The sensitivity is much higher for Triage and the two new chromatographic assays than for the conventional EIAs. These tests also have a high negative predictive value. For Triage, C. difficile antigen-positive, toxin A-negative results can be obtained; the clinical value of these must be established by additional studies. Overall, the new-generation assays are still less sensitive than the cytotoxin assay; however, they provided same-day results, could be used as a screening test and may be useful in laboratories without tissue-culture facilities. Our results do not allow the recommendation of one single assay for the diagnosis of C. difficile-associated diarrhea. It remains the case that laboratory results must be correlated and interpreted with the clinical presentation of the patient.
Background: Prostate-specific antigen (PSA) assays have historically produced different results. Our aim was to investigate the comparability of assay results of selected commercially available assay methods designed to measure total, free, or complexed PSA (tPSA, fPSA, and cPSA).
We may conclude that the point-of-care test can serve as a reliable alternative to the time consuming ELISA in the differential diagnosis between functional and organic bowel disease. Furthermore, it seems to be reliable in the follow-up of inflammatory bowel disease patients.
Background: Despite many publications regarding the role of faecal calprotectin (FC) in inflammatory bowel disease (IBD), clear recommendations for its use in clinical practice are currently lacking in the literature. Aim: The aim of this article is to provide practical guidance for clinicians for the use of FC in the detection and management of patients with IBD. Methods: All relevant publications were analysed and practical statements were proposed based on a Delphi consensus approach. Results: Different commercial assays have been developed but international standardisation is lacking. FC can help in the diagnosis process of IBD. In IBD, FC can predict response to therapy, detect subclinical inflammation and help to drive treatment decisions to achieve better endoscopic and clinical outcomes. After Crohn's surgery FC can identify patients with early endoscopic recurrence. Conclusion: Although major therapeutic changes should not be based on FC alone, FC is a valuable tool to optimise the care for IBD patients.
Background: We evaluated the analytical performance of six different faecal calprotectin immunoassays together with their diagnostic accuracy in the discrimination between functional and organic bowel disorders. Methods: The faecal samples were obtained from inflammatory bowel disease patients (n = 27) at the time of diagnosis [Crohn's disease (n = 15), colitis ulcerosa (n = 12)], gastroenterologic disease control patients (n = 52) and rheumatologic disease control patients (n = 26). All individuals included in the study underwent a concurrent ileocolonoscopy. Analytical performance (imprecision, accuracy, carry-over, correlation and agreement) and diagnostic accuracy (sensitivity, specificity, likelihood ratios) of the different assays were evaluated. Results: All methods demonstrated good analytical performance, but within-run and total imprecision varied depending on the assay methodology used. Using Passing Bablok and Bland-Altman analyses, low quantitative agreement was observed between the assays. All assays showed excellent diagnostic accuracy, with areas under the receiver operating characteristic curves (ROC) ranging from 0.974 to 0.998. The AUCs were not significantly different between assays (p > 0.05). Diagnostic sensitivity at the
The Thermo Fisher device is not reliable for extraction of faecal calprotectin. The performance characteristics of the EliA Calprotectin assay are statistically equivalent to the Bühlmann POCT.
In conclusion, the newly developed stool extraction device protocols showed acceptable and comparable performance to the stool weight method. Overall, the automated Liaison® Calprotectin and fCAL™ turbo assay showed good analytical and diagnostic performance for detection of IBD.
A young immunocompetent patient is presented with a very rare presentation of a common viral illness: herpes zoster of the left hemilarynx with sensorial and motoric neuropathy of three ipsilateral lower cranial nerves: IX, X and XI. The mucosal lesions were discovered during upper gastrointestinal endoscopy. PCR of erosional exsudate confirmed the clinical diagnosis. Antiviral therapy and corticosteroids possibly contributed to the prosperous evolution with complete healing.
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