ABSTRACT
OBJECTIVE: The aim of this study is to investigate the relationship between serum concentration of cardiac troponin T (cTnT) and other cardiac markers and ischemic heart disease (IHD) in end stage renal disease (ESRD) patients on chronic hemodialysis (HD). METHODS: This study was carried out at King Fahd Specialist Hospital, Buraidah, Kingdom of Saudi Arabia from July 2002 to September 2003. Cardiac troponin T was measured using Elecsys 2020 immunoassay system, a method that is specific for cTnT. The analytical range of cTnT assay was 0.01-25.0 ug/L. Seventy-three patients were divided into 4 groups: 20 patients with history of IHD, 17 patients with diabetes, 19 patients with diabetes and IHD and 17 patients without evidence of myocardial damage. RESULTS: Cardiac troponin T concentrations were > or =0.1 ug/L in 58% of HD patients. Fifty-three percent of diabetic patients had an increased cTnT, 37% of IHD patients had an increased cTnT, 59% of IHD and diabetic patients had an increased cTnT and 29% of noncardiac disease patients had an increased cTnT. Cardiac troponin T was increased more frequently in post-hemodialysis samples (13% pre-hemodialysis and 21% post-hemodialysis). CONCLUSION: Dialysis may alter measured cTnT concentrations in ESRD patients undergoing chronic dialysis. Sporadic or persistently increased cTnT appear to be the most specific of the currently available biochemical markers to predict subclinical myocardial damage in ESRD patients.
Subject(s)
Kidney Failure, Chronic/therapy , Myocardial Ischemia/diagnosis , Myocardial Ischemia/epidemiology , Renal Dialysis/adverse effects , Troponin T/blood , Adult , Age Distribution , Aged , Biomarkers/blood , Case-Control Studies , Cohort Studies , Female , Follow-Up Studies , Humans , Incidence , Kidney Failure, Chronic/complications , Kidney Failure, Chronic/diagnosis , Long-Term Care , Male , Middle Aged , Myocardial Ischemia/etiology , Probability , Prognosis , Reference Values , Renal Dialysis/methods , Risk Assessment , Saudi Arabia/epidemiology , Sensitivity and Specificity , Severity of Illness Index , Sex Distribution , Survival RateABSTRACT
In the present study, Cryptosporidium parvum was diagnosed in stool by Z-N stain, ELISA and PCR. The detected cases were 5.3%, 8.3% and 9.6% by the previous three methods, respectively. The sensitivity, specificity and accuracy of the different techniques were evaluated. The Z-N stain showed the lowest sensitivity and accuracy in relation to either ELISA or PCR. Moreover, the study revealed that the sensitivity, specificity and accuracy of ELISA detection of Cryptosporidium in relation to detection of DNA in stool by PCR were 84.2%, 96% and 88.8%, respectively. Consequently, PCR showed the best results. From a practical point of view, ELISA is recommended for wide spread use in diagnosis of cryptosporidiosis.
Subject(s)
Cryptosporidiosis/diagnosis , Cryptosporidium parvum/isolation & purification , Adult , Aged , Animals , Child, Preschool , Enzyme-Linked Immunosorbent Assay/methods , Feces/parasitology , Female , Humans , Immunocompetence , Immunocompromised Host , Infant , Male , Middle Aged , Polymerase Chain Reaction/methods , Sensitivity and Specificity , Staining and Labeling/methodsABSTRACT
In the present study, sera were examined using Fasciola-IHA, F-ELISA and Schistosoma-IHA. The sero-positive schistosomal patients were subjected to rectal snip, while the sero-positive fascioliasis ones were examined radiologically by plain chest X-ray and abdominal ultrasonography. Both F-IHA and F-ELISA gave 100% sensitivity. The specificity of both testes were 90.4% and 100% respectively. With the S-IHA, the parasitologically proven schistosomal mansoni patients gave 95% positivity, while the proven fascioliasis patients gave false positive (8%) with this S-IHA. The radiological findings of the fascioliasis patients confirmed ectopic pleuro-pulmonary infection in five patients. Ascitis was detected in one patient, the pleural effusion and ascitic fluids showed high eosinophils. However, Fasciola eggs were detected in three patients only. Two patients showed hepatic nodules, and another two had hepatic cystic lesions. Three patients had immature Fasciola worms in gall bladder. For diagnosis of human fascioliasis, serological and radiological means should be done side by side with the stool examination. This is particularly true in chronic cases and in schistosomiasis mansoni endemic areas.
