgeon reached values of 97% and 98%, respectively. The results of both groups are comparable with values in the literature, suggesting that ultrasound evaluation of appendicitis is not a diagnostic tool limited to a few experienced sonographers.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00191579
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