scholarly journals The progestogen challenge test in postmenopausal women: clinical and morphologic aspects

1996 ◽  
Vol 114 (3) ◽  
pp. 1166-1172
Author(s):  
Claudia de Carvalho Ramos Bortoletto ◽  
Edmund Chada Baracat ◽  
Wagner José Gonçalves ◽  
João Norberto Stávalle ◽  
Geraldo Rodrigues de Lima ◽  
...  
Keyword(s):  
Postmenopausal Women ◽  
Predictive Value ◽  
Fasting Blood Glucose ◽  
False Negative ◽  
Challenge Test ◽  
Endometrial Biopsy ◽  
Clinical Aspects ◽  
Age At Menarche ◽  
Histopathological Analysis ◽  
Negative Results

The clinical aspects and anatomopathological patterns of 150 postmenopausal women were studied using the progestogen challenge test. An endometrial biopsy was obtained and submitted to the progestogen test. A histopathological analysis of the uterine mucosa from women with a positive progestogen test revealed that the endometrium was active in 44 percent of cases and atrophic or inactive in 56 percent. In contrast, among women with a negative response, the endometrium was atrophic in 94 percent of cases and active in 6 percent. Analysis of clinical aspects did not show significant differences between groups in terms of age; age at menarche and at menopause; fasting blood glucose levels; or body mass. However, postmenopausal time was significantly shorter for women with a positive test, with a correlation between postmenopausal time of one to two years and test positivity. The progestogen challenge test for the detection of atrophic endometrium presented 78.57 percent sensitivity, 77.05 percent specificity, 44 percent positive predictive value, and 94 percent negative predictive value. Thus, when negative, the test is highly valuable, indicating the presence of atrophic endometrium in 94 percent of cases. False-negative results occurred in only 6 percent of the subjects, with no case of hyperplasia detected. However, when the response to the test was positive, the endometrium was atrophic in 56 percent of the cases. We suggest that, in order to avoid invasive procedures, the progestogen challenge test be combined with other methods such as transvaginal ultrasonography.

scholarly journals Evaluation of the Carba NP Test for Rapid Detection of Carbapenemase-Producing Enterobacteriaceae and Pseudomonas aeruginosa

2013 ◽  
Vol 57 (9) ◽  
pp. 4578-4580 ◽  
Author(s):  
Nathalie Tijet ◽  
David Boyd ◽  
Samir N. Patel ◽  
Michael R. Mulvey ◽  
Roberto G. Melano
Keyword(s):  
Pseudomonas Aeruginosa ◽  
Positive Predictive Value ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
Rapid Detection ◽  
False Negative ◽  
Bacterial Extract ◽  
Content Type ◽  
Negative Results ◽  
False Negative Results

ABSTRACTThe Carba NP test was evaluated against a panel of 244 carbapenemase- and non-carbapenemase-producingEnterobacteriaceaeandPseudomonas aeruginosaisolates. We confirmed the 100% specificity and positive predictive value of the test, but the sensitivity and negative predictive value were 72.5% and 69.2%, respectively, and increased to 80% and 77.3%, respectively, using a more concentrated bacterial extract. False-negative results were associated with mucoid strains or linked to enzymes with low carbapenemase activity, particularly OXA-48-like, which has emerged globally in enterobacteria.

Transhepatic forceps biopsy after PTCD for histological assessment of bile duct stenoses or occlusions

2019 ◽  
Vol 57 (02) ◽  
pp. 133-138
Author(s):  
Eva-Marie Warnken ◽  
Michael Uder ◽  
Hubert Stein ◽  
Michael Wucherer ◽  
Michael Lell ◽  
...  
Keyword(s):  
Predictive Value ◽  
False Negative ◽  
Short Term ◽  
Microsoft Excel ◽  
Ct Guided ◽  
Forceps Biopsy ◽  
Negative Results ◽  
False Negative Results ◽  
Pet Ct ◽  
Ct Guided Biopsy

Abstract Purpose The goal of this study was to evaluate the experience of 11 years of wire-guided forceps biopsy via PTCD in patients with obstructive jaundice. Materials and methods In a retrospective approach, 56 biopsies in 51 patients were analyzed (22 female, 29 male). Data was collected from 2006 to 2016. Mean age was 71 years (range: 34 – 86 years). Data was extracted from dig. Patients’ records (KIS, PACS, RIS) to be analyzed in Microsoft Excel. Results All 56 procedures were technically successful. Stenosis in anastomoses were benign due to scarring in 7 patients and in 9 due to papillitis or others. In 4 patients, results in anastomosis were malignant. In 19 patients without anastomosis, CCC was the diagnosis, thereof 10 klatskin, 9 stenosis in other locations, followed by gastric, pancreatic, and colon carcinoma in 5, 3, and 2 patients. Three patients had a CUP (multimetering in case of more than 1 related category). Overall results were 35 mal. and 16 benign, 76.8 % of all proc. had a correct histopathologic result, and 23.2 % were false negative. Sensitivity was 65.8 %, which results in negative predictive value of 58.1 %. There was no false positive and so specificity was 100 %, as was the positive predictive value. False negative results (no malignancy but clinically and imaging suspect) were corrected by rerunning the procedure, by CT-guided biopsy or by 1 PET-CT. In 1 case the surg. sample brought the result. Minor complications occurred in 8 patients: shivering in 1 case, distinct but hemodynamically not relevant hemobilia in 5 cases, 2 portovenal bleedings. All bleedings were short-term and self-limiting. Conclusion Despite good feasibility, low peri- and post-interv. risk and high validity the forceps biopsy via PTCD is not widely used. For experienced interventionalists, it is an effective method for obtaining histology.

scholarly journals Screening of Extended-Spectrum β-Lactamases (ESBL)-producing Klebsiella pneumoniae with ChromID ESBL Media

2018 ◽  
Vol 10 (3) ◽  
pp. 217-21
Author(s):  
Emy Noerwidayati ◽  
Andaru Dahesihdewi ◽  
Osman Sianipar
Keyword(s):  
Likelihood Ratio ◽  
Predictive Value ◽  
Clinical Laboratory ◽  
False Negative ◽  
Clinical Isolates ◽  
True Negative ◽  
Nasal Sinus ◽  
Negative Results ◽  
Extended Spectrum ◽  
Sensitivity Specificity

BACKGROUND: Klepsiella pneumoniae, one of clinical isolates, is frequently found causative agent of hospital acquired infection. Currently, K. pneumoniae is found as extended-Spectrum β-lactamases (ESBL) producer, allowing it to become multidrugresistant. A clinical laboratory with limited facility needs a valid, reliable, inexpensive and simple laboratory test to control its infection and antimicrobial-resistancy. The aim of this study is to evaluate the diagnostic performance of a ESBL media to detect ESBL-producing K. pneumoniae.METHODS: An independent and blind comparative study of ChromID ESBL media and Double Disc Synergy Test (DDST) was conducted for detecting the clinical isolate of ESBL-producing K. pneumoniae. Clinical isolates of K. pneumoniae collected from the Clinical Laboratory of Dr. Sardjito Hospital were isolated.RESULTS: There were 103 clinical isolates of K. pneumoniae, which were isolated from urine, pus, blood, stool, cerebrospinal fluid, sputum, drain liquid, nasal sinus liquid, gastric wash, bronchi liquid, injury liquid and nasal swab. The number of true positive, true negative, false positive and false negative results were 74, 18, 9 and 2, respectively. Meanwhile, the sensitivity, specificity, positive predictive value, negative predictive value, likelihood ratio for positive result and likelihood ratio for negative result of the new ESBL media were 97.4%, 66.7%, 89.2%, 90%, 2.9 and 0.03, respectively.CONCLUSION: Since the new ESBL media and DDST results were similar, so the new ESBL media could be used for screening patients with clinical presentation that indicating a high suspicious of ESBL-producing bacteria.KEYWORDS: K. pneumoniae, ChromID ESBL, DDST, ESBL, sensitivity

scholarly journals Combined CTP- IGF-1 Score: A New Score for Assessment of Disease Severity in HCV Related Liver Cirrhosis

2022 ◽  
Author(s):  
Elsayed Ghannam ◽  
Salah Rozaik ◽  
Ramy Hasan Agwa ◽  
Ahmed Marwan ◽  
Mervat El-Sayed Mashaly ◽  
...  
Keyword(s):  
Liver Cirrhosis ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
False Negative ◽  
The Body ◽  
P Value ◽  
Study Group ◽  
Negative Results ◽  
False Negative Results ◽  
Ctp Score

Abstract Background: Liver is the largest endocrine organ in the body. It is a key organ in insulin mediated metabolism, growth hormone and insulin like growth factors (IGF) pathway. Liver cirrhosis is the end result of many chronic diseases including hepatitis C virus infection. Child-Turcotte-Pugh (CTP) score is the standard used in assessment of hepatic reserve but it has its drawbacks in the form of subjective variables, hepatic encephalopathy and ascites. The aim of this work is to assess IGF-1 in patients with liver cirrhosis, correlate it with CTP score and assess value of modified combined CTP-IGF-1 score. Patients and Methods: 170 patients with CLD (liver cirrhosis) and 72 healthy controls in the study groups were enrolled in the study. All patients were subjected to thorough history, clinical examination and laboratory assessment. IGF-1 was measured and all patients were evaluated using CTP and CTP-IGF-1 scores. Results: IGF1 showed highly significant low values in the study group in comparison to controls (42.15 ± 27.976 and 66.31 ± 33.084 ng/ml respectively, p <0.001). It showed also highly significant negative correlation to CTP score in the study group (p < 0.001) with progressive decrements with CTP score stage progression where IGF1 levels were 48.32 ± 28.611, 40.28 ± 25.869 and 18.80 ± 15.953 ng/ml (mean ± standard deviation) in relation to CTP score groups A, B and C respectively (p value < 0.001). The combined CTP-IGF-1 score in comparison to the classic CTP score showed improved area under curve (0.848 and 0.854), sensitivity (71.2% and 88%), negative predictive value (41.7% and 53.7%), false negative results (49 and 19) and accuracy (75.73% and 83.98%) but decreased specificity (97.22% and 61.1%), positive predictive value (99.2% and 91.5%) and higher false positive results (1 and 14) respectively. Conclusion: IGF-1 show progressive decrements with progression of liver cirrhosis and is negatively correlated with CTP score. Addition of IGF-1 to CTP score to formulate combined score improves the AUC, sensitivity, negative predictive value and the accuracy of CTP score and decreases the false negative results.

scholarly journals Three-dimensional Transvaginal Ultrasound vs Office Hysteroscopy for Assessment of Uterine Cavity in Assisted Reproductive Program

2016 ◽  
Vol 8 (4) ◽  
pp. 290-293
Author(s):  
Ushma Patel
Keyword(s):  
Predictive Value ◽  
Transvaginal Ultrasound ◽  
False Negative ◽  
Three Dimensional ◽  
Uterine Cavity ◽  
Safe Procedure ◽  
Office Hysteroscopy ◽  
Diagnostic Efficacy ◽  
Menstrual Cycles ◽  
Negative Results

ABSTRACT Introduction The success of an assisted reproductive program (ARP) depends on the embryo quality and the intrauterine environment. It has been reported up until now that abnormal uterine findings occur in nearly 34 to 62% of infertile women worldwide. Due to this reason, uterine cavity evaluation is commonly recommended to screen for fibroids, polyps, adhesions, and mullerian abnormalities. Uterine cavity evaluation is usually accomplished with three-dimensional (3D) transvaginal ultrasound (TVS), sonohysterography, hysterosalpingography, and office hysteroscopy (OH). Materials and methods Uterine cavity evaluation was carried out in 239 infertile females undergoing ARP with twodimensional (2D) followed by 3D vaginal ultrasonography on day 21 of their menstrual cycles. Later, OH was carried out on 5th or 6th day of menstrual cycles. Results Out of 239 women, 3D TVS was abnormal in 28 (11.71%) and OH was abnormal in 53 (22.17%). Three-dimensional TVS agreed with OH in 16 (30.18%) abnormal cases and 179 (93.71%) normal cases. False-positive results for 3D TVS were 12 (6.28%) and false-negative results were 37 (69.81%). In our study, sensitivity of 3D TVS was 30.1%, specificity was 93.7%, positive predictive value was 57.1%, and negative predictive value was 82.8%. Conclusion Office hysteroscopy is an easy and safe procedure and has a better diagnostic efficacy than 3D TVS for uterine cavity evaluation in women undergoing ARP. How to cite this article Mishra VV, Patel U, Gandhi K. Threedimensional Transvaginal Ultrasound vs Office Hysteroscopy for Assessment of Uterine Cavity in Assisted Reproductive Program. J South Asian Feder Obst Gynae 2016;8(4):290-293.

scholarly journals Imaging Accuracy in Preoperative Staging of T3-T4 Laryngeal Cancers

Cancers ◽  
2020 ◽  
Vol 12 (5) ◽  
pp. 1074
Author(s):  
Marco Benazzo ◽  
Fabio Sovardi ◽  
Lorenzo Preda ◽  
Simone Mauramati ◽  
Sergio Carnevale ◽  
...  
Keyword(s):  
Anterior Commissure ◽  
Preoperative Staging ◽  
False Negative ◽  
Preoperative Imaging ◽  
Histopathological Analysis ◽  
Negative Results ◽  
False Negative Results ◽  
Prognostic Stratification ◽  
Paraglottic Space ◽  
Disease Free

Background: Preoperative imaging impacts treatment planning and prognosis in laryngeal cancers. We investigated the accuracy of standard computed tomography (CT) in evaluating tumor invasions at critical glottic areas. Methods: CT scans of glottic cancers treated by partial or total laryngectomy between Jan 2015 and Aug 2019 were reviewed to assess levels of tumor invasion at critical glottic subsites. CT accuracy in the identification of tumor extensions was determined against the gold standard of histopathological analysis of surgical samples. Results: This study included 64 patients. In the anterior commissure, CT showed high rates of false positives at all levels (sensitivity 56.2–70%, specificity 87.8–92.3%); in the anterior vocal fold, it overestimated the deep invasion (19.5% specificity, 90.3% sensitivity), while it underestimated the extralaryngeal spread (63.6% sensitivity, 98.1% specificity). In the posterior paraglottic space (pPGS), false negative results were more frequent for superficial extensions (25% sensitivity, 95.8% specificity) and deep invasions (58.8% sensitivity, 82.3% specificity). Shorter disease-specific and disease-free survivals were associated with pStage IV (p: 0.045 and 0.008) and with the pathological involvement of pPGS (p: 0.045 and 0.015). Conclusions: Negative prognostic correlation of pPGS involvement was confirmed on histopathological data. CT staging did not provide a satisfactory prognostic stratification and should be complemented with magnetic resonance imaging.

scholarly journals Rapid diagnostic test versus microscopy in the diagnosis of acute malaria in a district hospital in Enugu state, Southeast Nigeria

2017 ◽  
Vol 5 (1) ◽  
pp. 54
Author(s):  
Emmanuel I. Umegbolu ◽  
Chinedu N. Madukwe
Keyword(s):  
Predictive Value ◽  
District Hospital ◽  
Systemic Disease ◽  
False Negative ◽  
Malaria Diagnosis ◽  
World Health Organisation ◽  
Malaria Prevalence ◽  
World Health ◽  
Negative Results ◽  
Enugu State

Background: Malaria is a systemic disease caused by various species of Plasmodium, transmitted through the bite of a female Anopheles mosquito. According to the World Health Organisation, there were 214 million cases of malaria worldwide in 2015. Nigeria’s burden of malaria is about 51million cases and 207,000 deaths annually, accounting for 60% of outpatient visits to hospitals, 11% of maternal mortality, and 30% of child mortality. The study aimed to compare RDT and microscopy in malaria diagnosis in a District Hospital in Enugu state, Southeast Nigeria. Methods: Blood samples of 300 suspected cases of acute malaria were tested for malaria parasite using RDT and microscopy simultaneously. Results: In 2017, the study found a malaria prevalence of 25% (46.2% in children, and 18.1% in adults) in Awgu. RDT was positive in 38% and microscopy in 70.3% of cases. Both RDT and microscopy were positive in 36.3%, negative in 28.3%, and discordant in 35.4%. Sensitivity of RDT was 50.7% (89.4% in children, and 25.6% in adults). RDT had a specificity of 100% (both children and adults), positive predictive value of 1 (both children and adults), and negative predictive value of 0.6 (0.5 in children, 0.6 in adults). Conclusions: RDT (SD Malaria Ag P. f) had more sensitivity in children (89.4%) than adults (25.6%), and the occurrence of false negative results was more in adults (46.8%) than children (9.5%). All negative RDT results need to be examined microscopically, to rule out false negative cases.  

scholarly journals Pipelle Endometrial Biopsy vs Dilatation and Curettage to Diagnose Endometrial Diseases in Abnormal Uterine Bleeding

2017 ◽  
Vol 5 (2) ◽  
pp. 123-128
Author(s):  
Nikhitha Chandrashekar ◽  
Jyothi GS ◽  
Prasanna Shetty
Keyword(s):  
Predictive Value ◽  
Endometrial Hyperplasia ◽  
Tertiary Care ◽  
Abnormal Uterine Bleeding ◽  
Endometrial Biopsy ◽  
Uterine Bleeding ◽  
Histopathological Analysis ◽  
Care Hospital ◽  
Dilatation And Curettage ◽  
Risk Of Cancer

ABSTRACT Aim The objective of this study was to assess the adequacy of the sample aspirated in order to make a definite diagnosis of endometrial disease in abnormal uterine bleeding (AUB) and to draw comparisons between the histopathological findings of Pipelle endometrial aspiration biopsy and dilatation and curettage (D&C). Materials and methods Pipelle endometrial biopsy and D&C samples were collected from 100 patients with AUB in the Department of the Obstetrics and Gynecology and sent to the Department of Pathology of a tertiary care hospital for adequacy of the sample and for histopathological analysis. Results The Pipelle sample was adequate in 73% of the cases and inadequate in 27% compared with D&C, which showed 85% and 15%, respectively. About 53% of cases were comparable between D&C and Pipelle and 37% were discordant. For endometrial hyperplasia using Pipelle aspirator, the sensitivity was 58.8%, specificity was 91.6%, positive predictive value (PPV) was 58.8%, negative predictive value (NPV) was 91.6%, and concordance was 86%. For detection of endometrial carcinoma using Pipelle, the sensitivity was 50%, specificity was 99%, PPV was 50%, NPV was 99%, and concordance rate was 98%. Conclusion It is more convenient and cost-effective for patients to undergo pipelle biopsy to confirm normalcy and rule out endometrial hyperplasia rather than undergoing D&C initially. Out of the 27% of inadequate samples, 14.8% had fibroids and 11.1% had polyps, thus showing that tumors localized to a polyp or a small area of endometrium went undetected with Pipelle. Clinical significance Due to the high specificity and NPV and low sensitivity and PPV in diagnosing endometrial lesions and carcinomas, pipelle is suitable for women with a low risk of cancer. In cases where the diagnosis is hyperplasia on Pipelle, the patients are advised to undergo hysteroscopic-guided D&C following pipelle to confirm the diagnosis. This is also applicable for cases of polyps and fibroids. How to cite this article Chandrashekar N, Jyothi GS, Shetty P. Pipelle Endometrial Biopsy vs Dilatation and Curettage to Diagnose Endometrial Diseases in Abnormal Uterine Bleeding. J South Asian Feder Menopause Soc 2017;5(2):123-128.

scholarly journals Study of ascitic fluid cytology in ovarian tumors

2017 ◽  
Vol 5 (12) ◽  
pp. 5227 ◽  
Author(s):  
Chandralekha Janagam ◽  
Bhagyalakshmi Atla
Keyword(s):  
Ascitic Fluid ◽  
Predictive Value ◽  
False Positive ◽  
False Negative ◽  
Ovarian Tumors ◽  
Peritoneal Cytology ◽  
Negative Results ◽  
Benign Ovarian Tumours ◽  
False Negative Results ◽  
Fluid Cytology

Background: The objectives of this study were to examine the validity of ascitic fluid cytology in the detection of pathological findings, to examine the percentage of false positive and false negative results in the cytology of ascitic fluid and to determine the validity of peritoneal cytology in relation to the histopathological type of the ovarian tumour.Methods: This retrospective study, over a period of 6 months, included 106 peritoneal cytology findings. The experimental group included 106 cytology findings obtained from patients who presented with an abdominal lump/mass with ascites and diagnosed with ovarian tumors clinically. They included 88 benign ovarian tumours (83%) and 18 malignant ovarian tumors (17%). Patients with other causes of ascites were excluded from the study.Results: The sensitivity of peritoneal cytology is 90%, specificity is 96.5%, positive predictive value is 85.7%, and negative predictive value is 97.6%. In 1.8% of patients, the peritoneal cytology showed false negative results, while in 2.8%, the results were false positive. False negative results were found in one case of teratoma with squamous cell carcinoma and one case of yolk sac tumor. False positive results were found in 2 cases of tuberculous-salpingo- oophoritis and one case of chronic salpingo-oophoritis due to reactive mesothelial proliferation, mistaken for adenocarcinoma.Conclusions: Peritoneal cytology of ascitic fluid is highly specific and sensitive for detection of ovarian malignancies, particularly in grade 3 and grade 4 disease, since most of the patients with ovarian malignancies present to us at advanced stage of the disease.

scholarly journals Soft Salt-Mannitol Agar–Cloxacillin Test: a Highly Specific Bedside Screening Test for Detection of Colonization with Methicillin-Resistant Staphylococcus aureus

1998 ◽  
Vol 36 (4) ◽  
pp. 986-989 ◽  
Author(s):  
Nuria Mir ◽  
Miguel Sánchez ◽  
Fernando Baquero ◽  
Blanca López ◽  
Celia Calderón ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Staphylococcus Aureus ◽  
Intensive Care ◽  
Predictive Value ◽  
Color Change ◽  
False Negative ◽  
Clinical Samples ◽  
Methicillin Resistant ◽  
Negative Results ◽  
False Negative Results

The early detection of colonization with methicillin-resistantStaphylococcus aureus (MRSA) of patients in intensive-care units is an essential step in the strategy for preventing MRSA epidemics. In this study, tubes containing soft salt-mannitol agar with cloxacillin (6 μg/ml) (SSMAC) were prepared for inoculation of clinical samples at patients’ bedsides by personnel of an intensive-care unit. A total of 1,914 swabs from different sample sites of 81 patients were dipped into SSMAC tubes, and after 24 h of incubation (in an incubator located near the intensive-care unit), an evident color change was considered by the intensive-care-unit personnel to be an MRSA alarm. Sixty-three (3.3%) SSMAC tubes were considered positive for MRSA, 1,827 (95.4%) were considered negative, and 24 (1.2%) were considered intermediate. Compared with values for parallel conventional surveillance cultures for MRSA, excluding tubes with intermediate results, the SSMAC test had a sensitivity of 72.7%, a specificity of 99.2%, a positive predictive value of 76.2%, and a negative predictive value of 99.0%. When intermediate tubes were considered positive, the corresponding values were 75.3, 98.2, 63.2, and 99.0%, respectively. The sensitivity and specificity values of the test to identify MRSA-colonized patients were 89.4 and 100%, respectively. Oropharyngeal and naris specimens were the most reliable samples for MRSA detection. False-negative results were frequent in bronchial aspirates with low (<103 to 106CFU/ml) MRSA counts. False-positive results were mainly due to methicillin-resistant Staphylococcus haemolyticus. The SSMAC tube is a useful, rapid, and inexpensive tool for the early identification of MRSA-colonized patients and, consequently, for the implementation of measures to prevent the spread of MRSA.

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