Resumen ejecutivo del documento de consenso para la formación y el desarrollo de la ecografía clínica en Medicina Interna: recomendaciones desde el Grupo de Trabajo de Ecografía Clínica de la Sociedad Española de Medicina Interna (GTECO-SEMI) / Executive summary of the consensus document for the training and development of clinical ultrasound in internal medicine: Recommendations from the Clinical Ultrasound Working Group of the Spanish Society of Internal Medicine (GTECO-SEMI)

Introducción Dada la creciente adopción de la ecografía clínica en medicina, es fundamental estandarizar su aplicación, su formación y su investigación. Objetivos y métodos El propósito de este documento es proporcionar recomendaciones de consenso para responder cuestiones sobre la práctica y el funcionamiento de las unidades de ecografía clínica. Participaron 19 expertos y responsables de unidades avanzadas de ecografía clínica. Se utilizó un método de consenso Delphi modificado. Resultados Se consideraron un total de 137 declaraciones de consenso, basadas en la evidencia y en la opinión experta. Las declaraciones fueron distribuidas en 10 áreas. Un total de 99 recomendaciones alcanzaron consenso. Conclusiones Este consenso define los aspectos más importantes de la ecografía clínica en el ámbito de la Medicina Interna, con el objetivo de homogeneizar y promover este avance asistencial en sus diferentes vertientes. El documento ha sido elaborado por el Grupo de Trabajo de Ecografía Clínica y avalado por la Sociedad Española de Medicina Interna. (AU)

Introduction Given the increasing adoption of clinical ultrasound in medicine, it is essential to standardize its application, training, and research. Objectives and methods The purpose of this document is to provide consensus recommendations to address questions about the practice and operation of clinical ultrasound units. Nineteen experts and leaders from advanced clinical ultrasound units participated. A modified Delphi consensus method was used. Results A total of 137 consensus statements, based on evidence and expert opinion, were considered. The statements were distributed across 10 areas, and 99 recommendations achieved consensus. Conclusions This consensus defines the most important aspects of clinical ultrasound in the field of internal medicine, with the aim of standardizing and promoting this healthcare advancement in its various aspects. The document has been prepared by the Clinical Ultrasound Working Group and endorsed by the Spanish Society of Internal Medicine. (AU)

Andrographis paniculata (Burm.f.) Nees: Traditional uses, phytochemistry, pharmacological properties and quality control/quality assurance.

ETHNOPHARMACOLOGICAL RELEVANCE: Andrographis paniculata (Burm.f.) Nees is a medicinal herb of the Asian countries used in many traditional medicinal systems for the treatment of diarrhea, flu, leprosy, leptospirosis, malaria, rabies, upper respiratory infections, sinusitis, syphilis, tuberculosis and HIV/AIDS etc. AIM OF THE STUDY: This review aims to provide the comprehensive, accurate and authentic information on traditional uses, phytochemistry and pharmacological properties of various extracts/fractions as well as phytocostituents of A. paniculata. In addition, this review also aims to provide advance and sensitive analytical methods along with chemical markers used in the standardization of herbal products for quality control (QC)/quality assurance (QA). MATERIALS AND METHODS: All relevant publications were considered within the years 1983-2020. The publications were searched from Google Scholar, PubChem, Chemspider, PubMed, Elsevier, Wiley, Web of Science, China Knowledge Resource Integrated databases and ResearchGate using a combination of various relevant keywords. Besides, relevant published books and chapters were also considered those providing an overview of extant secondary literature related to traditional knowledge, phytochemistry, pharmacology and toxicity of the plant. RESULTS AND DISCUSSION: In this review, 344 compounds, including, terpenoid lactones, flavonoids, phenolic acids, triterpenes and volatile compounds were summarized out of which more than half of the compounds have no reported pharmacological activities yet. Terpenoid lactones and flavonoids are the major bioactive classes of compounds of A. paniculata which are responsible for pharmacological activities such as anticancer and antioxidant activities, respectively. Biosynthetic pathways and active sites for target proteins of both terpenoid lactones and flavonoids were considered. Analgesic, anticancer, antidiabetic, antifertility, antiinflammatory, antimalarial, antimicrobial, antioxidant, antipyretic, antiviral, antiretroviral, antivenom, cardioprotective, hepatoprotective, immunomodulatory and neuroprotective activities have been also reported. Andrographolide is a major characteristic active principle and responsible for most of the pharmacological activities. Therefore, andrographolide has been selected as a marker for the standardization of raw and marketed herbal products by TLC, HPTLC, HPLC, GC-MS, HPLC-MS and HPLC-MS/MS methods for QC/QA. CONCLUSIONS: Conclusive evidence showed that the pharmacological activities reported in crude extracts and chemical markers are supporting and provides confidence in the traditional use of A. paniculata as a herbal medicine. The andrographolide could be used as a chemical marker for the QC/QA of raw and A. paniculata derived herbal products. Lactone ring in terpenoid lactone is an active site for targeted proteins. More efforts should be focused on the identification of the chemical markers from A. paniculata to provide a practical basis for QC/QA. Several aspects such as the mechanism of therapeutic potential, molecular docking technology and multi-target network pharmacology are very important for drug discovery and needed more investigation and should be considered. This compilation may be helpful in further study and QC/QA.

[Importance of quality control of baciloscopy in laboratories that perform diagnosis of tuberculosis]. / Importancia del control de la calidad de la baciloscopia en los laboratorios de diagnóstico de tuberculosis.

BACKGROUND: Baciloscopy is the primary tool for pulmonary tuberculosis diagnosis, being this technique the most used internationally in the search for infectious cases. Quality control is the process of the rechecking smears by a highly qualified observer. AIM: To evaluate and highlight the importance of quality control of smear microscopy in the Provincial Laboratories diagnosticians of Tuberculosis in Cuba. METHODS: This study was conducted at the National Reference Laboratory and Research in Tuberculosis, Leprosy and Mycobacteria in the Institute of Tropical Medicine "Pedro Kouri", Havana, Cuba, Were evaluated 2676 smears received from January 2013 to December 2014, from Provincial Centers of Hygiene, Epidemiology and Microbiology of Cuba, including the special municipality Isla de la Juventud. RESULTS: 2,664 (99.5%) were concordant smears, the correlation obtained for the positive smears were 96.5% and 99.8% for negative. Were identified12 reading errors: 7 (3.5%) false positive and 5 (0.2%) false negatives. Slides were classified with adequate quality of smears in 2039 (76.2%), showed difficulties in realizing the extension in 1464 (54.7%) and staining were adequate in 2343 (87.6%). The kappa index was 0.9674. CONCLUSION: Although there was good agreement between observations it is recommended to improve the quality of extended, maintain staff training program that performs this activity, like regular supervision by specialists, to further improve the quality of diagnosis.

Importancia del control de la calidad de la baciloscopia en los laboratorios de diagnóstico de tuberculosis / Importance of quality control of baciloscopy in laboratories that perform diagnosis of tuberculosis

Introducción: La baciloscopia es la herramienta primaria en el diagnóstico de la tuberculosis (TBC) pulmonar activa, siendo esta la técnica más utilizada internacionalmente en la búsqueda de casos infecciosos. El control de calidad consiste en la relectura de las láminas por un observador altamente calificado. Objetivo: Evaluar y destacar la importancia del control de la calidad de la baciloscopia en los laboratorios provinciales encargados del diagnóstico de TBC en Cuba. Material y Métodos: Este estudio fue realizado en el Laboratorio Nacional de Referencia e Investigaciones de Tuberculosis, Lepra y Micobacterias del Instituto de Medicina Tropical "Pedro Kourí", La Habana, Cuba. Fueron evaluadas 2.676 láminas recibidas en el período de enero de 2013-diciembre de 2014, procedentes de los diferentes Centros Provinciales de Higiene, Epidemiología y Microbiología de Cuba, incluido el Municipio Especial Isla de la Juventud. Resultados: Hubo 2.664 (99,5%) láminas concordantes, la concordancia obtenida para las láminas positivas fue 96,5% y las negativas 99,8%. Se identificaron 12 errores de lectura: 7 (3,5%) falsos positivos, 5 (0,2%) falsos negativos. Se calificaron láminas con calidad de la muestra adecuada en 2.039 (76,2%), presentaron deficiencias en la realización de la extensión 1.464 (54,7%), y la tinción fue adecuada en 2.343 (87,6%). El índice de kappa fue de 0.9674. Conclusión: Aunque hubo una adecuada concordancia entre las observaciones realizadas, se recomienda mejorar la calidad del extendido, mantener programa de entrenamiento al personal que realiza esta actividad, al igual que las supervisiones periódicas por parte de especialistas, para continuar mejorando la calidad del diagnóstico.

Background: Baciloscopy is the primary tool for pulmonary tuberculosis diagnosis, being this technique the most used internationally in the search for infectious cases. Quality control is the process of the rechecking smears by a highly qualified observer. Aim: To evaluate and highlight the importance of quality control of smear microscopy in the Provincial Laboratories diagnosticians of Tuberculosis in Cuba. Methods: This study was conducted at the National Reference Laboratory and Research in Tuberculosis, Leprosy and Mycobacteria in the Institute of Tropical Medicine "Pedro Kouri", Havana, Cuba, Were evaluated 2676 smears received from January 2013 to December 2014, from Provincial Centers of Hygiene, Epidemiology and Microbiology of Cuba, including the special municipality Isla de la Juventud. Results: 2,664 (99.5%) were concordant smears, the correlation obtained for the positive smears were 96.5% and 99.8% for negative. Were identified12 reading errors: 7 (3.5%) false positive and 5 (0.2%) false negatives. Slides were classified with adequate quality of smears in 2039 (76.2%), showed difficulties in realizing the extension in 1464 (54.7%) and staining were adequate in 2343 (87.6%). The kappa index was 0.9674. Conclusion: Although there was good agreement between observations it is recommended to improve the quality of extended, maintain staff training program that performs this activity, like regular supervision by specialists, to further improve the quality of diagnosis.

Control de la calidad del seguimiento de contactos de tuberculosis pulmonar en Camagüey, Cuba (2008-2011) / Quality control in the follow-up of pulmonary tuberculosis contacts in Camaguez, Cuba (2008-2011)

Introducción La tuberculosis constituye en la actualidad un problema de salud en el municipio de Camagüey. ObjetivoEvaluar el cumplimiento de los lineamientos del Programa Nacional para el Control de la Tuberculosis para el seguimiento de los contactos de casos positivos de tuberculosis pulmonar en el municipio de Camagüey, Cuba. DiseñoEstudio descriptivo de corte transversal en el municipio de Camagüey entre los años 2008 y 2011. Métodos Se incluyeron 1.242 contactos resultantes de 39 casos de tuberculosis reportados en el período en estudio. Se revisaron las encuestas epidemiológicas y registros epidemiológicos de los casos reportados. Los resultados se procesaron y analizaron en el software estadístico SPSS 17.0, luego se representaron en tablas y gráficos. Se utilizó el porcentaje como medida de resumen. Se empleó como herramienta guía el “Formulario de seguimiento de los contactos de tuberculosis pulmonar” creado por expertos del grupo de investigación y vigilancia de tuberculosis, infecciones respiratorias agudas y lepra del Instituto de Medicina Tropical Pedro Kourí. Resultados Los contactos con examen inicial y cuatro controles completados presentaron 96,2 por ciento de aceptabilidad; en tanto, los contactos que tuvieron menos de cuatro controles reportaron resultados inferiores a 10 por ciento (3,3 por ciento). Todos los contactos fueron investigados desde el inicio y se les administró tratamiento de acuerdo a los lineamientos del programa.Conclusión Se observó que hay cumplimiento en los lineamientos del Programa Nacional de Control de la Tuberculosis para el seguimiento de los contactos de casos positivos de tuberculosis pulmonar. Éste es más riguroso en las edades tempranas y laboralmente activas (entre 25 y 54 años). La evaluación contribuyó a la identificación de las debilidades existentes como la poca sensibilidad de la población para someterse a los exámenes correspondientes en el Programa Nacional de Control de la Tuberculosis.

Introduction Tuberculosis is currently a health problem in the municipality of Camagüey. Purpose To assess compliance of guidelines issued by the National Program for the Control of Tuberculosis for the follow-up of contacts of positive cases of pulmonary tuberculosis in the municipality of Camagüey, Cuba. Design Descriptive cross-sectional design. Methods1,242 contacts resulting from 39 reported cases of tuberculosis during the study period were included in the municipality of Camagüey between 2008 and 2011. Epidemiological surveys and records of reported cases were reviewed. The results were processed and analyzed in SPSS 17.0 statistical software and subsequently presented in tables and graphs. The results were summarized by percentages. The “Follow-up form for contacts of pulmonary tuberculosis” was used as main guideline, which was created by experts of the Investigation and Monitoring of Tuberculosis, Acute Respiratory Infections, and Leprosy Workshop of Tropical Medicine Institute Pedro Kourí. Results Contacts that had an initial examination and four checkups had 96.2 percent of acceptability. Contacts that had fewer than four checkups showed less than 10 percent acceptability (3.3 percent). All contacts were assessed from the outset and were treated, in accordance with program guidelines. Conclusion We found adequate compliance of National Program for the Control of the Tuberculosis guidelines for follow-up of contacts of positive cases of pulmonary tuberculosis. Compliance is greater in younger age groups and in the actively employed (25 to 54 years). This evaluation contributed to identify existing weaknesses in follow-up, such as low interest of this population to undergo appropriate testing in the National Program of Control of Tuberculosis.

Giant tuberculin reaction associated with the homeopathic drug tuberculinum: a case report.

Giant reactions to the tuberculin skin test are extremely rare and have been previously reported almost exclusively in patients with lepromatous leprosy. We herein report a giant tuberculin reaction associated with the homeopathic drug Tuberculinum in a patient with no evidence of active tuberculosis or leprosy.

Phylogenetic analysis of a spontaneous cocoa bean fermentation metagenome reveals new insights into its bacterial and fungal community diversity.

This is the first report on the phylogenetic analysis of the community diversity of a single spontaneous cocoa bean box fermentation sample through a metagenomic approach involving 454 pyrosequencing. Several sequence-based and composition-based taxonomic profiling tools were used and evaluated to avoid software-dependent results and their outcome was validated by comparison with previously obtained culture-dependent and culture-independent data. Overall, this approach revealed a wider bacterial (mainly γ-Proteobacteria) and fungal diversity than previously found. Further, the use of a combination of different classification methods, in a software-independent way, helped to understand the actual composition of the microbial ecosystem under study. In addition, bacteriophage-related sequences were found. The bacterial diversity depended partially on the methods used, as composition-based methods predicted a wider diversity than sequence-based methods, and as classification methods based solely on phylogenetic marker genes predicted a more restricted diversity compared with methods that took all reads into account. The metagenomic sequencing analysis identified Hanseniaspora uvarum, Hanseniaspora opuntiae, Saccharomyces cerevisiae, Lactobacillus fermentum, and Acetobacter pasteurianus as the prevailing species. Also, the presence of occasional members of the cocoa bean fermentation process was revealed (such as Erwinia tasmaniensis, Lactobacillus brevis, Lactobacillus casei, Lactobacillus rhamnosus, Lactococcus lactis, Leuconostoc mesenteroides, and Oenococcus oeni). Furthermore, the sequence reads associated with viral communities were of a restricted diversity, dominated by Myoviridae and Siphoviridae, and reflecting Lactobacillus as the dominant host. To conclude, an accurate overview of all members of a cocoa bean fermentation process sample was revealed, indicating the superiority of metagenomic sequencing over previously used techniques.

Influence of soiling on boar taint in boars.

It has been suggested that skatole, one of the main compounds responsible for boar taint, can be lowered by keeping pigs clean, as skatole can be absorbed through skin and/or lungs (Hansen, Larsen, Jensen, HansenMoller & Bartongade, 1994). With this experiment, we further investigated this hypothesis by comparing extremely clean with extremely dirty animals with regard to the occurrence of boar taint. One group of boars was washed daily and pens were mucked on and littered down daily (CLEAN), a second group of boars was rubbed with faeces daily (DIRTY) and a third group of boars was kept in control conditions (CONTROL). The treatment was performed during the last four weeks before slaughter. According to the standardised consumer panel evaluations, boars subjected to extra soiling had a higher concentration of boar taint than boars that were kept extra clean. In contrast, expert panels judged general meat flavour to be inferior in CLEAN than CONTROL pigs. The home consumer panel, the hot iron method, and laboratory analyses, i.e., the presence of indole, skatole and androstenone in fat and serum, all showed no significant differences. So no clear indications towards skatole reduction by improving cleanliness of pigs were found.

Donor selection, retrieval and preparation of donor tissue. Donor selection.

Corneal transplantation safety is widely dependent on clinical donor selection. Donor-to-host transmission of rabies and Creutzfeldt-Jakob disease is well established, and it is lethal for the recipient. Taking into consideration this latter figure, contraindications to ocular tissue transplantation include not only rabies, contact with rabies virus, spongiform encephalitis, family history of spongiform encephalitis, recipients of human pituitary-derived hormones before 1987, surgery using dura mater and brain/spinal surgery before 1992, but also CNS diseases of unknown etiology or those with unknown risk of transmission. It has been established that hepatitis B virus and herpes simplex virus can be transmitted by corneal transplantation, and both diseases are contraindications to transplantation. HIV infection, syphilis, hepatitis C, hepatitis A, tuberculosis, HTLV-1 and -2 infection, active leprosy, active typhoid, smallpox and active malaria are also contraindications to ocular tissue transplantation even if no evidence of donor-to-recipient transmission has been demonstrated. A history of corneal refractive surgery in the donor eye, ocular inflammation, retinoblastoma, and malignant tumors of the anterior segment are contraindications to keratoplasty.

[Survey of the quality of leprosy diagnosis in Madagascar]. / Enquête sur la qualité du diagnostic de lèpre à Madagascar.

BACKGROUND: By 2005, Madagascar had not achieved its goal of eliminating leprosy. During reexamination of leprosy patients, rates of diagnostic error ranged from 4.5 to 62%, casting doubt on the reported prevalence of leprosy. We therefore decided to carry out a survey of the quality of leprosy diagnosis. PATIENTS AND METHODS: The survey consisted in reexamination of a sample of 102 new cases of leprosy (treated for less than three months). The sample was obtained from clusters of six patients, randomly drawn from the 111 districts in the country's six provinces. Two reexamination teams visited the target districts. Each team included at least three medical doctors: a doctor from the National Program, a WHO consultant and a dermatologist from partner NGOs in the program. RESULTS: The mean false-positive rate was 27.5%, ranging from 5.6 to 44.4% in the different provinces. The quality of leprosy diagnosis was found to be very poor, particularly in districts with a marked decrease in annual detection of leprosy cases. CONCLUSION: The high rate of false-positives during this survey could be due to the incompetence of peripheral health workers. This incompetence could be partly attributed to the decrease in leprosy detection, resulting in reduced familiarity of these health staff with leprosy diagnosis. Recommendations were made to the country concerning review of the leprosy case detection network and improvement of the quality of leprosy diagnosis in the field. Health workers involved in leprosy detection must have basic dermatological knowledge.

Validación del inmuno ensayo enzimático (ELISA) y hemoaglutinación indirecta (HAI) para el serodiagnóstico de la Enfermedad de Chagas / Validation of enzime-linked inmunosorbert assay (ELISA) and indirect hemagglutination (IHA) for serodiagnosis of Chagas Disease

Las técnicas serológicas constituyen una importante herramienta en la confirmación del diagnóstico de la enfermedad de Chagas inaparente y crónico. En estas fases de la enfermedad el diagnóstico parasitológico es muy poco sensible debido a la baja parasitemia que las caracteriza. Uno de los principales problemas plantedos en serodiagnóstico de esta protozoosis, lo constituye la diversidad de criterios en los diferentes laboratorios nacionales, es por ello que actualmente se están realizando esfuerzos para contribuir a su unificación, donde han jugado un papel importante tanto la comunidad científica como el Ministerio de Salud y Desarrollo Social (MSDS). En tal sentido, en el presente nos planteamos evaluar la validez de las técnicas de ELISA y HAI para contribuir con el control de calidad de serodiagnóstico de la Enfermedad de Chagas, utilizando un antígeno crudo de epimastigotas de Trypanosoma cruzy. Se ensayaron 100 sueros positivos y 100 negativos provenientes de individuos comprobadamente chagásicos y no chagásicos, además de determinar las reacciones cruzadas con el ensayo de 31 sueros de pacientes con otras enfermedades como malaria, lepra, TBC, toxoplasmosis, rangeliosis, leishmaniasis tegumentaria y visceral. Se determinó el punto de corte para cada prueba. El diagnóstico de referencia lo constituyó el resultado positivo y negativo que en conjunto fue obtenido por las tres pruebas serológicas utilizadas en el Laboratorio de Chagas de la Dirección General de Salud Ambiental y Contraloría Sanitaria del MSDS. Los resultados obtenidos reflejaron un 96 por ciento de sensibilidad y 97 por ciento de especifidad para ELISA. En HAI se obtuvo 99 por ciento tanto de sensibilidad como de especificidad

Liquid chromatography/tandem mass spectrometric bioanalysis using normal-phase columns with aqueous/organic mobile phases - a novel approach of eliminating evaporation and reconstitution steps in 96-well SPE.

Bioanalytical methods using automated 96-well solid-phase extraction (SPE) and liquid chromatography with electrospray tandem mass spectrometry (LC/MS/MS) are widely used in the pharmaceutical industry. SPE methods typically require manual steps of drying of the eluates and reconstituting of the analytes with a suitable injection solvent possessing elution strength weaker than the mobile phase. In this study, we demonstrated a novel approach of eliminating these two steps in 96-well SPE by using normal-phase LC/MS/MS methods with low aqueous/high organic mobile phases, which consisted of 70-95% organic solvent, 5-30% water, and small amount of volatile acid or buffer. While the commonly used SPE elution solvents (i.e. acetonitrile and methanol) have stronger elution strength than a mobile phase on reversed-phase chromatography, they are weaker elution solvents than a mobile phase for normal-phase LC/MS/MS and therefore can be injected directly. Analytical methods for a range of polar pharmaceutical compounds, namely, omeprazole, metoprolol, fexofenadine, pseudoephedrine as well as rifampin and its metabolite 25-desacetyl-rifampin, in biological fluids, were developed and optimized based on the foregoing principles. As a result of the time saving, a batch of 96 samples could be processed in one hour. These bioanalytical LC/MS/MS methods were validated according to "Guidance for Industry - Bioanalytical Method Validation" recommended by the Food and Drug Administration (FDA) of the United States.

Grau de incapacidade: indicador de prevalência oculta e qualidade do programa de controle da hanseníase em um Centro de Saúde-Escola no município de Uberlândia - MG / Degree of incapacity: an indicator for hidden prevalence and program quality of leprosy control in a University Health Center in the Uberlândia District

O longo período de incubaçäo da hanseníase, seus sintomas e sinais insidiosos, assim como as deficiências operacionais no Programa de Controle, produzem dificuldades em seu diagnóstico. Essa situaçäo cria condições para considerar que existe uma prevalência oculta que leva incapacidade ao doente e influi na cadeia de transmissäo. Este trabalho objetivou aplicar indicadores para análises epidemiológica e operacional do Programa de Controle da Hanseníase no Distrito Sanitário Oeste, Uberlândia-MG, avaliando as incapacidades físicas dos pacientes como medida da qualidade do programa e estimativa de prevalência oculta. Foram analisados 138 prontuários de hansenianos diagnosticados no Centro de Saúde Escola da Universidade Federal de Uberlândia (CSE-UFU), de janeiro de 1995 a julho de 2000. No diagnóstico, 24 por cento dos pacientes apresentaram algum grau de incapacidade, inclusive grau I, evidenciando diagnóstico tardio. Na alta, 68 por cento dos pacientes que iniciaram o tratamento com grau zero permaneceram nesse grau e, entre aqueles que iniciaram com grau I, 61,5 por cento mantiveram a condiçäo, 23,1 por cento regrediram para zero e 15,4 por cento näo tiveram registro. Os indicadores operacionais refletiram um atendimento de boa qualidade no CSE-UFU. A prevelência oculta estimada foi de 27 casos para o ano 2000, elevando a taxa de prevelência conhecida de 10,22/10.000 habitantes para a taxa de prevalência real de 13,67/10.000, evidenciando uma endemia muito alta de hanseníase no Distrito Oeste. Discute-se a necessidade de adotar a avaliaçäo do grau de incapacidades como indicador de morbidade e controle da doença nos vários níveis de atençäo a fim de planejar ações para detectar os focos de endemia oculta nas comunidades

Yeast populations in Sardinian feta cheese.

In this study, the yeast populations in feta cheese from two different Sardinian dairies were examined. Samples of good quality feta (32) and samples of feta with a slimy surface defect (10) were examined from Dairy A. Similar, samples of good quality feta (23), feta with slimy surface defects (14) and samples with swelling defects (6) were examined from Dairy B. Kluyveromyces lactis was the dominating species in feta from Dairy A (95.2% of samples) followed by Debaryomyces hansenii (76.2%), Dekkera anomala (28.6%) and Dek. bruxellensis (19%). D. hansenii was dominant in samples from Dairy B (93%), followed by K. lactis (23.3%), Geotrichum candidum (23.3%) and Dek. anomala (18.6%). No significant difference was observed between the occurrence of yeast species in feta of good quality and in feta with slimy surface defects, thus confirming that slimy production is not associated with yeast contaminations. The swelling of samples observed in Dairy B seems to be caused by Dek. anomala. In fact, this strong fermenting species was present in all swelled samples in numbers exceeding 10(6) CFU g(-1), while it was isolated in very low concentration in only 5.4% of good samples.

Lot quality assurance sampling (LQAS) for monitoring a leprosy elimination program.

In a statistical sense, prevalences of leprosy in different geographical areas can be called very low or rare. Conventional survey methods to monitor leprosy control programs, therefore, need large sample sizes, are expensive, and are time-consuming. Further, with the lowering of prevalence to the near-desired target level, 1 case per 10,000 population at national or subnational levels, the program administrator's concern will be shifted to smaller areas, e.g., districts, for assessment and, if needed, for necessary interventions. In this paper, Lot Quality Assurance Sampling (LQAS), a quality control tool in industry, is proposed to identify districts/regions having a prevalence of leprosy at or above a certain target level, e.g., 1 in 10,000. This technique can also be considered for identifying districts/regions at or below the target level of 1 per 10,000, i.e., areas where the elimination level is attained. For simulating various situations and strategies, a hypothetical computerized population of 10 million persons was created. This population mimics the actual population in terms of the empirical information on rural/urban distributions and the distribution of households by size for the state of Tamil Nadu, India. Various levels with respect to leprosy prevalence are created using this population. The distribution of the number of cases in the population was expected to follow the Poisson process, and this was also confirmed by examination. Sample sizes and corresponding critical values were computed using Poisson approximation. Initially, villages/towns are selected from the population and from each selected village/town households are selected using systematic sampling. Households instead of individuals are used as sampling units. This sampling procedure was simulated 1000 times in the computer from the base population. The results in four different prevalence situations meet the required limits of Type I error of 5% and 90% Power. It is concluded that after validation under field conditions, this method can be considered for a rapid assessment of the leprosy situation.

Quality control tests for vaccines in leprosy vaccine trial, Avadi.

All the vaccines supplied for the large scale comparative leprosy vaccine trial of ICRC bacilli, M.w, BCG plus killed M. leprae (candidate vaccines), BCG and normal saline (control arms) at CJIL Field Unit, Chennai were tested for quality control by the suppliers following the procedures laid down in the WHO protocol for killed M. leprae. Quality control for BCG was carried out at BCG vaccine laboratory as per protocol. Toxicity and sterility tests were done on all the vaccine batches/lots received. As part of the quality control, bacterial count, and protein estimation were also done. Studies showed that the bacterial content and protein concentration were comparable with the original preparations. Vaccines were free from micro-organisms, toxic materials and safe for human use. Thus the quality of all vaccine preparations was satisfactory.

Controle de qualidade intralaboratorial em hematologia: avaliação da precisão e exatidão dos equipamentos semi-automatizados (contador de leucócitos, hemoglobinômetro, microhematócrito, diluidor automático), no "Instituto Lauro de Souza Lima"

Neste estudo investigou-se o grau de reprodutividade e sensibilidade dos aparelhos hematológicos (Contador de leucócitos, hemoglobinômetro, microhematócrito), utilizados no laboratório clínico do Instituto Lauro de Souza Lima de Bauru, usando-se para isto 50 amostras triadas apenas de pacientes ambulatorial, da rotina do mesmo laboratório. Os resultados obtidos demonstram que independente do tempo de uso dos aparelhos, desde que se faça uma manutenção periódica nos mesmos, pode-se obter resultados confiáveis.

Determination of dapsone in serum and saliva using reversed-phase high-performance liquid chromatography with ultraviolet or electrochemical detection.

A simple, extractionless method for the determination of dapsone in serum and saliva is described. Reversed-phase high-performance liquid chromatography is used with UV detection at 295 nm or electrochemical detection at 0.7 V. Diazoxide in buffer is the internal standard for UV detection and practolol for electrochemical detection. Sample preparation is minimal with protein precipitation of serum samples whilst saliva samples are simply diluted with addition of an internal standard. Low-level serum and saliva samples are front-cut on-line with a 3 cm laboratory-made precolumn in the loop position on a standard Valco injection valve. Isocratic separation is achieved on a 250 mm x 4.6 mm I.D. stainless-steel Spherisorb S5 ODS-1 column. The mobile phase for high levels of dapsone is acetonitrile-elution buffer (12:88, v/v) at 2 ml/min and a column temperature of 40 degrees C for both serum and saliva separations. For the low-level assays using electrochemical detection and solid-phase clean-up, the mobile phase is acetonitrile-methanol-elution buffer (9:4:87, v/v/v). The UV and electrochemical detection limits are 25 ng/ml and 200 pg/ml, respectively, in both serum and saliva. This simple method is applicable to the routine monitoring of dapsone levels in serum from leprotic patients and electrochemical detection gives a simple, reliable method for the monitoring of trough values in subjects on anti-malarial prophylaxis.