scholarly journals Diagnostic Value of the13C Methacetin Breath Test in Various Stages of Chronic Liver Disease

2011 ◽  
Vol 2011 ◽  
pp. 1-6 ◽  
Author(s):  
Hamizah Razlan ◽  
Nurhayaty Muhamad Marzuki ◽  
Mei-Ling Sharon Tai ◽  
Azhar-Shah Shamsul ◽  
Tze-Zen Ong ◽  
...  
Keyword(s):  
Liver Disease ◽  
Liver Fibrosis ◽  
Positive Predictive Value ◽  
Predictive Value ◽  
Breath Test ◽  
Area Under The Curve ◽  
Diagnostic Value ◽  
Cross Sectional Study ◽  
Chronic Liver ◽  
Cross Sectional

The accuracy of the13C-methacetin breath test (13C-MBT) in differentiating between various stages of liver disease is not clear. A cross-sectional study of Asian patients was conducted to examine the predictive value of the13C-MBT in various stages of chronic liver diseases. Diagnostic accuracy of the breath test was determined by sensitivity, specificity, positive predictive value, negative predictive value, and area under the curve analysis. Seventy-seven patients (47 men/30 women, mean age50±16years) were recruited. Forty-seven patients had liver cirrhosis (Child Pugh A = 11, Child Pugh B = 15, and Child Pugh C = 21), 21 had fibrosis, and 9 had chronic inflammation. The sensitivity and positive predictive value for liver fibrosis, cirrhosis (all stages), Child-Pugh A, Child-Pugh B, and Child-Pugh C were 65% and 56%, 89% and 89%, 67% and 42%, 40% and 40%, and 50% and 77%, respectively. Area under curve values for fibrosis was 0.62 (0.39–0.86), whilst that for cirrhosis (all stages) was 0.95 (0.91–0.99). The13C-methacetin breath test has a poor predictive value for liver fibrosis but accurately determines advanced cirrhosis.

scholarly journals The diagnostic value of non-invasive serum liver fibrosis indices in the prediction of portal hypertension in cirrhotic patients: a cross-sectional study

2020 ◽  
Vol 8 (1) ◽  
pp. 23-23
Author(s):  
Masood Faghih Dinevari ◽  
Mohammad Hossein Somi ◽  
Mohammad Kazem Tarzamni ◽  
Leila Alizadeh ◽  
Samaneh Abbasian ◽  
...  
Keyword(s):  
Portal Hypertension ◽  
Liver Fibrosis ◽  
Color Doppler ◽  
Area Under The Curve ◽  
Predictive Marker ◽  
Diagnostic Value ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Non Invasive ◽  
Cirrhotic Patients

Introduction: Considering that portal hypertension is principally caused by hepatic fibrosis, some studies postulated the predictive value of serum liver fibrosis indices in the diagnosis of portal hypertension. In this study we assessed the prognostic value of serum indices in the diagnosis of portal hypertension in cirrhotic patients. Methods: One hundred two cirrhotic patients were selected according to inclusion/exclusion criteria. Cirrhosis and the Child-Pugh score was determined by the gastroenterologist. Portal hypertension was diagnosed by the radiologist using the color Doppler method. The fasting blood sample was drawn and different serum indices were determined. The following indices were calculated: FIB4, Fibroindex, APRI, FORNS, LOK. Results: The patients mean age was 54.39±6.60 years. About 52.94% of the patients were women. The mean liver enzymes level was higher in patients with portal hypertension. In 50.98% of patients, the etiology of cirrhosis was viral hepatitis. Significant differences was observed between the two groups regarding the studied indices (P<0.05). According to the results of the ROC curve, the FORNS index was a better predictive marker of portal hypertension in cirrhotic patients. The maximum AUC (area under the curve) was for the FORNS index. According to the results of diagnostic tests, the FORNS index had adequate sensitivity and specificity in the diagnosis of portal hypertension with the cut-off value of 8.51. Conclusion: The results of the present study showed that the FORNS index is a better predictor of portal hypertension in cirrhotic patients.

scholarly journals Utility of the SARC-F Questionnaire for Sarcopenia Screening in Patients with Chronic Liver Disease: A Multicenter Cross-Sectional Study in Japan

2021 ◽  
Vol 10 (15) ◽  
pp. 3448
Author(s):  
Tatsunori Hanai ◽  
Atsushi Hiraoka ◽  
Makoto Shiraki ◽  
Ryosuke Sugimoto ◽  
Nobuhito Taniki ◽  
...  
Keyword(s):  
Liver Disease ◽  
Chronic Liver Disease ◽  
Roc Curve ◽  
Predictive Value ◽  
Cross Sectional Study ◽  
Chronic Liver ◽  
Sectional Study ◽  
Roc Curve Analysis ◽  
Discriminative Ability ◽  
Cross Sectional

Diagnosing sarcopenia is challenging. This multicenter cross-sectional study aimed to evaluate the utility of the SARC-F score system for identifying sarcopenia in patients with chronic liver disease (CLD). We enrolled 717 patients from five participating centers who completed the SARC-F between November 2019 and March 2021. Sarcopenia was diagnosed based on the Japan Society of Hepatology Working Group on Sarcopenia in Liver Disease Consensus. Muscle strength was estimated using a grip dynamometer, and muscle mass was assessed using computed tomography or bioelectrical impedance analysis. The association between SARC-F and sarcopenia was analyzed using a logistic regression model. The optimal SARC-F cutoff value for identifying sarcopenia was determined using receiver operating characteristic (ROC) curve analysis. Of the 676 eligible patients, 15% were diagnosed with sarcopenia. The SARC-F distribution was 0 points in 63% of patients, 1 point in 17%, 2 points in 7%, 3 points in 4%, and ≥4 points in 8%. The SARC-F items of “Strength” (odds ratio (OR), 1.98; 95% confidence interval (CI), 1.03–3.80) and “Falls” (OR, 2.44; 95% CI, 1.48–4.03) were significantly associated with sarcopenia. The SARC-F value of 1 point showed a higher discriminative ability for identifying sarcopenia than the 4 points that are conventionally used (p < 0.001), with an area under the ROC curve of 0.68, sensitivity of 0.65, specificity of 0.68, positive predictive value of 0.27, and negative predictive value of 0.92. SARC-F is useful for identifying patients with CLD who are at risk of sarcopenia.

scholarly journals P0614URINARY EXOSOMAL MICRORNA-21 AS A MARKER OF SCRUB TYPHUS-ASSOCIATED ACUTE KIDNEY INJURY

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
In O Sun ◽  
Kwang Young Lee ◽  
A Young Cho
Keyword(s):  
Acute Kidney Injury ◽  
Kidney Disease ◽  
Scrub Typhus ◽  
Area Under The Curve ◽  
Kidney Injury ◽  
Diagnostic Value ◽  
Cross Sectional Study ◽  
Total Leukocyte Count ◽  
Cross Sectional ◽  
Exosomal Mirna

Abstract Background and Aims Urinary microRNA (miRNA)-21 is reported to be a biomarker for detection of acute kidney injury (AKI). Analysis of urinary exsome may serve as a novel diagnostic approach in kidney disease. The aim of this study is to investigate the clinical significance of urinary exosomal miRNA-21 for AKI in patients with scrub typhus. Method In a cross-sectional study, we collected 138 urine samples at the time of admission from 145 patients with scrub typhus. For 25 patients with scrub typhus-associated AKI and 25 age, sex-matched scrub typhus patient without AKI, we measured miRNA-21 in urinary exosomal fraction and compared diagnostic value in predictiong AKI. Results Compared with patients in the non-AKI group, patients in the AKI group were more likely to have one or more comorbidity such as diabetes (50% vs. 5%, P&lt;0.01) and chronic kidney disease (8% vs. 0%, P&lt;0.01). Total leukocyte count were higher in patients with AKI than in those without AKI (10.40 × 103/ mL vs. 6.40 × 103/mL, P&lt;0.01). The levels of urinary miRNA-21 were higher in the AKI group than in the non-AKI group. Urinary exosomal miRNA-21 levels correlated directly with serum neutrophil gelatinase-associated lipocalin values and total leukocyte counts and inversely with estimated glomerular filtration rate. The receiver operator characteristics curve analysis for urinary exosomal miRNA-21 showed good discriminative power for the diagnosis of scrub typhus-associated AKI, with area under the curve value of 0.907. Conclusion Urinary exosomal miRNA-21 could be a surrogate markers for the diagnosis of scrub typhus–associated AKI.

scholarly journals PEMERIKSAAN TINGKAT sdLDL SERUM SEBAGAI PETANDA DIAGNOSTIK STENOSIS KORONER (Serum sdLDL Level as A Diagnostic Marker of Coronary Stenosis)

2018 ◽  
Vol 22 (1) ◽  
pp. 9
Author(s):  
Indranila K Samsuria ◽  
Laily Adninta
Keyword(s):  
Predictive Value ◽  
Coronary Stenosis ◽  
Area Under The Curve ◽  
Clinical Pathology ◽  
Diagnostic Value ◽  
T Test ◽  
Cross Sectional ◽  
Increased Risk ◽  
Test Kit ◽  
Vascular Stenosis

Small dense LDL (sdLDL) is the LDL which particles are small and dense, it is pro-atherogenic. Increased levels of serum sdLDL areassociated with an increased risk of coronary stenosis. The aim of this study was to examine the diagnostic value of sd LDL in coronarystenosis. An analytical observational study with cross sectional approach was conducted at the Department of Clinical Pathology, MedicalFaculty of Diponegoro University/Dr. Kariadi Hospital and the Unit of Cardiac diseases during the period of March-October 2013. Thesubjects were 39 patients suspected of suffering a coronary stenosis. The diagnosis of coronary stenosis, degree of stenosis and numberof vascular stenosis was established at the time of cardiac catheterization. SdLDL assessment used a test kit. The statistical analysis usedwere unpaired t-test, Spearman correlation test, ROC analysis and diagnostic test. LDL levels in stenosis subjects, 35.4±9.01 mg/dL weresignificantly higher compared to levels in subjects that had no stenosis, 20.7±7.10 mg/dL (p<0.001; unpaired t-test). Correlation testresults showed a correlation between levels of serum sdLDL with severe degree of stenosis (correlation coefficient -0.64, p <0.001) and amoderate positive correlation between the number of vascular stenosis (Coefficient correlation 0.46; p=0.003; Spearman Correlation’sTest). The area under the curve of ROC was 0.9 (p <0.001). The cut off levels sdLDL were used to detect stenosis. The results showeda sensitivity of 85.2%, specificity of 75%, positive predictive value of 88.5%, negative predictive value of 69.2% and accuracy of 82%.Levels of serum sdLDL were associated with severe to extensive stenosis degree, and showed a good diagnostic value, thus, it can beused for screening to determine the presence of coronary stenosis.

scholarly journals ANALISIS FERITIN DAN AST TO PLATELET RATIO INDEX SEBAGAI PETANDA DERAJAT FIBROSIS PENYAKIT HATI KRONIS (Analysis Ferritin and AST to Platelet Ratio Index as a Marker Degree of Fibrosis Chronic Liver Disease)

2018 ◽  
Vol 22 (1) ◽  
pp. 72
Author(s):  
Yulianti Yasin ◽  
Uleng Bahrun ◽  
Ibrahim Abdul Samad
Keyword(s):  
Liver Disease ◽  
Chronic Liver Disease ◽  
Cell Damage ◽  
Clinical Chemistry ◽  
Cross Sectional Study ◽  
Chronic Liver ◽  
Impedance Method ◽  
Iron Deposit ◽  
Cross Sectional ◽  
Modified Method

Chronic liver disease is an endemic disease in Indonesia which is still a global health problem and detected when it’s developinginto fibrosis. The determination of fibrosis is important for the treatment and prognosis of chronic liver disease. AST to Platelet RatioIndex (APRI) score is the most common used to assess the degree of liver fibrosis. Ferritin is an iron deposit that found in the liver andthe levels depend on the degree of the cell damage. The aim of this study was to analyze ferritin levels as a marker of the fibrosis degreein the chronic liver disease. This cross-sectional study of 47 patients with chronic liver disease performed at Dr. Wahidin SudirohusodoGeneral Hospital between May–June 2012. The subjects are grouped into cirrhotic and noncirrhotic, based on the theory that in cirrhoticliver fibrosis was considered as an irreversible condition. AST to platelet ratio index score based on the Wai CT formulation, includingthe examination of AST by optimizing UV-test according to International Federation of Clinical Chemistry (IFCC) modified method onthe ABX Pentra 400, examination of platelet by impedance method on Sysmex XT 2000i and ferritin levels were measured by ECLIAmethod using Elecsys 2010 Analyzer. The Spearman correlation tests showed no association between ferritin levels and APRI in cirrhoticand non cirrhotic patients (p=0.704 and r=–0.057). In conclusion, ferritin can not be used as the marker in determining the degreeof fibrosis patients suffering chronic liver disease. Further studies are expected using a more valid method for determining the degree offibrosis such as liver biopsy or fibro scan.

scholarly journals ACCURACY OF THE UPPER LIP BITE TEST;

2012 ◽  
Vol 20 (01) ◽  
pp. 132-138
Author(s):  
MUHAMMAD ATIF ◽  
MUHAMMAD ABDULLAH ◽  
MUHAMMAD JAVAD YOUSAF ◽  
Khalid Buland
Keyword(s):  
Positive Predictive Value ◽  
Diagnostic Accuracy ◽  
Difficult Intubation ◽  
Predictive Value ◽  
Elective Surgery ◽  
Cross Sectional Study ◽  
Military Hospital ◽  
Upper Lip ◽  
Cross Sectional ◽  
Sensitivity Specificity

Objective: To compare the accuracy of Upper lip bite test with modified Mallampati classification for predicting the difficultlaryngoscopic intubation. Study Design: Cross sectional Study. Place and duration of study: The study was carried out at Department ofAnaesthesiology, Intensive Care and Pain management, Combined Military hospital, Rawalpindi from September 2008 to August 2009.Patients and Methods: Four hundred patients undergoing elective surgery meeting the inclusion/exclusion criteria were enrolled afterwritten informed consent. The airways of the patients were evaluated by using the modified Mallampati classification (MMP) and theUpper lip bite test (ULBT). MMP class 3 or 4 and ULBT class 3 were considered as indicators of difficult intubation. The laryngeal view wasgraded by Cormack and Lehane classification (Gold standard). Grade 1 or 2 was considered to represent easy intubation and grade 3 or 4to represent difficult intubation. Sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy werecalculated for both the tests separately by using the 2×2 table. Results: ULBT had a higher accuracy of 94%, specificity of 99.2% andpositive predictive value 70% compared to MMP accuracy of 82.7%, specificity of 84.4% and positive predictive value of 22.7%.Conclusions: The diagnostic accuracy of the Upper lip bite test was more than the modified Mallampati classification. We suggest that itbe compared with the other prevailing tests as well which are often used to assess difficult intubations.

scholarly journals Diagnostic Value of CK19, HBME-1 and TROP2 Biomarkers in Identification of Different Types of Thyroid Follicular Neoplasms

2021 ◽  
Author(s):  
Shohreh Vojuhi ◽  
Masoud Mohebbi ◽  
Zohreh Mousavi ◽  
Mohammadali Yaghoubi ◽  
Reza Ziaolhagh
Keyword(s):  
Positive Predictive Value ◽  
Papillary Carcinoma ◽  
Predictive Value ◽  
Thyroid Nodules ◽  
Follicular Adenoma ◽  
Thyroid Neoplasms ◽  
Diagnostic Value ◽  
Cross Sectional ◽  
Predictive Values ◽  
Different Types

Thyroid malignancies are found in 7% to 15% of all thyroid nodules. Immunohistochemical markers, including CK19, HBME-1and TROP2, have shown an effective role in identifying these malignancies. Hence, due to the lack of appropriate diagnostic tests for the identification of thyroid neoplasms, in this study, we aimed to determine the diagnostic value of these biomarkers in the identification of different types of follicular thyroid neoplasms. In this cross-sectional study, paraffin-embedded tissue blocks from the surgical resection of patients with thyroid nodules, referring to Imam Reza and Razavi Hospitals of Mashhad in 2017, were studied. Sensitivity, specificity, and positive and negative predictive values of these biomarkers for the identification of different types of follicular thyroid neoplasms were also studied. 129 patients with a mean age of 44.65±12.59 years participated in this study, of whom 101 (78.29%) were women. The most common type of follicular thyroid neoplasm was papillary carcinoma (60.47%). The highest sensitivity (94.87%) and positive predictive value (68.51%) in the detection of follicular neoplasms was observed by CK19 in papillary carcinoma. The sensitivity and positive predictive value of TROP2 in the detection of papillary neoplasms was 93.58% and 75.25%, respectively. In addition, HBME-1 had the highest specificity (72.54 %) and positive predictive value (81.57%) in identifying this neoplasm. The results of this study showed that CK19, HBME-1, and TROP2 had high diagnostic value in the detection of papillary thyroid neoplasms. Although these biomarkers had low diagnostic value in identifying follicular adenoma and carcinoma, given the high negative predictive value, they can be considered as powerful markers in identifying negative cases.

Comparison between qualitative and quantitative measurement of strength deficit in shoulder flexors of young females: a cross- sectional study

2021 ◽  
Vol 71 (11) ◽  
pp. 2559-2562
Author(s):  
Saadia Perwaiz ◽  
Muhammad Waqar Afzal ◽  
Ghulam Fatima
Keyword(s):  
Positive Predictive Value ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
Sampling Technique ◽  
Cross Sectional Study ◽  
Manual Muscle Testing ◽  
Primary Analysis ◽  
Cross Sectional ◽  
Young Females ◽  
Muscle Testing

Objective: To compare accuracy of manual muscle testing in detection of strength differences across grade 4 and 5 at different percentage deficits of dynamometric mean in shoulder flexors of young females.  Methods: Cross sectional research design, conducting primary analysis of strength of shoulder flexors measured through manual muscle testing and hand-held dynamometer. Three hundred young healthy females without any ailment of upper extremity or generalized health problem were selected from University of South Asia and Association of Fatima Jinnah Old Graduates, Lahore. Non-probability convenient sampling technique was used. The age group selected was 18-39 years. The strength of shoulder flexors measured through manual muscle testing and hand-held dynamometer was main outcome measure. Results: The overall diagnostic accuracy of manual muscle testing showed better results at 10% dynamometric measures. It was 63.33%(95% CI: 57.74%, 68.59%) in non-dominant shoulder flexors and 61.67% (95% CI: 56.05%, 66.99%) in dominant shoulder flexors. The positive predictive value (PPV) and specificity of manual muscle testing was better at 10% strength deficit in comparison with dynamometric measures, whereas negative predictive value (NPV) and sensitivity was better at 20% strength deficit. Contrasting association was found between positive predictive value (PPV) and sensitivity, negative predictive value and specificity.  Conclusion: The subjective area of grade 4 and 5 showed better, although not ideal, diagnostic worth at 10% deficit of dynamometric measures in shoulder flexors. Further exploration through study of contrasting trends between PPV and sensitivity by subgroup analysis is required. Continuous...

Liver Fibrosis is Associated with a Decrease in Gait Speed in Older Men with Chronic Liver Disease: A Retrospective Cross-Sectional Study

2021 ◽  
Author(s):  
Kenichi Fudeyasu ◽  
Takuo Nomura ◽  
Toshihiro Kawae ◽  
Daisuke Iwaki ◽  
Yuki Nakashima ◽  
...  
Keyword(s):  
Liver Disease ◽  
Liver Fibrosis ◽  
Chronic Liver Disease ◽  
Motor Function ◽  
Gait Speed ◽  
Older Patients ◽  
Knee Extension ◽  
Chronic Liver ◽  
Cross Sectional ◽  
The Impact

Abstract Background: Although it has already been reported that chronic liver disease (CLD) can induce sarcopenia, the impact of sarcopenia, especially on motor function, in older patients with CLD is still unclear. Therefore, we investigated the effects of liver fibrosis on motor function in these patients.Methods: In all, 117 older patients with CLD aged above 60 years (men, n=70; women, n=47) were included in this study. We examined the presence or absence of sarcopenia and checked motor functions such as muscle strength and walking speed. The results were compared between patients with FIB-4 index of >3.25, indicative of severe-degree liver fibrosis (SLF), and those with an index of <3.25, indicative of low-degree liver fibrosis (LLF). We also analyzed the factors related to the decrease in gait speed.Results: The decrease in gait speed (<1.0 m/s) was significantly higher (P = 0.027) and the knee extension force (KEF) was significantly lower (P = 0.010) in men with SLF than in those with LLF. In this study, liver fibrosis (odds ratio [OR] = 0.71, 95% confidence interval [CI] = 0.56–0.90) and KEF (OR = 1.09, 95% CI = 1.02–1.16) were identified as factors associated with the decrease in gait speed.Conclusions: Older male patients with CLD have decreased motor function as the disease progresses. We found that the decrease in gait speed is related to liver fibrosis and KEF. It is necessary to focus on the motor function of older patients with CLD, especially the gait speed.

TLR2 and TLR4 expressions in late-onset neonatal sepsis: Is it a potential novel biomarker?

2020 ◽  
pp. 1-7
Author(s):  
R. Rohsiswatmo ◽  
M. Azharry ◽  
T.T. Sari ◽  
Y. Bahasoan ◽  
D. Wulandari
Keyword(s):  
Blood Culture ◽  
Neonatal Sepsis ◽  
Predictive Value ◽  
Complete Blood Count ◽  
Late Onset ◽  
Diagnostic Value ◽  
Cross Sectional Study ◽  
Tlr4 Expression ◽  
Cross Sectional ◽  
Reactive Protein

BACKGROUND: Late-onset neonatal sepsis (LONS) detection is problematic as no single examinations (blood culture, c-reactive protein (CRP), procalcitonin (PCT)) are reliable. Toll-like receptors (TLRs), which detect the presence of pathogen-associated molecular patterns is a promising novel biomarker, but less studied in LONS. This study aimed to determine neutrophils and monocytes TLR2 and TLR4 expression in LONS and their diagnostic value. METHODS: A cross-sectional study conducted in May and June 2017 involving 52 neonates with clinical late-onset (>72 hours of age) sepsis. We examine complete blood count, I/T ratio, CRP, PCT, as well as TLR2 and TLR4 expression to compared with blood culture as the gold standard. We classified cases into proven or unproven sepsis. RESULT: The incidence of LONS was 32.6% in the subjects. The expression of TLR2 was low in LONS, while TLR4 was high. TLR4 neutrophil expression has 88.2% sensitivity, 20% specificity, 34.9% positive predictive value (PPV), 77.8% negative predictive value (NPV), and an AUC of 0.541. TLR4 monocyte expression has 92.1% sensitivity, 11.4% specificity, 34% PPV, 80% NPV, and an AUC of 0.528. The AUC of CRP is increased from 0.608 to 0.843 after combination with TLR4, comparable with CRP + PCT (AUC 0.829). CONCLUSION: The increase in TLR4 expression has good sensitivity but low specificity. TLR4 expression, in combination with CRP, could become a reliable biomarker for the diagnosis of LONS.

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