scholarly journals Differentiation of Transverse Sinus Thrombosis From Congenitally Atretic Transverse Sinus With TR-MRA：An Exploratory Study

2019 ◽  
Author(s):  
Dongdong Wang ◽  
Wenjie Cao ◽  
Yanan Xie ◽  
Yiping Lu ◽  
Xuanxuan Li ◽  
...  
Keyword(s):  
Gold Standard ◽  
Sinus Thrombosis ◽  
Final Diagnosis ◽  
Transverse Sinus ◽  
Time Resolved ◽  
Contrast Enhanced ◽  
Radiological Images ◽  
The Mean ◽  
Better Than

Abstract Background: We aimed to establish the value of Time-resolved contrast-enhanced magnetic resonance angiography (TR-MRA) in identifying thrombosis of transverse sinus(TS) in patients with a unilaterally absent TS signal on MRV. Methods: Forty-five patients who were suspected of TS thrombosis clinically with a unilaterally absent TS signal on phase contrast(PC) MRV, were evaluated with TR-MRA. Images obtained by each technique were assessed independently by two neuroradiologists for whether the absent signal was thrombosis or atretic TS. The final diagnosis given based on clinical data and all radiological images(including the asymmetry of the sigmoid notches and TR-MRA) by a consultant neurologist was set as the gold standard and then, the accuracy of radiological diagnosis were validated by observing the agreement with it. The image quality comparison between PC MRV and TR-MRA via calculating signal-to-noise ratios [SNRs] and contrast-to-noise ratios [CNRs] of the normal TS. Results: For imaging quality of normal TS, the mean SNR and CNR of TR-MRA were 452.14 and 440.92 respectively, significantly higher than the values of PC MRV (both p<0.001). The interobserver agreement of TR-MRA in identifying TS thrombosis from atretic TS was excellent [κ =0.951; 95% confidence interval (CI) 0.902-1.000], much higher than MRV (κ = 0.526; 95% CI, 0.389–0.663). Consensus of assessment based on TR-MRA was highly consistent with the gold standard (sensitivity of 100%, specificity of 93.75%) , superior to PC MRV (sensitivity of 75%, specificity of 81.8%). Conclusion: TR-MRA is better than PC MRV in the visualization of TS, and helpful to distinguish thrombosis from congenitally atretic TS.

scholarly journals Evaluation of the WHO/UNICEF algorithm for integrated management of childhood illness

2019 ◽  
Vol 6 (3) ◽  
pp. 1102
Author(s):  
Javaid Iqbal ◽  
Tarsem Lal Motten ◽  
Ashu Jamwal ◽  
Pallvi Sharma
Keyword(s):  
Gold Standard ◽  
Sick Child ◽  
Integrated Management ◽  
Final Diagnosis ◽  
Childhood Illness ◽  
Danger Signs ◽  
Appropriate Therapy ◽  
The Mean ◽  
Initial Selection ◽  
Better Than

Background: The present study was designed to evaluate the feasibility and utility of the integrated management of the childhood illness (IMCI) algorithm to diagnose the illnesses in children under the age of 2 months to 5 years.Methods: The study was conducted on 300 children, aged 2 months to 5 years, who presented with a fresh episode of any illness to the out-patient Department of the SMGS Hospital over a period of 9 months. Within these initial selection criteria, the WHO/UNICEF algorithm for management of the sick child was referred to, children were assessed and classified as per "IMCI" algorithm and treatments required were identified. The final diagnosis was made and appropriate therapy instituted served as the "Gold standard". The diagnostic and therapeutic agreements between the 'gold standard' and the IMCI and vertical (on the basis of primary presenting complaint) algorithms were computed.Results: Among all 300 subjects, more than one illness was present in 207 (69%) of subjects as per Gold standard diagnosis. The corresponding, figures for IMCI module were 141 (47%) and 222 (74%) for low and high malaria algorithms respectively. The mean illnesses per child were 2.12, 182 and 2.21, respectively. The subjects who would have been referred as per IMCI module had a greater co-existence of illnesses than those who would not have been referred (mean 2.5 versus 1.5 illnesses per child respectively). The specificity for general danger signs was 66% while the sensitivity was 71%.Conclusions: In conclusion, the performance of the IMCI algorithm is significantly better than the vertical disease specific algorithm. In addition, the IMCI algorithm incorporates an element of preventive care in the form of immunization and feeding advice.

A qualitative assessment of randomized controlled trials in otolaryngology

1998 ◽  
Vol 112 (5) ◽  
pp. 460-463 ◽  
Author(s):  
K. W. Ah-See ◽  
N. C. Molony
Keyword(s):  
Randomized Controlled Trials ◽  
Consort Statement ◽  
Qualitative Assessment ◽  
Controlled Trials ◽  
Randomized Controlled ◽  
Future Assessment ◽  
The Consort Statement ◽  
The Mean ◽  
Better Than

AbstractIn 1996 the CONSORT statement made recommendations on the strict reporting of randomized controlled trials (RCT). This will facilitate the future assessment of such trials and will highlight those trials that have been performed suboptimally and whose results may be biased.We have devised a scoring system, based on CONSORT, to assess RCT quality and by reading each original paper in full we have now assessed the quality of trials published from 1966 to 1995.The mean score for trials identified was 7.3 out of a maximum 12 points. No one journal was significantly better than the others. Trials in rhinology are reported better than head and neck oncology trials (mean scores 7.6 and 6.5 respectively). The past 30 years has not seen an improvement in the quality of the trials.The reporting of RCTs in the ENT literature is poor. CONSORT guidelines now exist and trialists are encouraged to adopt them when conducting future clinical trials.

Long-Term Dosing of AMG 531 in Thrombocytopenic Patients with Immune Thrombocytopenic Purpura: 48-Week Update.

Blood ◽  
2006 ◽  
Vol 108 (11) ◽  
pp. 476-476 ◽  
Author(s):  
David Kuter ◽  
James Bussel ◽  
James George ◽  
Louis Aledort ◽  
Alan Lichtin ◽  
...  
Keyword(s):  
Platelet Count ◽  
Neutralizing Antibodies ◽  
Sinus Thrombosis ◽  
Therapeutic Option ◽  
Subcutaneous Administration ◽  
Transverse Sinus ◽  
Platelet Response ◽  
Open Label ◽  
The Mean

Abstract AMG 531 is a novel thrombopoiesis-stimulating peptibody that increases platelet production by targeting the TPO receptor. The study described here is an ongoing, open-label extension assessing the safety and efficacy of long-term, weekly, subcutaneous administration of AMG 531 in ITP patients who have completed a previous AMG 531 study. Patients previously treated with AMG 531 receive the same starting dose as the final dose given in the previous study; placebo-treated patients begin the extension with a 1 μg/kg dose. Doses may be skipped, decreased, maintained, or increased based on platelet response. Patients who achieve a stable dose for at least 3 weeks (later amended to 4 weeks) may be allowed to self-administer the drug. A total of 104 patients have been enrolled; the longest AMG 531 treatment duration is 96 weeks. This planned interim analysis includes 36 patients (safety subset) whose previous study was a phase 2 trial. Data for patients previously enrolled in a phase 3 trial are still blinded. The 25 women and 11 men have a mean age of 50±13 (SD) years; 30 (83%) have had a splenectomy. Twelve patients entered the study using concurrent corticosteroids, which were tapered when the platelet count was &gt;50x109/L. Adverse event (AE) profiles were similar for the intervals of weeks 1–24 vs 25–48 and beyond. The most frequent were headache (incidence of 2.0 per 100 weeks of subject exposure for weeks 1–24 vs 1.7 for weeks 25–48), upper respiratory infection (1.3 vs 0.8), and fatigue (0.9 vs 1.0). Four patients had serious treatment-related AEs: vaginal hemorrhage/anemia (withdrawn from treatment), diffuse reticulin formation in the bone marrow (withdrawn), bone pain (continues on treatment), and transverse sinus thrombosis with papilledema and temporary decrease in visual acuity (64-year-old patient with diabetes mellitus and a platelet count of 293x109/L at the time of the AE; this patient continues on treatment). No neutralizing antibodies have been detected to date. The efficacy subset consists of 27 patients who completed week 48 or beyond. Both the mean platelet count and the mean dose of AMG 531 have remained stable between weeks 24–48. The mean platelet count was 100x109/L ± 4.4 (SE) during weeks 1–24 and 131x109/L ± 5.3 (SE) during weeks 25–48. Eleven patients (41%) have had at least one platelet count &gt;450x109/L, excluding counts associated with ITP rescue medication. Six of 12 patients were able to discontinue concurrent corticosteroids, and 2 had a &gt;25% dose reduction. Individualized weekly doses of AMG 531 provide a therapeutic option for ITP. Most patients have been able to maintain a safe platelet count and to decrease or discontinue concurrent corticosteroid therapy.

scholarly journals Non-contrast-enhanced MR portography and hepatic venography with time-spatial labeling inversion pulses: comparison at 1.5 Tesla and 3 Tesla

2015 ◽  
Vol 4 (5) ◽  
pp. 205846011558411 ◽  
Author(s):  
Tsuyoshi Ohno ◽  
Hiroyoshi Isoda ◽  
Akihiro Furuta ◽  
Kaori Togashi
Keyword(s):  
Image Quality ◽  
Portal Vein ◽  
Healthy Volunteers ◽  
Hepatic Vein ◽  
Inversion Recovery ◽  
3 Tesla ◽  
Selective Inversion ◽  
Contrast Enhanced ◽  
Better Than

Background A 3 Tesla (3 T) magnetic resonance (MR) scanner is a promising tool for upper abdominal MR angiography. However, there is no report focused on the image quality of non-contrast-enhanced MR portography and hepatic venography at 3 T. Purpose To compare and evaluate images of non-contrast-enhanced MR portography and hepatic venography with time-spatial labeling inversion pulses (Time-SLIP) at 1.5 Tesla (1.5 T) and 3 T. Material and Methods Twenty-five healthy volunteers were examined using respiratory-triggered three-dimensional balanced steady-state free-precession (bSSFP) with Time-SLIP. For portography, we used one tagging pulse (selective inversion recovery) and one non-selective inversion recovery pulse; for venography, two tagging pulses were used. The relative signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) were quantified, and the quality of visualization was evaluated. Results The CNRs of the main portal vein, right portal vein, and left portal vein at 3 T were better than at 1.5 T. The image quality scores for the portal branches of segment 4, 5, and 8 were significantly higher at 3 T than at 1.5 T. The CNR of the right hepatic vein (RHV) at 3 T was significantly lower than at 1.5 T. The image quality scores of RHV and the middle hepatic vein were higher at 1.5 T than at 3 T. For RHV visualization, the difference was statistically significant. Conclusion Non-contrast-enhanced MR portography with Time-SLIP at 3 T significantly improved visualization of the peripheral branch in healthy volunteers compared with1.5 T. Non-contrast-enhanced MR hepatic venography at 1.5 T was better than at 3 T.

scholarly journals International normalized ratio (INR) testing in Europe: between-laboratory comparability of test results obtained by Quick and Owren reagents

2018 ◽  
Vol 56 (10) ◽  
pp. 1698-1703 ◽  
Author(s):  
Piet Meijer ◽  
Karin Kynde ◽  
Antonius M.H.P. van den Besselaar ◽  
Marjan Van Blerk ◽  
Timothy A.L. Woods
Keyword(s):  
Plasma Sample ◽  
International Normalized Ratio ◽  
Test Results ◽  
Local Calibration ◽  
The Mean ◽  
The Difference ◽  
Clinically Significant ◽  
Single Plasma ◽  
Better Than

Abstract Background: This study was designed to obtain an overview of the analytical quality of the prothrombin time, reported as international normalized ratio (INR) and to assess the variation of INR results between European laboratories, the difference between Quick-type and Owren-type methods and the effect of using local INR calibration or not. In addition, we assessed the variation in INR results obtained for a single donation in comparison with a pool of several plasmas. Methods: A set of four different lyophilized plasma samples were distributed via national EQA organizations to participating laboratories for INR measurement. Results: Between-laboratory variation was lower in the Owren group than in the Quick group (on average: 6.7% vs. 8.1%, respectively). Differences in the mean INR value between the Owren and Quick group were relatively small (<0.20 INR). Between-laboratory variation was lower after local INR calibration (CV: 6.7% vs. 8.6%). For laboratories performing local calibration, the between-laboratory variation was quite similar for the Owren and Quick group (on average: 6.5% and 6.7%, respectively). Clinically significant differences in INR results (difference in INR>0.5) were observed between different reagents. No systematic significant differences in the between-laboratory variation for a single-plasma sample and a pooled plasma sample were observed. Conclusions: The comparability for laboratories using local calibration of their thromboplastin reagent is better than for laboratories not performing local calibration. Implementing local calibration is strongly recommended for the measurement of INR.

Carcass and eating quality of ram, castrated ram and ewe lambs

1990 ◽  
Vol 50 (2) ◽  
pp. 291-299 ◽  
Author(s):  
E. Dransfield ◽  
G. R. Nute ◽  
B. W. Hogg ◽  
B. R. Walters
Keyword(s):  
Eating Quality ◽  
Ewe Lambs ◽  
Shoulder Joints ◽  
Category Scaling ◽  
Longissimus Lumborum ◽  
The Mean ◽  
Similar Conformation ◽  
Entire Male ◽  
Better Than

ABSTRACTCarcass and meat composition and eating quality of m. longissimus lumborum (LI) and leg joints were compared in entire male (ram), castrated male (wether) and female (ewe) Dorset Down-cross and Suffolk-cross lambs at about 20 weeks old. Rams grew faster than wethers and ewes particularly in the earlier maturing Suffolk crosses. Carcass weights ranged from 13 to 24 kg and at the mean carcass weight of 17·7 kg ram carcasses yielded larger shoulder joints. Ram carcasses were assessed visually leaner than those from the other sexes with similar conformation scores. Dorset Down carcasses tended to be fatter than Suffolk carcasses and the leanest carcasses were from Suffolk rams. Intramuscular fatness in LI was similar in all sexes. Intramuscular collagen contents were higher in ram LI than in other sexes. There were no differences in protein content, pH or colour of raw or roast LI. In assessments of eating quality of LI by triangle tests, male and female assessors differentiated twin rams and wethers equally. Category scaling showed LI from ewes to be slightly tougher than those from rams and wethers. Consumer evaluation of leg joints did not detect any differences in odour due to sex and ram meat was assessed better than that from wethers or ewes.

scholarly journals Attitudes on vaccination among Portuguese travelers and Brazilian migrans: A pilot study in Portugal

2019 ◽  
Vol 49 ◽  
Author(s):  
Ricardo Igreja ◽  
Katy Barros ◽  
Rosa Teodosio
Keyword(s):  
Pilot Study ◽  
Protective Effect ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Web Based ◽  
The Mean ◽  
Self Administered Questionnaire ◽  
Travel Clinic ◽  
Better Than

Introduction: Anti-vaccination movements exist in Europe and it may reduce adherence to international vaccination.Objectives:To evaluate attitudes on vaccination among Portuguese travelers and Brazilian migrants in Portugal.Material and Methods:Between May and June 2019 a cross-sectional survey was carried out in the Travel Clinic of the Institute of Hygiene and Tropical Medicine of Lisbon. A self-administered questionnaire was applied after medical consultation. Travelers were asked about their attitudes to vaccines. An anonymous web-based survey was sent to Brazilian migrants living in Portugal for at least 6 months.Results: 55 Portuguese (P) travelers and 22 Brazilian (B) migrants answered the questionnaire. 47.3% of Portuguese travelers were male; the mean age was 33 years; reason for travel: tourism (43.6%) or business (30.9%). 31.8% of Brazilian migrants were male and the mean age was 44 years; 71.4% were living in Portugal for ≤ 2 years. Attitudes towards vaccines: 64.8% P and 68.2% B prefer to vaccine even when the risk of acquire a disease is low; 64.1% P and 95.5% B consider that the resistance acquired by disease is better than resistance acquired by vaccine; 75.5% P and 77.3% B prefer to vaccine even when diseases are not severe; 5.6% P and 13.6% B don’t take vaccines because they are afraid of side effects.About the reasons to accept a vaccine, travelers/migrants consider very important to trust in the doctor (100% P, 95.4% B), and the excellent protective effect of a vaccine (98.1% P, 90.9% B).Conclusions: Portuguese travelers and Brazilian migrants in Portugal seem to have a favorable attitude towards vaccination, despite the anti-vaccination movements in Europe. They believe that trust in the doctor and excellent protection of the vaccines are reasons to accept it. The quality of traveler's advice may maintain/increase adherence to vaccination. 

scholarly journals The Study of the Yield of DNA Extracted From Hairs of Postmortem Cases

2020 ◽  
Vol 43 (2) ◽  
pp. 9-18
Author(s):  
Kanchana Sujirachato ◽  
Suranan Tirawatnapong ◽  
Nurhasnee Mimae ◽  
Sirirat Inon ◽  
Adisuk Kaewdouengdee ◽  
...  
Keyword(s):  
Polymerase Chain Reaction ◽  
Isoamyl Alcohol ◽  
Personal Identification ◽  
Chain Reaction ◽  
Manner Of Death ◽  
Hair Roots ◽  
The Mean ◽  
Polymerase Chain ◽  
Better Than

Background: Problems frequently occur from hair extraction are low concentration and impurity of DNA. Methods: Hairs from 30 postmortem cases were collected. In each case, 5 and 10 hair roots were extracted DNA by Phenol/Chloroform/Isoamyl alcohol. The amount and purity of DNA (A260/280) were detected by NanoDrop spectrophotometer. The quality of DNA was examined using polymerase chain reaction (PCR). Amount of DNA was analyzed compared with gender, age, and manner of death. Results: The amount and purity of DNA extracted from 10 hair roots were slightly better than 5 hair roots (P > .05). The mean (range) of DNA concentration was 200.4 (35.2 - 799.6) ng/µL from 10 hair roots vs 148.2 (21.7 - 571.5) ng/µL from 5 hair roots in 30 µL volume whereas the mean (range) of A260/280 was 1.61 (1.31 - 1.99) in 10 hair roots vs 1.54 (1.32 - 1.90) in 5 hair roots. The results from NanoDrop showed no difference among various gender, age, and manners of death. Conclusions: DNA can be extracted from hair by Phenol/Chloroform/Isoamyl alcohol. The quantity and quality of DNA were good enough for personal identification by PCR. DNA extracted from 10 hair roots is better than 5 hair roots.  

Phase III randomized trial to evaluate the use of gabapentin alone vs with continuing an antidepressant in women failing an antidepressant for the treatment of hot flashes: North Central Cancer Treatment Group Study N00C3

2006 ◽  
Vol 24 (18_suppl) ◽  
pp. 526-526
Author(s):  
C. L. Loprinzi ◽  
J. W. Kugler ◽  
D. L. Barton ◽  
A. C. Dueck ◽  
L. K. Tschetter ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Alternative Therapy ◽  
Hot Flashes ◽  
The Other ◽  
Phase Iii ◽  
Temporary Increase ◽  
North Central ◽  
The Mean ◽  
Better Than

526 Background: Antidepressants do not adequately alleviate all HFs. Based on placebo-controlled data demonstrating that GABA is an alternative therapy for HFs, this trial was initiated to test whether the combination of an antidepressant and GABA was better than GABA alone in PTS with inadequate HF control on an antidepressant alone. Methods: Eligible PTS on antidepressants with bothersome HFs were randomized to two groups. PTS kept a daily HF diary during a baseline wk (while continuing their antidepressant). Following the baseline wk, all PTS were given GABA 300 mg at hs for 3 days, then BID for 3 days, and then TID for 22 days. One group continued their antidepressant while the other group was weaned off it over several days. PTS continued a daily HF diary during this 4-wk period. Efficacy was measured using the mean daily HF number and score; the latter measured by assigning points (1–4, for mild to very severe) to each HF and then adding the points for a given time. The study design provided 80% power to detect a difference in the changes from baseline at 4 wks between the two groups of 1.2 HFs/day, or 3 points/day in HF scores. Results: 115 PTS were randomized and given GABA. PTS continuing their antidepressant reported a 48% mean reduction in HF score after 4 wks, vs 49% for PTS stopping it (p=0.97). Mean HF numbers were reduced 50% and 47%, respectively (p=0.54). 16 other symptoms and quality of life items were measured by PT-completed weekly questionnaires, with the only suggestive changes from baseline between the two arms being more mood troubles after 2 wks of treatment (p=0.06) and more nervousness after 4 wks of treatment (p=0.01) in PTS stopping their antidepressant. Also, a mild temporary increase in dizziness after 1 wk of treatment was observed in the same group (p=0.08) suggestive of an antidepressant withdrawal reaction. Conclusion: This trial failed to provide any evidence that the combination of GABA and an antidepressant decreased HFs any more than did GABA alone in PTS who had inadequate HF control with an antidepressant alone. The 50% reduction in HFs in both arms is commensurate with the efficacy of GABA delineated in other published reports. No significant financial relationships to disclose.

The accuracy of titanium contrast-enhanced mammography: a retrospective multicentric study

2020 ◽  
Vol 61 (10) ◽  
pp. 1335-1342
Author(s):  
Ignacio González-Huebra ◽  
Patricia Malmierca ◽  
Arlette Elizalde ◽  
Jon Etxano ◽  
Ilse Vejborg ◽  
...  
Keyword(s):  
Roc Curves ◽  
Final Diagnosis ◽  
High Energy ◽  
Multicentric Study ◽  
Dense Breasts ◽  
Expert Radiologist ◽  
Contrast Enhanced ◽  
Pathological Confirmation ◽  
Different Levels ◽  
Better Than

Background Recently, a new mammography system to perform contrast-enhanced mammography has become available in the market. For the high-energy acquisition, it uses a titanium filter instead of a copper one, reducing the tube load while maintaining image quality. Purpose To retrospectively evaluate the accuracy of contrast-enhanced mammography with a titanium filter (TiCEM) in three readers with different grades of experience. Material and Methods IRB-approved retrospective multicentric lesion by lesion study with 200 lesions, all of them initially classified as BI-RADS categories 0/3/4/5 on mammography and/or ultrasound and with pathological confirmation, in 135 patients. Three readers with different levels of experience (expert, resident, intermediate) blinded to the final diagnosis, retrospectively evaluated the low-energy (LE) images and the combination of LE and recombined (subtracted) images and classified the lesions according to the BI-RADS categories. Reader 1 also categorized the breast density. ROC curves were performed for each reader. Results Out of the 200 lesions, 82 were benign and 118 malignant (20 DCIS, 10 ILC, 88 IDC). The AUCs of LE versus TiCEM for were: Reader 1: 0.7 vs. 0.88, P < 0.001; Reader 2: 0.63 vs. 0.83, P < 0.001; and Reader 3: 0.63 vs. 0.84, P < 0.001. For the three readers, the AUCs of LE versus TiCEM were significantly superior in both dense and non-dense breasts ( P < 0.001). Comparing the AUC of LE for Reader 1 (expert) versus the AUC of TiCEM for Reader 2 (resident) there were significant differences (0.7 vs. 0.83, P < 0.001). Conclusion The accuracy of TiCEM was significantly better for all the readers, in both dense and non-dense breasts. The accuracy of a resident reading a TiCEM study was better than the accuracy of an expert radiologist reading LE images.

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