scholarly journals Plasma Osteoprotegerin Correlates with Stroke Severity and the Occurrence of Microembolic Signals in Patients with Acute Ischemic Stroke

2019 ◽  
Vol 2019 ◽  
pp. 1-7
Author(s):  
Yanyan Cao ◽  
Congxian Cui ◽  
Hongqin Zhao ◽  
Xudong Pan ◽  
Wenjian Li ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Operating Characteristic ◽  
Characteristic Curve ◽  
National Institutes Of Health ◽  
Atherosclerotic Plaques ◽  
Stroke Severity ◽  
Large Artery ◽  
Unstable Plaque ◽  
Cutoff Value ◽  
Operating Characteristic Curve

Background. Instability of atherosclerotic plaques is associated with the occurrence of stroke. Microembolic signals (MESs) are an indicator of unstable plaque. A relationship between plasma osteoprotegerin (OPG) and ischemic stroke has already been identified. The aim of this study was to investigate whether plasma OPG levels have a relationship with MESs and to evaluate the feasibility of OPG as a biomarker of stroke severity and occurrence of MESs. Methods. Our study consisted of 127 patients with large artery atherosclerosis stroke and 56 controls. Patients were classified into subgroups based on stroke severity and the occurrence of MESs. MES-monitoring was performed for 60 min using transcranial Doppler within 72 h of stroke onset. Stroke severity at admission was assessed by the National Institutes of Health Stroke Scale. Results. Plasma OPG levels were significantly associated with stroke, MESs, and stroke severity at admission (adjusted OR [95% CI]: 1.002 [1.001–1.003] p<0.001; 1.002 [1.001–1.003] p=0.001; 1.001 [1.000–1.002] p=0.028). When plasma OPG levels were used to determine the stroke severity, the area under the receiver-operating characteristic curve (AUC) was 0.734 (95% CI: 0.625-0.843) based on a cutoff value of 1998.44 pg/ml; the sensitivity and specificity of this test were 80.6% and 65.6%, respectively. Furthermore, when the levels of OPG were used to distinguish the presence of MESs, the AUC was 0.766 (95% CI: 0.672-0.860); the cutoff value was 2107.91 pg/ml. The sensitivity of this cutoff value was 68.8% and the specificity was 73.7%. Conclusions. Plasma OPG levels correlate with stroke severity and the occurrence of MESs.

scholarly journals The Optimal Cutoff Value of D-dimer Levels to Predict in Hospital Mortality in Severe Cases of Coronavirus Disease 2019

2021 ◽  
Vol 9 (B) ◽  
pp. 1561-1564
Author(s):  
Ngakan Ketut Wira Suastika ◽  
Ketut Suega
Keyword(s):  
Hospital Mortality ◽  
Receiver Operating Characteristic Curve ◽  
Receiver Operating Characteristic ◽  
Operating Characteristic ◽  
Characteristic Curve ◽  
Area Under The Curve ◽  
Optimal Cutoff ◽  
Cutoff Value ◽  
Operating Characteristic Curve ◽  
D Dimer

Introduction: Coronavirus disease 2019 (Covid-19) can cause coagulation parameters abnormalities such as an increase of D-dimer levels especially in severe cases. The purpose of this study is to determine the differences of D-dimer levels in severe cases of Covid-19 who survived and non-survived and determine the optimal cut-off value of D-dimer levels to predict in-hospital mortality. Method: Data were obtained from confirmed Covid-19 patients who were treated from June to September 2020. The Mann-Whitney U test was used to determine differences of D-dimer levels in surviving and non-surviving patients. The optimal cut-off value and area under the curve (AUC) of the D-dimer level in predicting mortality were obtained by the receiver operating characteristic curve (ROC) method. Results: A total of 80 patients were recruited in this study. Levels of D-dimer were significantly higher in non-surviving patients (median 3.346 mg/ml; minimum – maximum: 0.939 – 50.000 mg/ml) compared to surviving patients (median 1.201 mg/ml; minimum – maximum: 0.302 – 29.425 mg/ml), p = 0.012. D-dimer levels higher than 1.500 mg/ml are the optimal cut-off value for predicting mortality in severe cases of Covid-19 with a sensitivity of 80.0%; specificity of 64.3%; and area under the curve of 0.754 (95% CI 0.586 - 0.921; p = 0.010). Conclusions: D-dimer levels can be used as a predictor of mortality in severe cases of Covid-19.

scholarly journals SAA (Serum Amyloid A)

Stroke ◽  
2020 ◽  
Vol 51 (12) ◽  
pp. 3523-3530
Author(s):  
Juliane Schweizer ◽  
Alejandro Bustamante ◽  
Vanessa Lapierre-Fétaud ◽  
Júlia Faura ◽  
Natalie Scherrer ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Receiver Operating Characteristic Curve ◽  
Odds Ratio ◽  
Adjusted Odds Ratio ◽  
Serum Amyloid A ◽  
Operating Characteristic ◽  
Independent Predictor ◽  
Characteristic Curve ◽  
Amyloid A ◽  
Operating Characteristic Curve

Background and Purpose: The aim of this study was to evaluate and independently validate SAA (serum amyloid A)—a recently discovered blood biomarker—to predict poststroke infections. Methods: The derivation cohort (A) was composed of 283 acute ischemic stroke patients and the independent validation cohort (B), of 367 patients. The primary outcome measure was any stroke-associated infection, defined by the criteria of the US Centers for Disease Control and Prevention, occurring during hospitalization. To determine the association of SAA levels on admission with the development of infections, logistic regression models were calculated. The discriminatory ability of SAA was assessed, by calculating the area under the receiver operating characteristic curve. Results: After adjusting for all predictors that were significantly associated with any infection in the univariate analysis, SAA remained an independent predictor in study A (adjusted odds ratio, 1.44 [95% CI, 1.16–1.79]; P =0.001) and in study B (adjusted odds ratio, 1.52 [1.05–2.22]; P =0.028). Adding SAA to the best regression model without the biomarker, the discriminatory accuracy improved from 0.76 (0.69–0.83) to 0.79 (0.72–0.86; P <0.001; likelihood ratio test) in study A. These results were externally validated in study B with an improvement in the area under the receiver operating characteristic curve, from 0.75 (0.70–0.81) to 0.76 (0.71–0.82; P <0.038). Conclusions: Among patients with ischemic stroke, blood SAA measured on admission is a novel independent predictor of infection after stroke. SAA improved the discrimination between patients who developed an infection compared with those who did not in both derivation and validation cohorts. Registration: URL: https://www.clinicaltrials.gov . Unique identifier: NCT00390962.

scholarly journals A Simple Hospital Mobility Scale for Acute Ischemic Stroke Patients Predicts Long-term Functional Outcome

2019 ◽  
Vol 33 (8) ◽  
pp. 614-622 ◽  
Author(s):  
Iara Maso ◽  
Elen Beatriz Pinto ◽  
Maiana Monteiro ◽  
Marina Makhoul ◽  
Tassiana Mendel ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Functional Outcome ◽  
Characteristic Curve ◽  
Intraclass Correlation ◽  
Prognostic Indicator ◽  
National Institutes Of Health ◽  
Stroke Severity ◽  
Stroke Patients ◽  
Derivation Cohort

Background. Stroke patients present restriction of mobility in the acute phase, and the use of a simple and specific scale can be useful to guide rehabilitation. Objective. To validate and propose a Hospital Mobility Scale (HMS) for ischemic stroke patients as well as to evaluate the HMS as a prognostic indicator. Methods. This study was performed in 2 phases: in the first, we developed the HMS content, and in the second, we defined its score and evaluated its psychometric properties. We performed a longitudinal prospective study consisting of 2 cohorts (derivation and validation cohorts). The data were collected in a stroke unit, and the following scales were applied during hospitalization: National Institutes of Health Stroke Scale to quantify stroke severity and the HMS to verify the degree of mobility. The primary outcome was the proportion of unfavorable functional outcomes, defined as a modified Barthel Index of <95. Results. We defined 3 tasks for HMS: sitting, standing, and gait. In the derivation cohort, the HMS presented an accuracy of 84.5% measured using the area under the receiver operating characteristic curve (95% CI = 78.3-90.7; P < .001), whereas in the validation cohort the accuracy was 87.8% (95% CI = 81.9%-93.7%; P < .001). The HMS presented a large standardized effect size (1.41) and excellent interexaminer agreement (intraclass correlation coefficient = 0.962; 95% CI = 0.917-0.983; P < .001). Conclusion. The HMS was able to predict accurately the functional outcome of poststroke patients, presented excellent interexaminer agreement, and was sensitive in detecting changes.

S-100β in predicting the need of hyperbaric oxygen in CO-induced delayed neurological sequels

2019 ◽  
Vol 39 (5) ◽  
pp. 614-623
Author(s):  
Amal SAF Hafez ◽  
Ghada N El-Sarnagawy
Keyword(s):  
Carbon Monoxide ◽  
Hyperbaric Oxygen ◽  
Operating Characteristic ◽  
Characteristic Curve ◽  
Area Under The Curve ◽  
Curve Analysis ◽  
Co Poisoning ◽  
Cutoff Value ◽  
The Mean ◽  
Operating Characteristic Curve

Background: Delayed neurological sequels (DNS) have been described after carbon monoxide (CO) poisoning. There is a need to find a new prognostic marker to guide the use of hyperbaric oxygen (HBO) therapy. Aim: To evaluate serum S-100β level in patients presenting with acute CO poisoning as an indicator of poisoning severity and predictor of DNS occurrence and HBO need in those patients. Methods: This prospective cohort study included patients with acute CO poisoning. On admission, carboxyhemoglobin (COHb) and S-100β levels were measured. Patients were followed up for 6 months for signs of DNS. Results: Out of 50 patients, 6 only developed DNS. The mean of S-100β levels was significantly higher in patients with severe poisoning and those with DNS. Receiver operating characteristic curve analysis revealed that S-100β had an area under the curve 0. 871; at a cutoff value ≥ 0.67 µg/L, its sensitivity and specificity were 100% and 77.3%, respectively. The sensitivity of S-100β was significantly higher than that of COHb, while its specificity and overall accuracy were significantly higher than those of HBO criteria. Conclusion: Serum S-100β level on admission could be a marker of poisoning severity and a predictor of CO-induced DNS development that guides the use of HBO therapy.

scholarly journals Relationship between the Severity of Coronary Artery Disease and Catheter-Associated Urethral Stricture in Patients with Acute Coronary Syndrome

2020 ◽  
Author(s):  
Ibrahim Yildiz ◽  
Fatih Gokalp ◽  
Cengiz Burak ◽  
Sinan Karazindiyanoglu ◽  
Pinar Ozmen Yildiz ◽  
...  
Keyword(s):  
Urethral Stricture ◽  
Operating Characteristic ◽  
Characteristic Curve ◽  
Curve Analysis ◽  
Syntax Score ◽  
Urethral Catheterization ◽  
Cutoff Value ◽  
Coronary Syndrome ◽  
Operating Characteristic Curve ◽  
Artery Disease

Background: Different arterial segments throughout the vascular system develop similar grades of atherosclerosis concomitantly. Urethral ischemia has been proposed as a cause of urethral stricture. Therefore, we aimed to investigate the relationship between coronary artery disease severity using a SYNTAX score and urethral stricture occurrence after urethral catheterization in patients with non–ST-segment-elevation acute coronary syndrome (ACS). Methods: This retrospective study consisted of 306 men with urethral catheters that were diagnosed with ACS and underwent coronary angiography between January 2016 and January 2018 in Kars Kafkas University and Osmaniye Government Hospital, Turkey. Hospital records were reviewed to collect the follow-up data of the patients regarding the occurrence of urethral stricture after urethral catheterization. The study population was divided into 2 groups according to urethral stricture development, and both groups were compared statistically. Results: SYNTAX scores were significantly higher in patients with urethral stricture than in those without urethral stricture (14.86±7.11 vs. 29.25±9.79; P<0.001). The SYNTAX score (OR=1.27; 95% CI: 1.16–1.39; P<0.001), diabetes, and serum albumin were found to be the independent predictors of urethral stricture. The receiver operating characteristic curve analysis showed that the cutoff value of the SYNTAX score for urethral stricture prediction was greater than 22.5, with 76.7% sensitivity and 85.1% specificity (AUC=0.88, 95% CI: 0.84–0.91; P<0.001). Results: SYNTAX scores were significantly higher in patients with urethral stricture than in those without urethral stricture (14.86±7.11 vs. 29.25±9.79; P<0.001). The SYNTAX score (OR=1.27; 95% CI: 1.16–1.39; P<0.001), diabetes, and serum albumin were found to be the independent predictors of urethral stricture. The receiver operating characteristic curve analysis showed that the cutoff value of the SYNTAX score for urethral stricture prediction was greater than 22.5, with 76.7% sensitivity and 85.1% specificity (AUC=0.88, 95% CI: 0.84–0.91; P<0.001).

Diagnostic usefulness of differential time to positivity in neutropenic cancer patients with suspected catheter-related candidemia

2019 ◽  
Vol 58 (1) ◽  
pp. 137-140
Author(s):  
Kyeong Min Jo ◽  
Sungim Choi ◽  
Kyung Hwa Jung ◽  
Jung Wan Park ◽  
Ji Hyun Yun ◽  
...  
Keyword(s):  
Confidence Interval ◽  
Cancer Patients ◽  
Diagnostic Performance ◽  
Operating Characteristic ◽  
Characteristic Curve ◽  
Optimal Cutoff ◽  
Cutoff Value ◽  
Time To Positivity ◽  
Diagnostic Usefulness ◽  
Operating Characteristic Curve

Abstract Methods for distinguishing catheter-related candidemia (CRC) from non-CRC before catheter removal remain limited. We thus evaluated the diagnostic performance of differential time to positivity (DTP) to diagnose CRC in neutropenic cancer patients with suspected CRC. Of the 35 patients enrolled, 15 (43%) with CRC (six definite and nine probable) and 17 (49%) with non-CRC were finally analyzed. Based on the receiver operating characteristic curve, the optimal cutoff value of DTP for diagnosing CRC was ≥1.45 hours with the sensitivity 80% (95% confidence interval [CI], 51–95) and specificity 100% (95% CI, 80–100), respectively.

scholarly journals Adiposity indicators lipid accumulation product and triglyceride-glucose index as alternate criteria for the diagnosis of metabolic obesity in adult

2018 ◽  
Vol 11 (2) ◽  
pp. 118
Author(s):  
Mariya Tabassum ◽  
Md. Matiur Rahman ◽  
Miliva Mozaffor
Keyword(s):  
Positive Predictive Value ◽  
Receiver Operating Characteristic Curve ◽  
Lipid Accumulation ◽  
Predictive Value ◽  
Operating Characteristic ◽  
Characteristic Curve ◽  
Lipid Accumulation Product ◽  
Cutoff Value ◽  
Triglyceride Glucose Index ◽  
Operating Characteristic Curve

<p class="Abstract">Metabolic obesity refers to the state of having metabolic syndrome irrespective of one’s body mass index. This study was aimed to elucidate the lipid accumulation product and triglyceride-glucose index as simple and alternate criteria for detecting metabolic obesity in adult. The study was conducted in 200 adult (age range: 19-45 years). According to lipid accumulation product and triglyceride-glucose index, the prevalence of metabolic obesity was 54.0% and 53.5% respectively. With a cutoff value of 45.5, the lipid accumulation product was found good to evaluate the metabolic obesity having area under receiver operating characteristic curve 0.9 (p=0.000), with sensitivity 90.9%, specificity 75.0%, positive predictive value 74.1%, and negative predictive value 91.3%. With a cutoff value of 8.7, the triglyceride-glucose index was found good to evaluate the metabolic obesity having area under receiver operating characteristic curve 0.9 (p=0.000), with sensitivity 95.5%, specificity 79.5%, positive predictive value 78.5%, and negative predictive value 95.7%. In conclusion, lipid accumulation product and triglyceride-glucose index are good as alternate criteria for diagnosing the metabolic obesity in adults.</p>

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