Lactulose/mannitol test and specificity, sensitivity, and area under curve of intestinal permeability parameters in patients with liver cirrhosis and Crohn's disease.

UNLABELLED: The purpose of this study was to investigate and compare the specificity, sensitivity, and area under curve (AUC) of the lactulose/mannitol ratio, lactulose/creatinine ratio, and lactulose recovery and their diagnostic value for intestinal permeability assessment within the absorption lactulose/mannitol (L/M) test. RESULTS: The value of the lactulose/mannitol ratio, lactulose/creatinine ratio, and the percentage of lactulose recovery in Crohn's disease (0.0763 +/- 0.0369; 99.62 +/- 67.87; 1.0478 +/- 0.6148) and in liver cirrhosis (0.0517 +/- 0.0365; 54.65 +/- 53.26; 0.838 +/- 0.929) were significantly different from the values measured in the control group (0.0123 +/- 0.0081; 10.95 +/- 7.07; 0.2438 +/- 0.1568), P < 0.0001-0.002). In Crohn's disease, specificity, sensitivity, and AUC were 100%, 89.5%, and 0.987, respectively, of the lactulose/mannitol ratio at a cut-off level of 0.022. In liver cirrhosis, the test characteristics were 88.5%, 84.2%, and 0.910 at a cut-off level of 0.018. CONCLUSION: The lactulose/mannitol ratio was evaluated to have the highest diagnostic value to assess intestinal permeability.

Efficacy of polymerase chain reaction for detection of deep mycotic infections: confirmation by autopsy.

A method based on polymerase chain reaction (PCR) amplification of fungal 18S rDNA sequences was tested for the detection of fungi in blood samples. In order to increase sensitivity and specificity, PCR products were hybridized to the radioactively labelled fragment of 18S rDNA gene. Blood from 28 patients with haematological malignancies was taken immediately after death and the results of PCR analysis were compared with results of autopsy examination. To the best of our knowledge, no study of such a design has been published previously. PCR analysis turned out to be very sensitive (92%) and specific (92%) as well as capable of detecting various kinds of fungal infections (localized as well as generalized).

[Diagnosis of mycotic infections in oncology patients using the polymerase chain reaction]. / Diagnostika mykotických infekcí u onkologicky nemocných pomocí polymerázové retezové reakce.

Diagnosis of mycotic infections is despite the immense effort devoted to this problem still very inaccurate. A new and promising method is the polymerase chain reaction, PCR, which theoretically can detect a single cell. In their original study the authors decided to develop a new method for the detection of fungi by PCR and to compare this examination with post-mortem findings. Thus it was possible to determine sufficiently reliably the sensitivity and specificity of the method. For the detection of fungi the authors selected the sequence coding for a small subunit of ribosomal RNA (18S rDNA). The method is able to detect the amount of DNA from some 10-100 cells. The sensitivity was 90% and the specificity 92%. The method is so far too laborious for common practice, its simplification would be however very useful.