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.

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.

scholarly journals The Role of Osteocalcin and Alkaline Phosphatase Immunohistochemistry in Osteosarcoma Diagnosis

2018 ◽  
Vol 2018 ◽  
pp. 1-5 ◽  
Author(s):  
Hasrayati Agustina ◽  
Ita Asyifa ◽  
Afiati Aziz ◽  
Bethy S. Hernowo
Keyword(s):  
Alkaline Phosphatase ◽  
Positive Predictive Value ◽  
Predictive Value ◽  
Bone Tumours ◽  
Small Specimen ◽  
Primary Bone ◽  
The Mean ◽  
Sensitivity Specificity ◽  
Primary Bone Tumours

Background. The diagnosis of Osteosarcoma (OSA) is not always straightforward. OSA may resemble Other Primary Bone Tumours (OPBT). The diagnosis of osteosarcoma is sometimes difficult especially in a very small specimen. Immunohistochemistry is one of ancillary testing types that can help the diagnosis of many tumours. The aim of this study was to evaluate the validity of Osteocalcin (OCN) and Alkaline Phosphatase (ALP) immunohistochemistry in discriminating OSA from OPBT. Method. This study included 50 selected human primary bone tumours, 25 cases of OSA and 25 cases of OPBT. Immunohistochemical evaluation of OCN and ALP was done for all cases. The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and overall accuracy were calculated. Result. The mean age of OSA and OPBT patients was 19.6±13.6 and 40.0±16.3 years, respectively. Osteocalcin was positive in 17/25 (68%) cases of OSA and 16/25 (64%) cases of OPBT (p=0.061). Alkaline Phosphatase was positive in 24/25 (96%) cases of OSA and 5/25 (20%) cases of OPBT (p<0.001). The sensitivity of OCN in OSA diagnosis was 68%, with specificity, PPV, NPV, and overall accuracy being 36%, 52%, 53%, and 52%, respectively. The sensitivity of ALP in OSA diagnosis was 96%, with specificity, PPV, NPV, and overall accuracy being 80%, 82.7%, 95.2%, and 88%, respectively. Conclusion. ALP immunohistochemistry is useful in discriminating OSA from OPBT. ALP is superior to OCN in OSA diagnosis. OCN cannot be used to differentiate between OSA and OPBT.

scholarly journals Pleural fluid serum bilirubin ratio for differentiating exudative and transudative effusions

2018 ◽  
Vol 56 (211) ◽  
pp. 662-665 ◽  
Author(s):  
Pawan Agrawal ◽  
Tirtha Man Shrestha ◽  
Pratap Narayan Prasad ◽  
Ramesh Prasad Aacharya ◽  
Priyanka Gupta
Keyword(s):  
Pleural Effusion ◽  
Pleural Fluid ◽  
Predictive Value ◽  
Serum Bilirubin ◽  
Clinical Decision ◽  
Final Diagnosis ◽  
University Teaching ◽  
Resource Limited ◽  
The Mean ◽  
Sensitivity Specificity

Background:  In pleural effusion, differentiating exudative and transudative fluid is an important clinical evaluation. The objective of the study was to determine the efficacy of pleural fluid serum bilirubin ratio in differentiating exudative and transudative effusions. In resource-limited settings with no facilities to measure lactate dehydrogenase (LDH) levels, using pleural fluid bilirubin ratio may help in better clinical decision. Methods:  It was a prospective observational study, conducted in the emergency department of Tribhuvan University Teaching Hospital. All the patients attending for emergency care with pleural effusion from 6th Jan 2015 to 5th Jan 2016 were included. The cases were divided as exudates and transudates on basis of final diagnosis. Serum and pleural fluid specimen were collected and sent for investigations. The data for various laboratory parameters especially those of lights criteria and bilirubin ratio were then analyzed and fluid nature was compared with results from parameters and final diagnoses. Results:  Among 103 cases, 71.84% had exudate and 28.16% had transudate. The commonest cause of effusion was pneumonia 35.92%, second being tubercular 23.30% followed by malignant effusion 12.60%, congestive heart failure 11.65%, chronic kidney disease 10.67% and liver cirrhosis 5.82%. The mean bilirubin ratio for exudates exceeded that for transudates. Considering the cutoff point of 0.6, the sensitivity, specificity, positive predictive value and negative predictive value were respectively 88.00%, 93.00%, 97.00% & 75.00%. Conclusions:   Pleural fluid serum bilirubin ratio can be utilized as a diagnostic tool for differentiating exudative and transudative effusions. Keywords:   bilirubin ratio; exudates; light’s criteria; pleural effusion; transudates.          

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.

scholarly journals Utility of tissue Xpert-Mtb/Rif for the diagnosis of intestinal tuberculosis in patients with ileocolonic ulcers

2019 ◽  
Vol 6 ◽  
pp. 204993611986393 ◽  
Author(s):  
Balaji L Bellam ◽  
Harshal S Mandavdhare ◽  
Kusum Sharma ◽  
Siddharth Shukla ◽  
Hariom Soni ◽  
...  
Keyword(s):  
Abdominal Pain ◽  
Positive Predictive Value ◽  
Retrospective Analysis ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
Intestinal Tuberculosis ◽  
Final Diagnosis ◽  
Intestinal Tissue ◽  
The Mean ◽  
Sensitivity Specificity

Introduction: Data on the use of Xpert Mtb/Rif for the diagnosis of intestinal tuberculosis is sparse. We report on the utility of Xpert Mtb/Rif testing for diagnosis of intestinal tuberculosis (ITB) in patients with ileocecal ulcers Methodology: We performed a retrospective analysis of patients with ileocecal ulcers and suspected to have ITB and in whom testing of intestinal tissue for Xpert Mtb/Rif was performed. The patients were divided into two groups: those with a final diagnosis of intestinal tuberculosis and those with other diagnosis. These patients were compared for clinical features and presentation. The sensitivity, specificity, positive predictive value, and negative predictive value of Xpert Mtb/Rif for the diagnosis of ITB were calculated. Results: Of the 40 patients studied, 23 were women and the mean age was 32.92 ± 12.78 years. Abdominal pain was present in 33 (88.5%) patients and diarrhea in 12 (30%). A total of 25 patients had underlying ITB whereas 15 patients had other diagnoses (Crohn’s disease, amebiasis, nonspecific ileitis, etc.). The sensitivity, specificity, negative predictive value, positive predictive value, and accuracy of GeneXpert-Mtb/Rif was 32% (CI: 14.95–53.50%), 100% (78.2–100), 46.88% (40.27–53.59%), 100 & 57.50 (40.89–72.89%) respectively. Conclusion: A positive GeneXpert-Mtb/Rif helps in the diagnosis of ITB, but the sensitivity is low.

scholarly journals Role of Maternal Serum Placental Protein 13 at 11-13 weeks of Pregnancy as a Predictor of Pre-eclampsia

2021 ◽  
Vol 7 (1) ◽  
pp. 47-51
Author(s):  
Mahfuja Asma ◽  
Farzana Sharmin ◽  
Firoza Begum ◽  
Mahbuba Begum ◽  
Muhammad Mahmud Alam
Keyword(s):  
Predictive Value ◽  
Area Under Curve ◽  
Antenatal Clinic ◽  
Mean Value ◽  
Maternal Serum ◽  
Elisa Technique ◽  
Placental Protein ◽  
The Mean ◽  
Sensitivity Specificity

Background: Prediction of pre-eclampsia is very important during pregnancy. Objective: The purpose of the present study was to find out the role of maternal serum placental protein 13 at 11 to 13 weeks of pregnancy as a predictor of pre-eclampsia. Methodology: This prospective cohort study was carried out including 83 pregnant women with early gestation (11-13 weeks) attending the antenatal clinic of BSMMU hospital, Dhaka, during the period of July 2019 to December 2019 for a period of six months. Maternal serum was taken for measurement of Placental Protein 13 by ELISA technique. Then the subjects were regularly followed up to term. At each visit they were clinically evaluated by measuring blood pressure and testing urine for protein by heat coagulation method. Proteinuria was confirmed by measuring 24 hour urinary total protein. Result: Out of 83 cases, 5 developed preeclampsia. The mean value of Placental Protein 13 in non-preeclampsia patients was 167.5±8.79 and in pre-eclamptic patients was 131.54±20.06. The cutoff point value of Placental Protein 13 for prediction of preeclampsia was 0.68 MoM. Area under curve (AUC) was 0.93. Sensitivity, specificity, positive predictive value and negative predictive value of this test were 80.00%, 94.94%, 50.00% and 98.68% respectively. The accuracy of this test was 93.98%. Conclusion: In conclusion maternal serum Placental Protein 13 can predict risk of development of preeclampsia. Journal of National Institute of Neurosciences Bangladesh, January 2021, Vol. 7, No. 1, pp. 47-51

Transvaginal Ultrasonography and Saline Infusion Sonography Compared to Hysteroscopy for Diagnosis of Intracavity Lesion: A 4-Year Experience in Suburban Referral Hospital

2020 ◽  
Vol 103 (6) ◽  
pp. 585-593
Keyword(s):  
Predictive Value ◽  
Final Diagnosis ◽  
Saline Infusion ◽  
Transvaginal Ultrasonography ◽  
Histopathological Diagnosis ◽  
Endometrial Polyps ◽  
Saline Infusion Sonography ◽  
Submucous Myoma ◽  
Kappa Value ◽  
Sensitivity Specificity

Objective: To evaluate the accuracy of transvaginal ultrasonography (TVS) and saline infusion sonography (SIS) in use for the diagnosis of endometrial polyps and submucous myoma compared to hysteroscopy. Histopathology was considered as the gold standard for final diagnosis. Materials and Methods: The present retrospective study was conducted at Bhumibol Adulyadej Hospital, Bangkok, Thailand between January 2014 and December 2017. Medical records of 150 patients who attended for hysteroscopy and histopathological diagnosis were reviewed. The accuracy of TVS and SIS for the diagnosis of endometrial polyps and submucous myoma were determined. Results: Out of 150 enrolled cases, endometrial polyp was the most frequent hysteroscopic finding in participants of the present study (92/150). Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy of TVS, SIS, and hysteroscopy compared to pathologic reports for detection endometrial polyps were 71.7% versus 93.5% versus 97.8%, 38.5% versus 52.2% versus 68.2%, 80.5% versus 88.7% versus 92.8%, 27.8% versus 66.7% versus 88.2%, and 64.4% versus 85.2% versus 92.1%, respectively. The sensitivity, specificity, PPV, NPV, and accuracy of TVS, SIS, and hysteroscopy for detection of submucous myoma were 81.6% versus 92.1% versus 94.7%, 66.7% versus 86.9% versus 100%, 77.5% versus 92.1% versus 100%, 72.0% versus 86.9% versus 90.9%, and 75.4% versus 90.2% versus 96.6%, respectively. The kappa value from TVS, SIS, and hysteroscopy when the histopathologic reports were overall intrauterine abnormalities, endometrial polyps and submucous myoma were 0.45/0.43/0.72, 0.77/0.76/0.89, and 0.92/0.92/1.00, respectively. Conclusion: Sensitivity, specificity, PPV, NPV, accuracy, and kappa value of SIS for detecting endometrial polyps and submucous myoma were better than TVS. Keywords: Ultrasonography, Saline infusion sonography, Hysteroscopy, Accuracy

scholarly journals Eotaxins and Their Receptor as Biomarkers of Colorectal Cancer

2021 ◽  
Vol 10 (12) ◽  
pp. 2675
Author(s):  
Monika Zajkowska ◽  
Agnieszka Kulczyńska-Przybik ◽  
Maciej Dulewicz ◽  
Kamil Safiejko ◽  
Marcin Juchimiuk ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
Diagnostic Tests ◽  
Diagnostic Utility ◽  
Healthy Controls ◽  
Serum Concentrations ◽  
Chemiluminescent Microparticle Immunoassay ◽  
Sensitivity Specificity ◽  
Immunoenzymatic Assay

Colorectal cancer (CRC) is one of the most common malignancies. Despite the availability of diagnostic tests, an increasing number of new cases is observed. That is why it is very important to search new markers that would show high diagnostic utility. Therefore, we made an attempt to assess the usefulness of eotaxins, as there are few studies that investigate their significance, in patients with CRC. The study included 80 subjects (CRC patients and healthy volunteers). Serum concentrations of all eotaxins were measured using a multiplexing method (Luminex), while CCR3 was measured by immunoenzymatic assay (ELISA). CRP levels were determined by immunoturbidimetry and classical tumor marker levels (CEA and CA 19-9) and were measured using chemiluminescent microparticle immunoassay (CMIA). The highest usefulness among the proteins tested showed CCR3. Its concentrations were significantly higher in the CRC group than in healthy controls. The diagnostic sensitivity, specificity, positive and negative predictive value, and the area under the ROC curve (AUC) of CCR3 were higher than those of CA 19-9. The maximum values for sensitivity, negative predictive value, and AUC were obtained for a combination of CCR3 and CRP. Our findings suggest the potential usefulness of CCR3 in the diagnosis of CRC, especially in combination with CRP or CEA.

Comparison of Papanicolaou Test With Visual Detection Tests in Screening for Cervical Cancer and Developing the Optimal Strategy for Low Resource Settings

2010 ◽  
Vol 20 (5) ◽  
pp. 862-868 ◽  
Author(s):  
Pakhee Aggarwal ◽  
Swaraj Batra ◽  
Gauri Gandhi ◽  
Vijay Zutshi
Keyword(s):  
Cervical Cancer ◽  
Predictive Value ◽  
Visual Inspection ◽  
Visual Detection ◽  
Alternative Methods ◽  
Papanicolaou Test ◽  
Low Resource Settings ◽  
Low Resource ◽  
The Mean ◽  
Sensitivity Specificity

Objectives:To compare the sensitivity, specificity, positive and negative predictive values, and accuracy of Papanicolaou test with visual inspection with acetic acid (VIA)/VIA using magnification devices (VIAM) and develop the best strategy for screening in low resource settings.Materials and Methods:This is a prospective cross-sectional study on 408 symptomatic multiparous women in the reproductive age group, sequentially using the Papanicolaou test, the VIA, and the VIAM for screening. Women with a positive screening test underwent guided biopsy and endocervical curettage. The site of biopsy was recorded. Histopathological findings were taken as the "gold" standard in comparing the methods.Results:The mean (SD) age was 32.3 (6.8) years (range, 15-49 years), whereas the mean (SD) parity was 2.9 (1.2) (range, 1-9). Abnormal cytological findings were detected in 2.9% patients, whereas the remaining smears were negative for any intraepithelial lesion or malignancy. A total of 113 cases were screened positive by one/all methods. The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of the Papanicolaou test, the VIA, and the VIAM were 24, 98, 42, 96, and 94%; 95, 78, 19, 99, and 79%; and 95, 78, 19, 99, and 79%, respectively, for high-grade lesions.Conclusions:The Papanicolaou test had low sensitivity but high specificity, whereas visual detection methods had a high sensitivity in addition to being cheaper. Alternative methods of screening such as VIA/VIAM can be a valuable alternative to the Papanicolaou test for cervical cancer screening in low resource settings. Visual inspection using magnification devices may be of benefit over VIA in doubtful cases.

scholarly journals Role of Chemical Biomarkers in Prediction of Intra-Amniotic Infection in Cases with Preterm Premature Rupture of Membrane, Observational Study

2019 ◽  
Vol 3 (2) ◽  
Keyword(s):  
Interleukin 6 ◽  
Mean Value ◽  
Maternal Serum ◽  
P Value ◽  
Subclinical Infection ◽  
Premature Rupture ◽  
Cutoff Value ◽  
The Mean ◽  
Sensitivity Specificity

Introduction: Early recognition of subclinical intra-amniotic infection before development of clinical Chorioamnionitis dramatically improve neonatal outcome before affection of fetal neurological function. Objective: this study was conducted to evaluate the role of procalcitonin and interleukin-6 in early prediction of intrauterine infection in pregnant women with premature rupture of membranes. Methods: This observational prospective cohort study was conducted on 100 pregnant women with preterm premature rupture of membrane (PPROM), Patients were divided into 2 groups: Group I: with normal CRP and WBCs level. Group2: with subclinical infection which was detected by elevated WBCs count >15,000 c/mm3 and / or positive CRP. This group was divided into two groups (Group (II) and Group (III) according to development of Chorioamnionitis. follow up of these patients was done to detect the cutoff value of procalcitonin and interleukin-6 as a predictive indicator of clinical intra-amniotic infection in patients with premature rupture of membrane. Results: This study showed that the mean value of maternal serum PCT concentration was higher in patients with clinical infection than its concentration in patients without infection or with subclinical infection with P-value 0.0001 which is highly significant between the studied cases and with cutoff value was >0.67ng/ml, sensitivity, specificity, PPV, NPV was 88.7%, 42.9%, 79.7% and 60% respectively and the mean value of maternal serum IL-6 concentration was also higher in patients with clinical infection than its concentration in patients without infection or with subclinical infection with P-value 0.001which is highly significant between the studied cases and with cutoff value was >11.1pg/ ml, sensitivity, specificity, PPV, NPV was 67.9%, 61.9%, 81.8% and 43.3% respectively. Conclusion: maternal serum procalcitonin is a good predictor of clinical intra-amniotic infection with good sensitivity, specificity, PPV, NPV which is nearly good as CRP which is better than serum interleukin-6 regarding sensitivity

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