scholarly journals Does Sequential Balloon Expulsion Test improve the screening of Defecation Disorders?

2020 ◽  
Author(s):  
Ana Célia Caetano ◽  
Dalila Costa ◽  
Raquel Gonçalves ◽  
Jorge Correia-Pinto ◽  
Carla Rolanda
Keyword(s):  
Predictive Value ◽  
Low Cost ◽  
Digital Rectal Examination ◽  
Tertiary Hospital ◽  
Screening Methods ◽  
Balloon Expulsion ◽  
Defecation Disorders ◽  
Physiological Evaluation ◽  
Balloon Expulsion Test ◽  
Physiological Tests

Abstract Purpose A Defecation Disorder (DD) is a difficulty in evacuation documented by physiological exams. However, this physiological evaluation can be cumbersome, inaccessible and costly. Three “low-cost” tools to evaluate DD – a clinical DD score, the balloon expulsion test (BET) and a digital rectal examination (DRE) score were evaluated as separate or combined tests for DD screening. Methods This prospective study occurred between January 2015 and March 2019 in the Gastroenterology Department of a tertiary hospital. Besides the gold standard physiological tests, constipated patients answered the clinical DD score and were evaluated by DRE and BET (standard and variable volume (vv)). Results From 98 constipated patients, 35 (38.9%) were diagnosed with DD according to Rome IV criteria, mainly female (n = 30, 86%) with a median age of 60 years old. The clinical DD score revealed an AUC of 0.417 (SE = 0.07, p = 0.191). The DRE score displayed an AUC of 0.56 (SE = 0.063, p = 0.301). The standard BET displayed a sensitivity of 86%, specificity of 58%, positive predictive value (PPV) of 57% and negative predictive value (NPV) of 86%. The sequential vvBET followed by standard BET improved the BET performance regarding the evaluation of DD, with a sensitivity of 86%, specificity of 67%, PPV of 63% and NPV of 87%. The sequential BET had an OR 8.942, p > 0.001, CI 3.18–25.14, revealing to be the most significant predictor for DD screening. Conclusion The sequential BET is a low cost, well-performing DD screening tool, appropriate to the Primary Care Setting.

scholarly journals Does sequential balloon expulsion test improve the screening of defecation disorders?

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
A. C. Caetano ◽  
D. Costa ◽  
R. Gonçalves ◽  
J. Correia-Pinto ◽  
C. Rolanda
Keyword(s):  
Predictive Value ◽  
Low Cost ◽  
Digital Rectal Examination ◽  
Tertiary Hospital ◽  
Balloon Expulsion ◽  
Defecation Disorders ◽  
Physiological Evaluation ◽  
Balloon Expulsion Test ◽  
Physiological Tests ◽  
Defecation Disorder

Abstract Background A defecation disorder (DD) is a difficulty in evacuation documented by physiological exams. However, this physiological evaluation can be cumbersome, inaccessible and costly. Three “low-cost” tools to evaluate DD—a clinical DD score, the balloon expulsion test (BET) and a digital rectal examination (DRE) score were evaluated as separate or combined tests for DD screening. Methods This prospective study occurred between January 2015 and March 2019 in the Gastroenterology Department of a tertiary hospital. Besides the gold standard physiological tests, constipated patients answered the clinical DD score and were evaluated by DRE and BET [standard and variable volume (VV)]. Results From 98 constipated patients, 35 (38.9%) were diagnosed with DD according to Rome IV criteria, mainly female (n = 30, 86%) with a median age of 60 years old. The clinical DD score revealed an AUC of 0.417 (SE = 0.07, p = 0.191). The DRE score displayed an AUC of 0.56 (SE = 0.063, p = 0.301). The standard BET displayed a sensitivity of 86%, specificity of 58%, positive predictive value (PPV) of 57% and negative predictive value (NPV) of 86%. The sequential VVBET followed by standard BET improved the BET performance regarding the evaluation of DD, with a sensitivity of 86%, specificity of 67%, PPV of 63% and NPV of 87%. The sequential BET had an OR 8.942, p > 0.001, CI 3.18–25.14, revealing to be the most significant predictor for DD screening. Conclusion The sequential BET is a low cost, well-performing DD screening tool, appropriate to the Primary Care Setting.

scholarly journals Digital Rectal Examination and Balloon Expulsion Test in the Study of Defecatory Disorders: Are They Suitable as Screening or Excluding Tests?

2016 ◽  
Vol 2016 ◽  
pp. 1-8 ◽  
Author(s):  
Ana C. Caetano ◽  
André Santa-Cruz ◽  
Carla Rolanda
Keyword(s):  
Sensitivity And Specificity ◽  
Low Cost ◽  
Random Effect ◽  
Digital Rectal Examination ◽  
Standard Test ◽  
Rectal Examination ◽  
Balloon Expulsion ◽  
Balloon Expulsion Test ◽  
Physiological Tests ◽  
Sensitivity Specificity

Background. Rome III criteria add physiological criteria to symptom-based criteria of chronic constipation (CC) for the diagnosis of defecatory disorders (DD). However, a gold-standard test is still lacking and physiological examination is expensive and time-consuming. Aim. Evaluate the usefulness of two low-cost tests—digital rectal examination (DRE) and balloon expulsion test (BET)—as screening or excluding tests of DD. Methods. We performed a systematic search in PUBMED and MEDLINE. We selected studies where constipated patients were evaluated by DRE or BET. Heterogeneity was assessed and random effect models were used to calculate the sensitivity, specificity, and negative predictive value (NPV) of the DRE and the BET. Results. Thirteen studies evaluating BET and four studies evaluating DRE (2329 patients) were selected. High heterogeneity (I2>80%) among studies was demonstrated. The studies evaluating the BET showed a sensitivity and specificity of 67% and 80%, respectively. Regarding the DRE, a sensitivity of 80% and specificity of 84% were calculated. NPV of 72% for the BET and NPV of 64% for the DRE were estimated. The sensitivity and specificity were similar when we restrict the analysis to studies using Rome criteria to define CC. The BET seems to perform better when a cut-off time of 2 minutes is used and when it is compared with a combination of physiological tests. Considering the DRE, strict criteria seem to improve the sensitivity but not the specificity of the test. Conclusion. Neither of the low-cost tests seems suitable for screening or excluding DD.

Predictive value of balloon expulsion test and symptom diary for selecting constipated patients without pelvic floor dyssynergia

2003 ◽  
Vol 124 (4) ◽  
pp. A683
Author(s):  
Belen Herreros ◽  
Miguel Minguez ◽  
Vicente Sanchiz ◽  
Perdro Almela ◽  
Vicente Hernandez ◽  
...  
Keyword(s):  
Pelvic Floor ◽  
Predictive Value ◽  
Pelvic Floor Dyssynergia ◽  
Balloon Expulsion ◽  
Balloon Expulsion Test ◽  
Symptom Diary

Predictive value of the balloon expulsion test for excluding the diagnosis of pelvic floor dyssynergia in constipation

2004 ◽  
Vol 126 (1) ◽  
pp. 57-62 ◽  
Author(s):  
Miguel Minguez ◽  
Belen Herreros ◽  
Vicente Sanchiz ◽  
Vicent Hernandez ◽  
Pedro Almela ◽  
...  
Keyword(s):  
Pelvic Floor ◽  
Predictive Value ◽  
Pelvic Floor Dyssynergia ◽  
Balloon Expulsion ◽  
Balloon Expulsion Test

scholarly journals Diagnosis of tuberculosis pleurisy with three endoscopic features via pleuroscopy

2021 ◽  
Vol 15 ◽  
pp. 175346662198953
Author(s):  
Chung-Shu Lee ◽  
Shih-Hong Li ◽  
Chih-Hao Chang ◽  
Fu-Tsai Chung ◽  
Li-Chung Chiu ◽  
...  
Keyword(s):  
Pleural Effusion ◽  
Predictive Value ◽  
Image Interpretation ◽  
Discrete Distribution ◽  
Unknown Origin ◽  
Tertiary Hospital ◽  
Public Health Campaign ◽  
Health Campaign ◽  
Predictive Values ◽  
Characteristic Features

Background: Tuberculosis (TB) is a constant threat even with a worldwide active public health campaign. Diagnosis of TB pleurisy is challenging in the case of pleural effusion of unknown origin after aspiration analysis. The study was designed to demonstrate a simple image interpretation technique to differentiate TB pleurisy from non-TB pleurisy using semi-rigid pleuroscopy. Methods: The study retrospectively enrolled 117 patients who underwent semi-rigid pleuroscopy from April 2016 to August 2018 in a tertiary hospital. We analyzed the possibility of TB pleurisy using three simple pleuroscopic images via semi-rigid pleuroscopy. Results: Among 117 patients, 28 patients (23.9%) were diagnosed with TB pleurisy. Sago-like nodules/micronodules, adhesion, and discrete distribution were noted in 20 (71.4%), 20 (71.4%), and 19 (67.9%) patients with TB pleurisy, respectively. Sago-like nodules/micronodules, adhesion, and discrete distribution were noted in six (6.7%), 37 (41.6%), and no (0.0%) patients with non-TB pleurisy, respectively. The positive and negative predictive values of any two out of three pleuroscopic patterns for TB pleurisy were 100.0% and 93.7%, respectively. Conclusions: A high positive predictive value for TB pleurisy was demonstrated by the presence of any two out of the three characteristic features. Absence of all three features had an excellent negative predictive value for TB pleurisy. Our diagnostic criteria reconfirm that pleuroscopic images can be used as predictors for TB pleurisy in patients with undiagnosed pleural effusion. The reviews of this paper are available via the supplementary material section.

scholarly journals Triage of Patients Suspected of COVID-19 in Chronic Hemodialysis: Eosinophil Count Differentiates Low and High Suspicion of COVID-19

2020 ◽  
Vol 10 (1) ◽  
pp. 4
Author(s):  
Romain Vial ◽  
Marion Gully ◽  
Mickael Bobot ◽  
Violaine Scarfoglière ◽  
Philippe Brunet ◽  
...  
Keyword(s):  
Predictive Value ◽  
Eosinophil Count ◽  
Characteristic Curve ◽  
Final Analysis ◽  
Hemodialysis Patients ◽  
Chronic Hemodialysis ◽  
Screening Methods ◽  
Dialysis Session ◽  
Diagnostic Study ◽  
Rt Pcr

Background: Daily management to shield chronic dialysis patients from SARS-CoV-2 contamination makes patient care cumbersome. There are no screening methods to date and a molecular biology platform is essential to perform RT-PCR for SARS-CoV-2; however, accessibility remains poor. Our goal was to assess whether the tools routinely used to monitor our hemodialysis patients could represent reliable and quickly accessible diagnostic indicators to improve the management of our hemodialysis patients in this pandemic environment. Methods: In this prospective observational diagnostic study, we recruited patients from La Conception hospital. Patients were eligible for inclusion if suspected of SARS-CoV-2 infection when arriving at our center for a dialysis session between March 12th and April 24th 2020. They were included if both RT-PCR result for SARS-CoV-2 and cell blood count on the day that infection was suspected were available. We calculated the area under the curve (AUC) of the receiver operating characteristic curve. Results: 37 patients were included in the final analysis, of which 16 (43.2%) were COVID-19 positive. For the day of suspected COVID-19, total leukocytes were significantly lower in the COVID-19 positive group (4.1 vs. 7.4 G/L, p = 0.0072) and were characterized by lower neutrophils (2.7 vs. 5.1 G/L, p = 0.021) and eosinophils (0.01 vs. 0.15 G/L, p = 0.0003). Eosinophil count below 0.045 G/L identified SARS-CoV-2 infection with AUC of 0.9 [95% CI 0.81—1] (p < 0.0001), sensitivity of 82%, specificity of 86%, a positive predictive value of 82%, a negative predictive value of 86% and a likelihood ratio of 6.04. Conclusions: Eosinophil count enables rapid routine screening of symptomatic chronic hemodialysis patients suspected of being COVID-19 within a range of low or high probability.

scholarly journals Development and validation of a prognostic COVID-19 severity assessment (COSA) score and machine learning models for patient triage at a tertiary hospital

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Verena Schöning ◽  
Evangelia Liakoni ◽  
Christine Baumgartner ◽  
Aristomenis K. Exadaktylos ◽  
Wolf E. Hautz ◽  
...  
Keyword(s):  
Machine Learning ◽  
Risk Stratification ◽  
Clinical Outcomes ◽  
Predictive Value ◽  
Validation Cohort ◽  
Tertiary Hospital ◽  
Learning Models ◽  
Clinical Risk ◽  
Machine Learning Models ◽  
Risk Stratification Score

Abstract Background Clinical risk scores and machine learning models based on routine laboratory values could assist in automated early identification of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) patients at risk for severe clinical outcomes. They can guide patient triage, inform allocation of health care resources, and contribute to the improvement of clinical outcomes. Methods In- and out-patients tested positive for SARS-CoV-2 at the Insel Hospital Group Bern, Switzerland, between February 1st and August 31st (‘first wave’, n = 198) and September 1st through November 16th 2020 (‘second wave’, n = 459) were used as training and prospective validation cohort, respectively. A clinical risk stratification score and machine learning (ML) models were developed using demographic data, medical history, and laboratory values taken up to 3 days before, or 1 day after, positive testing to predict severe outcomes of hospitalization (a composite endpoint of admission to intensive care, or death from any cause). Test accuracy was assessed using the area under the receiver operating characteristic curve (AUROC). Results Sex, C-reactive protein, sodium, hemoglobin, glomerular filtration rate, glucose, and leucocytes around the time of first positive testing (− 3 to + 1 days) were the most predictive parameters. AUROC of the risk stratification score on training data (AUROC = 0.94, positive predictive value (PPV) = 0.97, negative predictive value (NPV) = 0.80) were comparable to the prospective validation cohort (AUROC = 0.85, PPV = 0.91, NPV = 0.81). The most successful ML algorithm with respect to AUROC was support vector machines (median = 0.96, interquartile range = 0.85–0.99, PPV = 0.90, NPV = 0.58). Conclusion With a small set of easily obtainable parameters, both the clinical risk stratification score and the ML models were predictive for severe outcomes at our tertiary hospital center, and performed well in prospective validation.

scholarly journals Contribution of Nanomaterials to the Development of Electrochemical Aptasensors for the Detection of Antimicrobial Residues in Food Products

Chemosensors ◽  
2021 ◽  
Vol 9 (4) ◽  
pp. 69
Author(s):  
Valérie Gaudin
Keyword(s):  
Signal Amplification ◽  
Electrochemical Sensors ◽  
Low Cost ◽  
Food Products ◽  
Animal Origin ◽  
Screening Methods ◽  
Chemical Methods ◽  
Portable Instrumentation ◽  
Physico Chemical ◽  
Antimicrobial Residues

The detection of antimicrobial residues in food products of animal origin is of utmost importance. Indeed antimicrobial residues could be present in animal derived food products because of animal treatments for curative purposes or from illegal use. The usual screening methods to detect antimicrobial residues in food are microbiological, immunological or physico-chemical methods. The development of biosensors to propose sensitive, cheap and quick alternatives to classical methods is constantly increasing. Aptasensors are one of the major trends proposed in the literature, in parallel with the development of immunosensors based on antibodies. The characteristics of electrochemical sensors (i.e., low cost, miniaturization, and portable instrumentation) make them very good candidates to develop screening methods for antimicrobial residues in food products. This review will focus on the recent advances in the development of electrochemical aptasensors for the detection of antimicrobial residues in food products. The contribution of nanomaterials to improve the performance characteristics of electrochemical aptasensors (e.g., Sensitivity, easiness, stability) in the last ten years, as well as signal amplification techniques will be highlighted.

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