Evaluation of Infrared Thermography for the Detection of Footrot and White Line Disease Lesions in Dairy Sheep

The objectives of this study were to investigate temperature distribution at the sheep hoof and evaluate the reliability and diagnostic performance of infrared thermography (IRT) for the detection of footrot and white line disease (WLD) lesions in intensively reared dairy sheep. Hoof lesions were clinically assessed, and IRT was used to measure temperature distribution on hoof superficial tissue in 600 multiparous ewes. Binary regression models were developed and validated, and receiver operating characteristic curves were estimated to assess the predictive value and diagnostic performance of IRT for the detection of hoof lesions. The most sensitive prediction model for the detection of IFR was based on the difference between ambient and hoof heel temperature (sensitivity: 83.3%, specificity: 47.8%, and threshold value: 6.5 °C), whereas the most specific prediction model was based on the difference between ambient and coronary band temperature (sensitivity: 51.9%, specificity: 79.7%, and threshold value: 11.3 °C). In the case of WLD, the diagnostic performance of IRT had limited predictive value. IRT could be a useful tool for hoof health screening in dairy sheep. However, it must be cautiously adapted in cases where environmental, operating, and operator variables are not effectively controlled.

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Diagnostic Performance of a Combination of Shear Wave Elastography and B-Mode Ultrasonography in Differentiating Benign From Malignant Thyroid Nodules

Clinical and Experimental Otorhinolaryngology ◽

10.21053/ceo.2019.01235 ◽

2020 ◽

Vol 13 (2) ◽

pp. 186-193

Author(s):

Eung Koo Yeon ◽

Yu-Mee Sohn ◽

Mirinae Seo ◽

Eui-Jong Kim ◽

Young-Gyu Eun ◽

...

Keyword(s):

Shear Wave ◽

Predictive Value ◽

Diagnostic Performance ◽

Thyroid Nodules ◽

Multivariate Logistic Regression Analysis ◽

Shear Wave Elastography ◽

Surgical Excision ◽

Needle Aspiration ◽

The Difference ◽

Us Findings

Objectives. This study was conducted to compare clinicopathologic and radiologic factors between benign and malignant thyroid nodules and to evaluate the diagnostic performance of shear wave elastography (SWE) combined with B-mode ultrasonography (US) in differentiating malignant from benign thyroid nodules.Methods. This retrospective study included 92 consecutive patients with 95 thyroid nodules examined on B-mode US and SWE before US-guided fine-needle aspiration biopsy or surgical excision. B-mode US findings (composition, echogenicity, margin, shape, and calcification) and SWE elasticity parameters (maximum [Emax], mean, minimum, and nodule-to-normal parenchymal ratio of elasticity) were reviewed and compared between benign and malignant thyroid nodules. The diagnostic performance of B-mode US and SWE for predicting malignant thyroid nodules was analyzed. The optimal cutoff values of elasticity parameters for identifying malignancy were determined. Diagnostic performance was compared between B-mode US only, SWE only, and the combination of B-mode US with SWE.Results. On multivariate logistic regression analysis, age (odds ratio [OR], 0.90; P=0.028), a taller-than-wide shape (OR, 11.3; P=0.040), the presence of calcifications (OR, 15.0; P=0.021), and Emax (OR, 1.22; P=0.021) were independent predictors of malignancy in thyroid nodules. The combined use of B-mode US findings and SWE yielded improvements in sensitivity, the positive predictive value, the negative predictive value, and accuracy compared with the use of B-mode US findings only, but with no statistical significance.Conclusion. When SWE was combined with B-mode US, the diagnostic performance was better than when only B-mode US was used, although the difference was not statistically significant.

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Different Diagnostic Performance of Fibrinogen and D-Dimer in Periprosthetic Joint Infection: A Propensity Score Matched Study

10.21203/rs.3.rs-200422/v1 ◽

2021 ◽

Author(s):

Xi Chen ◽

Wenwei Qian ◽

Xisheng Weng ◽

Jin Lin ◽

Jin Jin ◽

...

Keyword(s):

Propensity Score ◽

Predictive Value ◽

Diagnostic Performance ◽

Joint Infection ◽

Diagnostic Value ◽

Optimal Threshold ◽

Operating Characteristics ◽

The Difference ◽

Sensitivity Specificity ◽

D Dimer

Abstract Background: Fibrinogen(Fbg) and D-dimer were introduced as biomarkers for the diagnosis of PJI. However, previous researches have reported controversial outcome on the diagnostic value of D-dimer in comparison to Fbg, CRP and ESR.Aim: This study aims to: 1.Determine the optimal threshold of plasma Fbg and D-dimer in the diagnosis of PJI and compare their diagnostic value to that of CRP and ESR. 2.Investigate if Fbg and D-dimer performs differently than CRP and ESR in different types of PJI.Methods: 115 revision cases after total hip arthroplasty(THA) and total knee arthroplasty(TKA) were identified. 30 PJI cases were matched to 60 Aseptic cases based on demographic characteristics using propensity score matching. Sensitivity, Specificity, Receiver operating characteristics(ROC), Negative predictive value(NPV) and Positive predictive value(PPV) were calculated and compared.Results: The optimal threshold is 1.69 mg/L for D-dimer and 3.655g/L for Fbg. Plasma Fbg, D-dimer, CRP and ESR were significantly higher in the PJI group than the Aseptic group. Fbg, D-dimer, CRP and ESR showed sensitivity of 0.83, 0.67, 0.83 and 0.8 respectively and showed specificity of 0.87, 0.77, 0.92 and 0.82 respectively. ROC curve showed that CRP has the highest AUC(0.90), followed by Fbg(0.89), ESR(0.88) and D-dimer(0.77).Conclusion: Plasma Fbg exhibited similar diagnostic performance comparing to CRP and ESR. Plasma D-dimer is of limited diagnostic value. In our study, Fbg and D-dimer did not show better diagnostic performance in any subtypes of PJI. Further studies are required to investigate the difference between serum D-dimer and plasma D-dimer in arthroplasty population.

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Diagnosis of cerebral hemorrhage before the era of computed tomography

Orvosi Hetilap ◽

10.1556/oh.2013.29739 ◽

2013 ◽

Vol 154 (44) ◽

pp. 1743-1746

Author(s):

Gergely Hofgárt ◽

Rita Szepesi ◽

Bertalan Vámosi ◽

László Csiba

Keyword(s):

Computed Tomography ◽

Cerebrospinal Fluid ◽

Positive Predictive Value ◽

Predictive Value ◽

Hemorrhagic Stroke ◽

Cranial Computed Tomography ◽

Cerebral Stroke ◽

Daily Routine ◽

Stroke Patients ◽

The Difference

Introduction: During the past decades there has been a great progress in neuroimaging methods. Cranial computed tomography is part of the daily routine now and its use allows a fast diagnosis of parenchymal hemorrhage. However, before the availability of computed tomography the differentiation between ischemic and hemorrhagic stroke was based on patient history, physical examination, percutan angiography and cerebrospinal fluid sampling, and the clinical utility could be evaluated by autopsy of deceased patients. Aim: The authors explored the diagnostic performance of cerebrospinal fluid examination for the diagnosis of ischemic and hemorrhagic stroke. Method: Data of 200 deceased stroke patients were retrospectively evaluated. All patients had liquor sampling at admission and all of them had brain autopsy. Results: Bloody or yellowish cerebrospinal fluid at admission had a positive predictive value of 87.5% for hemorrhagic stroke confirmed by autopsy, while clear cerebrospinal fluid had positive predictive value of 90.7% for ischemic stroke. Patients who had clear liquor, but autopsy revealed hemorrhagic stroke had higher protein level in the cerebrospinal fluid, but the difference was not statistically significant (p = 0.09). Conclusions: The results confirm the importance of pathological evaluation of the brain in cases deceased from cerebral stroke. With this article the authors wanted to salute for those who contributed to the development of the Hungarian neuropathology. In this year we remember the 110th anniversary of the birth, and the 60th anniversary of the death of professor Kálmán Sántha. Professor László Molnár would be 90 years old in 2013. Orv. Hetil., 154 (44), 1743–1746.

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Evaluation of aseptic loosening of knee prostheses by quantitative bone scintigraphy

Nuklearmedizin ◽

10.3413/nukmed-0123 ◽

2008 ◽

Vol 47 (04) ◽

pp. 163-166 ◽

Cited By ~ 6

Author(s):

D. Steiner ◽

S. Laurich ◽

R. Bauer ◽

J. Kordelle ◽

R. Klett

Keyword(s):

Aseptic Loosening ◽

Bone Scintigraphy ◽

Revision Surgery ◽

Predictive Value ◽

Knee Prostheses ◽

Treatment Regimes ◽

Golden Standard ◽

The Difference ◽

Sensitivity Specificity ◽

Asymptomatic Control

SummaryIn not infected knee prostheses bone scintigraphy is a possible method to diagnose mechanical loosening, and therefore, to affect treatment regimes in symptomatic patients. However, hitherto studies showed controversial results for the reliability of bone scintigraphy in diagnosing loosened knee prostheses by using asymptomatic control groups. Therefore, the aim of our study was to optimize the interpretation procedure and to evaluate the accuracy using results from revision surgery as standard. Methods: Retrospectively, we were able to examine the tibial component in 31 cemented prostheses. In this prostheses infection was excluded by histological or bacteriological examination during revision surgery. To quantify bone scintigraphy, we used medial and lateral tibial regions with a reference region from the contralateral femur. Results: To differentiate between loosened and intact prostheses we found a threshold of 5.0 for the maximum tibia to femur ratio of the both tibial regions and a threshold of 18% for the difference of the ratio of both tibial regions. Using these thresholds, values of 0.9, 1, 0.85, 1, and 0.94 were calculated for sensitivity, specificity, negative predictive value, positive predictive value, and accuracy, respectively. To get a sensitivity of 1, we found a lower threshold of 3.3 for the maximum tibia to femur ratio. Conclusion: Quantitative bone scintigraphy appears to be a reliable diagnostic tool for aseptic loosening of knee prostheses with thresholds evaluated by revision surgery results being the golden standard.

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Costs and the cost-effectiveness threshold

10.1093/oso/9780198794837.003.0019 ◽

2017 ◽

Author(s):

Jan Abel Olsen

Keyword(s):

Societal Perspective ◽

Threshold Value ◽

Quality Adjusted Life Year ◽

Healthcare Sector ◽

The Difference ◽

The Cost ◽

Qaly Threshold ◽

Cost Effectiveness Threshold ◽

Effectiveness Threshold ◽

Quality Adjusted Life

Chapter 19 starts by distinguishing between the two contrasting perspectives that an economic evaluation would take: the healthcare sector perspective versus the societal perspective. The former is considered a ‘narrow analysis’ which includes only the costs accruing within the healthcare sector, while the latter represents a ‘broad analysis’ that accounts for all resource implications in all sectors of the economy. After an investigation into various types of costs, a ‘limited societal perspective’ is suggested to be more appropriate than either of the two ‘extreme perspectives’. The chapter continues with a discussion of the cost per quality-adjusted life year (QALY) threshold and explains the difference between a demand side- versus a supply-side approach to determining a threshold value for a QALY.

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Predictive Evaluation on Cytological Sample of Metastatic Melanoma: The Role of BRAF Immunocytochemistry in the Molecular Era

Diagnostics ◽

10.3390/diagnostics11061110 ◽

2021 ◽

Vol 11 (6) ◽

pp. 1110

Author(s):

Andrea Ronchi ◽

Marco Montella ◽

Federica Zito Marino ◽

Michele Caraglia ◽

Anna Grimaldi ◽

...

Keyword(s):

Metastatic Melanoma ◽

Molecular Analysis ◽

Predictive Value ◽

Diagnostic Performance ◽

Cost Effective ◽

Needle Aspiration ◽

Braf V600e ◽

Mutational Status ◽

Needle Aspiration Cytology ◽

Sensitivity Specificity

Background: Cutaneous malignant melanoma is an aggressive neoplasm. In advanced cases, the therapeutic choice depends on the mutational status of BRAF. Fine needle aspiration cytology (FNA) is often applied to the management of patients affected by melanoma, mainly for the diagnosis of metastases. The evaluation of BRAF mutational status by sequencing technique on cytological samples may be inconvenient, as it is a time and biomaterial-consuming technique. Recently, BRAF immunocytochemistry (ICC) was applied for the evaluation of BRAF V600E mutational status. Although it may be useful mainly in cytological samples, data about BRAF ICC on cytological samples are missing. Methods: We performed BRAF ICC on a series of 50 FNA samples of metastatic melanoma. BRAF molecular analysis was performed on the same cytological samples or on the corresponding histological samples. Molecular analysis was considered the gold standard. Results: BRAF ICC results were adequate in 49 out of 50 (98%) cases, positive in 15 out of 50 (30%) cases and negative in 34 out of 50 (68%) of cases. Overall, BRAF ICC sensitivity, specificity, positive predictive value and negative predictive value results were 88.2%, 100%, 100% and 94.1%, respectively. The diagnostic performance of BRAF ICC results was perfect when molecular evaluation was performed on the same cytological samples. Hyperpigmentation represents the main limitation of the technique. Conclusions: BRAF ICC is a rapid, cost-effective method for detecting BRAF V600E mutation in melanoma metastases, applicable with high diagnostic performance to cytological samples. It could represent the first step to evaluate BRAF mutational status in cytological samples, mainly in poorly cellular cases.

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Predictive value of thyroxine for prognosis in pediatric septic shock: a prospective observational study

Journal of Pediatric Endocrinology and Metabolism ◽

10.1515/jpem-2019-0502 ◽

2020 ◽

Vol 33 (5) ◽

pp. 653-659

Author(s):

Jia Song ◽

Yun Cui ◽

Chunxia Wang ◽

Jiaying Dou ◽

Huijie Miao ◽

...

Keyword(s):

Septic Shock ◽

Thyroid Hormone ◽

Observational Study ◽

Hospital Mortality ◽

Predictive Value ◽

Prospective Observational Study ◽

Threshold Value ◽

Nonthyroidal Illness ◽

Hormone Levels ◽

Thyroid Hormone Levels

AbstractBackgroundThyroid hormone plays an important role in the adaptation of metabolic function to critically ill. The relationship between thyroid hormone levels and the outcomes of septic shock is still unclear. The aim of this study was to assess the predictive value of thyroid hormone for prognosis in pediatric septic shock.MethodsWe performed a prospective observational study in a pediatric intensive care unit (PICU). Patients with septic shock were enrolled from August 2017 to July 2019. Clinical and laboratory indexes were collected, and thyroid hormone levels were measured on PICU admission.ResultsNinety-three patients who fulfilled the inclusion criteria were enrolled in this study. The incidence of nonthyroidal illness syndrome (NTIS) was 87.09% (81/93) in patients with septic shock. Multivariate logistic regression analysis showed that T4 level was independently associated with in-hospital mortality in patients with septic shock (OR: 0.965, 95% CI: 0.937–0.993, p = 0.017). The area under receiver operating characteristic (ROC) curve (AUC) for T4 was 0.762 (95% CI: 0.655–0.869). The cutoff threshold value of 58.71 nmol/L for T4 offered a sensitivity of 61.54% and a specificity of 85.07%, and patients with T4 < 58.71 nmol/L showed high mortality (60.0%). Moreover, T4 levels were negatively associated with the pediatric risk of mortality III scores (PRISM III), lactate (Lac) level in septic shock children.ConclusionsNonthyroidal illness syndrome is common in pediatric septic shock. T4 is an independent predictor for in-hospital mortality, and patients with T4 < 58.71 nmol/L on PICU admission could be with a risk of hospital mortality.

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A Rapid Amniotic Fluid Interleukin-6 Assessment for the Identification of Intra-Amniotic Inflammation in Women with Preterm Labor and Intact Membranes

Fetal Diagnosis and Therapy ◽

10.1159/000513660 ◽

2021 ◽

pp. 1-6

Author(s):

Teresa Cobo ◽

Victoria Aldecoa ◽

Magdalena Holeckova ◽

Ctirad Andrys ◽

Xavier Filella ◽

...

Keyword(s):

Amniotic Fluid ◽

Predictive Model ◽

Predictive Value ◽

Preterm Labor ◽

Diagnostic Performance ◽

Clinical Signs ◽

Entire Study ◽

Microbial Invasion ◽

Automated Method ◽

Spontaneous Delivery

Objectives: A multivariable predictive model has recently been developed with good accuracy to predict spontaneous preterm delivery within 7 days in women with preterm labor (PTL) and intact membranes. However, this model measures amniotic fluid (AF) interleukin (IL)-6 concentrations using the ELISA method, thereby limiting clinical implementation. The main objectives of this study were to validate the automated immunoassay as a quantitative method to measure AF IL-6 in women with PTL and to evaluate the diagnostic performance of AF IL-6 alone and as part of a multivariable predictive model to predict spontaneous delivery in 7 days with this automated method. Study Design: This is a retrospective observational study in women with PTL below 34 weeks who underwent amniocentesis to rule out microbial invasion of the amniotic cavity. Women with clinical signs of chorioamnionitis, cervical length measurement at admission >5th centile, maternal age <18 years, and no consent to perform amniocentesis for this indication were excluded. The local Institutional Review Boards approved the study (HCB/2019/0940). Analysis of AF IL-6 Concentrations: AF IL-6 concentrations were measured using an automated Cobas e602 electrochemiluminescence immunoanalyzer and Human IL-6 Quantikine ELISA kit. Results: Of the entire study group (n = 100), 38 women spontaneously delivered within 7 days after admission. Both laboratory methods showed good agreement (intraclass correlation coefficient: 0.937 (95% confidence interval [CI] 0.908–0.957); p < 0.001). Diagnostic performance of AF IL-6 to predict spontaneous delivery within 7 days when it was included in the multivariable predictive model showed an area under the receiver operating characteristic curve of 0.894 (95% CI 0.799–0.955), sensitivity of 97%, specificity of 74%, positive predictive value of 73%, negative predictive value of 97%, positive likelihood ratio (LR) of 3.7, and negative LR of 0.045. Conclusion: While both analytical methods were comparable for measuring AF IL-6 concentrations in women with PTL, the Cobas immunoanalyzer provided rapid diagnosis of intra-amniotic inflammation within minutes. The predictive model showed a good diagnostic performance to target women at high risk of spontaneous delivery within 7 days.

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Comparison of the Diagnostic Performance of Novel Slim Biopsy Forceps with Conventional Biopsy Forceps for Biliary Stricture: A Multicenter Retrospective Study

Journal of Personalized Medicine ◽

10.3390/jpm11010055 ◽

2021 ◽

Vol 11 (1) ◽

pp. 55

Author(s):

Eun Suk Jung ◽

Se Woo Park ◽

Jung Hee Kim ◽

Jang Han Jung ◽

Min Jae Yang ◽

...

Keyword(s):

Adverse Events ◽

Predictive Value ◽

Diagnostic Performance ◽

Biliary Stricture ◽

Accurate Diagnosis ◽

The Novel ◽

Biopsy Forceps ◽

Tertiary Hospitals ◽

Tissue Acquisition ◽

Histological Confirmation

Novel slim biopsy forceps provide some technical advantages to facilitate a more accurate diagnosis, although we are not aware of any comparative studies. Therefore, we compared tissue acquisition and diagnostic accuracy between novel slim biopsy forceps and conventional biopsy forceps in cases with a biliary stricture. We reviewed 341 patients who underwent endoscopic retrograde cholangiopancreatography for the histological confirmation of biliary stricture at two tertiary hospitals between 2013 and 2020. The primary endpoint was the forceps’ diagnostic accuracies. We included 276 patients who underwent biopsy using the novel forceps (n = 130) or conventional forceps (n = 146). The novel forceps provided 81.7% sensitivity, 100.0% specificity, positive-predictive value (PPV) of 100.0%, and negative-predictive value (NPV) of 57.8%, with an accuracy of 85.4% when the diagnosis by endobiliary biopsy included suspected or positive malignancy. The conventional forceps provided 61.7% sensitivity, 100.0% specificity, PPV of 100.0%, and NPV of 36.1%, with an accuracy of 68.5%. Only novel forceps use was significantly associated with an accurate diagnosis (odds ratio: 2.70, 95% confidence interval: 1.52–5.00). There were no significant inter-group differences in the procedure-related rates of adverse events. Endobiliary biopsy using novel forceps offered better diagnostic performance and more acceptable procedure-related adverse events than conventional forceps.

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RELATIONS OF MOTOR ABILITY OF BALANCE AND SUCCESS OF PERFORMANCE OF GYMNASTICS ELEMENTS ON THE FLOOR EXERCISE

sportlogia ◽

10.5550/sgia.211701.en.jbljfb ◽

2021 ◽

Vol 17 (1) ◽

pp. 34-43

Author(s):

Saša Jovanović ◽

◽

Snežana Bijelić ◽

Adriana Ljubojević ◽

Dalibor Fulurija ◽

...

Keyword(s):

Physical Education ◽

Prediction Model ◽

Motor Skills ◽

Predictive Value ◽

Predictor Variable ◽

The Other ◽

Motor Ability ◽

Training Methodology ◽

Balance Ability ◽

The Relationship

The purpose of this study is to investigate the relationship between motor ability for balance and the performance of selected gymnastic elements on the floor in students aged 7-8 years, to provide an overview of the current motor status of the respondents at this age, and to develop suggestions for possible changes in the curriculum at this age, and to develop suggestions for supplementing training methodology. Training of selected gymnastics elements was conducted on a sample of 42 subjects who had no previous experience in performing gymnastics elements during regular physical education classes, and the predictor variable was tested using four tests assessing motor balance ability. The tests assessing motor balance ability showed a statistically significant predictive value for the performance of all three gymnastics exercises. It is noticeable that the value of the prediction model increased the more complex an item was derived, indicating the complexity of the motor balance space and the high and stable level of the same in the subjects at the time of testing. Regarding the tests used, it can be noted that the test FLAM was significantly involved in the prediction of performance success in all three gymnastic elements, while the other two tests showed their predictive value in the execution of the hand stand. On the other hand, the study shows that the gymnastic elements used should be used in physical education classes to contribute to the promotion and development of all motor skills of students and as part of the preparation for the execution of more complex elements on the floor and apparatus in higher grades.

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