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Utilization of Malaria diagnostic Tests and Receipt of Anti-Malarial Drugs by Febrile Patients Attending Outpatient Clinics of Health Centre IV Facilities in Mukono District, Uganda

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Health 2014年第13期6卷 1628-1642页

作者： Rose Naigino Achilles Katamba Harriet M. Babikako Aggrey Mukose Makerere University School of Public Health College of Health Sciences Kampala Uganda

Background: Failure to demonstrate the presence of malaria parasites prior to treatment with anti-malarial drugs remains a challenge in Uganda, often resulting into over-prescription of anti-malarial drugs to febrile patients suspected of malaria. The aim of this study was to describe the role of utilization of malaria diagnostic tests and associated factors in the receipt of anti-malarial drugs among febrile patients suspected of malaria. Methods: In a cross-sectional study design, client-exit interviews with febrile patients and key-informant interviews with purposively selected health workers were conducted at outpatient clinics of health centre IV facilities in Mukono district. Data entry and analysis were done using EpiData 3.2 and STATA 10 respectively. Data were described using frequency distributions and proportions. Chi square was used in two by two tables, odds ratios as the measure of association and an alpha level of 0.05 was used in all significance tests. Results: Out of 408 respondents, the majority were female (252, 61.8%) and a third of the samples were aged five years and below. The mean age in years was 3.3 with a standard deviation of 2.1. More than half of the respondents (359, 88%) utilized malaria diagnostic tests and about half (241, 59%) received anti-malarial drugs. There were no statistically significant differences between utilizers and non-utilizers in most characteristics except age, history of indoor residual spraying and perceived satisfaction with services at outpatient clinics. Utilizers were 75% less likely to receive anti-malarial drugs than non-utilizers after controlling for age, sex and residence (OR: 0.25, 95%CI: 0.09, 0.66). Frequent power cut-offs as well as limited knowledge on malaria treatment guidelines amongst laboratory personnel were some of the major limitations to microscopic diagnosis of malaria. Conclusion: Utilizers were 75% less likely to receive anti-malarial drugs as opposed to non-utilizers. This implies that

关键词： Malaria diagnostic Test Febrile Malaria Suspect Utilizers Receipt of Anti-Malarial Drugs

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Update on pre-diabetes: Focus on diagnostic criteria and cardiovascular risk

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World Journal of Diabetes 2016年第18期7卷 423-432页

作者： Antonino Di Pino Francesca Urbano Salvatore Piro Francesco Purrello Agata Maria Rabuazzo Department of Clinical and Experimental Medicine University of Catania

Pre-diabetes, which is typically defined as blood glucose concentrations higher than normal but lower than thediabetes threshold, is a high-risk state for diabetes and cardiovascular disease development. As such, it represents three groups of individuals: Those with impaired fasting glucose(IFG), those with impaired glucose tolerance(IGT) and those with a glycated haemoglobin(HbA1c) between 39-46 mmol/mol. Several clinical trials have shown the important role of IFG, IGT and HbA1c -pre-diabetes as predictive tools for the risk of developing type 2 diabetes. Moreover, with regard to cardiovascular disease, pre-diabetes is associated with more advanced vascular damage compared with normoglycaemia, independently of confounding factors. In view of these observations, diagnosis of pre-diabetes is mandatory to prevent or delay the development of the disease and its complications; however, a number of previous studies reported that the concordance between pre-diabetes diagnoses made by IFG, IGT or HbA1c is scarce and there are conflicting data as to which of these methods best predicts cardiovascular disease. This review highlights recent studies and cur-rent controversies in the field. In consideration of the expected increased use of HbA1c as a screening tool to identify individuals with alteration of glycaemic homeo-stasis, we focused on the evidence regarding the ability of HbA1c as a diagnostic tool for pre-diabetes and as a useful marker in identifying patients who have an increased risk for cardiovascular disease. Finally, we reviewed the current evidence regarding non-traditional glycaemic biomarkers and their use as alternatives to or additions to traditional ones.

关键词： Glycated haemoglobin Cardiovascular risk diagnostic criteria Non-traditional glycaemic markers Pre-diabetes

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Tumor-Associated Autoantibodies: Re-Optimization of EarlyCDT-Lung diagnostic Performance and Its Application to Indeterminate Pulmonary Nodules

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Journal of Cancer Therapy 2017年第5期8卷 506-517页

作者： Graham F. Healey Isabel K. Macdonald Chris Reynolds Jared Allen Andrea Murray Oncimmune Holdings plc Nottingham City Hospital Nottingham UK

Background: Low-dose computed tomography (CT) screening reduces lung cancer mortality but costs are prohibitive for most healthcare budgets due to high false positive rates. An adjunctive test able to distinguish malignant from benign pulmonary nodules would be hugely beneficial. EarlyCDT-Lung measures serum autoantibodies to tumor-associated antigens and has found clinical acceptance to aid early detection of lung cancer for high risk patients. However performance was optimized for screening. The construction of a receiver-operating characteristic (ROC) curve would enable optimization of performance for alternative settings, including nodule malignancy. Methods: A Monte-Carlo search method was used to construct a ROC curve using a case-control cohort, enabling high and low specificity versions of EarlyCDT-Lung to be determined. These were used for a theoretical evaluation of a nodule cohort, and positive predictive value (PPV) was calculated under the assumption of independence of risk source. Patients or their nodules are typically classified into three risk groups: low (0% - 10%), intermediate (10% - 65%) and high (>65%) risk of malignancy. The predicted shift in risk group by application of the high and low specificity versions, along with the current commercial EarlyCDT-Lung, was then estimated. Results: The ROC curve, with an area under the curve of 0.743, was constructed. The high specificity (98%), low specificity (49%) and current commercial (91% specificity) versions of EarlyCDT-Lung re-classified 27%, 23% and 26% of intermediate nodules, respectively, to either a higher (10%, 8% and 10%) or lower (17%, 15% and 16%) risk group. Conclusion: A ROC curve was constructed to allow performance prediction of EarlyCDT-Lung at different specificities in the indeterminate nodule setting. This enabled risk re-classification of intermediate risk nodules, and could therefore facilitate alternative more appropriate intervention. We have shown how a multivariate biomarke

关键词： Tumor-Associated Autoantibodies Indeterminate Pulmonary Nodules diagnostic Screening Computed Tomography ROC Curve

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Diagnosis of Malaria among Blood Donors in Port Harcourt, Nigeria: Microscopy or Rapid diagnostic Tests?

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Advances in Microbiology 2015年第5期5卷 358-363页

作者： Kennedy T. Wariso Ibinabo L. Oboro Department of Medical Microbiology and Parasitology University of Port Harcourt Teaching Hospital Port Harcourt Nigeria

The two most common techniques available for diagnosis of malaria in Nigeria are microscopy and rapid diagnostic tests (RDTs). However, in diagnosing asymptomatic Plasmodium parasitaemia among donors, the preferred technique should not only be timely but must not compromise diagnosis. It should be more sensitive with minimal chances of false negative results. This study was carried out to compare microscopy and RDTs as effective tools for diagnosis of Plasmodium parasitaemia among blood donors in Port Harcourt. There were 200 donors involved in the study among which 135 (67.5%) tested positive and 65 (32.5%) tested negative on microscopy whereas 30 (15.0%) tested positive and 170 (85.0%) tested negative to RDT with a statistically significant difference between both techniques. Data were analysed using the statistical package epi-info version 7.02. We therefore recommend that microscopy using giemsa-stained blood films remain the method of choice for diagnosis of Plasmodium parasitaemia among blood donors to prevent the spread of transfusion malaria.

关键词： Blood Donors Microscopy Rapid diagnostic Tests

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The diagnostic Challenges, Possible Etiologies and Lack of Researches of Hepatocellular Carcinoma in Somalia

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Open Journal of Gastroenterology 2017年第3期7卷 115-123页

作者： Mohamed Abdulkadir Hassan-Kadle Dufle Specialist Hospital Mogadishu Somalia Abrar Research and Training Centre Abrar University Mogadishu Somalia Peoples' Friendship University of Russia (RUDN University) Moscow Russia

Globally, hepatocellular carcinoma is the second amongst all causes of cancer deaths and it is one of the common malignancies in both developing and developed countries. The causes are variety all of the world ranging from geography, life style and advanced medical care that is available in those countries either developing such as Somalia or developed countries. Somali contributes to global burden of hepatitis B which is a known risk factor for HCC and has categorized to the world a part of high prevalence of hepatitis B which is greater than 10%, while there is no more available data of hepatitis C in Somalia that contributes the world. Diagnoses of hepatocellular carcinoma are now forward in many countries of developed world, but reality are different from developing countries such as Somalia which is now out for civil war and has a lack of medical experts in all fields of medicine such as physician, surgeons, pathologists, radiologists and the experts of the laboratory field, even if we have these medical personal who are few or they are elder than above 60 years old plus medical equipment (such as imaging and laboratory equipment). All these challenges, the author of this manuscript has faith in the diagnosis of hepatocellular carcinoma that can be rationally made to consider the clinical presentation of this disorder and to maximize use of offered diagnostic tools and to refer the few medical experts in the country.

关键词： diagnostic Challenges Hepatocellular Carcinoma Somalia

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Prospective Clinical Application of Thioredoxin Reductase as a Novel diagnostic Tumor Marker

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Journal of Biosciences and Medicines 2014年第4期2卷 44-53页

作者： Suofu Ye Nong Yang Weiwei Ma Yanran Fu Lin Wu Yueqin Li Lihui Liu Yi Hui Yu Qiu Siqing Mei Yan Li Huihui Zeng 1Health Science Center Peking University Beijing China 2State Key Laboratory of Natural and Biomimetic Drugs Peking University Beijing China 1Health Science Center Peking University Beijing China 2State Key Laboratory of Natural and Biomimetic Drugs Peking University Beijing China 4Keaise Clinical Examination Lab Wuhan China 5Keaise Medicine (Tianjin) Co. Ltd Tianjin China 6Tianjin International Joint Academy of Biotechnology and Medicine Tianjin China Department of Clinical Laboratory Renmin Hospital Wuhan University Wuhan China Department of Medical Oncology Hunan Provincial Tumor Hospital Changsha China Keaise Clinical Examination Lab Wuhan China

Background: Developing a novel, efficient biomarker for detecting malignant tumors is essential for the early diagnosis of cancers. Our aim was to assess the diagnostic value of a potential plasma tumor marker, thioredoxin reductase (TR), which is expressed in many types of malignant tumor, for the non-invasive detection of cancers. Methods: The plasma activities of TR were measured in 1513 patients with common clinical diseases, 59 patients with benign tumors, and 154 patients with cancers and 586 healthy controls. The area under the ROC curve (AUC) of TR and logistic regression results of different groups were compared by sensitivity, specificity and Youden’s index. diagnostic cut-offs and clinical reference intervals were established via ROC curve analysis. Results: The logistic regression indicated that TR activity can discriminate between cancers and benign tumors or other common diseases very well (p diagnostic gray zone (2.51 - 9.90) may be associated with benign tumors and some common clinical diseases. Conclusions: As a novel potential marker of malignant tumors with quantitative evaluation of proliferation, TR activity detection has an excellent diagnostic potential for early-stage malignant tumors. Impact: The convenient, economical, relatively non-invasive, and reproducible detection method of TR activity makes it suitable for routine clinical practice.

关键词： Thioredoxin Reductase diagnostic Marker Cancer Malignant Tumor TR Activity Abnormal Hyperplasia Proliferation

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Adenopathies in Internal Medicine Etiological Profile and diagnostic Limits

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Open Journal of Internal Medicine 2017年第3期7卷 80-96页

作者： Michel Assane Ndour Atoumane Faye Abdoulaye Leye Boundia Djiba Maimouna Sow Sy Baydi Kane Ngoné Diaba Diack Fall Codou Biram Yakham Mohamed Leye Mouhamed Dieng Nafy Ndiaye Léa Marie Kabou Abdoulaye Pouye Department of Internal Medicine/Endocrinology National Pikine Hospital Center Dakar Sénégal Department of Internal Medicine Center Hospital Aristide Le Dantec Dakar Sénégal Department of Hematology Center Hospital Aristide Le Dantec Dakar Sénégal

INTRODUCTION: An adenopathy is a pathological hypertrophy of a lymph node of various etiologies requiring a rigorous approach. Thus we proposed in this work to study the etiological particularities of patients admitted for adenopathy in order to identify their specificities. METHODS: This was an observational study of a transverse and descriptive type, which took place from 1 July 2015 to 30 June 2016 in the internal medicine department of the Aristide Le Dantec national hospital in Dakar. RESULTS: We identified 84 patients, consisted of 46 male and 38 female. The sex ratio was 1.2. The mean age was 37.5 years. The consultation period was on average 2 months with extremes of 1 month and 1 year. The mean hospital stay was 29. 2 days with extremes of 1 week and 2 months. The etiologies found were classified into 6 groups. Hemopathies (30.9%) were dominated by acute leukemia in 8 patients (9.52%), non-Hodgkin’s lymphoma in 9 patients (9.5%), Hodgkin’s disease in 5 patients (5.9%). Chronic lymphocytic leukemia was retained in 3 patients (3.5%) and Castleman disease in 1 patient. Systemic diseases (11.9%) were divided into lupus disease in 4 patients and rheumatoid arthritis in 4 patients, one case of Sj?gren’s syndrome and one case of sarcoidosis. Infections were very frequent in our study, found in 34 patients (40.4%). Tuberculosis was more frequent (27.3%). The association with HIV was noted in 4 patients. The other infections were pyogenic in 3 patients (3.5%), HIV in 6 patients (7.1%), Borrelia and toxoplasma in 1 patient respectively. Cancers (8.3%) were metastatic of primary tumors including the esophagus, lung, prostate, cavum, stomach, pancreas and breast, one case each. One patient presented lymphadenopathy with inguinal localization, the etiology of which was found to be thrombophlebitis of the right lower limb. The hystiocytic pathologies (3.5%) were all related to lymphohystiocytic activation syndrome (LHAS) secondary to tuberculosis in 2 patients and pyomyo

关键词： Adenopathy Etiologies Dakar diagnostic Limits

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Evaluation of an Innovative diagnostic Method for Detection of Antibodies and Antigens

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International Journal of Clinical Medicine 2017年第5期8卷 306-321页

作者： Mandana Asalkhou Navid Alem Neda A. Ahmadi Nina Hamedi Mehdi Alem Micro Detect Inc. Tustin USA

Reports manifest a continuing need for the development of rapid and on-site (point of care) assays. Current diagnostic methods commonly used for detection of antibodies and antigens have significant limitations. Scientists at Micro Detect, Inc. have developed an innovative diagnostic device (method) that can be utilized broadly for antibody/antigen interactions including diagnostic assays in the medical, veterinary and food industries. The developed device can be utilized for the detection of antibodies against a single antigen or vice versa. It can also be tailored for specific panels that detect antigens or antibodies for diverse infectious agents, proteins, hormones, tumor markers, autoimmune markers, and allergens. Additionally, it can also be used for detection of toxins, antitoxins, nucleic acids, enzymes, drugs, etc. in both humans and animals. Specimens used in different formats of the device can be tears, saliva, whole blood, serum, plasma, urine, stool, and other bodily discharges. The good intra and inter precisions and acceptable linearity of the device support reliable use of the device. The CV of the device is 1.9% - 2.2%. Likewise, the performance of the device using 92 confirmed negative and positive specimens via a typical assay showed 100% sensitivity, 80% specificity, 96.8% efficacy, 80% positive predictive value, and 100% negative predictive value. The results of our feasibility study suggest reliable utility of a device for rapid, easy-to-use, inexpensive, and on-site (point of care) diagnostic assays. This presents a potential breakthrough in diagnostic methodologies that can be integrated into modern medicine and food industries.

关键词： Rapid diagnostic Test UV Laser Spectroscopy Panel Antibody/Antigen Assays Point of Care Testing

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Colonoscopy a Real diagnostic Paragon

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Surgical Science 2017年第6期8卷 256-268页

作者： A. Z. Kaleem N. Naheed S. M. Ahmad Scunthorpe General Hospital North Lincolnshire & Goole NHS Foundation Trust Scunthorpe UK

diagnostic colonoscopy acquires the status of gold standard investigation for evaluation of colonic problems. Formally, colonoscopy was first initiated in June 1969 in America. Colonoscopic history can be traced back to 1958. Matsunaga from Japan was the pioneer as he used a gastrocamera which was the start of colonoscopic era. Flexible sigmoidoscopy was later introduced in 1963. Existing colonic perforation and refusal of a fully compos mentis patient, remain absolute contraindications to diagnostic colonoscopy. Bowel Perforation, although less common, is a disastrous complication of colonoscopy. It is a basic right of any patient who has been offered a colonoscopic procedure to have appropriate, clear and concise information about colonoscopy. Consent literally means permission or an agreement which is granted by a patient to a health care individual to receive examination, test, treatment or intervention. Colonoscopic consent process should be valid and has voluntary, fully informed and capacity aspects as its integral components. There were a lot of oppositions against colonoscopy at that time. It was believed to be dangerous and unnecessary exercise by many surgeons. Time has proved that to be a wrong perception. It is now believed to be an extremely useful diagnostic modality. It is safe procedure in experienced hands and provides valuable clinical information. Colonoscopy is not a pleasant investigation as it is usually related with pain and discomfort by patients;fortunately, good analgesia and safe conscious sedation make this hostile but worthwhile procedure tolerable to *** colonoscopy has kept its status of the gold standard investigation in diagnosing bowel cancer and has prime role in the assessment of majority of large bowel symptoms. Colonoscopy also retains the status of being an investigation with highest sensitivity and specificity, out of all available diagnostic modalities, for identifying adenomatous polyps and now it has acquired a

关键词： diagnostic Colonoscopy Indication Contraindication Complications Colorectal cancer Consent Communication

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Prostate Cancer diagnostic and Evaluation in Gaza-Strip, Palestine

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Health 2015年第11期7卷 1552-1559页

作者： Y. S. M. Alajerami K. M. Abushab S. I. Alagha A. M. Beeram Ahmed Najim Roentgen Department of Medical Radiology Al-Azhar University Gaza Strip Palestine Department of Computed Tomography Al-Shifa Hospital Gaza Strip Palestine

Prostate cancer has the third highest cancer incidence in Palestinian men with incidence rate about 4.5/100,000, and an increase in new cases by 50% between 2000 and 2015. Prostate cancer death rates have been obviously decreased in many countries due to treatment, precise screening. The current study aims to review and evaluate the new diagnosed prostate cancer in the Gaza Strip, Palestine. As a cross-sectional, quantitative and analytical approach based on structured review, the current study was conducted at Al-Shifa and European hospitals (main oncology departments in governmental hospitals). Interviews with newly diagnosed cancer prostate patients were carried out during the period of March and June, 2014;a total of 41 newly diagnosed with primary cancer prostate. Furthermore, demographic, health status, medical investigations and tests are reported from oncologists and hospital archives over the last five years (2010-2014). The current study showed that there were 41 new prostate cancer cases in three months with incidence rate 5.1 per 100,000. The highest rate of incidence was among the patients above age of 70+, 70 - 74 (29.3%). The results showed that 58.1% of the patients were smokers, and 22.6% used to smoke, while 16.1% responded they don’t smoke at all. The most common type of treatment used by participants was chemotherapy therapy followed by hormonal therapy and prostatectomy. The least common methods used for treatment were radiation therapy and combination of hormonal, radiation, and chemotherapy as only 5 participants used each type of these treatment options. The prevalence of prostate cancer was higher among men who lived in Gaza Governorate compared to other governorates. Limited use of radiation therapy was due to the unavailability of this treatment in Gaza Strip.

关键词： Prostate Cancer diagnostic and Evaluation Gaza Strip

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