ABSTRACT
Four different laboratory tests for diagnosis of Clostridium difficile-associated diarrhea were compared to determine the optimal one for management of patients with hospital-acquired diarrhea. Stool samples from 231 patients with diarrhea were tested by the following methods: culture for Clostridium difficile with subsequent determination of exotoxin production, with a toxigenic Clostridium difficile positive (TCP) result considered truly positive; enzyme immunoassay (EIA); latex agglutination test; and an immunobinding blot assay. The rates of positive results were as follows: EIA 5.5%, TCP 7.3%, latex agglutination 16.7%, and immunobinding blot assay 26.1%. Compared to the TCP results, the sensitivity and specificity were, respectively, 61 and 98% for EIA, 47 and 85% for latex agglutination, and 60 and 76% for the immunobinding blot assay. Samples from patients with > or = 6 stools/day were TCP and EIA positive in 27 and 17% of cases, respectively, whereas in patients with < 6 stools/day, these percentages decreased to 2 and 3%, respectively (p < 0.001). In hospitalized patients with > or = 6 stools/day, EIA appears to be the optimal test for diagnosis of Clostridium difficile-associated diarrhea, with a 73% positive predictive value and a 97% negative predictive value. However, in patients with < 6 stools/day, the prevalence of Clostridium difficile is low, and laboratory detection of this organism remains problematic.
Subject(s)
Clinical Laboratory Techniques/methods , Clostridioides difficile , Diarrhea/diagnosis , Enterocolitis, Pseudomembranous/diagnosis , Anti-Bacterial Agents/therapeutic use , Bacteriological Techniques , Cross Infection , Diarrhea/drug therapy , Enterocolitis, Pseudomembranous/drug therapy , Exotoxins/biosynthesis , Feces/microbiology , Hospitals , Humans , Immunoblotting , Immunoenzyme Techniques , Latex Fixation Tests , Predictive Value of Tests , Sensitivity and SpecificityABSTRACT
We describe a patient with unusual features of Q fever endocarditis. The unusual features of this case were the presence of an abscess surrounding the involved aortic valve and the appearance of circulating anticoagulants in the patient's serum.
Subject(s)
Endocarditis, Bacterial/microbiology , Q Fever/diagnosis , Abscess/microbiology , Aortic Valve/microbiology , Blood Coagulation , Heart Valve Diseases/microbiology , Humans , Immunoglobulins/analysis , Male , Middle Aged , Q Fever/complications , Sinus of Valsalva/microbiologySubject(s)
Cleft Lip/surgery , Cleft Palate/surgery , Age Factors , Child , Child, Preschool , Follow-Up Studies , Humans , Infant , Time FactorsSubject(s)
Cleft Lip/surgery , Cleft Palate/surgery , Surgery, Plastic , Follow-Up Studies , Humans , Infant , Time FactorsABSTRACT
Human lymphocytes contain glucuronyltransferase activity. This enzyme requires a high concentration of uridine diphosphoglucuronic acid and can be measured with testosterone as a substrate. This finding is of interest because glucuronidation is a deactivating process for many pharmacologically active compounds that are substrates of glucuronyltransferase.
Subject(s)
Glucuronosyltransferase/metabolism , Lymphocytes/enzymology , B-Lymphocytes/enzymology , Cell Line , Glucuronates/metabolism , Humans , In Vitro Techniques , Testosterone/metabolism , Time FactorsABSTRACT
In analysing our small series with caution we tend to support the findings of Lindsay (1971) and Blocksma et al. (1975). Thus the combination of no facial growth deformity and a reasonable rate of velopharyngeal competence has encouraged us to continue using this simple and safe procedure for the treatment of cleft palates with intact lip and alveolus.
