Comparison between Different Perforator Imaging Modalities for the Anterolateral Thigh Perforator Flap Transfer: A Prospective Study

2020 ◽  
Vol 36 (09) ◽  
pp. 686-693
Author(s):  
Lucas M. Ritschl ◽  
Andreas M. Fichter ◽  
Achim von Bomhard ◽  
Steffen Koerdt ◽  
Victoria Kehl ◽  
...  
Keyword(s):  
Positive Predictive Value ◽  
Prospective Study ◽  
Predictive Value ◽  
Perforator Flap ◽  
Flap Transfer ◽  
Anterolateral Thigh ◽  
American Society ◽  
A Prospective Study ◽  
Patient’S History ◽  
American Society Of Anesthesiologists

Abstract Background Perforator imaging is routinely performed before perforator flap harvest. Hand-held Doppler (hhD) and color duplex ultrasonography (CDU) are currently the most popular radiation-free methods for this purpose that can be applied by the surgeon alone. The aim of this study was to compare the accuracy, reliability, and feasibility of hhD and CDU with indocyanine green angiography (ICGA) in the anterolateral thigh perforator flap (ALTPF). Methods All consecutive ALTPF procedures between May 2017 and April 2018 were included in this prospective study. The perforators were visualized by three investigators independently and randomized, applying hhD, CDU, and ICGA. The presence and the distance to the identified perforator were registered. Further, body mass index (BMI), American Society of Anesthesiologists-status, and the patient's history regarding smoking, alcohol use, and diabetes mellitus were registered alongside gender and age to analyze possible confounders. Results A total of 12 patients were enrolled with a median age of 67 (52–87) years. In total, 30 perforators were detected intraoperatively as well as with the ICGA. The latter visualized the perforators significantly more precisely than hhD and CDU (p < 0.001 and p = 0.001). The sensitivity and positive predictive value were 67 and 62% for hhD, 73 and 64% for CDU, and 100 and 100% for ICGA, respectively. Conclusion According to this study, ICGA visualized perforators more accurately than the standard methods hhD and CDU. Further, it was associated with the highest sensitivity and positive predictive value. ICGA consistently delivered excellent results, whereas hhD and CDU showed variability.

Sensitivity and positive predictive value of CT, MRI and 123I-MIBG scintigraphy in localizing pheochromocytomas: A prospective study

2006 ◽  
Vol 27 (7) ◽  
pp. 583-587 ◽  
Author(s):  
Franco Lumachi ◽  
Alberto Tregnaghi ◽  
Pietro Zucchetta ◽  
Maria Cristina Marzola ◽  
Diego Cecchin ◽  
...  
Keyword(s):  
Positive Predictive Value ◽  
Prospective Study ◽  
Predictive Value ◽  
Mibg Scintigraphy ◽  
A Prospective Study

scholarly journals Perioperative mortality in children in a tertiary teaching hospital in Nigeria: a prospective study

2021 ◽  
Vol 4 (1) ◽  
pp. e000237
Author(s):  
Ademola Olusegun Talabi ◽  
Olugbenga Olalekan Ojo ◽  
Olurotimi Idowu Aaron ◽  
Oludayo Adedapo Sowande ◽  
Folayemi Aramide Faponle ◽  
...  
Keyword(s):  
Prospective Study ◽  
Congenital Anomalies ◽  
Healthcare Delivery ◽  
Mortality Rates ◽  
Perioperative Mortality ◽  
Predictors Of Mortality ◽  
Tertiary Teaching ◽  
American Society ◽  
A Prospective Study ◽  
American Society Of Anesthesiologists

BackgroundPerioperative mortality is one of the tools that can help to assess the adequacy of healthcare delivery in a nation. This audit was conducted to determine the 24-hour, 7-day and 30-day perioperative mortality rates and the predictors of mortality in a pediatric surgical cohort.MethodsThis was a prospective study of children whose ages ranged from a few hours to 15 years and who were operated on between May 2019 and April 2020. The primary outcome was to determine the incidence of in-hospital perioperative mortality.ResultsA total of 530 procedures were done in 502 children. Their ages ranged from a few hours to 15 years with a median of 36 months. The 24-hour, 7-day and 30-day mortality rates were 113.2 per 10 000 procedures [95% confidence interval (CI) =40 to 210], 207.6 per 10 000 procedures (95% CI=110 to 320) and 320.8 per 10 000 procedures (95% CI=190 to 470), respectively. Congenital anomalies complicated by postoperative sepsis contributed to death in the majority of cases. The predictors of mortality were neonatal age group [adjusted odds ratio (AOR)=19.92, 95% CI=2.32 to 170.37, p=0.006], higher American Society of Anesthesiologists Physical Status III and above (AOR=21.6, 95% CI=3.05 to 152.91, p=0.002), emergency surgery (AOR=17.1, 95% CI=5.21 to 60.27, p=0.001), congenital anomalies (AOR=12.7, 95% CI=3.37 to 47.52, p=0.001), and multiple surgical procedures (AOR=9.7, 95% CI=2.79 to 33.54, p=0.001).ConclusionPerioperative mortality remains high in our institution.

scholarly journals The Performance of Two Rapid Antigen Tests During Population-Level Screening for SARS-CoV-2 Infection

2021 ◽  
Vol 8 ◽  
Author(s):  
Mohammad Alghounaim ◽  
Hamad Bastaki ◽  
Farah Bin Essa ◽  
Hoda Motlagh ◽  
Salman Al-Sabah
Keyword(s):  
Positive Predictive Value ◽  
Prospective Study ◽  
Predictive Value ◽  
Point Of Care ◽  
Population Level ◽  
Lower Sensitivity ◽  
Rt Pcr ◽  
Antigen Tests ◽  
A Prospective Study ◽  
Antigen Testing

Background: SARS-CoV-2 antigen assays offer a rapid mean to diagnose and isolate infected individuals. However, their utility in population-level screening is unknown.Objectives: The performance of two antigen tests in detecting SARS-CoV-2 was assessed among individuals randomly selected in the community.Study Design: A prospective study that performed head-to-head comparison of two SARS-CoV-2 antigen assays. Individuals were recruited during community SARS-CoV-2 screening over 10 working days. Demographic and clinical data were collected. Standard Q COVID-19 Ag test, a point-of-care chromatographic assay, was conducted immediately, and then the sample was transported to the virology laboratory to perform PCR and the LIAISON SARS-CoV-2 Ag chemiluminesence immunoassay.Results: respiratory samples from 991 individuals were collected, and 62 were positive by PCR. Inconclusive PCR results were observed in 19 samples and were excluded. The median age of participants was 40.2 years (IQR 32.3–47.8), and 932 (94%) were males. Most (77.4%) of infections were asymptomatic. The sensitivity and the specificity of the LIAISON assay were 43.3% (95%CI 30.6–56.8) and 99.9% (95%CI 99.3–100). The Standard Q assay had lower sensitivity (30.6%, 95%CI 19.6–43.7) but similar specificity (98.8%, 95%CI, 97.8–99.4). Similarly, the LIAISON assay had higher positive predictive value (96.3%, 95%CI 81–99.9% vs. 63.3%, 95%CI, 43.9–80.1%). Both assays performed better in symptomatic patients and among samples with a low-cycle threshold (Ct &lt; 25).Conclusion: In our setting of random community surveillance, rapid antigen testing of nasopharyngeal swabs by either LIAISON SARS-CoV-2 Ag (DiaSorin) or Standard Q COVID-19 Ag (SD Biosensor) was less sensitive to detecting SARS-CoV-2 than the TaqPath COVID-19 RT-PCR.

scholarly journals The Value of Bacterial Culture During Clean Orthopedic Surgery a Prospective Study of 1,036 Patients

2004 ◽  
Vol 25 (6) ◽  
pp. 512-514 ◽  
Author(s):  
Louis Bernard ◽  
Christophe Sadowski ◽  
Daniel Monin ◽  
Richard Stern ◽  
Blaise Wyssa ◽  
...  
Keyword(s):  
Positive Predictive Value ◽  
Prospective Study ◽  
Negative Predictive Value ◽  
Orthopedic Surgery ◽  
Predictive Value ◽  
Postoperative Infection ◽  
Bacterial Culture ◽  
Bacterial Cultures ◽  
Sensitivity Specificity ◽  
A Prospective Study

AbstractObjective:To determine whether bacterial cultures of the wounds of patients undergoing clean orthopedic surgery would help predict infection.Methods:During 1 year, 1,256 cultures were performed for 1,102 patients who underwent clean orthopedic surgery. Results were analyzed to evaluate their ability to predict postoperative infection.Results:The sensitivity, specificity, positive predictive value, and negative predictive value of the cultures were 38%, 92%, 7%, and 99%, respectively.Conclusions:Cultures performed during clean orthopedic surgery were not useful for predicting postoperative infection.

scholarly journals Clinicopathological evaluation of acute appendicitis and the role of ultrasound in diagnosis: a prospective study

2019 ◽  
Vol 6 (5) ◽  
pp. 1471
Author(s):  
Tony Mathew ◽  
Amit Shivshankar Ammanagi
Keyword(s):  
Acute Appendicitis ◽  
Positive Predictive Value ◽  
Prospective Study ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
Scoring System ◽  
Lower Abdominal Pain ◽  
Negative Appendicectomy ◽  
A Prospective Study

Background: Acute appendicitis is the most common acute surgical condition of the abdomen. Delay in treatment of acute appendicitis causes lot of complication. Study was done with the objective to study the clinical and pathological presentations of acute appendicitis, to evaluate the role of ultrasound in early diagnosis of acute appendicitis and to reduce negative appendicectomy in patients.Methods: This is a prospective study done on 100 patients with acute right lower abdominal pain clinically presumed to be of appendicular origin. A thorough history, clinical examination and ultrasound scan, was done for all cases. All ultrasound positive cases were subjected to surgery and some negative cases were also taken for surgery based on clinical suspicion. The ultrasound diagnosis was compared with clinical findings, operative findings and histopathological examination reports.Results: The overall accuracy of clinical diagnosis (Alvarado scoring system) with histopathology findings was 72%. The overall sensitivity and specificity was 70.3% and 81.3% respectively and positive predictive value of was 95.2% whereas the negative predictive value was 34.2%. The overall accuracy of ultrasound with histopathology report was 93%, with a sensitivity of 96.4%, specificity of 75%, and a positive predictive value of 95% and a negative predictive value of 80%. Negative appendicectomy rate was 8.82% in females and 3.63% in males.Conclusions: The Alvarado scoring system combined with ultrasound can therefore be used as a cheap and inexpensive way of confirming acute appendicitis thus reducing negative appendicectomy rate.

PREDICTIVE VALUE OF LOW AT III LEVELS FOR THE OCCURRENCE OF IVH, IRDS AND DEATH IN PREMATURE NEONATES

1987 ◽  
Author(s):  
W van den Berg ◽  
M Peters ◽  
C Breederveld ◽  
J W ten Cate ◽  
J G Koppe
Keyword(s):  
Positive Predictive Value ◽  
Predictive Value ◽  
Distress Syndrome ◽  
Peripheral Vein ◽  
Premature Neonates ◽  
Significant Difference ◽  
At Iii ◽  
Diffuse Intravascular Coagulation ◽  
Idiopathic Respiratory Distress Syndrome ◽  
A Prospective Study

The observation of AT III deficiency in premature neonates with Idiopathic Respiratory Distress Syndrome (IRDS), suggests a positive predictive value for a poor outcome. The underlying diffuse intravascular coagulation could generate serious hemorrhagic complications like Peri/Intraventricular Hemorrhage (IVH).A prospective study was performed in consecutively born neonates to assess the predictive value of low AT III for theoccurrence of IVH, (gr. III/IV), IRDS, and death. Eighty-one neonates were included in the study during a period of 5 months. AT III levels were determined immediately after birth by a chromogenic substrate assay. Values in umbilical cord blood were identical with values in capillary or peripheral vein blood samples taken within 6 hours after birth. There was no correlation between AT III values and gestational age (r: 0.18). Twenty-four neonates with IRDS showed a mean AT III value of 0.23 U/ml (S. D. ± 0.07 U/ml) which was significantly lower than a mean AT III value of 0.35 U/ml (S. D. ± 0.1 U/ml) for neonates without IRDS (p ≺0.00005). When IVH gr. III/IV was diagnosed in neonates having IRDS (8/24) no significant difference in mean AT IIIact was observed with respect to jnean AT III levels of remaining neonates without this complication. No death occurred in neonates without IRDS. Mean AT IIIact (0.21 U/ml) in neonates with IRDS who died (9/24) was low compared with mean AT III levels of neonates with IRDS who survived (0.25 U/ml), but did not reach significance (p≻0.1). Assuming a critical value of AT III of 20% a positive predictive value of 89% for IRDS, 44% for IVH, and 56% for death was calculated. It is concluded that low AT Illact levels have a high predictive value for IRDS.

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