Rectal screening displays high negative predictive value for bloodstream infection with (ESBL-producing) Gram-negative bacteria in neonates with suspected sepsis in a low-resource setting neonatal care unit

SummaryThe high negative predictive value of FDG-PET in therapy control of Hodgkin lymphoma is proven by the data acquired up to now. Thus, the analysis of the HD15 trial has shown that consolidation radiotherapy might be omitted in PET negative patients after effective chemotherapy. Further response adapted therapy guided by PET seems to be a promising approach in reducing the toxicity for patients undergoing chemotherapy. The criteria used for the PET interpretation have been standardized by the German study groups for Hodgkin lymphoma patients and will be reevaluated in the current studies.

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Su1188 Transabdominal Ultrasound Has High Negative Predictive Value for Short-Term Complications of Inflammatory Bowel Disease

Gastroenterology ◽

10.1016/s0016-5085(15)31459-1 ◽

2015 ◽

Vol 148 (4) ◽

pp. S-432

Author(s):

Zuzana Zelinkova ◽

Barbora Kadleckova ◽

Beata Repakova

Keyword(s):

Inflammatory Bowel Disease ◽

Negative Predictive Value ◽

Bowel Disease ◽

Predictive Value ◽

Transabdominal Ultrasound ◽

Short Term ◽

High Negative Predictive Value ◽

Inflammatory Bowel

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The predictive value of signs and symptoms in predicting adverse maternal and perinatal outcomes in severe preeclampsia in a low-resource setting, findings from a cross-sectional study at Mpilo Central Hospital, Bulawayo, Zimbabwe

Pregnancy Hypertension ◽

10.1016/j.preghy.2020.05.004 ◽

2020 ◽

Vol 21 ◽

pp. 77-83

Author(s):

Solwayo Ngwenya ◽

Brian Jones ◽

Desmond Mwembe ◽

Hausitoe Nare ◽

Alexander Heazell

Keyword(s):

Predictive Value ◽

Perinatal Outcomes ◽

Signs And Symptoms ◽

Cross Sectional Study ◽

Sectional Study ◽

Central Hospital ◽

Cross Sectional ◽

Resource Setting ◽

Low Resource Setting ◽

Mpilo Central Hospital

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Association between clinical risk scores and mortality in atrial fibrillation: Systematic review and network meta-regression of 669,000 patients

European Journal of Preventive Cardiology ◽

10.1177/2047487318817662 ◽

2018 ◽

Vol 27 (6) ◽

pp. 633-644 ◽

Cited By ~ 3

Author(s):

Marco Proietti ◽

Alessio Farcomeni ◽

Giulio Francesco Romiti ◽

Arianna Di Rocco ◽

Filippo Placentino ◽

...

Keyword(s):

Atrial Fibrillation ◽

Negative Predictive Value ◽

Predictive Value ◽

Predictive Ability ◽

Risk Scores ◽

Clinical Risk ◽

Increased Risk ◽

High Negative Predictive Value ◽

Meta Regression

Aims Many clinical scores for risk stratification in patients with atrial fibrillation have been proposed, and some have been useful in predicting all-cause mortality. We aim to analyse the relationship between clinical risk score and all-cause death occurrence in atrial fibrillation patients. Methods We performed a systematic search in PubMed and Scopus from inception to 22 July 2017. We considered the following scores: ATRIA-Stroke, ATRIA-Bleeding, CHADS2, CHA2DS2-VASc, HAS-BLED, HATCH and ORBIT. Papers reporting data about scores and all-cause death rates were considered. Results Fifty studies and 71 scores groups were included in the analysis, with 669,217 patients. Data on ATRIA-Bleeding, CHADS2, CHA2DS2-VASc and HAS-BLED were available. All the scores were significantly associated with an increased risk for all-cause death. All the scores showed modest predictive ability at five years (c-indexes (95% confidence interval) CHADS2: 0.64 (0.63–0.65), CHA2DS2-VASc: 0.62 (0.61–0.64), HAS-BLED: 0.62 (0.58–0.66)). Network meta-regression found no significant differences in predictive ability. CHA2DS2-VASc score had consistently high negative predictive value (≥94%) at one, three and five years of follow-up; conversely it showed the highest probability of being the best performing score (63% at one year, 60% at three years, 68% at five years). Conclusion In atrial fibrillation patients, contemporary clinical risk scores are associated with an increased risk of all-cause death. Use of these scores for death prediction in atrial fibrillation patients could be considered as part of holistic clinical assessment. The CHA2DS2-VASc score had consistently high negative predictive value during follow-up and the highest probability of being the best performing clinical score.

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Accuracy of Visual Tests for Primary Cervical Cancer Screening in Rural Nepal

Journal of Nepal Medical Association ◽

10.31729/jnma.3857 ◽

2018 ◽

Vol 56 (214) ◽

pp. 917-923

Author(s):

Niresh Thapa ◽

Muna Maharjan ◽

Girishma Shrestha ◽

Narayani Maharjan ◽

Deborah Lindell ◽

...

Keyword(s):

Cervical Cancer ◽

Cancer Screening ◽

Negative Predictive Value ◽

Cervical Cancer Screening ◽

Predictive Value ◽

Odds Ratio ◽

Screening Program ◽

Diagnostic Odds Ratio ◽

Screening Tests ◽

Resource Setting

Introduction: In Nepal, cervical cancer is the most common female cancer. Unfortunately, there is no uniform effective screening system available all around the country. The objective of this study is to evaluate the cytology, Visual Inspection with Acetic Acid and with Lugol’s Iodine alone or in combination to detect a pre-cancerous lesion in rural Nepal.Methods: It is an analytical cross-sectional study. Convenience sampling technique was used to select participants who were apparently healthy, married, non- pregnant women of aged 20-65 years for cervical cancer screening program. Screening tests were performed on all eligible women (n=2143) after socio-demographic and reproductive health data collection. A biopsy was applied as a gold standard test. Cross-tabulations were used to describe the test sensitivity, specificity, positive predictive value, and negative predictive value at a 95% confidence interval. Diagnostic odds ratio was also calculated. Results: A majority, 2143 (94%), of women accepted and participated in this study. The sensitivity vs specificity of cytology, VIA, and VILI was 57.1% vs 98.3%, 71.4% vs 88.8% and 78.6% vs 85.1%, and of the co-testing of ‘Both positive VIA and VILI’ and ‘Either positive VIA or VILI’ was 64.3% vs 85.7% and 90.1% vs 83.7% respectively. Negative predictive value of all tests exceeded 99.7%. Cytology had the highest Diagnostic odds ratio (64.9), followed by the co-test ‘Either positive VIA or VILI’ (27.7).Conclusions: Cervical cancer screening by co-testing ‘Either positive VIA or VILI’ is more useful than cytology; VIA and or VILI are easy, safe, feasible and well-accepted tests in a low resource setting, Nepal.

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Predictive Factors for the Development of Central Line–Associated Bloodstream Infection Due to Gram-Negative Bacteria in Intensive Care Unit Patients After Surgery

Infection Control and Hospital Epidemiology ◽

10.1086/524334 ◽

2008 ◽

Vol 29 (1) ◽

pp. 51-56 ◽

Cited By ~ 32

Author(s):

Pranavi V. Sreeramoju ◽

Jocelyn Tolentino ◽

Sylvia Garcia-Houchins ◽

Stephen G. Weber

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

Bloodstream Infection ◽

Predictive Factors ◽

Tertiary Care ◽

Central Line ◽

Gram Negative Bacteria ◽

Gram Positive ◽

Gram Negative ◽

Gram Positive Bacteria

Objectives.To examine the relative proportions of central line-associated bloodstream infection (BSI) due to gram-negative bacteria and due to gram-positive bacteria among patients who had undergone surgery and patients who had not. The study also evaluated clinical predictive factors and unadjusted outcomes associated with central line-associated BSI caused by gram-negative bacteria in the postoperative period.Design.Observational, case-control study based on a retrospective review of medical records.Setting.University of Chicago Medical Center, a 500-bed tertiary care center located on Chicago's south side.Patients.Adult intensive care unit (ICU) patients who developed central line-associated BSI.Results.There were a total of 142 adult patients who met the Centers for Disease Control and Prevention National Nosocomial Infection Surveillance System definition for central line-associated BSI. Of those, 66 patients (46.5%) had infections due to gram-positive bacteria, 49 patients (34.5%) had infections due to gram-negative bacteria, 23 patients (16.2%) had infections due to yeast, and 4 patients (2.8%) had mixed infections. Patients who underwent surgery were more likely to develop central line-associated BSI due to gram-negative bacteria within 28 days of the surgery, compared with patients who had not had surgery recently (57.6% vs 27.3%; P = .002). On multivariable logistic regression analysis, diabetes mellitus (adjusted odds ratio [OR], 4.6 [95% CI, 1.2-18.1]; P = .03) and the presence of hypotension at the time of the first blood culture positive for a pathogen (adjusted OR, 9.8 [95% CI, 2.5-39.1]; P = .001 ) were found to be independently predictive of central line-associated BSI caused by gram-negative bacteria. Unadjusted outcomes were not different in the group with BSI due to gram-negative pathogens, compared to the group with BSI due to gram-positive pathogens.Conclusions.Clinicians caring for critically ill patients after surgery should be especially concerned about the possibility of central line-associated BSI caused by gram-negative pathogens. The presence of diabetes and hypotension appear to be significant associated factors.

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Serum Angiotensin-Converting Enzyme Has a High Negative Predictive Value in the Investigation for Systemic Sarcoidosis

American Journal of Ophthalmology ◽

10.1016/j.ajo.2018.07.010 ◽

2018 ◽

Vol 194 ◽

pp. 82-87 ◽

Cited By ~ 13

Author(s):

Rachael L. Niederer ◽

Ahmed Al-Janabi ◽

Sue L. Lightman ◽

Oren Tomkins-Netzer

Keyword(s):

Angiotensin Converting Enzyme ◽

Negative Predictive Value ◽

Predictive Value ◽

Converting Enzyme ◽

Serum Angiotensin Converting Enzyme ◽

High Negative Predictive Value ◽

Systemic Sarcoidosis

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Incidence of Heparin-Induced Thrombocytopenia in Patients With Newly Implanted Mechanical Circulatory Support Devices

Annals of Pharmacotherapy ◽

10.1177/10600280211038705 ◽

2021 ◽

pp. 106002802110387

Author(s):

Long To ◽

Dana Attar ◽

Brittany Lines ◽

Melissa McCarty ◽

Hassan Nemeh ◽

...

Keyword(s):

Negative Predictive Value ◽

Predictive Value ◽

Mechanical Circulatory Support ◽

Serotonin Release ◽

Circulatory Support ◽

Anticoagulation Management ◽

Heparin Induced Thrombocytopenia ◽

Mechanical Circulatory Support Devices ◽

High Negative Predictive Value ◽

Release Assay

Background: Heparin exposure and device-related thrombocytopenia complicate the diagnosis of heparin-induced thrombocytopenia (HIT) in patients receiving mechanical circulatory support (MCS). To improve anticoagulation management for patients with newly implanted MCS devices, incidence of confirmed HIT needs to be further characterized. Objectives: The purpose of this study is to describe the incidence of HIT and clinical utility of the 4Ts score in patients with newly implanted MCS devices. Methods: This is a retrospective analysis of MCS patients receiving unfractionated heparin from 2014 to 2017. The primary end point was incidence of laboratory-confirmed HIT. Strong positive, likely positive, low probability, and negative HIT categories were established based on heparin-induced platelet antibody (HIPA) and serotonin release assay (SRA). Secondary end points include characterization of platelet trends, argatroban use, incidence of HIT among each of the MCS devices, and utility of 4Ts score. Results: A total of 342 patient encounters met inclusion criteria, of which 68 HIPA tests and 25 SRAs were ordered. The incidence of HIT was 0.88% (3/342) and 4.4% (3/68) in patients with suspected HIT. Of the 68 HIPA tests, 3 (4.4%) were considered strong positive and 3 of the 25 SRAs were positive. Median 4Ts score was 4 [2.5-4] and optical density 0.19 [0.11-0.54]. The positive predictive value for the 4Ts score was 0.15 (CI = 0.03-0.46) and negative predictive value, 0.93 (CI = 0.82-0.98). Conclusion and Relevance: HIT occurs infrequently with newly implanted MCS devices. The 4Ts score appears to have a high negative predictive value for ruling out HIT.

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