scholarly journals Serum N-Terminal Pro-B-Type Natriuretic Peptide as a Biomarker of Critical Pulmonary Stenosis in Neonates

2022 ◽  
Vol 9 ◽  
Author(s):  
Zhiwei Lin ◽  
Yanru Chen ◽  
Lin Zhou ◽  
Sun Chen ◽  
Hongping Xia
Keyword(s):  
Natriuretic Peptide ◽  
Characteristic Curve ◽  
Pulmonary Stenosis ◽  
Area Under The Curve ◽  
Rank Correlation ◽  
Length Of Hospital Stay ◽  
Receiver Operator Characteristic Curve ◽  
Curve Analysis ◽  
Positive Correlation ◽  
Critical Pulmonary Stenosis

Objectives: To determine the efficacy of serum N-terminal pro-B-type natriuretic peptide (NT-proBNP) levels in predicting critical pulmonary stenosis (CPS) in neonates.Methods: All neonates with pulmonary stenosis (PS) admitted to the neonatal intensive care unit of Xinhua Hospital from October 2014 to December 2020 were retrospectively reviewed. Infants with serum NT-proBNP levels measured within 48 h after birth were enrolled and divided into CPS and non-CPS groups. Serum NT-proBNP levels and cardiac Doppler indices were compared between the two groups. Correlations were determined using the Spearman's rank correlation coefficient. Receiver operator characteristic curve analysis was used to explore the predictive value of NT-proBNP for identifying neonatal CPS.Results: Among 96 infants diagnosed with PS by echocardiography, 46 were enrolled (21 and 25 in the non-CPS and CPS groups, respectively). Serum NT-proBNP levels were significantly higher in the CPS group than in the non-CPS group [3,600 (2,040–8,251) vs. 1,280 (953–2,386) pg/ml, P = 0.003]. Spearman's analysis suggested a positive correlation between Ln(NT-proBNP) levels and the transvalvular pulmonary gradient (r = 0.311, P = 0.038), as well as between Ln(NT-proBNP) levels and pulmonary artery velocity (r = 0.308, P = 0.040). Receiver operating characteristic curve analysis showed that a cutoff serum NT-proBNP level of 2,395 pg/ml yielded a 66.7 and 78.9% sensitivity and specificity for identifying CPS, respectively. The area under the curve was 0.784 (95% CI, 0.637–0.931). A positive correlation was found between Ln(NT-proBNP) and length of hospital stay (r = 0.312, P < 0.05).Conclusion: Serum NT-proBNP level was positively correlated with PS severity and could be used as a biomarker to identify CPS in neonates.

scholarly journals Plasma CircRNAs for First Trimester Prediction of Preeclampsia and Potential Biomarkers

2021 ◽  
Vol 21 (03) ◽  
Author(s):  
Jie Lu
Keyword(s):  
Rna Sequencing ◽  
Expression Profiles ◽  
Characteristic Curve ◽  
Area Under The Curve ◽  
First Trimester ◽  
Receiver Operator Characteristic Curve ◽  
Curve Analysis ◽  
Circular Rnas ◽  
Healthy Controls ◽  
Qrt Pcr

ABSTRACT This study investigated expression profiles and mechanisms of circular RNAs on preeclampsia patients between 7-14 weeks. RNA sequencing demonstrated 12,579 circRNAs (7,684 upregulated and 4,895 downregulated) expressed differentially in 8 pairs of plasma samples from preeclampsia patients and healthy controls. Predicted 15 upregulated and 9 downregulated circRNAs then were assessed through qRT-PCR in 50 preeclampsia patients and 30 controls. Differentially expressed circRNAs in preeclampsia patients and controls were analyzed by RNA sequencing and gene ontology, Kyoto Encyclopedia of Genes and Genomes and circRNA-miRNA-mRNA network analyzed data. Hsa_circ_0046677 and hsa_circ_0029703 were markedly increased in preeclampsia patients. Receiver operator characteristic curve analysis indicated the area under the curve was 0.083 for hsa_circ_0046677 and 0.965 for hsa_circ_00429703 while the sensitivity and specificity of these two genes were 78 percent, 88 percent and 83 percent, 93 percent, respectively. Hsa_circ_0046677 and hsa_circ_00429703 had enormous potentials for diagnosing preeclampsia of pregnant women in the first trimester.

Diagnostic accuracy of IGF-1 for screening growth hormone deficiency: a prospective, single-center, diagnostic accuracy study

2021 ◽  
Author(s):  
Hideyuki Iwayama ◽  
Sachiko Kitagawa ◽  
Jyun Sada ◽  
Ryosuke Miyamoto ◽  
Tomohito Hayakawa ◽  
...  
Keyword(s):  
Growth Hormone ◽  
Diagnostic Accuracy ◽  
Growth Hormone Deficiency ◽  
Predictive Value ◽  
Screening Test ◽  
Characteristic Curve ◽  
Area Under The Curve ◽  
Rank Correlation ◽  
Hormone Deficiency ◽  
Height Velocity

Abstract Purpose We evaluated the diagnostic accuracy of insulin-like growth factor-1 (IGF-1) for screening growth hormone deficiency (GHD) to determine the usefulness of IGF-1 as a screening test. Methods On 298 consecutive children who had short stature or decreased height velocity, we measured IGF-1 levels and performed growth hormone (GH) secretion test using clonidine, arginine, and, in cases with different results of the two tests, L-dopa. Patients with congenital abnormalities were excluded. GHD was defined as peak GH ≤ 6.0 ng/mL in the two tests. Results We identified 60 and 238 patients with and without GHD, respectively. The mean IGF-1 (SD) was not significantly different between the GHD and non-GHD groups (p = 0.23). Receiver operating characteristic curve analysis demonstrated the best diagnostic accuracy at an IGF-1 cutoff of −1.493 SD, with sensitivity of 0.685, specificity of 0.417, positive predictive value of 0.25, negative predictive value of 0.823, and area under the curve of 0.517. Spearman’s rank correlation coefficient showed that IGF-1 (SD) was weakly correlated with age, bone age, height velocity before examination, weight (SD), and BMI (SD) and very weakly correlated with height (SD), target height (SD), and maximum GH peak. Conclusion IGF-1 level had poor diagnostic accuracy as a screening test for GHD. Correlation analysis revealed that none of the items increased the diagnostic power of IGF-1. Therefore, IGF-1 should not be used alone in the screening of GHD. A predictive biomarker for GHD should be developed in the future.

scholarly journals Volume, conductivity, and scatter parameters of leukocytes as early markers of sepsis and treatment response

2019 ◽  
Vol 11 (01) ◽  
pp. 029-033
Author(s):  
Parul Arora ◽  
Praveen Kumar Gupta ◽  
Raghavendra Lingaiah ◽  
Asok Kumar Mukhopadhyay
Keyword(s):  
Characteristic Curve ◽  
Area Under The Curve ◽  
Receiver Operator Characteristic Curve ◽  
Sepsis Group ◽  
Control Group ◽  
Cutoff Value ◽  
Volume Conductivity ◽  
Gram Positive Bacteria ◽  
Automated Hematology Analyzer ◽  
Culture Positive

Abstract INTRODUCTION: Morphologic changes in the size and granularity of leukocytes seen in sepsis could be measured using the volume, conductivity, and scatter (VCS parameters) from the automated hematology analyzers. The objective of this study is to find the clinical usefulness of VCS parameters as possible indicators of sepsis and to determine the effect of treatment on these parameters. METHODS: This observational study was conducted in a tertiary level hospital in India. Hemogram and VCS parameters obtained from LH 750 (Beckman coulter, Fullerton, CA) from 134 proven blood culture-positive cases of sepsis were reviewed on the day of culture positivity (day 0), day 3, and day 7 were analyzed and compared with those of samples from otherwise healthy 100 participants. Statistical analysis of data was done, and cutoff value was established using receiver-operator characteristic curve. RESULTS: Out of 134 culture-positive cases, 55.2% (n = 74) Gram-negative and 44.8% (n = 60) Gram-positive bacteria were isolated. The mean neutrophil volume (MNV) and mean monocyte volume (MMV) were higher in the sepsis group compared to that of the control group (165.43 ± 18.21 vs. 140.59 ± 7.6, P = 0.001 for MNV and 179.8 ± 14.16 vs. 164.54 ± 9.6, P = 0.001 for MMV). A significant decrease in MNV and MMV was observed with the initiation of the treatment. Significant changes in scatter and conductivity parameters were also noticed. A cutoff value of 150.2 for MNV gave a sensitivity and specificity of 79.1% and 95%, respectively, with an area under the curve (AUC) of 92.3%. With a cutoff of 168.3, MMV had a sensitivity of 80.6% and specificity of 77.5%, AUC of 83%. CONCLUSION: VCS parameters such as MNV and MMV can be easily obtained by an automated hematology analyzer and could be used for early detection and therapeutic response in sepsis.

Diagnostic and prognostic utility of phospholipase A activity in patients with acute pancreatitis: comparison with amylase and lipase

1991 ◽  
Vol 37 (3) ◽  
pp. 356-360 ◽  
Author(s):  
Steven C Kazmierczak ◽  
Frederick Van Lente ◽  
Edna D Hodges
Keyword(s):  
Acute Pancreatitis ◽  
Diagnostic Accuracy ◽  
Enzyme Activities ◽  
Serum Amylase ◽  
Characteristic Curve ◽  
Receiver Operator Characteristic Curve ◽  
Curve Analysis ◽  
Phospholipase A ◽  
Cutoff Values ◽  
Prognostic Utility

Abstract We compared the diagnostic and prognostic utility of phospholipase A (PLA; EC 3.1.1.4) for acute pancreatitis with that of amylase and lipase by analysis of sera from 151 consecutive patients presenting with abdominal pain in whom assays of serum amylase and (or) lipase had been ordered. We determined the diagnostic accuracy for both the initial and the peak enzyme activities. Maximal diagnostic accuracy obtained for the initial activities of amylase, lipase, and PLA was 0.83, 0.83, and 0.76 at cutoff values of 650, 650, and 41 U/L, respectively. Use of peak enzyme activities showed maximal diagnostic accuracy of 0.85, 0.86, and 0.73 at cutoff values of 650, 1050, and 42 U/L, respectively. Receiver-operator characteristic curve analysis revealed the diagnostic performance of amylase and lipase to be similar, whereas that of PLA was almost random and not incremental. As with amylase and lipase, PLA activities in sera showed no relation to patients' survival; three patients who died after an attack of acute pancreatitis failed to demonstrate the dramatic increases in PLA activity previously described. We conclude that assessing the severity of acute pancreatitis by using enzyme activities still remains problematical. Measurements of amylase or lipase activities provide similar diagnostic discrimination when appropriate cutoff values are used and remain the methods of choice for diagnosis of acute pancreatitis.

scholarly journals Discriminative validity of the lower and upper quarter Y balance test performance: a comparison between healthy trained and untrained youth

2020 ◽  
Vol 12 (1) ◽  
Author(s):  
Gerrit Schwiertz ◽  
Rainer Beurskens ◽  
Thomas Muehlbauer
Keyword(s):  
Test Performance ◽  
Dynamic Balance ◽  
Characteristic Curve ◽  
Area Under The Curve ◽  
Receiver Operator Characteristic Curve ◽  
Soccer Players ◽  
Balance Test ◽  
Discriminative Validity ◽  
Youth Athletes ◽  
Male Subjects

Abstract Background The Lower (YBT-LQ) and Upper (YBT-UQ) Quarter Y Balance Test have been widely used for the assessment of dynamic balance and shoulder mobility/stability, respectively. However, investigations on the validity of the two tests in youth are lacking. Therefore, we performed two studies to determine discriminative validity of the YBT-LQ (study 1) and the YBT-UQ (study 2) in healthy youth. Methods Sixty-nine male soccer players (age: 14.4 ± 1.9 yrs) and 69 age-matched untrained male subjects (14.3 ± 1.6 yrs) participated in study 1 and 37 young swimmers (age: 12.3 ± 2.1 yrs) as well as 37 age−/sex-matched individuals (age: 12.5 ± 2.0 yrs) took part in study 2. Absolute (cm) and relative (% leg/arm length) maximal reach distances per reach direction and the composite score of the YBT-LQ/UQ were used as outcome measures. One-way analysis of variance and the receiver operator characteristic curve analysis (i.e., calculating the area under the curve [AUC]) were conducted to assess discriminative validity. Results Concerning the relative values, youth athletes showed significantly better YBT-LQ (study 1: p < 0.001, d = 0.86–1.21) and YBT-UQ (study 2: p < 0.001, d = 0.88–1.48) test performances compared to age- and sex-matched untrained subjects. Further, AUC-values indicated a chance of ≥74% (YBT-LQ) and ≥ 71% (YBT-UQ) to discriminate between youth athletes and controls. These findings were confirmed when using the absolute data for analysis. Conclusions According to our results, the YBT-LQ and the YBT-UQ seem to be useful test instruments to discriminate trained and untrained healthy youth performance for dynamic balance and shoulder mobility/stability, respectively.

Discordant GH and IGF-1 Results in Treated Acromegaly: Impact of GH Cutoffs and Mean Values Assessment

2020 ◽  
Author(s):  
Claudia Campana ◽  
Francesco Cocchiara ◽  
Giuliana Corica ◽  
Federica Nista ◽  
Marica Arvigo ◽  
...  
Keyword(s):  
Characteristic Curve ◽  
Area Under The Curve ◽  
Receiver Operator Characteristic Curve ◽  
Mean Values ◽  
Pituitary Diseases ◽  
Discordance Rate ◽  
Values Assessment ◽  
The Mean ◽  
The Impact

Abstract Context Discordant growth hormone (GH) and insulin-like growth factor-1 (IGF-1) values are frequent in acromegaly. Objective To evaluate the impact of different GH cutoffs on discordance rate. To investigate whether the mean of consecutive GH measurements impacts discordance rate when matched to the last available IGF-1 value. Design Retrospective study. Setting Referral center for pituitary diseases. Patients Ninety acromegaly patients with at least 3 consecutive evaluations for GH and IGF-1 using the same assay in the same laboratory (median follow-up 13 years). Interventions Multimodal treatment of acromegaly. Main Outcome Measures Single fasting GH (GHf) and IGF-1 (IGF-1f). Mean of 3 GH measurements (GHm), collected during consecutive routine patients’ evaluations. Results At last evaluation GHf values were 1.99 ± 2.79 µg/L and age-adjusted IGF-1f was 0.86 ± 0.44 × upper limit of normality (mean ± SD). The discordance rate using GHf was 52.2% (cutoff 1 µg/L) and 35.6% (cutoff 2.5 µg/L) (P = 0.025). “High GH” discordance was more common for GHf &lt;1.0 µg/L, while “high IGF-1” was predominant for GHf &lt;2.5 µg/L (P &lt; 0.0001). Using GHm mitigated the impact of GH cutoffs on discordance (GHm &lt;1.0 µg/L: 43.3%; GHm &lt;2.5 µg/L: 38.9%; P = 0.265). At receiver-operator characteristic curve (ROC) analysis, both GHf and GHm were poor predictors of IGF-1f normalization (area under the curve [AUC] = 0.611 and AUC = 0.645, respectively). The prevalence of disease-related comorbidities did not significantly differ between controlled, discordant, and active disease patients. Discussion GH/IGF-1 discordance strongly depends on GH cutoffs. The use of GHm lessen the impact of GH cutoffs. Measurement of fasting GH levels (both GHf and GHm) is a poor predictor of IGF-1f normalization in our cohort.

scholarly journals Serodiagnostic Potential of Mycobacterium avium MAV2054 and MAV5183 Proteins

2012 ◽  
Vol 20 (2) ◽  
pp. 295-301 ◽  
Author(s):  
A-Rum Shin ◽  
Kil-Soo Lee ◽  
Kang In Lee ◽  
Tae Sun Shim ◽  
Won-Jung Koh ◽  
...  
Keyword(s):  
Mycobacterium Avium ◽  
Characteristic Curve ◽  
Receiver Operator Characteristic Curve ◽  
Curve Analysis ◽  
Antibody Responses ◽  
Enzyme Linked Immunosorbent Assay ◽  
Good Discrimination ◽  
Content Type ◽  
Pulmonary Tb ◽  
Latent Tb

ABSTRACTTheMycobacterium avium-M. intracellularecomplex (MAC) causes a pulmonary disease (PD) similar to tuberculosis (TB). Diagnosis of MAC-PD is complicated and time-consuming. In this study, the serodiagnostic potential of the newly identified MAV2054 and MAV5183 proteins was evaluated in subjects with MAC-PD, pulmonary TB, or latent TB and in noninfected healthy controls (HC), together with HspX and the 38-kDa antigen, well-known serodiagnosticM. tuberculosisantigens. All four antigens evoked significantly higher IgG responses in MAC-PD and active TB than in latent TB and HC subjects. Among the antigens, MAV2054 elicited the highest antibody responses in pulmonary TB and MAC-PD patients. IgG titers against MAV2054 and MAV5183 were significantly higher in MAC-PD than in pulmonary TB subjects. In addition, the levels of IgG against all antigens in theM. intracellulareand fibrocavitary forms were higher than those in theM. aviumand nodular bronchiectatic forms, respectively. Based on sensitivity and receiver operator characteristic curve analysis, the best candidates for detection of MAC-PD and pulmonary TB were MAV2054 and the 38-kDa antigen, respectively. In total, 76.0% of MAC-PD and 65.0% of active TB patients were reactive to at least two antigens. In contrast, only 2.8% of HC subjects were reactive with two or more antigens. Our findings suggest that an enzyme-linked immunosorbent assay (ELISA) using the four antigens would be valuable for screening for mycobacterial lung disease, including MAC-PD and pulmonary TB, although it does not provide good discrimination of the disease-causing pathogens.

scholarly journals SAT-086 Pituitary Volume as a Diagnostic Measure for Determining the Etiology of Short Stature in Children: Receiver Operating Characteristic Curve Analysis and Cutoff Values

2020 ◽  
Vol 4 (Supplement_1) ◽  
Author(s):  
Liam McGuirk ◽  
Tara P Patale ◽  
Nicholas Andrew Krasnow ◽  
Alice Alexandrov ◽  
James Haigney ◽  
...  
Keyword(s):  
Short Stature ◽  
Standard Error ◽  
Characteristic Curve ◽  
Area Under The Curve ◽  
Curve Analysis ◽  
Youden Index ◽  
Pediatric Endocrinology ◽  
Roc Curve Analysis ◽  
Gh Secretion ◽  
Cutoff Values

Abstract Background: It is speculated that pituitary volume (PV) is a marker of chronic growth hormone (GH) secretion. In previous studies, we determined that children with GH deficiency (GHD) and idiopathic short stature (ISS) had significantly smaller PVs than normal controls (NCs). Cutoff values for small PVs are needed to improve the clinical utility of PV in determining children who qualify for GH therapy. Objective: To define the cutoff between pathologic and nonpathologic PV in prepubertal and pubertal children with short stature (SS). Patients and Methods: The SS group was selected from the database of a pediatric endocrinology center, which was queried for siblings (SBs) aged 6–18 yrs who underwent a GH stimulation test and MRI between 2013–2019. All 77 SBs had SS, defined as 2 SDs below mean height for age, subnormal growth velocity for at least 6 months, or predicted height at least 2 inches discrepant from midparental height. The NC group was selected from the database of a neuroradiology center; these NCs consisted of 170 randomly selected subjects aged 6–18 yrs. Patients with MRI abnormalities were excluded. PVs were calculated using the ellipsoid formula (LxWxH/2). ROC curve analysis was utilized to generate cutoff values. The diagnosis of short stature was the dependent variable and PV was the independent variable. The PV with the highest Youden index was selected as the definitive cutoff for a small PV. Results: The mean (MN) and median (MD) age of SBs was 11.6 ±2.2 and 11.9 yrs, respectively, and the MN and MD age of the NCs was 12.6 ±3.4 and 13.2 yrs, respectively. The MN and MD age of prepubertal SBs (n=29) and NCs (n=58) were 9.3 ±1.2 and 9.7, and 8.6 ±1.4 and 8.6 yrs, respectively. The MN and MD age of pubertal SBs (n=48) and NCs (n=112) were 13.0 ±1.4 and 12.7, and 14.7 ±1.9 and 14.6 yrs, respectively. The difference in MN age between SBs and NCs was significant (p&lt;0.05). For prepubertal subjects, sensitivity was 86.21% and specificity was 68.97%. The distance to corner was 0.3396, and the highest Youden index was 0.5517, corresponding to a PV of 215.02 mm3. The Area Under the Curve (AUC) was 0.8395 with a standard error of 0.0426 (p&lt;0.001). For pubertal subjects, sensitivity was 81.25% and specificity was 79.46%. The distance to corner was 0.2781, and the highest Youden index was 0.6071, corresponding to a PV of 315.0 mm3. The AUC was 0.8460 with a standard error of 0.0337 (p&lt;0.001). Conclusion: To our knowledge, we present the first study on the sensitivity and specificity of PV in determining the etiology of SS. Our data suggest that prepubertal patients with a PV&lt;215.02 mm3 and pubertal patients with a PV&lt;315.00 mm3 have small pituitary glands. Statistically calculated cutoffs are necessary to accurately diagnose pituitary hypoplasia and should be utilized to determine the etiology of SS. Future studies should include children with Tanner staging and height SDs to generate more accurate PV cutoffs.

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