Articles: guaiac.
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Eur. J. Cancer Prev. · Dec 1995
Comparative StudyEvaluation and comparison of an immunochemical and a guaiac faecal occult blood screening test for colorectal neoplasia.
Guaiac tests for faecal occult blood are used for colorectal neoplasia screening. Specificity may be improved by using an immunochemical test for human blood. We evaluated and compared, within an endoscopic study, an immunochemical test for human stool albumin, BM-Test Colon Albumin, with the guaiac test, Hemoccult SENSA. ⋯ Overall, the guaiac test is more sensitive but less specific than the immunochemical test for colorectal neoplasia. However, the technical and diagnostic limitations of these tests must be appreciated, and because of their high positivity rate neither is suitable for mass screening. A more specific test for neoplasia is needed.
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A stool guaiac test is often performed on newly hospitalized patients as part of the admission evaluation. However, little is known regarding the value of testing stool obtained by digital rectal examination. We sought to document the use of the admission stool guaiac test in a teaching hospital, to determine its diagnostic yield, and to assess its potential benefit to patients. ⋯ Like other commonly applied diagnostic tests, the stool guaiac test obtained during the admission physical examination is best reserved for patients whose clinical presentation provides a reason for testing. In patients without clinical indications, the test is of uncertain value and only infrequently leads to important diagnoses.
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Rectal examination with guaiac testing is a standard part of the emergency department evaluation of acutely traumatized patients. Its major role is in the recognition of occult bowel injury. We questioned its efficacy in detecting occult rectal injury in patients with penetrating trauma. ⋯ Sensitivity was 100% (8/8) when the two were combined. Our findings suggest that guaiac testing is not accurate enough to rule out the presence of occult rectal injury. The result of guaiac testing must not influence the decision to further evaluate patients with high-risk injuries.
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Comparative Study
New screening method for occult gastrointestinal bleeding: immunologic and guaiac slide tests.
A valid mass screening method for occult, bleeding gastrointestinal pathology including colorectal cancer should be monospecific for human hemoglobin, sensitive for approximately 3 mg of human blood per 1 g of stool, capable of differentiating upper and lower gastrointestinal bleeding, cost effective, uncomplicated, and acceptable to patients. Hemoccult II, a guaiac peroxidase detection test, is nonspecific for human blood and cannot differentiate between upper and lower gastrointestinal bleeding. ⋯ The findings of this study indicate that the immunologic test may remedy the deficiencies of the guaiac test. The concomitant use of the immunologic and appropriately sensitive guaiac test appears to fulfill screening test requisites.
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Two guaiac slide tests (Hemoccult and Fe-Cult) were evaluated for their ability to detect blood in gastric juice and other fluid mixtures relevant to clinical testing in upper gastrointestinal hemorrhage. Blood was added to these fluid mixtures in various amounts sufficient to yield concentrations from 20 microL blood/dL to 4000 microL/dL. ⋯ In contrast, blood in gastric juice obtained from subjects previously given intravenous cimetidine tested positive at concentrations as low as 50 microL/dL. The ability of both test agents to detect blood in gastric juice was considerably enhanced by neutralizing gastric juice with 0.1 N NaOH.