Comparism of Microscopy and Molecular Diagnosis of Ehrlichia ruminantiumin Cattles in Makurdi Benue Nigeria

Introduction:Makurdi, is the capital city of Benue State, the food basket of the Nigeria, the city challenged withEhrlichia ruminantiumof cattlethatare responsible for severe losses caused either by negative impact of ticks blood loss or blood related infections, damage to hides and others. Aim:This study was designed to identify and Characterize Ehrlichia ruminantiumof Cattle within Makurdi Nigeria using microscopy and molecular techniques (PCR). Methodology:Blood sample were collected from a total of 432 cattle of both sexes and analyzed microscopically using thin blood film and DNA examination was done using polymerase chain reaction (PCR). Tick-borne pathogens were identified and characterized by PCR amplification using species specific primer of 16s rRNA for Ehrlichia. Data obtained were analyzed using chi square, t-test and P values at less than 0.05 were considered significantly different.Results:The result of comparison of prevalence of infection of haeomoparasite using microscopy and PCR revealed that, microscopy was not able to detect Ehrlichiawhile PCR yielded at percentage of 15%, Ehrlichiaprevalence. The percentage of prevalence ofhaemoparasite was highly detected by PCR than microscopy and this was statistically significant (P < 0.05). Conclusion:Ehrlichia ruminantiumin cattle have been seen to be prevalent in Makurdi metropolis and molecular method such as PCR can effectively diagnose the infection.

Clasificación y métodos de diagnóstico de las membranopatías / Classification and diagnostic methods of membranopathies

Introducción: Las membranopatías son anemias hemolíticas hereditarias debidas a anomalías cualitativas o deficiencias cuantitativas de las proteínas del citoesqueleto del glóbulo rojo. Objetivo: Actualizar el diagnóstico de las membranopatías con la inclusión de las últimas recomendaciones del comité de grupos de expertos a nivel nacional e internacional. Métodos: Se realizó una revisión de la literatura en inglés y español, a través del sitio web PubMed y el motor de búsqueda Google académico, de artículos publicados en los últimos cinco años. Análisis y síntesis de la información: Las enfermedades de mayor interés clínico son: la esferocitosis, la eliptocitosis y la estomatocitosis hereditaria. Estas en general se heredan con carácter autosómico dominante pero existen formas que se transmiten con carácter recesivo, sin descartar posible mutación de novo. Para su diagnóstico se utilizan pruebas que incluyen el estudio de la morfología de los glóbulos rojos, la fragilidad osmótica, la lisis de glicerol acidificado, la criohemólisis hipertónica, la prueba de unión a la eosina-5'-maleimida por citometría de flujo, la electroforesis en gel de poliacrilamida con dodecilsulfato sódico y la ectacitometría. Conclusiones: Las membranopatías pueden sospecharse de manera preliminar teniendo en cuenta algunas alteraciones de la morfología eritrocitaria, aunque el diagnóstico se basa en estudios familiares y otros de carácter confirmatorio de la enfermedad, como los estudios moleculares. Los profesionales de la salud que atienden a pacientes jóvenes con anemia deben considerar la posibilidad de una anemia hemolítica por trastornos de la membrana eritrocitaria(AU)

ABSTRACT Introduction: Membranopathies are inherited hemolytic anemias due to qualitative abnormalities or quantitative deficiencies of red blood cell cytoskeletal proteins. Objective: to update the diagnosis of membranopathies with the inclusion of the latest recommendations from the committee of expert groups at the national and international level. Methods: A review of the literature in English and Spanish was carried out, through the PubMed website and the academic search engine Google, in articles published in the last five years. Analysis and synthesis of information: The diseases of greatest clinical interest are: spherocytocis, elliptocytosis and hereditary stomatocytosis. These are generally inherited with an autosomal dominant character but there are forms that are transmitted recessively, without ruling out a possible de novo mutation. For its diagnosis, tests are used that include the study of red blood cell morphology, osmotic fragility, acidified glycerol lysis, hypertonic cryohemolysis, eosin-5'-maleimide binding test by flow cytometry, sodium dodecyl sulfate polyacrylamide gel electrophoresis and ectacytometry. Conclusions: Membranopathies can be preliminarily suspected taking into account some alterations in erythrocyte morphology, although the diagnosis is based on family studies and others confirming the disease, such as molecular studies. Healthcare professionals caring for young patients with anemia should consider the possibility of hemolytic anemia due to red cell membrane disorders(AU)

The constitution rule of TCM syndromes of diabetic peripheral neuropathy with real world data mining / 国际中医中药杂志

Objective:To annalyze the constitution rule and pathogenesis of Diabetic Peripheral Neuropathy (DPN) by data mining technology, so as to provide a theoretical reference for improving the therapeutic effect of TCM on treating DPN.Methods:343 cases of DPN patients dianosed with four TCM diagostic methods chosen from the Department of Endocrinology of Affiliated Hospital of Traditional Chinese Medicine of Guangzhou Medical University from January 2016 to January 2020 were collected. Statistical analysis software was used to conduct frequency analysis, correlation analysis and cluster analysis, and explained with TCM theory.Results:Among the 343 cases, 143 cases were male and 200 cases were female; Symptoms such as limb numbness, thirst, dry mouth, frequent urination at night, limb pain and so on occur more frequently; The main tongue images include thin white tongue, dark and red tongue or light red tongue; the main pulse conditions include string, fine and deep pulse. Numbness, thirst, dry mouth, thin and white fur, frequent nocturia and so on were closely related with other diseases. Four types of syndrome can be recombined by cluster analysis, which are blood stasis obstructing collaterals syndrome; kidney deficiency and blood stasis syndrome; stomach heat injuring Yin syndrome; spleen deficiency and phlegm dampness syndrome; heat toxin accumulation and syndrome of lingering pathogen due to deficient vital qi.Conclusion:The root of the disease is Yin deficiency with dry heat as the sympotom. Blood stasis runs through the whole process of the disease. The function of spleen and stomach should not be ignored in treatment.

An accurate analysis of the viral pathogen test results in children with acute respiratory tract infection / 中华实用儿科临床杂志

Acute viral respiratory tract infections among children have caused a substantial health burden worldwide.Early, rapid, and accurate diagnosis of viral etiologies is of great significance to optimal treatment, prevention of viral outbreaks and unnecessary use of antibiotics, and a favorable prognosis.At present, there are numerous laboratory diagnostic methods.It is urgent to correctly analyze the viral pathogen test results in children with acute respiratory tract infection using optimal methods.This review summarizes the diagnostic methods currently in use or soon to be applied in clinical practice and their interpretations of clinical reports, aiming to improve the understanding of the pathogenic results of respiratory viruses.

Acute endometritis induced by Escherichia coli in mares evaluated through color doppler ultrasonography / [Endometrite aguda induzida por Escherichia coli em éguas avaliadas por ultrassonografia com Doppler colorido]

The objectives of this study were to characterize the endometritis induced in mares using color Doppler ultrasonography and traditional exams. Experiment 1. Mares (n=20) were submitted to intrauterine inoculation with Escherichia coli. Uterine evaluation was performed at M0 and M1. Experiment 2. Animals were divided into two groups: control group (n=10), and treated group (n=10) using phytotherapeutic solution. In both groups, the uterine evaluation was performed at time T1, T2, and T3. Experiment 3: Uterine evaluation was compared after antibiotic therapy, phytotherapy, and M0. For statistical analysis, the Tukey test, t Student, and Anova test were applied. Experiment 1. The mean values of vascularization at M1 were significantly higher than those obtained at M0 (P<0.05). Bacterial growth was observed in all samples collected. Experiment 2. The mean value of vascularization at time T1 in both groups was significantly higher (P<0.05) compared to M2 and M3. Experiment 3. After antibiotic therapy, the vascularization of the body and uterine horns was not equivalent to the vascularization presented at M0. We can conclude that it was not possible to correlate results obtained by color Doppler ultrasonography with the traditional findings for the diagnosis of endometritis.(AU)

Os objetivos deste estudo foram caracterizar a endometrite induzida em éguas utilizando-se a ultrassonografia com Doppler colorido e exames tradicionais. Experimento 1: as éguas (n=20) foram submetidas à inoculação intrauterina com Escherichia coli. A avaliação uterina foi realizada em M0 e M1. Experimento 2: os animais foram divididos em dois grupos: grupo controle (n=10) e grupo tratado (n=10), sendo usada solução fitoterápica. Nos dois grupos, a avaliação uterina ocorreu nos momentos T1, T2 e T3. Experimento 3: a avaliação uterina foi comparada após antibioticoterapia, fitoterapia e M0. Para análise estatística, foram aplicados os testes de Tukey, t de Student e ANOVA. Experimento 1: os valores médios de vascularização em M1 foram significativamente maiores que os obtidos no M0 (P<0,05). Houve crescimento bacteriano em todas as amostras coletadas. Experimento 2: o valor médio da vascularização no tempo T1 nos dois grupos foi significativamente maior (P<0,05) do que o obtido em M2 e M3. Experimento 3: após antibioticoterapia, a vascularização do corpo e dos cornos uterinos não era equivalente à vascularização apresentada em M0. Pode-se concluir que não foi possível correlacionar os resultados obtidos pela ultrassonografia com Doppler colorido com os achados tradicionais para o diagnóstico de endometrite.(AU)

Investigation of Chagas disease within the same family: case study / Investigação da doença de Chagas em um mesmo núcleo familiar: estudo de caso

ABSTRACT Chagas disease (CD) is a neglected endemic disease. Its classic form of transmission occurs through hematophagous triatomine insects. Its classic form of transmission occurs through hematophagous triatomine insects. There are cases of the disease in non-endemic regions that occur through alternative transmissions, as this possibility also exists. The aim of this study was to report a case among members of a same family (born and resident in Taquarituba, São Paulo, Brazil) diagnosed with CD. The family matriarch lived in a mud house in the countryside and reported contact with the triatomine during childhood. Two grown-up children are also seroreactive; both reported not having contact with the insect as children. Medical record analyzes and new laboratory tests were performed. Clinical history and recent tests have confirmed positivity for CD in the matriarch and her grown-up children. Parasitological techniques have shown negative results, evidencing that they are in the chronic form of the disease. Congenital transmission may have occurred between them, as well as the possibility of vector transmission by secondary species cannot be ruled out, since the patients come from a municipality considered endemic for CD in the past.

RESUMEN La enfermedadde Chagas (EC) es una infección endémica que ha sido descuidada. Su forma clásica de transmisión ocurre mediante insectos triatominos hematófagos. Hay casos de la enfermedad en regiones no endémicas que ocurrieron por vías alternativas de transmisión, puesto que también hay esa posibilidad. El objetivo de este estudio fue reportar un caso de miembros de una misma familia diagnosticados con EC. La matriarca de la familia vivía en una casa hecha de barro en la zona ruraly reportó contacto con el triatomino en su infancia. Dos hijosson también sero-reactivos, pero no reportaron contacto con el insecto cuando eran ninos. Se hicieron análisis de historial médico y nuevaspruebas de laboratorio. El histórico clínico y laspruebas recientes confirmaran la positividad para EC, tanto en la madre como en los hijos. Las técnicasparasitológicas demostraron resultados negativos, comprobando la forma crónica de la enfermedad. Transmisión congénitapuede haber ocurrido entre ellos, así como no se puede descartar la posibilidad de ocurrencia de transmisión vectorial por especies secundarias, ya que los pacientes proceden de un municipio que fue considerado endémico para EC en el pasado.

RESUMO A doença de Chagas (DC) é uma enfermidade endêmica negligenciada. Sua forma clássica de transmissão ocorre por meio de insetos triatomíneos hematófagos. Há casos da doença em regiões não endêmicas ocorridos por transmissões alternativas, uma vez que também existe essa possibilidade. O objetivo deste estudo foi relatar um caso de membros da mesma família (natural e residente em Taquarituba, São Paulo, Brasil) diagnosticados com DC. A matriarca da família morava em uma casa de barro na zona rural e relatou contato com o triatomíneo na infância. Dois filhos também são sororreagentes; ambos relataram não terem tido contato com o inseto quando crianças. Análises de prontuário e novos testes laboratoriais foram feitos. O histórico clínico e os recentes exames confirmaram a positividade para DC, tanto na mãe quanto nos filhos. As técnicas parasitológicas demonstraram resultados negativos, constatando forma crônica da doença. Transmissão congênita pode ter ocorrido entre eles, assim como também não se pode descartar a possibilidade de ocorrência de transmissão vetorial por espécies secundárias, visto que os pacientes são oriundos de um município considerado endêmico para DC no passado.

Efectividad de los métodos diagnósticos para la detección de ehrlichiosis monocítica humana y canina / Effectivity of diagnostic methods for the detection of human and canine monocytic ehrlichiosis

Resumen La ehrlichiosis es una enfermedad transmitida por la picadura de garrapatas que afecta a perros y humanos, causada por las especies Ehrlichia canis y E. chaffeensis, respectivamente. Estas bacterias son gramnegativas, intracelulares obligadas, de aspecto cocoide a pleomorfo, que infectan los monocitos y desencadenan síntomas como fiebre elevada, anorexia, trombocitopenia, hemorragias, anemia y problemas graves como esplenomegalia, hepatomegalia y meningitis. Para diagnosticar esta enfermedad existen diversos métodos, entre los que se encuentran los hematológicos que evalúan la morfología de los monocitos en búsqueda de mórulas y la serología, que incluye la búsqueda de anticuerpos anti-Ehrlichia, pero que se encuentra limitado debido a la reactividad cruzada que presenta. Por otra parte, el cultivo de especies de Ehrlichia ha resultado ser un método efectivo para la obtención de antígenos y así desarrollar ensayos por inmunofluorescencia indirecta (IFI). El método por reacción de polimerasa en cadena ofrece un diagnóstico definitivo por tener una mayor sensibilidad y especificidad que los otros métodos, al haberse desarrollado cebadores género-específicos, así como especie-específicos. En esta revisión, se discutirán los diversos métodos aplicados al diagnóstico de esta enfermedad, así como las ventajas y desventajas que estos presentan.

Ehrlichiosis is a disease transmitted by tick's bite that affect dogs and humans caused by the species Ehrlichia canis and E. chaffeensis, respectively. These bacteria are obligated intracellular gram negatives, with a cocoid to pleomorph aspect and can infect monocytes and trigger symptoms such as high fever, anorexia, thrombocytopenia, hemorrhages, anemia, and some serious problems such as splenomegaly, hepatomegaly and meningitis. There are several diagnostic tests for ehrlichiosis such as the hematological ones that evaluate the morphology of the monocytes in search of morulae; serological tests that includes the search of anti-Ehrlichia antibodies, although they might be limited due to cross reaction with other species. In other hand, the culture of Ehrlichia species is an effective method to obtain antigens and even develop indirect immunofluorescence assays (IFA). The polymerase chain reaction offers a definitive diagnosis associated to the use of genus-specific and species-specific primers, as well as its increased sensibility and specificity, compared to the others methods. Thus, in this review, we will discuss various methods applied to the diagnosis of this disease, as well as the advantages and disadvantages that these present.

Loop-mediated Isothermal Amplification LAMP, Simple Alternative Technique of Molecular Diagnosis Process in Medicals Analysis: A Review

The Medical diagnostic process requires more various methods to cover all sorts of clinical demands. Those methods depend on the types of samples and the requested analysis. The Medical diagnostic is considered as a process until making a clinical decision about a physiopathology or infection through medicals analysis. Nucleic acid amplification methods continue to play a role in these medicals analysis processes, but, many gold conventional standard Methods are time-consumers, less sensitive, technically challenging. It is that reason why recently, after the development of the PCR technique; the real-time PCR became a frequently requested tool to diagnose the virus, bacteria, fungal and parasites infections in different pathologies, especially in developed countries. However, its availability remains a big problem in resource-limited countries like Africa continent. It is because of the issue due to cost, technology, human resource constraints and the remote areas with limited access to laboratory facilities which stays also a major problem. Nucleic acids amplification methods remain to be expensive, not accessible for all laboratories. In addition to this, they are easily inhibited and contaminated by the other biochemical reagents time-consumer, for this reason, other methods of nucleic acid amplification under isothermal conditions have emerged each with its particularities. Despite their successes, molecular biology should have a method that combines many of the advantages and accessible everywhere. So, in 2000, the LAMP method was developed and offered many advantages such as speed, specificity, high sensitivity and the cost of very low equipment. In this review, we present the different studies to confirm the advantages of LAMP that we consider as an alternative to PCR in molecular diagnostics with a wide range of use on clinical samples and in scientific research and also, the method to save the Africans patients from the high cost and time consuming of other amplification methods.

Progress and problems in diagnosis of tuberculosis in children / 中华实用儿科临床杂志

Tuberculosis (TB) is a serious threat to children′s health.The world health organization (WHO) reported that there were almost 1 million TB patients and 230 000 deaths among children globally in 2017.In order to control the prevalence of childhood TB, WHO put forward a blueprint of " towards zero death for childhood TB" . However, due to the difficulty in obtaining specimens, the lack of typical symptoms and the insufficient of existing diagnostic methods for children, it is hard to achieve the goal of zero death.The summary of the TB diagnosis status will promote to solve the current problems in children.

Progress and problems in diagnosis of tuberculosis in children / 中华实用儿科临床杂志

Tuberculosis (TB) is a serious threat to children's health.The world health organization (WHO) reported that there were almost 1 million TB patients and 230 000 deaths among children globally in 2017.In order to control the prevalence of childhood TB,WHO put forward a blueprint of "towards zero death for childhood TB".However,due to the difficulty in obtaining specimens,the lack of typical symptoms and the insufficient of existing diagnostic methods for children,it is hard to achieve the goal of zero death.The summary of the TB diagnosis status will promote to solve the current problems in children.

Identifying the Diagnostic Method of Children›s Illness in the Sutra of “Ngo mtshardga› stongtermdzod” / Монголын Анагаах Ухаан

@#Choijamts,the Buddhist image-maker and gelon of the Niislel Khuree (Capital Camp), lived during the last period of the 19th and early 20th centuries. He wrote a book “Gsorig zhungmangbsduspa›ibdudrtsi›isnyingpotshagrangzug rnguselba›ingomtshardga› stongtermdzodzhesbyababzhugs so” in short ngomtshardga› stongtermdzod. This is the comprehensive book about Traditional Mongolian medicine in Tibetan language and written by Mongolian scholar. In his book, the general diagnostic methods of traditional medicine consists of 3 parts: interrogation, pulse diagnosis, and analyzing patient’s urine. The diagnostic method in pediatrics in traditional medicine is based on the general method but different in some ways in consistence with the classification of diseases in children. For instance, there are 3 diagnostic methods in “Ngo mtshardga› stongtermdzod” are as follows:</br> 1. Inquire the symptoms of children from parents and examine the children’s faces</br> 2. Research the method of examining ear veins, identify its scientific nature, and open up possibility to use it in training</br> 3. Define the content and characteristics of methods of examining hot and cold quality of child’s ear by touching, and checking color and shape of veins and include these in curriculum of universities that offers traditional medicine program.</br> There are a number of interesting approaches to the diagnostic of children›s illnesses in the scope of the Sutra of “Ngo mtshardga› stongtermdzod”. In the future, there is a need for detailed study of each of these methods and input it into the curriculum,and teaching for medical students are essential.

Comparison of methodologies for detecting Trypanosoma cruzi parasites by microscopic observation of microhematocrit capillary tubes

Abstract INTRODUCTION: The microscopic examination of microhematocrit tubes (mHCT) has been proposed as the gold standard for acute and congenital Chagas disease diagnosis. We compared different mHCT methodologies detecting T. cruzi parasites in the blood. METHODS: The rotating method, water mount, and immersion oil methods were compared for their suitability, sensitivity, and specificity. RESULTS: The rotating method was easier, faster, and more sensitive than the others with 100% specificity. CONCLUSIONS: The rotating method is feasible for laboratory technicians with standard training in microscopic techniques and is recommended for the diagnosis of acute Chagas disease in primary health care facilities.

Abordagem das técnicas diagnósticas da DTM como uma doença biopsicossocial: uma revisão de literatura / Approach of diagnostic techniques of the DTM as a biopsychosocial disease: a literature review

Introdução: A disfunção temporomandibular (DTM) consiste em um conjunto de condições musculoesqueléticas e neuromusculares que envolve o complexo articular temporomandibular, a musculatura e os componentes ósseos adjacentes. Sua etiologia inclui múltiplos fatores desencadeantes biológicos, ambientais, emocionais, sociais e cognitivos. Objetivo: O trabalho objetivou realizar uma revisão de literatura a respeito dos métodos de diagnóstico englobando uma visão biopsicossocial da DTM. Materiais e Métodos: Constituise em uma busca bibliográfica realizada em uma respeitada base de pesquisa online para a produção do conhecimento em saúde: PubMed ­ U.S. National Library of Medicin, limitando-se a busca ao período de 2005 a 2019. Resultados: Devido a diversidade etiológica e características clínicas variadas, a análise biopsicossocial individualizada associada à exames imaginológicos surge como uma relevante ferramenta para o diagnóstico desse distúrbio. Conclusão: Uma abordagem de diagnóstico com base em um modelo de doença biopsicossocial é fundamental para que seja possível avaliar o paciente em toda a sua integralidade física, psicológica e social com o propósito de efetivar o planejamento de intervenções preventivas e terapêuticas sob medida para cada caso clínico.

Introduction: Temporomandibular dysfunction (TMD) consists of a set of musculoskeletal and neuromuscular conditions that involve the temporomandibular joint complex, the musculature and the adjacent bone components. Its etiology includes multiple biological, environmental, emotional, social and cognitive triggers. Objective: This study aimed to perform a literature review on diagnostic methods encompassing a biopsychosocial view of TMD. Materials and Methods: This study is a bibliographic search conducted in a respected online research base to produce health knowledge: PubMed - US National Library of Medicine, limiting the search to the period from 2005 to 2019. Results: Due to etiological diversity and varied clinical characteristics, individualized biopsychosocial analysis associated with imaging exams is a relevant tool for the diagnosis of this disorder. Conclusion: A diagnostic approach based on a biopsychosocial disease model is essential to assess the patient in all their physical, psychological and social completeness with the purpose of planning preventive and therapeutic interventions tailored to each case. clinical.

Prevalência de sarcopenia na Doença Pulmonar Obstrutiva Crônica: revisão sistemática / Prevalência de sarcopenia na Doença Pulmonar Obstrutiva Crônica: revisão sistemática Prevalence of sarcopenia in Chronic Obstructive Pulmonary Disease: systematic review

INTRODUÇÃO: DPOC está associada a um processo inflamatório sistêmico que pode causar sarcopenia, redução da função e massa muscular, embora sua frequência e intensidade não seja completamente conhecida em portadores dessa enfermidade. OBJETIVO: descrever a prevalência e métodos de identificação da sarcopenia na DPOC através de uma revisão sistemática. MATERIAIS E MÉTODOS: Revisão sistemática utilizando a metodologia PICO e palavras-chave (Chronic Obstructive Pulmonary Disease, Sarcopenia). Foram incluídos estudos publicados que estimaram a prevalência de sarcopenia na DPOC. Excluídos aqueles cujo método não detalhou o diagnóstico da sarcopenia. RESULTADOS: A pesquisa resultou inicialmente em 897 artigos. Desses, 877 foram excluídos, sendo 20 selecionados (15 transversais, cinco longitudinais, um caso/controle). As amostras variaram de 57 a 2.582 participantes, a maioria (70%) conduzida em ambulatório. Um estudo foi de base populacional. A idade média foi de 66 anos. A prevalência de sarcopenia na DPOC variou (4,4% a 86,5%). Os métodos diagnósticos utilizados para determinar massa muscular foram o Dual X-ray Absorptiometry, a bioimpedância e as equações de referência. A força muscular foi estimada utilizando-se a preensão manual em dinamômetros portáteis ou a flexão/extensão do joelho através do dinamômetro isocinético. A capacidade funcional foi avaliada pelo teste de caminhada dos seis minutos ou através do teste de velocidade da marcha. CONCLUSÃO: A prevalência de sarcopenia na DPOC encontrada nos estudos (4,4 a 86,5%) é muito variável. Influenciada não somente pela característica do paciente, mas também pelo local, delineamento e método diagnóstico utilizado. Uma padronização de métodos parece ser necessária para se uniformizar condutas na literatura. [AU]

COPD is associated with a systemic inflammatory process that can cause sarcopenia, reduced function and muscle mass, although its frequency and intensity is not completely known in patients with this disease. OBJECTIVE: To describe the prevalence and methods of identifying sarcopenia in COPD through a systematic review. METHODS AND MATERIALS: Systematic review using the PICO methodology and keywords (Chronic Obstructive Pulmonary Disease, Sarcopenia). We included published studies that estimated the prevalence of sarcopenia in COPD. Excluding those whose method did not detail the diagnosis of sarcopenia. RESULTS: The search resulted initially in 897 articles. Of these, 877 were excluded, of which 20 were selected (15 transverse, five longitudinal, one case / control). Samples ranged from 57 to 2,582 subjects, the majority (70%) conducted on an outpatient basis. One study was population-based. The mean age was 66 years. The prevalence of sarcopenia in COPD varied (4.4% to 86.5%). The diagnostic methods used to determine muscle mass were Dual X-ray Absorptiometry, bioimpedance and reference equations. Muscle strength was estimated using manual gripping on portable dynamometers or knee flexion / extension through the isokinetic dynamometer. Functional capacity was assessed by the six-minute walk test or gait speed test. CONCLUSION: The prevalence of sarcopenia in COPD found in the studies (4.4 to 86.5%) is very variable. Influenced not only by the patient's characteristic, but also by the location, design and diagnostic method used. A standardization of methods seems to be necessary to standardize conducts in the literature. [AU]

Diagnóstico de Metástasis Ováricas de un linfoma B diseminado mediante ecografía 3D / Diagnosis of Ovarian Metastases from disseminated B lymphoma using 3D ultrasound

RESUMEN La participación del aparato genitourinario en el contexto de la enfermedad hematológica maligna es bien conocida. No obstante, la afectación ovárica por linfomas es inusual, ya sea de novo o como manifestación tardía de linfoma diseminado. El objetivo de esta comunicación es exponer la aportación diagnóstica de la ecografía tridimensional (3D) en la detección de metástasis ováricas, cuando todavía algunas de las pruebas de imagen estándar como la tomografía computarizada (TAC) son normales. En este caso presentamos una paciente con linfoma B difuso de células grandes mediastínico de crecimiento rápido y diseminación precoz a aparato gastrointestinal y genitourinario.

ABSTRACT Genitourinary participation in the context of malignant hematologic disease is well known. However, ovarian involvement by lymphoma is unusual, either de novo or as late manifestation of disseminated lymphoma. The purpose of this communication is to show the diagnostic contribution of three-dimensional ultrasound (3D) in the detection of ovarian metastases, when still some of the standard imaging tests such as computed tomography (CT) are normal. Here we present a patient with primary mediastinal large B-cell lymphoma diffuse with fast growing and early dissemination to gastrointestinal and genitourinary tract.

Clinical impact and cost analysis of the use of either the Xpert MTB Rif test or sputum smear microscopy in the diagnosis of pulmonary tuberculosis in Rio de Janeiro, Brazil

Abstract INTRODUCTION: The molecular test Xpert MTB/RIF (Xpert) has been recommended for use in the diagnosis of pulmonary tuberculosis (PTB); however, data on the cost of incorporating it under routine conditions in high-burden countries are scarce. The clinical impact and costs incurred in adopting the Xpert test in routine PTB diagnosis was evaluated in a prospective study conducted from November 2012 to November of 2013, in the City of Rio de Janeiro, Brazil. METHODS: The diagnostic and therapeutic cascade for TB treatment was evaluated using Xpert in the first stage (S1), and sputum smear microscopy (SSM) in the second stage (S2). The mean costs associated with each diagnostic test were calculated including equipment, human resources, supplies, and infrastructure. RESULTS: We included 232 subjects with probable TB (S1 = 87; S2 = 145). The sensitivities of Xpert and SSM were 91.7% (22/24) and 79.1% (34/43), respectively. The median time between triage and TB treatment initiation in S1 (n = 24) was 14.5 days (IQR 8-28.0) and in S2 (n = 43) it was 8 days [interquartile range (IQR) 6-12.0]. The estimated mean costs per examination in S1 and S2 were US$24.61 and US$6.98, respectively. CONCLUSIONS: Compared with SSM, Xpert test showed a greater sensitivity, but it also had a time delay with respect to treatment initiation and a higher mean cost per examination.

Efficacy of parasitological diagnosis methods in wild animals kept in captivity / Eficácia dos métodos de diagnóstico parasitológico em animais silvestres mantidos em cativeiro

Parasitic diseases are common in wild animals kept in captivity, and the research of these parasites is a tool used in wildlife management actions. Once the method most used in the practice of veterinary laboratories is the direct examination, it was considered appropriate to report the parasitism in captivity wildlife comparing this technique with modified methods of Hoffman, Pons and Janer (HPJ) and Willis. Fresh feces were surveyed in eleven precincts with specimens of the class Reptilia, Birds and Mammalia. A positive result for the presence of parasites was observed in 81.8% of them, of which 18.2% were, 9.1% helminths and 54.6% protozoa and helminths simultaneously. The direct and HPJ methods were more specific for the identification of parasites, 72.7 and 63.6%, respectively, while the method of Willis showed less positive results (36.4%). It is concluded that the ideal routine in veterinary laboratory fecal examinations of wild animals is to use the HPJ method associated with the direct method for the detection of protozoa and/or helminths, in order to obtain more accurate results.(AU)

As enfermidades parasitárias são comumente encontradas em animais silvestres mantidos em cativeiro, e a pesquisa desses parasitas é uma ferramenta utilizada em ações de manejo de fauna. Uma vez que o método mais utilizado na prática dos laboratórios veterinários é o exame direto, diante disto, considerou-se oportuno relatar o parasitismo em silvestres de cativeiro comparando esta técnica com os métodos de Hoffman, Pons e Janer (HPJ) modificado e de Willis. Foram pesquisadas fezes frescas de onze recintos com espécimes das classes Reptilia, Aves e Mammalia, sendo que 81,8% foram positivas para a presença de parasitas em que 18,2% apresentavam protozoários em suas fezes, 9,1% helmintos e 54,6% protozoários e helmintos simultaneamente. O método direto e de HPJ foram mais específicos para identificação de parasitas, 72,7 e 63,6%, respectivamente, enquanto que o método de Willis apresentou menor positividade (36,4%). Conclui-se que o ideal na rotina laboratorial veterinária para exames coproparasitológicos de animais silvestres é a utilização do método HPJ associado ao método direto para detecção de protozoários e/ou helmintos, visando obter resultados mais precisos.(AU)

Regulating Sub-health Along Meridians And Viscera / 世界科学技术-中医药现代化

This study was aimed to observe the clinical effect of low frequency negative pressure meridian viscera regulating sub-health.According to the diagnostic criteria,34 cases of sub healthy subjects were randomly selected.The low frequency negative pressure meridian viscera regulating method was used.By analyzing the cupping spot color feedback conditioning information of the sub healthy subjects and conditioning before and after the synthesis of the four diagnostic methods of digital and quantitative,its effect was evaluated.After 4 weeks of continuous adjustment,34 cases of sub healthy subjects,compared with preconditioning,cupping spot color of the subjects was shallow or disappeared (P ＜ 0.01);after adjusting,the proportion of light red tongue and thin white tongue coating increased obviously (P ＜ 0.05),the proportion of ecchymosis tongue was decreased compared to precoditioning (P ＜ 0.05);after adjustment,core symptoms such as back pain,neck pain,anxiety and irritability,were alleviated or disappeared;after adjustment,the pulse string tightness decreased significantly (P ＜ 0.01).It was concluded that the low frequency negative pressure meridian viscera regulation can significantly improve discomfort symptoms of sub healthy subjects and promote therecovery of tongue,pulse and cupping spot color in sub healthy subjects.This method is worth popularizing and further exploring.

Clinical analysis of 258 cases of nasal-sinus benign and malignant tumors / 重庆医学

Objective To analyze the clinical features of 258 cases of nasal-sinus benign and malignant tumors to improve the accuracy of clinical diagnosis.Methods The clinical data of 258 patients with nasal-sinus tumor confirmed by pathology were retrospectively analyzed and the clinic differences between benign and malignant tumors were compared.Results The clinic manifestations of sinonasal neoplasm were varied.The incidences of epistaxis or blood in the tears,headache,facial numbness or pain,eye pain or epiphora were significantly higher in the benign tumors group than in the malignant tumors group (P＜0.05).Among 196 patients undergoing surgery,the coincidence rates of preoperative and postoperative paraffin sections were similar in the two groups (P＞0.05).Among 63 surgical patients with malignant tumors,the coincidence rate of 232 incised-margin frozen sections and postoperative paraffin sections was 98.70％ (229/232).Among 34 cases,the coincidence rate of frozen sections and postoperative paraffin sections was 91.18％0 (31/34),in which 6 cases were immediately intraoperative frozen,and 66.67％ (4/6) of the cases that changed into malignancy from benignity were not consistent with the preoperative diagnosis of paraffin sections.Conclusion The sinonasal tumors are lacking specificity in clinical manifestations,but rapid intraoperative frozen section examination is helpful to improve the diagnosis rate;continuously frozen pathological examination should be performed in malignant tumor margins.

Cervical cancer screening: from Pap smear to future strategies / Triagem de câncer do colo uterino: do teste de Papanicolaou a estratégias futuras

ABSTRACT Previously, the screening for detection of cervical cancer was performed by simple cervicovaginal sample collected by the physician whenever the patient attended the medical consultation, and soon it was established as the annual"Pap smear". Since then, an elementary test has evolved into a complex process with multiple algorithms for the identification of invasive disease. The detection of human papillomavirus (HPV) has become part of the new screening recommendations, resulting in major changes in the guidelines. This review intends to emphasize the most important topics that are part of cervical cancer screening, including cervical cytology and HPV detection, and to discuss particular aspects of cervical cancer in Brazil. Despite the great benefits achieved by the cervical cancer screening programs with cytology and HPV test, there are still important issues to be discussed and improved in defining future strategies, including simplicity and possible application in different socioeconomic contexts, definition of the best test or tests to be applied and recommended interval, minimizing possible harms. After the establishment of screening algorithms well defined by leading organizations, management protocols should be disseminated among physicians and patients by education programs.

RESUMO Inicialmente, a triagem para detecção do câncer de colo uterino era feita por meio de uma simples amostra cervicovaginal colhida pelo médico, sempre que o paciente comparecia à consulta médica; logo se estabeleceu como"exame de Papanicolaou" anual. Desde então, um teste elementar evoluiu para um processo complexo, com múltiplos algoritmos para identificação de doença invasiva. A detecção do papilomavírus humano (HPV) tornou-se parte das novas recomendações de triagem, resultando em grandes mudanças nas diretrizes. Esta revisão pretende enfatizar os tópicos mais importantes que fazem parte do rastreamento do câncer de colo do útero, incluindo citologia cervical e detecção do HPV, bem como discutir aspectos particulares do câncer de colo do útero no Brasil. Apesar dos grandes benefícios alcançados pelos programas de rastreamento do câncer de colo uterino por meio do uso da citologia e do teste de HPV, existem ainda pontos importantes a serem discutidos e melhorados na definição de estratégias futuras, como simplicidade e possível aplicação em diferentes contextos socioeconômicos, definição do melhor teste ou testes a serem aplicados e intervalo recomendável, minimizando possíveis danos. Após o estabelecimento de algoritmos de rastreamento bem definidos pelas principais organizações, protocolos de manejo devem ser divulgados entre médicos e pacientes por programas de educação.