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Morovati H, Kord M, Ahmadikia K, Eslami S, Hemmatzadeh M, Kurdestani KM, Khademi M, Darabian S. A Comprehensive Review of Identification Methods for Pathogenic Yeasts: Challenges and Approaches. Adv Biomed Res 2023; 12:187. [PMID: 37694259 PMCID: PMC10492613 DOI: 10.4103/abr.abr_375_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Revised: 03/04/2023] [Accepted: 03/06/2023] [Indexed: 09/12/2023] Open
Abstract
Given the increasing incidence of yeast infections and the presence of drug-resistant isolates, accurate identification of the pathogenic yeasts is essential for the management of yeast infections. In this review, we tried to introduce the routine and novel techniques applied for yeast identification. Laboratory identification methods of pathogenic yeast are classified into three categories; I. conventional methods, including microscopical and culture-base methods II. biochemical/physiological-processes methods III. molecular methods. While conventional and biochemical methods require more precautions and are not specific in some cases, molecular diagnostic methods are the optimum tools for diagnosing pathogenic yeasts in a short time with high accuracy and specificity, and having various methods that cover different purposes, and affordable costs for researchers. Nucleotide sequencing is a reference or gold standard for identifying pathogenic yeasts. Since it is an expensive method, it is not widely used in developing countries. However, novel identification techniques are constantly updated, and we recommend further studies in this field. The results of this study will guide researchers in finding more accurate diagnostic method(s) for their studies in a short period of time.
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Affiliation(s)
- Hamid Morovati
- Department of Parasitology and Mycology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mohammad Kord
- Department of Medical Parasitology and Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Kazem Ahmadikia
- Department of Medical Parasitology and Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Saba Eslami
- Central Research Laboratory, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Masoumeh Hemmatzadeh
- Department of Mycology, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
| | - Kian M. Kurdestani
- Department of Microbiology, Sanandaj Branch, Islamic Azad University, Sanandaj, Iran
| | | | - Sima Darabian
- Department of Medical Parasitology and Mycology, School of Medicine, Zanjan University of Medical Sciences, Zanjan, Iran
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2
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Picone DS, Stoneman E, Cremer A, Schultz MG, Otahal P, Hughes AD, Black JA, Bos WJ, Chen CH, Cheng HM, Dwyer N, Lacy P, Laugesen E, Liang F, Kim HL, Ohte N, Okada S, Omboni S, Ott C, Pereira T, Pucci G, Rajani R, Schmieder R, Sinha MD, Stewart R, Stouffer GA, Takazawa K, Wang J, Weber T, Westerhof BE, Williams B, Yamada H, Sharman JE. Sex Differences in Blood Pressure and Potential Implications for Cardiovascular Risk Management. Hypertension 2023; 80:316-324. [PMID: 35912678 DOI: 10.1161/hypertensionaha.122.19693] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
BACKGROUND Accurate blood pressure (BP) measurement is critical for optimal cardiovascular risk management. Age-related trajectories for cuff-measured BP accelerate faster in women compared with men, but whether cuff BP represents the intraarterial (invasive) aortic BP is unknown. This study aimed to determine the sex differences between cuff BP, invasive aortic BP, and the difference between the 2 measurements. METHODS Upper-arm cuff BP and invasive aortic BP were measured during coronary angiography in 1615 subjects from the Invasive Blood Pressure Consortium Database. This analysis comprised 22 different cuff BP devices from 28 studies. RESULTS Subjects were 64±11 years (range 40-89) and 32% women. For the same cuff systolic BP (SBP), invasive aortic SBP was 4.4 mm Hg higher in women compared with men. Cuff and invasive aortic SBP were higher in women compared with men, but the sex difference was more pronounced from invasive aortic SBP, was the lowest in younger ages, and the highest in older ages. Cuff diastolic blood pressure overestimated invasive diastolic blood pressure in both sexes. For cuff and invasive diastolic blood pressure separately, there were sex*age interactions in which diastolic blood pressure was higher in younger men and lower in older men, compared with women. Cuff pulse pressure underestimated invasive aortic pulse pressure in excess of 10 mm Hg for both sexes in older age. CONCLUSIONS For the same cuff SBP, invasive aortic SBP was higher in women compared with men. How this translates to cardiovascular risk prediction needs to be determined, but women may be at higher BP-related risk than estimated by cuff measurements.
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Affiliation(s)
- Dean S Picone
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia (D.S.P., E.S., M.G.S., P.O., J.A.B., N.D.)
| | - Elif Stoneman
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia (D.S.P., E.S., M.G.S., P.O., J.A.B., N.D.)
| | - Antoine Cremer
- Department of Cardiology/Hypertension, University Hospital of Bordeaux, France (A.C.)
| | - Martin G Schultz
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia (D.S.P., E.S., M.G.S., P.O., J.A.B., N.D.)
| | - Petr Otahal
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia (D.S.P., E.S., M.G.S., P.O., J.A.B., N.D.)
| | - Alun D Hughes
- MRC Unit for Lifelong Health and Ageing at UCL, Institute of Cardiovascular Sciences, University College London, United Kingdom (A.D.H.)
| | - J Andrew Black
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia (D.S.P., E.S., M.G.S., P.O., J.A.B., N.D.).,Royal Hobart Hospital, Hobart, Australia (J.A.B., N.D.)
| | - Willem Jan Bos
- Department of Internal Medicine, St Antonius Hospital, Nieuwegein, The Netherlands (W.J.B.).,Department of Internal Medicine, Leiden University Medical Center, The Netherlands (W.J.B.)
| | - Chen-Huan Chen
- Department of Internal Medicine, National Yang Ming Chiao Tung University College of Medicine (C.-H.C.)
| | - Hao-Min Cheng
- Department of Medicine (H.-M.C.), National Yang Ming Chiao Tung University College of Medicine, Taipei, Taiwan.,Institute of Public Health (H.-M.C.), National Yang Ming Chiao Tung University College of Medicine, Taipei, Taiwan.,Center for Evidence-based Medicine (H.-M.C.), Taipei Veterans General Hospital, Taiwan.,Department of Medical Education (H.-M.C.), Taipei Veterans General Hospital, Taiwan.,Institute of Health and Welfare Policy, National Yang Ming Chiao Tung University College of Medicine, Taipei, Taiwan (H.-M.C.)
| | - Nathan Dwyer
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia (D.S.P., E.S., M.G.S., P.O., J.A.B., N.D.).,Royal Hobart Hospital, Hobart, Australia (J.A.B., N.D.)
| | - Peter Lacy
- Institute of Cardiovascular Sciences University College London (UCL) and National Institute for Health Research (NIHR) UCL/UCL Hospitals Biomedical Research Centre, United Kingdom (P.L., B.W.)
| | - Esben Laugesen
- Department of Endocrinology and Internal Medicine, Aarhus University Hospital, Denmark (E.L.)
| | - Fuyou Liang
- School of Naval Architecture, Ocean and Civil Engineering, Shanghai Jiao Tong University, China (F.L.).,World-Class Research Center "Digital biodesign and personalized healthcare", Sechenov First Moscow State Medical University, Russia (F.L.)
| | - Hack-Lyoung Kim
- Division of Cardiology, Seoul National University Boramae Hospital, Seoul, South Korea (H.-L.K.)
| | - Nobuyuki Ohte
- Department of Cardio-Renal Medicine and Hypertension, Nagoya City University Graduate School of Medical Sciences, Japan (N.O.)
| | - Sho Okada
- Department of Cardiovascular Medicine, Chiba University Graduate School of Medicine, Japan (S.O.)
| | - Stefano Omboni
- Clinical Research Unit, Italian Institute of Telemedicine, Varese, Italy (S.O.).,Department of Cardiology, Sechenov First Moscow State Medical University, Russian Federation (S.O.)
| | - Christian Ott
- Department of Nephrology and Hypertension, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nürnberg, Germany (C.O., R.S.)
| | - Telmo Pereira
- Polytechnic Institute of Coimbra, Coimbra Health School, Coimbra, Portugal (T.P.).,Laboratory for Applied Health Research (LabinSaúde), Coimbra, Portugal (T.P.)
| | - Giacomo Pucci
- Unit of Internal Medicine at Terni University Hospital, Department of Medicine, University of Perugia, Italy (G.P.)
| | - Ronak Rajani
- Cardiology Department, Guy's and St. Thomas' Hospitals, London, United Kingdom (R.R.)
| | - Roland Schmieder
- Department of Nephrology and Hypertension, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nürnberg, Germany (C.O., R.S.)
| | - Manish D Sinha
- Kings College London British Heart Foundation Centre and Department of Clinical Pharmacology and Department of Paediatric Nephrology, Evelina London Children's Hospital, Guy's and St. Thomas' NHS Foundation Trust, United Kingdom (M.D.S)
| | - Ralph Stewart
- Green Lane Cardiovascular Service, Auckland City Hospital, University of Auckland, New Zealand (R.S.)
| | - George A Stouffer
- Division of Cardiology, University of North Carolina at Chapel Hill, Chapel Hill (G.A.S)
| | - Kenji Takazawa
- Center for Health Surveillance and Preventive Medicine, Tokyo Medical University Hospital, Japan (K.T.)
| | - Jiguang Wang
- Centre for Epidemiological Studies and Clinical Trials, Shanghai Key Laboratory of Hypertension, The Shanghai Institute of Hypertension, Department of Hypertension, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, China (J.W.)
| | - Thomas Weber
- Cardiology Department, Klinikum Wels-Grieskirchen, Austria (T.W.)
| | - Berend E Westerhof
- Department of Pulmonary Medicine, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Cardiovascular Sciences, The Netherlands (B.E.W.)
| | - Bryan Williams
- Institute of Cardiovascular Sciences University College London (UCL) and National Institute for Health Research (NIHR) UCL/UCL Hospitals Biomedical Research Centre, United Kingdom (P.L., B.W.)
| | - Hirotsugu Yamada
- Department of Community Medicine for Cardiology, Tokushima Graduate School of Biomedical Sciences, Japan (H.Y.)
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Toennesen LL, Vindum HH, Risom E, Pulga A, Nessar RM, Arshad A, Christophersen A, Park YS, Cold KM, Konge L, Clementsen PF. When Pulmonologists Are Novice to Navigational Bronchoscopy, What Predicts Diagnostic Yield? Diagnostics (Basel) 2022; 12:diagnostics12123127. [PMID: 36553134 PMCID: PMC9777088 DOI: 10.3390/diagnostics12123127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Revised: 12/05/2022] [Accepted: 12/07/2022] [Indexed: 12/14/2022] Open
Abstract
Predicting factors of diagnostic yield in electromagnetic navigation bronchoscopy (ENB) have been explored in a number of previous studies based on data from experienced operators. However, little is known about predicting factors when the procedure is carried out by operators in the beginning of their learning curve. We here aim to identify the role of operators' experience as well as lesion- and procedure characteristics on diagnostic yield of ENB procedures in the hands of novice ENB operators. Four operators from three centers without prior ENB experience were enrolled. The outcome of consecutive ENB procedures was assessed and classified as either diagnostic or non-diagnostic and predicting factors of diagnostic yield were assessed. A total of 215 procedures were assessed. A total of 122 (57%) of the ENB procedures resulted in diagnostic biopsies. Diagnostic ENB procedures were associated with a minor yet significant difference in tumor size compared to non-diagnostic/inconclusive ENB procedures (28 mm vs. 24 mm; p = 0.03). Diagnostic ENB procedures were associated with visible lesions at either fluoroscopy (p = 0.003) or radial endobronchial ultrasound (rEBUS), (p = 0.001). In the logistic regression model, lesion visibility on fluoroscopy, but none of operator experience, the presence of a bronchus sign, lesion size, or location nor visibility on rEBUS significantly impacted the diagnostic yield. In novice ENB operators, lesion visibility on fluoroscopy was the only factor found to increase the chance of obtaining a diagnostic sample.
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Affiliation(s)
- Louise L. Toennesen
- Department of Pulmonary Medicine, Copenhagen University Hospital, 2650 Hvidovre, Denmark
| | - Helene H. Vindum
- Department of Onchology, Aarhus University Hospital, 8200 Aarhus, Denmark
| | - Ellen Risom
- Department of Pulmonary Medicine, Odense University Hospital, 5000 Odense, Denmark
| | - Alexis Pulga
- Department of Pulmonary Medicine, Bispebjerg University Hospital, 2400 Copenhagen, Denmark
| | - Rafi M. Nessar
- Department of Pulmonary Medicine, Zealand University Hospital, 4000 Roskilde, Denmark
| | - Arman Arshad
- Department of Pulmonary Medicine, Odense University Hospital, 5000 Odense, Denmark
| | - Alice Christophersen
- Department of Pulmonary Medicine, Odense University Hospital, 5000 Odense, Denmark
| | - Yoon Soo Park
- Massachusetts General Hospital, Boston, MA 02114, USA
- Harvard Medical School, Boston, MA 02115, USA
| | - Kristoffer Mazanti Cold
- Faculty of Health and Medical Sciences, University of Copenhagen, 1165 Copenhagen, Denmark
- Copenhagen Academy for Medical Education and Simulation (CAMES), Rigshospitalet, University of Copenhagen and the Capital Region of Denmark, 1165 Copenhagen, Denmark
- Correspondence: ; Tel.: +45-38623862
| | - Lars Konge
- Faculty of Health and Medical Sciences, University of Copenhagen, 1165 Copenhagen, Denmark
- Copenhagen Academy for Medical Education and Simulation (CAMES), Rigshospitalet, University of Copenhagen and the Capital Region of Denmark, 1165 Copenhagen, Denmark
| | - Paul Frost Clementsen
- Faculty of Health and Medical Sciences, University of Copenhagen, 1165 Copenhagen, Denmark
- Copenhagen Academy for Medical Education and Simulation (CAMES), Rigshospitalet, University of Copenhagen and the Capital Region of Denmark, 1165 Copenhagen, Denmark
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4
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Seo HS, Park JS, Oh YW, Sung D, Lee AL. [Peer Review of Teleradiology at a Teleradiology Clinic: Comparison of Unacceptable Diagnosis and Clinically Significant Discrepancy between Radiology Sections and Imaging Modalities]. Taehan Yongsang Uihakhoe Chi 2021; 82:1545-1555. [PMID: 36238883 PMCID: PMC9431982 DOI: 10.3348/jksr.2020.0187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Revised: 01/18/2021] [Accepted: 02/03/2021] [Indexed: 11/15/2022]
Abstract
Purpose The purpose of this study was to evaluate the rates of unacceptable diagnosis and clinically significant diagnostic discrepancy in radiology sections and imaging modalities through a peer review of teleradiology. Materials and Methods Teleradiology peer reviews in a Korean teleradiology clinic in 2018 and 2019 were included. The peer review scores were classified as acceptable and unacceptable diagnoses and clinically insignificant and significant diagnostic discrepancy. The diagnostic discrepancy rates and clinical significance were compared among radiology sections and imaging modalities using the chi-square test. Results Of 1312 peer reviews, 117 (8.9%) cases had unacceptable diagnoses. Of 462 diagnostic discrepancies, the clinically significant discrepancy was observed in 104 (21.6%) cases. In radiology sections, the unacceptable diagnosis was highest in the musculoskeletal section (21.4%) (p < 0.05), followed by the abdominal section (7.3%) and neuro section (1.3%) (p < 0.05). The proportion of significant discrepancy was higher in the chest section (32.7%) than in the musculoskeletal (19.5%) and abdominal sections (17.1%) (p < 0.05). Regarding modalities, the number of unacceptable diagnoses was higher with MRI (16.2%) than plain radiology (7.8%) (p < 0.05). There was no significant difference in significant discrepancy. Conclusion Peer review provides the rates of unacceptable diagnosis and clinically significant discrepancy in teleradiology. These rates also differ with subspecialty and modality.
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5
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Valla V, Alzabin S, Koukoura A, Lewis A, Nielsen AA, Vassiliadis E. Companion Diagnostics: State of the Art and New Regulations. Biomark Insights 2021; 16:11772719211047763. [PMID: 34658618 PMCID: PMC8512279 DOI: 10.1177/11772719211047763] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Accepted: 09/02/2021] [Indexed: 11/15/2022] Open
Abstract
Companion diagnostics (CDx) hail promise of improving the drug development
process and precision medicine. However, there are various challenges involved
in the clinical development and regulation of CDx, which are considered
high-risk in vitro diagnostic medical devices given the role they play in
therapeutic decision-making and the complications they may introduce with
respect to their sensitivity and specificity. The European Union (E.U.) is
currently in the process of bringing into effect in vitro Diagnostic Medical
Devices Regulation (IVDR). The new Regulation is introducing a wide range of
stringent requirements for scientific validity, analytical and clinical
performance, as well as on post-market surveillance activities throughout the
lifetime of in vitro diagnostics (IVD). Compliance with General Safety and
Performance Requirements (GSPRs) adopts a risk-based approach, which is also the
case for the new classification system. This changing regulatory framework has
an impact on all stakeholders involved in the IVD Industry, including Authorized
Representatives, Distributors, Importers, Notified Bodies, and Reference
Laboratories and is expected to have a significant effect on the development of
new CDx.
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Affiliation(s)
| | - Saba Alzabin
- Department of Oncological Science, Icahn School of Medicine at Mount Sinai, New York, NY, USA.,Elm Scientific Ltd., London, UK
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6
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Nitkiewicz S, Barański R, Galewski M, Zajączkiewicz H, Kukwa A, Zając A, Ejdys S, Artiemjew P. Requirements for Supporting Diagnostic Equipment of Respiration Process in Humans. Sensors (Basel) 2021; 21:3479. [PMID: 34067611 DOI: 10.3390/s21103479] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Revised: 04/30/2021] [Accepted: 05/13/2021] [Indexed: 11/24/2022]
Abstract
There is abundant worldwide research conducted on the subject of the methods of human respiration process examination. However, many of these studies describe methods and present the results while often lacking insight into the hardware and software aspects of the devices used during the research. This paper’s goal is to present new equipment for assessing the parameters of human respiration, which can be easily adopted for daily diagnosis. This work deals with the issue of developing the correct method of obtaining measurement data. The requirements of the acquisition parameters are clearly pointed out and examples of the medical applications of the described device are shown. Statistical analysis of acquired signals proving its usability is also presented. In the examples of selected diseases of the Upper Respiratory Tract (URT), the advantages of the developed apparatus for supporting the diagnosis of URT patency have been proven.
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7
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Reguera-García MM, Leirós-Rodríguez R, Álvarez-Barrio L, Alonso-Cortés Fradejas B. Analysis of Postural Control in Sitting by Pressure Mapping in Patients with Multiple Sclerosis, Spinal Cord Injury and Friedreich's Ataxia: A Case Series Study. Sensors (Basel) 2020; 20:E6488. [PMID: 33202927 DOI: 10.3390/s20226488] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Revised: 11/09/2020] [Accepted: 11/11/2020] [Indexed: 11/20/2022]
Abstract
The postural control assessments in patients with neurological diseases lack reliability and sensitivity to small changes in patient functionality. The appearance of pressure mapping has allowed quantitative evaluation of postural control in sitting. This study was carried out to determine the evaluations in pressure mapping and verifying whether they are different between the three sample groups (multiple sclerosis, spinal cord injury and Friedreich’s ataxia), and to determine whether the variables extracted from the pressure mapping analysis are more sensitive than functional tests to evaluate the postural trunk control. A case series study was carried out in a sample of 10 adult patients with multiple sclerosis (n = 2), spinal cord injury (n = 4) and Friedreich’s ataxia (n = 4). The tests applied were: pressure mapping, seated Lateral Reach Test, seated Functional Reach Test, Berg Balance Scale, Posture and Postural Ability Scale, Function in Sitting Test, and Trunk Control Test. The participants with Friedreich’s ataxia showed a tendency to present a higher mean pressure on the seat of subject’s wheelchair compared to other groups. In parallel, users with spinal cord injury showed a tendency to present the highest values of maximum pressure and area of contact. People with different neurological pathologies and similar results in functional tests have very different results in the pressure mapping. Although it is not possible to establish a strong statistical correlation, the relationships between the pressure mapping variables and the functional tests seem to be numerous, especially in the multiple sclerosis group.
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Rodríguez-Almagro D, Obrero-Gaitán E, Lomas-Vega R, Zagalaz-Anula N, Osuna-Pérez MC, Achalandabaso-Ochoa A. New Mobile Device to Measure Verticality Perception: Results in Young Subjects with Headaches. Diagnostics (Basel) 2020; 10:E796. [PMID: 33036468 PMCID: PMC7601549 DOI: 10.3390/diagnostics10100796] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2020] [Revised: 09/30/2020] [Accepted: 10/02/2020] [Indexed: 02/07/2023] Open
Abstract
The subjective visual vertical (SVV) test has been frequently used to measure vestibular contribution to the perception of verticality. Recently, mobile devices have been used to efficiently perform this measurement. The aim of this study was to analyze the perception of verticality in subjects with migraines and headaches. A cross-sectional study was conducted that included 28 patients with migraine, 74 with tension-type headache (TTH), and 93 healthy subjects. The SVV test was used through a new virtual reality system. The mean absolute error (MAE) of degrees deviation was also measured to qualify subjects as positive when it was greater than 2.5°. No differences in the prevalence of misperception in verticality was found among healthy subjects (31.18%), migraineurs (21.43%), or those with TTH (33.78%) (p = 0.480). The MAE was not significantly different between the three groups (migraine = 1.36°, TTH = 1.61°, and healthy = 1.68°) (F = 1.097, p = 0.336, and η2 = 0.011). The perception of verticality could not be explained by any variable usually related to headaches. No significant differences exist in the vestibular contribution to the perception of verticality between patients with headaches and healthy subjects. New tests measuring visual and somatosensory contribution should be used to analyze the link between the perception of verticality and headaches.
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Affiliation(s)
| | | | - Rafael Lomas-Vega
- Department of Health Science, University of Jaén, Paraje Las Lagunillas s/n, 23071 Jaén, Spain; (D.R.-A.); (E.O.-G.); (N.Z.-A.); (M.C.O.-P.); (A.A.-O)
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9
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Affiliation(s)
- James E Sharman
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia (J.E.S.)
| | - Raj Padwal
- Department of Medicine, University of Alberta, Edmonton, Canada (R.P.)
| | - Norm R C Campbell
- Department of Medicine, Physiology and Pharmacology and Community Health Sciences, O'Brien Institute for Public Health and Libin Cardiovascular Institute of Alberta, University of Calgary, Canada (N.R.C.C.)
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10
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Sharman JE, O’Brien E, Alpert B, Schutte AE, Delles C, Olsen MH, Asmar R, Atkins N, Barbosa E, Calhoun D, Campbell NR, Chalmers J, Benjamin I, Jennings G, Laurent S, Boutouyrie P, Lopez-Jaramillo P, McManus RJ, Mihailidou AS, Ordunez P, Padwal R, Palatini P, Parati G, Poulter N, Rakotz MK, Rosendorff C, Saladini F, Scuteri A, Barroso WS, Cho MC, Sung KC, Townsend RR, Wang JG, Hansen TW, Wozniak G, Stergiou G. [Lancet Commission on Hypertension Group position statement on the global improvement of accuracy standards for devices that measure blood pressurePosicionamento do Grupo da Lancet Commission on Hypertension sobre a melhoria global dos padrões de acurácia para aparelhos que medem a pressão arterial]. Rev Panam Salud Publica 2020; 44:e21. [PMID: 32117468 PMCID: PMC7039279 DOI: 10.26633/rpsp.2020.21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2019] [Accepted: 08/14/2019] [Indexed: 11/24/2022] Open
Abstract
The Lancet Commission on Hypertension identified that a key action to address the worldwide burden of high blood pressure (BP) was to improve the quality of BP measurements by using BP devices that have been validated for accuracy. Currently, there are over 3 000 commercially available BP devices, but many do not have published data on accuracy testing according to established scientific standards. This problem is enabled through weak or absent regulations that allow clearance of devices for commercial use without formal validation. In addition, new BP technologies have emerged (e.g. cuffless sensors) for which there is no scientific consensus regarding BP measurement accuracy standards. Altogether, these issues contribute to the widespread availability of clinic and home BP devices with limited or uncertain accuracy, leading to inappropriate hypertension diagnosis, management and drug treatment on a global scale. The most significant problems relating to the accuracy of BP devices can be resolved by the regulatory requirement for mandatory independent validation of BP devices according to the universally-accepted International Organization for Standardization Standard. This is a primary recommendation for which there is an urgent international need. Other key recommendations are development of validation standards specifically for new BP technologies and online lists of accurate devices that are accessible to consumers and health professionals. Recommendations are aligned with WHO policies on medical devices and universal healthcare. Adherence to recommendations would increase the global availability of accurate BP devices and result in better diagnosis and treatment of hypertension, thus decreasing the worldwide burden from high BP.
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Affiliation(s)
- James E. Sharman
- Menzies Institute for Medical ResearchUniversidad de TasmaniaHobartTasmaniaAustraliaMenzies Institute for Medical Research, Universidad de Tasmania, Hobart, Tasmania, Australia.
| | - Eoin O’Brien
- The Conway InstituteUniversity College DublinDublínIrlandaThe Conway Institute, University College Dublin, Dublín, Irlanda.
| | - Bruce Alpert
- Centro de Ciencias de la SaludUniversidad de TennesseeMemphisTennesseeEstados UnidosCentro de Ciencias de la Salud, Universidad de Tennessee, Memphis, Tennessee, Estados Unidos (retirado)
| | - Aletta E. Schutte
- Equipo de investigación en hipertensión en África, Medical Research Council Unit for Hypertension and Cardiovascular DiseaseUniversidad del NoroestePotchefstroomSudáfricaEquipo de investigación en hipertensión en África, Medical Research Council Unit for Hypertension and Cardiovascular Disease, Universidad del Noroeste, Potchefstroom, Sudáfrica.
| | - Christian Delles
- Institute of Cardiovascular and Medical SciencesUniversidad de GlasgowGlasgowReino UnidoInstitute of Cardiovascular and Medical Sciences, Universidad de Glasgow, Glasgow, Reino Unido.
| | - Michael Hecht Olsen
- Departamento de Medicina Interna, Hospital Holbaek, Holbaek, Dinamarca; y Centre for Individualized Medicine in Arterial Diseases (CIMA), Hospital de la Universidad de OdenseUniversidad de Dinamarca MeridionalOdenseDinamarcaDinamarcaDepartamento de Medicina Interna, Hospital Holbaek, Holbaek, Dinamarca; y Centre for Individualized Medicine in Arterial Diseases (CIMA), Hospital de la Universidad de Odense, Universidad de Dinamarca Meridional, Odense, Dinamarca.
| | - Roland Asmar
- Institutos de la Fundación para la Investigación MédicaInstitutos de la Fundación para la Investigación MédicaGinebraSuizaInstitutos de la Fundación para la Investigación Médica, Ginebra, Suiza.
| | - Neil Atkins
- Medaval LtdaMedaval LtdaDublínIrlandaMedaval Ltda., Dublín, Irlanda.
| | - Eduardo Barbosa
- Liga para la hipertensión de Porto AlegreLiga para la hipertensión de Porto AlegrePorto AlegreBrasilLiga para la hipertensión de Porto Alegre, Porto Alegre, Brasil.
| | - David Calhoun
- Grupo de biología vascular e hipertensiónUniversidad de Alabama en BirminghamBirminghamEstados UnidosGrupo de biología vascular e hipertensión, Universidad de Alabama en Birmingham, Birmingham, Estados Unidos.
| | - Norm R.C. Campbell
- Departamento de Medicina, Fisiología y Farmacología y Ciencias de la Salud Comunitaria, O’Brien Institute for Public Health y Libin Cardiovascular Institute of AlbertaUniversidad de CalgaryCalgaryAlbertaCanadáDepartamento de Medicina, Fisiología y Farmacología y Ciencias de la Salud Comunitaria, O’Brien Institute for Public Health y Libin Cardiovascular Institute of Alberta, Universidad de Calgary, Calgary, Alberta, Canadá.
| | - John Chalmers
- George Institute for Global HealthUniversidad de Nueva Gales del SurSídneyNueva Gales del SurAustraliaGeorge Institute for Global Health, Universidad de Nueva Gales del Sur, Sídney, Nueva Gales del Sur, Australia.
| | - Ivor Benjamin
- American Heart AssociationAmerican Heart AssociationDallasTexasEstados UnidosAmerican Heart Association, Dallas, Texas, Estados Unidos.
| | - Garry Jennings
- Facultad de Medicina de SídneyUniversidad de Sídney y Baker Heart & Diabetes InstituteMelbourneVictoriaAustraliaFacultad de Medicina de Sídney, Universidad de Sídney y Baker Heart & Diabetes Institute, Melbourne, Victoria, Australia.
| | - Stéphane Laurent
- Departamentos de Farmacología, Hospital Europeo Georges Pompidou, Assistance Publique Hôpitaux de ParisInserm UMR 970 y Universidad Paris DescartesParísFranciaDepartamentos de Farmacología, Hospital Europeo Georges Pompidou, Assistance Publique Hôpitaux de Paris, Inserm UMR 970 y Universidad Paris Descartes, París, Francia.
| | - Pierre Boutouyrie
- Departamentos de Farmacología, Hospital Europeo Georges Pompidou, Assistance Publique Hôpitaux de ParisInserm UMR 970 y Universidad Paris DescartesParísFranciaDepartamentos de Farmacología, Hospital Europeo Georges Pompidou, Assistance Publique Hôpitaux de Paris, Inserm UMR 970 y Universidad Paris Descartes, París, Francia.
| | - Patricio Lopez-Jaramillo
- FOSCAL, Instituto Masira, Facultad de Ciencias de la SaludUDESBucaramangaColombiaFOSCAL, Instituto Masira, Facultad de Ciencias de la Salud, UDES, Bucaramanga, Colombia.
| | - Richard J. McManus
- Nuffield Department of Primary Care Health SciencesUniversidad de Oxford, Radcliffe Observatory QuarterOxfordReino UnidoNuffield Department of Primary Care Health Sciences, Universidad de Oxford, Radcliffe Observatory Quarter, Oxford, Reino Unido.
| | - Anastasia S. Mihailidou
- Laboratorio de Investigación Cardiovascular y HormonalDepartamento de Cardiología del Kolling Institute, Royal North Shore Hospital y Facultad de Medicina y Ciencias de la Salud, Universidad MacquarieSídneyNueva Gales del SurAustraliaLaboratorio de Investigación Cardiovascular y Hormonal, Departamento de Cardiología del Kolling Institute, Royal North Shore Hospital y Facultad de Medicina y Ciencias de la Salud, Universidad Macquarie, Sídney, Nueva Gales del Sur, Australia.
| | - Pedro Ordunez
- Departamento de Enfermedades no Transmisibles y Salud MentalOrganización Panamericana de la SaludWashington, D.CEstados UnidosDepartamento de Enfermedades no Transmisibles y Salud Mental. Organización Panamericana de la Salud, Washington, D.C., Estados Unidos.
| | - Raj Padwal
- Departamento de Medicina, Universidad de AlbertaDepartamento de Medicina, Universidad de AlbertaEdmontonAlbertaCanadáDepartamento de Medicina, Universidad de Alberta, Edmonton, Alberta, Canadá.
| | - Paolo Palatini
- Studium Patavinum, Universidad de PaduaStudium Patavinum, Universidad de PaduaPaduaItaliaStudium Patavinum, Universidad de Padua, Padua, Italia.
| | - Gianfranco Parati
- Istituto Auxologico Italiano, IRCCSDepartamento de Ciencias Cardiovasculares, Neurales y Metabólicas, Hospital San Luca, Milán, Italia; y Departamento de Medicina y Cirugía, Universidad de Milán-BicoccaMilánItaliaIstituto Auxologico Italiano, IRCCS, Departamento de Ciencias Cardiovasculares, Neurales y Metabólicas, Hospital San Luca, Milán, Italia; y Departamento de Medicina y Cirugía, Universidad de Milán-Bicocca, Milán, Italia.
| | - Neil Poulter
- Imperial Clinical Trials UnitImperial College LondonLondresReino UnidoImperial Clinical Trials Unit, Imperial College London, Londres, Reino Unido.
| | - Michael K. Rakotz
- Asociación Médica EstadounidenseMejorar los Resultados en Materia de SaludChicagoIllinoisEstados UnidosAsociación Médica Estadounidense, Mejorar los Resultados en Materia de Salud, Chicago, Illinois, Estados Unidos.
| | - Clive Rosendorff
- Mount Sinai HeartDepartamento de Medicina (cardiología), Icahn School of Medicine en Mount Sinai, Nueva York, Estados Unidos, y The James J. Peters VA Medical CenterBronxNueva YorkEstados UnidosMount Sinai Heart, Departamento de Medicina (cardiología), Icahn School of Medicine en Mount Sinai, Nueva York, Estados Unidos, y The James J. Peters VA Medical Center, Bronx, Nueva York, Estados Unidos.
| | - Francesca Saladini
- Departamento de MedicinaUniversidad de Padua; Unidad de Cardiología, Hospital de CittadellaPaduaItaliaDepartamento de Medicina, Universidad de Padua; Unidad de Cardiología, Hospital de Cittadella, Padua, Italia.
| | - Angelo Scuteri
- Departamento de Ciencias Médicas, Quirúrgicas y ExperimentalesUniversidad de SácerSácerItaliaDepartamento de Ciencias Médicas, Quirúrgicas y Experimentales, Universidad de Sácer, Sácer, Italia.
| | - Weimar Sebba Barroso
- Liga para la hipertensiónDepartamento de Cardiología, Universidad Federal de GoiásGoiâniaBrasilLiga para la hipertensión. Departamento de Cardiología, Universidad Federal de Goiás, Goiânia, Brasil.
| | - Myeong-Chan Cho
- Departamento de Medicina Interna, Facultad de Medicina de la Universidad Nacional ChungbukDepartamento de Medicina Interna, Facultad de Medicina de la Universidad Nacional ChungbukCheongjuRepública de CoreaDepartamento de Medicina Interna, Facultad de Medicina de la Universidad Nacional Chungbuk, Cheongju, República de Corea.
| | - Ki-Chul Sung
- División de CardiologíaDepartamento de Medicina Interna, Hospital Kangbuk Samsung, Facultad de Medicina de la Universidad SungkyunkwanSeúlRepública de CoreaDivisión de Cardiología, Departamento de Medicina Interna, Hospital Kangbuk Samsung, Facultad de Medicina de la Universidad Sungkyunkwan, Seúl, República de Corea.
| | - Raymond R. Townsend
- Facultad de Medicina PerelmanUniversidad de PensilvaniaFiladelfiaEstados UnidosFacultad de Medicina Perelman, Universidad de Pensilvania, Filadelfia, Estados Unidos.
| | - Ji-Guang Wang
- Instituto de hipertensión de Shanghai, Hospital RuijinFacultad de Medicina de la Universidad Shanghai JiaotongShanghaiChinaInstituto de hipertensión de Shanghai, Hospital Ruijin, Facultad de Medicina de la Universidad Shanghai Jiaotong, Shanghai, China.
| | - Tine Willum Hansen
- Steno Diabetes Center CopenhagenSteno Diabetes Center CopenhagenGentofteDinamarcaSteno Diabetes Center Copenhagen, Gentofte, Dinamarca.
| | - Gregory Wozniak
- Asociación Médica EstadounidenseMejorar los Resultados en Materia de SaludChicagoIllinoisEstados UnidosAsociación Médica Estadounidense, Mejorar los Resultados en Materia de Salud, Chicago, Illinois, Estados Unidos.
| | - George Stergiou
- Hypertension Center STRIDE-7Universidad Nacional y Kapodistríaca de Atenas, Facultad de Medicina, Tercer Departamento de Medicina, Hospital SotiriaAtenasGreciaHypertension Center STRIDE-7, Universidad Nacional y Kapodistríaca de Atenas, Facultad de Medicina, Tercer Departamento de Medicina, Hospital Sotiria, Atenas, Grecia.
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Sharman JE, O’Brien E, Alpert B, Schutte AE, Delles C, Hecht Olsen M, Asmar R, Atkins N, Barbosa E, Calhoun D, Campbell NR, Chalmers J, Benjamin I, Jennings G, Laurent S, Boutouyrie P, Lopez-Jaramillo P, McManus RJ, Mihailidou AS, Ordunez P, Padwal R, Palatini P, Parati G, Poulter N, Rakotz MK, Rosendorff C, Saladini F, Scuteri A, Sebba Barroso W, Cho MC, Sung KC, Townsend RR, Wang JG, Willum Hansen T, Wozniak G, Stergiou G. Lancet Commission on Hypertension group position statement on the global improvement of accuracy standards for devices that measure blood pressure. J Hypertens 2020; 38:21-29. [PMID: 31790375 PMCID: PMC6919228 DOI: 10.1097/hjh.0000000000002246] [Citation(s) in RCA: 80] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2019] [Revised: 08/05/2019] [Accepted: 08/14/2019] [Indexed: 02/03/2023]
Abstract
: The Lancet Commission on Hypertension identified that a key action to address the worldwide burden of high blood pressure (BP) was to improve the quality of BP measurements by using BP devices that have been validated for accuracy. Currently, there are over 3000 commercially available BP devices, but many do not have published data on accuracy testing according to established scientific standards. This problem is enabled through weak or absent regulations that allow clearance of devices for commercial use without formal validation. In addition, new BP technologies have emerged (e.g. cuffless sensors) for which there is no scientific consensus regarding BP measurement accuracy standards. Altogether, these issues contribute to the widespread availability of clinic and home BP devices with limited or uncertain accuracy, leading to inappropriate hypertension diagnosis, management and drug treatment on a global scale. The most significant problems relating to the accuracy of BP devices can be resolved by the regulatory requirement for mandatory independent validation of BP devices according to the universally-accepted International Organisation for Standardization Standard. This is a primary recommendation for which there is an urgent international need. Other key recommendations are development of validation standards specifically for new BP technologies and online lists of accurate devices that are accessible to consumers and health professionals. Recommendations are aligned with WHO policies on medical devices and universal healthcare. Adherence to recommendations would increase the global availability of accurate BP devices and result in better diagnosis and treatment of hypertension, thus decreasing the worldwide burden from high BP.
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Affiliation(s)
- James E. Sharman
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
| | - Eoin O’Brien
- The Conway Institute, University College Dublin, Dublin, Ireland
| | - Bruce Alpert
- University of Tennessee Health Science Center, Memphis, Tennessee, USA
| | - Aletta E. Schutte
- Hypertension in Africa Research Team, Medical Research Council Unit for Hypertension and Cardiovascular Disease, North-West University, Potchefstroom, South Africa
| | - Christian Delles
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK
| | - Michael Hecht Olsen
- Department of Internal Medicine, Holbaek Hospital, Holbaek
- Centre for Individualized Medicine in Arterial Diseases (CIMA), Odense University Hospital, University of Southern Denmark, Odense, Denmark
| | - Roland Asmar
- Foundation-Medical Research Institutes, Geneva, Switzerland
| | | | - Eduardo Barbosa
- Hypertension League of Porto Alegre, Porto Alegre, Rio Grande do Sul, Brazil
| | - David Calhoun
- Vascular Biology and Hypertension Group, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Norm R.C. Campbell
- Department of Medicine, Physiology and Pharmacology and Community Health Sciences, O’Brien Institute for Public Health and Libin Cardiovascular Institute of Alberta, University of Calgary, Calgary, Alberta, Canada
| | - John Chalmers
- The George Institute for Global Health, University of New South Wales, Sydney, New South Wales, Australia
| | | | - Garry Jennings
- Sydney Medical School, University of Sydney and Baker Heart & Diabetes Institute, Melbourne, Victoria, Australia
| | - Stéphane Laurent
- Department of Pharmacology, European Georges Pompidou Hospital, Assistance Publique Hôpitaux de Paris, Inserm UMR 970 and University Paris Descartes, Paris, France
| | - Pierre Boutouyrie
- Department of Pharmacology, European Georges Pompidou Hospital, Assistance Publique Hôpitaux de Paris, Inserm UMR 970 and University Paris Descartes, Paris, France
| | | | - Richard J. McManus
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Radcliffe Observatory Quarter, Oxford, UK
| | - Anastasia S. Mihailidou
- Cardiovascular & Hormonal Research Laboratory, Department of Cardiology & Kolling Institute, Royal North Shore Hospital and Faculty of Medicine and Health Sciences, Macquarie University, Sydney, New South Wales, Australia
| | - Pedro Ordunez
- Department of Non Communicable and Mental Health, Pan American Health Organization, Washington, District of Columbia
| | - Raj Padwal
- Department of Medicine, University of Alberta, Edmonton, Alberta, Canada
| | | | - Gianfranco Parati
- Department of Cardiovascular, Neural and Metabolic Sciences, Istituto Auxologico Italiano, IRCCS, San Luca Hospital
- Department of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy
| | - Neil Poulter
- Imperial Clinical Trials Unit, Imperial College London, London, UK
| | - Michael K. Rakotz
- American Medical Association, Improving Health Outcomes, Chicago, Illinois
| | - Clive Rosendorff
- Department of Medicine (Cardiology), Mount Sinai Heart, Icahn School of Medicine at Mount Sinai, New York
- The James J. Peters VA Medical Center, Bronx, New York, USA
| | - Francesca Saladini
- Cardiology Unit, Department of Medicine, University of Padova, Town Hospital of Cittadella, Padova
| | - Angelo Scuteri
- Department of Medical, Surgical, and Experimental Sciences, University of Sassari, Sassari, Italy
| | - Weimar Sebba Barroso
- Hypertension League, Department of Cardiology, Federal University of Goiás, Goiânia, Brazil
| | - Myeong-Chan Cho
- Department of Internal Medicine, Chungbuk National University College of Medicine, Cheongju
| | - Ki-Chul Sung
- Division of Cardiology, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Raymond R. Townsend
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Ji-Guang Wang
- The Shanghai Institute of Hypertension, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | | | - Gregory Wozniak
- American Medical Association, Improving Health Outcomes, Chicago, Illinois
| | - George Stergiou
- Third Department of Medicine, Hypertension Center STRIDE-7, National and Kapodistrian University of Athens, School of Medicine, Sotiria Hospital, Athens, Greece
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Hoogeveen RC, Meertens BR, Berkhout WER. Precision of aiming with a portable X-ray device (Nomad Pro 2) compared to a wall-mounted device in intraoral radiography. Dentomaxillofac Radiol 2019; 48:20180221. [PMID: 30982345 DOI: 10.1259/dmfr.20180221] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
METHODS AND MATERIALS 20 operators obtained intraoral radiographs of four regions (bitewing, upper molar, lower molar and upper anterior) in five mannequins, using HH and WM devices. Beam-aiming devices were fitted with metal cross-wires to project on image sensors. Deviation from ideal perpendicular incidence of beam was calculated, based on positions of cross-wires relative to gold-standard positions (i.e. average of 10-fold precise aiming by authors via WM system). Analytic models relied on Wilcoxon signed-rank test and mixed model analyses. RESULTS Mean deviations from perfect aim were 2.88˚ (± 1.80˚) for WM and 3.06˚ (± 1.90˚) for HH methods. The difference among all operators (HH vs WM) was 0.17˚ (± 2.48˚), which was not significant. Seven operators showed better aim by HH device (13 by WM system); and in one instance, this difference was significant. CONCLUSIONS Aiming precision proved similar for HH and WM methods of intraoral radiography, although individual operators may perform better using one of these modalities. Aim is not an expected limiting factor for image quality in HH (vs WM) diagnostics.
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Affiliation(s)
- Reinier C Hoogeveen
- 1 Department of Oral and Maxillofacial Radiology, Academic Center for Dentistry Amsterdam (ACTA) University of Amsterdam and Vrije Universiteit Amsterdam, Gustav Mahlerlaan , Amsterdam , The Netherlands
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Sumi S, Umemura N, Adachi M, Ohta T, Naganawa K, Kawaki H, Takayama E, Kondoh N, Sumitomo S. The luminance ratio of autofluorescence in a xenograft mouse model is stable through tumor growth stages. Clin Exp Dent Res 2018; 4:174-181. [PMID: 30386639 PMCID: PMC6203828 DOI: 10.1002/cre2.126] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2018] [Revised: 07/11/2018] [Accepted: 07/13/2018] [Indexed: 12/25/2022] Open
Abstract
The aim of this research was to investigate the value of autofluorescence imaging of oral cancer across different stages of tumor growth, to assist in detecting tumors. A xenograft mouse model was created with human oral squamous cell carcinoma cell line HSC-3 being subcutaneously inoculated into nude mice. Tumor imaging was performed with an autofluorescence imaging method (Illumiscan®) using the luminance ratio, which was defined as the luminance of the tumor site over the luminance of normal skin tissue normalized to a value of 1.0. This luminance ratio was continuously observed postinoculation. Tumor and normal skin tissues were harvested, and differences in the concentrations of flavin adenine dinucleotide and nicotinamide adenine dinucleotide were examined. The luminance ratio of the tumor sites was 0.85 ± 0.05, and there was no significant change in the ratio over time, even if the tumor proliferated and expanded. Furthermore, flavin adenine dinucleotide and nicotinamide adenine dinucleotide were significantly lower in tumor tissue than in normal skin tissue. A luminance ratio under 0.90 indicates a high possibility of tumor, irrespective of the tumor growth stage. However, this cutoff value was determined using a xenograft mouse model and therefore requires further validation before being used in clinical diagnosis.
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Affiliation(s)
- Shigeki Sumi
- Department of Oral and Maxillofacial SurgeryAsahi University School of DentistryJapan
| | - Naoki Umemura
- Department of Oral BiochemistryAsahi University School of DentistryJapan
| | - Makoto Adachi
- Department of Oral and Maxillofacial SurgeryAsahi University School of DentistryJapan
| | - Takahisa Ohta
- Department of Oral and Maxillofacial SurgeryAsahi University School of DentistryJapan
| | - Kosuke Naganawa
- Department of Oral and Maxillofacial SurgeryAsahi University School of DentistryJapan
| | - Harumi Kawaki
- Department of Oral BiochemistryAsahi University School of DentistryJapan
| | - Eiji Takayama
- Department of Oral BiochemistryAsahi University School of DentistryJapan
| | - Nobuo Kondoh
- Department of Oral BiochemistryAsahi University School of DentistryJapan
| | - Shinichiro Sumitomo
- Department of Oral and Maxillofacial SurgeryAsahi University School of DentistryJapan
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van Tilburg CWJ, Groeneweg JG, Stronks DL, Huygen FJPM. Inter-rater reliability of diagnostic criteria for sacroiliac joint-, disc- and facet joint pain. J Back Musculoskelet Rehabil 2018; 30:551-557. [PMID: 27858686 DOI: 10.3233/bmr-150495] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND/OBJECTIVE Several diagnostic criteria sets are described in the literature to identify low back pain subtypes, but very little is known about the inter-rater reliability of these criteria. We conducted a study to determine the reliability of diagnostic tests that point towards SI joint-, disc- or facet joint pain. METHODS Inter-rater reliability study alongside three randomized clinical trials. Multidisciplinary pain center of general hospital. Patients aged 18 or more with medical history and physical examination suggestive of sacroiliac joint-, disc- and facet joint pain on lumbar level. Making use of nowadays most common used diagnostic criteria, a physical examination is taken independently by three physicians (two pain physicians and one orthopedic surgeon). Inter-rater reliability (Kappa (κ) measure of agreement) and significance (p) between raters are presented. Strengths of agreement, indicated with κ values above 0,20, are presented in order of agreement. RESULTS One hundred patients were included. None of the parameters from the physical investigation had κ values of more than 0.21 (fair) in all pairs of raters. Between two raters (C and D), there was an almost perfect agreement on three parameters, more specifically ``Abnormal sensory and motor examination, hyperactive or diminished reflexes'', ``Sitting exam shows no reflex, motor or sensory signs in the legs'' and ``Straight leg raising (Laségue) negative between 30 and 70 degrees of flexion''. The ``Drop test positive'' parameters had moderate strength of agreement between raters A and D and fair strength between raters A and B. The ``Digital interspinous pressure test positive'' had moderate strength of agreement between raters C and D and fair strength of agreement between raters A and B as well as raters B and C. Three other parameters had a fair strength of agreement between two raters, all other parameters had a slight or poor strength of agreement. Inter-rater reliability, confidence intervals and significance of pooled items for SI joint-, disc- and facet joint pain are represented; κ values for the pooled parameters of the physical examination suggestive of SI joint pain stayed below 0.20 between all raters. The same applies for the pooled parameters of the physical examination suggestive of facet joint or disc pain. CONCLUSIONS The poor reliability of the diagnostic parameters seriously limits their predictive validity, and as such their use in patients with low back pain for more than 3 months.
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Affiliation(s)
- Cornelis W J van Tilburg
- Multidisciplinary Pain Center, Department of Anesthesiology, Bravis Hospital, Bergen op Zoom, The Netherlands
| | - Johannes G Groeneweg
- Center for Pain Medicine, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Dirk L Stronks
- Center for Pain Medicine, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Frank J P M Huygen
- Center for Pain Medicine, Erasmus University Medical Center, Rotterdam, The Netherlands
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Peng X, Schultz MG, Abhayaratna WP, Stowasser M, Sharman JE. Comparison of Central Blood Pressure Estimated by a Cuff-Based Device With Radial Tonometry. Am J Hypertens 2016; 29:1173-8. [PMID: 27317573 DOI: 10.1093/ajh/hpw063] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2016] [Accepted: 05/25/2016] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND New techniques that measure central blood pressure (BP) using an upper arm cuff-based approach require performance assessment. The aim of this study was to compare a cuff-based device (CuffCBP) to estimate central BP indices (systolic BP (SBP), diastolic BP (DBP), pulse pressure (PP), augmentation pressure (AP), augmentation index (AIx)) with noninvasive radial tonometry (TonCBP). METHODS Consecutive CuffCBP (SphygmoCor Xcel) and TonCBP (SphygmoCor 8.1) duplicate recordings were measured in 182 people with treated hypertension (aged 61±7 years, 48% male). Agreement between methods was assessed using standard calibration with brachial SBP and DBP (measured with the Xcel device), as well as with brachial mean arterial pressure (MAP; 40% form factor method) and DBP. RESULTS The mean difference ± SD for central SBP (cSBP), central DBP (cDBP), and central PP (cPP) between methods were -0.89±3.48mm Hg (intra-class correlation (ICC) 0.977; 95% confidence interval (CI) 0.973-0.982), -0.50±1.54mm Hg (ICC 0.992, 95% CI 0.987-0.993), and -0.42±3.57mm Hg (ICC 0.966, 95% CI 0.958-0.972), indicating good agreement. Wider limits of agreement were observed for central AP (cAP) and central AIx (cAIx) (-0.91±5.31mm Hg; ICC 0.802; 95% CI 0.756-0.839, -0.99±10.91%; ICC 0.749; 95% CI 0.691-0.796). Re-calibration with brachial MAP and DBP resulted in an overestimation of cSBP with CuffCBP compared with TonCBP (8.58±19.06mm Hg, ICC 0.164, 95% CI -0.029 to 0.321). CONCLUSION cSBP, cDBP, and cPP derived from CuffCBP are substantially equivalent to TonCBP, although the level of agreement is dependent on calibration method. Further validity testing of CuffCBP by comparison with invasively measured central BP will be required.
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Affiliation(s)
- Xiaoqing Peng
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia
| | - Martin G Schultz
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia
| | - Walter P Abhayaratna
- College of Medicine, Biology and Environment, Australian National University, Canberra, Australian Capital Territory, Australia
| | - Michael Stowasser
- Princess Alexandra Hospital, School of Medicine, The University of Queensland, Brisbane, Australia
| | - James E Sharman
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia;
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Gilbert CE, Babu RG, Gudlavalleti ASV, Anchala R, Shukla R, Ballabh PH, Vashist P, Ramachandra SS, Allagh K, Sagar J, Bandyopadhyay S, Murthy GVS. Eye care infrastructure and human resources for managing diabetic retinopathy in India: The India 11-city 9-state study. Indian J Endocrinol Metab 2016; 20:S3-S10. [PMID: 27144134 PMCID: PMC4847447 DOI: 10.4103/2230-8210.179768] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND There is a paucity of information on the availability of services for diagnosis and management of diabetic retinopathy (DR) in India. OBJECTIVES The study was undertaken to document existing healthcare infrastructure and practice patterns for managing DR. METHODS This cross-sectional study was conducted in 11 cities and included public and private eye care providers. Both multispecialty and stand-alone eye care facilities were included. Information was collected on the processes used in all steps of the program, from how diabetics were identified for screening through to policies about follow-up after treatment by administering a semistructured questionnaire and by using observational checklists. RESULTS A total of 86 eye units were included (31.4% multispecialty hospitals; 68.6% stand-alone clinics). The availability of a dedicated retina unit was reported by 68.6% (59) facilities. The mean number of outpatient consultations per year was 45,909 per responding facility, with nearly half being new registrations. A mean of 631 persons with sight-threatening-DR (ST-DR) were registered per year per facility. The commonest treatment for ST-DR was laser photocoagulation. Only 58% of the facilities reported having a full-time retina specialist on their rolls. More than half the eye care facilities (47; 54.6%) reported that their ophthalmologists would like further training in retina. Half (51.6%) of the facilities stated that they needed laser or surgical equipment. About 46.5% of the hospitals had a system to track patients needing treatment or for follow-up. CONCLUSIONS The study highlighted existing gaps in service provision at eye care facilities in India.
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Affiliation(s)
- Clare E. Gilbert
- Department of Clinical Research, International Centre for Eye Health, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK
| | - R. Giridhara Babu
- South Asia Centre for Disability Inclusive Development Research, Indian Institute of Public Health, Public Health Foundation of India, ANV Arcade, 1 Amar Cooperative Society, Kavuri Hills, Madhapur, Hyderabad, Telangana, India
| | - Aashrai Sai Venkat Gudlavalleti
- South Asia Centre for Disability Inclusive Development Research, Indian Institute of Public Health, Public Health Foundation of India, ANV Arcade, 1 Amar Cooperative Society, Kavuri Hills, Madhapur, Hyderabad, Telangana, India
| | - Raghupathy Anchala
- South Asia Centre for Disability Inclusive Development Research, Indian Institute of Public Health, Public Health Foundation of India, ANV Arcade, 1 Amar Cooperative Society, Kavuri Hills, Madhapur, Hyderabad, Telangana, India
| | - Rajan Shukla
- South Asia Centre for Disability Inclusive Development Research, Indian Institute of Public Health, Public Health Foundation of India, ANV Arcade, 1 Amar Cooperative Society, Kavuri Hills, Madhapur, Hyderabad, Telangana, India
| | - Pant Hira Ballabh
- South Asia Centre for Disability Inclusive Development Research, Indian Institute of Public Health, Public Health Foundation of India, ANV Arcade, 1 Amar Cooperative Society, Kavuri Hills, Madhapur, Hyderabad, Telangana, India
| | - Praveen Vashist
- Department of Community Ophthalmology, Dr. R. P. Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| | - Srikrishna S. Ramachandra
- South Asia Centre for Disability Inclusive Development Research, Indian Institute of Public Health, Public Health Foundation of India, ANV Arcade, 1 Amar Cooperative Society, Kavuri Hills, Madhapur, Hyderabad, Telangana, India
| | - Komal Allagh
- South Asia Centre for Disability Inclusive Development Research, Indian Institute of Public Health, Public Health Foundation of India, ANV Arcade, 1 Amar Cooperative Society, Kavuri Hills, Madhapur, Hyderabad, Telangana, India
| | - Jayanti Sagar
- South Asia Centre for Disability Inclusive Development Research, Indian Institute of Public Health, Public Health Foundation of India, ANV Arcade, 1 Amar Cooperative Society, Kavuri Hills, Madhapur, Hyderabad, Telangana, India
| | - Souvik Bandyopadhyay
- South Asia Centre for Disability Inclusive Development Research, Indian Institute of Public Health, Public Health Foundation of India, ANV Arcade, 1 Amar Cooperative Society, Kavuri Hills, Madhapur, Hyderabad, Telangana, India
| | - G. V. S. Murthy
- Department of Clinical Research, International Centre for Eye Health, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK
- South Asia Centre for Disability Inclusive Development Research, Indian Institute of Public Health, Public Health Foundation of India, ANV Arcade, 1 Amar Cooperative Society, Kavuri Hills, Madhapur, Hyderabad, Telangana, India
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Shinozaki S, Hayashi Y, Lefor AK, Yamamoto H. What is the best therapeutic strategy for colonoscopy of colorectal neoplasia? Future perspectives from the East. Dig Endosc 2016; 28:289-95. [PMID: 26524602 DOI: 10.1111/den.12566] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2015] [Revised: 10/23/2015] [Accepted: 10/29/2015] [Indexed: 12/22/2022]
Abstract
Development and improvement of endoscopic techniques and devices have changed the treatment of colorectal tumors over the last decade. For the treatment of diminutive polyps, the cold snare technique of the West is becoming a promising treatment in the East because of its short procedure time and low rate of delayed bleeding by eliminating the delayed effect of electrocautery. Rather than using piecemeal endoscopic mucosal resection or surgical resection for the treatment of large superficial tumors, the technique of the East of endoscopic submucosal dissection (ESD) achieves a high success rate of en bloc R0 resection, enabling detailed pathological evaluation with less invasive treatment. This procedure should also be useful in the West where large colorectal tumors are more frequent than in the East. Regarding outcomes, however, in the literature, the definition of 'curative resection' remains somewhat inconsistent and long-term outcomes of patients with deep submucosal and/or lymphovascular invasion in the en bloc specimen have not yet been determined. Large prospective, as well as retrospective, studies of these patients are warranted. When colorectal ESD is difficult because of size or location, the pocket-creation method and/or double-balloon-assisted technique may be useful. In the East, high-quality magnified chromoendoscopy is widely available, and endoscopists try to identify focal submucosal invasion. In the West, a systematic evaluation of surveillance for the prevention of colorectal cancer has been done and is highly refined. The East and West have much to learn from each other.
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Affiliation(s)
- Satoshi Shinozaki
- Division of Gastroenterology, Department of Medicine, Jichi Medical University, Tochigi, Japan.,Shinozaki Medical Clinic, Tochigi, Japan
| | - Yoshikazu Hayashi
- Division of Gastroenterology, Department of Medicine, Jichi Medical University, Tochigi, Japan
| | | | - Hironori Yamamoto
- Division of Gastroenterology, Department of Medicine, Jichi Medical University, Tochigi, Japan
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Abstract
The aim of the study was to present the current state and basis of functioning of an academic model of forensic expert activities in Poland and perspectives of their further development. The study material included information obtained from a preliminary survey among regional consultants within the ongoing activities of the national consultant team. The recently completed period of research infrastructure support within the policy of coherence of the European Union contributed to significant advances in scientific-educational potential of the majority of university forensic medicine centres. However, the improved educational base and purchases of new diagnostic devices were not associated with a considerable increase in staff resources of individual units, which finally decides about the renown of the entire discipline. It is necessary to undertake initiatives to highlight the importance of forensic medicine as a separate medical field and to increase the number of physicians starting specialist trainings. A highly profiled nature of the speciality necessitates cooperation with other centres and receptiveness to clinical fields. The establishment of various forms of cooperation is a measure of optimal use of equipment and stimulation of multi-centre research.
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Pischke SE, Hyler S, Tronstad C, Bergsland J, Fosse E, Halvorsen PS, Skulstad H, Tønnessen TI. Myocardial tissue CO2 tension detects coronary blood flow reduction after coronary artery bypass in real-time†. Br J Anaesth 2014; 114:414-22. [PMID: 25392231 DOI: 10.1093/bja/aeu381] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Coronary stenosis after coronary artery bypass grafting (CABG) may lead to myocardial ischaemia and is clinically difficult to diagnose. In a CABG model, we aimed at defining variables that detect hypoperfusion in real-time and correlate with impaired regional ventricular function by monitoring myocardial tissue metabolism. METHODS Off-pump CABG was performed in 10 pigs. Graft blood flow was reduced in 18 min intervals to 75, 50, and 25% of baseline flow with reperfusion between each flow reduction. Myocardial tissue Pco2 (Pt(CO2)), Po2, pH, glucose, lactate, and glycerol from the graft supplied region and a control region were obtained. Regional cardiac function was assessed as radial strain. RESULTS In comparison with baseline, myocardial pH decreased during 75, 50, and 25% flow reduction (-0.15; -0.22; -0.37, respectively, all P<0.05) whereas Pt(CO2) increased (+4.6 kPa; +7.8 kPa; +12.9 kPa, respectively, all P<0.05). pH and Pt(CO2) returned to baseline upon reperfusion. Lactate and glycerol increased flow-dependently, while glucose decreased. Regional ventricular contractile function declined significantly. All measured variables remained normal in the control region. Pt(CO2) correlated strongly with tissue lactate, pH, and contractile function (R=0.86, R=-0.91, R=-0.70, respectively, all P<0.001). New conductometric Pt(CO2) sensors were in agreement with established fibre-optic probes. Cardiac output was not altered. CONCLUSIONS Myocardial pH and Pt(CO2) monitoring can quantify the degree of regional tissue hypoperfusion in real-time and correlated well with cellular metabolism and contractile function, whereas cardiac output did not. New robust conductometric Pt(CO2) sensors have the potential to serve as a clinical cardiac monitoring tool during surgery and postoperatively.
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Affiliation(s)
- S E Pischke
- The Intervention Centre, Division for Emergencies and Critical Care Medicine
| | | | - C Tronstad
- Department of Clinical and Biomedical Engineering
| | | | - E Fosse
- The Intervention Centre, Institute for Clinical Medicine, University of Oslo, Oslo, Norway
| | | | - H Skulstad
- Clinic of Cardiology, Oslo University Hospital and
| | - T I Tønnessen
- Division for Emergencies and Critical Care Medicine, Institute for Clinical Medicine, University of Oslo, Oslo, Norway
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20
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Kang YR, Park HY, Jeon K, Koh WJ, Suh GY, Chung MP, Kim H, Kwon OJ, Choi YL, Han J, Um SW. EGFR and KRAS mutation analyses from specimens obtained by bronchoscopy and EBUS-TBNA. Thorac Cancer 2013; 4:264-272. [PMID: 28920245 DOI: 10.1111/1759-7714.12006] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2012] [Accepted: 10/18/2012] [Indexed: 01/05/2023] Open
Abstract
BACKGROUD Procurement of tumor tissue is mandatory for a mutation analysis in patients with non-small cell lung cancer. The purpose of this study was to evaluate the usefulness of bronchoscopic biopsy and endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) biopsy for detecting epidermal growth factor receptor (EGFR) and KRAS mutations in routine practice. METHODS Tumor DNA was extracted from formalin-fixed paraffin-embedded tissues, and amplifications of exons 18-21 of EGFR and codons 12, 13 and 61 of KRAS were performed using polymerase chain reaction (PCR). PCR products were subjected to direct sequencing in both directions. RESULTS Of 211 consecutive specimens, 201 (95.3%) were available for EGFR mutation analysis, and 196 (92.9%) were adequate for KRAS mutation analysis. EGFR and KRAS mutations were detected in 14.9% and 5.4%, respectively. A median of 16 days was spent from biopsy to the final report for either EGFR or KRAS mutation status. The detection rates for both mutations were similar between bronchoscopic biopsy and EBUS-TBNA (P > 0.05). Female gender (53.3%), never smoker (63.3%), and adenocarcinoma (96.7%) were predominant in patients with EGFR mutations. Among patients with adenocarcinoma (n = 104), the frequencies of EGFR and KRAS mutations were 27.9% and 10.6%, respectively. CONCLUSIONS Small tissue samples obtained by bronchoscopic biopsy and EBUS-TBNA are sufficient for detecting EGFR and KRAS mutations in routine practice. Therefore, concurrent mutational analyses of small tissue samples should be considered at the time of initial diagnosis.
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Affiliation(s)
- Yeh Rim Kang
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Hye Yun Park
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Kyeongman Jeon
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Won-Jung Koh
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Gee Young Suh
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Man Pyo Chung
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Hojoong Kim
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - O Jung Kwon
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Yoon-La Choi
- Department of Pathology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Joungho Han
- Department of Pathology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Sang-Won Um
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
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