Rapid and effective diagnosis of pulmonary tuberculosis with novel and sensitive loop-mediated isothermal amplification (LAMP) assay in clinical samples: a meta-analysis.

In recent years, Loop-mediated isothermal amplification (LAMP) assay has been introduced for the diagnosis of pulmonary tuberculosis (TB). We performed the meta-analysis to establish the overall accuracy of LAMP assay for diagnosing pulmonary TB. Based on comprehensive searches of the pubmed, embase and cochrane databases, we identified outcome datas from all articles estimating diagnostic accuracy with LAMP assay until 1 October 2012. A summary estimation for sensitivity, specificity, diagnostic odds ratios (DOR) and the area under the summary ROC curve (AUC) was calculated by using the bivariate random-effects approach. The meta-analysis included 10 studies (1920 suspected specimens). The summary estimate was 80.0% (95%CI, 78.0%-83.0%) for sensitivity, 96.0% (95%CI, 95.0%-97.0%) for specificity and 119.85/0.9633 for DOR/AUC in pulmonary TB. The findings in subgroup analysis were as follows: the accuracy of LAMP assay is higher in high quality level studies than moderate and low quality level studies. The pooled sensitivity for the diagnosis of pulmonary TB was 90.0% (95%CI, 86.0-93.0%) and 75.0% (95%CI, 71.0-78.0%) for high quality level studies and moderate combined low quality level studies, respectively, while the specificity was 99.0% (95%CI, 98.0-100.0%) and 91.0% (95%CI, 88.0-94.0%). Pulmonary TB can be rapidly and accurately diagnosed with LAMP assay.

Procalcitonin and C-reactive protein in the diagnosis and prediction of spontaneous bacterial peritonitis associated with chronic severe hepatitis B.

BACKGROUND: Procalcitonin (PCT), C-reactive protein (CRP), and white blood cells (WBCs) are inflammatory markers used to diagnose severe bacterial infections. We evaluated the diagnostic role of these markers and compared their accuracy for spontaneous bacterial peritonitis (SBP) associated with chronic severe hepatitis B (CSHB). METHODS: PCT and CRP concentrations, WBC count, and other hematological parameters were measured in serum from 84 well-characterized patients with CSHB, of whom 42 had SBP. Receiver operating characteristics (ROC) curve analysis was performed to assess the diagnostic accuracy. RESULTS: PCT and CRP concentrations were significantly higher in the CSHB patients with SBP (n=42) than CSHB patients without SBP (n=42). PCT and CRP concentrations were more accurate than WBC count for the diagnosis of CSHB-associated SBP. The optimal cutoff value of PCT was 0.48 ng/mL. The PCT concentration was significantly correlated with the CRP concentration and WBC count. CONCLUSIONS: Serum PCT and CRP seems to be better markers than WBC for the diagnosis of CSHB patients with SBP.