99mTc-labeled ubiquicidin scintigraphy

SummaryAim: Hip prosthesis implantation has witnessed a significant increase in recent years. Despite the advantages of this surgical procedure, it has some complications, the most serious of which is prosthetic infection. This study was conducted to investigate the feasibility of 99mTc-UBI scintigraphy in detection of infectious foci in painful hip prosthesis. UBI (Ubiquicidin 29–41) is an antimicrobial peptide fragment with the ability to target the bacterial colony directly. Patients, methods: 34 patients, aged 20–79 years, with painful hip prosthesis were included. 99mTc-UBI scan and three phase bone scan were performed and two nuclear medicine specialists interpreted the UBI scans with and without bone scan results at hand. Both qualitative and semiquantitative methods were used to interpret the 30 minute post injection images. The patients were actively followed up. According to the surgical findings, microbiological culture and active follow up, final diagnosis was made. Results: 24 negative and 10 positive UBI scans were recorded. The sensitivity, specificity, negative and positive predictive values and accuracy of the study were all 100%. Bone scan did not have any influence on UBI interpretation. We were able to achieve excellent differentiation between infected and non-infected prostheses with a cut off value of 1.8 for target to non target (T/NT) ratio. No adverse effects were noticed following UBI scan. Conclusion: Based on the findings, the authors believe that 99mTc-UBI scintigraphy, with its high sensitivity and specificity, provides the physician with an excellent tool for differentiating infection from aseptic loosening of hip prostheses. Using this radiopharmaceutical, it is possible to obtain highly accurate results only 30 minutes after the beginning of the study.

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Analysis of 18F-FDG uptake patterns in PET for diagnosis of septic and aseptic loosening after total hip arthroplasty

Nuklearmedizin ◽

10.1055/s-0038-1625733 ◽

2003 ◽

Vol 42 (06) ◽

pp. 234-239 ◽

Cited By ~ 21

Author(s):

T. Mumme ◽

P. Reinartz ◽

D. Wirtz ◽

F. U. Niethard ◽

U. Büll ◽

...

Keyword(s):

Aseptic Loosening ◽

Femoral Component ◽

Hip Prosthesis ◽

Prosthetic Infection ◽

Clinical Value ◽

Septic Loosening ◽

Hip Prostheses ◽

Fdg Uptake ◽

Positron Emission ◽

Painful Hip

Summary Aim: Identification of typical patterns for fluorodeoxyglucose (FDG) uptake in positron emission tomography (PET) to detect aseptic loosening of hip prosthesis (ace-tabular and/or femoral component) and prosthetic infection. Methods: 18 patients with painful hip prosthesis underwent PET using a dedicated full ring scanner after application of 200-300 MBq FDG. The interface between bone and surrounding soft tissue or bone as displayed on coronal slices was divided into 12 segments in accordance with the classifications of Delee and Gruen. FDG uptake in each of the segments was scored (0-3) by two independent observers. Intraoperative findings were regarded as the gold standard. Results: After surgical revision 14 acetabular components and 9 femoral components were found to be loose and prosthetic infection was present in 7 prostheses. Loosening of the acetabular component was correlated to enhanced uptake in the middle of the acetabular interface, while loosening of the femoral component was correlated to enhanced uptake in the proximal and middle segment of the lateral femoral interface and the proximal segment of the medial femoral interface. A similar pattern was found in prosthetic infection with high uptake along the middle portion of the lateral fe-moral interface. In 6 of 7 infected prostheses loosening of the acetabular and of the femoral component was present. Taking the typical uptake patterns as criteria for loosening and grade 3 uptake as an additional criterion for septic loosening the accuracy of PET imaging in the detection of loosening of the acetabular or the femoral component and of prosthetic infection was 72, 78 and 89%, respectively. Conclusion: This pilot study presents FDG-PET as a promising diagnostic tool for patients with painful hip prostheses. Its clinical value should be evaluated in a larger patient population.

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Evaluation of HiCrome KPC Agar for the Screening of Carbapenem-Resistant Enterobacterales Colonization in the ICU Setting of a Tertiary Care Hospital

Journal of Laboratory Physicians ◽

10.1055/s-0041-1732494 ◽

2021 ◽

Author(s):

Ashoka Mahapatra ◽

K Nikitha ◽

Sutapa Rath ◽

Bijayini Behera ◽

Kavita Gupta

Keyword(s):

Tertiary Care ◽

High Sensitivity ◽

Care Hospital ◽

Predictive Values ◽

Klebsiella Pneumoniae Carbapenemase ◽

Carbapenem Resistant ◽

Rectal Swabs ◽

Control And Prevention ◽

Indian Setting ◽

Sensitivity Specificity

Abstract Background Spread of carbapenem-resistant Enterobacterales (CRE) is a significant concern in intensive care unit (ICU) settings. Approaches to routine screening for CRE colonization in all ICU patients vary depending on institutional epidemiology and resources. The present study was aimed to evaluate the performance of HiCrome Klebsiella pneumoniae carbapenemase (KPC) agar for the detection of CRE colonization in ICU settings taking the Centers for Disease Control and Prevention (CDC) recommended method as reference. Methods Two-hundred and eighty rectal swabs (duplicate) from 140 patients were subjected to CRE detection in HiCrome KPC agar and MacConkey agar (CDC criteria). Results Using CDC method, total 41 CRE isolates were recovered comprising of 29 E scherichia coli, 11 Klebsiella, and 1 Enterobacter spp. On the other hand, 49 isolates of CRE recovered from 140 rectal swabs using HiCrome KPC agar, out of which 33 were E. coli, 15 Klebsiella, and 1 Enterobacter sp. Statistical Analysis Sensitivity, specificity, negative, and positive predictive values of CRE screening by HiCrome KPC agar were found to be 100% (91.4–100), 91.9% (84.8–95.8), 83.6% (70.9–91.4), and 100% (95.9–100), respectively, taking the CDC recommended method as reference. Conclusion HiCrome KPC agar has high sensitivity in screening CRE colonization. Further studies are needed to establish its applicability for detecting the predominant circulating carbapenemases in the Indian setting.

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The diagnosis of delirium in 80 emergency unit patients

Arquivos de Neuro-Psiquiatria ◽

10.1590/s0004-282x1998000200002 ◽

1998 ◽

Vol 56 (2) ◽

pp. 176-183

Author(s):

AFONSO CARLOS NEVES ◽

RICARDO DE CASTRO CINTRA SESSO ◽

HENRIQUE BALLALAI FERRAZ ◽

SÍLVIO FRANCISCO ◽

JOÃO BAPTISTA DOS REIS-FILHO

Keyword(s):

Correct Diagnosis ◽

Diagnostic Testing ◽

Final Diagnosis ◽

Initial Diagnosis ◽

University Hospital ◽

Emergency Unit ◽

Predictive Values ◽

Kappa Test ◽

History Of ◽

Sensitivity Specificity

We evaluated the initial and final diagnosis of 80 patients with delirium arriving at the emergence unit of a university hospital in a large Brazilian city over a period of 30 months up to December 1991. The diagnosis was based on the DSM-IIIR criteria. Patients with a known history of head trauma or epileptic seizure and patients younger than 13 years were excluded. Only patients with a disease of up to 7 days were included.The patients were subdivided into four etiologic groups: vascular; associated with the use of alcohol; infectious-parasitic; miscellaneous.The results showed a rate of correct diagnosis ranging from 65 to 80% with the use of kappa test (standard good to excelent). Sensitivity, specificity, positive predictive and negative predictive values had results showing different conditions for initial diagnosis in each group. This study can help the initial diagnosis of delirium and the choice for diagnostic testing.

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Searching for the Fetal Alcohol Behavioral Phenotype

Global Pediatric Health ◽

10.1177/2333794x20941337 ◽

2020 ◽

Vol 7 ◽

pp. 2333794X2094133

Author(s):

Gideon Koren ◽

Asher Ornoy

Keyword(s):

High Sensitivity ◽

Behavioral Phenotype ◽

Narrative Review ◽

Screening Tools ◽

Fetal Alcohol ◽

Predictive Values ◽

Published Evidence ◽

Sensitivity Specificity ◽

Fetal Alcohol Spectrum

This narrative review presents the emerging published evidence on the existence of a phenotypic behavior in children with fetal alcohol spectrum behavior. Such a phenotype, exhibiting high sensitivity, specificity, and predictive values, may assist clinicians and families in identifying children who often miss some of the information needed for full diagnosis, but who may benefit from these screening tools in mobilizing help to these youngsters and their families.

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Magnetic Resonance Imaging in the Diagnosis of Glomus Tumours of the Hand

Journal of Hand Surgery (European Volume) ◽

10.1016/j.jhsb.2005.06.009 ◽

2005 ◽

Vol 30 (5) ◽

pp. 535-540 ◽

Cited By ~ 74

Author(s):

M. M. AL-QATTAN ◽

A. AL-NAMLA ◽

A. AL-THUNAYAN ◽

F. AL-SUBHI ◽

A. F. EL-SHAYEB

Keyword(s):

Predictive Value ◽

Final Diagnosis ◽

Senior Author ◽

Glomus Tumour ◽

Resonance Imaging ◽

Predictive Values ◽

Final Histological Diagnosis ◽

Sensitivity Specificity ◽

The Cost ◽

Negative Imaging

This paper studies the sensitivity, specificity and predictive values of MRI in the diagnosis of glomus tumours of the hand and investigates the final diagnosis and outcome in cases with false positive or negative imaging tests. A total of 42 cases with the clinical diagnosis of a glomus tumour were included in the study. All patients underwent MRI and the results of MRI were correlated with the final histological diagnosis of the excised lesion. MRI had a sensitivity of 90%, a specificity of 50%, a positive predictive value of 97% and a negative predictive value of 20%. The four cases in which the MRI was negative all proved histologically to be glomus tumours. All four tumours were small (2–3 mm in diameter) and the lack of delineation of the lesions by MRI was attributed to their small size. Despite negative MRIs, surgical exploration identified the glomus tumours. Based on the results of the current study and the cost of MRI, the senior author has stopped ordering pre-operative MRIs in patients clinically diagnosed with a glomus tumour.

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PROKALSITONIN SEBAGAI PENANDA PEMBEDA INFEKSI BAKTERI DAN NON BAKTERI

INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY ◽

10.24293/ijcpml.v17i2.1019 ◽

2018 ◽

Vol 17 (2) ◽

pp. 76

Author(s):

Bastiana Bastiana ◽

Aryati Aryati ◽

Dominicus Husada ◽

M.Y. Probohoesodo

Keyword(s):

Bacterial Infection ◽

Roc Analysis ◽

Final Diagnosis ◽

Receiver Operating Curve ◽

Fluorescent Assay ◽

Infection Group ◽

Cross Sectional ◽

Predictive Values ◽

Significant Difference ◽

Sensitivity Specificity

Early diagnosis of an infection and prompt administration of an antibiotic can dramatically reduce morbidity and mortality.Procalcitonin (PCT), a precursor of calcitonin, has been proposed as a marker of bacterial infection. The aim of this study is to assess theefficiency of procalcitonin in children for the diagnosis of bacterial vs. non bacterial infection. This was a prospective, cross-sectional study.The subjects were enrolled consecutively, consisting of feverish children (temperature ³38.5° C) admitted to the Pediatric EmergencyDepartment with ages up to 12 years old. The subjects were divided into two groups according to their final diagnosis, bacterial and nonbacterial infection. Serum PCT concentration was measured by enzyme linked fluorescent assay (ELFA) method. Sensitivity, specificity,positive predictive and negative predictive values, and receiver operating curve (ROC) of PCT were calculated. Out of 54 patients,24 (44.4%) had a final diagnosis of bacterial infection. PCT showed a wide concentration range in the bacterial infection group (median:1.09 ng/mL, lower (L)=0.05 ng/mL, upper (U)=128.7 ng/mL) compared with non bacterial infection group (0.21 ng/mL; L=0.05ng/mL; U=12.15 ng/mL). There was a significant difference in PCT between the 2 groups (p=0.020). ROC analysis demonstrated anarea under curve (AUC) of 0.686 (95% CI, 0.534 to 0.838). Using a cut-off point of 0.5 ng/mL, the sensitivity, and specificity, positivepredictive and negative predictive values of PCT were 66.7%, 76.7%, 69.6%, 74.2%, respectively. In this study, PCT may be useful fordifferentiation of bacterial vs. non bacterial infection in children.

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Accuracy of a new hysteroscopic method in the assessment of tubal patency: Hysteroscopic Chromotubation

Gynecology Obstetrics and Reproductive Medicine ◽

10.21613/gorm.2017.692 ◽

2018 ◽

Vol 24 (2) ◽

pp. 82

Author(s):

Burak Yucel ◽

Emine Demirel ◽

Sefa Kelekci ◽

Kerem Doga Seckin ◽

Osama Shawki

Keyword(s):

Methylene Blue ◽

Cohort Study ◽

Gold Standard ◽

Uterine Cavity ◽

High Sensitivity ◽

Office Hysteroscopy ◽

Predictive Values ◽

Tubal Patency ◽

Infertile Women ◽

Sensitivity Specificity

ObjectiveThe aim of this study was to evaluate the diagnostic accuracy of hysteroscopic chromopertubation (HCT) in the assessment of tubal patency by comparing its results with laparoscopic chromopertubation (LCT).Study DesignThe population of this prospective cohort study consisted of both fertile and infertile women. Sixty-four women were included to the study. HCT was assessed by the observation of the transport of highly concentrated methylene blue from uterine cavity to tubal ostia. The results of HCT were compared with the results of LCT as a gold standard. The accuracy of HCT, sensitivity, specificity, positive and negative predictive values in diagnosing tubal patency were calculated.ResultsThe results of HCT and LCT were evaluated for right and left tubes, separately. One hundred and twenty-eight tubes were determined. Sensitivity, specificity, positive and negative predictive values for HCT were; 85.85%, 59.09%, 91% and 46.43%, respectively.Conclusion This study’s result showed that HCT had high sensitivity and moderate specificity values in the assessment of tubal patency. HCT during office hysteroscopy could give the chance to practitioners to assess tubal patency without subjecting the patient to multiple procedures.

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Dog Savior: Immediate Scent-Detection of SARS-COV-2 by Trained Dogs

10.1101/2020.06.17.158105 ◽

2020 ◽

Author(s):

Omar Vesga ◽

Andres F. Valencia ◽

Alejandro Mira ◽

Felipe Ossa ◽

Esteban Ocampo ◽

...

Keyword(s):

Infected Individual ◽

High Sensitivity ◽

The Body ◽

High Rate ◽

Diagnostic Tools ◽

Predictive Values ◽

Infected People ◽

Molecular Tests ◽

Production And Distribution ◽

Sensitivity Specificity

AbstractMolecular tests for viral diagnostics are essential to confront the COVID-19 pandemic, but their production and distribution cannot satisfy the current high demand. Early identification of infected people and their contacts is the key to being able to isolate them and prevent the dissemination of the pathogen; unfortunately, most countries are unable to do this due to the lack of diagnostic tools. Dogs can identify, with a high rate of precision, unique odors of volatile organic compounds generated during an infection; as a result, dogs can diagnose infectious agents by smelling specimens and, sometimes, the body of an infected individual. We trained six dogs of three different breeds to detect SARS-CoV-2 in respiratory secretions of infected patients and evaluated their performance experimentally, comparing it against the gold standard (rRT-PCR). Here we show that viral detection takes one second per specimen. After scent-interrogating 9,200 samples, our six dogs achieved independently and as a group very high sensitivity, specificity, predictive values, accuracy, and likelihood ratio, with very narrow confidence intervals. The highest metric was the negative predictive value, indicating that with a disease prevalence of 7.6%, 99.9% of the specimens indicated as negative by the dogs did not carry the virus. These findings demonstrate that dogs could be useful to track viral infection in humans, allowing COVID-19 free people to return to work safely.

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Diagnostic yield of transbronchial needle aspiration for lymphoma

South African Respiratory Journal ◽

10.7196/sarj.2016.v22i3.80 ◽

2016 ◽

Vol 22 (3) ◽

pp. 67

Author(s):

B Sonnekus ◽

J Steenkamp ◽

M Louw ◽

C F N Koegelenberg

Keyword(s):

Predictive Value ◽

Diagnostic Yield ◽

Cost Effective ◽

Final Diagnosis ◽

Needle Aspiration ◽

Tracheobronchial Tree ◽

Transbronchial Needle Aspiration ◽

Predictive Values ◽

Hilar Adenopathy ◽

Sensitivity Specificity

Background. Transbronchial needle aspiration (TBNA) is a minimally invasive bronchoscopic technique that is cost-effective and safe for diagnosing mediastinal and hilar adenopathy in lung cancer, other malignancies, sarcoidosis and infectious processes such as tuberculosis. Few studies have analysed the sensitivity, specificity and predictive values of TBNA for diagnosing lymphoma.Objective. To evaluate the diagnostic yield of TBNA for diagnosing mediastinal and hilar adenopathy in suspected lymphoma.Methods. We performed a retrospective analysis of collected data of patients with mediastinal and hilar adenopathy adjacent to the tracheobronchial tree detected by thoracic computed tomography, who underwent TBNA at Tygerberg Hospital between July 2010 and June 2013. We included 25 patients with suspected or proven lymphoma. Histology was used as the gold standard.Results. Adequate samples for cytological evaluation were obtained for 22 (88%) patients. Cytological diagnosis was possible for 8 (32%). For 17 (68%) who could not be diagnosed by TBNA alone, histology provided final diagnosis. Rapid on-site examination (ROSE) was performed in 23 (92%). In 17/23 (74%) cases, these had similar results to formal cytology. Only 4 (16%) had flow cytometry requested. Twelve (48%) had lymphoma confirmed on histology. TBNA cytology had 100% specificity and positive predictive value for suspicion of lymphoma. Sensitivity was 33% and negative predictive value 62%.Conclusion. TBNA is an appropriate first-line diagnostic procedure in evaluating mediastinal and hilar lymphadenopathy in suspected lymphoma. Biopsy should be the immediate second-line procedure when ROSE/cytology is suspicious of lymphoma or shows atypical cells. Patients with negative TBNA cytology, but high clinical or radiological suspicion of lymphoma, should be further investigated.

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Assessment of the diagnostic value of microsatellite instability in the urine of bladder cancer patients.

Journal of Clinical Oncology ◽

10.1200/jco.2019.37.7_suppl.384 ◽

2019 ◽

Vol 37 (7_suppl) ◽

pp. 384-384

Author(s):

Hussein Mustafa Khaled ◽

Abdel-Rahman Zekri ◽

Mai B Mohamed ◽

Fatma M Diab ◽

Mona Abdellateif ◽

...

Keyword(s):

Bladder Cancer ◽

Microsatellite Instability ◽

Tumor Tissue ◽

High Sensitivity ◽

Diagnostic Value ◽

Urine Samples ◽

Tissue Samples ◽

Predictive Values ◽

Promising Tool ◽

Sensitivity Specificity

384 Background: Microsatellite alterations in urine sediments have proved to be a promising tool for detection of bladder cancer (BC) due to its high sensitivity and specificity. Methods: We assessed the possible prognostic and predictive values of microsatellite alterations in tissue samples and urine sediments obtained from Egyptian patients with BC, and their utility as diagnostic, prognostic and predictive value. Microsatellite instability (MSI) and loss of heterozygosity (LOH) were assessed using 13 microsatellite markers in tumor tissue and urine sediments of 30 patients with BC. The concordance between MSI in tissue and urine samples was determined. Results: We found that MSI was more frequent than LOH (100% and 46.7%; respectively). D16S310, MBP and IFN-α showed the highest MSI frequency in urine samples (70%, 70% and 66.67%; respectively), while MBP, ACTBP2 and D9S171 (66.67%, 63.33%, and 60%; respectively) were the most frequently detected in tumor tissue. All markers correlated significantly with the pathological subtypes (more frequent in TCC) and hematuria. The concordance between tissue and urine was statistically significant for , D9S171, D16S476, FGA and ACTBP2 (P = 0.04, 0.015, 0.02 and 0.007; respectively). When we combined D16S476 and D9S171, the sensitivity, specificity, PPV and NPV reached (80.0%, 75.0%, 82.8% and 71.4%; respectively) for diagnosis of BC . Conclusions: Thus MSI in urine sediments could be a sensitive and reliable method for diagnosis of BC.

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