Desempeño del índice proteína/creatinina para predecir proteinuria significativa en pacientes con sospecha de preeclampsia

Objective: To assess the performance of the protein/creatinine index to predict proteinuria significantly and secondarily, to find the best cut-off point that had better sensitivity and specificity. Methods: Diagnostic test study developed in a cross-sectional design of patients exposed to the hypertensive syndrome of pregnancy who did or did not develop posterior preeclampsia. 173 patients were selected non-probabilistically. The new cutoff of protein/creatinine index was found using the ROC curve, we calculated sensitivity, specificity, positive and negative prediction value, positive and negative likelihood ratios and find the Spearman correlation with 24 hours urine proteinuria. Data analysis was performed using STATA software version 13. Results: The new cutoff was 0.39 with 68.3% sensitivity, specificity 73.5%, positive prediction value 91.3%, negative prediction value 36.2%, likelihood ratios (+) 2.58, likelihood ratios (-) 0.43 and an area under the curve of 0.7799. Excellent correlation was obtained with 24 hours proteinuria (rs =0.9308, p=0.000). Conclusion: Although the new cutoff for the protein/creatinine index is different from conventional, this conventional this is more specific and therefore may be useful in the outpatient management on patients with low suspicious of preeclampsia in our population. Keywords: Preeclampsia, Protein/Creatinine index, 24 hours proteinuria.

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Value and Diagnostic Efficacy of Fetal Morphology Assessment Using Ultrasound in A Poor-Resource Setting

Diagnostics ◽

10.3390/diagnostics9030109 ◽

2019 ◽

Vol 9 (3) ◽

pp. 109 ◽

Cited By ~ 1

Author(s):

Ukweh ◽

Ugbem ◽

Okeke ◽

Ekpo

Keyword(s):

Predictive Value ◽

Performance Metrics ◽

Area Under The Curve ◽

Youden Index ◽

Likelihood Ratios ◽

Diagnostic Efficacy ◽

Predictive Values ◽

Resource Setting ◽

Post Test ◽

Sensitivity Specificity

Background: Ultrasound is operator-dependent, and its value and efficacy in fetal morphology assessment in a low-resource setting is poorly understood. We assessed the value and efficacy of fetal morphology ultrasound assessment in a Nigerian setting. Materials and Methods: We surveyed fetal morphology ultrasound performed across five facilities and followed-up each fetus to ascertain the outcome. Fetuses were surveyed in the second trimester (18th–22nd weeks) using the International Society of Ultrasound in Obstetrics and Gynecology (ISUOG) guideline. Clinical and surgical reports were used as references to assess the diagnostic efficacy of ultrasound in livebirths, and autopsy reports to confirm anomalies in terminated pregnancies, spontaneous abortions, intrauterine fetal deaths, and still births. We calculated sensitivity, specificity, positive and negative predictive values, Area under the curve (AUC), Youden index, likelihood ratios, and post-test probabilities. Results: In total, 6520 fetuses of women aged 15–46 years (mean = 31.7 years) were surveyed. The overall sensitivity, specificity, and AUC were 77.1 (95% CI: 68–84.6), 99.5 (95% CI: 99.3–99.7), and 88.3 (95% CI: 83.7–92.2), respectively. Other performance metrics were: positive predictive value, 72.4 (95% CI: 64.7–79.0), negative predictive value, 99.6 (95% CI: 99.5–99.7), and Youden index (77.1%). Abnormality prevalence was 1.67% (95% CI: 1.37–2.01), and the positive and negative likelihood ratios were 254 (95% CI: 107.7–221.4) and 0.23 (95% CI: 0.16–0.33), respectively. The post-test probability for positive test was 72% (95% CI: 65–79). Conclusion: Fetal morphology assessment is valuable in a poor economics setting, however, the variation in the diagnostic efficacy across facilities and the limitations associated with the detection of circulatory system anomalies need to be addressed.

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Value of Xpert MTB/RIF Using Bronchoalveolar Lavage Fluid for the Diagnosis of Pulmonary Tuberculosis: A Systematic Review and Meta-Analysis

Journal of Clinical Microbiology ◽

10.1128/jcm.02170-20 ◽

2020 ◽

Author(s):

Hong-Chao Liu ◽

Yu-Lu Gao ◽

Dan-Feng Li ◽

Xi-Yi Zhao ◽

Yuan-Qing Pan ◽

...

Keyword(s):

Systematic Review ◽

Pulmonary Tuberculosis ◽

Bronchoalveolar Lavage ◽

Bronchoalveolar Lavage Fluid ◽

Meta Analysis ◽

Area Under The Curve ◽

Culture Method ◽

Lavage Fluid ◽

Likelihood Ratios ◽

Sensitivity Specificity

Background: The performance of Xpert MTB/RIF using bronchoalveolar lavage fluid (BAL) for the diagnosis of pulmonary tuberculosis (PTB) remains unclear. Therefore, a systematic review/meta-analysis was conducted. Methods: Studies published before December 31, 2019, were retrieved from the PubMed, Embase, and Web of Science databases using the keywords “pulmonary tuberculosis,” “Xpert MTB/RIF,” and “BAL.” Two independent evaluators extracted the data and assessed the bias risk of the included studies. A random-effects model was used to calculate the overall sensitivity, specificity, positive and negative likelihood ratios (PLR and NLR, respectively), diagnostic odds ratio (DOR), and the area under the curve (AUC), as well as the respective 95% confidence intervals (CIs). Results: Nineteen trials involving 3019 participants met the inclusion criteria. Compared to the culture method, the pooled sensitivity, specificity, PLR, NLR, DOR, and the AUC with 95% CIs of Xpert MTB/RIF were 0.87 (0.84–0.90), 0.92 (0.91–0.93), 10.21 (5.78–18.02), 0.16 (0.12–0.22), 78.95 (38.59–161.53), and 0.9467 (0.9462-0.9472), respectively. Relative to the composite reference standard, the observed values were 0.69 (0.65–0.72), 0.98 (0.98–0.99), 37.50 (18.59–75.62), 0.30 (0.21–0.43), 171.98 (80.82–365.96), and 0.9691 (0.9683–0.9699), respectively. All subgroups, except children, showed high sensitivity and specificity. Conclusions: The use of Xpert MTB/RIF in the context of BAL samples has a high diagnostic performance for PTB (except for children) and may serve as an alternative rapid diagnostic tool.

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Diagnostic Value of Left Ventricular Early Inflow-Outflow Index in Determining Severity of Mitral Regurgitation

Indonesian Journal of Cardiology ◽

10.30701/ijc.v38i2.729 ◽

2017 ◽

pp. 64-71

Author(s):

Vera Yulia ◽

Mefri Yanni ◽

Didik Hariyanto

Keyword(s):

Mitral Regurgitation ◽

Ejection Fraction ◽

Diagnostic Value ◽

Geometric Error ◽

Left Ventricular ◽

Cross Sectional ◽

Spectral Doppler ◽

Common Etiology ◽

Cross Sectional Design ◽

Sensitivity Specificity

Background: Determining severity of mitral regurgitation (MR) is very important, asit is related with prognosis and management of the disease. Currently, there is no goldstandard exists for quantification of MR severity using echocardiography. AmericanSociety of Echocardiography (ASE) guidelines recommend several parameters basedon integrative criteria using color and spectral Doppler and anatomic measurement.Left Ventricular Early Inflow Outflow Index (LVEIO Index) was proposed as one parameterto assess the severity of MR by omitting geometric error from regurgitantvolume method. Thus, LVEIO index offers a simple, easy and accurate measurementin determining severity of MR.Methods: This study was a diagnostic test research with cross-sectional design. Thesubjects were all patients with organic mitral regurgitation who underwent echocardiographyexamination to measure severity of MR using the LVEIO index as well asother parameters measurements based on parameters of ASE guidelines. Diagnostictest was used to determine the sensitivity, specificity, positive predictive value, negativepredictive value and accuracy of LVEIO index.Results: Of 49 patients in this study, 23 of them have severe MR and 26 are non-severeMR patients. The proportion of gender between two groups almost similar with an agerange from 56 to 61 years and the most common etiology finding was degenerative MR.Echocardiography examination showed the ejection fraction in severe MR was 63±4.2%and 64±3.9% in non-severe MR. The value of LAVI, MPAP, E-wave, VC, EROA andLVEIO index increased parallel with severity of MR (LAVI; 67±18.2 vs. 40±14.2 ml/m2,MPAP; 28±12.8 vs. 20±12.6 mmHg, E-wave 1.5±0.3 vs. 1±0.2 m/s, VC 0.8±0.3 vs.0.5±0.1 cm, EROA 0.4±0.1 vs 0,2±0,1cm2, LVEIO 9±2,4 vs. 5±1,8). The sensitivity,specificity, and accuracy of LVEIO index for diagnosis of severe MR were 86%, 84%,and 89%, respectively.Conclusion: LVEIO can be proposed as a relatively simple, easy and accurate methodin determining severity of MR.

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The Sensitivity and Specificity of Chicago Sky Blue (CSB) Dye in Comparisson with Potassium Hydroxide (KOH) Method for Superficial Dermatomycosis

Berkala Kedokteran ◽

10.20527/jbk.v16i2.9280 ◽

2020 ◽

Vol 16 (2) ◽

pp. 155

Author(s):

Amalia Nadiasari ◽

Diana Tri Ratnasari ◽

Masfufatun Masfufatun

Keyword(s):

Sensitivity And Specificity ◽

Potassium Hydroxide ◽

Pityriasis Versicolor ◽

Color Contrast ◽

Research Subjects ◽

Cross Sectional ◽

Proper Diagnosis ◽

Cross Sectional Design ◽

Sensitivity Specificity ◽

Higher Sensitivity

Abstract: Superficial dermatomycosis is a skin, nail and hair infection caused by fungal pathogen. Based on the pathogen, this infection can be divided into dermatophytosis, pityriasis versicolor and superficial candidiasis. The rapid and proper diagnosis is necessary to determine the initial theraphy and prevent the treatment delay. Superficial dermatomycosis diagnosis can be performed using anamnesis, physical examination or supporting investigation. The routine investigation method commonly use Potassium Hydroxide (KOH) because the KOH method is easy to be performed, rapid, simple and affordable. Chicago Sky Blue (CSB) is a dye to give a better color contrast to the fungi so the fungi would be easier to be detected. Objectives of this research is to observe the sensitivity and specifity difference of Chicago Sky Blue (CSB) dye and Potassium Hydroxide (KOH) methods for Superficial Dermatomycosis. The research was performed using cross sectional design analitical obsevation with 30 research subjects. The subjects consist of 15 superficial dermatomycosis patients and 15 non-superficial dermatomycosis patients. The samples were taken from the patients lesion swabs. The samples were checked using KOH and CSB, then observed by the medical analyst. The superficial dermatomycosis samples consist of mostly dermathophytosis (53.33%), then pityriasis versicolor (26.67%) and superficial candidiasis (20%). The sensitivity and specificity of KOH were 86.67% and 100%, respectively. The sensitivity and specificity of CSB were 93.33% and 100%, respectively. The CSB dye method has a higher sensitivity than KOH. The fungal elements are nicely dyed and more easily detected using CSB dye. Keywords: KOH, Chicago Sky Blue, sensitivity, specificity, superficial dermatomycosis

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Validation of the efficacy of the NUTRISCORE for the nutritional screening of cancer patients in China

BMC Cancer ◽

10.1186/s12885-021-09135-2 ◽

2022 ◽

Vol 22 (1) ◽

Author(s):

Junren Kang ◽

Hailong Li ◽

Xiaodong Shi ◽

Enling Ma ◽

Wei Chen

Keyword(s):

Cancer Patients ◽

Screening Tool ◽

Clinical Teaching ◽

Characteristic Curve ◽

Area Under The Curve ◽

Teaching Hospitals ◽

Kappa Index ◽

Nutritional Screening ◽

Cross Sectional ◽

Sensitivity Specificity

Abstract Background Malnutrition is common in cancer patients. The NUTRISCORE is a newly developed cancer-specific nutritional screening tool and was validated by comparison with the Patient-Generated Subjective Global Assessment (PG-SGA) and Malnutrition Screening Tool (MST) in Spain. We aimed to evaluate the performance of the NUTRISCORE, MST, and PG-SGA in estimating the risk of malnutrition in Chinese cancer patients. Methods Data from an open parallel and multicenter cross-sectional study in 29 clinical teaching hospitals in 14 Chinese cities were used. Cancer patients were assessed for malnutrition using the PG-SGA, NUTRISCORE, and MST. The sensitivity, specificity, and areas under the receiver operating characteristic curve were estimated for the NUTRISCORE and MST using the PG-SGA as a reference. Results A total of 1000 cancer patients were included. The mean age was 55.9 (19 to 92 years), and 47.5% were male. Of these patients, 450 (45.0%) had PG-SGA B and C, 29 (2.9%) had a NUTRISCORE ≥5, and 367 (36.7%) had an MST ≥ 2. Using the PG-SGA as a reference, the sensitivity, specificity, and area under the curve values of the NUTRISCORE were found to be 6.2, 99.8%, and 0.53, respectively. The sensitivity, specificity, and area under the curve values of the MST were 50.9, 74.9%, and 0.63, respectively. The kappa index between the NUTRISCORE and PG-SGA was 0.066, and that between the MST and PG-SGA was 0.262 (P < 0.05). Conclusions The NUTRISCORE had an extremely low sensitivity in cancer patients in China compared with the MST when the PG-SGA was used as a reference.

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Sleep disturbance scale for children as a diagnostic tool for sleep disorders in adolescents

Paediatrica Indonesiana ◽

10.14238/pi58.3.2018.133-7 ◽

2018 ◽

Vol 58 (3) ◽

pp. 133-7 ◽

Cited By ~ 1

Author(s):

Herwanto Herwanto ◽

Hesti Lestari ◽

Sarah M. Warouw ◽

Praevilia M. Salendu

Keyword(s):

Sleep Disturbance ◽

Sleep Disorders ◽

Predictive Value ◽

Objective Assessment ◽

Chi Square ◽

Cross Sectional ◽

Test Study ◽

Chi Square Test ◽

Sensitivity Specificity

Background. Sleep is an essential needs for every children. Sleep may cause a large effect on mental health, emotional, physical and immune system. If sleeping time is not sufficient, then sleep disturbance may occur. Objective assessment of the sleeping quality can be done by using Polysomnography and Actigraphy, while for assessing the subjectivity of sleeping quality and quantity can be used questionnaires or interviews. Sleep Disturbance Scale for Children or SDSC is a multidimensional sleeping assessment questionnaire.Objective. To determine the quality of sleeping in adolescents using SDSC.Methods. We conducted a diagnostic test study using cross sectional method, during March to April 2015 at the elementary schools in manado. The inclusion criteria were healthy adolescent aged 10 to 12 years, the parents were willing to sign the informed consent and answer the questionnaire, agreed to attach the wristactigraph. All datas were analyzed using chi square test and table 2 x 2 to showed sensitivity, specificity, positive predicitive value and negative predictive value.Results. Of 60 adolescents, 31 were female and 29 were male with the mean age 11.39 years. The results showed the sensitivity of SDSC was 80.6%, the specificity was 37.9%, the positive predictive value was 58.1% and negative predictive value was 64.7%.Conclusions. Sleep Disturbance Scale for Children is a good screening tool for early detection of sleep disorders in a adolescent.

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Evaluation of the performances of ‘typical’ imaging abnormalities of axial spondyloarthritis: results of the cross-sectional ILOS-DESIR study

RMD Open ◽

10.1136/rmdopen-2019-000918 ◽

2019 ◽

Vol 5 (1) ◽

pp. e000918 ◽

Cited By ~ 9

Author(s):

Anna Molto ◽

Laure Gossec ◽

Marie-Martine Lefèvre-Colau ◽

Violaine Foltz ◽

Romain Beaufort ◽

...

Keyword(s):

New York ◽

Chronic Back Pain ◽

Axial Spondyloarthritis ◽

Diagnostic Feature ◽

Likelihood Ratios ◽

Cross Sectional ◽

Recent Onset ◽

And Performance ◽

And Gender ◽

Sensitivity Specificity

ObjectiveTo evaluate the prevalence and performance as axial Spondyloarthritis (axSpA) diagnostic feature of radiographic and MRI lesions ‘typical’ of axSpA of the sacroiliac joint (SIJ) and spine in a mechanical chronic back pain (CBP) population and in an axSpA cohort.MethodsCross-sectional multicentre study. Patients: (1) recent onset axSpA (DESIR cohort) and (2) mechanical non-axSpA CBP matched for age and gender (ILOS study). Imaging: radiographs and MR scans were performed identically in both groups. All images were centrally read, blinded for diagnosis and for other imaging findings in the same patient. Statistical analysis: prevalence of lesions ‘typical of axSpA’ were compared in both groups. Sensitivity, specificity and positive likelihood ratios (LR+) of each lesion (and combination of lesions) were calculated.ResultsA total of 98 patients with CBP were included, and compared with 100 patients with recent onset axSpA. SIJ lesions were consistently more frequent in the axSpA group (35.0% vs 11.8% p<0.001, 35.0% vs 8.4% p<0.001% and 32.0% vs 10.0%. p<0.001 for modified New York criteria, MRI sacroiliitis and ≥3 erosions of the SIJ on MRI, respectively), and performed well (LR+ for ≥3 erosions 3.0 (95% CI 1.6 to 5.8)). Spine lesions were comparable across groups: radiographic lesions were rare, while all MRI lesions were frequent.ConclusionOur study confirms that ‘typical’ lesions can also be observed in patients with non-axSpA CBP but that SIJ lesions by all modalities remain the most valuable for diagnosis, including structural lesions of the SIJ. This suggests the potential interest of adding MRI SIJ structural lesions in the definition of MRI abnormalities for axSpA classification.

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Egg yolk immunoglobulin Y as a promising tool to detect immune complexes in neurocysticercosis serum samples

Transactions of the Royal Society of Tropical Medicine and Hygiene ◽

10.1093/trstmh/traa028 ◽

2020 ◽

Vol 114 (8) ◽

pp. 585-592

Author(s):

Gabriela B da Silva ◽

Lucas S da Faria ◽

Camila A Lopes ◽

Daniela S Nunes ◽

Vanessa S Ribeiro ◽

...

Keyword(s):

Area Under The Curve ◽

Egg Yolk ◽

Enzyme Linked Immunosorbent Assay ◽

Immunoglobulin Y ◽

Likelihood Ratios ◽

Serum Samples ◽

Promising Tool ◽

Egg Yolk Immunoglobulin ◽

Potential Applicability ◽

Sensitivity Specificity

Abstract Background Neurocysticercosis (NCC) is a neglected tropical disease and its diagnosis is still a challenge due to non-specific manifestations. Neuroimaging techniques are used in the diagnosis of NCC, however, due to the high cost of these methods and the advantages presented in the use of immunological tests, such as ease of performance and satisfactory results, immunoassays are commonly used to detect antibodies against Taenia sp. antigens. The aim of the present study was to produce, characterize and apply specific polyclonal immunoglobulin Y (IgY) anti-Taenia crassiceps extracted from egg yolk of hens immunized with T. crassiceps metacestodes. Methods Indirect enzyme-linked immunosorbent assay (ELISA), avidity ELISA, immunoblotting and indirect immunofluorescence tests were performed for characterization of IgY antibodies. Diagnostic performance was verified by ELISA for immune complex detection testing 90 serum samples. Results Values of sensitivity, specificity, positive and negative likelihood ratios (LR+/LR−) and area under the curve (AUC) were calculated and presented the following results: sensitivity 83.3%, specificity 96.7%, AUC 0.966, LR+ 25.0 and LR− 0.17. Conclusions Results of this pioneering and innovative study demonstrate that anti-T. crassiceps IgY antibodies present potential applicability and can be used as an efficient tool in human NCC serodiagnosis.

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HUBUNGAN SAFETY INSPECTION DAN PENGETAHUAN DENGAN UNSAFE ACTION DI DEPARTEMEN ROLLING MILL

The Indonesian Journal of Occupational Safety and Health ◽

10.20473/ijosh.v7i3.2018.300-309 ◽

2019 ◽

Vol 7 (3) ◽

pp. 300

Author(s):

Intan Kristianti ◽

Abdul Rohim Tualeka

Keyword(s):

Rolling Mill ◽

Sampling Technique ◽

Simple Random Sampling ◽

Individual Factors ◽

Spearman Correlation ◽

Cross Sectional ◽

Frequency Distributions ◽

Workplace Accidents ◽

Lack Of Control ◽

Cross Sectional Design

There are millions of workplace accidents in the world with the loss of hundreds of billions annually. One of the direct causes of accidents due to unsafe action. It stems from the lack of control by the management and the basic causes in the form of individual factors. This study is conducted to look at the factors correlated with unsafe action in the Department of Rolling Mill PT. X Sidoarjo. The research was conducted by observation using cross-sectional design and a quantitative approach. Questionnaires were administered to 70 respondents who were drawn using simple random sampling technique. The variables studied were safety inspection, knowledge, and unsafe action. Data was presented in the form of frequency distributions and cross-tabulations then statistically analyzed using Spearman correlation. The study was conducted using α of 0.05. The results showed that the respondents had a good knowledge, safety inspection in PT. X had been executed well, and had a lower category of unsafe action. There were a correlation between knowledge with unsafe action (p= 0.028; r= -0.262), and a correlation between safety inspection with unsafe action (p= 0.015; r= -0.288). It can be concluded that the higher knowledge and safety inspection, the unsafe action would be lower. Keywords: knowledge, safety inspection, unsafe action

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Relationship Between Storage and Recording with Quality of DPT Vaccine Cold Chain in Puskesmas

Jurnal Berkala Epidemiologi ◽

10.20473/jbe.v2i3.2014.380-391 ◽

2014 ◽

Vol 2 (3) ◽

pp. 380

Author(s):

Faradiba Hikmarida

Keyword(s):

Total Population ◽

Cold Chain ◽

Spearman Correlation ◽

Cross Sectional ◽

Correlation Test ◽

Descriptive Research ◽

Spearman Correlation Test ◽

Cross Sectional Design ◽

Dpt Vaccine

ABSTRACTIncreasing number of diphteria cases in Sidoarjo Regency, with occurrence of cases in those who had received DPT immunization shows the existence of problem concerning to immunization. The efficacy itself, depends on the quality of vaccines given. Insufficiency in cold chain may lower the quality of DPT vaccines. The purpose of this study was to analyze relationship between DPT vaccine storage and recording for DPT vaccines cold chain with quality of DPT vaccine cold chain in puskesmas Sidoarjo Regency. This research is a descriptive research with cross sectional design. Sample used were total population, which includes all 26 puskesmas within Sidoarjo. The variables were DPT vaccine storage, recording for DPT vaccines cold chain and quality of DPT vaccine cold chain. The result of this study showed that DPT vaccine storage was good (58%), recording for DPT vaccines cold chain were insufficient (77%), and quality of DPT vaccine cold chain in puskesmas was also good (62%). Spearman correlation test showed relationship between DPT vaccine storage and quality of DPT vaccine cold chain in Puskesmas was strong and positive (r = 0,561). Relationship between recording for DPT vaccines cold chain and quality of DPT vaccine cold chain in puskesmas was moderate and positive (r = 0,421). the better the storage for DPT vaccines and recording for DPT vaccines cold chain in puskesmas, the better its cold chain quality in puskesmas. Improvement in officers’ obedience in storing DPT vaccine and its recording concerning to the cold chain which appropriate according to procedures, were really needed.Keywords: storage, recording, quality, cold chain, DPT vaccine

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