scholarly journals A New ARDS Early Noninvasive Screening Protocol:Potential Value of SpO2 and FiO2 as a Diagnostic Tool

Author(s):  
Yan Xia ◽  
Qiancheng Xu ◽  
Zhiyuan Guo ◽  
Huijuan Zhang ◽  
Yingya Cao ◽  
...  

Abstract Background: A large number of recent studies have confirmed that the pulse oximetric saturation (SpO2)/fraction of inspired oxygen (FiO2) ratio (SFR) correlate well with PaO2/FiO2 ratio (PFR). However, whether SFR can replace PFR for the diagnosis and evaluate the severity of ARDS patients is unclearly. The purpose of this study is to explore potential value of SFR as a new diagnostic tool for ARDS, and establish a diagnostic process.Methods: 341 patients were included in this study, SFR and PFR values were recorded in the same time. 161 patients were used to establish the model, and 180 patients were used to verify the validity of the model. 161 groups of data were divide into hypoxic group (group H) and non-hypoxic group (group N) according to whether SpO2 was greater than 97%. For group H, the regression equation was established to describe the relationship between SFR and PFR. and calculated the value of SFR when PFR is 300. For group N, the correlation between each observation data and PFR were analyzed. Receiver operating characteristic (ROC) curve analysis was used to determine the diagnostic value of the index. Finally, a new diagnostic process was established for ARDS based on these results, and the reliability was verified with Berlin definition set as the gold standard for diagnosis and classification.Results: For group H the diagnostic linear equation is PFR = 0.9162*SFR-21.39 ( R2=0.66 , P<0.0001 ). After calculation, when PFR is 300, SFR is 352. For group N, There is a significant negative correlation between FiO2 and PFR((R= -0.521,P<0.0001)). The AUC of using FiO2 to diagnose ARDS was 0.694 (95%CI 0.571~0.817, P<0.005). When the cutoff value of FiO2 was 39%, the sensitivity was 0.838 and the specificity was 0.545. Therefore, in this new diagnosis progress, when SpO2≤97%, if SFR≤352, ARDS may exist; when SpO2>97%, if FiO2min>39%, there may be ARDS. The sensitivity, specificity, NPV, PPV, and accuracy of the new diagnosis progress for ARDS were 91.1%, 76.7%, 89.6%, 79.6%, and 83.9%, respectively. Conclusions: There are potential value of SpO2 and FiO2 as a noninvasive diagnostic tool for ARDS.

2021 ◽  
Author(s):  
Yan Xia ◽  
Qiancheng Xu ◽  
Zhiyuan Guo ◽  
Huijuan Zhang ◽  
Yingya Cao ◽  
...  

Abstract Background: A large number of recent studies have confirmed that the pulse oximetric saturation (SpO2)/fraction of inspired oxygen (FiO2) ratio (SFR) correlate well with PaO2/FiO2 ratio (PFR). However, whether SFR can replace PFR for the diagnosis and evaluate the severity of ARDS patients with advanced respiratory support is unclearly. The purpose of this study is to explore potential value of SFR ratio as a new diagnostic tool for ARDS by establishing new processes in patients who require high levels of oxygen support.Methods: 341 patients were included in this study, SFR and PFR values were recorded in the same time. 161 patients were used to establish the model, and 180 patients were used to verify the validity of the model. 161 groups of data were divide into hypoxic group (group H) and non-hypoxic group (group N) according to whether SpO2 was greater than 97%. For group H, the regression equation was established to describe the relationship between SFR and PFR. and calculated the value of SFR when PFR is 300. For group N, the correlation between each observation data andPFR were analyzed. Receiver operating characteristic (ROC) curve analysis was used to determine the diagnostic value of the index. Finally, a new diagnostic process was established for ARDS based on these results, and the reliability was verified with Berlin definition set as the gold standard for diagnosis and classification. Results: For group H, the diagnostic linear equation is PFR = 0.9162*SFR-21.39 ( R2=0.66 , P<0.0001 ). After calculation, when PFR is 300, SFR is 352. For group N, There is a significant negative correlation between FiO2 and PFR((R= -0.521,P<0.0001)). The AUC of using FiO2 to diagnose ARDS was 0.694 (95%CI 0.571~0.817, P < 0.005). When the cutoff value of FiO2 was 39%, the sensitivity was 0.838 and the specificity was 0.545. Therefore, in this new diagnosis progress, when SpO2≤97%, if SFR≤352, ARDS may exist; when SpO2>97%, if FiO2min>39%, there may be ARDS. The sensitivity, specificity, NPV, PPV, and accuracy of the new diagnosis progress for ARDS were 91.1%, 76.7%, 89.6%, 79.6%, and 83.9%, respectively. Conclusion: There are potential value of SpO2 and FiO2 as a noninvasive diagnostic tool for ARDS by new processes in patients who are already receiving high levels of oxygen support.


2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Xiao-hong Mao ◽  
Qiang Ye ◽  
Guo-bing Zhang ◽  
Jin-ying Jiang ◽  
Hong-ying Zhao ◽  
...  

Abstract Background Aberrant DNA methylation is significantly associated with breast cancer. Methods In this study, we aimed to determine novel methylation biomarkers using a bioinformatics analysis approach that could have clinical value for breast cancer diagnosis and prognosis. Firstly, differentially methylated DNA patterns were detected in breast cancer samples by comparing publicly available datasets (GSE72245 and GSE88883). Methylation levels in 7 selected methylation biomarkers were also estimated using the online tool UALCAN. Next, we evaluated the diagnostic value of these selected biomarkers in two independent cohorts, as well as in two mixed cohorts, through ROC curve analysis. Finally, prognostic value of the selected methylation biomarkers was evaluated breast cancer by the Kaplan-Meier plot analysis. Results In this study, a total of 23 significant differentially methylated sites, corresponding to 9 different genes, were identified in breast cancer datasets. Among the 9 identified genes, ADCY4, CPXM1, DNM3, GNG4, MAST1, mir129-2, PRDM14, and ZNF177 were hypermethylated. Importantly, individual value of each selected methylation gene was greater than 0.9, whereas predictive value for all genes combined was 0.9998. We also found the AUC for the combined signature of 7 genes (ADCY4, CPXM1, DNM3, GNG4, MAST1, PRDM14, ZNF177) was 0.9998 [95% CI 0.9994–1], and the AUC for the combined signature of 3 genes (MAST1, PRDM14, and ZNF177) was 0.9991 [95% CI 0.9976–1]. Results from additional validation analyses showed that MAST1, PRDM14, and ZNF177 had high sensitivity, specificity, and accuracy for breast cancer diagnosis. Lastly, patient survival analysis revealed that high expression of ADCY4, CPXM1, DNM3, PRDM14, PRKCB, and ZNF177 were significantly associated with better overall survival. Conclusions Methylation pattern of MAST1, PRDM14, and ZNF177 may represent new diagnostic biomarkers for breast cancer, while methylation of ADCY4, CPXM1, DNM3, PRDM14, PRKCB, and ZNF177 may hold prognostic potential for breast cancer.


Author(s):  
Dwi Priyadi Djatmiko ◽  
I Putu Adi Santosa ◽  
Elvin Richela Lawanto ◽  
Bogi Pratomo ◽  
Hani Susianti

Introduction. Alpha-Fetoprotein (AFP) is a tumor marker that has been widely used for HCC, but there has been no increased AFP in 35-45% patients with HCC. Protein induced by vitamin K absence or antagonist II (PIVKA-II) is an abnormal prothrombin secreted in HCC and is expected can be used for HCC diagnostic marker. The objective of this study was to compare serum PIVKA-II levels in the patients with HCC, cirrhosis and healthy control and determine the diagnostic value of PIVKA-II for hepatocellular carcinoma. Methods. This was a cross-section analytic observational study to identify the diagnostic value of PIVKA-II for HCC diagnosis. The diagnosis of 20 cirrhotic patients and 15 patients with HCC was established by history taking, physical examination, and additional examination according to the diagnosis criteria. A group of 12 individuals with normal liver function were used as healthy control subjects. Serum PIVKA-II levels were analyzed with immunoassay method. Comparison study used the Independent-Samples Kruskal Wallis Test. ROC curve analysis and 2x2 contingency table was used to calculate sensitivity, specificity, positive and negative predictive value (PPV and NPV).Results. The serum PIVKA-II level in the patients with HCC was significantly higher than in cirrhotic (p = 0,000) and healthy control patients (p = 0,000). Sensitivity, specificity, PPV, and NPV of PIVKA-II for diagnosis of HCC in cirrhotic patients at a cut-off value of 140.85 mAU/mL were 93.33%, 75%, 73.68%, and 93.75%, respectively (AUC = 0.87).Conclusions and Suggestions. PIVKA-II has high diagnostic value for HCC diagnosis. Diagnostic test that compare serum PIVKA-II level in any size of HCC nodules may be needed in the future.


2020 ◽  
Vol 2020 ◽  
pp. 1-10
Author(s):  
Jiejie Qin ◽  
Qian Yang ◽  
Hua Ye ◽  
Keyan Wang ◽  
Meng Zhang ◽  
...  

The serological biomarkers as noninvasive tests are the most promising way for diagnosing gastric cancer (GC). Serological proteome analysis (SERPA) has been used to identify tumor-associated antigens (TAAs) and the corresponding autoantibodies in many studies. To explore the relationship between gastric cancer development and serum autoantibody anti-GRP78 response found by the method of SERPA with the GC cell line AGS, we included two cohorts (133 GC and 133 normal individuals in test group; 300 GC and 300 normal individuals in validation group) of patients with newly diagnosed GC for verification. All GC and normal controls were matched by age and gender. The autoantibody levels of the sera in two cohorts were measured by immunoassay. Finally, the results showed that 78-kDa glucose-regulated protein (GRP78) was identified in GC by SERPA and the level of anti-GRP78 antibody in GC was higher than that in normal individuals in the two cohorts. Receiver operating characteristic (ROC) curve analysis showed similar diagnostic value of anti-GRP78 antibody in test group (AUC: 0.718) and validation group (AUC: 0.666) to identify GC patients from normal individuals. The AUCs of anti-GRP78 autoantibody in the diagnosis of GC patients with different clinical characteristic ranged from 0.676 to 0.773 in test group and ranged from 0.645 to 0.707 in validation group. In conclusion, autoantibody against GRP78 might be a potential diagnostic biomarker. Further large-scale studies will be needed to validate and improve its performance of the sensitivity, specificity, and AUC value in distinguishing GC from other diseases.


2017 ◽  
Vol 4 (10) ◽  
pp. 3196 ◽  
Author(s):  
Reno Rudiman ◽  
Tommy Ruchimat ◽  
Yohanes Ferdinand

Background: The diagnosis of appendicitis depends on the subjective criteria of clinical examination. However, distinguishing acute perforated appendicitis (local peritonitis) and non-perforated is often difficult especially in the elderly population that usually not clinically specific unless it has developed into generalized peritonitis. Between the non-perforated acute appendicitis and perforate should be distinguished because of different surgical approaches. C-reactive protein (CRP) and neutrophil-lymphocyte ratios are known to be associated with various conditions such as malignancy, heart disease, and inflammation, including acute perforated appendicitis. This examination not only is cheaper, but also feasible and available in peripheral hospitals compared to other supports such as ultrasound or CT scan, but this examination has not been routinely used so the purpose of this study is to examine the diagnostic accuracy of both laboratory parameters so as to assist a surgeon to determine whether the case of appendicitis has been perforated or not and can provide information to patients and the families about the diseases and surgical techniques to be performed.Methods: This study used cross sectional analytic in two groups, appendicitis with and without perforation group to know the value of sensitivity, specificity, positive predictor value, negative predictor value, from CRP and RNL in both groups.Results: Of the 46 patients who met the inclusion criteria, the mean age of patients with perforated appendicitis was 33.73±17.101, male sex counted 26 patients (56.5%) and women 20 patients (43.5%). Based on ROC curve analysis, CRP = 76,65 and RNL = 8,825 were obtained, and sensitivity, specificity, positive guess, negative prediction and accuracy value for CRP were 88.0%, 71.4%, 78 %, 5%, 83.3% and 80.4%; While for RNL of 64.0%, 80.9%, 80.0%, NDN, and 71.7%.Conclusions: CRP and RNL have a strong diagnostic value and is moderately strong in cases of perforated appendicitis.


2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Hideaki Tsuyoshi ◽  
Tetsuya Tsujikawa ◽  
Shizuka Yamada ◽  
Hidehiko Okazawa ◽  
Yoshio Yoshida

Abstract Purpose To evaluate the diagnostic potential of PET/MRI with 2-[18F]fluoro-2-deoxy-d-glucose ([18F]FDG) in ovarian cancer. Materials and methods Participants comprised 103 patients with suspected ovarian cancer underwent pretreatment [18F]FDG PET/MRI, contrast-enhanced CT (ceCT) and pelvic dynamic contrast-enhanced MRI (ceMRI). Diagnostic performance of [18F]FDG PET/MRI and ceMRI for assessing the characterization and the extent of the primary tumor (T stage) and [18F]FDG PET/MRI and ceCT for assessing nodal (N stage) and distant (M stage) metastases was evaluated by two experienced readers. Histopathological and follow-up imaging results were used as the gold standard. The McNemar test was employed for statistical analysis. Results Accuracy for the characterization of suspected ovarian cancer was significantly better for [18F]FDG PET/MRI (92.5%) [95% confidence interval (CI) 0.84–0.95] than for ceMRI (80.6%) (95% CI 0.72–0.83) (p < 0.05). Accuracy for T status was 96.4% (95% CI 0.96–0.96) and 92.9% (95% CI 0.93–0.93) for [18F]FDG PET/MRI and ceMRI/ceCT, respectively. Patient-based accuracies for N and M status were 100% (95% CI 0.88–1.00) and 100% (95% CI 0.88–1.00) for [18F]FDG PET/MRI and 85.2% (95% CI 0.76–0.85) and 30.8% (95% CI 0.19–0.31) for ceCT and M staging representing significant differences (p < 0.01). Lesion-based sensitivity, specificity and accuracy for N status were 78.6% (95% CI 0.57–0.91), 95.7% (95% CI 0.93–0.97) and 93.9% (95% CI 0.89–0.97) for [18F]FDG PET/MRI and 42.9% (95% CI 0.24–0.58), 96.6% (95% CI 0.94–0.98) and 90.8% (95% CI 0.87–0.94) for ceCT. Conclusions [18F]FDG PET/MRI offers better sensitivity and specificity for the characterization and M staging than ceMRI and ceCT, and diagnostic value for T and N staging equivalent to ceMRI and ceCT, suggesting that [18F]FDG PET/MRI might represent a useful diagnostic alternative to conventional imaging modalities in ovarian cancer.


Breast Cancer ◽  
2021 ◽  
Author(s):  
Xuemin Liu ◽  
Qingyu Chang ◽  
Haiqiang Wang ◽  
Hairong Qian ◽  
Yikun Jiang

Abstract Background MicroRNA-155 (miR-155) may function as a diagnostic biomarker of breast cancer (BC). Nevertheless, the available evidence is controversial. Therefore, we performed this study to summarize the global predicting role of miR-155 for early detection of BC and preliminarily explore the functional roles of miR-155 in BC. Methods We first collected published studies and applied the bivariate meta-analysis model to generate the pooled diagnostic parameters of miR-155 in diagnosing BC such as sensitivity, specificity and area under curve (AUC). Then, we applied function enrichment and protein–protein interactions (PPI) analyses to explore the potential mechanisms of miR-155. Results A total of 21 studies were finally included. The results indicated that miR-155 allowed for the discrimination between BC patients and healthy controls with a sensitivity of 0.87 (95% CI 0.78–0.93), specificity of 0.82 (0.72–0.89), and AUC of 0.91 (0.88–0.93). In addition, the overall sensitivity, specificity and AUC for circulating miR-155 were 0.88 (0.76–0.95), 0.83 (0.72–0.90), and 0.92 (0.89–0.94), respectively. Function enrichment analysis revealed several vital ontologies terms and pathways associated with BC occurrence and development. Furthermore, in the PPI network, ten hub genes and two significant modules were identified to be involved in some important pathways associated with the pathogenesis of BC. Conclusions We demonstrated that miR-155 has great potential to facilitate accurate BC detection and may serve as a promising diagnostic biomarker for BC. However, well-designed cohort studies and biological experiments should be implemented to confirm the diagnostic value of miR-155 before it can be applied to routine clinical procedures.


Author(s):  
Philipp Capetian ◽  
Veit Roessner ◽  
Caroline Korte ◽  
Susanne Walitza ◽  
Franz Riederer ◽  
...  

AbstractTetrahydroisoquinolines (TIQs) such as salsolinol (SAL), norsalsolinol (NSAL) and their methylated derivatives N-methyl-norsalsolinol (NMNSAL) and N-methyl-salsolinol (NMSAL), modulate dopaminergic neurotransmission and metabolism in the central nervous system. Dopaminergic neurotransmission is thought to play an important role in the pathophysiology of chronic tic disorders, such as Tourette syndrome (TS). Therefore, the urinary concentrations of these TIQ derivatives were measured in patients with TS and patients with comorbid attention-deficit/hyperactivity disorder (TS + ADHD) compared with controls. Seventeen patients with TS, 12 with TS and ADHD, and 19 age-matched healthy controls with no medication took part in this study. Free levels of NSAL, NMNSAL, SAL, and NMSAL in urine were measured by a two-phase chromatographic approach. Furthermore, individual TIQ concentrations in TS patients were used in receiver-operating characteristics (ROC) curve analysis to examine the diagnostic value. NSAL concentrations were elevated significantly in TS [434.67 ± 55.4 nmol/l (standard error of mean = S.E.M.), two-way ANOVA, p < 0.0001] and TS + ADHD patients [605.18 ± 170.21 nmol/l (S.E.M.), two-way ANOVA, p < 0.0001] compared with controls [107.02 ± 33.18 nmol/l (S.E.M.), two-way ANOVA, p < 0.0001] and NSAL levels in TS + ADHD patients were elevated significantly in comparison with TS patients (two-way ANOVA, p = 0.017). NSAL demonstrated an AUC of 0.93 ± 0.046 (S.E.M) the highest diagnostic value of all metabolites for the diagnosis of TS. Our results suggest a dopaminergic hyperactivity underlying the pathophysiology of TS and ADHD. In addition, NSAL concentrations in urine may be a potential diagnostic biomarker of TS.


Author(s):  
Carmelo Saraniti ◽  
Enzo Chianetta ◽  
Giuseppe Greco ◽  
Norhafiza Mat Lazim ◽  
Barbara Verro

Introduction Narrow-band imaging is an endoscopic diagnostic tool that, focusing on superficial vascular changes, is useful to detect suspicious laryngeal lesions, enabling their complete excision with safe and tailored resection margins. Objectives To analyze the applications and benefits of narrow-band imaging in detecting premalignant and malignant laryngeal lesions through a comparison with white-light endoscopy. Data Synthesis A literature search was performed in the PubMed, Scopus and Web of Science databases using strict keywords. Then, two authors independently analyzed the articles, read the titles and abstracts, and read completely only the relevant studies according to certain eligibility criteria. In total, 14 articles have been included in the present review; the sensitivity, specificity, positive and negative predictive values, and accuracy of pre- and/or intraoperative narrow-band imaging were analyzed. The analysis showed that narrow-band imaging is better than white-light endoscopy in terms of sensitivity, specificity, positive and negative predictive values, and accuracy regarding the ability to identify cancer and/or precancerous laryngeal lesions. Moreover, the intraoperative performance of narrow-band imaging resulted more effective than the in-office performance. Conclusion Narrow-band imaging is an effective diagnostic tool to detect premalignant and malignant laryngeal lesions and to define proper resection margins. Moreover, narrow-band imaging is useful in cases of leukoplakia that may cover a possible malignant lesion and that cannot be easily assessed with white-light endoscopy. Finally, a shared, simple and practical classification of laryngeal lesions, such as that of the European Laryngological Society, is required to identify a shared lesion management strategy. Key Points


2020 ◽  
Vol 0 (0) ◽  
Author(s):  
Lei Xi ◽  
Chunqing Yang

AbstractObjectivesThe main aim of the present study was to assess the diagnostic value of alpha-l-fucosidase (AFU) for hepatocellular carcinoma (HCC).MethodsStudies that explored the diagnostic value of AFU in HCC were searched in EMBASE, SCI, and PUBMED. The sensitivity, specificity, and DOR about the accuracy of serum AFU in the diagnosis of HCC were pooled. The methodological quality of each article was evaluated with QUADAS-2 (quality assessment for studies of diagnostic accuracy 2). Receiver operating characteristic curves (ROC) analysis was performed. Statistical analysis was conducted by using Review Manager 5 and Open Meta-analyst.ResultsEighteen studies were selected in this study. The pooled estimates for AFU vs. α-fetoprotein (AFP) in the diagnosis of HCC in 18 studies were as follows: sensitivity of 0.7352 (0.6827, 0.7818) vs. 0.7501 (0.6725, 0.8144), and specificity of 0.7681 (0.6946, 0.8283) vs. 0.8208 (0.7586, 0.8697), diagnostic odds ratio (DOR) of 7.974(5.302, 11.993) vs. 13.401 (8.359, 21.483), area under the curve (AUC) of 0.7968 vs. 0.8451, respectively.ConclusionsAFU is comparable to AFP for the diagnosis of HCC.


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