Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 2.785
Filtrar
1.
Ann Biol Clin (Paris) ; 78(5): 493-498, 2020 Oct 01.
Artigo em Inglês | MEDLINE | ID: mdl-33026345

RESUMO

Haptoglobin is a late positive acute phase protein of inflammation. Haptoglobin binds to free hemoglobin released from erythrocytes during intravascular hemolysis to form a complex which is removed shortly. Other properties like inhibition of oxidative stress and prostaglandin synthesis have been described. Three main phenotypes of haptoglobin have been identified: Hp1-1, Hp2-1, Hp2-2, which may have an impact in different diseases such as cardiovascular or infectious diseases. Haptoglobins of different phenotypes can be separated by capillary electrophoresis. They may induce a split of the alpha 2-globulin zone in the electrophoretic pattern. Hp1-1 and Hp2-1 phenotypes induce an important and a moderate split of the α2 globulin zone, respectively, whereas Hp2-2 does not. In vitro hemolysis and migration of a monoclonal component (i.e. immunoglobulin free light chain) may also induce a split of the alpha 2-globulin zone. In daily practice, Hp2-1 or Hp1-1 phenotypes could be notified in the electrophoresis report to alert the clinician about the possible physiopathological consequences.


Assuntos
Haptoglobinas/análise , Fenótipo , Doenças Cardiovasculares/sangue , Doenças Cardiovasculares/diagnóstico , Doenças Transmissíveis/sangue , Doenças Transmissíveis/diagnóstico , Diagnóstico Diferencial , Testes Diagnósticos de Rotina , Eletroforese/métodos , Haptoglobinas/química , Haptoglobinas/metabolismo , Hemoglobinas/metabolismo , Humanos , Inflamação/sangue , Inflamação/diagnóstico
2.
Cell ; 183(2): 296-300, 2020 10 15.
Artigo em Inglês | MEDLINE | ID: mdl-33064983

RESUMO

The SARS-CoV-2 pandemic has revealed that Africa needs a new public health order to be resilient, to adapt, and to cope with 21st-century disease threats. The new order will need strengthened continental and national public health institutions; local manufacturing of vaccines, therapeutics, and diagnostics; attraction, training, and retention of a public health workforce; and fostering of respectful local and international partnerships.


Assuntos
Doenças Transmissíveis/terapia , Saúde Pública , África , Controle de Doenças Transmissíveis , Doenças Transmissíveis/diagnóstico , Ocupações em Saúde/educação , Mão de Obra em Saúde , Humanos , Cooperação Internacional , Saúde Pública/educação , Administração em Saúde Pública
3.
Nat Commun ; 11(1): 4774, 2020 09 22.
Artigo em Inglês | MEDLINE | ID: mdl-32963224

RESUMO

Detection of microbial nucleic acids in body fluids has become the preferred method for rapid diagnosis of many infectious diseases. However, culture-based diagnostics that are time-consuming remain the gold standard approach in certain cases, such as sepsis. New culture-free methods are urgently needed. Here, we describe Single MOLecule Tethering or SMOLT, an amplification-free and purification-free molecular assay that can detect microorganisms in body fluids with high sensitivity without the need of culturing. The signal of SMOLT is generated by the displacement of micron-size beads tethered by DNA probes that are between 1 and 7 microns long. The molecular extension of thousands of DNA probes is determined with sub-micron precision using a robust and rapid optical approach. We demonstrate that SMOLT can detect nucleic acids directly in blood, urine and sputum at sub-femtomolar concentrations, and microorganisms in blood at 1 CFU mL-1 (colony forming unit per milliliter) threefold faster, with higher multiplexing capacity and with a more straight-forward protocol than amplified methodologies. SMOLT's clinical utility is further demonstrated by developing a multiplex assay for simultaneous detection of sepsis-causing Candida species directly in whole blood.


Assuntos
Líquidos Corporais/química , Técnicas de Diagnóstico Molecular/métodos , Ácidos Nucleicos/isolamento & purificação , Sepse/diagnóstico , Candida/genética , Candida/isolamento & purificação , Candidíase/diagnóstico , Contagem de Colônia Microbiana , Doenças Transmissíveis/diagnóstico , DNA/isolamento & purificação , Humanos , Ácidos Nucleicos/sangue , Ácidos Nucleicos/urina , Reação em Cadeia da Polimerase/métodos , RNA/isolamento & purificação , Sensibilidade e Especificidade , Sepse/microbiologia , Infecções Estafilocócicas/diagnóstico , Staphylococcus aureus/genética , Staphylococcus aureus/isolamento & purificação , Urina
4.
Biosens Bioelectron ; 169: 112592, 2020 Dec 01.
Artigo em Inglês | MEDLINE | ID: mdl-32942143

RESUMO

Global health and food security constantly face the challenge of emerging human and plant diseases caused by bacteria, viruses, fungi, and other pathogens. Disease outbreaks such as SARS, MERS, Swine Flu, Ebola, and COVID-19 (on-going) have caused suffering, death, and economic losses worldwide. To prevent the spread of disease and protect human populations, rapid point-of-care (POC) molecular diagnosis of human and plant diseases play an increasingly crucial role. Nucleic acid-based molecular diagnosis reveals valuable information at the genomic level about the identity of the disease-causing pathogens and their pathogenesis, which help researchers, healthcare professionals, and patients to detect the presence of pathogens, track the spread of disease, and guide treatment more efficiently. A typical nucleic acid-based diagnostic test consists of three major steps: nucleic acid extraction, amplification, and amplicon detection. Among these steps, nucleic acid extraction is the first step of sample preparation, which remains one of the main challenges when converting laboratory molecular assays into POC tests. Sample preparation from human and plant specimens is a time-consuming and multi-step process, which requires well-equipped laboratories and skilled lab personnel. To perform rapid molecular diagnosis in resource-limited settings, simpler and instrument-free nucleic acid extraction techniques are required to improve the speed of field detection with minimal human intervention. This review summarizes the recent advances in POC nucleic acid extraction technologies. In particular, this review focuses on novel devices or methods that have demonstrated applicability and robustness for the isolation of high-quality nucleic acid from complex raw samples, such as human blood, saliva, sputum, nasal swabs, urine, and plant tissues. The integration of these rapid nucleic acid preparation methods with miniaturized assay and sensor technologies would pave the road for the "sample-in-result-out" diagnosis of human and plant diseases, especially in remote or resource-limited settings.


Assuntos
Doenças Transmissíveis/diagnóstico , Dispositivos Lab-On-A-Chip , Ácidos Nucleicos/isolamento & purificação , Doenças das Plantas , Sistemas Automatizados de Assistência Junto ao Leito , Betacoronavirus/isolamento & purificação , Fracionamento Químico/instrumentação , Fracionamento Químico/métodos , Doenças Transmissíveis/microbiologia , Doenças Transmissíveis/parasitologia , Doenças Transmissíveis/virologia , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/virologia , Desenho de Equipamento , Humanos , Técnicas de Amplificação de Ácido Nucleico/instrumentação , Técnicas de Amplificação de Ácido Nucleico/métodos , Ácidos Nucleicos/sangue , Ácidos Nucleicos/urina , Pandemias , Doenças das Plantas/microbiologia , Doenças das Plantas/parasitologia , Doenças das Plantas/virologia , Pneumonia Viral/diagnóstico , Pneumonia Viral/virologia
5.
Nat Commun ; 11(1): 4365, 2020 08 31.
Artigo em Inglês | MEDLINE | ID: mdl-32868761

RESUMO

Current approaches explore bacterial genes that change transcriptionally upon stress exposure as diagnostics to predict antibiotic sensitivity. However, transcriptional changes are often specific to a species or antibiotic, limiting implementation to known settings only. While a generalizable approach, predicting bacterial fitness independent of strain, species or type of stress, would eliminate such limitations, it is unclear whether a stress-response can be universally captured. By generating a multi-stress and species RNA-Seq and experimental evolution dataset, we highlight the strengths and limitations of existing gene-panel based methods. Subsequently, we build a generalizable method around the observation that global transcriptional disorder seems to be a common, low-fitness, stress response. We quantify this disorder using entropy, which is a specific measure of randomness, and find that in low fitness cases increasing entropy and transcriptional disorder results from a loss of regulatory gene-dependencies. Using entropy as a single feature, we show that fitness and quantitative antibiotic sensitivity predictions can be made that generalize well beyond training data. Furthermore, we validate entropy-based predictions in 7 species under antibiotic and non-antibiotic conditions. By demonstrating the feasibility of universal predictions of bacterial fitness, this work establishes the fundamentals for potentially new approaches in infectious disease diagnostics.


Assuntos
Bactérias/genética , Evolução Molecular Direcionada , Farmacorresistência Bacteriana/genética , Estresse Fisiológico , Antibacterianos/farmacologia , Bactérias/efeitos dos fármacos , Bactérias/metabolismo , Fenômenos Fisiológicos Bacterianos , Doenças Transmissíveis/diagnóstico , Entropia , Regulação Bacteriana da Expressão Gênica , Genes Bacterianos , Genoma Bacteriano , Análise de Sequência de RNA , Streptococcus pneumoniae/efeitos dos fármacos , Streptococcus pneumoniae/genética , Streptococcus pneumoniae/metabolismo , Transcriptoma
6.
Am J Pathol ; 190(11): 2180-2184, 2020 11.
Artigo em Inglês | MEDLINE | ID: mdl-32827462

RESUMO

The current coronavirus disease 2019 (COVID-19) pandemic has raised concerns about the safety of laboratory personnel who handle tissue samples that harbor pathogens, including those performing autopsies. While pathologists have performed autopsies on infected decedents for centuries, universal precaution protocols for limiting exposure to pathogens were not developed until the 20th century. This article reviews the history and effectiveness of universal precautions, with an emphasis on performing autopsies on COVID-19 decedents.


Assuntos
Betacoronavirus/patogenicidade , Doenças Transmissíveis/patologia , Infecções por Coronavirus/patologia , Pneumonia Viral/patologia , Precauções Universais , Autopsia/métodos , Doenças Transmissíveis/diagnóstico , Infecções por Coronavirus/diagnóstico , Humanos , Pandemias , Pneumonia Viral/diagnóstico , Precauções Universais/métodos
8.
Int Marit Health ; 71(2): 129-139, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32604457

RESUMO

Until last year, terrorism, economic instability, poverty and natural disasters were considered the major threats to humans globally. Infectious diseases were seen as a minor problem. This, however, changed in 2020 when the global COVID-19 pandemic broke out and a new danger emerged. The latest events generated a lot of discussion on health hazards associated with international tourism and uncontrolled spread of pathogens across the borders. The major health problems of travelers to developing countries with harsh environmental conditions and endemic infectious diseases include gastrointestinal disorders, dermatoses, respiratory infections and fevers of unknown origin. A medical interview by an experienced physician is the foundation of the post-travel screening process both in symptomatic and asymptomatic travelers; the interview should focus on identifying exposure to risk factors (endemic infectious diseases, failure to adopt disease prevention measures, consumption of food or water from unsafe sources, insect bites, animal bites, travelling in large groups, unsafe sex with casual partners). While physical examination (identification of abnormalities) and diagnostic tests (identification of pathogens) can be useful for detecting illnesses and asymptomatic infections as well as assessing the general health condition of a patient, including his immune system. The aim of the article is to provide information on the post-travel screening process in symptomatic and asymptomatic travelers who have returned from areas with harsh climate conditions and low sanitation standards.


Assuntos
Controle de Doenças Transmissíveis/métodos , Doenças Transmissíveis/diagnóstico , Doenças Transmissíveis/epidemiologia , Doença Relacionada a Viagens , Betacoronavirus , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/prevenção & controle , Países em Desenvolvimento , Humanos , Pandemias/prevenção & controle , Pneumonia Viral/epidemiologia , Pneumonia Viral/prevenção & controle , Fatores de Risco
9.
Lancet Infect Dis ; 20(10): e268-e273, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-32717208

RESUMO

Outbreaks of infectious diseases are occurring with increasing frequency and unpredictability. The rapid development and deployment of diagnostics that can accurately and quickly identify pathogens as part of epidemic preparedness is needed now for the COVID-19 pandemic. WHO has developed a global research and innovation forum to facilitate, accelerate, and deepen research collaboration among countries and funders. Great progress has been made in the past decade, but access to specimens remains a major barrier for the development and evaluation of needed quality diagnostics. We present a sustainable model for a global network of country-owned biobanks with standardised methods for collection, characterisation, and archiving of specimens and pathogens to facilitate and accelerate diagnostics development and evaluation for COVID-19 and other diseases of epidemic potential. The biobanking network should be run on the guiding principles of transparency, equitable access, ethics, and respect for national laws that support country ownership and sustainability. Adapting the Nagoya Protocol on Access to Genetic Resources and the Fair and Equitable Sharing of Benefits, sharing of specimens from national biobanks can be rewarded through mechanisms such as equitable access to diagnostics at negotiated prices. Such networks should be prepared for any pathogen of epidemic potential.


Assuntos
Bancos de Espécimes Biológicos/organização & administração , Bancos de Espécimes Biológicos/normas , Doenças Transmissíveis/diagnóstico , Infecções por Coronavirus/diagnóstico , Pneumonia Viral/diagnóstico , Betacoronavirus/isolamento & purificação , Controle de Doenças Transmissíveis , Doenças Transmissíveis/epidemiologia , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/prevenção & controle , Testes Diagnósticos de Rotina , Epidemias/prevenção & controle , Humanos , Cooperação Internacional , Pandemias/prevenção & controle , Pneumonia Viral/epidemiologia , Pneumonia Viral/prevenção & controle , Manejo de Espécimes/normas , Desenvolvimento Sustentável
11.
Proc Biol Sci ; 287(1928): 20200944, 2020 06 10.
Artigo em Inglês | MEDLINE | ID: mdl-32517611

RESUMO

Cough, cough. Is that person sick, or do they just have a throat tickle? A growing body of research suggests pathogen threats shape key aspects of human sociality. However, less research has investigated specific processes involved in pathogen threat detection. Here, we examine whether perceivers can accurately detect pathogen threats using an understudied sensory modality-sound. Participants in four studies judged whether cough and sneeze sounds were produced by people infected with a communicable disease or not. We found no evidence that participants could accurately identify the origins of these sounds. Instead, the more disgusting they perceived a sound to be, the more likely they were to judge that it came from an infected person (regardless of whether it did). Thus, unlike research indicating perceivers can accurately diagnose infection using other sensory modalities (e.g. sight, smell), we find people overperceive pathogen threat in subjectively disgusting sounds.


Assuntos
Doenças Transmissíveis/diagnóstico , Tosse , Espirro , Som , Estimulação Acústica , Percepção Auditiva , Humanos
12.
Medicine (Baltimore) ; 99(25): e20876, 2020 Jun 19.
Artigo em Inglês | MEDLINE | ID: mdl-32569236

RESUMO

Noninfectious diseases may be diagnosed during infectious disease (ID) consultations. Among non-IDs, cancer diagnosis is important; however, epidemiological data describing the relationship between ID consultations and newly diagnosed cancer patients are scarce. This study described the frequency and tendency of new cancer diagnoses in patients after ID consultation.This retrospective study included adult inpatients who underwent ID consultations between October 2016 and March 2018. The demographic data and clinical manifestations of each case are described.Among the 380 inpatients who underwent ID consultations, 6 (1.6%) received a new cancer diagnosis after ID consultation. Among the initial most likely diagnoses, 3 patients were diagnosed with IDs and 3 were diagnosed with non-IDs. The initial most likely ID diagnosis was important for new cancer diagnoses (P = .004, odds ratio: 11.1, 95% confidence interval: 2.11-57.2); diagnostic errors, as judged by the physicians, occurred in 2 of the 6 cases.While the frequency of establishing new diagnoses during ID consultations is low, coexisting infection and cancer is possible. ID specialists should identify any patterns related to new cancer diagnosis in patients to prevent diagnostic error and improve the quality of diagnosis.


Assuntos
Doenças Transmissíveis/diagnóstico , Neoplasias/diagnóstico , Encaminhamento e Consulta/estatística & dados numéricos , Adulto , Idoso , Idoso de 80 Anos ou mais , Erros de Diagnóstico/estatística & dados numéricos , Feminino , Humanos , Japão , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos
14.
Pediatrics ; 145(6)2020 06.
Artigo em Inglês | MEDLINE | ID: mdl-32358069

RESUMO

BACKGROUND AND OBJECTIVES: Encephalitis can result in neurologic morbidity and mortality in children. Newly recognized infectious and noninfectious causes of encephalitis have become increasingly important over the past decade. METHODS: We retrospectively reviewed medical records from pediatric patients in Houston diagnosed with encephalitis in both an urban and rural catchment area between 2010 and 2017. We conducted an investigation to understand the etiology, clinical characteristics, and diagnostic testing practices in this population. RESULTS: We evaluated 231 patients who met the case definition of encephalitis, among which 42% had no recognized etiology. Among those with an identified etiology, the most common were infectious (73; 31%), including viral (n = 51; 22%), with the most frequent being West Nile virus (WNV; n = 12), and bacterial (n = 19; 8%), with the most frequent being Bartonella henselae (n = 7). Among cases of autoimmune encephalitis (n = 60; 26%), the most frequent cause was anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis (n = 31). Autoimmune causes were seen more commonly in female (P < .01) patients. Testing for herpes simplex virus and enterovirus was nearly universal; testing for anti-NMDAR encephalitis, WNV, and Bartonella was less common. CONCLUSIONS: WNV was the most common infectious cause of encephalitis in our pediatric population despite lower testing frequency for WNV than herpes simplex virus or enterovirus. Increasing testing for anti-NMDAR encephalitis resulted in frequent identification of cases. Increased awareness and testing for WNV and Bartonella would likely result in more identified causes of pediatric encephalitis. Earlier etiologic diagnosis of encephalitides may lead to improve clinical outcomes.


Assuntos
Encefalite Antirreceptor de N-Metil-D-Aspartato/epidemiologia , Doença da Arranhadura de Gato/epidemiologia , Encefalite/epidemiologia , Doença de Hashimoto/epidemiologia , Febre do Nilo Ocidental/epidemiologia , Adolescente , Encefalite Antirreceptor de N-Metil-D-Aspartato/diagnóstico , Encefalite Antirreceptor de N-Metil-D-Aspartato/imunologia , Autoanticorpos/imunologia , Doença da Arranhadura de Gato/diagnóstico , Doença da Arranhadura de Gato/imunologia , Criança , Pré-Escolar , Estudos de Coortes , Doenças Transmissíveis/diagnóstico , Doenças Transmissíveis/epidemiologia , Doenças Transmissíveis/imunologia , Encefalite/diagnóstico , Encefalite/imunologia , Feminino , Doença de Hashimoto/diagnóstico , Doença de Hashimoto/imunologia , Humanos , Lactente , Recém-Nascido , Masculino , Estudos Retrospectivos , Febre do Nilo Ocidental/diagnóstico , Febre do Nilo Ocidental/imunologia
15.
BMC Infect Dis ; 20(1): 359, 2020 May 20.
Artigo em Inglês | MEDLINE | ID: mdl-32434480

RESUMO

BACKGROUND: Substantial numbers of patients are now receiving either immunosuppressive therapies or chemotherapy. There are significant risks in such patients of developing opportunistic infections or re-activation of latent infections, with higher associated morbidity and mortality. The aim of this quality improvement project was to determine how effective 5 different specialties were in assessing and mitigating risks of developing opportunistic infections or re-activation of latent infections in patients undergoing immunosuppressive therapies. METHODS: This was a single centre audit where records of patients attending clinics providing immunosuppressive therapies were reviewed for the following: evidence of screening for blood-borne virus [BBV] infections, varicella and measles immunity, latent/active TB or hypogammaglobulinaemia, and whether appropriate vaccines had been advised or various infection risks discussed. These assessments were audited against both national and international guidelines, or a cross-specialty consensus guideline where specific recommendations were lacking. Two sub-populations were also analysed separately: patients receiving more potent immunosuppression and black and minority ethnic [BME] patients,. RESULTS: For the 204 patients fulfilling the inclusion criteria, BBV, varicella/measles and latent TB screening was inconsistent, as was advice for vaccinations, with few areas complying with specialty or consensus guidelines. Less than 10% of patients in one specialty were tested for HIV. In BME patients screening for HIV [60%], measles [0%] and varicella [40%] immunity and latent [30%] or active [20%] TB was low. Only 38% of patients receiving potent immunosuppression received Pneumocystis prophylaxis, with 3 of 4 specialties providing less than 15% of patients in this category with prophylaxis. CONCLUSIONS: Compliance with guidelines to mitigate risks of infection from immunosuppressive therapies was either inconsistent or poor for most specialties. New approaches to highlight such risks and assist appropriate pre-immunosuppression screening are needed.


Assuntos
Doenças Transmissíveis/diagnóstico , Fidelidade a Diretrizes , Imunossupressão/efeitos adversos , Adulto , Varicela/diagnóstico , Varicela/prevenção & controle , Controle de Doenças Transmissíveis , Doenças Transmissíveis/etiologia , Inglaterra , Feminino , Hospitais/estatística & dados numéricos , Humanos , Hospedeiro Imunocomprometido , Imunossupressores , Masculino , Sarampo/diagnóstico , Sarampo/prevenção & controle , Pessoa de Meia-Idade , Pneumonia por Pneumocystis/diagnóstico por imagem , Pneumonia por Pneumocystis/prevenção & controle , Estudos Retrospectivos , Vacinação , Viroses/diagnóstico , Viroses/prevenção & controle
16.
BMC Infect Dis ; 20(1): 270, 2020 Apr 07.
Artigo em Inglês | MEDLINE | ID: mdl-32264829

RESUMO

BACKGROUND: Scrub typhus is an acute febrile illness, which was caused by Orientia tsutsugamushi and transmitted through the bite of chiggers. The diagnosis of scrub typhus could be missed diagnosis due to the absence of the pathognomonic eschar. CASE PRESENTATION: A 76-year-old man was hospitalized with fever and kidney injury and was diagnosed of hemorrhagic fever with renal syndrome first. However, the situation of the illness deteriorated into refractory septic shock and multiple organ dysfunction rapidly,although the treatment of anti-sepsis was used in 3rd-5th day. Orientia tsutsugamushi was determined to be the causative pathogen by Next-generation sequencing of his plasma sample in 6th day. Then, the patient was treated with doxycycline and azithromycin and recovered quickly. CONCLUSIONS: Next-generation sequencing was a new diagnostic technology and could identify scrub typhus in accurately and fast without the pathognomonic eschar.


Assuntos
Bacteriemia/diagnóstico , Doenças Transmissíveis/diagnóstico , Sequenciamento de Nucleotídeos em Larga Escala/métodos , Orientia tsutsugamushi/genética , Tifo por Ácaros/diagnóstico , Choque Séptico/diagnóstico , Idoso , Animais , Azitromicina/uso terapêutico , Bacteriemia/tratamento farmacológico , Mordeduras e Picadas , Doenças Transmissíveis/tratamento farmacológico , Confiabilidade dos Dados , Doxiciclina/uso terapêutico , Humanos , Masculino , Tifo por Ácaros/tratamento farmacológico , Choque Séptico/tratamento farmacológico , Resultado do Tratamento , Trombiculidae/microbiologia
19.
Curr Med Sci ; 40(1): 110-116, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-32166672

RESUMO

We investigated whether an ordinary centrifuge can achieve the standard centrifugal effect required according to specifications for infectious disease screening using the Abbott i2000. Samples were collected and centrifuged following a standard operating procedure (SOP). They were then divided into three groups according to the results of the initial screening tests: a negative group, weak-positive group, and positive group. Twenty negative samples and all weak-positive and positive samples were re-analyzed. Two tubes for each re-analyzed sample were centrifuged simultaneously, one for 10 min at 10 000 × g, per recommendations, and one for 10 min at 2750 × g. No significant difference was found between the groups using different centrifugal forces. There was a strong correlation in the quantitative values between the two conditions of centrifugation. Consistency analysis showed a Cronbach's alpha > 0.8 for detection of Treponema pallidum, human immunodeficiency virus (HIV), hepatitis C virus (HCV), and hepatitis B surface antigen in the three groups (negative group, weak-positive group, and positive group) under different centrifugation conditions. Strong consistency was found under different centrifugal conditions, regardless of the initial testing results. In conclusion, we conducted centrifugation steps in duplicate, according to infectious disease screening protocols. Our study showed that all samples should be centrifuged using a recommended relative centrifugal force after a proper clotting time, as in the standard operating procedure of our laboratory. In this way, we were able to obtain the same results using an ordinary centrifuge as those obtained using a high-speed centrifuge, such as the Abbott i2000.


Assuntos
Centrifugação/métodos , Doenças Transmissíveis/diagnóstico , Manejo de Espécimes/instrumentação , Centrifugação/instrumentação , Centrifugação/normas , Guias como Assunto , HIV/isolamento & purificação , Hepacivirus/isolamento & purificação , Antígenos de Superfície da Hepatite B/metabolismo , Vírus da Hepatite B/isolamento & purificação , Humanos , Sensibilidade e Especificidade , Treponema pallidum/isolamento & purificação
20.
Infection ; 48(3): 317-321, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-32157610

RESUMO

PURPOSE: The Choosing Wisely® initiative is an international campaign addressing over- and underuse of diagnostic and therapeutic measures in infectious diseases among others. Since 2016, the German Society for Infectious Diseases (DGI) has constantly designed new items in this regard. Here we report the most recent recommendations. METHODS: The recommendations of the DGI are part of the "Klug entscheiden" initiative of the German Society of Internal Medicine (DGIM). Topics for the new items were suggested by members of the DGI, checked for scientific evidence and consented within the DGI and the DGIM before publication. RESULTS: The new recommendations are: (1) individuals with immune-suppression, advanced liver cirrhosis or renal insufficiency should receive a dual pneumococcal vaccination. (2) In case of positive blood cultures with Candida spp. thorough diagnostics and treatment should be initiated. (3) In case of suspected meningitis, adult patients should receive dexamethasone and antibiotics immediately after venipuncture for blood cultures and before potential imaging. (4) In case of suspected meningitis a CT scan before lumbar puncture should not be ordered-except for symptoms indicating high CSF pressure or focal brain pathology or in cases of severe immune-suppression. (5) In patients with suspected severe infections, a minimum of two pairs of blood cultures should be drawn using separate venipunctures prior to antibiotic therapy-regardless of body temperature. There is no need of a minimum time interval in between the blood draws. CONCLUSION: Applying these new Choosing Wisely® recommendations will increase patient safety and the value of health care.


Assuntos
Doenças Transmissíveis/diagnóstico , Doenças Transmissíveis/terapia , Assistência à Saúde , Guias de Prática Clínica como Assunto , Sociedades Médicas , Doenças Transmissíveis/diagnóstico por imagem , Alemanha , Humanos
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA