Effectiveness of Laboratory Markers in Determining Serious Bacterial Infection in Children with Fever without Source

2018 ◽  
Vol 13 (04) ◽  
pp. 287-292 ◽  
Author(s):  
Ahmet Gunduz ◽  
Capan Konca ◽  
Mehmet Turgut ◽  
Mehmet Tekin
Keyword(s):  
Positive Predictive Value ◽  
Bacterial Infection ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
Urine Analysis ◽  
Multivariate Logistic Regression Analysis ◽  
Predictive Markers ◽  
Receiver Operating Curve ◽  
Laboratory Markers ◽  
Significant Difference

AbstractWe assessed the effectiveness of laboratory markers in determining the presence of serious bacterial infection (SBI) in well-appearing children aged 3 months to 17 years with fever without source (FWS). One hundred eighteen patients aged between 3 months and 17 years presenting to the pediatric department due to fever and with no focus of fever determined through history and physical examination were included in this prospective study. SBI was determined in 14 (11.9%) of the 118 patients. No significant difference was determined between the two groups in terms of age, sex, degree of fever, duration of fever, and mean platelet volume. The neutrophil-to-lymphocyte ratio (NLR), C-reactive protein (CRP), and procalcitonin (PCT) were identified as independent predictive markers in a multivariate logistic regression analysis. PCT above 0.58 ng/mL emerged as the most sensitive and specific test at receiver operating curve analysis (sensitivity: 92.8%, specificity: 90.3%, area under the curve: 0.908, and p < 0.001). The method with the highest positive predictive value, 69.2, was a laboratory score consisting of CRP, PCT, and complete urine analysis ≥3 (95% confidence interval [CI]: 38.6–90.7), while the marker with the highest negative predictive value, 98.9, was PCT > 0.58 ng/mL (95% CI:94.3–99.8). The NLR, CRP, and PCT were independent predictive markers in determining the presence of SBI in well-appearing children with FWS. PCT was the marker with the highest sensitivity and specificity in determining presence of SBI. The method with the highest positive predictive value was laboratory score, while PCT was the marker with the best negative predictive value.

Evaluation of red blood cell parameters provided by the UF-5000 urine auto-analyzer in patients with glomerulonephritis

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Genki Mizuno ◽  
Masato Hoshi ◽  
Kentaro Nakamoto ◽  
Masayo Sakurai ◽  
Kazuko Nagashima ◽  
...  
Keyword(s):  
Positive Predictive Value ◽  
Iga Nephropathy ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
Blood Cells ◽  
Area Under The Curve ◽  
Cell Parameters ◽  
Significant Difference ◽  
Low Sensitivity ◽  
Cardinal Symptom

Abstract Objectives The microscopic examination of hematuria, a cardinal symptom of glomerulonephritis (GN), is time-consuming and labor-intensive. As an alternative, the fully automated urine particle analyzer UF-5000 can interpret the morphological information of the glomerular red blood cells (RBCs) using parameters such as UF-5000 small RBCs (UF-%sRBCs) and Lysed-RBCs. Methods Hematuria samples from 203 patients were analyzed using the UF-5000 and blood and urine chemistries to determine the cut-off values of RBC parameters for GN and non-glomerulonephritis (NGN) classification and confirm their sensitivity to the IgA nephropathy and non-IgA nephropathy groups. Results The UF-%sRBCs and Lysed-RBCs values differed significantly between the GN and NGN groups. The cut-off value of UF-%sRBCs was >56.8% (area under the curve, 0.649; sensitivity, 94.1%; specificity, 38.1%; positive predictive value, 68.3%; and negative predictive value, 82.1%), while that for Lysed-RBC was >4.6/μL (area under the curve, 0.708; sensitivity, 82.4%; specificity, 56.0%; positive predictive value, 72.6%; and negative predictive value, 69.1%). Moreover, there was no significant difference in the sensitivity between the IgA nephropathy and non-IgA nephropathy groups (87.1 and 89.8% for UF-%sRBCs and 83.9 and 78.4% for Lysed-RBCs, respectively). In the NGN group, the cut-off values showed low sensitivity (56.0% for UF-%sRBCs and 44.0% for Lysed-RBCs). Conclusions The RBC parameters of the UF-5000, specifically UF-%sRBCs and Lysed-RBCs, showed good cut-off values for the diagnosis of GN.

scholarly journals Diagnostic Performance of a Smart Device With Photoplethysmography Technology for Atrial Fibrillation Detection: Pilot Study (Pre-mAFA II Registry) (Preprint)

2018 ◽  
Author(s):  
Yong-Yan Fan ◽  
Yan-Guang Li ◽  
Jian Li ◽  
Wen-Kun Cheng ◽  
Zhao-Liang Shan ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Positive Predictive Value ◽  
Mobile Phone ◽  
Negative Predictive Value ◽  
Mobile Phones ◽  
Predictive Value ◽  
Normal Sinus Rhythm ◽  
Smart Devices ◽  
Smart Device ◽  
Significant Difference

BACKGROUND Atrial fibrillation (AF) is the most common sustained cardiac arrhythmia. The asymptomatic nature and paroxysmal frequency of AF lead to suboptimal early detection. A novel technology, photoplethysmography (PPG), has been developed for AF screening. However, there has been limited validation of mobile phone and smart band apps with PPG compared to 12-lead electrocardiograms (ECG). OBJECTIVE We investigated the feasibility and accuracy of a mobile phone and smart band for AF detection using pulse data measured by PPG. METHODS A total of 112 consecutive inpatients were recruited from the Chinese PLA General Hospital from March 15 to April 1, 2018. Participants were simultaneously tested with mobile phones (HUAWEI Mate 9, HUAWEI Honor 7X), smart bands (HUAWEI Band 2), and 12-lead ECG for 3 minutes. RESULTS In all, 108 patients (56 with normal sinus rhythm, 52 with persistent AF) were enrolled in the final analysis after excluding four patients with unclear cardiac rhythms. The corresponding sensitivity and specificity of the smart band PPG were 95.36% (95% CI 92.00%-97.40%) and 99.70% (95% CI 98.08%-99.98%), respectively. The positive predictive value of the smart band PPG was 99.63% (95% CI 97.61%-99.98%), the negative predictive value was 96.24% (95% CI 93.50%-97.90%), and the accuracy was 97.72% (95% CI 96.11%-98.70%). Moreover, the diagnostic sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of mobile phones with PPG for AF detection were over 94%. There was no significant difference after further statistical analysis of the results from the different smart devices compared with the gold-standard ECG (P>.99). CONCLUSIONS The algorithm based on mobile phones and smart bands with PPG demonstrated good performance in detecting AF and may represent a convenient tool for AF detection in at-risk individuals, allowing widespread screening of AF in the population. CLINICALTRIAL Chinese Clinical Trial Registry ChiCTR-OOC-17014138; http://www.chictr.org.cn/showproj.aspx?proj=24191 (Archived by WebCite at http://www.webcitation/76WXknvE6)

scholarly journals Assessment of occlusive disease of lower extremity arteries on the basis of anatomic region: Value of 128-slice multidetector CT angiography in comparison with digital subtraction angiography

2017 ◽  
Vol 12 (4) ◽  
pp. 179-186
Author(s):  
Roshan Pangeni ◽  
Ping Han ◽  
Feng Pan ◽  
Laxmi Pangeni Lamsal ◽  
Zhen Zhang ◽  
...  
Keyword(s):  
Positive Predictive Value ◽  
Lower Extremity ◽  
Digital Subtraction Angiography ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
Multidetector Ct ◽  
Digital Subtraction ◽  
Significant Difference ◽  
Arterial Occlusive Diseases ◽  
Sensitivity Specificity

Background & Objectives: The Previous studies of multidetector CT (MDCT) of the lower extremities for the detection of peripheral vascular disease showed high diagnostic accuracy but were performed with older generation systems. Our study aimed at assessing the diagnostic value of 128 MDCTA compared with that of digital subtraction angiography (DSA) in the grading of focal arterial disease of lower extremity arteries on the basis of anatomic regions.Materials & Methods: Forty-two patients with peripheral arterial occlusive diseases underwent both MDCTA and DSA. Lower extremity arteries depicted at MDCTA and DSA were graded separately for the degree of stenosis into 3 anatomic regions and 33 segments. Grading by MDCTA and DSA was done independently. Homogeneity analysis was used between MDCTA and DSA measurements in each patient. The sensitivity, specificity, positive predictive value and negative predictive value for detection of stenotic lesions were calculated for all anatomic regions, with findings at DSA used as the reference standard. Results: No statistically significant difference (P>.05) between DSA and MDCTA was present in Aorto-iliac and poplitiofemoral regions while there was statistically significant difference (P<.05) in the infrapopliteal region. The Sensitivity, Specificity, Positive Predictive Value and Negative Predictive Value based on a reading of MDCTA were 84.3%, 93.8%, 89.4% and 90.6% for aorto-iliac 86.6%, 94.7%, 84.1% and 94.7% for poplitiofemoral and 95.7%, 86.1%, 85.6% and 95.9% for infra-popliteal region respectively.Conclusion: MDCTA is excellent alternative in diagnosing lower extremity arterial occlusive diseases above the knee. DSA remains better on illustrating distal runoff vessels.

Comparative study of frozen and permanent section for diagnosis of toxic epidermal necrolysis

2020 ◽  
Author(s):  
Luke Burnett ◽  
Chunyang Wang ◽  
Feng Zhang ◽  
Stephan Adams ◽  
Joan Wilson ◽  
...  
Keyword(s):  
Positive Predictive Value ◽  
Diagnostic Accuracy ◽  
Toxic Epidermal Necrolysis ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
Frozen Section ◽  
Clinical Findings ◽  
P Value ◽  
Permanent Section ◽  
Significant Difference

Abstract Background Toxic epidermal necrolysis (TEN) is a severe, life-threatening mucocutaneous reaction, causing widespread sloughing of skin and mucosal surfaces. Accurate and prompt diagnosis is essential for optimal management and subsequent outcome. In this study, frozen sections were used as a rapid examination for initial diagnosis of TEN, and the frozen section diagnoses were assessed compared with permanent sections. Methods One hundred patients of suspected TEN were referred to our burn unit, and 67 had sufficient clinical findings for frozen and permanent biopsies. The accuracy of frozen section relative to permanent section was evaluated by calculating diagnostic accuracy, sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV). And McNemar’s tests were used to analyze the difference between the two methods. Results Fifty-two specimens were classified as TEN by frozen section, 51 of which were confirmed by permanent biopsy. The exception was diagnosed as bullous pemphigoid on permanent section. Fifteen specimens were read as negative for TEN on frozen slides but 4 were changed to positive by permanent biopsy. Overall, the diagnostic accuracy of frozen section was 92.5%, with sensitivity and specificity 92.7% and 91.7% respectively. The positive predictive value, or coherence of positive diagnosis between the two methods, was as high as 98.1%, and the negative predictive value was 73.3%. The p-value of McNemar’s tests was 0.375, indicating there was no significant difference between the two biopsy methods. Conclusion The data suggest that as a rapid histological assessment, frozen section is a reliable tool in the early diagnosis of TEN.

scholarly journals Three-hour post-ERCP amylase level: a useful indicator for early prediction of PEP

2019 ◽  
Author(s):  
Ze-Hui Lv ◽  
Da-Qing Kou ◽  
Shi-Bin Guo
Keyword(s):  
Positive Predictive Value ◽  
Diagnostic Accuracy ◽  
Negative Predictive Value ◽  
Roc Curve ◽  
Predictive Value ◽  
Serum Amylase ◽  
Amylase Level ◽  
Early Prediction ◽  
Serum Amylase Level ◽  
Significant Difference

Abstract Background : To evaluate the value of the 3-hour post-ERCP serum amylase level for early prediction of post-ERCP pancreatitis (PEP). Method: A study of 206 patients performed ERCP at a single centre was collected from 2011 to 2016. The serum amylase or lipase level was measured at 3 h after ERCP. The patients with PEP were recorded. ROC curves were used to statistically analyze the data: The enrolled patients were divided into two groups according to gender, then be analyzed respectively. We comprehensively evaluated the predictive value of PEP by serum amylase level 3-hour post-ERCP based on the results above. Results : In the 206 patients, the 3-hour post-ERCP pancreatic amylase level was used as the test variable, and the PEP occurrence as the state variable to plot the ROC curve. The optimal cut-off value was 351U/L (sensitivity 76.19%, specificity 83.24%, positive likelihood ratio 4.55, negative likelihood ratio 0.29, Youden index 59.43%). There were 83 patients with both 3-hour post-ERCP amylase level and lipase level detected. The area under the ROC curve for the 3-hour post-ERCP serum amylase was 0.780, and the 95% confidence interval was 0.676-0.864. The optimal cut-off is 380U/L, and there was no statistically significant difference between the two for diagnostic accuracy. According to gender, there was no statistically significant difference in the diagnostic accuracy of the two groups. In the male group, 436 U/L serum amylase provided the greatest diagnostic accuracy with sensitivity(SE) of 70.5%, specificity(SP) of 89.2%, positive predictive value (PPV) 87.5%, and negative predictive value (NPV) 78.1%. Whereas, in the female group, 357U/L serum amylase provided the greatest diagnostic accuracy with sensitivity of 76.9%, specificity of 81.2%, positive predictive value of 80.4%, negative predictive value of 77.9%. Conclusions: 1. The 3-hour post-ERCP serum amylase level is a useful measurement for predicting post-ERCP pancreatitis. 2. There was no significant difference between serum amylase and lipase 3-hour post-ERCP for predicting PEP. 3. There was no statistically significant difference between male and female using the 3-hour post-ERCP serum amylase level to prediction PEP . For female, the optimal cut-off value was 357 U/L, whereas male 436U/L .

scholarly journals Evaluation of uterine cervix with transvaginal ultrasonography in women with threatened preterm labor and or preterm labor

2018 ◽  
Vol 7 (2) ◽  
pp. 704 ◽  
Author(s):  
Akila Shree ◽  
Chitra A. K.
Keyword(s):  
Positive Predictive Value ◽  
Negative Predictive Value ◽  
Preterm Delivery ◽  
Predictive Value ◽  
Preterm Labor ◽  
Cervical Length ◽  
Transvaginal Ultrasonography ◽  
Singleton Pregnancy ◽  
Significant Difference ◽  
A Prospective Study

Background: Preterm delivery can be associated with substantial perinatal morbidity and mortality. Nearly in 5 to 13% of pregnancies, happening deliveries are preterm before 37 weeks' gestation. Thus, prediction of preterm labor in parturient can provide a window of opportunity to prevent these complications and to be better prepared to deal with them. Hence the current study has been conducted with an objective to assess the efficiency of cervical length and funneling as assessed by transvaginal ultrasonography in predicting preterm labor.Methods: The current study was a prospective study, conducted in the Department of Obstetrics Emergencies, Dhanalakshmi Srinivasan Medical College and Hospital between November 2015 to April 2017. The study population included 60 women with singleton pregnancy of gestational age between 28 + 0 and 36 + 6 weeks and with painful and regular contractions (>1/10 min for at least 1 hour). Cervical length, funnelling length measured at presentation and after 48 hours were considered as predictor variables. The outcomes of interest were delivery within 1 week, delivery before 37 weeks and delivery before 34 weeks.Results: There was a statistically significant difference in cervical length and funnelling length between term and preterm groups at the time of diagnosis and after 48 hours (P <0.001). The positive predictive value increased from 33.3% to 100% with cervical length ≤ 40 mm to ≤ 20 mm. The negative predictive value decreased from 100% to 79.2% with cervical length ≤40 mm to ≤20 mm. To predict a preterm delivery in threatened preterm delivery patients, the sensitivity of a cervical length of ≤25 mm was 77.7%, specificity was 95.2%, the positive predictive value was 87.5% and negative predictive value is 90.9%.Conclusions: Cervical length and funnelling as assessed by transvaginal ultrasonography are efficient in predicting preterm labor.

scholarly journals Dynamic Monitoring of sTREM-1 and Other Biomarkers in Acute Cholangitis

2020 ◽  
Vol 2020 ◽  
pp. 1-14
Author(s):  
Jiahui Jiang ◽  
Xiaolei Wang ◽  
Tongtong Cheng ◽  
Mingyue Han ◽  
Xinxin Wu ◽  
...  
Keyword(s):  
Positive Predictive Value ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
Acute Cholangitis ◽  
Dynamic Monitoring ◽  
Sepsis Group ◽  
Reactive Protein ◽  
Significant Difference ◽  
Group A ◽  
Group B

Background. Sepsis is a common complication of acute cholangitis (AC), which is associated with a high mortality rate. Our study is aimed at exploring the significance of white blood cell (WBC), C-reactive protein (CRP), procalcitonin (PCT), soluble triggering receptor expressed on myeloid cells 1 (sTREM-1), and temperature (T) alone or combined together in early identification and curative effect monitoring of AC with or without sepsis. Methods. 65 consecutive cases with AC and 76 control cases were enrolled. They were divided into three groups: Group A (AC with sepsis), Group B (AC without sepsis), and Group C (inpatients without AC or other infections). The levels of WBC, CRP, PCT, sTREM-1, and temperature were measured dynamically. The study was carried out and reported according to STARD 2015 reporting guidelines. Results. CRP had the highest AUC to identify AC from individuals without AC or other infections (AUC 1.000, sensitivity 100.0%, specificity 100.0%, positive predictive value 100.0%, and negative predictive value 100.0%). Among various single indexes, PCT performed best (AUC 0.785, sensitivity 75.8%, specificity 72.2%, positive predictive value 68.7%, and negative predictive value 78.8%) to distinguish sepsis with AC, while different combinations of indexes did not perform better. From day 1 to day 5 of hospitalization, the levels of sTREM-1 in Group A were the highest, followed by Groups B and C (P<0.05); on day 8, sTREM-1 levels in Groups A and B declined back to normal. However, other index levels among three groups still had a significant difference on day 10. Both in Groups A and B, sTREM-1 levels declined fast between day 1 and day 2 (P<0.05). Conclusions. CRP is the best biomarker to suggest infection here. PCT alone is sufficient enough to diagnose sepsis with AC. sTREM-1 is the best biomarker to monitor patients’ response to antimicrobial therapy and biliary drainage.

scholarly journals The sensitivity and specificity of rapid diagnostic test for malaria parasite in comparison to slide microscopy as gold standard

10.17158/522 ◽  
2016 ◽  
Vol 19 (2) ◽  
Author(s):  
John Mark De Real
Keyword(s):  
Positive Predictive Value ◽  
Negative Predictive Value ◽  
Diagnostic Test ◽  
Rapid Diagnostic Test ◽  
Sensitivity And Specificity ◽  
Predictive Value ◽  
Gold Standard ◽  
Malaria Parasite ◽  
High Sensitivity ◽  
Significant Difference

<p>The main objective of this study was to test the sensitivity and specificity of rapid diagnostic test for malaria parasite in comparison to slide microscopy as gold standard. Data were acquired from blood mass survey of malaria infection conducted in the community of Paquibato district, Davao City. There were 377 total participants examined through Rapid Diagnostic Test (RDT) and slide microscopy. Of the 377 participants tested, 16 (4.24%) of them were positive to Plasmodium falciparum and 68 (18.04%) were positive to Plasmodium vivax using slide microscopy. Of the 16 participants’ positive for P. faciparum, PfRDT (HRP-2) correctly identified 13 expressing 81.25% (low) sensitivity of the tool. Of the 68 participants’ positive for P. vivax, PvRDT (pLDH) correctly identified 65 expressing 95.59% (high) sensitivity. Both of the RDTs (HRP-2 and pLDH), however, attained 100% specificity. PfRDT (HRP-2) has a positive predictive value of 100% and a negative predictive value of 99.2%, likewise PvRDT (pLDH) has a positive predictive value of 100% and a negative predictive value of 99.04%, all in all, suggesting a high degree of reliability of SD BIOLINE Malaria Antigen P.f/P.v. the data showed no significant difference on the performance level of RDT, albeit less sensitive, compared to slide microscopy.</p><p><strong>Keywords:</strong> Health, malaria, sensitivity, specificity, HRP-2, pLDH, descriptive Davao City, Philippines.</p><div> </div>

scholarly journals Effects of antithrombotic drugs on the results of fecal immunochemical test in colorectal neoplasms screening

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Takashi Ibuka ◽  
Seiji Adachi ◽  
Yohei Horibe ◽  
Tomohiko Ohno ◽  
Masatoshi Mabuchi ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Positive Predictive Value ◽  
Colorectal Neoplasms ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
Fecal Immunochemical Test ◽  
Advanced Adenoma ◽  
Antithrombotic Drugs ◽  
Significant Difference ◽  
Immunochemical Test

AbstractFecal immunochemical test (FIT) is widely used as a colorectal cancer screening tool. Antithrombotic drugs may affect the screening performance of FIT for colorectal tumors. The aim of this study was to clarify the effect of antithrombotic agents on FIT accuracy in screening for colorectal neoplasms. This retrospective study enrolled a total of 758 patients who underwent both FIT and total colonoscopy. The effect of antithrombotic drugs on FIT accuracy in detecting colorectal neoplasms (CN), including colorectal cancer (CRC), advanced adenoma (AA), and non-advanced adenoma (NAA), was examined. Of the 758 patients, 144 (19%) received antithrombotic drugs (administration group). In administration group, 61/144 (42%) cases had CN [CRC:14, AA:15, NAA:32] and 217/614 (35%) cases had CN (CRC:43, AA:56, NAA:118) in non-administration group. The prevalence of CN was not significantly different between the two groups (p = 0.1157). There was no significant difference in sensitivity or specificity of the detection of all types of CN with or without taking antithrombotic drugs. Neither the positive predictive value nor negative predictive value of FIT was affected by antithrombotic drug administration. Taking antithrombotic drugs may not have a large impact on sensitivity, specificity, positive predictive value, or negative predictive value of FIT in screening for CN.

scholarly journals Added value of diffusion-weighted MRI in assessment of pleural lesions

2021 ◽  
Vol 52 (1) ◽  
Author(s):  
Youssriah Yahia Sabri ◽  
Ikram Hamed Mahmoud ◽  
Lamis Tarek El-Gendy ◽  
Mohamed Raafat Abd El-Mageed ◽  
Sally Fouad Tadros
Keyword(s):  
Positive Predictive Value ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
Diagnostic Value ◽  
Added Value ◽  
Adc Value ◽  
Pleural Diseases ◽  
Conventional Mri ◽  
Malignant Lesions

Abstract Background There are many causes of pleural disease including variable benign and malignant etiologies. DWI is a non-enhanced functional MRI technique that allows qualitative and quantitative characterization of tissues based on their water molecules diffusivity. The aim of this study was to evaluate the diagnostic value of DWI-MRI in detection and characterization of pleural diseases and its capability in differentiating benign from malignant pleural lesions. Results Conventional MRI was able to discriminate benign from malignant lesions by using morphological features (contour and thickness) with sensitivity 89.29%, specificity 76%, positive predictive value 89%, negative predictive value 76.92%, and accuracy 85.37%. ADC value as a quantitative parameter of DWI found that ADC values of malignant pleural diseases were significantly lower than that of benign lesions (P < 0.001). Hence, we discovered that using ADC mean value of 1.68 × 10-3 mm2/s as a cutoff value can differentiate malignant from benign pleural diseases with sensitivity 89.3%, specificity 100%, positive predictive value 100%, negative predictive value 81.2%, and accuracy 92.68% (P < 0.001). Conclusion Although DWI-MRI is unable to differentiate between malignant and benign pleural effusion, its combined morphological and functional information provide valid non-invasive method to accurately characterize pleural soft tissue diseases differentiating benign from malignant lesions with higher specificity and accuracy than conventional MRI.

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