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Liu J, Hu C, He J, Mu J, Wang S, Han Q, Li J, Lin M, Gao Q, Wu F, Zhou H. Diagnostic utility of gingival biopsy for pemphigus vulgaris and mucosa membrane pemphigoid: A 10-year cohort study. J Am Acad Dermatol 2024:S0190-9622(24)00490-0. [PMID: 38490369 DOI: 10.1016/j.jaad.2024.03.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2023] [Revised: 02/27/2024] [Accepted: 03/03/2024] [Indexed: 03/17/2024]
Affiliation(s)
- Junjiang Liu
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Frontier Innovation Center for Dental Medicine Plus & Department of Oral Medicine, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
| | - Can Hu
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Frontier Innovation Center for Dental Medicine Plus & Department of Oral Medicine, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
| | - Jing He
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Frontier Innovation Center for Dental Medicine Plus & Department of Oral Medicine, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
| | - Jingtian Mu
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Frontier Innovation Center for Dental Medicine Plus & Department of Oral Medicine, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
| | - Shimeng Wang
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Frontier Innovation Center for Dental Medicine Plus & Department of Oral Medicine, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
| | - Qi Han
- Department of Oral Pathology, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
| | - Jia Li
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Frontier Innovation Center for Dental Medicine Plus & Department of Oral Medicine, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
| | - Mei Lin
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Frontier Innovation Center for Dental Medicine Plus & Department of Oral Medicine, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
| | - Qinghong Gao
- Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
| | - Fanglong Wu
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Frontier Innovation Center for Dental Medicine Plus & Department of Oral Medicine, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China.
| | - Hongmei Zhou
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Frontier Innovation Center for Dental Medicine Plus & Department of Oral Medicine, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China.
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Tang JWY, Saiz A, Vulpe A, Ribas Latre A, Furtado R, Seth M, Valls Sanchez F. Diagnostic Utility of Thoracic Radiography and Abdominal Ultrasonography in Canine Immune-Mediated Polyarthritis: 77 Cases. Animals (Basel) 2024; 14:534. [PMID: 38396501 PMCID: PMC10885912 DOI: 10.3390/ani14040534] [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: 01/02/2024] [Revised: 01/24/2024] [Accepted: 01/26/2024] [Indexed: 02/25/2024] Open
Abstract
Thoracic radiography and abdominal ultrasonography are part of standard diagnostic investigations in cases of canine immune-mediated polyarthritis (IMPA). However, the clinical importance of thoracic and abdominal imaging towards the management of canine IMPA currently remains unknown. The primary aim of this study was to describe the findings documented on thoracic radiography and abdominal ultrasonography in dogs diagnosed with IMPA, and to evaluate the diagnostic utility of thoracic radiography and abdominal ultrasonography in the initial approach and management of these cases. Seventy-seven dogs diagnosed with IMPA who underwent thoracic radiography and abdominal ultrasonography at a single referral hospital between 2008 and 2022 were included. The diagnostic imaging studies of these 77 dogs were reviewed by one blinded board-certified diagnostic imaging specialist for quality assurance. The medical records, including the diagnostic imaging reports of these dogs, were then reviewed by three blinded board-certified internal medicine specialists. Using a modified version of a previous question and scoring system, the three internal medicine specialists then generated an answer for the overall diagnostic utility and a diagnostic utility score for thoracic radiography and abdominal ultrasonography for each case. The abnormal findings identified in radiography and ultrasonography were described. In the cases where the findings were considered significant enough to immediately affect the case management, the results of the further investigations that were subsequently performed were also described. No abnormalities were detected in thoracic radiography for 30 cases, and none were detected in abdominal ultrasound for 6. The majority of the internists considered thoracic radiography to be not useful in the overall case management at the time of IMPA diagnosis in 70 cases, and considered abdominal ultrasonography to be not useful in the overall case management in 57 cases. The majority of the internists agreed on the utility of thoracic radiography in 95% of the cases, and in 61% of the cases for abdominal ultrasonography. The most common finding in the thoracic radiography was a mild bronchial pulmonary pattern, and the most common in the abdominal ultrasonography was mild lymphadenomegaly. Therefore, although thoracic radiography and abdominal ultrasonography identified numerous abnormal findings in this population of dogs, in the majority of the cases, the findings were deemed not useful towards the overall case management at the time of the initial diagnosis of IMPA. Thus, the use of thoracic radiography and abdominal ultrasonography should be taken into careful consideration when considering initial diagnostic investigations for canine IMPA.
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Affiliation(s)
- Julia W. Y. Tang
- DWR Veterinary Specialists, Station Farm, London Road, Six Mile Bottom, Cambridgeshire CB8 0UH, UK (A.V.)
| | - Anna Saiz
- DWR Veterinary Specialists, Station Farm, London Road, Six Mile Bottom, Cambridgeshire CB8 0UH, UK (A.V.)
| | - Alina Vulpe
- DWR Veterinary Specialists, Station Farm, London Road, Six Mile Bottom, Cambridgeshire CB8 0UH, UK (A.V.)
| | | | - Rita Furtado
- DWR Veterinary Specialists, Station Farm, London Road, Six Mile Bottom, Cambridgeshire CB8 0UH, UK (A.V.)
| | - Mayank Seth
- KGS Veterinary Services Limited, Saffron Walden, Essex CB11 3GP, UK;
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Lamb AE, Rent S, Brannon AJ, Greer JL, Ndey-Bongo NP, Cho SH, Greenberg RG, Benjamin DK, Clark RH, Kumar KR. Diagnostic Utility of Cerebrospinal Fluid White Blood Cell Components for the Identification of Bacterial Meningitis in Infants. J Pediatric Infect Dis Soc 2023; 12:S44-S52. [PMID: 38146862 PMCID: PMC10750308 DOI: 10.1093/jpids/piad087] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Accepted: 10/10/2023] [Indexed: 12/27/2023]
Abstract
BACKGROUND To evaluate the diagnostic and predictive utility of cerebrospinal fluid (CSF) white blood cell (WBC) components in the diagnosis of bacterial meningitis in infants discharged from the neonatal intensive care unit (NICU). METHODS We identified a cohort of infants discharged from a Pediatrix NICU between 1997 and 2020 who did not have an immunodeficiency, had at least 1 CSF culture collected within the first 120 days of life, and at least 1 CSF laboratory specimen obtained on the day of culture collection. We only included an infant's first CSF culture and excluded cultures from CSF reservoirs and those growing contaminants or nonbacterial organisms. We examined the utility of CSF WBC components to diagnose or predict bacterial meningitis by calculating sensitivity, specificity, positive and negative predictive values, likelihood ratios, and area under the receiver operating curve (AUC) at different cutoff values for each parameter. We performed subgroup analysis excluding infants treated with antibiotics the day before CSF culture collection. RESULTS Of the 20 756 infants that met the study inclusion criteria, 320 (2%) were diagnosed with bacterial meningitis. We found (AUC [95% CI]) CSF WBC count (0.76 [0.73-0.79]), CSF neutrophil count (0.74 [0.70-0.78]), and CSF neutrophil percent (0.71 [0.67-0.75]) had the highest predictive values for bacterial meningitis, even when excluding infants with early antibiotic administration. CONCLUSIONS No single clinical prediction rule had the optimal discriminatory power for predicting culture-proven bacterial meningitis, and clinicians should be cautious when interpreting CSF WBC parameters in infants with suspected meningitis.
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Affiliation(s)
- Ashley E Lamb
- Duke Clinical Research Institute, Durham, North Carolina, USA
| | - Sharla Rent
- Department of Pediatrics, Duke University, Durham, North Carolina, USA
| | - Asia J Brannon
- Duke Clinical Research Institute, Durham, North Carolina, USA
| | | | | | - Stephen H Cho
- Duke Clinical Research Institute, Durham, North Carolina, USA
| | - Rachel G Greenberg
- Duke Clinical Research Institute, Durham, North Carolina, USA
- Department of Pediatrics, Duke University, Durham, North Carolina, USA
| | - Daniel K Benjamin
- Duke Clinical Research Institute, Durham, North Carolina, USA
- Department of Pediatrics, Duke University, Durham, North Carolina, USA
| | - Reese H Clark
- Pediatrix-Obstetrix Center for Research and Education, Sunrise, Florida, USA
| | - Karan R Kumar
- Duke Clinical Research Institute, Durham, North Carolina, USA
- Department of Pediatrics, Duke University, Durham, North Carolina, USA
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Wilson M, Wang JY, Andreev A, Katsanos AH, Selim M, Lioutas VA. Diagnostic utility of brain MRI in spontaneous intracerebral hemorrhage: A retrospective cohort study and meta-analysis. Eur Stroke J 2023; 8:1089-1096. [PMID: 37571850 PMCID: PMC10683734 DOI: 10.1177/23969873231192761] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2023] [Accepted: 07/02/2023] [Indexed: 08/13/2023] Open
Abstract
INTRODUCTION The diagnostic yield of brain Magnetic Resonance Imaging (MRI) in spontaneous intracerebral hemorrhage (ICH) is unclear. We performed both an independent single-center retrospective cohort study and a meta-analysis to assess the detection rate of secondary lesions on MRI in patients with spontaneous ICH. PATIENTS AND METHODS In the retrospective cohort study, we examined 856 consecutive patients with spontaneous ICH. Brain MRI scans on admission and follow-up were assessed for secondary lesions. We also examined clinical and CT radiographic variables associated with secondary lesions in univariable analysis. In the meta-analysis we searched PubMed and EMBASE for articles investigating the secondary lesion detection rate on brain MRI in spontaneous ICH. RESULTS Of the 856 patients with ICH, 481 (56%) had at least one brain BRI performed [70 ± 14 years, 270 (56% male)]. 462 (54%) had an admission MRI and 138 (16%) had both admission and follow-up MRIs. The detection rate of secondary lesions on admission MRIs was 24/462 (5.2%). 4/127 (3.1%) patients with a negative admission MRI had a lesion identified on follow-up MRI. No clinical or radiographic variables were associated with a secondary lesion on MRI using univariable analysis. The meta-analysis included five studies total (four identified in the PubMed and EMBASE searches and our cohort study) comprising 1147 patients with spontaneous ICH who underwent brain MRI. The pooled detection rate of secondary lesions was 11% (95% CI: 7-16). DISCUSSION AND CONCLUSION No predictors of secondary lesion detection were identified in our cohort study. Prospective studies are required to better understand the diagnostic utility of MRI in spontaneous ICH.
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Affiliation(s)
- Mitch Wilson
- Division of Vascular Neurology, Department of Neurology, Beth Israel Deaconess Medical Center/Harvard Medical School, Boston, MA, USA
| | - Jia-Yi Wang
- Division of Vascular Neurology, Department of Neurology, Beth Israel Deaconess Medical Center/Harvard Medical School, Boston, MA, USA
| | - Alexander Andreev
- Division of Vascular Neurology, Department of Neurology, Beth Israel Deaconess Medical Center/Harvard Medical School, Boston, MA, USA
| | - Aristeidis H Katsanos
- Division of Neurology, McMaster University & Population Health Research Institute, Hamilton, ON, Canada
| | - Magdy Selim
- Division of Vascular Neurology, Department of Neurology, Beth Israel Deaconess Medical Center/Harvard Medical School, Boston, MA, USA
| | - Vasileios-Arsenios Lioutas
- Division of Vascular Neurology, Department of Neurology, Beth Israel Deaconess Medical Center/Harvard Medical School, Boston, MA, USA
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Ahanotu A, DeVore EK, Carroll TL, Edelen M, Morcos M, Willard E, Zhao NW, Belafsky P, Shin JJ. Can EAT-10 Become EAT-5? Improving Measurement Efficiency of Dysphagia with Item Response Theory. Laryngoscope 2023; 133:3327-3333. [PMID: 37166087 DOI: 10.1002/lary.30732] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Revised: 03/31/2023] [Accepted: 04/16/2023] [Indexed: 05/12/2023]
Abstract
OBJECTIVES To assess: (1) the Eating Assessment Tool (EAT-10) with item response theory (IRT) to determine which individual items provide the most information, (2) the extent to which dysphagia is measured with subsets of items while maintaining precise score estimates, and (3) if 5-item scales have the differing discriminatory ability, as compared to the parent 10-item instrument. METHODS Prospectively collected data from 2,339 patients who completed the EAT-10 questionnaire during evaluation at a tertiary care otolaryngology clinic were utilized. IRT analyses provided discrimination and location parameters associated with individual questions. Residual item correlations were also assessed for redundant information. Based on these results, three 5-item subsets were further evaluated using item information function curves. Areas under receiver-operator characteristic curves (ROC-AUC) were also calculated to evaluate the discriminatory ability for dysphagia-related clinical diagnoses. RESULTS Item discrimination parameter estimates ranged from 1.71 to 5.46, with higher values indicating more information. Residual item correlations were determined within item pairs, and location parameters were calculated. Based on these data, in combination with clinical utility, three 5-item subsets were proposed and assessed. ROC-AUC analyses demonstrated no significant difference between the EAT-5-Alpha subset and the original 10-item instrument for discriminating dysphagia as a primary diagnosis (0.88, 0.88). The EAT-5-Clinical subset outperformed the original 10 instruments in ROC-AUC for aspiration. The EAT-5-Range subset was significantly associated with problems with thin liquids. CONCLUSIONS IRT analyses distinguished three proposed 5-item subsets of the EAT-10 instrument, supporting shorter survey options, while still reflecting the impact of dysphagia without significant loss of discrimination. LEVEL OF EVIDENCE 3 (Diagnostic testing with consistently applied reference standards, partial blinding). Laryngoscope, 133:3327-3333, 2023.
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Affiliation(s)
- Adaobi Ahanotu
- University of Maryland School of Medicine, Baltimore, Maryland, USA
| | - Elliana Kirsh DeVore
- Harvard Medical School, Boston, Massachusetts, USA
- Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - Thomas L Carroll
- Harvard Medical School, Boston, Massachusetts, USA
- Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - Maria Edelen
- Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - Mary Morcos
- Harvard Medical School, Boston, Massachusetts, USA
| | | | - Nina W Zhao
- University of California, Davis, California, USA
- University Hospitals Cleveland Medical Center, Cleveland, Ohio, USA
| | | | - Jennifer J Shin
- Harvard Medical School, Boston, Massachusetts, USA
- Center for Surgery and Public Health, Brigham and Women's Hospital, Boston, Massachusetts, USA
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Kennedy E, Zhang Y, Qadadha Y, Cheng C, Adil A, Bach K, Smith D, Arroyo N, Fernandes-Taylor S, Gettle LM, Mayer AM, Francis DO, Chiu AS. Rates of Detecting Thyroid Nodules Recommended for Biopsy with Ultrasound: Are All Indications Equal? Thyroid 2023; 33:1434-1440. [PMID: 37981778 PMCID: PMC10714116 DOI: 10.1089/thy.2023.0234] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/21/2023]
Abstract
Background: The use of thyroid ultrasound increases yearly, adding to costs and overdetection of clinically irrelevant nodules. We investigated which indications most commonly prompt referral for thyroid ultrasound and the diagnostic utility by indication. Methods: We performed a retrospective observational cohort study of adults (≥18 years) undergoing an initial dedicated thyroid ultrasound between 2017 and 2019 at a tertiary academic center. Indicated reasons for referral were categorized into suspected palpable nodule (SPN), compressive symptoms (CS), metabolic symptoms (MS), screening due to high-risk factors, follow-up of incidental finding on other imaging, and combination of factors. Percentage of ultrasounds with an identifiable nodule and with a nodule recommended for biopsy was compared by indication. Separate logistic regression models were used to identify factors associated with finding any nodule and a biopsy-recommended nodule. Results: Among the 1739 patients included, the most common indication for thyroid ultrasound was SPN (40%), followed by incidental imaging (28%), CS (13%), combination (11%), MS (6%), and high-risk factors (2%). Overall, 62% of ultrasounds identified a nodule. Ultrasounds performed for incidental findings had the highest rate of nodule identification (94%), compared with 55%, 39%, and 43%, for SPN, CS, and MS, respectively (p < 0.05). Only 27% of ultrasounds identified a biopsy-recommended nodule. Nodules found incidentally had the highest rate of biopsy-recommended nodules at 55%. Rates of biopsy-recommended nodules for SPN, CS, and MS were 21%, 6%, and 10%, respectively. Logistic regression demonstrated that compared with patients referred for an SPN, those with incidental nodules were 10 times more likely to have a nodule found on ultrasound (odds ratio [OR] = 10.6 [CI 7.0-16.0]), while those referred for CS were half as likely to have a nodule (OR = 0.5 [CI 0.4-0.7]). Similar factors were associated with identification of biopsy-recommended nodules. Conclusions: Of all new dedicated thyroid ultrasounds, only a quarter find biopsy-recommended nodules, and nearly 40% do not identify a nodule at all. Notably, only 55% of ultrasounds done for SPN found a nodule. Ultrasound for CS and MS had the lowest rates of detecting nodules. Providing clear guidance on when to order thyroid ultrasounds can help reduce unnecessary health care utilization and potential overtreatment.
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Affiliation(s)
- Elena Kennedy
- Section of Otolaryngology, Department of Surgery, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA
| | - Yanchen Zhang
- Section of Otolaryngology, Department of Surgery, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA
| | - Yazeed Qadadha
- Section of Otolaryngology, Department of Surgery, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA
| | - Christie Cheng
- Section of Otolaryngology, Department of Surgery, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA
| | - Abdullah Adil
- Section of Otolaryngology, Department of Surgery, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA
| | - Kathy Bach
- Section of Otolaryngology, Department of Surgery, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA
| | - Dave Smith
- Section of Otolaryngology, Department of Surgery, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA
| | - Natalia Arroyo
- Wisconsin Surgical Outcomes Research Program, Department of Surgery, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA
| | - Sara Fernandes-Taylor
- Wisconsin Surgical Outcomes Research Program, Department of Surgery, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA
| | - Lori Mankowski Gettle
- Department of Radiology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA
| | - Ann Marie Mayer
- Department of Surgery, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA
| | - David O. Francis
- Section of Otolaryngology, Department of Surgery, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA
- Wisconsin Surgical Outcomes Research Program, Department of Surgery, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA
| | - Alexander S. Chiu
- Section of Endocrine Surgery, Department of Surgery, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA
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Jurado-Martos F, Cardoso-Toset F, Tarradas C, Galán-Relaño Á, Sánchez-Carvajal JM, Ruedas-Torres I, Vera-Salmoral E, Larenas-Muñoz F, Carrasco L, Gómez-Laguna J, Lorenzo BH, Luque I. Evaluation of the diagnostic accuracy of the serological test for paratuberculosis in cattle according to tuberculosis status. Vet Rec 2023; 193:e3313. [PMID: 37718548 DOI: 10.1002/vetr.3313] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2023] [Revised: 07/18/2023] [Accepted: 07/24/2023] [Indexed: 09/19/2023]
Abstract
BACKGROUND Enzyme-linked immunosorbent assays (ELISAs) are the most widely used diagnostic tools in bovine paratuberculosis (bPTB) control. However, their diagnostic accuracy may be compromised by bovine tuberculosis (bTB) infection, as both diseases share diagnostic targets. METHODS The bPTB and bTB infection status of 228 animals was determined using microbiological tissue culture as a reference test. The diagnostic performance (sensitivity, specificity, likelihood ratios and predictive values) of the bPTB-ELISA on blood serum samples, taking into account the bPTB animal-level prevalence of the area and the bTB status of the animals, was evaluated. RESULTS A sensitivity of 40.7% (95% confidence interval [CI]: 27.5%-53.9%) and a specificity of 94.7% (95% CI: 91.4%-98.0%) were obtained for bPTB-ELISA in all animals. A bPTB-ELISA-positive animal would have a post-test probability of 70% or more of being infected in areas with a bPTB prevalence of 23% or more. A negative bPTB-ELISA result, in areas with a bPTB prevalence of 41% or less, would rule out the disease with more than 70% certainty. In bTB-positive animals, sensitivity increased (94.4% [95% CI: 81.4%-100%] vs. 25.1% [95% CI: 11.8%-38.4%]) and specificity decreased (82.6% [95% CI: 71.8%-93.4%] vs. 99.4% [95% CI: 98.0%-99.9%]). The bPTB-ELISA is a good tool to rule out bPTB co-infection in bTB-positive animals, while in bTB-negative animals, it allows confirmation of disease with more than 70% probability if disease prevalence is 6% or more. LIMITATIONS The observed differences could be enhanced by the effect of frequent application of the intradermal tuberculin test, which was unknown in the animals studied. CONCLUSIONS These results provide useful guidance for the application and interpretation of ELISA as a tool for bPTB disease control.
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Affiliation(s)
- Francisco Jurado-Martos
- CICAP-Food Research Centre, Pozoblanco, Cordoba, Spain
- Department of Animal Health, University of Cordoba, Cordoba, Spain
| | | | - Carmen Tarradas
- Department of Animal Health, University of Cordoba, Cordoba, Spain
- UIC Zoonosis y Enfermedades Emergentes ENZOEM, International Excellence Agrifood Campus 'ceiA3', University of Cordoba, Cordoba, Spain
| | | | - José María Sánchez-Carvajal
- Pathology and Immunology Group (UCO-PIG), Department of Anatomy and Comparative Pathology and Toxicology, University of Cordoba, Cordoba, Spain
| | - Inés Ruedas-Torres
- Pathology and Immunology Group (UCO-PIG), Department of Anatomy and Comparative Pathology and Toxicology, University of Cordoba, Cordoba, Spain
| | | | - Fernanda Larenas-Muñoz
- Pathology and Immunology Group (UCO-PIG), Department of Anatomy and Comparative Pathology and Toxicology, University of Cordoba, Cordoba, Spain
| | - Librado Carrasco
- UIC Zoonosis y Enfermedades Emergentes ENZOEM, International Excellence Agrifood Campus 'ceiA3', University of Cordoba, Cordoba, Spain
- Pathology and Immunology Group (UCO-PIG), Department of Anatomy and Comparative Pathology and Toxicology, University of Cordoba, Cordoba, Spain
| | - Jaime Gómez-Laguna
- UIC Zoonosis y Enfermedades Emergentes ENZOEM, International Excellence Agrifood Campus 'ceiA3', University of Cordoba, Cordoba, Spain
- Pathology and Immunology Group (UCO-PIG), Department of Anatomy and Comparative Pathology and Toxicology, University of Cordoba, Cordoba, Spain
| | - Belén Huerta Lorenzo
- Department of Animal Health, University of Cordoba, Cordoba, Spain
- UIC Zoonosis y Enfermedades Emergentes ENZOEM, International Excellence Agrifood Campus 'ceiA3', University of Cordoba, Cordoba, Spain
| | - Inmaculada Luque
- Department of Animal Health, University of Cordoba, Cordoba, Spain
- UIC Zoonosis y Enfermedades Emergentes ENZOEM, International Excellence Agrifood Campus 'ceiA3', University of Cordoba, Cordoba, Spain
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Pannu AK, Selvam S, Rahman N, Kumar D, Saroch A, Sharma AK, Sethi S, Yadav R, Bhatia V. Cerebrospinal fluid adenosine deaminase for the diagnosis of tuberculous meningitis. Biomark Med 2023; 17:209-218. [PMID: 37102870 DOI: 10.2217/bmm-2022-0838] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/28/2023] Open
Abstract
Background: A consensus on the diagnostic utility of cerebrospinal fluid adenosine deaminase (ADA) for tuberculous meningitis (TBM) is lacking. Methods: Patients aged ≥12 years admitted with CNS infections were enrolled prospectively. ADA was measured with spectrophotometry. Results: We enrolled 251 TBM and 131 other CNS infections. The optimal cutoff of ADA was calculated at 5.5 U/l against microbiological reference standard with area under curve 0.743, sensitivity 80.7%, specificity 60.3%, positive likelihood ratio 2.03 and negative likelihood ratio 3.12. The widely used cutoff value 10 U/l had specificity 82% and sensitivity 50%. The discriminating power was higher for TBM versus viral meningoencephalitis than bacterial or cryptococcal meningitis. Conclusion: Cerebrospinal fluid ADA has a low-to-modest diagnostic utility.
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Affiliation(s)
- Ashok K Pannu
- Department of Internal Medicine, Postgraduate Institute of Medical Education & Research, Nehru Hospital, Chandigarh, 160012, India
| | - Suresh Selvam
- Department of Internal Medicine, Postgraduate Institute of Medical Education & Research, Nehru Hospital, Chandigarh, 160012, India
| | - Nadim Rahman
- Department of Internal Medicine, Postgraduate Institute of Medical Education & Research, Nehru Hospital, Chandigarh, 160012, India
| | - Devender Kumar
- Department of Internal Medicine, Postgraduate Institute of Medical Education & Research, Nehru Hospital, Chandigarh, 160012, India
| | - Atul Saroch
- Department of Internal Medicine, Postgraduate Institute of Medical Education & Research, Nehru Hospital, Chandigarh, 160012, India
| | - Arun K Sharma
- Department of Gastroenterology, Postgraduate Institute of Medical Education & Research, Nehru Hospital, Chandigarh, 160012, India
| | - Sunil Sethi
- Department of Medical Microbiology, Postgraduate Institute of Medical Education & Research, Research Block A, Chandigarh, 160012, India
| | - Rakesh Yadav
- Department of Medical Microbiology, Postgraduate Institute of Medical Education & Research, Research Block A, Chandigarh, 160012, India
| | - Vikas Bhatia
- Department of Radiodiagnosis, Postgraduate Institute of Medical Education & Research, Nehru Hospital, Chandigarh, 160012, India
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Bosnić Z, Babič F, Anderková V, Štefanić M, Wittlinger T, Majnarić LT. A Critical Appraisal of the Diagnostic and Prognostic Utility of the Anti-Inflammatory Marker IL-37 in a Clinical Setting: A Case Study of Patients with Diabetes Type 2. Int J Environ Res Public Health 2023; 20:3695. [PMID: 36834391 PMCID: PMC9966907 DOI: 10.3390/ijerph20043695] [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] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Revised: 02/13/2023] [Accepted: 02/16/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND The role of the cytokine interleukin-37 (IL-37) has been recognized in reversing inflammation-mediated metabolic costs. The aim was to evaluate the clinical utility of this cytokine as a diagnostic and prognostic marker in patients with type 2 diabetes (T2D). METHODS We included 170 older (median: 66 years) individuals with T2D (females: 95) and classified as primary care attenders to assess the association of factors that describe patients with plasma IL-37 levels (expressed as quartiles) using multinomial regression models. We determined the diagnostic ability of IL-37 cut-offs to identify diabetes-related complications or patient subgroups by using Receiver Operating Characteristic analysis (c-statistics). RESULTS Frailty status was shown to have a suppressive effect on IL-37 circulating levels and a major modifying effect on associations of metabolic and inflammatory factors with IL-37, including the effects of treatments. Situations in which IL-37 reached a clinically significant discriminating ability included the model of IL-37 and C-Reactive Protein in differentiating among diabetic patients with low-normal/high BMI ((<25/≥25 kg/m2), and the model of IL-37 and Thyroid Stimulating Hormone in discriminating between women with/without metabolic syndrome. CONCLUSIONS The study has revealed limitations in using classical approaches in determining the diagnostic and prognostic utility of the cytokine IL-37 in patients with T2D and lain a foundation for new methodology approaches.
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Affiliation(s)
- Zvonimir Bosnić
- Department of Family Medicine, Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, Huttlerova 4, 31000 Osijek, Croatia
| | - František Babič
- Department of Cybernetics and Artificial Intelligence, Faculty of Electrical Engineering and Informatics, Technical University of Košice, 06601 Košice, Slovakia
| | - Viera Anderková
- Department of Cybernetics and Artificial Intelligence, Faculty of Electrical Engineering and Informatics, Technical University of Košice, 06601 Košice, Slovakia
| | - Mario Štefanić
- Department of Nuclear Medicine, Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, Huttlerova 4, 31000 Osijek, Croatia
| | - Thomas Wittlinger
- Department of Cardiology, Asklepios Hospital, University of Göttingen, 38642 Goslar, Germany
| | - Ljiljana Trtica Majnarić
- Department of Family Medicine, Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, Huttlerova 4, 31000 Osijek, Croatia
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10
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Gao M, Yu F, Dong R, Zhang K, Lv Y, Ma J, Wang D, Zhang H, Gai Z, Liu Y. Diagnostic application of exome sequencing in Chinese children with suspected inherited kidney diseases. Front Genet 2023; 13:933636. [PMID: 36685964 PMCID: PMC9853529 DOI: 10.3389/fgene.2022.933636] [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: 08/09/2022] [Accepted: 12/15/2022] [Indexed: 01/09/2023] Open
Abstract
Background: Inherited kidney diseases (IKDs) are a group of kidney diseases characterized by abnormal kidney structure or function caused by genetic factors, but they are not easily diagnosed in childhood due to either nonspecific symptoms and signs or clinically silent symptoms in the early stages until the progressive stages, even end-stages. Early diagnosis of IKDs is very urgent for timely treatment and improving outcomes of patients. So far, the etiological diagnosis has been accelerated with the advance of clinical genetic technology, particularly the advent of next-generation sequencing (NGS) that is not only a powerful tool for prompt and accurate diagnosis of IKDs but also gives therapy guidance to decrease the risk of unnecessary and harmful interventions. Methods: The patients presenting with urinalysis abnormalities or structural abnormalities from 149 Chinese families were enrolled in this study. The clinical features of the patients were collected, and the potentially causative gene variants were detected using exome sequencing. The clinical diagnostic utility of the genetic testing was assessed after more detailed clinical data were analyzed. Result: In total, 55 patients identified having causative variants by exome sequencing were genetically diagnosed, encompassing 16 (29.1%) autosomal dominant IKDs, 16 (29.1%) autosomal recessive IKDs, and 23 (41.8%) X-linked IKDs, with 25 unreported and 45 reported variants. The diagnostic yield was 36.9%. The utility of the exome sequencing was accessed, 12 patients (21.8%) were confirmed to have suspected IKDs, 26 patients (47.3%) discerned the specific sub-types of clinical category, and 17 patients (30.9%) with unknown etiology or lack of typical manifestations were reclassified. Conclusion: Our study supported that genetic testing plays a crucial role in the early diagnosis for children with IKDs, which affected follow-up treatment and prognostic assessment in clinical practice. Moreover, the variant spectrum associated with IKDs was expanded.
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Affiliation(s)
- Min Gao
- Pediatric Research Institute, Children’s Hospital Affiliated to Shandong University, Jinan, China,Shandong Provincial Clinical Research Center for Children’s Health and Disease, Jinan, China
| | - Fengling Yu
- Shandong Provincial Clinical Research Center for Children’s Health and Disease, Jinan, China,Clinical Laboratory, Children’s Hospital Affiliated to Shandong University, Ji’nan, China
| | - Rui Dong
- Pediatric Research Institute, Children’s Hospital Affiliated to Shandong University, Jinan, China,Shandong Provincial Clinical Research Center for Children’s Health and Disease, Jinan, China
| | - Kaihui Zhang
- Pediatric Research Institute, Children’s Hospital Affiliated to Shandong University, Jinan, China,Shandong Provincial Clinical Research Center for Children’s Health and Disease, Jinan, China
| | - Yuqiang Lv
- Pediatric Research Institute, Children’s Hospital Affiliated to Shandong University, Jinan, China,Shandong Provincial Clinical Research Center for Children’s Health and Disease, Jinan, China
| | - Jian Ma
- Pediatric Research Institute, Children’s Hospital Affiliated to Shandong University, Jinan, China,Shandong Provincial Clinical Research Center for Children’s Health and Disease, Jinan, China
| | - Dong Wang
- Pediatric Research Institute, Children’s Hospital Affiliated to Shandong University, Jinan, China,Shandong Provincial Clinical Research Center for Children’s Health and Disease, Jinan, China
| | - Hongxia Zhang
- Shandong Provincial Clinical Research Center for Children’s Health and Disease, Jinan, China,Department of Nephrology, Children’s Hospital Affiliated to Shandong University, Jinan, China,*Correspondence: Hongxia Zhang, ; Zhongtao Gai, ; Yi Liu,
| | - Zhongtao Gai
- Pediatric Research Institute, Children’s Hospital Affiliated to Shandong University, Jinan, China,Shandong Provincial Clinical Research Center for Children’s Health and Disease, Jinan, China,*Correspondence: Hongxia Zhang, ; Zhongtao Gai, ; Yi Liu,
| | - Yi Liu
- Pediatric Research Institute, Children’s Hospital Affiliated to Shandong University, Jinan, China,Shandong Provincial Clinical Research Center for Children’s Health and Disease, Jinan, China,*Correspondence: Hongxia Zhang, ; Zhongtao Gai, ; Yi Liu,
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11
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Pfeffer AB, Mørup SD, Andersen TR, Mohamed RA, Lambrechtsen J. Is There Any Improvement in Image Quality in Obese Patients When Using a New X-ray Tube and Deep Learning Image Reconstruction in Coronary Computed Tomography Angiography? Life (Basel) 2022; 12. [PMID: 36143464 DOI: 10.3390/life12091428] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Revised: 08/29/2022] [Accepted: 09/06/2022] [Indexed: 11/30/2022] Open
Abstract
Deep learning image reconstruction (DLIR) is a technique that should reduce noise and improve image quality. This study assessed the impact of using both higher tube currents as well as DLIR on the image quality and diagnostic accuracy. The study consisted of 51 symptomatic obese (BMI > 30 kg/m2) patients with low to moderate risk of coronary artery disease (CAD). All patients underwent coronary computed tomography angiography (CCTA) twice, first with the Revolution CT scanner and then with the upgraded Revolution Apex scanner with the ability to increase tube current. Images were reconstructed using ASiR-V 50% and DLIR. The image quality was evaluated by an observer using a Likert score and by ROI measurements in aorta and the myocardium. Image quality was significantly improved with the Revolution Apex scanner and reconstruction with DLIR resulting in an odds ratio of 1.23 (p = 0.017), and noise was reduced by 41%. A total of 88% of the image sets performed with Revolution Apex + DLIR were assessed as good enough for diagnosis compared to 69% of the image sets performed with Revolution Apex/CT + ASiR-V. In obese patients, the combination of higher tube current and DLIR significantly improves the subjective image quality and diagnostic utility and reduces noise.
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12
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Sagy I, Finkel-Oron A, Naamany E, Barski L, Abu-Shakra M, Molad Y, Shiber S. Diagnostic utility of clinical characteristics, laboratory tests, and serum ferritin in diagnosis of adult-onset Still disease. Medicine (Baltimore) 2022; 101:e30152. [PMID: 36042585 PMCID: PMC9410682 DOI: 10.1097/md.0000000000030152] [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] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
The diagnosis of adult-onset Still disease (AOSD) is challenging with ambiguous clinical presentation and no specific serological markers. We aim to evaluate the diagnostic utility of clinical, laboratory and serum ferritin features in established AOSD patients. We included all patients >18 years who were admitted to 2 tertiary medical centers (2003-2019) with serum ferritin above 1000 ng/mL. AOSD patients and non-AOSD controls were matched in 1:4 ratio for age and sex. The primary outcomes were sensitivity, specificity, positive/negative likelihood ratio and area under the curve (AUC) using clinical and laboratory characteristics based on the Yamaguchi classification criteria, in addition to serum ferritin. We identified 2658 patients with serum ferritin above 1000 ng/m, of whom 36 diagnosed with AOSD and 144 non-AOSD matched controls. Presence of arthralgia/arthritis showed the highest sensitivity (0.74), specificity (0.93), positive likelihood ratio (10.69), negative likelihood ratio (0.27) and AUC (0.83, 95% confidence interval 0.74-0.92) to the diagnosis of AOSD. On the other hand, serum ferritin showed variation and poorer results, depends on the chosen ferritin cutoff. Joint involvement showed the best diagnostic utility to establish the diagnosis of AOSD. Although clinicians use often elevated ferritin levels as an anchor to AOSD, the final diagnosis should be based on thorough clinical evaluation.
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Affiliation(s)
- Iftach Sagy
- Rheumatic Diseases Unit, Soroka University Medical Center, Beer Sheva, Israel
- Internal Medicine Division, Soroka University Medical Center, Beer Sheva, Israel
- Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel
| | - Alona Finkel-Oron
- Internal Medicine Division, Soroka University Medical Center, Beer Sheva, Israel
- Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel
| | - Eviatar Naamany
- Internal Medicine Division, Rabin Medical Center, Beilinsone Hospital, Petach Tikva, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Leonid Barski
- Internal Medicine Division, Soroka University Medical Center, Beer Sheva, Israel
- Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel
| | - Mahmoud Abu-Shakra
- Rheumatic Diseases Unit, Soroka University Medical Center, Beer Sheva, Israel
- Internal Medicine Division, Soroka University Medical Center, Beer Sheva, Israel
- Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel
| | - Yair Molad
- Institute of Rheumatology, Rabin Medical Center, Beilinsone Hospital, Petach Tikva, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Shachaf Shiber
- Institute of Rheumatology, Rabin Medical Center, Beilinsone Hospital, Petach Tikva, Israel
- Internal Medicine Division, Rabin Medical Center, Beilinsone Hospital, Petach Tikva, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- *Correspondence: Iftach Sagy, MD, PhD, Clinical Research Center, Soroka University Medical Center, POB 151, Beer-Sheva 84101, Israel (e-mail: )
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13
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Zajkowska M, Dulewicz M, Kulczyńska-Przybik A, Safiejko K, Juchimiuk M, Konopko M, Kozłowski L, Mroczko B. The Significance of Selected C-C Motif Chemokine Ligands in Colorectal Cancer Patients. J Clin Med 2022; 11:1794. [PMID: 35407400 DOI: 10.3390/jcm11071794] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Revised: 03/17/2022] [Accepted: 03/23/2022] [Indexed: 02/06/2023] Open
Abstract
Colorectal cancer (CRC) is one of the most frequently diagnosed neoplasms. Despite the advances in diagnostic tools and treatments, the number of CRC cases is increasing. Therefore, it is vital to search for new parameters that could be useful in its diagnosis. Thus, we wanted to assess the usefulness of selected CC chemokines (CCL2, CCL4, and CCL15) in CRC. The study included 115 subjects (75 CRC patients and 40 healthy volunteers). The serum concentrations of all parameters were measured using a multiplexing method (Luminex). The CRP levels were determined by immunoturbidimetry, and the classical tumor markers (CEA and CA 19-9) were measured using CMIA (chemiluminescent microparticle immunoassay). The concentrations of all parameters were higher in the CRC group when compared to the healthy controls. The diagnostic sensitivity, specificity, positive and negative predictive value, and area under the ROC curve (AUC) of all estimated CC chemokines were higher than those of CA 19-9. Interestingly, the obtained results also suggest CCL2's significance in the determination of local metastases and CCL4's significance in the determination of distant metastases. However, further studies concerning the role of selected CC chemokines in the course of colorectal cancer are necessary to confirm and to fully clarify their diagnostic utility and their clinical application as markers of CRC development.
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14
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Xue XH, Tao LL, Su DQ, Guo CJ, Liu H. Diagnostic utility of GDF15 in neurodegenerative diseases: A systematic review and meta-analysis. Brain Behav 2022; 12:e2502. [PMID: 35068064 PMCID: PMC8865151 DOI: 10.1002/brb3.2502] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Revised: 11/29/2021] [Accepted: 01/02/2022] [Indexed: 12/29/2022] Open
Abstract
INTRODUCTION GDF15 may be a potential biomarker for neurodegenerative diseases. In this analysis, we aimed to quantitative analysis the levels of GDF15 in patients with neurological diseases and in health control, and then to determine its potential diagnostic utility. METHODS Two researchers separately conducted a systematic search of the relevant studies up to January 2021 in Embase, PubMed, and Web of Science. Effect sizes were estimated to use the standardized mean difference (SMD) with 95% confidence interval (CI). Sensitivity and specificity were calculated by the summary receiver operating characteristics curve (SROC) method. The sensitivity analysis was performed by the "one-in/one-out" approach. Considering the considerable heterogeneity among studies, random-effects model was used for the meta-analysis investigation. RESULTS A total of eight articles were included in this meta-analysis and systematic review. The pooled results of the random effect model indicated GDF15 levels were significantly higher in patients with neurodegenerative disease than healthy people (SMD = 0.92, 95% CI: 0.44-1.40, Z = 3.75, p < 0.001). Sensitivity and specificity of biomarker of GDF15 were 0.90 (95% CI: 0.75-0.97), 0.77 (95% CI: 0.67-0.65), and AUC = 0.87 (95% CI: 0.84-0.90), respectively. CONCLUSIONS GDF15 levels were higher in patients with neurodegenerative disease than healthy people. And serum levels of GDF15 were a better marker for diagnostic utility of neurodegenerative disease.
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Affiliation(s)
- Xin-Hong Xue
- Department of Neurology, Liaocheng Hospital Affiliated to Shandong First Medical University, Liaocheng People's Hospital, Liaocheng, China
| | - Lin-Lin Tao
- Department of Neurology, Liaocheng Hospital Affiliated to Shandong First Medical University, Liaocheng People's Hospital, Liaocheng, China
| | - Dao-Qing Su
- Department of Neurosurgery, Liaocheng Hospital Affiliated to Shandong First Medical University, Liaocheng People's Hospital, Liaocheng, China
| | - Cun-Ju Guo
- Department of Neurology, Liaocheng Hospital Affiliated to Shandong First Medical University, Liaocheng People's Hospital, Liaocheng, China
| | - Hong Liu
- Department of Neurology, Liaocheng Hospital Affiliated to Shandong First Medical University, Liaocheng People's Hospital, Liaocheng, China
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15
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Abdullah I, Subramony N, Musekwa E, Nell EM, Alzanad F, Chetty C, Gantana E, Lohlun RK, Cerfontein W, Cochrane B, Chapanduka ZC. Indications and diagnostic value of bone marrow examination in HIV-positive individuals: A 3-year review at Tygerberg Hospital. S Afr J Infect Dis 2021; 36:273. [PMID: 34522695 PMCID: PMC8424746 DOI: 10.4102/sajid.v36i1.273] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2020] [Accepted: 05/06/2021] [Indexed: 11/01/2022] Open
Abstract
Background Bone marrow examination is a useful diagnostic tool in human immunodeficiency virus (HIV)-positive patients presenting with cytopenias and fever. However, its role in the afebrile and asymptomatic patient presenting with an isolated cytopenia is not well established. This study was conducted to determine the indications for bone marrow examination and its diagnostic yield, in HIV-positive patients at Tygerberg Hospital. Methods A retrospective, cross-sectional descriptive study was performed over a 3-year period from 01 September 2015 to 31 August 2018. The bone marrow examination reports for the HIV-positive patients who had a bone marrow examination during the study period were retrieved. Clinical and laboratory information was captured. Results Altogether 374 bone marrow reports for HIV-positive patients were found. The indication of the bone marrow examination included investigation of unexplained cytopenias, suspected haematological malignancies, follow-up examination for patients with known haematological diseases, staging of haematological or non-haematological malignancies and investigation of suspected disseminated infection. The patients' median age was 43 years and the interquartile range was 27-60 years. There was a slight female predominance with females 51% and males 49%. The diagnostic yield was 33.7%. Acute leukaemia and lymphoma were the most common diagnoses. Haematinic deficiency and pure red cell aplasia were found in the majority of cases with isolated anaemia. All cases with isolated thrombocytopenia were due to immune thrombocytopenia. Conclusion Bone marrow examination is a useful investigation for HIV-positive patients with cytopenias, suspected haematological malignancy and lymphoma staging. However, its early use in patients with isolated anaemia and isolated thrombocytopenia is questionable.
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Affiliation(s)
- Ibtisam Abdullah
- Department of Haematological Pathology, Stellenbosch University, Cape Town, South Africa.,National Health Laboratory Service, Cape Town, South Africa
| | - Nadhiya Subramony
- Department of Haematological Pathology, Stellenbosch University, Cape Town, South Africa.,National Health Laboratory Service, Cape Town, South Africa
| | - Ernest Musekwa
- Department of Haematological Pathology, Stellenbosch University, Cape Town, South Africa.,National Health Laboratory Service, Cape Town, South Africa
| | - Erica-Mari Nell
- Department of Haematological Pathology, Stellenbosch University, Cape Town, South Africa.,National Health Laboratory Service, Cape Town, South Africa
| | - Fatima Alzanad
- Department of Haematological Pathology, Stellenbosch University, Cape Town, South Africa.,National Health Laboratory Service, Cape Town, South Africa
| | - Carissa Chetty
- Department of Haematological Pathology, Stellenbosch University, Cape Town, South Africa.,National Health Laboratory Service, Cape Town, South Africa
| | - Ethan Gantana
- Department of Haematological Pathology, Stellenbosch University, Cape Town, South Africa.,National Health Laboratory Service, Cape Town, South Africa
| | - Robert K Lohlun
- Department of Haematological Pathology, Stellenbosch University, Cape Town, South Africa.,National Health Laboratory Service, Cape Town, South Africa
| | - Wardah Cerfontein
- Department of Haematological Pathology, Stellenbosch University, Cape Town, South Africa.,National Health Laboratory Service, Cape Town, South Africa
| | - Bridget Cochrane
- Department of Haematological Pathology, Stellenbosch University, Cape Town, South Africa.,National Health Laboratory Service, Cape Town, South Africa
| | - Zivanai C Chapanduka
- Department of Haematological Pathology, Stellenbosch University, Cape Town, South Africa.,National Health Laboratory Service, Cape Town, South Africa
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Rao S, Vazhayil V, Nandeesh BN, Beniwal M, Rao KVLN, Yasha TC, Somanna S, Santosh V, Mahadevan A. Diagnostic Utility of CUSA Specimen in Histopathological Evaluation of Tumors of Central Nervous System. Neurol India 2021; 68:1385-1388. [PMID: 33342873 DOI: 10.4103/0028-3886.304072] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Introduction Cavitron Ultrasonic Surgical Aspirator (CUSA) is a technique used for the surgical treatment of tumors that aids the surgeon in highly selective tumor sampling with minimal injury to surrounding tissues. The utility of the tissue obtained from CUSA for histopathological diagnosis of central nervous system tumors is not as well-known as its surgical benefits. Even though a few studies have evaluated the diagnostic accuracy of CUSA specimen, these have dealt with very few cases. Methodology In this study, we nil analysed 73 cases of CNS tumors (glial and non-glial) where CUSA specimen was available for histopathological examination and compared with findings on conventional samples as gold standard. Results Most frequent types of artefacts induced by CUSA included tissue breakdown resembling necrosis, empty spaces in tissues, and crush artefacts particularly in cellular tumors, that interfered with interpretation. CUSA samples were found optimal for diagnosis of non-glial tumors (45/73), (mainly mesenchymal), wherein the diagnostic utility was comparable to the conventional samples. Difficulties were encountered in glial neoplasms, medulloblastomas and meningiomas. In glial neoplasms (28/73), accurate grading was not possible (9/28, 32%) utilising CUSA samples alone as necrosis and mitosis were not represented. Similarly in meningiomas, mitosis and brain invasion, essential for grading, was not recognizable in CUSA samples. In medulloblastomas, extensive crush artefacts interfered with diagnosis and histological subtyping making it mandatory to examine conventional tissue samples and CUSA. Immunohistochemistry results were optimal with CUSA tissue, wherever performed. Conclusion The greatest benefits of CUSA, is its ability to sample multiple areas enhancing the yield in heterogenous tumors like gliosarcomas and its utility in tumors at surgically inaccessible sites. As a policy, we recommend that it is beneficial that all surgically excised tissues including those from the CUSA bottle and suction be sent for histopathological analysis for optimising diagnostic accuracy.
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Affiliation(s)
- Shilpa Rao
- Department of Neuropathology, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
| | - Vikas Vazhayil
- Department of Neurosurgery, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
| | - B N Nandeesh
- Department of Neuropathology, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
| | - Manish Beniwal
- Department of Neurosurgery, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
| | - K V L Narasinga Rao
- Department of Neurosurgery, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
| | - T C Yasha
- Department of Neuropathology, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
| | - Sampath Somanna
- Department of Neurosurgery, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
| | - Vani Santosh
- Department of Neuropathology, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
| | - Anita Mahadevan
- Department of Neuropathology, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
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17
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Zhou X, Reynolds C, Kamphaus RW. Diagnostic utility of Behavior Assessment System for Children-3 for children and adolescents with autism. Appl Neuropsychol Child 2021; 11:647-651. [PMID: 34098808 DOI: 10.1080/21622965.2021.1929232] [Citation(s) in RCA: 2] [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] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
This study examined the accuracy of the Behavior Assessment System for Children-3 for Autism Spectrum Disorder (ASD) diagnosis using parent (PRS) and teaching rating (TRS) scales. The accuracy of three PRS and TRS derived scores with strong theoretical relationships to ASD (Developmental Social Disorders [DSD], Atypicality [ATP], and Withdrawal [WIT]) and the Autism Probability Index (AUI) was examined. The T scores of 149 children with ASD were compared with typically developing children within similar demographics to assess diagnostic accuracy (i.e., differential validity). The results revealed statistically significant differences for all scales between the group with ASD and the matched group of typically developing children. Sensitivity and specificity were maximized for both the PRS and TRS when DSD, ATP, and WIT scales were greater than 60 and a cut score of on the AUI was set at 55. Overall, sensitivity and specificity indexes associated with these cut scores demonstrated strong diagnostic utility for differentiating the two groups.
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Affiliation(s)
- Xuechun Zhou
- Pearson Education-North America Division, San Antonio, Texas, USA
| | - Cecil Reynolds
- Educational Psychology Division, Texas A & M University, Austin, Texas, USA
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Kim SH, Park K, Yoon S, Choi Y, Lee SH, Choi KH. A Brief Online and Offline (Paper-and-Pencil) Screening Tool for Generalized Anxiety Disorder: The Final Phase in the Development and Validation of the Mental Health Screening Tool for Anxiety Disorders (MHS: A). Front Psychol 2021; 12:639366. [PMID: 33692730 PMCID: PMC7937919 DOI: 10.3389/fpsyg.2021.639366] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [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: 12/08/2020] [Accepted: 01/29/2021] [Indexed: 12/04/2022] Open
Abstract
Generalized anxiety disorder (GAD) can cause significant socioeconomic burden and daily life dysfunction; hence, therapeutic intervention through early detection is important. This study was the final stage of a 3-year anxiety screening tool development project that evaluated the psychometric properties and diagnostic screening utility of the Mental Health Screening Tool for Anxiety Disorders (MHS: A), which measures GAD. A total of 527 Koreans completed online and offline (i.e., paper-and pencil) versions of the MHS: A, Beck Anxiety Inventory (BAI), Generalized Anxiety Disorder-7 (GAD-7), and Penn State Worry Questionnaire (PSWQ). The participants had an average age of 38.6 years and included 340 (64.5%) females. Participants were also administered the Mini-International Neuropsychiatric Interview (MINI). Internal consistency, convergent/criterion validity, item characteristics, and test information were assessed based on the item response theory (IRT), and a factor analysis and cut-off score analyses were conducted. The MHS: A had good internal consistency and good convergent validity with other anxiety scales. The two versions (online/offline) of the MHS: A were nearly identical (r = 0.908). It had a one-factor structure and showed better diagnostic accuracy (online/offline: sensitivity = 0.98/0.90, specificity = 0.80/0.83) for GAD detection than the GAD-7 and BAI. The IRT analysis indicated that the MHS: A was most informative as a screening tool for GAD. The MHS: A can serve as a clinically useful screening tool for GAD in Korea. Furthermore, it can be administered both online and offline and can be flexibly used as a brief mental health screener, especially with the current rise in telehealth.
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Affiliation(s)
- Shin-Hyang Kim
- School of Psychology, Korea University, Seoul, South Korea.,KU Mind Health Institute, Korea University, Seoul, South Korea
| | - Kiho Park
- School of Psychology, Korea University, Seoul, South Korea.,KU Mind Health Institute, Korea University, Seoul, South Korea
| | - Seowon Yoon
- School of Psychology, Korea University, Seoul, South Korea
| | - Younyoung Choi
- Department of Adolescent Psychology, Hanyang Cyber University, Seoul, South Korea
| | - Seung-Hwan Lee
- Department of Psychiatry, Inje University Ilsanpaik Hospital, Goyang, South Korea
| | - Kee-Hong Choi
- School of Psychology, Korea University, Seoul, South Korea.,KU Mind Health Institute, Korea University, Seoul, South Korea
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19
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Ceylan SM, Kanmaz MA, Disikirik I, Karadeniz PG. Peak nasal inspiratory airflow measurements for assessing laryngopharyngeal reflux treatment. Clin Otolaryngol 2021; 46:796-801. [PMID: 33580555 DOI: 10.1111/coa.13737] [Citation(s) in RCA: 2] [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] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Revised: 12/08/2020] [Accepted: 01/31/2021] [Indexed: 12/18/2022]
Abstract
OBJECTIVES To evaluate the effect of laryngopharyngeal reflux (LPR) and antireflux treatment on peak nasal inspiratory airflow (PNIF). DESIGN Prospective observational study was conducted. SETTING Tertiary otorhinolaryngology clinic. PARTICIPANTS Adults with LPR and healthy controls. MAIN OUTCOME MEASURES PNIF measurements were performed on 60 patients who applied with complaints suggestive of LPR having higher Reflux Symptom Index (RSI) (>13) and Reflux Finding Scores (RFS) scores (>7). Proton pump inhibitor (PPI) treatment was started and PNIF measurements were repeated two months later. A total of 100 patients without any history of LPR and sinonasal disease were included in the study. RESULTS A statistically significant increase was observed in PNIF values after proton pump inhibitor treatment. The mean PNIF values of the LPR patients were 133.83 ± 27.99 L/min and 149.92 ± 23.23 L/min before and after treatment, respectively. The mean PNIF value in the control group was 145.0 ± 25.92 L/min. PNIF values were significantly lower in the LPR relative to the control group (P < .05). CONCLUSION Laryngopharyngeal reflux decreases PNIF. This negative effect on PNIF disappears after antireflux medication. The results of the study indicate that PNIF measurements may be an appropriate method for clinical diagnosis of LPR and evaluation of treatment results.
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Affiliation(s)
- Seyit M Ceylan
- Department of Otorhinolaryngology, Fatih Sultan Mehmet Training and Research Hospital, Istanbul, Turkey
| | - Mahmut A Kanmaz
- Department of Otorhinolaryngology, SANKO University, Gaziantep, Turkey
| | - Ilyas Disikirik
- Department of Physical Therapy and Rehabilitation, SANKO University, Gaziantep, Turkey
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20
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Li YJ, Liu WS, Bai ZC, Cao RX, Ren HH. Diagnostic performance of OCT and OCTA in less than 60-year-old patients with early POAG: a cross-sectional study. Int J Ophthalmol 2020; 13:1915-1921. [PMID: 33344190 DOI: 10.18240/ijo.2020.12.11] [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: 03/24/2020] [Accepted: 08/25/2020] [Indexed: 11/23/2022] Open
Abstract
AIM To observe and characterize imaging features of macular and optic disc areas in less than 60-year-old patients with early primary open angle glaucoma (POAG) by optical coherence tomography (OCT) and optical coherence tomography angiography (OCTA), and to evaluate the diagnostic value of OCT and OCTA. METHODS Totally 15 patients (23 eyes) with early POAG as observation group and 30 health people (30 eyes) as normal control group were enrolled in this cross-sectional study. OCTA-based superficial macula vessel density, superficial macula perfusion density, superficial optic disc vessel density, superficial optic disc perfusion density and spectral domain OCT (SD-OCT)-based macular area thickness, ganglion cell complex (GCC) thickness and retinal nerve fiber layer (RNFL) thickness were measured in the two groups. Independent t-test and receiver operating characteristic curve were used for analysis. Area under the receiver operating characteristic curves (AUROC) were used to measure the diagnostic utility. RESULTS Among all the parameters, the optimal diagnostic utility parameter was the superficial vessel density in the macular area (except the center of the macula), and the AUROC reached 0.98. The diagnostic utility of macular area perfusion density (except the center of the macula) was similar to that of superficial vessel density in the macular area, and the AUROC was above 0.97. Followed by the diagnostic utility of vessel density in the optic disc area, the best parameter was the inner ring of the vessel density, and its AUROC reached 0.97. The diagnostic utility of perfusion density in the optic disc area was slightly lower than that of vessel density in the optic disc area. The best parameter was the central optic disc perfusion density, and its AUROC was 0.95. The SD-OCT-based diagnostic utility parameters were generally lower than that mentioned above, the top three parameters were the inferior RNFL thickness (AUROC=0.919), the superior (AUROC=0.919) and the inferior GCC thickness (AUROC=0.9077). CONCLUSION The OCT-based diagnostic utility parameters are generally lower than the OCTA-based diagnostic utility parameters. OCTA has an important clinical application value in diagnosis and evaluation for less than 60-year-old patients with early POAG.
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Affiliation(s)
- Yan-Jie Li
- Department of Ophthalmology, the First Hospital of Shanxi Medical University, Taiyuan 030001, Shanxi Province, China
| | - Wei-Shai Liu
- Department of Ophthalmology, the First Hospital of Shanxi Medical University, Taiyuan 030001, Shanxi Province, China
| | - Zi-Chao Bai
- Department of Ophthalmology, the First Hospital of Shanxi Medical University, Taiyuan 030001, Shanxi Province, China
| | - Rong-Xia Cao
- Department of Ophthalmology, the First Hospital of Shanxi Medical University, Taiyuan 030001, Shanxi Province, China
| | - Hai-Hua Ren
- Shanxi Medical University, Taiyuan 030001, Shanxi Province, China
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21
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Bayrak BY, Paksoy N, Vural Ç. Diagnostic utility of fine needle aspiration cytology and core biopsy histopathology with or without immunohistochemical staining in the subtyping of the non-small cell lung carcinomas: Experience from an academic centre in Turkey. Cytopathology 2020; 32:331-337. [PMID: 33145811 DOI: 10.1111/cyt.12937] [Citation(s) in RCA: 4] [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] [Received: 07/23/2020] [Revised: 10/21/2020] [Accepted: 11/02/2020] [Indexed: 12/23/2022]
Abstract
INTRODUCTION This retrospective morphological study compared the results of fine needle aspiration (FNA) cytology, haematoxylin-eosin (HE)-stained samples and immunohistochemical (IHC)-stained core needle biopsy (CNB) histology samples for primary non-small cell lung cancer (NSCLC) subtyping. We assessed the diagnostic utility of these methods to investigate the contribution of each method to NSCLC subtyping. We also identified the point at which NSCLC subtyping could be performed using histomorphology alone without IHC. METHODOLOGY Concurrent FNA and CNB specimens obtained via a single computed tomography-guided procedure and diagnosed as NSCLC in the Pathology Department of our university within 3 years were reviewed. The results of FNA samples, HE-stained biopsies and IHC-stained biopsies were compared according to subtype. RESULTS A total of 141 subjects were enrolled in the study. For subtyping, FNA provided an accurate diagnosis in 70 (55.1%) of 127 eligible subjects after the exclusion of 14 cases determined as not otherwise specified. CNB histology without IHC achieved a diagnosis in 53 (41.7%) of 127 subjects, which was a significant difference (P < .05). The compatibility rate between HE-stained biopsy samples and IHC-stained biopsy samples was 41.7% (53/127). CONCLUSION The diagnosis rates achieved using FNA, HE-stained CNB samples and IHC-stained CNB samples were 54.6% (77/141), 37.6% (53/141) and 90.1% (127/141), respectively. The subtype was identified in 55.1% of the subjects evaluated using FNA and 41.7% of subjects assessed using HE-stained biopsy samples without IHC. FNA provided a better result for squamous cell carcinoma than adenocarcinoma (55.1% vs 47.6%), but the diagnosing of adenocarcinoma and squamous cell carcinoma using HE-stained biopsy samples was similar (42% vs 41.7%).
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Affiliation(s)
- Büşra Yaprak Bayrak
- Department of Pathology, Faculty of Medicine, University of Kocaeli, Izmit, Kocaeli, Turkey
| | - Nadir Paksoy
- Department of Pathology, Faculty of Medicine, University of Kocaeli, Izmit, Kocaeli, Turkey.,Cytopathology/FNA Private Practice, Izmit, Kocaeli, Turkey
| | - Çiğdem Vural
- Department of Pathology, Faculty of Medicine, University of Kocaeli, Izmit, Kocaeli, Turkey
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22
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Affiliation(s)
- Mike Leach
- Beatson West of Scotland Cancer Centre and Gartnavel Hospital, Glasgow, UK
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23
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da Motta C, Castilho P, Pato MT, Barreto Carvalho C. Construct validity, sensitivity and specificity of the USCD Performance-based Skill Assessment 2 in a mixed Portuguese sample. Hum Psychopharmacol 2020; 35:e2735. [PMID: 32374462 DOI: 10.1002/hup.2735] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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: 11/22/2019] [Revised: 02/07/2020] [Accepted: 04/01/2020] [Indexed: 11/09/2022]
Abstract
UNLABELLED Assessment batteries of functional capacity provide robust indicators of real-world functioning in major psychiatric illnesses and important information on an individual's ability to live autonomously and pursue relevant psychosocial goals. OBJECTIVES This study explores the psychometric properties of the Portuguese USCD Performance-based Skill Assessment 2 (UPSA-2-PT) in a mixed sample of Portuguese participants. METHOD A sample of 110 participants, 37 patients diagnosed with schizophrenia, 27 first-degree relatives of patients and 46 controls were administered the UPSA-2-PT and self-report questionnaires. The UPSA-2-PT reliability was assessed through inter-rater reliability and internal consistency, convergent validity with community integration and a receiver operating curve analysis was conducted to establish scores' sensitivity and specificity. Youden's Index was used to determine an optimal UPSA-2-PT cutoff score. RESULTS Findings show an excellent inter-rater reliability, good internal consistency and construct validity, consistent with previous studies in Western countries. The UPSA-2-PT also showed a good discriminant ability between patients and controls, and an overall percentage of correct classification of 86.7% based on the 81.59 cutoff. DISCUSSION Findings are congruous with previous versions, strengthening the body of evidence supporting the construct validity and providing a useful tool for research and clinical purposes to practitioners.
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Affiliation(s)
- Carolina da Motta
- Cognitive and Behavioural Centre for Research and Intervention (CINEICC), Faculty of Psychology and Educational Sciences, University of Coimbra, Portugal.,Department of Psychology, Faculty of Social and Human Sciences, University of Azores, Azores, Portugal
| | - Paula Castilho
- Cognitive and Behavioural Centre for Research and Intervention (CINEICC), Faculty of Psychology and Educational Sciences, University of Coimbra, Portugal
| | - Michele T Pato
- Director of the Institute for Genomic Health (IGH) - Department of Psychiatry and the Behavioral Sciences, State University of NewYork, Downstate Medical Center, New York, NY, USA
| | - Célia Barreto Carvalho
- Cognitive and Behavioural Centre for Research and Intervention (CINEICC), Faculty of Psychology and Educational Sciences, University of Coimbra, Portugal.,Department of Psychology, Faculty of Social and Human Sciences, University of Azores, Azores, Portugal.,Institute for Genomic Health - Department of Psychiatry/College of Medicine SUNY Downstate- Brooklyn, N.Y., USA
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24
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Gao Y, Li T, Han M, Li X, Wu D, Xu Y, Zhu Y, Liu Y, Wang X, Wang L. Diagnostic utility of clinical laboratory data determinations for patients with the severe COVID-19. J Med Virol 2020; 92:791-796. [PMID: 32181911 PMCID: PMC7228247 DOI: 10.1002/jmv.25770] [Citation(s) in RCA: 597] [Impact Index Per Article: 149.3] [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: 02/28/2020] [Revised: 03/12/2020] [Accepted: 03/13/2020] [Indexed: 12/13/2022]
Abstract
The role of clinical laboratory data in the differential diagnosis of the severe forms of COVID‐19 has not been definitely established. The aim of this study was to look for the warning index in severe COVID‐19 patients. We investigated 43 adult patients with COVID‐19. The patients were classified into mild group (28 patients) and severe group (15 patients). A comparison of the hematological parameters between the mild and severe groups showed significant differences in interleukin‐6 (IL‐6), d‐dimer (d‐D), glucose, thrombin time, fibrinogen, and C‐reactive protein (P < .05). The optimal threshold and area under the receiver operator characteristic curve (ROC) of IL‐6 were 24.3 and 0.795 µg/L, respectively, while those of d‐D were 0.28 and 0.750 µg/L, respectively. The area under the ROC curve of IL‐6 combined with d‐D was 0.840. The specificity of predicting the severity of COVID‐19 during IL‐6 and d‐D tandem testing was up to 93.3%, while the sensitivity of IL‐6 and d‐D by parallel test in the severe COVID‐19 was 96.4%. IL‐6 and d‐D were closely related to the occurrence of severe COVID‐19 in the adult patients, and their combined detection had the highest specificity and sensitivity for early prediction of the severity of COVID‐19 patients, which has important clinical value.
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Affiliation(s)
- Yong Gao
- Department of Clinical Laboratory, Fuyang Second People's Hospital, Fuyang, Anhui, China
| | - Tuantuan Li
- Department of Clinical Laboratory, Fuyang Second People's Hospital, Fuyang, Anhui, China
| | - Mingfeng Han
- Department of Clinical Laboratory, Fuyang Second People's Hospital, Fuyang, Anhui, China
| | - Xiuyong Li
- Department of Clinical Laboratory, Fuyang Second People's Hospital, Fuyang, Anhui, China
| | - Dong Wu
- Department of Pharmacy, Fuyang People's Hospital, Fuyang, Anhui, China
| | - Yuanhong Xu
- Department of Clinical Laboratory, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
| | - Yulin Zhu
- Department of Pediatrics, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
| | - Yan Liu
- Department of Microbiology, Anhui Medical University, Hefei, Anhui, China
| | - Xiaowu Wang
- Department of Clinical Laboratory, Fuyang Second People's Hospital, Fuyang, Anhui, China
| | - Linding Wang
- Department of Microbiology, Anhui Medical University, Hefei, Anhui, China
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25
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Park K, Jaekal E, Yoon S, Lee SH, Choi KH. Diagnostic Utility and Psychometric Properties of the Beck Depression Inventory-II Among Korean Adults. Front Psychol 2020; 10:2934. [PMID: 32038360 PMCID: PMC6985267 DOI: 10.3389/fpsyg.2019.02934] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [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: 10/17/2019] [Accepted: 12/11/2019] [Indexed: 11/29/2022] Open
Abstract
The Beck Depression Inventory-II (BDI-II) is one of the most widely used depression assessment tools in Korea. However, the psychometric properties and diagnostic cut-off point of the official Korean version of the BDI-II have not yet been reported. This study aims to clarify the psychometric properties and diagnostic utility of the Korean BDI-II. A total of 1,145 clinical and non-clinical Korean adults participated in this study. The BDI-II showed a high level of internal consistency and high correlations with other depression-related measures. Confirmatory factor analysis (CFA) was performed, and a 3-factor model showed the best model fit. To identify the diagnostic utility of the BDI-II, the Quality Assessment of Diagnostic Accuracy Studies 2nd Edition (QUADAS-2) methodology was applied in participant recruitment and research design. Results of ROC curve analysis suggested two optimal cut-off scores, 23 points for detecting major depressive disorder (MDD) (83.3% sensitivity, 86.8% specificity) and 17 points for depressive-related disorder (80.9% sensitivity, 76.4% specificity). To identify the usefulness of the BDI-II as a severity assessment tool or screening tool, a test information curve (TIC) was generated with an Item Response Theory (IRT) analysis. The TIC was flat and plateau-like, indicating its appropriateness as a severity rating tool. Research data supports the BDI-II as a reliable and valid screening tool as well as a severity rating tool in the Korean adult population.
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Affiliation(s)
- Kiho Park
- Department of Psychology, Korea University, Seoul, South Korea.,KU Mind Health Institute, Korea University, Seoul, South Korea
| | - Eunju Jaekal
- Department of Psychology, Korea University, Seoul, South Korea
| | - Seowon Yoon
- Department of Psychology, Korea University, Seoul, South Korea
| | - Seung-Hwan Lee
- Department of Psychiatry, Inje University Ilsanpaik Hospital, Goyang, South Korea.,Clinical Emotion and Cognition Research Laboratory, Inje University, Goyang, South Korea
| | - Kee-Hong Choi
- Department of Psychology, Korea University, Seoul, South Korea.,KU Mind Health Institute, Korea University, Seoul, South Korea
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26
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Sutar R, Chaturvedi SK. Symptom profile and diagnostic utility of depersonalization-derealization disorder: A retrospective critical review from India. Indian J Psychiatry 2020; 62:91-94. [PMID: 32001937 PMCID: PMC6964445 DOI: 10.4103/psychiatry.indianjpsychiatry_347_19] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2019] [Revised: 10/06/2019] [Accepted: 11/18/2019] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Depersonalization and derealization (DPDR) syndrome results from complex interwoven sensory motor experiences seen across psychiatric disorders. There is sparse literature from India on DPDR symptoms, their clinical and research utility. This study focuses frequency of coding the diagnosis of DPDR (ICD-10) and critical discussion about its clinical and research utility. METHODS A retrospective review of case files coded under ICD code F48.1 was carried out for 10 years and details were systematically analyzed for age, gender, duration, phenomenology, comorbid diagnosis, and pharmacological treatment. RESULTS Fourteen patients received the diagnosis of DPDR. Mean duration of DPDR syndrome was 6 years (standard deviation [SD] = 2.2) while mean age of presentation to hospital was 24 years (SD = 2.5). Tactile imagery (50%), self-environmental integration (42%), and dream-reality integration (28%) were the major themes. Selective serotonin reuptake inhibitors were used as primary medication for 65% of patients. CONCLUSION Isolated DPDR syndrome has been diagnosed very rarely in recent past. Reasons may include ignoring the comorbid DPDR coding, inability to articulate DPDR symptoms, inadequate documentation and misinterpretation of symptoms or actually less prevalence of DPDR syndrome in India. Considering scanty literature on DPDR as a primary diagnosis, more studies are required to identify the actual prevalence and coding of DPDR in future.
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Affiliation(s)
- Roshan Sutar
- Department of Psychiatry, All India Institute of Medical Sciences, Bhopal, Madhya Pradesh, India
| | - Santosh K Chaturvedi
- Department of Psychiatry, National Institute of Mental Health and Neuro Sciences, Bengaluru, Karnataka, India
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27
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de Haan A, Eijgelsheim M, Vogt L, Knoers NVAM, de Borst MH. Diagnostic Yield of Next-Generation Sequencing in Patients With Chronic Kidney Disease of Unknown Etiology. Front Genet 2019; 10:1264. [PMID: 31921302 PMCID: PMC6923268 DOI: 10.3389/fgene.2019.01264] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2019] [Accepted: 11/15/2019] [Indexed: 12/11/2022] Open
Abstract
Advances in next-generation sequencing (NGS) techniques, including whole exome sequencing, have facilitated cost-effective sequencing of large regions of the genome, enabling the implementation of NGS in clinical practice. Chronic kidney disease (CKD) is a major contributor to global burden of disease and is associated with an increased risk of morbidity and mortality. CKD can be caused by a wide variety of primary renal disorders. In about one in five CKD patients, no primary renal disease diagnosis can be established. Moreover, recent studies indicate that the clinical diagnosis may be incorrect in a substantial number of patients. Both the absence of a diagnosis or an incorrect diagnosis can have therapeutic implications. Genetic testing might increase the diagnostic accuracy in patients with CKD, especially in patients with unknown etiology. The diagnostic utility of NGS has been shown mainly in pediatric CKD cohorts, while emerging data suggest that genetic testing can also be a valuable diagnostic tool in adults with CKD. In addition to its implications for unexplained CKD, NGS can contribute to the diagnostic process in kidney diseases with an atypical presentation, where it may lead to reclassification of the primary renal disease diagnosis. So far, only a few studies have reported on the diagnostic yield of NGS-based techniques in patients with unexplained CKD. Here, we will discuss the potential diagnostic role of gene panels and whole exome sequencing in pediatric and adult patients with unexplained and atypical CKD.
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Affiliation(s)
- Amber de Haan
- Department of Internal Medicine, Division of Nephrology, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
| | - Mark Eijgelsheim
- Department of Internal Medicine, Division of Nephrology, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
| | - Liffert Vogt
- Section Nephrology, Amsterdam Cardiovascular Sciences, Department of Internal Medicine, Amsterdam University Medical Centre, University of Amsterdam, Amsterdam, Netherlands
| | - Nine V. A. M. Knoers
- Department of Genetics, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
| | - Martin H. de Borst
- Department of Internal Medicine, Division of Nephrology, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
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28
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Mistry J, Heneghan NR, Noblet T, Falla D, Rushton A. Diagnostic utility of patient history, clinical examination and screening tool data to identify neuropathic pain in low back-related leg pain: protocol for a systematic review. BMJ Open 2019; 9:e033187. [PMID: 31767596 PMCID: PMC6887074 DOI: 10.1136/bmjopen-2019-033187] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
INTRODUCTION Neuropathic low back-related leg pain (LBLP) can be a challenge to healthcare providers to diagnose and treat. Accurate diagnosis of neuropathic pain is fundamental to ensure appropriate intervention is given. However, to date there is no gold standard to diagnose neuropathic LBLP. Patient examination guidelines and screening tools have been developed and validated for the purpose of diagnosing neuropathic pain in LBLP; however, there has been no systematic review conducted to compare the diagnostic validity of these methods. Therefore, this systematic review will investigate the diagnostic utility of patient history, clinical examination and screening tool data to identify neuropathic pain in LBLP. METHODS AND ANALYSIS This protocol is informed and reported in line with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis-Protocols. CINAHL, EMBASE, MEDLINE, Web of Science, Cochrane Library, AMED, Pedro, PubMed, key journals and grey literature will be searched rigorously to find diagnostic accuracy studies investigating patient examination data to identify neuropathic pain in LBLP patients. Two independent reviewers will conduct the search, extract the data and assess risk of bias for included studies using the Quality Assessment of Diagnostic Accuracy Studies 2 tool. The overall quality of included studies will be evaluated using Grading of Recommendations, Assessment, Development and Evaluation guidelines. A meta-analysis will be conducted if deemed appropriate. Otherwise, a narrative synthesis will be conducted. ETHICS AND DISSEMINATION No research ethics is required for this systematic review since patient data will not be collected. This review will help to inform healthcare professionals and researchers on the most effective means in which to diagnose neuropathic pain in LBLP. Results of this review will be submitted for publication in a peer-review journal and conference presentations. PROSPERO REGISTRATION NUMBER CRD42019140861.
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Affiliation(s)
- Jai Mistry
- Physiotherapy, St George's Hospital NHS Foundation Trust, London, UK
- Centre of Precision Rehabilitation for Spinal Pain, University of Birmingham, Birmingham, UK
| | - Nicola R Heneghan
- Centre of Precision Rehabilitation for Spinal Pain, University of Birmingham, Birmingham, UK
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, UK
| | - Timothy Noblet
- Physiotherapy, St George's Hospital NHS Foundation Trust, London, UK
- Centre of Precision Rehabilitation for Spinal Pain, University of Birmingham, Birmingham, UK
| | - Deborah Falla
- Centre of Precision Rehabilitation for Spinal Pain, University of Birmingham, Birmingham, UK
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, UK
| | - Alison Rushton
- Centre of Precision Rehabilitation for Spinal Pain, University of Birmingham, Birmingham, UK
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, UK
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29
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Sanford EF, Clark MM, Farnaes L, Williams MR, Perry JC, Ingulli EG, Sweeney NM, Doshi A, Gold JJ, Briggs B, Bainbridge MN, Feddock M, Watkins K, Chowdhury S, Nahas SA, Dimmock DP, Kingsmore SF, Coufal NG; RCIGM Investigators. Rapid Whole Genome Sequencing Has Clinical Utility in Children in the PICU. Pediatr Crit Care Med 2019; 20:1007-20. [PMID: 31246743 DOI: 10.1097/PCC.0000000000002056] [Citation(s) in RCA: 93] [Impact Index Per Article: 18.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
OBJECTIVES Genetic disorders are a leading contributor to mortality in the neonatal ICU and PICU in the United States. Although individually rare, there are over 6,200 single-gene diseases, which may preclude a genetic diagnosis prior to ICU admission. Rapid whole genome sequencing is an emerging method of diagnosing genetic conditions in time to affect ICU management of neonates; however, its clinical utility has yet to be adequately demonstrated in critically ill children. This study evaluates next-generation sequencing in pediatric critical care. DESIGN Retrospective cohort study. SETTING Single-center PICU in a tertiary children's hospital. PATIENTS Children 4 months to 18 years admitted to the PICU who were nominated between July 2016 and May 2018. INTERVENTIONS Rapid whole genome sequencing with targeted phenotype-driven analysis was performed on patients and their parents, when parental samples were available. MEASUREMENTS AND MAIN RESULTS A molecular diagnosis was made by rapid whole genome sequencing in 17 of 38 children (45%). In four of the 17 patients (24%), the genetic diagnoses led to a change in management while in the PICU, including genome-informed changes in pharmacotherapy and transition to palliative care. Nine of the 17 diagnosed children (53%) had no dysmorphic features or developmental delay. Eighty-two percent of diagnoses affected the clinical management of the patient and/or family after PICU discharge, including avoidance of biopsy, administration of factor replacement, and surveillance for disorder-related sequelae. CONCLUSIONS This study demonstrates a retrospective evaluation for undiagnosed genetic disease in the PICU and clinical utility of rapid whole genome sequencing in a portion of critically ill children. Further studies are needed to identify PICU patients who will benefit from rapid whole genome sequencing early in PICU admission when the underlying etiology is unclear.
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30
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Hong A, Liu JN, Gowd AK, Dhawan A, Amin NH. Reliability and Accuracy of MRI in Orthopedics: A Survey of Its Use and Perceived Limitations. Clin Med Insights Arthritis Musculoskelet Disord 2019; 12:1179544119872972. [PMID: 31523134 PMCID: PMC6728666 DOI: 10.1177/1179544119872972] [Citation(s) in RCA: 7] [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] [Subscribe] [Scholar Register] [Received: 07/18/2019] [Accepted: 07/19/2019] [Indexed: 11/17/2022]
Abstract
Over the past decade, the use of magnetic resonance imaging (MRI) as a diagnostic tool has been increasing significantly in various fields of medicine due to its wide array of applications. As a result, its diagnostic efficacy and reliability come into question. Specifically, in the field of orthopedics, there has been little discussion on the problems many physicians face while using MRIs in practice. To gauge the perceived limitations of MRI, we designed a decision analysis to analyze the utility of MRIs and estimate the number of inconclusive MRIs ordered within an orthopedic practice to explore potential alternative avenues of diagnosis. A survey of 100 board-certified practicing orthopedic surgeons given at 2 national conferences was designed to assess the value, reliability, and diagnostic utility of MRIs in preoperative planning in shoulder and knee surgery. Of those surveyed, 93% reported that there was believed to be a problem with the accuracy of an MRI in the setting of a prior surgery and/or if previous hardware was present specifically pertaining to the knee or shoulder. The most common indications of concern regarding knee or shoulder MRI reliability among this sample group were previous patient hardware (19%), a previous surgery (16%), and a chondral defect (11%). In addition, when asked how many MRIs were believed to be inconclusive based on previous surgery/hardware alone in the last 6 months of practice, an average of 19 inconclusive MRIs was reported. This study summarizes some of the concerns of MRI use in the orthopedic community and attempts to add a unique perspective on the attitudes, decision-making, and apparent economic problems that they face as well as uncover specific instances where MRIs were determined to be unreliable and incomplete in aiding the diagnosis and treatment algorithm.
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Affiliation(s)
- Andrew Hong
- School of Medicine, Loma Linda
University, Loma Linda, CA, USA
| | - Joseph N Liu
- Loma Linda University Medical Center,
Loma Linda, CA, USA
| | - Anirudh K Gowd
- Wake Forest University Baptist Medical
Center, Winston-Salem, NC, USA
| | - Aman Dhawan
- Penn State Health Milton S. Hershey
Medical Center, Hershey, PA, USA
| | - Nirav H Amin
- Loma Linda University Medical Center,
Loma Linda, CA, USA
- Veterans Affairs Loma Linda Healthcare
System, Loma Linda, CA, USA
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31
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Patra S, Tellapragada C, Vandana KE, Mukhopadhyay C. Diagnostic utility of in-house loop-mediated isothermal amplification and real-time PCR targeting virB gene for direct detection of Brucella melitensis from clinical specimens. J Appl Microbiol 2019; 127:230-236. [PMID: 30897267 DOI: 10.1111/jam.14260] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [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: 01/09/2019] [Revised: 03/12/2019] [Accepted: 03/17/2019] [Indexed: 11/28/2022]
Abstract
AIMS In this present study, the utility of a newly developed loop-mediated isothermal amplification (LAMP) and real-time PCR assays designed to amplify the virB gene region of Brucella melitensis was evaluated from human clinical specimens. METHODS AND RESULTS Fifty-four culture-confirmed cases of brucellosis and 54 culture negative but clinically suspected cases of brucellosis were included in the study. Whole blood, serum and other nonblood specimens were collected and subjected to blood culture using automatic blood culture system, serological tests, LAMP assay and real-time PCR. Overall sensitivities of LAMP and real-time PCR assays were 67·5 and 68·3% respectively. For nonblood clinical specimens, we noticed a marked increase in the sensitivities of LAMP (88·9%) and real-time PCR (100%) assays. CONCLUSIONS Performance of LAMP and real-time PCR was not satisfactory for whole-blood specimens because of the low abundance of bacteria or DNA. On the other hand, using nonblood specimens, both the assays showed higher sensitivity and specificity which makes them a good alternative for the rapid diagnosis of human brucellosis. SIGNIFICANCE AND IMPACT OF THE STUDY The developed LAMP and real-time PCR assays are a specific and rapid diagnostic tool for direct and early detection of Brucella in clinical specimens.
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Affiliation(s)
- S Patra
- Department of Microbiology, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, Karnataka, 576104, India
| | - C Tellapragada
- Department of Microbiology, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, Karnataka, 576104, India
| | - K E Vandana
- Department of Microbiology, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, Karnataka, 576104, India
| | - C Mukhopadhyay
- Department of Microbiology, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, Karnataka, 576104, India
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32
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Herrera-García JD, Rego-García I, Guillén-Martínez V, Carrasco-García M, Valderrama-Martín C, Vílchez-Carrillo R, López-Alcalde S, Carnero-Pardo C. Discriminative validity of an abbreviated Semantic Verbal Fluency Test. Dement Neuropsychol 2019; 13:203-209. [PMID: 31285795 PMCID: PMC6601302 DOI: 10.1590/1980-57642018dn13-020009] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [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] [Indexed: 11/29/2022] Open
Abstract
Semantic verbal fluency (SVF) is one of the most widely used tests for cognitive
assessment due to its diagnostic utility (DU).
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Affiliation(s)
- José David Herrera-García
- Cognitive-Behavioral Neurology Unit, Neurology Department, Hospital Universitario Virgen de las Nieves, Granada, Spain
| | - Iago Rego-García
- Cognitive-Behavioral Neurology Unit, Neurology Department, Hospital Universitario Virgen de las Nieves, Granada, Spain
| | - Virginia Guillén-Martínez
- Cognitive-Behavioral Neurology Unit, Neurology Department, Hospital Universitario Virgen de las Nieves, Granada, Spain
| | | | - Carmen Valderrama-Martín
- Cognitive-Behavioral Neurology Unit, Neurology Department, Hospital Universitario Virgen de las Nieves, Granada, Spain
| | - Rosa Vílchez-Carrillo
- Cognitive-Behavioral Neurology Unit, Neurology Department, Hospital Universitario Virgen de las Nieves, Granada, Spain
| | - Samuel López-Alcalde
- Cognitive-Behavioral Neurology Unit, Neurology Department, Hospital Universitario Virgen de las Nieves, Granada, Spain
| | - Cristóbal Carnero-Pardo
- Cognitive-Behavioral Neurology Unit, Neurology Department, Hospital Universitario Virgen de las Nieves, Granada, Spain.,FIDYAN Neurocenter, Granada, Spain
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33
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Miyake T, Kim SJ, Shimoda M, Kagara N, Tanei T, Naoi Y, Shimazu K, Noguchi S. Diagnostic Utility of Third-Look, Contrast-Enhanced Sonography Followed by Needle Biopsy for MRI, But Not Second-look Ultrasonography-detected Breast Lesions. Anticancer Res 2019; 39:915-921. [PMID: 30711976 DOI: 10.21873/anticanres.13194] [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: 12/19/2018] [Revised: 01/12/2019] [Accepted: 01/14/2019] [Indexed: 11/10/2022]
Abstract
BACKGROUND/AIM To clarify the diagnostic utility of third-look, contrast-enhanced ultrasonography (CEUS) for MRI-detected breast lesions undetectable by unenhanced, second-look ultrasonography (MRI+/US- lesions). PATIENTS AND METHODS Clinical stage 0-IIA breast cancer patients who underwent CEUS for incidental MRI+/US- lesions (n=27; cohort 1) and patients with breast lesions detected only by MRI, to be examined by CEUS (n=15; cohort 2), were retrospectively analyzed. RESULTS Of the 42 MRI+/US- lesions, 23 (55%) were detected by CEUS and then examined by needle biopsy. Pathological examination showed that 10 of these 23 lesions were malignant. None of the 19 lesions undetected by CEUS were found to be histologically malignant or developed malignancy with a median follow-up of 18.5 months. The accuracy, sensitivity, and specificity of CEUS plus needle biopsy were 98%, 91%, and 100%, respectively. CONCLUSION Third-look CEUS followed by needle biopsy is useful in the initial diagnosis of MRI+/US- lesions.
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Affiliation(s)
- Tomohiro Miyake
- Department of Breast and Endocrine Surgery, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Seung Jin Kim
- Department of Breast and Endocrine Surgery, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Masafumi Shimoda
- Department of Breast and Endocrine Surgery, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Naofumi Kagara
- Department of Breast and Endocrine Surgery, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Tomonori Tanei
- Department of Breast and Endocrine Surgery, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Yasuto Naoi
- Department of Breast and Endocrine Surgery, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Kenzo Shimazu
- Department of Breast and Endocrine Surgery, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Shinzaburo Noguchi
- Department of Breast and Endocrine Surgery, Osaka University Graduate School of Medicine, Osaka, Japan
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Zajkowska M, Zbucka-Krętowska M, Sidorkiewicz I, Lubowicka E, Będkowska GE, Gacuta E, Szmitkowski M, Ławicki S. Human Plasma Levels of Vascular Endothelial Growth Factor, Matrix Metalloproteinase 9, and Tissue Inhibitor of Matrix Metalloproteinase 1 and Their Applicability as Tumor Markers in Diagnoses of Cervical Cancer Based on ROC Analysis. Cancer Control 2018; 25:1073274818789357. [PMID: 30037277 PMCID: PMC6058422 DOI: 10.1177/1073274818789357] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [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] [Indexed: 12/21/2022] Open
Abstract
Cervical cancer (CC) remains a major diagnostic problem. The introduction of
human papillomavirus vaccination significantly reduced the number of new cases;
however, the search for new methods that would earlier indicate the development
of cancerous changes is vital. The aim of this study was to investigate the
diagnostic power of those parameters in comparison to Cancer Antigen 125 (CA
125) and Squamous Cell Carcinoma Antigen (SCC-Ag) in patients with CC and in
relation to the control group. The study included 100 patients with CC and 50
healthy women. Plasma levels of tested parameters were determined by
enzyme-linked immunosorbent assay, CA 125, and SCC-Ag by chemiluminescent
microparticle immunoassay. Plasma levels of all parameters in the total cancer
group showed statistical significance (in all cases P <
.05). In stage I cancer, only vascular endothelial growth factor (VEGF) and
tissue inhibitors of metalloproteinase 1; in stage II, all the tested parameters
and CA 125; and in stage III + IV, VEGF, matrix metalloproteinase 9 (MMP-9), and
CA 125 showed statistical significance when compared to the healthy volunteers
group. Vascular endothelial growth factor showed the highest value of
sensitivity from all tested parameters (I: 75%, II: 76%, III + IV: 94%, and 82%
in total CC group). The highest specificity was obtained by MMP-9 (94%). In the
total CC, stage I, and stage II groups, all tested parameters showed
statistically significant area under the receiver operating characteristics
curve (AUC), but maximum range was obtained for the combination VEGF + SCC-Ag
(I: 0.9146, II: 0.8941, III + IV: 0.9139, total CC group: 0.9347). The combined
analysis of tested parameters and tumor markers resulted in an increase in
sensitivity and AUC values, which provides hope for developing new panel of
biomarkers that may be used in the diagnosis of CC in the future.
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Affiliation(s)
- Monika Zajkowska
- 1 Department of Biochemical Diagnostics, Medical University of Bialystok, Bialystok, Poland
| | - Monika Zbucka-Krętowska
- 2 Department of Reproduction and Gynecological Endocrinology, Medical University of Bialystok, Bialystok, Poland
| | - Iwona Sidorkiewicz
- 2 Department of Reproduction and Gynecological Endocrinology, Medical University of Bialystok, Bialystok, Poland
| | - Emilia Lubowicka
- 3 Department of Esthetic Medicine, Medical University of Bialystok, Bialystok, Poland
| | - Grażyna Ewa Będkowska
- 4 Department of Haematological Diagnostics, Medical University of Bialystok, Bialystok, Poland
| | - Ewa Gacuta
- 5 Department of Perinatology, Medical University of Bialystok, Bialystok, Poland
| | - Maciej Szmitkowski
- 1 Department of Biochemical Diagnostics, Medical University of Bialystok, Bialystok, Poland
| | - Sławomir Ławicki
- 1 Department of Biochemical Diagnostics, Medical University of Bialystok, Bialystok, Poland
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35
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Guo H, Duyzend MH, Coe BP, Baker C, Hoekzema K, Gerdts J, Turner TN, Zody MC, Beighley JS, Murali SC, Nelson BJ, Bamshad MJ, Nickerson DA, Bernier RA, Eichler EE. Genome sequencing identifies multiple deleterious variants in autism patients with more severe phenotypes. Genet Med 2018; 21:1611-1620. [PMID: 30504930 DOI: 10.1038/s41436-018-0380-2] [Citation(s) in RCA: 73] [Impact Index Per Article: 12.2] [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: 09/06/2018] [Accepted: 11/13/2018] [Indexed: 12/11/2022] Open
Abstract
PURPOSE To maximize the discovery of potentially pathogenic variants to better understand the diagnostic utility of genome sequencing (GS) and to assess how the presence of multiple risk events might affect the phenotypic severity in autism spectrum disorders (ASD). METHODS GS was applied to 180 simplex and multiplex ASD families (578 individuals, 213 patients) with exome sequencing and array comparative genomic hybridization further applied to a subset for validation and cross-platform comparisons. RESULTS We found that 40.8% of patients carried variants with evidence of disease risk, including a de novo frameshift variant in NR4A2 and two de novo missense variants in SYNCRIP, while 21.1% carried clinically relevant pathogenic or likely pathogenic variants. Patients with more than one risk variant (9.9%) were more severely affected with respect to cognitive ability compared with patients with a single or no-risk variant. We observed no instance among the 27 multiplex families where a pathogenic or likely pathogenic variant was transmitted to all affected members in the family. CONCLUSION The study demonstrates the diagnostic utility of GS, especially for multiple risk variants that contribute to the phenotypic severity, shows the genetic heterogeneity in multiplex families, and provides evidence for new genes for follow up.
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Affiliation(s)
- Hui Guo
- Department of Genome Sciences, University of Washington School of Medicine, Seattle, WA, USA.,Center for Medical Genetics, School of Life Sciences, Central South University, Changsha, Hunan, China
| | - Michael H Duyzend
- Department of Genome Sciences, University of Washington School of Medicine, Seattle, WA, USA
| | - Bradley P Coe
- Department of Genome Sciences, University of Washington School of Medicine, Seattle, WA, USA
| | - Carl Baker
- Department of Genome Sciences, University of Washington School of Medicine, Seattle, WA, USA
| | - Kendra Hoekzema
- Department of Genome Sciences, University of Washington School of Medicine, Seattle, WA, USA
| | - Jennifer Gerdts
- Department of Psychiatry, University of Washington, Seattle, WA, USA
| | - Tychele N Turner
- Department of Genome Sciences, University of Washington School of Medicine, Seattle, WA, USA
| | | | | | - Shwetha C Murali
- Department of Genome Sciences, University of Washington School of Medicine, Seattle, WA, USA
| | - Bradley J Nelson
- Department of Genome Sciences, University of Washington School of Medicine, Seattle, WA, USA
| | | | - Michael J Bamshad
- Department of Pediatrics, University of Washington School of Medicine, Seattle, WA, USA
| | - Deborah A Nickerson
- Department of Genome Sciences, University of Washington School of Medicine, Seattle, WA, USA
| | - Raphael A Bernier
- Department of Psychiatry, University of Washington, Seattle, WA, USA
| | - Evan E Eichler
- Department of Genome Sciences, University of Washington School of Medicine, Seattle, WA, USA. .,Howard Hughes Medical Institute, University of Washington, Seattle, WA, USA.
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36
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Qiu L, Zhou Y, Yu Q, Yu J, Li Q, Sun R. Decreased levels of regulatory B cells in patients with acute pancreatitis: association with the severity of the disease. Oncotarget 2018; 9:36067-36082. [PMID: 30546828 PMCID: PMC6281415 DOI: 10.18632/oncotarget.23911] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [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: 01/26/2017] [Accepted: 11/03/2017] [Indexed: 12/23/2022] Open
Abstract
Early stratification of the severity of acute pancreatitis (AP) is clinically important. Regulatory B cells have been found to be associated with disease activity of autoimmune diseases. However, the role of Regulatory B cells in AP remains unknown. We investigate the dynamic longitudinal changes in circulating IL-10-producing B cells (B10) and memory CD19+CD24hiCD27hi cells in patients with AP to evaluate their prediction utility for AP severity. B10, CD19+CD24hiCD27hi cells, inflammatory markers and cytokines were detected in patients with AP immediately after admission to the hospital (day 1), then on the third and seventh days. We observed decreases in lymphocytes, CD19+, B10, CD19+CD24hiCD27hi cells and lower mean fluorescence intensity (MFI) of CD80 and CD86 on B10 or CD19+CD24hiCD27hi cells in patients with AP, especially in those with severe acute pancreatitis (SAP). CD19+CD24hiCD27hi cells from patients with AP suppressed the cytokine productions of CD4+ T cells and CD14+ monocytes, but had impaired ability to induce regulatory T cells response. B10 and CD19+CD24hiCD27hi cells significantly increased in patients with mild acute pancreatitis (MAP) from day 1 to day 7, whereas these indexes remained stable in patients with SAP. B10 or CD19+CD24hiCD27hi cells were negatively correlated with the severity index (APACHE II score), inflammatory markers (C-reactive protein, CD64 index), and cytokines (IL-6, IL-17, TNF-α). Furthermore, receiver operating characteristic (ROC) curve analysis revealed that B10 and CD19+CD24hiCD27hi cells could predict the development of SAP. Thus, the detection of B10 and CD19+CD24hiCD27hi cells may be a practical way to improve the early assessment of AP severity.
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Affiliation(s)
- Liannv Qiu
- Department of Clinical Laboratory, Zhejiang Provincial People's Hospital, People's Hospital of Hangzhou Medical College, Hangzhou, 310004, China
| | - Yonglie Zhou
- Department of Clinical Laboratory, Zhejiang Provincial People's Hospital, People's Hospital of Hangzhou Medical College, Hangzhou, 310004, China
| | - Qinghua Yu
- Department of Clinical Laboratory, Zhejiang Provincial People's Hospital, People's Hospital of Hangzhou Medical College, Hangzhou, 310004, China
| | - Junde Yu
- Department of Clinical Laboratory, Zhejiang Provincial People's Hospital, People's Hospital of Hangzhou Medical College, Hangzhou, 310004, China
| | - Qian Li
- Department of Intensive Care Unit, Zhejiang Provincial People's Hospital, People's Hospital of Hangzhou Medical College, Hangzhou, 310004, China
| | - Renhua Sun
- Department of Intensive Care Unit, Zhejiang Provincial People's Hospital, People's Hospital of Hangzhou Medical College, Hangzhou, 310004, China
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37
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Vrolijk-Bosschaart TF, Verlinden E, Langendam MW, De Smet V, Teeuw AH, Brilleslijper-Kater SN, Benninga MA, Lindauer RJL. The Diagnostic Utility of the Child Sexual Behavior Inventory for Sexual Abuse: A Systematic Review. J Child Sex Abus 2018; 27:729-751. [PMID: 29889624 DOI: 10.1080/10538712.2018.1477215] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Children with alleged child sexual abuse (CSA) need to be assessed systematically. The use of validated instruments during the assessment, like the Child Sexual Behavior Inventory (CSBI), could add diagnostic value. We aim to assess the diagnostic utility of the CSBI to differentiate between sexually abused and non-abused children. We conducted a systematic review. We searched the electronic databases MEDLINE and PsychInfo for studies comparing CSBI scores in sexually abused children and non-abused children (2-12 years old). Two independent reviewers extracted data and assessed the methodological quality. We included 7 (out of 1048) articles. The CSBI total scores were significantly higher in CSA-victims compared with non-abused children (in case-control settings). However, in children with suspected CSA, the results were ambiguous. One study reported significant differences. Another study reported weak diagnostic ability for the CSBI-3 in children with suspected CSA (a sensitivity and specificity of 0.50, with a positive predictive value of 0.28, and a negative predictive value of 0.72). Research on the diagnostic utility of the CSBI for suspected CSA is limited and shows disappointing results. Until more research is done, the CSBI should not be used on its own to differentiate between sexually abused and non-abused children.
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Affiliation(s)
| | - Eva Verlinden
- b Department of Epidemiology & Health Promotion , Public Health Services , Amsterdam , The Netherlands
| | - Miranda W Langendam
- c Department of Clinical Epidemiology, Biostatistics and Bioinformatics , University of Amsterdam , Amsterdam , The Netherlands
| | - Vivienne De Smet
- c Department of Clinical Epidemiology, Biostatistics and Bioinformatics , University of Amsterdam , Amsterdam , The Netherlands
| | - Arianne H Teeuw
- a Department of Social Pediatrics , Academic Medical Centre , Amsterdam , The Netherlands
| | | | - Marc A Benninga
- a Department of Social Pediatrics , Academic Medical Centre , Amsterdam , The Netherlands
| | - Ramón J L Lindauer
- d Department of Child and Adolescent Psychiatry , Academic Medical Centre, Academic Centre for Child and Adolescent Psychiatry , Amsterdam , The Netherlands
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38
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Datar R, Prasad AN, Tay KY, Rupar CA, Ohorodnyk P, Miller M, Prasad C. Magnetic resonance imaging in the diagnosis of white matter signal abnormalities. Neuroradiol J 2018. [PMID: 29517408 DOI: 10.1177/1971400918764016] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [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: 11/16/2022] Open
Abstract
Background White matter abnormalities (WMAs) pose a diagnostic challenge when trying to establish etiologic diagnoses. During childhood and adult years, genetic disorders, metabolic disorders and acquired conditions are included in differential diagnoses. To assist clinicians and radiologists, a structured algorithm using cranial magnetic resonance imaging (MRI) has been recommended to aid in establishing working diagnoses that facilitate appropriate biochemical and genetic investigations. This retrospective pilot study investigated the validity and diagnostic utility of this algorithm when applied to white matter signal abnormalities (WMSAs) reported on imaging studies of patients seen in our clinics. Methods The MRI algorithm was applied to 31 patients selected from patients attending the neurometabolic/neurogenetic/metabolic/neurology clinics at a tertiary care hospital. These patients varied in age from 5 months to 79 years old, and were reported to have WMSAs on cranial MRI scans. Twenty-one patients had confirmed WMA diagnoses and 10 patients had non-specific WMA diagnoses (etiology unknown). Two radiologists, blinded to confirmed diagnoses, used clinical abstracts and the WMSAs present on patient MRI scans to classify possible WMA diagnoses utilizing the algorithm. Results The MRI algorithm displayed a sensitivity of 100%, a specificity of 30.0% and a positive predicted value of 74.1%. Cohen's kappa statistic for inter-radiologist agreement was 0.733, suggesting "good" agreement between radiologists. Conclusions Although a high diagnostic utility was not observed, results suggest that this MRI algorithm has promise as a clinical tool for clinicians and radiologists. We discuss the benefits and limitations of this approach.
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Affiliation(s)
- Ravi Datar
- 1 Schulich School of Medicine and Dentistry, Western University, London, ON, Canada.,2 Department of Medical Genetics, London Health Sciences Centre, London, ON, Canada
| | - Asuri Narayan Prasad
- 1 Schulich School of Medicine and Dentistry, Western University, London, ON, Canada.,3 Department of Paediatrics, London Health Sciences Centre, London, ON, Canada.,4 Division of Clinical Neurosciences, London Health Sciences Centre, London, ON, Canada.,5 Children's Health Research Institute, London Health Sciences Centre, London, ON, Canada
| | - Keng Yeow Tay
- 1 Schulich School of Medicine and Dentistry, Western University, London, ON, Canada.,6 Department of Medical Imaging, London Health Sciences Centre, London, ON, Canada
| | - Charles Anthony Rupar
- 1 Schulich School of Medicine and Dentistry, Western University, London, ON, Canada.,3 Department of Paediatrics, London Health Sciences Centre, London, ON, Canada.,5 Children's Health Research Institute, London Health Sciences Centre, London, ON, Canada.,7 Department of Pathology and Laboratory Medicine, London Health Sciences Centre, London, ON, Canada.,8 Department of Biochemistry, London Health Sciences Centre, London, ON, Canada
| | - Pavlo Ohorodnyk
- 6 Department of Medical Imaging, London Health Sciences Centre, London, ON, Canada
| | - Michael Miller
- 3 Department of Paediatrics, London Health Sciences Centre, London, ON, Canada.,5 Children's Health Research Institute, London Health Sciences Centre, London, ON, Canada
| | - Chitra Prasad
- 1 Schulich School of Medicine and Dentistry, Western University, London, ON, Canada.,3 Department of Paediatrics, London Health Sciences Centre, London, ON, Canada.,5 Children's Health Research Institute, London Health Sciences Centre, London, ON, Canada
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39
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Oh H, Park K, Yoon S, Kim Y, Lee SH, Choi YY, Choi KH. Clinical Utility of Beck Anxiety Inventory in Clinical and Nonclinical Korean Samples. Front Psychiatry 2018; 9:666. [PMID: 30564158 PMCID: PMC6288426 DOI: 10.3389/fpsyt.2018.00666] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2018] [Accepted: 11/19/2018] [Indexed: 12/16/2022] Open
Abstract
Despite the prominent use of the Beck Anxiety Inventory (BAI) in primary healthcare systems, few studies have confirmed its diagnostic utility and psychometric properties in non-Western countries. This study aims to clarify the clinical utility of the BAI as a screening tool for anxiety disorders according to DSM-IV criteria, based on blind recruitment and diagnostic interviews of both clinical and non-clinical participants in the Korean population. A total of 1,157 participants were involved in the final psychometric analysis, which included correlational analysis with other anxiety and depression self-report measures and mean score comparison with the Beck Depression Inventory (BDI). ROC analysis and calculation of positive and negative predictive values were conducted to examine diagnostic utility. The BAI was found to have high correlations with depression-related self-report measures (0.747-0.796) and moderate to high correlations with anxiety-related self-report measures (0.518-0.776). The ROC analysis failed to provide cutoff scores with adequate sensitivity and specificity for identifying participants with anxiety disorders (85.0% sensitivity, 88.1% specificity, and 92.8% AUC). The comparison of BAI and BDI mean scores for different diagnostic groups revealed that BAI and BDI scores were higher in the depressive or anxiety disorders group than in the non-clinical group. However, BAI mean score was not higher for the anxiety-only group than the depression-only group. Our data supports the BAI reliability and validity as a tool to measure the severity of general anxiety in clinical and non-clinical populations; however, it fails to capture the unique characteristics of anxiety disorders that distinguish them from depressive disorders. Further clinical implications of the BAI based on these results and some limitations of the study are discussed.
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Affiliation(s)
- Hyeonju Oh
- Department of Psychology, Clinical and Counseling Psychology, Korea University, Seoul, South Korea
| | - Kiho Park
- Department of Psychology, Clinical and Counseling Psychology, Korea University, Seoul, South Korea
| | - Seowon Yoon
- Department of Psychology, Clinical and Counseling Psychology, Korea University, Seoul, South Korea
| | - Yeseul Kim
- Department of Psychology, Clinical and Counseling Psychology, Korea University, Seoul, South Korea
| | - Seung-Hwan Lee
- Department of Adolescent Counseling, Hanyang Cyber University, Seoul, South Korea
| | - Yoon Young Choi
- Clinical Emotion and Cognition Research Laboratory, Inje University, Goyang, South Korea.,Department of Psychiatry, Ilsan Paik Hospital, College of Medicine, Inje University, Goyang, South Korea
| | - Kee-Hong Choi
- Department of Psychology, Clinical and Counseling Psychology, Korea University, Seoul, South Korea
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40
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Hartley T, Wagner JD, Warman-Chardon J, Tétreault M, Brady L, Baker S, Tarnopolsky M, Bourque PR, Parboosingh JS, Smith C, McInnes B, Innes AM, Bernier F, Curry CJ, Yoon G, Horvath GA, Bareke E, Gillespie M, Majewski J, Bulman DE, Dyment DA, Boycott KM. Whole-exome sequencing is a valuable diagnostic tool for inherited peripheral neuropathies: Outcomes from a cohort of 50 families. Clin Genet 2017; 93:301-309. [PMID: 28708278 DOI: 10.1111/cge.13101] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.9] [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: 04/14/2017] [Revised: 07/04/2017] [Accepted: 07/09/2017] [Indexed: 01/02/2023]
Abstract
The inherited peripheral neuropathies (IPNs) are characterized by marked clinical and genetic heterogeneity and include relatively frequent presentations such as Charcot-Marie-Tooth disease and hereditary motor neuropathy, as well as more rare conditions where peripheral neuropathy is associated with additional features. There are over 250 genes known to cause IPN-related disorders but it is estimated that in approximately 50% of affected individuals a molecular diagnosis is not achieved. In this study, we examine the diagnostic utility of whole-exome sequencing (WES) in a cohort of 50 families with 1 or more affected individuals with a molecularly undiagnosed IPN with or without additional features. Pathogenic or likely pathogenic variants in genes known to cause IPN were identified in 24% (12/50) of the families. A further 22% (11/50) of families carried sequence variants in IPN genes in which the significance remains unclear. An additional 12% (6/50) of families had variants in novel IPN candidate genes, 3 of which have been published thus far as novel discoveries (KIF1A, TBCK, and MCM3AP). This study highlights the use of WES in the molecular diagnostic approach of highly heterogeneous disorders, such as IPNs, places it in context of other published neuropathy cohorts, while further highlighting associated benefits for discovery.
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Affiliation(s)
- T Hartley
- Children's Hospital of Eastern Ontario Research Institute, University of Ottawa, Ottawa, Canada
| | - J D Wagner
- Children's Hospital of Eastern Ontario Research Institute, University of Ottawa, Ottawa, Canada
| | - J Warman-Chardon
- Children's Hospital of Eastern Ontario Research Institute, University of Ottawa, Ottawa, Canada.,Department of Genetics, Children's Hospital of Eastern Ontario, Ottawa, Canada
| | - M Tétreault
- Department of Human Genetics, McGill University, Montréal, Canada
| | - L Brady
- Department of Pediatrics, McMaster University Medical Centre, Hamilton, Canada
| | - S Baker
- Department of Medicine, McMaster University Medical Centre, Hamilton, Canada
| | - M Tarnopolsky
- Department of Pediatrics, McMaster University Medical Centre, Hamilton, Canada
| | - P R Bourque
- Department of Medicine, University of Ottawa, Ottawa, Canada
| | - J S Parboosingh
- Department of Medical Genetics, Cumming School of Medicine, University of Calgary, Calgary, Canada
| | - C Smith
- Department of Medical Genetics, Cumming School of Medicine, University of Calgary, Calgary, Canada
| | - B McInnes
- Department of Medical Genetics, Cumming School of Medicine, University of Calgary, Calgary, Canada
| | - A M Innes
- Department of Medical Genetics, Cumming School of Medicine, University of Calgary, Calgary, Canada.,Alberta Children's Hospital Research Institute, University of Calgary, Calgary, Canada
| | - F Bernier
- Department of Medical Genetics, Cumming School of Medicine, University of Calgary, Calgary, Canada.,Alberta Children's Hospital Research Institute, University of Calgary, Calgary, Canada
| | - C J Curry
- Department of Pediatrics, University of California, San Francisco, California
| | - G Yoon
- Divisions of Neurology and Clinical and Metabolic Genetics, The Hospital for Sick Children, University of Toronto, Toronto, Canada
| | - G A Horvath
- Division of Biochemical Diseases, Department of Pediatrics, B.C. Children's Hospital, University of British Columbia, Vancouver, Canada
| | - E Bareke
- Department of Human Genetics, McGill University, Montréal, Canada
| | - M Gillespie
- Children's Hospital of Eastern Ontario Research Institute, University of Ottawa, Ottawa, Canada
| | | | | | - J Majewski
- Department of Human Genetics, McGill University, Montréal, Canada
| | - D E Bulman
- Children's Hospital of Eastern Ontario Research Institute, University of Ottawa, Ottawa, Canada
| | - D A Dyment
- Children's Hospital of Eastern Ontario Research Institute, University of Ottawa, Ottawa, Canada.,Department of Genetics, Children's Hospital of Eastern Ontario, Ottawa, Canada
| | - K M Boycott
- Children's Hospital of Eastern Ontario Research Institute, University of Ottawa, Ottawa, Canada.,Department of Genetics, Children's Hospital of Eastern Ontario, Ottawa, Canada
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Orywal K, Jelski W, Werel T, Szmitkowski M. The Diagnostic Significance of Serum Alcohol Dehydrogenase Isoenzymes and Aldehyde Dehydrogenase Activity in Urinary Bladder Cancer Patients. Anticancer Res 2017; 37:3537-3541. [PMID: 28668843 DOI: 10.21873/anticanres.11722] [Citation(s) in RCA: 3] [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] [Received: 04/27/2017] [Revised: 05/13/2017] [Accepted: 05/16/2017] [Indexed: 11/10/2022]
Abstract
BACKGROUND The aim of this study was to investigate a potential role of alcohol dehydrogenase and aldehyde dehydrogenase as tumor markers for urinary bladder cancer. MATERIALS AND METHODS Serum samples were obtained from 41 patients with bladder cancer and 52 healthy individuals. Class III and IV of ADH and total ADH activity were measured by the photometric method. For measurement of class I and II ADH and ALDH activity, the fluorometric method was employed. RESULTS Significantly higher total activity of ADH was found in sera of both, low-grade and high-grade bladder cancer patients. The diagnostic sensitivity for total ADH activity was 81.5%, specificity 98.1%, positive (PPV) and negative (NPV) predictive values were 97.4% and 92.3% respectively. Area under ROC curve for total ADH activity was 0.848. CONCLUSION A potential role of total ADH activity as a marker for bladder cancer, is herein proposed.
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Affiliation(s)
- Karolina Orywal
- Department of Biochemical Diagnostics, Medical University of Bialystok, Bialystok, Poland
| | - Wojciech Jelski
- Department of Biochemical Diagnostics, Medical University of Bialystok, Bialystok, Poland
| | - Tadeusz Werel
- Department of Urology, Medical University of Bialystok, Bialystok, Poland
| | - Maciej Szmitkowski
- Department of Biochemical Diagnostics, Medical University of Bialystok, Bialystok, Poland
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42
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Dumnicka P, Sporek M, Mazur-Laskowska M, Ceranowicz P, Kuźniewski M, Drożdż R, Ambroży T, Olszanecki R, Kuśnierz-Cabala B. Serum Soluble Fms-Like Tyrosine Kinase 1 (sFlt-1) Predicts the Severity of Acute Pancreatitis. Int J Mol Sci 2016; 17:ijms17122038. [PMID: 27929426 PMCID: PMC5187838 DOI: 10.3390/ijms17122038] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2016] [Revised: 11/23/2016] [Accepted: 11/30/2016] [Indexed: 12/20/2022] Open
Abstract
Organ failure is the most important determinant of the severity of acute pancreatitis (AP). Soluble fms-like tyrosine kinase 1 (sFlt-1) is positively associated with organ failure in sepsis. Our aim was to evaluate the diagnostic utility of automated sFlt-1 measurements for early prediction of AP severity. Adult patients (66) with AP were recruited, including 46 with mild (MAP), 15 with moderately-severe (MSAP) and 5 with severe AP (SAP). Serum and urine samples were collected twice. Serum sFlt-1 was measured with automated electrochemiluminescence immunoassay. Serum concentrations of sFlt-1 were significantly higher in patients with MSAP and SAP as compared to MAP. SAP patients had the highest concentrations. At 24 and 48 h, sFlt-1 positively correlated with inflammatory markers (leukocyte count, C-reactive protein), kidney function (creatinine, urea, cystatin C, serum and urine neutrophil gelatinase-associated lipocalin, urine albumin/creatinine ratio), D-dimer and angiopoietin-2. sFlt-1 positively correlated with the bedside index of severity in AP (BISAP) score and the duration of hospital stay. Serum sFlt-1 above 139 pg/mL predicted more severe AP (MSAP + SAP). In the early phase of AP, sFlt-1 is positively associated with the severity of AP and predicts organ failure, in particular kidney failure. Serum sFlt-1 may be a practical way to improve early assessment of AP severity.
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Affiliation(s)
- Paulina Dumnicka
- Department of Medical Diagnostics, Jagiellonian University Medical College, 30-688 Kraków, Poland.
| | - Mateusz Sporek
- Surgery Department, The District Hospital, 34-200 Sucha Beskidzka, Poland.
- Department of Anatomy, Jagiellonian University Medical College, 31-034 Kraków, Poland.
| | | | - Piotr Ceranowicz
- Department of Physiology, Jagiellonian University Medical College, 31-531 Kraków, Poland.
| | - Marek Kuźniewski
- Chair and Department of Nephrology, Jagiellonian University Medical College, 31-501 Kraków, Poland.
| | - Ryszard Drożdż
- Department of Medical Diagnostics, Jagiellonian University Medical College, 30-688 Kraków, Poland.
| | - Tadeusz Ambroży
- Department of Theory of Sport and Kinesiology, Faculty of Physical Education and Sport, University of Physical Education, 31-571 Kraków, Poland.
| | - Rafał Olszanecki
- Department of Pharmacology, Jagiellonian University Medical College, 31-531 Kraków, Poland.
| | - Beata Kuśnierz-Cabala
- Department of Diagnostics, Chair of Clinical Biochemistry, Jagiellonian University Medical College, 31-501 Kraków, Poland.
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Isomura T, Sumitani M, Matsudaira K, Kawaguchi M, Inoue R, Hozumi J, Tanaka T, Oshima H, Mori K, Taketomi S, Inui H, Tahara K, Yamagami R, Hayakawa K. Development of the Japanese Version of the Leeds Assessment of the Neuropathic Symptoms and Signs Pain Scale: Diagnostic Utility in a Clinical Setting. Pain Pract 2016; 17:800-807. [PMID: 27770598 DOI: 10.1111/papr.12528] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [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: 05/19/2016] [Revised: 08/01/2016] [Accepted: 09/04/2016] [Indexed: 01/24/2023]
Abstract
OBJECTIVE We aimed to assess the diagnostic utility of the linguistically validated Japanese version of the Leeds Assessment of Neuropathic Symptoms and Signs Pain Scale (LANSS-J) as a screening tool for neuropathic pain in the clinical setting. METHODS Patients with neuropathic pain or nociceptive pain who were 20 to 85 years of age were included. Sensitivity and specificity using the original cutoff value of 12 were assessed to evaluate the diagnostic utility of the LANSS-J. Sensitivity and specificity with possible cutoff values were calculated, along with area under the receiver operating characteristic curve. We then evaluated agreement regarding assessment of the LANSS-J by two investigators. We used the intraclass correlation coefficient (ICC) for the total score and Cohen's kappa coefficient for each item. RESULTS Data for patients with neuropathic pain (n = 30) and those with nociceptive pain (n = 29) were analyzed. With a cutoff of 12, the sensitivity was 63.3% (19/30) and the specificity 93.1% (27/29). Sensitivity improved substantially with a cutoff of ≤ 11 (≥ 83.3%, 25/30). High specificity (93.1%, 27/29) was sustained with a cutoff of 9 to 12. The ICC for the total score was 0.85, indicating sufficient agreement. Kappa coefficients ranged from 0.68 to 0.84. CONCLUSIONS The LANSS-J is a valid screening tool for detecting neuropathic pain. Our results suggest that employing the original cutoff value provides high specificity, although a lower cutoff value of 10 or 11 (with its high specificity maintained) may be more beneficial when pain attributed to neuropathic mechanisms is suspected in Japanese patients.
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Affiliation(s)
- Tatsuya Isomura
- Clinical Study Support Inc., Nagoya, Japan.,Institute of Medical Science, Tokyo Medical University, Tokyo, Japan
| | - Masahiko Sumitani
- Department of Pain and Palliative Medicine, The University of Tokyo Hospital, Tokyo, Japan
| | - Ko Matsudaira
- Department of Medical Research and Management for Musculoskeletal Pain, 22nd Century Medical and Research Center, Faculty of Medicine, The University of Tokyo Hospital, Tokyo, Japan
| | | | - Reo Inoue
- Department of Pain and Palliative Medicine, The University of Tokyo Hospital, Tokyo, Japan
| | - Jun Hozumi
- Department of Pain and Palliative Medicine, The University of Tokyo Hospital, Tokyo, Japan
| | - Takeyuki Tanaka
- Orthopaedic Surgery in Sensory and Motor System Medicine, Division of Surgical Science, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Hirofumi Oshima
- Division of Science for Joint Reconstruction, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Kanto Mori
- Orthopaedic Surgery in Sensory and Motor System Medicine, Division of Surgical Science, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Shuji Taketomi
- Department of Orthopaedic Surgery, Faculty of Medicine, The University of Tokyo, Tokyo, Japan
| | - Hiroshi Inui
- Department of Orthopaedic Surgery, Faculty of Medicine, The University of Tokyo, Tokyo, Japan
| | - Keitaro Tahara
- Department of Orthopaedic Surgery, Faculty of Medicine, The University of Tokyo, Tokyo, Japan
| | - Ryota Yamagami
- Department of Orthopaedic Surgery, Faculty of Medicine, The University of Tokyo, Tokyo, Japan
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Abstract
OBJECTIVE The Das-Naglieri Cognitive Assessment System (CAS) is a test of cognitive abilities based on the Planning, Attention, Simultaneous, and Successive Theory (PASS). Studies of CAS performance by children with ADHD typically show lowest performance on Planning and deficits on Attention, but normal Simultaneous and Successive processing. Such distinct group differences studies support construct validity and are necessary, but not sufficient, for establishing diagnostic utility. METHOD Students meeting Diagnostic and Statistical Manual of Mental Disorders (4th ed., text rev.; DSM-IV-TR) criteria for ADHD (n = 20) and matched controls (n = 20) were assessed with the CAS to examine distinct group differences and diagnostic utility of CAS in correctly classifying the individuals from both groups. RESULTS CAS PASS scores were significantly related to ADHD characteristics demonstrating both distinct group differences (with medium to large effect sizes) and diagnostic utility (with medium effect sizes). CONCLUSION Support was observed for CAS PASS score characteristics previously observed among students with ADHD, and this is the first study to report on the diagnostic utility of CAS PASS scores. Given the small sample, additional large-scale studies and cross-validation is needed. (J. of Att. Dis. 2016; 20(6) 519-529).
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45
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Abbey CK, Wu Y, Burnside ES, Wunderlich A, Samuelson FW, Boone JM. A Utility/Cost Analysis of Breast Cancer Risk Prediction Algorithms. Proc SPIE Int Soc Opt Eng 2016; 9787:97871J. [PMID: 27335532 PMCID: PMC4913185 DOI: 10.1117/12.2217850] [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] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Breast cancer risk prediction algorithms are used to identify subpopulations that are at increased risk for developing breast cancer. They can be based on many different sources of data such as demographics, relatives with cancer, gene expression, and various phenotypic features such as breast density. Women who are identified as high risk may undergo a more extensive (and expensive) screening process that includes MRI or ultrasound imaging in addition to the standard full-field digital mammography (FFDM) exam. Given that there are many ways that risk prediction may be accomplished, it is of interest to evaluate them in terms of expected cost, which includes the costs of diagnostic outcomes. In this work we perform an expected-cost analysis of risk prediction algorithms that is based on a published model that includes the costs associated with diagnostic outcomes (true-positive, false-positive, etc.). We assume the existence of a standard screening method and an enhanced screening method with higher scan cost, higher sensitivity, and lower specificity. We then assess expected cost of using a risk prediction algorithm to determine who gets the enhanced screening method under the strong assumption that risk and diagnostic performance are independent. We find that if risk prediction leads to a high enough positive predictive value, it will be cost-effective regardless of the size of the subpopulation. Furthermore, in terms of the hit-rate and false-alarm rate of the of the risk-prediction algorithm, iso-cost contours are lines with slope determined by properties of the available diagnostic systems for screening.
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Affiliation(s)
- Craig K Abbey
- Dept. of Psychological and Brain Sciences, UC Santa Barbara, Santa Barbara, CA. USA 93106
| | - Yirong Wu
- Department of Radiology, University of Wisconsin, Madison, WI
| | | | - Adam Wunderlich
- Division of Imaging and Applied Mathematics, OSEL, CDRH, U.S. Food and Drug Administration, Silver Spring, Maryland 20993, USA
| | - Frank W Samuelson
- Division of Imaging and Applied Mathematics, OSEL, CDRH, U.S. Food and Drug Administration, Silver Spring, Maryland 20993, USA
| | - John M Boone
- Dept of Radiology, UC Davis Medical Center, Sacramento CA. USA
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46
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Jain D, Mathur SR, Iyer VK. Cell blocks in cytopathology: a review of preparative methods, utility in diagnosis and role in ancillary studies. Cytopathology 2014; 25:356-71. [PMID: 25113785 DOI: 10.1111/cyt.12174] [Citation(s) in RCA: 61] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/02/2014] [Indexed: 12/19/2022]
Abstract
The cell block (CB) is a routine procedure in cytopathology that has gained importance because of its pivotal role in diagnosis and ancillary studies. There is no precise review in the published literature that deals with the various methods of preparation of CB, its utility in diagnosis, immunocytochemistry (ICC) or molecular testing, and its drawbacks. An extensive literature search on CB in cytology using internet search engines was performed for this review employing the following keywords: cell block, cytoblock, cytology, cytopathology, methods, preparation, fixatives, diagnostic yield, ancillary and molecular studies. Ever since its introduction more than a century ago, the CB technique has undergone numerous modifications to improve the quality of the procedure; however, the overall principle remains the same in each method. CBs can be prepared from virtually all varieties of cytological samples. In today's era of personalized medicine, cytological specimens, including CBs, augment the utility of cytological samples in analysing the molecular alterations as effectively as surgical biopsies or resection specimens. With the availability of molecular targeted therapy for many cancers, a large number of recent studies have used cytological material or CBs for molecular characterization. The various techniques of CB preparation with different fixatives, their advantages and limitations, and issues of diagnostic yield are discussed in this review.
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Affiliation(s)
- D Jain
- Department of Pathology, All India Institute of Medical Sciences, New Delhi, India
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47
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Sarinc Ulasli S, Gunay E, Akar O, Halici B, Koyuncu T, Unlu M. Diagnostic utility of flexible bronchoscopy in elderly patients. Clin Respir J 2013; 8:357-63. [PMID: 24279944 DOI: 10.1111/crj.12081] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/08/2013] [Revised: 09/23/2013] [Accepted: 11/20/2013] [Indexed: 11/30/2022]
Abstract
BACKGROUND In the elderly population, diagnosis and initial treatment should be considered as soon as possible because of high disease incidence and complications. We aimed to evaluate the findings of flexible bronchoscopy (FB) and determine the diagnostic utility of FB in patients 65 years old and older. METHOD We retrospectively evaluated FB results. Demographic data, clinical and bronchoscopic findings, diagnostic procedures during FB and incidence of accurate diagnosis with FB both in patients 65 years old and older and in younger patients were determined. RESULTS A total of 745 patients [younger patients (<65 years, n = 378, F/M: 120/258) and older patients (≥65 years, n = 367, F/M: 88/279)] who underwent FB at our clinic between 2009 and 2012 were included. The mean age of older patients was 72.6 ± 5.8 years, while the mean age of younger patients was 50.9 ± 11.7 years. Overall, 188 older patients (51.2%) had an accurate diagnosis with the procedures used during bronchoscopy, and 179 younger patients (47.3%) had a final diagnosis with these procedures. The diagnostic utility of FB did not differ significantly between study groups (P = 0.291). During FB, 326 older patients (88.8%) had no complication, and 343 younger patients (90.7%) had no complications. No statistically significant difference was found between older and younger patients in terms of complications during FB (P = 0.389). CONCLUSION The results of this study indicate the high diagnostic value of FB together with low complication rates in patients aged 65 years and older.
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Affiliation(s)
- Sevinc Sarinc Ulasli
- Department of Pulmonary Diseases, Faculty of Medicine, Afyon Kocatepe University, Afyon, Turkey
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48
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Qaddoumi I, Sane M, Li S, Kocak M, Pai-Panandiker A, Harreld J, Klimo P, Wright K, Broniscer A, Gajjar A. Diagnostic utility and correlation of tumor markers in the serum and cerebrospinal fluid of children with intracranial germ cell tumors. Childs Nerv Syst 2012; 28:1017-24. [PMID: 22547227 PMCID: PMC3526807 DOI: 10.1007/s00381-012-1762-4] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.4] [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: 03/22/2012] [Accepted: 04/06/2012] [Indexed: 11/25/2022]
Abstract
PURPOSE In order to predict whether tumor markers assist in the histopathologic diagnosis of germ cell tumors (GCTs), we analyzed the correlation of beta human chorionic gonadotropin (βhCG) and alpha-fetoprotein (AFP) in serum and cerebrospinal fluid (CSF) samples at baseline and subsequent follow-up examinations. METHOD A retrospective study of patients diagnosed with intracranial GCTs between July 1985 and February 2011 at our institution was conducted to review clinical, surgical, radiological, laboratory, and histopathologic data. RESULTS Of the 67 patients eligible for the study, 42 had germinomas and 25 non-germinomatous GCTs. At baseline, serum and CSF AFP agreed in 97.9 % of patients (Cohen's Kappa 0.93). Baseline βhCG samples agreed in only 72.5 % of patients (Cohen's Kappa 0.46). In most cases, values were higher in serum for AFP and in CSF for βhCG. ROC curves estimated from logistic regression model indicated that CSF and serum samples had almost equal diagnostic utility, and the DeLong test showed that the difference in area under curves was not statistically significant. During follow-up (185 paired CSF and serum values from 43 patients), 90.3 % of AFP values correlated between CSF and serum (Cohen's Kappa 0.22, showing fair agreement). For βhCG, 96.2 % of values agreed in serum and CSF (Cohen's Kappa 0.61). CONCLUSIONS In some patients, intracranial GCTs can be diagnosed based solely upon positive serum AFP values. In addition, marker values from serum only may be sufficient to predict tumor relapse at interval follow-up examinations.
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Affiliation(s)
- Ibrahim Qaddoumi
- Department of Oncology, St. Jude Children's Research Hospital, Memphis, TN 38105, USA.
| | - Miheer Sane
- Pediatric Oncology Education Program, St. Jude Children’s Research Hospital, Memphis, TN 38105,Cornell University, New York, NY 10065
| | - Shaoyu Li
- Department of Biostatistics, St. Jude Children’s Research Hospital, Memphis, TN 38105
| | - Mehmet Kocak
- Department of Biostatistics, St. Jude Children’s Research Hospital, Memphis, TN 38105
| | - Atmaram Pai-Panandiker
- Department of Radiological Sciences, St. Jude Children’s Research Hospital, Memphis, TN 38105
| | - Julie Harreld
- Department of Radiological Sciences, St. Jude Children’s Research Hospital, Memphis, TN 38105
| | - Paul Klimo
- Department of Surgery, St. Jude Children’s Research Hospital, Memphis, TN 38105
| | - Karen Wright
- Department of Oncology, St. Jude Children’s Research Hospital, Memphis, TN 38105
| | - Alberto Broniscer
- Department of Oncology, St. Jude Children’s Research Hospital, Memphis, TN 38105
| | - Amar Gajjar
- Department of Oncology, St. Jude Children’s Research Hospital, Memphis, TN 38105
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Kaiser MD, Pelphrey KA. Disrupted action perception in autism: behavioral evidence, neuroendophenotypes, and diagnostic utility. Dev Cogn Neurosci 2012; 2:25-35. [PMID: 22682727 PMCID: PMC6987680 DOI: 10.1016/j.dcn.2011.05.005] [Citation(s) in RCA: 66] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2011] [Revised: 05/18/2011] [Accepted: 05/19/2011] [Indexed: 11/26/2022] Open
Abstract
Disruptions in the visual perception of biological motion are emerging as a hallmark of autism spectrum disorder (ASD), consistent with the pathognomonic social deficits of this neurodevelopmental disorder. Accumulating evidence suggests an early and marked divergence in ASD from the typical developmental tuning of brain regions to process social information. In this review, we discuss a relatively recent yet substantial literature of behavioral and neuroimaging studies that consistently indicates impairments in biological motion perception in ASD. We then illustrate the fundamental disruption in this form of social perception in autism, drawing connections between a genetic liability to develop autism and disrupted associated brain mechanisms, as we describe neuroendophenotypes of autism derived from an fMRI study of biological motion perception in children with autism and their unaffected siblings. Finally, we demonstrate the diagnostic utility of brain responses to biological motion. With the ability to measure brain function in the first year of life comes the potential to chart the development of disrupted biological motion processing in ASD and to specify the gene-brain-behavior interactions shaping this atypical trajectory. We propose that a comprehensive understanding of the development of impaired responses to biological motion in ASD can inform future diagnosis and treatment approaches.
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Affiliation(s)
- Martha D Kaiser
- Yale Child Study Center, Yale School of Medicine, 230 South Frontage Road, New Haven, CT 06520, United States.
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