scholarly journals Saliva: A Cutting Edge in Diagnostic Procedures

2014 ◽  
Vol 2014 ◽  
pp. 1-8 ◽  
Author(s):  
Senthamil Sindhu ◽  
Nithya Jagannathan
Keyword(s):  
Clinical Practice ◽  
Health Professionals ◽  
Dental Health ◽  
Screening Method ◽  
Disease Status ◽  
Diagnostic Procedures ◽  
Diagnostic Value ◽  
Molecular Techniques ◽  
Health And Disease ◽  
Salivary Diagnostics

The ability to monitor the health and disease status of the patient through saliva is a highly desirable goal for the health professionals. Considering the microconcentration of salivary constituents, saliva is explored to be diagnostic tool as it also meets the demands for an inexpensive, noninvasive and easy to use screening method. The incorporation of salivary diagnostics into clinical practice is gaining reality and will be of diagnostic value in the prospective future. The investigative use of saliva is not being applied only in dental health but also in various other systemic disorders. The advent of molecular techniques is gaining attention and this has triggered its application as a specific and sensitive biomarker in proteomics, genomics, and transcriptomics. This review discusses the basics of salivary diagnostics, expectoration techniques, and its application in various local and systemic disorders.

scholarly journals Evaluation of 16S rRNA primer sets for characterisation of microbiota in paediatric patients with autism spectrum disorder

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
L. Palkova ◽  
A. Tomova ◽  
G. Repiska ◽  
K. Babinska ◽  
B. Bokor ◽  
...  
Keyword(s):  
Autism Spectrum Disorder ◽  
16S Rrna ◽  
Dna Amplification ◽  
Disease Status ◽  
Autism Spectrum ◽  
Spectrum Disorder ◽  
Sequencing Analysis ◽  
Key Factor ◽  
Health And Disease ◽  
Primer Sets

AbstractAbstract intestinal microbiota is becoming a significant marker that reflects differences between health and disease status also in terms of gut-brain axis communication. Studies show that children with autism spectrum disorder (ASD) often have a mix of gut microbes that is distinct from the neurotypical children. Various assays are being used for microbiota investigation and were considered to be universal. However, newer studies showed that protocol for preparing DNA sequencing libraries is a key factor influencing results of microbiota investigation. The choice of DNA amplification primers seems to be the crucial for the outcome of analysis. In our study, we have tested 3 primer sets to investigate differences in outcome of sequencing analysis of microbiota in children with ASD. We found out that primers detected different portion of bacteria in samples especially at phylum level; significantly higher abundance of Bacteroides and lower Firmicutes were detected using 515f/806r compared to 27f/1492r and 27f*/1495f primers. So, the question is whether a gold standard of Firmicutes/Bacteroidetes ratio is a valuable and reliable universal marker, since two primer sets towards 16S rRNA can provide opposite information. Moreover, significantly higher relative abundance of Proteobacteria was detected using 27f/1492r. The beta diversity of sample groups differed remarkably and so the number of observed bacterial genera.

Between a logic of disruption and a logic of continuation: Negotiating the legitimacy of algorithms used in automated clinical decision-making

2021 ◽  
pp. 136345932199674
Author(s):  
Rikke Torenholt ◽  
Henriette Langstrup
Keyword(s):  
Decision Making ◽  
Clinical Practice ◽  
Patient Reported Outcomes ◽  
Patient Involvement ◽  
Clinical Decision Making ◽  
Diagnostic Procedures ◽  
Clinical Decision ◽  
Patient Reported ◽  
Pro Tools

In both popular and academic discussions of the use of algorithms in clinical practice, narratives often draw on the decisive potentialities of algorithms and come with the belief that algorithms will substantially transform healthcare. We suggest that this approach is associated with a logic of disruption. However, we argue that in clinical practice alongside this logic, another and less recognised logic exists, namely that of continuation: here the use of algorithms constitutes part of an established practice. Applying these logics as our analytical framing, we set out to explore how algorithms for clinical decision-making are enacted by political stakeholders, healthcare professionals, and patients, and in doing so, study how the legitimacy of delegating to an algorithm is negotiated and obtained. Empirically we draw on ethnographic fieldwork carried out in relation to attempts in Denmark to develop and implement Patient Reported Outcomes (PRO) tools – involving algorithmic sorting – in clinical practice. We follow the work within two disease areas: heart rehabilitation and breast cancer follow-up care. We show how at the political level, algorithms constitute tools for disrupting inefficient work and unsystematic patient involvement, whereas closer to the clinical practice, algorithms constitute a continuation of standardised and evidence-based diagnostic procedures and a continuation of the physicians’ expertise and authority. We argue that the co-existence of the two logics have implications as both provide a push towards the use of algorithms and how a logic of continuation may divert attention away from new issues introduced with automated digital decision-support systems.

Comparative analysis of diagnostic procedures for tumor detection rates in paired data

2018 ◽  
Vol 28 (5) ◽  
pp. 1477-1488
Author(s):  
Yaeji Lim ◽  
Ji Soo Choi ◽  
Kiyoun Kim ◽  
Mira Park ◽  
Seonwoo Kim
Keyword(s):  
Positive Predictive Value ◽  
Predictive Value ◽  
Correct Diagnosis ◽  
Disease Status ◽  
Diagnostic Procedures ◽  
Tumor Detection ◽  
Tumor Location ◽  
Test Statistic ◽  
Paired Data ◽  
Detection Rates

Diagnostic procedures are mostly used to detect a particular disease, and each procedure indicates the presence or absence of the disease in an individual. Sensitivity and positive predictive value, which are measures of the effectiveness of a diagnostic procedure, are simply calculated as the proportion of the individuals diagnosed with the disease by the test among the patients with the disease, and of the diseased persons among the individuals in whom the disease was detected by the test, respectively. For a diagnosis with such a binary result, sensitivity and the positive predictive value of diagnostic procedures can be compared using the chi-square statistic. However, in the treatment of cancer patients, it is important not only to diagnose the disease status of an individual patient but also to detect the correct location of the cancer. The tumor location may be incorrectly identified in some subjects diagnosed with cancer. It is therefore of interest whether a procedure that diagnoses cancer also correctly indicates the tumor location. In this paper, we re-define the sensitivity and the positive predictive value of tumor detection as the ratio of the number of cases with a correct diagnosis of the tumor location by the test to the number of cases of cancer, and as the ratio of patients with a correct diagnosis of the tumor location to the number of individuals diagnosed with cancer by the test, respectively. We refer to these parameters as ‘semi-sensitivity’ and ‘semi-positive predictive value’. To compare these ratios between diagnostic procedures, test statistics are developed from binary diagnostic results. Simulation studies conducted to evaluate the nominal level and power are presented, and two sets of example data are also analyzed using the new test statistic.

scholarly journals Recent Development toward the Next Clinical Practice of Primary Aldosteronism: A Literature Review

Biomedicines ◽  
2021 ◽  
Vol 9 (3) ◽  
pp. 310
Author(s):  
Yuta Tezuka ◽  
Yuto Yamazaki ◽  
Yasuhiro Nakamura ◽  
Hironobu Sasano ◽  
Fumitoshi Satoh
Keyword(s):  
Clinical Practice ◽  
Primary Aldosteronism ◽  
Diagnostic Procedures ◽  
Secondary Hypertension ◽  
Refractory Hypertension ◽  
Diagnostic Biomarkers ◽  
Histopathological Classification ◽  
Subtype Differentiation ◽  
Work Up

For the last seven decades, primary aldosteronism (PA) has been gradually recognized as a leading cause of secondary hypertension harboring increased risks of cardiovascular incidents compared to essential hypertension. Clinically, PA consists of two major subtypes, surgically curable and uncurable phenotypes, determined as unilateral or bilateral PA by adrenal venous sampling. In order to further optimize the treatment, surgery or medications, diagnostic procedures from screening to subtype differentiation is indispensable, while in the general clinical practice, the work-up rate is extremely low even in the patients with refractory hypertension because of the time-consuming and labor-intensive nature of the procedures. Therefore, a novel tool to simplify the diagnostic flow has been recently in enormous demand. In this review, we focus on recent progress in the following clinically important topics of PA: prevalence of PA and its subtypes, newly revealed histopathological classification of aldosterone-producing lesions, novel diagnostic biomarkers and prediction scores. More effective strategy to diagnose PA based on better understanding of its epidemiology and pathology should lead to early detection of PA and could decrease the cardiovascular and renal complications of the patients.

Epigenetics and DOHaD: how translation to predictive testing will require a better public understanding

2021 ◽  
pp. 1-7
Author(s):  
Fiona Lynch ◽  
Sharon Lewis ◽  
Ivan Macciocca ◽  
Jeffrey M. Craig
Keyword(s):  
Health Professionals ◽  
Early Life ◽  
Predictive Testing ◽  
Public Understanding ◽  
Future Research ◽  
Developmental Origins ◽  
Needed Information ◽  
Genes And Environment ◽  
Increased Risk ◽  
Health And Disease

Abstract Epigenetics is likely to play a role in the mediation of the effects of genes and environment in risk for many non-communicable diseases (NCDs). The Developmental Origins of Health and Disease (DOHaD) theory presents unique opportunities regarding the possibility of early life interventions to alter the epigenetic makeup of an individual, thereby modifying their risk for a variety of NCDs. While it is important to determine how we can lower the risk of these NCDs, it is equally important to understand how the public’s knowledge and opinion of DOHaD and epigenetic concepts may influence their willingness to undertake such interventions for themselves and their children. In this review, we provide an overview of epigenetics, DOHaD, NCDs, and the links between them. We explore the issues surrounding using epigenetics to identify those at increased risk of NCDs, including the concept of predictive testing of children. We also outline what is currently understood about the public’s understanding and opinion of epigenetics, DOHaD, and their relation to NCDs. In doing so, we demonstrate that it is essential that future research explores the public’s awareness and understanding of epigenetics and epigenetic concepts. This will provide much-needed information which will prepare health professionals for the introduction of epigenetic testing into future healthcare.

A survey of UK dental health professionals using a medicines information service: what questions do they ask and do they get useful answers?

BDJ ◽  
2011 ◽  
Vol 211 (1) ◽  
pp. 17-21 ◽  
Author(s):  
J. E. McEntee ◽  
S. L. Henderson ◽  
P. M. Rutter ◽  
J. Rutter ◽  
H. J. Davis ◽  
...  
Keyword(s):  
Health Professionals ◽  
Dental Health ◽  
Information Service ◽  
Medicines Information

scholarly journals Emerging pathology: Pulmonary disease caused by Mycobacterium xenopi - a challenge in clinical practice

2018 ◽  
Vol 75 (9) ◽  
pp. 949-953
Author(s):  
Dragica Pesut ◽  
Ruza Stevic ◽  
Jasmina Maric-Zivkovic ◽  
Biljana Savic ◽  
Ljudmila Nagorni-Obradovic
Keyword(s):  
Risk Factors ◽  
Clinical Practice ◽  
Pulmonary Disease ◽  
Randomized Clinical Trials ◽  
Posterior Part ◽  
Molecular Techniques ◽  
Host Susceptibility ◽  
Environmental Mycobacteria ◽  
Mycobacterium Xenopi ◽  
Sputum Conversion

Introduction. Human nontuberculous mycobacteria (NTM) or environmental mycobacteria related disease is on increase. Risk factors are unclear and associations are observed in relation to climate differences, population density, or host susceptibility. With availability of molecular techniques for NTM identification, we faced emergence of NTM pulmonary cases. The work is an invitation more to colleagues to enroll the rare NTM cases into large study group. Case report. During an episode of productive cough and fever in a 73-year-old HIV-negative man smoker with minimal sequellae of pulmonary tuberculosis, sputum smears were acid fast bacilli positive on direct microscopy. The L?wenstein- Jensen culture results were positive with 20, 30 and 50 colonies, and molecular identification confirmed Mycobacterium xenopi (M. xenopi). Standard chest radiography showed no signs of active lesions. Examination was completed with bronchoscopy and thorax multi-slice computed tomography (MSCT). Cavitary lesions in the apico-posterior part of the left upper lobe (LUL) were detected. Under treatment (rifampicin, ethambutol, clarithromycin) sputum conversion was achieved, but irregular cavitation in the LUL remained at MSCT after 6 and after 12 months with signs of minimal regression. Patient?s general condition only mildly improved and asthenia remained. Observed risk factors were previous pulmonary disease, tobacco smoking, malnutrition and prolonged emotional stress. Conclusion. M. xenopi related pulmonary disease, difficult to cure and with uncertain prognosis, is a challenge in clinical practice. Since treatment is still controversial, more randomized clinical trials are needed. Current international multicentre approach might be a good option for a larger sample size and development of new guide.

scholarly journals Tremorography in the clinical practice

2020 ◽  
Vol 9 (4) ◽  
pp. 61-72
Author(s):  
T. G. Govorova ◽  
T. E. Popova ◽  
A. A. Tappakhov
Keyword(s):  
Differential Diagnosis ◽  
Clinical Practice ◽  
Movement Disorders ◽  
Clinical Characteristics ◽  
Objective Assessment ◽  
Diagnostic Value ◽  
Common Type ◽  
Routine Practice ◽  
Pathological Tremor

Tremor is the most common type of movement disorders. In practice this differential diagnosis of hyperkinesis is diagnosed clinically and the use of additional methods of objective assessment of tremor increases the accuracy of diagnosis. The use of paraclinical methods of objective assessment of tremor improves the accuracy of diagnosis. Comparison of the neurophysiological parameters of tremor with clinical characteristics has a high diagnostic value, which justifies its use in the routine practice of neurologists. The purpose of the review is to analysis basic electrophysiological characteristics of pathological tremor, as well as the presentation of the material of its own observation.

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