0588 Ring Pulse Oximeter for Screening of Moderate to Severe OSA: A Pilot Study

Abstract Introduction To evaluate the utility of the ring pulse oximeter for screening of OSA in adults. Methods 87 adults were monitored by a ring pulse oximeter and PSG simultaneously during a nocturnal in-lab sleep testing. 3% oxygen desaturation index (ODI3); Mean oxygen saturation(MSpO2), Saturation impair time below 90% (SIT90) derived from an automated algorithm of the ring pulse oximeter. Meanwhile, the parameters of PSG were scored manually according to the AASM Manual. Correlation and receiver operator characteristic curve analysis were used to measure the accuracy of ring pulse oximeter and its diagnostic value for moderate to severe OSA (AHI≥15). Results Among the 87 participants, 18 cases were AHI<5, 17 cases were diagnosed with mild OSA (AHI:5-14.9), 25 cases were diagnosed with moderate OSA (AHI:15-29.9) and 27 cases were diagnosed with severe OSA (AHI≥30). There was no significant difference between PSG and ring pulse oximeter in regard to ODI3 (23.4±23.5 vs 24.7 ± 21.7), and SIT90 (1.54%, range 0.14%-8.99% vs. 3.20%, range 0.60%, 12.30%) (P>0.05], Further analysis indicated that two parameters from the oximeter correlated well with that derived from PSG (r=0.889, 0.567, respectively, both p<0.05). Although MSpO2 correlated significantly (r=0.448, P<0.05), the difference was remarkable [95.9%, range 94.0% to 97.0% vs. 94.5%, range 93.3% to 95.7%, p<0.05]. Bland-Altman plots showed that the agreement of these three parameters was within the clinical acceptance range. The ROC curve showed that the sensitivity and specificity of the ring pulse oximeter when the oximeter derived ODI3 ≥12.5 in the diagnosis of moderate to severe OSA were 82.7% and 74.3%, respectively. Conclusion The pilot study indicated that ring pulse oximeter can detect oxygen desaturation events accurately, therefore to be used as a screening tool for moderate to severe OSA. Support The study was supported by the National Natural Science Foundation of China (No. 81420108002 and NO. 81570083).

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Diagnostic Value of Virtual Touch Tissue Quantification for Breast Lesions with Different Size

BioMed Research International ◽

10.1155/2014/142504 ◽

2014 ◽

Vol 2014 ◽

pp. 1-7 ◽

Cited By ~ 13

Author(s):

Minghua Yao ◽

Jian Wu ◽

Liling Zou ◽

Guang Xu ◽

Juan Xie ◽

...

Keyword(s):

Characteristic Curve ◽

Diagnostic Value ◽

Lesion Size ◽

Normal Breast ◽

Pathological Examination ◽

Breast Lesions ◽

Virtual Touch Tissue Quantification ◽

Significant Difference ◽

The Difference ◽

Tissue Quantification

Purpose. To evaluate diagnostic value of the virtual touch tissue quantification (VTTQ) for breast lesions with different sizes.Materials and Methods. Patients with 206 breast lesions were categorized into three groups according to lesion size (<10 mm, 10–20 mm, and >20 mm). Breast lesions were examined by conventional ultrasound and VTTQ, and shear wave velocity (SWV) of each lesion and adjacent normal breast tissue were measured. Diagnoses were confirmed by pathological examination after surgery. The receiver-operating characteristic curve (ROC) analyses were performed to evaluate the diagnostic value of SWV, and the area under curves (AUC) was compared among groups.Results. SWV of malignant lesions was much higher than that of benign lesions, whereas the difference was not obvious for lesions <10 mm (P=0.15). There was statistical significant difference of AUC between lesions <10 mm and 10–20 mm (P<0.05), as well as lesions <10 mm and >20 mm (P<0.05). The sensitivity of lesions <10 mm was 33.33%, which was relatively low compared to other groups.Conclusion. According to our results, VTTQ is a promising method for breast lesions >10 mm, and further studies were warranted to improve sensitivity of VTTQ for breast lesions <10 mm.

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Adaptation and Validation of the Mini-Addenbrooke’s Cognitive Examination in Dementia in Arabic Speakers in Egypt

Dementia and Geriatric Cognitive Disorders ◽

10.1159/000513411 ◽

2020 ◽

Vol 49 (6) ◽

pp. 611-616

Author(s):

Tarik Qassem ◽

Mohamed S. Khater ◽

Tamer Emara ◽

Doha Rasheedy ◽

Heba M. Tawfik ◽

...

Keyword(s):

Screening Tool ◽

Characteristic Curve ◽

High Sensitivity ◽

Receiver Operator Characteristic Curve ◽

Cutoff Score ◽

Arabic Speakers ◽

Dementia Patients ◽

Significant Difference ◽

Sensitivity Specificity ◽

Addenbrooke’S Cognitive Examination

Background: The mini-Addenbrooke’s Cognitive Examination (m-ACE) is a brief cognitive battery that assesses 5 subdomains of cognition (attention, memory, verbal fluency, visuospatial abilities, and memory recall). It is scored out of 30 and can be administered in under 5 min providing a quick screening tool for assessment of cognition. Objectives: We aimed to adapt the m-ACE in Arabic speakers in Egypt and to validate it in dementia patients to provide cutoff scores. Methods: We included 37 patients with dementia (Alzheimer’s disease [n = 25], vascular dementia [n = 8], and dementia with Lewy body [n = 4]) and 43 controls. Results: There was a statistically significant difference (p < 0.001) on the total m-ACE score between dementia patients (mean 10.54 and standard deviation [SD] 5.83) and controls (mean 24.02 and SD 2.75). There was also a statistically significant difference between dementia patients and controls on all sub-score domains of the m-ACE (p < 0.05). Performance on the m-ACE significantly correlated with both the Mini-Mental State Examination (MMSE) and the Addenbrooke’s Cognitive Examination-III (ACE-III). Using a receiver operator characteristic curve, the optimal cutoff score for dementia on the m-ACE total score was found to be 18 (92% sensitivity, 95% specificity, and 94% accuracy). Conclusions: We adapted the m-ACE in Arabic speakers in Egypt and provided objective validation of it as a screening tool for dementia, with high sensitivity, specificity, and accuracy.

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Vaginal examination vs. cervical length – which is superior in predicting preterm birth?

Journal of Perinatal Medicine ◽

10.1515/jpm-2016-0273 ◽

2017 ◽

Vol 45 (8) ◽

Cited By ~ 4

Author(s):

Merav Sharvit ◽

Reut Weiss ◽

Yael Ganor Paz ◽

Keren Tzadikevitch Geffen ◽

Netanella Danielli Miller ◽

...

Keyword(s):

Preterm Birth ◽

Medical Center ◽

Characteristic Curve ◽

Multiple Pregnancy ◽

Predictive Ability ◽

Cervical Length ◽

Receiver Operator Characteristic Curve ◽

Retrospective Case ◽

Nulliparous Women ◽

Significant Difference

AbstractObjective:To compare the predictive value of preterm birth (PTB) by transvaginal sonographic cervical length (CL) measurement to digital examination of the cervix (Bishop score – BS), in patients with premature contractions (PC) and intact membranes.Design:A retrospective case-control study.Setting:Meir Medical Center, Kfar Saba, Israel.Population:Women at 24–34 weeks of gestation who were hospitalized with PC and intact membranes.Methods:All patients underwent CL and BS measurements upon admission. Power analysis revealed that 375 patients were needed to show a significant difference between the two methods for predicting PTB. Each one served as her own control.Main outcome measures:PTB<37 and<34 weeks.Results:Receiver-operator characteristic curve (ROC) and logistic regression analyses indicated a correlation between both shortened CL and increased BS to PTB (P<0.001). Neither test offered an advantage in predicting PTB. Areas under the curve for BS and CL ROC were similar for PTB before 37 weeks gestation (0.611 vs. 0.640, P=0.28). For nulliparous women, CL predicted PTB better that BS (0.642 vs. 0.724, P=0.03). For singleton and multiple pregnancy pregnancies, BS and CL did not differ significantly in predicting PTB (P=0.9, P=0.2, respectively). For nulliparous with multiple pregnancy, the BS and CL ROC curves differ nearly significantly (0.554 vs. 0.709, P=0.07), with better predictive ability for CL.Conclusions:CL and BS have similar value in predicting PTB in patients with PC. For nulliparous women, CL is superior over the BS.

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Diagnostic efficacy of serum and urinary netrin-1 in the early detection of diabetic nephropathy

Journal of Investigative Medicine ◽

10.1136/jim-2021-001785 ◽

2021 ◽

pp. jim-2021-001785

Author(s):

Rasha A Elkholy ◽

Reham L Younis ◽

Alzahraa A Allam ◽

Rasha Youssef Hagag ◽

Muhammad Tarek Abdel Ghafar

Keyword(s):

Diabetic Nephropathy ◽

Early Detection ◽

Characteristic Curve ◽

Fasting Blood Glucose ◽

Area Under The Curve ◽

Diagnostic Value ◽

Control Group ◽

Diagnostic Efficacy ◽

Significant Difference ◽

Patients With Diabetes

This study aimed to assess the diagnostic value of serum and urinary netrin-1 in patients with type 2 diabetes mellitus (T2DM) at different stages of diabetic nephropathy (DN) and to compare its efficacy of estimation in serum with that in the urine. This study was carried out on 135 patients with T2DM and 45 healthy subjects. The patients with diabetes were divided according to urinary albumin creatinine ratio (UACR) into: T2DM with normoalbuminuria, incipient DN with microalbuminuria, and overt DN with macroalbuminuria groups. Serum and urinary levels of netrin-1 were measured by ELISA. The mean levels of serum and urinary netrin-1 were significantly higher in the microalbuminuric and macroalbuminuric patients with DN than those in the normoalbuminuric patients with T2DM, with the highest values detected in macroalbuminuric patients with DN. Urinary netrin-1 level was significantly higher in the normoalbuminuric T2DM group than control group, whereas no significant difference existed regarding serum netrin-1 level. In T2DM groups, the urinary and serum netrin-1 correlated with each other and were independently related to fasting blood glucose, UACR, and estimated glomerular filtration rate. Receiver operating characteristic curve analysis showed that the area under the curve of urinary netrin-1 was 0.916 which is significantly higher than that of serum netrin-1 (0.812) for the detection of incipient DN and reached 0.938 on coestimation of both urinary and serum netrin-1. In conclusion, netrin-1 is a potential diagnostic marker for early detection of DN with its estimation in urine has higher accuracy than that of serum.

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Phospholipase A2 (PLA2) as an Early Indicator of Envenomation in Australian Elapid Snakebites (ASP-27)

Biomedicines ◽

10.3390/biomedicines8110459 ◽

2020 ◽

Vol 8 (11) ◽

pp. 459

Author(s):

Geoffrey K. Isbister ◽

Nandita Mirajkar ◽

Kellie Fakes ◽

Simon G. A. Brown ◽

Punnam Chander Veerati

Keyword(s):

Characteristic Curve ◽

Diagnostic Value ◽

Pla2 Activity ◽

Serum Samples ◽

Case Identification ◽

Chemical Company ◽

Significant Difference ◽

Ann Arbor ◽

Early Case ◽

Cayman Chemical

Early diagnosis of snake envenomation is essential, especially neurotoxicity and myotoxicity. We investigated the diagnostic value of serum phospholipase (PLA2) in Australian snakebites. In total, 115 envenomated and 80 non-envenomated patients were recruited over 2 years, in which an early blood sample was available pre-antivenom. Serum samples were analyzed for secretory PLA2 activity using a Cayman sPLA2 assay kit (#765001 Cayman Chemical Company, Ann Arbor MI, USA). Venom concentrations were measured for snake identification using venom-specific enzyme immunoassay. The most common snakes were Pseudonaja spp. (33), Notechis scutatus (24), Pseudechis porphyriacus (19) and Tropidechis carinatus (17). There was a significant difference in median PLA2 activity between non-envenomated (9 nmol/min/mL; IQR: 7–11) and envenomated patients (19 nmol/min/mL; IQR: 10–66, p < 0.0001) but Pseudonaja spp. were not different to non-envenomated. There was a significant correlation between venom concentrations and PLA2 activity (r = 0.71; p < 0.0001). PLA2 activity was predictive for envenomation; area under the receiver-operating-characteristic curve (AUC-ROC), 0.79 (95% confidence intervals [95%CI]: 0.72–0.85), which improved with brown snakes excluded, AUC-ROC, 0.88 (95%CI: 0.82–0.94). A cut-point of 16 nmol/min/mL gives a sensitivity of 72% and specificity of 100% for Australian snakes, excluding Pseudonaja. PLA2 activity was a good early predictor of envenomation in most Australian elapid bites. A bedside PLA2 activity test has potential utility for early case identification but may not be useful for excluding envenomation.

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The Diagnostic Value of Mir-133a in ST Elevation and Non-ST Elevation Myocardial Infarction: A Meta-Analysis

Cells ◽

10.3390/cells9040793 ◽

2020 ◽

Vol 9 (4) ◽

pp. 793

Author(s):

Yehuda Wexler ◽

Udi Nussinovitch

Keyword(s):

Myocardial Infarction ◽

Cardiovascular Disease ◽

Diagnostic Performance ◽

Characteristic Curve ◽

Diagnostic Value ◽

Receiver Operator Characteristic Curve ◽

St Elevation Myocardial Infarction ◽

Diagnostic Potential ◽

St Elevation ◽

The Impact

Numerous studies have reported correlations between plasma microRNA signatures and cardiovascular disease. MicroRNA-133a (Mir-133a) has been researched extensively for its diagnostic value in acute myocardial infarction (AMI). While initial results seemed promising, more recent studies cast doubt on the diagnostic utility of Mir-133a, calling its clinical prospects into question. Here, the diagnostic potential of Mir-133a was analyzed using data from multiple papers. Medline, Embase, and Web of Science were systematically searched for publications containing “Cardiovascular Disease”, “MicroRNA”, “Mir-133a” and their synonyms. Diagnostic performance was assessed using area under the summary receiver operator characteristic curve (AUC), while examining the impact of age, sex, final diagnosis, and time. Of the 753 identified publications, 9 were included in the quantitative analysis. The pooled AUC for Mir-133a was 0.73. Analyses performed separately on studies using healthy vs. symptomatic controls yielded pooled AUCs of 0.89 and 0.68, respectively. Age and sex were not found to significantly affect diagnostic performance. Our findings indicate that control characteristics and methodological inconsistencies are likely the causes of incongruent reports, and that Mir-133a may have limited use in distinguishing symptomatic patients from those suffering AMI. Lastly, we hypothesized that Mir-133a may find a new use as a risk stratification biomarker in patients with specific subsets of non-ST elevation myocardial infarction (NSTEMI).

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Point Shear Wave Elastography of the Spleen in Predicting the Presence of Esophageal Varices in Cirrhosis: Liver Stiffness vs. Spleen Stiffness

Journal of Diagnostic Medical Sonography ◽

10.1177/8756479319882006 ◽

2019 ◽

Vol 36 (2) ◽

pp. 95-101

Author(s):

Nadella Sindhu ◽

Prakashini Koteshwar ◽

Shiran Shetty

Keyword(s):

Esophageal Varices ◽

Statistical Tests ◽

Characteristic Curve ◽

Liver Stiffness ◽

Shear Wave Elastography ◽

Significant Difference ◽

Spleen Stiffness ◽

Cirrhotic Patients ◽

The Difference ◽

Combined Parameters

Objective: To determine the diagnostic ability of the spleen and liver stiffness in predicting the presence of esophageal varices (EVs). Methods: A sample of cirrhotic patients, diagnosed with sonography, was recruited. The cohorts’ liver stiffness (LS) and spleen stiffness (SS) were measured with the Philips’ Elast PQ technique. Platelet count and spleen size were also documented. The endoscopic report was used as the diagnostic gold standard. Singular and combined parameters were assessed to determine the presence of EV using an independent variable t test, area under the receiver operating characteristic curve, and multilogistic regression analysis statistical tests. Results: In predicting the presence of EV, there was a statistically significant difference in means of SS (2.13 ± 0.69 m/s vs. 3.23 ± 1.32 m/s) and LS (2.33 ± 1.20 m/s vs. 3.05 ± 1.4 m/s), as well as discriminating between groups of patients, with and without EV. The ability to diagnostically classify EV with SS and LS was fair while the remaining parameters were deemed poor, using a SS cutoff value of 1.99 m/s. Conclusion: Despite the difference in means, none of the assessed parameters demonstrated a better classification ability than endoscopy. LS and SS were equal in the prediction of EV in these patients. The LS estimate of fibrosis would have grossly predicted the presence of varices. However, the addition of SS, for the estimation of varices, provided no significant benefit.

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Association and diagnostic value of serum SPINK4 in colorectal cancer

PeerJ ◽

10.7717/peerj.6679 ◽

2019 ◽

Vol 7 ◽

pp. e6679 ◽

Cited By ~ 1

Author(s):

Mingzhi Xie ◽

Kezhi Li ◽

Jilin Li ◽

Dongcheng Lu ◽

Bangli Hu

Keyword(s):

Colorectal Cancer ◽

Gastric Cancer ◽

Cancer Patients ◽

Characteristic Curve ◽

Disease Free Survival ◽

Diagnostic Value ◽

Healthy Controls ◽

Significant Difference ◽

Peptidase Inhibitor ◽

Gastric Cancer Patients

The role of serum serine peptidase inhibitor, Kazal type 4 (SPINK4), in colorectal cancer (CRC) is largely unknown. This study aimed to explore the association and diagnostic value of serum SPINK4 in CRC. A total of 70 preoperative CRC patients, 30 postoperative CRC patients, 30 gastric cancer patients, and 30 healthy controls were enrolled. Using enzyme-linked immunosorbent assays, we found that the serum SPINK4 level was significantly increased in preoperative CRC compared with postoperative CRC patients, gastric cancer patients, and healthy controls (p < 0.05). The serum SPINK4 level was remarkably elevated in colon cancer compared with rectal cancer and was enhanced in the M1 stage compared with the M0 stage (p < 0.05). The area under the receiver operating characteristic curve of serum SPINK4 level in the diagnosis of CRC was 0.9186, with a sensitivity and specificity of 0.886 and 0.900, respectively, and a cut-off value of 2.065. There was no significant difference between high and low expression of serum SPINK4 regarding the overall survival time and disease-free survival (p > 0.05). This study demonstrated that the serum SPINK4 level increased in CRC and was associated with the location and distant metastasis of CRC. It had a high diagnostic value in CRC but was not associated with the survival of CRC patients.

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Study on Serum miR-204 Expression Levels in Patients with Severe Pneumonia and Patients with Primary Bronchial Lung Cancer and Its Diagnostic Value

Evidence-based Complementary and Alternative Medicine ◽

10.1155/2021/6034413 ◽

2021 ◽

Vol 2021 ◽

pp. 1-7

Author(s):

Wenhong Zheng ◽

Wei Huang ◽

Xuchao Yu

Keyword(s):

Lung Cancer ◽

Severe Pneumonia ◽

Diagnostic Value ◽

Control Group ◽

Qrt Pcr ◽

Kaplan Meier ◽

Significant Difference ◽

The Difference ◽

The Relationship ◽

Low Expression

Objective. To analyze the expression and clinical significance of miR-204 in the serum of patients with severe pneumonia (SP) and primary bronchial lung cancer (LC). Methods. 65 SP patients and 43 primary bronchial LC patients who were treated in the hospital from January 2017 to December 2018 were randomly selected as the SP group and LC group. At the same time, healthy patients from the physical examination department of the hospital were selected. 65 cases were the control group. QRT-PCR detected serum miR-204 expression and compared the differences between groups. The pathological data of patients were collected, and the relationship between serum miR-204 and the patient’s pathological data was compared; the area under the ROC curve and Kaplan–Meier curve were used to evaluate the diagnostic value of serum miR-204 for the two conditions and to explore the relationship between serum miR-204 and prognosis. Results. The serum miR-204 of the SP group was (0.43 ± 0.09), the serum miR-204 of the LC group was (0.40 ± 0.10), the serum miR-204 of the control group was (1.00 ± 0.09), and the miR-204 level of was significantly higher than that of the control group, and the difference between the groups was statistically significant ( P < 0.05). There was no significant difference in serum miR-204 levels between the SP group and the LC group ( P > 0.05). Serum miR-204 levels in SP patients with cumulative organs ≥3 were higher than those with cumulative organs <3, and the difference was statistically significant ( P < 0.001). In the LC group, in patients with stage III to IV and low and undifferentiated patients, the level of miR-204 was higher than that of stage I∼II and high and moderately differentiated patients, and the difference was statistically significant ( P < 0.001). The level of miR-204 in the two groups of patients (0.89 ± 0.10, 0.83 ± 0.13) who died of illness was significantly higher than that of the surviving patients (1.00 ± 0.11, 1.00 ± 0.10), and the difference was statistically significant ( P < 0.05); the survival rate of patients with high expression of miR-204 was higher than that of patients with low expression. The AUC of serum miR-204 level to SP and LC was 0.766 and 0.818, respectively. Conclusion. The level of miR-204 in the serum of SP patients and patients with primary bronchial LC was significantly lower than that of healthy people, and patients who died were lower than those who survived; the miR-204 in serum has a good diagnostic value for SP and LC and is related to the survival and prognosis of patients.

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The Diagnostic Value of Normalized ADC Using Spleen As A Reference Organ In Assessment Of Liver Fibrosis

QJM ◽

10.1093/qjmed/hcab106.036 ◽

2021 ◽

Vol 114 (Supplement_1) ◽

Author(s):

Omina Ahmed Kamal ◽

Aya Yassin Ahmed ◽

Mona Mohamed Ali ◽

Mai Ahmed Mostafa

Keyword(s):

Liver Fibrosis ◽

Sensitivity And Specificity ◽

Transient Elastography ◽

Characteristic Curve ◽

Diagnostic Value ◽

Control Group ◽

Group Data ◽

Significant Difference ◽

Apparent Diffusion ◽

Adc Values

Abstract Objectives To investigate the value of liver ADC normalization using spleen as a reference organ in liver fibrosis assessment, in comparison with transient elastography (Fibroscan). Materials and methods A total of 60 participants were included,30 HCV positive patients and 30 in the control group. We calculated mean Spleen apparent diffusion coefficient (ADC), liver mean ADC and normalized liver ADC (defined as the ratio of Liver ADC to spleen ADC) which were compared between cirrhotic patients and the control group. Data was analyzed and ROC was used to evaluate the performance of nADC. Results No significant difference between spleen ADC values of patient group and control group or in-between different fibrosis stages. A significant negative linear correlation between control and patient groups using ADC (r = -0.900; p = 0.0374) or nADC(r=-1:p<0,001).We also found that the mean liver ADC and nADC value in patients with hepatic fibrosis was significantly lower than that of volunteers (1.53 × 10 − 3 mm2/s vs.1.65 × 10 − 3 mm2/s, p = 0.001 &1.). Liver ADC only could distinguish F0 from F4. After analysis with ROC, there was a statistically significant difference between area under the receiver operating characteristic curve (AUC) of normalized liver ADC and ADC for all groups except for F4 stage. nADC AUC was 0.878 for detection of stage ≥ F2 with sensitivity and specificity of 87% & 80% respectively while ADC AUC was 0.548 with sensitivity and specificity of 62 % & 72% respectively(p = 0.021), ≥ F3 AUC of nADC was0.891 with sensitivity and specificity of 88.7 % & 80% respectively while ADC AUC is 0.603 with sensitivity and specificity of 72% & 72% respectively(p = 0.03), and F4 stage nADC AUC was0.879 for with sensitivity and specificity of 90% & 80% respectively ,while ADC AUC was 0.648 with sensitivity and specificity of 80 % & 72% respectively(p = 0.054) Conclusion Normalized liver ADC using the spleen as a reference organ increases the diagnostic performance of MRI in evaluation of liver fibrosis in comparison to ADC alone.

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