Accurate Gleason Grading of Prostatic Adenocarcinoma in Prostate Needle Biopsies by General Pathologists

2003 ◽  
Vol 127 (8) ◽  
pp. 1007-1008 ◽  
Author(s):  
Andrew A. Renshaw ◽  
Delray Schultz ◽  
Kerri Cote ◽  
Marian Loffredo ◽  
David E. Ziemba ◽  
...  
Keyword(s):  
Gleason Score ◽  
Prostatic Adenocarcinoma ◽  
Gleason Grading ◽  
Prostate Biopsies ◽  
Tumor Focus ◽  
Significant Difference ◽  
Appropriate Therapy ◽  
The Difference ◽  
Clinically Significant ◽  
Over Time

Abstract Context.—Gleason grading of prostatic adenocarcinoma in core needle biopsies is important for predicting prognosis and selecting appropriate therapy. Previous studies have shown that Gleason scores assigned by general pathologists have a low correlation with those assigned by urologic pathologists, and that general pathologists tend to undergrade prostate carcinoma. Objective.—To determine if the performance of general pathologists grading prostate needle biopsies has changed over time. Design.—Four hundred sixteen prostate biopsies from men treated at a single community-based institution between 1987 and 2000 were reviewed by one urologic pathologist (A.A.R.). The correlation between the original Gleason score and the reviewer's score was determined over time. Results.—Cases were divided into those performed and originally interpreted in the first half of the study (1987–1996) and those performed and originally interpreted in the second half (1996–2000). Overall concordance for exact Gleason score was 59% (244/416). The exact concordance of the Gleason score assigned by the original pathologist and the reviewer during the first half of the study was 51%, whereas in the second half of the study the concordance was significantly greater (66.3%, P = .002). However, when grouped into score categories of 6 or less, 7, and 8 or greater, there was no significant difference in the exact concordance between the first half of the study (78.3%) and the second half (78.4%). Fifty-five percent of the cases in which there was discordance were graded as 7 by the reference pathologist and 6 or less by the original pathologist. There was no correlation between concordance in Gleason score and the percentage of tissue involved by carcinoma. Conclusion.—The concordance between general pathologists' Gleason grading and that of a reference pathologist in this study is much higher than that in previously reported studies. Although exact concordance has significantly improved over time, concordance by clinically significant groups has remained high throughout the study, is dominated by the difference between Gleason score 7 and 6 or less, and is unrelated to the size of the tumor focus.

4971Blood viscosity and its relevance to the diagnosis and management of pulmonary hypertension: a new elephant in the cathlab

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
A Kempny ◽  
K Dimopoulos ◽  
A E Fraisse ◽  
G P Diller ◽  
L C Price ◽  
...  
Keyword(s):  
Pulmonary Hypertension ◽  
Cardiac Catheterization ◽  
Clinical Decision Making ◽  
Clinical Decision ◽  
Pulmonary Vasculature ◽  
Pulmonary Vascular Disease ◽  
Significant Difference ◽  
The Difference ◽  
Clinically Significant ◽  
The Relationship

Abstract Background Pulmonary vascular resistance (PVR) is an essential parameter assessed during cardiac catheterization. It is used to confirm pulmonary vascular disease, to assess response to targeted pulmonary hypertension (PH) therapy and to determine the possibility of surgery, such as closure of intra-cardiac shunt or transplantation. While PVR is believed to mainly reflect the properties of the pulmonary vasculature, it is also related to blood viscosity (BV). Objectives We aimed to assess the relationship between measured (mPVR) and viscosity-corrected PVR (cPVR) and its impact on clinical decision-making. Methods We assessed consecutive PH patients undergoing cardiac catheterization. BV was assessed using the Hutton method. Results We included 465 patients (56.6% female, median age 63y). The difference between mPVR and cPVR was highest in patients with abnormal Hb levels (anemic patients: 5.6 [3.4–8.0] vs 7.8Wood Units (WU) [5.1–11.9], P<0.001; patients with raised Hb: 10.8 [6.9–15.4] vs. 7.6WU [4.6–10.8], P<0.001, respectively). Overall, 33.3% patients had a clinically significant (>2.0WU) difference between mPVR and cPVR, and this was more pronounced in those with anemia (52.9%) or raised Hb (77.6%). In patients in the upper quartile for this difference, mPVR and cPVR differed by 4.0WU [3.4–5.2]. Adjustment of PVR required Conclusions We report, herewith, a clinically significant difference between mPVR and cPVR in a third of contemporary patients assessed for PH. This difference is most pronounced in patients with anemia, in whom mPVR significantly underestimates PVR, whereas in most patients with raised Hb, mPVR overestimates it. Our data suggest that routine adjustment for BV is necessary.

Attention Deficit Hyperactivity Disorder, Creativity, and the Effects of Methylphenidate

PEDIATRICS ◽  
1993 ◽  
Vol 91 (4) ◽  
pp. 816-819
Author(s):  
Jeanne B. Funk ◽  
John B. Chessare ◽  
Michael T. Weaver ◽  
Anita R. Exley
Keyword(s):  
Attention Deficit Hyperactivity Disorder ◽  
Attention Deficit ◽  
Repeated Measures ◽  
Creative Thinking ◽  
Adhd Group ◽  
Hyperactivity Disorder ◽  
Significant Difference ◽  
Quasi Experimental ◽  
The Difference ◽  
Clinically Significant

Given that children with attention deficit hyperactivity disorder (ADHD) are more impulsive than peers, this study explored whether they are correspondingly more creative, and whether creativity declines when impulsivity is decreased through methylphenidate (Ritalin) therapy. A repeated-measures quasi-experimental design was used to compare the performance of 19 boys with previously diagnosed ADHD and 21 comparison boys aged 8 through 11 on two administrations of alternate forms of the Torrance Tests of Creative Thinking-Figural (nonverbal). Boys with ADHD received prescribed methylphenidate only for the first session. Overall, mean Torrance summary scores for comparison boys (mean = 115.1, SD = 16.1) were higher than for boys with ADHD (mean = 107.6, SD = 12.7). However, the difference between means was small (7%) and did not meet the 25% criterion for a clinically significant difference. No changes in performance over time (comparison group) or medication state (ADHD group) were observed. These data suggest that, when measured nonverbally, the creative thinking performance of boys with ADHD is not superior to that of peers who do not have ADHD. Regarding the effects of methylphenidate, prescribed therapy did not influence performance on this measure of creative thinking.

scholarly journals A Comparison Between Two Types of Radiographic Film for Accuracy of Measurements of Approximal Osseous Defects

2006 ◽  
Vol 7 (3) ◽  
pp. 22-29
Author(s):  
Farah Masood ◽  
Christos Angelopoulos ◽  
Alan Glaros
Keyword(s):  
Bone Loss ◽  
Ground Truth ◽  
Radiographic Film ◽  
Radiographic Images ◽  
Accuracy Of Measurements ◽  
Significant Difference ◽  
Molar Teeth ◽  
The Difference ◽  
Clinically Significant ◽  
Osseous Defects

Abstract Aim The purpose of this study was to compare two types of conventional radiographic film: Ekta-speed plus and Insight (Eastman Kodak Co, Rochester NY, USA) for accuracy of measurements of approximal bone loss. Methods and Materials Four dried human mandibles with complete dentition were selected. Radiographic images were made with a standardized technique. Mesial and distal bone levels on the mandibular premolar and molar teeth were measured on the two types of radiographs (Ekta-speed plus and Insight) by nine observers. The data obtained by the observers were compared with the primary investigators’ corresponding measurements, which served as “the ground truth” for this study. Results The results of the analysis of variance (ANOVA) demonstrated a significant difference for the Ektaspeed plus film (p = .001), but the difference was not clinically significant. The level of intra-rater reliability was high for the observers (0.969 to 0.990). Conclusion Performance of Ekta-speed plus and Insight films was found to be similar. Citation Masood F, Angelopoulos C, Glaros A. A Comparison Between Two Types of Radiographic Film for Accuracy of Measurements of Approximal Osseous Defects. J Contemp Dent Pract 2006 July;(7)3:022-029.

scholarly journals Cancer Detection Rates of Systematic and Targeted Prostate Biopsies after Biparametric MRI

2020 ◽  
Vol 2020 ◽  
pp. 1-6
Author(s):  
Maudy C. W. Gayet ◽  
Anouk A. M. A. van der Aa ◽  
Harrie P. Beerlage ◽  
Bart Ph Schrier ◽  
Maaike Gielens ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Cancer Detection ◽  
Prostate Biopsy ◽  
Detection Rates ◽  
Prostate Biopsies ◽  
Significant Difference ◽  
Significant Pathology ◽  
Study Population ◽  
Clinically Significant ◽  
Control Study

Objective. To compare prostate cancer detection rates (CDRs) and pathology results with targeted prostate biopsy (TB) and systematic prostate biopsy (SB) in biopsy-naive men. Methods. An in-patient control study of 82 men undergoing SB and subsequent TB in case of positive prostate MRI between 2015 and 2017 in the Jeroen Bosch Hospital, the Netherlands. Results. Prostate cancer (PCa) was detected in 54.9% with 70.7% agreement between TB and SB. Significant PCa (Gleason score ≥7) was detected in 24.4%. The CDR with TB and SB was 35.4% and 48.8%, respectively (p=0.052). The CDR of significant prostate cancer with TB and SB was both 20.7%. Clinically significant pathology upgrading occurred in 7.3% by adding TB to SB and 22.0% by adding SB to TB. Conclusions. There is no statistically significant difference between CDRs of SB and TB. Both SB and TB miss significant PCas. Moreover, pathology upgrading occurred more often by adding SB to TB than vice versa. This indicates that the omission of SB in this study population might not be justified.

scholarly journals The Correlation between Diffusion-Weighted Imaging and Histopathological Evaluation of 356 Prostate Biopsy Sites in Patients with Prostatic Diseases

ISRN Urology ◽  
2012 ◽  
Vol 2012 ◽  
pp. 1-5 ◽  
Author(s):  
R. Kilinç ◽  
O. G. Doluoglu ◽  
B. Sakman ◽  
D. S. Ciliz ◽  
E. Yüksel ◽  
...  
Keyword(s):  
Prostate Biopsy ◽  
Diffusion Weighted Imaging ◽  
Definitive Treatment ◽  
Apparent Diffusion Coefficients ◽  
Prostate Biopsies ◽  
Diffusion Weighted ◽  
Significant Difference ◽  
Adc Values ◽  
The Difference ◽  
Prostatic Diseases

Purpose. The aim of this study is to investigate the reliability of diffusion MRI for detection of cancer foci by comparing diffusion-weighted imaging (DWI) results and pathology results of prostate biopsy sites. Methods. Of the patients who applied with lower urinary tract symptoms, 36 patients who had suspected DRE and/or PSA ≥2.5 ng/mL were included in the study. Patients underwent DWI prior to 10 cores-prostate biopsy. 356 biopsy cores were obtained from the patients. Foci from the patients with prostate cancer were labeled as malignant or benign foci, likewise foci from the patients with benign pathology were grouped as BPH and inflammation foci. Apparent diffusion coefficients (ADCs) of biopsy groups were compared with each other in order to measure the reliability of DWI in detection of PCa foci. Results. When ADC values of adenocarcinoma foci and BPH foci were compared, a statistically significant difference was found (P<0.001). When ADC values obtained from adenocarcinoma foci and chronic inflammation foci are compared, the difference between two groups is statistically significant, too (P<0.001). Conclusions. Biopsies focused on suspected regions after formation of ADC maps by means of DWI would provide to start definitive treatment immediately as well as being beneficial to prevent morbidity related to repeated prostate biopsies.

scholarly journals Evaluation of Pupils’ Knowledge about Kidney Health

2021 ◽  
Vol 18 (23) ◽  
pp. 12811
Author(s):  
Theodore Vassilikopoulos ◽  
Athena Kalokairinou ◽  
Georgia Kourlaba ◽  
Eirini Grapsa
Keyword(s):  
Renal Function ◽  
General Education ◽  
Knowledge Score ◽  
Cross Sectional Study ◽  
The Body ◽  
Cross Sectional ◽  
Convenience Sample ◽  
Significant Difference ◽  
The Difference ◽  
Clinically Significant

The purpose of this study was to investigate the level of renal function knowledge of primary school pupils in Greece. We conducted a cross-sectional study with a convenience sample of 220 pupils, coming from the 5th and 6th grades of general education schools. A questionnaire consisting of 11 questions was developed from scratch. However, based on an analysis of Cronbach’s alpha values obtained when individual questions were deleted, two questions were removed from the analysis, and only nine remained for analysis and participated in the calculation of the knowledge score. Moreover, the gender and daily habits of pupils regarding water consumption and frequency of urination were recorded. Pupils had a high percentage of correct knowledge about the number of kidneys (95.2%), whether a child may have problems with the kidneys (85.5%) and whether a person can survive with one kidney (68.5%). Low levels of knowledge were observed in the function and role of the kidneys (36.4%), as well as the part of the body where the kidneys are located (30.9%). The median (interquartile range (IQR)) total knowledge score was 6 (5–7), with no difference detected between genders (p = 0.135). A statistically significant difference between pupils of 5th and 6th grades was found but the difference did not seem to be clinically significant (p = 0.035). The present research demonstrates that pupils’ knowledge of renal function and the protection of their kidneys needs improvement.

scholarly journals Should All Steps Count When Using a Pedometer as a Measure of Physical Activity in Older Adults?

2007 ◽  
Vol 4 (3) ◽  
pp. 305-314 ◽  
Author(s):  
Alison L. Marshall
Keyword(s):  
Older Adults ◽  
Feedback Condition ◽  
Daily Step ◽  
Step Counts ◽  
Telephone Interviews ◽  
Significant Difference ◽  
Daily Step Count ◽  
Steps Per Day ◽  
The Difference ◽  
Clinically Significant

Purpose:The aim of this study was to determine if feedback on step counts from a pedometer encourages participants to increase walking.Methods:Randomly recruited older adults (n = 105) were asked to wear a pedometer for 2 wk. Half the participants were asked to monitor and record daily step counts during week 1 (feedback), then seal the pedometer shut during week 2 (no feedback). Half completed the study in reverse order. Self-reported walking was assessed via telephone interviews.Results:Significantly more steps were recorded per day (approximately 400 steps per day) when participants (n = 103, 63% women; mean BMI 25 ± 4) monitored their daily step count [t (102) = –2.30, P = 0.02)] compared to the no feedback condition. There was no statistically significant difference in self-reported walking (P = 0.31) between feedback conditions.Conclusion:The difference in daily step counts observed between conditions, while statistically significant, may not be considered clinically significant. Further, the non-significant difference in self-reported walking between conditions suggests that feedback on daily step counts from a pedometer does not encourage participants to increase their walking.

scholarly journals Physical Performance and Inflammation Responses during and after the Jiu-Jitsu Stimulated Match according to Recovery Treatment Methods

2020 ◽  
Vol 29 (3) ◽  
pp. 214-224
Author(s):  
Jong-Hyun Park ◽  
Sang-Hyun Lee ◽  
Su-Jin Kim ◽  
Jung-Ran Song ◽  
Hyo-Bum Kwak ◽  
...  
Keyword(s):  
Exercise Performance ◽  
Treatment Method ◽  
Self Healing ◽  
Active Recovery ◽  
Recovery Method ◽  
Oxygen Inhalation ◽  
Significant Difference ◽  
Before And After ◽  
The Difference ◽  
Over Time

PURPOSE: The purpose of this study was to induce sufficient fatigue through the Jiu-Jitsu game imitation exhaustion treatment that reflects the characteristics of Jiu-Jitsu competition, and then fatigue-related indicators according to the self-healing treatment method performed during the break between each treatment and to examine the effect on Jiu-Jitsu exercise performance.METHODS: Eight Jiu-Jitsu athletes (28.3±3.62 years, 24.6±2.5 kg/m<sup>2</sup>, 14.6±4.6% fat) participated in the study, and their exercise performance, RPE, lactate, CK, and CRP were measured after inducing exhaustion using the Jiu-Jitsu Fight Gone Bad (JFGB; 4 rounds×6 minutes JFGB, 12 minutes of recovery between rounds) test. These variables analyzed using two-way ANOVA with bonferroni’s correction.RESULTS: All the exercise performance, lactate level, and RPE showed only the difference over time according to JFGB treatment, and there was no significant difference according to recovery methods (passive recovery; PR, active recovery; AR, cryotherapy; CTR, oxygen inhalation; OIR). On the other hand, in the case of CRP, there was no significant difference in interaction effect, group, and time main effects. CK showed a significant difference only before and after JFGB treatment, but similarly, there was no difference according to recovery methods.CONCLUSIONS: Regardless of the recovery method, all variables showed a significant difference only over time according to the JFGB test, and the AR, CTR, and OIR methods were similar to the PR. However, it was observed that in the case of CK, immediately after the JFGB test, it increased significantly regardless of recovery measures.

Prevalence of Impaired Orthostasis after Concussion Injury

Neurology ◽  
2020 ◽  
Vol 95 (20 Supplement 1) ◽  
pp. S1.3-S2
Author(s):  
Michael F. La Fountaine ◽  
Asante Hohn ◽  
Caroline Leahy ◽  
Anthony Testa
Keyword(s):  
Collegiate Athletes ◽  
Transient State ◽  
Incidence Rates ◽  
Control Group ◽  
Clinical Approach ◽  
Male Age ◽  
Significant Difference ◽  
The Difference ◽  
Clinically Significant ◽  
A Prospective Study

ObjectiveTo determine the prevalence of orthostatic hypotension (OHypo) and hypertension (OHTN), respectively after a concussion in collegiate athletes.BackgroundOrthostasis causes a gravity-dependent redistribution of blood volume to the lower extremities. The baroreflex coordinates the cardiovascular autonomic nervous system to mitigate aberrant changes in systolic blood pressure (SBP). In autonomic dysfunction (AD), impaired accommodation may lead to a clinically significant? SBP decreases (OHypo: SBP fall = 20 mm Hg) or paradoxical increases (OHTN: SBP rise = 20 mm Hg) within 3 minutes of assuming the standing (STND) posture. Concussion injuries may induce a transient state of AD. A clinical approach to surveil this state has yet to be defined.Design/MethodsA prospective study was performed in 36 concussed (gender: 23 female, 13 male; age: 20 ± 1 years; height: 1.75 ± 0.12 meters; weight: 73 ± 14 kilograms) and 20 non-concussed athletes (gender: 12 female, 8 male; age: 21 ± 2 years; height: 1.74 ± 0.15 meters; weight: 72 ± 18 kilograms). Continuous beat-to-beat SBP was collected for 10-minutes in a resting supine position (SUP) and then for 3-minutes in the STND position within 48 hours (48H) of concussion. The average SBP was computed from the difference between SUP and the final 15 seconds of STND. SBP were then categorized: Normal (NR: SBP -15 to +15 mm Hg); Borderline OHypo (BordOHypo: SBP −16 to −19 mm Hg) and OHTN (BordOHTN: SBP +16 to +19 mm Hg); OHypo; and, OHTN.ResultsIn concussed athletes, the SBP prevalence rates were 42% NR, 31% OHypo, 11% OHTN, 11% BordOHTN, and 6% BordOHypo compared to 90% NR, 5% OHypo and 5% OHTN in the non-concussed athletes. ?2 test revealed a significant difference in this distribution (p = 0.012).ConclusionsWithin 48H of concussion injury, a combined 42% of injured athletes had an abnormal SBP response to orthostasis and a further 6% had borderline responses that warrant re-evaluation. The incidence rates for each circumstance exceeded the control group.

Clinical Trial of Topical Erythromycin in Inflammatory Acne

1981 ◽  
Vol 15 (5) ◽  
pp. 372-376 ◽  
Author(s):  
Randall A. Prince ◽  
Douglas A. Busch ◽  
Charles D. Hepler ◽  
Harley G. Feldick
Keyword(s):  
Inflammatory Lesion ◽  
Double Blind ◽  
Inflammatory Lesions ◽  
Erythromycin Base ◽  
Significant Difference ◽  
The Face ◽  
The Difference ◽  
Clinically Significant ◽  
Split Face ◽  
Paired T Test

Sixty-nine informed subjects participated in a split-face, double-blind trial of topical erythromycin base 2% in Vehicle/N® versus Vehicle/N® alone. All subjects had grades II or III acne as described by Pillsbury. Study solutions were assigned to a randomly selected side of the subject's face. Solutions were applied twice daily. Inflammatory lesion counts were performed by the same investigator during the eight weeks of study at biweekly intervals. The difference in inflammatory lesion counts from beginning to end of study for each side of the face was compared utilizing Student's paired t-test There was not a statistically significant difference in mean inflammatory lesions at the end of eight weeks (D̅ = 1.46, t = 1.36, df 68). There was, however, a significant difference at two and six weeks (D̅ = 2.59, t = 3.72, df 68; D̅ = 1.41, t = 2.03, df 68). Observed differences in lesion counts were not considered to be clinically significant.

Sign in / Sign up

Export Citation Format

Share Document