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

ژن درمانی شامل وارد کردن یک ژن به داخل یک سلول با هدف رسیدن به نوعی اثر درمانی است با انتقال نسخههای واجد عملکرد ژن مربوط به بیمار اصلح خصوصیات برگشت پذیر فنوتیپ جهش یافته امکان پذیر میشود.

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.

شناخته شده به عنوان : گاما گلوتامیل ترانسپپتیداز GGTP گاما GT GTP نام رسمی : گاما گلوتامیل انتقالی چرا آزمایش می شود؟ برای ارزیابی بیماری احتمالی کبد یا بیماری مجاری صفراوی یا برای تشخیص بیماری کبد و بیماری استخوانی به عنوان علت افزایش قلیایی فسفاتاز (ALP) ؛ گاهی اوقات برای سوءاستفاده از الکل و یا نظارت بر آن استفاده شود

پلاکت ¬ها دیسک هایی با قطر میکرون و حجم آنها fI 7-5 در خون EDTA می¬ باشند. عملکرد پلاکت¬ ها؛ هموستاز، نگهداری مقاومت عروق و انعقاد خون است.

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.

آزمایش کالپروتکتین جهت تشخیص بیماران مبتلا به بیماری کرون، کولیت اولسراتیو و سرطان های کلورکتال کالپروتکتین پروتئینی آنتی باکتریال با قابلیت اتصال به کلسیم و روی است و به دنبال فعال شدن نوتروفیل ها یا اتصال مونوسیت ها به آندوتلیال، کالپروتکتین موجود در غشا این سلول ها آزاد شده و میزان آن در سرم یا مایعات بدن افزایش می یابد.همچنین کالپروتکتین در اثر تخریب و یا مرگ سلولی آزاد می شود و در واقع با اثر باکتریواستاتیک وآپوپتوتیک یک شاخص مهم التهابی محسوب میشود.

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.

وسترن بلاتینگ یکی از روشهای بلاتینگ است که برای تشخیص و آنالیز پروتئین‌ها استفاده می‌شود. این روش یک آزمایش تأییدکننده است و وجود نوعی پادتن (ایمونوگلوبولین نوع جی) علیه چند نوع پروتئین ویروسی را بررسی می‌کند.

فاکتور۵ لیدن در اثر جهش یکی از فاکتورهای انعقادی خونی به نام فاکتور۵ ایجاد می گردد. این جهش می‌تواند سبب افزایش احتمال تشکیل لخته­‌های خونی به خصوص در وریدها گردد. اغلب افراد مبتلا به فاکتور لیدن۵ هیچ گاه دچار لخته‎های غیرطبیعی نمی‌شوند. اما برخی از بیماران دچار لخته‌هایی می‌شوند که منجر به مشکلات طولانی مدت یا مرگبار می‌گردد فاکتور لیدن۵ می تواند در هر دو جنس رخ دهد. احتمال ایجاد لخته در زنان در دوران حاملگی و استفاده از استروژن بیشتر است

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

اولین قدم بعد از انتخاب کنترل مناسب در اجرای فرآیند کنترل داخلی کیفیت در بخش آنالیتیک تعیین خطای مجاز است. علی رغم تلاش های همه جانبه آزمایشگاه ها حتی در بهترین شرایطدارای میزان اجتناب ناپذیری از خطا هستند پس مسئول آزمایشگاه می بایست با در نظر گرفتن شرایط آزمایشگاه میزان عدم دقت و عدم صحت و یا مجموع خطای کلی را محاسبه کند.

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.

آمیلاز (دیاستاز) یا 1 و 2- α- D- گلوکانوهیدرولاز (EC 3.2.1.1 ) که از جمله آنزیم‌های هیدولاز محسوب می‌شود، پیوندهای آلفا 1و4 پلی‌ساکاریدهایی مانند گلیکوژن و نشاسته را می‌شکند و آن را به مالتوز تبدیل می‌کند. آمیلاز در پانکراس برون‌ریز و غده‌های پاروتید ساخته می‌شود.

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.

آزمایش CBC یا شمارش کامل سلول های خونی، یک آزمایش بسیار کاربردی و رایج است که اطلاعات مهمی را به پزشک می دهد. در این مطلب قصد داریم ضمن مشخص نمودن رنج نرمال هر یک از سلول های خونی، به تفسیر آزمایش نیز بپردازیم. البته ذکر این نکته ضروری است که تفسیر جواب آزمایش حتما بایستی توسط پزشک معالج انجام شود زیرا هدف پزشک برای انجام آزمایش، طیف بسیار گسترده ای است و با توجه به شرایط بیمار را درخواست می شود و ذکر تمامی تفاسیر در اینجا نمی گنجد و در این مطلب فقط کلیات و تفاسیر اولیه و کلی را بیان می کنیم.

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.

اولین کسی که به عدم وجود غده تیموس پی برد شخصی بود به نام هارینگتون که در سال 1929 به این کشف نائل شد. در سال 1959 شخصی به نام لوبدل توانست به مشاهده همزمان هیپوپاراتیروئیدیسم مادرزادی و غیاب غده تیموس پرداخته و به تحلیل آن بپردازد. آنجلودی‌جرج نخستین فردی است که به بررسی روابط ایمونولوژیکی به همراه علائم هیپوپاراتیروئیدیسم مادرزادی و فقدان تیموس پرداخت. اولین شخصی که به وجود مونوزومی کروموزوم 22 و رابطه آن با اختلال دی جرج پی برد کلی نام داشت که ساکن فیلادلفیا بود و توانست منشا ژنتیکی برای این سندرم پیدا کند.

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.

نوع نمونه قابل اندازه‌گیری: برای فاکتورهای ۲، ۵، ۸، ۹، ۱۱، ۱۲ از پلاسمای سیتراته استفاده می‌شود که اگر فورا روی یخ قرار داده شود برای ۲ ساعت پایدار است و برای زمان بیشتر از ۲ ساعت باید آن را در فریز قرار داد. در مورد فاکتورهای ۷ و ۱۰ باید فورا آزمایش را انجام داد چرا که در 4 درجه به‌طور قابل توجهی ممکن است فعال شوند.