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1.
Recurso na Internet em Português | LIS - Localizador de Informação em Saúde, LIS-bvsms | ID: lis-47955

RESUMO

O termo "check-up" significa checar, conferir. Na medicina, é usado para designar uma avaliação médica de rotina, associada a exames específicos de acordo com idade, sexo e históricos pessoal e familiar. Com a vida atribulada e corrida, muitas pessoas passam, literalmente, anos sem ir ao médico e assim podem deixar passar sinais que o corpo dá como indicativo de problemas mais sérios.


Assuntos
Exames Médicos , Testes Diagnósticos de Rotina , Continuidade da Assistência ao Paciente
2.
PLoS One ; 15(11): e0240652, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33147228

RESUMO

In the current COVID19 crisis many national healthcare systems are confronted with an acute shortage of tests for confirming SARS-CoV-2 infections. For low overall infection levels in the population the pooling of samples can drastically amplify the testing capacity. Here we present a formula to estimate the optimal group-size for pooling, the efficiency gain (tested persons per test), and the expected upper bound of missed infections in pooled testing, all as a function of the population-wide infection levels and the false negative/positive rates of the currently used PCR tests. Assuming an infection level of 0.1% and a false negative rate of 2%, the optimal pool-size is about 34, and an efficiency gain of about 15 tested persons per test is possible. For an infection level of 1% the optimal pool-size is 11, the efficiency gain is 5.1 tested persons per test. For an infection level of 10% the optimal pool-size reduces to about 4, the efficiency gain is about 1.7 tested persons per test. For infection levels of 30% and higher there is no more benefit from pooling. To see to what extent replicates of the pooled tests improve the estimate of the maximal number of missed infections, we present results for 1 to 5 replicates.


Assuntos
Betacoronavirus/genética , Técnicas de Laboratório Clínico/métodos , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/epidemiologia , Testes Diagnósticos de Rotina/métodos , Pandemias , Pneumonia Viral/diagnóstico , Pneumonia Viral/epidemiologia , Manejo de Espécimes/métodos , Infecções por Coronavirus/virologia , Humanos , Pneumonia Viral/virologia , Reação em Cadeia da Polimerase/métodos , RNA Viral/genética
3.
An Acad Bras Cienc ; 92(4): e20201208, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33146237

RESUMO

The COVID-19 pandemic outbreak made the development of reliable, sensitive, and reproducible testing methods crucial throughout the world. Without proper analytical validation, testing results can be misinterpreted, leading to a certain degree of misinformation in the clinical area. To accurately assess the methods, the determination of an analytical linear range of response of the assay is fundamental. Based on this curve, the evaluation of some parameters as sensitivity, limit of detection, and limit of quantification can be done, as well as the establishment of cut-off values. Statistical treatments of the collected data can be performed for reproducibility and reliability evaluations. In this context, there is a wide range of analytical concerns that should be in-depth discussed in medical, biomedical and chemical areas. This letter aims to briefly clarify some analytical chemistry concepts, as sensitivity, cut-off and limit of detection, and their application towards clinical diagnosis.


Assuntos
Infecções por Coronavirus , Testes Diagnósticos de Rotina , Pandemias , Pneumonia Viral , Betacoronavirus , Técnicas de Laboratório Clínico , Infecções por Coronavirus/diagnóstico , Humanos , Reprodutibilidade dos Testes , Sensibilidade e Especificidade
4.
Mol Med Rep ; 22(6): 4485-4491, 2020 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-33173966

RESUMO

In December 2019, an emergence of pneumonia was detected in patients infected with a novel coronavirus (CoV) in Wuhan (Hubei, China). The International Committee on Taxonomy of Viruses named the virus severe acute respiratory syndrome­CoV­2 and the disease CoV disease­19 (COVID­19). Patients with COVID­19 present with symptoms associated with respiratory system dysfunction and hematological changes, including lymphopenia, thrombocytopenia and coagulation disorders. However, to the best of our knowledge, the pathogenesis of COVID­19 remains unclear. Therefore, understanding the mechanisms underlying the hematological changes that manifest during COVID­19 may aid in the development of treatments and may improve patient prognosis.


Assuntos
Betacoronavirus , Infecções por Coronavirus/sangue , Pneumonia Viral/sangue , Anticorpos Antivirais/imunologia , Complexo Antígeno-Anticorpo/imunologia , Antivirais/farmacologia , Antivirais/uso terapêutico , Betacoronavirus/imunologia , Microambiente Celular , Infecções por Coronavirus/complicações , Infecções por Coronavirus/tratamento farmacológico , Infecções por Coronavirus/terapia , Síndrome da Liberação de Citocina/sangue , Síndrome da Liberação de Citocina/etiologia , Síndrome da Liberação de Citocina/prevenção & controle , Citocinas/sangue , Testes Diagnósticos de Rotina , Endotélio Vascular/patologia , Testes Hematológicos , Hematopoese/efeitos dos fármacos , Células-Tronco Hematopoéticas/patologia , Humanos , Hipoalbuminemia/etiologia , Fígado/fisiopatologia , Pulmão/fisiopatologia , Linfopenia/etiologia , Linfopenia/fisiopatologia , Pandemias , Pneumonia Viral/complicações , Pneumonia Viral/tratamento farmacológico , Pneumonia Viral/terapia , Traumatismo por Reperfusão/etiologia , Trombocitopenia/etiologia , Trombocitopenia/fisiopatologia , Trombofilia/etiologia
5.
BMC Infect Dis ; 20(1): 835, 2020 Nov 11.
Artigo em Inglês | MEDLINE | ID: mdl-33176708

RESUMO

BACKGROUND: The spatial distribution and burden of dengue in sub-Saharan Africa remains highly uncertain, despite high levels of ecological suitability. The goal of this study was to describe the epidemiology of dengue among a cohort of febrile children presenting to outpatient facilities located in areas of western Uganda with differing levels of urbanicity and malaria transmission intensity. METHODS: Eligible children were first screened for malaria using rapid diagnostic tests. Children with a negative malaria result were tested for dengue using a combination NS1/IgM/IgG rapid test (SD Bioline Dengue Duo). Confirmatory testing by RT-PCR was performed in a subset of participants. Antigen-capture ELISA was performed to estimate seroprevalence. RESULTS: Only 6 of 1416 (0.42%) children had a positive dengue rapid test, while none of the RT-PCR results were positive. ELISA testing demonstrated reactive IgG antibodies in 28 (2.2%) participants with the highest prevalence seen at the urban site in Mbarara (19 of 392, 4.9%, p < 0.001). CONCLUSIONS: Overall, these findings suggest that dengue, while present, is an uncommon cause of non-malarial, pediatric febrile illness in western Uganda. Further investigation into the eocological factors that sustain low-level transmission in urban settings are urgently needed to reduce the risk of epidemics.


Assuntos
Vírus da Dengue/genética , Vírus da Dengue/imunologia , Dengue/diagnóstico , Dengue/epidemiologia , Febre/diagnóstico , Adolescente , Criança , Pré-Escolar , Dengue/virologia , Testes Diagnósticos de Rotina/efeitos adversos , Ensaio de Imunoadsorção Enzimática , Feminino , Humanos , Imunoglobulina G/imunologia , Imunoglobulina M/imunologia , Malária/diagnóstico , Malária/epidemiologia , Malária/parasitologia , Masculino , Plasmodium/imunologia , Plasmodium/isolamento & purificação , Prevalência , Estudos Prospectivos , Reação em Cadeia da Polimerase em Tempo Real , Estudos Soroepidemiológicos , Uganda/epidemiologia
6.
Isr J Health Policy Res ; 9(1): 58, 2020 10 28.
Artigo em Inglês | MEDLINE | ID: mdl-33115536

RESUMO

BACKGROUND: The heavy reliance on remote patient care (RPC) during the COVID-19 health crisis may have expedited the emergence of digital health tools that can contribute to safely and effectively moving the locus of care from the hospital to the community. Understanding how laypersons interpret the personal health information accessible to them via electronic patient records (EPRs) is crucial to healthcare planning and the design of services. Yet we still know little about how the format in which personal medical information is presented in the EPR (numerically, verbally, or graphically) affects individuals' understanding of the information, their assessment of its gravity, and the course of action they choose in response. METHODS: We employed an online questionnaire to assess respondents' reactions to 10 medical decision-making scenarios, where the same information was presented using different formats. In each scenario, respondents were presented with real (anonymized) patient lab results using either numeric expressions, graphs, or verbal expressions. Participants were asked to assess the gravity of the hypothetical patient's condition and the course of action they would follow if they were that patient. The questionnaire was distributed to more than 300 participants, of whom 225 submitted usable responses. RESULTS: Laypersons were more likely to overestimate the gravity of the information when it was presented either numerically or graphically compared to the narrative format. High perceived gravity was most likely to produce an inclination to actively seek medical attention, even when unwarranted. "Don't know" responses were most likely to produce an inclination to either search the Internet or wait for the doctor to call. POLICY RECOMMENDATIONS: We discuss the study's implications for the effective design of lab results in the patient portals. We suggest (1) that graphs, tables, and charts would be easier to interpret if coupled with a brief verbal explanation; (2) that highlighting an overall level of urgency may be more helpful than indicating a diversion from the norm; and (3) that statements of results should include the type of follow-up required.


Assuntos
Testes Diagnósticos de Rotina , Comunicação em Saúde/métodos , Conhecimentos, Atitudes e Prática em Saúde , Portais do Paciente , Adolescente , Adulto , Idoso , Gráficos por Computador , Feminino , Humanos , Idioma , Masculino , Conceitos Matemáticos , Pessoa de Meia-Idade , Inquéritos e Questionários , Adulto Jovem
7.
BMC Infect Dis ; 20(1): 803, 2020 Oct 29.
Artigo em Inglês | MEDLINE | ID: mdl-33121458

RESUMO

BACKGROUND: Soil-transmitted helminths are more prevalent in tropics and sub-tropics including Ethiopia. Despite their high prevalence, direct saline microscopy with its low sensitivity has been used as a diagnostic method in almost all health facilities in Ethiopia. Alternative diagnostic methods which have higher sensitivity are not yet implemented. Therefore, this study aimed to compare and evaluate the performance of diagnostic methods for soil transmitted helminths. METHODS: A cross-sectional study among 520 school children was conducted from October to December, 2019 in Amhara National Regional State. The study participants were selected using systematic random sampling technique. Stool samples were processed via formol ether concentration, Kato-Katz, spontaneous tube sedimentation and agar plate culture techniques. Data was entered into Epi-data version 3.1 and analysis was done using SPSS version 20.0. The sensitivity, specificity, and negative predictive value were calculated against the combined result. Strength of agreement of the diagnostic methods was determined by Kappa value. RESULTS: The Overall prevalence of soil transmitted helminths was 40.8% using combination of methods. The prevalence 24.4, 22.5, and 32.4%, respectively was recorded by using formol ether concentration, Kato-Katz and spontaneous tube sedimentation. The highest prevalence of hookworm (29.2%) was detected by the agar plate culture. The sensitivity and negative predictive value of formol ether concentration were 57.9 and 78.4%, for Kato-Katz thick smear 55.2 and 76.4%, for spontaneous tube sedimentation were 79.2 and 87.5% to soil transmitted helminths detection, respectively. The sensitivity and negative predictive value of agar plate culture to hookworm detection were 86.4 and 93.5%, respectively. CONCLUSION: Spontaneous tube sedimentation shows higher sensitivity in the detection of soil transmitted helminth infections. Agar plate culture method also indicated better performance for hookworm detection than other methods. Therefore, the employment of spontaneous tube sedimentation technique for routine laboratory and agar plate culture for research purposes will significantly aid in accurate diagnosis of parasitic infections.


Assuntos
Ancylostomatoidea/isolamento & purificação , Testes Diagnósticos de Rotina/métodos , Infecções por Uncinaria/diagnóstico , Infecções por Uncinaria/transmissão , Solo/parasitologia , Adolescente , Animais , Criança , Estudos Transversais , Etiópia/epidemiologia , Fezes/parasitologia , Feminino , Formaldeído , Infecções por Uncinaria/epidemiologia , Infecções por Uncinaria/parasitologia , Humanos , Masculino , Microscopia/métodos , Prevalência , Sensibilidade e Especificidade
8.
Viruses ; 12(10)2020 10 20.
Artigo em Inglês | MEDLINE | ID: mdl-33092065

RESUMO

BACKGROUND: RT-PCR on nasopharyngeal (NPS)/oropharyngeal swabs is the gold standard for diagnosis of SARS-CoV-2 infection and viral load monitoring. Oral fluid (OF) is an alternate clinical sample, easy and safer to collect and could be useful for COVID-19 diagnosis, monitoring viral load and shedding. METHODS: Optimal assay conditions and analytical sensitivity were established for the commercial Simplexa™ COVID-19 Direct assay adapted to OF matrix. The assay was used to test 337 OF and NPS specimens collected in parallel from 164 hospitalized patients; 50 bronchoalveolar lavage (BAL) specimens from a subgroup of severe COVID-19 cases were also analysed. RESULTS: Using Simplexa™ COVID-19 Direct on OF matrix, 100% analytical detection down to 1 TCID50/mL (corresponding to 4 × 103 copies (cp)/mL) was observed. No crossreaction with other viruses transmitted through the respiratory toute was observed. Parallel testing of 337 OF and NPS samples showed highly concordant results (κ = 0.831; 95 % CI = 0.771-0.891), and high correlation of Ct values (r = 0.921; p < 0.0001). High concordance and elevated correlation was observed also between OF and BAL. Prolonged viral RNA shedding was observed up to 100 days from symptoms onset (DSO), with 32% and 29% positivity observed in OF and NPS samples, respectively, collected between 60 and 100 DSO. CONCLUSIONS: Simplexa™ COVID-19 Direct assays on OF have high sensitivity and specificity to detect SARS-CoV-2 RNA and provide an alternative to NPS for diagnosis and monitoring SARS-CoV-2 shedding.


Assuntos
Betacoronavirus/fisiologia , Técnicas de Laboratório Clínico/métodos , Infecções por Coronavirus/virologia , Pneumonia Viral/virologia , Eliminação de Partículas Virais/fisiologia , Adulto , Idoso , Betacoronavirus/genética , Líquidos Corporais/virologia , Infecções por Coronavirus/diagnóstico , Testes Diagnósticos de Rotina , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Técnicas de Diagnóstico Molecular/métodos , Pandemias , Faringe/virologia , Pneumonia Viral/diagnóstico , RNA Viral/análise , Sensibilidade e Especificidade , Manejo de Espécimes , Carga Viral
9.
Isr Med Assoc J ; 22(10): 605-611, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-33070482

RESUMO

BACKGROUND: There is limited clinical information on coronavirus disease-19 (COVID-19) patients in Israel. OBJECTIVES: To describe the characteristics, outcomes, and potential associations of hospitalized COVID-19 patients in Israel. METHODS: We conducted a single-center, retrospective study of 58 consecutive laboratory-confirmed COVID-19 patients admitted to Laniado Hospital, Israel, between 14 March 2020 and 14 May 2020. Demographic, clinical, and laboratory data on admission were collected and analyzed, and the association to subsequent respiratory failure was assessed. RESULTS: Mean age of patients was 70.7 ± 16.9 years (53% males, 47% females.); 74% had at least one co-morbidity. Most patients were of Jewish Ashkenazi descent. During hospitalization 15 patients (mean age 78.18 ± 10.35 years); 80% male, 73% Sephardi descent developed respiratory failure rates of 60% occurring on average 10.6 days following intubation. Laboratory tests at admission displayed a significant increase in C-reactive protein (CRP) and creatine kinase (CK) and a decrease in absolute lymphocyte count (ALC) in patients who eventually developed respiratory failure (163.97 mg/L, 340.87 IU/L, 0.886 K/µl vs. 50.01 mg/L and 123.56 IU/L, 1.28 K/µl, respectively). Multivariate logistic analysis revealed an integrated parameter of CRP, CK, and ALC highly correlated with respiratory failure. Receiver operating characteristic curve revealed the area under the curve of CRP, CK, and ALC and the integrated parameter to be 0.910, 0.784, and 0.754, respectively. CRP was the strongest predictor to correlate with respiratory failure. CONCLUSIONS: CRP, CK, and ALC levels on admission could possibly be used to detect high-risk patients prone to develop respiratory failure.


Assuntos
Infecções por Coronavirus/epidemiologia , Progressão da Doença , Serviço Hospitalar de Emergência/estatística & dados numéricos , Pneumonia Viral/epidemiologia , Insuficiência Respiratória/mortalidade , Síndrome Respiratória Aguda Grave/diagnóstico , Síndrome Respiratória Aguda Grave/terapia , Centros Médicos Acadêmicos , Idoso , Idoso de 80 Anos ou mais , Proteína C-Reativa/análise , Estudos de Coortes , Infecções por Coronavirus/prevenção & controle , Creatina Quinase/análise , Testes Diagnósticos de Rotina/métodos , Feminino , Humanos , Israel , Laboratórios Hospitalares/organização & administração , Modelos Logísticos , Contagem de Linfócitos , Masculino , Pessoa de Meia-Idade , Análise Multivariada , Avaliação de Resultados em Cuidados de Saúde , Pandemias/prevenção & controle , Pandemias/estatística & dados numéricos , Pneumonia Viral/prevenção & controle , Curva ROC , Insuficiência Respiratória/diagnóstico , Insuficiência Respiratória/terapia , Estudos Retrospectivos , Taxa de Sobrevida
10.
PLoS One ; 15(10): e0240076, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33022019

RESUMO

Public health emergency of SARS-CoV-2 has facilitated diagnostic testing as a related medical countermeasure against COVID-19 outbreak. Numerous serologic antibody tests have become available through an expedited federal emergency use only process. This paper highlights the analytical characteristic of an ELISA based assay by AnshLabs and three random access immunoassay (RAIA) by DiaSorin, Roche, and Abbott that have been approved for emergency use authorization (EUA), at a tertiary academic center in a low disease-prevalence area. The AnshLabs gave higher estimates of sero-prevalence, over the three RAIA methods. For positive results, AnshLabs had 93.3% and 100% agreement with DiaSorin or Abbott and Roche respectively. For negative results, AnshLabs had 74.3% and 78.3% agreement with DiaSorin and Roche or Abbott respectively. All discrepant samples that were positive by AnshLabs and negative by RAIA tested positive by all-in-one step SARS-CoV-2 Total (COV2T) assay performed on the automated Siemens Advia Centaur XPT analyzer. None of these methods, however, are useful in early diagnosis of SARS-CoV-2.


Assuntos
Anticorpos Antivirais/imunologia , Betacoronavirus/imunologia , Técnicas de Laboratório Clínico/métodos , Infecções por Coronavirus/diagnóstico , Ensaio de Imunoadsorção Enzimática/métodos , Pneumonia Viral/diagnóstico , Testes Sorológicos/métodos , Infecções por Coronavirus/virologia , Testes Diagnósticos de Rotina , Humanos , Imunoglobulina G/sangue , Imunoglobulina M/sangue , Proteínas do Nucleocapsídeo/imunologia , Pandemias , Pneumonia Viral/virologia , Reação em Cadeia da Polimerase Via Transcriptase Reversa/métodos , Sensibilidade e Especificidade , Glicoproteína da Espícula de Coronavírus/imunologia
11.
Sci Rep ; 10(1): 16608, 2020 10 06.
Artigo em Inglês | MEDLINE | ID: mdl-33024174

RESUMO

The technique RT-qPCR for viral RNA detection is the current worldwide strategy used for early detection of the novel coronavirus SARS-CoV-2. RNA extraction is a key pre-analytical step in RT-qPCR, often achieved using commercial kits. However, the magnitude of the COVID-19 pandemic is causing disruptions to the global supply chains used by many diagnostic laboratories to procure the commercial kits required for RNA extraction. Shortage in these essential reagents is even more acute in developing countries with no means to produce kits locally. We sought to find an alternative procedure to replace commercial kits using common reagents found in molecular biology laboratories. Here we report a method for RNA extraction that takes about 40 min to complete ten samples, and is not more laborious than current commercial RNA extraction kits. We demonstrate that this method can be used to process nasopharyngeal swab samples and yields RT-qPCR results comparable to those obtained with commercial kits. Most importantly, this procedure can be easily implemented in any molecular diagnostic laboratory. Frequent testing is crucial for individual patient management as well as for public health decision making in this pandemic. Implementation of this method could maintain crucial testing going despite commercial kit shortages.


Assuntos
Betacoronavirus/genética , Infecções por Coronavirus/diagnóstico , Pneumonia Viral/diagnóstico , RNA Viral/genética , RNA Viral/isolamento & purificação , Reação em Cadeia da Polimerase em Tempo Real , Infecções por Coronavirus/virologia , Testes Diagnósticos de Rotina , Temperatura Alta , Humanos , Concentração de Íons de Hidrogênio , Indicadores e Reagentes , Pandemias , Pneumonia Viral/virologia , Kit de Reagentes para Diagnóstico/provisão & distribução
12.
Annu Int Conf IEEE Eng Med Biol Soc ; 2020: 4385-4389, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-33018967

RESUMO

In vivo fluorescence miniature microscopy has recently proven a major advance, enabling cellular imaging in freely behaving animals. However, fluorescence imaging suffers from autofluorescence, phototoxicity, photobleaching and non- homogeneous illumination artifacts. These factors limit the quality and time course of data collection. Bioluminescence provides an alternative kind of activity-dependent light indicator. Bioluminescent calcium indicators do not require light input, instead generating photons through chemiluminescence. As such, limitations inherent to the requirement for light presentation are eliminated. Further, bioluminescent indicators also do not require excitation light optics: the removal of these components should make a lighter and lower cost microscope with fewer assembly parts. While there has been significant recent progress in making brighter and faster bioluminescence indicators, the advances in imaging hardware have not yet been realized. A hardware challenge is that despite potentially higher signal-to-noise of bioluminescence, the signal strength is lower than that of fluorescence. An open question we address in this report is whether fluorescent miniature microscopes can be rendered sensitive enough to detect bioluminescence. We demonstrate this possibility in vitro and in vivo by implementing optimizations of the UCLA fluorescent miniscope v3.2. These optimizations yielded a miniscope (BLmini) which is 22% lighter in weight, has 45% fewer components, is up to 58% less expensive, offers up to 15 times stronger signal and is sensitive enough to capture spatiotemporal dynamics of bioluminescence in the brain with a signal-to-noise ratio of 34 dB.


Assuntos
Encéfalo , Testes Imunológicos , Animais , Testes Diagnósticos de Rotina , Microscopia de Fluorescência , Fotodegradação
13.
Annu Int Conf IEEE Eng Med Biol Soc ; 2020: 5136-5139, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-33019142

RESUMO

A mathematical model for DNA quantification was calibrated using experimental results from real-time 260nm absorption measurements of plasmonic PCR thermocycling. The effect of different PCR parameters on template amplification was investigated using the calibrated model.


Assuntos
DNA , Testes Diagnósticos de Rotina , Reação em Cadeia da Polimerase
14.
BMC Infect Dis ; 20(1): 741, 2020 Oct 09.
Artigo em Inglês | MEDLINE | ID: mdl-33036564

RESUMO

BACKGROUND: Cholera remains a major global health challenge. Uvira, in the Democratic Republic of the Congo (DRC), has had endemic cholera since the 1970's and has been implicated as a possible point of origin for national outbreaks. A previous study among this population, reported a case confirmation rate of 40% by rapid diagnostic test (RDT) among patients at the Uvira Cholera Treatment Centre (CTC). This study considers the prevalence and diversity of 15 enteric pathogens in suspected cholera cases seeking treatment at the Uvira CTC. METHODS: We used the Luminex xTAG® multiplex PCR to test for 15 enteric pathogens, including toxigenic strains of V. cholerae in rectal swabs preserved on Whatman FTA Elute cards. Results were interpreted on MAGPIX® and analyzed on the xTAG® Data Analysis Software. Prevalence of enteric pathogens were calculated and pathogen diversity was modelled with a Poisson regression. RESULTS: Among 269 enrolled CTC patients, PCR detected the presence of toxigenic Vibrio cholerae in 38% (103/269) of the patients, which were considered to be cholera cases. These strains were detected as the sole pathogen in 36% (37/103) of these cases. Almost half (45%) of all study participants carried multiple enteric pathogens (two or more). Enterotoxigenic Escherichia coli (36%) and Cryptosporidium (28%) were the other most common pathogens identified amongst all participants. No pathogen was detected in 16.4% of study participants. Mean number of pathogens was highest amongst boys and girls aged 1-15 years and lowest in women aged 16-81 years. Ninety-three percent of toxigenic V. cholerae strains detected by PCR were found in patients having tested positive for V. cholerae O1 by RDT. CONCLUSIONS: Our study supports previous results from DRC and other cholera endemic areas in sub-Sahara Africa with less than half of CTC admissions positive for cholera by PCR. More research is required to determine the causes of severe acute diarrhea in these low-resource, endemic areas to optimize treatment measures. TRIAL REGISTRATION: This study is part of the impact evaluation study entitled: "Impact Evaluation of Urban Water Supply Improvements on Cholera and Other Diarrheal Diseases in Uvira, Democratic Republic of Congo" registered on 10 October 2016 at clinicaltrials.gov Identification number: NCT02928341 .


Assuntos
Cólera/epidemiologia , Criptosporidiose/epidemiologia , Cryptosporidium/genética , Diarreia/epidemiologia , Surtos de Doenças , Escherichia coli Enterotoxigênica/genética , Infecções por Escherichia coli/epidemiologia , Vibrio cholerae/genética , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Animais , Criança , Pré-Escolar , Cólera/microbiologia , Criptosporidiose/parasitologia , República Democrática do Congo/epidemiologia , Testes Diagnósticos de Rotina , Diarreia/microbiologia , Doenças Endêmicas , Infecções por Escherichia coli/microbiologia , Feminino , Humanos , Lactente , Masculino , Pessoa de Meia-Idade , Reação em Cadeia da Polimerase Multiplex , Prevalência , Microbiologia da Água , Adulto Jovem
15.
BMC Infect Dis ; 20(1): 746, 2020 Oct 12.
Artigo em Inglês | MEDLINE | ID: mdl-33046016

RESUMO

BACKGROUND: Effective active case finding (ACF) activities are essential for early identification of new cases of active tuberculosis (TB) and latent TB infection (LTBI). Accurate diagnostics as well as the ability to identify contacts at high risk of infection are essential for ACF, and have not been systematically reported from Central Asia. The objective was to implement a pilot ACF program to determine the prevalence and risk factors for LTBI and active TB among contacts of individuals with TB in Kyrgyz Republic using Quantiferon-TB Gold plus (QuantiFERON). METHODS: An enhanced ACF project in the Kyrgyz Republic was implemented in which close and household (home) contacts of TB patients from the Issyk-Kul Oblast TB Center were visited at home. QuantiFERON and the tuberculin skin test (TST) alongside clinical and bacteriological examination were used to identify LTBI and active TB cases among contacts. The association for QuantiFERON positivity and risk factors were analysed and compared to TST results. RESULTS: Implementation of ACF with QuantiFERON involved close collaboration with the national sanitary and epidemiological services (SES) and laboratories in the Kyrgyz Republic. From 67 index cases, 296 contacts were enrolled of whom 253 had QuantiFERON or TST results; of those 103 contacts had LTBI (positive TST or IGRA), and four (1.4%) active TB cases were detected. Index case smear microscopy (OR 1.76) and high household density (OR 1.97) were significant risk factors for QuantiFERON positivity for all contacts. When stratified by age, association with smear positivity disappeared for children below 15 years. TST was not associated with any risk factor. CONCLUSIONS: This is the first time that ACF activities have been reported for Central Asia, and provide insight for implementation of effective ACF in the region. These ACF activities using QuantiFERON led to increase in the detection of LTBI and active cases, prior to patients seeking treatment. Household density should be taken into consideration as an important risk factor for the stratification of future ACF activities.


Assuntos
Busca de Comunicante/métodos , Testes de Liberação de Interferon-gama/métodos , Tuberculose Latente/diagnóstico , Tuberculose Latente/epidemiologia , Mycobacterium tuberculosis/imunologia , Tuberculose Pulmonar/diagnóstico , Tuberculose Pulmonar/epidemiologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Pré-Escolar , Testes Diagnósticos de Rotina , Características da Família , Feminino , Humanos , Lactente , Recém-Nascido , Quirguistão/epidemiologia , Tuberculose Latente/microbiologia , Masculino , Pessoa de Meia-Idade , Projetos Piloto , Prevalência , Fatores de Risco , Teste Tuberculínico/métodos , Tuberculose Pulmonar/microbiologia , Adulto Jovem
16.
Science ; 370(6514): 288-289, 2020 10 16.
Artigo em Inglês | MEDLINE | ID: mdl-33060347
19.
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
20.
Ann Biol Clin (Paris) ; 78(5): 519-526, 2020 Oct 01.
Artigo em Inglês | MEDLINE | ID: mdl-33026347

RESUMO

Digital morphology hematology analyzers are becoming more prevalent in laboratories Aims: investigate practices and assess the benefits and limits of digital automated microscopy in hematology. METHODS: questionnaire sent by e-mail in 2018 to French public and private laboratories. RESULTS: out of 118 responses (56 private, 62 public), 117 participants had a CellaVision® microscope, 1 had a West Medica®. Practices were sometimes different, especially in the choice of smears to be digitized or for quality controls (16.1% had internal quality controls, 48.3% external quality controls); 62.1% never used the red blood cell (RBC) characterization tool; the number of cells counted varied from 100 to 400. The study reported a high rate of agreement for these benefits: traceability (95.7%), staff training (94.1%), eye strain (91.4%), risk of error (87.2%), time saving (83.6%). Among the disadvantages, apart from the inadequate search for platelets clumps (93.2%), the agreement rates were often lower: adaptation to digital images (61.2%), difficult assessment of atypical morphologies (49.6%) or RBC morphology (49.6%). CONCLUSION: despite well-established benefits, standardization of practices and technical improvement are still needed.


Assuntos
Automação Laboratorial , Testes Hematológicos/instrumentação , Hematologia/instrumentação , Processamento de Imagem Assistida por Computador , Microscopia/instrumentação , Atitude do Pessoal de Saúde , Automação Laboratorial/instrumentação , Automação Laboratorial/métodos , Automação Laboratorial/estatística & dados numéricos , Computadores , Testes Diagnósticos de Rotina/instrumentação , Testes Diagnósticos de Rotina/métodos , Testes Diagnósticos de Rotina/estatística & dados numéricos , Testes Diagnósticos de Rotina/tendências , França/epidemiologia , Testes Hematológicos/métodos , Testes Hematológicos/estatística & dados numéricos , Testes Hematológicos/tendências , Hematologia/métodos , Hematologia/estatística & dados numéricos , Hematologia/tendências , Humanos , Processamento de Imagem Assistida por Computador/instrumentação , Processamento de Imagem Assistida por Computador/métodos , Processamento de Imagem Assistida por Computador/estatística & dados numéricos , Processamento de Imagem Assistida por Computador/tendências , Satisfação no Emprego , Microscopia/métodos , Microscopia/estatística & dados numéricos , Microscopia/tendências , Prática Profissional/estatística & dados numéricos , Prática Profissional/tendências , Controle de Qualidade , Inquéritos e Questionários
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