Asbestos-related diseases in mineworkers: a clinicopathological study

The accurate diagnosis of asbestos-related diseases is important because of past and current asbestos exposures. This study evaluated the reliability of clinical diagnoses of asbestos-related diseases in former mineworkers using autopsies as the reference standard.Sensitivity, specificity, positive predictive value and negative predictive value were calculated.The 149 cases identified had clinical examinations 0.3–7.4 years before death. More asbestos-related diseases were diagnosed at autopsy rather than clinically: 77 versus 52 for asbestosis, 27 versus 14 for mesothelioma and 22 versus 3 for lung cancer. Sensitivity and specificity values for clinical diagnoses were 50.6% and 81.9% for asbestosis, 40.7% and 97.5% for mesothelioma, and 13.6% and 100.0% for lung cancer. False-negative diagnoses of asbestosis were more likely using radiographs of acceptable (versus good) quality and in cases with pulmonary tuberculosis at autopsy.The low sensitivity values are indicative of the high proportion of false-negative diagnoses. It is unlikely that these were the result of disease manifestation between the last clinical assessment and autopsy. Where clinical features suggest asbestos-related diseases but the chest radiograph is negative, more sophisticated imaging techniques or immunohistochemistry for asbestos-related cancers should be used. Autopsies are useful for the detection of previously undiagnosed and misdiagnosed asbestos-related diseases, and for monitoring clinical practice and delivery of compensation.

Download Full-text

Diagnostic role of bronchoalveolar lavage: A cytohistopathological correlation

Journal of Pathology of Nepal ◽

10.3126/jpn.v9i1.23173 ◽

2019 ◽

Vol 9 (1) ◽

pp. 1441-144

Author(s):

Prabesh Kumar Choudhary ◽

Niraj Nepal ◽

Nirajan Mainali ◽

Ram Hari Ghimire

Keyword(s):

Lung Cancer ◽

Predictive Value ◽

Malignant Tumors ◽

False Negative ◽

Bronchial Biopsy ◽

Medical College ◽

Diagnostic Role ◽

Risk Of Malignancy ◽

Diagnosis Of Lung Cancer ◽

Sensitivity Specificity

Background: Tumors of lung are common in Nepal. The risk of malignancy has to be judged prior to surgery for which bronchoscopy is often done. Brocho-alveolar lavage and bronchial biopsy are routine procedure done for diagnosis of lung cancer during bronchoscopy. This study was done to correlate the cytology of broncho-alveolar lavage specimen with histopathology in malignant tumors of the lug in our setup. Materials and methods: This study was conducted at department of pathology, Nobel Medical College from August 2017 to December 2018. Histopathology reports with malignancy were compared to their cytological diagnosis. Results: A total of 141 cases were included in the study. Among the study population, Bronchogenic carcinoma was found more prevalent in female. The sensitivity, specificity, positive predictive value, negative predictive value and overall accuracy of broncho-alveolar lavage in the diagnosis of lung cancer were 88.1%, 97.98%, 94.7%, 95.1% and 95.03% respectively. Conclusions: Brochoalveolar lavage cytology has a greater accuracy for the diagnosis of lung cancer; however, benign cases need regular follow up as there are false negative cases.

Download Full-text

381 Role of CT scans of abdomen and pelvis in management of patients with immunotherapy-induced colitis

Journal for ImmunoTherapy of Cancer ◽

10.1136/jitc-2020-sitc2020.0381 ◽

2020 ◽

Vol 8 (Suppl 3) ◽

pp. A406-A406

Author(s):

Juan Ibarra Rovira ◽

Raghunandan Vikram ◽

Selvi Thirumurthi ◽

Bulent Yilmaz ◽

Heather Lin ◽

...

Keyword(s):

Negative Predictive Value ◽

Clinical Diagnosis ◽

Predictive Value ◽

Clinical Symptoms ◽

Cytotoxic T Lymphocyte ◽

Checkpoint Inhibitors ◽

Ct Scans ◽

Wall Thickening ◽

Low Sensitivity ◽

Sensitivity Specificity

BackgroundColitis is one of the most common immune-related adverse event in patients who receive immune checkpoint inhibitors targeting cytotoxic T-lymphocyte antigen 4 (CTLA-4) and programmed cell death-1 (PD-1). Although radiographic changes are reported on computed tomography such as mild diffuse bowel thickening or segmental colitis, the utility of CT in diagnosis of patients with suspected immune-related colitis is not well studied.MethodsCT scans of the abdomen and pelvis of 34 patients on immunotherapy with a clinical diagnosis of immunotherapy induced colitis and 19 patients receiving immunotherapy without clinical symptoms of colitis (control) were enrolled in this retrospective study. Segments of the colon (rectum, sigmoid, descending, transverse, ascending and cecum) were assessed independently by two fellowship trained abdominal imaging specialists with 7 and 13 years‘ experience who were blinded to the clinical diagnosis. Each segment was assessed for mucosal enhancement, wall thickening, distension, peri-serosal fat stranding. Any disagreements were resolved in consensus. The degree of distension and the spurious assignment of wall thickening were the most common causes for disagreement. The presence of any of the signs was considered as radiographic evidence of colitis.ResultsCT evidence of colitis was seen in 16 of 34 patients with symptoms of colitis. 7 of 19 patients who did not have symptoms of colitis showed signs of colitis on CT. The sensitivity, specificity, Positive Predictive Value and Negative Predictive Value for colitis on CT is 47%, 63.2%, 69.5% and 40%, respectively.ConclusionsCT has a low sensitivity, specificity and negative predictive value for the diagnosis of immunotherapy-induced colitis. CT has no role in the diagnosis of patients suspected of having uncomplicated immune-related colitis and should not be used routinely for management.Trial RegistrationThis protocol is not registered on clinicaltrials.gov.Ethics ApprovalThis protocol was IRB approved on: 11/16/2015 - IRB 4 Chair Designee FWA #: 00000363 OHRP IRB Registration Number: IRB 4 IRB00005015ConsentThis protocol utilizes an IRB approved waiver of consent.

Download Full-text

Comparison of 2D Fat Suppressed Proton Density (FS-PD) and 3D (WATS-c) MRI pulse sequences in evaluation of chondromalacia patellae

Egyptian Journal of Radiology and Nuclear Medicine ◽

10.1186/s43055-019-0102-z ◽

2019 ◽

Vol 50 (1) ◽

Author(s):

Ahmed Ibrahim Tawfik ◽

Wael Hamza Kamr ◽

Saher Ebrahim Taman

Keyword(s):

Diagnostic Performance ◽

False Negative ◽

Pulse Sequences ◽

Proton Density ◽

Grading System ◽

Reference Standard ◽

Mr Images ◽

Arthroscopic Findings ◽

Chondromalacia Patella ◽

Sensitivity Specificity

Abstract Background Comparing the diagnostic performance of widely used 2D FSE technique (fat-suppressed proton density; FS-PD) and the 3D technique (water-selective cartilage scan; WATS-c) in evaluation of the chondromalacia patella by using arthroscopy as reference standard Results Seventy-five adult patients were enrolled in this study. They underwent MRI examinations then arthroscopy done in 2–4 days after it. MRI was done using 2D (FS-PD) and 3D (WATS-c) sequences and MR images were compared by two radiologists separately, then grading of the cartilage lesions was performed according to modified Noyes grading system and comparison between grade 0–1, 2, and 3 lesions was done using arthroscopic findings as a reference. A false-negative result is considered if there was undergrading of chondromalacia and false-positive result if chondromalacia was overgraded. Each sequence sensitivity, specificity, and accuracy was calculated by both readers. For reader 1, the sensitivity is 69% for WATS-c and 80% for FS-PD and the accuracy is 90% for WATS-c and 92% for FS-PD and for reader 2, the sensitivity is 56% for WATS-c and 84% for FS-PD and the accuracy is 88% for WATS-c and 94% for FS-PD. Conclusion 2D FS-PD images showed better diagnostic performance than 3D WATS-c images for evaluating chondromalacia patella.

Download Full-text

Drawing the line in the Edinburgh Postnatal Depression Scale (EPDS): a vital decision

International Journal of Adolescent Medicine and Health ◽

10.1515/ijamh.2011.005 ◽

2011 ◽

Vol 23 (1) ◽

Cited By ~ 8

Author(s):

Dagmar Lagerberg ◽

Margaretha Magnusson ◽

Claes Sundelin

Keyword(s):

Positive Predictive Value ◽

Predictive Value ◽

Postnatal Depression ◽

Edinburgh Postnatal Depression Scale ◽

Depression Scale ◽

Child Interaction ◽

Mother Child Interaction ◽

Problem Behaviours ◽

Low Sensitivity ◽

Sensitivity Specificity

Abstract Background: The Edinburgh Postnatal Depression Scale (EPDS) is widely used in early child health care. This study examined the appropriateness of the recommended EPDS cut-off score 11/12. Methods: Two main analyses were performed: 1. Associations between EPDS scores and maternal health behaviour, stress, life events, perceived mother-child interaction quality and child behaviour. 2. Screening parameters of the EPDS, i.e., sensitivity, specificity and positive predictive value. EPDS scores were available for 438 mothers and maternal questionnaires for 361 mothers. Results: Already in the EPDS score intervals 6–8 and 9–11, there were notable adversities, according to maternal questionnaires, in stress, perceived quality of mother-child interaction, perceived child difficultness and child problem behaviours. Using maternal questionnaire reports about sadness/distress postpartum as standard, the recommended EPDS cut-off score 11/12 resulted in a very low sensitivity (24%). The cut-off score 6/7 yielded a sensitivity of 61%, a specificity of 82% and a positive predictive value of 61%. Conclusions: In terms of both clinical relevance and screening qualities, an EPDS cut-off score lower than 11/12 seems recommendable.

Download Full-text

Evaluation of a Rapid Immunochromatographic test kit to the Gold Standard Fluorescent Antibody test for diagnosis of rabies in animals in Bhutan

10.21203/rs.2.19414/v3 ◽

2020 ◽

Author(s):

Tenzin Tenzin ◽

Kelzang Lhamo ◽

Purna B Rai ◽

Dawa Tshering ◽

Pema Jamtsho ◽

...

Keyword(s):

Predictive Value ◽

Fluorescent Antibody ◽

False Negative ◽

Rapid Test ◽

Antibody Test ◽

Reference Standard ◽

Predictive Values ◽

Percent Agreement ◽

Test Kit ◽

Resource Poor

Abstract Background: Rabies kills approximately 59,000 people in the world each year worldwide. Rapid and accurate diagnosis of rabies is important for instituting rapid containment measures and for advising the exposed people for postexposure treatment. The application of a rapid diagnostic tests in the field can greatly enhance disease surveillance and diagnostic activities, especially in resource poor settings. In this study, a total of 179 brain tissue samples collected from different rabies suspect animal species (113 dogs, 50 cattle, 10 cats, 3 goats, 2 horses, and 1 bear) were selected and tested using both rapid immunochromatographic kit and the reference standard fluorescent antibody test (FAT). We evaluated the sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of a rapid antigen detection test kit produced by BioNote, Inc. (Hwaseong-si, Korea) relative to a FAT for its fit-for-purpose for confirmation of clinical cases of rabies for early response and enhancing rabies surveillance. Results: Among 179 samples examined in this study, there was a concordance in results by the rapid test and FAT in 115 positive samples and 54 negative samples. Test results were discordant in 10 samples which were positive by FAT, but negative (false negative) by rapid kit. The rapid test kit showed a sensitivity of 92% (95% CI: 85.9 – 95.6) and specificity of 100% (95% CI: 93.4 – 100) using FAT as the reference standard. The positive and negative predictive values were found to be 100% (95% CI:96.7 – 100) and 84.4% (95% CI: 73.6 – 91.3), respectively. Overall, there was 94.4% (95% CI: 90 – 96.9) test agreement between rapid test and FAT (Kappa value = 0.874) with a positive percent agreement and negative percent agreement of 92 and 100%, respectively. Conclusions: Our finding demonstrated that the rapid test kit (BioNote) can be used for rabies surveillance and confirming clinical case of rabies in animals for making rapid decisions particularly controlling rabies outbreaks in resource poor settings.

Download Full-text

Diagnostic Value of Rapid On-Site Evaluation for CT-Guided Percutaneous Fine Needle Aspiration in the Diagnosis of Pulmonary Occupying Lesions

BioMed Research International ◽

10.1155/2020/9842768 ◽

2020 ◽

Vol 2020 ◽

pp. 1-8

Author(s):

Tian-Feng Peng ◽

Tao Ren ◽

Han-Sheng Wang ◽

Zhe-Xiang Feng ◽

Mei-Fang Wang

Keyword(s):

Lung Cancer ◽

Fine Needle Aspiration ◽

Predictive Value ◽

Rate Sensitivity ◽

Needle Aspiration ◽

Ct Guided ◽

Fine Needle ◽

Site Evaluation ◽

Sensitivity Specificity ◽

The Rose

Objective. Rapid on-site evaluation (ROSE) is an effective and efficient auxiliary examination, but its value for CT-guided percutaneous fine-needle aspiration (FNA) in the diagnosis of pulmonary occupying lesions is unclear. This study is aimed at evaluating the clinical utility of ROSE for CT-guided percutaneous FNA. Methods. We reviewed 234 patients from September 2018 to April 2019. The result using ROSE was compared with the final pathological diagnosis of CT-guided percutaneous FNA, and we also compared the complications between the ROSE group and the NO-ROSE group. The final pathological diagnosis results served as the gold standard. We also analyzed the diagnostic rate of FNA and the sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of malignancy. The correlation between diverse pathological types of lung cancer was also taken into consideration. Results. In total, 132 patients underwent CT-guided percutaneous FNA with ROSE (ROSE group), and 102 did not (NO-ROSE group). The diagnostic rate, sensitivity, specificity, PPV, and NPV of the ROSE group were 91.6%, 89.1%, 94.1%, 93.4%, and 90.1%, respectively. The complication rates of the ROSE group and the NO-ROSE group were 8.33% and 16.67%, respectively. This difference was not statistically significant ( P > 0.05 ). In subsets of adenocarcinoma (AC) and small cell lung cancer (SCLC) patients, the ROSE result was highly consistent with the final pathological result. Conclusion. CT-guided percutaneous FNA combined with ROSE has a high diagnostic rate, sensitivity, and specificity for pulmonary occupying lesions and an acceptable rate of complications. This method is worthy of wide use given its high efficiency and safety.

Download Full-text

Correlation of colposcopy with biopsy in cases of abnormal cervical cytology

Nepal Journal of Obstetrics and Gynaecology ◽

10.3126/njog.v14i1.26625 ◽

2019 ◽

Vol 14 (1) ◽

pp. 36-39

Author(s):

Kirtipal Subedi

Keyword(s):

Predictive Value ◽

Prospective Observational Study ◽

Accurate Diagnosis ◽

Cervical Cytology ◽

Histopathological Diagnosis ◽

Cervical Biopsy ◽

Abnormal Cervical Cytology ◽

Disease Threshold ◽

Sensitivity Specificity

Aims: This study aims to find out the role of colposcopy and its correlation with cervical biopsy in detection of pre malignant cervical lesion. Methodology: This is hospital based prospective observational study on 60 cases with abnormal cervical cytology reports conducted in the Department of Obstetrics and Gynecology, PMWH, Thapathali, Kathmandu. Colposcopy guided biopsies were done and findings noted. Results: Among 60 cases enrolled in the study the most common cervical cytology finding was ASCUS, LSIL, HSIL and ASC-H present in 46.6%, 31.6%, 15% and 6.6% respectively. The colposcopy finding among these cases was normal, CIN1, CIN 2 and CIN 3 in 45%, 23.3%, 16.7% and 9% respectively. Among these cases the most common biopsy finding was normal, CIN 1, CIN 2, CIN 3 and squamous cell carcinoma in 55%, 18.3%, 8.3%, 15% and 3.3% respectively. The sensitivity, specificity, positive predictive value and negative predictive value of colposcopy with CIN 1 as disease threshold was calculated to be 80.6%, 93.1%, 81.8% and 92.6% respectively. While evaluating the validity of colposcopy with histopathology, colposcopy seems to make an accurate diagnosis in 75% of cases, overestimating in 15% and underestimating in 8% of cases. Conclusions: There is a good correlation of colposcopy with histopathological diagnosis of cervical cancer. Keywords: colposcopy, cytology, diagnosis, premalignant

Download Full-text

An assessment of chromosomal alterations detected by fluorescence in situ hybridisation in pancreatobiliary tract malignancy

BMC Gastroenterology ◽

10.1186/s12876-020-01439-0 ◽

2020 ◽

Vol 20 (1) ◽

Author(s):

Xiaohong Pu ◽

Hongwei Zheng ◽

Xin Yang ◽

Qing Ye ◽

Zhiwen Fan ◽

...

Keyword(s):

Predictive Value ◽

In Situ Hybridisation ◽

False Negative ◽

Chinese Patients ◽

Fluorescence In Situ Hybridisation ◽

Predictive Values ◽

Formalin Fixed Paraffin Embedded ◽

9P21 Locus ◽

Sensitivity Specificity

Abstract Background Using fluorescence in situ hybridisation (FISH) to detect any gain of chromosomes 3, 7, or 17 and loss of the 9p21 locus has been proven to be sensitive in the diagnosis of pancreatobiliary tumors. However, both genetic and environmental factors contribute to the pathogenesis of pancreatobiliary tumors. Therefore, it is unknown whether this method is suitable for Chinese patients with pancreatobiliary tumors. This study aims to compare the sensitivity, specificity, predictive values and accuracy of cytology, ERCP/MRCP and FISH based on Chinese patients with pancreatobiliary tumors,and to analyze differences between brushing-based and formalin-fixed paraffin-embedded (FFPE)-based FISH. Methods A total of 66 brush cytology specimens obtained during ERCP were detected by FISH and cytology test respectively to compare the sensitivity, specificity, predictive values and accuracy. Besides, FFPE-based FISH was performed on 46 corresponding paraffin sections of pancreatobiliary tumors obtained by surgical resection. Results Our findings demonstrate that FISH greatly improves diagnostic sensitivity and negative predictive value compared to ERCP/MRCP and cytology without much reduction in specificity and positive predictive value. However, our results also indicate that FFPE-based FISH could not effectively identify the false-negative of brushing-based FISH. Conclusions We believe that FISH can effectively distinguish true positive and false positive results of cytological or radiological suspicions of malignancy. However, FFPE-based FISH still does not precisely recognize the false-negative of brushing-based FISH. Both cytology-based and PPFE-based FISH had limitation in some specimens.

Download Full-text

Yield of Total Body GA-67 Scintigraphy in the Staging of Non-Small Cell Lung Cancer

Tumori Journal ◽

10.1177/030089168907500111 ◽

1989 ◽

Vol 75 (1) ◽

pp. 38-42 ◽

Cited By ~ 5

Author(s):

Gianfranco Buccheri ◽

Ferruccio Vola ◽

Domenico Ferrigno ◽

Antonio Curcio

Keyword(s):

Lung Cancer ◽

Small Cell Lung Cancer ◽

Cell Lung Cancer ◽

False Negative ◽

Small Cell ◽

Whole Body ◽

Small Cell Lung ◽

Mediastinal Disease ◽

Metastatic Sites ◽

Sensitivity Specificity

One hundred and one patients with histologically proved non-small cell lung cancer underwent whole body gallium-67 (TB Ga-67) scintigraphy as a part of their routine pretreatment evaluation. Twenty-eight of these patients were subsequently operated and pathologically staged for hilar and mediastinal disease. Two other patients underwent mediastinoscopy, but were judged unresectable at that time. All had computed tomography (CT) of the thorax, as well as radionuclide or CT scans of suspicious metastatic areas, and were carefully followed-up. When possible, a biopsy was performed of each suspected metastasis. Primary lung tumors concentrated Ga-67 in 94 patients. Sensitivity, specificity, and accuracy for hilar and mediastinal node metastases were 58%, 89%, and 77%, respectively. There were no false-negative gallium scans as regards secondary involvement of both liver and bone, whereas only 1 of the 4 brain metastases was detected by the technique. Sensitivity, specificity, and accuracy for all metastatic sites were 82%, 38%, and 56%, respectively. Fifty-five patients were classified as having a more advanced stage of disease by TB Ga-67 scintigraphy than at the initial clinical evaluation. However, 42 gallium-staged patients were ultimately re-classified differently according to all available clinical data. Using TB Ga-67 scintigraphy, 21 patients were found to have occult metastases which would not otherwise have been recognized; for the above reason, an unnecessary intervention was avoided in 6 of them.

Download Full-text

Test of a Noninvasive Instrument for Measuring Hemoglobin Concentration

International Journal of Technology Assessment in Health Care ◽

10.1017/s0266462300008527 ◽

1989 ◽

Vol 5 (4) ◽

pp. 659-667 ◽

Cited By ~ 14

Author(s):

Constanza I. Sanchez-Carrillo ◽

Teresita de Jesus Ramirez-Sanchez ◽

Marcela Zambrana-Castañeda- ◽

Beatrice J. Selwyn

Keyword(s):

Decision Making ◽

Negative Predictive Value ◽

Predictive Value ◽

False Negative ◽

Hemoglobin Concentration ◽

Reliability Test ◽

Intraobserver Variability ◽

Hemoglobin Content ◽

False Negatives ◽

Sensitivity Specificity

A colorimetric instrument for the noninvasive quantification of hemoglobin, designed using color shades resembling those observed in the conjunctiva, was tested. The instrument's colors are contrasted against the color of the conjunctiva to measure hemoglobin content. Sensitivity, specificity, negative predictive value, and false-negative value were estimated to test the instrument's accuracy; kappa coefficients were used to estimate inter- and intraobserver variability. Physician field evaluations of conjunctiva color for the screening of anemia, reported in the literature, have had sensitivities and specificities as high as 70%. Readings with the instrument demonstrated a 63% sensitivity, 72% specificity, and 38% false negatives for screening hemoglobin values of less than or equal to 13 g/dl. The interobserver kappa coefficients for three pairs of readers were good to excellent for the same hemoglobin screening value. Statistically significant differences were noted, however, between observers during the reliability test. The instrument can be used by unskilled personnel to improve their decision-making about whom to send for futher care or for supplementation with iron.

Download Full-text