The value of combined MRI, enhanced CT and 18F-FDG PET/CT in the diagnosis of recurrence and metastasis after surgery for ovarian cancer.

OBJECTIVE: The purpose of this article was to investigate the value of combined MRI, enhanced CT and 18F-FDG PET/CT in the diagnosis of recurrence and metastasis after surgery for ovarian cancer. METHODS: Ninety-five ovarian cancer patients were selected as the study subjects, all of them underwent surgical treatment, and MRI, enhanced CT and 18F-FDG PET/CT were performed on all of them in the postoperative follow-up, and the pathological results after the second operation were used as the diagnostic "gold standard". The diagnostic value (sensitivity, specificity, accuracy, negative predictive value and positive predictive value) of the three examination methods alone or in combination for the diagnosis of postoperative recurrence and metastasis of ovarian cancer was compared, and the detection rate was calculated when the lesion was the unit of study, so as to compare the efficacy of the three methods in the diagnosis of postoperative recurrent metastatic lesions of ovarian cancer. RESULTS: The sensitivity, specificity, accuracy, positive predictive value and negative predictive value of the combined group were higher than those of MRI and enhanced CT for recurrence and metastasis of ovarian cancer after surgery, and the specificity, accuracy and positive predictive value of the combined group were higher than those of the 18F-FDG PET/CT group, and those of the 18F-FDG PET/CT group were higher than those of the enhanced CT group (all P < 0.05). When the postoperative recurrent metastatic lesions of ovarian cancer were used as the study unit, the detection rate of lesions in the combined group was higher than that of the three examinations detected individually, and the detection rate of lesions in 18F-FDG PET/CT was higher than that of enhanced CT and MRI (P < 0.05). CONCLUSION: The combination of MRI, enhanced CT and 18F-FDG PET/CT can accurately diagnose recurrence and metastasis of ovarian cancer after surgery, detect recurrent metastatic lesions as early as possible, and improve patients' prognosis.

Diagnostic values of soluble triggering receptor expressed on myeloid cells (sTREM-1) and interferon-inducible protein-10 (IP-10) for severe mycoplasma pneumoniae pneumonia in children.

OBJECTIVE: Early diagnosis of Severity Mycoplasma Pneumoniae Pneumonia (SMPP) has been a worldwide concern in clinical practice. Two cytokines, soluble Triggering Receptor Expressed on Myeloid cells (sTREM-1) and Interferon-Inducible Protein-10 (IP-10), were proved to be implicated in bacterial infection diseases. However, the diagnostic value of sTREM-1 and IP-10 in MPP was poorly known. This study aimed to investigate the diagnostic value of sTREM-1 and IP-10 for SMPP. METHODS: In this prospective study, the authors enrolled 44 children with MPP, along with their clinical information. Blood samples were collected, and cytokine levels of sTREM-1 and IP-10 were detected with ELISA assay. RESULTS: Serum levels of sTREM-1 and IP-10 were positively correlated with the severity of MPP. In addition, sTREM-1 and IP-10 have significant potential in the diagnosis of SMPP with an Area Under Curve (AUC) of 0.8564 (p-value = 0.0001, 95% CI 0.7461 to 0.9668) and 0.8086 (p-value = 0.0002, 95% CI 0.6918 to 0.9254) respectively. Notably, the combined diagnostic value of sTREM-1 and IP-10 is up to 0.911 in children with SMPP (p-value < 0.001, 95% CI 0.830 to 0.993). CONCLUSIONS: Serum cytokine levels of sTREM-1 and IP-10 have a great potential diagnostic value in children with SMPP.

Diagnosis of SPECT/CT bone imaging combined with two serum examinations in patients with bone metastases from pulmonary cancer.

PURPOSE: To study the clinical diagnostic value of SPECT/CT bone imaging combined with two serum examinations in patients with bone metastases from pulmonary cancer. METHODS: The clinical data of 120 patients consistent with pulmonary cancer admitted to the First Affiliated Hospital of Hebei North University from March 2019 to December 2019 were selected for retrospective analysis, and they were divided into the bone metastasis group (n = 58) and non-bone metastasis group (n = 62) according to comprehensive evaluation result of X-ray, CT, MRI and clinical follow-up. The CT values of patients were obtained by SPECT/CT bone imaging to compare serum levels of ALP (alkaline phosphatase belongs to phosphoric monoester hydrolases, as a specific phosphatase, mainly in body tissues and body fluid) and BAP (bone alkaline phosphatase is formed by different modification and processing of alkaline phosphatase, and is mainly released by osteoblasts) and CT values of patients in both groups, using receiver operating characteristic (ROC) curve to evaluate the diagnostic efficacy of single detection and combined detection. RESULTS: SPECT/CT bone imaging in patients with bone metastasis from pulmonary cancer showed abnormal radioactive accumulation in spine, pelvis and bilateral ribs. Serum ALP, BAP and CT values in bone metastasis group were overtly higher than the non-bone metastasis group (P < 0.001). Logistic regression analysis showed that serum ALP, BAP and CT value were independent risk factors for bone metastasis from pulmonary cancer. The AUC value and Youden index of combined diagnosis were higher than those of single diagnosis. CONCLUSION: SPECT/CT bone imaging combined with serum detection of ALP and BAP in patients with pulmonary cancer is helpful for early diagnosis of bone metastasis, which provides more basis for the formulation and selection of clinical treatment options.

Diagnostic values of soluble triggering receptor expressed on myeloid cells (sTREM-1) and interferon-inducible protein-10 (IP-10) for severe mycoplasma pneumoniae pneumonia in children

Abstract Objective Early diagnosis of Severity Mycoplasma Pneumoniae Pneumonia (SMPP) has been a worldwide concern in clinical practice. Two cytokines, soluble Triggering Receptor Expressed on Myeloid cells (sTREM-1) and Interferon-Inducible Protein-10 (IP-10), were proved to be implicated in bacterial infection diseases. However, the diagnostic value of sTREM-1 and IP-10 in MPP was poorly known. This study aimed to investigate the diagnostic value of sTREM-1 and IP-10 for SMPP. Methods In this prospective study, the authors enrolled 44 children with MPP, along with their clinical information. Blood samples were collected, and cytokine levels of sTREM-1 and IP-10 were detected with ELISA assay. Results Serum levels of sTREM-1 and IP-10 were positively correlated with the severity of MPP. In addition, sTREM-1 and IP-10 have significant potential in the diagnosis of SMPP with an Area Under Curve (AUC) of 0.8564 (p-value = 0.0001, 95% CI 0.7461 to 0.9668) and 0.8086 (p-value = 0.0002, 95% CI 0.6918 to 0.9254) respectively. Notably, the combined diagnostic value of sTREM-1 and IP-10 is up to 0.911 in children with SMPP (p-value < 0.001, 95% CI 0.830 to 0.993). Conclusions Serum cytokine levels of sTREM-1 and IP-10 have a great potential diagnostic value in children with SMPP.

Diagnostic utility of salivary pepsin in laryngopharyngeal reflux: a systematic review and meta-analysis

Abstract Objective: Salivary pepsin has emerged as a biomarker for Laryngopharyngeal Reflux (LPR), which, however, has been questioned for its efficacy due to a lack of supporting medical data. Therefore, this study analyzed the diagnostic value of salivary pepsin for LPR and assessed a better cutoff value. Methods: Studies were searched in PubMed, Embase, and Cochrane Library from their receptions to October 1, 2021. Then, RevMan 5.3 and Stata 14.0 were utilized to summarize the diagnostic indexes for further meta-analysis. Data were separately extracted by two reviewers according to the trial data extraction form of the Cochrane Handbook. The risk of bias in Randomized Control Trials (RCTs) was evaluated with the Cochrane Risk of Bias Tool. Results: A total of 16 studies matched the criteria and were subjected to meta-analysis. The results revealed a pooled sensitivity of 61% (95% CI 50%-71%), a pooled specificity of 67% (95% CI 48%-81%), a positive likelihood ratio of 2 (95% CI 1.2-2.8), a negative likelihood ratio of 0.58 (95% CI 0.47-0.72), and the area under the receiver operating characteristic curve of 0.67 (95% CI 0.63-0.71). Subgroup analyses indicated that the cutoff value of pepsin at 50 ng/mL had a higher degree of diagnostic accuracy than that of pepsin at 16 ng/mL in cohort studies. Conclusion: The review demonstrated low diagnostic performance of salivary pepsin for LPR and that the cutoff value of 50 ng/mL pepsin had superior diagnostic accuracy. Nevertheless, the diagnostic value may vary dependent on the utilized diagnostic criteria. Therefore, additional research is needed on the improved way of identifying salivary pepsin in the diagnosis of LPR, and also longer-term and more rigorous RCTs are warranted to further assess the effectiveness of salivary pepsin.

Diagnostic utility of salivary pepsin in laryngopharyngeal reflux: a systematic review and meta-analysis.

OBJECTIVES: Salivary pepsin has emerged as a biomarker for Laryngopharyngeal Reflux (LPR), which, however, has been questioned for its efficacy due to a lack of supporting medical data. Therefore, this study analyzed the diagnostic value of salivary pepsin for LPR and assessed a better cutoff value. METHODS: Studies were searched in PubMed, Embase, and Cochrane Library from their receptions to October 1, 2021. Then, RevMan 5.3 and Stata 14.0 were utilized to summarize the diagnostic indexes for further meta-analysis. Data were separately extracted by two reviewers according to the trial data extraction form of the Cochrane Handbook. The risk of bias in Randomized Control Trials (RCTs) was evaluated with the Cochrane Risk of Bias Tool. RESULTS: A total of 16 studies matched the criteria and were subjected to meta-analysis. The results revealed a pooled sensitivity of 61% (95% CI 50%-71%), a pooled specificity of 67% (95% CI 48%-81%), a positive likelihood ratio of 2 (95% CI 1.2-2.8), a negative likelihood ratio of 0.58 (95% CI 0.47‒0.72), and the area under the receiver operating characteristic curve of 0.67 (95% CI 0.63‒0.71). Subgroup analyses indicated that the cutoff value of pepsin at 50 ng/mL had a higher degree of diagnostic accuracy than that of pepsin at 16 ng/mL in cohort studies. CONCLUSION: The review demonstrated low diagnostic performance of salivary pepsin for LPR and that the cutoff value of 50 ng/mL pepsin had superior diagnostic accuracy. Nevertheless, the diagnostic value may vary dependent on the utilized diagnostic criteria. Therefore, additional research is needed on the improved way of identifying salivary pepsin in the diagnosis of LPR, and also longer-term and more rigorous RCTs are warranted to further assess the effectiveness of salivary pepsin.

Comparison between carotid ultrasound and digital subtraction angiography in the diagnosis of carotid artery stenosis in patients with cerebral infarction / Comparación entre la ecografía carotídea y la angiografía por sustracción digital en el diagnostic de estenosis de la arteria carótida en pacientes con infarto cerebral

SUMMARY: This study aimed to compare the clinical value of carotid ultrasound and digital subtraction angiography (DSA) for carotid artery stenosis in patients with cerebral infarction. Sixty patients with cerebral infarction underwent carotid ultrasound and DSA. Carotid artery stenosis, degree of stenosis (mild, moderate, severe, and occlusion), and carotid artery plaques were recorded and compared. Carotid stenosis rate was 96.67 % (58/60) and 91.67 % (55/60) on DSA and carotid ultrasound, respectively, and the difference was not statistically significant. Mild, moderate, and severe carotid artery stenosis and occlusion were diagnosed in 35, 28, 20, and 17 arteries, respectively, with DSA, and in 39, 25, 10, and 9 arteries, respectively, with carotid ultrasound. There was a statistically significant difference in the degree of carotid stenosis between the two methods (p<0.05). The kappa value of carotid plaques detected by carotid ultrasound and DSA was 0.776, indicating good consistency. Both carotid ultrasound and DSA are effective for screening carotid artery stenosis and carotid atherosclerotic plaques. While carotid ultrasound is faster and more convenient, DSA can more accurately detect the degree of stenosis and presence of occlusion. Thus, our recommendation is a combination of carotid ultrasound and DSA in clinical settings to improve the convenience and accuracy of diagnosis.

Este estudio tuvo como objetivo comparar el valor clínico de la ecografía carotídea y la angiografía por sustracción digital (DSA) para la estenosis de la arteria carótida en pacientes con infarto cerebral. Sesenta pacientes con infarto cerebral fueron sometidos a ecografía carotídea y DSA. Se registraron y compararon la estenosis de la arteria carótida, el grado de estenosis (leve, moderada, grave y oclusión) y las placas de la arteria carótida. La tasa de estenosis carotídea fue del 96,67 % (58/60) y del 91,67 % (55/60) en DSA y ecografía carotídea, respectivamente, y la diferencia no fue estadísticamente significativa. Se diagnosticaron estenosis y oclusión de la arteria carótida leve, moderada y grave en 35, 28, 20 y 17 arterias, respectivamente, con DSA, y en 39, 25, 10 y 9 arterias, respectivamente, con ecografía carotídea. Hubo una diferencia estadísticamente significativa en el grado de estenosis carotídea entre los dos métodos (p<0,05). El valor kappa de las placas carotídeas detectadas por ecografía carotídea y DSA fue de 0,776, lo que indica una buena consistencia. Tanto la ecografía carotídea como la DSA son eficaces para detectar la estenosis de la arteria carótida y las placas ateroscleróticas carotídeas. Si bien la ecografía carotídea es más rápida y conveniente, la DSA puede detectar con mayor precisión el grado de estenosis y la presencia de oclusión. Por lo tanto, nuestra recomendación es una combinación de ecografía carotídea y DSA en entornos clínicos para mejorar la conveniencia y precisión del diagnóstico.

Assessing the Role of Uric Acid as a Predictor of Preeclampsia.

We assessed the diagnostic utility of uric acid for the prediction of preeclampsia. An observational prospective approach was carried out during 2014. Preeclamptic women were classified into 4 groups accordingly to the onset of preeclampsia and the presence of intrauterine growth restriction (IUGR). Serum uric acid levels, urea, and creatinine were measured. Receiver operating curves (ROC) of the uric acid levels ratio (UAr) between a dosage before and after the 20th week of gestation were performed. One thousand two hundred and ninety-third pregnant women were enrolled in this study. Eight hundred ten had non-complicated pregnancies, 40 preeclampsia, 33 gestational hypertension, and 20 IUGR without preeclampsia. Uric acid significantly raised after 20 weeks of gestation in women who develop preeclampsia before 34 weeks (Group A) or in those who develop preeclampsia after 37 weeks associated with IUGR (Group C). In women who develop preeclampsia after 34 weeks without IUGR (Groups B and D), uric acid increased after the 30th week of gestation. In all groups, UAr was greater than 1.5. In gestational hypertension, UAr was superior to 1.5 toward the end of gestation, while in IUGR without preeclampsia, the behavior of serum uric acid was similar to non-complicated pregnancies. In all cases, urea and creatinine showed normal values, confirming that patients had no renal compromise. ROC area was 0.918 [95% confidence interval (CI): 0.858-0.979) for the preeclampsia group and 0.955 (95% CI: 0.908-1.000) for Group A. UAr at a cut-off point ≥1.5 had a very low positive predictive value, but a high negative predictive value of 99.5% for preeclampsia and it reached 100% for Group A. Thus, a UAr less than 1.5 may be a helpful parameter with a strong exclusion value and high sensitivity for those women who are not expected to develop preeclampsia. Additionally, this low-cost test would allow for better use of resources in developing countries.

Correlation between the contrast-enhanced ultrasound image features and axillary lymph node metastasis of primary breast cancer and its diagnostic value.

PURPOSE: To analyze the correlation between contrast-enhanced ultrasound image features and axillary lymph node metastasis of primary breast cancer and its diagnostic value. METHODS: In this study, 64 patients with axillary lymph node metastasis of primary breast cancer diagnosed and treated in our hospital from February 2011 to March 2013 were collected as an observation group, and 54 patients without axillary lymph node metastasis were collected as a control group. All patients underwent a contrast-enhanced ultrasound examination, and the correlation between the contrast-enhanced ultrasound image features and axillary lymph node metastasis and its diagnostic value were analyzed. They were divided into two groups according to their survival conditions: the group with good efficacy and group with poor efficacy, and the prognostic factors of breast cancer in the two groups were analyzed. RESULTS: There were statistical differences in the peripheral acoustic halo, blood flow classification, ratio of length to diameter (L/D), maximum cortical thickness, and enhancement mode of lymph nodes between the two groups (p < 0.05). The area under ROC curve for diagnosis of axillary lymph node metastasis by contrast-enhanced ultrasound was 0.854, sensitivity was 83.33%, and specificity was 87.5%; L/D and enhancement mode were independent prognostic factors for breast cancer. CONCLUSIONS: Contrast-enhanced ultrasound image features have diagnostic and prognostic value for axillary lymph node metastasis of breast cancer.

Expression levels of SCCA and CYFRA 21-1 in serum of patients with laryngeal squamous cell carcinoma and their correlation with tumorigenesis and progression.

PURPOSE: To explore the concentration of squamous cell carcinoma antigen (SCCA), cytokeratin fragment antigen 21-1 (CYFRA21-1) in patients with laryngeal squamous cell carcinoma (LSCC) and its correlation with tumorigenesis and progression. METHODS: A total of 78 patients with LSCC admitted to our hospital from February 2010 to January 2016 were enrolled as the research group (RG), and another 41 healthy volunteers from the same period were selected as the control group (CG). The serum concentrations of SCCA and CYFRA21-1 in patients with LSCC were detected by ELISA, whose diagnostic value in LSCC were further analyzed by ROC curve. The prognosis and survival curves of patients with LSCC were observed according to the median value of serum SCCA and CYFRA21-1 concentrations. RESULTS: The concentration of CYFRA21-1 and SCCA in the RG was significantly higher than that in the CG (p < 0.050). The SCCA and CYFRA21-1 identified a significant difference in smoking, lymphatic metastasis, TNM staging, and differentiation degree (p < 0.050). The survival rate of the SCCA low-concentration group was significantly better than that of the high-concentration group, p < 0.050. The survival rate of the CYFRA21-1 low-concentration group was markedly better than that of the high-concentration group, p < 0.050. CONCLUSIONS: SCCA and CYFRA21-1 are highly concentrated in LSCC patients, which have good diagnostic efficacy for LSCC. In addition, they play some certain role in the occurrence and development of LSCC, and are expected to be markers for early diagnosis and prognosis of this disease.

Comparison of clinical diagnostic value of spiral CT with different dose in patients with early-stage peripheral lung cancer.

PURPOSE: To compare the clinical diagnostic value of spiral CT scan with different dose in patients with early-stage peripheral lung cancer. METHODS: A total of 163 cases of patients with early-stage peripheral lung cancer who came to People's Hospital of Rizhao for treatment from June 2014 to January 2017 were retrospectively analyzed. A total of 78 cases of patients who received low-dose CT scanning were the low-dose group, another 84 cases of patients who received routine dose CT scanning were the routine dose group. Multislice helical CT (MSCT) scanning was performed in both groups, with tube voltage of 120 kV. Tube current was 25 m A in the low-dose group and 250 m A in the routine dose group. In addition, a total of 80 patients with lobar pneumonia were added as the control group of diagnostic sensitivity, specificity and accuracy. Pathological diagnosis was taken as the gold standard to compare the diagnostic sensitivity, specificity and accuracy of the two groups. RESULTS: The image quality, nodules and signs of the two groups were compared, and the results of radiation dose of the two groups were compared. The diagnostic sensitivity, specificity and accuracy of the low-dose group were 82.05%, 87.50% and 84.81%, respectively. The diagnostic sensitivity, specificity and accuracy of the routine dose group were 85.71%, 86.25% and 85.97%, respectively. The diagnostic value of the two groups was not statistically significant (p > 0.05). However, the radiation dose in the low-dose group was significantly lower than that in the routine group. CONCLUSION: Low-dose MSCT scanning can meet the clinical requirements for imaging diagnosis of peripheral lung cancer, and can reduce the radiation dose of patients.

Long non-coding ribonucleic acid H19 and ten-eleven translocation enzyme 1 messenger RNA expression levels in uterine fibroids may predict their postoperative recurrence

OBJECTIVES: To investigate the predictive value of long non-coding RNA (lncRNA) H19 and the ten-eleven translocation enzyme 1 (TET1) transcriptional expression in postoperative recurrence of uterine fibroids (UFs). METHODS: Seventy-five patients with UF, who underwent surgical treatment, were enrolled in the treatment group, and 60 healthy individuals were enrolled in the control group. The relative expression levels of lncRNA H19 and TET1 mRNA in the serum and UF tissues were analyzed. The patients were further divided into a better curative (BC) group and a poor efficacy (PE) group to analyze the predictive value of lncRNA H19 and TET1 and the independent risk factors affecting the recurrence of UF. RESULTS: Compared with the control group, lncRNA H19 expression levels were significantly higher, while TET1 expression levels were significantly lower in the treatment group (p<0.001). The area under the receiver operating characteristic (ROC) curve (AUC) values of the two indicators for diagnostic importance were found to be 0.872 and 0.826, respectively. Compared with the PE group, lncRNA H19 expression levels were significantly lower, while TET1 expression levels were significantly higher in the BC group (p<0.001). The AUC values of the two indicators for their predictive efficacy were 0.788 and 0.812, respectively. Logistic regression analysis showed that age, menarche age, maximum diameter of UFs, number of UFs, lncRNA H19 levels, and TET1 levels were independent risk factors affecting UF recurrence. The AUC values of lncRNA H19 and TET1 for their predictive value for postoperative recurrence were 0.814 and 0.765, respectively. CONCLUSIONS: The lncRNA H19 and TET1 have high diagnostic and predictive efficacy for determining the postoperative recurrence of UFs.

Expression and significance of CK5/6, P63, P40, CK7, TTF-1, NapsinA, CD56, Syn and CgA in biopsy specimen of squamous cell carcinoma, adenocarcinoma and small cell lung carcinoma / Expresión y significado de CK5/6, P63, P40, CK7, TTF-1, NapsinA, CD56 Syn y CgA en muestras de biopsia de carcinoma de células escamosas, adenocarcinoma y carcinoma de células pequeñas de pulmón

Nine tumor and various potential biomarkers were measured and combined the information to diagnose disease, all patients accepted fiber bronchoscopy brush liquid based cytologyand histopathology examination in order to reliably detect lung cancer. The samples from 314 Chinese lung cancer patients were obtained and CK5/6, P63, P40, CK7, TTF-1, NapsinA CD56, Syn and CgA were measured with the immunohistochemical SP method and analyzed correlation of the expression of these markers with pathological and clinical features of squamous cell carcinoma, adenocarcinoma, and small cell lung carcinoma. Squamous cell carcinoma, adenocarcinoma and small cell carcinoma were 61 cases, 114 cases and 139 cases,CK5/6 and P63 expression were more frequent in squamous cell carcinoma, with sensitivity and specificity of 77.05 % and 96.44 %, 83.61 % and 88.93 %,and compared with adenocarcinoma and small cell carcinoma difference was statistically significant (P<0.05), The incidences of a positive P40 expression were 100 % in squamous cell carcinoma, with specificity of 98.81 %.CK7, TTF-1 and NapsinA expression were more frequent in adenocarcinoma, with sensitivity and specificity of 85.09 % and 78.69 %, 79.82 % and 93.44 %, 56.14 % and 95.08 %, and compared with squamous cell carcinoma and small cell carcinoma difference was statistically significant (P<0.05). TTF-1, Syn, CgA and CD56 expression were more frequent in adenocarcinoma, with sensitivity and specificity of 86.33 % and 93.44 %, 89.21 % and 98.36 %, 74.10 % and 100 %, 96.40 % and 96.72 %. The combined detection of CK5/6, P63 and P40 were more useful and specific in differentiating squamous cell carcinoma. CK7, TTF-1 and NapsinA were more useful and specific in differentiating lung adenocarcinoma. The impaired CD56, TTF-1, Syn and CgA reflects the progression of small cell lung cancer.

Se midieron tumores y utilizaron nueve biomarcadores potenciales y se analizó la información para diagnosticar la enfermedad. A todos los pacientes se les realizó citología en líquido con broncoscopía de fibra y examen histopatológico para detectar de manera confiable el cáncer pulmonar. Se obtuvieron muestras de 314 pacientes chinos con cáncer de pulmón y CK5 / 6, P63, P40, CK7, TTF-1, Napsina A, CD56, Syn y CgA se midieron a través de histoquímica SP y analizaron la correlación de la expresión de estos marcadores con características patológicas y clínicas de carcinoma de células escamosas, adenocarcinoma y carcinoma de células pequeñas en el cáncer de pulmón. El carcinoma de células escamosas, el adenocarcinoma y el carcinoma de células pequeñas fueron 61 casos, 114 casos y 139 casos, respectivamente, la expresión de CK5 / 6 y P63 fueron más frecuentes en el carcinoma de células escamosas, con una sensibilidad y especificidad del 77,05 % y 96,44 %, 83,61 % y 88,93 %, y en comparación con el adenocarcinoma y el carcinoma de células pequeñas, la diferencia fue estadísticamente significativa (P <0,05). La incidencia de ap la expresión positiva P40 fue del 100 % en el carcinoma de células escamosas, con una especificidad del 98,81 %. La expresión de CK7, TTF-1 y NapsinA fueron más frecuentes en el adenocarcinoma, con una sensibilidad y especificidad del 85,09 % y 78,69 %, 79,82 % y 93,44 %, 56,14 % y 95,08 %, y en comparación con el carcinoma de células escamosas y la diferencia de carcinoma de células pequeñas fue estadísticamente significativa (P <0,05) .TTF-1, Syn, CgA y la expresión de CD56 fueron más frecuentes en adenocarcinoma, con sensibilidad y especificidad de 86.33 % y 93.44 %, 89.21 % y 98.36 %, 74.10 % y 100 %, 96.40 % y 96.72 %. La detección combinada de CK5 / 6, P63 y P40 fue más útil y específica en la diferenciación del carcinoma de células escamosas. CK7, TTF-1 y NapsinA fueron más útiles y específicos para diferenciar el adenocarcinoma de pulmón. El deterioro de CD56, TTF-1, Syn y CgA refleja la progresión del cáncer de pulmón de células pequeñas.

Diagnostic Value of Anti-Fibrinogen Citrullinated Peptide in Rheumatoid Arthritis. / Valor diagnóstico de anticuerpos antipéptido citrulinado del fibrinógeno en la artritis reumatoide.

OBJECTIVE: To determinate the diagnostic value of an antibody against a citrullinated fibrinogen peptide in Cuban patients with rheumatoid arthritis, using an enzyme immunasay. MATERIALS AND METHODS: A citrullinated peptide of fibrinogen designed by informatics prediction was synthesized and used in an enzyme immunoassay. The participants were 81 patients with early disease, 81 patients with established disease, 58 patients with other rheumatic and inflammatory diseases, and 43 healthy individuals. Anti- citrullinated fibrinogen peptide, anti-mutated citrullinated vimentin, anti second generation citrullinated peptides and rheumatoid factor antibodies were determined by enzyme-linked immunosorbent assay. RESULTS: Determination of anti-citrullinated peptide of fibrinogen antibodies by the designed enzyme immunoassay showed the best diagnostic value in early rheumatoid arthritis patients, with the highest value sensitivity (84%), negative predictive value (85%), Youden index (0.73%) and area under the receiver operating curve (0.9192). Specificity (89%) and positive predictive value (88%) were higher than rheumatoid factor, similar to anti- mutated citrullinated vimentin, but lower than second generation anti-citrullinated peptides assay. The positivity of C-reactive protein was associated with the presence of anti- citrullinated fibrinogen peptide antibodies and the titres of these antibodies correlated with clinical activity in early disease. CONCLUSIONS: The immunoassay designed with a citrullinated fibrinogen peptide has a high diagnostic value and can identify patients with greater clinical activity in early rheumatoid arthritis.

[Diagnostic value of a predictive model for complete ruptures of the rotator cuff associated to subacromial impingement]. / Valor diagnóstico de un modelo de predicción clínico-radiográfico para rupturas completas del manguito de los rotadores por pinzamiento subacromial.

Pathology related to the rotator cuff remains among the most prevalent musculoskeletal diseases. There is an increasing need for imaging studies (MRI, US, arthroscopy) to test the diagnostic performance of the medical history and physical examination. OBJECTIVE: To prove the diagnostic value of a clinical-radiographic predictive model to find complete ruptures of the rotator cuff. MATERIAL AND METHODS: Descriptive, observational, prospective, transversal and analytical study. Fifty-five patients with preoperative shoulder pain were evaluated with 13 predictive variables: age > 50 years, nocturnal pain, muscle weakness, clinical signs of Neer, Hawkins, Jobe, external rotation lag (ERLS), belly-press, bear hug, and lift-off, radiographic measurement of subacromial space, acromial index and critical shoulder angle. Sensitivity, specificity, and positive and negative predictive values were measured in each variable, comparing the results of each one against the postoperative findings. RESULTS: Of the 55 patients evaluated, 42 had a complete rupture of the rotator cuff in the postoperative period. The eight variables with a higher diagnostic value were selected and a ROC curve was performed, providing an area under the curve of 0.88. CONCLUSIONS: This predictive model uses eight variables (age > 50 years, nocturnal pain, muscle weakness, Jobe, Hawkins, ERLS, subacromial space ≤ 6 mm, and critical shoulder angle > 35°), which together add the predictive value of 0.88 (AUC) to diagnose complete ruptures of the supraspinatus tendon.

La patología relacionada al manguito de los rotadores permanece entre las enfermedades musculoesqueléticas más prevalentes. Hay una creciente necesidad de estudios de imagen (RMN, US, artroscopía) para probar el rendimiento diagnóstico de la historia clínica y el examen físico. Objetivo: Demostrar el valor diagnóstico de un modelo predictor clínico-radiográfico para rupturas completas del manguito de los rotadores. Material y métodos: Estudio descriptivo, observacional, prospectivo, transversal, analítico. Se evaluaron 55 pacientes con dolor de hombro en forma preoperatoria con 13 variables de predicción: edad > 50 años, dolor nocturno, debilidad muscular, signos clínicos de Neer, Hawkins, Jobe, caída de la rotación externa, Napoleón, abrazo del oso, Gerber; medición radiológica del espacio subacromial, índice acromial y ángulo crítico del hombro. En cada variable se midió sensibilidad-especificidad, valor predictivo positivo y negativo. Se compararon los resultados de cada variable para diagnosticar rupturas del manguito de los rotadores contra los hallazgos postoperatorios. Resultados: De los 55 pacientes evaluados, 42 presentaron ruptura completa del mango rotador en el postoperatorio. Se seleccionaron las ocho variables con mayor valor diagnóstico y se realizó una curva ROC, proporcionando un área bajo la curva de 0.88. Conclusiones: Este modelo de predicción emplea ocho variables (edad > 50 años, dolor nocturno, debilidad muscular, caída de la rotación externa, Jobe, Hawkins, espacio subacromial ≤ 6 mm y ángulo crítico del hombro > 35°) que en conjunto suman el valor predictivo de 0.88 (AUC) para diagnosticar rupturas completas del tendón supraespinoso.

Comparison of Oropharyngeal and Nasopharyngeal Swab Specimens for the Detection of Mycoplasma pneumoniae in Children with Lower Respiratory Tract Infection.

The oropharyngeal swab specimen was superior to the nasopharyngeal swab specimen for the detection of Mycoplasma pneumoniae in children with lower respiratory tract infection. The oropharyngeal loop-mediated isothermal amplification had 100% sensitivity and specificity compared with polymerase chain reaction testing, whereas the oropharyngeal rapid antigen detection test using immunochromatographic assay had relatively low sensitivity (66%) and reasonable specificity (90.7%).

Valor diagnóstico de un modelo de predicción clínico-radiográfico para rupturas completas del manguito de los rotadores por pinzamiento subacromial / Diagnostic value of a predictive model for complete ruptures of the rotator cuff associated to subacromial impingement

Resumen: La patología relacionada al manguito de los rotadores permanece entre las enfermedades musculoesqueléticas más prevalentes. Hay una creciente necesidad de estudios de imagen (RMN, US, artroscopía) para probar el rendimiento diagnóstico de la historia clínica y el examen físico. Objetivo: Demostrar el valor diagnóstico de un modelo predictor clínico-radiográfico para rupturas completas del manguito de los rotadores. Material y métodos: Estudio descriptivo, observacional, prospectivo, transversal, analítico. Se evaluaron 55 pacientes con dolor de hombro en forma preoperatoria con 13 variables de predicción: edad > 50 años, dolor nocturno, debilidad muscular, signos clínicos de Neer, Hawkins, Jobe, caída de la rotación externa, Napoleón, abrazo del oso, Gerber; medición radiológica del espacio subacromial, índice acromial y ángulo crítico del hombro. En cada variable se midió sensibilidad-especificidad, valor predictivo positivo y negativo. Se compararon los resultados de cada variable para diagnosticar rupturas del manguito de los rotadores contra los hallazgos postoperatorios. Resultados: De los 55 pacientes evaluados, 42 presentaron ruptura completa del mango rotador en el postoperatorio. Se seleccionaron las ocho variables con mayor valor diagnóstico y se realizó una curva ROC, proporcionando un área bajo la curva de 0.88. Conclusiones: Este modelo de predicción emplea ocho variables (edad > 50 años, dolor nocturno, debilidad muscular, caída de la rotación externa, Jobe, Hawkins, espacio subacromial ≤ 6 mm y ángulo crítico del hombro > 35o) que en conjunto suman el valor predictivo de 0.88 (AUC) para diagnosticar rupturas completas del tendón supraespinoso.

Abstract: Pathology related to the rotator cuff remains among the most prevalent musculoskeletal diseases. There is an increasing need for imaging studies (MRI, US, arthroscopy) to test the diagnostic performance of the medical history and physical examination. Objective: To prove the diagnostic value of a clinical-radiographic predictive model to find complete ruptures of the rotator cuff. Material and methods: Descriptive, observational, prospective, transversal and analytical study. Fifty-five patients with preoperative shoulder pain were evaluated with 13 predictive variables: age > 50 years, nocturnal pain, muscle weakness, clinical signs of Neer, Hawkins, Jobe, external rotation lag (ERLS), belly-press, bear hug, and lift-off, radiographic measurement of subacromial space, acromial index and critical shoulder angle. Sensitivity, specificity, and positive and negative predictive values were measured in each variable, comparing the results of each one against the postoperative findings. Results: Of the 55 patients evaluated, 42 had a complete rupture of the rotator cuff in the postoperative period. The eight variables with a higher diagnostic value were selected and a ROC curve was performed, providing an area under the curve of 0.88. Conclusions: This predictive model uses eight variables (age > 50 years, nocturnal pain, muscle weakness, Jobe, Hawkins, ERLS, subacromial space ≤ 6 mm, and critical shoulder angle ˃ 35o), which together add the predictive value of 0.88 (AUC) to diagnose complete ruptures of the supraspinatus tendon.

Vida y obra de Abel Cetrángolo (1916 - 1977) / Life and work of Abel Cetrángolo (1916-1977)

Desde 1947 se inició el tratamiento específico de la tuberculosis que adquirió un valor inusitado, dado que el mismo modificó en el mundo entero el curso de la enfermedad tuberculosa. Roentgen desde 1895 nos mostró su ubicación en el pulmón, pero fue el laboratorio que permitió su diagnóstico y tratamiento, sucesivamente modificado con el transcurrir de los años. Abel Cetrángolo, como quien fuera su maestro y padrino de tesis, Andrés Arena entre nosotros, logró caracterizar al bacilo de Koch y en esa misma tesis nos enseñó el valor diagnóstico del contenido gástrico. Se distinguió por la seriedad de sus trabajos científicos tanto en Córdoba en la escuela de Gumersindo Sayago como en la Cátedra de Patología y Clínica de la Tuberculosis con la conducción de Raúl F Vaccarezza; fue un verdadero maestro para sus discípulos sentando bases valederas en sus conclusiones. Todo jefe de servicio debe trascender por lo que dejacientíficamente, pero también en la formación de médicos que puedan continuar en la profesión desde el punto de vista asistencial y docente con el ejemplo que él les legó.

Since 1947 the specific treatment of tuberculosis acquired an unused value, since it changed over the world the course of tuberculosis. Roentgen from 1895 showed us its location in the lung, but it was the laboratory that allowed its diagnosis and treatment, successively modified with the passing of the years. Abel Cetrángolo, and his former teacher and thesis godfather Andrés Arena among us, characterized the Koch bacillus and in that same thesis reinforced the value of gastric content. It was distinguished by the seriousness of his scientific works, both in Córdoba in Gumersido Sayago school and in the Department of Pathology and Clinical Tuberculosis headed by Raul F Vaccarezza, was a true master for his disciples sitting valid bases of conclusions. All service manager must transcend so scientifically leaves, but also in the training of doctors that can continue in the profession from the point of view clinical and teaching by example that he bequeathed them.

Utilidad de la endoscopia digestiva alta diagnóstica en pacientes menores de 18 años / Diagnostic Usefulness of Upper Gastrointestinal Endoscopy for Patients under 18 Years of Age

Objetivo: Definir la utilidad diagnóstica de la endoscopia digestiva alta en pacientes menores de 18 años. Materiales y métodos: Estudio descriptivo de corte transversal retrospectivo, basado en los hallazgos de la endoscopia digestiva alta e informes de los estudios histopatológicos resultantes de los procedimientos. Estos informes fueron encontrados en la base de datos de un centro de endoscopia hospitalario de referencia, de tercer nivel, en Bogotá, Colombia, entre enero de 2007 y enero de 2013. La población de origen fueron pacientes con edades entre los 5 y los 18 años, con un total de 113 pacientes, en los cuales se recolectó la información disponible sobre edad, género, diagnóstico endoscópico e histopatológico. Resultados: Durante el período de evaluación (entre enero 2007 y diciembre del 2012) se encontró un total de 113 registros en pacientes, entre los 5 y los 18 años de edad, con una distribución, según el género, de 61% (n=69) mujeres. El 16,8% (n = 19) del total de pacientes fueron menores de 12 años, por lo que requirieron de una sedación conducida por un anestesiólogo. Las indicaciones más frecuentes para la endoscopia fueron dolor abdominal 36% (n=40) y sangrado digestivo 19% (n=22); los diagnósticos endoscópicos más frecuentes fueron gastritis crónica antral 70% (n=79) y endoscopia normal 11,5% (n=13). De los pacientes, 9 presentaron úlcera péptica, pertenecientes a los 22 que consultaron por sangrado. Al 66% de los pacientes (n = 75) les realizaron biopsias durante el procedimiento endoscópico, cuyos análisis histopatológicos evidenciaron la presencia de Helicobacter pylori en un 71% (n=53) y de gastritis crónica en un 93% (n=70). En las muestras examinadas de este grupo de pacientes no se encontró metaplasia intestinal, atrofia gástrica o cáncer. Conclusión: Las indicaciones para realizar endoscopia digestiva alta diagnóstica en los niños deben ser consideradas y evaluadas críticamente, con el fin de aumentar el rendimiento diagnóstico y disminuir la exposición a riesgos inherentes al procedimiento, ya que la producción diagnóstica es muy baja, dado que los pacientes que consultaron por solo dolor abdominal no se les encontró ningún hallazgo relevante, en comparación con los del sangrado, que en el 41% (9/22) se les encontró úlcera.

Objective: The objective of this study was to define the diagnostic value of upper gastrointestinal endoscopy for patients under 18 years of age. Materials and Methods: This was a retrospective cross-sectional study based on findings from upper gastrointestinal endoscopy and resulting histopathology reports. These reports were found in the database of the endoscopy department at a third level medical center of referral in Bogotá, Colombia. Procedures were performs between January 2007 and January 2013. The study population consisted of 113 patients between the ages of five and seventeen years of age for whom all available information regarding age, gender and endoscopic and histopathological diagnoses was collected. Results: A total of 113 records of patients between 5 and 18 years old were found for the evaluation period between January 2007 and December 2012. Sixty one percent (n = 69) of these patients were female. 16.8% (n = 19) of the patients were under 12 years of age for which reason they required sedation administered by an anesthesiologist. The most common indications for endoscopy were abdominal pain (36 %, n = 40) and gastrointestinal bleeding (19 %, n = 22). The most common endoscopic diagnoses were chronic antral gastritis (70 %, n = 79) and normal endoscopy (11.5 %, n = 13). Of the 22 patients who underwent endoscopies because of bleeding, nine had peptic ulcers. Biopsies were taken from 66 % of the patients (n = 75). Histopathological analysis showed the presence of Helicobacter pylori in 71% (n = 53) of these patients and showed chronic gastritis in 93% (n = 70). The samples examined from this group of patients showed no signs of intestinal metaplasia, gastric atrophy or cancer. Conclusion: The indications for performing diagnostic upper endoscopy in children should be reconsidered and critically evaluated in order to increase the diagnostic yield and minimize exposure to inherent procedural risks. Current diagnostic yield is very low given that no relevant findings resulted from these procedures for many patients who consulted with a gastroenterologist simply because of abdominal pain, and ulcers were found in only 41% (9/22) of those who presented bleeding.

Valor diagnóstico de punción aspirativa con aguja fina en nódulo tiroideo: hospital Doctor Gustavo Fricke / Diagnostic value of puncture aspiration with fine needle in thyroide nodule: hospital Doctor Gustavo Fricke

Introducción: la punción aspirativa con aguja fina (PAAF) ha ido introduciéndose paulatinamente en la práctica clínica y constituye actualmente el método de elección en la aproximación diagnóstica del cáncer tiroideo. La PAAF ha contribuido a reducir el porcentaje de pacientes tiroidectomizados, 67 aumentando la cirugía por cáncer tiroideo del l5 porciento al 39 porciento. Objetivo: determinar el Valor diagnóstico de la PAAF en pacientes sometidos a tiroidectomía en el Hospital Doctor Gustavo Fricke (HGF), entre los71 años 2006-2007. Material y Método: estudio observacional descriptivo retrospectivo. Se utilizó el registro de pacientes sometidos a procedimiento quirúrgico por nódulo tiroideo, que hayan sido previamente estudiados con PAAF en policlínico de Endocrinología del HGF. Resultados: el valor diagnóstico de la PAAF, en el estudio pre-operatorio del nódulo tiroideo y su relación con la biopsia definitiva postoperatoria, alcanzó una sensibilidad de 7l porciento y una especificidad del 54,S porciento. Discusión: el rendimiento que alcanzó la PAAF de los nódulos tiroideos para excluir o confirmar carcinoma tiroideo fueron bajos en relación a estudios internacionales que poseen una sensibilidad del 83 porciento y una especificidad del 92 porciento.

Introduction: the flne-needle aspiration (FNA) has been gradually incorporated into the clinical practice and nowadays represents the method of choice in the diagnosis of the thyroid cancer. The FNA has helped to reduce the percentage of patients that undergo thyroidectomy, and it has increased the operation for thyroid cancer from 15 percent to 39 percent. Objetive: establish the diagnostic value ofthe FNA in patients submitted to thyroidectomy in Hospital Doctor Gustavo Fricke (HGF), between 2006 and 2007. Materials and Methods: this is a descriptive observational retrospective study. We used a register of patients submitted to surgical procedure for thyroid nodule that also have been studied with FNA in the clinic of Endocrinology of the HGF. Results: the diagnostic value of FNA in the preoperative study of the thyroid nodule and its relationship with the definitive surgical biopsy reaches a sensibility of 71 percent and a specificity of S4,8 percent. Discussion: the thyroid nodules FNA had a low performance for exclude or confirm thyroid carcinoma in thyroid nodules compared to international studies (sensibility 83 percent and specificity 92 percent).