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.

Evaluation of the Clinical Role of Strain Elastography in Patients Diagnosed With Congenital Torticollis

2021 ◽  
pp. 875647932098324
Author(s):  
Elif Özyazici Özkan ◽  
Mehmet Burak Ozkan ◽  
İshak Abdurrahman İsik
Keyword(s):  
Area Under The Curve ◽  
Muscle Group ◽  
Receiver Operating Curve ◽  
Control Group ◽  
Clinical Role ◽  
Congenital Muscular Torticollis ◽  
Cutoff Value ◽  
Strain Elastography ◽  
Specificity And Sensitivity ◽  
Muscular Torticollis

Objective: The objective of this study was to determine the elasticity of sternocleidomastoid muscle (SCM) in patients with congenital muscular torticollis (CMT). Methods: In all, 41 patients and 22 controls were included in the study, and the elasticity of the patients’ SCM was measured. Echogenicity, thickness, and strain values of the SCM were also obtained. Results: The thickness and strain values of the SCM were higher in the patient group than in the control group ( P = .02 and P = .15). For median values, there was no difference in echogenicity and strain. In the strain elastography evaluation of the receiver operating curve (ROC) for muscle echogenicity in the isoechoic muscle group, the specificity and sensitivity were determined to be 100% and 22%, respectively, for the area under the curve (AOC) value of 0.558 (95% confidence interval [CI], 0.424–0.6686), and the cutoff value was <1.4. In the hyperechoic muscle group, the ROC for AUC values was found to be 0.542 (95% CI, 0.411–0.6686), and the cutoff value was >1.4 with 100% sensitivity and 20.75 specificity. Conclusions: The strain elastography technique can be used in the diagnosis of CMT.

scholarly journals D-dimer as a biomarker for assessment of COVID-19 prognosis: D-dimer levels on admission and its role in predicting disease outcome in hospitalized patients with COVID-19

PLoS ONE ◽  
2021 ◽  
Vol 16 (8) ◽  
pp. e0256744
Author(s):  
Ayusha Poudel ◽  
Yashasa Poudel ◽  
Anurag Adhikari ◽  
Barun Babu Aryal ◽  
Debika Dangol ◽  
...  
Keyword(s):  
Proportional Hazards ◽  
Characteristic Curve ◽  
Area Under The Curve ◽  
Respiratory Illness ◽  
Immunofluorescence Assay ◽  
Cox Proportional Hazards ◽  
Optimal Cutoff ◽  
Cutoff Value ◽  
Potential Biomarker ◽  
D Dimer

Introduction Coronavirus Disease 2019 is a primarily respiratory illness that can cause thrombotic disorders. Elevation of D-dimer is a potential biomarker for poor prognosis in COVID-19, though optimal cutoff value for D-dimer to predict mortality has not yet been established. This study aims to assess the accuracy of admission D-dimer in the prognosis of COVID-19 and to establish the optimal cutoff D-dimer value to predict hospital mortality. Methods Clinical and laboratory parameters and outcomes of confirmed COVID-19 cases admitted to four hospitals in Kathmandu were retrospectively analyzed. Admitted COVID-19 cases with recorded D-dimer and definitive outcomes were included consecutively. D-dimer was measured using immunofluorescence assay and reported in Fibrinogen Equivalent Unit (μg/ml). The receiver operating characteristic curve was used to determine the accuracy of D-dimer in predicting mortality, and to calculate the optimal cutoff value, based on which patients were divided into two groups and predictive value of D-dimer for mortality was measured. Results 182 patients were included in the study out of which 34(18.7%) died during the hospital stay. The mean admission D-dimer among surviving patients was 1.067 μg/ml (±1.705 μg/ml), whereas that among patients who died was 3.208 μg/ml (±2.613 μg/ml). ROC curve for D-dimer and mortality gave an area under the curve of 0.807 (95% CI 0.728–0.886, p<0.001). Optimal cutoff value for D-dimer was 1.5 μg/ml (sensitivity 70.6%, specificity 78.4%). On Cox proportional hazards regression analysis, the unadjusted hazard ratio for high D-dimer was 6.809 (95% CI 3.249–14.268, p<0.001), and 5.862 (95% CI 2.751–12.489, p<0.001) when adjusted for age. Conclusion D-dimer value on admission is an accurate biomarker for predicting mortality in patients with COVID-19. 1.5 μg/ml is the optimal cutoff value of admission D-dimer for predicting mortality in COVID-19 patients.

scholarly journals Inflammatory Biomarkers Predictive of Metabolic Syndrome in a Nigerian Population: A Case-Control Study

2020 ◽  
Vol 6 (4) ◽  
pp. 382-390
Author(s):  
EN Adejumo ◽  
OA Adejumo ◽  
OA Ogundahunsi
Keyword(s):  
Metabolic Syndrome ◽  
Case Control Study ◽  
Inflammatory Marker ◽  
Characteristic Curve ◽  
Area Under The Curve ◽  
Case Control ◽  
Control Group ◽  
Necrosis Factor Alpha ◽  
Hs Crp ◽  
Control Study

Background: Inflammation is linked to the aetiopathogenesis of Metabolic syndrome (MetS). Objective: To assess the ability of high sensitivity C-Reactive Protein (hs-CRP), Tumour Necrosis Factor-alpha (TNFα) and Interleukin-6 (IL-6) to predict MetS. Methods: A case-control study involving 123 subjects with MetS (cases) and age-matched 123 subjects. without MetS (controls) was conducted. The levels of TNFα, IL-6, and hs-CRP between independent groups were compared. The Receiver Operative Characteristic Curve was used to assess the ability of inflammatory markers to discriminately identify MetS. Results: The mean age of the case and control groups was 49.9±0.9 years and 48.1±1.1 years (p = 0.274) respectively. The median levels of TNFα, IL-6 and hS-CRP were significantly higher among the cases than the control group in both genders (p <0.001). There was a significant increase in the serum values of the markers with increasing components of MetS (p <0.001). The Area Under the Curve of TNFα, IL-6 and hs-CRP was > 0.9 in both males and females. Conclusion: TNFα, IL-6, and hs-CRP identified MetS. There is a need for further studies to determine the inflammatory marker most predictive of MetS.

scholarly journals The Optimal Cutoff Value of D-dimer Levels to Predict in Hospital Mortality in Severe Cases of Coronavirus Disease 2019

2021 ◽  
Vol 9 (B) ◽  
pp. 1561-1564
Author(s):  
Ngakan Ketut Wira Suastika ◽  
Ketut Suega
Keyword(s):  
Hospital Mortality ◽  
Receiver Operating Characteristic Curve ◽  
Receiver Operating Characteristic ◽  
Operating Characteristic ◽  
Characteristic Curve ◽  
Area Under The Curve ◽  
Optimal Cutoff ◽  
Cutoff Value ◽  
Operating Characteristic Curve ◽  
D Dimer

Introduction: Coronavirus disease 2019 (Covid-19) can cause coagulation parameters abnormalities such as an increase of D-dimer levels especially in severe cases. The purpose of this study is to determine the differences of D-dimer levels in severe cases of Covid-19 who survived and non-survived and determine the optimal cut-off value of D-dimer levels to predict in-hospital mortality. Method: Data were obtained from confirmed Covid-19 patients who were treated from June to September 2020. The Mann-Whitney U test was used to determine differences of D-dimer levels in surviving and non-surviving patients. The optimal cut-off value and area under the curve (AUC) of the D-dimer level in predicting mortality were obtained by the receiver operating characteristic curve (ROC) method. Results: A total of 80 patients were recruited in this study. Levels of D-dimer were significantly higher in non-surviving patients (median 3.346 mg/ml; minimum – maximum: 0.939 – 50.000 mg/ml) compared to surviving patients (median 1.201 mg/ml; minimum – maximum: 0.302 – 29.425 mg/ml), p = 0.012. D-dimer levels higher than 1.500 mg/ml are the optimal cut-off value for predicting mortality in severe cases of Covid-19 with a sensitivity of 80.0%; specificity of 64.3%; and area under the curve of 0.754 (95% CI 0.586 - 0.921; p = 0.010). Conclusions: D-dimer levels can be used as a predictor of mortality in severe cases of Covid-19.

Diagnostic efficacy of serum and urinary netrin-1 in the early detection of diabetic nephropathy

2021 ◽  
pp. jim-2021-001785
Author(s):  
Rasha A Elkholy ◽  
Reham L Younis ◽  
Alzahraa A Allam ◽  
Rasha Youssef Hagag ◽  
Muhammad Tarek Abdel Ghafar
Keyword(s):  
Diabetic Nephropathy ◽  
Early Detection ◽  
Characteristic Curve ◽  
Fasting Blood Glucose ◽  
Area Under The Curve ◽  
Diagnostic Value ◽  
Control Group ◽  
Diagnostic Efficacy ◽  
Significant Difference ◽  
Patients With Diabetes

This study aimed to assess the diagnostic value of serum and urinary netrin-1 in patients with type 2 diabetes mellitus (T2DM) at different stages of diabetic nephropathy (DN) and to compare its efficacy of estimation in serum with that in the urine. This study was carried out on 135 patients with T2DM and 45 healthy subjects. The patients with diabetes were divided according to urinary albumin creatinine ratio (UACR) into: T2DM with normoalbuminuria, incipient DN with microalbuminuria, and overt DN with macroalbuminuria groups. Serum and urinary levels of netrin-1 were measured by ELISA. The mean levels of serum and urinary netrin-1 were significantly higher in the microalbuminuric and macroalbuminuric patients with DN than those in the normoalbuminuric patients with T2DM, with the highest values detected in macroalbuminuric patients with DN. Urinary netrin-1 level was significantly higher in the normoalbuminuric T2DM group than control group, whereas no significant difference existed regarding serum netrin-1 level. In T2DM groups, the urinary and serum netrin-1 correlated with each other and were independently related to fasting blood glucose, UACR, and estimated glomerular filtration rate. Receiver operating characteristic curve analysis showed that the area under the curve of urinary netrin-1 was 0.916 which is significantly higher than that of serum netrin-1 (0.812) for the detection of incipient DN and reached 0.938 on coestimation of both urinary and serum netrin-1. In conclusion, netrin-1 is a potential diagnostic marker for early detection of DN with its estimation in urine has higher accuracy than that of serum.

Predictive Value of The Combined Detection of Platelets, D-Dimer, and Procalcitonin On Severe Heat Stroke

2021 ◽  
Author(s):  
wang lei ◽  
jiang dai shan ◽  
zhang Yi ◽  
jia han yu ◽  
shen jun hua
Keyword(s):  
Body Temperature ◽  
Characteristic Curve ◽  
Heat Stroke ◽  
Area Under The Curve ◽  
General Information ◽  
The Body ◽  
Control Group ◽  
Clinical Test ◽  
Roc Curve Analysis ◽  
Combined Detection

Abstract BackgroundTo explore the clinical characteristics of patients with severe heat stroke, we explored the early sensitive indicators of heat stroke (HS) patients, with a view to early intervention for HS patients. MethodsFrom July 30, 2015 to October 5, 2020, 70 inpatients with severe heat stroke admitted to the Second Affiliated Hospital of Nantong University, Jiangsu Province were selected as the research objects. The general information and clinical test indicators of the patients were recorded, and all patients were assessed for acute physiology (APACH Ⅱ) upon admission. According to the severity of heatstroke, they were divided into three groups: control group (heat cramps and heat exhaustion), EHS, and CHS to compare the differences in indicators of each group. Further draw the receiver operating characteristic curve (ROC).Results1. According to the severity of heat stroke, 28 cases were divided into the control group, 24 cases in the EHS group, and 18 cases in the CHS group. The body temperature of the EHS group and the CHS group was significantly higher than that of the control group (both P<0.05), but there was no statistical difference in the body temperature of the EHS group and the CHS group; the DD, PCT, and APACH of the EHS group were significantly higher than those of the control group and the CHS group (both P＜0.05); PLT, CRP, Na, GLU of EHS group were lower than those of control group and CHS group (all P＜0.05), and the decrease of PLT was more significant; CHS group HbA1C was significantly higher than that of control group and EHS group (all P <0.05). 2. ROC curve analysis the areas under the curves of DD, PCT, and PLT are 0.670, 0.705, 0.791, respectively, the sensitivity is 40.48%, 100%, 73.81%, and the specificity is 96.43%, 32.14%, 78.57%, respectively. Using the combined analysis of the three series tests, the area under the curve was 0.838, the sensitivity was 71.43%, and the specificity was 85.71%. ConclusionsEHS patients have higher DD, PCT, APACH, but PLT, CRP, Na, and blood sugar are lower. At the same time, the significant decrease of PLT and the increase of PCT and DD may be early sensitive indicators of HS. The combined detection of the three can be used as a reference basis for early diagnosis of HS and critical illness.

Assessing Diabetic Foot Infections With the ThermoScale: A Comparative Thermometry Device Designed as a Patient Self-Screening Tool

2020 ◽  
pp. 153473462094830
Author(s):  
Laure Arts ◽  
Johan De Neve ◽  
Samira Baharlou ◽  
Nathalie Denecker ◽  
Laura Kerselaers ◽  
...  
Keyword(s):  
Temperature Measurement ◽  
Diabetic Foot ◽  
Characteristic Curve ◽  
Screening Method ◽  
Area Under The Curve ◽  
Control Group ◽  
Measurement Technology ◽  
Diabetic Patients ◽  
Home Setting ◽  
Diabetic Foot Infections

Diabetic foot infection (DFI) is an important risk factor for amputation, and late diagnosis or referral is often incriminated for poor outcome. To enable an earlier diagnosis of DFI, comparative foot thermometry has been suggested as a self-screening method for patients in a home setting. We validated the efficacy of the ThermoScale, a weighing scale outfitted with temperature sensors that allows accurate temperature measurement in both feet. Temperature differentials in DFI patients (n = 52) were compared with a control group of similar diabetic patients (n = 45) without any foot wounds. Based on these findings, we drafted a receiver operating characteristic curve to determine an area-under-the-curve of 0.8455. This value suggests that the ThermoScale, as a diagnostic test, is reasonably accurate. A cutoff value of 2.15 °C temperature difference corresponded with a sensitivity of 88.9% and a specificity of 61.5%. As wearables, portable health electronics, and telemedicine become increasingly popular, we think that comparative temperature measurement technology is valuable in improving early diagnosis of DFIs.

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 Discriminative Validity of the Lower and Upper Quarter Y Balance Test Performance in Healthy Youth

2020 ◽  
Author(s):  
Gerrit Schwiertz ◽  
Rainer Beurskens ◽  
Thomas Muehlbauer
Keyword(s):  
Test Performance ◽  
Dynamic Balance ◽  
Characteristic Curve ◽  
Area Under The Curve ◽  
Receiver Operator Characteristic Curve ◽  
Balance Test ◽  
Discriminative Validity ◽  
Youth Athletes ◽  
Valid Test ◽  
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. Normalized 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: 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.Conclusions: In healthy youth, the YBT-LQ and the YBT-UQ seem to be valid test instruments for the discriminative assessment of dynamic balance and shoulder mobility/stability, respectively.

Sign in / Sign up

Export Citation Format

Share Document