scholarly journals Reliability and relationship of colposcopical, cytological and hystopathological findings in the diagnostic process

2012 ◽  
Vol 69 (10) ◽  
pp. 869-873 ◽  
Author(s):  
Vera Milenkovic ◽  
Radmila Sparic ◽  
Jelena Dotlic ◽  
Lidija Tulic ◽  
Ljiljana Mirkovic ◽  
...  
Keyword(s):  
Predictive Value ◽  
Diagnostic Method ◽  
Diagnostic Methods ◽  
Diagnostic Process ◽  
Final Decision ◽  
Gynecology And Obstetrics ◽  
Clinical Center ◽  
Negative Findings ◽  
Malignant Changes ◽  
Relationship Of

Background/Aim. The question about the accuracy of cytology and colposcopy is more and more asked due to false positive and negative findings on the basis of which the decision on biopsy is made. The aim of this study was to examine reliability of biopsies based only on abnormal colposcopical findings, before receiving the results of Papanicolaou (PA) smear, by comparing findings of colposcopical, cytological and histopathological (HP) examinations as well as determining validity of these diagnostic methods. Methods. The study involved all patients who had their regular colposcopical and cytological examinations in the outpatient department during a two-year period (2009-2010) in the Clinic for Gynecology and Obstetrics, Clinical Center of Serbia, Belgrade. The material for HP examination was obtained by colposcopically directed biopsy, due to abnormal colposcopical findings and without waiting for PA smear results. The data obtained by these methods were statistically analyzed and compared. Furthermore, validity of colposcopical and cytological examinations was assessed. Results. Out of 127 patients highly significantly more patients had more malignant cervical changes on colposcopical exam compared to HP (p = 0.000), and cytological exam (p = 0.000). Highly significantly more patients had more malignant cervical changes on PA smear than HP exam (p = 0.000), unless when findings were assessed in the widest sense of benign and malignant changes when there were no significant differences in these findings (p = 0,450). Sensitivity of colposcopy as a diagnostic method was 87.5%, specificity 24.14%, positive predictive value (+PV) was 34.65% and negative predictive value (-PV) 80.77%. Sensitivity of PA smear as a diagnostic method was 62.5%, specificity 87.36%, +PV was 69.44%, and -PV 83.52%. Conclusion. Regarding the results of our study it is best to make a decision on treatment according to findings of all the three methods. Cytological analysis is more reliable than colposcopical examination. Therefore, it is advisable that following abnormal colposcopical findings, PA smear should always be taken and only after receiving the results further diagnostics can be planned (biopsy and HP). A final decision on the therapy has to be made based on HP findings which are the only method that can give the ultimate reliable diagnosis of cervical changes.

scholarly journals A Novel Diagnostic Model for Primary Adrenal Lymphoma

2021 ◽  
Vol 12 ◽  
Author(s):  
Kai Yu ◽  
Qingping Xue ◽  
Fangli Zhou ◽  
Haoming Tian ◽  
Qiao Xiang ◽  
...  
Keyword(s):  
Validation Study ◽  
Predictive Value ◽  
Diagnostic Method ◽  
Diagnostic Process ◽  
Primary Study ◽  
Diagnostic Model ◽  
Primary Adrenal Lymphoma ◽  
Adrenal Biopsy ◽  
Adrenal Lymphoma ◽  
Adrenal Masses

ObjectivePrimary adrenal lymphoma (PAL) is easily misdiagnosed as other adrenal masses, such as adrenocortical carcinoma and pheochromocytoma, but patients with PAL benefit little from surgery. The diagnostic method for PAL thus far is limited to adrenal biopsy. In our study, we aimed to develop a quick and efficient diagnostic method for PAL.Methods and ResultsAt the same institution, 505 patients (between 2009 and 2019) and 171 patients (between 2019 and 2020) were separately included in the primary and validation studies. Univariate and multivariate analyses were conducted to evaluate clinical manifestations, laboratory findings, and radiological characteristics. Four determinants (age, bilateral masses, high-density lipoprotein cholesterol, and lactate dehydrogenase) were selected and further incorporated into a regression model to screen PAL. Accordingly, the nomogram was developed for clinical practice. In the primary study, the nomogram showed good discrimination, with an area under the receiver operating characteristic (ROC) curve (AUC) of 95.4% (95% CI, 90.6%–100.0%). Further validation study verified the efficacy of the nomogram, with an AUC of 99.0% (95% CI, 96.9%–100.00%) and 100.0% in all patients and patients with bilateral masses, respectively, and a sensitivity/specificity/positive predictive value (PPV)/negative predictive value (NPV) of 66.67%/99.40%/66.67%/99.40%, 66.67%/100%/100%/92.86%, 50%/99.20%/50%/99.20%, and 100%/100%/100%/100%, in all patients, patients with bilateral adrenal masses, patients with nonfunctional adrenal masses, and patients with positive catecholamine results, respectively. The validation study also revealed a diagnostic specificity of 99.35% and 100% for patients with a unilateral adrenal mass and functional PCC, respectively.ConclusionsThe presented nomogram is the first user-friendly diagnostic model for PAL that simplifies the complex diagnostic process into personalized numeric estimates. We deem that patients who score below 50 are less likely to have PAL. We suggest that clinicians should arrange adrenal biopsy and surgery for patients with nonfunctional tumors and overt catecholamine-secreting tumors, respectively, who receive a score of 50 points or higher to confirm the diagnosis as soon as possible.

scholarly journals Prognostic and therapeutic implication of residual timorous tissue in cervix conizate

2007 ◽  
Vol 64 (1) ◽  
pp. 31-36
Author(s):  
Radomir Zivadinovic ◽  
Vekoslav Lilic ◽  
Aleksandra Petric ◽  
Aleksandra Tubic
Keyword(s):  
Therapeutic Approach ◽  
Statistical Significance ◽  
Statistical Processing ◽  
Positive Finding ◽  
Therapeutic Measure ◽  
Gynecology And Obstetrics ◽  
Significant Incidence ◽  
Clinical Center ◽  
Number Of Patients ◽  
Negative Findings

Background/Aim. Conization is an excisive technique used for both diagnostic and therapeutic purposes. If conizate margins do not show any pathologic changes (negative findings) it is also the only therapeutic measure which should be applied. In case of conizate margins affected by the disease (positive findings), it is necessary not only to assess various parameters but also to decide on a further therapeutic approach. The aim of this study was to determine the incidence of positive findings and its impact on a further optimal therapeutic approach choice. Methods. The data for analyses were retrospectively acquired through an insight into the medical records of the female patients who had undergone conization in the Institute for Gynecology and Obstetrics, Clinical Center of Serbia, within a period from 1995 to 2000. Histopathologic analyses of the bioptic and cervical conizate and reconizate samples were performed in the same institute. The acquired data were analyzed and statistically processed. Results. Within the above mentioned period, a total of 823 conizations were done. In 76 patients, positive findings were determined. The acquired data analysis revealed positive findings decrease during this period, yet with no statistical significance. Higher statistically significant incidence of positive findings, however, was revealed in the patients over 40 years of age. Also, a statistically significantly higher incidence of positive findings was revealed in the apex as compared with other localizations. During the period observed, there was the raise of the number of patients only followed up after the conization without reconization. Also evident was decreasing in the number of histerectomies followed by increasing in the number of reconizations, as the method for reintervention. The most common cause of histerectomy was the apex positive findings with no statistical significance, while of reconization it was positive finding on lateral conizate margins with statistical significance. The association of the apical conizate positive finding with that in the curettements in all the cases was in correlation with positive findings at reintervention. Conclusion. According to the results obtained by analyzing and statistical processing of the acquired data, it could be concluded that reconization does represent a more suitable reintervention in patients with positive conizate findings as compared to histerectomy.

The Accuracy of ACR TI-RADS Classification of Neck Ultrasound as a First-Line Diagnostic Approach for Thyroid Neoplasms in Pediatric Patients: A Retrospective Study

2018 ◽  
Vol 5 (1) ◽  
pp. 13-23
Author(s):  
Nikolai S. Grachev ◽  
Elena V. Feoktistova ◽  
Igor N. Vorozhtsov ◽  
Natalia V. Babaskina ◽  
Ekaterina Yu. Iaremenko ◽  
...  
Keyword(s):  
Thyroid Cancer ◽  
Predictive Value ◽  
Thyroid Nodules ◽  
Pediatric Patients ◽  
Thyroid Neoplasms ◽  
Diagnostic Methods ◽  
Diagnostic Approach ◽  
First Line ◽  
Neck Ultrasound

Background.Ultrasound (US)-guided fine-needle aspiration biopsy (FNAB) is the gold standard in diagnosing the pathological nature of undetermined thyroid nodules. However, in some instances limitations and shortcomings arise, making it insufficient for determining a specific diagnosis.Objective.Our aim was to evaluate the effectiveness of ACR TI-RADS classification of neck ultrasound as a first-line diagnostic approach for thyroid neoplasms in pediatric patients.Methods.A retrospective analysis was made of FNA and US protocols in 70 patients who underwent the examination and treatment at Dmitry Rogachev National Research Center between January 2012 and August 2017. In the retrospective series 70% (49/70) of patients undergone FNA and 43% (30/70) of them undergone repeated FNA. All US protocols were interpreted according to ACR TI-RADS system by the two independent experts. The clinical judgment was assessed using the concordance test and the reliability of preoperative diagnostic methods was analized.Results.According to histologic examination protocols, benign nodules reported greater multimorbidity 29% (20/70), compared with thyroid cancer 17% (12/70), complicating FNA procedure. A statistically significant predictor of thyroid cancer with a tumor size ACR TI-RADS showed a significant advantage of ACR TI-RADS due to higher sensitivity (97.6 vs 60%), specificity (78.6 vs 53.8%), positive predictive value (87.2 vs 71.4%), and negative predictive value (95.7 vs 41.2%). Concordance on the interpreted US protocols according to ACR TI-RADS classification between two experts was high, excluding accidental coincidence.Conclusion.The data support the feasibility of US corresponding to the ACR TI-RADS classification as a first-line diagnostic approach for thyroid neoplasm reducing the number of unnecessary biopsies for thyroid nodules.

DIAGNOSING QUALITY OF FRICTION SYSTEMS OF MECHANISMS OF DEVICES

2019 ◽  
Vol 1 (7) ◽  
pp. 10-13
Author(s):  
D. Yu. Ershov ◽  
I. N. Lukyanenko ◽  
E. E. Aman
Keyword(s):  
Surface Defects ◽  
Diagnostic Methods ◽  
Design Parameters ◽  
Diagnostic Model ◽  
Mechanical Assemblies ◽  
Local Defects ◽  
Relationship Of ◽  
The Relationship ◽  
Production And Operation

The article shows the need to develop diagnostic methods for monitoring the quality of lubrication systems, which makes it possible to study the dynamic processes of contacting elements of the friction systems of instrument mechanisms, taking into account roughness parameters, the presence of local surface defects of elements and the bearing capacity of a lubricant. In the present article, a modern diagnostic model has been developed to control the quality of the processes of production and operation of friction systems of instrument assemblies. With the help of the developed model, it becomes possible to establish the relationship of diagnostic and design parameters of the mechanical system, as well as the appearance of possible local defects and lubricant state, which characterize the quality of friction systems used in many mechanical assemblies of the mechanisms of devices. The research results are shown in the form of nomograms to assess the defects of the elements of friction mechanisms of the mechanisms of the devices.

scholarly journals Dermoscopic aspect of verrucous epidermal nevi: New findings

2019 ◽  
Author(s):  
ÖMER FARUK ELMAS ◽  
NECMETTİN AKDENİZ
Keyword(s):  
Polarized Light ◽  
Diagnostic Methods ◽  
The Other ◽  
Diagnostic Process ◽  
Fine Scale ◽  
Epidermal Nevus ◽  
Clinical Interpretation ◽  
New Findings ◽  
Clinical Variants ◽  
Histopathological Investigation

Background and Aim: Verrucous epidermal nevi are cutaneous hamartomas having many clinical variants. Dermoscopic features of verrucous epidermal nevus have rarely been investigated. We aimed to identify dermoscopic findings of the entity which will facilitate the diagnostic process by reducing the use of invasive diagnostic methods. Material and Methods: The study included the patients with histopathologically approved verrucous epidermal nevus. Clinical, dermoscopic and histopathological features of the patients were retrospectively reviewed and the findings identified were recorded. Dermoscopic examination was performed with a polarized-light handheld dermoscope with 10-fold magnification. Results: The most common dermoscopic features were thick brown circles, thick brown branched lines and terminal hairs. The most common vessel pattern was dotted vessels. Branched thick brown lines, brown globules, brown dots forming lines, serpiginous brown dots, white and brown exophytic papillary structures, fine scale, thick adherent scale and cerebriform structures were the other findings. Conclusion: We observed many vascular and non-vascular dermoscopic findings which have not been described previously for the entity. Dermoscopic examination of the verrucous epidermal nevi may lead more reliable clinical interpretation and thus it may reduce the need for histopathological investigation. Keywords: dermoscopy, large brown circles, verrucous epidermal nevus

scholarly journals Histopathological Changes in Helicobacter pylori Associated Gastritis and Scope of Special Stain and Immunohistochemistry as Diagnostic Aids

2020 ◽  
Vol 7 (50) ◽  
pp. 3027-3032
Author(s):  
Ruby Elizabeth Elias ◽  
Bindiya Gisuthan ◽  
Sreeganesh A.S
Keyword(s):  
Helicobacter Pylori ◽  
Positive Predictive Value ◽  
Negative Predictive Value ◽  
Chronic Gastritis ◽  
Predictive Value ◽  
Diagnostic Methods ◽  
P Value ◽  
Special Stain ◽  
Frequent Finding ◽  
H Pylori

BACKGROUND Helicobacter pylori associated chronic gastritis plays a vital role in the development of majority of gastric adenocarcinomas and most gastric MALT (Mucosa Associated Lymphoid Tissue) lymphomas. Many diagnostic methods are available for the identification of this organism. However, in gastroenterology practice, histopathological examination of biopsy samples provides visual identification of the pathogen and the associated mucosal changes with special stains like Giemsa. The aim of this study was to evaluate the efficacy of three stains H & E- (Haematoxylin and Eosin), Giemsa and IHC (Immunohistochemistry) in the identification of H. pylori. Associated histologic changes were noted and the relationship between the degree of colonisation and the activity and chronicity of gastritis were analysed. METHODS 585 gastric biopsies taken from dyspeptic patients were evaluated for gastritis, based on updated Sydney System. In 250 randomly selected cases, three staining methods were used. RESULTS Out of 585 cases, 413 (70.60 %) had features of chronic gastritis. Mild chronic gastritis was the commonest finding and is seen in most cases of mild H. pylori colonisation. When activity was monitored, mild activity was the most frequent finding [225 (38.46 %)]. Majority of the severe activity cases showed severe H. pylori colonisation. 13.16 %, 4.79 % and 7.35 % showed intestinal metaplasia, atrophy and dysplastic changes respectively. Out of 250 cases, H & E and Giemsa stains showed 45.6 % and 57.2 % positivity while IHC demonstrated maximum number of positivity (156 cases - 62.4 %). Sensitivity and specificity of H & E was found to be 77.90 % and 98.95 %, positive predictive value was 99.13 % and negative predictive value was 69.18 %. For Giemsa stain, sensitivity was 91.67 %, specificity was 100 %, positive predictive value was 100 % and negative predictive value was 87.85 %. DISCUSSION H. pylori gastritis was a frequent finding in dyspeptic patients in southern part of India. When chi-square test was done, a significant statistical relationship between the severity of H. pylori colonisation, activity and chronicity of gastritis was noted. P value was < 0.001. With the use of special stain, Giemsa and ancillary techniques like IHC, the detection rate of H. pylori was enhanced considerably. CONCLUSIONS With increasing number of H. pylori in the mucosa, there was increase in the chronicity and activity of gastritis. Although immunohistochemistry revealed more cases of H. pylori, Giemsa can be a cost-effective substitute, because of its high specificity and positive predictive value. KEYWORDS H. pylori Gastritis, Giemsa, Haematoxylin and Eosin Stain, Immunohistochemistry

scholarly journals Development of the city hospital in Novi Sad - part II

2019 ◽  
Vol 72 (7-8) ◽  
pp. 251-256
Author(s):  
Dusanka Dobanovacki ◽  
Nada Vuckovic ◽  
Radmila Gudovic ◽  
Vladimir Sakac ◽  
Milanka Tatic ◽  
...  
Keyword(s):  
Medical Rehabilitation ◽  
City Hospital ◽  
Financial Difficulties ◽  
Gynecology And Obstetrics ◽  
Clinical Center ◽  
Bed Capacity ◽  
1960S And 1970S ◽  
The 1960S ◽  
Novi Sad ◽  
Rehabilitation Clinic

At the end of the Second World War, the General State Hospital had seven departments, the same facilities, and the same bed capacity as in the pre-war period. In the newly formed state of Yugoslavia, intensive growth and modernization of the hospital began, despite the great financial difficulties. The hospital became the Main Provincial Hospital and new departments and services were established. Mainly during the 1960s and 1970s, ten new surgery departments were established, which later became independent clinics. The surgery departments occupied pavilions 1, 2, 3 and 4. Complex and contemporary abdominal and thoracic surgeries were performed. The Department of Internal Diseases became the Clinic of Internal Diseases and in 1964 it was moved to a newly equipped four-story building. The Clinic of Gynecology and Obstetrics was founded and it was moved into a modern, purpose-built facility with a 230 bed capacity for adult patients and 105 for newborns. Rapid progress has also been made in the development of the Clinic of Infectious Diseases, Clinic of Eye Diseases, Clinic of Ear, Nose and Throat Diseases, Neurology and Psychiatry Clinics, Clinic of Dermatovenereology Diseases, Medical Rehabilitation Clinic - as well as a modern laboratory, X-ray, blood transfusion, and polyclinic services. After the establishment of the Faculty of Medicine and the Clinical Center of Vojvodina, this large tertiary medical institution is the source of pride for Novi Sad. Founded 110 years ago, the hospital is still dedicated to providing better healthcare for patients.

scholarly journals Juvenile Type Granulosa Cell Tumor

2018 ◽  
Vol 19 (4) ◽  
pp. 389-392
Author(s):  
Branko Andric ◽  
Petar Arsenijevic ◽  
Nikola Jovic ◽  
Neda Arsenijevic ◽  
Zoran Protrka
Keyword(s):  
Female Patient ◽  
Granulosa Cell ◽  
Granulosa Cell Tumor ◽  
Cell Tumor ◽  
Plasma Testosterone ◽  
Histopathological Analysis ◽  
Gynecology And Obstetrics ◽  
Gynecological Examination ◽  
Clinical Center ◽  
Juvenile Type

Abstract Granulosa cell tumor is a type of neoplasm, which represents 2-5% of all ovarian cancers. About 5% of these tumors are juvenile- type and usually occur to girls before puberty and to women younger than thirty years of age. There are signs premature puberty or premature emergence of secondary sexual characteristics with irregular vaginal bleeding that occur to these kind of patients. To the rare cases, like this, the occurrence of granulosa cell tumors can cause the appearance of hyperandrogenism with high levels of plasma testosterone, leading to virilization which happened to this female patient. We will present the female patient who was 35 years old and which was originally hospitalized to the Clinic for Haematology Clinical Center Kragujevac, because of extreme fatigue accompanied by dizziness. During diagnostics the patient underwent to the complete gynecological examination. After gynecological examinations and necessary diagnostic procedures, it was decided continuing the treatment at the Clinic of Gynecology and Obstetrics Clinical Center Kragujevac, where she underwent a total abdominal hysterectomy with bilateral salpingo- oophorectomy for suspected uterine neoplasm. Histopathological analysis of the obtained material confirmed the presence of follicular cysts of both ovaries and juvenile type granulosa cell tumor on the right ovary; the uterus was enlarged with multiple fibroid tumors. Granulosa cell tumor should be suspected in the cases of girls and young females if there is present an ovarian cyst paired with signs of preterm puberty or hyperestrogenism. In this case, the presence of granulosa cell tumor was masked by signs of hyperandrogenism, which is not so typical, as well as the presence of uterine fibroids who have actually been the main cause for surgical treatment.

scholarly journals Identification of Multiple Outliers in a Generalized Linear Model with Continuous Variables

2016 ◽  
Vol 2016 ◽  
pp. 1-9 ◽  
Author(s):  
Loo Yee Peng ◽  
Habshah Midi ◽  
Sohel Rana ◽  
Anwar Fitrianto
Keyword(s):  
Generalized Linear Model ◽  
Diagnostic Method ◽  
Asymptotic Properties ◽  
Diagnostic Methods ◽  
Detection Methods ◽  
Diagnostic Tools ◽  
Continuous Variables ◽  
Numerical Examples ◽  
Multiple Outliers ◽  
Contamination Levels

In the statistical analysis of data, a model might be awfully fitted with the presence of outliers. Besides, it has been well established to use residuals for identification of outliers. The asymptotic properties of residuals can be utilized to contribute diagnostic tools. However, it is now evident that most of the existing diagnostic methods have failed in identifying multiple outliers. Therefore, this paper proposed a diagnostic method for the identification of multiple outliers in GLM, where traditionally used outlier detection methods are effortless as they undergo masking or swamping dilemma. Hence, an investigation was carried out to determine the capability of the proposed GSCPR method. The findings obtained from the numerical examples indicated that the performance of the proposed method was satisfactory for the identification of multiple outliers. Meanwhile, in the simulation study, two scenarios were considered to assess the validity of the proposed method. The proposed method consistently displayed higher percentage of correct detection, as well as lower rates of swamping and masking, regardless of the sample size and the contamination levels.

Diagnostic significance of magnetic resonance imaging in patients with cervical cancer after brachytherapy: a meta-analysis

2018 ◽  
Vol 60 (5) ◽  
pp. 670-676
Author(s):  
Ji Zhang ◽  
Weizhong Tian ◽  
Xinhua Bu ◽  
Xiulan Wang ◽  
Fangzheng Tian ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Cervical Cancer ◽  
Magnetic Resonance ◽  
Predictive Value ◽  
Residual Tumor ◽  
Uterine Cervical Cancer ◽  
Cochrane Library ◽  
Resonance Imaging ◽  
Diagnostic Significance ◽  
Gynecology And Obstetrics

Background Patients with uterine cervical cancer suffer high mortality. Accurate detection of a residual tumor by magnetic resonance imaging (MRI) during and after directed brachytherapy (BCT) is crucial for the success of cancer treatment and is a significant predictor of patient survival. Purpose To determine the diagnostic significance of MRI in detecting residual tumor tissue after BCT. Material and Methods The Web of Knowledge, Cochrane Library, and PubMed were systematically searched (January 1997 to December 2016) for post-brachytherapy MRI studies that measured residual tumors in patients with uterine cervical cancer. All data were analyzed using the Meta-Disc 1.4 program. Results Four clinical studies consisting of 163 patients (147 of whom were included in the present analysis) who were diagnosed with uterine cervical cancer according to the International Federation of Gynecology and Obstetrics (FIGO) staging system were included in the study. All the patients received BCT and underwent MRI detection of residual tumors tissue. In studies where the accuracy of MRI detection was confirmed by histological tests or gynecological tests, the summary estimates of specificity, sensitivity, positive predictive value, negative predictive value, and accuracy were 88.5%, 83.5%, 53.5%, 97.1%, and 84.3%, respectively. Conclusion MRI-directed BCT is commonly used for cervical cancer patients. Based on our investigation of four independent studies, MRI showed better prediction of positive results than negative results in patients with cervical cancer after BCT. However, more data on the greater numbers of patients are needed to establish the accuracy of MRI detection of cervical cancer after BCT.

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