Clinical utility of chromogranin A for the surveillance of succinate dehydrogenase B- and succinate dehydrogenase D-related paraganglioma

Background Patients with mutations of succinate dehydrogenase B (SDHB) and succinate dehydrogenase D (SDHD) are at high risk of paraganglioma necessitating surveillance. Chromogranin A has been proposed as a biochemical marker of paraganglioma. We sought to determine the diagnostic utility of chromogranin A in a population-based SDHx sample. Methods Tasmania is an island state with one tertiary referral centre for endocrine neoplasia. We performed a cross-sectional analysis of all adult SDHB ( n = 52) and SDHD ( n = 10) patients undergoing paraganglioma surveillance between 2011 and 2017. Chromogranin A was referenced against the outcome of paraganglioma surveillance with a minimum of 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) and plasma metanephrines (metanephrine and normetanephrine). Results Chromogranin A correctly predicted the result of paraganglioma surveillance more often in patients with SDHB compared with those with SDHD (77% vs. 22%, P = 0.003). In the SDHB group, chromogranin A demonstrated a sensitivity of 67% and specificity of 79% compared with 22% and 0% in the SDHD group. Chromogranin A identified one of three PET/CT-visualized SDHB-related paragangliomas with normal plasma metanephrines at the expense of nine false-positive results. A normal chromogranin A demonstrated a negative predictive value of 92% for SDHB-related paraganglioma. In patients with SDHB, plasma normetanephrine and metanephrine offered superior specificity (100%, P = 0.01 and 100%, P < 0.01, respectively) with comparable sensitivity (67%, P = 1.0 and 11%, P = 0.06, respectively) to chromogranin A. Conclusion Chromogranin A does not provide additive benefit to standard surveillance for predicting the presence of SDHB- or SDHD-related paraganglioma, but has a useful negative predictive value when normal in patients with SDHB mutation.

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Negative Predictive Value of Surveillance PET/CT in Head and Neck Squamous Cell Cancer

American Journal of Neuroradiology ◽

10.3174/ajnr.a3494 ◽

2013 ◽

Vol 34 (8) ◽

pp. 1632-1636 ◽

Cited By ~ 38

Author(s):

M. McDermott ◽

M. Hughes ◽

T. Rath ◽

J.T. Johnson ◽

D.E. Heron ◽

...

Keyword(s):

Head And Neck ◽

Negative Predictive Value ◽

Squamous Cell ◽

Predictive Value ◽

Squamous Cell Cancer ◽

Cell Cancer ◽

Pet Ct ◽

Neck Squamous Cell Cancer

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Impact of rural versus urban setting on kidney markers: a cross-sectional study in South-Kivu, DRCongo

BMC Nephrology ◽

10.1186/s12882-021-02431-w ◽

2021 ◽

Vol 22 (1) ◽

Author(s):

Mannix Imani Masimango ◽

Michel P. Hermans ◽

Espoir Bwenge Malembaka ◽

Pierre Wallemacq ◽

Ernest Kiswaya Sumaili ◽

...

Keyword(s):

Positive Predictive Value ◽

Negative Predictive Value ◽

Predictive Value ◽

Democratic Republic Of Congo ◽

Urban Setting ◽

Sub Saharan Africa ◽

Rural Site ◽

Urban Site ◽

Cross Sectional ◽

South Kivu

Abstract Background Most studies of chronic kidney disease (CKD) in Sub-Saharan Africa (SSA) have been conducted in urban settings. They relied on GFR estimated from serum creatinine alone and on the inexpensive, convenient urinary dipstick to assess proteinuria. The dipstick for proteinuria has not been directly compared with the gold standard albumin-to-creatinine ratio (ACR) in a large-sized study in SSA. We hereby assessed the influence of rural versus urban location on the level, interpretation, and diagnostic performance of proteinuria dipstick versus ACR. Methods In a cross-sectional population-based study of CKD in both urban (n = 587) and rural (n = 730) settings in South-Kivu, Democratic Republic of Congo (DRC), we assessed the prevalence, performance (sensitivity, specificity, positive predictive value and negative predictive value) and determinants of a positive dipstick proteinuria as compared with albuminuria (ACR). Albuminuria was subdivided into: A1 (< 30 mg/g creatinine), A2 (30 to 299 mg/g creatinine) and A3 (≥ 300 mg/g creatinine). Results The overall prevalence of positive dipstick proteinuria (≥ 1+) was 9.6 % (95 % CI, 7.9–11.3) and was higher in rural than in urban residents (13.1 % vs. 4.8 %, p < 0.001), whereas the prevalence of albuminuria (A2 or A3) was similar in both sites (6 % rural vs. 7.6 % urban, p = 0.31). In both sites, dipstick proteinuria ≥ 1 + had a poor sensitivity (< 50 %) and positive predictive value (< 11 %) for the detection of A2 or A3. The negative predictive value was 95 %. Diabetes [aOR 6.12 (1.52–24.53)] was a significant predictor of A3 whereas alkaline [aOR 7.45 (3.28–16.93)] and diluted urine [aOR 2.19 (1.35–3.57)] were the main predictors of positive dipstick proteinuria. Conclusions ACR and dipstick proteinuria have similar positivity rates in the urban site whereas, in the rural site, dipstick was 2-fold more often positive than ACR. The poor sensitivity and positive predictive value of the dipstick as compared with ACR makes it unattractive as a screening tool in community studies of CKD in SSA.

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Predicting the risk of respiratory distress in newborns with congenital pulmonary malformations

European Respiratory Journal ◽

10.1183/13993003.00949-2021 ◽

2021 ◽

pp. 2100949

Author(s):

Christophe Delacourt ◽

Nathalie Bertille ◽

Laurent J. Salomon ◽

Makan Rashenas ◽

Alexandra Benachi ◽

...

Keyword(s):

Respiratory Distress ◽

Negative Predictive Value ◽

Predictive Value ◽

Volume Ratio ◽

Predictive Ability ◽

Population Based ◽

Term Infants ◽

Predictive Variable ◽

Study Results ◽

Roc Area

ObjectivesMost children with prenatally diagnosed congenital pulmonary malformations (CPM) are asymptomatic at birth. We aimed to develop a parsimonious prognostic model for predicting the risk of neonatal respiratory distress (NRD) in preterm and term infants with CPM, based on the prenatal attributes of the malformation.MethodsMALFPULM is a prospective population-based nationally representative cohort including 436 pregnant women. The main predictive variable was the CPM volume ratio (CVR) measured at diagnosis (CVR first) and the highest CVR measured (CVR max). Separate models were estimated for preterm and term infants and were validated by bootstrapping.ResultsIn total, 67 of the 383 neonates studied (17%) had NRD. For infants born at term (>37 weeks, N=351), the most parsimonious model included CVR max as the only predictive variable (ROC area: 0.70±0.04, negative predictive value: 0.91). The probability of NRD increased linearly with increasing CVR max and remained below 10% for CVR max<0.4. In preterm infants (N=32), both CVR max and gestational age were important predictors of the risk of NRD (ROC area: 0.85±0.07). Models based on CVR first had a similar predictive ability.ConclusionsPredictive models based exclusively on CVR measurements had a high negative predictive value in infants born at term. Our study results could contribute to the individualised general risk assessment to guide decisions about the need for newborns with prenatally diagnosed CPM to be delivered at specialised centers.

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Evaluating Specivity, Sensitivity, Positive and Negative Predictive Values of CA125 for Diagnosing Ovarian Cancer

Journal of Arak University of Medical Sciences ◽

10.32598/jams.24.2.6002.1 ◽

2021 ◽

Vol 24 (2) ◽

pp. 196-203

Author(s):

Elahe Fini ◽

◽

Neda Nasirian ◽

Bahram Hosein Beigy ◽

◽

...

Keyword(s):

Ovarian Cancer ◽

Positive Predictive Value ◽

Tumor Marker ◽

Negative Predictive Value ◽

Predictive Value ◽

Screening Test ◽

High Sensitivity ◽

Medical Community ◽

Cross Sectional ◽

Predictive Values

Background and Aim: Ovarian cancer is among the most common cancers in women worldwide. CA125 is the most frequent biomarker used in the screening for ovarian cancer. CA125 has no high sensitivity and specificity as a screening test in the medical community; however, because of being simple and noninvasive, it is almost always requested for evaluation and ruling out cancer. It plays an important role in the treatment and post-treatment process, the prediction of prognosis, and the relapse of the disease. The present study aimed to determine the relationship between a high level of CA125 tumor marker and ovarian cancer by detecting spesivity, sensivity, positive and negative predictive values. Methods & Materials: In this cross-sectional study, all cases undergoing CA125 test in Velayat Hospital in 2017-1028 were evaluated for having ovarian cancer. In addition, the CA125 level was compared between healthy individuals and patients with ovarian cancer. Finally, the obtained data were analyzed using SPSS. Ethical Considerations: The present study was approved by the Qazvin University of Medical Sciences (Ethics Code: IR.QUMS.REC.1396.316). Results: In this study, 35.3% of the study participants received a definite diagnosis of ovarian cancer. Generally, CA125 values were negative in 41.8% and positive in.58.2% of the study subjects. The sensitivity of the test was measured as 80.1%, the specivity as 53.6%, the positive predictive value equaled 48.4%, and the negative predictive value was measured as 83%. There was a significant relationship between age and the presence of ovarian cancer, and serum CA125 levels. Conclusion: The present study suggested that age and the serum level of CA125 were statistically significant. Finally, CA125 levels were significantly related to ovarian cancer. It provided moderate specivity and specivity as well as low positive predictive value and high negative predictive value as a tumor marker; it is valuable for ruling out of tumor but not appropriate as a screening test.

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A study of quantitative and qualitative analysis of standardized speech samples in persons suffering from dysarthria due to various neurological disorder

International Journal of Advances in Medicine ◽

10.18203/2349-3933.ijam20204065 ◽

2020 ◽

Vol 7 (10) ◽

pp. 1527

Author(s):

Somesh Maheshwari

Keyword(s):

Positive Predictive Value ◽

Negative Predictive Value ◽

Predictive Value ◽

Normal Population ◽

Software Tool ◽

Cross Sectional ◽

Medical College ◽

Subject Variability ◽

Ataxic Dysarthria ◽

The Central Nervous System

Background: Dysarthria is manifested as a disorder of movement, it is important to recognize that sensori-motor integration (with tactile, proprioceptive, and auditory feed-back representing the crucial sensory components) is essential to speech motor control, from this standpoint, most or all dysarthria localized to the central nervous system should be thought of as sensori-motor rather than simply motor disturbances.Methods: This non-interventional, cross-sectional comparative, observational study, conducted in 100 study subjects (50 cases and 50 controls) from March 2016 to February 2017 at MGM medical college and MY hospital Indore, MP, India.Results: The mean age of normal population was 53 years and that of dysarthric population was 55 years. Among the dysarthric group, there were 10 cases of ataxic dysarthria, 23 cases of spastic dysarthria, and 9 cases of hypo kinetic dysarthria. There were 20 cases of mild dysarthria 19 cases of moderate dysarthria and 10 cases of severe dysarthria. In ataxic dysarthria, pitch break was found in 6 out of 10 subjects. It was found that there is negative predictive value 93.33%, and positive predictive value, 77.14% in spastic dysarthria and negative predictive value, 83.33% and positive predictive value, 90.90% in ataxic, whereas negative predictive value, 85.71% and positive predictive value, 95.34% in hypo kinetic dysarthria. Conclusions: Different types of dysarthria when analyzed with software tool after extracting pitch and formants showed specific patterns. These patterns correlated with the clinical diagnosis. And Pattern recognition of different dysarthria will help to identify the types of dysarthria in scientific way and prevent inter-subject variability.

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Role of Covid Antigen in the Diagnosis of Covid Positive in Obstetric Patients

10.53350/pjmhs2115103356 ◽

2021 ◽

Vol 15 (10) ◽

pp. 3356-3358

Author(s):

Ambreen Fatima ◽

Nidda Yaseen ◽

Amna Fareed ◽

Kashif Ali Samin ◽

Shumaela Kanwal ◽

...

Keyword(s):

Nucleic Acid ◽

Early Detection ◽

Negative Predictive Value ◽

Predictive Value ◽

False Negative ◽

Nucleic Acid Amplification ◽

Antigen Test ◽

Rt Pcr ◽

Cross Sectional ◽

Specificity And Sensitivity

Background and Aim: The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) rapid emergence postured significant challenges on the health system in recent years. The early detection of cases is thought to be critical in preventing this pandemic by coronavirus disease (COVID-19), especially important in the obstetrical population due to theirs numerous interactions with another parturient when hospitalized for delivery. Therefore, the present study aimed to assess the COVID antigen test performance in COVID-positive obstetrics patients. Materials and Methods: This cross-sectional study was conducted on 1296 Covid-19 asymptomatic women admitted to the Obstetrics and Gynaecology Department of Muhammad Teaching Hospital & Medical College, Peshawar and Fauji Foundation Hospital, Rawalpindi for the duration of six months from February 2021 to July 2021. Antigen-based test rapid diagnostic test (RDT) was used for screening out COVID-19 positive obstetrics patients or women through nasopharyngeal swabs. Women with negative rapid antigen test results were confirmed with RT-polymers chain reaction test of nucleic acid amplification tests (NAAT). Ethical approval and informed consent were taken from the hospital ethical committee and each individual respectively. All the known positive COVID-19 patients during admission were excluded. SPSS version 24 was used for data analysis. Results: The overall prevalence of rapid antigen-positive tested patients was 13.2% (171/1296). The prevalence of positive tested women through rapid antigen test, Nucleic Acid Amplification Test (NAAT), and RT-PCR were 27 (2.1%), 51 (3.9%), and 93 (7.2%) respectively. Of the total 1296 rapid antigen tests, 27 were positive, and the false-negative confirmed positive by NAAT was 144.Thus the sensitivity of the rapid antigen test was 15.8% and the negative predictive value was 93.7%. Of the total 298 Nucleic Acid Amplification Tested had sensitivity and negative predictive value of 89.6% and 99.06% respectively. RT-PCR was carried out on 972 patients, positive diagnosed cases were 36 while 15 were initially negative and were positive with the test was repeated. The sensitivity and negative predictive value was 71.45% and 95.8% respectively. Conclusion: Our study found that Ag-RDT plays a significant role in SARS-CoV-2 early detection in infected individuals, with high specificity and sensitivity to disease infectious stage, whether symptomatic or asymptomatic, and can be used as a decision supported tool. Early detection of COVID-19 status in women admitted for delivery could benefit neonatal protection care. Keywords: Covid-19; Rapid antigen test; RT-PCR test

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Comparison between qualitative and quantitative measurement of strength deficit in shoulder flexors of young females: a cross- sectional study

Journal of the Pakistan Medical Association ◽

10.47391/jpma.011431 ◽

2021 ◽

Vol 71 (11) ◽

pp. 2559-2562

Author(s):

Saadia Perwaiz ◽

Muhammad Waqar Afzal ◽

Ghulam Fatima

Keyword(s):

Positive Predictive Value ◽

Negative Predictive Value ◽

Predictive Value ◽

Sampling Technique ◽

Cross Sectional Study ◽

Manual Muscle Testing ◽

Primary Analysis ◽

Cross Sectional ◽

Young Females ◽

Muscle Testing

Objective: To compare accuracy of manual muscle testing in detection of strength differences across grade 4 and 5 at different percentage deficits of dynamometric mean in shoulder flexors of young females. Methods: Cross sectional research design, conducting primary analysis of strength of shoulder flexors measured through manual muscle testing and hand-held dynamometer. Three hundred young healthy females without any ailment of upper extremity or generalized health problem were selected from University of South Asia and Association of Fatima Jinnah Old Graduates, Lahore. Non-probability convenient sampling technique was used. The age group selected was 18-39 years. The strength of shoulder flexors measured through manual muscle testing and hand-held dynamometer was main outcome measure. Results: The overall diagnostic accuracy of manual muscle testing showed better results at 10% dynamometric measures. It was 63.33%(95% CI: 57.74%, 68.59%) in non-dominant shoulder flexors and 61.67% (95% CI: 56.05%, 66.99%) in dominant shoulder flexors. The positive predictive value (PPV) and specificity of manual muscle testing was better at 10% strength deficit in comparison with dynamometric measures, whereas negative predictive value (NPV) and sensitivity was better at 20% strength deficit. Contrasting association was found between positive predictive value (PPV) and sensitivity, negative predictive value and specificity. Conclusion: The subjective area of grade 4 and 5 showed better, although not ideal, diagnostic worth at 10% deficit of dynamometric measures in shoulder flexors. Further exploration through study of contrasting trends between PPV and sensitivity by subgroup analysis is required. Continuous...

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Diagnostic Value of WB-DWI Versus 18 F-FDG PET/CT for the Detection of Multiple Myeloma

10.21203/rs.3.rs-20429/v1 ◽

2020 ◽

Author(s):

Bei Zhang ◽

Li Zhang ◽

Bingyang Bian ◽

Fang Lin ◽

Zining Zhu ◽

...

Keyword(s):

Multiple Myeloma ◽

Positive Predictive Value ◽

Negative Predictive Value ◽

Predictive Value ◽

False Positive ◽

Fdg Pet ◽

Pet Ct ◽

Adc Values ◽

Sensitivity Specificity ◽

Fdg Pet Ct

Abstract BACKGROUND Whole body diffusion weighted imaging (WB-DWI) is commonly used for the detection of multiple myeloma (MM). Comparative data on the efficiency of WB-DWI compared with 18 F positron emission tomography computed tomography ( 18 F-FDG PET/CT) to detect MM are lacking. METHODS This was a retrospective, single-center study of twenty-two patients with MM enrolled from January 2019 to December 2019. All patients underwent WB-DWI and 18 F-FDG PET/CT. Pathological and clinical manifestations as well as radiologic follow-up were used for diagnosis. The overall accuracy, sensitivity, specificity, positive predictive value and negative predictive value of both methods were compared. The appearance diffusion coefficient (ADC) values of MM lesions and false-positive lesions were estimated. RESULTS A total of 214 MM bone lesions were evaluated. WB-DWI showed a higher overall accuracy than PET/CT (75.7% and 55.6%, respectively; < 0.05). However, for sensitivity, specificity, positive predictive value and negative predictive value, there were no significant differences for WB-DWI vs PET/CT (99.3% and 83.9%, 64.9% and 94.8%, 63.6% and 54.2%, 98.1% and 65.3%, respectively). The ADC value for MM lesions was significantly lower than that for false-positive lesions (p < 0.001). Receiver operating curve (ROC) curve analysis showed that the AUC was 0.846, and when the cut-off value was 0.745×10 -3 mm 2 /s, the sensitivity and specificity were 86.0% and 82.4%, respectively, which distinguished MM lesions from non-MM lesions. CONCLUSION WB-DWI may be a useful tool for the diagnosis of MM bone disease due to to higher overall accuracy and measurements of ADC values compared with PET/CT.

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A Cross-Sectional Study of Seroprevalence of Strongyloidiasis in Pregnant Women (Peruvian Amazon Basin)

Pathogens ◽

10.3390/pathogens9050348 ◽

2020 ◽

Vol 9 (5) ◽

pp. 348

Author(s):

Sonia Ortiz-Martínez ◽

José-Manuel Ramos-Rincón ◽

María-Esteyner Vásquez-Chasnamote ◽

Jhonatan Alarcón-Baldeón ◽

Jorge Parraguez-de-la-Cruz ◽

...

Keyword(s):

Pregnant Women ◽

Negative Predictive Value ◽

Predictive Value ◽

Amazon Basin ◽

Cross Sectional Study ◽

Index Test ◽

Peruvian Amazon ◽

Sectional Study ◽

Cross Sectional ◽

Baermann Technique

Strongyloidiasis is a soil-transmitted helminthiasis with a high global prevalence. Objectives: We aimed to evaluate the prevalence of Strongyloides stercoralis infection and assess strongyloidiasis serology as a screening technique in the Peruvian Amazon. Material and Methods: We performed a cross-sectional study of strongyloidiasis in 300 pregnant women in Iquitos (Peru) from 1 May 2019 to 15 June 2019. Women were tested using serology (Strongyloides IgG IVD-ELISA kit) as an index test and the modified Baermann technique and/or charcoal fecal culture as the parasitological reference standard. Results: The reference tests showed S. stercoralis in the stool of 30 women (prevalence: 10%; 95% confidence interval [CI] 7.1% to 13.9%), while 101 women tested positive on the blood test (prevalence: 33.7%; 95% CI 28.6% to 39.4%). Fourteen of the 15 women (93.3%) with positive results according to the modified Baermann technique, and 14 of the 23 women (56.5%) with positive charcoal cultures also had positive serological results. Serology showed a sensitivity of 63.3% and a negative predictive value of 94.4%. Conclusion: In Iquitos, pregnant women have a high prevalence of S stercoralis. S. stercoralis ELISA could be an excellent tool for population-based screening, as it has a high negative predictive value that can help to rule out the presence of active infection.

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