scholarly journals The optimal duration of anti-tuberculous therapy before pericardiectomy in constrictive tuberculous pericarditis

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Likui Fang ◽  
Guocan Yu ◽  
Bo Ye ◽  
Fangming Zhong ◽  
Gang Chen
Keyword(s):  
Potential Benefit ◽  
Operating Characteristic ◽  
Postoperative Hospital Stay ◽  
Youden Index ◽  
Survival Outcomes ◽  
Optimal Cutoff ◽  
Chest Drainage ◽  
Cutoff Value ◽  
Tuberculous Pericarditis ◽  
Optimal Duration

Abstract Background It is unclear about the duration of anti-tuberculous therapy before pericardiectomy (DATT) in the patients with constrictive tuberculous pericarditis. This study aims to explore the optimal DATT and its impact on surgical outcomes in these patients. Methods We retrospectively enrolled 93 patients with constrictive tuberculous pericarditis undergoing pericardiectomy and divided them into two groups according to the optimal cutoff value of DATT which was determined by the receiver operating characteristic (ROC) curve and Youden Index. Postoperative and survival outcomes were compared between the two groups. Results The optimal cutoff value of DATT was 1.05 (months). The enrolled patients were divided into the DATT ≤ 1.05 group and the DATT > 1.05 group, with 24 (25.8%) and 69 (74.2%) cases, respectively. Comparing with the DATT ≤ 1.05 group, the DATT > 1.05 group had shorter postoperative ICU stay (P = 0.023), duration of chest drainage (P = 0.002), postoperative hospital stay (P = 0.001) and lower incidence of postoperative complications (P < 0.001). There were no statistical differences between the two groups in recurrence and survival outcomes. Conclusions It would be of potential benefit to enhance recovery after pericardiectomy if DATT lasted for at least 1 month in the patients with constrictive tuberculous pericarditis.

scholarly journals The Optimal Duration of Anti-Tuberculous Therapy Before Pericardiectomy in Constrictive Tuberculous Pericarditis

2020 ◽  
Author(s):  
Likui Fang ◽  
Guocan Yu ◽  
Fangming Zhong ◽  
Gang Chen ◽  
Bo Ye
Keyword(s):  
Statistical Difference ◽  
Operating Characteristic ◽  
Enhanced Recovery ◽  
Postoperative Hospital Stay ◽  
Youden Index ◽  
Survival Outcomes ◽  
Optimal Cutoff ◽  
Chest Drainage ◽  
Cutoff Value ◽  
Tuberculous Pericarditis

Abstract Background: It is unclear about the duration of anti-tuberculous therapy before pericardiectomy (DATT) in the patients with constrictive tuberculous pericarditis. This study aims to explore the optimal DATT and its impacts in these patients.Methods: We retrospectively enrolled 93 patients with constrictive tuberculous pericarditis undergoing pericardiectomy and divided them into two groups according to the optimal cutoff value of DATT which was determined by the receiver operating characteristic (ROC) curve and Youden Index. Postoperative and survival outcomes were compared between the two groups.Results: The optimal cutoff value of DATT was 1.05 (months). The enrolled patients were divided into the DATT≤1.05 group and the DATT>1.05 group, with 24 (25.8%) and 69 (74.2%) cases, respectively. Comparing with the DATT≤1.05 group, the DATT>1.05 group had shorter postoperative ICU stay (P=0.023), duration of chest drainage (P=0.002), postoperative hospital stay (P=0.001) and lower incidence of postoperative complications (P<0.001). There was no statistical difference between the two groups in recurrence and survival outcomes.Conclusions: It would be of great benefit to enhanced recovery after pericardiectomy in the patients with constrictive tuberculous pericarditis if DATT lasted for at least one month.

scholarly journals The Optimal Duration of Anti-tuberculous Therapy Before Pericardiectomy in Constrictive Tuberculous Pericarditis

2020 ◽  
Author(s):  
Likui Fang ◽  
Guocan Yu ◽  
Bo Ye ◽  
Fangming Zhong ◽  
Gang Chen
Keyword(s):  
Statistical Difference ◽  
Operating Characteristic ◽  
Enhanced Recovery ◽  
Postoperative Hospital Stay ◽  
Youden Index ◽  
Survival Outcomes ◽  
Optimal Cutoff ◽  
Chest Drainage ◽  
Cutoff Value ◽  
Tuberculous Pericarditis

Abstract Background: It is unclear about the duration of anti-tuberculous therapy before pericardiectomy (DATT) in the patients with constrictive tuberculous pericarditis. This study aims to explore the optimal DATT and its impacts in these patients.Methods: We retrospectively enrolled 93 patients with constrictive tuberculous pericarditis undergoing pericardiectomy and divided them into two groups according to the optimal cutoff value of DATT which was determined by the receiver operating characteristic (ROC) curve and Youden Index. Postoperative and survival outcomes were compared between the two groups.Results: The optimal cutoff value of DATT was 1.05 (months). The enrolled patients were divided into the DATT≤1.05 group and the DATT>1.05 group, with 24 (25.8%) and 69 (74.2%) cases, respectively. Comparing with the DATT≤1.05 group, the DATT>1.05 group had shorter postoperative ICU stay (P=0.023), duration of chest drainage (P=0.002), postoperative hospital stay (P=0.001) and lower incidence of postoperative complications (P<0.001). There was no statistical difference between the two groups in recurrence and survival outcomes.Conclusions: It would be of great benefit to enhanced recovery after pericardiectomy in the patients with constrictive tuberculous pericarditis if DATT lasted for at least one month.

scholarly journals The Optimal Cutoff Value of D-dimer Levels to Predict in Hospital Mortality in Severe Cases of Coronavirus Disease 2019

2021 ◽  
Vol 9 (B) ◽  
pp. 1561-1564
Author(s):  
Ngakan Ketut Wira Suastika ◽  
Ketut Suega
Keyword(s):  
Hospital Mortality ◽  
Receiver Operating Characteristic Curve ◽  
Receiver Operating Characteristic ◽  
Operating Characteristic ◽  
Characteristic Curve ◽  
Area Under The Curve ◽  
Optimal Cutoff ◽  
Cutoff Value ◽  
Operating Characteristic Curve ◽  
D Dimer

Introduction: Coronavirus disease 2019 (Covid-19) can cause coagulation parameters abnormalities such as an increase of D-dimer levels especially in severe cases. The purpose of this study is to determine the differences of D-dimer levels in severe cases of Covid-19 who survived and non-survived and determine the optimal cut-off value of D-dimer levels to predict in-hospital mortality. Method: Data were obtained from confirmed Covid-19 patients who were treated from June to September 2020. The Mann-Whitney U test was used to determine differences of D-dimer levels in surviving and non-surviving patients. The optimal cut-off value and area under the curve (AUC) of the D-dimer level in predicting mortality were obtained by the receiver operating characteristic curve (ROC) method. Results: A total of 80 patients were recruited in this study. Levels of D-dimer were significantly higher in non-surviving patients (median 3.346 mg/ml; minimum – maximum: 0.939 – 50.000 mg/ml) compared to surviving patients (median 1.201 mg/ml; minimum – maximum: 0.302 – 29.425 mg/ml), p = 0.012. D-dimer levels higher than 1.500 mg/ml are the optimal cut-off value for predicting mortality in severe cases of Covid-19 with a sensitivity of 80.0%; specificity of 64.3%; and area under the curve of 0.754 (95% CI 0.586 - 0.921; p = 0.010). Conclusions: D-dimer levels can be used as a predictor of mortality in severe cases of Covid-19.

scholarly journals Differentiation of pontine infarction by size

Open Medicine ◽  
2020 ◽  
Vol 15 (1) ◽  
pp. 160-166
Author(s):  
Lei Yang ◽  
Wei Qin ◽  
Yue Li ◽  
Shuna Yang ◽  
Hua Gu ◽  
...  
Keyword(s):  
Roc Curve ◽  
Operating Characteristic ◽  
Lesion Size ◽  
Parent Artery ◽  
Optimal Cutoff ◽  
Cutoff Value ◽  
High Prevalence ◽  
Pontine Infarction ◽  
Artery Disease ◽  
Diagnostic Indicator

AbstractPurposeWe hypothesized that the current criteria may be unsuitable for lacunar pontine infarctions (LPI) diagnosis and that size criteria may indicate different stroke mechanisms.MethodsA total of 102 patients with isolated pontine infarctions were divided into a parent artery disease (PAD) and non-PAD groups according to stenosis of basilar artery. Further, 86 patients from the non-PAD group were divided into paramedian pontine infarction (PPI) and LPI groups. Data were collected from the three groups. The “golden” criterion for LPI was established based on the location of the infarction. A receiver operating characteristic (ROC) curve were used to evaluate the optimal cutoff value to use as an LPI diagnostic indicator.ResultsThere was a high prevalence of patients with PAD in both asymptomatic carotid atherosclerosis (ACAS) and PPI groups. Patients with PPI had a higher prevalence in diabetes and ACAS than those with LPI. Based upon the ROC curve, the optimal lesion size cutoff value for use as an LPI diagnostic indicator was 11.8 mm.ConclusionsDiffusion weighted imaging (DWI) cutoff points for predicting LPI may differ from that of the middle cerebral artery territory. The diameter of LPI may also indicate different stroke mechanisms.

scholarly journals A Novel Inflammation-Based Prognostic Score: The Fibrinogen/Albumin Ratio Predicts Prognoses of Patients after Curative Resection for Hepatocellular Carcinoma

2018 ◽  
Vol 2018 ◽  
pp. 1-11 ◽  
Author(s):  
Qiaodong Xu ◽  
Yongcong Yan ◽  
Songgang Gu ◽  
Kai Mao ◽  
Jianlong Zhang ◽  
...  
Keyword(s):  
Roc Curve ◽  
Prognostic Value ◽  
Curative Resection ◽  
Operating Characteristic ◽  
Curve Analysis ◽  
Prognostic Scores ◽  
Roc Curve Analysis ◽  
Optimal Cutoff ◽  
Albumin Ratio ◽  
Cutoff Value

Background. Inflammation is an important hallmark of cancer. Fibrinogen and albumin are both vital factors in systemic inflammation. This study investigated the prognostic value of the fibrinogen/albumin ratio in HCC patients who underwent curative resection. Methods. HCC patients (n=151) who underwent curative resection were evaluated retrospectively. The optimal cutoff value for the fibrinogen/albumin ratio was selected by receiver operating characteristic (ROC) curve analysis. Correlations between preoperative fibrinogen/albumin ratios and clinicopathologic characteristics were analyzed by χ2 test. The area under the receiver operating characteristic curve (AUC) was calculated to compare the prognostic value of the fibrinogen/albumin ratio with other prognostic scores (neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR), and albumin-bilirubin (ALBI) score). The overall survival (OS) and time to recurrence (TTR) were assessed by the log-rank test and the Cox proportional hazard regression model. Results. An optimal cutoff value of the preoperative fibrinogen/albumin ratio (0.062) was determined for 151 patients who underwent curative resection for HCC via a ROC curve analysis. Fibrinogen/albumin ratio > 0.062 was significantly associated with microvascular invasion, an advanced BCLC stage, and ALBI grade. Multivariate analyses revealed that fibrinogen/albumin ratio was an independent predictor for OS (P=0.003) and TTR (P=0.035). The prognostic ability of fibrinogen/albumin ratio was comparable to other prognostic scores (NLR, PLR, and ALBI score) by AUC analysis. Patients with a fibrinogen/albumin ratio > 0.062 had lower 1-, 3-, and 5-year OS rates (66.0%, 41.8%, and 28.2% versus 81.9%, 69.3%, and 56.1%, resp., P<0.001) and higher 1-, 3-, and 5-year recurrence rates (60.9%, 79.2%, and 90.5% versus 49.5%, 69.1%, and 77.1%, resp., P=0.008) compared with patients with fibrinogen/albumin ratio ≤ 0.062. Conclusion. The preoperative fibrinogen/albumin ratio is an effective prognostic factor for HCC patients who underwent curative resection. An elevated fibrinogen/albumin ratio significantly correlates with poorer survival and a higher risk of recurrence in HCC patients.

scholarly journals AB0692 CLINICAL SIGNIFICANCE OF LIPID PROFILES IN PATIENTS WITH AXIAL SPONDYLOARTHRITIS

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1641.2-1641
Author(s):  
Y. Huang ◽  
M. Liu ◽  
Q. Huang ◽  
T. W. Li
Keyword(s):  
Ankylosing Spondylitis ◽  
Clinical Significance ◽  
Healthy Subjects ◽  
Axial Spondyloarthritis ◽  
Density Lipoprotein ◽  
Lipid Profiles ◽  
Youden Index ◽  
Optimal Cutoff ◽  
Cutoff Value ◽  
Auc Value

Background:Axial spondyloarthritis (axSpA) is a chronic inflammatory disease of the sacroiliac joints and spine. Lipid profiles, including total cholesterol(TC), high-density lipoprotein cholesterol(HDL-c), low-density lipoprotein cholesterol (LDL-c), TC/HDL-c, triglycerides(TG), have been reported to be changed regularly in axSpA patients. However, the clinical significance of lipid profiles in axSpA patients is controversial.Objectives:The study aims to determine the clinical significance of TC, HDL-c, LDL-c, TC/HDL-c, TG for axSpA patients.Methods:A total of 208 axSpA patients and 113 healthy subjects were enrolled in the study retrospectively. TC, HDL-c, LDL-c, TC/HDL-c, TG, C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), Bath Ankylosing Spondylitis Disease Activity Index(BASDAI) were collected. AxSpA patients were divided into remission axSpA group(BASDAI<4, n=123) and active axSpA group(BASDAI≥4, n=85). Relationships between the parameters were assessed by the Sperman’ s correlations analysis. Receiver operation characteristic (ROC) curves were used to discriminate axSpA patients from healthy subjects and active axSpA group from remission axSpA group.Results:TC, HDL-c, and TG in axSpA group were lower than those of control group, while TC/HDL-c was higher (P<0.05). ROC curve results showed that the AUC value of HDL-c for axSpA was 0.790 (CI95%: 0.740-0.839), yielding a highest AUC value. The optimal cutoff value of HDL-c for axSpA was 1.095, with the Youden index of 0.496, sensitivity of 65.5% and specificity of 84.1%. HDL-c was negatively correlated with BASDAI (r=-0.159, P=0.022). TC/HDL-c was positively correlated with BASDAI (r=0.183, P=0.008). Besides, TC/HDL-c, CRP, ESR in active axSpA group were higher than those of remission axSpA group, while HDL-c was lower (P<0.05). ROC curve results showed that the AUC value of TC/HDL-c and CRP for active axSpA group were 0.621 (CI95%: 0.543-0.700) and 0.634 (CI95%: 0.556-0.712), yielding a higher AUC value than other parameters. The optimal cutoff value of TC/HDL-c for active axSpA group was 4.429, with the Youden index of 0.201, sensitivity of 40.2% and specificity of 79.9%.Conclusion:HDL-c was decreased in axSpA patients with a highest diagnostic value, compared with healthy control. TC/HDL-c was elevated in active axSpA patients, showing a significant correlation to the disease activity of axSpA.References:[1]Gluszko P, Bonek K, Rupinski R, et al. LIPID PROFILE AND ACTIVE SYSTEMIC INFLAMMATION MAY DIFFERENTLY AFFECT THE PATHOMECHANISM OF CARDIOVASCULAR DISORDERS IN ANKYLOSING SPONDYLITIS (AS) AND IN PSORIATIC ARTHRITIS (PSA)[J]. ANNALS OF THE RHEUMATIC DISEASES. 2016: 1146.Acknowledgments:This study was supported by Science and Technology Project of Guangzhou Haizhu District (Haike Business Infox 2018-89).Disclosure of Interests:None declared

scholarly journals The Diagnostic Value of Synovial Fluid Lymphocytes in Gout Patients

2021 ◽  
Vol 2021 ◽  
pp. 1-6
Author(s):  
Qidang Huang ◽  
Yukai Huang ◽  
Xin Guo ◽  
Junming Chen ◽  
Zheng Zhong ◽  
...  
Keyword(s):  
Synovial Fluid ◽  
Laboratory Data ◽  
Diagnostic Value ◽  
Youden Index ◽  
Optimal Cutoff ◽  
Cutoff Value ◽  
Synovial Fluid Cell ◽  
Cell Counts ◽  
Synovial Fluid Lymphocytes ◽  
Fluid Cell

Objective. This study is aimed at investigating the diagnostic value of synovial fluid cell counts in gout patients. Methods. A total of 185 gout, 64 rheumatoid arthritis (RA), 26 axial spondyloarthritis (axSpA), and 24 osteoarthritis (OA) patients were included in the study. According to serum uric acid (sUA) levels on attack, gout patients were divided into normal sUA gout patients and high sUA gout patients. The laboratory data were recorded. ROC curves were generated to evaluate the diagnostic value of the variables for gout patients and normal sUA gout patients compared with RA, axSpA, and OA patients. Results. The synovial fluid white blood cell (WBC), peripheral blood mononuclear cell (PBMC), monocyte, polymorphonuclear (PMN), and neutrophil counts in gout patients were higher than those in OA patients ( P < 0.05 ). The synovial fluid PBMC and lymphocyte counts in gout patients were lower than those in RA and axSpA patients ( P < 0.05 ). ROC curve results showed that the AUC values of lymphocytes and sUA for gout patients were 0.728 and 0.881, respectively, which were higher than those of other variables. The optimal cutoff value of lymphocytes for gout was 1.362, with a Youden index of 0.439, a sensitivity of 83.3%, and a specificity of 60.6%. The AUC values of lymphocytes, sUA, and CRP for normal sUA gout patients were 0.694, 0.643, and 0.700, respectively, which were higher than those of other variables. The optimal cutoff value of lymphocytes for normal sUA gout patients was 1.362, with a Youden index of 0.422, a sensitivity of 81.6%, and a specificity of 60.6%. Conclusions. The synovial fluid cell counts of gout patients were different from those of RA, axSpA, and OA patients. Synovial fluid lymphocytes had a higher diagnostic value for gout.

scholarly journals Association of Polypharmacy and Potentially Inappropriate Medications With Physical Functional Impairments in Older Adults With Cancer

2021 ◽  
Vol 19 (3) ◽  
pp. 267-274
Author(s):  
Mostafa R. Mohamed ◽  
Erika Ramsdale ◽  
Kah Poh Loh ◽  
Huiwen Xu ◽  
Amita Patil ◽  
...  
Keyword(s):  
Older Adults ◽  
Activities Of Daily Living ◽  
Physical Function ◽  
Daily Living ◽  
Youden Index ◽  
Potentially Inappropriate Medications ◽  
Optimal Cutoff ◽  
Cutoff Value ◽  
Patient Reported ◽  
Inappropriate Medications

Background: Polypharmacy and potentially inappropriate medications (PIMs) are prevalent in older adults with cancer, but their associations with physical function are not often studied. This study examined the associations of polypharmacy and PIMs with physical function in older adults with cancer, and determined the optimal cutoff value for the number of medications most strongly associated with physical functional impairment. Methods: This cross-sectional analysis used baseline data from a randomized study enrolling patients aged ≥70 years with advanced cancer starting a new systemic cancer treatment. We categorized PIM using 2015 American Geriatrics Society Beers Criteria. Three validated physical function measures were used to assess patient-reported impairments: activities of daily living (ADL) scale, instrumental activities of daily living (IADL) scale, and the Older Americans Resources and Services Physical Health (OARS PH) survey. Optimal cutoff value for number of medications was determined by the Youden index. Separate multivariate logistic regressions were then performed to examine associations of polypharmacy and PIMs with physical function measures. Results: Among 439 patients (mean age, 76.9 years), the Youden index identified ≥8 medications as the optimal cutoff value for polypharmacy; 43% were taking ≥8 medications and 62% were taking ≥1 PIMs. On multivariate analysis, taking ≥8 medications was associated with impairment in ADL (adjusted odds ratio [aOR], 1.64; 95% CI, 1.01–2.58) and OARS PH (aOR, 1.73; 95% CI, 1.01–2.98). PIMs were associated with impairments in IADL (aOR, 1.72; 95% CI, 1.09–2.73) and OARS PH (aOR, 1.97; 95% CI, 1.15–3.37). A cutoff of 5 medications was not associated with any of the physical function measures. Conclusions: Physical function, an important component of outcomes for older adults with cancer, is cross-sectionally associated with polypharmacy (defined as ≥8 medications) and with PIMs. Future studies should evaluate the association of polypharmacy with functional outcomes in this population in a longitudinal fashion.

Diagnostic usefulness of differential time to positivity in neutropenic cancer patients with suspected catheter-related candidemia

2019 ◽  
Vol 58 (1) ◽  
pp. 137-140
Author(s):  
Kyeong Min Jo ◽  
Sungim Choi ◽  
Kyung Hwa Jung ◽  
Jung Wan Park ◽  
Ji Hyun Yun ◽  
...  
Keyword(s):  
Confidence Interval ◽  
Cancer Patients ◽  
Diagnostic Performance ◽  
Operating Characteristic ◽  
Characteristic Curve ◽  
Optimal Cutoff ◽  
Cutoff Value ◽  
Time To Positivity ◽  
Diagnostic Usefulness ◽  
Operating Characteristic Curve

Abstract Methods for distinguishing catheter-related candidemia (CRC) from non-CRC before catheter removal remain limited. We thus evaluated the diagnostic performance of differential time to positivity (DTP) to diagnose CRC in neutropenic cancer patients with suspected CRC. Of the 35 patients enrolled, 15 (43%) with CRC (six definite and nine probable) and 17 (49%) with non-CRC were finally analyzed. Based on the receiver operating characteristic curve, the optimal cutoff value of DTP for diagnosing CRC was ≥1.45 hours with the sensitivity 80% (95% confidence interval [CI], 51–95) and specificity 100% (95% CI, 80–100), respectively.

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