Predictive Values of β-Trace Protein (Prostaglandin D Synthase) by Use of Laser-Nephelometry Assay for the Identification of Cerebrospinal Fluid

Neurosurgery ◽  
2002 ◽  
Vol 50 (3) ◽  
pp. 571-577 ◽  
Author(s):  
Gregor Bachmann ◽  
Hela Petereit ◽  
Uta Djenabi ◽  
Olaf Michel
Keyword(s):  
Cerebrospinal Fluid ◽  
Predictive Values ◽  
Laser Nephelometry ◽  
Prostaglandin D Synthase

scholarly journals Evaluating the cerebrospinal fluid tap test with the Hellström iNPH scale for patients with idiopathic normal pressure hydrocephalus

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Johanna Rydja ◽  
Andreas Eleftheriou ◽  
Fredrik Lundin
Keyword(s):  
Cerebrospinal Fluid ◽  
Scale Score ◽  
Normal Pressure Hydrocephalus ◽  
Postoperative Outcome ◽  
Normal Pressure ◽  
Idiopathic Normal Pressure Hydrocephalus ◽  
Urinary Continence ◽  
Predictive Values ◽  
Tap Test ◽  
Total Scale Score

Abstract Background The cerebrospinal fluid tap test (CSF TT) is used for selecting shunt surgery candidates among patients with idiopathic normal pressure hydrocephalus (iNPH). We aimed to evaluate the predictive value of the CSF TT, by using the Hellström iNPH scale for shunted iNPH patients with a standardized method. Methods One hundred and sixteen shunt-operated iNPH patients were retrospectively included in this study. The gait and balance domains in the iNPH scale were used as outcome measures for the CSF TT and the total iNPH scale score as the postoperative outcome. A positive response to CSF TT was defined as a change of ≥ 5 points in the gait domain and ≥ 16 points in the balance domain. Differences between CSF TT responders and non-responders, sensitivity, specificity, positive and negative predictive values, accuracy, and correlations between changes from baseline to post CSF TT and from baseline to the postoperative follow-up, were calculated. Results In the CSF TT there were 63.8% responders in the gait domain and correspondingly 44.3% in the balance domain. CSF TT responders had a significantly better postoperative outcome in the total scale score (gait P ≤ 0.001, balance P ≤ 0.012) and gait CSF TT responders improved more in gait (P ≤ 0.001) and balance CSF TT responders in balance (P ≤ 0.001). No differences between CSF TT gait or balance responders could be found in neuropsychological or urinary continence assessments postoperatively. The sensitivity and specificity of the CSF TT and the outcome of the total iNPH scale score postoperatively were 68.1% and 52.0% for gait and 47.8% and 68.0% for balance, respectively. Conclusions The CSF TT, with the Hellström iNPH scale as the outcome measure, has clear limitations in predicting postoperative results. The gait domain may be used to predict outcomes for gait, but the balance domain is too insensitive.

Association of Bacteria Species with Positive Predictive Value of Bacteria Isolated from Cerebrospinal Fluid Cultures: A Retrospective Cohort Study

2021 ◽  
Author(s):  
Yi Ye ◽  
Guanghui Zheng ◽  
Yueyue Kong ◽  
Jiawei Ma ◽  
Guojun Zhang ◽  
...  
Keyword(s):  
Cerebrospinal Fluid ◽  
Cohort Study ◽  
Positive Predictive Value ◽  
Retrospective Cohort Study ◽  
Predictive Value ◽  
Retrospective Cohort ◽  
Klebsiella Oxytoca ◽  
P Value ◽  
Coagulase Negative Staphylococci ◽  
Predictive Values

Abstract Background: Previous studies discuss the positive predictive value through whether the bacteria are coagulase-negative staphylococci. The view may need to be updated. The aim was to evaluate the positive predictive value of different bacteria species isolated from cerebrospinal fluid cultures and discuss the rationality to view coagulase-negative staphylococci as a group.Methods: This retrospective cohort study recruit all adults with positive cerebrospinal fluid cultures sampled by lumbar puncture 2012-2020 in the Department of Neurosurgery. The exposure was bacteria species, and the outcome was positive predictive value. An episode was defined as a patient with one bacteria. When episodes with a bacteria species reached five, the bacteria species was analyzed specifically. The positive predictive value was defined as the incidence of isolated-bacteria-related infected episodes. The isolated-bacteria-related infected episode was defined as the patient was with clinical features of bacterial meningitis, and the improvement was related to sensitive antibacterial agents. Then the differences of the positive predictive value of different bacteria in all specific bacteria species, coagulase-negative staphylococci, and non-coagulase-negative staphylococci bacteria were calculated, respectively. The results were statistically significant when P-value <.05.Results: 1180 episodes from 1133 patients with 79 bacteria were studied; the positive predictive value was 54.3%. The bacteria included 67 bacteria species, ten bacteria genus, viridans streptococci, and unclassified coagulase-negative staphylococci. Twenty-four specific bacteria species were analyzed. The range of positive predictive values of them was 29.4%-100.0% (P<.0001). The positive predictive value for Enterobacter aerogenes, Pseudomonas aeruginosa, Enterobacter cloacae, and Klebsiella oxytoca was the highest, while the positive predictive value for Staphylococcus cohnii was the lowest. Moreover, 767 (65.0%) were with coagulase-negative staphylococci, the positive predictive value was 46.4%, and the range was 29.4%-85.7% (P=.0020); 413 (35.0%) were with non-coagulase-negative staphylococci bacteria, the positive predictive value was 69.0%, and the range was 40.0%-100.0% (P<.0001).Conclusions: This study suggests that the positive predictive value of different bacteria species is different. It is more reasonable to discuss the positive predictive value of bacteria isolated from cerebrospinal fluid cultures through the bacteria species rather than whether they are coagulase-negative staphylococci.Trial registration: This is a retrospective study without interventions on participants.

Detection of Cerebrospinal Fluid Leaks Using the Endoscopic Fluorescein Test in the Post-Operative Period Following Pituitary and Ventral Skull Base Surgery

2021 ◽  
Author(s):  
Peter A. Benedict ◽  
Joseph R. Connors ◽  
Micah R. Timen ◽  
Nupur Bhatt ◽  
Richard Lebowitz ◽  
...  
Keyword(s):  
Cerebrospinal Fluid ◽  
Skull Base ◽  
Postoperative Period ◽  
Skull Base Surgery ◽  
Tertiary Care ◽  
Csf Leak ◽  
Csf Rhinorrhea ◽  
Predictive Values ◽  
Ventral Skull Base ◽  
Csf Leaks

Objective: Diagnosis of cerebrospinal fluid (CSF) leaks is sometimes challenging in the postoperative period following pituitary and ventral skull base surgery. Intrathecal fluorescein (ITF) may be useful in this setting. Design: Retrospective chart review Setting: Tertiary care center Methods and Participants: All patients who underwent pituitary and ventral skull base surgery performed by a single rhinologist between January 2017–March 2020 were included. There were 103 patients identified. Eighteen patients received 20 ITF injections due to clinical suspicion for CSF leak during the postoperative period without florid CSF rhinorrhea on clinical exam. Computed tomography scans with new or increasing intracranial air and intra-operative findings were used to confirm CSF leaks. Clinical courses were reviewed for at least 6 months after initial concern for leak as the final determinate of CSF leak. Main Outcome Measures: Specificity and safety of ITF Results: Eleven (61%) ITF patients were female and 7 (39%) were male. Average patient age was 52.50±11.89. There were 6 patients with confirmed postoperative CSF leaks, 3 of whom had evaluations with ITF. ITF use resulted in 2 true positives, 1 false negative, 17 true negatives and 0 false positives. ITF sensitivity was 67%, specificity was 100%, and positive and negative predictive values were 100% and 94.4%, respectively. There were no adverse effects from ITF use. Conclusions: Existing modalities for detecting postoperative CSF leaks suffer from suboptimal sensitivity and specificity, delayed result reporting, or limited availability. Intrathecal fluorescein represents a specific and safe test with potential utility in the postoperative setting.

The cerebrospinal fluid immunoglobulin G index as a diagnostic aid in multiple sclerosis: a Bayesian approach.

1982 ◽  
Vol 28 (2) ◽  
pp. 354-355 ◽  
Author(s):  
E A Hische ◽  
H J van der Helm ◽  
H K van Walbeek
Keyword(s):  
Multiple Sclerosis ◽  
Cerebrospinal Fluid ◽  
Immunoglobulin G ◽  
Graphical Representation ◽  
Likelihood Ratios ◽  
Serum Samples ◽  
Predictive Values ◽  
Definite Multiple Sclerosis ◽  
Igg Index ◽  
Diagnostic Usefulness

Abstract Having determined immunoglobulin G (IgG) and albumin concentrations in 1100 cerebrospinal fluid and serum samples, we calculated the IgG index. Likelihood ratios for multiple sclerosis were calculated by using a training set consisting of 100 patients with definite multiple sclerosis and one consisting of 97 patients suffering from diseases from which multiple sclerosis must be differentiated. Predictive values for multiple sclerosis, given different values for the IgG index, are given in a graphical representation of Bayes' theorem. We conclude that this approach increases the diagnostic usefulness of the IgG index for the diagnosis of multiple sclerosis.

Simultaneous determination of cerebrospinal fluid oligoclonal bands and the "gamma-protein index" by agarose electrophoresis and densitometry.

1986 ◽  
Vol 32 (1) ◽  
pp. 84-87 ◽  
Author(s):  
C A French ◽  
R P Tracy ◽  
R A Rudick ◽  
A M Kraemer ◽  
D A Arvan
Keyword(s):  
Cerebrospinal Fluid ◽  
Gamma Globulin ◽  
Oligoclonal Bands ◽  
Laboratory Procedure ◽  
Predictive Values ◽  
Qualitative And Quantitative ◽  
Agarose Electrophoresis ◽  
Sensitivity Specificity ◽  
Single Laboratory

Abstract Oligoclonal bands were identified in electropherograms of cerebrospinal fluid, and the "gamma-protein index" was concurrently calculated from the same strip. For the index, an upper limit of normal of 0.66 was established. We compared results with the clinical diagnosis in 69 patients with multiple sclerosis and 48 control patients with other diseases. Sensitivity, specificity, and positive predictive values of 73%, 96%, and 96%, respectively, were obtained from the index. An abnormal index and the presence of oligoclonal bands combined increased the positive predictive value to 100%. This approach may allow adequate qualitative and quantitative assessment of gamma-globulin abnormalities in cerebrospinal fluid after a single laboratory procedure.

scholarly journals Diagnostic Performance of Galactomannan Antigen Testing in Cerebrospinal Fluid

2015 ◽  
Vol 54 (2) ◽  
pp. 428-431 ◽  
Author(s):  
G. M. Chong ◽  
J. A. Maertens ◽  
K. Lagrou ◽  
G. J. Driessen ◽  
J. J. Cornelissen ◽  
...  
Keyword(s):  
Cerebrospinal Fluid ◽  
Diagnostic Performance ◽  
European Organization ◽  
Predictive Values ◽  
Gm Csf ◽  
Referral Hospitals ◽  
Study Population ◽  
Cerebral Biopsy ◽  
Sensitivity Specificity ◽  
Antigen Testing

Testing cerebrospinal fluid (CSF) for the presence of galactomannan (GM) antigen may help in diagnosing cerebral aspergillosis (CA). However, the use of the CSF GM test as a diagnostic test has been little studied. We evaluated its diagnostic performance by comparing the CSF GM optical density indexes (ODI) at different cutoffs in patients with probable and proven CA to those in patients without CA. Patients from 2 tertiary referral hospitals with suspected CA between 2004 and 2014 and in whom CSF GM ODI had been determined were selected. European Organization for Research and Treatment of Cancer/Invasive Infectious Diseases Study Mycoses Group (EORTC/MSG) definitions of invasive aspergillosis and CA were used, but with the exclusion of the test to be validated (i.e., the CSF GM test) as a microbiological EORTC/MSG criterion. The study population consisted of 44 patients (4 with proven CA, 13 with probable CA, and 27 with no CA). Of the 17 patients with CA, 15 had a CSF GM ODI of ≥2.0. Of 27 patients without CA, 26 had a CSF GM ODI of <0.5 and 1 had a CSF GM ODI of 8.2. When a GM CSF ODI cutoff of 1.0 was used, the sensitivity, specificity, and positive and negative predictive values were 88.2%, 96.3%, 93.8%, and 92.9%, respectively. The same results were found when a CSF GM ODI cutoff of 0.5 or 2.0 was used. Testing GM in CSF has a high diagnostic performance for diagnosing CA and may be useful to diagnose or virtually rule out the infection without the need for a cerebral biopsy.

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