109 resultados para Diagnostic Test Accuracy


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This article presents a case of relapse, with isolated neural manifestation, in a multibacillary patient previously treated with multidrug therapy for multibacillary leprosy (24 doses). The patient returned to the service six years after the end of treatment, with pain in hands and legs. He was investigated, and the serological monitoring showed an important increase in anti-phenolic glycolipid serum levels. A neural recurrence was suspected, since the patient had no new skin lesions. A new biopsy in the right ulnar nerve showed a bacilloscopy of 2 +, compatible with relapse. This is a literature review of the etiological, clinical, propedeutical and diagnostic aspects of this situation so poorly understood. © 2012 by Anais Brasileiros de Dermatologia.

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Pneumonia is an infectious disease with great morbidity and mortality worldwide. According to the current guidelines recommendations the authors reviewed the treatment of community-acquired pneumonia (CAP) and health care-associated pneumonia (HCAP). In this paper will be also presented data about etiology, clinics and diagnostic tools. © Copyright Moreira Jr. Editora.

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In order to determine antibodies anti-Leptospira spp. in dogs from Botucatu-SP with a clinical suspicion and the risk factors for this zoonosis, as well possible hematological and urine alterations were collected blood samples from 248 dogs. The diagnostic test performed was the Microscopic Agglutination Test (MAT) with 29 serovars of leptospires. Titers were considered reagent ≥200 and detected in 17.7% (44/248) of the dogs. The most frequent serovars were Autumnalis (20.5%); Pyrogenes (18.2%); Gryppothyphosa (15.9%); Canicola (13.6%); Bratislava and Copenhageni (9.1%); Andamana (4.5%) and Djasiman (2.3%). Regarding the analysis of the epidemiological questionnaire administered to owners of the dogs, there was statistical significance for sex, age and presence of rats at home, showing that, by logistic regression analysis, only the sex variable was been significantly associated to the presence of antibodies anti-Leptospira. The levels of urea and creatinine were significantly increased in the group of animals reagents to the Microscopic Agglutination Test, showing the renal damage in these animals and decreased hemoglobin level.

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Pós-graduação em Medicina Veterinária - FMVZ

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Pós-graduação em Biociências e Biotecnologia Aplicadas à Farmácia - FCFAR

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Pós-graduação em Pediatria - FMB

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The incidence of prostatic malignancy has increased the use of tissue markers to detect cancer. Tissue specific antigens or differentiation antigens are found on the surface of normal cells. Clinically, these antigens are important to diagnose alterations in the tissues and for immunotherapy. The objective of the present study was to evaluate the prostatic acid phosphatase concentration in blood and seminal plasma of intact and healthy dogs at different ages. The evaluation was carried out by spectrophotometer, using a commercial kit. The prostatic acid phosphatase (PAP) levels did not differ according to the age and did not correlate with age or prostatic dimensions verified by ultrasonography. The PAP concentration values varied greatly within each group. However, more studies are necessary to evaluate the role of prostatic acid phosphatase in the canine prostate and its importance as a diagnostic test for prostate disorders.

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Vocal nodules constitute the major cause of dysphonia during childhood. Auditory-perceptual and acoustic vocal analyses have been used to differentiate vocal nodules from normal voice in children.Purpose: To study the value of auditory-perceptual and acoustic vocal analyses in assessments of children with nodules.Design: Diagnostic test study.Patients and interventions: A comparative study was carried out including 100 children with videolaryngoscopic diagnosis of vocal nodules (nodule group-NG); and 100 children without vocal symptoms and with normal videolaryngoscopic exams (control group-CG). The age range of both groups was between 4 and 11 years. All children underwent auditory-perceptual vocal analyses (GRBASI scale); maximum phonation time and s/z ratio were calculated, and acoustic vocal analysis (MDVP software) were carried out.Results: There was no difference in the values of maximum phonation time and s/z ratio between groups. Auditory-perceptual analysis indicated greater compromising of voice parameters for NG, compared to CG: G (79 versus 24), R (53 versus 3), B (67 versus 23) and S (35 versus 1). The values of acoustic parameters jitter, PPQ shimmer, APQ, NHR and SPI were higher for NG for CG. The parameter f0 did not differ between groups.Conclusion: Compromising of auditory-perceptual (G, R, B and S) and acoustic vocal parameters (jitter, PPQ shimmer, APQ, NHR and SPI) was greater for children with nodules than for those of the control group, which makes them important methods for assessing child dysphonia. (C) 2013 Elsevier Ireland Ltd. All rights reserved.

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The prevalence of and possible risk factors for tuberculosis were studied in water buffalo from Para, Brazil. In this study, 3,917 pregnant and nonpregnant female Murrah and Mediterranean buffaloes were studied; 2,089 originated from Marajo Island, and 1,108 were from the mainland. The comparative cervical tuberculin test was used as a diagnostic test for tuberculosis in these animals. The prevalence of positive buffaloes was 3.5 % (100/2,809) on Marajo Island and 7.2% (80/1,108) on the mainland. The municipalities with the highest tuberculosis prevalence rates in animals were Ipixuna do Para (10.1 %), Marapanim (9.8 %), Chaves (9.4 %), Paragominas (8.6 %), and Cachoeira do Arari (6.7 %). The tuberculosis prevalence was not significantly different between the Murrah (4.3 %) and Mediterranean (4.8 %) breeds or between pregnant (5%) and nonpregnant (4.3%) buffaloes. Tuberculosis was detected in water buffaloes from Para, Brazil; the mainland buffalo exhibited the highest tuberculosis prevalence. These results indicate that this disease is dangerous to public health and buffalo farming in Para.

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The correct distinguishment of microorganisms involved in the periodontal disease pathogen, it is important in the understanding of its progression and adequate treatment planning. Considering this fact, some molecular methods of identification and quantification were developed and are extremely sensitive and precise in the characterization of different bacteria species. The present study aimed to realize a literature review, including studies that realized a comparative analysis between bacterial culture and real time PCR methods in the identification of pathogens. The bacterial culture method can possibly identify new microorganisms and realize antibiotics sensitivity tests. The real time PCR is a microbiologic test that identifies and quantifies bacterial species, through gene amplification of predetermined DNA fragments, with high sensitivity and specificity, and need a shorter operation time of the operator when compared to the bacterial culture method. In this way, to determine a specific diagnostic test, should be considered not only its precision in the identification of microorganisms, but the cost-benefit relationship as well.

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Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

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The identification of appropriate laboratory measures to confirm clinical hypotheses is important in routine paracoccidioidomycosis medical care. The clinical records and laboratory reports of 401 paracoccidioidomycosis patients attended at the Tropical Diseases Area, Faculdade de Medicina de Botucatu, from 1974 to 2008 were reviewed. Direct mycological (DM), cell block (CB), histopathological (HP), and double immunodiffusion (DID) tests were evaluated before treatment. Typical Paracoccidioides brasiliensis yeast forms were observed in clinical specimens of 86% of the patients, but 14% were detected only by serological test. DM of 51 different tissue specimens produced 74.5% sensitivity, and 62.5% sensitivity was observed in 112 sputum samples. CB in 483 sputum samples generated 55.3% sensitivity. HP performed in 239 samples from different tissues revealed 96.7% sensitivity. Serology carried out in 351 patients and 200 healthy controls provided 90.0% sensitivity, 100.0% specificity, 100.0% positive predictive value, 85.1% negative predictive value and 93.6% accuracy. Comparisons of laboratory measurements performed in the same patient showed that sensitivity decreases from HP to DID to CB and DM, with the last two assays providing similar sensitivities. This study demonstrated that P. brasiliensis identification by HP, CB, and/or DM associated with DID is sufficient to establish the laboratorial diagnosis of paracoccidioidomycosis in practically all cases. (C) 2011 Royal Society of Tropical Medicine and Hygiene. Published by Elsevier Ltd. All rights reserved.

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Objective To assess the diagnostic accuracy of the surface electromyography (sEMG) parameters associated with referred anterior knee pain in diagnosing patellofemoral pain syndrome (PFPS). Design Sensitivity and specificity analysis. Setting Physical rehabilitation center and laboratory of biomechanics and motor control. Participants Pain-free subjects (n=29) and participants with PFPS (n=22) selected by convenience. Interventions Not applicable. Main Outcome Measure The diagnostic accuracy was calculated for sEMG parameters’ reliability, precision, and ability to differentiate participants with and without PFPS. The selected sEMG parameter associated with anterior knee pain was considered as an index test and was compared with the reference standard for the diagnosis of PFPS. Intraclass correlation coefficient, SEM, independent t tests, sensitivity, specificity, negative and positive likelihood ratios, and negative and positive predictive values were used for the statistical analysis. Results The medium-frequency band (B2) parameter was reliable (intraclass correlation coefficient=.80–.90), precise (SEM=2.71–3.87 normalized unit), and able to differentiate participants with and without PFPS (P<.05). The association of B2 with anterior knee pain showed positive diagnostic accuracy values (specificity, .87; sensitivity, .70; negative likelihood ratio, .33; positive likelihood ratio, 5.63; negative predictive value, .72; and positive predictive value, .86). Conclusions The results provide evidence to support the use of EMG signals (B2 – frequency band of 45–96Hz) of the vastus lateralis and vastus medialis muscles with referred anterior knee pain in the diagnosis of PFPS.