scholarly journals Clinical Features of Early Stage COVID-19 in a Primary Care Setting

2021 ◽  
Vol 8 ◽  
Author(s):  
Yohei Kawatani ◽  
Kei Nakayama ◽  
Atsushi Sawamura ◽  
Koichi Fujikawa ◽  
Motoki Nagai ◽  
...  
Keyword(s):  
Primary Care ◽  
Blood Cell ◽  
White Blood Cell ◽  
Blood Test ◽  
Early Stage ◽  
Test Results ◽  
Negative Group ◽  
Initial Screening ◽  
Positive Group ◽  
Blood Tests

Background: The coronavirus disease 2019 (COVID-19) pandemic remains a global healthcare crisis. Nevertheless, the majority of COVID-19 cases involve mild to moderate symptoms in the early stages. The lack of information relating to these cases necessitates further investigation.Methods: Patients visiting the outpatient clinic at the Kamagaya General Hospital were screened by interview and body temperature check. After initial screening, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection was suspected in 481 patients who then underwent blood tests and the loop-mediated isothermal amplification (LAMP) test for SARS-CoV-2. Clinical characteristics between positive and negative SARS-CoV-2 groups were compared. Further, the novel predictive value of routine blood test results for SARS-CoV-2 infection was evaluated using ROC analysis.Results: A total of 15,560 patients visited our hospital during the study period. After exclusion and initial screening by interview, 481 patients underwent the LAMP test and routine blood tests. Of these patients, 69 (14.3%) were positive for SARS-CoV-2 and diagnosed with COVID-19 (positive group), and 412 (85.7%) were negative (negative group). The median period between the first onset of symptoms and visit to our hospital was 3.4 and 2.9 days in the negative and positive groups, respectively. Cough (p = 0.014), rhinorrhea (p = 0.039), and taste disorders (p < 0.001) were significantly more common in the positive group, while gastrointestinal symptoms in the negative group (p = 0.043). The white blood cell count (p < 0.001), neutrophil count (p < 0.001), and percentage of neutrophils (p < 0.001) were higher in the negative group. The percentage of monocytes (p < 0.001) and the levels of ferritin (p < 0.001) were higher in the positive group. As per the predictive values for COVID-19 using blood tests, the values for the area under the curve for the neutrophil-to-monocyte ratio (NMR), white blood cell-to-hemoglobin ratio (WHR), and the product of the two (NMWH) were 0.857, 0.837, and 0.887, respectively.Conclusion: Symptoms in early stage COVID-19 patients were similar to those in previous reports. Some blood test results were not consistent with previous reports. NMR, WHR, and NMWH are novel diagnostic scores in early-stage mild-symptom COVID-19 patients in primary care settings.

scholarly journals White Blood Cell and Granulocyte Counts Are Independent Predictive Factors for Prognosis of Advanced Pancreatic Caner

2018 ◽  
Vol 2018 ◽  
pp. 1-6 ◽  
Author(s):  
Lanyun Feng ◽  
Shihui Gu ◽  
Peng Wang ◽  
Hao Chen ◽  
Zhen Chen ◽  
...  
Keyword(s):  
Pancreatic Cancer ◽  
Overall Survival ◽  
Blood Cell ◽  
White Blood Cell ◽  
Predictive Factors ◽  
Blood Test ◽  
Cancer Prognosis ◽  
Test Results ◽  
Lymphocyte Ratio ◽  
High Death

Background. Pancreatic cancer is associated with high death rates and limited therapeutic options, with no effective predictive factors being available for prognosis at present. In this study, we evaluate the value of using blood test results for pancreatic cancer prognosis. Method. The records of 214 pancreatic cancer patients were reviewed. Blood test results for white blood cell (WBC), granulocyte, neutrophil, lymphocyte, platelet count, neutrophil-to-lymphocyte ratio (NLR), and platelet-to-lymphocyte ratio (PLR) were dichotomized on the basis of median values. This was followed by univariate and multivariate analyses between groups. Results. Patients with pretreatment values in the range WBC≥5.8×109/L, granulocyte≥3.7×109/L, neutrophil≥3.9×109/L, lymphocyte<1.4×109/L, and NLR≥2.8 showed significant correlations pointing to poorer overall survival. Multivariate analysis indicated that WBC≥5.8×109/L (HR=1.808; 95% CI=1.055–3.096; p=0.031) and granulocyte≥3.7×109/L (HR=7.346; 95% CI = 1.275–42.321; p=0.026) can be taken to be independent prognostic factors for overall survival in pancreatic patients. Conclusion. Pretreatment values of WBC and granulocyte count were independent factors with poor prognosis ability with respect to pancreatic cancer.

scholarly journals An in Depth Analysis of Factors Contributing to Diagnostic Delay in Myeloma: A Retrospective UK Study of Patients Journey from Primary Care to Specialist Secondary Care

Blood ◽  
2021 ◽  
Vol 138 (Supplement 1) ◽  
pp. 3007-3007
Author(s):  
Md Imran Hossain ◽  
Peter Hampson ◽  
Craig Nowell ◽  
Shamshad Khan ◽  
Ranjoy Sen ◽  
...  
Keyword(s):  
Primary Care ◽  
Secondary Care ◽  
Blood Test ◽  
Diagnostic Delay ◽  
Initial Presentation ◽  
Test Results ◽  
Presenting Symptoms ◽  
Blood Tests ◽  
Time To Diagnosis ◽  
Gp Visits

Abstract Introduction Patients with Multiple Myeloma (MM) often have a significant delay between onset of symptoms and diagnosis of disease. As a result, a significant number of patients present via emergency routes with severe co-morbidities which affect survival rates. Timely diagnosis relies on the early recognition of symptoms and blood test results which may indicate disease. Methods We examined the medical records of 142 newly diagnosed MM patients (121 intact immunoglobulin and 21 light chains) across 2 UK Hospitals. Patients included had not previously been diagnosed with a plasma cell dyscrasia, including Monoclonal Gammopathy of Undetermined Significance (MGUS). Clinical symptoms and blood test results were examined from the time of initial presentation to the healthcare system with symptoms indicative of MM, to the point of diagnosis in order to highlight patterns of symptoms and blood tests results which may give an early indication of disease. Blood tests results recorded included globulin, calcium, creatinine, erythroid sedimentation rate and haemoglobin. Time to diagnosis from presentation with symptoms indicative of MM was also measured as well as the patient pathway from the point of presentation to the point of diagnosis. Results The median time to diagnosis from initial presentation was 77 days (range 0 - 12,986). Initial presentation was most commonly via primary care (58.1%). Urgent secondary care presentation was documented in 28.5% which included acute medical unit (15.6%), the emergency department (7.1%), and other secondary care specialities (5.7%) respectively. Multiple GP visits were common prior to haematology referral with a median of 3 visits (range 1 - 40). Initial presenting symptoms varied, but of those with data recorded (n=107) back/bone pain was the most common (58.2%) followed by anaemia (18.7%), fracture (7.5%), recurrent infection (7.5%) and renal impairment (3.7%) respectively. Interestingly, analysis of evaluable blood test results revealed a raised globulin was most often evident prior to diagnosis with 58% of patients recording an abnormal globulin a median of 140 days (range 3 - 4297) prior to diagnosis of disease. Conclusions Multiple GP visits prior to establishing a diagnosis of myeloma is very common. Inclusion of abnormal globulin to reflex electrophoresis request and serum free light chain assay may serve as a useful trigger for investigation when interpreted alongside presenting symptoms and other blood test results. Increased awareness of myeloma warning signs in primary care may reduce diagnostic delay and avoid presentation with severe co-morbidities in emergency settings. Disclosures No relevant conflicts of interest to declare.

scholarly journals The use of routine blood tests to assist the diagnosis of COVID-19 in symptomatic hospitalized patients

2021 ◽  
pp. 000456322199907
Author(s):  
IT Parsons ◽  
AT Parsons ◽  
E Balme ◽  
G Hazell ◽  
R Gifford ◽  
...  
Keyword(s):  
Cell Count ◽  
Retrospective Review ◽  
Blood Test ◽  
Patient Flow ◽  
White Cell Count ◽  
Area Under The Curve ◽  
White Cell ◽  
Test Results ◽  
Rt Pcr ◽  
Blood Tests

Introduction Specific patterns of blood test results are associated with COVID-19 infection. The aim of this study was to identify which blood tests could be used to assist in diagnosing COVID-19. Method A retrospective review was performed on consecutive patients referred to hospital with a clinical suspicion of COVID-19 over a period of four weeks. The patient’s clinical presentation and severe acute respiratory syndrome coronavirus 2 reverse-transcription polymerase chain reaction (SARS-CoV-2 RT-PCR) were recorded. The patients were divided by diagnosis into COVID (COVID-19 infection) or CONTROL (an alternate diagnosis). A retrospective review of consecutive patients over a further two-week period was used for the purposes of validation. Results Overall, 399 patients (53% COVID, 47% CONTROL) were analysed. White cell count, neutrophils and lymphocytes were significantly lower, while lactate dehydrogenase and ferritin were significantly higher, in the COVID group in comparison to CONTROL. Combining the white cell count, lymphocytes and ferritin results into a COVID Combined Blood Test (CCBT) had an area under the curve of 0.79. Using a threshold CCBT of –0.8 resulted in a sensitivity of 0.85 and a specificity of 0.63. Analysing this against a further retrospective review of 181 suspected COVID-19 patients, using the same CCBT threshold, resulted in a sensitivity of 0.73 and a specificity of 0.75. The sensitivity was comparable to the SARS-CoV-2 RT PCR. Discussion Mathematically combining the blood tests has the potential to assist clinical acumen allowing for rapid streaming and more accurate patient flow pending definitive diagnosis. This may be of particular use in low-resource settings.

Predicting abnormal laboratory blood test results in the intensive care unit using novel features based on information theory and historical conditional probability (Preprint)

2021 ◽  
Author(s):  
Camilo E. Valderrama ◽  
Daniel J. Niven ◽  
Henry T. Stelfox ◽  
Joon Lee
Keyword(s):  
Machine Learning ◽  
Intensive Care ◽  
Conditional Probability ◽  
Blood Test ◽  
Laboratory Tests ◽  
Conditional Entropy ◽  
Admission Diagnosis ◽  
Test Results ◽  
Abnormal Laboratory ◽  
Blood Tests

BACKGROUND Redundancy in laboratory blood tests is common in intensive care units (ICU), affecting patients' health and increasing healthcare expenses. Medical communities have made recommendations to order laboratory tests more judiciously. Wise selection can rely on modern data-driven approaches that have been shown to help identify redundant laboratory blood tests in ICUs. However, most of these works have been developed for highly selected clinical conditions such as gastrointestinal bleeding. Moreover, features based on conditional entropy and conditional probability distribution have not been used to inform the need for performing a new test. OBJECTIVE We aimed to address the limitations of previous works by adapting conditional entropy and conditional probability to extract features to predict abnormal laboratory blood test results. METHODS We used an ICU dataset collected across Alberta, Canada which included 55,689 ICU admissions from 48,672 patients with different diagnoses. We investigated conditional entropy and conditional probability-based features by comparing the performances of two machine learning approaches to predict normal and abnormal results for 18 blood laboratory tests. Approach 1 used patients' vitals, age, sex, admission diagnosis, and other laboratory blood test results as features. Approach 2 used the same features plus the new conditional entropy and conditional probability-based features. RESULTS Across the 18 blood laboratory tests, both Approach 1 and Approach 2 achieved a median F1-score, AUC, precision-recall AUC, and Gmean above 80%. We found that the inclusion of the new features statistically significantly improved the capacity to predict abnormal laboratory blood test results in between ten and fifteen laboratory blood tests depending on the machine learning model. CONCLUSIONS Our novel approach with promising prediction results can help reduce over-testing in ICUs, as well as risks for patients and healthcare systems. CLINICALTRIAL N/A

Mo1575 The Characteristics of Colorectal Tumors in the Fecal Occult Blood Test-Positive Group and Negative Group of Asymptomatic Examinees

2013 ◽  
Vol 77 (5) ◽  
pp. AB433
Author(s):  
Kunihiko Wakamura ◽  
Shin-Ei Kudo ◽  
Hideyuki Miyachi ◽  
Daisuke Watanabe ◽  
Kenta Kodama ◽  
...  
Keyword(s):  
Blood Test ◽  
Fecal Occult Blood Test ◽  
Occult Blood ◽  
Fecal Occult Blood ◽  
Negative Group ◽  
Colorectal Tumors ◽  
Occult Blood Test ◽  
Positive Group ◽  
Fecal Occult

scholarly journals Autism Spectrum Disorders — in Search of Mechanistic Biomarkers

2019 ◽  
Vol 17 (1) ◽  
pp. 15-23
Author(s):  
N. Rabbani ◽  
P.J. Thornalley
Keyword(s):  
Autism Spectrum Disorders ◽  
Blood Test ◽  
Early Stage ◽  
Clinical Chemistry ◽  
Scientific Basis ◽  
Autism Spectrum ◽  
Blood Tests ◽  
Recent Emergence ◽  
Spectrum Disorders ◽  
Neuropsychiatric Conditions

Autism spectrum disorders are a group of neuropsychiatric conditions of increasing prevalence. They are initially detected in early development of children. Diagnosis is currently made on the basis of clinical behaviour and cognition. Improvements in accuracy, timeliness and access to diagnosis to help manage the condition is high on the agenda of the autistic communities. A blood test may help for early-stage detection of autism spectrum disorders to focus support where required — particularly when symptoms are most challenging. This article discusses briefly the scientific basis of diagnosis of autism spectrum disorders and recent emergence of candidate blood tests for autism. We conclude that further validation and improvements in understanding of autism spectrum disorders are required to provide the scientific basis and classifier characteristics for accurate and reliable diagnosis by clinical chemistry blood test.

The correlation of neutrophil/lymphocyte ratio and tumor reduction ratio in preoperative chermoradiotherapy for advanced rectal cancer.

2014 ◽  
Vol 32 (3_suppl) ◽  
pp. 633-633
Author(s):  
Koji Yasuda
Keyword(s):  
Rectal Cancer ◽  
Local Recurrence ◽  
Blood Test ◽  
Local Recurrence Rate ◽  
Lower Rectal Cancer ◽  
Test Results ◽  
Blood Tests ◽  
Tumor Reduction ◽  
Rectal Cancers ◽  
Reduction Effect

633 Background: Preoperative chemoradiotherapy (CRT) is widely used for the treatment of advanced lower rectal cancer and is considered to reduce the local recurrence rate and improve the anus preservation rate. However, the tumor reduction effect varies among patients, and thus far, no factor has yet been found to be effective in the prediction of therapeutic efficacy. Recent studies have shown tumor immunity in the tumor microenvironment to be involved in the anti-tumor effect of radiation and anti-cancer drugs. Among these studies, some show that the neutrophil/lymphocyte (NL) ratio in blood test results correlates with the therapeutic efficacy. We examined the correlation between the NL ratio based on blood test results and tumor-reducing effect of preoperative CRT on advanced lower rectal cancers. Methods: We included 30 advanced lower rectal cancer patients who underwent preoperative CRT during the period ranging from January 2008 to June 2013.For advanced lower rectal cancers classified as cT3orT4NXM0, preoperative CRT was conducted according to the following regimen: 50.4 Gy (1.8 Gy × 28 fr) + UFT (300 mg/day, LV [75 mg/day]) × 28 days. The neutrophil count and lymphocyte count were determined based on the blood tests conducted before and after CRT; the NL ratio was calculated, and the correlation between the value of the ratio and tumor reduction rate was examined. Results: Radical surgery was performed on 28 of the 30 patients who underwent preoperative CRT. One of the 28 patients showed local recurrence (rate, 3.6%). In addition, down stage tumors were found in 16 of the 28 patients, and the down stage rate was 57.1%. Significant differences (p < 0.0001) were found between the tumor reduction effect and NL ratio from blood tests before CRT, as well as between the tumor reduction effect and the ratio from blood tests after CRT. Conclusions: The above findings suggest anti-tumor immunity in the tumor microenvironment, particularly that lymphocytes might be involved in the antitumor effectiveness of preoperative CRT in advanced lower rectal cancers. In addition, NL ratio from blood tests could be a predictive factor of the tumor reduction effect.

scholarly journals Evaluation of PiB visual interpretation with CSF Aβ and longitudinal SUVR in J-ADNI study

2019 ◽  
Vol 34 (2) ◽  
pp. 108-118 ◽  
Author(s):  
Yusuke Okada ◽  
◽  
Takashi Kato ◽  
Kaori Iwata ◽  
Yasuyuki Kimura ◽  
...  
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Early Stage ◽  
Amyloid Pet ◽  
Negative Group ◽  
Visual Interpretation ◽  
Positive Group ◽  
Amyloid Accumulation ◽  
Over Time

Abstract Objective The objectives of the present study were to investigate (1) whether trinary visual interpretation of amyloid positron emission tomography (PET) imaging (negative/equivocal/positive) reflects quantitative amyloid measurements and the time course of 11C-Pittsburgh compound B (PiB) amyloid accumulation, and (2) whether visually equivocal scans represent an early stage of the Alzheimer’s disease (AD) continuum in terms of an intermediate state of quantitative amyloid measurements and the changes in amyloid accumulation over time. Methods From the National Bioscience Database Center Human Database of the Japanese Alzheimer’s Disease Neuroimaging Initiative, we selected 133 individuals for this study including 33 with Alzheimer’s disease dementia (ADD), 52 with late mild cognitive impairment (LMCI), and 48 cognitively normal (CN) subjects who underwent clinical assessment, PiB PET, and structural magnetic resonance imaging (MRI) with 2 or 3-years of follow-up. Sixty-eight of the 133 individuals underwent cerebrospinal fluid amyloid-β1-42 (CSF-Ab42) analysis at baseline. The standard uptake value ratio (SUVR) of PiB PET was calculated with a method using MRI at each visit. The cross-sectional values, longitudinal changes in SUVR, and baseline CSF-Ab42 were compared among groups, which were categorized based on trinary visual reads of amyloid PET (negative/equivocal/positive). Results From the trinary visual interpretation of the PiB PET images, 55 subjects were negative, 8 were equivocal, and 70 were positive. Negative interpretation was most frequent in the CN group (70.8/10.4/18.8%: negative/equivocal/positive), and positive was most frequent in the LMCI group (34.6/1.9/63.5%) and in the ADD group (9.1/6.1/84.8%). The baseline SUVRs were 1.08 ± 0.06 in the negative group, 1.23 ± 0.15 in the equivocal group, and 1.86 ± 0.31 in the positive group (F = 174.9, p < 0.001). The baseline CSF-Ab42 level was 463 ± 112 pg/mL in the negative group, 383 ± 125 pg/mL in the equivocal group, and 264 ± 69 pg/mL in the positive group (F = 37, p < 0.001). Over the 3-year follow-up, annual changes in SUVR were − 0.00 ± 0.02 in the negative group, 0.02 ± 0.02 in the equivocal group, and 0.04 ± 0.07 in the positive group (F = 8.4, p < 0.001). Conclusions Trinary visual interpretation (negative/equivocal/positive) of amyloid PET imaging reflects quantitative amyloid measurements evaluated with PET and the CSF amyloid test as well as the amyloid accumulation over time evaluated with PET over 3 years. Subjects in the early stage of the AD continuum could be identified with an equivocal scan, because they showed intermediate quantitative amyloid PET, CSF measurements, and the amyloid accumulation over time.

Project of Computer-aided Management of Therapeutical Apheresis

1993 ◽  
Vol 16 (5_suppl) ◽  
pp. 185-186
Author(s):  
C. Falco ◽  
N. Scarpato ◽  
G. Nappi ◽  
S. Formisano
Keyword(s):  
Data Base ◽  
Blood Test ◽  
Great Increase ◽  
Data Entry ◽  
Base System ◽  
Test Results ◽  
Blood Tests ◽  
Therapeutic Protocol ◽  
Computer Aided ◽  
Before And After

The great increase in hemapheresis units activity that occurred during the last years caused the need for a computer-aided management (1, 2). We present a project for a data base system able to manage therapeutical apheresis (3). The program consists of five sections. a) Patient's file card: it allows to record anamnesis, examination and blood test results easily and under computer's guidance. b) Choice of therapeutic protocol: Therapeutic protocol is fixed in this section (device to be used, apheretic method, plasma volume to be processed, blood tests before and after apheresis). c) Procedures: It provides procedure's data entry and guides the operator during the treatment on the ground of therapeutical protocol. d) Data processing: It allows statistics on data placed in the data base. e) Registers: It includes both a general register and the possibility of search by disease, device and method.

Sign in / Sign up

Export Citation Format

Share Document