Diagnostic significance of IgG and albumin indices versus oligoclonal band types in demyelinating disorders

2021 ◽  
pp. jclinpath-2021-207766
Author(s):  
Maria Belimezi ◽  
Antonios Kalliaropoulos ◽  
Alexios-Fotios A Mentis ◽  
George P Chrousos
Keyword(s):  
Area Under The Curve ◽  
Laboratory Diagnosis ◽  
Standard Test ◽  
Oligoclonal Band ◽  
Multinomial Regression ◽  
Diagnostic Significance ◽  
Diagnostic Time ◽  
Igg Index ◽  
And Gender ◽  
Demyelinating Disorders

AimsThe laboratory diagnosis of demyelinating inflammatory disorders (DIDs) relies on both intrathecal oligoclonal band (OCB) positivity and IgG index. Although OCB typing remains the gold-standard test for DIDs, it can be laborious and ambiguous, complicating diagnostics, and unduly increasing diagnostic time. We examined whether serum or cerebrospinal fluid (CSF) parameters can classify OCB types and, thus, be used as a replacement test to standard OCB typing.MethodsWe retrospectively analysed >1000 prospectively collected samples of patients with DIDs and quantified albumin and IgG levels in the CSF and serum. We determined OCB types by isoelectric focusing combined with immunofixation and evaluated the diagnostic accuracies of IgG and albumin indices in discriminating OCB types by receiver operating characteristic curves and multinomial regression.ResultsAn IgG index cut-off of 0.589 differentiated types 2/3 from types 1/4 (area under the curve 0.780, 95% CI 0.761 to 0.812, p<0.001; specificity: 71.10%, sensitivity: 73.45%). Albumin quotient cut-off values of 6.625 and of 6.707 discriminated type 1 from type 4 and type 2 from type 3, respectively (specificity: <55%, sensitivity: <75%). Female sex, age, IgG index, CSF IgG and serum albumin were associated with different OCB types.ConclusionsOur study reveals that IgG and albumin index can differentiate OCB types with adequate accuracy, especially if refined by age and gender.

Seroprevalence of leptospirosis in Chennai city, India.

2016 ◽  
Vol 5 (03) ◽  
pp. 4897 ◽  
Author(s):  
Padma Kumari J.* ◽  
Sheila Doris T. ◽  
Usha Krishnan K.
Keyword(s):  
Control Strategies ◽  
Signs And Symptoms ◽  
Laboratory Diagnosis ◽  
Community Change ◽  
Standard Test ◽  
Agglutination Test ◽  
Source Of Infection ◽  
Potential Reservoir ◽  
Study Population ◽  
Chennai City

Leptospirosis is a zoonotic disease, it occurs worldwide but is most common in tropical and subtropical countries. The magnitude of the problem varies from community to community. The serovars which cause the disease in a community change with adaptation to a new maintenance host and is epidemiologically important. Aims and Objectives: To determine the seroprevalence of leptospirosis in Chennai city. To identify the prevalent serovar in Chennai causing leptospirosis by using gold standard test Microscopic Agglutination Test (MAT). Methods: 1209 patients from Chennai, with fever of one-week duration and with signs and symptoms of Leptospirosis were the study population and were screened for Leptospirosis by Macroscopic Slide Agglutination Test (MSAT). The positive samples by MSAT were tested for the prevalent serovar and for confirmation by MAT and the results were analyzed statistically. Result: The seroprevalence of Leptospirosis is 17.8%. The prevalent serovar circulating in Chennai is L. grippotyphosa. Conclusion: Laboratory diagnosis is essential to confirm the current illness, and for epidemiological and public health reasons, namely to determine which serovar caused the infection, the likely source of infection and the potential reservoir and its location. This helps in control strategies.

scholarly journals Serum levels of CXCL-8, IL-10, and TNF-alpha in ankylosing spondylitis patients

Biomedicine ◽  
2021 ◽  
Vol 41 (3) ◽  
Author(s):  
Dhuha Karim
Keyword(s):  
Disease Severity ◽  
Functional Disability ◽  
White Blood Cells ◽  
Age Groups ◽  
Area Under The Curve ◽  
Serum Levels ◽  
Hla B27 ◽  
Diagnostic Significance ◽  
Significant Difference ◽  
Wbc Count

The mean age of AS patients was (35.0 ± 9.8) years.When the patients and control subjects were divided into different age groups (>40, 30-40, <30 years), the differences were not significantin terms of disease prevalence. The results also showed that the percentage of male patients is higher than that of females. There was no significant difference (P?0.05) between patients and controls in the distribution of males and females.Most of the patients had the disease for a period of 5 years or higher, with a disease severity of ? 2.1 and functional disability degree of I, II. The resultsshoweddifferent patterns of distribution for the three tested cytokines. A significant increase in the level of TNF-?, anon-significantincrease in the level of CXCL-8, and a significant decrease in the level of IL-10 were observed in the sera of patients with AS compared with the control.The patients also demonstrated significant decreases in the serum ALT and AST enzyme levels, hemoglobin (Hb) level, white blood cells (WBC) count, and erythrocyte sedimentation rate (ESR) (P?0.05).The percentage of HLA-B27-positive Iraqi patients was lower than that of the HLA-B27-negative patients. Some of these patterns were also exposed to changes related to some determinants in patients, which included age, sex, disease duration, disease severity, functional disability, and HLA-B27 positivity,along with association with clinical subtypes of AS.The area under the curve was determined for the parameters of ESR, IL-10, TNF-? and CXCL-8.The most significant factor was found to beESR, followed by IL-10, and then TNF-?, with the presence of significant differences, while there was no diagnostic significance for CXCL-8 ,which showed no significant difference (p?0.05).  

scholarly journals Serum levels of Trimethylamine-N-oxide in patients with ischemic stroke

2019 ◽  
Vol 39 (6) ◽  
Author(s):  
Maimaiti Rexidamu ◽  
Hongmei Li ◽  
Haiyan Jin ◽  
Jiankang Huang
Keyword(s):  
Ischemic Stroke ◽  
Operating Characteristic ◽  
Area Under The Curve ◽  
Serum Levels ◽  
Clinical Severity ◽  
Chinese Patients ◽  
Stroke Severity ◽  
Increased Risk ◽  
Median Level ◽  
And Gender

Abstract Objective: Accumulating evidence suggests that Trimethylamine-N-oxide (TMAO), a gut microbial metabolite, is implicated in the pathogenesis of many cardiovascular diseases. The aim of the present study was to investigate the serum levels of TMAO in Chinese patients with ischemic stroke. Method: In the present study, 255 consecutive patients with first-ever acute ischemic stroke and 255 age and gender-matched healthy volunteers were included for testing serum TMAO. Stroke severity was determined by the NIH Stroke Scale (NIHSS). The stroke severity was dichotomized as minor (NIHSS ≤ 5) and moderate-to-high clinical severity (NIHSS > 6). Results: The serum levels of TMAO in stroke ranged from 0.5 to 18.3 μM, with a median value of 5.8 (interquartile range (IQR), 3.3–10.0) μM, which was higher than in those controls (3.9; IQR, 2.6–6.1 μM). The median level of TMAO in those patients was significantly lower than in those moderate-to-high stroke patients (4.1 μM [IQR, 2.8–6.2] vs. 9.1 μM [5.1–11.0]; P<0.001). In univariate and multivariable models, the unadjusted risk of moderate-to-high stroke was increased by 31% (odds ratio (OR) = 1.31 [95% confidence interval (CI): 1.21–1.42], P<0.001) and 22% (OR = 1.22; 95% CI = 1.08–1.32; P<0.001), when TMAO was increased each by 1 μM. Based on the receiver operating characteristic (ROC) curve, the optimal cut-off value of serum level of TMAO as an indicator for screening of moderate-to-high stroke was estimated to be 6.6 μM, which yielded a sensitivity of 69.3 % and a specificity of 79.0%, with the area under the curve at 0.750 (95% CI, 0.687–0.812). Conclusions: Higher TMAO levels were associated with increased risk of first ischemic stroke and worse neurological deficit in Chinese patients.

scholarly journals Lymph node metastasis prediction of papillary thyroid carcinoma based on transfer learning radiomics

2020 ◽  
Vol 11 (1) ◽  
Author(s):  
Jinhua Yu ◽  
Yinhui Deng ◽  
Tongtong Liu ◽  
Jin Zhou ◽  
Xiaohong Jia ◽  
...  
Keyword(s):  
Lymph Node ◽  
Papillary Thyroid Carcinoma ◽  
Lymph Node Metastasis ◽  
Thyroid Carcinoma ◽  
Transfer Learning ◽  
Area Under The Curve ◽  
The Other ◽  
Papillary Thyroid ◽  
Node Metastasis ◽  
Diagnostic Time

Abstract Non-invasive assessment of the risk of lymph node metastasis (LNM) in patients with papillary thyroid carcinoma (PTC) is of great value for the treatment option selection. The purpose of this paper is to develop a transfer learning radiomics (TLR) model for preoperative prediction of LNM in PTC patients in a multicenter, cross-machine, multi-operator scenario. Here we report the TLR model produces a stable LNM prediction. In the experiments of cross-validation and independent testing of the main cohort according to diagnostic time, machine, and operator, the TLR achieves an average area under the curve (AUC) of 0.90. In the other two independent cohorts, TLR also achieves 0.93 AUC, and this performance is statistically better than the other three methods according to Delong test. Decision curve analysis also proves that the TLR model brings more benefit to PTC patients than other methods.

scholarly journals A Nomogram Model Identifies Eosinophilic Frequencies to Powerfully Discriminate Kawasaki Disease From Febrile Infections

2020 ◽  
Vol 8 ◽  
Author(s):  
Xiao-Ping Liu ◽  
Yi-Shuang Huang ◽  
Han-Bing Xia ◽  
Yi Sun ◽  
Xin-Ling Lang ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Kawasaki Disease ◽  
Systemic Vasculitis ◽  
Laboratory Data ◽  
Area Under The Curve ◽  
Validation Group ◽  
Model Group ◽  
Laboratory Findings ◽  
And Gender ◽  
Study Laboratory

Background: Kawasaki disease (KD) is a form of systemic vasculitis that occurs primarily in children under the age of 5 years old. No single laboratory data can currently distinguish KD from other febrile infection diseases. The purpose of this study was to establish a laboratory data model that can differentiate between KD and other febrile diseases caused by an infection in order to prevent coronary artery complications in KD.Methods: This study consisted of a total of 800 children (249 KD and 551 age- and gender-matched non-KD febrile infection illness) as a case-control study. Laboratory findings were analyzed using univariable, multivariable logistic regression, and nomogram models.Results: We selected 562 children at random as the model group and 238 as the validation group. The predictive nomogram included high eosinophil percentage (100 points), high C-reactive protein (93 points), high alanine transaminase (84 points), low albumin (79 points), and high white blood cell (64 points), which generated an area under the curve of 0.873 for the model group and 0.905 for the validation group. Eosinophilia showed the highest OR: 5.015 (95% CI:−3.068–8.197) during multiple logistic regression. The sensitivity and specificity in the validation group were 84.1 and 86%, respectively. The calibration curves of the validation group for the probability of KD showed near an agreement to the actual probability.Conclusion: Eosinophilia is a major factor in this nomogram model and had high precision for predicting KD. This report is the first among the existing literature to demonstrate the important role of eosinophil in KD by nomogram.

Montreal Cognitive Assessment for Screening Mild Cognitive Impairment: Variations in Test Performance and Scores by Education in Singapore

2015 ◽  
Vol 39 (3-4) ◽  
pp. 176-185 ◽  
Author(s):  
Tze Pin Ng ◽  
Lei Feng ◽  
Wee Shiong Lim ◽  
Mei Sian Chong ◽  
Tih Shih Lee ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Test Performance ◽  
Cognitive Assessment ◽  
Characteristic Curve ◽  
Area Under The Curve ◽  
Montreal Cognitive Assessment ◽  
Community Based ◽  
Education Group ◽  
And Gender

Background: The Montreal Cognitive Assessment (MoCA) was developed as a screening instrument for mild cognitive impairment (MCI). We evaluated the MoCA's test performance by educational groups among older Singaporean Chinese adults. Method: The MoCA and Mini-Mental State Examination (MMSE) were evaluated in two independent studies (clinic-based sample and community-based sample) of MCI and normal cognition (NC) controls, using receiver operating characteristic curve analyses: area under the curve (AUC), sensitivity (Sn), and specificity (Sp). Results: The MoCA modestly discriminated MCI from NC in both study samples (AUC = 0.63 and 0.65): Sn = 0.64 and Sp = 0.36 at a cut-off of 28/29 in the clinic-based sample, and Sn = 0.65 and Sp = 0.55 at a cut-off of 22/23 in the community-based sample. The MoCA's test performance was least satisfactory in the highest (>6 years) education group: AUC = 0.50 (p = 0.98), Sn = 0.54, and Sp = 0.51 at a cut-off of 27/28. Overall, the MoCA's test performance was not better than that of the MMSE. In multivariate analyses controlling for age and gender, MCI diagnosis was associated with a <1-point decrement in MoCA score (η2 = 0.010), but lower (1-6 years) and no education was associated with a 3- to 5-point decrement (η2 = 0.115 and η2 = 0.162, respectively). Conclusion: The MoCA's ability to discriminate MCI from NC was modest in this Chinese population, because it was far more sensitive to the effect of education than MCI diagnosis.

scholarly journals Choroidal and Retinal Thickness of Highly Myopic Eyes with Early Stage of Myopic Chorioretinopathy: Tessellation

2018 ◽  
Vol 2018 ◽  
pp. 1-9 ◽  
Author(s):  
Yanping Zhou ◽  
Minlu Song ◽  
Minwen Zhou ◽  
Yiming Liu ◽  
Fenghua Wang ◽  
...  
Keyword(s):  
Cox Regression ◽  
Retinal Thickness ◽  
Early Stage ◽  
Area Under The Curve ◽  
Diagnostic Value ◽  
Enhanced Depth Imaging ◽  
Depth Imaging ◽  
Logistic Regression Models ◽  
Logistics Regression ◽  
And Gender

Purpose. To investigate the choroidal thickness (CT) and retinal thickness (RT) in highly myopic tessellated eyes. Methods. In this study, 115 highly myopic eyes were recruited and divided as tessellated fundus (n=93) and normal fundus (n=22). RT and CT were quantified using optical coherence tomography with enhanced depth imaging (EDI-OCT). Correlation between subfoveal CT (SFCT) and tessellation was analyzed using logistic regression models. Results. Tessellated fundus eyes had thinner CT than did normal fundus eyes, while RT was not statistically different across groups. The tessellated eyes had a thinner choroid than did the control eyes at all measured macular locations (all P<0.05). After adjustment for AL, age, and gender, the SFCT was significantly associated with tessellation. The odds ratio (OR) and 95% confidence interval (CI) was 0.975 (0.960–0.990, P=0.001, binary logistics regression) and 0.991 (0.984–0.999, P=0.022, Cox regression). The area under the curve (AUC) of SFCT was the greatest for detecting tessellation (AUC = 0.824, P<0.001). For sensitivity and specificity analyses, SFCT had the highest diagnostic value (sensitivity = 81.8%, specificity = 74.2%). Conclusions. Highly myopic eyes with tessellation have thinner CT than do normal highly myopic eyes. CT may serve as an early pathologic predictor of high myopia.

Cytomorphometric Neutrophil and Monocyte Markers May Strengthen the Diagnosis of Sepsis

2016 ◽  
Vol 33 (12) ◽  
pp. 656-662
Author(s):  
Joy Mammen ◽  
Jui Choudhuri ◽  
Joshua Paul ◽  
Thomas Isaiah Sudarsan ◽  
T. Josephine ◽  
...  
Keyword(s):  
Critically Ill ◽  
Critically Ill Patients ◽  
Blood Donors ◽  
Area Under The Curve ◽  
Standard Test ◽  
Suspected Sepsis ◽  
Predictive Values ◽  
Reactive Protein ◽  
Sensitivity Specificity

Background: The diagnosis of sepsis is challenging in the absence of a gold standard test. Recent studies have explored the role of neutrophil and monocyte volume, conductivity, and scatter (VCS), derived from automated hematology analyzers, in diagnosing sepsis. We assessed the diagnostic accuracy of VCS parameters in critically ill patients with sepsis. Methodology: In this prospective study, VCS parameters, procalcitonin, and C-reactive protein (CRP) were assessed in patients with proven sepsis (cases) and 2 control groups (intensive care unit [ICU] patients without sepsis and healthy blood donors). The diagnostic property of each test was explored by calculating sensitivity, specificity, negative and positive predictive values, and area under the curve (AUC). Results: The study included 65 patients with sepsis, 58 nonseptic ICU controls, and 98 blood donors. Procalcitonin and CRP were not significantly different ( P > .06) between patients with sepsis and nonseptic patients. Mean (95% confidence interval [CI]) neutrophil volume (MNV) was significantly higher ( P < .001) in patients with sepsis (165.5; 95%CI 161.6-169.4) than in nonseptic (157.3; 95%CI 154.6-160.1) patients and donors (148.9; 95%CI 147.9-150). A similar pattern was seen with mean monocyte volume (MMoV). Neutrophil and monocyte conductivity and scatter parameters were variably associated. The AUC was highest for MMoV (0.74) and lowest for CRP (0.62). Among all parameters, MNV and MMoV had the highest specificity of 85% and 80%, respectively. Conclusion: In critically ill patients with suspected sepsis, VCS parameters may help strengthen the diagnostic probability of sepsis. Future studies may explore the role of serial monitoring of VCS to track response to antimicrobial therapy.

scholarly journals Multisequence Quantitative Magnetic Resonance Neurography of Brachial and Lumbosacral Plexus in Chronic Inflammatory Demyelinating Polyneuropathy

2021 ◽  
Vol 15 ◽  
Author(s):  
Xiaoyun Su ◽  
Xiangquan Kong ◽  
Osamah Alwalid ◽  
Jing Wang ◽  
Huiting Zhang ◽  
...  
Keyword(s):  
Magnetic Resonance ◽  
Negative Correlation ◽  
Diagnostic Performance ◽  
Chronic Inflammatory Demyelinating Polyneuropathy ◽  
Area Under The Curve ◽  
Demyelinating Polyneuropathy ◽  
Magnetic Resonance Neurography ◽  
Inflammatory Demyelinating Polyneuropathy ◽  
Mri Scans ◽  
And Gender

Background and PurposeChronic inflammatory demyelinating polyneuropathy (CIDP) is an uncommon demyelinating disorder. Although treatable, it is difficult to diagnose. The purpose of this study was to evaluate the diagnostic performance and abnormalities of plexus via quantitative multisequence magnetic resonance neurography (MRN) for CIDP.MethodsBrachial and lumbosacral (LS) plexus of 37 CIDP patients and 37 age- and gender-matched controls were examined by using multisequence MRN. Nerve diameter, nerve-to-muscle T2 signal intensity ratio (nT2), contrast-enhanced ratio (CR), fractional anisotropy (FA), and apparent diffusion coefficient (ADC) were determined in both plexus, and tractographies were performed. The disease histories and the Inflammatory Rasch-built Overall Disability Scale (I-RODS) questionnaire scores were documented before MRI scans.ResultsThe sizes of nerve roots were larger in CIDP (p &lt; 0.01). CR, nT2, and ADC were significantly higher, while FA was lower in CIDP than in controls (p &lt; 0.01). FA had the highest sensitivity (0.809) and area under the curve (AUC) (0.925), while the highest specificity was 0.961 for CR in single parameters. The combination of FA and CR has the highest sensitivity, specificity, accuracy, and AUC in the LS plexus. CR only had a weak correlation with nT2 (p &lt; 0.05). ADC and diameter had a positive correlation with nT2, and the diameter and nT2 had a negative correlation with FA in CIDP (p &lt; 0.05). FA had a negative correlation with the duration in the CIDP (r’s = −0.404, p &lt; 0.05). There was no significant correlation between the I-RODS scores and MR multiparameters (p &lt; 0.05).ConclusionMultisequence MRN possesses a high diagnostic performance in the LS plexus. Sampling perfection with application-optimized contrasts using different flip angle evolutions (SPACE) combined with DTI and contrast enhancement serves as a recommended composite protocol for CIDP.

scholarly journals Diagnostic and prognostic significance of dysregulated expression of circular RNAs in osteosarcoma

2020 ◽  
Author(s):  
Chenghao Zhang ◽  
Jieyu He ◽  
Lin Qi ◽  
Zhixi Duan ◽  
Lu Wan ◽  
...  
Keyword(s):  
Meta Analysis ◽  
Prognostic Significance ◽  
Area Under The Curve ◽  
Disease Free Survival ◽  
Diagnostic Odds Ratio ◽  
Cochrane Library ◽  
Clinicopathological Parameters ◽  
Circular Rnas ◽  
Diagnostic Significance ◽  
Enneking Stage

Abstract Background Circular RNAs (circRNAs) have emerged as pivotal regulators in osteosarcoma tumorigenesis and progression, but their prognostic and diagnostic significance remain unclear. Herein, we aimed to perform an updated meta-analysis to explore the clinical, diagnostic and prognostic values of circRNAs in osteosarcoma. Methods Several databases, including PubMed, Web of Science, EMBASE, Scopus and Cochrane Library, were systematically searched up to Mar 10, 2020. Eligible studies regarding the relationship between circRNAs levels and clinicopathological, diagnostic and prognostic values in osteosarcoma patients were included in this study. Pooled odds ratios (ORs) with corresponding 95% confidence intervals (CIs) were used to measure clinical characteristics, while hazard ratios (HRs) with 95% CIs were adopted to assess overall survival (OS) and disease-free survival (DFS). Results Overall, 26 relevant studies involving 1,652 patients with osteosarcoma were enrolled, with eighteen studies on clinicopathological parameters, ten on diagnosis and eighteen on prognosis. For clinical parameters, overexpression of oncogenic circRNAs was intimately correlated with larger tumor size (P <0.00001), advanced Enneking stage (P <0.00001), poor differentiation (P =0.0001), and distant metastasis (DM) (P <0.00001). In contrast, the downregulated circRNAs showed negative correlation with Enneking stage (P=0.002) and DM (P<0.0001). For the diagnostic values, the summary area under the curve (AUC) of circRNA for the discriminative efficacy between osteosarcoma patients and non-cancer counterparts was estimated to be 0.86 (95% CI: 0.83-0.89), with a weighted sensitivity of 0.80 (95% CI: 0.74-0.84), specificity of 0.80 (95%: 0.75-0.84), and diagnostic odds ratio (DOR) of 15.48 (10.85-22.10), respectively. For the prognostic significance, oncogenic circRNAs had poor OS (HR=1.92, 95% CI: 1.68-2.19) and DFS (HR=2.65, 95% CI: 2.02-3.49), while elevated expression of tumor-suppressor circRNAs were closely related to longer OS (HR=0.44, 95% CI: 0.28-0.69). Conclusions Taken together, our study showed that aberrantly expressed circRNA signatures could serve as potential predictive indicators in diagnosis and prognosis in patients with osteosarcoma.

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