Nasal Eosinophilia as a Marker for Allergic Rhinitis: A Controlled study of 50 Patients

Eosinophils are the principal effector cells involved in the pathogenesis of allergic inflammation. We conducted a study to investigate the validity of the nasal smear examination for detecting eosinophilia in patients with allergic rhinitis. Our study group was made up of 50 patients with allergic rhinitis and 50 age- and sex-matched controls without allergic rhinitis. Smears were obtained from nasal secretions in both groups and then fixed, stained, and studied under light microscopy. Statistical analysis revealed that the odds ratio for eosinophilia positivity in nasal smears in the rhinitis group was 25.61 with a 95% confidence interval of 8 to 78. The sensitivity, specificity, positive predictive value, and negative predictive value of this test were 74, 90, 88, and 77%, respectively. We conclude that the nasal eosinophilia test is highly specific and moderately sensitive in diagnosing allergic rhinitis, and that it therefore can be used as an easy, noninvasive, and inexpensive procedure for screening patients and for conducting epidemiologic studies of this disorder.

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Prognostic Significance of Low Serum Cholesterol after Cardiothoracic Surgery

Clinical Chemistry ◽

10.1093/clinchem/46.8.1114 ◽

2000 ◽

Vol 46 (8) ◽

pp. 1114-1120 ◽

Cited By ~ 12

Author(s):

Axel Stachon ◽

Andreas Böning ◽

Heike Weisser ◽

Axel Laczkovics ◽

Guido Skipka ◽

...

Keyword(s):

Predictive Value ◽

Odds Ratio ◽

Prognostic Significance ◽

Cardiothoracic Surgery ◽

Cholesterol Concentration ◽

Retrospective Case ◽

Machine Age ◽

The Mean ◽

Sensitivity Specificity ◽

Low Cholesterol

Abstract Background: The precise prognostic significance of critically low cholesterol concentrations in patients undergoing cardiothoracic surgery is unknown. Methods: In a retrospective case-control study, we analyzed the database of 2074 patients, of whom 87 died postoperatively in hospital. All patients underwent cardiothoracic surgery using a heart-lung machine. Age, sex, body mass index, preoperative ejection fraction, smoking, diabetes mellitus, type of operation, emergency surgery, renal deficiency, pulmonary hypertension, and endocarditis were considered together with serum concentrations of cholesterol, C-reactive protein, alanine aminotransferase, and triglycerides. The statistics included sensitivity, specificity, predictive value, odds ratio, and the ROC curve. Results: Cholesterol decreased sharply immediately after surgery in both the deceased and the survivors. In the deceased, the mean cholesterol concentration (± SE) remained rather low between days 4 and 7 after surgery [2.46 ± 0.16 mmol/L (95 ± 6 mg/dL)]. In the survivors at that time, the mean cholesterol concentration was significantly (P <0.001) higher [4.37 ± 0.03 mmol/L (169 ± 1 mg/dL)]. The positive predictive value of a critically low cholesterol concentration [<3.10 mmol/L (<120 mg/dL)] was 25.4%, increasing to 66.6% at a cutoff value of 1.55 mmol/L (60 mg/dL). The odds ratio under those circumstances was 15.5, and the area under curve (C-statistic) was 0.90. Conclusions: The cholesterol concentration between days 4 and 7 after cardiothoracic surgery possesses a high prognostic significance in terms of in-hospital mortality.

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T2 Hypointensity Aids in the Diagnosis of Intracranial Metastatic Adenocarcinoma

Canadian Journal of Neurological Sciences / Journal Canadien des Sciences Neurologiques ◽

10.1017/cjn.2019.338 ◽

2019 ◽

Vol 47 (2) ◽

pp. 210-213 ◽

Cited By ~ 1

Author(s):

Khunsa Faiz ◽

Alex Botsford ◽

Namita Sinha ◽

Simon Walling ◽

Jai Jai Shiva Shankar

Keyword(s):

Predictive Value ◽

Odds Ratio ◽

High Specificity ◽

Qualitative Assessment ◽

Resonance Imaging ◽

Metastatic Brain Tumors ◽

Intracranial Metastasis ◽

Normal Appearing White Matter ◽

Magnetic Resonance Imaging Mri ◽

Sensitivity Specificity

ABSTRACT:Background:The T2 hypointensity has been suggested to be associated with intracranial metastatic adenocarcinomas (IMA). The purpose of our study was to determine the association of T2 hypointensity with IMA.Methods:All patients with pathologically confirmed metastatic brain tumors who had a magnetic resonance imaging (MRI) at our institution in the last 10 years were retrospectively assessed. Qualitative assessment of the lesions on MRI was done by two separate readers who were blinded to the pathological diagnosis. For qualitative assessment, the T2 hypointensity in the lesion was compared with the contralateral normal appearing white matter. Odds ratio, sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were calculated.Results:Of 107 patients with intracranial metastasis, only 73 (40 females; 33 males; mean age 61 years) had MRI available for review. Of these, only 46 (25 females; 21 males; mean age 61 years) had pathologically proven IMA. T2 hypointensity was seen in 20% of IMA. The odds ratio of T2 hypointensity in IMA was 3 compared to nonadenocarcinomas but was not statistically significant (p = 0.16). Intralesional hemorrhage was seen in 20. When controlled for hemorrhage, the odds ratio for T2 hypointensity in IMA was 4.7. The specificity, sensitivity, PPV, and NPV for T2 hypointensity to diagnose IMA were 92%, 19%, 81%, and 40%, respectively.Conclusion:T2 hypointensity was seen only in 20% of IMA with an odds ratio of 4.7. T2 hypointensity showed a high specificity and PPV for diagnosis of IMA.

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Nasal hyperreactivity and inflammation in allergic rhinitis

Mediators of Inflammation ◽

10.1155/s0962935196000142 ◽

1996 ◽

Vol 5 (2) ◽

pp. 79-94 ◽

Cited By ~ 6

Author(s):

I. M. Garrelds ◽

C. de Graaf-in't Veld ◽

R. Gerth van Wijk ◽

F. J. Zijlstra

Keyword(s):

Allergic Rhinitis ◽

Clinical Manifestations ◽

Allergic Inflammation ◽

Inflammatory Cells ◽

Hay Fever ◽

Effector Cells ◽

Plasma Exudation ◽

History Of ◽

Definition Of ◽

Antigen Presenting

The history of allergic disease goes back to 1819, when Bostock described his own ‘periodical affection of the eyes and chest’, which he called ‘summer catarrh’. Since they thought it was produced by the effluvium of new hay, this condition was also called hay fever. Later, in 1873, Blackley established that pollen played an important role in the causation of hay fever. Nowadays, the definition of allergy is ‘An untoward physiologic event mediated by a variety of different immunologic reactions’. In this review, the term allergy will be restricted to the IgE-dependent reactions. The most important clinical manifestations of IgE-dependent reactions are allergic conjunctivitis, allergic rhinitis, allergic asthma and atopic dermatitis. However, this review will be restricted to allergic rhinitis. The histopathological features of allergic inflammation involve an increase in blood flow and vascular permeability, leading to plasma exudation and the formation of oedema. In addition, a cascade of events occurs which involves a variety of inflammatory cells. These inflammatory cells migrate under the influence of chemotactic agents to the site of injury and induce the process of repair. Several types of inflammatory cells have been implicated in the pathogenesis of allergic rhinitis. After specific or nonspecific stimuli, inflammatory mediators are generated from cells normally found in the nose, such as mast cells, antigen-presenting cells and epithelial cells (primary effector cells) and from cells recruited into the nose, such as basophils, eosinophils, lymphocytes, platelets and neutrophils (secondary effector cells). This review describes the identification of each of the inflammatory cells and their mediators which play a role in the perennial allergic processes in the nose of rhinitis patients.

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Abdominal Ultrasound and its diagnostic accuracy in diagnosing Acute Appendicitis: A Meta-Analysis

10.22541/au.162169445.54099389/v1 ◽

2021 ◽

Author(s):

Jian Fu ◽

Xu Zhou ◽

Liang Chen ◽

Sheng Lu

Keyword(s):

Acute Appendicitis ◽

Predictive Value ◽

Odds Ratio ◽

Meta Analysis ◽

Abdominal Ultrasound ◽

Final Diagnosis ◽

Diagnostic Odds Ratio ◽

Histopathological Study ◽

Sensitivity Specificity ◽

Suspected Acute Appendicitis

Background: Acute appendicitis (AA) is a common cause for abdominal pain encountering unnecessary surgeries in emergency departments. The present meta-analysis aims to assess the accuracy of abdominal ultrasound in suspected acute appendicitis cases in terms of sensitivity, specificity, and post-test odds for positive and negative results. Materials and Methods: An extensive and systematic search was conducted in Medline (via PubMed), Cinahl (via Ebsco), Scopus, and Web of Sciences from 2010 till the end of March 2021. Two authors analyzed studies for inclusion, collected results, and conducted analyses separately. The histopathological study on tissue collected during appendectomy served as the gold standard for determining the final diagnosis. The accuracy was determined by evaluating sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), diagnostic odds ratio. Results: Out of 3193 references, a total of 18 studies were selected. Overall sensitivity of 77.2% (95 % CI – 75.4 – 78.9%) and specificity of 60% (95 % CI – 58% – 62%) were observed. The diagnostic odds ratio of 6.88(95 % CI 1.99 – 23.82) was obtained. Conclusion: Abdominal ultrasound shows significant accuracy of diagnosis in patients with suspected acute appendicitis.

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Abdominal Ultrasound and Its Diagnostic Accuracy in Diagnosing Acute Appendicitis: A Meta-Analysis

Frontiers in Surgery ◽

10.3389/fsurg.2021.707160 ◽

2021 ◽

Vol 8 ◽

Author(s):

Jian Fu ◽

Xu Zhou ◽

Liang Chen ◽

Sheng Lu

Keyword(s):

Acute Appendicitis ◽

Predictive Value ◽

Odds Ratio ◽

Meta Analysis ◽

Abdominal Ultrasound ◽

Final Diagnosis ◽

Diagnostic Odds Ratio ◽

Negative Results ◽

Sensitivity Specificity ◽

Suspected Acute Appendicitis

Background: Acute appendicitis (AA) is a common cause of abdominal pain encountering unnecessary surgeries in emergency departments. The present meta-analysis aims to assess the accuracy of abdominal ultrasound in suspected acute appendicitis cases in terms of sensitivity, specificity, and post-test odds for positive and negative results.Materials and Methods: An extensive and systematic search was conducted in Medline (via PubMed), Cinahl (via Ebsco), Scopus, and Web of Sciences from 2010 till the end of March 2021. Two authors analyzed studies for inclusion, collected results, and conducted analyses separately. Examination of the histopathological tissue collected during appendectomy served as a gold standard for determining the final diagnosis of appendicitis. The accuracy was determined by evaluating sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), diagnostic odds ratio.Results: Out of 3,193 references, a total of 18 studies were selected. Overall sensitivity of 77.2% (95% CI – 75.4–78.9%) and specificity of 60% (95% CI – 58–62%) were observed. The diagnostic odds ratio of 6.88(95% CI 1.99–23.82) was obtained.Conclusion: Abdominal ultrasound shows significant accuracy of diagnosis in patients with suspected acute appendicitis.

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Comparison of Antileukotrienes and Antihistamines in the Treatment of Allergic Rhinitis

American Journal of Rhinology ◽

10.2500/ajr.2007.21.3044 ◽

2007 ◽

Vol 21 (4) ◽

pp. 439-443 ◽

Cited By ~ 6

Author(s):

Ching-Yin Ho ◽

Ching-Ting Tan

Keyword(s):

Allergic Rhinitis ◽

Low Dose ◽

Treated Group ◽

Nasal Symptom ◽

Controlled Study ◽

Control Group ◽

High Dose ◽

Nasal Resistance ◽

Before And After ◽

Nasal Secretions

Background The aim of this study was to compare the effect of antileukotriene (anti-LT), antihistamine, and a combination of anti-LT and antihistamine on the symptoms and nasal resistance in allergic rhinitis patients. Methods We performed a placebo-controlled study, with 120 persistent, moderate to severe allergic rhinitis patients randomly selected to receive the different treatments for 4 weeks: no treatment, 10 mg of cetirizine once per day, 20 mg of zafirlukast once per day, 20 mg of zafirlukast twice per day, a combination of 20 mg of zafirlukast and 10 mg of cetirizine once per day, or a combination of 20 mg of zafirlukast twice per day and 10 mg cetirizine once per day. The nasal secretion nitric oxide (NO) concentration, nasal symptom score, and nasal resistance were measured before and after treatment. Results Total symptom scores improved in each treated group compared with the control group (p < 0.05). Nasal obstruction significantly improved in the anti-LT-treated groups (p < 0.05). High-dose anti-LT or the combination of low-dose anti-LT and antihistamine significantly improved allergy symptoms compared with no treatment, low-dose anti-LT, or antihistamine alone (p < 0.05). Furthermore, anti-LT decreased NO concentration in nasal secretions (p < 0.05), regardless of the dose administered. Conclusion These results suggest that high-dose anti-LT alone or the combination of low-dose anti-LY and antihistamine can effectively treat allergic rhinitis.

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Typhoid fever among febrile Nigerian patients: Prevalence, diagnostic performance of the Widal test and antibiotic multi-drug resistance

Malawi Medical Journal ◽

10.4314/mmj.v31i3.4 ◽

2019 ◽

Vol 31 (3) ◽

pp. 184-192 ◽

Cited By ~ 4

Author(s):

Martin E Ohanu

Keyword(s):

Drug Resistance ◽

Typhoid Fever ◽

Predictive Value ◽

Antibiotic Susceptibility ◽

Agglutination Test ◽

Controlled Study ◽

Multi Drug Resistance ◽

Widal Test ◽

Culture Positivity ◽

Sensitivity Specificity

BackgroundOver-dependence on clinical presentation and/or the Widal agglutination test for the diagnosis of typhoid fever in developing countries can lead to antibiotic abuse. In Nigeria, the antibiotic resistance of typhoid organisms is poorly characterized. In this study, we determined the prevalence of culture positivity among patients suspected of having typhoid fever, evaluated the diagnostic value of the Widal test and the burden created by the multi-drug resistance of typhoid organisms in South-East Nigeria. MethodologyThis was a prospective and case-controlled study carried out between 2013 and 2016. We acquired samples of blood/stool/urine cultures, and data relating to the Widal agglutination test and malaria parasites from 810 febrile patients (suspected of having typhoid) and 288 apparently healthy controls. Individuals with a history of antibiotic use within the previous 14 days were excluded. We then carried out antibiotic susceptibility tests on all isolates. Multi-drug resistance was defined as a resistance to ≥3 of the antibiotics tested. We determined the sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of Widal test for typhoid laboratory diagnosis compared to bacterial culture which is the gold standard. A P-value <0.05 was considered to be statistically significant. ResultsThe mean age of typhoid suspects was 33.1±6.5 years and 50.7% were women. Of the 810 typhoid suspects tested, 114 (14.1%) had positive cultures for the typhoid organisms Salmonella enterica serovar paratyphi (72) and S. enterica serovar Typhi (42). Sample-specific rates of culture positivity were as follows: stool (72; 8.9%), blood (21; 2.6%) and urine (21; 2.6%), P<0.001. None of the controls had typhoid isolates. The sensitivity, specificity, PPV and NPV of the Widal test were 49.1%, 90.7%, 46.2% and 91.6%, respectively. Malaria parasitaemia was detected in 180 (22.2%) febrile patients, out of whom 115 (63.9%) had a positive Widal test for O/H antigens vs. 1% (6/630) in those with negative malaria parasite test results (P<0.001). The rate of false-positive Widal titres was 48%. Antibiotic multi-drug resistance was detected in 52.6% of patients. The antibiotics with the highest susceptibility were ciprofloxacin, levofloxacin and meropenem (all 100% susceptibility) and ceftriaxone (95.6% susceptibility). ConclusionOur data showed that while typhoid fever is common in Nigeria, malaria is more prevalent. Our analysis showed that the Widal test performed poorly as a diagnostic test and that the burden created by multi-drug resistance was high. Our data indicate that periodic surveillance of antibiotic susceptibility is critical for optimal typhoid therapy.

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Features of local inflammation of nasal mucosa in children with bronchial asthma

Russian otorhinolaryngology ◽

10.18692/1810-4800-2020-3-22-30 ◽

2020 ◽

Vol 19 (3) ◽

pp. 22-30

Author(s):

S. V. Krasil’nikova ◽

◽

T. I. Eliseeva ◽

E. V. Tush ◽

E. V. Bol’shova ◽

...

Keyword(s):

Allergic Rhinitis ◽

Bronchial Asthma ◽

Nasal Mucosa ◽

Allergic Inflammation ◽

Acute Stage ◽

Upper Respiratory Tract ◽

Local Inflammation ◽

Inflammatory Processes ◽

Nasal Secretions ◽

Relationship Of

Bronchial asthma (BA) is often associated with chronic inflammatory processes in the nasal mucosa; these processes give rise to allergic rhinitis (AR), chronic rhinosinusitis, adenoiditis and polypous rhinosinusitis. Due to their multiple symptoms, these diseases of the upper respiratory tract, especially allergic rhinitis, are often difficult to verify in patients with asthma. The aim of the study was to assess the features of local inflammation of the nasal mucosa in patients with BA and AR. Patients and methods. 93 children with BA were examined. General clinical, allergological, functional examination, measurement of endonasal temperature and determination of IgE and IL4 content in nasal secretions were performed. Results. Children with BA have lower values of endonasal temperature than healthy ones. There was a tendency to decrease endonasal temperature as the symptoms of AR increased. In the acute stage of AR, the temperature values were lower than in the remission stage, р = 0,02. The addition of infectious inflammation of the nasal mucosa in children with AD was accompanied by an increase in endonasal temperature, р = 0,04. The increase of the content of nasal IgE in acute AR – 115,6 (49,9; 181,2) ME/mg, compared to the remission period to 24,9 (6,2; 43,7) ME/mg. Exacerbation of AR was associated with increased IL4 to 109,7 (54,2; 165,2) PG/mg, in the period of remission – 34,4 (12,0; 56,8) PG/mg. The increase of these biomarkers of allergic inflammation have a correlative relationship, R = 0,44, p = 0,002. The relationship of IL4 content with endonasal temperature, R = 0,44 р = 0,02 was established. Conclusion. Patients with BA and AR showed a decrease in endonasal temperature compared to healthy ones. Exacerbation of AR in children with BA characterized by an increase in the content of nasal IgE and IL4 and a decrease in endonasal temperature, which allows us to consider these indicators as biomarkers of activation of allergic inflammation.

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Noninvasive Evaluation of Coronary Artery Bypass Grafts with 16-Slice Multidetector Computed Tomography

The Heart Surgery Forum ◽

10.1532/hsf98.20111075 ◽

2012 ◽

Vol 15 (1) ◽

pp. 12 ◽

Cited By ~ 1

Author(s):

Levent Sahiner ◽

Ali Oto ◽

Kudret Aytemir ◽

Tuncay Hazirolan ◽

Musturay Karcaaltincaba ◽

...

Keyword(s):

Computed Tomography ◽

Coronary Artery ◽

Diagnostic Accuracy ◽

Multidetector Computed Tomography ◽

Coronary Artery Bypass ◽

Predictive Value ◽

Artery Bypass ◽

Time Interval ◽

Mdct Angiography ◽

Sensitivity Specificity

Background: The aim of this study was to investigate the diagnostic accuracy of 16-slice multislice, multidetector computed tomography (MDCT) angiography for the evaluation of grafts in patients with coronary artery bypass grafting (CABG).Methods: Fifty-eight consecutive patients with CABG who underwent both MDCT and conventional invasive coronary angiography were included. The median time interval between the 2 procedures was 10 days (range, 1-32 days). The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of MDCT for the detection of occluded grafts were calculated. The accuracy of MDCT angiography for detecting significant stenoses in patent grafts and the evaluability of proximal and distal anastomoses were also investigated.Results: Optimal diagnostic images could not be obtained for only 3 (2%) of 153 grafts. Evaluation of the remaining 150 grafts revealed values for sensitivity, specificity, PPV, NPV, and diagnostic accuracy of the MDCT angiography procedure for the diagnosis of occluded grafts of 87%, 97%, 94%, 93%, and 92%, respectively. All of the proximal anastomoses were optimally visualized. In 4 (8%) of 50 patent arterial grafts, however, the distal anastomotic region could not be evaluated because of motion and surgical-clip artifacts. The accuracy of MDCT angiography for the detection of significant stenotic lesions was relatively low (the sensitivity, specificity, PPV, and NPV were 67%, 98%, 50%, and 99%, respectively). The number of significant lesions was insufficient to reach a reliable conclusion, however.Conclusion: Our study showed that MDCT angiography with 16-slice systems has acceptable diagnostic performance for the evaluation of coronary artery bypass graft patency.

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Accuracy of Rotator Cuff Tears and Tendinosis Diagnoses on Shoulder Ultrasound Performed by a Short-experienced Operator

American Journal of Sonography ◽

10.25259/ajs-22-2018 ◽

2018 ◽

Vol 1 ◽

pp. 9

Author(s):

Harshad Arvind Vanjare ◽

Jyoti Panwar

Keyword(s):

Rotator Cuff ◽

Negative Predictive Value ◽

Rotator Cuff Tear ◽

Predictive Value ◽

Rotator Cuff Tears ◽

Mri Findings ◽

Cuff Tear ◽

Experienced Operator ◽

Magnetic Resonance Imaging Mri ◽

Sensitivity Specificity

Objective The objective of the study was to assess the accuracy of ultrasound examination for the diagnosis of rotator cuff tear and tendinosis performed by a short experienced operator, compared to magnetic resonance imaging (MRI) results. Method A total of 70 subjects suspected to have rotator cuff tear or tendinosis and planned for shoulder MRI were included in the study. Shoulder ultrasound was performed either before or after the MRI scan on the same day. Ultrasound operator had a short experience in performing an ultrasound of the shoulder. Ultrasound findings were correlated to MRI findings. Results Sensitivity, specificity, positive predictive value, negative predictive value, and accuracy for the diagnosis of tendinosis were 58%, 84%, 63%, 80%, and 75%, respectively, and it was 68%, 91%, 73%, 88%, and 85%, respectively, for the diagnosis of rotator cuff tear. Conclusions Sensitivity for diagnosing rotator cuff tear or tendinosis was moderate but had a higher negative predictive value. Thus, the ultrasound operator with a short experience in performing shoulder ultrasound had moderate sensitivity in diagnosing tendinosis or tears; however, could exclude them with confidence.

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