scholarly journals Effect of adding magnifying BLI, magnifying NBI, and iodine staining to white light imaging in diagnosis of early esophageal cancer

2021 ◽  
Vol 09 (12) ◽  
pp. E1877-E1885
Author(s):  
Kenro Kawada ◽  
Miwako Arima ◽  
Ryoji Miyahara ◽  
Mika Tsunomiya ◽  
Masakazu Kikuchi ◽  
...  
Keyword(s):  
High Risk ◽  
White Light ◽  
Predictive Value ◽  
Blue Laser ◽  
High Risk Patients ◽  
Iodine Staining ◽  
Risk Patients ◽  
Malignant Lesions ◽  
Cancerous Lesions ◽  
White Light Imaging

Abstract Background and study aims We investigated the effect of adding magnifying blue laser imaging (BLI), magnifying narrow-band imaging (NBI), and iodine staining to white light imaging in diagnosis of early esophageal squamous cell carcinoma (EESCC) in high-risk patients. Patients and methods Between May 2013 and March 2016, two parallel prospective cohorts of patients received either primary WLI followed by NBI-magnifying endoscopy (ME) or primary WLI followed by BLI-ME, were studied. At the end of screening, both groups underwent iodine staining. The percentage of patients with newly detected esophageal malignant lesions in each group and the diagnostic ability of image-enhanced endoscopy (IEE)-ME were evaluated. Results There are 258 patients assigned to the NBI-ME group and 254 patients assigned to the BLI-ME group. The percentage of patients with one or more malignant lesions detected in the WLI + NBI-ME examination was similar in the WLI + BLI-ME examination (15 of 258 patients or 5.81 % vs. 14 of 254 patients or 5.51 %). However, four of 19 lesions in the NBI-ME group and six of 21 lesions in the BLI-ME group were overlooked and were detected by iodine staining. NBI-ME and BLI-ME showed similar accuracy in differentiation of cancerous lesions from non-cancerous lesions in diagnosis of EESCC (NBI/BLI: sensitivity, 87.5/89.5; specificity, 78.9/76.6; accuracy, 80.8/79.5; positive predictive value, 53.8/53.1; negative predictive value, 95.7/96.1). Conclusions Both NBI and BLI were useful for detection of EESCC. However, because some lesions were overlooked by even NBI and BLI, high-risk patients may benefit from use of iodine staining during endoscopic screening of EESCC (UMIN000023596).

scholarly journals TCT-90 The Clinical SYNTAX score has an additive predictive value in high risk patients

2014 ◽  
Vol 64 (11) ◽  
pp. B27
Author(s):  
Jeehoon Kang ◽  
Kyung Woo Park ◽  
Si-Hyuck Kang ◽  
Hae-Young Lee ◽  
Hyun-Jae Kang ◽  
...  
Keyword(s):  
High Risk ◽  
Predictive Value ◽  
Syntax Score ◽  
High Risk Patients ◽  
Risk Patients

scholarly journals The Kaiser score reliably excludes malignancy in benign contrast-enhancing lesions classified as BI-RADS 4 on breast MRI high-risk screening exams

2020 ◽  
Vol 30 (11) ◽  
pp. 6052-6061 ◽  
Author(s):  
Ruxandra Iulia Milos ◽  
Francesca Pipan ◽  
Anastasia Kalovidouri ◽  
Paola Clauser ◽  
Panagiotis Kapetas ◽  
...  
Keyword(s):  
Breast Cancer ◽  
High Risk ◽  
Diagnostic Accuracy ◽  
Breast Mri ◽  
Histopathological Diagnosis ◽  
Risk Screening ◽  
High Risk Patients ◽  
Risk Patients ◽  
Malignant Lesions ◽  
High Risk Screening

Abstract Objectives MRI is an integral part of breast cancer screening in high-risk patients. We investigated whether the application of the Kaiser score, a clinical decision-support tool, may be used to exclude malignancy in contrast-enhancing lesions classified as BI-RADS 4 on breast MRI screening exams. Methods This retrospective study included 183 consecutive, histologically proven, suspicious (MR BI-RADS 4) lesions detected within our local high-risk screening program. All lesions were evaluated according to the Kaiser score for breast MRI by three readers blinded to the final histopathological diagnosis. The Kaiser score ranges from 1 (lowest, cancer very unlikely) to 11 (highest, cancer very likely) and reflects increasing probabilities of malignancy, with scores greater than 4 requiring biopsy. Receiver operating characteristic (ROC) curve analysis was used to evaluate diagnostic accuracy. Results There were 142 benign and 41 malignant lesions, diagnosed in 159 patients (mean age, 43.6 years). Median Kaiser scores ranged between 2 and 5 in benign and 7 and 8 in malignant lesions. For all lesions, the Kaiser score’s accuracy, represented by the area under the curve (AUC), ranged between 86.5 and 90.2. The sensitivity of the Kaiser score was high, between 95.1 and 97.6% for all lesions, and was best in mass lesions. Application of the Kaiser score threshold for malignancy (≤ 4) could have potentially avoided 64 (45.1%) to 103 (72.5%) unnecessary biopsies in 142 benign lesions previously classified as BI-RADS 4. Conclusions The use of Kaiser score in high-risk MRI screening reliably excludes malignancy in more than 45% of contrast-enhancing lesions classified as BI-RADS 4. Key Points • The Kaiser score shows high diagnostic accuracy in identifying malignancy in contrast-enhancing lesions in patients undergoing high-risk screening for breast cancer. • The application of the Kaiser score may avoid > 45% of unnecessary breast biopsies in high-risk patients. • The Kaiser score aids decision-making in high-risk breast cancer MRI screening programs.

Diagnostic Accuracy of Stop-Bang Questionnaire in Diagnosing High Risk Patients of Obstructive Sleep Apnea Considering Polysomnography as a Gold Standard

2021 ◽  
Vol 15 (10) ◽  
pp. 2823-2825
Author(s):  
Masood uz Zaman Babar ◽  
Rizwan Ali Tunio ◽  
Sunil Dat Maheshwari ◽  
Ali Hassan ◽  
Hasham Masood Qureshi
Keyword(s):  
Obstructive Sleep Apnea ◽  
Standard Deviation ◽  
Sleep Apnea ◽  
High Risk ◽  
Diagnostic Accuracy ◽  
Predictive Value ◽  
Gold Standard ◽  
High Risk Patients ◽  
Obstructive Sleep ◽  
Risk Patients

Objective: To determine the diagnostic accuracy of stop-bang questionnaire to diagnose high risk patients of obstructive sleep apnea taking polysomnography as gold standard. Methodology: This cross-sectional descriptive study was conducted at Isra University Hospital Hyderabad and help taken from Sleep Disorder Laboratory, The Aga Khan Hospital, Karachi. Patients with age of 18 to 70 years, presenting with symptoms of OSA of either gender were included. History was taken from patients. STOP- BANG Questionnaire was filled out for each patient consenting to participate in the study. All information was noted and entered in the Proforma. Results: Mean age of patients was 40.1 with standard deviation 17.6, mean AHI score was 20 with standard deviation 6 and stop bang score showed average 6.8 with standard deviation 2.7. Distribution of gender showed that most of the patients were male. Diagnostic accuracy calculated for stop bang questionnaire, sensitivity 77.2%, Specificity 65.5%, Positive Predictive Value 75.4%, Negative Predictive Value 67.8%, Diagnostic Accuracy 72.3% of stop bang questionnaire as follows. Conclusion: This study confirms the STOP-Bang questionnaire's high performance in screening for Obstructive sleep apnea (OSA) in the surgical population and sleep clinic. The likelihood of OSA severity increases from moderate to severe with the increasing STOP-Bang score. Keywords: Obstructive sleep apnea, stop-bang questionnaire, apnea-hypopnea index, polysomnogram

scholarly journals The Predictive Value of Fragmented QRS and QRS Distortion for High-Risk Patients with STEMI and for the Reperfusion Success

2015 ◽  
Vol 20 (6) ◽  
pp. 578-585 ◽  
Author(s):  
Zulkif Tanriverdi ◽  
Huseyin Dursun ◽  
Mustafa Aytek Simsek ◽  
Baris Unal ◽  
Omer Kozan ◽  
...  
Keyword(s):  
High Risk ◽  
Predictive Value ◽  
High Risk Patients ◽  
Fragmented Qrs ◽  
Risk Patients

A randomized study of fluorescence bronchoscopy versus white-light bronchoscopy for early detection of lung cancer in high risk patients

Lung Cancer ◽  
2000 ◽  
Vol 29 (1) ◽  
pp. 244-245 ◽  
Author(s):  
T.C Kennedy ◽  
F.R Hirsch ◽  
Y.E Miller ◽  
S Prindiville ◽  
J.R Murphy ◽  
...  
Keyword(s):  
Lung Cancer ◽  
High Risk ◽  
Early Detection ◽  
White Light ◽  
Randomized Study ◽  
High Risk Patients ◽  
Risk Patients

scholarly journals Validation study of grace risk score for prognosis in Indian patients with non-STEMI

2017 ◽  
Vol 4 (4) ◽  
pp. 1036
Author(s):  
Rangamanikandan M. ◽  
Shivcharan Jelia ◽  
Meena S. R. ◽  
Shyam Bihari Meena ◽  
Devendra Ajmera ◽  
...  
Keyword(s):  
High Risk ◽  
Risk Score ◽  
Predictive Value ◽  
Statistical Significance ◽  
Cardiac Biomarkers ◽  
Female Ratio ◽  
High Risk Patients ◽  
Grace Risk Score ◽  
Risk Patients ◽  
Grace Score

Background: Cardiovascular disease has emerged as the single most important cause of death worldwide. Every patient of MI has to be stratified according to the risk factors, so that high risk patients can be identified and can be managed effectively GRACE risk score is one of the score used to calculate the risk in MI. Present study was undertaken to correlate GRACE risk score and mortality in non-STEMI.Methods: 200 patients of non-STEMI fulfilling the inclusion criteria admitted in wards of NMCH, Kota were recruited. GRACE risk score was calculated for all patients. Each patient monitored closely throughout their hospitalization. Each component of GRACE risk score was studied for statistical significance. Statistical analysis of correlation was done with chi square test and statistical significance was taken p < 0.05.Results: Mean age is 59.45±8.66 years, with male preponderance, male to female ratio 3:1. Maximum GRACE score is 300 and the minimum score is 86. Patients were categorized into low (74 patients), intermediate (60 patients), high risk (66 patients) according to GRACE score. 14 patients were expired and all of them are in high risk category. GRACE score had sensitivity (100%), specificity (72.04%), positive predictive value (21.2%) and negative predictive value (100%). Serum creatinine (p<0.001), heart rate (p<0.001), blood pressure (p<0.001), Killip class (p<0.001), cardiac biomarkers (p<0.001), ST segment changes (p<0.001) were significantly associated with adverse events. Age>50 (p<0.110) is not significant. Overall grace score demonstrated excellent discrimination (p<0.001), C statistics 0.99, 95% CI 115.742-151.221 for in hospital mortality.Conclusions: This study has shown GRACE risk score is highly accurate in predicting in hospital mortality in patients of non-STEMI. We should routinely use GRACE risk score in our hospital settings to identify the high-risk patients to decrease mortality. 

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