scholarly journals Pancreatic carcinoma: The contribution of CA 19-9 to the enhancement of diagnostic precision of imaging techniques

2003 ◽  
Vol 11 (3) ◽  
pp. 219-219
Author(s):  
Jasna Trifunovic ◽  
Ljubomir Muzikravic ◽  
Mladen Prvulovic ◽  
Svetlana Salma ◽  
Borislava Nikolin ◽  
...  
Keyword(s):  
Chronic Pancreatitis ◽  
Pancreatic Carcinoma ◽  
Imaging Techniques ◽  
Correct Diagnosis ◽  
False Negative ◽  
Focal Lesions ◽  
Disease Staging ◽  
Pancreatic Pathology

Background: Ultrasonography (US) and magnetic resonance (MR) are the most important imaging techniques in the diagnostics of pancreatic carcinoma and disease staging; they are also very useful in monitoring and follow-up of treatment efficacy. The problems with imaging diagnostics arise in certain cases of pancreatic focal lesions - for example in the differentiation of focal chronic pancreatitis and pancreatic carcinoma. Our objectives were the evaluation of US and MR reliability and determination of the importance of oncomarker CA 19-9 in the diagnostics of pancreatic carcinoma. Methods: Our investigation included patients with pancreatic focal mass suspected of malignancy. All patients were examined by ultrasonography, MR, and ultrasound-guided needle biopsy. Cytopathologic examination of the bioptic samples was used to diagnose the disease. Oncomarker CA 19-9 was done in all patients. Results: MR imaging and US examination made possible the correct diagnosis of carcinoma in case of 17 patients; in three patients with focal chronic pancreatitis the diagnosis was false positive. No case of false negative diagnosis was found. The value of oncomarker CA 19-9 was determined and it was clearly positive (over 150 U/ml) in all patients. Conclusion Imaging techniques gave good results in the evaluation of pancreatic pathology. However, when using imaging techniques differential diagnosis between focal chronic pancreatitis and pancreatic carcinoma seems to be major problem. Correlation of imaging technique and identification of CA 19-9 has an important role in the diagnostics of pancreatic carcinoma. Imaging techniques and identification of oncomarker CA 19-9 are complementary methods in the examination and diagnostics of pancreatic carcinoma and they allow better precision of diagnosis of pancreatic focal lesions.

scholarly journals Evaluation of imaging techniques and ca 19-9 in differential diagnosis of carcinoma and other focal lesions of pancreas

2004 ◽  
Vol 12 (2) ◽  
pp. 104-108 ◽  
Author(s):  
Jasna Trifunovic ◽  
Ljubomir Muzikravic ◽  
Mladen Prvulovic ◽  
Svetlana Salma ◽  
Borislava Nikolin ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Differential Diagnosis ◽  
Chronic Pancreatitis ◽  
Magnetic Resonance ◽  
Pancreatic Carcinoma ◽  
Tumor Antigen ◽  
Imaging Techniques ◽  
Resonance Imaging ◽  
Focal Lesions

BACKGROUND: Ultrasonography and magnetic resonance imaging are the most important imaging techniques in the diagnostics of pancreatic carcinoma and disease staging; they are also very useful in monitoring and follow-up of treatment efficacy. The problems with imaging diagnostics arise in certain cases of pancreatic focal lesions - for example in the differentiation of focal chronic pancreatitis and pancreatic carcinoma. Our objectives were the evaluation of ultrasonography and magnetic resonance imaging reliability and determination of the importance of tumor antigen CA 19-9 in the diagnostics of pancreatic carcinoma. METHODS: Our investigation included patients with pancreatic focal mass suspected of malignancy. All patients were examined by ultrasonography, MR, and ultrasound-guided needle biopsy. Cytopathologic examination of biopsied samples was used to diagnose the disease. Oncomarker levels CA 19-9 were assayed in all patients. RESULTS: Magnetic resonance imaging and ultrasonography examination made possible the correct diagnosis of carcinoma in case of 17 patients; in three patients with focal chronic pancreatitis the diagnosis was false positive. No case of false-negative diagnosis was found. The tumor antigen CA 19-9 in serum was determined and it was clearly positive (above 45U/ml) in all patients (17) with pancreatic cancer. CONCLUSION: Imaging techniques gave good results in the evaluation of pancreatic pathology. However, when using imaging techniques differential diagnosis between focal chronic pancreatitis and pancreatic carcinoma seems to be major problem. Correlation of imaging technique and determination of tumor antigen CA 19-9 has an important role in the diagnostics of pancreatic carcinoma. Imaging techniques and identification of tumor antigen CA 19-9 are complementary methods in the examination and diagnostics of pancreatic carcinoma and they allow better precision of diagnosis of pancreatic focal lesions.

scholarly journals Pharmaceutical care in the context of an Extension Project to care for patients with vaginal candidiasis with the strategy of carrying out antifungal resistance testing and community health prevention

2020 ◽  
Vol 13 (9) ◽  
pp. 91
Author(s):  
M. L. Menz ◽  
L. N. Calil ◽  
F. M. Bittencourt ◽  
A. Mezzari
Keyword(s):  
Pharmaceutical Care ◽  
Inhibitory Concentration ◽  
Correct Diagnosis ◽  
Antifungal Resistance ◽  
Vaginal Candidiasis ◽  
Resistance Testing ◽  
Candida Spp ◽  
Susceptibility Tests

Vaginal candidiasis, fungal infection caused by species of Candida spp. that affects women of all ages, cultures, habits, social and economic conditions. Its frequency and epidemiology is already reported, but resistance and therapeutic failures have been recorded. Methodology: In the Laboratory of Clinical and Toxicological Analyzes of the Faculty of Pharmacy of UFRGS (LACT), cervicovaginal collections of women were performed for Candida research and determination of species, after which susceptibility tests were performed to fluconazole, itraconazole, ketoconazole and nystatin. With the results obtained complement with the Pharmaceutical Care Project. Results: C. albicans was identified in 37% and in non-albicans species, C. glabrata in 27%. C. albicans was more sensitive to antifungals than C. glabrata, which presented a minimum inhibitory concentration (MIC) higher than C. albicans. Conclusion: Antifungal resistance has increased due to the use in prophylaxis and treatments without the correct diagnosis, requiring a more careful look at these patients. Thus, it is necessary to follow up the diagnosis and treatment by the health professional, the pharmacist, who has knowledge of the drug therapy used and this is obtained by the Pharmaceutical Care acting in the Project.

Biomarkers for Alzheimer’s Disease

2019 ◽  
Vol 16 (6) ◽  
pp. 518-528 ◽  
Author(s):  
Leonardo Guzman-Martinez ◽  
Ricardo B. Maccioni ◽  
Gonzalo A. Farías ◽  
Patricio Fuentes ◽  
Leonardo P. Navarrete
Keyword(s):  
Imaging Techniques ◽  
Clinical Settings ◽  
Invasive Procedures ◽  
Effective Interventions ◽  
The World ◽  
New Biomarkers ◽  
The Brain

Alzheimer´s disease (AD) and related forms of dementia are increasingly affecting the aging population throughout the world, at an alarming rate. The World Alzheimer´s Report indicates a prevalence of 46.8 million people affected by AD worldwide. As population ages, this number is projected to triple by 2050 unless effective interventions are developed and implemented. Urgent efforts are required for an early detection of this disease. The ultimate goal is the identification of viable targets for the development of molecular markers and validation of their use for early diagnosis of AD that may improve treatment and the disease outcome in patients. The diagnosis of AD has been difficult to resolve since approaches for early and accurate detection and follow-up of AD patients at the clinical level have been reported only recently. Some proposed AD biomarkers include the detection of pathophysiological processes in the brain in vivo with new imaging techniques and novel PET ligands, and the determination of pathogenic proteins in cerebrospinal fluid showing anomalous levels of hyperphosphorylated tau and low Aβ peptide. These biomarkers have been increasingly accepted by AD diagnostic criteria and are important tools for the design of clinical trials, but difficulties in accessibility to costly and invasive procedures have not been completely addressed in clinical settings. New biomarkers are currently being developed to allow determinations of multiple pathological processes including neuroinflammation, synaptic dysfunction, metabolic impairment, protein aggregation and neurodegeneration. Highly specific and sensitive blood biomarkers, using less-invasive procedures to detect AD, are derived from the discoveries of peripheric tau oligomers and amyloid variants in human plasma and platelets. We have also developed a blood tau biomarker that correlates with a cognitive decline and also with neuroimaging determinations of brain atrophy.

scholarly journals Mass Mimicking Autoimmune Pancreatitis— A Report of Two Cases and Review of Literature

2021 ◽  
Author(s):  
Diva S. Shah ◽  
Bharat Prajapati ◽  
Kintan Sanghavi ◽  
Shubhda Kanhere ◽  
Jagdish Kothari ◽  
...  
Keyword(s):  
Chronic Pancreatitis ◽  
Pancreatic Carcinoma ◽  
Autoimmune Pancreatitis ◽  
Therapeutic Strategy ◽  
Correct Diagnosis ◽  
Type I ◽  
Imaging Features ◽  
Review Of Literature ◽  
Oral Steroids ◽  
Optimal Therapeutic Strategy

AbstractAutoimmune pancreatitis (AIP) consists of two clinically histologically distinct forms (type I and II) of chronic pancreatitis that are histologically different. These forms of AIP classically respond to oral steroids. The focal form of AIP resembles pancreatic carcinoma both clinically and radiologically and it is of utmost importance to make an early correct diagnosis between these two diseases in order to identify the optimal therapeutic strategy and to avoid unnecessary laparotomy or pancreatic resection in AIP patients. Here we report focal forms of type I and II AIP with clinical and imaging features closely mimicking pancreatic carcinoma.

scholarly journals The importance of compression elastography in the evaluation of thyroid nodule malignancy

2017 ◽  
Vol 145 (9-10) ◽  
pp. 463-469
Author(s):  
Milos Gasic ◽  
Sava Stajic ◽  
Biljana Vitosevic ◽  
Predrag Mandic ◽  
Jasmina Ciric ◽  
...  
Keyword(s):  
Thyroid Gland ◽  
Roc Analysis ◽  
Imaging Techniques ◽  
Resistance Index ◽  
Strain Ratio ◽  
Malignant Lesions ◽  
Benign Nodules ◽  
Index Strain

Introduction/Objective. Compression, also called strain elastography imaging techniques, represent new echotomographic modality, which is a promising method for the differentiation of benign from malignant lesions, not only in the thyroid gland but also in other organs. The objective of this study is to evaluate the importance of compression elastography in the differentiation of benign and malignant thyroid nodules. Methods. We performed echotomographic examinations in B mode, and examinations using compression elastography in a total of 186 persons (152 females and 34 males, with the average age of 45.3 ? 13.5 years), with 264 nodules in the thyroid gland. Elastography was done in two steps: the first one through scoring elastographic figures, and the second one through the determination of the resistance index (strain ratio ? SR). Results. Using elastography scores by Fukunari, 44 of 60 malignant nodules had a score of 3?4, while 152 of the 204 benign nodules had a score of 1?2. Using the receiver operating characteristic (ROC) analysis, the best cut-off point obtained using elastography scores was 2, with a sensitivity of 73.3% and specificity of 74.5%. Using the software-calculated SR we found that out of 89 nodules with SR ? 2.5, 52 were malignant nodules, while out of 175 nodules with SR < 2.5, 167 were benign nodules. Using the ROC analysis, the best cut-off point obtained using SR was > 2.5, with a sensitivity of 86.7%, and specificity of 81.9%. Conclusion. As a follow-up of standard echotomographic examination in B mode, compression elastography is a newly developed and promising technique in the differentiation of benign from malignant lesions.

scholarly journals 18F-Fluorocholine-PET/CT for Localizing Hyperfunctioning Parathyroid Glands and Optimizing Surgical Treatment in Patients With Hyperparathyroidism

2021 ◽  
Author(s):  
Jörn-Markus Gass ◽  
Corinna Wicke ◽  
Carolina Mona ◽  
Klaus Strobel ◽  
Werner Müller ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Diagnostic Accuracy ◽  
Imaging Techniques ◽  
False Negative ◽  
Single Institution ◽  
Predictive Values ◽  
Surgical Exploration ◽  
Pet Ct ◽  
Normal Calcium

Abstract PurposeHyperparathyroidism (HPT) is a common disorder. Cure can only be achieved by removal of all diseased glands. Exact localization of hyperfunctioning glands is of importance to prevent extensive surgical exploration. The number of false negative/inconclusive results in standard imaging techniques is high. We aimed to evaluate the diagnostic accuracy of 18F-Fluorocholine-PET/CT (FCH-PET/CT) and its sensitivity in patients with primary, secondary/tertiary and familial HPT with negative and/or discordant findings in ultrasound and/or 99mTc-sestamibi scintigraphy/SPECT/CT.Methods96 patients with HPT and negative/equivocal conventional imaging were referred for FCH-PET/CT. 69 patients who have undergone surgery and histopathologic workup were analyzed in this retrospective single institution study. 60 patients suffered from primary HPT, 4 from secondary or tertiary HPT and 5 from familial HPT. Sensitivities, positive predictive values, and accuracies were calculated.ResultsAll patients showed normalized serum calcium levels in the postoperative period. The follow-up rate was 97%. 58 of 60 patients with primary HPT and 4 of 4 patients with secondary/tertiary HPT showed normal calcium- and PTH-levels after 6 months and were cured. 4 of 5 patients with familial HPT were cured. Sensitivity/positive predictive value (PPV) per lesion for primary HPT was 87.5/98.3%, for secondary/tertiary HPT 75/100% and for familial HPT 14.6/100%, respectively. Sensitivity/PPV per patient was 91.5/98.2% for primary HPT, 100/100% for secondary/tertiary HPT and 50/100% for familial HPT, respectively.ConclusionDiagnostic accuracy of 18F-Fluorocholine-PET/CT for patients with pHPT is excellent. 18F-Fluorocholine-PET/CT is a valuable tool for endocrine surgeons to optimize the surgical treatment of patients with hyperparathyroidism.

Atrial fibrillation detection by the subcutaneous defibrillator: real-world clinical performances and implications from a multicentre study

EP Europace ◽  
2020 ◽  
Vol 22 (11) ◽  
pp. 1628-1634
Author(s):  
Pierre Ollitrault ◽  
Peggy Jacon ◽  
Nathanaël Auquier ◽  
Laure Champ-Rigot ◽  
Mouna Ben Kilani ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Real World ◽  
Remote Monitoring ◽  
De Novo ◽  
Correct Diagnosis ◽  
False Negative ◽  
Detection Algorithm ◽  
Premature Ventricular Contractions ◽  
Predictive Values

Abstract Aims No data exist concerning the clinical performances of the subcutaneous implantable cardioverter-defibrillator (S-ICD) atrial fibrillation (AF) detection algorithm. We aimed to study the performances and implications of the latter in a ‘real-world’ setting. Methods and results Between July 2017 and August 2019, 155 consecutive S-ICD recipients were included. Endpoint of the study was the incidence of de novo or recurrent AF using a combined on-site and remote-monitoring follow-up approach. After a mean follow-up of 13 ± 8 months, 2531 AF alerts were generated for 55 patients. A blinded analysis of the 1950 subcutaneous electrocardiograms available was performed. Among them 47% were true AF, 23% were premature atrial contractions or non-sustained AF, 29% were premature ventricular contractions or non-sustained ventricular tachycardia, and 1% were misdetection. Fourteen percent (21/155) patients had at least one correct diagnosis of AF by the S-ICD algorithm. One patient presented symptomatic paroxysmal AF not diagnosed by the S-ICD algorithm (false negative patient). Patient-based sensitivity, specificity, positive, and negative predictive values were respectively 95%, 74%, 38%, and 99%. Among patients with at least one correct diagnosis of AF, 38% (8/21) had subsequent clinical implications (anticoagulation initiation or rhythm control therapies). Conclusion The S-ICD AF detection algorithm yields a high sensitivity for AF diagnosis. Low specificity and positive predictive value contribute to a high remote monitoring-notification workload and underline the necessity of a manual analysis. Atrial fibrillation diagnosis by the S-ICD AF detection algorithm might lead to significant therapeutic adjustments.

scholarly journals 18F-Fluorcholine-PET/CT for localizing hyperfunctioning parathyroid glands and optimizing surgical treatment in patients with hyperparathyroidism

2021 ◽  
Vol 108 (Supplement_4) ◽  
Author(s):  
J -M Gass ◽  
C Wicke ◽  
C Henzen ◽  
C Mona ◽  
K Strobel ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Diagnostic Accuracy ◽  
Imaging Techniques ◽  
False Negative ◽  
Surgical Removal ◽  
Single Institution ◽  
Predictive Values ◽  
Pet Ct ◽  
Normal Calcium

Abstract Objective Hyperparathyroidism (HPT) is a common endocrine disorder. Definitive cure can only be reached by surgical removal of all diseased glands. The surgical strategy and management continue to evolve. Exact preoperative localization of hyperfunctioning glands is of paramount importance to prevent unnecessary surgical exploration. Unfortunately, the number of false negative or inconclusive results in standard imaging techniques is rather high. The aim of this study is to evaluate the diagnostic accuracy of 18F-Fluorcholine-PET/CT (FCH-PET/CT) and its sensitivity in a large cohort of patients with primary as well as secondary/tertiary and familial HPT with negative and/or discordant findings in ultrasound and/or 99mTc-sestamibi scintigraphy/SPECT/CT. Methods Between 2015 and 2020 96 patients with HPT and negative/equivocal conventional imaging were referred for FCH-PET/CT. 69 patients who have undergone surgery and histopathologic workup were analyzed in this retrospective single institution study. 60 patients suffered from primary HPT, 4 from secondary or tertiary HPT and 5 from familial HPT. Sensitivities, positive predictive values, and accuracies were calculated. Results All patients showed normalized serum calcium levels in the direct postoperative period. 50 of 60 patients (8 results are awaited) with primary HPT and 4 of 4 patients with secondary/tertiary HPT showed normal calcium levels after 6 months and were cured. 4 of 5 patients with familial HPT were cured as well while 1 patient deceased before 6 month follow up. Sensitivity per lesion for primary HPT was 88%, for secondary/tertiary HPT 75% and for familial HPT 75%, respectively. Sensitivity per patient was 92% for primary HPT, 100% for secondary/tertiary HPT and 50% for familial HPT, respectively. Positive predictive value was 98% in primary HPT and 100% in secondary/tertiary HPT and 100% in familial HPT as well. Conclusion Diagnostic accuracy of 18F-Fluorcholine-PET/CT for patients with primary as well as secondary/tertiary and familial hyperparathyreoidism ist excellent . 18F-Fluorcholine-PET/CT is a valuable tool for endocrine surgeons to optimize the surgical treatment of patients with hyperparathyroidism.

scholarly journals Determination of Serum B12 Vitamin and Folic Acid Levels in Patient with Stroke

2001 ◽  
Vol 44 (1) ◽  
pp. 37-39
Author(s):  
Necat Yılmaz ◽  
Mustafa Yılmaz ◽  
Sadrettin Pençe ◽  
Jale Özaslan ◽  
Hasan Koçoğlu ◽  
...  
Keyword(s):  
Folic Acid ◽  
Imaging Techniques ◽  
Control Group ◽  
Vitamin B ◽  
Significant Difference ◽  
Brain Tomography ◽  
Magnetic Resonance Imaging Techniques ◽  
And Control

The aim of this study is to evaluate whether any relationship between stroke and vitamin B12, folic acid concentration. We examined 50 patients with stroke (male: 26 and female: 24) aged between (X±SD, year) 59±14 and 16 control subjects (male: 6 and female: 10) aged between (X±SD, year) 53±11. Patients were classified into two groups as infarct and hemorrhagic by using Computerised Brain Tomography and Cranial Nuclear Magnetic Resonance Imaging techniques. The percentage of patients with infract was 47.5 % in female and 52.5 % in male while it was 40 % in female and 60 % in male with hemorrhagic. The vitamin B12 levels of patients with infarct, hemorrhagic and control group were found as X±SEM, 355±47 pg/ml, 313±58 pg/ml, 1569±258 pg/ml and folic acid levels 13.4±2.6 ng/ml, 7.7±1.0 ng/ml, 14.8±4.0 ng/ml, respectively. The significant difference was found between subgroups of patients with stroke and control group in both folic acid and B12 vitamin levels (p<0.001 and p<0.0001, respectively). But, there was no significant difference between vitamin B12 and folic acid levels of patients with hemorrhagic and infarct. In order to well understand the effects of these vitamin in patients with stroke, more detailed follow up studies with long period are needed.

scholarly journals Multiple Supernumerary Teeth in a Nonsyndromic 12-Year-Old Female Patient - A Case Report

2014 ◽  
Vol 25 (1) ◽  
pp. 79-82
Author(s):  
Thiago de Santana Santos ◽  
Erick Ricardo Silva ◽  
Ana Célia Faria ◽  
Francisco Veríssimo de Mello Filho ◽  
Samuel Porfírio Xavier
Keyword(s):  
Case Report ◽  
Female Patient ◽  
Imaging Techniques ◽  
Correct Diagnosis ◽  
Radiographic Examination ◽  
Dental Arch ◽  
Cleidocranial Dysplasia ◽  
Supernumerary Teeth ◽  
Radiographic Images

Supernumerary teeth (ST) are uncommon alterations of development that may appear in either of the dental arches and that are frequently associated with syndromes such as cleidocranial dysplasia and Gardner syndrome. Multiple ST in individuals with no other disease or syndrome are very rare. In view of this situation, correct diagnosis, treatment and evaluation of ST with the use of appropriate imaging techniques are highly important. This case report presents radiographic images of a nonsyndromic 12-year-old female patient who presented with 14 supernumerary teeth and was treated under general anesthesia, with the extraction of all ST in a single surgical intervention. During the postoperative period, the patient did not complain of pain nor did she present any signs or symptoms of infection. During late follow-up period, due to difficulty in traction of the maxillary right canine and mandibular left first premolar towards the dental arch, it was necessary to extract these teeth under local anesthesia. Radiographic examination 3 years after surgery revealed the absence of ST and of diseases related to the existence of these teeth.

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