The Experts below are selected from a list of 315 Experts worldwide ranked by ideXlab platform
David P Steensma - One of the best experts on this subject based on the ideXlab platform.
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is refractory anaemia with ring sideroblasts and thrombocytosis rars t a necessary or useful Diagnostic Category
British Journal of Haematology, 2009Co-Authors: Douglas Wardrop, David P SteensmaAbstract:Summary Both the 2001 World Health Organisation (WHO) classification of haematopoietic neoplasms and the 2008 WHO classification revision include a distinctive Diagnostic Category, refractory anaemia with ring sideroblasts and thrombocytosis (RARS-T), to describe those rare patients who have both ≥15% ring sideroblasts and a sustained elevated platelet count. Recently, it has become clear that patients meeting WHO criteria for RARS-T have clonal JAK2V617F and MPLW515 mutations at a similar rate to essential thrombocythaemia (ET). Given that the provisional classification of RARS-T as a myelodysplastic syndrome/myeloproliferative neoplasm (MDS/MPN) overlap syndrome, rather than as a form of MPN (i.e., ET), rests principally upon the presence of ring sideroblasts, which are a non-specific morphological finding, these new molecular results prompt reconsideration of the necessity for a distinctive RARS-T Category. Here we review the historical developments that led up the definition of RARS-T as a disease entity, and we discuss conceptual understanding of RARS-T and arguments against continued use of RARS-T as a separate Diagnostic Category.
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Is refractory anaemia with ring sideroblasts and thrombocytosis (RARS‐T) a necessary or useful Diagnostic Category?
British journal of haematology, 2008Co-Authors: Douglas Wardrop, David P SteensmaAbstract:Summary Both the 2001 World Health Organisation (WHO) classification of haematopoietic neoplasms and the 2008 WHO classification revision include a distinctive Diagnostic Category, refractory anaemia with ring sideroblasts and thrombocytosis (RARS-T), to describe those rare patients who have both ≥15% ring sideroblasts and a sustained elevated platelet count. Recently, it has become clear that patients meeting WHO criteria for RARS-T have clonal JAK2V617F and MPLW515 mutations at a similar rate to essential thrombocythaemia (ET). Given that the provisional classification of RARS-T as a myelodysplastic syndrome/myeloproliferative neoplasm (MDS/MPN) overlap syndrome, rather than as a form of MPN (i.e., ET), rests principally upon the presence of ring sideroblasts, which are a non-specific morphological finding, these new molecular results prompt reconsideration of the necessity for a distinctive RARS-T Category. Here we review the historical developments that led up the definition of RARS-T as a disease entity, and we discuss conceptual understanding of RARS-T and arguments against continued use of RARS-T as a separate Diagnostic Category.
Isam A. Eltoum - One of the best experts on this subject based on the ideXlab platform.
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Suspicious cytologic Diagnostic Category in endoscopic ultrasound-guided FNA of the pancreas: Follow-up and outcomes
Cancer cytopathology, 2015Co-Authors: Evan Alston, Sejong Bae, Isam A. EltoumAbstract:BACKGROUND The objective of the current study was to assess how the suspicious Category is followed up in a large endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) service, its outcomes, and the predictors that are likely to be associated with the subsequent diagnosis of a neoplastic process. METHODS For pancreatic EUS-FNA samples with the suspicious Category diagnosis, the authors reviewed the electronic medical record for the method of follow-up and the risks associated with pancreatic malignancy. Logistic regression analysis was used to determine the risk factors that were likely to be associated with the diagnosis of a neoplastic lesion after a cytologic diagnosis of “suspicious.” RESULTS Of a total of 3832 EUS-FNA cases, 116 were diagnosed with suspicious cytology. A total of 90 of 98 neoplasms (92%) were identified, including 72 carcinomas (73%). Similar rates of neoplasia were detected after repeat FNA (34 of 37 neoplasms [92%]) and subsequent biopsy/surgical resection (44 of 46 neoplasms [96%]), but significantly fewer neoplasms were detected among patients with clinical follow-up (18 of 23 neoplasms [78%]). On multivariate analysis of the potential predictive variables listed above, the presence of a mass was found to be significantly associated with a higher rate of diagnosis of a neoplasm, whereas weight loss was significantly associated with a diagnosis of carcinoma. CONCLUSIONS The Diagnostic Category of “suspicious” is associated with a high risk of benign and malignant neoplasms, regardless of the method of follow-up. The presence of a mass and weight loss are significant predictors of a subsequent diagnosis of a neoplasm after suspicious cytology. In patients with suspicious cytology and these findings, surgery is recommended for resectable masses and repeat FNA for unresectable masses. Cancer (Cancer Cytopathol) 2015. © 2015 American Cancer Society.
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Atypical cytologic Diagnostic Category in EUS-FNA of the pancreas: Follow-up, outcomes, and predictive models
Cancer cytopathology, 2014Co-Authors: Evan Alston, Sejong Bae, Isam A. EltoumAbstract:BACKGROUND The objective of this study was to assess how atypical Diagnostic Category (ADC) is followed up, its outcomes, and the predictors that are associated with subsequent diagnosis of neoplasm/malignancy. METHODS We reviewed pancreatic endoscopic ultrasound fine-needle aspiration (EUS-FNA) with ADC and compared the rate of detection of neoplasms after a repeat FNA, a biopsy/resection, or a clinical follow-up following ADC. Logistic regression was used to determine the factors associated with the diagnosis of a neoplastic or a malignant lesion following ADC. Predictive probability for each case was calculated on the basis of the significant predictors, and whether it improved Diagnostic performance was assessed. RESULTS Of 3832 cases that received pancreatic EUS-FNAs, 187 (4.9%) were ADC. A total of 93 neoplasms (55%), including 61 carcinomas (36%), were detected after an atypical cytologic diagnosis. Similar rates of detecting neoplasms were observed after repeat FNA or biopsy/resection but higher than after clinical follow-up. The presence of a mass, history of alcohol use, and absence of a history of pancreatitis were significant predictors of a higher rate of diagnosis of neoplasm. Weight loss and bile flow obstruction were more likely to be associated with higher rates of carcinoma. Predictive probability demonstrated a wide range of risk and changed the ambiguous diagnosis to informative in 30% of cases. CONCLUSIONS ADC of pancreas is associated with a high risk of benign and malignant neoplasms regardless of the method of follow-up. The presences of a mass, alcohol use, and absence of a history of pancreatitis are significant predictors of a diagnosis of neoplasm, whereas weight loss and bile duct obstruction are significant predictors of ductal carcinoma following an ADC. Cancer (Cancer Cytopathol) 2014;122:428–434. © 2013 American Cancer Society.
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the frequency and cancer risk associated with the atypical cytologic Diagnostic Category in endoscopic ultrasound guided fine needle aspiration specimens of solid pancreatic lesions
Cancer Cytopathology, 2013Co-Authors: Mohammad S Abdelgawwad, Evan Alston, Isam A. EltoumAbstract:BACKGROUND The atypical cytologic Diagnostic Category is ambiguous and presents a management problem for pathologists and clinicians. This meta-analysis reviewed the frequency and cancer risk associated with atypical diagnoses in endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) specimens of solid pancreatic lesions. METHODS PubMed and Scopus were searched using the keywords “EUS-FNA” and “pancreas.” Articles were screened focusing on studies of solid lesions. Studies with information regarding the frequency and outcomes of atypical diagnoses were included; the “suspicious” Category was excluded from the analysis. The frequency of atypical diagnoses and the associated risk were calculated using the Comprehensive Meta-Analysis software. The authors assessed whether the following factors explained the heterogeneity of the studies: rapid on-site interpretation; type of reference standard; the study type, size, and site; and the frequency of inadequate, atypical, and positive categories. RESULTS A total of 23 studies with complete data regarding atypical diagnoses were identified, 12 of which had complete data available regarding outcomes. The frequency of the atypical Category ranged from 1% to 14% (mean, 5.3%; 95% confidence interval, 4.1%-6.9%). The risk of malignancy associated with an atypical diagnosis ranged from 25% to 100% (mean, 58%; 95% confidence interval, 47%-69%). There was significant heterogeneity noted among the studies (I-squared, 62%; P = .0004). The frequency of the atypical Category and its associated risk were found to be correlated only with the frequency of the specimens being positive for malignancy. CONCLUSIONS The rate of atypical diagnoses of the pancreas is similar to that of the thyroid but the risk of malignancy is higher. Significant heterogeneity exists among the studies reporting atypical diagnoses. There is a need for standardization of the reporting and management of atypical diagnoses in EUS-FNA specimens from the pancreas. Cancer (Cancer Cytopathol) 2013;121:620–8. © 2013 American Cancer Society.
Douglas Wardrop - One of the best experts on this subject based on the ideXlab platform.
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is refractory anaemia with ring sideroblasts and thrombocytosis rars t a necessary or useful Diagnostic Category
British Journal of Haematology, 2009Co-Authors: Douglas Wardrop, David P SteensmaAbstract:Summary Both the 2001 World Health Organisation (WHO) classification of haematopoietic neoplasms and the 2008 WHO classification revision include a distinctive Diagnostic Category, refractory anaemia with ring sideroblasts and thrombocytosis (RARS-T), to describe those rare patients who have both ≥15% ring sideroblasts and a sustained elevated platelet count. Recently, it has become clear that patients meeting WHO criteria for RARS-T have clonal JAK2V617F and MPLW515 mutations at a similar rate to essential thrombocythaemia (ET). Given that the provisional classification of RARS-T as a myelodysplastic syndrome/myeloproliferative neoplasm (MDS/MPN) overlap syndrome, rather than as a form of MPN (i.e., ET), rests principally upon the presence of ring sideroblasts, which are a non-specific morphological finding, these new molecular results prompt reconsideration of the necessity for a distinctive RARS-T Category. Here we review the historical developments that led up the definition of RARS-T as a disease entity, and we discuss conceptual understanding of RARS-T and arguments against continued use of RARS-T as a separate Diagnostic Category.
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Is refractory anaemia with ring sideroblasts and thrombocytosis (RARS‐T) a necessary or useful Diagnostic Category?
British journal of haematology, 2008Co-Authors: Douglas Wardrop, David P SteensmaAbstract:Summary Both the 2001 World Health Organisation (WHO) classification of haematopoietic neoplasms and the 2008 WHO classification revision include a distinctive Diagnostic Category, refractory anaemia with ring sideroblasts and thrombocytosis (RARS-T), to describe those rare patients who have both ≥15% ring sideroblasts and a sustained elevated platelet count. Recently, it has become clear that patients meeting WHO criteria for RARS-T have clonal JAK2V617F and MPLW515 mutations at a similar rate to essential thrombocythaemia (ET). Given that the provisional classification of RARS-T as a myelodysplastic syndrome/myeloproliferative neoplasm (MDS/MPN) overlap syndrome, rather than as a form of MPN (i.e., ET), rests principally upon the presence of ring sideroblasts, which are a non-specific morphological finding, these new molecular results prompt reconsideration of the necessity for a distinctive RARS-T Category. Here we review the historical developments that led up the definition of RARS-T as a disease entity, and we discuss conceptual understanding of RARS-T and arguments against continued use of RARS-T as a separate Diagnostic Category.
Peter M. Lewinsohn - One of the best experts on this subject based on the ideXlab platform.
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Research report Mixed anxiety depression: Taxometric exploration of the validity of a Diagnostic Category in youth
2007Co-Authors: Norman B. Schmidt, Roman Kotov, Amit Bernstein, Michael J. Zvolensky, Thomas E. Joiner, Peter M. LewinsohnAbstract:Background: Mixed anxiety depression (MAD) is a provisional diagnosis in the DSM-IV. This study determined whether MAD represents a discrete Category thereby evaluating the validity of MAD as a Diagnostic entity. Methods: Taxometric analyses and mixture modeling were used to discern whether MAD indicators constitute a distinct psychopathological Category (i.e., a taxon) in a large school-based sample of adolescents (N=706). Results: Each taxometric procedure (MAXCOV, MAMBAC) identified a taxon with a prevalence of 13%±2%. A non-taxometric procedure (multivariate mixture modeling) also supported the existence of a taxon with a prevalence of 12%. Bootstrapping procedures were used to construct a measure of MAD (i.e., MAD-T). Scale construction suggested that MAD may be best represented by 12 criteria that largely overlap with the DSM-IV, though some modifications were suggested. Examination of the construct validity of the MAD taxon indicated that it is associated mood and anxiety symptoms. Taxon membership was predictive of the development of mood and anxiety disorders over a 14-month longitudinal follow-up. Limitations: This Category should be studied in other populations including adult samples. Conclusions: MAD appears to be a viable Diagnostic Category for youth though it is recommended that future revisions of the DSM emphasize somewhat different criteria for this diagnosis.
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Mixed anxiety depression: taxometric exploration of the validity of a Diagnostic Category in youth.
Journal of Affective Disorders, 2006Co-Authors: Norman B. Schmidt, Roman Kotov, Amit Bernstein, Michael J. Zvolensky, Thomas E. Joiner, Peter M. LewinsohnAbstract:Abstract Background Mixed anxiety depression (MAD) is a provisional diagnosis in the DSM-IV. This study determined whether MAD represents a discrete Category thereby evaluating the validity of MAD as a Diagnostic entity. Methods Taxometric analyses and mixture modeling were used to discern whether MAD indicators constitute a distinct psychopathological Category (i.e., a taxon) in a large school-based sample of adolescents ( N = 706). Results Each taxometric procedure (MAXCOV, MAMBAC) identified a taxon with a prevalence of 13% ± 2%. A non-taxometric procedure (multivariate mixture modeling) also supported the existence of a taxon with a prevalence of 12%. Bootstrapping procedures were used to construct a measure of MAD (i.e., MAD-T). Scale construction suggested that MAD may be best represented by 12 criteria that largely overlap with the DSM-IV, though some modifications were suggested. Examination of the construct validity of the MAD taxon indicated that it is associated mood and anxiety symptoms. Taxon membership was predictive of the development of mood and anxiety disorders over a 14-month longitudinal follow-up. Limitations This Category should be studied in other populations including adult samples. Conclusions MAD appears to be a viable Diagnostic Category for youth though it is recommended that future revisions of the DSM emphasize somewhat different criteria for this diagnosis.
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Mixed anxiety depression: taxometric exploration of the validity of a Diagnostic Category in youth.
Journal of affective disorders, 2006Co-Authors: Norman B. Schmidt, Roman Kotov, Amit Bernstein, Michael J. Zvolensky, Thomas E. Joiner, Peter M. LewinsohnAbstract:Mixed anxiety depression (MAD) is a provisional diagnosis in the DSM-IV. This study determined whether MAD represents a discrete Category thereby evaluating the validity of MAD as a Diagnostic entity. Taxometric analyses and mixture modeling were used to discern whether MAD indicators constitute a distinct psychopathological Category (i.e., a taxon) in a large school-based sample of adolescents (N=706). Each taxometric procedure (MAXCOV, MAMBAC) identified a taxon with a prevalence of 13%+/-2%. A non-taxometric procedure (multivariate mixture modeling) also supported the existence of a taxon with a prevalence of 12%. Bootstrapping procedures were used to construct a measure of MAD (i.e., MAD-T). Scale construction suggested that MAD may be best represented by 12 criteria that largely overlap with the DSM-IV, though some modifications were suggested. Examination of the construct validity of the MAD taxon indicated that it is associated mood and anxiety symptoms. Taxon membership was predictive of the development of mood and anxiety disorders over a 14-month longitudinal follow-up. This Category should be studied in other populations including adult samples. MAD appears to be a viable Diagnostic Category for youth though it is recommended that future revisions of the DSM emphasize somewhat different criteria for this diagnosis.
Anders Wallin - One of the best experts on this subject based on the ideXlab platform.
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Vascular cognitive disorder: a new Diagnostic Category updating vascular cognitive impairment and vascular dementia
Journal of the Neurological Sciences, 2004Co-Authors: Gustavo C. Roman, Perminder S. Sachdev, Donald R. Royall, Roger Bullock, Jean Marc Orgogozo, Secundino López-pousa, Raul Arizaga, Anders WallinAbstract:Vascular cognitive impairment (VCI) was proposed as an umbrella term to include subjects affected with any degree of cognitive impairment resulting from cerebrovascular disease (CVD), ranging from mild cognitive impairment (MCI) to vascular dementia. VCI may or may not exclude the host of "focal" circumscribed impairments of specialized functions such as language (aphasia), intentional gesture (apraxia), or categorical recognition (agnosia), among others, that may result from a stroke. Therefore, there are no universally accepted Diagnostic criteria for VCI. We conclude that this concept could be more useful if it were to be limited to cases of vascular MCI without dementia, by analogy with the concept of amnestic MCI, currently considered the earliest clinically diagnosable stage of Alzheimer disease (AD). In agreement with our view,the Canadian Study on Health and Aging successfully implemented a restricted definition of VCI, excluding cases of dementia (i.e., vascular cognitive impairment no dementia, VCI-ND). The Canadian definition and Diagnostic criteria could be utilized for future studies of VCI. This definition excludes isolated impairments of specialized cognitive functions. Vascular dementia (VaD): The main problem of this Diagnostic Category stems from the currently accepted definition of dementia that requires memory loss as the sine qua non for the diagnosis. This may result in over-sampling of patients with AD worsened by stroke (AD+CVD). This problem was minimized in controlled clinical trials of VaD by excluding patients with a prior diagnosis of AD, those with pre-existing memory loss before the index stroke, and those with amnestic MCI. We propose a definition of dementia in VaD based on presence of abnormal executive control function, severe enough to interfere with social or occupational functioning. Vascular cognitive disorder (VCD): This term, proposed by Sachdev [P. Sachdev, Vascular cognitive disorder. Int J Geriat Psychiatry 14 (1999)402-403.] would become the global Diagnostic Category for cognitive impairment of vascular origin, ranging from VCI to VaD. It would include specific disease entities such as post-stroke VCI, post-stroke VaD, CADASIL, Binswanger disease, and AD plus CVD. This Category explicitly excludes isolated cognitive dysfunctions such as those mentioned above.