High negative predictive value diagnostic strategies for the reevaluation of early antifungal treatment: A multicenter prospective trial in patients at risk for invasive fungal infections

2015 ◽  
Vol 71 (2) ◽  
pp. 258-265 ◽  
Author(s):  
Lilia Hasseine ◽  
Sophie Cassaing ◽  
Florence Robert-Gangneux ◽  
Judith Fillaux ◽  
Pierre Marty ◽  
...  
Keyword(s):  
At Risk ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
Fungal Infections ◽  
Prospective Trial ◽  
Invasive Fungal Infections ◽  
Antifungal Treatment ◽  
Diagnostic Strategies ◽  
High Negative Predictive Value ◽  
Patients At Risk

scholarly journals Prophylaxis of Invasive Fungal Infections: A Review of the Use of Posaconazole

2009 ◽  
Vol 1 ◽  
pp. CMT.S1948
Author(s):  
Curtis D. Collins ◽  
Jeannina A. Smith ◽  
Daniel R. Kaul
Keyword(s):  
At Risk ◽  
Fungal Pathogens ◽  
Fungal Infections ◽  
Case Reports ◽  
Case Series ◽  
Individual Case ◽  
Invasive Fungal Infections ◽  
Cost Of Care ◽  
Therapeutic Drug ◽  
Patients At Risk

Invasive fungal infections (IFIs) cause significant morbidity, mortality, and increased cost of care in patients with hematological malignancies, prolonged (i.e. >7-10 days) treatment induced neutropenia, and other disease states causing underlying immunosuppression. One strategy often used to combat the development of invasive infections is the use of antifungal agents as prophylaxis in at risk patients. Posaconazole is an oral triazole with a useful spectrum of activity against many fungal pathogens of concern in patients at risk for the development of IFIs. Posaconazole is only available in oral formulation and therapeutic drug monitoring may provide value due to variable absorption and serum concentrations. Clinical efficacy and pharmacoeconomic data have demonstrated the utility of posaconazole in the treatment of oropharyngeal candidiasis and for prophylaxis in patients at risk for development of IFIs. Several organizations or expert groups involved in developing guidelines for the management of IFIs recommend posaconazole anti-fungal prophylaxis in patients with AML or MDS and chemotherapy induced neutropenia or significant GVHD. In addition, nonrandomized studies (largely of salvage therapy) and case series suggest that posaconazole may be effective as treatment for invasive aspergillosis, zygomycosis, and coccidiomycosis. Further, small case series or individual case reports suggest activity against other less commonly encountered filamentous fungi and Histoplasma.

Fungal contamination of water and water-related surfaces in three hospital wards with immunocompromised patients at risk for invasive fungal infections

2010 ◽  
Vol 11 (2) ◽  
pp. 36-41 ◽  
Author(s):  
Julia de Castro Figueiredo Fonseca ◽  
Adel Bouakline ◽  
Jean-Pierre Claisse ◽  
Martine Feuilhade ◽  
André Baruchel ◽  
...  
Keyword(s):  
At Risk ◽  
Fungal Infections ◽  
Invasive Fungal Infections ◽  
Immunocompromised Patients ◽  
Fungal Contamination ◽  
Patients At Risk ◽  
Hospital Wards

P6235Normal Body Mass index (BMI) can rule out metabolic syndrome

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
O Kobo ◽  
A M I R Karban ◽  
R Leiba ◽  
O Avizohar
Keyword(s):  
Metabolic Syndrome ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
Entire Cohort ◽  
High Negative Predictive Value ◽  
Patients At Risk ◽  
Observational Cohort ◽  
Obesity Indices ◽  
Rule Out ◽  
The Ideal

Abstract Objective To assess whether BMI can be used as a simple and reliable survey test for metabolic syndrome. Methods Observational, cohort study, among patients who visited Periodic Examinations Institute [PEI]. We analysed the correlation between obesity indices and presence of metabolic syndrome. We identified the ideal value of BMI for identification of patients at risk for MS. We also described the correlation between different BMI values and its' negative predictive value for metabolic syndrome. Results During study years, 23,993 patients visited the PEI, 12.5% of them fulfilled the criteria for metabolic syndrome. Women with metabolic syndrome had higher proportion of obesity, when compared to men (89.9% vs 52.6%, p<0.0001). Normal BMI had very high negative predictive value to rule out metabolic syndrome among men and women (98% and 96% respectively).Using ROC curve, we found BMI 27 to be the ideal value for identification of metabolic syndrome for the entire cohort (AUC 0.767, 95% CI 0.758–0.775, p<0.0001), for men (AUC 0.726, CI [0.715–0.738], p<0.0001) and for women (AUC 0.843, CI [0.831–0.855], p<0.0001). BMI below 30, provide negative predictive value of 91.1% to rule out metabolic syndrome. Conclusions BMI as single survey measurement of obesity offers high negative predictive value for metabolic syndrome and can be used by physician and patients for this purpose.

scholarly journals Validation of the Malnutrition Universal Screening Tool (MUST) in cancer

2011 ◽  
Vol 108 (2) ◽  
pp. 343-348 ◽  
Author(s):  
Carolina Boléo-Tomé ◽  
Isabel Monteiro-Grillo ◽  
Maria Camilo ◽  
Paula Ravasco
Keyword(s):  
At Risk ◽  
Weight Loss ◽  
Positive Predictive Value ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
Nutritional Risk ◽  
Percentage Weight Loss ◽  
Percentage Weight ◽  
Patients At Risk ◽  
Malnutrition Universal Screening Tool

In the present study, we aimed to validate the Malnutrition Universal Screening Tool (MUST) for routine nutritional screening in the radiation oncology setting, thus enabling timely and adequate referrals of patients at risk for individualised or advanced intervention. Towards this objective, we conducted a prospective cross-sectional study in 450 non-selected cancer patients (18–95 years) referred for radiotherapy. The following were the nutritional parameters: BMI (categorised by WHO's age/sex criteria), weight loss >5 % in the previous 3–6 months, Patient-Generated Subjective Global Assessment (PG-SGA – validated/specific for oncology) and nutritional risk by MUST. Sensitivity, specificity, predictive values and concordance were calculated to validate MUST v. PG-SGA and compare single parameters v. PG-SGA/MUST. BMI v. PG-SGA showed a negligible capacity to detect undernutrition: 0·27 sensitivity, 0·23 specificity, 0·35 positive predictive value and 0·31 negative predictive value. Conversely, percentage weight loss v. PG-SGA was highly effective: 0·76 sensitivity, 0·85 specificity, 0·79 positive predictive value and 0·85 negative predictive value. MUST v. PG-SGA successfully detected patients at risk: 0·80 sensitivity, 0·89 specificity, 0·87 positive predictive value and 1·0 negative predictive value; percentage weight loss v. MUST proved able to identify patients likely to be at risk: 0·85 sensitivity, 0·91 specificity, 0·90 positive predictive value and 1·0 negative predictive value. This is the first study in the radiation oncology setting to validate MUST: a simple and quick method applicable by any health professional, with a high validity for early screening, ideally to antedate a comprehensive nutritional assessment and guide for intervention. In this study, percentage weight loss in the previous 3–6 months does seem valid to predict nutritional risk, and may be the minimum in a busy routine.

FDG-PET in Hodgkin lymphoma

2008 ◽  
Vol 47 (06) ◽  
pp. 235-238 ◽  
Author(s):  
M. Dietlein ◽  
C. Mauz-Körholz ◽  
A. Engert ◽  
P. Borchmann ◽  
O. Sabri ◽  
...  
Keyword(s):  
Hodgkin Lymphoma ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
Fdg Pet ◽  
Study Groups ◽  
Therapy Control ◽  
German Study ◽  
High Negative Predictive Value ◽  
Consolidation Radiotherapy

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.

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

2018 ◽  
Vol 27 (6) ◽  
pp. 633-644 ◽  
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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