scholarly journals The utility of Coccidioides antigen and antibody detection in cerebrospinal fluid in the diagnosis of canine central nervous system coccidioidomycosis

2022 ◽  
pp. 1-5
Author(s):  
Christine D. Butkiewicz ◽  
Cody J. Alcott ◽  
Janelle Renschler ◽  
Lawrence J. Wheat ◽  
Lisa F. Shubitz
Keyword(s):  
Clinical Signs ◽  
High Specificity ◽  
Antibody Detection ◽  
Antibody Testing ◽  
Endemic Region ◽  
Predictive Values ◽  
Csf Analysis ◽  
Neurologic Disorders ◽  
Low Sensitivity ◽  
A Prospective Study

Abstract OBJECTIVE To evaluate the utility of enzyme immunoassays (EIAs) for the detection of Coccidioides antigen and antibody in CSF in the diagnosis of CNS coccidioidomycosis in dogs. ANIMALS 51 dogs evaluated for CNS disease in a single specialty center in Tucson in 2016. PROCEDURES Excess CSF after routine analysis was banked after collection from dogs presented to the neurology service. Samples were tested by EIA for presence of Coccidioides antigen and antibody. Clinical data were collected from medical records retrospectively. RESULTS 22 dogs were diagnosed with CNS coccidioidomycosis (CCM) or another neurologic disease (non-CCM). These groups of dogs overlapped in the presenting complaints, MRI results, and routine CSF analysis results. Four dogs, all with CCM, had positive antigen EIA results. With clinical diagnosis used as the reference standard, CSF antigen testing had low sensitivity (20%) but high specificity (100%) for diagnosis of CCM. Ten dogs with CCM and 4 dogs with other diagnoses had antibody detected in CSF by EIA. Sensitivity of CSF antibody testing was 46%, specificity was 86%, and positive and negative predictive values for the study population were 71% and 68%, respectively. Clinical Relevance Diagnosis of CNS coccidioidomycosis in dogs in an endemic region was hampered by overlap of clinical signs with other neurologic disorders and the low sensitivity of confirmatory diagnostics. The evaluated Coccidioides-specific EIAs performed on CSF can aid in the diagnosis. A prospective study is warranted to corroborate and refine these preliminary findings

Validity of hearTest Smartphone-Based Audiometry for Hearing Screening in Workers Exposed to Noise

2020 ◽  
Author(s):  
Luma Cordeiro Rodrigues ◽  
Silvia Ferrite ◽  
Ana Paula Corona
Keyword(s):  
Hearing Loss ◽  
High Specificity ◽  
Hearing Screening ◽  
Youden Index ◽  
Hearing Level ◽  
Predictive Values ◽  
Auditory Thresholds ◽  
The Mean ◽  
Low Sensitivity ◽  
Sensitivity Specificity

Abstract Purpose This article investigates the validity of a smartphone-based audiometry for hearing screening to identify hearing loss in workers exposed to noise. Research Design This is a validation study comparing hearing screening with the hearTest to conventional audiometry. The study population included all workers who attended the Brazilian Social Service of Industry to undergo periodic examinations. Sensitivity, specificity, the Youden index, and positive (PPV) and negative predictive values (NPV) for hearing screening obtained by the hearTest were estimated according to three definitions of hearing loss: any threshold greater than 25 dB hearing level (HL), the mean auditory thresholds for 0.5, 1, 2, and 4 kHz greater than 25 dB HL, and the mean thresholds for 3, 4, and 6 kHz greater than 25 dB HL. Note that 95% confidence intervals were calculated for all measurements. Results A total of 232 workers participated in the study. Hearing screening with the hearTest presented good sensitivity (93.8%), specificity (83.9%), and Youden index (77.7%) values, a NPV (97.2%), and a low PPV (69.0%) for the identification of hearing loss defined as any auditory threshold greater than 25 dB HL. For the other definitions of hearing loss, we observed high specificity, PPV and NPV, as well as low sensitivity and Youden index. Conclusion The hearTest is an accurate hearing screening tool to identify hearing loss in workers exposed to noise, including those with noise-induced hearing loss, although it does not replace conventional audiometry.

scholarly journals Validation of maternal report of early childhood caries status in Ile-Ife, Nigeria

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Morenike Oluwatoyin Folayan ◽  
Peter Alimi ◽  
Micheal O. Alade ◽  
Maha El Tantawi ◽  
Abiola A. Adeniyi ◽  
...  
Keyword(s):  
Predictive Value ◽  
Early Childhood Caries ◽  
High Specificity ◽  
Predictive Values ◽  
Maternal Report ◽  
History Of ◽  
Study Population ◽  
Inflation Factor ◽  
Maternal Reports ◽  
Low Sensitivity

Abstract Background To determine the validity of maternal reports of the presence of early childhood caries (ECC), and to identify maternal variables that increase the accuracy of the reports. Methods This secondary data analysis included 1155 mother–child dyads, recruited through a multi-stage sampling household approach in Ile-Ife Nigeria. Survey data included maternal characteristics (age, monthly income, decision-making ability) and maternal perception about whether or not her child (age 6 months to 5 years old) had ECC. Presence of ECC was clinically determined using the dmft index. Maternally reported and clinically determined ECC presence were compared using a chi-squared test. McNemar's test was used to assess the similarity of maternal and clinical reports of ECC. Sensitivity, specificity, positive and negative predictive values, absolute bias, relative bias and inflation factor were calculated. Statistical significance was determined at p < 0.05. Results The clinically-determined ECC prevalence was 4.6% (95% Confidence interval [CI]: 3.5–5.0) while the maternal-reported ECC prevalence was 3.4% (CI 2.4–4.6). Maternal reports underestimated the prevalence of ECC by 26.1% in comparison to the clinical evaluation. The results indicate low sensitivity (9.43%; CI 3.13–20.70) but high specificity (96.9%; CI 95.7–97.9). The positive predictive value was 12.8% (CI 4.3–27.4) while the negative predictive value was 95.7% (CI 94.3–96.8). The inflation factor for maternally reported ECC was 1.4. Sensitivity (50.0%; CI 6.8–93.2) and positive predictive value were highest (33.3%; CI 4.3–77.7) when the child had a history of visiting the dental clinic. Conclusions Mothers under-reported the presence of ECC in their children in this study population. The low sensitivity and positive predictive values of maternal report of ECC indicates that maternal reporting of presence of ECC may not be used as a valid tool to measure ECC in public health surveys. The high specificity and negative predictive values indicate that their report is a good measure of the absence of ECC in the study population. Child’s history of dental service utilization may be a proxy measure of presence of ECC.

scholarly journals Citrulline as a biomarker of short bowel syndrome in children

2020 ◽  
Vol 9 (4) ◽  
pp. 35-42
Author(s):  
K. Y. Marakhouski ◽  
A. A. Svirsky ◽  
A. M. Makhlin ◽  
N. D. Shmeleva ◽  
Z. I. Kuvaeva ◽  
...  
Keyword(s):  
Short Bowel Syndrome ◽  
High Performance ◽  
Clinical Signs ◽  
High Specificity ◽  
Control Group ◽  
Diagnostic Significance ◽  
Short Bowel ◽  
Citrulline Level ◽  
Low Sensitivity ◽  
Children Under 5

Purpose. To determine the diagnostic significance of blood citrulline level when estimating the short bowel syndrome (SBS) in children under 5 years old. To determine the blood citrulline level in children of different age. Methods. The examined group (N=31) included children under 5 who underwent small or small and large intestine resection and developed (15 children) or not developed (16 children) clinical signs of SBS. The control group included children who underwent no surgery on the GIT and had no congenital malformations and clinical signs of enteropathy (N=42). To determine the level of citrulline, overpressured high performance liquid column chromatography was used. Statistical analysis of the results was done with MedCalc® version 18.11.3. Results. Mean level of blood citrulline is 28.9 µmol/l in the examined group (95% CI 23.2–34.6) and 30.5 µmol/l in the control group (95% CI 25.0–35.1). Reliable data of the ratio between blood level citrulline and age of the child were obtained both among operated and non-operated children. The odds ratio of determining citrulline in blood was below 24.4 µmol/l in development of SBS clinical picture and amounted to 4.08 р < 0,05. Additional use of ROC analysis confirms the presence of interrelation between citrulline level and absence or presence of SBS clinical signs with 100% specificity and 43% sensitivity. The area under curve (categorical variable showing whether SBS is present or lacking) is 0,746, р = 0,005. Conclusion. Determination of serum citrulline as a diagnostic marker of short bowel syndrome in children under 5 found low sensitivity but high specificity. Thus, blood citrulline index can be used as a biomarker to diagnose SBS, to describe the course of SBS in detail and determine the risk of severe forms of this pathology in children under 5.

scholarly journals Reliability of Cobas Amplicor PCR test in detection of Mycobacterium tuberculosis in respiratory and nonorespiratory specimens

2009 ◽  
Vol 66 (12) ◽  
pp. 992-997
Author(s):  
Zorica Lepsanovic ◽  
Dejana Savic ◽  
Branka Tomanovic
Keyword(s):  
Mycobacterium Tuberculosis ◽  
High Sensitivity ◽  
High Specificity ◽  
Diagnostic Methods ◽  
Nucleic Acid Amplification ◽  
Culture Methods ◽  
Predictive Values ◽  
Polymerase Chain ◽  
Low Sensitivity ◽  
Sensitivity Specificity

Background/Aim. Traditional methods for detection of mycobacteria, such as microscopic examination for the presence of acid-fast bacilli and isolation of the organism by culture, have either a low sensitivity and/or specificity, or take weeks before a definite result is available. Molecular methods, especially those based on nucleic acid amplification, are rapid diagnostic methods which combine high sensitivity and high specificity. The aim of this study was to determine the usefulness of the Cobas Amplicor Mycobacterium tuberculosis polymerase chain reaction (CAPCR) assay in detecting the tuberculosis cause in respiratory and nonrespiratory specimens (compared to culture). Methods. Specimens were decontaminated by the N-acetyl-L-cystein- NaOH method. A 500 ?L aliquot of the processed specimen were used for inoculation of L?wenstein-Jensen (L-J) slants, a drop for acid-fast staining, and 100 ?L for PCR. The Cobas Amplicor PCR was performed according to the manufacturer's instructions. Results. A total of 110 respiratory and 355 nonrespiratory specimens were investigated. After resolving discrepancies by reviewing medical history, overall sensitivity, specificity, and positive and negative predictive values for CA-PCR assay compared to culture, were 83%, 100%, 100%, and 96.8%, respectively. In comparison, they were 50%, 99.7%, 87.5%, and 98%, respectively, for the nonrespiratory specimens. The inhibition rate was 2.8% for respiratory, and 7.6% for nonrespiratory specimens. Conclusion. CA-PCR is a reliable assay that enables specialists to start treatment promptly on a positive test result. Lower value for specificity in a group of nonrespiratory specimens is a consequence of an extremely small number of mycobacteria in some of them.

scholarly journals Detection of Leishmania infantum in Dogs by PCR with Lymph Node Aspirates and Blood

1999 ◽  
Vol 37 (9) ◽  
pp. 2931-2935 ◽  
Author(s):  
S. Reale ◽  
L. Maxia ◽  
F. Vitale ◽  
N. S. Glorioso ◽  
S. Caracappa ◽  
...  
Keyword(s):  
Lymph Node ◽  
Leishmania Infantum ◽  
Blot Hybridization ◽  
False Negative ◽  
Clinical Signs ◽  
Leishmania Braziliensis ◽  
Antibody Testing ◽  
Dot Blot ◽  
Predictive Values ◽  
Blood Samples

The PCR technique was applied to the diagnosis of leishmaniasis in dogs, both serologically negative and positive. DNA was taken from lymph node aspirates and blood. The primers 13a and 13b, derived fromLeishmania amazonies and Leishmania braziliensis kinetoplast DNA (kDNA), also amplifiedLeishmania infantum IPT1 constant region of minicircle kDNA. The amplified fragment is 116 bp long. It was cloned and the sequence was determined. A 70-bp inner fragment was designed and used as a probe in dot blot hybridization. A group of 124 dogs was examined, 37 of which showed typical symptoms of disease. PCR was performed on 124 blood samples and 52 lymph node aspirates. Using microscopic examination as the “gold standard,” we calculated sensitivity, specificity, and positive and negative predictive values of 100% using lymph node aspirates and values of 85, 80, 95, and 57%, respectively, using blood samples. We found that 40% of the animals without lesions and 38% of the animals with clinical signs gave false-negative results by indirect immunofluorescence antibody testing. These animals could contribute to the spreading of infection among dogs, and represent a potential risk for human health as well.

Evaluation of a card test for procalcitonin in continuous ambulatory peritoneal dialysis peritonitis

2007 ◽  
Vol 44 (5) ◽  
pp. 482-484 ◽  
Author(s):  
Fatma Meriç Yilmaz ◽  
Gülsen Yilmaz ◽  
Hatice Akay ◽  
Murat Duranay ◽  
Doğan Yücel
Keyword(s):  
Peritoneal Dialysis ◽  
Continuous Ambulatory Peritoneal Dialysis ◽  
Clinical Signs ◽  
High Specificity ◽  
Reactive Protein ◽  
Potential Marker ◽  
Wbc Count ◽  
Low Sensitivity ◽  
Laboratory Sign ◽  
Card Test

Background: Peritonitis is an important complication in continuous ambulatory peritoneal dialysis (CAPD) patients. Procalcitonin (PCT) has recently been identified as an inflammation marker and recommended as a new potential marker in CAPD peritonitis. We aimed to study a card test for PCT and compare the results with the conventional markers such as C-reactive protein (CRP), erythrocyte sedimentation rate (ESR) and white blood cell (WBC) count. Patients and methods: A total of 40 CAPD patients; 20 patients with an episode of peritonitis and 20 patients without any clinical or laboratory sign of infection were included in the study. PCT, CRP, ESR, WBC and dialysate cell count were performed at the beginning of the clinical signs of peritonitis. Results: CRP and ESR had the highest sensitivities (100% for both) but lower specificities (55 and 10%; respectively) and PCT had the highest specificity with a relatively low sensitivity (100 and 70%) according to the calculated results. Conclusions: The card test for PCT seems to be suitable for the adjunctional use in CAPD peritonitis, with its shorter turn-around time, appropriateness for near-patient testing and high specificity.

Diagnostic stability of first-episode psychosis

1999 ◽  
Vol 175 (6) ◽  
pp. 537-543 ◽  
Author(s):  
Shazad Amin ◽  
Swaran P. Singh ◽  
John Brewin ◽  
Peter B. Jones ◽  
Ian Medley ◽  
...  
Keyword(s):  
Temporal Stability ◽  
Bipolar Disorders ◽  
High Specificity ◽  
First Episode Psychosis ◽  
First Episode ◽  
Predictive Values ◽  
Diagnostic Stability ◽  
Episode Psychosis ◽  
Icd 10 ◽  
Low Sensitivity

BackgroundThe temporal stability of a diagnosis is one measure of its predictive validity.AimsTo measure diagnostic stability in first-episode psychosis using ICD–10 and DSM–III–R.MethodBetween 1992 and 1994 we ascertained a cohort of persons with first-episode psychosis (n=168), assigning to each a consensus diagnosis. At three-year follow-up, longitudinal consensus diagnoses, blind to onset diagnoses, were made. Stability was measured by the positive predictive values (PPVs) of onset diagnoses. For onset schizophrenia, we also calculated sensitivity, specificity and concordance (κ).ResultsFirst-episode ICD–10 and DSM–III–R schizophrenia had a PPV of over 80% at three years. Over one-third of cases with ICD–10 F20 schizophrenia at three years had non-schizophrenia diagnoses at onset. Manic psychoses showed the highest PPV (91%). For onset schizophrenia, both systems had high specificity (ICD–10: 89; DSM–III–R: 93%), but low sensitivity (ICD–10: 64%; DSM–III–R: 51%) and moderate concordance (ICD–10: 0.54; DSM–III–R: 0.46).ConclusionsBipolar disorders and schizophrenia showed the highest stability. DSM–III–R schizophrenia did not have greater stability than ICD–10 schizophrenia.

scholarly journals Independent, external validation of clinical prediction rules for the identification of extended-spectrum β-lactamase-producing Enterobacterales, University Hospital Basel, Switzerland, January 2010 to December 2016

2020 ◽  
Vol 25 (26) ◽  
Author(s):  
Isabelle Vock ◽  
Lisandra Aguilar-Bultet ◽  
Adrian Egli ◽  
Pranita D Tamma ◽  
Sarah Tschudin-Sutter
Keyword(s):  
Prediction Models ◽  
Bacterial Species ◽  
External Validation ◽  
High Specificity ◽  
University Hospital ◽  
Receiver Operating Curve ◽  
Retrospective Case ◽  
Predictive Values ◽  
Extended Spectrum ◽  
Low Sensitivity

Background Algorithms for predicting infection with extended-spectrum β-lactamase-producing Enterobacterales (ESBL-PE) on hospital admission or in patients with bacteraemia have been proposed, aiming to optimise empiric treatment decisions. Aim We sought to confirm external validity and transferability of two published prediction models as well as their integral components. Methods We performed a retrospective case–control study at University Hospital Basel, Switzerland. Consecutive patients with ESBL-producing Escherichia coli or Klebsiella pneumoniae isolated from blood samples between 1 January 2010 and 31 December 2016 were included. For each case, three non-ESBL-producing controls matching for date of detection and bacterial species were identified. The main outcome measure was the ability to accurately predict infection with ESBL-PE by measures of discrimination and calibration. Results Overall, 376 patients (94 patients, 282 controls) were analysed. Performance measures for prediction of ESBL-PE infection of both prediction models indicate adequate measures of calibration, but poor discrimination (area under receiver-operating curve: 0.627 and 0.651). History of ESBL-PE colonisation or infection was the single most predictive independent risk factor for ESBL-PE infection with high specificity (97%), low sensitivity (34%) and balanced positive and negative predictive values (80% and 82%). Conclusions Applying published prediction models to institutions these were not derived from, may result in substantial misclassification of patients considered as being at risk, potentially leading to wrong allocation of antibiotic treatment, negatively affecting patient outcomes and overall resistance rates in the long term. Future prediction models need to address differences in local epidemiology by allowing for customisation according to different settings.

The influence of tumor location, histology, and patient ethnicity on the accuracy of EUS in staging gastric and gastroesophageal junction (GEJ) cancers.

2016 ◽  
Vol 34 (4_suppl) ◽  
pp. 39-39
Author(s):  
Andy Z. Huang ◽  
Yiqing Xu ◽  
Yiwu Huang ◽  
Vimbai Nyemba ◽  
Than Than Aye ◽  
...  
Keyword(s):  
Gastroesophageal Junction ◽  
Preoperative Staging ◽  
High Specificity ◽  
Tumor Location ◽  
The Body ◽  
Gastric Body ◽  
Predictive Values ◽  
Asian Patients ◽  
Low Sensitivity ◽  
N Staging

39 Background: Endoscopic ultrasound (EUS) is a routine staging test performed in patients with gastric and GEJ cancers and is highly valuable in treatment planning. The reported accuracy varies from 40% to 90%. We aim to investigate the staging performance of EUS at our institution and hypothesize that EUS accuracy can be influenced by tumor location, histology, and patient ethnicity. Methods: We performed a retrospective analysis of patients diagnosed with gastric and GEJ cancer between January 2006 and June 2015 who had EUS proceeded directly by surgery. T and N staging by EUS were analyzed for their sensitivity, specificity, and positive (PPV) and negative predictive values using surgery as the gold standard. The following variables were evaluated: tumor histology (intestinal or diffuse type), location (GEJ, cardia, body, or antrum), and patient ethnicity (Asian versus non-Asian). Results: Over 46 patients who met the inclusion criteria, EUS had T and N accuracy of 47.8% and 58.7%, respectively (p <.05). EUS had high specificity (88%) but low sensitivity (38%) for N staging. In predicting T staging, EUS was most accurate when the tumor was located in the body (72%, n = 7) and least accurate in the cardia (33%, n = 6) with 46% (n = 13) in the GEJ and 45% (n = 20) in the antrum. EUS tended to upstage the T value when a tumor is located in the body or GEJ, and downstage it in the cardia or antrum. The PPV using EUS for T1, T2, T3, and T4 were 89%, 22%, 45%, and 57%, respectively. The PPV using EUS for N staging was 73%. EUS was more accurate for T in Asians (55%, n = 33) than in non-Asians (31%, n = 13), and in intestinal type (56%) than diffuse (36%). For N staging, it was most accurate in the body (86%) and least accurate in the GEJ (50%). It was also more accurate in diffuse tumors (79%) than intestinal (52%) and more accurate in non-Asians (77%) than in Asians (53%). Conclusions: EUS as a common tool in preoperative staging may be inaccurate when performed in community hospitals. The predictive rate appears to vary in Asian vs non-Asian patients and in intestinal vs diffuse tumors. It is most predictive when the tumor is T1 and located in the gastric body. A prospective study is needed to confirm these findings.

scholarly journals Comparison of Eight Commercially Available Faecal Point-of-Care Tests for Detection of Canine Parvovirus Antigen

Viruses ◽  
2021 ◽  
Vol 13 (10) ◽  
pp. 2080
Author(s):  
Julia Walter-Weingärtner ◽  
Michèle Bergmann ◽  
Karin Weber ◽  
Uwe Truyen ◽  
Cosmin Muresan ◽  
...  
Keyword(s):  
Point Of Care ◽  
Clinical Signs ◽  
Kappa Statistic ◽  
Laboratory Diagnosis ◽  
Canine Parvovirus ◽  
Predictive Values ◽  
Shelter Dogs ◽  
Low Sensitivity ◽  
Sensitivity Specificity ◽  
Point Of Care Tests

A real-time polymerase chain reaction (qPCR) is considered the gold standard for the laboratory diagnosis of canine parvovirus (CPV) infection but can only be performed in specialized laboratories. Several point-of-care tests (POCT), detecting CPV antigens in faeces within minutes, are commercially available. The aim of this study was to evaluate eight POCT in comparison with qPCR. Faecal samples of 150 dogs from three groups (H: 50 client-owned, healthy dogs, not vaccinated within the last four weeks; S: 50 shelter dogs, healthy, not vaccinated within the last four weeks; p = 50 dogs with clinical signs of CPV infection) were tested with eight POCT and qPCR. Practicability, sensitivity, specificity, positive (PPV) and negative predictive values (NPV), as well as overall accuracy were determined. To assess the differences between and agreement among POCT, McNemar’s test and Cohen’s Kappa statistic were performed. Specificity and PPV were 100.0% in all POCT. Sensitivity varied from 22.9–34.3% overall and from 32.7–49.0% in group P. VetexpertRapidTestCPVAg® had the highest sensitivity (34.3% overall, 49.0% group P) and differed significantly from the 3 POCT with the lowest sensitivities (Fassisi®Parvo (27.7% overall, 36.7% group P), Primagnost®ParvoH+K (24.3% overall, 34.7% group P), FASTest®PARVOCard (22.9% overall, 32.7% group P)). The agreement among all POCT was at least substantial (kappa >0.80). A positive POCT result confirmed the infection with CPV in unvaccinated dogs, whereas a negative POCT result did not definitely exclude CPV infection due to the low sensitivity of all POCT.

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