Novel Criteria for Parathyroid Hormone Levels in Parathyroid Hormone–Guided Parathyroid Surgery

2007 ◽  
Vol 131 (12) ◽  
pp. 1800-1804
Author(s):  
Robert de Vos tot Nederveen Cappel ◽  
Nicole Bouvy ◽  
Wouter de Herder ◽  
Yolanda de Rijke ◽  
Hans van Toor ◽  
...  
Keyword(s):  
Parathyroid Hormone ◽  
Primary Hyperparathyroidism ◽  
False Positive ◽  
Parathyroid Surgery ◽  
Cure Rate ◽  
True Negative ◽  
Tertiary Hyperparathyroidism ◽  
Negative Results ◽  
Future Evaluation ◽  
Positive Results

Abstract Context.—Novel criteria for decrease of perioperative parathyroid hormone measurement may improve the accuracy of perioperative quick parathyroid hormone (qPTH)–guided parathyroidectomy. Objective.—To assess overall cure rate based on conventional criteria (50% decline of qPTH). Perioperative qPTH levels were evaluated to determine novel criteria for successful parathyroid surgery. Design.—Analysis of perioperative qPTH measurement findings of all consecutive patients undergoing parathyroidectomy for hyperparathyroidism (72 with primary hyperparathyroidism and 28 with secondary or tertiary hyperparathyroidism or multiple endocrine neoplasia I/IIa disease). Results.—Measurement of qPTH (based solely on the criterion of greater than 50% decline of parathyroid hormone) in 72 patients with primary hyperparathyroidism (77 procedures) showed true-positive results in 69, false-positive results in 4, and true-negative results in 4 procedures. In our series, false-positive and true-negative results were associated with high postexcision levels. However, when qPTH declines of greater than 70% and 80% were used in cases of postexcision qPTH levels of 100 to 200 ng/L and greater than 200 ng/L, respectively, no false-positive results were observed. Conclusions.—Through adherence to these novel criteria, reexploration of the neck could have been prevented in 29% of patients with primary hyperparathyroidism due to multiple gland disease. These novel criteria demand future evaluation to establish their value.

A Colony Blot Immunoassay for the Rapid Identification of Bacillus cereus

2004 ◽  
Vol 67 (2) ◽  
pp. 387-390 ◽  
Author(s):  
CHI-HUA CHEN ◽  
HWIA CHENG DING
Keyword(s):  
Horseradish Peroxidase ◽  
Cell Surface ◽  
Bacillus Cereus ◽  
False Positive ◽  
Rapid Identification ◽  
True Negative ◽  
Negative Results ◽  
Bacillus Spp ◽  
Positive Results ◽  
Peroxidase Conjugate

A colony blot immunoassay was developed for the rapid identification of Bacillus cereus using antibodies against the 28.5-kDa cell-surface antigen of B. cereus. Suspect colonies from plates were blotted onto a Whatman #541 membrane, dried, and fixed by UV irradiation. The membrane was then immersed in an anti- B. cereus antibody-horseradish peroxidase conjugate for 60 min. After washing and reacting with 4-chloro-1-naphthol and H2O2, the appearance of purple spots indicated the presence of B. cereus. This assay effectively identified 61 of 62 B. cereus strains tested. Among 38 non– B. cereus strains, which were other Bacillus spp. (19 genera), 36 gave true-negative results, and 2 showed false-positive results. The sensitivity and specificity for B. cereus were 98.4 and 94.7%, respectively. The present assay is easy to use, and the rapid identification of B. cereus can be completed in 2.5 h.

Effects of Parathyroidectomy on Normocalcemic Primary Hyperparathyroidism and the Role of Intraoperative PTH Measurement

2021 ◽  
pp. 000313482110488
Author(s):  
Ehab Alameer ◽  
Mahmoud Omar ◽  
Marcus Hoof ◽  
Hosam Shalaby ◽  
Mohamed Abdelgawad ◽  
...  
Keyword(s):  
Parathyroid Hormone ◽  
Primary Hyperparathyroidism ◽  
Cure Rate ◽  
Tertiary Hyperparathyroidism ◽  
Intraoperative Pth ◽  
Intraoperative Parathyroid Hormone ◽  
Cure Rates ◽  
Current Guidelines ◽  
Normocalcemic Hyperparathyroidism

Background Normocalcemic primary hyperparathyroidism (NCpHPT) and normohormonal primary hyperparathyroidism (NHpHPT) are recently recognized variants of primary hyperparathyroidism. Current guidelines for the management hyperparathyroidism recognize NCpHPT as one of the areas that are recommended for more research due to limited available data. Methods A retrospective review of patients who had parathyroidectomy between 2014 and 2019. We excluded patients with multiple endocrine neoplasia syndromes and secondary and tertiary hyperparathyroidism. Included patients were classified based on the biochemical profile into classic or normocalcemic hyperparathyroidism group. Collected data included demographics, preoperative localizing imaging, intraoperative parathyroid hormone levels, and postoperative cure rates. Results 261 patients were included: 160 patients in the classic and 101 patients in the normocalcemic group. Patients in the normocalcemic group had significantly more negative sestamibi scans (n = 58 [8.2%] vs 78 [51.3%], P = <.01), smaller parathyroid glands (mean weight 436.0 ± 593.0 vs 742.4 ± 1109.0 mg, P = .02), higher parathyroid hyperplasia rates (n = 51 [50.5%] vs 69 [43.1%]), and significantly higher intraoperative parathyroid hormone at 10 minutes (78.1 ± 194.6 vs 43.9 ± 62.4 1, P = .04). Positive predictive value of both intraoperative parathyroid hormone and cure rate was lower in the normocalcemic group (84.2% vs 95.7%) and (80.5% vs 95%), respectively. Conclusion Normocalcemic hyperparathyroidism is a challenging disease. Surgeons should be aware of the lower cure rate in this group, interpret intraoperative parathyroid hormone with caution, and have a lower threshold for bilateral neck exploration and 4 glands visualization.

scholarly journals Evaluation of a rapid dipstick test, Malar-CheckTM, for the diagnosis of Plasmodium falciparum malaria in Brazil

2002 ◽  
Vol 44 (5) ◽  
pp. 293-296 ◽  
Author(s):  
Priscilla Elisangela AVILA ◽  
Karin KIRCHGATTER ◽  
Karen Cristina S. BRUNIALTI ◽  
Alessandra M. OLIVEIRA ◽  
Rinaldo F. SICILIANO ◽  
...  
Keyword(s):  
Plasmodium Falciparum ◽  
False Positive ◽  
False Negative ◽  
Plasmodium Falciparum Malaria ◽  
Dipstick Test ◽  
True Negative ◽  
Disease Evolution ◽  
Negative Results ◽  
False Positive Test ◽  
Positive Results

The present study was carried out to evaluate the Malar-CheckTM Pf test, an immunochromatographic assay that detects Plasmodium falciparum Histidine Rich Protein II, does not require equipment, and is easy and rapid to perform. In dilution assays performed to test sensitivity against known parasite density, Malar-CheckTMwere compared with thick blood smear (TBS), the gold standard for diagnosis. Palo Alto isolate or P. falciparum blood from patients with different parasitemias was used. The average cut-off points for each technique in three independent experiments were 12 and 71 parasites/mm³ (TBS and Malar-CheckTM, respectively). In the field assays, samples were collected from patients with fever who visited endemic regions. Compared to TBS, Malar-CheckTMyielded true-positive results in 38 patients, false-positive results in 3, true-negative results in 23, and false-negative result in 1. Malar-CheckTMperformed with samples from falciparum-infected patients after treatment showed persistence of antigen up to 30 days. Malar-CheckTM should aid the diagnosis of P. falciparum in remote areas and improve routine diagnosis even when microscopy is available. Previous P. falciparum infection, which can determine a false-positive test in cured individuals, should be considered. The prompt results obtained with the Malar-CheckTM for early diagnosis could avoid disease evolution to severe cases.

Critical Evaluation of Impedance Phlebography for the Diagnosis of Deep Vein Thrombosis

1974 ◽  
Vol 31 (02) ◽  
pp. 273-278
Author(s):  
Kenneth K Wu ◽  
John C Hoak ◽  
Robert W Barnes ◽  
Stuart L Frankel
Keyword(s):  
Deep Vein Thrombosis ◽  
False Positive ◽  
False Negative ◽  
Critical Evaluation ◽  
Original Method ◽  
Vein Thrombosis ◽  
Negative Results ◽  
False Negative Results ◽  
Deep Vein ◽  
Positive Results

SummaryIn order to evaluate its daily variability and reliability, impedance phlebography was performed daily or on alternate days on 61 patients with deep vein thrombosis, of whom 47 also had 125I-fibrinogen uptake tests and 22 had radiographic venography. The results showed that impedance phlebography was highly variable and poorly reliable. False positive results were noted in 8 limbs (18%) and false negative results in 3 limbs (7%). Despite its being simple, rapid and noninvasive, its clinical usefulness is doubtful when performed according to the original method.

scholarly journals Ultrasonographicpotencial in detection of Acute Appendicitis

2009 ◽  
Vol 8 (4) ◽  
pp. 140-147
Author(s):  
V. N. Piskunov ◽  
V. D. Zavadovskaya ◽  
N. G. Zavyalova
Keyword(s):  
Acute Appendicitis ◽  
False Negative ◽  
Power Doppler ◽  
Vermiform Appendix ◽  
Vascular Pattern ◽  
True Negative ◽  
Horizontal Section ◽  
Negative Results ◽  
Interior Wall ◽  
Positive Results

On the grounds of ultrasonography of 275 patients with suspected Acute Appendicitis (AA) the diagnosis was confirmed in 63 (22,9%) cases, it was true-positive results; in 3 (1,1%) cases of non-confirmed AA ultrasound findings were regarded as false-positive results. True-negative results of examination were obtained in 194 cases (70,5%) and false-negative results — in 15 cases (5,5%). The presence of rarevascularity of interior wall and clear visualization of vessels in mesentery of vermiform appendix is typical for congestive appendicitis. When phlegmonous appendicitis there are numerous vascular branches in interior wall blood stream of appendix: they make a picture of color «crown» in horizontal section and color «stripe» in longitudinal section. Gangrenous appendicitis is attached to few color spots in those parts of appendix wall which are not destroyed yet. Vascular pattern in adjacent intestinal loops predominates over vascular pattern of vermiform appendix. In case of empyema vermiform appendix vascular pattern in the wall is detected only in mesentery area. Vascular pattern of appendix is not detected in cases of appendicular infiltrate and periappendicular abscess unlike vascular pattern of adjacent intestinal loops which is rather intensified. The sensitivity of ultrasonography in AA detection was 80,7%, specificity — 98,4%, and accuracy — 93,4%. High index of diagnostic effectiveness of the method was obtained because of adoption of combining B-mode with both Colour Doppler and Power Doppler methods.

Low Rate of False-Positive Results with Use of A Rapid HIV Test

2002 ◽  
Vol 23 (6) ◽  
pp. 335-337 ◽  
Author(s):  
Cassandra D. Salgado ◽  
Heidi L. Flanagan ◽  
Doris M. Haverstick ◽  
Barry M. Farr
Keyword(s):  
Enzyme Immunoassay ◽  
False Positive ◽  
Diagnostic System ◽  
Rapid Test ◽  
Occupational Exposures ◽  
High Rate ◽  
Negative Results ◽  
Hiv Test ◽  
Rapid Hiv Test ◽  
Positive Results

Background:Occupational exposure to human immunodeficiency virus (HIV) is an important threat to healthcare workers. Centers for Disease Control and Prevention guidelines recommend prompt institution of prophylaxis. This requires (1) immediate prophylaxis after exposure, pending test results that may take more than 24 hours in many hospitals; or (2) performance of a rapid test. The Single Use Diagnostic System (SUDS)® HIV-1 Test is used to screen rapidly for antibodies to HIV type 1 in plasma or serum, with a reported sensitivity of more than 99.9%. We used this test from January 1999 until September 2000, when it was withdrawn from the market following reports claiming a high rate of false-positive results.Methods:We reviewed the results of postexposure HIV testing during 21 months.Results:A total of 884 SUDS tests were performed on source patients after occupational exposures (883 negative results, 1 reactive result). The results of repeat SUDS testing on the reactive specimen were also reactive, but the results of enzyme immunoassay and Western blot testing were negative. A new specimen from the same patient showed a negative result on SUDS testing. This suggested a specificity of 99.9%. In the 4 months after SUDS testing was suspended, there was 1 false-positive result on enzyme immunoassay for 1 of 132 source patients (presumed specificity, 99.2%).Conclusion:Use of the SUDS test facilitated rapid and accurate evaluation of source specimens, obviating unnecessary prophylaxis.

Thyroid Screening for Early Discharged Infants

PEDIATRICS ◽  
1996 ◽  
Vol 98 (1) ◽  
pp. 41-44
Author(s):  
Judy G. Saslow ◽  
Ernest M. Post ◽  
Carol A. Southard
Keyword(s):  
New Jersey ◽  
Congenital Hypothyroidism ◽  
False Positive ◽  
False Negative ◽  
Negative Results ◽  
Thyroid Screening ◽  
False Negative Results ◽  
Positive Results

Objective. As neonatal discharge before 24 hours of life becomes commonplace, the rejection of congenital hypothyroidism (CH) screening specimens obtained too early has created the need for numerous additional tests. We sought to determine whether the specimens obtained before 24 hours could be used safely. Methods. During a 31-day period we measured thyrotropin in all thyroid-screening specimens that had been obtained before 24 hours. We also examined the early specimens from every infant diagnosed in New Jersey with CH during 1993 or 1994. Results. Among the 663 specimens, those obtained at or before 12 hours and those from infants with birth weights less than 2500 g had too many low thyroxine results to be useful. Among the 515 specimens obtained at more than 12 to 24 hours from newborns weighing 2500 g or more, 37 (7%) had low thyroxine levels and 12 (2.3%) had thyrotropin levels of 20 µIU/mL (mU/L) or higher. Four hundred seventy-one of the 515 infants had subsequent specimens obtained at more than 24 hours, and none of the results were abnormal. There was no child weighing more than or equal to 2500 g who was diagnosed with CH in 1993 and 1994 whose specimen obtained at 24 hours or less was normal. Conclusions. Accepting specimens obtained at more than 12 to 24 hours from infants weighing 2500 g or more would have resulted in more than the usual number of false-positive results but no false-negative results. This would have decreased the requests for additional specimens by more than 90%.

PRE-OPERATIVE LOCALIZATION OF HYPERFUNCTIONING PARATHYROID TISSUE BY PARATHYROID SCINTIGRAPHY

1976 ◽  
Vol 81 (2) ◽  
pp. 298-309 ◽  
Author(s):  
P. Burckhardt ◽  
A. Bischof-Delaloye ◽  
B. Ruedi ◽  
B. Delaloye
Keyword(s):  
Primary Hyperparathyroidism ◽  
False Positive ◽  
Parathyroid Tissue ◽  
Tubular Reabsorption ◽  
Plasma Calcium ◽  
Parathyroid Scintigraphy ◽  
Biochemical Screening ◽  
Parathyroid Adenomas ◽  
Positive Results ◽  
Positive Focus

ABSTRACT In 22 patients who underwent surgery suspected of primary hyperparathyroidism, the surgical findings were compared with the results obtained by pre-operative parathyroid scanning and biochemical screening. Thirteen of 15 parathyroid adenomas were localized by pre-operative scanning, but in five of them a false positive focus was also described. The technique was less useful in primary hyperplasia. Comparable results were reported by other investigators. In both instances the best results were obtained in patients with high parathyroid activity as measured by plasma calcium, plasma alkaline phosphatase and tubular reabsorption of phosphorus (TRP). Parathyroid scintigraphy was especially helpful in the presence of ectopic adenomas and in patients who had undergone previous parathyroid surgery. Unfortunately, the possibility of false positive results makes it unreliable for the diagnosis of primary hyperparathyroidism.

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