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مقالات
Novel use Of Hydroxyurea in an African Region with Malaria (NOHARM): a trial for children with sickle cell anemia
نویسنده :
تاریخ انتشار : 1397/02/18
Hydroxyurea treatment is recommended for children with sickle cell anemia (SCA) living
in high-resource malaria-free regions, but its safety and efficacy in malaria-endemic
sub-Saharan Africa, where the greatest sickle-cell burden exists, remain unknown. In vitro
studies suggest hydroxyurea could increase malaria severity, and hydroxyureaassociated
neutropenia could worsen infections. NOHARM (Novel use Of Hydroxyurea
in an African Region with Malaria) was a randomized, double-blinded, placebo-controlled
trial conducted in malaria-endemic Uganda, comparing hydroxyurea to placebo at
20 6 2.5 mg/kg per day for 12 months. The primary outcome was incidence of clinicalmalaria.
Secondary outcomes included SCA-related adverse events (AEs), clinical and laboratory
effects, and hematological toxicities. Children received either hydroxyurea (N 5 104) or
placebo (N 5 103). Malaria incidence did not differ between children on hydroxyurea (0.05
episodes per child per year; 95% confidence interval [0.02, 0.13]) vs placebo (0.07
episodes per child per year [0.03, 0.16]); the hydroxyurea/placebo malaria incidence rate
ratio was 0.7 ([0.2, 2.7]; P 5 .61). Time to infection also did not differ significantly between
treatment arms. A composite SCA-related clinical outcome (vaso-occlusive painful crisis,
dactylitis, acute chest syndrome, splenic sequestration, or blood transfusion) was less frequent with hydroxyurea (45%) than placebo
(69%; P 5 .001). Children receiving hydroxyurea had significantly increased hemoglobin concentration and fetal hemoglobin, with
decreasedleukocytes and reticulocytes.Serious AEs, sepsis episodes, and dose-limiting toxicitieswere similar between treatment arms.
Three deaths occurred (2 hydroxyurea, 1 placebo, and none from malaria). Hydroxyurea treatment appears safe for children with SCA
living in malaria-endemic sub-Saharan Africa, without increased severe malaria, infections, or AEs. Hydroxyurea provides SCA-related
laboratory and clinical efficacy, but optimal dosing and monitoring regimens for Africa remain undefined. This trial was registered at
www.clinicaltrials.gov as #NCT01976416
برچسب ها :
Hydroxyurea
cell-anemia
hematological
Malaria
Children
Correlation of Treponemal Immunoassay Signal Strength Values with Reactivity of Confirmatory Treponemal Testing
نویسنده :
تاریخ انتشار : 1397/02/16
Automated treponemal immunoassays are used for syphilis screening
with the reverse-sequence algorithm; discordant results (e.g., enzyme immunoassay
[EIA] reactive and reactive plasma reagin [RPR] nonreactive) are resolved with a second
treponemal test. We conducted a study to determine automated immunoassay
signal strength values consistently correlating with reactive confirmatory treponemal
testing. We conducted a cross-sectional analysis of four automated immunoassays
(BioPlex 2200 microbead immunoassay [MBIA], Liaison chemiluminescence immunoassay
[CIA], Advia-Centaur CIA, and Trep-Sure EIA) and three manual assays (Treponema
pallidum particle agglutination [TP-PA], fluorescent treponemal antibody absorption
[FTA-ABS] test, and Inno-LIA line immunoassay). We compared signal
strength values of automated immunoassays and positive and negative agreement.
Among 1,995 specimens, 908 (45.5%) were true positives (4/7 tests reactive) and
1,087 (54.5%) were true negatives (4/7 tests nonreactive). Positive agreement
ranged from 86.1% (83.7 to 88.2%) for FTA-ABS to 99.7% (99.0 to 99.9%) for AdviaCentaur
CIA; negative agreement ranged from 86.3% (84.1 to 88.2%) for Trep-Sure
EIA to 100% for TP-PA (99.6 to 100%). Increasing signal strength values correlated
with increasing reactivity of confirmatory testing (P 0.0001 for all automated immunoassays
by Cochran-Armitage test for trend). All automated immunoassays had
signal strength cutoffs corresponding to 4/7 reactive treponemal tests. BioPlex
MBIA and Liaison CIA had signal strength cutoffs correlating with 99% and 100%
TP-PA reactivity, respectively. The Advia-Centaur CIA and Trep-Sure EIA had signal
strength cutoffs correlating with at least 95% TP-PA reactivity. All automated immunoassays
had signal strength cutoffs correlating with at least 95% FTA-ABS reactivity.
Assuming that a 95% level of confirmation is adequate, these signal strength values
can be used in lieu of confirmatory testing with TP-PA and FTA-ABS
برچسب ها :
algorithim
syphilis
treponemal
automated
immunoassays
Ability To Serologically Confirm Recent Zika Virus Infection in Areas with Varying Past Incidence of Dengue Virus Infection in the United States and U.S. Territories in 2016
نویسنده :
تاریخ انتشار : 1397/02/10
Cross-reactivity within flavivirus antibody assays, produced by shared
epitopes in the envelope proteins, can complicate the serological diagnosis of Zika virus
(ZIKAV) infection. We assessed the utility of the plaque reduction neutralization test
(PRNT) to confirm recent ZIKAV infections and rule out misleading positive immunoglobulin
M (IgM) results in areas with various levels of past dengue virus (DENV) infection incidence.
We reviewed PRNT results of sera collected for diagnosis of ZIKAV infection
from 1 January through 31 August 2016 with positive ZIKAV IgM results, and ZIKAV and
DENV PRNTs were performed. PRNT result interpretations included ZIKAV, unspecified
flavivirus, DENV infection, or negative. For this analysis, ZIKAV IgM was considered false
positive for samples interpreted as a DENV infection or negative. In U.S. states, 208
(27%) of 759 IgM-positive results were confirmed to be ZIKAV compared to 11 (21%) of
52 in the U.S. Virgin Islands (USVI), 15 (15%) of 103 in American Samoa, and 13 (11%) of
123 in Puerto Rico. In American Samoa and Puerto Rico, more than 80% of IgM-positive
results were unspecified flavivirus infections. The false-positivity rate was 27% in U.S.
states, 18% in the USVI, 2% in American Samoa, and 6% in Puerto Rico. In U.S. states,
the PRNT provided a virus-specific diagnosis or ruled out infection in the majority of
IgM-positive samples. Almost a third of ZIKAV IgM-positive results were not confirmed;
therefore, providers and patients must understand that IgM results are preliminary. In
territories with historically higher rates of DENV transmission, the PRNT usually could not
differentiate between ZIKAV and DENV infections.
برچسب ها :
confirmatory
serologic
Zika-virus
Total Laboratory Automation and Matrix-Assisted Laser Desorption Ionization–Time of Flight Mass Spectrometry Improve Turnaround Times in the Clinical Microbiology Laboratory: a Retrospective Analysis
نویسنده :
تاریخ انتشار : 1397/02/04
Technological advances have changed the practice of clinical microbiology.
We implemented Bruker matrix-assisted laser desorption ionization–time of
flight mass spectrometry (MALDI-TOF MS) and BD Kiestra total laboratory automation
(TLA) 4 and 3 years ago, respectively. To assess the impact of these new technologies,
we compared turnaround times (TATs) for positive and negative urine cultures
before and after implementation. In comparison I, TATs for 61,157 urine
cultures were extracted for two periods corresponding to pre-TLA and post-TLA,
both using MALDI-TOF MS for organism identification. In comparison II, time to organism
identification (ID) and antimicrobial susceptibility (AST) reports were calculated
for 5,402 positive culture reports representing four different periods: (i) manual
plating and conventional biochemical identification (CONV), (ii) manual plating and
MALDI-TOF MS identification (MALDI), (iii) MALDI-TOF MS identification and early
phase implementation of TLA (TLA1), and (iv) MALDI-TOF MS identification and late
phase implementation of TLA (TLA2). By the comparison I results, median pre- and
post-TLA TATs to organism IDs (18.5 to 16.9 h), AST results (41.8 to 40.8 h), and preliminary
results for negative cultures (17.7 to 13.6 h), including interquartile ranges
for all comparisons, were significantly decreased post-TLA (P 0.001). By the comparison
II results, MALDI significantly improved TAT to organism ID compared to
CONV (21.3 to 18 h). TLA further improved overall TAT to ID (18 to 16.5 h) and AST
(42.3 to 40.7 h) results compared to MALDI (P 0.001). In summary, TLA signifi-
cantly improved TAT to organism ID, AST report, and preliminary negative results.
MALDI-TOF MS significantly improved TAT for organism ID. Use of MALDI-TOF MS
and TLA individually and together results in significant decreases in microbiology report
TATs
برچسب ها :
MALDI-TOF-MS
clinical-microbiology
total-laboratory-automation
turnaround-time
Ixazomib significantly prolongs progression-free survival in high-risk relapsed/refractory myeloma patients
نویسنده :
تاریخ انتشار : 1397/01/14
Certain cytogenetic abnormalities are known to adversely impact outcomes in patients with
multiple myeloma (MM). The phase 3 TOURMALINE-MM1 study demonstrated a significant
improvement in progression-free survival (PFS) with ixazomib-lenalidomide-dexamethasone
(IRd) compared with placebo-lenalidomide-dexamethasone (placebo-Rd). This preplanned
analysis assessed the efficacy and safety of IRd vs placebo-Rd according to cytogenetic risk,
as assessed using fluorescencein situ hybridization. High-risk cytogenetic abnormalitieswere
defined as del(17p), t(4;14), and/or t(14;16); additionally, patients were assessed for 1q21
amplification. Of 722 randomized patients, 552 had cytogenetic results; 137 (25%) had high-risk
cytogenetic abnormalities and 172 (32%) had 1q21 amplification alone. PFS wasimproved with
IRd vs placebo-Rd in both high-risk and standard-risk cytogenetics subgroups: in high-risk
patients, the hazard ratio (HR) was 0.543 (95% confidence interval [CI], 0.321-0.918; P 5 .021),
with median PFS of 21.4 vs 9.7 months; in standard-risk patients, HR was 0.640 (95% CI, 0.462-
0.888; P 5 .007), with median PFS of 20.6 vs 15.6 months. This PFS benefit was consistent
across subgroups with individual high-risk cytogenetic abnormalities, including patients with
del(17p) (HR, 0.596; 95% CI, 0.286-1.243). PFS was also longer with IRd vs placebo-Rd in patients with 1q21 amplification (HR, 0.781; 95% CI,
0.492-1.240), and in the “expanded high-risk” group, defined as those with high-risk cytogenetic abnormalities and/or 1q21 amplification (HR,
0.664; 95% CI, 0.474-0.928). IRd demonstrated substantial benefit compared with placebo-Rd in relapsed and/or refractory MM (RRMM)
patients with high-risk and standard-risk cytogenetics, and improves the poor PFS associated with high-risk cytogenetic abnormalities.
برچسب ها :
RRMM-patients
Ixazomib
myeloma-patients
Evaluation of the Clinical Performance of the HPV-Risk Assay Using the VALGENT-3 Panel
نویسنده :
تاریخ انتشار : 1396/12/14
Human papillomavirus (HPV) testing is increasingly being incorporated
into cervical cancer screening. The Validation of HPV Genotyping Tests (VALGENT) is
a framework designed to evaluate the clinical performance of various HPV tests relative
to that of the validated and accepted comparator test in a formalized and uniform
manner. The aim of this study was to evaluate the clinical performance of the
HPV-Risk assay with samples from the VALGENT-3 panel and to compare its performance
to that of the clinically validated Hybrid Capture 2 assay (HC2). The VALGENT-3
panel comprises 1,300 consecutive samples from women participating in routine cervical
cancer screening and is enriched with 300 samples from women with abnormal cytology.
DNA was extracted from original ThinPrep PreservCyt medium aliquots, and
HPV testing was performed using the HPV-Risk assay by investigators blind to the
clinical data. HPV prevalence was analyzed, and the clinical performance of the HPVRisk
assay for the detection of cervical intraepithelial neoplasia grade 3 or worse
(CIN3) and CIN2 or worse (CIN2) relative to the performance of HC2 was assessed.
The sensitivity of the HPV-Risk assay for the detection of CIN3 was similar
to that of HC2 (relative sensitivity, 1.00; 95% confidence interval [CI], 0.95 to 1.05;
P 1.000), but the specificity of the HPV-Risk assay was significantly higher than
that of HC2 (relative specificity, 1.02; 95% CI, 1.01 to 1.04; P 0.001). For the detection
of CIN2, similar results were obtained, with the relative sensitivity being 0.98
(95% CI, 0.93 to 1.02; P 0.257) and the relative specificity being 1.02 (95% CI, 1.01
to 1.03; P 0.001). The performance of the HPV-Risk assay for the detection of
CIN3 and CIN2 was noninferior to that of HC2, with all P values being 0.006. In
conclusion, the HPV-Risk assay demonstrated noninferiority to the clinically validated
HC2 by the use of samples from the VALGENT-3 panel for test validation and comparison.
برچسب ها :
cervical-cancer-screening
human-papillomavirus
HPV-Risk-assay
Hybrid-Capture-2
HPV
Role of the Fibrinogen Degradation Products and D-Dimer in the Differential Diagnosis of Pulmonary Tuberculosis and Community-Acquired Pneumonia
نویسنده :
تاریخ انتشار : 1396/12/12
Differential diagnosis between pulmonary tuberculosis (TB) and community acquired pneumonia
(CAP) is often difficult. Pulmonary TB could induce a systemic hypercoagulable state. The present study aims to
investigate whether fibrinogen degradation products (FDP) and D-dimer play a diagnostic role for pulmonary TB.
برچسب ها :
pulmonary-TB
CAP
FDP
D-dimer
French Prospective Clinical Evaluation of the Aptima Mycoplasma genitalium CEIVD Assay and Macrolide Resistance Detection Using Three Distinct Assays
نویسنده :
تاریخ انتشار : 1396/12/07
The aim of this study was to evaluate the clinical performance of the
Aptima Mycoplasma genitalium transcription-mediated amplification (MG-TMA) CEmarked
for in vitro diagnosis (CE-IVD) assay for the detection of Mycoplasma genitalium
in male and female clinical samples in comparison with the in-house real-time
PCR (in-house PCR) assay routinely used in our laboratory. A total of 1,431 clinical
specimens obtained from 1,235 patients were prospectively collected at the Bacteriology
Department of Bordeaux University Hospital (France). Additional research-useonly
Aptima M. genitalium transcription-mediated amplification (TMA) assays, Alt1-
TMA and Alt2-TMA, were performed on discordant specimens to determine M.
genitalium infection status. All confirmed M. genitalium-positive specimens were
tested for macrolide resistance using three assays: the in-house 23S rRNA FRET PCR
assay, the SpeeDx ResistancePlus MG assay and the nested reverse transcription-PCR
(RT-PCR) sequencing assay. The comparison of the MG-TMA assay with the in-house
PCR results showed a moderate correlation (kappa value, 0.69). The MG-TMA assay
had higher clinical sensitivity compared to that of the in-house PCR assay (100% versus
59.74%, respectively) and similar specificity (99.10% versus 100%, respectively)
for M. genitalium detection. In this study, the prevalence of M. genitalium infection
was 5.90% (72/1,220 patients). The nested RT-PCR sequencing assay was the most
sensitive but the most laborious assay for detecting macrolide-resistance-associated
mutations. The prevalence of resistance was 8.33% (6/72). To our knowledge, this is
the first clinical evaluation of the MG-TMA CE-IVD assay. The MG-TMA assay performed
on the automated Panther system is a very sensitive and specific method for
the detection of M. genitalium in clinical specimens
برچسب ها :
Mycoplasma-genitalium
transcription-mediated-amplification
real-time-PCR
clinical-specimens
macrolide-resistance
Variable Sensitivity in Molecular Detection of Zika Virus in European Expert Laboratories: External Quality Assessment, November 2016
نویسنده :
تاریخ انتشار : 1396/12/05
Zika virus (ZIKV) infections are a significant public health concern. A
strong capability for ZIKV detection is an absolute requirement for adequate preparedness
and response strategies and individual patient care. The objective of this
study was to assess and improve the capability of European expert laboratories for
molecular testing for ZIKV through an external quality assessment (EQA) scheme.
Laboratories were provided a panel of 12 samples which included negative samples,
samples containing African- or Asian-lineage ZIKV at various concentrations (103 to
109 copies/ml), and samples containing dengue virus, yellow fever virus, or chikungunya
virus. The results were analyzed on the basis of the outcomes of testing for
the samples and the extraction and detection method used. Samples with a ZIKV
RNA status scored correctly by 50% of the laboratories were designated the core
sample. A total of 85 panel outcomes were submitted by 50 laboratories in 31 countries.
The results designated all samples as core samples. Thirty-three percent (28/85)
of the panel outcomes identified all samples. Analysis at the laboratory level showed
that only 40% of the laboratories (20/50), representing 45% of the countries, scored
sufficiently; i.e., they had at least one test operational that scored all core samples
correctly. There is a need for improvement of the molecular detection of ZIKV in
60% of the participating laboratories. While the specificity of the tests was more robust,
the results of the EQA showed large variation in test sensitivity. Improvements
should focus on both nucleic acid extraction and ZIKV detection methods.
برچسب ها :
EQA
laboratory-response
Zika-virus
laboratory-preparedness
external-quality-assessment
molecular-virus-diagnostics
Clinical Utility of Ordered Pathology Blood Smear Reviews - an Overused Resource?
نویسنده :
تاریخ انتشار : 1396/11/30
Blood smear reviews by pathologists (BSR) are ordered frequently at our institution, take time to
evaluate, and result in a written report. Minimal research has been done regarding the amount of novel data reported
and its clinical utility.
برچسب ها :
peripheral-blood-smear
pathologist-review
clinician
clinical-utility
High-Stringency Evaluation of the Automated BD Phoenix CPO Detect and Rapidec Carba NP Tests for Detection and Classification of Carbapenemases
نویسنده :
تاریخ انتشار : 1396/11/28
There is an urgent need for rapid, accurate detection and classification
of carbapenemases. The current study evaluated the automated BD Phoenix
CPO Detect and the manual bioMérieux Rapidec Carba NP tests for meeting
these needs. Both tests were challenged with 294 isolates of Enterobacteriaceae
spp., Pseudomonas aeruginosa, and Acinetobacter baumannii chosen to provide
extreme diagnostic difficulty. Carbapenemases such as KPC, NMC-A, IMI, SME,
NDM, SPM, IMP, VIM, and OXA-23, 40, 48, 58, 72, 181, and 232 were produced by
243 isolates and 51 carbapenemase-negative isolates included porin mutants and
producers of extended-spectrum -lactamases (ESBLs), AmpCs, K1, and broadspectrum
-lactamases. Both tests exhibited high sensitivity of carbapenemase detection
(97%). Due to the highly challenging carbapenemase-negative isolates,
specificities were lower than typical for evaluations involving mostly routine clinical
isolates. BD Phoenix CPO Detect was 68.6% specific and Rapidec Carba NP was
60.8% to 78.4% specific, depending on how borderline results were interpreted. Only
BD Phoenix CPO Detect classified carbapenemases. It correctly classified 85.0% of
class A, 72.4% of class B, and 88.6% of class D carbapenemases. Importantly with respect
to empirical therapy with new -lactamase inhibitor combinations such as ceftazidime/avibactam,
no class B carbapenemases were misclassified as class A carbapenemases.
Both tests offer advantages. Used alone, without initial susceptibility tests,
Rapidec Carba NP can provide positive results for some isolates after only 10 to 30
min incubation. BD Phoenix CPO Detect provides novel advantages such as automated
carbapenemase detection, inclusion in susceptibility panels to eliminate delays
and subjectivity in initiating carbapenemase tests, and classification of most carbapenemases.
برچسب ها :
CPO
CPO-Detect
KPC
NDM
Rapidec-Carba-NP
VIM
carbapenemase
Association between EZH2 Genetic Variants and Hepatocellular Carcinoma in a Chinese Han Population
نویسنده :
تاریخ انتشار : 1396/11/24
Hepatocellular carcinoma (HCC) is one of the most common malignancies worldwide. Studies have
shown that EZH2, as the member of the Polycomb groups (PcGs) family, plays an important biological role in the
occurrence and development of HCC. The association between the genetic variants of EZH2 and HCC is not yet
fully established.
برچسب ها :
hepatocellular-carcinoma
EZH2
gene-polymorphism
Cytoprotective activated protein C averts Nlrp3 inflammasome–induced ischemia-reperfusion injury via mTORC1 inhibition
نویسنده :
تاریخ انتشار : 1396/11/21
Cytoprotection by activated protein C (aPC) after ischemia-reperfusion injury (IRI) is
associated with apoptosis inhibition. However, IRI is hallmarked by inflammation, and
hence, cell-death forms disjunct from immunologically silent apoptosis are, in theory,
more likely to be relevant. Because pyroptosis (ie, cell death resulting from inflammasome
activation) is typically observed in IRI, we speculated that aPC ameliorates IRI by
inhibiting inflammasome activation. Here we analyzed the impact of aPC on inflammasome
activity in myocardial and renal IRIs. aPC treatment before or after myocardial IRI
reduced infarct size and Nlrp3 inflammasome activation in mice. Kinetic in vivo analyses
revealed that Nlrp3 inflammasome activation preceded myocardial injury and apoptosis,
corroborating a pathogenic role of the Nlrp3 inflammasome. The constitutively active
Nlrp3A350V mutation abolished the protective effect of aPC, demonstrating that Nlrp3
suppression is required for aPC-mediated protection from IRI. In vitro aPC inhibited
inflammasome activation in macrophages, cardiomyocytes, and cardiac fibroblasts via
proteinase-activated receptor 1 (PAR-1) and mammalian target of rapamycin complex 1
(mTORC1) signaling. Accordingly, inhibiting PAR-1 signaling, but not the anticoagulant properties of aPC, abolished the ability of aPC
to restrict Nlrp3 inflammasome activity and tissue damage in myocardial IRI. Targeting biased PAR-1 signaling via parmodulin-2
restricted mTORC1 and Nlrp3 inflammasome activation and limited myocardial IRI as efficiently as aPC. The relevance of aPCmediated
Nlrp3 inflammasome suppression after IRI was corroborated in renal IRI, where the tissue protective effect of aPC was
likewise dependent on Nlrp3 inflammasome suppression. These studies reveal that aPC protects from IRI by restricting mTORC1-
dependent inflammasome activation and thatmimicking biased aPC PAR-1 signaling using parmodulins may be a feasible therapeutic
approach to combat IRI.
برچسب ها :
protein-C
Cardiovascular-disease
ischemia-reperfusion
mTORC1
lytA Quantitative PCR on Sputum and Nasopharyngeal Swab Samples for Detection of Pneumococcal Pneumonia among the Elderly
نویسنده :
تاریخ انتشار : 1396/11/17
Real-time quantitative PCR (qPCR) assay of sputum or nasopharyngeal
specimens has shown promising results in the detection of pneumococcal
community-acquired pneumonia (PncCAP). We applied qPCR for the autolysin gene
(lytA) and compared sputum and nasopharyngeal swab (NPS) pneumococcal loads in
elderly patients with community-acquired pneumonia (CAP), and specifically in patients
with PncCAP, to those in patient groups with other respiratory diseases. We
studied patients aged 65 years with radiologically confirmed CAP, clinical CAP not
retrospectively radiologically confirmed, other acute respiratory infections, or stable
chronic lung disease. Pneumococcal etiology of CAP was ascertained by using a
combination of multiple diagnostic methods. We analyzed sputum and NPS specimens
by lytA qPCR with 104 pneumococcal genome equivalents (GE)/ml as a cutoff
for positivity. Among PncCAP patients, lytA qPCR detected pneumococci in 94% of
the sputum samples and in large quantities (mean, 6.82 1.02 log10 GE/ml) but less
frequently in NPS (44%) and in smaller quantities (5.55 0.92 log10 GE/ml). In all
other patient groups, 10% of the sputum samples and 5% of the NPS samples
were lytA qPCR positive; but when they were positive, the sputum pneumococcal
loads were similar to those in the PncCAP patients, suggesting a pneumococcal etiology
in these patients. This was supported by other pneumococcal assay results.
Overall, sputum lytA qPCR positivity was more common in PncCAP patients than in
the other patient groups, but the quantitative results were mainly similar. NPS lytA
qPCR was less sensitive than sputum lytA qPCR in detecting PncCAP.
برچسب ها :
community-acquired-pneumonia
nasopharynx
PCR
sputum
Streptococcus-pneumoniae
Fibulin-5 is Down-Regulated in Colorectal Cancer and Correlated with Clinicopathologic Characteristics
نویسنده :
تاریخ انتشار : 1396/11/15
Fibulin-5 has recently been considered as a potential tumor suppressor in human cancers. Several
studies have shown that it is down-regulated in a variety of tumor types and inhibits tumor growth and metastasis.
In this study, the expression of fibulin-5 in colorectal cancer (CRC) and its clinical significance were assessed.
برچسب ها :
fibulin-5
colorectal-cancer
clinical-significance
tumor-suppressor
Implementation of a Clinical Decision Support Tool for Stool Cultures and Parasitological Studies in Hospitalized Patients
نویسنده :
تاریخ انتشار : 1396/11/12
There is substantial evidence that stool culture and parasitological examinations
are of minimal to no value after 3 days of hospitalization. We implemented and
studied the impact of a clinical decision support tool (CDST) to decrease the number of
unnecessary stool cultures (STCUL), ova/parasite (O&P) examinations, and Giardia/Cryptosporidium
enzyme immunoassay screens (GC-EIA) performed for patients hospitalized 3
days. We studied the frequency of stool studies ordered before or on day 3 and after
day 3 of hospitalization (i.e., categorical orders/total number of orders) before and after
this intervention and denoted the numbers and types of microorganisms detected
within those time frames. This intervention, which corresponded to a custom-programmed
hard-stop alert tool in the Epic hospital information system, allowed providers to
override the intervention by calling the laboratory, if testing was deemed medically necessary.
Comparative statistics were employed to determine significance, and cost savings
were estimated based on our internal costs. Before the intervention, 129/670 (19.25%)
O&P examinations, 47/204 (23.04%) GC-EIA, and 249/1,229 (20.26%) STCUL were ordered
after 3 days of hospitalization. After the intervention, 46/521 (8.83%) O&P examinations,
27/157 (17.20%) GC-EIA, and 106/1,028 (10.31%) STCUL were ordered after 3 days of
hospitalization. The proportions of reductions in the number of tests performed after 3
days and the associated P values were 54.1% for O&P examinations (P 0.0001),
22.58% for GC-EIA (P 0.2807), and 49.1% for STCUL (P 0.0001). This was estimated
to have resulted in $8,108.84 of cost savings. The electronic CDST resulted in a substantial
reduction in the number of evaluations of stool cultures and the number of parasitological
examinations for patients hospitalized for more than 3 days and in a cost savings
while retaining the ability of the clinician to obtain these tests if clinically indicated.
برچسب ها :
O&P-examinations
stewardship
stool-culture
utilization
Comparison of Different Phenotypic Approaches To Screen and Detect mecC-Harboring Methicillin-Resistant Staphylococcus aureus
نویسنده :
تاریخ انتشار : 1396/11/10
Similar to mecA, mecC confers resistance against beta-lactams, leading
to the phenotype of methicillin-resistant Staphylococcus aureus (MRSA). However,
mecC-harboring MRSA strains pose special difficulties in their detection. The aim of this
study was to assess and compare different phenotypic systems for screening, identification,
and susceptibility testing of mecC-positive MRSA isolates. A well-characterized collect('io
of mecC-positive S. aureus isolates (n 111) was used for evaluation. Routinely
used approaches were studied to determine their suitability to correctly
identify mecC-harboring MRSA, including three (semi)automated antimicrobial susceptibility
testing (AST) systems and five selective chromogenic agar plates. Additionally,
a cefoxitin disk diffusion test and an oxacillin broth microdilution assay
were examined. All mecC-harboring MRSA isolates were able to grow on all chromogenic
MRSA screening plates tested. Detection of these isolates in AST systems
based on cefoxitin and/or oxacillin testing yielded overall positive agreements with
the mecC genotype of 97.3% (MicroScan WalkAway; Siemens), 91.9% (Vitek 2; bioMérieux),
and 64.9% (Phoenix, BD). The phenotypic resistance pattern most frequently
observed by AST devices was “cefoxitin resistance/oxacillin susceptibility,”
ranging from 54.1% (Phoenix) and 83.8% (Vitek 2) to 92.8% (WalkAway). The cefoxitin
disk diffusion and oxacillin broth microdilution assays categorized 100% and
61.3% of isolates to be MRSA, respectively. The chromogenic media tested confirmed
their suitability to reliably screen for mecC-harboring MRSA. The AST systems
showed false-negative results with varying numbers, misidentifying mecC-harboring
MRSA as methicillin-susceptible S. aureus. This study underlines cefoxitin’s status as
the superior surrogate mecC-positive MRSA marker.
برچسب ها :
MRSA
Staphylococcus-aureus
broth-microdilution
cefoxitin
chromogenic-media
disk-diffusion
mecC
methicillin-resistance
The Relationship between Trypsin/Calcitonin Gene Related Peptide (CGRP) in Serum and Acute Pancreatitis (AP)
نویسنده :
تاریخ انتشار : 1396/11/03
Activation of trypsin from proteolytic cleavage of trypsinogen in the pancreas can lead to acute pancreatitis.
Calcitonin gene related peptide (CGRP) from both peripheral and central neurons is involved in a variety
of physiological/pathophysiological processes, especially sensory (nociceptive) and efferent (effector) functions.
To better understand the change of trypsin/CGRP in acute pancreatitis, the study investigated the serum level of
trypsin/CGRP in patients with acute pancreatitis.
برچسب ها :
acute-pancreatitis
calcitonin-gene-related-peptide
trypsin
Structural Characterization of Clostridium sordellii Spores of Diverse Human, Animal, and Environmental Origin and Comparison to Clostridium difficile Spores
نویسنده :
تاریخ انتشار : 1396/11/01
Clostridium sordellii is an often-lethal bacterium causing human and animal
disease. Crucial to the infectious cycle of C. sordellii is its ability to produce
spores, which can germinate into toxin-producing vegetative bacteria under favorable
conditions. However, structural details of the C. sordellii spore are lacking. Here,
we used a range of electron microscopy techniques together with superresolution
optical microscopy to characterize the C. sordellii spore morphology with an emphasis
on the exosporium. The C. sordellii spore is made up of multiple layers with the
exosporium presenting as a smooth balloon-like structure that is open at the spore
poles. Focusing on the outer spore layers, we compared the morphologies of C. sordellii
spores derived from different strains and determined that there is some variation
between the spores, most notably with spores of some strains having tubular
appendages. Since Clostridium difficile is a close relative of C. sordellii, their spores
were compared by electron microscopy and their exosporia were found to be distinctly
different from each other. This study therefore provides new structural details
of the C. sordellii spore and offers insights into the physical structure of the exosporium
across clostridial species.
برچسب ها :
Clostridium
Clostridium-difficile
Clostridium-sordellii
endospores
exosporium
Cloning, Assembly, and Modification of the Primary Human Cytomegalovirus Isolate Toledo by Yeast-Based Transformation-Associated Recombination
نویسنده :
تاریخ انتشار : 1396/10/26
Genetic engineering of cytomegalovirus (CMV) currently relies on generating
a bacterial artificial chromosome (BAC) by introducing a bacterial origin of replication
into the viral genome using in vivo recombination in virally infected tissue
culture cells. However, this process is inefficient, results in adaptive mutations, and
involves deletion of viral genes to avoid oversized genomes when inserting the BAC
cassette. Moreover, BAC technology does not permit the simultaneous manipulation
of multiple genome loci and cannot be used to construct synthetic genomes. To
overcome these limitations, we adapted synthetic biology tools to clone CMV genomes
in Saccharomyces cerevisiae. Using an early passage of the human CMV isolate
Toledo, we first applied transformation-associated recombination (TAR) to clone
16 overlapping fragments covering the entire Toledo genome in Saccharomyces
cerevisiae. Then, we assembled these fragments by TAR in a stepwise process until
the entire genome was reconstituted in yeast. Since next-generation sequence analysis
revealed that the low-passage-number isolate represented a mixture of parental
and fibroblast-adapted genomes, we selectively modified individual DNA fragments
of fibroblast-adapted Toledo (Toledo-F) and again used TAR assembly to recreate parental
Toledo (Toledo-P). Linear, full-length HCMV genomes were transfected into
human fibroblasts to recover virus. Unlike Toledo-F, Toledo-P displayed characteristics
of primary isolates, including broad cellular tropism in vitro and the ability to establish
latency and reactivation in humanized mice. Our novel strategy thus enables
de novo cloning of CMV genomes, more-efficient genome-wide engineering, and
the generation of viral genomes that are partially or completely derived from
synthetic DNA.
برچسب ها :
Saccharomyces-cerevisiae
cloning
cytomegalovirus
genetic-recombination
تعمیر و تجهیز تجهیزات آزمایشگاهی : - Elabmarket . فروش . کیت . و . تجهیزات . آزمایشگاهی . دست . دوم . آزمایشگاه . آزما . تجه . - نصب و راه اندازی، کالیبراسیون، سرویس، تعمیر تجهیـزات آزمایشگاهی ، تعمیر دستگاه آزمایشگاهی مورد نیاز مراکز شامل : تعمیر اسپکتروفتومتر ، تعمیر میکروسکوپ ، تعمیر تانک ازت ، Ph متر و… توسط مهندسین و کارشناسان مجرب شرکت ای لب مارکت انجام می پذیرد - Elabmarket . فروش . کیت . و . تجهیزات . آزمایشگاهی . دست . دوم . آزمایشگاه . آزما . تجه . - ارسال تجهیزات آزمایشگاهی و کیت و لوازم مصرفی آزمایشگاه در تهران و سراسر ایران - Elabmarket . فروش . کیت . و . تجهیزات . آزمایشگاهی . دست . دوم . آزمایشگاه . آزما . تجه . - از انجا که ای لب مارکتنماینده برترین کمپانی های لوازم، کیت و تجهیزات آزمایشگاهی می باشدمانند پارس آزمون ، پیشتازطب ، بایرکس فارس ، وایداس ، اکبریه در زمینه کیت a1c ، ویتامین dو لوله وسایر تجهیزات آزمایشگاهی شما همکاران و مشتریان گرامی از تمامی نقاط ایران میتوانید بعد از خرید کالا آن را توسط (پست ، آژانس ، تیپاکس ، پیک و…) به راحتی دریافت نمایید - مشاوره خرید تجهیزات آزمایشگاهی - با ارائه مشاوره دقیق فنی، اطلاع رسانی جامع، مطلوب و با اتکاء به سال ها تجربه کاری و بهره گیری از کارشناسان متخصص در بخش فروش تجهیزات آزمایشگاهی شرکت ای لب مارکت شما را در انتخاب مناسب ترین و با کیفیت ترین تجهیزات آزمایشگاهی ، کیت از برترین کمپانی هایی فعال در ایران ، همراهی می نماید - تجهیزات آزمایشگاهی - مرجع تجهیزات آزمایشگاهی و دستگاه ها شامل اسپکتروفتومتر ، آب مقطرگیری ، PH متر ، TDS متر ، EC متر ، پلاریمتر ، پمپ خلا ، پیپت و پیپت پرکن ، تانک ازت ، ترازوی آزمایشگاهی ، چینی آلات ، دماسنج و چگالی سنج ، رفراکتومتر ، سانتریفیوژ ، شیشه آلات ، کاغذ صافی ، لام و لامل ، میکروسکوپ ، هات پلیت، اتوآنالایزر بیوشیمی ،سل کانتر،هود آزمایشگاهی ،آون،کیت آزمایشگاهی و … - وارد کننده و مرجع اصلی انواع میکروسکوپ های آزمایشگاهی - وارد کننده و مرجع اصلی انواع میکروسکوپ های آزمایشگاهی - میکروسکوپ - مجموعه ای لب مارکت مرجع انواع میکروسکوپ از کمپانی های معروف Nikon , Ziess , Olympus - -این میکروسکوپ ها شامل : انواع میکروسکوپ بیولوژی ، میکروسکوپ دانش آموزی ، میکروسکوپ متالوژی ، میکروسکوپ پلاریزان ، میکروسکوپ اینورت ، استریو میکروسکوپ ، میکروسکوپ یک چشمی ، میکروسکوپ دو چشمی ، میکروسکوپ سه چشمی ، میکروسکوپ استاد و دانشجو پنج و سه نفره ، میکروسکوپ اندازه گیری با نرم افزار سه بعدی میکروسکوپ چینی و نور عبوری انعکاسی از کمپانی های معروف نیکون ژاپن و الیمپوس ژاپن - انواع میکروسکوپ ها معمولا با یک سال گارانتی و ده سال خدمات پس از فروش ارائه می‌گردد- تعمیر و سرویس انواع میکروسکوپ ، آموزش کار با میکروسکوپ و راه‌اندازی میکروسکوپ توسط کارشناسان فنی مجرب درتمام نقاط ایران انجام می‌پذیرد - فروش تجهیزات آزمایشگاهی - فروش تجهیزات آزمایشگاهی در فروشگاه اینترنتی ای لب مارکت به محققین و صنعتگران گرامی انجام می شود- در راستای تسهیل خدمات آزمایشگاهی و تعامل بیشتر با دانشجویان و صنعتگران این خدمت با کمترین حاشیه سود، انجام می شود و در کمترین زمان ممکن به سراسر کشور ارسال می شود- هدف این مجموعه فراهم نمودن دسترسی سریع، آسان و ارزان به خدمات و تجهیزات آزمایشگاهی پیشرفته و استفاده از مشاوره‌های تخصصی در جهت ارتقاء کیفیت تحقیقات صنعتی، دانشگاهی و پژوهشی می‌باشد- - تجهیزات آزمایشگاهی ارایه شده در این فروشگاه با تخفیف های نزدیک به نمایشگاه ساخت ایران عرضه می شود و در بعضی از موارد قیمت ها از قیمت های عاملین فروش تخصصی نیز پایین تر است- همچنین کلیه گارانتی های شرکت های سازنده نیز همراه با تجهیزات ارایه خواهد شد- یکی دیگر از خدمات ارایه شده در زمینه تجهیزات، ارایه پیش فاکتور تجهیزات خارجی و همچنین خرید و تحویل دستگاه به مشتریان به صورت آنلاین می باشد- - فروشگاه اینترنتی ای لب مارکت اقدام به فروش انواع تجهیرات آزمایشگاهی عمومی مانند انواع کوره های حرارتی، آون، هیتر و … و همچنین تجهیزات تخصصی مانند اسپکتوفوتومتر، تجهیزات و پمپ خلا، اسپاترینگ، الکتروریسی و … کرده است - هدف این مجموعه فراهم نمودن دسترسی سریع، آسان و ارزان به تجهیزات آزمایشگاهی با تخفیفات نمایشگاه ساخت ایران برای مجموعه ها و متخصصانی که به هر طریق موفق به حضور و استفاده از خدمات این نمایشگاه نشده اند- - راه‌اندازی یک وب سایت با امکانات فنی و کاربر پسند برای سهولت استفاده توسط مشتریان، سیستم هوشمند پیگیری سفارشات، ارسال سریع محصولات درخواستی به سراسر کشور، انجام سریع خدمات آزمایشگاهی همراه با تجزیه و تحلیل نتایج و سایر خدمات، نشان دهنده رویکرد جدید این مجموعه در ارائه خدمات نوین پژوهشی می‌باشد- - تجهیزات آزمایشگاهی دست دوم - تجهیزات آزمایشگاهی دست دوم این امکان را برای راه اندازی ارزان قیمت آزمایشگاهها در اختیار جامعه آزمایشگاهی قرار می دهد -تجهیزات دست دوم مازاد آزمایشگاهها مانند اتوآنالایزر، سانتریفیوژ، سل کانتر ، هود، آون و--- می تواند مورد استفاده مرکز دیگر قرار گیرد- - استخدام آزمایشگاه - این امکان رو فراهم می آورد که کارشناسان علوم آزمایشگاهی، میکروبیولوژی ، ژنتیک و سایر رشته های مرتبط با آزمایشگاه امکان معرفی خود جهت بدست آوردن شغل مناسب در آزمایشگاه را داشته باشند- - اخبار آزمایشگاه - امکان بررسی سریع اخبار حوزه -
تعمیر و تجهیز تجهیزات آزمایشگاهی : . Elabmarket . فروش . کیت . و . تجهیزات . آزمایشگاهی . دست . دوم . آزمایشگاه . آزما . تجه . .
نصب و راه اندازی، کالیبراسیون، سرویس، تعمیر تجهیـزات آزمایشگاهی ، تعمیر دستگاه آزمایشگاهی مورد نیاز مراکز شامل : تعمیر اسپکتروفتومتر ، تعمیر میکروسکوپ ، تعمیر تانک ازت ، Ph متر و… توسط مهندسین و کارشناسان مجرب شرکت ای لب مارکت انجام می پذیرد . Elabmarket . فروش . کیت . و . تجهیزات . آزمایشگاهی . دست . دوم . آزمایشگاه . آزما . تجه . .
ارسال تجهیزات آزمایشگاهی و کیت و لوازم مصرفی آزمایشگاه در تهران و سراسر ایران . Elabmarket . فروش . کیت . و . تجهیزات . آزمایشگاهی . دست . دوم . آزمایشگاه . آزما . تجه . .
از انجا که ای لب مارکتنماینده برترین کمپانی های لوازم، کیت و تجهیزات آزمایشگاهی می باشدمانند پارس آزمون ، پیشتازطب ، بایرکس فارس ، وایداس ، اکبریه در زمینه کیت a1c ، ویتامین dو لوله وسایر تجهیزات آزمایشگاهی شما همکاران و مشتریان گرامی از تمامی نقاط ایران میتوانید بعد از خرید کالا آن را توسط (پست ، آژانس ، تیپاکس ، پیک و…) به راحتی دریافت نمایید .
مشاوره خرید تجهیزات آزمایشگاهی .
با ارائه مشاوره دقیق فنی، اطلاع رسانی جامع، مطلوب و با اتکاء به سال ها تجربه کاری و بهره گیری از کارشناسان متخصص در بخش فروش تجهیزات آزمایشگاهی شرکت ای لب مارکت شما را در انتخاب مناسب ترین و با کیفیت ترین تجهیزات آزمایشگاهی ، کیت از برترین کمپانی هایی فعال در ایران ، همراهی می نماید .
تجهیزات آزمایشگاهی .
مرجع تجهیزات آزمایشگاهی و دستگاه ها شامل اسپکتروفتومتر ، آب مقطرگیری ، PH متر ، TDS متر ، EC متر ، پلاریمتر ، پمپ خلا ، پیپت و پیپت پرکن ، تانک ازت ، ترازوی آزمایشگاهی ، چینی آلات ، دماسنج و چگالی سنج ، رفراکتومتر ، سانتریفیوژ ، شیشه آلات ، کاغذ صافی ، لام و لامل ، میکروسکوپ ، هات پلیت، اتوآنالایزر بیوشیمی ،سل کانتر،هود آزمایشگاهی ،آون،کیت آزمایشگاهی و … .
وارد کننده و مرجع اصلی انواع میکروسکوپ های آزمایشگاهی .
وارد کننده و مرجع اصلی انواع میکروسکوپ های آزمایشگاهی .
میکروسکوپ .
مجموعه ای لب مارکت مرجع انواع میکروسکوپ از کمپانی های معروف Nikon , Ziess , Olympus .
.این میکروسکوپ ها شامل : انواع میکروسکوپ بیولوژی ، میکروسکوپ دانش آموزی ، میکروسکوپ متالوژی ، میکروسکوپ پلاریزان ، میکروسکوپ اینورت ، استریو میکروسکوپ ، میکروسکوپ یک چشمی ، میکروسکوپ دو چشمی ، میکروسکوپ سه چشمی ، میکروسکوپ استاد و دانشجو پنج و سه نفره ، میکروسکوپ اندازه گیری با نرم افزار سه بعدی میکروسکوپ چینی و نور عبوری انعکاسی از کمپانی های معروف نیکون ژاپن و الیمپوس ژاپن .
انواع میکروسکوپ ها معمولا با یک سال گارانتی و ده سال خدمات پس از فروش ارائه می‌گردد. تعمیر و سرویس انواع میکروسکوپ ، آموزش کار با میکروسکوپ و راه‌اندازی میکروسکوپ توسط کارشناسان فنی مجرب درتمام نقاط ایران انجام می‌پذیرد .
فروش تجهیزات آزمایشگاهی .
فروش تجهیزات آزمایشگاهی در فروشگاه اینترنتی ای لب مارکت به محققین و صنعتگران گرامی انجام می شود. در راستای تسهیل خدمات آزمایشگاهی و تعامل بیشتر با دانشجویان و صنعتگران این خدمت با کمترین حاشیه سود، انجام می شود و در کمترین زمان ممکن به سراسر کشور ارسال می شود. هدف این مجموعه فراهم نمودن دسترسی سریع، آسان و ارزان به خدمات و تجهیزات آزمایشگاهی پیشرفته و استفاده از مشاوره‌های تخصصی در جهت ارتقاء کیفیت تحقیقات صنعتی، دانشگاهی و پژوهشی می‌باشد. .
تجهیزات آزمایشگاهی ارایه شده در این فروشگاه با تخفیف های نزدیک به نمایشگاه ساخت ایران عرضه می شود و در بعضی از موارد قیمت ها از قیمت های عاملین فروش تخصصی نیز پایین تر است. همچنین کلیه گارانتی های شرکت های سازنده نیز همراه با تجهیزات ارایه خواهد شد. یکی دیگر از خدمات ارایه شده در زمینه تجهیزات، ارایه پیش فاکتور تجهیزات خارجی و همچنین خرید و تحویل دستگاه به مشتریان به صورت آنلاین می باشد. .
فروشگاه اینترنتی ای لب مارکت اقدام به فروش انواع تجهیرات آزمایشگاهی عمومی مانند انواع کوره های حرارتی، آون، هیتر و … و همچنین تجهیزات تخصصی مانند اسپکتوفوتومتر، تجهیزات و پمپ خلا، اسپاترینگ، الکتروریسی و … کرده است . هدف این مجموعه فراهم نمودن دسترسی سریع، آسان و ارزان به تجهیزات آزمایشگاهی با تخفیفات نمایشگاه ساخت ایران برای مجموعه ها و متخصصانی که به هر طریق موفق به حضور و استفاده از خدمات این نمایشگاه نشده اند. .
راه‌اندازی یک وب سایت با امکانات فنی و کاربر پسند برای سهولت استفاده توسط مشتریان، سیستم هوشمند پیگیری سفارشات، ارسال سریع محصولات درخواستی به سراسر کشور، انجام سریع خدمات آزمایشگاهی همراه با تجزیه و تحلیل نتایج و سایر خدمات، نشان دهنده رویکرد جدید این مجموعه در ارائه خدمات نوین پژوهشی می‌باشد. .
تجهیزات آزمایشگاهی دست دوم .
تجهیزات آزمایشگاهی دست دوم این امکان را برای راه اندازی ارزان قیمت آزمایشگاهها در اختیار جامعه آزمایشگاهی قرار می دهد .تجهیزات دست دوم مازاد آزمایشگاهها مانند اتوآنالایزر، سانتریفیوژ، سل کانتر ، هود، آون و... می تواند مورد استفاده مرکز دیگر قرار گیرد. .
استخدام آزمایشگاه .
این امکان رو فراهم می آورد که کارشناسان علوم آزمایشگاهی، میکروبیولوژی ، ژنتیک و سایر رشته های مرتبط با آزمایشگاه امکان معرفی خود جهت بدست آوردن شغل مناسب در آزمایشگاه را داشته باشند. .
اخبار آزمایشگاه .
امکان بررسی سریع اخبار حوزه .
فروش تجهیزات آزمایشگاهی در Elabmarket و همچنین و جود مرجع کامل دست دوم . Elabmarket در تلاش است که برای شما بازار بزرگی از تسجهیزات دست دوم برای شما فراهم کند . همچنین Elabmarket در تلاش است که کیت آزمایشگاه به فروش رساند . با ما در تماس باشید . همچنین ELabmarket Elabmarket فروش کیت و تجهیزات آزمایشگاهی و دست دوم آزمایشگاه مقالات . شما در Elabmarket فروش کیت و تجهیزات آزمایشگاهی و دست دوم آزمایشگاه . ما همچنین به Elabmarket . فروش . کیت . و . تجهیزات . آزمایشگاهی . دست . دوم . آزمایشگاه . آزما . تجه . .
