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1.
MMWR Morb Mortal Wkly Rep ; 69(5): 140-146, 2020 Feb 07.
Artigo em Inglês | MEDLINE | ID: mdl-32027631

RESUMO

On December 31, 2019, Chinese health officials reported a cluster of cases of acute respiratory illness in persons associated with the Hunan seafood and animal market in the city of Wuhan, Hubei Province, in central China. On January 7, 2020, Chinese health officials confirmed that a novel coronavirus (2019-nCoV) was associated with this initial cluster (1). As of February 4, 2020, a total of 20,471 confirmed cases, including 2,788 (13.6%) with severe illness,* and 425 deaths (2.1%) had been reported by the National Health Commission of China (2). Cases have also been reported in 26 locations outside of mainland China, including documentation of some person-to-person transmission and one death (2). As of February 4, 11 cases had been reported in the United States. On January 30, the World Health Organization (WHO) Director-General declared that the 2019-nCoV outbreak constitutes a Public Health Emergency of International Concern.† On January 31, the U.S. Department of Health and Human Services (HHS) Secretary declared a U.S. public health emergency to respond to 2019-nCoV.§ Also on January 31, the president of the United States signed a "Proclamation on Suspension of Entry as Immigrants and Nonimmigrants of Persons who Pose a Risk of Transmitting 2019 Novel Coronavirus," which limits entry into the United States of persons who traveled to mainland China to U.S. citizens and lawful permanent residents and their families (3). CDC, multiple other federal agencies, state and local health departments, and other partners are implementing aggressive measures to slow transmission of 2019-nCoV in the United States (4,5). These measures require the identification of cases and their contacts in the United States and the appropriate assessment and care of travelers arriving from mainland China to the United States. These measures are being implemented in anticipation of additional 2019-nCoV cases in the United States. Although these measures might not prevent the eventual establishment of ongoing, widespread transmission of the virus in the United States, they are being implemented to 1) slow the spread of illness; 2) provide time to better prepare health care systems and the general public to be ready if widespread transmission with substantial associated illness occurs; and 3) better characterize 2019-nCoV infection to guide public health recommendations and the development of medical countermeasures including diagnostics, therapeutics, and vaccines. Public health authorities are monitoring the situation closely. As more is learned about this novel virus and this outbreak, CDC will rapidly incorporate new knowledge into guidance for action by CDC and state and local health departments.


Assuntos
Betacoronavirus/isolamento & purificação , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/virologia , Surtos de Doenças/prevenção & controle , Adulto , Idoso , Infecções por Coronavirus/prevenção & controle , Feminino , Humanos , Controle de Infecções , Laboratórios , Masculino , Pessoa de Meia-Idade , Guias de Prática Clínica como Assunto , Prática de Saúde Pública , Estados Unidos/epidemiologia
2.
MMWR Morb Mortal Wkly Rep ; 69(3): 63-66, 2020 Jan 24.
Artigo em Inglês | MEDLINE | ID: mdl-31971928

RESUMO

Since 2014, the recommended laboratory testing algorithm for diagnosing human immunodeficiency virus (HIV) infection has included a supplemental HIV-1/HIV-2 differentiation test to confirm infection type on the basis of the presence of type-specific antibodies (1). Correctly identifying HIV-1 and HIV-2 infections is vital because their epidemiology and clinical management differ. To describe the percentage of diagnoses for which an HIV-1/HIV-2 differentiation test result was reported and to categorize HIV type based on laboratory test results, 2010-2017 data from CDC's National HIV Surveillance System (NHSS) were analyzed. During 2010-2017, a substantial increase in the number of HIV-1/HIV-2 differentiation test results were reported to NHSS, consistent with implementation of the HIV laboratory-based testing algorithm recommended in 2014. However, >99.9% of all HIV infections identified in the United States were categorized as HIV-1, and the number of HIV-2 diagnoses (mono-infection or dual-infection) remained extremely low (<0.03% of all HIV infections). In addition, the overall number of false positive HIV-2 test results produced by the HIV-1/HIV-2 differentiation increased. The diagnostic value of a confirmatory antibody differentiation test in a setting with sensitive and specific screening tests and few HIV-2 infections might be limited. Evaluation and consideration of other HIV tests approved by the Food and Drug Administration (FDA) that might increase efficiencies in the CDC and Association of Public Health Laboratories-recommended HIV testing algorithm are warranted.


Assuntos
Testes Diagnósticos de Rotina/métodos , Infecções por HIV/diagnóstico , Infecções por HIV/virologia , HIV-2/isolamento & purificação , Adolescente , Adulto , Algoritmos , Feminino , Infecções por HIV/epidemiologia , Humanos , Laboratórios , Masculino , Pessoa de Meia-Idade , Estados Unidos/epidemiologia , Adulto Jovem
3.
Int J Cancer ; 146(3): 769-780, 2020 02 01.
Artigo em Inglês | MEDLINE | ID: mdl-30977119

RESUMO

Accurate, consistent and reproducible grading by pathologists is of key-importance for identification of individual patients with invasive breast cancer (IBC) that will or will not benefit from adjuvant systemic treatment. We studied the laboratory-specific grading variation using nationwide real-life data to create insight and awareness in grading variation. Synoptic pathology reports of all IBC resection-specimens, obtained between 2013 and 2016, were retrieved from the nationwide Dutch Pathology Registry (PALGA). Absolute differences in laboratory-proportions of Grades I-III were compared to the national reference. Multivariable logistic regression provided laboratory-specific odds ratios (ORs) for high- vs. low-grade IBC. 33,792 IBC pathology reports of 33,043 patients from 39 laboratories were included, of which 28.1% were reported as Grade I (range between laboratories 16.3-43.3%), 47.6% as Grade II (38.4-57.8%), and 24.3% as Grade III (15.5-34.3%). Based on national guidelines, the indication for adjuvant chemotherapy was dependent on histologic grade in 29.9% of patients. After case-mix correction, 20 laboratories (51.3%) showed a significantly deviant OR. Significant grading differences were also observed among pathologists within laboratories. In this cohort of 33,043 breast cancer patients, we observed substantial inter- and intra-laboratory variation in histologic grading. It can be anticipated that this has influenced outcome including exposure to unnecessary toxicity, since choice of adjuvant chemotherapy was dependent on grade in nearly a third of patients. Better standardization and training seems warranted.


Assuntos
Neoplasias da Mama/terapia , Mama/patologia , Laboratórios/estatística & dados numéricos , Patologia/estatística & dados numéricos , Seleção de Pacientes , Idoso , Mama/cirurgia , Neoplasias da Mama/patologia , Quimioterapia Adjuvante/efeitos adversos , Quimioterapia Adjuvante/métodos , Estudos de Coortes , Feminino , Humanos , Laboratórios/normas , Mastectomia , Pessoa de Meia-Idade , Gradação de Tumores , Países Baixos , Variações Dependentes do Observador , Patologistas/normas , Patologistas/estatística & dados numéricos , Patologia/normas , Guias de Prática Clínica como Assunto , Sistema de Registros/estatística & dados numéricos
9.
Water Sci Technol ; 80(6): 1118-1124, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31799955

RESUMO

Heavy metal contamination of water is a significant threat to organisms and to public health. Among them, chromium is one of the important heavy metals in the environment that originates mainly from anthropogenic activities. Natural red earth (NRE), a ferrous-coated natural sand, is one of the materials that could be used to remove heavy metals from contaminated water. Laboratory-scale simulated experiments were carried out to identify the retention behavior of Cr(VI) on NRE. The effects of solution pH, initial Cr(VI) concentration, the amount of NRE used and the contact time were examined. Almost 63% Cr(VI) was adsorbed within 20 minutes. When particle size ranged from 125 to 180 µm, the Cr adsorption data followed the Langmuir isotherm model, providing a higher R2 value of 0.9523, suggesting monolayer coverage on the homogeneous surface with a uniform distribution of energetic adsorption sites. The monolayer coverage of Cr on NRE is estimated as 11.35 mg/g. The data showed that NRE can be used to remove Cr(VI) from aqueous solutions effectively, and this method is found to be simple, effective, economical and environmentally friendly.


Assuntos
Poluentes Químicos da Água , Purificação da Água , Adsorção , Cromo , Concentração de Íons de Hidrogênio , Cinética , Laboratórios
10.
Sr Care Pharm ; 34(10): 636-643, 2019 Dec 01.
Artigo em Inglês | MEDLINE | ID: mdl-31818349

RESUMO

Laboratory tests play an essential role in diagnosing disease and in determining and monitoring medication therapy. Laboratory interference-inaccuracies resulting from other properties in the sample-from both endogenous and exogeneous sources, can potentially lead to erroneous diagnosis and changes in medications. Some types of laboratory interference are particularly common for elderly individuals. Pharmacists and other practitioners need to be aware of various common sources of interference with laboratory results so they can better assess the validity of laboratory values for their patients.


Assuntos
Serviços de Laboratório Clínico , Idoso , Humanos , Laboratórios , Farmacêuticos
11.
Med Lav ; 110(6): 446-458, 2019 Dec 17.
Artigo em Inglês | MEDLINE | ID: mdl-31846449

RESUMO

BACKGROUND: In recent years, under-vacuum sealing (UVS) and containers with formalin encapsulated in the lid have been proposed for the reduction of occupational exposure to airborne formaldehyde (FA) in healthcare environments. OBJECTIVES: We are presenting a study focused on the assessment of FA in hospitals: an automatic sampling system was set, different sampling devices were compared, and the concentration of FA was assessed, following its use in different scenarios. METHODS: Three different devices for sampling/measuring FA were compared. They are based on: 1. silica gel cartridges impregnated with 2,4-dinitrophenylhydrazine (2,4-DNPH); 2. SPME® fiber using O-(2,3,4,5,6-pentafluorobenzyl)hydroxylamine; 3. direct reading commercial instrumentation. Three typical scenarios using FA were investigated: operating theatres where small biopsies are soaked into closed-circuit system 4% FA containers, secretariat of pathology laboratories during the registration of biopsies and pathology laboratories during the filling procedure by UVS and the slicing of biopsies. RESULTS: The automatic sampling system allowed short-, long-, and in continuous-sampling time to measure airborne FA. Different sampling devices provided comparable results when tested to assess FA concentration ranging from 0.020-0.320 ppm in a test chamber, although  the devices based on 2,4-DNPH were  the best in terms of sensitivity and accuracy. The results of 246 samples showed that the FA concentration was less than 0.04 ppm in 91% of the measurements. CONCLUSIONS: The automatic methods efficiently allow sampling and measurement of FA in hospital settings. When using safe practices, the concentration of FA is well below occupational limit values.


Assuntos
Monitoramento Ambiental , Formaldeído , Hospitais , Exposição Ocupacional , Humanos , Laboratórios
12.
MMWR Morb Mortal Wkly Rep ; 68(50): 1162-1165, 2019 Dec 20.
Artigo em Inglês | MEDLINE | ID: mdl-31856146

RESUMO

On August 1, 2018, the Democratic Republic of the Congo Ministry of Health (DRC MoH) declared the tenth outbreak of Ebola virus disease (Ebola) in DRC, in the North Kivu province in eastern DRC on the border with Uganda, 8 days after another Ebola outbreak was declared over in northwest Équateur province. During mid- to late-July 2018, a cluster of 26 cases of acute hemorrhagic fever, including 20 deaths, was reported in North Kivu province.* Blood specimens from six patients hospitalized in the Mabalako health zone and sent to the Institut National de Recherche Biomédicale (National Biomedical Research Institute) in Kinshasa tested positive for Ebola virus. Genetic sequencing confirmed that the outbreaks in North Kivu and Équateur provinces were unrelated. From North Kivu province, the outbreak spread north to Ituri province, and south to South Kivu province (1). On July 17, 2019, the World Health Organization designated the North Kivu and Ituri outbreak a public health emergency of international concern, based on the geographic spread of the disease to Goma, the capital of North Kivu province, and to Uganda and the challenges to implementing prevention and control measures specific to this region (2). This report describes the outbreak in the North Kivu and Ituri provinces. As of November 17, 2019, a total of 3,296 Ebola cases and 2,196 (67%) deaths were reported, making this the second largest documented outbreak after the 2014-2016 epidemic in West Africa, which resulted in 28,600 cases and 11,325 deaths.† Since August 2018, DRC MoH has been collaborating with partners, including the World Health Organization, the United Nations Children's Fund, the United Nations Office for the Coordination of Humanitarian Affairs, the International Organization of Migration, The Alliance for International Medical Action (ALIMA), Médecins Sans Frontières, DRC Red Cross National Society, and CDC, to control the outbreak. Enhanced communication and effective community engagement, timing of interventions during periods of relative stability, and intensive training of local residents to manage response activities with periodic supervision by national and international personnel are needed to end the outbreak.


Assuntos
Surtos de Doenças , Doença pelo Vírus Ebola/epidemiologia , República Democrática do Congo/epidemiologia , Surtos de Doenças/prevenção & controle , Ebolavirus/isolamento & purificação , Feminino , Doença pelo Vírus Ebola/prevenção & controle , Humanos , Laboratórios , Masculino , Prática de Saúde Pública
13.
Med Lav ; 110(S1): 36-48, 2019 Dec 06.
Artigo em Italiano | MEDLINE | ID: mdl-31846445

RESUMO

BACKGROUND: The Clinica del Lavoro of Milan provided several contributions to industrial hygiene and occupational toxicology during the twentieth century. OBJECTIVES: Describe the first years of the laboratory of industrial hygiene of Milan through three figures who played a leading role: Enrico Carlo Vigliani, Nicola Zurlo and Gianmario Cavagna. METHODS: Scientific literature of the period 1948-1970 was investigated, also interviewing first-hand witnesses of that period. RESULTS: Enrico Vigliani was the first European scholar to understand the importance of a laboratory of industrial hygiene within his institution. Thanks to the support of private (Montecatini) and public (INAIL) institutions he succeeded in creating a laboratory in 1948. Nicola Zurlo, who directed this structure in the first thirty years, conducted innovative studies on chronic mercury intoxication, lead intoxication and silicosis, designing and creating instruments for capturing and analyzing atmospheric dust and protection devices. He conducted analysis of the health effects of organophosphorus insecticides and started to study the air pollution. Zurlo also provided an epistemological and methodological content to the discipline. Gianmario Cavagna, one of the first Italian toxicologists, contributed to the discovery of the origin of fevers caused by the inhalation of metal fumes and to the studies on the pathogenesis of byssinosis, hypothesizing a role of bacterial endotoxins in the genesis of this disease. CONCLUSIONS: The contributions provided by these three protagonists to industrial hygiene and occupational toxicology were relevant and made in those years the Clinica del Lavoro of Milan as a landmark, not only in Italy but also abroad.


Assuntos
Intoxicação por Chumbo , Saúde do Trabalhador , Medicina do Trabalho , História do Século XX , Humanos , Itália , Laboratórios , Intoxicação por Chumbo/história , Saúde do Trabalhador/história , Medicina do Trabalho/história
15.
Pan Afr Med J ; 33: 208, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31692729

RESUMO

The Mozambican Field Epidemiology and Laboratory Training Program (Moz-FELTP) is a two-year, competency-based post-graduate training and service program designed to build sustainable public health capacity in applied epidemiology. Despite the efforts, Moz-FELTP residents have historically difficulty to publishing their work for a variety of reasons that includes language barriers, lack of writing skills and motivation, limited budgetary support and lack of effective mentorship. This outline the need for different approaches to continuous improving the publication, such scientific writing mentorship for non-English FELTP residents.


Assuntos
Epidemiologia/educação , Linguagem , Editoração/estatística & dados numéricos , Pesquisa/educação , Educação Baseada em Competências , Humanos , Laboratórios , Mentores , Moçambique , Publicações Periódicas como Assunto/estatística & dados numéricos , Saúde Pública
17.
Zootaxa ; 4638(2): zootaxa.4638.2.2, 2019 Jul 16.
Artigo em Inglês | MEDLINE | ID: mdl-31712474

RESUMO

Portunus pelagicus (Linnaeus, 1758) sensu lato has been recognized as a species complex comprising four species. Of these four species, the larval stages of all except Portunus segnis (Forskål, 1775), have been described. The larvae of P. segnis, hatched from an ovigerous female, caught in the Gulf of Aqaba, were cultured in the laboratory up to the megalopa stage. All the larval stages are described herein for the first time. The number of aesthetascs of the antennules of all the zoeal stages of P. segnis differs from those of the larvae of the other species of the P. pelagicus species complex. In the telson forks of zoea I-IV of P. segnis, there is a pair of ventral spines and two pairs of dorsal spines, whereas in the other P. pelagicus species complex larvae, there is a pair each of ventral and dorsal spines. Another unique feature, in the megalopa of P. segnis, are two endopod hooks in pleonites I-V. Different zoeal and megalopal stages of P. segnis can be distinguished clearly from the other P. pelagicus species complex larvae based on the number of setae and patterns of different appendages.


Assuntos
Braquiúros , Animais , Feminino , Laboratórios , Larva , Arábia Saudita
18.
Probl Sotsialnoi Gig Zdravookhranenniiai Istor Med ; 27(Special Issue): 715-720, 2019 Aug.
Artigo em Russo | MEDLINE | ID: mdl-31747167

RESUMO

Authors considered the possibilities and limitations of EMIAS implementation in the laboratory service of the city of Moscow on the example of the development and implementation of an integrated Single Reference Laboratory Testing Directory (SRLTD). The article describes the analytical and methodological work performed to systematize the nomenclature when creating the directory. The advantages of SRLTD are assessed: new opportunities for further digitalization of the city's laboratory service, streamlining of medical documentation, convenience in obtaining laboratory data from doctors and patients, and the expected economic effect.


Assuntos
Laboratórios , Diagnóstico , Humanos , Laboratórios/normas , Moscou , Valores de Referência
19.
Zootaxa ; 4647(1): zootaxa.4647.1.25, 2019 Jul 26.
Artigo em Inglês | MEDLINE | ID: mdl-31716993

RESUMO

A new species of Pergalumna from soil and litter was reared in laboratory and a description of adult and juveniles is provided. Adults are characterized by having bands of striae in the posterior part of notogaster, the interlamellar seta are longer than all other prodorsal setae and the lenticular area covers most of the prodorsum. It differs from Pergalumna boliviana by having long interlamellar seta, bigger ellipsoidal porose area Aa and the presence of A2; it differs from Pergalumna paraboliviana by the shape of porose areas; i.e. Aa being ellipsoidal and big, A1 is the smallest, Ap is absent and there are longitudinal striate bands on the prodorsum and ventral plate.


Assuntos
Fabaceae , Ácaros , Animais , Laboratórios , México , Solo
20.
BMC Public Health ; 19(1): 1340, 2019 Oct 22.
Artigo em Inglês | MEDLINE | ID: mdl-31640646

RESUMO

BACKGROUND: Diarrhea is a major cause of morbidity and mortality, yet incidence and etiology data are limited. We conducted laboratory-based diarrhea surveillance in Guatemala. METHODS: A diarrhea case was defined as ≥3 loose stools in a 24-h period in a person presenting to the surveillance facilities. Epidemiologic data and stool specimens were collected. Specimens were tested for bacterial, parasitic, and viral pathogens. Yearly incidence was adjusted for healthcare seeking behaviors determined from a household survey conducted in the surveillance catchment area. RESULTS: From November 2008 to December 2012, the surveillance system captured 5331 diarrhea cases; among these 1381 (26%) had specimens tested for all enteric pathogens of interest. The adjusted incidence averaged 659 diarrhea cases per 10,000 persons per year, and was highest among children aged < 5 years, averaging 1584 cases per 10,000 children per year. Among 1381 (26%) specimens tested for all the pathogens of interest, 235 (17%) had a viral etiology, 275 (20%) had a bacterial, 50 (4%) had parasites, and 86 (6%) had co-infections. Among 827 (60%) specimens from children aged < 5 years, a virus was identified in 196 (23%) patients; 165 (20%) had norovirus and 99 (12%) rotavirus, including co-infections. Among 554 patients aged ≥5 years, 103 (19%) had a bacterial etiology, including diarrheagenic Escherichia coli in 94 (17%) cases, Shigella spp. in 31 (6%), Campylobacter spp. in 5 (1%), and Salmonella spp. in 4 (1%) cases. Detection of Giardia and Cryptosporidium was infrequent (73 cases; 5%). CONCLUSIONS: There was a substantial burden of viral and bacterial diarrheal diseases in Guatemala, highlighting the importance of strengthening laboratory capacity for rapid detection and control and for evaluation of public health interventions.


Assuntos
Disenteria/epidemiologia , Disenteria/etiologia , Vigilância em Saúde Pública/métodos , Adolescente , Adulto , Criança , Pré-Escolar , Fezes/microbiologia , Fezes/parasitologia , Fezes/virologia , Feminino , Guatemala/epidemiologia , Humanos , Incidência , Lactente , Laboratórios , Masculino , Pessoa de Meia-Idade , Adulto Jovem
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