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Chappell K, Van Vertloo L, Viall A, Scaccianoce J, LeVine DN. Rectally obtained fecal samples can be used for fecal occult blood testing in dogs, and fecal immunochemical tests do not detect canine or feline blood. Am J Vet Res 2024:1-7. [PMID: 38262140 DOI: 10.2460/ajvr.23.10.0235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Accepted: 01/03/2024] [Indexed: 01/25/2024]
Abstract
OBJECTIVE The first objective was to determine if the sample collection method (naturally voided vs digital rectal examination collection) affected fecal occult blood test (FOBT) results. The second objective was to assess the ability of human fecal hemoglobin immunochemical tests to detect canine and feline blood. ANIMALS 308 privately owned dogs, healthy and sick. METHODS Guaiac FOBTs were performed on paired voided and rectally obtained canine fecal samples. The kappa statistic was used to assess agreement between the 2 collection methods, and a multivariate regression model was used to identify factors associated with a positive FOBT. Two fecal immunochemical tests (FITs; Hemosure One Step and OC-Light S) were tested with serially diluted human, canine, and feline blood. RESULTS Voided and rectally obtained samples showed strong FOB-positivity agreement (k = 0.80), with 92.5% concordance and only 13/308 dogs negative on void but positive on rectal. Multivariate analysis showed dogs with gastrointestinal disease (P = .0008, rectal; P = .0001, void) were more likely and heavier dogs (P = .0037, rectal; P = .0022 void) were less likely to test FOBT positive. Health status, fasting status, NSAID use, and age were associated with FOBT results on univariate, but not multivariate, analysis. FITs did not detect canine or feline blood at any concentration while human blood performed as expected. CLINICAL RELEVANCE Rectally obtained fecal samples can be reliably used for FOBTs. Human FITs may not be suitable for companion animals, but evaluation of other available tests is needed.
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Affiliation(s)
- Kelly Chappell
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Iowa State University, Ames, IA
| | - Laura Van Vertloo
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Iowa State University, Ames, IA
| | - Austin Viall
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Iowa State University, Ames, IA
- Department of Pathology, Microbiology and Immunology, School of Veterinary Medicine, University of California-Davis, Davis, CA
| | - Jennifer Scaccianoce
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Iowa State University, Ames, IA
| | - Dana N LeVine
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Iowa State University, Ames, IA
- Department of Clinical Sciences, College of Veterinary Medicine, Auburn University, Auburn, AL
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Johnstone MS, MacLeod C, Digby J, Al-Azzawi Y, Pang G, Watson AJM, Strachan J, Mowat C, McSorley ST. Prevalence of repeat faecal immunochemical testing in symptomatic patients attending primary care. Colorectal Dis 2022; 24:1498-1504. [PMID: 35776684 PMCID: PMC10084108 DOI: 10.1111/codi.16240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Revised: 06/20/2022] [Accepted: 06/24/2022] [Indexed: 01/07/2023]
Abstract
AIM The faecal immunochemical test (FIT) for faecal haemoglobin (f-Hb) helps determine the risk of colorectal cancer (CRC) and has been integrated into symptomatic referral pathways. 'Safety netting' advice includes considering referral for persistent symptoms, but no published data exists on repeated FITs. We aimed to examine the prevalence of serial FITs in primary care and CRC risk in these patients. METHOD A multicentre, retrospective, observational study was conducted of patients with two or more consecutive f-Hb results within a year from three Scottish Health Boards which utilize FIT in primary care. Cancer registry data ensured identification of CRC cases. RESULTS Overall, 135 396 FIT results were reviewed, of which 12 359 were serial results reported within 12 months (9.1%), derived from 5761 patients. Of these, 42 (0.7%) were diagnosed with CRC. A total of 3487 (60.5%) patients had two f-Hb < 10 μg/g, 944 (16.4%) had f-Hb ≥ 10 μg/g followed by <10 μg/g, 704 (12.2%) f-Hb < 10 μg/g followed by ≥10 μg/g and 626 (10.9%) had two f-Hb ≥ 10 μg/g. The CRC rate in each group was 0.1%, 0.4%, 1.4% and 4.0%, respectively. Seven hundred and thirty four patients submitted more than two FITs within a year. The likelihood of one or more f-Hb ≥ 10 μg/g rose from 40.4% with two samples to 100% with six, while the CRC rate fell from 0.8% to 0%. CONCLUSION Serial FITs within a year account for 9.1% of all results in our Boards. CRC prevalence amongst symptomatic patients with serial FIT is lower than in single-FIT cohorts. Performing two FITs within a year for patients with persistent symptoms effectively acts as a safety net, while performing more than two within this timeframe is unlikely to be beneficial.
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Affiliation(s)
- Mark S Johnstone
- Academic Unit of Surgery, School of Medicine, Dentistry and Nursing, University of Glasgow, Glasgow, UK
| | | | - Jayne Digby
- Centre for Research into Cancer Prevention and Screening, School of Medicine, Ninewells, Hospital and Medical School, University of Dundee, Dundee, UK
| | - Yassir Al-Azzawi
- Academic Unit of Surgery, School of Medicine, Dentistry and Nursing, University of Glasgow, Glasgow, UK
| | - Grace Pang
- Academic Unit of Surgery, School of Medicine, Dentistry and Nursing, University of Glasgow, Glasgow, UK
| | | | - Judith Strachan
- Department of Blood Sciences, Ninewells Hospital and Medical School, Dundee, UK
| | - Craig Mowat
- Population Health & Genomics, School of Medicine, Ninewells Hospital and Medical School, University of Dundee, Dundee, UK
| | - Stephen T McSorley
- Academic Unit of Surgery, School of Medicine, Dentistry and Nursing, University of Glasgow, Glasgow, UK
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Johnstone MS, Miller G, Pang G, Burton P, Kourounis G, Winter J, Crighton E, Mansouri D, Witherspoon P, Smith K, McSorley ST. Alternative diagnoses and demographics associated with a raised quantitative faecal immunochemical test in symptomatic patients. Ann Clin Biochem 2022; 59:277-287. [PMID: 35044264 PMCID: PMC9280700 DOI: 10.1177/00045632221076771] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Background The faecal immunochemical test (FIT) has proven utility for colorectal cancer
detection in symptomatic patients. However, most patients with a raised
faecal haemoglobin (f-Hb) do not have colorectal cancer. We investigated
alternative diagnoses and demographics associated with a raised f-Hb in
symptomatic patients. Methods A retrospective, observational study was performed of patients with FIT
submitted between August 2018 to January 2019 in NHS Greater Glasgow and
Clyde followed by colonoscopy. Colonoscopy/pathology reports were searched
for alternative diagnoses. Covariables were compared using the χ2 test. Multivariate binary logistic regression identified independent
predictors of a raised f-Hb. Results 1272 patients were included. In addition to colorectal cancer (odds ratio
(OR), 9.27 (95% confidence interval (CI): 3.61–23.83; p
< 0.001)), older age (OR, 1.52 (95% CI: 1.00–2.32; p =
0.05)), deprivation (OR, 1.54 (95% CI: 1.21–1.94; p <
0.001)), oral anticoagulants (OR, 1.78 (95% CI: 1.01–3.15;
p = 0.046)), rectal bleeding (OR, 1.47 (95% CI:
1.15–1.88; p = 0.002)), advanced adenoma (OR, 7.52 (95% CI:
3.90–14.49; p < 0.001)), non-advanced polyps (OR, 1.78
(95% CI: 1.33–2.38; p < 0.001)) and inflammatory bowel
disease (IBD) (OR, 4.19 (95% CI: 2.17–8.07; p < 0.001))
independently predicted raised f-Hb. Deprivation (Scottish Index of Multiple
Deprivation (SIMD) 1-2: OR, 2.13 (95% CI: 1.38–3.29; p =
0.001)) independently predicted a raised f-Hb in patients with no pathology
found at colonoscopy. Conclusions An elevated f-Hb is independently associated with older age, deprivation,
anticoagulants, rectal bleeding, advanced adenoma, non-advanced polyps and
IBD in symptomatic patients. Deprivation is associated with a raised f-Hb in
the absence of pathology. This must be considered when utilising FIT in
symptomatic patients.
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Affiliation(s)
- Mark S Johnstone
- Academic Unit of Surgery, School of Medicine, 3526University of Glasgow, Glasgow, UK
| | - Gillian Miller
- Academic Unit of Surgery, School of Medicine, 3526University of Glasgow, Glasgow, UK
| | - Grace Pang
- Academic Unit of Surgery, School of Medicine, 3526University of Glasgow, Glasgow, UK
| | - Paul Burton
- eHealth, Corporate Services, Business Intelligence, NHS Greater Glasgow and Clyde, Glasgow, UK
| | - Georgios Kourounis
- Academic Unit of Surgery, School of Medicine, 3526University of Glasgow, Glasgow, UK
| | - Jack Winter
- Department of Gastroenterology, 59736Glasgow Royal Infirmary, NHS Greater Glasgow and Clyde, Glasgow, UK
| | - Emilia Crighton
- Public Health, Health Service, Public Health Screening, NHS Greater Glasgow and Clyde, Glasgow, UK
| | - David Mansouri
- Department of Coloproctology, 59736Glasgow Royal Infirmary, NHS Greater Glasgow and Clyde, Glasgow, UK
| | - Paul Witherspoon
- Department of Colorectal Surgery, 427872Queen Elizabeth University Hospital, NHS Greater Glasgow and Clyde, Glasgow, UK
| | - Karen Smith
- Department of Clinical Biochemistry, 59736Glasgow Royal Infirmary, NHS Greater Glasgow and Clyde, Glasgow, UK
| | - Stephen T McSorley
- Academic Unit of Surgery, School of Medicine, 3526University of Glasgow, Glasgow, UK
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Nguyen AQ, Dela Cruz JAD, Sun Y, Holmes TC, Xu X. Genetic cell targeting uncovers specific neuronal types and distinct subregions in the bed nucleus of the stria terminalis. J Comp Neurol 2016; 524:2379-99. [PMID: 26718312 DOI: 10.1002/cne.23954] [Citation(s) in RCA: 42] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2015] [Revised: 12/23/2015] [Accepted: 12/28/2015] [Indexed: 12/27/2022]
Abstract
The bed nucleus of the stria terminalis (BNST) plays an important role in fear, stress, and anxiety. It contains a collection of subnuclei delineated by gross cytoarchitecture features; however, there has yet to be a systematic examination of specific BNST neuronal types and their associated neurochemical makeup. The present study focuses on improved characterization of the anterior BNST based on differing molecular and chemical expression aided by mouse genetics. Specific Cre driver lines crossed with a fluorescent reporter line were used for genetic cell targeting and immunochemical staining. Using this new approach, we were able to robustly identify specific excitatory and inhibitory cell types in the BNST. The presence and distribution of excitatory neurons were firmly established; glutamatergic neurons in the anterior BNST accounted for about 14% and 31% of dorsal and ventral BNST cells, respectively. GABAergic neurons expressing different isoforms of glutamic acid decarboxylase were found to have differential subregional distributions. Almost no parvalbumin-expressing cells were found in the BNST, while somatostatin-expressing cells and calretinin-expressing cells account for modest proportions of BNST cells. In addition, vasoactive intestinal peptide-expressing axonal plexuses were prominent in the oval and juxtacapsular subregions. In addition, we discovered that corticotropin-releasing hormone-expressing cells contain GABAergic and glutamatergic subpopulations. Together, this study reveals new information on excitatory and inhibitory neurons in the BNST, which will facilitate genetic dissection and functional studies of BNST subregions. J. Comp. Neurol. 524:2379-2399, 2016. © 2016 Wiley Periodicals, Inc.
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Affiliation(s)
- Amanda Q Nguyen
- Department of Anatomy and Neurobiology, School of Medicine, University of California, Irvine, California, USA
| | - Julie A D Dela Cruz
- Department of Anatomy and Neurobiology, School of Medicine, University of California, Irvine, California, USA
| | - Yanjun Sun
- Department of Anatomy and Neurobiology, School of Medicine, University of California, Irvine, California, USA
| | - Todd C Holmes
- Department of Physiology and Biophysics, School of Medicine, University of California, Irvine, California, USA
| | - Xiangmin Xu
- Department of Anatomy and Neurobiology, School of Medicine, University of California, Irvine, California, USA.,Department of Biomedical Engineering, University of California, Irvine, California, USA.,Department of Microbiology and Molecular Genetics, University of California, Irvine, California, USA
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Elsafi SH, Alqahtani NI, Zakary NY, Al Zahrani EM. The sensitivity, specificity, predictive values, and likelihood ratios of fecal occult blood test for the detection of colorectal cancer in hospital settings. Clin Exp Gastroenterol 2015; 8:279-84. [PMID: 26392783 PMCID: PMC4573202 DOI: 10.2147/ceg.s86419] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
Objectives To study the performance of a single test using two fecal occult blood tests with colonoscopy for the detection of colorectal cancer (CRC) for the first time in Saudi Arabia to determine possible implications for the anticipated colorectal screening program. Materials and methods We compared the performance of guaiac and immunochemical fecal occult blood tests for the detection of CRC among patients of 50–74 years old attending two hospitals in the Eastern Region of Saudi Arabia. Samples of feces were collected from 257 asymptomatic patients and 20 cases of confirmed CRC, and they were tested simultaneously by the guaiac-based occult blood test and monoclonal antibody-based immunoassay kit. Colonoscopy was performed on all participants and the results were statistically analyzed with both positive and negative occult blood tests of both methods. Results Of the 277 subjects, 79 tested positive for occult blood with at least one method. Overall, the number of those with an occult blood-positive result by both tests was 39 (14.1%), while for 198 (71.5%), both tests were negative (P<0.0001); 40 (14.4%) samples showed a discrepant result. Colonoscopy data were obtained for all 277 patients. A total of three invasive cancers were detected among the screening group. Of the three, the guaiac test detected two cases, while the immunochemical test detected three of them. Of the 20 control cases, the guaiac test detected 13 CRC cases (P=0.03), while the immunochemical test detected 16 of them (P<0.0001). The sensitivity of guaiac and immunochemical tests for the detection of CRC in the screening group was 50.00% (95% confidence interval [CI] =6.76–93.24) and 75.00% (95% CI =19.41–99.37), respectively. For comparison, the sensitivity of the guaiac fecal occult blood test for detecting CRC among the control group was 65.00% (95% CI =40.78–84.61) while that of FIT was 80.00% (95% CI =56.34–94.27). The specificity of the guaiac and immunoassay tests was 77.87% (95% CI =72.24–82.83) and 90.12% (95% CI =85.76–93.50), respectively. The positive likelihood ratio of guaiac and immunochemical tests for the detection of CRC was 2.26 (95% CI =0.83–6.18) and 7.59 (95% CI =3.86–14.94), whereas the negative likelihood ratio was 0.64 (95% CI =0.24–1.71) and 0.28 (95% CI =0.05–1.52), respectively. The positive predictive values of guaiac and immunochemical tests were 3.45% (95% CI =0.426–11.91) and 10.71% (95% CI =2.27–28.23), respectively. There was no marked difference in the negative predictive values for both methods. The sensitivity of the fecal occult blood test by FIT was significantly higher for stages III and IV colorectal cancer than for stages I and II (P=0.01) and it was insignificant for the guaiac fecal occult blood test (P=0.07). Conclusion In areas where other advance screening methods of CRC are not feasible, the use of FIT can be considered.
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Affiliation(s)
- Salah H Elsafi
- Clinical Laboratory Science Department, Prince Sultan Military College of Health Sciences, Dhahran, Kingdom of Saudi Arabia
| | - Norah I Alqahtani
- Clinical Laboratory Science Department, Prince Sultan Military College of Health Sciences, Dhahran, Kingdom of Saudi Arabia
| | - Nawaf Y Zakary
- Gastroenterology and Endoscopy Unit, Internal Medicine Department, King Fahd Military Medical Complex, Dhahran, Kingdom of Saudi Arabia
| | - Eidan M Al Zahrani
- Prince Sultan Military College of Heath Sciences, Dhahran, Kingdom of Saudi Arabia
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San Antonio A, Liban K, Ikrar T, Tsyganovskiy E, Xu X. Distinct physiological and developmental properties of hippocampal CA2 subfield revealed by using anti-Purkinje cell protein 4 (PCP4) immunostaining. J Comp Neurol 2014; 522:1333-54. [PMID: 24166578 PMCID: PMC4001794 DOI: 10.1002/cne.23486] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2013] [Revised: 10/14/2013] [Accepted: 10/15/2013] [Indexed: 12/04/2022]
Abstract
The hippocampal CA2 subfield was initially identified by Lorente de Nó as an anatomically distinct region based on its cytoarchitectural features. Although there is an enormous body of literature on other hippocampal subfields (CA1 and CA3), relatively little is known about the physiological and developmental properties of CA2. Here we report identification of the CA2 region in the mouse by immunostaining with a Purkinje cell protein 4 (PCP4) antibody, which effectively delineates CA3/CA2 and CA2/CA1 borders and agrees well with previous cytoarchitectural definitions of CA2. The PCP4 immunostaining–delineated CA2 neurons have distinguishable differences in cell morphology, physiology, and synaptic circuit connections compared with distal CA3 and proximal CA1 regions. The average somatic sizes of excitatory cells differ across CA1–3, with the smallest to largest somatic size being CA1<CA2<CA3. CA2 excitatory cells have dense dendritic spines, but do not have thorny excrescences associated with bordering CA3 neurons. Photostimulation functional circuit mapping shows that CA2 excitatory neurons receives extensive synaptic input from CA3, but no detectable input from the dentate gyrus. CA2 excitatory cells also differ significantly from CA3 cells in intrinsic electrophysiological parameters, such as membrane capacitance and spiking rates. Although CA2 neurons differ from CA1 neurons for PCP4 and other marker expressions, these neurons have less distinct neurophysiological and morphological properties. Developmental examination revealed that PCP4 immunostaining first appears at postnatal day 4–5 and becomes successively more refined around CA2 until reaching adult form by postnatal day 21. J. Comp. Neurol. J. Comp. Neurol. 522:1333–1354, 2014. © 2013 Wiley Periodicals, Inc.
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Affiliation(s)
- Andrew San Antonio
- Department of Anatomy and Neurobiology, School of Medicine, University of California, Irvine, California, 92697-1275
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Major D, Bryant H, Delaney M, Fekete S, Gentile L, Harrison M, Mai V, Nicholson E, Taylor Y. Colorectal cancer screening in Canada: results from the first round of screening for five provincial programs. ACTA ACUST UNITED AC 2013; 20:252-7. [PMID: 24155629 DOI: 10.3747/co.20.1646] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
BACKGROUND Early implementation of programmatic colorectal cancer (crc) screening for average-risk individuals 50-74 years of age in Canada has used fecal occult blood tests [fts (guaiac or immunochemical)] and colonoscopy for follow-up of abnormal fts. This paper presents results of an evaluation of this crc screening. METHODS Five Canadian provincial programs provided aggregated data for individuals with a first-round ft processed between January 1, 2009, and December 31, 2011. RESULTS The 104,750 people who successfully completed a first round of screening represented 16.1% of those who had access to the programs between January 1, 2009, and December 31, 2011 (mean age: 61.2 years; men: 61.4 years; women: 61.1 years). Of those participants, 4661 had an abnormal ft (4.4%). Uptake of colonoscopy within 180 days after an abnormal ft was 80.5%, ranging from 67.8% to 89.5% by program. The positive predictive value (ppv) for adenoma was 35.9% for guaiac ft and 50.6% for immunochemical ft. Adenoma and crc detection rates were, respectively, 16.9 and 1.8 per 1000 screened. Of invasive crcs detected, 64.6% were stage i or ii. CONCLUSIONS Considering the variation in characteristics and stage of implementation of each provincial program, the collaboration of the provinces leading to this report on the early performance of crc screening in Canada is a major milestone. Targets are met or nearly met for significant indicators such as ppv for adenoma and cancer detection rate. Participation is expected to increase as programs are fully implemented in the provinces. Additional effort may be needed to improve timely access to follow-up colonoscopy.
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Affiliation(s)
- D Major
- Screening and Early Detection Portfolio, Canadian Partnership Against Cancer, Toronto, ON
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