In 2019, the American Society for Gastrointestinal Endoscopy (ASGE) guideline on the endoscopic management of choledocholithiasis modified the individual predictors of choledocholithiasis proposed in the widely referenced 2010 guideline to improve predictive performance. Nevertheless, the primary literature, especially for the 2019 iteration, is limited. We performed a systematic review with meta-analysis to examine the diagnostic performance of the 2010, and where possible the 2019, predictors. PROSPERO protocol CRD42020194226. A comprehensive literature search from 2001 to 2020 was performed to identify studies on the diagnostic performance of any of the 2010 and 2019 ASGE choledocholithiasis predictors. Identified studies underwent keyword screening, abstract review, and full-text review. The primary outcomes included multivariate odds ratios (ORs) and 95% confidence intervals for each criterion. Secondary outcomes were reported sensitivities, specificities, and positive and negative predictive value. A total of 20 studies met inclusion criteria. Based on reported ORs, of the 2010 guideline "very strong" predictors, ultrasound with stone had the strongest performance. Of the "strong" predictors, CBD > 6 mm demonstrated the strongest performance. "Moderate" predictors had inconsistent and/or weak performance; moreover, all studies reported gallstone pancreatitis as non-predictive of choledocholithiasis. Only one study examined the new predictor (bilirubin > 4 mg/dL and CBD > 6 mm) proposed in the 2019 guideline. Based on this review, aside from CBD stone on ultrasound, there is discordance between the proposed strength of 2010 choledocholithiasis predictors and their published diagnostic performance. The 2019 guideline appears to do away with the weakest 2010 predictors.
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http://dx.doi.org/10.1007/s12328-021-01575-4 | DOI Listing |
Epilepsia
January 2025
Division of Child Neurology, Stanford Medicine Children's Health, California, USA.
Objective: Seizures are a recognized complication of critical cardiovascular illness in infants and children. We assessed the diagnostic yield of continuous video-electroencephalography (cEEG) in a pediatric and neonatal cardiovascular intensive care unit (CVICU) by the symptoms and risk factors prompting cEEG evaluation.
Methods: This retrospective case series included all consecutive cEEGs in patients ≤21 years old performed in one CVICU over 38 months.
Radiol Phys Technol
January 2025
Department of Diagnostic Imaging, Tohoku University Graduate School of Medicine, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8575, Japan.
Self-supervised learning (SSL) has gained attention in the medical field as a deep learning approach utilizing unlabeled data. The Jigsaw puzzle task in SSL enables models to learn both features of images and the positional relationships within images. In breast cancer diagnosis, radiologists evaluate not only lesion-specific features but also the surrounding breast structures.
View Article and Find Full Text PDFJ Endocrinol Invest
January 2025
Section of Endocrinology, Geriatrics and Internal Medicine, Department of Medical Sciences, University of Ferrara, Ferrara, Italy.
Aim: This review aims to overview factors contributing to TAO development and addresses the targeted diagnostic work-up and treatment management in adult thalassemic patients.
Results: Osteoporosis management in Thalassemia is challenging because several factors contributing to its pathogenesis should be considered and controlled starting from child- hood. A multidisciplinary approach is crucial.
Clin J Gastroenterol
January 2025
Division of Endoscopy, Shizuoka Cancer Center, 1007 Shimonagakubo, Nagaizumi-Cho, Sunto-Gun, Shizuoka, 411-8777, Japan.
Anal canal cancer (ACC) is a rare yet noteworthy malignancy that is strongly associated with high-risk human papillomaviruses (HPVs). This case report highlights the diagnostic utility of endocytoscopy (EC) in distinguishing high-grade squamous intraepithelial lesions (HSILs) from low-grade lesions (LSILs) in a 57-year-old male presenting with hematochezia. Traditional magnifying endoscopy was inconclusive; however, EC provided detailed visualization of cellular and vascular changes, facilitating a diagnosis of HPV-associated HSIL or carcinoma in situ.
View Article and Find Full Text PDFChilds Nerv Syst
January 2025
Department of Pediatric Neurosurgery, Medical University of Silesia in Katowice, Medykow 16, 40-752, Katowice, Poland.
Purpose: This study aimed to summarize the existing English-language literature on central nervous system (CNS) meningeal melanocytomas in children, and additionally describe our institutional case report.
Methods: PubMed database was screened on September 2, 2024, for English-language papers reporting on pediatric patients with CNS meningeal melanocytoma.
Results: A total of 17 papers reporting on 18 patients with 19 CNS meningeal melanocytomas were found in the literature.
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