scholarly journals 332 The diagnostic role of shunt series radiographs (SSR) in children presenting to the children’s emergency department (CED) with suspected ventriculoperitoneal (VP) shunt failure

2020 ◽  
Vol 37 (12) ◽  
pp. 852.3-853
Author(s):  
Angharad Griffiths ◽  
Ikechukwu Okafor ◽  
Thomas Beattie
Keyword(s):  
Clinical Outcome ◽  
Sensitivity And Specificity ◽  
Clinical Information ◽  
Flow Diagram ◽  
List Type ◽  
Shunt Failure ◽  
Vp Shunt ◽  
Wide Range ◽  
Diagnostic Role

Aims/Objectives/BackgroundVP shunts are used to drain CSF from the cranial vault because of a wide range of pathologies and, like any piece of hardware, can fail. Traditionally investigations include SSR and CT. This project examines the role of SSR in evaluating children with suspected VP shunt failure.Primary outcome: Sensitivity and specificity of SSR in children presenting to the CED with concern for shunt failure.Methods/DesignConducted in a single centre, tertiary CED of the national Irish Neurosurgical(NS) referral centre (ED attendance:>50,000 patients/year). 100 sequential SSR requested by the CED were reviewed. Clinical information was extracted from electronic requests. Shunt failure was defined by the need for NS intervention(Revision).Abstract 332 Figure 1Abstract 332 Figure 2Results/ConclusionsSensitivity and specificity is presented in figure 1 (two by two table).100 radiographs performed in 84 children.22% shunts revised (see flow diagram).7 SSR’s were abnormal.85% (n=6) shunts revised. [5 following abnormal CT].Of the normal SSR’s; 16 had abnormal CT and revised.85/100 received CT.64 of 85 CT’s (75%) were normal.□6 of the 64 had focal shunt concern.SSR’s shouldn’t be used in isolation. NPV&PPV, Sensitivity&Specificity is low.SSR’s are beneficial where there’s concern over focal shunt problems (injury/pain/swelling) or following abnormal CT.VP shunt failure is not well investigated with SSR alone.SSR’s could be omitted where there is no focal shunt concern/after normal CT (without impacting clinical outcome) reducing radiation exposure and reduce impact on CED’s.59 SSR’s could have been avoided without adverse clinical outcome.

The role of imaging tests in electrotherapy

2020 ◽  
Vol 1 (54) ◽  
pp. 23-29
Author(s):  
Łukasz Mazurek ◽  
Agnieszka Kotalczyk ◽  
Michał Mazurek ◽  
Ewa Jędrzejczyk-Patej
Keyword(s):  
Sensitivity And Specificity ◽  
Therapeutic Process ◽  
Electronic Devices ◽  
Diagnosis And Treatment ◽  
Imaging Methods ◽  
Cardiac Implantable Electronic Devices ◽  
Wide Range

We currently have a wide range of different imaging tests that are constantly improving and developing. Each test has its sensitivity and specificity and is used in various fields of medicine. Knowledge of the possibilities of using imaging tests in electrotherapy is an important element of the diagnostic and therapeutic process. This article presents selected issues regarding the use of imaging methods in the diagnosis and treatment of patients with cardiac implantable electronic devices.

scholarly journals Cleveland Clinic Socre – What is the Role of a Novel Prognostic Treadmil Score to Diagnose Coronary Artery Disease?

2019 ◽  
Vol 14 (2) ◽  
pp. 62-66
Author(s):  
Md Mashiul Alam ◽  
Md Mukhlesur Rahman ◽  
Tanjima Parvin ◽  
Khurshed Ahmed ◽  
SM Mustafa Zaman ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Sensitivity And Specificity ◽  
Cleveland Clinic ◽  
Test Accuracy ◽  
Male And Female ◽  
St Segment ◽  
Diagnostic Role ◽  
Artery Disease

Background: Ischemic heart disease is increasing all over the world even in the developing countries like Bangladesh. The incidence rate of coronary artery disease is escalating very rapidly among both male and female population in our country. Though exercise treadmill test (ETT) is a well accepted non-invasive investigation to diagnose Coronary Artery Disease (CAD), it has a high false positive and false negative result if ST segment response alone is calculated for interpretation of the test. Accuracy of different treadmill scores in our population is largely unknown. Clevelan Clinic Score is a prognostic ETT score which is validated for prognostic indication but may have some diagnostic value as well. Objective: To know the diagnostic role of Cleveland Clinic Score, currently which has only prognostic implication. Method: A Cross-Sectional study was carried out on patients attending University Cardiac Center in Bangabandhu Sheikh Mujib Medical University (BSMMU) for stable chest pain to find out the accuracy of Cleveland Clinic Scores (CCS) in comparison to other diagnostic treadmill scores namely Duke Treadmill Score (DTS) and Simple Treadmill Score (STS).Total 130 persons including male and female who have undergone ETT were included according to inclusion and exclusion criteria. Coronary angiogram reports were collected after the procedure was performed as per clinical practice. The accuracy of ST segment response & different treadmill scores were calculated and compared with each other. Result: ETT scores had better sensitivity and specificity than ST segment response which was affected by workup bias more. CCS, DTS and STS have 83.3% & 60.9%; 71.4% & 71.7%; 64.3% & 78.3% sensitivity & specificity, respectively. Receiver Operator Characteristics (ROC) curve analysis showed all of the three scores have similar area under curve (AUC) that means they have similar accuracy to diagnose CAD. But they have different sensitivity and specificity for different cut off value. Overall analysis showed accuracy of STS (83.9%) is comparable to that of DTS (83.3%), CCS (77%) . Conclusion: Among the three treadmill scores Cleveland Clinic Score has comparable predictive accuracy when compared with DTS, STS. Though a prognostic ETT score, CCS may have diagnostic role which need to be validated further. University Heart Journal Vol. 14, No. 2, Jul 2018; 62-66

scholarly journals Diagnostic role of rapid urinary trypsinogen-2 strip test in acute pancreatitis

2021 ◽  
Vol 8 (5) ◽  
pp. 1674
Author(s):  
Meenal Jain ◽  
Vinoth Sundaresan ◽  
Siddhartha Gowthaman ◽  
Ramanathan Manickam
Keyword(s):  
Acute Pancreatitis ◽  
Acute Abdomen ◽  
Sensitivity And Specificity ◽  
Serum Amylase ◽  
Laboratory Methods ◽  
Pubmed Central ◽  
Diagnostic Role ◽  
Surgical Conditions ◽  
Strip Test

Acute pancreatitis is one of the most common surgical conditions that present with acute abdomen. Serum amylase and lipase are one of the most important and widely used laboratory methods to diagnosis acute pancreatitis. However, these tests have had unsatisfactory results in terms of their sensitivity and specificity. Urinary trypsinogen-2 strip test has been developed for the detection of increased levels of trypsinogen-2 in urine and has been suggested to play an important role in the screening of aucte pancreatitis on the basis of its rapid results. In this review, we aimed to assess the diagnostic role of the same existing articles using databases like pubmed, google scholar, medline, pubmed central. We analysed about 50 articles all of which were in English and 15 were excluded on the basis of our subject criteria. 

MOC31 Immunostaining in the Diagnosis of Metastatic Adenocarcinoma in Serous Fluid: Special Emphasis on Atypical Cytological Cases

2021 ◽  
pp. 1-8
Author(s):  
Saumya Sahu ◽  
Shelly Sharma ◽  
Parikshaa Gupta ◽  
Pranab Dey
Keyword(s):  
Sensitivity And Specificity ◽  
Serous Effusion ◽  
Metastatic Adenocarcinoma ◽  
Diagnostic Dilemma ◽  
Diagnostic Role ◽  
Atypical Cells ◽  
Cytological Features ◽  
Effusion Fluid

<b><i>Background:</i></b> The diagnosis of atypical cases in the effusion cytology sample often poses a challenge to the cytologists. <b><i>Aims and Objectives:</i></b> We evaluated the diagnostic role of MOC31 in the metastatic adenocarcinoma in effusion fluid. <b><i>Materials and Methods:</i></b> The cytological examination and MOC31 immunostaining in the cell block sections were carried out in 64 cases of serous effusion. A total of 23 cases showed atypical cytology, out of which suspicious for malignancy (SFM) and atypia of undetermined significance (AUS) were 19 and 4 cases, respectively. In these cases, we also performed calretinin immunostaining. The cytological features, results of MOC31 immunostaining, and follow-up data were correlated to find out the sensitivity and specificity of MOC31 immunostaining in the diagnosis of metastatic adenocarcinoma. <b><i>Result:</i></b> The sensitivity and specificity of MOC31 were 100%. MOC31 detected all the cases of metastatic adenocarcinoma. MOC31 showed strong positivity in 19 cases of SFM. All these cases had a malignant outcome in histopathology or follow-up data. In AUS cases, MOC31 immunostaining was negative with a benign outcome. In all the atypical but malignant cases calretinin stain showed diffuse cytoplasmic and nuclear positivity. In contrast, MOC31 showed strong membranous positivity and occasionally cytoplasmic positivity. <b><i>Conclusion:</i></b> MOC31 is an excellent marker of metastatic adenocarcinoma in the serous effusion. The membranous positivity of MOC31 and negative calretinin immuno­staining are helpful in atypical cytological cases to avoid the diagnostic dilemma. The MOC31 positivity is significantly useful in discrete atypical cells which are more challenging to recognize.

scholarly journals The PopN gate-keeper complex acts on the ATPase PscN to regulate the T3SS secretion switch from early to middle substrates in Pseudomonas aeruginosa

2020 ◽  
Author(s):  
Tuan-Dung Ngo ◽  
Caroline Perdu ◽  
Bakhos Jneid ◽  
Michel Ragno ◽  
Julia Novion Ducassou ◽  
...  
Keyword(s):  
Pseudomonas Aeruginosa ◽  
Type Iii Secretion ◽  
Secreted Proteins ◽  
List Type ◽  
Protein Protein Interaction ◽  
Microscale Thermophoresis ◽  
Wide Range ◽  
Chaperone Complex ◽  
Bacterial Cytoplasm

AbstractPseudomonas aeruginosa is an opportunistic bacterium of which the main virulence factor is the Type III Secretion System. The ATPase of this machinery, PscN (SctN), is thought to be localized at the base of the secretion apparatus and to participate in the recognition, chaperone dissociation and unfolding of exported T3SS proteins. In this work, a protein-protein interaction ELISA revealed the interaction of PscN with a wide range of exported T3SS proteins including the needle, translocator, gate-keeper and effector. These interactions were further confirmed by Microscale Thermophoresis that also indicated a preferential interaction of PscN with secreted proteins or protein-chaperone complex rather than with chaperones alone, in line with the release of the chaperones in the bacterial cytoplasm after the dissociation from their exported proteins. Moreover, we suggest a new role of the gate-keeper complex and the ATPase in the regulation of early substrates recognition by the T3SS. This finding sheds a new light on the mechanism of secretion switching from early to middle substrates in P. aeruginosa.HighlightsT3SS substrates are secreted sequentially but information on the switches are missingInteraction of the T3SS ATPase with secreted proteins were investigated by different approachesMicroscale Thermophoresis revealed a lower affinity for chaperones alone compared to complexesThe Gate-keeper complex binds to the ATPase and increases its affinity for the needle complexA new role of the Gate-keeper complex is proposed, directly acting on the T3SS ATPase

scholarly journals The role of the Sunfrail tool in the screening of frailty and in integrated community-hospital care pathways: a retrospective observational study

2021 ◽  
Author(s):  
Yari Longobucco ◽  
Fulvio Lauretani ◽  
Luciano Gionti ◽  
Sara Tagliaferri ◽  
Robbert Gobbens ◽  
...  
Keyword(s):  
Clinical Pathways ◽  
Area Under The Curve ◽  
Clinical Information ◽  
Falls Prevention ◽  
Social Model ◽  
University Hospital ◽  
List Type ◽  
Discriminating Power ◽  
The University

Abstract Background One of the most problematic expression of ageing is frailty, and an approach based on its early identification is mandatory. The Sunfrail-tool (ST), a 9-item questionnaire, is a promising instrument for screening frailty. Aims To assess the diagnostic accuracy and the construct validity between the ST and a Comprehensive Geriatric Assessment (CGA), composed by six tests representative of the bio-psycho-social model of frailty; To verify the discriminating power of five key-questions of the ST; To investigate the role of the ST in a clinical-pathway of falls’ prevention. Methods In this retrospective study, we enrolled 235 patients from the Frailty-Multimorbidity Lab of the University-Hospital of Parma. The STs’ answers were obtained from the patient’s clinical information. A patient was considered frail if at least one of the CGAs’ tests resulted positive. Results The ST was associated with the CGA’s judgement with an Area Under the Curve of 0.691 (CI 95%: 0.591–0.791). Each CGA’s test was associated with the ST total score. The five key-question showed a potential discriminating power in the CGA’s tests of the corresponding domains. The fall-related question of the ST was significantly associated with the Short Physical Performance Battery total score (OR: 0.839, CI 95%: 0.766–0.918), a proxy of the risk of falling. Discussion The results suggest that the ST can capture the complexity of frailty. The ST showed a good discriminating power, and it can guide a second-level assessment to key frailty domains and/or clinical pathways. Conclusions The ST is a valid and easy-to-use instrument for the screening of frailty.

The psychosis risk timeline: can we improve our preventive strategies? Part 1: early life

2019 ◽  
Vol 25 (05) ◽  
pp. 299-308
Author(s):  
Karen Romain ◽  
Alexandra Eriksson ◽  
Richard Onyon ◽  
Manoj Kumar
Keyword(s):  
Risk Factors ◽  
Early Life ◽  
Clinical Utility ◽  
Learning Objectives ◽  
List Type ◽  
Preventive Strategies ◽  
Wide Range ◽  
Psychosis Risk ◽  
Key Aspects

SUMMARYPsychosis is a complex presentation with a wide range of factors contributing to its development, biological and environmental. Psychosis is a feature present in a variety of psychiatric disorders. It is important for clinicians to keep up to date with evidence regarding current understanding of the reasons psychosis may occur. Furthermore, it is necessary to find clinical utility from this knowledge so that effective primary, secondary and tertiary preventative strategies can be considered. This article is the first of a three-part series that examines contemporary knowledge of risk factors for psychosis and presents an overview of current explanations. The articles focus on the psychosis risk timeline, which gives a structure within which to consider key aspects of risk likely to affect people at different stages of life. In this first article, early life is discussed. It covers elements that contribute in the prenatal and early childhood period and includes genetic, nutritional and infective risk factors.LEARNING OBJECTIVESAfter reading this article you will be able to: •give an up-to-date overview of psychosis risk factors that can affect early life•describe some important genetic risk factors•understand more about the role of environmental factors such as nutrition and infection.DECLARATION OF INTERESTNone.

scholarly journals The diagnostic role of the β-hCG discriminatory zone combined with the endometrial pattern for ectopic pregnancy in Chinese women

2019 ◽  
Vol 9 (1) ◽  
Author(s):  
Qi Lu ◽  
Yiwei Wang ◽  
Xiao Sun ◽  
Yuhong Li ◽  
Jing Wang ◽  
...  
Keyword(s):  
Ectopic Pregnancy ◽  
Chinese Women ◽  
Endometrial Thickness ◽  
Transvaginal Ultrasound ◽  
Diagnostic Value ◽  
Wide Range ◽  
Endometrial Pattern ◽  
Diagnostic Role ◽  
Β Hcg

Abstract Previous studies have regarded the discriminatory serum β-hCG zone (DSZ) as a valuable tool for the diagnosis of ectopic pregnancy (EP). However, the wide range of the DSZ makes achieving a clinical diagnosis of EP difficult, and these reports do not indicate whether the DSZ is suitable for an EP diagnosis in Chinese women. Several studies have indicated that the endometrial pattern in patients with EPs is different from that in patients with intrauterine pregnancies (IUPs). The aims of this study were to define the DSZ cutoff value for Chinese women, test whether the endometrial pattern is a suitable predictor for EP, and assess the diagnostic value of these indicators. We enrolled participants with IUPs or EPs with abdominal pain and/or vaginal bleeding, and serum β-hCG level measurements and transvaginal ultrasound (TVS) were performed to assess the diagnostic value of the indicators for EP. The sensitivity and specificity for identifying an EP were improved by combining the DSZ, endometrial thickness and trilaminar pattern indexes. The results of this study might be helpful toward providing further options for the diagnosis of EP, especially for patients without hemoperitoneum or colporrhagia.

Comparison of Deterministic and Linear Cosine Spatial Filtering of Transmission Electron Micrographs

1972 ◽  
Vol 30 ◽  
pp. 596-597
Author(s):  
David A. Ansley
Keyword(s):  
Spherical Aberration ◽  
Focal Length ◽  
Chromatic Aberration ◽  
Spatial Filter ◽  
Operating Conditions ◽  
Objective Lens ◽  
List Type ◽  
Spatial Filters ◽  
Transmission Electron ◽  
Wide Range

The coherence of the electron flux of a transmission electron microscope (TEM) limits the direct application of deconvolution techniques which have been used successfully on unmanned spacecraft programs. The theory assumes noncoherent illumination. Deconvolution of a TEM micrograph will, therefore, in general produce spurious detail rather than improved resolution.A primary goal of our research is to study the performance of several types of linear spatial filters as a function of specimen contrast, phase, and coherence. We have, therefore, developed a one-dimensional analysis and plotting program to simulate a wide 'range of operating conditions of the TEM, including adjustment of the:(1) Specimen amplitude, phase, and separation(2) Illumination wavelength, half-angle, and tilt(3) Objective lens focal length and aperture width(4) Spherical aberration, defocus, and chromatic aberration focus shift(5) Detector gamma, additive, and multiplicative noise constants(6) Type of spatial filter: linear cosine, linear sine, or deterministic

Triply-periodic nanostructures in surfactant, block copolymer, and biomembrane systems, and simulation of TEMs

1993 ◽  
Vol 51 ◽  
pp. 884-885
Author(s):  
David M. Anderson ◽  
Tomas Landh
Keyword(s):  
Liquid Crystalline ◽  
Diblock Copolymers ◽  
Cubic Phase ◽  
List Type ◽  
Interpenetrating Networks ◽  
Triply Periodic ◽  
Wide Range ◽  
Bicontinuous Cubic ◽  
Phase Liquid ◽  
Dividing Surface

First discovered in surfactant-water liquid crystalline systems, so-called ‘bicontinuous cubic phases’ have the property that hydropnilic and lipophilic microdomains form interpenetrating networks conforming to cubic lattices on the scale of nanometers. Later these same structures were found in star diblock copolymers, where the simultaneous continuity of elastomeric and glassy domains gives rise to unique physical properties. Today it is well-established that the symmetry and topology of such a morphology are accurately described by one of several triply-periodic minimal surfaces, and that the interface between hydrophilic and hydrophobic, or immiscible polymer, domains is described by a triply-periodic surface of constant, nonzero mean curvature. One example of such a dividing surface is shown in figure 5.The study of these structures has become of increasing importance in the past five years for two reasons:1)Bicontinuous cubic phase liquid crystals are now being polymerized to create microporous materials with monodispersed pores and readily functionalizable porewalls; figure 3 shows a TEM from a polymerized surfactant / methylmethacrylate / water cubic phase; and2)Compelling evidence has been found that these same morphologies describe biomembrane systems in a wide range of cells.

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