An international inter-laboratory study on Nosema spp. spore detection and quantification through microscopic examination of crushed honey bee abdomens.

Nosemosis is a microsporidian disease causing mortality and weakening of honey bee colonies, especially in the event of co-exposure to other sources of stress. As a result, the disease is regulated in some countries. Reliable and harmonised diagnosis is crucial to ensure the quality of surveillance and research results. For this reason, the first European Interlaboratory Comparison (ILC) was organised in 2017 in order to assess both the methods and the results obtained by National Reference Laboratories (NRLs) in counting Nosema spp. spores by microscopy. Implementing their own routine conditions of analysis, the 23 participants were asked to perform an assay on a panel of ten positive and negative samples of crushed honey bee abdomens. They were asked to report results from a qualitative and quantitative standpoint. The assessment covered specificity, sensitivity, trueness and precision. Quantitative results were analysed in compliance with international standards NF ISO 13528 (2015) and NF ISO 5725-2 (1994). Three results showed a lack of precision and five a lack of trueness. However, overall results indicated a global specificity of 98% and a global sensitivity of 100%, thus demonstrating the advanced performance of the microscopic methods applied to Nosema spores by the NRLs. Therefore, the study concluded that using microscopy to detect and quantify spores of Nosema spp. was reliable and valid.

Reliability of Morphological and PCR Methods for the Official Diagnosis of Aethina tumida (Coleoptera: Nitidulidae): A European Inter-Laboratory Comparison.

The Small Hive Beetle (Aethina tumida Murray, 1867) is an invasive scavenger of honeybees. Originally endemic in sub-Saharan Africa, it is regulated internationally in order to preserve the areas still free from this species. To ensure the reliability of official diagnoses in case of introduction, an inter-laboratory comparison was organised on the identification of A. tumida by morphology and real-time PCR. Twenty-two National Reference Laboratories in Europe participated in the study and analysed 12 samples with adult coleopterans and insect larvae. The performance of the laboratories was evaluated in terms of sensitivity and specificity. Sensitivity was satisfactory for all the participants and both types of methods, thus fully meeting the diagnostic challenge of confirming all truly positive cases as positive. Two participants encountered specificity problems. For one, the anomaly was minor whereas, for the other, the issues concerned a larger number of results, especially real-time PCR, which probably were related to inexperience with this technique. The comparison demonstrated the reliability of official diagnosis, including the entire analytical process of A. tumida identification: from the first step of the analysis to the expression of opinions. The performed diagnostic tools, in parallel with field surveillance, are essential to managing A. tumida introduction.

Nurses' observational study on the practice of secondary prevention in a cardiovascular department.

BACKGROUND: Although interventional studies have established the prognostic importance of the control of risk factors in patients with cardiovascular disease, reviews invariably show that the implementation of secondary prevention in patients with cardiovascular disease during hospitalization for acute manifestations or interventions is unsatisfactory. The aim of this study was to observe secondary prevention practice in a cardiovascular department, as part of a quality assurance program. METHODS: Two hundred and twenty patients discharged from the intensive coronary care unit, cardiac surgery unit and vascular surgery unit were prospectively included. Data were extracted from medical records and discharge documents. One hundred and eleven patients with at least one modifiable risk factor which was previously not corrected, were interviewed at discharge and were reassessed 3 months later. RESULTS: Written prescriptions about smoking cessation and weight reduction were given to 7 and 3% of smokers and overweight patients respectively. In 17% of patients no lipid measurement was reported, and in 49% of patients with low-density lipoprotein (LDL) cholesterol levels > 129 mg/dl statins were not prescribed. In patients with a history of infarction, aspirin and beta-blockers were prescribed in 90 and 64% respectively. In diabetics, statins were prescribed to 48% and angiotensin-converting enzyme inhibitors to 31%. Less than 40% of patients were able to refer appropriate levels for their blood pressure, weight, and cholesterol, and 30% fully comprehended the importance of smoking cessation. At the 3-month follow-up visit, 37% of patients had LDL cholesterol levels > 129 mg/dl--in half of these patients despite statins. In 61% of diabetics glycemic control was poor, and one third of smokers had not stopped smoking. CONCLUSIONS: These observations by the nurses have shown pitfalls in the implementation of guidelines, due to incomplete risk assessment, insufficient drug treatment and ineffective patient education. These data are the starting point for upcoming actions of quality improvement in the cardiovascular department of our hospital.