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[PMID]:29372596
[Au] Autor:Villanacci V; Lorenzi L; Donato F; Auricchio R; Dziechciarz P; Gyimesi J; Koletzko S; Misak Z; Laguna VM; Polanco I; Ramos D; Shamir R; Troncone R; Vriezinga SL; Mearin ML
[Ad] Endereço:Institute of Pathology, ASST Spedali Civili di Brescia, Brescia, Italy.
[Ti] Título:Histopathological evaluation of duodenal biopsy in the PreventCD project. An observational interobserver agreement study.
[So] Source:APMIS;126(3):208-214, 2018 Mar.
[Is] ISSN:1600-0463
[Cp] País de publicação:Denmark
[La] Idioma:eng
[Ab] Resumo:Aim of the current study was to evaluate the inter-observer agreement between pathologists in the diagnosis of celiac disease (CD), in the qualified context of a multicenter study. Biopsies from the "PreventCD" study, a multinational- prospective- randomized study in children with at least one-first-degree relative with CD and positive for HLA-DQ2/HLA-DQ8. Ninety-eight biopsies were evaluated. Considering diagnostic samples with villous atrophy (VA), the agreement was satisfactory (κ = 0.84), but much less when assessing the severity of these lesions. The use of the recently proposed Corazza-Villanacci classification showed a moderately higher level of agreement (κ = 0.39) than using the Marsh-Oberhuber system (κ = 0.31). 57.1% of cases were considered correctly oriented. A number of >4 samples per patient was statistically associated to a better agreement; orientation did not impact on κ values. Agreement results in this study appear more satisfactory than in previous papers and this is justified by the involvement of centers with experience in CD diagnosis and by the well-controlled setting. Despite this, the reproducibility was far from optimal with a poor agreement in grading the severity of VA. Our results stress the need of a minimum of four samples to be assessed by the pathologist.
[Mh] Termos MeSH primário: Doença Celíaca/diagnóstico
Doença Celíaca/patologia
Antígenos HLA-DQ/imunologia
Mucosa Intestinal/patologia
[Mh] Termos MeSH secundário: Biópsia
Criança
Pré-Escolar
Duodeno/patologia
Seres Humanos
Lactente
Variações Dependentes do Observador
Estudos Prospectivos
Reprodutibilidade dos Testes
[Pt] Tipo de publicação:JOURNAL ARTICLE; MULTICENTER STUDY; OBSERVATIONAL STUDY; RANDOMIZED CONTROLLED TRIAL
[Nm] Nome de substância:
0 (HLA-DQ Antigens); 0 (HLA-DQ2 antigen); 0 (HLA-DQ8 antigen)
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180309
[Lr] Data última revisão:
180309
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180127
[St] Status:MEDLINE
[do] DOI:10.1111/apm.12812


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[PMID]:28453758
[Au] Autor:Daperno M; Comberlato M; Bossa F; Armuzzi A; Biancone L; Bonanomi AG; Cosintino R; Lombardi G; Mangiarotti R; Papa A; Pica R; Grassano L; Pagana G; D'Incà R; Orlando A; Rizzello F; IGIBDEndo Group
[Ad] Endereço:Gastroenterology Unit, AO Ordine Mauriziano, Torino, TO, Italy.
[Ti] Título:Training Programs on Endoscopic Scoring Systems for Inflammatory Bowel Disease Lead to a Significant Increase in Interobserver Agreement Among Community Gastroenterologists.
[So] Source:J Crohns Colitis;11(5):556-561, 2017 May 01.
[Is] ISSN:1876-4479
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:Background and Aims: Endoscopic outcomes are increasingly used in clinical trials and in routine practice for inflammatory bowel disease [IBD] in order to reach more objective patient evaluations than possible using only clinical features. However, reproducibility of endoscopic scoring systems used to categorize endoscopic activity has been reported to be suboptimal. The aim of this study was to analyse the inter-rated agreement of non-dedicated gastroenterologists on IBD endoscopic scoring systems, and to explore the effects of a dedicated training programme on agreement. Methods: A total of 237 physicians attended training courses on IBD endoscopic scoring systems, and they independently scored a set of IBD endoscopic videos for ulcerative colitis [with Mayo endoscopic subscore], post-operative Crohn's disease [with Rutgeerts score] and luminal Crohn's disease (with the Simple Endoscopic Score for Crohn's Disease [SESCD] and Crohn's Endoscopic Index of Severity [CDEIS]). A second round of scoring was collected after discussion about determinants of discrepancy. Interobserver agreement was measured by means of the Fleiss' kappa [kappa] or intraclass correlation coefficient [ICC] as appropriate. Results: The inter-rater agreement increased from kappa 0.51 (95% confidence interval [95% CI] 0.48-0.55) to 0.76 [95% CI 0.72-0.79] for the Mayo endoscopic subscore, and from 0.45 [95% CI 0.40-0.50] to 0.79 [0.74-0.83] for the Rutgeerts score before and after the training programme, respectively, and both differences were significant [P < 0.0001]. The ICC was 0.77 [95% CI 0.56-0.96] for SESCD and 0.76 [0.54- 0.96] for CDEIS, respectively, with only one measurement. Discussion: The basal inter-rater agreement of inexperienced gastroenterologists focused on IBD management is moderate; however, a dedicated training programme can significantly impact on inter-rater agreement, increasing it to levels expected among expert central reviewers.
[Mh] Termos MeSH primário: Colonoscopia/educação
Gastroenterologistas/educação
Doenças Inflamatórias Intestinais/diagnóstico
[Mh] Termos MeSH secundário: Colite Ulcerativa/diagnóstico
Colite Ulcerativa/patologia
Doença de Crohn/diagnóstico
Doença de Crohn/patologia
Educação Médica Continuada/métodos
Gastroenterologistas/estatística & dados numéricos
Seres Humanos
Doenças Inflamatórias Intestinais/patologia
Variações Dependentes do Observador
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180308
[Lr] Data última revisão:
180308
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170429
[St] Status:MEDLINE
[do] DOI:10.1093/ecco-jcc/jjw181


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[PMID]:28465449
[Au] Autor:Geller BM; Nelson HD; Weaver DL; Frederick PD; Allison KH; Onega T; Carney PA; Tosteson ANA; Elmore JG
[Ad] Endereço:Department of Family Medicine, University of Vermont, Burlington, Vermont, USA.
[Ti] Título:Characteristics associated with requests by pathologists for second opinions on breast biopsies.
[So] Source:J Clin Pathol;70(11):947-953, 2017 Nov.
[Is] ISSN:1472-4146
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:AIMS: Second opinions in pathology improve patient safety by reducing diagnostic errors, leading to more appropriate clinical treatment decisions. Little objective data are available regarding the factors triggering a request for second opinion despite second opinion consultations being part of the diagnostic system of pathology. Therefore we sought to assess breast biopsy cases and interpreting pathologists characteristics associated with second opinion requests. METHODS: Collected pathologist surveys and their interpretations of 60 test set cases were used to explore the relationships between case characteristics, pathologist characteristics and case perceptions, and requests for second opinions. Data were evaluated by logistic regression and generalised estimating equations. RESULTS: 115 pathologists provided 6900 assessments; pathologists requested second opinions on 70% (4827/6900) of their assessments 36% (1731/4827) of these would not have been required by policy. All associations between case characteristics and requesting second opinions were statistically significant, including diagnostic category, breast density, biopsy type, and number of diagnoses noted per case. Exclusive of institutional policies, pathologists wanted second opinions most frequently for atypia (66%) and least frequently for invasive cancer (20%). Second opinion rates were higher when the pathologist had lower assessment confidence, in cases with higher perceived difficulty, and cases with borderline diagnoses. CONCLUSIONS: Pathologists request second opinions for challenging cases, particularly those with atypia, high breast density, core needle biopsies, or many co-existing diagnoses. Further studies should evaluate whether the case characteristics identified in this study could be used as clinical criteria to prompt system-level strategies for mandating second opinions.
[Mh] Termos MeSH primário: Biópsia
Doenças Mamárias/patologia
Mama/patologia
Patologistas
Encaminhamento e Consulta
[Mh] Termos MeSH secundário: Adulto
Idoso
Atitude do Pessoal de Saúde
Competência Clínica
Estudos Transversais
Diagnóstico Diferencial
Erros de Diagnóstico/prevenção & controle
Feminino
Conhecimentos, Atitudes e Prática em Saúde
Seres Humanos
Modelos Logísticos
Masculino
Meia-Idade
Variações Dependentes do Observador
Patologistas/psicologia
Valor Preditivo dos Testes
Reprodutibilidade dos Testes
[Pt] Tipo de publicação:JOURNAL ARTICLE; OBSERVATIONAL STUDY
[Em] Mês de entrada:1711
[Cu] Atualização por classe:180307
[Lr] Data última revisão:
180307
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170504
[St] Status:MEDLINE
[do] DOI:10.1136/jclinpath-2016-204231


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[PMID]:28749736
[Au] Autor:Weerawanich W; Shimizu M; Takeshita Y; Okamura K; Yoshida S; Yoshiura K
[Ad] Endereço:1 Department of Oral and Maxillofacial Radiology, Faculty of Dental Science, Kyushu University , Kyushu University , Fukuoka , Japan.
[Ti] Título:Cluster signal-to-noise analysis for evaluation of the information content in an image.
[So] Source:Dentomaxillofac Radiol;47(1):20170147, 2018 Jan.
[Is] ISSN:0250-832X
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:OBJECTIVES: (1) To develop an observer-free method of analysing image quality related to the observer performance in the detection task and (2) to analyse observer behaviour patterns in the detection of small mass changes in cone-beam CT images. METHODS: 13 observers detected holes in a Teflon phantom in cone-beam CT images. Using the same images, we developed a new method, cluster signal-to-noise analysis, to detect the holes by applying various cut-off values using ImageJ and reconstructing cluster signal-to-noise curves. We then evaluated the correlation between cluster signal-to-noise analysis and the observer performance test. We measured the background noise in each image to evaluate the relationship with false positive rates (FPRs) of the observers. Correlations between mean FPRs and intra- and interobserver variations were also evaluated. Moreover, we calculated true positive rates (TPRs) and accuracies from background noise and evaluated their correlations with TPRs from observers. RESULTS: Cluster signal-to-noise curves were derived in cluster signal-to-noise analysis. They yield the detection of signals (true holes) related to noise (false holes). This method correlated highly with the observer performance test (R = 0.9296). In noisy images, increasing background noise resulted in higher FPRs and larger intra- and interobserver variations. TPRs and accuracies calculated from background noise had high correlation with actual TPRs from observers; R was 0.9244 and 0.9338, respectively. CONCLUSIONS: Cluster signal-to-noise analysis can simulate the detection performance of observers and thus replace the observer performance test in the evaluation of image quality. Erroneous decision-making increased with increasing background noise.
[Mh] Termos MeSH primário: Tomografia Computadorizada de Feixe Cônico
Interpretação de Imagem Radiográfica Assistida por Computador/métodos
[Mh] Termos MeSH secundário: Seres Humanos
Variações Dependentes do Observador
Imagens de Fantasmas
Politetrafluoretileno
Razão Sinal-Ruído
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
9002-84-0 (Polytetrafluoroethylene)
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180301
[Lr] Data última revisão:
180301
[Sb] Subgrupo de revista:D
[Da] Data de entrada para processamento:170728
[St] Status:MEDLINE
[do] DOI:10.1259/dmfr.20170147


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[PMID]:29267317
[Au] Autor:Hassan T; Thiberville L; Hermant C; Lachkar S; Piton N; Guisier F; Salaun M
[Ad] Endereço:Department of Respiratory Care, Thoracic Oncology, and Respiratory Intensive Care & CIC-CRB U1404, Rouen University Hospital, Rouen, France.
[Ti] Título:Assessing the feasibility of confocal laser endomicroscopy in solitary pulmonary nodules for different part of the lungs, using either 0.6 or 1.4 mm probes.
[So] Source:PLoS One;12(12):e0189846, 2017.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Malignant solitary pulmonary nodules (SPN) have become more prevalent, with upper lobes predilection. Probe-based confocal laser endomicroscopy (pCLE) provides in-vivo imaging of SPN. However, the stiffness of the 1mm confocal probe (AlveoFlex) causes difficult accessibility to the upper lobes. A thinner 600µm probe designed for bile duct exploration (CholangioFlex) has the potential to reach the upper lobes. OBJECTIVES: To examine the accessibility of malignant SPNs in all segments of the lungs using either the 0.6mm or 1.4 mm probe and to assess the quality and inter observer interpretation of SPN confocal imaging obtained from either miniprobes. METHODS: Radial(r)-EBUS was used to locate and sample the SPN. In-vivo pCLE analysis of the SPN was performed using either CholangioFlex (apical and posterior segments of the upper lobes) or AlveoFlex (other segments) introduced into the guide sheath before sampling. pCLE features were compared between the two probes. RESULTS: Fourty-eight patients with malignant SPN were included (NCT01931579). The diagnostic accuracy for lung cancer using r-EBUS coupled with pCLE imaging was 79.2%. All the SPNs were successfully explored with either one of the probes (19 and 29 subjects for CholangioFlex and AlveoFlex, respectively). A specific solid pattern in the SPN was found in 30 pCLE explorations. Comparison between the two probes found no differences in the axial fibers thickness, cell size and specific solid pattern in the nodules. Extra-alveolar microvessel size appeared larger using CholangioFlex suggesting less compression effect. The kappa test for interobserver agreement for the identification of solid pattern was 0.74 (p = 0.001). CONCLUSION: This study demonstrates that pCLE imaging of SPNs is achievable in all segments of both lungs using either the 0.6mm or 1.4mm miniprobe.
[Mh] Termos MeSH primário: Microscopia Confocal/métodos
Nódulo Pulmonar Solitário/patologia
[Mh] Termos MeSH secundário: Idoso
Estudos de Viabilidade
Feminino
Seres Humanos
Masculino
Microscopia Confocal/instrumentação
Meia-Idade
Variações Dependentes do Observador
Projetos Piloto
Alvéolos Pulmonares/patologia
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180228
[Lr] Data última revisão:
180228
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171222
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0189846


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[PMID]:28468744
[Au] Autor:Özgen B; Bulut E; Dolgun A; Bajin MD; Sennaroglu L
[Ad] Endereço:Department of Radiology, Hacettepe University School of Medicine, Ankara, Turkey. burce@hacettepe.edu.tr.
[Ti] Título:Accuracy of turbo spin-echo diffusion-weighted imaging signal intensity measurements for the diagnosis of cholesteatoma.
[So] Source:Diagn Interv Radiol;23(4):300-306, 2017 Jul-Aug.
[Is] ISSN:1305-3612
[Cp] País de publicação:Turkey
[La] Idioma:eng
[Ab] Resumo:PURPOSE: We aimed to evaluate the diagnostic accuracy of turbo spin-echo diffusion-weighted imaging (TSE-DWI) at 3 T, for cholesteatoma (CS) diagnosis, using qualitative and quantitative methods with numerical assessment of signal intensity (SI), signal intensity ratios (SIR), and apparent diffusion coefficient (ADC) values. METHODS: In this retrospective study, two blinded observers independently evaluated the preoperative TSE-DWI images of 57 patients who were imaged with a presumed diagnosis of CS. Qualitative assessment with respect to the SI of the adjacent cortex and quantitative measurements of SI, SIR, and ADC values were performed. RESULTS: Surgery with histopathologic examination revealed 30 CS patients and 27 patients with non-cholesteatoma (NCS) lesions including chronic inflammation and cholesterol granuloma. On TSE-DWI, 96.7% of the CS lesions and none of the NCS lesions appeared hyperintense compared with the cortex. The mean SI and SIR indices of the CS group were significantly higher and the mean ADC values significantly lower compared with those of the NCS group (P < 0.001). Using specific cutoff values for SI (92.5) and SIR (0.9), CS could be diagnosed with 100% sensitivity and specificity. The use of quantitative imaging further increased the sensitivity of the TSE-DWI technique. CONCLUSION: The quantitative indices of SI, SIR, and ADC of TSE-DWI appear to be highly accurate parameters that can be used to confirm the diagnosis of CS.
[Mh] Termos MeSH primário: Colesteatoma da Orelha Média/diagnóstico por imagem
Imagem de Difusão por Ressonância Magnética/métodos
[Mh] Termos MeSH secundário: Adolescente
Adulto
Criança
Pré-Escolar
Diagnóstico Diferencial
Orelha Média/diagnóstico por imagem
Feminino
Seres Humanos
Masculino
Meia-Idade
Variações Dependentes do Observador
Estudos Retrospectivos
Sensibilidade e Especificidade
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180228
[Lr] Data última revisão:
180228
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170505
[St] Status:MEDLINE
[do] DOI:10.5152/dir.2017.16024


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[PMID]:29215311
[Au] Autor:Becker AS; Mueller M; Stoffel E; Marcon M; Ghafoor S; Boss A
[Ad] Endereço:1 Institute of Diagnostic and Interventional Radiology, University Hospital of Zurich , Zurich , Switzerland.
[Ti] Título:Classification of breast cancer in ultrasound imaging using a generic deep learning analysis software: a pilot study.
[So] Source:Br J Radiol;91(1083):20170576, 2018 Feb.
[Is] ISSN:1748-880X
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: To train a generic deep learning software (DLS) to classify breast cancer on ultrasound images and to compare its performance to human readers with variable breast imaging experience. METHODS: In this retrospective study, all breast ultrasound examinations from January 1, 2014 to December 31, 2014 at our institution were reviewed. Patients with post-surgical scars, initially indeterminate, or malignant lesions with histological diagnoses or 2-year follow-up were included. The DLS was trained with 70% of the images, and the remaining 30% were used to validate the performance. Three readers with variable expertise also evaluated the validation set (radiologist, resident, medical student). Diagnostic accuracy was assessed with a receiver operating characteristic analysis. RESULTS: 82 patients with malignant and 550 with benign lesions were included. Time needed for training was 7 min (DLS). Evaluation time for the test data set were 3.7 s (DLS) and 28, 22 and 25 min for human readers (decreasing experience). Receiver operating characteristic analysis revealed non-significant differences (p-values 0.45-0.47) in the area under the curve of 0.84 (DLS), 0.88 (experienced and intermediate readers) and 0.79 (inexperienced reader). CONCLUSION: DLS may aid diagnosing cancer on breast ultrasound images with an accuracy comparable to radiologists, and learns better and faster than a human reader with no prior experience. Further clinical trials with dedicated algorithms are warranted. Advances in knowledge: DLS can be trained classify cancer on breast ultrasound images high accuracy even with comparably few training cases. The fast evaluation speed makes real-time image analysis feasible.
[Mh] Termos MeSH primário: Neoplasias da Mama/diagnóstico por imagem
Neoplasias da Mama/patologia
Competência Clínica
Interpretação de Imagem Assistida por Computador/métodos
Aprendizado de Máquina
Ultrassonografia Mamária/métodos
[Mh] Termos MeSH secundário: Adolescente
Adulto
Idoso
Idoso de 80 Anos ou mais
Algoritmos
Feminino
Seres Humanos
Meia-Idade
Variações Dependentes do Observador
Estudos Retrospectivos
Software
Suíça
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180226
[Lr] Data última revisão:
180226
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:171208
[St] Status:MEDLINE
[do] DOI:10.1259/bjr.20170576


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[PMID]:28448667
[Au] Autor:Bater KL; Ishii LE; Papel ID; Kontis TC; Byrne PJ; Boahene KDO; Nellis JC; Ishii M
[Ad] Endereço:Johns Hopkins School of Medicine, Baltimore, Maryland.
[Ti] Título:Association Between Facial Rejuvenation and Observer Ratings of Youth, Attractiveness, Success, and Health.
[So] Source:JAMA Facial Plast Surg;19(5):360-367, 2017 Sep 01.
[Is] ISSN:2168-6092
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Importance: Surgical procedures for the aging face-including face-lift, blepharoplasty, and brow-lift-consistently rank among the most popular cosmetic services sought by patients. Although these surgical procedures are broadly classified as procedures that restore a youthful appearance, they may improve societal perceptions of attractiveness, success, and health, conferring an even larger social benefit than just restoring a youthful appearance to the face. Objectives: To determine if face-lift and upper facial rejuvenation surgery improve observer ratings of age, attractiveness, success, and health and to quantify the effect of facial rejuvenation surgery on each individual domain. Design, Setting, and Participants: A randomized clinical experiment was performed from August 30 to September 18, 2016, using web-based surveys featuring photographs of patients before and after facial rejuvenation surgery. Observers were randomly shown independent images of the 12 patients; within a given survey, observers saw either the preoperative or postoperative photograph of each patient to reduce the possibility of priming. Observers evaluated patient age using a slider bar ranging from 30 to 80 years that could be moved up or down in 1-year increments, and they ranked perceived attractiveness, success, and health using a 100-point visual analog scale. The bar on the 100-point scale began at 50; moving the bar to the right corresponded to a more positive rating in these measures and moving the bar to the left, a more negative rating. Main Outcomes and Measures: A multivariate mixed-effects regression model was used to understand the effect of face-lift and upper facial rejuvenation surgery on observer perceptions while accounting for individual biases of the participants. Ordinal rank change was calculated to understand the clinical effect size of changes across the various domains after surgery. Results: A total of 504 participants (333 women, 165 men, and 6 unspecified; mean age, 29 [range, 18-70] years) successfully completed the survey. A multivariate mixed-effects regression model revealed a statistically significant change in age (-4.61 years; 95% CI, -4.97 to -4.25) and attractiveness (6.72; 95% CI, 5.96-7.47) following facial rejuvenation surgery. Observer-perceived success (3.85; 95% CI, 3.12-4.57) and health (7.65; 95% CI; 6.87-8.42) also increased significantly as a result of facial rejuvenation surgery. Conclusions and Relevance: The data presented in this study demonstrate that patients are perceived as younger and more attractive by the casual observer after undergoing face-lift and upper facial rejuvenation surgery. These procedures also improved ratings of perceived success and health in our patient population. These findings suggest that facial rejuvenation surgery conveys an even larger societal benefit than merely restoring a youthful appearance to the face. Level of Evidence: NA.
[Mh] Termos MeSH primário: Envelhecimento/psicologia
Blefaroplastia/psicologia
Rejuvenescimento/psicologia
Ritidoplastia/psicologia
[Mh] Termos MeSH secundário: Logro
Adolescente
Adulto
Idoso
Idoso de 80 Anos ou mais
Atitude Frente à Saúde
Beleza
Feminino
Nível de Saúde
Seres Humanos
Masculino
Meia-Idade
Variações Dependentes do Observador
Projetos Piloto
Análise de Regressão
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL
[Em] Mês de entrada:1710
[Cu] Atualização por classe:180227
[Lr] Data última revisão:
180227
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170428
[St] Status:MEDLINE
[do] DOI:10.1001/jamafacial.2017.0126


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[PMID]:29443769
[Au] Autor:Cheng H; Yi D; Si J; Hu J; Yang Y; Peng J
[Ad] Endereço:National Academy of Innovation Strategy, China Association for Science and Technology.
[Ti] Título:Establishment of Comprehensive Indicators in TCM Pectoral-qi Case Report Based on Experts Diagnosis and Self-test Technology.
[So] Source:Medicine (Baltimore);97(7):e9916, 2018 Feb.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:RATIONALE: To establish TCM Pectoral-qi comprehensive indicators and highlight the inner structure among different variables in an objective way, the article uses Partial Least Square Second-order Latent Variable Model (PLS-SLVM) and accomplishes 3 different comprehensive indicators based on both experts diagnosis and self-test data. SLVM includes a measurement model that defines the relationship between observed variables and latent variables and a structure model that imputes relationships between latent variables. The article focuses on PLS as the estimation method. Without normal distribution and independence assumptions, PLS uses objective weighting methods based on the data. Bootstrap method (B = 200) is used to calculate the mean value and standard errors of the PLS estimates. The article chooses the percentile interval to obtain the confidence interval of PLS parameters. PATIENT CONCERNS: The patients were diagnosed by the means of experts diagnosis and self-test technology. On the one hand, the patients want to know the effect of self-test by wearing a kind of instrument. On the other hand, we want to establish TCM Pectoral-qi comprehensive indicators and highlight the inner structure among different variables in an objective way. DIAGNOSES: The group of 59 subjects are the same no matter whether they were diagnosed through TCM Pectoral-qi Assessment Questionnaire of self-test technology. INTERVENTIONS: The same group of 59 subjects keep wearing the instrument for hours and get the self-test data consequently. OUTCOMES: As one of comprehensive indicator establishing methods, PLS-SLVM highlights the structure state among variables and improves the evaluation efficiency. Furthermore, it provides a new tool and method in TCM diseases prevention and health security. LESSONS: As expected, PLS-SLVM is a useful tool due to its nonassumption of normal distribution and independence with consideration of correlation among different variables. Thus PLS-SLVM can be applied in ordinal data from assessment questionnaire and continuous data about physicochemical indexes for the same group of people. It displays that PLS-SLVM builds a connection between TCM experts diagnosis and the self-testing technology.
[Mh] Termos MeSH primário: Indicadores Básicos de Saúde
Medicina Tradicional Chinesa
Avaliação de Resultados (Cuidados de Saúde)
Qi
[Mh] Termos MeSH secundário: Algoritmos
China
Precisão da Medição Dimensional
Seres Humanos
Medicina Tradicional Chinesa/métodos
Medicina Tradicional Chinesa/normas
Modelos Teóricos
Variações Dependentes do Observador
Avaliação de Resultados (Cuidados de Saúde)/métodos
Avaliação de Resultados (Cuidados de Saúde)/normas
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180222
[Lr] Data última revisão:
180222
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180215
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000009916


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[PMID]:29315315
[Au] Autor:Lollert A; Stihl C; Hötker AM; Mengel E; König J; Laudemann K; Gökce S; Düber C; Staatz G
[Ad] Endereço:Department of Diagnostic and Interventional Radiology, Section of Pediatric Radiology, Medical Center of the Johannes Gutenberg University, Mainz, Germany.
[Ti] Título:Quantification of intramuscular fat in patients with late-onset Pompe disease by conventional magnetic resonance imaging for the long-term follow-up of enzyme replacement therapy.
[So] Source:PLoS One;13(1):e0190784, 2018.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: The objective of this study was to evaluate a quantitative method based on conventional T1-weighted magnetic resonance (MR) imaging to assess fatty muscular degeneration in patients with late-onset Pompe disease and to compare it with semi-quantitative visual evaluation (the Mercuri score). In addition, a long-term retrospective data analysis was performed to evaluate treatment response to enzyme replacement therapy with alglucosidase alfa. METHODS: MR images of the lumbar spine were acquired in 41 patients diagnosed with late-onset Pompe disease from 2006 through 2015. Two independent readers retrospectively evaluated fatty degeneration of the psoas and paraspinal muscles by applying the Mercuri score. Quantitative semi-automated muscle and fat tissue separation was performed, and inter-observer agreement and correlations with clinical parameters were assessed. Follow-up examinations were performed in 13 patients treated with alglucosidase alfa after a median of 39 months; in 7/13 patients, an additional follow-up examination was completed after a median of 63 months. RESULTS: Inter-observer agreement was high. Measurements derived from the quantitative method correlated well with Medical Research Council scores of muscle strength, with moderate correlations found for the 6-minute walk test, the 4-step stair climb test, and spirometry in the supine position. A significant increase in the MR-derived fat fraction of the psoas muscle was found between baseline and follow-up 1 (P = 0.016), as was a significant decrease in the performance on the 6-minute walk test (P = 0.006) and 4-step stair climb test (P = 0.034), as well as plasma creatine kinase (P = 0.016). No statistically significant difference in clinical or MR-derived parameters was found between follow-up 1 and follow-up 2. CONCLUSIONS: Quantification of fatty muscle degeneration using the semi-automated method can provide a more detailed overview of disease progression than semi-quantitative Mercuri scoring. MR-derived data correlated with clinical symptoms and patient exercise capacity. After an initial worsening, the fat fraction of the psoas muscle and performance on the 6-minute walk test stayed constant during long-term follow-up under enzyme replacement therapy.
[Mh] Termos MeSH primário: Tecido Adiposo/diagnóstico por imagem
Terapia de Reposição de Enzimas/métodos
Doença de Depósito de Glicogênio Tipo II/diagnóstico por imagem
Imagem por Ressonância Magnética/métodos
Músculo Esquelético/diagnóstico por imagem
alfa-Glucosidases/administração & dosagem
[Mh] Termos MeSH secundário: Adolescente
Adulto
Idade de Início
Idoso
Criança
Feminino
Seguimentos
Doença de Depósito de Glicogênio Tipo II/etiologia
Seres Humanos
Masculino
Meia-Idade
Músculo Esquelético/patologia
Variações Dependentes do Observador
Estudos Retrospectivos
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T
[Nm] Nome de substância:
EC 3.2.1.20 (GAA protein, human); EC 3.2.1.20 (alpha-Glucosidases)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180222
[Lr] Data última revisão:
180222
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180110
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0190784



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