Nonspecific Tests Research Articles

Drug-Induced Generalized Skin Eruption in a Diabetes Mellitus Patient Receiving a Dipeptidyl Peptidase-4 Inhibitor Plus Metformin

A generalized skin eruption with strong itching was induced by sitagliptin, a dipeptidyl peptidase-4 (DPP-4) inhibitor, in a patient almost 6 months after initiation of the drug. Physical examination revealed a spread of skin rash from chest to back, and abdomen and thigh. Discontinuation of the drug eliminated the skin rash immediately. The emergence of new rash ended, and the rash itself withered after 1 week. The spread of the rash gradually shrank and the skin lesions subsided, leaving pigmentation 1 month later. Two months after cessation of sitagliptin, the skin eruption had subsided and oral steroid medication was stopped, but some small eczematous eruptions continued to appear intermittently. Although a drug-induced lymphocyte stimulation test was negative for sitagliptin, nonspecific radioimmunosorbent test for immunoglobulin E was increased to 532 IU/mL, with a percentage of eosinophil of 7.4%. Sitagliptin has a phenyl ring, carbonyl group, and an absorption spectrum showing three absorption peaks (199.9, 265.0, 400.1 nm), and its photosensitive mechanism could have been responsible for the itchy edematous plaque. In the present case, the initial generalized skin eruption may have been induced by an allergic reaction to sitagliptin. Close attention should be paid to patients receiving this drug with a history of urticaria, and to the development of photosensitivity.

Confirmation biases across the psychosis continuum: The contribution of hypersalient evidence‐hypothesis matches

Hypersalience of evidence-hypothesis matches has recently been proposed as the cognitive mechanism responsible for the cognitive biases, which, in turn, may contribute to the formation and maintenance of delusions. However, supporting evidence for this construct is still required. Using two tasks designed to elicit three core facets of the confirmation bias (i.e., biased search of confirming evidence; biased interpretation of confirming evidence; and biased recall of confirming evidence), this article investigated the possibility that individuals with delusions and those identified as delusion-prone are hypersalient to evidence-hypothesis matches. A total of 75 participants (25 diagnosed with schizophrenia with a history of delusions; 25 non-clinical delusion-prone; 25 non-delusion-prone controls) completed both tasks. The results across both tasks showed that participants with schizophrenia and delusion-prone participants prefer: non-diagnostic or non-specific positive tests over diagnostic negative tests (biased search); rate confirming evidence as more important than disconfirming evidence (biased interpretation); and remember confirming evidence with greater ease than disconfirming evidence (biased recall). Participants with higher delusional ideation also failed to integrate disconfirmatory evidence to modify prior hypotheses. These results suggest that delusional ideation is linked to a hypersalience of evidence-hypothesis matches. The theoretical implications of this cognitive mechanism on the formation and maintenance of delusions are discussed.

The Role of Multimodality Imaging in the Evaluation of Takayasu Arteritis

Takayasu arteritis is a rare large vessel vasculitis of unknown etiology, in which both early diagnosis and follow-up present very significant challenges. The high incidence of disease-associated morbidity and significant risk of premature death-particularly in young adults-mandate the need to facilitate early diagnosis and aggressive treatment where appropriate. The aim of this review is to summarize the current level of knowledge regarding the usefulness of evolving imaging modalities in the diagnostic workup and management of patients suffering with Takayasu arteritis. We also propose an imaging algorithm for the evaluation of this population. A MEDLINE search for articles published between January 1999 and December 2011 was conducted using the following keywords: Takayasu arteritis, imaging modalities, echocardiogram, cardiac magnetic resonance, positron emission tomography scan, diagnosis. Imaging studies-particularly cardiac magnetic resonance-can assist early diagnosis by demonstrating vascular lesions even when angiography is negative, by identifying the presence of vascular inflammation and/or wall thickening; they are also useful for monitoring purposes. However, availability, expertise, high cost, and radiation are considerable limitations. Magnetic resonance imaging, although it can detect both anatomic and pathophysiologic changes without radiation, is time-consuming, needs high expertise, and still remains an expensive tool, not widely available. Knowledge of the advantages and limitations of the various imaging procedures can complement the physicians' clinical assessment and, along with nonspecific serologic tests, can aid them in diagnosing active arteritis and commence relevant treatment early on, as well as monitor activity and tailor therapy subsequently.

Effects of test experience and neocortical microgyria on spatial and non-spatial learning in rats

Neocortical neuronal migration anomalies such as microgyria and heterotopia have been associated with developmental language learning impairments in humans, and rapid auditory processing deficits in rodent models. Similar processing impairments have been suggested to play a causal role in human language impairment. Recent data from our group has shown spatial working memory deficits associated with neocortical microgyria in rats. Similar deficits have also been identified in humans with language learning impairments. To further explore the extent of learning deficits associated with cortical neuronal migration anomalies, we evaluated the effects of neocortical microgyria and test order experience using spatial (Morris water maze) and non-spatial water maze learning paradigms. Two independent groups were employed (G1 or G2) incorporating both microgyria and sham conditions. G1 received spatial testing for five days followed by non-spatial testing, while the reverse order was followed for G2. Initial analysis, including both test groups and both maze conditions, revealed a main effect of treatment, with microgyric rats performing significantly worse than shams. Overall analysis also revealed a task by order interaction, indicating that each group performed better on the second task as compared to the first, regardless of which task was presented first. Independent analyses of each task revealed a significant effect of treatment (microgyria worse than sham) only for the spatial water maze condition. Results indicate that prior maze experience (regardless of task type) leads to better subsequent performance. Results suggest that behavioral abnormalities associated with microgyria extend beyond auditory and working memory deficits seen in previous studies, to include spatial but not non-spatial learning impairments and that non-specific test experience may improve behavioral performance.

Engineering paper as a substrate for blood typing bio-diagnostics

The effect of paper structure on blood typing visualization was quantified and analyzed to engineer low-cost diagnostics. Commercial and experimental papers varying in fibre composition, basis weight, density and porosity were investigated for their ability to separate agglutinated (blood interacted with specific antibodies) from non-agglutinated (blood interacted with non-specific antibodies) red blood cells (RBCs). Antibodies solutions and blood samples were sequentially absorbed on paper, allowed to interact, eluded with a saline solution, and the intensity of the remaining blood spot was quantified by image analysis. The efficiency and clarity of RBC separation was quantified with the relative intensity (R.I.) index defined as the intensity ratio of the non-specific test over the specific system; the lower the R.I., the better is the separation between a positive from a negative test. Thick and dense papers are improper for blood typing as they retain indiscriminately both agglutinated and non-agglutinated RBCs. Thin and porous papers provided the best performance. The R.I. index (the lower the better) increased fairly linearly with paper density and thickness but inversely proportionally with paper pore size. The type of fibres played a minor role. The paper structure is critical in the design of blood typing assay. However, it is only one element of the diagnostic system to engineer with the interactions RBC-antibody-paper.

Importance of nonspecific laboratory tests in Brucella diagnosis

Amac: Brusella enfeksiyonlarinin ayirt edici klinik ozelligi olmadigindan, atesle seyreden hastaliklarla karisir. Bu calismada, brusellozlu hastalarda taniya spesifik olmayan laboratuvar testlerinin tanidaki degerini saptamak amaclanmistir. Gerec ve yontem: Aralik 2010-Mayis 2011 tarihleri arasinda Usak Devlet Hastanesi Merkez Laboratuvari\'na gelen, klinik olarak brusellozla uyumlu, Standart Tup Aglutinasyon (STA) testi ve Coombslu STA testi calisilan hasta ornekleri geriye donuk olarak tarandi. Kontrol grubu olarak Aralik 2010-Mayis 2011 tarihleri arasinda laboratuvara basvuran, STA testi sonucu negatif olan, bruselloz tanisi olmayan 62 hasta rastgele belirlendi. Bulgular: Hasta grubunun 54\'unde (%87.0) CRP yuksekligi, 44\'unde (%70.9) ESH yuksekligi, 22\'sinde (%35.4) AST yuksekligi, 7\'sinde (%11.2) ALT yuksekligi, 19\'unda (%30.6) Ferritin yuksekligi, 8\'inde (%12.9) anemi saptandi. Kontrol grubunun 7\'sinde (%11.2) CRP yuksekligi, 10\'unda (%16.1) ESH yuksekligi, 1\'inde (%1.6) AST yuksekligi, 1\'inde (%1.6) ALT yuksekligi, 6\'sinda (%9.6) anemi saptanirken, ferritin dusuklugu saptanan hasta olmadi. Sonuc: Sonuc olarak, brusellozda taniya spesifik testlerin yaninda, calismamizda istatistiksel olarak anlamli bulunan CRP, ESH, ALT, AST ve ferritin yuksekliginin de taniyi destekleyici testler olarak kullanilabilecegi sonucuna varilmistir.

Biological maturation, morphology, fitness, and motor coordination as part of a selection strategy in the search for international youth soccer players (age 15–16 years)

We report the morphology (height, weight, body fat, body mass index), fitness (strength, speed, agility, flexibility), and soccer-specific (dribbling) and non-specific motor coordination skills (Körper KoordinationsTest für Kinder; KTK) of 78 Belgian international youth soccer players aged 15–16 years with varying biological maturity status. The more mature players (U16 and U17) possessed higher morphological measures and outperformed their later maturing peers (U16 Futures and U17 Futures) on almost all fitness tests. However, soccer-specific and non-specific motor coordination tests did not distinguish the more mature players from the later maturing players in both age groups. When adjusted for the confounder (age at peak height velocity), multivariate analysis of covariance revealed that several morphology- and fitness-related parameters did not differ between selection groups, again in both age groups. These findings indicate that biological maturation affects morphology and fitness more so than motor coordination skills. In conclusion, to prevent the dropout of promising late maturing players, we suggest avoiding one-dimensional approaches and to include measures of biological maturity status as well as maturity independent performance tests during the talent identification and selection process.

Serum transthyretin concentration is decreased in dogs with nonthyroidal illness

Hypothyroidism in dogs is often difficult to diagnose owing to nonspecific clinical signs and laboratory test results that can be mimicked by nonthyroidal illness (NTI). Thyroxine (T4) circulates in blood mainly bound to T4-binding globulin and, to a lesser degree, transthyretin (TTR) and albumin. The concentration of total T4 depends on the concentrations of these binding proteins. We hypothesized that dogs with NTI and decreased serum total T4 concentrations would have decreased serum TTR concentrations. The objective of the study was to measure and compare serum TTR concentrations in healthy dogs, in dogs with NTI and low serum T4 concentrations, and in dogs with hypothyroidism. Assignment of dogs to 3 groups was based on physical examination and serum concentrations of T4 and TSH (mean ± SD): for healthy dogs (n = 13), T4 was 24.8 ± 3.6 nmol/L and TSH was 0.15 ± 0.08 μg/L; for dogs with NTI and low T4 (n = 20), T4 was 3.2 ± 3.0 nmol/L and TSH was 0.18 ± 0.13 μg/L; and for hypothyroid dogs (n = 19), T4 was 5.3 ± 4.3 nmol/L and TSH was 2.33 ± 1.90 μg/L). TTR concentrations in serum were determined semiquantitatively using western blot analysis. Serum TTR concentration (mean ± SD) was decreased in the dogs with NTI (24.8 ± 7.9 mg/L) compared with that of hypothyroid dogs (41.1 ± 21.4 mg/L, P = .0035). Differences were not found between TTR concentrations in clinically healthy dogs (33.3 ± 10.1 mg/L) and hypothyroid dogs or dogs with NTI. Serum TTR concentrations were significantly decreased in dogs with NTI and low T4 compared with concentrations in hypothyroid dogs. Additional studies should be done to determine if TTR concentrations can discriminate between dogs with NTI and low T4 and dogs with primary hypothyroidism.

Angora wool asthma in textile industry.

Up to now the exposures to hair and skin derivatives of animals have not yet been the subject of systematic studies. The observation of a clinical case has provided the opportunity for a review of the literature. The inpatient was a 49-year-old man, a carder in a textile factory, exposed to angora wool. He noticed the appearance of dyspnea during working hours. There was no eosinophilia in blood, and the results of pulmonary function tests were normal. The nonspecific bronchial provocation test with methacholine demonstrated an abnormal bronchial reactivity. The challenge test with angora wool was positive (decrease in FEV1 of more than 40%) as well as total IGE and specific IgE to rabbit epithelium (433 KU/l and 12.1 KUA/l, resp.). Several sources of allergens were found in the rabbit, and the main allergen was represented by proteins from epithelia, urine, and saliva. Most of these proteins belong to the family of lipocalin, they function as carriers for small hydrophobic molecules (vitamins and pheromones). If the diagnosis of occupational asthma caused by animal hair and skin derivatives may be relatively easy by means of the challenge test, defining etiology is complicated because of the lack of in vitro tests.

A Case of Atypical Giant Cell Arteritis Presenting as a Fever of Unknown Origin

Giant cell arteritis (GCA) is a systemic vasculitis predominantly found in individuals of Northern European ancestry over 50 years of age. Typically it presents with new-onset persistent headache, claudication of jaws, and existence of an abnormal temporal artery. However, the diagnosis of GCA and the assessment of its activity remain challenging, especially in patients presenting with a variety of non-specific symptoms and laboratory tests. In those cases, F-fluorodeoxyglucose positron emission tomography (F-FDG-PET) is useful for the diagnosis of GCA. Recently, the number of foreign patients who visit domestic hospitals for medical care is increasing in Korea. Here-in, we report a Russian patient who was admitted to our hospital with fever of unknown origin (FUO). FUO study was performed to search for infection or malignancy and GCA was suspected by F-FDG-PET. The patient was eventually diagnosed with GCA by random temporal artery biopsy.

Congenital Syphilis, Réunion Island, 2010

Congenital Syphilis, Réunion Island, 2010

A Test for Determining Endurance Capacity in Fencers

Until now endurance in fencers has been tested by non-specific ergometer tests even though the movement patterns during fencing are considerably different. The aim of the study was to evaluate a newly developed fencing-specific endurance test (FET). 2 studies were carried out: 28 fencers were tested by FET with fencing-specific footwork and incremental tests on cycle (CE) and treadmill ergometer (TM) in a random order. Afterwards fencing bouts (BOU) were conducted to determine specific physical load. Blood lactate and heart rates were measured. In a second study another group of 18 international and 20 national level fencers conducted FET to explore differences between groups. Comparison of CE, TM, FET and BOU revealed a significant correlation between FET and BOU (r=0.80, p<0.01), heart rates during CE and TM were significantly lower than in bouts (p<0.01). Performance at CE and TM hardly correlated with FET (r=0.30, p<0.05; r=0.31, p<0.05). Elite-fencers showed significantly better performance than non-elite fencers in FET (p<0.01). FET was suitable for determining specific endurance in fencers, allows a better assessment of physical demands during bouts than conventional ergometry and can be used to distinguish between fencers of different levels.

What to Do With Discordant Syphilis Serology Results

Traditionally, syphilis testing and screening has involved a nonspecific test such as rapid plasma reagin (RPR) followed if necessary by a confirmatory

The Aptly Named Nonspecific Pulmonary Function Test

The Aptly Named Nonspecific Pulmonary Function Test

Calidad ecotoxicológica de los sedimentos en fiordos del sur de Chile

We analysed the ecotoxicological quality of sediments in Moraleda, Puyuguapi and Elefantes Channels and Aysen Fjord, located between 44o and 46.5oS, using non-specific tests in order to evaluate their base conditions in terms of possible pollutants that may have been introduced in the area. The survival tests with Ampelisca araucana and Tisbe longicornis and fertility test with Arbacia spatuligera indicate that the sediments do not present problems of toxicity. Nevertheless, the increased cellular density observed in the tests with microalgae (Dunaliella tertiolecta, Dunaliella salina and Isochrysis galbana) indicates the accumulation of sediments rich in nutrients within the area.

The Nonspecific Pulmonary Function Test: Longitudinal Follow-up and Outcomes

The nonspecific (NS) pulmonary function (PF) pattern refers to a PF test with a normal total lung capacity (TLC), normal FEV₁/FVC ratio, and a low FEV₁, a low FVC, or both. Currently, no information is available regarding the long-term stability of the NS pattern or variables that predict changes in subjects with an initial NS PF pattern. From 1990 to 2005 we identified 1,284 subjects with an NS pattern on initial PF testing with one or more follow-up PF tests 6 months or more after the initial NS test result. Lung volumes, diffusing capacity, and spirometry data were analyzed. A multivariate, multinomial logistic regression model was used to study the association between different variables and the final PF pattern. Overall, 3,674 PF tests were performed in 1,284 subjects over a median follow-up period of 3 years. At last follow-up, 818/1,284 (64%) subjects continued to show the NS pattern, whereas 208/1,284 (16%) showed a restrictive pattern, 191/1,284 (15%) an obstructive pattern, 42/1,284 (3%) a normal pattern, and 25/1,284 (2%) a mixed pattern. The multinomial logistic regression analysis showed that increasing values for specific airway resistance and the difference between TLC and alveolar volume were predictors of a change to an obstructive pattern on follow-up. The NS pattern is a distinct and stable PF test pattern with roughly two-thirds of patients continuing to show this pattern on follow-up testing. Current interpretation guidelines erroneously label the NS pattern as representing obstruction and need to be changed to reflect these data.

Motor deficits in neurofibromatosis type 1 mice: the role of the cerebellum

Neurofibromatosis type 1 (NF1) is an autosomal dominantly inherited disease, characterized by various neurocutaneous symptoms, cognitive impairments and problems in fine and gross motor performance. Although cognitive deficits in NF1 have been attributed to increased release of the inhibitory neurotransmitter γ-amino butyric acid (GABA) in the hippocampus, the origin of the motor deficits is unknown. Cerebellar Purkinje cells, the sole output neurons of the cerebellar cortex, are GABAergic neurons and express neurofibromin at high levels, suggesting an important role for the cerebellum in the observed motor deficits in NF1. To test this, we determined the cerebellar contribution to motor problems in Nf1(+/-) mice, a validated mouse model for NF1. Using the Rotarod, a non-specific motor performance test, we confirmed that, like NF1 patients, Nf1(+/-) mice have motor deficits. Next, to evaluate the role of the cerebellum in these deficits, mice were subjected to cerebellum-specific motor performance and learning tests. Nf1(+/-) mice showed no impairment on the Erasmus ladder, as step time and number of missteps were not different. Furthermore, when compensatory eye movements were tested, no performance deficits were found in the optokinetic reflex and vestibulo-ocular reflex in the dark (VOR) or in the light (VVOR). Finally, Nf1(+/-) mice successfully completed short- and long-term VOR adaptation paradigms, tests that both depend on cerebellar function. Thus, despite the confirmed presence of motor performance problems in Nf1(+/-) mice, we found no indication of a cerebellar component. These results, combined with recent clinical data, suggest that cerebellar function is not overtly affected in NF1 patients.

Commentary on “Chronic Idiopathic Urticaria in Taiwan: A Clinical Study of Demographics, Aggravating Factors, Laboratory Findings, Serum Autoreactivity and Treatment Response”

In this issue, Lee et al performed a prospective cross-sectional, single-center study which included 62 chronic idiopathic urticaria (CIU) patients in Taiwan.1 A higher prevalence of atopy, especially allergic rhinitis, occurred in CIU patients than in general adult population in this study. The authors did not find any associations between the severities of CIU but patients with atopy were associated with poorer therapeutic response of secondgeneration antihistamine with standard dose. The role of atopy in CIU has been controversial. Despite the higher prevalence of atopy in CIU in this paper, a selection bias may be present because patients with poor response to standard dose of anti-histamine may be overrepresented in a tertiary referral hospital. Urticaria has been considered as a condition that the local dermal edema occurs because of the release of histamine from mast cells. However, recent studies have found the roles of other vasoactive mediators, such as prostaglandin, kinin, and interleukin-31 in the pathogenesis of CIU.2 The involvement of cytokines other than histamine provides an explanation for the ineffectiveness of antihistamine and the needs of immunomodulatory therapy in selected cases of CIU. Chronic urticaria is an enigmatic condition and search for a specific cause is often futile despite an extensive work-up. Food allergy is the most frequently sought after cause for chronic urticaria for the patients, and hence tests for specific IgE are often performed. However, only rarely can food be incriminated as the cause for chronic urticaria. Instead, there is emergent evidence to suggest an autoimmune basis in up to 60% of patients with CIU.3 Severe itching, extensive disease, more systemic symptoms, resistant to antihistamine treatment and need of immunosuppressant therapy are key clinical features described for this group of patients.4 Autologous serum skin test (ASST) is a nonspecific screening test which evaluates the presence of serum histamine-releasing factors and has been used as a surrogate test for the detection

Clinical utility of the erythrocyte sedimentation rate test and haemoglobin electrophoretic patterns among premarital couples in Port Harcourt, Nigeria

Background: The erythrocyte sedimentation rate (ESR) is a relatively non-specific test that is often ignored during the diagnosis and monitoring of disease. However, in recent times, the test is often requested alongside haemoglobin electrophoretic pattern as pre marital test. This study was aimed at determining the ESR values among these apparently healthy populations, correlate this parameter with Hb electrophoretic pattern and evaluate its usefulness in modern medicine.Materials and Methods: Standard haemoglobin electrophoresis run withcellulose acetate paper at pH 8.9 and Westergren method for ESR were used in the determinations.Results: The mean ESR value for the males was 12.48±10.0mm/hr while 20.77 ± 18.8 was obtained for the females. There was significant difference between the male and female values (t = 3.94; p < 0.01). Mild elevation of ESR (20–50 mm/hr) occurred in 6.67% of males, 11.1% of the females and 8.85% in the study population A moderately elevated value (ESR 51–99mm/hr) was observed in 2.2% males, 5.56% females and 3.38% in the study population. No extreme elevation (ESR >100mm/hr) was observed in the study population. ESR was found to correlate negatively with gender (r = -0.248; p

Non-specific laboratory test indicators of severity in hospitalized adults with swine influenza (H1N1) pneumonia

Non-specific laboratory test indicators of severity in hospitalized adults with swine influenza (H1N1) pneumonia