Reproducibility and refinement of urinary LH in the screening of progressive puberty in girls

Abstract Context First-voided urinary LH (FVU-LH) has been suggested as an alternative to gonadotropin-releasing hormone (GnRH) stimulation test for detection of precocious puberty. Objective To evaluate the reproducibility of FVU-LH, its correlation with basal and GnRH-stimulated gonadotropins, and its diagnostic value for differentiating progressive from non-progressive puberty. Design and participants Clinical and endocrine data were obtained from the medical records of 95 girls with suspected progressive puberty who underwent two consecutive FVU-LH tests. In 55 of these participants, GnRH stimulation test was performed close to the FVU-LH test. The reported cutoff levels of 5 IU/L and 1.16 IU/L for GnRH-stimulated LH and FVU-LH, respectively, were used as markers of progressive puberty, clinically defined as bone age advancement of >1 year and/or growth velocity SDS>2, in addition to thelarche. Results The two consecutive measurements of FVU-LH were highly correlated (r= 0.830; p<0.001). The higher of the two results was better correlated with basal gonadotropins and GnRH-stimulated LH. Furthermore, it aligned better with the clinical outcome of girls with early thelarche, which supports the approach of double tests of FVU-LH to distinguish progressive from non-progressive puberty. By comparison to GnRH-stimulated LH, the higher FVU-LH value had better sensitivity (68%), whereas peak LH had better specificity (91%) for the diagnosis of progressive puberty. Both tests had high positive predictive value and poor negative predictive value. Conclusions The higher value of paired FVU-LH tests can be used to screen girls with suspected progressive puberty and can reduce the need for GnRH stimulation test.

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Predictive Value of Dental Maturity for a Positive Gonadotropin-Releasing Hormone Stimulation Test Result in Girls with Precocious Puberty

Journal of Korean Medical Science ◽

10.3346/jkms.2017.32.2.296 ◽

2017 ◽

Vol 32 (2) ◽

pp. 296 ◽

Cited By ~ 6

Author(s):

Jee-Seon Baik ◽

Jin-Woo Choi ◽

Su Jin Kim ◽

Ji Hyun Kim ◽

Sollip Kim ◽

...

Keyword(s):

Precocious Puberty ◽

Predictive Value ◽

Gonadotropin Releasing Hormone ◽

Stimulation Test ◽

Releasing Hormone ◽

Hormone Stimulation ◽

Dental Maturity ◽

Test Result

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Analysis of D-dimer Levels in Deep Vein Thrombosis Patients

INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY ◽

10.24293/ijcpml.v26i2.1531 ◽

2020 ◽

Vol 26 (2) ◽

Author(s):

Anton Triyadi ◽

Rachmawati A. Muhiddin ◽

Agus Alim Abdullah

Keyword(s):

Predictive Value ◽

Medical Records ◽

Reference Value ◽

Diagnostic Value ◽

Rapid Diagnosis ◽

Vein Thrombosis ◽

The Mean ◽

Using Data ◽

Deep Vein ◽

D Dimer

It is reported the incidence of DVT is approximately 84 cases per 100,000 each year, with 30-50% of untreated DVT are atrisk for pulmonary embolism, causing a 12% increase in mortality rate. An accurate and rapid diagnosis of DVT is needed tominimize the risk of complications and prevent unnecessary anticoagulant therapy without waiting for the results of adiagnostic examination using ultrasound. This study aimed to determine the diagnostic value of plasma D-dimer levels onDoppler ultrasound for DVT diagnosis to help clinicians to select a rapid and accurate diagnostic test for DVT diagnosis. Thisresearch was a retrospective study using data from medical records and performed at the Medical Record Installation of Dr.Wahidin Sudirohusodo Hospital, Makassar, by taking data on patients with DVT along with the results of D-dimer andDoppler ultrasound from January to December 2018. D-dimer levels were measured using an immunoturbidimetric methodwith a reference value of<0.5 μg/mL. A total of 33 samples were obtained with a mean of D-dimer value was higher inpositive Doppler (5.29) compared to negative (2.31), although not statistically significant (p> 0.05). Also, the mean of Wellsscore was higher in positive Doppler (4.74) compared to negative (4.17), although not statistically significant (p> 0.05). Thediagnostic values of D-dimer were as follows: sensitivity of 92.6%, specificity of 33.3%, positive predictive value of 86.2%,negative predictive value of 50.0%, and accuracy of 81.8%. D-dimer test can be used both for screening and diagnostic testswith cut-off value ≥ 2 μg/mL.

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Evaluation of the clot burden score (cbs) for acute ischemic stroke (ais) in intent-to-treat patients.

Journal Of Cardiovascular, Neurovascular & Stroke ◽

10.32896/cvns.v1n1.11-15 ◽

2019 ◽

Vol 1 (1) ◽

pp. 11-15 ◽

Cited By ~ 1

Author(s):

Sarah Yaziz ◽

Ahmad Sobri Muda ◽

Wan Asyraf Wan Zaidi ◽

Nik Azuan Nik Ismail

Keyword(s):

Ischemic Stroke ◽

Clinical Outcome ◽

Acute Ischemic Stroke ◽

Predictive Value ◽

Area Under The Curve ◽

Rank Correlation ◽

Treatment Decision ◽

Roc Curves ◽

Significant Negative Correlation ◽

Clot Burden

Background : The clot burden score (CBS) is a scoring system used in acute ischemic stroke (AIS) to predict patient outcome and guide treatment decision. However, CBS is not routinely practiced in many institutions. This study aimed to investigate the feasibility of CBS as a relevant predictor of good clinical outcome in AIS cases. Methods: A retrospective data collection and review of AIS patients in a teaching hospital was done from June 2010 until June 2015. Patients were selected following the inclusion and exclusion criteria. These patients were followed up after 90 days of discharge. The Modified Rankin scale (mRS) was used to assess their outcome (functional status). Linear regression Spearman Rank correlation was performed between the CBS and mRS. The quality performance of the correlations was evaluated using Receiver operating characteristic (ROC) curves. Results: A total of 89 patients with AIS were analysed, 67.4% (n=60) male and 32.6% (n=29) female. Twenty-nine (29) patients (33.7%) had a CBS ?6, 6 patients (6.7%) had CBS <6, while 53 patients (59.6%) were deemed clot free. Ninety (90) days post insult, clinical assessment showed that 57 (67.6%) patients were functionally independent, 27 (30.3%) patients functionally dependent, and 5 (5.6%) patients were deceased. Data analysis reported a significant negative correlation (r= -0.611, p<0.001). ROC curves analysis showed an area under the curve of 0.81 at the cut-off point of 6.5. This showed that a CBS of more than 6 predicted a good mRS clinical outcome in AIS patients; with sensitivity of 98.2%, specificity of 53.1%, positive predictive value (PPV) of 76%, and negative predictive value (NPV) of 21%. Conclusion: CBS is a useful additional variable for the management of AIS cases, and should be incorporated into the routine radiological reporting for acute ischemic stroke (AIS) cases.

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DETEKSI ANTIBODI MULTIPEL HEPATITIS C DALAM DARAH DONOR

INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY ◽

10.24293/ijcpml.v21i3.738 ◽

2016 ◽

Vol 21 (3) ◽

pp. 261

Author(s):

Ranti Permatasari ◽

Aryati Aryati ◽

Budi Arifah

Keyword(s):

Hepatitis C ◽

Predictive Value ◽

Core Protein ◽

Rapid Test ◽

Antibody Test ◽

Diagnostic Value ◽

Hcv Infection ◽

Antibody Detection ◽

Hcv Rna ◽

Hcv Antibody

Hepatitis C (HCV) infection could be spread by blood transfusion. Screening of HCV in donor blood could prevent HCV infection to the recipient. HCV antibody test using rapid test of multiple antibody detection by immunochromatography method is an easy and rapid test that could detect four HCV antibodies separately. The aim of this study was to evaluate the diagnostic value of antibody HCV using multiple antibody detection rapid test in diagnosing HCV infection. This was an analytical observational study with a cross sectional design. The samples consisted of 42 donors’ blood serum from the Surabaya Branch of the Indonesian Red Cross which underwent HCV infection test using ELISA method. The samples were then tested using PCR HCV RNA as the gold standard and antibody HCV multiple antibodydetection rapid test The diagnostic value of HCV antibody test using multiple antibody detection rapid test by immunochromatography method showed a diagnostic sensitivity of 100%, diagnostic specificity of 75%, positive predictive value of 66.7% and negative predictive value of 100%, a diagnostic efficiency of 83.3%, with a positive probability ratio of 4 times. The most often positive antibody pattern was four (4) positive antibodies (core protein, NS3, NS4 and NS5). Core protein (CP) and NS3 were the most often positive antibodies. Based on this study result, the HCV antibody test using multiple antibody detection rapid test by immunochromatography method has a good diagnostic value.

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Added value of diffusion-weighted MRI in assessment of pleural lesions

Egyptian Journal of Radiology and Nuclear Medicine ◽

10.1186/s43055-021-00557-3 ◽

2021 ◽

Vol 52 (1) ◽

Author(s):

Youssriah Yahia Sabri ◽

Ikram Hamed Mahmoud ◽

Lamis Tarek El-Gendy ◽

Mohamed Raafat Abd El-Mageed ◽

Sally Fouad Tadros

Keyword(s):

Positive Predictive Value ◽

Negative Predictive Value ◽

Predictive Value ◽

Diagnostic Value ◽

Added Value ◽

Adc Value ◽

Pleural Diseases ◽

Conventional Mri ◽

Malignant Lesions

Abstract Background There are many causes of pleural disease including variable benign and malignant etiologies. DWI is a non-enhanced functional MRI technique that allows qualitative and quantitative characterization of tissues based on their water molecules diffusivity. The aim of this study was to evaluate the diagnostic value of DWI-MRI in detection and characterization of pleural diseases and its capability in differentiating benign from malignant pleural lesions. Results Conventional MRI was able to discriminate benign from malignant lesions by using morphological features (contour and thickness) with sensitivity 89.29%, specificity 76%, positive predictive value 89%, negative predictive value 76.92%, and accuracy 85.37%. ADC value as a quantitative parameter of DWI found that ADC values of malignant pleural diseases were significantly lower than that of benign lesions (P < 0.001). Hence, we discovered that using ADC mean value of 1.68 × 10-3 mm2/s as a cutoff value can differentiate malignant from benign pleural diseases with sensitivity 89.3%, specificity 100%, positive predictive value 100%, negative predictive value 81.2%, and accuracy 92.68% (P < 0.001). Conclusion Although DWI-MRI is unable to differentiate between malignant and benign pleural effusion, its combined morphological and functional information provide valid non-invasive method to accurately characterize pleural soft tissue diseases differentiating benign from malignant lesions with higher specificity and accuracy than conventional MRI.

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Rapid progressive central precocious puberty: diagnostic and predictive value of basal sex hormone levels and pelvic ultrasound

Journal of Pediatric Endocrinology and Metabolism ◽

10.1515/jpem-2019-0577 ◽

2020 ◽

Vol 33 (6) ◽

pp. 785-791

Author(s):

Valeria Calcaterra ◽

Catherine Klersy ◽

Federica Vinci ◽

Corrado Regalbuto ◽

Giulia Dobbiani ◽

...

Keyword(s):

Precocious Puberty ◽

Tanner Stage ◽

Central Precocious Puberty ◽

Bone Age ◽

Diagnostic Value ◽

Sex Hormone ◽

Pelvic Ultrasound ◽

Predictive Values ◽

Hormone Levels ◽

Ultrasound Parameters

AbstractObjectivesData on the predictive values of parameters included in the diagnostic work-up for precocious puberty (PP) remain limited. We detected the diagnostic value of basal sex hormone levels, pelvic ultrasound parameters and bone age assessment for activation of the hypothalamic-pituitary-gonadal axis in girls with PP, in order to help in the decision to perform GnRH testing.Patients and methodsWe retrospectively considered 177 girls with PP. According to puberty evolution, the girls were divided into two groups: rapid progressive central precocious puberty (RP-CPP) and non/slowly progressive/transient forms (SP-PP). In all patients we considered Tanner stage, basal luteinizing hormone (LH) and estradiol (E2) values, bone age, and pelvis examination. We assessed the diagnostic value of each variable and identified the number of pathological parameters that best identify patients with RP-CPP.ResultsBasal LH ≥ 0.2IU/L, E2 level ≥ 50 pmol/L, uterine longitudinal diameter ≥ 3.5 cm, transverse uterine diameter ≥ 1.5 cm, endometrial echo and ovarian volume ≥ 2 cm3 were significantly associated with RP-CPP (p ≤ 0.01). The ability to diagnose RP-CPP was enhanced with increasing number of pathological hormonal and instrumental parameters (p < 0.001). With more than three parameters detected, sensitivity and specificity reached 58% (95%CI 48–67) and 85% (95%CI 74–92), respectively, with a PPV = 86% (95%CI 76–93) and PPN = 54% (95%CI 43–54); the area under the ROC curve was 0.71 (95%CI 0.65–0.78).ConclusionDespite the availability of different tests, diagnosing RP-CPP remains difficult. A diagnosis model including at least three hormonal and/or ultrasound parameters may serve as a useful preliminary step in selecting patients who require GnRH testing for early detection of RC-PP.

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Should Contrast-Enhanced Harmonic Endoscopic Ultrasound Be Incorporated into the International Consensus Guidelines to Determine the Appropriate Treatment of Intraductal Papillary Mucinous Neoplasm?

Journal of Clinical Medicine ◽

10.3390/jcm10091818 ◽

2021 ◽

Vol 10 (9) ◽

pp. 1818

Author(s):

Tomohiro Yamazaki ◽

Mamoru Takenaka ◽

Shunsuke Omoto ◽

Tomoe Yoshikawa ◽

Rei Ishikawa ◽

...

Keyword(s):

Intraductal Papillary Mucinous Neoplasm ◽

Predictive Value ◽

Diagnostic Value ◽

Consensus Guidelines ◽

International Consensus ◽

Mucinous Neoplasm ◽

Appropriate Treatment ◽

Contrast Enhanced ◽

Diagnostic Values ◽

International Consensus Guidelines

This study aimed to investigate whether the incorporation of contrast-enhanced harmonic endoscopic ultrasound (CH-EUS) into the international consensus guidelines (ICG) for the management of intraductal papillary mucinous neoplasm (IPMN) could improve its malignancy diagnostic value. In this single-center retrospective study, 109 patients diagnosed with IPMN who underwent preoperative CH-EUS between March 2010 and December 2018 were enrolled. We analyzed each malignancy diagnostic value (sensitivity (Se), specificity (Sp), positive predictive value (PPV), and negative predictive value (NPV)) by replacing fundamental B-mode EUS with CH-EUS as the recommended test for patients with worrisome features (WF) (the CH-EUS incorporation ICG) and comparing the results to those obtained using the 2017 ICG. The malignancy diagnostic values as per the 2017 ICG were 78.9%, 42.3%, 60.0%, and 64.7% for Se, Sp, PPV, and NPV, respectively. The CH-EUS incorporation ICG plan improved the malignancy diagnostic values (Se 78.9%/Sp, 53.8%/PPV, 65.2%/NPV 70.0%). CH-EUS may be useful in determining the appropriate treatment strategies for IPMN.

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Value of Vascular and Non-Vascular Pattern on Computed Tomography Perfusion in Patients With Acute Isolated Aphasia

Stroke ◽

10.1161/strokeaha.120.028821 ◽

2020 ◽

Vol 51 (8) ◽

pp. 2480-2487

Author(s):

Salvatore Rudilosso ◽

Alejandro Rodríguez ◽

Sergio Amaro ◽

Víctor Obach ◽

Arturo Renú ◽

...

Keyword(s):

Computed Tomography ◽

Ischemic Stroke ◽

Clinical Outcome ◽

Predictive Value ◽

Brain Perfusion ◽

Complete Recovery ◽

Vascular Perfusion ◽

Computed Tomography Perfusion ◽

Stroke Mimic ◽

Ischemic Attack

Background and Purpose: Acute onset aphasia may be due to stroke but also to other causes, which are commonly referred to as stroke mimics. We hypothesized that, in patients with acute isolated aphasia, distinct brain perfusion patterns are related to the cause and the clinical outcome. Herein, we analyzed the prognostic yield and the diagnostic usefulness of computed tomography perfusion (CTP) in patients with acute isolated aphasia. Methods: From a single-center registry, we selected a cohort of 154 patients presenting with acute isolated aphasia who had a whole-brain CTP study available. We collected the main clinical and radiological data. We categorized brain perfusion studies on CTP into vascular and nonvascular perfusion patterns and the cause of aphasia as ischemic stroke, transient ischemic attack, stroke mimic, and undetermined cause. The primary clinical outcome was the persistence of aphasia at discharge. We analyzed the sensitivity, specificity, positive and negative predictive values of perfusion patterns to predict complete clinical recovery and ischemic stroke on follow-up imaging. Results: The cause of aphasia was an ischemic stroke in 58 patients (38%), transient ischemic attack in 3 (2%), stroke mimic in 68 (44%), and undetermined in 25 (16%). CTP showed vascular and nonvascular perfusion pattern in 62 (40%) and 92 (60%) patients, respectively. Overall, complete recovery occurred in 116 patients (75%). A nonvascular perfusion pattern predicted complete recovery (sensitivity 75.9%, specificity 89.5%, positive predictive value 95.7%, and negative predictive value 54.8%), and a vascular perfusion pattern was highly predictive of ischemic stroke (sensitivity 94.8%, specificity 92.7%, positive predictive value 88.7%, and negative predictive value 96.7%). The 3 patients with ischemic stroke without a vascular perfusion pattern fully recovered at discharge. Conclusions: CTP has prognostic value in the workup of patients with acute isolated aphasia. A nonvascular pattern is associated with higher odds of full recovery and may prompt the search for alternative causes of the symptoms.

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