Augmented histamine test,ewald test meal,and diagnex test

Summary and conclusions The augmented histamine test, the Ewald test meal, and the Diagnex tests have been compared in a series of 130 patients. The results indicate that although the results of these tests follow the same trend in a group of patients, no one test can be used to predict satisfactorily the results of the other two tests in the majority of individual patients.Although the Ewald test is as informative as the augmented histamine test in supporting a clinical diagnosis of duodenal ulcer, the latter shows most clearly the wide variations in the degree of hypersecretion in different patients with duodenal ulcer and is the most reliable test for establishing the presence of achlorhydria. The augmented histamine test is virtually free of any serious side effects and, furthermore, provides a reliable index of the parietal-cell mass. The augmented histamine test would thus appear to be of particular value as a guide to the nature and extent of surgery necessary for the satisfactory reduction of acid secretion in patients with peptic ulcer.Our findings support the claims made by previous workers regarding the value of the Diagnex test in the screening of large numbers of patients for achlorhydria or marked hypochlorhydria. Apart from its usefulness as an initial screening test in cancer detection programs, the test has a limited place in excluding a diagnosis of pericious anemia or duodenal ulcer.We wish to record our deep obligation to E. R. Squibb and Sons, New York, for supplies of Diagnex Blue and Diagnex reagent, and to Merck Sharp and Dohme, West Point, Pa. for supplies of Neo-Antergan maleate.     

Multiple sleep latency test and maintenance of wakefulness test

Excessive daytime sleepiness and fatigue are common complaints in the sleep clinic. The objective evaluation and quantification of these symptoms is important for both the diagnosis of underlying health problems and for gauging treatment response. The multiple sleep latency test measures physiologic sleepiness, whereas the maintenance of wakefulness test (MWT) aims to measure manifest sleepiness. Neither test correlates well with subjective measures of sleep such as the Epworth sleepiness scale and the Stanford sleepiness scale. Although in the past methodological testing differences existed, in 2005 updated practice parameters were published, promoting the standardization of testing procedures. In recent years, there has been an effort to document daytime sleepiness when associated with occupational risk. However, these laboratory-based tests may not reflect or predict real-life experience. Normative data for both tests, particularly the MWT, are limited, and are inadequate for the evaluation of pediatric patients, shift workers, and others.     

Multiple sleep latency test and maintenance of wakefulness test

In addition to overnight polysomnography, there are two special tests with which every sleep technologist should be familiar: the multiple sleep latency test and the maintenance of wakefulness test. These two tests classify excessive daytime sleepiness using objective data. The role of the sleep technologist is to understand and perform an accurate test so that sleep clinicians can use that data in diagnosing and treating their patients. This article provides step-by-step directions for performing these tests.     

Comparison of the pancreozymin-secretin test and the Lundh test meal

The pancreozymin-secretin test and the Lundh test meal were performed on different days for comparison. Statistically significant differences in six parameters indicate that the pancreozymin-secretin test is more sensitive in detecting mild, acute or chronic pancreatic disease (P<.01). Results of the Lundh test meal were clearly abnormal in patients with severe chronic pancreatic disease.     

凝聚胺法和抗人球蛋白法在交叉配血试验中的应用

目的:对凝聚胺法和抗人球蛋白法在交叉配血试验中结果不符进行分析,提出此情况下准确发布实验结果和及时解决问题的方案.方法:收集了8例临床交叉配血结果异常的病例,ABO以外抗体筛查和自身对照实验采用抗人球蛋白法,交叉配血试验采用盐水法、聚凝胺法和抗人球蛋白法.结果:ABO以外抗体筛查阳性,自身对照实验为阴性,8例病例均出现盐水法和聚凝胺法的主侧无凝集,而抗人球蛋白法的主侧凝集.结论:凝聚胺法在筛查IgG类抗体的灵敏度不如抗人球蛋白法,采用凝聚胺法和抗人球蛋白法进行交叉配血试验,遇到异常的实验结果时,应以抗人球蛋白法为准.     

Spirometry: quantitative test criteria and test acceptability

Quantitative test criteria have been developed to assess the acceptability of spirometric tracings. Most automated spirometers have been programmed with the criteria in order to assist in data collection. These instruments compare computed parameters from the collected tracings with the criteria and, after 3 acceptable FVC maneuvers have been collected, print out a statement indicating that "tests meet acceptability criteria." Technicians, nurses, and even their medical supervisors are beginning to rely on these statements as assuring overall test quality. However, a review of actual curves indicates that unacceptable results can be obtained from tests that comply with these standards. Although quantitative test criteria are a positive step toward quality assurance, they should be treated as they were developed, as "minimum" criteria. All curves should be inspected for visible defects, especially if the results are used to follow subjects longitudinally.     

A quantitative test for xerostomia. The Saxon test, an oral equivalent of the Schirmer test

We describe a simple, reproducible, and low-cost test for xerostomia, which involves chewing on a folded sterile sponge for 2 minutes. Saliva production is quantitated by weighing the sponge before and after chewing. Normal control subjects produced greater than or equal to 2.75 gm of saliva in 2 minutes. Three of 32 consecutive, unselected outpatients in allergy-immunology clinics and 9 of 38 patients in rheumatology clinics had decreased saliva production, which was significantly different compared with controls (P less than 0.01). The presence of sicca symptoms was highly correlated with quantitatively abnormal tear and saliva production, according to the results of the Saxon and Schirmer's tests.     

Pancreolauryl test

The sensitivity and specificity of the pancreolauryl test was evaluated in comparison with the NBT-PABA test, the estimation of fecal chymotrypsin and fat, and the secretin-pancreozymin test in 168 patients with and without pancreatic disease. The overall sensitivity rate was as follows: pancreolauryl test 90%, NBT-PABA test 86%, fecal chymotrypsin 66%. In patients with pancreatic steatorrhea the sensitivity of the pancreolauryl test was 100%, the NBT-PABA test 97%, and the fecal chymotrypsin estimation 92%. The specificity of these tests was: pancreolauryl test 97.6%, fecal chymotrypsin 87%, and NBT-PABA test 81.8%. The pancreolauryl test may be recommended as a noninvasive easy-to-perform tubeless pancreatic function test with a sufficiently high sensitivity and specificity.     

Impact on HIV test providers of giving a positive test result

The provision of a positive HIV antibody test result and the direction and support given to the test recipient are critical components of care and prevention. There has been little research that describes what happens in such interactions between recipient and provider. The impact on the test provider of delivering the HIV test result is an important issue to consider. The discomfort experienced by some health providers in giving a positive test result may have adverse effects on the client interaction or may carry over into subsequent client interactions. Utilizing a thematic analysis on interview data from 24 HIV test providers, we describe the impact of delivering a positive test result on HIV test providers, identify the factors that influence this impact, and describe strategies used to manage the impact. As with other health care professionals communicating "bad news,"HIV test providers experience a variety of impacts. While a small number of providers indicated little or no impact of delivering the HIV positive test result because the diagnosis is 'not the end of the world,' most indicated it was difficult as it was anticipated that the test recipient would (or did) find the news distressing. Several coping strategies were identified.