scholarly journals Role of Invasive Urodynamic Studies in Establishing Cauda Equina Syndrome and Postoperative Recovery

2020 ◽  
pp. 219256822097964
Author(s):  
Abhinandan Reddy Mallepally ◽  
Bibhudendu Mohapatra ◽  
Kalidutta Das
Keyword(s):  
Clinical Symptoms ◽  
False Positive Rate ◽  
Cauda Equina ◽  
Postoperative Recovery ◽  
Normal Bladder ◽  
Acontractile Detrusor ◽  
Positive Rate ◽  
Acute Radiculopathy ◽  
Operative Recovery

Study design: Retrospective with prospective follow-up. Objective: Confirming the diagnosis of CES based purely on symptoms and signs is unreliable and usually associated with high false positive rate. A missed diagnosis can permanently disable the patient. Present study aims to determine the relationship between clinical symptoms/ signs (bladder dysfunction) with UDS, subsequently aid in surgical decision making and assessing post-operative recovery. Methods: A prospective follow-up of patients with disc herniation and bladder symptoms from January 2018 to July 2020 was done. All patients underwent UDS and grouped into acontractile, hypocontractile and normal bladder. Data regarding PAS, VAC, GTP, timing to surgery and onset of radiculopathy and recovery with correlation to UDS was done preoperatively and post operatively. Results: 107 patients were studied (M-63/F-44). Patients with PAS present still had acontractile (61%) or hypocontractile (39%) detrusor and with VAC present, 57% had acontractile and 43% hypocontractile detrusors. 10 patients with both PAS and VAC present had acontractile detrusor. 82% patients with acute radiculopathy (<2 days) improved when operated <24 hrs while only 47% showed improvement with chronic radiculopathy. The detrusor function recovered in 66.1% when operated <12 hours, 40% in <12-24 hours of presentation. Conclusion: Adjuvant information from UDS in combination with clinicoradiological findings help in accurate diagnosis even in patients with no objective motor and sensory deficits. Quantitative findings on UDS are consistent with postoperative recovery of patient’s urination power, representing improvement and can be used as a prognostic factor.

Improving diagnosis of acute appendicitis with atypical findings by Tc-99m HMPAO leukocyte scan

2002 ◽  
Vol 41 (01) ◽  
pp. 37-41 ◽  
Author(s):  
S. Shung-Shung ◽  
S. Yu-Chien ◽  
Y. Mei-Due ◽  
W. Hwei-Chung ◽  
A. Kao
Keyword(s):  
Acute Appendicitis ◽  
False Positive ◽  
False Positive Rate ◽  
Accurate Method ◽  
Clinical Findings ◽  
Pathological Findings ◽  
Lower Quadrant ◽  
Predictive Values ◽  
Positive Rate

Summary Aim: Even with careful observation, the overall false-positive rate of laparotomy remains 10-15% when acute appendicitis was suspected. Therefore, the clinical efficacy of Tc-99m HMPAO labeled leukocyte (TC-WBC) scan for the diagnosis of acute appendicitis in patients presenting with atypical clinical findings is assessed. Patients and Methods: Eighty patients presenting with acute abdominal pain and possible acute appendicitis but atypical findings were included in this study. After intravenous injection of TC-WBC, serial anterior abdominal/pelvic images at 30, 60, 120 and 240 min with 800k counts were obtained with a gamma camera. Any abnormal localization of radioactivity in the right lower quadrant of the abdomen, equal to or greater than bone marrow activity, was considered as a positive scan. Results: 36 out of 49 patients showing positive TC-WBC scans received appendectomy. They all proved to have positive pathological findings. Five positive TC-WBC were not related to acute appendicitis, because of other pathological lesions. Eight patients were not operated and clinical follow-up after one month revealed no acute abdominal condition. Three of 31 patients with negative TC-WBC scans received appendectomy. They also presented positive pathological findings. The remaining 28 patients did not receive operations and revealed no evidence of appendicitis after at least one month of follow-up. The overall sensitivity, specificity, accuracy, positive and negative predictive values for TC-WBC scan to diagnose acute appendicitis were 92, 78, 86, 82, and 90%, respectively. Conclusion: TC-WBC scan provides a rapid and highly accurate method for the diagnosis of acute appendicitis in patients with equivocal clinical examination. It proved useful in reducing the false-positive rate of laparotomy and shortens the time necessary for clinical observation.

dtectDx Breast: A serum biomarker test for breast cancer detection used in conjunction with traditional mammography screening.

2013 ◽  
Vol 31 (26_suppl) ◽  
pp. 18-18
Author(s):  
Meredith C. Henderson ◽  
Keri Sweeten ◽  
Sherri Borman ◽  
Christa Corn ◽  
Lindsey Gordon ◽  
...  
Keyword(s):  
Breast Cancer ◽  
False Positive Rate ◽  
Standard Of Care ◽  
Patient Characteristics ◽  
Protein Biomarkers ◽  
Time Period ◽  
Positive Rate ◽  
Previous Clinical Study

18 Background: Provista Diagnostics has developed a test that analyzes serum concentrations of 5 protein biomarkers in order to detect breast cancer. The dtectDx Breast test utilizes a proprietary algorithm that has been described previously (Weber et al. 2010). In this study, it was noted that the algorithm performs best in women under age 50. The aim of this study was to evaluate the performance characteristics of dtectDx Breast in women under age 50 in a commercial setting and compare the results with data from the previous clinical study. Methods: The dtectDx Breast test measures the concentrations of IL-8, IL-12, VEGF, CEA, and HGF via ELISA. These data combined with select patient characteristics and Provista’s proprietary algorithm result in a test value that is characterized as normal or elevated. dtectDx Breast test reports issued for women under age 50 were reviewed from a 3-year time period and prescribing physicians were interviewed regarding follow-up care and outcome measures (largely imaging studies, if warranted). Results: Of the 908 patients, 8 samples were rejected based on serum quality. Of the remaining 900 patients, 121 were reported as elevated (12.7%). In 4 cases, these elevated results were confirmed cases of breast cancer. Of these, 2 patients initially showed no screening evidence of cancer, but upon further evaluation (after receipt of dtectDx Breast results) were diagnosed with breast cancer. dtectDx correctly identified DCIS 66% of the time (n=2). Conclusions: These results describe the use of dtectDx Breast in a clinical setting and confirm that the assay behaves similarly to previously published results (Weber et al 2010). While the false-positive rate is higher than predicted (12.7% vs 6.8%), the assay correctly identified 4 of 4 invasive cancers and 2 of 3 DCIS cases. Since two of the invasive cancer cases were originally not detected via standard screening procedures, the assay has demonstrated important clinical utility when used in conjunction with mammography/standard of care. Here we show that, in the commercial patient population, when combined with standard of care, dtectDx Breast improves the detection of breast cancer in women under 50.

scholarly journals Pregnancy data enable identification of relevant biomarkers and a partial prognosis of autism at birth

2020 ◽  
Author(s):  
Hugues Caly ◽  
Hamed Rabiei ◽  
Perrine Coste-Mazeau ◽  
Sebastien Hantz ◽  
Sophie Alain ◽  
...  
Keyword(s):  
Behavioral Interventions ◽  
Statistical Tests ◽  
False Positive Rate ◽  
Familial Risk ◽  
Autism Spectrum ◽  
Gradient Boosting ◽  
Decision Tree Classification ◽  
Positive Rate ◽  
History Of

AbstractAttempts to extract early biomarkers and expedite detection of Autism Spectrum Disorder (ASD) have been centered on postnatal measures of babies at familial risk. Here, we suggest that it might be possible to do these tasks already at birth relying on ultrasound and biological measurements routinely collected from pregnant mothers and fetuses during gestation and birth. We performed a gradient boosting decision tree classification analysis in parallel with statistical tests on a population of babies with typical development or later diagnosed with ASD. By focusing on minimization of the false positive rate, the cross-validated specificity of the classifier reached to 96% with a sensitivity of 41% and a positive predictive value of 77%. Extracted biomarkers included sex, maternal familial history of auto-immune diseases, maternal immunization to CMV, IgG CMV level, timing of fetal rotation on head, femoral length in the 3rd trimester, white cells in the 3rd trimester, fetal heart rate during labour, newborn feeding and newborn’s temperature difference between birth and one day after. Statistical models revealed that 38% of babies later diagnosed with ASD had significantly larger fetal cephalic perimeter than age matched neurotypical babies, suggesting an in-utero origin of the bigger brains of toddlers with ASD. Results pave the way to use pregnancy follow-up measurements to provide an early prognosis of ASD and implement pre-symptomatic behavioral interventions to attenuate efficiently ASD developmental sequels.

scholarly journals Identification of Amblyomma Javanense and Detection of Tick-Borne Ehrlichia Spp. In Confiscated Malayan Pangolins

2020 ◽  
Author(s):  
Junqiong Zhai ◽  
Yajiang Wu ◽  
Jinping Chen ◽  
Jiejian Zou ◽  
Fen Shan ◽  
...  
Keyword(s):  
Clinical Symptoms ◽  
Habitat Destruction ◽  
Nucleic Acid Detection ◽  
Histopathological Analysis ◽  
Rescue Operation ◽  
Illegal Hunting ◽  
Pcr Product ◽  
Positive Rate ◽  
Biological Methods

Abstract BackgroundDue to habitat destruction and illegal hunting and trade, the number of pangolins has been sharply reduced. To prevent their extinction, relevant departments are combined and active action have been taken. A total of 21 confiscated Malayan pangolins were rescued in 2019, but died continuously for unknown reasons. This study aimed to investigate the reasons for the death of these pangolin and rescue them.MethodsRecused Malayan pangolins were checked for clinical symptoms. Ticks on the surface of pangolins were collected and identified using morphological and molecular biological methods. Dead pangolins were autopsied for the gross lesion and tissues were collected for microscopic lesion using HE staining. Viral and protozoa pathogens’ detection were carried on ticks firstly and further confirmed in dead pangolin pathological tissues using PCR.ResultsWhen rescued, pangolins were in bad situation. More than 90% (19/21) of the rescued pangolins had ticks on their body surfaces. A total of 303 ticks were removed and identified as Amblyomma javanense (A. javanense) according to their morphology and the sequences of PCR product of 16S rRNA and internal transcribed spacer 2 (ITS2). Autopsy of the dead pangolins showed multiorgan damage, especially congestion and hemorrhage in lung, heart and kidney. Histopathological analysis revealed marked presence of inflammation in tissues. Pathogens’ nucleic acid detection showed ticks were only positive for Ehrlichia spp, with 56.7% positive rate of collected ticks (127/224), which was further confirmed in tissues from dead pangolins. Sick pangolins reduced clinical symptoms after medical treatment of intramuscular injection with doxycycline and kept alive before transfer.ConclusionsOur findings confirm that ehrlichiosis caused by Ehrlichia spp. from A. javanense might be one of the reasons for the confiscated pangolins’ death. More attention should be payed to tick-elimination work and the diagnoses and treatment of tick-borne diseases in the follow-up rescue operation.

OS08.6.A Glioblastoma treatment response machine learning monitoring biomarkers: a systematic review and meta-analysis

2021 ◽  
Vol 23 (Supplement_2) ◽  
pp. ii11-ii12
Author(s):  
T C Booth ◽  
A Chelliah ◽  
A Roman ◽  
A Al Busaidi ◽  
H Shuaib ◽  
...  
Keyword(s):  
Machine Learning ◽  
Treatment Response ◽  
Meta Analysis ◽  
False Positive Rate ◽  
Risk Of Bias ◽  
Response Monitoring ◽  
Reference Standard ◽  
Positive Rate ◽  
Test Sets

Abstract BACKGROUND The aim of the systematic review was to assess recently published studies on diagnostic test accuracy of glioblastoma treatment response monitoring biomarkers in adults, developed through machine learning (ML). MATERIAL AND METHODS PRISMA methodology was followed. Articles published 09/2018-01/2021 (since previous reviews) were searched for using MEDLINE, EMBASE, and the Cochrane Register by two reviewers independently. Included study participants were adult patients with high grade glioma who had undergone standard treatment (maximal resection, radiotherapy with concomitant and adjuvant temozolomide) and subsequently underwent follow-up imaging to determine treatment response status (specifically, distinguishing progression/recurrence from progression/recurrence mimics - the target condition). Risk of bias and applicability was assessed with QUADAS 2. A third reviewer arbitrated any discrepancy. Contingency tables were created for hold-out test sets and recall, specificity, precision, F1-score, balanced accuracy calculated. A meta-analysis was performed using a bivariate model for recall, false positive rate and area-under the receiver operator characteristic curve (AUC). RESULTS Eighteen studies were included with 1335 patients in training sets and 384 in test sets. To determine whether there was progression or a mimic, the reference standard combination of follow-up imaging and histopathology at re-operation was applied in 67% (13/18) of studies. The small numbers of patient included in studies, the high risk of bias and concerns of applicability in the study designs (particularly in relation to the reference standard and patient selection due to confounding), and the low level of evidence, suggest that limited conclusions can be drawn from the data. Ten studies (10/18, 56%) had internal or external hold-out test set data that could be included in a meta-analysis of monitoring biomarker studies. The pooled sensitivity was 0.77 (0.65–0.86). The pooled false positive rate (1-specificity) was 0.35 (0.25–0.47). The summary point estimate for the AUC was 0.77. CONCLUSION There is likely good diagnostic performance of machine learning models that use MRI features to distinguish between progression and mimics. The diagnostic performance of ML using implicit features did not appear to be superior to ML using explicit features. There are a range of ML-based solutions poised to become treatment response monitoring biomarkers for glioblastoma. To achieve this, the development and validation of ML models require large, well-annotated datasets where the potential for confounding in the study design has been carefully considered. Therefore, multidisciplinary efforts and multicentre collaborations are necessary.

scholarly journals LOW FALSE POSITIVE RATE OFKEPLERCANDIDATES ESTIMATED FROM A COMBINATION OFSPITZERAND FOLLOW-UP OBSERVATIONS

2015 ◽  
Vol 804 (1) ◽  
pp. 59 ◽  
Author(s):  
Jean-Michel Désert ◽  
David Charbonneau ◽  
Guillermo Torres ◽  
François Fressin ◽  
Sarah Ballard ◽  
...  
Keyword(s):  
False Positive ◽  
False Positive Rate ◽  
Positive Rate

Review and management of breast lesions detected with breast tomosynthesis but not visible on mammography and ultrasonography

2017 ◽  
Vol 58 (12) ◽  
pp. 1442-1447 ◽  
Author(s):  
Fusun Taskin ◽  
Yasemin Durum ◽  
Aykut Soyder ◽  
Alparslan Unsal
Keyword(s):  
Breast Lesion ◽  
False Positive Rate ◽  
Breast Mri ◽  
Breast Lesions ◽  
Management Options ◽  
Breast Tomosynthesis ◽  
Ethical Committee Approval ◽  
Positive Rate ◽  
Magnetic Resonance Imaging Mri

Background Breast tomosynthesis is more sensitive than mammography and can detect lesions that are not always visible with conventional methods such as digital mammography (MG) and ultrasonography (US). No standardized approach is available for the management of lesions that are detectable with tomosynthesis but are not visible on MG or US. Purpose To review suspicious breast lesions detected with tomosynthesis but not visible on two-dimensional (2D) MG or US and to determine the management options for these lesions. Material and Methods Ethical committee approval was obtained. The radiological records, biopsy or surgery results, and follow-up findings of 107 patients who had a tomosynthesis-positive but MG- or US-negative breast lesion between 2011 and 2016 were retrospectively evaluated. Results Of 107 lesions visible only with tomosynthesis, 74% were architectural distortions and 26% were asymmetrical opacities. All patients underwent magnetic resonance imaging (MRI) for further evaluation. Among the 48 (45%) MRI-negative lesions, none had a suspicious alteration during the follow-up period. Among the MRI-positive lesions, 28% of the 50 architectural distortions and 11% of the nine asymmetrical opacities were malignant. Conclusion Given the inherent high false-positive rate of breast tomosynthesis, breast MRI prior to biopsy may reduce the number of unnecessary biopsies for suspicious breast lesions that are tomosynthesis-positive only.

scholarly journals Using Z-score to optimize population-specific DDH screening: a retrospective study in Hangzhou, China

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Haomin Li ◽  
Liqi Shu ◽  
Jin Yu ◽  
Zeng Xian ◽  
Huilong Duan ◽  
...  
Keyword(s):  
False Positive ◽  
False Positive Rate ◽  
Developmental Dysplasia ◽  
Z Score ◽  
Local Regression ◽  
X Ray ◽  
Positive Rate ◽  
Z Scores ◽  
Highly Correlated

Abstract Background DDH (Developmental Dysplasia of the Hip) screening can potentially avert many morbidities and reduce costs. The debate about universal vs. selective DDH ultrasonography screening in different countries revolves to a large extent around effectiveness, cost, and the possibility of overdiagnosis and overtreatment. In this study, we proposed and evaluated a Z-score enhanced Graf method to optimize population-specific DDH screening. Methods A total of 39,710 history ultrasonography hip examinations were collected to establish a sex, side specific and age-based Z-scores model using the local regression method. The correlation between Z-scores and classic Graf types was analyzed. Four thousand two hundred twenty-nine cases with follow-up ultrasonographic examinations and 5284 cases with follow-up X-ray examinations were used to evaluate the false positive rate of the first examination based on the subsequent examinations. The results using classic Graf types and the Z-score enhanced types were compared. Results The Z-score enhanced Graf types were highly correlated with the classic Graf’s classification (R = 0.67, p < 0.001). Using the Z-scores ≥2 as a threshold could reduce by 86.56 and 80.44% the false positives in the left and right hips based on the follow-up ultrasonographic examinations, and reduce by 78.99% false-positive cases based on the follow-up X-ray examinations, respectively. Conclusions Using an age, sex and side specific Z-scores enhanced Graf’s method can better control the false positive rate in DDH screening among different populations.

scholarly journals Follow-Up SARS-CoV-2 PCR Testing Outcomes From a Large Reference Lab in the US

2021 ◽  
Vol 9 ◽  
Author(s):  
Adam Sullivan ◽  
David Alfego ◽  
Brian Poirier ◽  
Jonathan Williams ◽  
Dorothy Adcock ◽  
...  
Keyword(s):  
United States ◽  
Cohort Study ◽  
False Positive ◽  
False Positive Rate ◽  
The United States ◽  
Positive Test ◽  
Test Results ◽  
Rt Pcr ◽  
Positive Rate

By analyzing COVID-19 sequential COVID-19 test results of patients across the United States, we herein attempt to quantify some of the observations we've made around long-term infection (and false-positive rates), as well as provide observations on the uncertainty of sampling variability and other dynamics of COVID-19 infection in the United States. Retrospective cohort study of a registry of RT-PCR testing results for all patients tested at any of the reference labs operated by Labcorp® including both positive, negative, and inconclusive results, from March 1, 2020 to January 28, 2021, including patients from all 50 states and outlying US territories. The study included 22 million patients with RT-PCR qualitative test results for SARS-CoV-2, of which 3.9 million had more than one test at Labcorp. We observed a minuscule &lt;0.1% basal positive rate for follow up tests &gt;115 days, which could account for false positives, long-haulers, and/or reinfection but is indistinguishable in the data. In observing repeat-testing, for patients who have a second test after a first RT-PCR, 30% across the cohort tested negative on the second test. For patients who test positive first and subsequently negative within 96 h (40% of positive test results), 18% of tests will subsequently test positive within another 96-h span. For those who first test negative and then positive within 96 h (2.3% of negative tests), 56% will test negative after a third and subsequent 96-h period. The sudden changes in RT-PCR test results for SARS-CoV-2 from this large cohort study suggest that negative test results during active infection or exposure can change rapidly within just days or hours. We also demonstrate that there does not appear to be a basal false positive rate among patients who test positive &gt;115 days after their first RT-PCR positive test while failing to observe any evidence of widespread reinfection.

scholarly journals Audit of the first > 7500 noninvasive prenatal aneuploidy tests in a Swiss genetics center

2021 ◽  
Author(s):  
Anahita Bajka ◽  
Michael Bajka ◽  
Fabian Chablais ◽  
Tilo Burkhardt
Keyword(s):  
Pregnancy Outcome ◽  
False Positive Rate ◽  
Prenatal Testing ◽  
Accurate Method ◽  
Test Results ◽  
Data Set ◽  
Single Nucleotide ◽  
Noninvasive Prenatal Testing ◽  
Positive Rate

Abstract Objectives Noninvasive prenatal testing (NIPT) is actually the most accurate method of screening for fetal chromosomal aberration (FCA). We used pregnancy outcome record to evaluate a complete data set of single nucleotide polymorphism-based test results performed by a Swiss genetics center. Materials and methods The Panorama® test assesses the risk of fetal trisomies (21, 18 and 13), gonosomal aneuploidy (GAN), triploidy or vanishing twins (VTT) and five different microdeletions (MD). We evaluated all 7549 test results meeting legal and quality requirements taken in women with nondonor singleton pregnancies between April 2013 and September 2016 classifying them as high or low risk. Follow-up ended after 9 months, data collection 7 months later. Results The Panorama® test provided conclusive results in 96.1% of cases, detecting 153 FCA: T21 n = 76, T18 n = 19, T13 n = 15, GAN n = 19, VTT n = 13 and MD n = 11 (overall prevalence 2.0%). Pregnancy outcome record was available for 68.6% of conclusive laboratory results, including 2.0% high-risk cases. In this cohort the Panorama® test exhibited 99.90% sensitivity for each trisomy; specificity was 99.90% for T21, 99.98% for T18 and 99.94% for T13. False positive rate was 0.10% for T21, 0.02% for T18 and 0.06% for T13. Conclusion SNP-based testing by a Swiss genetics center confirms the expected accuracy of NIPT in FCA detection.

Sign in / Sign up

Export Citation Format

Share Document