The value of quantitative histology in the diagnosis of fracture-related infection

2018 ◽  
Vol 100-B (7) ◽  
pp. 966-972 ◽  
Author(s):  
M. Morgenstern ◽  
N. A. Athanasou ◽  
J. Y. Ferguson ◽  
W-J. Metsemakers ◽  
B. L. Atkins ◽  
...  
Keyword(s):  
Positive Predictive Value ◽  
High Power ◽  
Predictive Value ◽  
Histological Analysis ◽  
Single Specimen ◽  
High Power Field ◽  
Infected Nonunion ◽  
Aseptic Nonunions ◽  
Aseptic Nonunion

Aims This study aimed to investigate the role of quantitative histological analysis in the diagnosis of fracture-related infection (FRI). Patients and Methods The clinical features, microbiology culture results, and histological analysis in 156 surgically treated nonunions were used to stratify the likelihood of associated infection. There were 64 confirmed infected nonunions (one or more confirmatory criteria: pus, sinus, and bacterial growth in two or more samples), 66 aseptic nonunions (no confirmatory criteria), and 26 possibly infected nonunions (pathogen identified from a single specimen and no confirmatory criteria). The histological inflammatory response was assessed by average neutrophil polymorph (NPs) counts per high-power field (HPF) and compared with the established diagnosis. Results Assuming a cut-off of over five neutrophils per high-power field to diagnose septic nonunion, there was 80% sensitivity and 100% specificity (accuracy 90%). Using a cut-off of no neutrophils seen in any high-power field to diagnose aseptic nonunion, there was a sensitivity of 85% and a specificity of 98% (accuracy 92%). Conclusion Histology can be used in a bimodal fashion as a diagnostic test for FRI. The presence of more than five NPs/HPF had a positive predictive value for infected nonunion of 100%, while the complete absence of any NPs is almost always indicative of an aseptic nonunion (positive predictive value of 98%). Cite this article: Bone Joint J 2018;100-B:966–72.

Study of Role of Ultrasonography in Evaluation of Thyroid Nodules

2019 ◽  
Vol 9 (1) ◽  
pp. 2-6
Author(s):  
Merina Gyawali ◽  
Prakash Sharma
Keyword(s):  
Positive Predictive Value ◽  
Predictive Value ◽  
Thyroid Nodules ◽  
Histological Analysis ◽  
Shape Sensitivity ◽  
Aspiration Cytology ◽  
Common Clinical Finding ◽  
Sensitivity Specificity ◽  
Pattern Sensitivity

Introduction: Thyroid nodules are a very common clinical finding which can be single ormultinodular and benign or malignant. Ultrasonography (USG) followed by USG guided fineneedle aspiration cytology (FNAC) is usually done in evaluating any thyroid nodule that ispalpable on physical examination. The purpose of this study was to study the role of USG in evaluating thyroid nodules and its correlation with findings of FNAC of thyroid. Methods: One hundred and twenty five patients with palpable thyroid referred for USG neckwere included in the study. Ultrasonography assessments of thyroid with different parameters were done. The findings were later compared with FNAC thyroid. Results: On FNAC and histological analysis, thyroid malignancy was observed in 14 out of 125 (11.21%) subjects. Malignant nodules on USG demonstrated hypoechoic pattern (sensitivity 82.3%, specificity 97.2%, and positive predictive value 82.3%), irregular margins (sensitivity 77.8%, specificity 96.3%, and accuracy 77.8%), central vascularity (sensitivity 82.3%, specificity 95.4%, and positive predictive value 73.7%) and taller-than-wider shape (sensitivity 82.3%, specificity 96.3%, and accuracy 77.8%). Sixteen cases with suspicion of malignant thyroid nodules demonstrated these 2 or more USG features. Sensitivity, specificity and positive predictive value of thyroid nodules for detecting malignancy increased to 87.5%, 98.2% and 87.5% respectively when two or more of these USG features were present. Conclusions: Thyroid USG demonstrating hypoechoic pattern, irregular margins, centralvascularity and taller-than-wider shape had potential of being malignant. Thyroid nodules were found to have more malignant potential when two or more of these USG features were present.

The role of histology in the diagnosis of spondylodiscitis

2019 ◽  
Vol 101-B (3) ◽  
pp. 246-252 ◽  
Author(s):  
E. Iwata ◽  
M. Scarborough ◽  
G. Bowden ◽  
M. McNally ◽  
Y. Tanaka ◽  
...  
Keyword(s):  
Predictive Value ◽  
Histological Analysis ◽  
Final Diagnosis ◽  
Diagnostic Sensitivity ◽  
Diagnostic Utility ◽  
High Power Field ◽  
Laboratory Investigations ◽  
The Mean ◽  
Sensitivity Specificity

AimsThe aim of this study was to determine the diagnostic utility of histological analysis in spinal biopsies for spondylodiscitis (SD).Patients and MethodsClinical features, radiology, results of microbiology, histology, and laboratory investigations in 50 suspected SD patients were evaluated. In 29 patients, the final (i.e. treatment-based) diagnosis was pyogenic SD; in seven patients, the final diagnosis was mycobacterial SD. In pyogenic SD, the neutrophil polymorph (NP) infiltrate was scored semi-quantitatively by determining the mean number of NPs per (×400) high-power field (HPF).ResultsOf the 29 pyogenic SD patients, 17 had positive microbiology and 21 positive histology (i.e. one or more NPs per HPF on average). All non-SD patients showed less than one NP per HPF. The presence of one or more NPs per HPF had a diagnostic sensitivity of 72.4%, specificity 100%, accuracy 100%, positive predictive value (PPV) 81.0%, and negative predictive value (NPV) 61.9%. Sensitivity, specificity, and accuracy were greater using the criterion of positive histology and/or microbiology than positive histology or microbiology alone. Granulomas were identified histologically in seven mycobacterial SD patients, and positive microbiology was detected in four.ConclusionThe diagnosis of pyogenic SD was more often confirmed by positive histology (one or more NPs per HPF on average) than by microbiology, although diagnostic sensitivity was greater when both histology and microbiology were positive. Cite this article: Bone Joint J 2019;101-B:246–252.

scholarly journals Role of diffusion-weighted magnetic resonance imaging in assessment of mammographically detected asymmetric densities

2020 ◽  
Vol 51 (1) ◽  
Author(s):  
Mohamed Zidan ◽  
Shimaa Ali Saad ◽  
Eman Abo Elhamd ◽  
Hosam Eldin Galal ◽  
Reem Elkady
Keyword(s):  
Positive Predictive Value ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
Benign Lesions ◽  
Adc Value ◽  
Dce Mri ◽  
Diffusion Weighted ◽  
Breast Asymmetries ◽  
Malignant Lesions

Abstract Background Asymmetric breast density is a potentially perplexing finding; it may be due to normal hormonal variation of the parenchymal pattern and summation artifact or it may indicate an underlying true pathology. The current study aimed to identify the role of diffusion-weighted imaging (DWI) and the apparent diffusion coefficient (ADC) values in the assessment of breast asymmetries. Results Fifty breast lesions were detected corresponding to the mammographic asymmetry. There were 35 (70%) benign lesions and 15 (30%) malignant lesions. The mean ADC value was 1.59 ± 0.4 × 10–3 mm2/s for benign lesions and 0.82 ± 0.3 × 10–3 mm2/s for malignant lesions. The ADC cutoff value to differentiate between benign and malignant lesions was 1.10 × 10–3 mm2/s with sensitivity 80%, specificity 88.6%, positive predictive value 75%, negative predictive value 91%, and accuracy 86%. Best results were achieved by implementation of the combined DCE-MRI and DWI protocol, with sensitivity 93.3%, specificity 94.3%, positive predictive value 87.5%, negative predictive value 97.1%, and accuracy 94%. Conclusion Dynamic contrast-enhanced MRI (DCE-MRI) was the most sensitive method for the detection of the underlying malignant pathology of breast asymmetries. However, it provided a limited specificity that may cause improper final BIRADS classification and may increase the unnecessary invasive procedures. DWI was used as an adjunctive method to DCE-MRI that maintained high sensitivity and increased specificity and the overall diagnostic accuracy of breast MRI examination. Best results can be achieved by the combined protocol of DCE-MRI and DWI.

The Role of Nasal Cytology in the Diagnosis of Chronic Sinusitis

1989 ◽  
Vol 3 (1) ◽  
pp. 13-15 ◽  
Author(s):  
Fredrick F. Gill ◽  
James B. Neiburger
Keyword(s):  
Allergic Rhinitis ◽  
High Power ◽  
Chronic Sinusitis ◽  
High Power Field ◽  
Nasal Cytology ◽  
Sinus Radiography

Currently the role of nasal cytology in the diagnosis of chronic sinusitis is not well defined. Therefore, we compared the results of nasal cytology with the results of sinus radiography in 300 patients with allergic rhinitis who had both tests performed as part of their initial allergy evaluation. Radiography was significantly more likely to be positive when there were >5 neutrophils/high-power field or <5 eosinophils/high-power field on nasal cytology. These findings were fairly sensitive but nonspecific as predictors of radiographic pathology.

The role of prostatic urethral biopsies as a staging tool for bladder cancer

2016 ◽  
Vol 10 (4) ◽  
pp. 359-363
Author(s):  
Adam W Nelson ◽  
Richard A Parker ◽  
Karan Wadhwa ◽  
Alexandra J Colquhoun ◽  
William H Turner
Keyword(s):  
Bladder Cancer ◽  
Positive Predictive Value ◽  
Retrospective Review ◽  
Predictive Value ◽  
Frozen Section ◽  
Prostatic Urethra ◽  
Published Data ◽  
Apical Margin ◽  
Single Centre

Objective: To determine the incidence of prostatic urethral involvement in our patient population and how prostatic urethral biopsy correlates with final cystectomy pathology. Patients and methods: We conducted a retrospective review of prostatic urethral biopsies (PUB) performed between February 2008 and April 2012 in a single centre. PUB pathology was correlated with cystectomy pathology. Results: PUB was undergone by 172 patients with a median age of 70 years (range: 37–84 years): There were 35 (20%) patients having a positive PUB and 137 (80%) who were negative. Of the 94 patients who underwent cystectomy, we found that when the entire prostatic urethra was sectioned, 20 (21%) patients had cancer in the prostatic urethra. Cancer was found in 17 (77%) of 22 patients with a positive PUB and in three (4%) out of the 72 with a negative PUB (positive predictive value (PPV) 77%, negative predictive value (NPV) 96%, sensitivity 85% and specificity 93%). In all 94 patients, the prostatic apical margin was negative. Conclusion: Disease in the prostatic urethra affected 20% of patients, consistent with published data. Prostatic urethral apical margins were all negative. Intra-operative frozen section would have missed cancer in the 20 patients with prostatic urethral cancer, whereas PUB identified 17 (85%) of the 20 patients. These data confirm the value of using PUB before cystectomy, in our UK population.

scholarly journals ROLE OF HYSTEROSALPINGOGRAPHY IN MANAGEMENT OF FEMALE INFERTILITY AND ITS LAPAROSCOPIC CORRELATION

2019 ◽  
pp. 1-2
Author(s):  
(prof.) Alka Agrawal
Keyword(s):  
Positive Predictive Value ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
Uterine Cavity ◽  
Fallopian Tubes ◽  
Radiographic Technique ◽  
Invasive Techniques ◽  
Work Up ◽  
Tubal Pathology

BACKGROUND : Infertility nowadays has become a medical as well as social problem.Laboratory findings alone is inconclusive in diagnosing infertility.HSG is the radiographic technique for evaluation of uterine cavity & fallopian tubes..Direct visualization of abdominal and pelvic organs in laparoscopy allows a definite diagnosis where clinical examination & less invasive techniques such as ultrasound & HSG fail to identify the abnormality. AIMS & OBJECTIVES :To determine the role of HSG in the evaluation of infertility & to correlate its findings with laparoscopy. METHODS : 75 infertile females aged between 20-40 years were included. HSG & laparoscopy was performed in all patients & findings were analysed. RESULTS : Sensitivity of HSG was 80 %,specificity was 76 % with positive predictive value 63%, negative predictive value 88 % in detecting tubal pathology. Sensitivity of HSG in detecting uterine pathology was 67%, specificity 73%, positive predictive value 39% and negative predictive value 89%. CONCLUSION : HSG has reasonably good sensitivity & specificity in diagnosing tubal & uerine pathology while laparoscopy has diagnostic as well as therapeutic approach.Hence they are complimentary to each other in infertility work up.

scholarly journals The role of rebound tenderness in acute appendicitis and appendicular perforation

2017 ◽  
Vol 4 (2) ◽  
pp. 725
Author(s):  
Yashwant R. Lamture ◽  
Varsha P. Gajbhiye
Keyword(s):  
Acute Appendicitis ◽  
Positive Predictive Value ◽  
Sensitivity And Specificity ◽  
Predictive Value ◽  
Study Data ◽  
Rebound Tenderness ◽  
Important Sign ◽  
Male Patients ◽  
Rule Out

Background: Acute appendicitis is the most common surgical emergency. Inspite of sophisticated new investigations mainstay of diagnosis depends on clinical sign and symptoms, rebound tenderness is very important sign with controversial views regarding it in available literature. Hence this study was undertaken to prove its efficacy of it related to rule out appendicular perforations.Methods: This study was conducted in 418 patients with 186 female and 251 male. Patients were of acute appendicitis operated for appendicectomy were included in the study. Data analysis was done by data statistic software.Results: The sensitivity and specificity of rebound tenderness to diagnose acute appendicitis is 65% and 73.6% respectively whereas the sensitivity and specificity of rebound tenderness to diagnose appendicular perforation was 94% and23.3% respectively with positive predictive value is 5 and negative predictive value is 99.Conclusions: Hence it indicates that rebound tenderness is very important to rule out complications like perforation or peritonitis and to support diagnosis of acute appendicitis. It has minimal significance to diagnose perforation of appendix as positive predictive value is less.

scholarly journals Role of laparoscopy in the Etiologic Diagnosis of Ascites of Unknown Origin

2017 ◽  
Vol 13 (1) ◽  
pp. 13-16
Author(s):  
Anup Sharma ◽  
P. Thapa ◽  
S. N. Gupta
Keyword(s):  
Positive Predictive Value ◽  
Peritoneal Carcinomatosis ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
College Teaching ◽  
Unknown Origin ◽  
Peritoneal Tuberculosis ◽  
Medical College ◽  
Etiologic Diagnosis

Introduction: Ascites is a consequence of many different etiologies, such as liver cirrhosis, neoplasm, tuberculous peritonitis, pyogenic peritonitis, congestive heart failure, renal and pancreatic diseases but, in some situations, ascites is of unknown cause in spite of comprehensive study. The aim of this study was to identify the role of laparoscopy in the etiological diagnosis of ascites of unknown origin.Methods: This was a prospective study of the patients who underwent diagnostic laparoscopy to determine the causes of ascites of unknown origin in the Department of Surgery, Nepalgunj Medical College Teaching Hospital from April 2012 to May 2014. All the patients underwent laparoscopy for the evaluation of ascites after appropriate clinical and laboratory examinations, which failed to reveal the cause.Results: Peritoneal tuberculosis and carcinomatosis peritonei were the two most common causes found in 37.14% and 57.14% of cases respectively. The average age of the patients was 52 years. Distension of abdomen, abdominal pain and weight loss were the most frequently observed symptoms in 33 patients (100%), 26 patients (74.28%) and 18 patients (51.42%) respectively. The CT scan findings, were a omental thickening in 28 cases (80%), peritoneal nodules in 7(20%) patients and the intraabdominal lymph nodes in 13 patients (39.39%). Ovarian mass was found in 4 patients (11.42%). The histological diagnosis was a peritoneal carcinomatosis in 13 (37.14%) patients and peritoneal tuberculosis in 20 (57.1%) patients and in two patients nonspecific inflammation. The sensitivity and specificity of laparoscopic diagnosis in the diagnosis of peritoneal tuberculosis were 78.67% and 98.6% respectively and in the diagnosis of peritoneal carcinomatosis were 94.78% and 72.2% respectively. The positive predictive value was 97.3% and the negative predictive value was 73.7% for peritoneal tuberculosis and for peritoneal carcinomatosis the positive predictive value was 83.7% and negative predictive value was 94.87%.Conclusion: The etiologic diagnosis of ascites of unknown origin is difficult despite the availability of several tests. Laparoscopy with peritoneal biopsy has still got a role in diagnosing these types of ascites where the other laboratory and imaging studies fail to reveal the cause.Journal of Nepalgunj Medical College Vol.13(1) 2015: 13-16

ROLE OF MAMMOGRAPHY AND CORE BIOPSY IN THE DIAGNOSIS OF BREAST TUMOR

2017 ◽  
pp. 69-72
Author(s):  
Trong Hung Phan ◽  
Cong Thuan Dang ◽  
Thanh Thao Nguyen
Keyword(s):  
Breast Cancer ◽  
Positive Predictive Value ◽  
Predictive Value ◽  
Breast Tumor ◽  
Core Biopsy ◽  
Breast Tumors ◽  
Breast Disease ◽  
University Hospital ◽  
Sensitivity Specificity

Introduction: Breast tumor is a popular disease. Breast cancer is the most common cancer in women. Mammography is the chosen screening test and ultrasound-guided core-needle biopsy provides (US-CNB) the pathologic result for treatment. Objective: To study the role of mammography and core biopsy in diagnosis of breast tumors. Materials and methodology: Prospective and retrospective study of 33 breast tumors examined mammograms at Hue University Hospital and Hue Central Hospital from 7/2014 to 4/2017. Results: Mean age of breast cancer: 52 years old, of benign breast disease: 53 years old. 86% of all cases admitted to hospital due to self-detecting breast tumor. Locations: 0-3h 33.3%, 9-12h 27.2%. Sensitivity, specificity and accuracy of mammography were 76.9%, 28.6% and 66.7% respectively. Sensitivity, specificity, positive predictive value, negative predictive value, accuracy value of US-CNB were 95.2%, 85.6%, 95.2%, 85.6% and 92.9%, respectively. The value of combined with mammograms and US-CNB has improved the specificity and positive predictive value to 100%, accuracy value to 95.2%. Moreover, this combination discovered 7.1% breast cancer more. Conclusion: US-CNB is a safe and less traumatic diagnostic tool with high pathologic efficiency. Combining mammography and US-CNB increases the diagnostic value. Key words: Breast tumor, breast cancer, mammograms

scholarly journals Role of ascitic fluid adenosine deaminase (ADA) and serum CA-125 in the diagnosis of tuberculous peritonitis

2015 ◽  
Vol 40 (3) ◽  
pp. 89-91 ◽  
Author(s):  
N Ali ◽  
NC Nath ◽  
R Parvin ◽  
A Rahman ◽  
TM Bhuiyan ◽  
...  
Keyword(s):  
Positive Predictive Value ◽  
Negative Predictive Value ◽  
Diagnostic Test ◽  
Ascitic Fluid ◽  
Predictive Value ◽  
Ca 125 ◽  
Histopathological Diagnosis ◽  
Diagnostic Modality ◽  
Cross Sectional

This cross sectional study was carried out in the department of gastroenterology, BIRDEM, Dhaka from January 2010 to May 2011 to determine the role of ascitic fluid ADA and serum CA-125 in the diagnosis of clinically suspected tubercular peritonitis. Total 30 patients (age 39.69±21.26, 18M/12F) with clinical suspicion of tuberculosis peritonitis were included in this study after analyzing selection criteria. Laparoscopic peritoneal biopsy with ‘histopathological diagnosis’ was considered gold standard against which accuracics of two biomarkers (ADA & CA-125) were compared. Cut off value of ADA and CA-125 are 24 u/l, 35 U/ml respectively. Sensitivity, specificity, positive predictive value, negative predictive value and accuracy of ADA as a diagnostic modality in tuberculos peritonitis were 87.5%, 83.33%, 95.45%, 62.5% and 86.67% respectively where as CA-125 was found to have 83.33% sensitivity, 50% specificity, 86.9% positive predictive value, 42.85% negative predictive value and 76.6% accuracy. Both biomarkers are simple, non-invasive, rapid and relatively cheap diagnostic test where as laparoscopy is an invasive procedure, costly & requires trained staff and not without risk and also not feasible in all the centre in our country. So ascitic fluid ADA and serum CA-125 are important diagnostic test for peritoneal tuberculosis.Bangladesh Med Res Counc Bull 2014; 40 (3): 89-91

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