Algorithm of Screening and Monitoring of Hypertension in Rural Outpatient Clinics: the Realities of Practice Through the Prism of the Recommendations

The objective: of the study was a comparative analysis and identify the informativeness of diagnostic methods available in conditions of rural outpatient clinic and formulate the algorithm of screening and monitoring of hypertension in the practice of family doctors. Patients and methods: The study involved 62 patients with hypertension of the second-degree severity. In the first group diagnosis of AH was performed by the methods available in conditions of rural outpatient clinic, in the second group the reference methods were used. The clinical laboratory tests and instrumental examination were made. Informativeness of the methods available in conditions of rural outpatient clinic was defined on base of data of sensitivity, specificity and positive predictive value. Results. Home blood pressure measurement in terms of rural family medicine is the most justified because of the low cost of the survey, the possibility of continuous control of hypertension, the relative autonomy of the patient and results with data DMAT is approximate, high rates of sensitivity and specificity. Use ECG criteria for their relatively high sensitivity and specificity of the method proves informative and justifies its use in the village for early diagnosis of heart damage in patients with hypertension. Definition of ankle brachial index is informative, non-invasive, affordable method to detect the presence of vascular pathology, to evaluate dynamics during treatment. Determination of MAU is an affordable quality marker of kidney damage in hypertension, with high sensitivity and specificity. For a more accurate diagnosis be to calculate glomerular filtration rate. Lipid metabolism at clinic should be determined by the level of total cholesterol. Carbohydrate metabolism enough to carry on fasting glucose and glucose1tolerant test. Conclusion. It is proved the simple in performance, the cheap and routine methods that are used widely can to inform about cardiovascular risk and to determine the prognosis of illness in patients with hypertension.

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Trends in Diagnosis for Active Tuberculosis Using Nanomaterials

Current Medicinal Chemistry ◽

10.2174/0929867325666180912105617 ◽

2019 ◽

Vol 26 (11) ◽

pp. 1946-1959 ◽

Cited By ~ 3

Author(s):

Le Minh Tu Phan ◽

Lemma Teshome Tufa ◽

Hwa-Jung Kim ◽

Jaebeom Lee ◽

Tae Jung Park

Keyword(s):

Sensitivity And Specificity ◽

High Efficiency ◽

Point Of Care ◽

High Sensitivity ◽

Signs And Symptoms ◽

Diagnostic Methods ◽

Advantages And Disadvantages ◽

Treatment And Prevention ◽

Clinical Tools ◽

Diagnostic Applications

Background:Tuberculosis (TB), one of the leading causes of death worldwide, is difficult to diagnose based only on signs and symptoms. Methods for TB detection are continuously being researched to design novel effective clinical tools for the diagnosis of TB.Objective:This article reviews the methods to diagnose TB at the latent and active stages and to recognize prospective TB diagnostic methods based on nanomaterials.Methods:The current methods for TB diagnosis were reviewed by evaluating their advantages and disadvantages. Furthermore, the trends in TB detection using nanomaterials were discussed regarding their performance capacity for clinical diagnostic applications.Results:Current methods such as microscopy, culture, and tuberculin skin test are still being employed to diagnose TB, however, a highly sensitive point of care tool without false results is still needed. The utilization of nanomaterials to detect the specific TB biomarkers with high sensitivity and specificity can provide a possible strategy to rapidly diagnose TB. Although it is challenging for nanodiagnostic platforms to be assessed in clinical trials, active TB diagnosis using nanomaterials is highly expected to achieve clinical significance for regular application. In addition, aspects and future directions in developing the high-efficiency tools to diagnose active TB using advanced nanomaterials are expounded.Conclusion:This review suggests that nanomaterials have high potential as rapid, costeffective tools to enhance the diagnostic sensitivity and specificity for the accurate diagnosis, treatment, and prevention of TB. Hence, portable nanobiosensors can be alternative effective tests to be exploited globally after clinical trial execution.

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Accurate clinical detection of exon copy number variants in a targeted NGS panel using DECoN

Wellcome Open Research ◽

10.12688/wellcomeopenres.10069.1 ◽

2016 ◽

Vol 1 ◽

pp. 20 ◽

Cited By ~ 29

Author(s):

Anna Fowler ◽

Shazia Mahamdallie ◽

Elise Ruark ◽

Sheila Seal ◽

Emma Ramsay ◽

...

Keyword(s):

False Discovery Rate ◽

Sensitivity And Specificity ◽

Copy Number ◽

Clinical Laboratory ◽

Copy Number Variants ◽

High Sensitivity ◽

Targeted Next Generation Sequencing ◽

Gene Testing ◽

False Discovery ◽

Targeted Ngs

Background: Targeted next generation sequencing (NGS) panels are increasingly being used in clinical genomics to increase capacity, throughput and affordability of gene testing. Identifying whole exon deletions or duplications (termed exon copy number variants, ‘exon CNVs’) in exon-targeted NGS panels has proved challenging, particularly for single exon CNVs. Methods: We developed a tool for the Detection of Exon Copy Number variants (DECoN), which is optimised for analysis of exon-targeted NGS panels in clinical settings. We evaluated DECoN performance using 96 samples with independently validated exon CNV data. We performed simulations to evaluate DECoN detection performance of single exon CNVs and evaluate performance using different coverage levels and sample numbers. Finally, we implemented DECoN in a clinical laboratory that tests BRCA1 and BRCA2 with the TruSight Cancer Panel (TSCP). We used DECoN to analyse 1,919 samples, validating exon CNV detections by multiplex ligation-dependent probe amplification (MLPA). Results: In the evaluation set, DECoN achieved 100% sensitivity and 99% specificity for BRCA exon CNVs, including identification of 8 single exon CNVs. DECoN also identified 14/15 exon CNVs in 8 other genes. Simulations of all possible BRCA single exon CNVs gave a mean sensitivity of 98% for deletions and 95% for duplications. DECoN performance remained excellent with different levels of coverage and sample numbers; sensitivity and specificity was >98% with the typical NGS run parameters. In the clinical pipeline, DECoN automatically analyses pools of 48 samples at a time, taking 24 minutes per pool, on average. DECoN detected 24 BRCA exon CNVs, of which 23 were confirmed by MLPA, giving a false discovery rate of 4%. Specificity was 99.7%. Conclusions: DECoN is a fast, accurate, exon CNV detection tool readily implementable in research and clinical NGS pipelines. It has high sensitivity and specificity and acceptable false discovery rate. DECoN is freely available at www.icr.ac.uk/decon.

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Lung Ultrasound Examination in Patients with SARS-CoV-2 Infection: Multicenter Study

Journal of Clinical Medicine ◽

10.3390/jcm10153255 ◽

2021 ◽

Vol 10 (15) ◽

pp. 3255

Author(s):

Natalia Buda ◽

Jolanta Cylwik ◽

Katarzyna Mróz ◽

Renata Rudzińska ◽

Paweł Dubik ◽

...

Keyword(s):

Interstitial Pneumonia ◽

Sensitivity And Specificity ◽

Lung Ultrasound ◽

High Sensitivity ◽

Hospitalized Patients ◽

Diagnostic Methods ◽

High Resolution Computed Tomography ◽

Diagnostic Modality ◽

Diagnostic Modalities ◽

B Lines

Background: The COVID-19 pandemic has, by necessity, contributed to rapid advancements in medicine. Owing to the necessity of following strict anti-epidemic sanitary measures when taking care of infected patients, the accessibility of standard diagnostic methods may be limited. Consequently, the significance and potential of bedside diagnostic modalities increase, including lung ultrasound (LUS). Method: Multicenter registry study involving adult patients with confirmed COVID-19, for whom LUS was performed. Results: A total of 228 patients (61% males) qualified for the study. The average age was 60 years (±14), 40% were older than 65 years of age. In 130 from 173 hospitalized patients, HRCT (high-resolution computed tomography) was performed. In 80% of patients, LUS findings indicated interstitial pneumonia. In hospitalized patients multifocally located single B-lines, symmetrical B-lines, and areas of white lung were significantly more frequent as compared to ambulatory patients. LUS findings, both those indicating interstitial syndrome and consolidations, were positively correlated with HRCT images. As compared to HRCT, the sensitivity and specificity of LUS in detecting interstitial pneumonia were 97% and 100%, respectively. Conclusions: As compared to HRCT, LUS is characterized by a very high sensitivity and specificity in detecting interstitial pneumonia in COVID-19 patients. Potentially, LUS can be a particularly useful diagnostic modality for COVID-19 patients pneumonia.

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Comparison between central and ambulatory blood pressure measurements in early detection of end organ damage: a single-center prospective non-randomized controlled trial

The Egyptian Heart Journal ◽

10.1186/s43044-019-0013-3 ◽

2019 ◽

Vol 71 (1) ◽

Author(s):

Doaa A. Fouad ◽

Hosam Hassan Al Araby ◽

Mohammad Ashraf ◽

Ahmed El-Sherif El-Kousy

Keyword(s):

Blood Pressure ◽

Early Detection ◽

Sensitivity And Specificity ◽

Ambulatory Blood Pressure ◽

Ankle Brachial Index ◽

High Sensitivity ◽

Organ Damage ◽

Left Ventricular ◽

Significant Relation ◽

End Organ Damage

Abstract Background Both ambulatory blood pressure (AMBP) and non-invasive central blood pressure (NCBP) monitoring could be used as predictors for early detection of hypertensive end organ damage (EOD). However, the comparison between these two methods needs more clarification. Our cross-sectional study included 100 hypertensive patients with a mean age of 47.52 ± 8.35 years on regular antihypertensive treatment for ≥ 1 year (50 controlled, 50 uncontrolled). We compared associations, sensitivity, and specificity of EOD parameters with office, AMBP, and NCBP measurements. We measured left ventricular mass index (LVMI), carotid intimal medial thickness (CIMT), ankle-brachial index (ABI), serum creatinine, glomerular filtration rate (GFR), and pulse wave velocity (PWV). Results We found a significant relation between SBP of NCBP, AMBP and LVMI, and CIMT, PWV, and GFR respectively (P < 0.05) while office SBP showed no significant relation. Systolic AMBP showed a high sensitivity to ABI (98%) and CIMT (92%) while systolic NCBP had 92% specificity and DBP showed 90% sensitivity for ABI. Conclusion AMBP and NCBP show a significant relation to LVMI, CIMT, PWV, and GFR with little superiority of central BP while office BP does not. Systolic ABPM has high sensitivity to ABI and CIMT and systolic NCBP has a high sensitivity and specificity to ABI.

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Performance of Tsol-p27 antigen for the serological diagnosis of cysticercosis in Mozambique

Journal of Helminthology ◽

10.1017/s0022149x15000747 ◽

2015 ◽

Vol 90 (5) ◽

pp. 630-633 ◽

Cited By ~ 2

Author(s):

N. Nhancupe ◽

E.V. Noormahomed ◽

S. Afonso ◽

K.I. Falk ◽

J. Lindh

Keyword(s):

Western Blot ◽

Sensitivity And Specificity ◽

Blot Analysis ◽

Western Blot Analysis ◽

Low Cost ◽

High Sensitivity ◽

Diagnostic Methods ◽

Enzyme Linked Immunosorbent Assay ◽

Serum Samples ◽

Neuroimaging Techniques

AbstractThe diagnosis of neurocysticercosis (NCC) requires expensive neuroimaging techniques that are seldom affordable for people in endemic countries. Accordingly, there is a need for new low-cost diagnostic methods that offer high sensitivity and specificity. In this study, we evaluated Western blot analysis of the previously described recombinant antigen Tsol-p27 in relation to a commercial or in-house enzyme-linked immunosorbent assay (ELISA) for NCC, and compared the results with those provided by a commercial enzyme-linked immunoelectrotransfer blot (EITB) assay, which was regarded as the reference standard method. The analysed serum samples were obtained from 165 people, 18 of whom were confirmed to be NCC positive by EITB. Comparing our Western blot analysis of Tsol-p27 with a previous evaluation performed in Central America showed similar specificity (96.69% versus 97.8%) and sensitivity (85.71% versus 86.7%). The present results indicate that the recombinant Tsol-p27 antigen provides good sensitivity and specificity, and might be preferable as a diagnostic antigen in poorly equipped laboratories in endemic countries.

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Rapid and Visible RPA-Cas12a fluorescence Assay for Accurate Detection of Zoonotic Dermatophytes

10.1101/2021.06.04.446987 ◽

2021 ◽

Author(s):

Liyang Wang ◽

Jinyu Fu ◽

Guang Cai ◽

Di Zhang ◽

Shuobo Shi ◽

...

Keyword(s):

Sensitivity And Specificity ◽

Limit Of Detection ◽

Diagnostic Testing ◽

High Sensitivity ◽

Trichophyton Mentagrophytes ◽

Fluorescence Assay ◽

Diagnostic Methods ◽

Clinical Samples ◽

Microsporum Canis ◽

Fungal Culture

Background: Dermatophytosis is an infectious disease of global significance caused by several fungal species, which affects the hair, nails, or superficial layers of the skin. The most common zoonotic dermatophytes are Microsporum canis, Nannizzia gypsea and Trichophyton mentagrophytes. Wood's lamp examination, microscopic identification and fungal culture are the main conventional diagnostic methods used in clinics. Less common methods are dermatophyte PCR and biopsy/histopathology. However, these methods also have limitations for providing both accuracy and timely on-site detection. The recent development of CRISPR-based diagnostic platform provides the possibility of a rapid, accurate, and portable diagnostic tool, which has huge potential for clinical applications. Objectives: The purpose of this study is to establish a molecular method for rapid and accurate diagnosis of clinical dermatophytes, which can accelerate clinical diagnostic testing and help timely treatment. Methods: In this paper, we design a Cas12a-based assay combined with recombinase polymerase amplification (RPA) to differentiate three main zoonotic dermatophytes. The limit of detection (LOD) is determined by using standard strains. A total of 25 clinical samples (hair and scurf) are identified to evaluate the sensitivity and specificity of this assay. Results: The RPA-Cas12a method showed high sensitivity and specificity (100% and 100%, respectively). The results could be observed directly by naked-eyes, and all tested samples were consistent with fungal culture and sequencing results. Conclusions: Compared with other methods, the RPA-Cas12a-fluorescence assay requires less time (30 minutes) and less complicated equipment, and visible changes can be clearly observed, which is suitable for on-site clinical diagnosis.

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Sensitivity and Specificity of Ankle Brachial Index (ABI) and Pulse Wave Handheld Doppler (PWHD) Compared with Angiography as Diagnostic Test for Patients with Peripheral Artery Disease (PAD)

Journal of Indonesian Society for Vascular and Endovascular Surgery ◽

10.36864/jinasvs.2021.1.005 ◽

2021 ◽

Vol 2 (1) ◽

pp. 10-11

Author(s):

Valdy Thomas ◽

Djony Tjandra ◽

Richard Sumangkut ◽

Billy Karundeng ◽

Grace Korompis

Keyword(s):

Diagnostic Test ◽

Sensitivity And Specificity ◽

Peripheral Artery Disease ◽

Ankle Brachial Index ◽

High Sensitivity ◽

Ease Of Use ◽

Peripheral Artery ◽

Cross Sectional ◽

Tibial Artery ◽

Artery Disease

Background: Peripheral artery disease (PAD) is a clinical condition that occurs due to atherosclerosis and narrowing of the arteries involving the aorta, branches of the visceral arteries such as the iliac arteries, and the arteries of the distal extremities. The femoropopliteal artery is the most commonly involved site in patients with atherosclerotic PAD. Ankle Brachial Index (ABI) determination may have limited value in some patients with diabetes, because calcification of the tibial artery can render it uncompressible, resulting in a very high ABI value (>1.40). Handheld vascular Doppler with pulse volume waveform interpretation (PVW) is an easily available and non-invasive modality for evaluation of the inferior extremity arteries and can detect the severity of blood flow disturbances or ongoing PAD. The best diagnostic method for PAD is angiography using digital substraction angiography (DSA) to assess existing atherosclerotic lesions. The advantages of ABI and PWHD examinations are in terms of simplicity, ease of use, and non-invasiveness instead of angiography in PAD diagnosis led the investigators to compare the sensitivity and specificity values between ABI and PWHD with angiography as a diagnostic test for PAD patients. Methods: This study used a cross-sectional diagnostic test design with the subjects were patients diagnosed with PAD, both outpatients and inpatients at Prof. DR. R.D Kandou Manado. ABI, PWHD and angiography examination were performed on all study subjects. Results: The data show that ABI has a sensitivity of 95.2% and a specificity of 80% in diagnosing PAD patients when compared to angiography as the standard of diagnosis of PAD. PWHD compared to angiography has a sensitivity of 100% and a specificity of 100%. When ABI and PWHD are combined, it has a sensitivity of 100% with a specificity of 80%. The sensitivity and specificity of PWHD compared to angiography based on angiographic location in popliteal artery has a sensitivity of 91.7% and a specificity of 92.6%. PWHD compared with angiography on posterior tibial artery (PTA) has a sensitivity of 81% and a specificity of 88.9%. ABI compared with angiography on dorsalis pedis artery has a sensitivity of 100% and a specificity of 71.4%, with p <0.0001. Conclusion: The high sensitivity and specificity of ABI and PWHD can be used as a diagnostic test tool for PAD patients by general practitioners in first level health facilities.

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The Sensitivity and Specificity of the Caffeine-Halothane Contracture Test

Anesthesiology ◽

10.1097/00000542-199803000-00006 ◽

1998 ◽

Vol 88 (3) ◽

pp. 579-588 ◽

Cited By ~ 131

Author(s):

Gregory C. Allen ◽

Marilyn Green Larach ◽

Allen R. Kunselman

Keyword(s):

Malignant Hyperthermia ◽

Sensitivity And Specificity ◽

Clinical Laboratory ◽

High Sensitivity ◽

Youden Index ◽

Clinical Criteria ◽

The North ◽

Diagnostic Thresholds ◽

Diagnostic Threshold ◽

Component Test

Background The caffeine-halothane contracture test (CHCT) is the only recognized laboratory test to diagnose malignant hyperthermia (MH). The authors report the results of their analysis of pooled data from the North American Malignant Hyperthermia Registry database to determine the sensitivity and specificity of the CHCT. Methods The MH Clinical Grading Scale was used to identify 32 case subjects who were "almost certain" to be MH susceptible based on clinical criteria alone. Their CHCT results were compared with those of a group of 120 control subjects considered to be at low risk for MH. Diagnostic thresholds of the CHCT were adjusted, and its component tests were combined to generate receiver operating characteristic curves. The maximal Youden index for each component test was chosen as the diagnostic threshold indicative of MH susceptibility. Results The highest sensitivity (97%; 95% CI, 84-100%) was achieved with a two-component test with thresholds of > or = 0.5 g contracture for 3% halothane, > or = 0.3 g contracture at 2 mM caffeine, or both, considered positive for MH. The test specificity was 78% (95% CI, 69-85%). The addition of other CHCT component tests did not improve CHCT sensitivity or specificity. Conclusion The CHCT achieves high sensitivity and acceptable specificity as a clinical laboratory diagnostic test when it is performed according to published standards. However, it cannot be used as a screening test because of the low prevalence of MH in the general population.

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