scholarly journals Ultrasound for Appendicitis: Performance and Integration with Clinical Parameters

2016 ◽  
Vol 2016 ◽  
pp. 1-8 ◽  
Author(s):  
Fanny Löfvenberg ◽  
Martin Salö
Keyword(s):  
Predictive Value ◽  
Negative Likelihood Ratio ◽  
C Reactive Protein ◽  
Suspected Appendicitis ◽  
Reactive Protein ◽  
First Choice ◽  
Sensitivity Specificity ◽  
Surgery Center ◽  
Appendicitis Score ◽  
Higher Sensitivity

Objective. To evaluate the performance of ultrasound in pediatric appendicitis and the integration of US with the pediatric appendicitis score (PAS) and C-reactive protein (CRP).Method. An institution-based, retrospective study of children who underwent abdominal US for suspected appendicitis between 2012 and 2015 at a tertiary pediatric surgery center. US results were dichotomized, with a nonvisualized appendix considered as a negative examination.Results. In total, 438 children were included (mean 8.5 years, 54% boys), with an appendicitis rate of 29%. The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) for US were 82%, 97%, 92%, and 93%, respectively, without significant age or gender differences. Pediatric radiologists had significantly higher sensitivity compared to general radiologists, 88% and 71%, respectively (p<0.01), but no differences were seen for specificity, PPV, and NPV. The sensitivity, NPV, and negative likelihood ratio for the combination of negative US, PAS < 5, and CRP < 5 mg/L were 98%, 98%, and 0.05 (95% CI 0.03–0.15).Conclusion. US may be a useful tool for evaluating children with suspected appendicitis, regardless of age or gender, and should be the first choice of imaging modalities. Combining US with PAS and CRP may reduce several unnecessary admissions for in-hospital observation.

C-Reactive Protein as A Fungal Infection Marker in Acute Leukemia Patients

2021 ◽  
Vol 27 (2) ◽  
pp. 212
Author(s):  
Brigitte Rina Aninda Sidharta ◽  
JB. Suparyatmo ◽  
Avanti Fitri Astuti
Keyword(s):  
Acute Leukemia ◽  
Predictive Value ◽  
Bacterial Infections ◽  
Fungal Infections ◽  
Lymphoblastic Leukemia ◽  
Negative Likelihood Ratio ◽  
Receiver Operating Curve ◽  
High Morbidity ◽  
C Reactive Protein ◽  
Reactive Protein

Invasive Fungal Infections (IFIs) can cause serious problems in cancer patients and may result in high morbidity andmortality. C-reactive protein levels increase in response to injury, infection, and inflammation. C-reactive protein increasesin bacterial infections (mean of 32 mg/L) and in fungal infections (mean of 9 mg/L). This study aimed to determineC-Reactive Protein (CRP) as a marker of fungal infections in patients with acute leukemia by establishing cut-off values ofCRP. This study was an observational analytical study with a cross-sectional approach and was carried out at the Departmentof Clinical Pathology and Microbiology of Dr. Moewardi Hospital in Surakarta from May until August 2019. The inclusioncriteria were patients with acute leukemia who were willing to participate in this study, while exclusion criteria were patientswith liver disease. There were 61 samples consisting of 30 male and 31 female patients with ages ranging from 1 to 70 years.Fifty-four patients (88.5%) were diagnosed with Acute Lymphoblastic Leukemia (ALL) and 30 (49.18%) were in themaintenance phase. The risk factors found in those patients were neutropenia 50-1500 μL (23.8%), use of intravenous line(22%), and corticosteroid therapy for more than one week (20.9%). The median of CRP in the group of patients with positiveculture results was 11.20 mg/L (11.20-26.23 mg/L) and negative culture results in 0.38 mg/L (0.01-18.63 mg/L). The cut-offvalue of CRP using the Receiver Operating Curve (ROC) was 9.54 mg/L (area under curve 0.996 and p. 0.026), with a sensitivityof 100%, specificity of 93.2%, Positive Predictive Value (PPV) of 33.3%, Negative Predictive Value (PPV) of 100%, PositiveLikelihood Ratio (PLR) of 1.08, Negative Likelihood Ratio (NLR) of 0 and accuracy of 93.4%. C-reactive protein can be used asa screening marker for fungal infections in patients with acute leukemia.

scholarly journals Diagnostic Role of Pediatric Appendicitis Score (PAS) in Appendicitis of Children

2016 ◽  
Vol 6 (1) ◽  
pp. 16-19
Author(s):  
Susankar Kumar Mondal ◽  
AKM Zahid Hossain ◽  
Mizanur Rahman ◽  
Gazi Zahirul Hasan ◽  
Kaniz Hasina ◽  
...  
Keyword(s):  
Predictive Value ◽  
Age Group ◽  
Good Tool ◽  
Suspected Appendicitis ◽  
Diagnostic Role ◽  
Group 5 ◽  
Negative Appendicectomy ◽  
Sensitivity Specificity ◽  
Appendicitis Score

Appendicitis is one of the most common causes of acute abdominal pain in pediatrics and is the most common indication for emergency abdominal surgery in childhood. The diagnosis of pediatric appendicitis remains challenging. To evaluate the role of pediatric appendicitis score (PAS) in the diagnosis of appendicitis of children.Methods: In this study, 200 suspected appendicitis patients attended in four private hospitals in old Dhaka city over a period of about 34 months from January 2011 to May 2014 were selected as study subjects. Patient age, sex and each of the eight PAS components were collected. Children who had PAS less than six were discharged and contacted by telephone upto 1 month to verify final outcome. Rest of the children with PAS equal or more than 6 were underwent appendectomy.Results: Two hundred patients were assessed in this study. Out of them 67 (33.5%) children had appendicitis and 76 (38.0%) children had PAS equal or more than 6. In appendicitis children, maximum (85.3%) children were in age group 10- 16 years and 10 (14.7%) patients were in age group 5-9 years.Male (73.5%) were predominant than female (26.5%) in appendicitis children. Migration of pain, nausea and anorexia were in 43 (63.2%), 45 (66.2%) and 48 (70.6%) appendicitis children respectively. Fever, cough/percussion tenderness and tenderness in RLQ were in 37 (54.4%), 52 (76.5%) and 59 (86.8%) appendicitis children respectively. Leukocytosis andneutophilia were present in 42 (61.8%) and 46 (67.6%) appendicitis children respectively. The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and accuracy rate of PAS were 80.6%, 83.5%, 71.1%, 89.5% and 82.5% respectively.Conclusion: Paediatric Appendicitis Score is a good tool but not good enough for diagnosis of paediatirc appedicitis. It cannot be recommended for diagnosis of paediatric appendicitis because its negative appendicectomy rate as well as wrongly discharged rate is high.J. Paediatr. Surg. Bangladesh 6(1): 16-19, 2015 (Jan)

scholarly journals Soluble myeloid triggering receptor expressed on myeloid cell 1 might have more diagnostic value for bacterial ascites than C-reactive protein

2018 ◽  
Vol 13 (1) ◽  
pp. 456-462
Author(s):  
Qiang Guo ◽  
Chuanqin Xu ◽  
Chao Sun ◽  
Yubao Zhao ◽  
Weifu Zhang
Keyword(s):  
Predictive Value ◽  
Myeloid Cell ◽  
Roc Curves ◽  
Diagnostic Value ◽  
Control Group ◽  
Health Examination ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Sensitivity Specificity ◽  
Medical University

AbstractThe timely and accurate diagnosis of ascites is of great significance for early treatment and prognostication. This study explored the value of soluble myeloid triggering receptor expressed on myeloid cell 1 (sTREM-1) and C-reactive protein (CRP) for assessing ascites. A total of 133 patients with ascites who received treatment at the Affiliated Hospital of Taishan Medical University between September 2015 and September 2017 were retrospectively analyzed. The ascites in 22, 45, 33 and 33 patients were tuberculous, bacterial, tumorous, and transudative, respectively. Healthy volunteers (n=30) who received a health examination at the same hospital during the same period constituted the control group. Before treatment, both ascitic sTREM-1 and CRP showed significant differences among the ascites subgroups (P<0.001), with the highest levels in the bacterial subgroup. Serum sTREM-1 and CRP also showed significant differences among the groups. A correlation analysis showed a positive correlation between sTREM-1 and CRP. ROC curves of the bacterial subgroup showed that when the optimal cutoff point was set to 20.2, the sensitivity, specificity, positive predictive value, and negative predictive value of the serum sTREM-1 index were 0.933, 0.955, 0.914, and 0.965, respectively. sTREM-1 may provide more diagnostic value than CRP for the diagnosis of bacterial ascites.

scholarly journals The Diagnostic Value of the Pleural Fluid C-Reactive Protein in Parapneumonic Effusions

2016 ◽  
Vol 2016 ◽  
pp. 1-6 ◽  
Author(s):  
Shimon Izhakian ◽  
Walter G. Wasser ◽  
Benjamin D. Fox ◽  
Baruch Vainshelboim ◽  
Mordechai R. Kramer
Keyword(s):  
Heart Failure ◽  
Pleural Effusion ◽  
Pleural Fluid ◽  
Predictive Value ◽  
Medical Center ◽  
Diagnostic Value ◽  
Parapneumonic Effusion ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Sensitivity Specificity

Purpose. The aim of this study was to evaluate the sensitivity of pleural C-reactive protein (CRP) biomarker levels in identifying parapneumonic effusions.Methods. A single-center, retrospective review of 244 patients diagnosed with pleural effusions was initiated among patients at the Rabin Medical Center, Petah Tikva, Israel, between January 2011 and December 2013. The patients were categorized into 4 groups according to their type of pleural effusion as follows: heart failure, malignant, post-lung transplantation, and parapneumonic effusion.Results. The pleural CRP levels significantly differentiated the four groups (p<0.001) with the following means: parapneumonic effusion,5.38±4.85 mg/dL; lung transplant,2.77±2.66 mg/dL; malignancy,1.19±1.51 mg/dL; and heart failure,0.57±0.81 mg/dL. The pleural fluid CRP cut-off value for differentiating among parapneumonic effusions and the other 3 groups was 1.38 mg/dL. The sensitivity, specificity, positive predictive value, and negative predictive value were 84.2%, 71.5%, 37%, and 95%, respectively. A backward logistic regression model selected CRP as the single predictor of parapneumonic effusion (OR = 1.59, 95% CI = 1.37–1.89).Conclusions. Pleural fluid CRP levels can be used to distinguish between parapneumonic effusions and other types of exudative effusions. CRP levels < 0.64 mg/dL are likely to indicate a pleural effusion from congestive heart failure, whereas levels ≥ 1.38 mg/dL are suggestive of an infectious etiology.

scholarly journals Prediction of Coronary Artery Aneurysms in Children With Kawasaki Disease Before Starting Initial Treatment

2021 ◽  
Vol 9 ◽  
Author(s):  
Ching-Ying Huang ◽  
Nan-Chang Chiu ◽  
Fu-Yuan Huang ◽  
Yen-Chun Chao ◽  
Hsin Chi
Keyword(s):  
Coronary Artery ◽  
Kawasaki Disease ◽  
Predictive Value ◽  
Primary Treatment ◽  
C Reactive Protein ◽  
Coronary Artery Aneurysms ◽  
Reactive Protein ◽  
Clinical Challenge ◽  
Z Scores ◽  
Sensitivity Specificity

Background: Precisely predicting coronary artery aneurysms (CAAs) remains a clinical challenge. We aimed to investigate whether coronary dimensions adjusted for body surface area (Z scores) on baseline echocardiography and clinical variables before primary treatment could predict the presence of late CAAs.Methods: We conducted a retrospective study including children hospitalized for Kawasaki disease and received intravenous immunoglobulin within 10 days of illness. We defined late CAAs as a maximum Z score (Zmax) ≥2.5 of the left main, right, or left anterior descending coronary artery at 11–60 days of illness. Associations between late CAAs and clinical parameters and baseline maximum Z scores were analyzed.Results: Among the 314 included children, 31 (9.9%) had late CAAs. Male, higher C-reactive protein, and higher baseline Zmax were risk factors of late CAAs. Late CAAs were significantly associated with baseline Zmax ≥2.0 vs. &lt;2.0 (25 [32.5%] vs. 6 [2.5%], P &lt; 0.001). The odds ratio for late CAAs among the patients with baseline Zmax ≥2.0 vs. &lt;2.0 was 18.5 (95% confidence interval, 7.23 to 47.41, P &lt; 0.001). The sensitivity, specificity, positive predictive value, and negative predictive value of baseline Zmax ≥2.0 for the presence of later CAAs were 80.6, 81.6, 32.5, and 97.5%, respectively.Conclusions: Findings from this study suggest that Zmax ≥2.0 of coronary arteries on baseline echocardiography may be used to predict children at a high risk of late CAAs and allow for targeted early intensification therapy.

scholarly journals Usefulness of CSF C-Reactive Protein in Differentiating Pyogenic and Aseptic Meningitis

1970 ◽  
Vol 22 (1) ◽  
pp. 78-81 ◽  
Author(s):  
M Belal Uddin ◽  
Manjira Rahman ◽  
AB Siddique
Keyword(s):  
Predictive Value ◽  
Febrile Convulsion ◽  
Cross Sectional Study ◽  
Suspected Case ◽  
C Reactive Protein ◽  
College Hospital ◽  
Cross Sectional ◽  
Medical College ◽  
Reactive Protein ◽  
Sensitivity Specificity

A cross sectional study was done about usefulness of CSF- C reactive protein determining the sensitivity, specificity and predictive value of CSF C-reactive protein estimation. The study was conducted in all the Pediatric unit of Rajshahi Medical College Hospital from March 2008 to July 2009. A total of 130 suspected case of meningitis patients were included in the study. Cerebrospinal fluid culture and C-reactive protein were done for all the patients. Among them 102 were diagnosed as meningitis and 28 were other than meningitis. They were diagnosed as febrile convulsion, seizure disorder, IVH, Among these diagnosed as meningitis, CSF culture were positive in 66 patient and CSF C-reactive protein were positive in 59 patients. Sensitivity and specificity of CSF C-reactive protein were 89.39% and 100% respectively. Predictive value of positive and negative test for CSF-CRP was 100% and 83.72%. DOI: 10.3329/taj.v22i1.5021 TAJ 2009; 22(1): 78-81

Erythrocyte Sedimentation Rate Combined With the Probe-to-Bone Test for Fast and Early Diagnosis of Diabetic Foot Osteomyelitis

2020 ◽  
pp. 153473462092327 ◽  
Author(s):  
Jun Xu ◽  
Fang Cheng ◽  
Yanming Li ◽  
Jinghang Zhang ◽  
Shuhong Feng ◽  
...  
Keyword(s):  
Blood Cell ◽  
Sedimentation Rate ◽  
Diabetic Foot ◽  
Predictive Value ◽  
C Reactive Protein ◽  
Blood Cell Count ◽  
Reactive Protein ◽  
Erythrocyte Sedimentation ◽  
Sensitivity Specificity ◽  
Diabetic Foot Osteomyelitis

This study aimed to investigate the erythrocyte sedimentation rate (ESR) optimal cutoff point in Chinese patients with diabetic foot osteomyelitis (DFO) and to evaluate the screening value of ESR combined with probe-to-bone (PTB) test for a fast diagnosis of DFO in early stage. A total of 204 diabetic inpatients with foot infection were tested for white blood cell count, neutrophil %, C reactive protein, and ESR at admission within 24 hours. All patients were performed PTB test. Patients with DFO (111) were confirmed by bone biopsy, the other patients (86) had only soft tissue infection. Although white blood cell count, neutrophil %, C-reactive protein, and ESR were different between the 2 groups, only area under curve of ESR was 0.832, with the value as a diagnostic indicator. The best cut point of ESR was >43 mm/h; the sensitivity, specificity, positive predictive value (+PV), and negative predictive value (−PV) were 82.9%, 70.5%, 0.78, and 0.77, respectively. ESR combined with PTB test (serial test), the sensitivity, specificity, +PV, −PV, positive likelihood ratio (+LR), and negative LR (−LR) were 63.56%, 98%, 0.97, 0.67, 31.75, and 0.37, respectively. ESR combined with PTB test (parallel test), the sensitivity, specificity, +PV, −PV, +LR, and −LR were 96%, 65.7%, 0.78, 093, 2.8, and 0.06, respectively, combined with PTB test is simple, favorable for application, and can early fast screening patients with DFO in high-risk patients.

scholarly journals PROKALSITONIN, CRP DAN PRESEPSIN SERUM DI SIRS

2016 ◽  
Vol 20 (3) ◽  
pp. 183
Author(s):  
Hendrianingtyas Hendrianingtyas ◽  
Banundari RH ◽  
Indranila KS ◽  
Imam Budiwiyono
Keyword(s):  
Blood Culture ◽  
Predictive Value ◽  
Gold Standard ◽  
Clinical Signs ◽  
Diagnostic Value ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Risk Of Death ◽  
Higher Sensitivity ◽  
Septic Condition

Infection in ICU patients can lead to a septic condition with clinical signs similar to Systemic Inflammatory Response Syndrome (SIRS). The high risk of death and high cost of sepsis is the reason to find an early marker in diagnosing sepsis. Blood culture can givea result in 1-3 days, so C reactive protein, procalcitonin and presepsin which are fast and accurate are needed to find a septic condition in SIRS patients. The aim of this study is to determine the diagnostic value of CRP, PCT and presepsin of sepsis with blood culture as the gold standard., The samples were collected from 32 clinically SIRS patients in the Dr. Kariadi Hosiptal, Semarang. The PCT level was measured using ELFA method, CRP level by PET IA method, while presepsin level by CLEA method. The determined area was under curve (AUC) and the cut off level was determined by 2×2 table to find out the sensitivity, spesificity, positive predictive value, negative predictive value and likelihood ratio of CRP, PCT and presepsin as well. The AUC of PCT, CRP and presepsin was 0.78 (cut off 4.314 ng/mL); 0.673 (cut off 10.245 mg/L) and 0.814 (cut off 1134.5 pg/mL). The presepsin level had a higher sensitivity (90%) than PCT (80%) and CRP (70%). PCT specificity was 72.73%, presepsin and CRP specificity each was 68.18%. Based on this study, AUC and sensitivity of presepsin level were found higher than the PCT and CRP level.

scholarly journals A hematologic scoring system and C-reactive protein compared to blood cultures for diagnosing bacterial neonatal sepsis

2017 ◽  
Vol 57 (2) ◽  
pp. 70
Author(s):  
Deddy Eka Febri Liestiadi ◽  
Emil Azlin ◽  
Selvi Nafianti
Keyword(s):  
Blood Culture ◽  
Likelihood Ratio ◽  
Neonatal Sepsis ◽  
Predictive Value ◽  
Scoring System ◽  
Positive Likelihood Ratio ◽  
Negative Likelihood Ratio ◽  
Blood Cultures ◽  
C Reactive Protein ◽  
Reactive Protein

Background Neonatal sepsis is the leading cause of death after pneumonia. Definitive bacterial sepsis diagnoses are made by blood culture results, which require a lengthy time. C-reactive protein (CRP) levels and a hematologic scoring system by Rodwell et al. are rapid tests that may be useful for diagnosing neonatal sepsis.                 Objective To determine the diagnostic value of CRP measurement and a hematologic scoring system compared to blood culture as the gold standard for diagnosing neonatal sepsis. Methods A cross-sectional study was conducted from April to August 2015 in the Neonatology Ward of Haji Adam Malik Hospital, Medan. A total of 43 neonates who were clinically suspected to have sepsis underwent CRP, hematologic scoring, and blood cultures. The IT ratio and procalcitonin indices were also examined. Diagnostic values were analyzed by a 2x2 table.Results Fourteen percent from all sample had positive bacterial culture. The CRP measurements had a sensitivity of 92.8%, specificity of 62%, positive predictive value (PPV) of 54.1%, negative predictive value (NPV) of 94.7%, positive likelihood ratio (PLR) of 2.44, and negative likelihood ratio (NLR) of 0.11. The hematologic scoring system had a sensitivity of 100%, specificity of 82.7%, PPV of 73.6%, NPV of 100%, PLR of 5.78, and NLR of 0. Procalcitonin and IT ratio show a good value of sensitivity and NPV, respectively. Conclusion The hematologic scoring system has better specificity than CRP measurement as compared to blood culture. However, both tests have good sensitivity for diagnosing neonatal sepsis.

scholarly journals DIAGNOSTIC VALUE OF C-REACTIVE PROTEIN AND THE INFLUENCE OF VISCERAL FAT IN PATIENTS WITH OBESITY AND ACUTE APPENDICITIS

2018 ◽  
Vol 31 (1) ◽  
Author(s):  
Adham do Amaral e CASTRO ◽  
Thelma Larocca SKARE ◽  
Fernando Ide YAMAUCHI ◽  
Adriano TACHIBANA ◽  
Suheyla Pollyana Pereira RIBEIRO ◽  
...  
Keyword(s):  
Acute Appendicitis ◽  
Visceral Fat ◽  
Predictive Value ◽  
Epidemiological Data ◽  
Diagnostic Value ◽  
C Reactive Protein ◽  
Visceral Fat Area ◽  
Reactive Protein ◽  
Clinical Records ◽  
Sensitivity Specificity

ABSTRACT Background: The C reactive protein (CRP) is one of the most accurate inflammatory markers in acute appendicitis (AA). Obesity leads to a pro-inflammatory state with increased CRP, which may interfere with the interpretation of this laboratory test in AA. Aim: To assess sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of CRP in patients with AA and their correlation to body mass index (BMI) and body fat composition. Method: This is a retrospective study based on clinical records and imaging studies of 191 subjects with histopathologically confirmed AA compared to 249 controls who underwent abdominal computed tomography (CT). Clinical and epidemiological data, BMI, and CRP values were extracted from medical records. CT scans were assessed for AA findings and body composition measurements. Results: CRP values increased according to patients’ BMI, with varying sensitivity from 79.78% in subjects with normal or lean BMI, 87.87% in overweight, and 93.5% in individuals with obesity. A similar pattern was observed for NPV: an increase with increasing BMI, 69.3% in individuals with normal or lean BMI, 84.3% in overweight, and 91.3% in individuals with obesity. There was a positive correlation between CRP and visceral fat area in patients with AA. Conclusions: Variations exist for sensitivity, specificity, PPV, and NPV values of CRP in patients with AA, stratified by BMI. An increase in visceral fat area is associated with elevated CRP across the BMI spectrum.

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