Elevated D-Dimer Levels Predict a Poor Outcome in Critically Ill Patients

D-dimer is a biomarker of thrombosis and recently been considered to predict a poor outcome in patients with infectious diseases. Plasma D-dimer levels were measured in critically ill patients to examine their relationship with the poor outcome. The plasma D-dimer levels were markedly higher in the patients with various underlying disease especially venous thromboembolism in comparison to those without severe underlying diseases. The plasma D-dimer levels in non-survivors were significantly higher than those in survivors. In a receiver operating characteristic analysis, the area under the curve was high for the disseminated intravascular coagulation (DIC) score, the D-dimer value, and the prothrombin time-international normalize ratio (PT-INR). Adequate cut-off values for predicting the outcome were 3 as follows: DIC score, 3 points; D-dimer, 4.2 mg/L; and PT-INR, 1.08. D-dimer, which is a biomarker for thrombosis, is increased in various underlying diseases and predicts a poor outcome.

Download Full-text

Usefulness of sialic acid for diagnosis of sepsis in critically ill patients: a retrospective study

BMC Anesthesiology ◽

10.1186/s12871-020-01197-2 ◽

2020 ◽

Vol 20 (1) ◽

Author(s):

Bo Yao ◽

Wen-juan Liu ◽

Di Liu ◽

Jin-yan Xing ◽

Li-juan Zhang

Keyword(s):

Sialic Acid ◽

Critically Ill ◽

Critically Ill Patients ◽

Incomplete Data ◽

Acid Level ◽

Operating Characteristic ◽

Area Under The Curve ◽

Diagnostic Efficacy ◽

Receiver Operating Characteristic Curves ◽

Sensitivity Specificity

Abstract Background Early diagnosis of sepsis is very important. It is necessary to find effective and adequate biomarkers in order to diagnose sepsis. In this study, we compared the value of sialic acid and procalcitonin for diagnosing sepsis. Methods Newly admitted intensive care unit patients were enrolled from January 2019 to June 2019. We retrospectively collected patient data, including presence of sepsis or not, procalcitonin level and sialic acid level. Receiver operating characteristic curves for the ability of sialic acid, procalcitonin and combination of sialic acid and procalcitonin to diagnose sepsis were carried out. Results A total of 644 patients were admitted to our department from January 2019 to June 2019. The incomplete data were found in 147 patients. Finally, 497 patients data were analyzed. The sensitivity, specificity and area under the curve for the diagnosis of sepsis with sialic acid, procalcitonin and combination of sialic acid and procalcitonin were 64.2, 78.3%, 0.763; 67.9, 84.0%, 0.816 and 75.2, 84.6%, 0.854. Moreover, sialic acid had good values for diagnosing septic patients with viral infection, with 87.5% sensitivity, 82.2% specificity, and 0.882 the area under the curve. Conclusions Compared to procalcitonin, sialic acid had a lower diagnostic efficacy for diagnosing sepsis in critically ill patients. However, the combination of sialic acid and procalcitonin had a higher diagnostic efficacy for sepsis. Moreover, sialic acid had good value for diagnosing virus-induced sepsis.

Download Full-text

Investigating the clinico-anatomical dissociation in the behavioral variant of Alzheimer disease

Alzheimer s Research & Therapy ◽

10.1186/s13195-020-00717-z ◽

2020 ◽

Vol 12 (1) ◽

Author(s):

Ellen H. Singleton ◽

Yolande A. L. Pijnenburg ◽

Carole H. Sudre ◽

Colin Groot ◽

Elena Kochova ◽

...

Keyword(s):

Operating Characteristic ◽

Receiver Operating Characteristic Analysis ◽

Area Under The Curve ◽

Posterior Cingulate Cortex ◽

White Matter Hyperintensity ◽

Salience Network ◽

Characteristic Analysis ◽

Cognitively Normal ◽

Metabolic Connectivity ◽

Subcortical Volume

Abstract Background We previously found temporoparietal-predominant atrophy patterns in the behavioral variant of Alzheimer’s disease (bvAD), with relative sparing of frontal regions. Here, we aimed to understand the clinico-anatomical dissociation in bvAD based on alternative neuroimaging markers. Methods We retrospectively included 150 participants, including 29 bvAD, 28 “typical” amnestic-predominant AD (tAD), 28 behavioral variant of frontotemporal dementia (bvFTD), and 65 cognitively normal participants. Patients with bvAD were compared with other diagnostic groups on glucose metabolism and metabolic connectivity measured by [18F]FDG-PET, and on subcortical gray matter and white matter hyperintensity (WMH) volumes measured by MRI. A receiver-operating-characteristic-analysis was performed to determine the neuroimaging measures with highest diagnostic accuracy. Results bvAD and tAD showed predominant temporoparietal hypometabolism compared to controls, and did not differ in direct contrasts. However, overlaying statistical maps from contrasts between patients and controls revealed broader frontoinsular hypometabolism in bvAD than tAD, partially overlapping with bvFTD. bvAD showed greater anterior default mode network (DMN) involvement than tAD, mimicking bvFTD, and reduced connectivity of the posterior cingulate cortex with prefrontal regions. Analyses of WMH and subcortical volume showed closer resemblance of bvAD to tAD than to bvFTD, and larger amygdalar volumes in bvAD than tAD respectively. The top-3 discriminators for bvAD vs. bvFTD were FDG posterior-DMN-ratios (bvAD<bvFTD), MRI posterior-DMN-ratios (bvAD<bvFTD), MRI salience-network-ratios (bvAD>bvFTD, area under the curve [AUC] range 0.85–0.91, all p < 0.001). The top-3 for bvAD vs. tAD were amygdalar volume (bvAD>tAD), MRI anterior-DMN-ratios (bvAD<tAD), FDG anterior-DMN-ratios (bvAD<tAD, AUC range 0.71–0.84, all p < 0.05). Conclusions Subtle frontoinsular hypometabolism and anterior DMN involvement may underlie the prominent behavioral phenotype in bvAD.

Download Full-text

The ability of free to total prostate-specific antigen and prostate-specific antigen density to detect clinically significant prostate cancer in men undergoing transperineal template biopsy

Journal of Clinical Urology ◽

10.1177/2051415817730494 ◽

2017 ◽

Vol 10 (6) ◽

pp. 529-534 ◽

Cited By ~ 1

Author(s):

Surayne V Segaran ◽

Amr M Emara ◽

Tharani Mahesan ◽

Joshua Silverman ◽

Hashim U Ahmed ◽

...

Keyword(s):

Prostate Cancer ◽

Prostate Specific Antigen ◽

Operating Characteristic ◽

Receiver Operating Characteristic Analysis ◽

Specific Antigen ◽

Area Under The Curve ◽

Characteristic Analysis ◽

Total Prostate Specific Antigen ◽

Prostate Specific Antigen Density ◽

Clinically Significant

Objective: The purpose of this study was to determine the ability of the ratio of free to total prostate-specific antigen and prostate-specific antigen density to predict the presence of clinically significant prostate cancer on template biopsies. The value of these tests may be underestimated as they were previously validated against sextant transrectal biopsy of the prostate, which has been proved to miss a large proportion of significant prostate cancers. The ability of these tests to specifically detect clinically significant cancers has not previously been studied. Patients and methods: A retrospective analysis was performed of patients undergoing transperineal template biopsy who also had free to total prostate-specific antigen and prostate-specific antigen density. Receiver-operating characteristic analysis was performed to determine the comparative utility of each test in the detection of all cancers as well as clinically significant cancers, by means of the area under the curve. Results: Data from 293 patients were analysed. Prostate cancer was detected in 72% of patients, of which 62% of this group had clinically significant disease. Receiver-operating characteristic analysis demonstrated the superiority of prostate-specific antigen density and free to total prostate-specific antigen over standard prostate-specific antigen in the overall detection of cancer (area under the curve 0.662 and 0.674 vs 0.534, p=0.003 and 0.02 respectively). Both tests were even more effective in the detection of clinically significant cancers (area under the curve 0.755 and 0.715 vs 0.572, p<0.0001 and 0.009 respectively). Conclusion: The free to total prostate-specific antigen and prostate-specific antigen density both appear to perform well at detecting clinically significant prostate cancer in our population of men undergoing template biopsy. The potential role of these inexpensive tests should not be overlooked as they may be of value when deciding which patients require biopsy following an initial magnetic resonance imaging scan and also for those on surveillance protocols.

Download Full-text

Evaluation of a Novel Plasma (1,3)-β-d-Glucan Detection Assay for Diagnosis of Candidemia in Pediatric Patients

Journal of Clinical Microbiology ◽

10.1128/jcm.00673-15 ◽

2015 ◽

Vol 53 (9) ◽

pp. 3017-3020 ◽

Cited By ~ 13

Author(s):

Ying Liu ◽

Feng Chen ◽

Xiaodong Zhu ◽

Lisong Shen ◽

Sean X. Zhang

Keyword(s):

Positive Predictive Value ◽

Receiver Operating Characteristic ◽

Negative Predictive Value ◽

Predictive Value ◽

Operating Characteristic ◽

Pediatric Patients ◽

Receiver Operating Characteristic Analysis ◽

Area Under The Curve ◽

Characteristic Analysis ◽

Detection Assay

We evaluated a novel plasma (1,3)-β-d-glucan (BDG) detection assay for the diagnosis of candidemia in children. The median BDG levels were 73.4 pg/ml in patients with candidemia and <10 pg/ml in patients without candidemia (P< 0.001). Receiver operating characteristic analysis revealed a cutoff point of 14 pg/ml and an area under the curve of 0.802. At these values, the assay demonstrated 68% sensitivity, 91% specificity, 66% positive predictive value, and 91% negative predictive value. Plasma BDG levels were undetectable in 18 candidemia cases.

Download Full-text

Screening for Aphasia in NeuroDegeneration for the Diagnosis of Patients with Primary Progressive Aphasia: Clinical Validity and Psychometric Properties

Dementia and Geriatric Cognitive Disorders ◽

10.1159/000492632 ◽

2018 ◽

Vol 46 (3-4) ◽

pp. 243-252 ◽

Cited By ~ 5

Author(s):

Petronilla Battista ◽

Eleonora Catricalà ◽

Marco Piccininni ◽

Massimiliano Copetti ◽

Valentina Esposito ◽

...

Keyword(s):

Operating Characteristic ◽

Receiver Operating Characteristic Analysis ◽

Area Under The Curve ◽

Primary Progressive Aphasia ◽

Clinical Validity ◽

Characteristic Analysis ◽

Progressive Aphasia ◽

Primary Progressive ◽

Convergent And Divergent Validity ◽

Good Internal Consistency

Background: We evaluated the psychometric proprieties of the Screening for Aphasia in NeuroDegeneration (SAND) battery in Italian primary progressive aphasia (PPA) and movement disorder (MD) patients. Methods: The sample included 30 consecutive PPA and 45 MD patients who completed the SAND battery together with a clinical interview and a neurological/neuropsychological examination and 130 healthy controls (HC). Results: The SAND battery showed good internal consistency and good convergent and divergent validity. receiver operating characteristic analysis revealed an area under the curve of 0.978 for PPA versus HC and of 0.786 for PPA versus MD. A cutoff ≥3 gave a sensitivity of 0.933% and a specificity of 0.946% for discriminating PPA versus HC, whereas a cutoff ≥5 gave a sensitivity of 0.767% and a specificity of 0.667% for discriminating PPA versus MD. Conclusion: These results indicate that the SAND battery is an adequate, reliable, and valid diagnostic tool for PPA.

Download Full-text

Soluble C-Type Lectin-Like Receptor 2 Is a Biomarker for Disseminated Intravascular Coagulation

Journal of Clinical Medicine ◽

10.3390/jcm10132860 ◽

2021 ◽

Vol 10 (13) ◽

pp. 2860

Author(s):

Akitaka Yamamoto ◽

Hideo Wada ◽

Yuhuko Ichkawa ◽

Motoko Tanaka ◽

Haruhiko Tashiro ◽

...

Keyword(s):

Critically Ill ◽

Disseminated Intravascular Coagulation ◽

Critically Ill Patients ◽

Plasma Levels ◽

Clinical Syndrome ◽

Intravascular Coagulation ◽

Activated Platelets ◽

Underlying Diseases ◽

Soluble C ◽

D Dimer

Disseminated intravascular coagulation (DIC) is induced by excess activation coagulation, and activated platelets are also involved in pathogenesis. Therefore, plasma levels of soluble C-type lectin-like receptor 2 (sCLEC-2), a new marker for platelet activation, can be expected as a marker of DIC in critically ill patients. Plasma levels of sCLEC-2 and D-dimer were measured using the STACIA system. Plasma sCLEC-2 and D-dimer levels were significantly higher in patients with underlying diseases of DIC than in those with unidentified clinical syndrome (UCS). Plasma sCLEC-2 levels were significantly higher in the patients with DIC and Pre-DIC than in those without DIC or Pre-DIC. Similarly, plasma D-dimer levels were also significantly higher in patients with DIC and Pre-DIC than in those without DIC or Pre-DIC. The plasma sCLEC-2 levels in all patients and those with a DIC score ≤ 4 were significantly higher in non-survivors than survivors. The plasma D-dimer levels in all patients, those with a DIC score ≥ 5 and those with a DIC score ≤ 4, were significantly higher in non-survivors than in survivors. The plasma sCLEC-2 is expected as a marker for DIC/Pre-DIC as well as the prognostic marker in critically ill patients.

Download Full-text

Identification of Synonyms Using Definition Similarities in Japanese Medical Device Adverse Event Terminology

Applied Sciences ◽

10.3390/app11083659 ◽

2021 ◽

Vol 11 (8) ◽

pp. 3659

Author(s):

Ayako Yagahara ◽

Masahito Uesugi ◽

Hideto Yokoi

Keyword(s):

Medical Device ◽

Operating Characteristic ◽

Receiver Operating Characteristic Analysis ◽

Area Under The Curve ◽

High Accuracy ◽

Levenshtein Distance ◽

Characteristic Analysis ◽

Distributed Representations ◽

Detection Tool ◽

Important Concern

Japanese medical device adverse events terminology, published by the Japan Federation of Medical Devices Associations (JFMDA terminology), contains entries for 89 terminology items, with each of the terminology entries created independently. It is necessary to establish and verify the consistency of these terminology entries and map them efficiently and accurately. Therefore, developing an automatic synonym detection tool is an important concern. Such tools for edit distances and distributed representations have achieved good performance in previous studies. The purpose of this study was to identify synonyms in JFMDA terminology and evaluate the accuracy using these algorithms. A total of 125 definition sentence pairs were created from the terminology as baselines. Edit distances (Levenshtein and Jaro–Winkler distance) and distributed representations (Word2vec, fastText, and Doc2vec) were employed for calculating similarities. Receiver operating characteristic analysis was carried out to evaluate the accuracy of synonym detection. A comparison of the accuracies of the algorithms showed that the Jaro–Winkler distance had the highest sensitivity, Doc2vec with DM had the highest specificity, and the Levenshtein distance had the highest value in area under the curve. Edit distances and Doc2vec makes it possible to obtain high accuracy in predicting synonyms in JFMDA terminology.

Download Full-text

Neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio: novel markers for the diagnosis and prognosis in patients with restenosis following CAS

Biomarkers in Medicine ◽

10.2217/bmm-2019-0155 ◽

2020 ◽

Vol 14 (4) ◽

pp. 271-282 ◽

Cited By ~ 1

Author(s):

Xiang Bao ◽

Gezhi Zhou ◽

Wei Xu ◽

Xiaobo Liu ◽

Zhijun Ye ◽

...

Keyword(s):

Operating Characteristic ◽

Receiver Operating Characteristic Analysis ◽

Prognostic Significance ◽

Area Under The Curve ◽

Prognostic Indicator ◽

Neutrophil To Lymphocyte Ratio ◽

Characteristic Analysis ◽

Platelet To Lymphocyte Ratio ◽

Lymphocyte Ratio ◽

Diagnosis And Prognosis

Aim: In this study, we investigated the effect of neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio on restenosis status in patients undergoing carotid angioplasty stenting (CAS). Methodology & results: Clinical imageology and receiver operating characteristic analysis were utilized to study the prognostic significance of NLRs/platelet-to-lymphocyte ratios and their correlation with survival. NLR of restenosis (+) patients was evidently increased after the CAS procedures, while the NLR of restenosis (-) patients before the CAS procedures being the lowest. Area under the curve of pre-CAS NLR or/and post-CAS NLR were all evidently higher than 50%. Also, restenosis incidence was the highest in patients with both high pre-CAS and high post-CAS values. Conclusion: Therefore, NLR can be utilized as an independent prognostic indicator to predict the incidence of restenosis after CAS procedures.

Download Full-text