Comparison of Pre- and Postoperative Histopathology Results in Patients with Endometrial Carcinoma

2021 ◽  
Author(s):  
Yinglan Zhang ◽  
Yu Zhao ◽  
Yuan Li
Keyword(s):  
Endometrial Carcinoma ◽  
Clinical Data ◽  
Preoperative Diagnosis ◽  
Preoperative Assessment ◽  
Weighted Kappa ◽  
Cross Sectional ◽  
Significant Difference ◽  
Kappa Value ◽  
Grade 3 ◽  
High Consistency

Abstract Background: Preoperative histopathology is considered the most effective method for evaluation of endometrial carcinoma, and plays a crucial role in deciding the extent of surgical resection. In this study, we analysed clinical data to evaluate the accuracy of preoperative diagnosis by comparing preoperative hysteroscopic biopsy results with postoperative histopathological results. Methods: This was a cross-sectional, retrospective study of patients who underwent hysteroscopic biopsy and subsequent hysterectomy for endometrial carcinoma. Clinical data were collected for 289 patients who were diagnosed with endometrial carcinoma based on hysteroscopy. We compared the histotype and tumour differentiation grade to evaluate the accuracy of diagnosis based on preoperative hysteroscopic biopsy.Results: Compared with the postoperative histotype results, the overall accuracy of the preoperative histotype results was 94.8%, and the kappa value was 0.725 (p < 0.001). The weighted kappa value for agreement between preoperative and postoperative histopathological grade was 0.616, indicating the level of agreement was “substantial” (95% CI 0.538–0.695). The rate of misdiagnosis based on hysteroscopy was significantly higher for grade 3 cancer than for grade 1 cancer, and there was no significant difference for grade 2 cancer compared with the other two grades.Conclusions: Hysteroscopy is a reliable method for preoperative diagnosis of endometrial carcinoma. Preoperative assessment of histotype by hysteroscopy showed high consistency with postoperative results. However, there was a significantly higher rate of misdiagnosis for patients with poorly differentiated tumour, which may lead to overtreatment. For these patients, we recommend analysing frozen sections before determining a final treatment strategy.

scholarly journals Pediatric triage variations among nurses, pediatric and emergency residents using the Canadian triage and acuity scale

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Saleh Alshaibi ◽  
Tala AlBassri ◽  
Suliman AlQeuflie ◽  
Winnie Philip ◽  
Nesrin Alharthy
Keyword(s):  
Clinical Signs ◽  
Sampling Technique ◽  
Weighted Kappa ◽  
P Value ◽  
Kappa Statistics ◽  
Cross Sectional ◽  
Pediatric Residents ◽  
Significant Difference ◽  
The Right ◽  
Triage Level

Abstract Background Emergency care continues to be a challenge, since patients’ arrival is unscheduled and could occur at the same time which may fill the Emergency Department with non-urgent patients. Triaging is an integral part of every busy ED. The Canadian Triage and Acuity Scale (CTAS) is considered an accurate tool to be used outside Canada. This study aims to identify the chosen triage level and compare the variation between registered nurses, pediatric and adult emergency residents by using CTAS cases. Method This study was conducted at King Abdulaziz Medical City,Saudi Arabia. A cross-sectional self-administered questionnaire was used, and which contains 15 case scenarios with different triage levels. All cases were adopted from a Canadian triage course after receiving permission. Each case provides the patient’s symptoms, clinical signs and mode of arrival to the ED. The participants were instructed to assign a triage level using the following scale. A non-random sampling technique was used for this study. The rates of agreement between residents were calculated using kappa statistics (weighted-kappa) (95%CI). Result A total of 151 participants completed the study questionnaire which include 15 case scenarios. 73 were nurses and 78 were residents. The results showed 51.3, 56.6, and 59.9% mis-triaged the cases among the nurses, emergency residents, and pediatric residents respectively. Triage scores were compared using the Kruskal Wallis test and were statistically significant with a p value of 0.006. The mean ranks for nurses, emergency residents and pediatric residents were 86.41, 73.6 and 59.96, respectively. The Kruskal Wallis Post-Hoc test was performed to see which groups were statistically significant, and it was found that there was a significant difference between nurses and pediatrics residents (P value = 0.005). Moreover, there were no significant differences found between nurses and ER residents (P value> 0.05). Conclusion The triaging system was found to be a very important tool to prioritize patients based on their complaints. The results showed that nurses had the greatest experience in implementing patients on the right triage level. On the other hand, ER and pediatric residents need to develop more knowledge about CTAS and become exposed more to the triaging system during their training.

scholarly journals An evaluation of the impact of a school nutrition programme in Vietnam

2007 ◽  
Vol 10 (8) ◽  
pp. 819-826 ◽  
Author(s):  
Andrew Hall ◽  
Tran Thi Minh Hanh ◽  
Katherine Farley ◽  
Tran Pham Nha Quynh ◽  
Frank Valdivia
Keyword(s):  
Weight Gain ◽  
Primary Schools ◽  
School Nutrition ◽  
Cross Sectional ◽  
Cluster Evaluation ◽  
Significant Difference ◽  
Level Model ◽  
Grade 3 ◽  
The Impact ◽  
Nutrition Programme

AbstractObjectiveTo evaluate the effectiveness of a school nutrition programme on the weight gain and growth of Vietnamese schoolchildren.DesignA proximate cluster evaluation of children in seven schools, in which fortified milk and biscuits supplying 300 kcal of energy were being given on school days, compared with children in 14 nearby schools with no feeding. All children were dewormed.SettingTwenty-one primary schools in Dong Thap Province, Vietnam.SubjectsA cohort of 1080 children in grade 1 of 21 primary schools, and a cross-sectional interview of 400 children in grade 3.ResultsThe programme gave children the equivalent of 90 kcal day− 1 over 17 months. t-Tests showed a small but statistically significant difference between groups in their average gain in weight and height: 3.19 versus 2.95 kg (P < 0.001) and 8.15 versus 7.88 cm (P = 0.008). A multiple-level model showed that the programme was statistically significant after controlling for clustering of children in schools, sex, age and initial underweight (P = 0.024). A significant impact on height was also seen in a regression model, but not when controlling for school. The most undernourished children tended to gain the least weight. There was no evidence of substitution.ConclusionThe programme had a small but significant effect on weight gain, but the most undernourished children benefited the least. Methods need to be developed to target them. This design may offer a means of estimating the impact of school feeding on growth in other programme settings.

scholarly journals Replicability of the Questionnaire Assessing the Addition of IN NATURA Vegetable Oil to the Child’s Diet

2021 ◽  
pp. 28-38
Author(s):  
Beatriz Araújo Cassane Martins ◽  
Haydée Serrão Lanzillotti ◽  
Maria Elisa Barros
Keyword(s):  
Vegetable Oil ◽  
Internal Consistency ◽  
Rio De Janeiro ◽  
Weighted Kappa ◽  
Cross Sectional Study ◽  
Multivariate Normality ◽  
P Value ◽  
Cross Sectional ◽  
Significant Difference ◽  
The University

Objective: To verify the replicability of the questionnaire Assessing the Addition of IN NATURA Vegetable Oil to the Child’s Diet”. Study design: observational cross-sectional study. Place and Duration of Study: The study was carried out in two pediatric outpatient clinics, one of which refers to a health plan operator (SJM), municipality of São João de Meriti (RJ) and the other, at the Polyclinic Piquet Carneiro of the University from the State of Rio de Janeiro (PPC/UERJ), municipality of Rio de Janeiro (RJ), from March 2017 to January 2019. Sample: Responsible for children feeding, that is, those who buy the food prepare it or serve meals. SJM, n=150 and PPC/UERJ; n=150. Methodology: Doornik-Hansen test verified the Multivariate normality of the scores distribution of the items according to Likert scale. Kaiser-Meyer-Olkin was used as a criterion for identify the adequately of sample for the data adjustment. Conbrach's alpha indicated the internal consistency (coherence) between items on each dimension. The reproducibility by reliability was tested by test-retest by using the weighted Kappa coefficient. Results: Multivariate normality of the SJM scores: (chi2 (22)=602.969 Prob chi2=.0000) and PPC/UERJ: (chi2(22)=411.666 Prob chi2=.0000), adequacy of the samples, KMO: SJM=0.78 to 0.92 and PPC/UERJ=0.76 to 0.92, internal consistency of dimensions (Dimension 1 and 2) by Cronbach's alpha greater than 0.75 for SJM and PPC/UERJ, reproducibility of the questionnaire by weighted Kappa: 0.90 (p value.008), t test for two independent samples, SJM and PPC/UERJ: significant difference for Dimension 1, but not for Dimension 2.

scholarly journals Evaluation of GeneXpert MTB/RIF for detecting Mycobacterium tuberculosis in a hospital in China

2017 ◽  
Vol 45 (2) ◽  
pp. 816-822 ◽  
Author(s):  
Tingyu Tang ◽  
Fang Liu ◽  
Xiaoling Lu ◽  
Qingdong Huang
Keyword(s):  
Mycobacterium Tuberculosis ◽  
Predictive Value ◽  
Rate Sensitivity ◽  
Turnaround Time ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Significant Difference ◽  
Kappa Value ◽  
Positive Rate ◽  
Sensitivity Specificity

Objective To evaluate the performance of GeneXpert MTB/RIF in diagnosing pulmonary tuberculosis (TB) in China. Methods This cross-sectional study included sputum specimens of 240 suspected TB cases. Specimens were examined by light microscopy for the presence of acid-fast bacilli, which were cultured by the BACTEC MGIT 960 (M960) system and detected by the GeneXpert MTB/RIF assay. The positive rate, sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and average turnaround time of methods were evaluated. Results The positive rate was 36.6% (87/238) for the GeneXpert MTB/RIF assay and 34.0% (81/238) by M960 culture, with no significant difference between methods (χ2 = 0.33, p > 0.05). According to culture results, sensitivity of the GeneXpert MTB/RIF assay was 84.0% (68/81), specificity was 87.8% (129/147), the PPV was 78.2% (68/87), and the NPV was 87.2% (129/148). The agreement for results between Gene Xpert MTB/RIF and the M960 system was 82.8% and the Kappa value was 0.73. Conclusion The GeneXpert MTB/RIF assay is a simple, rapid, and accurate test for detecting Mycobacterium tuberculosis in sputum specimens.

Expression and Clinical Significance of Sperm-Associated Antigen 9 in Patients With Endometrial Carcinoma

2012 ◽  
Vol 22 (1) ◽  
pp. 87-93 ◽  
Author(s):  
Peng Yu ◽  
Lei Yan ◽  
Hui Zhang ◽  
Xiaoyan Lin ◽  
Xingbo Zhao
Keyword(s):  
Immune Response ◽  
Endometrial Cancer ◽  
Endometrial Carcinoma ◽  
Humoral Immune Response ◽  
Enzyme Linked Immunosorbent Assay ◽  
Serum Samples ◽  
Humoral Immune ◽  
Significant Difference ◽  
New Type ◽  
Grade 3

ObjectiveTo investigate the expression and humoral immune response of sperm-associated antigen 9 (SPAG9) in endometri al carcinoma.MethodsSperm-associated antigen 9 gene expression levels were evaluated in endometrial carcinoma, endometrial hyperplasia, adjacent tissues, and normal endometrial tissues by reverse transcriptase-polymerase chain reaction, immunohistochemistry, and Western blot. Sperm-associated antigen 9 concentration in serum samples from 10 healthy women, 20 women with benign diseases, and 50 women with endometrial carcinoma was detected by enzyme-linked immunosorbent assay.Results(1) Sperm-associated antigen 9 antibodies were detected in approximately 72% of patients with endometrial cancer but not in healthy controls. (2) A significant difference has been found among pathological types and degrees (P < 0.05), and it was also found to be expressed in transferred lymph nodes. (3) Sperm-associated antigen 9 serum concentration (ng/mL) of patients with endometrial carcinoma is significantly higher than those of the healthy group (P < 0.05). Patients harboring grade 3 endometrial carcinoma were found to have significantly higher SPAG9 concentrations than those of grade 1/grade 2 (P = 0.003).ConclusionsSPAG9 is positively expressed in endometrial cancer, and with a high humoral immune response in patients. It may serve as a new type of endometrial cancer markers for early detection, diagnosis and treatment.

scholarly journals Perbedaan Nilai The Clinic GBS Severity Evaluation Scale (CGSES) dan Skala Disabilitas Sindroma Guillain-Barre (SDSGB) pada Pasien Sindroma Guillian Barre dengan dan tanpa Imunoterapi

2021 ◽  
Vol 10 (2) ◽  
pp. 80-90
Author(s):  
Berliana Sidabutar ◽  
◽  
Ahmad Rizal Ganiem ◽  
Nushrotul Lailiyya ◽  
Nani Kurniani ◽  
...  
Keyword(s):  
Length Of Stay ◽  
Observational Study ◽  
Physical Examination ◽  
Subjective Assessment ◽  
Cross Sectional ◽  
Disability Scale ◽  
Significant Difference ◽  
Kappa Value ◽  
Nerve Paresis ◽  
Guillain Barré

Background and objective: The Clinical GBS Severity Evaluation Scale (CGSES) was developed to determine immunotherapy of GBS patients more objectively. GBS Disability Scale (SDSGB) describes severity of GBS and assesses effectiveness of immunotherapy. Purpose of this study was to measure difference of CGSES and GBSDS in GBS patients with and without immunotherapy and to compare the suitability of subjective decisions with CGSES. Subject and Methods: This is a comparative cross-sectional analytic observational study retrospectively in GBS patients from January 2015-March 2020 hospitalized at Dr Hasan Sadikin Hospital, Bandung. Results: There were 92 subjects (35 with and 57 without immunotherapy). Mean age was 41.5 years, and male:female ratio was 57.6%:42.4%. There were no differences in demographics and physical examination between two groups, except for cranial nerve paresis (62.9% vs. 33.3%; p=0.006). There was a difference in mean length of stay with and without immunotherapy (29.5 ± 34.4 vs. 11.4 ± 4.1 days, p=0.0001). Results of the CGSES assessment with and without immunotherapy had a significant difference (p=0.035). There were significant differences in GBSDS at admission and discharge with (p=0.007) and without immunotherapy (p=0.025). There was a discrepancy between subjective decisions and CGSES value (Kappa value 0.117; 95% CI 0.021-0.213). Conclusion: There were differences in CGSES and GBSDS in group of GBS patients with and without immunotherapy. There was a discrepancy between subjective assessment of decision to give immunotherapy with CGSES scoring.

scholarly journals Application Value of SAT-TB Combined with Acid-Fast Staining in the Diagnosis and Treatment of Pulmonary Tuberculosis

2020 ◽  
Vol 2020 ◽  
pp. 1-5
Author(s):  
Chaochao Qiu ◽  
Ning Pan ◽  
Yueying Zhou ◽  
Hongye Ning ◽  
Xinchun Ye ◽  
...  
Keyword(s):  
Pulmonary Tuberculosis ◽  
Positive Predictive Value ◽  
Predictive Value ◽  
Gold Standard ◽  
Diagnosis And Treatment ◽  
Significant Difference ◽  
Kappa Value ◽  
High Consistency ◽  
Sensitivity Specificity ◽  
Acid Fast Staining

Objectives. This study is aimed at evaluating the clinical application value of RNA simultaneous amplification and testing method for Mycobacterium tuberculosis (SAT-TB) combined with acid-fast staining in the diagnosis and treatment of pulmonary tuberculosis (PTB). Methods. This paper included 168 suspected and confirmed PTB sufferers admitted to The Sixth People’s Hospital of Wenzhou from December 2018 to December 2019, whose sputum was collected and tested using SAT-TB, smear acid-fast staining method, and the BACTEC MGIT 960 system. With the MGIT 960 culture test method as the gold standard, the application value of SAT-TB, acid-fast staining, or SAT-TB combined with acid-fast staining in the diagnosis and treatment of PTB was assessed. Results. With the MGIT 960 culture as the gold standard, the sensitivity, specificity, positive predictive value, and negative predictive value of SAT-TB for the diagnosis of PTB were 57.3%, 92.5%, 84.3%, and 73.5%, respectively. The conformity was 76.8%, and the Kappa value was 0.515, suggesting a statistically significant difference ( χ 2 = 7.314 , p < 0.05 ) and a general consistency degree. Additionally, the sensitivity, specificity, positive predictive value, and negative predictive value of SAT-TB combined with sputum smear acid-fast staining were 81.3%, 86.0%, 88.4%, and 80.8%, respectively, with the MGIT 960 culture still the gold standard. The conformity and Kappa value were 83.9% and 0.672, respectively, showing no statistically significant difference ( χ 2 = 0.438 , p > 0.05 ) and a relatively high consistency degree. Conclusion. SAT-TB combined with acid-fast staining had a similar detection rate to that of the MGIT 960 culture test with a high consistency degree, which could be applied in the diagnosis of PTB efficiently and accurately.

scholarly journals Efficacy of magnetic resonance imaging in assessment of myometrial invasion of carcinoma endometrium

2019 ◽  
Vol 7 (5) ◽  
pp. 1638
Author(s):  
Sheen Maria James ◽  
Robert P. Ambooken ◽  
Rahul Raj K. ◽  
Vipin Krishnan ◽  
Manu Joseph
Keyword(s):  
Endometrial Carcinoma ◽  
Myometrial Invasion ◽  
Preoperative Assessment ◽  
Female Reproductive Tract ◽  
Resected Specimen ◽  
Histopathological Diagnosis ◽  
Mri Findings ◽  
Figo Staging ◽  
Carcinoma Endometrium ◽  
Significant Difference

Background: Endometrial carcinoma is the fourth most common cancer in females and the most common malignancy of the female reproductive tract. The prognosis of endometrial carcinoma depends on a number of factors, including stage, depth of myometrial invasion, lympho-vascular invasion, nodal status and histologic grade. Preoperative assessment with MRI is essential for planning surgery and lymph node sampling. The objectives of this study were to determine the myometrial invasion of endometrial carcinoma by MRI and to obtain histopathology in surgically resected specimen, to compare the MRI findings of myometrial invasion in endometrial carcinoma with histopathology in respectable cases.Methods: Authors analyzed 41 cases in whom, histopathological diagnosis of carcinoma endometrium was established by means of pre-treatment biopsy. Consenting patients were taken up for preoperative MRI FIGO staging. MR images were reviewed for parameters like depth of myometrial invasion. Further surgical management followed by histopathological FIGO staging was done.Results: The study showed MRI was highly sensitive and specific tool for identifying depth of myometrial invasion, cervical invasion, serosal invasion, vaginal and parametrial invasion.Conclusions: There was statistically significant difference between histopathological and MRI assessment of local invasion of endometrial carcinoma.

scholarly journals Acromioaxillosuprasternal Notch Index and Old Head and Anatomic Neck Criteria in Predicting Difficult Laryngoscopy in Tracheal Intubation in Children under General Anesthesia

2019 ◽  
Vol 4 (2) ◽  
Author(s):  
Nedasadat Mansouritehrani
Keyword(s):  
General Anesthesia ◽  
Cross Sectional Study ◽  
Neck Circumference ◽  
Difficult Laryngoscopy ◽  
Sectional Study ◽  
Upper Lip ◽  
Cross Sectional ◽  
Significant Difference ◽  
Grade 3 ◽  
Better Than

Introduction: Currently, various methods are being used for determining difficult laryngoscopy. The present study aimed to compare the acromioaxillosuprasternal notch index function with the old head and neck anatomic criteria in predicting difficult laryngoscopy with respect to trachea intubation under general anesthesia in children. Materials and Methods: In this cross-sectional study, 379 children under intubation with general anesthesia entered the study. Patients were divided into two groups: easy laryngoscopy (grades 1 and 2) and difficult laryngoscopy (grades 3 and 4) based on Cormack-Lehane score. The thyromental distance systems, height to thyromental distance, Upper-Lip-Bite test, neck circumference, and acromioaxillosuprasternal notch index were studied and compared. Results: Laryngoscopy was difficult in 48 subjects (38 were grade 3 and 10 were grade 4). Interestingly, no significant difference was detected between easy and difficult laryngoscopies based on the thyromental distance, neck circumference,  height to thyromental distance, and acromioaxillosuprasternal notch index (P>0.05). height to thyromental distance , acromioaxillosuprasternal notch index , and neck circumference have a sensitivity of 32.2%, 47.9%, 51.1%, respectively, and the specificity was 52.7%, 45.6%, and 48.9%, respectively. Conclusion: Neck circumference and acromioaxillosuprasternal notch index outperform the  height to thyromental distance. On the other hand, Modified Mallampati test is better than Upper-Lip-Bite test in determining difficult laryngoscopy in children.

scholarly journals Computerised tomographic profile of ethmoid roof on basis of keros classification among ethnic Kashmiri’s

2016 ◽  
Vol 2 (1) ◽  
pp. 1 ◽  
Author(s):  
Imran Nazir Salroo ◽  
Nisar Hussain Dar ◽  
Aamir Yousuf ◽  
Kousar Sideeq Lone
Keyword(s):  
Age Groups ◽  
Preoperative Assessment ◽  
Descriptive Study ◽  
T Test ◽  
Ct Scans ◽  
Cross Sectional ◽  
Exact Test ◽  
Significant Difference ◽  
The Mean ◽  
The Right

<p class="abstract"><strong><span lang="EN-US">Background: </span></strong>The purpose of this study was to evaluate the ethmoid roof on computerized tomography of nose and paranasal sinuses of Kashmiri people and distribute them on basis of KEROS classification.</p><p class="abstract"><strong><span lang="EN-US">Methods: </span></strong>Cross sectional descriptive study, the randomly selected paranasal sinus computed tomography (PNS CT) scans coronal cuts .Total of One hundred PNS CT scans done at the SMHS Hospital from April 2015 to September 2015 were reviewed, and selected for study. The bilateral heights of the lateral lamellae of the cribriform plate were obtained, independently coded, and classified according to keros.</p><p class="abstract"><strong><span lang="EN-US">Results: </span></strong>The mean height of the lateral lamella among Kashmir’s was seen to be 5.08mm and 29% of patient’s CT PNS were classified as Keros I, 61% were classified as Keros II and 10% were classified as Keros III. There was significant difference in the distribution of Keros classification between the right and left lateral lamella. There was no significant difference in the height of the lateral lamella (t-test: p=0.98 on right side &amp; p =0.89 on left side) and the distribution of Keros classification (Fisher’s Exact test: p = 0.823) among younger (1-14 year) and older (&gt;14 year) Kashmiri age groups. There is significant difference in the height (t-test: p=0.03 on right side and p=0.03 on left side) and the distribution of Keros classification is statistically insignificant (Fishers Exact Test: p=0.11) between Kashmiri females and males.</p><p class="abstract"><strong><span lang="EN-US">Conclusions: </span></strong>Preoperative assessment of ethmoid roof anatomy and keros level is mandatory for alerting the surgeon of the potential iatrogenic injury during endoscopic sinus surgeries to minimize the grave complications during ESS.</p>

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