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  1. Article ; Online: Hybrid panel of biomarkers can be useful in the diagnosis of pleural and peritoneal effusions.

    Faria, Daniel K / Faria, Caroline S / Doi, Dimitria / Acencio, Milena M P / Antonangelo, Leila

    Clinica chimica acta; international journal of clinical chemistry

    2019  Volume 497, Page(s) 48–53

    Abstract: Background: In clinical practice, pleural and peritoneal effusions are usual diagnosis. We evaluated the performance of a hybrid panel of biomarkers in the diagnosis of the main diseases affecting pleura and/or peritoneum.: Methods: Samples of ... ...

    Abstract Background: In clinical practice, pleural and peritoneal effusions are usual diagnosis. We evaluated the performance of a hybrid panel of biomarkers in the diagnosis of the main diseases affecting pleura and/or peritoneum.
    Methods: Samples of pleural/ peritoneal fluid from 120 patients were evaluated for: CEA (carcinoembryonic antigen), VEGF-A (vascular endothelial growth factor A), PD-L1/B7-H1 (programmed death-ligand 1), NGAL (neutrophil gelatinase-associated lipocalin), TREM-1 (triggering receptor expressed in myeloid cells type-1) and IFNγ (gamma-interferon) by Luminex®; CALP (Calprotectin) by ELISA, and ADA (adenosine deaminase) by enzymatic deamination.
    Results: For malignant effusion (ME) diagnosis, CEA and NGAL presented superior performance than VEGF-A, PD-L1 and CALP. A CEA-NGAL association showed good sensitivity (86.6%) and accuracy (79.2%). For non-tuberculous infectious effusion (NTBIE), NGAL presented the best performance with sensitivity (75.0%), specificity (62.0%) and accuracy (65.0%) higher than TREM-1 and CALP; however, when associated, although with good sensitivity, there was important decrease in specificity. For tuberculous pleural effusion (TPE), IFNy-ADA presented excellent sensitivity (100%), specificity (87.6%), NPV (100%) and accuracies (~90%).
    Conclusions: CEA, NGAL, ADA and IFNy were useful in discriminating ME and TPE. However, for NTBIE diagnosis, the hybrid panel did not demonstrate advantages over the classic parameters.
    MeSH term(s) Adenosine Deaminase/analysis ; Adenosine Deaminase/metabolism ; Adolescent ; Adult ; Aged ; Aged, 80 and over ; Biomarkers/analysis ; Enzyme-Linked Immunosorbent Assay ; Female ; Humans ; Interferon-gamma/analysis ; Interferon-gamma/metabolism ; Male ; Middle Aged ; Paracentesis ; Pleural Effusion, Malignant/diagnosis ; Young Adult
    Chemical Substances Biomarkers ; Interferon-gamma (82115-62-6) ; Adenosine Deaminase (EC 3.5.4.4)
    Language English
    Publishing date 2019-07-13
    Publishing country Netherlands
    Document type Journal Article
    ZDB-ID 80228-1
    ISSN 1873-3492 ; 0009-8981
    ISSN (online) 1873-3492
    ISSN 0009-8981
    DOI 10.1016/j.cca.2019.07.015
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Perception of usefulness of laboratory tests ordering by internal medicine residents in ambulatory setting: A single-center prospective cohort study.

    Doi, Dimitria / Vale, Romulo Ribeiro do / Monteiro, Jean Michell Correia / Plens, Glauco Cabral Marinho / Ferreira Junior, Mario / Fonseca, Luiz Augusto Marcondes / Perazzio, Sandro Félix / Besen, Bruno Adler Maccagnan Pinheiro / Lichtenstein, Arnaldo / Taniguchi, Leandro Utino / Sumita, Nairo Massakazu / Corá, Aline Pivetta / Eisencraft, Adriana Pasmanik / Duarte, Alberto José da Silva

    PloS one

    2021  Volume 16, Issue 5, Page(s) e0250769

    Abstract: The demand for high value health care uncovered a steady trend in laboratory tests ordering and inappropriate testing practices. Residents' training in laboratory ordering practice provides an opportunity for quality improvement. We collected information ...

    Abstract The demand for high value health care uncovered a steady trend in laboratory tests ordering and inappropriate testing practices. Residents' training in laboratory ordering practice provides an opportunity for quality improvement. We collected information on demographics, the main reason for the appointment, preexisting medical conditions and presence of co-morbidities from first-visit patients to the internal medicine outpatient service of our university general hospital. We also collected information on all laboratory tests ordered by the attending medical residents. At a follow-up visit, we recorded residents' subjective perception on the usefulness of each ordered laboratory test for the purposes of diagnosis, prognosis, treatment or screening. We observed that 17.3% of all ordered tests had no perceived utility by the attending resident. Tests were usually ordered to exclude differential diagnoses (26.7%) and to help prognosis estimation (19.1%). Age and co-morbidity influenced the chosen category to legitimate usefulness of tests ordering. This study suggests that clinical objectives (diagnosis, prognosis, treatment or prevention) as well as personalization to age and previous health conditions should be considered before test ordering to allow a more appropriate laboratory tests ordering, but further studies are necessary to examine this framework beyond this medical training scenario.
    MeSH term(s) Adult ; Ambulatory Care Facilities/statistics & numerical data ; Attitude of Health Personnel ; Clinical Laboratory Techniques ; Cohort Studies ; Female ; Humans ; Internal Medicine/education ; Internship and Residency/statistics & numerical data ; Male
    Language English
    Publishing date 2021-05-11
    Publishing country United States
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ISSN 1932-6203
    ISSN (online) 1932-6203
    DOI 10.1371/journal.pone.0250769
    Database MEDical Literature Analysis and Retrieval System OnLINE

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