Combination Of Diagnostic Tools Research Articles

The use of cardiometric and electrodermal activity indicators for the attestation of visual online content

The article presents some results of an interdisciplinary study aimed at clarifying the conditions for the use of cardiometric and electrodermal indicators of human activity as a means of attesting to visual online content. To record personal reactions to selected visual objects, the authors use a range of tools, including computer cardiometers, portable eye trackers and polygraphs of various modifications. To achieve this goal, the authors conducted a multi-level test of Russian youth using current political symbols and images from online communities and other social media platforms. The results of the study prove the high efficiency of using cardio-oculometric detection combined with automatic recording of electrodermal activity to obtain reliable information about affective and rational-logical features of perception of visual online content. The study also extends the research understanding of the specifics of using this combination of diagnostic tools in different conditions.

Diagnostic performance of the vesical imaging-reporting and data system for detecting muscle-invasive bladder cancer in real clinical settings: Comparison with diagnostic cystoscopy.

We herein compared the diagnostic performance of Vesical Imaging-Reporting and Data System (VI-RADS) scoring with diagnostic cystoscopy and evaluated diagnostic accuracies based on tumor locations. Among 112 bladder cancer patients who underwent multiparametric magnetic resonance imaging and diagnostic cystoscopy preoperatively to detect bladder cancer, 61 were analyzed. VI-RADS was categorized into 5 stages by 2 radiologists (R1 and R2). Cut-off values ≥3 indicated muscle-invasive bladder cancer (MIBC). Muscle invasion (MI) was visually evaluated using diagnostic cystoscopy by 2 urologists (U1 and U2). The sensitivity and specificity of VI-RADS scores and diagnostic cystoscopy for diagnosing MI were compared. 16 patients (26.2%) were pathologically diagnosed with MIBC. Regarding MI diagnostic accuracy, the sensitivity/specificity of VI-RADS scores were 93.8/88.9% by R1 and 87.5/86.7% by R2, while those of diagnostic cystoscopy were 56.3/68.9% by U1 and 68.8/84.4% by U2. Therefore, the diagnostic accuracy of VI-RADS was significantly higher than that of cystoscopy, particularly for tumors located on the bladder neck, trigone, dome, and posterior and anterior walls. Over- and under-diagnosis rates were higher with VI-RADS than with diagnostic cystoscopy (25.9% vs. 14.8%) for tumors located on the lateral wall or ureteral orifice. VI-RADS had superior diagnostic performance for detecting MI, especially in tumors located at the bladder neck/trigone/dome/posterior and anterior wall. However, VI-RADS was inferior to cystoscopy in terms of MI detection for tumors located on the lateral wall or ureteral orifice. Therefore, a combination of diagnostic tools is recommended for the accurate staging of these tumors.

Pulmonary hypertension in systemic sclerosis: diagnosis by systematic screening and prognosis after three years follow-up

BackgroundSystemic sclerosis (SSc) is a rare disease, and the presence of pulmonary hypertension can be a determining factor in prognosis. The aim of this study was to evaluate the diagnosis, profile, and prognosis of systemic sclerosis pulmonary hypertension (SSc-PH) diagnosed by systematic screening in a Brazilian population.MethodsA cohort of SSc patients underwent systematic screening for SSc-PH. Patients were referred for right heart catheterization (RHC) according to transthoracic echocardiogram or a combination of diagnostic tools. The clinical, immunological, and hemodynamic features and prognosis after 3 years were evaluated.ResultsTwenty patients underwent RHC. SSc pulmonary arterial hypertension (SSc-PAH) was the most common group of SSc-PH. These patients had long disease duration, high urate levels and highly elevated mean pulmonary arterial pressure (mPAP) and peripheral vascular resistance (PVR) on hemodynamics. Patients with mPAP > 20– < 25 mmHg had hemodynamic features of intermediate disease. Patients with SSc-PH associated to interstitial lung disease (SSc-ILD-PH) had signs of vasculopathy on hemodynamics. In patients with no-SSc-PH, the survival at 1, 2, and 3 years was 96%, 92% and 92%, respectively and in patients with SSc-PH it was 86.7%, 60% and 53.3%, respectively.ConclusionsPatients identified with SSc-PAH and SSc-ILD-PH in our screening had severe clinical and hemodynamic features. Mortality remains high in SSc-PH but was more related to Bo-PAH and SSc-ILD-PH, while in SSc-PAH, the prognosis was better. Trial registration: Current Controlled Trials ISRCTN 72968188, July 8th, 2021. Retrospectively registered.

ДИАГНОСТИКА ИШЕМИЧЕСКОЙ БОЛЕЗНИ СЕРДЦА С ИСПОЛЬЗОВАНИЕМ ВАРИАБЕЛЬНОСТИ СЕРДЕЧНОГО РИТМА И ДИСПЕРСИОННОГО КАРТИРОВАНИЯ МИОКАРДА ПРИ ПРОВЕДЕНИИ СТРЕСС-ЭХОКАРДИОГРАФИИ

The authors present a stress-echocardiography (stress-echoECG) technique enhanced with dispersion mapping and heart rate variability analysis. This combination of diagnostic tools increases IHD diagnostics sensitivity and specificity to 96 and 89 % respectively.

Peripheral Vascular Anomalies - Essentials in Periinterventional Imaging.

Peripheral vascular anomalies represent a rare disease with an underlying congenital mesenchymal and angiogenetic disorder. Vascular anomalies are subdivided into vascular tumors and vascular malformations. Both entities include characteristic features and flow dynamics. Symptoms can occur in infancy and adulthood. Vascular anomalies may be accompanied by characteristic clinical findings which facilitate disease classification. The role of periinterventional imaging is to confirm the clinically suspected diagnosis, taking into account the extent and location of the vascular anomaly for the purpose of treatment planning. In accordance with the International Society for the Study of Vascular Anomalies (ISSVA), vascular anomalies are mainly categorized as slow-flow and fast-flow lesions. Based on the diagnosis and flow dynamics of the vascular anomaly, the recommended periinterventional imaging is described, ranging from ultrasonography and plain radiography to dedicated ultrafast CT and MRI protocols, percutaneous phlebography and transcatheter angiography. Each vascular anomaly requires dedicated imaging. Differentiation between slow-flow and fast-flow vascular anomalies facilitates selection of the appropriate imaging modality or a combination of diagnostic tools. Slow-flow congenital vascular anomalies mainly include venous and lymphatic or combined malformations. Ultrasound and MRI and especially MR-venography are essential for periinterventional imaging. Arteriovenous malformations are fast-flow vascular anomalies. They should be imaged with dedicated MR protocols, especially when extensive. CT with 4D perfusion imaging as well as time-resolved 3D MR-A allow multiplanar perfusion-based assessment of the multiple arterial inflow and venous drainage vessels of arterio-venous malformations. These imaging tools should be subject to intervention planning, as they can reduce procedure time significantly. Fast-flow vascular tumors like hemangiomas should be worked up with ultrasound, including color-coded duplex sonography, MRI and transcatheter angiography in case of a therapeutic approach. In combined malformation syndromes, radiological imaging has to be adapted according to the dominant underlying vessels and their flow dynamics. Guide to evaluation of flow dynamics in peripheral vascular anomalies, involving vascular malformations and vascular tumors with the intention to facilitate selection of periinterventional imaging modalities and diagnostic and therapeutic approach to vascular anomalies. · Peripheral vascular anomalies include vascular malformations and vascular tumors. Both entities represent a rare disease with an underlying congenital mesenchymal or angiogenetic disorder. · The role of periinterventional imaging is confirmation ofthe diagnosis by assessing the flow dynamics of the vascular anomaly. · Slow-flow congenital vascular anomalies include venous, lymphatic and venolymphatic malformations. Arteriovenous malformations are fast-flow vascular anomalies, whereas hemangiomas are fast-flow vascular tumors that are frequently associated with fast-flow arteriovenous shunts. The periinterventional imaging modalities of choice include dedicated MR protocols and CT with 4D perfusion imaging as well as invasive transcatheter angiography.. · Sadick M, Overhoff D, Baessler B et al. Peripheral Vascular Anomalies - Essentials in Periinterventional Imaging. Fortschr Röntgenstr 2020; 192: 150 - 162.

Clinical, Laboratory and Ultrasonographic Findings of Diabetic Dog with Emphysematous Cystitis

Background: Emphysematous cystitis is a rare inflammatory disease of the lower urinary tract characterized by the accumulation of gas within the wall and lumen of the urinary bladder. The clinical manifestations of emphysematous cystitis resemble those of bacterial cystitis, often hindering the differentiation between the two. In this work, we report a case of emphysematous cystitis in a diabetic dog. The diagnosis of cystitis was followed by ultrasonography for the early detection of emphysematous cystitis, which showed the presence of multifocal and irregular hyperechoic interfaces forming a distal reverberation artifact. Case: A 9-year-old female dog was referred to VETCLINIC Veterinary Hospital 24 hours with a history of urinary incontinence, polydipsia, polyuria, and diabetes mellitus. At first, the blood glucose was measured and found to be 376 mg/dL. Blood count, biochemical measurements of alkaline phosphatase (AF), urea, creatinine, and alanine aminotransferase (AAT), urinalysis, urine culture with antimicrobial susceptibility testing, and abdominal ultrasonography were performed. The hematological exams showed that the serum was lipemic and with hemolysis; the values of AAT, AF, and total plasma proteins were above the reference values; hematocrit was below the normal level; erythrocyte rouleaux and thrombocytosis with platelet aggregates were present. Urinalysis showed the presence of traces of proteins, glucose, and occult blood as well as granular and hyaline cylinders and transitional epithelial cells. In urine culture, growth of the aerobic bacteria Klebsiella pneumoniae was observed, being sensitive to most of the antimicrobials. Ultrasonography showed the presence of gas in the wall of the urinary bladder, besides a discrete thickening of the wall, compatible with the diagnosis of emphysematous cystitis. Discussion: The first report of emphysematous cystitis in dogs was made in 1926 in a diabetic dog. Emphysematous cystitis is complicated, characterized by the presence of gas in the wall and lumen of the urinary bladder. It is usually reported in patients with diabetes mellitus. The patient presented with a very high glycemic index (376 mg/dL), in addition to having a history of urinary obstruction and presence of bladder stones, which may have acted as predisposing factors for the onset of emphysematous cystitis. In the present case, ultrasonography was the examination of choice. Hyperechoic reverberation-forming lines, identified as gas present in the topography of the urinary bladder, were easily visualized, as described in the literature. For the treatment of this condition, adequate management of the diet and the correct use of antimicrobials are of fundamental importance since the presence of diabetes mellitus in this patient can present serious complications in the future. This report shows the importance of the use of a combination of diagnostic tools to arrive at the correct diagnosis of the patient.

A co-infection case report of Taenia saginata in a patient with subclinical clonorchiasis confirmed by the combination of diagnostic tools

BackgroundClonorchiasis is the common parasitic infection in the general population of the Republic of Korea, however, taeniasis is scarcely reported recently. Here, we describe a case of co-infection with the cestode T. saginata in a patient with subclinical clonorchiasis diagnosed by a combination of diagnostic tools in Korea.Case presentationA 56-year-old man visited the hospital having passed proglottids in his stool for the past two months and brought a stool sample with segments to our hospital. He had no abdominal symptoms, such as nausea, vomiting, abdominal pain, diarrhea, or constipation. He used to consume raw beef and fish frequently. We could not find evidence of gravid proglottids which contain fully developed uteri filled with ova or branched uterine structures, within the submitted sample. To identify the tapeworm species, we carried out molecular analyses on the proglottids. The cox1 and ef1a sequences had a 100% match with those of T. saginata and differed from the sequences of the other Taenia species. Upon examination of stool samples fixed by formalin-ether concentration method, no Taenia species ova were observed in 10 slides. Instead, C. sinensis ova were observed, despite the level of IgG specific to C. sinensis being within the normal range. The patient was treated with praziquantel (25 mg/kg, three times a day) for 3 days, and subsequently C. sinensis ova were not found in his stool.ConclusionOur case indicates that a combination of morphological, serological, and molecular diagnostic tools should be used for the accurate diagnosis of subclinical parasitic infections.

Effect of laser beam size on the dynamics of ultrashort laser-produced aluminum plasma in vacuum

In laser-produced plasma experiments, the diameter of the irradiating laser beam on the target surface is a major parameter that influences the ablation mechanisms, plasma emission intensity, charged particle ejection, and plume morphology. In this work, the expansion dynamics of an ultrashort laser-produced aluminum plasma is investigated as a function of the laser beam size on the target, using a combination of diagnostic tools, viz., optical emission spectroscopy, fast gated time-resolved imaging, and ion current measurements. A Ti:sapphire laser delivering 100 fs, 6 mJ pulses at 800 nm is used for producing plasma from a pure Al target placed in vacuum (10−5 Torr) at different positions with respect to the geometrical focus of the beam. Optical emission spectroscopic analysis of the plasma shows that higher emission intensities and ion populations are obtained for smaller beam sizes. Time-resolved Intensified Charge Coupled Device (ICCD) imaging of the expanding plasma shows a spherical morphology for plumes produced by smaller beam sizes and a cylindrical morphology for those produced by larger beam sizes. Temporal profiles of ion emission measured using a Faraday cup are in agreement with ICCD data, featuring a dual peak structure for larger beam sizes indicating distinct slow and fast ionic species, arising from changes in the ablation mechanism for varying laser fluences. Plume expansion is modelled by free expansion for the fast species and by shock wave propagation for the slow species. Ion flux and velocities are relatively high for smaller beam sizes. These studies can be of potential importance for laser processing applications, including laser welding, drilling, and micromachining.

Combination of Diagnostic Tools for the Proper Identification of Moisture Pathologies in Modern Residential Buildings

A study of moisture pathologies in a modern residential multifamily building is presented. The housing block was designed under the regulation NBE-CT of 1979 in northern Spain. After the appearance of some moisture problems in the façades, three complementary studies were conducted to analyze the situation of the envelope and diagnose the best improvement possibilities. First, indoor conditions of temperature and humidity of the apartments with moisture pathologies were monitored. During 40 winter days, the occupancy, heating operation, and natural ventilation were analyzed. Second, the inner and outer surface temperatures of the studied façades were measured. Thermal insulation degree, thermal capacity, and thermal bridge effects were measured to assess the risk of interstitial condensation under the real conditions of use. Third, an infrared thermographic survey was carried out, which allowed the detection of irregularities and the assessment of moisture problems. The wrong interpretations, which would have been made if the complementary studies had not been done, are exposed. The key towards the accurate diagnosis was the combination of tools. Finally, some technical solutions based on ventilation or thermal insulation enhancement are proposed as different ways to reduce the high levels of relative humidity indoors and minimize the risk of condensation in the future.

Diagnosis of invasive fungal diseases in haematology and oncology: 2018 update of the recommendations of the infectious diseases working party of the German society for hematology and medical oncology (AGIHO).

Invasive fungal diseases (IFD) are a primary cause of morbidity and mortality in patients with haematological malignancies. These infections are mostly life-threatening and an early diagnosis and initiation of appropriate antifungal therapy are essential for the clinical outcome. Most commonly, Aspergillus and Candida species are involved. However, other Non-Aspergillus moulds are increasingly identified in case of documented IFD. For definite diagnosis of IFD, a combination of diagnostic tools have to be applied, including conventional mycological culture and non-conventional microbiological tests such as antibody/antigen and molecular tests, as well as histopathology and radiology. Although varying widely in cancer patients, the risk of invasive fungal infection is highest in those with allogeneic stem cell transplantation and those with acute leukaemia and markedly lower in patients with solid cancer. Since the last edition of Diagnosis of Invasive Fungal Diseases recommendations of the German Society for Hematology and Oncology in 2012, integrated care pathways have been proposed for the management and therapy of IFDs with either a diagnostic driven strategy as opposed to a clinical or empirical driven strategy. This update discusses the impact of this additional evidence and effective revisions.

Schistosomiasis in immigrants, refugees and travellers in an Italian referral centre for tropical diseases

BackgroundSchistosomiasis is one of the most important neglected tropical diseases. If unrecognised and untreated, the chronic infection can lead to irreversible complications.MethodsRetrospective observational study aimed at describing clinical history, laboratory findings and imaging presentation of imported schistosomiasis diagnosed at the Centre for Tropical Diseases, Sacro Cuore Don Calabria Hospital of Negrar, Verona, Italy from 2010 to 2014. The aim of our study was to assess differences in demographic characteristics, clinical presentation, laboratory data and ultrasound findings between immigrants/visiting friends and relatives (VFR) from endemic countries (endemic group) and expatriates/travellers (non-endemic group).ResultsA total of 272 patients were retrieved: 234 in the endemic and 38 in the non-endemic group. Most of the patients acquired schistosomiasis in Africa (97.4%). Symptoms were reported by 52.9% of the patients; abdominal pain (36%), macroscopic hematuria (11.3%), and genito-urinary symptoms (7.4%) being the most frequently reported. Increased IgE and blood eosinophilia were observed in 169 (63.8%) and 130 (47.8%) patients, respectively. The proportion of positive serology was 250/272 (91.9%).The Circulating Cathodic Antigen CCA for Schistosoma mansoni was positive in 14/61 individuals (23%). At microscopy, infected subjects were 103/272 (37.9%). The species of Schistosoma found were S. haematobium (47.6%), S. mansoni (46.6%) or both (5.8%). Schistosomiasis was classified as confirmed in 103 (37.9%), probable in 165 (60.6%) and suspected in 4 (1.5%) cases using clinical presentation, laboratory data and ultrasound findings. The infection was further classified based on organ involvement: intestinal (17.9%), hepatosplenic (5.1%), urogenital (48.9%), and indeterminate (43.8%).The comparative analysis of endemic and non-endemic patients highlighted differences in sex and age. Endemic patients had more frequent ova identification (41.9% vs. 13.2%, P < 0.001) and increased IgE (70% vs. 26.3%, P < 0.001) when compared with non-endemic. Multivariate analyses showed that younger age, abnormal ultrasound findings and blood eosinophilia were significantly associated with positive microscopy (OR = 0.94, OR = 2.12, OR = 1.98, respectively).ConclusionsSymptoms, eosinophilia and abnormal ultrasound findings were present in about half of patients, without differences between groups. Many patients had positive serology but negative microscopy, indicating that schistosomiasis might be misdiagnosed. A combination of diagnostic tools may facilitate the diagnosis.

Comparative analyses of thoracic radiographs and bronchoalveolar lavage of dogs and cats with chronic bronchial diseases

There is a high incidence of bronchitis and asthma cases in veterinary medicine. Thoracic radiographs and bronchoalveolar lavage (BAL) are commonly performed for definitive diagnosis in dogs and cats with suspected bronchitis and asthma. It is believed that a combination of diagnostic tools is the best choice to achieve a diagnosis. The aim of this study was to evaluate the efficacy of thoracic radiographs and BAL in the diagnosis of chronic bronchial disease (CBD) in dogs and cats and whether there is any specific radiographic finding that could influence the indication for bronchoalveolar lavage. It was performed a cross-sectional, prospective, observational study including forty client-owned dogs and cats with lower respiratory tract signs and positive radiographic opacities that were evaluated with BAL followed by cytology and culture. The radiographic results compared with BAL culture showed a sensitivity of 38%, specificity of 95% and accuracy of 65% in detecting patients with pneumonia associated with chronic bronchial disease. Thoracic radiographs were effective in diagnosing 65% of the patients, radiographs plus BAL cytology diagnosed 75% of patients and the combination of radiographs, BAL cytology and culture diagnosed 95% of the patients with chronic bronchial disease. In conclusion, the combination of radiographic examination with BAL followed by cytological and microbiological analyses increases diagnostic success in CBD.

Predicting Lung Volume Reduction after Endobronchial Valve Therapy Is Maximized Using a Combination of Diagnostic Tools

Background: Bronchoscopic lung volume reduction using one-way endobronchial valves (EBVs) has been proven to be effective in patients with severe emphysema. However, the selection of patients without collateral ventilation prior to treatment is critical for procedural success. Collateral ventilation can be assessed directly with the Chartis system or indirectly using computed tomography (CT) fissure analysis. Objectives: We retrospectively evaluated the diagnostic value of a combination of the quantitative CT interlobar fissure completeness score (FCS) and Chartis in predicting responders to EBV therapy. Methods: CT data from four prospective studies were pooled and analyzed using semiautomated software to quantify the completeness of interlobar fissures. These FCSs were compared to a reference standard of achieving ≥350 ml of target lobe volume reduction after EBV treatment. Using a receiver operating characteristic curve, optimal thresholds predictive of complete fissures (responders) and incomplete fissures (non-responders) were determined. A subgroup of patients with partially complete fissures was identified, where software had lower accuracy. The complementary value of Chartis was investigated in this group. Results: A fissure was defined as complete (FCS >95%), incomplete (FCS <80%), or partially complete (80% < FCS < 95%). The positive predictive value (PPV) of complete fissures is 88.1%, and the negative predictive value (NPV) is 92.9%, with an overall accuracy of 89.2%. Chartis was utilized in patients with partially complete fissures, with a PPV of 82.3%, an NPV of 84.6%, and an accuracy of 83.3%. Conclusion: Combining diagnostic tools could reduce the burden on patients and the healthcare system while providing clinicians with a better means for patient selection for EBV therapy.

Delayed posterior circulation insufficiency in pediatric moyamoya disease.

Approximately 30% of patients with moyamoya disease (MMD) have presented with involvement of the posterior circulation, mainly the posterior cerebral artery (PCA). Diagnosis of delayed progression of PCA stenosis in MMD may be difficult due to the diversity in clinical features. The goal of this study was to evaluate pediatric MMD patients with delayed PCA involvement after completion of revascularization of the anterior circulation. Forty-one pediatric MMD patients who underwent revascularization of the PCA territory due to delayed posterior circulation insufficiency MMD from 2006 to 2011 were retrospectively reviewed. The average interval between the initial operation and the occipital artery (OA) procedure was 5.0 years. Common symptoms were headaches and transient visual symptoms. The decision to operate was made based on a combination of diagnostic tools. The results obtained with perfusion MRI, SPECT, MR angiography, and EEG supported posterior circulation insufficiency in 78, 41, 73, and 71% of patients, respectively. Encephaloduroarteriosynangiosis (EDAS) using the OA was performed in 15 patients, and 26 patients received multiple burr hole trephination of the occipital area. All patients showed clinical improvement. Clinicians should be aware of the possibility of delayed involvement of the PCA in pediatric MMD patients. The clinical decision regarding treatment should be based on a combination of symptomatology and the results obtained with various tools to assess whether the blood flow in the PCA territory is insufficient. Surgical treatment using indirect revascularization appears to be effective for patients with delayed PCA involvement.

Gastro-oesophageal reflux in noncystic fibrosis bronchiectasis.

The clinical presentation of noncystic fibrosis bronchiectasis may be complicated by concomitant conditions, including gastro-oesophageal reflux (GOR). Increased acidic GOR is principally caused by gastro-oesophageal junction incompetence and may arise from lower oesophageal sphincter hypotension, including transient relaxations, hiatus hernia, and oesophageal dysmotility. Specific pathophysiological features which are characteristic of respiratory diseases including coughing may further increase the risk of GOR in bronchiectasis. Reflux may impact on lung disease severity by two mechanisms, reflex bronchoconstriction and pulmonary microaspiration. Symptomatic and clinically silent reflux has been detected in bronchiectasis, with the prevalence of 26 to 75%. The cause and effect relationship has not been established, but preliminary reports suggest that GOR may influence the severity of bronchiectasis. Further studies examining the implications of GOR in this condition, including its effect across the disease spectrum using a combination of diagnostic tools, will clarify the clinical significance of this comorbidity.

Emerging technologies for diagnosis of dental caries: The road so far

It is now universally recognized that the development of new technologies for early detection and quantitative monitoring of dental decay at an early stage of formation could provide health and economic benefits ranging from timely preventive interventions to reduction in the time required for clinical trials of anticaries agents. The use of technologies as adjunct to clinical visual examination for caries diagnosis will facilitate preventive care in dentistry to lower treatment cost as well as reduce the cost and time for testing potential anticaries agents. This article describes the various technologies available to aid the dental practitioners in detecting dental caries at the earliest stage of its formation, assessing the activities of the detected carious lesion, and quantitatively or qualitatively monitoring of the lesion over time. The need and the importance of these technologies were also discussed. The data discussed are primarily based on published scientific studies and reviews from case reports, clinical trials, and in vitro and in vivo studies. References have been traced manually by MEDLINE® or through manufacturer’s websites. While some of the devices are fully developed and commercially available, others are still under development. The devices vary in their modes of action as well as their capability as caries diagnostic aids. It is clear that the differences in caries presentations and behavior in different anatomical sites make it unlikely that any one diagnostic modality will have adequate sensitivity and specificity of detection of carious lesions for all sites; a combination of diagnostic tools will help us diagnose lesions earlier and detect failing restorations sooner, all to avoid more costly, destructive dental procedures and truly take dentistry into the preventive rather than the reactive mode.

Implications of EGFR PharmDx™ Kit for cetuximab eligibility

EGF receptor (EGFR) represents an attractive target for anticancer therapies in a variety of malignant neoplasms, including colorectal, non-small-cell lung, head and neck carcinomas and gliomas. Monoclonal antibodies, such as cetuximab, are directed against the extracellular EGFR domain, whereas small molecules are targeting the intracellular tyrosine kinase domain. Particularly for application of drugs against extracellular EGFR parts, knowledge about EGFR levels within the cell membrane is of high import, because only EGFR-depending tumors respond to these therapeutic approaches. Immunohistochemical investigation of tissue slides of the primary tumor are performed to screen for EGFR occurrence in tumor cells. Since 2004, the combination of ‘EGFR PharmDx™ kit’, a diagnostic test for EGFR, and subsequent application of cetuximab in EGFR-positive colon carcinomas has been approved by the US FDA. It represents the second approved combination of diagnostic tools and dependent application of monoclonal antibody therapies after the successful HercepTest™/Herceptin™ for breast carcinomas. This proceeding represents an important step toward a personalized cancer therapy with major advantages for patients, mainly reduction of toxic side effects and dramatically increased efficiency.

Magnetic Resonance Imaging Meets Immunology: An Unusual Combination of Diagnostic Tools Leads to the Diagnosis Actinomycosis

Magnetic Resonance Imaging Meets Immunology: An Unusual Combination of Diagnostic Tools Leads to the Diagnosis Actinomycosis

A combination of diagnostic tools for rapid screening of ovine listeriosis

A combined serological and PCR method for the detection of Listeria monocytogenes infection in symptomatic and asymptomatic ovine flocks was evaluated. Seventy-eight milk samples and 157 serum samples were analysed using a L. monocytogenes PCR detection kit and an anti-listeriolysin O IgG immunoassay kit. The combined use of these commercial kits allowed a rapid and effective detection of L. monocytogenes infection in both the early stage, before seroconversion, and in a later phase, even after antibiotic therapy.

Effects of cloud diabatic heating on the early development of the FASTEX IOP17 cyclone

AbstractA set of numerical simulations is used to study the first development phase of ‘The FASTEX cyclone’, a particularly well sampled frontal cyclone system that developed on the trailing front of a primary large‐scale baroclinic wave during Intensive Observation Period 17 (IOP17) of FASTEX (the Fronts and Atlantic Storm‐Track EXperiment). the role of diabatically induced vertical circulations is investigated with a combination of diagnostic tools, including a generalized omega equation and Keyser's psi‐vector technique, applied to the model outputs. the full‐physics simulation shows a good agreement with observed data, particularly the splitting of the upper‐level flow into a pair of jet streaks. Analysis of the contributions to the vertical ageostrophic transverse circulations near the jet‐streak‐pair structure, shows that a positive feedback exists between the storm's dynamical configuration and the diabatic processes. In the second part of the paper, this interpretation is confirmed by a sensitivity analysis excluding cloud processes. Results suggest that, after initial baroclinic growth, the storm evolves towards a purely diabatic deepening regime, leading to a ‘diabatic Rossby wave’ mechanism, as proposed by recent wave‐CISK (Conditional Instability of the Second Kind) theoretical studies.