scholarly journals Using Doppler sonography resistive index for the diagnosis of perinatal asphyxia: a multi-centered study

2020 ◽  
Author(s):  
Parisa Pishdad ◽  
Fatemeh Yarmahmoodi ◽  
Tannaz Eghbali ◽  
Peyman Arasteh ◽  
Seyyed Mostajab Razavi
Keyword(s):  
Cerebral Artery ◽  
Predictive Value ◽  
Doppler Sonography ◽  
Perinatal Asphyxia ◽  
Negative Likelihood Ratio ◽  
Resistive Index ◽  
Characteristic Analysis ◽  
Mri Findings ◽  
Diagnostic Modality ◽  
Basilar Arteries

Abstract Background and objectiveInhere we evaluated the efficacy of Doppler sonography (DS) of the anterior cerebral artery (ACA), middle cerebral artery (MCA) and the basilar arteries (BA) based on resistive index (RI) for the diagnosis of asphyxia.MethodsIn this multi-centered cross-sectional study, neonates with clinical diagnosis of asphyxia, were considered for study. During the first 24 hours, neonates underwent DS. MRI was done for each neonate during the first month, after discharge or during hospital admission, after obtaining clinical stability. Staging based on DS was compared with staging based on MRI.ResultsOverall, 34 patients entered the study. DS of the ACA, MCA, BA all had significant correlation with MRI findings (regarding severity of asphyxia) (r>0.8 and p<0.001).In the receiver-operating-characteristic analysis, ideal cut-off point for diagnoses of asphyxia based on ACA and BA was RI≤0.62 [area under the curve (AUC) =0.957 and 95% CI: 0.819-0.997; sensitivity=95.65; specificity=100; positive predictive value (PPV) =100; negative predictive value (NPV) =90.9 and negative likelihood ratio (NLR) =0.043]. Regarding MCA, similarly, a RI≤0.62 was ideal for differentiating between normal and asphyxiated neonates (AUC=0.990 and 95% CI: 0.873-1; sensitivity=91.30; specificity=100; PPV=91.2; NPV=100 and NLR=0.087).ConclusionFor evaluating neonates clinically suspected of asphyxia, DS can be used as a first line diagnostic modality and RI of ≤0.62 is an appropriate cut-off for the diagnosis of perinatal asphyxia.

Resistive Index in Late-Onset Neonatal Sepsis

2018 ◽  
Vol 32 (4) ◽  
pp. 93-97
Author(s):  
Rameshwor Yengkhom ◽  
Pradeep Suryawanshi ◽  
Snehal Ingale ◽  
Bhvya Gupta ◽  
Sujata Deshpande
Keyword(s):  
Cerebral Artery ◽  
Neonatal Sepsis ◽  
Anterior Cerebral Artery ◽  
Late Onset ◽  
Perinatal Asphyxia ◽  
Newborn Infants ◽  
Resistive Index ◽  
Genetic Syndromes ◽  
Hemodynamic State ◽  
The Mean

Background and Objectives: Hemodynamics in neonatal sepsis is complex and poorly understood. Several studies have reported conflicting findings on cerebral blood flow (CBF) in sepsis from severely increased flow to severely decreased flow. The objective of our study was to study CBF by measuring the resistive index (RI) of the anterior cerebral artery in late-onset neonatal sepsis (LONS). Methods: All newborn infants admitted in our neonatal intensive care unit with suspected LONS during the period from January 2017 to December 2017 underwent point-of-care transcranial Doppler ultrasonography to measure the RI of the anterior cerebral artery within 24 h of clinical presentation before starting inotropes if at all required. Infants with congenital heart disease, perinatal asphyxia, major congenital malformations, and genetic syndromes were excluded. Neonates with positive culture were included in the final analysis. Results: Of 89 suspected LONS, 33 were culture positive and were analyzed. The mean admission weight was 2.33 ± 0.76 kg. The mean gestational age was 33.5 ± 3.4 wk. Most common organism isolated was Klebsiella pneumoniae (82%). The RI was high in 54.5% (17 of 33) and normal in 45.5% (15 of 33) cases. Conclusions: LONS is a unique and complex hemodynamic state and we found it associated with the high RI indicating decreased CBF. A larger study may help in more understanding of this unique hemodynamic association.

Accuracy of Rotator Cuff Tears and Tendinosis Diagnoses on Shoulder Ultrasound Performed by a Short-experienced Operator

2018 ◽  
Vol 1 ◽  
pp. 9
Author(s):  
Harshad Arvind Vanjare ◽  
Jyoti Panwar
Keyword(s):  
Rotator Cuff ◽  
Negative Predictive Value ◽  
Rotator Cuff Tear ◽  
Predictive Value ◽  
Rotator Cuff Tears ◽  
Mri Findings ◽  
Cuff Tear ◽  
Experienced Operator ◽  
Magnetic Resonance Imaging Mri ◽  
Sensitivity Specificity

Objective The objective of the study was to assess the accuracy of ultrasound examination for the diagnosis of rotator cuff tear and tendinosis performed by a short experienced operator, compared to magnetic resonance imaging (MRI) results. Method A total of 70 subjects suspected to have rotator cuff tear or tendinosis and planned for shoulder MRI were included in the study. Shoulder ultrasound was performed either before or after the MRI scan on the same day. Ultrasound operator had a short experience in performing an ultrasound of the shoulder. Ultrasound findings were correlated to MRI findings. Results Sensitivity, specificity, positive predictive value, negative predictive value, and accuracy for the diagnosis of tendinosis were 58%, 84%, 63%, 80%, and 75%, respectively, and it was 68%, 91%, 73%, 88%, and 85%, respectively, for the diagnosis of rotator cuff tear. Conclusions Sensitivity for diagnosing rotator cuff tear or tendinosis was moderate but had a higher negative predictive value. Thus, the ultrasound operator with a short experience in performing shoulder ultrasound had moderate sensitivity in diagnosing tendinosis or tears; however, could exclude them with confidence.

Preoperative MRI findings and prediction of diagnostic utility of foramen ovale electrodes

2020 ◽  
Vol 132 (3) ◽  
pp. 692-699 ◽  
Author(s):  
Sarah K. Bick ◽  
Marjan S. Dolatshahi ◽  
Benjamin L. Grannan ◽  
Andrew J. Cole ◽  
Daniel B. Hoch ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Treatment Decision ◽  
Temporal Lobectomy ◽  
Categorical Variables ◽  
Continuous Variables ◽  
Foramen Ovale ◽  
Mri Findings ◽  
Noninvasive Methods ◽  
Diagnostic Modality ◽  
Diagnostic Investigations

OBJECTIVEForamen ovale electrodes (FOEs) are a minimally invasive method to localize mesial temporal seizures in cases in which noninvasive methods are inconclusive. The objective of this study was to identify factors predicting the ability of FOEs to yield a diagnosis in order to determine optimal candidates for this procedure.METHODSAll cases of diagnostic investigations performed with FOEs at the authors’ institution between 2005 and 2017 were reviewed. FOE investigation was defined as diagnostic if it led to a treatment decision. Demographic and clinical variables for diagnostic and nondiagnostic investigations were compared using a Wilcoxon rank-sum test for continuous variables and Fisher’s exact test for categorical variables.RESULTSNinety-three patients underwent investigations performed with FOEs during the study period and were included in the study. FOE investigation was diagnostic in 75.3% of cases. Of patients who underwent anterior temporal lobectomy following diagnostic FOE evaluation, 75.9% were Engel class I at last follow-up (average 40.1 months). When the diagnostic and nondiagnostic FOE groups were compared, patients who had diagnostic investigations were more likely to be male (57.1% male vs 26.1% in the nondiagnostic group, p = 0.015). They were also more likely to have temporal lesions on preoperative MRI (p = 0.018).CONCLUSIONSFOEs are a useful, minimally invasive diagnostic modality resulting in a treatment decision in 75% of cases. Male patients and patients with temporal lesions on MRI may be most likely to benefit from FOE investigation.

scholarly journals Circulating tumour DNA methylation in hepatocellular carcinoma diagnosis using digital droplet PCR

2021 ◽  
Vol 49 (3) ◽  
pp. 030006052199296
Author(s):  
Juan Wang ◽  
Liu Yang ◽  
Yanjun Diao ◽  
Jiayun Liu ◽  
Jinjie Li ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Dna Methylation ◽  
Likelihood Ratio ◽  
Predictive Value ◽  
Positive Likelihood Ratio ◽  
Negative Likelihood Ratio ◽  
Control Group ◽  
Control Subjects ◽  
Droplet Pcr ◽  
Healthy Control

Objective To evaluate the performance of a DNA methylation-based digital droplet polymerase chain reaction (ddPCR) assay to detect aberrant DNA methylation in cell-free DNA (cfDNA) and to determine its application in the detection of hepatocellular carcinoma (HCC). Methods The present study recruited patients with liver-related diseases and healthy control subjects. Blood samples were used for the extraction of cfDNA, which was then bisulfite converted and the extent of DNA methylation quantified using a ddPCR platform. Results A total of 97 patients with HCC, 80 healthy control subjects and 46 patients with chronic hepatitis B/C virus infection were enrolled in the study. The level of cfDNA in the HCC group was significantly higher than that in the healthy control group. For the detection of HCC, based on a cut-off value of 15.7% for the cfDNA methylation ratio, the sensitivity and specificity were 78.57% and 89.38%, respectively. The diagnostic accuracy was 85.27%, the positive predictive value was 81.91% and the negative predictive value was 87.20%. The positive likelihood ratio of 15.7% in HCC diagnosis was 7.40, while the negative likelihood ratio was 0.24. Conclusions A sensitive methylation-based assay might serve as a liquid biopsy test for diagnosing HCC.

scholarly journals Doppler ultrasound in pregnancy – quality requirements of DEGUM and clinical application (part 2)

2021 ◽  
Author(s):  
Renaldo Faber ◽  
Kai-Sven Heling ◽  
Horst Steiner ◽  
Ulrich Gembruch
Keyword(s):  
Blood Flow ◽  
Middle Cerebral Artery ◽  
Cerebral Artery ◽  
Umbilical Artery ◽  
Prophylactic Treatment ◽  
Doppler Sonography ◽  
First Trimester ◽  
Ductus Venosus ◽  
Fetal Diagnosis

AbstractThis second part on Doppler sonography in prenatal medicine and obstetrics reviews its clinical applications. While this has not become the initially anticipated screening tool, it is used for the diagnosis and surveillance of a variety of fetal pathologies. For example, the sonography-based determination of uterine artery blood flow indices is an important parameter for the first trimester multimodal preeclampsia risk assessment, increasing accuracy and providing indication for the prophylactic treatment with aspirin. It also has significant implications for the diagnosis and surveillance of growth-restricted fetuses in the second and third trimesters through Doppler-sonographic analysis of umbilical artery, middle cerebral artery and ductus venosus. Here, especially the hemodynamics of the ductus venosus provides a critical criterium for birth management of severe, early-onset FGR before 34 + 0 weeks of gestation. Further, determination of maximum blood flow velocity of the middle cerebral artery is a central parameter in fetal diagnosis of anemia which has been significantly improved by this analysis. However, it is important to note that the mentioned improvements can only be achieved through highest methodological quality. Importantly, all these analyses are also applied to twins and higher order multiples. Here, for the differential diagnosis of specific complications such as TTTS, TAPS and TRAP, the application of Doppler sonography has become indispensable. To conclude, the successful application of Doppler sonography requires both exact methodology and precise pathophysiological interpretation of the data.

The Resistive Index in Renal Doppler Sonography: Where Do We Stand?

2003 ◽  
Vol 180 (4) ◽  
pp. 885-892 ◽  
Author(s):  
Mitchell E. Tublin ◽  
Ronald O. Bude ◽  
Joel F. Platt
Keyword(s):  
Doppler Sonography ◽  
Resistive Index ◽  
Renal Doppler

C-Reactive Protein as A Fungal Infection Marker in Acute Leukemia Patients

2021 ◽  
Vol 27 (2) ◽  
pp. 212
Author(s):  
Brigitte Rina Aninda Sidharta ◽  
JB. Suparyatmo ◽  
Avanti Fitri Astuti
Keyword(s):  
Acute Leukemia ◽  
Predictive Value ◽  
Bacterial Infections ◽  
Fungal Infections ◽  
Lymphoblastic Leukemia ◽  
Negative Likelihood Ratio ◽  
Receiver Operating Curve ◽  
High Morbidity ◽  
C Reactive Protein ◽  
Reactive Protein

Invasive Fungal Infections (IFIs) can cause serious problems in cancer patients and may result in high morbidity andmortality. C-reactive protein levels increase in response to injury, infection, and inflammation. C-reactive protein increasesin bacterial infections (mean of 32 mg/L) and in fungal infections (mean of 9 mg/L). This study aimed to determineC-Reactive Protein (CRP) as a marker of fungal infections in patients with acute leukemia by establishing cut-off values ofCRP. This study was an observational analytical study with a cross-sectional approach and was carried out at the Departmentof Clinical Pathology and Microbiology of Dr. Moewardi Hospital in Surakarta from May until August 2019. The inclusioncriteria were patients with acute leukemia who were willing to participate in this study, while exclusion criteria were patientswith liver disease. There were 61 samples consisting of 30 male and 31 female patients with ages ranging from 1 to 70 years.Fifty-four patients (88.5%) were diagnosed with Acute Lymphoblastic Leukemia (ALL) and 30 (49.18%) were in themaintenance phase. The risk factors found in those patients were neutropenia 50-1500 μL (23.8%), use of intravenous line(22%), and corticosteroid therapy for more than one week (20.9%). The median of CRP in the group of patients with positiveculture results was 11.20 mg/L (11.20-26.23 mg/L) and negative culture results in 0.38 mg/L (0.01-18.63 mg/L). The cut-offvalue of CRP using the Receiver Operating Curve (ROC) was 9.54 mg/L (area under curve 0.996 and p. 0.026), with a sensitivityof 100%, specificity of 93.2%, Positive Predictive Value (PPV) of 33.3%, Negative Predictive Value (PPV) of 100%, PositiveLikelihood Ratio (PLR) of 1.08, Negative Likelihood Ratio (NLR) of 0 and accuracy of 93.4%. C-reactive protein can be used asa screening marker for fungal infections in patients with acute leukemia.

Doppler sonography in the diagnosis of antepartum pyelonephritis: value of intrarenal resistive index measurements.

1996 ◽  
Vol 15 (1) ◽  
pp. 13-17 ◽  
Author(s):  
M T Keogan ◽  
B S Hertzberg ◽  
M A Kliewer ◽  
D M DeLong ◽  
E K Paulson ◽  
...  
Keyword(s):  
Doppler Sonography ◽  
Resistive Index

scholarly journals Misuse of ultrasound for palpable undescended testis by primary care providers: A prospective study

2015 ◽  
Vol 9 (11-12) ◽  
pp. 387 ◽  
Author(s):  
Nathan C Wong ◽  
Rahul K Bansal ◽  
Armando J Lorenzo ◽  
Jorge DeMaria ◽  
Luis H Braga
Keyword(s):  
Primary Care ◽  
Physical Examination ◽  
Likelihood Ratio ◽  
Predictive Value ◽  
Undescended Testis ◽  
Positive Likelihood Ratio ◽  
Negative Likelihood Ratio ◽  
Primary Care Providers ◽  
Care Providers ◽  
Hospital Patients

<p><strong>Introduction:</strong> Although previous evidence has shown that ultrasound is unreliable to diagnose undescended testis, many primary care providers (PCP) continue to misuse it. We assessed the performance of ultrasound as a diagnostic tool for palpable undescended testis, as well as the diagnostic agreement between PCP and pediatric urologists.</p><p><strong>Methods:</strong> We performed a prospective observational cohort study between 2011 and 2013 for consecutive boys referred with a diagnosis of undescended testis to our tertiary pediatric hospital. Patients referred without an ultrasound and those with non-palpable testes were excluded. Data on referring diagnosis, pediatric urology examination and ultrasound reports were analyzed.</p><p><strong>Results:</strong> Our study consisted of 339 boys. Of these, patients without an ultrasound (n = 132) and those with non-palpable testes (n = 38) were excluded. In the end, there were 169 pateints in this study. Ultrasound was performed in 50% of referred boys showing 256 undescended testis. The mean age at time of referral was 45 months. When ultrasound was compared to physical examination by the pediatric urologist, agreement was only 34%. The performance of ultrasound for palpable undescended testis was: sensitivity = 100%; specificity = 16%; positive predictive value = 34%; negative predictive value = 100%; positive likelihood ratio = 1.2; and negative likelihood ratio = 0. Diagnosis of undescended testis by PCP was confirmed by physical examination in 30% of cases, with 70% re-diagnosed with normal or retractile testes.</p><p><strong>Conclusion:</strong> Ultrasound performed poorly to assess for palpable undescended testis in boys and should not be used. Although the study has important limitations, there is an increasing need for education and evidence-based guidelines for PCP in the management of undescended testis.</p>

scholarly journals Predictive Value of Interim PET/CT in DLBCL Treated with R-CHOP: Meta-Analysis

2015 ◽  
Vol 2015 ◽  
pp. 1-8 ◽  
Author(s):  
Na Sun ◽  
Jinhua Zhao ◽  
Wenli Qiao ◽  
Taisong Wang
Keyword(s):  
Likelihood Ratio ◽  
Predictive Value ◽  
Meta Analysis ◽  
Prognostic Significance ◽  
Positive Likelihood Ratio ◽  
Negative Likelihood Ratio ◽  
Chop Chemotherapy ◽  
Interim Pet ◽  
Pet Ct ◽  
Fdg Pet Ct

Objective.We conducted a meta-analysis to evaluate the predictive value of interim18F-FDG PET/CT in patients with DLBCL treated with R-CHOP chemotherapy.Methods.We searched for articles published in PubMed, ScienceDirect, Wiley, Scopus, and Ovid database from inception to March 2014. Articles related to interim PET/CT in patients with DLBCL treated with R-CHOP chemotherapy were selected. PFS with or without OS was chosen as the endpoint to evaluate the prognostic significance of interim PET/CT.Results.Six studies with a total of 605 cases were included. The sensitivity of interim PET/CT ranged from 21.2% to 89.7%, and the pooled sensitivity was 52.4%. The specificity of interim PET/CT ranged from 37.4% to 90.7%, and the pooled specificity was 67.8%. The pooled positive likelihood ratio and negative likelihood ratio were 1.780 and 0.706, respectively. The explained AUC was 0.6978 and theQ*was 0.6519.Conclusions.The sensitivity and specificity of interim PET/CT in predicting the outcome of DLBCL patients treated with R-CHOP chemotherapy were not satisfactory (52.4% and 67.8%, resp.). To improve this, some more work should be done to unify the response criteria and some more research to assess the prognostic value of interim PET/CT with semiquantitative analysis.

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