scholarly journals Bi-Polar RF, Still the Gold Standard for Non-Invasive Fat Volume Reduction

2015 ◽  
Vol 05 (04) ◽  
pp. 247-253
Author(s):  
James K. M. Chan ◽  
Inna Belenky ◽  
Monica Elman
Keyword(s):  
Gold Standard ◽  
Volume Reduction ◽  
Non Invasive ◽  
Fat Volume

Diagnostic efficacy and suitability of trans-thoracic ultrasonography for pleural fluid detection – The future non-invasive gold-standard?

2020 ◽  
Vol 13 (4) ◽  
pp. 184-190
Author(s):  
Muhammad Irfan ◽  
Abdul Rasheed Qureshi ◽  
Zeeshan Ashraf ◽  
Muhammad Amjad Ramzan ◽  
Tehmina Naeem ◽  
...  
Keyword(s):  
Pleural Effusion ◽  
Diagnostic Accuracy ◽  
Pleural Fluid ◽  
Gold Standard ◽  
Pleural Effusions ◽  
Diagnostic Efficacy ◽  
Chest Sonography ◽  
X Ray ◽  
Non Invasive ◽  
Fluid Detection

ABSTRACT Background: Conventionally Pleural effusions are suspected by history of pleuritis, evaluated by physical signs and multiple view radiography. Trans-thoracic pleural aspiration is done and aspirated pleural fluid is considered the gold-standard for pleural effusion. Chest sonography has the advantage of having high diagnostic efficacy over radiography for the detection of pleural effusion. Furthermore, ultrasonography is free from radiation hazards, inexpensive, readily available  and feasible for use in ICU, pregnant and pediatric patients. This study aims to explore the diagnostic accuracy of trans-thoracic ultrasonography for pleural fluid detection, which is free of such disadvantages. The objective is to determine the diagnostic efficacy of trans-thoracic ultrasound for detecting pleural effusion and also to assess its suitability for being a non-invasive gold-standard.   Subject and Methods: This retrospective study of 4597 cases was conducted at pulmonology  OPD-Gulab Devi Teaching Hospital, Lahore from November 2016 to July 2018. Adult patients with clinical features suggesting pleural effusions were included while those where no suspicion of pleural effusion, patients < 14 years and pregnant ladies were excluded. Patients were subjected to chest x-ray PA and Lateral views and chest ultrasonography was done by a senior qualified radiologist in OPD. Ultrasound-guided pleural aspiration was done in OPD & fluid was sent for analysis. At least 10ml aspirated fluid was considered as diagnostic for pleural effusion. Patient files containing history, physical examination, x-ray reports, ultrasound reports, pleural aspiration notes and informed consent were retrieved, reviewed and findings were recorded in the preformed proforma. Results were tabulated and conclusion was drawn by statistical analysis. Results: Out of 4597 cases, 4498 pleural effusion were manifested on CXR and only 2547(56.62%) pleural effusions were proved by ultrasound while 2050 (45.57%) cases were reported as no Pleural effusion. Chest sonography demonstrated sensitivity, specificity, PPV, NPV and diagnostic accuracy 100 % each. Conclusions: Trans-thoracic ultrasonography revealed an excellent efficacy that is why it can be considered as non-invasive gold standard for the detection of pleural effusion.

scholarly journals Buccal swabs as non-invasive specimens for detection of severe acute respiratory syndrome coronavirus-2

2021 ◽  
Vol 49 (5) ◽  
pp. 030006052110169
Author(s):  
Ritu Gaur ◽  
Dipesh Kumar Verma ◽  
Ritin Mohindra ◽  
Kapil Goyal ◽  
Shipra Gupta ◽  
...  
Keyword(s):  
Severe Acute Respiratory Syndrome ◽  
Internal Control ◽  
Gold Standard ◽  
Detection System ◽  
Buccal Swab ◽  
Non Invasive ◽  
Human Rnase ◽  
Buccal Swabs ◽  
Reverse Transcription Quantitative Pcr ◽  
Env Protein

Introduction The current gold standard for detection of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) RNA involves subjecting nasopharyngeal or oropharyngeal swabs to reverse transcription quantitative PCR (RT-qPCR). However, both sample types need to be collected by trained professionals. Using self-collected buccal swabs as an alternative could simplify and accelerate diagnosis of coronavirus disease 2019 (COVID-19). Objective To assess self-collected buccal swab samples as an alternative method for SARS-CoV-2 detection in patients with COVID-19. Methods Buccal swab samples were self-collected by 73 patients with COVID-19. Total RNA was extracted using Qiagen kits. RNA encoding the SARS-CoV-2 Env protein and human RNase P as an internal control was amplified using the TRUPCR® SARS-CoV-2 RT-qPCR kit version 2.1 and a Bio-Rad CFX96 Real-Time Detection System. Result The sensitivity of RT-qPCR from buccal swabs was 58.9% (43/73; 95% confidence interval [CI] 46.77%–70.27%) and that of RT-qPCR from saliva was 62.90% (39/62; 95% CI 49.69%–74.84%) taking positive SARS-CoV-2 RT-qPCR from nasopharyngeal swabs as the gold standard. Conclusion Self-collected buccal swabs are promising alternatives to nasopharyngeal or oropharyngeal swabs for SARS CoV-2 detection.

Diagnostic accuracy of Instantaneous Wave-Free Ratio (iFR) for the assessment of myocardial ischaemia: a comparison with non-invasive stress imaging

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
L Stazzoni ◽  
L Tessandori ◽  
P Spontoni ◽  
M Angelillis ◽  
C Giannini ◽  
...  
Keyword(s):  
Diagnostic Accuracy ◽  
Myocardial Ischaemia ◽  
Gold Standard ◽  
Coronary Revascularization ◽  
Stress Test ◽  
Invasive Coronary Angiography ◽  
Coronary Syndrome ◽  
Non Invasive ◽  
Coronary Stenoses ◽  
Epicardial Stenosis

Abstract Background Instantaneous Wave-Free Ratio (iFR) allows for the assessment of the haemodynamic effects of epicardial coronary stenoses without the need for hyperaemia; iFR is currently recommended as a means to evaluate myocardial ischaemia. Purpose To assess the diagnostic accuracy of iFR with respect to the identification of coronary epicardial stenoses causing ischemia. Therefore, we combined anatomical (% stenosis at invasive coronary angiography, ICA) and functional (non-invasive imaging stress test, NIST) information to obtain a “gold standard” for the identification of stenoses causing ischaemia. Methods We enrolled 71 patients (52 male, 19 female; age mean 68.4±8.1 years) with chronic coronary syndrome or low-risk acute coronary syndrome without ST segment elevation who had at least a NIST and who had at least one vessel with a 50%-85% stenosis at ICA. iFR was measured in all coronary arteries with stenosis &gt;50% and categorised according to the 0.89 threshold for ischaemia. Results iFR was assessed in 122 vessels. In a per-vessel analysis, in 56.7% ischaemia was present both at iFR and NIST, in 21.3% ischaemia was absent in both, while in 23.0% ischaemia was found at NIST but not confirmed by iFR. The overall accuracy of iFR with respect to NIST was 90.1%. However, when considering as the “gold standard” for coronary disease causing ischaemia the contemporary presence of an epicardial stenosis &gt;70% at ICA and a positive NIST, the diagnostic accuracy of iFR greatly improved. The sensibility, specificity, PPV, NPV and accuracy were 96.5%, 75.0%, 73.3%, 96.7% and 84.4%, respectively. In case of discordance between NIST and iFR, revascularization was based on iFR. At a mean follow-up of 23±18 months, the composite endpoint of MACE (major adverse cardiac events, defined as the composite of all-cause death, nonfatal MI and unplanned coronary revascularization) occurred in 16.4%, while death/MI occurred in 11.9%. Stratification according to the per-patient concordance between iFR and NIST showed no significant differences in rates of MACE (p=0.50) and death/MI (p=0.20). Stratification based on iFR showed a higher death/MI rate in iFR-positive patients (11.9% vs. 0%, p=0.047) and a trend to higher MACE rate (11.9% vs. 4.47% p=0.14), Conclusions The diagnostic accuracy of iFR is low when compared with NIST as the reference for myocardial ischaemia, but it is very high when compared with the combined presence of epicardial stenosis and positive NIST. Therefore, iFR can accurately guide the decision to treat or defer revascularization of intermediate coronary stenoses, being most useful in patients with multivessel CAD and when non-invasive functional data are lacking or discordant with anatomy. Funding Acknowledgement Type of funding source: None

scholarly journals miRNAs and lncRNAs: Potential Non-Invasive Biomarkers for Endometriosis

Biomedicines ◽  
2021 ◽  
Vol 9 (11) ◽  
pp. 1662
Author(s):  
Ioana Maria Maier ◽  
Adrian Cornel Maier
Keyword(s):  
Clinical Trials ◽  
Minimally Invasive ◽  
Gold Standard ◽  
Noncoding Rnas ◽  
Long Noncoding Rnas ◽  
Diagnostic Methods ◽  
Non Invasive ◽  
Invasive Method ◽  
Minimally Invasive Methods ◽  
Exploratory Laparoscopy

Many studies have tried to understand the mechanism of endometriosis and its manner of manifestation. However, the only method of diagnosis considered as the gold standard in endometriosis is an invasive method called exploratory laparoscopy. Hence, there is a need to identify non-invasive or minimally invasive methods to minimize patients’ suffering, thus increasing their addressability at the earliest possible staging of the disease, and to diagnose this condition as soon as possible. miRNAs (microRNAs) and lncRNAs (long-noncoding RNAs) are potential non-invasive diagnostic methods for endometriosis. Multiple clinical trials indicate that miRNA can be used as a non-invasive method in the diagnosis and differentiation of endometriosis stages.

scholarly journals Non-Invasive Scale Measurement of Cardiac Output Compared with the Gold-Standard Direct Fick Method: A Feasibility Study

2021 ◽  
Author(s):  
Daniel Yazdi ◽  
Sarin Patel ◽  
Suriya Sridaran ◽  
Evan Wilson ◽  
Sarah Smith ◽  
...  
Keyword(s):  
Cardiac Output ◽  
Stroke Volume ◽  
Cardiac Function ◽  
Exercise Test ◽  
Gold Standard ◽  
Cardiopulmonary Exercise Test ◽  
Cardiac Monitoring ◽  
Non Invasive ◽  
Cardiopulmonary Exercise ◽  
The Mean

AbstractBackgroundObjective markers of cardiac function are limited in the outpatient setting and may be beneficial for monitoring patients with chronic cardiac conditions.ObjectiveWe assess the accuracy of a scale, with the ability to capture ballistocardiography, electrocardiography, and impedance plethysmography signals from a patient’s feet while standing on the scale, in measuring stroke volume and cardiac output compared to the gold-standard direct Fick method.MethodsThirty-two patients with unexplained dyspnea undergoing level 3 invasive cardiopulmonary exercise test at a tertiary medical center were included in the final analysis. We obtained scale and direct Fick measurements of stroke volume and cardiac output before and immediately after invasive cardiopulmonary exercise test.ResultsStroke volume and cardiac output from a cardiac scale and the direct Fick method correlated with r = 0.81 and r = 0.85, respectively (P < 0.001 each). The mean absolute error of the scale estimated stroke volume was -1.58 mL, with a 95% limits of agreement (LOA) of -21.97 mL to 18.81 mL. The mean error for the scale estimated cardiac output was -0.31 L/min, with a 95% LOA of -2.62 L/min to 2.00 L/min. The change in stroke volume and cardiac output before and after exercise were 78.9% and 96.7% concordant, respectively between the two measuring methods.ConclusionsThis novel scale with cardiac monitoring abilities may allow for non-invasive, longitudinal measures of cardiac function. Using the widely accepted form factor of a bathroom scale, this method of monitoring can be easily integrated into a patient’s lifestyle.

scholarly journals Progress of non-invasive diagnostic of liver fibrosis: review of modern laboratory methods

2020 ◽  
pp. 224-232
Author(s):  
E. A. Kulebina ◽  
A. N. Surkov
Keyword(s):  
Liver Fibrosis ◽  
Gold Standard ◽  
Diagnostic Techniques ◽  
Serum Markers ◽  
Diagnostic Systems ◽  
Non Invasive ◽  
Type Iv ◽  
Acid Type ◽  
Experimental Laboratory ◽  
Invasive Techniques

Fibrosis and cirrhosis are traditionally diagnosed by making a biopsy. However, in recent decades, scientists around the world have shown that the accepted “gold standard of diagnosis” – morphological assessment of biopsy – has a number of limitations. The search for non-invasive techniques to diagnose fibrosis has led to the development of many scales using laboratory indices. Non-invasive diagnostic techniques are safer for the patient than liver biopsy. In addition, they can be repeated in a dynamic to assess the condition of the liver over time. Most currently available non-invasive diagnostic techniques are considerably cheaper than the accepted “gold standard”. Their practical use is increasing every year, and in a number of countries the frequency of liver biopsies in viral hepatitis B and C is steadily decreasing due to the development of serum and imaging diagnostic systems. Recent studies show that the assessment of the degree of fibrosis by non-invasive methods is as accurate as a morphological study. In recent years, a number of serum markers have been considered as non-invasive diagnostics of the stages of liver fibrosis, among which the largest number of studies are devoted to hyaluronic acid, type IV collagen, and their combination with various common laboratory tests. The latest non-invasive techniques will make a significant paradigm shift in the evaluation of liver fibrosis in the near future. In this review we have analyzed widely used as well as experimental laboratory techniques used in the diagnosis of liver fibrosis.

STUDY ON EFFICACY OF ULTRASOUND AND FOB IN CONFIRMING THE PLACEMENT OF LARYNGEAL MASK AIRWAY

2021 ◽  
pp. 48-49
Author(s):  
Ganga Nagalakshmi ◽  
Subha J.
Keyword(s):  
Test Performance ◽  
Predictive Value ◽  
Gold Standard ◽  
Linear Structure ◽  
Invasive Technique ◽  
Non Invasive ◽  
Optimal Depth ◽  
Correct Placement ◽  
Linear Probe ◽  
Standard Tool

Ultrasound is a safe and non invasive technique for assessing the airway . In this observational study, 60 patients belonging to ASAClasses I and II scheduled for elective general surgery without any airway abnormality were included. Squared wave of capnogramTransverse neck ultrasound was performed using linear probe (8- 13Hz) started from hyoid bone (hyperechoic supercial inverted Ushaped linear structure)probe moved caudally with slight cephalad angle visualization of vocal cord & arytenoids. The Ultrasound arytenoid grade had a signicant correlation with LMA rotation grade.The incidence of LMAMalposition by ultrasound was found to be 80% .With regard to the test performance ,US was found to have a sensitivity of 92%,with a positive predictive value of 94% to detect the LMA rotation of any number of degrees. The specicity was 62% with a negative predictive value of 55%. FOB Examination is the gold standard tool for conrmation of the correct placement of LMA. ,we evaluated USG as a tool to conrm the placement comparing with the FOB examinationThe FOB examination is invasive & interrupts the ventilation during procedure. It cannot be done frequently intra-operatively compromising ventilation. These problems can be overcome by using ultrasound.USG detects the rotation of LMAeven if it is positioned at optimal depth thereby predicting the chance of dislodgement during the course of surgery.

scholarly journals Ultrasound - first imaging modality in the detection of parathyroid adenomas

2008 ◽  
Vol 12 (3) ◽  
pp. 64 ◽  
Author(s):  
R Ahmed ◽  
N Khan ◽  
S Ellemdin ◽  
K Gayaparsad
Keyword(s):  
Nuclear Medicine ◽  
High Resolution ◽  
Gold Standard ◽  
Imaging Modality ◽  
Non Invasive ◽  
Highly Sensitive ◽  
Parathyroid Adenomas ◽  
Thyroid Adenomas ◽  
Invasive Method ◽  
Ultrasound Features

Abstract We present a series of 12 patients in whom the typical ultrasound features of parathyroid adenomas were accurately demonstrated. High resolution ultrasound [in experienced hands] is a highly sensitive accurate, safe and non invasive method of localizing parathyroid adenomas especially in patients with typically located glands and an absence of thyroid pathology. Our aim was to compare ultrasound with nuclear medicine as an imaging gold standard in patients with thyroid adenomas.

Reliability of a New Method to Determine Foot Arch Height for Clinicians

2019 ◽  
Vol 109 (3) ◽  
pp. 187-192
Author(s):  
James A. Charles ◽  
Clare Mignot ◽  
Herbert F. Jelinek
Keyword(s):  
Gold Standard ◽  
Routine Clinical Practice ◽  
Arch Height ◽  
Linear Modeling ◽  
Important Indicator ◽  
Non Invasive ◽  
Foot Arch ◽  
Arch Index ◽  
Post Hoc ◽  
Processing Steps

Background: Arch height is an important indicator of risk of foot pathology. The current non-invasive gold standard based on footprint information requires extensive pre-processing. Methods used to obtain arch height that are accurate and easier to use are required in routine clinical practice. Methods: The proposed arch index diagonals (AId) method for determining the arch index (AI) reduces the complexity of the preprocessing steps. All footprints were first prepared as required by the Cavanagh and Rodgers method for determining the AI and then compared to the proposed diagonals method. Results were classified according to the Cavanagh and Rodgers cut-off values into three groups of low, normal and high AI. ANOVA and Tukey's post hoc tests were applied to identify significant differences between AI groups. Linear modeling was applied to determine the fit of the new AId method compared to the Cavanagh and Rodgers AI. Results: One hundred and ninety-six footprints were analyzed. The ANOVA indicated significant differences between the groups for AId (F1,194=94.49, p&lt;0.0001) and the Tukey post hoc tests indicated significant differences between the pair-wise comparisons (p&lt;0.001). Linear modeling indicated that the AId ratio classified more footprints in the high arch group compared to Cavanagh and Rodgers results (R2=32%, p&lt; 0.01). Intra- and inter-rater correspondence was above 90% and confirmed that the AId results provided a better indication of arch height. Conclusions: The proposed method simplifies current processing steps to derive the arch height.

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