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61.
Gesine Respondek MD Sigrun Roeber MD Hans Kretzschmar MD Claire Troakes PhD Safa Al‐Sarraj FRCPath Ellen Gelpi MD Carles Gaig MD Wang Zheng Chiu MD John C. van Swieten MD Wolfgang H. Oertel MD Günter U. Höglinger MD 《Movement disorders》2013,28(4):504-509
Autopsy is the diagnostic gold standard for progressive supranuclear palsy (PSP). The National Institute of Neurological Disorders and Stroke and Society for Progressive Supranuclear Palsy (NINDS‐SPSP) criteria for the clinical diagnosis of “probable” PSP are thought to possess high specificity and low sensitivity. The NINDS‐SPSP criteria for “possible” PSP are considered to increase sensitivity at the expense of specificity. The Neuroprotection and Natural History in Parkinson Plus Syndromes (NNIPPS) criteria are intended to improve sensitivity while maintaining high specificity. The aim of this study was to conduct a clinicopathological evaluation of the NINDS‐SPSP and NNIPPS criteria in tertiary neurological centers. Defined clinical features and their year of onset were recorded by chart review in neuropathologically diagnosed patients with PSP, Parkinsons's disease (PD), MSA parkinsonism and corticobasal degeneration from four European brain banks. Fulfilment of the clinical diagnostic criteria was verified for each year after disease onset and for the final antemortem record. We analyzed 98 PSP patients and 46 disease controls. The NINDS‐SPSP “probable” criteria yielded shorter time to diagnosis, slightly higher specificity and positive predictive value (PPV), and similar sensitivity, compared with the NNIPPS criteria. Unexpectedly, the NINDS‐SPSP “possible” criteria yielded the lowest sensitivity, specificity, and PPV. A combination of NINDS‐SPSP possible and probable criteria yielded the highest sensitivity. We suggest that the NINDS‐SPSP probable criteria might be preferred for recruitment of patients for clinical trials, where an early and specific diagnosis is important. For routine clinical care, where high sensitivity is crucial, a combination of NINDS possible and probable criteria might be preferred. © 2013 Movement Disorder Society 相似文献
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Jina Pakpoor Micheal Raad Andrew Harris Varun Puvanesarajah Joseph K. Canner Rohini Nadgir Amit Jain 《Journal of the American College of Radiology》2019,16(11):1522-1527
ObjectiveHigh-value care guidelines from multiple medical societies recommend against imaging for the initial evaluation of low back pain in the absence of red flag symptoms. We aimed to determine the current temporal and geographic landscape of imaging ordering patterns for this indication among US primary care providers.MethodsUsing a national commercial insurance claims database, we identified patients between 18 and 64 years old who presented to a primary care provider for an initial evaluation of low back pain between 2011 and 2016. Patients were identified via International Classification of Diseases codes, and the use of diagnostic imaging was identified by Current Procedural Terminology codes. Geographic regions were based on the location of patient residence.ResultsOverall, 627,118 encounters met inclusion criteria. Imaging acquisitions increased over time, from 14% of encounters in 2011 to 16% in 2016 (P < .01). Radiographs represented 96% of ordered imaging, CT 2%, and MRI 3%. The likelihood of having any imaging for low back pain varied significantly by US census region and by US state (P < .01). The greatest use of imaging was in the Midwest (13.9%) and the South (18.5%), and lowest in the Northeast and West (6.2% and 13.6%).DiscussionImaging utilization for the initial evaluation of low back pain by primary care providers has increased on a national level from 2011 to 2016, largely represented by radiographs. Significant regional variation also exists. Encouragingly, the use of advanced imaging has remained at a low level in the primary care setting (<1.0%). 相似文献
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Transoral laser microsurgery for oropharyngeal squamous cell carcinoma: A paradigm shift in therapeutic approach 下载免费PDF全文
Mark D. Wilkie MRCS DO‐HNS Navdeep S. Upile MRCS DO‐HNS Andrew S. Lau MRCS DO‐HNS Stephen P. Williams MRCS Jon Sheard FRCPath Tim R. Helliwell FRCPath Max Robinson FRCPath Jennifer Rodrigues FRCA Krishna Beemireddy FRCA Huw Lewis–Jones FRCR Rebecca Hanlon FRCR David Husband FRCR Aditya Shenoy FRCR Nicholas J. Roland FRCS Shaun R. Jackson FRCS Fazilet Bekiroglu FRCS Sankalap Tandon FRCS Jeffrey Lancaster FRCS Terence M. Jones FRCS 《Head & neck》2016,38(8):1263-1270
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Feasibility of a novel classification for parotid gland cytology: A retrospective review of 512 cytology reports taken from 4 United Kingdom general hospitals 下载免费PDF全文
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Walker NJ Yoshizawa K Miller RA Brix AE Sells DM Jokinen MP Wyde ME Easterling M Nyska A 《Toxicologic pathology》2007,35(7):880-889
Dioxin and dioxin-related compounds have been associated with high incidences of pulmonary dysfunctions and/or cancers in humans. To evaluate the relative potencies of effects of these compounds, the National Toxicology Program completed a series of two-year bioassays which were conducted using female Harlan Sprague-Dawley rats. The rats were treated orally for up to 2 years with 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD), 3,3',4,4',5-pentachlorobiphenyl (PCB126), 2,3,4,7,8-pentachlorodibenzofuran (PeCDF), and a ternary mixture of TCDD, PCB126 and PeCDF. In addition to treatment-related effects reported in other organs, a variety of pulmonary lesions were observed that were related to exposure. Pulmonary CYP1A1-associated 7-ethoxyresorufin-O-deethylase (EROD) activity was increased in all dosed groups. The most common non-neoplastic lesions, which occurred in all studies, were bronchiolar metaplasia and squamous metaplasia of the alveolar epithelium. Cystic keratinizing epithelioma was the most commonly observed neoplasm which occurred in all studies. A low incidence of squamous cell carcinoma was associated only with PCB126 treatment. Potential mechanisms leading to altered differentiation and/or proliferation of bronchiolar and alveolar epithelia may be through CYP1A1 induction or disruption of retinoid metabolism. 相似文献
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