scholarly journals Evaluating the Positive Predictive Value of Alkaline Phosphatase in Diagnostic Peritoneal Lavage (DPL) for the Need of Further Surgery in Patients with Torso Traumas

2018 ◽  
Vol In Press (In Press) ◽  
Author(s):  
Khosro Ayazi ◽  
Gholam Hossein Hayatollah ◽  
Farbod Emami Yeganeh ◽  
Elham Mirzaian ◽  
Behzad Nemati Honar
2019 ◽  
Vol 26 (06) ◽  
Author(s):  
Abdul Ghaffar ◽  
Saeed Mahmood ◽  
Muhammad Kareemullah ◽  
Saqib Uddin Khan ◽  
Ambreen Akram ◽  
...  

Background: Abdominal trauma can be mysterious to some practitioners. If patients are evaluated for being stable or unstable, then abdominal trauma can be easily managed. Using a combination of physical examination, eFAST Scan, DPL and CT scans, patients can be quickly and efficiently evaluated. Objectives: To determine the positive predictive value (PPV) of computed tomography and diagnostic peritoneal lavage for diagnosis of solid organ damage in patients with blunt abdominal trauma (BAT) taking surgical findings as gold standard. Study Design: Cross sectional study. Setting: Department of Surgery at Lahore General Hospital, Lahore. Period: Six months i.e. from 21.5.2016 to 20.11.2016. Materials and Methods: Data Collection: CT scan was performed with oral and intravenous contrast. DPL was done with sample assessment. Only those cases were included with positive findings in CT Scan or DPL. These patients underwent laparotomy under general anesthesia by a one standard surgical team. Results of surgical findings were compared between groups with CT scan and DPL. All the information was collected on predesigned proforma. Results: The mean age of the patients was 44.48±14.83 years. There were 66 (55%) males and 54 (45%) females in our study. In this study PPV for CT-scan group was 90.1% while PPV for group with DPL was 51.3%. Conclusion: PPV for CT Scan group was higher than that of DPL group for diagnosing solid organ damage in patients with BAT. Hence, evidence shows that CT Scan should be used as an initial investigation of choice in haemo-dynamically stable patients with BAT.


1992 ◽  
Vol 38 (12) ◽  
pp. 2546-2551 ◽  
Author(s):  
V O Van Hoof ◽  
A T Van Oosterom ◽  
L G Lepoutre ◽  
M E De Broe

Abstract Early treatment of patients with malignant disease and liver or bone metastasis may increase their survival time. We have used the activity patterns of liver and bone isoenzymes of alkaline phosphatase (ALP), separated by agarose gel electrophoresis, to detect early metastasis. We studied ALP isoenzyme patterns in a background population of 101 patients with no evidence of any disease that might influence this pattern; a healthy reference population (n = 330); and the following three groups of patients: 143 with malignant disease, 47 with nonmalignant liver disease, and 22 with nonmalignant bone disease. Cutoff and predictive values of liver ALP, high-molecular-mass (high-M(r)) ALP, and bone ALP were established for detecting liver and bone metastasis. The positive predictive value of liver and high-M(r) ALP was higher than that of total ALP in detecting liver metastasis, but liver and high-M(r) ALP did not enable us to differentiate between malignant and nonmalignant liver disease. Total ALP activity was of slightly more value than liver and high-M(r) ALP in enabling us to rule out liver metastasis. From bone ALP activity we could not distinguish between nonmalignant bone disease and bone metastasis. The negative predictive value of bone ALP in the diagnosis of bone metastasis was low, but its positive predictive value was high and superior to that of total ALP.


1993 ◽  
Vol 34 (6) ◽  
pp. 829-833 ◽  
Author(s):  
Jonathan H. Jaffin ◽  
M. Gage Ochsner ◽  
Frederic J. Cole ◽  
Grace S. Rozycki ◽  
Mary Kass ◽  
...  

2018 ◽  
Vol 2018 ◽  
pp. 1-5 ◽  
Author(s):  
Hasrayati Agustina ◽  
Ita Asyifa ◽  
Afiati Aziz ◽  
Bethy S. Hernowo

Background. The diagnosis of Osteosarcoma (OSA) is not always straightforward. OSA may resemble Other Primary Bone Tumours (OPBT). The diagnosis of osteosarcoma is sometimes difficult especially in a very small specimen. Immunohistochemistry is one of ancillary testing types that can help the diagnosis of many tumours. The aim of this study was to evaluate the validity of Osteocalcin (OCN) and Alkaline Phosphatase (ALP) immunohistochemistry in discriminating OSA from OPBT. Method. This study included 50 selected human primary bone tumours, 25 cases of OSA and 25 cases of OPBT. Immunohistochemical evaluation of OCN and ALP was done for all cases. The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and overall accuracy were calculated. Result. The mean age of OSA and OPBT patients was 19.6±13.6 and 40.0±16.3 years, respectively. Osteocalcin was positive in 17/25 (68%) cases of OSA and 16/25 (64%) cases of OPBT (p=0.061). Alkaline Phosphatase was positive in 24/25 (96%) cases of OSA and 5/25 (20%) cases of OPBT (p<0.001). The sensitivity of OCN in OSA diagnosis was 68%, with specificity, PPV, NPV, and overall accuracy being 36%, 52%, 53%, and 52%, respectively. The sensitivity of ALP in OSA diagnosis was 96%, with specificity, PPV, NPV, and overall accuracy being 80%, 82.7%, 95.2%, and 88%, respectively. Conclusion. ALP immunohistochemistry is useful in discriminating OSA from OPBT. ALP is superior to OCN in OSA diagnosis. OCN cannot be used to differentiate between OSA and OPBT.


1992 ◽  
Vol 33 (1) ◽  
pp. 155
Author(s):  
Jonathan H. Jaffin ◽  
M. Gage Ochsner ◽  
Frederic J. Cole ◽  
Grace S. Rozycki ◽  
Howard R. Champion

2011 ◽  
Vol 2011 ◽  
pp. 1-5 ◽  
Author(s):  
Bülent Güngör ◽  
Kasım Çağlayan ◽  
Cafer Polat ◽  
Deniz Şeren ◽  
Kenan Erzurumlu ◽  
...  

Background and Aim. There are no accurate methods of differentiating acute biliary pancreatitis. Obstructions of biliary ducts, idiopathic pancreatitis may be related with biliary origin which needs identification for acute treatment. We searched for the predictivity of biochemical markers in early acute biliary pancreatitis. Patients and Methods. Serum levels of AST (Aspartate Transaminase),ALT (Alanine Transaminase), ALP (Alkaline Phosphatase), GGT (Gamma Glutamyl Transferase), total bilirubin, direct bilirubin, LDH (Lactate Dehydrogenase), amylase, lipase, CRP (C-Reactive Protein) and WBC (White Blood Cell) were measured in 157 patients with acute pancreatitis. Biliary and nonbiliary pancreatitis were differentiated by Magnetic Resonance Cholangiopancreatography (MRCP), Endoscopic Retrograde Cholangiopancreatography (ERCP), Intraoperative Cholangiopancreatography (IOC). Cut-off points of admission biochemical markers with sensitivity, specifity, positive predictive value and negative predictive value were determined after identification of significant variables. Receiver Operator Curves were plotted for each biochemical marker. Results. Serum Alkaline Phosphatase, total bilirubin, direct bilirubin, amylase and lipase levels were significantly higher in biliary pancreatitis with a positive predictive value of 80.8%, 83.9%, 81.6%, 78.8%, 79.7%. Conclusion. Increased Alkaline Phosphatase,total bilirubin, direct bilirubin, amylase and lipase levels may be used in prediction of biliary pancreatitis.


2013 ◽  
Vol 154 (44) ◽  
pp. 1743-1746
Author(s):  
Gergely Hofgárt ◽  
Rita Szepesi ◽  
Bertalan Vámosi ◽  
László Csiba

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.


2019 ◽  
pp. 96-100
Author(s):  
Thi Ngoc Suong Le ◽  
Pham Chi Tran ◽  
Van Huy Tran

Acute pancreatitis (AP) is an acute inflammation of the pancreas, usually occurs suddenly with a variety of clinical symptoms, complications of multiple organ failure and high mortality rates. Objectives: To determine the value of combination of HAP score and BISAP score in predicting the severity of acute pancreatitis of the Atlanta 2012 Classification. Patients and Methods: 75 patients of acute pancreatitis hospitalized at Hue Central Hospital between March 2017 and July 2018; HAP and BISHAP score is calculated within the first 24 hours. The severity of AP was classified by the revised Atlanta criteria 2012. Results: When combining the HAP and BISAP scores in predicting the severity of acute pancreatitis, the area under the ROC curve was 0,923 with sensitivity value was 66.7%, specificity value was 97.1%; positive predictive value was 66.7%, negative predictive value was 97.1%. Conclusion: The combination of HAP and BISAP scores increased the sensitivity, predictive value, and prognostic value in predicting the severity of acute pancreatitis of the revised Atlanta 2012 classification in compare to each single scores. Key words: HAPscore, BiSAP score, acute pancreatitis, predicting severity


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