Diagnosis and Detection of Sarcoidosis An Official American Thoracic Society Clinical Practice Guideline

Background: The diagnosis of sarcoidosis is not standardized but is based on three major criteria: a compatible clinical presentation, finding nonnecrotizing granulomatous inflammation in one or more tissue samples, and the exclusion of alternative causes of granulomatous disease. There are no universally accepted measures to determine if each diagnostic criterion has been satisfied; therefore, the diagnosis of sarcoidosis is never fully secure.Methods: Systematic reviews and, when appropriate, meta-analyses were performed to summarize the best available evidence. The evidence was appraised using the Grading of Recommendations, Assessment, Development, and Evaluation approach and then discussed by a multidisciplinary panel. Recommendations for or against various diagnostic tests were formulated and graded after the expert panel weighed desirable and undesirable consequences, certainty of estimates, feasibility, and acceptability.Results: The clinical presentation, histopathology, and exclusion of alternative diagnoses were summarized. On the basis of the available evidence, the expert committee made 1 strong recommendation for baseline serum calcium testing, 13 conditional recommendations, and 1 best practice statement. All evidence was very low quality.Conclusions: The panel used systematic reviews of the evidence to inform clinical recommendations in favor of or against various diagnostic tests in patients with suspected or known sarcoidosis. The evidence and recommendations should be revisited as new evidence becomes available

Some epigraphic and archaeological documents from Western Anatolia during the late Ottoman period

The focus of this article is on the post-medieval archaeological heritage of Izmir, especially during the 19th century. The material selected consists of Armenian inscriptions from Izmir and its close environs, since there is a paucity of archaeological scholarship for the Armenian community of the Ottoman Empire. The paper is based on the survey of sixteen Armenian inscriptions across nine locations in and around Izmir, with discussion of the Armenian material culture of the Late Ottoman Period, as well as transcription and translation of these inscriptions, although a history of Armenia in general is outside the scope of the article. As Armenian grave markers can be taken as active interventions in social relations, this paper offers a potential for reconstructing the social complexities of late Ottoman Izmir