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Objectives: The diagnosis of Whipple's disease (WD) is commonly confirmed by histology demonstrating Periodic Acid Schiff (PAS)-positive macrophages in the duodenal mucosa. Analysis of intestinal tissue or other specimens using polymerase chain reaction (PCR) is a more sensitive method. However, the relevance of positive PCR findings is still controversial. Therefore, we evaluated the relevance of histology and PCR findings to establishing the diagnosis of WD in a series of WD patients initially presenting with suspected rheumatic diseases.Method: Between 2006 and 2014, 20 patients with seronegative rheumatic diseases tested positive for Tropheryma whipplei (Tw) by PCR and/or histology and were enrolled in a retrospective analysis of the diagnostic value of both procedures.Results: Seven of the 20 cases (35%) were diagnosed with 'classic' WD as indicated by PAS-positive macrophages. In the remaining 13 patients, the presence of Tw was detected by intestinal (n = 10) or synovial PCR analysis (n = 3). Two of the 20 patients (10%) with evidence of Tw did not respond to antibiotic therapy. They were not considered to suffer from WD. Therefore, relying only on histological findings of intestinal biopsies would have missed 11 (61%) of the 18 patients with WD in our cohort. In comparison, PCR of intestinal biopsies detected Tw-DNA in 14 (93%) of the 15 WD patients evaluated. Patients with a positive histology did not differ from PCR-positive patients with regard to sex, age, or duration of disease, but more often presented with gastrointestinal symptoms.Conclusions: A substantial number of WD patients present without typical intestinal histology findings. Additional PCR analysis of intestinal tissue or synovial fluid increased the sensitivity of the diagnostic evaluation and should be considered particularly in patients presenting with atypical seronegative rheumatic diseases and a high-risk profile for WD. [ABSTRACT FROM AUTHOR]

International collaboration in teaching and research has expanded as a result of the widespread accessibility and use of the World Wide Web. While on-line education has experienced the greatest growth, the use of remote laboratories in research and teaching is relatively new. The development of a remote ergonomics laboratory using a new Internet technology is described. The purpose of the remote laboratory is to provide international access to an advanced thermal manikin technology which provides a platform for measuring the thermodynamic properties of protective clothing during exposure to controlled environmental conditions. To date, the laboratory has generated global interest and promoted international collaboration in ergonomics teaching and research. [ABSTRACT FROM AUTHOR]

We present the case of an otherwise healthy female hairdresser of Brazilian origin who started to have pain and swelling in her left arm. An antecubital abscess was surgically treated at another institution and there was good initial wound healing. Swelling then recurred and fistulae appeared in the scar. Our diagnostic workup revealed an isolated intramuscular tuberculous abscess, which was successfully treated by an antituberculous drug regimen. [ABSTRACT FROM AUTHOR]

We describe a sensitive and reliable method for detection and differentiation of the five relevant EuropeanBorrelia burgdorferisensu lato species (B. burgdorferisensu stricto,B. afzelii,B. garinii,B. valaisiana,andB. lusitaniae), based on a heminestedospA-PCR followed by restriction enzyme analysis. Sensitivity was one borrelia per PCR except forB. afzelii,where it was five per PCR. None of seven relapsing fever borreliae, eightLeptospiraserovars or twoTreponemaspecies were amplified. ExceptB. garinii, each of the fiveB. burgdorferis.l. species is represented by one or two characteristic restriction fragment length polymorphism (RFLP) patterns. Analysis of the heterogeneous group ofB. gariniiresulted in five different RFLP patterns, corresponding to the OspA types 3-7 associated with this species. In a pilot study on 529Ixodes ricinusticks from three different regions in Southern Germany, all species and OspA types were found exceptB. lusitaniaeandB. gariniiOspA type 7, arguing for a broad distribution of almost all OspA types. A further notable finding was the focal prevalence of OspA type 4, which has rarely been detected in ticks previously. Thus, the developed method provides a fast and simple tool for epidemiological studies on the heterogeneity of species and OspA types in Europe which has important implications for the development of vaccines and (microbiological) test systems for Europe. [ABSTRACT FROM AUTHOR]

One hundred and three patients who had previously tested positive for community-acquired methicillin-resistant Staphylococcus aureus (cMRSA) were followed up for a mean time of 32.6 months. Eighty patients had a history of skin or soft tissue infection, and the remainder were mostly asymptomatic carriers. Of 103 patients, only two reported ongoing symptoms with abscess formation. Of 81 nasal swabs available, 30.9% were positive for S. aureus but only four yielded Panton-Valentine leukocidin- positive methicillin-resistant S. aureus. In summary, we were unable to find persistent health issues or nasal colonization with cMRSA in a cohort of previously cMRSA-infected/colonized patients. [ABSTRACT FROM AUTHOR]

The article presents a case study of a juvenile dwarf rabbit or Oryctolagus cuniculus that has signs of dyspnea and suspected ascites which was subjected for necropsy. The findings show a watery red pleural effusion, whitish striated foci on the lungs and multifocal scars found in the cortex of kidneys. The histologic examination manifests interstitial chronic lymphoplasmacellular nephritis in the kidneys, Mycobacterium genavense in the lungs and a multifocal granulomatous in the brain.

Abstract: Background: HIV-1 viral load assays are critical tools to monitor antiretroviral therapy efficacy in HIV-infected patients. Two assays based on real-time PCR are available, the Abbott Real-Time HIV-1 assay (Abbott assay) and the new Roche COBAS® AmpliPrep/COBAS® TaqMan® HIV-1 test, v. 2.0 (TaqMan® test v2.0). Objectives: We have compared the performance of the two assays in 546 clinical plasma specimens of group M strains from Luxembourg and Rwanda. Study design: Our analyses focused on subtype inclusivity and platforms accuracy for 328 low level viremia samples. Results: Strong agreement and linear correlation were observed between the two assays (R 2 =0.95) over a wide dynamic range. Bland–Altman analysis showed a mean difference of 0.04log10 indicating minimal overall viral load quantification differences between both platforms. One subtype C was severely underquantified by TaqMan® test v2.0 for which sequence analysis revealed multiple mismatches between the viral sequence and the primer/probe regions. A non significant lower quantification of the Abbott assay was shown for subtype A1 with a mean log10 difference of 0.24. For specimens under 200cp/mL, the overall agreement was 90% at the cut-off of 50cp/mL and 67% at assay''s lower limit of detection of 20 and 40cp/mL. 309 samples were retested by the COBAS® AMPLICOR® HIV-1 MONITOR Test, v. 1.5 and a lack of agreement between the three assays around their lower limit of quantification was revealed. Conclusions: Both real-time tests were closely comparable in the quantification of viral load specimens of ten HIV-1 subtypes and recombinant forms. [Copyright &y& Elsevier]

Background: Quality control (QC), quality assurance, and standardization are crucial for modern diagnostic testing in the field of medical microbiology. The need for efficient QC to ensure accurate laboratory results, treatment, and infection prevention has led to significant efforts in standardizing assay reagents and workflows. External quality assessment (EQA) schemes, like those offered by INSTAND, play a vital role in evaluating in-house and commercial routine diagnostic assays, regarded as mandatory by national and global guidelines. The recent impact of polymerase chain reaction/nucleic acid amplification technology (PCR/NAAT) assays in medical microbiology requires that high-performing assays be distinguished from inadequately performing ones, especially those made by inexperienced suppliers., Objectives: The study assesses the evolving diagnostic performance trends over 2 decades for the detection of EHEC/STEC, Borrelia ( B.) burgdorferi , and MRSA/cMRSA. It explores the historical context of assay utilization, participant engagement, and rates of correct results in EQA schemes. The research seeks to identify patterns in assay preferences, participant proficiency, and the challenges encountered in detecting emerging variants or clinical strains., Results: The study highlights the decline in in-house PCR assay usage, the emergence of new diagnostic challenges, and educational aspects within EQA schemes. Specific examples, such as the inclusion, in certain EQA surveys, of EHEC strains carrying stx -2f or B. miyamotoi , highlight the role of EQAs in increasing awareness and diagnostic capabilities. Advancements in MRSA detection, especially through the adoption of commercial assays, demonstrate the impact that technology evolution has had on diagnostic performance., Conclusion: Achieving excellence in diagnostic molecular microbiology involves a multifaceted approach, including well-evaluated assays, careful instrumentation selection, and structured training programs. EQA schemes contribute significantly to this pursuit by providing insights into the evolving diagnostic landscape and identifying areas for improvement in the diagnostic workflow as well as in PCR/NAAT assay design., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Kremser, Weiss, Kaufmann-Stoeck, Vierbaum, Kappler, Schellenberg, Hiergeist, Fingerle, Baier and Reischl.)

With the emergence of enormous amounts of data, numerous ways to visualize such data have been used. Bar, circular, line, radar and bubble graphs that are ubiquitous were investigated for their effectiveness. Fourteen participants performed four types of evaluations: between categories (cities), within categories (transport modes within a city), all categories, and a direct reading within a category from a graph. The representations were presented in random order and participants were asked to respond to sixteen questions to the best of their ability after visually scanning the related graph. There were two trials on two separate days for each participant. Eye movements were recorded using an eye tracker. Bar and line graphs show superiority over circular and radial graphs in effectiveness, efficiency, and perceived ease of use primarily due to eye saccades. The radar graph had the worst performance. "Vibration-type" fill pattern could be improved by adding colors and symbolic fills. Design guidelines are proposed for the effective representation of data so that the presentation and communication of information are effective., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Between April and June 2020, i.e., during the first wave of pandemic coronavirus disease 2019 (COVID-19), 55 patients underwent long-term treatment in the intensive care unit at the University Hospital of Regensburg. Most of them were transferred from smaller hospitals, often due to the need for an extracorporeal membrane oxygenation system. Autopsy was performed in 8/17 COVID-19-proven patients after long-term treatment (mean: 33.6 days). Autopsy revealed that the typical pathological changes occurring during the early stages of the disease (e.g., thrombosis, endothelitis, capillaritis) are less prevalent at this stage, while severe diffuse alveolar damage and especially coinfection with different fungal species were the most conspicuous finding. In addition, signs of macrophage activation syndrome was detected in 7 of 8 patients. Thus, fungal infections were a leading cause of death in our cohort of severely ill patients and may alter clinical management of patients, particularly in long-term periods of treatment., (© 2021. The Author(s).)

We examined fecal specimens of patients with diarrhea from 3 continents for Tropheryma whipplei and enteropathogens. T. whipplei was most common in South Africa, followed by Singapore and Germany. Its presence was associated with the presence of other pathogens. An independent causative role in diarrhea appears unlikely.