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The People Who Helped You Change Your Life is a personal account of the most inspiring people I’ve ever met, and all of the subsequent changes that I have made in my life to the point where I feel…
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The people who made the change were elected based on their ability and experience, but were also chosen because, in the person of Joel Fluegel, they immediately began to embrace this new vision and make it happen. This new…A critical appraisal of the predictive value of C-reactive protein (CRP) in diagnosis of recent streptococcal pharyngitis.
A two-year multicenter trial evaluated the value of the acute-phase reactant C-reactive protein (CRP) to diagnose recent streptococcal pharyngitis, in patients with tonsillar swelling. A total of 527 patients presenting with tonsillar swelling were enrolled into the trial and underwent culture of the tonsillar and submandibular pharynx swabs. A diagnosis of recent streptococcal pharyngitis was made on the basis of the presence of streptococci on culture of the pharynx. Since an increased CRP level also occurs in a broad spectrum of infections and autoimmune disorders, the diagnostic accuracy of the CRP test (cut-off limit 20 mg/L) was also assessed by comparison with a proven diagnosis of acute tonsillitis. Overall, a total of 522 patients (993 tonsillar swabs) were enrolled into the study. Of these patients, 88.2% (456/522) were diagnosed with acute tonsillitis. For the prediction of recent streptococcal pharyngitis, a CRP level > or =20 mg/L yielded a sensitivity of 77% and a specificity of 85.6% (positive predictive value 73.2%; negative predictive value 86.4%). The likelihood ratios (LR+ and LR-) were 2.9 and 0.3, respectively. In the presence of tonsillar swelling, a CRP level of > or =20 mg/L showed a sensitivity of 78.7%, a specificity of 63.8%, a positive predictive value of 70.4%, and a
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