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1.
Sensors (Basel) ; 21(4)2021 Feb 11.
Artículo en Inglés | MEDLINE | ID: mdl-33670317

RESUMEN

Alzheimer's disease is the most prevalent dementia among the elderly population. Early detection is critical because it can help with future planning for those potentially affected. This paper uses a three-dimensional DenseNet architecture to detect Alzheimer's disease in magnetic resonance imaging. Our work is restricted to the use of freely available tools. We constructed a deep neural network classifier with metrics of 0.86¯ mean accuracy, 0.86¯ mean sensitivity (micro-average), 0.86¯ mean specificity (micro-average), and 0.91¯ area under the receiver operating characteristic curve (micro-average) for the task of discriminating between five different disease stages or classes. The use of tools available for free ensures the reproducibility of the study and the applicability of the classification system in developing countries.


Asunto(s)
Enfermedad de Alzheimer , Redes Neurales de la Computación , Anciano , Anciano de 80 o más Años , Enfermedad de Alzheimer/diagnóstico por imagen , Diagnóstico Precoz , Femenino , Humanos , Imagen por Resonancia Magnética , Masculino , Persona de Mediana Edad , Curva ROC , Reproducibilidad de los Resultados
2.
Mikrochim Acta ; 188(4): 121, 2021 03 10.
Artículo en Inglés | MEDLINE | ID: mdl-33694010

RESUMEN

A voltammetric genosensor has been developed for the early diagnosis of COVID-19 by determination of RNA-dependent RNA polymerase (RdRP) sequence as a specific target of novel coronavirus. The severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) uses an RdRP for the replication of its genome and the transcription of its genes. Here, the silver ions (Ag+) in the hexathia-18-crown-6 (HT18C6) were used for the first time as a redox probe. Then, the HT18C6(Ag) incorporated carbon paste electrode (CPE) was further modified with chitosan and PAMAM dendrimer-coated silicon quantum dots (SiQDs@PAMAM) for immobilization of probe sequences (aminated oligonucleotides). The current intensity of differential pulse voltammetry using the redox probe was found to decrease with increasing the concentration of target sequence. Based on such signal-off trend, the proposed genosensor exhibited a good linear response to SARS-CoV-2 RdRP in the concentration range 1.0 pM-8.0 nM with a regression equation I (µA) = - 6.555 log [RdRP sequence] (pM) + 32.676 (R2 = 0.995) and a limit of detection (LOD) of 0.3 pM. The standard addition method with different spike concentrations of RdRP sequence in human sputum samples showed a good recovery for real sample analysis (> 95%). Therefore, the developed voltammetric genosensor can be used to determine SARS-CoV-2 RdRP sequence in sputum samples. PAMAM-functionalized SiQDs were used as a versatile electrochemical platform for the SARS-CoV-2 RdRP detection based on a signal off sensing strategy. In this study, for the first time, the silver ions (Ag+) in the hexathia-18-crown-6 carrier were applied as an electrochemical probe.


Asunto(s)
/instrumentación , Nanotecnología/métodos , /genética , Técnicas Biosensibles , Dendrímeros , Diagnóstico Precoz , Electrodos , Humanos , Límite de Detección , Esputo/virología , Replicación Viral/genética
3.
BMC Infect Dis ; 21(1): 287, 2021 Mar 20.
Artículo en Inglés | MEDLINE | ID: mdl-33743629

RESUMEN

BACKGROUND: Talaromyces marneffei (T. marneffei) is an opportunistic pathogen that infects immunodeficient children. The aim of the study is to determine the clinical features and peripheral immune state of Talaromyces marneffei (T. marneffei) infections in children for early detection and diagnosis. METHODS: We retrospectively reviewed 21 pediatric patients who were diagnosed with T. marneffei infections and were followed up in the Guangzhou Women and Children's Medical Center from January 2010 to January 2020. For each patient, we collected and analyzed clinical characteristics, peripheral immunological results, genetic tests, complications and prognosis. RESULTS: Common clinical features of the patients included fever (20/21, 95.24%), cough (17/21, 80.95%) and hepatomegaly (17/21, 80.95%). Severe complications included septic shock (12/21, 57.14%), hemophagocytic lymphohistiocytosis (HLH) (11/21, 52.38%), acute respiratory distress syndrome (ARDS) (10/21, 47.62%), multiple organ dysfunction syndrome (MODS) (9/21, 42.86%), and disseminated intravascular coagulation (DIC) (7/21, 33.33%). Eleven children (11/21, 52.38%) eventually died of T. marneffei infections. All patients were HIV negative. Seven cases revealed reduced antibody levels, especially IgG. Higher levels of IgE were detected in 9 cases with an obvious increase in two patients. Ten patients showed decreased complement C3 levels, some of whom had low C4 levels. Three patients displayed decreased absolute T lymphocyte counts, including the CD 4+ and CD 8+ subsets. A reduction in NK cells was present in most patients. No patient had positive nitro blue tetrazolium (NBT) test results. Nine patients were screened for common genetic mutations. Of the cases, one case had no disease-specific gene mutation. Four children had confirmed hyperimmunoglobulin M syndrome (HIGM) with CD40LG variation, one case had severe combined immunodeficiency (SCID), and one case had hyper-IgE syndrome (HIES). One patient was identified as having a heterozygous mutation in STAT3 gene; however, he showed no typical clinical manifestations of HIES at his age. One patient had a mutated COPA gene with uncertain pathogenic potential. Another patient was diagnosed with HIES that depended on her clinical features and the National Institutes of Health (NIH) scoring system. CONCLUSIONS: T. marneffei infections in HIV-negative children induced severe systemic complications and poor prognosis. Children with T. marneffei infections commonly exhibited abnormal immunoglobulin levels in peripheral blood, particularly decreased IgG or increased IgE levels, further suggesting possible underlying PIDs in these patients.


Asunto(s)
Anticuerpos Antifúngicos/sangre , Micosis/inmunología , Niño , China , Diagnóstico Precoz , Femenino , Seronegatividad para VIH , Humanos , Masculino , Micosis/diagnóstico , Estudios Retrospectivos , Talaromyces
5.
Pol Merkur Lekarski ; 49(289): 80-83, 2021 Feb 24.
Artículo en Inglés | MEDLINE | ID: mdl-33713100

RESUMEN

Severe combined immunodeficiency (SCID) is a group of lifethreatening diseases, for which early diagnostics, before the development of infectious complications, is extremely important. Newborn screening for SCID with T-cell receptor excision circle (TREC) and kappa-deleting recombination excision circle (KREC) assay for the identification of T- and B-lymphopenia has been implemented in a number of highly developed countries of the world. A number of studies proved the clinical and cost-effectiveness of screening for SCID by using TREC assay. However, both clinical benefits and economic costs for screening may vary depending on country and continent, requiring pilot projects to establish reference values of TREC and KREC levels for the diagnosis of SCID and other diseases associated with T- and B-lymphopenia, as well as determination of cost-effectiveness/costbenefit ratio and expediency of their further implementation. Other challenges, outlined in the article, need to be solved. The development of hematopoietic stem cell transplantation in Ukraine opens up full opportunities for the implementation of newborn screening for SCID. The expediency of conducting a pilot study to determine the most effective method (TREC or TREC/KREC) and the algorithm for SCID detection has been shown.


Asunto(s)
Inmunodeficiencia Combinada Grave , Análisis Costo-Beneficio , Diagnóstico Precoz , Humanos , Recién Nacido , Tamizaje Neonatal , Proyectos Piloto , Inmunodeficiencia Combinada Grave/diagnóstico
6.
Medicine (Baltimore) ; 100(9): e24535, 2021 Mar 05.
Artículo en Inglés | MEDLINE | ID: mdl-33655920

RESUMEN

OBJECTIVE: To establish whether early use of magnetic resonance imaging (MRI) or computed tomography (CT) influences treatment and outcome of patients with low back pain. METHODS: This study will be implemented from March 2021 to March 2022 at Huzhou Traditional Chinese Medicine Hospital Affiliated to Zhejiang Chinese Medical University. The experiment was granted through the Research Ethics Committee of Huzhou Traditional Chinese Medicine Hospital Affiliated to Zhejiang Chinese Medical University (R609320987). Patients who have symptomatic lumbar spine disorders at presentation are eligible for the trial if there is clinical uncertainty about the need for imaging (MRI or CT). Patients are excluded who required immediate referral for imaging (those who had signs suggestive of serious abnormalities or disease or who required surgical intervention), who have undergone MR imaging or CT of the spine within 1 year, who do not need imaging, and who have pain of a nonspinal origin. The primary outcome measure is the Aberdeen Low Back Pain (ALBP) score. Other principal outcome measure is the Short Form 36. RESULTS: Table 1 will show the quality of life outcome measures between groups. CONCLUSION: This study may guide the policy makers to develop an evidence-based protocol to assess the effect of early use of MRI or CT in the treatment of patients with low back pain.


Asunto(s)
Toma de Decisiones Clínicas/métodos , Dolor de la Región Lumbar/diagnóstico por imagen , Imagen por Resonancia Magnética , Tomografía Computarizada por Rayos X , Adulto , Anciano , Anciano de 80 o más Años , Diagnóstico Precoz , Femenino , Humanos , Dolor de la Región Lumbar/terapia , Masculino , Persona de Mediana Edad , Dimensión del Dolor , Calidad de Vida , Ensayos Clínicos Controlados Aleatorios como Asunto , Resultado del Tratamiento
8.
Recenti Prog Med ; 112(3): 216-218, 2021 03.
Artículo en Inglés | MEDLINE | ID: mdl-33687360

RESUMEN

We analysed RRI and other hemodynamic, re-spiratory and inflammation parameters in critically ill pa-tients affected by severe covid-19 with acute distress respi-ratory syndrome (ARDS) aiming at verifying their modifica-tions during supine and prone positioning and any mutual correlation or interplay with RRI.


Asunto(s)
Velocidad del Flujo Sanguíneo , Inflamación/fisiopatología , Riñón/fisiopatología , Pulmón/fisiopatología , Arteria Renal/fisiopatología , Circulación Renal , /fisiopatología , Biomarcadores , Proteína C-Reactiva/análisis , /complicaciones , Creatinina/sangre , Diástole , Diagnóstico Precoz , Femenino , Humanos , Inflamación/sangre , Inflamación/diagnóstico , Pruebas de Función Renal , Masculino , Persona de Mediana Edad , Oxígeno/sangre , Posición Prona , /etiología , Posición Supina , Sístole
9.
Appl Microbiol Biotechnol ; 105(7): 2615-2624, 2021 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-33710356

RESUMEN

A most discussed topic of the new decade, COVID-19 is an infectious disease caused by the recently discovered SARS-CoV-2. With an exceedingly high transmission rate, COVID-19 has affected almost all the countries in the world. Absent any vaccine or specific treatment, the humanity is left with nothing but the legacy method of quarantine. However, quarantine can only be effective when combined with early diagnosis of suspected cases. With their high sensitivity and unmatched specificity, biosensors have become an area of interest for development of novel diagnostic methods. Compared to the more traditional diagnostics, nanobiotechnology introduces biosensors as different diagnostics with greater versatility in application. Today, a growing number of analytes are being accurately identified by these nanoscopic sensing machines. Several reports of validated application with real samples further strengthen this idea. As of recent, there has been a rise in the number of studies on portable biosensors. Despite the slow progression, certain devices with embedded biosensors have managed to be of diagnostic value in several countries. The perceptible increase in development of mobile platforms has revolutionized the healthcare delivery system in the new millennium. The present article reviews the most recent advancements in development of diagnostic nanobiosensors and their application in the clinical fields. KEY POINTS: • There is no specific treatment for highly transmissible SARS-CoV-2. • Early diagnosis is critical for control of pandemic. • Highly sensitive/specific nanobiosensors are emerging assets against COVID-19.


Asunto(s)
Técnicas Biosensibles/métodos , Diagnóstico Precoz , Técnicas Biosensibles/instrumentación , Humanos , Técnicas de Diagnóstico Molecular , Nanotecnología , Técnicas de Amplificación de Ácido Nucleico , /aislamiento & purificación
10.
Nutr Metab Cardiovasc Dis ; 31(4): 1137-1147, 2021 04 09.
Artículo en Inglés | MEDLINE | ID: mdl-33712363

RESUMEN

BACKGROUND AND AIMS: In-stent restenosis (ISR) remains the most daunting challenge of current treatments of coronary artery disease (CAD). MicroRNAs (miRNAs) are prominent regulators of key pathological processes leading to restenosis and used as diagnostic tools in different studies. miR-152 and miR-148a are implicated to contribute in the putative intracellular mechanisms of ISR. The aim of present study is to investigate the potential early-stage diagnostic role of miR-152 and miR-148a expression levels for ISR in peripheral blood mononuclear cells (PBMCs) of patients who underwent stent implantation. METHODS AND RESULTS: The miRNAs that are supposed to be involved in the ISR were nominated by bioinformatics approach mainly using miRWalk3. Then by quantitative real-time PCR, we determined the relative expression of miR-152 and miR-148a of PBMCs from ISR patients with their age/sex-matched controls. RESULTS: The presence of ISR significantly coincided with a decrease in the relative expression of miR-152. The area under the curve (AUC) for miR-152 receiver operating characteristic (ROC) curve was 0.717 (95% CI; 0.60-0.83) with a sensitivity of 70% and a specificity of 67%, suggesting that the miRNA expression level might be employed to identify patients at risk of ISR. CONCLUSIONS: To the best of our knowledge, this is the first work to show that the miR-152 expression level can possibly be applied to predict CAD patients at risk of ISR. The results suggest that the expression levels of miR-152 in PBMCs may serve as a biomarker for ISR. Our finding suggests the importance of miRNA levels in PBMCs as a novel biological tool to detect diseases in their early clinical stages.


Asunto(s)
Enfermedad de la Arteria Coronaria/terapia , Reestenosis Coronaria/sangre , Leucocitos Mononucleares/metabolismo , MicroARNs/sangre , Intervención Coronaria Percutánea/efectos adversos , Intervención Coronaria Percutánea/instrumentación , Stents , Adulto , Anciano , Anciano de 80 o más Años , Biomarcadores/sangre , Estudios de Casos y Controles , Biología Computacional , Enfermedad de la Arteria Coronaria/sangre , Enfermedad de la Arteria Coronaria/diagnóstico por imagen , Reestenosis Coronaria/diagnóstico por imagen , Reestenosis Coronaria/etiología , Diagnóstico Precoz , Femenino , Humanos , Masculino , Persona de Mediana Edad , Valor Predictivo de las Pruebas , Factores de Tiempo , Resultado del Tratamiento
11.
Medicine (Baltimore) ; 100(12): e25266, 2021 Mar 26.
Artículo en Inglés | MEDLINE | ID: mdl-33761727

RESUMEN

INTRODUCTION: The objective is to analyze the clinical diagnosis and treatment of children with rescindable posterior encephalopathy syndrome (PRES) and intracranial hemorrhage (ICH) to improve the pediatrician's understanding of PRES combined with ICH in children. PATIENT CONCERNS AND DIAGNOSIS: After liver transplantation, the patient developed symptoms of epilepsy and coma. Meanwhile, massive necrosis of acute cerebral infarction and small hemorrhage was observed in the left cerebellar hemisphere and left occipital lobe, respectively. The above symptoms were initially diagnosed as PRES. INTERVENTIONS AND OUTCOMES: After adjusting the anti-rejection drug regimen, it was found that the child's neurological symptoms were relieved, and the limb motor function gradually recovered during follow-up. Imaging examination showed significant improvement on abnormal signals in brain. CONCLUSION: In general, children with PRES may further develop ICH and contribute to a poor prognosis. Early diagnosis, detection of risk factors and timely adjustment of medication regimen are the keys to prevent irreversible brain damage.


Asunto(s)
Conductos Biliares/anomalías , Atresia Biliar/cirugía , Infarto Cerebral , Inmunosupresión , Hemorragias Intracraneales , Síndrome de Leucoencefalopatía Posterior , Ajuste de Riesgo/métodos , Atresia Biliar/diagnóstico , Atresia Biliar/etiología , Encéfalo/diagnóstico por imagen , Daño Encefálico Crónico/etiología , Daño Encefálico Crónico/prevención & control , Infarto Cerebral/diagnóstico , Infarto Cerebral/etiología , Preescolar , Diagnóstico Precoz , Humanos , Inmunosupresión/efectos adversos , Inmunosupresión/métodos , Hemorragias Intracraneales/diagnóstico , Hemorragias Intracraneales/etiología , Trasplante de Hígado/métodos , Imagen por Resonancia Magnética/métodos , Masculino , Síndrome de Leucoencefalopatía Posterior/diagnóstico , Síndrome de Leucoencefalopatía Posterior/etiología , Síndrome de Leucoencefalopatía Posterior/fisiopatología , Síndrome de Leucoencefalopatía Posterior/terapia , Tomografía Computarizada por Rayos X/métodos
12.
Arch Virol ; 166(4): 1083-1092, 2021 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-33544254

RESUMEN

Rabies, which is caused by rabies virus (RABV), poses an ever-present threat to public health in most countries of the world. Once clinical signs appear, the mortality of rabies approaches 100%. To date, no effective method for early rabies diagnosis has been developed. In this study, an RPA-CRISPR nucleic-acid-based assay was developed for early rabies diagnosis by detecting viral RNA shedding in the cerebrospinal fluid (CSF) of rats. This method can detect a single copy of RABV genomic RNA in 1 µL of liquid. RABV genomic RNA released from viral particles in the CSF could be detected via RPA-CRISPR as early as 3 days postinfection in a rat model. This study provides an RPA-CRISPR technique for early detection of RABV with potential application in the clinical diagnosis of human rabies.


Asunto(s)
Sistemas CRISPR-Cas , Técnicas de Diagnóstico Molecular/métodos , Técnicas de Amplificación de Ácido Nucleico , Virus de la Rabia/aislamiento & purificación , Rabia/diagnóstico , Animales , Modelos Animales de Enfermedad , Diagnóstico Precoz , ARN Viral/líquido cefalorraquídeo , ARN Viral/genética , Rabia/líquido cefalorraquídeo , Virus de la Rabia/genética , Ratas , Ratas Sprague-Dawley , Sensibilidad y Especificidad
13.
Biosensors (Basel) ; 11(2)2021 Jan 24.
Artículo en Inglés | MEDLINE | ID: mdl-33561091

RESUMEN

This systematic review aimed to assess the advantages of biosensors in detecting biomarkers for the early diagnosis of osteoarthritis (OA). OA is the most prevalent musculoskeletal disease and is a leading cause of disability and pain worldwide. The diagnosis of OA could be performed through clinical examinations and imaging only during the late stages of the disease. Biomarkers could be used for the diagnosis of the disease in the very early stages. Biosensors could detect biomarkers with high accuracy and low costs. This paper focuses on the biosensors mainly adopted to detect OA markers (electrochemical, optical, Quartz crystal microbalance, molecular and wearable biosensors). A comprehensive search on PubMed, Cochrane, CINAHL and Embase databases was conducted from the inception to November 2020. The Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines were used to improve the reporting of the review. The Methodological Index for Non-Randomized Studies (MINORS) was used for quality assessment. From a total amount of 1086 studies identified, only 19 articles were eligible for this study. The main advantages of the biosensors reported were accuracy, limited cost and ease of use, compared to traditional methods (ELISA). Otherwise, due to the lack of data and the low level of evidence of the papers included, it was impossible to find significant results. Therefore, further high-quality studies are required.


Asunto(s)
Biomarcadores/química , Técnicas Biosensibles , Monitoreo Fisiológico/métodos , Osteoartritis/diagnóstico , Diagnóstico Precoz , Humanos , Tecnicas de Microbalanza del Cristal de Cuarzo
14.
Biomolecules ; 11(2)2021 01 30.
Artículo en Inglés | MEDLINE | ID: mdl-33573324

RESUMEN

The epidemic due to the novel coronavirus (SARS-CoV-2) is now a global concern, posing a severe threat to the health of populations. At present, all countries in the world are stepping up the development of vaccines and antiviral agents to prevent the infection and further transmission of SARS-CoV-2. An in-depth investigation of the target organs and pathogenesis regarding SARS-CoV-2 infection will be beneficial for virus therapy. Besides pulmonary injury, SARS-CoV-2 also causes cardiac injury, but the exact mechanisms are unclear. This review summarizes the essential structural characteristics of SARS-CoV-2 and angiotensin-converting enzyme 2 (ACE2), describes the cardiac manifestations following SARS-CoV-2 infection, and explores the mechanisms of cardiac injury targeting ACE2 after the viral invasion. We aim to help the timely detection of related symptoms and implementation of therapeutic measures by clinicians for SARS-CoV-2 infection.


Asunto(s)
/efectos de los fármacos , Cardiopatías/etiología , /patogenicidad , /fisiología , Antivirales/farmacología , Antivirales/uso terapéutico , /tratamiento farmacológico , Sistemas de Liberación de Medicamentos , Diagnóstico Precoz , Genoma Viral , Cardiopatías/diagnóstico , Humanos , /aislamiento & purificación
15.
Sensors (Basel) ; 21(3)2021 Jan 30.
Artículo en Inglés | MEDLINE | ID: mdl-33573296

RESUMEN

Thermography enables non-invasive, accessible, and easily repeated foot temperature measurements for diabetic patients, promoting early detection and regular monitoring protocols, that limit the incidence of disabling conditions associated with diabetic foot disorders. The establishment of this application into standard diabetic care protocols requires to overcome technical issues, particularly the foot sole segmentation. In this work we implemented and evaluated several segmentation approaches which include conventional and Deep Learning methods. Multimodal images, constituted by registered visual-light, infrared and depth images, were acquired for 37 healthy subjects. The segmentation methods explored were based on both visual-light as well as infrared images, and optimization was achieved using the spatial information provided by the depth images. Furthermore, a ground truth was established from the manual segmentation performed by two independent researchers. Overall, the performance level of all the implemented approaches was satisfactory. Although the best performance, in terms of spatial overlap, accuracy, and precision, was found for the Skin and U-Net approaches optimized by the spatial information. However, the robustness of the U-Net approach is preferred.


Asunto(s)
Aprendizaje Profundo , Diabetes Mellitus , Pie Diabético , Enfermedades del Pie , Pie Diabético/diagnóstico por imagen , Diagnóstico Precoz , Pie/diagnóstico por imagen , Humanos , Termografía
16.
BMC Med ; 19(1): 50, 2021 02 17.
Artículo en Inglés | MEDLINE | ID: mdl-33596902

RESUMEN

BACKGROUND: Following implementation of strong containment measures, several countries and regions have low detectable community transmission of COVID-19. We developed an efficient, rapid, and scalable surveillance strategy to detect remaining COVID-19 community cases through exhaustive identification of every active transmission chain. We identified measures to enable early detection and effective management of any reintroduction of transmission once containment measures are lifted to ensure strong containment measures do not require reinstatement. METHODS: We compared efficiency and sensitivity to detect community transmission chains through testing of the following: hospital cases; fever, cough and/or ARI testing at community/primary care; and asymptomatic testing; using surveillance evaluation methods and mathematical modelling, varying testing capacities, reproductive number (R) and weekly cumulative incidence of COVID-19 and non-COVID-19 respiratory symptoms using data from Australia. We assessed system requirements to identify all transmission chains and follow up all cases and primary contacts within each chain, per million population. RESULTS: Assuming 20% of cases are asymptomatic and 30% of symptomatic COVID-19 cases present for testing, with R = 2.2, a median of 14 unrecognised community cases (8 infectious) occur when a transmission chain is identified through hospital surveillance versus 7 unrecognised cases (4 infectious) through community-based surveillance. The 7 unrecognised community upstream cases are estimated to generate a further 55-77 primary contacts requiring follow-up. The unrecognised community cases rise to 10 if 50% of cases are asymptomatic. Screening asymptomatic community members cannot exhaustively identify all cases under any of the scenarios assessed. The most important determinant of testing requirements for symptomatic screening is levels of non-COVID-19 respiratory illness. If 4% of the community have respiratory symptoms, and 1% of those with symptoms have COVID-19, exhaustive symptomatic screening requires approximately 11,600 tests/million population using 1/4 pooling, with 98% of cases detected (2% missed), given 99.9% sensitivity. Even with a drop in sensitivity to 70%, pooling was more effective at detecting cases than individual testing under all scenarios examined. CONCLUSIONS: Screening all acute respiratory disease in the community, in combination with exhaustive and meticulous case and contact identification and management, enables appropriate early detection and elimination of COVID-19 community transmission. An important component is identification, testing, and management of all contacts, including upstream contacts (i.e. potential sources of infection for identified cases, and their related transmission chains). Pooling allows increased case detection when testing capacity is limited, even given reduced test sensitivity. Critical to the effectiveness of all aspects of surveillance is appropriate community engagement, messaging to optimise testing uptake and compliance with other measures.


Asunto(s)
/epidemiología , Vida Independiente/tendencias , Modelos Teóricos , Vigilancia de la Población/métodos , Australia/epidemiología , Número Básico de Reproducción/prevención & control , Diagnóstico Precoz , Estudios de Factibilidad , Hospitalización/tendencias , Humanos , Estudios Longitudinales , Tamizaje Masivo/métodos , Tamizaje Masivo/tendencias
17.
BMJ Case Rep ; 14(2)2021 Feb 04.
Artículo en Inglés | MEDLINE | ID: mdl-33541951

RESUMEN

Alkaptonuria is a rare genetic disorder resulting in abnormality of tyrosine metabolism. It is one of the Garrod's tetrad of 'inborn errors of metabolism' proposed to have Mendelian recessive inheritance. The disorder is characterised by deposition of homogentisic acid leading to ochronosis and ochronotic osteoarthropathy; however, blackish discoloration of urine is the only childhood manifestation. Other manifestations present only after third decade. A 13-year-old boy presented to paediatric nephrology clinic with blackish discolouration of urine since infancy. Examination revealed bluish black discolouration of bilateral sclera and ear cartilage; however, he had no symptoms of ochronotic osteoarthropathy. Genetic test pointed towards alkaptonuria. Currently, he is on regular follow-up and is being treated with vitamin C to delay the progression of the disease. Early diagnosis with appropriate intervention delays the onset of complications and preserves the quality of life of the patient.


Asunto(s)
Alcaptonuria/diagnóstico , Antioxidantes/administración & dosificación , Ácido Ascórbico/administración & dosificación , Diagnóstico Precoz , Ocronosis/complicaciones , Adolescente , Alcaptonuria/genética , Progresión de la Enfermedad , Humanos , Masculino , Esclerótica
18.
PLoS One ; 16(2): e0247606, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33617597

RESUMEN

BACKGROUND: Since COVID-19 pandemic is a global crisis, tests with high sensitivity and specificity are crucial for the identification and management of COVID-19 patients. There is an urgent need for low-cost rapid antigen COVID-19 test with a good diagnostic performance. Although various antigen rapid detection tests are widely available, strong evidence of their usefulness in clinical practice are still limited. Therefore, our aim was to evaluate clinical performance of STANDARD Q COVID-19 Ag Test (SD Biosensor, Gyeonggi-do, South Korea). METHODS: The performance of the STANDARD Q COVID-19 Ag Test for the detection of SARS-CoV-2 antigen was evaluated in comparison to RT-qPCR results in 120 symptomatic patients (median age 49, IQR 36-70) who presented to health care facility in Novi Sad, Vojvodina, Serbia. RESULTS: Twenty five out of 120 samples have been tested positive using STANDARD Q COVID-19 Ag Test, and all of them were also positive on RT-qPCR. Overall, the STANDARD Q COVID-19 Ag Test showed sensitivity of 58.1% (95% CI 42.1-73.0) but it was higher in the early days of disease, when the highest viral loads were detected. During the first five days after the symptom onset, the sensitivity ranged from 66.7% to 100% and the pooled accuracy and Kappa values were high (0.92 and 0.852). CONCLUSIONS: A strong agreement between performance of STANDARD Q COVID-19 Ag Test and RT-qPCR was observed during the first five days of illness, suggesting that this rapid antigenic test can be very useful for COVID-19 diagnosis in the early phase of disease.


Asunto(s)
Antígenos Virales/análisis , /diagnóstico , Nasofaringe , /aislamiento & purificación , Diagnóstico Precoz , Humanos , Persona de Mediana Edad , Nasofaringe/inmunología , Nasofaringe/virología , Sensibilidad y Especificidad , Serbia/epidemiología
19.
BMJ Case Rep ; 14(2)2021 Feb 09.
Artículo en Inglés | MEDLINE | ID: mdl-33563692

RESUMEN

An 81-year-old woman, diabetic and hypertensive, presented with nausea and intermittent vomiting. She had dysphagia and loss of appetite for over 6 weeks and significant weight loss over 3 weeks and was admitted in general surgery unit on emergency basis. Investigations revealed dilated stomach and a stone in first part of duodenum, with probable site of obstruction at level of first part of duodenum, secondary to a cholecystoduodenal fistula. With a preoperative diagnosis of Bouveret's syndrome, she underwent laparotomy and subtotal cholecystectomy. Postoperative recovery was delayed due to gastroparesis and delayed gastric emptying which resolved with conservative management. Successful management of this case required a multidisciplinary team approach. Early diagnosis was the key to management. Mode of treatment and management of Bouveret's syndrome should be tailored to suit patient's age, comorbidities and performance status.


Asunto(s)
Cálculos Biliares/complicaciones , Obstrucción de la Salida Gástrica/etiología , Obstrucción de la Salida Gástrica/cirugía , Anciano de 80 o más Años , Biomarcadores/sangre , Colecistectomía , Diagnóstico Diferencial , Diagnóstico Precoz , Femenino , Cálculos Biliares/diagnóstico por imagen , Obstrucción de la Salida Gástrica/diagnóstico por imagen , Humanos , Laparotomía , Complicaciones Posoperatorias/diagnóstico por imagen , Complicaciones Posoperatorias/terapia , Síndrome
20.
Int J Oral Maxillofac Implants ; 36(1): 115-121, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33600531

RESUMEN

PURPOSE: Peri-implantitis, a potentially progressive disease that occurs in patients with dental implants, is more aggressive than periodontal lesions, which makes the prevention of peri-implantitis an important priority. Due to problems in the early detection of peri-implantitis, there is an urgent need for discovering novel biologic molecules with the ability of early diagnosis. The goal of this study was to profile the microRNA content of saliva samples collected from patients with titanium-aluminum-vanadium alloy dental implants who experienced peri-implantitis and to find potential diagnostic markers for detection of this disease. MATERIALS AND METHODS: The microRNA expression profiles of eight saliva samples (four collected from patients with peri-implantitis, four collected from patients who have successful implants) were investigated, and the deregulation of select microRNAs was further confirmed using quantitative polymerase chain reaction. RESULTS: The expressions of 179 microRNAs were found as deregulated in the saliva of peri-implantitis patients in comparison to controls. Then, downregulation of miR-4484 was confirmed in the saliva of peri-implantitis patients in a larger validation cohort. Also, 40% of non-peri-implantitis patients and 78% of peri-implantitis patients had significantly decreased miR-4484 expression in saliva samples collected after 4 to 6 months subsequent to implant placement compared with samples collected before implant placement. CONCLUSION: Considering these findings, microRNA content of saliva might be proposed as a plausible source for the early diagnosis of peri-implantitis, where miR-4484 might serve as an encouraging early diagnostic biomarker.


Asunto(s)
Implantes Dentales , MicroARNs , Periimplantitis , Biomarcadores , Implantes Dentales/efectos adversos , Diagnóstico Precoz , Humanos , MicroARNs/genética , Periimplantitis/diagnóstico , Saliva
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