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Clinical pathway diagnostic test

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https://www.readbyqxmd.com/read/28513998/ibd-due-to-pid-inflammatory-bowel-disease-caused-by-primary-immunodeficiencies-clinical-presentations-review-of-literature-and-proposal-of-a-rational-diagnostic-algorithm
#1
REVIEW
Daniel Tegtmeyer, Maximilian Seidl, Patrick Gerner, Ulrich Baumann, Christian Klemann
Inflammatory bowel diseases (IBD) including Crohn's disease (CD) and ulcerative colitis (UC) have a multifactorial pathogenesis with complex interactions between polygenetic predispositions and environmental factors. However, IBD can also be caused by monogenic diseases, such as primary immunodeficiencies (PID). Recently, an increasing number of these altogether rare diseases has been described to present often primarily, or solely as IBD. Early recognition of these conditions enables adaption of therapies and thus directly benefits the course of IBDs...
May 17, 2017: Pediatric Allergy and Immunology
https://www.readbyqxmd.com/read/28510335/proteoforms-in-peripheral-blood-mononuclear-cells-as-novel-rejection-biomarkers-in-liver-transplant-recipients
#2
T K Toby, M Abecassis, K Kim, P M Thomas, R T Fellers, R D LeDuc, N L Kelleher, J Demetris, J Levitsky
Biomarker profiles of acute rejection in liver transplant recipients could enhance the diagnosis and management of recipients. Our aim was to identify diagnostic proteoform signatures of acute rejection in circulating immune cells, using an emergent "top down" proteomics methodology. We prepared differentially processed and cryopreserved cell lysates from 26 non-viral liver transplant recipients by molecular weight-based fractionation and analyzed them by mass spectrometry of whole proteins in three steps: 1) Nanocapillary liquid chromatography coupled with high-resolution tandem mass spectrometry; 2) database searching to identify and characterize intact proteoforms; 3) data processing through a hierarchical linear model matching the study design to quantify proteoform fold changes in patients with rejection vs...
May 16, 2017: American Journal of Transplantation
https://www.readbyqxmd.com/read/28501910/targeting-the-dominant-mechanism-of-coronary-microvascular-dysfunction-with-intracoronary-physiology-tests
#3
REVIEW
Hernán Mejía-Rentería, Nina van der Hoeven, Tim P van de Hoef, Julius Heemelaar, Nicola Ryan, Amir Lerman, Niels van Royen, Javier Escaned
The coronary microcirculation plays a key role in modulating blood supply to the myocardium. Several factors like myocardial oxygen demands, endothelial and neurogenic conditions determine its function. Although there is available evidence supporting microvascular dysfunction as an important cause of myocardial ischaemia, with both prognostic and symptomatic implications, its diagnosis and management in clinical practice is still relegated to a second plane. Both diagnostic and therapeutic approaches are hampered by the broadness of the concept of microvascular dysfunction, which fails addressing the plurality of mechanisms leading to dysfunction...
May 13, 2017: International Journal of Cardiovascular Imaging
https://www.readbyqxmd.com/read/28499889/recent-advances-in-epilepsy-genetics
#4
REVIEW
Alessandro Orsini, Federico Zara, Pasquale Striano
In last few years there has been rapid increase in the knowledge of epilepsy genetics. Nowadays, it is estimated that genetic epilepsies include over than 30% of all epilepsy syndromes. Several genetic tests are now available for diagnostic purposes in clinical practice. In particular, next-generation sequencing has proven to be effective in revealing gene mutations causing epilepsies in up to a third of the patients. This has lead also to functional studies that have given insight into disease pathophysiology and consequently to the identification of potential therapeutic targets opening the way of precision medicine for epilepsy patients...
May 9, 2017: Neuroscience Letters
https://www.readbyqxmd.com/read/28499299/-current-diagnostic-procedures-for-diagnosing-vertigo-and-dizziness
#5
Leif Erik Walther
Modern diagnostic methods such as video head impulse test and cervical and ocular vestibular evoked myogenic potentials allow to measure canal and otolith function quantitatively and objectively. These methods contribute to a complex assessment of the functional integrity of all 5 sensory elements of the vestibular organ for the first time. Moreover, in combination with additional vestibular tests frequency specific and time depended changes of impairments of vestibular sensors and their pathways can be assessed...
April 2017: Laryngo- Rhino- Otologie
https://www.readbyqxmd.com/read/28487129/identification-of-potential-diagnostic-biomarkers-of-acute-pancreatitis-by-serum-metabolomic-profiles
#6
Hong Xiao, Jian-Hua Huang, Xing-Wen Zhang, Rida Ahmed, Qing-Ling Xie, Bin Li, Yi-Ming Zhu, Xiong Cai, Qing-Hua Peng, Yu-Hui Qin, Hui-Yong Huang, Wei Wang
Acute pancreatitis (AP) is defined as an acute inflammation of pancreas that may cause damage to other tissues and organs depending upon the severity of symptoms. The diagnosis of AP is usually made by detection of raised circulating pancreatic enzyme levels, but there are occasional false positive and false negative diagnoses and such tests are often normal in delayed presentations. More accurate biomarkers would help in such situations. In this study, the global metabolites' changes of AP patients (APP) were profiled by using gas chromatography-mass spectrometry (GC-MS)...
May 3, 2017: Pancreatology: Official Journal of the International Association of Pancreatology (IAP) ... [et Al.]
https://www.readbyqxmd.com/read/28472808/idiopathic-pulmonary-fibrosis-molecular-endotypes-of-fibrosis-stratifying-existing-and-emerging-therapies
#7
Daniele Magnini, Giuliano Montemurro, Bruno Iovene, Linda Tagliaboschi, Rafael Emanuele Gerardi, Erminia Lo Greco, Teresa Bruni, Alessio Fabbrizzi, Francesco Lombardi, Luca Richeldi
Idiopathic pulmonary fibrosis (IPF) is a specific form of chronic, progressive fibrosing interstitial pneumonia of unknown causes. Current diagnostic criteria are based on radiological, clinical, and histopathological features but, unfortunately, still many patients remain undiagnosed. Two currently approved therapies, pirfenidone and nintedanib, slow down disease progression but failed to block or revert it. On the other hand, many of the therapeutic agents tested in several clinical trials have not given satisfactory answers, probably due to the pathological heterogeneity of the disease...
2017: Respiration; International Review of Thoracic Diseases
https://www.readbyqxmd.com/read/28467580/how-to-avoid-negative-appendectomies-can-us-achieve-this
#8
Kinyas Kartal, Pınar Yazıcı, Taner Mehmet Ünlü, Mehmet Uludağ, Mehmet Mihmanlı
BACKGROUND: Clinical diagnosis of acute appendicitis is based primarily on symptoms and physical findings. However, diagnosis of appendicitis is not always straightforward. The aim of this study was to demonstrate the diagnostic effectiveness of ultrasonography (US) in these cases in combination with white blood cell count (WBC) and C-reactive protein (CRP) level. METHODS: Retrospective analysis of data collected on 470 consecutive patients who underwent appendectomy at the same institution between January 2014 and January 2016 was conducted...
March 2017: Ulusal Travma Ve Acil Cerrahi Dergisi, Turkish Journal of Trauma & Emergency Surgery: TJTES
https://www.readbyqxmd.com/read/28466882/asia-pacific-consensus-statement-on-the-optimal-use-of-high-sensitivity-troponin-assays-in-acute-coronary-syndromes-diagnosis-focus-on-hs-tni
#9
COMMENT
Jack Wei Chieh Tan, Carolyn S P Lam, Sazzli Shahlan Kasim, Tar Choon Aw, Joel M Abanilla, Wei-Ting Chang, Van Phuoc Dang, Maria Iboleon-Dy, Sari Sri Mumpuni, Arintaya Phommintikul, Manh Cuong Ta, Punkiat Topipat, Kai Hang Yiu, Louise Cullen
OBJECTIVE: High-sensitivity troponin (hs-Tn) assays need to be applied appropriately to improve diagnosis and patient outcomes in acute coronary syndromes (ACS). METHODS: Experts from Asia Pacific convened in 2015 to provide data-driven consensus-based, region-specific recommendations and develop an algorithm for the appropriate incorporation of this assay into the ACS assessment and treatment pathway. RESULTS: Nine recommendations were developed by the expert panel: (1) troponin is the preferred cardiac biomarker for diagnostic assessment of ACS and is indicated for patients with symptoms of possible ACS; (2) hs-Tn assays are recommended; (3) serial testing is required for all patients; (4) testing should be performed at presentation and 3 hours later; (5) gender-specific cut-off values should be used for hs-Tn I assays; (6) hs-Tn I level >10 times the upper limit of normal should be considered to 'rule in' a diagnosis of ACS; (7) dynamic change >50% in hs-Tn I level from presentation to 3-hour retest identifies patients at high risk for ACS; (8) where only point-of-care testing is available, patients with elevated readings should be considered at high risk, while patients with low/undetectable readings should be retested after 6 hours or sent for laboratory testing and (9) regular education on the appropriate use of troponin tests is essential...
2017: Heart Asia
https://www.readbyqxmd.com/read/28464835/streamlining-staging-of-lung-and-colorectal-cancer-with-whole-body-mri-study-protocols-for-two-multicentre-non-randomised-single-arm-prospective-diagnostic-accuracy-studies-streamline-c-and-streamline-l
#10
Stuart A Taylor, Sue Mallett, Anne Miles, Sandy Beare, Gauraang Bhatnagar, John Bridgewater, Rob Glynne-Jones, Vicky Goh, Ashley M Groves, Sam M Janes, Dow Mu Koh, Steve Morris, Alison Morton, Neal Navani, Alf Oliver, Anwar R Padhani, Shonit Punwani, Andrea G Rockall, Steve Halligan
BACKGROUND AND AIMS: Rapid and accurate cancer staging following diagnosis underpins patient management, in particular the identification of distant metastatic disease. Current staging guidelines recommend sequential deployment of various imaging platforms such as computerised tomography (CT) and positron emission tomography (PET) which can be time and resource intensive and onerous for patients. Recent studies demonstrate that whole body magnetic resonance Imaging (WB-MRI) may stage cancer efficiently in a single visit, with potentially greater accuracy than current staging investigations...
May 2, 2017: BMC Cancer
https://www.readbyqxmd.com/read/28460339/recommendations-for-molecular-testing-in-classical-ph1-neg-myeloproliferative-disorders-a-consensus-project-of-the-italian-society-of-hematology
#11
REVIEW
Paola Guglielmelli, Daniela Pietra, Fabrizio Pane, Alessandro Pancrazzi, Mario Cazzola, Alessandro M Vannucchi, Sante Tura, Giovanni Barosi
The discovery that Philadelphia-negative classical myeloproliferative neoplasms (MPNs) present with several molecular abnormalities, including the mostly represented JAK2V617F mutation, opened new horizons in the diagnosis, prognosis, and monitoring of these disorders. However, the great strides in the knowledge on molecular genetics need parallel progresses on the best approach to methods for detecting and reporting disease-associated mutations, and to shape the most effective and rationale testing pathway in the diagnosis, prognosis and monitoring of MPNs...
April 23, 2017: Leukemia Research
https://www.readbyqxmd.com/read/28454087/evaluation-of-autoantibody-signatures-in-meningioma-patients-using-human-proteome-arrays
#12
Shabarni Gupta, Shuvolina Mukherjee, Parvez Syed, Narendra Goud Pandala, Saket Choudhary, Vedita Anand Singh, Namrata Singh, Heng Zhu, Sridhar Epari, Santosh B Noronha, Aliasgar Moiyadi, Sanjeeva Srivastava
Meningiomas are one of the most common tumors of the Central nervous system (CNS). This study aims to identify the autoantibody biomarkers in meningiomas using high-density human proteome arrays (~17,000 full-length recombinant human proteins). Screening of sera from 15 unaffected healthy individuals, 10 individuals with meningioma grade I and 5 with meningioma grade II was performed. This comprehensive proteomics based investigation revealed the dysregulation of 489 and 104 proteins in grades I and II of meningioma, respectively, along with the enrichment of several signalling pathways, which might play a crucial role in the manifestation of the disease...
April 10, 2017: Oncotarget
https://www.readbyqxmd.com/read/28446943/the-updated-nice-guidelines-cardiac-ct-as-the-first-line-test-for-coronary-artery-disease
#13
REVIEW
Alastair J Moss, Michelle C Williams, David E Newby, Edward D Nicol
PURPOSE OF REVIEW: Cost-effective care pathways are integral to delivering sustainable healthcare programmes. Due to the overestimation of coronary artery disease using traditional risk tables, non-invasive testing has been utilised to improve risk stratification and initiate appropriate management to reduce the dependence on invasive investigations. In line with recent technological improvements, cardiac CT is a modality that offers a detailed anatomical assessment of coronary artery disease comparable to invasive coronary angiography...
2017: Current Cardiovascular Imaging Reports
https://www.readbyqxmd.com/read/28446515/role-of-biomarkers-for-the-prevention-assessment-and-management-of-heart-failure-a-scientific-statement-from-the-american-heart-association
#14
REVIEW
Sheryl L Chow, Alan S Maisel, Inder Anand, Biykem Bozkurt, Rudolf A de Boer, G Michael Felker, Gregg C Fonarow, Barry Greenberg, James L Januzzi, Michael S Kiernan, Peter P Liu, Thomas J Wang, Clyde W Yancy, Michael R Zile
BACKGROUND AND PURPOSE: Natriuretic peptides have led the way as a diagnostic and prognostic tool for the diagnosis and management of heart failure (HF). More recent evidence suggests that natriuretic peptides along with the next generation of biomarkers may provide added value to medical management, which could potentially lower risk of mortality and readmissions. The purpose of this scientific statement is to summarize the existing literature and to provide guidance for the utility of currently available biomarkers...
April 26, 2017: Circulation
https://www.readbyqxmd.com/read/28445293/possible-pathways-used-to-predict-different-stages-of-lung-adenocarcinoma
#15
Xiaodong Chen, Qiongyu Duan, Ying Xuan, Yunan Sun, Rong Wu
We aimed to find some specific pathways that can be used to predict the stage of lung adenocarcinoma.RNA-Seq expression profile data and clinical data of lung adenocarcinoma (stage I [37], stage II 161], stage III [75], and stage IV [45]) were obtained from the TCGA dataset. The differentially expressed genes were merged, correlation coefficient matrix between genes was constructed with correlation analysis, and unsupervised clustering was carried out with hierarchical clustering method. The specific coexpression network in every stage was constructed with cytoscape software...
April 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28444709/male-bladder-outlet-obstruction-time-to-re-evaluate-the-definition-and-reconsider-our-diagnostic-pathway-ici-rs-2015
#16
REVIEW
Kevin Rademakers, Marcus J Drake, Andrew Gammie, Jens C Djurhuus, Peter F W M Rosier, Paul Abrams, Christopher Harding
The diagnosis of bladder outlet obstruction (BOO) in the male is dependent on measurements of pressure and flow made during urodynamic studies. The procedure of urodynamics and the indices used to delineate BOO are well standardized largely as a result of the work of the International Continence Society. The clinical utility of the diagnosis of BOO is however, less well defined and there are several shortcomings and gaps in the currently available medical literature. Consequently the International Consultation on Incontinence Research Society (ICI-RS) held a think tank session in 2015 entitled "Male bladder outlet obstruction: Time to re-evaluate the definition and reconsider our diagnostic pathway?" This manuscript details the discussions that took place within that think tank setting out the pros and cons of the current definition of BOO and exploring alternative clinical tests (alone or in combination) which may be useful in the future investigation of male patients with lower urinary tract symptoms...
April 2017: Neurourology and Urodynamics
https://www.readbyqxmd.com/read/28444705/under-what-circumstances-should-stress-incontinence-surgery-be-performed-at-the-same-time-as-prolapse-surgery-ici-rs-2015
#17
REVIEW
Vik Khullar, Ralf Anding, Dudley Robinson, David Castro-Diaz, Roger Dmochowski, Linda Cardozo
AIMS: An International Consultation on Incontinence-Research Society (ICI-RS) Think Tank in 2015 discussed and evaluated the evidence of when stress incontinence surgery should be performed with prolapse surgery and highlighted evidence gaps, with the aim of recommending further clinical and research proposals. METHODS: A review of the literature assessing randomized studies where women with vaginal prolapse have been randomized to vaginal prolapse surgery with or without continence surgery were evaluated...
April 2017: Neurourology and Urodynamics
https://www.readbyqxmd.com/read/28444640/diagnostic-value-of-the-dual-luciferase-report-assay-for-predicting-response-to-glucocorticoid-in-children-with-acute-lymphoblastic-leukemia
#18
X Wang, P Chen, Y Sun, Y Chen, M Mao, T Jiang, J Ouyang
OBJECTIVE: Resistance to glucocorticoid (GC) is a significant clinical problem in some cases of acute lymphoblastic leukemia (ALL). Current methods of assessing GC resistance are time consuming and have limited reproducibility; in this study, we sought to define a new method of evaluating GC sensitivity and resistance in vitro. METHODS: Based on the mechanisms of GC resistance, we hypothesized that the dual-luciferase report (DLR) assay could reflect the transcription effects of GC downstream of the GC-glucocorticoid receptor signaling pathway, thereby allowing the evaluation of reactions to GC...
April 25, 2017: Clinical & Translational Oncology
https://www.readbyqxmd.com/read/28428191/the-role-of-minimal-residual-disease-testing-in-myeloma-treatment-selection-and-drug-development-current-value-and-future-applications
#19
Kenneth C Anderson, Daniel Auclair, Gary J Kelloff, Caroline C Sigman, Herve Avet-Loiseau, Ann T Farrell, Nicole J Gormley, Shaji K Kumar, Ola Landgren, Nikhil C Munshi, Michele Cavo, Faith E Davies, Alessandra Di Bacco, Jennifer S Dickey, Steven I Gutman, Howard R Higley, Mohamad A Hussein, J Milburn Jessup, Ilan R Kirsch, Richard F Little, Robert D Loberg, Jens G Lohr, Lata Mukundan, James L Omel, Trevor J Pugh, Gregory H Reaman, Michael D Robbins, A Kate Sasser, Nancy Valente, Elena Zamagni
Treatment of myeloma has benefited from the introduction of more effective and better tolerated agents, improvements in supportive care, better understanding of disease biology, revision of diagnostic criteria, and new sensitive and specific tools for disease prognostication and management. Assessment of minimal residual disease (MRD) in response to therapy is one of these tools, as longer progression-free survival (PFS) is seen consistently among patients who have achieved MRD negativity. Current therapies lead to unprecedented frequency and depth of response, and next generation flow and sequencing methods to measure MRD in bone marrow are in use and being developed with sensitivities in the range of 10(-5)‒10(-6) cells...
April 20, 2017: Clinical Cancer Research: An Official Journal of the American Association for Cancer Research
https://www.readbyqxmd.com/read/28424823/-coma-in-the-emergency-room
#20
M Braun, C J Ploner, T Lindner, M Möckel, W U Schmidt
Coma of unknown origin (CUO) is a frequent unspecific emergency symptom associated with a high mortality. A fast diagnostic work-up is essential given the wide spectrum of underlying diagnoses that are made up of approximately 50% primary central nervous system (CNS) pathologies and approximately 50% extracerebral, almost exclusively internal medical causes. Despite the high mortality associated with this symptom, there are currently no generally accepted management guidelines for adult patients presenting with CUO...
April 19, 2017: Der Nervenarzt
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