scholarly journals Predicting Malignancy in Entirely Solid-appearing Adnexal Masses on Gray-Scale Ultrasound Based on Additional Ultrasound Findings, Clinical Complaints and Biochemical Parameters: A Retrospective Study

Author(s):  
Juan Luis Alcázar ◽  
Laura Pineda ◽  
Jesús Utrilla-Layna

ABSTRACT Purpose To determine which clinical, biochemical and other sonographic parameters could be useful to predict malignancy in sonographically solid adnexal masses. Materials and methods Clinical, biochemical and other sonographic features from 227 women diagnosed as having an entirely solid adnexal mass on B-mode gray-scale ultrasound were reviewed for this retrospective study. All patients had undergone surgery and mass removal. Definitive histologic diagnosis was available in all cases. All parameters were compared to final histological diagnosis (benign or malignant) in univariate statistical analysis. Then a stepwise forward logistic regression analysis was performed to identify those features that independently predict malignancy. Results A total of 227 masses were analyzed. Patients’ mean age was 52.9 years (range: 15-84 years). A total of 150 masses were malignant and 77 were benign. In 52 cases carcinomatosis was observed on ultrasound scan and all theses cases were malignant. In the remaining 175 cases, univariate analysis showed statistical differences between benign and malignant tumors all parameters except tumor's volume. After logistic regression analysis tumor contour, acoustic shadowing, amount of color and CA 125 were identified as independent predictors of malignancy. Using a logistic model 94.4% of malignant tumors and 85.7% of benign tumors would be correctly identified. Conclusion The presence of carcinomatosis is invariably associated to malignancy. In absence of carcinomatosis, irregular tumor contour, absence of acoustic shadowing, moderate or abundant blood flow and a high CA 125 are associated to malignancy. How to cite this article Utrilla-Layna J, Olartecoechea B, Aubá M, Ruiz-Zambrana A, Pineda L, Alcázar JL. Predicting Malignancy in Entirely Solid-appearing Adnexal Masses on Gray-Scale Ultrasound Based on Additional Ultrasound Findings, Clinical Complaints and Biochemical Parameters: A Retrospective Study. Donald School J Ultrasound Obstet Gynecol 2013;7(1):80-85.

Author(s):  
Juan Luis Alcázar ◽  
Pedro Royo ◽  
Laura Pineda

Abstract To determine which clinical, biochemical and other sonographic parameters could be useful to predict malignancy in sonographically solid adnexal masses. Methods Clinical (age, menopausal status, complaints and physical examination), biochemical (serum CA-125 levels) and other sonographic features (tumor volume, ascites, bilaterality, blood flow location and velocimetric pattern) from 163 women diagnosed as having a solid adnexal mass on B-mode gray-scale ultrasound were reviewed for this retrospective study. All patients had undergone surgery and mass removal. Definitive histologic diagnosis was available in all cases. All parameters were compared to final histological diagnosis (benign or malignant) in univariate statistical analysis. Then a stepwise forward logistic regression analysis was performed to identify those features that independently predict malignancy. Results A total of 173 masses were analyzed. Patients mean age was 52.4 years (range: 15 to 84 years) 117 masses were malignant and 56 were benign. After univariate analysis all parameters showed statistical differences between benign and malignant tumors. After logistic regression analysis only central blood flow (odd ratio: 64.2, 95% CI: 17.07 to 242.03) and presence of ascites (odd ratio: 32.77, 95% CI: 5.38 to 199.72) were identified as independent predictors of malignancy. The presence of one of these two features correlated to malignancy in 98.6% of cases. The absence of both was found in 82.1% of benign tumors. Conclusions The presence or absence of ascites or central blood flow may be helpful for discriminating benign from malignant solid adnexal masses.


2021 ◽  
Vol 8 ◽  
Author(s):  
Xiya Lu ◽  
Zhijing Wang ◽  
Liu Yang ◽  
Changqing Yang ◽  
Meiyi Song

Background and Objectives: Liver cirrhosis is known to be associated with atrial arrhythmia. However, the risk factors for atrial arrhythmia in patients with liver cirrhosis remain unclear. This retrospective study aimed to investigate the risk factors for atrial arrhythmia in patients with liver cirrhosis.Methods: In the present study, we collected data from 135 patients with liver cirrhosis who were admitted to the Department of Gastroenterology at Shanghai Tongji Hospital. We examined the clinical information recorded, with the aim of identifying the risk factors for atrial arrhythmia in patients with liver cirrhosis. Multiple logistic regression analysis was used to screen for significant factors differentiating liver cirrhosis patients with atrial arrhythmia from those without atrial arrhythmia.Results: The data showed that there were seven significantly different factors that distinguished the group with atrial arrhythmia from the group without atrial arrhythmia. The seven factors were age, white blood cell count (WBC), albumin (ALB), serum Na+, B-type natriuretic peptide (BNP), ascites, and Child-Pugh score. The results of multivariate logistic regression analysis suggested that age (β = 0.094, OR = 1.098, 95% CI 1.039–1.161, P = 0.001) and ascites (β =1.354, OR = 3.874, 95% CI 1.202–12.483, P = 0.023) were significantly associated with atrial arrhythmia.Conclusion: In the present study, age and ascites were confirmed to be risk factors associated with atrial arrhythmia in patients with liver cirrhosis.


2020 ◽  
Author(s):  
Brittany Thomas ◽  
Herschel Knapp ◽  
Frances Patmon

Abstract Background: Rapid response calls and cardiac arrests are often preceded by observable signs of clinical deterioration often hours prior to the adverse event.Objectives: The purpose of this retrospective study was to identify risk factors that provide predictive value in determining the likelihood of a Rapid Response Call on adult telemetry patients at a single-centre community hospital.Design: This was a retrospective study based on secondary data analysis. After approval by the Institutional Review Board was obtained (CANV DHIRB-2018-362), we utilized the electronic medical record system to extract de-identified quantitative data from patient medical records.Setting: This study utilized medical records from patients on the Telemetry unit at a single-centre, 230-bed community hospital.Participants: The sample consisted of 250 randomized de-identified medical records from both patients who did and did not require a rapid response between January and December, 2018. Patients who were less than 18 years of age and those who were transferred to another facility or to another hospital were excluded from the analyses.Methods: The variables that were collected included age, gender, race, primary admitting medical diagnosis, hemoglobin, potassium, magnesium, creatinine, lactic acid, and urine output. Additional variables collected in four-hour increments included the vital signs: temperature, heart rate, oxygen saturation, respirations, systolic and diastolic blood pressure, and level of consciousness which was scored using the adult Glasgow Coma Scale. Logistic regression analysis was used to identify which of these variables were statistically significant in predicting patient deterioration.Results: The following predictors were statistically significant (a = 0.05 with 95% Confidence Intervals [CI]): For every one beat increase in heart rate 4 hours prior to a RRT, the odds of a RRT increased by 4.9% (p=0.003) (CI=95% 1.016, 1.084). For every one increase in respirations, the odds of a RRT increased by 42.8% (p=0.004) (95% CI 1.11, 1.82), 8 hours before the RRT, and by 47% (p=0.002) (95% CI 1.15, 1.87), 12 hours before a RRT. African Americans had 20.6 times the odds of experiencing an RRT compared to Caucasians (p<0.001) (95% CI 3.4, 124.6), Hispanics had 56.6 times the odds of experiencing a RRT compared to Caucasians (p<0.001) (95% CI 11.4, 280.4), and other races had 6.3 times the odds of a RRT compared to Caucasians (p=0.044) (95% CI 1.05, 38.5).Conclusions: Such predictors can be used to identify early signs of deterioration that can alert health care providers to early intervention.


2015 ◽  
Vol 6 ◽  
pp. JCM.S27202
Author(s):  
Hiromi Hamamoto ◽  
Koji Nakanishi ◽  
Mitsuhiko Noda

We attempted to examine whether withdrawal from insulin therapy is or is not possible with administration of additional alogliptin and identify the contributing factors. The subjects were 43 adult patients with type 2 diabetes undergoing insulin therapy after admission. After glucotoxicity was removed, 25 mg alogliptin was additionally administered. Insulin was reduced by 15.6 ± 13.0 units (mean ± SD), and 17 patients (39.5%) completely withdrew from insulin therapy. Several factors were compared between the two groups of patients: those who could withdraw from insulin therapy and those who could not. The former group showed lower HbA1c levels on admission, a lower insulin dose before adding alogliptin, lower injection frequencies, and longer treatment histories prior to admission. Logistic regression analysis showed that lower insulin dose contributed significantly to withdrawal. These results suggest that a lower insulin dose is the best predictor for withdrawal from insulin therapy after adding alogliptin.


2014 ◽  
Vol 2014 ◽  
pp. 1-6 ◽  
Author(s):  
Sinem Sudolmuş ◽  
Nadiye Köroğlu ◽  
Gökhan Yıldırım ◽  
Volkan Ülker ◽  
Ahmet Gülkılık ◽  
...  

Objective. The role of single preoperative serum CA-125 levels in predicting pelvic or paraaortic lymph node metastasis in patients operated for epithelial ovarian cancer has been investigated.Methods. 176 patients diagnosed with epithelial ovarian carcinoma after staging laparotomy between January 2002 and May 2010 were evaluated retrospectively.Results. The mean, geometric mean, and median of preoperative serum CA-125 levels were 632,6, 200,29, and 191,5 U/mL, respectively. The cut-off value predicting lymph node metastases in the ROC curve was 71,92 U/mL, which is significant in logistic regression analysis (P=0.005). The preoperative log CA-125 levels were also statistically significant in predicting lymph node metastasis in logistic regression analysis (P=0.008).Conclusions. The tumor marker CA-125, which increases with grade independent of the effect of stage in EOC, is predictive of lymph node metastasis with a high rate of false positivity in Turkish population. The high false positive rate may obscure the predictive value of CA-125.


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