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pediatrics sensitivity and specificity study

Sarah Dellière, Nathalie Neveux, Jean-Pascal De Bandt, Luc Cynober
The value of transthyretin (TTR) measurement for assessing malnutrition is under debate due to its sensitivity to inflammation and frequent confusion over its meaning (i.e. as a marker of diagnosis, prognosis, or efficacy of refeeding). Moreover, there is still no ESPEN/ASPEN guideline on its use and cut-off values. Here the aim was to evaluate the overall perception of the value of this parameter and its utilization worldwide. A panel of international experts in the field were surveyed on the use of TTR in clinical practice in their country, on the guidelines issued by their national health authorities, and on the cut-off values used to diagnose malnutrition...
September 25, 2018: Clinical Nutrition: Official Journal of the European Society of Parenteral and Enteral Nutrition
Stella Stabouli, Thomaitsa Nika, Konstantinos Kollios, Christina Antza, Ioannis Doundoulakis, Vasilios Kotsis
OBJECTIVE: We assessed the performance of the simplified American Academy Pediatrics (AAP) 2017 guideline table and a simplified table based on the Fourth Report blood pressure (BP) reference tables for high BP screening compared with the European Society Hypertension 2016 guideline diagnostic thresholds. METHODS: We obtained data from a cross-sectional, school-based screening study in north Greece during 2013-2016. BP was measured by mercury sphygmomanometer. The simple tables' performance for high BP was assessed by receiver operator characteristic curve analysis, area under the curve (AUC), sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV)...
October 10, 2018: Journal of Hypertension
Fang Fang, Xiaohan Hu, Xiaomei Dai, Sanfeng Wang, Zhenjiang Bai, Jiao Chen, Jian Pan, Xiaozhong Li, Jian Wang, Yanhong Li
BACKGROUND: Research on acute kidney injury (AKI) has focused on identifying early biomarkers. However, whether AKI could be diagnosed in the absence of the classic signs of clinical AKI and whether the condition of subclinical AKI, identified by damage or functional biomarkers in the absence of oliguria or increased serum creatinine (sCr) levels, is clinically significant remains to be elucidated in critically ill children. The aims of the study were to investigate the associations between urinary cystatin C (uCysC) levels and AKI and mortality and to determine whether uCysC-positive subclinical AKI is associated with adverse outcomes in critically ill neonates and children...
October 10, 2018: Critical Care: the Official Journal of the Critical Care Forum
Joseph R England, Jordan S Gross, Eric A White, Dakshesh B Patel, Jasmin T England, Phillip M Cheng
OBJECTIVE: The purpose of this study is to determine whether a deep convolutional neural network (DCNN) trained on a dataset of limited size can accurately diagnose traumatic pediatric elbow effusion on lateral radiographs. MATERIALS AND METHODS: A total of 901 lateral elbow radiographs from 882 pediatric patients who presented to the emergency department with upper extremity trauma were divided into a training set (657 images), a validation set (115 images), and an independent test set (129 images)...
October 9, 2018: AJR. American Journal of Roentgenology
Soham Dasgupta, Megan Stark, Sonal Bhatt, Peter Fischbach, Shriprasad Deshpande
INTRODUCTION: A cardiac cause is an extremely rare etiology of pediatric chest pain. Despite its low sensitivity/specificity, exercise stress testing (EST) is widely used to determine the prognosis in patients with suspected/established coronary disease. We aimed to look at the utility of a combined cardiopulmonary EST in the evaluation of pediatric patients with chest pain. METHODS: After institutional review board approval, a retrospective chart review was performed of all pediatric patients who were referred for an EST for chest pain from January 2014 to 2017...
October 9, 2018: Congenital Heart Disease
R Jiang, M S Kelly, J C Routh
OBJECTIVE: Bowel and bladder dysfunction (BBD) is a clinical syndrome defined by the coexistence of constipation and lower urinary tract symptoms. Although BBD is a common condition in pediatric urology and can cause significant stress to patients/parents, clinical diagnosis of BBD has not been standardized. Bowel and bladder dysfunction instruments have gained popularity over the past decade to aid in diagnosis. In this review, the currently published BBD symptom questionnaires were summarized and an analysis on their psychometric validation process was provided...
August 28, 2018: Journal of Pediatric Urology
Aimee Baer Ellington, Walter Kuhn, Matthew Lyon
Prospective studies have shown sensitivities of 73% to 88% and specificities of 98% to 100% for using the focused assessment with sonography for trauma (FAST) examination to identify free fluid in adult trauma patients. However, the efficacy of FAST examinations for pediatric trauma patients has not been well defined, and studies looking at diagnostic performance have had varied results. We describe 3 cases of the potential pitfalls of the pediatric FAST examination in pediatric trauma patients using an advanced-processing ultrasound machine...
October 7, 2018: Journal of Ultrasound in Medicine: Official Journal of the American Institute of Ultrasound in Medicine
V Jordan Greenbaum, Michelle S Livings, Betty S Lai, Laurel Edinburgh, Peggy Baikie, Sophia R Grant, Jamie Kondis, Hillary W Petska, Mary Jo Bowman, Lori Legano, Oriaku Kas-Osoka, Shannon Self-Brown
PURPOSE: Estimate the prevalence of child sex trafficking (CST) among patients seeking care in multiple healthcare settings; evaluate a short screening tool to identify victims in a healthcare setting. METHODS: This cross-sectional observational study involved patients from 16 sites throughout the U.S.: five pediatric emergency departments, six child advocacy centers, and five teen clinics. Participants included English-speaking youth ages 11-17years. For emergency department sites, inclusion criteria included a chief complaint of sexual violence...
October 4, 2018: Journal of Adolescent Health: Official Publication of the Society for Adolescent Medicine
Carolyne Ghobrial, Engy Adel Mogahed, Hanaa El-Karaksy
Ascitic fluid infection is a major cause of morbidity and mortality in cirrhotic patients, requiring early diagnosis and therapy. We aimed to determine predictors of ascitic fluid infection in children with chronic liver disease. The study included 45 children with chronic liver disease and ascites who underwent 66 paracentesis procedures. Full history taking and clinical examination of all patients were obtained including fever, abdominal pain and tenderness and respiratory distress. Investigations included: complete blood count, C-reactive protein, full liver function tests, ascitic fluid biochemical analysis, cell count and culture...
2018: PloS One
Anna Budai, András Czigler, Eszter Mikó-Baráth, Vanda A Nemes, Gábor Horváth, Ágota Pusztai, David P Piñero, Gábor Jandó
PURPOSE: Stereo vision tests are widely used in the clinical practice for screening amblyopia and amblyogenic conditions. According to literature, none of these tests seems to be suitable to be used alone as a simple and reliable tool. There has been a growing interest in developing new types of stereo vision tests, with sufficient sensitivity to detect amblyopia. This new generation of assessment tools should be computer based, and their reliability must be statistically warranted. The present study reports the clinical evaluation of a screening system based on random dot stereograms using a tablet as display...
October 3, 2018: Graefe's Archive for Clinical and Experimental Ophthalmology
Zafer Dokumcu, Bade Toker Kurtmen, Emre Divarci, Petek Bayindir Tamay, Timur Kose, Murat Sezak, Geylani Ozok, Orkan Ergun, Ahmet Celik
Background: Decision-making for management may sometimes be difficult in acute appendicitis (AA). Various diagnostic scoring systems exist, but their sensitivity and specificity rates are far from ideal. In this study, the determination of the predictors and the effect of radiological data and developing a new scoring system were aimed. Methods: Medical records of patients who were hospitalized for AA between February 2012 and October 2016 were retrospectively reviewed...
2018: Emergency Medicine International
Takekazu Miyoshi, Hiroshi Hosoda, Michikazu Nakai, Kunihiro Nishimura, Mikiya Miyazato, Kenji Kangawa, Tomoaki Ikeda, Jun Yoshimatsu, Naoto Minamino
BACKGROUND: Diagnosis of fetal heart failure depends primarily on fetal ultrasonography assessment. Our recent study demonstrated that plasma natriuretic peptide levels in umbilical cord blood were correlated with the severity of heart failure in fetuses with congenital heart defects or arrhythmias. However, percutaneous umbilical blood sampling is an invasive procedure, and therefore less or non-invasive biomarkers reflecting fetal heart failure are required. OBJECTIVES: The aim of this study was to investigate the possibility whether maternal serum biomarkers can diagnose fetal heart failure in fetuses with congenital heart defects or arrhythmias...
September 28, 2018: American Journal of Obstetrics and Gynecology
Sulafa Ali, Tajudeen Bushari
Background: Handheld echocardiography (HHE) has been increasingly used for rheumatic heart disease screening and in adult emergency room settings. Aims: This study aimed to validate the accuracy of HHE in the diagnosis of congenital heart disease (CHD). Settings and Design Methodology: This is a prospective study carried out at three pediatric cardiology outpatient clinics in Khartoum, Sudan.All patients with suspected CHD were evaluated by clinical examination followed by HHE, performed using a modified segmental approach...
September 2018: Annals of Pediatric Cardiology
Daniel J Schumacher, Abigail Martini, Eric Holmboe, Kartik Varadarajan, Jamiu Busari, Cees van der Vleuten, Carol Carraccio
OBJECTIVE: Despite the need for quality measures relevant to the work residents complete, few attempts have sought to address this gap. Resident sensitive quality measures (RSQMs) can help fill this void. This study engaged resident and supervisor stakeholders to develop and inform next steps in creating such measures. METHODS: Two separate nominal group techniques (NGT), one with residents and one with faculty and fellow supervisors, were used to generate RSQMs for three specific illnesses (asthma, bronchiolitis, closed head injury) as well as general care for the pediatric emergency department (PED)...
September 27, 2018: Academic Pediatrics
Paul Tangermann, Federica Branchi, Alice Itzlinger, Jens Aschenbeck, Stefan Schubert, Jochen Maul, Thomas Liceni, Andreas Schröder, Frank Heller, Wolfgang Spitz, Ulrich Möhler, Ulrich Graefe, Michael Radke, Stefan Trenkel, Markus Schmitt, Christoph Loddenkemper, Jan C Preiß, Reiner Ullrich, Severin Daum, Britta Siegmund, Christian Bojarski, Michael Schumann
BACKGROUND & AIMS: Point of care tests (POCTs) might be used to identify patients with undiagnosed celiac disease who require further evaluation. We performed a large multicenter study to determine the performance of a POCT for celiac disease and assessed celiac disease prevalence in endoscopy centers. METHODS: We performed a prospective study of 1055 patients (888 adults; median age, 48 yrs and 167 children; median age, 10yrs) referred to 8 endoscopy centers in Germany, for various indications, from January 2016 through June 2017...
September 26, 2018: Clinical Gastroenterology and Hepatology
Yasuo Aihara, Sinichiro Watanabe, Kosaku Amano, Kana Komatsu, Kentaro Chiba, Kosuke Imanaka, Tomokatsu Hori, Takashi Ohba, Hitoshi Dairoku, Yoshikazu Okada, Osami Kubo, Takakazu Kawamata
OBJECTIVE: Placental alkaline phosphatase (PLAP) in CSF can provide a very high diagnostic value in cases of intracranial germ cell tumors (GCTs), especially in pure germinomas, to the level of not requiring histological confirmation. Unlike other tumor markers, reliable data analysis with respect to the diagnostic value of PLAP serum or CSF levels has not been available until now. This is the first systematic and comprehensive study examining the diagnostic value of CSF PLAP in patients with intracranial GCTs...
September 28, 2018: Journal of Neurosurgery
Ruth Ann Marrie, Julia O'Mahony, Colleen Maxwell, Vicki Ling, E Ann Yeh, Douglas L Arnold, Amit Bar-Or, Brenda Banwell
OBJECTIVE: To validate a case definition of multiple sclerosis (MS) in the pediatric population using administrative (health claims) data, and to estimate the incidence and prevalence of MS in the pediatric population for Ontario, Canada. METHODS: We used population-based administrative data to identify persons aged ≤18 years with MS. We assessed the performance of multiple administrative case definitions using a clinical reference cohort including children with MS, children with monophasic demyelinating syndromes, and healthy children; we report sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV)...
September 26, 2018: Neurology
Crystal M Keller, Dawn McNeill, Jill T Piper, Saurabh R Sinha
Subtemporal electrode chains are part of the international 10-10 system. Since 2012, they have been routinely used at our institution in adult patients with intractable epilepsy who are undergoing video EEG evaluation for epilepsy surgery. In 2016, this was extended to the pediatric population. However, there are few data regarding the utility of these electrodes. We performed a retrospective study to investigate the sensitivity and specificity for detection and lateralization of an ictal EEG pattern in patients with temporal lobe epilepsy...
2018: Neurodiagnostic Journal
Neha S Kwatra, Samuel Nurko, Catherine Stamoulis, Anthony E Falone, Frederick D Grant, S Ted Treves
OBJECTIVES: Chronic acalculous cholecystitis (CAC) increasingly is being diagnosed as a cause of recurring biliary symptoms in children, but its clinical diagnosis remains challenging. The primary objective was to evaluate the utility of hepato-cholescintigraphy in pediatric patients with suspected CAC. A secondary objective was to describe their clinical follow-up after diagnosis. METHODS: Medical records of patients (aged 9-20 years) who underwent hepato-cholescintigraphy from February 2008 to January 2012 were reviewed...
September 25, 2018: Journal of Pediatric Gastroenterology and Nutrition
E M Kenyon, J C Lipscomb, R A Pegram, B J George, R N Hines
Biotransformation rates extrapolated from in vitro data are used increasingly in human physiologically based pharmacokinetic (PBPK) models. This practice requires use of scaling factors, including microsomal content (mg of microsomal protein/g liver, MPPGL), enzyme specific content, and liver mass as a fraction of body weight (FVL). Previous analyses indicated that scaling factor variability impacts pharmacokinetic (PK) outcomes used in adult population dose-response studies. This analysis was extended to pediatric populations because large inter-individual differences in enzyme ontogeny likely would further contribute to scaling factor variability...
September 25, 2018: Toxicological Sciences: An Official Journal of the Society of Toxicology
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