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We aimed to elucidate the accuracy and optimal cut-off point of the self-diagnosis of influenza and the associated clinical symptoms of children by their guardians, compared with those of the rapid influenza diagnostic test (RIDT).
Seasonal influenza is a common outpatient problem during the winter season. A paediatric influenza epidemic has socio-economic impacts like temporary school closure, school event cancellations, and unscheduled work absences among parents. Hence, early identification and assessment of influenza to prevent its spread is important from a societal perspective.
We performed a cross-sectional observational study in a rural clinic in Japan every winter season from December 2013 to March 2016. We retrospectively extracted information from the medical records and pre-examination checklists of 24 patients aged <12 years (mean age, 5.4 years; men, 54.2%). The data extracted from the medical records and pre-examination checklist included the baseline characteristics (age, sex and past medical history of influenza), clinical signs and symptoms, diagnosis by guardians (%) and RIDT results.
The optimal cut-off point of the self-diagnosis of influenza by guardians was 80%, with a sensitivity and specificity of 63.6% (95% confidence interval: 30.8–89.1) and 92.3% (64.0–99.8). At a 50% cut-off point, the sensitivity and specificity were 90.9% (58.7–99.8) and 53.8% (25.1−80.8). The accuracy of feeling severely sick, as estimated by the guardians showed a sensitivity and specificity of 90.9% (58.7–99.8) and 69.2% (38.6–90.9). Our study indicates that the diagnosis of seasonal influenza by guardians to their children would be useful in the establishment of both confirmatory diagnoses when it has high probability above the optimal cut-off point (80%), and exclusion diagnosis when it has low probability (50%). Not feeling severely sick, estimated by the guardians might be a useful indicator for the exclusion of paediatric influenza.
Because of its lethal prognosis when advanced, early detection and resection of gastric cancer remains the best means of treating this neoplasm. In the hope of detecting this cancer in its earliest possible form, chromoendoscopy with indigo carmine spray was developed. This technique enhances fine surface structures and color contrast of the mucosa, resulting in improved diagnostic accuracy. Since the late 1990s, advances in biomedical optics have been applied to overcome the limitations of chromoendoscopy for detecting various gastrointestinal (GI) diseases. Endoscopists require meticulous endoscopic technique and considerable clinical experience in diagnosing early gastric cancer (EGC). New and improved endoscopic modalities are being developed for screening high-risk patients.
The flexible spectral imaging color enhancement (FICE) system was introduced in 2005 as a novel image-processing tool for video endoscopy. FICE enhances the contrast of the gastric mucosal surface without the use of dyes. Because image processing can be executed using the endoscope processor, FICE does not require modification of the light source as does the narrow band imaging (NBI) system. Additionally, FICE provides optimal band images with the same light intensity as the conventional endoscope. Indeed, FICE can facilitate detection of changes in EGC without magnification and can accurately confirm the diagnosis of cancer with 40-fold magnification.
After an endoscopically detailed examination has been performed and the patient meets inclusion criteria, endoscopic therapy of EGC can be performed with the expectation of a complete cure.
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