scholarly journals Screening of Extended-Spectrum β-Lactamases (ESBL)-producing Klebsiella pneumoniae with ChromID ESBL Media

2018 ◽  
Vol 10 (3) ◽  
pp. 217-21
Author(s):  
Emy Noerwidayati ◽  
Andaru Dahesihdewi ◽  
Osman Sianipar
Keyword(s):  
Likelihood Ratio ◽  
Predictive Value ◽  
Clinical Laboratory ◽  
False Negative ◽  
Clinical Isolates ◽  
True Negative ◽  
Nasal Sinus ◽  
Negative Results ◽  
Extended Spectrum ◽  
Sensitivity Specificity

BACKGROUND: Klepsiella pneumoniae, one of clinical isolates, is frequently found causative agent of hospital acquired infection. Currently, K. pneumoniae is found as extended-Spectrum β-lactamases (ESBL) producer, allowing it to become multidrugresistant. A clinical laboratory with limited facility needs a valid, reliable, inexpensive and simple laboratory test to control its infection and antimicrobial-resistancy. The aim of this study is to evaluate the diagnostic performance of a ESBL media to detect ESBL-producing K. pneumoniae.METHODS: An independent and blind comparative study of ChromID ESBL media and Double Disc Synergy Test (DDST) was conducted for detecting the clinical isolate of ESBL-producing K. pneumoniae. Clinical isolates of K. pneumoniae collected from the Clinical Laboratory of Dr. Sardjito Hospital were isolated.RESULTS: There were 103 clinical isolates of K. pneumoniae, which were isolated from urine, pus, blood, stool, cerebrospinal fluid, sputum, drain liquid, nasal sinus liquid, gastric wash, bronchi liquid, injury liquid and nasal swab. The number of true positive, true negative, false positive and false negative results were 74, 18, 9 and 2, respectively. Meanwhile, the sensitivity, specificity, positive predictive value, negative predictive value, likelihood ratio for positive result and likelihood ratio for negative result of the new ESBL media were 97.4%, 66.7%, 89.2%, 90%, 2.9 and 0.03, respectively.CONCLUSION: Since the new ESBL media and DDST results were similar, so the new ESBL media could be used for screening patients with clinical presentation that indicating a high suspicious of ESBL-producing bacteria.KEYWORDS: K. pneumoniae, ChromID ESBL, DDST, ESBL, sensitivity

The role of serum periostin in the diagnosis of asthma: A meta-analysis

2020 ◽  
Vol 41 (4) ◽  
pp. 240-247
Author(s):  
Lei Yang ◽  
Qingtao Zhao ◽  
Shuyu Wang
Keyword(s):  
Diagnostic Accuracy ◽  
Meta Analysis ◽  
Characteristic Curve ◽  
False Negative ◽  
Summary Receiver Operating Characteristic ◽  
True Negative ◽  
Negative Results ◽  
Noninvasive Biomarker ◽  
Sensitivity Specificity ◽  
Serum Periostin

Background: Serum periostin has been proposed as a noninvasive biomarker for asthma diagnosis and management. However, its accuracy for the diagnosis of asthma in different populations is not completely clear. Methods: This meta-analysis aimed to evaluate the diagnostic accuracy of periostin level in the clinical determination of asthma. Several medical literature data bases were searched for relevant studies through December 1, 2019. The numbers of patients with true-positive, false-positive, false-negative, and true-negative results for the periostin level were extracted from each individual study. We assessed the risk of bias by using Quality Assessment of Diagnostic Accuracy Studies 2. We used the meta-analysis to produce summary estimates of accuracy. Results: In total, nine studies with 1757 subjects met the inclusion criteria. The pooled estimates of sensitivity, specificity, and diagnostic odds ratios for the detection of asthma were 0.58 (95% confidence interval [CI], 0.38‐0.76), 0.86 (95% CI, 0.74‐0.93), and 8.28 (95% CI, 3.67‐18.68), respectively. The area under the summary receiver operating characteristic curve was 0.82 (95% CI, 0.79‐0.85). And significant publication bias was found in this meta‐analysis (p = 0.39). Conclusion: Serum periostin may be used for the diagnosis of asthma, with moderate diagnostic accuracy.

scholarly journals CT evaluation of malignant PNS mass and histopathological correlation

2016 ◽  
Vol 6 (1) ◽  
pp. 33
Author(s):  
Tahmina Islam ◽  
Salauddin Al-Azad ◽  
Lubna Khondker ◽  
Sabina Akhter
Keyword(s):  
Ct Scan ◽  
Predictive Value ◽  
False Negative ◽  
True Negative ◽  
Cross Sectional ◽  
Nasal Sinus ◽  
Computed Tomographic ◽  
Histopathological Correlation ◽  
Ct Evaluation ◽  
Malignant Mass

<p><strong>Background:</strong> Computed tomography (CT) is the gold standard for exact delineation of paranasal sinus(PNS) disease. There are many radiologically important diseases of paranasal sinuses.<strong> </strong></p><p><strong>Objective:</strong> to evaluate the malignant PNS mass by computed tomographic image and the findings of this modality were compared with histopathological result.</p><p><strong>Methods:</strong> It was a cross sectional type of study and carried out with suspected PNS mass having patients during January 2009 to Octo­ber 2010.</p><p><strong>Results:</strong> The mean age of the patients was 35.95 ± 18.24 and common complaints of the patients were nasal obstruction (73.7%) and maximum 53.9% patients had PNS mass in maxillary sinuses. Out of 76 cases 21.1 % found malignant mass on CT and after histopathology 19. 7% had malignant mass. Out of all cases 14 were diagnosed as malig­nant PNS mass by CT scan and confirmed by histopathological evaluation and they were true positive. Two cases were diagnosed as malignant PNS mass by CT scan but not confirmed by histopathological findings and they were false positive. Of 60 cases, which were diagnosed by CT scan, one was confirmed as malignant and 59 were benign by histopa­thology. They were false negative and true negative respectively. Sensitivity of CT scan to diagnose malignant PNS mass was 93.3%, specificity 96.7%, positive predictive value 87.5%, negative predictive value 98.3% and accuracy 96.1 %.<strong> </strong></p><p><strong>Conclusion:</strong> CT scan of the malignant para nasal sinus mass provides more information and better image quality and CT diagnosis correlate well with the findings of histopathology.</p>

scholarly journals Validity of protein-creatinine and protein-osmolality ratios in the estimation of massive proteinuria in children with nephrotic syndrome

2007 ◽  
Vol 47 (4) ◽  
pp. 139
Author(s):  
M. Sukmawati ◽  
K. Suarta
Keyword(s):  
Nephrotic Syndrome ◽  
Predictive Value ◽  
Diagnostic Tests ◽  
Quantitative Methods ◽  
False Negative ◽  
Creatinine Ratio ◽  
Negative Results ◽  
False Negative Results ◽  
Sensitivity Specificity ◽  
Posttest Probability

Background Children with nephrotic syndrome have massiveproteinuria, a rate of excretion equal to or greater than 40 mg/hour/m 2 body surface. The ability to quantitate massive urinaryprotein excretion is very important for both diagnostic andprognostic purposes. Quantification of proteinuria using 24-hoururine collection (Esbach) is difficult to do especially in children;moreover, many false-positive and false-negative results arereported for any semi-quantitative methods such as dipstick andsulfosalicylic acid measurement.Objective To determine the accuracy of protein-creatinine ratio(PCR) and protein-osmolality ratio (POR) in quantification ofmassive proteinuria in children with nephrotic syndrome.Methods Diagnostic tests were conducted on children withnephrotic syndrome aged 2-12 years with Esbach as a referencestandard. Sensitivity, specificity, positive predictive value (PPV),negative predictive value, (NPV), pre and posttest probabilitywere compared between PCR and POR.Results Study patients consisted of 47 children, 38 (81%) withmassive proteinuria. PCR has sensitivity of 92%, specificity of78%, PPV of 95%, NPV of 70% and posttest probability of 95%.POR has sensitivity of 76%, specificity of 78%, PPV of 94%, NPVof 44% and posttest probability of 94%.Conclusion Both PCR and POR are accurate to determine massiveproteinuria in children with nephrotic syndrome.

scholarly journals Characterization of Focal Liver Lesions using CEUS and MRI with Liver-Specific Contrast Media: Experience of a Single Radiologic Center

2017 ◽  
Vol 38 (06) ◽  
pp. 619-625 ◽  
Author(s):  
Lukas Beyer ◽  
Florian Wassermann ◽  
Benedikt Pregler ◽  
Katharina Michalik ◽  
Janine Rennert ◽  
...  
Keyword(s):  
Contrast Media ◽  
Predictive Value ◽  
False Negative ◽  
Focal Liver Lesions ◽  
Liver Lesions ◽  
Predictive Values ◽  
Negative Results ◽  
False Negative Results ◽  
Sensitivity Specificity

Abstract Aim The purpose of this study was to compare contrast-enhanced ultrasound (CEUS), magnetic resonance imaging (MRI) using liver-specific contrast agent and a combination of both for the characterization of focal liver lesions (FLL). Methods 83 patients with both benign and malignant liver lesions were examined using CEUS and MRI after the intravenous administration of liver-specific contrast media. All patients had inconclusive results from prior imaging examinations. Histopathological specimens could be obtained in 53 patients. Ultrasound was performed using a multi-frequency curved probe (1 – 6 MHz) after the injection of 1 – 2.4 ml ultrasound contrast media. The sensitivity, specificity, positive predictive value and negative predictive value of CEUS, MRI and a combination of both (CEUS + MRI) were compared. Results The sensitivity, specificity, positive and negative predictive values regarding lesion classification were 90.9 %, 70.6 %, 92.3 % and 66.6 %, respectively, for CEUS; 90.9 %, 82.4 %, 95.2 % and 70.0 %, respectively, for MRI; and 96.9 %, 70.6 %, 92.7 % and 85.7 % respectively, for CEUS + MRI. There were no statistically significant differences. 6 malignant lesions were missed using CEUS or MRI alone (false negatives). The use of both modalities combined reduced the false-negative results to 2. Conclusion CEUS and MRI with liver-specific contrast media are very reliable and of equal informative value in the characterization of focal liver lesions. The number of false-negative results can be decreased using a combination of the two methods.

scholarly journals 273. Low Positive Predictive Value of β-d-Glucan in Hematology Patients Receiving Antimold Prophylaxis

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S150-S151
Author(s):  
Eui Jin Chang ◽  
Kang Il Jun ◽  
Song Mi Moon ◽  
Wan Beom Park ◽  
Ji Hwan Bang ◽  
...  
Keyword(s):  
Positive Predictive Value ◽  
Predictive Value ◽  
False Negative ◽  
Diagnostic Value ◽  
Tertiary Hospital ◽  
Diagnostic Purpose ◽  
True Negative ◽  
Graft Vs Host Disease ◽  
Sensitivity Specificity ◽  
Low Prevalence

Abstract Background Detection of β-D-glucan (BDG) in serum is recognized as the mycological evidence in the diagnosis of invasive fungal infection (IFI). However, its diagnostic value in low prevalence of IFI has not been elucidated. We aimed to examine the performance of BDG in hematology patients receiving antimold prophylaxis. Methods We retrospectively reviewed all BDG results performed for the purpose of diagnosis or surveillance for IFI in hematology patients receiving posaconazole or micafungin prophylaxis from January 2017 to February 2019 in a tertiary hospital. At least two consecutive positive results of BDG were regarded as positive BDG. All the episodes were classified into true-positive (TP, positive BDG with probable/proven IFI), true-negative (TN, negative BDG without probable/proven IFI), false-positive (FP, positive BDG without probable/proven IFI), false-negative (FN, negative BDG with probable/proven IFI), and nonevaluable (could not be determined for the occurrence of breakthrough IFI). When BDG test was performed in the setting of persistent fever ≥72 hours in spite of broad-spectrum antibiotics or with a suspicion of IFI, it was defined as a diagnostic BDG episode, while others were defined as a surveillance BDG episode. Results Of a total of 140 episodes, 24 episodes were non-evaluable. Among 116 evaluable episodes, 75 received induction chemotherapy for acute leukemia or myelodysplastic syndrome, 35 underwent stem cell transplantation, and 10 had intensive treatment for graft-vs.-host disease. There were three episodes of probable/proven IFI (2.6%). Ninety-one (78.4%) were performed with diagnostic purpose, while 25 (21.6%) were performed for surveillance. TP, TN, FP, and FN were 2 (1.7%), 91, 22, and 1, respectively. Sensitivity, specificity, positive predictive value (PPV), and negative predictive value were 66.7%, 80.5%, 8.3% and 98.9%, respectively. PPV was 13.3% and 0% in diagnostic and surveillance BDG episodes, respectively. Conclusion The PPV of BDG was low in hematology patients receiving antimold prophylaxis, even in the diagnostic-driven episodes. The routine screening of BDG is not helpful, and the BDG test may be used for exclusion of IFI rather than for diagnosis in these patients. Disclosures All authors: No reported disclosures.

scholarly journals Comparison of diagnostic accuracy of papanicoloau (PAP) Smear and visual inspection using acetic acid (VIA) in screening of cervical carcinoma, taking biopsy as gold standard.

2020 ◽  
Vol 27 (04) ◽  
pp. 863-869
Author(s):  
Shakila Yasmin ◽  
Tahira Munir ◽  
Ayesha Javaid ◽  
Khalid Fahim Yasin ◽  
Junaid Hassan
Keyword(s):  
Acetic Acid ◽  
Diagnostic Accuracy ◽  
Cervical Carcinoma ◽  
Predictive Value ◽  
Visual Inspection ◽  
Pap Smear ◽  
False Negative ◽  
True Positive ◽  
True Negative ◽  
Sensitivity Specificity

Study Design: Cross-sectional descriptive study. Setting: Department of Obstetrics & Gynecology, Bahawal Victoria Hospital, Bahawalpur. Period: 05 August 2016 to 05 Feb 2017. Material & Methods: A total of 228 suspected patients of cervical carcinoma and age of 20-50 years were included. Patients with acute cervicitis, pregnant females, h/o abnormal cytology and obvious lesion on cervix were excluded. All the patients were underwent papanicoloau (PAP) smear and visual inspection using acetic acid. The results of papanicoloau (PAP) smear and visual inspection using acetic acid (VIA) were compared with cervical biopsy report. Results: In 110 papanicoloau (PAP) smear positive patients, 97 were True Positive and 13 were False Positive. Among, 118 papanicoloau (PAP) smear negative patients, 18 were False Negative whereas 100 were True Negative. Overall sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy of papanicoloau ( PAP )smear in screening of cervical carcinoma was 84.35%, 88.50%, 88.18%, 84.75% and 86.40% respectively. In 114 visual inspection using acetic acid (VIA) positive patients, 95 were True Positive and 19 were False Positive. Among, 114 visual inspection using acetic acid (VIA) negative patients, 20 were False Negative whereas 94 were True Negative. Overall sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy of visual inspection using acetic acid ( VIA) in  screening of cervical carcinoma was 82.61%, 83.19%, 83.33% 82.46% and 82.89% respectively. Conclusion: This study concluded that papanicoloau ( PAP) smear and visual inspection using acetic acid (VIA) in screening of cervical carcinoma are highly sensitive, accurate and having almost equal diagnostic accuracy.

scholarly journals ALVARADO SCORING SYSTEM

2018 ◽  
Vol 25 (07) ◽  
pp. 1059-1063
Author(s):  
Rizwan Ahmad ◽  
Ammara Liaquat ◽  
Amna Liaquat
Keyword(s):  
Negative Predictive Value ◽  
Predictive Value ◽  
Scoring System ◽  
False Negative ◽  
Perforated Appendicitis ◽  
Negative Appendectomy ◽  
True Negative ◽  
Chronic Appendicitis ◽  
Group I ◽  
Sensitivity Specificity

Objectives: To evaluate the diagnostic accuracy (discrimination) andimplementation performance of Alvarado score. Study Design: Cross sectional study. Setting:Surgical Unit of Nishtar Hospital Multan under supervision of consultant Surgeons of Department.Period: 01 year from November 2016 to October 2017. Methodology: For quantitative variableslike age of patients Mean and SD was calculated, and frequency percentages were calculatedfor categorical data like gender. Negative appendectomy rate, positive predictive value,negative predictive value, sensitivity, specificity was calculated by using 2-2 contingency table.Results: Overall, 100% (n=300) patients enrolled in this study, both genders. Alvarado scoringat presentation, 15% (n=45) patients were categorized into Group I. 13% (n=39) patients wereincluded in Group II. While, 72% (n=216) were enrolled in Group III. Diagnostic test was positivein 223 patients. While, acute appendicitis was confirmed histo-pathologically in 160 patients.Gangrenous appendicitis observed in 3 patients. Chronic appendicitis, perforated appendicitis,appendicular abscess, no specific pathology, gangrenous intestine and salpingo-oophoritiswas observed as 31, 6, 9, 6, 3 and 5 respectively. There were 174 patients true positive, 49 werefalse positive, 59 were false negative and 18 were true negative. Sensitivity, specificity, negativepredictive value and negative predictive value were 74.68% 26.87%, 78.02% and 23.37%respectively. Conclusion: Alvarado scoring system is useful tool in diagnosis of appendicitisin pre-operative period which can be useful for surgeons at any level of health care. Accordingto our study observations Alvarado scoring system has better sensitivity 74.68% but specificity26.87% which shows that Alvarado scoring system is helpful in diagnosis of appendicitis but notmuch helpful in preventing negative laparotomies.

Epidemiology of depression in Azerbaijani urban female population. Cross-cultural comparison of depression incidence/prevalence indicators

2017 ◽  
Vol 41 (S1) ◽  
pp. S575-S575
Author(s):  
F. Mammadova ◽  
M. Sultanov ◽  
A. Hajiyeva ◽  
M. Aichberger ◽  
A. Heinz
Keyword(s):  
Predictive Value ◽  
False Negative ◽  
Cultural Factors ◽  
Point Prevalence ◽  
True Negative ◽  
Female Population ◽  
Negative Results ◽  
Language Groups ◽  
Competing Interest ◽  
The Impact

IntroductionThe aim is to determine the prevalence and incidence of depression for an Azerbaijani female sample and explore the impact of cultural factors on depression.ObjectivesTo determine: the optimal cut-off point of ZDRS; the point prevalence and 3 month incidence of depression; risk factors for depression. To compare the depression prevalence in the two language groups of the Azerbaijani population (Azerbaijani-speaking and Russian-speaking) for determining possible impact of cultural factors on depression.MethodsThe first screening with ZDRS (Az) and ZDRS (Ru) were carried out with 1500 research participants, who filled out the questionnaires at their homes. All the screened subjects who score 40 and more on ZDRS were examined by MINI. True-positive and false-positive results were defined. Ten percent of the screened subjects, who score less than 40 on ZDRS were randomly chosen for clinical interviews to define true-negative and false-negative results. According to the analysis the optimal cut-off point of ZDRS in the Azerbaijani female population was found with the definition of its sensitivity, specificity, positive predictive value and negative predictive value. Based on the optimal cut-off point of ZDRS, point prevalence and incidence of depression was determined in Azerbaijan. The follow-up screening was conducted to determine the 3 month incidence of depression.ResultsThe determined prevalence and incidence of depression will be reported with the optimal cut-off point of ZDRS.ConclusionsThe results of the current study suggested that the ZDRS was a valid tool for use in screening patients with depression disorders but need a modification.Disclosure of interestThe authors have not supplied their declaration of competing interest.

scholarly journals Limited Positive Predictive Value of β-d-Glucan in Hematologic Patients Receiving Antimold Prophylaxis

2020 ◽  
Vol 7 (3) ◽  
Author(s):  
Euijin Chang ◽  
Taek Soo Kim ◽  
Chang Kyung Kang ◽  
Kang Il Jun ◽  
Dongyeop Shin ◽  
...  
Keyword(s):  
Positive Predictive Value ◽  
Predictive Value ◽  
False Negative ◽  
Diagnostic Value ◽  
Tertiary Hospital ◽  
True Positive ◽  
True Negative ◽  
Cell Transplants ◽  
Sensitivity Specificity ◽  
Low Prevalence

Abstract Background Diagnostic value of β-d-glucan (BDG) in populations with low prevalence of invasive fungal infection (IFI), such as hematologic patients receiving antimold prophylaxis, should be re-evaluated. Methods We retrospectively reviewed episodes with BDG results in hematologic patients receiving antimold prophylaxis from January 2017 to August 2019 in a tertiary hospital. The episodes were classified as true positive ([TP] positive BDG with IFI), true negative ([TN] negative BDG without IFI), false positive ([FP] positive BDG without IFI), false negative ([FN] negative BDG with IFI), and nonevaluable. Results A total of 203 episodes were analyzed: 101 episodes (49.8%) were from stem cell transplants, 89 (43.8%) were from induction chemotherapy, and 13 (6.4%) were from graft-versus-host disease treatment. There were 62 nonevaluable episodes. Among 141 evaluable ones, there were 8 (5.7%) episodes of probable/proven IFI. True positive, TN, FP, and FN cases were 4 (2.8%), 112 (79.4%), 21 (14.9%), and 4 (2.8%) episodes, respectively. Sensitivity, specificity, positive predictive value, and negative predictive value were 50.0%, 84.2%, 16.1%, and 96.5%, respectively. Positive predictive value was 26.7% and 0.0% in diagnostic and surveillance episodes, respectively. Conclusions β-d-glucan test should be used to exclude IFI rather than for diagnosis in these patients.

scholarly journals Difference in the performance of diagnosing colorectal liver metastasis between computed tomography and carcinoembryonic antigen

2020 ◽  
Author(s):  
Keqian Zhang ◽  
Tianqi Mao ◽  
Zhicheng He ◽  
Xiaojiao Wu ◽  
Yu Peng ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Liver Metastasis ◽  
Carcinoembryonic Antigen ◽  
Colorectal Liver Metastasis ◽  
Predictive Value ◽  
False Negative ◽  
Magnetic Bead ◽  
Detection Sensitivity ◽  
True Negative ◽  
Sensitivity Specificity

Abstract Background: The study was performed to compare the diagnostic roles of computed tomography (CT) and carcinoembryonic antigen (CEA) in colorectal liver metastasis (CRLM).Methods: 255 patients with colorectal cancer (CRC) were enrolled. These patients were confirmed as CRLM by histopathological assay. CT scans of the liver were performed with a 64-slice CT system. Serum CEA levels were determined using a human circulating cancer biomarker magnetic bead panel. True positive (TP), false positive (FP), true negative (TN) and false negative (FN) were calculated for CT and CEA with histopathological assay as golden standard.Results: 142 CRLM patients and 113 non-CRLM patients were confirmed in the study. There were no obvious differences in age, sex and Dukes stage between CRLM and non-CRLM patients (P＞0.05). Diagnostic roles of CT and CEA on per-patient and per-lesion were analyzed. Detection sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of CT on per-patient basis were 74.7%, 56.4%, 52.1%, and 77.9%, respectively. Sensitivity, specificity, PPV and NPV of CEA were 64.4%, 51.4%, 49.3%, and 67.3%. In the analysis on per-lesion basis, detection sensitivity, specificity, PPV, and NPV of CT were increased to 87.8%, 88.8%, 91.5%, and 84.1%, respectively. Detection sensitivity, specificity, PPV and NPV of CEA on per-lesion basis were 82.6%, 64.4%, 63.4%, and 83.2%.Conclusion: CT exhibited better performances than CEA in diagnosis of CRLM on both of per-patient and per-lesion basis.

Sign in / Sign up

Export Citation Format

Share Document