PROKALSITONIN SEBAGAI PENANDA PEMBEDA INFEKSI BAKTERI DAN NON BAKTERI

Early diagnosis of an infection and prompt administration of an antibiotic can dramatically reduce morbidity and mortality.Procalcitonin (PCT), a precursor of calcitonin, has been proposed as a marker of bacterial infection. The aim of this study is to assess theefficiency of procalcitonin in children for the diagnosis of bacterial vs. non bacterial infection. This was a prospective, cross-sectional study.The subjects were enrolled consecutively, consisting of feverish children (temperature ³38.5° C) admitted to the Pediatric EmergencyDepartment with ages up to 12 years old. The subjects were divided into two groups according to their final diagnosis, bacterial and nonbacterial infection. Serum PCT concentration was measured by enzyme linked fluorescent assay (ELFA) method. Sensitivity, specificity,positive predictive and negative predictive values, and receiver operating curve (ROC) of PCT were calculated. Out of 54 patients,24 (44.4%) had a final diagnosis of bacterial infection. PCT showed a wide concentration range in the bacterial infection group (median:1.09 ng/mL, lower (L)=0.05 ng/mL, upper (U)=128.7 ng/mL) compared with non bacterial infection group (0.21 ng/mL; L=0.05ng/mL; U=12.15 ng/mL). There was a significant difference in PCT between the 2 groups (p=0.020). ROC analysis demonstrated anarea under curve (AUC) of 0.686 (95% CI, 0.534 to 0.838). Using a cut-off point of 0.5 ng/mL, the sensitivity, and specificity, positivepredictive and negative predictive values of PCT were 66.7%, 76.7%, 69.6%, 74.2%, respectively. In this study, PCT may be useful fordifferentiation of bacterial vs. non bacterial infection in children.

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Efficacy of Yale observation scale to detect serious bacterial infection in febrile children aged one to 36 months

Journal of Patan Academy of Health Sciences ◽

10.3126/jpahs.v1i2.16641 ◽

2015 ◽

Vol 1 (2) ◽

pp. 23-26

Author(s):

Prerana Kansakar ◽

Prakash Sundar Shrestha ◽

Merina Shrestha

Keyword(s):

Bacterial Infection ◽

Febrile Illness ◽

Cross Sectional Study ◽

University Teaching ◽

Cross Sectional ◽

Predictive Values ◽

Serious Illness ◽

Observation Scale ◽

Yale Observation Scale ◽

Sensitivity Specificity

Introductions: In most children aged 1-36 months, the cause of a febrile illness is a self limiting viral infection. It is very difficult to distinguish these from serious bacterial infection. Objective of this study is to assess the efficacy of the Yale Observation Scale (YOS) to detect serious bacterial infection in febrile children aged 1-36 months.Methods: YOS scores were assigned as a part of a cross- sectional study in 100 children presenting in Tribhuvan University teaching hospital with fever to divide the child into well- looking if YOS ≤10 or ill- looking if YOS >10. Then the history, examination and necessary investigation was performed to come to a diagnosis of non- serious illness and serious bacterial infection.Results: Serious bacterial infection was found in 33(33%) of the patients. The sensitivity, specificity, positive and negative predictive values for a YOS score greater than 10 to detect serious bacterial infection were 45.45%, 88.05%%, 65.21% and 76.62%, respectively.Conclusions: A YOS ≤10 predicts non-serious illness while a YOS>10 does not necessarily indicate serious bacterial infection and should undergo further evaluation to confirm serious bacterial infection.

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The value of serum progesterone level on day of human chorionic gonadotrophin administration / metaphase II oocyte ratio in predicting IVF/ICSI outcome in patients with normal ovarian reserve

Journal of Ovarian Research ◽

10.1186/s13048-021-00800-5 ◽

2021 ◽

Vol 14 (1) ◽

Author(s):

Ahmad Mahran ◽

Mohammed Khairy ◽

Reham Elkhateeb ◽

Abdel Rahman Hegazy ◽

Ayman Abdelmeged ◽

...

Keyword(s):

Sensitivity And Specificity ◽

Ovarian Response ◽

Pregnancy Rates ◽

Clinical Pregnancy ◽

Progesterone Level ◽

Receiver Operating Curve ◽

Serum Progesterone ◽

Predictive Values ◽

Significant Difference ◽

Assisted Reproduction Treatment

Abstract Background The clinical implication of the increased serum progesterone level on the day of HCG administration in assisted reproduction treatment (ART) is still controversial. The current study aimed to compare the predictive value of serum progesterone on day of HCG administration / metaphase II oocyte (P/MII) ratio on IVF/ ICSI outcome to serum progesterone (P) level alone and the ratio of serum progesterone/estradiol level (P/E2) ratio in prediction of pregnancy rates after ART. Material & methods Two hundred patients admitted to the IVF/ICSI program at Minia IVF center in Egypt in the period from October 2016 to May 2018 were included in this study. Serum Progesterone (P) and Estradiol (E2) levels were estimated on the day of HCG administration. The ratio between serum P and the number of MII oocytes (P/MII ratio) was calculated and the predictive values of the three parameters (P, P/E2 ratio and P/MII ratio) in prediction of cycle outcomes were measured. Results P/ MII oocyte ratio was significantly lower in patients who attained clinical pregnancy (n = 97) as compared with those who couldn’t whilst there was no significant difference in P and P/E2 ratio between the two groups. Using a cut off value of 0.125, the sensitivity and specificity of progesterone/ MII ratio in prediction of no pregnancy in IVF/ICSI were 75.7 and 77.1% respectively with the area under The Receiver operating curve (ROC-AUC) = 0.808. The respective values of the ROC-AUC for the P and P/E2 ratio were 0.651 and 0.712 with sensitivity and specificity of 71.2 and 73.5%for P level and of 72.5 and 75.3% for P/E2 ratio. Implantation or clinical pregnancy rates were significantly different between patients with high and low P/MII ratio irrespective of day of embryo transfer (day 3 or 5). Conclusions In patients with normal ovarian response, serum progesterone on day of HCG / MII oocyte ratio can be a useful predictor of pregnancy outcomes and in deciding on freezing of all embryos for later transfer instead of high progesterone level alone.

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COVID-19 Seroprevalence among Healthcare Workers of a Large COVID-19 Hospital in Rome Reveals Strengths and Limits of Two Different Serological Tests

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18052650 ◽

2021 ◽

Vol 18 (5) ◽

pp. 2650

Author(s):

Giuseppe Vetrugno ◽

Daniele Ignazio La Milia ◽

Floriana D’Ambrosio ◽

Marcello Di Pumpo ◽

Roberta Pastorino ◽

...

Keyword(s):

Blood Test ◽

Healthcare Workers ◽

Point Of Care ◽

Venous Blood ◽

Administrative Staff ◽

Serological Tests ◽

Predictive Values ◽

Work From Home ◽

Significant Difference ◽

Sensitivity Specificity

Healthcare workers are at the forefront against COVID-19, worldwide. Since Fondazione Policlinico Universitario A. Gemelli (FPG) IRCCS was enlisted as a COVID-19 hospital, the healthcare workers deployed to COVID-19 wards were separated from those with limited/no exposure, whereas the administrative staff were designated to work from home. Between 4 June and 3 July 2020, an investigation was conducted to evaluate the seroprevalence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) immunoglobulin (IgG) antibodies among the employees of the FPG using point-of-care (POC) and venous blood tests. Sensitivity, specificity, and predictive values were determined with reverse-transcription polymerase chain reaction on nasal/oropharyngeal swabs as the diagnostic gold standard. The participants enrolled amounted to 4777. Seroprevalence was 3.66% using the POC test and 1.19% using the venous blood test, with a significant difference (p < 0.05). The POC test sensitivity and specificity were, respectively, 63.64% (95% confidence interval (CI): 62.20% to 65.04%) and 96.64% (95% CI: 96.05% to 97.13%), while those of the venous blood test were, respectively, 78.79% (95% CI: 77.58% to 79.94%) and 99.36% (95% CI: 99.07% to 99.55%). Among the low-risk populations, the POC test’s predictive values were 58.33% (positive) and 98.23% (negative), whereas those of the venous blood test were 92.86% (positive) and 98.53% (negative). According to our study, these serological tests cannot be a valid alternative to diagnose COVID-19 infection in progress.

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Accuracy of the fluorescence-aided identification technique (FIT) for detecting tooth-colored restorations utilizing different fluorescence-inducing devices: an ex vivo comparative study

Clinical Oral Investigations ◽

10.1007/s00784-021-03826-7 ◽

2021 ◽

Author(s):

W. Leontiev ◽

E. Magni ◽

C. Dettwiler ◽

C. Meller ◽

R. Weiger ◽

...

Keyword(s):

Multivariate Analysis ◽

Ex Vivo ◽

Predictive Values ◽

Composite Restorations ◽

Significant Difference ◽

Identification Technique ◽

Illumination Method ◽

Sensitivity Specificity ◽

Entire Procedure ◽

Higher Sensitivity

Abstract Objectives The aim of the present study was to compare the accuracy of the conventional illumination method (CONV) and the fluorescence-aided identification technique (FIT) for distinguishing between composite restorations and intact teeth using different fluorescence-inducing devices commonly used for FIT. Materials and methods Six groups of six dentists equipped with one of six different FIT systems each independently attempted to identify composite restorations and intact teeth on a full-mouth model with 22 composite restorations using CONV and, 1 h later, FIT. The entire procedure was repeated 1 week later. Sensitivity, specificity, and positive (PPV) and negative (NPV) predictive values, including 95% confidence intervals (CI), were calculated for CONV and FIT overall and for each device. The influence of examiner age, method, and device on each parameter was assessed by multivariate analysis of variance. Results The sensitivity (84%, CI 81–86%), specificity (94%, CI 93–96%), PPV (92%, CI 90–94%), and NPV (90%, CI 88–91%) of FIT was significantly higher than that of CONV (47%, CI 44–50%; 82%, CI 79–84%; 66%, CI 62–69%, and 69%, CI 68–71%, respectively; p<0.001). The differences between CONV and FIT were significant for all parameters and FIT systems except VistaCam, which achieved no significant difference in specificity. Examiners younger than 40 years attained significantly higher sensitivity and negative predictive values than older examiners. Conclusions FIT is more reliable for detecting composite restorations than the conventional illumination method. Clinical relevance FIT can be considered an additional or alternative tool for improving the detection of composite restorations.

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The diagnosis of delirium in 80 emergency unit patients

Arquivos de Neuro-Psiquiatria ◽

10.1590/s0004-282x1998000200002 ◽

1998 ◽

Vol 56 (2) ◽

pp. 176-183

Author(s):

AFONSO CARLOS NEVES ◽

RICARDO DE CASTRO CINTRA SESSO ◽

HENRIQUE BALLALAI FERRAZ ◽

SÍLVIO FRANCISCO ◽

JOÃO BAPTISTA DOS REIS-FILHO

Keyword(s):

Correct Diagnosis ◽

Diagnostic Testing ◽

Final Diagnosis ◽

Initial Diagnosis ◽

University Hospital ◽

Emergency Unit ◽

Predictive Values ◽

Kappa Test ◽

History Of ◽

Sensitivity Specificity

We evaluated the initial and final diagnosis of 80 patients with delirium arriving at the emergence unit of a university hospital in a large Brazilian city over a period of 30 months up to December 1991. The diagnosis was based on the DSM-IIIR criteria. Patients with a known history of head trauma or epileptic seizure and patients younger than 13 years were excluded. Only patients with a disease of up to 7 days were included.The patients were subdivided into four etiologic groups: vascular; associated with the use of alcohol; infectious-parasitic; miscellaneous.The results showed a rate of correct diagnosis ranging from 65 to 80% with the use of kappa test (standard good to excelent). Sensitivity, specificity, positive predictive and negative predictive values had results showing different conditions for initial diagnosis in each group. This study can help the initial diagnosis of delirium and the choice for diagnostic testing.

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Evaluation of a Rapid Diagnostic Test Currently Being Used in the Management of Malaria in Patients of the Hia/Chu-Parakou and the Boko Zone Hospital in Northern Benin

Austin Journal of Infectious Diseases ◽

10.26420/austinjinfectdis.2021.1057 ◽

2021 ◽

Vol 8 (4) ◽

Author(s):

Tokponnon F ◽

◽

Osse R ◽

Houessou C ◽

Akogbeto M ◽

...

Keyword(s):

Diagnostic Test ◽

Rapid Diagnostic Test ◽

Probabilistic Method ◽

Health Centers ◽

Patient Identification ◽

Cross Sectional ◽

Predictive Values ◽

Parasitological Diagnosis ◽

Sensitivity Specificity ◽

Adequate Management

Parasitological diagnosis is a fundamental element in the adequate management of the disease. In the last decade, there has been a resurgence of interest in the development of malaria Rapid Diagnostic Test (RDT) kits. This is the case with SD Bioline Malaria Ag Pf, which searches for HRP2 antigen by immunochromatography. The objective of this study is to compare the results of RDT SD Bioline Malaria Ag Pf in use with the results of Thick Gout (TG) in the biological diagnosis of malaria. This was a cross-sectional, descriptive and evaluative study carried out at the Hôpital d’Instruction des Armées-Center Hospitalier et Universitaire de Parakou and at the Boko zone hospital from April 20 to July 30, 2015. Patient identification, we used the non-probabilistic method and the convenience choice technique. The study involved 503 patients. The results of this study showed a good performance of the RDT SD Bioline Malaria Ag Pf. Among the 503 patients, 199 or 39.6% were positive for the RDT against 180 or 35.8% positive for the Thick Gout (TG). Sensitivity, specificity, positive and negative predictive values of the test compared to the thick film were respectively (91.7%, 89.5%, 82.9, 95) and the Kappa coefficient of 0.88 testifies a good match. False positive cases are noted in patients on treatment and even after recovery due to the persistence of the HRP2 antigen in the blood. However, it constitutes an interesting alternative to the management of malaria. At the end of this study, we suggest continuing the use of RDTs in health centers where microscopy is absent and/or reinforcing microscopy, and to strengthen staff training in the management of malaria cases.

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Technical attributes of Australian youth soccer players: Implications for talent identification

International Journal of Sports Science & Coaching ◽

10.1177/1747954116676108 ◽

2016 ◽

Vol 11 (6) ◽

pp. 819-824 ◽

Cited By ~ 9

Author(s):

Brad S Keller ◽

Annette J Raynor ◽

Lyndell Bruce ◽

Fiona Iredale

Keyword(s):

The State ◽

Soccer Players ◽

Receiver Operating Curve ◽

Cross Sectional ◽

Talent Identification ◽

Youth Soccer ◽

Technical Ability ◽

State Elite ◽

Significant Difference ◽

Post Hoc

Objectives To determine whether the technical ability of Australian youth soccer players could distinguish between various playing levels. Design A cross-sectional observational design was used with each player required to complete four technical tests. Methods Sixty-two participants were representatives of three cohorts of youth soccer in Australia: national elite ( n = 18), state elite ( n = 22) and sub-elite ( n = 22). The technical tests used were Loughborough Short Passing Test (LSPT), long passing test (LPT), shooting test and speed dribbling, with all players familiarised with the tests prior to data collection. Differences between cohorts were analysed using a multiple analysis of variance test with follow-up analyses of variance and Tukey Honest Significant Difference post-hoc test, which were subsequently used to inform a sensitivity analysis, more specifically a bootstrapped receiver operating curve to determine cut-off scores for each variable. Results The national elite cohort scored better than state- and sub-elite cohorts on the LSPT, however, the state elite produced the fastest time before penalties. The sub-elite cohort scored less points on the LPT compared to both national- and state-elite cohorts, on both feet. In regards to speed dribbling, national-elite players were faster than both the state- and sub-elite cohorts. Shooting accuracy and velocity were able to discriminate the national- and sub-elite cohorts on the dominant foot, with shooting velocity on the nondominant foot being faster for the national elite compared to both the state- and sub-elite cohorts. Conclusions A number of differences in technical ability were identified between varying levels of Australian youth soccer players. Youth soccer coaches and sports scientists should use the cut-off scores for the technical tests in the talent identification and development process, with aspiring players aiming to reach these levels.

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Abstract P348: Perfusion Collateral Index vs. Hypoperfusion Intensity Ratio in Assessment of Angiographic Collateral Scores in Patients With Acute Ischemic Stroke

Stroke ◽

10.1161/str.52.suppl_1.p348 ◽

2021 ◽

Vol 52 (Suppl_1) ◽

Author(s):

Brian Tsui ◽

Iris Chen ◽

Joe Qiao ◽

Kasra Khatibi ◽

Lucido Ponce Mejia ◽

...

Keyword(s):

Ischemic Stroke ◽

Acute Ischemic Stroke ◽

Perfusion Imaging ◽

Intensity Ratio ◽

Roc Analysis ◽

Cerebral Blood Volume ◽

Imaging Biomarker ◽

Lesion Volume ◽

Significant Difference ◽

Sensitivity Specificity

Background and Purpose: In acute ischemic stroke (AIS), perfusion imaging, while not directly visualizing collateral vessels, can provide important insight into collateral robustness, indexed by perfusion lesion volume and by perfusion lesion heterogeneity. Two proposed perfusion lesion heterogeneity measures indexing collateral status are the Perfusion Collateral Index (PCI) and Hypoperfusion Intensity Ratio (HIR), but their accuracy compared with direct collateral assessment on DSA has been incompletely characterized. Methods: Consecutive AIS patients with anterior circulation large vessel occlusion who underwent pre-endovascular thrombectomy MRI perfusion imaging were included. MRI measures analyzed were: 1) Perfusion Collateral Index ( PCI) - the volume of moderately hypoperfused tissue (arterial tissue delay time between 2 and 6 seconds: ATD 2-6sec ) multiplied by its corresponding relative cerebral blood volume using Olea software; 2) Hypoperfusion Intensity Ratio (HIR) ratio of moderate TMax >6 s lesion volume versus severe Tmax >10 s lesion volume with the RAPID software program. DSA collateral scores were evaluated by ASITN grading and dichotomized to inadequate (ASTIN <2) vs. adequate (ASTIN ≥3). Results: Among 48 patients meeting entry criteria, age (mean ± SD) was 70 (± 15.2), 54% were female, and NIHSS (median, IQR) was 15 (10-19). For HIR, there was no significant difference in score values in patients with adequate vs inadequate collaterals: 0.35 ± 0.20 vs 0.39 ± 0.25, p=0.68. ROC analysis using previously described cut-off of 0.4 resulted in an AUC of 0.52 and sensitivity/specificity of 71% / 33%. For PCI, score values were significantly higher in patients with adequate vs inadequate collaterals, 117 ± 61 vs. 57 ± 41, p=0.002. ROC analysis using previously described cut-off of 62 resulted in an AUC of 0.8 and sensitivity/specificity of 84% / 78%. Conclusion: Collateral status can be accurately assessed on perfusion MRI with the Perfusion Collateral Index, which outperformed the Hypoperfusion Intensity Ratio. MRI-PCI is an informative imaging biomarker of collateral status in patients with AIS.

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Validation of Psoas Muscle Index as a predictor of successful extubation in elderly intensive care patients: a retrospective cohort study

10.21203/rs.2.22396/v1 ◽

2020 ◽

Author(s):

Fumimasa Kobori ◽

Kazunari Azuma ◽

Shiro Mishima ◽

Jun Oda

Keyword(s):

Intensive Care ◽

Psoas Muscle ◽

Extubation Failure ◽

Cross Sectional Area ◽

Sectional Area ◽

Cross Sectional ◽

Predictive Values ◽

Failure Group ◽

Success Group ◽

Sensitivity Specificity

Abstract Background Extubation failure-associated factors haven't been investigated in elderly patients. We hypothesized that psoas cross-sectional area, an emerging indicator of frailty, can be a predictor of extubation outcomes. Methods This retrospective study analyzed data from patients admitted between January and April 2016 at the intensive care unit (ICU) of the Tokyo Medical University Hospital. Patients were considered eligible if aged ≥65 years, required intubation at the emergency room, and were admitted to ICU for <24 h. Overall, 39 ICU patients were eligible and categorized into two groups: extubation success (n = 24) and extubation failure (n = 15) groups. The psoas cross-sectional area was measured at the third lumbar level on computer tomography images. Regions of interest were drawn freehand to outline the left and right psoas by an emergency physician. The average left and right psoas cross-sectional areas, used as the patient’s psoas cross-sectional area, were calculated. Psoas Muscle Index (PMI) was defined as the psoas cross-sectional area/height 2 . Primary outcome was to evaluate differences between the psoas cross-sectional area and f(PMI) between the groups, if any. Secondary outcome was to derive cut-off values using ROC curves. Results Both groups were comparable in terms of demographic characteristics. Psoas cross-sectional area (success group, 1776.5 ± 498.2 mm 2 , failure group, 1391.2 ± 589.4 mm 2 ; p = 0.022) and PMI (success group, 1089 ± 270.7 mm 2 /m 2 , failure group, 889 ± 338.5 mm 2 /m 2 ; p = 0.032) were significantly greater in the success group than in the failure group. ROC curve of the psoas cross-sectional area and PMI were used to calculate sensitivity and speciﬁcity. ROC AUC was 0.74 for psoas cross-sectional area, and at a cut-off of 1260 points, the sensitivity, speciﬁcity, and positive and negative predictive values were 95.8%, 60.0%, 79.3%, and 90.0%, respectively. ROC AUC for PMI was 0.73, and at a cut-off of 812 points, the sensitivity, speciﬁcity, and positive and negative predictive values were 95.8%, 46.7%, 74.2%, and 87.5%, respectively. Conclusions The psoas cross-sectional area and PMI can predict extubation outcomes in elderly intensive care patients.

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Diagnostic and Prognostic Validity of Proadrenomedullin among Neonates with Sepsis in Tertiary Care Hospitals of Southern India

International Journal of Pediatrics ◽

10.1155/2018/7908148 ◽

2018 ◽

Vol 2018 ◽

pp. 1-5 ◽

Cited By ~ 1

Author(s):

Raja Kannan ◽

Suchetha S. Rao ◽

Prasanna Mithra ◽

B. Dhanashree ◽

Shantharam Baliga ◽

...

Keyword(s):

Clinical Outcome ◽

Neonatal Sepsis ◽

Tertiary Care ◽

Cross Sectional Study ◽

Cross Sectional ◽

Predictive Values ◽

Clinical Sepsis ◽

A Value ◽

Sepsis Screen ◽

Sensitivity Specificity

Introduction. To evaluate Proadrenomedullin (Pro-ADM) as the diagnostic and prognostic marker in neonatal sepsis. Materials and Methods. In this cross-sectional study, Pro-ADM levels were estimated in 54 neonates with clinical sepsis and positive sepsis screen (cases) and 54 controls without clinical sepsis. Repeat Pro-ADM levels were estimated after 72 hours in cases. Pro-ADM levels were compared with the clinical outcome. Results and Discussion. Median Pro-ADM levels in cases were 31.8 (IQR: 27.8-39.4) pmol/ml which was significantly higher than controls 5.1 (IQR; 3.1-7.7) pmol/ml. From the constructed ROC curve, a value of 14.5 pmol/ml was taken as the cut-off for sepsis. Pro-ADM had 100% sensitivity, specificity, and positive predictive values (PPV) in detecting sepsis at 14.5 pmol/ml. Among cases, a decrease in Pro-ADM level by 10 pmol/ml was associated with 99% survival. Pro-ADM value of 35 pmol/ml had 100% specificity and PPV in predicting mortality. Conclusion. Pro-ADM can be used as a single biomarker for detecting neonatal sepsis, predicting clinical outcome and prognosis.

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