Prospective study with rapid and low cost serodiagnostic assay for rickettsial infections in children of Vijayapura district, Northern Karnataka, India

Background: Rickettsial infections do exist in study area posing diagnostic difficulties. The study is aimed to compare performance of serological assays for rapid and low-cost diagnosis for rickettsial infections in northern Karnataka, India.Methods: Prospective study was done on 40 children upto 12 years old, hospitalized during 1-year period with fever and presence of one or more of the clinical features of rickettsial infections. Clinical and biochemical findings and serological assays such as indirect immunofluorescence assay (IFA), enzyme-linked immunosorbent assay-IgM (ELISA-IgM) and Weil-Felix were used to diagnose the disease. Statistical analysis was used to compare the results. Performance characteristics such as sensitivity, specificity, positive predictive value, negative predictive value and accuracy were calculated using MedCalc for Windows.Results: All 40 patients met the inclusion criteria (23 males and 17 females). Mortality was 2%. Predominant age group was 1-3 years (57.50%). Fever, rashes and hepatosplenomegaly was in all 40 patients (100%); whereas other clinical features showed mixed results. Biochemical findings: anemia in 90%, thrombocytopenia in 45% and elevated transaminases 57.50% and 55%. The ELI-SA-IgM assay showed a sensitivity of 95.00%, a specificity of 95.24% and 95.12% accuracy. The Weil-Felix assay showed a sensitivity of 77.50%, a specificity of 81.63% and 79.78% accu-racy. ELISA-IgM test showed only 5% (p=0.5555) and Weil-Felix test showed 12.50% (p=0.3816) non-significant difference when both compared with IFA test. Whereas ELISA-IgM showed 17.50% more significant (p=0.0239) when compared with Weil-Felix.Conclusions: ELISA-IgM may serve as rapid and low cost serodiagnostic assay over IFA for rickettsial infections.

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Reliability of digital panoramic radiography in the diagnosis of carotid artery calcifications

Radiologia Brasileira ◽

10.1590/s0100-39842014000100011 ◽

2014 ◽

Vol 47 (1) ◽

pp. 28-32 ◽

Cited By ~ 3

Author(s):

Vilson Lacerda Brasileiro Junior ◽

Aníbal Henrique Barbosa Luna ◽

Marcelo Augusto Oliveira de Sales ◽

Tânia Lemos Coelho Rodrigues ◽

Priscilla Lopes da Fonseca Abrantes Sarmento ◽

...

Keyword(s):

High Risk ◽

Carotid Artery ◽

Positive Predictive Value ◽

Predictive Value ◽

Carotid Arteries ◽

Panoramic Radiography ◽

Digital Panoramic Radiography ◽

Significant Difference ◽

Mcnemar’S Test ◽

Sensitivity Specificity

Objective The present study evaluated the reliability of digital panoramic radiography in the diagnosis of carotid artery calcifications. Materials and Methods Thirty-five patients under high-risk for development of carotid artery calcifications who had digital panoramic radiography were referred to undergo ultrasonography. Thus, 70 arteries were assessed by both methods. The main parameters utilized to evaluate the panoramic radiography reliability in the diagnosis of carotid artery calcifications were accuracy, sensitivity, specificity and positive predictive value of this method as compared with ultrasonography. Additionally, the McNemar's test was utilized to verify whether there was a statistically significant difference between digital panoramic radiography and ultrasonography. Results Ultrasonography demonstrated carotid artery calcifications in 17 (48.57%) patients. Such individuals presented with a total of 29 (41.43%) carotid arteries affected by calcification. Radiography was accurate in 71.43% (n = 50) of cases evaluated. The degree of sensitivity of this method was 37.93%, specificity of 95.12% and positive predictive value of 84.61%. A statistically significant difference (p < 0.001) was observed between the methods evaluated in their capacity to diagnose carotid artery calcifications. Conclusion Digital panoramic radiography should not be indicated as a method of choice in the investigation of carotid artery calcifications.

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35. Accuracy of anal cytology in predicting histological HSIL: baseline results from the Australian Study of the Prevention of Anal Cancer (SPANC)

Sexual Health ◽

10.1071/shv10n6ab35 ◽

2013 ◽

Vol 10 (6) ◽

pp. 587

Author(s):

Jennifer Roberts ◽

Clare Biro ◽

Annabelle Farnsworth ◽

Debbie Ekman ◽

Marjorie Adams ◽

...

Keyword(s):

Predictive Value ◽

Screening Program ◽

Anal Carcinoma ◽

Hiv Positive ◽

Homosexual Men ◽

Significant Difference ◽

Anal Cytology ◽

Cytological Abnormality ◽

Sensitivity Specificity ◽

The Bethesda System

Background Anal cytology may form the basis of a future screening program to prevent anal carcinoma. Therefore, the accuracy of anal Papanicolaou tests in detecting histological HSIL needs to be evaluated. Methods: SPANC is a 3-year prospective study in homosexual men aged ≥35 years. At each of five visits, men undergo collection of a ThinPrep® anal cytological sample, high-resolution anoscopy (HRA) and biopsy of any abnormalities. Cytology is reported using the Bethesda system. Histology is reported using lower anogenital squamous terminology. Results: 351 men had a baseline visit by end July 2013. Median age was 49 (range: 35–79) years and 101 (28.8%) men were HIV positive. Anal cytology results were: unsatisfactory in 21 (6.0%), negative in 143 (40.7%), ASC-US in 51 (14.5%), LSIL in 22 (6.3%), ASC-H in 45 (12.8%) and HSIL in 69 (19.7%). 293 of 351 (83.5%) men had baseline histology. The most severe abnormality for each was: negative for SIL in 98 (33.4%), LSIL in 87 (29.7%) and HSIL in 108 (36.9%). Anal cytology sensitivity for histological HSIL (at ASC-US threshold) was 79.0%. Specificity was 53.8%. Positive predictive value (PPV) of any cytological abnormality for histological HSIL was 44.4% and PPV of HSIL cytoprediction was 63.8%. Negative predictive value (NPV) was 84.6%. Overall there was no significant difference between HIV positive and negative men with respect to sensitivity, specificity, PPV or NPV. Conclusions: These results indicate that histological HSIL is common in homosexual men. The finding of any cytological abnormality should prompt HRA. However, both cytology and HRA can miss or underestimate significant lesions in a single screening.

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Comparison of an IgG-Specific Enzyme-Linked Immunosorbent Assay Cutoff of 0.4 Versus 0.8 and 1.0 Optical Density Units for Heparin-Induced Thrombocytopenia

Clinical and Applied Thrombosis/Hemostasis ◽

10.1177/1076029615606532 ◽

2016 ◽

Vol 23 (3) ◽

pp. 282-286 ◽

Cited By ~ 5

Author(s):

Brianne M. Ritchie ◽

Jean M. Connors ◽

Katelyn W. Sylvester

Keyword(s):

Optical Density ◽

Immunosorbent Assay ◽

Predictive Value ◽

Retrospective Chart Review ◽

Serotonin Release ◽

Enzyme Linked Immunosorbent Assay ◽

Platelet Factor ◽

Heparin Induced Thrombocytopenia ◽

Institutional Review ◽

Sensitivity Specificity

Background: Previous studies have demonstrated optimized diagnostic accuracy in utilizing higher antiheparin–platelet factor 4 (PF4) enzyme-linked immunosorbent assay (ELISA) optical density (OD) thresholds for diagnosing heparin-induced thrombocytopenia (HIT). We describe the incidence of positive serotonin release assay (SRA) results, as well as performance characteristics, for antiheparin–PF4 ELISA thresholds ≥0.4, ≥0.8, and ≥1.0 OD units in the diagnosis of HIT at our institution. Methods: Following institutional review board approval, we conducted a single-center retrospective chart review on adult inpatients with a differential diagnosis of HIT evaluated by both antiheparin–PF4 ELISA and SRA from 2012 to 2014. The major endpoints were to assess incidence of positive SRA results, sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy at antiheparin–PF4 ELISA values ≥0.4 OD units when compared to values ≥0.8 and ≥1.0 OD units. Clinical characteristics, including demographics, laboratory values, clinical and safety outcomes, length of stay, and mortality, were collected. Results: A total of 140 patients with 140 antiheparin–PF4 ELISA and SRA values were evaluated, of which 23 patients were SRA positive (16.4%) and 117 patients were SRA negative (83.6%). We identified a sensitivity of 91.3% versus 82.6% and 73.9%, specificity of 61.5% versus 87.2% and 91.5%, PPV of 31.8% versus 55.9% and 63.0%, NPV of 97.3% versus 96.2% and 94.7%, and accuracy of 66.4% versus 86.4% and 88.6% at antiheparin–PF4 ELISA thresholds ≥0.4, ≥0.8, and ≥1.0 OD units, respectively. Conclusion: Our study suggests an increased antiheparin–PF4 ELISA threshold of 0.8 or 1.0 OD units enhances specificity, PPV, and accuracy while maintaining NPV with decreased sensitivity.

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Comparison of International Federation of cervical pathology and colposcopy nomenclature (2011) and Swede score for assessment of cervical lesions

10.21203/rs.3.rs-169936/v1 ◽

2021 ◽

Author(s):

Bindiya Gupta ◽

Rashmi Shreya ◽

Shalini Rajaram ◽

Anshuja Singla ◽

Sandhya Jain ◽

...

Keyword(s):

Positive Predictive Value ◽

Prospective Study ◽

Negative Predictive Value ◽

Predictive Value ◽

Gold Standard ◽

International Federation ◽

Objective Method ◽

Cervical Lesions ◽

Sensitivity Specificity ◽

Strength Of Association

Abstract Purpose: Standardization of colposcopic evaluation is important as it is observer dependent.The aim of the study was to compare the strength of association of colposcopic findings by International Federation of Colposcopy and Cervical Pathology (IFCPC) nomenclature and Swede score. Methods: In the prospective study, 150 women aged 30 to 60 years with abnormal screening results underwent colposcopy, the findings were evaluated using both IFCPC and Swede score and biopsy was taken from abnormal areas. Performances by both the methods were calculated taking biopsy as gold standard. Results: Nineteen ≥ CIN2 lesions were detected. The sensitivity, specificity, positive predictive value and negative predictive value for detecting ≥ CIN2 lesion by IFCPC scoring was 63.6%, 96.0%, 78.7%, 91.9%. Using Swede score, sensitivity, specificity, positive predictive value and negative predictive value at cut off of 8 were 42.4, 95%, 96.6% and 81.8% while at cut-off of 5, these were 96%, 88.3%,76.7% and 93.6%. The agreement between IFCPC major lesion and Swede score ≥ 8 for ≥ CIN2 was 0.626 (p<0.01). Conclusion: Swede score is an easier and more objective method for colposcopic evaluation and a score >8 can be applied to the screen and treat programme.

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Complement Component C1q as an Emerging Biomarker for the Diagnosis of Tuberculous Pleural Effusion

Frontiers in Microbiology ◽

10.3389/fmicb.2021.765471 ◽

2021 ◽

Vol 12 ◽

Author(s):

Xin Qiao ◽

Ming-Ming Shao ◽

Feng-Shuang Yi ◽

Huan-Zhong Shi

Keyword(s):

Pleural Effusion ◽

Confidence Interval ◽

Diagnostic Accuracy ◽

Predictive Value ◽

Complement Component ◽

Enzyme Linked Immunosorbent Assay ◽

Age And Gender ◽

Tuberculous Pleural Effusion ◽

And Gender ◽

Sensitivity Specificity

Background and Objective: The accurate differential diagnosis of tuberculous pleural effusion (TPE) from other exudative pleural effusions is often challenging. We aimed to validate the accuracy of complement component C1q in pleural fluid (PF) in diagnosing TPE.Methods: The level of C1q protein in the PF from 49 patients with TPE and 61 patients with non-tuberculous pleural effusion (non-TPE) was quantified by enzyme-linked immunosorbent assay, and the diagnostic performance was assessed by receiver operating characteristic (ROC) curves based on the age and gender of the patients.Results: The statistics showed that C1q could accurately diagnose TPE. Regardless of age and gender, with a cutoff of 6,883.9 ng/mL, the area under the curve (AUC), sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of C1q for discriminating TPE were 0.898 (95% confidence interval: 0.825–0.947), 91.8 (80.4–97.7), 80.3 (68.2–89.4), 78.9 (69.2–86.2), and 92.5 (82.6–96.9), respectively. In subgroup analysis, the greatest diagnostic accuracy was achieved in the younger group (≤ 50 years of age) with an AUC of 0.981 (95% confidence interval: 0.899–0.999) at the cutoff of 6,098.0 ng/mL. The sensitivity, specificity, PLR, NLR, PPV, and NPV of C1q were 95.0 (83.1–99.4), 92.3 (64.0–99.8), 97.4 (85.2–99.6), and 85.7 (60.6–95.9), respectively.Conclusion: Complement component C1q protein was validated by this study to be a promising biomarker for diagnosing TPE with high diagnostic accuracy, especially among younger patients.

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Spiral Flow Fube for Contrast Medium Reduction in Coronary CT Angiography

International Cardiovascular Forum Journal ◽

10.17987/icfj.v9i0.375 ◽

2017 ◽

Vol 9 ◽

Author(s):

Nobuo Tomizawa ◽

Yayoi Hayakawa ◽

Shinichi Inoh ◽

Takeshi Nojo ◽

Satoshi Uemura ◽

...

Keyword(s):

Contrast Medium ◽

Predictive Value ◽

Diagnostic Performance ◽

Left Main ◽

Spiral Flow ◽

Flow Tube ◽

Coronary Ct ◽

Shaped Tube ◽

Significant Difference ◽

Sensitivity Specificity

ObjectivesTo assess the diagnostic performance and enhancement of coronary CT with reduced contrast medium using the spiral flow tube compared with the T-shaped tube.MethodsWe retrospectively included 444 patients who underwent catheter examination within 2 months after coronary CT. The first 222 patients received 21.0 mgI/kg/s of contrast medium using the T-shaped tube and the injected contrast medium was reduced by 6% (19.8 mgI/kg/s) in the last 222 patients using the spiral flow tube. We compared the per vessel diagnostic performance for detecting obstructive stenosis (≥50%) by catheter examination and the enhancement of proximal coronary arteries.ResultsThe sensitivity, specificity, positive predictive value, negative predictive value and accuracy was 96%, 84%, 72%, 98% and 87% using the spiral flow tube and 93%, 83%, 68%, 97% and 86% using the T-shaped tube, respectively, without significance. The enhancement of left main (spiral flow vs T-shape, 407 ± 53 vs 407 ± 62 HU, p = 0.95) and right coronary (419 ± 58 vs 415 ± 61 HU, p = 0.49) arteries did not show significant difference.ConclusionsThe spiral flow tube would maintain the diagnostic performance and coronary enhancement with reduced contrast medium compared with the T-shaped tube.

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Agreement of Enzyme-Linked Immunosorbent Assay With Rapid Plasma Reagin and Treponema pallidum Hemagglutination Assay for Screening and Diagnosis of Syphilis at National Blood Bank Service in Addis Ababa, Ethiopia

American Journal of Clinical Pathology ◽

10.1093/ajcp/aqz131.007 ◽

2019 ◽

Vol 152 (Supplement_1) ◽

pp. S153-S154

Author(s):

Jemal Ibrahim ◽

Ejigayehu Afework ◽

Mintewab Hussein

Keyword(s):

Positive Predictive Value ◽

Predictive Value ◽

Addis Ababa ◽

Treponema Pallidum ◽

Blood Bank ◽

Enzyme Linked Immunosorbent Assay ◽

Rapid Plasma Reagin ◽

Hemagglutination Assay ◽

Kappa Value ◽

Sensitivity Specificity

Abstract Objectives To determine the agreement of enzyme-linked immunosorbent assay (ELISA) with rapid plasma reagin (RPR) and Treponema pallidum hemagglutination assay (TPHA) at the National Blood Bank Service in Addis Ababa, Ethiopia. Methods The study was conducted from January to June 2016 on 190 syphilis ELISA positive and 190 negative samples stored at the National Blood Bank Service (NBBS) laboratory, Addis Ababa, Ethiopia, from July 2015 to December 2015. A systematic random sampling method was used to select samples. The data were analyzed by SPSS version 20 software. The overall percent agreement, kappa value, sensitivity, specificity, positive predictive value, and negative predictive value of the tests were calculated. Results From 190 positive sera, 151 (80%) were confirmed as positive by TPHA, and 39 (20%) were found false positive; 59 (31.1%) of them were positive and 131 (68.9%) were false positive by RPR. From 190 negative sera, all were negative by RPR and TPHA. The sensitivity, specificity, positive predictive value, and negative predictive value of TPHA were 99.9%, 85%, 79%, and 100%, respectively, while RPR was 62%, 99%, 100%, and 63%, respectively. Overall percent agreement of ELISA with TPHA was 90% and corresponding kappa value was 0.795, and ELISA with RPR was 66% with a kappa value of 0.375. Conclusion TPHA was very sensitive; there was substantial agreement with ELISA. Whereas RPR was highly specific and less sensitive, there was fair agreement with ELISA. TPHA can be used interchangeably with ELISA to screen blood in blood bank laboratories.

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Evaluation of GeneXpert MTB/RIF for detecting Mycobacterium tuberculosis in a hospital in China

Journal of International Medical Research ◽

10.1177/0300060517698618 ◽

2017 ◽

Vol 45 (2) ◽

pp. 816-822 ◽

Cited By ~ 12

Author(s):

Tingyu Tang ◽

Fang Liu ◽

Xiaoling Lu ◽

Qingdong Huang

Keyword(s):

Mycobacterium Tuberculosis ◽

Predictive Value ◽

Rate Sensitivity ◽

Turnaround Time ◽

Cross Sectional Study ◽

Cross Sectional ◽

Significant Difference ◽

Kappa Value ◽

Positive Rate ◽

Sensitivity Specificity

Objective To evaluate the performance of GeneXpert MTB/RIF in diagnosing pulmonary tuberculosis (TB) in China. Methods This cross-sectional study included sputum specimens of 240 suspected TB cases. Specimens were examined by light microscopy for the presence of acid-fast bacilli, which were cultured by the BACTEC MGIT 960 (M960) system and detected by the GeneXpert MTB/RIF assay. The positive rate, sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and average turnaround time of methods were evaluated. Results The positive rate was 36.6% (87/238) for the GeneXpert MTB/RIF assay and 34.0% (81/238) by M960 culture, with no significant difference between methods (χ2 = 0.33, p > 0.05). According to culture results, sensitivity of the GeneXpert MTB/RIF assay was 84.0% (68/81), specificity was 87.8% (129/147), the PPV was 78.2% (68/87), and the NPV was 87.2% (129/148). The agreement for results between Gene Xpert MTB/RIF and the M960 system was 82.8% and the Kappa value was 0.73. Conclusion The GeneXpert MTB/RIF assay is a simple, rapid, and accurate test for detecting Mycobacterium tuberculosis in sputum specimens.

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Comparison of Chemicon SimulFluor Direct Fluorescent Antibody Staining with Cell Culture and Shell Vial Direct Immunoperoxidase Staining for Detection of Herpes Simplex Virus and with Cytospin Direct Immunofluorescence Staining for Detection of Varicella-Zoster Virus

Clinical and Diagnostic Laboratory Immunology ◽

10.1128/cdli.8.5.909-912.2001 ◽

2001 ◽

Vol 8 (5) ◽

pp. 909-912 ◽

Cited By ~ 23

Author(s):

Edward L. Chan ◽

Ken Brandt ◽

Greg B. Horsman

Keyword(s):

Cell Culture ◽

Predictive Value ◽

Fluorescent Antibody ◽

Turnaround Time ◽

Immunofluorescence Assay ◽

Direct Immunofluorescence ◽

Shell Vial ◽

Varicella Zoster ◽

Simplex Virus ◽

Sensitivity Specificity

ABSTRACT A new rapid direct immunofluorescence assay, the SimulFluor direct fluorescent-antibody (DFA) assay, which can simultaneously detect herpes simplex virus types 1 and 2 (HSV-1 and -2) and varicella-zoster virus (VZV), was evaluated in comparison with our current standard procedures of (i) shell vial direct immunoperoxidase (shell vial IP) staining and cell culture for detection of HSV and (ii) cytospin DFA staining for VZV detection. A total of 517 vesicular, oral, genital, and skin lesion specimens were tested by all three procedures. For HSV detection, the SimulFluor DFA assay had an overall sensitivity, specificity, positive predictive value, and negative predictive value of 80.0, 98.3, 92.3, and 95.1%, respectively, when compared to culture. Shell vial IP staining had a sensitivity, specificity, positive predictive value, and negative predictive value of 87.6, 100, 100, and 96.9%, respectively, when compared with cell culture. The SimulFluor DFA assay, however, offers same-day, 1.5-hours results versus a 1- to 2-day wait for shell vial IP staining results and a 1- to 6-day wait for culture results for HSV. For VZV detection SimulFluor DFA staining detected 27 positive specimens as compared to 31 by our standard cytospin DFA technique—a correlation of 87.1%. A positive SimulFluor reaction for VZV is indicated by yellow-gold fluorescence compared to the bright apple-green fluorescence observed by cytospin DFA staining. There is no difference in turnaround time between the two assays. The SimulFluor DFA assay is a rapid immunofluorescence assay that can detect 80% of the HSV-positive specimens and 87% of the VZV-positive specimens with a 1.5-h turnaround time.

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Amide Proton Transfer-Weighted (APTw) Imaging of Intracranial Infection in Children: Initial Experience and Comparison with Gadolinium-Enhanced T1-Weighted Imaging

BioMed Research International ◽

10.1155/2020/6418343 ◽

2020 ◽

Vol 2020 ◽

pp. 1-13

Author(s):

Hong Zhang ◽

Xiaolu Tang ◽

Yanqiu Lv ◽

Di Hu ◽

Jihang Sun ◽

...

Keyword(s):

Proton Transfer ◽

Predictive Value ◽

Amide Proton ◽

High Signal ◽

Noninvasive Technique ◽

Intracranial Infection ◽

Amide Proton Transfer ◽

Significant Difference ◽

Sensitivity Specificity ◽

Age Range

Purpose. To evaluate the performance of amide proton transfer-weighted (APTw) imaging against the reference standard of gadolinium-enhanced T1-weighted imaging (Gd-T1w) in children with intracranial infection. Materials and Methods. Twenty-eight pediatric patients (15 males and 13 females; age range 1-163 months) with intracranial infection were recruited in this study. 2D APTw imaging and conventional MR sequences were conducted using a 3 T MRI scanner. Kappa (κ) statistics and the McNemar test were performed to determine whether the hyperintensity on APTw was related to the enhancement on Gd-T1w. The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of APTw imaging to predict lesion enhancement were calculated. Result. In twelve patients with brain abscesses, the enhancing rim of the abscesses on the Gd-T1w images was consistently hyperintense on the APTw images. In eight patients with viral encephalitis, three showed slight spotted gadolinium enhancement, while the APTw image also showed a slight spotted high signal. Five of these patients showed no enhancement on Gd-T1w and isointensity on the APTw image. In eleven patients with meningitis, increased APTw signal intensities were clearly visible in gadolinium-enhancing meninges. Sixty infectious lesions (71%) showed enhancement on Gd-T1w images. The sensitivity and specificity of APTw were 93.3% (56/60) and 91.7% (22/24). APTw demonstrated excellent agreement (κ=0.83) with Gd-T1w, with no significant difference (P=0.69) in detection of infectious lesions. Conclusions. These initial data show that APTw MRI is a noninvasive technique for the detection and characterization of intracranial infectious lesions. APTw MRI enabled similar detection of infectious lesions to Gd-T1w and may provide an injection-free means of evaluation of intracranial infection.

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