scholarly journals DIAGNOSTIC SIGNIFICANCE OF CLINICAL AND LABORATORY INDICES IN VERIFICATION OF ACUTE NON-STREPTOCOCCAL TONSYLOPHARYNGITIS IN CHILDREN

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
L.A. Ivanova ◽  
I.B. Horbatiuk ◽  
Ir.B. Horbatiuk ◽  
I.V. Balaniuk ◽  
A.O. Shkilnyuk

The aim of the study - to study the diagnostic significance of clinical and laboratoryparameters in the verification of acute non-streptococcal tonsillopharyngitis in childrenin order to determine rational treatment tactics.Material and methods. To achieve this aim, two clinical groups were formed. The first (I,main) group consisted of 66 patients with acute tonsillopharyngitis of non-streptococcaletiology, as evidenced by the negative result of bacterial examination of the lavage ofthe pharynx and posterior pharyngeal wall. The second (II) clinical group included 32children diagnosed with "streptococcal acute tonsillopharyngitis".Results. The total score on the McIsaac scale, which did not exceed 2 points, wasregistered in 15.2 ± 4.4% of group I patients and 6.2 ± 4.2% of patients in the comparisongroup. The sensitivity of the method was 15.2%, specificity – 93.7%, positive and negativepredicted value – 83.3% and 34.8%, respectively, with odds ratio – 2.6 [95% CI: 0.5-13,0]. The average content of leukocytes in the blood less than 8.9 × 109/l was registeredin 57.6% of patients of group I and 48.8% of representatives of the second (P˃0.05). Thesensitivity of this laboratory test in the detection of non-streptococcal tonsillopharyngitiswas 57.6%, specificity – 55.6%, predicted value of a positive result – 54.1%, predictedvalue of a negative result – 59.1%. The relative risk of non-streptococcal etiology of ATPwhen registering a patient with less than 8.9 × 109/l of peripheral blood leukocytes was1.7 (95% CI 0.9-2.9), the absolute risk – 0.1 with odds ratio of 1.7 (95% CI 0.9-2.9).Conclusions. The proposed clinical scales and some paraclinical parameters haveinsufficient diagnostic value, so they cannot be used independently for early verificationof non-streptococcal etiology of tonsillopharyngitis in children.

2017 ◽  
Vol 8 (1) ◽  
pp. 15-18
Author(s):  
O. K. Koloskova ◽  
T. M. Bilous ◽  
M. V. Dikal ◽  
U. V. Lomakina ◽  
T. G. Kopchuk ◽  
...  

The aim of research was to improve the management of bronchial asthma in children by examining the peculiarities and diagnostic value of reaction markers of eosinophil granulocytes in the sputum and peripheral blood of patients with signs of eosinophil and non-eosinophil phenotypes of this disease. A cohort of 118 school-age children suffering from BA was examined during a period free from attacks. Group I (the main group ) included 61 schoolchildren with signs of eosinophil phenotype (EP) of asthma detected by the character of bronchial inflammation with eosinophil granulocytes present in the sputum at a level of >3%, group II (the comparison group) included 57 patients with a lower number of eosinophils in the sputum (non-eosinophil phenotype (NP) of BA). The average index of the relative content of eosinophils in the peripheral blood among the representatives of group I was 5.82 ± 0.63%, and in children with the signs of NPBA – 6.02 ± 0.74% (P > 0.05), and average indices in the groups of absolute eosinophil number in the blood were 0.37 ± 0.04 and 0.41 ± 0.05 respectively (P > 0.05). The negative reserve of NBT eosinophils in the sputum as a test to verify EPBA showed the following diagnostic values: specificity – 83.3%, predicted value of a positive result – 95.6%. IL-5 content in the blood serum of children with EPBA was 5.99 ± 1.74 ng/ml, in patients of group ІІ – only 1.99 ± 0.49 ng/ml (P < 0.05). Eosinophil cationic protein (ЕСР) in the sputum of patients of group I reached 2.72 ± 0.35 ng/ml, and in the comparison group – only 1.74 ± 0.34 ng/ml (P < 0.05), when the content of ECP in sputum was >1.0 ng/ml the risk of EPBA showed a statistically significant increase: OR = 4.13, RR = 2.02, and AR – 0.34. The efficacy of the standardized basic anti-inflammatory therapy in patients of clinical group I was higher as compared to the children with the signs of NPBA, which was illustrated by the reduced risk of inadequate control of the disease: the index of absolute risk decrease was 31.7%, relative risk – 57.1% with necessary minimal number of patients – 1.75. 


1965 ◽  
Vol 30 (2) ◽  
pp. 166-173 ◽  
Author(s):  
Alta R. Brooks ◽  
Ralph L. Shelton ◽  
Karl A. Youngstrom

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Bei Zhang ◽  
Shuhui Hong ◽  
Guihui Zhang ◽  
Fengnian Rong

Abstract Background Colposcopy offers an accurate way to the diagnose of cervical precancerous lesions. However, the diagnostic accuracy of colposcopy is unsatisfied. This study was to evaluate colposcopic accuracy according to the 2011 International Federation of Cervical Pathology and Colposcopy (IFCPC) terminology. Methods A retrospective cohort study was performed in 1,838 patients who underwent colposcopy in Shandong Qianfoshan Hospital, Cheeloo College of Medicine, Shandong University from October 2013 to April 2018. Using conization or cervical biopsy pathology as the gold standard, the agreement between colposcopic diagnosis and pathologic diagnosis was calculated, and correlations between variables were analyzed. Results As an authoritative and widely used terminology for colposcopy diagnosis, the 2011 IFCPC terminology has certain clinical practicality and diagnostic accuracy. However, some signs such as mosaic, punctation, sharp border, inner border sign and ridge sign had high specificity but unsatisfactory sensitivity, which limited the diagnostic value. Therefore, we discussed the Lugol’s staining, a very common sign in colposcopy, and analyzed the diagnostic significance of bright yellow staining in low-grade squamous intraepithelial lesion (LSIL) and mustard yellow staining in high-grade squamous intraepithelial lesion (HSIL). The results showed that mustard yellow may be a valuable indicator in the diagnosis of HSIL. Conclusion The 2011 IFCPC colposcope terminology has standardized interpretations of the colposcopic findings and improved the accuracy of colposcopy diagnosis. The aceto-white epithelium still has important diagnostic value; however, the value of a few signs is needed to be discussed and new signs are expected to be discovered. Although the significance of Lugol’s staining was diminishing, mustard yellow might be a valuable indicator for the diagnosis of HSIL.


Author(s):  
Konstantin Robertovich Gulyabin

There has been a recent obvious trend towards the increased prevalence of chronic rhinitis – 10-20% of the population experiences this disorder. Vasomotor rhinitis, sometimes also called idiopathic rhinitis, is the indisputable leader among various chronic rhinitis forms (allergic, infectious, atrophic, catarrhal and hypertrophic). The term of vasomotor rhinitis has been the subject of experts' repeated criticism because neurovisceral innervation disorders that underlie this condition are found in almost every form of chronic rhinitis. The main clinical manifestations of vasomotor rhinitis include a feeling of nasal congestion and nasal respiratory obstruction, regular abundant discharge of clear mucus and a feeling of its trickling down the posterior pharyngeal wall. A past respiratory viral infection treated by excessive quantities of vasoconstrictor drops triggers the vasomotor rhinitis onset in most cases.


1987 ◽  
Vol 101 (7) ◽  
pp. 749-752 ◽  
Author(s):  
C. Triaridis ◽  
M. G. Tsalighopoulos ◽  
A. Kouloulas ◽  
A. Vartholomeos

SummaryA rare case of a schwannoma localized on the posterior pharyngeal wall is presented. It concerns a young man with an inflammatory ulcerated mass in the posterior wall of the pharynx causing severe difficulty in swallowing.Although schwannomas of the lateral pharyngeal wall are common, only one case located on the posterior wall has been described. The origin of these tumours at this particular site is thought to be the sympathetic nervous plexus of the posterior pharyngeal wall.In presenting our case, we comment on the origin of posterior pharyngeal wall schwannomas.


Author(s):  
Naglaa El-Toukhy Ramadan El-Toukhy ◽  
Sharaf Elsayed Ali Hassanien ◽  
Ramy A. Metwaly ◽  
Medhat A. Khalil ◽  
Badawy A. Abdulaziz

Background and Study Aims: Portal hypertension is one of the most important complications of liver cirrhosis. The prevalence of varices among cirrhotic patients is variable. Therefore, endoscopic screening of all patients with liver cirrhosis would result in a large number of unnecessary additional burdens to endoscopic units. Our aim was to assess the diagnostic accuracy of spleen stiffness measured by transient elastography (Fibroscan) for prediction of the presence of varices in patients with hepatitis C related cirrhosis. Patients and Methods: The study was carried out on 100 patients with HCV-induced cirrhosis and were divided into 2 groups according to presence or absence of varices by Esophago-gastro-duodenoscopy: Group I: patients with HCV-induced cirrhosis with varices; Group II: patients with HCV-induced cirrhosis without varices. Clinical and laboratory parameters, andominal ultrasonography, Upper gastrointestinal endoscopy and transient elastography to assess the liver and spleen stiffness were carried out to all studied persons. Results: Spleen stiffness had significant diagnostic value to differentiate between cirrhotic patients with varices and cirrhotic patients without varices , it had significant diagnostic value in presence of esophageal varices at cut-off (≥46.4 K Pascal) the sensitivity for detection of esophageal varices was 93%, specificity 100%, positive predictive value (PPV) was 80%, negative predictive value (NPV) was 100%; accuracy was 95% and area under the curve was 0.98 denoting that spleen stiffness is a good predictor of esophageal varices. Conclusion: Spleen stiffness was considered as an excellent predictor of esophageal varices and better than liver stiffness in prediction of esophageal varices presence and had significant diagnostic value to differentiate between the patients with varices and patients without varices at cut off (≥46.4 K Pascal) and it may have a role in variceal grading.


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