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1.
Biochem Med (Zagreb) ; 30(1): 010502, 2020 Feb 15.
Artículo en Inglés | MEDLINE | ID: mdl-31839720

RESUMEN

Extravascular body fluids (EBF) analysis can provide useful information in the differential diagnosis of conditions that caused their accumulation. Their unique nature and particular requirements accompanying EBF analysis need to be recognized in order to minimize possible negative implications on patient safety. This recommendation was prepared by the members of the Working group for extravascular body fluid samples (WG EBFS). It is designed to address the total testing process and clinical significance of tests used in EBF analysis. The recommendation begins with a chapter addressing validation of methods used in EBF analysis, and continues with specific recommendations for serous fluids analysis. It is organized in sections referring to the preanalytical, analytical and postanalytical phase with specific recommendations presented in boxes. Its main goal is to assist in the attainment of national harmonization of serous fluid analysis and ultimately improve patient safety and healthcare outcomes. This recommendation is intended to all laboratory professionals performing EBF analysis and healthcare professionals involved in EBF collection and processing. Cytological and microbiological evaluations of EBF are beyond the scope of this document.


Asunto(s)
Líquidos Corporales/química , Técnicas de Laboratorio Clínico/normas , Líquidos Corporales/metabolismo , Exudados y Transudados/química , Exudados y Transudados/metabolismo , Guías como Asunto , Humanos , Seguridad del Paciente , Derrame Pleural/diagnóstico , Garantía de la Calidad de Atención de Salud , Sociedades Médicas , Manejo de Especímenes/normas
2.
Adv Gerontol ; 32(4): 530-535, 2019.
Artículo en Ruso | MEDLINE | ID: mdl-31800180

RESUMEN

Due to the increase in the proportion of elderly women, the prevalence of ovarian cancer is increasing, which requires the search for new methods of its diagnosis. The aim of the work is to analyze the content and informativeness of immunoglobulins and phagocytic activity of peripheral blood to improve the diagnosis of ovarian cancer among elderly women. In 78 patients with ovarian cancer aged 65-70 years immunological and spectrophotometric methods studied phagocytic activity and the level of peripheral blood immunoglobulins. 42 women of the same age with no ovarian cancer served as control. The primary importance of circulating immune complexes, phagocyte migration inhibition index and neutrophil activity index for laboratory diagnosis of ovarian cancer among the elderly was established. The use of highly informative parameters of systemic immunity improves the diagnosis of ovarian cancer in the elderly.


Asunto(s)
Inmunoglobulinas , Neoplasias Ováricas , Fagocitosis , Anciano , Técnicas de Laboratorio Clínico , Femenino , Humanos , Inmunoglobulinas/sangre , Neutrófilos/metabolismo , Neoplasias Ováricas/sangre , Neoplasias Ováricas/diagnóstico , Neoplasias Ováricas/fisiopatología
3.
Rev. salud pública Parag ; 9(2): [P29-P34], Dic 2019.
Artículo en Español | LILACS, BDNPAR | ID: biblio-1047052

RESUMEN

Introducción: En Paraguay, la epidemia del VIH se encuentra concentrada en población clave. La ruta principal de transmisión de las infecciones de transmisión del VIH y la Sífilis es la sexual. Las mujeres trabajadoras sexuales (MTS) presentan riesgo incrementado debido a su trabajo sexual y sus comportamientos de riesgo. Objetivo: Determinar la prevalencia de VIH/Sífilis y el comportamiento de riesgo de la población de mujeres trabajadoras sexuales en seis regiones sanitarias del país durante el año 2017. Material y Métodos: El diseño del estudio fue observacional, corte transversal. La metodología utilizada para la selección de la muestra fue la de TLS (muestreo tiempo-ubicación). Se utilizaron pruebas rápidas como tamizaje inicial en todas las mujeres que ingresaron al estudio y a la vez se aplicó un instrumento para los comportamientos de riesgo. Resultados: Ingresaron 643 MTS, la edad media fue de 27 años, donde el 50% tenían entre 22 y 34 años. El 88.11% (585) realizaba el trabajo sexual en locales (prostíbulos, saunas, salón de masajes y departamentos) y el 11.89% (58) en paradas en las calles. La prevalencia del VIH fue de 1.34% (CI95% 0.513.48) y de Sífilis 8.59% (CI95% 5.78-12.59). El uso de condón en la última relación con el cliente fue de 96.02% y del 25.78% con la pareja estable en la última relación sexual. El consumo de drogas en los últimos 6 meses por más de 25 días fue de 10.78% (44/643) para la cocaína. El 54.17% de las MTS encuestadas se consideraron en igual riesgo de adquirir el VIH en comparación con el resto de las personas. Conclusión: La prevalencia de VIH fue baja y de Sífilis elevada en MTS. Se observó bajo porcentaje de uso de condón con la pareja estable, alto consumo de drogas y baja percepción de riesgo. Es importante considerar estos aspectos en el momento de planificar las intervenciones en MTS: parejas, drogas y percepción de riesgo para que se pueda lograr la eficiencia de las mismas. Palabras clave: Seroprevalencia de VIH; Serodiagnóstico de la Sífilis; Grupos de Riesgo; Paraguay


Introduction: The HIV epidemic in Paraguay is concentrated in key population. The main route of HIV and Syphilis infections transmission is sexual. Female sex workers (FSW) have increased risk due to their sex work and risk behaviors. Objective: To determine the HIV/Syphilis prevalence and risk behavior in the population of female sex workers in six health regions from the country during 2017. Material and Methods: This is a cross-sectional study. The methodology used for the selection of the sample was the TLS (time-location sampling). Rapid tests were used as initial screening of all women who entered the study and at the same time an instrument for risk behaviors was applied. Results: Of 643 FSW enrolled, the average age was 27 years, where 50% were between 22 and 34 years old. 88.11% (585) performed sex work in premises (brothels, saunas, massage parlors and departments) and 11.89% (58) at street. The HIV prevalence was 1.34% (95% CI 0.513.48) and 8.59% Syphilis (95% CI 5.78-12.59). Condom use in the last relationship with the client was 96.02% and 25.78% with the stable partner in the last sexual relationship. 54.17% of the FSW surveyed were considered at equal risk of acquiring HIV compared to the rest of the people. Conclusion: The prevalence of HIV was low and Syphilis was high in MTS. A low percentage of condom use was observed with the stable partner, high drug use and low risk perception. It is important to consider these aspects when planning interventions in MTS: couples, drugs and low risk perception so that their efficiency can be achieved. Keywords: HIV seroprevalence; Serodiagnostic of Syphilis; Risk Groups; Paraguay


Asunto(s)
Humanos , Femenino , Adulto , Trabajo Sexual , Mujeres Trabajadoras , Serodiagnóstico de la Sífilis , Prevalencia , VIH/inmunología , Técnicas de Laboratorio Clínico , Conductas de Riesgo para la Salud
4.
Prensa méd. argent ; 105(11): 827-835, dic2019. tab
Artículo en Inglés | LILACS, BINACIS | ID: biblio-1049981

RESUMEN

The metabolic syndrome (MetS) or insulin resistance syndrome is widespread and multi-factorial disorder. This article aims to assess and observe samples with the MetS to start efforts to take the proper treatments to minimize the risk of cardiovascular diseases. Additionally, we evaluate the association of Helicobacter pylori (H. Pylori) Ab tests with MetS. To meet this goal, 350 reviewers of K1 Hospital are participated in this work for six months from October 2016 to March 2017. The patients (N=350) are divided into two groups, a group subjects with MetS (N=109), whereas the latter is without MetS (N=241). A venous blood sample is taken after 8 hours of fasting to measure fasting blood glucose, H. Pylori Ab test and other required biochemical assays. Additionally, blood pressure (BP), Body Mass Index (BMI) (i.e. weight and height), and waist circumference are measured. The assays revealed that the frequency of MetS is 31.1% as per the modified National Cholesterol Education Program Adult Treatment Panel III (NCEP: ATPIII) criteria. Furthermore, a statistically significant age (p=0.02) corresponded higher rate of MetS cases is larger than 40 years old (i.e. 69%). Moreover, BMI recorded as (27.6 ± 4.4 vs 31.4 ± 4.5, p <0.001), height (169 ± 8.4 vs 168.1 ± 8.5, p ≤ 0.11), weight (78.8 ± 12.3 vs 88.6 ± 13.2, p<0.01) and waist circumference (83.3 ± 16.1 vs 96.3 ± 11.6, p<0.001). Besides, BP showed positively correlation with systolic (120.3 ± 10.6 vs 130.6 ± 10.8, p<0.04) and diastolic (70.9 ± 0.9 vs 80.8 ± 10, p<0.01). The biochemical assays for employees with and without MetS are mean values of fasting Serum glucose (5.3 ± 1.4 vs 7.5 ± 3.2, p ≤ 0.001). The highest average total cholesterol recorded as (4.3 ± 1.3 vs 4.9 ± 1.3, p ≤ 0.001), serum triglyceride (2 ± 1.5 vs 2.8 ± 1.2, p ≤ 0.001) and lower HDL levels (1.2 ± 0.5 vs 0.8 ± 0.1, p ≤ 0.001). Accordingly, the results showed that H. Pylori infection is associated significantly with metabolic syndrome. In consequence, the outcome demonstrated high rates of obesity and overweight in MetS cases


Asunto(s)
Humanos , Enfermedades Cardiovasculares/terapia , Estudios de Casos y Controles , Helicobacter pylori , Infecciones por Helicobacter/terapia , Técnicas de Laboratorio Clínico , Síndrome Metabólico/terapia , Diabetes Mellitus Tipo 2/terapia
5.
Diagn. tratamento ; 24(4): [135-142], out - dez. 2019. tab, graf
Artículo en Portugués | LILACS | ID: biblio-1049377

RESUMEN

Introdução: A automedicação ocorre, em especial, por fatores sociais, econômicos e culturais, podendo refletir na eficácia do tratamento antibacteriano, devido à adaptação das bactérias aos antibióticos de primeira escolha. A resistência bacteriana é uma problemática mundial. Objetivo: Verificar a etiologia e o perfil de resistência de bactérias isoladas em uroculturas frente aos antibióticos comumente utilizados em um hospital no município de Macapá (AP), Brasil. Métodos: Trata-se de um estudo transversal com coleta de dados no sistema de registros cadastrais do Laboratório Central de Saúde Pública do Amapá, onde foram processadas as uroculturas oriundas do hospital-alvo deste estudo, no período de junho de 2016 a junho de 2018. Resultados: Os resultados demonstraram que, das 2.078 uroculturas, 289 (13,9%) eram positivas, sendo 55% de pacientes do sexo feminino. As infecções urinárias foram causadas, predominantemente, por enterobactérias Escherichia coli (50,4%) e Klebsiella pneumoniae (21%), sendo sensíveis ao meropenem e à amicacina, e respectivamente resistentes às quinolonas norfloxacina (63% e 66%) e ciprofloxacina (61% e 46,6%). Por outro lado, Staphylococcus aureus (1,4%) apresentou maior resistência à eritromicina (100%) e à oxacilina (50%). O Enterococcus faecalis (5%) foi mais resistente aos antibióticos ciprofloxacina, ampicilina e gentamicina, com 35,7%. Conclusão: Os uropatógenos foram mais frequentes no sexo feminino entre a faixa etária de 40 a 79 anos. Os microrganismos mais isolados foram as bactérias Escherichia coli e Klebsiella pneumoniae, que apresentaram perfil de resistência às quinolonas norfloxacina e ciprofloxacina, o que foi associado ao frequente uso empírico destes fármacos no tratamento de infecções do trato urinário. Verificou-se a existência de bactérias como Burkholderia cepacia e Stenotrophomonas maltophillia, que, por serem resistentes à maioria dos fármacos clinicamente utilizados, representam preocupação especial para os pacientes em condições de imunodepressão.


Asunto(s)
Infecciones Urinarias , Infección Hospitalaria , Epidemiología , Técnicas de Laboratorio Clínico , Antibacterianos
6.
J Med Life ; 12(3): 215-220, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31666819

RESUMEN

The final stage of the diagnostic of primary hyperaldosteronism is to identify the causes of excessive secretion of aldosterone and determination of its variants. Based on the analysis of literature data, the diagnostic value, sensitivity and specificity of the methods of radiation diagnostics for primary hyperaldosteronism were assessed: ultrasound, computed tomography, magnetic resonance imaging, photon emission tomography, magnetic resonance spectroscopy, scintigraphy with iodine radiopharmaceuticals. The causes of false-positive and false-negative evaluations of changes in adrenal glands in the application of these diagnostics have been analyzed. There are many genetic and morphological studies when searching the literature data on the principles and methods of distinguishing the nosological forms of primary hyperaldosteronism based on the results of the aldosterone level estimation in the separated blood from the central veins of both adrenal glands or segmental veins of one gland with subsequent determination of the concentration gradient. It was noted that topical diagnostics and, especially, the determination of nosological forms of primary hyperaldosteronism are complex and expensive, but their results allow choosing an appropriate treatment approach for each particular case.


Asunto(s)
Técnicas de Laboratorio Clínico , Hiperaldosteronismo/diagnóstico , Glándulas Suprarrenales/diagnóstico por imagen , Glándulas Suprarrenales/patología , Aldosterona/metabolismo , Humanos , Hiperaldosteronismo/diagnóstico por imagen , Hiperaldosteronismo/patología , Tomografía Computarizada por Rayos X
7.
Zhongguo Xue Xi Chong Bing Fang Zhi Za Zhi ; 31(4): 456-459, 2019 Jul 23.
Artículo en Chino | MEDLINE | ID: mdl-31612690

RESUMEN

OBJECTIVE: To analyze the epidemiological and clinical data of an imported case of visceral leishmaniasis in Henan Province, and explore the method of laboratory diagnosis of kala-azar. METHODS: The epidemiological and clinical data of an imported visceral leishmaniasis patient were analyzed. Leishmania donovani bodies in bone marrow smears were observed microscopically. The antibody was detected by using rK39 dipstick test strips. Two pairs of specific primers, K13A-K13B and LITSR-L5.8S, were used to amplify kinetoplast DNA and internal transcribed spacer of rDNA of the parasite, respectively. RESULTS: The patient had been in the epidemic area of visceral leishmaniasis, and had symptoms such as irregular fever, splenomegaly, pancytopenia, and inversed ratio of albumin and globulin. The amastigotes of L. donovani were found in the bone marrow smears, and rK39 test strip was positive, and the PCR products of K13A-K13B and LITSR-L5.8S were 87 bp and 285 bp respectively. The similarities of the two fragment sequences to the corresponding sequences of L. donovani were 94% and 100%, respectively. CONCLUSIONS: The case is diagnosed as visceral leishmaniasis according to the epidemiological data, clinical manifestations and laboratory test results of the patient, and the pathogen is L. donovani.


Asunto(s)
Enfermedades Transmisibles Importadas , Leishmania donovani , Leishmaniasis Visceral , Anticuerpos Antiprotozoarios/sangre , Médula Ósea/parasitología , Técnicas de Laboratorio Clínico , Enfermedades Transmisibles Importadas/diagnóstico , Enfermedades Transmisibles Importadas/parasitología , Cartilla de ADN , Humanos , Leishmania donovani/genética , Leishmaniasis Visceral/diagnóstico , Reacción en Cadena de la Polimerasa
8.
J Med Microbiol ; 68(11): 1622-1628, 2019 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-31596198

RESUMEN

Introduction. Nosocomial transmission of Mycobacterium tuberculosis is an important health issue and the detection of tuberculosis (TB) cases is the main tool for controlling this disease.Aim. We aimed to assess the possible occurrence of nosocomial transmission of M. tuberculosis in a reference hospital for HIV/AIDS patients and evaluate both the performance of the Xpert MTB/RIF (Xpert) platform and drug resistance profiles.Methodology. We evaluated the performance of the Xpert platform. Samples that tested positive on the BACTEC MGIT 320 (MGIT320) platform were submitted for genotyping and drug susceptibility testing.Results. In this study, pulmonary and extrapulmonary samples from 407 patients were evaluated, and among these, 15.5 % were diagnosed with TB by the MGIT320 platform, with a TB/HIV coinfection rate of 52.4 %. The Xpert platform gave positive results for TB for 11 samples with negative results on the MGIT320 platform. In the genotyping results, 53.3 % of the strains clustered; of these strains, half were in two of the four clusters formed, and the patients had visited the hospital on the same day. Drug resistance was observed in 11.7 % of the strains.Conclusion. Putative nosocomial transmission of M. tuberculosis was detected, showing that genotyping is a powerful approach for understanding the dynamics of M. tuberculosis transmission, especially in a high-burden TB and HIV landscape.


Asunto(s)
Infecciones por VIH/complicaciones , Técnicas de Diagnóstico Molecular/métodos , Mycobacterium tuberculosis/aislamiento & purificación , Tuberculosis Pulmonar/microbiología , Síndrome de Inmunodeficiencia Adquirida/complicaciones , Antibióticos Antituberculosos/farmacología , Técnicas de Laboratorio Clínico , Infección Hospitalaria/diagnóstico , Infección Hospitalaria/microbiología , Estudios Transversales , Farmacorresistencia Bacteriana , Humanos , Pruebas de Sensibilidad Microbiana , Mycobacterium tuberculosis/clasificación , Mycobacterium tuberculosis/efectos de los fármacos , Mycobacterium tuberculosis/genética , Filogenia , Tuberculosis , Tuberculosis Pulmonar/diagnóstico
9.
Rev Bras Epidemiol ; 22Suppl 02(Suppl 02): e190002.supl.2, 2019.
Artículo en Portugués, Inglés | MEDLINE | ID: mdl-31596373

RESUMEN

INTRODUCTION: This article aims to estimate reference values for laboratory tests of cholesterol, glycosylated hemoglobin and creatinine for the Brazilian adult population. METHODS: A descriptive study carried out with laboratory data from the National Health Survey (Pesquisa Nacional de Saúde - PNS). Samples of blood and urine were collected in a PNS subsample of 8,952 individuals aged 18 years old or older. To determine the reference values, exclusion criteria were applied: presence of previous diseases and outliers, defined by values outside the range estimated by the mean ± 1.96 × standard deviation. Subsequently, reference values were calculated according to gender, age group and race/skin color. RESULTS: Differences in reference values according to gender were observed. Women had higher values of total cholesterol, LDL-c and HDL-c. Glycosylated hemoglobin showed similar values in relation to gender, and creatinine was higher among men. The mean reference values were higher in the elderly population, aged 60 years old or older. The mean, lower and upper limits of total cholesterol and fractions of non-white people were slightly lower. There was no difference according to race/skin color for glycosylated hemoglobin and creatinine. CONCLUSION: The establishment of national reference parameters for laboratory tests, adapted to the sociodemographic and geographic characteristics, provides relevant information for evaluation of diagnosis and treatment of chronic diseases in Brazil.


Asunto(s)
Colesterol/sangre , Técnicas de Laboratorio Clínico/normas , Creatinina/análisis , Hemoglobina A Glucada/análisis , Adolescente , Adulto , Grupo de Ascendencia Continental Africana , Brasil , Grupo de Ascendencia Continental Europea , Femenino , Encuestas Epidemiológicas/métodos , Encuestas Epidemiológicas/estadística & datos numéricos , Humanos , Masculino , Persona de Mediana Edad , Valores de Referencia , Factores Sexuales , Adulto Joven
10.
Rev Bras Epidemiol ; 22Suppl 02(Suppl 02): E190003.SUPL.2, 2019.
Artículo en Portugués, Inglés | MEDLINE | ID: mdl-31596374

RESUMEN

OBJECTIVE: To describe reference values for blood counts obtained from laboratory tests in the Brazilian adult population according to laboratory results from the National Health Survey (Pesquisa Nacional de Saúde - PNS), by gender, age group and skin color. METHODS: The initial sample consisted of 8,952 adults. To determine the reference values, individuals with prior diseases and outliers were excluded. Mean values, standard deviation and limits were stratified by gender, age group and skin color. RESULTS: For red blood cells, men presented a mean value of 5.0 million per mm3 (limits: 4.3-5.8) and women, 4.5 million per mm3 (limits: 3.9-5.1). Hemoglobin levels were higher among men with a mean of 14.9 g/dL (13.0-16.9), and in women, 13.2 g/dL (11.5-14.9). The mean number of white blood cells among men was 6.142/mm3 (2.843-9.440) and 6.426/mm3 (2.883-9.969) for women. Other parameters showed close values between the genders. Regarding age groups and skin color, mean values, standard deviation and limits of the exams presented small variations. CONCLUSION: Hematological reference values based on the national survey allow for the establishment of specific reference limits for gender, age and skin color. The results presented here may contribute to the establishment of better evidence and criteria for the care, diagnosis and treatment of diseases.


Asunto(s)
Recuento de Células Sanguíneas/normas , Técnicas de Laboratorio Clínico/normas , Encuestas Epidemiológicas/normas , Adolescente , Adulto , Factores de Edad , Brasil/etnología , Estudios Transversales , Femenino , Humanos , Masculino , Persona de Mediana Edad , Valores de Referencia , Factores Sexuales , Adulto Joven
11.
Rev Bras Epidemiol ; 22Suppl 02(Suppl 02): E190004.SUPL.2, 2019.
Artículo en Portugués, Inglés | MEDLINE | ID: mdl-31596375

RESUMEN

INTRODUCTION: This article aims at describing the National Health Survey (Pesquisa Nacional de Saúde- PNS) methodology of collecting laboratory exams data. METHODOLOGY: A subsample of 25% of the census tracts was selected, according to the stratification of the PNS sample, with a probability inversely proportional to the difficulty of collection. The collection of blood and urine was done in the households by a laboratory agent, among residents selected for individual interview. Due to the difficulties found in the field work, the sample did not reach the minimum expected number in some strata, and a post-stratification procedure was proposed for the data analysis. RESULTS: The collection of biospecimens was performed in 8,952 individuals. Laboratory tests were: glycated hemoglobin; total cholesterol; LDL cholesterol; HDL cholesterol; serology for dengue; red blood cell count (erythrogram) and white series count (leukogram); high performance liquid chromatography (HPLC) for diagnosis of hemoglobinopathies; creatinine. Theexcretion of potassium, salt and sodium and creatinine was estimated in the urine. The database of laboratory exams was weighed and made publicly available on the Oswaldo Cruz Foundation's PNS website and can be accessed without prior authorization. CONCLUSION: The total subsample of laboratory exams is of great value, since it allowed us to establish national reference parameters adequate to sociodemographic and geographic characteristics of the Brazilian population, providing relevant and complementary information for the analysis of the health situation of Brazil.


Asunto(s)
Técnicas de Laboratorio Clínico/métodos , Recolección de Datos/métodos , Bases de Datos Factuales , Encuestas Epidemiológicas/métodos , Adolescente , Adulto , Recolección de Muestras de Sangre/métodos , Brasil , Colesterol/sangre , Cromatografía Líquida de Alta Presión , Dengue/sangre , Recuento de Eritrocitos , Femenino , Humanos , Recuento de Leucocitos , Masculino , Persona de Mediana Edad , Toma de Muestras de Orina/métodos , Adulto Joven
12.
West Afr J Med ; 36(3): 283-285, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31622493

RESUMEN

BACKGROUND: Latent Tuberculosis (LTBI) affects approximately a third of the world population. Paediatric health workers caring for adolescent Tuberculosis (TB) patients in high TB endemic regions are particularly susceptible as they are exposed to TB in the community and in the work place. However, there is a paucity of reports on LTBI in paediatric health workers. OBJECTIVES: To identify the factors that could have resulted in latent TB in a paediatric health worker Methods/Results: We present a case of a 38-year old female paediatrician who was diagnosed with LTBI by a positive QuantiFERON-TB gold test during the routine new entry immigrant screening for tuberculosis on arrival in the United Kingdom for postgraduate studies. She was treated with three months course of Rifampicin and Isoniazid (plus pyridoxine). CONCLUSION: Latent TB infection may have been acquired from her involvement in the management of adolescents with adult type TB without the use of personal protective equipment. In this case, routine systematic screening of an at risk individual helped to eliminate TB infection. RECOMMENDATION: Paediatric health workers should use personal protective equipment when managing childhood TB and should also be routinely screened for latent TB.


Asunto(s)
Antituberculosos/uso terapéutico , Personal de Salud , Isoniazida/uso terapéutico , Tuberculosis Latente/tratamiento farmacológico , Mycobacterium tuberculosis/aislamiento & purificación , Piridoxina/uso terapéutico , Rifampin/uso terapéutico , Adolescente , Adulto , Técnicas de Laboratorio Clínico , Femenino , Humanos , Transmisión de Enfermedad Infecciosa de Paciente a Profesional , Tuberculosis Latente/diagnóstico , Exposición Profesional , Resultado del Tratamiento
13.
Klin Lab Diagn ; 64(9): 560-564, 2019.
Artículo en Ruso | MEDLINE | ID: mdl-31610109

RESUMEN

Human babesiosis caused by parasitic protozoan Babesia spp. is sporadic zoonotic vector-borne infection. The course of babesiosis and prognosis depend on the type of pathogen and on the patient's immunological status. Significance this disease is a severe, often fatal course with immunocompromissed patients resembling complicated falciparum malaria. In Europe to date, more than 50 cases of confirmed human babesiosis have been reported in most cases caused by Babesia divergens. Possible there are unrecognized cases. Pathogen is an obligate intraerythrocyte parasite of vertebrate animals. The organism is transmitted from animal to man through bite of Ixodidae tick. Asexual reproduction of the parasite occurs in a vertebrate host. The pathogenesis of babesiosis is caused by the destruction of host cells. Intensive haemolysis of red blood cells leads to the development of haemolytic anemia, haematuria, jaundice, and polyorgan failure may develop. The clinical manifestations of the disease are nonspecific. Detection of intraerythrocyte parasites in blood smears stained Gimsa-Romanovsky confirms the proposed diagnosis. Blood smears and some laboratory signs from fatal cases were analyzed in the Reference-centre of E. I. Martsinovskii Institute. Original microphotographs B. divergens are shown. The main morphological forms of the parasite are shown. In addition to the well-known tetrades of parasites «Maltese Cross¼, for the first time, the parasites dividing into 6 interconnected trophozoites - "sextet" - were found. Originally, the invasion of Babesia in a normoblast is shown. An unusually high multiple invasion (14 parasites) of erythrocytes is noted. Because the patients, initially, were incorrectly diagnosed with malaria, the differential diagnosis of Babesia with Plasmodium is described step-by-step. It is important, since the treatment with antimalarial drugs is ineffective. Deviation laboratory signs are discussed. Complex morphological characteristics allowed us to speciated the parasites as B. divergens. DNA was detected in the sample with specific primers Bab di hsp70F/Bab di hsp70R and the probe Bab di hsp70P. The sequence demonstrated 99-100% and 98% similarity to the 18S rRNA gene fragment of B. divergence and Babesia venatorum, respectively. Molecular biological and serological methods of laboratory diagnosis of babesiosis are considered.


Asunto(s)
Babesia , Babesiosis/diagnóstico , Animales , Técnicas de Laboratorio Clínico , Cartilla de ADN , Diagnóstico Diferencial , Eritrocitos/parasitología , Humanos , Malaria Falciparum , Garrapatas/parasitología
14.
Sichuan Da Xue Xue Bao Yi Xue Ban ; 50(3): 379-384, 2019 May.
Artículo en Chino | MEDLINE | ID: mdl-31631607

RESUMEN

Objective: To develop a PCR method for Entamoeba histolytica( E.histolytica) detection in fecal specimens, and to compare the performance of PCR to that of microscopy and ELISA. Methods: Two pairs of self-designed primers and 2 pairs of primers from references based on small subunit ribosome RNA (SSU rRNA) fragment of E. histolytica standard strain were synthetized. DNA from E. histolytica reference strain were amilified by the conventional PCR using the 4 pairs of primers. 221 stool samples from diarrhea patients were collected and detected for E. histolytica by three methods: Entamoeba trophozoites and cysts detection by microscopy, E. histolytica-specific antigen detection using enzyme-linked immunosorbent assay (ELISA) kit ( E. HISTOLYTICA II), amplification of SSU rRNA fragment of E. histolytica by PCR method. Positive rate of three methods were compared by chi-square test, and Kappa test was applied to determine the concordance among the three methods. Results: Specific fragments of E. histolytica were amplified by the PCR method we developed in this study. Positive rates of PCR, microscopy and ELISA were 2.26%, 0.90% and 9.50%, respectively. The positive rates of the three methods were significantly different ( χ 2 =23.34, P<0.01). The Kappa value of PCR and microscopy was 0.216, and that of PCR and ELISA method was -0.134, both of which showed a weak consistency. PCR results showed best consistency with clinical diagnosis. Conclusion: The PCR method we established in this study has a better performance in accuracy than microscopy and ELISA have in laboratory diagnosis of E. histolytica infection.


Asunto(s)
Entamoeba histolytica/aislamiento & purificación , Entamebiasis/diagnóstico , Reacción en Cadena de la Polimerasa , Técnicas de Laboratorio Clínico , Ensayo de Inmunoadsorción Enzimática , Heces/parasitología , Humanos , Microscopía , Sensibilidad y Especificidad
16.
Klin Lab Diagn ; 64(8): 459-462, 2019.
Artículo en Ruso | MEDLINE | ID: mdl-31479599

RESUMEN

The use of point-of-care diagnostics can prevent a number of complications and leading to improved health outcomes for patients in critical condition. Research have shown that elongation of the preanalytic stage leading of errors of studies and changes the results of a number of laboratory parameters. The article presents the key problems associated with the elongation of the preanalytic stage and possible solutions to address the shortcomings of existing diagnostics.


Asunto(s)
Técnicas de Laboratorio Clínico , Medicina de Desastres , Pruebas en el Punto de Atención , Fase Preanalítica , Cuidados Críticos , Humanos , Laboratorios
17.
Malar J ; 18(1): 300, 2019 Sep 02.
Artículo en Inglés | MEDLINE | ID: mdl-31477111

RESUMEN

BACKGROUND: The ability to report vaccine-induced IgG responses in terms of µg/mL, as opposed arbitrary units (AU), enables a more informed interpretation of the magnitude of the immune response, and better comparison between vaccines targeting different antigens. However, these interpretations rely on the accuracy of the methodology, which is used to generate ELISA data in µg/mL. In a previous clinical trial of a vaccine targeting the apical membrane antigen 1 (AMA1) from Plasmodium falciparum, three laboratories (Oxford, NIH and WRAIR) reported ELISA data in µg/mL that were correlated but not concordant. This current study sought to harmonize the methodology used to generate a conversion factor (CF) for ELISA analysis of human anti-AMA1 IgG responses across the three laboratories. METHODS: Purified IgG was distributed to the three laboratories and, following a set protocol provided by NIH, AMA1-specific human IgG was affinity purified. A new "harmonized CF" was generated by each laboratory using their in-house ELISA, and the original clinical trial ELISA data were re-analysed accordingly. RESULTS: Statistical analysis showed that the data remained highly correlated across all three laboratories, although only Oxford and NIH were able to harmonize their CF for ELISA and generate concordant data. CONCLUSIONS: This study enabled two out of the three laboratories to harmonize their µg/mL readouts for the human anti-AMA1 IgG ELISA, but results reported from WRAIR are ~ twofold higher. Given the need to validate such information for each species and antigen of interest, it is important to bear in mind these likely differences when interpreting µg/mL ELISA data in the future.


Asunto(s)
Anticuerpos Antiprotozoarios/análisis , Técnicas de Laboratorio Clínico/normas , Ensayo de Inmunoadsorción Enzimática/normas , Inmunoglobulina G/análisis , Vacunas contra la Malaria/inmunología , Anticuerpos Antiprotozoarios/inmunología , Antígenos de Protozoos/inmunología , Ensayos Clínicos como Asunto , Humanos , Inmunoglobulina G/inmunología , Malaria Falciparum/prevención & control , Proteínas de la Membrana/inmunología , Plasmodium falciparum/inmunología , Proteínas Protozoarias/inmunología
18.
Clín. investig. ginecol. obstet. (Ed. impr.) ; 46(3): 95-101, jul.-sept. 2019. graf, tab
Artículo en Español | IBECS | ID: ibc-182714

RESUMEN

Objetivo: Medir la frecuencia con la que resultan positivos los marcadores del laboratorio clínico en pacientes con preeclampsia severa (PS) admitidas en una unidad de cuidados intensivos (UCI). Diseño: Estudio transversal. Ámbito: UCI de la Unidad Médica de Alta Especialidad Hospital de Ginecología y Obstetricia N.o 3 del Centro Médico Nacional La Raza del Instituto Mexicano del Seguro Social, Ciudad de México, México. Pacientes: Un total de 212 pacientes embarazadas con PS admitidas en la UCI del 1 de junio al 31 de diciembre del 2016. Intervenciones: Se consultaron los resultados del laboratorio clínico de su admisión a la UCI para identificar el porcentaje de aparición de los marcadores positivos de la PS. Variables de interés: Marcadores de la PS: hemoglobina (Hb) <10g/dL, cuenta plaquetaria (Plaq) <100.000plaquetas/μL, glucosa ˃180mg/dL, creatinina sérica (Cr) >1,1mg/dL, ácido úrico (Au) >4,0mg/dL, aspartato aminotransferasa (AST) >70U/L, deshidrogenasa láctica (DHL) >600U/L, pH arterial <7,32, déficit de base del fluido extracelular (DB fec) >8mmol/L y lactato >4mmol/L. Resultados: Marcadores positivos en el 93,39% (n=198) de los casos con la siguiente distribución: Au ˃4mg/dL, 88,48% (n=169, media de 6,2±1,04mg/dL); AST˃70U/L, 25,13% (n=48, media de 180,4±73,08U/L); Plaq<100.000plaquetas/μL, 24,08% (n=46, media de 71.600±22.970plaquetas/μL); DHL˃600U/L, 21,98% (n=42, media de 1.021,3±476U/L); Cr˃1,1mg/dL, 13,08% (n=25, media de 1,33±0,34mg/dL); pH arterial <7,32, 7,32% (n=14, media de 7,30±0,01); DB fec ˃8mmol/L, 6,28% (n=12, media de 9±0,2mmol/L); glucosa ˃180mg/dL, 3,30% (n=7, media de 187,85±2,67mg/dL); lactato ˃4mmol/L, 1,04% (n=2), y Hb˂10g/dL, 0%. Conclusiones: Los marcadores positivos más frecuentes fueron Au, AST, Plaq, DHL y Cr


Objective: To measure the frequency of positive results for clinical laboratory markers in patients with severe preeclampsia (SP) admitted in an intensive care unit (ICU). Design: Cross-sectional study. Setting: ICU of the High-Specialty Medical Unit, Hospital of Gynecology and Obstetrics No. 3, National Medical Center La Raza, Mexican Institute of Social Security, Mexico City, Mexico. Patients: 212 pregnant patients with SP admitted to the ICU between June 1 and December 31, 2016. Interventions: Laboratory results were consulted to identify the percentage of positive markers of SP. Variables of interest: SP markers: hemoglobin (Hb) <10g/dL, platelet count (Plat) <100,000 platelets/μL, glucose ˃180mg/dL, serum creatinine (Cr) >1.1mg/dL, uric acid (Ua) >4.0mg/dL, aminotransferase aspartate (AST) >70U/L, lactic deshydrogenase (LDH) >600U/L, blood pH <7.32, deficit of base of extra cellular fluid (DB ecf) >8mmol/L and lactate >4mmol/L. Results: Positive markers 93.39% (n=198) with the following distribution: Ua˃4mg/dL, 88.48% (n=169, mean 6.2±1.04mg/dL); AST˃70U/L, 25.13% (n=48, mean 180.4±73.08U/L); Plat<100,000platelets/μL, 24.08% (n=46, mean 71,600±22,970platelets/μL); LDH˃600U/L, 21.98% (n=42, mean 1,021.3±476U/L); Cr˃1.1mg/dL, 13.08% (n=25, mean 1.33±0.34mg/dL); blood pH<7.32, 7.32% (n=14, mean 7.30±0.01); DB ecf˃8mmol/L, 6.28% (n=12, mean 9±0.2mmol/L); glucose ˃180mg/dL, 3.30% (n=7, mean 187.85±2.67mg/dL); lactate ˃4mmol/L, 1.04% (n=2), and Hb˂10g/dL, 0%. Conclusions: The most frequent positive markers of SP were Ua, AST, Plat, LDH and Cr


Asunto(s)
Humanos , Femenino , Embarazo , Adulto , Preeclampsia/diagnóstico , Unidades de Cuidados Intensivos , Biomarcadores/análisis , Técnicas de Laboratorio Clínico , Estudios Transversales , Síndrome HELLP/diagnóstico , México
19.
Rev. argent. salud publica ; 10(40): 39-43, 30 de septiembre 2019.
Artículo en Español | LILACS, BINACIS, ARGMSAL | ID: biblio-1024850

RESUMEN

La tuberculosis representa un desafío para la salud pública, entre otras causas, por las dificultades diagnósticas. La baciloscopía y el cultivo en medio sólido presentan obstáculos técnicos y demandan tiempo. OBJETIVOS: Realizar una evaluación completa de tecnología sanitaria sobre incorporación de nuevos equipamientos de diagnóstico in vitro para tuberculosis en el sistema de salud pública de Neuquén. MÉTODOS: Un equipo multidisciplinario e independiente analizó los recursos locales, efectuó una búsqueda sistemática con análisis de rendimiento diagnóstico, impacto económico, organizacional y en la equidad. RESULTADOS: Se identificaron como potenciales incorporaciones la microscopía de fluorescencia, los cultivos en medio líquido y la biología molecular. Los tres presentan evidencias de mayor sensibilidad y especificidad que la baciloscopía. La biología molecular acorta los tiempos de diagnóstico, requiere mínima capacitación del personal y presenta un costo muy superior a otras tecnologías. El cultivo en medio líquido acorta el tiempo al diagnóstico y es factible de ser incorporado. CONCLUSIONES: Se observaron tensiones entre escenarios, donde la maximización de la eficiencia incrementa inequidades en el acceso. La metodología de consenso facilita la toma de decisiones sobre incorporación de tecnologías. Se recomienda incorporar microscopía por fluorescencia en laboratorios de cabecera y un equipo de cultivo en medio líquido, centralizando las muestras.


Asunto(s)
Tuberculosis , Técnicas de Laboratorio Clínico , Evaluación de la Tecnología Biomédica
20.
Clin Lab ; 65(8)2019 Aug 01.
Artículo en Inglés | MEDLINE | ID: mdl-31414736

RESUMEN

BACKGROUND: Clostridioides (formerly Clostridium) difficile infection (CDI) is linked to misuse of antimicrobials. The prevalence of disease varies with difficulties of establishing the diagnosis because of the lack of sensitivity and specificity of laboratory tests. The clinical impact of upgrading CDI testing from routine to molecular based-algorithm is still unclear. The aim of this study is to assess the impact of upgrading CDI testing from routine to molecular based-algorithm on the management of CDI and evaluate the role of antimicrobials on the course of CDI. METHODS: This is an observational case-study. A total of 564 patients were included from whom stool samples were tested by enzyme immunoassay (EIA) and Xpert for C. difficile. Data on the number and results of tests ordered, antimicrobial exposure, comorbidities, and treatment with metronidazole or vancomycin were collected. The main outcome measures were C. difficile tests (EIA and Xpert C. difficile Assay) and prevalence of CDI. RESULTS: CDI was found in 9 and 10 cases out of 313 and 254 patients tested by the EIA and Xpert C. difficile assay, respectively, giving an overall incidence of 0.03 per 1,000 patient tested. Reduction was noted in the number of tests ordered per patient for presumptive CDI after shifting to the Xpert C. difficile assay which was not statistically significant (p-value 0.2). Also, there was less metronidazole and vancomycin therapy initiated for patients with a negative C. difficile test (p-value 0.2) observed with molecular testing. CONCLUSIONS: Xpert C. difficile testing is a supportive tool for diagnosing CDI with rapid turnaround time that is helpful for patient management and initiating effective infection control measures. The clinical accuracy of the assay is still to be determined in the context of low carriage rate in the local patient population.


Asunto(s)
Algoritmos , Infecciones por Clostridium/diagnóstico , Clostridium difficile/aislamiento & purificación , Heces/microbiología , Adulto , Anciano , Anciano de 80 o más Años , Antibacterianos/uso terapéutico , Técnicas de Laboratorio Clínico/métodos , Infecciones por Clostridium/epidemiología , Infecciones por Clostridium/microbiología , Clostridium difficile/efectos de los fármacos , Clostridium difficile/fisiología , Humanos , Técnicas para Inmunoenzimas/métodos , Persona de Mediana Edad , Técnicas de Diagnóstico Molecular/métodos , Prevalencia , Estudios Prospectivos , Arabia Saudita/epidemiología , Sensibilidad y Especificidad , Adulto Joven
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