Diagnostic value of faecal calprotectin in paediatric gastroenterology clinical practice

Tremor is the most common type of movement disorders. In practice this differential diagnosis of hyperkinesis is diagnosed clinically and the use of additional methods of objective assessment of tremor increases the accuracy of diagnosis. The use of paraclinical methods of objective assessment of tremor improves the accuracy of diagnosis. Comparison of the neurophysiological parameters of tremor with clinical characteristics has a high diagnostic value, which justifies its use in the routine practice of neurologists. The purpose of the review is to analysis basic electrophysiological characteristics of pathological tremor, as well as the presentation of the material of its own observation.

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P285 Is faecal immunochemical test a suitable alternative to faecal calprotectin in children?

Journal of Crohn s and Colitis ◽

10.1093/ecco-jcc/jjz203.414 ◽

2020 ◽

Vol 14 (Supplement_1) ◽

pp. S294-S295

Author(s):

K SANDHU ◽

R Ayling ◽

S Naik

Keyword(s):

Intestinal Inflammation ◽

Cost Effective ◽

Paediatric Population ◽

Diagnostic Value ◽

Indeterminate Colitis ◽

Faecal Calprotectin ◽

Suitable Alternative ◽

Faecal Immunochemical Test ◽

Paired Samples ◽

Immunochemical Test

Abstract Background Faecal calprotectin (FCP) has widely been used as a non-invasive marker for intestinal inflammation in children. Faecal immunochemical test (FIT) is well established in bowel cancer screening programmes in adults. FIT is cost-effective and easier to handle in comparison to FCP. We aimed to evaluate the performance of FIT in the paediatric population and compare it with FCP. Methods Clinicians in paediatric gastroenterology clinic who requested FCP for further investigation. These patients provided a sample of FIT from the same stool. These samples were collected over a 10-month period from November 2018 to September 2019. FIT samples were taken into a proprietary tube (Eiken Chemical, Tokyo, Japan) and stored at 4°C until analysis. FCP was measured using Liason Calprotectin (Diasorin, Italy). Results 131 samples were returned; 131 FIT and 102 FCP of which 7 calprotectin samples were insufficient for analysis. In 95 patients we had paired samples for FIT and FCP. The normal range for FCP was 0–200 µg/g and for FIT was 0–4 µg/g. Twenty-three of 95 patients were non-IBD (24.2%). In the IBD group; 42 had Crohn’s, 27 ulcerative colitis and 3 indeterminate colitis. 15 were new diagnosis of IBD. In the 95 patients; FIT was normal (<4 µg/g) in 50 patients and abnormal (>4 µg/g) in 45 patients. FCP was normal (<200 µg/g) in 45 patients and abnormal (>200 µg/g) in 50 patients. FIT positively correlated with calprotectin, Spearman’s rank coefficient 0.653, p < 0.001. There were 32 patients with FIT >20µg/g and in 29 of these patients, FCP was >200 µg/g. In 60 patients with FIT and in 35 patients with FCP underwent colonoscopies. Table 1 shows the diagnostic value of FIT in comparison to histological inflammation. The correlation of FIT with histological findings are shown in Figure 1. All patients with normal histology had a FIT <4 µg/g. In 91.4% of patients with moderate to severe histological inflammation had a FIT >5 µg/g. Conclusion Our study is the first to compare FIT and FCP in the paediatric population. Our results suggest that FIT correlates well with FCP and can be used to differentiate between functional bowel disease and inflammation in children. A FIT of > 20 µg/g was consistent with the finding of severe inflammation.

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1834. Incremental Diagnostic Value of 16S Ribosomal RNA Gene Polymerase Chain Reaction/Sanger Sequencing in Clinical Practice

Open Forum Infectious Diseases ◽

10.1093/ofid/ofz359.096 ◽

2019 ◽

Vol 6 (Supplement_2) ◽

pp. S44-S44

Author(s):

Sarwat Khalil ◽

Madiha Fida ◽

Douglas W Challener ◽

Omar Abu Saleh ◽

Muhammad R Sohail ◽

...

Keyword(s):

Polymerase Chain Reaction ◽

Clinical Practice ◽

16S Rrna ◽

Ribosomal Rna ◽

Mayo Clinic ◽

Sanger Sequencing ◽

Diagnostic Value ◽

Chain Reaction ◽

Material Support ◽

Polymerase Chain

Abstract Background Polymerase chain reaction (PCR)/sequencing targeting the 16S ribosomal RNA (rRNA) gene to detect bacteria in normally sterile tissues and fluids has become increasingly popular in clinical medicine. This culture-independent technique can detect bacteria that are nonviable or difficult to cultivate using conventional methods. The clinical value of this type of testing is not well defined. We aimed to assess the diagnostic value of 16S rRNA PCR/Sanger sequencing as a clinical diagnostic assay at Mayo Clinic. Methods This is an interim analysis of the first 173 of 478 patients who had 16S rRNA PCR/Sanger sequencing done on sterile tissues or fluids at our institution from April, 2017 to November, 2018 as part of routine clinical practice. Medical records are being retrospectively reviewed, with results compared with those of culture. Results We reviewed 207 specimens from 173 patients (musculoskeletal 79%, cardiovascular 7%, central nervous system 4%, other 9%) that underwent 16S rRNA PCR/Sanger sequencing by clinical request (Table 1). In 90% of these specimens, the test was pre-planned rather than added-on. Nine specimens were excluded from analysis, as cultures were not performed. Overall concordance of culture with PCR/sequencing was 81% (160/197; P < 0.0001). Of 44 culture-positive specimens, PCR detected the same bacterium in 21 (48%) (Table 2). 45% (20/44) of those with positive cultures and 46% of those with positive PCR/sequencing results had received prior antimicrobial therapy (Table 3). PCR was negative in 139/144 specimens that were culture-negative (97%). PCR/sequencing was helpful in detecting a putative bacterial pathogen in 4 patients with negative cultures (Table 4). Conclusion Overall, 16S rRNA PCR/Sanger sequencing improved diagnostic yield compared with culture in a minority of cases. The described assay is limited by its inability to detect polymicrobial infections, a technical limitation that could possibly be addressed using massive parallel sequencing. Careful selection of cases and a save and add-on approach may be more cost-effective than upfront testing, although this was requested in a minority of cases. Disclosures Robin Patel, MD, ASM and IDSA: Other Financial or Material Support, Travel reimbursement, editor’s stipends; CD Diagnostics, Merck, Hutchison Biofilm Medical Solutions, Accelerate Diagnostics, ContraFect, TenNor Therapeutics Limited, Shionogi: Grant/Research Support; Curetis, Specific Technologies, NextGen Diagnostics, PathoQuest, Qvella: Consultant; NBME, Up-to-Date, the Infectious Diseases Board Review Course: Honorarium recipient, Other Financial or Material Support; Patent on Bordetella pertussis/parapertussis PCR issued, a patent on a device/method for sonication with royalties paid by Samsung to Mayo Clinic, and a patent on an anti-biofilm substance issued: Other Financial or Material Support, Patents.

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