Browsing by Subject "Diagnostics"

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  • Vaarno, Jenni; Myller, Jyri; Bachour, Adel; Koskinen, Heli; Bäck, Leif; Klockars, Tuomas; Koskinen, Anni (2020)
    Purpose We have previously demonstrated that dogs can be trained to distinguish the urine of patients with obstructive sleep apnea (OSA) from that of healthy controls based on olfaction. Encouraged by these promising results, we wanted to investigate if a detection dog could work as a screening tool for OSA. The objective of this study was to prospectively assess the dogs' ability to identify sleep apnea in patients with OSA suspicion. Methods Urine samples were collected from 50 patients suspected of having OSA. The urine sample was classified as positive for OSA when the patient had a respiratory event index of 5/h or more. The accuracy of two trained dogs in identifying OSA was tested in a prospective blinded setting. Results Both of the dogs correctly detected approximately half of the positive and negative samples. There were no statistically significant differences in the dogs' ability to recognize more severe cases of OSA, as compared to milder cases. Conclusion According to our study, dogs cannot be used to screen for OSA in clinical settings, most likely due to the heterogenic nature of OSA.
  • Reusken, Chantal; Boonstra, Marrit; Rugebregt, Sharona; Scherbeijn, Sandra; Chandler, Felicity; Avsic-Zupanc, Tatjana; Vapalahti, Olli; Koopmans, Marion; GeurtsvanKessel, Corine H. (2019)
    Background: Tick-borne encephalitis (TBE) is an infectious disease endemic to large parts of Europe and Asia. Diagnosing TBE often relies on the detection of TBEV-specific antibodies in serum and cerebrospinal fluid (CSF) as viral genome is mostly not detectable once neurological symptoms occur. Objectives: We evaluated the performance of TBEV IgM and IgG ELISAs in both serum and CSF of confirmed TBEV patients and discuss the role of (CSF) serology in TBEV diagnostics. Study design: For the assay evaluation we collected specimen from confirmed TBEV patients. Assay specificity was assessed using sera from patients with a related flavivirus infection or other acute infection. A selected ELISA assay was used to analyze TBEV-specific antibodies in CSF and to evaluate the use in confirming TBE diagnosis. Results: In this study the overall sensitivity of the IgM TBEV ELISAs was acceptable (94-100 %). Four out of five IgM ELISA's demonstrated an excellent overall specificity from 94-100% whereas a low overall specificity was observed for the IgG TBEV ELISAs (30-71%). Intrathecal antibody production against TBEV was demonstrated in a subset of TBE patients. Conclusions: In four out of five ELISAs, IgM testing in serum and CSF of TBE patients is specific and confirmative. The lack of IgG specificity in all ELISAs emphasizes the need of confirmatory testing by virus neutralisation, depending on the patient's background and the geographic location of exposure to TBEV. A CSF-serum IgG antibody index can support the diagnosis specifically in chronic disease or once IgM has disappeared.
  • Nurmi, Visa; Hedman, Lea; Perdomo, Maria F.; Weseslindtner, Lukas; Hedman, Klaus (2021)
    Background: Antimicrobial IgG avidity is measured in the diagnosis of infectious disease, for dating of primary infection or immunization. It is generally determined by either of two approaches, termed here the avidity index (AI) or end-point ratio (EPR), which differ in complexity and workload. While several variants of these approaches have been introduced, little comparative information exists on their clinical utility. Methods: This study was performed to systematically compare the performances of these approaches and to design a new sensitive and specific calculation method, for easy implementation in the laboratory. The avidities obtained by AI, EPR, and the newly developed approach were compared, across parvovirus B19, cytomegalovirus, Toxoplasma gondii, rubella virus, and Epstein-Barr virus panels comprising 460 sera from individuals with a recent primary infection or long-term immunity. Results: With optimal IgG concentrations, all approaches performed equally, appropriately discriminating primary infections from past immunity (area under the receiver operating characteristic curve (AUC) 0.93-0.94). However, at lower IgG concentrations, the avidity status (low, borderline, high) changed in 17% of samples using AI (AUC 0.88), as opposed to 4% using EPR (AUC 0.91) and 6% using the new method (AUC 0.93). Conclusions: The new method measures IgG avidity accurately, in a broad range of IgG levels, while the popular AI approach calls for a sufficiently high antibody concentration. (c) 2021 The Authors. Published by Elsevier Ltd on behalf of International Society for Infectious Diseases. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).
  • Kainulainen, Veera; Elf, Sonja; Susi, Petri; Mäki, Minna; Pitkäranta, Anne; Koskinen, Janne O.; Korpela, Riitta; Eboigbodin, Kevin E. (2019)
    Background: Rhinovirus (RV), a major cause of respiratory infection in humans, imposes an enormous economic burden due to the direct and indirect costs associated with the illness. Accurate and timely diagnosis is crucial for deciding the appropriate clinical approach and minimizing unnecessary prescription of antibiotics. Diagnosis of RV is extremely challenging due to genetic and serological variability among its numerous types and their similarity to enteroviruses. Objective: We sought to develop a rapid nucleic acid test that can be used for the detection of Rhinovirus within both laboratory and near patient settings. Study design: We developed and evaluated a novel isothermal nucleic acid amplification method called Reverse Transcription Strand Invasion-Based Amplification (RT-SIBA) to rapidly detect Rhinovirus from clinical specimens. Result: The method, RT-SIBA, detected RV in clinical specimens with high analytical sensitivity (96%) and specificity (100%). The time to positive result was significantly shorter for the RV RT-SIBA assay than for a reference RV nucleic acid amplification method (RT-qPCR). Conclusion: The rapid detection time of the RV SIBA assay, as well as its compatibility with portable instruments, will facilitate prompt diagnosis of infection and thereby improve patient care.
  • Elf, Sonja; Auvinen, Pauliina; Jahn, Lisa; Liikonen, Karoliina; Sjöblom, Solveig; Saavalainen, Päivi; Mäki, Minna; Eboigbodin, Kevin E. (2018)
    Isothermal nucleic acid amplification methods can potentially shorten the amount of time required to diagnose influenza. We developed and evaluated a novel isothermal nucleic acid amplification method, RT-SIBA to rapidly detect and differentiate between influenza A and B viruses in a single reaction tube. The performance of the RT-SIBA Influenza assay was compared with two established RT-PCR methods. The sensitivities of the RT-SIBA, RealStar RT-PCR, and CDC RT-PCR assays for the detection of influenza A and B viruses in the clinical specimens were 98.8%, 100%, and 89.3%, respectively. All three assays demonstrated a specificity of 100%. The average time to positive result was significantly shorter with the RT-SIBA Influenza assay (90 min). The method can be run using battery-operated, portable devices with a small footprint and therefore has potential applications in both laboratory and near-patient settings. (C) 2018 Elsevier Inc. All rights reserved.
  • Guntinas-Lichius, Orlando; Volk, Gerd Fabian; Olsen, Kerry D.; Mäkitie, Antti A.; Silver, Carl E.; Zafereo, Mark E.; Rinaldo, Alessandra; Randolph, Gregory W.; Simo, Ricard; Shaha, Ashok R.; Vander Poorten, Vincent; Ferlito, Alfio (2020)
    Purpose Facial nerve electrodiagnostics is a well-established and important tool for decision making in patients with facial nerve diseases. Nevertheless, many otorhinolaryngologist-head and neck surgeons do not routinely use facial nerve electrodiagnostics. This may be due to a current lack of agreement on methodology, interpretation, validity, and clinical application. Electrophysiological analyses of the facial nerve and the mimic muscles can assist in diagnosis, assess the lesion severity, and aid in decision making. With acute facial palsy, it is a valuable tool for predicting recovery. Methods This paper presents a guideline prepared by members of the International Head and Neck Scientific Group and of the Multidisciplinary Salivary Gland Society for use in cases of peripheral facial nerve disorders based on a systematic literature search. Results Required equipment, practical implementation, and interpretation of the results of facial nerve electrodiagnostics are presented. Conclusion The aim of this guideline is to inform all involved parties (i.e. otorhinolaryngologist-head and neck surgeons and other medical specialists, therapeutic professionals and the affected persons) and to provide practical recommendations for the diagnostic use of facial nerve electrodiagnostics.
  • Venermo, M.; Settembre, N.; Albäck, A.; Vikatmaa, P.; Aho, P. -S.; Lepantalo, M.; Inoue, Y.; Terasaki, H. (2016)
    Background: Ankle brachial index (ABI), toe pressures (TP), and transcutaneous oxygen pressure (TcPO2) are traditionally used in the assessment of critical limb ischemia (CLI). Indocyanine green (ICG) fluorescence imaging can be used to evaluate local circulation in the foot and to evaluate the severity of ischemia. This prospective study analyzed the suitability of a fluorescence imaging system (photodynamic eye [PDE]) in CLI. Material and methods: Forty-one patients with CLI were included. Of the patients, 66% had diabetes and there was an ischemic tissue lesion in 70% of the limbs. ABI, toe pressures, TcPO2 and ICG-fluorescence imaging (ICG-FI) were measured in each leg. To study the repeatability of the ICG-FI, each patient underwent the study twice. After the procedure, foot circulation was measured using a time-intensity curve, where T1/2 (the time needed to achieve half of the maximum fluorescence intensity) and PDE10 (increase of the intensity during the first 10 s) were determined. A time-intensity curve was plotted using the same areas as for the TcPO2 probes (n=123). Results: The mean ABI was 0.43, TP 21 mmHg, TcPO2 23 mmHg, T1/2 38 5, and PDE10 19 AU. Time-intensity curves were repeatable. In a Bland-Altman scatter plot, the 95% limits of agreement of PDE10 was 9.9 AU and the corresponding value of T1/2 was 14 s. Correlation between ABI and TP was significant (R=.73, p Conclusions: According to this pilot study, ICG-Fl with PDE can be used in the assessment of blood supply in the ischemic foot. (C) 2016 European Society for Vascular Surgery. Published by Elsevier Ltd. All rights reserved.
  • Olkkonen, Vesa; Gylling, Helena; Ikonen, Elina (2017)
    Non-cholesterol sterols are present in our body at very low concentrations as compared to cholesterol. Small changes in the structure of sterol molecules confer them highly distinct biological activities. The best-known example are steroid hormones derived from cholesterol. During the past decade, our knowledge of also other biomolecules related to or derived from cholesterol, particularly plant sterols, biosynthetic precursors of cholesterol, and oxysterols, has expanded rapidly. In this review article we recapitulate the latest insights into the properties and physiological activities of these non-cholesterol sterols, as well as their importance in disease processes and potential as diagnostic biomarkers. (C) 2015 Elsevier Ltd. All rights reserved.
  • Laitinen, Juulia (Helsingin yliopisto, 2020)
    Status epilepticus on elimistön hätätila, johon liittyy merkittävä vammautumis- sekä kuolleisuusriski. Päivystyksellinen elektroenkefalografia (EEG) on nonkonvulsiivisen status epilepticuksen diagnosoinnin tärkeä työkalu. Status epilepticuksen nopea hoito parantaa potilaan ennustetta ja ehkäisee vakavia komplikaatioita. Tutkimus pyrkii selvittämään virka-ajan ulkopuolisten EEG-tutkimusten kysyntää, löydöksiä sekä osuvuutta nonkonvulsiivisen status epilepticuksen diagnosoinnissa. Tutkimus antaa Kliinisen neurofysiologian osastolle objektiivista tietoa nykyisten EEG-käytäntöjen toimivuudesta. Retrospektiivinen arkistotutkimus käsittelee potilaita, joille tehtiin 8-kanavainen myssy-EEG virka-ajan ulkopuolella vuosina 2018-2020 HUS Meilahden sairaalassa. Vuosien 2013-2016 potilaista on tehty pilottitutkimus, jonka tuloksiin vertaamme viime vuosien tilannetta. Myssy-EEG tehtiin kahden vuoden aikana virka-ajan ulkopuolella 160 potilaalle. Status epilepticuksia löytyi vain 6% rekisteröinneistä. Suurin osa löydöksistä oli normaaleja tai yleishäiriöitä. 26% potilaista tehtiin 21-kanavainen kontrolli-EEG-rekisteröinti, jonka tulos vastasi varsin hyvin myssy-EEG:tä. Elektrodipaikkojen muutos keväällä 2019 ei lisännyt status epilepticus-löydöksiä. Tässä tutkimuksessa ei saatu viitteitä siitä, että myssy-EEG olisi yhdessäkään tapauksessa jättänyt SE:n tunnistamatta. Öisin rekisteröityjä myssy-EEG:itä tarkasteltiin vuosina 2016-2020. Tuona aikana rekisteröinti tehtiin 31 potilaalle. Status epilepticuksia esiintyi öisinkin 6 prosentissa rekisteröinneistä. Neurologit osasivat poissulkea status epilepticuksen varsin hyvin, mutta kolmasosa potilaista hoidettiin silti kliinisen oireilun perusteella. Yksikään SE ei jäänyt vaille hoitoa. Sekä päivystys-EEG:t että status epilepticukset painottuvat selvästi virka-aikaan. Virka-ajan ulkopuolisten EEG-rekisteröintien määrä on kasvanut viime vuosina, mutta status epilepticuksien määrä on pysynyt samana. Myssy-EEG tunnistaa status epilepticuksen riittävän tarkasti. Nykyinen EEG-käytäntö on toimiva ja luotettava status epilepticuksen diagnostiikan osalta.