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1.
Ann Acad Med Singap ; 49(7): 456-461, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-33000108

RESUMO

Coronavirus disease 2019 (COVID-19) is caused by the severe acute respiratory syndrome coronavirus 2 and was declared a global pandemic by the World Health Organization on 11 March 2020. A definitive diagnosis of COVID-19 is made after a positive result is obtained on reverse transcription-polymerase chain reaction assay. In Singapore, rigorous contact tracing was practised to contain the spread of the virus. Nasal swabs and chest radiographs (CXR) were also taken from individuals who were suspected to be infected by COVID-19 upon their arrival at a centralised screening centre. From our experience, about 40% of patients who tested positive for COVID-19 had initial CXR that appeared "normal". In this case series, we described the temporal evolution of COVID-19 in patients with an initial "normal" CXR. Since CXR has limited sensitivity and specificity in COVID-19, it is not suitable as a first-line diagnostic tool. However, when CXR changes become unequivocally abnormal, close monitoring is recommended to manage potentially severe COVID-19 pneumonia.


Assuntos
Betacoronavirus , Técnicas de Laboratório Clínico , Infecções por Coronavirus/complicações , Infecções por Coronavirus/diagnóstico por imagem , Pulmão/diagnóstico por imagem , Pneumonia Viral/complicações , Pneumonia Viral/diagnóstico por imagem , Adulto , Infecções por Coronavirus/diagnóstico , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pandemias , Radiografia , Sensibilidade e Especificidade
2.
Comput Math Methods Med ; 2020: 9756518, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33014121

RESUMO

The COVID-19 diagnostic approach is mainly divided into two broad categories, a laboratory-based and chest radiography approach. The last few months have witnessed a rapid increase in the number of studies use artificial intelligence (AI) techniques to diagnose COVID-19 with chest computed tomography (CT). In this study, we review the diagnosis of COVID-19 by using chest CT toward AI. We searched ArXiv, MedRxiv, and Google Scholar using the terms "deep learning", "neural networks", "COVID-19", and "chest CT". At the time of writing (August 24, 2020), there have been nearly 100 studies and 30 studies among them were selected for this review. We categorized the studies based on the classification tasks: COVID-19/normal, COVID-19/non-COVID-19, COVID-19/non-COVID-19 pneumonia, and severity. The sensitivity, specificity, precision, accuracy, area under the curve, and F1 score results were reported as high as 100%, 100%, 99.62, 99.87%, 100%, and 99.5%, respectively. However, the presented results should be carefully compared due to the different degrees of difficulty of different classification tasks.


Assuntos
Betacoronavirus , Técnicas de Laboratório Clínico , Infecções por Coronavirus/diagnóstico por imagem , Pandemias , Pneumonia Viral/diagnóstico por imagem , Interpretação de Imagem Radiográfica Assistida por Computador/métodos , Tomografia Computadorizada por Raios X/estatística & dados numéricos , Inteligência Artificial , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/epidemiologia , Aprendizado Profundo , Humanos , Redes Neurais de Computação , Pneumonia/classificação , Pneumonia/diagnóstico por imagem , Pneumonia Viral/epidemiologia , Interpretação de Imagem Radiográfica Assistida por Computador/estatística & dados numéricos , Radiografia Torácica/estatística & dados numéricos , Sensibilidade e Especificidade
3.
BMC Med Imaging ; 20(1): 111, 2020 10 02.
Artigo em Inglês | MEDLINE | ID: mdl-33008329

RESUMO

BACKGROUND: To develop and validate a nomogram for early identification of severe coronavirus disease 2019 (COVID-19) based on initial clinical and CT characteristics. METHODS: The initial clinical and CT imaging data of 217 patients with COVID-19 were analyzed retrospectively from January to March 2020. Two hundred seventeen patients with 146 mild cases and 71 severe cases were randomly divided into training and validation cohorts. Independent risk factors were selected to construct the nomogram for predicting severe COVID-19. Nomogram performance in terms of discrimination and calibration ability was evaluated using the area under the curve (AUC), calibration curve, decision curve, clinical impact curve and risk chart. RESULTS: In the training cohort, the severity score of lung in the severe group (7, interquartile range [IQR]:5-9) was significantly higher than that of the mild group (4, IQR,2-5) (P < 0.001). Age, density, mosaic perfusion sign and severity score of lung were independent risk factors for severe COVID-19. The nomogram had a AUC of 0.929 (95% CI, 0.889-0.969), sensitivity of 84.0% and specificity of 86.3%, in the training cohort, and a AUC of 0.936 (95% CI, 0.867-1.000), sensitivity of 90.5% and specificity of 88.6% in the validation cohort. The calibration curve, decision curve, clinical impact curve and risk chart showed that nomogram had high accuracy and superior net benefit in predicting severe COVID-19. CONCLUSION: The nomogram incorporating initial clinical and CT characteristics may help to identify the severe patients with COVID-19 in the early stage.


Assuntos
Infecções por Coronavirus/diagnóstico por imagem , Pulmão/diagnóstico por imagem , Nomogramas , Pneumonia Viral/diagnóstico por imagem , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Área Sob a Curva , Criança , Diagnóstico Precoce , Humanos , Pessoa de Meia-Idade , Pandemias , Distribuição Aleatória , Estudos Retrospectivos , Sensibilidade e Especificidade , Índice de Gravidade de Doença , Tomografia Computadorizada por Raios X , Adulto Jovem
4.
Beijing Da Xue Xue Bao Yi Xue Ban ; 52(5): 897-901, 2020 Oct 18.
Artigo em Chinês | MEDLINE | ID: mdl-33047726

RESUMO

OBJECTIVE: To evaluate the classification criteria of early rheumatoid arthritis (ERA) and compare the sensitivity and specificity with the criteria of 1987 American College of Rheumatology (ACR) criteria and 2010 ACR/European League Against Rheumatism (EULAR). METHODS: Patients from 4 hospitals, aged more than 16 years, with arthritis, whose disease duration was ≤1 year, and with ≥1 joint pain and swelling were enrolled in the study. The indicators including clinical manifestations, laboratory tests and imaging examinations were observed. The ERA patients were dignosed by two experienced rheumatologists based on the clinical features, drug therapy information and radiography features. RESULTS: (1) A total of 325 patients with arthritis were enrolled, including 98 males (30.15%) and 227 females (69.85%), The average age was (47.53±14.44) years, and the median disease duration was 5 (2, 8) months. Finally, 236 patients were dignosed with ERA, and 89 patients were dignosed with other diseases (Non-ERA, including osteoarthritis, reactive arthritis, undifferentiated arthritis, spondyloarthritis, etc). (2) The sensitivity of ERA criteria was 87.29%, and the specificity was 84.37%. The sensitivity was higher than that of 1987 ACR criteria (χ2=43.641, P < 0.001), and had no significant difference compared with 2010 ACR/EULAR criteria (χ2=0.446, P=0.593). But the specificity of ERA criteria was lower than that of 1987 ACR criteria (χ2=4.891, P=0.027), which was not statistically significant compared with 2010 ACR/EULAR criteria (χ2=0.044, P=1.000). (3) In the patients with arthritis whose disease duration was ≤3 months and ≤6 months, the sensitivity of ERA criteria was 81.71% and 86.79%, respectively, both were higher than the 1987 ACR criteria (χ2=7.131, P=0.008; χ2=22.015, P < 0.001) and had no statistically difference compared with the 2010 ACR/EULAR criteria (χ2=0.220, P=0.755; χ2=0.473, P=0.491). The differences of the three criteria in specificity were not statistically significant. (4) The three different classification criteria were consistent with the clinical diagnosis, among which the ERA criteria and 2010 ACR/EULAR criteria were slightly higher (Kappa>0.6). The results of the consistency comparison between the three criteria showed that the ERA criteria and 2010 ACR/EULAR criteria had a better consistency (Kappa=0.836). CONCLUSION: The sensitivity of ERA classification criteria in the diagnosis of ERA was higher than that of 1987 ACR criteria, and was equivalent to that of 2010 ACR/EULAR criteria. There is no significant difference in specificity between these three criteria. The ERA criteria can also identify patients with RA at a very early stage in arthritis with disease duration ≤3 months.


Assuntos
Artrite Reumatoide , Osteoartrite , Reumatologia , Adolescente , Adulto , Artrite Reumatoide/diagnóstico , Artrite Reumatoide/diagnóstico por imagem , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Radiografia , Sensibilidade e Especificidade , Estados Unidos
6.
Biomed Res Int ; 2020: 7610678, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33029522

RESUMO

Background: There is a shortage of chemical reagents for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) diagnosis and a surge of SARS-CoV-2 cases, especially in limited-resource settings. Therefore, the combination of an optimal assay kit is necessary. Methods: We compared the ability to screen SARS-CoV-2 among three primer-probe sets in two different master mixes, Invitrogen™ SuperScript™ III One-Step RT-PCR and LightCycler Multiplex RNA Virus Master. Results: The assay with TIB-Molbiol, IDT, and Phu Sa sets for LightCycler Multiplex RNA Virus Master or Invitrogen™ SuperScript™ III One-Step RT-PCR showed positive results from a single reaction of triplicate in the three days of 4.8 copies per reaction. R squared and amplification efficiency were 0.97 and ranged from 107 to 108%, respectively. Conclusions: Our findings indicated that TIB-Molbiol, IDT, and Phu Sa primer-probe sets could be beneficial for the laboratory screening of SARS-CoV-2 by RT-qPCR assay of E gene. There is a need to consider the combination of these reagent sets as a new strategy to increase the testing capacity of screening programs for COVID-19.


Assuntos
Betacoronavirus/genética , Técnicas de Laboratório Clínico/métodos , Infecções por Coronavirus/diagnóstico , Primers do DNA/genética , Pneumonia Viral/diagnóstico , Sondas RNA/genética , Betacoronavirus/isolamento & purificação , Técnicas de Laboratório Clínico/estatística & dados numéricos , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/virologia , Humanos , Reação em Cadeia da Polimerase Multiplex/métodos , Reação em Cadeia da Polimerase Multiplex/estatística & dados numéricos , Pandemias , Pneumonia Viral/epidemiologia , Pneumonia Viral/virologia , RNA Viral/genética , Reação em Cadeia da Polimerase em Tempo Real/métodos , Reação em Cadeia da Polimerase em Tempo Real/estatística & dados numéricos , Reação em Cadeia da Polimerase Via Transcriptase Reversa/métodos , Reação em Cadeia da Polimerase Via Transcriptase Reversa/estatística & dados numéricos , Sensibilidade e Especificidade
7.
BMC Infect Dis ; 20(1): 747, 2020 Oct 12.
Artigo em Inglês | MEDLINE | ID: mdl-33046047

RESUMO

BACKGROUND: Sudden exacerbations and respiratory failure are major causes of death in patients with severe coronavirus disease 2019(COVID-19) pneumonia, but indicators for the prediction and treatment of severe patients are still lacking. METHODS: A retrospective analysis of 67 collected cases was conducted and included approximately 67 patients with COVID-19 pneumonia who were admitted to the Suzhou Fifth People's Hospital from January 1, 2020 to February 8, 2020. The epidemiological, clinical and imaging characteristics as well as laboratory data of the 67 patients were analyzed. RESULTS: The study found that fibrinogen (FIB) was increased in 45 (65.2%) patients, and when FIB reached a critical value of 4.805 g/L, the sensitivity and specificity、DA, helping to distinguish general and severe cases, were 100 and 14%、92.9%, respectively, which were significantly better than those for lymphocyte count and myoglobin. Chest CT images indicated that the cumulative number of lung lobes with lesions in severe patients was significantly higher than that in general patients (P < 0.05), and the cumulative number of lung lobes with lesions was negatively correlated with lymphocyte count and positively correlated with myoglobin and FIB. Our study also found that there was no obvious effect of hormone therapy in patients with severe COVID-19. CONCLUSIONS: Based on the retrospective analysis, FIB was found to be increased in severe patients and was better than lymphocyte count and myoglobin in distinguishing general and severe patients. The study also suggested that hormone treatment has no significant effect on COVID-19.


Assuntos
Técnicas de Laboratório Clínico , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/patologia , Pneumonia Viral/epidemiologia , Pneumonia Viral/patologia , Adulto , Betacoronavirus/patogenicidade , China/epidemiologia , Infecções por Coronavirus/diagnóstico , Feminino , Fibrinogênio/análise , Hospitalização , Humanos , Pulmão/patologia , Contagem de Linfócitos , Masculino , Pessoa de Meia-Idade , Pandemias , Pneumonia Viral/diagnóstico , Estudos Retrospectivos , Sensibilidade e Especificidade
8.
Zhong Nan Da Xue Xue Bao Yi Xue Ban ; 45(8): 973-979, 2020 Aug 28.
Artigo em Inglês, Chinês | MEDLINE | ID: mdl-33053541

RESUMO

OBJECTIVES: To analyze the CT manifestations,clinical symptoms, laboratory test and the interrelationship of them with secondary invasive pulmonary aspergillosis (IPA) in hematologic patients so as to improve the diagnosis and prognosis of this disease. METHODS: A total of 37 hematologic patients suspected of IPA in a tertiary referral center were selectedfrom Jun. 2004 to Sep. 2016 and the CT characteristics, clinical manifestations, laboratory test of these patients were retrospectively analyzed. RESULTS: There were 8 patients confirmed as IPA by sputum culture or bronchoalveolar lavage fluid culture among the 37 hematologic patients.The sensitivity of CT in the diagnosis of IPA was 75.0%, the specificity was 79.3%, the positive predictive value was 42.9%, and the negative predictive value was 91.3%. Multiple patchy shadows in both lungs were the most common CT signs of suspected and confirmed patients, followed by nodules, air bronchogram, cavitary lesions, consolidation, mass shadows, halo, and crescent sign. Cough, expectoration, and fever were the most common symptoms among the suspected and confirmed patients. ß-D-glucan (G)/galactomannan antigen (GM) tests for the most patients were negative, but the number of people with elevated procalcitonin (PCT) in the confirmed patients (57.1%) was higher than that in the suspected patients (31.4%). Results of sputum culture, PCT, G/GM test, and clinical manifestations were compared between the CT lesion progression group and the absorption group, and no significant difference was observed. CONCLUSIONS: Hematologic patients are susceptible to IPA. CT features showed no obvious specificity, and the G/GM test was normal in most patients. So when hematologic patients have clinical symptoms such as cough, expectoration and fever, the possibility of combination with IPA should be considered as soon as possible, and relevant examinations such as sputum culture, bronchoalveolar lavage fluid culture and pathological examination should be completed for early diagnosis and treatment to improve the prognosis of patients.


Assuntos
Aspergilose Pulmonar Invasiva , Humanos , Aspergilose Pulmonar Invasiva/complicações , Aspergilose Pulmonar Invasiva/diagnóstico , Aspergilose Pulmonar Invasiva/diagnóstico por imagem , Pulmão , Estudos Retrospectivos , Sensibilidade e Especificidade , Tomografia Computadorizada por Raios X
10.
Rev Med Liege ; 75(10): 644-648, 2020 Oct.
Artigo em Francês | MEDLINE | ID: mdl-33030839

RESUMO

The diagnosis of heart failure can sometimes be challenging for the clinician because presentation circumstances and heart failure phenotypes are varied. The identification and validation of sensitive and specific biomarkers for this condition are still a subject of intensive research. Among them, natriuretic peptides (ANP, BNP, NTproBNP) are widely used and validated as markers of heart failure. Their appropriate use and correct interpretation, however, require knowledge of their indications, specificities and limitations. The European Society of Cardiology has recently issued recommendations in this regard. This article summarizes them in order to facilitate the understanding and the use of natriuretic peptides in clinical practice. It also discusses their use in the etiological diagnosis of pleural effusions caused by heart failure.


Assuntos
Insuficiência Cardíaca , Derrame Pleural , Biomarcadores , Insuficiência Cardíaca/diagnóstico , Insuficiência Cardíaca/terapia , Humanos , Peptídeos Natriuréticos , Sensibilidade e Especificidade
11.
In Vivo ; 34(5): 3039-3045, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32871850

RESUMO

BACKGROUND: Antibody testing is necessary to identify immune individuals in the post-initial wave of the COVID-19 pandemic. PATIENTS AND METHODS: We prospectively evaluated the performance of a quantitative point-of-care test (POCT) for SARS-CoV-2 antibodies. The patient group (PG) comprised of hospitalized confirmed COVID-19 cases. Asymptomatic healthcare volunteers with negative rRT-PCR were included in the control group (CG). Measurement of IgM and IgG was obtained by dry fluorescence immunoassay. RESULTS: Twenty-six PG (65.9±15.4 years old, male 57.7%) and 18 CG (45.6±10.1 years old, male 33.3%) were included. By manufacturer's cut-off (≥0.04 mIU/ml), sensitivity and specificity were 73.08% and 88.89% for IgM and 88.46% and 33.33% for IgG, respectively. Estimated areas under the ROC curve were 0.907 and 0.848 for IgM and IgG, respectively. Results were improved using a cut-off of IgM ≥0.05 mIU/ml and IgG ≥0.10 mIU/ml. CONCLUSION: Using stringent cut-off values, SARS-CoV-2 antibody POCT detects immune people and can be used during socioeconomic normalization of communities.


Assuntos
Anticorpos Antivirais/isolamento & purificação , Betacoronavirus/isolamento & purificação , Infecções por Coronavirus/diagnóstico , Pandemias , Pneumonia Viral/diagnóstico , Idoso , Anticorpos Antivirais/sangue , Betacoronavirus/patogenicidade , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/virologia , Grécia/epidemiologia , Humanos , Imunoglobulina G/sangue , Imunoglobulina G/isolamento & purificação , Masculino , Pessoa de Meia-Idade , Pneumonia Viral/epidemiologia , Pneumonia Viral/virologia , Sistemas Automatizados de Assistência Junto ao Leito , Sensibilidade e Especificidade
12.
Rev Peru Med Exp Salud Publica ; 37(2): 203-209, 2020.
Artigo em Espanhol, Inglês | MEDLINE | ID: mdl-32876207

RESUMO

OBJECTIVE: To determine the additional diagnostic performance of a rapid serological test for detection of IgM and IgG antibodies compared to the real-time polymerase chain reaction (RT-PCR) test; for detection of SARS-CoV-2. MATERIALS AND METHODS: A cross-sectional study was carried out including patients hospitalized for COVID-19 in 3 hospitals, health workers exposed to the infection and outpatients who met suspicious case criteria, all of which underwent the molecular test (RT-PCR) and the rapid serological test. The additional diagnostic performance of rapid serological test was evaluated in comparison to molecular tests. Likewise, an approximation was made to the sensitivity and specificity of the rapid serological test. RESULTS: 144 people were included. With the rapid test, 19.4% of positive results were obtained compared to 11.1% in the molecular test (p = 0.03). The rapid serological test detected 21 cases that had been negative by the initial (RT-PCR), providing an additional diagnostic performance of 56.8% compared to the RT-PCR. The additional diagnostic performance was 50.0% during the first week, 70.0% during the second week and 50.0% during the third week of symptom onset. The sensitivity of the rapid serological test was 43.8% and the specificity of 98.9%. CONCLUSIONS: The rapid serological test was able to detect a greater number of cases than those detected by the molecular test especially after the second week of onset of symptoms. It also showed high specificity. It is therefore useful as a complementary test to RT-PCR, especially during the second and third week of illness.


Assuntos
Betacoronavirus/isolamento & purificação , Técnicas de Laboratório Clínico , Infecções por Coronavirus/diagnóstico , Imunoglobulina G/sangue , Imunoglobulina M/sangue , Pneumonia Viral/diagnóstico , Adulto , Infecções por Coronavirus/imunologia , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pandemias , Pneumonia Viral/imunologia , Reação em Cadeia da Polimerase em Tempo Real/métodos , Sensibilidade e Especificidade , Testes Sorológicos/métodos
13.
Monaldi Arch Chest Dis ; 90(3)2020 Sep 02.
Artigo em Inglês | MEDLINE | ID: mdl-32875776

RESUMO

Lung Ultrasound (LUS) is regarded to be potentially useful to diagnose lung injury in older adults living in nursing homes with suspected COVID-19 pneumonia. We aimed at evaluating presence lung injury among senior nursing home residents by LUS performed with portable wireless scanner echography. The study population consisted of 150 residents with a mean age of 88 years (85% female) residing in 12 nursing homes in Northern Italy. Subjects had to have a history of recent onset of symptoms compatible with COVID-19 pneumonia or have been exposed to the contagion of patients carrying the disease. COVID-19 testing was performed with SARS-CoV-2 nasal-pharyngeal (NP) swabs. Positive subjects to LUS scanning were considered those with non-coascelent B-lines in >3 zones, coalescent B-lines in >3 zones and with iperdensed patchy non-consolidated lungs. Sixty-three percent had positive NP testing and 65% had LUS signs of pulmonary injury. LUS had a sensitivity of 79% in predicting positive NP testing. Sixteen percent of residents tested negative for SARSCoV-2 carried the signs of COVID-19 lung injury at LUS. There were 92 patients (61%) with current or recent symptoms.Positivity to LUS scanning was reported in 73% of residents with symptoms, while it was 53% in those without (P=0.016). A positive NP testing was observed in 66% of residents with symptoms and in 57% of those without (P=0.27). We conclude that assessment of LUS by portable wireless scanner echography can be profitability utilized to diagnose lung injury among senior nursing home residents with or without symptoms compatible with COVID-19 pneumonia.


Assuntos
Infecções por Coronavirus , Lesão Pulmonar/diagnóstico por imagem , Pandemias , Pneumonia Viral/diagnóstico , Testes Imediatos , Ultrassonografia , Idoso de 80 Anos ou mais , Betacoronavirus/isolamento & purificação , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/fisiopatologia , Feminino , Instituição de Longa Permanência para Idosos/estatística & dados numéricos , Humanos , Itália/epidemiologia , Masculino , Casas de Saúde/estatística & dados numéricos , Pneumonia Viral/epidemiologia , Pneumonia Viral/etiologia , Pneumonia Viral/fisiopatologia , Valor Preditivo dos Testes , Sensibilidade e Especificidade , Ultrassonografia/instrumentação , Ultrassonografia/métodos , Tecnologia sem Fio
14.
Medicine (Baltimore) ; 99(35): e20932, 2020 Aug 28.
Artigo em Inglês | MEDLINE | ID: mdl-32871859

RESUMO

BACKGROUND: Accurate clinical staging of patients with cholangiocarcinoma (CCA) has a significant impact on treatment decisions. In this study, we aimed to compare the diagnostic value of magnetic resonance imaging (MRI) and 18-fludeoxyglucose positron emission tomography/computed tomography (F-FDG PET/CT) for staging of CCA. METHODS: We performed comprehensive systematic search in Web of Science (including MEDLINE) and Excerpta Medica Database for relevant diagnostic studies in accordance with the preferred reporting items for systematic reviews and meta-analysis statement. Based on data extracted from patient-based analysis, we calculated the pooled sensitivity and specificity with the 95% confidence intervals (CIs). In addition, the publication bias was assessed by Deek funnel plot of the asymmetry test. The potential heterogeneity was explored by threshold effect analysis and subgroup analyses. RESULTS: Thirty-two studies with 1626 patients were included in present analysis. In T stage, the pooled sensitivity and specificity of MRI were 0.90 (95% CI 0.86-0.93), 0.84 (95% CI 0.73-0.91) respectively. The pooled sensitivity and specificity of F-FDG PET/CT were 0.91 (95% CI 0.83-0.95) and 0.85 (0.64-0.95) respectively. In N stage, the pooled sensitivity and specificity of MRI were 0.64 (95% CI 0.52-0.74) and 0.69 (95% CI 0.51-0.87) respectively. The pooled sensitivity and specificity of PET/CT were 0.52 (95% CI 0.37-0.66) and 0.92 (95% CI 0.79-0.97) respectively. In M stage, the pooled sensitivity and specificity of F-FDG PET/CT were 0.56 (95% CI, 0.42-0.69) and 0.95 (95% CI, 0.91-0.97) respectively. The Deek test revealed no significant publication bias. No threshold effect was identified. The subgroup analyses showed that pathological type (extrahepatic cholangiocarcinoma vs hilar cholangiocarcinoma/intrahepatic cholangiocarcinoma), country (Asia vs non-Asia) and type of MRI (1.5T vs. 3.0T) were potential causes for the heterogeneity of MRI studies and country (Asia vs non-Asia) was a potential source for F-FDG PET/CT studies. CONCLUSION: The analysis suggested that both modalities provide reasonable diagnostic accuracy in T stage without significant differences between them. We recommend that both modalities be considered based on local availability and practice for the diagnosis of primary CCA tumors. In N stage, the diagnosis of lymph node metastasis (N) of CCA is still limited by MRI and F-FDG PET/CT, due to unsatisfactory diagnostic accuracy of both. Nevertheless, F-FDG PET/CT can be used to confirm lymph node metastasis while a negative result may not rule out metastasis. Furthermore, F-FDG PET/CT have a low sensitivity and a high specificity for detection of distant metastasis.


Assuntos
Neoplasias dos Ductos Biliares/patologia , Colangiocarcinoma/diagnóstico por imagem , Imagem por Ressonância Magnética/métodos , Tomografia por Emissão de Pósitrons/métodos , Idoso , Colangiocarcinoma/epidemiologia , Feminino , Fluordesoxiglucose F18/administração & dosagem , Humanos , Metástase Linfática/diagnóstico por imagem , Metástase Linfática/patologia , Masculino , Pessoa de Meia-Idade , Imagem Multimodal/métodos , Estadiamento de Neoplasias/métodos , Sensibilidade e Especificidade , Tomografia Computadorizada por Raios X/métodos
15.
S Afr Med J ; 110(9): 842-845, 2020 07 17.
Artigo em Inglês | MEDLINE | ID: mdl-32880264

RESUMO

Antibody tests for the novel coronavirus, SARS-CoV2, have been developed both as rapid diagnostic assays and for high-throughput formal serology platforms. Although these tests may be a useful adjunct to a diagnostic strategy, they have a number of limitations. Because of the antibody and viral dynamics of the coronavirus, their sensitivity can be variable, especially at early time points after symptom onset. Additional data are required on the performance of the tests in the South African population, especially with regard to development and persistence of antibody responses and whether antibodies are protective against reinfection. These tests may, however, be useful in guiding the public health response, providing data for research (including seroprevalence surveys and vaccine initiatives) and development of therapeutic strategies.


Assuntos
Betacoronavirus , Técnicas de Laboratório Clínico , Infecções por Coronavirus , Testes Imunológicos/métodos , Pandemias , Pneumonia Viral , Testes Sorológicos/métodos , Betacoronavirus/genética , Betacoronavirus/imunologia , Betacoronavirus/isolamento & purificação , Técnicas de Laboratório Clínico/métodos , Técnicas de Laboratório Clínico/normas , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/imunologia , Humanos , Pneumonia Viral/diagnóstico , Pneumonia Viral/epidemiologia , Pneumonia Viral/imunologia , Reprodutibilidade dos Testes , Sensibilidade e Especificidade , Estudos Soroepidemiológicos , África do Sul/epidemiologia
16.
BMC Infect Dis ; 20(1): 650, 2020 Sep 04.
Artigo em Inglês | MEDLINE | ID: mdl-32887568

RESUMO

BACKGROUND: Cryptococcus is a conditional pathogenic fungus causing cryptococcosis, which is one of the most serious fungal diseases faced by humans. Lateral flow immunochromatographic assay (LFA) is successfully applied to the rapid detection of cryptococcal antigens. METHODS: Studies were retrieved systematically from the Embase, PubMed, Web of Science, and Cochrane Library before July 2019. The quality of the studies was assessed by Review Manager 5.0 based on the Quality Assessment of Diagnostic Accuracy Study guidelines. The extracted data from the included studies were analyzed by Meta-DiSc 1.4. Stata 12.0 software was used to detect the publication bias. RESULTS: A total of 15 articles with 31 fourfold tables were adopted by inclusion and exclusion criteria. The merged sensitivity and specificity in serum were 0.98 and 0.98, respectively, and those in the cerebrospinal fluid were 0.99 and 0.99, respectively. CONCLUSIONS: Compared to the urine and other samples, LFA in serum and cerebrospinal fluid is favorable evidence for the diagnosis of cryptococcosis with high specificity and sensitivity.


Assuntos
Criptococose/diagnóstico , Imunoensaio/métodos , Antígenos de Fungos/sangue , Antígenos de Fungos/líquido cefalorraquidiano , Antígenos de Fungos/urina , Líquido Cefalorraquidiano/microbiologia , Testes Diagnósticos de Rotina/métodos , Humanos , Sensibilidade e Especificidade
17.
Sci Total Environ ; 741: 140447, 2020 Nov 01.
Artigo em Inglês | MEDLINE | ID: mdl-32887010

RESUMO

Contaminated water resources remain a major global concern regarding public health. The majority of water safety protocols include indicators of microbial contamination to evaluate the potential risk to public health and are key elements of quality guidelines. Among these, markers for total coliforms and fecal coliforms are strong indicators of co-contamination with other pathogens. Traditional methods, recurring to slow and cumbersome culture-based approaches, have been gradually replaced by molecular methods, capable of faster and more specific screening. These are usually PCR-based methods that may allow for multiple pathogen detection but require dedicated laboratory equipment, hindering the rapid on-site assessment. Here, we used a multiplex Loop-Mediated Isothermal Amplification (mLAMP) strategy for the amplification of two markers associated with the contamination by total and fecal coliforms (e.g. Escherichia coli) - lacZ and uidA genes, respectively - thus allowing for single tube multiplex detection. The mLAMP products were then subject to an Au-nanoprobe colorimetric detection assay for precise discrimination of targets. This approach was validated in 22 water samples that were also screened for the presence of lacZ and uidA using standard and quantitative PCR, with the capability for discriminating the contamination level, e.g. a semi-quantitative evaluation of water quality.


Assuntos
Escherichia coli , Técnicas de Amplificação de Ácido Nucleico , Fezes , Reação em Cadeia da Polimerase em Tempo Real , Sensibilidade e Especificidade
19.
Artigo em Russo | MEDLINE | ID: mdl-32929925

RESUMO

BACKGROUND: A search for accurate linear discriminant function (LDF) allowing the diagnosis of schizophrenia and estimation of treatment effectiveness according to EEG is an urgent problem. OBJECTIVE: To develop a methodology for discriminant EEG analysis for minimizing the overlearning effect, selection of optimal LDF model and evaluation of its generalizing ability. MATERIAL AND METHODS: Two hundred and twenty patients with schizophrenia and 1400 people without psychiatric diseases, who were comparable in basic characteristics, were enrolled. EEG was recorded using 16 leads, 10-20 system and aural reference electrodes. EEG was processed by spectral and coherent analysis. RESULTS: After linear discriminant analysis, LDF was obtained to differentiate people with schizophrenia from healthy subjects and a formula was selected from LDF that included 8 predictors (spectral and coherent parameters of standard EEG ranges theta, alpha and beta) with 90% sensitivity and 80% specificity, significance level for Wilks' lambda p<3.9E-28 and the Mahalanobis distance between training set centroids 4,6. CONCLUSION: A method for obtaining optimal LDF models and selection the best one with further LDF generalizing ability assessment is suggested.


Assuntos
Esquizofrenia , Diagnóstico Diferencial , Análise Discriminante , Eletroencefalografia , Humanos , Sensibilidade e Especificidade
20.
Medicine (Baltimore) ; 99(33): e20021, 2020 Aug 14.
Artigo em Inglês | MEDLINE | ID: mdl-32871968

RESUMO

To evaluate the diagnostic performance of net influx rate (Ki) values from a whole-body dynamic (WBD) Ga-DOTATOC-PET/CT acquisition to differentiate pancreatic neuroendocrine tumors (pNETs) from physiological uptake of pancreatic uncinate process (UP).Patients who were benefited from a WBD acquisition for the assessment of a known well-differentiated neuroendocrine tumor (NET)/suspicion of disease in the prospective GAPET-NET cohort were screened. Only patients with a confirmed pNET/UP as our gold standard were included. The positron emission tomography (PET) procedure consisted in a single-bed dynamic acquisition centered on the heart, followed by a whole-body dynamic acquisition and then a static acquisition. Dynamic (Ki calculated according to Patlak method), static (SUVmax, SUVmean, SUVpeak) parameters, and tumor-to-liver and tumor-to-spleen ratio (TLRKi and TSRKi (according to hepatic/splenic Ki)), tumor SUVmax to liver SUVmax (TM/LM), tumor SUVmax to liver SUVmean (TM/Lm), tumor SUVmax to spleen SUVmax (TM/SM), and tumor SUVmax to spleen SUVmean (TM/Sm) (according to hepatic/splenic SUVmax and SUVmean respectively) were calculated. A Receiver Operating Characteristic (ROC) analysis was performed to evaluate their diagnostic performance to distinguish UP from pNET.One hundred five patients benefited from a WBD between July 2018 and July 2019. Eighteen (17.1%) had an UP and 26 (24.8%) a pNET. For parameters alone, the Ki and SUVpeak had the best sensitivity (88.5%) while the Ki, SUVmax, and SUVmean had the best specificity (94.4%). The best diagnostic accuracy was obtained with Ki (90.9%). For ratios, the TLRKi and the TSRKi had the best sensitivity (95.7%) while the TM/SM and TM/Sm the best specificity (100%). TLRKi had the best diagnostic accuracy (95.1%) and the best area under the curve (AUC) (0.990).Our study is the first one to evaluate the interest of a WBD acquisition to differentiate UP from pNETs and shows excellent diagnostic performances of the Ki approach.


Assuntos
Tumores Neuroendócrinos/diagnóstico por imagem , Pâncreas/diagnóstico por imagem , Neoplasias Pancreáticas/diagnóstico por imagem , Tomografia Computadorizada com Tomografia por Emissão de Pósitrons , Imagem Corporal Total , Diagnóstico Diferencial , Feminino , Humanos , Fígado/diagnóstico por imagem , Masculino , Pessoa de Meia-Idade , Octreotida/análogos & derivados , Compostos Organometálicos , Tomografia Computadorizada com Tomografia por Emissão de Pósitrons/métodos , Estudos Prospectivos , Compostos Radiofarmacêuticos , Sensibilidade e Especificidade , Baço/diagnóstico por imagem , Imagem Corporal Total/métodos
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